hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|WA,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Astria Toppenish Hospital,12/4/2024,2.0.0,Astria Toppenish Hospital,502 W 4th AVE Toppenish WA 98948-1616,814670687,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,code|3,code|3|type,setting,drug_unit_of_measurement,drug_type_of_measurement,standard_charge|gross,standard_charge|discounted_cash,modifiers,standard_charge|AETNA|COMMERCIAL|negotiated_dollar,standard_charge|AETNA|COMMERCIAL|negotiated_percentage,standard_charge|AETNA|COMMERCIAL|negotiated_algorithm,estimated_amount|AETNA|COMMERCIAL,standard_charge|AETNA|COMMERCIAL|methodology,additional_payer_notes|AETNA|COMMERCIAL,standard_charge|AETNA_MEDICARE|MEDICARE|negotiated_dollar,standard_charge|AETNA_MEDICARE|MEDICARE|negotiated_percentage,standard_charge|AETNA_MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|AETNA_MEDICARE|MEDICARE,standard_charge|AETNA_MEDICARE|MEDICARE|methodology,additional_payer_notes|AETNA_MEDICARE|MEDICARE,standard_charge|AMERIGROUP|MEDICAID|negotiated_dollar,standard_charge|AMERIGROUP|MEDICAID|negotiated_percentage,standard_charge|AMERIGROUP|MEDICAID|negotiated_algorithm,estimated_amount|AMERIGROUP|MEDICAID,standard_charge|AMERIGROUP|MEDICAID|methodology,additional_payer_notes|AMERIGROUP|MEDICAID,standard_charge|BCCHP|COMMERCIAL|negotiated_dollar,standard_charge|BCCHP|COMMERCIAL|negotiated_percentage,standard_charge|BCCHP|COMMERCIAL|negotiated_algorithm,estimated_amount|BCCHP|COMMERCIAL,standard_charge|BCCHP|COMMERCIAL|methodology,additional_payer_notes|BCCHP|COMMERCIAL,standard_charge|CHPW_MEDICAID|MEDICAID|negotiated_dollar,standard_charge|CHPW_MEDICAID|MEDICAID|negotiated_percentage,standard_charge|CHPW_MEDICAID|MEDICAID|negotiated_algorithm,estimated_amount|CHPW_MEDICAID|MEDICAID,standard_charge|CHPW_MEDICAID|MEDICAID|methodology,additional_payer_notes|CHPW_MEDICAID|MEDICAID,standard_charge|CHPW_MEDICARE|MEDICARE|negotiated_dollar,standard_charge|CHPW_MEDICARE|MEDICARE|negotiated_percentage,standard_charge|CHPW_MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|CHPW_MEDICARE|MEDICARE,standard_charge|CHPW_MEDICARE|MEDICARE|methodology,additional_payer_notes|CHPW_MEDICARE|MEDICARE,standard_charge|CIGNA|COMMERCIAL|negotiated_dollar,standard_charge|CIGNA|COMMERCIAL|negotiated_percentage,standard_charge|CIGNA|COMMERCIAL|negotiated_algorithm,estimated_amount|CIGNA|COMMERCIAL,standard_charge|CIGNA|COMMERCIAL|methodology,additional_payer_notes|CIGNA|COMMERCIAL,standard_charge|CHPW_CASCADE_CARE|MEDICARE|negotiated_dollar,standard_charge|CHPW_CASCADE_CARE|MEDICARE|negotiated_percentage,standard_charge|CHPW_CASCADE_CARE|MEDICARE|negotiated_algorithm,estimated_amount|CHPW_CASCADE_CARE|MEDICARE,standard_charge|CHPW_CASCADE_CARE|MEDICARE|methodology,additional_payer_notes|CHPW_CASCADE_CARE|MEDICARE,standard_charge|COORDINATED_CARE_MEDICAID|MEDICAID|negotiated_dollar,standard_charge|COORDINATED_CARE_MEDICAID|MEDICAID|negotiated_percentage,standard_charge|COORDINATED_CARE_MEDICAID|MEDICAID|negotiated_algorithm,estimated_amount|COORDINATED_CARE_MEDICAID|MEDICAID,standard_charge|COORDINATED_CARE_MEDICAID|MEDICAID|methodology,additional_payer_notes|COORDINATED_CARE_MEDICAID|MEDICAID,standard_charge|COORDINATED_CARE_AMBETTER_EXCHANGE|MEDICARE|negotiated_dollar,standard_charge|COORDINATED_CARE_AMBETTER_EXCHANGE|MEDICARE|negotiated_percentage,standard_charge|COORDINATED_CARE_AMBETTER_EXCHANGE|MEDICARE|negotiated_algorithm,estimated_amount|COORDINATED_CARE_AMBETTER_EXCHANGE|MEDICARE,standard_charge|COORDINATED_CARE_AMBETTER_EXCHANGE|MEDICARE|methodology,additional_payer_notes|COORDINATED_CARE_AMBETTER_EXCHANGE|MEDICARE,standard_charge|FIRST_CHOICE_NETWORK|COMMERCIAL|negotiated_dollar,standard_charge|FIRST_CHOICE_NETWORK|COMMERCIAL|negotiated_percentage,standard_charge|FIRST_CHOICE_NETWORK|COMMERCIAL|negotiated_algorithm,estimated_amount|FIRST_CHOICE_NETWORK|COMMERCIAL,standard_charge|FIRST_CHOICE_NETWORK|COMMERCIAL|methodology,additional_payer_notes|FIRST_CHOICE_NETWORK|COMMERCIAL,standard_charge|GREAT_RIVERS|COMMERCIAL|negotiated_dollar,standard_charge|GREAT_RIVERS|COMMERCIAL|negotiated_percentage,standard_charge|GREAT_RIVERS|COMMERCIAL|negotiated_algorithm,estimated_amount|GREAT_RIVERS|COMMERCIAL,standard_charge|GREAT_RIVERS|COMMERCIAL|methodology,additional_payer_notes|GREAT_RIVERS|COMMERCIAL,standard_charge|HEALTH_ALLIANCE_MEDICARE|MEDICARE|negotiated_dollar,standard_charge|HEALTH_ALLIANCE_MEDICARE|MEDICARE|negotiated_percentage,standard_charge|HEALTH_ALLIANCE_MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|HEALTH_ALLIANCE_MEDICARE|MEDICARE,standard_charge|HEALTH_ALLIANCE_MEDICARE|MEDICARE|methodology,additional_payer_notes|HEALTH_ALLIANCE_MEDICARE|MEDICARE,standard_charge|HEALTHCOMP|COMMERCIAL|negotiated_dollar,standard_charge|HEALTHCOMP|COMMERCIAL|negotiated_percentage,standard_charge|HEALTHCOMP|COMMERCIAL|negotiated_algorithm,estimated_amount|HEALTHCOMP|COMMERCIAL,standard_charge|HEALTHCOMP|COMMERCIAL|methodology,additional_payer_notes|HEALTHCOMP|COMMERCIAL,standard_charge|HMA_IHS_MEDICARE|MEDICARE|negotiated_dollar,standard_charge|HMA_IHS_MEDICARE|MEDICARE|negotiated_percentage,standard_charge|HMA_IHS_MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|HMA_IHS_MEDICARE|MEDICARE,standard_charge|HMA_IHS_MEDICARE|MEDICARE|methodology,additional_payer_notes|HMA_IHS_MEDICARE|MEDICARE,standard_charge|HUMANA|COMMERCIAL|negotiated_dollar,standard_charge|HUMANA|COMMERCIAL|negotiated_percentage,standard_charge|HUMANA|COMMERCIAL|negotiated_algorithm,estimated_amount|HUMANA|COMMERCIAL,standard_charge|HUMANA|COMMERCIAL|methodology,additional_payer_notes|HUMANA|COMMERCIAL,standard_charge|HUMANA_MEDICARE|MEDICARE|negotiated_dollar,standard_charge|HUMANA_MEDICARE|MEDICARE|negotiated_percentage,standard_charge|HUMANA_MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|HUMANA_MEDICARE|MEDICARE,standard_charge|HUMANA_MEDICARE|MEDICARE|methodology,additional_payer_notes|HUMANA_MEDICARE|MEDICARE,standard_charge|KAISER|COMMERCIAL|negotiated_dollar,standard_charge|KAISER|COMMERCIAL|negotiated_percentage,standard_charge|KAISER|COMMERCIAL|negotiated_algorithm,estimated_amount|KAISER|COMMERCIAL,standard_charge|KAISER|COMMERCIAL|methodology,additional_payer_notes|KAISER|COMMERCIAL,standard_charge|KAISER_MEDICAID|MEDICAID|negotiated_dollar,standard_charge|KAISER_MEDICAID|MEDICAID|negotiated_percentage,standard_charge|KAISER_MEDICAID|MEDICAID|negotiated_algorithm,estimated_amount|KAISER_MEDICAID|MEDICAID,standard_charge|KAISER_MEDICAID|MEDICAID|methodology,additional_payer_notes|KAISER_MEDICAID|MEDICAID,standard_charge|KAISER_MEDICARE|MEDICARE|negotiated_dollar,standard_charge|KAISER_MEDICARE|MEDICARE|negotiated_percentage,standard_charge|KAISER_MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|KAISER_MEDICARE|MEDICARE,standard_charge|KAISER_MEDICARE|MEDICARE|methodology,additional_payer_notes|KAISER_MEDICARE|MEDICARE,standard_charge|LI|COMMERCIAL|negotiated_dollar,standard_charge|LI|COMMERCIAL|negotiated_percentage,standard_charge|LI|COMMERCIAL|negotiated_algorithm,estimated_amount|LI|COMMERCIAL,standard_charge|LI|COMMERCIAL|methodology,additional_payer_notes|LI|COMMERCIAL,standard_charge|MEDICAID|MEDICAID|negotiated_dollar,standard_charge|MEDICAID|MEDICAID|negotiated_percentage,standard_charge|MEDICAID|MEDICAID|negotiated_algorithm,estimated_amount|MEDICAID|MEDICAID,standard_charge|MEDICAID|MEDICAID|methodology,additional_payer_notes|MEDICAID|MEDICAID,standard_charge|MEDICARE|MEDICARE|negotiated_dollar,standard_charge|MEDICARE|MEDICARE|negotiated_percentage,standard_charge|MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|MEDICARE|MEDICARE,standard_charge|MEDICARE|MEDICARE|methodology,additional_payer_notes|MEDICARE|MEDICARE,standard_charge|MEDICARE_ADVANTAGE|MEDICARE|negotiated_dollar,standard_charge|MEDICARE_ADVANTAGE|MEDICARE|negotiated_percentage,standard_charge|MEDICARE_ADVANTAGE|MEDICARE|negotiated_algorithm,estimated_amount|MEDICARE_ADVANTAGE|MEDICARE,standard_charge|MEDICARE_ADVANTAGE|MEDICARE|methodology,additional_payer_notes|MEDICARE_ADVANTAGE|MEDICARE,standard_charge|MOLINA|MEDICAID|negotiated_dollar,standard_charge|MOLINA|MEDICAID|negotiated_percentage,standard_charge|MOLINA|MEDICAID|negotiated_algorithm,estimated_amount|MOLINA|MEDICAID,standard_charge|MOLINA|MEDICAID|methodology,additional_payer_notes|MOLINA|MEDICAID,standard_charge|MOLINA_EXCHANGE|MEDICAID|negotiated_dollar,standard_charge|MOLINA_EXCHANGE|MEDICAID|negotiated_percentage,standard_charge|MOLINA_EXCHANGE|MEDICAID|negotiated_algorithm,estimated_amount|MOLINA_EXCHANGE|MEDICAID,standard_charge|MOLINA_EXCHANGE|MEDICAID|methodology,additional_payer_notes|MOLINA_EXCHANGE|MEDICAID,standard_charge|MOLINA_MEDICARE|MEDICARE|negotiated_dollar,standard_charge|MOLINA_MEDICARE|MEDICARE|negotiated_percentage,standard_charge|MOLINA_MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|MOLINA_MEDICARE|MEDICARE,standard_charge|MOLINA_MEDICARE|MEDICARE|methodology,additional_payer_notes|MOLINA_MEDICARE|MEDICARE,standard_charge|PREMERA|COMMERCIAL|negotiated_dollar,standard_charge|PREMERA|COMMERCIAL|negotiated_percentage,standard_charge|PREMERA|COMMERCIAL|negotiated_algorithm,estimated_amount|PREMERA|COMMERCIAL,standard_charge|PREMERA|COMMERCIAL|methodology,additional_payer_notes|PREMERA|COMMERCIAL,standard_charge|PREMERA_AFFORDABLE_CARE|COMMERCIAL|negotiated_dollar,standard_charge|PREMERA_AFFORDABLE_CARE|COMMERCIAL|negotiated_percentage,standard_charge|PREMERA_AFFORDABLE_CARE|COMMERCIAL|negotiated_algorithm,estimated_amount|PREMERA_AFFORDABLE_CARE|COMMERCIAL,standard_charge|PREMERA_AFFORDABLE_CARE|COMMERCIAL|methodology,additional_payer_notes|PREMERA_AFFORDABLE_CARE|COMMERCIAL,standard_charge|PREMERA_MEDICARE|MEDICARE|negotiated_dollar,standard_charge|PREMERA_MEDICARE|MEDICARE|negotiated_percentage,standard_charge|PREMERA_MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|PREMERA_MEDICARE|MEDICARE,standard_charge|PREMERA_MEDICARE|MEDICARE|methodology,additional_payer_notes|PREMERA_MEDICARE|MEDICARE,standard_charge|REGENCE|COMMERCIAL|negotiated_dollar,standard_charge|REGENCE|COMMERCIAL|negotiated_percentage,standard_charge|REGENCE|COMMERCIAL|negotiated_algorithm,estimated_amount|REGENCE|COMMERCIAL,standard_charge|REGENCE|COMMERCIAL|methodology,additional_payer_notes|REGENCE|COMMERCIAL,standard_charge|REGENCE_MEDICARE|MEDICARE|negotiated_dollar,standard_charge|REGENCE_MEDICARE|MEDICARE|negotiated_percentage,standard_charge|REGENCE_MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|REGENCE_MEDICARE|MEDICARE,standard_charge|REGENCE_MEDICARE|MEDICARE|methodology,additional_payer_notes|REGENCE_MEDICARE|MEDICARE,standard_charge|TPSC|COMMERCIAL|negotiated_dollar,standard_charge|TPSC|COMMERCIAL|negotiated_percentage,standard_charge|TPSC|COMMERCIAL|negotiated_algorithm,estimated_amount|TPSC|COMMERCIAL,standard_charge|TPSC|COMMERCIAL|methodology,additional_payer_notes|TPSC|COMMERCIAL,standard_charge|ZENITH|COMMERCIAL|negotiated_dollar,standard_charge|ZENITH|COMMERCIAL|negotiated_percentage,standard_charge|ZENITH|COMMERCIAL|negotiated_algorithm,estimated_amount|ZENITH|COMMERCIAL,standard_charge|ZENITH|COMMERCIAL|methodology,additional_payer_notes|ZENITH|COMMERCIAL,standard_charge|UMR|COMMERCIAL|negotiated_dollar,standard_charge|UMR|COMMERCIAL|negotiated_percentage,standard_charge|UMR|COMMERCIAL|negotiated_algorithm,estimated_amount|UMR|COMMERCIAL,standard_charge|UMR|COMMERCIAL|methodology,additional_payer_notes|UMR|COMMERCIAL,standard_charge|UHC|COMMERCIAL|negotiated_dollar,standard_charge|UHC|COMMERCIAL|negotiated_percentage,standard_charge|UHC|COMMERCIAL|negotiated_algorithm,estimated_amount|UHC|COMMERCIAL,standard_charge|UHC|COMMERCIAL|methodology,additional_payer_notes|UHC|COMMERCIAL,standard_charge|UHC_MEDICAID|MEDICAID|negotiated_dollar,standard_charge|UHC_MEDICAID|MEDICAID|negotiated_percentage,standard_charge|UHC_MEDICAID|MEDICAID|negotiated_algorithm,estimated_amount|UHC_MEDICAID|MEDICAID,standard_charge|UHC_MEDICAID|MEDICAID|methodology,additional_payer_notes|UHC_MEDICAID|MEDICAID,standard_charge|UHC_MEDICARE|MEDICARE|negotiated_dollar,standard_charge|UHC_MEDICARE|MEDICARE|negotiated_percentage,standard_charge|UHC_MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|UHC_MEDICARE|MEDICARE,standard_charge|UHC_MEDICARE|MEDICARE|methodology,additional_payer_notes|UHC_MEDICARE|MEDICARE,standard_charge|TRICARE|MEDICARE|negotiated_dollar,standard_charge|TRICARE|MEDICARE|negotiated_percentage,standard_charge|TRICARE|MEDICARE|negotiated_algorithm,estimated_amount|TRICARE|MEDICARE,standard_charge|TRICARE|MEDICARE|methodology,additional_payer_notes|TRICARE|MEDICARE,standard_charge|VA|MEDICARE|negotiated_dollar,standard_charge|VA|MEDICARE|negotiated_percentage,standard_charge|VA|MEDICARE|negotiated_algorithm,estimated_amount|VA|MEDICARE,standard_charge|VA|MEDICARE|methodology,additional_payer_notes|VA|MEDICARE,standard_charge|WASHINGTON_STATE_HCA|MEDICAID|negotiated_dollar,standard_charge|WASHINGTON_STATE_HCA|MEDICAID|negotiated_percentage,standard_charge|WASHINGTON_STATE_HCA|MEDICAID|negotiated_algorithm,estimated_amount|WASHINGTON_STATE_HCA|MEDICAID,standard_charge|WASHINGTON_STATE_HCA|MEDICAID|methodology,additional_payer_notes|WASHINGTON_STATE_HCA|MEDICAID,standard_charge|min,standard_charge|max,additional_generic_notes
ANTIDPRS TRIC MS 6PL,30180337,CDM,301,RC,80337,HCPCS,Outpatient,,,387,251.55,,340.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,387,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,243.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",59.21,15.3,,,percent of total billed charges,15.3% of total billed charges,267.03,69,,,percent of total billed charges,69% of total billed charges,387,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,387,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,387,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,145.9,37.7,,,percent of total billed charges,37.70% of total billed charges,145.9,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,131.19,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,301.86,78,,,percent of total billed charges,78% of total billed charges,387,100,,,percent of total billed charges,100% of total billed charges,319.66,82.6,,,percent of total billed charges,82.6% of total billed charges,319.66,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.02,16.8,,,percent of total billed charges,16.8% of total billed charges,59.21,387,
MDMA,30180359,CDM,301,RC,80359,HCPCS,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,35,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,35,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,11.87,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
"80356 .Opiates,MS,WB/S/P Rfx LC",30180356,CDM,301,RC,80356,HCPCS,Outpatient,,,95,61.75,,83.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,95,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",14.54,15.3,,,percent of total billed charges,15.3% of total billed charges,65.55,69,,,percent of total billed charges,69% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,95,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,95,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.82,37.7,,,percent of total billed charges,37.70% of total billed charges,35.82,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,32.21,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,74.1,78,,,percent of total billed charges,78% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,14.54,95,
80356 Heroin Metab (LC),30180356,CDM,301,RC,80356,HCPCS,Outpatient,,,99,64.35,,87.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,99,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62.37,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",15.15,15.3,,,percent of total billed charges,15.3% of total billed charges,68.31,69,,,percent of total billed charges,69% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,99,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,99,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.32,37.7,,,percent of total billed charges,37.70% of total billed charges,37.32,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,33.56,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,77.22,78,,,percent of total billed charges,78% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,15.15,99,
80359 Ext Amphetamine Conf LC 910990,30180359,CDM,301,RC,80359,HCPCS,Outpatient,,,225,146.25,,198,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,141.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",34.43,15.3,,,percent of total billed charges,15.3% of total billed charges,155.25,69,,,percent of total billed charges,69% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,225,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,225,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,76.28,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,175.5,78,,,percent of total billed charges,78% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.8,16.8,,,percent of total billed charges,16.8% of total billed charges,34.43,225,
80361 Codeine (LC),30180361,CDM,301,RC,80361,HCPCS,Outpatient,,,99,64.35,,87.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,99,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62.37,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",15.15,15.3,,,percent of total billed charges,15.3% of total billed charges,68.31,69,,,percent of total billed charges,69% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,99,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,99,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.32,37.7,,,percent of total billed charges,37.70% of total billed charges,37.32,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,33.56,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,77.22,78,,,percent of total billed charges,78% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,15.15,99,
80365 Oxycodone (LC),30180365,CDM,301,RC,80365,HCPCS,Outpatient,,,134,87.10,,117.92,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,84.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",20.5,15.3,,,percent of total billed charges,15.3% of total billed charges,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,134,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,134,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,45.43,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.51,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,134,
"81001 Urinalysis, Routine RLC",30781001,CDM,307,RC,81001,HCPCS,Outpatient,,,65,42.25,,57.2,88,,,percent of total billed charges,88% of total Billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,65,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,40.95,63,,,percent of total billed charges,63% of total billed charges,5.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,9.95,15.3,,,percent of total billed charges,15.3% of total billed charges,44.85,69,,,percent of total billed charges,69% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,65,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,65,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,12.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,22.04,33.9,,,percent of total billed charges,33.9% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,50.7,78,,,percent of total billed charges,78% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,65,
"BCR-ABL1, CML/ALL, PCR, Qnt LC 480481",30081207,CDM,301,RC,81207,HCPCS,Outpatient,,,735,477.75,,646.8,88,,,percent of total billed charges,88% of total Billed charges,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,735,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,463.05,63,,,percent of total billed charges,63% of total billed charges,253.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,112.46,15.3,,,percent of total billed charges,15.3% of total billed charges,507.15,69,,,percent of total billed charges,69% of total billed charges,735,100,,,percent of total billed charges,100% of total billed charges,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,735,100,,,percent of total billed charges,100% of total billed charges,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,735,100,,,percent of total billed charges,100% of total billed charges,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,554.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,277.1,37.7,,,percent of total billed charges,37.70% of total billed charges,277.1,37.7,,,percent of total billed charges,37.70% of total billed charges,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,249.17,33.9,,,percent of total billed charges,33.9% of total billed charges,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,573.3,78,,,percent of total billed charges,78% of total billed charges,735,100,,,percent of total billed charges,100% of total billed charges,607.11,82.6,,,percent of total billed charges,82.6% of total billed charges,607.11,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,146.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,144.84,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,735,
81338 Myeloproliferative Leukemia (MPL) Mutation Analysis LC,31081338,CDM,310,RC,81338,HCPCS,Outpatient,,,648,421.20,,570.24,88,,,percent of total billed charges,88% of total Billed charges,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,648,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,408.24,63,,,percent of total billed charges,63% of total billed charges,263.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,225.5,150,,,Fee Schedule,150% of Medicare OPPS rate,447.12,69,,,percent of total billed charges,69% of total billed charges,648,100,,,percent of total billed charges,100% of total billed charges,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,648,100,,,percent of total billed charges,100% of total billed charges,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,648,100,,,percent of total billed charges,100% of total billed charges,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,575.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,244.3,37.7,,,percent of total billed charges,37.70% of total billed charges,244.3,37.7,,,percent of total billed charges,37.70% of total billed charges,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,219.67,33.9,,,percent of total billed charges,33.9% of total billed charges,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,505.44,78,,,percent of total billed charges,78% of total billed charges,648,100,,,percent of total billed charges,100% of total billed charges,535.25,82.6,,,percent of total billed charges,82.6% of total billed charges,535.25,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,151.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,150.33,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,648,
ALBUMIN SERUM,30182040,CDM,301,RC,82040,HCPCS,Outpatient,,,122,79.30,,107.36,88,,,percent of total billed charges,88% of total Billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,122,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,76.86,63,,,percent of total billed charges,63% of total billed charges,8.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,18.67,15.3,,,percent of total billed charges,15.3% of total billed charges,84.18,69,,,percent of total billed charges,69% of total billed charges,122,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,122,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,122,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,18.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,45.99,37.7,,,percent of total billed charges,37.70% of total billed charges,45.99,37.7,,,percent of total billed charges,37.70% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,41.36,33.9,,,percent of total billed charges,33.9% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,95.16,78,,,percent of total billed charges,78% of total billed charges,122,100,,,percent of total billed charges,100% of total billed charges,100.77,82.6,,,percent of total billed charges,82.6% of total billed charges,100.77,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,122,
"ALDOSTERONE,24 HR URINE",30182088,CDM,301,RC,82088,HCPCS,Outpatient,,,77,50.05,,67.76,88,,,percent of total billed charges,88% of total Billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,77,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,48.51,63,,,percent of total billed charges,63% of total billed charges,71.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,11.78,15.3,,,percent of total billed charges,15.3% of total billed charges,53.13,69,,,percent of total billed charges,69% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,77,100,,,percent of total billed charges,100% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,77,100,,,percent of total billed charges,100% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,155.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,26.1,33.9,,,percent of total billed charges,33.9% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,60.06,78,,,percent of total billed charges,78% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,41.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.78,155.86,
ALPHA-FETO PROTEIN (NON-MAT),30182105,CDM,301,RC,82105,HCPCS,Outpatient,,,347,225.55,,305.36,88,,,percent of total billed charges,88% of total Billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,347,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,63,,,percent of total billed charges,63% of total billed charges,29.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,53.09,15.3,,,percent of total billed charges,15.3% of total billed charges,239.43,69,,,percent of total billed charges,69% of total billed charges,347,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,347,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,347,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,64.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,130.82,37.7,,,percent of total billed charges,37.70% of total billed charges,130.82,37.7,,,percent of total billed charges,37.70% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,117.63,33.9,,,percent of total billed charges,33.9% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,270.66,78,,,percent of total billed charges,78% of total billed charges,347,100,,,percent of total billed charges,100% of total billed charges,286.62,82.6,,,percent of total billed charges,82.6% of total billed charges,286.62,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,347,
Alpha Fetoprotein Amnio LC,30082106,CDM,300,RC,82106,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,63,,,percent of total billed charges,63% of total billed charges,29.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,70,100,,,percent of total billed charges,100% of total billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,70,100,,,percent of total billed charges,100% of total billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,65.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17,100,,,Fee Schedule,100% of Medicare OPPS rate,17,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17,100,,,Fee Schedule,100% of Medicare OPPS rate,17,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17,100,,,Fee Schedule,100% of Medicare OPPS rate,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,23.73,33.9,,,percent of total billed charges,33.9% of total billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17,100,,,Fee Schedule,100% of Medicare OPPS rate,17.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,70,
ALPHA-FETO PROTEIN (NON-MAT),30182105,CDM,301,RC,82105,HCPCS,Outpatient,,,290,188.50,,255.2,88,,,percent of total billed charges,88% of total Billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,290,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,182.7,63,,,percent of total billed charges,63% of total billed charges,29.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,44.37,15.3,,,percent of total billed charges,15.3% of total billed charges,200.1,69,,,percent of total billed charges,69% of total billed charges,290,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,290,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,290,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,64.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,109.33,37.7,,,percent of total billed charges,37.70% of total billed charges,109.33,37.7,,,percent of total billed charges,37.70% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,98.31,33.9,,,percent of total billed charges,33.9% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,226.2,78,,,percent of total billed charges,78% of total billed charges,290,100,,,percent of total billed charges,100% of total billed charges,239.54,82.6,,,percent of total billed charges,82.6% of total billed charges,239.54,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,290,
ARSENIC ANY SOURCE,30182175,CDM,301,RC,82175,HCPCS,Outpatient,,,286,185.90,,251.68,88,,,percent of total billed charges,88% of total Billed charges,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,286,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,180.18,63,,,percent of total billed charges,63% of total billed charges,33.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,43.76,15.3,,,percent of total billed charges,15.3% of total billed charges,197.34,69,,,percent of total billed charges,69% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,286,100,,,percent of total billed charges,100% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,286,100,,,percent of total billed charges,100% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,107.82,37.7,,,percent of total billed charges,37.70% of total billed charges,107.82,37.7,,,percent of total billed charges,37.70% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,96.95,33.9,,,percent of total billed charges,33.9% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,223.08,78,,,percent of total billed charges,78% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,19.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.97,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,286,
APOLIPOPROTEIN A,30182172,CDM,301,RC,82172,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,141.12,63,,,percent of total billed charges,63% of total billed charges,36.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,34.27,15.3,,,percent of total billed charges,15.3% of total billed charges,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,80.66,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,75.94,33.9,,,percent of total billed charges,33.9% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,21.3,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,224,
APOLIPOPROTEIN A,30182172,CDM,301,RC,82172,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,141.12,63,,,percent of total billed charges,63% of total billed charges,36.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,34.27,15.3,,,percent of total billed charges,15.3% of total billed charges,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,80.66,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,75.94,33.9,,,percent of total billed charges,33.9% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,21.3,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,224,
Bilirubin Direct,30182248,CDM,301,RC,82248,HCPCS,Outpatient,,,65,42.25,,57.2,88,,,percent of total billed charges,88% of total Billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,65,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,40.95,63,,,percent of total billed charges,63% of total billed charges,8.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,9.95,15.3,,,percent of total billed charges,15.3% of total billed charges,44.85,69,,,percent of total billed charges,69% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,65,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,65,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,22.04,33.9,,,percent of total billed charges,33.9% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,50.7,78,,,percent of total billed charges,78% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,65,
BILIRUBIN TOTAL,30182247,CDM,301,RC,82247,HCPCS,Outpatient,,,64,41.60,,56.32,88,,,percent of total billed charges,88% of total Billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,64,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,40.32,63,,,percent of total billed charges,63% of total billed charges,8.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,9.79,15.3,,,percent of total billed charges,15.3% of total billed charges,44.16,69,,,percent of total billed charges,69% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,64,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,64,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,24.13,37.7,,,percent of total billed charges,37.70% of total billed charges,24.13,37.7,,,percent of total billed charges,37.70% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,21.7,33.9,,,percent of total billed charges,33.9% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,78,,,percent of total billed charges,78% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,64,
"82248 Bilirubin Fractionated, Neonatal RLC",30182248,CDM,301,RC,82248,HCPCS,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,1,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,0.63,63,,,percent of total billed charges,63% of total billed charges,8.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,0.38,37.7,,,percent of total billed charges,37.70% of total billed charges,0.38,37.7,,,percent of total billed charges,37.70% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,0.34,33.9,,,percent of total billed charges,33.9% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.15,19.2,
CHOLESTEROL FLUID,30182465,CDM,301,RC,82465,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,52.29,63,,,percent of total billed charges,63% of total billed charges,7.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,16.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,83,
PSEUDOCHOLINESTERASE,30182480,CDM,301,RC,82480,HCPCS,Outpatient,,,182,118.30,,160.16,88,,,percent of total billed charges,88% of total Billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,182,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,63,,,percent of total billed charges,63% of total billed charges,13.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,27.85,15.3,,,percent of total billed charges,15.3% of total billed charges,125.58,69,,,percent of total billed charges,69% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,182,100,,,percent of total billed charges,100% of total billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,182,100,,,percent of total billed charges,100% of total billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,30.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,61.7,33.9,,,percent of total billed charges,33.9% of total billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,141.96,78,,,percent of total billed charges,78% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,7.94,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,182,
CPK TOTAL,30182550,CDM,301,RC,82550,HCPCS,Outpatient,,,122,79.30,,107.36,88,,,percent of total billed charges,88% of total Billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,122,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,76.86,63,,,percent of total billed charges,63% of total billed charges,11.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,18.67,15.3,,,percent of total billed charges,15.3% of total billed charges,84.18,69,,,percent of total billed charges,69% of total billed charges,122,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,122,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,122,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,24.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,45.99,37.7,,,percent of total billed charges,37.70% of total billed charges,45.99,37.7,,,percent of total billed charges,37.70% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,41.36,33.9,,,percent of total billed charges,33.9% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,95.16,78,,,percent of total billed charges,78% of total billed charges,122,100,,,percent of total billed charges,100% of total billed charges,100.77,82.6,,,percent of total billed charges,82.6% of total billed charges,100.77,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,6.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,122,
Creatine Kinase (CK) LC,30182550,CDM,301,RC,82550,HCPCS,Outpatient,,,143,92.95,,125.84,88,,,percent of total billed charges,88% of total Billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,143,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,90.09,63,,,percent of total billed charges,63% of total billed charges,11.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,21.88,15.3,,,percent of total billed charges,15.3% of total billed charges,98.67,69,,,percent of total billed charges,69% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,24.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,48.48,33.9,,,percent of total billed charges,33.9% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,111.54,78,,,percent of total billed charges,78% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,6.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,143,
CREATININE URINE RANDOM,30182570,CDM,301,RC,82570,HCPCS,Outpatient,,,71,46.15,,62.48,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,71,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,44.73,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,10.86,15.3,,,percent of total billed charges,15.3% of total billed charges,48.99,69,,,percent of total billed charges,69% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,71,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,71,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,26.77,37.7,,,percent of total billed charges,37.70% of total billed charges,26.77,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.07,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,55.38,78,,,percent of total billed charges,78% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,71,
CREATININE URINE RANDOM,30182570,CDM,301,RC,82570,HCPCS,Outpatient,,,71,46.15,,62.48,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,71,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,44.73,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,10.86,15.3,,,percent of total billed charges,15.3% of total billed charges,48.99,69,,,percent of total billed charges,69% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,71,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,71,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,26.77,37.7,,,percent of total billed charges,37.70% of total billed charges,26.77,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.07,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,55.38,78,,,percent of total billed charges,78% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,71,
ESTRIOL,30182677,CDM,301,RC,82677,HCPCS,Outpatient,,,172,111.80,,151.36,88,,,percent of total billed charges,88% of total Billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,172,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,42.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,26.32,15.3,,,percent of total billed charges,15.3% of total billed charges,118.68,69,,,percent of total billed charges,69% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,92.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,58.31,33.9,,,percent of total billed charges,33.9% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,134.16,78,,,percent of total billed charges,78% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,172,
ESTRIOL,30182677,CDM,301,RC,82677,HCPCS,Outpatient,,,464,301.60,,408.32,88,,,percent of total billed charges,88% of total Billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,464,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,42.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,70.99,15.3,,,percent of total billed charges,15.3% of total billed charges,320.16,69,,,percent of total billed charges,69% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,464,100,,,percent of total billed charges,100% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,464,100,,,percent of total billed charges,100% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,92.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,157.3,33.9,,,percent of total billed charges,33.9% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,361.92,78,,,percent of total billed charges,78% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,464,
30182670,30182670,CDM,310,RC,82670,HCPCS,Outpatient,,,140,91.00,,123.2,88,,,percent of total billed charges,88% of total Billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,140,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,88.2,63,,,percent of total billed charges,63% of total billed charges,48.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,41.91,150,,,Fee Schedule,150% of Medicare OPPS rate,96.6,69,,,percent of total billed charges,69% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,140,100,,,percent of total billed charges,100% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,140,100,,,percent of total billed charges,100% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,106.87,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,52.78,37.7,,,percent of total billed charges,37.70% of total billed charges,52.78,37.7,,,percent of total billed charges,37.70% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,47.46,33.9,,,percent of total billed charges,33.9% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,109.2,78,,,percent of total billed charges,78% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,28.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,140,
Ferritin LC,30182728,CDM,301,RC,82728,HCPCS,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,21,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,13.23,63,,,percent of total billed charges,63% of total billed charges,23.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,21,100,,,percent of total billed charges,100% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,21,100,,,percent of total billed charges,100% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,52.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,7.92,37.7,,,percent of total billed charges,37.70% of total billed charges,7.92,37.7,,,percent of total billed charges,37.70% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,7.12,33.9,,,percent of total billed charges,33.9% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,13.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.21,52.13,
IGA SALIVA,30182784,CDM,301,RC,82784,HCPCS,Outpatient,,,153,99.45,,134.64,88,,,percent of total billed charges,88% of total Billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,153,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,96.39,63,,,percent of total billed charges,63% of total billed charges,16.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,23.41,15.3,,,percent of total billed charges,15.3% of total billed charges,105.57,69,,,percent of total billed charges,69% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,35.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,51.87,33.9,,,percent of total billed charges,33.9% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,119.34,78,,,percent of total billed charges,78% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,153,
"Immunoglobulin A, G, M, Qn, Serum LC",30182784,CDM,301,RC,82784,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,113.4,63,,,percent of total billed charges,63% of total billed charges,16.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,35.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,61.02,33.9,,,percent of total billed charges,33.9% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,180,
GLUCOSE BLOOD,30182947,CDM,301,RC,82947,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,45,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,28.35,63,,,percent of total billed charges,63% of total billed charges,6.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,45,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,45,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,15.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,45,
GLUCOSE TOL 5HR TEST,30182952,CDM,301,RC,82952,HCPCS,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,35,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,22.05,63,,,percent of total billed charges,63% of total billed charges,6.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,35,100,,,percent of total billed charges,100% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,35,100,,,percent of total billed charges,100% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,14.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,11.87,33.9,,,percent of total billed charges,33.9% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,35,
GGT,30182977,CDM,301,RC,82977,HCPCS,Outpatient,,,118,76.70,,103.84,88,,,percent of total billed charges,88% of total Billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,118,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,74.34,63,,,percent of total billed charges,63% of total billed charges,12.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,18.05,15.3,,,percent of total billed charges,15.3% of total billed charges,81.42,69,,,percent of total billed charges,69% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,118,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,118,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,27.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,44.49,37.7,,,percent of total billed charges,37.70% of total billed charges,44.49,37.7,,,percent of total billed charges,37.70% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,40,33.9,,,percent of total billed charges,33.9% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,92.04,78,,,percent of total billed charges,78% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,7.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,118,
GGT,30182977,CDM,301,RC,82977,HCPCS,Outpatient,,,118,76.70,,103.84,88,,,percent of total billed charges,88% of total Billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,118,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,74.34,63,,,percent of total billed charges,63% of total billed charges,12.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,18.05,15.3,,,percent of total billed charges,15.3% of total billed charges,81.42,69,,,percent of total billed charges,69% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,118,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,118,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,27.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,44.49,37.7,,,percent of total billed charges,37.70% of total billed charges,44.49,37.7,,,percent of total billed charges,37.70% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,40,33.9,,,percent of total billed charges,33.9% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,92.04,78,,,percent of total billed charges,78% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,7.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,118,
LH LC,30183002,CDM,301,RC,83002,HCPCS,Outpatient,,,358,232.70,,315.04,88,,,percent of total billed charges,88% of total Billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,225.54,63,,,percent of total billed charges,63% of total billed charges,32.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,54.77,15.3,,,percent of total billed charges,15.3% of total billed charges,247.02,69,,,percent of total billed charges,69% of total billed charges,358,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,358,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,358,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,70.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,134.97,37.7,,,percent of total billed charges,37.70% of total billed charges,134.97,37.7,,,percent of total billed charges,37.70% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,121.36,33.9,,,percent of total billed charges,33.9% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,279.24,78,,,percent of total billed charges,78% of total billed charges,358,100,,,percent of total billed charges,100% of total billed charges,295.71,82.6,,,percent of total billed charges,82.6% of total billed charges,295.71,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,358,
30183001,30183001,CDM,301,RC,83001,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,63,63,,,percent of total billed charges,63% of total billed charges,32.51,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,71.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,100,
HAPTOGLOBIN QUANT,30183010,CDM,301,RC,83010,HCPCS,Outpatient,,,207,134.55,,182.16,88,,,percent of total billed charges,88% of total Billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,207,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,130.41,63,,,percent of total billed charges,63% of total billed charges,22.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,31.67,15.3,,,percent of total billed charges,15.3% of total billed charges,142.83,69,,,percent of total billed charges,69% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,207,100,,,percent of total billed charges,100% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,207,100,,,percent of total billed charges,100% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,48.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,70.17,33.9,,,percent of total billed charges,33.9% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,161.46,78,,,percent of total billed charges,78% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,12.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,207,
HAPTOGLOBIN QUANT,30183010,CDM,301,RC,83010,HCPCS,Outpatient,,,207,134.55,,182.16,88,,,percent of total billed charges,88% of total Billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,207,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,130.41,63,,,percent of total billed charges,63% of total billed charges,22.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,31.67,15.3,,,percent of total billed charges,15.3% of total billed charges,142.83,69,,,percent of total billed charges,69% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,207,100,,,percent of total billed charges,100% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,207,100,,,percent of total billed charges,100% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,48.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,70.17,33.9,,,percent of total billed charges,33.9% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,161.46,78,,,percent of total billed charges,78% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,12.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,207,
HYDROXYINDOLACETIC 5-HIAA,30183497,CDM,301,RC,83497,HCPCS,Outpatient,,,264,171.60,,232.32,88,,,percent of total billed charges,88% of total Billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,264,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,166.32,63,,,percent of total billed charges,63% of total billed charges,22.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,49.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,89.5,33.9,,,percent of total billed charges,33.9% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,13.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,264,
HYDROXYINDOLACETIC 5-HIAA,30183497,CDM,301,RC,83497,HCPCS,Outpatient,,,264,171.60,,232.32,88,,,percent of total billed charges,88% of total Billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,264,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,166.32,63,,,percent of total billed charges,63% of total billed charges,22.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,49.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,89.5,33.9,,,percent of total billed charges,33.9% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,13.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,264,
"Clotting inhibitors or anticoagulants; protein S, free",30585306,CDM,305,RC,85306,HCPCS,Outpatient,,,496,322.40,,436.48,88,,,percent of total billed charges,88% of total Billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,496,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,312.48,63,,,percent of total billed charges,63% of total billed charges,26.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,75.89,15.3,,,percent of total billed charges,15.3% of total billed charges,342.24,69,,,percent of total billed charges,69% of total billed charges,496,100,,,percent of total billed charges,100% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,496,100,,,percent of total billed charges,100% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,496,100,,,percent of total billed charges,100% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,58.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,186.99,37.7,,,percent of total billed charges,37.70% of total billed charges,186.99,37.7,,,percent of total billed charges,37.70% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,168.14,33.9,,,percent of total billed charges,33.9% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,386.88,78,,,percent of total billed charges,78% of total billed charges,496,100,,,percent of total billed charges,100% of total billed charges,409.7,82.6,,,percent of total billed charges,82.6% of total billed charges,409.7,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,15.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,496,
83516 ANCA Profile LC,30183516,CDM,301,RC,83516,HCPCS,Outpatient,,,34.59,22.48,,30.44,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,34.59,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,5.29,15.3,,,percent of total billed charges,15.3% of total billed charges,23.87,69,,,percent of total billed charges,69% of total billed charges,34.59,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,34.59,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,34.59,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,13.04,37.7,,,percent of total billed charges,37.70% of total billed charges,13.04,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.73,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,26.98,78,,,percent of total billed charges,78% of total billed charges,34.59,100,,,percent of total billed charges,100% of total billed charges,28.57,82.6,,,percent of total billed charges,82.6% of total billed charges,28.57,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.29,44.1,
83516 Endo(IgA) w/Reflex+tTG(IgA) LC,30183516,CDM,301,RC,83516,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,83,
CYTOKINES,30183520,CDM,301,RC,83520,HCPCS,Outpatient,,,51,33.15,,44.88,88,,,percent of total billed charges,88% of total Billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,51,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.22,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,7.8,15.3,,,percent of total billed charges,15.3% of total billed charges,35.19,69,,,percent of total billed charges,69% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,51,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,51,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,66.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.29,33.9,,,percent of total billed charges,33.9% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,39.78,78,,,percent of total billed charges,78% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.8,66.05,
Kappa and Lambda Light Chains LC,30183521,CDM,301,RC,83521,HCPCS,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,61,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,38.43,63,,,percent of total billed charges,63% of total billed charges,30.22,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,23,37.7,,,percent of total billed charges,37.70% of total billed charges,23,37.7,,,percent of total billed charges,37.70% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,20.68,33.9,,,percent of total billed charges,33.9% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,61,
83550 Iron Binding Capacity LC,30183550,CDM,301,RC,83550,HCPCS,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,27,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,17.01,63,,,percent of total billed charges,63% of total billed charges,15.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,27,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,27,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,33.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.18,37.7,,,percent of total billed charges,37.70% of total billed charges,10.18,37.7,,,percent of total billed charges,37.70% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.15,33.9,,,percent of total billed charges,33.9% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,33.43,
iSTAT Lactate (lactic acid),30183605,CDM,301,RC,83605,HCPCS,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.9,63,,,percent of total billed charges,63% of total billed charges,20.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,44.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.17,33.9,,,percent of total billed charges,33.9% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.59,44.25,
LEAD URINE,30083655,CDM,300,RC,83655,HCPCS,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,21.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,46.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,113,
LIPOPROTEIN BLOOD ELEC SEPQN,30183700,CDM,301,RC,83700,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,23.31,63,,,percent of total billed charges,63% of total billed charges,19.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,43.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,12.54,33.9,,,percent of total billed charges,33.9% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.66,43.06,
LIPOPROFILE NMR,30183704,CDM,301,RC,83704,HCPCS,Outpatient,,,76,49.40,,66.88,88,,,percent of total billed charges,88% of total Billed charges,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,76,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,47.88,63,,,percent of total billed charges,63% of total billed charges,59.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,11.63,15.3,,,percent of total billed charges,15.3% of total billed charges,52.44,69,,,percent of total billed charges,69% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,76,100,,,percent of total billed charges,100% of total billed charges,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,76,100,,,percent of total billed charges,100% of total billed charges,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,130.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,28.65,37.7,,,percent of total billed charges,37.70% of total billed charges,28.65,37.7,,,percent of total billed charges,37.70% of total billed charges,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,25.76,33.9,,,percent of total billed charges,33.9% of total billed charges,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.28,78,,,percent of total billed charges,78% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,34.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.19,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.63,130.77,
NEPHELOMETRY NES,30183883,CDM,301,RC,83883,HCPCS,Outpatient,,,543,352.95,,477.84,88,,,percent of total billed charges,88% of total Billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,543,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,342.09,63,,,percent of total billed charges,63% of total billed charges,23.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,83.08,15.3,,,percent of total billed charges,15.3% of total billed charges,374.67,69,,,percent of total billed charges,69% of total billed charges,543,100,,,percent of total billed charges,100% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,543,100,,,percent of total billed charges,100% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,543,100,,,percent of total billed charges,100% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,52.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,204.71,37.7,,,percent of total billed charges,37.70% of total billed charges,204.71,37.7,,,percent of total billed charges,37.70% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,184.08,33.9,,,percent of total billed charges,33.9% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,423.54,78,,,percent of total billed charges,78% of total billed charges,543,100,,,percent of total billed charges,100% of total billed charges,448.52,82.6,,,percent of total billed charges,82.6% of total billed charges,448.52,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,543,
NEPHELOMETRY NES,30183883,CDM,301,RC,83883,HCPCS,Outpatient,,,122,79.30,,107.36,88,,,percent of total billed charges,88% of total Billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,122,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,76.86,63,,,percent of total billed charges,63% of total billed charges,23.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,18.67,15.3,,,percent of total billed charges,15.3% of total billed charges,84.18,69,,,percent of total billed charges,69% of total billed charges,122,100,,,percent of total billed charges,100% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,122,100,,,percent of total billed charges,100% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,122,100,,,percent of total billed charges,100% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,52.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,45.99,37.7,,,percent of total billed charges,37.70% of total billed charges,45.99,37.7,,,percent of total billed charges,37.70% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,41.36,33.9,,,percent of total billed charges,33.9% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,95.16,78,,,percent of total billed charges,78% of total billed charges,122,100,,,percent of total billed charges,100% of total billed charges,100.77,82.6,,,percent of total billed charges,82.6% of total billed charges,100.77,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,122,
PTH Intact LC,30183970,CDM,301,RC,83970,HCPCS,Outpatient,,,227,147.55,,199.76,88,,,percent of total billed charges,88% of total Billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,227,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,143.01,63,,,percent of total billed charges,63% of total billed charges,72.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,34.73,15.3,,,percent of total billed charges,15.3% of total billed charges,156.63,69,,,percent of total billed charges,69% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,157.89,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,76.95,33.9,,,percent of total billed charges,33.9% of total billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,177.06,78,,,percent of total billed charges,78% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,41.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.6,227,
ALKALINE PHOSPHATASE BONE SPEC,30184080,CDM,301,RC,84080,HCPCS,Outpatient,,,258,167.70,,227.04,88,,,percent of total billed charges,88% of total Billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,258,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,162.54,63,,,percent of total billed charges,63% of total billed charges,25.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,39.47,15.3,,,percent of total billed charges,15.3% of total billed charges,178.02,69,,,percent of total billed charges,69% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,56.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,33.9,,,percent of total billed charges,33.9% of total billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,201.24,78,,,percent of total billed charges,78% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,14.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,258,
PROTEIN RANDOM URINE,30184156,CDM,301,RC,84156,HCPCS,Outpatient,,,394,256.10,,346.72,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,394,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,248.22,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,60.28,15.3,,,percent of total billed charges,15.3% of total billed charges,271.86,69,,,percent of total billed charges,69% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,394,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,394,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,133.57,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,307.32,78,,,percent of total billed charges,78% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,394,
Protein Elec + Interp LC,30184155,CDM,301,RC,84155,HCPCS,Outpatient,,,92,59.80,,80.96,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,92,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,57.96,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.08,15.3,,,percent of total billed charges,15.3% of total billed charges,63.48,69,,,percent of total billed charges,69% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,92,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,92,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,31.19,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,71.76,78,,,percent of total billed charges,78% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,92,
PSA Free LC,30184154,CDM,301,RC,84154,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,32.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,70.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,146,
Protein Total LC,30184155,CDM,301,RC,84155,HCPCS,Outpatient,,,92,59.80,,80.96,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,92,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,57.96,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.08,15.3,,,percent of total billed charges,15.3% of total billed charges,63.48,69,,,percent of total billed charges,69% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,92,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,92,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,31.19,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,71.76,78,,,percent of total billed charges,78% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,92,
ELECTROPHORESIS URINE QUANT 24,30184166,CDM,301,RC,84166,HCPCS,Outpatient,,,560,364.00,,492.8,88,,,percent of total billed charges,88% of total Billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,560,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,352.8,63,,,percent of total billed charges,63% of total billed charges,31.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,85.68,15.3,,,percent of total billed charges,15.3% of total billed charges,386.4,69,,,percent of total billed charges,69% of total billed charges,560,100,,,percent of total billed charges,100% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,560,100,,,percent of total billed charges,100% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,560,100,,,percent of total billed charges,100% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,68.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,211.12,37.7,,,percent of total billed charges,37.70% of total billed charges,211.12,37.7,,,percent of total billed charges,37.70% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,189.84,33.9,,,percent of total billed charges,33.9% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,436.8,78,,,percent of total billed charges,78% of total billed charges,560,100,,,percent of total billed charges,100% of total billed charges,462.56,82.6,,,percent of total billed charges,82.6% of total billed charges,462.56,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,560,
ELECTROPHORESIS URINE QUANT 24,30184166,CDM,301,RC,84166,HCPCS,Outpatient,,,533,346.45,,469.04,88,,,percent of total billed charges,88% of total Billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,533,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,335.79,63,,,percent of total billed charges,63% of total billed charges,31.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,81.55,15.3,,,percent of total billed charges,15.3% of total billed charges,367.77,69,,,percent of total billed charges,69% of total billed charges,533,100,,,percent of total billed charges,100% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,533,100,,,percent of total billed charges,100% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,533,100,,,percent of total billed charges,100% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,68.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,200.94,37.7,,,percent of total billed charges,37.70% of total billed charges,200.94,37.7,,,percent of total billed charges,37.70% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.69,33.9,,,percent of total billed charges,33.9% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,415.74,78,,,percent of total billed charges,78% of total billed charges,533,100,,,percent of total billed charges,100% of total billed charges,440.26,82.6,,,percent of total billed charges,82.6% of total billed charges,440.26,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,533,
PROTEIN PHORESIS SERUM,30184165,CDM,301,RC,84165,HCPCS,Outpatient,,,451,293.15,,396.88,88,,,percent of total billed charges,88% of total Billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,451,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,284.13,63,,,percent of total billed charges,63% of total billed charges,18.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,69,15.3,,,percent of total billed charges,15.3% of total billed charges,311.19,69,,,percent of total billed charges,69% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,451,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,451,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,41.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,152.89,33.9,,,percent of total billed charges,33.9% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,351.78,78,,,percent of total billed charges,78% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,451,
"Protein Electro, Random Ur LC",30184166,CDM,301,RC,84166,HCPCS,Outpatient,,,644,418.60,,566.72,88,,,percent of total billed charges,88% of total Billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,644,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,405.72,63,,,percent of total billed charges,63% of total billed charges,31.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,98.53,15.3,,,percent of total billed charges,15.3% of total billed charges,444.36,69,,,percent of total billed charges,69% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,644,100,,,percent of total billed charges,100% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,644,100,,,percent of total billed charges,100% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,68.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,218.32,33.9,,,percent of total billed charges,33.9% of total billed charges,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,502.32,78,,,percent of total billed charges,78% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.82,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,644,
"Protein, Electrophoresis Frac Qaunt LC",30184165,CDM,301,RC,84165,HCPCS,Outpatient,,,531,345.15,,467.28,88,,,percent of total billed charges,88% of total Billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,531,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,334.53,63,,,percent of total billed charges,63% of total billed charges,18.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,81.24,15.3,,,percent of total billed charges,15.3% of total billed charges,366.39,69,,,percent of total billed charges,69% of total billed charges,531,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,531,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,531,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,41.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,200.19,37.7,,,percent of total billed charges,37.70% of total billed charges,200.19,37.7,,,percent of total billed charges,37.70% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,180.01,33.9,,,percent of total billed charges,33.9% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,414.18,78,,,percent of total billed charges,78% of total billed charges,531,100,,,percent of total billed charges,100% of total billed charges,438.61,82.6,,,percent of total billed charges,82.6% of total billed charges,438.61,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,531,
Testosterone Total LC,30184403,CDM,301,RC,84403,HCPCS,Outpatient,,,475,308.75,,418,88,,,percent of total billed charges,88% of total Billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,475,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,299.25,63,,,percent of total billed charges,63% of total billed charges,45.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,72.68,15.3,,,percent of total billed charges,15.3% of total billed charges,327.75,69,,,percent of total billed charges,69% of total billed charges,475,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,475,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,475,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,98.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,179.08,37.7,,,percent of total billed charges,37.70% of total billed charges,179.08,37.7,,,percent of total billed charges,37.70% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,161.03,33.9,,,percent of total billed charges,33.9% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,370.5,78,,,percent of total billed charges,78% of total billed charges,475,100,,,percent of total billed charges,100% of total billed charges,392.35,82.6,,,percent of total billed charges,82.6% of total billed charges,392.35,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,26.06,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,475,
Testosterone Total LC,30184403,CDM,301,RC,84403,HCPCS,Outpatient,,,453,294.45,,398.64,88,,,percent of total billed charges,88% of total Billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,453,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,285.39,63,,,percent of total billed charges,63% of total billed charges,45.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,69.31,15.3,,,percent of total billed charges,15.3% of total billed charges,312.57,69,,,percent of total billed charges,69% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,453,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,453,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,98.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,153.57,33.9,,,percent of total billed charges,33.9% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,353.34,78,,,percent of total billed charges,78% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,26.06,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,453,
TestT+SHBG+TestFW LC,30184410,CDM,301,RC,84410,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,63,63,,,percent of total billed charges,63% of total billed charges,89.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,196.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,51.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,51.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.3,196.14,
"84439 Thyroxine, free (FT4) LC",30184439,CDM,301,RC,84439,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,23.31,63,,,percent of total billed charges,63% of total billed charges,15.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,34.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,12.54,33.9,,,percent of total billed charges,33.9% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,9.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.66,37,
SGPT OR ALT,30184460,CDM,301,RC,84460,HCPCS,Outpatient,,,111,72.15,,97.68,88,,,percent of total billed charges,88% of total Billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,111,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,69.93,63,,,percent of total billed charges,63% of total billed charges,9.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,16.98,15.3,,,percent of total billed charges,15.3% of total billed charges,76.59,69,,,percent of total billed charges,69% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,111,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,111,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,20.27,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,37.63,33.9,,,percent of total billed charges,33.9% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,86.58,78,,,percent of total billed charges,78% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.35,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,111,
SGPT OR ALT,30184460,CDM,301,RC,84460,HCPCS,Outpatient,,,111,72.15,,97.68,88,,,percent of total billed charges,88% of total Billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,111,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,69.93,63,,,percent of total billed charges,63% of total billed charges,9.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,16.98,15.3,,,percent of total billed charges,15.3% of total billed charges,76.59,69,,,percent of total billed charges,69% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,111,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,111,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,20.27,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,37.63,33.9,,,percent of total billed charges,33.9% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,86.58,78,,,percent of total billed charges,78% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.35,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,111,
TRIGLYCERIDES BODY FLUID,30184478,CDM,301,RC,84478,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,10.04,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,21.95,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,94,
Uric Acid A+ANA LC,30184550,CDM,301,RC,84550,HCPCS,Outpatient,,,89,57.85,,78.32,88,,,percent of total billed charges,88% of total Billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,89,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,56.07,63,,,percent of total billed charges,63% of total billed charges,7.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,13.62,15.3,,,percent of total billed charges,15.3% of total billed charges,61.41,69,,,percent of total billed charges,69% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,89,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,89,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,17.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,33.55,37.7,,,percent of total billed charges,37.70% of total billed charges,33.55,37.7,,,percent of total billed charges,37.70% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,30.17,33.9,,,percent of total billed charges,33.9% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,69.42,78,,,percent of total billed charges,78% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,89,
BETA HCG QUANT SERUM,30184702,CDM,301,RC,84702,HCPCS,Outpatient,,,406,263.90,,357.28,88,,,percent of total billed charges,88% of total Billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,406,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,255.78,63,,,percent of total billed charges,63% of total billed charges,26.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,62.12,15.3,,,percent of total billed charges,15.3% of total billed charges,280.14,69,,,percent of total billed charges,69% of total billed charges,406,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,406,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,406,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,57.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,153.06,37.7,,,percent of total billed charges,37.70% of total billed charges,153.06,37.7,,,percent of total billed charges,37.70% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,137.63,33.9,,,percent of total billed charges,33.9% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,78,,,percent of total billed charges,78% of total billed charges,406,100,,,percent of total billed charges,100% of total billed charges,335.36,82.6,,,percent of total billed charges,82.6% of total billed charges,335.36,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,406,
BETA HCG QUANT SERUM,30184702,CDM,301,RC,84702,HCPCS,Outpatient,,,428,278.20,,376.64,88,,,percent of total billed charges,88% of total Billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,428,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,269.64,63,,,percent of total billed charges,63% of total billed charges,26.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,65.48,15.3,,,percent of total billed charges,15.3% of total billed charges,295.32,69,,,percent of total billed charges,69% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,428,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,428,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,57.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,145.09,33.9,,,percent of total billed charges,33.9% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,333.84,78,,,percent of total billed charges,78% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,428,
Hemoglobin,30585018,CDM,305,RC,85018,HCPCS,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,54,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,34.02,63,,,percent of total billed charges,63% of total billed charges,4.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,18.31,33.9,,,percent of total billed charges,33.9% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.37,54,
iSTAT Blood count; hematocrit (Hct),30585014,CDM,305,RC,85014,HCPCS,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,6,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,3.78,63,,,percent of total billed charges,63% of total billed charges,4.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,6,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,6,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.26,37.7,,,percent of total billed charges,37.70% of total billed charges,2.26,37.7,,,percent of total billed charges,37.70% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.03,33.9,,,percent of total billed charges,33.9% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.92,9.06,
Blood count; complete (CBC) LC,30585027,CDM,305,RC,85027,HCPCS,Outpatient,,,172,111.80,,151.36,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,172,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,108.36,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,26.32,15.3,,,percent of total billed charges,15.3% of total billed charges,118.68,69,,,percent of total billed charges,69% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,58.31,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,134.16,78,,,percent of total billed charges,78% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,172,
CBC LC,30585025,CDM,305,RC,85025,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,117.18,63,,,percent of total billed charges,63% of total billed charges,13.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,29.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,63.05,33.9,,,percent of total billed charges,33.9% of total billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,186,
RBC COUNT ONLY,30585041,CDM,305,RC,85041,HCPCS,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,52,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,32.76,63,,,percent of total billed charges,63% of total billed charges,5.28,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,52,100,,,percent of total billed charges,100% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,52,100,,,percent of total billed charges,100% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,11.55,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,17.63,33.9,,,percent of total billed charges,33.9% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.02,52,
Platelet Count LC,30585049,CDM,305,RC,85049,HCPCS,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,26,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,63,,,percent of total billed charges,63% of total billed charges,7.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,percent of total billed charges,100% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,percent of total billed charges,100% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,17.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,9.8,37.7,,,percent of total billed charges,37.70% of total billed charges,9.8,37.7,,,percent of total billed charges,37.70% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.81,33.9,,,percent of total billed charges,33.9% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.52,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,26,
FACTOR VIII ACTIVITY,30585240,CDM,305,RC,85240,HCPCS,Outpatient,,,210,136.50,,184.8,88,,,percent of total billed charges,88% of total Billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,210,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,132.3,63,,,percent of total billed charges,63% of total billed charges,31.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,32.13,15.3,,,percent of total billed charges,15.3% of total billed charges,144.9,69,,,percent of total billed charges,69% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,210,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,210,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,68.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,33.9,,,percent of total billed charges,33.9% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,163.8,78,,,percent of total billed charges,78% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,18.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,210,
Factor VIII Activity LC,30585240,CDM,305,RC,85240,HCPCS,Outpatient,,,247,160.55,,217.36,88,,,percent of total billed charges,88% of total Billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,247,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,155.61,63,,,percent of total billed charges,63% of total billed charges,31.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,37.79,15.3,,,percent of total billed charges,15.3% of total billed charges,170.43,69,,,percent of total billed charges,69% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,68.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,83.73,33.9,,,percent of total billed charges,33.9% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,192.66,78,,,percent of total billed charges,78% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,18.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,247,
Factor VIII Antigen LC,30585246,CDM,305,RC,85246,HCPCS,Outpatient,,,517,336.05,,454.96,88,,,percent of total billed charges,88% of total Billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.29,100,,,Fee Schedule,100% of WA Medicaid,517,100,,,percent of total billed charges,100% of total billed charges,16.78,103,,,Fee Schedule,103% of WA Medicaid,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,325.71,63,,,percent of total billed charges,63% of total billed charges,40.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,16.29,100,,,Fee Schedule,100% of WA Medicaid,79.1,15.3,,,percent of total billed charges,15.3% of total billed charges,356.73,69,,,percent of total billed charges,69% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,517,100,,,percent of total billed charges,100% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,517,100,,,percent of total billed charges,100% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,87.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,12.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.18,130,,,Fee Schedule,130% of WA Medicaid ,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,175.26,33.9,,,percent of total billed charges,33.9% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,403.26,78,,,percent of total billed charges,78% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,23.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.07,517,
PROTEIN S TOTAL,30585305,CDM,305,RC,85305,HCPCS,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,58,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,36.54,63,,,percent of total billed charges,63% of total billed charges,20.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,58,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,58,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,19.66,33.9,,,percent of total billed charges,33.9% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,58,
zHEXAGONAL PHASE PHOSPHOLIPID,30585598,CDM,305,RC,85598,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,52.29,63,,,percent of total billed charges,63% of total billed charges,31.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,68.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,18.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,83,
PT 1:NP LC 241426,30585611,CDM,305,RC,85611,HCPCS,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,101,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,63.63,63,,,percent of total billed charges,63% of total billed charges,6.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,15.45,15.3,,,percent of total billed charges,15.3% of total billed charges,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,15.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,34.24,33.9,,,percent of total billed charges,33.9% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,3.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.94,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,101,
PT LC 241426,30085610,CDM,300,RC,85610,HCPCS,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,101,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,63.63,63,,,percent of total billed charges,63% of total billed charges,7.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,15.45,15.3,,,percent of total billed charges,15.3% of total billed charges,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,16.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,34.24,33.9,,,percent of total billed charges,33.9% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,101,
DRVTT LC 241426,30585613,CDM,305,RC,85613,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,16.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,36.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,271,
"PT, Prothrombin Time (LC #117079 APS)",AFC30585610,CDM,305,RC,85610,HCPCS,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,28,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,17.64,63,,,percent of total billed charges,63% of total billed charges,7.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,28,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,28,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,16.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.56,37.7,,,percent of total billed charges,37.70% of total billed charges,10.56,37.7,,,percent of total billed charges,37.70% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,9.49,33.9,,,percent of total billed charges,33.9% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,28,
dRVVT  (LC #117079 APS),AFC30585613,CDM,305,RC,85613,HCPCS,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,61,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,38.43,63,,,percent of total billed charges,63% of total billed charges,16.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,36.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,23,37.7,,,percent of total billed charges,37.70% of total billed charges,23,37.7,,,percent of total billed charges,37.70% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,20.68,33.9,,,percent of total billed charges,33.9% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,61,
RBC SICKLE CELL TEST,30585660,CDM,305,RC,85660,HCPCS,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,60.48,63,,,percent of total billed charges,63% of total billed charges,9.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,21.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,32.54,33.9,,,percent of total billed charges,33.9% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,96,
zTHROMBIN TIME,30585670,CDM,305,RC,85670,HCPCS,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,101,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,63.63,63,,,percent of total billed charges,63% of total billed charges,10.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,15.45,15.3,,,percent of total billed charges,15.3% of total billed charges,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,22.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,34.24,33.9,,,percent of total billed charges,33.9% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,101,
Thrombin Time (LC #117079 APS),AFC30585670,CDM,305,RC,85670,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,23.31,63,,,percent of total billed charges,63% of total billed charges,10.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,22.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12.54,33.9,,,percent of total billed charges,33.9% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,37,
PTT-LA LC 241426,30585732,CDM,305,RC,85732,HCPCS,Outpatient,,,129,83.85,,113.52,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,129,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,81.27,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,19.74,15.3,,,percent of total billed charges,15.3% of total billed charges,89.01,69,,,percent of total billed charges,69% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,129,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,129,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,48.63,37.7,,,percent of total billed charges,37.70% of total billed charges,48.63,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,43.73,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,100.62,78,,,percent of total billed charges,78% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,129,
PTT  (LC #117079 APS),AFC30585730,CDM,305,RC,85730,HCPCS,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,39,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,24.57,63,,,percent of total billed charges,63% of total billed charges,10.51,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,39,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,39,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,22.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,14.7,37.7,,,percent of total billed charges,37.70% of total billed charges,14.7,37.7,,,percent of total billed charges,37.70% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,13.22,33.9,,,percent of total billed charges,33.9% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,39,
CENTROMERE ANTIBODY,30286038,CDM,302,RC,86038,HCPCS,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,54,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,34.02,63,,,percent of total billed charges,63% of total billed charges,21.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,46.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.31,33.9,,,percent of total billed charges,33.9% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,54,
CENTROMERE ANTIBODY,30286038,CDM,302,RC,86038,HCPCS,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,54,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,34.02,63,,,percent of total billed charges,63% of total billed charges,21.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,46.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.31,33.9,,,percent of total billed charges,33.9% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,54,
ANCA Profile LC,30286037,CDM,302,RC,86037,HCPCS,Outpatient,,,36.15,23.50,,31.81,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,36.15,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,22.77,63,,,percent of total billed charges,63% of total billed charges,21.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,5.53,15.3,,,percent of total billed charges,15.3% of total billed charges,24.94,69,,,percent of total billed charges,69% of total billed charges,36.15,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,36.15,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,36.15,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.63,37.7,,,percent of total billed charges,37.70% of total billed charges,13.63,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,28.2,78,,,percent of total billed charges,78% of total billed charges,36.15,100,,,percent of total billed charges,100% of total billed charges,29.86,82.6,,,percent of total billed charges,82.6% of total billed charges,29.86,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.53,36.15,
"C-Reactive Protein, Quant LC",30286140,CDM,302,RC,86140,HCPCS,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,36,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,22.68,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,36,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,36,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,12.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.18,36,
Cardiolipin Ab  (LC #117079 APS),AFC30286147,CDM,302,RC,86147,HCPCS,Outpatient,,,162,105.30,,142.56,88,,,percent of total billed charges,88% of total Billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,162,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,102.06,63,,,percent of total billed charges,63% of total billed charges,44.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,24.79,15.3,,,percent of total billed charges,15.3% of total billed charges,111.78,69,,,percent of total billed charges,69% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,97.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,54.92,33.9,,,percent of total billed charges,33.9% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,126.36,78,,,percent of total billed charges,78% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,162,
Beta 2 Glyco 1 Ab  (LC #117079 APS),AFC30286146,CDM,302,RC,86146,HCPCS,Outpatient,,,162,105.30,,142.56,88,,,percent of total billed charges,88% of total Billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,162,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,102.06,63,,,percent of total billed charges,63% of total billed charges,44.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,24.79,15.3,,,percent of total billed charges,15.3% of total billed charges,111.78,69,,,percent of total billed charges,69% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,97.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,54.92,33.9,,,percent of total billed charges,33.9% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,126.36,78,,,percent of total billed charges,78% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,162,
CCP Antibodies IgG/IgA LC,30286200,CDM,302,RC,86200,HCPCS,Outpatient,,,97,63.05,,85.36,88,,,percent of total billed charges,88% of total Billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,97,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,61.11,63,,,percent of total billed charges,63% of total billed charges,22.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.84,15.3,,,percent of total billed charges,15.3% of total billed charges,66.93,69,,,percent of total billed charges,69% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,32.88,33.9,,,percent of total billed charges,33.9% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,75.66,78,,,percent of total billed charges,78% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,13.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,97,
CYCLIC CITRULL PEPTIDE AB IGG,30286200,CDM,302,RC,86200,HCPCS,Outpatient,,,82,53.30,,72.16,88,,,percent of total billed charges,88% of total Billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,82,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,51.66,63,,,percent of total billed charges,63% of total billed charges,22.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,12.55,15.3,,,percent of total billed charges,15.3% of total billed charges,56.58,69,,,percent of total billed charges,69% of total billed charges,82,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,82,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,82,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,30.91,37.7,,,percent of total billed charges,37.70% of total billed charges,30.91,37.7,,,percent of total billed charges,37.70% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,27.8,33.9,,,percent of total billed charges,33.9% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,63.96,78,,,percent of total billed charges,78% of total billed charges,82,100,,,percent of total billed charges,100% of total billed charges,67.73,82.6,,,percent of total billed charges,82.6% of total billed charges,67.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,13.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,82,
ANTI DNA DBL STRAND,30286225,CDM,302,RC,86225,HCPCS,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,61,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,38.43,63,,,percent of total billed charges,63% of total billed charges,24.04,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,52.55,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,23,37.7,,,percent of total billed charges,37.70% of total billed charges,23,37.7,,,percent of total billed charges,37.70% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,20.68,33.9,,,percent of total billed charges,33.9% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,13.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,61,
ANTI DNA DBL STRAND,30286225,CDM,302,RC,86225,HCPCS,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,61,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,38.43,63,,,percent of total billed charges,63% of total billed charges,24.04,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,52.55,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,23,37.7,,,percent of total billed charges,37.70% of total billed charges,23,37.7,,,percent of total billed charges,37.70% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,20.68,33.9,,,percent of total billed charges,33.9% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,13.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,61,
86235 .ANA Comprehensive Plus Profile LC,30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,94,
86235 .ENA+DNA/DS+Antich+Centro+FA... LC,30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,94,
"Sjogren's Ab, SS-B LC",30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,94,61.10,91,82.72,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,94,
ANNA TYPE 1,30286256,CDM,302,RC,86256,HCPCS,Outpatient,,,53,34.45,,46.64,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,53,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,33.39,63,,,percent of total billed charges,63% of total billed charges,21.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,8.11,15.3,,,percent of total billed charges,15.3% of total billed charges,36.57,69,,,percent of total billed charges,69% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,46.09,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,17.97,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,41.34,78,,,percent of total billed charges,78% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,53,
BETA-2 TRANSFERRIN BODY FLUID,30286335,CDM,302,RC,86335,HCPCS,Outpatient,,,181,117.65,,159.28,88,,,percent of total billed charges,88% of total Billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,181,100,,,percent of total billed charges,100% of total billed charges,28.1,103,,,Fee Schedule,103% of WA Medicaid,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,114.03,63,,,percent of total billed charges,63% of total billed charges,51.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,27.69,15.3,,,percent of total billed charges,15.3% of total billed charges,124.89,69,,,percent of total billed charges,69% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,181,100,,,percent of total billed charges,100% of total billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,181,100,,,percent of total billed charges,100% of total billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,112.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,20.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,27.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.47,130,,,Fee Schedule,130% of WA Medicaid ,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,61.36,33.9,,,percent of total billed charges,33.9% of total billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,141.18,78,,,percent of total billed charges,78% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,29.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.21,181,
HYPERSENSITIVITY PNEUMONITIS,30286331,CDM,302,RC,86331,HCPCS,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,58,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,36.54,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,58,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,58,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,19.66,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,58,
T Cell Total Count LC,30286359,CDM,302,RC,86359,HCPCS,Outpatient,,,204,132.60,,179.52,88,,,percent of total billed charges,88% of total Billed charges,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,204,100,,,percent of total billed charges,100% of total billed charges,28.1,103,,,Fee Schedule,103% of WA Medicaid,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,128.52,63,,,percent of total billed charges,63% of total billed charges,66.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,31.21,15.3,,,percent of total billed charges,15.3% of total billed charges,140.76,69,,,percent of total billed charges,69% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,204,100,,,percent of total billed charges,100% of total billed charges,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,204,100,,,percent of total billed charges,100% of total billed charges,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,144.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,20.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,27.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.47,130,,,Fee Schedule,130% of WA Medicaid ,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,76.91,37.7,,,percent of total billed charges,37.70% of total billed charges,76.91,37.7,,,percent of total billed charges,37.70% of total billed charges,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,69.16,33.9,,,percent of total billed charges,33.9% of total billed charges,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,159.12,78,,,percent of total billed charges,78% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,38.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.72,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.21,204,
Rheumatoid Factor (RA) LC,30286431,CDM,302,RC,86431,HCPCS,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,36,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,22.68,63,,,percent of total billed charges,63% of total billed charges,9.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,36,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,36,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,21.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,12.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.51,36,
"RA Latex Turbid, LC",30286431,CDM,302,RC,86431,HCPCS,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,36,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,22.68,63,,,percent of total billed charges,63% of total billed charges,9.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,36,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,36,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,21.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,12.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.51,36,
RA TITER,30286431,CDM,302,RC,86431,HCPCS,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,31,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,19.53,63,,,percent of total billed charges,63% of total billed charges,9.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,21.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,10.51,33.9,,,percent of total billed charges,33.9% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.74,31,
86602 Hypersensitivity Pneumonitis,30286602,CDM,302,RC,86602,HCPCS,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,18.9,63,,,percent of total billed charges,63% of total billed charges,17.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,38.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.17,33.9,,,percent of total billed charges,33.9% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.59,38.93,
ANTIBODY BACTERIUM,30286609,CDM,302,RC,86609,HCPCS,Outpatient,,,284,184.60,,249.92,88,,,percent of total billed charges,88% of total Billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,284,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,178.92,63,,,percent of total billed charges,63% of total billed charges,22.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,43.45,15.3,,,percent of total billed charges,15.3% of total billed charges,195.96,69,,,percent of total billed charges,69% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,49.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,96.28,33.9,,,percent of total billed charges,33.9% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,221.52,78,,,percent of total billed charges,78% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,284,
ANTIBODY ASPERGILLUS,30286606,CDM,302,RC,86606,HCPCS,Outpatient,,,86,55.90,,75.68,88,,,percent of total billed charges,88% of total Billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,86,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,54.18,63,,,percent of total billed charges,63% of total billed charges,26.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.16,15.3,,,percent of total billed charges,15.3% of total billed charges,59.34,69,,,percent of total billed charges,69% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,86,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,86,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,57.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,32.42,37.7,,,percent of total billed charges,37.70% of total billed charges,32.42,37.7,,,percent of total billed charges,37.70% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,29.15,33.9,,,percent of total billed charges,33.9% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,67.08,78,,,percent of total billed charges,78% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,86,
ANTIBODY CYTOMEGALOVIRUS IGM,30286645,CDM,302,RC,86645,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,29.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,64.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,17.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,308,
EPSTEIN BARR (EA),30286663,CDM,302,RC,86663,HCPCS,Outpatient,,,198,128.70,,174.24,88,,,percent of total billed charges,88% of total Billed charges,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,63,,,percent of total billed charges,63% of total billed charges,22.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,30.29,15.3,,,percent of total billed charges,15.3% of total billed charges,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,50.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,67.12,33.9,,,percent of total billed charges,33.9% of total billed charges,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,198,
EPSTEIN-BARR VIRAL CAP IGG,30286665,CDM,302,RC,86665,HCPCS,Outpatient,,,152,98.80,,133.76,88,,,percent of total billed charges,88% of total Billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,152,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,95.76,63,,,percent of total billed charges,63% of total billed charges,31.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,23.26,15.3,,,percent of total billed charges,15.3% of total billed charges,104.88,69,,,percent of total billed charges,69% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,152,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,152,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,69.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,57.3,37.7,,,percent of total billed charges,37.70% of total billed charges,57.3,37.7,,,percent of total billed charges,37.70% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,51.53,33.9,,,percent of total billed charges,33.9% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,118.56,78,,,percent of total billed charges,78% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,152,
"HSV 1 IgG, Type Spec LC",30286695,CDM,302,RC,86695,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,43.47,63,,,percent of total billed charges,63% of total billed charges,23.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,50.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,23.39,33.9,,,percent of total billed charges,33.9% of total billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,13.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,69,
HERPES SIMPLEX TYPE 2 IGG,30286696,CDM,302,RC,86696,HCPCS,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,91,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,57.33,63,,,percent of total billed charges,63% of total billed charges,33.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.92,15.3,,,percent of total billed charges,15.3% of total billed charges,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,91,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,91,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,74.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,30.85,33.9,,,percent of total billed charges,33.9% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,91,
HERPES SIMPLEX TYPE I IGG,30286695,CDM,302,RC,86695,HCPCS,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,61,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,38.43,63,,,percent of total billed charges,63% of total billed charges,23.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,50.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,23,37.7,,,percent of total billed charges,37.70% of total billed charges,23,37.7,,,percent of total billed charges,37.70% of total billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,20.68,33.9,,,percent of total billed charges,33.9% of total billed charges,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,13.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.19,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,61,
Panel 083904 (HIV-1) LC,30286701,CDM,302,RC,86701,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,75,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,47.25,63,,,percent of total billed charges,63% of total billed charges,15.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,25.43,33.9,,,percent of total billed charges,33.9% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,75,
HIV-1 ANTIBODY,30286701,CDM,302,RC,86701,HCPCS,Outpatient,,,64,41.60,,56.32,88,,,percent of total billed charges,88% of total Billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,64,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,40.32,63,,,percent of total billed charges,63% of total billed charges,15.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,9.79,15.3,,,percent of total billed charges,15.3% of total billed charges,44.16,69,,,percent of total billed charges,69% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,64,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,64,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,24.13,37.7,,,percent of total billed charges,37.70% of total billed charges,24.13,37.7,,,percent of total billed charges,37.70% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,21.7,33.9,,,percent of total billed charges,33.9% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,78,,,percent of total billed charges,78% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,64,
"Hep A Ab, Total LC",30286708,CDM,302,RC,86708,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,58.59,63,,,percent of total billed charges,63% of total billed charges,21.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,47.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,31.53,33.9,,,percent of total billed charges,33.9% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,12.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,93,
"Hep B Surface Ab, Qual LC",30286706,CDM,302,RC,86706,HCPCS,Outpatient,,,155,100.75,,136.4,88,,,percent of total billed charges,88% of total Billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,155,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,97.65,63,,,percent of total billed charges,63% of total billed charges,18.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,23.72,15.3,,,percent of total billed charges,15.3% of total billed charges,106.95,69,,,percent of total billed charges,69% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,41.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,52.55,33.9,,,percent of total billed charges,33.9% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,120.9,78,,,percent of total billed charges,78% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,155,
MUMPS IGG,30286735,CDM,302,RC,86735,HCPCS,Outpatient,,,204,132.60,,179.52,88,,,percent of total billed charges,88% of total Billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,204,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,128.52,63,,,percent of total billed charges,63% of total billed charges,22.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,31.21,15.3,,,percent of total billed charges,15.3% of total billed charges,140.76,69,,,percent of total billed charges,69% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,204,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,204,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,49.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,76.91,37.7,,,percent of total billed charges,37.70% of total billed charges,76.91,37.7,,,percent of total billed charges,37.70% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,69.16,33.9,,,percent of total billed charges,33.9% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,159.12,78,,,percent of total billed charges,78% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,204,
Parvo B19 IgM LC,30286747,CDM,302,RC,86747,HCPCS,Outpatient,,,62.7,40.76,,55.18,88,,,percent of total billed charges,88% of total Billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,62.7,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,39.5,63,,,percent of total billed charges,63% of total billed charges,26.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,9.59,15.3,,,percent of total billed charges,15.3% of total billed charges,43.26,69,,,percent of total billed charges,69% of total billed charges,62.7,100,,,percent of total billed charges,100% of total billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,62.7,100,,,percent of total billed charges,100% of total billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,62.7,100,,,percent of total billed charges,100% of total billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,57.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,23.64,37.7,,,percent of total billed charges,37.70% of total billed charges,23.64,37.7,,,percent of total billed charges,37.70% of total billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,21.26,33.9,,,percent of total billed charges,33.9% of total billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,48.91,78,,,percent of total billed charges,78% of total billed charges,62.7,100,,,percent of total billed charges,100% of total billed charges,51.79,82.6,,,percent of total billed charges,82.6% of total billed charges,51.79,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,15.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,62.7,
Rickettsia Antibody LC,30286757,CDM,302,RC,86757,HCPCS,Outpatient,,,381,247.65,,335.28,88,,,percent of total billed charges,88% of total Billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,381,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,240.03,63,,,percent of total billed charges,63% of total billed charges,33.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,58.29,15.3,,,percent of total billed charges,15.3% of total billed charges,262.89,69,,,percent of total billed charges,69% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,381,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,381,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,74.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,129.16,33.9,,,percent of total billed charges,33.9% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,297.18,78,,,percent of total billed charges,78% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,381,
RUBELLA VIRUS AB IGM EIA,30086762,CDM,300,RC,86762,HCPCS,Outpatient,,,247,160.55,,217.36,88,,,percent of total billed charges,88% of total Billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,247,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,155.61,63,,,percent of total billed charges,63% of total billed charges,25.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,37.79,15.3,,,percent of total billed charges,15.3% of total billed charges,170.43,69,,,percent of total billed charges,69% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,83.73,33.9,,,percent of total billed charges,33.9% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,192.66,78,,,percent of total billed charges,78% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,247,
Toxoplasma Abs IgM LC,30286778,CDM,302,RC,86778,HCPCS,Outpatient,,,309,200.85,,271.92,88,,,percent of total billed charges,88% of total Billed charges,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,309,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,194.67,63,,,percent of total billed charges,63% of total billed charges,25.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,47.28,15.3,,,percent of total billed charges,15.3% of total billed charges,213.21,69,,,percent of total billed charges,69% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,309,100,,,percent of total billed charges,100% of total billed charges,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,309,100,,,percent of total billed charges,100% of total billed charges,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,55.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,104.75,33.9,,,percent of total billed charges,33.9% of total billed charges,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,241.02,78,,,percent of total billed charges,78% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,14.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.41,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,309,
"West Nile Virus Antibody, CSF LC",30286789,CDM,302,RC,86789,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,25.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,146,
Thyroglobulin Anttibody LC,30286800,CDM,302,RC,86800,HCPCS,Outpatient,,,363,235.95,,319.44,88,,,percent of total billed charges,88% of total Billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,363,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,228.69,63,,,percent of total billed charges,63% of total billed charges,27.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,55.54,15.3,,,percent of total billed charges,15.3% of total billed charges,250.47,69,,,percent of total billed charges,69% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,363,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,363,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,60.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,123.06,33.9,,,percent of total billed charges,33.9% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,283.14,78,,,percent of total billed charges,78% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,16.06,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,363,
Hep C Virus AB LC,30286803,CDM,302,RC,86803,HCPCS,Outpatient,,,174,113.10,,153.12,88,,,percent of total billed charges,88% of total Billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,109.62,63,,,percent of total billed charges,63% of total billed charges,24.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,54.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.41,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,174,
Antibody Screen LC,30086850,CDM,300,RC,86850,HCPCS,Outpatient,,,188,122.20,,165.44,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,188,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,118.44,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,28.76,15.3,,,percent of total billed charges,15.3% of total billed charges,129.72,69,,,percent of total billed charges,69% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,188,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,188,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,63.73,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,146.64,78,,,percent of total billed charges,78% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,202.15,
Rh Only,30086901,CDM,300,RC,86901,HCPCS,Outpatient,,,262,170.30,,230.56,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,262,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,165.06,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,40.09,15.3,,,percent of total billed charges,15.3% of total billed charges,180.78,69,,,percent of total billed charges,69% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,262,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,262,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,88.82,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,204.36,78,,,percent of total billed charges,78% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,262,
ABO LC,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
Urine CUL LC,30687086,CDM,306,RC,87086,HCPCS,Outpatient,,,166,107.90,,146.08,88,,,percent of total billed charges,88% of total Billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,166,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,104.58,63,,,percent of total billed charges,63% of total billed charges,14.12,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,25.4,15.3,,,percent of total billed charges,15.3% of total billed charges,114.54,69,,,percent of total billed charges,69% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,30.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,56.27,33.9,,,percent of total billed charges,33.9% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,129.48,78,,,percent of total billed charges,78% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,8.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,166,
Chlamydia Culture LC,30687110,CDM,306,RC,87110,HCPCS,Outpatient,,,378,245.70,,332.64,88,,,percent of total billed charges,88% of total Billed charges,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,378,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,238.14,63,,,percent of total billed charges,63% of total billed charges,34.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,57.83,15.3,,,percent of total billed charges,15.3% of total billed charges,260.82,69,,,percent of total billed charges,69% of total billed charges,378,100,,,percent of total billed charges,100% of total billed charges,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,378,100,,,percent of total billed charges,100% of total billed charges,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,378,100,,,percent of total billed charges,100% of total billed charges,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,74.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,142.51,37.7,,,percent of total billed charges,37.70% of total billed charges,142.51,37.7,,,percent of total billed charges,37.70% of total billed charges,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,128.14,33.9,,,percent of total billed charges,33.9% of total billed charges,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,294.84,78,,,percent of total billed charges,78% of total billed charges,378,100,,,percent of total billed charges,100% of total billed charges,312.23,82.6,,,percent of total billed charges,82.6% of total billed charges,312.23,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,19.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.6,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,378,
"Smear, Primary Src w/Interp LC",30687209,CDM,306,RC,87209,HCPCS,Outpatient,,,97,63.05,,85.36,88,,,percent of total billed charges,88% of total Billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,97,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,61.11,63,,,percent of total billed charges,63% of total billed charges,31.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,14.84,15.3,,,percent of total billed charges,15.3% of total billed charges,66.93,69,,,percent of total billed charges,69% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,68.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,32.88,33.9,,,percent of total billed charges,33.9% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,75.66,78,,,percent of total billed charges,78% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,18.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,97,
ACID FAST SMEAR,30687206,CDM,306,RC,87206,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.44,63,,,percent of total billed charges,63% of total billed charges,9.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,20.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,29.83,33.9,,,percent of total billed charges,33.9% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,88,
VIRAL CULTURE SHELL,30687254,CDM,306,RC,87254,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,55.44,63,,,percent of total billed charges,63% of total billed charges,34.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,74.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,29.83,33.9,,,percent of total billed charges,33.9% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,19.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,88,
ADENOVIRUS ANTIGEN,30087260,CDM,300,RC,87260,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,250,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,157.5,63,,,percent of total billed charges,63% of total billed charges,25.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,250,100,,,percent of total billed charges,100% of total billed charges,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,250,100,,,percent of total billed charges,100% of total billed charges,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,55.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,84.75,33.9,,,percent of total billed charges,33.9% of total billed charges,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,14.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,250,
INFLUENZA AB AG BY DFA,30687276,CDM,306,RC,87276,HCPCS,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,55,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,34.65,63,,,percent of total billed charges,63% of total billed charges,28.12,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,55,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,55,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,61.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,18.65,33.9,,,percent of total billed charges,33.9% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,61.46,
PARAINFLUENZA BY DFA,30687279,CDM,306,RC,87279,HCPCS,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,61,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,38.43,63,,,percent of total billed charges,63% of total billed charges,28.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,62.84,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,23,37.7,,,percent of total billed charges,37.70% of total billed charges,23,37.7,,,percent of total billed charges,37.70% of total billed charges,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,20.68,33.9,,,percent of total billed charges,33.9% of total billed charges,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,16.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,62.84,
INFLUENZA B AG BY DFA,30687275,CDM,306,RC,87275,HCPCS,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,60.48,63,,,percent of total billed charges,63% of total billed charges,21.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,46.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,32.54,33.9,,,percent of total billed charges,33.9% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,96,
VIRAL RESP SCREEN BY DFA,30087299,CDM,300,RC,87299,HCPCS,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,54,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,34.02,63,,,percent of total billed charges,63% of total billed charges,28.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,61.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,18.31,33.9,,,percent of total billed charges,33.9% of total billed charges,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.1,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,61.58,
87328 cryptosporidium LC,30687328,CDM,306,RC,87328,HCPCS,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,24.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,13.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,113,
HBsAG Screen LC,30687340,CDM,306,RC,87340,HCPCS,Outpatient,,,159,103.35,,139.92,88,,,percent of total billed charges,88% of total Billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,159,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,100.17,63,,,percent of total billed charges,63% of total billed charges,18.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,24.33,15.3,,,percent of total billed charges,15.3% of total billed charges,109.71,69,,,percent of total billed charges,69% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,159,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,159,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,39.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,53.9,33.9,,,percent of total billed charges,33.9% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,124.02,78,,,percent of total billed charges,78% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,10.43,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,159,
HIV 1 and2 LC,30087389,CDM,300,RC,87389,HCPCS,Outpatient,,,57,37.05,,50.16,88,,,percent of total billed charges,88% of total Billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,57,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,35.91,63,,,percent of total billed charges,63% of total billed charges,42.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,8.72,15.3,,,percent of total billed charges,15.3% of total billed charges,39.33,69,,,percent of total billed charges,69% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,57,100,,,percent of total billed charges,100% of total billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,57,100,,,percent of total billed charges,100% of total billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,92.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,21.49,37.7,,,percent of total billed charges,37.70% of total billed charges,21.49,37.7,,,percent of total billed charges,37.70% of total billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,19.32,33.9,,,percent of total billed charges,33.9% of total billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,44.46,78,,,percent of total billed charges,78% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,24.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,92.1,
Clostridium difficile Quik Chek Complete,30687449,CDM,306,RC,87449,HCPCS,Outpatient,,,185,120.25,,162.8,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,185,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,116.55,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,28.31,15.3,,,percent of total billed charges,15.3% of total billed charges,127.65,69,,,percent of total billed charges,69% of total billed charges,185,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,185,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,185,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,69.75,37.7,,,percent of total billed charges,37.70% of total billed charges,69.75,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,62.72,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,144.3,78,,,percent of total billed charges,78% of total billed charges,185,100,,,percent of total billed charges,100% of total billed charges,152.81,82.6,,,percent of total billed charges,82.6% of total billed charges,152.81,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,185,
CHLAMYDIA PNEUMONIAE PCR,30687486,CDM,306,RC,87486,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,52.29,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.7,134.21,
87481 Candidiasis Panel AVR,30687481,CDM,306,RC,87481,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87481 Vaginosis/Vaginitis Panel AVR,30687481,CDM,306,RC,87481,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87481 Cervicitis/Vaginitis Panel AVR,30687481,CDM,306,RC,87481,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87481 Vaginosis/Vaginitis Extended Panel AVR,30687481,CDM,306,RC,87481,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87481 Standard Panel AVR,30687481,CDM,306,RC,87481,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87481 Comprehensive UTI Panel AVR,30687481,CDM,306,RC,87481,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87491 Leukorrhea Panel - Extended AVR,30180185,CDM,306,RC,87491,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
CHLAMYDIA TRACH AMP PROBE,30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,213,138.45,,187.44,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.19,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,32.59,15.3,,,percent of total billed charges,15.3% of total billed charges,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,72.21,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,213,
87510 GardnVerella vaginalis by DNA Prb LC 180026,30687510,CDM,306,RC,87510,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,35.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,76.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,31.53,33.9,,,percent of total billed charges,33.9% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,93,
87511 Cervicitis/Vaginitis Panel AVR,30687511,CDM,306,RC,87511,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87511 PID/Infertility Panel AVR,30687511,CDM,306,RC,87511,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87511 Vaginosis/Vaginitis Extended Panel AVR,30687511,CDM,306,RC,87511,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
"Herpes Simplex Virus (HSV) Types 1 and 2, NAA LC",30687529,CDM,306,RC,87529,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,75.6,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,134.21,
87529 HSV1 and HSV2 AVR,30687529,CDM,306,RC,87529,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87529 Genital Ulcer Panel AVR,30687529,CDM,306,RC,87529,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87538 HIV-2 Qual RNA LC,30687538,CDM,306,RC,87538,HCPCS,Outpatient,,,123,79.95,,108.24,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,123,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,77.49,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,18.82,15.3,,,percent of total billed charges,15.3% of total billed charges,84.87,69,,,percent of total billed charges,69% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,123,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,123,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,46.37,37.7,,,percent of total billed charges,37.70% of total billed charges,46.37,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,41.7,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,95.94,78,,,percent of total billed charges,78% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,134.21,
87556 MTB detection by DNA or RNA,30687556,CDM,306,RC,87556,HCPCS,Outpatient,,,107,69.55,,94.16,88,,,percent of total billed charges,88% of total Billed charges,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,107,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,67.41,63,,,percent of total billed charges,63% of total billed charges,72.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,16.37,15.3,,,percent of total billed charges,15.3% of total billed charges,73.83,69,,,percent of total billed charges,69% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,107,100,,,percent of total billed charges,100% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,107,100,,,percent of total billed charges,100% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,159.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,36.27,33.9,,,percent of total billed charges,33.9% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,83.46,78,,,percent of total billed charges,78% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,42.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,41.68,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.37,159.42,
NEISSERIA GONORR AMP PROBE,30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,213,138.45,,187.44,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.19,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,32.59,15.3,,,percent of total billed charges,15.3% of total billed charges,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,72.21,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,213,
"Neisseria gonorrhoeae, NAA LC",30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,251,163.15,,220.88,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,251,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,158.13,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,38.4,15.3,,,percent of total billed charges,15.3% of total billed charges,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,251,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,251,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,85.09,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,251,
NEISSERIA GONORR AMP PROBE,30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,165,107.25,,145.2,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,165,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,103.95,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,55.94,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,165,
87591 N.Gonorrhea (GeneXpert),30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,75.6,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,134.21,
87591 N.Gonorrhea (GeneXpert),30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,75.6,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,134.21,
87591 Cervicitis/Vaginitis Panel AVR,30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87591 Chlamydia/Gonorrhea Panel AVR,30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87591 PID/Infertility Panel AVR,30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87591 Leukorrhea Panel AVR,30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87591 Vaginosis/Vaginitis Extended Panel AVR,30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87591 Leukorrhea Panel - Extended AVR,30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87624 HPV Aptima LC,30687624,CDM,306,RC,87624,HCPCS,Outpatient,,,145,94.25,,127.6,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,145,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,91.35,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,22.19,15.3,,,percent of total billed charges,15.3% of total billed charges,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,49.16,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,145,
RESP VIRUS 12-25 TARGETS,30687633,CDM,306,RC,87633,HCPCS,Outpatient,,,830,539.50,,730.4,88,,,percent of total billed charges,88% of total Billed charges,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,830,100,,,percent of total billed charges,100% of total billed charges,100.54,103,,,Fee Schedule,103% of WA Medicaid,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,522.9,63,,,percent of total billed charges,63% of total billed charges,729.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,126.99,15.3,,,percent of total billed charges,15.3% of total billed charges,572.7,69,,,percent of total billed charges,69% of total billed charges,830,100,,,percent of total billed charges,100% of total billed charges,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,830,100,,,percent of total billed charges,100% of total billed charges,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,830,100,,,percent of total billed charges,100% of total billed charges,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,1594.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,72.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,99.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.89,130,,,Fee Schedule,130% of WA Medicaid ,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,312.91,37.7,,,percent of total billed charges,37.70% of total billed charges,312.91,37.7,,,percent of total billed charges,37.70% of total billed charges,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,281.37,33.9,,,percent of total billed charges,33.9% of total billed charges,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,647.4,78,,,percent of total billed charges,78% of total billed charges,830,100,,,percent of total billed charges,100% of total billed charges,685.58,82.6,,,percent of total billed charges,82.6% of total billed charges,685.58,82.6,,,percent of total billed charges,82.6% of total billed charges,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,420.94,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,416.78,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.3,1594.18,
87634 RSV (GeneXpert),30684634,CDM,306,RC,87634,HCPCS,Outpatient,,,179,116.35,,157.52,88,,,percent of total billed charges,88% of total Billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,179,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,112.77,63,,,percent of total billed charges,63% of total billed charges,122.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,27.39,15.3,,,percent of total billed charges,15.3% of total billed charges,123.51,69,,,percent of total billed charges,69% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,268.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,60.68,33.9,,,percent of total billed charges,33.9% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,139.62,78,,,percent of total billed charges,78% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,268.51,
87653 Aerobic Vaginitis Panel AVR,30687563,CDM,306,RC,87653,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87653 Comprehensive UTI Panel AVR,30687653,CDM,306,RC,87653,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
TRICHOMONAS VAGIN DIR PROBE,30687661,CDM,306,RC,87661,HCPCS,Outpatient,,,179,116.35,,157.52,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,179,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,112.77,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,27.39,15.3,,,percent of total billed charges,15.3% of total billed charges,123.51,69,,,percent of total billed charges,69% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,60.68,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,139.62,78,,,percent of total billed charges,78% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,179,
87510 GardnVerella vaginalis by DNA Prb LC 180026,30687660,CDM,306,RC,87660,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,35.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,76.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,31.53,33.9,,,percent of total billed charges,33.9% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,93,
87661 Cervicitis/Vaginitis Panel AVR,30687661,CDM,306,RC,87661,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87661 Leukorrhea Panel AVR,30687661,CDM,306,RC,87661,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87661 Vaginosis/Vaginitis Panel AVR,30687661,CDM,306,RC,87661,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87661 PID/Infertility Panel AVR,30687661,CDM,306,RC,87661,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87661 Vaginosis/Vaginitis Extended Panel AVR,30687661,CDM,306,RC,87661,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
"Respiratory Profile, PCR LC",30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,717,466.05,,630.96,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,717,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,451.71,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,109.7,15.3,,,percent of total billed charges,15.3% of total billed charges,494.73,69,,,percent of total billed charges,69% of total billed charges,717,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,717,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,717,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,270.31,37.7,,,percent of total billed charges,37.70% of total billed charges,270.31,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,243.06,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,559.26,78,,,percent of total billed charges,78% of total billed charges,717,100,,,percent of total billed charges,100% of total billed charges,592.24,82.6,,,percent of total billed charges,82.6% of total billed charges,592.24,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,717,
Bacterial Vaginosis NAA LC,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,165,107.25,,145.2,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,165,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,103.95,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,55.94,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,165,
87798 Standard Panel AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87798 Vaginosis/Vaginitis Extended Panel AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87798 Vaginosis/Vaginitis Panel AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87798 Cervicitis/Vaginitis Panel AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87798 Mycoplasma Panel AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87798 Aerobic Vaginitis Panel AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87798 PID/Infertility Panel AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87798 Bacterial Vaginosis Panel AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87798 Comprehensive UTI Panel AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
87798 Genital Ulcer Panel A,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
"87804 Sofia Flu A, B",30687804,CDM,306,RC,87804,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,63,63,,,percent of total billed charges,63% of total billed charges,28.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,63.3,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,16.71,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,100,
BV+CG+TRICH(NAA)+YstCUL LC,30687905,CDM,306,RC,87905,HCPCS,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,18,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,11.34,63,,,percent of total billed charges,63% of total billed charges,21.38,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,18,100,,,percent of total billed charges,100% of total billed charges,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,18,100,,,percent of total billed charges,100% of total billed charges,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,46.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.79,37.7,,,percent of total billed charges,37.70% of total billed charges,6.79,37.7,,,percent of total billed charges,37.70% of total billed charges,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.1,33.9,,,percent of total billed charges,33.9% of total billed charges,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,12.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.75,46.74,
88173 Cytopathology Interpretation and Report,31188173,CDM,311,RC,88173,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,34.17,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,24.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.13,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.57,202.15,
31188175,31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,110,71.50,,96.8,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,110,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,69.3,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,75.9,69,,,percent of total billed charges,69% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,37.29,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,85.8,78,,,percent of total billed charges,78% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,110,
88185 Flow cytometry,31188185,CDM,311,RC,88185,HCPCS,Outpatient,,,174,113.10,,153.12,88,,,percent of total billed charges,88% of total Billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,87,50,,,percent of total billed charges,50% of total Billed charges,109.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,174,100,,,percent of total billed charges,100% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,174,100,,,percent of total billed charges,100% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,107.62,61.85,,,percent of total billed charges,61.85% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87,50,,,percent of total billed charges,50% of total Billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87,50,,,percent of total billed charges,50% of total Billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,87,50,,,percent of total billed charges,50% of total Billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,87,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,174,
88305 Surgical Pathology- 1st Site LC,31088305,CDM,310,RC,88305,HCPCS,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,350,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,220.5,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,350,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,350,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,118.65,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,350,
Immunohistochemical Staining Program LC,31088341,CDM,310,RC,88341,HCPCS,Outpatient,,,198,128.70,,174.24,88,,,percent of total billed charges,88% of total Billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,99,50,,,percent of total billed charges,50% of total Billed charges,124.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,30.29,15.3,,,percent of total billed charges,15.3% of total billed charges,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,198,100,,,percent of total billed charges,100% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,198,100,,,percent of total billed charges,100% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,122.46,61.85,,,percent of total billed charges,61.85% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99,50,,,percent of total billed charges,50% of total Billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99,50,,,percent of total billed charges,50% of total Billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,99,50,,,percent of total billed charges,50% of total Billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,67.12,33.9,,,percent of total billed charges,33.9% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,99,50,,,percent of total billed charges,50% of total Billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,198,
88381 Manual Microdissection,30188381,CDM,301,RC,88381,HCPCS,Outpatient,,,361,234.65,,317.68,88,,,percent of total billed charges,88% of total Billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid,361,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,180.5,50,,,percent of total billed charges,50% of total Billed charges,227.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,55.23,15.3,,,percent of total billed charges,15.3% of total billed charges,249.09,69,,,percent of total billed charges,69% of total billed charges,361,100,,,percent of total billed charges,100% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,361,100,,,percent of total billed charges,100% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,361,100,,,percent of total billed charges,100% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,223.28,61.85,,,percent of total billed charges,61.85% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.5,50,,,percent of total billed charges,50% of total Billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.5,50,,,percent of total billed charges,50% of total Billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,180.5,50,,,percent of total billed charges,50% of total Billed charges,136.1,37.7,,,percent of total billed charges,37.70% of total billed charges,136.1,37.7,,,percent of total billed charges,37.70% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,122.38,33.9,,,percent of total billed charges,33.9% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,281.58,78,,,percent of total billed charges,78% of total billed charges,361,100,,,percent of total billed charges,100% of total billed charges,298.19,82.6,,,percent of total billed charges,82.6% of total billed charges,298.19,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,180.5,50,,,percent of total billed charges,50% of total Billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,361,
Small Bowel follow through,32074248,CDM,320,RC,74248,HCPCS,Outpatient,,,2325,1511.25,TC,2046,88,,,percent of total billed charges,88% of total Billed charges,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2325,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1464.75,63,,,percent of total billed charges,63% of total billed charges,89.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,355.73,15.3,,,percent of total billed charges,15.3% of total billed charges,1604.25,69,,,percent of total billed charges,69% of total billed charges,2325,100,,,percent of total billed charges,100% of total billed charges,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2325,100,,,percent of total billed charges,100% of total billed charges,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2325,100,,,percent of total billed charges,100% of total billed charges,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1438.01,61.85,,,percent of total billed charges,61.85% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,876.53,37.7,,,percent of total billed charges,37.70% of total billed charges,876.53,37.7,,,percent of total billed charges,37.70% of total billed charges,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,788.18,33.9,,,percent of total billed charges,33.9% of total billed charges,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1813.5,78,,,percent of total billed charges,78% of total billed charges,2325,100,,,percent of total billed charges,100% of total billed charges,1920.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1920.45,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,52.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,51.5,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.5,2325,
ALLERGEN INDIVIDUAL,30286003,CDM,302,RC,86003,HCPCS,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,12,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,7.56,63,,,percent of total billed charges,63% of total billed charges,9.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,19.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,4.52,37.7,,,percent of total billed charges,37.70% of total billed charges,4.52,37.7,,,percent of total billed charges,37.70% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,4.07,33.9,,,percent of total billed charges,33.9% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.84,19.96,
Anaerobic Culture,30687075,CDM,306,RC,87075,HCPCS,Outpatient,,,212,137.80,,186.56,88,,,percent of total billed charges,88% of total Billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,212,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,133.56,63,,,percent of total billed charges,63% of total billed charges,16.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,32.44,15.3,,,percent of total billed charges,15.3% of total billed charges,146.28,69,,,percent of total billed charges,69% of total billed charges,212,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,212,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,212,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,36.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,79.92,37.7,,,percent of total billed charges,37.70% of total billed charges,79.92,37.7,,,percent of total billed charges,37.70% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,71.87,33.9,,,percent of total billed charges,33.9% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,165.36,78,,,percent of total billed charges,78% of total billed charges,212,100,,,percent of total billed charges,100% of total billed charges,175.11,82.6,,,percent of total billed charges,82.6% of total billed charges,175.11,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,212,
CORTISOL STIM ADD,30082533,CDM,300,RC,82533,HCPCS,Outpatient,,,366,237.90,,322.08,88,,,percent of total billed charges,88% of total Billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,366,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,230.58,63,,,percent of total billed charges,63% of total billed charges,28.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,56,15.3,,,percent of total billed charges,15.3% of total billed charges,252.54,69,,,percent of total billed charges,69% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,62.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,124.07,33.9,,,percent of total billed charges,33.9% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,285.48,78,,,percent of total billed charges,78% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,366,
CT ABDOMEN W/W/O CONT,35274170,CDM,352,RC,74170,HCPCS,Outpatient,,,5423,3524.95,TC,4772.24,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3416.49,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3741.87,69,,,percent of total billed charges,69% of total billed charges,5423,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5423,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5423,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2044.47,37.7,,,percent of total billed charges,37.70% of total billed charges,2044.47,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1838.4,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4229.94,78,,,percent of total billed charges,78% of total billed charges,5423,100,,,percent of total billed charges,100% of total billed charges,4479.4,82.6,,,percent of total billed charges,82.6% of total billed charges,4479.4,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5423,
CT ABDOMEN W/CONTRAST,35274160,CDM,352,RC,74160,HCPCS,Outpatient,,,4568,2969.20,TC,4019.84,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4568,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2877.84,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3151.92,69,,,percent of total billed charges,69% of total billed charges,4568,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4568,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4568,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1722.14,37.7,,,percent of total billed charges,37.70% of total billed charges,1722.14,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1548.55,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3563.04,78,,,percent of total billed charges,78% of total billed charges,4568,100,,,percent of total billed charges,100% of total billed charges,3773.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3773.17,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4568,
CT ABDOMEN W/O CONTRAST,35274150,CDM,352,RC,74150,HCPCS,Outpatient,,,3182,2068.30,TC,2800.16,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3182,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2004.66,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2195.58,69,,,percent of total billed charges,69% of total billed charges,3182,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3182,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3182,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1199.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1199.61,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1078.7,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2481.96,78,,,percent of total billed charges,78% of total billed charges,3182,100,,,percent of total billed charges,100% of total billed charges,2628.33,82.6,,,percent of total billed charges,82.6% of total billed charges,2628.33,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3182,
CT Abdomen/Pelvis w/ + w/o Contrast,35274178,CDM,352,RC,74178,HCPCS,Outpatient,,,8672,5636.80,TC,7631.36,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,5463.36,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,5983.68,69,,,percent of total billed charges,69% of total billed charges,8672,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8672,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8672,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3269.34,37.7,,,percent of total billed charges,37.70% of total billed charges,3269.34,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2939.81,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6764.16,78,,,percent of total billed charges,78% of total billed charges,8672,100,,,percent of total billed charges,100% of total billed charges,7163.07,82.6,,,percent of total billed charges,82.6% of total billed charges,7163.07,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.9,8672,
CT ABD  PELVIS W/CONTRAST,35274177,CDM,352,RC,74177,HCPCS,Outpatient,,,8097,5263.05,TC,7125.36,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,5101.11,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,5586.93,69,,,percent of total billed charges,69% of total billed charges,8097,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8097,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8097,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3052.57,37.7,,,percent of total billed charges,37.70% of total billed charges,3052.57,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2744.88,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6315.66,78,,,percent of total billed charges,78% of total billed charges,8097,100,,,percent of total billed charges,100% of total billed charges,6688.12,82.6,,,percent of total billed charges,82.6% of total billed charges,6688.12,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.9,8097,
CT ABD  PELVIS W/O CONTRAST,35274176,CDM,352,RC,74176,HCPCS,Outpatient,,,5612,3647.80,TC,4938.56,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3535.56,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3872.28,69,,,percent of total billed charges,69% of total billed charges,5612,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,5612,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,5612,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2115.72,37.7,,,percent of total billed charges,37.70% of total billed charges,2115.72,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1902.47,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,4377.36,78,,,percent of total billed charges,78% of total billed charges,5612,100,,,percent of total billed charges,100% of total billed charges,4635.51,82.6,,,percent of total billed charges,82.6% of total billed charges,4635.51,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.9,5612,
CTA AORTA W/RUNOFFS WW/O CONT,35275635,CDM,352,RC,75635,HCPCS,Outpatient,,,7953,5169.45,TC,6998.64,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5010.39,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,5487.57,69,,,percent of total billed charges,69% of total billed charges,7953,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7953,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7953,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2998.28,37.7,,,percent of total billed charges,37.70% of total billed charges,2998.28,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2696.07,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6203.34,78,,,percent of total billed charges,78% of total billed charges,7953,100,,,percent of total billed charges,100% of total billed charges,6569.18,82.6,,,percent of total billed charges,82.6% of total billed charges,6569.18,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,7953,
CTA NECK WW/O CONTRAST,35170498,CDM,351,RC,70498,HCPCS,Outpatient,,,5213,3388.45,TC,4587.44,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3284.19,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3596.97,69,,,percent of total billed charges,69% of total billed charges,5213,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5213,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5213,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1965.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1965.3,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1767.21,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4066.14,78,,,percent of total billed charges,78% of total billed charges,5213,100,,,percent of total billed charges,100% of total billed charges,4305.94,82.6,,,percent of total billed charges,82.6% of total billed charges,4305.94,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5213,
CT Angio Abdomen and Pelvis,35274174,CDM,352,RC,74174,HCPCS,Outpatient,,,3829,2488.85,TC,3369.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,3829,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2412.27,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2642.01,69,,,percent of total billed charges,69% of total billed charges,3829,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3829,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3829,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1443.53,37.7,,,percent of total billed charges,37.70% of total billed charges,1443.53,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1298.03,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2986.62,78,,,percent of total billed charges,78% of total billed charges,3829,100,,,percent of total billed charges,100% of total billed charges,3162.75,82.6,,,percent of total billed charges,82.6% of total billed charges,3162.75,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,258.21,3829,
CT CHEST WW/O CONTRAST,35271270,CDM,352,RC,71270,HCPCS,Outpatient,,,5926,3851.90,TC,5214.88,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3733.38,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,4088.94,69,,,percent of total billed charges,69% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2008.91,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4622.28,78,,,percent of total billed charges,78% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5926,
CT CHEST W CONTRAST,35271260,CDM,352,RC,71260,HCPCS,Outpatient,,,4679,3041.35,TC,4117.52,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4679,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2947.77,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3228.51,69,,,percent of total billed charges,69% of total billed charges,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1763.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1763.98,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1586.18,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3649.62,78,,,percent of total billed charges,78% of total billed charges,4679,100,,,percent of total billed charges,100% of total billed charges,3864.85,82.6,,,percent of total billed charges,82.6% of total billed charges,3864.85,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4679,
CT CHEST WO CONTRAST,35271250,CDM,352,RC,71250,HCPCS,Outpatient,,,3344,2173.60,TC,2942.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3344,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2106.72,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2307.36,69,,,percent of total billed charges,69% of total billed charges,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1260.69,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1133.62,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2608.32,78,,,percent of total billed charges,78% of total billed charges,3344,100,,,percent of total billed charges,100% of total billed charges,2762.14,82.6,,,percent of total billed charges,82.6% of total billed charges,2762.14,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3344,
CT MAXILLOFACIAL W/W/O CO,35170488,CDM,351,RC,70488,HCPCS,Outpatient,,,2732,1775.80,TC,2404.16,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,2732,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1721.16,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1885.08,69,,,percent of total billed charges,69% of total billed charges,2732,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2732,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2732,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1029.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1029.96,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,926.15,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2130.96,78,,,percent of total billed charges,78% of total billed charges,2732,100,,,percent of total billed charges,100% of total billed charges,2256.63,82.6,,,percent of total billed charges,82.6% of total billed charges,2256.63,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,2732,
CT MAXILLOFACIAL W/CONT,35170487,CDM,351,RC,70487,HCPCS,Outpatient,,,2574,1673.10,TC,2265.12,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,2574,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1621.62,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1776.06,69,,,percent of total billed charges,69% of total billed charges,2574,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2574,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2574,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,970.4,37.7,,,percent of total billed charges,37.70% of total billed charges,970.4,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,872.59,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2007.72,78,,,percent of total billed charges,78% of total billed charges,2574,100,,,percent of total billed charges,100% of total billed charges,2126.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2126.12,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,2574,
CT MAXILLOFACIAL W/O CONT,35170480,CDM,351,RC,70480,HCPCS,Outpatient,,,3790,2463.50,TC,3335.2,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3790,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2387.7,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2615.1,69,,,percent of total billed charges,69% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3790,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3790,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1284.81,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2956.2,78,,,percent of total billed charges,78% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3790,
CT NECK W/W/O CONTRAST,35170492,CDM,351,RC,70492,HCPCS,Outpatient,,,4232,2750.80,TC,3724.16,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4232,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2666.16,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2920.08,69,,,percent of total billed charges,69% of total billed charges,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1595.46,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1434.65,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3300.96,78,,,percent of total billed charges,78% of total billed charges,4232,100,,,percent of total billed charges,100% of total billed charges,3495.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3495.63,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4232,
CT NECK W/CONTRAST,35170491,CDM,351,RC,70491,HCPCS,Outpatient,,,3972,2581.80,TC,3495.36,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,3972,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2502.36,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2740.68,69,,,percent of total billed charges,69% of total billed charges,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1497.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1497.44,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1346.51,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3098.16,78,,,percent of total billed charges,78% of total billed charges,3972,100,,,percent of total billed charges,100% of total billed charges,3280.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3280.87,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,3972,
CT NECK W/O CONTRAST,35170490,CDM,351,RC,70490,HCPCS,Outpatient,,,3058,1987.70,TC,2691.04,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3058,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1926.54,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2110.02,69,,,percent of total billed charges,69% of total billed charges,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1152.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1152.87,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1036.66,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2385.24,78,,,percent of total billed charges,78% of total billed charges,3058,100,,,percent of total billed charges,100% of total billed charges,2525.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2525.91,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3058,
Calcium,30082310,CDM,300,RC,82310,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,52.29,63,,,percent of total billed charges,63% of total billed charges,9.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,19.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,83,
Creatinine Urine,30082570,CDM,300,RC,82570,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,74,
E5621 Pooled Cryo,390P9012,CDM,390,RC,P9012,HCPCS,Outpatient,,,188,122.20,,165.44,88,,,percent of total billed charges,88% of total Billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,188,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,118.44,63,,,percent of total billed charges,63% of total billed charges,104.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,28.76,15.3,,,percent of total billed charges,15.3% of total billed charges,129.72,69,,,percent of total billed charges,69% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,188,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,188,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,63.73,33.9,,,percent of total billed charges,33.9% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,146.64,78,,,percent of total billed charges,78% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,60.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.76,437.85,
IgG LC,30083516,CDM,300,RC,83516,HCPCS,Outpatient,,,232,150.80,,204.16,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,232,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,35.5,15.3,,,percent of total billed charges,15.3% of total billed charges,160.08,69,,,percent of total billed charges,69% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,78.65,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,78,,,percent of total billed charges,78% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,232,
Influenza B,30087804,CDM,300,RC,87804,HCPCS,Outpatient,,,134,87.10,QW|59,117.92,88,,,percent of total billed charges,88% of total Billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,134,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,84.42,63,,,percent of total billed charges,63% of total billed charges,28.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,20.5,15.3,,,percent of total billed charges,15.3% of total billed charges,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,63.3,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,45.43,33.9,,,percent of total billed charges,33.9% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,16.71,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,134,
Iron,30083540,CDM,300,RC,83540,HCPCS,Outpatient,,,128,83.20,,112.64,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,128,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,80.64,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,43.39,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,128,
MG Tomo Diagnostic Bilat,40177062,CDM,401,RC,77062,HCPCS,Outpatient,,,139,90.35,TC,122.32,88,,,percent of total billed charges,88% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,69.5,50,,,percent of total billed charges,50% of total Billed charges,87.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,45.62,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,85.97,61.85,,,percent of total billed charges,61.85% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.5,50,,,percent of total billed charges,50% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.5,50,,,percent of total billed charges,50% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,69.5,50,,,percent of total billed charges,50% of total Billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69.5,50,,,percent of total billed charges,50% of total Billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.27,139,
MG Tomo Diagnostic Unilat,40177061,CDM,401,RC,77061,HCPCS,Outpatient,,,139,90.35,TC,122.32,88,,,percent of total billed charges,88% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,69.5,50,,,percent of total billed charges,50% of total Billed charges,87.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,45.62,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,85.97,61.85,,,percent of total billed charges,61.85% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.5,50,,,percent of total billed charges,50% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.5,50,,,percent of total billed charges,50% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,69.5,50,,,percent of total billed charges,50% of total Billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69.5,50,,,percent of total billed charges,50% of total Billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.27,139,
MG Tomo Screening,40377063,CDM,403,RC,77063,HCPCS,Outpatient,,,204,132.60,TC,179.52,88,,,percent of total billed charges,88% of total Billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,204,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,128.52,63,,,percent of total billed charges,63% of total billed charges,43.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,31.21,15.3,,,percent of total billed charges,15.3% of total billed charges,140.76,69,,,percent of total billed charges,69% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,204,100,,,percent of total billed charges,100% of total billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,204,100,,,percent of total billed charges,100% of total billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,98.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,76.91,37.7,,,percent of total billed charges,37.70% of total billed charges,76.91,37.7,,,percent of total billed charges,37.70% of total billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,69.16,33.9,,,percent of total billed charges,33.9% of total billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,159.12,78,,,percent of total billed charges,78% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,25.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.92,204,
WBC Diff Only,30585007,CDM,305,RC,85007,HCPCS,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,58,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,36.54,63,,,percent of total billed charges,63% of total billed charges,6.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,58,100,,,percent of total billed charges,100% of total billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,58,100,,,percent of total billed charges,100% of total billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,19.66,33.9,,,percent of total billed charges,33.9% of total billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,58,
Protoporphyrin (FEP/ZPP),30184202,CDM,301,RC,84202,HCPCS,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,220,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,138.6,63,,,percent of total billed charges,63% of total billed charges,25.11,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,33.66,15.3,,,percent of total billed charges,15.3% of total billed charges,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,220,100,,,percent of total billed charges,100% of total billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,220,100,,,percent of total billed charges,100% of total billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,54.88,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,74.58,33.9,,,percent of total billed charges,33.9% of total billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,14.49,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,220,
SHIGA TOXIN 2,30687899,CDM,306,RC,87899,HCPCS,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,61,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,38.43,63,,,percent of total billed charges,63% of total billed charges,28.12,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,61.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,23,37.7,,,percent of total billed charges,37.70% of total billed charges,23,37.7,,,percent of total billed charges,37.70% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,20.68,33.9,,,percent of total billed charges,33.9% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,61.46,
Testosterone Total,30084403,CDM,300,RC,84403,HCPCS,Outpatient,,,404,262.60,,355.52,88,,,percent of total billed charges,88% of total Billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,404,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,254.52,63,,,percent of total billed charges,63% of total billed charges,45.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,61.81,15.3,,,percent of total billed charges,15.3% of total billed charges,278.76,69,,,percent of total billed charges,69% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,404,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,404,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,98.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,136.96,33.9,,,percent of total billed charges,33.9% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,315.12,78,,,percent of total billed charges,78% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,26.06,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,404,
Total Iron Binding Capacity,30083550,CDM,300,RC,83550,HCPCS,Outpatient,,,172,111.80,,151.36,88,,,percent of total billed charges,88% of total Billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,172,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,108.36,63,,,percent of total billed charges,63% of total billed charges,15.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,26.32,15.3,,,percent of total billed charges,15.3% of total billed charges,118.68,69,,,percent of total billed charges,69% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,33.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,58.31,33.9,,,percent of total billed charges,33.9% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,134.16,78,,,percent of total billed charges,78% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,172,
ULTRASOUND BIOPHYSICAL PROFILE,40276818,CDM,402,RC,76818,HCPCS,Outpatient,,,519,337.35,TC,456.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,519,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,326.97,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,358.11,69,,,percent of total billed charges,69% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,175.94,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,404.82,78,,,percent of total billed charges,78% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,519,
Urine Creatinine,30182570,CDM,301,RC,82570,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,74,
West Nile Virus EIA IgM LC,30286788,CDM,302,RC,86788,HCPCS,Outpatient,,,153,99.45,,134.64,88,,,percent of total billed charges,88% of total Billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,153,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,96.39,63,,,percent of total billed charges,63% of total billed charges,29.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,23.41,15.3,,,percent of total billed charges,15.3% of total billed charges,105.57,69,,,percent of total billed charges,69% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,64.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,51.87,33.9,,,percent of total billed charges,33.9% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,119.34,78,,,percent of total billed charges,78% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,17.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,153,
XR Hysterosalpingogram S and I,74740,CDM,320,RC,74740,HCPCS,Outpatient,,,276,179.40,TC,242.88,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,276,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,173.88,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,42.23,15.3,,,percent of total billed charges,15.3% of total billed charges,190.44,69,,,percent of total billed charges,69% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,276,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,276,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,104.05,37.7,,,percent of total billed charges,37.70% of total billed charges,104.05,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,93.56,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,215.28,78,,,percent of total billed charges,78% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.23,934.91,
0001A- Pfizer-Biontech Covid-19 Vaccine - 1st Dose,0001A,CDM,771,RC,,,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,9.34,17.304,,,percent of total billed charges,17.304% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,33.4,61.85,,,percent of total billed charges,61.85% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.25,17.136,,,percent of total billed charges,17.136% of total billed charges,11.79,21.84,,,percent of total billed charges,21.84% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,18.31,33.9,,,percent of total billed charges,33.9% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
0001A- Pfizer-Biontech Covid-19 Vaccine - 1st Dose,7710001A,CDM,771,RC,,,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,17.63,33.9,,,percent of total billed charges,33.9% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
0002A- Pfizer-Biontech Covid-19 Vaccine - 2nd Dose,0002A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
Immunization administration by intramuscular injection of se,7710002A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
0011A- Moderna Covid-19 Vaccine - 1st Dose,0011A,CDM,771,RC,,,Outpatient,,,51,33.15,,44.88,88,,,percent of total billed charges,88% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,8.83,17.304,,,percent of total billed charges,17.304% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,32.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,15.3,,,percent of total billed charges,15.3% of total billed charges,35.19,69,,,percent of total billed charges,69% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,31.54,61.85,,,percent of total billed charges,61.85% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.74,17.136,,,percent of total billed charges,17.136% of total billed charges,11.14,21.84,,,percent of total billed charges,21.84% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,17.29,33.9,,,percent of total billed charges,33.9% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,39.78,78,,,percent of total billed charges,78% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,51,
Moderna Covid-19 Vaccine - 1st Dose,7710011A,CDM,771,RC,,,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,17.63,33.9,,,percent of total billed charges,33.9% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
Moderna Covid-19 Vaccine - 2nd Dose,0012A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
Moderna Covid-19 Vaccine - 2nd Dose,7710012A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
0031A Janssen Covid-19 Vaccine Administration Charge,0031A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
0031A Janssen Covid-19 Vaccine Administration Charge,0031A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
0064A- Moderna Covid-19 Vaccine - Booster Dose,0064A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
0071A- Pfizer-Biontech Covid-19 Pediatric Vaccine - 1st Dose,0071A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
0072A- Pfizer-Biontech Covid-19 Pediatric Vaccine - 2nd Dose,0072A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
0074A- Pfizer-Biontech Covid-19 Pediatric Vaccine - Booster,0074A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
0081A- Pfizer-Biontech Covid-19 Pediatric (6m-4y) Vaccine Ad,0081A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
0082A- Pfizer-Biontech Covid-19 Pediatric (6m-4y) Vaccine Ad,0082A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
0124A - Pfizer-Biontech Covid-19 Bivalent Booster Administra,0124A,CDM,771,RC,,,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,20.76,17.304,,,percent of total billed charges,17.304% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.56,17.136,,,percent of total billed charges,17.136% of total billed charges,26.21,21.84,,,percent of total billed charges,21.84% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,120,
0134A - Moderna Covid-19 Bivalent Booster Administration Cha,0134A,CDM,771,RC,,,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,20.76,17.304,,,percent of total billed charges,17.304% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.56,17.136,,,percent of total billed charges,17.136% of total billed charges,26.21,21.84,,,percent of total billed charges,21.84% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,120,
THER/PROPH/DIAG INJ IV PUSH,96374,CDM,940,RC,96374,HCPCS,Outpatient,,,157,102.05,,138.16,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,157,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,24.02,15.3,,,percent of total billed charges,15.3% of total billed charges,108.33,69,,,percent of total billed charges,69% of total billed charges,157,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,157,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,157,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,59.19,37.7,,,percent of total billed charges,37.70% of total billed charges,59.19,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,53.22,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,122.46,78,,,percent of total billed charges,78% of total billed charges,157,100,,,percent of total billed charges,100% of total billed charges,129.68,82.6,,,percent of total billed charges,82.6% of total billed charges,129.68,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.02,826.71,
AQUATIC EXER/15MIN/-GP,42097113,CDM,420,RC,97113,HCPCS,Outpatient,,,250,162.50,GP,220,88,,,percent of total billed charges,88% of total Billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicaid,250,100,,,percent of total billed charges,100% of total billed charges,21.83,103,,,Fee Schedule,103% of WA Medicaid,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,157.5,63,,,percent of total billed charges,63% of total billed charges,65.28,175,,,Fee Schedule,175% of Medicare OPPS Rate,21.83,100,,,Fee Schedule,100% of WA Medicaid,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,250,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,250,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,147.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,22.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.38,130,,,Fee Schedule,130% of WA Medicaid ,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,84.75,33.9,,,percent of total billed charges,33.9% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.83,250,
ELECTROCARDIOGRAM,93005,CDM,730,RC,93005,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,24.47,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,302.4,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,73.44,15.3,,,percent of total billed charges,15.3% of total billed charges,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.89,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,162.72,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,480,
81479 Bill Molec Unlisted Procedure (81206 +81207) ZB3RV,31081479,CDM,310,RC,81479,HCPCS,Outpatient,,,1552,1008.80,,1365.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,39.02,100,,,Fee Schedule,100% of WA Medicaid,1552,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,977.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,39.02,100,,,Fee Schedule,100% of WA Medicaid,237.46,15.3,,,percent of total billed charges,15.3% of total billed charges,1070.88,69,,,percent of total billed charges,69% of total billed charges,1552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,585.1,37.7,,,percent of total billed charges,37.70% of total billed charges,585.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,526.13,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1210.56,78,,,percent of total billed charges,78% of total billed charges,1552,100,,,percent of total billed charges,100% of total billed charges,1281.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1281.95,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,1552,
88108 Bill Cyto Non-Gyn Conc Tech Avero,31188108,CDM,311,RC,88108,HCPCS,Outpatient,,,172,111.80,,151.36,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,172,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,108.36,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,26.32,15.3,,,percent of total billed charges,15.3% of total billed charges,118.68,69,,,percent of total billed charges,69% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,58.31,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,134.16,78,,,percent of total billed charges,78% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,172,
Gyn Cytology - Pathologist Interpretation,31188141,CDM,311,RC,88141,HCPCS,Outpatient,,,161,104.65,,141.68,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,15.56,100,,,Fee Schedule,100% of WA Medicaid,161,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,101.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.56,100,,,Fee Schedule,100% of WA Medicaid,24.63,15.3,,,percent of total billed charges,15.3% of total billed charges,111.09,69,,,percent of total billed charges,69% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,161,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,161,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,60.7,37.7,,,percent of total billed charges,37.70% of total billed charges,60.7,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,54.58,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,125.58,78,,,percent of total billed charges,78% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,161,
88142 AP Bill Gyn Cytology Liquid Prep,31188142,CDM,311,RC,88142,HCPCS,Outpatient,,,66,42.90,,58.08,88,,,percent of total billed charges,88% of total Billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,66,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,41.58,63,,,percent of total billed charges,63% of total billed charges,35.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,30.39,150,,,Fee Schedule,150% of Medicare OPPS rate,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,77.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,22.37,33.9,,,percent of total billed charges,33.9% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,77.49,
Labcorp 88274 Molecular Cytogenetics ISH 25-99,31088274,CDM,310,RC,88274,HCPCS,Outpatient,,,1008,655.20,,887.04,88,,,percent of total billed charges,88% of total Billed charges,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,1008,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,635.04,63,,,percent of total billed charges,63% of total billed charges,74.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,63.57,150,,,Fee Schedule,150% of Medicare OPPS rate,695.52,69,,,percent of total billed charges,69% of total billed charges,1008,100,,,percent of total billed charges,100% of total billed charges,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,1008,100,,,percent of total billed charges,100% of total billed charges,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,1008,100,,,percent of total billed charges,100% of total billed charges,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,162.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,380.02,37.7,,,percent of total billed charges,37.70% of total billed charges,380.02,37.7,,,percent of total billed charges,37.70% of total billed charges,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,341.71,33.9,,,percent of total billed charges,33.9% of total billed charges,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,786.24,78,,,percent of total billed charges,78% of total billed charges,1008,100,,,percent of total billed charges,100% of total billed charges,832.61,82.6,,,percent of total billed charges,82.6% of total billed charges,832.61,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,42.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,1008,
iSTAT CG4 Blood Gases POCT,30182803,CDM,301,RC,82803,HCPCS,Outpatient,,,66,42.90,,58.08,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,66,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,41.58,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,10.1,15.3,,,percent of total billed charges,15.3% of total billed charges,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,22.37,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.1,99.71,
"iSTAT Basic metabolic panel (Calcium, ionized) Chem8+",30180047,CDM,301,RC,80047,HCPCS,Outpatient,,,41.19,26.77,,36.25,88,,,percent of total billed charges,88% of total Billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,41.19,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,25.95,63,,,percent of total billed charges,63% of total billed charges,24.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,6.3,15.3,,,percent of total billed charges,15.3% of total billed charges,28.42,69,,,percent of total billed charges,69% of total billed charges,41.19,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,52.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,15.53,37.7,,,percent of total billed charges,37.70% of total billed charges,15.53,37.7,,,percent of total billed charges,37.70% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.96,33.9,,,percent of total billed charges,33.9% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,32.13,78,,,percent of total billed charges,78% of total billed charges,41.19,100,,,percent of total billed charges,100% of total billed charges,34.02,82.6,,,percent of total billed charges,82.6% of total billed charges,34.02,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.86,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,52.51,
59051 FETAL MONITOR  NON OB Charge,72059051,CDM,720,RC,59051,HCPCS,Outpatient,,,234,152.10,,205.92,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,147.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",35.8,15.3,,,percent of total billed charges,15.3% of total billed charges,161.46,69,,,percent of total billed charges,69% of total billed charges,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88.22,37.7,,,percent of total billed charges,37.70% of total billed charges,88.22,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,79.33,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,182.52,78,,,percent of total billed charges,78% of total billed charges,234,100,,,percent of total billed charges,100% of total billed charges,193.28,82.6,,,percent of total billed charges,82.6% of total billed charges,193.28,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.31,16.8,,,percent of total billed charges,16.8% of total billed charges,35.8,234,
Fetal Nonstress Test,76159025,CDM,761,RC,59025,HCPCS,Outpatient,,,529,343.85,,465.52,88,,,percent of total billed charges,88% of total Billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,165.98,100,,,Fee Schedule,100% of WA Medicaid,529,100,,,percent of total billed charges,100% of total billed charges,170.96,103,,,Fee Schedule,103% of WA Medicaid,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,333.27,63,,,percent of total billed charges,63% of total billed charges,355.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,165.98,100,,,Fee Schedule,100% of WA Medicaid,80.94,15.3,,,percent of total billed charges,15.3% of total billed charges,365.01,69,,,percent of total billed charges,69% of total billed charges,529,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,529,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,529,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,691.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,122.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,169.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,215.77,130,,,Fee Schedule,130% of WA Medicaid ,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,199.43,37.7,,,percent of total billed charges,37.70% of total billed charges,199.43,37.7,,,percent of total billed charges,37.70% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,179.33,33.9,,,percent of total billed charges,33.9% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,412.62,78,,,percent of total billed charges,78% of total billed charges,529,100,,,percent of total billed charges,100% of total billed charges,436.95,82.6,,,percent of total billed charges,82.6% of total billed charges,436.95,82.6,,,percent of total billed charges,82.6% of total billed charges,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,205.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.94,691.92,
Antibody Screen Gel,30086850,CDM,300,RC,86850,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,308,
ABO/Rh.,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
Antibody Screen Gel,30086850,CDM,300,RC,86850,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,308,
DAT Poly Tube,30086880,CDM,300,RC,86880,HCPCS,Outpatient,,,506,328.90,,445.28,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,506,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,318.78,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,77.42,15.3,,,percent of total billed charges,15.3% of total billed charges,349.14,69,,,percent of total billed charges,69% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,171.53,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,394.68,78,,,percent of total billed charges,78% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,506,
DAT IgG Tube,30086880,CDM,300,RC,86880,HCPCS,Outpatient,,,506,328.90,,445.28,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,506,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,318.78,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,77.42,15.3,,,percent of total billed charges,15.3% of total billed charges,349.14,69,,,percent of total billed charges,69% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,171.53,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,394.68,78,,,percent of total billed charges,78% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,506,
ABO/Rh.,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
ABO Only,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
ABO Only,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
ABO,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
Antibody Screen Gel,30086850,CDM,300,RC,86850,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,308,
Antigen Type,3098905,CDM,309,RC,86905,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,1183.25,
Antibody Screen Tube,30086850,CDM,300,RC,86850,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,308,
Antibody ID,30086870,CDM,300,RC,86870,HCPCS,Outpatient,,,743,482.95,,653.84,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,124.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,743,100,,,percent of total billed charges,100% of total billed charges,128.57,17.304,,,percent of total billed charges,17.304% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,468.09,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,113.68,15.3,,,percent of total billed charges,15.3% of total billed charges,512.67,69,,,percent of total billed charges,69% of total billed charges,743,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,743,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,743,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,124.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,127.32,17.136,,,percent of total billed charges,17.136% of total billed charges,162.27,21.84,,,percent of total billed charges,21.84% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,280.11,37.7,,,percent of total billed charges,37.70% of total billed charges,280.11,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,251.88,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,579.54,78,,,percent of total billed charges,78% of total billed charges,743,100,,,percent of total billed charges,100% of total billed charges,613.72,82.6,,,percent of total billed charges,82.6% of total billed charges,613.72,82.6,,,percent of total billed charges,82.6% of total billed charges,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,113.68,1183.25,
Bill ABO,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
BILL RH,30086901,CDM,300,RC,86901,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,308,
Bill Only Rh Phenotyping,30986906,CDM,309,RC,86906,HCPCS,Outpatient,,,105,68.25,,92.4,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,105,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,66.15,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,16.07,15.3,,,percent of total billed charges,15.3% of total billed charges,72.45,69,,,percent of total billed charges,69% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,35.6,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,78,,,percent of total billed charges,78% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,137.47,
BILL DAT,30086880,CDM,300,RC,86880,HCPCS,Outpatient,,,506,328.90,,445.28,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,506,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,318.78,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,77.42,15.3,,,percent of total billed charges,15.3% of total billed charges,349.14,69,,,percent of total billed charges,69% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,171.53,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,394.68,78,,,percent of total billed charges,78% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,506,
Bill Only ABID Panel,30086870,CDM,300,RC,86870,HCPCS,Outpatient,,,743,482.95,,653.84,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,124.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,743,100,,,percent of total billed charges,100% of total billed charges,128.57,17.304,,,percent of total billed charges,17.304% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,468.09,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,113.68,15.3,,,percent of total billed charges,15.3% of total billed charges,512.67,69,,,percent of total billed charges,69% of total billed charges,743,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,743,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,743,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,124.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,127.32,17.136,,,percent of total billed charges,17.136% of total billed charges,162.27,21.84,,,percent of total billed charges,21.84% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,280.11,37.7,,,percent of total billed charges,37.70% of total billed charges,280.11,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,251.88,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,579.54,78,,,percent of total billed charges,78% of total billed charges,743,100,,,percent of total billed charges,100% of total billed charges,613.72,82.6,,,percent of total billed charges,82.6% of total billed charges,613.72,82.6,,,percent of total billed charges,82.6% of total billed charges,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,113.68,1183.25,
BILL Antibody ID,30086870,CDM,300,RC,86870,HCPCS,Outpatient,,,506,328.90,,445.28,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,85.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,506,100,,,percent of total billed charges,100% of total billed charges,87.56,17.304,,,percent of total billed charges,17.304% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,318.78,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,77.42,15.3,,,percent of total billed charges,15.3% of total billed charges,349.14,69,,,percent of total billed charges,69% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,85.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,86.71,17.136,,,percent of total billed charges,17.136% of total billed charges,110.51,21.84,,,percent of total billed charges,21.84% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,171.53,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,394.68,78,,,percent of total billed charges,78% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,77.42,1183.25,
Pretreatment of serum for use in RBC antibody identification,30086976,CDM,300,RC,86976,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,24.68,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,17.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,24.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.14,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.74,100.22,
Bill Only Thawing,30086927,CDM,300,RC,86927,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,325,100,,,percent of total billed charges,100% of total billed charges,24.68,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,204.75,63,,,percent of total billed charges,63% of total billed charges,304.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,325,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,325,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.95,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,17.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,24.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.14,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.94,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.74,605.95,
Bill Only Antigen Typing,30986902,CDM,309,RC,86902,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,1183.25,
Bill Only RBC Ag,30986905,CDM,309,RC,86905,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,1183.25,
Bill Only Absorption,30286978,CDM,302,RC,86978,HCPCS,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,101,100,,,percent of total billed charges,100% of total billed charges,24.68,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.63,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,15.45,15.3,,,percent of total billed charges,15.3% of total billed charges,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.14,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,34.24,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.45,137.47,
Bill Only REF ABID Panel,30086870,CDM,300,RC,86870,HCPCS,Outpatient,,,743,482.95,,653.84,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,124.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,743,100,,,percent of total billed charges,100% of total billed charges,128.57,17.304,,,percent of total billed charges,17.304% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,468.09,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,113.68,15.3,,,percent of total billed charges,15.3% of total billed charges,512.67,69,,,percent of total billed charges,69% of total billed charges,743,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,743,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,743,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,124.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,127.32,17.136,,,percent of total billed charges,17.136% of total billed charges,162.27,21.84,,,percent of total billed charges,21.84% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,280.11,37.7,,,percent of total billed charges,37.70% of total billed charges,280.11,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,251.88,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,579.54,78,,,percent of total billed charges,78% of total billed charges,743,100,,,percent of total billed charges,100% of total billed charges,613.72,82.6,,,percent of total billed charges,82.6% of total billed charges,613.72,82.6,,,percent of total billed charges,82.6% of total billed charges,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,124.82,16.8,,,percent of total billed charges,16.8% of total billed charges,113.68,1183.25,
Bill Only Electronic Crossmatch,30086923,CDM,300,RC,86923,HCPCS,Outpatient,,,192,124.80,,168.96,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,32.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,192,100,,,percent of total billed charges,100% of total billed charges,33.22,17.304,,,percent of total billed charges,17.304% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,120.96,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,29.38,15.3,,,percent of total billed charges,15.3% of total billed charges,132.48,69,,,percent of total billed charges,69% of total billed charges,192,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,192,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,192,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,32.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,32.9,17.136,,,percent of total billed charges,17.136% of total billed charges,41.93,21.84,,,percent of total billed charges,21.84% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,72.38,37.7,,,percent of total billed charges,37.70% of total billed charges,72.38,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,65.09,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,149.76,78,,,percent of total billed charges,78% of total billed charges,192,100,,,percent of total billed charges,100% of total billed charges,158.59,82.6,,,percent of total billed charges,82.6% of total billed charges,158.59,82.6,,,percent of total billed charges,82.6% of total billed charges,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,29.38,605.96,
Cold agglutinin; screen,30286156,CDM,302,RC,86156,HCPCS,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,33,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,20.79,63,,,percent of total billed charges,63% of total billed charges,14.12,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,30.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,11.19,33.9,,,percent of total billed charges,33.9% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,8.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.05,33,
IAT Coombs ARC,30086885,CDM,300,RC,86885,HCPCS,Outpatient,,,457,297.05,,402.16,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,457,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,287.91,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,69.92,15.3,,,percent of total billed charges,15.3% of total billed charges,315.33,69,,,percent of total billed charges,69% of total billed charges,457,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,457,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,457,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,172.29,37.7,,,percent of total billed charges,37.70% of total billed charges,172.29,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,154.92,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,356.46,78,,,percent of total billed charges,78% of total billed charges,457,100,,,percent of total billed charges,100% of total billed charges,377.48,82.6,,,percent of total billed charges,82.6% of total billed charges,377.48,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,605.96,
"Pretreatment of RBCs for use in RBC antibody detection, iden",30086970,CDM,300,RC,86970,HCPCS,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,104,100,,,percent of total billed charges,100% of total billed charges,24.68,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,15.91,15.3,,,percent of total billed charges,15.3% of total billed charges,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.14,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,35.26,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.91,137.47,
"Pretreatment of RBCs for use in RBC antibody detection, iden",30086971,CDM,300,RC,86971,HCPCS,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,42,100,,,percent of total billed charges,100% of total billed charges,24.68,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.46,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,6.43,15.3,,,percent of total billed charges,15.3% of total billed charges,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,42,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,42,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,17.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,24.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.14,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.43,1183.25,
ABO/Rh,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
XM AHG Gel Interp:Compatible,30086922,CDM,300,RC,86922,HCPCS,Outpatient,,,481,312.65,,423.28,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,481,100,,,percent of total billed charges,100% of total billed charges,83.23,17.304,,,percent of total billed charges,17.304% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,303.03,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,15.3,,,percent of total billed charges,15.3% of total billed charges,331.89,69,,,percent of total billed charges,69% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,82.42,17.136,,,percent of total billed charges,17.136% of total billed charges,105.05,21.84,,,percent of total billed charges,21.84% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,163.06,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,375.18,78,,,percent of total billed charges,78% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,605.96,
XM AHG Tube Interp:Compatible,30086921,CDM,300,RC,86921,HCPCS,Outpatient,,,481,312.65,,423.28,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,481,100,,,percent of total billed charges,100% of total billed charges,83.23,17.304,,,percent of total billed charges,17.304% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,303.03,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,15.3,,,percent of total billed charges,15.3% of total billed charges,331.89,69,,,percent of total billed charges,69% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,82.42,17.136,,,percent of total billed charges,17.136% of total billed charges,105.05,21.84,,,percent of total billed charges,21.84% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,163.06,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,375.18,78,,,percent of total billed charges,78% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,605.96,
XM IS Interp:Compatible,30086920,CDM,300,RC,86920,HCPCS,Outpatient,,,481,312.65,,423.28,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,481,100,,,percent of total billed charges,100% of total billed charges,83.23,17.304,,,percent of total billed charges,17.304% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,303.03,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,15.3,,,percent of total billed charges,15.3% of total billed charges,331.89,69,,,percent of total billed charges,69% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,82.42,17.136,,,percent of total billed charges,17.136% of total billed charges,105.05,21.84,,,percent of total billed charges,21.84% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,163.06,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,375.18,78,,,percent of total billed charges,78% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,605.96,
Computer XM OK,30086923,CDM,300,RC,86923,HCPCS,Outpatient,,,192,124.80,,168.96,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,32.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,192,100,,,percent of total billed charges,100% of total billed charges,33.22,17.304,,,percent of total billed charges,17.304% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,120.96,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,29.38,15.3,,,percent of total billed charges,15.3% of total billed charges,132.48,69,,,percent of total billed charges,69% of total billed charges,192,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,192,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,192,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,32.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,32.9,17.136,,,percent of total billed charges,17.136% of total billed charges,41.93,21.84,,,percent of total billed charges,21.84% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,72.38,37.7,,,percent of total billed charges,37.70% of total billed charges,72.38,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,65.09,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,149.76,78,,,percent of total billed charges,78% of total billed charges,192,100,,,percent of total billed charges,100% of total billed charges,158.59,82.6,,,percent of total billed charges,82.6% of total billed charges,158.59,82.6,,,percent of total billed charges,82.6% of total billed charges,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,29.38,605.96,
Cord DAT,30086927,CDM,300,RC,86927,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,325,100,,,percent of total billed charges,100% of total billed charges,24.68,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,204.75,63,,,percent of total billed charges,63% of total billed charges,304.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,325,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,325,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.95,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,17.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,24.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.14,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.94,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,23.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.74,605.95,
Cord ABO/Rh.,30086906,CDM,300,RC,86906,HCPCS,Outpatient,,,105,68.25,,92.4,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,105,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,66.15,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,16.07,15.3,,,percent of total billed charges,15.3% of total billed charges,72.45,69,,,percent of total billed charges,69% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,35.6,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,78,,,percent of total billed charges,78% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,137.47,
Cord ABORh,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
Cord ABORh.,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
DAT Poly Tube,30086880,CDM,300,RC,86880,HCPCS,Outpatient,,,506,328.90,,445.28,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,506,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,318.78,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,77.42,15.3,,,percent of total billed charges,15.3% of total billed charges,349.14,69,,,percent of total billed charges,69% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,171.53,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,394.68,78,,,percent of total billed charges,78% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,506,
DAT IgG Tube,30086880,CDM,300,RC,86880,HCPCS,Outpatient,,,506,328.90,,445.28,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,506,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,318.78,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,77.42,15.3,,,percent of total billed charges,15.3% of total billed charges,349.14,69,,,percent of total billed charges,69% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,171.53,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,394.68,78,,,percent of total billed charges,78% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,506,
DAT IgG Gel,30086880,CDM,300,RC,86880,HCPCS,Outpatient,,,506,328.90,,445.28,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,506,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,318.78,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,77.42,15.3,,,percent of total billed charges,15.3% of total billed charges,349.14,69,,,percent of total billed charges,69% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,171.53,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,394.68,78,,,percent of total billed charges,78% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,506,
E0167 RBC CPD 500,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E0178 RBC CPD 500 Irr,390P9040,CDM,390,RC,P9040,HCPCS,Outpatient,,,782,508.30,,688.16,88,,,percent of total billed charges,88% of total Billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,782,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,492.66,63,,,percent of total billed charges,63% of total billed charges,441.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,119.65,15.3,,,percent of total billed charges,15.3% of total billed charges,539.58,69,,,percent of total billed charges,69% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,996.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,265.1,33.9,,,percent of total billed charges,33.9% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,609.96,78,,,percent of total billed charges,78% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,255,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.27,996.6,
E0332 RBC CPD AS1 500 LR Irr,390P9040,CDM,390,RC,P9040,HCPCS,Outpatient,,,782,508.30,,688.16,88,,,percent of total billed charges,88% of total Billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,782,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,492.66,63,,,percent of total billed charges,63% of total billed charges,441.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,119.65,15.3,,,percent of total billed charges,15.3% of total billed charges,539.58,69,,,percent of total billed charges,69% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,996.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,265.1,33.9,,,percent of total billed charges,33.9% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,609.96,78,,,percent of total billed charges,78% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,255,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.27,996.6,
E0336 RBC CPD AS1 500 LR,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E0336 Dv RBC CPD AS1 500 LR,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E0385 RBC CPD AS5 450,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E0661 Aph RBC CP2D AS3 LR Irr,390P9040,CDM,390,RC,P9040,HCPCS,Outpatient,,,782,508.30,,688.16,88,,,percent of total billed charges,88% of total Billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,782,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,492.66,63,,,percent of total billed charges,63% of total billed charges,441.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,119.65,15.3,,,percent of total billed charges,15.3% of total billed charges,539.58,69,,,percent of total billed charges,69% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,996.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,265.1,33.9,,,percent of total billed charges,33.9% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,609.96,78,,,percent of total billed charges,78% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,255,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.27,996.6,
E0668 Aph RBC CP2D AS3 LR Irr 1,390P9040,CDM,390,RC,P9040,HCPCS,Outpatient,,,782,508.30,,688.16,88,,,percent of total billed charges,88% of total Billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,782,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,492.66,63,,,percent of total billed charges,63% of total billed charges,441.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,119.65,15.3,,,percent of total billed charges,15.3% of total billed charges,539.58,69,,,percent of total billed charges,69% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,996.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,265.1,33.9,,,percent of total billed charges,33.9% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,609.96,78,,,percent of total billed charges,78% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,255,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.27,996.6,
E0669 Aph RBC CP2D AS3 LR Irr 2,390P9040,CDM,390,RC,P9040,HCPCS,Outpatient,,,782,508.30,,688.16,88,,,percent of total billed charges,88% of total Billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,782,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,492.66,63,,,percent of total billed charges,63% of total billed charges,441.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,119.65,15.3,,,percent of total billed charges,15.3% of total billed charges,539.58,69,,,percent of total billed charges,69% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,996.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,265.1,33.9,,,percent of total billed charges,33.9% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,609.96,78,,,percent of total billed charges,78% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,255,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.27,996.6,
E0676 Aph RBC CP2D AS3 Irr 1,390P9040,CDM,390,RC,P9040,HCPCS,Outpatient,,,782,508.30,,688.16,88,,,percent of total billed charges,88% of total Billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,782,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,492.66,63,,,percent of total billed charges,63% of total billed charges,441.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,119.65,15.3,,,percent of total billed charges,15.3% of total billed charges,539.58,69,,,percent of total billed charges,69% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,996.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,265.1,33.9,,,percent of total billed charges,33.9% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,609.96,78,,,percent of total billed charges,78% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,255,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.27,996.6,
E0677 Aph RBC CP2D AS3 Irr 2,390P9040,CDM,390,RC,P9040,HCPCS,Outpatient,,,782,508.30,,688.16,88,,,percent of total billed charges,88% of total Billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,782,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,492.66,63,,,percent of total billed charges,63% of total billed charges,441.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,119.65,15.3,,,percent of total billed charges,15.3% of total billed charges,539.58,69,,,percent of total billed charges,69% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,996.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,265.1,33.9,,,percent of total billed charges,33.9% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,609.96,78,,,percent of total billed charges,78% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,255,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.27,996.6,
E0678 Aph RBC CP2D AS3 LR,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E0685 Aph RBC CP2D AS3 LR 1,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E0686 Aph RBC CP2D AS3 LR 2,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E0686 Aph Dv RBC CP2D AS3 LR 2,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E0869 Aph FFP ACDA,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,272.14,
E2121 Thawed Aph Plasma ACDA,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,416,270.40,,366.08,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,416,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,262.08,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,63.65,15.3,,,percent of total billed charges,15.3% of total billed charges,287.04,69,,,percent of total billed charges,69% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,141.02,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,324.48,78,,,percent of total billed charges,78% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.65,416,
E2684 Thawed Plasma CPD,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,416,270.40,,366.08,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,416,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,262.08,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,63.65,15.3,,,percent of total billed charges,15.3% of total billed charges,287.04,69,,,percent of total billed charges,69% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,141.02,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,324.48,78,,,percent of total billed charges,78% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.65,416,
E2701 Thawed Plasma CPD <24h,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,272.14,
E2719 Thawed Plasma CPDA1 <24h,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,272.14,
E3046 Aph Plt ACDA LR Irr,390P9037,CDM,390,RC,P9037,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,1176.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,2361.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,679.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,2361.28,
E3056 Aph Plt ACDA LR Irr 1,390P9037,CDM,390,RC,P9037,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,1176.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,2361.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,679.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,2361.28,
E3057 Aph Plt ACDA LR Irr 2,390P9037,CDM,390,RC,P9037,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,1176.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,2361.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,679.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,2361.28,
E3058 Aph Plt ACDA LR Irr 3,390P9037,CDM,390,RC,P9037,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,1176.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,2361.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,679.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,2361.28,
E3077 Aph Plt ACDA LR,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1437,934.05,,1264.56,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1437,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,905.31,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,219.86,15.3,,,percent of total billed charges,15.3% of total billed charges,991.53,69,,,percent of total billed charges,69% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,487.14,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.86,78,,,percent of total billed charges,78% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,219.86,1862.01,
E3087 Aph Plt ACDA LR 1,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1437,934.05,,1264.56,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1437,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,905.31,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,219.86,15.3,,,percent of total billed charges,15.3% of total billed charges,991.53,69,,,percent of total billed charges,69% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,487.14,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.86,78,,,percent of total billed charges,78% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,219.86,1862.01,
E3088 Aph Plt ACDA LR 2,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1437,934.05,,1264.56,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1437,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,905.31,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,219.86,15.3,,,percent of total billed charges,15.3% of total billed charges,991.53,69,,,percent of total billed charges,69% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,487.14,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.86,78,,,percent of total billed charges,78% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,219.86,1862.01,
E3089 Aph Plt ACDA LR 3,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1437,934.05,,1264.56,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1437,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,905.31,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,219.86,15.3,,,percent of total billed charges,15.3% of total billed charges,991.53,69,,,percent of total billed charges,69% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,487.14,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.86,78,,,percent of total billed charges,78% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,219.86,1862.01,
E3591 Thawed Pooled Cryto,390P9012,CDM,390,RC,P9012,HCPCS,Outpatient,,,1106,718.90,,973.28,88,,,percent of total billed charges,88% of total Billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1106,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,696.78,63,,,percent of total billed charges,63% of total billed charges,104.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,169.22,15.3,,,percent of total billed charges,15.3% of total billed charges,763.14,69,,,percent of total billed charges,69% of total billed charges,1106,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,1106,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,1106,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,416.96,37.7,,,percent of total billed charges,37.70% of total billed charges,416.96,37.7,,,percent of total billed charges,37.70% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,374.93,33.9,,,percent of total billed charges,33.9% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,862.68,78,,,percent of total billed charges,78% of total billed charges,1106,100,,,percent of total billed charges,100% of total billed charges,913.56,82.6,,,percent of total billed charges,82.6% of total billed charges,913.56,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,60.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.87,1106,
E4154 RBC CPDA1 LV Acadj,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E4156 RBC CPD AS1 LV Acadj,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E4157 RBC CP2D AS3 LV Acadj,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E5017 RBC CPD LV,390P9016,CDM,390,RC,P9016,HCPCS,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,544,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,342.72,63,,,percent of total billed charges,63% of total billed charges,316.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,544,100,,,percent of total billed charges,100% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,721.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,205.09,37.7,,,percent of total billed charges,37.70% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,184.42,33.9,,,percent of total billed charges,33.9% of total billed charges,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,180.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.23,721.05,
E5115 Aph RBC CPDA1 LR Irr 1,390P9040,CDM,390,RC,P9040,HCPCS,Outpatient,,,782,508.30,,688.16,88,,,percent of total billed charges,88% of total Billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,782,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,492.66,63,,,percent of total billed charges,63% of total billed charges,441.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,119.65,15.3,,,percent of total billed charges,15.3% of total billed charges,539.58,69,,,percent of total billed charges,69% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,782,100,,,percent of total billed charges,100% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,996.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,294.81,37.7,,,percent of total billed charges,37.70% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,265.1,33.9,,,percent of total billed charges,33.9% of total billed charges,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,609.96,78,,,percent of total billed charges,78% of total billed charges,782,100,,,percent of total billed charges,100% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,645.93,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,255,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.48,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.27,996.6,
E5548 Thawed Aph Plasma ACDA 1,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,416,270.40,,366.08,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,416,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,262.08,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,63.65,15.3,,,percent of total billed charges,15.3% of total billed charges,287.04,69,,,percent of total billed charges,69% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,141.02,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,324.48,78,,,percent of total billed charges,78% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.65,416,
E5549 Thawed Aph Plasma ACDA 2,390P0959,CDM,390,RC,P9059,HCPCS,Outpatient,,,416,270.40,,366.08,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,416,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,262.08,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,63.65,15.3,,,percent of total billed charges,15.3% of total billed charges,287.04,69,,,percent of total billed charges,69% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,416,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,141.02,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,324.48,78,,,percent of total billed charges,78% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.65,416,
E5621 Pooled Cryo 5 Units,390P9012,CDM,390,RC,P9012,HCPCS,Outpatient,,,221,143.65,,194.48,88,,,percent of total billed charges,88% of total Billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,221,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,139.23,63,,,percent of total billed charges,63% of total billed charges,104.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,33.81,15.3,,,percent of total billed charges,15.3% of total billed charges,152.49,69,,,percent of total billed charges,69% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,221,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,221,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,74.92,33.9,,,percent of total billed charges,33.9% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,172.38,78,,,percent of total billed charges,78% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,60.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.81,437.85,
E7001 Aph Plt ACDA PASC LR,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
E7002 Aph Plt ACDA PASC LR 1,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1437,934.05,,1264.56,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1437,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,905.31,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,219.86,15.3,,,percent of total billed charges,15.3% of total billed charges,991.53,69,,,percent of total billed charges,69% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,487.14,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.86,78,,,percent of total billed charges,78% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,219.86,1862.01,
E7003 Aph Plt ACDA PASC LR 2,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1437,934.05,,1264.56,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1437,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,905.31,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,219.86,15.3,,,percent of total billed charges,15.3% of total billed charges,991.53,69,,,percent of total billed charges,69% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,487.14,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.86,78,,,percent of total billed charges,78% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,219.86,1862.01,
E7004 Aph Plt ACDA PASC LR 3,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1437,934.05,,1264.56,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1437,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,905.31,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,219.86,15.3,,,percent of total billed charges,15.3% of total billed charges,991.53,69,,,percent of total billed charges,69% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1437,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,541.75,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,487.14,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.86,78,,,percent of total billed charges,78% of total billed charges,1437,100,,,percent of total billed charges,100% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.96,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,219.86,1862.01,
E7005 Aph Plt ACDA PASC LR Irr,390P9037,CDM,390,RC,P9037,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,1176.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,2361.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,679.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,2361.28,
E7006 Aph Plt ACDA PASC LR Irr 1,390P9037,CDM,390,RC,P9037,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,1176.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,2361.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,679.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,2361.28,
E7007 Aph Plt ACDA PASC LR Irr 2,390P9037,CDM,390,RC,P9037,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,1176.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,2361.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,679.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,2361.28,
E7008 Aph Plt ACDA PASC LR Irr 3,390P9037,CDM,390,RC,P9037,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,1176.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,2361.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,679.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,672.48,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,2361.28,
E7607 Aph Aplasma ACDA RT<=24 Frz<=24 4,390P9012,CDM,390,RC,P9012,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,104.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,60.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,437.85,
E7644 Aph Plasma RT<=24 Frz<=24 Dv,390P9012,CDM,390,RC,P9012,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,104.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,60.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,437.85,
E7648 Aph APlasma ACDA RT<=24 Frz<=24 2,390P9012,CDM,390,RC,P9012,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,104.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,60.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,437.85,
E7646 Aph APlasma ACDA RT<=24 Frz<=24 1,390P9012,CDM,390,RC,P9012,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,104.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,60.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,437.85,
E7650 Aph Aplasma ACDA RT<=24 Frz<=24 3,390P9012,CDM,390,RC,P9012,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,104.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,60.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,59.87,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,437.85,
E7731Thawed Aph Plasma ACDA RT<24Fr<24,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,272.14,
E7731 Thawed Aph Plas ACDA RT<24Fr<24 Dv,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,272.14,
E7753 Thawed Aph Plas ACDA RT<24Fr<24 4,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,272.14,
E7750 Thawed Aph Plas ACDA RT<24Frz<24 1,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,272.14,
E7751 Thawed Aph PlasACDART<24Frz<24 2Dv,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,221,143.65,,194.48,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,221,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,139.23,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,33.81,15.3,,,percent of total billed charges,15.3% of total billed charges,152.49,69,,,percent of total billed charges,69% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,221,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,221,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,74.92,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,172.38,78,,,percent of total billed charges,78% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.81,272.14,
E7751 Thawed Aph Plas ACDA RT<24Frz<24 2,390P9059,CDM,390,RC,P9059,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,138.03,103,,,Fee Schedule,103% of WA Medicaid,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,126.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,272.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,73.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,72.56,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.46,272.14,
E8340 Aph Plt ACDA>PASC LR Psoralen,390P9016,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
E8342 Aph Plr ACDA>PASC LR Psoralen 2,390P9016,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
E8344 Aph Plt ACDA>PASC LR<3E11Psoralen,390P9016,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
E8343 Aph Plt ACDA>PASC LR Psoralen 3,390P9016,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
E8341 Aph Plt ACDA>PASC LR Psoralen 1,390P9016,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
E8343 Aph Plt ACDA>PASC LR Pso 3 Dv,390P9016,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
E9755 Aph Cnv Frzn Plsma ACDA COVID-19 2,390P9017,CDM,390,RC,P9017,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138.03,103,,,Fee Schedule,103% of WA Medicaid,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,139.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,316.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,80.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.95,316.17,
E9752 Aph Cnv Thwd Plsma ACDA COVID19 Dv,390P9017,CDM,390,RC,P9017,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138.03,103,,,Fee Schedule,103% of WA Medicaid,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,139.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,316.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,80.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.95,316.17,
E9764 Aph Cnv Thwd Plsma ACDA COVID-19 3,390P9017,CDM,390,RC,P9017,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138.03,103,,,Fee Schedule,103% of WA Medicaid,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,139.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,316.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,80.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.95,316.17,
E9762 Aph Cnv Thwd Plsma ACDA COVID-19 1,390P9017,CDM,390,RC,P9017,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138.03,103,,,Fee Schedule,103% of WA Medicaid,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,139.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,316.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,80.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.95,316.17,
E9763 Aph Cnv Thwd Plsma ACDA COVID-19 2,390P9017,CDM,390,RC,P9017,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138.03,103,,,Fee Schedule,103% of WA Medicaid,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,139.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,316.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,80.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.95,316.17,
E9765 Aph Cnv Thwd Plsma ACDA COVID-19 4,390P9017,CDM,390,RC,P9017,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138.03,103,,,Fee Schedule,103% of WA Medicaid,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,139.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,316.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,80.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.95,316.17,
E9780 Cnv Thwd Plasma CPD COVID-19,390P9017,CDM,390,RC,P9017,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138.03,103,,,Fee Schedule,103% of WA Medicaid,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,139.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,316.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,80.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.95,316.17,
E9780 Cnv Thwd Plasma CPD COVID-19 Dv,390P9017,CDM,390,RC,P9017,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138.03,103,,,Fee Schedule,103% of WA Medicaid,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,139.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,316.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,80.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.95,316.17,
E9811 Conv Thawed Plasma CPDA1 COVID-19,390P9017,CDM,390,RC,P9017,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138.03,103,,,Fee Schedule,103% of WA Medicaid,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,139.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,316.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,99.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.22,130,,,Fee Schedule,130% of WA Medicaid ,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,80.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,79.95,100,,,Fee Schedule,100% of Medicare OPPS rate,134.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.95,316.17,
EA007 Aph Platelets ACDA LR BM>=36h,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA008 Aph Platelets ACDA LR BM>=36h 1,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA009 Aph Platelets ACDA LR BM>=36h 2,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA019 Aph Plts ACDA Irr LR <3e11 BM>=36h,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA017 Aph Plts ACDA Irr LR BM>=36h 2,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA018 Aph Plts ACDA Irr LR BM>=36h 3,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA015 Aph Platelets ACDA Irr LR BM>=36h,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA016 Aph Plts ACDA Irr LR BM>=36h 1,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA010 Aph Platelets ACDA LR BM>=36h 3,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA011 Aph Plts ACDA LR <3e11 BM>=36h,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA013 Aph Plts ACDA LR <3e11 BM>=36h 2,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA014 Aph Plts ACDA LR <3e11 BM>=36h 3,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA012 Aph Plts ACDA LR <3e11 BM>=36h 1,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA022 AphPlt ACDA Irr LR <3e11 BM>=36h 3,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA020 AphPlt ACDA Irr LR <3e11 BM>=36h 1,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA021 AphPlt ACDA Irr LR <3e11 BM>=36h 2,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA138 Aph Plts ACDA>PASC LR BM>=36h 2,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA137 Aph Plts ACDA>PASC LR BM>=36h 1,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA139 Aph Plts ACDA>PASC LR BM>=36h 3,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA136 Aph Platelets ACDA>PASC LR BM>=36h,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA140 Aph Plts ACDAPASC LR <3e11 BM>=36h,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA143 AphPlt ACDAPASC LR <3e11 BM>=36h 3,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA141 AphPlt ACDAPASC LR <3e11 BM>=36h 1,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA142 AphPlt ACDAPASC LR <3e11 BM>=36h 2,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA156 AphPlt ACDA>PASC IrrLR <3e11 BM>36,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA155 Aph Plts ACDA>PASC IrrLR BM>=36h 3,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA154 Aph Plts ACDA>PASC IrrLR BM>=36h 2,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA153 Aph Plts ACDA>PASC IrrLR BM>=36h 1,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA152 Aph Plts ACDA>PASC Irr LR BM>=36h,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA158 AphPltACDAPASC IrrLR <3e11 BM>36 2,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA159 AphPltACDAPASC IrrLR <3e11 BM>36 3,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
EA157 AphPltACDAPASC IrrLR <3e11 BM>36 1,390P9035,CDM,390,RC,P9035,HCPCS,Outpatient,,,1900,1235.00,,1672,88,,,percent of total billed charges,88% of total Billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,1900,100,,,percent of total billed charges,100% of total billed charges,346.91,103,,,Fee Schedule,103% of WA Medicaid,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,63,,,percent of total billed charges,63% of total billed charges,826.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid,290.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1311,69,,,percent of total billed charges,69% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1900,100,,,percent of total billed charges,100% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1862.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,249.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,343.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.85,130,,,Fee Schedule,130% of WA Medicaid ,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,716.3,37.7,,,percent of total billed charges,37.70% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1482,78,,,percent of total billed charges,78% of total billed charges,1900,100,,,percent of total billed charges,100% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.4,82.6,,,percent of total billed charges,82.6% of total billed charges,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,477.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,472.33,100,,,Fee Schedule,100% of Medicare OPPS rate,336.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.49,1900,
Elution,30986860,CDM,309,RC,86860,HCPCS,Outpatient,,,506,328.90,,445.28,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,85.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,506,100,,,percent of total billed charges,100% of total billed charges,87.56,17.304,,,percent of total billed charges,17.304% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,318.78,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,77.42,15.3,,,percent of total billed charges,15.3% of total billed charges,349.14,69,,,percent of total billed charges,69% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,506,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,85.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,86.71,17.136,,,percent of total billed charges,17.136% of total billed charges,110.51,21.84,,,percent of total billed charges,21.84% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,171.53,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,394.68,78,,,percent of total billed charges,78% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,77.42,605.96,
Fetal Screen,30085461,CDM,300,RC,85461,HCPCS,Outpatient,,,248,161.20,,218.24,88,,,percent of total billed charges,88% of total Billed charges,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,248,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,156.24,63,,,percent of total billed charges,63% of total billed charges,16.38,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,37.94,15.3,,,percent of total billed charges,15.3% of total billed charges,171.12,69,,,percent of total billed charges,69% of total billed charges,248,100,,,percent of total billed charges,100% of total billed charges,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,248,100,,,percent of total billed charges,100% of total billed charges,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,248,100,,,percent of total billed charges,100% of total billed charges,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,35.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,93.5,37.7,,,percent of total billed charges,37.70% of total billed charges,93.5,37.7,,,percent of total billed charges,37.70% of total billed charges,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,84.07,33.9,,,percent of total billed charges,33.9% of total billed charges,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,193.44,78,,,percent of total billed charges,78% of total billed charges,248,100,,,percent of total billed charges,100% of total billed charges,204.85,82.6,,,percent of total billed charges,82.6% of total billed charges,204.85,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.36,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,248,
XM AHG Gel Interp:Incompatible,30086922,CDM,300,RC,86922,HCPCS,Outpatient,,,481,312.65,,423.28,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,481,100,,,percent of total billed charges,100% of total billed charges,83.23,17.304,,,percent of total billed charges,17.304% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,303.03,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,15.3,,,percent of total billed charges,15.3% of total billed charges,331.89,69,,,percent of total billed charges,69% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,82.42,17.136,,,percent of total billed charges,17.136% of total billed charges,105.05,21.84,,,percent of total billed charges,21.84% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,163.06,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,375.18,78,,,percent of total billed charges,78% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,605.96,
XM AHG Tube Interp:Incompatible,30086921,CDM,300,RC,86921,HCPCS,Outpatient,,,481,312.65,,423.28,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,481,100,,,percent of total billed charges,100% of total billed charges,83.23,17.304,,,percent of total billed charges,17.304% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,303.03,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,15.3,,,percent of total billed charges,15.3% of total billed charges,331.89,69,,,percent of total billed charges,69% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,82.42,17.136,,,percent of total billed charges,17.136% of total billed charges,105.05,21.84,,,percent of total billed charges,21.84% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,163.06,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,375.18,78,,,percent of total billed charges,78% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,605.96,
XM AHG Gel Interp:Least Incompatible,30086922,CDM,300,RC,86922,HCPCS,Outpatient,,,481,312.65,,423.28,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,481,100,,,percent of total billed charges,100% of total billed charges,83.23,17.304,,,percent of total billed charges,17.304% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,303.03,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,15.3,,,percent of total billed charges,15.3% of total billed charges,331.89,69,,,percent of total billed charges,69% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,82.42,17.136,,,percent of total billed charges,17.136% of total billed charges,105.05,21.84,,,percent of total billed charges,21.84% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,163.06,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,375.18,78,,,percent of total billed charges,78% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,605.96,
XM AHG Tube Interp:Least Incompatible,30086921,CDM,300,RC,86921,HCPCS,Outpatient,,,481,312.65,,423.28,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,481,100,,,percent of total billed charges,100% of total billed charges,83.23,17.304,,,percent of total billed charges,17.304% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,303.03,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,15.3,,,percent of total billed charges,15.3% of total billed charges,331.89,69,,,percent of total billed charges,69% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,481,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,82.42,17.136,,,percent of total billed charges,17.136% of total billed charges,105.05,21.84,,,percent of total billed charges,21.84% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,163.06,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,375.18,78,,,percent of total billed charges,78% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,605.96,
Neonatal ABORh,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
Neonatal ABORh,30086900,CDM,300,RC,86900,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,454.8,
REF Antibody Titer,30086886,CDM,300,RC,86886,HCPCS,Outpatient,,,743,482.95,,653.84,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,743,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,468.09,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,113.68,15.3,,,percent of total billed charges,15.3% of total billed charges,512.67,69,,,percent of total billed charges,69% of total billed charges,743,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,743,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,743,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,280.11,37.7,,,percent of total billed charges,37.70% of total billed charges,280.11,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,251.88,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,579.54,78,,,percent of total billed charges,78% of total billed charges,743,100,,,percent of total billed charges,100% of total billed charges,613.72,82.6,,,percent of total billed charges,82.6% of total billed charges,613.72,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,743,
REF Kleihauer-Betke,30085460,CDM,300,RC,85460,HCPCS,Outpatient,,,170,110.50,,149.6,88,,,percent of total billed charges,88% of total Billed charges,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,170,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,107.1,63,,,percent of total billed charges,63% of total billed charges,13.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,26.01,15.3,,,percent of total billed charges,15.3% of total billed charges,117.3,69,,,percent of total billed charges,69% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,29.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,57.63,33.9,,,percent of total billed charges,33.9% of total billed charges,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,132.6,78,,,percent of total billed charges,78% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.73,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,170,
Rh Only,30086901,CDM,300,RC,86901,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,308,
RhIG,636J2790,CDM,636,RC,J2790,HCPCS,Outpatient,,,236,153.40,,207.68,88,,,percent of total billed charges,88% of total Billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,82.95,100,,,Fee Schedule,100% of WA Medicaid,236,100,,,percent of total billed charges,100% of total billed charges,85.44,103,,,Fee Schedule,103% of WA Medicaid,118,50,,,percent of total billed charges,50% of total Billed charges,148.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,82.95,100,,,Fee Schedule,100% of WA Medicaid,36.11,15.3,,,percent of total billed charges,15.3% of total billed charges,162.84,69,,,percent of total billed charges,69% of total billed charges,236,100,,,percent of total billed charges,100% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,236,100,,,percent of total billed charges,100% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,236,100,,,percent of total billed charges,100% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,145.97,61.85,,,percent of total billed charges,61.85% of total billed charges,82.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,118,50,,,percent of total billed charges,50% of total Billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,55.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,118,50,,,percent of total billed charges,50% of total Billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,84.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.83,130,,,Fee Schedule,130% of WA Medicaid ,118,50,,,percent of total billed charges,50% of total Billed charges,88.97,37.7,,,percent of total billed charges,37.70% of total billed charges,88.97,37.7,,,percent of total billed charges,37.70% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,80,33.9,,,percent of total billed charges,33.9% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,184.08,78,,,percent of total billed charges,78% of total billed charges,236,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,82.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,118,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,118,50,,,percent of total billed charges,50% of total Billed charges,82.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.11,236,
Weak D,30086901,CDM,300,RC,86901,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,3.98,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.02,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,3.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,308,
Basic Metabolic Panel +ICA,30180047,CDM,301,RC,80047,HCPCS,Outpatient,,,240,156.00,,211.2,88,,,percent of total billed charges,88% of total Billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,240,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,151.2,63,,,percent of total billed charges,63% of total billed charges,24.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,36.72,15.3,,,percent of total billed charges,15.3% of total billed charges,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,52.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,81.36,33.9,,,percent of total billed charges,33.9% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.86,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,240,
CARDIAC REHAB W/O MONITOR,94393797,CDM,943,RC,93797,HCPCS,Outpatient,,,509,330.85,,447.92,88,,,percent of total billed charges,88% of total Billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9.87,100,,,Fee Schedule,100% of WA Medicaid,509,100,,,percent of total billed charges,100% of total billed charges,9.87,103,,,Fee Schedule,103% of WA Medicaid,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,320.67,63,,,percent of total billed charges,63% of total billed charges,235.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.87,100,,,Fee Schedule,100% of WA Medicaid,77.88,15.3,,,percent of total billed charges,15.3% of total billed charges,351.21,69,,,percent of total billed charges,69% of total billed charges,509,100,,,percent of total billed charges,100% of total billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,509,100,,,percent of total billed charges,100% of total billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,509,100,,,percent of total billed charges,100% of total billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,471.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.83,130,,,Fee Schedule,130% of WA Medicaid ,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,191.89,37.7,,,percent of total billed charges,37.70% of total billed charges,191.89,37.7,,,percent of total billed charges,37.70% of total billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,172.55,33.9,,,percent of total billed charges,33.9% of total billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,397.02,78,,,percent of total billed charges,78% of total billed charges,509,100,,,percent of total billed charges,100% of total billed charges,420.43,82.6,,,percent of total billed charges,82.6% of total billed charges,420.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,136.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.87,509,
CARDIAC REHAB W/ MONITOR,94393798,CDM,943,RC,93798,HCPCS,Outpatient,,,589,382.85,,518.32,88,,,percent of total billed charges,88% of total Billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,15.18,100,,,Fee Schedule,100% of WA Medicaid,589,100,,,percent of total billed charges,100% of total billed charges,15.18,103,,,Fee Schedule,103% of WA Medicaid,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,371.07,63,,,percent of total billed charges,63% of total billed charges,235.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.18,100,,,Fee Schedule,100% of WA Medicaid,90.12,15.3,,,percent of total billed charges,15.3% of total billed charges,406.41,69,,,percent of total billed charges,69% of total billed charges,589,100,,,percent of total billed charges,100% of total billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,589,100,,,percent of total billed charges,100% of total billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,589,100,,,percent of total billed charges,100% of total billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,471.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,15.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19.73,130,,,Fee Schedule,130% of WA Medicaid ,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,222.05,37.7,,,percent of total billed charges,37.70% of total billed charges,222.05,37.7,,,percent of total billed charges,37.70% of total billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,199.67,33.9,,,percent of total billed charges,33.9% of total billed charges,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,459.42,78,,,percent of total billed charges,78% of total billed charges,589,100,,,percent of total billed charges,100% of total billed charges,486.51,82.6,,,percent of total billed charges,82.6% of total billed charges,486.51,82.6,,,percent of total billed charges,82.6% of total billed charges,15.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,136.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,134.77,100,,,Fee Schedule,100% of Medicare OPPS rate,15.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.18,589,
94618 PULM STRESS TEST - 6 MIN WALK CHARGE,46094618,CDM,460,RC,94618,HCPCS,Outpatient,,,330,214.50,,290.4,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,330,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,207.9,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,50.49,15.3,,,percent of total billed charges,15.3% of total billed charges,227.7,69,,,percent of total billed charges,69% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,111.87,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,257.4,78,,,percent of total billed charges,78% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,454.8,
CARD REHAB GRADUATE EXERCISE,943,CDM,943,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,2.64,37.7,,,percent of total billed charges,37.70% of total billed charges,2.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,2.37,33.9,,,percent of total billed charges,33.9% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
EVENT MONITOR RECORDING,73193270,CDM,731,RC,93270,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,51.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,308,100,,,percent of total billed charges,100% of total billed charges,53.3,17.304,,,percent of total billed charges,17.304% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,67.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,150.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,51.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,52.78,17.136,,,percent of total billed charges,17.136% of total billed charges,67.27,21.84,,,percent of total billed charges,21.84% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,38.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,38.46,308,
CARDIOVASCULAR STRESS,48293017,CDM,482,RC,93017,HCPCS,Outpatient,,,963,625.95,,847.44,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,963,100,,,percent of total billed charges,100% of total billed charges,155.52,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,606.69,63,,,percent of total billed charges,63% of total billed charges,560.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,147.34,15.3,,,percent of total billed charges,15.3% of total billed charges,664.47,69,,,percent of total billed charges,69% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,111.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,154.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.29,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,363.05,37.7,,,percent of total billed charges,37.70% of total billed charges,363.05,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326.46,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,751.14,78,,,percent of total billed charges,78% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.84,1074.33,
EKG,EKG1,CDM,730,RC,93005,HCPCS,Outpatient,,,346,224.90,,304.48,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,346,100,,,percent of total billed charges,100% of total billed charges,24.47,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,217.98,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,52.94,15.3,,,percent of total billed charges,15.3% of total billed charges,238.74,69,,,percent of total billed charges,69% of total billed charges,346,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,346,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,346,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.89,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,130.44,37.7,,,percent of total billed charges,37.70% of total billed charges,130.44,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,117.29,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,269.88,78,,,percent of total billed charges,78% of total billed charges,346,100,,,percent of total billed charges,100% of total billed charges,285.8,82.6,,,percent of total billed charges,82.6% of total billed charges,285.8,82.6,,,percent of total billed charges,82.6% of total billed charges,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,346,
ELECTROCARDIOGRAM,73093005,CDM,730,RC,93005,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,24.47,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,302.4,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,73.44,15.3,,,percent of total billed charges,15.3% of total billed charges,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.89,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,162.72,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,480,
ELECTROCARDIOGRAM,73093005,CDM,730,RC,93005,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,24.47,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,302.4,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,73.44,15.3,,,percent of total billed charges,15.3% of total billed charges,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.89,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,162.72,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,480,
HEALTHY HEART CHECK,301,CDM,301,RC,,,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,12.46,17.304,,,percent of total billed charges,17.304% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,45.36,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,15.3,,,percent of total billed charges,15.3% of total billed charges,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,44.53,61.85,,,percent of total billed charges,61.85% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.34,17.136,,,percent of total billed charges,17.136% of total billed charges,15.72,21.84,,,percent of total billed charges,21.84% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,24.41,33.9,,,percent of total billed charges,33.9% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,72,
EVENT MONITOR RECORDING ONLY,73193270,CDM,731,RC,93270,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,51.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,308,100,,,percent of total billed charges,100% of total billed charges,53.3,17.304,,,percent of total billed charges,17.304% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,194.04,63,,,percent of total billed charges,63% of total billed charges,67.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,308,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,150.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,51.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,52.78,17.136,,,percent of total billed charges,17.136% of total billed charges,67.27,21.84,,,percent of total billed charges,21.84% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,104.41,33.9,,,percent of total billed charges,33.9% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,38.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,38.46,100,,,Fee Schedule,100% of Medicare OPPS rate,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,38.46,308,
HOLTER MONITOR RECORD/HOOKUP,73193225,CDM,731,RC,93225,HCPCS,Outpatient,,,372,241.80,,327.36,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,61.52,100,,,Fee Schedule,100% of WA Medicaid,372,100,,,percent of total billed charges,100% of total billed charges,63.37,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,234.36,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,61.52,100,,,Fee Schedule,100% of WA Medicaid,56.92,15.3,,,percent of total billed charges,15.3% of total billed charges,256.68,69,,,percent of total billed charges,69% of total billed charges,372,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,372,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,372,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,45.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,62.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.98,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,140.24,37.7,,,percent of total billed charges,37.70% of total billed charges,140.24,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,126.11,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,290.16,78,,,percent of total billed charges,78% of total billed charges,372,100,,,percent of total billed charges,100% of total billed charges,307.27,82.6,,,percent of total billed charges,82.6% of total billed charges,307.27,82.6,,,percent of total billed charges,82.6% of total billed charges,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.57,454.8,
EKG RHYTHM STRIP,73093041,CDM,730,RC,93041,HCPCS,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,220,100,,,percent of total billed charges,100% of total billed charges,24.47,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,138.6,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,33.66,15.3,,,percent of total billed charges,15.3% of total billed charges,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,220,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,220,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.89,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,74.58,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,226.12,
"23929 Unlisted procedure, shoulder.",76123929,CDM,761,RC,23929,HCPCS,Outpatient,,,424,275.60,,373.12,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,424,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,267.12,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,64.87,15.3,,,percent of total billed charges,15.3% of total billed charges,292.56,69,,,percent of total billed charges,69% of total billed charges,424,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,424,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,424,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,159.85,37.7,,,percent of total billed charges,37.70% of total billed charges,159.85,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,143.74,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,330.72,78,,,percent of total billed charges,78% of total billed charges,424,100,,,percent of total billed charges,100% of total billed charges,350.22,82.6,,,percent of total billed charges,82.6% of total billed charges,350.22,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.87,837.64,
64495 - INJ PARAVERT F JNT L/S 3 LEV.,76164495,CDM,761,RC,64495,HCPCS,Outpatient,,,639,415.35,,562.32,88,,,percent of total billed charges,88% of total Billed charges,319.5,50,,,percent of total billed charges,50% of total Billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid,639,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,319.5,50,,,percent of total billed charges,50% of total Billed charges,402.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,770.67,100,,,Fee Schedule,100% of WA Medicaid,97.77,15.3,,,percent of total billed charges,15.3% of total billed charges,440.91,69,,,percent of total billed charges,69% of total billed charges,639,100,,,percent of total billed charges,100% of total billed charges,319.5,50,,,percent of total billed charges,50% of total Billed charges,639,100,,,percent of total billed charges,100% of total billed charges,319.5,50,,,percent of total billed charges,50% of total Billed charges,639,100,,,percent of total billed charges,100% of total billed charges,319.5,50,,,percent of total billed charges,50% of total Billed charges,395.22,61.85,,,percent of total billed charges,61.85% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,319.5,50,,,percent of total billed charges,50% of total Billed charges,319.5,50,,,percent of total billed charges,50% of total Billed charges,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,319.5,50,,,percent of total billed charges,50% of total Billed charges,319.5,50,,,percent of total billed charges,50% of total Billed charges,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,319.5,50,,,percent of total billed charges,50% of total Billed charges,240.9,37.7,,,percent of total billed charges,37.70% of total billed charges,240.9,37.7,,,percent of total billed charges,37.70% of total billed charges,319.5,50,,,percent of total billed charges,50% of total Billed charges,216.62,33.9,,,percent of total billed charges,33.9% of total billed charges,319.5,50,,,percent of total billed charges,50% of total Billed charges,498.42,78,,,percent of total billed charges,78% of total billed charges,639,100,,,percent of total billed charges,100% of total billed charges,527.81,82.6,,,percent of total billed charges,82.6% of total billed charges,527.81,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,319.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,319.5,50,,,percent of total billed charges,50% of total Billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.77,1001.87,
CENTRAL CATH NONTUN AGE 5+YRS,76136556,CDM,761,RC,36556,HCPCS,Outpatient,,,4928,3203.20,,4336.64,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3104.64,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,753.98,15.3,,,percent of total billed charges,15.3% of total billed charges,3400.32,69,,,percent of total billed charges,69% of total billed charges,4928,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4928,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4928,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1857.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1857.86,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.59,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3843.84,78,,,percent of total billed charges,78% of total billed charges,4928,100,,,percent of total billed charges,100% of total billed charges,4070.53,82.6,,,percent of total billed charges,82.6% of total billed charges,4070.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,750.54,11625.57,
PICC LINE INSERT > 5 YEARS OLD,76036569,CDM,760,RC,36569,HCPCS,Outpatient,,,3873,2517.45,,3408.24,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,3873,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2439.99,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,774.6,15.3,,,percent of total billed charges,15.3% of total billed charges,2672.37,69,,,percent of total billed charges,69% of total billed charges,3873,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3873,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3873,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1460.12,37.7,,,percent of total billed charges,37.70% of total billed charges,1460.12,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1312.95,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3020.94,78,,,percent of total billed charges,78% of total billed charges,3873,100,,,percent of total billed charges,100% of total billed charges,3199.1,82.6,,,percent of total billed charges,82.6% of total billed charges,3199.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,750.54,5712.48,
92136570,92136570,CDM,921,RC,36570,HCPCS,Outpatient,,,2166,1407.90,,1906.08,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,2166,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1364.58,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,331.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1494.54,69,,,percent of total billed charges,69% of total billed charges,2166,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2166,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2166,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,816.58,37.7,,,percent of total billed charges,37.70% of total billed charges,816.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,734.27,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1689.48,78,,,percent of total billed charges,78% of total billed charges,2166,100,,,percent of total billed charges,100% of total billed charges,1789.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1789.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,331.4,11625.57,
REMOVE TUNNELED CVC NO PORT/PU,76136589,CDM,761,RC,36589,HCPCS,Outpatient,,,1385,900.25,,1218.8,88,,,percent of total billed charges,88% of total Billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,1385,100,,,percent of total billed charges,100% of total billed charges,678.35,103,,,Fee Schedule,103% of WA Medicaid,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,872.55,63,,,percent of total billed charges,63% of total billed charges,1121.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,211.91,15.3,,,percent of total billed charges,15.3% of total billed charges,955.65,69,,,percent of total billed charges,69% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,1385,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,1385,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2200.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,487.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,671.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.17,130,,,Fee Schedule,130% of WA Medicaid ,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,469.52,33.9,,,percent of total billed charges,33.9% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,1080.3,78,,,percent of total billed charges,78% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,647.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,211.91,2200.34,
DECLOT VASCULAR DEVICE,76036593,CDM,760,RC,36593,HCPCS,Outpatient,,,994,646.10,,874.72,88,,,percent of total billed charges,88% of total Billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,994,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,626.22,63,,,percent of total billed charges,63% of total billed charges,604.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,198.8,15.3,,,percent of total billed charges,15.3% of total billed charges,685.86,69,,,percent of total billed charges,69% of total billed charges,994,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,994,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,994,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1262.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,374.74,37.7,,,percent of total billed charges,37.70% of total billed charges,374.74,37.7,,,percent of total billed charges,37.70% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,336.97,33.9,,,percent of total billed charges,33.9% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,775.32,78,,,percent of total billed charges,78% of total billed charges,994,100,,,percent of total billed charges,100% of total billed charges,821.04,82.6,,,percent of total billed charges,82.6% of total billed charges,821.04,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,348.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,198.8,1262.42,
LAB DRAW VIA CENTRAL LINE,30036592,CDM,300,RC,36592,HCPCS,Outpatient,,,401,260.65,,352.88,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,401,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,61.35,15.3,,,percent of total billed charges,15.3% of total billed charges,276.69,69,,,percent of total billed charges,69% of total billed charges,401,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,401,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,401,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,151.18,37.7,,,percent of total billed charges,37.70% of total billed charges,151.18,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,135.94,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,312.78,78,,,percent of total billed charges,78% of total billed charges,401,100,,,percent of total billed charges,100% of total billed charges,331.23,82.6,,,percent of total billed charges,82.6% of total billed charges,331.23,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.15,454.8,
BONE MARROW ASPIRATION,76038220,CDM,760,RC,38220,HCPCS,Outpatient,,,4211,2737.15,,3705.68,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,4211,100,,,percent of total billed charges,100% of total billed charges,1102.48,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2652.93,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,842.2,15.3,,,percent of total billed charges,15.3% of total billed charges,2905.59,69,,,percent of total billed charges,69% of total billed charges,4211,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4211,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4211,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,792.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1091.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1391.48,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1587.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1587.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1427.53,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3284.58,78,,,percent of total billed charges,78% of total billed charges,4211,100,,,percent of total billed charges,100% of total billed charges,3478.29,82.6,,,percent of total billed charges,82.6% of total billed charges,3478.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,792.87,5715.97,
BONE MARROW BIOPSY NDL OR TROC,76038221,CDM,760,RC,38221,HCPCS,Outpatient,,,1119,727.35,,984.72,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,1119,100,,,percent of total billed charges,100% of total billed charges,1102.48,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,704.97,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,223.8,15.3,,,percent of total billed charges,15.3% of total billed charges,772.11,69,,,percent of total billed charges,69% of total billed charges,1119,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1119,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1119,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,792.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1091.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1391.48,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,421.86,37.7,,,percent of total billed charges,37.70% of total billed charges,421.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,379.34,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,872.82,78,,,percent of total billed charges,78% of total billed charges,1119,100,,,percent of total billed charges,100% of total billed charges,924.29,82.6,,,percent of total billed charges,82.6% of total billed charges,924.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,223.8,5715.97,
38222 DIAGNOSTIC BONE MARROW; BIOPSY AND ASPIRATION,38222,CDM,761,RC,38222,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1102.48,103,,,Fee Schedule,103% of WA Medicaid,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,5071.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,9628.23,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,792.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1091.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1391.48,130,,,Fee Schedule,130% of WA Medicaid ,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2927.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,792.87,9628.23,
"51701 CATHETER INSERTION,SIMPLE CHARGE",76151701,CDM,761,RC,51701,HCPCS,Outpatient,,,169,109.85,,148.72,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,169,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,106.47,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,25.86,15.3,,,percent of total billed charges,15.3% of total billed charges,116.61,69,,,percent of total billed charges,69% of total billed charges,169,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,169,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,169,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,48.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,63.71,37.7,,,percent of total billed charges,37.70% of total billed charges,63.71,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,57.29,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.82,78,,,percent of total billed charges,78% of total billed charges,169,100,,,percent of total billed charges,100% of total billed charges,139.59,82.6,,,percent of total billed charges,82.6% of total billed charges,139.59,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.86,454.8,
51703 CATHETERIZATION COMPLEX CHARGE,76151703,CDM,761,RC,51703,HCPCS,Outpatient,,,275,178.75,,242,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,275,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,173.25,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,42.08,15.3,,,percent of total billed charges,15.3% of total billed charges,189.75,69,,,percent of total billed charges,69% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,275,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,275,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,48.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,93.23,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,214.5,78,,,percent of total billed charges,78% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.08,566.91,
FINGER STICK FOR GLUCOSE METER,30082962,CDM,300,RC,82962,HCPCS,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,49,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,30.87,63,,,percent of total billed charges,63% of total billed charges,5.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,12.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,16.61,33.9,,,percent of total billed charges,33.9% of total billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,49,
IMMUNIZATION ADMIN 1 VACCINE,77190471,CDM,771,RC,90471,HCPCS,Outpatient,,,391,254.15,,344.08,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,391,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,246.33,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,59.82,15.3,,,percent of total billed charges,15.3% of total billed charges,269.79,69,,,percent of total billed charges,69% of total billed charges,391,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,391,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,391,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,147.41,37.7,,,percent of total billed charges,37.70% of total billed charges,147.41,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,132.55,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,304.98,78,,,percent of total billed charges,78% of total billed charges,391,100,,,percent of total billed charges,100% of total billed charges,322.97,82.6,,,percent of total billed charges,82.6% of total billed charges,322.97,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.64,391,
IMMUNIZATION ADMIN EA ADD'L,77190472,CDM,771,RC,90472,HCPCS,Outpatient,,,466,302.90,,410.08,88,,,percent of total billed charges,88% of total Billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,466,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,233,50,,,percent of total billed charges,50% of total Billed charges,293.58,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,71.3,15.3,,,percent of total billed charges,15.3% of total billed charges,321.54,69,,,percent of total billed charges,69% of total billed charges,466,100,,,percent of total billed charges,100% of total billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,466,100,,,percent of total billed charges,100% of total billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,466,100,,,percent of total billed charges,100% of total billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,288.22,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233,50,,,percent of total billed charges,50% of total Billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,233,50,,,percent of total billed charges,50% of total Billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,233,50,,,percent of total billed charges,50% of total Billed charges,175.68,37.7,,,percent of total billed charges,37.70% of total billed charges,175.68,37.7,,,percent of total billed charges,37.70% of total billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,157.97,33.9,,,percent of total billed charges,33.9% of total billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,363.48,78,,,percent of total billed charges,78% of total billed charges,466,100,,,percent of total billed charges,100% of total billed charges,384.92,82.6,,,percent of total billed charges,82.6% of total billed charges,384.92,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,233,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.64,466,
IV INF THERA INITIAL 1ST HR,AMB820025,CDM,761,RC,96365,HCPCS,Outpatient,,,885,575.25,,778.8,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,885,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,135.41,15.3,,,percent of total billed charges,15.3% of total billed charges,610.65,69,,,percent of total billed charges,69% of total billed charges,885,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,885,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,885,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,333.65,37.7,,,percent of total billed charges,37.70% of total billed charges,333.65,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,300.02,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,690.3,78,,,percent of total billed charges,78% of total billed charges,885,100,,,percent of total billed charges,100% of total billed charges,731.01,82.6,,,percent of total billed charges,82.6% of total billed charges,731.01,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,135.41,885,
IV INFUSION SEQUENTIAL EA HR,AMB820061,CDM,761,RC,96367,HCPCS,Outpatient,,,563,365.95,,495.44,88,,,percent of total billed charges,88% of total Billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,563,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,86.14,15.3,,,percent of total billed charges,15.3% of total billed charges,388.47,69,,,percent of total billed charges,69% of total billed charges,563,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,563,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,563,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,251.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,212.25,37.7,,,percent of total billed charges,37.70% of total billed charges,212.25,37.7,,,percent of total billed charges,37.70% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,190.86,33.9,,,percent of total billed charges,33.9% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,439.14,78,,,percent of total billed charges,78% of total billed charges,563,100,,,percent of total billed charges,100% of total billed charges,465.04,82.6,,,percent of total billed charges,82.6% of total billed charges,465.04,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.84,563,
CHEMO ADM SUBQ/IM NON HORMONAL,33196401,CDM,331,RC,96401,HCPCS,Outpatient,,,615,399.75,,541.2,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,615,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,387.45,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,94.1,15.3,,,percent of total billed charges,15.3% of total billed charges,424.35,69,,,percent of total billed charges,69% of total billed charges,615,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,615,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,615,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,231.86,37.7,,,percent of total billed charges,37.70% of total billed charges,231.86,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,208.49,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,479.7,78,,,percent of total billed charges,78% of total billed charges,615,100,,,percent of total billed charges,100% of total billed charges,507.99,82.6,,,percent of total billed charges,82.6% of total billed charges,507.99,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,615,
HORMONAL ANTI-NEOPLASTIC,33196402,CDM,331,RC,96402,HCPCS,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,364,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,229.32,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,55.69,15.3,,,percent of total billed charges,15.3% of total billed charges,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,123.4,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,364,
IVPUSH TECHNIQUE SGL/INIT DRUG,33596409,CDM,335,RC,96409,HCPCS,Outpatient,,,885,575.25,,778.8,88,,,percent of total billed charges,88% of total Billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,885,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,557.55,63,,,percent of total billed charges,63% of total billed charges,604.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,135.41,15.3,,,percent of total billed charges,15.3% of total billed charges,610.65,69,,,percent of total billed charges,69% of total billed charges,885,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,885,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,885,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,333.65,37.7,,,percent of total billed charges,37.70% of total billed charges,333.65,37.7,,,percent of total billed charges,37.70% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,300.02,33.9,,,percent of total billed charges,33.9% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,690.3,78,,,percent of total billed charges,78% of total billed charges,885,100,,,percent of total billed charges,100% of total billed charges,731.01,82.6,,,percent of total billed charges,82.6% of total billed charges,731.01,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,348.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,885,
CHEMO ADM:INTRALESIONAL 1-7LES,33196405,CDM,331,RC,96405,HCPCS,Outpatient,,,557,362.05,,490.16,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,557,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,350.91,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,85.22,15.3,,,percent of total billed charges,15.3% of total billed charges,384.33,69,,,percent of total billed charges,69% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,188.82,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,434.46,78,,,percent of total billed charges,78% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,557,
INTRALESIONAL > 7 LESIONS,33196406,CDM,331,RC,96406,HCPCS,Outpatient,,,791,514.15,,696.08,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,791,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,498.33,63,,,percent of total billed charges,63% of total billed charges,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,121.02,15.3,,,percent of total billed charges,15.3% of total billed charges,545.79,69,,,percent of total billed charges,69% of total billed charges,791,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,791,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,791,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,298.21,37.7,,,percent of total billed charges,37.70% of total billed charges,298.21,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,268.15,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,616.98,78,,,percent of total billed charges,78% of total billed charges,791,100,,,percent of total billed charges,100% of total billed charges,653.37,82.6,,,percent of total billed charges,82.6% of total billed charges,653.37,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,826.71,
INT OR PROLONG CHEM >8HR WPUMP,33596416,CDM,335,RC,96416,HCPCS,Outpatient,,,1453,944.45,,1278.64,88,,,percent of total billed charges,88% of total Billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,1453,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,915.39,63,,,percent of total billed charges,63% of total billed charges,604.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,222.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1002.57,69,,,percent of total billed charges,69% of total billed charges,1453,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1453,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1453,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1262.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,547.78,37.7,,,percent of total billed charges,37.70% of total billed charges,547.78,37.7,,,percent of total billed charges,37.70% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,492.57,33.9,,,percent of total billed charges,33.9% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1133.34,78,,,percent of total billed charges,78% of total billed charges,1453,100,,,percent of total billed charges,100% of total billed charges,1200.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1200.18,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,348.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,222.31,1453,
EA ADD'L SEQ INF DIF DRUG/1HR,33596417,CDM,335,RC,96417,HCPCS,Outpatient,,,347,225.55,,305.36,88,,,percent of total billed charges,88% of total Billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,347,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,53.09,15.3,,,percent of total billed charges,15.3% of total billed charges,239.43,69,,,percent of total billed charges,69% of total billed charges,347,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,347,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,347,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,251.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,130.82,37.7,,,percent of total billed charges,37.70% of total billed charges,130.82,37.7,,,percent of total billed charges,37.70% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,117.63,33.9,,,percent of total billed charges,33.9% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,270.66,78,,,percent of total billed charges,78% of total billed charges,347,100,,,percent of total billed charges,100% of total billed charges,286.62,82.6,,,percent of total billed charges,82.6% of total billed charges,286.62,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.09,354.88,
IVPUSH TECHNIQUE EA ADD'D DRUG,33596411,CDM,335,RC,96411,HCPCS,Outpatient,,,354,230.10,,311.52,88,,,percent of total billed charges,88% of total Billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,354,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,223.02,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,54.16,15.3,,,percent of total billed charges,15.3% of total billed charges,244.26,69,,,percent of total billed charges,69% of total billed charges,354,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,354,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,354,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,251.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,133.46,37.7,,,percent of total billed charges,37.70% of total billed charges,133.46,37.7,,,percent of total billed charges,37.70% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,120.01,33.9,,,percent of total billed charges,33.9% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,276.12,78,,,percent of total billed charges,78% of total billed charges,354,100,,,percent of total billed charges,100% of total billed charges,292.4,82.6,,,percent of total billed charges,82.6% of total billed charges,292.4,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,354,
CHEMO ADM IV INF 1HR SGL INIT,33596413,CDM,335,RC,96413,HCPCS,Outpatient,,,1453,944.45,,1278.64,88,,,percent of total billed charges,88% of total Billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,1453,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,915.39,63,,,percent of total billed charges,63% of total billed charges,604.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,222.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1002.57,69,,,percent of total billed charges,69% of total billed charges,1453,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1453,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1453,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1262.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,547.78,37.7,,,percent of total billed charges,37.70% of total billed charges,547.78,37.7,,,percent of total billed charges,37.70% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,492.57,33.9,,,percent of total billed charges,33.9% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1133.34,78,,,percent of total billed charges,78% of total billed charges,1453,100,,,percent of total billed charges,100% of total billed charges,1200.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1200.18,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,348.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,202.21,1453,
CHEMO ADM IV INF EA ADD'L HR,33596415,CDM,335,RC,96415,HCPCS,Outpatient,,,272,176.80,,239.36,88,,,percent of total billed charges,88% of total Billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,272,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,171.36,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,41.62,15.3,,,percent of total billed charges,15.3% of total billed charges,187.68,69,,,percent of total billed charges,69% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,251.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,92.21,33.9,,,percent of total billed charges,33.9% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,212.16,78,,,percent of total billed charges,78% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.62,600.65,
96450 CHEMO CNS (INTRATHECAL),96450,CDM,280,RC,96450,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,475.9,103,,,Fee Schedule,103% of WA Medicaid,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,604.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1262.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,348.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,342.25,1262.42,
IMPLNT VENOUS DEVICE IRRIGATIO,76096523,CDM,760,RC,96523,HCPCS,Outpatient,,,401,260.65,,352.88,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,401,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,80.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276.69,69,,,percent of total billed charges,69% of total billed charges,401,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,401,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,401,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,151.18,37.7,,,percent of total billed charges,37.70% of total billed charges,151.18,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,135.94,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,312.78,78,,,percent of total billed charges,78% of total billed charges,401,100,,,percent of total billed charges,100% of total billed charges,331.23,82.6,,,percent of total billed charges,82.6% of total billed charges,331.23,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,401,
99195 PHLEBOTOMY - THERAPEUTIC CHARGE,99195,CDM,940,RC,99195,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,54.44,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.15,454.8,
OP VISIT LEVEL 5 NEW PT,51099205,CDM,510,RC,99205,HCPCS,Outpatient,,,321,208.65,,282.48,88,,,percent of total billed charges,88% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,321,100,,,percent of total billed charges,100% of total billed charges,55.55,17.304,,,percent of total billed charges,17.304% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,202.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,49.11,15.3,,,percent of total billed charges,15.3% of total billed charges,221.49,69,,,percent of total billed charges,69% of total billed charges,321,100,,,percent of total billed charges,100% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,321,100,,,percent of total billed charges,100% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,321,100,,,percent of total billed charges,100% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,198.54,61.85,,,percent of total billed charges,61.85% of total billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,55.01,17.136,,,percent of total billed charges,17.136% of total billed charges,70.11,21.84,,,percent of total billed charges,21.84% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,160.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,160.5,50,,,percent of total billed charges,50% of total Billed charges,250.38,78,,,percent of total billed charges,78% of total billed charges,321,100,,,percent of total billed charges,100% of total billed charges,265.15,82.6,,,percent of total billed charges,82.6% of total billed charges,265.15,82.6,,,percent of total billed charges,82.6% of total billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,160.5,50,,,percent of total billed charges,50% of total Billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,49.11,321,
OP VISIT LEVEL 2 NEW PT,51099202,CDM,510,RC,99202,HCPCS,Outpatient,,,117,76.05,,102.96,88,,,percent of total billed charges,88% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,117,100,,,percent of total billed charges,100% of total billed charges,20.25,17.304,,,percent of total billed charges,17.304% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,73.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,17.9,15.3,,,percent of total billed charges,15.3% of total billed charges,80.73,69,,,percent of total billed charges,69% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,117,100,,,percent of total billed charges,100% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,117,100,,,percent of total billed charges,100% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,72.36,61.85,,,percent of total billed charges,61.85% of total billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,20.05,17.136,,,percent of total billed charges,17.136% of total billed charges,25.55,21.84,,,percent of total billed charges,21.84% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,58.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58.5,50,,,percent of total billed charges,50% of total Billed charges,91.26,78,,,percent of total billed charges,78% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58.5,50,,,percent of total billed charges,50% of total Billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,17.9,117,
OP VISIT LEVEL 3 NEW PT,51099203,CDM,510,RC,99203,HCPCS,Outpatient,,,165,107.25,,145.2,88,,,percent of total billed charges,88% of total Billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,27.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,165,100,,,percent of total billed charges,100% of total billed charges,28.55,17.304,,,percent of total billed charges,17.304% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,103.95,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.72,16.8,,,percent of total billed charges,16.8% of total billed charges,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,165,100,,,percent of total billed charges,100% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,165,100,,,percent of total billed charges,100% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,102.05,61.85,,,percent of total billed charges,61.85% of total billed charges,27.72,16.8,,,percent of total billed charges,16.8% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,27.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,28.27,17.136,,,percent of total billed charges,17.136% of total billed charges,36.04,21.84,,,percent of total billed charges,21.84% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,82.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,82.5,50,,,percent of total billed charges,50% of total Billed charges,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,27.72,16.8,,,percent of total billed charges,16.8% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,82.5,50,,,percent of total billed charges,50% of total Billed charges,27.72,16.8,,,percent of total billed charges,16.8% of total billed charges,25.25,165,
OP VISIT LEVEL 4 NEW PT,51099204,CDM,510,RC,99204,HCPCS,Outpatient,,,256,166.40,,225.28,88,,,percent of total billed charges,88% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,256,100,,,percent of total billed charges,100% of total billed charges,44.3,17.304,,,percent of total billed charges,17.304% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,161.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,39.17,15.3,,,percent of total billed charges,15.3% of total billed charges,176.64,69,,,percent of total billed charges,69% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,256,100,,,percent of total billed charges,100% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,256,100,,,percent of total billed charges,100% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,158.34,61.85,,,percent of total billed charges,61.85% of total billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,43.87,17.136,,,percent of total billed charges,17.136% of total billed charges,55.91,21.84,,,percent of total billed charges,21.84% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,128,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,128,50,,,percent of total billed charges,50% of total Billed charges,199.68,78,,,percent of total billed charges,78% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,128,50,,,percent of total billed charges,50% of total Billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,39.17,256,
OP VISIT LEVEL 5 EST PT,51099215,CDM,510,RC,99215,HCPCS,Outpatient,,,624,405.60,,549.12,88,,,percent of total billed charges,88% of total Billed charges,312,50,,,percent of total billed charges,50% of total Billed charges,104.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,624,100,,,percent of total billed charges,100% of total billed charges,107.98,17.304,,,percent of total billed charges,17.304% of total billed charges,312,50,,,percent of total billed charges,50% of total Billed charges,393.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,104.83,16.8,,,percent of total billed charges,16.8% of total billed charges,95.47,15.3,,,percent of total billed charges,15.3% of total billed charges,430.56,69,,,percent of total billed charges,69% of total billed charges,624,100,,,percent of total billed charges,100% of total billed charges,312,50,,,percent of total billed charges,50% of total Billed charges,624,100,,,percent of total billed charges,100% of total billed charges,312,50,,,percent of total billed charges,50% of total Billed charges,624,100,,,percent of total billed charges,100% of total billed charges,312,50,,,percent of total billed charges,50% of total Billed charges,385.94,61.85,,,percent of total billed charges,61.85% of total billed charges,104.83,16.8,,,percent of total billed charges,16.8% of total billed charges,312,50,,,percent of total billed charges,50% of total Billed charges,312,50,,,percent of total billed charges,50% of total Billed charges,104.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,312,50,,,percent of total billed charges,50% of total Billed charges,312,50,,,percent of total billed charges,50% of total Billed charges,106.93,17.136,,,percent of total billed charges,17.136% of total billed charges,136.28,21.84,,,percent of total billed charges,21.84% of total billed charges,312,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,312,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,312,50,,,percent of total billed charges,50% of total Billed charges,486.72,78,,,percent of total billed charges,78% of total billed charges,624,100,,,percent of total billed charges,100% of total billed charges,515.42,82.6,,,percent of total billed charges,82.6% of total billed charges,515.42,82.6,,,percent of total billed charges,82.6% of total billed charges,104.83,16.8,,,percent of total billed charges,16.8% of total billed charges,312,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,312,50,,,percent of total billed charges,50% of total Billed charges,104.83,16.8,,,percent of total billed charges,16.8% of total billed charges,95.47,624,
OP VISIT LEVEL 1 EST PT,51099211,CDM,510,RC,99211,HCPCS,Outpatient,,,479,311.35,,421.52,88,,,percent of total billed charges,88% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,479,100,,,percent of total billed charges,100% of total billed charges,82.89,17.304,,,percent of total billed charges,17.304% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,301.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,73.29,15.3,,,percent of total billed charges,15.3% of total billed charges,330.51,69,,,percent of total billed charges,69% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,479,100,,,percent of total billed charges,100% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,479,100,,,percent of total billed charges,100% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,296.26,61.85,,,percent of total billed charges,61.85% of total billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,82.08,17.136,,,percent of total billed charges,17.136% of total billed charges,104.61,21.84,,,percent of total billed charges,21.84% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,239.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,239.5,50,,,percent of total billed charges,50% of total Billed charges,373.62,78,,,percent of total billed charges,78% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,239.5,50,,,percent of total billed charges,50% of total Billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,73.29,479,
OP VISIT LEVEL 2 EST PT,51099212,CDM,510,RC,99212,HCPCS,Outpatient,,,479,311.35,,421.52,88,,,percent of total billed charges,88% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,479,100,,,percent of total billed charges,100% of total billed charges,82.89,17.304,,,percent of total billed charges,17.304% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,301.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,73.29,15.3,,,percent of total billed charges,15.3% of total billed charges,330.51,69,,,percent of total billed charges,69% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,479,100,,,percent of total billed charges,100% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,479,100,,,percent of total billed charges,100% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,296.26,61.85,,,percent of total billed charges,61.85% of total billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,82.08,17.136,,,percent of total billed charges,17.136% of total billed charges,104.61,21.84,,,percent of total billed charges,21.84% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,239.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,239.5,50,,,percent of total billed charges,50% of total Billed charges,373.62,78,,,percent of total billed charges,78% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,239.5,50,,,percent of total billed charges,50% of total Billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,73.29,479,
OP VISIT LEVEL 3 EST PT,51099213,CDM,510,RC,99213,HCPCS,Outpatient,,,427,277.55,,375.76,88,,,percent of total billed charges,88% of total Billed charges,213.5,50,,,percent of total billed charges,50% of total Billed charges,71.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,427,100,,,percent of total billed charges,100% of total billed charges,73.89,17.304,,,percent of total billed charges,17.304% of total billed charges,213.5,50,,,percent of total billed charges,50% of total Billed charges,269.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,71.74,16.8,,,percent of total billed charges,16.8% of total billed charges,65.33,15.3,,,percent of total billed charges,15.3% of total billed charges,294.63,69,,,percent of total billed charges,69% of total billed charges,427,100,,,percent of total billed charges,100% of total billed charges,213.5,50,,,percent of total billed charges,50% of total Billed charges,427,100,,,percent of total billed charges,100% of total billed charges,213.5,50,,,percent of total billed charges,50% of total Billed charges,427,100,,,percent of total billed charges,100% of total billed charges,213.5,50,,,percent of total billed charges,50% of total Billed charges,264.1,61.85,,,percent of total billed charges,61.85% of total billed charges,71.74,16.8,,,percent of total billed charges,16.8% of total billed charges,213.5,50,,,percent of total billed charges,50% of total Billed charges,213.5,50,,,percent of total billed charges,50% of total Billed charges,71.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,213.5,50,,,percent of total billed charges,50% of total Billed charges,213.5,50,,,percent of total billed charges,50% of total Billed charges,73.17,17.136,,,percent of total billed charges,17.136% of total billed charges,93.26,21.84,,,percent of total billed charges,21.84% of total billed charges,213.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,213.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,213.5,50,,,percent of total billed charges,50% of total Billed charges,333.06,78,,,percent of total billed charges,78% of total billed charges,427,100,,,percent of total billed charges,100% of total billed charges,352.7,82.6,,,percent of total billed charges,82.6% of total billed charges,352.7,82.6,,,percent of total billed charges,82.6% of total billed charges,71.74,16.8,,,percent of total billed charges,16.8% of total billed charges,213.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,213.5,50,,,percent of total billed charges,50% of total Billed charges,71.74,16.8,,,percent of total billed charges,16.8% of total billed charges,65.33,427,
OP VISIT LEVEL 4 EST PT,51099214,CDM,510,RC,99214,HCPCS,Outpatient,,,447,290.55,,393.36,88,,,percent of total billed charges,88% of total Billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,75.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,447,100,,,percent of total billed charges,100% of total billed charges,77.35,17.304,,,percent of total billed charges,17.304% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,281.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.1,16.8,,,percent of total billed charges,16.8% of total billed charges,68.39,15.3,,,percent of total billed charges,15.3% of total billed charges,308.43,69,,,percent of total billed charges,69% of total billed charges,447,100,,,percent of total billed charges,100% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,447,100,,,percent of total billed charges,100% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,447,100,,,percent of total billed charges,100% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,276.47,61.85,,,percent of total billed charges,61.85% of total billed charges,75.1,16.8,,,percent of total billed charges,16.8% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,75.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,76.6,17.136,,,percent of total billed charges,17.136% of total billed charges,97.62,21.84,,,percent of total billed charges,21.84% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,223.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,223.5,50,,,percent of total billed charges,50% of total Billed charges,348.66,78,,,percent of total billed charges,78% of total billed charges,447,100,,,percent of total billed charges,100% of total billed charges,369.22,82.6,,,percent of total billed charges,82.6% of total billed charges,369.22,82.6,,,percent of total billed charges,82.6% of total billed charges,75.1,16.8,,,percent of total billed charges,16.8% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,223.5,50,,,percent of total billed charges,50% of total Billed charges,75.1,16.8,,,percent of total billed charges,16.8% of total billed charges,68.39,447,
OBSERVATION G0378,G0378,CDM,762,RC,G0378,HCPCS,Outpatient,,,701,455.65,,616.88,88,,,percent of total billed charges,88% of total Billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,117.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,701,100,,,percent of total billed charges,100% of total billed charges,121.3,17.304,,,percent of total billed charges,17.304% of total billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,441.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.77,16.8,,,percent of total billed charges,16.8% of total billed charges,140.2,15.3,,,percent of total billed charges,15.3% of total billed charges,483.69,69,,,percent of total billed charges,69% of total billed charges,701,100,,,percent of total billed charges,100% of total billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,701,100,,,percent of total billed charges,100% of total billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,701,100,,,percent of total billed charges,100% of total billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,433.57,61.85,,,percent of total billed charges,61.85% of total billed charges,117.77,16.8,,,percent of total billed charges,16.8% of total billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,537.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,350.5,50,,,percent of total billed charges,50% of total Billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,120.12,17.136,,,percent of total billed charges,17.136% of total billed charges,153.1,21.84,,,percent of total billed charges,21.84% of total billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,264.28,37.7,,,percent of total billed charges,37.70% of total billed charges,264.28,37.7,,,percent of total billed charges,37.70% of total billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,237.64,33.9,,,percent of total billed charges,33.9% of total billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,546.78,78,,,percent of total billed charges,78% of total billed charges,701,100,,,percent of total billed charges,100% of total billed charges,579.03,82.6,,,percent of total billed charges,82.6% of total billed charges,579.03,82.6,,,percent of total billed charges,82.6% of total billed charges,117.77,16.8,,,percent of total billed charges,16.8% of total billed charges,350.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350.5,50,,,percent of total billed charges,50% of total Billed charges,117.77,16.8,,,percent of total billed charges,16.8% of total billed charges,117.77,701,
Observation Level 1 G0379,G0379,CDM,769,RC,G0379,HCPCS,Outpatient,,,701,455.65,,616.88,88,,,percent of total billed charges,88% of total Billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,117.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,701,100,,,percent of total billed charges,100% of total billed charges,121.3,17.304,,,percent of total billed charges,17.304% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,441.63,63,,,percent of total billed charges,63% of total billed charges,1146.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,117.77,16.8,,,percent of total billed charges,16.8% of total billed charges,140.2,15.3,,,percent of total billed charges,15.3% of total billed charges,483.69,69,,,percent of total billed charges,69% of total billed charges,701,100,,,percent of total billed charges,100% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,701,100,,,percent of total billed charges,100% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,701,100,,,percent of total billed charges,100% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2121.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,117.77,16.8,,,percent of total billed charges,16.8% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,117.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,120.12,17.136,,,percent of total billed charges,17.136% of total billed charges,153.1,21.84,,,percent of total billed charges,21.84% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,264.28,37.7,,,percent of total billed charges,37.70% of total billed charges,264.28,37.7,,,percent of total billed charges,37.70% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,237.64,33.9,,,percent of total billed charges,33.9% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,546.78,78,,,percent of total billed charges,78% of total billed charges,701,100,,,percent of total billed charges,100% of total billed charges,579.03,82.6,,,percent of total billed charges,82.6% of total billed charges,579.03,82.6,,,percent of total billed charges,82.6% of total billed charges,117.77,16.8,,,percent of total billed charges,16.8% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,661.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,117.77,16.8,,,percent of total billed charges,16.8% of total billed charges,117.77,2121.11,
"Arterial catheterization or cannulation for sampling, monito",76136620,CDM,761,RC,36620,HCPCS,Outpatient,,,223,144.95,,196.24,88,,,percent of total billed charges,88% of total Billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,223,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,111.5,50,,,percent of total billed charges,50% of total Billed charges,140.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,34.12,15.3,,,percent of total billed charges,15.3% of total billed charges,153.87,69,,,percent of total billed charges,69% of total billed charges,223,100,,,percent of total billed charges,100% of total billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,223,100,,,percent of total billed charges,100% of total billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,223,100,,,percent of total billed charges,100% of total billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,137.93,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.5,50,,,percent of total billed charges,50% of total Billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.5,50,,,percent of total billed charges,50% of total Billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,111.5,50,,,percent of total billed charges,50% of total Billed charges,84.07,37.7,,,percent of total billed charges,37.70% of total billed charges,84.07,37.7,,,percent of total billed charges,37.70% of total billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,75.6,33.9,,,percent of total billed charges,33.9% of total billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,173.94,78,,,percent of total billed charges,78% of total billed charges,223,100,,,percent of total billed charges,100% of total billed charges,184.2,82.6,,,percent of total billed charges,82.6% of total billed charges,184.2,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,111.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.12,744.35,
IV INFUSION HYDRATION 31M-1HR,45096360,CDM,450,RC,96360,HCPCS,Outpatient,,,528,343.20,,464.64,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,528,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,80.78,15.3,,,percent of total billed charges,15.3% of total billed charges,364.32,69,,,percent of total billed charges,69% of total billed charges,528,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,528,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,528,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,199.06,37.7,,,percent of total billed charges,37.70% of total billed charges,199.06,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,178.99,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,411.84,78,,,percent of total billed charges,78% of total billed charges,528,100,,,percent of total billed charges,100% of total billed charges,436.13,82.6,,,percent of total billed charges,82.6% of total billed charges,436.13,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.78,826.71,
IV INFUSION HYDRATION ADDL HR,45096361,CDM,450,RC,96361,HCPCS,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,132,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,44.75,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.2,600.65,
IV INFUSION THX/PX/DX FIRST HR,45096365,CDM,450,RC,96365,HCPCS,Outpatient,,,702,456.30,,617.76,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,702,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,107.41,15.3,,,percent of total billed charges,15.3% of total billed charges,484.38,69,,,percent of total billed charges,69% of total billed charges,702,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,702,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,702,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,264.65,37.7,,,percent of total billed charges,37.70% of total billed charges,264.65,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,237.98,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,547.56,78,,,percent of total billed charges,78% of total billed charges,702,100,,,percent of total billed charges,100% of total billed charges,579.85,82.6,,,percent of total billed charges,82.6% of total billed charges,579.85,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.41,826.71,
IV INFUSION THX/PX/DX ADDL HR,45096366,CDM,450,RC,96366,HCPCS,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,132,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,44.75,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.2,600.65,
IV INFUSION ADDL SEQ 1HR,45096367,CDM,450,RC,96367,HCPCS,Outpatient,,,447,290.55,,393.36,88,,,percent of total billed charges,88% of total Billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,447,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,68.39,15.3,,,percent of total billed charges,15.3% of total billed charges,308.43,69,,,percent of total billed charges,69% of total billed charges,447,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,447,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,447,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,251.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,168.52,37.7,,,percent of total billed charges,37.70% of total billed charges,168.52,37.7,,,percent of total billed charges,37.70% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,151.53,33.9,,,percent of total billed charges,33.9% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,348.66,78,,,percent of total billed charges,78% of total billed charges,447,100,,,percent of total billed charges,100% of total billed charges,369.22,82.6,,,percent of total billed charges,82.6% of total billed charges,369.22,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.39,447,
CONCURRENT IV THER,45096368,CDM,450,RC,96368,HCPCS,Outpatient,,,423,274.95,,372.24,88,,,percent of total billed charges,88% of total Billed charges,211.5,50,,,percent of total billed charges,50% of total Billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid,423,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,211.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,272.98,100,,,Fee Schedule,100% of WA Medicaid,64.72,15.3,,,percent of total billed charges,15.3% of total billed charges,291.87,69,,,percent of total billed charges,69% of total billed charges,423,100,,,percent of total billed charges,100% of total billed charges,211.5,50,,,percent of total billed charges,50% of total Billed charges,423,100,,,percent of total billed charges,100% of total billed charges,211.5,50,,,percent of total billed charges,50% of total Billed charges,423,100,,,percent of total billed charges,100% of total billed charges,211.5,50,,,percent of total billed charges,50% of total Billed charges,261.63,61.85,,,percent of total billed charges,61.85% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,211.5,50,,,percent of total billed charges,50% of total Billed charges,211.5,50,,,percent of total billed charges,50% of total Billed charges,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,211.5,50,,,percent of total billed charges,50% of total Billed charges,211.5,50,,,percent of total billed charges,50% of total Billed charges,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,211.5,50,,,percent of total billed charges,50% of total Billed charges,159.47,37.7,,,percent of total billed charges,37.70% of total billed charges,159.47,37.7,,,percent of total billed charges,37.70% of total billed charges,211.5,50,,,percent of total billed charges,50% of total Billed charges,143.4,33.9,,,percent of total billed charges,33.9% of total billed charges,211.5,50,,,percent of total billed charges,50% of total Billed charges,329.94,78,,,percent of total billed charges,78% of total billed charges,423,100,,,percent of total billed charges,100% of total billed charges,349.4,82.6,,,percent of total billed charges,82.6% of total billed charges,349.4,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,211.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,211.5,50,,,percent of total billed charges,50% of total Billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.72,423,
INJ THER/DX IM/SQ,45096372,CDM,450,RC,96372,HCPCS,Outpatient,,,302,196.30,,265.76,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,46.21,15.3,,,percent of total billed charges,15.3% of total billed charges,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,102.38,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,302,
S-INJ NON CHEMO IA,45096373,CDM,450,RC,96373,HCPCS,Outpatient,,,1339,870.35,,1178.32,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,1339,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,204.87,15.3,,,percent of total billed charges,15.3% of total billed charges,923.91,69,,,percent of total billed charges,69% of total billed charges,1339,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1339,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1339,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,504.8,37.7,,,percent of total billed charges,37.70% of total billed charges,504.8,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,453.92,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1044.42,78,,,percent of total billed charges,78% of total billed charges,1339,100,,,percent of total billed charges,100% of total billed charges,1106.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1106.01,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,1339,
THERAPEUTIC IV PUSH,45096374,CDM,450,RC,96374,HCPCS,Outpatient,,,438,284.70,,385.44,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,438,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,67.01,15.3,,,percent of total billed charges,15.3% of total billed charges,302.22,69,,,percent of total billed charges,69% of total billed charges,438,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,438,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,438,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,165.13,37.7,,,percent of total billed charges,37.70% of total billed charges,165.13,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,148.48,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,341.64,78,,,percent of total billed charges,78% of total billed charges,438,100,,,percent of total billed charges,100% of total billed charges,361.79,82.6,,,percent of total billed charges,82.6% of total billed charges,361.79,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,826.71,
THERA EA AD IV PUSH,45096375,CDM,450,RC,96375,HCPCS,Outpatient,,,288,187.20,,253.44,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,288,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,44.06,15.3,,,percent of total billed charges,15.3% of total billed charges,198.72,69,,,percent of total billed charges,69% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,288,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,288,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,97.63,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,224.64,78,,,percent of total billed charges,78% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,288,
THER AD IVP SAME MED,45096376,CDM,450,RC,96376,HCPCS,Outpatient,,,296,192.40,,260.48,88,,,percent of total billed charges,88% of total Billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid,296,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,148,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid,45.29,15.3,,,percent of total billed charges,15.3% of total billed charges,204.24,69,,,percent of total billed charges,69% of total billed charges,296,100,,,percent of total billed charges,100% of total billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,296,100,,,percent of total billed charges,100% of total billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,296,100,,,percent of total billed charges,100% of total billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,183.08,61.85,,,percent of total billed charges,61.85% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148,50,,,percent of total billed charges,50% of total Billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,148,50,,,percent of total billed charges,50% of total Billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,148,50,,,percent of total billed charges,50% of total Billed charges,111.59,37.7,,,percent of total billed charges,37.70% of total billed charges,111.59,37.7,,,percent of total billed charges,37.70% of total billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,100.34,33.9,,,percent of total billed charges,33.9% of total billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,230.88,78,,,percent of total billed charges,78% of total billed charges,296,100,,,percent of total billed charges,100% of total billed charges,244.5,82.6,,,percent of total billed charges,82.6% of total billed charges,244.5,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,148,50,,,percent of total billed charges,50% of total Billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,296,
ER DEPT BASIC VISIT,45099281,CDM,450,RC,99281,HCPCS,Outpatient,,,268,174.20,,235.84,88,,,percent of total billed charges,88% of total Billed charges,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,45.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,268,100,,,percent of total billed charges,100% of total billed charges,46.37,17.304,,,percent of total billed charges,17.304% of total billed charges,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,168.84,63,,,percent of total billed charges,63% of total billed charges,158.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,565,15.3,,,percent of total billed charges,15.3% of total billed charges,184.92,69,,,percent of total billed charges,69% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,268,100,,,percent of total billed charges,100% of total billed charges,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,268,100,,,percent of total billed charges,100% of total billed charges,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,294.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,45.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,45.92,17.136,,,percent of total billed charges,17.136% of total billed charges,58.53,21.84,,,percent of total billed charges,21.84% of total billed charges,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,101.04,37.7,,,percent of total billed charges,37.70% of total billed charges,101.04,37.7,,,percent of total billed charges,37.70% of total billed charges,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,209.04,78,,,percent of total billed charges,78% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,91.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,90.55,100,,,Fee Schedule,100% of Medicare OPPS rate,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,45.02,565,
ER DEPT LIMITED VISIT,45099282,CDM,450,RC,99282,HCPCS,Outpatient,,,456,296.40,25,401.28,88,,,percent of total billed charges,88% of total Billed charges,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,76.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,456,100,,,percent of total billed charges,100% of total billed charges,78.91,17.304,,,percent of total billed charges,17.304% of total billed charges,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,287.28,63,,,percent of total billed charges,63% of total billed charges,291.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,76.61,16.8,,,percent of total billed charges,16.8% of total billed charges,565,15.3,,,percent of total billed charges,15.3% of total billed charges,314.64,69,,,percent of total billed charges,69% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,456,100,,,percent of total billed charges,100% of total billed charges,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,456,100,,,percent of total billed charges,100% of total billed charges,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,534.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,76.61,16.8,,,percent of total billed charges,16.8% of total billed charges,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,76.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,78.14,17.136,,,percent of total billed charges,17.136% of total billed charges,99.59,21.84,,,percent of total billed charges,21.84% of total billed charges,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,355.68,78,,,percent of total billed charges,78% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,76.61,16.8,,,percent of total billed charges,16.8% of total billed charges,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,168.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,166.81,100,,,Fee Schedule,100% of Medicare OPPS rate,76.61,16.8,,,percent of total billed charges,16.8% of total billed charges,76.61,565,
ER DEPT INTERMEDIATE VISIT,45099283,CDM,450,RC,99283,HCPCS,Outpatient,,,803,521.95,25,706.64,88,,,percent of total billed charges,88% of total Billed charges,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,134.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,803,100,,,percent of total billed charges,100% of total billed charges,138.95,17.304,,,percent of total billed charges,17.304% of total billed charges,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,505.89,63,,,percent of total billed charges,63% of total billed charges,509.26,175,,,Fee Schedule,175% of Medicare OPPS Rate,134.9,16.8,,,percent of total billed charges,16.8% of total billed charges,565,15.3,,,percent of total billed charges,15.3% of total billed charges,554.07,69,,,percent of total billed charges,69% of total billed charges,803,100,,,percent of total billed charges,100% of total billed charges,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,803,100,,,percent of total billed charges,100% of total billed charges,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,803,100,,,percent of total billed charges,100% of total billed charges,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,940.88,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,134.9,16.8,,,percent of total billed charges,16.8% of total billed charges,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,134.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,137.6,17.136,,,percent of total billed charges,17.136% of total billed charges,175.38,21.84,,,percent of total billed charges,21.84% of total billed charges,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,302.73,37.7,,,percent of total billed charges,37.70% of total billed charges,302.73,37.7,,,percent of total billed charges,37.70% of total billed charges,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,626.34,78,,,percent of total billed charges,78% of total billed charges,803,100,,,percent of total billed charges,100% of total billed charges,663.28,82.6,,,percent of total billed charges,82.6% of total billed charges,663.28,82.6,,,percent of total billed charges,82.6% of total billed charges,134.9,16.8,,,percent of total billed charges,16.8% of total billed charges,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,293.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,291.01,100,,,Fee Schedule,100% of Medicare OPPS rate,134.9,16.8,,,percent of total billed charges,16.8% of total billed charges,134.9,940.88,
ER DEPT EXTENSIVE VISIT,45099284,CDM,450,RC,99284,HCPCS,Outpatient,,,1384,899.60,25,1217.92,88,,,percent of total billed charges,88% of total Billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,232.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,1384,100,,,percent of total billed charges,100% of total billed charges,239.49,17.304,,,percent of total billed charges,17.304% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,871.92,63,,,percent of total billed charges,63% of total billed charges,790.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,232.51,16.8,,,percent of total billed charges,16.8% of total billed charges,565,15.3,,,percent of total billed charges,15.3% of total billed charges,954.96,69,,,percent of total billed charges,69% of total billed charges,1384,100,,,percent of total billed charges,100% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1384,100,,,percent of total billed charges,100% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1384,100,,,percent of total billed charges,100% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1477.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,232.51,16.8,,,percent of total billed charges,16.8% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,232.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,237.16,17.136,,,percent of total billed charges,17.136% of total billed charges,302.27,21.84,,,percent of total billed charges,21.84% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,521.77,37.7,,,percent of total billed charges,37.70% of total billed charges,521.77,37.7,,,percent of total billed charges,37.70% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1079.52,78,,,percent of total billed charges,78% of total billed charges,1384,100,,,percent of total billed charges,100% of total billed charges,1143.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1143.18,82.6,,,percent of total billed charges,82.6% of total billed charges,232.51,16.8,,,percent of total billed charges,16.8% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,456.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,232.51,16.8,,,percent of total billed charges,16.8% of total billed charges,232.51,1477.69,
ER DEPT MAJOR VISIT,45099285,CDM,450,RC,99285,HCPCS,Outpatient,,,3693,2400.45,25,3249.84,88,,,percent of total billed charges,88% of total Billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,620.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,3693,100,,,percent of total billed charges,100% of total billed charges,639.04,17.304,,,percent of total billed charges,17.304% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2326.59,63,,,percent of total billed charges,63% of total billed charges,1146.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,620.42,16.8,,,percent of total billed charges,16.8% of total billed charges,565,15.3,,,percent of total billed charges,15.3% of total billed charges,2548.17,69,,,percent of total billed charges,69% of total billed charges,3693,100,,,percent of total billed charges,100% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3693,100,,,percent of total billed charges,100% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3693,100,,,percent of total billed charges,100% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2121.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,620.42,16.8,,,percent of total billed charges,16.8% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,620.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,632.83,17.136,,,percent of total billed charges,17.136% of total billed charges,806.55,21.84,,,percent of total billed charges,21.84% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1392.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1392.26,37.7,,,percent of total billed charges,37.70% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2880.54,78,,,percent of total billed charges,78% of total billed charges,3693,100,,,percent of total billed charges,100% of total billed charges,3050.42,82.6,,,percent of total billed charges,82.6% of total billed charges,3050.42,82.6,,,percent of total billed charges,82.6% of total billed charges,620.42,16.8,,,percent of total billed charges,16.8% of total billed charges,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,661.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,655.13,100,,,Fee Schedule,100% of Medicare OPPS rate,620.42,16.8,,,percent of total billed charges,16.8% of total billed charges,565,3693,
CRITICAL CARE 30-74 MIN,45099291,CDM,450,RC,99291,HCPCS,Outpatient,,,4611,2997.15,25,4057.68,88,,,percent of total billed charges,88% of total Billed charges,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,774.65,16.8,,,percent of total billed charges,16.8% of total Billed charges,4611,100,,,percent of total billed charges,100% of total billed charges,797.89,17.304,,,percent of total billed charges,17.304% of total billed charges,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,2904.93,63,,,percent of total billed charges,63% of total billed charges,1583.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,774.65,16.8,,,percent of total billed charges,16.8% of total billed charges,565,15.3,,,percent of total billed charges,15.3% of total billed charges,3181.59,69,,,percent of total billed charges,69% of total billed charges,4611,100,,,percent of total billed charges,100% of total billed charges,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4611,100,,,percent of total billed charges,100% of total billed charges,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4611,100,,,percent of total billed charges,100% of total billed charges,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,2814.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,774.65,16.8,,,percent of total billed charges,16.8% of total billed charges,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,774.65,16.8,,,percent of total billed charges,16.8% of total Billed charges,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,790.14,17.136,,,percent of total billed charges,17.136% of total billed charges,1007.04,21.84,,,percent of total billed charges,21.84% of total billed charges,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1738.35,37.7,,,percent of total billed charges,37.70% of total billed charges,1738.35,37.7,,,percent of total billed charges,37.70% of total billed charges,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,3596.58,78,,,percent of total billed charges,78% of total billed charges,4611,100,,,percent of total billed charges,100% of total billed charges,3808.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3808.69,82.6,,,percent of total billed charges,82.6% of total billed charges,774.65,16.8,,,percent of total billed charges,16.8% of total billed charges,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,914.13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,905.08,100,,,Fee Schedule,100% of Medicare OPPS rate,774.65,16.8,,,percent of total billed charges,16.8% of total billed charges,565,4611,
CRITICAL CARE EA ADD 30MIN,45099292,CDM,450,RC,99292,HCPCS,Outpatient,,,1717,1116.05,,1510.96,88,,,percent of total billed charges,88% of total Billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,288.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,1717,100,,,percent of total billed charges,100% of total billed charges,297.11,17.304,,,percent of total billed charges,17.304% of total billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,1081.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,288.46,16.8,,,percent of total billed charges,16.8% of total billed charges,565,15.3,,,percent of total billed charges,15.3% of total billed charges,1184.73,69,,,percent of total billed charges,69% of total billed charges,1717,100,,,percent of total billed charges,100% of total billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,1717,100,,,percent of total billed charges,100% of total billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,1717,100,,,percent of total billed charges,100% of total billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,1061.96,61.85,,,percent of total billed charges,61.85% of total billed charges,288.46,16.8,,,percent of total billed charges,16.8% of total billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,288.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,294.23,17.136,,,percent of total billed charges,17.136% of total billed charges,374.99,21.84,,,percent of total billed charges,21.84% of total billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,647.31,37.7,,,percent of total billed charges,37.70% of total billed charges,647.31,37.7,,,percent of total billed charges,37.70% of total billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,858.5,50,,,percent of total billed charges,50% of total Billed charges,1339.26,78,,,percent of total billed charges,78% of total billed charges,1717,100,,,percent of total billed charges,100% of total billed charges,1418.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1418.24,82.6,,,percent of total billed charges,82.6% of total billed charges,288.46,16.8,,,percent of total billed charges,16.8% of total billed charges,858.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,858.5,50,,,percent of total billed charges,50% of total Billed charges,288.46,16.8,,,percent of total billed charges,16.8% of total billed charges,288.46,1717,
MED NUT THERAPY GROUP 30MIN,94297804,CDM,942,RC,97804,HCPCS,Outpatient,,,65,42.25,,57.2,88,,,percent of total billed charges,88% of total Billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,9.87,100,,,Fee Schedule,100% of WA Medicaid,65,100,,,percent of total billed charges,100% of total billed charges,9.87,103,,,Fee Schedule,103% of WA Medicaid,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,40.95,63,,,percent of total billed charges,63% of total billed charges,26.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.87,100,,,Fee Schedule,100% of WA Medicaid,9.95,15.3,,,percent of total billed charges,15.3% of total billed charges,44.85,69,,,percent of total billed charges,69% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,65,100,,,percent of total billed charges,100% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,65,100,,,percent of total billed charges,100% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,60.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.83,130,,,Fee Schedule,130% of WA Medicaid ,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,22.04,33.9,,,percent of total billed charges,33.9% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,50.7,78,,,percent of total billed charges,78% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,9.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,15.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,9.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.87,65,
NUTRITION ANALYSIS INIT EA 15M,94297802,CDM,942,RC,97802,HCPCS,Outpatient,,,140,91.00,,123.2,88,,,percent of total billed charges,88% of total Billed charges,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,21.64,100,,,Fee Schedule,100% of WA Medicaid,140,100,,,percent of total billed charges,100% of total billed charges,21.64,103,,,Fee Schedule,103% of WA Medicaid,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,88.2,63,,,percent of total billed charges,63% of total billed charges,56.11,175,,,Fee Schedule,175% of Medicare OPPS Rate,21.64,100,,,Fee Schedule,100% of WA Medicaid,21.42,15.3,,,percent of total billed charges,15.3% of total billed charges,96.6,69,,,percent of total billed charges,69% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,140,100,,,percent of total billed charges,100% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,140,100,,,percent of total billed charges,100% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,126.84,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,21.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.13,130,,,Fee Schedule,130% of WA Medicaid ,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,52.78,37.7,,,percent of total billed charges,37.70% of total billed charges,52.78,37.7,,,percent of total billed charges,37.70% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,47.46,33.9,,,percent of total billed charges,33.9% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,109.2,78,,,percent of total billed charges,78% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,21.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,32.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.22,100,,,Fee Schedule,100% of Medicare OPPS rate,21.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.42,140,
MED NUT THRP-RE-ASSESS-15MIN,94297803,CDM,942,RC,97803,HCPCS,Outpatient,,,121,78.65,,106.48,88,,,percent of total billed charges,88% of total Billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,121,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,76.23,63,,,percent of total billed charges,63% of total billed charges,47.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,18.51,15.3,,,percent of total billed charges,15.3% of total billed charges,83.49,69,,,percent of total billed charges,69% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,121,100,,,percent of total billed charges,100% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,121,100,,,percent of total billed charges,100% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,108.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,37.7,,,percent of total billed charges,37.70% of total billed charges,45.62,37.7,,,percent of total billed charges,37.70% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,41.02,33.9,,,percent of total billed charges,33.9% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,94.38,78,,,percent of total billed charges,78% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,27.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.51,121,
DIABETES MANAGE TRN IND/GROUP,94200001,CDM,942,RC,,,Outpatient,,,53,34.45,,46.64,88,,,percent of total billed charges,88% of total Billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,53,100,,,percent of total billed charges,100% of total billed charges,9.17,17.304,,,percent of total billed charges,17.304% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,33.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,8.11,15.3,,,percent of total billed charges,15.3% of total billed charges,36.57,69,,,percent of total billed charges,69% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,53,100,,,percent of total billed charges,100% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,53,100,,,percent of total billed charges,100% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,32.78,61.85,,,percent of total billed charges,61.85% of total billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.5,50,,,percent of total billed charges,50% of total Billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,9.08,17.136,,,percent of total billed charges,17.136% of total billed charges,11.58,21.84,,,percent of total billed charges,21.84% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,17.97,33.9,,,percent of total billed charges,33.9% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,41.34,78,,,percent of total billed charges,78% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.5,50,,,percent of total billed charges,50% of total Billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,8.11,53,
DIABETES MANAGE TRN PER INDIV,94200002,CDM,942,RC,,,Outpatient,,,177,115.05,,155.76,88,,,percent of total billed charges,88% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,30.63,17.304,,,percent of total billed charges,17.304% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,111.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,15.3,,,percent of total billed charges,15.3% of total billed charges,122.13,69,,,percent of total billed charges,69% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,109.47,61.85,,,percent of total billed charges,61.85% of total billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,30.33,17.136,,,percent of total billed charges,17.136% of total billed charges,38.66,21.84,,,percent of total billed charges,21.84% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,66.73,37.7,,,percent of total billed charges,37.70% of total billed charges,66.73,37.7,,,percent of total billed charges,37.70% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,60,33.9,,,percent of total billed charges,33.9% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,138.06,78,,,percent of total billed charges,78% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,177,
DIABETES SLF MANGMT INDV 30MIN,942G0108,CDM,942,RC,G0108,HCPCS,Outpatient,,,238,154.70,,209.44,88,,,percent of total billed charges,88% of total Billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,59.14,100,,,Fee Schedule,100% of WA Medicaid,238,100,,,percent of total billed charges,100% of total billed charges,60.91,103,,,Fee Schedule,103% of WA Medicaid,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,149.94,63,,,percent of total billed charges,63% of total billed charges,95.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.14,100,,,Fee Schedule,100% of WA Medicaid,36.41,15.3,,,percent of total billed charges,15.3% of total billed charges,164.22,69,,,percent of total billed charges,69% of total billed charges,238,100,,,percent of total billed charges,100% of total billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,238,100,,,percent of total billed charges,100% of total billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,238,100,,,percent of total billed charges,100% of total billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,214.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,60.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.88,130,,,Fee Schedule,130% of WA Medicaid ,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,89.73,37.7,,,percent of total billed charges,37.70% of total billed charges,89.73,37.7,,,percent of total billed charges,37.70% of total billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,80.68,33.9,,,percent of total billed charges,33.9% of total billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,185.64,78,,,percent of total billed charges,78% of total billed charges,238,100,,,percent of total billed charges,100% of total billed charges,196.59,82.6,,,percent of total billed charges,82.6% of total billed charges,196.59,82.6,,,percent of total billed charges,82.6% of total billed charges,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,55.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.41,238,
DIABETES SLF MANGMT GRP 30MIN,942G0109,CDM,942,RC,G0109,HCPCS,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,41.37,100,,,Fee Schedule,100% of WA Medicaid,72,100,,,percent of total billed charges,100% of total billed charges,42.61,103,,,Fee Schedule,103% of WA Medicaid,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,45.36,63,,,percent of total billed charges,63% of total billed charges,27.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,41.37,100,,,Fee Schedule,100% of WA Medicaid,11.02,15.3,,,percent of total billed charges,15.3% of total billed charges,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,72,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,72,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,60.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,42.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.79,130,,,Fee Schedule,130% of WA Medicaid ,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,24.41,33.9,,,percent of total billed charges,33.9% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,16.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.02,72,
MED NUT 2ND RE-EVAL IND 15M,942G0270,CDM,942,RC,G0270,HCPCS,Outpatient,,,143,92.95,,125.84,88,,,percent of total billed charges,88% of total Billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,177.09,100,,,Fee Schedule,100% of WA Medicaid,143,100,,,percent of total billed charges,100% of total billed charges,182.4,103,,,Fee Schedule,103% of WA Medicaid,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,90.09,63,,,percent of total billed charges,63% of total billed charges,47.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,177.09,100,,,Fee Schedule,100% of WA Medicaid,21.88,15.3,,,percent of total billed charges,15.3% of total billed charges,98.67,69,,,percent of total billed charges,69% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,108.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,177.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,180.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,230.22,130,,,Fee Schedule,130% of WA Medicaid ,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,48.48,33.9,,,percent of total billed charges,33.9% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,111.54,78,,,percent of total billed charges,78% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,177.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,27.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.46,100,,,Fee Schedule,100% of Medicare OPPS rate,177.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.88,230.22,
MED NUT 2ND RE-EVAL GRP 30M,942G0271,CDM,942,RC,G0271,HCPCS,Outpatient,,,65,42.25,,57.2,88,,,percent of total billed charges,88% of total Billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,177.09,100,,,Fee Schedule,100% of WA Medicaid,65,100,,,percent of total billed charges,100% of total billed charges,182.4,103,,,Fee Schedule,103% of WA Medicaid,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,40.95,63,,,percent of total billed charges,63% of total billed charges,26.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,177.09,100,,,Fee Schedule,100% of WA Medicaid,9.95,15.3,,,percent of total billed charges,15.3% of total billed charges,44.85,69,,,percent of total billed charges,69% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,65,100,,,percent of total billed charges,100% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,65,100,,,percent of total billed charges,100% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,60.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,177.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,180.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,230.22,130,,,Fee Schedule,130% of WA Medicaid ,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,22.04,33.9,,,percent of total billed charges,33.9% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,50.7,78,,,percent of total billed charges,78% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,177.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,15.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.57,100,,,Fee Schedule,100% of Medicare OPPS rate,177.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.95,230.22,
CHILDBIRTH CLASSES,942S9436,CDM,942,RC,S9436,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,60.91,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,56.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of WA Medicaid,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,90,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,90,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.88,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,30.51,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.77,90,
HEMODIALYSIS,80190935,CDM,801,RC,90935,HCPCS,Outpatient,,,4756,3091.40,,4185.28,88,,,percent of total billed charges,88% of total Billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,689.5,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,710.19,103,,,Fee Schedule,103% of WA Medicaid,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2996.28,63,,,percent of total billed charges,63% of total billed charges,1247.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,689.5,100,,,Fee Schedule,100% of WA Medicaid,727.67,15.3,,,percent of total billed charges,15.3% of total billed charges,3281.64,69,,,percent of total billed charges,69% of total billed charges,4756,100,,,percent of total billed charges,100% of total billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4756,100,,,percent of total billed charges,100% of total billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4756,100,,,percent of total billed charges,100% of total billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2658.27,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,689.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,510.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,703.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,896.36,130,,,Fee Schedule,130% of WA Medicaid ,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,1793.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1793.01,37.7,,,percent of total billed charges,37.70% of total billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,1612.28,33.9,,,percent of total billed charges,33.9% of total billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.68,78,,,percent of total billed charges,78% of total billed charges,4756,100,,,percent of total billed charges,100% of total billed charges,3928.46,82.6,,,percent of total billed charges,82.6% of total billed charges,3928.46,82.6,,,percent of total billed charges,82.6% of total billed charges,689.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,719.86,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,689.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,510.74,4756,
PERITONEAL DIALYSIS INPT,80290945,CDM,802,RC,90945,HCPCS,Outpatient,,,1393,905.45,,1225.84,88,,,percent of total billed charges,88% of total Billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,689.5,100,,,Fee Schedule,100% of WA Medicaid,1393,100,,,percent of total billed charges,100% of total billed charges,710.19,103,,,Fee Schedule,103% of WA Medicaid,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,877.59,63,,,percent of total billed charges,63% of total billed charges,790.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,689.5,100,,,Fee Schedule,100% of WA Medicaid,213.13,15.3,,,percent of total billed charges,15.3% of total billed charges,961.17,69,,,percent of total billed charges,69% of total billed charges,1393,100,,,percent of total billed charges,100% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1393,100,,,percent of total billed charges,100% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1393,100,,,percent of total billed charges,100% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1477.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,689.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,510.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,703.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,896.36,130,,,Fee Schedule,130% of WA Medicaid ,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,525.16,37.7,,,percent of total billed charges,37.70% of total billed charges,525.16,37.7,,,percent of total billed charges,37.70% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,472.23,33.9,,,percent of total billed charges,33.9% of total billed charges,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1086.54,78,,,percent of total billed charges,78% of total billed charges,1393,100,,,percent of total billed charges,100% of total billed charges,1150.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1150.62,82.6,,,percent of total billed charges,82.6% of total billed charges,689.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,456.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,451.75,100,,,Fee Schedule,100% of Medicare OPPS rate,689.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,213.13,1477.69,
DIALYSIS NON-ROUTINE OP,820G0257,CDM,821,RC,G0257,HCPCS,Outpatient,,,2680,1742.00,,2358.4,88,,,percent of total billed charges,88% of total Billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,689.5,100,,,Fee Schedule,100% of WA Medicaid,2680,100,,,percent of total billed charges,100% of total billed charges,710.19,103,,,Fee Schedule,103% of WA Medicaid,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,1688.4,63,,,percent of total billed charges,63% of total billed charges,1247.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,689.5,100,,,Fee Schedule,100% of WA Medicaid,410.04,15.3,,,percent of total billed charges,15.3% of total billed charges,1849.2,69,,,percent of total billed charges,69% of total billed charges,2680,100,,,percent of total billed charges,100% of total billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2680,100,,,percent of total billed charges,100% of total billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2680,100,,,percent of total billed charges,100% of total billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2658.27,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,689.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,510.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,703.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,896.36,130,,,Fee Schedule,130% of WA Medicaid ,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,1010.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1010.36,37.7,,,percent of total billed charges,37.70% of total billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,908.52,33.9,,,percent of total billed charges,33.9% of total billed charges,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2090.4,78,,,percent of total billed charges,78% of total billed charges,2680,100,,,percent of total billed charges,100% of total billed charges,2213.68,82.6,,,percent of total billed charges,82.6% of total billed charges,2213.68,82.6,,,percent of total billed charges,82.6% of total billed charges,689.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,719.86,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,712.74,100,,,Fee Schedule,100% of Medicare OPPS rate,689.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,410.04,2680,
FINE NEEDLE ASPIR. W/O IMAGE,45010021,CDM,450,RC,10021,HCPCS,Outpatient,,,528,343.20,,464.64,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,568.92,100,,,Fee Schedule,100% of WA Medicaid,528,100,,,percent of total billed charges,100% of total billed charges,585.99,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,332.64,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,568.92,100,,,Fee Schedule,100% of WA Medicaid,80.78,15.3,,,percent of total billed charges,15.3% of total billed charges,364.32,69,,,percent of total billed charges,69% of total billed charges,528,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,528,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,528,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,568.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,421.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,580.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,739.6,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,199.06,37.7,,,percent of total billed charges,37.70% of total billed charges,199.06,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,178.99,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,411.84,78,,,percent of total billed charges,78% of total billed charges,528,100,,,percent of total billed charges,100% of total billed charges,436.13,82.6,,,percent of total billed charges,82.6% of total billed charges,436.13,82.6,,,percent of total billed charges,82.6% of total billed charges,568.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,568.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.78,1404.97,
I  D SUBCUT ABCESS SIMPLE,45010060,CDM,450,RC,10060,HCPCS,Outpatient,,,689,447.85,,606.32,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,689,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,434.07,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,105.42,15.3,,,percent of total billed charges,15.3% of total billed charges,475.41,69,,,percent of total billed charges,69% of total billed charges,689,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,689,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,689,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,259.75,37.7,,,percent of total billed charges,37.70% of total billed charges,259.75,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,233.57,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,537.42,78,,,percent of total billed charges,78% of total billed charges,689,100,,,percent of total billed charges,100% of total billed charges,569.11,82.6,,,percent of total billed charges,82.6% of total billed charges,569.11,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105.42,729.41,
I  D ABCESS COMPLEX,45010061,CDM,450,RC,10061,HCPCS,Outpatient,,,689,447.85,,606.32,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,689,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,434.07,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,105.42,15.3,,,percent of total billed charges,15.3% of total billed charges,475.41,69,,,percent of total billed charges,69% of total billed charges,689,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,689,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,689,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,259.75,37.7,,,percent of total billed charges,37.70% of total billed charges,259.75,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,233.57,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,537.42,78,,,percent of total billed charges,78% of total billed charges,689,100,,,percent of total billed charges,100% of total billed charges,569.11,82.6,,,percent of total billed charges,82.6% of total billed charges,569.11,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105.42,1404.97,
I  D PILONIDIAL SIMPLE,45010080,CDM,450,RC,10080,HCPCS,Outpatient,,,689,447.85,,606.32,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,689,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,434.07,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,105.42,15.3,,,percent of total billed charges,15.3% of total billed charges,475.41,69,,,percent of total billed charges,69% of total billed charges,689,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,689,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,689,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,259.75,37.7,,,percent of total billed charges,37.70% of total billed charges,259.75,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,233.57,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,537.42,78,,,percent of total billed charges,78% of total billed charges,689,100,,,percent of total billed charges,100% of total billed charges,569.11,82.6,,,percent of total billed charges,82.6% of total billed charges,569.11,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105.42,2526.76,
I  D PILONIDAL CYST COMPLEX,45010081,CDM,450,RC,10081,HCPCS,Outpatient,,,740,481.00,,651.2,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,989.16,100,,,Fee Schedule,100% of WA Medicaid,740,100,,,percent of total billed charges,100% of total billed charges,1018.83,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,466.2,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,989.16,100,,,Fee Schedule,100% of WA Medicaid,113.22,15.3,,,percent of total billed charges,15.3% of total billed charges,510.6,69,,,percent of total billed charges,69% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,740,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,740,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,732.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1008.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1285.91,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,250.86,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,577.2,78,,,percent of total billed charges,78% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.22,2526.76,
INC  REMOVAL FB SUBQ SIMPLE,45010120,CDM,450,RC,10120,HCPCS,Outpatient,,,689,447.85,,606.32,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,689,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,434.07,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,105.42,15.3,,,percent of total billed charges,15.3% of total billed charges,475.41,69,,,percent of total billed charges,69% of total billed charges,689,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,689,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,689,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,259.75,37.7,,,percent of total billed charges,37.70% of total billed charges,259.75,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,233.57,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,537.42,78,,,percent of total billed charges,78% of total billed charges,689,100,,,percent of total billed charges,100% of total billed charges,569.11,82.6,,,percent of total billed charges,82.6% of total billed charges,569.11,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105.42,1404.97,
INC  REMOVAL FB SUBQ COMPLEX,45010121,CDM,450,RC,10121,HCPCS,Outpatient,,,3667,2383.55,,3226.96,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid,3667,100,,,percent of total billed charges,100% of total billed charges,1066.24,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2310.21,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid,561.05,15.3,,,percent of total billed charges,15.3% of total billed charges,2530.23,69,,,percent of total billed charges,69% of total billed charges,3667,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3667,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3667,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,766.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1055.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1345.74,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1382.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1382.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1243.11,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2860.26,78,,,percent of total billed charges,78% of total billed charges,3667,100,,,percent of total billed charges,100% of total billed charges,3028.94,82.6,,,percent of total billed charges,82.6% of total billed charges,3028.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,561.05,5715.97,
I  D HEMATOMA,45010140,CDM,450,RC,10140,HCPCS,Outpatient,,,2719,1767.35,,2392.72,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,989.16,100,,,Fee Schedule,100% of WA Medicaid,2719,100,,,percent of total billed charges,100% of total billed charges,1018.83,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1712.97,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,989.16,100,,,Fee Schedule,100% of WA Medicaid,416.01,15.3,,,percent of total billed charges,15.3% of total billed charges,1876.11,69,,,percent of total billed charges,69% of total billed charges,2719,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2719,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2719,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,732.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1008.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1285.91,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1025.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1025.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,921.74,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.82,78,,,percent of total billed charges,78% of total billed charges,2719,100,,,percent of total billed charges,100% of total billed charges,2245.89,82.6,,,percent of total billed charges,82.6% of total billed charges,2245.89,82.6,,,percent of total billed charges,82.6% of total billed charges,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,416.01,5715.97,
PUNCT ASP ABSCESS/CY,45010160,CDM,450,RC,10160,HCPCS,Outpatient,,,273,177.45,,240.24,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,273,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,171.99,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,41.77,15.3,,,percent of total billed charges,15.3% of total billed charges,188.37,69,,,percent of total billed charges,69% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,92.55,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,212.94,78,,,percent of total billed charges,78% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.77,1404.97,
DEB/ECZEMA OR INFECT SKIN <10%,45011000,CDM,450,RC,11000,HCPCS,Outpatient,,,273,177.45,,240.24,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,273,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,171.99,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,41.77,15.3,,,percent of total billed charges,15.3% of total billed charges,188.37,69,,,percent of total billed charges,69% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,92.55,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,212.94,78,,,percent of total billed charges,78% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.77,2129.45,
DEB/ECZEMA OR INFECT SKIN >10%,45011001,CDM,450,RC,11001,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,338.73,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,302.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,338.73,100,,,Fee Schedule,100% of WA Medicaid,73.44,15.3,,,percent of total billed charges,15.3% of total billed charges,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,480,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,480,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,162.72,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.44,480,
DEBRID OPEN FX/DISLOC SKIN/SUB,45011010,CDM,450,RC,11010,HCPCS,Outpatient,,,1027,667.55,,903.76,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,1027,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,647.01,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,157.13,15.3,,,percent of total billed charges,15.3% of total billed charges,708.63,69,,,percent of total billed charges,69% of total billed charges,1027,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1027,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1027,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,387.18,37.7,,,percent of total billed charges,37.70% of total billed charges,387.18,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,348.15,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,801.06,78,,,percent of total billed charges,78% of total billed charges,1027,100,,,percent of total billed charges,100% of total billed charges,848.3,82.6,,,percent of total billed charges,82.6% of total billed charges,848.3,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,157.13,2526.76,
DEBRIDE INC REMOV OF FM AT SIT,45011012,CDM,450,RC,11012,HCPCS,Outpatient,,,3178,2065.70,,2796.64,88,,,percent of total billed charges,88% of total Billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,903.83,100,,,Fee Schedule,100% of WA Medicaid,3178,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2002.14,63,,,percent of total billed charges,63% of total billed charges,5071.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,903.83,100,,,Fee Schedule,100% of WA Medicaid,486.23,15.3,,,percent of total billed charges,15.3% of total billed charges,2192.82,69,,,percent of total billed charges,69% of total billed charges,3178,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3178,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3178,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,9628.23,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1198.11,37.7,,,percent of total billed charges,37.70% of total billed charges,1198.11,37.7,,,percent of total billed charges,37.70% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1077.34,33.9,,,percent of total billed charges,33.9% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2478.84,78,,,percent of total billed charges,78% of total billed charges,3178,100,,,percent of total billed charges,100% of total billed charges,2625.03,82.6,,,percent of total billed charges,82.6% of total billed charges,2625.03,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2927.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,486.23,9628.23,
DEBRID SKIN  SUBQ,45011042,CDM,450,RC,11042,HCPCS,Outpatient,,,636,413.40,,559.68,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,636,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,400.68,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,97.31,15.3,,,percent of total billed charges,15.3% of total billed charges,438.84,69,,,percent of total billed charges,69% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,636,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,636,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,215.6,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,496.08,78,,,percent of total billed charges,78% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.31,1404.97,
"DEBRIDEMENT,SKIN,TISSUE,MUSCLE",45011043,CDM,450,RC,11043,HCPCS,Outpatient,,,636,413.40,,559.68,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,636,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,400.68,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,97.31,15.3,,,percent of total billed charges,15.3% of total billed charges,438.84,69,,,percent of total billed charges,69% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,636,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,636,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,215.6,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,496.08,78,,,percent of total billed charges,78% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.31,2129.45,
11044 DEBRIDE TISSUE/MUSCLE/BONE TechFee,45011044,CDM,450,RC,11044,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,903.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,930.95,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,903.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,669.51,5715.97,
"Paring or cutting of benign hyperkeratotic lesion (eg, corn",45011055,CDM,450,RC,11055,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,43.47,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,23.39,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.56,729.42,
11102 TANGENTIAL BIOPSY SKIN SINGLE LESION,76111102,CDM,761,RC,11102,HCPCS,Outpatient,,,368,239.20,,323.84,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,368,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,231.84,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,56.3,15.3,,,percent of total billed charges,15.3% of total billed charges,253.92,69,,,percent of total billed charges,69% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,368,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,368,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.75,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,287.04,78,,,percent of total billed charges,78% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.3,729.41,
11103 Tangntl bx skin ea sep/addl,76111103,CDM,761,RC,11103,HCPCS,Outpatient,,,182,118.30,,160.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,401.45,100,,,Fee Schedule,100% of WA Medicaid,182,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,114.66,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,401.45,100,,,Fee Schedule,100% of WA Medicaid,27.85,15.3,,,percent of total billed charges,15.3% of total billed charges,125.58,69,,,percent of total billed charges,69% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,182,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,182,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,61.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,141.96,78,,,percent of total billed charges,78% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.85,521.88,
REMOVAL SKINTAGS UP TO 15,45011200,CDM,450,RC,11200,HCPCS,Outpatient,,,273,177.45,,240.24,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,273,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.99,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,41.77,15.3,,,percent of total billed charges,15.3% of total billed charges,188.37,69,,,percent of total billed charges,69% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,92.55,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,212.94,78,,,percent of total billed charges,78% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.77,729.42,
EXCISION BENIGN LESION < 0.5CM,45011420,CDM,450,RC,11420,HCPCS,Outpatient,,,1654,1075.10,,1455.52,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid,1654,100,,,percent of total billed charges,100% of total billed charges,1066.24,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1042.02,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid,253.06,15.3,,,percent of total billed charges,15.3% of total billed charges,1141.26,69,,,percent of total billed charges,69% of total billed charges,1654,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1654,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1654,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,766.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1055.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1345.74,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,623.56,37.7,,,percent of total billed charges,37.70% of total billed charges,623.56,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,560.71,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1290.12,78,,,percent of total billed charges,78% of total billed charges,1654,100,,,percent of total billed charges,100% of total billed charges,1366.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1366.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,253.06,5715.97,
EXCISION LESION BENIGN 1.1-2CM,45011422,CDM,450,RC,11422,HCPCS,Outpatient,,,1350,877.50,,1188,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid,1350,100,,,percent of total billed charges,100% of total billed charges,1066.24,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,850.5,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid,206.55,15.3,,,percent of total billed charges,15.3% of total billed charges,931.5,69,,,percent of total billed charges,69% of total billed charges,1350,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1350,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1350,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,766.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1055.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1345.74,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,508.95,37.7,,,percent of total billed charges,37.70% of total billed charges,508.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,457.65,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1053,78,,,percent of total billed charges,78% of total billed charges,1350,100,,,percent of total billed charges,100% of total billed charges,1115.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1115.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,206.55,5715.97,
EX BENIGN LESION <0.5 ON FACE,45011440,CDM,450,RC,11440,HCPCS,Outpatient,,,1371,891.15,,1206.48,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1371,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,863.73,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,209.76,15.3,,,percent of total billed charges,15.3% of total billed charges,945.99,69,,,percent of total billed charges,69% of total billed charges,1371,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1371,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1371,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,516.87,37.7,,,percent of total billed charges,37.70% of total billed charges,516.87,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,464.77,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1069.38,78,,,percent of total billed charges,78% of total billed charges,1371,100,,,percent of total billed charges,100% of total billed charges,1132.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1132.45,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,209.76,2526.76,
EXCISION BENIGN LESION 2.1-3.0,45011443,CDM,450,RC,11443,HCPCS,Outpatient,,,2470,1605.50,,2173.6,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid,2470,100,,,percent of total billed charges,100% of total billed charges,1066.24,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1556.1,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid,377.91,15.3,,,percent of total billed charges,15.3% of total billed charges,1704.3,69,,,percent of total billed charges,69% of total billed charges,2470,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2470,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2470,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,766.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1055.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1345.74,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,931.19,37.7,,,percent of total billed charges,37.70% of total billed charges,931.19,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,837.33,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1926.6,78,,,percent of total billed charges,78% of total billed charges,2470,100,,,percent of total billed charges,100% of total billed charges,2040.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2040.22,82.6,,,percent of total billed charges,82.6% of total billed charges,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,377.91,5715.97,
TRIM NONDYSTOPHIC NAIL,45011719,CDM,450,RC,11719,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,60.86,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,53.55,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,43.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,60.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.81,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.01,226.12,
NAIL AVULSION,45011730,CDM,450,RC,11730,HCPCS,Outpatient,,,668,434.20,,587.84,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,668,100,,,percent of total billed charges,100% of total billed charges,60.86,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,420.84,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,102.2,15.3,,,percent of total billed charges,15.3% of total billed charges,460.92,69,,,percent of total billed charges,69% of total billed charges,668,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,668,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,668,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,43.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,60.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.81,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,251.84,37.7,,,percent of total billed charges,37.70% of total billed charges,251.84,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,226.45,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,521.04,78,,,percent of total billed charges,78% of total billed charges,668,100,,,percent of total billed charges,100% of total billed charges,551.77,82.6,,,percent of total billed charges,82.6% of total billed charges,551.77,82.6,,,percent of total billed charges,82.6% of total billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.77,729.42,
SUBUNGUAL HEMATOMA,45011740,CDM,450,RC,11740,HCPCS,Outpatient,,,247,160.55,,217.36,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,247,100,,,percent of total billed charges,100% of total billed charges,60.86,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,155.61,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,37.79,15.3,,,percent of total billed charges,15.3% of total billed charges,170.43,69,,,percent of total billed charges,69% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,43.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,60.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.81,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,83.73,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,192.66,78,,,percent of total billed charges,78% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.79,454.8,
EXCISION NAIL TA,45011750,CDM,450,RC,11750,HCPCS,Outpatient,,,1889,1227.85,,1662.32,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1889,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1190.07,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,289.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1303.41,69,,,percent of total billed charges,69% of total billed charges,1889,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1889,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1889,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,712.15,37.7,,,percent of total billed charges,37.70% of total billed charges,712.15,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,640.37,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1473.42,78,,,percent of total billed charges,78% of total billed charges,1889,100,,,percent of total billed charges,100% of total billed charges,1560.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1560.31,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,289.02,1889,
REPAIR NAIL BED,45011760,CDM,450,RC,11760,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,60.86,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,43.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,60.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.81,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.77,2129.45,
INGROWN NAIL TA,45011765,CDM,450,RC,11765,HCPCS,Outpatient,,,668,434.20,,587.84,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,668,100,,,percent of total billed charges,100% of total billed charges,60.86,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,420.84,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,102.2,15.3,,,percent of total billed charges,15.3% of total billed charges,460.92,69,,,percent of total billed charges,69% of total billed charges,668,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,668,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,668,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,43.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,60.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.81,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,251.84,37.7,,,percent of total billed charges,37.70% of total billed charges,251.84,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,226.45,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,521.04,78,,,percent of total billed charges,78% of total billed charges,668,100,,,percent of total billed charges,100% of total billed charges,551.77,82.6,,,percent of total billed charges,82.6% of total billed charges,551.77,82.6,,,percent of total billed charges,82.6% of total billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.77,1404.98,
LAC SPL < 2.5CM TR/EX,45012001,CDM,450,RC,12001,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,840,
LACERATION SPL 7.5CM TR/EX,45012002,CDM,450,RC,12002,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,840,
LACERATION SPL 12.5CM TR/EX,45012004,CDM,450,RC,12004,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,840,
LACERATION SPL 20CM TR/EX,45012005,CDM,450,RC,12005,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,1404.98,
LACERATION SPL 30CM NONFACE,45012006,CDM,450,RC,12006,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,1404.98,
LACERATION SPL > 30CM TR/EX,45012007,CDM,450,RC,12007,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,840,
LACERATION SPL < 2.5CM FACE,45012011,CDM,450,RC,12011,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,840,
LACERATION SPL 5.0CM FACE,45012013,CDM,450,RC,12013,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,840,
LACERATION SPL 7.5 CM FACE,45012014,CDM,450,RC,12014,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,840,
LACERATION SPL 12.5CM FACE,45012015,CDM,450,RC,12015,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,840,
LACERATION SPL 20CM FACE,45012016,CDM,450,RC,12016,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,1404.98,
LACERATION SPL 30CM FACE,45012017,CDM,450,RC,12017,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,1404.98,
LACERATION SPL > 30CM FACE,45012018,CDM,450,RC,12018,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,840,
12020 TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE TechFee,45012020,CDM,450,RC,12020,HCPCS,Outpatient,,,1813,1178.45,,1595.44,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,1813,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1142.19,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,277.39,15.3,,,percent of total billed charges,15.3% of total billed charges,1250.97,69,,,percent of total billed charges,69% of total billed charges,1813,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1813,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1813,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,683.5,37.7,,,percent of total billed charges,37.70% of total billed charges,683.5,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,614.61,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1414.14,78,,,percent of total billed charges,78% of total billed charges,1813,100,,,percent of total billed charges,100% of total billed charges,1497.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1497.54,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,250.91,2129.45,
LACERATION INT < 2.5CM TR/SCA,45012031,CDM,450,RC,12031,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.97,
LACERATION INT 7.5CM TR/SCA,45012032,CDM,450,RC,12032,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.97,
LACERATION INT 12.5CM TR/SC,45012034,CDM,450,RC,12034,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.97,
LACERATION INT 20CM TR/SCAL,45012035,CDM,450,RC,12035,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.97,
LACERATION INT 30CM TR/SCAL,45012036,CDM,450,RC,12036,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,2129.45,
LACERATION INT > 30CM TR/SC,45012037,CDM,450,RC,12037,HCPCS,Outpatient,,,4129,2683.85,,3633.52,88,,,percent of total billed charges,88% of total Billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,4129,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,2601.27,63,,,percent of total billed charges,63% of total billed charges,3255.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,631.74,15.3,,,percent of total billed charges,15.3% of total billed charges,2849.01,69,,,percent of total billed charges,69% of total billed charges,4129,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,4129,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,4129,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6968.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1556.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1556.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1399.73,33.9,,,percent of total billed charges,33.9% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3220.62,78,,,percent of total billed charges,78% of total billed charges,4129,100,,,percent of total billed charges,100% of total billed charges,3410.55,82.6,,,percent of total billed charges,82.6% of total billed charges,3410.55,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1878.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,250.91,6968.7,
LACERATION INT <2.5CM NK/HD/FT,45012041,CDM,450,RC,12041,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.98,
LACERATION INT 7.5CM NK/HD/FT,45012042,CDM,450,RC,12042,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.97,
LACERATION INT 12.5CM NK/HD/FT,45012044,CDM,450,RC,12044,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,2129.45,
LACERATION INT 20CM NK/HD/FT,45012045,CDM,450,RC,12045,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,2129.45,
LACERATION INT 30CM NK/HD/FT,45012046,CDM,450,RC,12046,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,2129.45,
LACERATION INT > 30CM NK/HD/FT,45012047,CDM,450,RC,12047,HCPCS,Outpatient,,,4129,2683.85,,3633.52,88,,,percent of total billed charges,88% of total Billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,4129,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,2601.27,63,,,percent of total billed charges,63% of total billed charges,3255.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,631.74,15.3,,,percent of total billed charges,15.3% of total billed charges,2849.01,69,,,percent of total billed charges,69% of total billed charges,4129,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,4129,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,4129,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6968.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1556.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1556.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1399.73,33.9,,,percent of total billed charges,33.9% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3220.62,78,,,percent of total billed charges,78% of total billed charges,4129,100,,,percent of total billed charges,100% of total billed charges,3410.55,82.6,,,percent of total billed charges,82.6% of total billed charges,3410.55,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1878.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,250.91,6968.7,
LACERATION INT < 2.5CM FACE,45012051,CDM,450,RC,12051,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.97,
LACERATION INT 5.OCM FACE,45012052,CDM,450,RC,12052,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.97,
LACERATION INT 7.5CM FACE,45012053,CDM,450,RC,12053,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.97,
LACERATION INT 12.5CM FACE,45012054,CDM,450,RC,12054,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.98,
LACERATION INT 20CM FACE,45012055,CDM,450,RC,12055,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.97,
LACERATION INT 30CM FACE,45012056,CDM,450,RC,12056,HCPCS,Outpatient,,,840,546.00,,739.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,840,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,529.2,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,128.52,15.3,,,percent of total billed charges,15.3% of total billed charges,579.6,69,,,percent of total billed charges,69% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,840,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,316.68,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,284.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,655.2,78,,,percent of total billed charges,78% of total billed charges,840,100,,,percent of total billed charges,100% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,693.84,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.52,1404.98,
LACERATION COMPLEX 2.5CM TRUNK,45013100,CDM,450,RC,13100,HCPCS,Outpatient,,,1280,832.00,,1126.4,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1280,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,806.4,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,195.84,15.3,,,percent of total billed charges,15.3% of total billed charges,883.2,69,,,percent of total billed charges,69% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,433.92,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,998.4,78,,,percent of total billed charges,78% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.84,2129.45,
LACERATION COMPLEX 7.5CM TRUNK,45013101,CDM,450,RC,13101,HCPCS,Outpatient,,,1280,832.00,,1126.4,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1280,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,806.4,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,195.84,15.3,,,percent of total billed charges,15.3% of total billed charges,883.2,69,,,percent of total billed charges,69% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,433.92,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,998.4,78,,,percent of total billed charges,78% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.84,2129.45,
LACERATION COMPLEX 2.5CM S/A/L,45013120,CDM,450,RC,13120,HCPCS,Outpatient,,,1280,832.00,,1126.4,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1280,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,806.4,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,195.84,15.3,,,percent of total billed charges,15.3% of total billed charges,883.2,69,,,percent of total billed charges,69% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,433.92,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,998.4,78,,,percent of total billed charges,78% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.84,2129.45,
LACERATION COMPLEX 7.5CM S/A/L,45013121,CDM,450,RC,13121,HCPCS,Outpatient,,,1280,832.00,,1126.4,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1280,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,806.4,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,195.84,15.3,,,percent of total billed charges,15.3% of total billed charges,883.2,69,,,percent of total billed charges,69% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,433.92,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,998.4,78,,,percent of total billed charges,78% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.84,2129.45,
COMPLEX REPAIR ADD 5CM OR LESS,45013122,CDM,450,RC,13122,HCPCS,Outpatient,,,1184,769.60,,1041.92,88,,,percent of total billed charges,88% of total Billed charges,592,50,,,percent of total billed charges,50% of total Billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid,1184,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,592,50,,,percent of total billed charges,50% of total Billed charges,745.92,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,401.45,100,,,Fee Schedule,100% of WA Medicaid,181.15,15.3,,,percent of total billed charges,15.3% of total billed charges,816.96,69,,,percent of total billed charges,69% of total billed charges,1184,100,,,percent of total billed charges,100% of total billed charges,592,50,,,percent of total billed charges,50% of total Billed charges,1184,100,,,percent of total billed charges,100% of total billed charges,592,50,,,percent of total billed charges,50% of total Billed charges,1184,100,,,percent of total billed charges,100% of total billed charges,592,50,,,percent of total billed charges,50% of total Billed charges,732.3,61.85,,,percent of total billed charges,61.85% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,592,50,,,percent of total billed charges,50% of total Billed charges,592,50,,,percent of total billed charges,50% of total Billed charges,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,592,50,,,percent of total billed charges,50% of total Billed charges,592,50,,,percent of total billed charges,50% of total Billed charges,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,592,50,,,percent of total billed charges,50% of total Billed charges,446.37,37.7,,,percent of total billed charges,37.70% of total billed charges,446.37,37.7,,,percent of total billed charges,37.70% of total billed charges,592,50,,,percent of total billed charges,50% of total Billed charges,401.38,33.9,,,percent of total billed charges,33.9% of total billed charges,592,50,,,percent of total billed charges,50% of total Billed charges,923.52,78,,,percent of total billed charges,78% of total billed charges,1184,100,,,percent of total billed charges,100% of total billed charges,977.98,82.6,,,percent of total billed charges,82.6% of total billed charges,977.98,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,592,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,592,50,,,percent of total billed charges,50% of total Billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,181.15,1184,
LACERATION COMPLEX 2.5CM FHF,45013131,CDM,450,RC,13131,HCPCS,Outpatient,,,1280,832.00,,1126.4,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1280,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,806.4,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,195.84,15.3,,,percent of total billed charges,15.3% of total billed charges,883.2,69,,,percent of total billed charges,69% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,433.92,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,998.4,78,,,percent of total billed charges,78% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.84,1404.97,
LACERATION COMPLEX 7.5CM FHF,45013132,CDM,450,RC,13132,HCPCS,Outpatient,,,1280,832.00,,1126.4,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1280,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,806.4,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,195.84,15.3,,,percent of total billed charges,15.3% of total billed charges,883.2,69,,,percent of total billed charges,69% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,433.92,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,998.4,78,,,percent of total billed charges,78% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.84,2129.45,
LAC COMPLEX EA ADDL 5CM OR LES,45013133,CDM,450,RC,13133,HCPCS,Outpatient,,,993,645.45,,873.84,88,,,percent of total billed charges,88% of total Billed charges,496.5,50,,,percent of total billed charges,50% of total Billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid,993,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,496.5,50,,,percent of total billed charges,50% of total Billed charges,625.59,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,401.45,100,,,Fee Schedule,100% of WA Medicaid,151.93,15.3,,,percent of total billed charges,15.3% of total billed charges,685.17,69,,,percent of total billed charges,69% of total billed charges,993,100,,,percent of total billed charges,100% of total billed charges,496.5,50,,,percent of total billed charges,50% of total Billed charges,993,100,,,percent of total billed charges,100% of total billed charges,496.5,50,,,percent of total billed charges,50% of total Billed charges,993,100,,,percent of total billed charges,100% of total billed charges,496.5,50,,,percent of total billed charges,50% of total Billed charges,614.17,61.85,,,percent of total billed charges,61.85% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,496.5,50,,,percent of total billed charges,50% of total Billed charges,496.5,50,,,percent of total billed charges,50% of total Billed charges,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,496.5,50,,,percent of total billed charges,50% of total Billed charges,496.5,50,,,percent of total billed charges,50% of total Billed charges,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,496.5,50,,,percent of total billed charges,50% of total Billed charges,374.36,37.7,,,percent of total billed charges,37.70% of total billed charges,374.36,37.7,,,percent of total billed charges,37.70% of total billed charges,496.5,50,,,percent of total billed charges,50% of total Billed charges,336.63,33.9,,,percent of total billed charges,33.9% of total billed charges,496.5,50,,,percent of total billed charges,50% of total Billed charges,774.54,78,,,percent of total billed charges,78% of total billed charges,993,100,,,percent of total billed charges,100% of total billed charges,820.22,82.6,,,percent of total billed charges,82.6% of total billed charges,820.22,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,496.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,496.5,50,,,percent of total billed charges,50% of total Billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,151.93,993,
"SUTURE COMPLEX EYE,NOSE <1CM",45013150,CDM,450,RC,13150,HCPCS,Outpatient,,,4129,2683.85,,3633.52,88,,,percent of total billed charges,88% of total Billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,693.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4129,100,,,percent of total billed charges,100% of total billed charges,714.48,17.304,,,percent of total billed charges,17.304% of total billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,2601.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,693.67,16.8,,,percent of total billed charges,16.8% of total billed charges,631.74,15.3,,,percent of total billed charges,15.3% of total billed charges,2849.01,69,,,percent of total billed charges,69% of total billed charges,4129,100,,,percent of total billed charges,100% of total billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,4129,100,,,percent of total billed charges,100% of total billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,4129,100,,,percent of total billed charges,100% of total billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,2553.79,61.85,,,percent of total billed charges,61.85% of total billed charges,693.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,693.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,707.55,17.136,,,percent of total billed charges,17.136% of total billed charges,901.77,21.84,,,percent of total billed charges,21.84% of total billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,1556.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1556.63,37.7,,,percent of total billed charges,37.70% of total billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,1399.73,33.9,,,percent of total billed charges,33.9% of total billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,3220.62,78,,,percent of total billed charges,78% of total billed charges,4129,100,,,percent of total billed charges,100% of total billed charges,3410.55,82.6,,,percent of total billed charges,82.6% of total billed charges,3410.55,82.6,,,percent of total billed charges,82.6% of total billed charges,693.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2064.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2064.5,50,,,percent of total billed charges,50% of total Billed charges,693.67,16.8,,,percent of total billed charges,16.8% of total billed charges,631.74,4129,
"SUTURE COMPLEX EYE,NOSE 2.5CM",45013151,CDM,450,RC,13151,HCPCS,Outpatient,,,1280,832.00,,1126.4,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1280,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,806.4,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,195.84,15.3,,,percent of total billed charges,15.3% of total billed charges,883.2,69,,,percent of total billed charges,69% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,433.92,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,998.4,78,,,percent of total billed charges,78% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.84,2129.45,
LACERATION COMPLEX 7.5CM FACE,45013152,CDM,450,RC,13152,HCPCS,Outpatient,,,1280,832.00,,1126.4,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1280,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,806.4,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,195.84,15.3,,,percent of total billed charges,15.3% of total billed charges,883.2,69,,,percent of total billed charges,69% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1280,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,433.92,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,998.4,78,,,percent of total billed charges,78% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.84,2129.45,
LACERATION COMPLEX ADD'L 5CM,45013153,CDM,450,RC,13153,HCPCS,Outpatient,,,625,406.25,,550,88,,,percent of total billed charges,88% of total Billed charges,312.5,50,,,percent of total billed charges,50% of total Billed charges,1035.18,100,,,Fee Schedule,100% of WA Medicaid,625,100,,,percent of total billed charges,100% of total billed charges,1066.24,103,,,Fee Schedule,103% of WA Medicaid,312.5,50,,,percent of total billed charges,50% of total Billed charges,393.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1035.18,100,,,Fee Schedule,100% of WA Medicaid,95.63,15.3,,,percent of total billed charges,15.3% of total billed charges,431.25,69,,,percent of total billed charges,69% of total billed charges,625,100,,,percent of total billed charges,100% of total billed charges,312.5,50,,,percent of total billed charges,50% of total Billed charges,625,100,,,percent of total billed charges,100% of total billed charges,312.5,50,,,percent of total billed charges,50% of total Billed charges,625,100,,,percent of total billed charges,100% of total billed charges,312.5,50,,,percent of total billed charges,50% of total Billed charges,386.56,61.85,,,percent of total billed charges,61.85% of total billed charges,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,312.5,50,,,percent of total billed charges,50% of total Billed charges,312.5,50,,,percent of total billed charges,50% of total Billed charges,766.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,312.5,50,,,percent of total billed charges,50% of total Billed charges,312.5,50,,,percent of total billed charges,50% of total Billed charges,1055.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1345.74,130,,,Fee Schedule,130% of WA Medicaid ,312.5,50,,,percent of total billed charges,50% of total Billed charges,235.63,37.7,,,percent of total billed charges,37.70% of total billed charges,235.63,37.7,,,percent of total billed charges,37.70% of total billed charges,312.5,50,,,percent of total billed charges,50% of total Billed charges,211.88,33.9,,,percent of total billed charges,33.9% of total billed charges,312.5,50,,,percent of total billed charges,50% of total Billed charges,487.5,78,,,percent of total billed charges,78% of total billed charges,625,100,,,percent of total billed charges,100% of total billed charges,516.25,82.6,,,percent of total billed charges,82.6% of total billed charges,516.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,312.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,312.5,50,,,percent of total billed charges,50% of total Billed charges,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.63,1345.74,
"REMOVAL OF SUTURES UNDER ANES, OTHER SURGEON",45015851,CDM,450,RC,15851,HCPCS,Outpatient,,,6040,3926.00,,5315.2,88,,,percent of total billed charges,88% of total Billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1066.24,103,,,Fee Schedule,103% of WA Medicaid,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3805.2,63,,,percent of total billed charges,63% of total billed charges,3255.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid,924.12,15.3,,,percent of total billed charges,15.3% of total billed charges,4167.6,69,,,percent of total billed charges,69% of total billed charges,6040,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6040,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6040,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6968.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,766.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1055.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1345.74,130,,,Fee Schedule,130% of WA Medicaid ,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,2277.08,37.7,,,percent of total billed charges,37.70% of total billed charges,2277.08,37.7,,,percent of total billed charges,37.70% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,2047.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,4711.2,78,,,percent of total billed charges,78% of total billed charges,6040,100,,,percent of total billed charges,100% of total billed charges,4989.04,82.6,,,percent of total billed charges,82.6% of total billed charges,4989.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1878.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,766.8,6968.7,
15853 Removal of sutures and staples not requiring anesthesi,45015853,CDM,450,RC,15853,HCPCS,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,7.09,17.304,,,percent of total billed charges,17.304% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,15.3,,,percent of total billed charges,15.3% of total billed charges,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.36,61.85,,,percent of total billed charges,61.85% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,7.03,17.136,,,percent of total billed charges,17.136% of total billed charges,8.95,21.84,,,percent of total billed charges,21.84% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,37.7,,,percent of total billed charges,37.70% of total billed charges,15.46,37.7,,,percent of total billed charges,37.70% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,13.9,33.9,,,percent of total billed charges,33.9% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,41,
BURN INITIAL,45016000,CDM,450,RC,16000,HCPCS,Outpatient,,,398,258.70,,350.24,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,398,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,250.74,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,60.89,15.3,,,percent of total billed charges,15.3% of total billed charges,274.62,69,,,percent of total billed charges,69% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,398,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,398,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,134.92,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,310.44,78,,,percent of total billed charges,78% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.89,729.42,
BURN DRESSING W/O ANES SMALL,45016020,CDM,450,RC,16020,HCPCS,Outpatient,,,398,258.70,,350.24,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,398,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,250.74,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,60.89,15.3,,,percent of total billed charges,15.3% of total billed charges,274.62,69,,,percent of total billed charges,69% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,398,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,398,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,134.92,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,310.44,78,,,percent of total billed charges,78% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.89,729.42,
BURN DRESSING MEDIUM,45016025,CDM,450,RC,16025,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,302.4,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,73.44,15.3,,,percent of total billed charges,15.3% of total billed charges,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,162.72,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.44,729.41,
BURN DRESSING LARGE,45016030,CDM,450,RC,16030,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,302.4,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,73.44,15.3,,,percent of total billed charges,15.3% of total billed charges,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,162.72,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.44,1404.97,
INCISION OF BURN SCAB INITIAL,45016035,CDM,450,RC,16035,HCPCS,Outpatient,,,1055,685.75,,928.4,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,1055,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,664.65,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,161.42,15.3,,,percent of total billed charges,15.3% of total billed charges,727.95,69,,,percent of total billed charges,69% of total billed charges,1055,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1055,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1055,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,397.74,37.7,,,percent of total billed charges,37.70% of total billed charges,397.74,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,357.65,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,822.9,78,,,percent of total billed charges,78% of total billed charges,1055,100,,,percent of total billed charges,100% of total billed charges,871.43,82.6,,,percent of total billed charges,82.6% of total billed charges,871.43,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,161.42,1404.97,
ESCHAROTOMY ADD'L INCISION,45016036,CDM,450,RC,16036,HCPCS,Outpatient,,,437,284.05,,384.56,88,,,percent of total billed charges,88% of total Billed charges,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,338.73,100,,,Fee Schedule,100% of WA Medicaid,437,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,275.31,63,,,percent of total billed charges,63% of total billed charges,437,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,338.73,100,,,Fee Schedule,100% of WA Medicaid,66.86,15.3,,,percent of total billed charges,15.3% of total billed charges,301.53,69,,,percent of total billed charges,69% of total billed charges,437,100,,,percent of total billed charges,100% of total billed charges,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,437,100,,,percent of total billed charges,100% of total billed charges,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,437,100,,,percent of total billed charges,100% of total billed charges,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,437,100,,,Fee Schedule,Pays at line item charges due to status indicator C,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,164.75,37.7,,,percent of total billed charges,37.70% of total billed charges,164.75,37.7,,,percent of total billed charges,37.70% of total billed charges,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,148.14,33.9,,,percent of total billed charges,33.9% of total billed charges,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,340.86,78,,,percent of total billed charges,78% of total billed charges,437,100,,,percent of total billed charges,100% of total billed charges,360.96,82.6,,,percent of total billed charges,82.6% of total billed charges,360.96,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,437,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,437,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.86,440.34,
OBLITORATE WART VIA CURRETT,45017110,CDM,450,RC,17110,HCPCS,Outpatient,,,879,571.35,,773.52,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,879,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,553.77,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,134.49,15.3,,,percent of total billed charges,15.3% of total billed charges,606.51,69,,,percent of total billed charges,69% of total billed charges,879,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,879,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,879,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,331.38,37.7,,,percent of total billed charges,37.70% of total billed charges,331.38,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,297.98,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,685.62,78,,,percent of total billed charges,78% of total billed charges,879,100,,,percent of total billed charges,100% of total billed charges,726.05,82.6,,,percent of total billed charges,82.6% of total billed charges,726.05,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,109.13,879,
CHEM CAUTERIZATION OF GRAN TIS,45017250,CDM,450,RC,17250,HCPCS,Outpatient,,,247,160.55,,217.36,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,247,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,155.61,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,37.79,15.3,,,percent of total billed charges,15.3% of total billed charges,170.43,69,,,percent of total billed charges,69% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,83.73,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,192.66,78,,,percent of total billed charges,78% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.79,729.42,
"Unlisted procedure, skin, mucous membrane and subcutaneous t",45017999,CDM,450,RC,17999,HCPCS,Outpatient,,,545,354.25,,479.6,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,545,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,343.35,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,83.39,15.3,,,percent of total billed charges,15.3% of total billed charges,376.05,69,,,percent of total billed charges,69% of total billed charges,545,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,545,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,545,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,205.47,37.7,,,percent of total billed charges,37.70% of total billed charges,205.47,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,184.76,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,425.1,78,,,percent of total billed charges,78% of total billed charges,545,100,,,percent of total billed charges,100% of total billed charges,450.17,82.6,,,percent of total billed charges,82.6% of total billed charges,450.17,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.39,729.42,
NEEDLE ASPIRATIION CYST/BREAST,45019000,CDM,450,RC,19000,HCPCS,Outpatient,,,964,626.60,,848.32,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,568.92,100,,,Fee Schedule,100% of WA Medicaid,964,100,,,percent of total billed charges,100% of total billed charges,585.99,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,607.32,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,568.92,100,,,Fee Schedule,100% of WA Medicaid,147.49,15.3,,,percent of total billed charges,15.3% of total billed charges,665.16,69,,,percent of total billed charges,69% of total billed charges,964,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,964,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,964,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,568.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,421.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,580.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,739.6,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,363.43,37.7,,,percent of total billed charges,37.70% of total billed charges,363.43,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,326.8,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,751.92,78,,,percent of total billed charges,78% of total billed charges,964,100,,,percent of total billed charges,100% of total billed charges,796.26,82.6,,,percent of total billed charges,82.6% of total billed charges,796.26,82.6,,,percent of total billed charges,82.6% of total billed charges,568.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,568.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,147.49,2526.76,
EXP PENETRATING WND EXTREMITY,45020103,CDM,450,RC,20103,HCPCS,Outpatient,,,683,443.95,,601.04,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,683,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,430.29,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,104.5,15.3,,,percent of total billed charges,15.3% of total billed charges,471.27,69,,,percent of total billed charges,69% of total billed charges,683,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,683,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,683,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,257.49,37.7,,,percent of total billed charges,37.70% of total billed charges,257.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,231.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,532.74,78,,,percent of total billed charges,78% of total billed charges,683,100,,,percent of total billed charges,100% of total billed charges,564.16,82.6,,,percent of total billed charges,82.6% of total billed charges,564.16,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,104.5,2893.89,
REMOVAL FB IN MUSCLE SIMPLE,45020520,CDM,450,RC,20520,HCPCS,Outpatient,,,1371,891.15,,1206.48,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,1371,100,,,percent of total billed charges,100% of total billed charges,1618.96,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,863.73,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,209.76,15.3,,,percent of total billed charges,15.3% of total billed charges,945.99,69,,,percent of total billed charges,69% of total billed charges,1371,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1371,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1371,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1603.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2043.35,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,516.87,37.7,,,percent of total billed charges,37.70% of total billed charges,516.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,464.77,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1069.38,78,,,percent of total billed charges,78% of total billed charges,1371,100,,,percent of total billed charges,100% of total billed charges,1132.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1132.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,209.76,5715.97,
"INJECTION, CARPAL TUNNEL",45020526,CDM,450,RC,20526,HCPCS,Outpatient,,,532,345.80,,468.16,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,532,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,335.16,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,81.4,15.3,,,percent of total billed charges,15.3% of total billed charges,367.08,69,,,percent of total billed charges,69% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,532,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,532,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,180.35,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,414.96,78,,,percent of total billed charges,78% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.4,1061,
TRIGGER PT INJECTION-TENDON,45020550,CDM,450,RC,20550,HCPCS,Outpatient,,,730,474.50,,642.4,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,730,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,459.9,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,111.69,15.3,,,percent of total billed charges,15.3% of total billed charges,503.7,69,,,percent of total billed charges,69% of total billed charges,730,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,730,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,730,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,275.21,37.7,,,percent of total billed charges,37.70% of total billed charges,275.21,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,247.47,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,569.4,78,,,percent of total billed charges,78% of total billed charges,730,100,,,percent of total billed charges,100% of total billed charges,602.98,82.6,,,percent of total billed charges,82.6% of total billed charges,602.98,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.69,1061,
TRIGGER PT INJ 1-2 MUSCLE GRP,45020552,CDM,450,RC,20552,HCPCS,Outpatient,,,663,430.95,,583.44,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,663,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,417.69,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,101.44,15.3,,,percent of total billed charges,15.3% of total billed charges,457.47,69,,,percent of total billed charges,69% of total billed charges,663,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,663,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,663,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,249.95,37.7,,,percent of total billed charges,37.70% of total billed charges,249.95,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,224.76,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,517.14,78,,,percent of total billed charges,78% of total billed charges,663,100,,,percent of total billed charges,100% of total billed charges,547.64,82.6,,,percent of total billed charges,82.6% of total billed charges,547.64,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.44,1061,
TRIGGER PT INJ 3-MORE MUSC GRP,45020553,CDM,450,RC,20553,HCPCS,Outpatient,,,663,430.95,,583.44,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,663,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,417.69,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,101.44,15.3,,,percent of total billed charges,15.3% of total billed charges,457.47,69,,,percent of total billed charges,69% of total billed charges,663,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,663,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,663,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,249.95,37.7,,,percent of total billed charges,37.70% of total billed charges,249.95,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,224.76,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,517.14,78,,,percent of total billed charges,78% of total billed charges,663,100,,,percent of total billed charges,100% of total billed charges,547.64,82.6,,,percent of total billed charges,82.6% of total billed charges,547.64,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.44,1061,
ARTHROCENT ASP/INJ SM JT TA,45020600,CDM,450,RC,20600,HCPCS,Outpatient,,,1115,724.75,,981.2,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,1115,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,702.45,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,170.6,15.3,,,percent of total billed charges,15.3% of total billed charges,769.35,69,,,percent of total billed charges,69% of total billed charges,1115,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1115,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1115,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,420.36,37.7,,,percent of total billed charges,37.70% of total billed charges,420.36,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,377.99,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,869.7,78,,,percent of total billed charges,78% of total billed charges,1115,100,,,percent of total billed charges,100% of total billed charges,920.99,82.6,,,percent of total billed charges,82.6% of total billed charges,920.99,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,160.53,1115,
ARTHROCENT ASP/INJ MED JT,45020605,CDM,450,RC,20605,HCPCS,Outpatient,,,1115,724.75,,981.2,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,1115,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,702.45,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,170.6,15.3,,,percent of total billed charges,15.3% of total billed charges,769.35,69,,,percent of total billed charges,69% of total billed charges,1115,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1115,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1115,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,420.36,37.7,,,percent of total billed charges,37.70% of total billed charges,420.36,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,377.99,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,869.7,78,,,percent of total billed charges,78% of total billed charges,1115,100,,,percent of total billed charges,100% of total billed charges,920.99,82.6,,,percent of total billed charges,82.6% of total billed charges,920.99,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,160.53,1115,
ARTHROCENTESIS MAJOR JOINT,45020610,CDM,450,RC,20610,HCPCS,Outpatient,,,730,474.50,,642.4,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,730,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,459.9,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,111.69,15.3,,,percent of total billed charges,15.3% of total billed charges,503.7,69,,,percent of total billed charges,69% of total billed charges,730,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,730,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,730,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,275.21,37.7,,,percent of total billed charges,37.70% of total billed charges,275.21,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,247.47,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,569.4,78,,,percent of total billed charges,78% of total billed charges,730,100,,,percent of total billed charges,100% of total billed charges,602.98,82.6,,,percent of total billed charges,82.6% of total billed charges,602.98,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.69,1061,
ASPIRATION OR INJ GANGLION CYS,45020612,CDM,450,RC,20612,HCPCS,Outpatient,,,514,334.10,,452.32,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,514,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,323.82,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,78.64,15.3,,,percent of total billed charges,15.3% of total billed charges,354.66,69,,,percent of total billed charges,69% of total billed charges,514,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,514,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,514,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,193.78,37.7,,,percent of total billed charges,37.70% of total billed charges,193.78,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,174.25,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,400.92,78,,,percent of total billed charges,78% of total billed charges,514,100,,,percent of total billed charges,100% of total billed charges,424.56,82.6,,,percent of total billed charges,82.6% of total billed charges,424.56,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.64,1061,
"REMOVAL OF IMPL WIRE, PIN, ROD",45020670,CDM,450,RC,20670,HCPCS,Outpatient,,,3402,2211.30,,2993.76,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2168.78,100,,,Fee Schedule,100% of WA Medicaid,3402,100,,,percent of total billed charges,100% of total billed charges,2233.84,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2143.26,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,2168.78,100,,,Fee Schedule,100% of WA Medicaid,520.51,15.3,,,percent of total billed charges,15.3% of total billed charges,2347.38,69,,,percent of total billed charges,69% of total billed charges,3402,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3402,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3402,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2168.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1606.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2212.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2819.42,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1282.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1282.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1153.28,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2653.56,78,,,percent of total billed charges,78% of total billed charges,3402,100,,,percent of total billed charges,100% of total billed charges,2810.05,82.6,,,percent of total billed charges,82.6% of total billed charges,2810.05,82.6,,,percent of total billed charges,82.6% of total billed charges,2168.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2168.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,520.51,5715.98,
CL TX NASAL SEP FX W/WO STABIL,45021337,CDM,450,RC,21337,HCPCS,Outpatient,,,3402,2211.30,,2993.76,88,,,percent of total billed charges,88% of total Billed charges,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,3402,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,2143.26,63,,,percent of total billed charges,63% of total billed charges,5746.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,520.51,15.3,,,percent of total billed charges,15.3% of total billed charges,2347.38,69,,,percent of total billed charges,69% of total billed charges,3402,100,,,percent of total billed charges,100% of total billed charges,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,3402,100,,,percent of total billed charges,100% of total billed charges,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,3402,100,,,percent of total billed charges,100% of total billed charges,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,11116.67,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,1282.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1282.55,37.7,,,percent of total billed charges,37.70% of total billed charges,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,1153.28,33.9,,,percent of total billed charges,33.9% of total billed charges,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,2653.56,78,,,percent of total billed charges,78% of total billed charges,3402,100,,,percent of total billed charges,100% of total billed charges,2810.05,82.6,,,percent of total billed charges,82.6% of total billed charges,2810.05,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,3316.71,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3283.88,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,296.48,11116.67,
CL TX FX OF ORBIT W/O MANIP,45021400,CDM,450,RC,21400,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,412.25,103,,,Fee Schedule,103% of WA Medicaid,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,982.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1837.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,566.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,296.48,1837.71,
CL TX MANDIBULAR FX W/O MANIP,45021450,CDM,450,RC,21450,HCPCS,Outpatient,,,703,456.95,,618.64,88,,,percent of total billed charges,88% of total Billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,703,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,442.89,63,,,percent of total billed charges,63% of total billed charges,982.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,107.56,15.3,,,percent of total billed charges,15.3% of total billed charges,485.07,69,,,percent of total billed charges,69% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1837.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,238.32,33.9,,,percent of total billed charges,33.9% of total billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,548.34,78,,,percent of total billed charges,78% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,566.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.56,1837.71,
TX TMJ DISLOCATION UNCOMPLICAT,45021480,CDM,450,RC,21480,HCPCS,Outpatient,,,592,384.80,,520.96,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,592,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,372.96,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,90.58,15.3,,,percent of total billed charges,15.3% of total billed charges,408.48,69,,,percent of total billed charges,69% of total billed charges,592,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,592,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,592,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,223.18,37.7,,,percent of total billed charges,37.70% of total billed charges,223.18,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,200.69,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,461.76,78,,,percent of total billed charges,78% of total billed charges,592,100,,,percent of total billed charges,100% of total billed charges,488.99,82.6,,,percent of total billed charges,82.6% of total billed charges,488.99,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,837.64,
FRACTURE RIBS EACH,45021800,CDM,450,RC,21800,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,745,100,,,percent of total billed charges,100% of total billed charges,128.91,17.304,,,percent of total billed charges,17.304% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,469.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,745,100,,,percent of total billed charges,100% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,745,100,,,percent of total billed charges,100% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,460.78,61.85,,,percent of total billed charges,61.85% of total billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,127.66,17.136,,,percent of total billed charges,17.136% of total billed charges,162.71,21.84,,,percent of total billed charges,21.84% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,372.5,50,,,percent of total billed charges,50% of total Billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,113.99,745,
CL TX STERNAL FX,45021820,CDM,450,RC,21820,HCPCS,Outpatient,,,737,479.05,,648.56,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,737,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,464.31,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,112.76,15.3,,,percent of total billed charges,15.3% of total billed charges,508.53,69,,,percent of total billed charges,69% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,249.84,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,574.86,78,,,percent of total billed charges,78% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.76,837.64,
CL TX VERT PROCESS,45022305,CDM,450,RC,,,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,745,100,,,percent of total billed charges,100% of total billed charges,128.91,17.304,,,percent of total billed charges,17.304% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,469.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,745,100,,,percent of total billed charges,100% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,745,100,,,percent of total billed charges,100% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,460.78,61.85,,,percent of total billed charges,61.85% of total billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,127.66,17.136,,,percent of total billed charges,17.136% of total billed charges,162.71,21.84,,,percent of total billed charges,21.84% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,372.5,50,,,percent of total billed charges,50% of total Billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,113.99,745,
FRACTURE CLAVICLE-W/O,45023500,CDM,450,RC,23500,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
REDUCTION CLAVICLE,45023505,CDM,450,RC,23505,HCPCS,Outpatient,,,8185,5320.25,,7202.8,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5156.55,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,1252.31,15.3,,,percent of total billed charges,15.3% of total billed charges,5647.65,69,,,percent of total billed charges,69% of total billed charges,8185,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,8185,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,8185,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3085.75,37.7,,,percent of total billed charges,37.70% of total billed charges,3085.75,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,2774.72,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,6384.3,78,,,percent of total billed charges,78% of total billed charges,8185,100,,,percent of total billed charges,100% of total billed charges,6760.81,82.6,,,percent of total billed charges,82.6% of total billed charges,6760.81,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,296.48,8185,
CL TX STERNOCLAV DISLOC W/MAN,45023525,CDM,450,RC,23525,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CL ACROMIOCLAV DIS W/O,45023540,CDM,450,RC,23540,HCPCS,Outpatient,,,737,479.05,,648.56,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,737,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,464.31,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,112.76,15.3,,,percent of total billed charges,15.3% of total billed charges,508.53,69,,,percent of total billed charges,69% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,249.84,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,574.86,78,,,percent of total billed charges,78% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.76,837.64,
CLOSED TX SCAPULAR FX W/O MANI,45023570,CDM,450,RC,23570,HCPCS,Outpatient,,,434,282.10,,381.92,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,434,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,273.42,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,66.4,15.3,,,percent of total billed charges,15.3% of total billed charges,299.46,69,,,percent of total billed charges,69% of total billed charges,434,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,434,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,434,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,163.62,37.7,,,percent of total billed charges,37.70% of total billed charges,163.62,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,147.13,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,338.52,78,,,percent of total billed charges,78% of total billed charges,434,100,,,percent of total billed charges,100% of total billed charges,358.48,82.6,,,percent of total billed charges,82.6% of total billed charges,358.48,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.4,837.64,
TX CL HUMERAL FX W/O MAN NECK,45023600,CDM,450,RC,23600,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
CLSD TX RPOX HUMERAL FX W/MANI,45023605,CDM,450,RC,23605,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,5656.45,
TX CL HUMERAL HEAD W/O MANIP,45023620,CDM,450,RC,23620,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
REDUCTION SHOULDER DISLOCATION,45023650,CDM,450,RC,23650,HCPCS,Outpatient,,,976,634.40,,858.88,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,976,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,614.88,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,149.33,15.3,,,percent of total billed charges,15.3% of total billed charges,673.44,69,,,percent of total billed charges,69% of total billed charges,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,367.95,37.7,,,percent of total billed charges,37.70% of total billed charges,367.95,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,330.86,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,761.28,78,,,percent of total billed charges,78% of total billed charges,976,100,,,percent of total billed charges,100% of total billed charges,806.18,82.6,,,percent of total billed charges,82.6% of total billed charges,806.18,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,149.33,976,
REDUC SHLDR DISLOCAT;REQU ANES,45023655,CDM,450,RC,23655,HCPCS,Outpatient,,,941,611.65,,828.08,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,941,100,,,percent of total billed charges,100% of total billed charges,916.1,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,592.83,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,143.97,15.3,,,percent of total billed charges,15.3% of total billed charges,649.29,69,,,percent of total billed charges,69% of total billed charges,941,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,941,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,941,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,354.76,37.7,,,percent of total billed charges,37.70% of total billed charges,354.76,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,319,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,733.98,78,,,percent of total billed charges,78% of total billed charges,941,100,,,percent of total billed charges,100% of total billed charges,777.27,82.6,,,percent of total billed charges,82.6% of total billed charges,777.27,82.6,,,percent of total billed charges,82.6% of total billed charges,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,143.97,5656.45,
"ID BURSA,ELBOW",45023931,CDM,450,RC,23931,HCPCS,Outpatient,,,3894,2531.10,,3426.72,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,3894,100,,,percent of total billed charges,100% of total billed charges,1618.96,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2453.22,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,595.78,15.3,,,percent of total billed charges,15.3% of total billed charges,2686.86,69,,,percent of total billed charges,69% of total billed charges,3894,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3894,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3894,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1603.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2043.35,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1468.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1468.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1320.07,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3037.32,78,,,percent of total billed charges,78% of total billed charges,3894,100,,,percent of total billed charges,100% of total billed charges,3216.44,82.6,,,percent of total billed charges,82.6% of total billed charges,3216.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,595.78,5715.97,
"Removal of foreign body, upper arm or elbow area; subcutaneo",45024200,CDM,450,RC,24200,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1618.96,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1603.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2043.35,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1164.3,5715.97,
TX CL HUMERAL SHAFT W/O MANIP,45024500,CDM,450,RC,24500,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
CLOSED TX HUMORUS W/MANIPULAT,45024505,CDM,450,RC,24505,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,5656.45,
TX FX DIST HUM W/O MANIP SUP/E,45024530,CDM,450,RC,24530,HCPCS,Outpatient,,,438,284.70,,385.44,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,438,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,275.94,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,67.01,15.3,,,percent of total billed charges,15.3% of total billed charges,302.22,69,,,percent of total billed charges,69% of total billed charges,438,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,438,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,438,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,165.13,37.7,,,percent of total billed charges,37.70% of total billed charges,165.13,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,148.48,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,341.64,78,,,percent of total billed charges,78% of total billed charges,438,100,,,percent of total billed charges,100% of total billed charges,361.79,82.6,,,percent of total billed charges,82.6% of total billed charges,361.79,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.01,837.64,
TX FX DISTAL HUMERUS W/MAN,45024535,CDM,450,RC,24535,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,5656.45,
TX FX HUMERAL EPI W/O MANIP,45024560,CDM,450,RC,24560,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CL HUMERAL CONDYLAR FX MED,45024576,CDM,450,RC,24576,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
REDUCTION ELBOW DISLOCATION,45024600,CDM,450,RC,24600,HCPCS,Outpatient,,,1198,778.70,,1054.24,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,1198,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,754.74,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,183.29,15.3,,,percent of total billed charges,15.3% of total billed charges,826.62,69,,,percent of total billed charges,69% of total billed charges,1198,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,1198,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,1198,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,451.65,37.7,,,percent of total billed charges,37.70% of total billed charges,451.65,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,406.12,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,934.44,78,,,percent of total billed charges,78% of total billed charges,1198,100,,,percent of total billed charges,100% of total billed charges,989.55,82.6,,,percent of total billed charges,82.6% of total billed charges,989.55,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,183.29,1198,
CL TX FX/DISCLO ELBOW W MANIP,45024620,CDM,450,RC,24620,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,5656.45,
TX RADIAL HEAD SUBLUXATION CHD,45024640,CDM,450,RC,24640,HCPCS,Outpatient,,,976,634.40,,858.88,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,976,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,614.88,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,149.33,15.3,,,percent of total billed charges,15.3% of total billed charges,673.44,69,,,percent of total billed charges,69% of total billed charges,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,367.95,37.7,,,percent of total billed charges,37.70% of total billed charges,367.95,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,330.86,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,761.28,78,,,percent of total billed charges,78% of total billed charges,976,100,,,percent of total billed charges,100% of total billed charges,806.18,82.6,,,percent of total billed charges,82.6% of total billed charges,806.18,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,149.33,976,
TX RADIAL HEAD OR NECK FX W/O,45024650,CDM,450,RC,24650,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX RADIAL HD FX W/MANIP,45024655,CDM,450,RC,24655,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,5656.45,
"TX FX ULNAR, PROX W/O MANIP",45024670,CDM,450,RC,24670,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
"Unlisted procedure, humerus or elbow",45024999,CDM,450,RC,24999,HCPCS,Outpatient,,,660,429.00,,580.8,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,660,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,415.8,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,100.98,15.3,,,percent of total billed charges,15.3% of total billed charges,455.4,69,,,percent of total billed charges,69% of total billed charges,660,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,660,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,660,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,248.82,37.7,,,percent of total billed charges,37.70% of total billed charges,248.82,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,223.74,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,514.8,78,,,percent of total billed charges,78% of total billed charges,660,100,,,percent of total billed charges,100% of total billed charges,545.16,82.6,,,percent of total billed charges,82.6% of total billed charges,545.16,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,100.98,837.64,
TX CL FX RADIAL SHFT W/O MANIP,45025500,CDM,450,RC,25500,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CL FX RADIAL SHAFT W/MANIP,45025505,CDM,450,RC,25505,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,5656.45,
TX FX ULNAR SHAFT W/O,45025530,CDM,450,RC,25530,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CL RADIAL ULNAR W/O,45025560,CDM,450,RC,25560,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX FX RADIAL/ULNAR SHFT W/MANI,45025565,CDM,450,RC,25565,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,5656.45,
TX FX DISTAL RADIAL COLLES W/O,45025600,CDM,450,RC,25600,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX FX NAVICULAR W/O,45025622,CDM,450,RC,25622,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX FX CARPAL W/O MANIP,45025630,CDM,450,RC,25630,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CL ULNAR STYLOID,45025650,CDM,450,RC,25650,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
FINGER ABSCESS DRAIN SIMPLE,45026010,CDM,450,RC,26010,HCPCS,Outpatient,,,433,281.45,,381.04,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,433,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,272.79,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,66.25,15.3,,,percent of total billed charges,15.3% of total billed charges,298.77,69,,,percent of total billed charges,69% of total billed charges,433,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,433,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,433,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,163.24,37.7,,,percent of total billed charges,37.70% of total billed charges,163.24,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,146.79,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,337.74,78,,,percent of total billed charges,78% of total billed charges,433,100,,,percent of total billed charges,100% of total billed charges,357.66,82.6,,,percent of total billed charges,82.6% of total billed charges,357.66,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.25,729.41,
ID FINGER ABSCESS COMPLEX,45026011,CDM,450,RC,26011,HCPCS,Outpatient,,,2592,1684.80,,2280.96,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,989.16,100,,,Fee Schedule,100% of WA Medicaid,2592,100,,,percent of total billed charges,100% of total billed charges,1018.83,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1632.96,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,989.16,100,,,Fee Schedule,100% of WA Medicaid,396.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1788.48,69,,,percent of total billed charges,69% of total billed charges,2592,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2592,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2592,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,732.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1008.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1285.91,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,977.18,37.7,,,percent of total billed charges,37.70% of total billed charges,977.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,878.69,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2021.76,78,,,percent of total billed charges,78% of total billed charges,2592,100,,,percent of total billed charges,100% of total billed charges,2140.99,82.6,,,percent of total billed charges,82.6% of total billed charges,2140.99,82.6,,,percent of total billed charges,82.6% of total billed charges,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,396.58,5715.97,
"REPAIR FLEXOR TENDON,FINGER",45026350,CDM,450,RC,26350,HCPCS,Outpatient,,,3597,2338.05,,3165.36,88,,,percent of total billed charges,88% of total Billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid,3597,100,,,percent of total billed charges,100% of total billed charges,1229.08,103,,,Fee Schedule,103% of WA Medicaid,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,2266.11,63,,,percent of total billed charges,63% of total billed charges,5777.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid,550.34,15.3,,,percent of total billed charges,15.3% of total billed charges,2481.93,69,,,percent of total billed charges,69% of total billed charges,3597,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3597,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3597,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,11498.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,883.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1217.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1551.26,130,,,Fee Schedule,130% of WA Medicaid ,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1356.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1356.07,37.7,,,percent of total billed charges,37.70% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1219.38,33.9,,,percent of total billed charges,33.9% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,2805.66,78,,,percent of total billed charges,78% of total billed charges,3597,100,,,percent of total billed charges,100% of total billed charges,2971.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2971.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3334.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,550.34,11498.59,
"REPAIR EXT TENDON, HAND EACH",45026410,CDM,450,RC,26410,HCPCS,Outpatient,,,3926,2551.90,,3454.88,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid,3926,100,,,percent of total billed charges,100% of total billed charges,1229.08,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,2473.38,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid,600.68,15.3,,,percent of total billed charges,15.3% of total billed charges,2708.94,69,,,percent of total billed charges,69% of total billed charges,3926,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3926,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3926,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,883.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1217.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1551.26,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1480.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1480.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1330.91,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3062.28,78,,,percent of total billed charges,78% of total billed charges,3926,100,,,percent of total billed charges,100% of total billed charges,3242.88,82.6,,,percent of total billed charges,82.6% of total billed charges,3242.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,600.68,5656.45,
FINGER EXTENSON TENDON REPAIR,45026418,CDM,450,RC,26418,HCPCS,Outpatient,,,3849,2501.85,,3387.12,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid,3849,100,,,percent of total billed charges,100% of total billed charges,1229.08,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,2424.87,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid,588.9,15.3,,,percent of total billed charges,15.3% of total billed charges,2655.81,69,,,percent of total billed charges,69% of total billed charges,3849,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3849,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3849,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,883.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1217.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1551.26,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1451.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1451.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1304.81,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3002.22,78,,,percent of total billed charges,78% of total billed charges,3849,100,,,percent of total billed charges,100% of total billed charges,3179.27,82.6,,,percent of total billed charges,82.6% of total billed charges,3179.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,588.9,5656.45,
"Repair of collateral ligament, metacarpophalangeal or interp",45026540,CDM,450,RC,26540,HCPCS,Outpatient,,,3363,2185.95,,2959.44,88,,,percent of total billed charges,88% of total Billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid,3363,100,,,percent of total billed charges,100% of total billed charges,1229.08,103,,,Fee Schedule,103% of WA Medicaid,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,2118.69,63,,,percent of total billed charges,63% of total billed charges,5777.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid,514.54,15.3,,,percent of total billed charges,15.3% of total billed charges,2320.47,69,,,percent of total billed charges,69% of total billed charges,3363,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3363,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3363,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,11498.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,883.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1217.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1551.26,130,,,Fee Schedule,130% of WA Medicaid ,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1267.85,37.7,,,percent of total billed charges,37.70% of total billed charges,1267.85,37.7,,,percent of total billed charges,37.70% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1140.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,2623.14,78,,,percent of total billed charges,78% of total billed charges,3363,100,,,percent of total billed charges,100% of total billed charges,2777.84,82.6,,,percent of total billed charges,82.6% of total billed charges,2777.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3334.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,514.54,11498.59,
FX METACARPAL EACH,45026600,CDM,450,RC,26600,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX FX METACARPAL W/MANIP EACH,45026605,CDM,450,RC,26605,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CL DISLOC THUMB W/MANIP,45026641,CDM,450,RC,26641,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
26670 CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES TechF,45026670,CDM,450,RC,26670,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,240.53,837.64,
TX METACARPAL DISLOC W/MANIP,45026700,CDM,450,RC,26700,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX FX PHALANX PROX/MEDIAL W/O,45026720,CDM,450,RC,26720,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX FX PHALANX PROX/MED W/MANIP,45026725,CDM,450,RC,26725,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CLD FINGER FX ARTICU W/MANI,45026742,CDM,450,RC,26742,HCPCS,Outpatient,,,464,301.60,,408.32,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,464,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,292.32,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,70.99,15.3,,,percent of total billed charges,15.3% of total billed charges,320.16,69,,,percent of total billed charges,69% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,464,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,464,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,157.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,361.92,78,,,percent of total billed charges,78% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.99,5656.45,
TX CL FX FINGER,45026740,CDM,450,RC,26740,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
FX DISTAL PHALANX,45026750,CDM,450,RC,26750,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX FX PHALANX DISTAL W/MANIP,45026755,CDM,450,RC,26755,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
OPEN TREATMENT FINGER/THUMB,45026765,CDM,450,RC,26765,HCPCS,Outpatient,,,3046,1979.90,,2680.48,88,,,percent of total billed charges,88% of total Billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,4786.08,100,,,Fee Schedule,100% of WA Medicaid,3046,100,,,percent of total billed charges,100% of total billed charges,4929.66,103,,,Fee Schedule,103% of WA Medicaid,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1918.98,63,,,percent of total billed charges,63% of total billed charges,5777.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,4786.08,100,,,Fee Schedule,100% of WA Medicaid,466.04,15.3,,,percent of total billed charges,15.3% of total billed charges,2101.74,69,,,percent of total billed charges,69% of total billed charges,3046,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3046,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3046,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,11498.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4786.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3545.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,4881.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6221.9,130,,,Fee Schedule,130% of WA Medicaid ,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1148.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1148.34,37.7,,,percent of total billed charges,37.70% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1032.59,33.9,,,percent of total billed charges,33.9% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,2375.88,78,,,percent of total billed charges,78% of total billed charges,3046,100,,,percent of total billed charges,100% of total billed charges,2516,82.6,,,percent of total billed charges,82.6% of total billed charges,2516,82.6,,,percent of total billed charges,82.6% of total billed charges,4786.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3334.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,4786.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,466.04,11498.59,
TX DISLOCATION FINGER,45026770,CDM,450,RC,26770,HCPCS,Outpatient,,,748,486.20,,658.24,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,748,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,471.24,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,114.44,15.3,,,percent of total billed charges,15.3% of total billed charges,516.12,69,,,percent of total billed charges,69% of total billed charges,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,282,37.7,,,percent of total billed charges,37.70% of total billed charges,282,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,253.57,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,583.44,78,,,percent of total billed charges,78% of total billed charges,748,100,,,percent of total billed charges,100% of total billed charges,617.85,82.6,,,percent of total billed charges,82.6% of total billed charges,617.85,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.44,837.64,
26775 CLTX IPHAL JT DISLC W/MANJ REQ ANES TechFee,45026775,CDM,450,RC,26775,HCPCS,Outpatient,,,712,462.80,,626.56,88,,,percent of total billed charges,88% of total Billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,712,100,,,percent of total billed charges,100% of total billed charges,916.1,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,448.56,63,,,percent of total billed charges,63% of total billed charges,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,108.94,15.3,,,percent of total billed charges,15.3% of total billed charges,491.28,69,,,percent of total billed charges,69% of total billed charges,712,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,712,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,712,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,268.42,37.7,,,percent of total billed charges,37.70% of total billed charges,268.42,37.7,,,percent of total billed charges,37.70% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,241.37,33.9,,,percent of total billed charges,33.9% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,555.36,78,,,percent of total billed charges,78% of total billed charges,712,100,,,percent of total billed charges,100% of total billed charges,588.11,82.6,,,percent of total billed charges,82.6% of total billed charges,588.11,82.6,,,percent of total billed charges,82.6% of total billed charges,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.94,1156.25,
"AMPUTATION, FINGER OR THUMB",45026951,CDM,450,RC,26951,HCPCS,Outpatient,,,3597,2338.05,,3165.36,88,,,percent of total billed charges,88% of total Billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid,3597,100,,,percent of total billed charges,100% of total billed charges,1229.08,103,,,Fee Schedule,103% of WA Medicaid,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,2266.11,63,,,percent of total billed charges,63% of total billed charges,5777.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid,550.34,15.3,,,percent of total billed charges,15.3% of total billed charges,2481.93,69,,,percent of total billed charges,69% of total billed charges,3597,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3597,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3597,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,11498.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,883.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1217.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1551.26,130,,,Fee Schedule,130% of WA Medicaid ,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1356.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1356.07,37.7,,,percent of total billed charges,37.70% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1219.38,33.9,,,percent of total billed charges,33.9% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,2805.66,78,,,percent of total billed charges,78% of total billed charges,3597,100,,,percent of total billed charges,100% of total billed charges,2971.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2971.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3334.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1193.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,550.34,11498.59,
AMP ANY DIGIT CLOSE W/LOC FLAP,45026952,CDM,450,RC,26952,HCPCS,Outpatient,,,3926,2551.90,,3454.88,88,,,percent of total billed charges,88% of total Billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1978.8,100,,,Fee Schedule,100% of WA Medicaid,3926,100,,,percent of total billed charges,100% of total billed charges,2038.17,103,,,Fee Schedule,103% of WA Medicaid,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,2473.38,63,,,percent of total billed charges,63% of total billed charges,5777.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,1978.8,100,,,Fee Schedule,100% of WA Medicaid,600.68,15.3,,,percent of total billed charges,15.3% of total billed charges,2708.94,69,,,percent of total billed charges,69% of total billed charges,3926,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3926,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3926,100,,,percent of total billed charges,100% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,11498.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1978.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1465.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,2018.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2572.45,130,,,Fee Schedule,130% of WA Medicaid ,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1480.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1480.1,37.7,,,percent of total billed charges,37.70% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1330.91,33.9,,,percent of total billed charges,33.9% of total billed charges,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3062.28,78,,,percent of total billed charges,78% of total billed charges,3926,100,,,percent of total billed charges,100% of total billed charges,3242.88,82.6,,,percent of total billed charges,82.6% of total billed charges,3242.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1978.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3334.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1978.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,600.68,11498.59,
FX COCCYX,45027200,CDM,450,RC,27200,HCPCS,Outpatient,,,748,486.20,,658.24,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,748,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,471.24,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,114.44,15.3,,,percent of total billed charges,15.3% of total billed charges,516.12,69,,,percent of total billed charges,69% of total billed charges,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,282,37.7,,,percent of total billed charges,37.70% of total billed charges,282,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,253.57,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,583.44,78,,,percent of total billed charges,78% of total billed charges,748,100,,,percent of total billed charges,100% of total billed charges,617.85,82.6,,,percent of total billed charges,82.6% of total billed charges,617.85,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.44,837.64,
CL TX GR TROCHANTERIC FX W/O M,45027246,CDM,450,RC,27246,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,1170,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,737.1,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,1170,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,1170,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,179.01,1170,
CL TX HIP DISLOC TRAUM W/O ANE,45027250,CDM,450,RC,27250,HCPCS,Outpatient,,,748,486.20,,658.24,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,748,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,471.24,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,114.44,15.3,,,percent of total billed charges,15.3% of total billed charges,516.12,69,,,percent of total billed charges,69% of total billed charges,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,282,37.7,,,percent of total billed charges,37.70% of total billed charges,282,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,253.57,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,583.44,78,,,percent of total billed charges,78% of total billed charges,748,100,,,percent of total billed charges,100% of total billed charges,617.85,82.6,,,percent of total billed charges,82.6% of total billed charges,617.85,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.44,837.64,
"Closed treatment of hip dislocation, traumatic; requiring an",45027252,CDM,450,RC,27252,HCPCS,Outpatient,,,5021,3263.65,,4418.48,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,916.1,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3163.23,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,768.21,15.3,,,percent of total billed charges,15.3% of total billed charges,3464.49,69,,,percent of total billed charges,69% of total billed charges,5021,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5021,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5021,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1892.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1892.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1702.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3916.38,78,,,percent of total billed charges,78% of total billed charges,5021,100,,,percent of total billed charges,100% of total billed charges,4147.35,82.6,,,percent of total billed charges,82.6% of total billed charges,4147.35,82.6,,,percent of total billed charges,82.6% of total billed charges,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,658.83,5656.45,
CLOSED TX HIP DISL POST ARTHRO,45027265,CDM,450,RC,27265,HCPCS,Outpatient,,,748,486.20,,658.24,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,748,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,471.24,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,114.44,15.3,,,percent of total billed charges,15.3% of total billed charges,516.12,69,,,percent of total billed charges,69% of total billed charges,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,748,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,282,37.7,,,percent of total billed charges,37.70% of total billed charges,282,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,253.57,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,583.44,78,,,percent of total billed charges,78% of total billed charges,748,100,,,percent of total billed charges,100% of total billed charges,617.85,82.6,,,percent of total billed charges,82.6% of total billed charges,617.85,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.44,837.64,
REM FB DEEP THIGHREG/NEW AREA,45027372,CDM,450,RC,27372,HCPCS,Outpatient,,,2457,1597.05,,2162.16,88,,,percent of total billed charges,88% of total Billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,2457,100,,,percent of total billed charges,100% of total billed charges,1618.96,103,,,Fee Schedule,103% of WA Medicaid,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1547.91,63,,,percent of total billed charges,63% of total billed charges,5071.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,375.92,15.3,,,percent of total billed charges,15.3% of total billed charges,1695.33,69,,,percent of total billed charges,69% of total billed charges,2457,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2457,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2457,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,9628.23,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1603.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2043.35,130,,,Fee Schedule,130% of WA Medicaid ,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,926.29,37.7,,,percent of total billed charges,37.70% of total billed charges,926.29,37.7,,,percent of total billed charges,37.70% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,832.92,33.9,,,percent of total billed charges,33.9% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1916.46,78,,,percent of total billed charges,78% of total billed charges,2457,100,,,percent of total billed charges,100% of total billed charges,2029.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2029.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2927.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,375.92,9628.23,
TX CL FX FEMORAL SHFT WO MANIP,45027500,CDM,450,RC,27500,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
CLD TX FEM SHAFT W/MAN,45027502,CDM,450,RC,27502,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,5656.45,
TX CL FX FEM DISTAL W/WO MANIP,45027508,CDM,450,RC,27508,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CL FX PATELLAR,45027520,CDM,450,RC,27520,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX FX PROX TIB W/O MANIP,45027530,CDM,450,RC,27530,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
KNEE DISLOCATION REDUCED,45027550,CDM,450,RC,27550,HCPCS,Outpatient,,,976,634.40,,858.88,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,976,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,614.88,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,149.33,15.3,,,percent of total billed charges,15.3% of total billed charges,673.44,69,,,percent of total billed charges,69% of total billed charges,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,367.95,37.7,,,percent of total billed charges,37.70% of total billed charges,367.95,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,330.86,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,761.28,78,,,percent of total billed charges,78% of total billed charges,976,100,,,percent of total billed charges,100% of total billed charges,806.18,82.6,,,percent of total billed charges,82.6% of total billed charges,806.18,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,149.33,976,
REDUCTION DISLOCATED PATELLA,45027560,CDM,450,RC,27560,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
UNLISTED PROCEDURE FEMUR/KNEE,45027599,CDM,450,RC,27599,HCPCS,Outpatient,,,886,575.90,,779.68,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,886,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,558.18,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,135.56,15.3,,,percent of total billed charges,15.3% of total billed charges,611.34,69,,,percent of total billed charges,69% of total billed charges,886,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,886,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,886,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,334.02,37.7,,,percent of total billed charges,37.70% of total billed charges,334.02,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,300.35,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,691.08,78,,,percent of total billed charges,78% of total billed charges,886,100,,,percent of total billed charges,100% of total billed charges,731.84,82.6,,,percent of total billed charges,82.6% of total billed charges,731.84,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,135.56,886,
TX CL FX TIB/FIB SHAFT W/O,45027750,CDM,450,RC,27750,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CL FX TIB/FIB W/MANIP,45027752,CDM,450,RC,27752,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,5656.45,
TX FX TIBIA DISTAL W/O,45027760,CDM,450,RC,27760,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
2 CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ TechFee,45027762,CDM,450,RC,27762,HCPCS,Outpatient,,,5021,3263.65,,4418.48,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3163.23,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,768.21,15.3,,,percent of total billed charges,15.3% of total billed charges,3464.49,69,,,percent of total billed charges,69% of total billed charges,5021,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5021,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5021,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1892.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1892.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1702.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3916.38,78,,,percent of total billed charges,78% of total billed charges,5021,100,,,percent of total billed charges,100% of total billed charges,4147.35,82.6,,,percent of total billed charges,82.6% of total billed charges,4147.35,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,296.48,5656.45,
TX FX FIBULAR SHAFT W/O MANIP,45027780,CDM,450,RC,27780,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CL FX FIBULA/ANKLE W/O,45027786,CDM,450,RC,27786,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
CL TX DISTAL FIBULAR FX W/MANI,45027788,CDM,450,RC,27788,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX FX BIMAL ANKLE W/O MANIP,45027808,CDM,450,RC,27808,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CL FX BIMAL ANKLE W/MANIP,45027810,CDM,450,RC,27810,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,5656.45,
CLOSED TX TRI MALLEOLAR FX W/O,45027816,CDM,450,RC,27816,HCPCS,Outpatient,,,899,584.35,,791.12,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,899,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,566.37,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,137.55,15.3,,,percent of total billed charges,15.3% of total billed charges,620.31,69,,,percent of total billed charges,69% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,899,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,899,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,304.76,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,701.22,78,,,percent of total billed charges,78% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,137.55,899,
CLSD TX TRIMALLEOLAR ANK W/MAN,45027818,CDM,450,RC,27818,HCPCS,Outpatient,,,4172,2711.80,,3671.36,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,4172,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,2628.36,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,638.32,15.3,,,percent of total billed charges,15.3% of total billed charges,2878.68,69,,,percent of total billed charges,69% of total billed charges,4172,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,4172,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,4172,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1572.84,37.7,,,percent of total billed charges,37.70% of total billed charges,1572.84,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1414.31,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3254.16,78,,,percent of total billed charges,78% of total billed charges,4172,100,,,percent of total billed charges,100% of total billed charges,3446.07,82.6,,,percent of total billed charges,82.6% of total billed charges,3446.07,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,296.48,5656.45,
FX DISTAL TIBIA W/O,45027824,CDM,450,RC,27824,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
ANKLE DISLOCATION REDUCTION,45027840,CDM,450,RC,27840,HCPCS,Outpatient,,,976,634.40,,858.88,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,976,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,614.88,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,149.33,15.3,,,percent of total billed charges,15.3% of total billed charges,673.44,69,,,percent of total billed charges,69% of total billed charges,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,976,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,367.95,37.7,,,percent of total billed charges,37.70% of total billed charges,367.95,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,330.86,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,761.28,78,,,percent of total billed charges,78% of total billed charges,976,100,,,percent of total billed charges,100% of total billed charges,806.18,82.6,,,percent of total billed charges,82.6% of total billed charges,806.18,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,149.33,976,
REMOVAL FB FOOT SUBCUTANEOUS,45028190,CDM,450,RC,28190,HCPCS,Outpatient,,,1371,891.15,,1206.48,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1371,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,863.73,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,209.76,15.3,,,percent of total billed charges,15.3% of total billed charges,945.99,69,,,percent of total billed charges,69% of total billed charges,1371,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1371,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1371,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,516.87,37.7,,,percent of total billed charges,37.70% of total billed charges,516.87,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,464.77,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1069.38,78,,,percent of total billed charges,78% of total billed charges,1371,100,,,percent of total billed charges,100% of total billed charges,1132.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1132.45,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,209.76,2526.76,
REMOVAL FB FOOT DEEP,45028192,CDM,450,RC,28192,HCPCS,Outpatient,,,3573,2322.45,,3144.24,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,3573,100,,,percent of total billed charges,100% of total billed charges,1618.96,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2250.99,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,546.67,15.3,,,percent of total billed charges,15.3% of total billed charges,2465.37,69,,,percent of total billed charges,69% of total billed charges,3573,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3573,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3573,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1603.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2043.35,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1347.02,37.7,,,percent of total billed charges,37.70% of total billed charges,1347.02,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1211.25,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2786.94,78,,,percent of total billed charges,78% of total billed charges,3573,100,,,percent of total billed charges,100% of total billed charges,2951.3,82.6,,,percent of total billed charges,82.6% of total billed charges,2951.3,82.6,,,percent of total billed charges,82.6% of total billed charges,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,546.67,5715.97,
FX CALCANEUS W/O MANIP,45028400,CDM,450,RC,28400,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX CL FX TALUS W/O MANIP,45028430,CDM,450,RC,28430,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX FX TARSAL BONE W/O MANIP,45028450,CDM,450,RC,28450,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
FX METATARSAL EACH W/O,45028470,CDM,450,RC,28470,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
FX GREAT TOE W/O,45028490,CDM,450,RC,28490,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
CLSD TX FX GREAT TOE W/MANIP,45028495,CDM,450,RC,28495,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
FX OTHER TOE W/O,45028510,CDM,450,RC,28510,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
CLOSED FX TOE W/MANIPULATION,45028515,CDM,450,RC,28515,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
28630 CLTX METATARSOPHLNGL JT DISLC W/O ANES TechFee,45028630,CDM,450,RC,28630,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,240.53,837.64,
REDUCTION DISLOCATED FING/TOE,45028660,CDM,450,RC,28660,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,837.64,
TX TOE DIS W/ANS,28665,CDM,360,RC,28665,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,916.1,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.91,3367,
TX TOE DIS W/ANS,28665,CDM,360,RC,28665,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,916.1,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.91,3367,
TX TOE DIS W/ANS,28665,CDM,360,RC,28665,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,916.1,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.91,3367,
TX TOE DIS W/ANS,28665,CDM,360,RC,28665,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,916.1,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.91,3367,
TX TOE DIS W/ANS,28665,CDM,360,RC,28665,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,916.1,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.91,3367,
TX TOE DIS W/ANS,28665,CDM,360,RC,28665,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,916.1,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.91,3367,
TX TOE DIS W/ANS,28665,CDM,360,RC,28665,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,916.1,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.91,3367,
TX TOE DIS W/ ANS,28665,CDM,360,RC,28665,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,916.1,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.91,3367,
TX TOE DIS W/ANS,28665,CDM,360,RC,28665,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,916.1,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.91,3367,
TX TOE DIS W/ANS,28665,CDM,360,RC,28665,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,916.1,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,658.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,907.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156.25,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,889.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.91,3367,
OPEN TX: DISLOCATION TOE JOINT,45028675,CDM,450,RC,28675,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,4786.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4929.66,103,,,Fee Schedule,103% of WA Medicaid,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,5777.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,4786.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,11498.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4786.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3545.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,4881.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6221.9,130,,,Fee Schedule,130% of WA Medicaid ,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4786.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,3334.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3301.45,100,,,Fee Schedule,100% of Medicare OPPS rate,4786.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3301.45,11498.59,
APPLICATION CAST ELBOW FINGER SHORT ARM,45029075,CDM,450,RC,29075,HCPCS,Outpatient,,,974,633.10,,857.12,88,,,percent of total billed charges,88% of total Billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,974,100,,,percent of total billed charges,100% of total billed charges,174.75,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,613.62,63,,,percent of total billed charges,63% of total billed charges,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,149.02,15.3,,,percent of total billed charges,15.3% of total billed charges,672.06,69,,,percent of total billed charges,69% of total billed charges,974,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,974,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,974,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,125.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,173.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.57,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,367.2,37.7,,,percent of total billed charges,37.70% of total billed charges,367.2,37.7,,,percent of total billed charges,37.70% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,330.19,33.9,,,percent of total billed charges,33.9% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,759.72,78,,,percent of total billed charges,78% of total billed charges,974,100,,,percent of total billed charges,100% of total billed charges,804.52,82.6,,,percent of total billed charges,82.6% of total billed charges,804.52,82.6,,,percent of total billed charges,82.6% of total billed charges,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,125.68,979.75,
LONG SPLINT,45029105,CDM,450,RC,29105,HCPCS,Outpatient,,,899,584.35,,791.12,88,,,percent of total billed charges,88% of total Billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,899,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,566.37,63,,,percent of total billed charges,63% of total billed charges,281.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,137.55,15.3,,,percent of total billed charges,15.3% of total billed charges,620.31,69,,,percent of total billed charges,69% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,899,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,899,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,573.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,304.76,33.9,,,percent of total billed charges,33.9% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,701.22,78,,,percent of total billed charges,78% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,162.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,899,
SHORT ARM SPLINT STATIC,45029125,CDM,450,RC,29125,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,169.47,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,41.16,15.3,,,percent of total billed charges,15.3% of total billed charges,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,91.19,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,454.8,
FINGER SPLINT APPLIC STATIC,45029130,CDM,450,RC,29130,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,169.47,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,41.16,15.3,,,percent of total billed charges,15.3% of total billed charges,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,91.19,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,454.8,
RIB BELT,45029200,CDM,450,RC,29200,HCPCS,Outpatient,,,584,379.60,,513.92,88,,,percent of total billed charges,88% of total Billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,584,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,367.92,63,,,percent of total billed charges,63% of total billed charges,281.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,89.35,15.3,,,percent of total billed charges,15.3% of total billed charges,402.96,69,,,percent of total billed charges,69% of total billed charges,584,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,584,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,584,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,573.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,220.17,37.7,,,percent of total billed charges,37.70% of total billed charges,220.17,37.7,,,percent of total billed charges,37.70% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,197.98,33.9,,,percent of total billed charges,33.9% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,455.52,78,,,percent of total billed charges,78% of total billed charges,584,100,,,percent of total billed charges,100% of total billed charges,482.38,82.6,,,percent of total billed charges,82.6% of total billed charges,482.38,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,162.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,584,
STRAPPING SHOULDER,45029240,CDM,450,RC,29240,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,169.47,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,41.16,15.3,,,percent of total billed charges,15.3% of total billed charges,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,91.19,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,454.8,
STRAPPING ELBOW OR WRIST,45029260,CDM,450,RC,29260,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,169.47,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,41.16,15.3,,,percent of total billed charges,15.3% of total billed charges,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,91.19,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,269,
STRAPPING HAND OR FINGER,45029280,CDM,450,RC,29280,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,169.47,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,41.16,15.3,,,percent of total billed charges,15.3% of total billed charges,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,91.19,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,269,
LONG LEG SPLINT,45029505,CDM,450,RC,29505,HCPCS,Outpatient,,,899,584.35,,791.12,88,,,percent of total billed charges,88% of total Billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,899,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,566.37,63,,,percent of total billed charges,63% of total billed charges,281.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,137.55,15.3,,,percent of total billed charges,15.3% of total billed charges,620.31,69,,,percent of total billed charges,69% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,899,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,899,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,573.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,304.76,33.9,,,percent of total billed charges,33.9% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,701.22,78,,,percent of total billed charges,78% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,162.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,899,
SHORT LEG SPLINT,45029515,CDM,450,RC,29515,HCPCS,Outpatient,,,899,584.35,,791.12,88,,,percent of total billed charges,88% of total Billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,899,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,566.37,63,,,percent of total billed charges,63% of total billed charges,281.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,137.55,15.3,,,percent of total billed charges,15.3% of total billed charges,620.31,69,,,percent of total billed charges,69% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,899,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,899,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,573.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,304.76,33.9,,,percent of total billed charges,33.9% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,701.22,78,,,percent of total billed charges,78% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,162.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,899,
STRAPPING - KNEE,45029530,CDM,450,RC,29530,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,169.47,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,41.16,15.3,,,percent of total billed charges,15.3% of total billed charges,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,91.19,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,454.8,
STRAPPING - ANKLE,45029540,CDM,450,RC,29540,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,169.47,63,,,percent of total billed charges,63% of total billed charges,281.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,41.16,15.3,,,percent of total billed charges,15.3% of total billed charges,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,573.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,91.19,33.9,,,percent of total billed charges,33.9% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,162.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,573.54,
STRAPPING TOES,45029550,CDM,450,RC,29550,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,40.34,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,169.47,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid,41.16,15.3,,,percent of total billed charges,15.3% of total billed charges,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,29.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.91,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,91.19,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.01,269,
CAST REMOVAL LOMG ARM/LEG,45029705,CDM,450,RC,29705,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,174.75,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,169.47,63,,,percent of total billed charges,63% of total billed charges,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,41.16,15.3,,,percent of total billed charges,15.3% of total billed charges,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,269,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,125.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,173.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.57,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,91.19,33.9,,,percent of total billed charges,33.9% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.16,979.75,
REMOVAL INTRANASAL FB,45030300,CDM,450,RC,30300,HCPCS,Outpatient,,,582,378.30,,512.16,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,582,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,366.66,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,89.05,15.3,,,percent of total billed charges,15.3% of total billed charges,401.58,69,,,percent of total billed charges,69% of total billed charges,582,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,582,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,582,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,219.41,37.7,,,percent of total billed charges,37.70% of total billed charges,219.41,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,197.3,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,453.96,78,,,percent of total billed charges,78% of total billed charges,582,100,,,percent of total billed charges,100% of total billed charges,480.73,82.6,,,percent of total billed charges,82.6% of total billed charges,480.73,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,582,
CAUTERIZE NASAL MUCOSA,45030801,CDM,450,RC,30801,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,827.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,852.54,103,,,Fee Schedule,103% of WA Medicaid,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2722.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,827.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,5495.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,613.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,844.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1076.02,130,,,Fee Schedule,130% of WA Medicaid ,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,613.12,5495.75,
NASAL HEMORR ANTERIOR SIMPLE,45030901,CDM,450,RC,30901,HCPCS,Outpatient,,,762,495.30,,670.56,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,762,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,480.06,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,116.59,15.3,,,percent of total billed charges,15.3% of total billed charges,525.78,69,,,percent of total billed charges,69% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,762,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,762,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,258.32,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,594.36,78,,,percent of total billed charges,78% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,762,
NASAL HEMORR ANTERIOR COMPLEX,45030903,CDM,450,RC,30903,HCPCS,Outpatient,,,762,495.30,,670.56,88,,,percent of total billed charges,88% of total Billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,762,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,480.06,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,116.59,15.3,,,percent of total billed charges,15.3% of total billed charges,525.78,69,,,percent of total billed charges,69% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,762,100,,,percent of total billed charges,100% of total billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,762,100,,,percent of total billed charges,100% of total billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,454.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,258.32,33.9,,,percent of total billed charges,33.9% of total billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,594.36,78,,,percent of total billed charges,78% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,131.58,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,762,
NASAL HEMORR POSTERIOR PACKING,45030905,CDM,450,RC,30905,HCPCS,Outpatient,,,762,495.30,,670.56,88,,,percent of total billed charges,88% of total Billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,762,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,480.06,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,116.59,15.3,,,percent of total billed charges,15.3% of total billed charges,525.78,69,,,percent of total billed charges,69% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,762,100,,,percent of total billed charges,100% of total billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,762,100,,,percent of total billed charges,100% of total billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,454.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,258.32,33.9,,,percent of total billed charges,33.9% of total billed charges,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,594.36,78,,,percent of total billed charges,78% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,131.58,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.28,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,762,
NASAL HEMORR POSTERIOR SUBS,45030906,CDM,450,RC,30906,HCPCS,Outpatient,,,762,495.30,,670.56,88,,,percent of total billed charges,88% of total Billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,762,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,480.06,63,,,percent of total billed charges,63% of total billed charges,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,116.59,15.3,,,percent of total billed charges,15.3% of total billed charges,525.78,69,,,percent of total billed charges,69% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,762,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,762,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,258.32,33.9,,,percent of total billed charges,33.9% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,594.36,78,,,percent of total billed charges,78% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,859.63,
"NASAL ENDOSCOPY, DIAG",45031231,CDM,450,RC,31231,HCPCS,Outpatient,,,311,202.15,,273.68,88,,,percent of total billed charges,88% of total Billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,311,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,195.93,63,,,percent of total billed charges,63% of total billed charges,353.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,47.58,15.3,,,percent of total billed charges,15.3% of total billed charges,214.59,69,,,percent of total billed charges,69% of total billed charges,311,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,311,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,311,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,667.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,117.25,37.7,,,percent of total billed charges,37.70% of total billed charges,117.25,37.7,,,percent of total billed charges,37.70% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,105.43,33.9,,,percent of total billed charges,33.9% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,242.58,78,,,percent of total billed charges,78% of total billed charges,311,100,,,percent of total billed charges,100% of total billed charges,256.89,82.6,,,percent of total billed charges,82.6% of total billed charges,256.89,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,204.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.58,667.83,
ENDOTRACHEAL INTUBATION,45031500,CDM,450,RC,31500,HCPCS,Outpatient,,,1581,1027.65,,1391.28,88,,,percent of total billed charges,88% of total Billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,1581,100,,,percent of total billed charges,100% of total billed charges,843.18,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,996.03,63,,,percent of total billed charges,63% of total billed charges,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,241.89,15.3,,,percent of total billed charges,15.3% of total billed charges,1090.89,69,,,percent of total billed charges,69% of total billed charges,1581,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1581,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1581,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,606.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,834.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1064.21,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,596.04,37.7,,,percent of total billed charges,37.70% of total billed charges,596.04,37.7,,,percent of total billed charges,37.70% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,535.96,33.9,,,percent of total billed charges,33.9% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1233.18,78,,,percent of total billed charges,78% of total billed charges,1581,100,,,percent of total billed charges,100% of total billed charges,1305.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1305.91,82.6,,,percent of total billed charges,82.6% of total billed charges,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,241.89,1581,
CHANGE TRACH TUBE,45031502,CDM,450,RC,31502,HCPCS,Outpatient,,,602,391.30,,529.76,88,,,percent of total billed charges,88% of total Billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,602,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,379.26,63,,,percent of total billed charges,63% of total billed charges,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,92.11,15.3,,,percent of total billed charges,15.3% of total billed charges,415.38,69,,,percent of total billed charges,69% of total billed charges,602,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,602,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,602,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,226.95,37.7,,,percent of total billed charges,37.70% of total billed charges,226.95,37.7,,,percent of total billed charges,37.70% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,204.08,33.9,,,percent of total billed charges,33.9% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,469.56,78,,,percent of total billed charges,78% of total billed charges,602,100,,,percent of total billed charges,100% of total billed charges,497.25,82.6,,,percent of total billed charges,82.6% of total billed charges,497.25,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,859.63,
LARYNGOSCOPY INDIRECT,45031505,CDM,450,RC,31505,HCPCS,Outpatient,,,440,286.00,,387.2,88,,,percent of total billed charges,88% of total Billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,440,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,277.2,63,,,percent of total billed charges,63% of total billed charges,353.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,67.32,15.3,,,percent of total billed charges,15.3% of total billed charges,303.6,69,,,percent of total billed charges,69% of total billed charges,440,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,440,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,440,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,667.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,165.88,37.7,,,percent of total billed charges,37.70% of total billed charges,165.88,37.7,,,percent of total billed charges,37.70% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,149.16,33.9,,,percent of total billed charges,33.9% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,343.2,78,,,percent of total billed charges,78% of total billed charges,440,100,,,percent of total billed charges,100% of total billed charges,363.44,82.6,,,percent of total billed charges,82.6% of total billed charges,363.44,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,204.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.32,667.83,
"31526 - Laryngoscopy direct, with or without trach",45031526,CDM,450,RC,31526,HCPCS,Outpatient,,,6043,3927.95,,5317.84,88,,,percent of total billed charges,88% of total Billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,684.89,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,705.44,103,,,Fee Schedule,103% of WA Medicaid,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,3807.09,63,,,percent of total billed charges,63% of total billed charges,3029.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,684.89,100,,,Fee Schedule,100% of WA Medicaid,924.58,15.3,,,percent of total billed charges,15.3% of total billed charges,4169.67,69,,,percent of total billed charges,69% of total billed charges,6043,100,,,percent of total billed charges,100% of total billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,6043,100,,,percent of total billed charges,100% of total billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,6043,100,,,percent of total billed charges,100% of total billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,6079.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,507.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,698.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,890.36,130,,,Fee Schedule,130% of WA Medicaid ,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,2278.21,37.7,,,percent of total billed charges,37.70% of total billed charges,2278.21,37.7,,,percent of total billed charges,37.70% of total billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,2048.58,33.9,,,percent of total billed charges,33.9% of total billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,4713.54,78,,,percent of total billed charges,78% of total billed charges,6043,100,,,percent of total billed charges,100% of total billed charges,4991.52,82.6,,,percent of total billed charges,82.6% of total billed charges,4991.52,82.6,,,percent of total billed charges,82.6% of total billed charges,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1748.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,507.33,6079.13,
"Laryngoscopy, direct, operative, with foreign body removal;",45031530,CDM,450,RC,31530,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,684.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,705.44,103,,,Fee Schedule,103% of WA Medicaid,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,3029.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,684.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,6079.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,507.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,698.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,890.36,130,,,Fee Schedule,130% of WA Medicaid ,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1748.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,507.33,6079.13,
LARYNGOSCOPY/DIRECT W/SCOPE,45031575,CDM,450,RC,31575,HCPCS,Outpatient,,,440,286.00,,387.2,88,,,percent of total billed charges,88% of total Billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,440,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,277.2,63,,,percent of total billed charges,63% of total billed charges,353.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,67.32,15.3,,,percent of total billed charges,15.3% of total billed charges,303.6,69,,,percent of total billed charges,69% of total billed charges,440,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,440,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,440,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,667.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,165.88,37.7,,,percent of total billed charges,37.70% of total billed charges,165.88,37.7,,,percent of total billed charges,37.70% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,149.16,33.9,,,percent of total billed charges,33.9% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,343.2,78,,,percent of total billed charges,78% of total billed charges,440,100,,,percent of total billed charges,100% of total billed charges,363.44,82.6,,,percent of total billed charges,82.6% of total billed charges,363.44,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,204.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.32,667.83,
LARYNGOSCOPY,45031579,CDM,450,RC,31579,HCPCS,Outpatient,,,9117,5926.05,,8022.96,88,,,percent of total billed charges,88% of total Billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,684.89,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,705.44,103,,,Fee Schedule,103% of WA Medicaid,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,5743.71,63,,,percent of total billed charges,63% of total billed charges,728.82,175,,,Fee Schedule,175% of Medicare OPPS Rate,684.89,100,,,Fee Schedule,100% of WA Medicaid,1394.9,15.3,,,percent of total billed charges,15.3% of total billed charges,6290.73,69,,,percent of total billed charges,69% of total billed charges,9117,100,,,percent of total billed charges,100% of total billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9117,100,,,percent of total billed charges,100% of total billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9117,100,,,percent of total billed charges,100% of total billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,1529.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,507.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,698.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,890.36,130,,,Fee Schedule,130% of WA Medicaid ,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3437.11,37.7,,,percent of total billed charges,37.70% of total billed charges,3437.11,37.7,,,percent of total billed charges,37.70% of total billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3090.66,33.9,,,percent of total billed charges,33.9% of total billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,7111.26,78,,,percent of total billed charges,78% of total billed charges,9117,100,,,percent of total billed charges,100% of total billed charges,7530.64,82.6,,,percent of total billed charges,82.6% of total billed charges,7530.64,82.6,,,percent of total billed charges,82.6% of total billed charges,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,420.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,416.47,9117,
Remove Foreign Body  Larynx Tech Fee,45031577,CDM,450,RC,31577,HCPCS,Outpatient,,,1519,987.35,,1336.72,88,,,percent of total billed charges,88% of total Billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,684.89,100,,,Fee Schedule,100% of WA Medicaid,1519,100,,,percent of total billed charges,100% of total billed charges,705.44,103,,,Fee Schedule,103% of WA Medicaid,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,956.97,63,,,percent of total billed charges,63% of total billed charges,728.82,175,,,Fee Schedule,175% of Medicare OPPS Rate,684.89,100,,,Fee Schedule,100% of WA Medicaid,232.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1048.11,69,,,percent of total billed charges,69% of total billed charges,1519,100,,,percent of total billed charges,100% of total billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,1519,100,,,percent of total billed charges,100% of total billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,1519,100,,,percent of total billed charges,100% of total billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,1529.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,507.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,698.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,890.36,130,,,Fee Schedule,130% of WA Medicaid ,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,572.66,37.7,,,percent of total billed charges,37.70% of total billed charges,572.66,37.7,,,percent of total billed charges,37.70% of total billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,514.94,33.9,,,percent of total billed charges,33.9% of total billed charges,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,1184.82,78,,,percent of total billed charges,78% of total billed charges,1519,100,,,percent of total billed charges,100% of total billed charges,1254.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1254.69,82.6,,,percent of total billed charges,82.6% of total billed charges,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,420.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,416.47,100,,,Fee Schedule,100% of Medicare OPPS rate,684.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,232.41,1529.58,
TRACHEOSTOMY EMERGENT,45031603,CDM,450,RC,31603,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1856.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1911.99,103,,,Fee Schedule,103% of WA Medicaid,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2722.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,1856.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,5495.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1856.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1375.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1893.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2413.19,130,,,Fee Schedule,130% of WA Medicaid ,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1856.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1856.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1375.03,5495.75,
"TRACH, CRICOTHYROID",45031605,CDM,450,RC,31605,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1856.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1911.99,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,1856.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1856.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1375.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1893.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2413.19,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1856.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1856.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.13,2413.19,
TUBE THORACOSTOMY,45032551,CDM,450,RC,32551,HCPCS,Outpatient,,,4389,2852.85,,3862.32,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,4389,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2765.07,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,671.52,15.3,,,percent of total billed charges,15.3% of total billed charges,3028.41,69,,,percent of total billed charges,69% of total billed charges,4389,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4389,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4389,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1654.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1654.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1487.87,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3423.42,78,,,percent of total billed charges,78% of total billed charges,4389,100,,,percent of total billed charges,100% of total billed charges,3625.31,82.6,,,percent of total billed charges,82.6% of total billed charges,3625.31,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,635.74,5712.48,
32554 THORACENTESIS W/O IMAGING TechFee,45032554,CDM,450,RC,32554,HCPCS,Outpatient,,,1877,1220.05,,1651.76,88,,,percent of total billed charges,88% of total Billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,1877,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1182.51,63,,,percent of total billed charges,63% of total billed charges,1121.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,287.18,15.3,,,percent of total billed charges,15.3% of total billed charges,1295.13,69,,,percent of total billed charges,69% of total billed charges,1877,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1877,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1877,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2200.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,707.63,37.7,,,percent of total billed charges,37.70% of total billed charges,707.63,37.7,,,percent of total billed charges,37.70% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,636.3,33.9,,,percent of total billed charges,33.9% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1464.06,78,,,percent of total billed charges,78% of total billed charges,1877,100,,,percent of total billed charges,100% of total billed charges,1550.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1550.4,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,647.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,287.18,2200.34,
"Pleural drainage, percutaneous, with insertion of indwelling",45032556,CDM,450,RC,32556,HCPCS,Outpatient,,,5940,3861.00,,5227.2,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3742.2,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,908.82,15.3,,,percent of total billed charges,15.3% of total billed charges,4098.6,69,,,percent of total billed charges,69% of total billed charges,5940,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5940,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5940,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2239.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2239.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2013.66,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4633.2,78,,,percent of total billed charges,78% of total billed charges,5940,100,,,percent of total billed charges,100% of total billed charges,4906.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4906.44,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,635.74,6601.69,
32555 ASPIRATE PLEURA W/ IMAGING Tech Fee,45032555,CDM,450,RC,32555,HCPCS,Outpatient,,,1877,1220.05,,1651.76,88,,,percent of total billed charges,88% of total Billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,1877,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1182.51,63,,,percent of total billed charges,63% of total billed charges,1121.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,287.18,15.3,,,percent of total billed charges,15.3% of total billed charges,1295.13,69,,,percent of total billed charges,69% of total billed charges,1877,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1877,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1877,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2200.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,707.63,37.7,,,percent of total billed charges,37.70% of total billed charges,707.63,37.7,,,percent of total billed charges,37.70% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,636.3,33.9,,,percent of total billed charges,33.9% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1464.06,78,,,percent of total billed charges,78% of total billed charges,1877,100,,,percent of total billed charges,100% of total billed charges,1550.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1550.4,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,647.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,287.18,2200.34,
"Pericardiocentesis, including imaging guidance, when perform",45033016,CDM,450,RC,33016,HCPCS,Outpatient,,,2353,1529.45,,2070.64,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,2353,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1482.39,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,360.01,15.3,,,percent of total billed charges,15.3% of total billed charges,1623.57,69,,,percent of total billed charges,69% of total billed charges,2353,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2353,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2353,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,887.08,37.7,,,percent of total billed charges,37.70% of total billed charges,887.08,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,797.67,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1835.34,78,,,percent of total billed charges,78% of total billed charges,2353,100,,,percent of total billed charges,100% of total billed charges,1943.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1943.58,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,360.01,5712.48,
SCALP VENIPUNCTURE < 3,45036405,CDM,450,RC,36405,HCPCS,Outpatient,,,84,54.60,,73.92,88,,,percent of total billed charges,88% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,2.1,100,,,Fee Schedule,100% of WA Medicaid,84,100,,,percent of total billed charges,100% of total billed charges,2.16,103,,,Fee Schedule,103% of WA Medicaid,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.1,100,,,Fee Schedule,100% of WA Medicaid,12.85,15.3,,,percent of total billed charges,15.3% of total billed charges,57.96,69,,,percent of total billed charges,69% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,51.95,61.85,,,percent of total billed charges,61.85% of total billed charges,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42,50,,,percent of total billed charges,50% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,1.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42,50,,,percent of total billed charges,50% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,2.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2.73,130,,,Fee Schedule,130% of WA Medicaid ,42,50,,,percent of total billed charges,50% of total Billed charges,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,28.48,33.9,,,percent of total billed charges,33.9% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,65.52,78,,,percent of total billed charges,78% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42,50,,,percent of total billed charges,50% of total Billed charges,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.55,84,
VENIPUNCTURE COMPLEX > 3,45036410,CDM,450,RC,36410,HCPCS,Outpatient,,,84,54.60,,73.92,88,,,percent of total billed charges,88% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid,84,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52.86,100,,,Fee Schedule,100% of WA Medicaid,12.85,15.3,,,percent of total billed charges,15.3% of total billed charges,57.96,69,,,percent of total billed charges,69% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,51.95,61.85,,,percent of total billed charges,61.85% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42,50,,,percent of total billed charges,50% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42,50,,,percent of total billed charges,50% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,42,50,,,percent of total billed charges,50% of total Billed charges,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,28.48,33.9,,,percent of total billed charges,33.9% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,65.52,78,,,percent of total billed charges,78% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42,50,,,percent of total billed charges,50% of total Billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.85,84,
VENOUS CUTDOWN > AGE 1,45036425,CDM,450,RC,36425,HCPCS,Outpatient,,,76,49.40,,66.88,88,,,percent of total billed charges,88% of total Billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,76,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,47.88,63,,,percent of total billed charges,63% of total billed charges,711.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,11.63,15.3,,,percent of total billed charges,15.3% of total billed charges,52.44,69,,,percent of total billed charges,69% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,76,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,76,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1097.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,28.65,37.7,,,percent of total billed charges,37.70% of total billed charges,28.65,37.7,,,percent of total billed charges,37.70% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,25.76,33.9,,,percent of total billed charges,33.9% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,59.28,78,,,percent of total billed charges,78% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,410.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.63,1097.77,
CENTRAL LINE PLCMT >5 YRS,45036556,CDM,450,RC,36556,HCPCS,Outpatient,,,4419,2872.35,,3888.72,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,4419,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2783.97,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,676.11,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.11,69,,,percent of total billed charges,69% of total billed charges,4419,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4419,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4419,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1665.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1665.96,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1498.04,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3446.82,78,,,percent of total billed charges,78% of total billed charges,4419,100,,,percent of total billed charges,100% of total billed charges,3650.09,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,676.11,11625.57,
CENTRAL LINE PLCMT <5 YRS,45036555,CDM,450,RC,36555,HCPCS,Outpatient,,,4736,3078.40,,4167.68,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2983.68,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,724.61,15.3,,,percent of total billed charges,15.3% of total billed charges,3267.84,69,,,percent of total billed charges,69% of total billed charges,4736,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4736,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4736,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1785.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1785.47,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1605.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3694.08,78,,,percent of total billed charges,78% of total billed charges,4736,100,,,percent of total billed charges,100% of total billed charges,3911.94,82.6,,,percent of total billed charges,82.6% of total billed charges,3911.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,724.61,11625.57,
PICC LINE PLCMT >5 YRS,45036569,CDM,450,RC,36569,HCPCS,Outpatient,,,3474,2258.10,,3057.12,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,3474,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.62,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,531.52,15.3,,,percent of total billed charges,15.3% of total billed charges,2397.06,69,,,percent of total billed charges,69% of total billed charges,3474,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3474,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3474,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1309.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1309.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1177.69,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2709.72,78,,,percent of total billed charges,78% of total billed charges,3474,100,,,percent of total billed charges,100% of total billed charges,2869.52,82.6,,,percent of total billed charges,82.6% of total billed charges,2869.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,531.52,5712.48,
PICC LINE PLCMT <5 YRS,45036568,CDM,450,RC,36568,HCPCS,Outpatient,,,4736,3078.40,,4167.68,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2983.68,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,724.61,15.3,,,percent of total billed charges,15.3% of total billed charges,3267.84,69,,,percent of total billed charges,69% of total billed charges,4736,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4736,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4736,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1785.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1785.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1605.5,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3694.08,78,,,percent of total billed charges,78% of total billed charges,4736,100,,,percent of total billed charges,100% of total billed charges,3911.94,82.6,,,percent of total billed charges,82.6% of total billed charges,3911.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,724.61,5712.48,
36591 BLOOD COLLECTION FROM PORTACATHTECH FEE,45036591,CDM,450,RC,36591,HCPCS,Outpatient,,,359,233.35,,315.92,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,359,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,54.93,15.3,,,percent of total billed charges,15.3% of total billed charges,247.71,69,,,percent of total billed charges,69% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,121.7,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,280.02,78,,,percent of total billed charges,78% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.15,454.8,
PLACEMENT/NDL INTRAOSSEOUS INF,45036680,CDM,450,RC,36680,HCPCS,Outpatient,,,895,581.75,,787.6,88,,,percent of total billed charges,88% of total Billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,895,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,563.85,63,,,percent of total billed charges,63% of total billed charges,711.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,136.94,15.3,,,percent of total billed charges,15.3% of total billed charges,617.55,69,,,percent of total billed charges,69% of total billed charges,895,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,895,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,895,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1097.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,337.42,37.7,,,percent of total billed charges,37.70% of total billed charges,337.42,37.7,,,percent of total billed charges,37.70% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,303.41,33.9,,,percent of total billed charges,33.9% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,698.1,78,,,percent of total billed charges,78% of total billed charges,895,100,,,percent of total billed charges,100% of total billed charges,739.27,82.6,,,percent of total billed charges,82.6% of total billed charges,739.27,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,410.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,136.94,1097.77,
THROMBOLYTIC THERAPY STROKE,45037195,CDM,450,RC,37195,HCPCS,Outpatient,,,198,128.70,,174.24,88,,,percent of total billed charges,88% of total Billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,63,,,percent of total billed charges,63% of total billed charges,604.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,30.29,15.3,,,percent of total billed charges,15.3% of total billed charges,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1262.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,67.12,33.9,,,percent of total billed charges,33.9% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,348.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.29,1262.42,
BONE MARROW ASPIRATION,45038220,CDM,450,RC,38220,HCPCS,Outpatient,,,3776,2454.40,,3322.88,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,3776,100,,,percent of total billed charges,100% of total billed charges,1102.48,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2378.88,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,577.73,15.3,,,percent of total billed charges,15.3% of total billed charges,2605.44,69,,,percent of total billed charges,69% of total billed charges,3776,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3776,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3776,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,792.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1091.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1391.48,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1423.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1423.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1280.06,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2945.28,78,,,percent of total billed charges,78% of total billed charges,3776,100,,,percent of total billed charges,100% of total billed charges,3118.98,82.6,,,percent of total billed charges,82.6% of total billed charges,3118.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,577.73,5715.97,
"REPAIR LIP, VERMILLION",45040650,CDM,450,RC,40650,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,103.1,103,,,Fee Schedule,103% of WA Medicaid,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,982.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1837.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,566.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,1837.71,
REP LIP UPTOHALF HT VERMBORDER,45040652,CDM,450,RC,40652,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,103.1,103,,,Fee Schedule,103% of WA Medicaid,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,982.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1837.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,566.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,1837.71,
REPAIR LIP >1/2 VERMILION BORD,45040654,CDM,450,RC,40654,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,827.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,852.54,103,,,Fee Schedule,103% of WA Medicaid,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2722.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,827.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,5495.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,613.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,844.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1076.02,130,,,Fee Schedule,130% of WA Medicaid ,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,613.12,5495.75,
ID ABSCESS MOUTH SIMPLE,45040800,CDM,450,RC,40800,HCPCS,Outpatient,,,703,456.95,,618.64,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid,703,100,,,percent of total billed charges,100% of total billed charges,1784.31,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,442.89,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid,107.56,15.3,,,percent of total billed charges,15.3% of total billed charges,485.07,69,,,percent of total billed charges,69% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1283.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1766.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2252.04,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,238.32,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,548.34,78,,,percent of total billed charges,78% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1732.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.56,2526.76,
CLOSED LACERATION MOUTH < 2.5,45040830,CDM,450,RC,40830,HCPCS,Outpatient,,,703,456.95,,618.64,88,,,percent of total billed charges,88% of total Billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,703,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.89,63,,,percent of total billed charges,63% of total billed charges,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,107.56,15.3,,,percent of total billed charges,15.3% of total billed charges,485.07,69,,,percent of total billed charges,69% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,238.32,33.9,,,percent of total billed charges,33.9% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,548.34,78,,,percent of total billed charges,78% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,859.63,
CLOSED LACERATION MOUTH > 2.5,45040831,CDM,450,RC,40831,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1784.31,103,,,Fee Schedule,103% of WA Medicaid,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,982.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1837.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1283.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1766.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2252.04,130,,,Fee Schedule,130% of WA Medicaid ,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1732.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,566.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,561.17,2252.04,
SUTURE REPAIR TONGUE < 2.5 CM,45041250,CDM,450,RC,41250,HCPCS,Outpatient,,,703,456.95,,618.64,88,,,percent of total billed charges,88% of total Billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,703,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,442.89,63,,,percent of total billed charges,63% of total billed charges,711.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,107.56,15.3,,,percent of total billed charges,15.3% of total billed charges,485.07,69,,,percent of total billed charges,69% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1097.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,238.32,33.9,,,percent of total billed charges,33.9% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,548.34,78,,,percent of total billed charges,78% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,410.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,1097.77,
SUTURE REPAIR TONGUE > 2.6 CM,45041252,CDM,450,RC,41252,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,103.1,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,859.63,
ID ABCESS DENTOALVEOLAR,45041800,CDM,450,RC,41800,HCPCS,Outpatient,,,703,456.95,,618.64,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,703,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,442.89,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,107.56,15.3,,,percent of total billed charges,15.3% of total billed charges,485.07,69,,,percent of total billed charges,69% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,238.32,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,548.34,78,,,percent of total billed charges,78% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,703,
REMOVAL FB DENTOALVEOLAR,45041805,CDM,450,RC,41805,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1784.31,103,,,Fee Schedule,103% of WA Medicaid,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2722.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,5495.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1283.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1766.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2252.04,130,,,Fee Schedule,130% of WA Medicaid ,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1732.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1732.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1283.21,5495.75,
ID PERITONSILLAR ABSCESS,45042700,CDM,450,RC,42700,HCPCS,Outpatient,,,703,456.95,,618.64,88,,,percent of total billed charges,88% of total Billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,703,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.89,63,,,percent of total billed charges,63% of total billed charges,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,107.56,15.3,,,percent of total billed charges,15.3% of total billed charges,485.07,69,,,percent of total billed charges,69% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,238.32,33.9,,,percent of total billed charges,33.9% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,548.34,78,,,percent of total billed charges,78% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,859.63,
FB REMOVAL PHARYNX,45042809,CDM,450,RC,42809,HCPCS,Outpatient,,,601,390.65,,528.88,88,,,percent of total billed charges,88% of total Billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,601,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,378.63,63,,,percent of total billed charges,63% of total billed charges,711.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,91.95,15.3,,,percent of total billed charges,15.3% of total billed charges,414.69,69,,,percent of total billed charges,69% of total billed charges,601,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,601,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,601,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1097.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,226.58,37.7,,,percent of total billed charges,37.70% of total billed charges,226.58,37.7,,,percent of total billed charges,37.70% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,203.74,33.9,,,percent of total billed charges,33.9% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,468.78,78,,,percent of total billed charges,78% of total billed charges,601,100,,,percent of total billed charges,100% of total billed charges,496.43,82.6,,,percent of total billed charges,82.6% of total billed charges,496.43,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,410.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,1097.77,
CONTROL OROPHARYNGEAL HEM SIMP,45042960,CDM,450,RC,42960,HCPCS,Outpatient,,,703,456.95,,618.64,88,,,percent of total billed charges,88% of total Billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,827.71,100,,,Fee Schedule,100% of WA Medicaid,703,100,,,percent of total billed charges,100% of total billed charges,852.54,103,,,Fee Schedule,103% of WA Medicaid,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,442.89,63,,,percent of total billed charges,63% of total billed charges,982.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,827.71,100,,,Fee Schedule,100% of WA Medicaid,107.56,15.3,,,percent of total billed charges,15.3% of total billed charges,485.07,69,,,percent of total billed charges,69% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,703,100,,,percent of total billed charges,100% of total billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1837.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,613.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,844.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1076.02,130,,,Fee Schedule,130% of WA Medicaid ,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,265.03,37.7,,,percent of total billed charges,37.70% of total billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,238.32,33.9,,,percent of total billed charges,33.9% of total billed charges,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,548.34,78,,,percent of total billed charges,78% of total billed charges,703,100,,,percent of total billed charges,100% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,580.68,82.6,,,percent of total billed charges,82.6% of total billed charges,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,566.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,561.17,100,,,Fee Schedule,100% of Medicare OPPS rate,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.56,1837.71,
GASTRIC INTUBATION TREATMENT,94043753,CDM,940,RC,43753,HCPCS,Outpatient,,,487,316.55,,428.56,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,81.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,487,100,,,percent of total billed charges,100% of total billed charges,84.27,17.304,,,percent of total billed charges,17.304% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,306.81,63,,,percent of total billed charges,63% of total billed charges,560.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,81.82,16.8,,,percent of total billed charges,16.8% of total billed charges,74.51,15.3,,,percent of total billed charges,15.3% of total billed charges,336.03,69,,,percent of total billed charges,69% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,487,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,487,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,81.82,16.8,,,percent of total billed charges,16.8% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,81.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,83.45,17.136,,,percent of total billed charges,17.136% of total billed charges,106.36,21.84,,,percent of total billed charges,21.84% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,165.09,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,379.86,78,,,percent of total billed charges,78% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,81.82,16.8,,,percent of total billed charges,16.8% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,81.82,16.8,,,percent of total billed charges,16.8% of total billed charges,74.51,1074.33,
ANORECTAL EXAM NO ANESTHESIA,45045999,CDM,450,RC,45999,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1367,103,,,Fee Schedule,103% of WA Medicaid,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1631.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3224.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,983.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1353.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1725.34,130,,,Fee Schedule,130% of WA Medicaid ,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,941.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,932.2,3224.22,
ID ABCESS PERIRECTAL,45046040,CDM,450,RC,46040,HCPCS,Outpatient,,,4114,2674.10,,3620.32,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid,4114,100,,,percent of total billed charges,100% of total billed charges,1367,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2591.82,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid,629.44,15.3,,,percent of total billed charges,15.3% of total billed charges,2838.66,69,,,percent of total billed charges,69% of total billed charges,4114,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4114,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4114,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,983.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1353.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1725.34,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1550.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1550.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1394.65,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3208.92,78,,,percent of total billed charges,78% of total billed charges,4114,100,,,percent of total billed charges,100% of total billed charges,3398.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3398.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,629.44,4212.68,
ID PERIANAL ABCESS SUPERFICI,45046050,CDM,450,RC,46050,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,1367,103,,,Fee Schedule,103% of WA Medicaid,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,1631.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3224.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,983.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1353.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1725.34,130,,,Fee Schedule,130% of WA Medicaid ,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,941.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,3224.22,
INCISION THROMBOSED HEMORRHOID,45046083,CDM,450,RC,46083,HCPCS,Outpatient,,,1010,656.50,,888.8,88,,,percent of total billed charges,88% of total Billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid,1010,100,,,percent of total billed charges,100% of total billed charges,1367,103,,,Fee Schedule,103% of WA Medicaid,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,636.3,63,,,percent of total billed charges,63% of total billed charges,441.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid,154.53,15.3,,,percent of total billed charges,15.3% of total billed charges,696.9,69,,,percent of total billed charges,69% of total billed charges,1010,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1010,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1010,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1081.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,983.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1353.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1725.34,130,,,Fee Schedule,130% of WA Medicaid ,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,380.77,37.7,,,percent of total billed charges,37.70% of total billed charges,380.77,37.7,,,percent of total billed charges,37.70% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,342.39,33.9,,,percent of total billed charges,33.9% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,787.8,78,,,percent of total billed charges,78% of total billed charges,1010,100,,,percent of total billed charges,100% of total billed charges,834.26,82.6,,,percent of total billed charges,82.6% of total billed charges,834.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,254.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,154.53,1725.34,
EXCISION THROMB EXT HEMORRHOID,45046320,CDM,450,RC,46320,HCPCS,Outpatient,,,1010,656.50,,888.8,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid,1010,100,,,percent of total billed charges,100% of total billed charges,1367,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,636.3,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid,154.53,15.3,,,percent of total billed charges,15.3% of total billed charges,696.9,69,,,percent of total billed charges,69% of total billed charges,1010,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1010,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1010,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,983.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1353.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1725.34,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,380.77,37.7,,,percent of total billed charges,37.70% of total billed charges,380.77,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,342.39,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,787.8,78,,,percent of total billed charges,78% of total billed charges,1010,100,,,percent of total billed charges,100% of total billed charges,834.26,82.6,,,percent of total billed charges,82.6% of total billed charges,834.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1327.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,154.53,4212.68,
ANOSCOPY,45046600,CDM,450,RC,46600,HCPCS,Outpatient,,,601,390.65,,528.88,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,601,100,,,percent of total billed charges,100% of total billed charges,624,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,378.63,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,91.95,15.3,,,percent of total billed charges,15.3% of total billed charges,414.69,69,,,percent of total billed charges,69% of total billed charges,601,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,601,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,601,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,617.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.58,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,226.58,37.7,,,percent of total billed charges,37.70% of total billed charges,226.58,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,203.74,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,468.78,78,,,percent of total billed charges,78% of total billed charges,601,100,,,percent of total billed charges,100% of total billed charges,496.43,82.6,,,percent of total billed charges,82.6% of total billed charges,496.43,82.6,,,percent of total billed charges,82.6% of total billed charges,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.95,787.58,
ANOSCOPY REMOVAL FOREIGN BODY,45046608,CDM,450,RC,46608,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,900.92,103,,,Fee Schedule,103% of WA Medicaid,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1631.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3224.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,941.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,3224.22,
ABD PARACENTESIS WO IMAGING,45049082,CDM,450,RC,49082,HCPCS,Outpatient,,,2236,1453.40,,1967.68,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,2236,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1408.68,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,342.11,15.3,,,percent of total billed charges,15.3% of total billed charges,1542.84,69,,,percent of total billed charges,69% of total billed charges,2236,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2236,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2236,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,842.97,37.7,,,percent of total billed charges,37.70% of total billed charges,842.97,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,758,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1744.08,78,,,percent of total billed charges,78% of total billed charges,2236,100,,,percent of total billed charges,100% of total billed charges,1846.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1846.94,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,342.11,3289.02,
49083 PARACENTESIS ABDOMINAL W/ IMAGING Tech Fee,45049083,CDM,450,RC,49083,HCPCS,Outpatient,,,2303,1496.95,,2026.64,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,2303,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1450.89,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,352.36,15.3,,,percent of total billed charges,15.3% of total billed charges,1589.07,69,,,percent of total billed charges,69% of total billed charges,2303,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2303,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2303,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,868.23,37.7,,,percent of total billed charges,37.70% of total billed charges,868.23,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,780.72,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1796.34,78,,,percent of total billed charges,78% of total billed charges,2303,100,,,percent of total billed charges,100% of total billed charges,1902.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1902.28,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,352.36,3289.02,
BLADDER ASPIRATION,45051100,CDM,450,RC,51100,HCPCS,Outpatient,,,976,634.40,,858.88,88,,,percent of total billed charges,88% of total Billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,342.36,100,,,Fee Schedule,100% of WA Medicaid,976,100,,,percent of total billed charges,100% of total billed charges,352.63,103,,,Fee Schedule,103% of WA Medicaid,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,614.88,63,,,percent of total billed charges,63% of total billed charges,441.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,342.36,100,,,Fee Schedule,100% of WA Medicaid,149.33,15.3,,,percent of total billed charges,15.3% of total billed charges,673.44,69,,,percent of total billed charges,69% of total billed charges,976,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,976,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,976,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1081.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,253.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,349.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,445.07,130,,,Fee Schedule,130% of WA Medicaid ,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,367.95,37.7,,,percent of total billed charges,37.70% of total billed charges,367.95,37.7,,,percent of total billed charges,37.70% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,330.86,33.9,,,percent of total billed charges,33.9% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,761.28,78,,,percent of total billed charges,78% of total billed charges,976,100,,,percent of total billed charges,100% of total billed charges,806.18,82.6,,,percent of total billed charges,82.6% of total billed charges,806.18,82.6,,,percent of total billed charges,82.6% of total billed charges,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,254.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,149.33,1081.19,
BLADDER IRRIGATION,45051700,CDM,450,RC,51700,HCPCS,Outpatient,,,977,635.05,,859.76,88,,,percent of total billed charges,88% of total Billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,977,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,615.51,63,,,percent of total billed charges,63% of total billed charges,441.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,149.48,15.3,,,percent of total billed charges,15.3% of total billed charges,674.13,69,,,percent of total billed charges,69% of total billed charges,977,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,977,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,977,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1081.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,48.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,368.33,37.7,,,percent of total billed charges,37.70% of total billed charges,368.33,37.7,,,percent of total billed charges,37.70% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,331.2,33.9,,,percent of total billed charges,33.9% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,762.06,78,,,percent of total billed charges,78% of total billed charges,977,100,,,percent of total billed charges,100% of total billed charges,807,82.6,,,percent of total billed charges,82.6% of total billed charges,807,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,254.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.07,1081.19,
INSERT NON INDWELL CATH,45051701,CDM,450,RC,51701,HCPCS,Outpatient,,,160,104.00,,140.8,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,160,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,100.8,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,24.48,15.3,,,percent of total billed charges,15.3% of total billed charges,110.4,69,,,percent of total billed charges,69% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,48.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,54.24,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,124.8,78,,,percent of total billed charges,78% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.48,454.8,
INSERTION FOLEY CATHETER,45051702,CDM,450,RC,51702,HCPCS,Outpatient,,,601,390.65,,528.88,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,601,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,378.63,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,91.95,15.3,,,percent of total billed charges,15.3% of total billed charges,414.69,69,,,percent of total billed charges,69% of total billed charges,601,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,601,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,601,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,48.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,226.58,37.7,,,percent of total billed charges,37.70% of total billed charges,226.58,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,203.74,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,468.78,78,,,percent of total billed charges,78% of total billed charges,601,100,,,percent of total billed charges,100% of total billed charges,496.43,82.6,,,percent of total billed charges,82.6% of total billed charges,496.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.07,601,
CATHERIZATION COMPLEX,45051703,CDM,450,RC,51703,HCPCS,Outpatient,,,264,171.60,,232.32,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,264,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,166.32,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,48.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,89.5,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.39,566.91,
POST VOID RESID BY US CPT,45051798,CDM,450,RC,51798,HCPCS,Outpatient,,,241,156.65,,212.08,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,241,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,151.83,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,36.87,15.3,,,percent of total billed charges,15.3% of total billed charges,166.29,69,,,percent of total billed charges,69% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,241,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,241,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,48.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,90.86,37.7,,,percent of total billed charges,37.70% of total billed charges,90.86,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,81.7,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,187.98,78,,,percent of total billed charges,78% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.87,241,
45052281,45052281,CDM,450,RC,52281,HCPCS,Outpatient,,,5264,3421.60,,4632.32,88,,,percent of total billed charges,88% of total Billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1405.94,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1448.12,103,,,Fee Schedule,103% of WA Medicaid,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,3316.32,63,,,percent of total billed charges,63% of total billed charges,3635.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,1405.94,100,,,Fee Schedule,100% of WA Medicaid,805.39,15.3,,,percent of total billed charges,15.3% of total billed charges,3632.16,69,,,percent of total billed charges,69% of total billed charges,5264,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,5264,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,5264,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,7284.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1405.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1041.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1434.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1827.72,130,,,Fee Schedule,130% of WA Medicaid ,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1984.53,37.7,,,percent of total billed charges,37.70% of total billed charges,1984.53,37.7,,,percent of total billed charges,37.70% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1784.5,33.9,,,percent of total billed charges,33.9% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,4105.92,78,,,percent of total billed charges,78% of total billed charges,5264,100,,,percent of total billed charges,100% of total billed charges,4348.06,82.6,,,percent of total billed charges,82.6% of total billed charges,4348.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1405.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2098.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1405.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,805.39,7284.07,
MEATOTOMY CUT MEATUS EXCINFANT,45053020,CDM,450,RC,53020,HCPCS,Outpatient,,,644,418.60,,566.72,88,,,percent of total billed charges,88% of total Billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2646.75,100,,,Fee Schedule,100% of WA Medicaid,644,100,,,percent of total billed charges,100% of total billed charges,2726.15,103,,,Fee Schedule,103% of WA Medicaid,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,405.72,63,,,percent of total billed charges,63% of total billed charges,3635.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,2646.75,100,,,Fee Schedule,100% of WA Medicaid,98.53,15.3,,,percent of total billed charges,15.3% of total billed charges,444.36,69,,,percent of total billed charges,69% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,644,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,644,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,7284.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2646.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2699.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3440.77,130,,,Fee Schedule,130% of WA Medicaid ,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,218.32,33.9,,,percent of total billed charges,33.9% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,502.32,78,,,percent of total billed charges,78% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,2646.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2098.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2646.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.53,7284.07,
UNLIST PROCEDURE URINARY SYS,45053899,CDM,450,RC,53899,HCPCS,Outpatient,,,1089,707.85,,958.32,88,,,percent of total billed charges,88% of total Billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,1089,100,,,percent of total billed charges,100% of total billed charges,1400.69,103,,,Fee Schedule,103% of WA Medicaid,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,686.07,63,,,percent of total billed charges,63% of total billed charges,441.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,166.62,15.3,,,percent of total billed charges,15.3% of total billed charges,751.41,69,,,percent of total billed charges,69% of total billed charges,1089,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1089,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1089,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1081.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1007.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1387.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1767.86,130,,,Fee Schedule,130% of WA Medicaid ,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,410.55,37.7,,,percent of total billed charges,37.70% of total billed charges,410.55,37.7,,,percent of total billed charges,37.70% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,369.17,33.9,,,percent of total billed charges,33.9% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,849.42,78,,,percent of total billed charges,78% of total billed charges,1089,100,,,percent of total billed charges,100% of total billed charges,899.51,82.6,,,percent of total billed charges,82.6% of total billed charges,899.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,254.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,166.62,1767.86,
SLITTING OF PREPUSE;EXCP NEWBO,45054001,CDM,450,RC,54001,HCPCS,Outpatient,,,1228,798.20,,1080.64,88,,,percent of total billed charges,88% of total Billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1768.95,100,,,Fee Schedule,100% of WA Medicaid,1228,100,,,percent of total billed charges,100% of total billed charges,1822.02,103,,,Fee Schedule,103% of WA Medicaid,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,773.64,63,,,percent of total billed charges,63% of total billed charges,3635.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,1768.95,100,,,Fee Schedule,100% of WA Medicaid,187.88,15.3,,,percent of total billed charges,15.3% of total billed charges,847.32,69,,,percent of total billed charges,69% of total billed charges,1228,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1228,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1228,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,7284.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1768.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1310.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1804.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2299.64,130,,,Fee Schedule,130% of WA Medicaid ,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,462.96,37.7,,,percent of total billed charges,37.70% of total billed charges,462.96,37.7,,,percent of total billed charges,37.70% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,416.29,33.9,,,percent of total billed charges,33.9% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,957.84,78,,,percent of total billed charges,78% of total billed charges,1228,100,,,percent of total billed charges,100% of total billed charges,1014.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1014.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1768.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2098.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1768.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.88,7284.07,
54220 PENILE IRRIGATION TechFee,45054220,CDM,450,RC,54220,HCPCS,Outpatient,,,698,453.70,,614.24,88,,,percent of total billed charges,88% of total Billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,698,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,439.74,63,,,percent of total billed charges,63% of total billed charges,441.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,106.79,15.3,,,percent of total billed charges,15.3% of total billed charges,481.62,69,,,percent of total billed charges,69% of total billed charges,698,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,698,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,698,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1081.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,48.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,263.15,37.7,,,percent of total billed charges,37.70% of total billed charges,263.15,37.7,,,percent of total billed charges,37.70% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,236.62,33.9,,,percent of total billed charges,33.9% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,544.44,78,,,percent of total billed charges,78% of total billed charges,698,100,,,percent of total billed charges,100% of total billed charges,576.55,82.6,,,percent of total billed charges,82.6% of total billed charges,576.55,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,254.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.07,1081.19,
FORESKIN MANIPULATION,45054450,CDM,450,RC,54450,HCPCS,Outpatient,,,420,273.00,,369.6,88,,,percent of total billed charges,88% of total Billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,342.36,100,,,Fee Schedule,100% of WA Medicaid,420,100,,,percent of total billed charges,100% of total billed charges,352.63,103,,,Fee Schedule,103% of WA Medicaid,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,264.6,63,,,percent of total billed charges,63% of total billed charges,441.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,342.36,100,,,Fee Schedule,100% of WA Medicaid,64.26,15.3,,,percent of total billed charges,15.3% of total billed charges,289.8,69,,,percent of total billed charges,69% of total billed charges,420,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,420,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,420,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1081.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,253.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,349.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,445.07,130,,,Fee Schedule,130% of WA Medicaid ,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,158.34,37.7,,,percent of total billed charges,37.70% of total billed charges,158.34,37.7,,,percent of total billed charges,37.70% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,142.38,33.9,,,percent of total billed charges,33.9% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,327.6,78,,,percent of total billed charges,78% of total billed charges,420,100,,,percent of total billed charges,100% of total billed charges,346.92,82.6,,,percent of total billed charges,82.6% of total billed charges,346.92,82.6,,,percent of total billed charges,82.6% of total billed charges,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,254.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.26,1081.19,
REDUCTION OF TOSION OF TESTIS,45054600,CDM,450,RC,54600,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1855.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1910.67,103,,,Fee Schedule,103% of WA Medicaid,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,6222.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,1855.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,12497.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1855.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1374.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1892.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2411.53,130,,,Fee Schedule,130% of WA Medicaid ,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1855.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3591.3,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1855.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1374.09,12497.73,
45055100,45055100,CDM,450,RC,55100,HCPCS,Outpatient,,,4162,2705.30,,3662.56,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1855.02,100,,,Fee Schedule,100% of WA Medicaid,4162,100,,,percent of total billed charges,100% of total billed charges,1910.67,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2622.06,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1855.02,100,,,Fee Schedule,100% of WA Medicaid,636.79,15.3,,,percent of total billed charges,15.3% of total billed charges,2871.78,69,,,percent of total billed charges,69% of total billed charges,4162,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4162,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4162,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1855.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1374.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1892.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2411.53,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1569.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1569.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1410.92,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3246.36,78,,,percent of total billed charges,78% of total billed charges,4162,100,,,percent of total billed charges,100% of total billed charges,3437.81,82.6,,,percent of total billed charges,82.6% of total billed charges,3437.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1855.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1855.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,636.79,5715.97,
ID PERINEAL ABSCESS,45056405,CDM,450,RC,56405,HCPCS,Outpatient,,,1034,672.10,,909.92,88,,,percent of total billed charges,88% of total Billed charges,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,177.73,100,,,Fee Schedule,100% of WA Medicaid,1034,100,,,percent of total billed charges,100% of total billed charges,183.06,103,,,Fee Schedule,103% of WA Medicaid,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,651.42,63,,,percent of total billed charges,63% of total billed charges,572.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,177.73,100,,,Fee Schedule,100% of WA Medicaid,158.2,15.3,,,percent of total billed charges,15.3% of total billed charges,713.46,69,,,percent of total billed charges,69% of total billed charges,1034,100,,,percent of total billed charges,100% of total billed charges,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1034,100,,,percent of total billed charges,100% of total billed charges,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1034,100,,,percent of total billed charges,100% of total billed charges,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1143.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,177.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,131.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,181.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,231.05,130,,,Fee Schedule,130% of WA Medicaid ,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,389.82,37.7,,,percent of total billed charges,37.70% of total billed charges,389.82,37.7,,,percent of total billed charges,37.70% of total billed charges,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,350.53,33.9,,,percent of total billed charges,33.9% of total billed charges,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,806.52,78,,,percent of total billed charges,78% of total billed charges,1034,100,,,percent of total billed charges,100% of total billed charges,854.08,82.6,,,percent of total billed charges,82.6% of total billed charges,854.08,82.6,,,percent of total billed charges,82.6% of total billed charges,177.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,330.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,327.2,100,,,Fee Schedule,100% of Medicare OPPS rate,177.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.65,1143.51,
ID ABCESS BARTHOLIN GLAND,45056420,CDM,450,RC,56420,HCPCS,Outpatient,,,892,579.80,,784.96,88,,,percent of total billed charges,88% of total Billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,177.73,100,,,Fee Schedule,100% of WA Medicaid,892,100,,,percent of total billed charges,100% of total billed charges,183.06,103,,,Fee Schedule,103% of WA Medicaid,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,561.96,63,,,percent of total billed charges,63% of total billed charges,355.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,177.73,100,,,Fee Schedule,100% of WA Medicaid,136.48,15.3,,,percent of total billed charges,15.3% of total billed charges,615.48,69,,,percent of total billed charges,69% of total billed charges,892,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,892,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,892,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,691.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,177.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,131.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,181.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,231.05,130,,,Fee Schedule,130% of WA Medicaid ,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,336.28,37.7,,,percent of total billed charges,37.70% of total billed charges,336.28,37.7,,,percent of total billed charges,37.70% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,302.39,33.9,,,percent of total billed charges,33.9% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,695.76,78,,,percent of total billed charges,78% of total billed charges,892,100,,,percent of total billed charges,100% of total billed charges,736.79,82.6,,,percent of total billed charges,82.6% of total billed charges,736.79,82.6,,,percent of total billed charges,82.6% of total billed charges,177.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,205.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,177.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.65,892,
ID VAG HEMATOMA:OB/POSTPARTUM,45057022,CDM,450,RC,57022,HCPCS,Outpatient,,,1019,662.35,,896.72,88,,,percent of total billed charges,88% of total Billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1708.92,100,,,Fee Schedule,100% of WA Medicaid,1019,100,,,percent of total billed charges,100% of total billed charges,1760.19,103,,,Fee Schedule,103% of WA Medicaid,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,641.97,63,,,percent of total billed charges,63% of total billed charges,5071.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,1708.92,100,,,Fee Schedule,100% of WA Medicaid,155.91,15.3,,,percent of total billed charges,15.3% of total billed charges,703.11,69,,,percent of total billed charges,69% of total billed charges,1019,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1019,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1019,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,9628.23,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1708.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1265.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1743.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2221.6,130,,,Fee Schedule,130% of WA Medicaid ,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,384.16,37.7,,,percent of total billed charges,37.70% of total billed charges,384.16,37.7,,,percent of total billed charges,37.70% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,345.44,33.9,,,percent of total billed charges,33.9% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,794.82,78,,,percent of total billed charges,78% of total billed charges,1019,100,,,percent of total billed charges,100% of total billed charges,841.69,82.6,,,percent of total billed charges,82.6% of total billed charges,841.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1708.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2927.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1708.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,155.91,9628.23,
VAGINAL DELIVERY ONLY,45059409,CDM,450,RC,59409,HCPCS,Outpatient,,,4431,2880.15,,3899.28,88,,,percent of total billed charges,88% of total Billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1955.83,100,,,Fee Schedule,100% of WA Medicaid,4431,100,,,percent of total billed charges,100% of total billed charges,2014.51,103,,,Fee Schedule,103% of WA Medicaid,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2791.53,63,,,percent of total billed charges,63% of total billed charges,5580.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,1955.83,100,,,Fee Schedule,100% of WA Medicaid,677.94,15.3,,,percent of total billed charges,15.3% of total billed charges,3057.39,69,,,percent of total billed charges,69% of total billed charges,4431,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,4431,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,4431,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10656.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1955.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1994.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2542.58,130,,,Fee Schedule,130% of WA Medicaid ,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1670.49,37.7,,,percent of total billed charges,37.70% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1502.11,33.9,,,percent of total billed charges,33.9% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3456.18,78,,,percent of total billed charges,78% of total billed charges,4431,100,,,percent of total billed charges,100% of total billed charges,3660.01,82.6,,,percent of total billed charges,82.6% of total billed charges,3660.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1955.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3220.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1955.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,677.94,10656.86,
TREATMENT OF MISCARRIAGE,45059812,CDM,450,RC,59812,HCPCS,Outpatient,,,1897,1233.05,,1669.36,88,,,percent of total billed charges,88% of total Billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1591.42,100,,,Fee Schedule,100% of WA Medicaid,1897,100,,,percent of total billed charges,100% of total billed charges,1639.16,103,,,Fee Schedule,103% of WA Medicaid,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1195.11,63,,,percent of total billed charges,63% of total billed charges,5580.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,1591.42,100,,,Fee Schedule,100% of WA Medicaid,290.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1308.93,69,,,percent of total billed charges,69% of total billed charges,1897,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1897,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1897,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10656.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1591.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1178.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1623.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2068.84,130,,,Fee Schedule,130% of WA Medicaid ,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,715.17,37.7,,,percent of total billed charges,37.70% of total billed charges,715.17,37.7,,,percent of total billed charges,37.70% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,643.08,33.9,,,percent of total billed charges,33.9% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1479.66,78,,,percent of total billed charges,78% of total billed charges,1897,100,,,percent of total billed charges,100% of total billed charges,1566.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1566.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1591.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3220.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1591.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,290.24,10656.86,
LUMBAR PUNCTURE,45062270,CDM,450,RC,62270,HCPCS,Outpatient,,,1704,1107.60,,1499.52,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1704,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1073.52,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,260.71,15.3,,,percent of total billed charges,15.3% of total billed charges,1175.76,69,,,percent of total billed charges,69% of total billed charges,1704,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1704,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1704,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,642.41,37.7,,,percent of total billed charges,37.70% of total billed charges,642.41,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,577.66,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1329.12,78,,,percent of total billed charges,78% of total billed charges,1704,100,,,percent of total billed charges,100% of total billed charges,1407.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1407.5,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,260.71,2578.03,
POST EPIDURAL BLOOD PATCH,45062273,CDM,450,RC,62273,HCPCS,Outpatient,,,1278,830.70,,1124.64,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1278,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,805.14,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,195.53,15.3,,,percent of total billed charges,15.3% of total billed charges,881.82,69,,,percent of total billed charges,69% of total billed charges,1278,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1278,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1278,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,481.81,37.7,,,percent of total billed charges,37.70% of total billed charges,481.81,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,433.24,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,996.84,78,,,percent of total billed charges,78% of total billed charges,1278,100,,,percent of total billed charges,100% of total billed charges,1055.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1055.63,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.53,2578.03,
DIGITAL NERVE BLOCK,45064400,CDM,450,RC,64400,HCPCS,Outpatient,,,1488,967.20,,1309.44,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,1488,100,,,percent of total billed charges,100% of total billed charges,403.97,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,937.44,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,227.66,15.3,,,percent of total billed charges,15.3% of total billed charges,1026.72,69,,,percent of total billed charges,69% of total billed charges,1488,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1488,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1488,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,290.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,400.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.87,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,560.98,37.7,,,percent of total billed charges,37.70% of total billed charges,560.98,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,504.43,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1160.64,78,,,percent of total billed charges,78% of total billed charges,1488,100,,,percent of total billed charges,100% of total billed charges,1229.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1229.09,82.6,,,percent of total billed charges,82.6% of total billed charges,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,227.66,1488,
"NERVE BLOCK, GR OCCIPITAL",45064405,CDM,450,RC,64405,HCPCS,Outpatient,,,557,362.05,,490.16,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,557,100,,,percent of total billed charges,100% of total billed charges,403.97,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,350.91,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,85.22,15.3,,,percent of total billed charges,15.3% of total billed charges,384.33,69,,,percent of total billed charges,69% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,290.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,400.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.87,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,188.82,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,434.46,78,,,percent of total billed charges,78% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.22,1061,
"NERVE BLOCK, BRACHIAL PLEXUS",45064415,CDM,450,RC,64415,HCPCS,Outpatient,,,566,367.90,,498.08,88,,,percent of total billed charges,88% of total Billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1045.11,100,,,Fee Schedule,100% of WA Medicaid,566,100,,,percent of total billed charges,100% of total billed charges,1076.46,103,,,Fee Schedule,103% of WA Medicaid,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,356.58,63,,,percent of total billed charges,63% of total billed charges,1626.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,1045.11,100,,,Fee Schedule,100% of WA Medicaid,86.6,15.3,,,percent of total billed charges,15.3% of total billed charges,390.54,69,,,percent of total billed charges,69% of total billed charges,566,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,566,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,566,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3341.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1045.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,774.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1066.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1358.64,130,,,Fee Schedule,130% of WA Medicaid ,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,213.38,37.7,,,percent of total billed charges,37.70% of total billed charges,213.38,37.7,,,percent of total billed charges,37.70% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,191.87,33.9,,,percent of total billed charges,33.9% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,441.48,78,,,percent of total billed charges,78% of total billed charges,566,100,,,percent of total billed charges,100% of total billed charges,467.52,82.6,,,percent of total billed charges,82.6% of total billed charges,467.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,938.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1045.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.6,3341.26,
PERIPHERAL NERVE BLOCK,45064450,CDM,450,RC,64450,HCPCS,Outpatient,,,566,367.90,,498.08,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,566,100,,,percent of total billed charges,100% of total billed charges,403.97,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,356.58,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,86.6,15.3,,,percent of total billed charges,15.3% of total billed charges,390.54,69,,,percent of total billed charges,69% of total billed charges,566,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,566,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,566,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,290.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,400.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,213.38,37.7,,,percent of total billed charges,37.70% of total billed charges,213.38,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,191.87,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,441.48,78,,,percent of total billed charges,78% of total billed charges,566,100,,,percent of total billed charges,100% of total billed charges,467.52,82.6,,,percent of total billed charges,82.6% of total billed charges,467.52,82.6,,,percent of total billed charges,82.6% of total billed charges,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.6,2578.03,
REMOVAL FB CONJUNCTIVAL SIMPLE,45065205,CDM,450,RC,65205,HCPCS,Outpatient,,,477,310.05,,419.76,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,65.54,100,,,Fee Schedule,100% of WA Medicaid,477,100,,,percent of total billed charges,100% of total billed charges,67.51,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,300.51,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,65.54,100,,,Fee Schedule,100% of WA Medicaid,72.98,15.3,,,percent of total billed charges,15.3% of total billed charges,329.13,69,,,percent of total billed charges,69% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,477,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,477,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,48.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,66.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.21,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,161.7,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,372.06,78,,,percent of total billed charges,78% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.55,477,
REM FB CONJUNCTIVAL EMBEDDED,45065210,CDM,450,RC,65210,HCPCS,Outpatient,,,477,310.05,,419.76,88,,,percent of total billed charges,88% of total Billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,65.54,100,,,Fee Schedule,100% of WA Medicaid,477,100,,,percent of total billed charges,100% of total billed charges,67.51,103,,,Fee Schedule,103% of WA Medicaid,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,300.51,63,,,percent of total billed charges,63% of total billed charges,711.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,65.54,100,,,Fee Schedule,100% of WA Medicaid,72.98,15.3,,,percent of total billed charges,15.3% of total billed charges,329.13,69,,,percent of total billed charges,69% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,477,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,477,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1097.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,48.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,66.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.21,130,,,Fee Schedule,130% of WA Medicaid ,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,161.7,33.9,,,percent of total billed charges,33.9% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,372.06,78,,,percent of total billed charges,78% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,410.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.55,1097.77,
REM FB CORNEAL W/O SLIT LAMP,45065220,CDM,450,RC,65220,HCPCS,Outpatient,,,477,310.05,,419.76,88,,,percent of total billed charges,88% of total Billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,65.54,100,,,Fee Schedule,100% of WA Medicaid,477,100,,,percent of total billed charges,100% of total billed charges,67.51,103,,,Fee Schedule,103% of WA Medicaid,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,300.51,63,,,percent of total billed charges,63% of total billed charges,711.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,65.54,100,,,Fee Schedule,100% of WA Medicaid,72.98,15.3,,,percent of total billed charges,15.3% of total billed charges,329.13,69,,,percent of total billed charges,69% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,477,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,477,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1097.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,48.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,66.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.21,130,,,Fee Schedule,130% of WA Medicaid ,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,161.7,33.9,,,percent of total billed charges,33.9% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,372.06,78,,,percent of total billed charges,78% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,410.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.55,1097.77,
REM FB CORNEAL W/LAMP,45065222,CDM,450,RC,65222,HCPCS,Outpatient,,,477,310.05,,419.76,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,65.54,100,,,Fee Schedule,100% of WA Medicaid,477,100,,,percent of total billed charges,100% of total billed charges,67.51,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,300.51,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,65.54,100,,,Fee Schedule,100% of WA Medicaid,72.98,15.3,,,percent of total billed charges,15.3% of total billed charges,329.13,69,,,percent of total billed charges,69% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,477,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,477,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,48.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,66.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.21,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,161.7,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,372.06,78,,,percent of total billed charges,78% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,65.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.55,477,
"REMOVAL FB,CORNEAL,CURETTAGE",45065435,CDM,450,RC,65435,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,478.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,492.47,103,,,Fee Schedule,103% of WA Medicaid,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1807.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,478.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,3288.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,478.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,354.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,487.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,621.56,130,,,Fee Schedule,130% of WA Medicaid ,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,478.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,1042.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1032.64,100,,,Fee Schedule,100% of Medicare OPPS rate,478.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,354.16,3288.78,
ID STY/EYELID,45067700,CDM,450,RC,67700,HCPCS,Outpatient,,,798,518.70,,702.24,88,,,percent of total billed charges,88% of total Billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,283.94,100,,,Fee Schedule,100% of WA Medicaid,798,100,,,percent of total billed charges,100% of total billed charges,292.46,103,,,Fee Schedule,103% of WA Medicaid,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,502.74,63,,,percent of total billed charges,63% of total billed charges,519.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,283.94,100,,,Fee Schedule,100% of WA Medicaid,122.09,15.3,,,percent of total billed charges,15.3% of total billed charges,550.62,69,,,percent of total billed charges,69% of total billed charges,798,100,,,percent of total billed charges,100% of total billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,798,100,,,percent of total billed charges,100% of total billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,798,100,,,percent of total billed charges,100% of total billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,1061.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,283.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,210.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,289.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,369.12,130,,,Fee Schedule,130% of WA Medicaid ,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,300.85,37.7,,,percent of total billed charges,37.70% of total billed charges,300.85,37.7,,,percent of total billed charges,37.70% of total billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,270.52,33.9,,,percent of total billed charges,33.9% of total billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,622.44,78,,,percent of total billed charges,78% of total billed charges,798,100,,,percent of total billed charges,100% of total billed charges,659.15,82.6,,,percent of total billed charges,82.6% of total billed charges,659.15,82.6,,,percent of total billed charges,82.6% of total billed charges,283.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,300.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,283.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,122.09,1061.45,
Canthotomy (separate procedure),45067715,CDM,450,RC,67715,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,1208.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1244.27,103,,,Fee Schedule,103% of WA Medicaid,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,4171.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,1208.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,8134.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1208.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,894.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,1232.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1570.44,130,,,Fee Schedule,130% of WA Medicaid ,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1208.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,2407.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2383.44,100,,,Fee Schedule,100% of Medicare OPPS rate,1208.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,894.84,8134.6,
"REMOVAL OF EMBEDDED FB, EYELID",45067938,CDM,450,RC,67938,HCPCS,Outpatient,,,895,581.75,,787.6,88,,,percent of total billed charges,88% of total Billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,283.94,100,,,Fee Schedule,100% of WA Medicaid,895,100,,,percent of total billed charges,100% of total billed charges,292.46,103,,,Fee Schedule,103% of WA Medicaid,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,563.85,63,,,percent of total billed charges,63% of total billed charges,519.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,283.94,100,,,Fee Schedule,100% of WA Medicaid,136.94,15.3,,,percent of total billed charges,15.3% of total billed charges,617.55,69,,,percent of total billed charges,69% of total billed charges,895,100,,,percent of total billed charges,100% of total billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,895,100,,,percent of total billed charges,100% of total billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,895,100,,,percent of total billed charges,100% of total billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,1061.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,283.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,210.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,289.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,369.12,130,,,Fee Schedule,130% of WA Medicaid ,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,337.42,37.7,,,percent of total billed charges,37.70% of total billed charges,337.42,37.7,,,percent of total billed charges,37.70% of total billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,303.41,33.9,,,percent of total billed charges,33.9% of total billed charges,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,698.1,78,,,percent of total billed charges,78% of total billed charges,895,100,,,percent of total billed charges,100% of total billed charges,739.27,82.6,,,percent of total billed charges,82.6% of total billed charges,739.27,82.6,,,percent of total billed charges,82.6% of total billed charges,283.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,300.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,297.12,100,,,Fee Schedule,100% of Medicare OPPS rate,283.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,136.94,1061.45,
DRAIN EXT EAR ABSCESS/HEMATOMA,45069000,CDM,450,RC,69000,HCPCS,Outpatient,,,477,310.05,,419.76,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,477,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,300.51,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,72.98,15.3,,,percent of total billed charges,15.3% of total billed charges,329.13,69,,,percent of total billed charges,69% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,477,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,477,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,161.7,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,372.06,78,,,percent of total billed charges,78% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.98,2526.76,
DRAIN EXT AUDITORY CANAL ABCES,45069020,CDM,450,RC,69020,HCPCS,Outpatient,,,883,573.95,,777.04,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,883,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,556.29,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,135.1,15.3,,,percent of total billed charges,15.3% of total billed charges,609.27,69,,,percent of total billed charges,69% of total billed charges,883,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,883,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,883,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,332.89,37.7,,,percent of total billed charges,37.70% of total billed charges,332.89,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,299.34,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,688.74,78,,,percent of total billed charges,78% of total billed charges,883,100,,,percent of total billed charges,100% of total billed charges,729.36,82.6,,,percent of total billed charges,82.6% of total billed charges,729.36,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,2526.76,
REM FB EXT AUDITORY CANAL,45069200,CDM,450,RC,69200,HCPCS,Outpatient,,,366,237.90,,322.08,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,61.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,366,100,,,percent of total billed charges,100% of total billed charges,63.33,17.304,,,percent of total billed charges,17.304% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,230.58,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,61.49,16.8,,,percent of total billed charges,16.8% of total billed charges,56,15.3,,,percent of total billed charges,15.3% of total billed charges,252.54,69,,,percent of total billed charges,69% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,61.49,16.8,,,percent of total billed charges,16.8% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,61.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,62.72,17.136,,,percent of total billed charges,17.136% of total billed charges,79.93,21.84,,,percent of total billed charges,21.84% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,124.07,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,285.48,78,,,percent of total billed charges,78% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,61.49,16.8,,,percent of total billed charges,16.8% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,61.49,16.8,,,percent of total billed charges,16.8% of total billed charges,56,454.8,
REMOVE IMPACTED EAR WAX,45069209,CDM,450,RC,69209,HCPCS,Outpatient,,,79,51.35,,69.52,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,13.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,79,100,,,percent of total billed charges,100% of total billed charges,13.67,17.304,,,percent of total billed charges,17.304% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,49.77,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,12.09,15.3,,,percent of total billed charges,15.3% of total billed charges,54.51,69,,,percent of total billed charges,69% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,79,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,79,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,13.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,17.136,,,percent of total billed charges,17.136% of total billed charges,17.25,21.84,,,percent of total billed charges,21.84% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,29.78,37.7,,,percent of total billed charges,37.70% of total billed charges,29.78,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,26.78,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,61.62,78,,,percent of total billed charges,78% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,12.09,226.12,
Clear Outer Ear Canal Tech,45069205,CDM,450,RC,69205,HCPCS,Outpatient,,,5678,3690.70,,4996.64,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,827.71,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,852.54,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3577.14,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,827.71,100,,,Fee Schedule,100% of WA Medicaid,868.73,15.3,,,percent of total billed charges,15.3% of total billed charges,3917.82,69,,,percent of total billed charges,69% of total billed charges,5678,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5678,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5678,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,613.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,844.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1076.02,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2140.61,37.7,,,percent of total billed charges,37.70% of total billed charges,2140.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1924.84,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4428.84,78,,,percent of total billed charges,78% of total billed charges,5678,100,,,percent of total billed charges,100% of total billed charges,4690.03,82.6,,,percent of total billed charges,82.6% of total billed charges,4690.03,82.6,,,percent of total billed charges,82.6% of total billed charges,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,613.12,5715.97,
CERUMEN REMOVAL,45069210,CDM,450,RC,69210,HCPCS,Outpatient,,,279,181.35,,245.52,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,46.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,279,100,,,percent of total billed charges,100% of total billed charges,48.28,17.304,,,percent of total billed charges,17.304% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,175.77,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.87,16.8,,,percent of total billed charges,16.8% of total billed charges,42.69,15.3,,,percent of total billed charges,15.3% of total billed charges,192.51,69,,,percent of total billed charges,69% of total billed charges,279,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,279,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,279,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.87,16.8,,,percent of total billed charges,16.8% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,46.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,47.81,17.136,,,percent of total billed charges,17.136% of total billed charges,60.93,21.84,,,percent of total billed charges,21.84% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,105.18,37.7,,,percent of total billed charges,37.70% of total billed charges,105.18,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,94.58,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,217.62,78,,,percent of total billed charges,78% of total billed charges,279,100,,,percent of total billed charges,100% of total billed charges,230.45,82.6,,,percent of total billed charges,82.6% of total billed charges,230.45,82.6,,,percent of total billed charges,82.6% of total billed charges,46.87,16.8,,,percent of total billed charges,16.8% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,46.87,16.8,,,percent of total billed charges,16.8% of total billed charges,42.69,279,
PPD SKIN TEST,45086580,CDM,450,RC,86580,HCPCS,Outpatient,,,148,96.20,,130.24,88,,,percent of total billed charges,88% of total Billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,148,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,93.24,63,,,percent of total billed charges,63% of total billed charges,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,22.64,15.3,,,percent of total billed charges,15.3% of total billed charges,102.12,69,,,percent of total billed charges,69% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,148,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,148,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,55.8,37.7,,,percent of total billed charges,37.70% of total billed charges,55.8,37.7,,,percent of total billed charges,37.70% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,50.17,33.9,,,percent of total billed charges,33.9% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,115.44,78,,,percent of total billed charges,78% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,148,
IMMUNIZATION ADMINISTRATION,45090471,CDM,450,RC,90471,HCPCS,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,350,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,220.5,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,350,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,350,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,118.65,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.65,350,
VACCINE (ADDITIONAL),45090472,CDM,450,RC,90472,HCPCS,Outpatient,,,418,271.70,,367.84,88,,,percent of total billed charges,88% of total Billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,418,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,209,50,,,percent of total billed charges,50% of total Billed charges,263.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,63.95,15.3,,,percent of total billed charges,15.3% of total billed charges,288.42,69,,,percent of total billed charges,69% of total billed charges,418,100,,,percent of total billed charges,100% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,418,100,,,percent of total billed charges,100% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,418,100,,,percent of total billed charges,100% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,258.53,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,209,50,,,percent of total billed charges,50% of total Billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,209,50,,,percent of total billed charges,50% of total Billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,209,50,,,percent of total billed charges,50% of total Billed charges,157.59,37.7,,,percent of total billed charges,37.70% of total billed charges,157.59,37.7,,,percent of total billed charges,37.70% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,141.7,33.9,,,percent of total billed charges,33.9% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,326.04,78,,,percent of total billed charges,78% of total billed charges,418,100,,,percent of total billed charges,100% of total billed charges,345.27,82.6,,,percent of total billed charges,82.6% of total billed charges,345.27,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,209,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,209,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.65,418,
ADMIN IMMUN VACCINE ORAL/NASAL,45090473,CDM,450,RC,90473,HCPCS,Outpatient,,,151,98.15,,132.88,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,151,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,95.13,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,23.1,15.3,,,percent of total billed charges,15.3% of total billed charges,104.19,69,,,percent of total billed charges,69% of total billed charges,151,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,151,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,151,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,56.93,37.7,,,percent of total billed charges,37.70% of total billed charges,56.93,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,51.19,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,117.78,78,,,percent of total billed charges,78% of total billed charges,151,100,,,percent of total billed charges,100% of total billed charges,124.73,82.6,,,percent of total billed charges,82.6% of total billed charges,124.73,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.1,251.75,
CPR,45092950,CDM,450,RC,92950,HCPCS,Outpatient,,,1088,707.20,,957.44,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,1088,100,,,percent of total billed charges,100% of total billed charges,843.18,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,685.44,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,166.46,15.3,,,percent of total billed charges,15.3% of total billed charges,750.72,69,,,percent of total billed charges,69% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1088,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1088,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,606.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,834.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1064.21,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,368.83,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,848.64,78,,,percent of total billed charges,78% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,166.46,1088,
TRANSCUTANEOUS PACING,45092953,CDM,450,RC,92953,HCPCS,Outpatient,,,2149,1396.85,,1891.12,88,,,percent of total billed charges,88% of total Billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,582.08,100,,,Fee Schedule,100% of WA Medicaid,2149,100,,,percent of total billed charges,100% of total billed charges,599.54,103,,,Fee Schedule,103% of WA Medicaid,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,1353.87,63,,,percent of total billed charges,63% of total billed charges,1161.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,582.08,100,,,Fee Schedule,100% of WA Medicaid,328.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1482.81,69,,,percent of total billed charges,69% of total billed charges,2149,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2149,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2149,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2282.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,431.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,593.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,756.7,130,,,Fee Schedule,130% of WA Medicaid ,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,810.17,37.7,,,percent of total billed charges,37.70% of total billed charges,810.17,37.7,,,percent of total billed charges,37.70% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,728.51,33.9,,,percent of total billed charges,33.9% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,1676.22,78,,,percent of total billed charges,78% of total billed charges,2149,100,,,percent of total billed charges,100% of total billed charges,1775.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1775.07,82.6,,,percent of total billed charges,82.6% of total billed charges,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,670.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,328.8,2282.77,
CARDIOVERSION ELECTIVE EXT,45092960,CDM,450,RC,92960,HCPCS,Outpatient,,,2475,1608.75,,2178,88,,,percent of total billed charges,88% of total Billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,582.08,100,,,Fee Schedule,100% of WA Medicaid,2475,100,,,percent of total billed charges,100% of total billed charges,599.54,103,,,Fee Schedule,103% of WA Medicaid,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,1559.25,63,,,percent of total billed charges,63% of total billed charges,1161.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,582.08,100,,,Fee Schedule,100% of WA Medicaid,378.68,15.3,,,percent of total billed charges,15.3% of total billed charges,1707.75,69,,,percent of total billed charges,69% of total billed charges,2475,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2475,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2475,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2282.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,431.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,593.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,756.7,130,,,Fee Schedule,130% of WA Medicaid ,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,933.08,37.7,,,percent of total billed charges,37.70% of total billed charges,933.08,37.7,,,percent of total billed charges,37.70% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,839.03,33.9,,,percent of total billed charges,33.9% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,1930.5,78,,,percent of total billed charges,78% of total billed charges,2475,100,,,percent of total billed charges,100% of total billed charges,2044.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2044.35,82.6,,,percent of total billed charges,82.6% of total billed charges,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,670.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,378.68,2475,
THROMBOLYSIS CORONARY W/IV THP,45092977,CDM,450,RC,92977,HCPCS,Outpatient,,,1262,820.30,,1110.56,88,,,percent of total billed charges,88% of total Billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,1262,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,795.06,63,,,percent of total billed charges,63% of total billed charges,604.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,193.09,15.3,,,percent of total billed charges,15.3% of total billed charges,870.78,69,,,percent of total billed charges,69% of total billed charges,1262,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1262,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1262,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1262.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,475.77,37.7,,,percent of total billed charges,37.70% of total billed charges,475.77,37.7,,,percent of total billed charges,37.70% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,427.82,33.9,,,percent of total billed charges,33.9% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,984.36,78,,,percent of total billed charges,78% of total billed charges,1262,100,,,percent of total billed charges,100% of total billed charges,1042.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1042.41,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,348.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,193.09,1262.42,
EKG-ER,93005,CDM,730,RC,93005,HCPCS,Outpatient,,,542,352.30,,476.96,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,542,100,,,percent of total billed charges,100% of total billed charges,24.47,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,341.46,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,82.93,15.3,,,percent of total billed charges,15.3% of total billed charges,373.98,69,,,percent of total billed charges,69% of total billed charges,542,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,542,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,542,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.89,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,204.33,37.7,,,percent of total billed charges,37.70% of total billed charges,204.33,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,183.74,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,422.76,78,,,percent of total billed charges,78% of total billed charges,542,100,,,percent of total billed charges,100% of total billed charges,447.69,82.6,,,percent of total billed charges,82.6% of total billed charges,447.69,82.6,,,percent of total billed charges,82.6% of total billed charges,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,542,
RHYTHM STRIP,73093041,CDM,730,RC,93041,HCPCS,Outpatient,,,249,161.85,,219.12,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,249,100,,,percent of total billed charges,100% of total billed charges,24.47,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,156.87,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,38.1,15.3,,,percent of total billed charges,15.3% of total billed charges,171.81,69,,,percent of total billed charges,69% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.89,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,84.41,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,194.22,78,,,percent of total billed charges,78% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,249,
PULSE OX SINGLE,46094760,CDM,460,RC,94760,HCPCS,Outpatient,,,164,106.60,,144.32,88,,,percent of total billed charges,88% of total Billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,27.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,164,100,,,percent of total billed charges,100% of total billed charges,28.38,17.304,,,percent of total billed charges,17.304% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,103.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.55,16.8,,,percent of total billed charges,16.8% of total billed charges,25.09,15.3,,,percent of total billed charges,15.3% of total billed charges,113.16,69,,,percent of total billed charges,69% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,164,100,,,percent of total billed charges,100% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,164,100,,,percent of total billed charges,100% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,101.43,61.85,,,percent of total billed charges,61.85% of total billed charges,27.55,16.8,,,percent of total billed charges,16.8% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,27.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,28.1,17.136,,,percent of total billed charges,17.136% of total billed charges,35.82,21.84,,,percent of total billed charges,21.84% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,61.83,37.7,,,percent of total billed charges,37.70% of total billed charges,61.83,37.7,,,percent of total billed charges,37.70% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,55.6,33.9,,,percent of total billed charges,33.9% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,127.92,78,,,percent of total billed charges,78% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,27.55,16.8,,,percent of total billed charges,16.8% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,82,50,,,percent of total billed charges,50% of total Billed charges,27.55,16.8,,,percent of total billed charges,16.8% of total billed charges,25.09,164,
PULSE OX Multiple TechFee,45094761,CDM,450,RC,94761,HCPCS,Outpatient,,,340,221.00,,299.2,88,,,percent of total billed charges,88% of total Billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,57.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,340,100,,,percent of total billed charges,100% of total billed charges,58.83,17.304,,,percent of total billed charges,17.304% of total billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,214.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,57.12,16.8,,,percent of total billed charges,16.8% of total billed charges,52.02,15.3,,,percent of total billed charges,15.3% of total billed charges,234.6,69,,,percent of total billed charges,69% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,340,100,,,percent of total billed charges,100% of total billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,340,100,,,percent of total billed charges,100% of total billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,210.29,61.85,,,percent of total billed charges,61.85% of total billed charges,57.12,16.8,,,percent of total billed charges,16.8% of total billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,57.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,58.26,17.136,,,percent of total billed charges,17.136% of total billed charges,74.26,21.84,,,percent of total billed charges,21.84% of total billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,115.26,33.9,,,percent of total billed charges,33.9% of total billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,265.2,78,,,percent of total billed charges,78% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,57.12,16.8,,,percent of total billed charges,16.8% of total billed charges,170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,170,50,,,percent of total billed charges,50% of total Billed charges,57.12,16.8,,,percent of total billed charges,16.8% of total billed charges,52.02,340,
"DEBRIDEMENT WOUND, SCISSORS/SCAPEL 20SQTECH",45097597,CDM,450,RC,97597,HCPCS,Outpatient,,,714,464.10,,628.32,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,714,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,449.82,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,109.24,15.3,,,percent of total billed charges,15.3% of total billed charges,492.66,69,,,percent of total billed charges,69% of total billed charges,714,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,714,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,714,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,269.18,37.7,,,percent of total billed charges,37.70% of total billed charges,269.18,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,242.05,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,556.92,78,,,percent of total billed charges,78% of total billed charges,714,100,,,percent of total billed charges,100% of total billed charges,589.76,82.6,,,percent of total billed charges,82.6% of total billed charges,589.76,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,109.24,729.41,
99152 MOD SED SAME PHYS/QHP 5/>YRS INITIAL 15 Tech Fee,45099152,CDM,450,RC,99152,HCPCS,Outpatient,,,521,338.65,,458.48,88,,,percent of total billed charges,88% of total Billed charges,260.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid,521,100,,,percent of total billed charges,100% of total billed charges,22.18,103,,,Fee Schedule,103% of WA Medicaid,260.5,50,,,percent of total billed charges,50% of total Billed charges,328.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.54,100,,,Fee Schedule,100% of WA Medicaid,79.71,15.3,,,percent of total billed charges,15.3% of total billed charges,359.49,69,,,percent of total billed charges,69% of total billed charges,521,100,,,percent of total billed charges,100% of total billed charges,260.5,50,,,percent of total billed charges,50% of total Billed charges,521,100,,,percent of total billed charges,100% of total billed charges,260.5,50,,,percent of total billed charges,50% of total Billed charges,521,100,,,percent of total billed charges,100% of total billed charges,260.5,50,,,percent of total billed charges,50% of total Billed charges,322.24,61.85,,,percent of total billed charges,61.85% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,260.5,50,,,percent of total billed charges,50% of total Billed charges,260.5,50,,,percent of total billed charges,50% of total Billed charges,15.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,260.5,50,,,percent of total billed charges,50% of total Billed charges,260.5,50,,,percent of total billed charges,50% of total Billed charges,21.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28,130,,,Fee Schedule,130% of WA Medicaid ,260.5,50,,,percent of total billed charges,50% of total Billed charges,196.42,37.7,,,percent of total billed charges,37.70% of total billed charges,196.42,37.7,,,percent of total billed charges,37.70% of total billed charges,260.5,50,,,percent of total billed charges,50% of total Billed charges,176.62,33.9,,,percent of total billed charges,33.9% of total billed charges,260.5,50,,,percent of total billed charges,50% of total Billed charges,406.38,78,,,percent of total billed charges,78% of total billed charges,521,100,,,percent of total billed charges,100% of total billed charges,430.35,82.6,,,percent of total billed charges,82.6% of total billed charges,430.35,82.6,,,percent of total billed charges,82.6% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,260.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.95,521,
99151 MOD CS SAME INIT 15M <5 TechFee,45099151,CDM,450,RC,99151,HCPCS,Outpatient,,,503,326.95,,442.64,88,,,percent of total billed charges,88% of total Billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid,503,100,,,percent of total billed charges,100% of total billed charges,22.18,103,,,Fee Schedule,103% of WA Medicaid,251.5,50,,,percent of total billed charges,50% of total Billed charges,316.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.54,100,,,Fee Schedule,100% of WA Medicaid,76.96,15.3,,,percent of total billed charges,15.3% of total billed charges,347.07,69,,,percent of total billed charges,69% of total billed charges,503,100,,,percent of total billed charges,100% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,503,100,,,percent of total billed charges,100% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,503,100,,,percent of total billed charges,100% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,311.11,61.85,,,percent of total billed charges,61.85% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,251.5,50,,,percent of total billed charges,50% of total Billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,15.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,251.5,50,,,percent of total billed charges,50% of total Billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,21.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28,130,,,Fee Schedule,130% of WA Medicaid ,251.5,50,,,percent of total billed charges,50% of total Billed charges,189.63,37.7,,,percent of total billed charges,37.70% of total billed charges,189.63,37.7,,,percent of total billed charges,37.70% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,170.52,33.9,,,percent of total billed charges,33.9% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,392.34,78,,,percent of total billed charges,78% of total billed charges,503,100,,,percent of total billed charges,100% of total billed charges,415.48,82.6,,,percent of total billed charges,82.6% of total billed charges,415.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,251.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,251.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.95,503,
99155 MOD SED SAME PHYS/QHP 5/>YRS INITIAL 15 Tech Fee,45099155,CDM,450,RC,99155,HCPCS,Outpatient,,,503,326.95,,442.64,88,,,percent of total billed charges,88% of total Billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid,503,100,,,percent of total billed charges,100% of total billed charges,22.18,103,,,Fee Schedule,103% of WA Medicaid,251.5,50,,,percent of total billed charges,50% of total Billed charges,316.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.54,100,,,Fee Schedule,100% of WA Medicaid,76.96,15.3,,,percent of total billed charges,15.3% of total billed charges,347.07,69,,,percent of total billed charges,69% of total billed charges,503,100,,,percent of total billed charges,100% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,503,100,,,percent of total billed charges,100% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,503,100,,,percent of total billed charges,100% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,311.11,61.85,,,percent of total billed charges,61.85% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,251.5,50,,,percent of total billed charges,50% of total Billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,15.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,251.5,50,,,percent of total billed charges,50% of total Billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,21.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28,130,,,Fee Schedule,130% of WA Medicaid ,251.5,50,,,percent of total billed charges,50% of total Billed charges,189.63,37.7,,,percent of total billed charges,37.70% of total billed charges,189.63,37.7,,,percent of total billed charges,37.70% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,170.52,33.9,,,percent of total billed charges,33.9% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,392.34,78,,,percent of total billed charges,78% of total billed charges,503,100,,,percent of total billed charges,100% of total billed charges,415.48,82.6,,,percent of total billed charges,82.6% of total billed charges,415.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,251.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,251.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.95,503,
99157 MOD SED SAME PHYS/QHP 5/>YRS INITIAL 15 Tech Fee,45099157,CDM,450,RC,99157,HCPCS,Outpatient,,,503,326.95,,442.64,88,,,percent of total billed charges,88% of total Billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid,503,100,,,percent of total billed charges,100% of total billed charges,22.18,103,,,Fee Schedule,103% of WA Medicaid,251.5,50,,,percent of total billed charges,50% of total Billed charges,316.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.54,100,,,Fee Schedule,100% of WA Medicaid,76.96,15.3,,,percent of total billed charges,15.3% of total billed charges,347.07,69,,,percent of total billed charges,69% of total billed charges,503,100,,,percent of total billed charges,100% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,503,100,,,percent of total billed charges,100% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,503,100,,,percent of total billed charges,100% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,311.11,61.85,,,percent of total billed charges,61.85% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,251.5,50,,,percent of total billed charges,50% of total Billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,15.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,251.5,50,,,percent of total billed charges,50% of total Billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,21.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28,130,,,Fee Schedule,130% of WA Medicaid ,251.5,50,,,percent of total billed charges,50% of total Billed charges,189.63,37.7,,,percent of total billed charges,37.70% of total billed charges,189.63,37.7,,,percent of total billed charges,37.70% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,170.52,33.9,,,percent of total billed charges,33.9% of total billed charges,251.5,50,,,percent of total billed charges,50% of total Billed charges,392.34,78,,,percent of total billed charges,78% of total billed charges,503,100,,,percent of total billed charges,100% of total billed charges,415.48,82.6,,,percent of total billed charges,82.6% of total billed charges,415.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,251.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,251.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.95,503,
IPECAC EMESIS W/OBSERVATION,45099175,CDM,450,RC,99175,HCPCS,Outpatient,,,617,401.05,,542.96,88,,,percent of total billed charges,88% of total Billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,103.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,617,100,,,percent of total billed charges,100% of total billed charges,106.77,17.304,,,percent of total billed charges,17.304% of total billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,388.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,103.66,16.8,,,percent of total billed charges,16.8% of total billed charges,94.4,15.3,,,percent of total billed charges,15.3% of total billed charges,425.73,69,,,percent of total billed charges,69% of total billed charges,617,100,,,percent of total billed charges,100% of total billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,617,100,,,percent of total billed charges,100% of total billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,617,100,,,percent of total billed charges,100% of total billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,381.61,61.85,,,percent of total billed charges,61.85% of total billed charges,103.66,16.8,,,percent of total billed charges,16.8% of total billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,103.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,105.73,17.136,,,percent of total billed charges,17.136% of total billed charges,134.75,21.84,,,percent of total billed charges,21.84% of total billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,232.61,37.7,,,percent of total billed charges,37.70% of total billed charges,232.61,37.7,,,percent of total billed charges,37.70% of total billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,209.16,33.9,,,percent of total billed charges,33.9% of total billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,481.26,78,,,percent of total billed charges,78% of total billed charges,617,100,,,percent of total billed charges,100% of total billed charges,509.64,82.6,,,percent of total billed charges,82.6% of total billed charges,509.64,82.6,,,percent of total billed charges,82.6% of total billed charges,103.66,16.8,,,percent of total billed charges,16.8% of total billed charges,308.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,308.5,50,,,percent of total billed charges,50% of total Billed charges,103.66,16.8,,,percent of total billed charges,16.8% of total billed charges,94.4,617,
CLOSED TX DISTAL RAD W/MANI,45025605,CDM,450,RC,25605,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,469.35,63,,,percent of total billed charges,63% of total billed charges,2868.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,745,100,,,percent of total billed charges,100% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,5656.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,252.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1639.28,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.99,5656.45,
ADHESIVE WND CLOSE-DERMABOND,450G0168,CDM,450,RC,G0168,HCPCS,Outpatient,,,458,297.70,,403.04,88,,,percent of total billed charges,88% of total Billed charges,229,50,,,percent of total billed charges,50% of total Billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid,458,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,229,50,,,percent of total billed charges,50% of total Billed charges,288.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168.4,100,,,Fee Schedule,100% of WA Medicaid,70.07,15.3,,,percent of total billed charges,15.3% of total billed charges,316.02,69,,,percent of total billed charges,69% of total billed charges,458,100,,,percent of total billed charges,100% of total billed charges,229,50,,,percent of total billed charges,50% of total Billed charges,458,100,,,percent of total billed charges,100% of total billed charges,229,50,,,percent of total billed charges,50% of total Billed charges,458,100,,,percent of total billed charges,100% of total billed charges,229,50,,,percent of total billed charges,50% of total Billed charges,283.27,61.85,,,percent of total billed charges,61.85% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,229,50,,,percent of total billed charges,50% of total Billed charges,229,50,,,percent of total billed charges,50% of total Billed charges,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,229,50,,,percent of total billed charges,50% of total Billed charges,229,50,,,percent of total billed charges,50% of total Billed charges,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,229,50,,,percent of total billed charges,50% of total Billed charges,172.67,37.7,,,percent of total billed charges,37.70% of total billed charges,172.67,37.7,,,percent of total billed charges,37.70% of total billed charges,229,50,,,percent of total billed charges,50% of total Billed charges,155.26,33.9,,,percent of total billed charges,33.9% of total billed charges,229,50,,,percent of total billed charges,50% of total Billed charges,357.24,78,,,percent of total billed charges,78% of total billed charges,458,100,,,percent of total billed charges,100% of total billed charges,378.31,82.6,,,percent of total billed charges,82.6% of total billed charges,378.31,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,229,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,229,50,,,percent of total billed charges,50% of total Billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.07,458,
TRAUMA TEAM ACT W/CRIT CARE,681G0390,CDM,681,RC,G0390,HCPCS,Outpatient,,,4065,2642.25,,3577.2,88,,,percent of total billed charges,88% of total Billed charges,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,4065,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,2560.95,63,,,percent of total billed charges,63% of total billed charges,2443.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,,,,,Other,"Not Separately reimbursable
",621.95,15.3,,,percent of total billed charges,15.3% of total billed charges,2804.85,69,,,percent of total billed charges,69% of total billed charges,4065,100,,,percent of total billed charges,100% of total billed charges,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,4065,100,,,percent of total billed charges,100% of total billed charges,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,4065,100,,,percent of total billed charges,100% of total billed charges,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,3829.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,,,,,Other,Not Separately reimbursable,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.51,37.7,,,percent of total billed charges,37.70% of total billed charges,1532.51,37.7,,,percent of total billed charges,37.70% of total billed charges,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1378.04,33.9,,,percent of total billed charges,33.9% of total billed charges,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,3170.7,78,,,percent of total billed charges,78% of total billed charges,4065,100,,,percent of total billed charges,100% of total billed charges,3357.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3357.69,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1410.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1396.43,100,,,Fee Schedule,100% of Medicare OPPS rate,682.92,16.8,,,percent of total billed charges,16.8% of total billed charges,621.95,4065,
G0425 ER TELEHEALTH CONS 30 MIN,G0425,CDM,450,RC,G0425,HCPCS,Outpatient,,,490,318.50,,431.2,88,,,percent of total billed charges,88% of total Billed charges,245,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,490,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,245,50,,,percent of total billed charges,50% of total Billed charges,308.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",74.97,15.3,,,percent of total billed charges,15.3% of total billed charges,338.1,69,,,percent of total billed charges,69% of total billed charges,490,100,,,percent of total billed charges,100% of total billed charges,245,50,,,percent of total billed charges,50% of total Billed charges,490,100,,,percent of total billed charges,100% of total billed charges,245,50,,,percent of total billed charges,50% of total Billed charges,490,100,,,percent of total billed charges,100% of total billed charges,245,50,,,percent of total billed charges,50% of total Billed charges,303.07,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,245,50,,,percent of total billed charges,50% of total Billed charges,245,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,245,50,,,percent of total billed charges,50% of total Billed charges,245,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,245,50,,,percent of total billed charges,50% of total Billed charges,184.73,37.7,,,percent of total billed charges,37.70% of total billed charges,184.73,37.7,,,percent of total billed charges,37.70% of total billed charges,245,50,,,percent of total billed charges,50% of total Billed charges,166.11,33.9,,,percent of total billed charges,33.9% of total billed charges,245,50,,,percent of total billed charges,50% of total Billed charges,382.2,78,,,percent of total billed charges,78% of total billed charges,490,100,,,percent of total billed charges,100% of total billed charges,404.74,82.6,,,percent of total billed charges,82.6% of total billed charges,404.74,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,245,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,245,50,,,percent of total billed charges,50% of total Billed charges,82.32,16.8,,,percent of total billed charges,16.8% of total billed charges,74.97,490,
G0426 ER TELEHEALTH CONS 50 MIN,G0425,CDM,450,RC,G0425,HCPCS,Outpatient,,,668,434.20,,587.84,88,,,percent of total billed charges,88% of total Billed charges,334,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,668,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,334,50,,,percent of total billed charges,50% of total Billed charges,420.84,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",102.2,15.3,,,percent of total billed charges,15.3% of total billed charges,460.92,69,,,percent of total billed charges,69% of total billed charges,668,100,,,percent of total billed charges,100% of total billed charges,334,50,,,percent of total billed charges,50% of total Billed charges,668,100,,,percent of total billed charges,100% of total billed charges,334,50,,,percent of total billed charges,50% of total Billed charges,668,100,,,percent of total billed charges,100% of total billed charges,334,50,,,percent of total billed charges,50% of total Billed charges,413.16,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,334,50,,,percent of total billed charges,50% of total Billed charges,334,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,334,50,,,percent of total billed charges,50% of total Billed charges,334,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,334,50,,,percent of total billed charges,50% of total Billed charges,251.84,37.7,,,percent of total billed charges,37.70% of total billed charges,251.84,37.7,,,percent of total billed charges,37.70% of total billed charges,334,50,,,percent of total billed charges,50% of total Billed charges,226.45,33.9,,,percent of total billed charges,33.9% of total billed charges,334,50,,,percent of total billed charges,50% of total Billed charges,521.04,78,,,percent of total billed charges,78% of total billed charges,668,100,,,percent of total billed charges,100% of total billed charges,551.77,82.6,,,percent of total billed charges,82.6% of total billed charges,551.77,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,334,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,334,50,,,percent of total billed charges,50% of total Billed charges,112.22,16.8,,,percent of total billed charges,16.8% of total billed charges,102.2,668,
G0427 ER TELEHEALTH CONS 70 MIN,G0427,CDM,450,RC,G0427,HCPCS,Outpatient,,,988,642.20,,869.44,88,,,percent of total billed charges,88% of total Billed charges,494,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,988,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,494,50,,,percent of total billed charges,50% of total Billed charges,622.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",151.16,15.3,,,percent of total billed charges,15.3% of total billed charges,681.72,69,,,percent of total billed charges,69% of total billed charges,988,100,,,percent of total billed charges,100% of total billed charges,494,50,,,percent of total billed charges,50% of total Billed charges,988,100,,,percent of total billed charges,100% of total billed charges,494,50,,,percent of total billed charges,50% of total Billed charges,988,100,,,percent of total billed charges,100% of total billed charges,494,50,,,percent of total billed charges,50% of total Billed charges,611.08,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,494,50,,,percent of total billed charges,50% of total Billed charges,494,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,494,50,,,percent of total billed charges,50% of total Billed charges,494,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,494,50,,,percent of total billed charges,50% of total Billed charges,372.48,37.7,,,percent of total billed charges,37.70% of total billed charges,372.48,37.7,,,percent of total billed charges,37.70% of total billed charges,494,50,,,percent of total billed charges,50% of total Billed charges,334.93,33.9,,,percent of total billed charges,33.9% of total billed charges,494,50,,,percent of total billed charges,50% of total Billed charges,770.64,78,,,percent of total billed charges,78% of total billed charges,988,100,,,percent of total billed charges,100% of total billed charges,816.09,82.6,,,percent of total billed charges,82.6% of total billed charges,816.09,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,494,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,494,50,,,percent of total billed charges,50% of total Billed charges,165.98,16.8,,,percent of total billed charges,16.8% of total billed charges,151.16,988,
"99203 Telehealth via audiovideo, NPt Visit Lvl 3",TELE99203,CDM,510,RC,99203,HCPCS,Outpatient,,,128,83.20,,112.64,88,,,percent of total billed charges,88% of total Billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,21.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,128,100,,,percent of total billed charges,100% of total billed charges,22.15,17.304,,,percent of total billed charges,17.304% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,80.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.5,16.8,,,percent of total billed charges,16.8% of total billed charges,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,128,100,,,percent of total billed charges,100% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,128,100,,,percent of total billed charges,100% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,79.17,61.85,,,percent of total billed charges,61.85% of total billed charges,21.5,16.8,,,percent of total billed charges,16.8% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,21.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,21.93,17.136,,,percent of total billed charges,17.136% of total billed charges,27.96,21.84,,,percent of total billed charges,21.84% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,64,50,,,percent of total billed charges,50% of total Billed charges,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,21.5,16.8,,,percent of total billed charges,16.8% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,64,50,,,percent of total billed charges,50% of total Billed charges,21.5,16.8,,,percent of total billed charges,16.8% of total billed charges,19.58,128,
"99204 Telehealth via audiovideo, NPt Visit Lvl 4",TELE99204,CDM,510,RC,99204,HCPCS,Outpatient,,,197,128.05,,173.36,88,,,percent of total billed charges,88% of total Billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,33.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,197,100,,,percent of total billed charges,100% of total billed charges,34.09,17.304,,,percent of total billed charges,17.304% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,124.11,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.1,16.8,,,percent of total billed charges,16.8% of total billed charges,30.14,15.3,,,percent of total billed charges,15.3% of total billed charges,135.93,69,,,percent of total billed charges,69% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,197,100,,,percent of total billed charges,100% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,197,100,,,percent of total billed charges,100% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,121.84,61.85,,,percent of total billed charges,61.85% of total billed charges,33.1,16.8,,,percent of total billed charges,16.8% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,33.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,33.76,17.136,,,percent of total billed charges,17.136% of total billed charges,43.02,21.84,,,percent of total billed charges,21.84% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,98.5,50,,,percent of total billed charges,50% of total Billed charges,153.66,78,,,percent of total billed charges,78% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,33.1,16.8,,,percent of total billed charges,16.8% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,98.5,50,,,percent of total billed charges,50% of total Billed charges,33.1,16.8,,,percent of total billed charges,16.8% of total billed charges,30.14,197,
"99205 Telehealth via audiovideo, NPt Visit Lvl 5",TELE99205,CDM,510,RC,99205,HCPCS,Outpatient,,,248,161.20,,218.24,88,,,percent of total billed charges,88% of total Billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,41.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,248,100,,,percent of total billed charges,100% of total billed charges,42.91,17.304,,,percent of total billed charges,17.304% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,156.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,41.66,16.8,,,percent of total billed charges,16.8% of total billed charges,37.94,15.3,,,percent of total billed charges,15.3% of total billed charges,171.12,69,,,percent of total billed charges,69% of total billed charges,248,100,,,percent of total billed charges,100% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,248,100,,,percent of total billed charges,100% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,248,100,,,percent of total billed charges,100% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,153.39,61.85,,,percent of total billed charges,61.85% of total billed charges,41.66,16.8,,,percent of total billed charges,16.8% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,41.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,42.5,17.136,,,percent of total billed charges,17.136% of total billed charges,54.16,21.84,,,percent of total billed charges,21.84% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,124,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,124,50,,,percent of total billed charges,50% of total Billed charges,193.44,78,,,percent of total billed charges,78% of total billed charges,248,100,,,percent of total billed charges,100% of total billed charges,204.85,82.6,,,percent of total billed charges,82.6% of total billed charges,204.85,82.6,,,percent of total billed charges,82.6% of total billed charges,41.66,16.8,,,percent of total billed charges,16.8% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,124,50,,,percent of total billed charges,50% of total Billed charges,41.66,16.8,,,percent of total billed charges,16.8% of total billed charges,37.94,248,
INPATIENT VISIT LEVEL 2,99232,CDM,960,RC,99232,HCPCS,Outpatient,,,221,143.65,,194.48,88,,,percent of total billed charges,88% of total Billed charges,5.46,100,,,Fee Schedule,100% of Medicare rate,44.39,100,,,Fee Schedule,100% of WA Medicaid,221,100,,,percent of total billed charges,100% of total billed charges,45.72,103,,,Fee Schedule,103% of WA Medicaid,5.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,44.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,152.49,69,,,percent of total billed charges,69% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,221,100,,,percent of total billed charges,100% of total billed charges,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,221,100,,,percent of total billed charges,100% of total billed charges,5.46,100,,,Fee Schedule,100% of Medicare OPPS rate,136.69,61.85,,,percent of total billed charges,61.85% of total billed charges,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,57.71,130,,,Fee Schedule,130% of WA Medicaid ,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,7491.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.38,78,,,percent of total billed charges,78% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.46,7491.9,
.%fPSA Reflex LC,30184154,CDM,301,RC,84154,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,32.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,70.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,146,
".6-Acetylmorphine, MS, Ur RFX LC",30180356,CDM,301,RC,80356,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
CULTURE ID NUCLEIC ACID PRB 1,30687149,CDM,306,RC,87149,HCPCS,Outpatient,,,272,176.80,,239.36,88,,,percent of total billed charges,88% of total Billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,272,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,171.36,63,,,percent of total billed charges,63% of total billed charges,35.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,41.62,15.3,,,percent of total billed charges,15.3% of total billed charges,187.68,69,,,percent of total billed charges,69% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,272,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,272,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,76.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,92.21,33.9,,,percent of total billed charges,33.9% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,212.16,78,,,percent of total billed charges,78% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,272,
.ANA Comprehensive Plus Profile LC,30183516,CDM,301,RC,83516,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,83,
AMPHETAMINES MS 1-2,30180324,CDM,301,RC,80324,HCPCS,Outpatient,,,541,351.65,,476.08,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,541,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,340.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",82.77,15.3,,,percent of total billed charges,15.3% of total billed charges,373.29,69,,,percent of total billed charges,69% of total billed charges,541,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,541,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,541,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,203.96,37.7,,,percent of total billed charges,37.70% of total billed charges,203.96,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,183.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,421.98,78,,,percent of total billed charges,78% of total billed charges,541,100,,,percent of total billed charges,100% of total billed charges,446.87,82.6,,,percent of total billed charges,82.6% of total billed charges,446.87,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,90.89,16.8,,,percent of total billed charges,16.8% of total billed charges,82.77,541,
".Amphetamines, MS, Ur RFX LC",30180325,CDM,301,RC,80324,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,48,
".Barbirturates,MS,WB/S/P Rfx LC",30180345,CDM,301,RC,80345,HCPCS,Outpatient,,,295,191.75,,259.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,295,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,185.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",45.14,15.3,,,percent of total billed charges,15.3% of total billed charges,203.55,69,,,percent of total billed charges,69% of total billed charges,295,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,295,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,295,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,111.22,37.7,,,percent of total billed charges,37.70% of total billed charges,111.22,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,100.01,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,230.1,78,,,percent of total billed charges,78% of total billed charges,295,100,,,percent of total billed charges,100% of total billed charges,243.67,82.6,,,percent of total billed charges,82.6% of total billed charges,243.67,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,45.14,295,
".Barbiturates, MS, Ur RFX LC",30180345,CDM,301,RC,80345,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
".Benzodiazepines,MS,WB/S/P Rfx LC",30180347,CDM,301,RC,80347,HCPCS,Outpatient,,,144,93.60,,126.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,90.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",22.03,15.3,,,percent of total billed charges,15.3% of total billed charges,99.36,69,,,percent of total billed charges,69% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.29,37.7,,,percent of total billed charges,37.70% of total billed charges,54.29,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,48.82,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,112.32,78,,,percent of total billed charges,78% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.19,16.8,,,percent of total billed charges,16.8% of total billed charges,22.03,144,
".Benzodiazepines, MS, Ur RFX LC",30180347,CDM,301,RC,80347,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,48,
".Buprenorphine, MS, Ur RFX LC",30180348,CDM,301,RC,80348,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,48,
CALR (calreticulin) LC,31081219,CDM,310,RC,81219,HCPCS,Outpatient,,,580,377.00,,510.4,88,,,percent of total billed charges,88% of total Billed charges,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,580,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,365.4,63,,,percent of total billed charges,63% of total billed charges,212.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,182.45,150,,,Fee Schedule,150% of Medicare OPPS rate,400.2,69,,,percent of total billed charges,69% of total billed charges,580,100,,,percent of total billed charges,100% of total billed charges,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,580,100,,,percent of total billed charges,100% of total billed charges,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,580,100,,,percent of total billed charges,100% of total billed charges,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,465.23,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,218.66,37.7,,,percent of total billed charges,37.70% of total billed charges,218.66,37.7,,,percent of total billed charges,37.70% of total billed charges,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,196.62,33.9,,,percent of total billed charges,33.9% of total billed charges,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,452.4,78,,,percent of total billed charges,78% of total billed charges,580,100,,,percent of total billed charges,100% of total billed charges,479.08,82.6,,,percent of total billed charges,82.6% of total billed charges,479.08,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,122.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,121.63,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,580,
".Cannabinoids, MS, Ur RFX LC",30180349,CDM,301,RC,80349,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
88142 AP Bill Gyn Cytology Liquid Prep,31188142,CDM,311,RC,88142,HCPCS,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,55,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,34.65,63,,,percent of total billed charges,63% of total billed charges,35.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,30.39,150,,,Fee Schedule,150% of Medicare OPPS rate,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55,100,,,percent of total billed charges,100% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55,100,,,percent of total billed charges,100% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,77.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,18.65,33.9,,,percent of total billed charges,33.9% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,77.49,
COCAINE MS,30180353,CDM,301,RC,80353,HCPCS,Outpatient,,,382,248.30,,336.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,382,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,240.66,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",58.45,15.3,,,percent of total billed charges,15.3% of total billed charges,263.58,69,,,percent of total billed charges,69% of total billed charges,382,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,382,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,382,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,144.01,37.7,,,percent of total billed charges,37.70% of total billed charges,144.01,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,129.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,297.96,78,,,percent of total billed charges,78% of total billed charges,382,100,,,percent of total billed charges,100% of total billed charges,315.53,82.6,,,percent of total billed charges,82.6% of total billed charges,315.53,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64.18,16.8,,,percent of total billed charges,16.8% of total billed charges,58.45,382,
".Cocaine and Mtb, MS, Ur RFX LC",30180353,CDM,301,RC,80353,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
.ENA+DNA/DS+Antich+Centro+FA... LC,30183516,CDM,301,RC,83516,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,83,
ANNA TYPE 1,30286256,CDM,302,RC,86256,HCPCS,Outpatient,,,53,34.45,,46.64,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,53,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,33.39,63,,,percent of total billed charges,63% of total billed charges,21.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,8.11,15.3,,,percent of total billed charges,15.3% of total billed charges,36.57,69,,,percent of total billed charges,69% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,46.09,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,17.97,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,41.34,78,,,percent of total billed charges,78% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,53,
.Enhanced Liver Fibrosis (ELF) LC,30081517,CDM,300,RC,81517,HCPCS,Outpatient,,,1202,781.30,,1057.76,88,,,percent of total billed charges,88% of total Billed charges,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,201.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,1202,100,,,percent of total billed charges,100% of total billed charges,207.99,17.304,,,percent of total billed charges,17.304% of total billed charges,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,757.26,63,,,percent of total billed charges,63% of total billed charges,308.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,201.94,16.8,,,percent of total billed charges,16.8% of total billed charges,183.91,15.3,,,percent of total billed charges,15.3% of total billed charges,829.38,69,,,percent of total billed charges,69% of total billed charges,1202,100,,,percent of total billed charges,100% of total billed charges,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,1202,100,,,percent of total billed charges,100% of total billed charges,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,1202,100,,,percent of total billed charges,100% of total billed charges,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,201.94,16.8,,,percent of total billed charges,16.8% of total billed charges,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,201.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,205.97,17.136,,,percent of total billed charges,17.136% of total billed charges,262.52,21.84,,,percent of total billed charges,21.84% of total billed charges,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,453.15,37.7,,,percent of total billed charges,37.70% of total billed charges,453.15,37.7,,,percent of total billed charges,37.70% of total billed charges,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,407.48,33.9,,,percent of total billed charges,33.9% of total billed charges,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,937.56,78,,,percent of total billed charges,78% of total billed charges,1202,100,,,percent of total billed charges,100% of total billed charges,992.85,82.6,,,percent of total billed charges,82.6% of total billed charges,992.85,82.6,,,percent of total billed charges,82.6% of total billed charges,201.94,16.8,,,percent of total billed charges,16.8% of total billed charges,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,177.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,176.19,100,,,Fee Schedule,100% of Medicare OPPS rate,201.94,16.8,,,percent of total billed charges,16.8% of total billed charges,176.19,1202,
".Ethanol Biomarkers, MS, Ur RFX LC",30180321,CDM,301,RC,80321,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
".Fentanyl, MS, Ur, RFX LC",30180354,CDM,301,RC,80354,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,48,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,48,
.Fetal Hemoglobin LC,30183020,CDM,301,RC,83020,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,117.18,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,63.05,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,186,
.Gabapentin IA WB/SP RFX LC,30180171,CDM,301,RC,80171,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,450,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,283.5,63,,,percent of total billed charges,63% of total billed charges,37.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,450,100,,,percent of total billed charges,100% of total billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,450,100,,,percent of total billed charges,100% of total billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,82.88,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,152.55,33.9,,,percent of total billed charges,33.9% of total billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,21.88,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,450,
HIV-2,30286702,CDM,302,RC,86702,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,141.12,63,,,percent of total billed charges,63% of total billed charges,23.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,34.27,15.3,,,percent of total billed charges,15.3% of total billed charges,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,51.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,75.94,33.9,,,percent of total billed charges,33.9% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,13.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,224,
".HPV Genotypes 16/18,45 LC",30687625,CDM,306,RC,87625,HCPCS,Outpatient,,,130.87,85.07,,115.17,88,,,percent of total billed charges,88% of total Billed charges,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,130.87,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,82.45,63,,,percent of total billed charges,63% of total billed charges,70.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,20.02,15.3,,,percent of total billed charges,15.3% of total billed charges,90.3,69,,,percent of total billed charges,69% of total billed charges,130.87,100,,,percent of total billed charges,100% of total billed charges,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,130.87,100,,,percent of total billed charges,100% of total billed charges,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,130.87,100,,,percent of total billed charges,100% of total billed charges,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,155.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,49.34,37.7,,,percent of total billed charges,37.70% of total billed charges,49.34,37.7,,,percent of total billed charges,37.70% of total billed charges,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,44.36,33.9,,,percent of total billed charges,33.9% of total billed charges,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,102.08,78,,,percent of total billed charges,78% of total billed charges,130.87,100,,,percent of total billed charges,100% of total billed charges,108.1,82.6,,,percent of total billed charges,82.6% of total billed charges,108.1,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,40.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.54,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,155.1,
.Hepatitis C Genotype LC 550486,30087902,CDM,300,RC,87902,HCPCS,Outpatient,,,1391,904.15,,1224.08,88,,,percent of total billed charges,88% of total Billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,1391,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,876.33,63,,,percent of total billed charges,63% of total billed charges,450.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,212.82,15.3,,,percent of total billed charges,15.3% of total billed charges,959.79,69,,,percent of total billed charges,69% of total billed charges,1391,100,,,percent of total billed charges,100% of total billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1391,100,,,percent of total billed charges,100% of total billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1391,100,,,percent of total billed charges,100% of total billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,984.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,524.41,37.7,,,percent of total billed charges,37.70% of total billed charges,524.41,37.7,,,percent of total billed charges,37.70% of total billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,471.55,33.9,,,percent of total billed charges,33.9% of total billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1084.98,78,,,percent of total billed charges,78% of total billed charges,1391,100,,,percent of total billed charges,100% of total billed charges,1148.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1148.97,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,260.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,1391,
Hexagonal Phase Phospholipid Reflex LC 241426,30585598,CDM,305,RC,85598,HCPCS,Outpatient,,,210,136.50,,184.8,88,,,percent of total billed charges,88% of total Billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,210,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,132.3,63,,,percent of total billed charges,63% of total billed charges,31.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,32.13,15.3,,,percent of total billed charges,15.3% of total billed charges,144.9,69,,,percent of total billed charges,69% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,210,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,210,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,68.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,33.9,,,percent of total billed charges,33.9% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,163.8,78,,,percent of total billed charges,78% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,18.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,210,
Hgb Fractionation by HPLC LC,30183021,CDM,301,RC,83021,HCPCS,Outpatient,,,262,170.30,,230.56,88,,,percent of total billed charges,88% of total Billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,262,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,165.06,63,,,percent of total billed charges,63% of total billed charges,31.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,40.09,15.3,,,percent of total billed charges,15.3% of total billed charges,180.78,69,,,percent of total billed charges,69% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,262,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,262,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,69.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,88.82,33.9,,,percent of total billed charges,33.9% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,204.36,78,,,percent of total billed charges,78% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,262,
IFE PE and FLC Serum LC,30286334,CDM,302,RC,86334,HCPCS,Outpatient,,,213,138.45,,187.44,88,,,percent of total billed charges,88% of total Billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,134.19,63,,,percent of total billed charges,63% of total billed charges,39.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,32.59,15.3,,,percent of total billed charges,15.3% of total billed charges,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,85.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,72.21,33.9,,,percent of total billed charges,33.9% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,213,
BETA 2 TRANSFERRIN,30286334,CDM,302,RC,86334,HCPCS,Outpatient,,,181,117.65,,159.28,88,,,percent of total billed charges,88% of total Billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,181,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,114.03,63,,,percent of total billed charges,63% of total billed charges,39.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,27.69,15.3,,,percent of total billed charges,15.3% of total billed charges,124.89,69,,,percent of total billed charges,69% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,181,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,181,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,85.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,61.36,33.9,,,percent of total billed charges,33.9% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,141.18,78,,,percent of total billed charges,78% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,181,
.JAK2 Exons 12-15 LC ZB3RV,31081279,CDM,310,RC,81279,HCPCS,Outpatient,,,1350,877.50,,1188,88,,,percent of total billed charges,88% of total Billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,1350,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,850.5,63,,,percent of total billed charges,63% of total billed charges,324.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,277.8,150,,,Fee Schedule,150% of Medicare OPPS rate,931.5,69,,,percent of total billed charges,69% of total billed charges,1350,100,,,percent of total billed charges,100% of total billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1350,100,,,percent of total billed charges,100% of total billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1350,100,,,percent of total billed charges,100% of total billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,708.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,508.95,37.7,,,percent of total billed charges,37.70% of total billed charges,508.95,37.7,,,percent of total billed charges,37.70% of total billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,457.65,33.9,,,percent of total billed charges,33.9% of total billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1053,78,,,percent of total billed charges,78% of total billed charges,1350,100,,,percent of total billed charges,100% of total billed charges,1115.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1115.1,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,187.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,1350,
LYME WESTERN BLOT,30286617,CDM,302,RC,86617,HCPCS,Outpatient,,,377,245.05,,331.76,88,,,percent of total billed charges,88% of total Billed charges,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,377,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,237.51,63,,,percent of total billed charges,63% of total billed charges,27.1,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,57.68,15.3,,,percent of total billed charges,15.3% of total billed charges,260.13,69,,,percent of total billed charges,69% of total billed charges,377,100,,,percent of total billed charges,100% of total billed charges,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,377,100,,,percent of total billed charges,100% of total billed charges,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,377,100,,,percent of total billed charges,100% of total billed charges,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,59.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,142.13,37.7,,,percent of total billed charges,37.70% of total billed charges,142.13,37.7,,,percent of total billed charges,37.70% of total billed charges,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,127.8,33.9,,,percent of total billed charges,33.9% of total billed charges,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,294.06,78,,,percent of total billed charges,78% of total billed charges,377,100,,,percent of total billed charges,100% of total billed charges,311.4,82.6,,,percent of total billed charges,82.6% of total billed charges,311.4,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.49,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,377,
SENSITIVITY ADD'L-MIC,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,369,239.85,,324.72,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,369,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,232.47,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,56.46,15.3,,,percent of total billed charges,15.3% of total billed charges,254.61,69,,,percent of total billed charges,69% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,125.09,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,287.82,78,,,percent of total billed charges,78% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,369,
SENSITIVITY ADD'L-MIC,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,369,239.85,,324.72,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,369,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,232.47,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,56.46,15.3,,,percent of total billed charges,15.3% of total billed charges,254.61,69,,,percent of total billed charges,69% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,125.09,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,287.82,78,,,percent of total billed charges,78% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,369,
".Methadone,MS,WB/S/P Rfx LC",30180358,CDM,301,RC,80358,HCPCS,Outpatient,,,456,296.40,,401.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,456,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,287.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",69.77,15.3,,,percent of total billed charges,15.3% of total billed charges,314.64,69,,,percent of total billed charges,69% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,456,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,456,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,154.58,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,355.68,78,,,percent of total billed charges,78% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.61,16.8,,,percent of total billed charges,16.8% of total billed charges,69.77,456,
".Methadone, MS, Ur RFX LC",30180358,CDM,301,RC,80358,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
AFB SENSITIVITY,30687188,CDM,306,RC,87188,HCPCS,Outpatient,,,156,101.40,,137.28,88,,,percent of total billed charges,88% of total Billed charges,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,156,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,98.28,63,,,percent of total billed charges,63% of total billed charges,11.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,23.87,15.3,,,percent of total billed charges,15.3% of total billed charges,107.64,69,,,percent of total billed charges,69% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,25.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,52.88,33.9,,,percent of total billed charges,33.9% of total billed charges,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,121.68,78,,,percent of total billed charges,78% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,6.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.64,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,156,
SENSITIVITY ADD'L-MIC,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,369,239.85,,324.72,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,369,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,232.47,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,56.46,15.3,,,percent of total billed charges,15.3% of total billed charges,254.61,69,,,percent of total billed charges,69% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,125.09,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,287.82,78,,,percent of total billed charges,78% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,369,
".Opiates,MS,WB/S/P Rfx LC",30180361,CDM,301,RC,80361,HCPCS,Outpatient,,,95,61.75,,83.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,95,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",14.54,15.3,,,percent of total billed charges,15.3% of total billed charges,65.55,69,,,percent of total billed charges,69% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,95,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,95,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.82,37.7,,,percent of total billed charges,37.70% of total billed charges,35.82,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,32.21,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,74.1,78,,,percent of total billed charges,78% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,14.54,95,
".Opiate Class, MS, Ur RFX LC",30180361,CDM,301,RC,80361,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
ACID-FAST BACILLI ID,30687153,CDM,306,RC,87153,HCPCS,Outpatient,,,473,307.45,,416.24,88,,,percent of total billed charges,88% of total Billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,473,100,,,percent of total billed charges,100% of total billed charges,100.54,103,,,Fee Schedule,103% of WA Medicaid,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,297.99,63,,,percent of total billed charges,63% of total billed charges,201.88,175,,,Fee Schedule,175% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,72.37,15.3,,,percent of total billed charges,15.3% of total billed charges,326.37,69,,,percent of total billed charges,69% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,441.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,72.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,99.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.89,130,,,Fee Schedule,130% of WA Medicaid ,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,160.35,33.9,,,percent of total billed charges,33.9% of total billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,368.94,78,,,percent of total billed charges,78% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,116.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.3,473,
ACID-FAST BACILLI ID,30687153,CDM,306,RC,87153,HCPCS,Outpatient,,,473,307.45,,416.24,88,,,percent of total billed charges,88% of total Billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,473,100,,,percent of total billed charges,100% of total billed charges,100.54,103,,,Fee Schedule,103% of WA Medicaid,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,297.99,63,,,percent of total billed charges,63% of total billed charges,201.88,175,,,Fee Schedule,175% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,72.37,15.3,,,percent of total billed charges,15.3% of total billed charges,326.37,69,,,percent of total billed charges,69% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,441.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,72.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,99.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.89,130,,,Fee Schedule,130% of WA Medicaid ,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,160.35,33.9,,,percent of total billed charges,33.9% of total billed charges,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,368.94,78,,,percent of total billed charges,78% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,116.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,115.36,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.3,473,
".Oxycodones,MS,WB/S/P Rfx LC",30180365,CDM,301,RC,80365,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,152.55,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
".Oxycodone Class, MS, Ur RFX LC",30180365,CDM,301,RC,80365,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
PTT-LA Incub Mix Reflex LC 241426,30585732,CDM,305,RC,85732,HCPCS,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,85.05,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,45.77,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,135,
PTT-LA Mix Reflex LC 241426,30585732,CDM,305,RC,85732,HCPCS,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,85.05,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,45.77,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,135,
".Pap IG, Ct-Ng TV LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,433.2,281.58,,381.22,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,433.2,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.92,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,298.91,69,,,percent of total billed charges,69% of total billed charges,433.2,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,433.2,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,433.2,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,163.32,37.7,,,percent of total billed charges,37.70% of total billed charges,163.32,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,146.85,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,337.9,78,,,percent of total billed charges,78% of total billed charges,433.2,100,,,percent of total billed charges,100% of total billed charges,357.82,82.6,,,percent of total billed charges,82.6% of total billed charges,357.82,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,433.2,
".Phencyclidine,MS,WB/S/P Rfx LC",30183992,CDM,301,RC,83992,HCPCS,Outpatient,,,73,47.45,,64.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,9.88,100,,,Fee Schedule,100% of WA Medicaid,73,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,45.99,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.88,100,,,Fee Schedule,100% of WA Medicaid,11.17,15.3,,,percent of total billed charges,15.3% of total billed charges,50.37,69,,,percent of total billed charges,69% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,73,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,73,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,24.75,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,56.94,78,,,percent of total billed charges,78% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,73,
".Phencyclidine, MS, Ur RFX LC",30183992,CDM,301,RC,83992,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,9.88,100,,,Fee Schedule,100% of WA Medicaid,45,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.88,100,,,Fee Schedule,100% of WA Medicaid,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.89,45,
".Propoxyphene,MS,WB/S/P Rfx LC",30180367,CDM,301,RC,80367,HCPCS,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,27,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,27,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.18,37.7,,,percent of total billed charges,37.70% of total billed charges,10.18,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,9.15,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
".Propoxyphene, MS, Ur RFX LC",30180367,CDM,301,RC,80367,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
HIV DNA BY PCR,30687535,CDM,306,RC,87535,HCPCS,Outpatient,,,394,256.10,,346.72,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,394,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,248.22,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,60.28,15.3,,,percent of total billed charges,15.3% of total billed charges,271.86,69,,,percent of total billed charges,69% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,394,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,394,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,133.57,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,307.32,78,,,percent of total billed charges,78% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,394,
HIV DNA BY PCR,30687535,CDM,306,RC,87535,HCPCS,Outpatient,,,394,256.10,,346.72,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,394,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,248.22,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,60.28,15.3,,,percent of total billed charges,15.3% of total billed charges,271.86,69,,,percent of total billed charges,69% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,394,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,394,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,133.57,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,307.32,78,,,percent of total billed charges,78% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,394,
.RPR LC,30286592,CDM,302,RC,86592,HCPCS,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,104,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,15.91,15.3,,,percent of total billed charges,15.3% of total billed charges,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,35.26,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,104,
VDRL/RPR(QUANT),30286593,CDM,302,RC,86593,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,53.55,63,,,percent of total billed charges,63% of total billed charges,7.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,16.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.4,85,
SENSITIVITY ADD'L-MIC,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,369,239.85,,324.72,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,369,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,232.47,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,56.46,15.3,,,percent of total billed charges,15.3% of total billed charges,254.61,69,,,percent of total billed charges,69% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,125.09,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,287.82,78,,,percent of total billed charges,78% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,369,
"SYMPATHOMIMETICS, Amphetamines LC",30980326,CDM,309,RC,80326,HCPCS,Outpatient,,,225,146.25,,198,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,141.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",34.43,15.3,,,percent of total billed charges,15.3% of total billed charges,155.25,69,,,percent of total billed charges,69% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,225,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,225,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,76.28,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,175.5,78,,,percent of total billed charges,78% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.8,16.8,,,percent of total billed charges,16.8% of total billed charges,34.43,225,
.Serotonin Release Assay LC,30182542,CDM,301,RC,82542,HCPCS,Outpatient,,,213,138.45,,187.44,88,,,percent of total billed charges,88% of total Billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.19,63,,,percent of total billed charges,63% of total billed charges,42.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,32.59,15.3,,,percent of total billed charges,15.3% of total billed charges,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,92.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,72.21,33.9,,,percent of total billed charges,33.9% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,213,
SENSITIVITY ADD'L-MIC,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,369,239.85,,324.72,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,369,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,232.47,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,56.46,15.3,,,percent of total billed charges,15.3% of total billed charges,254.61,69,,,percent of total billed charges,69% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,369,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,125.09,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,287.82,78,,,percent of total billed charges,78% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,369,
".THC,MS,WB/S/P Rfx LC",30180349,CDM,301,RC,80349,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,152.55,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
TT PT/PSO4 MIX,30585670,CDM,305,RC,85670,HCPCS,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,29,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,18.27,63,,,percent of total billed charges,63% of total billed charges,10.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,29,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,29,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,22.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10.93,37.7,,,percent of total billed charges,37.70% of total billed charges,10.93,37.7,,,percent of total billed charges,37.70% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9.83,33.9,,,percent of total billed charges,33.9% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,29,
".Tapentadol, MS, Ur RFX LC",30180372,CDM,301,RC,80372,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
.Thrombin Neut 117203 LC,030585670R,CDM,305,RC,85670,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,23.31,63,,,percent of total billed charges,63% of total billed charges,10.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,22.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12.54,33.9,,,percent of total billed charges,33.9% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,37,
THYROGLOBULIN,30184432,CDM,301,RC,84432,HCPCS,Outpatient,,,270,175.50,,237.6,88,,,percent of total billed charges,88% of total Billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,270,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,170.1,63,,,percent of total billed charges,63% of total billed charges,28.1,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,41.31,15.3,,,percent of total billed charges,15.3% of total billed charges,186.3,69,,,percent of total billed charges,69% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,270,100,,,percent of total billed charges,100% of total billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,270,100,,,percent of total billed charges,100% of total billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,61.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,91.53,33.9,,,percent of total billed charges,33.9% of total billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,210.6,78,,,percent of total billed charges,78% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16.22,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,270,
.ThyraMIR LC,3100018,CDM,310,RC,0018U,HCPCS,Outpatient,,,8000,5200.00,,7040,88,,,percent of total billed charges,88% of total Billed charges,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,5040,63,,,percent of total billed charges,63% of total billed charges,5253.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,,,,,Other,"Not Separately reimbursable
",4503.14,150,,,Fee Schedule,150% of Medicare OPPS rate,5520,69,,,percent of total billed charges,69% of total billed charges,8000,100,,,percent of total billed charges,100% of total billed charges,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,8000,100,,,percent of total billed charges,100% of total billed charges,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,8000,100,,,percent of total billed charges,100% of total billed charges,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,11482.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,,,,,Other,Not Separately reimbursable,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,3016,37.7,,,percent of total billed charges,37.70% of total billed charges,3016,37.7,,,percent of total billed charges,37.70% of total billed charges,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,2712,33.9,,,percent of total billed charges,33.9% of total billed charges,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,6240,78,,,percent of total billed charges,78% of total billed charges,8000,100,,,percent of total billed charges,100% of total billed charges,6608,82.6,,,percent of total billed charges,82.6% of total billed charges,6608,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,3032.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3002.09,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,"Not Separately reimbursable
",2712,11482.99,
.Tramadol Conf. LC,30080373,CDM,300,RC,80373,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,152.55,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
".Tramadol, MS, Ur RFX LC",30180373,CDM,301,RC,80373,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
.Trich vag by NAA LC,30687661,CDM,306,RC,87661,HCPCS,Outpatient,,,188,122.20,,165.44,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,188,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,118.44,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,28.76,15.3,,,percent of total billed charges,15.3% of total billed charges,129.72,69,,,percent of total billed charges,69% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,188,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,188,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,63.73,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,146.64,78,,,percent of total billed charges,78% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,188,
VIRAL CULTURE SHELL,30687254,CDM,306,RC,87254,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,55.44,63,,,percent of total billed charges,63% of total billed charges,34.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,74.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,29.83,33.9,,,percent of total billed charges,33.9% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,19.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,88,
.aPTT 1:1 Normal Plasma 117159 LC,030585730R,CDM,305,RC,85730,HCPCS,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,39,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,24.57,63,,,percent of total billed charges,63% of total billed charges,10.51,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,39,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,39,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,22.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,14.7,37.7,,,percent of total billed charges,37.70% of total billed charges,14.7,37.7,,,percent of total billed charges,37.70% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,13.22,33.9,,,percent of total billed charges,33.9% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,39,
dRVVT Mix Reflex LC 241426,30585613,CDM,305,RC,85613,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,56.7,63,,,percent of total billed charges,63% of total billed charges,16.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,36.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,30.51,33.9,,,percent of total billed charges,33.9% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,90,
dRVVT Confirm Reflex LC 241426,30585613,CDM,305,RC,85613,HCPCS,Outpatient,,,143,92.95,,125.84,88,,,percent of total billed charges,88% of total Billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,143,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,90.09,63,,,percent of total billed charges,63% of total billed charges,16.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,21.88,15.3,,,percent of total billed charges,15.3% of total billed charges,98.67,69,,,percent of total billed charges,69% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,36.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,48.48,33.9,,,percent of total billed charges,33.9% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,111.54,78,,,percent of total billed charges,78% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,143,
.dRVVT Confirm 117924 LC,030585613R,CDM,305,RC,85613,HCPCS,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,61,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,38.43,63,,,percent of total billed charges,63% of total billed charges,16.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,36.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,23,37.7,,,percent of total billed charges,37.70% of total billed charges,23,37.7,,,percent of total billed charges,37.70% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,20.68,33.9,,,percent of total billed charges,33.9% of total billed charges,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,9.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,61,
009191 Pap Smear 2 Slides LC,31188164,CDM,311,RC,88164,HCPCS,Outpatient,,,90.72,58.97,,79.83,88,,,percent of total billed charges,88% of total Billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,90.72,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,57.15,63,,,percent of total billed charges,63% of total billed charges,31.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,26.64,150,,,Fee Schedule,150% of Medicare OPPS rate,62.6,69,,,percent of total billed charges,69% of total billed charges,90.72,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,90.72,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,90.72,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,57.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,34.2,37.7,,,percent of total billed charges,37.70% of total billed charges,34.2,37.7,,,percent of total billed charges,37.70% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,30.75,33.9,,,percent of total billed charges,33.9% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,70.76,78,,,percent of total billed charges,78% of total billed charges,90.72,100,,,percent of total billed charges,100% of total billed charges,74.93,82.6,,,percent of total billed charges,82.6% of total billed charges,74.93,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,90.72,
"IFE, Dara-Specific, Serum LC",30086334,CDM,302,RC,86334,HCPCS,Outpatient,,,213,138.45,,187.44,88,,,percent of total billed charges,88% of total Billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,134.19,63,,,percent of total billed charges,63% of total billed charges,39.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,32.59,15.3,,,percent of total billed charges,15.3% of total billed charges,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,85.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,72.21,33.9,,,percent of total billed charges,33.9% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,213,
17-OH Progesterone LCMS LC,30183498,CDM,301,RC,83498,HCPCS,Outpatient,,,525,341.25,,462,88,,,percent of total billed charges,88% of total Billed charges,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,525,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,330.75,63,,,percent of total billed charges,63% of total billed charges,47.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,80.33,15.3,,,percent of total billed charges,15.3% of total billed charges,362.25,69,,,percent of total billed charges,69% of total billed charges,525,100,,,percent of total billed charges,100% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,525,100,,,percent of total billed charges,100% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,525,100,,,percent of total billed charges,100% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,103.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,197.93,37.7,,,percent of total billed charges,37.70% of total billed charges,197.93,37.7,,,percent of total billed charges,37.70% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,177.98,33.9,,,percent of total billed charges,33.9% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,409.5,78,,,percent of total billed charges,78% of total billed charges,525,100,,,percent of total billed charges,100% of total billed charges,433.65,82.6,,,percent of total billed charges,82.6% of total billed charges,433.65,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,27.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.17,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,525,
"180071 Vaginitis + HSV, NuSwab LC",30687801,CDM,306,RC,87801,HCPCS,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,200,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,126,63,,,percent of total billed charges,63% of total billed charges,122.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,200,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,200,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,268.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,67.8,33.9,,,percent of total billed charges,33.9% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,268.51,
"183444 MTB-RIF, AFB sm/cul, Sputum LC",30687116,CDM,306,RC,87116,HCPCS,Outpatient,,,499,324.35,,439.12,88,,,percent of total billed charges,88% of total Billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,499,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,314.37,63,,,percent of total billed charges,63% of total billed charges,18.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,76.35,15.3,,,percent of total billed charges,15.3% of total billed charges,344.31,69,,,percent of total billed charges,69% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,499,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,499,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,169.16,33.9,,,percent of total billed charges,33.9% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,389.22,78,,,percent of total billed charges,78% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,499,
"2019 Novel Coronavirus (CoVID-19), NAA LC",30687635,CDM,306,RC,87635,HCPCS,Outpatient,,,268,174.20,,235.84,88,,,percent of total billed charges,88% of total Billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,268,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,168.84,63,,,percent of total billed charges,63% of total billed charges,89.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,41,15.3,,,percent of total billed charges,15.3% of total billed charges,184.92,69,,,percent of total billed charges,69% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,268,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,268,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,101.04,37.7,,,percent of total billed charges,37.70% of total billed charges,101.04,37.7,,,percent of total billed charges,37.70% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,90.85,33.9,,,percent of total billed charges,33.9% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,209.04,78,,,percent of total billed charges,78% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,268,
"2019 Novel Coronavirus (CoVID19), NAA INC",30687635,CDM,306,RC,87635,HCPCS,Outpatient,,,228,148.20,,200.64,88,,,percent of total billed charges,88% of total Billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,228,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,143.64,63,,,percent of total billed charges,63% of total billed charges,89.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,34.88,15.3,,,percent of total billed charges,15.3% of total billed charges,157.32,69,,,percent of total billed charges,69% of total billed charges,228,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,228,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,228,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,85.96,37.7,,,percent of total billed charges,37.70% of total billed charges,85.96,37.7,,,percent of total billed charges,37.70% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,77.29,33.9,,,percent of total billed charges,33.9% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,177.84,78,,,percent of total billed charges,78% of total billed charges,228,100,,,percent of total billed charges,100% of total billed charges,188.33,82.6,,,percent of total billed charges,82.6% of total billed charges,188.33,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,228,
25-Hydroxyvitamin D LCMS D2+D3 LC,30182306,CDM,301,RC,82306,HCPCS,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,220,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,138.6,63,,,percent of total billed charges,63% of total billed charges,51.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,33.66,15.3,,,percent of total billed charges,15.3% of total billed charges,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,220,100,,,percent of total billed charges,100% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,220,100,,,percent of total billed charges,100% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,113.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,74.58,33.9,,,percent of total billed charges,33.9% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,220,
"480875  KRAS Gene Mutation Analysis, IVD LC",31081275,CDM,310,RC,81275,HCPCS,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,567,63,,,percent of total billed charges,63% of total billed charges,338.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,289.88,150,,,Fee Schedule,150% of Medicare OPPS rate,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,900,100,,,percent of total billed charges,100% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,900,100,,,percent of total billed charges,100% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,739.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,305.1,33.9,,,percent of total billed charges,33.9% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,195.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,900,
KRAS Extended Analysis LC,31081275,CDM,310,RC,81275,HCPCS,Outpatient,,,1454,945.10,,1279.52,88,,,percent of total billed charges,88% of total Billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,1454,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,916.02,63,,,percent of total billed charges,63% of total billed charges,338.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,289.88,150,,,Fee Schedule,150% of Medicare OPPS rate,1003.26,69,,,percent of total billed charges,69% of total billed charges,1454,100,,,percent of total billed charges,100% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1454,100,,,percent of total billed charges,100% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1454,100,,,percent of total billed charges,100% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,739.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,548.16,37.7,,,percent of total billed charges,37.70% of total billed charges,548.16,37.7,,,percent of total billed charges,37.70% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,492.91,33.9,,,percent of total billed charges,33.9% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.12,78,,,percent of total billed charges,78% of total billed charges,1454,100,,,percent of total billed charges,100% of total billed charges,1201,82.6,,,percent of total billed charges,82.6% of total billed charges,1201,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,195.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,1454,
"481120 NRAS Gene Mutation Analysis, Extended LC",30181311,CDM,310,RC,81311,HCPCS,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,1000,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,630,63,,,percent of total billed charges,63% of total billed charges,517.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,443.69,150,,,Fee Schedule,150% of Medicare OPPS rate,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,1000,100,,,percent of total billed charges,100% of total billed charges,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,1000,100,,,percent of total billed charges,100% of total billed charges,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,1131.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,377,37.7,,,percent of total billed charges,37.70% of total billed charges,377,37.7,,,percent of total billed charges,37.70% of total billed charges,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,339,33.9,,,percent of total billed charges,33.9% of total billed charges,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,298.74,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,295.79,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,1131.39,
"489555 Jak2, Quant w/rfx CALR 12-15 LC",31081270,CDM,310,RC,81270,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,600,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,378,63,,,percent of total billed charges,63% of total billed charges,160.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,137.49,150,,,Fee Schedule,150% of Medicare OPPS rate,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,600,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,600,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,350.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,92.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,600,
5' Nucleotidase LC,30183915,CDM,301,RC,83915,HCPCS,Outpatient,,,228,148.20,,200.64,88,,,percent of total billed charges,88% of total Billed charges,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,228,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,143.64,63,,,percent of total billed charges,63% of total billed charges,19.51,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,34.88,15.3,,,percent of total billed charges,15.3% of total billed charges,157.32,69,,,percent of total billed charges,69% of total billed charges,228,100,,,percent of total billed charges,100% of total billed charges,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,228,100,,,percent of total billed charges,100% of total billed charges,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,228,100,,,percent of total billed charges,100% of total billed charges,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,42.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,85.96,37.7,,,percent of total billed charges,37.70% of total billed charges,85.96,37.7,,,percent of total billed charges,37.70% of total billed charges,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,77.29,33.9,,,percent of total billed charges,33.9% of total billed charges,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,177.84,78,,,percent of total billed charges,78% of total billed charges,228,100,,,percent of total billed charges,100% of total billed charges,188.33,82.6,,,percent of total billed charges,82.6% of total billed charges,188.33,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,11.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.15,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,228,
CREATININE URINE RANDOM,30182570,CDM,301,RC,82570,HCPCS,Outpatient,,,71,46.15,,62.48,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,71,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,44.73,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,10.86,15.3,,,percent of total billed charges,15.3% of total billed charges,48.99,69,,,percent of total billed charges,69% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,71,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,71,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,26.77,37.7,,,percent of total billed charges,37.70% of total billed charges,26.77,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.07,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,55.38,78,,,percent of total billed charges,78% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,71,
"5-HIAA,Quant 24 Hr Urine LC 004069",30183497,CDM,301,RC,83497,HCPCS,Outpatient,,,131,85.15,,115.28,88,,,percent of total billed charges,88% of total Billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,131,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,82.53,63,,,percent of total billed charges,63% of total billed charges,22.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,20.04,15.3,,,percent of total billed charges,15.3% of total billed charges,90.39,69,,,percent of total billed charges,69% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,131,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,131,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,49.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,49.39,37.7,,,percent of total billed charges,37.70% of total billed charges,49.39,37.7,,,percent of total billed charges,37.70% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,44.41,33.9,,,percent of total billed charges,33.9% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,102.18,78,,,percent of total billed charges,78% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,13.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,131,
80055 Obstetric panel,30180055,CDM,301,RC,80055,HCPCS,Outpatient,,,143,92.95,,125.84,88,,,percent of total billed charges,88% of total Billed charges,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,143,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,90.09,63,,,percent of total billed charges,63% of total billed charges,83.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,21.88,15.3,,,percent of total billed charges,15.3% of total billed charges,98.67,69,,,percent of total billed charges,69% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,182.87,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,48.48,33.9,,,percent of total billed charges,33.9% of total billed charges,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,111.54,78,,,percent of total billed charges,78% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,48.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,47.81,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,182.87,
"Drug Screen 17 w/Conf, Ur LC",30180307,CDM,301,RC,80307,HCPCS,Outpatient,,,1080,702.00,,950.4,88,,,percent of total billed charges,88% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,181.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1080,100,,,percent of total billed charges,100% of total billed charges,186.88,17.304,,,percent of total billed charges,17.304% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,680.4,63,,,percent of total billed charges,63% of total billed charges,108.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,181.44,16.8,,,percent of total billed charges,16.8% of total billed charges,165.24,15.3,,,percent of total billed charges,15.3% of total billed charges,745.2,69,,,percent of total billed charges,69% of total billed charges,1080,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1080,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1080,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,237.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,181.44,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,181.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,185.07,17.136,,,percent of total billed charges,17.136% of total billed charges,235.87,21.84,,,percent of total billed charges,21.84% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,407.16,37.7,,,percent of total billed charges,37.70% of total billed charges,407.16,37.7,,,percent of total billed charges,37.70% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,366.12,33.9,,,percent of total billed charges,33.9% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,842.4,78,,,percent of total billed charges,78% of total billed charges,1080,100,,,percent of total billed charges,100% of total billed charges,892.08,82.6,,,percent of total billed charges,82.6% of total billed charges,892.08,82.6,,,percent of total billed charges,82.6% of total billed charges,181.44,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,181.44,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,1080,
Blood Gas Arterial,30082803,CDM,300,RC,82803,HCPCS,Outpatient,,,413,268.45,,363.44,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,413,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,260.19,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,63.19,15.3,,,percent of total billed charges,15.3% of total billed charges,284.97,69,,,percent of total billed charges,69% of total billed charges,413,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,413,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,413,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,155.7,37.7,,,percent of total billed charges,37.70% of total billed charges,155.7,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,140.01,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,322.14,78,,,percent of total billed charges,78% of total billed charges,413,100,,,percent of total billed charges,100% of total billed charges,341.14,82.6,,,percent of total billed charges,82.6% of total billed charges,341.14,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,413,
Blood Gas Arterial,30082803,CDM,300,RC,82803,HCPCS,Outpatient,,,160,104.00,,140.8,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,160,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,100.8,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,24.48,15.3,,,percent of total billed charges,15.3% of total billed charges,110.4,69,,,percent of total billed charges,69% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,54.24,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,124.8,78,,,percent of total billed charges,78% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,160,
"ACTH, Plasma LC",30182024,CDM,301,RC,82024,HCPCS,Outpatient,,,947,615.55,,833.36,88,,,percent of total billed charges,88% of total Billed charges,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,947,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,596.61,63,,,percent of total billed charges,63% of total billed charges,67.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,144.89,15.3,,,percent of total billed charges,15.3% of total billed charges,653.43,69,,,percent of total billed charges,69% of total billed charges,947,100,,,percent of total billed charges,100% of total billed charges,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,947,100,,,percent of total billed charges,100% of total billed charges,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,947,100,,,percent of total billed charges,100% of total billed charges,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,147.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,357.02,37.7,,,percent of total billed charges,37.70% of total billed charges,357.02,37.7,,,percent of total billed charges,37.70% of total billed charges,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,321.03,33.9,,,percent of total billed charges,33.9% of total billed charges,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,738.66,78,,,percent of total billed charges,78% of total billed charges,947,100,,,percent of total billed charges,100% of total billed charges,782.22,82.6,,,percent of total billed charges,82.6% of total billed charges,782.22,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,38.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.6,947,
AChR Binding Abs LC,30183519,CDM,301,RC,83519,HCPCS,Outpatient,,,197,128.05,,173.36,88,,,percent of total billed charges,88% of total Billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,197,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,32.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,30.14,15.3,,,percent of total billed charges,15.3% of total billed charges,135.93,69,,,percent of total billed charges,69% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,197,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,197,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,70.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,74.27,37.7,,,percent of total billed charges,37.70% of total billed charges,74.27,37.7,,,percent of total billed charges,37.70% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,66.78,33.9,,,percent of total billed charges,33.9% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,153.66,78,,,percent of total billed charges,78% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.58,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,197,
AChR Blocking Abs LC,30183519,CDM,301,RC,83519,HCPCS,Outpatient,,,193,125.45,,169.84,88,,,percent of total billed charges,88% of total Billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,193,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,32.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,29.53,15.3,,,percent of total billed charges,15.3% of total billed charges,133.17,69,,,percent of total billed charges,69% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,193,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,193,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,70.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,65.43,33.9,,,percent of total billed charges,33.9% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,150.54,78,,,percent of total billed charges,78% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.58,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,193,
AChR Modulating Antibodies LC,30183519,CDM,301,RC,83519,HCPCS,Outpatient,,,193,125.45,,169.84,88,,,percent of total billed charges,88% of total Billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,193,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,32.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,29.53,15.3,,,percent of total billed charges,15.3% of total billed charges,133.17,69,,,percent of total billed charges,69% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,193,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,193,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,70.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,65.43,33.9,,,percent of total billed charges,33.9% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,150.54,78,,,percent of total billed charges,78% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.58,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,193,
"Vasopressin (antidiuretic hormone, ADH) LC",30184588,CDM,301,RC,84588,HCPCS,Outpatient,,,167.25,108.71,,147.18,88,,,percent of total billed charges,88% of total Billed charges,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,167.25,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,105.37,63,,,percent of total billed charges,63% of total billed charges,59.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,25.59,15.3,,,percent of total billed charges,15.3% of total billed charges,115.4,69,,,percent of total billed charges,69% of total billed charges,167.25,100,,,percent of total billed charges,100% of total billed charges,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,167.25,100,,,percent of total billed charges,100% of total billed charges,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,167.25,100,,,percent of total billed charges,100% of total billed charges,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,129.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,63.05,37.7,,,percent of total billed charges,37.70% of total billed charges,63.05,37.7,,,percent of total billed charges,37.70% of total billed charges,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,56.7,33.9,,,percent of total billed charges,33.9% of total billed charges,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,130.46,78,,,percent of total billed charges,78% of total billed charges,167.25,100,,,percent of total billed charges,100% of total billed charges,138.15,82.6,,,percent of total billed charges,82.6% of total billed charges,138.15,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,34.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33.94,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.6,167.25,
CULTURE ID NUCLEIC ACID PRB 1,30687149,CDM,306,RC,87149,HCPCS,Outpatient,,,272,176.80,,239.36,88,,,percent of total billed charges,88% of total Billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,272,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,171.36,63,,,percent of total billed charges,63% of total billed charges,35.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,41.62,15.3,,,percent of total billed charges,15.3% of total billed charges,187.68,69,,,percent of total billed charges,69% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,272,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,272,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,76.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,92.21,33.9,,,percent of total billed charges,33.9% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,212.16,78,,,percent of total billed charges,78% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,272,
AFP Tetra (PR4),30286336,CDM,302,RC,86336,HCPCS,Outpatient,,,107,69.55,,94.16,88,,,percent of total billed charges,88% of total Billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,107,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,67.41,63,,,percent of total billed charges,63% of total billed charges,27.28,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,16.37,15.3,,,percent of total billed charges,15.3% of total billed charges,73.83,69,,,percent of total billed charges,69% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,107,100,,,percent of total billed charges,100% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,107,100,,,percent of total billed charges,100% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,59.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,36.27,33.9,,,percent of total billed charges,33.9% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,83.46,78,,,percent of total billed charges,78% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,15.74,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,107,
"AFP, Tumor Marker LC",30182105,CDM,301,RC,82105,HCPCS,Outpatient,,,429,278.85,,377.52,88,,,percent of total billed charges,88% of total Billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,429,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,270.27,63,,,percent of total billed charges,63% of total billed charges,29.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,65.64,15.3,,,percent of total billed charges,15.3% of total billed charges,296.01,69,,,percent of total billed charges,69% of total billed charges,429,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,429,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,429,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,64.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,161.73,37.7,,,percent of total billed charges,37.70% of total billed charges,161.73,37.7,,,percent of total billed charges,37.70% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,145.43,33.9,,,percent of total billed charges,33.9% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,334.62,78,,,percent of total billed charges,78% of total billed charges,429,100,,,percent of total billed charges,100% of total billed charges,354.35,82.6,,,percent of total billed charges,82.6% of total billed charges,354.35,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,429,
"AFP, Open Spina Bifida LC",30182105,CDM,301,RC,82105,HCPCS,Outpatient,,,408,265.20,,359.04,88,,,percent of total billed charges,88% of total Billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,408,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,257.04,63,,,percent of total billed charges,63% of total billed charges,29.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,62.42,15.3,,,percent of total billed charges,15.3% of total billed charges,281.52,69,,,percent of total billed charges,69% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,64.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,138.31,33.9,,,percent of total billed charges,33.9% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,318.24,78,,,percent of total billed charges,78% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,408,
"AFP/AChE/HbF, Amniotic Fluid LC",30082106,CDM,300,RC,82106,HCPCS,Outpatient,,,139,90.35,,122.32,88,,,percent of total billed charges,88% of total Billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17,100,,,Fee Schedule,100% of Medicare OPPS rate,87.57,63,,,percent of total billed charges,63% of total billed charges,29.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,65.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17,100,,,Fee Schedule,100% of Medicare OPPS rate,17,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17,100,,,Fee Schedule,100% of Medicare OPPS rate,17,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17,100,,,Fee Schedule,100% of Medicare OPPS rate,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,17,100,,,Fee Schedule,100% of Medicare OPPS rate,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17,100,,,Fee Schedule,100% of Medicare OPPS rate,17.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,139,
SGPT OR ALT,30184460,CDM,301,RC,84460,HCPCS,Outpatient,,,116,75.40,,102.08,88,,,percent of total billed charges,88% of total Billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,116,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,73.08,63,,,percent of total billed charges,63% of total billed charges,9.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,17.75,15.3,,,percent of total billed charges,15.3% of total billed charges,80.04,69,,,percent of total billed charges,69% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,116,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,116,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,20.27,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,39.32,33.9,,,percent of total billed charges,33.9% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,90.48,78,,,percent of total billed charges,78% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.35,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,116,
Transferase; alanine amino (ALT) (SGPT) LC,30184460,CDM,301,RC,84460,HCPCS,Outpatient,,,97,63.05,,85.36,88,,,percent of total billed charges,88% of total Billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,97,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,61.11,63,,,percent of total billed charges,63% of total billed charges,9.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.84,15.3,,,percent of total billed charges,15.3% of total billed charges,66.93,69,,,percent of total billed charges,69% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,20.27,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,32.88,33.9,,,percent of total billed charges,33.9% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,75.66,78,,,percent of total billed charges,78% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,5.35,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,97,
ANNA TYPE 1,30286256,CDM,302,RC,86256,HCPCS,Outpatient,,,53,34.45,,46.64,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,53,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,33.39,63,,,percent of total billed charges,63% of total billed charges,21.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,8.11,15.3,,,percent of total billed charges,15.3% of total billed charges,36.57,69,,,percent of total billed charges,69% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,46.09,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,17.97,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,41.34,78,,,percent of total billed charges,78% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,53,
ANA w/Rflx+C3+C4+RA QN+CCP(... LC,30286160,CDM,302,RC,86160,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12,100,,,Fee Schedule,100% of Medicare OPPS rate,53.55,63,,,percent of total billed charges,63% of total billed charges,21,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,45.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12.12,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,85,
ANA W/Rfx to all if Positive,30286038,CDM,302,RC,86038,HCPCS,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,56,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.28,63,,,percent of total billed charges,63% of total billed charges,21.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,46.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.98,33.9,,,percent of total billed charges,33.9% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,56,
ANA w/Reflex LC,30286038,CDM,302,RC,86038,HCPCS,Outpatient,,,66,42.90,,58.08,88,,,percent of total billed charges,88% of total Billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,66,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,41.58,63,,,percent of total billed charges,63% of total billed charges,21.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,10.1,15.3,,,percent of total billed charges,15.3% of total billed charges,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,46.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,22.37,33.9,,,percent of total billed charges,33.9% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,66,
ANCA Profile LC,30286037,CDM,302,RC,86037,HCPCS,Outpatient,,,36.15,23.50,,31.81,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,36.15,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,22.77,63,,,percent of total billed charges,63% of total billed charges,21.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,5.53,15.3,,,percent of total billed charges,15.3% of total billed charges,24.94,69,,,percent of total billed charges,69% of total billed charges,36.15,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,36.15,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,36.15,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.63,37.7,,,percent of total billed charges,37.70% of total billed charges,13.63,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,28.2,78,,,percent of total billed charges,78% of total billed charges,36.15,100,,,percent of total billed charges,100% of total billed charges,29.86,82.6,,,percent of total billed charges,82.6% of total billed charges,29.86,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.53,36.15,
ANCA+Sca(IgA/G) LC,30286671,CDM,302,RC,86671,HCPCS,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,60.48,63,,,percent of total billed charges,63% of total billed charges,21.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,46.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,32.54,33.9,,,percent of total billed charges,33.9% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,96,
ANCA by IFA (RDL) LC,30286036,CDM,302,RC,86036,HCPCS,Outpatient,,,36.15,23.50,,31.81,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,36.15,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,22.77,63,,,percent of total billed charges,63% of total billed charges,21.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,5.53,15.3,,,percent of total billed charges,15.3% of total billed charges,24.94,69,,,percent of total billed charges,69% of total billed charges,36.15,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,36.15,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,36.15,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.63,37.7,,,percent of total billed charges,37.70% of total billed charges,13.63,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,28.2,78,,,percent of total billed charges,78% of total billed charges,36.15,100,,,percent of total billed charges,100% of total billed charges,29.86,82.6,,,percent of total billed charges,82.6% of total billed charges,29.86,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.53,36.15,
SGOT OR AST,30184450,CDM,301,RC,84450,HCPCS,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,113,
Abdominal Fluid Cytology LC,31188112,CDM,311,RC,88112,HCPCS,Outpatient,,,203,131.95,,178.64,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,203,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,127.89,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,31.06,15.3,,,percent of total billed charges,15.3% of total billed charges,140.07,69,,,percent of total billed charges,69% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,68.82,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,158.34,78,,,percent of total billed charges,78% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,203,
Acetaminophen,30180143,CDM,301,RC,80307,HCPCS,Outpatient,,,277,180.05,,243.76,88,,,percent of total billed charges,88% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,46.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,277,100,,,percent of total billed charges,100% of total billed charges,47.93,17.304,,,percent of total billed charges,17.304% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,174.51,63,,,percent of total billed charges,63% of total billed charges,108.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.54,16.8,,,percent of total billed charges,16.8% of total billed charges,42.38,15.3,,,percent of total billed charges,15.3% of total billed charges,191.13,69,,,percent of total billed charges,69% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,237.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.54,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,46.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,47.47,17.136,,,percent of total billed charges,17.136% of total billed charges,60.5,21.84,,,percent of total billed charges,21.84% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,93.9,33.9,,,percent of total billed charges,33.9% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,216.06,78,,,percent of total billed charges,78% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,46.54,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,46.54,16.8,,,percent of total billed charges,16.8% of total billed charges,42.38,277,
Acetone Serum,30182009,CDM,301,RC,82009,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,52.29,63,,,percent of total billed charges,63% of total billed charges,7.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,17.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,83,
ACID FAST CULTURE,30687116,CDM,306,RC,87116,HCPCS,Outpatient,,,73,47.45,,64.24,88,,,percent of total billed charges,88% of total Billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,73,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,45.99,63,,,percent of total billed charges,63% of total billed charges,18.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,11.17,15.3,,,percent of total billed charges,15.3% of total billed charges,50.37,69,,,percent of total billed charges,69% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,73,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,73,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,33.9,,,percent of total billed charges,33.9% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,56.94,78,,,percent of total billed charges,78% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,73,
Activated PTT,30585730,CDM,305,RC,85730,HCPCS,Outpatient,,,111,72.15,,97.68,88,,,percent of total billed charges,88% of total Billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,111,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,69.93,63,,,percent of total billed charges,63% of total billed charges,10.51,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,16.98,15.3,,,percent of total billed charges,15.3% of total billed charges,76.59,69,,,percent of total billed charges,69% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,111,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,111,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,22.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,37.63,33.9,,,percent of total billed charges,33.9% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,86.58,78,,,percent of total billed charges,78% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,111,
Actin (Smooth Muscle) Antibody LC,30183516,CDM,301,RC,83516,HCPCS,Outpatient,,,137,89.05,,120.56,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,137,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,20.96,15.3,,,percent of total billed charges,15.3% of total billed charges,94.53,69,,,percent of total billed charges,69% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,137,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,137,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,46.44,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,106.86,78,,,percent of total billed charges,78% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,137,
Acute Viral Hepatitis LC,30180074,CDM,301,RC,80074,HCPCS,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,167,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,105.21,63,,,percent of total billed charges,63% of total billed charges,83.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,25.55,15.3,,,percent of total billed charges,15.3% of total billed charges,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,182.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,56.61,33.9,,,percent of total billed charges,33.9% of total billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,48.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,182.18,
Aerobic Vaginitis Panel AVR,30687640,CDM,306,RC,87640,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
ALBUMIN SERUM,30182040,CDM,301,RC,82040,HCPCS,Outpatient,,,128,83.20,,112.64,88,,,percent of total billed charges,88% of total Billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,128,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,80.64,63,,,percent of total billed charges,63% of total billed charges,8.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,18.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,43.39,33.9,,,percent of total billed charges,33.9% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,128,
Albumin Body Fluid,30182042,CDM,301,RC,82042,HCPCS,Outpatient,,,138,89.70,,121.44,88,,,percent of total billed charges,88% of total Billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,138,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,86.94,63,,,percent of total billed charges,63% of total billed charges,13.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,21.11,15.3,,,percent of total billed charges,15.3% of total billed charges,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,138,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,138,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,29.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,46.78,33.9,,,percent of total billed charges,33.9% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.85,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,138,
Albumin Level 24 Hr Urine,30182042,CDM,301,RC,82042,HCPCS,Outpatient,,,138,89.70,,121.44,88,,,percent of total billed charges,88% of total Billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,138,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,86.94,63,,,percent of total billed charges,63% of total billed charges,13.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,21.11,15.3,,,percent of total billed charges,15.3% of total billed charges,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,138,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,138,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,29.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,46.78,33.9,,,percent of total billed charges,33.9% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.85,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,138,
Albumin CSF,30182042,CDM,301,RC,82042,HCPCS,Outpatient,,,138,89.70,,121.44,88,,,percent of total billed charges,88% of total Billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,138,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,86.94,63,,,percent of total billed charges,63% of total billed charges,13.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,21.11,15.3,,,percent of total billed charges,15.3% of total billed charges,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,138,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,138,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,29.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,46.78,33.9,,,percent of total billed charges,33.9% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.85,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,138,
"Albumin, Body Fluid LC",30182042,CDM,301,RC,82042,HCPCS,Outpatient,,,39.96,25.97,,35.16,88,,,percent of total billed charges,88% of total Billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,39.96,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,25.17,63,,,percent of total billed charges,63% of total billed charges,13.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,6.11,15.3,,,percent of total billed charges,15.3% of total billed charges,27.57,69,,,percent of total billed charges,69% of total billed charges,39.96,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,39.96,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,39.96,100,,,percent of total billed charges,100% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,29.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,15.06,37.7,,,percent of total billed charges,37.70% of total billed charges,15.06,37.7,,,percent of total billed charges,37.70% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,13.55,33.9,,,percent of total billed charges,33.9% of total billed charges,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,31.17,78,,,percent of total billed charges,78% of total billed charges,39.96,100,,,percent of total billed charges,100% of total billed charges,33.01,82.6,,,percent of total billed charges,82.6% of total billed charges,33.01,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,7.85,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,39.96,
Alcohol Serum Level,30182077,CDM,301,RC,82077,HCPCS,Outpatient,,,326,211.90,,286.88,88,,,percent of total billed charges,88% of total Billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,326,100,,,percent of total billed charges,100% of total billed charges,56.41,17.304,,,percent of total billed charges,17.304% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,205.38,63,,,percent of total billed charges,63% of total billed charges,30.22,175,,,Fee Schedule,175% of Medicare OPPS Rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,49.88,15.3,,,percent of total billed charges,15.3% of total billed charges,224.94,69,,,percent of total billed charges,69% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,326,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,326,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,66.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,55.86,17.136,,,percent of total billed charges,17.136% of total billed charges,71.2,21.84,,,percent of total billed charges,21.84% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,110.51,33.9,,,percent of total billed charges,33.9% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,254.28,78,,,percent of total billed charges,78% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,17.27,326,
Alcohol Blood,30182077,CDM,301,RC,82077,HCPCS,Outpatient,,,326,211.90,,286.88,88,,,percent of total billed charges,88% of total Billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,326,100,,,percent of total billed charges,100% of total billed charges,56.41,17.304,,,percent of total billed charges,17.304% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,205.38,63,,,percent of total billed charges,63% of total billed charges,30.22,175,,,Fee Schedule,175% of Medicare OPPS Rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,49.88,15.3,,,percent of total billed charges,15.3% of total billed charges,224.94,69,,,percent of total billed charges,69% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,326,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,326,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,66.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,55.86,17.136,,,percent of total billed charges,17.136% of total billed charges,71.2,21.84,,,percent of total billed charges,21.84% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,110.51,33.9,,,percent of total billed charges,33.9% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,254.28,78,,,percent of total billed charges,78% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,17.27,326,
Aldolase LC,82085,CDM,300,RC,82085,HCPCS,Outpatient,,,188,122.20,,165.44,88,,,percent of total billed charges,88% of total Billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,188,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,118.44,63,,,percent of total billed charges,63% of total billed charges,16.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,28.76,15.3,,,percent of total billed charges,15.3% of total billed charges,129.72,69,,,percent of total billed charges,69% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,188,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,188,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,37.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,63.73,33.9,,,percent of total billed charges,33.9% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,146.64,78,,,percent of total billed charges,78% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,188,
Aldosterone U LC,30182088,CDM,301,RC,82088,HCPCS,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,91,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,57.33,63,,,percent of total billed charges,63% of total billed charges,71.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,13.92,15.3,,,percent of total billed charges,15.3% of total billed charges,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,91,100,,,percent of total billed charges,100% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,91,100,,,percent of total billed charges,100% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,155.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,30.85,33.9,,,percent of total billed charges,33.9% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,41.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.92,155.86,
Aldosterone LCMS LC,30182088,CDM,301,RC,82088,HCPCS,Outpatient,,,227,147.55,,199.76,88,,,percent of total billed charges,88% of total Billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,227,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,143.01,63,,,percent of total billed charges,63% of total billed charges,71.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,34.73,15.3,,,percent of total billed charges,15.3% of total billed charges,156.63,69,,,percent of total billed charges,69% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,155.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,76.95,33.9,,,percent of total billed charges,33.9% of total billed charges,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,177.06,78,,,percent of total billed charges,78% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,41.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.75,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.6,227,
Aldosterone/Renin Ratio LC,30184244,CDM,301,RC,84244,HCPCS,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,364,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,229.32,63,,,percent of total billed charges,63% of total billed charges,38.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,55.69,15.3,,,percent of total billed charges,15.3% of total billed charges,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,84.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,123.4,33.9,,,percent of total billed charges,33.9% of total billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,22.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,364,
Alkaline Phosphatase,30184075,CDM,301,RC,84075,HCPCS,Outpatient,,,163,105.95,,143.44,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,163,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,102.69,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,24.94,15.3,,,percent of total billed charges,15.3% of total billed charges,112.47,69,,,percent of total billed charges,69% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,163,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,163,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,127.14,78,,,percent of total billed charges,78% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,163,
Alk Phos Isoenzyme LC,30184075,CDM,301,RC,84075,HCPCS,Outpatient,,,183,118.95,,161.04,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,183,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,115.29,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,28,15.3,,,percent of total billed charges,15.3% of total billed charges,126.27,69,,,percent of total billed charges,69% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,62.04,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,142.74,78,,,percent of total billed charges,78% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,183,
ALKALINE PHOSPHATASE BONE SPEC,30184080,CDM,301,RC,84080,HCPCS,Outpatient,,,299,194.35,,263.12,88,,,percent of total billed charges,88% of total Billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,299,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,188.37,63,,,percent of total billed charges,63% of total billed charges,25.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,45.75,15.3,,,percent of total billed charges,15.3% of total billed charges,206.31,69,,,percent of total billed charges,69% of total billed charges,299,100,,,percent of total billed charges,100% of total billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,299,100,,,percent of total billed charges,100% of total billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,299,100,,,percent of total billed charges,100% of total billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,56.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,112.72,37.7,,,percent of total billed charges,37.70% of total billed charges,112.72,37.7,,,percent of total billed charges,37.70% of total billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,101.36,33.9,,,percent of total billed charges,33.9% of total billed charges,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,233.22,78,,,percent of total billed charges,78% of total billed charges,299,100,,,percent of total billed charges,100% of total billed charges,246.97,82.6,,,percent of total billed charges,82.6% of total billed charges,246.97,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,14.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.78,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,299,
Allergens (11) Foods LC,30286003,CDM,302,RC,86003,HCPCS,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,63,,,percent of total billed charges,63% of total billed charges,9.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,19.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,33.9,,,percent of total billed charges,33.9% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.14,19.96,
Allergens (17) LC 605801,30286003,CDM,302,RC,86003,HCPCS,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,63,,,percent of total billed charges,63% of total billed charges,9.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,19.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,33.9,,,percent of total billed charges,33.9% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.14,19.96,
Allergens (15) Foods LC,30286003,CDM,302,RC,86003,HCPCS,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,63,,,percent of total billed charges,63% of total billed charges,9.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,19.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,33.9,,,percent of total billed charges,33.9% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.14,19.96,
Allergens (35) Foods LC,30286003,CDM,302,RC,86003,HCPCS,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,63,,,percent of total billed charges,63% of total billed charges,9.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,19.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,33.9,,,percent of total billed charges,33.9% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.14,19.96,
Allergens (3) LC 605853,30286003,CDM,302,RC,86003,HCPCS,Outpatient,,,80,52.00,,70.4,88,,,percent of total billed charges,88% of total Billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,80,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,50.4,63,,,percent of total billed charges,63% of total billed charges,9.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,12.24,15.3,,,percent of total billed charges,15.3% of total billed charges,55.2,69,,,percent of total billed charges,69% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,80,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,80,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,19.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,30.16,37.7,,,percent of total billed charges,37.70% of total billed charges,30.16,37.7,,,percent of total billed charges,37.70% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,27.12,33.9,,,percent of total billed charges,33.9% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,62.4,78,,,percent of total billed charges,78% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.22,80,
Allergens (5) LC 672748,30286003,CDM,302,RC,86003,HCPCS,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,63,,,percent of total billed charges,63% of total billed charges,9.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,19.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,33.9,,,percent of total billed charges,33.9% of total billed charges,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,5.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.22,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.14,19.96,
Alpha-1-Antitrypsin LC,30182103,CDM,301,RC,82103,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,141.12,63,,,percent of total billed charges,63% of total billed charges,23.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,34.27,15.3,,,percent of total billed charges,15.3% of total billed charges,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,51.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,75.94,33.9,,,percent of total billed charges,33.9% of total billed charges,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,13.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.44,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,224,
Alpha Thalassemia LC,30081257,CDM,300,RC,81257,HCPCS,Outpatient,,,555,360.75,,488.4,88,,,percent of total billed charges,88% of total Billed charges,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,555,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,349.65,63,,,percent of total billed charges,63% of total billed charges,178.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,84.92,15.3,,,percent of total billed charges,15.3% of total billed charges,382.95,69,,,percent of total billed charges,69% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,555,100,,,percent of total billed charges,100% of total billed charges,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,555,100,,,percent of total billed charges,100% of total billed charges,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,391.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,188.15,33.9,,,percent of total billed charges,33.9% of total billed charges,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,432.9,78,,,percent of total billed charges,78% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,103.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,102.26,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,555,
"Aluminum, P/S LC",30182108,CDM,301,RC,82108,HCPCS,Outpatient,,,521,338.65,,458.48,88,,,percent of total billed charges,88% of total Billed charges,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,521,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,328.23,63,,,percent of total billed charges,63% of total billed charges,44.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,79.71,15.3,,,percent of total billed charges,15.3% of total billed charges,359.49,69,,,percent of total billed charges,69% of total billed charges,521,100,,,percent of total billed charges,100% of total billed charges,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,521,100,,,percent of total billed charges,100% of total billed charges,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,521,100,,,percent of total billed charges,100% of total billed charges,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,97.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,196.42,37.7,,,percent of total billed charges,37.70% of total billed charges,196.42,37.7,,,percent of total billed charges,37.70% of total billed charges,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,176.62,33.9,,,percent of total billed charges,33.9% of total billed charges,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,406.38,78,,,percent of total billed charges,78% of total billed charges,521,100,,,percent of total billed charges,100% of total billed charges,430.35,82.6,,,percent of total billed charges,82.6% of total billed charges,430.35,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,25.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.48,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,521,
Amebiasis Antibodies LC,30286753,CDM,302,RC,86753,HCPCS,Outpatient,,,84,54.60,,73.92,88,,,percent of total billed charges,88% of total Billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,84,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,52.92,63,,,percent of total billed charges,63% of total billed charges,21.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,12.85,15.3,,,percent of total billed charges,15.3% of total billed charges,57.96,69,,,percent of total billed charges,69% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,84,100,,,percent of total billed charges,100% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,84,100,,,percent of total billed charges,100% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,47.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,28.48,33.9,,,percent of total billed charges,33.9% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,78,,,percent of total billed charges,78% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,12.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,84,
Ammonia,30182140,CDM,301,RC,82140,HCPCS,Outpatient,,,252,163.80,,221.76,88,,,percent of total billed charges,88% of total Billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,252,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,158.76,63,,,percent of total billed charges,63% of total billed charges,25.49,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,38.56,15.3,,,percent of total billed charges,15.3% of total billed charges,173.88,69,,,percent of total billed charges,69% of total billed charges,252,100,,,percent of total billed charges,100% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,252,100,,,percent of total billed charges,100% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,252,100,,,percent of total billed charges,100% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,55.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,95,37.7,,,percent of total billed charges,37.70% of total billed charges,95,37.7,,,percent of total billed charges,37.70% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,85.43,33.9,,,percent of total billed charges,33.9% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,196.56,78,,,percent of total billed charges,78% of total billed charges,252,100,,,percent of total billed charges,100% of total billed charges,208.15,82.6,,,percent of total billed charges,82.6% of total billed charges,208.15,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,14.71,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,252,
"Ammonia, Plasma",30182140,CDM,301,RC,82140,HCPCS,Outpatient,,,252,163.80,,221.76,88,,,percent of total billed charges,88% of total Billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,252,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,158.76,63,,,percent of total billed charges,63% of total billed charges,25.49,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,38.56,15.3,,,percent of total billed charges,15.3% of total billed charges,173.88,69,,,percent of total billed charges,69% of total billed charges,252,100,,,percent of total billed charges,100% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,252,100,,,percent of total billed charges,100% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,252,100,,,percent of total billed charges,100% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,55.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,95,37.7,,,percent of total billed charges,37.70% of total billed charges,95,37.7,,,percent of total billed charges,37.70% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,85.43,33.9,,,percent of total billed charges,33.9% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,196.56,78,,,percent of total billed charges,78% of total billed charges,252,100,,,percent of total billed charges,100% of total billed charges,208.15,82.6,,,percent of total billed charges,82.6% of total billed charges,208.15,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,14.71,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,252,
Amylase,30182150,CDM,301,RC,82150,HCPCS,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,18.9,63,,,percent of total billed charges,63% of total billed charges,11.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,24.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,10.17,33.9,,,percent of total billed charges,33.9% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,30,
Amylase Body Fluid,30182150,CDM,301,RC,82150,HCPCS,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,18.9,63,,,percent of total billed charges,63% of total billed charges,11.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,24.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,10.17,33.9,,,percent of total billed charges,33.9% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,30,
Amylase Body Fluid LC,30182150,CDM,301,RC,82150,HCPCS,Outpatient,,,19.44,12.64,,17.11,88,,,percent of total billed charges,88% of total Billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,19.44,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,63,,,percent of total billed charges,63% of total billed charges,11.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,2.97,15.3,,,percent of total billed charges,15.3% of total billed charges,13.41,69,,,percent of total billed charges,69% of total billed charges,19.44,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,19.44,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,19.44,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,24.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,7.33,37.7,,,percent of total billed charges,37.70% of total billed charges,7.33,37.7,,,percent of total billed charges,37.70% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.59,33.9,,,percent of total billed charges,33.9% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,15.16,78,,,percent of total billed charges,78% of total billed charges,19.44,100,,,percent of total billed charges,100% of total billed charges,16.06,82.6,,,percent of total billed charges,82.6% of total billed charges,16.06,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.97,24.78,
Anaerobe Identification Only LC,30687076,CDM,306,RC,87076,HCPCS,Outpatient,,,414,269.10,,364.32,88,,,percent of total billed charges,88% of total Billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,414,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,260.82,63,,,percent of total billed charges,63% of total billed charges,14.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,63.34,15.3,,,percent of total billed charges,15.3% of total billed charges,285.66,69,,,percent of total billed charges,69% of total billed charges,414,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,414,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,414,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,30.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,156.08,37.7,,,percent of total billed charges,37.70% of total billed charges,156.08,37.7,,,percent of total billed charges,37.70% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,140.35,33.9,,,percent of total billed charges,33.9% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,322.92,78,,,percent of total billed charges,78% of total billed charges,414,100,,,percent of total billed charges,100% of total billed charges,341.96,82.6,,,percent of total billed charges,82.6% of total billed charges,341.96,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,414,
Anal Pap AVR,31188160,CDM,311,RC,88160,HCPCS,Outpatient,,,288.75,187.69,,254.1,88,,,percent of total billed charges,88% of total Billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,288.75,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,181.91,63,,,percent of total billed charges,63% of total billed charges,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,44.18,15.3,,,percent of total billed charges,15.3% of total billed charges,199.24,69,,,percent of total billed charges,69% of total billed charges,288.75,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,288.75,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,288.75,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,108.86,37.7,,,percent of total billed charges,37.70% of total billed charges,108.86,37.7,,,percent of total billed charges,37.70% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,97.89,33.9,,,percent of total billed charges,33.9% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,225.23,78,,,percent of total billed charges,78% of total billed charges,288.75,100,,,percent of total billed charges,100% of total billed charges,238.51,82.6,,,percent of total billed charges,82.6% of total billed charges,238.51,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,288.75,
Androstenedione LCMS LC,30182157,CDM,301,RC,82157,HCPCS,Outpatient,,,539,350.35,,474.32,88,,,percent of total billed charges,88% of total Billed charges,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,539,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,339.57,63,,,percent of total billed charges,63% of total billed charges,51.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,82.47,15.3,,,percent of total billed charges,15.3% of total billed charges,371.91,69,,,percent of total billed charges,69% of total billed charges,539,100,,,percent of total billed charges,100% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,539,100,,,percent of total billed charges,100% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,539,100,,,percent of total billed charges,100% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,111.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,203.2,37.7,,,percent of total billed charges,37.70% of total billed charges,203.2,37.7,,,percent of total billed charges,37.70% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,182.72,33.9,,,percent of total billed charges,33.9% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,420.42,78,,,percent of total billed charges,78% of total billed charges,539,100,,,percent of total billed charges,100% of total billed charges,445.21,82.6,,,percent of total billed charges,82.6% of total billed charges,445.21,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.28,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,539,
Angiotensin-Converting Enzyme LC,30182164,CDM,301,RC,82164,HCPCS,Outpatient,,,282,183.30,,248.16,88,,,percent of total billed charges,88% of total Billed charges,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,282,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,177.66,63,,,percent of total billed charges,63% of total billed charges,25.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,43.15,15.3,,,percent of total billed charges,15.3% of total billed charges,194.58,69,,,percent of total billed charges,69% of total billed charges,282,100,,,percent of total billed charges,100% of total billed charges,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,282,100,,,percent of total billed charges,100% of total billed charges,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,282,100,,,percent of total billed charges,100% of total billed charges,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,55.84,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,106.31,37.7,,,percent of total billed charges,37.70% of total billed charges,106.31,37.7,,,percent of total billed charges,37.70% of total billed charges,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,95.6,33.9,,,percent of total billed charges,33.9% of total billed charges,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,219.96,78,,,percent of total billed charges,78% of total billed charges,282,100,,,percent of total billed charges,100% of total billed charges,232.93,82.6,,,percent of total billed charges,82.6% of total billed charges,232.93,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,14.74,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.6,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,282,
Antithrombin Antigen LC,30585301,CDM,305,RC,85301,HCPCS,Outpatient,,,119,77.35,,104.72,88,,,percent of total billed charges,88% of total Billed charges,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,119,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,74.97,63,,,percent of total billed charges,63% of total billed charges,18.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,18.21,15.3,,,percent of total billed charges,15.3% of total billed charges,82.11,69,,,percent of total billed charges,69% of total billed charges,119,100,,,percent of total billed charges,100% of total billed charges,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,119,100,,,percent of total billed charges,100% of total billed charges,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,119,100,,,percent of total billed charges,100% of total billed charges,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,41.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,44.86,37.7,,,percent of total billed charges,37.70% of total billed charges,44.86,37.7,,,percent of total billed charges,37.70% of total billed charges,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,40.34,33.9,,,percent of total billed charges,33.9% of total billed charges,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,92.82,78,,,percent of total billed charges,78% of total billed charges,119,100,,,percent of total billed charges,100% of total billed charges,98.29,82.6,,,percent of total billed charges,82.6% of total billed charges,98.29,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,10.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.81,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,119,
IA2 AUTOANTIBODIES,30286341,CDM,302,RC,86341,HCPCS,Outpatient,,,153,99.45,,134.64,88,,,percent of total billed charges,88% of total Billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,153,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,96.39,63,,,percent of total billed charges,63% of total billed charges,41.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,23.41,15.3,,,percent of total billed charges,15.3% of total billed charges,105.57,69,,,percent of total billed charges,69% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,90.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,51.87,33.9,,,percent of total billed charges,33.9% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,119.34,78,,,percent of total billed charges,78% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,23.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,153,
Anti-Jo-1 LC,30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,94,
Anti-Centromere B Antibodies LC,30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,43.47,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,23.39,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,69,
Antinuclear Antibodies Direct LC,30286038,CDM,302,RC,86038,HCPCS,Outpatient,,,66,42.90,,58.08,88,,,percent of total billed charges,88% of total Billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,66,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,41.58,63,,,percent of total billed charges,63% of total billed charges,21.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,10.1,15.3,,,percent of total billed charges,15.3% of total billed charges,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,46.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,22.37,33.9,,,percent of total billed charges,33.9% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,66,
Antiextractable Nuclear Ag LC,30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,184,119.60,,161.92,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,184,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,115.92,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,28.15,15.3,,,percent of total billed charges,15.3% of total billed charges,126.96,69,,,percent of total billed charges,69% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,143.52,78,,,percent of total billed charges,78% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,184,
Antistreptolysin O Ab LC,30286060,CDM,302,RC,86060,HCPCS,Outpatient,,,141,91.65,,124.08,88,,,percent of total billed charges,88% of total Billed charges,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,141,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,88.83,63,,,percent of total billed charges,63% of total billed charges,12.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,21.57,15.3,,,percent of total billed charges,15.3% of total billed charges,97.29,69,,,percent of total billed charges,69% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,141,100,,,percent of total billed charges,100% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,141,100,,,percent of total billed charges,100% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,27.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,53.16,37.7,,,percent of total billed charges,37.70% of total billed charges,53.16,37.7,,,percent of total billed charges,37.70% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,47.8,33.9,,,percent of total billed charges,33.9% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,109.98,78,,,percent of total billed charges,78% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,7.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,141,
ANTITHROMBIN III;ACTIVITY,30585300,CDM,305,RC,85300,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,20.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,45.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.85,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,194,
Antiscleroderma-70 Antibodies LC,30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,94,
Antiglomerular BM Ab LC,30183516,CDM,301,RC,83516,HCPCS,Outpatient,,,163,105.95,,143.44,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,163,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,24.94,15.3,,,percent of total billed charges,15.3% of total billed charges,112.47,69,,,percent of total billed charges,69% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,163,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,163,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,127.14,78,,,percent of total billed charges,78% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,163,
Anti-dsDNA Antibodies LC,30286225,CDM,302,RC,86225,HCPCS,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,72,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,45.36,63,,,percent of total billed charges,63% of total billed charges,24.04,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,11.02,15.3,,,percent of total billed charges,15.3% of total billed charges,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,72,100,,,percent of total billed charges,100% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,72,100,,,percent of total billed charges,100% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,52.55,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,24.41,33.9,,,percent of total billed charges,33.9% of total billed charges,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,13.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.74,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,72,
Antimyeloperoxidase (MPO) Abs,30183520,CDM,301,RC,83520,HCPCS,Outpatient,,,51,33.15,,44.88,88,,,percent of total billed charges,88% of total Billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,51,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.22,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,7.8,15.3,,,percent of total billed charges,15.3% of total billed charges,35.19,69,,,percent of total billed charges,69% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,51,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,51,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,66.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.29,33.9,,,percent of total billed charges,33.9% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,39.78,78,,,percent of total billed charges,78% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.8,66.05,
"Anticardiolipin Ab, IgG/M, Qn LC",30286147,CDM,302,RC,86147,HCPCS,Outpatient,,,134,87.10,,117.92,88,,,percent of total billed charges,88% of total Billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,134,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,84.42,63,,,percent of total billed charges,63% of total billed charges,44.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,20.5,15.3,,,percent of total billed charges,15.3% of total billed charges,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,97.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,45.43,33.9,,,percent of total billed charges,33.9% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,134,
"Antinuclear Antibodies, IFA LC",30286038,CDM,302,RC,86038,HCPCS,Outpatient,,,66,42.90,,58.08,88,,,percent of total billed charges,88% of total Billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,66,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,41.58,63,,,percent of total billed charges,63% of total billed charges,21.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,10.1,15.3,,,percent of total billed charges,15.3% of total billed charges,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,46.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,22.37,33.9,,,percent of total billed charges,33.9% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,66,
"Antifungal Suscep, Fluconazole LC",306182220,CDM,306,RC,87186,HCPCS,Outpatient,,,478.5,311.03,,421.08,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,478.5,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,301.46,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,73.21,15.3,,,percent of total billed charges,15.3% of total billed charges,330.17,69,,,percent of total billed charges,69% of total billed charges,478.5,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,478.5,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,478.5,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,180.39,37.7,,,percent of total billed charges,37.70% of total billed charges,180.39,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,162.21,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,373.23,78,,,percent of total billed charges,78% of total billed charges,478.5,100,,,percent of total billed charges,100% of total billed charges,395.24,82.6,,,percent of total billed charges,82.6% of total billed charges,395.24,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,478.5,
"Anti-Chromatin Ab, IgG (RDL) LC",30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,131,85.15,,115.28,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,131,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,82.53,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,20.04,15.3,,,percent of total billed charges,15.3% of total billed charges,90.39,69,,,percent of total billed charges,69% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,131,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,131,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,49.39,37.7,,,percent of total billed charges,37.70% of total billed charges,49.39,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,44.41,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,102.18,78,,,percent of total billed charges,78% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,131,
Antiphospholipid Syndrome LC,30585598,CDM,305,RC,85598,HCPCS,Outpatient,,,210,136.50,,184.8,88,,,percent of total billed charges,88% of total Billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,210,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,132.3,63,,,percent of total billed charges,63% of total billed charges,31.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,32.13,15.3,,,percent of total billed charges,15.3% of total billed charges,144.9,69,,,percent of total billed charges,69% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,210,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,210,100,,,percent of total billed charges,100% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,68.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,33.9,,,percent of total billed charges,33.9% of total billed charges,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,163.8,78,,,percent of total billed charges,78% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,18.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,210,
Apolipoprotein B LC,30182172,CDM,301,RC,82172,HCPCS,Outpatient,,,264,171.60,,232.32,88,,,percent of total billed charges,88% of total Billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,264,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,166.32,63,,,percent of total billed charges,63% of total billed charges,36.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,80.66,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.5,33.9,,,percent of total billed charges,33.9% of total billed charges,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,21.3,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,264,
"Aspergillus Ag, BAL/Serum LC",30687305,CDM,306,RC,87305,HCPCS,Outpatient,,,498.18,323.82,,438.4,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,498.18,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,313.85,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,76.22,15.3,,,percent of total billed charges,15.3% of total billed charges,343.74,69,,,percent of total billed charges,69% of total billed charges,498.18,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,498.18,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,498.18,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,187.81,37.7,,,percent of total billed charges,37.70% of total billed charges,187.81,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,168.88,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,388.58,78,,,percent of total billed charges,78% of total billed charges,498.18,100,,,percent of total billed charges,100% of total billed charges,411.5,82.6,,,percent of total billed charges,82.6% of total billed charges,411.5,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,498.18,
B-Type Natriuretic Peptide,30183880,CDM,301,RC,83880,HCPCS,Outpatient,,,160,104.00,,140.8,88,,,percent of total billed charges,88% of total Billed charges,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,160,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,100.8,63,,,percent of total billed charges,63% of total billed charges,68.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,24.48,15.3,,,percent of total billed charges,15.3% of total billed charges,110.4,69,,,percent of total billed charges,69% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,150.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,54.24,33.9,,,percent of total billed charges,33.9% of total billed charges,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,124.8,78,,,percent of total billed charges,78% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,39.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,39.26,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,160,
B.pertussisB.parapertussis PCR LC,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,194,
"BCR-ABL1, CML/ALL, PCR Qn LC 480481",30081206,CDM,301,RC,81206,HCPCS,Outpatient,,,832,540.80,,732.16,88,,,percent of total billed charges,88% of total Billed charges,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,832,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,524.16,63,,,percent of total billed charges,63% of total billed charges,286.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,127.3,15.3,,,percent of total billed charges,15.3% of total billed charges,574.08,69,,,percent of total billed charges,69% of total billed charges,832,100,,,percent of total billed charges,100% of total billed charges,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,832,100,,,percent of total billed charges,100% of total billed charges,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,832,100,,,percent of total billed charges,100% of total billed charges,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,627.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,313.66,37.7,,,percent of total billed charges,37.70% of total billed charges,313.66,37.7,,,percent of total billed charges,37.70% of total billed charges,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,282.05,33.9,,,percent of total billed charges,33.9% of total billed charges,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,648.96,78,,,percent of total billed charges,78% of total billed charges,832,100,,,percent of total billed charges,100% of total billed charges,687.23,82.6,,,percent of total billed charges,82.6% of total billed charges,687.23,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,165.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,163.96,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,832,
Body Fluid Cell Count w/Diff If Indicated,30989050,CDM,300,RC,89050,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,8.91,103,,,Fee Schedule,103% of WA Medicaid,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,63,63,,,percent of total billed charges,63% of total billed charges,8.26,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,6.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.24,130,,,Fee Schedule,130% of WA Medicaid ,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.72,100,
Body Fluid Differential,30089051,CDM,300,RC,89051,HCPCS,Outpatient,,,125,81.25,,110,88,,,percent of total billed charges,88% of total Billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,125,100,,,percent of total billed charges,100% of total billed charges,8.91,103,,,Fee Schedule,103% of WA Medicaid,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,78.75,63,,,percent of total billed charges,63% of total billed charges,9.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,19.13,15.3,,,percent of total billed charges,15.3% of total billed charges,86.25,69,,,percent of total billed charges,69% of total billed charges,125,100,,,percent of total billed charges,100% of total billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,125,100,,,percent of total billed charges,100% of total billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,125,100,,,percent of total billed charges,100% of total billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,21.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,6.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.24,130,,,Fee Schedule,130% of WA Medicaid ,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,47.13,37.7,,,percent of total billed charges,37.70% of total billed charges,47.13,37.7,,,percent of total billed charges,37.70% of total billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,42.38,33.9,,,percent of total billed charges,33.9% of total billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,97.5,78,,,percent of total billed charges,78% of total billed charges,125,100,,,percent of total billed charges,100% of total billed charges,103.25,82.6,,,percent of total billed charges,82.6% of total billed charges,103.25,82.6,,,percent of total billed charges,82.6% of total billed charges,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,5.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.6,125,
BK Quant PCR (Urine) LC,30687799,CDM,306,RC,87799,HCPCS,Outpatient,,,1248.75,811.69,,1098.9,88,,,percent of total billed charges,88% of total Billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,1248.75,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,74.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,191.06,15.3,,,percent of total billed charges,15.3% of total billed charges,861.64,69,,,percent of total billed charges,69% of total billed charges,1248.75,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1248.75,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1248.75,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,163.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,470.78,37.7,,,percent of total billed charges,37.70% of total billed charges,470.78,37.7,,,percent of total billed charges,37.70% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,423.33,33.9,,,percent of total billed charges,33.9% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,974.03,78,,,percent of total billed charges,78% of total billed charges,1248.75,100,,,percent of total billed charges,100% of total billed charges,1031.47,82.6,,,percent of total billed charges,82.6% of total billed charges,1031.47,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,43.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,1248.75,
BK Quant PCR (Plasma/Serum) LC 138962,30687799,CDM,306,RC,87799,HCPCS,Outpatient,,,605,393.25,,532.4,88,,,percent of total billed charges,88% of total Billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,605,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,74.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,92.57,15.3,,,percent of total billed charges,15.3% of total billed charges,417.45,69,,,percent of total billed charges,69% of total billed charges,605,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,605,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,605,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,163.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,228.09,37.7,,,percent of total billed charges,37.70% of total billed charges,228.09,37.7,,,percent of total billed charges,37.70% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,205.1,33.9,,,percent of total billed charges,33.9% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,471.9,78,,,percent of total billed charges,78% of total billed charges,605,100,,,percent of total billed charges,100% of total billed charges,499.73,82.6,,,percent of total billed charges,82.6% of total billed charges,499.73,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,43.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,605,
Bill PERIPH BLOOD SMEAR INTER,30085060,CDM,300,RC,85060,HCPCS,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,5.08,100,,,Fee Schedule,100% of WA Medicaid,91,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,57.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.08,100,,,Fee Schedule,100% of WA Medicaid,13.92,15.3,,,percent of total billed charges,15.3% of total billed charges,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,91,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,91,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,30.85,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,91,
Blood Smear Review,30585007,CDM,305,RC,85007,HCPCS,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,10,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.3,63,,,percent of total billed charges,63% of total billed charges,6.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10,100,,,percent of total billed charges,100% of total billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10,100,,,percent of total billed charges,100% of total billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3.77,37.7,,,percent of total billed charges,37.70% of total billed charges,3.77,37.7,,,percent of total billed charges,37.70% of total billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3.39,33.9,,,percent of total billed charges,33.9% of total billed charges,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.53,14.53,
Blood Urea Nitrogen,30184520,CDM,301,RC,84520,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,63,,,percent of total billed charges,63% of total billed charges,6.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,70,100,,,percent of total billed charges,100% of total billed charges,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,70,100,,,percent of total billed charges,100% of total billed charges,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,15.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,23.73,33.9,,,percent of total billed charges,33.9% of total billed charges,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,3.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,70,
"BV + CG + Trich, NAA w/Yeast Cul LC",30687102,CDM,306,RC,87102,HCPCS,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,9,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,5.67,63,,,percent of total billed charges,63% of total billed charges,14.71,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,9,100,,,percent of total billed charges,100% of total billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,9,100,,,percent of total billed charges,100% of total billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,32.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,3.39,37.7,,,percent of total billed charges,37.70% of total billed charges,3.39,37.7,,,percent of total billed charges,37.70% of total billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,3.05,33.9,,,percent of total billed charges,33.9% of total billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,8.49,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.38,32.16,
Bacterial Vaginosis NAA LC,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,165,107.25,,145.2,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,165,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,103.95,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,55.94,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,165,
Bacterial Vaginosis Panel AVR,30687511,CDM,306,RC,87511,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Basic Metabolic Panel,30180048,CDM,301,RC,80048,HCPCS,Outpatient,,,206,133.90,,181.28,88,,,percent of total billed charges,88% of total Billed charges,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,206,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,129.78,63,,,percent of total billed charges,63% of total billed charges,14.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,31.52,15.3,,,percent of total billed charges,15.3% of total billed charges,142.14,69,,,percent of total billed charges,69% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,32.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,69.83,33.9,,,percent of total billed charges,33.9% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,160.68,78,,,percent of total billed charges,78% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.46,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,206,
Benzodiazepine Conf (LCMSMS) LC 910569,30180347,CDM,301,RC,80347,HCPCS,Outpatient,,,144,93.60,,126.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,90.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",22.03,15.3,,,percent of total billed charges,15.3% of total billed charges,99.36,69,,,percent of total billed charges,69% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.29,37.7,,,percent of total billed charges,37.70% of total billed charges,54.29,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,48.82,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,112.32,78,,,percent of total billed charges,78% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.19,16.8,,,percent of total billed charges,16.8% of total billed charges,22.03,144,
Beta hCG Quantitative,30184702,CDM,301,RC,84702,HCPCS,Outpatient,,,428,278.20,,376.64,88,,,percent of total billed charges,88% of total Billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,428,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,269.64,63,,,percent of total billed charges,63% of total billed charges,26.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,65.48,15.3,,,percent of total billed charges,15.3% of total billed charges,295.32,69,,,percent of total billed charges,69% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,428,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,428,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,57.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,145.09,33.9,,,percent of total billed charges,33.9% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,333.84,78,,,percent of total billed charges,78% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,428,
BETA 2 MICROGLOBULIN,30182232,CDM,301,RC,82232,HCPCS,Outpatient,,,221,143.65,,194.48,88,,,percent of total billed charges,88% of total Billed charges,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,221,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,139.23,63,,,percent of total billed charges,63% of total billed charges,28.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,33.81,15.3,,,percent of total billed charges,15.3% of total billed charges,152.49,69,,,percent of total billed charges,69% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,221,100,,,percent of total billed charges,100% of total billed charges,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,221,100,,,percent of total billed charges,100% of total billed charges,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,61.88,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74.92,33.9,,,percent of total billed charges,33.9% of total billed charges,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,172.38,78,,,percent of total billed charges,78% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,16.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,221,
"Bile Acids, Fractionated LCMS LC",30182542,CDM,301,RC,82542,HCPCS,Outpatient,,,213,138.45,,187.44,88,,,percent of total billed charges,88% of total Billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.19,63,,,percent of total billed charges,63% of total billed charges,42.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,32.59,15.3,,,percent of total billed charges,15.3% of total billed charges,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,92.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,72.21,33.9,,,percent of total billed charges,33.9% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,213,
Bile Acids LC,30082239,CDM,300,RC,82239,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,56.7,63,,,percent of total billed charges,63% of total billed charges,29.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,65.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,30.51,33.9,,,percent of total billed charges,33.9% of total billed charges,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,17.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.12,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,90,
Bilirubin Total,30182247,CDM,301,RC,82247,HCPCS,Outpatient,,,68,44.20,,59.84,88,,,percent of total billed charges,88% of total Billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,68,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,63,,,percent of total billed charges,63% of total billed charges,8.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,10.4,15.3,,,percent of total billed charges,15.3% of total billed charges,46.92,69,,,percent of total billed charges,69% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,23.05,33.9,,,percent of total billed charges,33.9% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,53.04,78,,,percent of total billed charges,78% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,68,
Bilirubin Neonatal,30082247,CDM,300,RC,82247,HCPCS,Outpatient,,,68,44.20,,59.84,88,,,percent of total billed charges,88% of total Billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,68,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,63,,,percent of total billed charges,63% of total billed charges,8.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,10.4,15.3,,,percent of total billed charges,15.3% of total billed charges,46.92,69,,,percent of total billed charges,69% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,23.05,33.9,,,percent of total billed charges,33.9% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,53.04,78,,,percent of total billed charges,78% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,68,
"BILIRUBIN TOTAL, BODY FLUID",30182247,CDM,301,RC,82247,HCPCS,Outpatient,,,68,44.20,,59.84,88,,,percent of total billed charges,88% of total Billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,68,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,63,,,percent of total billed charges,63% of total billed charges,8.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,10.4,15.3,,,percent of total billed charges,15.3% of total billed charges,46.92,69,,,percent of total billed charges,69% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,23.05,33.9,,,percent of total billed charges,33.9% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,53.04,78,,,percent of total billed charges,78% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,68,
Bilirubin Direct,30182248,CDM,301,RC,82248,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,43.47,63,,,percent of total billed charges,63% of total billed charges,8.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,23.39,33.9,,,percent of total billed charges,33.9% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,69,
Bilirubin; total,30182247,CDM,301,RC,82247,HCPCS,Outpatient,,,68,44.20,,59.84,88,,,percent of total billed charges,88% of total Billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,68,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,63,,,percent of total billed charges,63% of total billed charges,8.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,10.4,15.3,,,percent of total billed charges,15.3% of total billed charges,46.92,69,,,percent of total billed charges,69% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,68,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,23.05,33.9,,,percent of total billed charges,33.9% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,53.04,78,,,percent of total billed charges,78% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,68,
"Bilirubin Fractionated, Neonatal RLC",30182247,CDM,301,RC,82247,HCPCS,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,1,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,0.63,63,,,percent of total billed charges,63% of total billed charges,8.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,0.38,37.7,,,percent of total billed charges,37.70% of total billed charges,0.38,37.7,,,percent of total billed charges,37.70% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,0.34,33.9,,,percent of total billed charges,33.9% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.15,19.2,
General Health Panel,30180050,CDM,301,RC,80050,HCPCS,Outpatient,,,617,401.05,,542.96,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,7.45,100,,,Fee Schedule,100% of WA Medicaid,617,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,388.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.45,100,,,Fee Schedule,100% of WA Medicaid,94.4,15.3,,,percent of total billed charges,15.3% of total billed charges,425.73,69,,,percent of total billed charges,69% of total billed charges,617,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,617,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,617,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,232.61,37.7,,,percent of total billed charges,37.70% of total billed charges,232.61,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,209.16,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,481.26,78,,,percent of total billed charges,78% of total billed charges,617,100,,,percent of total billed charges,100% of total billed charges,509.64,82.6,,,percent of total billed charges,82.6% of total billed charges,509.64,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,617,
Bill PATHOLOGY CONSULT LIMITED,31080500,CDM,310,RC,80500,HCPCS,Outpatient,,,102,66.30,,89.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,33.17,100,,,Fee Schedule,100% of WA Medicaid,102,100,,,percent of total billed charges,100% of total billed charges,34.17,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,64.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.17,100,,,Fee Schedule,100% of WA Medicaid,15.61,15.3,,,percent of total billed charges,15.3% of total billed charges,70.38,69,,,percent of total billed charges,69% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,102,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,102,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.13,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,34.58,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,79.56,78,,,percent of total billed charges,78% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.61,202.15,
Bill BRAF GENE ANALYSIS,31081210,CDM,310,RC,81210,HCPCS,Outpatient,,,567,368.55,,498.96,88,,,percent of total billed charges,88% of total Billed charges,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,567,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,357.21,63,,,percent of total billed charges,63% of total billed charges,306.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,263.1,150,,,Fee Schedule,150% of Medicare OPPS rate,391.23,69,,,percent of total billed charges,69% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,567,100,,,percent of total billed charges,100% of total billed charges,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,567,100,,,percent of total billed charges,100% of total billed charges,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,670.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,192.21,33.9,,,percent of total billed charges,33.9% of total billed charges,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,442.26,78,,,percent of total billed charges,78% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,177.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,175.4,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,670.9,
Bill EGFR MUTATION ANALYSIS,30181235,CDM,301,RC,81235,HCPCS,Outpatient,,,1517,986.05,,1334.96,88,,,percent of total billed charges,88% of total Billed charges,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,364.01,100,,,Fee Schedule,100% of WA Medicaid,1517,100,,,percent of total billed charges,100% of total billed charges,374.93,103,,,Fee Schedule,103% of WA Medicaid,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,955.71,63,,,percent of total billed charges,63% of total billed charges,568.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,364.01,100,,,Fee Schedule,100% of WA Medicaid,232.1,15.3,,,percent of total billed charges,15.3% of total billed charges,1046.73,69,,,percent of total billed charges,69% of total billed charges,1517,100,,,percent of total billed charges,100% of total billed charges,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1517,100,,,percent of total billed charges,100% of total billed charges,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1517,100,,,percent of total billed charges,100% of total billed charges,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1241.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,364.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,269.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,371.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,473.21,130,,,Fee Schedule,130% of WA Medicaid ,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,571.91,37.7,,,percent of total billed charges,37.70% of total billed charges,571.91,37.7,,,percent of total billed charges,37.70% of total billed charges,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,514.26,33.9,,,percent of total billed charges,33.9% of total billed charges,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.26,78,,,percent of total billed charges,78% of total billed charges,1517,100,,,percent of total billed charges,100% of total billed charges,1253.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1253.04,82.6,,,percent of total billed charges,82.6% of total billed charges,364.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,327.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,324.58,100,,,Fee Schedule,100% of Medicare OPPS rate,364.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,232.1,1517,
Bill IGH GENE REARRANGEMENT ANAL,31081261,CDM,310,RC,81261,HCPCS,Outpatient,,,953,619.45,,838.64,88,,,percent of total billed charges,88% of total Billed charges,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,953,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,600.39,63,,,percent of total billed charges,63% of total billed charges,346.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,296.99,150,,,Fee Schedule,150% of Medicare OPPS rate,657.57,69,,,percent of total billed charges,69% of total billed charges,953,100,,,percent of total billed charges,100% of total billed charges,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,953,100,,,percent of total billed charges,100% of total billed charges,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,953,100,,,percent of total billed charges,100% of total billed charges,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,757.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,323.07,33.9,,,percent of total billed charges,33.9% of total billed charges,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,743.34,78,,,percent of total billed charges,78% of total billed charges,953,100,,,percent of total billed charges,100% of total billed charges,787.18,82.6,,,percent of total billed charges,82.6% of total billed charges,787.18,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,199.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,197.99,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,953,
Bill Kras Gene Analysis,31081275,CDM,310,RC,81275,HCPCS,Outpatient,,,719,467.35,,632.72,88,,,percent of total billed charges,88% of total Billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,719,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,452.97,63,,,percent of total billed charges,63% of total billed charges,338.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,289.88,150,,,Fee Schedule,150% of Medicare OPPS rate,496.11,69,,,percent of total billed charges,69% of total billed charges,719,100,,,percent of total billed charges,100% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,719,100,,,percent of total billed charges,100% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,719,100,,,percent of total billed charges,100% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,739.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,271.06,37.7,,,percent of total billed charges,37.70% of total billed charges,271.06,37.7,,,percent of total billed charges,37.70% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,243.74,33.9,,,percent of total billed charges,33.9% of total billed charges,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,560.82,78,,,percent of total billed charges,78% of total billed charges,719,100,,,percent of total billed charges,100% of total billed charges,593.89,82.6,,,percent of total billed charges,82.6% of total billed charges,593.89,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,195.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,193.25,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,739.18,
Bill MICROSATELLITE INSTABILITY,31081301,CDM,310,RC,81301,HCPCS,Outpatient,,,1427,927.55,,1255.76,88,,,percent of total billed charges,88% of total Billed charges,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,1427,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,899.01,63,,,percent of total billed charges,63% of total billed charges,609.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,522.84,150,,,Fee Schedule,150% of Medicare OPPS rate,984.63,69,,,percent of total billed charges,69% of total billed charges,1427,100,,,percent of total billed charges,100% of total billed charges,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,1427,100,,,percent of total billed charges,100% of total billed charges,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,1427,100,,,percent of total billed charges,100% of total billed charges,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,1333.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,537.98,37.7,,,percent of total billed charges,37.70% of total billed charges,537.98,37.7,,,percent of total billed charges,37.70% of total billed charges,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,483.75,33.9,,,percent of total billed charges,33.9% of total billed charges,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,1113.06,78,,,percent of total billed charges,78% of total billed charges,1427,100,,,percent of total billed charges,100% of total billed charges,1178.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1178.7,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,352.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,348.56,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,1427,
Bill T CELL (TCRGAMMA),31081342,CDM,310,RC,81342,HCPCS,Outpatient,,,869,564.85,,764.72,88,,,percent of total billed charges,88% of total Billed charges,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,869,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,547.47,63,,,percent of total billed charges,63% of total billed charges,352.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,302.25,150,,,Fee Schedule,150% of Medicare OPPS rate,599.61,69,,,percent of total billed charges,69% of total billed charges,869,100,,,percent of total billed charges,100% of total billed charges,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,869,100,,,percent of total billed charges,100% of total billed charges,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,869,100,,,percent of total billed charges,100% of total billed charges,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,770.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,327.61,37.7,,,percent of total billed charges,37.70% of total billed charges,327.61,37.7,,,percent of total billed charges,37.70% of total billed charges,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,294.59,33.9,,,percent of total billed charges,33.9% of total billed charges,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,677.82,78,,,percent of total billed charges,78% of total billed charges,869,100,,,percent of total billed charges,100% of total billed charges,717.79,82.6,,,percent of total billed charges,82.6% of total billed charges,717.79,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,203.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,201.5,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,869,
Bill PROGESTERONE RECEPTOR,30184234,CDM,301,RC,84234,HCPCS,Outpatient,,,362,235.30,,318.56,88,,,percent of total billed charges,88% of total Billed charges,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,362,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,228.06,63,,,percent of total billed charges,63% of total billed charges,113.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,55.39,15.3,,,percent of total billed charges,15.3% of total billed charges,249.78,69,,,percent of total billed charges,69% of total billed charges,362,100,,,percent of total billed charges,100% of total billed charges,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,362,100,,,percent of total billed charges,100% of total billed charges,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,362,100,,,percent of total billed charges,100% of total billed charges,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,248.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,136.47,37.7,,,percent of total billed charges,37.70% of total billed charges,136.47,37.7,,,percent of total billed charges,37.70% of total billed charges,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,122.72,33.9,,,percent of total billed charges,33.9% of total billed charges,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,282.36,78,,,percent of total billed charges,78% of total billed charges,362,100,,,percent of total billed charges,100% of total billed charges,299.01,82.6,,,percent of total billed charges,82.6% of total billed charges,299.01,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,64.88,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.6,362,
Bill Bone Marrow Smear Intrerp,31085097,CDM,310,RC,85097,HCPCS,Outpatient,,,1441,936.65,,1268.08,88,,,percent of total billed charges,88% of total Billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,242.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,1441,100,,,percent of total billed charges,100% of total billed charges,249.35,17.304,,,percent of total billed charges,17.304% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,907.83,63,,,percent of total billed charges,63% of total billed charges,1534.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,242.09,16.8,,,percent of total billed charges,16.8% of total billed charges,220.47,15.3,,,percent of total billed charges,15.3% of total billed charges,994.29,69,,,percent of total billed charges,69% of total billed charges,1441,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,1441,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,1441,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,2665.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,242.09,16.8,,,percent of total billed charges,16.8% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,242.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,246.93,17.136,,,percent of total billed charges,17.136% of total billed charges,314.71,21.84,,,percent of total billed charges,21.84% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,543.26,37.7,,,percent of total billed charges,37.70% of total billed charges,543.26,37.7,,,percent of total billed charges,37.70% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,488.5,33.9,,,percent of total billed charges,33.9% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,1123.98,78,,,percent of total billed charges,78% of total billed charges,1441,100,,,percent of total billed charges,100% of total billed charges,1190.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1190.27,82.6,,,percent of total billed charges,82.6% of total billed charges,242.09,16.8,,,percent of total billed charges,16.8% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,885.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,242.09,16.8,,,percent of total billed charges,16.8% of total billed charges,220.47,2665.63,
Bill CYTO NON GYN SMEAR INTERP,31088104,CDM,310,RC,88104,HCPCS,Outpatient,,,141,91.65,,124.08,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,141,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,88.83,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,21.57,15.3,,,percent of total billed charges,15.3% of total billed charges,97.29,69,,,percent of total billed charges,69% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,141,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,141,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,53.16,37.7,,,percent of total billed charges,37.70% of total billed charges,53.16,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,47.8,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,109.98,78,,,percent of total billed charges,78% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,141,
Bill Cyto Path Cell Enhance Tech,31088112,CDM,310,RC,88112,HCPCS,Outpatient,,,473,307.45,,416.24,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,473,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,297.99,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,72.37,15.3,,,percent of total billed charges,15.3% of total billed charges,326.37,69,,,percent of total billed charges,69% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,160.35,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,368.94,78,,,percent of total billed charges,78% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,473,
Bill CYTO OTHER SOURCE SCREEN,31188160,CDM,311,RC,88160,HCPCS,Outpatient,,,166,107.90,,146.08,88,,,percent of total billed charges,88% of total Billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,166,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,104.58,63,,,percent of total billed charges,63% of total billed charges,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,25.4,15.3,,,percent of total billed charges,15.3% of total billed charges,114.54,69,,,percent of total billed charges,69% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,56.27,33.9,,,percent of total billed charges,33.9% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,129.48,78,,,percent of total billed charges,78% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,166,
Bill CYTO EXT STUDY >5,31188162,CDM,311,RC,88162,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,117.18,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,63.05,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,202.15,
Bill PAP SMEAR DIAGNOSTIC-BETHESDA,31188164,CDM,311,RC,88164,HCPCS,Outpatient,,,77,50.05,,67.76,88,,,percent of total billed charges,88% of total Billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,77,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,48.51,63,,,percent of total billed charges,63% of total billed charges,31.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,26.64,150,,,Fee Schedule,150% of Medicare OPPS rate,53.13,69,,,percent of total billed charges,69% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,77,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,77,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,57.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,26.1,33.9,,,percent of total billed charges,33.9% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,60.06,78,,,percent of total billed charges,78% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,77,
Bill FNA EVALUATION,31088172,CDM,310,RC,88172,HCPCS,Outpatient,,,496,322.40,,436.48,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,496,100,,,percent of total billed charges,100% of total billed charges,36.82,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,312.48,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,75.89,15.3,,,percent of total billed charges,15.3% of total billed charges,342.24,69,,,percent of total billed charges,69% of total billed charges,496,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,496,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,496,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.47,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,186.99,37.7,,,percent of total billed charges,37.70% of total billed charges,186.99,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,168.14,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,386.88,78,,,percent of total billed charges,78% of total billed charges,496,100,,,percent of total billed charges,100% of total billed charges,409.7,82.6,,,percent of total billed charges,82.6% of total billed charges,409.7,82.6,,,percent of total billed charges,82.6% of total billed charges,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.48,605.96,
Bill FNA EVAL INTERP  RPT,31088173,CDM,310,RC,88173,HCPCS,Outpatient,,,496,322.40,,436.48,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,496,100,,,percent of total billed charges,100% of total billed charges,34.17,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,312.48,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,75.89,15.3,,,percent of total billed charges,15.3% of total billed charges,342.24,69,,,percent of total billed charges,69% of total billed charges,496,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,496,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,496,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,24.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.13,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,186.99,37.7,,,percent of total billed charges,37.70% of total billed charges,186.99,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,168.14,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,386.88,78,,,percent of total billed charges,78% of total billed charges,496,100,,,percent of total billed charges,100% of total billed charges,409.7,82.6,,,percent of total billed charges,82.6% of total billed charges,409.7,82.6,,,percent of total billed charges,82.6% of total billed charges,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.57,496,
Bill FLOW CYTOMETRY TECH INITIAL,31088184,CDM,310,RC,88184,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,36.82,103,,,Fee Schedule,103% of WA Medicaid,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,398.16,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,96.7,15.3,,,percent of total billed charges,15.3% of total billed charges,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.47,130,,,Fee Schedule,130% of WA Medicaid ,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,214.25,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.48,1183.25,
Bill FLOW CYTOMETRY TECH EA ADD,31088185,CDM,310,RC,88185,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,55.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,88,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,88,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,29.83,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.46,88,
Bill FLOW CYTOMETRY INTERP 2-8,31088187,CDM,310,RC,88187,HCPCS,Outpatient,,,179,116.35,,157.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid,179,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,112.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid,27.39,15.3,,,percent of total billed charges,15.3% of total billed charges,123.51,69,,,percent of total billed charges,69% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,179,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,179,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,60.68,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,139.62,78,,,percent of total billed charges,78% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,179,
Bill FLOW CYTOMETRY INTERP 9-15,31088188,CDM,310,RC,88188,HCPCS,Outpatient,,,880,572.00,,774.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid,880,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,554.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid,134.64,15.3,,,percent of total billed charges,15.3% of total billed charges,607.2,69,,,percent of total billed charges,69% of total billed charges,880,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,880,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,880,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,331.76,37.7,,,percent of total billed charges,37.70% of total billed charges,331.76,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,298.32,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,686.4,78,,,percent of total billed charges,78% of total billed charges,880,100,,,percent of total billed charges,100% of total billed charges,726.88,82.6,,,percent of total billed charges,82.6% of total billed charges,726.88,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,880,
Bill FLOW CYTOMETRY INTERP 16 >,31088189,CDM,310,RC,88189,HCPCS,Outpatient,,,837,544.05,,736.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid,837,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,527.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid,128.06,15.3,,,percent of total billed charges,15.3% of total billed charges,577.53,69,,,percent of total billed charges,69% of total billed charges,837,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,837,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,837,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,315.55,37.7,,,percent of total billed charges,37.70% of total billed charges,315.55,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,283.74,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,652.86,78,,,percent of total billed charges,78% of total billed charges,837,100,,,percent of total billed charges,100% of total billed charges,691.36,82.6,,,percent of total billed charges,82.6% of total billed charges,691.36,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,837,
Bill TISS CX NON NEOPLASTIC DISORDER,31188230,CDM,311,RC,88230,HCPCS,Outpatient,,,757,492.05,,666.16,88,,,percent of total billed charges,88% of total Billed charges,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,757,100,,,percent of total billed charges,100% of total billed charges,36.82,103,,,Fee Schedule,103% of WA Medicaid,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,476.91,63,,,percent of total billed charges,63% of total billed charges,203.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,174.74,150,,,Fee Schedule,150% of Medicare OPPS rate,522.33,69,,,percent of total billed charges,69% of total billed charges,757,100,,,percent of total billed charges,100% of total billed charges,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,757,100,,,percent of total billed charges,100% of total billed charges,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,757,100,,,percent of total billed charges,100% of total billed charges,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,445.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,36.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.47,130,,,Fee Schedule,130% of WA Medicaid ,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,285.39,37.7,,,percent of total billed charges,37.70% of total billed charges,285.39,37.7,,,percent of total billed charges,37.70% of total billed charges,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,256.62,33.9,,,percent of total billed charges,33.9% of total billed charges,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,590.46,78,,,percent of total billed charges,78% of total billed charges,757,100,,,percent of total billed charges,100% of total billed charges,625.28,82.6,,,percent of total billed charges,82.6% of total billed charges,625.28,82.6,,,percent of total billed charges,82.6% of total billed charges,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,117.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,116.49,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.48,757,
Bill CRYO SKIN OR SOLID TISS BIOPSY,31188233,CDM,311,RC,88233,HCPCS,Outpatient,,,1283,833.95,,1129.04,88,,,percent of total billed charges,88% of total Billed charges,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,1283,100,,,percent of total billed charges,100% of total billed charges,36.82,103,,,Fee Schedule,103% of WA Medicaid,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,808.29,63,,,percent of total billed charges,63% of total billed charges,246.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,211.1,150,,,Fee Schedule,150% of Medicare OPPS rate,885.27,69,,,percent of total billed charges,69% of total billed charges,1283,100,,,percent of total billed charges,100% of total billed charges,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1283,100,,,percent of total billed charges,100% of total billed charges,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1283,100,,,percent of total billed charges,100% of total billed charges,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,538.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,36.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.47,130,,,Fee Schedule,130% of WA Medicaid ,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,483.69,37.7,,,percent of total billed charges,37.70% of total billed charges,483.69,37.7,,,percent of total billed charges,37.70% of total billed charges,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,434.94,33.9,,,percent of total billed charges,33.9% of total billed charges,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1000.74,78,,,percent of total billed charges,78% of total billed charges,1283,100,,,percent of total billed charges,100% of total billed charges,1059.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1059.76,82.6,,,percent of total billed charges,82.6% of total billed charges,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,142.13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,140.72,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.48,1283,
Bill TISS CX NEOPLASTIC DISORDERS,31188237,CDM,311,RC,88237,HCPCS,Outpatient,,,609,395.85,,535.92,88,,,percent of total billed charges,88% of total Billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,609,100,,,percent of total billed charges,100% of total billed charges,36.82,103,,,Fee Schedule,103% of WA Medicaid,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,383.67,63,,,percent of total billed charges,63% of total billed charges,251.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,215.63,150,,,Fee Schedule,150% of Medicare OPPS rate,420.21,69,,,percent of total billed charges,69% of total billed charges,609,100,,,percent of total billed charges,100% of total billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,609,100,,,percent of total billed charges,100% of total billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,609,100,,,percent of total billed charges,100% of total billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,549.84,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,36.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.47,130,,,Fee Schedule,130% of WA Medicaid ,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,229.59,37.7,,,percent of total billed charges,37.70% of total billed charges,229.59,37.7,,,percent of total billed charges,37.70% of total billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,206.45,33.9,,,percent of total billed charges,33.9% of total billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,475.02,78,,,percent of total billed charges,78% of total billed charges,609,100,,,percent of total billed charges,100% of total billed charges,503.03,82.6,,,percent of total billed charges,82.6% of total billed charges,503.03,82.6,,,percent of total billed charges,82.6% of total billed charges,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,145.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.48,609,
Bill CHROM ANALYSIS 5 CELLS,31188261,CDM,311,RC,88261,HCPCS,Outpatient,,,853,554.45,,750.64,88,,,percent of total billed charges,88% of total Billed charges,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,853,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,537.39,63,,,percent of total billed charges,63% of total billed charges,462.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,396.51,150,,,Fee Schedule,150% of Medicare OPPS rate,588.57,69,,,percent of total billed charges,69% of total billed charges,853,100,,,percent of total billed charges,100% of total billed charges,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,853,100,,,percent of total billed charges,100% of total billed charges,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,853,100,,,percent of total billed charges,100% of total billed charges,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,1011.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,321.58,37.7,,,percent of total billed charges,37.70% of total billed charges,321.58,37.7,,,percent of total billed charges,37.70% of total billed charges,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,289.17,33.9,,,percent of total billed charges,33.9% of total billed charges,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,665.34,78,,,percent of total billed charges,78% of total billed charges,853,100,,,percent of total billed charges,100% of total billed charges,704.58,82.6,,,percent of total billed charges,82.6% of total billed charges,704.58,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,266.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,264.33,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,1011.1,
Bill CHROM ANALYSIS 15-20 CELLS,31188262,CDM,311,RC,88262,HCPCS,Outpatient,,,881,572.65,,775.28,88,,,percent of total billed charges,88% of total Billed charges,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,881,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,555.03,63,,,percent of total billed charges,63% of total billed charges,219.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,188.24,150,,,Fee Schedule,150% of Medicare OPPS rate,607.89,69,,,percent of total billed charges,69% of total billed charges,881,100,,,percent of total billed charges,100% of total billed charges,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,881,100,,,percent of total billed charges,100% of total billed charges,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,881,100,,,percent of total billed charges,100% of total billed charges,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,479.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,332.14,37.7,,,percent of total billed charges,37.70% of total billed charges,332.14,37.7,,,percent of total billed charges,37.70% of total billed charges,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,298.66,33.9,,,percent of total billed charges,33.9% of total billed charges,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,687.18,78,,,percent of total billed charges,78% of total billed charges,881,100,,,percent of total billed charges,100% of total billed charges,727.71,82.6,,,percent of total billed charges,82.6% of total billed charges,727.71,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,126.74,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,125.49,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,881,
Bill CHROM ANALYSIS 20-25 CELLS,31188264,CDM,311,RC,88264,HCPCS,Outpatient,,,778,505.70,,684.64,88,,,percent of total billed charges,88% of total Billed charges,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,778,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,490.14,63,,,percent of total billed charges,63% of total billed charges,253.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,216.92,150,,,Fee Schedule,150% of Medicare OPPS rate,536.82,69,,,percent of total billed charges,69% of total billed charges,778,100,,,percent of total billed charges,100% of total billed charges,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,778,100,,,percent of total billed charges,100% of total billed charges,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,778,100,,,percent of total billed charges,100% of total billed charges,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,553.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,293.31,37.7,,,percent of total billed charges,37.70% of total billed charges,293.31,37.7,,,percent of total billed charges,37.70% of total billed charges,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,263.74,33.9,,,percent of total billed charges,33.9% of total billed charges,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,606.84,78,,,percent of total billed charges,78% of total billed charges,778,100,,,percent of total billed charges,100% of total billed charges,642.63,82.6,,,percent of total billed charges,82.6% of total billed charges,642.63,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,146.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,144.61,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,778,
Bill MOLECULAR CYTO DNA PROBE,31188271,CDM,311,RC,88271,HCPCS,Outpatient,,,240,156.00,,211.2,88,,,percent of total billed charges,88% of total Billed charges,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,240,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,151.2,63,,,percent of total billed charges,63% of total billed charges,37.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,32.13,150,,,Fee Schedule,150% of Medicare OPPS rate,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,81.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,81.36,33.9,,,percent of total billed charges,33.9% of total billed charges,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,21.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.42,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.42,240,
Bill MOLEC INTERPHASE INSITU,31088275,CDM,310,RC,88275,HCPCS,Outpatient,,,262,170.30,,230.56,88,,,percent of total billed charges,88% of total Billed charges,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,262,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,165.06,63,,,percent of total billed charges,63% of total billed charges,89.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,76.79,150,,,Fee Schedule,150% of Medicare OPPS rate,180.78,69,,,percent of total billed charges,69% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,262,100,,,percent of total billed charges,100% of total billed charges,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,262,100,,,percent of total billed charges,100% of total billed charges,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,195.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,88.82,33.9,,,percent of total billed charges,33.9% of total billed charges,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.36,78,,,percent of total billed charges,78% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,51.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,51.19,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,262,
Bill Chrom Anal ADDL Karyotype,31188280,CDM,311,RC,88280,HCPCS,Outpatient,,,178,115.70,,156.64,88,,,percent of total billed charges,88% of total Billed charges,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,178,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,112.14,63,,,percent of total billed charges,63% of total billed charges,58.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,50.21,150,,,Fee Schedule,150% of Medicare OPPS rate,122.82,69,,,percent of total billed charges,69% of total billed charges,178,100,,,percent of total billed charges,100% of total billed charges,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,178,100,,,percent of total billed charges,100% of total billed charges,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,178,100,,,percent of total billed charges,100% of total billed charges,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,128.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,67.11,37.7,,,percent of total billed charges,37.70% of total billed charges,67.11,37.7,,,percent of total billed charges,37.70% of total billed charges,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,60.34,33.9,,,percent of total billed charges,33.9% of total billed charges,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,138.84,78,,,percent of total billed charges,78% of total billed charges,178,100,,,percent of total billed charges,100% of total billed charges,147.03,82.6,,,percent of total billed charges,82.6% of total billed charges,147.03,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,33.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33.47,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,178,
Bill CHROM COUNT ADDL CELL,31188285,CDM,311,RC,88285,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,53.55,63,,,percent of total billed charges,63% of total billed charges,47.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,40.37,150,,,Fee Schedule,150% of Medicare OPPS rate,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,102.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,27.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.91,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.91,102.93,
Bill CHROM COUNT ADDL HIGH STUDY,31088289,CDM,310,RC,88289,HCPCS,Outpatient,,,162,105.30,,142.56,88,,,percent of total billed charges,88% of total Billed charges,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,162,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,102.06,63,,,percent of total billed charges,63% of total billed charges,60.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,51.65,150,,,Fee Schedule,150% of Medicare OPPS rate,111.78,69,,,percent of total billed charges,69% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,131.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,54.92,33.9,,,percent of total billed charges,33.9% of total billed charges,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,126.36,78,,,percent of total billed charges,78% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,34.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.43,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,162,
Bill PATHOLOGY LEVEL I,31288300,CDM,312,RC,88300,HCPCS,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,113,
Bill PATHOLOGY LEVEL II,31288302,CDM,312,RC,88302,HCPCS,Outpatient,,,196,127.40,,172.48,88,,,percent of total billed charges,88% of total Billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,196,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,123.48,63,,,percent of total billed charges,63% of total billed charges,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,29.99,15.3,,,percent of total billed charges,15.3% of total billed charges,135.24,69,,,percent of total billed charges,69% of total billed charges,196,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,196,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,196,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,73.89,37.7,,,percent of total billed charges,37.70% of total billed charges,73.89,37.7,,,percent of total billed charges,37.70% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,66.44,33.9,,,percent of total billed charges,33.9% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,152.88,78,,,percent of total billed charges,78% of total billed charges,196,100,,,percent of total billed charges,100% of total billed charges,161.9,82.6,,,percent of total billed charges,82.6% of total billed charges,161.9,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,196,
Bill PATHOLOGY LEVEL III,31288304,CDM,312,RC,88304,HCPCS,Outpatient,,,258,167.70,,227.04,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,258,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,162.54,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,39.47,15.3,,,percent of total billed charges,15.3% of total billed charges,178.02,69,,,percent of total billed charges,69% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,201.24,78,,,percent of total billed charges,78% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,258,
Bill PATHOLOGY LEVEL IV,31288305,CDM,312,RC,88305,HCPCS,Outpatient,,,298,193.70,,262.24,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,298,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,187.74,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,45.59,15.3,,,percent of total billed charges,15.3% of total billed charges,205.62,69,,,percent of total billed charges,69% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,298,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,298,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,101.02,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,232.44,78,,,percent of total billed charges,78% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,298,
Bill PATHOLOGY LEVEL V,31288307,CDM,312,RC,88307,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,398.16,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,96.7,15.3,,,percent of total billed charges,15.3% of total billed charges,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,214.25,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,1183.25,
Bill PATHOLOGY LEVEL VI,31288309,CDM,312,RC,88309,HCPCS,Outpatient,,,1012,657.80,,890.56,88,,,percent of total billed charges,88% of total Billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,1012,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,637.56,63,,,percent of total billed charges,63% of total billed charges,1534.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,154.84,15.3,,,percent of total billed charges,15.3% of total billed charges,698.28,69,,,percent of total billed charges,69% of total billed charges,1012,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,1012,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,1012,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,2665.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,381.52,37.7,,,percent of total billed charges,37.70% of total billed charges,381.52,37.7,,,percent of total billed charges,37.70% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,343.07,33.9,,,percent of total billed charges,33.9% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,789.36,78,,,percent of total billed charges,78% of total billed charges,1012,100,,,percent of total billed charges,100% of total billed charges,835.91,82.6,,,percent of total billed charges,82.6% of total billed charges,835.91,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,885.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,2665.63,
Bill DECALCIFICATION PROCEDURE,31288311,CDM,312,RC,88311,HCPCS,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,46,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,46,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,46,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15.59,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.04,46,
Labcorp Bill SPECIAL STAINS GROUP I,31288312,CDM,312,RC,88312,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,117.18,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,63.05,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,202.15,
Bill SPECIAL STAINS GROUP II,31288313,CDM,312,RC,88313,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,117.18,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.05,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,186,
Bill HISTO STAIN FROZEN SECT,31288314,CDM,312,RC,88314,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,75,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,47.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,75,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,75,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,25.43,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.48,75,
Bill CYTOCHEMICAL STAIN,31188319,CDM,311,RC,88319,HCPCS,Outpatient,,,1011,657.15,,889.68,88,,,percent of total billed charges,88% of total Billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,1011,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,636.93,63,,,percent of total billed charges,63% of total billed charges,1534.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,154.68,15.3,,,percent of total billed charges,15.3% of total billed charges,697.59,69,,,percent of total billed charges,69% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,1011,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,1011,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,2665.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,342.73,33.9,,,percent of total billed charges,33.9% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,788.58,78,,,percent of total billed charges,78% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,885.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,2665.63,
Bill CONSULT RPT ON OS SLIDES,31288321,CDM,312,RC,88321,HCPCS,Outpatient,,,736,478.40,,647.68,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,736,100,,,percent of total billed charges,100% of total billed charges,34.17,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,463.68,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,112.61,15.3,,,percent of total billed charges,15.3% of total billed charges,507.84,69,,,percent of total billed charges,69% of total billed charges,736,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,736,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,736,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,24.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,33.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.13,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,277.47,37.7,,,percent of total billed charges,37.70% of total billed charges,277.47,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,249.5,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,574.08,78,,,percent of total billed charges,78% of total billed charges,736,100,,,percent of total billed charges,100% of total billed charges,607.94,82.6,,,percent of total billed charges,82.6% of total billed charges,607.94,82.6,,,percent of total billed charges,82.6% of total billed charges,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.57,736,
Bill CONSULT 2ND PREP SLIDE,31288323,CDM,312,RC,88323,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,34.17,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,398.16,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,96.7,15.3,,,percent of total billed charges,15.3% of total billed charges,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,24.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.13,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,214.25,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.57,632,
Bill PATH CONSULT IN SURGERY,31288329,CDM,312,RC,88329,HCPCS,Outpatient,,,207,134.55,,182.16,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,207,100,,,percent of total billed charges,100% of total billed charges,34.17,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,130.41,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,31.67,15.3,,,percent of total billed charges,15.3% of total billed charges,142.83,69,,,percent of total billed charges,69% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,207,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,207,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,33.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.13,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,70.17,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,161.46,78,,,percent of total billed charges,78% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.57,207,
Bill FROZEN SECTION SINGLE SPECIMEN,31288331,CDM,312,RC,88331,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,34.17,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,398.16,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,96.7,15.3,,,percent of total billed charges,15.3% of total billed charges,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,24.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,33.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.13,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,214.25,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.57,632,
Bill FROZEN SECTION ADDL TISSUE BLK,31288332,CDM,312,RC,88332,HCPCS,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,33.17,100,,,Fee Schedule,100% of WA Medicaid,41,100,,,percent of total billed charges,100% of total billed charges,34.17,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,25.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.17,100,,,Fee Schedule,100% of WA Medicaid,6.27,15.3,,,percent of total billed charges,15.3% of total billed charges,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,41,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,41,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.13,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,15.46,37.7,,,percent of total billed charges,37.70% of total billed charges,15.46,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,13.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.27,43.13,
Bill ICC ADD AB PER SLIDE,31288341,CDM,312,RC,88341,HCPCS,Outpatient,,,218,141.70,,191.84,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,218,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,137.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,33.35,15.3,,,percent of total billed charges,15.3% of total billed charges,150.42,69,,,percent of total billed charges,69% of total billed charges,218,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,218,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,218,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,82.19,37.7,,,percent of total billed charges,37.70% of total billed charges,82.19,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,73.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,170.04,78,,,percent of total billed charges,78% of total billed charges,218,100,,,percent of total billed charges,100% of total billed charges,180.07,82.6,,,percent of total billed charges,82.6% of total billed charges,180.07,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,218,
Bill ICC 1ST AB SLID NMCR,31288342,CDM,312,RC,88342,HCPCS,Outpatient,,,242,157.30,,212.96,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,242,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,152.46,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,37.03,15.3,,,percent of total billed charges,15.3% of total billed charges,166.98,69,,,percent of total billed charges,69% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,242,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,242,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,82.04,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,188.76,78,,,percent of total billed charges,78% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,605.96,
Bill ICC MLTPX AB ST,31288344,CDM,312,RC,88344,HCPCS,Outpatient,,,316,205.40,,278.08,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,316,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,199.08,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,48.35,15.3,,,percent of total billed charges,15.3% of total billed charges,218.04,69,,,percent of total billed charges,69% of total billed charges,316,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,316,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,316,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,119.13,37.7,,,percent of total billed charges,37.70% of total billed charges,119.13,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,107.12,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,246.48,78,,,percent of total billed charges,78% of total billed charges,316,100,,,percent of total billed charges,100% of total billed charges,261.02,82.6,,,percent of total billed charges,82.6% of total billed charges,261.02,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,1183.25,
Bill IMMUNOFLUORESCENT AB DIRECT,31288346,CDM,312,RC,88346,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,398.16,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,96.7,15.3,,,percent of total billed charges,15.3% of total billed charges,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,214.25,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,1183.25,
Bill ELECTRON MICROSCOPY DIAGNOSTIC,31288348,CDM,312,RC,88348,HCPCS,Outpatient,,,1552,1008.80,,1365.76,88,,,percent of total billed charges,88% of total Billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,1552,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,977.76,63,,,percent of total billed charges,63% of total billed charges,1534.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,237.46,15.3,,,percent of total billed charges,15.3% of total billed charges,1070.88,69,,,percent of total billed charges,69% of total billed charges,1552,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,1552,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,1552,100,,,percent of total billed charges,100% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,2665.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,585.1,37.7,,,percent of total billed charges,37.70% of total billed charges,585.1,37.7,,,percent of total billed charges,37.70% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,526.13,33.9,,,percent of total billed charges,33.9% of total billed charges,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,1210.56,78,,,percent of total billed charges,78% of total billed charges,1552,100,,,percent of total billed charges,100% of total billed charges,1281.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1281.95,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,885.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,877.04,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,2665.63,
Bill IMF SPEC ADDL AB ST,31288350,CDM,312,RC,88350,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,398.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,96.7,15.3,,,percent of total billed charges,15.3% of total billed charges,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,632,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,632,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,214.25,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,632,
Bill TUMOR IHC QT MAN,31288360,CDM,312,RC,88360,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,398.16,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,96.7,15.3,,,percent of total billed charges,15.3% of total billed charges,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,214.25,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,632,
Bill TUMOR IHC QT AUTO,31288361,CDM,312,RC,88361,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,398.16,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,96.7,15.3,,,percent of total billed charges,15.3% of total billed charges,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,214.25,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,1183.25,
Bill TIS HYBRID AD SNG PRB,31288364,CDM,312,RC,88364,HCPCS,Outpatient,,,443,287.95,,389.84,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,443,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,279.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,67.78,15.3,,,percent of total billed charges,15.3% of total billed charges,305.67,69,,,percent of total billed charges,69% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,443,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,443,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,150.18,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,345.54,78,,,percent of total billed charges,78% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,443,
Bill TIS HYBRID SPEC INIT,31288365,CDM,312,RC,88365,HCPCS,Outpatient,,,443,287.95,,389.84,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,443,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,279.09,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,67.78,15.3,,,percent of total billed charges,15.3% of total billed charges,305.67,69,,,percent of total billed charges,69% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,150.18,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,345.54,78,,,percent of total billed charges,78% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,605.96,
Bill TIS HYBRID MUL PRB,31288366,CDM,312,RC,88366,HCPCS,Outpatient,,,443,287.95,,389.84,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,443,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,279.09,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,67.78,15.3,,,percent of total billed charges,15.3% of total billed charges,305.67,69,,,percent of total billed charges,69% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,150.18,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,345.54,78,,,percent of total billed charges,78% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,1183.25,
Bill INSITU HYBR EA PROBE COMP ASST,31288367,CDM,312,RC,88367,HCPCS,Outpatient,,,323,209.95,,284.24,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,323,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,203.49,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,49.42,15.3,,,percent of total billed charges,15.3% of total billed charges,222.87,69,,,percent of total billed charges,69% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,323,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,323,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,109.5,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,251.94,78,,,percent of total billed charges,78% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,1183.25,
Bill Ins Hybr Man Sp IniI,31288368,CDM,312,RC,88368,HCPCS,Outpatient,,,554,360.10,,487.52,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,554,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,349.02,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,84.76,15.3,,,percent of total billed charges,15.3% of total billed charges,382.26,69,,,percent of total billed charges,69% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,554,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,554,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,187.81,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,432.12,78,,,percent of total billed charges,78% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,1183.25,
Bill INS HYBRD MAN SNG PR,31288369,CDM,312,RC,88369,HCPCS,Outpatient,,,554,360.10,,487.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,554,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,349.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,84.76,15.3,,,percent of total billed charges,15.3% of total billed charges,382.26,69,,,percent of total billed charges,69% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,554,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,554,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,187.81,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,432.12,78,,,percent of total billed charges,78% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,554,
Bill INS HYBR AUT SNG PR,31288373,CDM,312,RC,88373,HCPCS,Outpatient,,,484,314.60,,425.92,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,484,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,304.92,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,74.05,15.3,,,percent of total billed charges,15.3% of total billed charges,333.96,69,,,percent of total billed charges,69% of total billed charges,484,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,484,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,484,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,182.47,37.7,,,percent of total billed charges,37.70% of total billed charges,182.47,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,164.08,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,377.52,78,,,percent of total billed charges,78% of total billed charges,484,100,,,percent of total billed charges,100% of total billed charges,399.78,82.6,,,percent of total billed charges,82.6% of total billed charges,399.78,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,484,
Bill INS HYBR AUT MUL PR,31288374,CDM,312,RC,88374,HCPCS,Outpatient,,,548,356.20,,482.24,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,548,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,345.24,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,83.84,15.3,,,percent of total billed charges,15.3% of total billed charges,378.12,69,,,percent of total billed charges,69% of total billed charges,548,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,548,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,548,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,206.6,37.7,,,percent of total billed charges,37.70% of total billed charges,206.6,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,185.77,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,427.44,78,,,percent of total billed charges,78% of total billed charges,548,100,,,percent of total billed charges,100% of total billed charges,452.65,82.6,,,percent of total billed charges,82.6% of total billed charges,452.65,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,605.96,
Bill INS HYBR MAN MUL PR,31288377,CDM,312,RC,88377,HCPCS,Outpatient,,,554,360.10,,487.52,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,554,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,349.02,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,84.76,15.3,,,percent of total billed charges,15.3% of total billed charges,382.26,69,,,percent of total billed charges,69% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,554,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,554,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,187.81,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,432.12,78,,,percent of total billed charges,78% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,605.96,
Bill MICRODISSECTION,31088381,CDM,310,RC,88381,HCPCS,Outpatient,,,363,235.95,,319.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,363,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,228.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid,55.54,15.3,,,percent of total billed charges,15.3% of total billed charges,250.47,69,,,percent of total billed charges,69% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,363,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,363,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,123.06,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,283.14,78,,,percent of total billed charges,78% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,363,
Bill UNLISTED MISC PATH LAB,31088399,CDM,310,RC,88399,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,117.18,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,63.05,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,202.15,
Bill SPECIMEN HANDLING,30099001,CDM,300,RC,99001,HCPCS,Outpatient,,,107,69.55,,94.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,2.1,100,,,Fee Schedule,100% of WA Medicaid,107,100,,,percent of total billed charges,100% of total billed charges,2.16,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,67.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.1,100,,,Fee Schedule,100% of WA Medicaid,16.37,15.3,,,percent of total billed charges,15.3% of total billed charges,73.83,69,,,percent of total billed charges,69% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,107,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,107,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2.73,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,36.27,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,83.46,78,,,percent of total billed charges,78% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.55,107,
Bill Urinalysis w/Microscopic,30781001,CDM,307,RC,81001,HCPCS,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,55,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,34.65,63,,,percent of total billed charges,63% of total billed charges,5.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,55,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,55,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,12.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,18.65,33.9,,,percent of total billed charges,33.9% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,55,
Bill Only UA Micro Not Ind,30781003,CDM,307,RC,81003,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,3.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,40,
Bill GLU POCT,BGP,CDM,301,RC,82948,HCPCS,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,62,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,39.06,63,,,percent of total billed charges,63% of total billed charges,8.82,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,9.49,15.3,,,percent of total billed charges,15.3% of total billed charges,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,62,100,,,percent of total billed charges,100% of total billed charges,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,62,100,,,percent of total billed charges,100% of total billed charges,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,19.27,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,21.02,33.9,,,percent of total billed charges,33.9% of total billed charges,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,5.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,62,
Buprenorphine LC,30180348,CDM,301,RC,80348,HCPCS,Outpatient,,,285,185.25,,250.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,285,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,179.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",43.61,15.3,,,percent of total billed charges,15.3% of total billed charges,196.65,69,,,percent of total billed charges,69% of total billed charges,285,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,285,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,285,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,107.45,37.7,,,percent of total billed charges,37.70% of total billed charges,107.45,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,96.62,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,222.3,78,,,percent of total billed charges,78% of total billed charges,285,100,,,percent of total billed charges,100% of total billed charges,235.41,82.6,,,percent of total billed charges,82.6% of total billed charges,235.41,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47.88,16.8,,,percent of total billed charges,16.8% of total billed charges,43.61,285,
Bill Basic Metabolic Panel +ICA,30180047,CDM,301,RC,80047,HCPCS,Outpatient,,,204,132.60,,179.52,88,,,percent of total billed charges,88% of total Billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,204,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,128.52,63,,,percent of total billed charges,63% of total billed charges,24.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,31.21,15.3,,,percent of total billed charges,15.3% of total billed charges,140.76,69,,,percent of total billed charges,69% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,204,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,204,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,52.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,76.91,37.7,,,percent of total billed charges,37.70% of total billed charges,76.91,37.7,,,percent of total billed charges,37.70% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,69.16,33.9,,,percent of total billed charges,33.9% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,159.12,78,,,percent of total billed charges,78% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.86,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,204,
"HLA Class I Antibody, Class II Ab Scrn",30286828,CDM,302,RC,86828,HCPCS,Outpatient,,,255,165.75,,224.4,88,,,percent of total billed charges,88% of total Billed charges,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,23.6,100,,,Fee Schedule,100% of WA Medicaid,255,100,,,percent of total billed charges,100% of total billed charges,24.31,103,,,Fee Schedule,103% of WA Medicaid,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,160.65,63,,,percent of total billed charges,63% of total billed charges,112.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.6,100,,,Fee Schedule,100% of WA Medicaid,39.02,15.3,,,percent of total billed charges,15.3% of total billed charges,175.95,69,,,percent of total billed charges,69% of total billed charges,255,100,,,percent of total billed charges,100% of total billed charges,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,255,100,,,percent of total billed charges,100% of total billed charges,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,255,100,,,percent of total billed charges,100% of total billed charges,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,245.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,17.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,24.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.68,130,,,Fee Schedule,130% of WA Medicaid ,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,96.14,37.7,,,percent of total billed charges,37.70% of total billed charges,96.14,37.7,,,percent of total billed charges,37.70% of total billed charges,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,86.45,33.9,,,percent of total billed charges,33.9% of total billed charges,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,198.9,78,,,percent of total billed charges,78% of total billed charges,255,100,,,percent of total billed charges,100% of total billed charges,210.63,82.6,,,percent of total billed charges,82.6% of total billed charges,210.63,82.6,,,percent of total billed charges,82.6% of total billed charges,23.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,64.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,64.19,100,,,Fee Schedule,100% of Medicare OPPS rate,23.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.48,255,
Bill Only Organism ID - Mold LC,30687107,CDM,306,RC,87107,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,56.7,63,,,percent of total billed charges,63% of total billed charges,18.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,39.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,30.51,33.9,,,percent of total billed charges,33.9% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,90,
"Beta 2 Glycoprotein I antibody, each",30286146,CDM,302,RC,86146,HCPCS,Outpatient,,,217,141.05,,190.96,88,,,percent of total billed charges,88% of total Billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,217,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,136.71,63,,,percent of total billed charges,63% of total billed charges,44.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,33.2,15.3,,,percent of total billed charges,15.3% of total billed charges,149.73,69,,,percent of total billed charges,69% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,217,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,217,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,97.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,81.81,37.7,,,percent of total billed charges,37.70% of total billed charges,81.81,37.7,,,percent of total billed charges,37.70% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,73.56,33.9,,,percent of total billed charges,33.9% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,169.26,78,,,percent of total billed charges,78% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,217,
Avero Bill SPECIAL STAINS GROUP I,31288312,CDM,312,RC,88312,HCPCS,Outpatient,,,336,218.40,,295.68,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,336,100,,,percent of total billed charges,100% of total billed charges,20.52,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,211.68,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,51.41,15.3,,,percent of total billed charges,15.3% of total billed charges,231.84,69,,,percent of total billed charges,69% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,336,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,336,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,113.9,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,262.08,78,,,percent of total billed charges,78% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,336,
31188161,31188161,CDM,311,RC,88161,HCPCS,Outpatient,,,119,77.35,,104.72,88,,,percent of total billed charges,88% of total Billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,119,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,74.97,63,,,percent of total billed charges,63% of total billed charges,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,18.21,15.3,,,percent of total billed charges,15.3% of total billed charges,82.11,69,,,percent of total billed charges,69% of total billed charges,119,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,119,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,119,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,44.86,37.7,,,percent of total billed charges,37.70% of total billed charges,44.86,37.7,,,percent of total billed charges,37.70% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,40.34,33.9,,,percent of total billed charges,33.9% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,92.82,78,,,percent of total billed charges,78% of total billed charges,119,100,,,percent of total billed charges,100% of total billed charges,98.29,82.6,,,percent of total billed charges,82.6% of total billed charges,98.29,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.21,119,
Bronchial Washings Cytology LC,31188112,CDM,311,RC,88112,HCPCS,Outpatient,,,203,131.95,,178.64,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,203,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,127.89,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,31.06,15.3,,,percent of total billed charges,15.3% of total billed charges,140.07,69,,,percent of total billed charges,69% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,68.82,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,158.34,78,,,percent of total billed charges,78% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,203,
31188104,31188104,CDM,311,RC,88104,HCPCS,Outpatient,,,359,233.35,,315.92,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,359,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,226.17,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,54.93,15.3,,,percent of total billed charges,15.3% of total billed charges,247.71,69,,,percent of total billed charges,69% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,121.7,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,280.02,78,,,percent of total billed charges,78% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,359,
Brucella Antibody IgG/IgM LC,30286622,CDM,302,RC,86622,HCPCS,Outpatient,,,124,80.60,,109.12,88,,,percent of total billed charges,88% of total Billed charges,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,124,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,78.12,63,,,percent of total billed charges,63% of total billed charges,15.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,18.97,15.3,,,percent of total billed charges,15.3% of total billed charges,85.56,69,,,percent of total billed charges,69% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,124,100,,,percent of total billed charges,100% of total billed charges,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,124,100,,,percent of total billed charges,100% of total billed charges,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,34.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,42.04,33.9,,,percent of total billed charges,33.9% of total billed charges,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,96.72,78,,,percent of total billed charges,78% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,124,
"C albicans + C glabrata, NAA LC",30687801,CDM,306,RC,87801,HCPCS,Outpatient,,,243,157.95,,213.84,88,,,percent of total billed charges,88% of total Billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,243,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,153.09,63,,,percent of total billed charges,63% of total billed charges,122.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,37.18,15.3,,,percent of total billed charges,15.3% of total billed charges,167.67,69,,,percent of total billed charges,69% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,243,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,243,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,268.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,82.38,33.9,,,percent of total billed charges,33.9% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,189.54,78,,,percent of total billed charges,78% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,268.51,
"C Difficile Toxins, Molecular",30687324,CDM,306,RC,87324,HCPCS,Outpatient,,,264,171.60,,232.32,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,264,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,166.32,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,89.5,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,264,
"C difficile Toxins A+B, EIA LC",30687324,CDM,306,RC,87324,HCPCS,Outpatient,,,327,212.55,,287.76,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,327,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,206.01,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,50.03,15.3,,,percent of total billed charges,15.3% of total billed charges,225.63,69,,,percent of total billed charges,69% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,327,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,327,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,110.85,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,255.06,78,,,percent of total billed charges,78% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,327,
C difficile Toxin Gene NAA LC,30687493,CDM,306,RC,87493,HCPCS,Outpatient,,,141.75,92.14,,124.74,88,,,percent of total billed charges,88% of total Billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,141.75,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,89.3,63,,,percent of total billed charges,63% of total billed charges,65.22,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,21.69,15.3,,,percent of total billed charges,15.3% of total billed charges,97.81,69,,,percent of total billed charges,69% of total billed charges,141.75,100,,,percent of total billed charges,100% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,141.75,100,,,percent of total billed charges,100% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,141.75,100,,,percent of total billed charges,100% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,142.55,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,53.44,37.7,,,percent of total billed charges,37.70% of total billed charges,53.44,37.7,,,percent of total billed charges,37.70% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,48.05,33.9,,,percent of total billed charges,33.9% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,110.57,78,,,percent of total billed charges,78% of total billed charges,141.75,100,,,percent of total billed charges,100% of total billed charges,117.09,82.6,,,percent of total billed charges,82.6% of total billed charges,117.09,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,37.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,142.55,
C-Diff Toxin B PCR (GeneXpert),30687493,CDM,306,RC,87493,HCPCS,Outpatient,,,95,61.75,,83.6,88,,,percent of total billed charges,88% of total Billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,95,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,59.85,63,,,percent of total billed charges,63% of total billed charges,65.22,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,14.54,15.3,,,percent of total billed charges,15.3% of total billed charges,65.55,69,,,percent of total billed charges,69% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,95,100,,,percent of total billed charges,100% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,95,100,,,percent of total billed charges,100% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,142.55,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,35.82,37.7,,,percent of total billed charges,37.70% of total billed charges,35.82,37.7,,,percent of total billed charges,37.70% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,32.21,33.9,,,percent of total billed charges,33.9% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,74.1,78,,,percent of total billed charges,78% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,37.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.27,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.54,142.55,
C-Peptide LC,30184681,CDM,301,RC,84681,HCPCS,Outpatient,,,402,261.30,,353.76,88,,,percent of total billed charges,88% of total Billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,402,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,253.26,63,,,percent of total billed charges,63% of total billed charges,36.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,61.51,15.3,,,percent of total billed charges,15.3% of total billed charges,277.38,69,,,percent of total billed charges,69% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,79.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,136.28,33.9,,,percent of total billed charges,33.9% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,313.56,78,,,percent of total billed charges,78% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,21.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,402,
C-Reactive Protein,30286140,CDM,302,RC,86140,HCPCS,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,32,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,20.16,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,32,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,32,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,12.06,37.7,,,percent of total billed charges,37.70% of total billed charges,12.06,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.85,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.9,32,
C-Reactive Protein High Sensitivity,30086141,CDM,300,RC,86141,HCPCS,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,220,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,138.6,63,,,percent of total billed charges,63% of total billed charges,22.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,33.66,15.3,,,percent of total billed charges,15.3% of total billed charges,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,220,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,220,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,74.58,33.9,,,percent of total billed charges,33.9% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,13.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,220,
"C-Reactive Protein, Cardiac LC",30286141,CDM,302,RC,86141,HCPCS,Outpatient,,,247,160.55,,217.36,88,,,percent of total billed charges,88% of total Billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,247,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,155.61,63,,,percent of total billed charges,63% of total billed charges,22.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,37.79,15.3,,,percent of total billed charges,15.3% of total billed charges,170.43,69,,,percent of total billed charges,69% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,83.73,33.9,,,percent of total billed charges,33.9% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,192.66,78,,,percent of total billed charges,78% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,13.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,247,
C-reactive protein LC,30286140,CDM,302,RC,86140,HCPCS,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,38,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,23.94,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,38,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,38,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.33,37.7,,,percent of total billed charges,37.70% of total billed charges,14.33,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.18,38,
Clostridium Difficile Toxins,30087324,CDM,300,RC,87324,HCPCS,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,58,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,36.54,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,58,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,58,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,19.66,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,58,
Clostridium difficile Quik Chek Complete,30687324,CDM,306,RC,87324,HCPCS,Outpatient,,,196,127.40,,172.48,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,196,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,123.48,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,29.99,15.3,,,percent of total billed charges,15.3% of total billed charges,135.24,69,,,percent of total billed charges,69% of total billed charges,196,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,196,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,196,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,73.89,37.7,,,percent of total billed charges,37.70% of total billed charges,73.89,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,66.44,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,152.88,78,,,percent of total billed charges,78% of total billed charges,196,100,,,percent of total billed charges,100% of total billed charges,161.9,82.6,,,percent of total billed charges,82.6% of total billed charges,161.9,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,196,
C1 Esterase Inhibitor LC,30286160,CDM,302,RC,86160,HCPCS,Outpatient,,,105,68.25,,92.4,88,,,percent of total billed charges,88% of total Billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,105,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12,100,,,Fee Schedule,100% of Medicare OPPS rate,66.15,63,,,percent of total billed charges,63% of total billed charges,21,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,16.07,15.3,,,percent of total billed charges,15.3% of total billed charges,72.45,69,,,percent of total billed charges,69% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,45.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12,100,,,Fee Schedule,100% of Medicare OPPS rate,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,35.6,33.9,,,percent of total billed charges,33.9% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,78,,,percent of total billed charges,78% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12.12,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,105,
"C1 Esterase Inhibitor, Func LC",30286161,CDM,302,RC,86161,HCPCS,Outpatient,,,159,103.35,,139.92,88,,,percent of total billed charges,88% of total Billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,159,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12,100,,,Fee Schedule,100% of Medicare OPPS rate,100.17,63,,,percent of total billed charges,63% of total billed charges,21,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,24.33,15.3,,,percent of total billed charges,15.3% of total billed charges,109.71,69,,,percent of total billed charges,69% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,159,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,159,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,45.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12,100,,,Fee Schedule,100% of Medicare OPPS rate,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,53.9,33.9,,,percent of total billed charges,33.9% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,124.02,78,,,percent of total billed charges,78% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12.12,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,159,
C3d Immune Complexes LC,30286332,CDM,302,RC,86332,HCPCS,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,132,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,83.16,63,,,percent of total billed charges,63% of total billed charges,42.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,93.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,44.75,33.9,,,percent of total billed charges,33.9% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,24.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,132,
C4+C3 LC,30286160,CDM,302,RC,86160,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12,100,,,Fee Schedule,100% of Medicare OPPS rate,53.55,63,,,percent of total billed charges,63% of total billed charges,21,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,45.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12.12,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,85,
CA 19-9 LC,30286301,CDM,302,RC,86301,HCPCS,Outpatient,,,402,261.30,,353.76,88,,,percent of total billed charges,88% of total Billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,402,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,253.26,63,,,percent of total billed charges,63% of total billed charges,36.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,61.51,15.3,,,percent of total billed charges,15.3% of total billed charges,277.38,69,,,percent of total billed charges,69% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,79.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,136.28,33.9,,,percent of total billed charges,33.9% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,313.56,78,,,percent of total billed charges,78% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,21.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,402,
CA 27.29 LC,30286300,CDM,302,RC,86300,HCPCS,Outpatient,,,402,261.30,,353.76,88,,,percent of total billed charges,88% of total Billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,402,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,253.26,63,,,percent of total billed charges,63% of total billed charges,36.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,61.51,15.3,,,percent of total billed charges,15.3% of total billed charges,277.38,69,,,percent of total billed charges,69% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,79.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,136.28,33.9,,,percent of total billed charges,33.9% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,313.56,78,,,percent of total billed charges,78% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,21.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,402,
Cord Blood Gas (Arterial),30082803,CDM,300,RC,82803,HCPCS,Outpatient,,,408,265.20,,359.04,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,408,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,257.04,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,62.42,15.3,,,percent of total billed charges,15.3% of total billed charges,281.52,69,,,percent of total billed charges,69% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,138.31,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,318.24,78,,,percent of total billed charges,78% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,408,
CBC w/ Manual Differential,30585027,CDM,305,RC,85027,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,146,
CBC w/ Differential,30585025,CDM,305,RC,85025,HCPCS,Outpatient,,,158,102.70,,139.04,88,,,percent of total billed charges,88% of total Billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,158,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,99.54,63,,,percent of total billed charges,63% of total billed charges,13.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,24.17,15.3,,,percent of total billed charges,15.3% of total billed charges,109.02,69,,,percent of total billed charges,69% of total billed charges,158,100,,,percent of total billed charges,100% of total billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,158,100,,,percent of total billed charges,100% of total billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,158,100,,,percent of total billed charges,100% of total billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,29.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,59.57,37.7,,,percent of total billed charges,37.70% of total billed charges,59.57,37.7,,,percent of total billed charges,37.70% of total billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,53.56,33.9,,,percent of total billed charges,33.9% of total billed charges,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,123.24,78,,,percent of total billed charges,78% of total billed charges,158,100,,,percent of total billed charges,100% of total billed charges,130.51,82.6,,,percent of total billed charges,82.6% of total billed charges,130.51,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,158,
Hemogram Automated,30585027,CDM,305,RC,85027,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,146,
CAPILLARY BLOOD GAS,30182803,CDM,301,RC,82803,HCPCS,Outpatient,,,408,265.20,,359.04,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,408,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,257.04,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,62.42,15.3,,,percent of total billed charges,15.3% of total billed charges,281.52,69,,,percent of total billed charges,69% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,138.31,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,318.24,78,,,percent of total billed charges,78% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,408,
Blood Gas Capillary RT,30082803,CDM,300,RC,82803,HCPCS,Outpatient,,,408,265.20,,359.04,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,408,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,257.04,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,62.42,15.3,,,percent of total billed charges,15.3% of total billed charges,281.52,69,,,percent of total billed charges,69% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,138.31,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,318.24,78,,,percent of total billed charges,78% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,408,
CCP Antibodies IgG/IgA LC,30286200,CDM,302,RC,86200,HCPCS,Outpatient,,,97,63.05,,85.36,88,,,percent of total billed charges,88% of total Billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,97,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,61.11,63,,,percent of total billed charges,63% of total billed charges,22.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.84,15.3,,,percent of total billed charges,15.3% of total billed charges,66.93,69,,,percent of total billed charges,69% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,32.88,33.9,,,percent of total billed charges,33.9% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,75.66,78,,,percent of total billed charges,78% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,13.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,97,
CEA LC,30182378,CDM,301,RC,82378,HCPCS,Outpatient,,,385,250.25,,338.8,88,,,percent of total billed charges,88% of total Billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,385,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,242.55,63,,,percent of total billed charges,63% of total billed charges,33.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,58.91,15.3,,,percent of total billed charges,15.3% of total billed charges,265.65,69,,,percent of total billed charges,69% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,72.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,130.52,33.9,,,percent of total billed charges,33.9% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,300.3,78,,,percent of total billed charges,78% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,19.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,385,
"CEA, Fluid LC",30182378,CDM,301,RC,82378,HCPCS,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,92.61,63,,,percent of total billed charges,63% of total billed charges,33.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,72.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,19.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.96,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,147,
iSTAT CG4 Blood Gases POCT,30182803,CDM,301,RC,82803,HCPCS,Outpatient,,,66,42.90,,58.08,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,66,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,41.58,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,10.1,15.3,,,percent of total billed charges,15.3% of total billed charges,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,22.37,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.1,99.71,
CPK ISOENZYMES,30182552,CDM,301,RC,82552,HCPCS,Outpatient,,,233,151.45,,205.04,88,,,percent of total billed charges,88% of total Billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,233,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,146.79,63,,,percent of total billed charges,63% of total billed charges,23.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,35.65,15.3,,,percent of total billed charges,15.3% of total billed charges,160.77,69,,,percent of total billed charges,69% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,233,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,233,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,51.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,87.84,37.7,,,percent of total billed charges,37.70% of total billed charges,87.84,37.7,,,percent of total billed charges,37.70% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,78.99,33.9,,,percent of total billed charges,33.9% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,181.74,78,,,percent of total billed charges,78% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.52,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,233,
CLO Test,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,26,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,63,,,percent of total billed charges,63% of total billed charges,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,9.8,37.7,,,percent of total billed charges,37.70% of total billed charges,9.8,37.7,,,percent of total billed charges,37.70% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,8.81,33.9,,,percent of total billed charges,33.9% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.98,26,
Comprehensive Metabolic Panel,30180053,CDM,301,RC,80053,HCPCS,Outpatient,,,340,221.00,,299.2,88,,,percent of total billed charges,88% of total Billed charges,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,340,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,214.2,63,,,percent of total billed charges,63% of total billed charges,18.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,52.02,15.3,,,percent of total billed charges,15.3% of total billed charges,234.6,69,,,percent of total billed charges,69% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,340,100,,,percent of total billed charges,100% of total billed charges,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,340,100,,,percent of total billed charges,100% of total billed charges,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,40.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,115.26,33.9,,,percent of total billed charges,33.9% of total billed charges,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,265.2,78,,,percent of total billed charges,78% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,10.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.56,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,340,
CMV PCR LC,30687496,CDM,306,RC,87496,HCPCS,Outpatient,,,588,382.20,,517.44,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,588,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,370.44,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.96,15.3,,,percent of total billed charges,15.3% of total billed charges,405.72,69,,,percent of total billed charges,69% of total billed charges,588,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,588,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,588,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,221.68,37.7,,,percent of total billed charges,37.70% of total billed charges,221.68,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,199.33,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,458.64,78,,,percent of total billed charges,78% of total billed charges,588,100,,,percent of total billed charges,100% of total billed charges,485.69,82.6,,,percent of total billed charges,82.6% of total billed charges,485.69,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,588,
CMV Abs IgG/IgM LC,30086644,CDM,300,RC,86644,HCPCS,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,50,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,31.5,63,,,percent of total billed charges,63% of total billed charges,25.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,50,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,50,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.85,37.7,,,percent of total billed charges,37.70% of total billed charges,18.85,37.7,,,percent of total billed charges,37.70% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,16.95,33.9,,,percent of total billed charges,33.9% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,55.04,
CMV Quant DNA PCR (Plasma) LC,30687497,CDM,306,RC,87497,HCPCS,Outpatient,,,1884,1224.60,,1657.92,88,,,percent of total billed charges,88% of total Billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,1884,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1186.92,63,,,percent of total billed charges,63% of total billed charges,74.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,288.25,15.3,,,percent of total billed charges,15.3% of total billed charges,1299.96,69,,,percent of total billed charges,69% of total billed charges,1884,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1884,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1884,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,163.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,710.27,37.7,,,percent of total billed charges,37.70% of total billed charges,710.27,37.7,,,percent of total billed charges,37.70% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,638.68,33.9,,,percent of total billed charges,33.9% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1469.52,78,,,percent of total billed charges,78% of total billed charges,1884,100,,,percent of total billed charges,100% of total billed charges,1556.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1556.18,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,43.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,1884,
Venipuncture Routine,30036415,CDM,300,RC,36415,HCPCS,Outpatient,,,96,62.40,,,,,,Other,Not Separately reimbursable,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.1,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,2.16,103,,,Fee Schedule,103% of WA Medicaid,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,15.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.1,100,,,Fee Schedule,100% of WA Medicaid,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,11.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,1.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2.73,130,,,Fee Schedule,130% of WA Medicaid ,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,32.54,33.9,,,percent of total billed charges,33.9% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.55,96,
CORDSTAT 13 LC,30080307,CDM,300,RC,80307,HCPCS,Outpatient,,,326,211.90,,286.88,88,,,percent of total billed charges,88% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,326,100,,,percent of total billed charges,100% of total billed charges,56.41,17.304,,,percent of total billed charges,17.304% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,205.38,63,,,percent of total billed charges,63% of total billed charges,108.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,49.88,15.3,,,percent of total billed charges,15.3% of total billed charges,224.94,69,,,percent of total billed charges,69% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,237.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,55.86,17.136,,,percent of total billed charges,17.136% of total billed charges,71.2,21.84,,,percent of total billed charges,21.84% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,110.51,33.9,,,percent of total billed charges,33.9% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,254.28,78,,,percent of total billed charges,78% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,49.88,326,
CORDSTAT 9 LC,30080307,CDM,300,RC,80307,HCPCS,Outpatient,,,401,260.65,,352.88,88,,,percent of total billed charges,88% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,67.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,401,100,,,percent of total billed charges,100% of total billed charges,69.39,17.304,,,percent of total billed charges,17.304% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,252.63,63,,,percent of total billed charges,63% of total billed charges,108.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,67.37,16.8,,,percent of total billed charges,16.8% of total billed charges,61.35,15.3,,,percent of total billed charges,15.3% of total billed charges,276.69,69,,,percent of total billed charges,69% of total billed charges,401,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,401,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,401,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,237.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,67.37,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,67.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,68.72,17.136,,,percent of total billed charges,17.136% of total billed charges,87.58,21.84,,,percent of total billed charges,21.84% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,151.18,37.7,,,percent of total billed charges,37.70% of total billed charges,151.18,37.7,,,percent of total billed charges,37.70% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,135.94,33.9,,,percent of total billed charges,33.9% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,312.78,78,,,percent of total billed charges,78% of total billed charges,401,100,,,percent of total billed charges,100% of total billed charges,331.23,82.6,,,percent of total billed charges,82.6% of total billed charges,331.23,82.6,,,percent of total billed charges,82.6% of total billed charges,67.37,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,67.37,16.8,,,percent of total billed charges,16.8% of total billed charges,61.35,401,
COVID-19 Rapid Antigen POCT,30287811,CDM,302,RC,87811,HCPCS,Outpatient,,,108,70.20,,95.04,88,,,percent of total billed charges,88% of total Billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,108,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,68.04,63,,,percent of total billed charges,63% of total billed charges,72.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,16.52,15.3,,,percent of total billed charges,15.3% of total billed charges,74.52,69,,,percent of total billed charges,69% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,108,100,,,percent of total billed charges,100% of total billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,108,100,,,percent of total billed charges,100% of total billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,41.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,40.72,37.7,,,percent of total billed charges,37.70% of total billed charges,40.72,37.7,,,percent of total billed charges,37.70% of total billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,36.61,33.9,,,percent of total billed charges,33.9% of total billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,84.24,78,,,percent of total billed charges,78% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,41.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,108,
CSF Cell Count W/Diff if Indicated,30989050,CDM,300,RC,89050,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,8.91,103,,,Fee Schedule,103% of WA Medicaid,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,8.26,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,6.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.24,130,,,Fee Schedule,130% of WA Medicaid ,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.72,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.72,194,
CSF Differential,30989051,CDM,309,RC,89051,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,8.91,103,,,Fee Schedule,103% of WA Medicaid,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,63,63,,,percent of total billed charges,63% of total billed charges,9.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,21.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,6.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.24,130,,,Fee Schedule,130% of WA Medicaid ,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,5.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.6,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.6,100,
CT/NG PCR (GeneXpert),30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,179,116.35,,157.52,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,179,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,112.77,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,27.39,15.3,,,percent of total billed charges,15.3% of total billed charges,123.51,69,,,percent of total billed charges,69% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,60.68,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,139.62,78,,,percent of total billed charges,78% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,179,
Calcium Ionized,30082330,CDM,301,RC,82330,HCPCS,Outpatient,,,155,100.75,,136.4,88,,,percent of total billed charges,88% of total Billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,155,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,97.65,63,,,percent of total billed charges,63% of total billed charges,23.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,23.72,15.3,,,percent of total billed charges,15.3% of total billed charges,106.95,69,,,percent of total billed charges,69% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.55,33.9,,,percent of total billed charges,33.9% of total billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,120.9,78,,,percent of total billed charges,78% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,13.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,155,
CADMIUM BLOOD,30182300,CDM,301,RC,82300,HCPCS,Outpatient,,,103,66.95,,90.64,88,,,percent of total billed charges,88% of total Billed charges,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,103,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,64.89,63,,,percent of total billed charges,63% of total billed charges,41.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,15.76,15.3,,,percent of total billed charges,15.3% of total billed charges,71.07,69,,,percent of total billed charges,69% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,90.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,34.92,33.9,,,percent of total billed charges,33.9% of total billed charges,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,80.34,78,,,percent of total billed charges,78% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,23.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,23.64,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,103,
Calcium Total,30182310,CDM,301,RC,82310,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,55.44,63,,,percent of total billed charges,63% of total billed charges,9.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,19.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,29.83,33.9,,,percent of total billed charges,33.9% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,88,
Calcitonin LC,30182308,CDM,301,RC,82308,HCPCS,Outpatient,,,548,356.20,,482.24,88,,,percent of total billed charges,88% of total Billed charges,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,548,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,345.24,63,,,percent of total billed charges,63% of total billed charges,46.88,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,83.84,15.3,,,percent of total billed charges,15.3% of total billed charges,378.12,69,,,percent of total billed charges,69% of total billed charges,548,100,,,percent of total billed charges,100% of total billed charges,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,548,100,,,percent of total billed charges,100% of total billed charges,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,548,100,,,percent of total billed charges,100% of total billed charges,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,102.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,206.6,37.7,,,percent of total billed charges,37.70% of total billed charges,206.6,37.7,,,percent of total billed charges,37.70% of total billed charges,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,185.77,33.9,,,percent of total billed charges,33.9% of total billed charges,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,427.44,78,,,percent of total billed charges,78% of total billed charges,548,100,,,percent of total billed charges,100% of total billed charges,452.65,82.6,,,percent of total billed charges,82.6% of total billed charges,452.65,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,27.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.79,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,548,
"Calcium, Ionized LC",30182330,CDM,301,RC,82330,HCPCS,Outpatient,,,338,219.70,,297.44,88,,,percent of total billed charges,88% of total Billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,338,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,212.94,63,,,percent of total billed charges,63% of total billed charges,23.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,51.71,15.3,,,percent of total billed charges,15.3% of total billed charges,233.22,69,,,percent of total billed charges,69% of total billed charges,338,100,,,percent of total billed charges,100% of total billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,338,100,,,percent of total billed charges,100% of total billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,338,100,,,percent of total billed charges,100% of total billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,127.43,37.7,,,percent of total billed charges,37.70% of total billed charges,127.43,37.7,,,percent of total billed charges,37.70% of total billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,114.58,33.9,,,percent of total billed charges,33.9% of total billed charges,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,263.64,78,,,percent of total billed charges,78% of total billed charges,338,100,,,percent of total billed charges,100% of total billed charges,279.19,82.6,,,percent of total billed charges,82.6% of total billed charges,279.19,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,13.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.68,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,338,
"VITAMIN D,1,25-DIHYDROXY",30182652,CDM,301,RC,82652,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,317.52,63,,,percent of total billed charges,63% of total billed charges,67.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,77.11,15.3,,,percent of total billed charges,15.3% of total billed charges,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,504,100,,,percent of total billed charges,100% of total billed charges,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,504,100,,,percent of total billed charges,100% of total billed charges,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,147.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,170.86,33.9,,,percent of total billed charges,33.9% of total billed charges,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,38.88,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,38.5,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,504,
"Calculi, Urinary LC 120790",30182360,CDM,301,RC,82360,HCPCS,Outpatient,,,144,93.60,,126.72,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,144,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,90.72,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,22.03,15.3,,,percent of total billed charges,15.3% of total billed charges,99.36,69,,,percent of total billed charges,69% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,144,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,144,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,54.29,37.7,,,percent of total billed charges,37.70% of total billed charges,54.29,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.82,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,112.32,78,,,percent of total billed charges,78% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,144,
"Calprotectin, Fecal LC",30183993,CDM,301,RC,83993,HCPCS,Outpatient,,,967,628.55,,850.96,88,,,percent of total billed charges,88% of total Billed charges,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,967,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,609.21,63,,,percent of total billed charges,63% of total billed charges,34.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,147.95,15.3,,,percent of total billed charges,15.3% of total billed charges,667.23,69,,,percent of total billed charges,69% of total billed charges,967,100,,,percent of total billed charges,100% of total billed charges,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,967,100,,,percent of total billed charges,100% of total billed charges,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,967,100,,,percent of total billed charges,100% of total billed charges,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,75.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,364.56,37.7,,,percent of total billed charges,37.70% of total billed charges,364.56,37.7,,,percent of total billed charges,37.70% of total billed charges,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,327.81,33.9,,,percent of total billed charges,33.9% of total billed charges,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,754.26,78,,,percent of total billed charges,78% of total billed charges,967,100,,,percent of total billed charges,100% of total billed charges,798.74,82.6,,,percent of total billed charges,82.6% of total billed charges,798.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,19.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.63,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,967,
Cancer Antigen (CA) 15-3 LC,30286300,CDM,302,RC,86300,HCPCS,Outpatient,,,425,276.25,,374,88,,,percent of total billed charges,88% of total Billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,425,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,267.75,63,,,percent of total billed charges,63% of total billed charges,36.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,65.03,15.3,,,percent of total billed charges,15.3% of total billed charges,293.25,69,,,percent of total billed charges,69% of total billed charges,425,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,425,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,425,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,79.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,160.23,37.7,,,percent of total billed charges,37.70% of total billed charges,160.23,37.7,,,percent of total billed charges,37.70% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,144.08,33.9,,,percent of total billed charges,33.9% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,331.5,78,,,percent of total billed charges,78% of total billed charges,425,100,,,percent of total billed charges,100% of total billed charges,351.05,82.6,,,percent of total billed charges,82.6% of total billed charges,351.05,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,21.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,425,
Cancer Antigen (CA) 125 LC,30286304,CDM,302,RC,86304,HCPCS,Outpatient,,,584,379.60,,513.92,88,,,percent of total billed charges,88% of total Billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,584,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,367.92,63,,,percent of total billed charges,63% of total billed charges,36.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,89.35,15.3,,,percent of total billed charges,15.3% of total billed charges,402.96,69,,,percent of total billed charges,69% of total billed charges,584,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,584,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,584,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,79.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,220.17,37.7,,,percent of total billed charges,37.70% of total billed charges,220.17,37.7,,,percent of total billed charges,37.70% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,197.98,33.9,,,percent of total billed charges,33.9% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,455.52,78,,,percent of total billed charges,78% of total billed charges,584,100,,,percent of total billed charges,100% of total billed charges,482.38,82.6,,,percent of total billed charges,82.6% of total billed charges,482.38,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,21.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,584,
Candidiasis Panel AVR,30687481,CDM,306,RC,87481,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
CARBAMAZEPINE (TEGRETOL),30180156,CDM,301,RC,80156,HCPCS,Outpatient,,,252,163.80,,221.76,88,,,percent of total billed charges,88% of total Billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,252,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,158.76,63,,,percent of total billed charges,63% of total billed charges,25.49,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,38.56,15.3,,,percent of total billed charges,15.3% of total billed charges,173.88,69,,,percent of total billed charges,69% of total billed charges,252,100,,,percent of total billed charges,100% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,252,100,,,percent of total billed charges,100% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,252,100,,,percent of total billed charges,100% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,55.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,95,37.7,,,percent of total billed charges,37.70% of total billed charges,95,37.7,,,percent of total billed charges,37.70% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,85.43,33.9,,,percent of total billed charges,33.9% of total billed charges,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,196.56,78,,,percent of total billed charges,78% of total billed charges,252,100,,,percent of total billed charges,100% of total billed charges,208.15,82.6,,,percent of total billed charges,82.6% of total billed charges,208.15,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,14.71,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.57,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,252,
CARBON DIOXIDE,30182374,CDM,301,RC,82374,HCPCS,Outpatient,,,71,46.15,,62.48,88,,,percent of total billed charges,88% of total Billed charges,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,71,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,44.73,63,,,percent of total billed charges,63% of total billed charges,8.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,10.86,15.3,,,percent of total billed charges,15.3% of total billed charges,48.99,69,,,percent of total billed charges,69% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,71,100,,,percent of total billed charges,100% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,71,100,,,percent of total billed charges,100% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,18.66,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,26.77,37.7,,,percent of total billed charges,37.70% of total billed charges,26.77,37.7,,,percent of total billed charges,37.70% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,24.07,33.9,,,percent of total billed charges,33.9% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,55.38,78,,,percent of total billed charges,78% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,4.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.88,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,71,
Carboxyhemoglobin Venous,30082375,CDM,300,RC,82375,HCPCS,Outpatient,,,142,92.30,,124.96,88,,,percent of total billed charges,88% of total Billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,21.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,12.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,142,
CARBOXYHEMOGLOBIN,30182375,CDM,301,RC,82375,HCPCS,Outpatient,,,142,92.30,,124.96,88,,,percent of total billed charges,88% of total Billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,21.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,12.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,142,
Carboxy-THC (GCMS) LC,30180349,CDM,301,RC,80349,HCPCS,Outpatient,,,310,201.50,,272.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",47.43,15.3,,,percent of total billed charges,15.3% of total billed charges,213.9,69,,,percent of total billed charges,69% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,105.09,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,241.8,78,,,percent of total billed charges,78% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52.08,16.8,,,percent of total billed charges,16.8% of total billed charges,47.43,310,
Carbon Monoxide Level (Arterial),30182375,CDM,300,RC,82375,HCPCS,Outpatient,,,142,92.30,,124.96,88,,,percent of total billed charges,88% of total Billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,21.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,12.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,142,
CATECHOLAMINES FRAC BLOOD,30182384,CDM,301,RC,82384,HCPCS,Outpatient,,,299,194.35,,263.12,88,,,percent of total billed charges,88% of total Billed charges,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,299,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,188.37,63,,,percent of total billed charges,63% of total billed charges,44.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,45.75,15.3,,,percent of total billed charges,15.3% of total billed charges,206.31,69,,,percent of total billed charges,69% of total billed charges,299,100,,,percent of total billed charges,100% of total billed charges,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,299,100,,,percent of total billed charges,100% of total billed charges,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,299,100,,,percent of total billed charges,100% of total billed charges,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,96.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,112.72,37.7,,,percent of total billed charges,37.70% of total billed charges,112.72,37.7,,,percent of total billed charges,37.70% of total billed charges,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,101.36,33.9,,,percent of total billed charges,33.9% of total billed charges,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,233.22,78,,,percent of total billed charges,78% of total billed charges,299,100,,,percent of total billed charges,100% of total billed charges,246.97,82.6,,,percent of total billed charges,82.6% of total billed charges,246.97,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,25.5,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.25,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,299,
Ceruloplasmin LC,30182390,CDM,301,RC,82390,HCPCS,Outpatient,,,231,150.15,,203.28,88,,,percent of total billed charges,88% of total Billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,231,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,145.53,63,,,percent of total billed charges,63% of total billed charges,18.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,35.34,15.3,,,percent of total billed charges,15.3% of total billed charges,159.39,69,,,percent of total billed charges,69% of total billed charges,231,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,231,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,231,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,41.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,87.09,37.7,,,percent of total billed charges,37.70% of total billed charges,87.09,37.7,,,percent of total billed charges,37.70% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,78.31,33.9,,,percent of total billed charges,33.9% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,180.18,78,,,percent of total billed charges,78% of total billed charges,231,100,,,percent of total billed charges,100% of total billed charges,190.81,82.6,,,percent of total billed charges,82.6% of total billed charges,190.81,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,231,
Cervicitis/Vaginitis Panel AVR,30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Chlamydia trachomatis Culture LC,30687140,CDM,306,RC,87140,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,75.6,63,,,percent of total billed charges,63% of total billed charges,9.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,21.3,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,5.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,120,
Chlamydia/GC Amplification LC,30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,194,
"Chlamydia, Conjunctiva, NAA LC",30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,162,105.30,,142.56,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,162,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,102.06,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,24.79,15.3,,,percent of total billed charges,15.3% of total billed charges,111.78,69,,,percent of total billed charges,69% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,54.92,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,126.36,78,,,percent of total billed charges,78% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,162,
Chlamydia and Gonorrhea (GeneXpert),30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,179,116.35,,157.52,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,179,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,112.77,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,27.39,15.3,,,percent of total billed charges,15.3% of total billed charges,123.51,69,,,percent of total billed charges,69% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,60.68,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,139.62,78,,,percent of total billed charges,78% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,179,
Chlamydia trachomatis AVR,30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Chlamydia/Gonorrhea Panel AVR,30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
CHLORIDE BLOOD,30182435,CDM,301,RC,82435,HCPCS,Outpatient,,,84,54.60,,73.92,88,,,percent of total billed charges,88% of total Billed charges,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,84,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,52.92,63,,,percent of total billed charges,63% of total billed charges,8.04,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.85,15.3,,,percent of total billed charges,15.3% of total billed charges,57.96,69,,,percent of total billed charges,69% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,84,100,,,percent of total billed charges,100% of total billed charges,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,84,100,,,percent of total billed charges,100% of total billed charges,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,17.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,28.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,78,,,percent of total billed charges,78% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,4.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.59,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,84,
Chloride Level Body Fluid,30182438,CDM,301,RC,82438,HCPCS,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,43,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5,100,,,Fee Schedule,100% of Medicare OPPS rate,27.09,63,,,percent of total billed charges,63% of total billed charges,8.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,5,100,,,Fee Schedule,100% of Medicare OPPS rate,43,100,,,percent of total billed charges,100% of total billed charges,5,100,,,Fee Schedule,100% of Medicare OPPS rate,43,100,,,percent of total billed charges,100% of total billed charges,5,100,,,Fee Schedule,100% of Medicare OPPS rate,19.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5,100,,,Fee Schedule,100% of Medicare OPPS rate,5,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5,100,,,Fee Schedule,100% of Medicare OPPS rate,5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5,100,,,Fee Schedule,100% of Medicare OPPS rate,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,5,100,,,Fee Schedule,100% of Medicare OPPS rate,14.58,33.9,,,percent of total billed charges,33.9% of total billed charges,5,100,,,Fee Schedule,100% of Medicare OPPS rate,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5,100,,,Fee Schedule,100% of Medicare OPPS rate,5.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,43,
CHLORIDE 24HR URINE,30182436,CDM,301,RC,82436,HCPCS,Outpatient,,,82,53.30,,72.16,88,,,percent of total billed charges,88% of total Billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,82,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,51.66,63,,,percent of total billed charges,63% of total billed charges,10.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.55,15.3,,,percent of total billed charges,15.3% of total billed charges,56.58,69,,,percent of total billed charges,69% of total billed charges,82,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,82,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,82,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,21.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,30.91,37.7,,,percent of total billed charges,37.70% of total billed charges,30.91,37.7,,,percent of total billed charges,37.70% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,27.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,63.96,78,,,percent of total billed charges,78% of total billed charges,82,100,,,percent of total billed charges,100% of total billed charges,67.73,82.6,,,percent of total billed charges,82.6% of total billed charges,67.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,5.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,82,
Cholesterol Serum Total,30182465,CDM,301,RC,82465,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,7.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,16.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,94,
HDL CHOLESTEROL,30183718,CDM,301,RC,83718,HCPCS,Outpatient,,,149,96.85,,131.12,88,,,percent of total billed charges,88% of total Billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,149,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,93.87,63,,,percent of total billed charges,63% of total billed charges,14.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,22.8,15.3,,,percent of total billed charges,15.3% of total billed charges,102.81,69,,,percent of total billed charges,69% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,149,100,,,percent of total billed charges,100% of total billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,149,100,,,percent of total billed charges,100% of total billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,31.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,50.51,33.9,,,percent of total billed charges,33.9% of total billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,116.22,78,,,percent of total billed charges,78% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,8.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,149,
Cholesterol Body Fluid,30182465,CDM,301,RC,82465,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,7.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,16.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.34,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,94,
Cholesterol LDL,30183721,CDM,301,RC,83721,HCPCS,Outpatient,,,174,113.10,,153.12,88,,,percent of total billed charges,88% of total Billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,109.62,63,,,percent of total billed charges,63% of total billed charges,18.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,40.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,10.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,174,
Cholinesterase LC,30182480,CDM,301,RC,82480,HCPCS,Outpatient,,,214,139.10,,188.32,88,,,percent of total billed charges,88% of total Billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,214,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,134.82,63,,,percent of total billed charges,63% of total billed charges,13.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,32.74,15.3,,,percent of total billed charges,15.3% of total billed charges,147.66,69,,,percent of total billed charges,69% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,30.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,72.55,33.9,,,percent of total billed charges,33.9% of total billed charges,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,166.92,78,,,percent of total billed charges,78% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,7.94,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.87,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,214,
"Cholinesterase, Plasma and RBC LC",30182482,CDM,301,RC,82482,HCPCS,Outpatient,,,158,102.70,,139.04,88,,,percent of total billed charges,88% of total Billed charges,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,158,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,99.54,63,,,percent of total billed charges,63% of total billed charges,17.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,24.17,15.3,,,percent of total billed charges,15.3% of total billed charges,109.02,69,,,percent of total billed charges,69% of total billed charges,158,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,158,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,158,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,37.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,59.57,37.7,,,percent of total billed charges,37.70% of total billed charges,59.57,37.7,,,percent of total billed charges,37.70% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,53.56,33.9,,,percent of total billed charges,33.9% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,123.24,78,,,percent of total billed charges,78% of total billed charges,158,100,,,percent of total billed charges,100% of total billed charges,130.51,82.6,,,percent of total billed charges,82.6% of total billed charges,130.51,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.81,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,158,
Chromogranin A LC 140848,30286316,CDM,302,RC,86316,HCPCS,Outpatient,,,198,128.70,,174.24,88,,,percent of total billed charges,88% of total Billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,63,,,percent of total billed charges,63% of total billed charges,36.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,30.29,15.3,,,percent of total billed charges,15.3% of total billed charges,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,79.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,67.12,33.9,,,percent of total billed charges,33.9% of total billed charges,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,21.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.81,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,198,
"Chromosome, Leukemia/Lymphoma LC",30288237,CDM,302,RC,88237,HCPCS,Outpatient,,,513.15,333.55,,451.57,88,,,percent of total billed charges,88% of total Billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,513.15,100,,,percent of total billed charges,100% of total billed charges,36.82,103,,,Fee Schedule,103% of WA Medicaid,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,323.28,63,,,percent of total billed charges,63% of total billed charges,251.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,78.51,15.3,,,percent of total billed charges,15.3% of total billed charges,354.07,69,,,percent of total billed charges,69% of total billed charges,513.15,100,,,percent of total billed charges,100% of total billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,513.15,100,,,percent of total billed charges,100% of total billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,513.15,100,,,percent of total billed charges,100% of total billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,549.84,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,36.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.47,130,,,Fee Schedule,130% of WA Medicaid ,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,193.46,37.7,,,percent of total billed charges,37.70% of total billed charges,193.46,37.7,,,percent of total billed charges,37.70% of total billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,173.96,33.9,,,percent of total billed charges,33.9% of total billed charges,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,400.26,78,,,percent of total billed charges,78% of total billed charges,513.15,100,,,percent of total billed charges,100% of total billed charges,423.86,82.6,,,percent of total billed charges,82.6% of total billed charges,423.86,82.6,,,percent of total billed charges,82.6% of total billed charges,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,145.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,143.75,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.48,549.84,
ELECTROPHORECTIC TECH,30182664,CDM,301,RC,82664,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,141.12,63,,,percent of total billed charges,63% of total billed charges,107.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,34.27,15.3,,,percent of total billed charges,15.3% of total billed charges,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,235.23,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,75.94,33.9,,,percent of total billed charges,33.9% of total billed charges,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,62.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,61.5,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,235.23,
Citric Acid (Citrate) U LC,30182507,CDM,301,RC,82507,HCPCS,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,92.61,63,,,percent of total billed charges,63% of total billed charges,48.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,106.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,28.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.8,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,147,
"Clozapine (Clozaril), Serum LC",30180159,CDM,301,RC,80159,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,75.6,63,,,percent of total billed charges,63% of total billed charges,35.26,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,77.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,20.35,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,120,
Cocaine Metab Confirm LC,30180353,CDM,301,RC,80353,HCPCS,Outpatient,,,310,201.50,,272.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",47.43,15.3,,,percent of total billed charges,15.3% of total billed charges,213.9,69,,,percent of total billed charges,69% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,105.09,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,241.8,78,,,percent of total billed charges,78% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52.08,16.8,,,percent of total billed charges,16.8% of total billed charges,47.43,310,
Coccidioides CF Antibody LC,30286635,CDM,302,RC,86635,HCPCS,Outpatient,,,235,152.75,,206.8,88,,,percent of total billed charges,88% of total Billed charges,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,148.05,63,,,percent of total billed charges,63% of total billed charges,20.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,35.96,15.3,,,percent of total billed charges,15.3% of total billed charges,162.15,69,,,percent of total billed charges,69% of total billed charges,235,100,,,percent of total billed charges,100% of total billed charges,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,235,100,,,percent of total billed charges,100% of total billed charges,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,235,100,,,percent of total billed charges,100% of total billed charges,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,43.87,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,88.6,37.7,,,percent of total billed charges,37.70% of total billed charges,88.6,37.7,,,percent of total billed charges,37.70% of total billed charges,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,79.67,33.9,,,percent of total billed charges,33.9% of total billed charges,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,183.3,78,,,percent of total billed charges,78% of total billed charges,235,100,,,percent of total billed charges,100% of total billed charges,194.11,82.6,,,percent of total billed charges,82.6% of total billed charges,194.11,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.58,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,235,
"Occult Blood, Fecal, IA LC",30182274,CDM,301,RC,82274,HCPCS,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,101,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,63.63,63,,,percent of total billed charges,63% of total billed charges,27.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,15.45,15.3,,,percent of total billed charges,15.3% of total billed charges,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,60.89,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,34.24,33.9,,,percent of total billed charges,33.9% of total billed charges,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,16.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.92,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,101,
Complement C4 LC,30286160,CDM,302,RC,86160,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12,100,,,Fee Schedule,100% of Medicare OPPS rate,53.55,63,,,percent of total billed charges,63% of total billed charges,21,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,45.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12.12,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,85,
COMPLEMENT TOTAL (CH 50),30286162,CDM,302,RC,86162,HCPCS,Outpatient,,,334,217.10,,293.92,88,,,percent of total billed charges,88% of total Billed charges,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,334,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,210.42,63,,,percent of total billed charges,63% of total billed charges,35.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,51.1,15.3,,,percent of total billed charges,15.3% of total billed charges,230.46,69,,,percent of total billed charges,69% of total billed charges,334,100,,,percent of total billed charges,100% of total billed charges,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,334,100,,,percent of total billed charges,100% of total billed charges,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,334,100,,,percent of total billed charges,100% of total billed charges,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,77.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,125.92,37.7,,,percent of total billed charges,37.70% of total billed charges,125.92,37.7,,,percent of total billed charges,37.70% of total billed charges,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,113.23,33.9,,,percent of total billed charges,33.9% of total billed charges,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,260.52,78,,,percent of total billed charges,78% of total billed charges,334,100,,,percent of total billed charges,100% of total billed charges,275.88,82.6,,,percent of total billed charges,82.6% of total billed charges,275.88,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,20.52,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.32,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,334,
Complement C3 LC,30286160,CDM,302,RC,86160,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12,100,,,Fee Schedule,100% of Medicare OPPS rate,53.55,63,,,percent of total billed charges,63% of total billed charges,21,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,45.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,12,100,,,Fee Schedule,100% of Medicare OPPS rate,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare OPPS rate,12.12,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,85,
Comp panel Leukemia/Lymphoma LC,31188184,CDM,311,RC,88184,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,36.82,103,,,Fee Schedule,103% of WA Medicaid,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.47,130,,,Fee Schedule,130% of WA Medicaid ,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.48,1183.25,
Comp Bld Drug Scr w/Med Rpt LC,30180307,CDM,301,RC,80307,HCPCS,Outpatient,,,1080,702.00,,950.4,88,,,percent of total billed charges,88% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,181.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1080,100,,,percent of total billed charges,100% of total billed charges,186.88,17.304,,,percent of total billed charges,17.304% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,680.4,63,,,percent of total billed charges,63% of total billed charges,108.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,181.44,16.8,,,percent of total billed charges,16.8% of total billed charges,165.24,15.3,,,percent of total billed charges,15.3% of total billed charges,745.2,69,,,percent of total billed charges,69% of total billed charges,1080,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1080,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1080,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,237.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,181.44,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,181.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,185.07,17.136,,,percent of total billed charges,17.136% of total billed charges,235.87,21.84,,,percent of total billed charges,21.84% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,407.16,37.7,,,percent of total billed charges,37.70% of total billed charges,407.16,37.7,,,percent of total billed charges,37.70% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,366.12,33.9,,,percent of total billed charges,33.9% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,842.4,78,,,percent of total billed charges,78% of total billed charges,1080,100,,,percent of total billed charges,100% of total billed charges,892.08,82.6,,,percent of total billed charges,82.6% of total billed charges,892.08,82.6,,,percent of total billed charges,82.6% of total billed charges,181.44,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,181.44,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,1080,
Comprehensive UTI Panel AVR,30687640,CDM,306,RC,87640,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Copper LC,30182525,CDM,301,RC,82525,HCPCS,Outpatient,,,309,200.85,,271.92,88,,,percent of total billed charges,88% of total Billed charges,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,309,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,194.67,63,,,percent of total billed charges,63% of total billed charges,21.71,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,47.28,15.3,,,percent of total billed charges,15.3% of total billed charges,213.21,69,,,percent of total billed charges,69% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,309,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,309,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,47.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,104.75,33.9,,,percent of total billed charges,33.9% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,241.02,78,,,percent of total billed charges,78% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,12.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.41,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,309,
Cord Blood Gas (Venous),30082803,CDM,300,RC,82803,HCPCS,Outpatient,,,408,265.20,,359.04,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,408,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,257.04,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,62.42,15.3,,,percent of total billed charges,15.3% of total billed charges,281.52,69,,,percent of total billed charges,69% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,138.31,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,318.24,78,,,percent of total billed charges,78% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,408,
Coronavirus SARS Ag (Sofia),30687426,CDM,306,RC,87426,HCPCS,Outpatient,,,185,120.25,,162.8,88,,,percent of total billed charges,88% of total Billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,185,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,116.55,63,,,percent of total billed charges,63% of total billed charges,61.82,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,28.31,15.3,,,percent of total billed charges,15.3% of total billed charges,127.65,69,,,percent of total billed charges,69% of total billed charges,185,100,,,percent of total billed charges,100% of total billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,185,100,,,percent of total billed charges,100% of total billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,185,100,,,percent of total billed charges,100% of total billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,69.75,37.7,,,percent of total billed charges,37.70% of total billed charges,69.75,37.7,,,percent of total billed charges,37.70% of total billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,62.72,33.9,,,percent of total billed charges,33.9% of total billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,144.3,78,,,percent of total billed charges,78% of total billed charges,185,100,,,percent of total billed charges,100% of total billed charges,152.81,82.6,,,percent of total billed charges,82.6% of total billed charges,152.81,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,35.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,185,
Cortisol Baseline,30082533,CDM,300,RC,82533,HCPCS,Outpatient,,,366,237.90,,322.08,88,,,percent of total billed charges,88% of total Billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,366,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,230.58,63,,,percent of total billed charges,63% of total billed charges,28.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,56,15.3,,,percent of total billed charges,15.3% of total billed charges,252.54,69,,,percent of total billed charges,69% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,62.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,124.07,33.9,,,percent of total billed charges,33.9% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,285.48,78,,,percent of total billed charges,78% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,366,
Cortisol Stimulated,30080400,CDM,300,RC,80400,HCPCS,Outpatient,,,319,207.35,,280.72,88,,,percent of total billed charges,88% of total Billed charges,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,319,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,200.97,63,,,percent of total billed charges,63% of total billed charges,57.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,48.81,15.3,,,percent of total billed charges,15.3% of total billed charges,220.11,69,,,percent of total billed charges,69% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,319,100,,,percent of total billed charges,100% of total billed charges,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,319,100,,,percent of total billed charges,100% of total billed charges,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,124.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,108.14,33.9,,,percent of total billed charges,33.9% of total billed charges,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,248.82,78,,,percent of total billed charges,78% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.94,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.6,319,
Cortisol AM,30182533,CDM,301,RC,82533,HCPCS,Outpatient,,,162,105.30,,142.56,88,,,percent of total billed charges,88% of total Billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,162,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,102.06,63,,,percent of total billed charges,63% of total billed charges,28.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,24.79,15.3,,,percent of total billed charges,15.3% of total billed charges,111.78,69,,,percent of total billed charges,69% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,62.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,54.92,33.9,,,percent of total billed charges,33.9% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,126.36,78,,,percent of total billed charges,78% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,162,
CORTISOL 24HR URINE,30182530,CDM,301,RC,82530,HCPCS,Outpatient,,,451,293.15,,396.88,88,,,percent of total billed charges,88% of total Billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,451,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,284.13,63,,,percent of total billed charges,63% of total billed charges,29.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,69,15.3,,,percent of total billed charges,15.3% of total billed charges,311.19,69,,,percent of total billed charges,69% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,451,100,,,percent of total billed charges,100% of total billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,451,100,,,percent of total billed charges,100% of total billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,63.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,152.89,33.9,,,percent of total billed charges,33.9% of total billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,351.78,78,,,percent of total billed charges,78% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,16.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,451,
Cortisol LC,30182533,CDM,301,RC,82533,HCPCS,Outpatient,,,154,100.10,,135.52,88,,,percent of total billed charges,88% of total Billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,154,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,97.02,63,,,percent of total billed charges,63% of total billed charges,28.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,23.56,15.3,,,percent of total billed charges,15.3% of total billed charges,106.26,69,,,percent of total billed charges,69% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,154,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,154,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,62.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,52.21,33.9,,,percent of total billed charges,33.9% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,120.12,78,,,percent of total billed charges,78% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,154,
Cortisol - AM LC,30182533,CDM,301,RC,82533,HCPCS,Outpatient,,,411,267.15,,361.68,88,,,percent of total billed charges,88% of total Billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,411,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,258.93,63,,,percent of total billed charges,63% of total billed charges,28.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,62.88,15.3,,,percent of total billed charges,15.3% of total billed charges,283.59,69,,,percent of total billed charges,69% of total billed charges,411,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,411,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,411,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,62.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,154.95,37.7,,,percent of total billed charges,37.70% of total billed charges,154.95,37.7,,,percent of total billed charges,37.70% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,139.33,33.9,,,percent of total billed charges,33.9% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,320.58,78,,,percent of total billed charges,78% of total billed charges,411,100,,,percent of total billed charges,100% of total billed charges,339.49,82.6,,,percent of total billed charges,82.6% of total billed charges,339.49,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,411,
Cortisol (3 Specimens) LC,30182533,CDM,301,RC,82533,HCPCS,Outpatient,,,154,100.10,,135.52,88,,,percent of total billed charges,88% of total Billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,154,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,97.02,63,,,percent of total billed charges,63% of total billed charges,28.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,23.56,15.3,,,percent of total billed charges,15.3% of total billed charges,106.26,69,,,percent of total billed charges,69% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,154,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,154,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,62.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,52.21,33.9,,,percent of total billed charges,33.9% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,120.12,78,,,percent of total billed charges,78% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,154,
CORTISOL 24HR URINE,30182530,CDM,301,RC,82530,HCPCS,Outpatient,,,451,293.15,,396.88,88,,,percent of total billed charges,88% of total Billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,451,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,284.13,63,,,percent of total billed charges,63% of total billed charges,29.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,69,15.3,,,percent of total billed charges,15.3% of total billed charges,311.19,69,,,percent of total billed charges,69% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,451,100,,,percent of total billed charges,100% of total billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,451,100,,,percent of total billed charges,100% of total billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,63.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,152.89,33.9,,,percent of total billed charges,33.9% of total billed charges,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,351.78,78,,,percent of total billed charges,78% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,16.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.71,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,451,
Cortisol PM,30082533,CDM,300,RC,82533,HCPCS,Outpatient,,,366,237.90,,322.08,88,,,percent of total billed charges,88% of total Billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,366,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,230.58,63,,,percent of total billed charges,63% of total billed charges,28.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,56,15.3,,,percent of total billed charges,15.3% of total billed charges,252.54,69,,,percent of total billed charges,69% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,62.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,124.07,33.9,,,percent of total billed charges,33.9% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,285.48,78,,,percent of total billed charges,78% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,366,
Cortisol Dexamethasone Reflex LC,30182533,CDM,301,RC,82533,HCPCS,Outpatient,,,217,141.05,,190.96,88,,,percent of total billed charges,88% of total Billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,217,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,136.71,63,,,percent of total billed charges,63% of total billed charges,28.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,33.2,15.3,,,percent of total billed charges,15.3% of total billed charges,149.73,69,,,percent of total billed charges,69% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,217,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,217,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,62.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,81.81,37.7,,,percent of total billed charges,37.70% of total billed charges,81.81,37.7,,,percent of total billed charges,37.70% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,73.56,33.9,,,percent of total billed charges,33.9% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,169.26,78,,,percent of total billed charges,78% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,217,
CREATININE CLEARANCE,30182575,CDM,301,RC,82575,HCPCS,Outpatient,,,163,105.95,,143.44,88,,,percent of total billed charges,88% of total Billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,163,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,102.69,63,,,percent of total billed charges,63% of total billed charges,16.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,24.94,15.3,,,percent of total billed charges,15.3% of total billed charges,112.47,69,,,percent of total billed charges,69% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,163,100,,,percent of total billed charges,100% of total billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,163,100,,,percent of total billed charges,100% of total billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,36.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,33.9,,,percent of total billed charges,33.9% of total billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,127.14,78,,,percent of total billed charges,78% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,9.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,163,
Creatinine Serum,30182565,CDM,301,RC,82565,HCPCS,Outpatient,,,78,50.70,,68.64,88,,,percent of total billed charges,88% of total Billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,78,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,49.14,63,,,percent of total billed charges,63% of total billed charges,8.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.93,15.3,,,percent of total billed charges,15.3% of total billed charges,53.82,69,,,percent of total billed charges,69% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,78,100,,,percent of total billed charges,100% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,78,100,,,percent of total billed charges,100% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,19.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,29.41,37.7,,,percent of total billed charges,37.70% of total billed charges,29.41,37.7,,,percent of total billed charges,37.70% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,26.44,33.9,,,percent of total billed charges,33.9% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,60.84,78,,,percent of total billed charges,78% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,5.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,78,
Creatinine Body Fluid,30182570,CDM,301,RC,82570,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,74,
CreatU+5 HIAA LC,30182570,CDM,301,RC,82570,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,52.29,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,83,
"Creatine Kinase (CK), MB/Total LC",30182553,CDM,301,RC,82553,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,195,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,122.85,63,,,percent of total billed charges,63% of total billed charges,20.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,195,100,,,percent of total billed charges,100% of total billed charges,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,195,100,,,percent of total billed charges,100% of total billed charges,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,44.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,11.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.55,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,195,
CREATININE CLEARANCE,30182575,CDM,301,RC,82575,HCPCS,Outpatient,,,163,105.95,,143.44,88,,,percent of total billed charges,88% of total Billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,163,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,102.69,63,,,percent of total billed charges,63% of total billed charges,16.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,24.94,15.3,,,percent of total billed charges,15.3% of total billed charges,112.47,69,,,percent of total billed charges,69% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,163,100,,,percent of total billed charges,100% of total billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,163,100,,,percent of total billed charges,100% of total billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,36.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,33.9,,,percent of total billed charges,33.9% of total billed charges,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,127.14,78,,,percent of total billed charges,78% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,9.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.46,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,163,
"Cryoglobulin, Ql, Rflx LC",30182595,CDM,301,RC,82595,HCPCS,Outpatient,,,81,52.65,,71.28,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,81,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,51.03,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.39,15.3,,,percent of total billed charges,15.3% of total billed charges,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,27.46,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,81,
CRYPTOSPORIUM ANTIGEN,30687328,CDM,306,RC,87328,HCPCS,Outpatient,,,77,50.05,,67.76,88,,,percent of total billed charges,88% of total Billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,77,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,48.51,63,,,percent of total billed charges,63% of total billed charges,24.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,11.78,15.3,,,percent of total billed charges,15.3% of total billed charges,53.13,69,,,percent of total billed charges,69% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,77,100,,,percent of total billed charges,100% of total billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,77,100,,,percent of total billed charges,100% of total billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,26.1,33.9,,,percent of total billed charges,33.9% of total billed charges,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,60.06,78,,,percent of total billed charges,78% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,13.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,77,
Cryptococcus Antigen CSF,30287327,CDM,302,RC,87327,HCPCS,Outpatient,,,115,74.75,,101.2,88,,,percent of total billed charges,88% of total Billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,115,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,72.45,63,,,percent of total billed charges,63% of total billed charges,23.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,17.6,15.3,,,percent of total billed charges,15.3% of total billed charges,79.35,69,,,percent of total billed charges,69% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,115,100,,,percent of total billed charges,100% of total billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,115,100,,,percent of total billed charges,100% of total billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,51.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,43.36,37.7,,,percent of total billed charges,37.70% of total billed charges,43.36,37.7,,,percent of total billed charges,37.70% of total billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,38.99,33.9,,,percent of total billed charges,33.9% of total billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,89.7,78,,,percent of total billed charges,78% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,13.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,115,
"Cryptococcus Antigen, Serum LC",30687899,CDM,306,RC,87899,HCPCS,Outpatient,,,110,71.50,,96.8,88,,,percent of total billed charges,88% of total Billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,110,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,69.3,63,,,percent of total billed charges,63% of total billed charges,28.12,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,16.83,15.3,,,percent of total billed charges,15.3% of total billed charges,75.9,69,,,percent of total billed charges,69% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,61.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,37.29,33.9,,,percent of total billed charges,33.9% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,85.8,78,,,percent of total billed charges,78% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,110,
Crystal Examination Body Fluid,30089060,CDM,300,RC,89060,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,8.91,103,,,Fee Schedule,103% of WA Medicaid,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,43.47,63,,,percent of total billed charges,63% of total billed charges,12.82,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,28.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.24,130,,,Fee Schedule,130% of WA Medicaid ,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,23.39,33.9,,,percent of total billed charges,33.9% of total billed charges,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,7.4,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.33,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.4,69,
"Ct/GC NAA, Pharyngeal LC",30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,213,138.45,,187.44,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.19,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,32.59,15.3,,,percent of total billed charges,15.3% of total billed charges,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,72.21,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,213,
"Ct, Ng, Trich vag by NAA LC",30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,194,
"Ct/GC NAA, Rectal LC",30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,194,
"Ct/GC NAA, Pharyngeal LC",30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,194,
"Ct/GC NAA, Pharyngeal LC",30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,213,138.45,,187.44,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.19,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,32.59,15.3,,,percent of total billed charges,15.3% of total billed charges,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,72.21,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,213,
"Cyclosporine, Blood LC",30180158,CDM,301,RC,80158,HCPCS,Outpatient,,,858,557.70,,755.04,88,,,percent of total billed charges,88% of total Billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,858,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,540.54,63,,,percent of total billed charges,63% of total billed charges,31.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,131.27,15.3,,,percent of total billed charges,15.3% of total billed charges,592.02,69,,,percent of total billed charges,69% of total billed charges,858,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,858,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,858,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,69.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,323.47,37.7,,,percent of total billed charges,37.70% of total billed charges,323.47,37.7,,,percent of total billed charges,37.70% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,290.86,33.9,,,percent of total billed charges,33.9% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,669.24,78,,,percent of total billed charges,78% of total billed charges,858,100,,,percent of total billed charges,100% of total billed charges,708.71,82.6,,,percent of total billed charges,82.6% of total billed charges,708.71,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,858,
Cystic Fibrosis Profile LC,30181220,CDM,301,RC,81220,HCPCS,Outpatient,,,368,239.20,,323.84,88,,,percent of total billed charges,88% of total Billed charges,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,364.01,100,,,Fee Schedule,100% of WA Medicaid,368,100,,,percent of total billed charges,100% of total billed charges,374.93,103,,,Fee Schedule,103% of WA Medicaid,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,231.84,63,,,percent of total billed charges,63% of total billed charges,974.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,364.01,100,,,Fee Schedule,100% of WA Medicaid,56.3,15.3,,,percent of total billed charges,15.3% of total billed charges,253.92,69,,,percent of total billed charges,69% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,368,100,,,percent of total billed charges,100% of total billed charges,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,368,100,,,percent of total billed charges,100% of total billed charges,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2128.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,364.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,269.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,371.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,473.21,130,,,Fee Schedule,130% of WA Medicaid ,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,124.75,33.9,,,percent of total billed charges,33.9% of total billed charges,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,287.04,78,,,percent of total billed charges,78% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,364.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,562.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,556.6,100,,,Fee Schedule,100% of Medicare OPPS rate,364.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.3,2128.99,
CYSTATIN C,30182610,CDM,301,RC,82610,HCPCS,Outpatient,,,117,76.05,,102.96,88,,,percent of total billed charges,88% of total Billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,117,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,73.71,63,,,percent of total billed charges,63% of total billed charges,32.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,17.9,15.3,,,percent of total billed charges,15.3% of total billed charges,80.73,69,,,percent of total billed charges,69% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,117,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,117,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,70.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,44.11,37.7,,,percent of total billed charges,37.70% of total billed charges,44.11,37.7,,,percent of total billed charges,37.70% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,39.66,33.9,,,percent of total billed charges,33.9% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,91.26,78,,,percent of total billed charges,78% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,117,
"Cytomegalovirus (CMV) Ab, IgM LC",30286645,CDM,302,RC,86645,HCPCS,Outpatient,,,362,235.30,,318.56,88,,,percent of total billed charges,88% of total Billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,362,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,228.06,63,,,percent of total billed charges,63% of total billed charges,29.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,55.39,15.3,,,percent of total billed charges,15.3% of total billed charges,249.78,69,,,percent of total billed charges,69% of total billed charges,362,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,362,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,362,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,64.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,136.47,37.7,,,percent of total billed charges,37.70% of total billed charges,136.47,37.7,,,percent of total billed charges,37.70% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,122.72,33.9,,,percent of total billed charges,33.9% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,282.36,78,,,percent of total billed charges,78% of total billed charges,362,100,,,percent of total billed charges,100% of total billed charges,299.01,82.6,,,percent of total billed charges,82.6% of total billed charges,299.01,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,17.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,362,
D-Dimer,30585379,CDM,305,RC,85379,HCPCS,Outpatient,,,145,94.25,,127.6,88,,,percent of total billed charges,88% of total Billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,145,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,91.35,63,,,percent of total billed charges,63% of total billed charges,17.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,22.19,15.3,,,percent of total billed charges,15.3% of total billed charges,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,38.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,49.16,33.9,,,percent of total billed charges,33.9% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,145,
DHEA-Sulfate LC,30082627,CDM,300,RC,82627,HCPCS,Outpatient,,,429,278.85,,377.52,88,,,percent of total billed charges,88% of total Billed charges,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,429,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,270.27,63,,,percent of total billed charges,63% of total billed charges,38.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,65.64,15.3,,,percent of total billed charges,15.3% of total billed charges,296.01,69,,,percent of total billed charges,69% of total billed charges,429,100,,,percent of total billed charges,100% of total billed charges,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,429,100,,,percent of total billed charges,100% of total billed charges,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,429,100,,,percent of total billed charges,100% of total billed charges,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,85.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,161.73,37.7,,,percent of total billed charges,37.70% of total billed charges,161.73,37.7,,,percent of total billed charges,37.70% of total billed charges,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,145.43,33.9,,,percent of total billed charges,33.9% of total billed charges,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,334.62,78,,,percent of total billed charges,78% of total billed charges,429,100,,,percent of total billed charges,100% of total billed charges,354.35,82.6,,,percent of total billed charges,82.6% of total billed charges,354.35,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,22.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.23,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,429,
DHEA LC,30182626,CDM,301,RC,82626,HCPCS,Outpatient,,,163,105.95,,143.44,88,,,percent of total billed charges,88% of total Billed charges,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,163,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,102.69,63,,,percent of total billed charges,63% of total billed charges,44.22,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,24.94,15.3,,,percent of total billed charges,15.3% of total billed charges,112.47,69,,,percent of total billed charges,69% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,163,100,,,percent of total billed charges,100% of total billed charges,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,163,100,,,percent of total billed charges,100% of total billed charges,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,96.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,33.9,,,percent of total billed charges,33.9% of total billed charges,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,127.14,78,,,percent of total billed charges,78% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,25.52,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,163,
DUI Legal Blood Draw,DUI,CDM,300,RC,36415,HCPCS,Outpatient,,,90,58.50,,,,,,Other,Not Separately reimbursable,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.1,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,2.16,103,,,Fee Schedule,103% of WA Medicaid,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,15.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.1,100,,,Fee Schedule,100% of WA Medicaid,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,11.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,1.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2.73,130,,,Fee Schedule,130% of WA Medicaid ,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,30.51,33.9,,,percent of total billed charges,33.9% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.55,90,
"Dexamethasone, Serum LC",30180299,CDM,301,RC,80299,HCPCS,Outpatient,,,92.07,59.85,,81.02,88,,,percent of total billed charges,88% of total Billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,92.07,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,58,63,,,percent of total billed charges,63% of total billed charges,32.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,14.09,15.3,,,percent of total billed charges,15.3% of total billed charges,63.53,69,,,percent of total billed charges,69% of total billed charges,92.07,100,,,percent of total billed charges,100% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,92.07,100,,,percent of total billed charges,100% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,92.07,100,,,percent of total billed charges,100% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,71.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,34.71,37.7,,,percent of total billed charges,37.70% of total billed charges,34.71,37.7,,,percent of total billed charges,37.70% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,31.21,33.9,,,percent of total billed charges,33.9% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,71.81,78,,,percent of total billed charges,78% of total billed charges,92.07,100,,,percent of total billed charges,100% of total billed charges,76.05,82.6,,,percent of total billed charges,82.6% of total billed charges,76.05,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,18.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,92.07,
Digitoxin LC,30180299,CDM,301,RC,80299,HCPCS,Outpatient,,,258,167.70,,227.04,88,,,percent of total billed charges,88% of total Billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,258,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,162.54,63,,,percent of total billed charges,63% of total billed charges,32.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,39.47,15.3,,,percent of total billed charges,15.3% of total billed charges,178.02,69,,,percent of total billed charges,69% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,71.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,33.9,,,percent of total billed charges,33.9% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,201.24,78,,,percent of total billed charges,78% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,18.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,258,
Digoxin Total,30180162,CDM,301,RC,80162,HCPCS,Outpatient,,,232,150.80,,204.16,88,,,percent of total billed charges,88% of total Billed charges,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,232,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,146.16,63,,,percent of total billed charges,63% of total billed charges,23.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,35.5,15.3,,,percent of total billed charges,15.3% of total billed charges,160.08,69,,,percent of total billed charges,69% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,50.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,78.65,33.9,,,percent of total billed charges,33.9% of total billed charges,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,78,,,percent of total billed charges,78% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,13.41,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.28,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,232,
Drug Screen 10 w/Conf LC,30080307,CDM,300,RC,80307,HCPCS,Outpatient,,,326,211.90,,286.88,88,,,percent of total billed charges,88% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,326,100,,,percent of total billed charges,100% of total billed charges,56.41,17.304,,,percent of total billed charges,17.304% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,205.38,63,,,percent of total billed charges,63% of total billed charges,108.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,49.88,15.3,,,percent of total billed charges,15.3% of total billed charges,224.94,69,,,percent of total billed charges,69% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,237.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,55.86,17.136,,,percent of total billed charges,17.136% of total billed charges,71.2,21.84,,,percent of total billed charges,21.84% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,110.51,33.9,,,percent of total billed charges,33.9% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,254.28,78,,,percent of total billed charges,78% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,49.88,326,
E coli Shiga Toxin EIA LC,30687427,CDM,306,RC,87427,HCPCS,Outpatient,,,74.4,48.36,,65.47,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,74.4,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,46.87,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,11.38,15.3,,,percent of total billed charges,15.3% of total billed charges,51.34,69,,,percent of total billed charges,69% of total billed charges,74.4,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,74.4,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,74.4,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,28.05,37.7,,,percent of total billed charges,37.70% of total billed charges,28.05,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,25.22,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,58.03,78,,,percent of total billed charges,78% of total billed charges,74.4,100,,,percent of total billed charges,100% of total billed charges,61.45,82.6,,,percent of total billed charges,82.6% of total billed charges,61.45,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,74.4,
"EBV Ab VCA, IgG LC",30286665,CDM,302,RC,86665,HCPCS,Outpatient,,,329,213.85,,289.52,88,,,percent of total billed charges,88% of total Billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,329,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,207.27,63,,,percent of total billed charges,63% of total billed charges,31.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,50.34,15.3,,,percent of total billed charges,15.3% of total billed charges,227.01,69,,,percent of total billed charges,69% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,329,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,329,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,69.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,124.03,37.7,,,percent of total billed charges,37.70% of total billed charges,124.03,37.7,,,percent of total billed charges,37.70% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,111.53,33.9,,,percent of total billed charges,33.9% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,256.62,78,,,percent of total billed charges,78% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,329,
"EBV Ab VCA, IgM LC",30286665,CDM,302,RC,86665,HCPCS,Outpatient,,,179,116.35,,157.52,88,,,percent of total billed charges,88% of total Billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,179,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,112.77,63,,,percent of total billed charges,63% of total billed charges,31.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,27.39,15.3,,,percent of total billed charges,15.3% of total billed charges,123.51,69,,,percent of total billed charges,69% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,69.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,60.68,33.9,,,percent of total billed charges,33.9% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,139.62,78,,,percent of total billed charges,78% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,179,
EBNA AB,30286664,CDM,302,RC,86664,HCPCS,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,54,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,34.02,63,,,percent of total billed charges,63% of total billed charges,26.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,58.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.31,33.9,,,percent of total billed charges,33.9% of total billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,15.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,58.48,
EBV Antibody Profile LC,30286664,CDM,302,RC,86664,HCPCS,Outpatient,,,198,128.70,,174.24,88,,,percent of total billed charges,88% of total Billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,63,,,percent of total billed charges,63% of total billed charges,26.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,30.29,15.3,,,percent of total billed charges,15.3% of total billed charges,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,58.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,67.12,33.9,,,percent of total billed charges,33.9% of total billed charges,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,15.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.29,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,198,
EPSTEIN-BARR VIRAL CAP IGG,30286665,CDM,302,RC,86665,HCPCS,Outpatient,,,152,98.80,,133.76,88,,,percent of total billed charges,88% of total Billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,152,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,95.76,63,,,percent of total billed charges,63% of total billed charges,31.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,23.26,15.3,,,percent of total billed charges,15.3% of total billed charges,104.88,69,,,percent of total billed charges,69% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,152,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,152,100,,,percent of total billed charges,100% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,69.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,57.3,37.7,,,percent of total billed charges,37.70% of total billed charges,57.3,37.7,,,percent of total billed charges,37.70% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,51.53,33.9,,,percent of total billed charges,33.9% of total billed charges,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,118.56,78,,,percent of total billed charges,78% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,18.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,152,
MITOCHONDRIAL ANTIBODY,30286255,CDM,302,RC,86255,HCPCS,Outpatient,,,264,171.60,,232.32,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,264,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,166.32,63,,,percent of total billed charges,63% of total billed charges,21.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,46.09,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,89.5,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,264,
Eosinophil Smear - Nasal,30089190,CDM,300,RC,89190,HCPCS,Outpatient,,,64,41.60,,56.32,88,,,percent of total billed charges,88% of total Billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,64,100,,,percent of total billed charges,100% of total billed charges,8.91,103,,,Fee Schedule,103% of WA Medicaid,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,40.32,63,,,percent of total billed charges,63% of total billed charges,10.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,9.79,15.3,,,percent of total billed charges,15.3% of total billed charges,44.16,69,,,percent of total billed charges,69% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,64,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,64,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,22.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,6.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.24,130,,,Fee Schedule,130% of WA Medicaid ,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,24.13,37.7,,,percent of total billed charges,37.70% of total billed charges,24.13,37.7,,,percent of total billed charges,37.70% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,21.7,33.9,,,percent of total billed charges,33.9% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,78,,,percent of total billed charges,78% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,5.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.79,64,
EOSINOPHIL COUNT,30585048,CDM,305,RC,85048,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,30.24,63,,,percent of total billed charges,63% of total billed charges,4.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.54,48,
Epstein-Barr Virus PCR LC,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,490,318.50,,431.2,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,490,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,308.7,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,74.97,15.3,,,percent of total billed charges,15.3% of total billed charges,338.1,69,,,percent of total billed charges,69% of total billed charges,490,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,490,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,490,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,184.73,37.7,,,percent of total billed charges,37.70% of total billed charges,184.73,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,166.11,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,382.2,78,,,percent of total billed charges,78% of total billed charges,490,100,,,percent of total billed charges,100% of total billed charges,404.74,82.6,,,percent of total billed charges,82.6% of total billed charges,404.74,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,490,
Erythrocyte Sedimentation Rate (ESR),30585652,CDM,305,RC,85652,HCPCS,Outpatient,,,84,54.60,,73.92,88,,,percent of total billed charges,88% of total Billed charges,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,84,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,52.92,63,,,percent of total billed charges,63% of total billed charges,4.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,12.85,15.3,,,percent of total billed charges,15.3% of total billed charges,57.96,69,,,percent of total billed charges,69% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,84,100,,,percent of total billed charges,100% of total billed charges,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,84,100,,,percent of total billed charges,100% of total billed charges,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,10.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,28.48,33.9,,,percent of total billed charges,33.9% of total billed charges,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,78,,,percent of total billed charges,78% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,2.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.7,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.7,84,
Erythropoietin (EPO) LC,30182668,CDM,301,RC,82668,HCPCS,Outpatient,,,363,235.95,,319.44,88,,,percent of total billed charges,88% of total Billed charges,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,363,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,228.69,63,,,percent of total billed charges,63% of total billed charges,32.88,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,55.54,15.3,,,percent of total billed charges,15.3% of total billed charges,250.47,69,,,percent of total billed charges,69% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,363,100,,,percent of total billed charges,100% of total billed charges,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,363,100,,,percent of total billed charges,100% of total billed charges,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,71.87,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,123.06,33.9,,,percent of total billed charges,33.9% of total billed charges,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,283.14,78,,,percent of total billed charges,78% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,18.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.79,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,363,
ESTRIOL,30182677,CDM,301,RC,82677,HCPCS,Outpatient,,,172,111.80,,151.36,88,,,percent of total billed charges,88% of total Billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,172,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,42.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,26.32,15.3,,,percent of total billed charges,15.3% of total billed charges,118.68,69,,,percent of total billed charges,69% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,92.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,58.31,33.9,,,percent of total billed charges,33.9% of total billed charges,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,134.16,78,,,percent of total billed charges,78% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,24.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,172,
"Estradiol, Sensitive LC",30182670,CDM,301,RC,82670,HCPCS,Outpatient,,,567,368.55,,498.96,88,,,percent of total billed charges,88% of total Billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,567,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,357.21,63,,,percent of total billed charges,63% of total billed charges,48.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,86.75,15.3,,,percent of total billed charges,15.3% of total billed charges,391.23,69,,,percent of total billed charges,69% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,567,100,,,percent of total billed charges,100% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,567,100,,,percent of total billed charges,100% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,106.87,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,192.21,33.9,,,percent of total billed charges,33.9% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,442.26,78,,,percent of total billed charges,78% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,28.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,567,
Estradiol LC,30182670,CDM,301,RC,82670,HCPCS,Outpatient,,,567,368.55,,498.96,88,,,percent of total billed charges,88% of total Billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,567,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,357.21,63,,,percent of total billed charges,63% of total billed charges,48.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,86.75,15.3,,,percent of total billed charges,15.3% of total billed charges,391.23,69,,,percent of total billed charges,69% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,567,100,,,percent of total billed charges,100% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,567,100,,,percent of total billed charges,100% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,106.87,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,192.21,33.9,,,percent of total billed charges,33.9% of total billed charges,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,442.26,78,,,percent of total billed charges,78% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,28.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,567,
Estrone LC,30182679,CDM,301,RC,82679,HCPCS,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,85.05,63,,,percent of total billed charges,63% of total billed charges,43.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,95.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,45.77,33.9,,,percent of total billed charges,33.9% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,25.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.95,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,135,
Estrogens Fractionated LC,30082671,CDM,300,RC,82671,HCPCS,Outpatient,,,270,175.50,,237.6,88,,,percent of total billed charges,88% of total Billed charges,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,270,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,170.1,63,,,percent of total billed charges,63% of total billed charges,56.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,41.31,15.3,,,percent of total billed charges,15.3% of total billed charges,186.3,69,,,percent of total billed charges,69% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,270,100,,,percent of total billed charges,100% of total billed charges,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,270,100,,,percent of total billed charges,100% of total billed charges,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,123.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,91.53,33.9,,,percent of total billed charges,33.9% of total billed charges,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,210.6,78,,,percent of total billed charges,78% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,32.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.29,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.6,270,
Ethosuximide (Zarontin) LC,30180168,CDM,301,RC,80168,HCPCS,Outpatient,,,335,217.75,,294.8,88,,,percent of total billed charges,88% of total Billed charges,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,335,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,211.05,63,,,percent of total billed charges,63% of total billed charges,28.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,51.26,15.3,,,percent of total billed charges,15.3% of total billed charges,231.15,69,,,percent of total billed charges,69% of total billed charges,335,100,,,percent of total billed charges,100% of total billed charges,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,335,100,,,percent of total billed charges,100% of total billed charges,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,335,100,,,percent of total billed charges,100% of total billed charges,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,62.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,126.3,37.7,,,percent of total billed charges,37.70% of total billed charges,126.3,37.7,,,percent of total billed charges,37.70% of total billed charges,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,113.57,33.9,,,percent of total billed charges,33.9% of total billed charges,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,261.3,78,,,percent of total billed charges,78% of total billed charges,335,100,,,percent of total billed charges,100% of total billed charges,276.71,82.6,,,percent of total billed charges,82.6% of total billed charges,276.71,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,16.5,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,335,
EVEROLIMUS,30180169,CDM,301,RC,80169,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,153.72,63,,,percent of total billed charges,63% of total billed charges,24.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,37.33,15.3,,,percent of total billed charges,15.3% of total billed charges,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,52.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,82.72,33.9,,,percent of total billed charges,33.9% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.86,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,244,
Ext Amphetamine Conf LC 910990,30180324,CDM,301,RC,80324,HCPCS,Outpatient,,,669,434.85,,588.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,669,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,421.47,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",102.36,15.3,,,percent of total billed charges,15.3% of total billed charges,461.61,69,,,percent of total billed charges,69% of total billed charges,669,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,669,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,669,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,252.21,37.7,,,percent of total billed charges,37.70% of total billed charges,252.21,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,226.79,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,521.82,78,,,percent of total billed charges,78% of total billed charges,669,100,,,percent of total billed charges,100% of total billed charges,552.59,82.6,,,percent of total billed charges,82.6% of total billed charges,552.59,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,112.39,16.8,,,percent of total billed charges,16.8% of total billed charges,102.36,669,
METHYLMALONIC ACID,30182542,CDM,301,RC,82542,HCPCS,Outpatient,,,181,117.65,,159.28,88,,,percent of total billed charges,88% of total Billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,181,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,114.03,63,,,percent of total billed charges,63% of total billed charges,42.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,27.69,15.3,,,percent of total billed charges,15.3% of total billed charges,124.89,69,,,percent of total billed charges,69% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,181,100,,,percent of total billed charges,100% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,181,100,,,percent of total billed charges,100% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,92.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,61.36,33.9,,,percent of total billed charges,33.9% of total billed charges,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,141.18,78,,,percent of total billed charges,78% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,181,
FIB-4 w/rflx to Enhanced Liver Fibrosis (ELF) 402175 LC,30184450,CDM,301,RC,84450,HCPCS,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,113,
FSH LC,30183001,CDM,301,RC,83001,HCPCS,Outpatient,,,359,233.35,,315.92,88,,,percent of total billed charges,88% of total Billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,359,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,226.17,63,,,percent of total billed charges,63% of total billed charges,32.51,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,54.93,15.3,,,percent of total billed charges,15.3% of total billed charges,247.71,69,,,percent of total billed charges,69% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,71.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,121.7,33.9,,,percent of total billed charges,33.9% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,280.02,78,,,percent of total billed charges,78% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,359,
FSH and LH LC,30183001,CDM,301,RC,83001,HCPCS,Outpatient,,,359,233.35,,315.92,88,,,percent of total billed charges,88% of total Billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,359,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,226.17,63,,,percent of total billed charges,63% of total billed charges,32.51,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,54.93,15.3,,,percent of total billed charges,15.3% of total billed charges,247.71,69,,,percent of total billed charges,69% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,71.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,121.7,33.9,,,percent of total billed charges,33.9% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,280.02,78,,,percent of total billed charges,78% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,359,
Factor V Activity LC,30585220,CDM,305,RC,85220,HCPCS,Outpatient,,,60,39.00,,52.8,88,,,percent of total billed charges,88% of total Billed charges,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,60,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,37.8,63,,,percent of total billed charges,63% of total billed charges,30.88,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,9.18,15.3,,,percent of total billed charges,15.3% of total billed charges,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,67.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,20.34,33.9,,,percent of total billed charges,33.9% of total billed charges,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,17.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.64,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,67.51,
Factor VIII Activity LC,30585240,CDM,305,RC,85240,HCPCS,Outpatient,,,259,168.35,,227.92,88,,,percent of total billed charges,88% of total Billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,259,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,163.17,63,,,percent of total billed charges,63% of total billed charges,31.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,39.63,15.3,,,percent of total billed charges,15.3% of total billed charges,178.71,69,,,percent of total billed charges,69% of total billed charges,259,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,259,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,259,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,68.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,97.64,37.7,,,percent of total billed charges,37.70% of total billed charges,97.64,37.7,,,percent of total billed charges,37.70% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,87.8,33.9,,,percent of total billed charges,33.9% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,202.02,78,,,percent of total billed charges,78% of total billed charges,259,100,,,percent of total billed charges,100% of total billed charges,213.93,82.6,,,percent of total billed charges,82.6% of total billed charges,213.93,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,18.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,259,
Factor IX Activity LC,30585250,CDM,305,RC,85250,HCPCS,Outpatient,,,270,175.50,,237.6,88,,,percent of total billed charges,88% of total Billed charges,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,16.29,100,,,Fee Schedule,100% of WA Medicaid,270,100,,,percent of total billed charges,100% of total billed charges,16.78,103,,,Fee Schedule,103% of WA Medicaid,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,170.1,63,,,percent of total billed charges,63% of total billed charges,33.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,16.29,100,,,Fee Schedule,100% of WA Medicaid,41.31,15.3,,,percent of total billed charges,15.3% of total billed charges,186.3,69,,,percent of total billed charges,69% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,270,100,,,percent of total billed charges,100% of total billed charges,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,270,100,,,percent of total billed charges,100% of total billed charges,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,72.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,12.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,16.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.18,130,,,Fee Schedule,130% of WA Medicaid ,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,91.53,33.9,,,percent of total billed charges,33.9% of total billed charges,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,210.6,78,,,percent of total billed charges,78% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,19.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.04,100,,,Fee Schedule,100% of Medicare OPPS rate,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.07,270,
Factor X Activity LC,30585260,CDM,305,RC,85260,HCPCS,Outpatient,,,123,79.95,,108.24,88,,,percent of total billed charges,88% of total Billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,123,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,77.49,63,,,percent of total billed charges,63% of total billed charges,31.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,18.82,15.3,,,percent of total billed charges,15.3% of total billed charges,84.87,69,,,percent of total billed charges,69% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,123,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,123,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,68.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,46.37,37.7,,,percent of total billed charges,37.70% of total billed charges,46.37,37.7,,,percent of total billed charges,37.70% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,41.7,33.9,,,percent of total billed charges,33.9% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,95.94,78,,,percent of total billed charges,78% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,18.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,123,
Factor XI Activity LC,30585270,CDM,305,RC,85270,HCPCS,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,364,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,229.32,63,,,percent of total billed charges,63% of total billed charges,31.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,55.69,15.3,,,percent of total billed charges,15.3% of total billed charges,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,68.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,123.4,33.9,,,percent of total billed charges,33.9% of total billed charges,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,18.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,364,
Factor VIII Bethesda Titer LC,30585335,CDM,305,RC,85335,HCPCS,Outpatient,,,293,190.45,,257.84,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,293,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,184.59,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,44.83,15.3,,,percent of total billed charges,15.3% of total billed charges,202.17,69,,,percent of total billed charges,69% of total billed charges,293,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,293,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,293,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,110.46,37.7,,,percent of total billed charges,37.70% of total billed charges,110.46,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,99.33,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,228.54,78,,,percent of total billed charges,78% of total billed charges,293,100,,,percent of total billed charges,100% of total billed charges,242.02,82.6,,,percent of total billed charges,82.6% of total billed charges,242.02,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,293,
Factor II Activity LC,30585210,CDM,305,RC,85210,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,63,63,,,percent of total billed charges,63% of total billed charges,22.71,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,49.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,13.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.98,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,100,
F5 GENE LEIDEN VARIANT ZB0O4,30181241,CDM,301,RC,81241,HCPCS,Outpatient,,,273,177.45,,240.24,88,,,percent of total billed charges,88% of total Billed charges,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,273,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,171.99,63,,,percent of total billed charges,63% of total billed charges,128.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,41.77,15.3,,,percent of total billed charges,15.3% of total billed charges,188.37,69,,,percent of total billed charges,69% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,280.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,92.55,33.9,,,percent of total billed charges,33.9% of total billed charges,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,212.94,78,,,percent of total billed charges,78% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,74.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,73.37,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,280.64,
"Factor II, DNA Analysis LC 511162 ZB0N4",31081240,CDM,310,RC,81240,HCPCS,Outpatient,,,258,167.70,,227.04,88,,,percent of total billed charges,88% of total Billed charges,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,258,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,162.54,63,,,percent of total billed charges,63% of total billed charges,114.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,98.54,150,,,Fee Schedule,150% of Medicare OPPS rate,178.02,69,,,percent of total billed charges,69% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,251.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,33.9,,,percent of total billed charges,33.9% of total billed charges,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,201.24,78,,,percent of total billed charges,78% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,66.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,65.69,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,258,
Iron Panel,30183540,CDM,301,RC,83540,HCPCS,Outpatient,,,128,83.20,,112.64,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,128,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,80.64,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,43.39,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,128,
Fecal WBC,30687205,CDM,306,RC,87205,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,43.47,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,23.39,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,69,
"Fecal Fat, Quantitative LC",30182710,CDM,301,RC,82710,HCPCS,Outpatient,,,344,223.60,,302.72,88,,,percent of total billed charges,88% of total Billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,344,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,63,,,percent of total billed charges,63% of total billed charges,29.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,52.63,15.3,,,percent of total billed charges,15.3% of total billed charges,237.36,69,,,percent of total billed charges,69% of total billed charges,344,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,344,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,344,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,64.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,129.69,37.7,,,percent of total billed charges,37.70% of total billed charges,129.69,37.7,,,percent of total billed charges,37.70% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,116.62,33.9,,,percent of total billed charges,33.9% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,268.32,78,,,percent of total billed charges,78% of total billed charges,344,100,,,percent of total billed charges,100% of total billed charges,284.14,82.6,,,percent of total billed charges,82.6% of total billed charges,284.14,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,344,
"Fecal Fat, Qualitative LC",30182705,CDM,301,RC,82705,HCPCS,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,34,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,21.42,63,,,percent of total billed charges,63% of total billed charges,8.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,34,100,,,percent of total billed charges,100% of total billed charges,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,34,100,,,percent of total billed charges,100% of total billed charges,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,19.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,33.9,,,percent of total billed charges,33.9% of total billed charges,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,5.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.09,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,34,
"Fentanyl Screen, UR Rfx LC",30180307,CDM,301,RC,80307,HCPCS,Outpatient,,,326,211.90,,286.88,88,,,percent of total billed charges,88% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,326,100,,,percent of total billed charges,100% of total billed charges,56.41,17.304,,,percent of total billed charges,17.304% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,205.38,63,,,percent of total billed charges,63% of total billed charges,108.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,49.88,15.3,,,percent of total billed charges,15.3% of total billed charges,224.94,69,,,percent of total billed charges,69% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,237.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,55.86,17.136,,,percent of total billed charges,17.136% of total billed charges,71.2,21.84,,,percent of total billed charges,21.84% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,110.51,33.9,,,percent of total billed charges,33.9% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,254.28,78,,,percent of total billed charges,78% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,49.88,326,
Ferritin,30182728,CDM,301,RC,82728,HCPCS,Outpatient,,,288,187.20,,253.44,88,,,percent of total billed charges,88% of total Billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,288,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,181.44,63,,,percent of total billed charges,63% of total billed charges,23.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,44.06,15.3,,,percent of total billed charges,15.3% of total billed charges,198.72,69,,,percent of total billed charges,69% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,288,100,,,percent of total billed charges,100% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,288,100,,,percent of total billed charges,100% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,52.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,97.63,33.9,,,percent of total billed charges,33.9% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,224.64,78,,,percent of total billed charges,78% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,13.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,288,
Ferritin LC,30182728,CDM,301,RC,82728,HCPCS,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,21,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,13.23,63,,,percent of total billed charges,63% of total billed charges,23.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,21,100,,,percent of total billed charges,100% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,21,100,,,percent of total billed charges,100% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,52.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,7.92,37.7,,,percent of total billed charges,37.70% of total billed charges,7.92,37.7,,,percent of total billed charges,37.70% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,7.12,33.9,,,percent of total billed charges,33.9% of total billed charges,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,13.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.63,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.21,52.13,
FETAL FIBRONECTIN,30182731,CDM,301,RC,82731,HCPCS,Outpatient,,,765,497.25,,673.2,88,,,percent of total billed charges,88% of total Billed charges,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,98.85,100,,,Fee Schedule,100% of WA Medicaid,765,100,,,percent of total billed charges,100% of total billed charges,101.81,103,,,Fee Schedule,103% of WA Medicaid,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,481.95,63,,,percent of total billed charges,63% of total billed charges,112.71,175,,,Fee Schedule,175% of Medicare OPPS Rate,98.85,100,,,Fee Schedule,100% of WA Medicaid,117.05,15.3,,,percent of total billed charges,15.3% of total billed charges,527.85,69,,,percent of total billed charges,69% of total billed charges,765,100,,,percent of total billed charges,100% of total billed charges,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,765,100,,,percent of total billed charges,100% of total billed charges,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,765,100,,,percent of total billed charges,100% of total billed charges,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,246.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,98.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,73.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,100.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.5,130,,,Fee Schedule,130% of WA Medicaid ,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,288.41,37.7,,,percent of total billed charges,37.70% of total billed charges,288.41,37.7,,,percent of total billed charges,37.70% of total billed charges,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,259.34,33.9,,,percent of total billed charges,33.9% of total billed charges,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,596.7,78,,,percent of total billed charges,78% of total billed charges,765,100,,,percent of total billed charges,100% of total billed charges,631.89,82.6,,,percent of total billed charges,82.6% of total billed charges,631.89,82.6,,,percent of total billed charges,82.6% of total billed charges,98.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,65.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,64.41,100,,,Fee Schedule,100% of Medicare OPPS rate,98.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.41,765,
Fibrinogen Activity,30585384,CDM,305,RC,85384,HCPCS,Outpatient,,,148,96.20,,130.24,88,,,percent of total billed charges,88% of total Billed charges,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,148,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,93.24,63,,,percent of total billed charges,63% of total billed charges,17.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,22.64,15.3,,,percent of total billed charges,15.3% of total billed charges,102.12,69,,,percent of total billed charges,69% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,148,100,,,percent of total billed charges,100% of total billed charges,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,148,100,,,percent of total billed charges,100% of total billed charges,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,55.8,37.7,,,percent of total billed charges,37.70% of total billed charges,55.8,37.7,,,percent of total billed charges,37.70% of total billed charges,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,50.17,33.9,,,percent of total billed charges,33.9% of total billed charges,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,115.44,78,,,percent of total billed charges,78% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,9.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.72,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,148,
Fine-Needle Aspiration LC,31188173,CDM,311,RC,88173,HCPCS,Outpatient,,,282,183.30,,248.16,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,282,100,,,percent of total billed charges,100% of total billed charges,34.17,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,177.66,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid,43.15,15.3,,,percent of total billed charges,15.3% of total billed charges,194.58,69,,,percent of total billed charges,69% of total billed charges,282,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,282,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,282,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,24.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.13,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,106.31,37.7,,,percent of total billed charges,37.70% of total billed charges,106.31,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,95.6,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,219.96,78,,,percent of total billed charges,78% of total billed charges,282,100,,,percent of total billed charges,100% of total billed charges,232.93,82.6,,,percent of total billed charges,82.6% of total billed charges,232.93,82.6,,,percent of total billed charges,82.6% of total billed charges,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.57,282,
Fine Needle Aspiration Cytology With Immediate Assessment LC,31188172,CDM,311,RC,88172,HCPCS,Outpatient,,,1146.75,745.39,,1009.14,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,1146.75,100,,,percent of total billed charges,100% of total billed charges,36.82,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,722.45,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,175.45,15.3,,,percent of total billed charges,15.3% of total billed charges,791.26,69,,,percent of total billed charges,69% of total billed charges,1146.75,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1146.75,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1146.75,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.47,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,432.32,37.7,,,percent of total billed charges,37.70% of total billed charges,432.32,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,388.75,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,894.47,78,,,percent of total billed charges,78% of total billed charges,1146.75,100,,,percent of total billed charges,100% of total billed charges,947.22,82.6,,,percent of total billed charges,82.6% of total billed charges,947.22,82.6,,,percent of total billed charges,82.6% of total billed charges,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.48,1146.75,
Flow Cytometry AVR,31088184,CDM,310,RC,88184,HCPCS,Outpatient,,,232,150.80,,204.16,88,,,percent of total billed charges,88% of total Billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,232,100,,,percent of total billed charges,100% of total billed charges,36.82,103,,,Fee Schedule,103% of WA Medicaid,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,146.16,63,,,percent of total billed charges,63% of total billed charges,641.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,35.5,15.3,,,percent of total billed charges,15.3% of total billed charges,160.08,69,,,percent of total billed charges,69% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,36.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.47,130,,,Fee Schedule,130% of WA Medicaid ,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,78.65,33.9,,,percent of total billed charges,33.9% of total billed charges,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,78,,,percent of total billed charges,78% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,370.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,366.62,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.48,1183.25,
Influenza A/B,30687804,CDM,306,RC,87804,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,63,63,,,percent of total billed charges,63% of total billed charges,28.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,63.3,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,16.71,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,100,
Flu A/B PCR (GeneXpert),30687502,CDM,306,RC,87502,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,100.54,103,,,Fee Schedule,103% of WA Medicaid,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,153.72,63,,,percent of total billed charges,63% of total billed charges,167.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,37.33,15.3,,,percent of total billed charges,15.3% of total billed charges,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,366.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,72.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,99.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.89,130,,,Fee Schedule,130% of WA Medicaid ,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,82.72,33.9,,,percent of total billed charges,33.9% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,96.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.33,366.43,
Flu (GeneXpert Xpress) POCT,30687502,CDM,306,RC,87502,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,100.54,103,,,Fee Schedule,103% of WA Medicaid,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,153.72,63,,,percent of total billed charges,63% of total billed charges,167.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,37.33,15.3,,,percent of total billed charges,15.3% of total billed charges,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,366.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,72.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,99.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.89,130,,,Fee Schedule,130% of WA Medicaid ,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,82.72,33.9,,,percent of total billed charges,33.9% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,96.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.33,366.43,
Flu/RSV (GeneXpert Xpress) POCT,30687502,CDM,306,RC,87502,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,100.54,103,,,Fee Schedule,103% of WA Medicaid,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,153.72,63,,,percent of total billed charges,63% of total billed charges,167.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,37.33,15.3,,,percent of total billed charges,15.3% of total billed charges,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,366.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,72.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,99.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.89,130,,,Fee Schedule,130% of WA Medicaid ,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,82.72,33.9,,,percent of total billed charges,33.9% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,96.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.33,366.43,
Folate Serum,30182746,CDM,301,RC,82746,HCPCS,Outpatient,,,253,164.45,,222.64,88,,,percent of total billed charges,88% of total Billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,159.39,63,,,percent of total billed charges,63% of total billed charges,25.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,56.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,14.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,253,
Folate (Folic Acid) LC,30182746,CDM,301,RC,82746,HCPCS,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,27,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,17.01,63,,,percent of total billed charges,63% of total billed charges,25.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,27,100,,,percent of total billed charges,100% of total billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,27,100,,,percent of total billed charges,100% of total billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,56.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,10.18,37.7,,,percent of total billed charges,37.70% of total billed charges,10.18,37.7,,,percent of total billed charges,37.70% of total billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,9.15,33.9,,,percent of total billed charges,33.9% of total billed charges,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,14.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.7,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.13,56.22,
FSH,30183001,CDM,301,RC,83001,HCPCS,Outpatient,,,320,208.00,,281.6,88,,,percent of total billed charges,88% of total Billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,320,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,201.6,63,,,percent of total billed charges,63% of total billed charges,32.51,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,48.96,15.3,,,percent of total billed charges,15.3% of total billed charges,220.8,69,,,percent of total billed charges,69% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,320,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,320,100,,,percent of total billed charges,100% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,71.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,108.48,33.9,,,percent of total billed charges,33.9% of total billed charges,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,249.6,78,,,percent of total billed charges,78% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,18.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,320,
Free T4,30184439,CDM,301,RC,84439,HCPCS,Outpatient,,,128,83.20,,112.64,88,,,percent of total billed charges,88% of total Billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,128,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,80.64,63,,,percent of total billed charges,63% of total billed charges,15.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,34.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,43.39,33.9,,,percent of total billed charges,33.9% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,9.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,128,
"Free K+L Lt Chains,Qn LC",30183883,CDM,301,RC,83883,HCPCS,Outpatient,,,157,102.05,,138.16,88,,,percent of total billed charges,88% of total Billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,157,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,98.91,63,,,percent of total billed charges,63% of total billed charges,23.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,24.02,15.3,,,percent of total billed charges,15.3% of total billed charges,108.33,69,,,percent of total billed charges,69% of total billed charges,157,100,,,percent of total billed charges,100% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,157,100,,,percent of total billed charges,100% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,157,100,,,percent of total billed charges,100% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,52.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,59.19,37.7,,,percent of total billed charges,37.70% of total billed charges,59.19,37.7,,,percent of total billed charges,37.70% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,53.22,33.9,,,percent of total billed charges,33.9% of total billed charges,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,122.46,78,,,percent of total billed charges,78% of total billed charges,157,100,,,percent of total billed charges,100% of total billed charges,129.68,82.6,,,percent of total billed charges,82.6% of total billed charges,129.68,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.6,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,157,
"Fructose, Semen Analysis LC #001875",30082757,CDM,300,RC,82757,HCPCS,Outpatient,,,115,74.75,,101.2,88,,,percent of total billed charges,88% of total Billed charges,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,115,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,72.45,63,,,percent of total billed charges,63% of total billed charges,30.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,17.6,15.3,,,percent of total billed charges,15.3% of total billed charges,79.35,69,,,percent of total billed charges,69% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,115,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,115,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,66.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,43.36,37.7,,,percent of total billed charges,37.70% of total billed charges,43.36,37.7,,,percent of total billed charges,37.70% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,38.99,33.9,,,percent of total billed charges,33.9% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,89.7,78,,,percent of total billed charges,78% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,17.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.34,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,115,
Fructosamine LC,30182985,CDM,301,RC,82985,HCPCS,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,87,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,54.81,63,,,percent of total billed charges,63% of total billed charges,29.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,64.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,16.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.76,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,87,
Fungus (Mycology) Culture LC,30687101,CDM,306,RC,87101,HCPCS,Outpatient,,,216,140.40,,190.08,88,,,percent of total billed charges,88% of total Billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,216,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,136.08,63,,,percent of total billed charges,63% of total billed charges,13.49,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,33.05,15.3,,,percent of total billed charges,15.3% of total billed charges,149.04,69,,,percent of total billed charges,69% of total billed charges,216,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,216,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,216,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,29.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,81.43,37.7,,,percent of total billed charges,37.70% of total billed charges,81.43,37.7,,,percent of total billed charges,37.70% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,73.22,33.9,,,percent of total billed charges,33.9% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,168.48,78,,,percent of total billed charges,78% of total billed charges,216,100,,,percent of total billed charges,100% of total billed charges,178.42,82.6,,,percent of total billed charges,82.6% of total billed charges,178.42,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,7.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,216,
GLUCOSE-6-PHOS DEHYD,30082955,CDM,300,RC,82955,HCPCS,Outpatient,,,53,34.45,,46.64,88,,,percent of total billed charges,88% of total Billed charges,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,53,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,33.39,63,,,percent of total billed charges,63% of total billed charges,16.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,8.11,15.3,,,percent of total billed charges,15.3% of total billed charges,36.57,69,,,percent of total billed charges,69% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,37.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,17.97,33.9,,,percent of total billed charges,33.9% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,41.34,78,,,percent of total billed charges,78% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,9.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.69,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,53,
GAD-65 Autoantibody LC,30286341,CDM,302,RC,86341,HCPCS,Outpatient,,,310,201.50,,272.8,88,,,percent of total billed charges,88% of total Billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,310,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,195.3,63,,,percent of total billed charges,63% of total billed charges,41.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,47.43,15.3,,,percent of total billed charges,15.3% of total billed charges,213.9,69,,,percent of total billed charges,69% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,310,100,,,percent of total billed charges,100% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,310,100,,,percent of total billed charges,100% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,90.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,33.9,,,percent of total billed charges,33.9% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,241.8,78,,,percent of total billed charges,78% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,23.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,23.57,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,310,
Glucose 2 Hour,30082950,CDM,301,RC,82950,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,58.59,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,31.53,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,93,
NEURONTIN,30180171,CDM,301,RC,80171,HCPCS,Outpatient,,,103,66.95,,90.64,88,,,percent of total billed charges,88% of total Billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,103,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,64.89,63,,,percent of total billed charges,63% of total billed charges,37.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,15.76,15.3,,,percent of total billed charges,15.3% of total billed charges,71.07,69,,,percent of total billed charges,69% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,82.88,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,34.92,33.9,,,percent of total billed charges,33.9% of total billed charges,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,80.34,78,,,percent of total billed charges,78% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,21.88,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,103,
GGT,30182977,CDM,301,RC,82977,HCPCS,Outpatient,,,124,80.60,,109.12,88,,,percent of total billed charges,88% of total Billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,124,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,78.12,63,,,percent of total billed charges,63% of total billed charges,12.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,18.97,15.3,,,percent of total billed charges,15.3% of total billed charges,85.56,69,,,percent of total billed charges,69% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,124,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,124,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,27.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,42.04,33.9,,,percent of total billed charges,33.9% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,96.72,78,,,percent of total billed charges,78% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,7.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.2,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,124,
Gastric Occult Blood,30182271,CDM,301,RC,82271,HCPCS,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,56,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,35.28,63,,,percent of total billed charges,63% of total billed charges,9.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,56,100,,,percent of total billed charges,100% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,56,100,,,percent of total billed charges,100% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,20.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,18.98,33.9,,,percent of total billed charges,33.9% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,5.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.32,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,56,
Gastrin LC,30182941,CDM,301,RC,82941,HCPCS,Outpatient,,,361,234.65,,317.68,88,,,percent of total billed charges,88% of total Billed charges,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,361,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,227.43,63,,,percent of total billed charges,63% of total billed charges,30.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,55.23,15.3,,,percent of total billed charges,15.3% of total billed charges,249.09,69,,,percent of total billed charges,69% of total billed charges,361,100,,,percent of total billed charges,100% of total billed charges,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,361,100,,,percent of total billed charges,100% of total billed charges,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,361,100,,,percent of total billed charges,100% of total billed charges,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,67.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,136.1,37.7,,,percent of total billed charges,37.70% of total billed charges,136.1,37.7,,,percent of total billed charges,37.70% of total billed charges,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,122.38,33.9,,,percent of total billed charges,33.9% of total billed charges,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,281.58,78,,,percent of total billed charges,78% of total billed charges,361,100,,,percent of total billed charges,100% of total billed charges,298.19,82.6,,,percent of total billed charges,82.6% of total billed charges,298.19,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,17.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.63,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,361,
Genital Ulcer Panel AVR,30687529,CDM,306,RC,87529,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
GENTAMICIN LEVEL,30180170,CDM,301,RC,80170,HCPCS,Outpatient,,,359,233.35,,315.92,88,,,percent of total billed charges,88% of total Billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,359,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.17,63,,,percent of total billed charges,63% of total billed charges,28.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,54.93,15.3,,,percent of total billed charges,15.3% of total billed charges,247.71,69,,,percent of total billed charges,69% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,121.7,33.9,,,percent of total billed charges,33.9% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,280.02,78,,,percent of total billed charges,78% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,359,
GENTAMICIN LEVEL PEAK,30180170,CDM,301,RC,80170,HCPCS,Outpatient,,,359,233.35,,315.92,88,,,percent of total billed charges,88% of total Billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,359,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.17,63,,,percent of total billed charges,63% of total billed charges,28.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,54.93,15.3,,,percent of total billed charges,15.3% of total billed charges,247.71,69,,,percent of total billed charges,69% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,121.7,33.9,,,percent of total billed charges,33.9% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,280.02,78,,,percent of total billed charges,78% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,359,
GENTAMICIN RANDOM,30180170,CDM,301,RC,80170,HCPCS,Outpatient,,,359,233.35,,315.92,88,,,percent of total billed charges,88% of total Billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,359,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.17,63,,,percent of total billed charges,63% of total billed charges,28.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,54.93,15.3,,,percent of total billed charges,15.3% of total billed charges,247.71,69,,,percent of total billed charges,69% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,121.7,33.9,,,percent of total billed charges,33.9% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,280.02,78,,,percent of total billed charges,78% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,359,
GENTAMICIN LEVEL TROUGH,30180170,CDM,301,RC,80170,HCPCS,Outpatient,,,359,233.35,,315.92,88,,,percent of total billed charges,88% of total Billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,359,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.17,63,,,percent of total billed charges,63% of total billed charges,28.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,54.93,15.3,,,percent of total billed charges,15.3% of total billed charges,247.71,69,,,percent of total billed charges,69% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,359,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,121.7,33.9,,,percent of total billed charges,33.9% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,280.02,78,,,percent of total billed charges,78% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,359,
Giardia Antigen,30687329,CDM,306,RC,87329,HCPCS,Outpatient,,,177,115.05,,155.76,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,177,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,111.51,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,27.08,15.3,,,percent of total billed charges,15.3% of total billed charges,122.13,69,,,percent of total billed charges,69% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,177,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,177,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,66.73,37.7,,,percent of total billed charges,37.70% of total billed charges,66.73,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,60,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,138.06,78,,,percent of total billed charges,78% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,177,
"Giardia lamblia Ag, EIA LC",30687329,CDM,306,RC,87329,HCPCS,Outpatient,,,208,135.20,,183.04,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,208,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,131.04,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,31.82,15.3,,,percent of total billed charges,15.3% of total billed charges,143.52,69,,,percent of total billed charges,69% of total billed charges,208,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,208,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,208,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,78.42,37.7,,,percent of total billed charges,37.70% of total billed charges,78.42,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,70.51,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,162.24,78,,,percent of total billed charges,78% of total billed charges,208,100,,,percent of total billed charges,100% of total billed charges,171.81,82.6,,,percent of total billed charges,82.6% of total billed charges,171.81,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,208,
Giardia/Cryptosporidium EIA LC,30687329,CDM,306,RC,87329,HCPCS,Outpatient,,,98,63.70,,86.24,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,98,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,61.74,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,14.99,15.3,,,percent of total billed charges,15.3% of total billed charges,67.62,69,,,percent of total billed charges,69% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,98,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,98,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,33.22,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,76.44,78,,,percent of total billed charges,78% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,98,
"Gliadin IgG/IgA Ab Prof, EIA LC",30183516,CDM,301,RC,83516,HCPCS,Outpatient,,,92,59.80,,80.96,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,92,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,14.08,15.3,,,percent of total billed charges,15.3% of total billed charges,63.48,69,,,percent of total billed charges,69% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,92,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,92,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,31.19,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,71.76,78,,,percent of total billed charges,78% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,92,
GLUCOSE BLOOD,30182947,CDM,301,RC,82947,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,30.24,63,,,percent of total billed charges,63% of total billed charges,6.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,15.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,48,
Glucose Body Fluid,30182945,CDM,301,RC,82945,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,75,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,47.25,63,,,percent of total billed charges,63% of total billed charges,6.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,15.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,25.43,33.9,,,percent of total billed charges,33.9% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,75,
Glucose CSF,30182945,CDM,301,RC,82945,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,75,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,47.25,63,,,percent of total billed charges,63% of total billed charges,6.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,15.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,25.43,33.9,,,percent of total billed charges,33.9% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,75,
Glucose 1 Hour,30082950,CDM,300,RC,82950,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,58.59,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,31.53,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,93,
Glucose 3 Hour,30182952,CDM,301,RC,82952,HCPCS,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,36,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,22.68,63,,,percent of total billed charges,63% of total billed charges,6.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,36,100,,,percent of total billed charges,100% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,36,100,,,percent of total billed charges,100% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,14.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,12.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,36,
Glucose 1 Hour Post Prandial,30082950,CDM,300,RC,82950,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,141.12,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,34.27,15.3,,,percent of total billed charges,15.3% of total billed charges,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,75.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,224,
GLUCOSE 2 HR PP,30182950,CDM,301,RC,82950,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,141.12,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,34.27,15.3,,,percent of total billed charges,15.3% of total billed charges,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,75.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,224,
Glucose Tolerance Test - 3 Hours,30082951,CDM,300,RC,82951,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,150.57,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,36.57,15.3,,,percent of total billed charges,15.3% of total billed charges,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,81.02,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,239,
Glucose Tolerance Test - 4 Hours,30082951,CDM,300,RC,82951,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,150.57,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,36.57,15.3,,,percent of total billed charges,15.3% of total billed charges,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,81.02,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,239,
Glucose Tolerance Test - 5 Hours,30082951,CDM,300,RC,82951,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,150.57,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,36.57,15.3,,,percent of total billed charges,15.3% of total billed charges,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,81.02,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,239,
Glucose Tolerance Test - 6 Hours,30082951,CDM,300,RC,82951,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,150.57,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,36.57,15.3,,,percent of total billed charges,15.3% of total billed charges,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,81.02,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,239,
Glucose 1 Hour Post Prandial OB,30082950,CDM,300,RC,82950,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,141.12,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,34.27,15.3,,,percent of total billed charges,15.3% of total billed charges,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,75.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,224,
Glucose 1 Hour,30182950,CDM,301,RC,82950,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,58.59,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,31.53,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,93,
"Glucose, Body Fluid LC",30182945,CDM,301,RC,82945,HCPCS,Outpatient,,,11.79,7.66,,10.38,88,,,percent of total billed charges,88% of total Billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.79,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,7.43,63,,,percent of total billed charges,63% of total billed charges,6.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,1.8,15.3,,,percent of total billed charges,15.3% of total billed charges,8.14,69,,,percent of total billed charges,69% of total billed charges,11.79,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,11.79,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,11.79,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,15.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.44,37.7,,,percent of total billed charges,37.70% of total billed charges,4.44,37.7,,,percent of total billed charges,37.70% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4,33.9,,,percent of total billed charges,33.9% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.2,78,,,percent of total billed charges,78% of total billed charges,11.79,100,,,percent of total billed charges,100% of total billed charges,9.74,82.6,,,percent of total billed charges,82.6% of total billed charges,9.74,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.8,15.03,
GTT 3 Hr OB Add'l Specimen,30082952,CDM,300,RC,82952,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,141.12,63,,,percent of total billed charges,63% of total billed charges,6.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,34.27,15.3,,,percent of total billed charges,15.3% of total billed charges,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,224,100,,,percent of total billed charges,100% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,14.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,75.94,33.9,,,percent of total billed charges,33.9% of total billed charges,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.92,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,224,
Glucose Fasting OB,30082950,CDM,300,RC,82950,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,58.59,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,31.53,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,93,
Glucose Tolerance Test 3 Hr OB,30082951,CDM,300,RC,82951,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,150.57,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,36.57,15.3,,,percent of total billed charges,15.3% of total billed charges,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,81.02,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,239,
GLUCOSE TOL 2HR,30182951,CDM,301,RC,82951,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,150.57,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,36.57,15.3,,,percent of total billed charges,15.3% of total billed charges,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,81.02,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,239,
Glucose Tolerance Test 30m,30082951,CDM,300,RC,82951,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,150.57,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,36.57,15.3,,,percent of total billed charges,15.3% of total billed charges,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,81.02,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,239,
Group B Strep PCR (GeneXpert),30687653,CDM,306,RC,87653,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.7,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.51,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.77,134.21,
Group B Streptococcus AVR,30687653,CDM,306,RC,87653,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Growth Hormone LC,30183003,CDM,301,RC,83003,HCPCS,Outpatient,,,341,221.65,,300.08,88,,,percent of total billed charges,88% of total Billed charges,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,341,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,214.83,63,,,percent of total billed charges,63% of total billed charges,29.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,52.17,15.3,,,percent of total billed charges,15.3% of total billed charges,235.29,69,,,percent of total billed charges,69% of total billed charges,341,100,,,percent of total billed charges,100% of total billed charges,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,341,100,,,percent of total billed charges,100% of total billed charges,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,341,100,,,percent of total billed charges,100% of total billed charges,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,63.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,128.56,37.7,,,percent of total billed charges,37.70% of total billed charges,128.56,37.7,,,percent of total billed charges,37.70% of total billed charges,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,115.6,33.9,,,percent of total billed charges,33.9% of total billed charges,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,265.98,78,,,percent of total billed charges,78% of total billed charges,341,100,,,percent of total billed charges,100% of total billed charges,281.67,82.6,,,percent of total billed charges,82.6% of total billed charges,281.67,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,16.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.67,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,341,
Helicobacter Pylori Antibody IgG,30086677,CDM,300,RC,86677,HCPCS,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,43,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,27.09,63,,,percent of total billed charges,63% of total billed charges,29.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,43,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,43,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,64.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,14.58,33.9,,,percent of total billed charges,33.9% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,17.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.58,64.45,
"H. pylori, IgG Abs LC",30286677,CDM,302,RC,86677,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,55.44,63,,,percent of total billed charges,63% of total billed charges,29.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,64.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.83,33.9,,,percent of total billed charges,33.9% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,17.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,88,
"H. pylori Stool Ag, EIA LC",30687338,CDM,306,RC,87338,HCPCS,Outpatient,,,497,323.05,,437.36,88,,,percent of total billed charges,88% of total Billed charges,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,497,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,313.11,63,,,percent of total billed charges,63% of total billed charges,25.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,76.04,15.3,,,percent of total billed charges,15.3% of total billed charges,342.93,69,,,percent of total billed charges,69% of total billed charges,497,100,,,percent of total billed charges,100% of total billed charges,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,497,100,,,percent of total billed charges,100% of total billed charges,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,497,100,,,percent of total billed charges,100% of total billed charges,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,55,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,187.37,37.7,,,percent of total billed charges,37.70% of total billed charges,187.37,37.7,,,percent of total billed charges,37.70% of total billed charges,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,168.48,33.9,,,percent of total billed charges,33.9% of total billed charges,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,387.66,78,,,percent of total billed charges,78% of total billed charges,497,100,,,percent of total billed charges,100% of total billed charges,410.52,82.6,,,percent of total billed charges,82.6% of total billed charges,410.52,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,14.52,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.38,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,497,
H. pylori Breath Test LC,30083013,CDM,300,RC,83013,HCPCS,Outpatient,,,426,276.90,,374.88,88,,,percent of total billed charges,88% of total Billed charges,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,98.85,100,,,Fee Schedule,100% of WA Medicaid,426,100,,,percent of total billed charges,100% of total billed charges,101.81,103,,,Fee Schedule,103% of WA Medicaid,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,268.38,63,,,percent of total billed charges,63% of total billed charges,117.88,175,,,Fee Schedule,175% of Medicare OPPS Rate,98.85,100,,,Fee Schedule,100% of WA Medicaid,65.18,15.3,,,percent of total billed charges,15.3% of total billed charges,293.94,69,,,percent of total billed charges,69% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,426,100,,,percent of total billed charges,100% of total billed charges,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,426,100,,,percent of total billed charges,100% of total billed charges,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,257.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,98.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,73.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,100.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.5,130,,,Fee Schedule,130% of WA Medicaid ,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,160.6,37.7,,,percent of total billed charges,37.70% of total billed charges,160.6,37.7,,,percent of total billed charges,37.70% of total billed charges,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,144.41,33.9,,,percent of total billed charges,33.9% of total billed charges,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,332.28,78,,,percent of total billed charges,78% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,98.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,68.03,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,67.36,100,,,Fee Schedule,100% of Medicare OPPS rate,98.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.18,426,
H.pylori IgG/IgA Ab LC,30286677,CDM,302,RC,86677,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,9.67,103,,,Fee Schedule,103% of WA Medicaid,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,29.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,64.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,17.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,64.45,
30687517,30687517,CDM,306,RC,87517,HCPCS,Outpatient,,,1652,1073.80,,1453.76,88,,,percent of total billed charges,88% of total Billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,1652,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1040.76,63,,,percent of total billed charges,63% of total billed charges,74.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,252.76,15.3,,,percent of total billed charges,15.3% of total billed charges,1139.88,69,,,percent of total billed charges,69% of total billed charges,1652,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1652,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1652,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,163.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,622.8,37.7,,,percent of total billed charges,37.70% of total billed charges,622.8,37.7,,,percent of total billed charges,37.70% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,560.03,33.9,,,percent of total billed charges,33.9% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1288.56,78,,,percent of total billed charges,78% of total billed charges,1652,100,,,percent of total billed charges,100% of total billed charges,1364.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1364.55,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,43.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,1652,
30687517,30687517,CDM,306,RC,87517,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,25.49,103,,,Fee Schedule,103% of WA Medicaid,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,74.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,163.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,43.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,163.86,
HBsAg Screen LC,30687340,CDM,306,RC,87340,HCPCS,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,167,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,105.21,63,,,percent of total billed charges,63% of total billed charges,18.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,25.55,15.3,,,percent of total billed charges,15.3% of total billed charges,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,39.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,56.61,33.9,,,percent of total billed charges,33.9% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,10.43,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,167,
HCV Antibody LC,30286803,CDM,302,RC,86803,HCPCS,Outpatient,,,183,118.95,,161.04,88,,,percent of total billed charges,88% of total Billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,183,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,115.29,63,,,percent of total billed charges,63% of total billed charges,24.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,28,15.3,,,percent of total billed charges,15.3% of total billed charges,126.27,69,,,percent of total billed charges,69% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,54.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,62.04,33.9,,,percent of total billed charges,33.9% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,142.74,78,,,percent of total billed charges,78% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.41,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,183,
HCV FibroSure LC,30182247,CDM,301,RC,82247,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,75,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,47.25,63,,,percent of total billed charges,63% of total billed charges,8.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,25.43,33.9,,,percent of total billed charges,33.9% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,75,
HCV Genotyping Non Reflex LC,30087902,CDM,300,RC,87902,HCPCS,Outpatient,,,1391,904.15,,1224.08,88,,,percent of total billed charges,88% of total Billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,1391,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,876.33,63,,,percent of total billed charges,63% of total billed charges,450.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,212.82,15.3,,,percent of total billed charges,15.3% of total billed charges,959.79,69,,,percent of total billed charges,69% of total billed charges,1391,100,,,percent of total billed charges,100% of total billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1391,100,,,percent of total billed charges,100% of total billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1391,100,,,percent of total billed charges,100% of total billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,984.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,524.41,37.7,,,percent of total billed charges,37.70% of total billed charges,524.41,37.7,,,percent of total billed charges,37.70% of total billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,471.55,33.9,,,percent of total billed charges,33.9% of total billed charges,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,1084.98,78,,,percent of total billed charges,78% of total billed charges,1391,100,,,percent of total billed charges,100% of total billed charges,1148.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1148.97,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,260.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,257.45,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,1391,
"HCV RT-PCR, Quant (Non-Graph) LC",30687522,CDM,306,RC,87522,HCPCS,Outpatient,,,870,565.50,,765.6,88,,,percent of total billed charges,88% of total Billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,870,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,548.1,63,,,percent of total billed charges,63% of total billed charges,74.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,133.11,15.3,,,percent of total billed charges,15.3% of total billed charges,600.3,69,,,percent of total billed charges,69% of total billed charges,870,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,870,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,870,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,163.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,327.99,37.7,,,percent of total billed charges,37.70% of total billed charges,327.99,37.7,,,percent of total billed charges,37.70% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,294.93,33.9,,,percent of total billed charges,33.9% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,678.6,78,,,percent of total billed charges,78% of total billed charges,870,100,,,percent of total billed charges,100% of total billed charges,718.62,82.6,,,percent of total billed charges,82.6% of total billed charges,718.62,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,43.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,870,
"HCV RNA by PCR, Qn Rfx Geno LC",30687522,CDM,306,RC,87522,HCPCS,Outpatient,,,531,345.15,,467.28,88,,,percent of total billed charges,88% of total Billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,531,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,334.53,63,,,percent of total billed charges,63% of total billed charges,74.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,81.24,15.3,,,percent of total billed charges,15.3% of total billed charges,366.39,69,,,percent of total billed charges,69% of total billed charges,531,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,531,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,531,100,,,percent of total billed charges,100% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,163.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,200.19,37.7,,,percent of total billed charges,37.70% of total billed charges,200.19,37.7,,,percent of total billed charges,37.70% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,180.01,33.9,,,percent of total billed charges,33.9% of total billed charges,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,414.18,78,,,percent of total billed charges,78% of total billed charges,531,100,,,percent of total billed charges,100% of total billed charges,438.61,82.6,,,percent of total billed charges,82.6% of total billed charges,438.61,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,43.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.84,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,531,
HER-2/CEP17 FISH LC,31088377,CDM,310,RC,88377,HCPCS,Outpatient,,,2237,1454.05,,1968.56,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,2237,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1409.31,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,342.26,15.3,,,percent of total billed charges,15.3% of total billed charges,1543.53,69,,,percent of total billed charges,69% of total billed charges,2237,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2237,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2237,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,843.35,37.7,,,percent of total billed charges,37.70% of total billed charges,843.35,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,758.34,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1744.86,78,,,percent of total billed charges,78% of total billed charges,2237,100,,,percent of total billed charges,100% of total billed charges,1847.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1847.76,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,2237,
HIV ANTIBODY 1 AND 2,30286703,CDM,302,RC,86703,HCPCS,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,150,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,94.5,63,,,percent of total billed charges,63% of total billed charges,23.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,150,100,,,percent of total billed charges,100% of total billed charges,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,150,100,,,percent of total billed charges,100% of total billed charges,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,52.44,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,50.85,33.9,,,percent of total billed charges,33.9% of total billed charges,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,13.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,150,
HIV 1/2 Antibody Screen,30086701,CDM,300,RC,86701,HCPCS,Outpatient,,,68,44.20,,59.84,88,,,percent of total billed charges,88% of total Billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,68,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,42.84,63,,,percent of total billed charges,63% of total billed charges,15.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,10.4,15.3,,,percent of total billed charges,15.3% of total billed charges,46.92,69,,,percent of total billed charges,69% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,68,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,68,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,23.05,33.9,,,percent of total billed charges,33.9% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,53.04,78,,,percent of total billed charges,78% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,68,
HIV 1/2 Antibody w/ Interp,30286701,CDM,302,RC,86701,HCPCS,Outpatient,,,174,113.10,,153.12,88,,,percent of total billed charges,88% of total Billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,109.62,63,,,percent of total billed charges,63% of total billed charges,15.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,8.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.89,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,174,
HIV-1/HIV-2 Qualitative RNA LC,30687535,CDM,306,RC,87535,HCPCS,Outpatient,,,464,301.60,,408.32,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,464,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,292.32,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,70.99,15.3,,,percent of total billed charges,15.3% of total billed charges,320.16,69,,,percent of total billed charges,69% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,464,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,464,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,157.3,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,361.92,78,,,percent of total billed charges,78% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,464,
HLA B 27 Disease Association LC ZB3HG,31081374,CDM,310,RC,81374,HCPCS,Outpatient,,,496,322.40,,436.48,88,,,percent of total billed charges,88% of total Billed charges,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,496,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,312.48,63,,,percent of total billed charges,63% of total billed charges,130.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,111.5,150,,,Fee Schedule,150% of Medicare OPPS rate,342.24,69,,,percent of total billed charges,69% of total billed charges,496,100,,,percent of total billed charges,100% of total billed charges,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,496,100,,,percent of total billed charges,100% of total billed charges,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,496,100,,,percent of total billed charges,100% of total billed charges,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,284.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,186.99,37.7,,,percent of total billed charges,37.70% of total billed charges,186.99,37.7,,,percent of total billed charges,37.70% of total billed charges,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,168.14,33.9,,,percent of total billed charges,33.9% of total billed charges,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,386.88,78,,,percent of total billed charges,78% of total billed charges,496,100,,,percent of total billed charges,100% of total billed charges,409.7,82.6,,,percent of total billed charges,82.6% of total billed charges,409.7,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,75.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,74.33,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,496,
HP5 LC,30286704,CDM,302,RC,86704,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,58.59,63,,,percent of total billed charges,63% of total billed charges,21.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,46.09,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,31.53,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,93,
HPV Aptima LC,30687624,CDM,306,RC,87624,HCPCS,Outpatient,,,165,107.25,,145.2,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,165,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,103.95,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,55.94,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,165,
HPV Aptima LC,30687624,CDM,306,RC,87624,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,134.21,
"HPV, cobas high-risk/16/18 LC",30687624,CDM,306,RC,87624,HCPCS,Outpatient,,,165,107.25,,145.2,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,165,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,103.95,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,55.94,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,165,
HSV 1/2 PCR LC,30687529,CDM,306,RC,87529,HCPCS,Outpatient,,,218,141.70,,191.84,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,218,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,137.34,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,33.35,15.3,,,percent of total billed charges,15.3% of total billed charges,150.42,69,,,percent of total billed charges,69% of total billed charges,218,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,218,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,218,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,82.19,37.7,,,percent of total billed charges,37.70% of total billed charges,82.19,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,73.9,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,170.04,78,,,percent of total billed charges,78% of total billed charges,218,100,,,percent of total billed charges,100% of total billed charges,180.07,82.6,,,percent of total billed charges,82.6% of total billed charges,180.07,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,218,
"HSV 1 and 2-Spec AB, IgG w/Rflx LC 164922",30286696,CDM,302,RC,86696,HCPCS,Outpatient,,,102,66.30,,89.76,88,,,percent of total billed charges,88% of total Billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,102,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,64.26,63,,,percent of total billed charges,63% of total billed charges,33.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,15.61,15.3,,,percent of total billed charges,15.3% of total billed charges,70.38,69,,,percent of total billed charges,69% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,74.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,34.58,33.9,,,percent of total billed charges,33.9% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,79.56,78,,,percent of total billed charges,78% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,102,
"HSV, IgM I/II Combination LC",30286694,CDM,302,RC,86694,HCPCS,Outpatient,,,116,75.40,,102.08,88,,,percent of total billed charges,88% of total Billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,116,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,73.08,63,,,percent of total billed charges,63% of total billed charges,25.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,17.75,15.3,,,percent of total billed charges,15.3% of total billed charges,80.04,69,,,percent of total billed charges,69% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,116,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,116,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,39.32,33.9,,,percent of total billed charges,33.9% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,90.48,78,,,percent of total billed charges,78% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,116,
"HSV-2 Type Spec Ab, IgG w/Rflx LC 163033",30286696,CDM,302,RC,86696,HCPCS,Outpatient,,,102,66.30,,89.76,88,,,percent of total billed charges,88% of total Billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,102,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,64.26,63,,,percent of total billed charges,63% of total billed charges,33.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,15.61,15.3,,,percent of total billed charges,15.3% of total billed charges,70.38,69,,,percent of total billed charges,69% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,74.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,34.58,33.9,,,percent of total billed charges,33.9% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,79.56,78,,,percent of total billed charges,78% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,102,
HSV1 and HSV2 AVR,30687529,CDM,306,RC,87529,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
HSVIgM+HSV1/HSV2(IgG) LC 240823,30286694,CDM,302,RC,86694,HCPCS,Outpatient,,,121,78.65,,106.48,88,,,percent of total billed charges,88% of total Billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,121,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,76.23,63,,,percent of total billed charges,63% of total billed charges,25.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,18.51,15.3,,,percent of total billed charges,15.3% of total billed charges,83.49,69,,,percent of total billed charges,69% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,121,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,121,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,37.7,,,percent of total billed charges,37.70% of total billed charges,45.62,37.7,,,percent of total billed charges,37.70% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,41.02,33.9,,,percent of total billed charges,33.9% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,94.38,78,,,percent of total billed charges,78% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,121,
"HTLV-I/II Antibodies, Qual. LC",30286790,CDM,302,RC,86790,HCPCS,Outpatient,,,60,39.00,,52.8,88,,,percent of total billed charges,88% of total Billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,60,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,37.8,63,,,percent of total billed charges,63% of total billed charges,22.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,9.18,15.3,,,percent of total billed charges,15.3% of total billed charges,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,49.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,20.34,33.9,,,percent of total billed charges,33.9% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,60,
Haptoglobin LC,30183010,CDM,301,RC,83010,HCPCS,Outpatient,,,243,157.95,,213.84,88,,,percent of total billed charges,88% of total Billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,243,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,153.09,63,,,percent of total billed charges,63% of total billed charges,22.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,37.18,15.3,,,percent of total billed charges,15.3% of total billed charges,167.67,69,,,percent of total billed charges,69% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,243,100,,,percent of total billed charges,100% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,243,100,,,percent of total billed charges,100% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,48.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,82.38,33.9,,,percent of total billed charges,33.9% of total billed charges,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,189.54,78,,,percent of total billed charges,78% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,12.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.58,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,243,
"Heavy Metals Profile I, Blood LC",30183825,CDM,301,RC,83825,HCPCS,Outpatient,,,333,216.45,,293.04,88,,,percent of total billed charges,88% of total Billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,333,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,209.79,63,,,percent of total billed charges,63% of total billed charges,28.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,50.95,15.3,,,percent of total billed charges,15.3% of total billed charges,229.77,69,,,percent of total billed charges,69% of total billed charges,333,100,,,percent of total billed charges,100% of total billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,333,100,,,percent of total billed charges,100% of total billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,333,100,,,percent of total billed charges,100% of total billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,62.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,125.54,37.7,,,percent of total billed charges,37.70% of total billed charges,125.54,37.7,,,percent of total billed charges,37.70% of total billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,112.89,33.9,,,percent of total billed charges,33.9% of total billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,259.74,78,,,percent of total billed charges,78% of total billed charges,333,100,,,percent of total billed charges,100% of total billed charges,275.06,82.6,,,percent of total billed charges,82.6% of total billed charges,275.06,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,333,
"Helicobacter pylori, IgA LC",30286677,CDM,302,RC,86677,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,55.44,63,,,percent of total billed charges,63% of total billed charges,29.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,64.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.83,33.9,,,percent of total billed charges,33.9% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,17.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,88,
"Helicobacter pylori, IgM Ab LC",30286677,CDM,302,RC,86677,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,55.44,63,,,percent of total billed charges,63% of total billed charges,29.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,64.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.83,33.9,,,percent of total billed charges,33.9% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,17.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,88,
ABSOLUTE CD4 COUNT,30286361,CDM,302,RC,86361,HCPCS,Outpatient,,,123,79.95,,108.24,88,,,percent of total billed charges,88% of total Billed charges,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,123,100,,,percent of total billed charges,100% of total billed charges,28.1,103,,,Fee Schedule,103% of WA Medicaid,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,77.49,63,,,percent of total billed charges,63% of total billed charges,46.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,18.82,15.3,,,percent of total billed charges,15.3% of total billed charges,84.87,69,,,percent of total billed charges,69% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,123,100,,,percent of total billed charges,100% of total billed charges,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,123,100,,,percent of total billed charges,100% of total billed charges,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,102.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,20.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,27.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.47,130,,,Fee Schedule,130% of WA Medicaid ,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,46.37,37.7,,,percent of total billed charges,37.70% of total billed charges,46.37,37.7,,,percent of total billed charges,37.70% of total billed charges,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,41.7,33.9,,,percent of total billed charges,33.9% of total billed charges,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,95.94,78,,,percent of total billed charges,78% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,27.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.78,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.82,123,
HEMATOCRIT,30585014,CDM,305,RC,85014,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.24,63,,,percent of total billed charges,63% of total billed charges,4.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.37,48,
"Hematopath Consultation, Smear LC",30585060,CDM,305,RC,85060,HCPCS,Outpatient,,,107,69.55,,94.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,5.08,100,,,Fee Schedule,100% of WA Medicaid,107,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,67.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.08,100,,,Fee Schedule,100% of WA Medicaid,16.37,15.3,,,percent of total billed charges,15.3% of total billed charges,73.83,69,,,percent of total billed charges,69% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,107,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,107,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,36.27,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,83.46,78,,,percent of total billed charges,78% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,107,
HEMOGLOBIN,30585018,CDM,305,RC,85018,HCPCS,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,58,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,36.54,63,,,percent of total billed charges,63% of total billed charges,4.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,58,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,58,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.66,33.9,,,percent of total billed charges,33.9% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.37,58,
Hematocrit,30585014,CDM,305,RC,85014,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.24,63,,,percent of total billed charges,63% of total billed charges,4.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.37,48,
Hemoglobin A1c POCT,30183036,CDM,301,RC,83036,HCPCS,Outpatient,,,206,133.90,,181.28,88,,,percent of total billed charges,88% of total Billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,206,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,129.78,63,,,percent of total billed charges,63% of total billed charges,16.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,31.52,15.3,,,percent of total billed charges,15.3% of total billed charges,142.14,69,,,percent of total billed charges,69% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,37.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,69.83,33.9,,,percent of total billed charges,33.9% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.68,78,,,percent of total billed charges,78% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,206,
Hemoglobin A1c LC,30183036,CDM,301,RC,83036,HCPCS,Outpatient,,,242,157.30,,212.96,88,,,percent of total billed charges,88% of total Billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,242,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,152.46,63,,,percent of total billed charges,63% of total billed charges,16.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,37.03,15.3,,,percent of total billed charges,15.3% of total billed charges,166.98,69,,,percent of total billed charges,69% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,242,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,242,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,37.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,82.04,33.9,,,percent of total billed charges,33.9% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,188.76,78,,,percent of total billed charges,78% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,242,
Hemosiderin U LC,30183070,CDM,301,RC,83070,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,56.7,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,30.51,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,90,
Hepatic Function Panel,30180076,CDM,301,RC,80076,HCPCS,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,14.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,31.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,8.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.17,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,113,
Hep Be Ag LC,30687350,CDM,306,RC,87350,HCPCS,Outpatient,,,73,47.45,,64.24,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,73,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,45.99,63,,,percent of total billed charges,63% of total billed charges,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,11.17,15.3,,,percent of total billed charges,15.3% of total billed charges,50.37,69,,,percent of total billed charges,69% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,73,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,73,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,56.94,78,,,percent of total billed charges,78% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,73,
"Hep B Core Ab, Tot LC",30286704,CDM,302,RC,86704,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,58.59,63,,,percent of total billed charges,63% of total billed charges,21.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,46.09,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,31.53,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,93,
"Hep A Ab, Total LC",30286708,CDM,302,RC,86708,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,58.59,63,,,percent of total billed charges,63% of total billed charges,21.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,47.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,31.53,33.9,,,percent of total billed charges,33.9% of total billed charges,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,12.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,93,
"Hep A Ab, IgM LC",30286709,CDM,302,RC,86709,HCPCS,Outpatient,,,153,99.45,,134.64,88,,,percent of total billed charges,88% of total Billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,153,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,96.39,63,,,percent of total billed charges,63% of total billed charges,19.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,23.41,15.3,,,percent of total billed charges,15.3% of total billed charges,105.57,69,,,percent of total billed charges,69% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,43.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,51.87,33.9,,,percent of total billed charges,33.9% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,119.34,78,,,percent of total billed charges,78% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,153,
HEPATITIS B CORE AB IGM,30286705,CDM,302,RC,86705,HCPCS,Outpatient,,,143,92.95,,125.84,88,,,percent of total billed charges,88% of total Billed charges,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,143,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,90.09,63,,,percent of total billed charges,63% of total billed charges,20.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,21.88,15.3,,,percent of total billed charges,15.3% of total billed charges,98.67,69,,,percent of total billed charges,69% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,45.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,48.48,33.9,,,percent of total billed charges,33.9% of total billed charges,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,111.54,78,,,percent of total billed charges,78% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11.88,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,143,
Hepatitis B Surface Antigen,30087340,CDM,300,RC,87467,HCPCS,Outpatient,,,142,92.30,,124.96,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,6.49,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,89.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.49,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,142,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,142,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,142,
Hepatitis C Antibody,30286803,CDM,302,RC,86803,HCPCS,Outpatient,,,156,101.40,,137.28,88,,,percent of total billed charges,88% of total Billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,156,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,98.28,63,,,percent of total billed charges,63% of total billed charges,24.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,23.87,15.3,,,percent of total billed charges,15.3% of total billed charges,107.64,69,,,percent of total billed charges,69% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,54.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,52.88,33.9,,,percent of total billed charges,33.9% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,121.68,78,,,percent of total billed charges,78% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.41,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,156,
ANTI-XA HEPARIN,30585520,CDM,305,RC,85520,HCPCS,Outpatient,,,201,130.65,,176.88,88,,,percent of total billed charges,88% of total Billed charges,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,201,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,126.63,63,,,percent of total billed charges,63% of total billed charges,22.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,30.75,15.3,,,percent of total billed charges,15.3% of total billed charges,138.69,69,,,percent of total billed charges,69% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,201,100,,,percent of total billed charges,100% of total billed charges,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,201,100,,,percent of total billed charges,100% of total billed charges,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,50.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,68.14,33.9,,,percent of total billed charges,33.9% of total billed charges,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,156.78,78,,,percent of total billed charges,78% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,13.22,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.09,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,201,
Hepatitis D Virus (HDV) Total LC,30286692,CDM,302,RC,86692,HCPCS,Outpatient,,,320,208.00,,281.6,88,,,percent of total billed charges,88% of total Billed charges,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,320,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,201.6,63,,,percent of total billed charges,63% of total billed charges,30.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,48.96,15.3,,,percent of total billed charges,15.3% of total billed charges,220.8,69,,,percent of total billed charges,69% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,320,100,,,percent of total billed charges,100% of total billed charges,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,320,100,,,percent of total billed charges,100% of total billed charges,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,108.48,33.9,,,percent of total billed charges,33.9% of total billed charges,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,249.6,78,,,percent of total billed charges,78% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,320,
Hepatitis B Surf Ab Quant LC,30086317,CDM,300,RC,86317,HCPCS,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,62,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,39.06,63,,,percent of total billed charges,63% of total billed charges,26.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,9.49,15.3,,,percent of total billed charges,15.3% of total billed charges,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,62,100,,,percent of total billed charges,100% of total billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,62,100,,,percent of total billed charges,100% of total billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,57.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,21.02,33.9,,,percent of total billed charges,33.9% of total billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,15.13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,62,
Heparin Induced Platelet W/Rfx LC,30286022,CDM,302,RC,86022,HCPCS,Outpatient,,,329,213.85,,289.52,88,,,percent of total billed charges,88% of total Billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,329,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,207.27,63,,,percent of total billed charges,63% of total billed charges,32.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,50.34,15.3,,,percent of total billed charges,15.3% of total billed charges,227.01,69,,,percent of total billed charges,69% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,329,100,,,percent of total billed charges,100% of total billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,329,100,,,percent of total billed charges,100% of total billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,70.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,124.03,37.7,,,percent of total billed charges,37.70% of total billed charges,124.03,37.7,,,percent of total billed charges,37.70% of total billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,111.53,33.9,,,percent of total billed charges,33.9% of total billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,256.62,78,,,percent of total billed charges,78% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,18.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,329,
Hepatitis Panel (4) LC,30180074,CDM,301,RC,80074,HCPCS,Outpatient,,,1116,725.40,,982.08,88,,,percent of total billed charges,88% of total Billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,1116,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,703.08,63,,,percent of total billed charges,63% of total billed charges,83.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,170.75,15.3,,,percent of total billed charges,15.3% of total billed charges,770.04,69,,,percent of total billed charges,69% of total billed charges,1116,100,,,percent of total billed charges,100% of total billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,1116,100,,,percent of total billed charges,100% of total billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,1116,100,,,percent of total billed charges,100% of total billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,182.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,420.73,37.7,,,percent of total billed charges,37.70% of total billed charges,420.73,37.7,,,percent of total billed charges,37.70% of total billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,378.32,33.9,,,percent of total billed charges,33.9% of total billed charges,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,870.48,78,,,percent of total billed charges,78% of total billed charges,1116,100,,,percent of total billed charges,100% of total billed charges,921.82,82.6,,,percent of total billed charges,82.6% of total billed charges,921.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,48.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,47.63,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,1116,
Hepatitis B Surface Antigen w/ Interp,30087340,CDM,300,RC,87340,HCPCS,Outpatient,,,149,96.85,,131.12,88,,,percent of total billed charges,88% of total Billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,149,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,93.87,63,,,percent of total billed charges,63% of total billed charges,18.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,22.8,15.3,,,percent of total billed charges,15.3% of total billed charges,102.81,69,,,percent of total billed charges,69% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,149,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,149,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,39.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,50.51,33.9,,,percent of total billed charges,33.9% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,116.22,78,,,percent of total billed charges,78% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,10.43,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.33,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,149,
Hepatitis C Antibody w/ Interp,30286803,CDM,302,RC,86803,HCPCS,Outpatient,,,156,101.40,,137.28,88,,,percent of total billed charges,88% of total Billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,156,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,98.28,63,,,percent of total billed charges,63% of total billed charges,24.97,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,23.87,15.3,,,percent of total billed charges,15.3% of total billed charges,107.64,69,,,percent of total billed charges,69% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,54.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,52.88,33.9,,,percent of total billed charges,33.9% of total billed charges,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,121.68,78,,,percent of total billed charges,78% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14.41,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,156,
"Hered.Hemochromatosis, DNA LC ZB0N2",30181256,CDM,301,RC,81256,HCPCS,Outpatient,,,302,196.30,,265.76,88,,,percent of total billed charges,88% of total Billed charges,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,190.26,63,,,percent of total billed charges,63% of total billed charges,114.38,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,46.21,15.3,,,percent of total billed charges,15.3% of total billed charges,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,250,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,102.38,33.9,,,percent of total billed charges,33.9% of total billed charges,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,66.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,65.36,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,302,
"Herpes Simplex Virus (HSV) Types 1 and 2, NAA LC",30687529,CDM,306,RC,87529,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,75.6,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,134.21,
Hemoglobin A1c,30183036,CDM,301,RC,83036,HCPCS,Outpatient,,,206,133.90,,181.28,88,,,percent of total billed charges,88% of total Billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,206,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,129.78,63,,,percent of total billed charges,63% of total billed charges,16.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,31.52,15.3,,,percent of total billed charges,15.3% of total billed charges,142.14,69,,,percent of total billed charges,69% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,37.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,69.83,33.9,,,percent of total billed charges,33.9% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.68,78,,,percent of total billed charges,78% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,206,
Hgb Solubility LC,30585660,CDM,305,RC,85660,HCPCS,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,9.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,21.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.51,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,113,
HEMOGLOBIN F QUANT,30183021,CDM,301,RC,83021,HCPCS,Outpatient,,,223,144.95,,196.24,88,,,percent of total billed charges,88% of total Billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,223,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,140.49,63,,,percent of total billed charges,63% of total billed charges,31.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,34.12,15.3,,,percent of total billed charges,15.3% of total billed charges,153.87,69,,,percent of total billed charges,69% of total billed charges,223,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,223,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,223,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,69.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,84.07,37.7,,,percent of total billed charges,37.70% of total billed charges,84.07,37.7,,,percent of total billed charges,37.70% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,75.6,33.9,,,percent of total billed charges,33.9% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,173.94,78,,,percent of total billed charges,78% of total billed charges,223,100,,,percent of total billed charges,100% of total billed charges,184.2,82.6,,,percent of total billed charges,82.6% of total billed charges,184.2,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,223,
Hgb Fractionation Cascade LC,30183020,CDM,301,RC,83020,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,117.18,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,63.05,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,186,
Hgb Frac by HPLC+Solubility LC,30183021,CDM,301,RC,83021,HCPCS,Outpatient,,,262,170.30,,230.56,88,,,percent of total billed charges,88% of total Billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,262,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,165.06,63,,,percent of total billed charges,63% of total billed charges,31.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,40.09,15.3,,,percent of total billed charges,15.3% of total billed charges,180.78,69,,,percent of total billed charges,69% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,262,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,262,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,69.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,88.82,33.9,,,percent of total billed charges,33.9% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,204.36,78,,,percent of total billed charges,78% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,262,
High Sensitivity Troponin I,30184484,CDM,301,RC,84484,HCPCS,Outpatient,,,442,287.30,,388.96,88,,,percent of total billed charges,88% of total Billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,442,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,278.46,63,,,percent of total billed charges,63% of total billed charges,21.82,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,67.63,15.3,,,percent of total billed charges,15.3% of total billed charges,304.98,69,,,percent of total billed charges,69% of total billed charges,442,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,442,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,442,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,47.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,166.63,37.7,,,percent of total billed charges,37.70% of total billed charges,166.63,37.7,,,percent of total billed charges,37.70% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,149.84,33.9,,,percent of total billed charges,33.9% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,344.76,78,,,percent of total billed charges,78% of total billed charges,442,100,,,percent of total billed charges,100% of total billed charges,365.09,82.6,,,percent of total billed charges,82.6% of total billed charges,365.09,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,442,
High-Risk HPV Panel with Genotyping AVR,30687624,CDM,306,RC,87624,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Histoplasma Gal'mannan Ag Ser LC,30687385,CDM,306,RC,87385,HCPCS,Outpatient,,,155.23,100.90,,136.6,88,,,percent of total billed charges,88% of total Billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,155.23,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,97.79,63,,,percent of total billed charges,63% of total billed charges,23.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,23.75,15.3,,,percent of total billed charges,15.3% of total billed charges,107.11,69,,,percent of total billed charges,69% of total billed charges,155.23,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,155.23,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,155.23,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,50.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,58.52,37.7,,,percent of total billed charges,37.70% of total billed charges,58.52,37.7,,,percent of total billed charges,37.70% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,52.62,33.9,,,percent of total billed charges,33.9% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,121.08,78,,,percent of total billed charges,78% of total billed charges,155.23,100,,,percent of total billed charges,100% of total billed charges,128.22,82.6,,,percent of total billed charges,82.6% of total billed charges,128.22,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.38,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,155.23,
"Homocyst(e)ine, Plasma LC",30183090,CDM,301,RC,83090,HCPCS,Outpatient,,,327,212.55,,287.76,88,,,percent of total billed charges,88% of total Billed charges,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,327,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,206.01,63,,,percent of total billed charges,63% of total billed charges,31.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,50.03,15.3,,,percent of total billed charges,15.3% of total billed charges,225.63,69,,,percent of total billed charges,69% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,327,100,,,percent of total billed charges,100% of total billed charges,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,327,100,,,percent of total billed charges,100% of total billed charges,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,68.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,110.85,33.9,,,percent of total billed charges,33.9% of total billed charges,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,255.06,78,,,percent of total billed charges,78% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,18.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.92,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,327,
Human Granulocytic Ehrlich-HGE LC,30286666,CDM,302,RC,86666,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,63,,,percent of total billed charges,63% of total billed charges,17.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,70,100,,,percent of total billed charges,100% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,70,100,,,percent of total billed charges,100% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,38.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,23.73,33.9,,,percent of total billed charges,33.9% of total billed charges,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,70,
Hypersensitivity Pneumonitis#6 LC,30286671,CDM,302,RC,86671,HCPCS,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,101,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,63.63,63,,,percent of total billed charges,63% of total billed charges,21.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,15.45,15.3,,,percent of total billed charges,15.3% of total billed charges,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,101,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,46.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,34.24,33.9,,,percent of total billed charges,33.9% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,101,
Hypersensitivity Pneumonitis  LC,30286671,CDM,302,RC,86671,HCPCS,Outpatient,,,111,72.15,,97.68,88,,,percent of total billed charges,88% of total Billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,111,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,69.93,63,,,percent of total billed charges,63% of total billed charges,21.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,16.98,15.3,,,percent of total billed charges,15.3% of total billed charges,76.59,69,,,percent of total billed charges,69% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,111,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,111,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,46.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,37.63,33.9,,,percent of total billed charges,33.9% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,86.58,78,,,percent of total billed charges,78% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,111,
IFE U+Prot U LC,30184156,CDM,301,RC,84156,HCPCS,Outpatient,,,487,316.55,,428.56,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,487,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,306.81,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74.51,15.3,,,percent of total billed charges,15.3% of total billed charges,336.03,69,,,percent of total billed charges,69% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,487,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,487,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,165.09,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,379.86,78,,,percent of total billed charges,78% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,487,
IFE and PE LC,30286334,CDM,302,RC,86334,HCPCS,Outpatient,,,213,138.45,,187.44,88,,,percent of total billed charges,88% of total Billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,134.19,63,,,percent of total billed charges,63% of total billed charges,39.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,32.59,15.3,,,percent of total billed charges,15.3% of total billed charges,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,85.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,72.21,33.9,,,percent of total billed charges,33.9% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,22.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.34,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,213,
IGF-1 LC,30184305,CDM,301,RC,84305,HCPCS,Outpatient,,,457,297.05,,402.16,88,,,percent of total billed charges,88% of total Billed charges,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,457,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,287.91,63,,,percent of total billed charges,63% of total billed charges,37.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,69.92,15.3,,,percent of total billed charges,15.3% of total billed charges,315.33,69,,,percent of total billed charges,69% of total billed charges,457,100,,,percent of total billed charges,100% of total billed charges,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,457,100,,,percent of total billed charges,100% of total billed charges,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,457,100,,,percent of total billed charges,100% of total billed charges,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,172.29,37.7,,,percent of total billed charges,37.70% of total billed charges,172.29,37.7,,,percent of total billed charges,37.70% of total billed charges,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,154.92,33.9,,,percent of total billed charges,33.9% of total billed charges,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,356.46,78,,,percent of total billed charges,78% of total billed charges,457,100,,,percent of total billed charges,100% of total billed charges,377.48,82.6,,,percent of total billed charges,82.6% of total billed charges,377.48,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,21.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,457,
30183520,30183520,CDM,301,RC,83520,HCPCS,Outpatient,,,97,63.05,,85.36,88,,,percent of total billed charges,88% of total Billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,97,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.22,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,14.84,15.3,,,percent of total billed charges,15.3% of total billed charges,66.93,69,,,percent of total billed charges,69% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,66.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,32.88,33.9,,,percent of total billed charges,33.9% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,75.66,78,,,percent of total billed charges,78% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,97,
"IGP,rfx Aptima HPV all pth LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,368,239.20,,323.84,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,368,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,231.84,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,253.92,69,,,percent of total billed charges,69% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,368,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,368,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,124.75,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,287.04,78,,,percent of total billed charges,78% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,368,
"IGP,rfx Aptima HPV all pth LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,91,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,57.33,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,91,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,91,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,30.85,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,101.78,
".IGP,CtNgTv,Apt HPV,rfx16/18,45 LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,110,71.50,,96.8,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,110,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,69.3,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,75.9,69,,,percent of total billed charges,69% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,37.29,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,85.8,78,,,percent of total billed charges,78% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,110,
"IGP,rfx Aptima HPV all pth LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,368,239.20,,323.84,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,368,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,231.84,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,253.92,69,,,percent of total billed charges,69% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,368,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,368,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,124.75,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,287.04,78,,,percent of total billed charges,78% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,368,
"IGP,rfx Aptima HPV all pth LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,101.78,
"IGP,rfx Aptima HPV all pth LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,101.78,
"IGP,rfx Aptima HPV all pth LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,101.78,
"IGP, CtNg, rfx Aptima HPV ASCU (Charted) LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,277,180.05,,243.76,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,277,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,174.51,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,191.13,69,,,percent of total billed charges,69% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,93.9,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,216.06,78,,,percent of total billed charges,78% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,277,
INR,30085610,CDM,300,RC,85610,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,43.47,63,,,percent of total billed charges,63% of total billed charges,7.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,16.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,23.39,33.9,,,percent of total billed charges,33.9% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,69,
INR POC Lab,30085610,CDM,300,RC,85610,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,43.47,63,,,percent of total billed charges,63% of total billed charges,7.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,16.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,23.39,33.9,,,percent of total billed charges,33.9% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,69,
IgE+Allergens(23) LC 602224,30182785,CDM,301,RC,82785,HCPCS,Outpatient,,,429,278.85,,377.52,88,,,percent of total billed charges,88% of total Billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,429,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,270.27,63,,,percent of total billed charges,63% of total billed charges,28.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,65.64,15.3,,,percent of total billed charges,15.3% of total billed charges,296.01,69,,,percent of total billed charges,69% of total billed charges,429,100,,,percent of total billed charges,100% of total billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,429,100,,,percent of total billed charges,100% of total billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,429,100,,,percent of total billed charges,100% of total billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,62.95,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,161.73,37.7,,,percent of total billed charges,37.70% of total billed charges,161.73,37.7,,,percent of total billed charges,37.70% of total billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,145.43,33.9,,,percent of total billed charges,33.9% of total billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,334.62,78,,,percent of total billed charges,78% of total billed charges,429,100,,,percent of total billed charges,100% of total billed charges,354.35,82.6,,,percent of total billed charges,82.6% of total billed charges,354.35,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,16.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,429,
"IgG, Subclasses(1-4) LC",30182787,CDM,301,RC,82787,HCPCS,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,46,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,28.98,63,,,percent of total billed charges,63% of total billed charges,14.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,46,100,,,percent of total billed charges,100% of total billed charges,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,46,100,,,percent of total billed charges,100% of total billed charges,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,15.59,33.9,,,percent of total billed charges,33.9% of total billed charges,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,8.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.02,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,46,
Immunofixation U LC,30286335,CDM,302,RC,86335,HCPCS,Outpatient,,,213,138.45,,187.44,88,,,percent of total billed charges,88% of total Billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,28.1,103,,,Fee Schedule,103% of WA Medicaid,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,134.19,63,,,percent of total billed charges,63% of total billed charges,51.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,32.59,15.3,,,percent of total billed charges,15.3% of total billed charges,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,112.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,20.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,27.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.47,130,,,Fee Schedule,130% of WA Medicaid ,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,72.21,33.9,,,percent of total billed charges,33.9% of total billed charges,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,29.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.35,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.21,213,
"Immunoglobulins A/G/M, Qn, Ser LC",30182784,CDM,301,RC,82784,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,113.4,63,,,percent of total billed charges,63% of total billed charges,16.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,35.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,61.02,33.9,,,percent of total billed charges,33.9% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,180,
"Immunoglobulin G, Qn LC 001776",30182784,CDM,301,RC,82784,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,113.4,63,,,percent of total billed charges,63% of total billed charges,16.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,35.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,61.02,33.9,,,percent of total billed charges,33.9% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,180,
"Immunoglobulin A, Qn LC",30182784,CDM,301,RC,82784,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,113.4,63,,,percent of total billed charges,63% of total billed charges,16.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,35.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,61.02,33.9,,,percent of total billed charges,33.9% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,180,
"Immunoglobulin M, Qn LC",30182784,CDM,301,RC,82784,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,113.4,63,,,percent of total billed charges,63% of total billed charges,16.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,35.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,61.02,33.9,,,percent of total billed charges,33.9% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,180,
"Immunoglobulin E, Total LC",30182785,CDM,301,RC,82785,HCPCS,Outpatient,,,429,278.85,,377.52,88,,,percent of total billed charges,88% of total Billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,429,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,270.27,63,,,percent of total billed charges,63% of total billed charges,28.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,65.64,15.3,,,percent of total billed charges,15.3% of total billed charges,296.01,69,,,percent of total billed charges,69% of total billed charges,429,100,,,percent of total billed charges,100% of total billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,429,100,,,percent of total billed charges,100% of total billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,429,100,,,percent of total billed charges,100% of total billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,62.95,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,161.73,37.7,,,percent of total billed charges,37.70% of total billed charges,161.73,37.7,,,percent of total billed charges,37.70% of total billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,145.43,33.9,,,percent of total billed charges,33.9% of total billed charges,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,334.62,78,,,percent of total billed charges,78% of total billed charges,429,100,,,percent of total billed charges,100% of total billed charges,354.35,82.6,,,percent of total billed charges,82.6% of total billed charges,354.35,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,16.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.46,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,429,
Immunohistochemical Stain(s) LC,31088342,CDM,310,RC,88342,HCPCS,Outpatient,,,215,139.75,,189.2,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,37.5,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,135.45,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid,32.9,15.3,,,percent of total billed charges,15.3% of total billed charges,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,37.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.33,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,72.89,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.97,605.96,
"Influenza A Abs, CF LC",30286710,CDM,302,RC,86710,HCPCS,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,87,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,54.81,63,,,percent of total billed charges,63% of total billed charges,23.71,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,51.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,13.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,87,
Insulin Antibodies LC,30286337,CDM,302,RC,86337,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,113.4,63,,,percent of total billed charges,63% of total billed charges,37.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,81.89,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,61.02,33.9,,,percent of total billed charges,33.9% of total billed charges,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,21.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.41,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,180,
Insulin LC,30183525,CDM,301,RC,83525,HCPCS,Outpatient,,,156,101.40,,137.28,88,,,percent of total billed charges,88% of total Billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,156,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,98.28,63,,,percent of total billed charges,63% of total billed charges,20,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,23.87,15.3,,,percent of total billed charges,15.3% of total billed charges,107.64,69,,,percent of total billed charges,69% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,43.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,52.88,33.9,,,percent of total billed charges,33.9% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,121.68,78,,,percent of total billed charges,78% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,156,
INSULIN,30183525,CDM,301,RC,83525,HCPCS,Outpatient,,,133,86.45,,117.04,88,,,percent of total billed charges,88% of total Billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,133,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,83.79,63,,,percent of total billed charges,63% of total billed charges,20,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,20.35,15.3,,,percent of total billed charges,15.3% of total billed charges,91.77,69,,,percent of total billed charges,69% of total billed charges,133,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,133,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,133,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,43.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,50.14,37.7,,,percent of total billed charges,37.70% of total billed charges,50.14,37.7,,,percent of total billed charges,37.70% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,45.09,33.9,,,percent of total billed charges,33.9% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,103.74,78,,,percent of total billed charges,78% of total billed charges,133,100,,,percent of total billed charges,100% of total billed charges,109.86,82.6,,,percent of total billed charges,82.6% of total billed charges,109.86,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,133,
INSULIN,30183525,CDM,301,RC,83525,HCPCS,Outpatient,,,133,86.45,,117.04,88,,,percent of total billed charges,88% of total Billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,133,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,83.79,63,,,percent of total billed charges,63% of total billed charges,20,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,20.35,15.3,,,percent of total billed charges,15.3% of total billed charges,91.77,69,,,percent of total billed charges,69% of total billed charges,133,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,133,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,133,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,43.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,50.14,37.7,,,percent of total billed charges,37.70% of total billed charges,50.14,37.7,,,percent of total billed charges,37.70% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,45.09,33.9,,,percent of total billed charges,33.9% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,103.74,78,,,percent of total billed charges,78% of total billed charges,133,100,,,percent of total billed charges,100% of total billed charges,109.86,82.6,,,percent of total billed charges,82.6% of total billed charges,109.86,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,133,
PHOSPHATIDYLSERINE IGG,30184163,CDM,301,RC,84163,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,130,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,63,,,percent of total billed charges,63% of total billed charges,26.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,57.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,130,
DIMERIC INHIBINA (DIA),30286336,CDM,302,RC,86336,HCPCS,Outpatient,,,102,66.30,,89.76,88,,,percent of total billed charges,88% of total Billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,102,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,64.26,63,,,percent of total billed charges,63% of total billed charges,27.28,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,15.61,15.3,,,percent of total billed charges,15.3% of total billed charges,70.38,69,,,percent of total billed charges,69% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,59.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,34.58,33.9,,,percent of total billed charges,33.9% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,79.56,78,,,percent of total billed charges,78% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,15.74,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.59,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,102,
IntelliGEN(R) Myeloid LC,30081415,CDM,300,RC,81450,HCPCS,Outpatient,,,12862.5,8360.63,,11319,88,,,percent of total billed charges,88% of total Billed charges,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,2160.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2225.73,17.304,,,percent of total billed charges,17.304% of total billed charges,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8103.38,63,,,percent of total billed charges,63% of total billed charges,1329.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,2160.9,16.8,,,percent of total billed charges,16.8% of total billed charges,1967.96,15.3,,,percent of total billed charges,15.3% of total billed charges,8875.13,69,,,percent of total billed charges,69% of total billed charges,12862.5,100,,,percent of total billed charges,100% of total billed charges,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,12862.5,100,,,percent of total billed charges,100% of total billed charges,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,12862.5,100,,,percent of total billed charges,100% of total billed charges,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2160.9,16.8,,,percent of total billed charges,16.8% of total billed charges,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,2160.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,2204.12,17.136,,,percent of total billed charges,17.136% of total billed charges,2809.17,21.84,,,percent of total billed charges,21.84% of total billed charges,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,4849.16,37.7,,,percent of total billed charges,37.70% of total billed charges,4849.16,37.7,,,percent of total billed charges,37.70% of total billed charges,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,4360.39,33.9,,,percent of total billed charges,33.9% of total billed charges,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10032.75,78,,,percent of total billed charges,78% of total billed charges,12862.5,100,,,percent of total billed charges,100% of total billed charges,10624.43,82.6,,,percent of total billed charges,82.6% of total billed charges,10624.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2160.9,16.8,,,percent of total billed charges,16.8% of total billed charges,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,767.12,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,759.53,100,,,Fee Schedule,100% of Medicare OPPS rate,2160.9,16.8,,,percent of total billed charges,16.8% of total billed charges,759.53,12862.5,
Intrinsic Factor Abs LC,30286340,CDM,302,RC,86340,HCPCS,Outpatient,,,323,209.95,,284.24,88,,,percent of total billed charges,88% of total Billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,323,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,203.49,63,,,percent of total billed charges,63% of total billed charges,26.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,49.42,15.3,,,percent of total billed charges,15.3% of total billed charges,222.87,69,,,percent of total billed charges,69% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,323,100,,,percent of total billed charges,100% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,323,100,,,percent of total billed charges,100% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,57.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,109.5,33.9,,,percent of total billed charges,33.9% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,251.94,78,,,percent of total billed charges,78% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,15.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,323,
Iron,30083540,CDM,300,RC,83540,HCPCS,Outpatient,,,128,83.20,,112.64,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,128,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,80.64,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,43.39,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,128,
Iron and TIBC LC,30183540,CDM,301,RC,83540,HCPCS,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,20,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.6,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,20,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,20,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,7.54,37.7,,,percent of total billed charges,37.70% of total billed charges,7.54,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.78,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.06,24.74,
Iron LC,30183540,CDM,301,RC,83540,HCPCS,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,20,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.6,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,20,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,20,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,7.54,37.7,,,percent of total billed charges,37.70% of total billed charges,7.54,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.78,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.06,24.74,
"JAK2 V617F, reflex to E12-15 LC",31081270,CDM,310,RC,81270,HCPCS,Outpatient,,,510,331.50,,448.8,88,,,percent of total billed charges,88% of total Billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,510,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,321.3,63,,,percent of total billed charges,63% of total billed charges,160.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,137.49,150,,,Fee Schedule,150% of Medicare OPPS rate,351.9,69,,,percent of total billed charges,69% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,510,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,510,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,350.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,172.89,33.9,,,percent of total billed charges,33.9% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,397.8,78,,,percent of total billed charges,78% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,92.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,510,
JAK2 V617F Qt Rfx CALR/MPL LC,31081270,CDM,310,RC,81270,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,600,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,378,63,,,percent of total billed charges,63% of total billed charges,160.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,137.49,150,,,Fee Schedule,150% of Medicare OPPS rate,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,600,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,600,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,350.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,92.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,600,
"JAK2 V617F, reflex to E12-15 LC",31081270,CDM,310,RC,81270,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,600,100,,,percent of total billed charges,100% of total billed charges,40.2,103,,,Fee Schedule,103% of WA Medicaid,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,378,63,,,percent of total billed charges,63% of total billed charges,160.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid,137.49,150,,,Fee Schedule,150% of Medicare OPPS rate,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,600,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,600,100,,,percent of total billed charges,100% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,350.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.73,130,,,Fee Schedule,130% of WA Medicaid ,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,92.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,91.66,100,,,Fee Schedule,100% of Medicare OPPS rate,39.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.91,600,
Kidney Stone Analysis LC,30182365,CDM,301,RC,82365,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,45,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,28.35,63,,,percent of total billed charges,63% of total billed charges,22.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,45,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,45,100,,,percent of total billed charges,100% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,49.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,13.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.9,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.89,49.34,
L. pneumophila Serogp 1 Ur Ag LC,30687449,CDM,306,RC,87449,HCPCS,Outpatient,,,197,128.05,,173.36,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,197,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,124.11,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,30.14,15.3,,,percent of total billed charges,15.3% of total billed charges,135.93,69,,,percent of total billed charges,69% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,197,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,197,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,74.27,37.7,,,percent of total billed charges,37.70% of total billed charges,74.27,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,66.78,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,153.66,78,,,percent of total billed charges,78% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,197,
Lactic Acid,30183605,CDM,301,RC,83605,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,117.18,63,,,percent of total billed charges,63% of total billed charges,20.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,44.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,63.05,33.9,,,percent of total billed charges,33.9% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,186,
LA Ven - Sepsis 2Hr,30083605,CDM,301,RC,83605,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,117.18,63,,,percent of total billed charges,63% of total billed charges,20.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,44.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,63.05,33.9,,,percent of total billed charges,33.9% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,186,
"Lactate dehydrogenase (LD), Body Fluid LC",30183615,CDM,301,RC,83615,HCPCS,Outpatient,,,18.12,11.78,,15.95,88,,,percent of total billed charges,88% of total Billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,18.12,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,11.42,63,,,percent of total billed charges,63% of total billed charges,10.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,2.77,15.3,,,percent of total billed charges,15.3% of total billed charges,12.5,69,,,percent of total billed charges,69% of total billed charges,18.12,100,,,percent of total billed charges,100% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,18.12,100,,,percent of total billed charges,100% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,18.12,100,,,percent of total billed charges,100% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,23.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,37.7,,,percent of total billed charges,37.70% of total billed charges,6.83,37.7,,,percent of total billed charges,37.70% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,6.14,33.9,,,percent of total billed charges,33.9% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,14.13,78,,,percent of total billed charges,78% of total billed charges,18.12,100,,,percent of total billed charges,100% of total billed charges,14.97,82.6,,,percent of total billed charges,82.6% of total billed charges,14.97,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,6.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.77,23.1,
LDL Cholesterol (Direct) LC,30183721,CDM,301,RC,83721,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,195,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,122.85,63,,,percent of total billed charges,63% of total billed charges,18.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,195,100,,,percent of total billed charges,100% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,195,100,,,percent of total billed charges,100% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,40.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,10.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,195,
Lacosamide LC,30180235,CDM,301,RC,80235,HCPCS,Outpatient,,,560.25,364.16,,493.02,88,,,percent of total billed charges,88% of total Billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,560.25,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,352.96,63,,,percent of total billed charges,63% of total billed charges,47.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,85.72,15.3,,,percent of total billed charges,15.3% of total billed charges,386.57,69,,,percent of total billed charges,69% of total billed charges,560.25,100,,,percent of total billed charges,100% of total billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,560.25,100,,,percent of total billed charges,100% of total billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,560.25,100,,,percent of total billed charges,100% of total billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,103.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,211.21,37.7,,,percent of total billed charges,37.70% of total billed charges,211.21,37.7,,,percent of total billed charges,37.70% of total billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,189.92,33.9,,,percent of total billed charges,33.9% of total billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,437,78,,,percent of total billed charges,78% of total billed charges,560.25,100,,,percent of total billed charges,100% of total billed charges,462.77,82.6,,,percent of total billed charges,82.6% of total billed charges,462.77,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,27.38,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,560.25,
LDH,30183615,CDM,301,RC,83615,HCPCS,Outpatient,,,105,68.25,,92.4,88,,,percent of total billed charges,88% of total Billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,105,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,66.15,63,,,percent of total billed charges,63% of total billed charges,10.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,16.07,15.3,,,percent of total billed charges,15.3% of total billed charges,72.45,69,,,percent of total billed charges,69% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,23.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,35.6,33.9,,,percent of total billed charges,33.9% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,78,,,percent of total billed charges,78% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,6.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,105,
LDH Body Fluid,30183615,CDM,301,RC,83615,HCPCS,Outpatient,,,105,68.25,,92.4,88,,,percent of total billed charges,88% of total Billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,105,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,66.15,63,,,percent of total billed charges,63% of total billed charges,10.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,16.07,15.3,,,percent of total billed charges,15.3% of total billed charges,72.45,69,,,percent of total billed charges,69% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,23.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,35.6,33.9,,,percent of total billed charges,33.9% of total billed charges,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,78,,,percent of total billed charges,78% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,6.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.04,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,105,
Lactic Acid (Venous) - Sepsis,30083605,CDM,301,RC,83605,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,117.18,63,,,percent of total billed charges,63% of total billed charges,20.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,186,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,44.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,63.05,33.9,,,percent of total billed charges,33.9% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,11.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.57,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,186,
Lactose Tolerance Test LC,30182951,CDM,301,RC,82951,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,43.47,63,,,percent of total billed charges,63% of total billed charges,22.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,23.39,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,12.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.87,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,69,
Lamotrigine (Lamictal) LC,30180175,CDM,301,RC,80175,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,195,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,122.85,63,,,percent of total billed charges,63% of total billed charges,23.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,195,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,195,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,50.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.38,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,195,
"Lead, Blood (Adult) LC 007625",30183655,CDM,301,RC,83655,HCPCS,Outpatient,,,139,90.35,,122.32,88,,,percent of total billed charges,88% of total Billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,87.57,63,,,percent of total billed charges,63% of total billed charges,21.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,46.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,139,
"zLead Standard Profile, Blood LC 038158",30183655,CDM,301,RC,83655,HCPCS,Outpatient,,,139,90.35,,122.32,88,,,percent of total billed charges,88% of total Billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,87.57,63,,,percent of total billed charges,63% of total billed charges,21.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,46.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,139,
"Lead, Blood (Pediatric) LC 717009",30183655,CDM,301,RC,83655,HCPCS,Outpatient,,,139,90.35,,122.32,88,,,percent of total billed charges,88% of total Billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,87.57,63,,,percent of total billed charges,63% of total billed charges,21.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,46.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,139,
Lead Stan Profile LC 038170,30183655,CDM,301,RC,83655,HCPCS,Outpatient,,,139,90.35,,122.32,88,,,percent of total billed charges,88% of total Billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,87.57,63,,,percent of total billed charges,63% of total billed charges,21.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,46.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,139,
CULTURE WOUND AEROBIC,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,115,74.75,,101.2,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,115,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,72.45,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,17.6,15.3,,,percent of total billed charges,15.3% of total billed charges,79.35,69,,,percent of total billed charges,69% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,115,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,115,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,43.36,37.7,,,percent of total billed charges,37.70% of total billed charges,43.36,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,38.99,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,89.7,78,,,percent of total billed charges,78% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,115,
Leptospira IgM LC,30286720,CDM,302,RC,86720,HCPCS,Outpatient,,,155,100.75,,136.4,88,,,percent of total billed charges,88% of total Billed charges,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,155,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,97.65,63,,,percent of total billed charges,63% of total billed charges,28.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,23.72,15.3,,,percent of total billed charges,15.3% of total billed charges,106.95,69,,,percent of total billed charges,69% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,61.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,52.55,33.9,,,percent of total billed charges,33.9% of total billed charges,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,120.9,78,,,percent of total billed charges,78% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,16.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.2,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,155,
Leukorrhea Panel AVR,30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Leukorrhea Panel AVR - Extended,30687563,CDM,306,RC,87563,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
"Levetiracetam (Keppra), S LC",30180177,CDM,301,RC,80177,HCPCS,Outpatient,,,210,136.50,,184.8,88,,,percent of total billed charges,88% of total Billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,210,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,132.3,63,,,percent of total billed charges,63% of total billed charges,23.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,32.13,15.3,,,percent of total billed charges,15.3% of total billed charges,144.9,69,,,percent of total billed charges,69% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,210,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,210,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,50.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,33.9,,,percent of total billed charges,33.9% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,163.8,78,,,percent of total billed charges,78% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.38,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,210,
Lipase,30183690,CDM,301,RC,83690,HCPCS,Outpatient,,,134,87.10,,117.92,88,,,percent of total billed charges,88% of total Billed charges,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,134,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,84.42,63,,,percent of total billed charges,63% of total billed charges,12.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,20.5,15.3,,,percent of total billed charges,15.3% of total billed charges,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,26.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,45.43,33.9,,,percent of total billed charges,33.9% of total billed charges,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,6.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.89,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,134,
Lipid Panel,30180061,CDM,301,RC,80061,HCPCS,Outpatient,,,289,187.85,,254.32,88,,,percent of total billed charges,88% of total Billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,289,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,182.07,63,,,percent of total billed charges,63% of total billed charges,23.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,44.22,15.3,,,percent of total billed charges,15.3% of total billed charges,199.41,69,,,percent of total billed charges,69% of total billed charges,289,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,289,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,289,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,51.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,108.95,37.7,,,percent of total billed charges,37.70% of total billed charges,108.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,97.97,33.9,,,percent of total billed charges,33.9% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,225.42,78,,,percent of total billed charges,78% of total billed charges,289,100,,,percent of total billed charges,100% of total billed charges,238.71,82.6,,,percent of total billed charges,82.6% of total billed charges,238.71,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.52,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,289,
Lipoprotein Phenotyping LC,30180061,CDM,301,RC,80061,HCPCS,Outpatient,,,323,209.95,,284.24,88,,,percent of total billed charges,88% of total Billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,323,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,203.49,63,,,percent of total billed charges,63% of total billed charges,23.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,49.42,15.3,,,percent of total billed charges,15.3% of total billed charges,222.87,69,,,percent of total billed charges,69% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,323,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,323,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,51.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109.5,33.9,,,percent of total billed charges,33.9% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,251.94,78,,,percent of total billed charges,78% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.52,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,323,
Lipoprotein (a) LC,30183695,CDM,301,RC,83695,HCPCS,Outpatient,,,290,188.50,,255.2,88,,,percent of total billed charges,88% of total Billed charges,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,290,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,182.7,63,,,percent of total billed charges,63% of total billed charges,25.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,44.37,15.3,,,percent of total billed charges,15.3% of total billed charges,200.1,69,,,percent of total billed charges,69% of total billed charges,290,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,290,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,290,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,54.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,109.33,37.7,,,percent of total billed charges,37.70% of total billed charges,109.33,37.7,,,percent of total billed charges,37.70% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,98.31,33.9,,,percent of total billed charges,33.9% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,226.2,78,,,percent of total billed charges,78% of total billed charges,290,100,,,percent of total billed charges,100% of total billed charges,239.54,82.6,,,percent of total billed charges,82.6% of total billed charges,239.54,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,14.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,290,
Lithium Level,30080178,CDM,300,RC,80178,HCPCS,Outpatient,,,145,94.25,,127.6,88,,,percent of total billed charges,88% of total Billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,145,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,91.35,63,,,percent of total billed charges,63% of total billed charges,11.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,22.19,15.3,,,percent of total billed charges,15.3% of total billed charges,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,25.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,49.16,33.9,,,percent of total billed charges,33.9% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.61,145,
Lithium Lvl,30080178,CDM,300,RC,80178,HCPCS,Outpatient,,,145,94.25,,127.6,88,,,percent of total billed charges,88% of total Billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,145,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,91.35,63,,,percent of total billed charges,63% of total billed charges,11.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,22.19,15.3,,,percent of total billed charges,15.3% of total billed charges,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,25.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,49.16,33.9,,,percent of total billed charges,33.9% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.61,145,
Liver Kidney Microsomal Ab LC,30286376,CDM,302,RC,86376,HCPCS,Outpatient,,,240,156.00,,211.2,88,,,percent of total billed charges,88% of total Billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,240,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,151.2,63,,,percent of total billed charges,63% of total billed charges,25.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,36.72,15.3,,,percent of total billed charges,15.3% of total billed charges,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,55.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,81.36,33.9,,,percent of total billed charges,33.9% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,14.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,240,
Lupus Anticoagulant Panel LC,30585705,CDM,305,RC,85705,HCPCS,Outpatient,,,642,417.30,,564.96,88,,,percent of total billed charges,88% of total Billed charges,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,642,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,404.46,63,,,percent of total billed charges,63% of total billed charges,16.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,98.23,15.3,,,percent of total billed charges,15.3% of total billed charges,442.98,69,,,percent of total billed charges,69% of total billed charges,642,100,,,percent of total billed charges,100% of total billed charges,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,642,100,,,percent of total billed charges,100% of total billed charges,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,642,100,,,percent of total billed charges,100% of total billed charges,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,36.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,242.03,37.7,,,percent of total billed charges,37.70% of total billed charges,242.03,37.7,,,percent of total billed charges,37.70% of total billed charges,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,217.64,33.9,,,percent of total billed charges,33.9% of total billed charges,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,500.76,78,,,percent of total billed charges,78% of total billed charges,642,100,,,percent of total billed charges,100% of total billed charges,530.29,82.6,,,percent of total billed charges,82.6% of total billed charges,530.29,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,9.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.63,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,642,
Luteinizing Hormone (LH),30183002,CDM,301,RC,83002,HCPCS,Outpatient,,,319,207.35,,280.72,88,,,percent of total billed charges,88% of total Billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,319,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,200.97,63,,,percent of total billed charges,63% of total billed charges,32.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,48.81,15.3,,,percent of total billed charges,15.3% of total billed charges,220.11,69,,,percent of total billed charges,69% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,319,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,319,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,70.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,108.14,33.9,,,percent of total billed charges,33.9% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,248.82,78,,,percent of total billed charges,78% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,319,
Luteinizing Hormone(LH) LC,30183002,CDM,301,RC,83002,HCPCS,Outpatient,,,358,232.70,,315.04,88,,,percent of total billed charges,88% of total Billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,225.54,63,,,percent of total billed charges,63% of total billed charges,32.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,54.77,15.3,,,percent of total billed charges,15.3% of total billed charges,247.02,69,,,percent of total billed charges,69% of total billed charges,358,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,358,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,358,100,,,percent of total billed charges,100% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,70.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,134.97,37.7,,,percent of total billed charges,37.70% of total billed charges,134.97,37.7,,,percent of total billed charges,37.70% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,121.36,33.9,,,percent of total billed charges,33.9% of total billed charges,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,279.24,78,,,percent of total billed charges,78% of total billed charges,358,100,,,percent of total billed charges,100% of total billed charges,295.71,82.6,,,percent of total billed charges,82.6% of total billed charges,295.71,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,18.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.52,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,358,
"Lyme, Total Ab Test/Reflex LC",30286618,CDM,302,RC,86618,HCPCS,Outpatient,,,366,237.90,,322.08,88,,,percent of total billed charges,88% of total Billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,366,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,230.58,63,,,percent of total billed charges,63% of total billed charges,29.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,56,15.3,,,percent of total billed charges,15.3% of total billed charges,252.54,69,,,percent of total billed charges,69% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,65.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,124.07,33.9,,,percent of total billed charges,33.9% of total billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,285.48,78,,,percent of total billed charges,78% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,366,
Lyme (B. burgdorferi) PCR LC,30687476,CDM,306,RC,87476,HCPCS,Outpatient,,,590,383.50,,519.2,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,590,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,371.7,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,90.27,15.3,,,percent of total billed charges,15.3% of total billed charges,407.1,69,,,percent of total billed charges,69% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,200.01,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,460.2,78,,,percent of total billed charges,78% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,590,
Lyme Disease Total Antibody w/Reflex to Immunoassay LC,30286618,CDM,302,RC,86618,HCPCS,Outpatient,,,366,237.90,,322.08,88,,,percent of total billed charges,88% of total Billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,366,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,230.58,63,,,percent of total billed charges,63% of total billed charges,29.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,56,15.3,,,percent of total billed charges,15.3% of total billed charges,252.54,69,,,percent of total billed charges,69% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,65.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,124.07,33.9,,,percent of total billed charges,33.9% of total billed charges,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,285.48,78,,,percent of total billed charges,78% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,366,
Electrolyte Panel,30180051,CDM,301,RC,80051,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,55.44,63,,,percent of total billed charges,63% of total billed charges,12.26,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,26.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,29.83,33.9,,,percent of total billed charges,33.9% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,7.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.01,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,88,
MRSA Screen PCR (GeneXpert),30687641,CDM,306,RC,87641,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.7,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.51,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.77,134.21,
Magnesium,30183735,CDM,301,RC,83735,HCPCS,Outpatient,,,142,92.30,,124.96,88,,,percent of total billed charges,88% of total Billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,11.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,25.62,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,6.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,142,
Magnesium Urine,30083735,CDM,300,RC,83735,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,30.24,63,,,percent of total billed charges,63% of total billed charges,11.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,25.62,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,6.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,48,
Magnesium 24 Hour Urine,30183735,CDM,301,RC,83735,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,30.24,63,,,percent of total billed charges,63% of total billed charges,11.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,25.62,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,6.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.7,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,48,
"Manganese, P LC",30183785,CDM,301,RC,83785,HCPCS,Outpatient,,,206,133.90,,181.28,88,,,percent of total billed charges,88% of total Billed charges,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,206,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,129.78,63,,,percent of total billed charges,63% of total billed charges,46.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,31.52,15.3,,,percent of total billed charges,15.3% of total billed charges,142.14,69,,,percent of total billed charges,69% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,101.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,69.83,33.9,,,percent of total billed charges,33.9% of total billed charges,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,160.68,78,,,percent of total billed charges,78% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,26.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.65,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,206,
CULTURE VIRUS,30687252,CDM,306,RC,87252,HCPCS,Outpatient,,,116,75.40,,102.08,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,116,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,73.08,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,17.75,15.3,,,percent of total billed charges,15.3% of total billed charges,80.04,69,,,percent of total billed charges,69% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,116,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,116,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,39.32,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,90.48,78,,,percent of total billed charges,78% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,116,
RUBEOLA,30286765,CDM,302,RC,86765,HCPCS,Outpatient,,,60,39.00,,52.8,88,,,percent of total billed charges,88% of total Billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,60,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,37.8,63,,,percent of total billed charges,63% of total billed charges,22.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,9.18,15.3,,,percent of total billed charges,15.3% of total billed charges,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,49.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,20.34,33.9,,,percent of total billed charges,33.9% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,60,
Meconium 5 Panel LC,30080307,CDM,300,RC,80307,HCPCS,Outpatient,,,311,202.15,,273.68,88,,,percent of total billed charges,88% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,52.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,311,100,,,percent of total billed charges,100% of total billed charges,53.82,17.304,,,percent of total billed charges,17.304% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,195.93,63,,,percent of total billed charges,63% of total billed charges,108.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.25,16.8,,,percent of total billed charges,16.8% of total billed charges,47.58,15.3,,,percent of total billed charges,15.3% of total billed charges,214.59,69,,,percent of total billed charges,69% of total billed charges,311,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,311,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,311,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,237.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.25,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,52.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,53.29,17.136,,,percent of total billed charges,17.136% of total billed charges,67.92,21.84,,,percent of total billed charges,21.84% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,117.25,37.7,,,percent of total billed charges,37.70% of total billed charges,117.25,37.7,,,percent of total billed charges,37.70% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,105.43,33.9,,,percent of total billed charges,33.9% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,242.58,78,,,percent of total billed charges,78% of total billed charges,311,100,,,percent of total billed charges,100% of total billed charges,256.89,82.6,,,percent of total billed charges,82.6% of total billed charges,256.89,82.6,,,percent of total billed charges,82.6% of total billed charges,52.25,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,52.25,16.8,,,percent of total billed charges,16.8% of total billed charges,47.58,311,
"Mercury, Blood LC",30183825,CDM,301,RC,83825,HCPCS,Outpatient,,,333,216.45,,293.04,88,,,percent of total billed charges,88% of total Billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,333,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,209.79,63,,,percent of total billed charges,63% of total billed charges,28.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,50.95,15.3,,,percent of total billed charges,15.3% of total billed charges,229.77,69,,,percent of total billed charges,69% of total billed charges,333,100,,,percent of total billed charges,100% of total billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,333,100,,,percent of total billed charges,100% of total billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,333,100,,,percent of total billed charges,100% of total billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,62.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,125.54,37.7,,,percent of total billed charges,37.70% of total billed charges,125.54,37.7,,,percent of total billed charges,37.70% of total billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,112.89,33.9,,,percent of total billed charges,33.9% of total billed charges,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,259.74,78,,,percent of total billed charges,78% of total billed charges,333,100,,,percent of total billed charges,100% of total billed charges,275.06,82.6,,,percent of total billed charges,82.6% of total billed charges,275.06,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,333,
"Metanephrines, Frac, Qn, U24 LC",30183835,CDM,301,RC,83835,HCPCS,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,132,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,83.16,63,,,percent of total billed charges,63% of total billed charges,29.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,64.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,44.75,33.9,,,percent of total billed charges,33.9% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,17.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,132,
"Metanephrines, Pheochromocyt LC",30183835,CDM,301,RC,83835,HCPCS,Outpatient,,,89,57.85,,78.32,88,,,percent of total billed charges,88% of total Billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,89,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,56.07,63,,,percent of total billed charges,63% of total billed charges,29.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,13.62,15.3,,,percent of total billed charges,15.3% of total billed charges,61.41,69,,,percent of total billed charges,69% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,89,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,89,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,64.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,33.55,37.7,,,percent of total billed charges,37.70% of total billed charges,33.55,37.7,,,percent of total billed charges,37.70% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,30.17,33.9,,,percent of total billed charges,33.9% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,69.42,78,,,percent of total billed charges,78% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,17.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,89,
"Metanephrines, Frac., Pl. Free LC",30183835,CDM,301,RC,83835,HCPCS,Outpatient,,,406,263.90,,357.28,88,,,percent of total billed charges,88% of total Billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,406,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,255.78,63,,,percent of total billed charges,63% of total billed charges,29.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,62.12,15.3,,,percent of total billed charges,15.3% of total billed charges,280.14,69,,,percent of total billed charges,69% of total billed charges,406,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,406,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,406,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,64.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,153.06,37.7,,,percent of total billed charges,37.70% of total billed charges,153.06,37.7,,,percent of total billed charges,37.70% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,137.63,33.9,,,percent of total billed charges,33.9% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,316.68,78,,,percent of total billed charges,78% of total billed charges,406,100,,,percent of total billed charges,100% of total billed charges,335.36,82.6,,,percent of total billed charges,82.6% of total billed charges,335.36,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,17.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,406,
Methemoglobin Quantitative,30083050,CDM,300,RC,83050,HCPCS,Outpatient,,,133,86.45,,117.04,88,,,percent of total billed charges,88% of total Billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,133,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,83.79,63,,,percent of total billed charges,63% of total billed charges,14.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,20.35,15.3,,,percent of total billed charges,15.3% of total billed charges,91.77,69,,,percent of total billed charges,69% of total billed charges,133,100,,,percent of total billed charges,100% of total billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,133,100,,,percent of total billed charges,100% of total billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,133,100,,,percent of total billed charges,100% of total billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,31.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,50.14,37.7,,,percent of total billed charges,37.70% of total billed charges,50.14,37.7,,,percent of total billed charges,37.70% of total billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,45.09,33.9,,,percent of total billed charges,33.9% of total billed charges,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,103.74,78,,,percent of total billed charges,78% of total billed charges,133,100,,,percent of total billed charges,100% of total billed charges,109.86,82.6,,,percent of total billed charges,82.6% of total billed charges,109.86,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,8.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.19,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,133,
Methylmalonic Acid LC,30183921,CDM,301,RC,83921,HCPCS,Outpatient,,,345,224.25,,303.6,88,,,percent of total billed charges,88% of total Billed charges,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,345,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,217.35,63,,,percent of total billed charges,63% of total billed charges,37.11,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,52.79,15.3,,,percent of total billed charges,15.3% of total billed charges,238.05,69,,,percent of total billed charges,69% of total billed charges,345,100,,,percent of total billed charges,100% of total billed charges,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,345,100,,,percent of total billed charges,100% of total billed charges,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,345,100,,,percent of total billed charges,100% of total billed charges,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,81.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,130.07,37.7,,,percent of total billed charges,37.70% of total billed charges,130.07,37.7,,,percent of total billed charges,37.70% of total billed charges,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,116.96,33.9,,,percent of total billed charges,33.9% of total billed charges,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,269.1,78,,,percent of total billed charges,78% of total billed charges,345,100,,,percent of total billed charges,100% of total billed charges,284.97,82.6,,,percent of total billed charges,82.6% of total billed charges,284.97,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,21.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.21,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,345,
Microalbumin 24hr Urine,30182043,CDM,301,RC,82043,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,23.31,63,,,percent of total billed charges,63% of total billed charges,10.11,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,22.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,12.54,33.9,,,percent of total billed charges,33.9% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,37,
31188161,31188161,CDM,311,RC,88161,HCPCS,Outpatient,,,289,187.85,,254.32,88,,,percent of total billed charges,88% of total Billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,289,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,182.07,63,,,percent of total billed charges,63% of total billed charges,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,44.22,15.3,,,percent of total billed charges,15.3% of total billed charges,199.41,69,,,percent of total billed charges,69% of total billed charges,289,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,289,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,289,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,108.95,37.7,,,percent of total billed charges,37.70% of total billed charges,108.95,37.7,,,percent of total billed charges,37.70% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,97.97,33.9,,,percent of total billed charges,33.9% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,225.42,78,,,percent of total billed charges,78% of total billed charges,289,100,,,percent of total billed charges,100% of total billed charges,238.71,82.6,,,percent of total billed charges,82.6% of total billed charges,238.71,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,289,
Abdominal Fluid Cytology LC,31188112,CDM,311,RC,88112,HCPCS,Outpatient,,,339,220.35,,298.32,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,339,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,213.57,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,51.87,15.3,,,percent of total billed charges,15.3% of total billed charges,233.91,69,,,percent of total billed charges,69% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,339,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,339,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,114.92,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,264.42,78,,,percent of total billed charges,78% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,339,
Mitochondrial (M2) Antibody LC,30186381,CDM,302,RC,86381,HCPCS,Outpatient,,,98.28,63.88,,86.49,88,,,percent of total billed charges,88% of total Billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,98.28,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,61.92,63,,,percent of total billed charges,63% of total billed charges,44.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,15.04,15.3,,,percent of total billed charges,15.3% of total billed charges,67.81,69,,,percent of total billed charges,69% of total billed charges,98.28,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,98.28,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,98.28,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,37.05,37.7,,,percent of total billed charges,37.70% of total billed charges,37.05,37.7,,,percent of total billed charges,37.70% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,33.32,33.9,,,percent of total billed charges,33.9% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,76.66,78,,,percent of total billed charges,78% of total billed charges,98.28,100,,,percent of total billed charges,100% of total billed charges,81.18,82.6,,,percent of total billed charges,82.6% of total billed charges,81.18,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,25.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.45,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,98.28,
Mononucleosis Screen,30086308,CDM,300,RC,86308,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,56.7,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,90,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,30.51,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.18,90,
"MUMPS ABS, IGG",30286735,CDM,302,RC,86735,HCPCS,Outpatient,,,214,139.10,,188.32,88,,,percent of total billed charges,88% of total Billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,214,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,134.82,63,,,percent of total billed charges,63% of total billed charges,22.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,32.74,15.3,,,percent of total billed charges,15.3% of total billed charges,147.66,69,,,percent of total billed charges,69% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,49.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,72.55,33.9,,,percent of total billed charges,33.9% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,166.92,78,,,percent of total billed charges,78% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,214,
MUMPS IGG,30286735,CDM,302,RC,86735,HCPCS,Outpatient,,,76,49.40,,66.88,88,,,percent of total billed charges,88% of total Billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,76,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,47.88,63,,,percent of total billed charges,63% of total billed charges,22.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,11.63,15.3,,,percent of total billed charges,15.3% of total billed charges,52.44,69,,,percent of total billed charges,69% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,76,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,76,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,49.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,28.65,37.7,,,percent of total billed charges,37.70% of total billed charges,28.65,37.7,,,percent of total billed charges,37.70% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,25.76,33.9,,,percent of total billed charges,33.9% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,59.28,78,,,percent of total billed charges,78% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,76,
VIRAL CULTURE SHELL,30687254,CDM,306,RC,87254,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,55.44,63,,,percent of total billed charges,63% of total billed charges,34.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,74.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,29.83,33.9,,,percent of total billed charges,33.9% of total billed charges,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,19.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,88,
"Mutation Sequence Analysis,1st LC ZB594",31081403,CDM,310,RC,81403,HCPCS,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,110.23,103,,,Fee Schedule,103% of WA Medicaid,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,567,63,,,percent of total billed charges,63% of total billed charges,324.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid,277.8,150,,,Fee Schedule,150% of Medicare OPPS rate,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,900,100,,,percent of total billed charges,100% of total billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,900,100,,,percent of total billed charges,100% of total billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,708.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,79.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.13,130,,,Fee Schedule,130% of WA Medicaid ,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,305.1,33.9,,,percent of total billed charges,33.9% of total billed charges,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,187.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,185.2,100,,,Fee Schedule,100% of Medicare OPPS rate,107.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.27,900,
MYCOPLASMA PNEUMONIAE IGG,30286738,CDM,302,RC,86738,HCPCS,Outpatient,,,184,119.60,,161.92,88,,,percent of total billed charges,88% of total Billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,184,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,115.92,63,,,percent of total billed charges,63% of total billed charges,23.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,28.15,15.3,,,percent of total billed charges,15.3% of total billed charges,126.96,69,,,percent of total billed charges,69% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,50.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,33.9,,,percent of total billed charges,33.9% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,143.52,78,,,percent of total billed charges,78% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,184,
MYCOPHENOLIC ACID,30180180,CDM,301,RC,80180,HCPCS,Outpatient,,,81,52.65,,71.28,88,,,percent of total billed charges,88% of total Billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,81,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,51.03,63,,,percent of total billed charges,63% of total billed charges,31.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,12.39,15.3,,,percent of total billed charges,15.3% of total billed charges,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,69.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,27.46,33.9,,,percent of total billed charges,33.9% of total billed charges,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,18.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,81,
Mycoplasma Panel AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Mycoplasma genitalium AVR,30687563,CDM,306,RC,87563,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Myoglobin U LC,30183874,CDM,301,RC,83874,HCPCS,Outpatient,,,249,161.85,,219.12,88,,,percent of total billed charges,88% of total Billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,249,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,156.87,63,,,percent of total billed charges,63% of total billed charges,22.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,38.1,15.3,,,percent of total billed charges,15.3% of total billed charges,171.81,69,,,percent of total billed charges,69% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,49.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,84.41,33.9,,,percent of total billed charges,33.9% of total billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,194.22,78,,,percent of total billed charges,78% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,13.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,249,
Myoglobin LC,30183874,CDM,301,RC,83874,HCPCS,Outpatient,,,277,180.05,,243.76,88,,,percent of total billed charges,88% of total Billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,277,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,174.51,63,,,percent of total billed charges,63% of total billed charges,22.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,42.38,15.3,,,percent of total billed charges,15.3% of total billed charges,191.13,69,,,percent of total billed charges,69% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,49.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,93.9,33.9,,,percent of total billed charges,33.9% of total billed charges,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,216.06,78,,,percent of total billed charges,78% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,13.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.92,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,277,
NASH FibroSure LC,30184450,CDM,301,RC,84450,HCPCS,Outpatient,,,126,81.90,,110.88,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,126,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,79.38,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,19.28,15.3,,,percent of total billed charges,15.3% of total billed charges,86.94,69,,,percent of total billed charges,69% of total billed charges,126,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,126,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,126,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,47.5,37.7,,,percent of total billed charges,37.70% of total billed charges,47.5,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,42.71,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,98.28,78,,,percent of total billed charges,78% of total billed charges,126,100,,,percent of total billed charges,100% of total billed charges,104.08,82.6,,,percent of total billed charges,82.6% of total billed charges,104.08,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,126,
NMR LipoProf+Graph LC,30180061,CDM,301,RC,80061,HCPCS,Outpatient,,,323,209.95,,284.24,88,,,percent of total billed charges,88% of total Billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,323,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,203.49,63,,,percent of total billed charges,63% of total billed charges,23.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,49.42,15.3,,,percent of total billed charges,15.3% of total billed charges,222.87,69,,,percent of total billed charges,69% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,323,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,323,100,,,percent of total billed charges,100% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,51.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109.5,33.9,,,percent of total billed charges,33.9% of total billed charges,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,251.94,78,,,percent of total billed charges,78% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,13.52,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.39,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,323,
"Neisseria gonorrhoeae, NAA LC",30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,194,
Neisseria gonorrhoeae AVR,30687591,CDM,306,RC,87591,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Newborn Screen (PKU),30084030,CDM,300,RC,84030,HCPCS,Outpatient,,,354,230.10,,311.52,88,,,percent of total billed charges,88% of total Billed charges,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,354,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,223.02,63,,,percent of total billed charges,63% of total billed charges,9.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,54.16,15.3,,,percent of total billed charges,15.3% of total billed charges,244.26,69,,,percent of total billed charges,69% of total billed charges,354,100,,,percent of total billed charges,100% of total billed charges,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,354,100,,,percent of total billed charges,100% of total billed charges,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,354,100,,,percent of total billed charges,100% of total billed charges,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,21.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,133.46,37.7,,,percent of total billed charges,37.70% of total billed charges,133.46,37.7,,,percent of total billed charges,37.70% of total billed charges,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,120.01,33.9,,,percent of total billed charges,33.9% of total billed charges,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,276.12,78,,,percent of total billed charges,78% of total billed charges,354,100,,,percent of total billed charges,100% of total billed charges,292.4,82.6,,,percent of total billed charges,82.6% of total billed charges,292.4,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,354,
"Nicotine and Metabolite, Ur Qn LC",30180323,CDM,301,RC,80323,HCPCS,Outpatient,,,251,163.15,,220.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,158.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",38.4,15.3,,,percent of total billed charges,15.3% of total billed charges,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,251,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,251,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,85.09,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42.17,16.8,,,percent of total billed charges,16.8% of total billed charges,38.4,251,
Non-gyn Pap AVR,31188104,CDM,311,RC,88104,HCPCS,Outpatient,,,266.25,173.06,,234.3,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,266.25,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,167.74,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,40.74,15.3,,,percent of total billed charges,15.3% of total billed charges,183.71,69,,,percent of total billed charges,69% of total billed charges,266.25,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,266.25,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,266.25,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,100.38,37.7,,,percent of total billed charges,37.70% of total billed charges,100.38,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,90.26,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,207.68,78,,,percent of total billed charges,78% of total billed charges,266.25,100,,,percent of total billed charges,100% of total billed charges,219.92,82.6,,,percent of total billed charges,82.6% of total billed charges,219.92,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,266.25,
"Norovirus, RT-PCR LC",30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,320,208.00,,281.6,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,320,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,201.6,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,48.96,15.3,,,percent of total billed charges,15.3% of total billed charges,220.8,69,,,percent of total billed charges,69% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,320,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,320,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,108.48,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,249.6,78,,,percent of total billed charges,78% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,320,
"C albicans + C glabrata, NAA LC",30687801,CDM,306,RC,87801,HCPCS,Outpatient,,,170,110.50,,149.6,88,,,percent of total billed charges,88% of total Billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,170,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,107.1,63,,,percent of total billed charges,63% of total billed charges,122.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,26.01,15.3,,,percent of total billed charges,15.3% of total billed charges,117.3,69,,,percent of total billed charges,69% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,268.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,57.63,33.9,,,percent of total billed charges,33.9% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,132.6,78,,,percent of total billed charges,78% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,268.51,
"180071 Vaginitis + HSV, NuSwab LC",30687801,CDM,306,RC,87801,HCPCS,Outpatient,,,170,110.50,,149.6,88,,,percent of total billed charges,88% of total Billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,170,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,107.1,63,,,percent of total billed charges,63% of total billed charges,122.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,26.01,15.3,,,percent of total billed charges,15.3% of total billed charges,117.3,69,,,percent of total billed charges,69% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,268.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,57.63,33.9,,,percent of total billed charges,33.9% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,132.6,78,,,percent of total billed charges,78% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,268.51,
Occult Blood Stool I,30082270,CDM,300,RC,82270,HCPCS,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,49,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,30.87,63,,,percent of total billed charges,63% of total billed charges,7.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.61,33.9,,,percent of total billed charges,33.9% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,49,
Occult Blood Stool II,30082270,CDM,300,RC,82270,HCPCS,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,49,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,30.87,63,,,percent of total billed charges,63% of total billed charges,7.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.61,33.9,,,percent of total billed charges,33.9% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,49,
Occult Blood Stool III,30082270,CDM,300,RC,82270,HCPCS,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,49,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,30.87,63,,,percent of total billed charges,63% of total billed charges,7.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.61,33.9,,,percent of total billed charges,33.9% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,49,
Occult Blood Stool Screen,30182272,CDM,301,RC,82270,HCPCS,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,63,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.69,63,,,percent of total billed charges,63% of total billed charges,7.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,21.36,33.9,,,percent of total billed charges,33.9% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,63,
Occult Blood Screen 1-3,30082270,CDM,301,RC,82270,HCPCS,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,49,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,30.87,63,,,percent of total billed charges,63% of total billed charges,7.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.61,33.9,,,percent of total billed charges,33.9% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,49,
"Organism ID, Bacteria LC",30687077,CDM,306,RC,87077,HCPCS,Outpatient,,,249,161.85,,219.12,88,,,percent of total billed charges,88% of total Billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,249,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,156.87,63,,,percent of total billed charges,63% of total billed charges,14.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,38.1,15.3,,,percent of total billed charges,15.3% of total billed charges,171.81,69,,,percent of total billed charges,69% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,30.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,84.41,33.9,,,percent of total billed charges,33.9% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,194.22,78,,,percent of total billed charges,78% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,249,
"Organism Identification, Yeast LC",30687106,CDM,306,RC,87106,HCPCS,Outpatient,,,289.5,188.18,,254.76,88,,,percent of total billed charges,88% of total Billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,289.5,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,182.39,63,,,percent of total billed charges,63% of total billed charges,18.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,44.29,15.3,,,percent of total billed charges,15.3% of total billed charges,199.76,69,,,percent of total billed charges,69% of total billed charges,289.5,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,289.5,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,289.5,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,39.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,109.14,37.7,,,percent of total billed charges,37.70% of total billed charges,109.14,37.7,,,percent of total billed charges,37.70% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,98.14,33.9,,,percent of total billed charges,33.9% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,225.81,78,,,percent of total billed charges,78% of total billed charges,289.5,100,,,percent of total billed charges,100% of total billed charges,239.13,82.6,,,percent of total billed charges,82.6% of total billed charges,239.13,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,289.5,
Osmolality Blood,30183930,CDM,301,RC,83930,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,11.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,25.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,74,
Osmolality Urine,30083935,CDM,300,RC,83935,HCPCS,Outpatient,,,615,399.75,,541.2,88,,,percent of total billed charges,88% of total Billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,615,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,387.45,63,,,percent of total billed charges,63% of total billed charges,11.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,94.1,15.3,,,percent of total billed charges,15.3% of total billed charges,424.35,69,,,percent of total billed charges,69% of total billed charges,615,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,615,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,615,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,26.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,231.86,37.7,,,percent of total billed charges,37.70% of total billed charges,231.86,37.7,,,percent of total billed charges,37.70% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,208.49,33.9,,,percent of total billed charges,33.9% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,479.7,78,,,percent of total billed charges,78% of total billed charges,615,100,,,percent of total billed charges,100% of total billed charges,507.99,82.6,,,percent of total billed charges,82.6% of total billed charges,507.99,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.88,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,615,
"Osmolality, Urine LC",30183935,CDM,301,RC,83935,HCPCS,Outpatient,,,179,116.35,,157.52,88,,,percent of total billed charges,88% of total Billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,179,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,112.77,63,,,percent of total billed charges,63% of total billed charges,11.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,27.39,15.3,,,percent of total billed charges,15.3% of total billed charges,123.51,69,,,percent of total billed charges,69% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,26.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,60.68,33.9,,,percent of total billed charges,33.9% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,139.62,78,,,percent of total billed charges,78% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.88,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,179,
"Osmolality, Blood LC",30183930,CDM,301,RC,83930,HCPCS,Outpatient,,,179,116.35,,157.52,88,,,percent of total billed charges,88% of total Billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,179,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,112.77,63,,,percent of total billed charges,63% of total billed charges,11.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,27.39,15.3,,,percent of total billed charges,15.3% of total billed charges,123.51,69,,,percent of total billed charges,69% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,25.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,60.68,33.9,,,percent of total billed charges,33.9% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,139.62,78,,,percent of total billed charges,78% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,179,
Ova + Parasite Exam LC,30687177,CDM,306,RC,87177,HCPCS,Outpatient,,,206,133.90,,181.28,88,,,percent of total billed charges,88% of total Billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,206,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,129.78,63,,,percent of total billed charges,63% of total billed charges,15.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,31.52,15.3,,,percent of total billed charges,15.3% of total billed charges,142.14,69,,,percent of total billed charges,69% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,34.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,69.83,33.9,,,percent of total billed charges,33.9% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,160.68,78,,,percent of total billed charges,78% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,8.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,206,
"Oxalate, Quant, U24 LC",30183945,CDM,301,RC,83945,HCPCS,Outpatient,,,263,170.95,,231.44,88,,,percent of total billed charges,88% of total Billed charges,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,263,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,165.69,63,,,percent of total billed charges,63% of total billed charges,25.28,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,40.24,15.3,,,percent of total billed charges,15.3% of total billed charges,181.47,69,,,percent of total billed charges,69% of total billed charges,263,100,,,percent of total billed charges,100% of total billed charges,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,263,100,,,percent of total billed charges,100% of total billed charges,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,263,100,,,percent of total billed charges,100% of total billed charges,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,55.27,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,99.15,37.7,,,percent of total billed charges,37.70% of total billed charges,99.15,37.7,,,percent of total billed charges,37.70% of total billed charges,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,89.16,33.9,,,percent of total billed charges,33.9% of total billed charges,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,205.14,78,,,percent of total billed charges,78% of total billed charges,263,100,,,percent of total billed charges,100% of total billed charges,217.24,82.6,,,percent of total billed charges,82.6% of total billed charges,217.24,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,14.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.45,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,263,
"Oxcarbazepine (Trileptal),S LC",30180183,CDM,301,RC,80183,HCPCS,Outpatient,,,116,75.40,,102.08,88,,,percent of total billed charges,88% of total Billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,116,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,73.08,63,,,percent of total billed charges,63% of total billed charges,23.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,17.75,15.3,,,percent of total billed charges,15.3% of total billed charges,80.04,69,,,percent of total billed charges,69% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,116,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,116,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,50.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,39.32,33.9,,,percent of total billed charges,33.9% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,90.48,78,,,percent of total billed charges,78% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.38,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,116,
PAP IGP Aptima HPV LC,31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,110,71.50,,96.8,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,110,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,69.3,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,75.9,69,,,percent of total billed charges,69% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,37.29,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,85.8,78,,,percent of total billed charges,78% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,110,
"PAP IGP, Aptima HPV, rfx 16/18,45 LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,110,71.50,,96.8,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,110,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,69.3,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,75.9,69,,,percent of total billed charges,69% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,37.29,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,85.8,78,,,percent of total billed charges,78% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,110,
".Pap IG, Ct-Ng TV LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,101.78,
"PAP IGP, CtNg, rfx Aptima HPV ASCU LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,277,180.05,,243.76,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,277,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,174.51,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,191.13,69,,,percent of total billed charges,69% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,93.9,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,216.06,78,,,percent of total billed charges,78% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,277,
"IGP,rfx Aptima HPV all pth LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,101.78,
"199305 PAP IGP, Apt HPV,rfx 16/18,45 LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,110,71.50,,96.8,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,110,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,69.3,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,75.9,69,,,percent of total billed charges,69% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,110,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,37.29,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,85.8,78,,,percent of total billed charges,78% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,110,
PID/Infertility Panel AVR,30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
POC Osmolality Serum,30083930,CDM,300,RC,83930,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,11.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,25.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,74,
POC Urine Osmolality,30083935,CDM,300,RC,83935,HCPCS,Outpatient,,,615,399.75,,541.2,88,,,percent of total billed charges,88% of total Billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,615,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,387.45,63,,,percent of total billed charges,63% of total billed charges,11.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,94.1,15.3,,,percent of total billed charges,15.3% of total billed charges,424.35,69,,,percent of total billed charges,69% of total billed charges,615,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,615,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,615,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,26.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,231.86,37.7,,,percent of total billed charges,37.70% of total billed charges,231.86,37.7,,,percent of total billed charges,37.70% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,208.49,33.9,,,percent of total billed charges,33.9% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,479.7,78,,,percent of total billed charges,78% of total billed charges,615,100,,,percent of total billed charges,100% of total billed charges,507.99,82.6,,,percent of total billed charges,82.6% of total billed charges,507.99,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.88,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,615,
"iSTAT Basic metabolic panel (Calcium, ionized) Chem8+",30180047,CDM,301,RC,80047,HCPCS,Outpatient,,,41.19,26.77,,36.25,88,,,percent of total billed charges,88% of total Billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,41.19,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,25.95,63,,,percent of total billed charges,63% of total billed charges,24.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,6.3,15.3,,,percent of total billed charges,15.3% of total billed charges,28.42,69,,,percent of total billed charges,69% of total billed charges,41.19,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,52.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,15.53,37.7,,,percent of total billed charges,37.70% of total billed charges,15.53,37.7,,,percent of total billed charges,37.70% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.96,33.9,,,percent of total billed charges,33.9% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,32.13,78,,,percent of total billed charges,78% of total billed charges,41.19,100,,,percent of total billed charges,100% of total billed charges,34.02,82.6,,,percent of total billed charges,82.6% of total billed charges,34.02,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.86,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,52.51,
POCT INR - TOP Coagucheck,30085610,CDM,300,RC,85610,HCPCS,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,12,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,7.56,63,,,percent of total billed charges,63% of total billed charges,7.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,16.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.52,37.7,,,percent of total billed charges,37.70% of total billed charges,4.52,37.7,,,percent of total billed charges,37.70% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.07,33.9,,,percent of total billed charges,33.9% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.84,16.4,
POCT iSTAT INR,30085610,CDM,300,RC,85610,HCPCS,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,12,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,7.56,63,,,percent of total billed charges,63% of total billed charges,7.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,12,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,16.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.52,37.7,,,percent of total billed charges,37.70% of total billed charges,4.52,37.7,,,percent of total billed charges,37.70% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.07,33.9,,,percent of total billed charges,33.9% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.84,16.4,
Prostate specific antigen (PSA) total; Diagnostic,30184153,CDM,301,RC,84153,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,302.4,63,,,percent of total billed charges,63% of total billed charges,32.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,73.44,15.3,,,percent of total billed charges,15.3% of total billed charges,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,70.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,162.72,33.9,,,percent of total billed charges,33.9% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,480,
PSA Screening,30184153,CDM,301,RC,G0103,HCPCS,Outpatient,,,405,263.25,,356.4,88,,,percent of total billed charges,88% of total Billed charges,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,405,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,255.15,63,,,percent of total billed charges,63% of total billed charges,33.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,61.97,15.3,,,percent of total billed charges,15.3% of total billed charges,279.45,69,,,percent of total billed charges,69% of total billed charges,405,100,,,percent of total billed charges,100% of total billed charges,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,405,100,,,percent of total billed charges,100% of total billed charges,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,405,100,,,percent of total billed charges,100% of total billed charges,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,73.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,152.69,37.7,,,percent of total billed charges,37.70% of total billed charges,152.69,37.7,,,percent of total billed charges,37.70% of total billed charges,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,137.3,33.9,,,percent of total billed charges,33.9% of total billed charges,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,315.9,78,,,percent of total billed charges,78% of total billed charges,405,100,,,percent of total billed charges,100% of total billed charges,334.53,82.6,,,percent of total billed charges,82.6% of total billed charges,334.53,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,19.5,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,405,
PSA Total+% Free LC,30184153,CDM,301,RC,84153,HCPCS,Outpatient,,,448,291.20,,394.24,88,,,percent of total billed charges,88% of total Billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,448,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,282.24,63,,,percent of total billed charges,63% of total billed charges,32.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,68.54,15.3,,,percent of total billed charges,15.3% of total billed charges,309.12,69,,,percent of total billed charges,69% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,448,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,448,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,70.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,151.87,33.9,,,percent of total billed charges,33.9% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,349.44,78,,,percent of total billed charges,78% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,448,
PSA Total (Reflex To Free) LC,30184153,CDM,301,RC,84153,HCPCS,Outpatient,,,448,291.20,,394.24,88,,,percent of total billed charges,88% of total Billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,448,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,282.24,63,,,percent of total billed charges,63% of total billed charges,32.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,68.54,15.3,,,percent of total billed charges,15.3% of total billed charges,309.12,69,,,percent of total billed charges,69% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,448,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,448,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,70.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,151.87,33.9,,,percent of total billed charges,33.9% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,349.44,78,,,percent of total billed charges,78% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,448,
Prothrombin Time and INR,30085610,CDM,300,RC,85610,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,43.47,63,,,percent of total billed charges,63% of total billed charges,7.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,16.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,23.39,33.9,,,percent of total billed charges,33.9% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,69,
Ca+PTH Intact LC,30182310,CDM,301,RC,82310,HCPCS,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,104,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,63,,,percent of total billed charges,63% of total billed charges,9.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,15.91,15.3,,,percent of total billed charges,15.3% of total billed charges,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,19.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,35.26,33.9,,,percent of total billed charges,33.9% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,104,
PTHrP (PTH-Related Peptide),30182397,CDM,301,RC,82397,HCPCS,Outpatient,,,267,173.55,,234.96,88,,,percent of total billed charges,88% of total Billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,267,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,168.21,63,,,percent of total billed charges,63% of total billed charges,24.71,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,40.85,15.3,,,percent of total billed charges,15.3% of total billed charges,184.23,69,,,percent of total billed charges,69% of total billed charges,267,100,,,percent of total billed charges,100% of total billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,267,100,,,percent of total billed charges,100% of total billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,267,100,,,percent of total billed charges,100% of total billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,100.66,37.7,,,percent of total billed charges,37.70% of total billed charges,100.66,37.7,,,percent of total billed charges,37.70% of total billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,90.51,33.9,,,percent of total billed charges,33.9% of total billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,208.26,78,,,percent of total billed charges,78% of total billed charges,267,100,,,percent of total billed charges,100% of total billed charges,220.54,82.6,,,percent of total billed charges,82.6% of total billed charges,220.54,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,14.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,267,
Pancreatic Elastase Fecal LC,30182653,CDM,301,RC,82653,HCPCS,Outpatient,,,735,477.75,,646.8,88,,,percent of total billed charges,88% of total Billed charges,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,735,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,463.05,63,,,percent of total billed charges,63% of total billed charges,40.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,112.46,15.3,,,percent of total billed charges,15.3% of total billed charges,507.15,69,,,percent of total billed charges,69% of total billed charges,735,100,,,percent of total billed charges,100% of total billed charges,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,735,100,,,percent of total billed charges,100% of total billed charges,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,735,100,,,percent of total billed charges,100% of total billed charges,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,277.1,37.7,,,percent of total billed charges,37.70% of total billed charges,277.1,37.7,,,percent of total billed charges,37.70% of total billed charges,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,249.17,33.9,,,percent of total billed charges,33.9% of total billed charges,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,573.3,78,,,percent of total billed charges,78% of total billed charges,735,100,,,percent of total billed charges,100% of total billed charges,607.11,82.6,,,percent of total billed charges,82.6% of total billed charges,607.11,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,23.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.97,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,735,
Panel 083904 (HIV-2) LC,30286702,CDM,302,RC,86702,HCPCS,Outpatient,,,263,170.95,,231.44,88,,,percent of total billed charges,88% of total Billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,263,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,165.69,63,,,percent of total billed charges,63% of total billed charges,23.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,40.24,15.3,,,percent of total billed charges,15.3% of total billed charges,181.47,69,,,percent of total billed charges,69% of total billed charges,263,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,263,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,263,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,51.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,99.15,37.7,,,percent of total billed charges,37.70% of total billed charges,99.15,37.7,,,percent of total billed charges,37.70% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,89.16,33.9,,,percent of total billed charges,33.9% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,205.14,78,,,percent of total billed charges,78% of total billed charges,263,100,,,percent of total billed charges,100% of total billed charges,217.24,82.6,,,percent of total billed charges,82.6% of total billed charges,217.24,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,13.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.52,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,263,
HIV Ag/Ab with Reflex LC 083935,30687389,CDM,306,RC,87389,HCPCS,Outpatient,,,57,37.05,,50.16,88,,,percent of total billed charges,88% of total Billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,57,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,35.91,63,,,percent of total billed charges,63% of total billed charges,42.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,8.72,15.3,,,percent of total billed charges,15.3% of total billed charges,39.33,69,,,percent of total billed charges,69% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,57,100,,,percent of total billed charges,100% of total billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,57,100,,,percent of total billed charges,100% of total billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,92.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,21.49,37.7,,,percent of total billed charges,37.70% of total billed charges,21.49,37.7,,,percent of total billed charges,37.70% of total billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,19.32,33.9,,,percent of total billed charges,33.9% of total billed charges,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,44.46,78,,,percent of total billed charges,78% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,24.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,92.1,
Pap IG (Image Guided) LC,31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,91,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,57.33,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,91,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,91,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,30.85,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,101.78,
"Pap IG, rfx HPV all pth LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,91,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,57.33,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,91,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,91,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,30.85,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,101.78,
"IGP,rfx Aptima HPV all pth LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,101.78,
"Pap IG, Ct-Ng TV LC",31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,434,282.10,,381.92,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,434,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,273.42,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,299.46,69,,,percent of total billed charges,69% of total billed charges,434,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,434,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,434,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,163.62,37.7,,,percent of total billed charges,37.70% of total billed charges,163.62,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,147.13,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,338.52,78,,,percent of total billed charges,78% of total billed charges,434,100,,,percent of total billed charges,100% of total billed charges,358.48,82.6,,,percent of total billed charges,82.6% of total billed charges,358.48,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,434,
88142 AP Bill Gyn Cytology Liquid Prep,31188142,CDM,311,RC,88142,HCPCS,Outpatient,,,136,88.40,,119.68,88,,,percent of total billed charges,88% of total Billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,136,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,85.68,63,,,percent of total billed charges,63% of total billed charges,35.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,30.39,150,,,Fee Schedule,150% of Medicare OPPS rate,93.84,69,,,percent of total billed charges,69% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,136,100,,,percent of total billed charges,100% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,136,100,,,percent of total billed charges,100% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,77.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,51.27,37.7,,,percent of total billed charges,37.70% of total billed charges,51.27,37.7,,,percent of total billed charges,37.70% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,46.1,33.9,,,percent of total billed charges,33.9% of total billed charges,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,106.08,78,,,percent of total billed charges,78% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,20.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.26,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,136,
009191 Pap Smear 2 Slides LC,31188164,CDM,311,RC,88164,HCPCS,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,33,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,20.79,63,,,percent of total billed charges,63% of total billed charges,31.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,26.64,150,,,Fee Schedule,150% of Medicare OPPS rate,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,57.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,11.19,33.9,,,percent of total billed charges,33.9% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.19,57.94,
009191 Pap Smear 2 Slides LC,31188164,CDM,311,RC,88164,HCPCS,Outpatient,,,66,42.90,,58.08,88,,,percent of total billed charges,88% of total Billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,66,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,41.58,63,,,percent of total billed charges,63% of total billed charges,31.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,26.64,150,,,Fee Schedule,150% of Medicare OPPS rate,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,57.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,22.37,33.9,,,percent of total billed charges,33.9% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,66,
009100 Pap Smear LC,31188164,CDM,311,RC,88164,HCPCS,Outpatient,,,45.36,29.48,,39.92,88,,,percent of total billed charges,88% of total Billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,45.36,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,28.58,63,,,percent of total billed charges,63% of total billed charges,31.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,26.64,150,,,Fee Schedule,150% of Medicare OPPS rate,31.3,69,,,percent of total billed charges,69% of total billed charges,45.36,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,45.36,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,45.36,100,,,percent of total billed charges,100% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,57.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.1,37.7,,,percent of total billed charges,37.70% of total billed charges,17.1,37.7,,,percent of total billed charges,37.70% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.38,33.9,,,percent of total billed charges,33.9% of total billed charges,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,35.38,78,,,percent of total billed charges,78% of total billed charges,45.36,100,,,percent of total billed charges,100% of total billed charges,37.47,82.6,,,percent of total billed charges,82.6% of total billed charges,37.47,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,57.94,
Parathyroid Hormone Intact,30083970,CDM,300,RC,83970,HCPCS,Outpatient,,,193,125.45,,169.84,88,,,percent of total billed charges,88% of total Billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,193,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,121.59,63,,,percent of total billed charges,63% of total billed charges,72.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,29.53,15.3,,,percent of total billed charges,15.3% of total billed charges,133.17,69,,,percent of total billed charges,69% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,193,100,,,percent of total billed charges,100% of total billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,193,100,,,percent of total billed charges,100% of total billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,157.89,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,65.43,33.9,,,percent of total billed charges,33.9% of total billed charges,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,150.54,78,,,percent of total billed charges,78% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,41.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,41.28,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.6,193,
Partial Thromboplastin Time,30085730,CDM,305,RC,85730,HCPCS,Outpatient,,,111,72.15,,97.68,88,,,percent of total billed charges,88% of total Billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,111,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,69.93,63,,,percent of total billed charges,63% of total billed charges,10.51,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,16.98,15.3,,,percent of total billed charges,15.3% of total billed charges,76.59,69,,,percent of total billed charges,69% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,111,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,111,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,22.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,37.63,33.9,,,percent of total billed charges,33.9% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,86.58,78,,,percent of total billed charges,78% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,111,
Parvo B19 IgG LC,30286747,CDM,302,RC,86747,HCPCS,Outpatient,,,62.7,40.76,,55.18,88,,,percent of total billed charges,88% of total Billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,62.7,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,39.5,63,,,percent of total billed charges,63% of total billed charges,26.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,9.59,15.3,,,percent of total billed charges,15.3% of total billed charges,43.26,69,,,percent of total billed charges,69% of total billed charges,62.7,100,,,percent of total billed charges,100% of total billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,62.7,100,,,percent of total billed charges,100% of total billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,62.7,100,,,percent of total billed charges,100% of total billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,57.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,23.64,37.7,,,percent of total billed charges,37.70% of total billed charges,23.64,37.7,,,percent of total billed charges,37.70% of total billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,21.26,33.9,,,percent of total billed charges,33.9% of total billed charges,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,48.91,78,,,percent of total billed charges,78% of total billed charges,62.7,100,,,percent of total billed charges,100% of total billed charges,51.79,82.6,,,percent of total billed charges,82.6% of total billed charges,51.79,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,15.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.03,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,62.7,
Pathology Report LC,9958018,CDM,312,RC,88300,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,20.52,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,100.22,
PHENOBARBITAL,30180184,CDM,301,RC,80184,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,26.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,58.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,15.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.3,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,146,
Phenytoin,30180185,CDM,301,RC,80185,HCPCS,Outpatient,,,229,148.85,,201.52,88,,,percent of total billed charges,88% of total Billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,229,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,144.27,63,,,percent of total billed charges,63% of total billed charges,23.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,35.04,15.3,,,percent of total billed charges,15.3% of total billed charges,158.01,69,,,percent of total billed charges,69% of total billed charges,229,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,229,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,229,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,50.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,86.33,37.7,,,percent of total billed charges,37.70% of total billed charges,86.33,37.7,,,percent of total billed charges,37.70% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,77.63,33.9,,,percent of total billed charges,33.9% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,178.62,78,,,percent of total billed charges,78% of total billed charges,229,100,,,percent of total billed charges,100% of total billed charges,189.15,82.6,,,percent of total billed charges,82.6% of total billed charges,189.15,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.38,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,229,
PHENYTOIN FREE,30180186,CDM,301,RC,80186,HCPCS,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,150,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,94.5,63,,,percent of total billed charges,63% of total billed charges,24.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,150,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,150,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,52.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,50.85,33.9,,,percent of total billed charges,33.9% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,13.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,150,
"Phenytoin, Free, Serum LC",30180186,CDM,301,RC,80186,HCPCS,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,150,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,94.5,63,,,percent of total billed charges,63% of total billed charges,24.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,150,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,150,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,52.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,50.85,33.9,,,percent of total billed charges,33.9% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,13.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.76,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,150,
Phosphorus,30184100,CDM,301,RC,84100,HCPCS,Outpatient,,,105,68.25,,92.4,88,,,percent of total billed charges,88% of total Billed charges,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,105,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,66.15,63,,,percent of total billed charges,63% of total billed charges,8.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,16.07,15.3,,,percent of total billed charges,15.3% of total billed charges,72.45,69,,,percent of total billed charges,69% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,18.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,35.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,78,,,percent of total billed charges,78% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,105,
"PHOSPHORUS, RANDOM URINE",30184105,CDM,301,RC,84105,HCPCS,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,49,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,30.87,63,,,percent of total billed charges,63% of total billed charges,10.11,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,22.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,16.61,33.9,,,percent of total billed charges,33.9% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,49,
PHOSPHORUS 24HR URINE,30184105,CDM,301,RC,84105,HCPCS,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,49,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,30.87,63,,,percent of total billed charges,63% of total billed charges,10.11,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,22.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,16.61,33.9,,,percent of total billed charges,33.9% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,49,
PINWORM PREP,30687172,CDM,306,RC,87172,HCPCS,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,104,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,15.91,15.3,,,percent of total billed charges,15.3% of total billed charges,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,35.26,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,104,
AUTOMATED PLATELET COUNT,30585049,CDM,305,RC,85049,HCPCS,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,26,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,63,,,percent of total billed charges,63% of total billed charges,7.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,percent of total billed charges,100% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,percent of total billed charges,100% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,17.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,9.8,37.7,,,percent of total billed charges,37.70% of total billed charges,9.8,37.7,,,percent of total billed charges,37.70% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.81,33.9,,,percent of total billed charges,33.9% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.52,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,26,
PLATELET AGGREGATION,30585576,CDM,305,RC,85576,HCPCS,Outpatient,,,174,113.10,,153.12,88,,,percent of total billed charges,88% of total Billed charges,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,16.29,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,16.78,103,,,Fee Schedule,103% of WA Medicaid,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,109.62,63,,,percent of total billed charges,63% of total billed charges,43.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,16.29,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,95.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,12.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,16.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.18,130,,,Fee Schedule,130% of WA Medicaid ,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,25.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.91,100,,,Fee Schedule,100% of Medicare OPPS rate,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.07,174,
Platelet Count Manual,30085049,CDM,300,RC,85049,HCPCS,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,26,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,16.38,63,,,percent of total billed charges,63% of total billed charges,7.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,percent of total billed charges,100% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,percent of total billed charges,100% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,17.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,9.8,37.7,,,percent of total billed charges,37.70% of total billed charges,9.8,37.7,,,percent of total billed charges,37.70% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.81,33.9,,,percent of total billed charges,33.9% of total billed charges,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.52,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,26,
Platelet Antibody Profile LC,30286022,CDM,302,RC,86022,HCPCS,Outpatient,,,105,68.25,,92.4,88,,,percent of total billed charges,88% of total Billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,105,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,66.15,63,,,percent of total billed charges,63% of total billed charges,32.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,16.07,15.3,,,percent of total billed charges,15.3% of total billed charges,72.45,69,,,percent of total billed charges,69% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,70.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,35.6,33.9,,,percent of total billed charges,33.9% of total billed charges,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,78,,,percent of total billed charges,78% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,18.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,105,
Pleural Fluid Cytology LC,31188112,CDM,311,RC,88112,HCPCS,Outpatient,,,203,131.95,,178.64,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,203,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,127.89,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,31.06,15.3,,,percent of total billed charges,15.3% of total billed charges,140.07,69,,,percent of total billed charges,69% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,68.82,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,158.34,78,,,percent of total billed charges,78% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,203,
Pneumocystis PCR LC 816658,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,691,449.15,,608.08,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,691,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,435.33,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,105.72,15.3,,,percent of total billed charges,15.3% of total billed charges,476.79,69,,,percent of total billed charges,69% of total billed charges,691,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,691,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,691,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,260.51,37.7,,,percent of total billed charges,37.70% of total billed charges,260.51,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,234.25,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,538.98,78,,,percent of total billed charges,78% of total billed charges,691,100,,,percent of total billed charges,100% of total billed charges,570.77,82.6,,,percent of total billed charges,82.6% of total billed charges,570.77,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,691,
Porphyrins Qn Urine LC,30184120,CDM,301,RC,84120,HCPCS,Outpatient,,,101.85,66.20,,89.63,88,,,percent of total billed charges,88% of total Billed charges,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,101.85,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,64.17,63,,,percent of total billed charges,63% of total billed charges,25.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,15.58,15.3,,,percent of total billed charges,15.3% of total billed charges,70.28,69,,,percent of total billed charges,69% of total billed charges,101.85,100,,,percent of total billed charges,100% of total billed charges,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,101.85,100,,,percent of total billed charges,100% of total billed charges,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,101.85,100,,,percent of total billed charges,100% of total billed charges,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,56.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,38.4,37.7,,,percent of total billed charges,37.70% of total billed charges,38.4,37.7,,,percent of total billed charges,37.70% of total billed charges,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,34.53,33.9,,,percent of total billed charges,33.9% of total billed charges,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,79.44,78,,,percent of total billed charges,78% of total billed charges,101.85,100,,,percent of total billed charges,100% of total billed charges,84.13,82.6,,,percent of total billed charges,82.6% of total billed charges,84.13,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,14.85,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.71,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,101.85,
Potassium,30184132,CDM,301,RC,84132,HCPCS,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,60.48,63,,,percent of total billed charges,63% of total billed charges,8.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,18.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,32.54,33.9,,,percent of total billed charges,33.9% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,96,
POTASSIUM 24HR URINE,30184133,CDM,301,RC,84133,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,8.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,18.09,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,74,
Potassium Body Fluid,30184132,CDM,301,RC,84132,HCPCS,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,60.48,63,,,percent of total billed charges,63% of total billed charges,8.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,18.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,32.54,33.9,,,percent of total billed charges,33.9% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.76,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,96,
POTASSIUM RANDOM URINE,30184133,CDM,301,RC,84133,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,8.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,18.09,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,74,
PREALBUMIN,30184134,CDM,301,RC,84134,HCPCS,Outpatient,,,84,54.60,,73.92,88,,,percent of total billed charges,88% of total Billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,84,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,52.92,63,,,percent of total billed charges,63% of total billed charges,25.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,12.85,15.3,,,percent of total billed charges,15.3% of total billed charges,57.96,69,,,percent of total billed charges,69% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,84,100,,,percent of total billed charges,100% of total billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,84,100,,,percent of total billed charges,100% of total billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,55.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,28.48,33.9,,,percent of total billed charges,33.9% of total billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,78,,,percent of total billed charges,78% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,14.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,84,
Prealbumin LC,30184134,CDM,301,RC,84134,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,25.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,55.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,14.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.59,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,94,
"Pregnenolone, MS LC",30184140,CDM,301,RC,84140,HCPCS,Outpatient,,,215.64,140.17,,189.76,88,,,percent of total billed charges,88% of total Billed charges,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,215.64,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,135.85,63,,,percent of total billed charges,63% of total billed charges,36.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,32.99,15.3,,,percent of total billed charges,15.3% of total billed charges,148.79,69,,,percent of total billed charges,69% of total billed charges,215.64,100,,,percent of total billed charges,100% of total billed charges,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,215.64,100,,,percent of total billed charges,100% of total billed charges,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,215.64,100,,,percent of total billed charges,100% of total billed charges,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,79.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,81.3,37.7,,,percent of total billed charges,37.70% of total billed charges,81.3,37.7,,,percent of total billed charges,37.70% of total billed charges,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,73.1,33.9,,,percent of total billed charges,33.9% of total billed charges,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,168.2,78,,,percent of total billed charges,78% of total billed charges,215.64,100,,,percent of total billed charges,100% of total billed charges,178.12,82.6,,,percent of total billed charges,82.6% of total billed charges,178.12,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,20.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.67,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,215.64,
"144053 Pregnancy, Initial Screen LC",30286592,CDM,302,RC,86592,HCPCS,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,104,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,15.91,15.3,,,percent of total billed charges,15.3% of total billed charges,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,35.26,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,104,
Procalcitonin (PCT),30184145,CDM,301,RC,84145,HCPCS,Outpatient,,,899,584.35,,791.12,88,,,percent of total billed charges,88% of total Billed charges,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,899,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,566.37,63,,,percent of total billed charges,63% of total billed charges,47.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,137.55,15.3,,,percent of total billed charges,15.3% of total billed charges,620.31,69,,,percent of total billed charges,69% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,899,100,,,percent of total billed charges,100% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,899,100,,,percent of total billed charges,100% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,104.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,304.76,33.9,,,percent of total billed charges,33.9% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,701.22,78,,,percent of total billed charges,78% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.22,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,899,
Progesterone LC,30184144,CDM,301,RC,84144,HCPCS,Outpatient,,,529,343.85,,465.52,88,,,percent of total billed charges,88% of total Billed charges,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,529,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,333.27,63,,,percent of total billed charges,63% of total billed charges,36.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,80.94,15.3,,,percent of total billed charges,15.3% of total billed charges,365.01,69,,,percent of total billed charges,69% of total billed charges,529,100,,,percent of total billed charges,100% of total billed charges,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,529,100,,,percent of total billed charges,100% of total billed charges,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,529,100,,,percent of total billed charges,100% of total billed charges,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,79.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,199.43,37.7,,,percent of total billed charges,37.70% of total billed charges,199.43,37.7,,,percent of total billed charges,37.70% of total billed charges,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,179.33,33.9,,,percent of total billed charges,33.9% of total billed charges,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,412.62,78,,,percent of total billed charges,78% of total billed charges,529,100,,,percent of total billed charges,100% of total billed charges,436.95,82.6,,,percent of total billed charges,82.6% of total billed charges,436.95,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,21.06,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.86,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,529,
Prolactin LC,30184146,CDM,301,RC,84146,HCPCS,Outpatient,,,379,246.35,,333.52,88,,,percent of total billed charges,88% of total Billed charges,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,379,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,238.77,63,,,percent of total billed charges,63% of total billed charges,33.91,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,57.99,15.3,,,percent of total billed charges,15.3% of total billed charges,261.51,69,,,percent of total billed charges,69% of total billed charges,379,100,,,percent of total billed charges,100% of total billed charges,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,379,100,,,percent of total billed charges,100% of total billed charges,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,379,100,,,percent of total billed charges,100% of total billed charges,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,74.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,142.88,37.7,,,percent of total billed charges,37.70% of total billed charges,142.88,37.7,,,percent of total billed charges,37.70% of total billed charges,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,128.48,33.9,,,percent of total billed charges,33.9% of total billed charges,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,295.62,78,,,percent of total billed charges,78% of total billed charges,379,100,,,percent of total billed charges,100% of total billed charges,313.05,82.6,,,percent of total billed charges,82.6% of total billed charges,313.05,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,19.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.38,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,379,
PSA Total,30184153,CDM,301,RC,84153,HCPCS,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,400,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,252,63,,,percent of total billed charges,63% of total billed charges,32.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,400,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,400,100,,,percent of total billed charges,100% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,70.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,150.8,37.7,,,percent of total billed charges,37.70% of total billed charges,150.8,37.7,,,percent of total billed charges,37.70% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,135.6,33.9,,,percent of total billed charges,33.9% of total billed charges,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,18.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,400,
Prostatic Acid Phos LC,30184066,CDM,301,RC,84066,HCPCS,Outpatient,,,198,128.70,,174.24,88,,,percent of total billed charges,88% of total Billed charges,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,63,,,percent of total billed charges,63% of total billed charges,16.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,30.29,15.3,,,percent of total billed charges,15.3% of total billed charges,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,36.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,67.12,33.9,,,percent of total billed charges,33.9% of total billed charges,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,9.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.66,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,198,
Protein Total,30184155,CDM,301,RC,84155,HCPCS,Outpatient,,,82,53.30,,72.16,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,82,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,51.66,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.55,15.3,,,percent of total billed charges,15.3% of total billed charges,56.58,69,,,percent of total billed charges,69% of total billed charges,82,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,82,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,82,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,30.91,37.7,,,percent of total billed charges,37.70% of total billed charges,30.91,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,27.8,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,63.96,78,,,percent of total billed charges,78% of total billed charges,82,100,,,percent of total billed charges,100% of total billed charges,67.73,82.6,,,percent of total billed charges,82.6% of total billed charges,67.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,82,
Protein Body Fluid,30184157,CDM,301,RC,84157,HCPCS,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,63,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4,100,,,Fee Schedule,100% of Medicare OPPS rate,39.69,63,,,percent of total billed charges,63% of total billed charges,7,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,63,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,63,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,15.3,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4,100,,,Fee Schedule,100% of Medicare OPPS rate,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,21.36,33.9,,,percent of total billed charges,33.9% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,63,
Protein CSF,30084157,CDM,300,RC,84157,HCPCS,Outpatient,,,343,222.95,,301.84,88,,,percent of total billed charges,88% of total Billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,343,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4,100,,,Fee Schedule,100% of Medicare OPPS rate,216.09,63,,,percent of total billed charges,63% of total billed charges,7,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,52.48,15.3,,,percent of total billed charges,15.3% of total billed charges,236.67,69,,,percent of total billed charges,69% of total billed charges,343,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,343,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,343,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,15.3,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4,100,,,Fee Schedule,100% of Medicare OPPS rate,129.31,37.7,,,percent of total billed charges,37.70% of total billed charges,129.31,37.7,,,percent of total billed charges,37.70% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,116.28,33.9,,,percent of total billed charges,33.9% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,267.54,78,,,percent of total billed charges,78% of total billed charges,343,100,,,percent of total billed charges,100% of total billed charges,283.32,82.6,,,percent of total billed charges,82.6% of total billed charges,283.32,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,343,
"Protein Electro, U24 LC",30184156,CDM,301,RC,84156,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,74,
"Prot Electro+Interp, U24 LC",30184156,CDM,301,RC,84156,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,74,
PROTEIN TOTAL SERUM,30184155,CDM,301,RC,84155,HCPCS,Outpatient,,,78,50.70,,68.64,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,78,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,49.14,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.93,15.3,,,percent of total billed charges,15.3% of total billed charges,53.82,69,,,percent of total billed charges,69% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,78,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,78,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,29.41,37.7,,,percent of total billed charges,37.70% of total billed charges,29.41,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,26.44,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,60.84,78,,,percent of total billed charges,78% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,78,
"Protoporphyrin, FEP/ZPP LC",30184202,CDM,301,RC,84202,HCPCS,Outpatient,,,166,107.90,,146.08,88,,,percent of total billed charges,88% of total Billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,166,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,104.58,63,,,percent of total billed charges,63% of total billed charges,25.11,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,25.4,15.3,,,percent of total billed charges,15.3% of total billed charges,114.54,69,,,percent of total billed charges,69% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,54.88,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,56.27,33.9,,,percent of total billed charges,33.9% of total billed charges,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,129.48,78,,,percent of total billed charges,78% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,14.49,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.35,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,166,
PROTEIN C ANTIGEN,30585302,CDM,305,RC,85302,HCPCS,Outpatient,,,209,135.85,,183.92,88,,,percent of total billed charges,88% of total Billed charges,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,209,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,131.67,63,,,percent of total billed charges,63% of total billed charges,21.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,31.98,15.3,,,percent of total billed charges,15.3% of total billed charges,144.21,69,,,percent of total billed charges,69% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,209,100,,,percent of total billed charges,100% of total billed charges,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,209,100,,,percent of total billed charges,100% of total billed charges,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,45.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,78.79,37.7,,,percent of total billed charges,37.70% of total billed charges,78.79,37.7,,,percent of total billed charges,37.70% of total billed charges,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,70.85,33.9,,,percent of total billed charges,33.9% of total billed charges,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,163.02,78,,,percent of total billed charges,78% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,12.13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,209,
PROTEIN C ACTIVITY,30585303,CDM,305,RC,85303,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,170.73,63,,,percent of total billed charges,63% of total billed charges,24.22,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,271,100,,,percent of total billed charges,100% of total billed charges,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,52.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,91.87,33.9,,,percent of total billed charges,33.9% of total billed charges,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,13.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.84,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,271,
PROTEIN S ACTIVITY,30585306,CDM,305,RC,85306,HCPCS,Outpatient,,,267,173.55,,234.96,88,,,percent of total billed charges,88% of total Billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,267,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,168.21,63,,,percent of total billed charges,63% of total billed charges,26.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,40.85,15.3,,,percent of total billed charges,15.3% of total billed charges,184.23,69,,,percent of total billed charges,69% of total billed charges,267,100,,,percent of total billed charges,100% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,267,100,,,percent of total billed charges,100% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,267,100,,,percent of total billed charges,100% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,58.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,100.66,37.7,,,percent of total billed charges,37.70% of total billed charges,100.66,37.7,,,percent of total billed charges,37.70% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,90.51,33.9,,,percent of total billed charges,33.9% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,208.26,78,,,percent of total billed charges,78% of total billed charges,267,100,,,percent of total billed charges,100% of total billed charges,220.54,82.6,,,percent of total billed charges,82.6% of total billed charges,220.54,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,15.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,267,
Prot+CreatU (Random) LC,30182570,CDM,301,RC,82570,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,52.29,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,83,
PROTEIN S ACTIVITY,30585306,CDM,305,RC,85306,HCPCS,Outpatient,,,267,173.55,,234.96,88,,,percent of total billed charges,88% of total Billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,267,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,168.21,63,,,percent of total billed charges,63% of total billed charges,26.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,40.85,15.3,,,percent of total billed charges,15.3% of total billed charges,184.23,69,,,percent of total billed charges,69% of total billed charges,267,100,,,percent of total billed charges,100% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,267,100,,,percent of total billed charges,100% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,267,100,,,percent of total billed charges,100% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,58.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,100.66,37.7,,,percent of total billed charges,37.70% of total billed charges,100.66,37.7,,,percent of total billed charges,37.70% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,90.51,33.9,,,percent of total billed charges,33.9% of total billed charges,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,208.26,78,,,percent of total billed charges,78% of total billed charges,267,100,,,percent of total billed charges,100% of total billed charges,220.54,82.6,,,percent of total billed charges,82.6% of total billed charges,220.54,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,15.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.32,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,267,
Protein Elec + Interp LC,30184165,CDM,301,RC,84165,HCPCS,Outpatient,,,531,345.15,,467.28,88,,,percent of total billed charges,88% of total Billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,531,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,334.53,63,,,percent of total billed charges,63% of total billed charges,18.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,81.24,15.3,,,percent of total billed charges,15.3% of total billed charges,366.39,69,,,percent of total billed charges,69% of total billed charges,531,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,531,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,531,100,,,percent of total billed charges,100% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,41.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,200.19,37.7,,,percent of total billed charges,37.70% of total billed charges,200.19,37.7,,,percent of total billed charges,37.70% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,180.01,33.9,,,percent of total billed charges,33.9% of total billed charges,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,414.18,78,,,percent of total billed charges,78% of total billed charges,531,100,,,percent of total billed charges,100% of total billed charges,438.61,82.6,,,percent of total billed charges,82.6% of total billed charges,438.61,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,10.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,531,
"Protein Electro, Random Ur LC",30184156,CDM,301,RC,84156,HCPCS,Outpatient,,,487,316.55,,428.56,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,487,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,306.81,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74.51,15.3,,,percent of total billed charges,15.3% of total billed charges,336.03,69,,,percent of total billed charges,69% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,487,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,487,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,165.09,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,379.86,78,,,percent of total billed charges,78% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,487,
"Protein, Body Fluid LC",30184157,CDM,301,RC,84157,HCPCS,Outpatient,,,12.75,8.29,,11.22,88,,,percent of total billed charges,88% of total Billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.75,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4,100,,,Fee Schedule,100% of Medicare OPPS rate,8.03,63,,,percent of total billed charges,63% of total billed charges,7,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,1.95,15.3,,,percent of total billed charges,15.3% of total billed charges,8.8,69,,,percent of total billed charges,69% of total billed charges,12.75,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,12.75,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,12.75,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,15.3,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,37.7,,,percent of total billed charges,37.70% of total billed charges,4.81,37.7,,,percent of total billed charges,37.70% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.32,33.9,,,percent of total billed charges,33.9% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,9.95,78,,,percent of total billed charges,78% of total billed charges,12.75,100,,,percent of total billed charges,100% of total billed charges,10.53,82.6,,,percent of total billed charges,82.6% of total billed charges,10.53,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.95,15.3,
Protein S Deficiency Profile LC,30585305,CDM,305,RC,85305,HCPCS,Outpatient,,,381,247.65,,335.28,88,,,percent of total billed charges,88% of total Billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,381,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,240.03,63,,,percent of total billed charges,63% of total billed charges,20.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,58.29,15.3,,,percent of total billed charges,15.3% of total billed charges,262.89,69,,,percent of total billed charges,69% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,381,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,381,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,129.16,33.9,,,percent of total billed charges,33.9% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,297.18,78,,,percent of total billed charges,78% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,381,
QuantiFERON (Client Incubated) LC 182893,30286480,CDM,302,RC,86480,HCPCS,Outpatient,,,342,222.30,,300.96,88,,,percent of total billed charges,88% of total Billed charges,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,342,100,,,percent of total billed charges,100% of total billed charges,28.1,103,,,Fee Schedule,103% of WA Medicaid,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,215.46,63,,,percent of total billed charges,63% of total billed charges,108.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,52.33,15.3,,,percent of total billed charges,15.3% of total billed charges,235.98,69,,,percent of total billed charges,69% of total billed charges,342,100,,,percent of total billed charges,100% of total billed charges,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,342,100,,,percent of total billed charges,100% of total billed charges,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,342,100,,,percent of total billed charges,100% of total billed charges,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,237.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,20.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,27.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.47,130,,,Fee Schedule,130% of WA Medicaid ,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,128.93,37.7,,,percent of total billed charges,37.70% of total billed charges,128.93,37.7,,,percent of total billed charges,37.70% of total billed charges,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,115.94,33.9,,,percent of total billed charges,33.9% of total billed charges,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,266.76,78,,,percent of total billed charges,78% of total billed charges,342,100,,,percent of total billed charges,100% of total billed charges,282.49,82.6,,,percent of total billed charges,82.6% of total billed charges,282.49,82.6,,,percent of total billed charges,82.6% of total billed charges,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,62.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,61.98,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.21,342,
RBC COUNT ONLY,30585041,CDM,305,RC,85041,HCPCS,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,54,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,34.02,63,,,percent of total billed charges,63% of total billed charges,5.28,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,54,100,,,percent of total billed charges,100% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,11.55,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,18.31,33.9,,,percent of total billed charges,33.9% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.02,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.02,54,
Rheumatoid Factor Qualitative,30084157,CDM,300,RC,84157,HCPCS,Outpatient,,,343,222.95,,301.84,88,,,percent of total billed charges,88% of total Billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,343,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4,100,,,Fee Schedule,100% of Medicare OPPS rate,216.09,63,,,percent of total billed charges,63% of total billed charges,7,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,52.48,15.3,,,percent of total billed charges,15.3% of total billed charges,236.67,69,,,percent of total billed charges,69% of total billed charges,343,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,343,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,343,100,,,percent of total billed charges,100% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,15.3,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4,100,,,Fee Schedule,100% of Medicare OPPS rate,129.31,37.7,,,percent of total billed charges,37.70% of total billed charges,129.31,37.7,,,percent of total billed charges,37.70% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,116.28,33.9,,,percent of total billed charges,33.9% of total billed charges,4,100,,,Fee Schedule,100% of Medicare OPPS rate,267.54,78,,,percent of total billed charges,78% of total billed charges,343,100,,,percent of total billed charges,100% of total billed charges,283.32,82.6,,,percent of total billed charges,82.6% of total billed charges,283.32,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,343,
HIV DNA BY PCR,30687535,CDM,306,RC,87535,HCPCS,Outpatient,,,394,256.10,,346.72,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,394,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,248.22,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,60.28,15.3,,,percent of total billed charges,15.3% of total billed charges,271.86,69,,,percent of total billed charges,69% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,394,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,394,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,133.57,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,307.32,78,,,percent of total billed charges,78% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,394,
HIV-1 RNA BY PCR QUANT,30687536,CDM,306,RC,87536,HCPCS,Outpatient,,,410,266.50,,360.8,88,,,percent of total billed charges,88% of total Billed charges,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,410,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,258.3,63,,,percent of total billed charges,63% of total billed charges,148.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,62.73,15.3,,,percent of total billed charges,15.3% of total billed charges,282.9,69,,,percent of total billed charges,69% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,410,100,,,percent of total billed charges,100% of total billed charges,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,410,100,,,percent of total billed charges,100% of total billed charges,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,325.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,154.57,37.7,,,percent of total billed charges,37.70% of total billed charges,154.57,37.7,,,percent of total billed charges,37.70% of total billed charges,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,138.99,33.9,,,percent of total billed charges,33.9% of total billed charges,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,319.8,78,,,percent of total billed charges,78% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,85.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,85.1,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,410,
RNP Antibodies LC,30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,94,
Rupture of Fetal Membranes Test,30084112,CDM,300,RC,84112,HCPCS,Outpatient,,,313,203.45,,275.44,88,,,percent of total billed charges,88% of total Billed charges,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,98.85,100,,,Fee Schedule,100% of WA Medicaid,313,100,,,percent of total billed charges,100% of total billed charges,101.81,103,,,Fee Schedule,103% of WA Medicaid,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,171.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,98.85,100,,,Fee Schedule,100% of WA Medicaid,47.89,15.3,,,percent of total billed charges,15.3% of total billed charges,215.97,69,,,percent of total billed charges,69% of total billed charges,313,100,,,percent of total billed charges,100% of total billed charges,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,313,100,,,percent of total billed charges,100% of total billed charges,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,313,100,,,percent of total billed charges,100% of total billed charges,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,375.27,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,98.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,73.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,100.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.5,130,,,Fee Schedule,130% of WA Medicaid ,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,118,37.7,,,percent of total billed charges,37.70% of total billed charges,118,37.7,,,percent of total billed charges,37.70% of total billed charges,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,106.11,33.9,,,percent of total billed charges,33.9% of total billed charges,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,244.14,78,,,percent of total billed charges,78% of total billed charges,313,100,,,percent of total billed charges,100% of total billed charges,258.54,82.6,,,percent of total billed charges,82.6% of total billed charges,258.54,82.6,,,percent of total billed charges,82.6% of total billed charges,98.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,99.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,98.11,100,,,Fee Schedule,100% of Medicare OPPS rate,98.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.89,375.27,
Rapid Plasma Reagin Qualitative,30086592,CDM,300,RC,86592,HCPCS,Outpatient,,,318,206.70,,279.84,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,318,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,200.34,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,48.65,15.3,,,percent of total billed charges,15.3% of total billed charges,219.42,69,,,percent of total billed charges,69% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,318,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,318,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,119.89,37.7,,,percent of total billed charges,37.70% of total billed charges,119.89,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,107.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,248.04,78,,,percent of total billed charges,78% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,318,
RPR LC,30286592,CDM,302,RC,86592,HCPCS,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,104,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,15.91,15.3,,,percent of total billed charges,15.3% of total billed charges,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,35.26,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,104,
RSV,30687807,CDM,306,RC,87807,HCPCS,Outpatient,,,230,149.50,,202.4,88,,,percent of total billed charges,88% of total Billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,230,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,144.9,63,,,percent of total billed charges,63% of total billed charges,22.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,35.19,15.3,,,percent of total billed charges,15.3% of total billed charges,158.7,69,,,percent of total billed charges,69% of total billed charges,230,100,,,percent of total billed charges,100% of total billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,230,100,,,percent of total billed charges,100% of total billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,230,100,,,percent of total billed charges,100% of total billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,50.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,86.71,37.7,,,percent of total billed charges,37.70% of total billed charges,86.71,37.7,,,percent of total billed charges,37.70% of total billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,77.97,33.9,,,percent of total billed charges,33.9% of total billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,179.4,78,,,percent of total billed charges,78% of total billed charges,230,100,,,percent of total billed charges,100% of total billed charges,189.98,82.6,,,percent of total billed charges,82.6% of total billed charges,189.98,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,13.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,230,
Flu A/B PCR (GeneXpert) + RSV,30687502,CDM,306,RC,87502,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,100.54,103,,,Fee Schedule,103% of WA Medicaid,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,153.72,63,,,percent of total billed charges,63% of total billed charges,167.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,37.33,15.3,,,percent of total billed charges,15.3% of total billed charges,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,366.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,72.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,99.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.89,130,,,Fee Schedule,130% of WA Medicaid ,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,82.72,33.9,,,percent of total billed charges,33.9% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,96.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.33,366.43,
VDRL/RPR(QUANT),30286593,CDM,302,RC,86593,HCPCS,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,63,,,percent of total billed charges,63% of total billed charges,7.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,14,100,,,percent of total billed charges,100% of total billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,16.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,33.9,,,percent of total billed charges,33.9% of total billed charges,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.14,16.83,
Renal Function Panel,30180069,CDM,301,RC,80069,HCPCS,Outpatient,,,145,94.25,,127.6,88,,,percent of total billed charges,88% of total Billed charges,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,145,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,91.35,63,,,percent of total billed charges,63% of total billed charges,15.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid,22.19,15.3,,,percent of total billed charges,15.3% of total billed charges,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,33.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,7.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.69,130,,,Fee Schedule,130% of WA Medicaid ,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,49.16,33.9,,,percent of total billed charges,33.9% of total billed charges,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,8.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.68,100,,,Fee Schedule,100% of Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,145,
"Renin Activity, P LC",30184244,CDM,301,RC,84244,HCPCS,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,364,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,229.32,63,,,percent of total billed charges,63% of total billed charges,38.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,55.69,15.3,,,percent of total billed charges,15.3% of total billed charges,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,84.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,123.4,33.9,,,percent of total billed charges,33.9% of total billed charges,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,22.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.99,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,364,
PTHrP (PTH-Related Peptide),30182397,CDM,301,RC,82397,HCPCS,Outpatient,,,379,246.35,,333.52,88,,,percent of total billed charges,88% of total Billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,379,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,238.77,63,,,percent of total billed charges,63% of total billed charges,24.71,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,57.99,15.3,,,percent of total billed charges,15.3% of total billed charges,261.51,69,,,percent of total billed charges,69% of total billed charges,379,100,,,percent of total billed charges,100% of total billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,379,100,,,percent of total billed charges,100% of total billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,379,100,,,percent of total billed charges,100% of total billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,142.88,37.7,,,percent of total billed charges,37.70% of total billed charges,142.88,37.7,,,percent of total billed charges,37.70% of total billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,128.48,33.9,,,percent of total billed charges,33.9% of total billed charges,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,295.62,78,,,percent of total billed charges,78% of total billed charges,379,100,,,percent of total billed charges,100% of total billed charges,313.05,82.6,,,percent of total billed charges,82.6% of total billed charges,313.05,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,14.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.12,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,379,
MYCOPLASMA BY PCR,30687581,CDM,306,RC,87581,HCPCS,Outpatient,,,376,244.40,,330.88,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,376,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,236.88,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,57.53,15.3,,,percent of total billed charges,15.3% of total billed charges,259.44,69,,,percent of total billed charges,69% of total billed charges,376,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,376,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,376,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,141.75,37.7,,,percent of total billed charges,37.70% of total billed charges,141.75,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,127.46,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,293.28,78,,,percent of total billed charges,78% of total billed charges,376,100,,,percent of total billed charges,100% of total billed charges,310.58,82.6,,,percent of total billed charges,82.6% of total billed charges,310.58,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,376,
Respiratory Syncytial Virus (Sofia),30687807,CDM,306,RC,87807,HCPCS,Outpatient,,,230,149.50,,202.4,88,,,percent of total billed charges,88% of total Billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,230,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,144.9,63,,,percent of total billed charges,63% of total billed charges,22.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,35.19,15.3,,,percent of total billed charges,15.3% of total billed charges,158.7,69,,,percent of total billed charges,69% of total billed charges,230,100,,,percent of total billed charges,100% of total billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,230,100,,,percent of total billed charges,100% of total billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,230,100,,,percent of total billed charges,100% of total billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,50.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,86.71,37.7,,,percent of total billed charges,37.70% of total billed charges,86.71,37.7,,,percent of total billed charges,37.70% of total billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,77.97,33.9,,,percent of total billed charges,33.9% of total billed charges,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,179.4,78,,,percent of total billed charges,78% of total billed charges,230,100,,,percent of total billed charges,100% of total billed charges,189.98,82.6,,,percent of total billed charges,82.6% of total billed charges,189.98,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,13.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.1,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,230,
Retic Count w/ IRF,30085046,CDM,300,RC,85046,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,9.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,21.3,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,5.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.57,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,74,
Retic Count Automated,30085045,CDM,300,RC,85045,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,6.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,15.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,4.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.99,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,74,
T-3 REVERSE,30184482,CDM,301,RC,84482,HCPCS,Outpatient,,,105,68.25,,92.4,88,,,percent of total billed charges,88% of total Billed charges,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,105,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,66.15,63,,,percent of total billed charges,63% of total billed charges,27.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,16.07,15.3,,,percent of total billed charges,15.3% of total billed charges,72.45,69,,,percent of total billed charges,69% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,60.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,35.6,33.9,,,percent of total billed charges,33.9% of total billed charges,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,78,,,percent of total billed charges,78% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.76,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,105,
Rheumatoid Arthritis Profile LC,30286200,CDM,302,RC,86200,HCPCS,Outpatient,,,97,63.05,,85.36,88,,,percent of total billed charges,88% of total Billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,97,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,61.11,63,,,percent of total billed charges,63% of total billed charges,22.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.84,15.3,,,percent of total billed charges,15.3% of total billed charges,66.93,69,,,percent of total billed charges,69% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,97,100,,,percent of total billed charges,100% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,32.88,33.9,,,percent of total billed charges,33.9% of total billed charges,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,75.66,78,,,percent of total billed charges,78% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,13.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.95,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,97,
Rheumatoid Arthritis Factor LC,30286431,CDM,302,RC,86431,HCPCS,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,36,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,22.68,63,,,percent of total billed charges,63% of total billed charges,9.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,36,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,36,100,,,percent of total billed charges,100% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,21.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,12.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.67,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.51,36,
"Rotavirus Ag, EIA LC",30687425,CDM,306,RC,87425,HCPCS,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,167,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,105.21,63,,,percent of total billed charges,63% of total billed charges,20.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,25.55,15.3,,,percent of total billed charges,15.3% of total billed charges,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,45.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,56.61,33.9,,,percent of total billed charges,33.9% of total billed charges,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.98,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,167,
Rubella IgG Antibody,30086762,CDM,300,RC,86762,HCPCS,Outpatient,,,258,167.70,,227.04,88,,,percent of total billed charges,88% of total Billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,258,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,162.54,63,,,percent of total billed charges,63% of total billed charges,25.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,39.47,15.3,,,percent of total billed charges,15.3% of total billed charges,178.02,69,,,percent of total billed charges,69% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,33.9,,,percent of total billed charges,33.9% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,201.24,78,,,percent of total billed charges,78% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,258,
"Rubella Antibodies, IgG LC",30086762,CDM,300,RC,86762,HCPCS,Outpatient,,,304,197.60,,267.52,88,,,percent of total billed charges,88% of total Billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,304,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,191.52,63,,,percent of total billed charges,63% of total billed charges,25.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,46.51,15.3,,,percent of total billed charges,15.3% of total billed charges,209.76,69,,,percent of total billed charges,69% of total billed charges,304,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,304,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,304,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,114.61,37.7,,,percent of total billed charges,37.70% of total billed charges,114.61,37.7,,,percent of total billed charges,37.70% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,103.06,33.9,,,percent of total billed charges,33.9% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,237.12,78,,,percent of total billed charges,78% of total billed charges,304,100,,,percent of total billed charges,100% of total billed charges,251.1,82.6,,,percent of total billed charges,82.6% of total billed charges,251.1,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,304,
"Rubeola Antibodies, IgG LC",30286765,CDM,302,RC,86765,HCPCS,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,150,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,94.5,63,,,percent of total billed charges,63% of total billed charges,22.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,150,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,150,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,49.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,50.85,33.9,,,percent of total billed charges,33.9% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,150,
Rubella IgG Antibody w/ Interp,30286762,CDM,302,RC,86762,HCPCS,Outpatient,,,103,66.95,,90.64,88,,,percent of total billed charges,88% of total Billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,103,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,64.89,63,,,percent of total billed charges,63% of total billed charges,25.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,15.76,15.3,,,percent of total billed charges,15.3% of total billed charges,71.07,69,,,percent of total billed charges,69% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,34.92,33.9,,,percent of total billed charges,33.9% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,80.34,78,,,percent of total billed charges,78% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,103,
SARS-CoV-2 (COVID-19) PCR (GeneXpert),30687635,CDM,306,RC,87635,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,153.72,63,,,percent of total billed charges,63% of total billed charges,89.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,37.33,15.3,,,percent of total billed charges,15.3% of total billed charges,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,82.72,33.9,,,percent of total billed charges,33.9% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,244,
SARS-CoV-2 (COVID-19) IgG Ab LC,30286769,CDM,302,RC,86769,HCPCS,Outpatient,,,129,83.85,,113.52,88,,,percent of total billed charges,88% of total Billed charges,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,129,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,81.27,63,,,percent of total billed charges,63% of total billed charges,73.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,19.74,15.3,,,percent of total billed charges,15.3% of total billed charges,89.01,69,,,percent of total billed charges,69% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,129,100,,,percent of total billed charges,100% of total billed charges,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,129,100,,,percent of total billed charges,100% of total billed charges,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,42.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,48.63,37.7,,,percent of total billed charges,37.70% of total billed charges,48.63,37.7,,,percent of total billed charges,37.70% of total billed charges,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,43.73,33.9,,,percent of total billed charges,33.9% of total billed charges,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.62,78,,,percent of total billed charges,78% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,42.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.13,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,129,
SARS-CoV-2 (COVID-19)/Flu/RSV (GeneXpert Plus),3003241U,CDM,306,RC,87637,HCPCS,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,364,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,229.32,63,,,percent of total billed charges,63% of total billed charges,249.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,55.69,15.3,,,percent of total billed charges,15.3% of total billed charges,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,123.4,33.9,,,percent of total billed charges,33.9% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,144.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,364,
SARS/Flu A andB Ag (Sofia 2),30687428,CDM,306,RC,87428,HCPCS,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,364,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,229.32,63,,,percent of total billed charges,63% of total billed charges,123,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,55.69,15.3,,,percent of total billed charges,15.3% of total billed charges,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,63.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,123.4,33.9,,,percent of total billed charges,33.9% of total billed charges,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,70.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,70.29,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,364,
SARS-CoV-2 COVID-19/Flu/RSV (GeneXpert),003000241U,CDM,306,RC,87637,HCPCS,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,364,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,229.32,63,,,percent of total billed charges,63% of total billed charges,249.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,55.69,15.3,,,percent of total billed charges,15.3% of total billed charges,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,123.4,33.9,,,percent of total billed charges,33.9% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,144.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,364,
POCT SARS-CoV-2 (COVID-19)/Flu/RSV (Genexpert),0003000241U,CDM,306,RC,87637,HCPCS,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,364,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,229.32,63,,,percent of total billed charges,63% of total billed charges,249.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,55.69,15.3,,,percent of total billed charges,15.3% of total billed charges,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,123.4,33.9,,,percent of total billed charges,33.9% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,144.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,364,
SARS-CoV-2 (COVID-19) PCR (GeneXpert) POCT,30687635,CDM,306,RC,87635,HCPCS,Outpatient,,,131,85.15,,115.28,88,,,percent of total billed charges,88% of total Billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,131,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,82.53,63,,,percent of total billed charges,63% of total billed charges,89.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,20.04,15.3,,,percent of total billed charges,15.3% of total billed charges,90.39,69,,,percent of total billed charges,69% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,131,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,131,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,49.39,37.7,,,percent of total billed charges,37.70% of total billed charges,49.39,37.7,,,percent of total billed charges,37.70% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,44.41,33.9,,,percent of total billed charges,33.9% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,102.18,78,,,percent of total billed charges,78% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,131,
Saccharomyces cerevisiae Panel LC,30286671,CDM,302,RC,86671,HCPCS,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,60.48,63,,,percent of total billed charges,63% of total billed charges,21.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,46.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,32.54,33.9,,,percent of total billed charges,33.9% of total billed charges,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,96,
Salicylate,30180307,CDM,301,RC,80179,HCPCS,Outpatient,,,277,180.05,,243.76,88,,,percent of total billed charges,88% of total Billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,277,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,174.51,63,,,percent of total billed charges,63% of total billed charges,32.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,42.38,15.3,,,percent of total billed charges,15.3% of total billed charges,191.13,69,,,percent of total billed charges,69% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,71.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,93.9,33.9,,,percent of total billed charges,33.9% of total billed charges,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,216.06,78,,,percent of total billed charges,78% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,18.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.64,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,277,
"Salivary Cortisol,MS LC",30182533,CDM,301,RC,82533,HCPCS,Outpatient,,,217,141.05,,190.96,88,,,percent of total billed charges,88% of total Billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,217,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,136.71,63,,,percent of total billed charges,63% of total billed charges,28.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,33.2,15.3,,,percent of total billed charges,15.3% of total billed charges,149.73,69,,,percent of total billed charges,69% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,217,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,217,100,,,percent of total billed charges,100% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,62.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,81.81,37.7,,,percent of total billed charges,37.70% of total billed charges,81.81,37.7,,,percent of total billed charges,37.70% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,73.56,33.9,,,percent of total billed charges,33.9% of total billed charges,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,169.26,78,,,percent of total billed charges,78% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.3,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,217,
Semen Examination Post Vasectomy,30089321,CDM,300,RC,89321,HCPCS,Outpatient,,,160,104.00,,140.8,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,160,100,,,percent of total billed charges,100% of total billed charges,8.91,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,100.8,63,,,percent of total billed charges,63% of total billed charges,21.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,24.48,15.3,,,percent of total billed charges,15.3% of total billed charges,110.4,69,,,percent of total billed charges,69% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,46.09,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.24,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,54.24,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,124.8,78,,,percent of total billed charges,78% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.4,160,
Serum Pregnancy Test Qualitative,30084703,CDM,300,RC,84703,HCPCS,Outpatient,,,129,83.85,,113.52,88,,,percent of total billed charges,88% of total Billed charges,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,129,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,81.27,63,,,percent of total billed charges,63% of total billed charges,13.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,19.74,15.3,,,percent of total billed charges,15.3% of total billed charges,89.01,69,,,percent of total billed charges,69% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,129,100,,,percent of total billed charges,100% of total billed charges,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,129,100,,,percent of total billed charges,100% of total billed charges,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,28.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,48.63,37.7,,,percent of total billed charges,37.70% of total billed charges,48.63,37.7,,,percent of total billed charges,37.70% of total billed charges,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,43.73,33.9,,,percent of total billed charges,33.9% of total billed charges,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,100.62,78,,,percent of total billed charges,78% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,7.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.52,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,129,
Sex Horm Binding Glob LC,30184270,CDM,301,RC,84270,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,75.6,63,,,percent of total billed charges,63% of total billed charges,38.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,83.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,21.94,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,120,
SHIGA TOXIN 1,30687899,CDM,306,RC,87899,HCPCS,Outpatient,,,60,39.00,,52.8,88,,,percent of total billed charges,88% of total Billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,60,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,37.8,63,,,percent of total billed charges,63% of total billed charges,28.12,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,9.18,15.3,,,percent of total billed charges,15.3% of total billed charges,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,61.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,20.34,33.9,,,percent of total billed charges,33.9% of total billed charges,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,16.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,61.46,
"Sirolimus (Rapamune), Blood LC",30180195,CDM,301,RC,80195,HCPCS,Outpatient,,,243,157.95,,213.84,88,,,percent of total billed charges,88% of total Billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,243,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,153.09,63,,,percent of total billed charges,63% of total billed charges,24.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,37.18,15.3,,,percent of total billed charges,15.3% of total billed charges,167.67,69,,,percent of total billed charges,69% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,243,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,243,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,52.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,82.38,33.9,,,percent of total billed charges,33.9% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,189.54,78,,,percent of total billed charges,78% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.86,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,243,
Sjogren's Anti-SS-A LC,30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,94,
Sjogren's Anti-SS-B LC,30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,94,
"Sjogren's Ab, Anti-SS-A/-SS-B LC",30286235,CDM,302,RC,86235,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,63,,,percent of total billed charges,63% of total billed charges,31.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,94,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,68.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,31.87,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.93,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,94,
Sodium Level,30184295,CDM,301,RC,84295,HCPCS,Outpatient,,,92,59.80,,80.96,88,,,percent of total billed charges,88% of total Billed charges,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,92,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,57.96,63,,,percent of total billed charges,63% of total billed charges,8.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,14.08,15.3,,,percent of total billed charges,15.3% of total billed charges,63.48,69,,,percent of total billed charges,69% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,92,100,,,percent of total billed charges,100% of total billed charges,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,92,100,,,percent of total billed charges,100% of total billed charges,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,18.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,31.19,33.9,,,percent of total billed charges,33.9% of total billed charges,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,71.76,78,,,percent of total billed charges,78% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4.85,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,92,
Sodium 24 Hr Urine,30184300,CDM,301,RC,84300,HCPCS,Outpatient,,,103,66.95,,90.64,88,,,percent of total billed charges,88% of total Billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,103,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,64.89,63,,,percent of total billed charges,63% of total billed charges,8.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,15.76,15.3,,,percent of total billed charges,15.3% of total billed charges,71.07,69,,,percent of total billed charges,69% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,34.92,33.9,,,percent of total billed charges,33.9% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,80.34,78,,,percent of total billed charges,78% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,103,
SODIUM BODY FLUID,30184302,CDM,301,RC,84302,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,52.29,63,,,percent of total billed charges,63% of total billed charges,8.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,18.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,4.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.86,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,83,
Sodium Urine,30184300,CDM,301,RC,84300,HCPCS,Outpatient,,,103,66.95,,90.64,88,,,percent of total billed charges,88% of total Billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,103,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,64.89,63,,,percent of total billed charges,63% of total billed charges,8.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,15.76,15.3,,,percent of total billed charges,15.3% of total billed charges,71.07,69,,,percent of total billed charges,69% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,34.92,33.9,,,percent of total billed charges,33.9% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,80.34,78,,,percent of total billed charges,78% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,103,
Soluble Liver Antigen (SLA) AutoAntibody LC,30283516,CDM,302,RC,83516,HCPCS,Outpatient,,,106.11,68.97,,93.38,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,106.11,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,16.23,15.3,,,percent of total billed charges,15.3% of total billed charges,73.22,69,,,percent of total billed charges,69% of total billed charges,106.11,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,106.11,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,106.11,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,40,37.7,,,percent of total billed charges,37.70% of total billed charges,40,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,35.97,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,82.77,78,,,percent of total billed charges,78% of total billed charges,106.11,100,,,percent of total billed charges,100% of total billed charges,87.65,82.6,,,percent of total billed charges,82.6% of total billed charges,87.65,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,106.11,
Specific Gravity Urine,30781002,CDM,307,RC,81002,HCPCS,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,85.05,63,,,percent of total billed charges,63% of total billed charges,6.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,13.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,45.77,33.9,,,percent of total billed charges,33.9% of total billed charges,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,3.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.48,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,135,
"016502 Spotted Fever Abs, IgG, IgM",30286757,CDM,302,RC,86757,HCPCS,Outpatient,,,381,247.65,,335.28,88,,,percent of total billed charges,88% of total Billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,381,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,240.03,63,,,percent of total billed charges,63% of total billed charges,33.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,58.29,15.3,,,percent of total billed charges,15.3% of total billed charges,262.89,69,,,percent of total billed charges,69% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,381,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,381,100,,,percent of total billed charges,100% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,74.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,129.16,33.9,,,percent of total billed charges,33.9% of total billed charges,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,297.18,78,,,percent of total billed charges,78% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.35,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,381,
Sputum Cytology LC,31188108,CDM,311,RC,88108,HCPCS,Outpatient,,,184,119.60,,161.92,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,184,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,115.92,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,28.15,15.3,,,percent of total billed charges,15.3% of total billed charges,126.96,69,,,percent of total billed charges,69% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,143.52,78,,,percent of total billed charges,78% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,184,
Standard Panel AVR,30687511,CDM,306,RC,87511,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
"Stool Culture, Yersinia Only LC",30687046,CDM,306,RC,87046,HCPCS,Outpatient,,,57,37.05,,50.16,88,,,percent of total billed charges,88% of total Billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,57,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,35.91,63,,,percent of total billed charges,63% of total billed charges,16.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,8.72,15.3,,,percent of total billed charges,15.3% of total billed charges,39.33,69,,,percent of total billed charges,69% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,57,100,,,percent of total billed charges,100% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,57,100,,,percent of total billed charges,100% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,36.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,21.49,37.7,,,percent of total billed charges,37.70% of total billed charges,21.49,37.7,,,percent of total billed charges,37.70% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,19.32,33.9,,,percent of total billed charges,33.9% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,44.46,78,,,percent of total billed charges,78% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,9.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,57,
"Strep A, Rapid",30687880,CDM,306,RC,87880,HCPCS,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,56,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,35.28,63,,,percent of total billed charges,63% of total billed charges,28.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,56,100,,,percent of total billed charges,100% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,56,100,,,percent of total billed charges,100% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,63.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,18.98,33.9,,,percent of total billed charges,33.9% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,16.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,63.22,
Strep B Rapid,30087880,CDM,300,RC,87880,HCPCS,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,56,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,35.28,63,,,percent of total billed charges,63% of total billed charges,28.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,56,100,,,percent of total billed charges,100% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,56,100,,,percent of total billed charges,100% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,63.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,18.98,33.9,,,percent of total billed charges,33.9% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,16.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,63.22,
Strep A (Sofia),30687430,CDM,306,RC,87430,HCPCS,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,31,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,19.53,63,,,percent of total billed charges,63% of total billed charges,29.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,64.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.51,33.9,,,percent of total billed charges,33.9% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.74,64.29,
Strep A (GeneXpert Xpress) POCT,30687651,CDM,306,RC,87651,HCPCS,Outpatient,,,31,20.15,QW,27.28,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,31,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,19.53,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.51,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.74,134.21,
SurePath Pap AVR,31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,101.25,65.81,,89.1,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,101.25,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,63.79,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,69.86,69,,,percent of total billed charges,69% of total billed charges,101.25,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.25,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.25,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,38.17,37.7,,,percent of total billed charges,37.70% of total billed charges,38.17,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,34.32,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,78.98,78,,,percent of total billed charges,78% of total billed charges,101.25,100,,,percent of total billed charges,100% of total billed charges,83.63,82.6,,,percent of total billed charges,82.6% of total billed charges,83.63,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,101.78,
Surgical AVR,31288300,CDM,312,RC,88300,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,20.52,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,14.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,20.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.9,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,19.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.76,100.22,
T pallidum Screening Cascade LC,30186780,CDM,301,RC,86780,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,53.55,63,,,percent of total billed charges,63% of total billed charges,23.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,50.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,85,
T pallidum Immunoblot LC,30186780,CDM,301,RC,86780,HCPCS,Outpatient,,,98,63.70,,86.24,88,,,percent of total billed charges,88% of total Billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,98,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,61.74,63,,,percent of total billed charges,63% of total billed charges,23.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,14.99,15.3,,,percent of total billed charges,15.3% of total billed charges,67.62,69,,,percent of total billed charges,69% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,98,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,98,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,50.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,33.22,33.9,,,percent of total billed charges,33.9% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,76.44,78,,,percent of total billed charges,78% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,98,
T-Lymphocyte Helper/Suppressor LC,30286360,CDM,302,RC,86360,HCPCS,Outpatient,,,590,383.50,,519.2,88,,,percent of total billed charges,88% of total Billed charges,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,590,100,,,percent of total billed charges,100% of total billed charges,28.1,103,,,Fee Schedule,103% of WA Medicaid,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,371.7,63,,,percent of total billed charges,63% of total billed charges,82.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid,90.27,15.3,,,percent of total billed charges,15.3% of total billed charges,407.1,69,,,percent of total billed charges,69% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,179.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,20.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,27.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.47,130,,,Fee Schedule,130% of WA Medicaid ,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,200.01,33.9,,,percent of total billed charges,33.9% of total billed charges,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,460.2,78,,,percent of total billed charges,78% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,47.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,46.98,100,,,Fee Schedule,100% of Medicare OPPS rate,27.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.21,590,
T3 Free,30084481,CDM,300,RC,84481,HCPCS,Outpatient,,,366,237.90,,322.08,88,,,percent of total billed charges,88% of total Billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,366,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,230.58,63,,,percent of total billed charges,63% of total billed charges,29.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,56,15.3,,,percent of total billed charges,15.3% of total billed charges,252.54,69,,,percent of total billed charges,69% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,366,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,64.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,124.07,33.9,,,percent of total billed charges,33.9% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,285.48,78,,,percent of total billed charges,78% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,17.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,366,
T3 Uptake LC,30184479,CDM,301,RC,84479,HCPCS,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,62,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,39.06,63,,,percent of total billed charges,63% of total billed charges,11.32,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,9.49,15.3,,,percent of total billed charges,15.3% of total billed charges,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,62,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,62,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,24.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.02,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.47,62,
T3 Free,30184481,CDM,301,RC,84481,HCPCS,Outpatient,,,638,414.70,,561.44,88,,,percent of total billed charges,88% of total Billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,638,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,401.94,63,,,percent of total billed charges,63% of total billed charges,29.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,97.61,15.3,,,percent of total billed charges,15.3% of total billed charges,440.22,69,,,percent of total billed charges,69% of total billed charges,638,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,638,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,638,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,64.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,37.7,,,percent of total billed charges,37.70% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,216.28,33.9,,,percent of total billed charges,33.9% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,497.64,78,,,percent of total billed charges,78% of total billed charges,638,100,,,percent of total billed charges,100% of total billed charges,526.99,82.6,,,percent of total billed charges,82.6% of total billed charges,526.99,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,17.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,638,
T4 Total,30084436,CDM,300,RC,84436,HCPCS,Outpatient,,,145,94.25,,127.6,88,,,percent of total billed charges,88% of total Billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,145,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,91.35,63,,,percent of total billed charges,63% of total billed charges,12.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,22.19,15.3,,,percent of total billed charges,15.3% of total billed charges,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,26.27,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.16,33.9,,,percent of total billed charges,33.9% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,6.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.87,145,
TSH w/ Rflx to FT4,30184443,CDM,301,RC,84443,HCPCS,Outpatient,,,159,103.35,,139.92,88,,,percent of total billed charges,88% of total Billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,159,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,100.17,63,,,percent of total billed charges,63% of total billed charges,29.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,24.33,15.3,,,percent of total billed charges,15.3% of total billed charges,109.71,69,,,percent of total billed charges,69% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,159,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,159,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,64.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,53.9,33.9,,,percent of total billed charges,33.9% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,124.02,78,,,percent of total billed charges,78% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,159,
TSH LC,30184443,CDM,301,RC,84443,HCPCS,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,18,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.34,63,,,percent of total billed charges,63% of total billed charges,29.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,18,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,18,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,64.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.79,37.7,,,percent of total billed charges,37.70% of total billed charges,6.79,37.7,,,percent of total billed charges,37.70% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.1,33.9,,,percent of total billed charges,33.9% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.75,64.26,
TSH+Free T4 LC,30184443,CDM,301,RC,84443,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,43.47,63,,,percent of total billed charges,63% of total billed charges,29.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,69,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,64.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,23.39,33.9,,,percent of total billed charges,33.9% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,69,
Tacrolimus by Immunoassay LC 711034,30180197,CDM,301,RC,80197,HCPCS,Outpatient,,,154,100.10,,135.52,88,,,percent of total billed charges,88% of total Billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,154,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,97.02,63,,,percent of total billed charges,63% of total billed charges,24.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,23.56,15.3,,,percent of total billed charges,15.3% of total billed charges,106.26,69,,,percent of total billed charges,69% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,154,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,154,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,52.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,52.21,33.9,,,percent of total billed charges,33.9% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,120.12,78,,,percent of total billed charges,78% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.86,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,154,
"Tacrolimus (FK506), Blood LC 700248",30180197,CDM,301,RC,80197,HCPCS,Outpatient,,,402,261.30,,353.76,88,,,percent of total billed charges,88% of total Billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,402,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,253.26,63,,,percent of total billed charges,63% of total billed charges,24.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,61.51,15.3,,,percent of total billed charges,15.3% of total billed charges,277.38,69,,,percent of total billed charges,69% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,52.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,136.28,33.9,,,percent of total billed charges,33.9% of total billed charges,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,313.56,78,,,percent of total billed charges,78% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,13.86,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.73,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,402,
Testosterone Total,30084403,CDM,300,RC,84403,HCPCS,Outpatient,,,404,262.60,,355.52,88,,,percent of total billed charges,88% of total Billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,404,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,254.52,63,,,percent of total billed charges,63% of total billed charges,45.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,61.81,15.3,,,percent of total billed charges,15.3% of total billed charges,278.76,69,,,percent of total billed charges,69% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,404,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,404,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,98.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,136.96,33.9,,,percent of total billed charges,33.9% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,315.12,78,,,percent of total billed charges,78% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,26.06,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,404,
Testosterone LC,30184403,CDM,301,RC,84403,HCPCS,Outpatient,,,453,294.45,,398.64,88,,,percent of total billed charges,88% of total Billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,453,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,285.39,63,,,percent of total billed charges,63% of total billed charges,45.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,69.31,15.3,,,percent of total billed charges,15.3% of total billed charges,312.57,69,,,percent of total billed charges,69% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,453,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,453,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,98.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,153.57,33.9,,,percent of total billed charges,33.9% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,353.34,78,,,percent of total billed charges,78% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,26.06,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,453,
"Testosterone, Total, LC/MS LC",30184403,CDM,301,RC,84403,HCPCS,Outpatient,,,453,294.45,,398.64,88,,,percent of total billed charges,88% of total Billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,453,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,285.39,63,,,percent of total billed charges,63% of total billed charges,45.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,69.31,15.3,,,percent of total billed charges,15.3% of total billed charges,312.57,69,,,percent of total billed charges,69% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,453,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,453,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,98.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,153.57,33.9,,,percent of total billed charges,33.9% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,353.34,78,,,percent of total billed charges,78% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,26.06,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.81,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,453,
"Testosterone,Free and Total LC 140103",30184402,CDM,301,RC,84402,HCPCS,Outpatient,,,517,336.05,,454.96,88,,,percent of total billed charges,88% of total Billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,517,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,325.71,63,,,percent of total billed charges,63% of total billed charges,44.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,79.1,15.3,,,percent of total billed charges,15.3% of total billed charges,356.73,69,,,percent of total billed charges,69% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,517,100,,,percent of total billed charges,100% of total billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,517,100,,,percent of total billed charges,100% of total billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,97.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,175.26,33.9,,,percent of total billed charges,33.9% of total billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,403.26,78,,,percent of total billed charges,78% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,25.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,517,
SEX HORMONE BIND GLOBULIN,30184270,CDM,301,RC,84270,HCPCS,Outpatient,,,102,66.30,,89.76,88,,,percent of total billed charges,88% of total Billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,102,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,64.26,63,,,percent of total billed charges,63% of total billed charges,38.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,15.61,15.3,,,percent of total billed charges,15.3% of total billed charges,70.38,69,,,percent of total billed charges,69% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,83.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.58,33.9,,,percent of total billed charges,33.9% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,79.56,78,,,percent of total billed charges,78% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,21.94,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,102,
SEX HORMONE BIND GLOBULIN,30184270,CDM,301,RC,84270,HCPCS,Outpatient,,,102,66.30,,89.76,88,,,percent of total billed charges,88% of total Billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,102,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,64.26,63,,,percent of total billed charges,63% of total billed charges,38.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,15.61,15.3,,,percent of total billed charges,15.3% of total billed charges,70.38,69,,,percent of total billed charges,69% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,83.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.58,33.9,,,percent of total billed charges,33.9% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,79.56,78,,,percent of total billed charges,78% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,21.94,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.73,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,102,
"Testosterone, Free+Total, LC/MS LC 070195",30084402,CDM,300,RC,84402,HCPCS,Outpatient,,,453,294.45,,398.64,88,,,percent of total billed charges,88% of total Billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,453,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,285.39,63,,,percent of total billed charges,63% of total billed charges,44.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,69.31,15.3,,,percent of total billed charges,15.3% of total billed charges,312.57,69,,,percent of total billed charges,69% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,453,100,,,percent of total billed charges,100% of total billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,453,100,,,percent of total billed charges,100% of total billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,97.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,153.57,33.9,,,percent of total billed charges,33.9% of total billed charges,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,353.34,78,,,percent of total billed charges,78% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,25.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,25.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,453,
Tetanus Antitoxoid IgG Ab LC,30086317,CDM,300,RC,86317,HCPCS,Outpatient,,,303,196.95,,266.64,88,,,percent of total billed charges,88% of total Billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,303,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,190.89,63,,,percent of total billed charges,63% of total billed charges,26.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,46.36,15.3,,,percent of total billed charges,15.3% of total billed charges,209.07,69,,,percent of total billed charges,69% of total billed charges,303,100,,,percent of total billed charges,100% of total billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,303,100,,,percent of total billed charges,100% of total billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,303,100,,,percent of total billed charges,100% of total billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,57.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,114.23,37.7,,,percent of total billed charges,37.70% of total billed charges,114.23,37.7,,,percent of total billed charges,37.70% of total billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,102.72,33.9,,,percent of total billed charges,33.9% of total billed charges,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,236.34,78,,,percent of total billed charges,78% of total billed charges,303,100,,,percent of total billed charges,100% of total billed charges,250.28,82.6,,,percent of total billed charges,82.6% of total billed charges,250.28,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,15.13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.99,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,303,
TgAb+Thyrog IMA reflex if Neg LC,30286800,CDM,302,RC,86800,HCPCS,Outpatient,,,363,235.95,,319.44,88,,,percent of total billed charges,88% of total Billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,363,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,228.69,63,,,percent of total billed charges,63% of total billed charges,27.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,55.54,15.3,,,percent of total billed charges,15.3% of total billed charges,250.47,69,,,percent of total billed charges,69% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,363,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,363,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,60.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,123.06,33.9,,,percent of total billed charges,33.9% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,283.14,78,,,percent of total billed charges,78% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,16.06,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,363,
"TgAb+Thyroglobulin,IMA or LCMS LC",30286800,CDM,302,RC,86800,HCPCS,Outpatient,,,65,42.25,,57.2,88,,,percent of total billed charges,88% of total Billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,65,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,40.95,63,,,percent of total billed charges,63% of total billed charges,27.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,9.95,15.3,,,percent of total billed charges,15.3% of total billed charges,44.85,69,,,percent of total billed charges,69% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,65,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,65,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,60.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,22.04,33.9,,,percent of total billed charges,33.9% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,50.7,78,,,percent of total billed charges,78% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,16.06,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,65,
Theophylline LC,30180198,CDM,301,RC,80198,HCPCS,Outpatient,,,273,177.45,,240.24,88,,,percent of total billed charges,88% of total Billed charges,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,273,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,171.99,63,,,percent of total billed charges,63% of total billed charges,24.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,41.77,15.3,,,percent of total billed charges,15.3% of total billed charges,188.37,69,,,percent of total billed charges,69% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.55,33.9,,,percent of total billed charges,33.9% of total billed charges,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,212.94,78,,,percent of total billed charges,78% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,14.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.14,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,273,
Therapeutic Phlebotomy,99195,CDM,904,RC,99195,HCPCS,Outpatient,,,281,182.65,,247.28,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,281,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,177.03,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,42.99,15.3,,,percent of total billed charges,15.3% of total billed charges,193.89,69,,,percent of total billed charges,69% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,281,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,281,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,105.94,37.7,,,percent of total billed charges,37.70% of total billed charges,105.94,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,95.26,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,219.18,78,,,percent of total billed charges,78% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.15,454.8,
ThinPrep Pap AVR,31188175,CDM,311,RC,88175,HCPCS,Outpatient,,,101.25,65.81,,89.1,88,,,percent of total billed charges,88% of total Billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,101.25,100,,,percent of total billed charges,100% of total billed charges,16.03,103,,,Fee Schedule,103% of WA Medicaid,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,63.79,63,,,percent of total billed charges,63% of total billed charges,46.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid,39.92,150,,,Fee Schedule,150% of Medicare OPPS rate,69.86,69,,,percent of total billed charges,69% of total billed charges,101.25,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.25,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.25,100,,,percent of total billed charges,100% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,101.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.23,130,,,Fee Schedule,130% of WA Medicaid ,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,38.17,37.7,,,percent of total billed charges,37.70% of total billed charges,38.17,37.7,,,percent of total billed charges,37.70% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,34.32,33.9,,,percent of total billed charges,33.9% of total billed charges,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,78.98,78,,,percent of total billed charges,78% of total billed charges,101.25,100,,,percent of total billed charges,100% of total billed charges,83.63,82.6,,,percent of total billed charges,82.6% of total billed charges,83.63,82.6,,,percent of total billed charges,82.6% of total billed charges,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,26.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.61,100,,,Fee Schedule,100% of Medicare OPPS rate,15.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,101.78,
Thiocyanate LC,30184430,CDM,301,RC,84430,HCPCS,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,132,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,83.16,63,,,percent of total billed charges,63% of total billed charges,20.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,44.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,44.75,33.9,,,percent of total billed charges,33.9% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,11.74,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.63,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,132,
Thiopurine Methyltransferase LC,30184433,CDM,301,RC,84433,HCPCS,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,567,63,,,percent of total billed charges,63% of total billed charges,38.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,900,100,,,percent of total billed charges,100% of total billed charges,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,900,100,,,percent of total billed charges,100% of total billed charges,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,305.1,33.9,,,percent of total billed charges,33.9% of total billed charges,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,22.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.17,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,900,
3100245,3100245,CDM,310,RC,0245U,HCPCS,Outpatient,,,3655,2375.75,,3216.4,88,,,percent of total billed charges,88% of total Billed charges,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,364.01,100,,,Fee Schedule,100% of WA Medicaid,3655,100,,,percent of total billed charges,100% of total billed charges,374.93,103,,,Fee Schedule,103% of WA Medicaid,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,2302.65,63,,,percent of total billed charges,63% of total billed charges,2215.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,364.01,100,,,Fee Schedule,100% of WA Medicaid,1899.11,150,,,Fee Schedule,150% of Medicare OPPS rate,2521.95,69,,,percent of total billed charges,69% of total billed charges,3655,100,,,percent of total billed charges,100% of total billed charges,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,3655,100,,,percent of total billed charges,100% of total billed charges,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,3655,100,,,percent of total billed charges,100% of total billed charges,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,364.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,269.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,371.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,473.21,130,,,Fee Schedule,130% of WA Medicaid ,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,1377.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1377.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,1239.05,33.9,,,percent of total billed charges,33.9% of total billed charges,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,2850.9,78,,,percent of total billed charges,78% of total billed charges,3655,100,,,percent of total billed charges,100% of total billed charges,3019.03,82.6,,,percent of total billed charges,82.6% of total billed charges,3019.03,82.6,,,percent of total billed charges,82.6% of total billed charges,364.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,1278.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1266.07,100,,,Fee Schedule,100% of Medicare OPPS rate,364.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,269.63,3655,
Thyroid Stimulating Hormone,30184443,CDM,301,RC,84443,HCPCS,Outpatient,,,159,103.35,,139.92,88,,,percent of total billed charges,88% of total Billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,159,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,100.17,63,,,percent of total billed charges,63% of total billed charges,29.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,24.33,15.3,,,percent of total billed charges,15.3% of total billed charges,109.71,69,,,percent of total billed charges,69% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,159,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,159,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,64.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,53.9,33.9,,,percent of total billed charges,33.9% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,124.02,78,,,percent of total billed charges,78% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,16.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.8,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,159,
Thyroglobulin by LCMS LC,30184432,CDM,301,RC,84432,HCPCS,Outpatient,,,318,206.70,,279.84,88,,,percent of total billed charges,88% of total Billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,318,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,200.34,63,,,percent of total billed charges,63% of total billed charges,28.1,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,48.65,15.3,,,percent of total billed charges,15.3% of total billed charges,219.42,69,,,percent of total billed charges,69% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,318,100,,,percent of total billed charges,100% of total billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,318,100,,,percent of total billed charges,100% of total billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,61.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,119.89,37.7,,,percent of total billed charges,37.70% of total billed charges,119.89,37.7,,,percent of total billed charges,37.70% of total billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,107.8,33.9,,,percent of total billed charges,33.9% of total billed charges,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,248.04,78,,,percent of total billed charges,78% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16.22,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,318,
Thyroxine (T4) LC,30184436,CDM,301,RC,84436,HCPCS,Outpatient,,,162,105.30,,142.56,88,,,percent of total billed charges,88% of total Billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,162,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,102.06,63,,,percent of total billed charges,63% of total billed charges,12.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,24.79,15.3,,,percent of total billed charges,15.3% of total billed charges,111.78,69,,,percent of total billed charges,69% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,26.27,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,54.92,33.9,,,percent of total billed charges,33.9% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,126.36,78,,,percent of total billed charges,78% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,6.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.87,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.87,162,
"Thyroxine (T4) Free, Direct, S LC",30184439,CDM,301,RC,84439,HCPCS,Outpatient,,,144,93.60,,126.72,88,,,percent of total billed charges,88% of total Billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,144,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,90.72,63,,,percent of total billed charges,63% of total billed charges,15.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,22.03,15.3,,,percent of total billed charges,15.3% of total billed charges,99.36,69,,,percent of total billed charges,69% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,144,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,144,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,34.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,54.29,37.7,,,percent of total billed charges,37.70% of total billed charges,54.29,37.7,,,percent of total billed charges,37.70% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,48.82,33.9,,,percent of total billed charges,33.9% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,112.32,78,,,percent of total billed charges,78% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,9.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.02,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,144,
Thyroid Peroxidase (TPO) Ab LC,30286376,CDM,302,RC,86376,HCPCS,Outpatient,,,357,232.05,,314.16,88,,,percent of total billed charges,88% of total Billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,357,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,224.91,63,,,percent of total billed charges,63% of total billed charges,25.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,54.62,15.3,,,percent of total billed charges,15.3% of total billed charges,246.33,69,,,percent of total billed charges,69% of total billed charges,357,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,357,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,357,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,55.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,134.59,37.7,,,percent of total billed charges,37.70% of total billed charges,134.59,37.7,,,percent of total billed charges,37.70% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,121.02,33.9,,,percent of total billed charges,33.9% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,278.46,78,,,percent of total billed charges,78% of total billed charges,357,100,,,percent of total billed charges,100% of total billed charges,294.88,82.6,,,percent of total billed charges,82.6% of total billed charges,294.88,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,14.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,357,
THYROGLOBULIN ANTIB,30286800,CDM,302,RC,86800,HCPCS,Outpatient,,,309,200.85,,271.92,88,,,percent of total billed charges,88% of total Billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,309,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,194.67,63,,,percent of total billed charges,63% of total billed charges,27.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,47.28,15.3,,,percent of total billed charges,15.3% of total billed charges,213.21,69,,,percent of total billed charges,69% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,309,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,309,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,60.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,104.75,33.9,,,percent of total billed charges,33.9% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,241.02,78,,,percent of total billed charges,78% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,16.06,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,309,
Thyroid Stim Immunoglobulin LC,30184445,CDM,301,RC,84445,HCPCS,Outpatient,,,639,415.35,,562.32,88,,,percent of total billed charges,88% of total Billed charges,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,639,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,402.57,63,,,percent of total billed charges,63% of total billed charges,89,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,97.77,15.3,,,percent of total billed charges,15.3% of total billed charges,440.91,69,,,percent of total billed charges,69% of total billed charges,639,100,,,percent of total billed charges,100% of total billed charges,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,639,100,,,percent of total billed charges,100% of total billed charges,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,639,100,,,percent of total billed charges,100% of total billed charges,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,194.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,240.9,37.7,,,percent of total billed charges,37.70% of total billed charges,240.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,216.62,33.9,,,percent of total billed charges,33.9% of total billed charges,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,498.42,78,,,percent of total billed charges,78% of total billed charges,639,100,,,percent of total billed charges,100% of total billed charges,527.81,82.6,,,percent of total billed charges,82.6% of total billed charges,527.81,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,51.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,50.86,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.6,639,
Thyroid Antibodies LC,30286376,CDM,302,RC,86376,HCPCS,Outpatient,,,298,193.70,,262.24,88,,,percent of total billed charges,88% of total Billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,298,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,187.74,63,,,percent of total billed charges,63% of total billed charges,25.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,45.59,15.3,,,percent of total billed charges,15.3% of total billed charges,205.62,69,,,percent of total billed charges,69% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,298,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,298,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,55.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,101.02,33.9,,,percent of total billed charges,33.9% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,232.44,78,,,percent of total billed charges,78% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,14.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.55,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,298,
Topiramate (Topamax) LC,30180201,CDM,301,RC,80201,HCPCS,Outpatient,,,206,133.90,,181.28,88,,,percent of total billed charges,88% of total Billed charges,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,206,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,129.78,63,,,percent of total billed charges,63% of total billed charges,20.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,31.52,15.3,,,percent of total billed charges,15.3% of total billed charges,142.14,69,,,percent of total billed charges,69% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,45.59,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,69.83,33.9,,,percent of total billed charges,33.9% of total billed charges,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,160.68,78,,,percent of total billed charges,78% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,12.03,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.92,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,206,
Total Iron Binding Capacity,30083550,CDM,300,RC,83550,HCPCS,Outpatient,,,172,111.80,,151.36,88,,,percent of total billed charges,88% of total Billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,172,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,108.36,63,,,percent of total billed charges,63% of total billed charges,15.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,26.32,15.3,,,percent of total billed charges,15.3% of total billed charges,118.68,69,,,percent of total billed charges,69% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,33.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,58.31,33.9,,,percent of total billed charges,33.9% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,134.16,78,,,percent of total billed charges,78% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,172,
"Toxoplasma gondii Ab, IgG, Qn LC",30286777,CDM,302,RC,86777,HCPCS,Outpatient,,,309,200.85,,271.92,88,,,percent of total billed charges,88% of total Billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,309,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,194.67,63,,,percent of total billed charges,63% of total billed charges,25.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,47.28,15.3,,,percent of total billed charges,15.3% of total billed charges,213.21,69,,,percent of total billed charges,69% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,309,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,309,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,104.75,33.9,,,percent of total billed charges,33.9% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,241.02,78,,,percent of total billed charges,78% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,309,
Toxoplasma Abs IgG/IgM LC,30286777,CDM,302,RC,86777,HCPCS,Outpatient,,,309,200.85,,271.92,88,,,percent of total billed charges,88% of total Billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,309,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,194.67,63,,,percent of total billed charges,63% of total billed charges,25.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,47.28,15.3,,,percent of total billed charges,15.3% of total billed charges,213.21,69,,,percent of total billed charges,69% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,309,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,309,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,104.75,33.9,,,percent of total billed charges,33.9% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,241.02,78,,,percent of total billed charges,78% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,309,
Transferrin LC,30184466,CDM,301,RC,84466,HCPCS,Outpatient,,,254,165.10,,223.52,88,,,percent of total billed charges,88% of total Billed charges,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,254,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,160.02,63,,,percent of total billed charges,63% of total billed charges,22.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,38.86,15.3,,,percent of total billed charges,15.3% of total billed charges,175.26,69,,,percent of total billed charges,69% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,254,100,,,percent of total billed charges,100% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,254,100,,,percent of total billed charges,100% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,48.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,86.11,33.9,,,percent of total billed charges,33.9% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,198.12,78,,,percent of total billed charges,78% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.76,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,254,
Treponema pallidum Abs LC 082370,30186780,CDM,301,RC,86780,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,23.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,50.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,13.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,146,
Treponema pallidum (Syphilis) AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
TRICHOMONAS VAGIN DIR PROBE,30687661,CDM,306,RC,87661,HCPCS,Outpatient,,,160,104.00,,140.8,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,160,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,100.8,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,24.48,15.3,,,percent of total billed charges,15.3% of total billed charges,110.4,69,,,percent of total billed charges,69% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,54.24,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,124.8,78,,,percent of total billed charges,78% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,160,
Tricyclic Antidepressant Conf LC 739070,30180369,CDM,301,RC,80369,HCPCS,Outpatient,,,208,135.20,,183.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,208,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",31.82,15.3,,,percent of total billed charges,15.3% of total billed charges,143.52,69,,,percent of total billed charges,69% of total billed charges,208,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,208,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,208,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,78.42,37.7,,,percent of total billed charges,37.70% of total billed charges,78.42,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,70.51,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,162.24,78,,,percent of total billed charges,78% of total billed charges,208,100,,,percent of total billed charges,100% of total billed charges,171.81,82.6,,,percent of total billed charges,82.6% of total billed charges,171.81,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.94,16.8,,,percent of total billed charges,16.8% of total billed charges,31.82,208,
Trichomonas Vaginalis AVR,30687661,CDM,306,RC,87661,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Triglycerides,30184478,CDM,301,RC,84478,HCPCS,Outpatient,,,60,39.00,,52.8,88,,,percent of total billed charges,88% of total Billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,60,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,37.8,63,,,percent of total billed charges,63% of total billed charges,10.04,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,9.18,15.3,,,percent of total billed charges,15.3% of total billed charges,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,21.95,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,20.34,33.9,,,percent of total billed charges,33.9% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,60,
Triglyceride Body Fluid,30184478,CDM,301,RC,84478,HCPCS,Outpatient,,,60,39.00,,52.8,88,,,percent of total billed charges,88% of total Billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,60,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,37.8,63,,,percent of total billed charges,63% of total billed charges,10.04,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,9.18,15.3,,,percent of total billed charges,15.3% of total billed charges,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,21.95,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,20.34,33.9,,,percent of total billed charges,33.9% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,60,
Triiodothyronine T3 Free LC,30184481,CDM,301,RC,84481,HCPCS,Outpatient,,,431,280.15,,379.28,88,,,percent of total billed charges,88% of total Billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,431,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,271.53,63,,,percent of total billed charges,63% of total billed charges,29.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,65.94,15.3,,,percent of total billed charges,15.3% of total billed charges,297.39,69,,,percent of total billed charges,69% of total billed charges,431,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,431,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,431,100,,,percent of total billed charges,100% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,64.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,162.49,37.7,,,percent of total billed charges,37.70% of total billed charges,162.49,37.7,,,percent of total billed charges,37.70% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,146.11,33.9,,,percent of total billed charges,33.9% of total billed charges,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,336.18,78,,,percent of total billed charges,78% of total billed charges,431,100,,,percent of total billed charges,100% of total billed charges,356.01,82.6,,,percent of total billed charges,82.6% of total billed charges,356.01,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,17.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.94,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,431,
Triiodothyronine (T3) LC,30184480,CDM,301,RC,84480,HCPCS,Outpatient,,,221,143.65,,194.48,88,,,percent of total billed charges,88% of total Billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,221,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,139.23,63,,,percent of total billed charges,63% of total billed charges,24.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,33.81,15.3,,,percent of total billed charges,15.3% of total billed charges,152.49,69,,,percent of total billed charges,69% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,221,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,221,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,54.23,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74.92,33.9,,,percent of total billed charges,33.9% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,172.38,78,,,percent of total billed charges,78% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,221,
Troponin-I,30184484,CDM,301,RC,84484,HCPCS,Outpatient,,,214,139.10,,188.32,88,,,percent of total billed charges,88% of total Billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,214,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,134.82,63,,,percent of total billed charges,63% of total billed charges,21.82,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,32.74,15.3,,,percent of total billed charges,15.3% of total billed charges,147.66,69,,,percent of total billed charges,69% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,47.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,72.55,33.9,,,percent of total billed charges,33.9% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,166.92,78,,,percent of total billed charges,78% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,214,
Troponin- I Biosite,30184484,CDM,301,RC,84484,HCPCS,Outpatient,,,275,178.75,,242,88,,,percent of total billed charges,88% of total Billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,275,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,173.25,63,,,percent of total billed charges,63% of total billed charges,21.82,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,42.08,15.3,,,percent of total billed charges,15.3% of total billed charges,189.75,69,,,percent of total billed charges,69% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,275,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,275,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,47.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,93.23,33.9,,,percent of total billed charges,33.9% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,214.5,78,,,percent of total billed charges,78% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,275,
Tryptase LC,30183520,CDM,301,RC,83520,HCPCS,Outpatient,,,106,68.90,,93.28,88,,,percent of total billed charges,88% of total Billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,106,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.22,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,16.22,15.3,,,percent of total billed charges,15.3% of total billed charges,73.14,69,,,percent of total billed charges,69% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,66.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,35.93,33.9,,,percent of total billed charges,33.9% of total billed charges,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,82.68,78,,,percent of total billed charges,78% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,106,
Albumin Level Urine,30082040,CDM,300,RC,82040,HCPCS,Outpatient,,,128,83.20,,112.64,88,,,percent of total billed charges,88% of total Billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,128,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,80.64,63,,,percent of total billed charges,63% of total billed charges,8.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,18.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,43.39,33.9,,,percent of total billed charges,33.9% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.95,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,128,
Amylase Urine,30182150,CDM,301,RC,82150,HCPCS,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,18.9,63,,,percent of total billed charges,63% of total billed charges,11.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,24.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,10.17,33.9,,,percent of total billed charges,33.9% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,30,
CALCIUM RANDOM URINE,30182340,CDM,301,RC,82340,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,23.31,63,,,percent of total billed charges,63% of total billed charges,10.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,23.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,12.54,33.9,,,percent of total billed charges,33.9% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,6.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,37,
CHLORIDE RANDOM URINE,30182436,CDM,301,RC,82436,HCPCS,Outpatient,,,82,53.30,,72.16,88,,,percent of total billed charges,88% of total Billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,82,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,51.66,63,,,percent of total billed charges,63% of total billed charges,10.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.55,15.3,,,percent of total billed charges,15.3% of total billed charges,56.58,69,,,percent of total billed charges,69% of total billed charges,82,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,82,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,82,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,21.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,30.91,37.7,,,percent of total billed charges,37.70% of total billed charges,30.91,37.7,,,percent of total billed charges,37.70% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,27.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,63.96,78,,,percent of total billed charges,78% of total billed charges,82,100,,,percent of total billed charges,100% of total billed charges,67.73,82.6,,,percent of total billed charges,82.6% of total billed charges,67.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,5.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,82,
Creatinine Urine,30182570,CDM,301,RC,82570,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,74,
U Dipstick Cotinine (Nicotine) POCT,30080305,CDM,300,RC,80305,HCPCS,Outpatient,,,66,42.90,QW,58.08,88,,,percent of total billed charges,88% of total Billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,11.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,66,100,,,percent of total billed charges,100% of total billed charges,11.42,17.304,,,percent of total billed charges,17.304% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,41.58,63,,,percent of total billed charges,63% of total billed charges,22.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,10.1,15.3,,,percent of total billed charges,15.3% of total billed charges,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,48.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,11.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,11.31,17.136,,,percent of total billed charges,17.136% of total billed charges,14.41,21.84,,,percent of total billed charges,21.84% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,22.37,33.9,,,percent of total billed charges,33.9% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,12.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,10.1,66,
Urine Drug Screen,30180306,CDM,301,RC,80306,HCPCS,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,22.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,22.84,17.304,,,percent of total billed charges,17.304% of total billed charges,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,83.16,63,,,percent of total billed charges,63% of total billed charges,29.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,65.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,22.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,22.62,17.136,,,percent of total billed charges,17.136% of total billed charges,28.83,21.84,,,percent of total billed charges,21.84% of total billed charges,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,44.75,33.9,,,percent of total billed charges,33.9% of total billed charges,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,17.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.14,100,,,Fee Schedule,100% of Medicare OPPS rate,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,132,
Glucose Urine,30082945,CDM,300,RC,82945,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,75,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,47.25,63,,,percent of total billed charges,63% of total billed charges,6.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,15.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,25.43,33.9,,,percent of total billed charges,33.9% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,75,
Microalbumin/Creatinine Ratio Urine,30182043,CDM,301,RC,82043,HCPCS,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,104,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,65.52,63,,,percent of total billed charges,63% of total billed charges,10.11,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,15.91,15.3,,,percent of total billed charges,15.3% of total billed charges,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,104,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,22.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,35.26,33.9,,,percent of total billed charges,33.9% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,5.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.78,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,104,
Protein/Creatinine Ratio Urine,30184156,CDM,301,RC,84156,HCPCS,Outpatient,,,414,269.10,,364.32,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,414,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,260.82,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,63.34,15.3,,,percent of total billed charges,15.3% of total billed charges,285.66,69,,,percent of total billed charges,69% of total billed charges,414,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,414,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,414,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,156.08,37.7,,,percent of total billed charges,37.70% of total billed charges,156.08,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,140.35,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,322.92,78,,,percent of total billed charges,78% of total billed charges,414,100,,,percent of total billed charges,100% of total billed charges,341.96,82.6,,,percent of total billed charges,82.6% of total billed charges,341.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,414,
Protein Urine,30184156,CDM,301,RC,84156,HCPCS,Outpatient,,,414,269.10,,364.32,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,414,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,260.82,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,63.34,15.3,,,percent of total billed charges,15.3% of total billed charges,285.66,69,,,percent of total billed charges,69% of total billed charges,414,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,414,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,414,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,156.08,37.7,,,percent of total billed charges,37.70% of total billed charges,156.08,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,140.35,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,322.92,78,,,percent of total billed charges,78% of total billed charges,414,100,,,percent of total billed charges,100% of total billed charges,341.96,82.6,,,percent of total billed charges,82.6% of total billed charges,341.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,414,
Urine Pregnancy Test Qualitative,30081025,CDM,300,RC,81025,HCPCS,Outpatient,,,124,80.60,,109.12,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,124,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,78.12,63,,,percent of total billed charges,63% of total billed charges,15.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,18.97,15.3,,,percent of total billed charges,15.3% of total billed charges,85.56,69,,,percent of total billed charges,69% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,124,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,124,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,42.04,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,96.72,78,,,percent of total billed charges,78% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,124,
CALCIUM 24HR URINE,30182340,CDM,301,RC,82340,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,23.31,63,,,percent of total billed charges,63% of total billed charges,10.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,23.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,12.54,33.9,,,percent of total billed charges,33.9% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,6.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.03,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,37,
Protein 24 Hr Urine,30184156,CDM,301,RC,84156,HCPCS,Outpatient,,,414,269.10,,364.32,88,,,percent of total billed charges,88% of total Billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,414,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,260.82,63,,,percent of total billed charges,63% of total billed charges,6.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,63.34,15.3,,,percent of total billed charges,15.3% of total billed charges,285.66,69,,,percent of total billed charges,69% of total billed charges,414,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,414,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,414,100,,,percent of total billed charges,100% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,14.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,156.08,37.7,,,percent of total billed charges,37.70% of total billed charges,156.08,37.7,,,percent of total billed charges,37.70% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,140.35,33.9,,,percent of total billed charges,33.9% of total billed charges,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,322.92,78,,,percent of total billed charges,78% of total billed charges,414,100,,,percent of total billed charges,100% of total billed charges,341.96,82.6,,,percent of total billed charges,82.6% of total billed charges,341.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,414,
Creatinine 24 Hr Urine,30182570,CDM,301,RC,82570,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,46.62,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,74,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,74,
Amylase 24 Hr Urine,30182150,CDM,301,RC,82150,HCPCS,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,18.9,63,,,percent of total billed charges,63% of total billed charges,11.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,24.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,10.17,33.9,,,percent of total billed charges,33.9% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,30,
Glucose Level 24 hour Urine,30082947,CDM,300,RC,82947,HCPCS,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,13,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,8.19,63,,,percent of total billed charges,63% of total billed charges,6.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,13,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,13,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,15.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.9,37.7,,,percent of total billed charges,37.70% of total billed charges,4.9,37.7,,,percent of total billed charges,37.70% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.41,33.9,,,percent of total billed charges,33.9% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,3.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.93,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.99,15.03,
UA Complete w/ Culture if Indicated,30781003,CDM,307,RC,81003,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,3.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,40,
UA Microscopic,30781015,CDM,307,RC,81015,HCPCS,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,31,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19.53,63,,,percent of total billed charges,63% of total billed charges,5.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.66,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,10.51,33.9,,,percent of total billed charges,33.9% of total billed charges,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,31,
URINALYSIS AUTO W/MICRO,30781001,CDM,307,RC,81001,HCPCS,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,55,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,34.65,63,,,percent of total billed charges,63% of total billed charges,5.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,55,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,55,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,12.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,18.65,33.9,,,percent of total billed charges,33.9% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,55,
UA w/ Microscopic if Indicated,30781003,CDM,307,RC,81003,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,3.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,40,
UA  w/ Microscopic,30781003,CDM,307,RC,81003,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,3.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,40,
UA w/ Micro if Indicated  Culture if Indicated,30781003,CDM,307,RC,81003,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,3.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,40,
"Urinalysis, Routine RLC",30781003,CDM,307,RC,81003,HCPCS,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,2,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1.26,63,,,percent of total billed charges,63% of total billed charges,3.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,0.75,37.7,,,percent of total billed charges,37.70% of total billed charges,0.75,37.7,,,percent of total billed charges,37.70% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,0.68,33.9,,,percent of total billed charges,33.9% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.31,8.6,
UREA NITROGEN 24HR URINE,30184540,CDM,301,RC,84540,HCPCS,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,63,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,39.69,63,,,percent of total billed charges,63% of total billed charges,9.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,63,100,,,percent of total billed charges,100% of total billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,63,100,,,percent of total billed charges,100% of total billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,21.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,21.36,33.9,,,percent of total billed charges,33.9% of total billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,63,
UREA NITROGEN URINE,30184540,CDM,301,RC,84540,HCPCS,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,63,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,39.69,63,,,percent of total billed charges,63% of total billed charges,9.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,63,100,,,percent of total billed charges,100% of total billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,63,100,,,percent of total billed charges,100% of total billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,21.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,21.36,33.9,,,percent of total billed charges,33.9% of total billed charges,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.56,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,63,
Ureaplasma urealyticum AVR,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Uric Acid,30184550,CDM,301,RC,84550,HCPCS,Outpatient,,,79,51.35,,69.52,88,,,percent of total billed charges,88% of total Billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,79,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,49.77,63,,,percent of total billed charges,63% of total billed charges,7.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,12.09,15.3,,,percent of total billed charges,15.3% of total billed charges,54.51,69,,,percent of total billed charges,69% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,79,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,79,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,17.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,29.78,37.7,,,percent of total billed charges,37.70% of total billed charges,29.78,37.7,,,percent of total billed charges,37.70% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,26.78,33.9,,,percent of total billed charges,33.9% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,61.62,78,,,percent of total billed charges,78% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,79,
"URIC ACID, URINE",30184560,CDM,301,RC,84560,HCPCS,Outpatient,,,358,232.70,,315.04,88,,,percent of total billed charges,88% of total Billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,225.54,63,,,percent of total billed charges,63% of total billed charges,8.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,54.77,15.3,,,percent of total billed charges,15.3% of total billed charges,247.02,69,,,percent of total billed charges,69% of total billed charges,358,100,,,percent of total billed charges,100% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,358,100,,,percent of total billed charges,100% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,358,100,,,percent of total billed charges,100% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,19.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,134.97,37.7,,,percent of total billed charges,37.70% of total billed charges,134.97,37.7,,,percent of total billed charges,37.70% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,121.36,33.9,,,percent of total billed charges,33.9% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,279.24,78,,,percent of total billed charges,78% of total billed charges,358,100,,,percent of total billed charges,100% of total billed charges,295.71,82.6,,,percent of total billed charges,82.6% of total billed charges,295.71,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,358,
URIC ACID 24HR URINE,30184560,CDM,301,RC,84560,HCPCS,Outpatient,,,358,232.70,,315.04,88,,,percent of total billed charges,88% of total Billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,225.54,63,,,percent of total billed charges,63% of total billed charges,8.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,54.77,15.3,,,percent of total billed charges,15.3% of total billed charges,247.02,69,,,percent of total billed charges,69% of total billed charges,358,100,,,percent of total billed charges,100% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,358,100,,,percent of total billed charges,100% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,358,100,,,percent of total billed charges,100% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,19.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,134.97,37.7,,,percent of total billed charges,37.70% of total billed charges,134.97,37.7,,,percent of total billed charges,37.70% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,121.36,33.9,,,percent of total billed charges,33.9% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,279.24,78,,,percent of total billed charges,78% of total billed charges,358,100,,,percent of total billed charges,100% of total billed charges,295.71,82.6,,,percent of total billed charges,82.6% of total billed charges,295.71,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,358,
Uric A+ANA w/Rflx+RA Qn+CRP... LC,30286038,CDM,302,RC,86038,HCPCS,Outpatient,,,66,42.90,,58.08,88,,,percent of total billed charges,88% of total Billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,66,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,41.58,63,,,percent of total billed charges,63% of total billed charges,21.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,10.1,15.3,,,percent of total billed charges,15.3% of total billed charges,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,46.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,22.37,33.9,,,percent of total billed charges,33.9% of total billed charges,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,12.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.09,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,66,
"Uric Acid, Body Fluid LC",30184560,CDM,301,RC,84560,HCPCS,Outpatient,,,15.24,9.91,,13.41,88,,,percent of total billed charges,88% of total Billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,15.24,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,9.6,63,,,percent of total billed charges,63% of total billed charges,8.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,2.33,15.3,,,percent of total billed charges,15.3% of total billed charges,10.52,69,,,percent of total billed charges,69% of total billed charges,15.24,100,,,percent of total billed charges,100% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,15.24,100,,,percent of total billed charges,100% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,15.24,100,,,percent of total billed charges,100% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,19.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.75,37.7,,,percent of total billed charges,37.70% of total billed charges,5.75,37.7,,,percent of total billed charges,37.70% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.17,33.9,,,percent of total billed charges,33.9% of total billed charges,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,11.89,78,,,percent of total billed charges,78% of total billed charges,15.24,100,,,percent of total billed charges,100% of total billed charges,12.59,82.6,,,percent of total billed charges,82.6% of total billed charges,12.59,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.33,19.43,
Urinalysis Dipstick,30781003,CDM,307,RC,81003,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,3.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,40,
EOSINOPHILS URINE,30089190,CDM,300,RC,89190,HCPCS,Outpatient,,,64,41.60,,56.32,88,,,percent of total billed charges,88% of total Billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,64,100,,,percent of total billed charges,100% of total billed charges,8.91,103,,,Fee Schedule,103% of WA Medicaid,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,40.32,63,,,percent of total billed charges,63% of total billed charges,10.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,9.79,15.3,,,percent of total billed charges,15.3% of total billed charges,44.16,69,,,percent of total billed charges,69% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,64,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,64,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,22.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,6.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.24,130,,,Fee Schedule,130% of WA Medicaid ,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,24.13,37.7,,,percent of total billed charges,37.70% of total billed charges,24.13,37.7,,,percent of total billed charges,37.70% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,21.7,33.9,,,percent of total billed charges,33.9% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,78,,,percent of total billed charges,78% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,5.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.79,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.79,64,
Urine Cytology LC,31188112,CDM,311,RC,88112,HCPCS,Outpatient,,,203,131.95,,178.64,88,,,percent of total billed charges,88% of total Billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid,203,100,,,percent of total billed charges,100% of total billed charges,26.78,103,,,Fee Schedule,103% of WA Medicaid,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,127.89,63,,,percent of total billed charges,63% of total billed charges,96.72,175,,,Fee Schedule,175% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid,31.06,15.3,,,percent of total billed charges,15.3% of total billed charges,140.07,69,,,percent of total billed charges,69% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,203,100,,,percent of total billed charges,100% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,202.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,19.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.8,130,,,Fee Schedule,130% of WA Medicaid ,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,68.82,33.9,,,percent of total billed charges,33.9% of total billed charges,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,158.34,78,,,percent of total billed charges,78% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,55.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.26,100,,,Fee Schedule,100% of Medicare OPPS rate,26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.26,203,
Urine Fentanyl Screen,30180307,CDM,301,RC,80307,HCPCS,Outpatient,,,277,180.05,,243.76,88,,,percent of total billed charges,88% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,46.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,277,100,,,percent of total billed charges,100% of total billed charges,47.93,17.304,,,percent of total billed charges,17.304% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,174.51,63,,,percent of total billed charges,63% of total billed charges,108.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.54,16.8,,,percent of total billed charges,16.8% of total billed charges,42.38,15.3,,,percent of total billed charges,15.3% of total billed charges,191.13,69,,,percent of total billed charges,69% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,277,100,,,percent of total billed charges,100% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,237.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.54,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,46.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,47.47,17.136,,,percent of total billed charges,17.136% of total billed charges,60.5,21.84,,,percent of total billed charges,21.84% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,93.9,33.9,,,percent of total billed charges,33.9% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,216.06,78,,,percent of total billed charges,78% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,46.54,16.8,,,percent of total billed charges,16.8% of total billed charges,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,62.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.14,100,,,Fee Schedule,100% of Medicare OPPS rate,46.54,16.8,,,percent of total billed charges,16.8% of total billed charges,42.38,277,
Blood Gas Venous,30082803,CDM,300,RC,82803,HCPCS,Outpatient,,,408,265.20,,359.04,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,408,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,257.04,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,62.42,15.3,,,percent of total billed charges,15.3% of total billed charges,281.52,69,,,percent of total billed charges,69% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,138.31,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,318.24,78,,,percent of total billed charges,78% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,408,
Blood Gas Venous RT,30082803,CDM,300,RC,82803,HCPCS,Outpatient,,,408,265.20,,359.04,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,408,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,257.04,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,62.42,15.3,,,percent of total billed charges,15.3% of total billed charges,281.52,69,,,percent of total billed charges,69% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,138.31,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,318.24,78,,,percent of total billed charges,78% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,408,
"VDRL, CSF LC",30286592,CDM,302,RC,86592,HCPCS,Outpatient,,,356,231.40,,313.28,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,356,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,224.28,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,54.47,15.3,,,percent of total billed charges,15.3% of total billed charges,245.64,69,,,percent of total billed charges,69% of total billed charges,356,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,356,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,356,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,37.7,,,percent of total billed charges,37.70% of total billed charges,134.21,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,120.68,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,277.68,78,,,percent of total billed charges,78% of total billed charges,356,100,,,percent of total billed charges,100% of total billed charges,294.06,82.6,,,percent of total billed charges,82.6% of total billed charges,294.06,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,356,
"VIP, P LC",30184586,CDM,301,RC,84586,HCPCS,Outpatient,,,407,264.55,,358.16,88,,,percent of total billed charges,88% of total Billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,407,100,,,percent of total billed charges,100% of total billed charges,30.04,103,,,Fee Schedule,103% of WA Medicaid,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,256.41,63,,,percent of total billed charges,63% of total billed charges,61.82,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid,62.27,15.3,,,percent of total billed charges,15.3% of total billed charges,280.83,69,,,percent of total billed charges,69% of total billed charges,407,100,,,percent of total billed charges,100% of total billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,407,100,,,percent of total billed charges,100% of total billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,407,100,,,percent of total billed charges,100% of total billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,21.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,29.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.91,130,,,Fee Schedule,130% of WA Medicaid ,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,153.44,37.7,,,percent of total billed charges,37.70% of total billed charges,153.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,137.97,33.9,,,percent of total billed charges,33.9% of total billed charges,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,317.46,78,,,percent of total billed charges,78% of total billed charges,407,100,,,percent of total billed charges,100% of total billed charges,336.18,82.6,,,percent of total billed charges,82.6% of total billed charges,336.18,82.6,,,percent of total billed charges,82.6% of total billed charges,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,35.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.33,100,,,Fee Schedule,100% of Medicare OPPS rate,29.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.6,407,
"Vaginitis/Vaginosis, DNA Probe LC 180026",30687480,CDM,306,RC,87480,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,35.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,93,100,,,percent of total billed charges,100% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,76.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,31.53,33.9,,,percent of total billed charges,33.9% of total billed charges,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,20.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,93,
"Vaginitis Plus w/Candida, NuSwab LC",30687801,CDM,306,RC,87801,HCPCS,Outpatient,,,286,185.90,,251.68,88,,,percent of total billed charges,88% of total Billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,286,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,180.18,63,,,percent of total billed charges,63% of total billed charges,122.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,43.76,15.3,,,percent of total billed charges,15.3% of total billed charges,197.34,69,,,percent of total billed charges,69% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,286,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,286,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,268.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,107.82,37.7,,,percent of total billed charges,37.70% of total billed charges,107.82,37.7,,,percent of total billed charges,37.70% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,96.95,33.9,,,percent of total billed charges,33.9% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,223.08,78,,,percent of total billed charges,78% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,286,
"Vaginitis Plus (VG+), NuSwab",30687801,CDM,306,RC,87801,HCPCS,Outpatient,,,173,112.45,,152.24,88,,,percent of total billed charges,88% of total Billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,173,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,108.99,63,,,percent of total billed charges,63% of total billed charges,122.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,26.47,15.3,,,percent of total billed charges,15.3% of total billed charges,119.37,69,,,percent of total billed charges,69% of total billed charges,173,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,173,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,173,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,268.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,65.22,37.7,,,percent of total billed charges,37.70% of total billed charges,65.22,37.7,,,percent of total billed charges,37.70% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,58.65,33.9,,,percent of total billed charges,33.9% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,134.94,78,,,percent of total billed charges,78% of total billed charges,173,100,,,percent of total billed charges,100% of total billed charges,142.9,82.6,,,percent of total billed charges,82.6% of total billed charges,142.9,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,70.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,70.2,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,268.51,
Vaginosis/Vaginitis Panel AVR,30687511,CDM,306,RC,87511,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Vaginosis/Vaginitis Extended Panel AVR,30687491,CDM,306,RC,87491,HCPCS,Outpatient,,,89.49,58.17,,78.75,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,89.49,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,56.38,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,13.69,15.3,,,percent of total billed charges,15.3% of total billed charges,61.75,69,,,percent of total billed charges,69% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,89.49,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,33.74,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.34,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,69.8,78,,,percent of total billed charges,78% of total billed charges,89.49,100,,,percent of total billed charges,100% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.69,134.21,
Valproic Acid Total,30180164,CDM,301,RC,80164,HCPCS,Outpatient,,,179,116.35,,157.52,88,,,percent of total billed charges,88% of total Billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,179,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,112.77,63,,,percent of total billed charges,63% of total billed charges,23.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,27.39,15.3,,,percent of total billed charges,15.3% of total billed charges,123.51,69,,,percent of total billed charges,69% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,179,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,51.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,60.68,33.9,,,percent of total billed charges,33.9% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,139.62,78,,,percent of total billed charges,78% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,179,
Vancomycin,30180202,CDM,301,RC,80202,HCPCS,Outpatient,,,190,123.50,,167.2,88,,,percent of total billed charges,88% of total Billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,119.7,63,,,percent of total billed charges,63% of total billed charges,23.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,29.07,15.3,,,percent of total billed charges,15.3% of total billed charges,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,51.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,64.41,33.9,,,percent of total billed charges,33.9% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,190,
Vancomycin Peak,30180202,CDM,301,RC,80202,HCPCS,Outpatient,,,190,123.50,,167.2,88,,,percent of total billed charges,88% of total Billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,119.7,63,,,percent of total billed charges,63% of total billed charges,23.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,29.07,15.3,,,percent of total billed charges,15.3% of total billed charges,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,51.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,64.41,33.9,,,percent of total billed charges,33.9% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,190,
Vancomycin Trough,30180202,CDM,301,RC,80202,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,153.72,63,,,percent of total billed charges,63% of total billed charges,23.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,37.33,15.3,,,percent of total billed charges,15.3% of total billed charges,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,51.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,82.72,33.9,,,percent of total billed charges,33.9% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,244,
Vancomycin Lvl Trough AUC,30180202,CDM,301,RC,80202,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,153.72,63,,,percent of total billed charges,63% of total billed charges,23.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,37.33,15.3,,,percent of total billed charges,15.3% of total billed charges,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,51.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,82.72,33.9,,,percent of total billed charges,33.9% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,244,
Vancomycin Lvl Peak AUC,30180202,CDM,301,RC,80202,HCPCS,Outpatient,,,190,123.50,,167.2,88,,,percent of total billed charges,88% of total Billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,119.7,63,,,percent of total billed charges,63% of total billed charges,23.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,29.07,15.3,,,percent of total billed charges,15.3% of total billed charges,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,51.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,64.41,33.9,,,percent of total billed charges,33.9% of total billed charges,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,13.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,190,
"Vanillylmandelic Acid, U24 LC",30184585,CDM,301,RC,84585,HCPCS,Outpatient,,,317,206.05,,278.96,88,,,percent of total billed charges,88% of total Billed charges,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,317,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,199.71,63,,,percent of total billed charges,63% of total billed charges,27.12,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,48.5,15.3,,,percent of total billed charges,15.3% of total billed charges,218.73,69,,,percent of total billed charges,69% of total billed charges,317,100,,,percent of total billed charges,100% of total billed charges,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,317,100,,,percent of total billed charges,100% of total billed charges,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,317,100,,,percent of total billed charges,100% of total billed charges,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,59.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,119.51,37.7,,,percent of total billed charges,37.70% of total billed charges,119.51,37.7,,,percent of total billed charges,37.70% of total billed charges,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,107.46,33.9,,,percent of total billed charges,33.9% of total billed charges,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,247.26,78,,,percent of total billed charges,78% of total billed charges,317,100,,,percent of total billed charges,100% of total billed charges,261.84,82.6,,,percent of total billed charges,82.6% of total billed charges,261.84,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,15.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.5,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,317,
"Varicella Zoster Abs, IgG/IgM LC",30286787,CDM,302,RC,86787,HCPCS,Outpatient,,,276,179.40,,242.88,88,,,percent of total billed charges,88% of total Billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,276,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,173.88,63,,,percent of total billed charges,63% of total billed charges,22.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,42.23,15.3,,,percent of total billed charges,15.3% of total billed charges,190.44,69,,,percent of total billed charges,69% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,276,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,276,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,49.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,104.05,37.7,,,percent of total billed charges,37.70% of total billed charges,104.05,37.7,,,percent of total billed charges,37.70% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,93.56,33.9,,,percent of total billed charges,33.9% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,215.28,78,,,percent of total billed charges,78% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,276,
"Varicella-Zoster V Ab, IgG LC",30286787,CDM,302,RC,86787,HCPCS,Outpatient,,,291,189.15,,256.08,88,,,percent of total billed charges,88% of total Billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,291,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,183.33,63,,,percent of total billed charges,63% of total billed charges,22.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,44.52,15.3,,,percent of total billed charges,15.3% of total billed charges,200.79,69,,,percent of total billed charges,69% of total billed charges,291,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,291,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,291,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,49.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,109.71,37.7,,,percent of total billed charges,37.70% of total billed charges,109.71,37.7,,,percent of total billed charges,37.70% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,98.65,33.9,,,percent of total billed charges,33.9% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,226.98,78,,,percent of total billed charges,78% of total billed charges,291,100,,,percent of total billed charges,100% of total billed charges,240.37,82.6,,,percent of total billed charges,82.6% of total billed charges,240.37,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,291,
"Varicella-Zoster Ab, IgM LC",30286787,CDM,302,RC,86787,HCPCS,Outpatient,,,263,170.95,,231.44,88,,,percent of total billed charges,88% of total Billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,263,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,165.69,63,,,percent of total billed charges,63% of total billed charges,22.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,40.24,15.3,,,percent of total billed charges,15.3% of total billed charges,181.47,69,,,percent of total billed charges,69% of total billed charges,263,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,263,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,263,100,,,percent of total billed charges,100% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,49.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,99.15,37.7,,,percent of total billed charges,37.70% of total billed charges,99.15,37.7,,,percent of total billed charges,37.70% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,89.16,33.9,,,percent of total billed charges,33.9% of total billed charges,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,205.14,78,,,percent of total billed charges,78% of total billed charges,263,100,,,percent of total billed charges,100% of total billed charges,217.24,82.6,,,percent of total billed charges,82.6% of total billed charges,217.24,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,13,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.88,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,263,
Vectra LC,30081490,CDM,300,RC,81490,HCPCS,Outpatient,,,989,642.85,,870.32,88,,,percent of total billed charges,88% of total Billed charges,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,989,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,623.07,63,,,percent of total billed charges,63% of total billed charges,1471.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,,,,,Other,"Not Separately reimbursable
",151.32,15.3,,,percent of total billed charges,15.3% of total billed charges,682.41,69,,,percent of total billed charges,69% of total billed charges,989,100,,,percent of total billed charges,100% of total billed charges,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,989,100,,,percent of total billed charges,100% of total billed charges,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,989,100,,,percent of total billed charges,100% of total billed charges,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3215.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,,,,,Other,Not Separately reimbursable,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,372.85,37.7,,,percent of total billed charges,37.70% of total billed charges,372.85,37.7,,,percent of total billed charges,37.70% of total billed charges,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,335.27,33.9,,,percent of total billed charges,33.9% of total billed charges,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,771.42,78,,,percent of total billed charges,78% of total billed charges,989,100,,,percent of total billed charges,100% of total billed charges,816.91,82.6,,,percent of total billed charges,82.6% of total billed charges,816.91,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,849.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,840.65,100,,,Fee Schedule,100% of Medicare OPPS rate,166.15,16.8,,,percent of total billed charges,16.8% of total billed charges,151.32,3215.48,
Venipuncture Routine,30036415,CDM,300,RC,36415,HCPCS,Outpatient,,,96,62.40,,,,,,Other,Not Separately reimbursable,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.1,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,2.16,103,,,Fee Schedule,103% of WA Medicaid,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,15.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.1,100,,,Fee Schedule,100% of WA Medicaid,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,96,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,11.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,1.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2.73,130,,,Fee Schedule,130% of WA Medicaid ,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,32.54,33.9,,,percent of total billed charges,33.9% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.55,96,
CULTURE VIRUS,30687252,CDM,306,RC,87252,HCPCS,Outpatient,,,116,75.40,,102.08,88,,,percent of total billed charges,88% of total Billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,116,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,73.08,63,,,percent of total billed charges,63% of total billed charges,45.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,17.75,15.3,,,percent of total billed charges,15.3% of total billed charges,80.04,69,,,percent of total billed charges,69% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,116,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,116,100,,,percent of total billed charges,100% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,99.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,39.32,33.9,,,percent of total billed charges,33.9% of total billed charges,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,90.48,78,,,percent of total billed charges,78% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,26.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,26.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,116,
Hepatitis B core antibody (HBcAb) total; Screen LC,30286704,CDM,302,RC,86704,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,113.4,63,,,percent of total billed charges,63% of total billed charges,21.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,46.09,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,61.02,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,180,
RSV AG DFA,30687280,CDM,306,RC,87280,HCPCS,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,55,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,34.65,63,,,percent of total billed charges,63% of total billed charges,23.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,55,100,,,percent of total billed charges,100% of total billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,55,100,,,percent of total billed charges,100% of total billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,51.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,18.65,33.9,,,percent of total billed charges,33.9% of total billed charges,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,13.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.42,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,55,
Vitamin B12,30182607,CDM,301,RC,82607,HCPCS,Outpatient,,,273,177.45,,240.24,88,,,percent of total billed charges,88% of total Billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,273,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,171.99,63,,,percent of total billed charges,63% of total billed charges,26.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,41.77,15.3,,,percent of total billed charges,15.3% of total billed charges,188.37,69,,,percent of total billed charges,69% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,273,100,,,percent of total billed charges,100% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,57.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,92.55,33.9,,,percent of total billed charges,33.9% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,212.94,78,,,percent of total billed charges,78% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,15.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,273,
Vitamin D 25 Hydroxy,30182306,CDM,301,RC,82306,HCPCS,Outpatient,,,187,121.55,,164.56,88,,,percent of total billed charges,88% of total Billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,187,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,117.81,63,,,percent of total billed charges,63% of total billed charges,51.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,28.61,15.3,,,percent of total billed charges,15.3% of total billed charges,129.03,69,,,percent of total billed charges,69% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,187,100,,,percent of total billed charges,100% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,187,100,,,percent of total billed charges,100% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,113.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,70.5,37.7,,,percent of total billed charges,37.70% of total billed charges,70.5,37.7,,,percent of total billed charges,37.70% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,63.39,33.9,,,percent of total billed charges,33.9% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,145.86,78,,,percent of total billed charges,78% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,187,
"Vitamin B6, P LC",30184207,CDM,301,RC,84207,HCPCS,Outpatient,,,418,271.70,,367.84,88,,,percent of total billed charges,88% of total Billed charges,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,418,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,263.34,63,,,percent of total billed charges,63% of total billed charges,49.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,63.95,15.3,,,percent of total billed charges,15.3% of total billed charges,288.42,69,,,percent of total billed charges,69% of total billed charges,418,100,,,percent of total billed charges,100% of total billed charges,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,418,100,,,percent of total billed charges,100% of total billed charges,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,418,100,,,percent of total billed charges,100% of total billed charges,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,107.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,157.59,37.7,,,percent of total billed charges,37.70% of total billed charges,157.59,37.7,,,percent of total billed charges,37.70% of total billed charges,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,141.7,33.9,,,percent of total billed charges,33.9% of total billed charges,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,326.04,78,,,percent of total billed charges,78% of total billed charges,418,100,,,percent of total billed charges,100% of total billed charges,345.27,82.6,,,percent of total billed charges,82.6% of total billed charges,345.27,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,28.38,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,28.1,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,418,
Vitamin A LC,30184590,CDM,301,RC,84590,HCPCS,Outpatient,,,247,160.55,,217.36,88,,,percent of total billed charges,88% of total Billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,247,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,155.61,63,,,percent of total billed charges,63% of total billed charges,20.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,37.79,15.3,,,percent of total billed charges,15.3% of total billed charges,170.43,69,,,percent of total billed charges,69% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,83.73,33.9,,,percent of total billed charges,33.9% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,192.66,78,,,percent of total billed charges,78% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.61,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,247,
Vitamin E LC,30184446,CDM,301,RC,84446,HCPCS,Outpatient,,,253,164.45,,222.64,88,,,percent of total billed charges,88% of total Billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,159.39,63,,,percent of total billed charges,63% of total billed charges,24.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,54.23,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,253,
"Vitamin D, 25-Hydroxy LC",30182306,CDM,301,RC,82306,HCPCS,Outpatient,,,758,492.70,,667.04,88,,,percent of total billed charges,88% of total Billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,758,100,,,percent of total billed charges,100% of total billed charges,29.67,103,,,Fee Schedule,103% of WA Medicaid,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,477.54,63,,,percent of total billed charges,63% of total billed charges,51.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid,115.97,15.3,,,percent of total billed charges,15.3% of total billed charges,523.02,69,,,percent of total billed charges,69% of total billed charges,758,100,,,percent of total billed charges,100% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,758,100,,,percent of total billed charges,100% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,758,100,,,percent of total billed charges,100% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,113.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,21.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.44,130,,,Fee Schedule,130% of WA Medicaid ,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,285.77,37.7,,,percent of total billed charges,37.70% of total billed charges,285.77,37.7,,,percent of total billed charges,37.70% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,256.96,33.9,,,percent of total billed charges,33.9% of total billed charges,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,591.24,78,,,percent of total billed charges,78% of total billed charges,758,100,,,percent of total billed charges,100% of total billed charges,626.11,82.6,,,percent of total billed charges,82.6% of total billed charges,626.11,82.6,,,percent of total billed charges,82.6% of total billed charges,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.6,100,,,Fee Schedule,100% of Medicare OPPS rate,28.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.33,758,
"Vitamin B1 (Thiamine), Blood LC",30084425,CDM,300,RC,84425,HCPCS,Outpatient,,,416,270.40,,366.08,88,,,percent of total billed charges,88% of total Billed charges,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,416,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,262.08,63,,,percent of total billed charges,63% of total billed charges,37.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,63.65,15.3,,,percent of total billed charges,15.3% of total billed charges,287.04,69,,,percent of total billed charges,69% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,416,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,416,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,81.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,141.02,33.9,,,percent of total billed charges,33.9% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,324.48,78,,,percent of total billed charges,78% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,21.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.23,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,416,
VITAMIN K,30184597,CDM,301,RC,84597,HCPCS,Outpatient,,,253,164.45,,222.64,88,,,percent of total billed charges,88% of total Billed charges,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,159.39,63,,,percent of total billed charges,63% of total billed charges,24.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,52.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,13.85,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.72,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,253,
"Vitamin B2, Whole Blood",30184252,CDM,301,RC,84252,HCPCS,Outpatient,,,137,89.05,,120.56,88,,,percent of total billed charges,88% of total Billed charges,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,137,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,86.31,63,,,percent of total billed charges,63% of total billed charges,35.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,20.96,15.3,,,percent of total billed charges,15.3% of total billed charges,94.53,69,,,percent of total billed charges,69% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,137,100,,,percent of total billed charges,100% of total billed charges,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,137,100,,,percent of total billed charges,100% of total billed charges,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,77.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,46.44,33.9,,,percent of total billed charges,33.9% of total billed charges,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,106.86,78,,,percent of total billed charges,78% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,20.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.23,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,137,
Vitamin B12 LC,30182607,CDM,301,RC,82607,HCPCS,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,17,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,10.71,63,,,percent of total billed charges,63% of total billed charges,26.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,17,100,,,percent of total billed charges,100% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,17,100,,,percent of total billed charges,100% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,57.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.41,37.7,,,percent of total billed charges,37.70% of total billed charges,6.41,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,5.76,33.9,,,percent of total billed charges,33.9% of total billed charges,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,15.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.08,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.6,57.68,
Vitamin B3 (Niacin+Metabolite) LC,30184591,CDM,301,RC,84591,HCPCS,Outpatient,,,328,213.20,,288.64,88,,,percent of total billed charges,88% of total Billed charges,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,328,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,206.64,63,,,percent of total billed charges,63% of total billed charges,29.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,50.18,15.3,,,percent of total billed charges,15.3% of total billed charges,226.32,69,,,percent of total billed charges,69% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,328,100,,,percent of total billed charges,100% of total billed charges,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,328,100,,,percent of total billed charges,100% of total billed charges,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,65.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,123.66,37.7,,,percent of total billed charges,37.70% of total billed charges,123.66,37.7,,,percent of total billed charges,37.70% of total billed charges,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,111.19,33.9,,,percent of total billed charges,33.9% of total billed charges,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,255.84,78,,,percent of total billed charges,78% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,17.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.05,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,328,
vWF Multimers LC,30585247,CDM,305,RC,85247,HCPCS,Outpatient,,,711.72,462.62,,626.31,88,,,percent of total billed charges,88% of total Billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.29,100,,,Fee Schedule,100% of WA Medicaid,711.72,100,,,percent of total billed charges,100% of total billed charges,16.78,103,,,Fee Schedule,103% of WA Medicaid,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,448.38,63,,,percent of total billed charges,63% of total billed charges,40.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,16.29,100,,,Fee Schedule,100% of WA Medicaid,108.89,15.3,,,percent of total billed charges,15.3% of total billed charges,491.09,69,,,percent of total billed charges,69% of total billed charges,711.72,100,,,percent of total billed charges,100% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,711.72,100,,,percent of total billed charges,100% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,711.72,100,,,percent of total billed charges,100% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,87.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,12.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.18,130,,,Fee Schedule,130% of WA Medicaid ,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,268.32,37.7,,,percent of total billed charges,37.70% of total billed charges,268.32,37.7,,,percent of total billed charges,37.70% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,241.27,33.9,,,percent of total billed charges,33.9% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,555.14,78,,,percent of total billed charges,78% of total billed charges,711.72,100,,,percent of total billed charges,100% of total billed charges,587.88,82.6,,,percent of total billed charges,82.6% of total billed charges,587.88,82.6,,,percent of total billed charges,82.6% of total billed charges,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,23.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.07,711.72,
"Voriconazole, Serum/Plasma LC",30180285,CDM,301,RC,80285,HCPCS,Outpatient,,,386.88,251.47,,340.45,88,,,percent of total billed charges,88% of total Billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,386.88,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,243.73,63,,,percent of total billed charges,63% of total billed charges,47.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,59.19,15.3,,,percent of total billed charges,15.3% of total billed charges,266.95,69,,,percent of total billed charges,69% of total billed charges,386.88,100,,,percent of total billed charges,100% of total billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,386.88,100,,,percent of total billed charges,100% of total billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,386.88,100,,,percent of total billed charges,100% of total billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,103.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,145.85,37.7,,,percent of total billed charges,37.70% of total billed charges,145.85,37.7,,,percent of total billed charges,37.70% of total billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,131.15,33.9,,,percent of total billed charges,33.9% of total billed charges,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,301.77,78,,,percent of total billed charges,78% of total billed charges,386.88,100,,,percent of total billed charges,100% of total billed charges,319.56,82.6,,,percent of total billed charges,82.6% of total billed charges,319.56,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,27.38,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,386.88,
Body Fluid Cell Count with Differential If Indicated,30989050,CDM,309,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
"West Nile Virus Antibody, CSF LC",30286788,CDM,302,RC,86788,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,29.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,64.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,17.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.85,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,146,
West Nile Virus Ab LC,30286789,CDM,302,RC,86789,HCPCS,Outpatient,,,153,99.45,,134.64,88,,,percent of total billed charges,88% of total Billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,153,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,96.39,63,,,percent of total billed charges,63% of total billed charges,25.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,23.41,15.3,,,percent of total billed charges,15.3% of total billed charges,105.57,69,,,percent of total billed charges,69% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,51.87,33.9,,,percent of total billed charges,33.9% of total billed charges,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,119.34,78,,,percent of total billed charges,78% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,153,
West Nile Virus RT PCR LC,30687798,CDM,306,RC,87798,HCPCS,Outpatient,,,405,263.25,,356.4,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,405,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,255.15,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,61.97,15.3,,,percent of total billed charges,15.3% of total billed charges,279.45,69,,,percent of total billed charges,69% of total billed charges,405,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,405,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,405,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,152.69,37.7,,,percent of total billed charges,37.70% of total billed charges,152.69,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,137.3,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,315.9,78,,,percent of total billed charges,78% of total billed charges,405,100,,,percent of total billed charges,100% of total billed charges,334.53,82.6,,,percent of total billed charges,82.6% of total billed charges,334.53,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,405,
WET PREP,30687210,CDM,306,RC,87210,HCPCS,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,59,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,37.17,63,,,percent of total billed charges,63% of total billed charges,10.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,9.03,15.3,,,percent of total billed charges,15.3% of total billed charges,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,59,100,,,percent of total billed charges,100% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,59,100,,,percent of total billed charges,100% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,22.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,22.24,37.7,,,percent of total billed charges,37.70% of total billed charges,22.24,37.7,,,percent of total billed charges,37.70% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,20,33.9,,,percent of total billed charges,33.9% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,5.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.82,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,59,
White Blood Cell Count (WBC),30085048,CDM,300,RC,85048,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,30.24,63,,,percent of total billed charges,63% of total billed charges,4.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.54,48,
"White Blood Cells (WBC), Stool LC",30989055,CDM,309,RC,89055,HCPCS,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,49,100,,,percent of total billed charges,100% of total billed charges,8.91,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,30.87,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,49,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,8.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.24,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.61,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,49,
"Yeast Only, Culture LC",30687101,CDM,306,RC,87101,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,75,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,47.25,63,,,percent of total billed charges,63% of total billed charges,13.49,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,75,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,29.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,25.43,33.9,,,percent of total billed charges,33.9% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,7.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,75,
"Zinc, Plasma or Serum LC",30184630,CDM,301,RC,84630,HCPCS,Outpatient,,,281,182.65,,247.28,88,,,percent of total billed charges,88% of total Billed charges,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,281,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,177.03,63,,,percent of total billed charges,63% of total billed charges,19.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,42.99,15.3,,,percent of total billed charges,15.3% of total billed charges,193.89,69,,,percent of total billed charges,69% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,281,100,,,percent of total billed charges,100% of total billed charges,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,281,100,,,percent of total billed charges,100% of total billed charges,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,43.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.85,130,,,Fee Schedule,130% of WA Medicaid ,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,105.94,37.7,,,percent of total billed charges,37.70% of total billed charges,105.94,37.7,,,percent of total billed charges,37.70% of total billed charges,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,95.26,33.9,,,percent of total billed charges,33.9% of total billed charges,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,219.18,78,,,percent of total billed charges,78% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,11.5,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.39,100,,,Fee Schedule,100% of Medicare OPPS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,281,
Zonisamide(Zonegran) LC,30180203,CDM,301,RC,80203,HCPCS,Outpatient,,,198,128.70,,174.24,88,,,percent of total billed charges,88% of total Billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,9.73,103,,,Fee Schedule,103% of WA Medicaid,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,63,,,percent of total billed charges,63% of total billed charges,23.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid,30.29,15.3,,,percent of total billed charges,15.3% of total billed charges,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,50.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.28,130,,,Fee Schedule,130% of WA Medicaid ,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,67.12,33.9,,,percent of total billed charges,33.9% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,13.38,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13.25,100,,,Fee Schedule,100% of Medicare OPPS rate,9.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7,198,
zaPTTMx+dRVVT+Hexago+PT+PT M... LC 236823,30085730,CDM,300,RC,85730,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,63,63,,,percent of total billed charges,63% of total billed charges,10.51,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,22.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,100,
dRVVT+PT+PT Mix+PTT LA+TTMx LC 241426,30585670,CDM,305,RC,85670,HCPCS,Outpatient,,,125,81.25,,110,88,,,percent of total billed charges,88% of total Billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,125,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,78.75,63,,,percent of total billed charges,63% of total billed charges,10.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,19.13,15.3,,,percent of total billed charges,15.3% of total billed charges,86.25,69,,,percent of total billed charges,69% of total billed charges,125,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,125,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,125,100,,,percent of total billed charges,100% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,22.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,47.13,37.7,,,percent of total billed charges,37.70% of total billed charges,47.13,37.7,,,percent of total billed charges,37.70% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,42.38,33.9,,,percent of total billed charges,33.9% of total billed charges,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,97.5,78,,,percent of total billed charges,78% of total billed charges,125,100,,,percent of total billed charges,100% of total billed charges,103.25,82.6,,,percent of total billed charges,82.6% of total billed charges,103.25,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,125,
"iSTAT Total B-hCG Gonadotropin, chorionic (hCG); quantitativ",30184702,CDM,301,RC,84702,HCPCS,Outpatient,,,428,278.20,,376.64,88,,,percent of total billed charges,88% of total Billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,428,100,,,percent of total billed charges,100% of total billed charges,11.67,103,,,Fee Schedule,103% of WA Medicaid,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,269.64,63,,,percent of total billed charges,63% of total billed charges,26.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid,65.48,15.3,,,percent of total billed charges,15.3% of total billed charges,295.32,69,,,percent of total billed charges,69% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,428,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,428,100,,,percent of total billed charges,100% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,57.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.73,130,,,Fee Schedule,130% of WA Medicaid ,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,145.09,33.9,,,percent of total billed charges,33.9% of total billed charges,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,333.84,78,,,percent of total billed charges,78% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,428,
iSTAT Cardiac Troponin I Quantitative POCT,30184484,CDM,301,RC,84484,HCPCS,Outpatient,,,275,178.75,,242,88,,,percent of total billed charges,88% of total Billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,275,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,173.25,63,,,percent of total billed charges,63% of total billed charges,21.82,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,42.08,15.3,,,percent of total billed charges,15.3% of total billed charges,189.75,69,,,percent of total billed charges,69% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,275,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,275,100,,,percent of total billed charges,100% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,47.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,93.23,33.9,,,percent of total billed charges,33.9% of total billed charges,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,214.5,78,,,percent of total billed charges,78% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.47,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,275,
iSTAT Creatinine; blood POCT,30182565,CDM,301,RC,82565,HCPCS,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,85.05,63,,,percent of total billed charges,63% of total billed charges,8.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,19.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,45.77,33.9,,,percent of total billed charges,33.9% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,5.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.12,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,135,
pH Venous,30082800,CDM,300,RC,82800,HCPCS,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,167,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11,100,,,Fee Schedule,100% of Medicare OPPS rate,105.21,63,,,percent of total billed charges,63% of total billed charges,19.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,25.55,15.3,,,percent of total billed charges,15.3% of total billed charges,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,42.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11,100,,,Fee Schedule,100% of Medicare OPPS rate,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,56.61,33.9,,,percent of total billed charges,33.9% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,167,
pH Arterial,30082800,CDM,300,RC,82800,HCPCS,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,167,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11,100,,,Fee Schedule,100% of Medicare OPPS rate,105.21,63,,,percent of total billed charges,63% of total billed charges,19.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,25.55,15.3,,,percent of total billed charges,15.3% of total billed charges,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,42.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11,100,,,Fee Schedule,100% of Medicare OPPS rate,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,56.61,33.9,,,percent of total billed charges,33.9% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,167,
PH BODY FLUID,30183986,CDM,301,RC,83986,HCPCS,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,33,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,20.79,63,,,percent of total billed charges,63% of total billed charges,6.26,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,13.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,11.19,33.9,,,percent of total billed charges,33.9% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.58,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,33,
PH VENOUS SAMPLE,30182800,CDM,301,RC,82800,HCPCS,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,167,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11,100,,,Fee Schedule,100% of Medicare OPPS rate,105.21,63,,,percent of total billed charges,63% of total billed charges,19.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,25.55,15.3,,,percent of total billed charges,15.3% of total billed charges,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,42.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11,100,,,Fee Schedule,100% of Medicare OPPS rate,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,56.61,33.9,,,percent of total billed charges,33.9% of total billed charges,11,100,,,Fee Schedule,100% of Medicare OPPS rate,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11,100,,,Fee Schedule,100% of Medicare OPPS rate,11.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,167,
pH Urine,30781003,CDM,307,RC,81003,HCPCS,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,32,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,20.16,63,,,percent of total billed charges,63% of total billed charges,3.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,32,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,32,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,12.06,37.7,,,percent of total billed charges,37.70% of total billed charges,12.06,37.7,,,percent of total billed charges,37.70% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,10.85,33.9,,,percent of total billed charges,33.9% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,32,
t-Transglutaminase (tTG) IgA LC,30186364,CDM,301,RC,86364,HCPCS,Outpatient,,,177,115.05,,155.76,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,177,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,111.51,63,,,percent of total billed charges,63% of total billed charges,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,27.08,15.3,,,percent of total billed charges,15.3% of total billed charges,122.13,69,,,percent of total billed charges,69% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,177,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,177,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,66.73,37.7,,,percent of total billed charges,37.70% of total billed charges,66.73,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,60,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,138.06,78,,,percent of total billed charges,78% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,177,
t-Transglutaminase (tTG) IgG LC,30186364,CDM,301,RC,86364,HCPCS,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,220,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,138.6,63,,,percent of total billed charges,63% of total billed charges,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,33.66,15.3,,,percent of total billed charges,15.3% of total billed charges,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,220,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,220,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,74.58,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,220,
tTG IgA/G LC,30186364,CDM,301,RC,86364,HCPCS,Outpatient,,,187,121.55,,164.56,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,187,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,117.81,63,,,percent of total billed charges,63% of total billed charges,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,28.61,15.3,,,percent of total billed charges,15.3% of total billed charges,129.03,69,,,percent of total billed charges,69% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,187,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,187,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,70.5,37.7,,,percent of total billed charges,37.70% of total billed charges,70.5,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,63.39,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,145.86,78,,,percent of total billed charges,78% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,187,
von Willebrand Profile LC,30585245,CDM,305,RC,85245,HCPCS,Outpatient,,,503,326.95,,442.64,88,,,percent of total billed charges,88% of total Billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.29,100,,,Fee Schedule,100% of WA Medicaid,503,100,,,percent of total billed charges,100% of total billed charges,16.78,103,,,Fee Schedule,103% of WA Medicaid,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,316.89,63,,,percent of total billed charges,63% of total billed charges,40.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,16.29,100,,,Fee Schedule,100% of WA Medicaid,76.96,15.3,,,percent of total billed charges,15.3% of total billed charges,347.07,69,,,percent of total billed charges,69% of total billed charges,503,100,,,percent of total billed charges,100% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,503,100,,,percent of total billed charges,100% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,503,100,,,percent of total billed charges,100% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,87.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,12.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.18,130,,,Fee Schedule,130% of WA Medicaid ,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,189.63,37.7,,,percent of total billed charges,37.70% of total billed charges,189.63,37.7,,,percent of total billed charges,37.70% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,170.52,33.9,,,percent of total billed charges,33.9% of total billed charges,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,392.34,78,,,percent of total billed charges,78% of total billed charges,503,100,,,percent of total billed charges,100% of total billed charges,415.48,82.6,,,percent of total billed charges,82.6% of total billed charges,415.48,82.6,,,percent of total billed charges,82.6% of total billed charges,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,23.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.94,100,,,Fee Schedule,100% of Medicare OPPS rate,16.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.07,503,
Creatine Kinase (CPK),30182550,CDM,301,RC,82550,HCPCS,Outpatient,,,128,83.20,,112.64,88,,,percent of total billed charges,88% of total Billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,128,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,80.64,63,,,percent of total billed charges,63% of total billed charges,11.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,24.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,43.39,33.9,,,percent of total billed charges,33.9% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,6.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.51,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,128,
IV INFUSION HYDRATION 31M-1HR,76196360,CDM,761,RC,96360,HCPCS,Outpatient,,,665,432.25,,585.2,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,665,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,101.75,15.3,,,percent of total billed charges,15.3% of total billed charges,458.85,69,,,percent of total billed charges,69% of total billed charges,665,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,665,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,665,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,250.71,37.7,,,percent of total billed charges,37.70% of total billed charges,250.71,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,225.44,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,518.7,78,,,percent of total billed charges,78% of total billed charges,665,100,,,percent of total billed charges,100% of total billed charges,549.29,82.6,,,percent of total billed charges,82.6% of total billed charges,549.29,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.75,826.71,
IV INFUSION HYDRATION ADDL HR,76196361,CDM,761,RC,96361,HCPCS,Outpatient,,,166,107.90,,146.08,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,166,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,25.4,15.3,,,percent of total billed charges,15.3% of total billed charges,114.54,69,,,percent of total billed charges,69% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,56.27,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,129.48,78,,,percent of total billed charges,78% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.4,600.65,
IV INFUSION THX/PX/DX FIRST HR,76196365,CDM,761,RC,96365,HCPCS,Outpatient,,,885,575.25,,778.8,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,885,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,135.41,15.3,,,percent of total billed charges,15.3% of total billed charges,610.65,69,,,percent of total billed charges,69% of total billed charges,885,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,885,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,885,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,333.65,37.7,,,percent of total billed charges,37.70% of total billed charges,333.65,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,300.02,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,690.3,78,,,percent of total billed charges,78% of total billed charges,885,100,,,percent of total billed charges,100% of total billed charges,731.01,82.6,,,percent of total billed charges,82.6% of total billed charges,731.01,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,135.41,885,
IV INFUSION THX/PX/DX ADDL HR,76196366,CDM,761,RC,96366,HCPCS,Outpatient,,,166,107.90,,146.08,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,166,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,25.4,15.3,,,percent of total billed charges,15.3% of total billed charges,114.54,69,,,percent of total billed charges,69% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,56.27,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,129.48,78,,,percent of total billed charges,78% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.4,600.65,
IV INFUSION ADDL SEQ 1HR,76196367,CDM,761,RC,96367,HCPCS,Outpatient,,,563,365.95,,495.44,88,,,percent of total billed charges,88% of total Billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,563,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,86.14,15.3,,,percent of total billed charges,15.3% of total billed charges,388.47,69,,,percent of total billed charges,69% of total billed charges,563,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,563,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,563,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,251.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,212.25,37.7,,,percent of total billed charges,37.70% of total billed charges,212.25,37.7,,,percent of total billed charges,37.70% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,190.86,33.9,,,percent of total billed charges,33.9% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,439.14,78,,,percent of total billed charges,78% of total billed charges,563,100,,,percent of total billed charges,100% of total billed charges,465.04,82.6,,,percent of total billed charges,82.6% of total billed charges,465.04,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.84,563,
CONCURRENT IV THER,76196368,CDM,761,RC,96368,HCPCS,Outpatient,,,533,346.45,,469.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,272.98,100,,,Fee Schedule,100% of WA Medicaid,533,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,272.98,100,,,Fee Schedule,100% of WA Medicaid,81.55,15.3,,,percent of total billed charges,15.3% of total billed charges,367.77,69,,,percent of total billed charges,69% of total billed charges,533,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,533,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,533,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,200.94,37.7,,,percent of total billed charges,37.70% of total billed charges,200.94,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,180.69,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,415.74,78,,,percent of total billed charges,78% of total billed charges,533,100,,,percent of total billed charges,100% of total billed charges,440.26,82.6,,,percent of total billed charges,82.6% of total billed charges,440.26,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.55,533,
IV HYDRATION INITIAL 1ST HOUR,AMB820058,CDM,761,RC,96360,HCPCS,Outpatient,,,665,432.25,,585.2,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,665,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,101.75,15.3,,,percent of total billed charges,15.3% of total billed charges,458.85,69,,,percent of total billed charges,69% of total billed charges,665,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,665,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,665,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,250.71,37.7,,,percent of total billed charges,37.70% of total billed charges,250.71,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,225.44,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,518.7,78,,,percent of total billed charges,78% of total billed charges,665,100,,,percent of total billed charges,100% of total billed charges,549.29,82.6,,,percent of total billed charges,82.6% of total billed charges,549.29,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.75,826.71,
IV HYDRATION EA ADDL HR,AMB20059,CDM,761,RC,96361,HCPCS,Outpatient,,,166,107.90,,146.08,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,166,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,25.4,15.3,,,percent of total billed charges,15.3% of total billed charges,114.54,69,,,percent of total billed charges,69% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,56.27,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,129.48,78,,,percent of total billed charges,78% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.4,600.65,
IV INF THERAPEUTIC EA ADD'L HR,AMB820045,CDM,761,RC,96366,HCPCS,Outpatient,,,166,107.90,,146.08,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,166,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,25.4,15.3,,,percent of total billed charges,15.3% of total billed charges,114.54,69,,,percent of total billed charges,69% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,56.27,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,129.48,78,,,percent of total billed charges,78% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.4,600.65,
96365 IV INFUSION 2ND VISIT SAMEDAY,AMB820052,CDM,761,RC,96365,HCPCS,Outpatient,,,885,575.25,59,778.8,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,885,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,135.41,15.3,,,percent of total billed charges,15.3% of total billed charges,610.65,69,,,percent of total billed charges,69% of total billed charges,885,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,885,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,885,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,333.65,37.7,,,percent of total billed charges,37.70% of total billed charges,333.65,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,300.02,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,690.3,78,,,percent of total billed charges,78% of total billed charges,885,100,,,percent of total billed charges,100% of total billed charges,731.01,82.6,,,percent of total billed charges,82.6% of total billed charges,731.01,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,135.41,885,
96366 IV INFUSION 2ND VISIT SAMEDAY EA ADDT'L HOUR,AMB820057,CDM,761,RC,96366,HCPCS,Outpatient,,,166,107.90,59,146.08,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,166,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,25.4,15.3,,,percent of total billed charges,15.3% of total billed charges,114.54,69,,,percent of total billed charges,69% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,56.27,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,129.48,78,,,percent of total billed charges,78% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.4,600.65,
INJ THER/DX IM/SQ,76196372,CDM,761,RC,96372,HCPCS,Outpatient,,,381,247.65,,335.28,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,381,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,58.29,15.3,,,percent of total billed charges,15.3% of total billed charges,262.89,69,,,percent of total billed charges,69% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,381,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,381,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,129.16,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,297.18,78,,,percent of total billed charges,78% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,381,
S-INJ NON CHEMO IA,26096373,CDM,260,RC,96373,HCPCS,Outpatient,,,1687,1096.55,,1484.56,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,1687,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,258.11,15.3,,,percent of total billed charges,15.3% of total billed charges,1164.03,69,,,percent of total billed charges,69% of total billed charges,1687,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1687,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1687,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,636,37.7,,,percent of total billed charges,37.70% of total billed charges,636,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,571.89,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1315.86,78,,,percent of total billed charges,78% of total billed charges,1687,100,,,percent of total billed charges,100% of total billed charges,1393.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1393.46,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,1687,
THERAPEUTIC IV PUSH,76196374,CDM,761,RC,96374,HCPCS,Outpatient,,,552,358.80,,485.76,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,552,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,84.46,15.3,,,percent of total billed charges,15.3% of total billed charges,380.88,69,,,percent of total billed charges,69% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,552,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,552,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,187.13,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,430.56,78,,,percent of total billed charges,78% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,826.71,
THERA EA AD IV PUSH,76196375,CDM,761,RC,96375,HCPCS,Outpatient,,,363,235.95,,319.44,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,363,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,55.54,15.3,,,percent of total billed charges,15.3% of total billed charges,250.47,69,,,percent of total billed charges,69% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,363,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,363,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,123.06,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,283.14,78,,,percent of total billed charges,78% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,363,
THER AD IVP SAME MED,76196376,CDM,761,RC,96376,HCPCS,Outpatient,,,373,242.45,,328.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid,373,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid,57.07,15.3,,,percent of total billed charges,15.3% of total billed charges,257.37,69,,,percent of total billed charges,69% of total billed charges,373,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,373,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,373,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,140.62,37.7,,,percent of total billed charges,37.70% of total billed charges,140.62,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,126.45,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,290.94,78,,,percent of total billed charges,78% of total billed charges,373,100,,,percent of total billed charges,100% of total billed charges,308.1,82.6,,,percent of total billed charges,82.6% of total billed charges,308.1,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,373,
IV PUSH SAME DRUG ADDON AFT 31,AMB20079,CDM,260,RC,96376,HCPCS,Outpatient,,,373,242.45,,328.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid,373,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid,57.07,15.3,,,percent of total billed charges,15.3% of total billed charges,257.37,69,,,percent of total billed charges,69% of total billed charges,373,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,373,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,373,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,140.62,37.7,,,percent of total billed charges,37.70% of total billed charges,140.62,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,126.45,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,290.94,78,,,percent of total billed charges,78% of total billed charges,373,100,,,percent of total billed charges,100% of total billed charges,308.1,82.6,,,percent of total billed charges,82.6% of total billed charges,308.1,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,373,
96374 IV INJECTION 2ND VISIT SAMEDAY,AMB820053,CDM,761,RC,96374,HCPCS,Outpatient,,,552,358.80,59,485.76,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,552,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,84.46,15.3,,,percent of total billed charges,15.3% of total billed charges,380.88,69,,,percent of total billed charges,69% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,552,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,552,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,187.13,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,430.56,78,,,percent of total billed charges,78% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,826.71,
"M0222- Bebtelovimab, injection and post administration monit",M0222,CDM,771,RC,M0222,HCPCS,Outpatient,,,1326,861.90,,1166.88,88,,,percent of total billed charges,88% of total Billed charges,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,1326,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,835.38,63,,,percent of total billed charges,63% of total billed charges,656.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,202.88,15.3,,,percent of total billed charges,15.3% of total billed charges,914.94,69,,,percent of total billed charges,69% of total billed charges,1326,100,,,percent of total billed charges,100% of total billed charges,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1326,100,,,percent of total billed charges,100% of total billed charges,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1326,100,,,percent of total billed charges,100% of total billed charges,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,499.9,37.7,,,percent of total billed charges,37.70% of total billed charges,499.9,37.7,,,percent of total billed charges,37.70% of total billed charges,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,449.51,33.9,,,percent of total billed charges,33.9% of total billed charges,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1034.28,78,,,percent of total billed charges,78% of total billed charges,1326,100,,,percent of total billed charges,100% of total billed charges,1095.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1095.28,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,378.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,375.21,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.8,1326,
"Intravenous infusion, casirivimab and imdevimab includes inf",M0243,CDM,771,RC,M0243,HCPCS,Outpatient,,,1735,1127.75,,1526.8,88,,,percent of total billed charges,88% of total Billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,1735,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1093.05,63,,,percent of total billed charges,63% of total billed charges,843.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,265.46,15.3,,,percent of total billed charges,15.3% of total billed charges,1197.15,69,,,percent of total billed charges,69% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1830.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,588.17,33.9,,,percent of total billed charges,33.9% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1353.3,78,,,percent of total billed charges,78% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,487.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,265.46,1830.16,
Bamlan and Estesev Infusion,M0245,CDM,771,RC,M0245,HCPCS,Outpatient,,,1735,1127.75,,1526.8,88,,,percent of total billed charges,88% of total Billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,1735,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1093.05,63,,,percent of total billed charges,63% of total billed charges,843.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,265.46,15.3,,,percent of total billed charges,15.3% of total billed charges,1197.15,69,,,percent of total billed charges,69% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1830.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,588.17,33.9,,,percent of total billed charges,33.9% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1353.3,78,,,percent of total billed charges,78% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,487.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,265.46,1830.16,
"Intravenous infusion, tocilizumab, for hospitalized adults a",M0249,CDM,771,RC,M0249,HCPCS,Outpatient,,,1735,1127.75,,1526.8,88,,,percent of total billed charges,88% of total Billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,1735,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1093.05,63,,,percent of total billed charges,63% of total billed charges,843.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,265.46,15.3,,,percent of total billed charges,15.3% of total billed charges,1197.15,69,,,percent of total billed charges,69% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,588.17,33.9,,,percent of total billed charges,33.9% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1353.3,78,,,percent of total billed charges,78% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,487.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,265.46,1735,
"M0247 Intravenous infusion, sotrovimab, includes infusion an",M0247,CDM,771,RC,M0247,HCPCS,Outpatient,,,1735,1127.75,,1526.8,88,,,percent of total billed charges,88% of total Billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,1735,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1093.05,63,,,percent of total billed charges,63% of total billed charges,843.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,265.46,15.3,,,percent of total billed charges,15.3% of total billed charges,1197.15,69,,,percent of total billed charges,69% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,588.17,33.9,,,percent of total billed charges,33.9% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1353.3,78,,,percent of total billed charges,78% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,487.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,265.46,1735,
"Intravenous infusion, tocilizumab, for hospitalized adults a",M0250,CDM,771,RC,M0250,HCPCS,Outpatient,,,1735,1127.75,,1526.8,88,,,percent of total billed charges,88% of total Billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,1735,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1093.05,63,,,percent of total billed charges,63% of total billed charges,843.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,265.46,15.3,,,percent of total billed charges,15.3% of total billed charges,1197.15,69,,,percent of total billed charges,69% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1735,100,,,percent of total billed charges,100% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,588.17,33.9,,,percent of total billed charges,33.9% of total billed charges,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,1353.3,78,,,percent of total billed charges,78% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,487.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,482.26,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,265.46,1735,
Bullous pemphigoid 180 Antibody LC,30183516,CDM,301,RC,83516,HCPCS,Outpatient,,,124,80.60,,109.12,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,124,100,,,percent of total billed charges,100% of total billed charges,11.27,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid,18.97,15.3,,,percent of total billed charges,15.3% of total billed charges,85.56,69,,,percent of total billed charges,69% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,124,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,124,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.23,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,42.04,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,96.72,78,,,percent of total billed charges,78% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,11.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.53,100,,,Fee Schedule,100% of Medicare OPPS rate,10.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,124,
Fetal non-stress test,76159025,CDM,761,RC,59025,HCPCS,Outpatient,,,337,219.05,,296.56,88,,,percent of total billed charges,88% of total Billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,165.98,100,,,Fee Schedule,100% of WA Medicaid,337,100,,,percent of total billed charges,100% of total billed charges,170.96,103,,,Fee Schedule,103% of WA Medicaid,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,212.31,63,,,percent of total billed charges,63% of total billed charges,355.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,165.98,100,,,Fee Schedule,100% of WA Medicaid,51.56,15.3,,,percent of total billed charges,15.3% of total billed charges,232.53,69,,,percent of total billed charges,69% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,337,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,337,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,691.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,122.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,169.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,215.77,130,,,Fee Schedule,130% of WA Medicaid ,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,127.05,37.7,,,percent of total billed charges,37.70% of total billed charges,127.05,37.7,,,percent of total billed charges,37.70% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,114.24,33.9,,,percent of total billed charges,33.9% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,262.86,78,,,percent of total billed charges,78% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,205.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.56,691.92,
ACID FAST SMEAR,30687206,CDM,306,RC,87206,HCPCS,Outpatient,,,109,70.85,,95.92,88,,,percent of total billed charges,88% of total Billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,109,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,68.67,63,,,percent of total billed charges,63% of total billed charges,9.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,16.68,15.3,,,percent of total billed charges,15.3% of total billed charges,75.21,69,,,percent of total billed charges,69% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,20.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,36.95,33.9,,,percent of total billed charges,33.9% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,85.02,78,,,percent of total billed charges,78% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,109,
ACID FAST CULTURE,30687116,CDM,306,RC,87116,HCPCS,Outpatient,,,499,324.35,,439.12,88,,,percent of total billed charges,88% of total Billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,499,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,314.37,63,,,percent of total billed charges,63% of total billed charges,18.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,76.35,15.3,,,percent of total billed charges,15.3% of total billed charges,344.31,69,,,percent of total billed charges,69% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,499,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,499,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,169.16,33.9,,,percent of total billed charges,33.9% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,389.22,78,,,percent of total billed charges,78% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,499,
KOH Prep,30687206,CDM,306,RC,87206,HCPCS,Outpatient,,,109,70.85,,95.92,88,,,percent of total billed charges,88% of total Billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,109,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,68.67,63,,,percent of total billed charges,63% of total billed charges,9.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,16.68,15.3,,,percent of total billed charges,15.3% of total billed charges,75.21,69,,,percent of total billed charges,69% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,20.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,36.95,33.9,,,percent of total billed charges,33.9% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,85.02,78,,,percent of total billed charges,78% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,109,
"183444 MTB-RIF, AFB sm/cul, Sputum LC",30687116,CDM,306,RC,87116,HCPCS,Outpatient,,,499,324.35,,439.12,88,,,percent of total billed charges,88% of total Billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,499,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,314.37,63,,,percent of total billed charges,63% of total billed charges,18.9,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,76.35,15.3,,,percent of total billed charges,15.3% of total billed charges,344.31,69,,,percent of total billed charges,69% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,499,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,499,100,,,percent of total billed charges,100% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,169.16,33.9,,,percent of total billed charges,33.9% of total billed charges,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,389.22,78,,,percent of total billed charges,78% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,499,
CULTURE ANAEROBIC,30687075,CDM,306,RC,87075,HCPCS,Outpatient,,,227,147.55,,199.76,88,,,percent of total billed charges,88% of total Billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,227,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,143.01,63,,,percent of total billed charges,63% of total billed charges,16.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,34.73,15.3,,,percent of total billed charges,15.3% of total billed charges,156.63,69,,,percent of total billed charges,69% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,36.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,76.95,33.9,,,percent of total billed charges,33.9% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,177.06,78,,,percent of total billed charges,78% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,227,
Anaerobe Identification Only LC,30687076,CDM,306,RC,87076,HCPCS,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,87,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,54.81,63,,,percent of total billed charges,63% of total billed charges,14.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,30.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,87,
ANAEROBIC ID,30687076,CDM,306,RC,87076,HCPCS,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,87,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,54.81,63,,,percent of total billed charges,63% of total billed charges,14.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,30.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,87,
30687168,30687168,CDM,306,RC,87168,HCPCS,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,43,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,27.09,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,43,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,43,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,14.58,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,43,
Blood Culture,30687040,CDM,306,RC,87040,HCPCS,Outpatient,,,248,161.20,,218.24,88,,,percent of total billed charges,88% of total Billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,248,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,156.24,63,,,percent of total billed charges,63% of total billed charges,18.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,37.94,15.3,,,percent of total billed charges,15.3% of total billed charges,171.12,69,,,percent of total billed charges,69% of total billed charges,248,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,248,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,248,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,39.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,93.5,37.7,,,percent of total billed charges,37.70% of total billed charges,93.5,37.7,,,percent of total billed charges,37.70% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,84.07,33.9,,,percent of total billed charges,33.9% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,193.44,78,,,percent of total billed charges,78% of total billed charges,248,100,,,percent of total billed charges,100% of total billed charges,204.85,82.6,,,percent of total billed charges,82.6% of total billed charges,204.85,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,248,
CULTURE BODY FLUID,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,317.52,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,77.11,15.3,,,percent of total billed charges,15.3% of total billed charges,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,504,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,504,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,170.86,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,504,
CULTURE BONE MARROW,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,317.52,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,77.11,15.3,,,percent of total billed charges,15.3% of total billed charges,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,504,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,504,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,170.86,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,504,
KOH Prep,30687206,CDM,306,RC,87206,HCPCS,Outpatient,,,109,70.85,,95.92,88,,,percent of total billed charges,88% of total Billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,109,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,68.67,63,,,percent of total billed charges,63% of total billed charges,9.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,16.68,15.3,,,percent of total billed charges,15.3% of total billed charges,75.21,69,,,percent of total billed charges,69% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,20.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,36.95,33.9,,,percent of total billed charges,33.9% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,85.02,78,,,percent of total billed charges,78% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,109,
CULTURE CATH TIP,30687071,CDM,306,RC,87070,HCPCS,Outpatient,,,495,321.75,,435.6,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,495,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,311.85,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,75.74,15.3,,,percent of total billed charges,15.3% of total billed charges,341.55,69,,,percent of total billed charges,69% of total billed charges,495,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,495,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,495,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,186.62,37.7,,,percent of total billed charges,37.70% of total billed charges,186.62,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,167.81,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,386.1,78,,,percent of total billed charges,78% of total billed charges,495,100,,,percent of total billed charges,100% of total billed charges,408.87,82.6,,,percent of total billed charges,82.6% of total billed charges,408.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,495,
RMC-Etest,30687181,CDM,306,RC,87181,HCPCS,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,43,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,27.09,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,43,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,43,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,14.58,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.75,43,
RMC-Etest,30687181,CDM,306,RC,87181,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.75,40,
CULTURE CSF,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,402,261.30,,353.76,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,402,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,253.26,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,61.51,15.3,,,percent of total billed charges,15.3% of total billed charges,277.38,69,,,percent of total billed charges,69% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,136.28,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,313.56,78,,,percent of total billed charges,78% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,402,
TISSUE GRIND,30687176,CDM,306,RC,87176,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,52.29,63,,,percent of total billed charges,63% of total billed charges,10.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,83,100,,,percent of total billed charges,100% of total billed charges,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,22.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,28.14,33.9,,,percent of total billed charges,33.9% of total billed charges,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,5.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.88,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,83,
CONCENTRATION FOR INF AGENT,30687015,CDM,306,RC,87015,HCPCS,Outpatient,,,134,87.10,,117.92,88,,,percent of total billed charges,88% of total Billed charges,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,134,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,84.42,63,,,percent of total billed charges,63% of total billed charges,11.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,20.5,15.3,,,percent of total billed charges,15.3% of total billed charges,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,25.55,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,45.43,33.9,,,percent of total billed charges,33.9% of total billed charges,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,6.74,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.68,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,134,
PRESUMP URINE ID,30687088,CDM,306,RC,87088,HCPCS,Outpatient,,,207,134.55,,182.16,88,,,percent of total billed charges,88% of total Billed charges,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,207,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,130.41,63,,,percent of total billed charges,63% of total billed charges,14.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,31.67,15.3,,,percent of total billed charges,15.3% of total billed charges,142.83,69,,,percent of total billed charges,69% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,207,100,,,percent of total billed charges,100% of total billed charges,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,207,100,,,percent of total billed charges,100% of total billed charges,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,30.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,70.17,33.9,,,percent of total billed charges,33.9% of total billed charges,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,161.46,78,,,percent of total billed charges,78% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,8.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.09,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,207,
STREP LATEX AGGLUTINATION,30687147,CDM,306,RC,87147,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,30.24,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,48,
ANAEROBIC ID,30687076,CDM,306,RC,87076,HCPCS,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,87,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,54.81,63,,,percent of total billed charges,63% of total billed charges,14.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,30.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,87,
CULTURE ANAEROBIC,30687075,CDM,306,RC,87075,HCPCS,Outpatient,,,227,147.55,,199.76,88,,,percent of total billed charges,88% of total Billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,227,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,143.01,63,,,percent of total billed charges,63% of total billed charges,16.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,34.73,15.3,,,percent of total billed charges,15.3% of total billed charges,156.63,69,,,percent of total billed charges,69% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,36.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,76.95,33.9,,,percent of total billed charges,33.9% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,177.06,78,,,percent of total billed charges,78% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,9.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.47,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,227,
LATEX AGGLUTINATION,30687147,CDM,306,RC,87147,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,30.24,63,,,percent of total billed charges,63% of total billed charges,9.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19.81,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.18,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,48,
FUNGUS IDENTIFICATION,30687107,CDM,306,RC,87185,HCPCS,Outpatient,,,215,139.75,,189.2,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,135.45,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,32.9,15.3,,,percent of total billed charges,15.3% of total billed charges,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,72.89,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.75,215,
BETA LACTAMASE,30687185,CDM,306,RC,87185,HCPCS,Outpatient,,,79,51.35,,69.52,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,79,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,49.77,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,12.09,15.3,,,percent of total billed charges,15.3% of total billed charges,54.51,69,,,percent of total billed charges,69% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,79,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,79,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,29.78,37.7,,,percent of total billed charges,37.70% of total billed charges,29.78,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,26.78,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,61.62,78,,,percent of total billed charges,78% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.75,79,
Fungus (Mycology) Culture LC,30687101,CDM,306,RC,87101,HCPCS,Outpatient,,,363,235.95,,319.44,88,,,percent of total billed charges,88% of total Billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,363,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,228.69,63,,,percent of total billed charges,63% of total billed charges,13.49,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,55.54,15.3,,,percent of total billed charges,15.3% of total billed charges,250.47,69,,,percent of total billed charges,69% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,363,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,363,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,29.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,136.85,37.7,,,percent of total billed charges,37.70% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,123.06,33.9,,,percent of total billed charges,33.9% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,283.14,78,,,percent of total billed charges,78% of total billed charges,363,100,,,percent of total billed charges,100% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,299.84,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,7.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.71,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,363,
RMC-Etest,,,306,RC,87181,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.75,40,
CULTURE EAR,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,403,261.95,,354.64,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,403,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,253.89,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,61.66,15.3,,,percent of total billed charges,15.3% of total billed charges,278.07,69,,,percent of total billed charges,69% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,136.62,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,314.34,78,,,percent of total billed charges,78% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,403,
CULTURE EYE,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,403,261.95,,354.64,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,403,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,253.89,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,61.66,15.3,,,percent of total billed charges,15.3% of total billed charges,278.07,69,,,percent of total billed charges,69% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,136.62,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,314.34,78,,,percent of total billed charges,78% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,403,
"Organism ID, Bacteria LC",30687077,CDM,306,RC,87077,HCPCS,Outpatient,,,261,169.65,,229.68,88,,,percent of total billed charges,88% of total Billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,261,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,164.43,63,,,percent of total billed charges,63% of total billed charges,14.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,39.93,15.3,,,percent of total billed charges,15.3% of total billed charges,180.09,69,,,percent of total billed charges,69% of total billed charges,261,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,261,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,261,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,30.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,98.4,37.7,,,percent of total billed charges,37.70% of total billed charges,98.4,37.7,,,percent of total billed charges,37.70% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,88.48,33.9,,,percent of total billed charges,33.9% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,203.58,78,,,percent of total billed charges,78% of total billed charges,261,100,,,percent of total billed charges,100% of total billed charges,215.59,82.6,,,percent of total billed charges,82.6% of total billed charges,215.59,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,261,
CULTURE FUNGUS (BLOOD),30687103,CDM,306,RC,87103,HCPCS,Outpatient,,,346,224.90,,304.48,88,,,percent of total billed charges,88% of total Billed charges,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,346,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,217.98,63,,,percent of total billed charges,63% of total billed charges,35.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,52.94,15.3,,,percent of total billed charges,15.3% of total billed charges,238.74,69,,,percent of total billed charges,69% of total billed charges,346,100,,,percent of total billed charges,100% of total billed charges,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,346,100,,,percent of total billed charges,100% of total billed charges,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,346,100,,,percent of total billed charges,100% of total billed charges,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,78.25,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,130.44,37.7,,,percent of total billed charges,37.70% of total billed charges,130.44,37.7,,,percent of total billed charges,37.70% of total billed charges,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,117.29,33.9,,,percent of total billed charges,33.9% of total billed charges,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,269.88,78,,,percent of total billed charges,78% of total billed charges,346,100,,,percent of total billed charges,100% of total billed charges,285.8,82.6,,,percent of total billed charges,82.6% of total billed charges,285.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,20.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.46,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,346,
"BV + CG + Trich, NAA w/Yeast Cul LC",30687102,CDM,306,RC,87102,HCPCS,Outpatient,,,327,212.55,,287.76,88,,,percent of total billed charges,88% of total Billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,327,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,206.01,63,,,percent of total billed charges,63% of total billed charges,14.71,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,50.03,15.3,,,percent of total billed charges,15.3% of total billed charges,225.63,69,,,percent of total billed charges,69% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,327,100,,,percent of total billed charges,100% of total billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,327,100,,,percent of total billed charges,100% of total billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,32.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,110.85,33.9,,,percent of total billed charges,33.9% of total billed charges,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,255.06,78,,,percent of total billed charges,78% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,8.49,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.41,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,327,
CULTURE GC,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,258,167.70,,227.04,88,,,percent of total billed charges,88% of total Billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,258,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,162.54,63,,,percent of total billed charges,63% of total billed charges,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,39.47,15.3,,,percent of total billed charges,15.3% of total billed charges,178.02,69,,,percent of total billed charges,69% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,33.9,,,percent of total billed charges,33.9% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,201.24,78,,,percent of total billed charges,78% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,258,
CULTURE GENITAL,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,402,261.30,,353.76,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,402,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,253.26,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,61.51,15.3,,,percent of total billed charges,15.3% of total billed charges,277.38,69,,,percent of total billed charges,69% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,402,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,136.28,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,313.56,78,,,percent of total billed charges,78% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,402,
"Organism ID, Bacteria LC",30687077,CDM,306,RC,87077,HCPCS,Outpatient,,,261,169.65,,229.68,88,,,percent of total billed charges,88% of total Billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,261,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,164.43,63,,,percent of total billed charges,63% of total billed charges,14.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,39.93,15.3,,,percent of total billed charges,15.3% of total billed charges,180.09,69,,,percent of total billed charges,69% of total billed charges,261,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,261,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,261,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,30.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,98.4,37.7,,,percent of total billed charges,37.70% of total billed charges,98.4,37.7,,,percent of total billed charges,37.70% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,88.48,33.9,,,percent of total billed charges,33.9% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,203.58,78,,,percent of total billed charges,78% of total billed charges,261,100,,,percent of total billed charges,100% of total billed charges,215.59,82.6,,,percent of total billed charges,82.6% of total billed charges,215.59,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,261,
"Organism ID, Bacteria LC",30687077,CDM,306,RC,87077,HCPCS,Outpatient,,,261,169.65,,229.68,88,,,percent of total billed charges,88% of total Billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,261,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,164.43,63,,,percent of total billed charges,63% of total billed charges,14.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,39.93,15.3,,,percent of total billed charges,15.3% of total billed charges,180.09,69,,,percent of total billed charges,69% of total billed charges,261,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,261,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,261,100,,,percent of total billed charges,100% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,30.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,98.4,37.7,,,percent of total billed charges,37.70% of total billed charges,98.4,37.7,,,percent of total billed charges,37.70% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,88.48,33.9,,,percent of total billed charges,33.9% of total billed charges,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,203.58,78,,,percent of total billed charges,78% of total billed charges,261,100,,,percent of total billed charges,100% of total billed charges,215.59,82.6,,,percent of total billed charges,82.6% of total billed charges,215.59,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,8.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.08,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,261,
GRAM STAIN ORDER,30687205,CDM,306,RC,87205,HCPCS,Outpatient,,,81,52.65,,71.28,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,81,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,51.03,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,12.39,15.3,,,percent of total billed charges,15.3% of total billed charges,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,27.46,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,81,
GRAM STAIN,30687205,CDM,306,RC,87205,HCPCS,Outpatient,,,81,52.65,,71.28,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,81,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,51.03,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,12.39,15.3,,,percent of total billed charges,15.3% of total billed charges,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,27.46,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,81,
Gram Stain,30687205,CDM,306,RC,87205,HCPCS,Outpatient,,,81,52.65,,71.28,88,,,percent of total billed charges,88% of total Billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,81,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,51.03,63,,,percent of total billed charges,63% of total billed charges,7.47,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,12.39,15.3,,,percent of total billed charges,15.3% of total billed charges,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,16.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,27.46,33.9,,,percent of total billed charges,33.9% of total billed charges,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,4.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.26,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.26,81,
CLO Test,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,276,179.40,,242.88,88,,,percent of total billed charges,88% of total Billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,276,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,173.88,63,,,percent of total billed charges,63% of total billed charges,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,42.23,15.3,,,percent of total billed charges,15.3% of total billed charges,190.44,69,,,percent of total billed charges,69% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,276,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,276,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,104.05,37.7,,,percent of total billed charges,37.70% of total billed charges,104.05,37.7,,,percent of total billed charges,37.70% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,93.56,33.9,,,percent of total billed charges,33.9% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,215.28,78,,,percent of total billed charges,78% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,276,
KOH Prep,30687206,CDM,306,RC,87206,HCPCS,Outpatient,,,109,70.85,,95.92,88,,,percent of total billed charges,88% of total Billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,109,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,68.67,63,,,percent of total billed charges,63% of total billed charges,9.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,16.68,15.3,,,percent of total billed charges,15.3% of total billed charges,75.21,69,,,percent of total billed charges,69% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,20.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,36.95,33.9,,,percent of total billed charges,33.9% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,85.02,78,,,percent of total billed charges,78% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,109,
ACID FAST SMEAR,30687206,CDM,306,RC,87206,HCPCS,Outpatient,,,109,70.85,,95.92,88,,,percent of total billed charges,88% of total Billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,109,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,68.67,63,,,percent of total billed charges,63% of total billed charges,9.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,16.68,15.3,,,percent of total billed charges,15.3% of total billed charges,75.21,69,,,percent of total billed charges,69% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,20.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,36.95,33.9,,,percent of total billed charges,33.9% of total billed charges,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,85.02,78,,,percent of total billed charges,78% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,5.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.39,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,109,
CLO Test,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,284,184.60,,249.92,88,,,percent of total billed charges,88% of total Billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,284,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,178.92,63,,,percent of total billed charges,63% of total billed charges,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,43.45,15.3,,,percent of total billed charges,15.3% of total billed charges,195.96,69,,,percent of total billed charges,69% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,96.28,33.9,,,percent of total billed charges,33.9% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,221.52,78,,,percent of total billed charges,78% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,284,
CULTURE GC,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,284,184.60,,249.92,88,,,percent of total billed charges,88% of total Billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,284,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,178.92,63,,,percent of total billed charges,63% of total billed charges,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,43.45,15.3,,,percent of total billed charges,15.3% of total billed charges,195.96,69,,,percent of total billed charges,69% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,96.28,33.9,,,percent of total billed charges,33.9% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,221.52,78,,,percent of total billed charges,78% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,284,
Strep Culture,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,25.35,
RMC-GNDCEtest,30687181,CDM,306,RC,87181,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.75,40,
Minimum Inhibitory Concentration,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,183,118.95,,161.04,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,183,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,115.29,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,28,15.3,,,percent of total billed charges,15.3% of total billed charges,126.27,69,,,percent of total billed charges,69% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,62.04,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,142.74,78,,,percent of total billed charges,78% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,183,
CULTURE WOUND AEROBIC,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,448,291.20,,394.24,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,448,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,282.24,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,68.54,15.3,,,percent of total billed charges,15.3% of total billed charges,309.12,69,,,percent of total billed charges,69% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,448,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,448,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,151.87,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,349.44,78,,,percent of total billed charges,78% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,448,
OVA AND PARASITES,30687177,CDM,306,RC,87177,HCPCS,Outpatient,,,222,144.30,,195.36,88,,,percent of total billed charges,88% of total Billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,222,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,139.86,63,,,percent of total billed charges,63% of total billed charges,15.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,33.97,15.3,,,percent of total billed charges,15.3% of total billed charges,153.18,69,,,percent of total billed charges,69% of total billed charges,222,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,222,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,222,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,34.04,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,83.69,37.7,,,percent of total billed charges,37.70% of total billed charges,83.69,37.7,,,percent of total billed charges,37.70% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,75.26,33.9,,,percent of total billed charges,33.9% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,173.16,78,,,percent of total billed charges,78% of total billed charges,222,100,,,percent of total billed charges,100% of total billed charges,183.37,82.6,,,percent of total billed charges,82.6% of total billed charges,183.37,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,8.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.9,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,222,
30687169,30687169,CDM,306,RC,87169,HCPCS,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,39,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,24.57,63,,,percent of total billed charges,63% of total billed charges,7.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,39,100,,,percent of total billed charges,100% of total billed charges,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,39,100,,,percent of total billed charges,100% of total billed charges,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,14.7,37.7,,,percent of total billed charges,37.70% of total billed charges,14.7,37.7,,,percent of total billed charges,37.70% of total billed charges,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,13.22,33.9,,,percent of total billed charges,33.9% of total billed charges,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,4.35,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.3,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.3,39,
RMC-Etest,30687181,CDM,306,RC,87181,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.75,40,
30687184,30687184,CDM,306,RC,87184,HCPCS,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,92.61,63,,,percent of total billed charges,63% of total billed charges,13.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,28.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,7.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,147,
30687184,30687184,CDM,306,RC,87184,HCPCS,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,92.61,63,,,percent of total billed charges,63% of total billed charges,13.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,28.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,7.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,147,
30687184,30687184,CDM,306,RC,87184,HCPCS,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,92.61,63,,,percent of total billed charges,63% of total billed charges,13.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,28.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,7.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.48,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,147,
SENSITIVITY ADD'L-MIC,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,456,296.40,,401.28,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,456,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,287.28,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,69.77,15.3,,,percent of total billed charges,15.3% of total billed charges,314.64,69,,,percent of total billed charges,69% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,154.58,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,355.68,78,,,percent of total billed charges,78% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,456,
SENSITIVITY ADD'L-MIC,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,456,296.40,,401.28,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,456,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,287.28,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,69.77,15.3,,,percent of total billed charges,15.3% of total billed charges,314.64,69,,,percent of total billed charges,69% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,154.58,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,355.68,78,,,percent of total billed charges,78% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,456,
SENSITIVITY ADD'L-MIC,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,456,296.40,,401.28,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,456,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,287.28,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,69.77,15.3,,,percent of total billed charges,15.3% of total billed charges,314.64,69,,,percent of total billed charges,69% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,154.58,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,355.68,78,,,percent of total billed charges,78% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,456,
SENSITIVITY ADD'L-MIC,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,456,296.40,,401.28,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,456,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,287.28,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,69.77,15.3,,,percent of total billed charges,15.3% of total billed charges,314.64,69,,,percent of total billed charges,69% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,456,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,154.58,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,355.68,78,,,percent of total billed charges,78% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,456,
RMC-Etest,,,306,RC,87181,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.75,40,
CULTURE RESPIRATORY,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,408,265.20,,359.04,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,408,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,257.04,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,62.42,15.3,,,percent of total billed charges,15.3% of total billed charges,281.52,69,,,percent of total billed charges,69% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,138.31,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,318.24,78,,,percent of total billed charges,78% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,408,
SUN-NEG GN84,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,183,118.95,,161.04,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,183,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,115.29,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,28,15.3,,,percent of total billed charges,15.3% of total billed charges,126.27,69,,,percent of total billed charges,69% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,62.04,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,142.74,78,,,percent of total billed charges,78% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,183,
SUN-POS GP67,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,183,118.95,,161.04,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,183,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,115.29,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,28,15.3,,,percent of total billed charges,15.3% of total billed charges,126.27,69,,,percent of total billed charges,69% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,62.04,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,142.74,78,,,percent of total billed charges,78% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,183,
SUN-GP 74 SPN Sens,30687186,CDM,306,RC,87186,HCPCS,Outpatient,,,183,118.95,,161.04,88,,,percent of total billed charges,88% of total Billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,183,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,115.29,63,,,percent of total billed charges,63% of total billed charges,15.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,28,15.3,,,percent of total billed charges,15.3% of total billed charges,126.27,69,,,percent of total billed charges,69% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,33.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,62.04,33.9,,,percent of total billed charges,33.9% of total billed charges,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,142.74,78,,,percent of total billed charges,78% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,8.73,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.65,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,183,
CULTURE WOUND AEROBIC,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,408,265.20,,359.04,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,408,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,257.04,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,62.42,15.3,,,percent of total billed charges,15.3% of total billed charges,281.52,69,,,percent of total billed charges,69% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,408,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,138.31,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,318.24,78,,,percent of total billed charges,78% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,408,
CLO Test,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,284,184.60,,249.92,88,,,percent of total billed charges,88% of total Billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,284,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,178.92,63,,,percent of total billed charges,63% of total billed charges,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,43.45,15.3,,,percent of total billed charges,15.3% of total billed charges,195.96,69,,,percent of total billed charges,69% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,96.28,33.9,,,percent of total billed charges,33.9% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,221.52,78,,,percent of total billed charges,78% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,284,
CLO Test,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,284,184.60,,249.92,88,,,percent of total billed charges,88% of total Billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,284,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,178.92,63,,,percent of total billed charges,63% of total billed charges,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,43.45,15.3,,,percent of total billed charges,15.3% of total billed charges,195.96,69,,,percent of total billed charges,69% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,96.28,33.9,,,percent of total billed charges,33.9% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,221.52,78,,,percent of total billed charges,78% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,284,
CLO Test,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,25.35,
Stool Culture,30687045,CDM,306,RC,87045,HCPCS,Outpatient,,,218,141.70,,191.84,88,,,percent of total billed charges,88% of total Billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,218,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,137.34,63,,,percent of total billed charges,63% of total billed charges,16.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,33.35,15.3,,,percent of total billed charges,15.3% of total billed charges,150.42,69,,,percent of total billed charges,69% of total billed charges,218,100,,,percent of total billed charges,100% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,218,100,,,percent of total billed charges,100% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,218,100,,,percent of total billed charges,100% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,36.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,82.19,37.7,,,percent of total billed charges,37.70% of total billed charges,82.19,37.7,,,percent of total billed charges,37.70% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,73.9,33.9,,,percent of total billed charges,33.9% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,170.04,78,,,percent of total billed charges,78% of total billed charges,218,100,,,percent of total billed charges,100% of total billed charges,180.07,82.6,,,percent of total billed charges,82.6% of total billed charges,180.07,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,9.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,218,
CULTURE YERSENIA,30687046,CDM,306,RC,87046,HCPCS,Outpatient,,,53,34.45,,46.64,88,,,percent of total billed charges,88% of total Billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,53,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,33.39,63,,,percent of total billed charges,63% of total billed charges,16.52,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,8.11,15.3,,,percent of total billed charges,15.3% of total billed charges,36.57,69,,,percent of total billed charges,69% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,36.1,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,17.97,33.9,,,percent of total billed charges,33.9% of total billed charges,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,41.34,78,,,percent of total billed charges,78% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,9.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.44,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,53,
Strep Culture,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,279,181.35,,245.52,88,,,percent of total billed charges,88% of total Billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,279,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,175.77,63,,,percent of total billed charges,63% of total billed charges,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,42.69,15.3,,,percent of total billed charges,15.3% of total billed charges,192.51,69,,,percent of total billed charges,69% of total billed charges,279,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,279,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,279,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,105.18,37.7,,,percent of total billed charges,37.70% of total billed charges,105.18,37.7,,,percent of total billed charges,37.70% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,94.58,33.9,,,percent of total billed charges,33.9% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,217.62,78,,,percent of total billed charges,78% of total billed charges,279,100,,,percent of total billed charges,100% of total billed charges,230.45,82.6,,,percent of total billed charges,82.6% of total billed charges,230.45,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,279,
CULTURE WOUND AEROBIC,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,317.52,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,77.11,15.3,,,percent of total billed charges,15.3% of total billed charges,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,504,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,504,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,170.86,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,504,
CULTURE THROAT,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,157,102.05,,138.16,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,157,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,98.91,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,24.02,15.3,,,percent of total billed charges,15.3% of total billed charges,108.33,69,,,percent of total billed charges,69% of total billed charges,157,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,157,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,157,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,59.19,37.7,,,percent of total billed charges,37.70% of total billed charges,59.19,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,53.22,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,122.46,78,,,percent of total billed charges,78% of total billed charges,157,100,,,percent of total billed charges,100% of total billed charges,129.68,82.6,,,percent of total billed charges,82.6% of total billed charges,129.68,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,157,
CULTURE TISSUE,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,448,291.20,,394.24,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,448,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,282.24,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,68.54,15.3,,,percent of total billed charges,15.3% of total billed charges,309.12,69,,,percent of total billed charges,69% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,448,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,448,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,151.87,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,349.44,78,,,percent of total billed charges,78% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,448,
Culture Urine,30687086,CDM,306,RC,87086,HCPCS,Outpatient,,,166,107.90,,146.08,88,,,percent of total billed charges,88% of total Billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,166,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,104.58,63,,,percent of total billed charges,63% of total billed charges,14.12,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,25.4,15.3,,,percent of total billed charges,15.3% of total billed charges,114.54,69,,,percent of total billed charges,69% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,166,100,,,percent of total billed charges,100% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,30.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,56.27,33.9,,,percent of total billed charges,33.9% of total billed charges,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,129.48,78,,,percent of total billed charges,78% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,8.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.07,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,166,
Strep Culture,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,284,184.60,,249.92,88,,,percent of total billed charges,88% of total Billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,284,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,178.92,63,,,percent of total billed charges,63% of total billed charges,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,43.45,15.3,,,percent of total billed charges,15.3% of total billed charges,195.96,69,,,percent of total billed charges,69% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,284,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,96.28,33.9,,,percent of total billed charges,33.9% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,221.52,78,,,percent of total billed charges,78% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,284,
RMC-Etest,30687181,CDM,306,RC,87181,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,40,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,25.2,63,,,percent of total billed charges,63% of total billed charges,8.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,40,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,18.16,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,13.56,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,4.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.75,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.75,40,
Wound Culture,30687070,CDM,306,RC,87070,HCPCS,Outpatient,,,495,321.75,,435.6,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,495,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,311.85,63,,,percent of total billed charges,63% of total billed charges,15.08,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,75.74,15.3,,,percent of total billed charges,15.3% of total billed charges,341.55,69,,,percent of total billed charges,69% of total billed charges,495,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,495,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,495,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,186.62,37.7,,,percent of total billed charges,37.70% of total billed charges,186.62,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,167.81,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,386.1,78,,,percent of total billed charges,78% of total billed charges,495,100,,,percent of total billed charges,100% of total billed charges,408.87,82.6,,,percent of total billed charges,82.6% of total billed charges,408.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.7,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,495,
"Organism Identification, Yeast LC",30687106,CDM,306,RC,87106,HCPCS,Outpatient,,,215,139.75,,189.2,88,,,percent of total billed charges,88% of total Billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,135.45,63,,,percent of total billed charges,63% of total billed charges,18.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,32.9,15.3,,,percent of total billed charges,15.3% of total billed charges,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,39.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,72.89,33.9,,,percent of total billed charges,33.9% of total billed charges,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,10.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10.32,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,215,
CULTURE YEAST,30687081,CDM,306,RC,87081,HCPCS,Outpatient,,,448,291.20,,394.24,88,,,percent of total billed charges,88% of total Billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,448,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,282.24,63,,,percent of total billed charges,63% of total billed charges,11.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,68.54,15.3,,,percent of total billed charges,15.3% of total billed charges,309.12,69,,,percent of total billed charges,69% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,448,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,448,100,,,percent of total billed charges,100% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.35,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,151.87,33.9,,,percent of total billed charges,33.9% of total billed charges,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,349.44,78,,,percent of total billed charges,78% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.63,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,448,
"OT Cog Ther Intervent, First 15 Min Asst",97129,CDM,430,RC,97129,HCPCS,Outpatient,,,246,159.90,CO|GO,216.48,88,,,percent of total billed charges,88% of total Billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,246,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,154.98,63,,,percent of total billed charges,63% of total billed charges,38.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,37.64,15.3,,,percent of total billed charges,15.3% of total billed charges,169.74,69,,,percent of total billed charges,69% of total billed charges,246,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,246,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,246,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,89.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,92.74,37.7,,,percent of total billed charges,37.70% of total billed charges,92.74,37.7,,,percent of total billed charges,37.70% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,83.39,33.9,,,percent of total billed charges,33.9% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,191.88,78,,,percent of total billed charges,78% of total billed charges,246,100,,,percent of total billed charges,100% of total billed charges,203.2,82.6,,,percent of total billed charges,82.6% of total billed charges,203.2,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.22,246,
EEG AWAKE/ASLEEP AT BEDSIDE,74095819,CDM,740,RC,95819,HCPCS,Outpatient,,,1083,703.95,,953.04,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,287.75,100,,,Fee Schedule,100% of WA Medicaid,1083,100,,,percent of total billed charges,100% of total billed charges,296.39,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,682.29,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,287.75,100,,,Fee Schedule,100% of WA Medicaid,165.7,15.3,,,percent of total billed charges,15.3% of total billed charges,747.27,69,,,percent of total billed charges,69% of total billed charges,1083,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1083,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1083,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,287.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,213.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,293.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,374.08,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,408.29,37.7,,,percent of total billed charges,37.70% of total billed charges,408.29,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,367.14,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,844.74,78,,,percent of total billed charges,78% of total billed charges,1083,100,,,percent of total billed charges,100% of total billed charges,894.56,82.6,,,percent of total billed charges,82.6% of total billed charges,894.56,82.6,,,percent of total billed charges,82.6% of total billed charges,287.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,287.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,165.7,1083,
EEG SLEEP ONLY,74095822,CDM,740,RC,95822,HCPCS,Outpatient,,,1452,943.80,,1277.76,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,287.75,100,,,Fee Schedule,100% of WA Medicaid,1452,100,,,percent of total billed charges,100% of total billed charges,296.39,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,287.75,100,,,Fee Schedule,100% of WA Medicaid,222.16,15.3,,,percent of total billed charges,15.3% of total billed charges,1001.88,69,,,percent of total billed charges,69% of total billed charges,1452,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1452,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1452,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,287.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,213.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,293.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,374.08,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,547.4,37.7,,,percent of total billed charges,37.70% of total billed charges,547.4,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,492.23,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1132.56,78,,,percent of total billed charges,78% of total billed charges,1452,100,,,percent of total billed charges,100% of total billed charges,1199.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1199.35,82.6,,,percent of total billed charges,82.6% of total billed charges,287.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,287.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,213.15,1452,
EEG DEATH EVALUATION,74095824,CDM,740,RC,95824,HCPCS,Outpatient,,,920,598.00,,809.6,88,,,percent of total billed charges,88% of total Billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,287.75,100,,,Fee Schedule,100% of WA Medicaid,920,100,,,percent of total billed charges,100% of total billed charges,296.39,103,,,Fee Schedule,103% of WA Medicaid,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,579.6,63,,,percent of total billed charges,63% of total billed charges,956.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,287.75,100,,,Fee Schedule,100% of WA Medicaid,140.76,15.3,,,percent of total billed charges,15.3% of total billed charges,634.8,69,,,percent of total billed charges,69% of total billed charges,920,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,920,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,920,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1981.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,287.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,213.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,293.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,374.08,130,,,Fee Schedule,130% of WA Medicaid ,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,346.84,37.7,,,percent of total billed charges,37.70% of total billed charges,346.84,37.7,,,percent of total billed charges,37.70% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,311.88,33.9,,,percent of total billed charges,33.9% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,717.6,78,,,percent of total billed charges,78% of total billed charges,920,100,,,percent of total billed charges,100% of total billed charges,759.92,82.6,,,percent of total billed charges,82.6% of total billed charges,759.92,82.6,,,percent of total billed charges,82.6% of total billed charges,287.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,552.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,287.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.76,1981.61,
Pfizer-Biontech Covid-19 Vaccine Admin-3rd Dose,0003A,CDM,771,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
"CHANGE OF BLADDER TUBE, SIMPLE CHARGE",76151705,CDM,761,RC,51705,HCPCS,Outpatient,,,814,529.10,,716.32,88,,,percent of total billed charges,88% of total Billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,814,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,512.82,63,,,percent of total billed charges,63% of total billed charges,441.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,124.54,15.3,,,percent of total billed charges,15.3% of total billed charges,561.66,69,,,percent of total billed charges,69% of total billed charges,814,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,814,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,814,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1081.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,48.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,306.88,37.7,,,percent of total billed charges,37.70% of total billed charges,306.88,37.7,,,percent of total billed charges,37.70% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,275.95,33.9,,,percent of total billed charges,33.9% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,634.92,78,,,percent of total billed charges,78% of total billed charges,814,100,,,percent of total billed charges,100% of total billed charges,672.36,82.6,,,percent of total billed charges,82.6% of total billed charges,672.36,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,254.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.07,1081.19,
OCT STRESS TEST,92059020,CDM,920,RC,59020,HCPCS,Outpatient,,,662,430.30,,582.56,88,,,percent of total billed charges,88% of total Billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,165.98,100,,,Fee Schedule,100% of WA Medicaid,662,100,,,percent of total billed charges,100% of total billed charges,170.96,103,,,Fee Schedule,103% of WA Medicaid,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,417.06,63,,,percent of total billed charges,63% of total billed charges,355.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,165.98,100,,,Fee Schedule,100% of WA Medicaid,101.29,15.3,,,percent of total billed charges,15.3% of total billed charges,456.78,69,,,percent of total billed charges,69% of total billed charges,662,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,662,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,662,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,691.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,122.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,169.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,215.77,130,,,Fee Schedule,130% of WA Medicaid ,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,249.57,37.7,,,percent of total billed charges,37.70% of total billed charges,249.57,37.7,,,percent of total billed charges,37.70% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,224.42,33.9,,,percent of total billed charges,33.9% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,516.36,78,,,percent of total billed charges,78% of total billed charges,662,100,,,percent of total billed charges,100% of total billed charges,546.81,82.6,,,percent of total billed charges,82.6% of total billed charges,546.81,82.6,,,percent of total billed charges,82.6% of total billed charges,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,205.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.29,691.92,
FETAL MONITOR  NON OB,72059051,CDM,720,RC,59051,HCPCS,Outpatient,,,234,152.10,,205.92,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,147.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",35.8,15.3,,,percent of total billed charges,15.3% of total billed charges,161.46,69,,,percent of total billed charges,69% of total billed charges,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88.22,37.7,,,percent of total billed charges,37.70% of total billed charges,88.22,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,79.33,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,182.52,78,,,percent of total billed charges,78% of total billed charges,234,100,,,percent of total billed charges,100% of total billed charges,193.28,82.6,,,percent of total billed charges,82.6% of total billed charges,193.28,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.31,16.8,,,percent of total billed charges,16.8% of total billed charges,35.8,234,
EXT VERSION ANTE MANIP,72059412,CDM,720,RC,59412,HCPCS,Outpatient,,,7465,4852.25,,6569.2,88,,,percent of total billed charges,88% of total Billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,586.37,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,603.96,103,,,Fee Schedule,103% of WA Medicaid,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,4702.95,63,,,percent of total billed charges,63% of total billed charges,5580.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,586.37,100,,,Fee Schedule,100% of WA Medicaid,1142.15,15.3,,,percent of total billed charges,15.3% of total billed charges,5150.85,69,,,percent of total billed charges,69% of total billed charges,7465,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7465,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7465,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10656.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,586.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,434.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,598.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,762.28,130,,,Fee Schedule,130% of WA Medicaid ,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2814.31,37.7,,,percent of total billed charges,37.70% of total billed charges,2814.31,37.7,,,percent of total billed charges,37.70% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2530.64,33.9,,,percent of total billed charges,33.9% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5822.7,78,,,percent of total billed charges,78% of total billed charges,7465,100,,,percent of total billed charges,100% of total billed charges,6166.09,82.6,,,percent of total billed charges,82.6% of total billed charges,6166.09,82.6,,,percent of total billed charges,82.6% of total billed charges,586.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3220.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,586.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,434.35,10656.86,
SPINAL PUNCTURE LUMBAR DX CHARGE,76162270,CDM,761,RC,62270,HCPCS,Outpatient,,,1508,980.20,,1327.04,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1508,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,950.04,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,230.72,15.3,,,percent of total billed charges,15.3% of total billed charges,1040.52,69,,,percent of total billed charges,69% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,511.21,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1176.24,78,,,percent of total billed charges,78% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,230.72,2578.03,
ADMIN OF VACCINE,77190471,CDM,771,RC,90471,HCPCS,Outpatient,,,310,201.50,,272.8,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,310,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,195.3,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,47.43,15.3,,,percent of total billed charges,15.3% of total billed charges,213.9,69,,,percent of total billed charges,69% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,310,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,310,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,241.8,78,,,percent of total billed charges,78% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.64,310,
INJ VACCINE ADDL,77190472,CDM,771,RC,,,Outpatient,,,370,240.50,,325.6,88,,,percent of total billed charges,88% of total Billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,62.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,370,100,,,percent of total billed charges,100% of total billed charges,64.02,17.304,,,percent of total billed charges,17.304% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,233.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,62.16,16.8,,,percent of total billed charges,16.8% of total billed charges,56.61,15.3,,,percent of total billed charges,15.3% of total billed charges,255.3,69,,,percent of total billed charges,69% of total billed charges,370,100,,,percent of total billed charges,100% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,370,100,,,percent of total billed charges,100% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,370,100,,,percent of total billed charges,100% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,62.16,16.8,,,percent of total billed charges,16.8% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,185,50,,,percent of total billed charges,50% of total Billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,63.4,17.136,,,percent of total billed charges,17.136% of total billed charges,80.81,21.84,,,percent of total billed charges,21.84% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,139.49,37.7,,,percent of total billed charges,37.70% of total billed charges,139.49,37.7,,,percent of total billed charges,37.70% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,125.43,33.9,,,percent of total billed charges,33.9% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,288.6,78,,,percent of total billed charges,78% of total billed charges,370,100,,,percent of total billed charges,100% of total billed charges,305.62,82.6,,,percent of total billed charges,82.6% of total billed charges,305.62,82.6,,,percent of total billed charges,82.6% of total billed charges,62.16,16.8,,,percent of total billed charges,16.8% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,185,50,,,percent of total billed charges,50% of total Billed charges,62.16,16.8,,,percent of total billed charges,16.8% of total billed charges,56.61,370,
ADMIN IMMUN VACCINE ORAL/NASAL,77190473,CDM,771,RC,90473,HCPCS,Outpatient,,,115,74.75,,101.2,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,115,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.45,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,17.6,15.3,,,percent of total billed charges,15.3% of total billed charges,79.35,69,,,percent of total billed charges,69% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,115,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,115,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,43.36,37.7,,,percent of total billed charges,37.70% of total billed charges,43.36,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,38.99,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,89.7,78,,,percent of total billed charges,78% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,251.75,
IV INJECTION INITIAL PUSH,AMB820035,CDM,260,RC,96374,HCPCS,Outpatient,,,438,284.70,,385.44,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,438,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,67.01,15.3,,,percent of total billed charges,15.3% of total billed charges,302.22,69,,,percent of total billed charges,69% of total billed charges,438,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,438,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,438,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,165.13,37.7,,,percent of total billed charges,37.70% of total billed charges,165.13,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,148.48,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,341.64,78,,,percent of total billed charges,78% of total billed charges,438,100,,,percent of total billed charges,100% of total billed charges,361.79,82.6,,,percent of total billed charges,82.6% of total billed charges,361.79,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,826.71,
IV INJECTION NEW DRUG,AMB820060,CDM,260,RC,96375,HCPCS,Outpatient,,,288,187.20,,253.44,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,288,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,44.06,15.3,,,percent of total billed charges,15.3% of total billed charges,198.72,69,,,percent of total billed charges,69% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,288,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,288,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,97.63,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,224.64,78,,,percent of total billed charges,78% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,288,
IM/SUBQ INJECTION,AMB820018,CDM,761,RC,96372,HCPCS,Outpatient,,,302,196.30,,265.76,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,46.21,15.3,,,percent of total billed charges,15.3% of total billed charges,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,102.38,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,302,
IV PUSH EA ADDL NEW DRUG,84096375,CDM,940,RC,96375,HCPCS,Outpatient,,,288,187.20,,253.44,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,288,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,44.06,15.3,,,percent of total billed charges,15.3% of total billed charges,198.72,69,,,percent of total billed charges,69% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,288,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,288,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,97.63,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,224.64,78,,,percent of total billed charges,78% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,288,
OP VISIT LEVEL 1,76199201,CDM,761,RC,99211,HCPCS,Outpatient,,,283,183.95,,249.04,88,,,percent of total billed charges,88% of total Billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,47.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,283,100,,,percent of total billed charges,100% of total billed charges,48.97,17.304,,,percent of total billed charges,17.304% of total billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,178.29,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,47.54,16.8,,,percent of total billed charges,16.8% of total billed charges,43.3,15.3,,,percent of total billed charges,15.3% of total billed charges,195.27,69,,,percent of total billed charges,69% of total billed charges,283,100,,,percent of total billed charges,100% of total billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,283,100,,,percent of total billed charges,100% of total billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,283,100,,,percent of total billed charges,100% of total billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,175.04,61.85,,,percent of total billed charges,61.85% of total billed charges,47.54,16.8,,,percent of total billed charges,16.8% of total billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,47.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,48.49,17.136,,,percent of total billed charges,17.136% of total billed charges,61.81,21.84,,,percent of total billed charges,21.84% of total billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,106.69,37.7,,,percent of total billed charges,37.70% of total billed charges,106.69,37.7,,,percent of total billed charges,37.70% of total billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,141.5,50,,,percent of total billed charges,50% of total Billed charges,220.74,78,,,percent of total billed charges,78% of total billed charges,283,100,,,percent of total billed charges,100% of total billed charges,233.76,82.6,,,percent of total billed charges,82.6% of total billed charges,233.76,82.6,,,percent of total billed charges,82.6% of total billed charges,47.54,16.8,,,percent of total billed charges,16.8% of total billed charges,141.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,141.5,50,,,percent of total billed charges,50% of total Billed charges,47.54,16.8,,,percent of total billed charges,16.8% of total billed charges,43.3,283,
OP VISIT LEVEL 2 NEW PT,76199202,CDM,761,RC,99202,HCPCS,Outpatient,,,447,290.55,,393.36,88,,,percent of total billed charges,88% of total Billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,75.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,447,100,,,percent of total billed charges,100% of total billed charges,77.35,17.304,,,percent of total billed charges,17.304% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,281.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.1,16.8,,,percent of total billed charges,16.8% of total billed charges,68.39,15.3,,,percent of total billed charges,15.3% of total billed charges,308.43,69,,,percent of total billed charges,69% of total billed charges,447,100,,,percent of total billed charges,100% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,447,100,,,percent of total billed charges,100% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,447,100,,,percent of total billed charges,100% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,276.47,61.85,,,percent of total billed charges,61.85% of total billed charges,75.1,16.8,,,percent of total billed charges,16.8% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,75.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,76.6,17.136,,,percent of total billed charges,17.136% of total billed charges,97.62,21.84,,,percent of total billed charges,21.84% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,168.52,37.7,,,percent of total billed charges,37.70% of total billed charges,168.52,37.7,,,percent of total billed charges,37.70% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,223.5,50,,,percent of total billed charges,50% of total Billed charges,348.66,78,,,percent of total billed charges,78% of total billed charges,447,100,,,percent of total billed charges,100% of total billed charges,369.22,82.6,,,percent of total billed charges,82.6% of total billed charges,369.22,82.6,,,percent of total billed charges,82.6% of total billed charges,75.1,16.8,,,percent of total billed charges,16.8% of total billed charges,223.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,223.5,50,,,percent of total billed charges,50% of total Billed charges,75.1,16.8,,,percent of total billed charges,16.8% of total billed charges,68.39,447,
OP VISIT LEVEL 3 NEW PT,76199203,CDM,761,RC,99203,HCPCS,Outpatient,,,839,545.35,,738.32,88,,,percent of total billed charges,88% of total Billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,140.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,839,100,,,percent of total billed charges,100% of total billed charges,145.18,17.304,,,percent of total billed charges,17.304% of total billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,528.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,140.95,16.8,,,percent of total billed charges,16.8% of total billed charges,128.37,15.3,,,percent of total billed charges,15.3% of total billed charges,578.91,69,,,percent of total billed charges,69% of total billed charges,839,100,,,percent of total billed charges,100% of total billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,839,100,,,percent of total billed charges,100% of total billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,839,100,,,percent of total billed charges,100% of total billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,518.92,61.85,,,percent of total billed charges,61.85% of total billed charges,140.95,16.8,,,percent of total billed charges,16.8% of total billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,140.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,143.77,17.136,,,percent of total billed charges,17.136% of total billed charges,183.24,21.84,,,percent of total billed charges,21.84% of total billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,316.3,37.7,,,percent of total billed charges,37.70% of total billed charges,316.3,37.7,,,percent of total billed charges,37.70% of total billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,419.5,50,,,percent of total billed charges,50% of total Billed charges,654.42,78,,,percent of total billed charges,78% of total billed charges,839,100,,,percent of total billed charges,100% of total billed charges,693.01,82.6,,,percent of total billed charges,82.6% of total billed charges,693.01,82.6,,,percent of total billed charges,82.6% of total billed charges,140.95,16.8,,,percent of total billed charges,16.8% of total billed charges,419.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,419.5,50,,,percent of total billed charges,50% of total Billed charges,140.95,16.8,,,percent of total billed charges,16.8% of total billed charges,128.37,839,
OP VISIT LEVEL 3 NEW PT,76199204,CDM,761,RC,99204,HCPCS,Outpatient,,,1673,1087.45,,1472.24,88,,,percent of total billed charges,88% of total Billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,281.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,1673,100,,,percent of total billed charges,100% of total billed charges,289.5,17.304,,,percent of total billed charges,17.304% of total billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,1053.99,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,281.06,16.8,,,percent of total billed charges,16.8% of total billed charges,255.97,15.3,,,percent of total billed charges,15.3% of total billed charges,1154.37,69,,,percent of total billed charges,69% of total billed charges,1673,100,,,percent of total billed charges,100% of total billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,1673,100,,,percent of total billed charges,100% of total billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,1673,100,,,percent of total billed charges,100% of total billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,1034.75,61.85,,,percent of total billed charges,61.85% of total billed charges,281.06,16.8,,,percent of total billed charges,16.8% of total billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,281.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,286.69,17.136,,,percent of total billed charges,17.136% of total billed charges,365.38,21.84,,,percent of total billed charges,21.84% of total billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,630.72,37.7,,,percent of total billed charges,37.70% of total billed charges,630.72,37.7,,,percent of total billed charges,37.70% of total billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,836.5,50,,,percent of total billed charges,50% of total Billed charges,1304.94,78,,,percent of total billed charges,78% of total billed charges,1673,100,,,percent of total billed charges,100% of total billed charges,1381.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1381.9,82.6,,,percent of total billed charges,82.6% of total billed charges,281.06,16.8,,,percent of total billed charges,16.8% of total billed charges,836.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,836.5,50,,,percent of total billed charges,50% of total Billed charges,281.06,16.8,,,percent of total billed charges,16.8% of total billed charges,255.97,1673,
OB VISIT LEVEL 1,76199211,CDM,761,RC,99211,HCPCS,Outpatient,,,380,247.00,,334.4,88,,,percent of total billed charges,88% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,65.76,17.304,,,percent of total billed charges,17.304% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,239.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,235.03,61.85,,,percent of total billed charges,61.85% of total billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,65.12,17.136,,,percent of total billed charges,17.136% of total billed charges,82.99,21.84,,,percent of total billed charges,21.84% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,58.14,380,
OB VISIT LEVEL 2,76199212,CDM,761,RC,99212,HCPCS,Outpatient,,,380,247.00,,334.4,88,,,percent of total billed charges,88% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,65.76,17.304,,,percent of total billed charges,17.304% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,239.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,235.03,61.85,,,percent of total billed charges,61.85% of total billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,65.12,17.136,,,percent of total billed charges,17.136% of total billed charges,82.99,21.84,,,percent of total billed charges,21.84% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,58.14,380,
OB VISIT LEVEL 3,76199213,CDM,761,RC,99213,HCPCS,Outpatient,,,339,220.35,,298.32,88,,,percent of total billed charges,88% of total Billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,56.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,339,100,,,percent of total billed charges,100% of total billed charges,58.66,17.304,,,percent of total billed charges,17.304% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,213.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,56.95,16.8,,,percent of total billed charges,16.8% of total billed charges,51.87,15.3,,,percent of total billed charges,15.3% of total billed charges,233.91,69,,,percent of total billed charges,69% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,339,100,,,percent of total billed charges,100% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,339,100,,,percent of total billed charges,100% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,209.67,61.85,,,percent of total billed charges,61.85% of total billed charges,56.95,16.8,,,percent of total billed charges,16.8% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,56.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,58.09,17.136,,,percent of total billed charges,17.136% of total billed charges,74.04,21.84,,,percent of total billed charges,21.84% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,169.5,50,,,percent of total billed charges,50% of total Billed charges,264.42,78,,,percent of total billed charges,78% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,56.95,16.8,,,percent of total billed charges,16.8% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,169.5,50,,,percent of total billed charges,50% of total Billed charges,56.95,16.8,,,percent of total billed charges,16.8% of total billed charges,51.87,339,
OB VISIT LEVEL 4,76199214,CDM,761,RC,99214,HCPCS,Outpatient,,,355,230.75,,312.4,88,,,percent of total billed charges,88% of total Billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,59.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,355,100,,,percent of total billed charges,100% of total billed charges,61.43,17.304,,,percent of total billed charges,17.304% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,223.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,59.64,16.8,,,percent of total billed charges,16.8% of total billed charges,54.32,15.3,,,percent of total billed charges,15.3% of total billed charges,244.95,69,,,percent of total billed charges,69% of total billed charges,355,100,,,percent of total billed charges,100% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,355,100,,,percent of total billed charges,100% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,355,100,,,percent of total billed charges,100% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,219.57,61.85,,,percent of total billed charges,61.85% of total billed charges,59.64,16.8,,,percent of total billed charges,16.8% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,59.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,60.83,17.136,,,percent of total billed charges,17.136% of total billed charges,77.53,21.84,,,percent of total billed charges,21.84% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,133.84,37.7,,,percent of total billed charges,37.70% of total billed charges,133.84,37.7,,,percent of total billed charges,37.70% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,177.5,50,,,percent of total billed charges,50% of total Billed charges,276.9,78,,,percent of total billed charges,78% of total billed charges,355,100,,,percent of total billed charges,100% of total billed charges,293.23,82.6,,,percent of total billed charges,82.6% of total billed charges,293.23,82.6,,,percent of total billed charges,82.6% of total billed charges,59.64,16.8,,,percent of total billed charges,16.8% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,177.5,50,,,percent of total billed charges,50% of total Billed charges,59.64,16.8,,,percent of total billed charges,16.8% of total billed charges,54.32,355,
OB VISIT LEVEL 5,76199215,CDM,761,RC,99215,HCPCS,Outpatient,,,723,469.95,,636.24,88,,,percent of total billed charges,88% of total Billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,121.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,723,100,,,percent of total billed charges,100% of total billed charges,125.11,17.304,,,percent of total billed charges,17.304% of total billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,455.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,121.46,16.8,,,percent of total billed charges,16.8% of total billed charges,110.62,15.3,,,percent of total billed charges,15.3% of total billed charges,498.87,69,,,percent of total billed charges,69% of total billed charges,723,100,,,percent of total billed charges,100% of total billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,723,100,,,percent of total billed charges,100% of total billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,723,100,,,percent of total billed charges,100% of total billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,447.18,61.85,,,percent of total billed charges,61.85% of total billed charges,121.46,16.8,,,percent of total billed charges,16.8% of total billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,121.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,123.89,17.136,,,percent of total billed charges,17.136% of total billed charges,157.9,21.84,,,percent of total billed charges,21.84% of total billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,272.57,37.7,,,percent of total billed charges,37.70% of total billed charges,272.57,37.7,,,percent of total billed charges,37.70% of total billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,361.5,50,,,percent of total billed charges,50% of total Billed charges,563.94,78,,,percent of total billed charges,78% of total billed charges,723,100,,,percent of total billed charges,100% of total billed charges,597.2,82.6,,,percent of total billed charges,82.6% of total billed charges,597.2,82.6,,,percent of total billed charges,82.6% of total billed charges,121.46,16.8,,,percent of total billed charges,16.8% of total billed charges,361.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,361.5,50,,,percent of total billed charges,50% of total Billed charges,121.46,16.8,,,percent of total billed charges,16.8% of total billed charges,110.62,723,
EPIDURAL FOR OB DELIVERY CHARGE,37000000,CDM,370,RC,,,Outpatient,,,1728,1123.20,,1520.64,88,,,percent of total billed charges,88% of total Billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,290.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,1728,100,,,percent of total billed charges,100% of total billed charges,299.01,17.304,,,percent of total billed charges,17.304% of total billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,1088.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,290.3,16.8,,,percent of total billed charges,16.8% of total billed charges,264.38,15.3,,,percent of total billed charges,15.3% of total billed charges,1192.32,69,,,percent of total billed charges,69% of total billed charges,1728,100,,,percent of total billed charges,100% of total billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,1728,100,,,percent of total billed charges,100% of total billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,1728,100,,,percent of total billed charges,100% of total billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,1068.77,61.85,,,percent of total billed charges,61.85% of total billed charges,290.3,16.8,,,percent of total billed charges,16.8% of total billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,290.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,296.11,17.136,,,percent of total billed charges,17.136% of total billed charges,377.4,21.84,,,percent of total billed charges,21.84% of total billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,651.46,37.7,,,percent of total billed charges,37.70% of total billed charges,651.46,37.7,,,percent of total billed charges,37.70% of total billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,585.79,33.9,,,percent of total billed charges,33.9% of total billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,1347.84,78,,,percent of total billed charges,78% of total billed charges,1728,100,,,percent of total billed charges,100% of total billed charges,1427.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1427.33,82.6,,,percent of total billed charges,82.6% of total billed charges,290.3,16.8,,,percent of total billed charges,16.8% of total billed charges,864,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,864,50,,,percent of total billed charges,50% of total Billed charges,290.3,16.8,,,percent of total billed charges,16.8% of total billed charges,264.38,1728,
ADMIN FLU VACCINE,771G0008,CDM,771,RC,G0008,HCPCS,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,132,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,83.16,63,,,percent of total billed charges,63% of total billed charges,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,44.75,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.2,162.5,
ADMIN PNEUMO VACCINE,771G0009,CDM,771,RC,G0009,HCPCS,Outpatient,,,335,217.75,,294.8,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,335,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,211.05,63,,,percent of total billed charges,63% of total billed charges,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,51.26,15.3,,,percent of total billed charges,15.3% of total billed charges,231.15,69,,,percent of total billed charges,69% of total billed charges,335,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,335,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,335,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,126.3,37.7,,,percent of total billed charges,37.70% of total billed charges,126.3,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,113.57,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,261.3,78,,,percent of total billed charges,78% of total billed charges,335,100,,,percent of total billed charges,100% of total billed charges,276.71,82.6,,,percent of total billed charges,82.6% of total billed charges,276.71,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.64,335,
HEP B VACCINE ADMIN,771G0010,CDM,771,RC,G0010,HCPCS,Outpatient,,,216,140.40,,190.08,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,216,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,136.08,63,,,percent of total billed charges,63% of total billed charges,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,33.05,15.3,,,percent of total billed charges,15.3% of total billed charges,149.04,69,,,percent of total billed charges,69% of total billed charges,216,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,216,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,216,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,81.43,37.7,,,percent of total billed charges,37.70% of total billed charges,81.43,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,73.22,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,168.48,78,,,percent of total billed charges,78% of total billed charges,216,100,,,percent of total billed charges,100% of total billed charges,178.42,82.6,,,percent of total billed charges,82.6% of total billed charges,178.42,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.05,216,
G0463 Hospital Outpatient Visit Charge,761G0463,CDM,761,RC,G0463,HCPCS,Outpatient,,,290,188.50,,255.2,88,,,percent of total billed charges,88% of total Billed charges,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,48.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,290,100,,,percent of total billed charges,100% of total billed charges,50.18,17.304,,,percent of total billed charges,17.304% of total billed charges,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,182.7,63,,,percent of total billed charges,63% of total billed charges,235.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,48.72,16.8,,,percent of total billed charges,16.8% of total billed charges,44.37,15.3,,,percent of total billed charges,15.3% of total billed charges,200.1,69,,,percent of total billed charges,69% of total billed charges,290,100,,,percent of total billed charges,100% of total billed charges,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,290,100,,,percent of total billed charges,100% of total billed charges,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,290,100,,,percent of total billed charges,100% of total billed charges,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,482.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,48.72,16.8,,,percent of total billed charges,16.8% of total billed charges,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,48.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,49.69,17.136,,,percent of total billed charges,17.136% of total billed charges,63.34,21.84,,,percent of total billed charges,21.84% of total billed charges,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,109.33,37.7,,,percent of total billed charges,37.70% of total billed charges,109.33,37.7,,,percent of total billed charges,37.70% of total billed charges,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,98.31,33.9,,,percent of total billed charges,33.9% of total billed charges,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,226.2,78,,,percent of total billed charges,78% of total billed charges,290,100,,,percent of total billed charges,100% of total billed charges,239.54,82.6,,,percent of total billed charges,82.6% of total billed charges,239.54,82.6,,,percent of total billed charges,82.6% of total billed charges,48.72,16.8,,,percent of total billed charges,16.8% of total billed charges,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,136.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,134.82,100,,,Fee Schedule,100% of Medicare OPPS rate,48.72,16.8,,,percent of total billed charges,16.8% of total billed charges,44.37,482.38,
LABOR LEVEL I PER HOUR,72000001,CDM,720,RC,,,Outpatient,,,4215,2739.75,,3709.2,88,,,percent of total billed charges,88% of total Billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,708.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4215,100,,,percent of total billed charges,100% of total billed charges,729.36,17.304,,,percent of total billed charges,17.304% of total billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,2655.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,708.12,16.8,,,percent of total billed charges,16.8% of total billed charges,644.9,15.3,,,percent of total billed charges,15.3% of total billed charges,2908.35,69,,,percent of total billed charges,69% of total billed charges,4215,100,,,percent of total billed charges,100% of total billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,4215,100,,,percent of total billed charges,100% of total billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,4215,100,,,percent of total billed charges,100% of total billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,2606.98,61.85,,,percent of total billed charges,61.85% of total billed charges,708.12,16.8,,,percent of total billed charges,16.8% of total billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,708.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,722.28,17.136,,,percent of total billed charges,17.136% of total billed charges,920.56,21.84,,,percent of total billed charges,21.84% of total billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,1589.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1589.06,37.7,,,percent of total billed charges,37.70% of total billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,1428.89,33.9,,,percent of total billed charges,33.9% of total billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,3287.7,78,,,percent of total billed charges,78% of total billed charges,4215,100,,,percent of total billed charges,100% of total billed charges,3481.59,82.6,,,percent of total billed charges,82.6% of total billed charges,3481.59,82.6,,,percent of total billed charges,82.6% of total billed charges,708.12,16.8,,,percent of total billed charges,16.8% of total billed charges,2107.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2107.5,50,,,percent of total billed charges,50% of total Billed charges,708.12,16.8,,,percent of total billed charges,16.8% of total billed charges,644.9,4215,
LABOR LEVEL II PER HOUR,72000002,CDM,720,RC,,,Outpatient,,,4307,2799.55,,3790.16,88,,,percent of total billed charges,88% of total Billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,723.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,4307,100,,,percent of total billed charges,100% of total billed charges,745.28,17.304,,,percent of total billed charges,17.304% of total billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,2713.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,723.58,16.8,,,percent of total billed charges,16.8% of total billed charges,658.97,15.3,,,percent of total billed charges,15.3% of total billed charges,2971.83,69,,,percent of total billed charges,69% of total billed charges,4307,100,,,percent of total billed charges,100% of total billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,4307,100,,,percent of total billed charges,100% of total billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,4307,100,,,percent of total billed charges,100% of total billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,2663.88,61.85,,,percent of total billed charges,61.85% of total billed charges,723.58,16.8,,,percent of total billed charges,16.8% of total billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,723.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,738.05,17.136,,,percent of total billed charges,17.136% of total billed charges,940.65,21.84,,,percent of total billed charges,21.84% of total billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,1623.74,37.7,,,percent of total billed charges,37.70% of total billed charges,1623.74,37.7,,,percent of total billed charges,37.70% of total billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,1460.07,33.9,,,percent of total billed charges,33.9% of total billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,3359.46,78,,,percent of total billed charges,78% of total billed charges,4307,100,,,percent of total billed charges,100% of total billed charges,3557.58,82.6,,,percent of total billed charges,82.6% of total billed charges,3557.58,82.6,,,percent of total billed charges,82.6% of total billed charges,723.58,16.8,,,percent of total billed charges,16.8% of total billed charges,2153.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2153.5,50,,,percent of total billed charges,50% of total Billed charges,723.58,16.8,,,percent of total billed charges,16.8% of total billed charges,658.97,4307,
LABOR LEVEL III PER HOUR,72000003,CDM,720,RC,,,Outpatient,,,4421,2873.65,,3890.48,88,,,percent of total billed charges,88% of total Billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,742.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,4421,100,,,percent of total billed charges,100% of total billed charges,765.01,17.304,,,percent of total billed charges,17.304% of total billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,2785.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.73,16.8,,,percent of total billed charges,16.8% of total billed charges,676.41,15.3,,,percent of total billed charges,15.3% of total billed charges,3050.49,69,,,percent of total billed charges,69% of total billed charges,4421,100,,,percent of total billed charges,100% of total billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,4421,100,,,percent of total billed charges,100% of total billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,4421,100,,,percent of total billed charges,100% of total billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,2734.39,61.85,,,percent of total billed charges,61.85% of total billed charges,742.73,16.8,,,percent of total billed charges,16.8% of total billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,742.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,757.58,17.136,,,percent of total billed charges,17.136% of total billed charges,965.55,21.84,,,percent of total billed charges,21.84% of total billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,1666.72,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.72,37.7,,,percent of total billed charges,37.70% of total billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,1498.72,33.9,,,percent of total billed charges,33.9% of total billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,3448.38,78,,,percent of total billed charges,78% of total billed charges,4421,100,,,percent of total billed charges,100% of total billed charges,3651.75,82.6,,,percent of total billed charges,82.6% of total billed charges,3651.75,82.6,,,percent of total billed charges,82.6% of total billed charges,742.73,16.8,,,percent of total billed charges,16.8% of total billed charges,2210.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210.5,50,,,percent of total billed charges,50% of total Billed charges,742.73,16.8,,,percent of total billed charges,16.8% of total billed charges,676.41,4421,
LEVEL I DELIVERY,72000011,CDM,720,RC,,,Outpatient,,,7464,4851.60,,6568.32,88,,,percent of total billed charges,88% of total Billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,1253.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1291.57,17.304,,,percent of total billed charges,17.304% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,4702.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1253.95,16.8,,,percent of total billed charges,16.8% of total billed charges,1141.99,15.3,,,percent of total billed charges,15.3% of total billed charges,5150.16,69,,,percent of total billed charges,69% of total billed charges,7464,100,,,percent of total billed charges,100% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,7464,100,,,percent of total billed charges,100% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,7464,100,,,percent of total billed charges,100% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,4616.48,61.85,,,percent of total billed charges,61.85% of total billed charges,1253.95,16.8,,,percent of total billed charges,16.8% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,1253.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,1279.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1630.14,21.84,,,percent of total billed charges,21.84% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,2813.93,37.7,,,percent of total billed charges,37.70% of total billed charges,2813.93,37.7,,,percent of total billed charges,37.70% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,2530.3,33.9,,,percent of total billed charges,33.9% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,5821.92,78,,,percent of total billed charges,78% of total billed charges,7464,100,,,percent of total billed charges,100% of total billed charges,6165.26,82.6,,,percent of total billed charges,82.6% of total billed charges,6165.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1253.95,16.8,,,percent of total billed charges,16.8% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3732,50,,,percent of total billed charges,50% of total Billed charges,1253.95,16.8,,,percent of total billed charges,16.8% of total billed charges,1141.99,7464,
LEVEL II DELIVERY,72000012,CDM,720,RC,,,Outpatient,,,7464,4851.60,,6568.32,88,,,percent of total billed charges,88% of total Billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,1253.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1291.57,17.304,,,percent of total billed charges,17.304% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,4702.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1253.95,16.8,,,percent of total billed charges,16.8% of total billed charges,1141.99,15.3,,,percent of total billed charges,15.3% of total billed charges,5150.16,69,,,percent of total billed charges,69% of total billed charges,7464,100,,,percent of total billed charges,100% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,7464,100,,,percent of total billed charges,100% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,7464,100,,,percent of total billed charges,100% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,4616.48,61.85,,,percent of total billed charges,61.85% of total billed charges,1253.95,16.8,,,percent of total billed charges,16.8% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,1253.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,1279.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1630.14,21.84,,,percent of total billed charges,21.84% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,2813.93,37.7,,,percent of total billed charges,37.70% of total billed charges,2813.93,37.7,,,percent of total billed charges,37.70% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,2530.3,33.9,,,percent of total billed charges,33.9% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,5821.92,78,,,percent of total billed charges,78% of total billed charges,7464,100,,,percent of total billed charges,100% of total billed charges,6165.26,82.6,,,percent of total billed charges,82.6% of total billed charges,6165.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1253.95,16.8,,,percent of total billed charges,16.8% of total billed charges,3732,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3732,50,,,percent of total billed charges,50% of total Billed charges,1253.95,16.8,,,percent of total billed charges,16.8% of total billed charges,1141.99,7464,
ELEC STIM MAN/15MIN/-GO,43097032X,CDM,430,RC,97032,HCPCS,Outpatient,,,190,123.50,GO,167.2,88,,,percent of total billed charges,88% of total Billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,119.7,63,,,percent of total billed charges,63% of total billed charges,25.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,29.07,15.3,,,percent of total billed charges,15.3% of total billed charges,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,64.41,33.9,,,percent of total billed charges,33.9% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,190,
OT Attended E-Stim Assistant Units,43097032X,CDM,430,RC,97032,HCPCS,Outpatient,,,190,123.50,GO|CO,167.2,88,,,percent of total billed charges,88% of total Billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,119.7,63,,,percent of total billed charges,63% of total billed charges,25.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,29.07,15.3,,,percent of total billed charges,15.3% of total billed charges,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,64.41,33.9,,,percent of total billed charges,33.9% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,190,
CONTRAST BATH/15MIN/-GO,43097034X,CDM,430,RC,97034,HCPCS,Outpatient,,,106,68.90,GO,93.28,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,106,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,66.78,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,16.22,15.3,,,percent of total billed charges,15.3% of total billed charges,73.14,69,,,percent of total billed charges,69% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,57.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,35.93,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,82.68,78,,,percent of total billed charges,78% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,106,
OT Contrast Bath Assistant Units,43097034X,CDM,430,RC,97034,HCPCS,Outpatient,,,106,68.90,GO|CO,93.28,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,106,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,66.78,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,16.22,15.3,,,percent of total billed charges,15.3% of total billed charges,73.14,69,,,percent of total billed charges,69% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,57.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,35.93,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,82.68,78,,,percent of total billed charges,78% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,106,
"OT Community, Work Reintegration Assistant Units",43097537X,CDM,430,RC,97537,HCPCS,Outpatient,,,264,171.60,GO|CO,232.32,88,,,percent of total billed charges,88% of total Billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,264,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,166.32,63,,,percent of total billed charges,63% of total billed charges,56.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,124.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,89.5,33.9,,,percent of total billed charges,33.9% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.79,264,
"OT Cog Ther Intervent, First 15 Min Asst",43097129,CDM,430,RC,97129,HCPCS,Outpatient,,,103,66.95,CO|GO,90.64,88,,,percent of total billed charges,88% of total Billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,103,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,64.89,63,,,percent of total billed charges,63% of total billed charges,38.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,15.76,15.3,,,percent of total billed charges,15.3% of total billed charges,71.07,69,,,percent of total billed charges,69% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,103,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,89.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,38.83,37.7,,,percent of total billed charges,37.70% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,34.92,33.9,,,percent of total billed charges,33.9% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,80.34,78,,,percent of total billed charges,78% of total billed charges,103,100,,,percent of total billed charges,100% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,85.08,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.76,103,
"OT Cog Ther Intervent, Addl 15 Min Asst",43097130,CDM,430,RC,97130,HCPCS,Outpatient,,,99,64.35,CO|GO,87.12,88,,,percent of total billed charges,88% of total Billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,99,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,62.37,63,,,percent of total billed charges,63% of total billed charges,36.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,15.15,15.3,,,percent of total billed charges,15.3% of total billed charges,68.31,69,,,percent of total billed charges,69% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,99,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,99,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,84.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,37.32,37.7,,,percent of total billed charges,37.70% of total billed charges,37.32,37.7,,,percent of total billed charges,37.70% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,33.56,33.9,,,percent of total billed charges,33.9% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,77.22,78,,,percent of total billed charges,78% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.41,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.15,99,
OT EVAL- LOW COMP,43497165X,CDM,434,RC,97165,HCPCS,Outpatient,,,380,247.00,GO,334.4,88,,,percent of total billed charges,88% of total Billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,179.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,378.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,104.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,380,
OT EVAL- MOD COMP,43497166X,CDM,434,RC,97166,HCPCS,Outpatient,,,380,247.00,GO,334.4,88,,,percent of total billed charges,88% of total Billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,179.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,378.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,104.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,380,
OT EVAL- HGH COMP,43497167X,CDM,434,RC,97167,HCPCS,Outpatient,,,380,247.00,GO,334.4,88,,,percent of total billed charges,88% of total Billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,179.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,378.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,104.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,380,
OCCUP THERAPY GROUP/-GO,43397150,CDM,433,RC,97150,HCPCS,Outpatient,,,139,90.35,GO,122.32,88,,,percent of total billed charges,88% of total Billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,10.44,103,,,Fee Schedule,103% of WA Medicaid,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,87.57,63,,,percent of total billed charges,63% of total billed charges,31.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.57,130,,,Fee Schedule,130% of WA Medicaid ,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.44,139,
OT Group Therapy Assistant Units,43097150X,CDM,430,RC,97150,HCPCS,Outpatient,,,139,90.35,GO|CO,122.32,88,,,percent of total billed charges,88% of total Billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,10.44,103,,,Fee Schedule,103% of WA Medicaid,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,87.57,63,,,percent of total billed charges,63% of total billed charges,31.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.57,130,,,Fee Schedule,130% of WA Medicaid ,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.44,139,
IONTOPHORESIS/15MIN/-GO,43097033X,CDM,430,RC,97033,HCPCS,Outpatient,,,189,122.85,GO,166.32,88,,,percent of total billed charges,88% of total Billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,189,100,,,percent of total billed charges,100% of total billed charges,11.77,103,,,Fee Schedule,103% of WA Medicaid,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,119.07,63,,,percent of total billed charges,63% of total billed charges,34.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,28.92,15.3,,,percent of total billed charges,15.3% of total billed charges,130.41,69,,,percent of total billed charges,69% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,78.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,12.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.3,130,,,Fee Schedule,130% of WA Medicaid ,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,64.07,33.9,,,percent of total billed charges,33.9% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,147.42,78,,,percent of total billed charges,78% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.77,189,
MANUAL THERAPY/15MIN/-GO,43097140X,CDM,430,RC,97140,HCPCS,Outpatient,,,253,164.45,GO,222.64,88,,,percent of total billed charges,88% of total Billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,159.39,63,,,percent of total billed charges,63% of total billed charges,47.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,106.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.72,130,,,Fee Schedule,130% of WA Medicaid ,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.94,253,
MASSAGE EA 15MIN/-GO,43097124X,CDM,430,RC,97124,HCPCS,Outpatient,,,113,73.45,GO,99.44,88,,,percent of total billed charges,88% of total Billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,17.84,103,,,Fee Schedule,103% of WA Medicaid,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,54.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,18.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.19,130,,,Fee Schedule,130% of WA Medicaid ,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.29,113.99,
OT Massage Assistant Units,43097124X,CDM,430,RC,97124,HCPCS,Outpatient,,,113,73.45,GO|CO,99.44,88,,,percent of total billed charges,88% of total Billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,17.84,103,,,Fee Schedule,103% of WA Medicaid,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,54.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,18.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.19,130,,,Fee Schedule,130% of WA Medicaid ,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.29,113.99,
OT Manual Therapy Assistant Units,43097140X,CDM,430,RC,97140,HCPCS,Outpatient,,,253,164.45,GO|CO,222.64,88,,,percent of total billed charges,88% of total Billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,159.39,63,,,percent of total billed charges,63% of total billed charges,47.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,106.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.72,130,,,Fee Schedule,130% of WA Medicaid ,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.94,253,
NEUROMUSC RE-ED/15MIN/-GO,43097112X,CDM,430,RC,97112,HCPCS,Outpatient,,,215,139.75,GO,189.2,88,,,percent of total billed charges,88% of total Billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,19.93,103,,,Fee Schedule,103% of WA Medicaid,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.45,63,,,percent of total billed charges,63% of total billed charges,59.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,32.9,15.3,,,percent of total billed charges,15.3% of total billed charges,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,20.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.91,130,,,Fee Schedule,130% of WA Medicaid ,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,72.89,33.9,,,percent of total billed charges,33.9% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.93,215,
DEBRIDEMENT NON-SELCT/SESS/-GO,43097602X,CDM,430,RC,97602,HCPCS,Outpatient,,,695,451.75,GO,611.6,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,695,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,437.85,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,106.34,15.3,,,percent of total billed charges,15.3% of total billed charges,479.55,69,,,percent of total billed charges,69% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,235.61,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,542.1,78,,,percent of total billed charges,78% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.34,729.42,
OT Neuromuscular Reeducation Assistant Units,43097112X,CDM,430,RC,97112,HCPCS,Outpatient,,,215,139.75,GO|CO,189.2,88,,,percent of total billed charges,88% of total Billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,19.93,103,,,Fee Schedule,103% of WA Medicaid,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.45,63,,,percent of total billed charges,63% of total billed charges,59.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,32.9,15.3,,,percent of total billed charges,15.3% of total billed charges,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,20.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.91,130,,,Fee Schedule,130% of WA Medicaid ,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,72.89,33.9,,,percent of total billed charges,33.9% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.93,215,
ORTHOTIC MGMT EA 15M OT,43097760X,CDM,430,RC,97760,HCPCS,Outpatient,,,165,107.25,GO,145.2,88,,,percent of total billed charges,88% of total Billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,165,100,,,percent of total billed charges,100% of total billed charges,29.04,103,,,Fee Schedule,103% of WA Medicaid,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,103.95,63,,,percent of total billed charges,63% of total billed charges,85.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,193.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.75,130,,,Fee Schedule,130% of WA Medicaid ,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,55.94,33.9,,,percent of total billed charges,33.9% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.25,193.2,
ORTH/PROS CHECKOUT EST 15M GO,43097763X,CDM,430,RC,97763,HCPCS,Outpatient,,,174,113.10,GO,153.12,88,,,percent of total billed charges,88% of total Billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,109.62,63,,,percent of total billed charges,63% of total billed charges,93.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,212.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,54.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.77,212.21,
ORTHOTIC MGMT EA 15M OT,43097760X,CDM,430,RC,97760,HCPCS,Outpatient,,,165,107.25,GO,145.2,88,,,percent of total billed charges,88% of total Billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,165,100,,,percent of total billed charges,100% of total billed charges,29.04,103,,,Fee Schedule,103% of WA Medicaid,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,103.95,63,,,percent of total billed charges,63% of total billed charges,85.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,193.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.75,130,,,Fee Schedule,130% of WA Medicaid ,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,55.94,33.9,,,percent of total billed charges,33.9% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.25,193.2,
"OT Orthotic Management, Train Assistant Units",43097760X,CDM,430,RC,97760,HCPCS,Outpatient,,,165,107.25,GO|CO,145.2,88,,,percent of total billed charges,88% of total Billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,165,100,,,percent of total billed charges,100% of total billed charges,29.04,103,,,Fee Schedule,103% of WA Medicaid,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,103.95,63,,,percent of total billed charges,63% of total billed charges,85.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,193.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.75,130,,,Fee Schedule,130% of WA Medicaid ,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,55.94,33.9,,,percent of total billed charges,33.9% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.25,193.2,
"OT Orthotic/Prosthetic Manage,Train Assistant Units",43097763X,CDM,430,RC,97763,HCPCS,Outpatient,,,174,113.10,GO|CO,153.12,88,,,percent of total billed charges,88% of total Billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,109.62,63,,,percent of total billed charges,63% of total billed charges,93.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,212.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,54.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.77,212.21,
PARAFFIN BATH/-GO,43097018X,CDM,430,RC,97018,HCPCS,Outpatient,,,135,87.75,GO,118.8,88,,,percent of total billed charges,88% of total Billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,3.42,103,,,Fee Schedule,103% of WA Medicaid,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,85.05,63,,,percent of total billed charges,63% of total billed charges,9.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,22.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.45,130,,,Fee Schedule,130% of WA Medicaid ,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,45.77,33.9,,,percent of total billed charges,33.9% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.42,135,
FUNCT CAP TEST/15MIN/-GO,43097750X,CDM,430,RC,97750,HCPCS,Outpatient,,,219,142.35,GO,192.72,88,,,percent of total billed charges,88% of total Billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,219,100,,,percent of total billed charges,100% of total billed charges,20.12,103,,,Fee Schedule,103% of WA Medicaid,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,137.97,63,,,percent of total billed charges,63% of total billed charges,60.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,33.51,15.3,,,percent of total billed charges,15.3% of total billed charges,151.11,69,,,percent of total billed charges,69% of total billed charges,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,132.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.16,130,,,Fee Schedule,130% of WA Medicaid ,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,82.56,37.7,,,percent of total billed charges,37.70% of total billed charges,82.56,37.7,,,percent of total billed charges,37.70% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,74.24,33.9,,,percent of total billed charges,33.9% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,170.82,78,,,percent of total billed charges,78% of total billed charges,219,100,,,percent of total billed charges,100% of total billed charges,180.89,82.6,,,percent of total billed charges,82.6% of total billed charges,180.89,82.6,,,percent of total billed charges,82.6% of total billed charges,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,35.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.12,219,
SELECT DEBRIDE/20 CM OR < GO,43097597X,CDM,430,RC,97597,HCPCS,Outpatient,,,695,451.75,GO,611.6,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,695,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,437.85,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,106.34,15.3,,,percent of total billed charges,15.3% of total billed charges,479.55,69,,,percent of total billed charges,69% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,235.61,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,542.1,78,,,percent of total billed charges,78% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.34,729.41,
OT RE-EVAL/-GO,43497168X,CDM,434,RC,97168,HCPCS,Outpatient,,,249,161.85,GO,219.12,88,,,percent of total billed charges,88% of total Billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41,100,,,Fee Schedule,100% of WA Medicaid,249,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,156.87,63,,,percent of total billed charges,63% of total billed charges,124.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,41,100,,,Fee Schedule,100% of WA Medicaid,38.1,15.3,,,percent of total billed charges,15.3% of total billed charges,171.81,69,,,percent of total billed charges,69% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,255.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.3,130,,,Fee Schedule,130% of WA Medicaid ,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,84.41,33.9,,,percent of total billed charges,33.9% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,194.22,78,,,percent of total billed charges,78% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,72.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.1,255.24,
SENSORY INTEGRATION/GO,43097533X,CDM,430,RC,97533,HCPCS,Outpatient,,,251,163.15,GO,220.88,88,,,percent of total billed charges,88% of total Billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicaid,251,100,,,percent of total billed charges,100% of total billed charges,38.15,103,,,Fee Schedule,103% of WA Medicaid,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,158.13,63,,,percent of total billed charges,63% of total billed charges,111.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,38.15,100,,,Fee Schedule,100% of WA Medicaid,38.4,15.3,,,percent of total billed charges,15.3% of total billed charges,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,233.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.6,130,,,Fee Schedule,130% of WA Medicaid ,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,85.09,33.9,,,percent of total billed charges,33.9% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.15,251,
ACT DAILY LIV/15MIN/-GO,43097535X,CDM,430,RC,97535,HCPCS,Outpatient,,,142,92.30,GO,124.96,88,,,percent of total billed charges,88% of total Billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,19.36,103,,,Fee Schedule,103% of WA Medicaid,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,58.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,129.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.17,130,,,Fee Schedule,130% of WA Medicaid ,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.36,142,
SELECT DEBRIDE > 20 CM GO,43097598X,CDM,430,RC,97598,HCPCS,Outpatient,,,900,585.00,GO,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,450,50,,,percent of total billed charges,50% of total Billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,305.1,33.9,,,percent of total billed charges,33.9% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,137.7,1174.99,
SELECT DEBRIDE/20 CM OR < GO,43097597X,CDM,430,RC,97597,HCPCS,Outpatient,,,695,451.75,GO,611.6,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,695,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,437.85,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,106.34,15.3,,,percent of total billed charges,15.3% of total billed charges,479.55,69,,,percent of total billed charges,69% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,235.61,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,542.1,78,,,percent of total billed charges,78% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.34,729.41,
OT Sensory Integrative Tech Assistant Units,43097533X,CDM,430,RC,97533,HCPCS,Outpatient,,,251,163.15,GO|CO,220.88,88,,,percent of total billed charges,88% of total Billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicaid,251,100,,,percent of total billed charges,100% of total billed charges,38.15,103,,,Fee Schedule,103% of WA Medicaid,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,158.13,63,,,percent of total billed charges,63% of total billed charges,111.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,38.15,100,,,Fee Schedule,100% of WA Medicaid,38.4,15.3,,,percent of total billed charges,15.3% of total billed charges,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,233.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.6,130,,,Fee Schedule,130% of WA Medicaid ,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,85.09,33.9,,,percent of total billed charges,33.9% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.15,251,
"OT Self Care, Home Mgmt Assistant Units",43097535X,CDM,430,RC,97535,HCPCS,Outpatient,,,142,92.30,GO|CO,124.96,88,,,percent of total billed charges,88% of total Billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,19.36,103,,,Fee Schedule,103% of WA Medicaid,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,58.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,129.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.17,130,,,Fee Schedule,130% of WA Medicaid ,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.36,142,
THERA EXERCISE/15MIN/-GO,43097110X,CDM,430,RC,97110,HCPCS,Outpatient,,,171,111.15,GO,150.48,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,171,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,107.73,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,26.16,15.3,,,percent of total billed charges,15.3% of total billed charges,117.99,69,,,percent of total billed charges,69% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,57.97,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,133.38,78,,,percent of total billed charges,78% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,171,
THERAPEUTIC ACT/15MIN/-GO,43097530X,CDM,430,RC,97530,HCPCS,Outpatient,,,194,126.10,GO,170.72,88,,,percent of total billed charges,88% of total Billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,65.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,194,
THERAP ACT 1:1/15MIN/-GP,42097530X,CDM,430,RC,97530,HCPCS,Outpatient,,,194,126.10,GO,170.72,88,,,percent of total billed charges,88% of total Billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,65.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,194,
THERA EXERCISE/15MIN/-GO,43097110X,CDM,430,RC,97110,HCPCS,Outpatient,,,171,111.15,GO,150.48,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,171,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,107.73,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,26.16,15.3,,,percent of total billed charges,15.3% of total billed charges,117.99,69,,,percent of total billed charges,69% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,57.97,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,133.38,78,,,percent of total billed charges,78% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,171,
THERAPEUTIC ACT/15MIN/-GO,43097530X,CDM,430,RC,97530,HCPCS,Outpatient,,,194,126.10,GO,170.72,88,,,percent of total billed charges,88% of total Billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,65.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,194,
"Therapeutic procedure, 1 or more areas, each 15 minutes; the",43097110,CDM,430,RC,97110,HCPCS,Outpatient,,,184,119.60,CO|GO,161.92,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,184,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,115.92,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,28.15,15.3,,,percent of total billed charges,15.3% of total billed charges,126.96,69,,,percent of total billed charges,69% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,143.52,78,,,percent of total billed charges,78% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,184,
"Therapeutic activities, direct (one-on-one) patient contact",43097530,CDM,430,RC,97530,HCPCS,Outpatient,,,194,126.10,GO|CO,170.72,88,,,percent of total billed charges,88% of total Billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,65.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,194,
ULTRASOUND/15MIN/-GO,43097035X,CDM,430,RC,97035,HCPCS,Outpatient,,,214,139.10,GO,188.32,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,214,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,134.82,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,32.74,15.3,,,percent of total billed charges,15.3% of total billed charges,147.66,69,,,percent of total billed charges,69% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,56.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,72.55,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,166.92,78,,,percent of total billed charges,78% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,214,
"Electrical stimulation (unattended), to one or more areas fo",430G0283,CDM,430,RC,G0283,HCPCS,Outpatient,,,155,100.75,CO|GO,136.4,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,155,100,,,percent of total billed charges,100% of total billed charges,29.97,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,97.65,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,23.72,15.3,,,percent of total billed charges,15.3% of total billed charges,106.95,69,,,percent of total billed charges,69% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,50.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,21.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.83,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,52.55,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,120.9,78,,,percent of total billed charges,78% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.84,155,
"Application of a modality to 1 or more areas; ultrasound, ea",43097035,CDM,430,RC,97035,HCPCS,Outpatient,,,225,146.25,CO|GO,198,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,225,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,141.75,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,34.43,15.3,,,percent of total billed charges,15.3% of total billed charges,155.25,69,,,percent of total billed charges,69% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,225,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,225,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,56.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,76.28,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,175.5,78,,,percent of total billed charges,78% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,225,
VASOPNEUMATIC DEVICES/-GO,43097016X,CDM,430,RC,97016,HCPCS,Outpatient,,,134,87.10,GO,117.92,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,134,100,,,percent of total billed charges,100% of total billed charges,6.83,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,84.42,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,20.5,15.3,,,percent of total billed charges,15.3% of total billed charges,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,46.67,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.88,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,45.43,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.83,134,
WHIRLPOOL/-GO,43097022X,CDM,430,RC,97022,HCPCS,Outpatient,,,176,114.40,GO,154.88,88,,,percent of total billed charges,88% of total Billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,176,100,,,percent of total billed charges,100% of total billed charges,10.25,103,,,Fee Schedule,103% of WA Medicaid,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,110.88,63,,,percent of total billed charges,63% of total billed charges,30.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,26.93,15.3,,,percent of total billed charges,15.3% of total billed charges,121.44,69,,,percent of total billed charges,69% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,69.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.33,130,,,Fee Schedule,130% of WA Medicaid ,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,59.66,33.9,,,percent of total billed charges,33.9% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,137.28,78,,,percent of total billed charges,78% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.25,176,
WHIRLPOOL/-GO,43097022X,CDM,430,RC,97022,HCPCS,Outpatient,,,176,114.40,GO,154.88,88,,,percent of total billed charges,88% of total Billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,176,100,,,percent of total billed charges,100% of total billed charges,10.25,103,,,Fee Schedule,103% of WA Medicaid,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,110.88,63,,,percent of total billed charges,63% of total billed charges,30.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,26.93,15.3,,,percent of total billed charges,15.3% of total billed charges,121.44,69,,,percent of total billed charges,69% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,69.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.33,130,,,Fee Schedule,130% of WA Medicaid ,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,59.66,33.9,,,percent of total billed charges,33.9% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,137.28,78,,,percent of total billed charges,78% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.25,176,
Application of a modality to 1 or more areas; whirlpool,43097022,CDM,430,RC,97022,HCPCS,Outpatient,,,180,117.00,CO|GO,158.4,88,,,percent of total billed charges,88% of total Billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,10.25,103,,,Fee Schedule,103% of WA Medicaid,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,113.4,63,,,percent of total billed charges,63% of total billed charges,30.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,69.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.33,130,,,Fee Schedule,130% of WA Medicaid ,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,61.02,33.9,,,percent of total billed charges,33.9% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.25,180,
"Electrical stimulation (unattended), to one or more areas fo",430G0283,CDM,430,RC,G0283,HCPCS,Outpatient,,,155,100.75,CO|GO,136.4,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,155,100,,,percent of total billed charges,100% of total billed charges,29.97,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,97.65,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,23.72,15.3,,,percent of total billed charges,15.3% of total billed charges,106.95,69,,,percent of total billed charges,69% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,50.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,21.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.83,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,52.55,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,120.9,78,,,percent of total billed charges,78% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.84,155,
"Electrical stimulation (unattended), to one or more areas fo",430G0283,CDM,430,RC,G0283,HCPCS,Outpatient,,,155,100.75,CO|GO,136.4,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,155,100,,,percent of total billed charges,100% of total billed charges,29.97,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,97.65,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,23.72,15.3,,,percent of total billed charges,15.3% of total billed charges,106.95,69,,,percent of total billed charges,69% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,155,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,50.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,21.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.83,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,52.55,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,120.9,78,,,percent of total billed charges,78% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.84,155,
PARAFFIN BATH/-GO,43097018,CDM,430,RC,97018,HCPCS,Outpatient,,,135,87.75,GO,118.8,88,,,percent of total billed charges,88% of total Billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,3.42,103,,,Fee Schedule,103% of WA Medicaid,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,85.05,63,,,percent of total billed charges,63% of total billed charges,9.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,22.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.45,130,,,Fee Schedule,130% of WA Medicaid ,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,45.77,33.9,,,percent of total billed charges,33.9% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.42,135,
VASOPNEUMATIC DEVICES/-GO,43097016,CDM,430,RC,97016,HCPCS,Outpatient,,,134,87.10,GO,117.92,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,134,100,,,percent of total billed charges,100% of total billed charges,6.83,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,84.42,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,20.5,15.3,,,percent of total billed charges,15.3% of total billed charges,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,46.67,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.88,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,45.43,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.83,134,
Application of a modality to 1 or more areas; hot or cold pa,43097010,CDM,430,RC,97010,HCPCS,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,35,100,,,percent of total billed charges,100% of total billed charges,29.97,103,,,Fee Schedule,103% of WA Medicaid,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,22.05,63,,,percent of total billed charges,63% of total billed charges,10.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,35,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,35,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,23.87,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,21.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,29.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.83,130,,,Fee Schedule,130% of WA Medicaid ,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.87,33.9,,,percent of total billed charges,33.9% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.36,37.83,
WHIRLPOOL/-GO,43097022,CDM,430,RC,97022,HCPCS,Outpatient,,,176,114.40,GO,154.88,88,,,percent of total billed charges,88% of total Billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,176,100,,,percent of total billed charges,100% of total billed charges,10.25,103,,,Fee Schedule,103% of WA Medicaid,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,110.88,63,,,percent of total billed charges,63% of total billed charges,30.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,26.93,15.3,,,percent of total billed charges,15.3% of total billed charges,121.44,69,,,percent of total billed charges,69% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,69.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.33,130,,,Fee Schedule,130% of WA Medicaid ,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,59.66,33.9,,,percent of total billed charges,33.9% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,137.28,78,,,percent of total billed charges,78% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.25,176,
ULTRASOUND/15MIN/-GO,43097035,CDM,430,RC,97035,HCPCS,Outpatient,,,214,139.10,GO,188.32,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,214,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,134.82,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,32.74,15.3,,,percent of total billed charges,15.3% of total billed charges,147.66,69,,,percent of total billed charges,69% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,56.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,72.55,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,166.92,78,,,percent of total billed charges,78% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,214,
ELEC STIM MAN/15MIN/-GO,43097032,CDM,430,RC,97032,HCPCS,Outpatient,,,190,123.50,GO,167.2,88,,,percent of total billed charges,88% of total Billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,119.7,63,,,percent of total billed charges,63% of total billed charges,25.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,29.07,15.3,,,percent of total billed charges,15.3% of total billed charges,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,64.41,33.9,,,percent of total billed charges,33.9% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,190,
IONTOPHORESIS/15MIN/-GO,43097033,CDM,430,RC,97033,HCPCS,Outpatient,,,189,122.85,GO,166.32,88,,,percent of total billed charges,88% of total Billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,189,100,,,percent of total billed charges,100% of total billed charges,11.77,103,,,Fee Schedule,103% of WA Medicaid,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,119.07,63,,,percent of total billed charges,63% of total billed charges,34.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,28.92,15.3,,,percent of total billed charges,15.3% of total billed charges,130.41,69,,,percent of total billed charges,69% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,78.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,12.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.3,130,,,Fee Schedule,130% of WA Medicaid ,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,64.07,33.9,,,percent of total billed charges,33.9% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,147.42,78,,,percent of total billed charges,78% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.77,189,
CONTRAST BATH/15MIN/-GO,43097034,CDM,430,RC,97034,HCPCS,Outpatient,,,106,68.90,GO,93.28,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,106,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,66.78,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,16.22,15.3,,,percent of total billed charges,15.3% of total billed charges,73.14,69,,,percent of total billed charges,69% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,57.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,35.93,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,82.68,78,,,percent of total billed charges,78% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,106,
NEUROMUSC RE-ED/15MIN/-GO,43097112,CDM,430,RC,97112,HCPCS,Outpatient,,,215,139.75,GO,189.2,88,,,percent of total billed charges,88% of total Billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,19.93,103,,,Fee Schedule,103% of WA Medicaid,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.45,63,,,percent of total billed charges,63% of total billed charges,59.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,32.9,15.3,,,percent of total billed charges,15.3% of total billed charges,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,20.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.91,130,,,Fee Schedule,130% of WA Medicaid ,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,72.89,33.9,,,percent of total billed charges,33.9% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.93,215,
THERA EXERCISE/15MIN/-GO,43097110,CDM,430,RC,97110,HCPCS,Outpatient,,,171,111.15,GO,150.48,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,171,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,107.73,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,26.16,15.3,,,percent of total billed charges,15.3% of total billed charges,117.99,69,,,percent of total billed charges,69% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,57.97,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,133.38,78,,,percent of total billed charges,78% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,171,
MASSAGE EA 15MIN/-GO,43097124,CDM,430,RC,97124,HCPCS,Outpatient,,,113,73.45,GO,99.44,88,,,percent of total billed charges,88% of total Billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,17.84,103,,,Fee Schedule,103% of WA Medicaid,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,54.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,18.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.19,130,,,Fee Schedule,130% of WA Medicaid ,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.29,113.99,
OT Cognitive Skills Development Initial 15 min,43097129,CDM,430,RC,97129,HCPCS,Outpatient,,,246,159.90,GO,216.48,88,,,percent of total billed charges,88% of total Billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,246,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,154.98,63,,,percent of total billed charges,63% of total billed charges,38.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,37.64,15.3,,,percent of total billed charges,15.3% of total billed charges,169.74,69,,,percent of total billed charges,69% of total billed charges,246,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,246,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,246,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,89.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,92.74,37.7,,,percent of total billed charges,37.70% of total billed charges,92.74,37.7,,,percent of total billed charges,37.70% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,83.39,33.9,,,percent of total billed charges,33.9% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,191.88,78,,,percent of total billed charges,78% of total billed charges,246,100,,,percent of total billed charges,100% of total billed charges,203.2,82.6,,,percent of total billed charges,82.6% of total billed charges,203.2,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.22,246,
OT Cognitive Skills Development Each add 15,43097130,CDM,430,RC,97130,HCPCS,Outpatient,,,143,92.95,GO,125.84,88,,,percent of total billed charges,88% of total Billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,143,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,90.09,63,,,percent of total billed charges,63% of total billed charges,36.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,21.88,15.3,,,percent of total billed charges,15.3% of total billed charges,98.67,69,,,percent of total billed charges,69% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,84.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,48.48,33.9,,,percent of total billed charges,33.9% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,111.54,78,,,percent of total billed charges,78% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.41,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.2,143,
MANUAL THERAPY/15MIN/-GO,43097140,CDM,430,RC,97140,HCPCS,Outpatient,,,253,164.45,GO,222.64,88,,,percent of total billed charges,88% of total Billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,159.39,63,,,percent of total billed charges,63% of total billed charges,47.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,106.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.72,130,,,Fee Schedule,130% of WA Medicaid ,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.94,253,
OT EVAL- HGH COMP,43497167,CDM,434,RC,97167,HCPCS,Outpatient,,,380,247.00,GO,334.4,88,,,percent of total billed charges,88% of total Billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,179.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,378.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,104.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,380,
OT EVAL- LOW COMP,43497165,CDM,434,RC,97165,HCPCS,Outpatient,,,380,247.00,GO,334.4,88,,,percent of total billed charges,88% of total Billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,179.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,378.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,104.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,380,
OT EVAL- MOD COMP,43497166,CDM,434,RC,97166,HCPCS,Outpatient,,,380,247.00,GO,334.4,88,,,percent of total billed charges,88% of total Billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,179.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,378.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,104.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,380,
OT RE-EVAL/-GO,43497168,CDM,434,RC,97168,HCPCS,Outpatient,,,249,161.85,GO,219.12,88,,,percent of total billed charges,88% of total Billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41,100,,,Fee Schedule,100% of WA Medicaid,249,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,156.87,63,,,percent of total billed charges,63% of total billed charges,124.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,41,100,,,Fee Schedule,100% of WA Medicaid,38.1,15.3,,,percent of total billed charges,15.3% of total billed charges,171.81,69,,,percent of total billed charges,69% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,255.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.3,130,,,Fee Schedule,130% of WA Medicaid ,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,84.41,33.9,,,percent of total billed charges,33.9% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,194.22,78,,,percent of total billed charges,78% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,72.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.1,255.24,
ACT DAILY LIV/15MIN/-GO,43097535,CDM,430,RC,97535,HCPCS,Outpatient,,,142,92.30,GO,124.96,88,,,percent of total billed charges,88% of total Billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,19.36,103,,,Fee Schedule,103% of WA Medicaid,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,58.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,129.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.17,130,,,Fee Schedule,130% of WA Medicaid ,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.36,142,
THERAPEUTIC ACT/15MIN/-GO,43097530,CDM,430,RC,97530,HCPCS,Outpatient,,,194,126.10,GO,170.72,88,,,percent of total billed charges,88% of total Billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,65.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,194,
SENSORY INTEGRATION/GO,43097533,CDM,430,RC,97533,HCPCS,Outpatient,,,251,163.15,GO,220.88,88,,,percent of total billed charges,88% of total Billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicaid,251,100,,,percent of total billed charges,100% of total billed charges,38.15,103,,,Fee Schedule,103% of WA Medicaid,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,158.13,63,,,percent of total billed charges,63% of total billed charges,111.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,38.15,100,,,Fee Schedule,100% of WA Medicaid,38.4,15.3,,,percent of total billed charges,15.3% of total billed charges,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,233.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.6,130,,,Fee Schedule,130% of WA Medicaid ,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,85.09,33.9,,,percent of total billed charges,33.9% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.15,251,
COMM/WORK REINT/15MIN/-GO,43097537,CDM,430,RC,97537,HCPCS,Outpatient,,,264,171.60,GO,232.32,88,,,percent of total billed charges,88% of total Billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,264,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,166.32,63,,,percent of total billed charges,63% of total billed charges,56.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,124.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,89.5,33.9,,,percent of total billed charges,33.9% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.79,264,
SELECT DEBRIDE/20 CM OR < GO,43097597,CDM,430,RC,97597,HCPCS,Outpatient,,,695,451.75,GO,611.6,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,695,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,437.85,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,106.34,15.3,,,percent of total billed charges,15.3% of total billed charges,479.55,69,,,percent of total billed charges,69% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,235.61,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,542.1,78,,,percent of total billed charges,78% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.34,729.41,
SELECT DEBRIDE > 20 CM GO,43097598,CDM,430,RC,97598,HCPCS,Outpatient,,,900,585.00,GO,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,450,50,,,percent of total billed charges,50% of total Billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,305.1,33.9,,,percent of total billed charges,33.9% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,137.7,1174.99,
DEBRIDEMENT NON-SELCT/SESS/-GO,43097602,CDM,430,RC,97602,HCPCS,Outpatient,,,695,451.75,GO,611.6,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,695,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,437.85,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,106.34,15.3,,,percent of total billed charges,15.3% of total billed charges,479.55,69,,,percent of total billed charges,69% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,235.61,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,542.1,78,,,percent of total billed charges,78% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.34,729.42,
DEBRIDEMENT NON-SELCT/SESS/-GO,43097602,CDM,430,RC,97602,HCPCS,Outpatient,,,695,451.75,GO,611.6,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,695,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,437.85,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,106.34,15.3,,,percent of total billed charges,15.3% of total billed charges,479.55,69,,,percent of total billed charges,69% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,235.61,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,542.1,78,,,percent of total billed charges,78% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.34,729.42,
FUNCT CAP TEST/15MIN/-GO,43097750,CDM,430,RC,97750,HCPCS,Outpatient,,,219,142.35,GO,192.72,88,,,percent of total billed charges,88% of total Billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,219,100,,,percent of total billed charges,100% of total billed charges,20.12,103,,,Fee Schedule,103% of WA Medicaid,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,137.97,63,,,percent of total billed charges,63% of total billed charges,60.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,33.51,15.3,,,percent of total billed charges,15.3% of total billed charges,151.11,69,,,percent of total billed charges,69% of total billed charges,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,132.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.16,130,,,Fee Schedule,130% of WA Medicaid ,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,82.56,37.7,,,percent of total billed charges,37.70% of total billed charges,82.56,37.7,,,percent of total billed charges,37.70% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,74.24,33.9,,,percent of total billed charges,33.9% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,170.82,78,,,percent of total billed charges,78% of total billed charges,219,100,,,percent of total billed charges,100% of total billed charges,180.89,82.6,,,percent of total billed charges,82.6% of total billed charges,180.89,82.6,,,percent of total billed charges,82.6% of total billed charges,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,35.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.12,219,
ORTHOTIC MGMT EA 15M OT,43097760,CDM,430,RC,97760,HCPCS,Outpatient,,,165,107.25,GO,145.2,88,,,percent of total billed charges,88% of total Billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,165,100,,,percent of total billed charges,100% of total billed charges,29.04,103,,,Fee Schedule,103% of WA Medicaid,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,103.95,63,,,percent of total billed charges,63% of total billed charges,85.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,193.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.75,130,,,Fee Schedule,130% of WA Medicaid ,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,55.94,33.9,,,percent of total billed charges,33.9% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.25,193.2,
ORTH/PROS CHECKOUT EST 15M GO,43097763,CDM,430,RC,97763,HCPCS,Outpatient,,,174,113.10,GO,153.12,88,,,percent of total billed charges,88% of total Billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,109.62,63,,,percent of total billed charges,63% of total billed charges,93.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,212.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,54.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.77,212.21,
Qualified nonphysician healthcare professional online assess,43098971,CDM,430,RC,98971,HCPCS,Outpatient,,,92,59.80,GO,80.96,88,,,percent of total billed charges,88% of total Billed charges,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,92,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,57.96,63,,,percent of total billed charges,63% of total billed charges,35.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,,,,,Other,"Not Separately reimbursable
",14.08,15.3,,,percent of total billed charges,15.3% of total billed charges,63.48,69,,,percent of total billed charges,69% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,92,100,,,percent of total billed charges,100% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,92,100,,,percent of total billed charges,100% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,78.3,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,,,,,Other,Not Separately reimbursable,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,31.19,33.9,,,percent of total billed charges,33.9% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,71.76,78,,,percent of total billed charges,78% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,21.03,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.82,100,,,Fee Schedule,100% of Medicare OPPS rate,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.08,92,
ACT DAILY LIV/15MIN/-GO,43097535X,CDM,430,RC,97535,HCPCS,Outpatient,,,142,92.30,GO,124.96,88,,,percent of total billed charges,88% of total Billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,19.36,103,,,Fee Schedule,103% of WA Medicaid,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,58.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,129.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.17,130,,,Fee Schedule,130% of WA Medicaid ,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.36,142,
ELEC STIM MAN/15MIN/-GO,43097032X,CDM,430,RC,97032,HCPCS,Outpatient,,,190,123.50,GO,167.2,88,,,percent of total billed charges,88% of total Billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,119.7,63,,,percent of total billed charges,63% of total billed charges,25.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,29.07,15.3,,,percent of total billed charges,15.3% of total billed charges,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,64.41,33.9,,,percent of total billed charges,33.9% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,190,
ORTH/PROS CHECKOUT EST 15M GO,43097763X,CDM,430,RC,97763,HCPCS,Outpatient,,,174,113.10,GO,153.12,88,,,percent of total billed charges,88% of total Billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,109.62,63,,,percent of total billed charges,63% of total billed charges,93.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,212.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,54.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.77,212.21,
COMM/WORK REINT/15MIN/-GO,43097537X,CDM,430,RC,97537,HCPCS,Outpatient,,,264,171.60,GO,232.32,88,,,percent of total billed charges,88% of total Billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,264,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,166.32,63,,,percent of total billed charges,63% of total billed charges,56.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,124.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,89.5,33.9,,,percent of total billed charges,33.9% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.79,264,
E STIM UNATTEND NON-WOUND GO,430G0283,CDM,430,RC,G0283,HCPCS,Outpatient,,,130,84.50,GO,114.4,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,130,100,,,percent of total billed charges,100% of total billed charges,29.97,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,50.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,21.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.83,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.84,130,
G0283 OT ELEC STIM MEDICARE CHARGE,GOG0283,CDM,430,RC,G0283,HCPCS,Outpatient,,,130,84.50,GO|GO,114.4,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,130,100,,,percent of total billed charges,100% of total billed charges,29.97,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,50.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,21.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.83,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.84,130,
OCCUP THERAPY GROUP/-GO,43397150,CDM,433,RC,97150,HCPCS,Outpatient,,,139,90.35,GO,122.32,88,,,percent of total billed charges,88% of total Billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,10.44,103,,,Fee Schedule,103% of WA Medicaid,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,87.57,63,,,percent of total billed charges,63% of total billed charges,31.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.57,130,,,Fee Schedule,130% of WA Medicaid ,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.44,139,
IONTOPHORESIS/15MIN/-GO,43097033X,CDM,430,RC,97033,HCPCS,Outpatient,,,189,122.85,GO,166.32,88,,,percent of total billed charges,88% of total Billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,189,100,,,percent of total billed charges,100% of total billed charges,11.77,103,,,Fee Schedule,103% of WA Medicaid,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,119.07,63,,,percent of total billed charges,63% of total billed charges,34.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,28.92,15.3,,,percent of total billed charges,15.3% of total billed charges,130.41,69,,,percent of total billed charges,69% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,78.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,12.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.3,130,,,Fee Schedule,130% of WA Medicaid ,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,64.07,33.9,,,percent of total billed charges,33.9% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,147.42,78,,,percent of total billed charges,78% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.77,189,
97140 MANUAL THERAPY-MANIPULATION 15 CHARGE,43097140,CDM,430,RC,97140,HCPCS,Outpatient,,,253,164.45,GO,222.64,88,,,percent of total billed charges,88% of total Billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,159.39,63,,,percent of total billed charges,63% of total billed charges,47.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,106.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.72,130,,,Fee Schedule,130% of WA Medicaid ,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.94,253,
MASSAGE EA 15MIN/-GO,43097124X,CDM,430,RC,97124,HCPCS,Outpatient,,,113,73.45,GO,99.44,88,,,percent of total billed charges,88% of total Billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,17.84,103,,,Fee Schedule,103% of WA Medicaid,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,54.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,18.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.19,130,,,Fee Schedule,130% of WA Medicaid ,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.29,113.99,
NEUROMUSC RE-ED/15MIN/-GO,43097112X,CDM,430,RC,97112,HCPCS,Outpatient,,,215,139.75,GO,189.2,88,,,percent of total billed charges,88% of total Billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,19.93,103,,,Fee Schedule,103% of WA Medicaid,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.45,63,,,percent of total billed charges,63% of total billed charges,59.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,32.9,15.3,,,percent of total billed charges,15.3% of total billed charges,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,20.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.91,130,,,Fee Schedule,130% of WA Medicaid ,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,72.89,33.9,,,percent of total billed charges,33.9% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.93,215,
CONTRAST BATH/15MIN/-GO,43097034X,CDM,430,RC,97034,HCPCS,Outpatient,,,106,68.90,GO,93.28,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,106,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,66.78,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,16.22,15.3,,,percent of total billed charges,15.3% of total billed charges,73.14,69,,,percent of total billed charges,69% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,57.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,35.93,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,82.68,78,,,percent of total billed charges,78% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,106,
OT EVAL- HGH COMP,43497167X,CDM,434,RC,97167,HCPCS,Outpatient,,,380,247.00,GO,334.4,88,,,percent of total billed charges,88% of total Billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,179.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,378.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,104.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,380,
OT EVAL- LOW COMP,43497165X,CDM,434,RC,97165,HCPCS,Outpatient,,,380,247.00,GO,334.4,88,,,percent of total billed charges,88% of total Billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,179.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,378.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,104.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,380,
MANUAL THERAPY/15MIN/-GO,43097140X,CDM,430,RC,97140,HCPCS,Outpatient,,,253,164.45,GO,222.64,88,,,percent of total billed charges,88% of total Billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,159.39,63,,,percent of total billed charges,63% of total billed charges,47.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,106.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.72,130,,,Fee Schedule,130% of WA Medicaid ,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.94,253,
OT EVAL- MOD COMP,43497166X,CDM,434,RC,97166,HCPCS,Outpatient,,,380,247.00,GO,334.4,88,,,percent of total billed charges,88% of total Billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,179.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,378.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,104.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.23,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,380,
FUNCT CAP TEST/15MIN/-GO,43097750X,CDM,430,RC,97750,HCPCS,Outpatient,,,219,142.35,GO,192.72,88,,,percent of total billed charges,88% of total Billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,219,100,,,percent of total billed charges,100% of total billed charges,20.12,103,,,Fee Schedule,103% of WA Medicaid,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,137.97,63,,,percent of total billed charges,63% of total billed charges,60.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,33.51,15.3,,,percent of total billed charges,15.3% of total billed charges,151.11,69,,,percent of total billed charges,69% of total billed charges,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,132.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.16,130,,,Fee Schedule,130% of WA Medicaid ,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,82.56,37.7,,,percent of total billed charges,37.70% of total billed charges,82.56,37.7,,,percent of total billed charges,37.70% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,74.24,33.9,,,percent of total billed charges,33.9% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,170.82,78,,,percent of total billed charges,78% of total billed charges,219,100,,,percent of total billed charges,100% of total billed charges,180.89,82.6,,,percent of total billed charges,82.6% of total billed charges,180.89,82.6,,,percent of total billed charges,82.6% of total billed charges,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,35.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.12,219,
OT RE-EVAL/-GO,43497168X,CDM,434,RC,97168,HCPCS,Outpatient,,,249,161.85,GO,219.12,88,,,percent of total billed charges,88% of total Billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41,100,,,Fee Schedule,100% of WA Medicaid,249,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,156.87,63,,,percent of total billed charges,63% of total billed charges,124.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,41,100,,,Fee Schedule,100% of WA Medicaid,38.1,15.3,,,percent of total billed charges,15.3% of total billed charges,171.81,69,,,percent of total billed charges,69% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,249,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,255.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.3,130,,,Fee Schedule,130% of WA Medicaid ,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,84.41,33.9,,,percent of total billed charges,33.9% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,194.22,78,,,percent of total billed charges,78% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,72.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.4,100,,,Fee Schedule,100% of Medicare OPPS rate,41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.1,255.24,
SELECT DEBRIDE/20 CM OR < GO,43097597X,CDM,430,RC,97597,HCPCS,Outpatient,,,695,451.75,GO,611.6,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,695,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,437.85,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,106.34,15.3,,,percent of total billed charges,15.3% of total billed charges,479.55,69,,,percent of total billed charges,69% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,235.61,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,542.1,78,,,percent of total billed charges,78% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.34,729.41,
SELECT DEBRIDE > 20 CM GO,43097598X,CDM,430,RC,97598,HCPCS,Outpatient,,,900,585.00,GO,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,450,50,,,percent of total billed charges,50% of total Billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,305.1,33.9,,,percent of total billed charges,33.9% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,137.7,1174.99,
VASOPNEUMATIC DEVICES/-GO,43097016X,CDM,430,RC,97016,HCPCS,Outpatient,,,134,87.10,GO,117.92,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,134,100,,,percent of total billed charges,100% of total billed charges,6.83,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,84.42,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,20.5,15.3,,,percent of total billed charges,15.3% of total billed charges,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,46.67,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.88,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,45.43,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.83,134,
WHIRLPOOL/-GO,43097022X,CDM,430,RC,97022,HCPCS,Outpatient,,,176,114.40,GO,154.88,88,,,percent of total billed charges,88% of total Billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,176,100,,,percent of total billed charges,100% of total billed charges,10.25,103,,,Fee Schedule,103% of WA Medicaid,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,110.88,63,,,percent of total billed charges,63% of total billed charges,30.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,26.93,15.3,,,percent of total billed charges,15.3% of total billed charges,121.44,69,,,percent of total billed charges,69% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,69.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.33,130,,,Fee Schedule,130% of WA Medicaid ,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,59.66,33.9,,,percent of total billed charges,33.9% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,137.28,78,,,percent of total billed charges,78% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.25,176,
ORTHOTIC MGMT EA 15M OT,43097760X,CDM,430,RC,97760,HCPCS,Outpatient,,,165,107.25,GO,145.2,88,,,percent of total billed charges,88% of total Billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,165,100,,,percent of total billed charges,100% of total billed charges,29.04,103,,,Fee Schedule,103% of WA Medicaid,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,103.95,63,,,percent of total billed charges,63% of total billed charges,85.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,193.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.75,130,,,Fee Schedule,130% of WA Medicaid ,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,55.94,33.9,,,percent of total billed charges,33.9% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.25,193.2,
PARAFFIN BATH/-GO,43097018X,CDM,430,RC,97018,HCPCS,Outpatient,,,135,87.75,GO,118.8,88,,,percent of total billed charges,88% of total Billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,3.42,103,,,Fee Schedule,103% of WA Medicaid,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,85.05,63,,,percent of total billed charges,63% of total billed charges,9.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,22.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.45,130,,,Fee Schedule,130% of WA Medicaid ,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,45.77,33.9,,,percent of total billed charges,33.9% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.42,135,
SENSORY INTEGRATION/GO,43097533X,CDM,430,RC,97533,HCPCS,Outpatient,,,251,163.15,GO,220.88,88,,,percent of total billed charges,88% of total Billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicaid,251,100,,,percent of total billed charges,100% of total billed charges,38.15,103,,,Fee Schedule,103% of WA Medicaid,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,158.13,63,,,percent of total billed charges,63% of total billed charges,111.93,175,,,Fee Schedule,175% of Medicare OPPS Rate,38.15,100,,,Fee Schedule,100% of WA Medicaid,38.4,15.3,,,percent of total billed charges,15.3% of total billed charges,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,233.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.6,130,,,Fee Schedule,130% of WA Medicaid ,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,85.09,33.9,,,percent of total billed charges,33.9% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,64.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,64.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.15,251,
THERA EXERCISE/15MIN/-GO,42097110X,CDM,430,RC,97110,HCPCS,Outpatient,,,171,111.15,GO,150.48,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,171,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,107.73,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,26.16,15.3,,,percent of total billed charges,15.3% of total billed charges,117.99,69,,,percent of total billed charges,69% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,57.97,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,133.38,78,,,percent of total billed charges,78% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,171,
THERAP ACT 1:1/15MIN/-GP,42097530X,CDM,430,RC,97530,HCPCS,Outpatient,,,194,126.10,GO,170.72,88,,,percent of total billed charges,88% of total Billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,65.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,194,
ULTRASOUND/15MIN/-GO,43097035X,CDM,430,RC,97035,HCPCS,Outpatient,,,214,139.10,GO,188.32,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,214,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,134.82,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,32.74,15.3,,,percent of total billed charges,15.3% of total billed charges,147.66,69,,,percent of total billed charges,69% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,56.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,72.55,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,166.92,78,,,percent of total billed charges,78% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,214,
99211 OP CLINIC LEVEL 1 (BRIEF),AMB820051,CDM,761,RC,99211,HCPCS,Outpatient,,,380,247.00,,334.4,88,,,percent of total billed charges,88% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,65.76,17.304,,,percent of total billed charges,17.304% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,239.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,235.03,61.85,,,percent of total billed charges,61.85% of total billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,65.12,17.136,,,percent of total billed charges,17.136% of total billed charges,82.99,21.84,,,percent of total billed charges,21.84% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,58.14,380,
99212 OP CLINIC LEVEL 2 (1+HR),AMB820004,CDM,761,RC,99212,HCPCS,Outpatient,,,380,247.00,,334.4,88,,,percent of total billed charges,88% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,65.76,17.304,,,percent of total billed charges,17.304% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,239.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,235.03,61.85,,,percent of total billed charges,61.85% of total billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,65.12,17.136,,,percent of total billed charges,17.136% of total billed charges,82.99,21.84,,,percent of total billed charges,21.84% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,63.84,16.8,,,percent of total billed charges,16.8% of total billed charges,58.14,380,
99213 OP CLINIC LEVEL 3 (2+HR),AMB820046,CDM,761,RC,99213,HCPCS,Outpatient,,,339,220.35,,298.32,88,,,percent of total billed charges,88% of total Billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,56.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,339,100,,,percent of total billed charges,100% of total billed charges,58.66,17.304,,,percent of total billed charges,17.304% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,213.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,56.95,16.8,,,percent of total billed charges,16.8% of total billed charges,51.87,15.3,,,percent of total billed charges,15.3% of total billed charges,233.91,69,,,percent of total billed charges,69% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,339,100,,,percent of total billed charges,100% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,339,100,,,percent of total billed charges,100% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,209.67,61.85,,,percent of total billed charges,61.85% of total billed charges,56.95,16.8,,,percent of total billed charges,16.8% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,56.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,58.09,17.136,,,percent of total billed charges,17.136% of total billed charges,74.04,21.84,,,percent of total billed charges,21.84% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,169.5,50,,,percent of total billed charges,50% of total Billed charges,264.42,78,,,percent of total billed charges,78% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,56.95,16.8,,,percent of total billed charges,16.8% of total billed charges,169.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,169.5,50,,,percent of total billed charges,50% of total Billed charges,56.95,16.8,,,percent of total billed charges,16.8% of total billed charges,51.87,339,
99214 OP CLINIC LEVEL 4 (3+ HR),AMB820047,CDM,761,RC,99214,HCPCS,Outpatient,,,355,230.75,,312.4,88,,,percent of total billed charges,88% of total Billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,59.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,355,100,,,percent of total billed charges,100% of total billed charges,61.43,17.304,,,percent of total billed charges,17.304% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,223.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,59.64,16.8,,,percent of total billed charges,16.8% of total billed charges,54.32,15.3,,,percent of total billed charges,15.3% of total billed charges,244.95,69,,,percent of total billed charges,69% of total billed charges,355,100,,,percent of total billed charges,100% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,355,100,,,percent of total billed charges,100% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,355,100,,,percent of total billed charges,100% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,219.57,61.85,,,percent of total billed charges,61.85% of total billed charges,59.64,16.8,,,percent of total billed charges,16.8% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,59.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,60.83,17.136,,,percent of total billed charges,17.136% of total billed charges,77.53,21.84,,,percent of total billed charges,21.84% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,133.84,37.7,,,percent of total billed charges,37.70% of total billed charges,133.84,37.7,,,percent of total billed charges,37.70% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,177.5,50,,,percent of total billed charges,50% of total Billed charges,276.9,78,,,percent of total billed charges,78% of total billed charges,355,100,,,percent of total billed charges,100% of total billed charges,293.23,82.6,,,percent of total billed charges,82.6% of total billed charges,293.23,82.6,,,percent of total billed charges,82.6% of total billed charges,59.64,16.8,,,percent of total billed charges,16.8% of total billed charges,177.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,177.5,50,,,percent of total billed charges,50% of total Billed charges,59.64,16.8,,,percent of total billed charges,16.8% of total billed charges,54.32,355,
Insertion of peripherally inserted central venous catheter,88800001,CDM,761,RC,36569,HCPCS,Outpatient,,,2780,1807.00,,2446.4,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,2780,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1751.4,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,425.34,15.3,,,percent of total billed charges,15.3% of total billed charges,1918.2,69,,,percent of total billed charges,69% of total billed charges,2780,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2780,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2780,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1048.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1048.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,942.42,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2168.4,78,,,percent of total billed charges,78% of total billed charges,2780,100,,,percent of total billed charges,100% of total billed charges,2296.28,82.6,,,percent of total billed charges,82.6% of total billed charges,2296.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,425.34,5712.48,
36573 INS PICC INCL IMAG >5YR CHARGE,76136573,CDM,761,RC,36573,HCPCS,Outpatient,,,2928,1903.20,,2576.64,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,2928,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1844.64,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,447.98,15.3,,,percent of total billed charges,15.3% of total billed charges,2020.32,69,,,percent of total billed charges,69% of total billed charges,2928,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2928,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2928,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1103.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1103.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,992.59,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2283.84,78,,,percent of total billed charges,78% of total billed charges,2928,100,,,percent of total billed charges,100% of total billed charges,2418.53,82.6,,,percent of total billed charges,82.6% of total billed charges,2418.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,447.98,5712.48,
COVID-19 Rapid Antigen POC (RE),30287811,CDM,302,RC,87811,HCPCS,Outpatient,,,127,82.55,,111.76,88,,,percent of total billed charges,88% of total Billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,127,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,80.01,63,,,percent of total billed charges,63% of total billed charges,72.41,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,19.43,15.3,,,percent of total billed charges,15.3% of total billed charges,87.63,69,,,percent of total billed charges,69% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,127,100,,,percent of total billed charges,100% of total billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,127,100,,,percent of total billed charges,100% of total billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,41.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,47.88,37.7,,,percent of total billed charges,37.70% of total billed charges,47.88,37.7,,,percent of total billed charges,37.70% of total billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,43.05,33.9,,,percent of total billed charges,33.9% of total billed charges,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,99.06,78,,,percent of total billed charges,78% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,41.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,41.38,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,127,
Flu (GeneXpert Xpress) POCT,30687502,CDM,306,RC,87502,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,100.54,103,,,Fee Schedule,103% of WA Medicaid,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,153.72,63,,,percent of total billed charges,63% of total billed charges,167.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,37.33,15.3,,,percent of total billed charges,15.3% of total billed charges,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,366.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,72.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,99.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.89,130,,,Fee Schedule,130% of WA Medicaid ,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,82.72,33.9,,,percent of total billed charges,33.9% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,96.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.33,366.43,
Flu/RSV (GeneXpert Xpress) POCT,30687502,CDM,306,RC,87502,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,100.54,103,,,Fee Schedule,103% of WA Medicaid,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,153.72,63,,,percent of total billed charges,63% of total billed charges,167.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid,37.33,15.3,,,percent of total billed charges,15.3% of total billed charges,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,244,100,,,percent of total billed charges,100% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,366.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,72.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,99.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.89,130,,,Fee Schedule,130% of WA Medicaid ,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,82.72,33.9,,,percent of total billed charges,33.9% of total billed charges,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,96.75,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.8,100,,,Fee Schedule,100% of Medicare OPPS rate,97.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.33,366.43,
Hemoglobin A1C POCT,30183036,CDM,301,RC,83036,HCPCS,Outpatient,,,206,133.90,,181.28,88,,,percent of total billed charges,88% of total Billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,206,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,129.78,63,,,percent of total billed charges,63% of total billed charges,16.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,31.52,15.3,,,percent of total billed charges,15.3% of total billed charges,142.14,69,,,percent of total billed charges,69% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,206,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,37.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,77.66,37.7,,,percent of total billed charges,37.70% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,69.83,33.9,,,percent of total billed charges,33.9% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.68,78,,,percent of total billed charges,78% of total billed charges,206,100,,,percent of total billed charges,100% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,170.16,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,206,
POCT SARS-CoV-2 (COVID-19)/Flu/RSV (Genexpert),0003000241U,CDM,306,RC,87637,HCPCS,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,364,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,229.32,63,,,percent of total billed charges,63% of total billed charges,249.6,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,55.69,15.3,,,percent of total billed charges,15.3% of total billed charges,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,364,100,,,percent of total billed charges,100% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,123.4,33.9,,,percent of total billed charges,33.9% of total billed charges,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,144.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,142.63,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,364,
SARS-CoV-2 (COVID-19) PCR (GeneXpert) POC,30687635,CDM,306,RC,87635,HCPCS,Outpatient,,,131,85.15,,115.28,88,,,percent of total billed charges,88% of total Billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,131,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,82.53,63,,,percent of total billed charges,63% of total billed charges,89.79,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,20.04,15.3,,,percent of total billed charges,15.3% of total billed charges,90.39,69,,,percent of total billed charges,69% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,131,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,131,100,,,percent of total billed charges,100% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,49.39,37.7,,,percent of total billed charges,37.70% of total billed charges,49.39,37.7,,,percent of total billed charges,37.70% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,44.41,33.9,,,percent of total billed charges,33.9% of total billed charges,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,102.18,78,,,percent of total billed charges,78% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,51.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,51.31,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,131,
Strep A (GeneXpert Xpress) POCT,30687651,CDM,306,RC,87651,HCPCS,Outpatient,,,31,20.15,QW,27.28,88,,,percent of total billed charges,88% of total Billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,31,100,,,percent of total billed charges,100% of total billed charges,25.49,103,,,Fee Schedule,103% of WA Medicaid,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,19.53,63,,,percent of total billed charges,63% of total billed charges,61.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,134.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.18,130,,,Fee Schedule,130% of WA Medicaid ,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,10.51,33.9,,,percent of total billed charges,33.9% of total billed charges,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,35.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.09,100,,,Fee Schedule,100% of Medicare OPPS rate,24.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.74,134.21,
U Dipstick Cotinine (Nicotine) POCT,30080305,CDM,300,RC,80305,HCPCS,Outpatient,,,66,42.90,QW,58.08,88,,,percent of total billed charges,88% of total Billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,11.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,66,100,,,percent of total billed charges,100% of total billed charges,11.42,17.304,,,percent of total billed charges,17.304% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,41.58,63,,,percent of total billed charges,63% of total billed charges,22.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,10.1,15.3,,,percent of total billed charges,15.3% of total billed charges,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,66,100,,,percent of total billed charges,100% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,48.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,11.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,11.31,17.136,,,percent of total billed charges,17.136% of total billed charges,14.41,21.84,,,percent of total billed charges,21.84% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,22.37,33.9,,,percent of total billed charges,33.9% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,12.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,12.6,100,,,Fee Schedule,100% of Medicare OPPS rate,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,10.1,66,
AQUATIC EXER/15MIN/-GP,42097113X,CDM,420,RC,97113,HCPCS,Outpatient,,,236,153.40,GP,207.68,88,,,percent of total billed charges,88% of total Billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicaid,236,100,,,percent of total billed charges,100% of total billed charges,21.83,103,,,Fee Schedule,103% of WA Medicaid,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,148.68,63,,,percent of total billed charges,63% of total billed charges,65.28,175,,,Fee Schedule,175% of Medicare OPPS Rate,21.83,100,,,Fee Schedule,100% of WA Medicaid,36.11,15.3,,,percent of total billed charges,15.3% of total billed charges,162.84,69,,,percent of total billed charges,69% of total billed charges,236,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,236,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,236,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,147.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,22.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.38,130,,,Fee Schedule,130% of WA Medicaid ,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,88.97,37.7,,,percent of total billed charges,37.70% of total billed charges,88.97,37.7,,,percent of total billed charges,37.70% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,80,33.9,,,percent of total billed charges,33.9% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,184.08,78,,,percent of total billed charges,78% of total billed charges,236,100,,,percent of total billed charges,100% of total billed charges,194.94,82.6,,,percent of total billed charges,82.6% of total billed charges,194.94,82.6,,,percent of total billed charges,82.6% of total billed charges,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.83,236,
ASSIST TECH ASSESS EA 15MIN GP,42097755X,CDM,420,RC,97755,HCPCS,Outpatient,,,197,128.05,GP,173.36,88,,,percent of total billed charges,88% of total Billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,22.59,100,,,Fee Schedule,100% of WA Medicaid,197,100,,,percent of total billed charges,100% of total billed charges,22.59,103,,,Fee Schedule,103% of WA Medicaid,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,124.11,63,,,percent of total billed charges,63% of total billed charges,67.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.59,100,,,Fee Schedule,100% of WA Medicaid,30.14,15.3,,,percent of total billed charges,15.3% of total billed charges,135.93,69,,,percent of total billed charges,69% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,197,100,,,percent of total billed charges,100% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,197,100,,,percent of total billed charges,100% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,148.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,22.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,23.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.37,130,,,Fee Schedule,130% of WA Medicaid ,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,74.27,37.7,,,percent of total billed charges,37.70% of total billed charges,74.27,37.7,,,percent of total billed charges,37.70% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,66.78,33.9,,,percent of total billed charges,33.9% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,153.66,78,,,percent of total billed charges,78% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,22.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,39.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,22.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.59,197,
ELEC STIM MAN/15MIN/-GP,42097032X,CDM,420,RC,97032,HCPCS,Outpatient,,,190,123.50,GP,167.2,88,,,percent of total billed charges,88% of total Billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,119.7,63,,,percent of total billed charges,63% of total billed charges,25.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,29.07,15.3,,,percent of total billed charges,15.3% of total billed charges,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,64.41,33.9,,,percent of total billed charges,33.9% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,190,
PT Attended E-Stim Assistant Units,42097032,CDM,420,RC,97032,HCPCS,Outpatient,,,199,129.35,GP|CQ,175.12,88,,,percent of total billed charges,88% of total Billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,199,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,125.37,63,,,percent of total billed charges,63% of total billed charges,25.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,30.45,15.3,,,percent of total billed charges,15.3% of total billed charges,137.31,69,,,percent of total billed charges,69% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,199,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,199,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,75.02,37.7,,,percent of total billed charges,37.70% of total billed charges,75.02,37.7,,,percent of total billed charges,37.70% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,67.46,33.9,,,percent of total billed charges,33.9% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,155.22,78,,,percent of total billed charges,78% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,199,
PT Aquatic Assistant Units,42097113,CDM,420,RC,97113,HCPCS,Outpatient,,,247,160.55,GP|CQ,217.36,88,,,percent of total billed charges,88% of total Billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicaid,247,100,,,percent of total billed charges,100% of total billed charges,21.83,103,,,Fee Schedule,103% of WA Medicaid,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,155.61,63,,,percent of total billed charges,63% of total billed charges,65.28,175,,,Fee Schedule,175% of Medicare OPPS Rate,21.83,100,,,Fee Schedule,100% of WA Medicaid,37.79,15.3,,,percent of total billed charges,15.3% of total billed charges,170.43,69,,,percent of total billed charges,69% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,247,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,147.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,22.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.38,130,,,Fee Schedule,130% of WA Medicaid ,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,83.73,33.9,,,percent of total billed charges,33.9% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,192.66,78,,,percent of total billed charges,78% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.83,247,
CONTRAST BATH15MIN/-GP,42097034X,CDM,420,RC,97034,HCPCS,Outpatient,,,106,68.90,GP,93.28,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,106,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,66.78,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,16.22,15.3,,,percent of total billed charges,15.3% of total billed charges,73.14,69,,,percent of total billed charges,69% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,106,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,57.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,35.93,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,82.68,78,,,percent of total billed charges,78% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,106,
COMM/WORK REINT/15MIN/-GP,42097537X,CDM,420,RC,97537,HCPCS,Outpatient,,,264,171.60,GP,232.32,88,,,percent of total billed charges,88% of total Billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,264,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,166.32,63,,,percent of total billed charges,63% of total billed charges,56.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,264,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,124.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,99.53,37.7,,,percent of total billed charges,37.70% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,89.5,33.9,,,percent of total billed charges,33.9% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.79,264,
420,,,420,RC,,,Outpatient,,,235,152.75,,206.8,88,,,percent of total billed charges,88% of total Billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,39.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,235,100,,,percent of total billed charges,100% of total billed charges,40.66,17.304,,,percent of total billed charges,17.304% of total billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,148.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,39.48,16.8,,,percent of total billed charges,16.8% of total billed charges,35.96,15.3,,,percent of total billed charges,15.3% of total billed charges,162.15,69,,,percent of total billed charges,69% of total billed charges,235,100,,,percent of total billed charges,100% of total billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,235,100,,,percent of total billed charges,100% of total billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,235,100,,,percent of total billed charges,100% of total billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39.48,16.8,,,percent of total billed charges,16.8% of total billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,39.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,40.27,17.136,,,percent of total billed charges,17.136% of total billed charges,51.32,21.84,,,percent of total billed charges,21.84% of total billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,88.6,37.7,,,percent of total billed charges,37.70% of total billed charges,88.6,37.7,,,percent of total billed charges,37.70% of total billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,79.67,33.9,,,percent of total billed charges,33.9% of total billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,183.3,78,,,percent of total billed charges,78% of total billed charges,235,100,,,percent of total billed charges,100% of total billed charges,194.11,82.6,,,percent of total billed charges,82.6% of total billed charges,194.11,82.6,,,percent of total billed charges,82.6% of total billed charges,39.48,16.8,,,percent of total billed charges,16.8% of total billed charges,117.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,117.5,50,,,percent of total billed charges,50% of total Billed charges,39.48,16.8,,,percent of total billed charges,16.8% of total billed charges,35.96,235,
"PT Community,Work Reintegration Assistant Units",42097537,CDM,420,RC,97537,HCPCS,Outpatient,,,236,153.40,CQ|GP,207.68,88,,,percent of total billed charges,88% of total Billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,236,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,148.68,63,,,percent of total billed charges,63% of total billed charges,56.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,36.11,15.3,,,percent of total billed charges,15.3% of total billed charges,162.84,69,,,percent of total billed charges,69% of total billed charges,236,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,236,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,236,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,124.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,88.97,37.7,,,percent of total billed charges,37.70% of total billed charges,88.97,37.7,,,percent of total billed charges,37.70% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,80,33.9,,,percent of total billed charges,33.9% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,184.08,78,,,percent of total billed charges,78% of total billed charges,236,100,,,percent of total billed charges,100% of total billed charges,194.94,82.6,,,percent of total billed charges,82.6% of total billed charges,194.94,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.79,236,
THER PROC GROUP 2/MORE IND-GP,42097150X,CDM,420,RC,97150,HCPCS,Outpatient,,,139,90.35,GP,122.32,88,,,percent of total billed charges,88% of total Billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,10.44,103,,,Fee Schedule,103% of WA Medicaid,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,87.57,63,,,percent of total billed charges,63% of total billed charges,31.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.57,130,,,Fee Schedule,130% of WA Medicaid ,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.44,139,
MANUAL THERAPY/15MIN/-GP,42097140X,CDM,420,RC,97140,HCPCS,Outpatient,,,253,164.45,GP,222.64,88,,,percent of total billed charges,88% of total Billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,159.39,63,,,percent of total billed charges,63% of total billed charges,47.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,106.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.72,130,,,Fee Schedule,130% of WA Medicaid ,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.94,253,
PT EVAL- LOW COMP,42497161X,CDM,424,RC,97161,HCPCS,Outpatient,,,380,247.00,GP,334.4,88,,,percent of total billed charges,88% of total Billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,177.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,390.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,103.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,390.49,
PT EVAL- MOD COMP,42497162X,CDM,424,RC,97162,HCPCS,Outpatient,,,380,247.00,GP,334.4,88,,,percent of total billed charges,88% of total Billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,177.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,390.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,103.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,390.49,
PT EVAL- HGH COMP,42497163X,CDM,424,RC,97163,HCPCS,Outpatient,,,380,247.00,GP,334.4,88,,,percent of total billed charges,88% of total Billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,63,,,percent of total billed charges,63% of total billed charges,177.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,58.14,15.3,,,percent of total billed charges,15.3% of total billed charges,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,380,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,390.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,103.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.14,390.49,
GAIT TRAINING/15MIN/-GP,42197116X,CDM,421,RC,97116,HCPCS,Outpatient,,,172,111.80,GP,151.36,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,172,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,108.36,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,26.32,15.3,,,percent of total billed charges,15.3% of total billed charges,118.68,69,,,percent of total billed charges,69% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,58.31,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,134.16,78,,,percent of total billed charges,78% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,172,
THER PROC GROUP 2/MORE IND-GP,42097150X,CDM,420,RC,97150,HCPCS,Outpatient,,,139,90.35,GP,122.32,88,,,percent of total billed charges,88% of total Billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,10.44,103,,,Fee Schedule,103% of WA Medicaid,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,87.57,63,,,percent of total billed charges,63% of total billed charges,31.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,139,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.57,130,,,Fee Schedule,130% of WA Medicaid ,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,47.12,33.9,,,percent of total billed charges,33.9% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.44,139,
PT Group Therapy Assistant Units,42097150,CDM,423,RC,97150,HCPCS,Outpatient,,,145,94.25,CQ|GP,127.6,88,,,percent of total billed charges,88% of total Billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,145,100,,,percent of total billed charges,100% of total billed charges,10.44,103,,,Fee Schedule,103% of WA Medicaid,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,91.35,63,,,percent of total billed charges,63% of total billed charges,31.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,22.19,15.3,,,percent of total billed charges,15.3% of total billed charges,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,145,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.57,130,,,Fee Schedule,130% of WA Medicaid ,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,49.16,33.9,,,percent of total billed charges,33.9% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.44,145,
PT Gait Training Assistant Units,42197116,CDM,421,RC,97116,HCPCS,Outpatient,,,184,119.60,GP|CQ,161.92,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,184,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,115.92,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,28.15,15.3,,,percent of total billed charges,15.3% of total billed charges,126.96,69,,,percent of total billed charges,69% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,143.52,78,,,percent of total billed charges,78% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,184,
THERAPEUTIC,42097110X,CDM,420,RC,97110,HCPCS,Outpatient,,,171,111.15,GP,150.48,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,171,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,107.73,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,26.16,15.3,,,percent of total billed charges,15.3% of total billed charges,117.99,69,,,percent of total billed charges,69% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,57.97,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,133.38,78,,,percent of total billed charges,78% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,171,
IONTOPHORESIS/15MIN,42097033X,CDM,420,RC,97033,HCPCS,Outpatient,,,189,122.85,GP,166.32,88,,,percent of total billed charges,88% of total Billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,189,100,,,percent of total billed charges,100% of total billed charges,11.77,103,,,Fee Schedule,103% of WA Medicaid,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,119.07,63,,,percent of total billed charges,63% of total billed charges,34.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,28.92,15.3,,,percent of total billed charges,15.3% of total billed charges,130.41,69,,,percent of total billed charges,69% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,189,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,78.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,12.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.3,130,,,Fee Schedule,130% of WA Medicaid ,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,64.07,33.9,,,percent of total billed charges,33.9% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,147.42,78,,,percent of total billed charges,78% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.77,189,
INFRARED,42097026X,CDM,420,RC,97026,HCPCS,Outpatient,,,35,22.75,GP,30.8,88,,,percent of total billed charges,88% of total Billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of WA Medicaid,35,100,,,percent of total billed charges,100% of total billed charges,3.99,103,,,Fee Schedule,103% of WA Medicaid,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,11.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.99,100,,,Fee Schedule,100% of WA Medicaid,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,35,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,35,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,25.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,4.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.19,130,,,Fee Schedule,130% of WA Medicaid ,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11.87,33.9,,,percent of total billed charges,33.9% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,3.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,6.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.99,35,
PT Iontophoresis Assistant Units,42097033,CDM,420,RC,97033,HCPCS,Outpatient,,,198,128.70,CQ|GP,174.24,88,,,percent of total billed charges,88% of total Billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,11.77,103,,,Fee Schedule,103% of WA Medicaid,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,63,,,percent of total billed charges,63% of total billed charges,34.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,30.29,15.3,,,percent of total billed charges,15.3% of total billed charges,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,78.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,12.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.3,130,,,Fee Schedule,130% of WA Medicaid ,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,67.12,33.9,,,percent of total billed charges,33.9% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.77,198,
MANUAL THERAPY/15MIN/-GP,42097140X,CDM,420,RC,97140,HCPCS,Outpatient,,,253,164.45,GP,222.64,88,,,percent of total billed charges,88% of total Billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,159.39,63,,,percent of total billed charges,63% of total billed charges,47.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,106.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.72,130,,,Fee Schedule,130% of WA Medicaid ,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.94,253,
MASSAGE/15MIN/-GP,42097124X,CDM,420,RC,97124,HCPCS,Outpatient,,,113,73.45,GP,99.44,88,,,percent of total billed charges,88% of total Billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,17.84,103,,,Fee Schedule,103% of WA Medicaid,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,54.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,18.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.19,130,,,Fee Schedule,130% of WA Medicaid ,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.29,113.99,
TRACTION MECHANICAL/-GP,42097012X,CDM,420,RC,97012,HCPCS,Outpatient,,,121,78.65,GP,106.48,88,,,percent of total billed charges,88% of total Billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,121,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,76.23,63,,,percent of total billed charges,63% of total billed charges,24.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,18.51,15.3,,,percent of total billed charges,15.3% of total billed charges,83.49,69,,,percent of total billed charges,69% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,121,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,121,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,37.7,,,percent of total billed charges,37.70% of total billed charges,45.62,37.7,,,percent of total billed charges,37.70% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,41.02,33.9,,,percent of total billed charges,33.9% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,94.38,78,,,percent of total billed charges,78% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,121,
PT Manual Therapy Assistant Units,42097140,CDM,420,RC,97140,HCPCS,Outpatient,,,266,172.90,GP|CQ,234.08,88,,,percent of total billed charges,88% of total Billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,266,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,167.58,63,,,percent of total billed charges,63% of total billed charges,47.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,40.7,15.3,,,percent of total billed charges,15.3% of total billed charges,183.54,69,,,percent of total billed charges,69% of total billed charges,266,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,266,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,266,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,106.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.72,130,,,Fee Schedule,130% of WA Medicaid ,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,100.28,37.7,,,percent of total billed charges,37.70% of total billed charges,100.28,37.7,,,percent of total billed charges,37.70% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,90.17,33.9,,,percent of total billed charges,33.9% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,207.48,78,,,percent of total billed charges,78% of total billed charges,266,100,,,percent of total billed charges,100% of total billed charges,219.72,82.6,,,percent of total billed charges,82.6% of total billed charges,219.72,82.6,,,percent of total billed charges,82.6% of total billed charges,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.94,266,
NEURO RE-ED/15MIN/-GP,42197112X,CDM,420,RC,97112,HCPCS,Outpatient,,,215,139.75,GP,189.2,88,,,percent of total billed charges,88% of total Billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,19.93,103,,,Fee Schedule,103% of WA Medicaid,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.45,63,,,percent of total billed charges,63% of total billed charges,59.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,32.9,15.3,,,percent of total billed charges,15.3% of total billed charges,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,215,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,20.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.91,130,,,Fee Schedule,130% of WA Medicaid ,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,72.89,33.9,,,percent of total billed charges,33.9% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.93,215,
NEG PRESS WOUND TX >50 CM GP,42097606X,CDM,420,RC,97606,HCPCS,Outpatient,,,557,362.05,GP,490.16,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,557,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,350.91,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,85.22,15.3,,,percent of total billed charges,15.3% of total billed charges,384.33,69,,,percent of total billed charges,69% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,188.82,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,434.46,78,,,percent of total billed charges,78% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.22,1404.98,
NEG PRESS WOUND TX <50 CM GP,42097605X,CDM,420,RC,97605,HCPCS,Outpatient,,,557,362.05,GP,490.16,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,557,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,350.91,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,85.22,15.3,,,percent of total billed charges,15.3% of total billed charges,384.33,69,,,percent of total billed charges,69% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,188.82,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,434.46,78,,,percent of total billed charges,78% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.22,729.42,
DEBRIDEMENT NON-SELCT/SESS/-GP,42097602X,CDM,420,RC,97602,HCPCS,Outpatient,,,695,451.75,GP,611.6,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,695,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,437.85,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,106.34,15.3,,,percent of total billed charges,15.3% of total billed charges,479.55,69,,,percent of total billed charges,69% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,235.61,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,542.1,78,,,percent of total billed charges,78% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.34,729.42,
PT Neuromuscular Reeducation Assistant Units,42097112,CDM,420,RC,97112,HCPCS,Outpatient,,,226,146.90,CQ|GP,198.88,88,,,percent of total billed charges,88% of total Billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,226,100,,,percent of total billed charges,100% of total billed charges,19.93,103,,,Fee Schedule,103% of WA Medicaid,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,142.38,63,,,percent of total billed charges,63% of total billed charges,59.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,34.58,15.3,,,percent of total billed charges,15.3% of total billed charges,155.94,69,,,percent of total billed charges,69% of total billed charges,226,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,226,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,226,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,20.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.91,130,,,Fee Schedule,130% of WA Medicaid ,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,85.2,37.7,,,percent of total billed charges,37.70% of total billed charges,85.2,37.7,,,percent of total billed charges,37.70% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,76.61,33.9,,,percent of total billed charges,33.9% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,176.28,78,,,percent of total billed charges,78% of total billed charges,226,100,,,percent of total billed charges,100% of total billed charges,186.68,82.6,,,percent of total billed charges,82.6% of total billed charges,186.68,82.6,,,percent of total billed charges,82.6% of total billed charges,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.93,226,
ORTH/PROS CHECKOUT EST 15M GP,42097763X,CDM,420,RC,97763,HCPCS,Outpatient,,,174,113.10,GP,153.12,88,,,percent of total billed charges,88% of total Billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,109.62,63,,,percent of total billed charges,63% of total billed charges,93.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,174,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,212.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,54.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.77,212.21,
ORTHOTIC MGMT EA 15M PT,42097760X,CDM,420,RC,97760,HCPCS,Outpatient,,,165,107.25,GP,145.2,88,,,percent of total billed charges,88% of total Billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,165,100,,,percent of total billed charges,100% of total billed charges,29.04,103,,,Fee Schedule,103% of WA Medicaid,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,103.95,63,,,percent of total billed charges,63% of total billed charges,85.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,165,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,193.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.75,130,,,Fee Schedule,130% of WA Medicaid ,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,62.21,37.7,,,percent of total billed charges,37.70% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,55.94,33.9,,,percent of total billed charges,33.9% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.25,193.2,
"PT Orthotic Management, Train Assistant Units",42097760,CDM,420,RC,97760,HCPCS,Outpatient,,,266,172.90,CQ|GP,234.08,88,,,percent of total billed charges,88% of total Billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,266,100,,,percent of total billed charges,100% of total billed charges,29.04,103,,,Fee Schedule,103% of WA Medicaid,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,167.58,63,,,percent of total billed charges,63% of total billed charges,85.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,40.7,15.3,,,percent of total billed charges,15.3% of total billed charges,183.54,69,,,percent of total billed charges,69% of total billed charges,266,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,266,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,266,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,193.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.75,130,,,Fee Schedule,130% of WA Medicaid ,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,100.28,37.7,,,percent of total billed charges,37.70% of total billed charges,100.28,37.7,,,percent of total billed charges,37.70% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,90.17,33.9,,,percent of total billed charges,33.9% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,207.48,78,,,percent of total billed charges,78% of total billed charges,266,100,,,percent of total billed charges,100% of total billed charges,219.72,82.6,,,percent of total billed charges,82.6% of total billed charges,219.72,82.6,,,percent of total billed charges,82.6% of total billed charges,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.04,266,
"PT Orthotic/Prost Mgmt,Train Assist Unit",42097763,CDM,420,RC,97763,HCPCS,Outpatient,,,183,118.95,GP|CQ,161.04,88,,,percent of total billed charges,88% of total Billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,183,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,115.29,63,,,percent of total billed charges,63% of total billed charges,93.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,28,15.3,,,percent of total billed charges,15.3% of total billed charges,126.27,69,,,percent of total billed charges,69% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,183,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,212.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,62.04,33.9,,,percent of total billed charges,33.9% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,142.74,78,,,percent of total billed charges,78% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,54.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.77,212.21,
PARAFFIN BATH,42097018X,CDM,420,RC,97018,HCPCS,Outpatient,,,135,87.75,GP,118.8,88,,,percent of total billed charges,88% of total Billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,3.42,103,,,Fee Schedule,103% of WA Medicaid,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,85.05,63,,,percent of total billed charges,63% of total billed charges,9.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,135,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,22.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.45,130,,,Fee Schedule,130% of WA Medicaid ,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,45.77,33.9,,,percent of total billed charges,33.9% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.42,135,
FUNCT CAP TEST 15 MIN/-GP,42097750X,CDM,420,RC,97750,HCPCS,Outpatient,,,219,142.35,GP,192.72,88,,,percent of total billed charges,88% of total Billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,219,100,,,percent of total billed charges,100% of total billed charges,20.12,103,,,Fee Schedule,103% of WA Medicaid,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,137.97,63,,,percent of total billed charges,63% of total billed charges,60.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,33.51,15.3,,,percent of total billed charges,15.3% of total billed charges,151.11,69,,,percent of total billed charges,69% of total billed charges,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,219,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,132.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.16,130,,,Fee Schedule,130% of WA Medicaid ,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,82.56,37.7,,,percent of total billed charges,37.70% of total billed charges,82.56,37.7,,,percent of total billed charges,37.70% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,74.24,33.9,,,percent of total billed charges,33.9% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,170.82,78,,,percent of total billed charges,78% of total billed charges,219,100,,,percent of total billed charges,100% of total billed charges,180.89,82.6,,,percent of total billed charges,82.6% of total billed charges,180.89,82.6,,,percent of total billed charges,82.6% of total billed charges,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,35.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.12,219,
PROS TRAIN UP/LO EXT15M PT,42097761X,CDM,420,RC,97761,HCPCS,Outpatient,,,161,104.65,GP,141.68,88,,,percent of total billed charges,88% of total Billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicaid,161,100,,,percent of total billed charges,100% of total billed charges,24.86,103,,,Fee Schedule,103% of WA Medicaid,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,101.43,63,,,percent of total billed charges,63% of total billed charges,74.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.86,100,,,Fee Schedule,100% of WA Medicaid,24.63,15.3,,,percent of total billed charges,15.3% of total billed charges,111.09,69,,,percent of total billed charges,69% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,161,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,161,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,163.44,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,25.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.32,130,,,Fee Schedule,130% of WA Medicaid ,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,60.7,37.7,,,percent of total billed charges,37.70% of total billed charges,60.7,37.7,,,percent of total billed charges,37.70% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,54.58,33.9,,,percent of total billed charges,33.9% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,125.58,78,,,percent of total billed charges,78% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,43.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.63,163.44,
Application of a modality to 1 or more areas; paraffin bath,43097018,CDM,430,RC,97018,HCPCS,Outpatient,,,142,92.30,CO|GO,124.96,88,,,percent of total billed charges,88% of total Billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,3.42,103,,,Fee Schedule,103% of WA Medicaid,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,9.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,22.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.45,130,,,Fee Schedule,130% of WA Medicaid ,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.42,142,
"PT Prosthetic Mgmt,Train Assistant Units",42097761,CDM,420,RC,97761,HCPCS,Outpatient,,,169,109.85,CQ|GP,148.72,88,,,percent of total billed charges,88% of total Billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicaid,169,100,,,percent of total billed charges,100% of total billed charges,24.86,103,,,Fee Schedule,103% of WA Medicaid,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,106.47,63,,,percent of total billed charges,63% of total billed charges,74.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.86,100,,,Fee Schedule,100% of WA Medicaid,25.86,15.3,,,percent of total billed charges,15.3% of total billed charges,116.61,69,,,percent of total billed charges,69% of total billed charges,169,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,169,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,169,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,163.44,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,25.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.32,130,,,Fee Schedule,130% of WA Medicaid ,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,63.71,37.7,,,percent of total billed charges,37.70% of total billed charges,63.71,37.7,,,percent of total billed charges,37.70% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,57.29,33.9,,,percent of total billed charges,33.9% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,131.82,78,,,percent of total billed charges,78% of total billed charges,169,100,,,percent of total billed charges,100% of total billed charges,139.59,82.6,,,percent of total billed charges,82.6% of total billed charges,139.59,82.6,,,percent of total billed charges,82.6% of total billed charges,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,43.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.86,169,
PT RE-EVALUATION/-GP,42497164X,CDM,424,RC,97164,HCPCS,Outpatient,,,226,146.90,GP,198.88,88,,,percent of total billed charges,88% of total Billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,Fee Schedule,100% of WA Medicaid,226,100,,,percent of total billed charges,100% of total billed charges,41.19,103,,,Fee Schedule,103% of WA Medicaid,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,142.38,63,,,percent of total billed charges,63% of total billed charges,123.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,41.19,100,,,Fee Schedule,100% of WA Medicaid,34.58,15.3,,,percent of total billed charges,15.3% of total billed charges,155.94,69,,,percent of total billed charges,69% of total billed charges,226,100,,,percent of total billed charges,100% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,226,100,,,percent of total billed charges,100% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,226,100,,,percent of total billed charges,100% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,267.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,41.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,42.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.55,130,,,Fee Schedule,130% of WA Medicaid ,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,85.2,37.7,,,percent of total billed charges,37.70% of total billed charges,85.2,37.7,,,percent of total billed charges,37.70% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,76.61,33.9,,,percent of total billed charges,33.9% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,176.28,78,,,percent of total billed charges,78% of total billed charges,226,100,,,percent of total billed charges,100% of total billed charges,186.68,82.6,,,percent of total billed charges,82.6% of total billed charges,186.68,82.6,,,percent of total billed charges,82.6% of total billed charges,41.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,71.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.58,267.41,
ADL/15MIN/-GP,42097535X,CDM,420,RC,97535,HCPCS,Outpatient,,,142,92.30,GP,124.96,88,,,percent of total billed charges,88% of total Billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,19.36,103,,,Fee Schedule,103% of WA Medicaid,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,58.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,129.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.17,130,,,Fee Schedule,130% of WA Medicaid ,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.36,142,
SELECT DEBRIDE/20 CM OR < GP,42097597X,CDM,420,RC,97597,HCPCS,Outpatient,,,695,451.75,GP,611.6,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,695,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,437.85,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,106.34,15.3,,,percent of total billed charges,15.3% of total billed charges,479.55,69,,,percent of total billed charges,69% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,695,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,235.61,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,542.1,78,,,percent of total billed charges,78% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.34,729.41,
SELECT DEBRIDE > 20 CM GP,42097598X,CDM,420,RC,97598,HCPCS,Outpatient,,,900,585.00,GP,792,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,900,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,900,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,305.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,137.7,1174.99,
THERAPEUTIC EX/15MIN/-GP,42097110X,CDM,420,RC,97110,HCPCS,Outpatient,,,171,111.15,GP,150.48,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,171,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,107.73,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,26.16,15.3,,,percent of total billed charges,15.3% of total billed charges,117.99,69,,,percent of total billed charges,69% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,57.97,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,133.38,78,,,percent of total billed charges,78% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,171,
THERAP ACT 1:1/15MIN/-GP,42097530X,CDM,420,RC,97530,HCPCS,Outpatient,,,172,111.80,GO,151.36,88,,,percent of total billed charges,88% of total Billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,172,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,108.36,63,,,percent of total billed charges,63% of total billed charges,65.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,26.32,15.3,,,percent of total billed charges,15.3% of total billed charges,118.68,69,,,percent of total billed charges,69% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,172,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,58.31,33.9,,,percent of total billed charges,33.9% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,134.16,78,,,percent of total billed charges,78% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,172,
PT Therapeutic Exercise Assistant Units,42097110,CDM,420,RC,97110,HCPCS,Outpatient,,,184,119.60,GP|CQ,161.92,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,184,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,115.92,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,28.15,15.3,,,percent of total billed charges,15.3% of total billed charges,126.96,69,,,percent of total billed charges,69% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,143.52,78,,,percent of total billed charges,78% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,184,
THERAPEUTIC ACT/15MIN/-GO,42097530,CDM,420,RC,97530,HCPCS,Outpatient,,,194,126.10,GO,170.72,88,,,percent of total billed charges,88% of total Billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,65.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,194,
ULTRASOUND/15MIN/-GP,42097035X,CDM,420,RC,97035,HCPCS,Outpatient,,,214,139.10,GP,188.32,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,214,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,134.82,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,32.74,15.3,,,percent of total billed charges,15.3% of total billed charges,147.66,69,,,percent of total billed charges,69% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,214,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,56.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,72.55,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,166.92,78,,,percent of total billed charges,78% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,214,
ELECTRIC STIMULATION THERAPY,42097014X,CDM,420,RC,97014,HCPCS,Outpatient,,,73,47.45,GP,64.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,7.21,100,,,Fee Schedule,100% of WA Medicaid,73,100,,,percent of total billed charges,100% of total billed charges,7.21,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,45.99,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.21,100,,,Fee Schedule,100% of WA Medicaid,11.17,15.3,,,percent of total billed charges,15.3% of total billed charges,50.37,69,,,percent of total billed charges,69% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,73,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,73,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.37,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,24.75,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,56.94,78,,,percent of total billed charges,78% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,7.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.21,73,
ELEC STIM MAN/15MIN/-GP,42097032X,CDM,420,RC,97032,HCPCS,Outpatient,,,190,123.50,GP,167.2,88,,,percent of total billed charges,88% of total Billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,119.7,63,,,percent of total billed charges,63% of total billed charges,25.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,29.07,15.3,,,percent of total billed charges,15.3% of total billed charges,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,190,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,64.41,33.9,,,percent of total billed charges,33.9% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,190,
ULTRAVIOLET,42097028X,CDM,420,RC,97028,HCPCS,Outpatient,,,44,28.60,GP,38.72,88,,,percent of total billed charges,88% of total Billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.93,100,,,Fee Schedule,100% of WA Medicaid,44,100,,,percent of total billed charges,100% of total billed charges,4.93,103,,,Fee Schedule,103% of WA Medicaid,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,27.72,63,,,percent of total billed charges,63% of total billed charges,14.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.93,100,,,Fee Schedule,100% of WA Medicaid,6.73,15.3,,,percent of total billed charges,15.3% of total billed charges,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,44,100,,,percent of total billed charges,100% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,44,100,,,percent of total billed charges,100% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,31.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.41,130,,,Fee Schedule,130% of WA Medicaid ,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,16.59,37.7,,,percent of total billed charges,37.70% of total billed charges,16.59,37.7,,,percent of total billed charges,37.70% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,14.92,33.9,,,percent of total billed charges,33.9% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,4.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.93,44,
"Electrical stimulation (unattended), to one or more areas fo",421G0283,CDM,420,RC,G0283,HCPCS,Outpatient,,,130,84.50,CO|GO,114.4,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,130,100,,,percent of total billed charges,100% of total billed charges,29.97,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,50.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,21.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.83,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.84,130,
ULTRASOUND/15MIN/-GO,42097035,CDM,420,RC,97035,HCPCS,Outpatient,,,225,146.25,GO,198,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,225,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,141.75,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,34.43,15.3,,,percent of total billed charges,15.3% of total billed charges,155.25,69,,,percent of total billed charges,69% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,225,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,225,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,56.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,76.28,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,175.5,78,,,percent of total billed charges,78% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,225,
VASOPNEUMATIC DEVICES/-GP,42097016X,CDM,420,RC,97016,HCPCS,Outpatient,,,134,87.10,GP,117.92,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,134,100,,,percent of total billed charges,100% of total billed charges,6.83,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,84.42,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,20.5,15.3,,,percent of total billed charges,15.3% of total billed charges,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,134,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,46.67,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.88,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,45.43,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.83,134,
WHEELCHAIR MNGT/15MIN/-GP,42097542X,CDM,420,RC,97542,HCPCS,Outpatient,,,147,95.55,GP,129.36,88,,,percent of total billed charges,88% of total Billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,92.61,63,,,percent of total billed charges,63% of total billed charges,56.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,125.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.79,147,
WHIRLPOOL/-GP,42097022X,CDM,420,RC,97022,HCPCS,Outpatient,,,176,114.40,GP,154.88,88,,,percent of total billed charges,88% of total Billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,176,100,,,percent of total billed charges,100% of total billed charges,10.25,103,,,Fee Schedule,103% of WA Medicaid,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,110.88,63,,,percent of total billed charges,63% of total billed charges,30.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,26.93,15.3,,,percent of total billed charges,15.3% of total billed charges,121.44,69,,,percent of total billed charges,69% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,176,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,69.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.33,130,,,Fee Schedule,130% of WA Medicaid ,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,59.66,33.9,,,percent of total billed charges,33.9% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,137.28,78,,,percent of total billed charges,78% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.25,176,
PT Wheelchair Management Assistant Units,42097542,CDM,420,RC,97542,HCPCS,Outpatient,,,162,105.30,CQ|GO,142.56,88,,,percent of total billed charges,88% of total Billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,162,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,102.06,63,,,percent of total billed charges,63% of total billed charges,56.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,24.79,15.3,,,percent of total billed charges,15.3% of total billed charges,111.78,69,,,percent of total billed charges,69% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,162,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,125.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,54.92,33.9,,,percent of total billed charges,33.9% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,126.36,78,,,percent of total billed charges,78% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.79,162,
INJ TENDON SHEATH OR LIGAMENT,84020550,CDM,360,RC,20550,HCPCS,Outpatient,,,265,172.25,,233.2,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,265,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,166.95,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,182.85,69,,,percent of total billed charges,69% of total billed charges,265,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,265,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,265,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,99.91,37.7,,,percent of total billed charges,37.70% of total billed charges,99.91,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,89.84,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,206.7,78,,,percent of total billed charges,78% of total billed charges,265,100,,,percent of total billed charges,100% of total billed charges,218.89,82.6,,,percent of total billed charges,82.6% of total billed charges,218.89,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,89.84,3367,
INJ SINGLE/MULTI TRIGGER PTS,84020552,CDM,360,RC,20552,HCPCS,Outpatient,,,248,161.20,,218.24,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,248,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,156.24,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,171.12,69,,,percent of total billed charges,69% of total billed charges,248,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,248,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,248,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,93.5,37.7,,,percent of total billed charges,37.70% of total billed charges,93.5,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,84.07,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,193.44,78,,,percent of total billed charges,78% of total billed charges,248,100,,,percent of total billed charges,100% of total billed charges,204.85,82.6,,,percent of total billed charges,82.6% of total billed charges,204.85,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84.07,3367,
ARTHROCENTESIS INTERMED JT/BUR,84020605,CDM,761,RC,20605,HCPCS,Outpatient,,,987,641.55,,868.56,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,987,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,621.81,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,151.01,15.3,,,percent of total billed charges,15.3% of total billed charges,681.03,69,,,percent of total billed charges,69% of total billed charges,987,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,987,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,987,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,372.1,37.7,,,percent of total billed charges,37.70% of total billed charges,372.1,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,334.59,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,769.86,78,,,percent of total billed charges,78% of total billed charges,987,100,,,percent of total billed charges,100% of total billed charges,815.26,82.6,,,percent of total billed charges,82.6% of total billed charges,815.26,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,151.01,1061,
ARTHROCENTESIS MAJOR JT/BURSA,84020610,CDM,761,RC,20610,HCPCS,Outpatient,,,297,193.05,,261.36,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,297,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,187.11,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,45.44,15.3,,,percent of total billed charges,15.3% of total billed charges,204.93,69,,,percent of total billed charges,69% of total billed charges,297,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,297,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,297,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,111.97,37.7,,,percent of total billed charges,37.70% of total billed charges,111.97,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,100.68,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,231.66,78,,,percent of total billed charges,78% of total billed charges,297,100,,,percent of total billed charges,100% of total billed charges,245.32,82.6,,,percent of total billed charges,82.6% of total billed charges,245.32,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.44,1061,
INJ FOR SPINE DISK XRAY LUMBAR,84062290,CDM,761,RC,62290,HCPCS,Outpatient,,,822,534.30,,723.36,88,,,percent of total billed charges,88% of total Billed charges,411,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid,822,100,,,percent of total billed charges,100% of total billed charges,281.05,103,,,Fee Schedule,103% of WA Medicaid,411,50,,,percent of total billed charges,50% of total Billed charges,517.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,272.87,100,,,Fee Schedule,100% of WA Medicaid,125.77,15.3,,,percent of total billed charges,15.3% of total billed charges,567.18,69,,,percent of total billed charges,69% of total billed charges,822,100,,,percent of total billed charges,100% of total billed charges,411,50,,,percent of total billed charges,50% of total Billed charges,822,100,,,percent of total billed charges,100% of total billed charges,411,50,,,percent of total billed charges,50% of total Billed charges,822,100,,,percent of total billed charges,100% of total billed charges,411,50,,,percent of total billed charges,50% of total Billed charges,508.41,61.85,,,percent of total billed charges,61.85% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,411,50,,,percent of total billed charges,50% of total Billed charges,411,50,,,percent of total billed charges,50% of total Billed charges,202.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,411,50,,,percent of total billed charges,50% of total Billed charges,411,50,,,percent of total billed charges,50% of total Billed charges,278.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.73,130,,,Fee Schedule,130% of WA Medicaid ,411,50,,,percent of total billed charges,50% of total Billed charges,309.89,37.7,,,percent of total billed charges,37.70% of total billed charges,309.89,37.7,,,percent of total billed charges,37.70% of total billed charges,411,50,,,percent of total billed charges,50% of total Billed charges,278.66,33.9,,,percent of total billed charges,33.9% of total billed charges,411,50,,,percent of total billed charges,50% of total Billed charges,641.16,78,,,percent of total billed charges,78% of total billed charges,822,100,,,percent of total billed charges,100% of total billed charges,678.97,82.6,,,percent of total billed charges,82.6% of total billed charges,678.97,82.6,,,percent of total billed charges,82.6% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,411,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,411,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,125.77,822,
INJ SP DISK XRAY CERV/THORAC,84062291,CDM,761,RC,62291,HCPCS,Outpatient,,,819,532.35,,720.72,88,,,percent of total billed charges,88% of total Billed charges,409.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid,819,100,,,percent of total billed charges,100% of total billed charges,281.05,103,,,Fee Schedule,103% of WA Medicaid,409.5,50,,,percent of total billed charges,50% of total Billed charges,515.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,272.87,100,,,Fee Schedule,100% of WA Medicaid,125.31,15.3,,,percent of total billed charges,15.3% of total billed charges,565.11,69,,,percent of total billed charges,69% of total billed charges,819,100,,,percent of total billed charges,100% of total billed charges,409.5,50,,,percent of total billed charges,50% of total Billed charges,819,100,,,percent of total billed charges,100% of total billed charges,409.5,50,,,percent of total billed charges,50% of total Billed charges,819,100,,,percent of total billed charges,100% of total billed charges,409.5,50,,,percent of total billed charges,50% of total Billed charges,506.55,61.85,,,percent of total billed charges,61.85% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,409.5,50,,,percent of total billed charges,50% of total Billed charges,409.5,50,,,percent of total billed charges,50% of total Billed charges,202.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,409.5,50,,,percent of total billed charges,50% of total Billed charges,409.5,50,,,percent of total billed charges,50% of total Billed charges,278.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.73,130,,,Fee Schedule,130% of WA Medicaid ,409.5,50,,,percent of total billed charges,50% of total Billed charges,308.76,37.7,,,percent of total billed charges,37.70% of total billed charges,308.76,37.7,,,percent of total billed charges,37.70% of total billed charges,409.5,50,,,percent of total billed charges,50% of total Billed charges,277.64,33.9,,,percent of total billed charges,33.9% of total billed charges,409.5,50,,,percent of total billed charges,50% of total Billed charges,638.82,78,,,percent of total billed charges,78% of total billed charges,819,100,,,percent of total billed charges,100% of total billed charges,676.49,82.6,,,percent of total billed charges,82.6% of total billed charges,676.49,82.6,,,percent of total billed charges,82.6% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,409.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,409.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,125.31,819,
NJX INTERLAMINAR LMBR/SAC,84062323,CDM,761,RC,62323,HCPCS,Outpatient,,,482,313.30,,424.16,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,482,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,303.66,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,73.75,15.3,,,percent of total billed charges,15.3% of total billed charges,332.58,69,,,percent of total billed charges,69% of total billed charges,482,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,482,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,482,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,181.71,37.7,,,percent of total billed charges,37.70% of total billed charges,181.71,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,163.4,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,375.96,78,,,percent of total billed charges,78% of total billed charges,482,100,,,percent of total billed charges,100% of total billed charges,398.13,82.6,,,percent of total billed charges,82.6% of total billed charges,398.13,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.75,2578.03,
N BLOCK INJ FEM SINGLE,84064447,CDM,360,RC,64447,HCPCS,Outpatient,,,322,209.30,,283.36,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1045.11,100,,,Fee Schedule,100% of WA Medicaid,322,100,,,percent of total billed charges,100% of total billed charges,1076.46,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,202.86,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,1045.11,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,222.18,69,,,percent of total billed charges,69% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,322,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,322,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1045.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,774.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1066.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1358.64,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,121.39,37.7,,,percent of total billed charges,37.70% of total billed charges,121.39,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,109.16,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,251.16,78,,,percent of total billed charges,78% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1045.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,109.16,3367,
TRANSFORAMINAL INJC/T SPINE 1L,84064479,CDM,761,RC,64479,HCPCS,Outpatient,,,2417,1571.05,,2126.96,88,,,percent of total billed charges,88% of total Billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,2417,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1522.71,63,,,percent of total billed charges,63% of total billed charges,1626.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,369.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1667.73,69,,,percent of total billed charges,69% of total billed charges,2417,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2417,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2417,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3341.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,911.21,37.7,,,percent of total billed charges,37.70% of total billed charges,911.21,37.7,,,percent of total billed charges,37.70% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,819.36,33.9,,,percent of total billed charges,33.9% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1885.26,78,,,percent of total billed charges,78% of total billed charges,2417,100,,,percent of total billed charges,100% of total billed charges,1996.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1996.44,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,938.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,369.8,3341.26,
TRANSFORAMINAL INJL/S SPINE 1L,84064483,CDM,761,RC,64483,HCPCS,Outpatient,,,2292,1489.80,,2016.96,88,,,percent of total billed charges,88% of total Billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,2292,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1443.96,63,,,percent of total billed charges,63% of total billed charges,1626.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,350.68,15.3,,,percent of total billed charges,15.3% of total billed charges,1581.48,69,,,percent of total billed charges,69% of total billed charges,2292,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2292,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2292,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3341.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,864.08,37.7,,,percent of total billed charges,37.70% of total billed charges,864.08,37.7,,,percent of total billed charges,37.70% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,776.99,33.9,,,percent of total billed charges,33.9% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1787.76,78,,,percent of total billed charges,78% of total billed charges,2292,100,,,percent of total billed charges,100% of total billed charges,1893.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1893.19,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,938.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,350.68,3341.26,
TRANSFORAMINAL INJL/S SPINE 2L,84064484,CDM,761,RC,64484,HCPCS,Outpatient,,,1340,871.00,,1179.2,88,,,percent of total billed charges,88% of total Billed charges,670,50,,,percent of total billed charges,50% of total Billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid,1340,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,670,50,,,percent of total billed charges,50% of total Billed charges,844.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,770.67,100,,,Fee Schedule,100% of WA Medicaid,205.02,15.3,,,percent of total billed charges,15.3% of total billed charges,924.6,69,,,percent of total billed charges,69% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,670,50,,,percent of total billed charges,50% of total Billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,670,50,,,percent of total billed charges,50% of total Billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,670,50,,,percent of total billed charges,50% of total Billed charges,828.79,61.85,,,percent of total billed charges,61.85% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,670,50,,,percent of total billed charges,50% of total Billed charges,670,50,,,percent of total billed charges,50% of total Billed charges,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,670,50,,,percent of total billed charges,50% of total Billed charges,670,50,,,percent of total billed charges,50% of total Billed charges,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,670,50,,,percent of total billed charges,50% of total Billed charges,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,670,50,,,percent of total billed charges,50% of total Billed charges,454.26,33.9,,,percent of total billed charges,33.9% of total billed charges,670,50,,,percent of total billed charges,50% of total Billed charges,1045.2,78,,,percent of total billed charges,78% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,670,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,670,50,,,percent of total billed charges,50% of total Billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,205.02,1340,
TRANSFORAMINAL INJC/T SPINE 2L,84064480,CDM,360,RC,64480,HCPCS,Outpatient,,,1505,978.25,,1324.4,88,,,percent of total billed charges,88% of total Billed charges,752.5,50,,,percent of total billed charges,50% of total Billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid,1505,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,752.5,50,,,percent of total billed charges,50% of total Billed charges,948.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,770.67,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1038.45,69,,,percent of total billed charges,69% of total billed charges,1505,100,,,percent of total billed charges,100% of total billed charges,752.5,50,,,percent of total billed charges,50% of total Billed charges,1505,100,,,percent of total billed charges,100% of total billed charges,752.5,50,,,percent of total billed charges,50% of total Billed charges,1505,100,,,percent of total billed charges,100% of total billed charges,752.5,50,,,percent of total billed charges,50% of total Billed charges,930.84,61.85,,,percent of total billed charges,61.85% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,752.5,50,,,percent of total billed charges,50% of total Billed charges,752.5,50,,,percent of total billed charges,50% of total Billed charges,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,752.5,50,,,percent of total billed charges,50% of total Billed charges,752.5,50,,,percent of total billed charges,50% of total Billed charges,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,752.5,50,,,percent of total billed charges,50% of total Billed charges,567.39,37.7,,,percent of total billed charges,37.70% of total billed charges,567.39,37.7,,,percent of total billed charges,37.70% of total billed charges,752.5,50,,,percent of total billed charges,50% of total Billed charges,510.2,33.9,,,percent of total billed charges,33.9% of total billed charges,752.5,50,,,percent of total billed charges,50% of total Billed charges,1173.9,78,,,percent of total billed charges,78% of total billed charges,1505,100,,,percent of total billed charges,100% of total billed charges,1243.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1243.13,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,752.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,752.5,50,,,percent of total billed charges,50% of total Billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,510.2,3367,
FACET INJ C/T SPINE ONE LEVEL,84064490,CDM,761,RC,64490,HCPCS,Outpatient,,,719,467.35,,632.72,88,,,percent of total billed charges,88% of total Billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,719,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,452.97,63,,,percent of total billed charges,63% of total billed charges,1626.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,110.01,15.3,,,percent of total billed charges,15.3% of total billed charges,496.11,69,,,percent of total billed charges,69% of total billed charges,719,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,719,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,719,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3341.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,271.06,37.7,,,percent of total billed charges,37.70% of total billed charges,271.06,37.7,,,percent of total billed charges,37.70% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,243.74,33.9,,,percent of total billed charges,33.9% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,560.82,78,,,percent of total billed charges,78% of total billed charges,719,100,,,percent of total billed charges,100% of total billed charges,593.89,82.6,,,percent of total billed charges,82.6% of total billed charges,593.89,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,938.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.01,3341.26,
FACET INJ C/T SPINE SEC LEVEL,84064491,CDM,360,RC,64491,HCPCS,Outpatient,,,404,262.60,,355.52,88,,,percent of total billed charges,88% of total Billed charges,202,50,,,percent of total billed charges,50% of total Billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid,404,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,202,50,,,percent of total billed charges,50% of total Billed charges,254.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,770.67,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,278.76,69,,,percent of total billed charges,69% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,202,50,,,percent of total billed charges,50% of total Billed charges,404,100,,,percent of total billed charges,100% of total billed charges,202,50,,,percent of total billed charges,50% of total Billed charges,404,100,,,percent of total billed charges,100% of total billed charges,202,50,,,percent of total billed charges,50% of total Billed charges,249.87,61.85,,,percent of total billed charges,61.85% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202,50,,,percent of total billed charges,50% of total Billed charges,202,50,,,percent of total billed charges,50% of total Billed charges,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,202,50,,,percent of total billed charges,50% of total Billed charges,202,50,,,percent of total billed charges,50% of total Billed charges,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,202,50,,,percent of total billed charges,50% of total Billed charges,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,202,50,,,percent of total billed charges,50% of total Billed charges,136.96,33.9,,,percent of total billed charges,33.9% of total billed charges,202,50,,,percent of total billed charges,50% of total Billed charges,315.12,78,,,percent of total billed charges,78% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,202,50,,,percent of total billed charges,50% of total Billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,136.96,3367,
FACET INJ L/S SPINE ONE LEVEL,84064493,CDM,761,RC,64493,HCPCS,Outpatient,,,610,396.50,,536.8,88,,,percent of total billed charges,88% of total Billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,610,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,384.3,63,,,percent of total billed charges,63% of total billed charges,1626.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,93.33,15.3,,,percent of total billed charges,15.3% of total billed charges,420.9,69,,,percent of total billed charges,69% of total billed charges,610,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,610,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,610,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3341.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,229.97,37.7,,,percent of total billed charges,37.70% of total billed charges,229.97,37.7,,,percent of total billed charges,37.70% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,206.79,33.9,,,percent of total billed charges,33.9% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,475.8,78,,,percent of total billed charges,78% of total billed charges,610,100,,,percent of total billed charges,100% of total billed charges,503.86,82.6,,,percent of total billed charges,82.6% of total billed charges,503.86,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,938.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,93.33,3341.26,
FACET INJ L/S SPINE SEC LEVEL,84064494,CDM,761,RC,64494,HCPCS,Outpatient,,,344,223.60,,302.72,88,,,percent of total billed charges,88% of total Billed charges,172,50,,,percent of total billed charges,50% of total Billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid,344,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,172,50,,,percent of total billed charges,50% of total Billed charges,216.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,770.67,100,,,Fee Schedule,100% of WA Medicaid,52.63,15.3,,,percent of total billed charges,15.3% of total billed charges,237.36,69,,,percent of total billed charges,69% of total billed charges,344,100,,,percent of total billed charges,100% of total billed charges,172,50,,,percent of total billed charges,50% of total Billed charges,344,100,,,percent of total billed charges,100% of total billed charges,172,50,,,percent of total billed charges,50% of total Billed charges,344,100,,,percent of total billed charges,100% of total billed charges,172,50,,,percent of total billed charges,50% of total Billed charges,212.76,61.85,,,percent of total billed charges,61.85% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,172,50,,,percent of total billed charges,50% of total Billed charges,172,50,,,percent of total billed charges,50% of total Billed charges,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,172,50,,,percent of total billed charges,50% of total Billed charges,172,50,,,percent of total billed charges,50% of total Billed charges,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,172,50,,,percent of total billed charges,50% of total Billed charges,129.69,37.7,,,percent of total billed charges,37.70% of total billed charges,129.69,37.7,,,percent of total billed charges,37.70% of total billed charges,172,50,,,percent of total billed charges,50% of total Billed charges,116.62,33.9,,,percent of total billed charges,33.9% of total billed charges,172,50,,,percent of total billed charges,50% of total Billed charges,268.32,78,,,percent of total billed charges,78% of total billed charges,344,100,,,percent of total billed charges,100% of total billed charges,284.14,82.6,,,percent of total billed charges,82.6% of total billed charges,284.14,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,172,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,172,50,,,percent of total billed charges,50% of total Billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.63,1001.87,
XRAY FOR LOWER SPINE DISK,84072295,CDM,329,RC,72295,HCPCS,Outpatient,,,299,194.35,,263.12,88,,,percent of total billed charges,88% of total Billed charges,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,299,100,,,percent of total billed charges,100% of total billed charges,544.08,103,,,Fee Schedule,103% of WA Medicaid,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,188.37,63,,,percent of total billed charges,63% of total billed charges,3446.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,45.75,15.3,,,percent of total billed charges,15.3% of total billed charges,206.31,69,,,percent of total billed charges,69% of total billed charges,299,100,,,percent of total billed charges,100% of total billed charges,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,299,100,,,percent of total billed charges,100% of total billed charges,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,299,100,,,percent of total billed charges,100% of total billed charges,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,7127.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,391.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,538.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,686.71,130,,,Fee Schedule,130% of WA Medicaid ,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,112.72,37.7,,,percent of total billed charges,37.70% of total billed charges,112.72,37.7,,,percent of total billed charges,37.70% of total billed charges,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,101.36,33.9,,,percent of total billed charges,33.9% of total billed charges,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,233.22,78,,,percent of total billed charges,78% of total billed charges,299,100,,,percent of total billed charges,100% of total billed charges,246.97,82.6,,,percent of total billed charges,82.6% of total billed charges,246.97,82.6,,,percent of total billed charges,82.6% of total billed charges,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,1989.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1969.32,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.75,7127.26,
GUIDENEEDLE PLACEMENT,40276942,CDM,402,RC,76942,HCPCS,Outpatient,,,1145,744.25,,1007.6,88,,,percent of total billed charges,88% of total Billed charges,572.5,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid,1145,100,,,percent of total billed charges,100% of total billed charges,105.01,103,,,Fee Schedule,103% of WA Medicaid,572.5,50,,,percent of total billed charges,50% of total Billed charges,721.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,101.95,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,790.05,69,,,percent of total billed charges,69% of total billed charges,1145,100,,,percent of total billed charges,100% of total billed charges,572.5,50,,,percent of total billed charges,50% of total Billed charges,1145,100,,,percent of total billed charges,100% of total billed charges,572.5,50,,,percent of total billed charges,50% of total Billed charges,1145,100,,,percent of total billed charges,100% of total billed charges,572.5,50,,,percent of total billed charges,50% of total Billed charges,708.18,61.85,,,percent of total billed charges,61.85% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,572.5,50,,,percent of total billed charges,50% of total Billed charges,572.5,50,,,percent of total billed charges,50% of total Billed charges,75.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,572.5,50,,,percent of total billed charges,50% of total Billed charges,572.5,50,,,percent of total billed charges,50% of total Billed charges,103.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.54,130,,,Fee Schedule,130% of WA Medicaid ,572.5,50,,,percent of total billed charges,50% of total Billed charges,431.67,37.7,,,percent of total billed charges,37.70% of total billed charges,431.67,37.7,,,percent of total billed charges,37.70% of total billed charges,572.5,50,,,percent of total billed charges,50% of total Billed charges,388.16,33.9,,,percent of total billed charges,33.9% of total billed charges,572.5,50,,,percent of total billed charges,50% of total Billed charges,893.1,78,,,percent of total billed charges,78% of total billed charges,1145,100,,,percent of total billed charges,100% of total billed charges,945.77,82.6,,,percent of total billed charges,82.6% of total billed charges,945.77,82.6,,,percent of total billed charges,82.6% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,572.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,572.5,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.52,1145,
FLUORO NEEDLE PLACEMENT,84077002,CDM,320,RC,77002,HCPCS,Outpatient,,,1519,987.35,TC,1336.72,88,,,percent of total billed charges,88% of total Billed charges,759.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,1519,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,759.5,50,,,percent of total billed charges,50% of total Billed charges,956.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,232.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1048.11,69,,,percent of total billed charges,69% of total billed charges,1519,100,,,percent of total billed charges,100% of total billed charges,759.5,50,,,percent of total billed charges,50% of total Billed charges,1519,100,,,percent of total billed charges,100% of total billed charges,759.5,50,,,percent of total billed charges,50% of total Billed charges,1519,100,,,percent of total billed charges,100% of total billed charges,759.5,50,,,percent of total billed charges,50% of total Billed charges,939.5,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,759.5,50,,,percent of total billed charges,50% of total Billed charges,759.5,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,759.5,50,,,percent of total billed charges,50% of total Billed charges,759.5,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,759.5,50,,,percent of total billed charges,50% of total Billed charges,572.66,37.7,,,percent of total billed charges,37.70% of total billed charges,572.66,37.7,,,percent of total billed charges,37.70% of total billed charges,759.5,50,,,percent of total billed charges,50% of total Billed charges,514.94,33.9,,,percent of total billed charges,33.9% of total billed charges,759.5,50,,,percent of total billed charges,50% of total Billed charges,1184.82,78,,,percent of total billed charges,78% of total billed charges,1519,100,,,percent of total billed charges,100% of total billed charges,1254.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1254.69,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,759.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,759.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,1519,
FLUORO GUIDANCE,84077003,CDM,320,RC,77003,HCPCS,Outpatient,,,2696,1752.40,,2372.48,88,,,percent of total billed charges,88% of total Billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,2696,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,1348,50,,,percent of total billed charges,50% of total Billed charges,1698.48,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,412.49,15.3,,,percent of total billed charges,15.3% of total billed charges,1860.24,69,,,percent of total billed charges,69% of total billed charges,2696,100,,,percent of total billed charges,100% of total billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,2696,100,,,percent of total billed charges,100% of total billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,2696,100,,,percent of total billed charges,100% of total billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,1667.48,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1348,50,,,percent of total billed charges,50% of total Billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1348,50,,,percent of total billed charges,50% of total Billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,1348,50,,,percent of total billed charges,50% of total Billed charges,1016.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1016.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,913.94,33.9,,,percent of total billed charges,33.9% of total billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,2102.88,78,,,percent of total billed charges,78% of total billed charges,2696,100,,,percent of total billed charges,100% of total billed charges,2226.9,82.6,,,percent of total billed charges,82.6% of total billed charges,2226.9,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1348,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1348,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,2696,
CONSCIOUS SEDATION 1ST 15 MIN,37099152,CDM,370,RC,99152,HCPCS,Outpatient,,,464,301.60,,408.32,88,,,percent of total billed charges,88% of total Billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid,464,100,,,percent of total billed charges,100% of total billed charges,22.18,103,,,Fee Schedule,103% of WA Medicaid,232,50,,,percent of total billed charges,50% of total Billed charges,292.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.54,100,,,Fee Schedule,100% of WA Medicaid,70.99,15.3,,,percent of total billed charges,15.3% of total billed charges,320.16,69,,,percent of total billed charges,69% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,464,100,,,percent of total billed charges,100% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,464,100,,,percent of total billed charges,100% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,286.98,61.85,,,percent of total billed charges,61.85% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232,50,,,percent of total billed charges,50% of total Billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,15.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,232,50,,,percent of total billed charges,50% of total Billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,21.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28,130,,,Fee Schedule,130% of WA Medicaid ,232,50,,,percent of total billed charges,50% of total Billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,157.3,33.9,,,percent of total billed charges,33.9% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,361.92,78,,,percent of total billed charges,78% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,232,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.95,464,
CONSCIOUS SEDATION EA ADD15MIN,84099153,CDM,370,RC,99153,HCPCS,Outpatient,,,464,301.60,,408.32,88,,,percent of total billed charges,88% of total Billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid,464,100,,,percent of total billed charges,100% of total billed charges,22.18,103,,,Fee Schedule,103% of WA Medicaid,232,50,,,percent of total billed charges,50% of total Billed charges,292.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.54,100,,,Fee Schedule,100% of WA Medicaid,70.99,15.3,,,percent of total billed charges,15.3% of total billed charges,320.16,69,,,percent of total billed charges,69% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,464,100,,,percent of total billed charges,100% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,464,100,,,percent of total billed charges,100% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,286.98,61.85,,,percent of total billed charges,61.85% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232,50,,,percent of total billed charges,50% of total Billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,15.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,232,50,,,percent of total billed charges,50% of total Billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,21.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28,130,,,Fee Schedule,130% of WA Medicaid ,232,50,,,percent of total billed charges,50% of total Billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,157.3,33.9,,,percent of total billed charges,33.9% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,361.92,78,,,percent of total billed charges,78% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,232,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.95,464,
20610 ARTHROCENTESIS INJECTION JOINT OR BURSA,76120610,CDM,761,RC,20610,HCPCS,Outpatient,,,663,430.95,,583.44,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,663,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,417.69,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,101.44,15.3,,,percent of total billed charges,15.3% of total billed charges,457.47,69,,,percent of total billed charges,69% of total billed charges,663,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,663,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,663,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,249.95,37.7,,,percent of total billed charges,37.70% of total billed charges,249.95,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,224.76,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,517.14,78,,,percent of total billed charges,78% of total billed charges,663,100,,,percent of total billed charges,100% of total billed charges,547.64,82.6,,,percent of total billed charges,82.6% of total billed charges,547.64,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.44,1061,
"Arterial catheterization or cannulation for sampling, monito",76136620,CDM,761,RC,36620,HCPCS,Outpatient,,,223,144.95,,196.24,88,,,percent of total billed charges,88% of total Billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,223,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,111.5,50,,,percent of total billed charges,50% of total Billed charges,140.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,34.12,15.3,,,percent of total billed charges,15.3% of total billed charges,153.87,69,,,percent of total billed charges,69% of total billed charges,223,100,,,percent of total billed charges,100% of total billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,223,100,,,percent of total billed charges,100% of total billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,223,100,,,percent of total billed charges,100% of total billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,137.93,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.5,50,,,percent of total billed charges,50% of total Billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.5,50,,,percent of total billed charges,50% of total Billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,111.5,50,,,percent of total billed charges,50% of total Billed charges,84.07,37.7,,,percent of total billed charges,37.70% of total billed charges,84.07,37.7,,,percent of total billed charges,37.70% of total billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,75.6,33.9,,,percent of total billed charges,33.9% of total billed charges,111.5,50,,,percent of total billed charges,50% of total Billed charges,173.94,78,,,percent of total billed charges,78% of total billed charges,223,100,,,percent of total billed charges,100% of total billed charges,184.2,82.6,,,percent of total billed charges,82.6% of total billed charges,184.2,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,111.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.12,744.35,
49083-Abdominal Paracentesis w/ Imaging Guide,45049083,CDM,450,RC,49083,HCPCS,Outpatient,,,2038,1324.70,,1793.44,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,2038,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1283.94,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,311.81,15.3,,,percent of total billed charges,15.3% of total billed charges,1406.22,69,,,percent of total billed charges,69% of total billed charges,2038,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2038,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2038,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,768.33,37.7,,,percent of total billed charges,37.70% of total billed charges,768.33,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,690.88,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1589.64,78,,,percent of total billed charges,78% of total billed charges,2038,100,,,percent of total billed charges,100% of total billed charges,1683.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1683.39,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,311.81,3289.02,
90471: IM/SUBQ First dose,90471,CDM,450,RC,90471,HCPCS,Outpatient,,,310,201.50,,272.8,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,310,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,195.3,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,47.43,15.3,,,percent of total billed charges,15.3% of total billed charges,213.9,69,,,percent of total billed charges,69% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,310,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,310,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,241.8,78,,,percent of total billed charges,78% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.65,310,
94002 VENTILATION ASSIST  MGMT INPATIENT 1ST DAY,41094002,CDM,410,RC,94002,HCPCS,Outpatient,,,2807,1824.55,,2470.16,88,,,percent of total billed charges,88% of total Billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,2807,100,,,percent of total billed charges,100% of total billed charges,597.3,103,,,Fee Schedule,103% of WA Medicaid,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1768.41,63,,,percent of total billed charges,63% of total billed charges,1118.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,429.47,15.3,,,percent of total billed charges,15.3% of total billed charges,1936.83,69,,,percent of total billed charges,69% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1971.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,429.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,591.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,753.87,130,,,Fee Schedule,130% of WA Medicaid ,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,951.57,33.9,,,percent of total billed charges,33.9% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2189.46,78,,,percent of total billed charges,78% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,645.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,429.47,2807,
VENTILATOR MGMT EA SUB DAY,41094003,CDM,410,RC,94003,HCPCS,Outpatient,,,2317,1506.05,,2038.96,88,,,percent of total billed charges,88% of total Billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,2317,100,,,percent of total billed charges,100% of total billed charges,597.3,103,,,Fee Schedule,103% of WA Medicaid,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1459.71,63,,,percent of total billed charges,63% of total billed charges,1118.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,354.5,15.3,,,percent of total billed charges,15.3% of total billed charges,1598.73,69,,,percent of total billed charges,69% of total billed charges,2317,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2317,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2317,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1971.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,429.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,591.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,753.87,130,,,Fee Schedule,130% of WA Medicaid ,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,873.51,37.7,,,percent of total billed charges,37.70% of total billed charges,873.51,37.7,,,percent of total billed charges,37.70% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,785.46,33.9,,,percent of total billed charges,33.9% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1807.26,78,,,percent of total billed charges,78% of total billed charges,2317,100,,,percent of total billed charges,100% of total billed charges,1913.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1913.84,82.6,,,percent of total billed charges,82.6% of total billed charges,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,645.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,354.5,2317,
94640 AIRWAY INHALATION TREATMENT,41094640,CDM,410,RC,94640,HCPCS,Outpatient,,,666,432.90,,586.08,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,5.5,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.15,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.5,763.26,
CONT INHAL TX FIRST HOUR,41094644,CDM,410,RC,94644,HCPCS,Outpatient,,,740,481.00,,651.2,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,740,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,466.2,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,113.22,15.3,,,percent of total billed charges,15.3% of total billed charges,510.6,69,,,percent of total billed charges,69% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,740,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,740,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,250.86,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,577.2,78,,,percent of total billed charges,78% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,740,
CONT INHAL TX EA ADD HOUR,41094645,CDM,410,RC,94645,HCPCS,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid,700,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,46.89,100,,,Fee Schedule,100% of WA Medicaid,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,350,50,,,percent of total billed charges,50% of total Billed charges,263.9,37.7,,,percent of total billed charges,37.70% of total billed charges,263.9,37.7,,,percent of total billed charges,37.70% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,237.3,33.9,,,percent of total billed charges,33.9% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,700,
AEROSOL TRX PENTAMIDINE,41094642,CDM,410,RC,94642,HCPCS,Outpatient,,,760,494.00,,668.8,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,760,100,,,percent of total billed charges,100% of total billed charges,34.79,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,478.8,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,116.28,15.3,,,percent of total billed charges,15.3% of total billed charges,524.4,69,,,percent of total billed charges,69% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,760,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,760,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,35.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,257.64,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,592.8,78,,,percent of total billed charges,78% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.79,763.26,
BIPAP/CPAP INIT  MGMT,41094660,CDM,410,RC,94660,HCPCS,Outpatient,,,866,562.90,,762.08,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,866,100,,,percent of total billed charges,100% of total billed charges,115.13,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,545.58,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,132.5,15.3,,,percent of total billed charges,15.3% of total billed charges,597.54,69,,,percent of total billed charges,69% of total billed charges,866,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,866,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,866,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,82.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,114.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.31,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,326.48,37.7,,,percent of total billed charges,37.70% of total billed charges,326.48,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,293.57,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,675.48,78,,,percent of total billed charges,78% of total billed charges,866,100,,,percent of total billed charges,100% of total billed charges,715.32,82.6,,,percent of total billed charges,82.6% of total billed charges,715.32,82.6,,,percent of total billed charges,82.6% of total billed charges,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.8,866,
FLUTTER VALVE INITIAL,41094667,CDM,410,RC,94667,HCPCS,Outpatient,,,666,432.90,,586.08,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,14.24,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,14.24,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.51,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.24,666,
FLUTTER VALVE SUB,41094668,CDM,410,RC,94668,HCPCS,Outpatient,,,399,259.35,,351.12,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,399,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,251.37,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,61.05,15.3,,,percent of total billed charges,15.3% of total billed charges,275.31,69,,,percent of total billed charges,69% of total billed charges,399,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,399,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,399,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,150.42,37.7,,,percent of total billed charges,37.70% of total billed charges,150.42,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,135.26,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,311.22,78,,,percent of total billed charges,78% of total billed charges,399,100,,,percent of total billed charges,100% of total billed charges,329.57,82.6,,,percent of total billed charges,82.6% of total billed charges,329.57,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,454.8,
DEMO/EVAL GEN/NEBUL/MDI/IPPB,41094664,CDM,410,RC,94664,HCPCS,Outpatient,,,666,432.90,,586.08,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,763.26,
ASTHMA EDUCATIION (30 MIN),41098960,CDM,410,RC,98960,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,60.91,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.88,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.8,76.88,
ASTHMA EDUCATION (15 MIN),41098961,CDM,410,RC,98961,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,42.61,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.79,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.64,53.79,
PULM FUNC TST PLESTHYSMOGRAPH,46094726,CDM,460,RC,94726,HCPCS,Outpatient,,,314,204.10,,276.32,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,314,100,,,percent of total billed charges,100% of total billed charges,94.95,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,197.82,63,,,percent of total billed charges,63% of total billed charges,560.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,48.04,15.3,,,percent of total billed charges,15.3% of total billed charges,216.66,69,,,percent of total billed charges,69% of total billed charges,314,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,314,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,314,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,68.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,94.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.84,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,118.38,37.7,,,percent of total billed charges,37.70% of total billed charges,118.38,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,106.45,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,244.92,78,,,percent of total billed charges,78% of total billed charges,314,100,,,percent of total billed charges,100% of total billed charges,259.36,82.6,,,percent of total billed charges,82.6% of total billed charges,259.36,82.6,,,percent of total billed charges,82.6% of total billed charges,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.04,1074.33,
CPR,48192950,CDM,481,RC,92950,HCPCS,Outpatient,,,963,625.95,,847.44,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,963,100,,,percent of total billed charges,100% of total billed charges,843.18,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,606.69,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,147.34,15.3,,,percent of total billed charges,15.3% of total billed charges,664.47,69,,,percent of total billed charges,69% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,606.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,834.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1064.21,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,363.05,37.7,,,percent of total billed charges,37.70% of total billed charges,363.05,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326.46,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,751.14,78,,,percent of total billed charges,78% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,147.34,1074.33,
CO/MEMBRANE DIFFUSE CAPACITY,46094729,CDM,460,RC,94729,HCPCS,Outpatient,,,285,185.25,,250.8,88,,,percent of total billed charges,88% of total Billed charges,142.5,50,,,percent of total billed charges,50% of total Billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid,285,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,142.5,50,,,percent of total billed charges,50% of total Billed charges,179.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,46.89,100,,,Fee Schedule,100% of WA Medicaid,43.61,15.3,,,percent of total billed charges,15.3% of total billed charges,196.65,69,,,percent of total billed charges,69% of total billed charges,285,100,,,percent of total billed charges,100% of total billed charges,142.5,50,,,percent of total billed charges,50% of total Billed charges,285,100,,,percent of total billed charges,100% of total billed charges,142.5,50,,,percent of total billed charges,50% of total Billed charges,285,100,,,percent of total billed charges,100% of total billed charges,142.5,50,,,percent of total billed charges,50% of total Billed charges,176.27,61.85,,,percent of total billed charges,61.85% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.5,50,,,percent of total billed charges,50% of total Billed charges,142.5,50,,,percent of total billed charges,50% of total Billed charges,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.5,50,,,percent of total billed charges,50% of total Billed charges,142.5,50,,,percent of total billed charges,50% of total Billed charges,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,142.5,50,,,percent of total billed charges,50% of total Billed charges,107.45,37.7,,,percent of total billed charges,37.70% of total billed charges,107.45,37.7,,,percent of total billed charges,37.70% of total billed charges,142.5,50,,,percent of total billed charges,50% of total Billed charges,96.62,33.9,,,percent of total billed charges,33.9% of total billed charges,142.5,50,,,percent of total billed charges,50% of total Billed charges,222.3,78,,,percent of total billed charges,78% of total billed charges,285,100,,,percent of total billed charges,100% of total billed charges,235.41,82.6,,,percent of total billed charges,82.6% of total billed charges,235.41,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,142.5,50,,,percent of total billed charges,50% of total Billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,285,
END TIDAL CO2 INITIAL DAY,46094770,CDM,460,RC,94799,HCPCS,Outpatient,,,912,592.80,,802.56,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,912,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,574.56,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,139.54,15.3,,,percent of total billed charges,15.3% of total billed charges,629.28,69,,,percent of total billed charges,69% of total billed charges,912,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,912,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,912,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,343.82,37.7,,,percent of total billed charges,37.70% of total billed charges,343.82,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,309.17,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,711.36,78,,,percent of total billed charges,78% of total billed charges,912,100,,,percent of total billed charges,100% of total billed charges,753.31,82.6,,,percent of total billed charges,82.6% of total billed charges,753.31,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,912,
RESP TX LUNG STRENGTH 15MIN,410G0237,CDM,410,RC,G0237,HCPCS,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,33.01,103,,,Fee Schedule,103% of WA Medicaid,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,92.61,63,,,percent of total billed charges,63% of total billed charges,53.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,100.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,23.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.67,130,,,Fee Schedule,130% of WA Medicaid ,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.49,147,
GAS ANALYSIS REST INDIR,46094690,CDM,460,RC,94690,HCPCS,Outpatient,,,201,130.65,,176.88,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,201,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,126.63,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,30.75,15.3,,,percent of total billed charges,15.3% of total billed charges,138.69,69,,,percent of total billed charges,69% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,201,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,201,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,68.14,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,156.78,78,,,percent of total billed charges,78% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.75,226.12,
RESP TX  RESP FUNCTION 15MIN,410G0238,CDM,410,RC,G0238,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,33.01,103,,,Fee Schedule,103% of WA Medicaid,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,53.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,100.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,23.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.67,130,,,Fee Schedule,130% of WA Medicaid ,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.34,146,
Manual Therapy Minutes,43097140,CDM,430,RC,97140,HCPCS,Outpatient,,,253,164.45,GO,222.64,88,,,percent of total billed charges,88% of total Billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,159.39,63,,,percent of total billed charges,63% of total billed charges,47.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,253,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,106.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.72,130,,,Fee Schedule,130% of WA Medicaid ,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.94,253,
PT Infrared Therapy Minutes,42097033,CDM,420,RC,97033,HCPCS,Outpatient,,,198,128.70,CQ|GP,174.24,88,,,percent of total billed charges,88% of total Billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,11.77,103,,,Fee Schedule,103% of WA Medicaid,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,63,,,percent of total billed charges,63% of total billed charges,34.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,30.29,15.3,,,percent of total billed charges,15.3% of total billed charges,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,78.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,12.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.3,130,,,Fee Schedule,130% of WA Medicaid ,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,67.12,33.9,,,percent of total billed charges,33.9% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.77,198,
Peak Flow,41094375,CDM,460,RC,94375,HCPCS,Outpatient,,,675,438.75,,594,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,675,100,,,percent of total billed charges,100% of total billed charges,94.95,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,425.25,63,,,percent of total billed charges,63% of total billed charges,560.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,103.28,15.3,,,percent of total billed charges,15.3% of total billed charges,465.75,69,,,percent of total billed charges,69% of total billed charges,675,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,675,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,675,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,68.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,94.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.84,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,254.48,37.7,,,percent of total billed charges,37.70% of total billed charges,254.48,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,228.83,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,526.5,78,,,percent of total billed charges,78% of total billed charges,675,100,,,percent of total billed charges,100% of total billed charges,557.55,82.6,,,percent of total billed charges,82.6% of total billed charges,557.55,82.6,,,percent of total billed charges,82.6% of total billed charges,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.29,1074.33,
SPIROM PP B-D P/F STUDY,46094060,CDM,460,RC,94060,HCPCS,Outpatient,,,1155,750.75,,1016.4,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,1155,100,,,percent of total billed charges,100% of total billed charges,94.95,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,727.65,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,176.72,15.3,,,percent of total billed charges,15.3% of total billed charges,796.95,69,,,percent of total billed charges,69% of total billed charges,1155,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1155,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1155,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,68.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,94.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.84,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,435.44,37.7,,,percent of total billed charges,37.70% of total billed charges,435.44,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,391.55,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,900.9,78,,,percent of total billed charges,78% of total billed charges,1155,100,,,percent of total billed charges,100% of total billed charges,954.03,82.6,,,percent of total billed charges,82.6% of total billed charges,954.03,82.6,,,percent of total billed charges,82.6% of total billed charges,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.29,1155,
SPIROM SIMPL INCL FLO,46094010,CDM,460,RC,94010,HCPCS,Outpatient,,,792,514.80,,696.96,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,792,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,498.96,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,121.18,15.3,,,percent of total billed charges,15.3% of total billed charges,546.48,69,,,percent of total billed charges,69% of total billed charges,792,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,792,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,792,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,298.58,37.7,,,percent of total billed charges,37.70% of total billed charges,298.58,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,268.49,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,617.76,78,,,percent of total billed charges,78% of total billed charges,792,100,,,percent of total billed charges,100% of total billed charges,654.19,82.6,,,percent of total billed charges,82.6% of total billed charges,654.19,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,792,
SPUTUM COLLECTION,30089220,CDM,300,RC,89220,HCPCS,Outpatient,,,707,459.55,,622.16,88,,,percent of total billed charges,88% of total Billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,707,100,,,percent of total billed charges,100% of total billed charges,36.82,103,,,Fee Schedule,103% of WA Medicaid,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,445.41,63,,,percent of total billed charges,63% of total billed charges,304.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid,108.17,15.3,,,percent of total billed charges,15.3% of total billed charges,487.83,69,,,percent of total billed charges,69% of total billed charges,707,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,707,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,707,100,,,percent of total billed charges,100% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,605.96,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,36.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.47,130,,,Fee Schedule,130% of WA Medicaid ,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,266.54,37.7,,,percent of total billed charges,37.70% of total billed charges,266.54,37.7,,,percent of total billed charges,37.70% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,239.67,33.9,,,percent of total billed charges,33.9% of total billed charges,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,551.46,78,,,percent of total billed charges,78% of total billed charges,707,100,,,percent of total billed charges,100% of total billed charges,583.98,82.6,,,percent of total billed charges,82.6% of total billed charges,583.98,82.6,,,percent of total billed charges,82.6% of total billed charges,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,175.95,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,174.21,100,,,Fee Schedule,100% of Medicare OPPS rate,35.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.48,707,
Therapeutic Phlebotomy ONCOLOGY.,90499195,CDM,904,RC,99195,HCPCS,Outpatient,,,331,215.15,,291.28,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,331,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,208.53,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,50.64,15.3,,,percent of total billed charges,15.3% of total billed charges,228.39,69,,,percent of total billed charges,69% of total billed charges,331,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,331,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,331,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,124.79,37.7,,,percent of total billed charges,37.70% of total billed charges,124.79,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,112.21,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,258.18,78,,,percent of total billed charges,78% of total billed charges,331,100,,,percent of total billed charges,100% of total billed charges,273.41,82.6,,,percent of total billed charges,82.6% of total billed charges,273.41,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.15,454.8,
TOTAL VITAL CAPACITY,46094150,CDM,460,RC,94150,HCPCS,Outpatient,,,621,403.65,,546.48,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,621,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,391.23,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,95.01,15.3,,,percent of total billed charges,15.3% of total billed charges,428.49,69,,,percent of total billed charges,69% of total billed charges,621,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,621,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,621,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,234.12,37.7,,,percent of total billed charges,37.70% of total billed charges,234.12,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,210.52,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,484.38,78,,,percent of total billed charges,78% of total billed charges,621,100,,,percent of total billed charges,100% of total billed charges,512.95,82.6,,,percent of total billed charges,82.6% of total billed charges,512.95,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,621,
OBSERVATION,OBSERVATION,CDM,762,RC,G0378,HCPCS,Outpatient,,,166,107.90,,146.08,88,,,percent of total billed charges,88% of total Billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,27.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,166,100,,,percent of total billed charges,100% of total billed charges,28.72,17.304,,,percent of total billed charges,17.304% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,104.58,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.89,16.8,,,percent of total billed charges,16.8% of total billed charges,33.2,15.3,,,percent of total billed charges,15.3% of total billed charges,114.54,69,,,percent of total billed charges,69% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,166,100,,,percent of total billed charges,100% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,166,100,,,percent of total billed charges,100% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,102.67,61.85,,,percent of total billed charges,61.85% of total billed charges,27.89,16.8,,,percent of total billed charges,16.8% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,537.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83,50,,,percent of total billed charges,50% of total Billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,28.45,17.136,,,percent of total billed charges,17.136% of total billed charges,36.25,21.84,,,percent of total billed charges,21.84% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,62.58,37.7,,,percent of total billed charges,37.70% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,56.27,33.9,,,percent of total billed charges,33.9% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,129.48,78,,,percent of total billed charges,78% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,27.89,16.8,,,percent of total billed charges,16.8% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,83,50,,,percent of total billed charges,50% of total Billed charges,27.89,16.8,,,percent of total billed charges,16.8% of total billed charges,27.89,537.65,
Application of a modality to 1 or more areas; hot or cold pa,42097010,CDM,420,RC,97010,HCPCS,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,35,100,,,percent of total billed charges,100% of total billed charges,29.97,103,,,Fee Schedule,103% of WA Medicaid,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,22.05,63,,,percent of total billed charges,63% of total billed charges,10.96,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,35,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,35,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,23.87,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,21.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,29.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.83,130,,,Fee Schedule,130% of WA Medicaid ,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11.87,33.9,,,percent of total billed charges,33.9% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.43,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.36,37.83,
TRACTION MECHANICAL/-GP,42097012,CDM,420,RC,97012,HCPCS,Outpatient,,,128,83.20,GP,112.64,88,,,percent of total billed charges,88% of total Billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,128,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,80.64,63,,,percent of total billed charges,63% of total billed charges,24.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,43.39,33.9,,,percent of total billed charges,33.9% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,128,
ELECTRIC STIMULATION THERAPY,42097014,CDM,420,RC,97014,HCPCS,Outpatient,,,77,50.05,GP,67.76,88,,,percent of total billed charges,88% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,7.21,100,,,Fee Schedule,100% of WA Medicaid,77,100,,,percent of total billed charges,100% of total billed charges,7.21,103,,,Fee Schedule,103% of WA Medicaid,38.5,50,,,percent of total billed charges,50% of total Billed charges,48.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.21,100,,,Fee Schedule,100% of WA Medicaid,11.78,15.3,,,percent of total billed charges,15.3% of total billed charges,53.13,69,,,percent of total billed charges,69% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,47.62,61.85,,,percent of total billed charges,61.85% of total billed charges,7.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.5,50,,,percent of total billed charges,50% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,7.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.5,50,,,percent of total billed charges,50% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,7.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.37,130,,,Fee Schedule,130% of WA Medicaid ,38.5,50,,,percent of total billed charges,50% of total Billed charges,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,26.1,33.9,,,percent of total billed charges,33.9% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,60.06,78,,,percent of total billed charges,78% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,7.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38.5,50,,,percent of total billed charges,50% of total Billed charges,7.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.21,77,
PARAFFIN BATH,42097018,CDM,420,RC,97018,HCPCS,Outpatient,,,143,92.95,GP,125.84,88,,,percent of total billed charges,88% of total Billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,143,100,,,percent of total billed charges,100% of total billed charges,3.42,103,,,Fee Schedule,103% of WA Medicaid,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,90.09,63,,,percent of total billed charges,63% of total billed charges,9.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,21.88,15.3,,,percent of total billed charges,15.3% of total billed charges,98.67,69,,,percent of total billed charges,69% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,22.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.45,130,,,Fee Schedule,130% of WA Medicaid ,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,48.48,33.9,,,percent of total billed charges,33.9% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,111.54,78,,,percent of total billed charges,78% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.42,143,
VASOPNEUMATIC DEVICES/-GP,42097016,CDM,420,RC,97016,HCPCS,Outpatient,,,142,92.30,GP,124.96,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,6.83,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,46.67,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.88,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.83,142,
DIATHERMY,42097024,CDM,420,RC,97024,HCPCS,Outpatient,,,38,24.70,GP,33.44,88,,,percent of total billed charges,88% of total Billed charges,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.37,100,,,Fee Schedule,100% of WA Medicaid,38,100,,,percent of total billed charges,100% of total billed charges,4.37,103,,,Fee Schedule,103% of WA Medicaid,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,23.94,63,,,percent of total billed charges,63% of total billed charges,12.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.37,100,,,Fee Schedule,100% of WA Medicaid,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,38,100,,,percent of total billed charges,100% of total billed charges,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,38,100,,,percent of total billed charges,100% of total billed charges,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,27.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.68,130,,,Fee Schedule,130% of WA Medicaid ,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,14.33,37.7,,,percent of total billed charges,37.70% of total billed charges,14.33,37.7,,,percent of total billed charges,37.70% of total billed charges,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,12.88,33.9,,,percent of total billed charges,33.9% of total billed charges,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,4.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,7.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7.47,100,,,Fee Schedule,100% of Medicare OPPS rate,4.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.37,38,
ULTRAVIOLET,42097028,CDM,420,RC,97028,HCPCS,Outpatient,,,47,30.55,GP,41.36,88,,,percent of total billed charges,88% of total Billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.93,100,,,Fee Schedule,100% of WA Medicaid,47,100,,,percent of total billed charges,100% of total billed charges,4.93,103,,,Fee Schedule,103% of WA Medicaid,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,29.61,63,,,percent of total billed charges,63% of total billed charges,14.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.93,100,,,Fee Schedule,100% of WA Medicaid,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,47,100,,,percent of total billed charges,100% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,47,100,,,percent of total billed charges,100% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,31.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.41,130,,,Fee Schedule,130% of WA Medicaid ,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,17.72,37.7,,,percent of total billed charges,37.70% of total billed charges,17.72,37.7,,,percent of total billed charges,37.70% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,15.93,33.9,,,percent of total billed charges,33.9% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.93,47,
WHIRLPOOL/-GP,42097022,CDM,420,RC,97022,HCPCS,Outpatient,,,187,121.55,GP,164.56,88,,,percent of total billed charges,88% of total Billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,187,100,,,percent of total billed charges,100% of total billed charges,10.25,103,,,Fee Schedule,103% of WA Medicaid,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,117.81,63,,,percent of total billed charges,63% of total billed charges,30.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,28.61,15.3,,,percent of total billed charges,15.3% of total billed charges,129.03,69,,,percent of total billed charges,69% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,187,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,187,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,69.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.33,130,,,Fee Schedule,130% of WA Medicaid ,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,70.5,37.7,,,percent of total billed charges,37.70% of total billed charges,70.5,37.7,,,percent of total billed charges,37.70% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,63.39,33.9,,,percent of total billed charges,33.9% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,145.86,78,,,percent of total billed charges,78% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.25,187,
INFRARED,42097026,CDM,420,RC,97026,HCPCS,Outpatient,,,37,24.05,GP,32.56,88,,,percent of total billed charges,88% of total Billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,3.99,103,,,Fee Schedule,103% of WA Medicaid,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,11.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.99,100,,,Fee Schedule,100% of WA Medicaid,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,25.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,4.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.19,130,,,Fee Schedule,130% of WA Medicaid ,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12.54,33.9,,,percent of total billed charges,33.9% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,3.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,6.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.99,37,
HUBBARD TANK EACH 15 MINUTES,42097036,CDM,420,RC,97036,HCPCS,Outpatient,,,198,128.70,GP,174.24,88,,,percent of total billed charges,88% of total Billed charges,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,20.88,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,20.88,103,,,Fee Schedule,103% of WA Medicaid,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,63,,,percent of total billed charges,63% of total billed charges,62.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,20.88,100,,,Fee Schedule,100% of WA Medicaid,30.29,15.3,,,percent of total billed charges,15.3% of total billed charges,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,198,100,,,percent of total billed charges,100% of total billed charges,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,135.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,20.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,20.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,21.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.14,130,,,Fee Schedule,130% of WA Medicaid ,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,67.12,33.9,,,percent of total billed charges,33.9% of total billed charges,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,20.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,36.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,35.96,100,,,Fee Schedule,100% of Medicare OPPS rate,20.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.88,198,
ELEC STIM MAN/15MIN/-GP,42097032,CDM,420,RC,97032,HCPCS,Outpatient,,,201,130.65,GP,176.88,88,,,percent of total billed charges,88% of total Billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,201,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,126.63,63,,,percent of total billed charges,63% of total billed charges,25.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,30.75,15.3,,,percent of total billed charges,15.3% of total billed charges,138.69,69,,,percent of total billed charges,69% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,201,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,201,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,68.14,33.9,,,percent of total billed charges,33.9% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,156.78,78,,,percent of total billed charges,78% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,201,
IONTOPHORESIS/15MIN,42097033,CDM,420,RC,97033,HCPCS,Outpatient,,,200,130.00,GP,176,88,,,percent of total billed charges,88% of total Billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,200,100,,,percent of total billed charges,100% of total billed charges,11.77,103,,,Fee Schedule,103% of WA Medicaid,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,126,63,,,percent of total billed charges,63% of total billed charges,34.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,200,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,200,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,78.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,12.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.3,130,,,Fee Schedule,130% of WA Medicaid ,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,67.8,33.9,,,percent of total billed charges,33.9% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.77,200,
CONTRAST BATH15MIN/-GP,42097034,CDM,420,RC,97034,HCPCS,Outpatient,,,112,72.80,GP,98.56,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,112,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,70.56,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,17.14,15.3,,,percent of total billed charges,15.3% of total billed charges,77.28,69,,,percent of total billed charges,69% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,112,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,112,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,57.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,42.22,37.7,,,percent of total billed charges,37.70% of total billed charges,42.22,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,37.97,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,87.36,78,,,percent of total billed charges,78% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,112,
ULTRASOUND/15MIN/-GP,42097035,CDM,420,RC,97035,HCPCS,Outpatient,,,227,147.55,GP,199.76,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,227,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,143.01,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,34.73,15.3,,,percent of total billed charges,15.3% of total billed charges,156.63,69,,,percent of total billed charges,69% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,56.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,76.95,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,177.06,78,,,percent of total billed charges,78% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,227,
THERAPEUTIC EX/15MIN/-GP,42097110,CDM,420,RC,97110,HCPCS,Outpatient,,,181,117.65,GP,159.28,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,181,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,114.03,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,27.69,15.3,,,percent of total billed charges,15.3% of total billed charges,124.89,69,,,percent of total billed charges,69% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,181,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,181,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,61.36,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,141.18,78,,,percent of total billed charges,78% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,181,
NEURO RE-ED/15MIN/-GP,42197112,CDM,421,RC,97112,HCPCS,Outpatient,,,228,148.20,GP,200.64,88,,,percent of total billed charges,88% of total Billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,228,100,,,percent of total billed charges,100% of total billed charges,19.93,103,,,Fee Schedule,103% of WA Medicaid,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,143.64,63,,,percent of total billed charges,63% of total billed charges,59.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,34.88,15.3,,,percent of total billed charges,15.3% of total billed charges,157.32,69,,,percent of total billed charges,69% of total billed charges,228,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,228,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,228,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,20.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.91,130,,,Fee Schedule,130% of WA Medicaid ,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,85.96,37.7,,,percent of total billed charges,37.70% of total billed charges,85.96,37.7,,,percent of total billed charges,37.70% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,77.29,33.9,,,percent of total billed charges,33.9% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,177.84,78,,,percent of total billed charges,78% of total billed charges,228,100,,,percent of total billed charges,100% of total billed charges,188.33,82.6,,,percent of total billed charges,82.6% of total billed charges,188.33,82.6,,,percent of total billed charges,82.6% of total billed charges,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.93,228,
GAIT TRAINING/15MIN/-GP,42197116,CDM,421,RC,97116,HCPCS,Outpatient,,,182,118.30,GP,160.16,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,182,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,27.85,15.3,,,percent of total billed charges,15.3% of total billed charges,125.58,69,,,percent of total billed charges,69% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,182,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,182,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,61.7,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,141.96,78,,,percent of total billed charges,78% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,182,
MASSAGE/15MIN/-GP,42097124,CDM,420,RC,97124,HCPCS,Outpatient,,,120,78.00,GP,105.6,88,,,percent of total billed charges,88% of total Billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,17.84,103,,,Fee Schedule,103% of WA Medicaid,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,75.6,63,,,percent of total billed charges,63% of total billed charges,54.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,18.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.19,130,,,Fee Schedule,130% of WA Medicaid ,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.84,120,
Cognitive Skills Development intial 15 minutes,42097129,CDM,420,RC,97129,HCPCS,Outpatient,,,261,169.65,GP,229.68,88,,,percent of total billed charges,88% of total Billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,261,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,164.43,63,,,percent of total billed charges,63% of total billed charges,38.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,39.93,15.3,,,percent of total billed charges,15.3% of total billed charges,180.09,69,,,percent of total billed charges,69% of total billed charges,261,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,261,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,261,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,89.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,98.4,37.7,,,percent of total billed charges,37.70% of total billed charges,98.4,37.7,,,percent of total billed charges,37.70% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,88.48,33.9,,,percent of total billed charges,33.9% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,203.58,78,,,percent of total billed charges,78% of total billed charges,261,100,,,percent of total billed charges,100% of total billed charges,215.59,82.6,,,percent of total billed charges,82.6% of total billed charges,215.59,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.22,261,
Cognitive Skill Development Each add 15 Min,42097130,CDM,420,RC,97130,HCPCS,Outpatient,,,152,98.80,GP,133.76,88,,,percent of total billed charges,88% of total Billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,152,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,95.76,63,,,percent of total billed charges,63% of total billed charges,36.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,23.26,15.3,,,percent of total billed charges,15.3% of total billed charges,104.88,69,,,percent of total billed charges,69% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,152,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,152,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,84.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,57.3,37.7,,,percent of total billed charges,37.70% of total billed charges,57.3,37.7,,,percent of total billed charges,37.70% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,51.53,33.9,,,percent of total billed charges,33.9% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,118.56,78,,,percent of total billed charges,78% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.41,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.2,152,
MANUAL THERAPY/15MIN/-GP,42097140,CDM,420,RC,97140,HCPCS,Outpatient,,,268,174.20,GP,235.84,88,,,percent of total billed charges,88% of total Billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,268,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,168.84,63,,,percent of total billed charges,63% of total billed charges,47.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,41,15.3,,,percent of total billed charges,15.3% of total billed charges,184.92,69,,,percent of total billed charges,69% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,268,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,268,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,106.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.72,130,,,Fee Schedule,130% of WA Medicaid ,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,101.04,37.7,,,percent of total billed charges,37.70% of total billed charges,101.04,37.7,,,percent of total billed charges,37.70% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,90.85,33.9,,,percent of total billed charges,33.9% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,209.04,78,,,percent of total billed charges,78% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.94,268,
THER PROC GROUP 2/MORE IND-GP,42097150,CDM,420,RC,97150,HCPCS,Outpatient,,,147,95.55,GP,129.36,88,,,percent of total billed charges,88% of total Billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,10.44,103,,,Fee Schedule,103% of WA Medicaid,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,92.61,63,,,percent of total billed charges,63% of total billed charges,31.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.57,130,,,Fee Schedule,130% of WA Medicaid ,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.44,147,
PT EVAL- LOW COMP,42497161,CDM,424,RC,97161,HCPCS,Outpatient,,,403,261.95,GP,354.64,88,,,percent of total billed charges,88% of total Billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,403,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,253.89,63,,,percent of total billed charges,63% of total billed charges,177.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,61.66,15.3,,,percent of total billed charges,15.3% of total billed charges,278.07,69,,,percent of total billed charges,69% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,390.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,136.62,33.9,,,percent of total billed charges,33.9% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,314.34,78,,,percent of total billed charges,78% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,103.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.22,403,
PT EVAL- MOD COMP,42497162,CDM,424,RC,97162,HCPCS,Outpatient,,,403,261.95,GP,354.64,88,,,percent of total billed charges,88% of total Billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,403,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,253.89,63,,,percent of total billed charges,63% of total billed charges,177.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,61.66,15.3,,,percent of total billed charges,15.3% of total billed charges,278.07,69,,,percent of total billed charges,69% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,390.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,136.62,33.9,,,percent of total billed charges,33.9% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,314.34,78,,,percent of total billed charges,78% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,103.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.22,403,
PT EVAL- HGH COMP,42497163,CDM,424,RC,97163,HCPCS,Outpatient,,,403,261.95,GP,354.64,88,,,percent of total billed charges,88% of total Billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,403,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,253.89,63,,,percent of total billed charges,63% of total billed charges,177.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,61.66,15.3,,,percent of total billed charges,15.3% of total billed charges,278.07,69,,,percent of total billed charges,69% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,390.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,136.62,33.9,,,percent of total billed charges,33.9% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,314.34,78,,,percent of total billed charges,78% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,103.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.22,403,
PT RE-EVALUATION/-GP,42497164,CDM,424,RC,97164,HCPCS,Outpatient,,,240,156.00,GP,211.2,88,,,percent of total billed charges,88% of total Billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,Fee Schedule,100% of WA Medicaid,240,100,,,percent of total billed charges,100% of total billed charges,41.19,103,,,Fee Schedule,103% of WA Medicaid,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,151.2,63,,,percent of total billed charges,63% of total billed charges,123.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,41.19,100,,,Fee Schedule,100% of WA Medicaid,36.72,15.3,,,percent of total billed charges,15.3% of total billed charges,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,267.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,41.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,42.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.55,130,,,Fee Schedule,130% of WA Medicaid ,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,81.36,33.9,,,percent of total billed charges,33.9% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,41.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,71.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.72,267.41,
THERAP ACT 1:1/15MIN/-GP,42097530,CDM,420,RC,97530,HCPCS,Outpatient,,,182,118.30,GO,160.16,88,,,percent of total billed charges,88% of total Billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,182,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,63,,,percent of total billed charges,63% of total billed charges,65.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,27.85,15.3,,,percent of total billed charges,15.3% of total billed charges,125.58,69,,,percent of total billed charges,69% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,182,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,182,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,61.7,33.9,,,percent of total billed charges,33.9% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,141.96,78,,,percent of total billed charges,78% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,182,
ADL/15MIN/-GP,42097535,CDM,420,RC,97535,HCPCS,Outpatient,,,151,98.15,GP,132.88,88,,,percent of total billed charges,88% of total Billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,151,100,,,percent of total billed charges,100% of total billed charges,19.36,103,,,Fee Schedule,103% of WA Medicaid,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,95.13,63,,,percent of total billed charges,63% of total billed charges,58.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,23.1,15.3,,,percent of total billed charges,15.3% of total billed charges,104.19,69,,,percent of total billed charges,69% of total billed charges,151,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,151,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,151,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,129.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.17,130,,,Fee Schedule,130% of WA Medicaid ,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,56.93,37.7,,,percent of total billed charges,37.70% of total billed charges,56.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,51.19,33.9,,,percent of total billed charges,33.9% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,117.78,78,,,percent of total billed charges,78% of total billed charges,151,100,,,percent of total billed charges,100% of total billed charges,124.73,82.6,,,percent of total billed charges,82.6% of total billed charges,124.73,82.6,,,percent of total billed charges,82.6% of total billed charges,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.36,151,
COMM/WORK REINT/15MIN/-GP,42097537,CDM,420,RC,97537,HCPCS,Outpatient,,,280,182.00,GP,246.4,88,,,percent of total billed charges,88% of total Billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,280,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,176.4,63,,,percent of total billed charges,63% of total billed charges,56.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,42.84,15.3,,,percent of total billed charges,15.3% of total billed charges,193.2,69,,,percent of total billed charges,69% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,124.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,105.56,37.7,,,percent of total billed charges,37.70% of total billed charges,105.56,37.7,,,percent of total billed charges,37.70% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,94.92,33.9,,,percent of total billed charges,33.9% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,218.4,78,,,percent of total billed charges,78% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.79,280,
WHEELCHAIR MNGT/15MIN/-GP,42097542,CDM,420,RC,97542,HCPCS,Outpatient,,,156,101.40,GP,137.28,88,,,percent of total billed charges,88% of total Billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,156,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,98.28,63,,,percent of total billed charges,63% of total billed charges,56.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,23.87,15.3,,,percent of total billed charges,15.3% of total billed charges,107.64,69,,,percent of total billed charges,69% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,125.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,52.88,33.9,,,percent of total billed charges,33.9% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,121.68,78,,,percent of total billed charges,78% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.79,156,
SELECT DEBRIDE/20 CM OR < GP,42097597,CDM,420,RC,97597,HCPCS,Outpatient,,,737,479.05,GP,648.56,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,737,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,464.31,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,112.76,15.3,,,percent of total billed charges,15.3% of total billed charges,508.53,69,,,percent of total billed charges,69% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,249.84,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,574.86,78,,,percent of total billed charges,78% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.76,737,
SELECT DEBRIDE > 20 CM GP,42097598,CDM,420,RC,97598,HCPCS,Outpatient,,,954,620.10,GP,839.52,88,,,percent of total billed charges,88% of total Billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid,954,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,477,50,,,percent of total billed charges,50% of total Billed charges,601.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid,145.96,15.3,,,percent of total billed charges,15.3% of total billed charges,658.26,69,,,percent of total billed charges,69% of total billed charges,954,100,,,percent of total billed charges,100% of total billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,954,100,,,percent of total billed charges,100% of total billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,954,100,,,percent of total billed charges,100% of total billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,590.05,61.85,,,percent of total billed charges,61.85% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,477,50,,,percent of total billed charges,50% of total Billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,477,50,,,percent of total billed charges,50% of total Billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,477,50,,,percent of total billed charges,50% of total Billed charges,359.66,37.7,,,percent of total billed charges,37.70% of total billed charges,359.66,37.7,,,percent of total billed charges,37.70% of total billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,323.41,33.9,,,percent of total billed charges,33.9% of total billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,744.12,78,,,percent of total billed charges,78% of total billed charges,954,100,,,percent of total billed charges,100% of total billed charges,788,82.6,,,percent of total billed charges,82.6% of total billed charges,788,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,477,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,477,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,145.96,1174.99,
DEBRIDEMENT NON-SELCT/SESS/-GP,42097602,CDM,420,RC,97602,HCPCS,Outpatient,,,737,479.05,GP,648.56,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,737,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,464.31,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,112.76,15.3,,,percent of total billed charges,15.3% of total billed charges,508.53,69,,,percent of total billed charges,69% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,249.84,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,574.86,78,,,percent of total billed charges,78% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.76,737,
NEG PRESS WOUND TX >50 CM GP,42097606,CDM,420,RC,97606,HCPCS,Outpatient,,,590,383.50,GP,519.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,590,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,371.7,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,90.27,15.3,,,percent of total billed charges,15.3% of total billed charges,407.1,69,,,percent of total billed charges,69% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,200.01,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,460.2,78,,,percent of total billed charges,78% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.27,1404.98,
NEG PRESS WOUND TX <50 CM GP,42097605,CDM,420,RC,97605,HCPCS,Outpatient,,,590,383.50,GP,519.2,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,590,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,371.7,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,90.27,15.3,,,percent of total billed charges,15.3% of total billed charges,407.1,69,,,percent of total billed charges,69% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,200.01,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,460.2,78,,,percent of total billed charges,78% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.27,729.42,
ASSIST TECH ASSESS EA 15MIN GP,42097755,CDM,420,RC,97755,HCPCS,Outpatient,,,209,135.85,GP,183.92,88,,,percent of total billed charges,88% of total Billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,22.59,100,,,Fee Schedule,100% of WA Medicaid,209,100,,,percent of total billed charges,100% of total billed charges,22.59,103,,,Fee Schedule,103% of WA Medicaid,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,131.67,63,,,percent of total billed charges,63% of total billed charges,67.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.59,100,,,Fee Schedule,100% of WA Medicaid,31.98,15.3,,,percent of total billed charges,15.3% of total billed charges,144.21,69,,,percent of total billed charges,69% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,209,100,,,percent of total billed charges,100% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,209,100,,,percent of total billed charges,100% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,148.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,22.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,23.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.37,130,,,Fee Schedule,130% of WA Medicaid ,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,78.79,37.7,,,percent of total billed charges,37.70% of total billed charges,78.79,37.7,,,percent of total billed charges,37.70% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,70.85,33.9,,,percent of total billed charges,33.9% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,163.02,78,,,percent of total billed charges,78% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,22.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,39.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,22.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.59,209,
FUNCT CAP TEST 15 MIN/-GP,42097750,CDM,420,RC,97750,HCPCS,Outpatient,,,232,150.80,GP,204.16,88,,,percent of total billed charges,88% of total Billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,232,100,,,percent of total billed charges,100% of total billed charges,20.12,103,,,Fee Schedule,103% of WA Medicaid,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,146.16,63,,,percent of total billed charges,63% of total billed charges,60.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,35.5,15.3,,,percent of total billed charges,15.3% of total billed charges,160.08,69,,,percent of total billed charges,69% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,132.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.16,130,,,Fee Schedule,130% of WA Medicaid ,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,78.65,33.9,,,percent of total billed charges,33.9% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,78,,,percent of total billed charges,78% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,35.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.12,232,
ORTHOTIC MGMT EA 15M PT,42097760,CDM,420,RC,97760,HCPCS,Outpatient,,,175,113.75,GP,154,88,,,percent of total billed charges,88% of total Billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,175,100,,,percent of total billed charges,100% of total billed charges,29.04,103,,,Fee Schedule,103% of WA Medicaid,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,110.25,63,,,percent of total billed charges,63% of total billed charges,85.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,26.78,15.3,,,percent of total billed charges,15.3% of total billed charges,120.75,69,,,percent of total billed charges,69% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,175,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,175,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,193.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.75,130,,,Fee Schedule,130% of WA Medicaid ,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.33,33.9,,,percent of total billed charges,33.9% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,136.5,78,,,percent of total billed charges,78% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.78,193.2,
ORTH/PROS CHECKOUT EST 15M GP,42097763,CDM,420,RC,97763,HCPCS,Outpatient,,,184,119.60,GP,161.92,88,,,percent of total billed charges,88% of total Billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,184,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,115.92,63,,,percent of total billed charges,63% of total billed charges,93.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,28.15,15.3,,,percent of total billed charges,15.3% of total billed charges,126.96,69,,,percent of total billed charges,69% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,212.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,33.9,,,percent of total billed charges,33.9% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,143.52,78,,,percent of total billed charges,78% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,54.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.77,212.21,
PROS TRAIN UP/LO EXT15M PT,42097761,CDM,420,RC,97761,HCPCS,Outpatient,,,171,111.15,GP,150.48,88,,,percent of total billed charges,88% of total Billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicaid,171,100,,,percent of total billed charges,100% of total billed charges,24.86,103,,,Fee Schedule,103% of WA Medicaid,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,107.73,63,,,percent of total billed charges,63% of total billed charges,74.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.86,100,,,Fee Schedule,100% of WA Medicaid,26.16,15.3,,,percent of total billed charges,15.3% of total billed charges,117.99,69,,,percent of total billed charges,69% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,163.44,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,25.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.32,130,,,Fee Schedule,130% of WA Medicaid ,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,57.97,33.9,,,percent of total billed charges,33.9% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,133.38,78,,,percent of total billed charges,78% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,43.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.86,171,
ADL/15MIN/-GP,42097535X,CDM,420,RC,97535,HCPCS,Outpatient,,,151,98.15,GP,132.88,88,,,percent of total billed charges,88% of total Billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,151,100,,,percent of total billed charges,100% of total billed charges,19.36,103,,,Fee Schedule,103% of WA Medicaid,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,95.13,63,,,percent of total billed charges,63% of total billed charges,58.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,23.1,15.3,,,percent of total billed charges,15.3% of total billed charges,104.19,69,,,percent of total billed charges,69% of total billed charges,151,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,151,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,151,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,129.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.17,130,,,Fee Schedule,130% of WA Medicaid ,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,56.93,37.7,,,percent of total billed charges,37.70% of total billed charges,56.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,51.19,33.9,,,percent of total billed charges,33.9% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,117.78,78,,,percent of total billed charges,78% of total billed charges,151,100,,,percent of total billed charges,100% of total billed charges,124.73,82.6,,,percent of total billed charges,82.6% of total billed charges,124.73,82.6,,,percent of total billed charges,82.6% of total billed charges,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.36,151,
AQUATIC EXER/15MIN/-GP,42097113X,CDM,420,RC,97113,HCPCS,Outpatient,,,250,162.50,GP,220,88,,,percent of total billed charges,88% of total Billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicaid,250,100,,,percent of total billed charges,100% of total billed charges,21.83,103,,,Fee Schedule,103% of WA Medicaid,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,157.5,63,,,percent of total billed charges,63% of total billed charges,65.28,175,,,Fee Schedule,175% of Medicare OPPS Rate,21.83,100,,,Fee Schedule,100% of WA Medicaid,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,250,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,250,100,,,percent of total billed charges,100% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,147.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,22.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.38,130,,,Fee Schedule,130% of WA Medicaid ,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,84.75,33.9,,,percent of total billed charges,33.9% of total billed charges,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,37.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.47,100,,,Fee Schedule,100% of Medicare OPPS rate,21.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.83,250,
ELEC STIM MAN/15MIN/-GP,42097032X,CDM,420,RC,97032,HCPCS,Outpatient,,,201,130.65,GP,176.88,88,,,percent of total billed charges,88% of total Billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,201,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,126.63,63,,,percent of total billed charges,63% of total billed charges,25.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,30.75,15.3,,,percent of total billed charges,15.3% of total billed charges,138.69,69,,,percent of total billed charges,69% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,201,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,201,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,68.14,33.9,,,percent of total billed charges,33.9% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,156.78,78,,,percent of total billed charges,78% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,14.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.53,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,201,
ORTH/PROS CHECKOUT EST 15M GP,42097763X,CDM,420,RC,97763,HCPCS,Outpatient,,,184,119.60,GP,161.92,88,,,percent of total billed charges,88% of total Billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,184,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,115.92,63,,,percent of total billed charges,63% of total billed charges,93.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,28.15,15.3,,,percent of total billed charges,15.3% of total billed charges,126.96,69,,,percent of total billed charges,69% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,184,100,,,percent of total billed charges,100% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,212.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,33.9,,,percent of total billed charges,33.9% of total billed charges,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,143.52,78,,,percent of total billed charges,78% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,54.28,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,53.74,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.77,212.21,
Custom splint,27030862,CDM,270,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
Dexamethasone,63609920,CDM,636,RC,,,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.13,17.304,,,percent of total billed charges,17.304% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,8.05,17.136,,,percent of total billed charges,17.136% of total billed charges,10.26,21.84,,,percent of total billed charges,21.84% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,17.72,37.7,,,percent of total billed charges,37.70% of total billed charges,17.72,37.7,,,percent of total billed charges,37.70% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,15.93,33.9,,,percent of total billed charges,33.9% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,47,
E STIM UNATTEND NON-WOUND GP,421G0283,CDM,420,RC,G0283,HCPCS,Outpatient,,,138,89.70,GP,121.44,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,138,100,,,percent of total billed charges,100% of total billed charges,29.97,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,86.94,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid,21.11,15.3,,,percent of total billed charges,15.3% of total billed charges,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,138,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,138,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,50.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,21.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.83,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,46.78,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.84,138,
Electrodes,27095355,CDM,270,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,8.65,17.304,,,percent of total billed charges,17.304% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,30.93,61.85,,,percent of total billed charges,61.85% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.57,17.136,,,percent of total billed charges,17.136% of total billed charges,10.92,21.84,,,percent of total billed charges,21.84% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,50,
FUNCT CAP TEST 15 MIN/-GP,42097750X,CDM,420,RC,97750,HCPCS,Outpatient,,,232,150.80,GP,204.16,88,,,percent of total billed charges,88% of total Billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,232,100,,,percent of total billed charges,100% of total billed charges,20.12,103,,,Fee Schedule,103% of WA Medicaid,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,146.16,63,,,percent of total billed charges,63% of total billed charges,60.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid,35.5,15.3,,,percent of total billed charges,15.3% of total billed charges,160.08,69,,,percent of total billed charges,69% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,132.38,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.16,130,,,Fee Schedule,130% of WA Medicaid ,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,78.65,33.9,,,percent of total billed charges,33.9% of total billed charges,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,78,,,percent of total billed charges,78% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,35.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.73,100,,,Fee Schedule,100% of Medicare OPPS rate,20.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.12,232,
GAIT TRAINING/15MIN/-GP,42197116X,CDM,421,RC,97116,HCPCS,Outpatient,,,182,118.30,GP,160.16,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,182,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,27.85,15.3,,,percent of total billed charges,15.3% of total billed charges,125.58,69,,,percent of total billed charges,69% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,182,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,182,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,61.7,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,141.96,78,,,percent of total billed charges,78% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,182,
THER PROC GROUP 2/MORE IND-GP,42097150X,CDM,420,RC,97150,HCPCS,Outpatient,,,147,95.55,GP,129.36,88,,,percent of total billed charges,88% of total Billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,10.44,103,,,Fee Schedule,103% of WA Medicaid,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,92.61,63,,,percent of total billed charges,63% of total billed charges,31.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,69.46,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.57,130,,,Fee Schedule,130% of WA Medicaid ,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,18.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.44,147,
INFRARED,42097026X,CDM,420,RC,97026,HCPCS,Outpatient,,,37,24.05,GP,32.56,88,,,percent of total billed charges,88% of total Billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,3.99,103,,,Fee Schedule,103% of WA Medicaid,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,11.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.99,100,,,Fee Schedule,100% of WA Medicaid,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,37,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,25.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,4.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.19,130,,,Fee Schedule,130% of WA Medicaid ,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12.54,33.9,,,percent of total billed charges,33.9% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,3.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,6.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.99,37,
IONTOPHORESIS/15MIN,42097033X,CDM,420,RC,97033,HCPCS,Outpatient,,,200,130.00,GP,176,88,,,percent of total billed charges,88% of total Billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,200,100,,,percent of total billed charges,100% of total billed charges,11.77,103,,,Fee Schedule,103% of WA Medicaid,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,126,63,,,percent of total billed charges,63% of total billed charges,34.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,200,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,200,100,,,percent of total billed charges,100% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,78.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,12.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.3,130,,,Fee Schedule,130% of WA Medicaid ,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,67.8,33.9,,,percent of total billed charges,33.9% of total billed charges,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,19.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19.71,100,,,Fee Schedule,100% of Medicare OPPS rate,11.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.77,200,
MANUAL THERAPY/15MIN/-GP,42097140X,CDM,420,RC,97140,HCPCS,Outpatient,,,268,174.20,GP,235.84,88,,,percent of total billed charges,88% of total Billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,268,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,168.84,63,,,percent of total billed charges,63% of total billed charges,47.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid,41,15.3,,,percent of total billed charges,15.3% of total billed charges,184.92,69,,,percent of total billed charges,69% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,268,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,268,100,,,percent of total billed charges,100% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,106.72,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,16.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.72,130,,,Fee Schedule,130% of WA Medicaid ,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,101.04,37.7,,,percent of total billed charges,37.70% of total billed charges,101.04,37.7,,,percent of total billed charges,37.70% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,90.85,33.9,,,percent of total billed charges,33.9% of total billed charges,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,209.04,78,,,percent of total billed charges,78% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,27.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.49,100,,,Fee Schedule,100% of Medicare OPPS rate,15.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.94,268,
MASSAGE/15MIN/-GP,42097124X,CDM,420,RC,97124,HCPCS,Outpatient,,,120,78.00,GP,105.6,88,,,percent of total billed charges,88% of total Billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,17.84,103,,,Fee Schedule,103% of WA Medicaid,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,75.6,63,,,percent of total billed charges,63% of total billed charges,54.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,120,100,,,percent of total billed charges,100% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,113.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,18.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.19,130,,,Fee Schedule,130% of WA Medicaid ,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,31.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,31.03,100,,,Fee Schedule,100% of Medicare OPPS rate,17.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.84,120,
TRACTION MECHANICAL/-GP,42097012X,CDM,420,RC,97012,HCPCS,Outpatient,,,128,83.20,GP,112.64,88,,,percent of total billed charges,88% of total Billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,128,100,,,percent of total billed charges,100% of total billed charges,8.35,103,,,Fee Schedule,103% of WA Medicaid,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,80.64,63,,,percent of total billed charges,63% of total billed charges,24.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,128,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,57.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.86,130,,,Fee Schedule,130% of WA Medicaid ,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,43.39,33.9,,,percent of total billed charges,33.9% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,14.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.18,100,,,Fee Schedule,100% of Medicare OPPS rate,8.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.35,128,
NEURO RE-ED/15MIN/-GP,42197112X,CDM,420,RC,97112,HCPCS,Outpatient,,,228,148.20,GP,200.64,88,,,percent of total billed charges,88% of total Billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,228,100,,,percent of total billed charges,100% of total billed charges,19.93,103,,,Fee Schedule,103% of WA Medicaid,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,143.64,63,,,percent of total billed charges,63% of total billed charges,59.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid,34.88,15.3,,,percent of total billed charges,15.3% of total billed charges,157.32,69,,,percent of total billed charges,69% of total billed charges,228,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,228,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,228,100,,,percent of total billed charges,100% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,135.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,20.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.91,130,,,Fee Schedule,130% of WA Medicaid ,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,85.96,37.7,,,percent of total billed charges,37.70% of total billed charges,85.96,37.7,,,percent of total billed charges,37.70% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,77.29,33.9,,,percent of total billed charges,33.9% of total billed charges,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,177.84,78,,,percent of total billed charges,78% of total billed charges,228,100,,,percent of total billed charges,100% of total billed charges,188.33,82.6,,,percent of total billed charges,82.6% of total billed charges,188.33,82.6,,,percent of total billed charges,82.6% of total billed charges,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,34.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,34.33,100,,,Fee Schedule,100% of Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.93,228,
DEBRIDEMENT NON-SELCT/SESS/-GP,42097602X,CDM,420,RC,97602,HCPCS,Outpatient,,,737,479.05,GP,648.56,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,737,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,464.31,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,112.76,15.3,,,percent of total billed charges,15.3% of total billed charges,508.53,69,,,percent of total billed charges,69% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,249.84,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,574.86,78,,,percent of total billed charges,78% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.76,737,
ORTHOTIC MGMT EA 15M PT,42097760X,CDM,420,RC,97760,HCPCS,Outpatient,,,175,113.75,GP,154,88,,,percent of total billed charges,88% of total Billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,175,100,,,percent of total billed charges,100% of total billed charges,29.04,103,,,Fee Schedule,103% of WA Medicaid,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,110.25,63,,,percent of total billed charges,63% of total billed charges,85.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid,26.78,15.3,,,percent of total billed charges,15.3% of total billed charges,120.75,69,,,percent of total billed charges,69% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,175,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,175,100,,,percent of total billed charges,100% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,193.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.75,130,,,Fee Schedule,130% of WA Medicaid ,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59.33,33.9,,,percent of total billed charges,33.9% of total billed charges,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,136.5,78,,,percent of total billed charges,78% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,49.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.87,100,,,Fee Schedule,100% of Medicare OPPS rate,29.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.78,193.2,
ASSIST TECH ASSESS EA 15MIN GP,42097755X,CDM,420,RC,97755,HCPCS,Outpatient,,,209,135.85,GP,183.92,88,,,percent of total billed charges,88% of total Billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,22.59,100,,,Fee Schedule,100% of WA Medicaid,209,100,,,percent of total billed charges,100% of total billed charges,22.59,103,,,Fee Schedule,103% of WA Medicaid,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,131.67,63,,,percent of total billed charges,63% of total billed charges,67.62,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.59,100,,,Fee Schedule,100% of WA Medicaid,31.98,15.3,,,percent of total billed charges,15.3% of total billed charges,144.21,69,,,percent of total billed charges,69% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,209,100,,,percent of total billed charges,100% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,209,100,,,percent of total billed charges,100% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,148.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,22.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,23.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.37,130,,,Fee Schedule,130% of WA Medicaid ,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,78.79,37.7,,,percent of total billed charges,37.70% of total billed charges,78.79,37.7,,,percent of total billed charges,37.70% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,70.85,33.9,,,percent of total billed charges,33.9% of total billed charges,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,163.02,78,,,percent of total billed charges,78% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,22.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,39.36,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,38.97,100,,,Fee Schedule,100% of Medicare OPPS rate,22.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.59,209,
CONTRAST BATH15MIN/-GP,42097034X,CDM,420,RC,97034,HCPCS,Outpatient,,,112,72.80,GP,98.56,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,112,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,70.56,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,17.14,15.3,,,percent of total billed charges,15.3% of total billed charges,77.28,69,,,percent of total billed charges,69% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,112,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,112,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,57.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,42.22,37.7,,,percent of total billed charges,37.70% of total billed charges,42.22,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,37.97,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,87.36,78,,,percent of total billed charges,78% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,112,
COMM/WORK REINT/15MIN/-GP,42097537X,CDM,420,RC,97537,HCPCS,Outpatient,,,280,182.00,GP,246.4,88,,,percent of total billed charges,88% of total Billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,280,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,176.4,63,,,percent of total billed charges,63% of total billed charges,56.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,42.84,15.3,,,percent of total billed charges,15.3% of total billed charges,193.2,69,,,percent of total billed charges,69% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,280,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,124.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,105.56,37.7,,,percent of total billed charges,37.70% of total billed charges,105.56,37.7,,,percent of total billed charges,37.70% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,94.92,33.9,,,percent of total billed charges,33.9% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,218.4,78,,,percent of total billed charges,78% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.79,280,
PT EVAL- HGH COMP,42497163X,CDM,424,RC,97163,HCPCS,Outpatient,,,403,261.95,GP,354.64,88,,,percent of total billed charges,88% of total Billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,403,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,253.89,63,,,percent of total billed charges,63% of total billed charges,177.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,61.66,15.3,,,percent of total billed charges,15.3% of total billed charges,278.07,69,,,percent of total billed charges,69% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,390.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,136.62,33.9,,,percent of total billed charges,33.9% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,314.34,78,,,percent of total billed charges,78% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,103.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.22,403,
PT EVAL- LOW COMP,42497161X,CDM,424,RC,97161,HCPCS,Outpatient,,,403,261.95,GP,354.64,88,,,percent of total billed charges,88% of total Billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,403,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,253.89,63,,,percent of total billed charges,63% of total billed charges,177.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,61.66,15.3,,,percent of total billed charges,15.3% of total billed charges,278.07,69,,,percent of total billed charges,69% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,390.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,136.62,33.9,,,percent of total billed charges,33.9% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,314.34,78,,,percent of total billed charges,78% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,103.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.22,403,
PT EVAL- MOD COMP,42497162X,CDM,424,RC,97162,HCPCS,Outpatient,,,403,261.95,GP,354.64,88,,,percent of total billed charges,88% of total Billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,403,100,,,percent of total billed charges,100% of total billed charges,59.22,103,,,Fee Schedule,103% of WA Medicaid,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,253.89,63,,,percent of total billed charges,63% of total billed charges,177.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid,61.66,15.3,,,percent of total billed charges,15.3% of total billed charges,278.07,69,,,percent of total billed charges,69% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,390.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,60.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.99,130,,,Fee Schedule,130% of WA Medicaid ,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,136.62,33.9,,,percent of total billed charges,33.9% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,314.34,78,,,percent of total billed charges,78% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,103.21,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,102.19,100,,,Fee Schedule,100% of Medicare OPPS rate,59.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.22,403,
PT RE-EVALUATION/-GP,42497164X,CDM,424,RC,97164,HCPCS,Outpatient,,,240,156.00,GP,211.2,88,,,percent of total billed charges,88% of total Billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,Fee Schedule,100% of WA Medicaid,240,100,,,percent of total billed charges,100% of total billed charges,41.19,103,,,Fee Schedule,103% of WA Medicaid,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,151.2,63,,,percent of total billed charges,63% of total billed charges,123.48,175,,,Fee Schedule,175% of Medicare OPPS Rate,41.19,100,,,Fee Schedule,100% of WA Medicaid,36.72,15.3,,,percent of total billed charges,15.3% of total billed charges,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,267.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,41.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,42.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.55,130,,,Fee Schedule,130% of WA Medicaid ,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,81.36,33.9,,,percent of total billed charges,33.9% of total billed charges,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,41.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,71.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.06,100,,,Fee Schedule,100% of Medicare OPPS rate,41.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.72,267.41,
ADL/15MIN/-GP,42097535,CDM,420,RC,97535,HCPCS,Outpatient,,,151,98.15,GP,132.88,88,,,percent of total billed charges,88% of total Billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,151,100,,,percent of total billed charges,100% of total billed charges,19.36,103,,,Fee Schedule,103% of WA Medicaid,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,95.13,63,,,percent of total billed charges,63% of total billed charges,58.07,175,,,Fee Schedule,175% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid,23.1,15.3,,,percent of total billed charges,15.3% of total billed charges,104.19,69,,,percent of total billed charges,69% of total billed charges,151,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,151,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,151,100,,,percent of total billed charges,100% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,129.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.17,130,,,Fee Schedule,130% of WA Medicaid ,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,56.93,37.7,,,percent of total billed charges,37.70% of total billed charges,56.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,51.19,33.9,,,percent of total billed charges,33.9% of total billed charges,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,117.78,78,,,percent of total billed charges,78% of total billed charges,151,100,,,percent of total billed charges,100% of total billed charges,124.73,82.6,,,percent of total billed charges,82.6% of total billed charges,124.73,82.6,,,percent of total billed charges,82.6% of total billed charges,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,33.68,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33.35,100,,,Fee Schedule,100% of Medicare OPPS rate,19.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.36,151,
NEG PRESS WOUND TX <50 CM GP,42097605X,CDM,420,RC,97605,HCPCS,Outpatient,,,590,383.50,GP,519.2,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,590,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,371.7,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,90.27,15.3,,,percent of total billed charges,15.3% of total billed charges,407.1,69,,,percent of total billed charges,69% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,200.01,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,460.2,78,,,percent of total billed charges,78% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.27,729.42,
NEG PRESS WOUND TX >50 CM GP,42097606X,CDM,420,RC,97606,HCPCS,Outpatient,,,590,383.50,GP,519.2,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,590,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,371.7,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,90.27,15.3,,,percent of total billed charges,15.3% of total billed charges,407.1,69,,,percent of total billed charges,69% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,590,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,222.43,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,200.01,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,460.2,78,,,percent of total billed charges,78% of total billed charges,590,100,,,percent of total billed charges,100% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,487.34,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.27,1404.98,
PARAFFIN BATH,42097018X,CDM,420,RC,97018,HCPCS,Outpatient,,,143,92.95,GP,125.84,88,,,percent of total billed charges,88% of total Billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,143,100,,,percent of total billed charges,100% of total billed charges,3.42,103,,,Fee Schedule,103% of WA Medicaid,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,90.09,63,,,percent of total billed charges,63% of total billed charges,9.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid,21.88,15.3,,,percent of total billed charges,15.3% of total billed charges,98.67,69,,,percent of total billed charges,69% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,143,100,,,percent of total billed charges,100% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,22.53,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.45,130,,,Fee Schedule,130% of WA Medicaid ,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,48.48,33.9,,,percent of total billed charges,33.9% of total billed charges,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,111.54,78,,,percent of total billed charges,78% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,5.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.74,100,,,Fee Schedule,100% of Medicare OPPS rate,3.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.42,143,
PROS TRAIN UP/LO EXT15M PT,42097761X,CDM,420,RC,97761,HCPCS,Outpatient,,,171,111.15,GP,150.48,88,,,percent of total billed charges,88% of total Billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicaid,171,100,,,percent of total billed charges,100% of total billed charges,24.86,103,,,Fee Schedule,103% of WA Medicaid,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,107.73,63,,,percent of total billed charges,63% of total billed charges,74.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.86,100,,,Fee Schedule,100% of WA Medicaid,26.16,15.3,,,percent of total billed charges,15.3% of total billed charges,117.99,69,,,percent of total billed charges,69% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,171,100,,,percent of total billed charges,100% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,163.44,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,25.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.32,130,,,Fee Schedule,130% of WA Medicaid ,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,57.97,33.9,,,percent of total billed charges,33.9% of total billed charges,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,133.38,78,,,percent of total billed charges,78% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,43.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,42.64,100,,,Fee Schedule,100% of Medicare OPPS rate,24.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.86,171,
SVC PT IN HOME OR HEALTH SET,42000001,CDM,420,RC,,,Outpatient,,,220,143.00,GP,193.6,88,,,percent of total billed charges,88% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,220,100,,,percent of total billed charges,100% of total billed charges,38.07,17.304,,,percent of total billed charges,17.304% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,138.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,33.66,15.3,,,percent of total billed charges,15.3% of total billed charges,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,220,100,,,percent of total billed charges,100% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,220,100,,,percent of total billed charges,100% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,136.07,61.85,,,percent of total billed charges,61.85% of total billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,37.7,17.136,,,percent of total billed charges,17.136% of total billed charges,48.05,21.84,,,percent of total billed charges,21.84% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,74.58,33.9,,,percent of total billed charges,33.9% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,110,50,,,percent of total billed charges,50% of total Billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,33.66,220,
SELECT DEBRIDE/20 CM OR < GP,42097597X,CDM,420,RC,97597,HCPCS,Outpatient,,,737,479.05,GP,648.56,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,737,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,464.31,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,112.76,15.3,,,percent of total billed charges,15.3% of total billed charges,508.53,69,,,percent of total billed charges,69% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,249.84,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,574.86,78,,,percent of total billed charges,78% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.76,737,
SELECT DEBRIDE > 20 CM GP,42097598X,CDM,420,RC,97598,HCPCS,Outpatient,,,954,620.10,GP,839.52,88,,,percent of total billed charges,88% of total Billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid,954,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,477,50,,,percent of total billed charges,50% of total Billed charges,601.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid,145.96,15.3,,,percent of total billed charges,15.3% of total billed charges,658.26,69,,,percent of total billed charges,69% of total billed charges,954,100,,,percent of total billed charges,100% of total billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,954,100,,,percent of total billed charges,100% of total billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,954,100,,,percent of total billed charges,100% of total billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,590.05,61.85,,,percent of total billed charges,61.85% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,477,50,,,percent of total billed charges,50% of total Billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,477,50,,,percent of total billed charges,50% of total Billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,477,50,,,percent of total billed charges,50% of total Billed charges,359.66,37.7,,,percent of total billed charges,37.70% of total billed charges,359.66,37.7,,,percent of total billed charges,37.70% of total billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,323.41,33.9,,,percent of total billed charges,33.9% of total billed charges,477,50,,,percent of total billed charges,50% of total Billed charges,744.12,78,,,percent of total billed charges,78% of total billed charges,954,100,,,percent of total billed charges,100% of total billed charges,788,82.6,,,percent of total billed charges,82.6% of total billed charges,788,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,477,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,477,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,145.96,1174.99,
THERAP ACT 1:1/15MIN/-GP,42097530X,CDM,420,RC,97530,HCPCS,Outpatient,,,182,118.30,GO,160.16,88,,,percent of total billed charges,88% of total Billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,182,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,63,,,percent of total billed charges,63% of total billed charges,65.36,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,27.85,15.3,,,percent of total billed charges,15.3% of total billed charges,125.58,69,,,percent of total billed charges,69% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,182,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,182,100,,,percent of total billed charges,100% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,151.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,61.7,33.9,,,percent of total billed charges,33.9% of total billed charges,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,141.96,78,,,percent of total billed charges,78% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,37.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,37.51,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,182,
THERAPEUTIC EX/15MIN/-GP,42097110X,CDM,420,RC,97110,HCPCS,Outpatient,,,181,117.65,GP,159.28,88,,,percent of total billed charges,88% of total Billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,181,100,,,percent of total billed charges,100% of total billed charges,17.46,103,,,Fee Schedule,103% of WA Medicaid,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,114.03,63,,,percent of total billed charges,63% of total billed charges,52.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid,27.69,15.3,,,percent of total billed charges,15.3% of total billed charges,124.89,69,,,percent of total billed charges,69% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,181,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,181,100,,,percent of total billed charges,100% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,116.17,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.7,130,,,Fee Schedule,130% of WA Medicaid ,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,61.36,33.9,,,percent of total billed charges,33.9% of total billed charges,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,141.18,78,,,percent of total billed charges,78% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,30.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.89,100,,,Fee Schedule,100% of Medicare OPPS rate,17.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.46,181,
ULTRASOUND/15MIN/-GP,42097035X,CDM,420,RC,97035,HCPCS,Outpatient,,,227,147.55,GP,199.76,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,227,100,,,percent of total billed charges,100% of total billed charges,8.54,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,143.01,63,,,percent of total billed charges,63% of total billed charges,24.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid,34.73,15.3,,,percent of total billed charges,15.3% of total billed charges,156.63,69,,,percent of total billed charges,69% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,227,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,56.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.1,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,76.95,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,177.06,78,,,percent of total billed charges,78% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,14.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,14.23,100,,,Fee Schedule,100% of Medicare OPPS rate,8.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.54,227,
ULTRAVIOLET,42097028X,CDM,420,RC,97028,HCPCS,Outpatient,,,47,30.55,GP,41.36,88,,,percent of total billed charges,88% of total Billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.93,100,,,Fee Schedule,100% of WA Medicaid,47,100,,,percent of total billed charges,100% of total billed charges,4.93,103,,,Fee Schedule,103% of WA Medicaid,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,29.61,63,,,percent of total billed charges,63% of total billed charges,14.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.93,100,,,Fee Schedule,100% of WA Medicaid,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,47,100,,,percent of total billed charges,100% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,47,100,,,percent of total billed charges,100% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,31.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,5.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.41,130,,,Fee Schedule,130% of WA Medicaid ,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,17.72,37.7,,,percent of total billed charges,37.70% of total billed charges,17.72,37.7,,,percent of total billed charges,37.70% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,15.93,33.9,,,percent of total billed charges,33.9% of total billed charges,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,8.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.48,100,,,Fee Schedule,100% of Medicare OPPS rate,4.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.93,47,
ELECTRIC STIMULATION THERAPY,42097014X,CDM,420,RC,97014,HCPCS,Outpatient,,,77,50.05,GP,67.76,88,,,percent of total billed charges,88% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,7.21,100,,,Fee Schedule,100% of WA Medicaid,77,100,,,percent of total billed charges,100% of total billed charges,7.21,103,,,Fee Schedule,103% of WA Medicaid,38.5,50,,,percent of total billed charges,50% of total Billed charges,48.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.21,100,,,Fee Schedule,100% of WA Medicaid,11.78,15.3,,,percent of total billed charges,15.3% of total billed charges,53.13,69,,,percent of total billed charges,69% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,47.62,61.85,,,percent of total billed charges,61.85% of total billed charges,7.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.5,50,,,percent of total billed charges,50% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,7.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.5,50,,,percent of total billed charges,50% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,7.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.37,130,,,Fee Schedule,130% of WA Medicaid ,38.5,50,,,percent of total billed charges,50% of total Billed charges,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,26.1,33.9,,,percent of total billed charges,33.9% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,60.06,78,,,percent of total billed charges,78% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,7.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38.5,50,,,percent of total billed charges,50% of total Billed charges,7.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.21,77,
VASOPNEUMATIC DEVICES/-GP,42097016X,CDM,420,RC,97016,HCPCS,Outpatient,,,142,92.30,GP,124.96,88,,,percent of total billed charges,88% of total Billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,6.83,103,,,Fee Schedule,103% of WA Medicaid,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,89.46,63,,,percent of total billed charges,63% of total billed charges,20.42,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,142,100,,,percent of total billed charges,100% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,46.67,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.88,130,,,Fee Schedule,130% of WA Medicaid ,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,48.14,33.9,,,percent of total billed charges,33.9% of total billed charges,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,11.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11.84,100,,,Fee Schedule,100% of Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.83,142,
WHEELCHAIR MNGT/15MIN/-GP,42097542X,CDM,420,RC,97542,HCPCS,Outpatient,,,156,101.40,GP,137.28,88,,,percent of total billed charges,88% of total Billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,156,100,,,percent of total billed charges,100% of total billed charges,18.79,103,,,Fee Schedule,103% of WA Medicaid,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,98.28,63,,,percent of total billed charges,63% of total billed charges,56.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid,23.87,15.3,,,percent of total billed charges,15.3% of total billed charges,107.64,69,,,percent of total billed charges,69% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,125.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,19.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.43,130,,,Fee Schedule,130% of WA Medicaid ,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,52.88,33.9,,,percent of total billed charges,33.9% of total billed charges,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,121.68,78,,,percent of total billed charges,78% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,32.28,100,,,Fee Schedule,100% of Medicare OPPS rate,18.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.79,156,
WHIRLPOOL/-GP,42097022X,CDM,420,RC,97022,HCPCS,Outpatient,,,187,121.55,GP,164.56,88,,,percent of total billed charges,88% of total Billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,187,100,,,percent of total billed charges,100% of total billed charges,10.25,103,,,Fee Schedule,103% of WA Medicaid,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,117.81,63,,,percent of total billed charges,63% of total billed charges,30.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid,28.61,15.3,,,percent of total billed charges,15.3% of total billed charges,129.03,69,,,percent of total billed charges,69% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,187,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,187,100,,,percent of total billed charges,100% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,69.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.33,130,,,Fee Schedule,130% of WA Medicaid ,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,70.5,37.7,,,percent of total billed charges,37.70% of total billed charges,70.5,37.7,,,percent of total billed charges,37.70% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,63.39,33.9,,,percent of total billed charges,33.9% of total billed charges,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,145.86,78,,,percent of total billed charges,78% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,17.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.39,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.25,187,
ANES FOR DX ARTERIO/VENOGRAPHY,84001916,CDM,360,RC,1916,HCPCS,Outpatient,,,861,559.65,,757.68,88,,,percent of total billed charges,88% of total Billed charges,430.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid,861,100,,,percent of total billed charges,100% of total billed charges,22.18,103,,,Fee Schedule,103% of WA Medicaid,430.5,50,,,percent of total billed charges,50% of total Billed charges,542.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.54,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,594.09,69,,,percent of total billed charges,69% of total billed charges,861,100,,,percent of total billed charges,100% of total billed charges,430.5,50,,,percent of total billed charges,50% of total Billed charges,861,100,,,percent of total billed charges,100% of total billed charges,430.5,50,,,percent of total billed charges,50% of total Billed charges,861,100,,,percent of total billed charges,100% of total billed charges,430.5,50,,,percent of total billed charges,50% of total Billed charges,532.53,61.85,,,percent of total billed charges,61.85% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,430.5,50,,,percent of total billed charges,50% of total Billed charges,430.5,50,,,percent of total billed charges,50% of total Billed charges,15.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,430.5,50,,,percent of total billed charges,50% of total Billed charges,430.5,50,,,percent of total billed charges,50% of total Billed charges,21.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28,130,,,Fee Schedule,130% of WA Medicaid ,430.5,50,,,percent of total billed charges,50% of total Billed charges,324.6,37.7,,,percent of total billed charges,37.70% of total billed charges,324.6,37.7,,,percent of total billed charges,37.70% of total billed charges,430.5,50,,,percent of total billed charges,50% of total Billed charges,291.88,33.9,,,percent of total billed charges,33.9% of total billed charges,430.5,50,,,percent of total billed charges,50% of total Billed charges,671.58,78,,,percent of total billed charges,78% of total billed charges,861,100,,,percent of total billed charges,100% of total billed charges,711.19,82.6,,,percent of total billed charges,82.6% of total billed charges,711.19,82.6,,,percent of total billed charges,82.6% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,430.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,430.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.95,3367,
TRLUML PERIP ATHRC RENAL ART,8400234T,CDM,361,RC,0234T,HCPCS,Outpatient,,,57382,37298.30,,50496.16,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16110.1,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,16593.41,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,36150.66,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,16110.1,100,,,Fee Schedule,100% of WA Medicaid,8779.45,15.3,,,percent of total billed charges,15.3% of total billed charges,39593.58,69,,,percent of total billed charges,69% of total billed charges,57382,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,57382,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,57382,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,16110.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11933.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16432.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20943.14,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,21633.01,37.7,,,percent of total billed charges,37.70% of total billed charges,21633.01,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,19452.5,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,44757.96,78,,,percent of total billed charges,78% of total billed charges,57382,100,,,percent of total billed charges,100% of total billed charges,47397.53,82.6,,,percent of total billed charges,82.6% of total billed charges,47397.53,82.6,,,percent of total billed charges,82.6% of total billed charges,16110.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16110.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,57382,
TRLUML PERP ATHRC VISC - IP,8400235T,CDM,361,RC,0235T,HCPCS,Outpatient,,,57382,37298.30,,50496.16,88,,,percent of total billed charges,88% of total Billed charges,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5310.28,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5469.59,103,,,Fee Schedule,103% of WA Medicaid,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,36150.66,63,,,percent of total billed charges,63% of total billed charges,57382,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5310.28,100,,,Fee Schedule,100% of WA Medicaid,8779.45,15.3,,,percent of total billed charges,15.3% of total billed charges,39593.58,69,,,percent of total billed charges,69% of total billed charges,57382,100,,,percent of total billed charges,100% of total billed charges,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,57382,100,,,percent of total billed charges,100% of total billed charges,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,57382,100,,,percent of total billed charges,100% of total billed charges,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,57382,100,,,Fee Schedule,Pays at line item charges due to status indicator C,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3933.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5416.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6903.37,130,,,Fee Schedule,130% of WA Medicaid ,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,21633.01,37.7,,,percent of total billed charges,37.70% of total billed charges,21633.01,37.7,,,percent of total billed charges,37.70% of total billed charges,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,19452.5,33.9,,,percent of total billed charges,33.9% of total billed charges,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,44757.96,78,,,percent of total billed charges,78% of total billed charges,57382,100,,,percent of total billed charges,100% of total billed charges,47397.53,82.6,,,percent of total billed charges,82.6% of total billed charges,47397.53,82.6,,,percent of total billed charges,82.6% of total billed charges,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,57382,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,57382,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3933.54,57382,
TRLUML PERIP ATHRC ILIAC ART,8400238T,CDM,361,RC,0238T,HCPCS,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,2,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1.26,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65260.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,0.75,37.7,,,percent of total billed charges,37.70% of total billed charges,0.75,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,0.68,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.31,65260.52,
FLUID DRAIN SOFT TIS PERC GUID,84010030,CDM,361,RC,10030,HCPCS,Outpatient,,,6332,4115.80,,5572.16,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,989.16,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1018.83,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,3989.16,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,989.16,100,,,Fee Schedule,100% of WA Medicaid,968.8,15.3,,,percent of total billed charges,15.3% of total billed charges,4369.08,69,,,percent of total billed charges,69% of total billed charges,6332,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6332,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,6332,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,732.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1008.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1285.91,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2387.16,37.7,,,percent of total billed charges,37.70% of total billed charges,2387.16,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2146.55,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4938.96,78,,,percent of total billed charges,78% of total billed charges,6332,100,,,percent of total billed charges,100% of total billed charges,5230.23,82.6,,,percent of total billed charges,82.6% of total billed charges,5230.23,82.6,,,percent of total billed charges,82.6% of total billed charges,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,717.61,6332,
10060 Drainage of skin abscess,76110060,CDM,761,RC,10060,HCPCS,Outpatient,,,353,229.45,,310.64,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,353,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,222.39,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,54.01,15.3,,,percent of total billed charges,15.3% of total billed charges,243.57,69,,,percent of total billed charges,69% of total billed charges,353,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,353,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,353,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,133.08,37.7,,,percent of total billed charges,37.70% of total billed charges,133.08,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,119.67,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,275.34,78,,,percent of total billed charges,78% of total billed charges,353,100,,,percent of total billed charges,100% of total billed charges,291.58,82.6,,,percent of total billed charges,82.6% of total billed charges,291.58,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.01,729.41,
"11104 Punch Biopsy of skin, single",76111104,CDM,761,RC,11104,HCPCS,Outpatient,,,494,321.10,,434.72,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,494,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,311.22,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,75.58,15.3,,,percent of total billed charges,15.3% of total billed charges,340.86,69,,,percent of total billed charges,69% of total billed charges,494,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,494,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,494,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,186.24,37.7,,,percent of total billed charges,37.70% of total billed charges,186.24,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,167.47,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,385.32,78,,,percent of total billed charges,78% of total billed charges,494,100,,,percent of total billed charges,100% of total billed charges,408.04,82.6,,,percent of total billed charges,82.6% of total billed charges,408.04,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.58,1404.97,
"11105 Punch Biopsy of Skin, Each Additional Lesion Procedure",76111105,CDM,761,RC,11105,HCPCS,Outpatient,,,116,75.40,,102.08,88,,,percent of total billed charges,88% of total Billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid,116,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,58,50,,,percent of total billed charges,50% of total Billed charges,73.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,401.45,100,,,Fee Schedule,100% of WA Medicaid,17.75,15.3,,,percent of total billed charges,15.3% of total billed charges,80.04,69,,,percent of total billed charges,69% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,116,100,,,percent of total billed charges,100% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,116,100,,,percent of total billed charges,100% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,71.75,61.85,,,percent of total billed charges,61.85% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58,50,,,percent of total billed charges,50% of total Billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58,50,,,percent of total billed charges,50% of total Billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,58,50,,,percent of total billed charges,50% of total Billed charges,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,39.32,33.9,,,percent of total billed charges,33.9% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,90.48,78,,,percent of total billed charges,78% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58,50,,,percent of total billed charges,50% of total Billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.75,521.88,
"Simple repair of superficial wounds of scalp, neck, axillae",76112001,CDM,761,RC,12001,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,398.16,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,96.7,15.3,,,percent of total billed charges,15.3% of total billed charges,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,214.25,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.7,729.42,
12013 Simple Repair of Superficial Wound of Face,76112013,CDM,761,RC,12013,HCPCS,Outpatient,,,843,547.95,,741.84,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,843,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,531.09,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,128.98,15.3,,,percent of total billed charges,15.3% of total billed charges,581.67,69,,,percent of total billed charges,69% of total billed charges,843,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,843,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,843,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,317.81,37.7,,,percent of total billed charges,37.70% of total billed charges,317.81,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,285.78,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,657.54,78,,,percent of total billed charges,78% of total billed charges,843,100,,,percent of total billed charges,100% of total billed charges,696.32,82.6,,,percent of total billed charges,82.6% of total billed charges,696.32,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.74,843,
EXCISION OF CHEST WALL TUMOR,84021601,CDM,360,RC,21601,HCPCS,Outpatient,,,4669,3034.85,,4108.72,88,,,percent of total billed charges,88% of total Billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2020.72,100,,,Fee Schedule,100% of WA Medicaid,4669,100,,,percent of total billed charges,100% of total billed charges,2081.34,103,,,Fee Schedule,103% of WA Medicaid,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2941.47,63,,,percent of total billed charges,63% of total billed charges,5071.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,2020.72,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,3221.61,69,,,percent of total billed charges,69% of total billed charges,4669,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,4669,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,4669,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,9628.23,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2020.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1496.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2061.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2626.94,130,,,Fee Schedule,130% of WA Medicaid ,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1760.21,37.7,,,percent of total billed charges,37.70% of total billed charges,1760.21,37.7,,,percent of total billed charges,37.70% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1582.79,33.9,,,percent of total billed charges,33.9% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3641.82,78,,,percent of total billed charges,78% of total billed charges,4669,100,,,percent of total billed charges,100% of total billed charges,3856.59,82.6,,,percent of total billed charges,82.6% of total billed charges,3856.59,82.6,,,percent of total billed charges,82.6% of total billed charges,2020.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2927.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2020.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1496.83,9628.23,
"19285 Placement of breast localization device(s) (eg, clip,",76119285,CDM,761,RC,19285,HCPCS,Outpatient,,,1241,806.65,,1092.08,88,,,percent of total billed charges,88% of total Billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,1241,100,,,percent of total billed charges,100% of total billed charges,1298.41,103,,,Fee Schedule,103% of WA Medicaid,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,781.83,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,189.87,15.3,,,percent of total billed charges,15.3% of total billed charges,856.29,69,,,percent of total billed charges,69% of total billed charges,1241,100,,,percent of total billed charges,100% of total billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1241,100,,,percent of total billed charges,100% of total billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1241,100,,,percent of total billed charges,100% of total billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,933.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1285.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1638.77,130,,,Fee Schedule,130% of WA Medicaid ,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,467.86,37.7,,,percent of total billed charges,37.70% of total billed charges,467.86,37.7,,,percent of total billed charges,37.70% of total billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,420.7,33.9,,,percent of total billed charges,33.9% of total billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,967.98,78,,,percent of total billed charges,78% of total billed charges,1241,100,,,percent of total billed charges,100% of total billed charges,1025.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1025.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,189.87,2526.77,
BONE BX DEEP SURG,84020225,CDM,361,RC,20225,HCPCS,Outpatient,,,5066,3292.90,,4458.08,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1618.96,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3191.58,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,775.1,15.3,,,percent of total billed charges,15.3% of total billed charges,3495.54,69,,,percent of total billed charges,69% of total billed charges,5066,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5066,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5066,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1603.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2043.35,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1909.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1909.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1717.37,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3951.48,78,,,percent of total billed charges,78% of total billed charges,5066,100,,,percent of total billed charges,100% of total billed charges,4184.52,82.6,,,percent of total billed charges,82.6% of total billed charges,4184.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,775.1,5715.97,
INJ OF SINUS TRACT THERAPEUTIC,84020500,CDM,360,RC,20500,HCPCS,Outpatient,,,553,359.45,,486.64,88,,,percent of total billed charges,88% of total Billed charges,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,827.71,100,,,Fee Schedule,100% of WA Medicaid,553,100,,,percent of total billed charges,100% of total billed charges,852.54,103,,,Fee Schedule,103% of WA Medicaid,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,348.39,63,,,percent of total billed charges,63% of total billed charges,2722.09,175,,,Fee Schedule,175% of Medicare OPPS Rate,827.71,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,381.57,69,,,percent of total billed charges,69% of total billed charges,553,100,,,percent of total billed charges,100% of total billed charges,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,553,100,,,percent of total billed charges,100% of total billed charges,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,553,100,,,percent of total billed charges,100% of total billed charges,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,5495.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,613.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,844.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1076.02,130,,,Fee Schedule,130% of WA Medicaid ,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,208.48,37.7,,,percent of total billed charges,37.70% of total billed charges,208.48,37.7,,,percent of total billed charges,37.70% of total billed charges,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,187.47,33.9,,,percent of total billed charges,33.9% of total billed charges,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,431.34,78,,,percent of total billed charges,78% of total billed charges,553,100,,,percent of total billed charges,100% of total billed charges,456.78,82.6,,,percent of total billed charges,82.6% of total billed charges,456.78,82.6,,,percent of total billed charges,82.6% of total billed charges,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1555.49,100,,,Fee Schedule,100% of Medicare OPPS rate,827.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.47,5495.75,
INJ SINUS TRACT DIAGNOSTIC SUR,84020501,CDM,361,RC,20501,HCPCS,Outpatient,,,1683,1093.95,,1481.04,88,,,percent of total billed charges,88% of total Billed charges,841.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid,1683,100,,,percent of total billed charges,100% of total billed charges,281.05,103,,,Fee Schedule,103% of WA Medicaid,841.5,50,,,percent of total billed charges,50% of total Billed charges,1060.29,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,272.87,100,,,Fee Schedule,100% of WA Medicaid,257.5,15.3,,,percent of total billed charges,15.3% of total billed charges,1161.27,69,,,percent of total billed charges,69% of total billed charges,1683,100,,,percent of total billed charges,100% of total billed charges,841.5,50,,,percent of total billed charges,50% of total Billed charges,1683,100,,,percent of total billed charges,100% of total billed charges,841.5,50,,,percent of total billed charges,50% of total Billed charges,1683,100,,,percent of total billed charges,100% of total billed charges,841.5,50,,,percent of total billed charges,50% of total Billed charges,1040.94,61.85,,,percent of total billed charges,61.85% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,841.5,50,,,percent of total billed charges,50% of total Billed charges,841.5,50,,,percent of total billed charges,50% of total Billed charges,202.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,841.5,50,,,percent of total billed charges,50% of total Billed charges,841.5,50,,,percent of total billed charges,50% of total Billed charges,278.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.73,130,,,Fee Schedule,130% of WA Medicaid ,841.5,50,,,percent of total billed charges,50% of total Billed charges,634.49,37.7,,,percent of total billed charges,37.70% of total billed charges,634.49,37.7,,,percent of total billed charges,37.70% of total billed charges,841.5,50,,,percent of total billed charges,50% of total Billed charges,570.54,33.9,,,percent of total billed charges,33.9% of total billed charges,841.5,50,,,percent of total billed charges,50% of total Billed charges,1312.74,78,,,percent of total billed charges,78% of total billed charges,1683,100,,,percent of total billed charges,100% of total billed charges,1390.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1390.16,82.6,,,percent of total billed charges,82.6% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,841.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,841.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,202.12,1683,
REM FOREIGN BODY MUSCLE/TENDON,84020520,CDM,360,RC,20520,HCPCS,Outpatient,,,953,619.45,,838.64,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,953,100,,,percent of total billed charges,100% of total billed charges,1618.96,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,600.39,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,657.57,69,,,percent of total billed charges,69% of total billed charges,953,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,953,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,953,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1603.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2043.35,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,323.07,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,743.34,78,,,percent of total billed charges,78% of total billed charges,953,100,,,percent of total billed charges,100% of total billed charges,787.18,82.6,,,percent of total billed charges,82.6% of total billed charges,787.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,323.07,5715.97,
"20526 Injection, therapeutic carpal tunnel",84020526,CDM,761,RC,20526,HCPCS,Outpatient,,,532,345.80,,468.16,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,532,100,,,percent of total billed charges,100% of total billed charges,223.22,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,335.16,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid,81.4,15.3,,,percent of total billed charges,15.3% of total billed charges,367.08,69,,,percent of total billed charges,69% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,532,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,532,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,160.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,221.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.73,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,180.35,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,414.96,78,,,percent of total billed charges,78% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,216.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.4,1061,
ASPIR/INJ TREATMENT BONE CYST,84020615,CDM,360,RC,20615,HCPCS,Outpatient,,,1048,681.20,,922.24,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,443.75,100,,,Fee Schedule,100% of WA Medicaid,1048,100,,,percent of total billed charges,100% of total billed charges,457.07,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,660.24,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,443.75,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,723.12,69,,,percent of total billed charges,69% of total billed charges,1048,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1048,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1048,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,328.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,452.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,576.88,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,395.1,37.7,,,percent of total billed charges,37.70% of total billed charges,395.1,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,355.27,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,817.44,78,,,percent of total billed charges,78% of total billed charges,1048,100,,,percent of total billed charges,100% of total billed charges,865.65,82.6,,,percent of total billed charges,82.6% of total billed charges,865.65,82.6,,,percent of total billed charges,82.6% of total billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,328.7,3367,
"Arthrocentesis, aspiration and/or injection, major joint or",84020611,CDM,761,RC,20611,HCPCS,Outpatient,,,268,174.20,,235.84,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,443.75,100,,,Fee Schedule,100% of WA Medicaid,268,100,,,percent of total billed charges,100% of total billed charges,457.07,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,168.84,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,443.75,100,,,Fee Schedule,100% of WA Medicaid,41,15.3,,,percent of total billed charges,15.3% of total billed charges,184.92,69,,,percent of total billed charges,69% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,268,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,268,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,328.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,452.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,576.88,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,101.04,37.7,,,percent of total billed charges,37.70% of total billed charges,101.04,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,90.85,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,209.04,78,,,percent of total billed charges,78% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41,1061,
"Closed treatment of carpometacarpal dislocation, other than",76126670,CDM,761,RC,26670,HCPCS,Outpatient,,,737,479.05,,648.56,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,737,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,464.31,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,112.76,15.3,,,percent of total billed charges,15.3% of total billed charges,508.53,69,,,percent of total billed charges,69% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,249.84,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,574.86,78,,,percent of total billed charges,78% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.76,837.64,
Interphalangeal Joint w/man w/o Anesthesia,76126770,CDM,761,RC,26770,HCPCS,Outpatient,,,771,501.15,,678.48,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,771,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,485.73,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,117.96,15.3,,,percent of total billed charges,15.3% of total billed charges,531.99,69,,,percent of total billed charges,69% of total billed charges,771,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,771,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,771,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,290.67,37.7,,,percent of total billed charges,37.70% of total billed charges,290.67,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,261.37,33.9,,,percent of total billed charges,33.9% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,601.38,78,,,percent of total billed charges,78% of total billed charges,771,100,,,percent of total billed charges,100% of total billed charges,636.85,82.6,,,percent of total billed charges,82.6% of total billed charges,636.85,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.96,837.64,
INJ FOR SACROILIAC JOINT,84027096,CDM,761,RC,27096,HCPCS,Outpatient,,,859,558.35,,755.92,88,,,percent of total billed charges,88% of total Billed charges,429.5,50,,,percent of total billed charges,50% of total Billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid,859,100,,,percent of total billed charges,100% of total billed charges,457.07,103,,,Fee Schedule,103% of WA Medicaid,429.5,50,,,percent of total billed charges,50% of total Billed charges,541.17,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,443.75,100,,,Fee Schedule,100% of WA Medicaid,131.43,15.3,,,percent of total billed charges,15.3% of total billed charges,592.71,69,,,percent of total billed charges,69% of total billed charges,859,100,,,percent of total billed charges,100% of total billed charges,429.5,50,,,percent of total billed charges,50% of total Billed charges,859,100,,,percent of total billed charges,100% of total billed charges,429.5,50,,,percent of total billed charges,50% of total Billed charges,859,100,,,percent of total billed charges,100% of total billed charges,429.5,50,,,percent of total billed charges,50% of total Billed charges,531.29,61.85,,,percent of total billed charges,61.85% of total billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,429.5,50,,,percent of total billed charges,50% of total Billed charges,429.5,50,,,percent of total billed charges,50% of total Billed charges,328.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,429.5,50,,,percent of total billed charges,50% of total Billed charges,429.5,50,,,percent of total billed charges,50% of total Billed charges,452.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,576.88,130,,,Fee Schedule,130% of WA Medicaid ,429.5,50,,,percent of total billed charges,50% of total Billed charges,323.84,37.7,,,percent of total billed charges,37.70% of total billed charges,323.84,37.7,,,percent of total billed charges,37.70% of total billed charges,429.5,50,,,percent of total billed charges,50% of total Billed charges,291.2,33.9,,,percent of total billed charges,33.9% of total billed charges,429.5,50,,,percent of total billed charges,50% of total Billed charges,670.02,78,,,percent of total billed charges,78% of total billed charges,859,100,,,percent of total billed charges,100% of total billed charges,709.53,82.6,,,percent of total billed charges,82.6% of total billed charges,709.53,82.6,,,percent of total billed charges,82.6% of total billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,429.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,429.5,50,,,percent of total billed charges,50% of total Billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.43,859,
"REMOVAL FB,FOOT,DEEP",84028192,CDM,360,RC,28192,HCPCS,Outpatient,,,2002,1301.30,,1761.76,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,2002,100,,,percent of total billed charges,100% of total billed charges,1618.96,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1261.26,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1381.38,69,,,percent of total billed charges,69% of total billed charges,2002,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2002,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2002,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1603.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2043.35,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,754.75,37.7,,,percent of total billed charges,37.70% of total billed charges,754.75,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,678.68,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1561.56,78,,,percent of total billed charges,78% of total billed charges,2002,100,,,percent of total billed charges,100% of total billed charges,1653.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1653.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,678.68,5715.97,
"Laryngoscopy, indirect; with removal of foreign body",45031511,CDM,450,RC,31511,HCPCS,Outpatient,,,233,151.45,,205.04,88,,,percent of total billed charges,88% of total Billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,233,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,146.79,63,,,percent of total billed charges,63% of total billed charges,353.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,35.65,15.3,,,percent of total billed charges,15.3% of total billed charges,160.77,69,,,percent of total billed charges,69% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,233,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,233,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,667.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,87.84,37.7,,,percent of total billed charges,37.70% of total billed charges,87.84,37.7,,,percent of total billed charges,37.70% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,78.99,33.9,,,percent of total billed charges,33.9% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,181.74,78,,,percent of total billed charges,78% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,204.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.65,667.83,
THORACENTESIS W/O IMAGING,76132554,CDM,761,RC,32554,HCPCS,Outpatient,,,1661,1079.65,,1461.68,88,,,percent of total billed charges,88% of total Billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,1661,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1046.43,63,,,percent of total billed charges,63% of total billed charges,1121.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,254.13,15.3,,,percent of total billed charges,15.3% of total billed charges,1146.09,69,,,percent of total billed charges,69% of total billed charges,1661,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1661,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1661,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2200.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,626.2,37.7,,,percent of total billed charges,37.70% of total billed charges,626.2,37.7,,,percent of total billed charges,37.70% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,563.08,33.9,,,percent of total billed charges,33.9% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1295.58,78,,,percent of total billed charges,78% of total billed charges,1661,100,,,percent of total billed charges,100% of total billed charges,1371.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1371.99,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,647.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,254.13,2200.34,
THORACENTESIS;IMAGING GUIDED,84032555,CDM,761,RC,32555,HCPCS,Outpatient,,,4230,2749.50,,3722.4,88,,,percent of total billed charges,88% of total Billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,4230,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2664.9,63,,,percent of total billed charges,63% of total billed charges,1121.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,647.19,15.3,,,percent of total billed charges,15.3% of total billed charges,2918.7,69,,,percent of total billed charges,69% of total billed charges,4230,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4230,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4230,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2200.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1594.71,37.7,,,percent of total billed charges,37.70% of total billed charges,1594.71,37.7,,,percent of total billed charges,37.70% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1433.97,33.9,,,percent of total billed charges,33.9% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3299.4,78,,,percent of total billed charges,78% of total billed charges,4230,100,,,percent of total billed charges,100% of total billed charges,3493.98,82.6,,,percent of total billed charges,82.6% of total billed charges,3493.98,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,647.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,635.74,4230,
INSERT CATH PLEURA W IMAGE,84032550,CDM,329,RC,32550,HCPCS,Outpatient,,,7466,4852.90,,6570.08,88,,,percent of total billed charges,88% of total Billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4703.58,63,,,percent of total billed charges,63% of total billed charges,6175.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,1142.3,15.3,,,percent of total billed charges,15.3% of total billed charges,5151.54,69,,,percent of total billed charges,69% of total billed charges,7466,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7466,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,7466,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,12932.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2814.68,37.7,,,percent of total billed charges,37.70% of total billed charges,2814.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2530.97,33.9,,,percent of total billed charges,33.9% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,5823.48,78,,,percent of total billed charges,78% of total billed charges,7466,100,,,percent of total billed charges,100% of total billed charges,6166.92,82.6,,,percent of total billed charges,82.6% of total billed charges,6166.92,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3564.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,635.74,12932.7,
CHEST TUBE PLACEMENT,84032551,CDM,360,RC,32551,HCPCS,Outpatient,,,1171,761.15,,1030.48,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,1171,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,737.73,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,807.99,69,,,percent of total billed charges,69% of total billed charges,1171,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1171,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1171,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,441.47,37.7,,,percent of total billed charges,37.70% of total billed charges,441.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,396.97,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,913.38,78,,,percent of total billed charges,78% of total billed charges,1171,100,,,percent of total billed charges,100% of total billed charges,967.25,82.6,,,percent of total billed charges,82.6% of total billed charges,967.25,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,396.97,5712.48,
"32557 Pleural drainage, percutaneous procedure with insert i",76132557,CDM,761,RC,32557,HCPCS,Outpatient,,,2928,1903.20,,2576.64,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,2928,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1844.64,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,447.98,15.3,,,percent of total billed charges,15.3% of total billed charges,2020.32,69,,,percent of total billed charges,69% of total billed charges,2928,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2928,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2928,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1103.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1103.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,992.59,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2283.84,78,,,percent of total billed charges,78% of total billed charges,2928,100,,,percent of total billed charges,100% of total billed charges,2418.53,82.6,,,percent of total billed charges,82.6% of total billed charges,2418.53,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,447.98,5712.48,
"PERICARDIOCENTESIS; INITIAL|Pericardiocentesis, including imaging guidance, when perform",84033010|84033016,CDM,361,RC,33016,HCPCS,Outpatient,,,2082,1353.30,,1832.16,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,2082,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1311.66,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,318.55,15.3,,,percent of total billed charges,15.3% of total billed charges,1436.58,69,,,percent of total billed charges,69% of total billed charges,2082,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2082,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2082,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,784.91,37.7,,,percent of total billed charges,37.70% of total billed charges,784.91,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,705.8,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1623.96,78,,,percent of total billed charges,78% of total billed charges,2082,100,,,percent of total billed charges,100% of total billed charges,1719.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1719.73,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,318.55,5712.48,
"33017 Peri Drain w/indwelling Cath Insert, Percuta",84033017,CDM,481,RC,33017,HCPCS,Outpatient,,,1076,699.40,,946.88,88,,,percent of total billed charges,88% of total Billed charges,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,858.26,100,,,Fee Schedule,100% of WA Medicaid,1076,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,677.88,63,,,percent of total billed charges,63% of total billed charges,1076,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,858.26,100,,,Fee Schedule,100% of WA Medicaid,164.63,15.3,,,percent of total billed charges,15.3% of total billed charges,742.44,69,,,percent of total billed charges,69% of total billed charges,1076,100,,,percent of total billed charges,100% of total billed charges,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1076,100,,,percent of total billed charges,100% of total billed charges,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1076,100,,,percent of total billed charges,100% of total billed charges,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1076,100,,,Fee Schedule,Pays at line item charges due to status indicator C,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,405.65,37.7,,,percent of total billed charges,37.70% of total billed charges,405.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,364.76,33.9,,,percent of total billed charges,33.9% of total billed charges,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,839.28,78,,,percent of total billed charges,78% of total billed charges,1076,100,,,percent of total billed charges,100% of total billed charges,888.78,82.6,,,percent of total billed charges,82.6% of total billed charges,888.78,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1076,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,1076,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,164.63,1115.74,
PACER SING PERM IN/REPL VE SUR,84033207,CDM,361,RC,33207,HCPCS,Outpatient,,,3052,1983.80,,2685.76,88,,,percent of total billed charges,88% of total Billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,3052,100,,,percent of total billed charges,100% of total billed charges,7701.7,103,,,Fee Schedule,103% of WA Medicaid,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1922.76,63,,,percent of total billed charges,63% of total billed charges,19060,175,,,Fee Schedule,175% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,466.96,15.3,,,percent of total billed charges,15.3% of total billed charges,2105.88,69,,,percent of total billed charges,69% of total billed charges,3052,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,3052,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,3052,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,42250.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,5538.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7626.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9720.59,130,,,Fee Schedule,130% of WA Medicaid ,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1150.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1150.6,37.7,,,percent of total billed charges,37.70% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1034.63,33.9,,,percent of total billed charges,33.9% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,2380.56,78,,,percent of total billed charges,78% of total billed charges,3052,100,,,percent of total billed charges,100% of total billed charges,2520.95,82.6,,,percent of total billed charges,82.6% of total billed charges,2520.95,82.6,,,percent of total billed charges,82.6% of total billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11000.35,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,466.96,42250.94,
INSERT NEW/REPL PERMAN PACEMAK Dual,84033208,CDM,481,RC,33208,HCPCS,Outpatient,,,2754,1790.10,,2423.52,88,,,percent of total billed charges,88% of total Billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,2754,100,,,percent of total billed charges,100% of total billed charges,7701.7,103,,,Fee Schedule,103% of WA Medicaid,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1735.02,63,,,percent of total billed charges,63% of total billed charges,19060,175,,,Fee Schedule,175% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,421.36,15.3,,,percent of total billed charges,15.3% of total billed charges,1900.26,69,,,percent of total billed charges,69% of total billed charges,2754,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,2754,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,2754,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,42250.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,5538.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7626.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9720.59,130,,,Fee Schedule,130% of WA Medicaid ,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1038.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1038.26,37.7,,,percent of total billed charges,37.70% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,933.61,33.9,,,percent of total billed charges,33.9% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,2148.12,78,,,percent of total billed charges,78% of total billed charges,2754,100,,,percent of total billed charges,100% of total billed charges,2274.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2274.8,82.6,,,percent of total billed charges,82.6% of total billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11000.35,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,421.36,42250.94,
INSERT TEMP PACEMAKER SUR SING,84033210,CDM,361,RC,33210,HCPCS,Outpatient,,,920,598.00,,809.6,88,,,percent of total billed charges,88% of total Billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,920,100,,,percent of total billed charges,100% of total billed charges,1576.9,103,,,Fee Schedule,103% of WA Medicaid,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,579.6,63,,,percent of total billed charges,63% of total billed charges,15164.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,140.76,15.3,,,percent of total billed charges,15.3% of total billed charges,634.8,69,,,percent of total billed charges,69% of total billed charges,920,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,920,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,920,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,33120.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1561.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1990.26,130,,,Fee Schedule,130% of WA Medicaid ,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,346.84,37.7,,,percent of total billed charges,37.70% of total billed charges,346.84,37.7,,,percent of total billed charges,37.70% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,311.88,33.9,,,percent of total billed charges,33.9% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,717.6,78,,,percent of total billed charges,78% of total billed charges,920,100,,,percent of total billed charges,100% of total billed charges,759.92,82.6,,,percent of total billed charges,82.6% of total billed charges,759.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8751.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.76,33120.11,
PACER DUAL TEMP INS/REPL SURG,84033211,CDM,361,RC,33211,HCPCS,Outpatient,,,17109,11120.85,,15055.92,88,,,percent of total billed charges,88% of total Billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1576.9,103,,,Fee Schedule,103% of WA Medicaid,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10778.67,63,,,percent of total billed charges,63% of total billed charges,15164.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,2617.68,15.3,,,percent of total billed charges,15.3% of total billed charges,11805.21,69,,,percent of total billed charges,69% of total billed charges,17109,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17109,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17109,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,33120.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1561.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1990.26,130,,,Fee Schedule,130% of WA Medicaid ,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,6450.09,37.7,,,percent of total billed charges,37.70% of total billed charges,6450.09,37.7,,,percent of total billed charges,37.70% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5799.95,33.9,,,percent of total billed charges,33.9% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,13345.02,78,,,percent of total billed charges,78% of total billed charges,17109,100,,,percent of total billed charges,100% of total billed charges,14132.03,82.6,,,percent of total billed charges,82.6% of total billed charges,14132.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8751.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1134.05,33120.11,
REPOSITION LEADS,84033215,CDM,361,RC,33215,HCPCS,Outpatient,,,6258,4067.70,,5507.04,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1576.9,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3942.54,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,957.47,15.3,,,percent of total billed charges,15.3% of total billed charges,4318.02,69,,,percent of total billed charges,69% of total billed charges,6258,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6258,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6258,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1561.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1990.26,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2359.27,37.7,,,percent of total billed charges,37.70% of total billed charges,2359.27,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2121.46,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4881.24,78,,,percent of total billed charges,78% of total billed charges,6258,100,,,percent of total billed charges,100% of total billed charges,5169.11,82.6,,,percent of total billed charges,82.6% of total billed charges,5169.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,957.47,11625.57,
INSERT 2 ELEC PERM PACE/AICD,84033217,CDM,361,RC,33217,HCPCS,Outpatient,,,17109,11120.85,,15055.92,88,,,percent of total billed charges,88% of total Billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1576.9,103,,,Fee Schedule,103% of WA Medicaid,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10778.67,63,,,percent of total billed charges,63% of total billed charges,15164.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,2617.68,15.3,,,percent of total billed charges,15.3% of total billed charges,11805.21,69,,,percent of total billed charges,69% of total billed charges,17109,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17109,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,17109,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,33120.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1561.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1990.26,130,,,Fee Schedule,130% of WA Medicaid ,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,6450.09,37.7,,,percent of total billed charges,37.70% of total billed charges,6450.09,37.7,,,percent of total billed charges,37.70% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5799.95,33.9,,,percent of total billed charges,33.9% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,13345.02,78,,,percent of total billed charges,78% of total billed charges,17109,100,,,percent of total billed charges,100% of total billed charges,14132.03,82.6,,,percent of total billed charges,82.6% of total billed charges,14132.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8751.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1134.05,33120.11,
REPAIR SINGLE LEAD,84033218,CDM,361,RC,33218,HCPCS,Outpatient,,,14463,9400.95,,12727.44,88,,,percent of total billed charges,88% of total Billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1576.9,103,,,Fee Schedule,103% of WA Medicaid,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9111.69,63,,,percent of total billed charges,63% of total billed charges,7009.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,2212.84,15.3,,,percent of total billed charges,15.3% of total billed charges,9979.47,69,,,percent of total billed charges,69% of total billed charges,14463,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,14463,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,14463,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,13976.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1561.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1990.26,130,,,Fee Schedule,130% of WA Medicaid ,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5452.55,37.7,,,percent of total billed charges,37.70% of total billed charges,5452.55,37.7,,,percent of total billed charges,37.70% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4902.96,33.9,,,percent of total billed charges,33.9% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,11281.14,78,,,percent of total billed charges,78% of total billed charges,14463,100,,,percent of total billed charges,100% of total billed charges,11946.44,82.6,,,percent of total billed charges,82.6% of total billed charges,11946.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4045.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1134.05,14463,
PACER ELECT DUAL REPAIR SURG,84033220,CDM,361,RC,33220,HCPCS,Outpatient,,,16684,10844.60,,14681.92,88,,,percent of total billed charges,88% of total Billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1576.9,103,,,Fee Schedule,103% of WA Medicaid,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,10510.92,63,,,percent of total billed charges,63% of total billed charges,7009.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,2552.65,15.3,,,percent of total billed charges,15.3% of total billed charges,11511.96,69,,,percent of total billed charges,69% of total billed charges,16684,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,16684,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,16684,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,13976.6,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1561.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1990.26,130,,,Fee Schedule,130% of WA Medicaid ,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6289.87,37.7,,,percent of total billed charges,37.70% of total billed charges,6289.87,37.7,,,percent of total billed charges,37.70% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5655.88,33.9,,,percent of total billed charges,33.9% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,13013.52,78,,,percent of total billed charges,78% of total billed charges,16684,100,,,percent of total billed charges,100% of total billed charges,13780.98,82.6,,,percent of total billed charges,82.6% of total billed charges,13780.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4045.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1134.05,16684,
RELOCATE POCKET PPG SURG,84033222,CDM,361,RC,33222,HCPCS,Outpatient,,,6160,4004.00,,5420.8,88,,,percent of total billed charges,88% of total Billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1576.9,103,,,Fee Schedule,103% of WA Medicaid,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3880.8,63,,,percent of total billed charges,63% of total billed charges,3255.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,942.48,15.3,,,percent of total billed charges,15.3% of total billed charges,4250.4,69,,,percent of total billed charges,69% of total billed charges,6160,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6160,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6160,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6968.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1561.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1990.26,130,,,Fee Schedule,130% of WA Medicaid ,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,2322.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2322.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,2088.24,33.9,,,percent of total billed charges,33.9% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,4804.8,78,,,percent of total billed charges,78% of total billed charges,6160,100,,,percent of total billed charges,100% of total billed charges,5088.16,82.6,,,percent of total billed charges,82.6% of total billed charges,5088.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1878.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,942.48,6968.7,
INSERT PACING LEAD  CONNECT,84033224,CDM,361,RC,33224,HCPCS,Outpatient,,,40350,26227.50,,35508,88,,,percent of total billed charges,88% of total Billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7701.7,103,,,Fee Schedule,103% of WA Medicaid,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,25420.5,63,,,percent of total billed charges,63% of total billed charges,19060,175,,,Fee Schedule,175% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,6173.55,15.3,,,percent of total billed charges,15.3% of total billed charges,27841.5,69,,,percent of total billed charges,69% of total billed charges,40350,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,40350,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,40350,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,42250.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,5538.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7626.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9720.59,130,,,Fee Schedule,130% of WA Medicaid ,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,15211.95,37.7,,,percent of total billed charges,37.70% of total billed charges,15211.95,37.7,,,percent of total billed charges,37.70% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,13678.65,33.9,,,percent of total billed charges,33.9% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,31473,78,,,percent of total billed charges,78% of total billed charges,40350,100,,,percent of total billed charges,100% of total billed charges,33329.1,82.6,,,percent of total billed charges,82.6% of total billed charges,33329.1,82.6,,,percent of total billed charges,82.6% of total billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11000.35,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,42250.94,
NEW CORONARY SINUS LEAD,84033225,CDM,360,RC,33225,HCPCS,Outpatient,,,39376,25594.40,,34650.88,88,,,percent of total billed charges,88% of total Billed charges,19688,50,,,percent of total billed charges,50% of total Billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7701.7,103,,,Fee Schedule,103% of WA Medicaid,19688,50,,,percent of total billed charges,50% of total Billed charges,24806.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7477.38,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,27169.44,69,,,percent of total billed charges,69% of total billed charges,39376,100,,,percent of total billed charges,100% of total billed charges,19688,50,,,percent of total billed charges,50% of total Billed charges,39376,100,,,percent of total billed charges,100% of total billed charges,19688,50,,,percent of total billed charges,50% of total Billed charges,39376,100,,,percent of total billed charges,100% of total billed charges,19688,50,,,percent of total billed charges,50% of total Billed charges,24354.06,61.85,,,percent of total billed charges,61.85% of total billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19688,50,,,percent of total billed charges,50% of total Billed charges,19688,50,,,percent of total billed charges,50% of total Billed charges,5538.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19688,50,,,percent of total billed charges,50% of total Billed charges,19688,50,,,percent of total billed charges,50% of total Billed charges,7626.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9720.59,130,,,Fee Schedule,130% of WA Medicaid ,19688,50,,,percent of total billed charges,50% of total Billed charges,14844.75,37.7,,,percent of total billed charges,37.70% of total billed charges,14844.75,37.7,,,percent of total billed charges,37.70% of total billed charges,19688,50,,,percent of total billed charges,50% of total Billed charges,13348.46,33.9,,,percent of total billed charges,33.9% of total billed charges,19688,50,,,percent of total billed charges,50% of total Billed charges,30713.28,78,,,percent of total billed charges,78% of total billed charges,39376,100,,,percent of total billed charges,100% of total billed charges,32524.58,82.6,,,percent of total billed charges,82.6% of total billed charges,32524.58,82.6,,,percent of total billed charges,82.6% of total billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19688,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19688,50,,,percent of total billed charges,50% of total Billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3367,39376,
REPO LV LEAD,84033226,CDM,361,RC,33226,HCPCS,Outpatient,,,7039,4575.35,,6194.32,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6298.95,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,6487.92,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4434.57,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,6298.95,100,,,Fee Schedule,100% of WA Medicaid,1076.97,15.3,,,percent of total billed charges,15.3% of total billed charges,4856.91,69,,,percent of total billed charges,69% of total billed charges,7039,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7039,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7039,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4665.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6424.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8188.64,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2653.7,37.7,,,percent of total billed charges,37.70% of total billed charges,2653.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.22,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5490.42,78,,,percent of total billed charges,78% of total billed charges,7039,100,,,percent of total billed charges,100% of total billed charges,5814.21,82.6,,,percent of total billed charges,82.6% of total billed charges,5814.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1076.97,11625.57,
GEN REPLACE SING SURG,84033227,CDM,361,RC,33227,HCPCS,Outpatient,,,48130,31284.50,,42354.4,88,,,percent of total billed charges,88% of total Billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7701.7,103,,,Fee Schedule,103% of WA Medicaid,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,30321.9,63,,,percent of total billed charges,63% of total billed charges,15164.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,7363.89,15.3,,,percent of total billed charges,15.3% of total billed charges,33209.7,69,,,percent of total billed charges,69% of total billed charges,48130,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,48130,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,48130,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,33120.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5538.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7626.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9720.59,130,,,Fee Schedule,130% of WA Medicaid ,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,18145.01,37.7,,,percent of total billed charges,37.70% of total billed charges,18145.01,37.7,,,percent of total billed charges,37.70% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,16316.07,33.9,,,percent of total billed charges,33.9% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,37541.4,78,,,percent of total billed charges,78% of total billed charges,48130,100,,,percent of total billed charges,100% of total billed charges,39755.38,82.6,,,percent of total billed charges,82.6% of total billed charges,39755.38,82.6,,,percent of total billed charges,82.6% of total billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8751.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,48130,
REPLACE OF GENERATOR PACEMAKER,84033228,CDM,360,RC,33228,HCPCS,Outpatient,,,2141,1391.65,,1884.08,88,,,percent of total billed charges,88% of total Billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,2141,100,,,percent of total billed charges,100% of total billed charges,7701.7,103,,,Fee Schedule,103% of WA Medicaid,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1348.83,63,,,percent of total billed charges,63% of total billed charges,19060,175,,,Fee Schedule,175% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1477.29,69,,,percent of total billed charges,69% of total billed charges,2141,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,2141,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,2141,100,,,percent of total billed charges,100% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,42250.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,5538.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7626.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9720.59,130,,,Fee Schedule,130% of WA Medicaid ,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,807.16,37.7,,,percent of total billed charges,37.70% of total billed charges,807.16,37.7,,,percent of total billed charges,37.70% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,725.8,33.9,,,percent of total billed charges,33.9% of total billed charges,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,1669.98,78,,,percent of total billed charges,78% of total billed charges,2141,100,,,percent of total billed charges,100% of total billed charges,1768.47,82.6,,,percent of total billed charges,82.6% of total billed charges,1768.47,82.6,,,percent of total billed charges,82.6% of total billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11000.35,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10891.43,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,725.8,42250.94,
REM/REP PM GEN MULTI LEADS,84033229,CDM,361,RC,33229,HCPCS,Outpatient,,,52774,34303.10,,46441.12,88,,,percent of total billed charges,88% of total Billed charges,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7701.7,103,,,Fee Schedule,103% of WA Medicaid,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,33247.62,63,,,percent of total billed charges,63% of total billed charges,34779.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,8074.42,15.3,,,percent of total billed charges,15.3% of total billed charges,36414.06,69,,,percent of total billed charges,69% of total billed charges,52774,100,,,percent of total billed charges,100% of total billed charges,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,52774,100,,,percent of total billed charges,100% of total billed charges,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,52774,100,,,percent of total billed charges,100% of total billed charges,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,75608.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,5538.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,7626.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9720.59,130,,,Fee Schedule,130% of WA Medicaid ,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,19895.8,37.7,,,percent of total billed charges,37.70% of total billed charges,19895.8,37.7,,,percent of total billed charges,37.70% of total billed charges,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,17890.39,33.9,,,percent of total billed charges,33.9% of total billed charges,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,41163.72,78,,,percent of total billed charges,78% of total billed charges,52774,100,,,percent of total billed charges,100% of total billed charges,43591.32,82.6,,,percent of total billed charges,82.6% of total billed charges,43591.32,82.6,,,percent of total billed charges,82.6% of total billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,20072.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,19874.18,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,75608.83,
INSERT PULSE GEN W MULTI LEADS,84033231,CDM,361,RC,33231,HCPCS,Outpatient,,,174437,113384.05,,153504.56,88,,,percent of total billed charges,88% of total Billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,23091.96,103,,,Fee Schedule,103% of WA Medicaid,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,109895.31,63,,,percent of total billed charges,63% of total billed charges,58722.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid,26688.86,15.3,,,percent of total billed charges,15.3% of total billed charges,120361.53,69,,,percent of total billed charges,69% of total billed charges,174437,100,,,percent of total billed charges,100% of total billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,174437,100,,,percent of total billed charges,100% of total billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,174437,100,,,percent of total billed charges,100% of total billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,133409.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,16606.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,22867.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29145.19,130,,,Fee Schedule,130% of WA Medicaid ,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,65762.75,37.7,,,percent of total billed charges,37.70% of total billed charges,65762.75,37.7,,,percent of total billed charges,37.70% of total billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,59134.14,33.9,,,percent of total billed charges,33.9% of total billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,136060.86,78,,,percent of total billed charges,78% of total billed charges,174437,100,,,percent of total billed charges,100% of total billed charges,144084.96,82.6,,,percent of total billed charges,82.6% of total billed charges,144084.96,82.6,,,percent of total billed charges,82.6% of total billed charges,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,33891.41,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,174437,
REMOVAL OF PERMANENT PACEMAKER,84033241,CDM,361,RC,33241,HCPCS,Outpatient,,,8619,5602.35,,7584.72,88,,,percent of total billed charges,88% of total Billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6298.95,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,6487.92,103,,,Fee Schedule,103% of WA Medicaid,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5429.97,63,,,percent of total billed charges,63% of total billed charges,7009.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,6298.95,100,,,Fee Schedule,100% of WA Medicaid,1318.71,15.3,,,percent of total billed charges,15.3% of total billed charges,5947.11,69,,,percent of total billed charges,69% of total billed charges,8619,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,8619,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,8619,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,13976.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4665.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6424.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8188.64,130,,,Fee Schedule,130% of WA Medicaid ,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3249.36,37.7,,,percent of total billed charges,37.70% of total billed charges,3249.36,37.7,,,percent of total billed charges,37.70% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2921.84,33.9,,,percent of total billed charges,33.9% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6722.82,78,,,percent of total billed charges,78% of total billed charges,8619,100,,,percent of total billed charges,100% of total billed charges,7119.29,82.6,,,percent of total billed charges,82.6% of total billed charges,7119.29,82.6,,,percent of total billed charges,82.6% of total billed charges,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4045.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1318.71,13976.61,
REMOVE ICD ELECT0TRANS EXTRACT,84033244,CDM,361,RC,33244,HCPCS,Outpatient,,,9490,6168.50,,8351.2,88,,,percent of total billed charges,88% of total Billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1576.9,103,,,Fee Schedule,103% of WA Medicaid,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5978.7,63,,,percent of total billed charges,63% of total billed charges,7009.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,1451.97,15.3,,,percent of total billed charges,15.3% of total billed charges,6548.1,69,,,percent of total billed charges,69% of total billed charges,9490,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9490,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9490,100,,,percent of total billed charges,100% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,13976.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1561.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1990.26,130,,,Fee Schedule,130% of WA Medicaid ,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3577.73,37.7,,,percent of total billed charges,37.70% of total billed charges,3577.73,37.7,,,percent of total billed charges,37.70% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3217.11,33.9,,,percent of total billed charges,33.9% of total billed charges,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7402.2,78,,,percent of total billed charges,78% of total billed charges,9490,100,,,percent of total billed charges,100% of total billed charges,7838.74,82.6,,,percent of total billed charges,82.6% of total billed charges,7838.74,82.6,,,percent of total billed charges,82.6% of total billed charges,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4045.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4005.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1134.05,13976.61,
REM/REP CVD GEN SINGLE LEAD,84033262,CDM,361,RC,33262,HCPCS,Outpatient,,,174437,113384.05,,153504.56,88,,,percent of total billed charges,88% of total Billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,23091.96,103,,,Fee Schedule,103% of WA Medicaid,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,109895.31,63,,,percent of total billed charges,63% of total billed charges,42073.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid,26688.86,15.3,,,percent of total billed charges,15.3% of total billed charges,120361.53,69,,,percent of total billed charges,69% of total billed charges,174437,100,,,percent of total billed charges,100% of total billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,174437,100,,,percent of total billed charges,100% of total billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,174437,100,,,percent of total billed charges,100% of total billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,93601.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,16606.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,22867.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29145.19,130,,,Fee Schedule,130% of WA Medicaid ,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,65762.75,37.7,,,percent of total billed charges,37.70% of total billed charges,65762.75,37.7,,,percent of total billed charges,37.70% of total billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,59134.14,33.9,,,percent of total billed charges,33.9% of total billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,136060.86,78,,,percent of total billed charges,78% of total billed charges,174437,100,,,percent of total billed charges,100% of total billed charges,144084.96,82.6,,,percent of total billed charges,82.6% of total billed charges,144084.96,82.6,,,percent of total billed charges,82.6% of total billed charges,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,24282.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,174437,
REM/REP PM GEN DUAL LEADS,84033263,CDM,361,RC,33263,HCPCS,Outpatient,,,46927,30502.55,,41295.76,88,,,percent of total billed charges,88% of total Billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,23091.96,103,,,Fee Schedule,103% of WA Medicaid,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,29564.01,63,,,percent of total billed charges,63% of total billed charges,42073.46,175,,,Fee Schedule,175% of Medicare OPPS Rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid,7179.83,15.3,,,percent of total billed charges,15.3% of total billed charges,32379.63,69,,,percent of total billed charges,69% of total billed charges,46927,100,,,percent of total billed charges,100% of total billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,46927,100,,,percent of total billed charges,100% of total billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,46927,100,,,percent of total billed charges,100% of total billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,93601.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,16606.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,22867.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29145.19,130,,,Fee Schedule,130% of WA Medicaid ,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,17691.48,37.7,,,percent of total billed charges,37.70% of total billed charges,17691.48,37.7,,,percent of total billed charges,37.70% of total billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,15908.25,33.9,,,percent of total billed charges,33.9% of total billed charges,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,36603.06,78,,,percent of total billed charges,78% of total billed charges,46927,100,,,percent of total billed charges,100% of total billed charges,38761.7,82.6,,,percent of total billed charges,82.6% of total billed charges,38761.7,82.6,,,percent of total billed charges,82.6% of total billed charges,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,24282.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24041.98,100,,,Fee Schedule,100% of Medicare OPPS rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,93601.39,
REM IMPL/DEFIB/PUL/GEN RPLSAME,84033264,CDM,360,RC,33264,HCPCS,Outpatient,,,1978,1285.70,,1740.64,88,,,percent of total billed charges,88% of total Billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid,1978,100,,,percent of total billed charges,100% of total billed charges,23091.96,103,,,Fee Schedule,103% of WA Medicaid,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,1246.14,63,,,percent of total billed charges,63% of total billed charges,58722.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1364.82,69,,,percent of total billed charges,69% of total billed charges,1978,100,,,percent of total billed charges,100% of total billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,1978,100,,,percent of total billed charges,100% of total billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,1978,100,,,percent of total billed charges,100% of total billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,133409.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,16606.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,22867.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29145.19,130,,,Fee Schedule,130% of WA Medicaid ,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,745.71,37.7,,,percent of total billed charges,37.70% of total billed charges,745.71,37.7,,,percent of total billed charges,37.70% of total billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,670.54,33.9,,,percent of total billed charges,33.9% of total billed charges,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,1542.84,78,,,percent of total billed charges,78% of total billed charges,1978,100,,,percent of total billed charges,100% of total billed charges,1633.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1633.83,82.6,,,percent of total billed charges,82.6% of total billed charges,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,33891.41,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,33555.87,100,,,Fee Schedule,100% of Medicare OPPS rate,22419.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,670.54,133409.05,
IMPLANT PAT-ACTIVE HT RECORDER,84033285,CDM,481,RC,33285,HCPCS,Outpatient,,,26463,17200.95,,23287.44,88,,,percent of total billed charges,88% of total Billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7701.7,103,,,Fee Schedule,103% of WA Medicaid,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,16671.69,63,,,percent of total billed charges,63% of total billed charges,15164.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid,4048.84,15.3,,,percent of total billed charges,15.3% of total billed charges,18259.47,69,,,percent of total billed charges,69% of total billed charges,26463,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,26463,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,26463,100,,,percent of total billed charges,100% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,33120.11,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5538.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7626.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9720.59,130,,,Fee Schedule,130% of WA Medicaid ,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9976.55,37.7,,,percent of total billed charges,37.70% of total billed charges,9976.55,37.7,,,percent of total billed charges,37.70% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8970.96,33.9,,,percent of total billed charges,33.9% of total billed charges,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,20641.14,78,,,percent of total billed charges,78% of total billed charges,26463,100,,,percent of total billed charges,100% of total billed charges,21858.44,82.6,,,percent of total billed charges,82.6% of total billed charges,21858.44,82.6,,,percent of total billed charges,82.6% of total billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8751.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8665.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4048.84,33120.11,
REMOVE PT ACT CARD EVENT MON,84033286,CDM,361,RC,33286,HCPCS,Outpatient,,,1002,651.30,,881.76,88,,,percent of total billed charges,88% of total Billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,1002,100,,,percent of total billed charges,100% of total billed charges,1576.9,103,,,Fee Schedule,103% of WA Medicaid,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,631.26,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid,153.31,15.3,,,percent of total billed charges,15.3% of total billed charges,691.38,69,,,percent of total billed charges,69% of total billed charges,1002,100,,,percent of total billed charges,100% of total billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1002,100,,,percent of total billed charges,100% of total billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1002,100,,,percent of total billed charges,100% of total billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1561.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1990.26,130,,,Fee Schedule,130% of WA Medicaid ,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,377.75,37.7,,,percent of total billed charges,37.70% of total billed charges,377.75,37.7,,,percent of total billed charges,37.70% of total billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,339.68,33.9,,,percent of total billed charges,33.9% of total billed charges,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,781.56,78,,,percent of total billed charges,78% of total billed charges,1002,100,,,percent of total billed charges,100% of total billed charges,827.65,82.6,,,percent of total billed charges,82.6% of total billed charges,827.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,153.31,2526.77,
INSERT I-AORT PERCUT DEVICE,84033967,CDM,360,RC,33967,HCPCS,Outpatient,,,1266,822.90,,1114.08,88,,,percent of total billed charges,88% of total Billed charges,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7477.38,100,,,Fee Schedule,100% of WA Medicaid,1266,100,,,percent of total billed charges,100% of total billed charges,7701.7,103,,,Fee Schedule,103% of WA Medicaid,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,797.58,63,,,percent of total billed charges,63% of total billed charges,1266,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7477.38,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,873.54,69,,,percent of total billed charges,69% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1266,100,,,percent of total billed charges,100% of total billed charges,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1266,100,,,percent of total billed charges,100% of total billed charges,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1266,100,,,Fee Schedule,Pays at line item charges due to status indicator C,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5538.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7626.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9720.59,130,,,Fee Schedule,130% of WA Medicaid ,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,429.17,33.9,,,percent of total billed charges,33.9% of total billed charges,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,987.48,78,,,percent of total billed charges,78% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1266,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,1266,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7477.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,429.17,9720.59,
INSERT VAD ARTERY ACCESS,84033990,CDM,361,RC,33990,HCPCS,Outpatient,,,2967,1928.55,,2610.96,88,,,percent of total billed charges,88% of total Billed charges,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,498.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,2967,100,,,percent of total billed charges,100% of total billed charges,513.41,17.304,,,percent of total billed charges,17.304% of total billed charges,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1869.21,63,,,percent of total billed charges,63% of total billed charges,2967,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,498.46,16.8,,,percent of total billed charges,16.8% of total billed charges,453.95,15.3,,,percent of total billed charges,15.3% of total billed charges,2047.23,69,,,percent of total billed charges,69% of total billed charges,2967,100,,,percent of total billed charges,100% of total billed charges,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,2967,100,,,percent of total billed charges,100% of total billed charges,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,2967,100,,,percent of total billed charges,100% of total billed charges,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,2967,100,,,Fee Schedule,Pays at line item charges due to status indicator C,498.46,16.8,,,percent of total billed charges,16.8% of total billed charges,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,498.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,508.43,17.136,,,percent of total billed charges,17.136% of total billed charges,647.99,21.84,,,percent of total billed charges,21.84% of total billed charges,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1118.56,37.7,,,percent of total billed charges,37.70% of total billed charges,1118.56,37.7,,,percent of total billed charges,37.70% of total billed charges,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1005.81,33.9,,,percent of total billed charges,33.9% of total billed charges,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,2314.26,78,,,percent of total billed charges,78% of total billed charges,2967,100,,,percent of total billed charges,100% of total billed charges,2450.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2450.74,82.6,,,percent of total billed charges,82.6% of total billed charges,498.46,16.8,,,percent of total billed charges,16.8% of total billed charges,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,2967,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,2967,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,498.46,16.8,,,percent of total billed charges,16.8% of total billed charges,453.95,2967,
REMOVE VAD DIFFERENT SESSION,84033992,CDM,361,RC,33992,HCPCS,Outpatient,,,1718,1116.70,,1511.84,88,,,percent of total billed charges,88% of total Billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,6298.95,100,,,Fee Schedule,100% of WA Medicaid,1718,100,,,percent of total billed charges,100% of total billed charges,6487.92,103,,,Fee Schedule,103% of WA Medicaid,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1082.34,63,,,percent of total billed charges,63% of total billed charges,1718,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,6298.95,100,,,Fee Schedule,100% of WA Medicaid,262.85,15.3,,,percent of total billed charges,15.3% of total billed charges,1185.42,69,,,percent of total billed charges,69% of total billed charges,1718,100,,,percent of total billed charges,100% of total billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,percent of total billed charges,100% of total billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,percent of total billed charges,100% of total billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,Fee Schedule,Pays at line item charges due to status indicator C,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,4665.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,6424.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8188.64,130,,,Fee Schedule,130% of WA Medicaid ,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,647.69,37.7,,,percent of total billed charges,37.70% of total billed charges,647.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,582.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1340.04,78,,,percent of total billed charges,78% of total billed charges,1718,100,,,percent of total billed charges,100% of total billed charges,1419.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1419.07,82.6,,,percent of total billed charges,82.6% of total billed charges,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,262.85,8188.64,
REPOSITION VAD DIFF SESSION,84033993,CDM,360,RC,33993,HCPCS,Outpatient,,,1718,1116.70,,1511.84,88,,,percent of total billed charges,88% of total Billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,6298.95,100,,,Fee Schedule,100% of WA Medicaid,1718,100,,,percent of total billed charges,100% of total billed charges,6487.92,103,,,Fee Schedule,103% of WA Medicaid,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1082.34,63,,,percent of total billed charges,63% of total billed charges,1718,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,6298.95,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1185.42,69,,,percent of total billed charges,69% of total billed charges,1718,100,,,percent of total billed charges,100% of total billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,percent of total billed charges,100% of total billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,percent of total billed charges,100% of total billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,Fee Schedule,Pays at line item charges due to status indicator C,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,4665.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,6424.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8188.64,130,,,Fee Schedule,130% of WA Medicaid ,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,647.69,37.7,,,percent of total billed charges,37.70% of total billed charges,647.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,582.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1340.04,78,,,percent of total billed charges,78% of total billed charges,1718,100,,,percent of total billed charges,100% of total billed charges,1419.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1419.07,82.6,,,percent of total billed charges,82.6% of total billed charges,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,1718,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,1718,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,6298.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,582.4,8188.64,
INJ TREAT PSEUDOANEURYSM,84036002,CDM,361,RC,36002,HCPCS,Outpatient,,,626,406.90,,550.88,88,,,percent of total billed charges,88% of total Billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,626,100,,,percent of total billed charges,100% of total billed charges,781.83,103,,,Fee Schedule,103% of WA Medicaid,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,394.38,63,,,percent of total billed charges,63% of total billed charges,1121.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,95.78,15.3,,,percent of total billed charges,15.3% of total billed charges,431.94,69,,,percent of total billed charges,69% of total billed charges,626,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,626,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,626,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2200.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,562.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,774.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,986.78,130,,,Fee Schedule,130% of WA Medicaid ,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,236,37.7,,,percent of total billed charges,37.70% of total billed charges,236,37.7,,,percent of total billed charges,37.70% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,212.21,33.9,,,percent of total billed charges,33.9% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,488.28,78,,,percent of total billed charges,78% of total billed charges,626,100,,,percent of total billed charges,100% of total billed charges,517.08,82.6,,,percent of total billed charges,82.6% of total billed charges,517.08,82.6,,,percent of total billed charges,82.6% of total billed charges,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,647.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.78,2200.34,
INJ PROC CONTRAST VENOGRAPHY,84036005,CDM,361,RC,36005,HCPCS,Outpatient,,,717,466.05,,630.96,88,,,percent of total billed charges,88% of total Billed charges,358.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,717,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,358.5,50,,,percent of total billed charges,50% of total Billed charges,451.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,109.7,15.3,,,percent of total billed charges,15.3% of total billed charges,494.73,69,,,percent of total billed charges,69% of total billed charges,717,100,,,percent of total billed charges,100% of total billed charges,358.5,50,,,percent of total billed charges,50% of total Billed charges,717,100,,,percent of total billed charges,100% of total billed charges,358.5,50,,,percent of total billed charges,50% of total Billed charges,717,100,,,percent of total billed charges,100% of total billed charges,358.5,50,,,percent of total billed charges,50% of total Billed charges,443.46,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,358.5,50,,,percent of total billed charges,50% of total Billed charges,358.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,358.5,50,,,percent of total billed charges,50% of total Billed charges,358.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,358.5,50,,,percent of total billed charges,50% of total Billed charges,270.31,37.7,,,percent of total billed charges,37.70% of total billed charges,270.31,37.7,,,percent of total billed charges,37.70% of total billed charges,358.5,50,,,percent of total billed charges,50% of total Billed charges,243.06,33.9,,,percent of total billed charges,33.9% of total billed charges,358.5,50,,,percent of total billed charges,50% of total Billed charges,559.26,78,,,percent of total billed charges,78% of total billed charges,717,100,,,percent of total billed charges,100% of total billed charges,592.24,82.6,,,percent of total billed charges,82.6% of total billed charges,592.24,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,358.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,358.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,109.7,744.35,
INTRO CATH SUP/INF VENA CAVA,84036010,CDM,361,RC,36010,HCPCS,Outpatient,,,2395,1556.75,,2107.6,88,,,percent of total billed charges,88% of total Billed charges,1197.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,2395,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,1197.5,50,,,percent of total billed charges,50% of total Billed charges,1508.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,366.44,15.3,,,percent of total billed charges,15.3% of total billed charges,1652.55,69,,,percent of total billed charges,69% of total billed charges,2395,100,,,percent of total billed charges,100% of total billed charges,1197.5,50,,,percent of total billed charges,50% of total Billed charges,2395,100,,,percent of total billed charges,100% of total billed charges,1197.5,50,,,percent of total billed charges,50% of total Billed charges,2395,100,,,percent of total billed charges,100% of total billed charges,1197.5,50,,,percent of total billed charges,50% of total Billed charges,1481.31,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1197.5,50,,,percent of total billed charges,50% of total Billed charges,1197.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1197.5,50,,,percent of total billed charges,50% of total Billed charges,1197.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,1197.5,50,,,percent of total billed charges,50% of total Billed charges,902.92,37.7,,,percent of total billed charges,37.70% of total billed charges,902.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1197.5,50,,,percent of total billed charges,50% of total Billed charges,811.91,33.9,,,percent of total billed charges,33.9% of total billed charges,1197.5,50,,,percent of total billed charges,50% of total Billed charges,1868.1,78,,,percent of total billed charges,78% of total billed charges,2395,100,,,percent of total billed charges,100% of total billed charges,1978.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1978.27,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1197.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1197.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,366.44,2395,
PLACE CATHETER IN VEIN,84036011,CDM,360,RC,36011,HCPCS,Outpatient,,,752,488.80,,661.76,88,,,percent of total billed charges,88% of total Billed charges,376,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,752,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,376,50,,,percent of total billed charges,50% of total Billed charges,473.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,518.88,69,,,percent of total billed charges,69% of total billed charges,752,100,,,percent of total billed charges,100% of total billed charges,376,50,,,percent of total billed charges,50% of total Billed charges,752,100,,,percent of total billed charges,100% of total billed charges,376,50,,,percent of total billed charges,50% of total Billed charges,752,100,,,percent of total billed charges,100% of total billed charges,376,50,,,percent of total billed charges,50% of total Billed charges,465.11,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,376,50,,,percent of total billed charges,50% of total Billed charges,376,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,376,50,,,percent of total billed charges,50% of total Billed charges,376,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,376,50,,,percent of total billed charges,50% of total Billed charges,283.5,37.7,,,percent of total billed charges,37.70% of total billed charges,283.5,37.7,,,percent of total billed charges,37.70% of total billed charges,376,50,,,percent of total billed charges,50% of total Billed charges,254.93,33.9,,,percent of total billed charges,33.9% of total billed charges,376,50,,,percent of total billed charges,50% of total Billed charges,586.56,78,,,percent of total billed charges,78% of total billed charges,752,100,,,percent of total billed charges,100% of total billed charges,621.15,82.6,,,percent of total billed charges,82.6% of total billed charges,621.15,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,376,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,376,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,254.93,3367,
CATH PLC VENOUSE 2ND ORD/SEL,84036012,CDM,360,RC,36012,HCPCS,Outpatient,,,1027,667.55,,903.76,88,,,percent of total billed charges,88% of total Billed charges,513.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,1027,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,513.5,50,,,percent of total billed charges,50% of total Billed charges,647.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,708.63,69,,,percent of total billed charges,69% of total billed charges,1027,100,,,percent of total billed charges,100% of total billed charges,513.5,50,,,percent of total billed charges,50% of total Billed charges,1027,100,,,percent of total billed charges,100% of total billed charges,513.5,50,,,percent of total billed charges,50% of total Billed charges,1027,100,,,percent of total billed charges,100% of total billed charges,513.5,50,,,percent of total billed charges,50% of total Billed charges,635.2,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,513.5,50,,,percent of total billed charges,50% of total Billed charges,513.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,513.5,50,,,percent of total billed charges,50% of total Billed charges,513.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,513.5,50,,,percent of total billed charges,50% of total Billed charges,387.18,37.7,,,percent of total billed charges,37.70% of total billed charges,387.18,37.7,,,percent of total billed charges,37.70% of total billed charges,513.5,50,,,percent of total billed charges,50% of total Billed charges,348.15,33.9,,,percent of total billed charges,33.9% of total billed charges,513.5,50,,,percent of total billed charges,50% of total Billed charges,801.06,78,,,percent of total billed charges,78% of total billed charges,1027,100,,,percent of total billed charges,100% of total billed charges,848.3,82.6,,,percent of total billed charges,82.6% of total billed charges,848.3,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,513.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,513.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,348.15,3367,
INTRO CATH MAIN PULMON ARTERY,84036013,CDM,361,RC,36013,HCPCS,Outpatient,,,2217,1441.05,,1950.96,88,,,percent of total billed charges,88% of total Billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,2217,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,1108.5,50,,,percent of total billed charges,50% of total Billed charges,1396.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,339.2,15.3,,,percent of total billed charges,15.3% of total billed charges,1529.73,69,,,percent of total billed charges,69% of total billed charges,2217,100,,,percent of total billed charges,100% of total billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,2217,100,,,percent of total billed charges,100% of total billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,2217,100,,,percent of total billed charges,100% of total billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,1371.21,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1108.5,50,,,percent of total billed charges,50% of total Billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1108.5,50,,,percent of total billed charges,50% of total Billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,1108.5,50,,,percent of total billed charges,50% of total Billed charges,835.81,37.7,,,percent of total billed charges,37.70% of total billed charges,835.81,37.7,,,percent of total billed charges,37.70% of total billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,751.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,1729.26,78,,,percent of total billed charges,78% of total billed charges,2217,100,,,percent of total billed charges,100% of total billed charges,1831.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1831.24,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1108.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1108.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,339.2,2217,
SELECT CATH PLMT LT/RT PULM,84036014,CDM,361,RC,36014,HCPCS,Outpatient,,,2217,1441.05,,1950.96,88,,,percent of total billed charges,88% of total Billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,2217,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,1108.5,50,,,percent of total billed charges,50% of total Billed charges,1396.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,339.2,15.3,,,percent of total billed charges,15.3% of total billed charges,1529.73,69,,,percent of total billed charges,69% of total billed charges,2217,100,,,percent of total billed charges,100% of total billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,2217,100,,,percent of total billed charges,100% of total billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,2217,100,,,percent of total billed charges,100% of total billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,1371.21,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1108.5,50,,,percent of total billed charges,50% of total Billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1108.5,50,,,percent of total billed charges,50% of total Billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,1108.5,50,,,percent of total billed charges,50% of total Billed charges,835.81,37.7,,,percent of total billed charges,37.70% of total billed charges,835.81,37.7,,,percent of total billed charges,37.70% of total billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,751.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1108.5,50,,,percent of total billed charges,50% of total Billed charges,1729.26,78,,,percent of total billed charges,78% of total billed charges,2217,100,,,percent of total billed charges,100% of total billed charges,1831.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1831.24,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1108.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1108.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,339.2,2217,
SELCT CATH PLMT SEG/SUBSEG,84036015,CDM,361,RC,36015,HCPCS,Outpatient,,,2804,1822.60,,2467.52,88,,,percent of total billed charges,88% of total Billed charges,1402,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,2804,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,1402,50,,,percent of total billed charges,50% of total Billed charges,1766.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,429.01,15.3,,,percent of total billed charges,15.3% of total billed charges,1934.76,69,,,percent of total billed charges,69% of total billed charges,2804,100,,,percent of total billed charges,100% of total billed charges,1402,50,,,percent of total billed charges,50% of total Billed charges,2804,100,,,percent of total billed charges,100% of total billed charges,1402,50,,,percent of total billed charges,50% of total Billed charges,2804,100,,,percent of total billed charges,100% of total billed charges,1402,50,,,percent of total billed charges,50% of total Billed charges,1734.27,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1402,50,,,percent of total billed charges,50% of total Billed charges,1402,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1402,50,,,percent of total billed charges,50% of total Billed charges,1402,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,1402,50,,,percent of total billed charges,50% of total Billed charges,1057.11,37.7,,,percent of total billed charges,37.70% of total billed charges,1057.11,37.7,,,percent of total billed charges,37.70% of total billed charges,1402,50,,,percent of total billed charges,50% of total Billed charges,950.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1402,50,,,percent of total billed charges,50% of total Billed charges,2187.12,78,,,percent of total billed charges,78% of total billed charges,2804,100,,,percent of total billed charges,100% of total billed charges,2316.1,82.6,,,percent of total billed charges,82.6% of total billed charges,2316.1,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1402,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1402,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,424.13,2804,
INTRO NDL/CATH BRACH ART,84036140,CDM,361,RC,36140,HCPCS,Outpatient,,,1455,945.75,,1280.4,88,,,percent of total billed charges,88% of total Billed charges,727.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,1455,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,727.5,50,,,percent of total billed charges,50% of total Billed charges,916.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,222.62,15.3,,,percent of total billed charges,15.3% of total billed charges,1003.95,69,,,percent of total billed charges,69% of total billed charges,1455,100,,,percent of total billed charges,100% of total billed charges,727.5,50,,,percent of total billed charges,50% of total Billed charges,1455,100,,,percent of total billed charges,100% of total billed charges,727.5,50,,,percent of total billed charges,50% of total Billed charges,1455,100,,,percent of total billed charges,100% of total billed charges,727.5,50,,,percent of total billed charges,50% of total Billed charges,899.92,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,727.5,50,,,percent of total billed charges,50% of total Billed charges,727.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,727.5,50,,,percent of total billed charges,50% of total Billed charges,727.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,727.5,50,,,percent of total billed charges,50% of total Billed charges,548.54,37.7,,,percent of total billed charges,37.70% of total billed charges,548.54,37.7,,,percent of total billed charges,37.70% of total billed charges,727.5,50,,,percent of total billed charges,50% of total Billed charges,493.25,33.9,,,percent of total billed charges,33.9% of total billed charges,727.5,50,,,percent of total billed charges,50% of total Billed charges,1134.9,78,,,percent of total billed charges,78% of total billed charges,1455,100,,,percent of total billed charges,100% of total billed charges,1201.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1201.83,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,727.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,727.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,222.62,1455,
PLACE CATHETER IN AORTA,84036200,CDM,360,RC,36200,HCPCS,Outpatient,,,681,442.65,,599.28,88,,,percent of total billed charges,88% of total Billed charges,340.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,681,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,340.5,50,,,percent of total billed charges,50% of total Billed charges,429.03,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,469.89,69,,,percent of total billed charges,69% of total billed charges,681,100,,,percent of total billed charges,100% of total billed charges,340.5,50,,,percent of total billed charges,50% of total Billed charges,681,100,,,percent of total billed charges,100% of total billed charges,340.5,50,,,percent of total billed charges,50% of total Billed charges,681,100,,,percent of total billed charges,100% of total billed charges,340.5,50,,,percent of total billed charges,50% of total Billed charges,421.2,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,340.5,50,,,percent of total billed charges,50% of total Billed charges,340.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,340.5,50,,,percent of total billed charges,50% of total Billed charges,340.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,340.5,50,,,percent of total billed charges,50% of total Billed charges,256.74,37.7,,,percent of total billed charges,37.70% of total billed charges,256.74,37.7,,,percent of total billed charges,37.70% of total billed charges,340.5,50,,,percent of total billed charges,50% of total Billed charges,230.86,33.9,,,percent of total billed charges,33.9% of total billed charges,340.5,50,,,percent of total billed charges,50% of total Billed charges,531.18,78,,,percent of total billed charges,78% of total billed charges,681,100,,,percent of total billed charges,100% of total billed charges,562.51,82.6,,,percent of total billed charges,82.6% of total billed charges,562.51,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,340.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,340.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,230.86,3367,
SEL CATH PLMT BRACHIO 1ST ORD,84036215,CDM,361,RC,36215,HCPCS,Outpatient,,,4579,2976.35,,4029.52,88,,,percent of total billed charges,88% of total Billed charges,2289.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,4579,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,2289.5,50,,,percent of total billed charges,50% of total Billed charges,2884.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,700.59,15.3,,,percent of total billed charges,15.3% of total billed charges,3159.51,69,,,percent of total billed charges,69% of total billed charges,4579,100,,,percent of total billed charges,100% of total billed charges,2289.5,50,,,percent of total billed charges,50% of total Billed charges,4579,100,,,percent of total billed charges,100% of total billed charges,2289.5,50,,,percent of total billed charges,50% of total Billed charges,4579,100,,,percent of total billed charges,100% of total billed charges,2289.5,50,,,percent of total billed charges,50% of total Billed charges,2832.11,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2289.5,50,,,percent of total billed charges,50% of total Billed charges,2289.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2289.5,50,,,percent of total billed charges,50% of total Billed charges,2289.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,2289.5,50,,,percent of total billed charges,50% of total Billed charges,1726.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1726.28,37.7,,,percent of total billed charges,37.70% of total billed charges,2289.5,50,,,percent of total billed charges,50% of total Billed charges,1552.28,33.9,,,percent of total billed charges,33.9% of total billed charges,2289.5,50,,,percent of total billed charges,50% of total Billed charges,3571.62,78,,,percent of total billed charges,78% of total billed charges,4579,100,,,percent of total billed charges,100% of total billed charges,3782.25,82.6,,,percent of total billed charges,82.6% of total billed charges,3782.25,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2289.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2289.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,424.13,4579,
SEL CATH PLMT BRACHIO 2ND,84036216,CDM,361,RC,36216,HCPCS,Outpatient,,,1136,738.40,,999.68,88,,,percent of total billed charges,88% of total Billed charges,568,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,1136,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,568,50,,,percent of total billed charges,50% of total Billed charges,715.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,173.81,15.3,,,percent of total billed charges,15.3% of total billed charges,783.84,69,,,percent of total billed charges,69% of total billed charges,1136,100,,,percent of total billed charges,100% of total billed charges,568,50,,,percent of total billed charges,50% of total Billed charges,1136,100,,,percent of total billed charges,100% of total billed charges,568,50,,,percent of total billed charges,50% of total Billed charges,1136,100,,,percent of total billed charges,100% of total billed charges,568,50,,,percent of total billed charges,50% of total Billed charges,702.62,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,568,50,,,percent of total billed charges,50% of total Billed charges,568,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,568,50,,,percent of total billed charges,50% of total Billed charges,568,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,568,50,,,percent of total billed charges,50% of total Billed charges,428.27,37.7,,,percent of total billed charges,37.70% of total billed charges,428.27,37.7,,,percent of total billed charges,37.70% of total billed charges,568,50,,,percent of total billed charges,50% of total Billed charges,385.1,33.9,,,percent of total billed charges,33.9% of total billed charges,568,50,,,percent of total billed charges,50% of total Billed charges,886.08,78,,,percent of total billed charges,78% of total billed charges,1136,100,,,percent of total billed charges,100% of total billed charges,938.34,82.6,,,percent of total billed charges,82.6% of total billed charges,938.34,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,568,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,568,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,173.81,1136,
SEL CATH PLMT BRACHIO 3RD ORD,84036217,CDM,361,RC,36217,HCPCS,Outpatient,,,5753,3739.45,,5062.64,88,,,percent of total billed charges,88% of total Billed charges,2876.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,2876.5,50,,,percent of total billed charges,50% of total Billed charges,3624.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,880.21,15.3,,,percent of total billed charges,15.3% of total billed charges,3969.57,69,,,percent of total billed charges,69% of total billed charges,5753,100,,,percent of total billed charges,100% of total billed charges,2876.5,50,,,percent of total billed charges,50% of total Billed charges,5753,100,,,percent of total billed charges,100% of total billed charges,2876.5,50,,,percent of total billed charges,50% of total Billed charges,5753,100,,,percent of total billed charges,100% of total billed charges,2876.5,50,,,percent of total billed charges,50% of total Billed charges,3558.23,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2876.5,50,,,percent of total billed charges,50% of total Billed charges,2876.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2876.5,50,,,percent of total billed charges,50% of total Billed charges,2876.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,2876.5,50,,,percent of total billed charges,50% of total Billed charges,2168.88,37.7,,,percent of total billed charges,37.70% of total billed charges,2168.88,37.7,,,percent of total billed charges,37.70% of total billed charges,2876.5,50,,,percent of total billed charges,50% of total Billed charges,1950.27,33.9,,,percent of total billed charges,33.9% of total billed charges,2876.5,50,,,percent of total billed charges,50% of total Billed charges,4487.34,78,,,percent of total billed charges,78% of total billed charges,5753,100,,,percent of total billed charges,100% of total billed charges,4751.98,82.6,,,percent of total billed charges,82.6% of total billed charges,4751.98,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2876.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2876.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,424.13,5753,
SEL CATH PLMT BRACHIO 2ND ORD,84036218,CDM,361,RC,36218,HCPCS,Outpatient,,,4701,3055.65,,4136.88,88,,,percent of total billed charges,88% of total Billed charges,2350.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,2350.5,50,,,percent of total billed charges,50% of total Billed charges,2961.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,719.25,15.3,,,percent of total billed charges,15.3% of total billed charges,3243.69,69,,,percent of total billed charges,69% of total billed charges,4701,100,,,percent of total billed charges,100% of total billed charges,2350.5,50,,,percent of total billed charges,50% of total Billed charges,4701,100,,,percent of total billed charges,100% of total billed charges,2350.5,50,,,percent of total billed charges,50% of total Billed charges,4701,100,,,percent of total billed charges,100% of total billed charges,2350.5,50,,,percent of total billed charges,50% of total Billed charges,2907.57,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2350.5,50,,,percent of total billed charges,50% of total Billed charges,2350.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2350.5,50,,,percent of total billed charges,50% of total Billed charges,2350.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,2350.5,50,,,percent of total billed charges,50% of total Billed charges,1772.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1772.28,37.7,,,percent of total billed charges,37.70% of total billed charges,2350.5,50,,,percent of total billed charges,50% of total Billed charges,1593.64,33.9,,,percent of total billed charges,33.9% of total billed charges,2350.5,50,,,percent of total billed charges,50% of total Billed charges,3666.78,78,,,percent of total billed charges,78% of total billed charges,4701,100,,,percent of total billed charges,100% of total billed charges,3883.03,82.6,,,percent of total billed charges,82.6% of total billed charges,3883.03,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2350.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2350.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,424.13,4701,
PLACE CATH INOM ART W CCA,84036222,CDM,361,RC,36222,HCPCS,Outpatient,,,9581,6227.65,,8431.28,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6036.03,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,1465.89,15.3,,,percent of total billed charges,15.3% of total billed charges,6610.89,69,,,percent of total billed charges,69% of total billed charges,9581,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9581,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9581,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3612.04,37.7,,,percent of total billed charges,37.70% of total billed charges,3612.04,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3247.96,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7473.18,78,,,percent of total billed charges,78% of total billed charges,9581,100,,,percent of total billed charges,100% of total billed charges,7913.91,82.6,,,percent of total billed charges,82.6% of total billed charges,7913.91,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1465.89,11625.58,
PLACE CATH INOM ART W CCA BI,84036223,CDM,361,RC,36223,HCPCS,Outpatient,,,16506,10728.90,,14525.28,88,,,percent of total billed charges,88% of total Billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,10398.78,63,,,percent of total billed charges,63% of total billed charges,9808.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,2525.42,15.3,,,percent of total billed charges,15.3% of total billed charges,11389.14,69,,,percent of total billed charges,69% of total billed charges,16506,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16506,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16506,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19379.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6222.76,37.7,,,percent of total billed charges,37.70% of total billed charges,6222.76,37.7,,,percent of total billed charges,37.70% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5595.53,33.9,,,percent of total billed charges,33.9% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12874.68,78,,,percent of total billed charges,78% of total billed charges,16506,100,,,percent of total billed charges,100% of total billed charges,13633.96,82.6,,,percent of total billed charges,82.6% of total billed charges,13633.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5661.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2525.42,19379.78,
PLACE CATH CAROTID ART,84036224,CDM,361,RC,36224,HCPCS,Outpatient,,,16785,10910.25,,14770.8,88,,,percent of total billed charges,88% of total Billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,10574.55,63,,,percent of total billed charges,63% of total billed charges,9808.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,2568.11,15.3,,,percent of total billed charges,15.3% of total billed charges,11581.65,69,,,percent of total billed charges,69% of total billed charges,16785,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16785,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16785,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19379.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6327.95,37.7,,,percent of total billed charges,37.70% of total billed charges,6327.95,37.7,,,percent of total billed charges,37.70% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5690.12,33.9,,,percent of total billed charges,33.9% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13092.3,78,,,percent of total billed charges,78% of total billed charges,16785,100,,,percent of total billed charges,100% of total billed charges,13864.41,82.6,,,percent of total billed charges,82.6% of total billed charges,13864.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5661.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2568.11,19379.78,
PLACE CATH SUBCLAVIAN ART BI,84036225,CDM,361,RC,36225,HCPCS,Outpatient,,,16511,10732.15,,14529.68,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10401.93,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,2526.18,15.3,,,percent of total billed charges,15.3% of total billed charges,11392.59,69,,,percent of total billed charges,69% of total billed charges,16511,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,16511,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,16511,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6224.65,37.7,,,percent of total billed charges,37.70% of total billed charges,6224.65,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5597.23,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12878.58,78,,,percent of total billed charges,78% of total billed charges,16511,100,,,percent of total billed charges,100% of total billed charges,13638.09,82.6,,,percent of total billed charges,82.6% of total billed charges,13638.09,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2526.18,16511,
PLACE CATH VERTEBRAL ART,84036226,CDM,361,RC,36226,HCPCS,Outpatient,,,16785,10910.25,,14770.8,88,,,percent of total billed charges,88% of total Billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,10574.55,63,,,percent of total billed charges,63% of total billed charges,9808.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,2568.11,15.3,,,percent of total billed charges,15.3% of total billed charges,11581.65,69,,,percent of total billed charges,69% of total billed charges,16785,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16785,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16785,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19379.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6327.95,37.7,,,percent of total billed charges,37.70% of total billed charges,6327.95,37.7,,,percent of total billed charges,37.70% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5690.12,33.9,,,percent of total billed charges,33.9% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13092.3,78,,,percent of total billed charges,78% of total billed charges,16785,100,,,percent of total billed charges,100% of total billed charges,13864.41,82.6,,,percent of total billed charges,82.6% of total billed charges,13864.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5661.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2568.11,19379.78,
SEL CATH PLMT FEM 1ST ORD SURG,84036245,CDM,481,RC,36245,HCPCS,Outpatient,,,3725,2421.25,,3278,88,,,percent of total billed charges,88% of total Billed charges,1862.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,3725,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,1862.5,50,,,percent of total billed charges,50% of total Billed charges,2346.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,569.93,15.3,,,percent of total billed charges,15.3% of total billed charges,2570.25,69,,,percent of total billed charges,69% of total billed charges,3725,100,,,percent of total billed charges,100% of total billed charges,1862.5,50,,,percent of total billed charges,50% of total Billed charges,3725,100,,,percent of total billed charges,100% of total billed charges,1862.5,50,,,percent of total billed charges,50% of total Billed charges,3725,100,,,percent of total billed charges,100% of total billed charges,1862.5,50,,,percent of total billed charges,50% of total Billed charges,2303.91,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1862.5,50,,,percent of total billed charges,50% of total Billed charges,1862.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1862.5,50,,,percent of total billed charges,50% of total Billed charges,1862.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,1862.5,50,,,percent of total billed charges,50% of total Billed charges,1404.33,37.7,,,percent of total billed charges,37.70% of total billed charges,1404.33,37.7,,,percent of total billed charges,37.70% of total billed charges,1862.5,50,,,percent of total billed charges,50% of total Billed charges,1262.78,33.9,,,percent of total billed charges,33.9% of total billed charges,1862.5,50,,,percent of total billed charges,50% of total Billed charges,2905.5,78,,,percent of total billed charges,78% of total billed charges,3725,100,,,percent of total billed charges,100% of total billed charges,3076.85,82.6,,,percent of total billed charges,82.6% of total billed charges,3076.85,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1862.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1862.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,424.13,3725,
SELECTIVE CATH SECOND ORDER,84036246,CDM,360,RC,36246,HCPCS,Outpatient,,,4720,3068.00,,4153.6,88,,,percent of total billed charges,88% of total Billed charges,2360,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,2360,50,,,percent of total billed charges,50% of total Billed charges,2973.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,3256.8,69,,,percent of total billed charges,69% of total billed charges,4720,100,,,percent of total billed charges,100% of total billed charges,2360,50,,,percent of total billed charges,50% of total Billed charges,4720,100,,,percent of total billed charges,100% of total billed charges,2360,50,,,percent of total billed charges,50% of total Billed charges,4720,100,,,percent of total billed charges,100% of total billed charges,2360,50,,,percent of total billed charges,50% of total Billed charges,2919.32,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2360,50,,,percent of total billed charges,50% of total Billed charges,2360,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2360,50,,,percent of total billed charges,50% of total Billed charges,2360,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,2360,50,,,percent of total billed charges,50% of total Billed charges,1779.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1779.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2360,50,,,percent of total billed charges,50% of total Billed charges,1600.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2360,50,,,percent of total billed charges,50% of total Billed charges,3681.6,78,,,percent of total billed charges,78% of total billed charges,4720,100,,,percent of total billed charges,100% of total billed charges,3898.72,82.6,,,percent of total billed charges,82.6% of total billed charges,3898.72,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2360,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2360,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,424.13,4720,
SEL CATH PLACE ART SYS 3RD ORD,84036247,CDM,360,RC,36247,HCPCS,Outpatient,,,1540,1001.00,,1355.2,88,,,percent of total billed charges,88% of total Billed charges,770,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,1540,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,770,50,,,percent of total billed charges,50% of total Billed charges,970.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1062.6,69,,,percent of total billed charges,69% of total billed charges,1540,100,,,percent of total billed charges,100% of total billed charges,770,50,,,percent of total billed charges,50% of total Billed charges,1540,100,,,percent of total billed charges,100% of total billed charges,770,50,,,percent of total billed charges,50% of total Billed charges,1540,100,,,percent of total billed charges,100% of total billed charges,770,50,,,percent of total billed charges,50% of total Billed charges,952.49,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,770,50,,,percent of total billed charges,50% of total Billed charges,770,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,770,50,,,percent of total billed charges,50% of total Billed charges,770,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,770,50,,,percent of total billed charges,50% of total Billed charges,580.58,37.7,,,percent of total billed charges,37.70% of total billed charges,580.58,37.7,,,percent of total billed charges,37.70% of total billed charges,770,50,,,percent of total billed charges,50% of total Billed charges,522.06,33.9,,,percent of total billed charges,33.9% of total billed charges,770,50,,,percent of total billed charges,50% of total Billed charges,1201.2,78,,,percent of total billed charges,78% of total billed charges,1540,100,,,percent of total billed charges,100% of total billed charges,1272.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1272.04,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,770,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,424.13,3367,
CATH EA ADD 2/3RD ABD/PELVIC,84036248,CDM,361,RC,36248,HCPCS,Outpatient,,,789,512.85,,694.32,88,,,percent of total billed charges,88% of total Billed charges,394.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,789,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,394.5,50,,,percent of total billed charges,50% of total Billed charges,497.07,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,120.72,15.3,,,percent of total billed charges,15.3% of total billed charges,544.41,69,,,percent of total billed charges,69% of total billed charges,789,100,,,percent of total billed charges,100% of total billed charges,394.5,50,,,percent of total billed charges,50% of total Billed charges,789,100,,,percent of total billed charges,100% of total billed charges,394.5,50,,,percent of total billed charges,50% of total Billed charges,789,100,,,percent of total billed charges,100% of total billed charges,394.5,50,,,percent of total billed charges,50% of total Billed charges,488,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,394.5,50,,,percent of total billed charges,50% of total Billed charges,394.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,394.5,50,,,percent of total billed charges,50% of total Billed charges,394.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,394.5,50,,,percent of total billed charges,50% of total Billed charges,297.45,37.7,,,percent of total billed charges,37.70% of total billed charges,297.45,37.7,,,percent of total billed charges,37.70% of total billed charges,394.5,50,,,percent of total billed charges,50% of total Billed charges,267.47,33.9,,,percent of total billed charges,33.9% of total billed charges,394.5,50,,,percent of total billed charges,50% of total Billed charges,615.42,78,,,percent of total billed charges,78% of total billed charges,789,100,,,percent of total billed charges,100% of total billed charges,651.71,82.6,,,percent of total billed charges,82.6% of total billed charges,651.71,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,394.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,394.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,120.72,789,
INS CATH REN ART 1ST UNILAT,84036251,CDM,481,RC,36251,HCPCS,Outpatient,,,13496,8772.40,,11876.48,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8502.48,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,2064.89,15.3,,,percent of total billed charges,15.3% of total billed charges,9312.24,69,,,percent of total billed charges,69% of total billed charges,13496,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,13496,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,13496,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5087.99,37.7,,,percent of total billed charges,37.70% of total billed charges,5087.99,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4575.14,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10526.88,78,,,percent of total billed charges,78% of total billed charges,13496,100,,,percent of total billed charges,100% of total billed charges,11147.7,82.6,,,percent of total billed charges,82.6% of total billed charges,11147.7,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2064.89,13496,
INS CATH REN ART 1ST BILAT,84036252,CDM,361,RC,36252,HCPCS,Outpatient,,,13496,8772.40,,11876.48,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8502.48,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,2064.89,15.3,,,percent of total billed charges,15.3% of total billed charges,9312.24,69,,,percent of total billed charges,69% of total billed charges,13496,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,13496,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,13496,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5087.99,37.7,,,percent of total billed charges,37.70% of total billed charges,5087.99,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4575.14,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10526.88,78,,,percent of total billed charges,78% of total billed charges,13496,100,,,percent of total billed charges,100% of total billed charges,11147.7,82.6,,,percent of total billed charges,82.6% of total billed charges,11147.7,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2064.89,13496,
INS CATH REN ART 2ND + UNILAT,84036253,CDM,361,RC,36253,HCPCS,Outpatient,,,15182,9868.30,,13360.16,88,,,percent of total billed charges,88% of total Billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9564.66,63,,,percent of total billed charges,63% of total billed charges,9808.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,2322.85,15.3,,,percent of total billed charges,15.3% of total billed charges,10475.58,69,,,percent of total billed charges,69% of total billed charges,15182,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15182,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,15182,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19379.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5723.61,37.7,,,percent of total billed charges,37.70% of total billed charges,5723.61,37.7,,,percent of total billed charges,37.70% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5146.7,33.9,,,percent of total billed charges,33.9% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,11841.96,78,,,percent of total billed charges,78% of total billed charges,15182,100,,,percent of total billed charges,100% of total billed charges,12540.33,82.6,,,percent of total billed charges,82.6% of total billed charges,12540.33,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5661.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2322.85,19379.78,
INS CATH REN ART 2ND + BILAT,84036254,CDM,361,RC,36254,HCPCS,Outpatient,,,15182,9868.30,,13360.16,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9564.66,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,2322.85,15.3,,,percent of total billed charges,15.3% of total billed charges,10475.58,69,,,percent of total billed charges,69% of total billed charges,15182,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,15182,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,15182,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5723.61,37.7,,,percent of total billed charges,37.70% of total billed charges,5723.61,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5146.7,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11841.96,78,,,percent of total billed charges,78% of total billed charges,15182,100,,,percent of total billed charges,100% of total billed charges,12540.33,82.6,,,percent of total billed charges,82.6% of total billed charges,12540.33,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2322.85,15182,
"36410 - Venipuncture, Age 3 Years or Older",76136410,CDM,761,RC,36410,HCPCS,Outpatient,,,253,164.45,,222.64,88,,,percent of total billed charges,88% of total Billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,126.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52.86,100,,,Fee Schedule,100% of WA Medicaid,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,253,100,,,percent of total billed charges,100% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,253,100,,,percent of total billed charges,100% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,156.48,61.85,,,percent of total billed charges,61.85% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.5,50,,,percent of total billed charges,50% of total Billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.5,50,,,percent of total billed charges,50% of total Billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,126.5,50,,,percent of total billed charges,50% of total Billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,85.77,33.9,,,percent of total billed charges,33.9% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,126.5,50,,,percent of total billed charges,50% of total Billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.71,253,
CATH PORTAL VEIN PERC,84036481,CDM,361,RC,36481,HCPCS,Outpatient,,,466,302.90,,410.08,88,,,percent of total billed charges,88% of total Billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,466,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,233,50,,,percent of total billed charges,50% of total Billed charges,293.58,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,71.3,15.3,,,percent of total billed charges,15.3% of total billed charges,321.54,69,,,percent of total billed charges,69% of total billed charges,466,100,,,percent of total billed charges,100% of total billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,466,100,,,percent of total billed charges,100% of total billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,466,100,,,percent of total billed charges,100% of total billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,288.22,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233,50,,,percent of total billed charges,50% of total Billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,233,50,,,percent of total billed charges,50% of total Billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,233,50,,,percent of total billed charges,50% of total Billed charges,175.68,37.7,,,percent of total billed charges,37.70% of total billed charges,175.68,37.7,,,percent of total billed charges,37.70% of total billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,157.97,33.9,,,percent of total billed charges,33.9% of total billed charges,233,50,,,percent of total billed charges,50% of total Billed charges,363.48,78,,,percent of total billed charges,78% of total billed charges,466,100,,,percent of total billed charges,100% of total billed charges,384.92,82.6,,,percent of total billed charges,82.6% of total billed charges,384.92,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,233,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.3,744.35,
VEN CATH FOR SEL ORGAN SAMPLE,84036500,CDM,361,RC,36500,HCPCS,Outpatient,,,2034,1322.10,,1789.92,88,,,percent of total billed charges,88% of total Billed charges,1017,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,2034,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,1017,50,,,percent of total billed charges,50% of total Billed charges,1281.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,311.2,15.3,,,percent of total billed charges,15.3% of total billed charges,1403.46,69,,,percent of total billed charges,69% of total billed charges,2034,100,,,percent of total billed charges,100% of total billed charges,1017,50,,,percent of total billed charges,50% of total Billed charges,2034,100,,,percent of total billed charges,100% of total billed charges,1017,50,,,percent of total billed charges,50% of total Billed charges,2034,100,,,percent of total billed charges,100% of total billed charges,1017,50,,,percent of total billed charges,50% of total Billed charges,1258.03,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1017,50,,,percent of total billed charges,50% of total Billed charges,1017,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1017,50,,,percent of total billed charges,50% of total Billed charges,1017,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,1017,50,,,percent of total billed charges,50% of total Billed charges,766.82,37.7,,,percent of total billed charges,37.70% of total billed charges,766.82,37.7,,,percent of total billed charges,37.70% of total billed charges,1017,50,,,percent of total billed charges,50% of total Billed charges,689.53,33.9,,,percent of total billed charges,33.9% of total billed charges,1017,50,,,percent of total billed charges,50% of total Billed charges,1586.52,78,,,percent of total billed charges,78% of total billed charges,2034,100,,,percent of total billed charges,100% of total billed charges,1680.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1680.08,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1017,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1017,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,311.2,2034,
INSRT NON-TNNL CVC >=5YR SURG,84036556,CDM,761,RC,36556,HCPCS,Outpatient,,,3911,2542.15,,3441.68,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,3911,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2463.93,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,598.38,15.3,,,percent of total billed charges,15.3% of total billed charges,2698.59,69,,,percent of total billed charges,69% of total billed charges,3911,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3911,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3911,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1474.45,37.7,,,percent of total billed charges,37.70% of total billed charges,1474.45,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1325.83,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3050.58,78,,,percent of total billed charges,78% of total billed charges,3911,100,,,percent of total billed charges,100% of total billed charges,3230.49,82.6,,,percent of total billed charges,82.6% of total billed charges,3230.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,598.38,11625.57,
INSRT TUNNELED CVC >=5YR SURG,84036558,CDM,481,RC,36558,HCPCS,Outpatient,,,3713,2413.45,,3267.44,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid,3713,100,,,percent of total billed charges,100% of total billed charges,2038.45,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2339.19,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid,568.09,15.3,,,percent of total billed charges,15.3% of total billed charges,2561.97,69,,,percent of total billed charges,69% of total billed charges,3713,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3713,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3713,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1465.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2018.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2572.8,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1399.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1399.8,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1258.71,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2896.14,78,,,percent of total billed charges,78% of total billed charges,3713,100,,,percent of total billed charges,100% of total billed charges,3066.94,82.6,,,percent of total billed charges,82.6% of total billed charges,3066.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1979.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,568.09,11625.57,
PICC LINE REPLACEMENT,48136568,CDM,481,RC,36568,HCPCS,Outpatient,,,4191,2724.15,,3688.08,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,4191,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2640.33,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,641.22,15.3,,,percent of total billed charges,15.3% of total billed charges,2891.79,69,,,percent of total billed charges,69% of total billed charges,4191,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4191,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4191,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1580.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1580.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1420.75,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3268.98,78,,,percent of total billed charges,78% of total billed charges,4191,100,,,percent of total billed charges,100% of total billed charges,3461.77,82.6,,,percent of total billed charges,82.6% of total billed charges,3461.77,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,641.22,5712.48,
PICC LINE INSERT > 5 YEARS OLD,84036569,CDM,761,RC,36569,HCPCS,Outpatient,,,3074,1998.10,,2705.12,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,3074,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1936.62,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,470.32,15.3,,,percent of total billed charges,15.3% of total billed charges,2121.06,69,,,percent of total billed charges,69% of total billed charges,3074,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3074,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3074,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1158.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1158.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1042.09,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2397.72,78,,,percent of total billed charges,78% of total billed charges,3074,100,,,percent of total billed charges,100% of total billed charges,2539.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2539.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,470.32,5712.48,
INSERTION POWER PORT,84036578,CDM,360,RC,36578,HCPCS,Outpatient,,,1235,802.75,,1086.8,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,1235,100,,,percent of total billed charges,100% of total billed charges,678.35,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,778.05,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,852.15,69,,,percent of total billed charges,69% of total billed charges,1235,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1235,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1235,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,487.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,671.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.17,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,465.6,37.7,,,percent of total billed charges,37.70% of total billed charges,465.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,418.67,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,963.3,78,,,percent of total billed charges,78% of total billed charges,1235,100,,,percent of total billed charges,100% of total billed charges,1020.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1020.11,82.6,,,percent of total billed charges,82.6% of total billed charges,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,418.67,11625.57,
REPAIR CVC ONLY SURG,84036575,CDM,361,RC,36575,HCPCS,Outpatient,,,3683,2393.95,,3241.04,88,,,percent of total billed charges,88% of total Billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,3683,100,,,percent of total billed charges,100% of total billed charges,678.35,103,,,Fee Schedule,103% of WA Medicaid,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2320.29,63,,,percent of total billed charges,63% of total billed charges,1121.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,563.5,15.3,,,percent of total billed charges,15.3% of total billed charges,2541.27,69,,,percent of total billed charges,69% of total billed charges,3683,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3683,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3683,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2200.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,487.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,671.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.17,130,,,Fee Schedule,130% of WA Medicaid ,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1388.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1388.49,37.7,,,percent of total billed charges,37.70% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1248.54,33.9,,,percent of total billed charges,33.9% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2872.74,78,,,percent of total billed charges,78% of total billed charges,3683,100,,,percent of total billed charges,100% of total billed charges,3042.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3042.16,82.6,,,percent of total billed charges,82.6% of total billed charges,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,647.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,487.85,3683,
REPAIR CVC W/PORT/PUMP  SURG,84036576,CDM,361,RC,36576,HCPCS,Outpatient,,,3703,2406.95,,3258.64,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,3703,100,,,percent of total billed charges,100% of total billed charges,678.35,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2332.89,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,566.56,15.3,,,percent of total billed charges,15.3% of total billed charges,2555.07,69,,,percent of total billed charges,69% of total billed charges,3703,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3703,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3703,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,487.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,671.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.17,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1396.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1396.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1255.32,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2888.34,78,,,percent of total billed charges,78% of total billed charges,3703,100,,,percent of total billed charges,100% of total billed charges,3058.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3058.68,82.6,,,percent of total billed charges,82.6% of total billed charges,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,487.85,5712.48,
36571 Insertion of peripherally inserted central venous acce,76136571,CDM,761,RC,36571,HCPCS,Outpatient,,,8757,5692.05,,7706.16,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5516.91,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,1339.82,15.3,,,percent of total billed charges,15.3% of total billed charges,6042.33,69,,,percent of total billed charges,69% of total billed charges,8757,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8757,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8757,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3301.39,37.7,,,percent of total billed charges,37.70% of total billed charges,3301.39,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2968.62,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6830.46,78,,,percent of total billed charges,78% of total billed charges,8757,100,,,percent of total billed charges,100% of total billed charges,7233.28,82.6,,,percent of total billed charges,82.6% of total billed charges,7233.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,750.54,11625.57,
REPLACE TUNNELED CVC W/O PORT,84036581,CDM,761,RC,36581,HCPCS,Outpatient,,,1159,753.35,,1019.92,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid,1159,100,,,percent of total billed charges,100% of total billed charges,2038.45,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,730.17,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid,177.33,15.3,,,percent of total billed charges,15.3% of total billed charges,799.71,69,,,percent of total billed charges,69% of total billed charges,1159,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1159,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1159,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1465.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2018.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2572.8,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,436.94,37.7,,,percent of total billed charges,37.70% of total billed charges,436.94,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,392.9,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,904.02,78,,,percent of total billed charges,78% of total billed charges,1159,100,,,percent of total billed charges,100% of total billed charges,957.33,82.6,,,percent of total billed charges,82.6% of total billed charges,957.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1979.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,177.33,11625.57,
REPLACE TUNNELED CVC W/PORT,84036582,CDM,360,RC,36582,HCPCS,Outpatient,,,1803,1171.95,,1586.64,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid,1803,100,,,percent of total billed charges,100% of total billed charges,2038.45,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1135.89,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1244.07,69,,,percent of total billed charges,69% of total billed charges,1803,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1803,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1803,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1465.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2018.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2572.8,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,679.73,37.7,,,percent of total billed charges,37.70% of total billed charges,679.73,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,611.22,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1406.34,78,,,percent of total billed charges,78% of total billed charges,1803,100,,,percent of total billed charges,100% of total billed charges,1489.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1489.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1979.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1979.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,611.22,11625.57,
REMOVE TUNNELD CVC SURG,84036589,CDM,761,RC,36589,HCPCS,Outpatient,,,832,540.80,,732.16,88,,,percent of total billed charges,88% of total Billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,832,100,,,percent of total billed charges,100% of total billed charges,678.35,103,,,Fee Schedule,103% of WA Medicaid,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,524.16,63,,,percent of total billed charges,63% of total billed charges,1121.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,127.3,15.3,,,percent of total billed charges,15.3% of total billed charges,574.08,69,,,percent of total billed charges,69% of total billed charges,832,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,832,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,832,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2200.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,487.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,671.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.17,130,,,Fee Schedule,130% of WA Medicaid ,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,313.66,37.7,,,percent of total billed charges,37.70% of total billed charges,313.66,37.7,,,percent of total billed charges,37.70% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,282.05,33.9,,,percent of total billed charges,33.9% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,648.96,78,,,percent of total billed charges,78% of total billed charges,832,100,,,percent of total billed charges,100% of total billed charges,687.23,82.6,,,percent of total billed charges,82.6% of total billed charges,687.23,82.6,,,percent of total billed charges,82.6% of total billed charges,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,647.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,127.3,2200.34,
36589 REMOVAL VENOUS DEVICE,76136589,CDM,761,RC,36589,HCPCS,Outpatient,,,1099,714.35,,967.12,88,,,percent of total billed charges,88% of total Billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,1099,100,,,percent of total billed charges,100% of total billed charges,678.35,103,,,Fee Schedule,103% of WA Medicaid,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,692.37,63,,,percent of total billed charges,63% of total billed charges,1121.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,168.15,15.3,,,percent of total billed charges,15.3% of total billed charges,758.31,69,,,percent of total billed charges,69% of total billed charges,1099,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,1099,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,1099,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2200.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,487.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,671.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.17,130,,,Fee Schedule,130% of WA Medicaid ,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,414.32,37.7,,,percent of total billed charges,37.70% of total billed charges,414.32,37.7,,,percent of total billed charges,37.70% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,372.56,33.9,,,percent of total billed charges,33.9% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,857.22,78,,,percent of total billed charges,78% of total billed charges,1099,100,,,percent of total billed charges,100% of total billed charges,907.77,82.6,,,percent of total billed charges,82.6% of total billed charges,907.77,82.6,,,percent of total billed charges,82.6% of total billed charges,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,647.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,168.15,2200.34,
REMOVAL TUNNELED CVC W/PORT,84036590,CDM,360,RC,36590,HCPCS,Outpatient,,,1311,852.15,,1153.68,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,1311,100,,,percent of total billed charges,100% of total billed charges,678.35,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,825.93,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,904.59,69,,,percent of total billed charges,69% of total billed charges,1311,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1311,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1311,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,487.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,671.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.17,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,494.25,37.7,,,percent of total billed charges,37.70% of total billed charges,494.25,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,444.43,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1022.58,78,,,percent of total billed charges,78% of total billed charges,1311,100,,,percent of total billed charges,100% of total billed charges,1082.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1082.89,82.6,,,percent of total billed charges,82.6% of total billed charges,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,444.43,5712.48,
PICC W/O SUBQ PORT > 5 YRS OLD,84036591,CDM,360,RC,36591,HCPCS,Outpatient,,,318,206.70,,279.84,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,318,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,219.42,69,,,percent of total billed charges,69% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,318,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,318,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,119.89,37.7,,,percent of total billed charges,37.70% of total billed charges,119.89,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,107.8,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,248.04,78,,,percent of total billed charges,78% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.15,3367,
CENTRAL LINE DECLOT W/THROM AG,84036593,CDM,360,RC,36593,HCPCS,Outpatient,,,789,512.85,,694.32,88,,,percent of total billed charges,88% of total Billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,789,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,497.07,63,,,percent of total billed charges,63% of total billed charges,604.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,544.41,69,,,percent of total billed charges,69% of total billed charges,789,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,789,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,789,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1262.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,297.45,37.7,,,percent of total billed charges,37.70% of total billed charges,297.45,37.7,,,percent of total billed charges,37.70% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,267.47,33.9,,,percent of total billed charges,33.9% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,615.42,78,,,percent of total billed charges,78% of total billed charges,789,100,,,percent of total billed charges,100% of total billed charges,651.71,82.6,,,percent of total billed charges,82.6% of total billed charges,651.71,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,348.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,202.21,3367,
SURG SHEATH SEP ACCESS SURG,84036595,CDM,361,RC,36595,HCPCS,Outpatient,,,7529,4893.85,,6625.52,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,678.35,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4743.27,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,1151.94,15.3,,,percent of total billed charges,15.3% of total billed charges,5195.01,69,,,percent of total billed charges,69% of total billed charges,7529,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7529,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7529,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,487.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,671.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.17,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2838.43,37.7,,,percent of total billed charges,37.70% of total billed charges,2838.43,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2552.33,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5872.62,78,,,percent of total billed charges,78% of total billed charges,7529,100,,,percent of total billed charges,100% of total billed charges,6218.95,82.6,,,percent of total billed charges,82.6% of total billed charges,6218.95,82.6,,,percent of total billed charges,82.6% of total billed charges,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,487.85,11625.57,
MECH REMOVE TUNNELED CV CATH,84036596,CDM,360,RC,36596,HCPCS,Outpatient,,,218,141.70,,191.84,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,218,100,,,percent of total billed charges,100% of total billed charges,678.35,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,137.34,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,150.42,69,,,percent of total billed charges,69% of total billed charges,218,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,218,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,218,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,487.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,671.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.17,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,82.19,37.7,,,percent of total billed charges,37.70% of total billed charges,82.19,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,73.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,170.04,78,,,percent of total billed charges,78% of total billed charges,218,100,,,percent of total billed charges,100% of total billed charges,180.07,82.6,,,percent of total billed charges,82.6% of total billed charges,180.07,82.6,,,percent of total billed charges,82.6% of total billed charges,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.9,5712.48,
REPOSITION OF CVC W/FLUORO SUR,84036597,CDM,361,RC,36597,HCPCS,Outpatient,,,395,256.75,,347.6,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,395,100,,,percent of total billed charges,100% of total billed charges,678.35,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,248.85,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,60.44,15.3,,,percent of total billed charges,15.3% of total billed charges,272.55,69,,,percent of total billed charges,69% of total billed charges,395,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,395,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,395,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,487.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,671.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.17,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,148.92,37.7,,,percent of total billed charges,37.70% of total billed charges,148.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,133.91,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,308.1,78,,,percent of total billed charges,78% of total billed charges,395,100,,,percent of total billed charges,100% of total billed charges,326.27,82.6,,,percent of total billed charges,82.6% of total billed charges,326.27,82.6,,,percent of total billed charges,82.6% of total billed charges,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.44,5712.48,
VENOGRAM EXISTING LINE,84036598,CDM,761,RC,36598,HCPCS,Outpatient,,,1542,1002.30,,1356.96,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.87,100,,,Fee Schedule,100% of WA Medicaid,1542,100,,,percent of total billed charges,100% of total billed charges,281.05,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,971.46,63,,,percent of total billed charges,63% of total billed charges,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.87,100,,,Fee Schedule,100% of WA Medicaid,235.93,15.3,,,percent of total billed charges,15.3% of total billed charges,1063.98,69,,,percent of total billed charges,69% of total billed charges,1542,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1542,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1542,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,202.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,278.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.73,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,581.33,37.7,,,percent of total billed charges,37.70% of total billed charges,581.33,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,522.74,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1202.76,78,,,percent of total billed charges,78% of total billed charges,1542,100,,,percent of total billed charges,100% of total billed charges,1273.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1273.69,82.6,,,percent of total billed charges,82.6% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,202.12,1542,
36593 DECLOT BY THMROMBOLYTIC AGENTS,AMB820078,CDM,761,RC,36593,HCPCS,Outpatient,,,789,512.85,,694.32,88,,,percent of total billed charges,88% of total Billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,789,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,497.07,63,,,percent of total billed charges,63% of total billed charges,604.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,120.72,15.3,,,percent of total billed charges,15.3% of total billed charges,544.41,69,,,percent of total billed charges,69% of total billed charges,789,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,789,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,789,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1262.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,297.45,37.7,,,percent of total billed charges,37.70% of total billed charges,297.45,37.7,,,percent of total billed charges,37.70% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,267.47,33.9,,,percent of total billed charges,33.9% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,615.42,78,,,percent of total billed charges,78% of total billed charges,789,100,,,percent of total billed charges,100% of total billed charges,651.71,82.6,,,percent of total billed charges,82.6% of total billed charges,651.71,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,348.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,120.72,1262.42,
36592 LAB DRAW VIA CENTRAL LINE,AMB820028,CDM,761,RC,36592,HCPCS,Outpatient,,,318,206.70,,279.84,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,318,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,48.65,15.3,,,percent of total billed charges,15.3% of total billed charges,219.42,69,,,percent of total billed charges,69% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,318,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,318,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,119.89,37.7,,,percent of total billed charges,37.70% of total billed charges,119.89,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,107.8,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,248.04,78,,,percent of total billed charges,78% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.15,454.8,
ARTERIAL CATH LINE INSERT SURG,84036620,CDM,481,RC,36620,HCPCS,Outpatient,,,211,137.15,,185.68,88,,,percent of total billed charges,88% of total Billed charges,105.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid,211,100,,,percent of total billed charges,100% of total billed charges,589.75,103,,,Fee Schedule,103% of WA Medicaid,105.5,50,,,percent of total billed charges,50% of total Billed charges,132.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,572.57,100,,,Fee Schedule,100% of WA Medicaid,32.28,15.3,,,percent of total billed charges,15.3% of total billed charges,145.59,69,,,percent of total billed charges,69% of total billed charges,211,100,,,percent of total billed charges,100% of total billed charges,105.5,50,,,percent of total billed charges,50% of total Billed charges,211,100,,,percent of total billed charges,100% of total billed charges,105.5,50,,,percent of total billed charges,50% of total Billed charges,211,100,,,percent of total billed charges,100% of total billed charges,105.5,50,,,percent of total billed charges,50% of total Billed charges,130.5,61.85,,,percent of total billed charges,61.85% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.5,50,,,percent of total billed charges,50% of total Billed charges,105.5,50,,,percent of total billed charges,50% of total Billed charges,424.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105.5,50,,,percent of total billed charges,50% of total Billed charges,105.5,50,,,percent of total billed charges,50% of total Billed charges,584.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.35,130,,,Fee Schedule,130% of WA Medicaid ,105.5,50,,,percent of total billed charges,50% of total Billed charges,79.55,37.7,,,percent of total billed charges,37.70% of total billed charges,79.55,37.7,,,percent of total billed charges,37.70% of total billed charges,105.5,50,,,percent of total billed charges,50% of total Billed charges,71.53,33.9,,,percent of total billed charges,33.9% of total billed charges,105.5,50,,,percent of total billed charges,50% of total Billed charges,164.58,78,,,percent of total billed charges,78% of total billed charges,211,100,,,percent of total billed charges,100% of total billed charges,174.29,82.6,,,percent of total billed charges,82.6% of total billed charges,174.29,82.6,,,percent of total billed charges,82.6% of total billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,105.5,50,,,percent of total billed charges,50% of total Billed charges,572.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.28,744.35,
FISTULA ACCESS AND IMAGING,84036901,CDM,360,RC,36901,HCPCS,Outpatient,,,6270,4075.50,,5517.6,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3950.1,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4326.3,69,,,percent of total billed charges,69% of total billed charges,6270,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,6270,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,6270,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2363.79,37.7,,,percent of total billed charges,37.70% of total billed charges,2363.79,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2125.53,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4890.6,78,,,percent of total billed charges,78% of total billed charges,6270,100,,,percent of total billed charges,100% of total billed charges,5179.02,82.6,,,percent of total billed charges,82.6% of total billed charges,5179.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,6270,
FISTUAL IMAGING W/PTA,84036902,CDM,360,RC,36902,HCPCS,Outpatient,,,24590,15983.50,,21639.2,88,,,percent of total billed charges,88% of total Billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,15491.7,63,,,percent of total billed charges,63% of total billed charges,10202.1,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,16967.1,69,,,percent of total billed charges,69% of total billed charges,24590,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,24590,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,24590,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,20137.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9270.43,37.7,,,percent of total billed charges,37.70% of total billed charges,9270.43,37.7,,,percent of total billed charges,37.70% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,8336.01,33.9,,,percent of total billed charges,33.9% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,19180.2,78,,,percent of total billed charges,78% of total billed charges,24590,100,,,percent of total billed charges,100% of total billed charges,20311.34,82.6,,,percent of total billed charges,82.6% of total billed charges,20311.34,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5888.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2386.68,24590,
FISTULA IMAGING W/ STENT,84036903,CDM,360,RC,36903,HCPCS,Outpatient,,,4911,3192.15,,4321.68,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3093.93,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,3388.59,69,,,percent of total billed charges,69% of total billed charges,4911,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,4911,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,4911,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1851.45,37.7,,,percent of total billed charges,37.70% of total billed charges,1851.45,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1664.83,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3830.58,78,,,percent of total billed charges,78% of total billed charges,4911,100,,,percent of total billed charges,100% of total billed charges,4056.49,82.6,,,percent of total billed charges,82.6% of total billed charges,4056.49,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1664.83,40799.76,
FISTULA IMAGING W/THROMBECTOMY,84036904,CDM,360,RC,36904,HCPCS,Outpatient,,,16045,10429.25,,14119.6,88,,,percent of total billed charges,88% of total Billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10108.35,63,,,percent of total billed charges,63% of total billed charges,10202.1,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,11071.05,69,,,percent of total billed charges,69% of total billed charges,16045,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16045,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,16045,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,20137.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,6048.97,37.7,,,percent of total billed charges,37.70% of total billed charges,6048.97,37.7,,,percent of total billed charges,37.70% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5439.26,33.9,,,percent of total billed charges,33.9% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12515.1,78,,,percent of total billed charges,78% of total billed charges,16045,100,,,percent of total billed charges,100% of total billed charges,13253.17,82.6,,,percent of total billed charges,82.6% of total billed charges,13253.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5888.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2386.68,20137.31,
FISTUAL IMAGING W/THROMBECTOMY/PTA,84036905,CDM,320,RC,36905,HCPCS,Outpatient,,,32649,21221.85,,28731.12,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5469.59,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,20568.87,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,4995.3,15.3,,,percent of total billed charges,15.3% of total billed charges,22527.81,69,,,percent of total billed charges,69% of total billed charges,32649,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,32649,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,32649,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3933.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5416.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6903.37,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12308.67,37.7,,,percent of total billed charges,37.70% of total billed charges,12308.67,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11068.01,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,25466.22,78,,,percent of total billed charges,78% of total billed charges,32649,100,,,percent of total billed charges,100% of total billed charges,26968.07,82.6,,,percent of total billed charges,82.6% of total billed charges,26968.07,82.6,,,percent of total billed charges,82.6% of total billed charges,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3933.54,40799.76,
FISTULA IMAGING W/THROMBECTOMY/STENT,84036906,CDM,360,RC,36906,HCPCS,Outpatient,,,12971,8431.15,,11414.48,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,8171.73,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,8949.99,69,,,percent of total billed charges,69% of total billed charges,12971,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,12971,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,12971,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65260.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4890.07,37.7,,,percent of total billed charges,37.70% of total billed charges,4890.07,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4397.17,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,10117.38,78,,,percent of total billed charges,78% of total billed charges,12971,100,,,percent of total billed charges,100% of total billed charges,10714.05,82.6,,,percent of total billed charges,82.6% of total billed charges,10714.05,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3367,65260.52,
REVISE TIPS,84037183,CDM,361,RC,37183,HCPCS,Outpatient,,,36204,23532.60,,31859.52,88,,,percent of total billed charges,88% of total Billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5469.59,103,,,Fee Schedule,103% of WA Medicaid,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,22808.52,63,,,percent of total billed charges,63% of total billed charges,10202.1,175,,,Fee Schedule,175% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,5539.21,15.3,,,percent of total billed charges,15.3% of total billed charges,24980.76,69,,,percent of total billed charges,69% of total billed charges,36204,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,36204,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,36204,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,20137.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3933.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5416.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6903.37,130,,,Fee Schedule,130% of WA Medicaid ,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,13648.91,37.7,,,percent of total billed charges,37.70% of total billed charges,13648.91,37.7,,,percent of total billed charges,37.70% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12273.16,33.9,,,percent of total billed charges,33.9% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,28239.12,78,,,percent of total billed charges,78% of total billed charges,36204,100,,,percent of total billed charges,100% of total billed charges,29904.5,82.6,,,percent of total billed charges,82.6% of total billed charges,29904.5,82.6,,,percent of total billed charges,82.6% of total billed charges,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5888.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3933.54,36204,
PRIMARY ART MECH THROMBO SURG,84037184,CDM,361,RC,37184,HCPCS,Outpatient,,,16931,11005.15,,14899.28,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5469.59,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,10666.53,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,2590.44,15.3,,,percent of total billed charges,15.3% of total billed charges,11682.39,69,,,percent of total billed charges,69% of total billed charges,16931,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,16931,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,16931,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,3933.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5416.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6903.37,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,6382.99,37.7,,,percent of total billed charges,37.70% of total billed charges,6382.99,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5739.61,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,13206.18,78,,,percent of total billed charges,78% of total billed charges,16931,100,,,percent of total billed charges,100% of total billed charges,13985.01,82.6,,,percent of total billed charges,82.6% of total billed charges,13985.01,82.6,,,percent of total billed charges,82.6% of total billed charges,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2590.44,40799.76,
PRIMARY ART MECH THROMBO AD ON,84037185,CDM,361,RC,37185,HCPCS,Outpatient,,,12965,8427.25,,11409.2,88,,,percent of total billed charges,88% of total Billed charges,6482.5,50,,,percent of total billed charges,50% of total Billed charges,5310.28,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5469.59,103,,,Fee Schedule,103% of WA Medicaid,6482.5,50,,,percent of total billed charges,50% of total Billed charges,8167.95,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5310.28,100,,,Fee Schedule,100% of WA Medicaid,1983.65,15.3,,,percent of total billed charges,15.3% of total billed charges,8945.85,69,,,percent of total billed charges,69% of total billed charges,12965,100,,,percent of total billed charges,100% of total billed charges,6482.5,50,,,percent of total billed charges,50% of total Billed charges,12965,100,,,percent of total billed charges,100% of total billed charges,6482.5,50,,,percent of total billed charges,50% of total Billed charges,12965,100,,,percent of total billed charges,100% of total billed charges,6482.5,50,,,percent of total billed charges,50% of total Billed charges,8018.85,61.85,,,percent of total billed charges,61.85% of total billed charges,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6482.5,50,,,percent of total billed charges,50% of total Billed charges,6482.5,50,,,percent of total billed charges,50% of total Billed charges,3933.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6482.5,50,,,percent of total billed charges,50% of total Billed charges,6482.5,50,,,percent of total billed charges,50% of total Billed charges,5416.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6903.37,130,,,Fee Schedule,130% of WA Medicaid ,6482.5,50,,,percent of total billed charges,50% of total Billed charges,4887.81,37.7,,,percent of total billed charges,37.70% of total billed charges,4887.81,37.7,,,percent of total billed charges,37.70% of total billed charges,6482.5,50,,,percent of total billed charges,50% of total Billed charges,4395.14,33.9,,,percent of total billed charges,33.9% of total billed charges,6482.5,50,,,percent of total billed charges,50% of total Billed charges,10112.7,78,,,percent of total billed charges,78% of total billed charges,12965,100,,,percent of total billed charges,100% of total billed charges,10709.09,82.6,,,percent of total billed charges,82.6% of total billed charges,10709.09,82.6,,,percent of total billed charges,82.6% of total billed charges,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6482.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6482.5,50,,,percent of total billed charges,50% of total Billed charges,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1983.65,12965,
SEC PER TRANSLUM THROM SURG,84037186,CDM,361,RC,37186,HCPCS,Outpatient,,,16433,10681.45,,14461.04,88,,,percent of total billed charges,88% of total Billed charges,8216.5,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,8216.5,50,,,percent of total billed charges,50% of total Billed charges,10352.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9883.65,100,,,Fee Schedule,100% of WA Medicaid,2514.25,15.3,,,percent of total billed charges,15.3% of total billed charges,11338.77,69,,,percent of total billed charges,69% of total billed charges,16433,100,,,percent of total billed charges,100% of total billed charges,8216.5,50,,,percent of total billed charges,50% of total Billed charges,16433,100,,,percent of total billed charges,100% of total billed charges,8216.5,50,,,percent of total billed charges,50% of total Billed charges,16433,100,,,percent of total billed charges,100% of total billed charges,8216.5,50,,,percent of total billed charges,50% of total Billed charges,10163.81,61.85,,,percent of total billed charges,61.85% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8216.5,50,,,percent of total billed charges,50% of total Billed charges,8216.5,50,,,percent of total billed charges,50% of total Billed charges,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8216.5,50,,,percent of total billed charges,50% of total Billed charges,8216.5,50,,,percent of total billed charges,50% of total Billed charges,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,8216.5,50,,,percent of total billed charges,50% of total Billed charges,6195.24,37.7,,,percent of total billed charges,37.70% of total billed charges,6195.24,37.7,,,percent of total billed charges,37.70% of total billed charges,8216.5,50,,,percent of total billed charges,50% of total Billed charges,5570.79,33.9,,,percent of total billed charges,33.9% of total billed charges,8216.5,50,,,percent of total billed charges,50% of total Billed charges,12817.74,78,,,percent of total billed charges,78% of total billed charges,16433,100,,,percent of total billed charges,100% of total billed charges,13573.66,82.6,,,percent of total billed charges,82.6% of total billed charges,13573.66,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8216.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8216.5,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2514.25,16433,
PERC MECH THROM W/LYSIS INIT,84037187,CDM,361,RC,37187,HCPCS,Outpatient,,,14613,9498.45,,12859.44,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9206.19,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,2235.79,15.3,,,percent of total billed charges,15.3% of total billed charges,10082.97,69,,,percent of total billed charges,69% of total billed charges,14613,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,14613,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,14613,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5509.1,37.7,,,percent of total billed charges,37.70% of total billed charges,5509.1,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,4953.81,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11398.14,78,,,percent of total billed charges,78% of total billed charges,14613,100,,,percent of total billed charges,100% of total billed charges,12070.34,82.6,,,percent of total billed charges,82.6% of total billed charges,12070.34,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2235.79,40799.76,
VENOUS MECH THROMBO ADD ON,84037188,CDM,361,RC,37188,HCPCS,Outpatient,,,12965,8427.25,,11409.2,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8167.95,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,1983.65,15.3,,,percent of total billed charges,15.3% of total billed charges,8945.85,69,,,percent of total billed charges,69% of total billed charges,12965,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12965,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,12965,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4887.81,37.7,,,percent of total billed charges,37.70% of total billed charges,4887.81,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4395.14,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10112.7,78,,,percent of total billed charges,78% of total billed charges,12965,100,,,percent of total billed charges,100% of total billed charges,10709.09,82.6,,,percent of total billed charges,82.6% of total billed charges,10709.09,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1983.65,12965,
INS ENDOVAS VENA CAVA FILTER,84037191,CDM,361,RC,37191,HCPCS,Outpatient,,,12812,8327.80,,11274.56,88,,,percent of total billed charges,88% of total Billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,8071.56,63,,,percent of total billed charges,63% of total billed charges,9808.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,1960.24,15.3,,,percent of total billed charges,15.3% of total billed charges,8840.28,69,,,percent of total billed charges,69% of total billed charges,12812,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12812,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,12812,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19379.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4830.12,37.7,,,percent of total billed charges,37.70% of total billed charges,4830.12,37.7,,,percent of total billed charges,37.70% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,4343.27,33.9,,,percent of total billed charges,33.9% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9993.36,78,,,percent of total billed charges,78% of total billed charges,12812,100,,,percent of total billed charges,100% of total billed charges,10582.71,82.6,,,percent of total billed charges,82.6% of total billed charges,10582.71,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5661.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1960.24,19379.77,
RETRIEVE/REMOVE IVC FILTER,84037193,CDM,361,RC,37193,HCPCS,Outpatient,,,7654,4975.10,,6735.52,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4822.02,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,1171.06,15.3,,,percent of total billed charges,15.3% of total billed charges,5281.26,69,,,percent of total billed charges,69% of total billed charges,7654,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7654,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7654,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2885.56,37.7,,,percent of total billed charges,37.70% of total billed charges,2885.56,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2594.71,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5970.12,78,,,percent of total billed charges,78% of total billed charges,7654,100,,,percent of total billed charges,100% of total billed charges,6322.2,82.6,,,percent of total billed charges,82.6% of total billed charges,6322.2,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1171.06,11625.57,
REMOVE INTRAVASCULAR FB,84037197,CDM,361,RC,37197,HCPCS,Outpatient,,,9535,6197.75,,8390.8,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6007.05,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,1458.86,15.3,,,percent of total billed charges,15.3% of total billed charges,6579.15,69,,,percent of total billed charges,69% of total billed charges,9535,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9535,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9535,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3594.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3594.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3232.37,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7437.3,78,,,percent of total billed charges,78% of total billed charges,9535,100,,,percent of total billed charges,100% of total billed charges,7875.91,82.6,,,percent of total billed charges,82.6% of total billed charges,7875.91,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1458.86,11625.57,
REPOSITION OF VENA CAVA FILTER,84037492,CDM,481,RC,37192,HCPCS,Outpatient,,,7380,4797.00,,6494.4,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4649.4,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,1129.14,15.3,,,percent of total billed charges,15.3% of total billed charges,5092.2,69,,,percent of total billed charges,69% of total billed charges,7380,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7380,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7380,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2782.26,37.7,,,percent of total billed charges,37.70% of total billed charges,2782.26,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2501.82,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5756.4,78,,,percent of total billed charges,78% of total billed charges,7380,100,,,percent of total billed charges,100% of total billed charges,6095.88,82.6,,,percent of total billed charges,82.6% of total billed charges,6095.88,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1129.14,11625.57,
TRANSCATHETER BIOPSY,84037200,CDM,360,RC,37200,HCPCS,Outpatient,,,1314,854.10,,1156.32,88,,,percent of total billed charges,88% of total Billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,1314,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,827.82,63,,,percent of total billed charges,63% of total billed charges,9808.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,906.66,69,,,percent of total billed charges,69% of total billed charges,1314,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,1314,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,1314,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19379.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,495.38,37.7,,,percent of total billed charges,37.70% of total billed charges,495.38,37.7,,,percent of total billed charges,37.70% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,445.45,33.9,,,percent of total billed charges,33.9% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,1024.92,78,,,percent of total billed charges,78% of total billed charges,1314,100,,,percent of total billed charges,100% of total billed charges,1085.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1085.36,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5661.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,445.45,19379.77,
THROMBOLYTIC ART THERAPY,84037211,CDM,360,RC,37211,HCPCS,Outpatient,,,1843,1197.95,,1621.84,88,,,percent of total billed charges,88% of total Billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,1843,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,1161.09,63,,,percent of total billed charges,63% of total billed charges,9808.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1271.67,69,,,percent of total billed charges,69% of total billed charges,1843,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,1843,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,1843,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19379.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,694.81,37.7,,,percent of total billed charges,37.70% of total billed charges,694.81,37.7,,,percent of total billed charges,37.70% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,624.78,33.9,,,percent of total billed charges,33.9% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,1437.54,78,,,percent of total billed charges,78% of total billed charges,1843,100,,,percent of total billed charges,100% of total billed charges,1522.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1522.32,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5661.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,624.78,19379.77,
THROMBOLYTIC VENOUS THERAPY,84037212,CDM,361,RC,37212,HCPCS,Outpatient,,,3288,2137.20,,2893.44,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,3288,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2071.44,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,503.06,15.3,,,percent of total billed charges,15.3% of total billed charges,2268.72,69,,,percent of total billed charges,69% of total billed charges,3288,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3288,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3288,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1239.58,37.7,,,percent of total billed charges,37.70% of total billed charges,1239.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1114.63,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2564.64,78,,,percent of total billed charges,78% of total billed charges,3288,100,,,percent of total billed charges,100% of total billed charges,2715.89,82.6,,,percent of total billed charges,82.6% of total billed charges,2715.89,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,503.06,11625.57,
THROMB ART/VEN THERAPY SUBSEQ,84037213,CDM,361,RC,37213,HCPCS,Outpatient,,,7338,4769.70,,6457.44,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4622.94,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,1122.71,15.3,,,percent of total billed charges,15.3% of total billed charges,5063.22,69,,,percent of total billed charges,69% of total billed charges,7338,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7338,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7338,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2766.43,37.7,,,percent of total billed charges,37.70% of total billed charges,2766.43,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2487.58,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5723.64,78,,,percent of total billed charges,78% of total billed charges,7338,100,,,percent of total billed charges,100% of total billed charges,6061.19,82.6,,,percent of total billed charges,82.6% of total billed charges,6061.19,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1122.71,11625.57,
CESSATION ART/VEN THROMB THER,84037214,CDM,361,RC,37214,HCPCS,Outpatient,,,7338,4769.70,,6457.44,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4622.94,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,1122.71,15.3,,,percent of total billed charges,15.3% of total billed charges,5063.22,69,,,percent of total billed charges,69% of total billed charges,7338,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7338,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7338,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2766.43,37.7,,,percent of total billed charges,37.70% of total billed charges,2766.43,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2487.58,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5723.64,78,,,percent of total billed charges,78% of total billed charges,7338,100,,,percent of total billed charges,100% of total billed charges,6061.19,82.6,,,percent of total billed charges,82.6% of total billed charges,6061.19,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1122.71,11625.57,
TXCATH STENT DIS EMBO PROT SUR,84037215,CDM,361,RC,37215,HCPCS,Outpatient,,,9398,6108.70,,8270.24,88,,,percent of total billed charges,88% of total Billed charges,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,10125.25,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10429,103,,,Fee Schedule,103% of WA Medicaid,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5920.74,63,,,percent of total billed charges,63% of total billed charges,9398,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,10125.25,100,,,Fee Schedule,100% of WA Medicaid,1437.89,15.3,,,percent of total billed charges,15.3% of total billed charges,6484.62,69,,,percent of total billed charges,69% of total billed charges,9398,100,,,percent of total billed charges,100% of total billed charges,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,9398,100,,,percent of total billed charges,100% of total billed charges,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,9398,100,,,percent of total billed charges,100% of total billed charges,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,9398,100,,,Fee Schedule,Pays at line item charges due to status indicator C,10125.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7500.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,10327.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13162.82,130,,,Fee Schedule,130% of WA Medicaid ,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3543.05,37.7,,,percent of total billed charges,37.70% of total billed charges,3543.05,37.7,,,percent of total billed charges,37.70% of total billed charges,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3185.92,33.9,,,percent of total billed charges,33.9% of total billed charges,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7330.44,78,,,percent of total billed charges,78% of total billed charges,9398,100,,,percent of total billed charges,100% of total billed charges,7762.75,82.6,,,percent of total billed charges,82.6% of total billed charges,7762.75,82.6,,,percent of total billed charges,82.6% of total billed charges,10125.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,9398,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,9398,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,10125.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1437.89,13162.82,
ILIAC REVASC,84037220,CDM,361,RC,37220,HCPCS,Outpatient,,,38643,25117.95,,34005.84,88,,,percent of total billed charges,88% of total Billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5469.59,103,,,Fee Schedule,103% of WA Medicaid,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,24345.09,63,,,percent of total billed charges,63% of total billed charges,10202.1,175,,,Fee Schedule,175% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,5912.38,15.3,,,percent of total billed charges,15.3% of total billed charges,26663.67,69,,,percent of total billed charges,69% of total billed charges,38643,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,38643,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,38643,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,20137.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3933.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5416.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6903.37,130,,,Fee Schedule,130% of WA Medicaid ,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,14568.41,37.7,,,percent of total billed charges,37.70% of total billed charges,14568.41,37.7,,,percent of total billed charges,37.70% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,13099.98,33.9,,,percent of total billed charges,33.9% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,30141.54,78,,,percent of total billed charges,78% of total billed charges,38643,100,,,percent of total billed charges,100% of total billed charges,31919.12,82.6,,,percent of total billed charges,82.6% of total billed charges,31919.12,82.6,,,percent of total billed charges,82.6% of total billed charges,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5888.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3933.54,38643,
REVAS ILIAC ART W/STENT PLACE,84037221,CDM,360,RC,37221,HCPCS,Outpatient,,,2509,1630.85,,2207.92,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,2509,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1580.67,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1731.21,69,,,percent of total billed charges,69% of total billed charges,2509,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2509,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2509,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,945.89,37.7,,,percent of total billed charges,37.70% of total billed charges,945.89,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,850.55,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1957.02,78,,,percent of total billed charges,78% of total billed charges,2509,100,,,percent of total billed charges,100% of total billed charges,2072.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2072.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,850.55,40799.76,
REVAS ENDO OPEN PER ILIAC ART,84037222,CDM,360,RC,37222,HCPCS,Outpatient,,,889,577.85,,782.32,88,,,percent of total billed charges,88% of total Billed charges,444.5,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid,889,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,444.5,50,,,percent of total billed charges,50% of total Billed charges,560.07,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9883.65,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,613.41,69,,,percent of total billed charges,69% of total billed charges,889,100,,,percent of total billed charges,100% of total billed charges,444.5,50,,,percent of total billed charges,50% of total Billed charges,889,100,,,percent of total billed charges,100% of total billed charges,444.5,50,,,percent of total billed charges,50% of total Billed charges,889,100,,,percent of total billed charges,100% of total billed charges,444.5,50,,,percent of total billed charges,50% of total Billed charges,549.85,61.85,,,percent of total billed charges,61.85% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,444.5,50,,,percent of total billed charges,50% of total Billed charges,444.5,50,,,percent of total billed charges,50% of total Billed charges,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,444.5,50,,,percent of total billed charges,50% of total Billed charges,444.5,50,,,percent of total billed charges,50% of total Billed charges,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,444.5,50,,,percent of total billed charges,50% of total Billed charges,335.15,37.7,,,percent of total billed charges,37.70% of total billed charges,335.15,37.7,,,percent of total billed charges,37.70% of total billed charges,444.5,50,,,percent of total billed charges,50% of total Billed charges,301.37,33.9,,,percent of total billed charges,33.9% of total billed charges,444.5,50,,,percent of total billed charges,50% of total Billed charges,693.42,78,,,percent of total billed charges,78% of total billed charges,889,100,,,percent of total billed charges,100% of total billed charges,734.31,82.6,,,percent of total billed charges,82.6% of total billed charges,734.31,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,444.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,444.5,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,301.37,12848.75,
ILIAC REVASC W/STENT ADD-ON,84037223,CDM,361,RC,37223,HCPCS,Outpatient,,,30914,20094.10,,27204.32,88,,,percent of total billed charges,88% of total Billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,15457,50,,,percent of total billed charges,50% of total Billed charges,19475.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4729.84,15.3,,,percent of total billed charges,15.3% of total billed charges,21330.66,69,,,percent of total billed charges,69% of total billed charges,30914,100,,,percent of total billed charges,100% of total billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,30914,100,,,percent of total billed charges,100% of total billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,30914,100,,,percent of total billed charges,100% of total billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,19120.31,61.85,,,percent of total billed charges,61.85% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15457,50,,,percent of total billed charges,50% of total Billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15457,50,,,percent of total billed charges,50% of total Billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,15457,50,,,percent of total billed charges,50% of total Billed charges,11654.58,37.7,,,percent of total billed charges,37.70% of total billed charges,11654.58,37.7,,,percent of total billed charges,37.70% of total billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,10479.85,33.9,,,percent of total billed charges,33.9% of total billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,24112.92,78,,,percent of total billed charges,78% of total billed charges,30914,100,,,percent of total billed charges,100% of total billed charges,25534.96,82.6,,,percent of total billed charges,82.6% of total billed charges,25534.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15457,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15457,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,30914,
FEM/POPL REVAS W/TLA,84037224,CDM,361,RC,37224,HCPCS,Outpatient,,,25278,16430.70,,22244.64,88,,,percent of total billed charges,88% of total Billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5469.59,103,,,Fee Schedule,103% of WA Medicaid,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,15925.14,63,,,percent of total billed charges,63% of total billed charges,10202.1,175,,,Fee Schedule,175% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,3867.53,15.3,,,percent of total billed charges,15.3% of total billed charges,17441.82,69,,,percent of total billed charges,69% of total billed charges,25278,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,25278,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,25278,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,20137.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3933.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5416.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6903.37,130,,,Fee Schedule,130% of WA Medicaid ,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9529.81,37.7,,,percent of total billed charges,37.70% of total billed charges,9529.81,37.7,,,percent of total billed charges,37.70% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,8569.24,33.9,,,percent of total billed charges,33.9% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,19716.84,78,,,percent of total billed charges,78% of total billed charges,25278,100,,,percent of total billed charges,100% of total billed charges,20879.63,82.6,,,percent of total billed charges,82.6% of total billed charges,20879.63,82.6,,,percent of total billed charges,82.6% of total billed charges,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5888.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3867.53,25278,
FEM/POPL REVAS W/ATHER,84037225,CDM,481,RC,37225,HCPCS,Outpatient,,,65625,42656.25,,57750,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,41343.75,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,10040.63,15.3,,,percent of total billed charges,15.3% of total billed charges,45281.25,69,,,percent of total billed charges,69% of total billed charges,65625,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65625,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65625,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,24740.63,37.7,,,percent of total billed charges,37.70% of total billed charges,24740.63,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,22246.88,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,51187.5,78,,,percent of total billed charges,78% of total billed charges,65625,100,,,percent of total billed charges,100% of total billed charges,54206.25,82.6,,,percent of total billed charges,82.6% of total billed charges,54206.25,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,65625,
FEM/POPL REVASC W/STENT,84037226,CDM,361,RC,37226,HCPCS,Outpatient,,,64279,41781.35,,56565.52,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40495.77,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,9834.69,15.3,,,percent of total billed charges,15.3% of total billed charges,44352.51,69,,,percent of total billed charges,69% of total billed charges,64279,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,64279,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,64279,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,24233.18,37.7,,,percent of total billed charges,37.70% of total billed charges,24233.18,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,21790.58,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,50137.62,78,,,percent of total billed charges,78% of total billed charges,64279,100,,,percent of total billed charges,100% of total billed charges,53094.45,82.6,,,percent of total billed charges,82.6% of total billed charges,53094.45,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,64279,
FEM/POPL REVASC STNT  ATHER,84037227,CDM,361,RC,37227,HCPCS,Outpatient,,,68920,44798.00,,60649.6,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,43419.6,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,10544.76,15.3,,,percent of total billed charges,15.3% of total billed charges,47554.8,69,,,percent of total billed charges,69% of total billed charges,68920,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,68920,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,68920,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65260.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,25982.84,37.7,,,percent of total billed charges,37.70% of total billed charges,25982.84,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,23363.88,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,53757.6,78,,,percent of total billed charges,78% of total billed charges,68920,100,,,percent of total billed charges,100% of total billed charges,56927.92,82.6,,,percent of total billed charges,82.6% of total billed charges,56927.92,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,68920,
TIB/PER REVASC W/TLA,84037228,CDM,361,RC,37228,HCPCS,Outpatient,,,38643,25117.95,,34005.84,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5469.59,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,24345.09,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid,5912.38,15.3,,,percent of total billed charges,15.3% of total billed charges,26663.67,69,,,percent of total billed charges,69% of total billed charges,38643,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,38643,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,38643,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3933.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5416.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6903.37,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,14568.41,37.7,,,percent of total billed charges,37.70% of total billed charges,14568.41,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,13099.98,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,30141.54,78,,,percent of total billed charges,78% of total billed charges,38643,100,,,percent of total billed charges,100% of total billed charges,31919.12,82.6,,,percent of total billed charges,82.6% of total billed charges,31919.12,82.6,,,percent of total billed charges,82.6% of total billed charges,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5310.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3933.54,40799.76,
TIB/PER REVASC W/ATHER,84037229,CDM,361,RC,37229,HCPCS,Outpatient,,,55467,36053.55,,48810.96,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,34944.21,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,8486.45,15.3,,,percent of total billed charges,15.3% of total billed charges,38272.23,69,,,percent of total billed charges,69% of total billed charges,55467,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,55467,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,55467,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65260.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,20911.06,37.7,,,percent of total billed charges,37.70% of total billed charges,20911.06,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18803.31,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,43264.26,78,,,percent of total billed charges,78% of total billed charges,55467,100,,,percent of total billed charges,100% of total billed charges,45815.74,82.6,,,percent of total billed charges,82.6% of total billed charges,45815.74,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,65260.52,
TIB/PER REVASC W/STENT,84037230,CDM,361,RC,37230,HCPCS,Outpatient,,,65625,42656.25,,57750,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,41343.75,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,10040.63,15.3,,,percent of total billed charges,15.3% of total billed charges,45281.25,69,,,percent of total billed charges,69% of total billed charges,65625,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65625,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65625,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65260.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,24740.63,37.7,,,percent of total billed charges,37.70% of total billed charges,24740.63,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,22246.88,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,51187.5,78,,,percent of total billed charges,78% of total billed charges,65625,100,,,percent of total billed charges,100% of total billed charges,54206.25,82.6,,,percent of total billed charges,82.6% of total billed charges,54206.25,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,65625,
TIB/PER REVASC ADD-ON,84037232,CDM,361,RC,37232,HCPCS,Outpatient,,,30914,20094.10,,27204.32,88,,,percent of total billed charges,88% of total Billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,15457,50,,,percent of total billed charges,50% of total Billed charges,19475.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4729.84,15.3,,,percent of total billed charges,15.3% of total billed charges,21330.66,69,,,percent of total billed charges,69% of total billed charges,30914,100,,,percent of total billed charges,100% of total billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,30914,100,,,percent of total billed charges,100% of total billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,30914,100,,,percent of total billed charges,100% of total billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,19120.31,61.85,,,percent of total billed charges,61.85% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15457,50,,,percent of total billed charges,50% of total Billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15457,50,,,percent of total billed charges,50% of total Billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,15457,50,,,percent of total billed charges,50% of total Billed charges,11654.58,37.7,,,percent of total billed charges,37.70% of total billed charges,11654.58,37.7,,,percent of total billed charges,37.70% of total billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,10479.85,33.9,,,percent of total billed charges,33.9% of total billed charges,15457,50,,,percent of total billed charges,50% of total Billed charges,24112.92,78,,,percent of total billed charges,78% of total billed charges,30914,100,,,percent of total billed charges,100% of total billed charges,25534.96,82.6,,,percent of total billed charges,82.6% of total billed charges,25534.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15457,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15457,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,30914,
TIBPER REV ASC W/ATHER ADD-ON,84037233,CDM,360,RC,37233,HCPCS,Outpatient,,,1553,1009.45,,1366.64,88,,,percent of total billed charges,88% of total Billed charges,776.5,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid,1553,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,776.5,50,,,percent of total billed charges,50% of total Billed charges,978.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9883.65,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1071.57,69,,,percent of total billed charges,69% of total billed charges,1553,100,,,percent of total billed charges,100% of total billed charges,776.5,50,,,percent of total billed charges,50% of total Billed charges,1553,100,,,percent of total billed charges,100% of total billed charges,776.5,50,,,percent of total billed charges,50% of total Billed charges,1553,100,,,percent of total billed charges,100% of total billed charges,776.5,50,,,percent of total billed charges,50% of total Billed charges,960.53,61.85,,,percent of total billed charges,61.85% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,776.5,50,,,percent of total billed charges,50% of total Billed charges,776.5,50,,,percent of total billed charges,50% of total Billed charges,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,776.5,50,,,percent of total billed charges,50% of total Billed charges,776.5,50,,,percent of total billed charges,50% of total Billed charges,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,776.5,50,,,percent of total billed charges,50% of total Billed charges,585.48,37.7,,,percent of total billed charges,37.70% of total billed charges,585.48,37.7,,,percent of total billed charges,37.70% of total billed charges,776.5,50,,,percent of total billed charges,50% of total Billed charges,526.47,33.9,,,percent of total billed charges,33.9% of total billed charges,776.5,50,,,percent of total billed charges,50% of total Billed charges,1211.34,78,,,percent of total billed charges,78% of total billed charges,1553,100,,,percent of total billed charges,100% of total billed charges,1282.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1282.78,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,776.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,776.5,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,526.47,12848.75,
REVSC OPN/PRQ TIB/PERO STENT,84037234,CDM,361,RC,37234,HCPCS,Outpatient,,,34766,22597.90,,30594.08,88,,,percent of total billed charges,88% of total Billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,17383,50,,,percent of total billed charges,50% of total Billed charges,21902.58,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9883.65,100,,,Fee Schedule,100% of WA Medicaid,5319.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23988.54,69,,,percent of total billed charges,69% of total billed charges,34766,100,,,percent of total billed charges,100% of total billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,34766,100,,,percent of total billed charges,100% of total billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,34766,100,,,percent of total billed charges,100% of total billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,21502.77,61.85,,,percent of total billed charges,61.85% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17383,50,,,percent of total billed charges,50% of total Billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17383,50,,,percent of total billed charges,50% of total Billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,17383,50,,,percent of total billed charges,50% of total Billed charges,13106.78,37.7,,,percent of total billed charges,37.70% of total billed charges,13106.78,37.7,,,percent of total billed charges,37.70% of total billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,11785.67,33.9,,,percent of total billed charges,33.9% of total billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,27117.48,78,,,percent of total billed charges,78% of total billed charges,34766,100,,,percent of total billed charges,100% of total billed charges,28716.72,82.6,,,percent of total billed charges,82.6% of total billed charges,28716.72,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17383,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17383,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,34766,
TIB/PER REVASC STNT  ATHER,84037235,CDM,361,RC,37235,HCPCS,Outpatient,,,34766,22597.90,,30594.08,88,,,percent of total billed charges,88% of total Billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,17383,50,,,percent of total billed charges,50% of total Billed charges,21902.58,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9883.65,100,,,Fee Schedule,100% of WA Medicaid,5319.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23988.54,69,,,percent of total billed charges,69% of total billed charges,34766,100,,,percent of total billed charges,100% of total billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,34766,100,,,percent of total billed charges,100% of total billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,34766,100,,,percent of total billed charges,100% of total billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,21502.77,61.85,,,percent of total billed charges,61.85% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17383,50,,,percent of total billed charges,50% of total Billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17383,50,,,percent of total billed charges,50% of total Billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,17383,50,,,percent of total billed charges,50% of total Billed charges,13106.78,37.7,,,percent of total billed charges,37.70% of total billed charges,13106.78,37.7,,,percent of total billed charges,37.70% of total billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,11785.67,33.9,,,percent of total billed charges,33.9% of total billed charges,17383,50,,,percent of total billed charges,50% of total Billed charges,27117.48,78,,,percent of total billed charges,78% of total billed charges,34766,100,,,percent of total billed charges,100% of total billed charges,28716.72,82.6,,,percent of total billed charges,82.6% of total billed charges,28716.72,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17383,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17383,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,34766,
STENT TRUNK/UPP EXT INIT ART,84037236,CDM,361,RC,37236,HCPCS,Outpatient,,,33915,22044.75,,29845.2,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,21366.45,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,5189,15.3,,,percent of total billed charges,15.3% of total billed charges,23401.35,69,,,percent of total billed charges,69% of total billed charges,33915,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,33915,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,33915,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12785.96,37.7,,,percent of total billed charges,37.70% of total billed charges,12785.96,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11497.19,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,26453.7,78,,,percent of total billed charges,78% of total billed charges,33915,100,,,percent of total billed charges,100% of total billed charges,28013.79,82.6,,,percent of total billed charges,82.6% of total billed charges,28013.79,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,40799.76,
STENT TRUNK/UPP EXT EA ADD ART,84037237,CDM,361,RC,37237,HCPCS,Outpatient,,,36214,23539.10,,31868.32,88,,,percent of total billed charges,88% of total Billed charges,18107,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,18107,50,,,percent of total billed charges,50% of total Billed charges,22814.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9883.65,100,,,Fee Schedule,100% of WA Medicaid,5540.74,15.3,,,percent of total billed charges,15.3% of total billed charges,24987.66,69,,,percent of total billed charges,69% of total billed charges,36214,100,,,percent of total billed charges,100% of total billed charges,18107,50,,,percent of total billed charges,50% of total Billed charges,36214,100,,,percent of total billed charges,100% of total billed charges,18107,50,,,percent of total billed charges,50% of total Billed charges,36214,100,,,percent of total billed charges,100% of total billed charges,18107,50,,,percent of total billed charges,50% of total Billed charges,22398.36,61.85,,,percent of total billed charges,61.85% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18107,50,,,percent of total billed charges,50% of total Billed charges,18107,50,,,percent of total billed charges,50% of total Billed charges,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18107,50,,,percent of total billed charges,50% of total Billed charges,18107,50,,,percent of total billed charges,50% of total Billed charges,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,18107,50,,,percent of total billed charges,50% of total Billed charges,13652.68,37.7,,,percent of total billed charges,37.70% of total billed charges,13652.68,37.7,,,percent of total billed charges,37.70% of total billed charges,18107,50,,,percent of total billed charges,50% of total Billed charges,12276.55,33.9,,,percent of total billed charges,33.9% of total billed charges,18107,50,,,percent of total billed charges,50% of total Billed charges,28246.92,78,,,percent of total billed charges,78% of total billed charges,36214,100,,,percent of total billed charges,100% of total billed charges,29912.76,82.6,,,percent of total billed charges,82.6% of total billed charges,29912.76,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18107,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18107,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,36214,
STENT PLACE INIT VEIN,84037238,CDM,361,RC,37238,HCPCS,Outpatient,,,33915,22044.75,,29845.2,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,21366.45,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,5189,15.3,,,percent of total billed charges,15.3% of total billed charges,23401.35,69,,,percent of total billed charges,69% of total billed charges,33915,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,33915,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,33915,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12785.96,37.7,,,percent of total billed charges,37.70% of total billed charges,12785.96,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11497.19,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,26453.7,78,,,percent of total billed charges,78% of total billed charges,33915,100,,,percent of total billed charges,100% of total billed charges,28013.79,82.6,,,percent of total billed charges,82.6% of total billed charges,28013.79,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,40799.76,
STENT TRUNK/UP EXT EA ADD VEIN,84037239,CDM,361,RC,37239,HCPCS,Outpatient,,,16397,10658.05,,14429.36,88,,,percent of total billed charges,88% of total Billed charges,8198.5,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,8198.5,50,,,percent of total billed charges,50% of total Billed charges,10330.11,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9883.65,100,,,Fee Schedule,100% of WA Medicaid,2508.74,15.3,,,percent of total billed charges,15.3% of total billed charges,11313.93,69,,,percent of total billed charges,69% of total billed charges,16397,100,,,percent of total billed charges,100% of total billed charges,8198.5,50,,,percent of total billed charges,50% of total Billed charges,16397,100,,,percent of total billed charges,100% of total billed charges,8198.5,50,,,percent of total billed charges,50% of total Billed charges,16397,100,,,percent of total billed charges,100% of total billed charges,8198.5,50,,,percent of total billed charges,50% of total Billed charges,10141.54,61.85,,,percent of total billed charges,61.85% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8198.5,50,,,percent of total billed charges,50% of total Billed charges,8198.5,50,,,percent of total billed charges,50% of total Billed charges,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8198.5,50,,,percent of total billed charges,50% of total Billed charges,8198.5,50,,,percent of total billed charges,50% of total Billed charges,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,8198.5,50,,,percent of total billed charges,50% of total Billed charges,6181.67,37.7,,,percent of total billed charges,37.70% of total billed charges,6181.67,37.7,,,percent of total billed charges,37.70% of total billed charges,8198.5,50,,,percent of total billed charges,50% of total Billed charges,5558.58,33.9,,,percent of total billed charges,33.9% of total billed charges,8198.5,50,,,percent of total billed charges,50% of total Billed charges,12789.66,78,,,percent of total billed charges,78% of total billed charges,16397,100,,,percent of total billed charges,100% of total billed charges,13543.92,82.6,,,percent of total billed charges,82.6% of total billed charges,13543.92,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8198.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8198.5,50,,,percent of total billed charges,50% of total Billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2508.74,16397,
VAC EMBOL OCCLU IMAGE VENOUS,84037241,CDM,360,RC,37241,HCPCS,Outpatient,,,12266,7972.90,,10794.08,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7727.58,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,8463.54,69,,,percent of total billed charges,69% of total billed charges,12266,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12266,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12266,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,4624.28,37.7,,,percent of total billed charges,37.70% of total billed charges,4624.28,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,4158.17,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9567.48,78,,,percent of total billed charges,78% of total billed charges,12266,100,,,percent of total billed charges,100% of total billed charges,10131.72,82.6,,,percent of total billed charges,82.6% of total billed charges,10131.72,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3367,40799.76,
VAC EMBOL OCCLU IMAGE ARTERIAL,84037242,CDM,360,RC,37242,HCPCS,Outpatient,,,19113,12423.45,,16819.44,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,12041.19,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,13187.97,69,,,percent of total billed charges,69% of total billed charges,19113,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,19113,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,19113,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7205.6,37.7,,,percent of total billed charges,37.70% of total billed charges,7205.6,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,6479.31,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,14908.14,78,,,percent of total billed charges,78% of total billed charges,19113,100,,,percent of total billed charges,100% of total billed charges,15787.34,82.6,,,percent of total billed charges,82.6% of total billed charges,15787.34,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3367,40799.76,
EMBOLIZE/OCCLUSION FOR TUMORS,84037243,CDM,360,RC,37243,HCPCS,Outpatient,,,33177,21565.05,,29195.76,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,10180.16,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,20901.51,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,22892.13,69,,,percent of total billed charges,69% of total billed charges,33177,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,33177,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,33177,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7321.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10081.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12848.75,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,12507.73,37.7,,,percent of total billed charges,37.70% of total billed charges,12507.73,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11247,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,25878.06,78,,,percent of total billed charges,78% of total billed charges,33177,100,,,percent of total billed charges,100% of total billed charges,27404.2,82.6,,,percent of total billed charges,82.6% of total billed charges,27404.2,82.6,,,percent of total billed charges,82.6% of total billed charges,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9883.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3367,40799.76,
TRLUML BALO ANTIOP 1ST ART,84037246,CDM,360,RC,37246,HCPCS,Outpatient,,,1686,1095.90,,1483.68,88,,,percent of total billed charges,88% of total Billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,1686,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1062.18,63,,,percent of total billed charges,63% of total billed charges,10202.1,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1163.34,69,,,percent of total billed charges,69% of total billed charges,1686,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1686,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1686,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,20137.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,635.62,37.7,,,percent of total billed charges,37.70% of total billed charges,635.62,37.7,,,percent of total billed charges,37.70% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,571.55,33.9,,,percent of total billed charges,33.9% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1315.08,78,,,percent of total billed charges,78% of total billed charges,1686,100,,,percent of total billed charges,100% of total billed charges,1392.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1392.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5888.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,571.55,20137.31,
IR-TLUM BAL ANG 1STV,84037248,CDM,360,RC,37248,HCPCS,Outpatient,,,28437,18484.05,,25024.56,88,,,percent of total billed charges,88% of total Billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,17915.31,63,,,percent of total billed charges,63% of total billed charges,10202.1,175,,,Fee Schedule,175% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,19621.53,69,,,percent of total billed charges,69% of total billed charges,28437,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,28437,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,28437,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,20137.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10720.75,37.7,,,percent of total billed charges,37.70% of total billed charges,10720.75,37.7,,,percent of total billed charges,37.70% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9640.14,33.9,,,percent of total billed charges,33.9% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,22180.86,78,,,percent of total billed charges,78% of total billed charges,28437,100,,,percent of total billed charges,100% of total billed charges,23488.96,82.6,,,percent of total billed charges,82.6% of total billed charges,23488.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5888.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2386.68,28437,
IVUS PERIPHIAL ADDL SURG,84037251,CDM,361,RC,37251,HCPCS,Outpatient,,,7531,4895.15,,6627.28,88,,,percent of total billed charges,88% of total Billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,1265.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1303.16,17.304,,,percent of total billed charges,17.304% of total billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,4744.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1265.21,16.8,,,percent of total billed charges,16.8% of total billed charges,1152.24,15.3,,,percent of total billed charges,15.3% of total billed charges,5196.39,69,,,percent of total billed charges,69% of total billed charges,7531,100,,,percent of total billed charges,100% of total billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,7531,100,,,percent of total billed charges,100% of total billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,7531,100,,,percent of total billed charges,100% of total billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,4657.92,61.85,,,percent of total billed charges,61.85% of total billed charges,1265.21,16.8,,,percent of total billed charges,16.8% of total billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,1265.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,1290.51,17.136,,,percent of total billed charges,17.136% of total billed charges,1644.77,21.84,,,percent of total billed charges,21.84% of total billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,2839.19,37.7,,,percent of total billed charges,37.70% of total billed charges,2839.19,37.7,,,percent of total billed charges,37.70% of total billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,2553.01,33.9,,,percent of total billed charges,33.9% of total billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,5874.18,78,,,percent of total billed charges,78% of total billed charges,7531,100,,,percent of total billed charges,100% of total billed charges,6220.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6220.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1265.21,16.8,,,percent of total billed charges,16.8% of total billed charges,3765.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3765.5,50,,,percent of total billed charges,50% of total Billed charges,1265.21,16.8,,,percent of total billed charges,16.8% of total billed charges,1152.24,7531,
IVUS SUPERVISION SI,84037252,CDM,320,RC,37252,HCPCS,Outpatient,,,818,531.70,,719.84,88,,,percent of total billed charges,88% of total Billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,137.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,818,100,,,percent of total billed charges,100% of total billed charges,141.55,17.304,,,percent of total billed charges,17.304% of total billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,515.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,137.42,16.8,,,percent of total billed charges,16.8% of total billed charges,125.15,15.3,,,percent of total billed charges,15.3% of total billed charges,564.42,69,,,percent of total billed charges,69% of total billed charges,818,100,,,percent of total billed charges,100% of total billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,818,100,,,percent of total billed charges,100% of total billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,818,100,,,percent of total billed charges,100% of total billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,505.93,61.85,,,percent of total billed charges,61.85% of total billed charges,137.42,16.8,,,percent of total billed charges,16.8% of total billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,137.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,140.17,17.136,,,percent of total billed charges,17.136% of total billed charges,178.65,21.84,,,percent of total billed charges,21.84% of total billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,308.39,37.7,,,percent of total billed charges,37.70% of total billed charges,308.39,37.7,,,percent of total billed charges,37.70% of total billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,277.3,33.9,,,percent of total billed charges,33.9% of total billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,638.04,78,,,percent of total billed charges,78% of total billed charges,818,100,,,percent of total billed charges,100% of total billed charges,675.67,82.6,,,percent of total billed charges,82.6% of total billed charges,675.67,82.6,,,percent of total billed charges,82.6% of total billed charges,137.42,16.8,,,percent of total billed charges,16.8% of total billed charges,409,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,409,50,,,percent of total billed charges,50% of total Billed charges,137.42,16.8,,,percent of total billed charges,16.8% of total billed charges,125.15,818,
UNLISTED PROC VASC SURGERY,84037799,CDM,761,RC,37799,HCPCS,Outpatient,,,2509,1630.85,,2207.92,88,,,percent of total billed charges,88% of total Billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1955.89,100,,,Fee Schedule,100% of WA Medicaid,2509,100,,,percent of total billed charges,100% of total billed charges,2014.57,103,,,Fee Schedule,103% of WA Medicaid,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1580.67,63,,,percent of total billed charges,63% of total billed charges,1121.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,1955.89,100,,,Fee Schedule,100% of WA Medicaid,383.88,15.3,,,percent of total billed charges,15.3% of total billed charges,1731.21,69,,,percent of total billed charges,69% of total billed charges,2509,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2509,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2509,100,,,percent of total billed charges,100% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2200.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1955.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1995.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2542.66,130,,,Fee Schedule,130% of WA Medicaid ,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,945.89,37.7,,,percent of total billed charges,37.70% of total billed charges,945.89,37.7,,,percent of total billed charges,37.70% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,850.55,33.9,,,percent of total billed charges,33.9% of total billed charges,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1957.02,78,,,percent of total billed charges,78% of total billed charges,2509,100,,,percent of total billed charges,100% of total billed charges,2072.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2072.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1955.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,647.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1955.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,383.88,2542.66,
BONE MARROW BX SURG,84038221,CDM,361,RC,38221,HCPCS,Outpatient,,,2383,1548.95,,2097.04,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,2383,100,,,percent of total billed charges,100% of total billed charges,1102.48,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1501.29,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,364.6,15.3,,,percent of total billed charges,15.3% of total billed charges,1644.27,69,,,percent of total billed charges,69% of total billed charges,2383,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2383,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2383,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,792.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1091.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1391.48,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,898.39,37.7,,,percent of total billed charges,37.70% of total billed charges,898.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,807.84,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1858.74,78,,,percent of total billed charges,78% of total billed charges,2383,100,,,percent of total billed charges,100% of total billed charges,1968.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1968.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,364.6,5715.97,
"Drug-induced sleep endoscopy, with dynamic evaluation of vel",36042975,CDM,360,RC,42975,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,317.52,63,,,percent of total billed charges,63% of total billed charges,3029.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,504,100,,,percent of total billed charges,100% of total billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,504,100,,,percent of total billed charges,100% of total billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,311.72,61.85,,,percent of total billed charges,61.85% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,170.86,33.9,,,percent of total billed charges,33.9% of total billed charges,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1748.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1731.14,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,3367,
PLACE NASO/ORO-GASTRIC TUBE,84043752,CDM,361,RC,43752,HCPCS,Outpatient,,,256,166.40,,225.28,88,,,percent of total billed charges,88% of total Billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,256,100,,,percent of total billed charges,100% of total billed charges,624,103,,,Fee Schedule,103% of WA Medicaid,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,161.28,63,,,percent of total billed charges,63% of total billed charges,711.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,39.17,15.3,,,percent of total billed charges,15.3% of total billed charges,176.64,69,,,percent of total billed charges,69% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,256,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,256,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1097.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,617.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.58,130,,,Fee Schedule,130% of WA Medicaid ,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,96.51,37.7,,,percent of total billed charges,37.70% of total billed charges,96.51,37.7,,,percent of total billed charges,37.70% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,86.78,33.9,,,percent of total billed charges,33.9% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,199.68,78,,,percent of total billed charges,78% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,410.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.17,1097.77,
REPO NASO/ORO GASTRC FEED TUBE,84043761,CDM,361,RC,43761,HCPCS,Outpatient,,,2607,1694.55,,2294.16,88,,,percent of total billed charges,88% of total Billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,2607,100,,,percent of total billed charges,100% of total billed charges,624,103,,,Fee Schedule,103% of WA Medicaid,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1642.41,63,,,percent of total billed charges,63% of total billed charges,441.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,398.87,15.3,,,percent of total billed charges,15.3% of total billed charges,1798.83,69,,,percent of total billed charges,69% of total billed charges,2607,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,2607,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,2607,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1081.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,617.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.58,130,,,Fee Schedule,130% of WA Medicaid ,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,982.84,37.7,,,percent of total billed charges,37.70% of total billed charges,982.84,37.7,,,percent of total billed charges,37.70% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,883.77,33.9,,,percent of total billed charges,33.9% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,2033.46,78,,,percent of total billed charges,78% of total billed charges,2607,100,,,percent of total billed charges,100% of total billed charges,2153.38,82.6,,,percent of total billed charges,82.6% of total billed charges,2153.38,82.6,,,percent of total billed charges,82.6% of total billed charges,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,254.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,252.08,2607,
IR CHOLE DRAIN CHECK (BOTH),84047531,CDM,360,RC,47531,HCPCS,Outpatient,,,629,408.85,,553.52,88,,,percent of total billed charges,88% of total Billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,629,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,396.27,63,,,percent of total billed charges,63% of total billed charges,6175.28,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,434.01,69,,,percent of total billed charges,69% of total billed charges,629,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,629,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,629,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,12932.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,237.13,37.7,,,percent of total billed charges,37.70% of total billed charges,237.13,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,213.23,33.9,,,percent of total billed charges,33.9% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,490.62,78,,,percent of total billed charges,78% of total billed charges,629,100,,,percent of total billed charges,100% of total billed charges,519.55,82.6,,,percent of total billed charges,82.6% of total billed charges,519.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3564.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,213.23,12932.7,
IR PERC CHOLANGIOGRAM GALLBLAD,84047532,CDM,360,RC,47532,HCPCS,Outpatient,,,1399,909.35,,1231.12,88,,,percent of total billed charges,88% of total Billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1399,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,881.37,63,,,percent of total billed charges,63% of total billed charges,6175.28,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,965.31,69,,,percent of total billed charges,69% of total billed charges,1399,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1399,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1399,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,12932.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,527.42,37.7,,,percent of total billed charges,37.70% of total billed charges,527.42,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,474.26,33.9,,,percent of total billed charges,33.9% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1091.22,78,,,percent of total billed charges,78% of total billed charges,1399,100,,,percent of total billed charges,100% of total billed charges,1155.57,82.6,,,percent of total billed charges,82.6% of total billed charges,1155.57,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3564.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,474.26,12932.7,
IR PTC EXT (BILLARY SYSTEM),84047533,CDM,360,RC,47533,HCPCS,Outpatient,,,1966,1277.90,,1730.08,88,,,percent of total billed charges,88% of total Billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,1966,100,,,percent of total billed charges,100% of total billed charges,2337.65,103,,,Fee Schedule,103% of WA Medicaid,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1238.58,63,,,percent of total billed charges,63% of total billed charges,6175.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1356.54,69,,,percent of total billed charges,69% of total billed charges,1966,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1966,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1966,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,12932.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1681.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2314.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2950.43,130,,,Fee Schedule,130% of WA Medicaid ,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,741.18,37.7,,,percent of total billed charges,37.70% of total billed charges,741.18,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,666.47,33.9,,,percent of total billed charges,33.9% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1533.48,78,,,percent of total billed charges,78% of total billed charges,1966,100,,,percent of total billed charges,100% of total billed charges,1623.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1623.92,82.6,,,percent of total billed charges,82.6% of total billed charges,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3564.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,666.47,12932.7,
IR PTC IN/EXT (BILLARY SYSTEM),84047534,CDM,360,RC,47534,HCPCS,Outpatient,,,2519,1637.35,,2216.72,88,,,percent of total billed charges,88% of total Billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,2519,100,,,percent of total billed charges,100% of total billed charges,2337.65,103,,,Fee Schedule,103% of WA Medicaid,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1586.97,63,,,percent of total billed charges,63% of total billed charges,6175.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1738.11,69,,,percent of total billed charges,69% of total billed charges,2519,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2519,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2519,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,12932.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1681.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2314.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2950.43,130,,,Fee Schedule,130% of WA Medicaid ,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,949.66,37.7,,,percent of total billed charges,37.70% of total billed charges,949.66,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,853.94,33.9,,,percent of total billed charges,33.9% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1964.82,78,,,percent of total billed charges,78% of total billed charges,2519,100,,,percent of total billed charges,100% of total billed charges,2080.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2080.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3564.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,853.94,12932.7,
IR PTC CONV EXT TO INT BILLSYS,84047535,CDM,360,RC,47535,HCPCS,Outpatient,,,1448,941.20,,1274.24,88,,,percent of total billed charges,88% of total Billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,1448,100,,,percent of total billed charges,100% of total billed charges,2337.65,103,,,Fee Schedule,103% of WA Medicaid,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,912.24,63,,,percent of total billed charges,63% of total billed charges,6175.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,999.12,69,,,percent of total billed charges,69% of total billed charges,1448,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1448,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1448,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,12932.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1681.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2314.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2950.43,130,,,Fee Schedule,130% of WA Medicaid ,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,545.9,37.7,,,percent of total billed charges,37.70% of total billed charges,545.9,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,490.87,33.9,,,percent of total billed charges,33.9% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1129.44,78,,,percent of total billed charges,78% of total billed charges,1448,100,,,percent of total billed charges,100% of total billed charges,1196.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1196.05,82.6,,,percent of total billed charges,82.6% of total billed charges,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3564.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,490.87,12932.7,
IR CHOLE DRAIN EXCHANGE (BOTH),84047536,CDM,360,RC,47536,HCPCS,Outpatient,,,930,604.50,,818.4,88,,,percent of total billed charges,88% of total Billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,930,100,,,percent of total billed charges,100% of total billed charges,2337.65,103,,,Fee Schedule,103% of WA Medicaid,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,585.9,63,,,percent of total billed charges,63% of total billed charges,6175.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,641.7,69,,,percent of total billed charges,69% of total billed charges,930,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,930,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,930,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,12932.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,1681.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2314.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2950.43,130,,,Fee Schedule,130% of WA Medicaid ,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,350.61,37.7,,,percent of total billed charges,37.70% of total billed charges,350.61,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,315.27,33.9,,,percent of total billed charges,33.9% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,725.4,78,,,percent of total billed charges,78% of total billed charges,930,100,,,percent of total billed charges,100% of total billed charges,768.18,82.6,,,percent of total billed charges,82.6% of total billed charges,768.18,82.6,,,percent of total billed charges,82.6% of total billed charges,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3564.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,315.27,12932.7,
IR CHOLE DRAIN REMOVAL (BOTH),84047537,CDM,360,RC,47537,HCPCS,Outpatient,,,622,404.30,,547.36,88,,,percent of total billed charges,88% of total Billed charges,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,622,100,,,percent of total billed charges,100% of total billed charges,624,103,,,Fee Schedule,103% of WA Medicaid,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,391.86,63,,,percent of total billed charges,63% of total billed charges,1618.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,429.18,69,,,percent of total billed charges,69% of total billed charges,622,100,,,percent of total billed charges,100% of total billed charges,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,622,100,,,percent of total billed charges,100% of total billed charges,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,622,100,,,percent of total billed charges,100% of total billed charges,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,617.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.58,130,,,Fee Schedule,130% of WA Medicaid ,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,234.49,37.7,,,percent of total billed charges,37.70% of total billed charges,234.49,37.7,,,percent of total billed charges,37.70% of total billed charges,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,210.86,33.9,,,percent of total billed charges,33.9% of total billed charges,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,485.16,78,,,percent of total billed charges,78% of total billed charges,622,100,,,percent of total billed charges,100% of total billed charges,513.77,82.6,,,percent of total billed charges,82.6% of total billed charges,513.77,82.6,,,percent of total billed charges,82.6% of total billed charges,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,933.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.58,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.86,3367,
EX CHOLE PTA/STENT W/O (DRAIN),84047538,CDM,360,RC,47538,HCPCS,Outpatient,,,2069,1344.85,,1820.72,88,,,percent of total billed charges,88% of total Billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,2069,100,,,percent of total billed charges,100% of total billed charges,2337.65,103,,,Fee Schedule,103% of WA Medicaid,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1303.47,63,,,percent of total billed charges,63% of total billed charges,10299.04,175,,,Fee Schedule,175% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1427.61,69,,,percent of total billed charges,69% of total billed charges,2069,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2069,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2069,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,20558.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1681.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2314.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2950.43,130,,,Fee Schedule,130% of WA Medicaid ,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,780.01,37.7,,,percent of total billed charges,37.70% of total billed charges,780.01,37.7,,,percent of total billed charges,37.70% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,701.39,33.9,,,percent of total billed charges,33.9% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1613.82,78,,,percent of total billed charges,78% of total billed charges,2069,100,,,percent of total billed charges,100% of total billed charges,1708.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1708.99,82.6,,,percent of total billed charges,82.6% of total billed charges,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5944.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,701.39,20558.19,
NEW CHOLE PTA/STENT W/O DRAIN,84047539,CDM,360,RC,47539,HCPCS,Outpatient,,,2792,1814.80,,2456.96,88,,,percent of total billed charges,88% of total Billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,2792,100,,,percent of total billed charges,100% of total billed charges,2337.65,103,,,Fee Schedule,103% of WA Medicaid,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1758.96,63,,,percent of total billed charges,63% of total billed charges,10299.04,175,,,Fee Schedule,175% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1926.48,69,,,percent of total billed charges,69% of total billed charges,2792,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2792,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2792,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,20558.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1681.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2314.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2950.43,130,,,Fee Schedule,130% of WA Medicaid ,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1052.58,37.7,,,percent of total billed charges,37.70% of total billed charges,1052.58,37.7,,,percent of total billed charges,37.70% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,946.49,33.9,,,percent of total billed charges,33.9% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2177.76,78,,,percent of total billed charges,78% of total billed charges,2792,100,,,percent of total billed charges,100% of total billed charges,2306.19,82.6,,,percent of total billed charges,82.6% of total billed charges,2306.19,82.6,,,percent of total billed charges,82.6% of total billed charges,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5944.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2269.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,946.49,20558.19,
NEW CHOLE PTA/STENT W/DRAIN,84047540,CDM,360,RC,47540,HCPCS,Outpatient,,,3332,2165.80,,2932.16,88,,,percent of total billed charges,88% of total Billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5749.65,100,,,Fee Schedule,100% of WA Medicaid,3332,100,,,percent of total billed charges,100% of total billed charges,5922.14,103,,,Fee Schedule,103% of WA Medicaid,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2099.16,63,,,percent of total billed charges,63% of total billed charges,10299.04,175,,,Fee Schedule,175% of Medicare OPPS Rate,5749.65,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2299.08,69,,,percent of total billed charges,69% of total billed charges,3332,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,3332,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,3332,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,20558.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5749.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4259,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5864.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7474.55,130,,,Fee Schedule,130% of WA Medicaid ,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1256.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1256.16,37.7,,,percent of total billed charges,37.70% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1129.55,33.9,,,percent of total billed charges,33.9% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2598.96,78,,,percent of total billed charges,78% of total billed charges,3332,100,,,percent of total billed charges,100% of total billed charges,2752.23,82.6,,,percent of total billed charges,82.6% of total billed charges,2752.23,82.6,,,percent of total billed charges,82.6% of total billed charges,5749.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5944.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5749.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1129.55,20558.19,
PERC DIL BILIARY W/O STENT SUR,84047555,CDM,361,RC,47555,HCPCS,Outpatient,,,8689,5647.85,,7646.32,88,,,percent of total billed charges,88% of total Billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3987.05,103,,,Fee Schedule,103% of WA Medicaid,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,5474.07,63,,,percent of total billed charges,63% of total billed charges,6175.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid,1329.42,15.3,,,percent of total billed charges,15.3% of total billed charges,5995.41,69,,,percent of total billed charges,69% of total billed charges,8689,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,8689,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,8689,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,12932.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2867.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3948.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5032.19,130,,,Fee Schedule,130% of WA Medicaid ,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3275.75,37.7,,,percent of total billed charges,37.70% of total billed charges,3275.75,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2945.57,33.9,,,percent of total billed charges,33.9% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,6777.42,78,,,percent of total billed charges,78% of total billed charges,8689,100,,,percent of total billed charges,100% of total billed charges,7177.11,82.6,,,percent of total billed charges,82.6% of total billed charges,7177.11,82.6,,,percent of total billed charges,82.6% of total billed charges,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3564.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1329.42,12932.7,
BILIARY STENT PLACE SURG,84047556,CDM,361,RC,47556,HCPCS,Outpatient,,,15481,10062.65,,13623.28,88,,,percent of total billed charges,88% of total Billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3987.05,103,,,Fee Schedule,103% of WA Medicaid,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,9753.03,63,,,percent of total billed charges,63% of total billed charges,18373.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid,2368.59,15.3,,,percent of total billed charges,15.3% of total billed charges,10681.89,69,,,percent of total billed charges,69% of total billed charges,15481,100,,,percent of total billed charges,100% of total billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,15481,100,,,percent of total billed charges,100% of total billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,15481,100,,,percent of total billed charges,100% of total billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,20558.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2867.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3948.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5032.19,130,,,Fee Schedule,130% of WA Medicaid ,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,5836.34,37.7,,,percent of total billed charges,37.70% of total billed charges,5836.34,37.7,,,percent of total billed charges,37.70% of total billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,5248.06,33.9,,,percent of total billed charges,33.9% of total billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,12075.18,78,,,percent of total billed charges,78% of total billed charges,15481,100,,,percent of total billed charges,100% of total billed charges,12787.31,82.6,,,percent of total billed charges,82.6% of total billed charges,12787.31,82.6,,,percent of total billed charges,82.6% of total billed charges,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,10604.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2368.59,20558.19,
CHOLEDONCHAL STENT SURG,84047801,CDM,361,RC,47801,HCPCS,Outpatient,,,696,452.40,,612.48,88,,,percent of total billed charges,88% of total Billed charges,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5749.65,100,,,Fee Schedule,100% of WA Medicaid,696,100,,,percent of total billed charges,100% of total billed charges,5922.14,103,,,Fee Schedule,103% of WA Medicaid,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,438.48,63,,,percent of total billed charges,63% of total billed charges,696,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5749.65,100,,,Fee Schedule,100% of WA Medicaid,106.49,15.3,,,percent of total billed charges,15.3% of total billed charges,480.24,69,,,percent of total billed charges,69% of total billed charges,696,100,,,percent of total billed charges,100% of total billed charges,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,696,100,,,percent of total billed charges,100% of total billed charges,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,696,100,,,percent of total billed charges,100% of total billed charges,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,696,100,,,Fee Schedule,Pays at line item charges due to status indicator C,5749.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,4259,100,,,Fee Schedule,100% of WA Medicare OPPS rate,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5864.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7474.55,130,,,Fee Schedule,130% of WA Medicaid ,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,262.39,37.7,,,percent of total billed charges,37.70% of total billed charges,262.39,37.7,,,percent of total billed charges,37.70% of total billed charges,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,235.94,33.9,,,percent of total billed charges,33.9% of total billed charges,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,542.88,78,,,percent of total billed charges,78% of total billed charges,696,100,,,percent of total billed charges,100% of total billed charges,574.9,82.6,,,percent of total billed charges,82.6% of total billed charges,574.9,82.6,,,percent of total billed charges,82.6% of total billed charges,5749.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,696,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,696,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5749.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.49,7474.55,
PARACENTESIS: IMAGING GUIDED,36049083,CDM,360,RC,49083,HCPCS,Outpatient,,,1979,1286.35,,1741.52,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,1979,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1246.77,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1365.51,69,,,percent of total billed charges,69% of total billed charges,1979,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1979,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1979,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,746.08,37.7,,,percent of total billed charges,37.70% of total billed charges,746.08,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,670.88,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1543.62,78,,,percent of total billed charges,78% of total billed charges,1979,100,,,percent of total billed charges,100% of total billed charges,1634.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1634.65,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,493.23,3367,
Abdominal paracentesis (diagnostic or therapeutic); with ima,84049083,CDM,761,RC,49083,HCPCS,Outpatient,,,1979,1286.35,,1741.52,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,1979,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1246.77,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,302.79,15.3,,,percent of total billed charges,15.3% of total billed charges,1365.51,69,,,percent of total billed charges,69% of total billed charges,1979,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1979,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1979,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,746.08,37.7,,,percent of total billed charges,37.70% of total billed charges,746.08,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,670.88,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1543.62,78,,,percent of total billed charges,78% of total billed charges,1979,100,,,percent of total billed charges,100% of total billed charges,1634.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1634.65,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,302.79,3289.02,
"49185 SCLEROTHERAPY OF A FLUID COLLECTION (EG, LYMPHOCELE, C",76149185,CDM,761,RC,49185,HCPCS,Outpatient,,,9041,5876.65,,7956.08,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5695.83,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,1383.27,15.3,,,percent of total billed charges,15.3% of total billed charges,6238.29,69,,,percent of total billed charges,69% of total billed charges,9041,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,9041,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,9041,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3408.46,37.7,,,percent of total billed charges,37.70% of total billed charges,3408.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3064.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,7051.98,78,,,percent of total billed charges,78% of total billed charges,9041,100,,,percent of total billed charges,100% of total billed charges,7467.87,82.6,,,percent of total billed charges,82.6% of total billed charges,7467.87,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,493.23,9041,
DRAIN/CATHETER W/IMAGING,84049406,CDM,360,RC,49406,HCPCS,Outpatient,,,4754,3090.10,,4183.52,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2995.02,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,3280.26,69,,,percent of total billed charges,69% of total billed charges,4754,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4754,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4754,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1792.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1792.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1611.61,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3708.12,78,,,percent of total billed charges,78% of total billed charges,4754,100,,,percent of total billed charges,100% of total billed charges,3926.8,82.6,,,percent of total billed charges,82.6% of total billed charges,3926.8,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,493.23,5715.97,
INSERTION PD CATHETER,84049421,CDM,360,RC,49421,HCPCS,Outpatient,,,6923,4499.95,,6092.24,88,,,percent of total billed charges,88% of total Billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3355.36,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3456.02,103,,,Fee Schedule,103% of WA Medicaid,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,4361.49,63,,,percent of total billed charges,63% of total billed charges,6175.27,175,,,Fee Schedule,175% of Medicare OPPS Rate,3355.36,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4776.87,69,,,percent of total billed charges,69% of total billed charges,6923,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,6923,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,6923,100,,,percent of total billed charges,100% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,12932.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3355.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2485.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3422.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4361.97,130,,,Fee Schedule,130% of WA Medicaid ,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2609.97,37.7,,,percent of total billed charges,37.70% of total billed charges,2609.97,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,2346.9,33.9,,,percent of total billed charges,33.9% of total billed charges,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,5399.94,78,,,percent of total billed charges,78% of total billed charges,6923,100,,,percent of total billed charges,100% of total billed charges,5718.4,82.6,,,percent of total billed charges,82.6% of total billed charges,5718.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3355.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3564.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3528.73,100,,,Fee Schedule,100% of Medicare OPPS rate,3355.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2346.9,12932.7,
REMOVAL OF PD CATH,84049422,CDM,360,RC,49422,HCPCS,Outpatient,,,1780,1157.00,,1566.4,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,1780,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1121.4,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1228.2,69,,,percent of total billed charges,69% of total billed charges,1780,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1780,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1780,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,671.06,37.7,,,percent of total billed charges,37.70% of total billed charges,671.06,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,603.42,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1388.4,78,,,percent of total billed charges,78% of total billed charges,1780,100,,,percent of total billed charges,100% of total billed charges,1470.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1470.28,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,493.23,11625.58,
PLACE GASTROSTOMY TUBE PERC,84049440,CDM,360,RC,49440,HCPCS,Outpatient,,,1067,693.55,,938.96,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,1067,100,,,percent of total billed charges,100% of total billed charges,624,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,672.21,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,736.23,69,,,percent of total billed charges,69% of total billed charges,1067,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1067,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1067,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,617.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.58,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,402.26,37.7,,,percent of total billed charges,37.70% of total billed charges,402.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,361.71,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,832.26,78,,,percent of total billed charges,78% of total billed charges,1067,100,,,percent of total billed charges,100% of total billed charges,881.34,82.6,,,percent of total billed charges,82.6% of total billed charges,881.34,82.6,,,percent of total billed charges,82.6% of total billed charges,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,361.71,6601.69,
GASTRO TUBE CHGN SURG,84049450,CDM,361,RC,49450,HCPCS,Outpatient,,,890,578.50,,783.2,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,890,100,,,percent of total billed charges,100% of total billed charges,624,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,560.7,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,136.17,15.3,,,percent of total billed charges,15.3% of total billed charges,614.1,69,,,percent of total billed charges,69% of total billed charges,890,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,890,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,890,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,617.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.58,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,335.53,37.7,,,percent of total billed charges,37.70% of total billed charges,335.53,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,301.71,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,694.2,78,,,percent of total billed charges,78% of total billed charges,890,100,,,percent of total billed charges,100% of total billed charges,735.14,82.6,,,percent of total billed charges,82.6% of total billed charges,735.14,82.6,,,percent of total billed charges,82.6% of total billed charges,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,136.17,3289.02,
49451 REPLACE DUOD/JEJ TUBE PERC,84049451,CDM,761,RC,49451,HCPCS,Outpatient,,,3281,2132.65,,2887.28,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,3281,100,,,percent of total billed charges,100% of total billed charges,624,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2067.03,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,501.99,15.3,,,percent of total billed charges,15.3% of total billed charges,2263.89,69,,,percent of total billed charges,69% of total billed charges,3281,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3281,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3281,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,617.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.58,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1236.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1236.94,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1112.26,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2559.18,78,,,percent of total billed charges,78% of total billed charges,3281,100,,,percent of total billed charges,100% of total billed charges,2710.11,82.6,,,percent of total billed charges,82.6% of total billed charges,2710.11,82.6,,,percent of total billed charges,82.6% of total billed charges,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,448.76,3289.02,
CON INJECT OF EXIST STOMY TUBE,84049465,CDM,360,RC,49465,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,122.22,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,194,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,65.77,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.77,3367,
IR NEPH TUBE REMOVAL,84050389,CDM,360,RC,50389,HCPCS,Outpatient,,,339,220.35,,298.32,88,,,percent of total billed charges,88% of total Billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,342.36,100,,,Fee Schedule,100% of WA Medicaid,339,100,,,percent of total billed charges,100% of total billed charges,352.63,103,,,Fee Schedule,103% of WA Medicaid,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,213.57,63,,,percent of total billed charges,63% of total billed charges,1219.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,342.36,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,233.91,69,,,percent of total billed charges,69% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,339,100,,,percent of total billed charges,100% of total billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,339,100,,,percent of total billed charges,100% of total billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2335.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,253.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,349.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,445.07,130,,,Fee Schedule,130% of WA Medicaid ,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,114.92,33.9,,,percent of total billed charges,33.9% of total billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,264.42,78,,,percent of total billed charges,78% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,703.71,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.92,3367,
IR NEPH TUBE CHECK,84050431,CDM,360,RC,50431,HCPCS,Outpatient,,,428,278.20,,376.64,88,,,percent of total billed charges,88% of total Billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,342.36,100,,,Fee Schedule,100% of WA Medicaid,428,100,,,percent of total billed charges,100% of total billed charges,352.63,103,,,Fee Schedule,103% of WA Medicaid,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,269.64,63,,,percent of total billed charges,63% of total billed charges,1219.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,342.36,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,295.32,69,,,percent of total billed charges,69% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,428,100,,,percent of total billed charges,100% of total billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,428,100,,,percent of total billed charges,100% of total billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2335.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,253.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,349.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,445.07,130,,,Fee Schedule,130% of WA Medicaid ,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,145.09,33.9,,,percent of total billed charges,33.9% of total billed charges,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,333.84,78,,,percent of total billed charges,78% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,703.71,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,696.74,100,,,Fee Schedule,100% of Medicare OPPS rate,342.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,145.09,3367,
IR NEPH TUBE PLACEMENT,84050432,CDM,360,RC,50432,HCPCS,Outpatient,,,1396,907.40,,1228.48,88,,,percent of total billed charges,88% of total Billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,1396,100,,,percent of total billed charges,100% of total billed charges,1400.69,103,,,Fee Schedule,103% of WA Medicaid,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,879.48,63,,,percent of total billed charges,63% of total billed charges,3635.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,963.24,69,,,percent of total billed charges,69% of total billed charges,1396,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1396,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1396,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,7284.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1007.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1387.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1767.86,130,,,Fee Schedule,130% of WA Medicaid ,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,526.29,37.7,,,percent of total billed charges,37.70% of total billed charges,526.29,37.7,,,percent of total billed charges,37.70% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,473.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1088.88,78,,,percent of total billed charges,78% of total billed charges,1396,100,,,percent of total billed charges,100% of total billed charges,1153.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1153.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2098.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,473.24,7284.07,
IR NEPHROURETERAL PLACEMENT,84050433,CDM,360,RC,50433,HCPCS,Outpatient,,,1717,1116.05,,1510.96,88,,,percent of total billed charges,88% of total Billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid,1717,100,,,percent of total billed charges,100% of total billed charges,2730.36,103,,,Fee Schedule,103% of WA Medicaid,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1081.71,63,,,percent of total billed charges,63% of total billed charges,6222.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1184.73,69,,,percent of total billed charges,69% of total billed charges,1717,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1717,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1717,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,12497.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1963.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2703.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3446.08,130,,,Fee Schedule,130% of WA Medicaid ,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,647.31,37.7,,,percent of total billed charges,37.70% of total billed charges,647.31,37.7,,,percent of total billed charges,37.70% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,582.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1339.26,78,,,percent of total billed charges,78% of total billed charges,1717,100,,,percent of total billed charges,100% of total billed charges,1418.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1418.24,82.6,,,percent of total billed charges,82.6% of total billed charges,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3591.3,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,582.06,12497.73,
IR NEPHROURETERAL CONVERSION,84050434,CDM,360,RC,50434,HCPCS,Outpatient,,,1319,857.35,,1160.72,88,,,percent of total billed charges,88% of total Billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,1319,100,,,percent of total billed charges,100% of total billed charges,1400.69,103,,,Fee Schedule,103% of WA Medicaid,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,830.97,63,,,percent of total billed charges,63% of total billed charges,3635.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,910.11,69,,,percent of total billed charges,69% of total billed charges,1319,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1319,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1319,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,7284.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1007.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1387.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1767.86,130,,,Fee Schedule,130% of WA Medicaid ,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,497.26,37.7,,,percent of total billed charges,37.70% of total billed charges,497.26,37.7,,,percent of total billed charges,37.70% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,447.14,33.9,,,percent of total billed charges,33.9% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1028.82,78,,,percent of total billed charges,78% of total billed charges,1319,100,,,percent of total billed charges,100% of total billed charges,1089.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1089.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2098.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,447.14,7284.07,
IR NEPH TUBE EXCHANGE,84050435,CDM,360,RC,50435,HCPCS,Outpatient,,,649,421.85,,571.12,88,,,percent of total billed charges,88% of total Billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,649,100,,,percent of total billed charges,100% of total billed charges,1400.69,103,,,Fee Schedule,103% of WA Medicaid,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,408.87,63,,,percent of total billed charges,63% of total billed charges,3635.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,447.81,69,,,percent of total billed charges,69% of total billed charges,649,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,649,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,649,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,7284.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1007.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1387.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1767.86,130,,,Fee Schedule,130% of WA Medicaid ,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,244.67,37.7,,,percent of total billed charges,37.70% of total billed charges,244.67,37.7,,,percent of total billed charges,37.70% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,220.01,33.9,,,percent of total billed charges,33.9% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,506.22,78,,,percent of total billed charges,78% of total billed charges,649,100,,,percent of total billed charges,100% of total billed charges,536.07,82.6,,,percent of total billed charges,82.6% of total billed charges,536.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2098.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,220.01,7284.07,
CHG URETERO CATH SURG,84050688,CDM,361,RC,50688,HCPCS,Outpatient,,,5026,3266.90,,4422.88,88,,,percent of total billed charges,88% of total Billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1400.69,103,,,Fee Schedule,103% of WA Medicaid,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,3166.38,63,,,percent of total billed charges,63% of total billed charges,3635.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,768.98,15.3,,,percent of total billed charges,15.3% of total billed charges,3467.94,69,,,percent of total billed charges,69% of total billed charges,5026,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,5026,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,5026,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,7284.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1007.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1387.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1767.86,130,,,Fee Schedule,130% of WA Medicaid ,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1894.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1894.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1703.81,33.9,,,percent of total billed charges,33.9% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,3920.28,78,,,percent of total billed charges,78% of total billed charges,5026,100,,,percent of total billed charges,100% of total billed charges,4151.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4151.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2098.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,768.98,7284.07,
IR EXIST ACCESS URETERAL STENT,84050693,CDM,360,RC,50693,HCPCS,Outpatient,,,1380,897.00,,1214.4,88,,,percent of total billed charges,88% of total Billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid,1380,100,,,percent of total billed charges,100% of total billed charges,2730.36,103,,,Fee Schedule,103% of WA Medicaid,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,869.4,63,,,percent of total billed charges,63% of total billed charges,6222.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,952.2,69,,,percent of total billed charges,69% of total billed charges,1380,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1380,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1380,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,12497.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1963.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2703.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3446.08,130,,,Fee Schedule,130% of WA Medicaid ,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,520.26,37.7,,,percent of total billed charges,37.70% of total billed charges,520.26,37.7,,,percent of total billed charges,37.70% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,467.82,33.9,,,percent of total billed charges,33.9% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1076.4,78,,,percent of total billed charges,78% of total billed charges,1380,100,,,percent of total billed charges,100% of total billed charges,1139.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1139.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3591.3,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,467.82,12497.73,
NEW ACCESS URET STENT W/ODRAIN,84050694,CDM,360,RC,50694,HCPCS,Outpatient,,,1843,1197.95,,1621.84,88,,,percent of total billed charges,88% of total Billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid,1843,100,,,percent of total billed charges,100% of total billed charges,2730.36,103,,,Fee Schedule,103% of WA Medicaid,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1161.09,63,,,percent of total billed charges,63% of total billed charges,6222.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1271.67,69,,,percent of total billed charges,69% of total billed charges,1843,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1843,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1843,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,12497.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1963.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2703.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3446.08,130,,,Fee Schedule,130% of WA Medicaid ,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,694.81,37.7,,,percent of total billed charges,37.70% of total billed charges,694.81,37.7,,,percent of total billed charges,37.70% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,624.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1437.54,78,,,percent of total billed charges,78% of total billed charges,1843,100,,,percent of total billed charges,100% of total billed charges,1522.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1522.32,82.6,,,percent of total billed charges,82.6% of total billed charges,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3591.3,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,624.78,12497.73,
NEW ACCESS URET STENT W/DRAIN,84050695,CDM,360,RC,50695,HCPCS,Outpatient,,,2255,1465.75,,1984.4,88,,,percent of total billed charges,88% of total Billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid,2255,100,,,percent of total billed charges,100% of total billed charges,2730.36,103,,,Fee Schedule,103% of WA Medicaid,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1420.65,63,,,percent of total billed charges,63% of total billed charges,6222.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1555.95,69,,,percent of total billed charges,69% of total billed charges,2255,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2255,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2255,100,,,percent of total billed charges,100% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,12497.73,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1963.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2703.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3446.08,130,,,Fee Schedule,130% of WA Medicaid ,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,850.14,37.7,,,percent of total billed charges,37.70% of total billed charges,850.14,37.7,,,percent of total billed charges,37.70% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,764.45,33.9,,,percent of total billed charges,33.9% of total billed charges,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1758.9,78,,,percent of total billed charges,78% of total billed charges,2255,100,,,percent of total billed charges,100% of total billed charges,1862.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1862.63,82.6,,,percent of total billed charges,82.6% of total billed charges,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,3591.3,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3555.75,100,,,Fee Schedule,100% of Medicare OPPS rate,2650.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,764.45,12497.73,
ASPIRATION OF BLADDER,84051102,CDM,360,RC,51102,HCPCS,Outpatient,,,770,500.50,,677.6,88,,,percent of total billed charges,88% of total Billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1405.94,100,,,Fee Schedule,100% of WA Medicaid,770,100,,,percent of total billed charges,100% of total billed charges,1448.12,103,,,Fee Schedule,103% of WA Medicaid,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,485.1,63,,,percent of total billed charges,63% of total billed charges,3635.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,1405.94,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,531.3,69,,,percent of total billed charges,69% of total billed charges,770,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,770,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,770,100,,,percent of total billed charges,100% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,7284.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1405.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1041.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1434.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1827.72,130,,,Fee Schedule,130% of WA Medicaid ,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,290.29,37.7,,,percent of total billed charges,37.70% of total billed charges,290.29,37.7,,,percent of total billed charges,37.70% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,261.03,33.9,,,percent of total billed charges,33.9% of total billed charges,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,600.6,78,,,percent of total billed charges,78% of total billed charges,770,100,,,percent of total billed charges,100% of total billed charges,636.02,82.6,,,percent of total billed charges,82.6% of total billed charges,636.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1405.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,2098.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2077.46,100,,,Fee Schedule,100% of Medicare OPPS rate,1405.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,261.03,7284.07,
INS CATH FOLEY SIMPLE,84051702,CDM,361,RC,51702,HCPCS,Outpatient,,,532,345.80,,468.16,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,532,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,335.16,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,81.4,15.3,,,percent of total billed charges,15.3% of total billed charges,367.08,69,,,percent of total billed charges,69% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,532,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,532,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,48.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,180.35,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,414.96,78,,,percent of total billed charges,78% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.07,532,
51702 CATHETER INSERTION FOLEY,AMB820027,CDM,761,RC,51702,HCPCS,Outpatient,,,532,345.80,,468.16,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,532,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,335.16,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,81.4,15.3,,,percent of total billed charges,15.3% of total billed charges,367.08,69,,,percent of total billed charges,69% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,532,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,532,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,48.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,180.35,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,414.96,78,,,percent of total billed charges,78% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.07,532,
excision procedures on the cervix uter,76157500,CDM,761,RC,57500,HCPCS,Outpatient,,,2266,1472.90,,1994.08,88,,,percent of total billed charges,88% of total Billed charges,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,412.4,100,,,Fee Schedule,100% of WA Medicaid,2266,100,,,percent of total billed charges,100% of total billed charges,424.77,103,,,Fee Schedule,103% of WA Medicaid,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,1427.58,63,,,percent of total billed charges,63% of total billed charges,1434.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,412.4,100,,,Fee Schedule,100% of WA Medicaid,346.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1563.54,69,,,percent of total billed charges,69% of total billed charges,2266,100,,,percent of total billed charges,100% of total billed charges,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,2266,100,,,percent of total billed charges,100% of total billed charges,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,2266,100,,,percent of total billed charges,100% of total billed charges,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,2573.24,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,412.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,305.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,420.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,536.12,130,,,Fee Schedule,130% of WA Medicaid ,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,854.28,37.7,,,percent of total billed charges,37.70% of total billed charges,854.28,37.7,,,percent of total billed charges,37.70% of total billed charges,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,768.17,33.9,,,percent of total billed charges,33.9% of total billed charges,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,1767.48,78,,,percent of total billed charges,78% of total billed charges,2266,100,,,percent of total billed charges,100% of total billed charges,1871.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1871.72,82.6,,,percent of total billed charges,82.6% of total billed charges,412.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,828.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,819.95,100,,,Fee Schedule,100% of Medicare OPPS rate,412.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,305.48,2573.24,
"EPISIOTOMY OR VAGINAL REPAIR, BY OTHER THAN ATTENDING.",72059300,CDM,720,RC,59300,HCPCS,Outpatient,,,9376,6094.40,,8250.88,88,,,percent of total billed charges,88% of total Billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1708.92,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1760.19,103,,,Fee Schedule,103% of WA Medicaid,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5906.88,63,,,percent of total billed charges,63% of total billed charges,5580.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,1708.92,100,,,Fee Schedule,100% of WA Medicaid,1434.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6469.44,69,,,percent of total billed charges,69% of total billed charges,9376,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9376,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9376,100,,,percent of total billed charges,100% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10656.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1708.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1265.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1743.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2221.6,130,,,Fee Schedule,130% of WA Medicaid ,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3534.75,37.7,,,percent of total billed charges,37.70% of total billed charges,3534.75,37.7,,,percent of total billed charges,37.70% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3178.46,33.9,,,percent of total billed charges,33.9% of total billed charges,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7313.28,78,,,percent of total billed charges,78% of total billed charges,9376,100,,,percent of total billed charges,100% of total billed charges,7744.58,82.6,,,percent of total billed charges,82.6% of total billed charges,7744.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1708.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,3220.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3188.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1708.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1265.87,10656.86,
"VAGINAL DELIVERY ONLY, AFTER PREVIOUS CESARE",72059614,CDM,720,RC,59614,HCPCS,Outpatient,,,9376,6094.40,,8250.88,88,,,percent of total billed charges,88% of total Billed charges,4688,50,,,percent of total billed charges,50% of total Billed charges,1955.83,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2014.51,103,,,Fee Schedule,103% of WA Medicaid,4688,50,,,percent of total billed charges,50% of total Billed charges,5906.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1955.83,100,,,Fee Schedule,100% of WA Medicaid,1434.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6469.44,69,,,percent of total billed charges,69% of total billed charges,9376,100,,,percent of total billed charges,100% of total billed charges,4688,50,,,percent of total billed charges,50% of total Billed charges,9376,100,,,percent of total billed charges,100% of total billed charges,4688,50,,,percent of total billed charges,50% of total Billed charges,9376,100,,,percent of total billed charges,100% of total billed charges,4688,50,,,percent of total billed charges,50% of total Billed charges,5799.06,61.85,,,percent of total billed charges,61.85% of total billed charges,1955.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4688,50,,,percent of total billed charges,50% of total Billed charges,4688,50,,,percent of total billed charges,50% of total Billed charges,1448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4688,50,,,percent of total billed charges,50% of total Billed charges,4688,50,,,percent of total billed charges,50% of total Billed charges,1994.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2542.58,130,,,Fee Schedule,130% of WA Medicaid ,4688,50,,,percent of total billed charges,50% of total Billed charges,3534.75,37.7,,,percent of total billed charges,37.70% of total billed charges,3534.75,37.7,,,percent of total billed charges,37.70% of total billed charges,4688,50,,,percent of total billed charges,50% of total Billed charges,3178.46,33.9,,,percent of total billed charges,33.9% of total billed charges,4688,50,,,percent of total billed charges,50% of total Billed charges,7313.28,78,,,percent of total billed charges,78% of total billed charges,9376,100,,,percent of total billed charges,100% of total billed charges,7744.58,82.6,,,percent of total billed charges,82.6% of total billed charges,7744.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1955.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4688,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4688,50,,,percent of total billed charges,50% of total Billed charges,1955.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1434.53,9376,
62273 INJECT EPIDURAL PATCH CHARGE,AMB820076,CDM,761,RC,62273,HCPCS,Outpatient,,,1451,943.15,,1276.88,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1451,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,914.13,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,222,15.3,,,percent of total billed charges,15.3% of total billed charges,1001.19,69,,,percent of total billed charges,69% of total billed charges,1451,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1451,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1451,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,547.03,37.7,,,percent of total billed charges,37.70% of total billed charges,547.03,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,491.89,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1131.78,78,,,percent of total billed charges,78% of total billed charges,1451,100,,,percent of total billed charges,100% of total billed charges,1198.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1198.53,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,222,2578.03,
SPINAL PUNCTURE LUMBAR DX,84062270,CDM,361,RC,62270,HCPCS,Outpatient,,,1508,980.20,,1327.04,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1508,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,950.04,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,230.72,15.3,,,percent of total billed charges,15.3% of total billed charges,1040.52,69,,,percent of total billed charges,69% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,511.21,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1176.24,78,,,percent of total billed charges,78% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,230.72,2578.03,
MYELOGRAM LUMBAR SPINE,84062284,CDM,360,RC,62284,HCPCS,Outpatient,,,1006,653.90,,885.28,88,,,percent of total billed charges,88% of total Billed charges,503,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid,1006,100,,,percent of total billed charges,100% of total billed charges,281.05,103,,,Fee Schedule,103% of WA Medicaid,503,50,,,percent of total billed charges,50% of total Billed charges,633.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,272.87,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,694.14,69,,,percent of total billed charges,69% of total billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,503,50,,,percent of total billed charges,50% of total Billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,503,50,,,percent of total billed charges,50% of total Billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,503,50,,,percent of total billed charges,50% of total Billed charges,622.21,61.85,,,percent of total billed charges,61.85% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,503,50,,,percent of total billed charges,50% of total Billed charges,503,50,,,percent of total billed charges,50% of total Billed charges,202.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,503,50,,,percent of total billed charges,50% of total Billed charges,503,50,,,percent of total billed charges,50% of total Billed charges,278.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.73,130,,,Fee Schedule,130% of WA Medicaid ,503,50,,,percent of total billed charges,50% of total Billed charges,379.26,37.7,,,percent of total billed charges,37.70% of total billed charges,379.26,37.7,,,percent of total billed charges,37.70% of total billed charges,503,50,,,percent of total billed charges,50% of total Billed charges,341.03,33.9,,,percent of total billed charges,33.9% of total billed charges,503,50,,,percent of total billed charges,50% of total Billed charges,784.68,78,,,percent of total billed charges,78% of total billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,830.96,82.6,,,percent of total billed charges,82.6% of total billed charges,830.96,82.6,,,percent of total billed charges,82.6% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,503,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,503,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,202.12,3367,
MYELOGRAPHY VIA LUMBAR INJ,84062303,CDM,360,RC,62303,HCPCS,Outpatient,,,3923,2549.95,,3452.24,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,3923,100,,,percent of total billed charges,100% of total billed charges,544.08,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2471.49,63,,,percent of total billed charges,63% of total billed charges,1429.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2706.87,69,,,percent of total billed charges,69% of total billed charges,3923,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3923,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3923,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.44,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,391.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,538.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,686.71,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1478.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1478.97,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1329.9,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3059.94,78,,,percent of total billed charges,78% of total billed charges,3923,100,,,percent of total billed charges,100% of total billed charges,3240.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3240.4,82.6,,,percent of total billed charges,82.6% of total billed charges,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,391.29,3923,
INTERLAMINAR INJ C/T SPINE,84062310,CDM,360,RC,62310,HCPCS,Outpatient,,,1758,1142.70,,1547.04,88,,,percent of total billed charges,88% of total Billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,295.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,304.2,17.304,,,percent of total billed charges,17.304% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,1107.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,295.34,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1213.02,69,,,percent of total billed charges,69% of total billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,1087.32,61.85,,,percent of total billed charges,61.85% of total billed charges,295.34,16.8,,,percent of total billed charges,16.8% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,295.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,301.25,17.136,,,percent of total billed charges,17.136% of total billed charges,383.95,21.84,,,percent of total billed charges,21.84% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,662.77,37.7,,,percent of total billed charges,37.70% of total billed charges,662.77,37.7,,,percent of total billed charges,37.70% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,595.96,33.9,,,percent of total billed charges,33.9% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,1371.24,78,,,percent of total billed charges,78% of total billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,1452.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1452.11,82.6,,,percent of total billed charges,82.6% of total billed charges,295.34,16.8,,,percent of total billed charges,16.8% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,879,50,,,percent of total billed charges,50% of total Billed charges,295.34,16.8,,,percent of total billed charges,16.8% of total billed charges,295.34,3367,
INTERLAMINAR INJ L/S SPINE,84062311,CDM,360,RC,62311,HCPCS,Outpatient,,,1758,1142.70,,1547.04,88,,,percent of total billed charges,88% of total Billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,295.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,304.2,17.304,,,percent of total billed charges,17.304% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,1107.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,295.34,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1213.02,69,,,percent of total billed charges,69% of total billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,1087.32,61.85,,,percent of total billed charges,61.85% of total billed charges,295.34,16.8,,,percent of total billed charges,16.8% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,295.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,301.25,17.136,,,percent of total billed charges,17.136% of total billed charges,383.95,21.84,,,percent of total billed charges,21.84% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,662.77,37.7,,,percent of total billed charges,37.70% of total billed charges,662.77,37.7,,,percent of total billed charges,37.70% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,595.96,33.9,,,percent of total billed charges,33.9% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,1371.24,78,,,percent of total billed charges,78% of total billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,1452.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1452.11,82.6,,,percent of total billed charges,82.6% of total billed charges,295.34,16.8,,,percent of total billed charges,16.8% of total billed charges,879,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,879,50,,,percent of total billed charges,50% of total Billed charges,295.34,16.8,,,percent of total billed charges,16.8% of total billed charges,295.34,3367,
BLOOD PATCH,84063707,CDM,360,RC,63707,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,4192.88,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,4318.67,103,,,Fee Schedule,103% of WA Medicaid,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,141.12,63,,,percent of total billed charges,63% of total billed charges,224,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,4192.88,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,224,100,,,percent of total billed charges,100% of total billed charges,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,224,100,,,percent of total billed charges,100% of total billed charges,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,224,100,,,Fee Schedule,Pays at line item charges due to status indicator C,4192.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3105.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,4276.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5450.75,130,,,Fee Schedule,130% of WA Medicaid ,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,75.94,33.9,,,percent of total billed charges,33.9% of total billed charges,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,4192.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,224,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,224,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,4192.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.94,5450.75,
64405 Injection anesthetic agent or steroid greater occipita,84064405,CDM,761,RC,64405,HCPCS,Outpatient,,,557,362.05,,490.16,88,,,percent of total billed charges,88% of total Billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,557,100,,,percent of total billed charges,100% of total billed charges,403.97,103,,,Fee Schedule,103% of WA Medicaid,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,350.91,63,,,percent of total billed charges,63% of total billed charges,528.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,85.22,15.3,,,percent of total billed charges,15.3% of total billed charges,384.33,69,,,percent of total billed charges,69% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1061,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,290.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,400.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.87,130,,,Fee Schedule,130% of WA Medicaid ,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,188.82,33.9,,,percent of total billed charges,33.9% of total billed charges,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,434.46,78,,,percent of total billed charges,78% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,305.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,302.08,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.22,1061,
INJ ANE AGENT PERIPHEAL NERVE,84064450,CDM,360,RC,64450,HCPCS,Outpatient,,,464,301.60,,408.32,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,464,100,,,percent of total billed charges,100% of total billed charges,403.97,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,292.32,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,320.16,69,,,percent of total billed charges,69% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,464,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,464,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,290.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,400.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,157.3,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,361.92,78,,,percent of total billed charges,78% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,157.3,3367,
"64454 Injection(s), anesthetic agent(s) and/or steroid; geni",76164454,CDM,761,RC,64454,HCPCS,Outpatient,,,922,599.30,,811.36,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,922,100,,,percent of total billed charges,100% of total billed charges,403.97,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,580.86,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,141.07,15.3,,,percent of total billed charges,15.3% of total billed charges,636.18,69,,,percent of total billed charges,69% of total billed charges,922,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,922,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,922,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,290.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,400.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,347.59,37.7,,,percent of total billed charges,37.70% of total billed charges,347.59,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,312.56,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,719.16,78,,,percent of total billed charges,78% of total billed charges,922,100,,,percent of total billed charges,100% of total billed charges,761.57,82.6,,,percent of total billed charges,82.6% of total billed charges,761.57,82.6,,,percent of total billed charges,82.6% of total billed charges,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,141.07,2578.03,
Open implantation of hypoglossal nerve neurostimulator array,36064582,CDM,360,RC,64582,HCPCS,Outpatient,,,90189,58622.85,,79366.32,88,,,percent of total billed charges,88% of total Billed charges,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,18609.86,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,19168.16,103,,,Fee Schedule,103% of WA Medicaid,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,56819.07,63,,,percent of total billed charges,63% of total billed charges,55426.2,175,,,Fee Schedule,175% of Medicare OPPS Rate,18609.86,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,62230.41,69,,,percent of total billed charges,69% of total billed charges,90189,100,,,percent of total billed charges,100% of total billed charges,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,90189,100,,,percent of total billed charges,100% of total billed charges,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,90189,100,,,percent of total billed charges,100% of total billed charges,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,55781.9,61.85,,,percent of total billed charges,61.85% of total billed charges,18609.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,13785.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,18982.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24192.82,130,,,Fee Schedule,130% of WA Medicaid ,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,34001.25,37.7,,,percent of total billed charges,37.70% of total billed charges,34001.25,37.7,,,percent of total billed charges,37.70% of total billed charges,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,30574.07,33.9,,,percent of total billed charges,33.9% of total billed charges,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,70347.42,78,,,percent of total billed charges,78% of total billed charges,90189,100,,,percent of total billed charges,100% of total billed charges,74496.11,82.6,,,percent of total billed charges,82.6% of total billed charges,74496.11,82.6,,,percent of total billed charges,82.6% of total billed charges,18609.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,31988.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,31672.12,100,,,Fee Schedule,100% of Medicare OPPS rate,18609.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3367,90189,
Revision or replacement of hypoglossal nerve neurostimulato,36064583,CDM,360,RC,64583,HCPCS,Outpatient,,,33450,21742.50,,29436,88,,,percent of total billed charges,88% of total Billed charges,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,5344.89,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5505.24,103,,,Fee Schedule,103% of WA Medicaid,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,21073.5,63,,,percent of total billed charges,63% of total billed charges,24314.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,5344.89,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,23080.5,69,,,percent of total billed charges,69% of total billed charges,33450,100,,,percent of total billed charges,100% of total billed charges,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,33450,100,,,percent of total billed charges,100% of total billed charges,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,33450,100,,,percent of total billed charges,100% of total billed charges,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,20688.83,61.85,,,percent of total billed charges,61.85% of total billed charges,5344.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,3959.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,5451.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6948.36,130,,,Fee Schedule,130% of WA Medicaid ,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,12610.65,37.7,,,percent of total billed charges,37.70% of total billed charges,12610.65,37.7,,,percent of total billed charges,37.70% of total billed charges,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,11339.55,33.9,,,percent of total billed charges,33.9% of total billed charges,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,26091,78,,,percent of total billed charges,78% of total billed charges,33450,100,,,percent of total billed charges,100% of total billed charges,27629.7,82.6,,,percent of total billed charges,82.6% of total billed charges,27629.7,82.6,,,percent of total billed charges,82.6% of total billed charges,5344.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,14032.89,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,13893.96,100,,,Fee Schedule,100% of Medicare OPPS rate,5344.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3367,33450,
"Removal of hypoglossal nerve neurostimulator array, pulse ge",36064584,CDM,360,RC,64584,HCPCS,Outpatient,,,17472,11356.80,,15375.36,88,,,percent of total billed charges,88% of total Billed charges,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,3381.79,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3483.24,103,,,Fee Schedule,103% of WA Medicaid,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,11007.36,63,,,percent of total billed charges,63% of total billed charges,11890.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,3381.79,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,12055.68,69,,,percent of total billed charges,69% of total billed charges,17472,100,,,percent of total billed charges,100% of total billed charges,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,17472,100,,,percent of total billed charges,100% of total billed charges,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,17472,100,,,percent of total billed charges,100% of total billed charges,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,10806.43,61.85,,,percent of total billed charges,61.85% of total billed charges,3381.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,2505.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,3449.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4396.32,130,,,Fee Schedule,130% of WA Medicaid ,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6586.94,37.7,,,percent of total billed charges,37.70% of total billed charges,6586.94,37.7,,,percent of total billed charges,37.70% of total billed charges,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,5923.01,33.9,,,percent of total billed charges,33.9% of total billed charges,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,13628.16,78,,,percent of total billed charges,78% of total billed charges,17472,100,,,percent of total billed charges,100% of total billed charges,14431.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14431.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3381.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,6862.37,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,6794.43,100,,,Fee Schedule,100% of Medicare OPPS rate,3381.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2505.03,17472,
ACT,84085347,CDM,305,RC,85347,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,53.55,63,,,percent of total billed charges,63% of total billed charges,7.49,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,85,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,16.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,4.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,85,
PERC CARD ANGIOPLASTY 1 ART,84092920,CDM,481,RC,92920,HCPCS,Outpatient,,,40333,26216.45,,35493.04,88,,,percent of total billed charges,88% of total Billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,25409.79,63,,,percent of total billed charges,63% of total billed charges,10202.1,175,,,Fee Schedule,175% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,6170.95,15.3,,,percent of total billed charges,15.3% of total billed charges,27829.77,69,,,percent of total billed charges,69% of total billed charges,40333,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40333,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40333,100,,,percent of total billed charges,100% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,20137.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,15205.54,37.7,,,percent of total billed charges,37.70% of total billed charges,15205.54,37.7,,,percent of total billed charges,37.70% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,13672.89,33.9,,,percent of total billed charges,33.9% of total billed charges,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,31459.74,78,,,percent of total billed charges,78% of total billed charges,40333,100,,,percent of total billed charges,100% of total billed charges,33315.06,82.6,,,percent of total billed charges,82.6% of total billed charges,33315.06,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5888.05,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5829.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,40333,
PERC CARD ANGIOPLASTY ADDL ART,84092921,CDM,481,RC,92921,HCPCS,Outpatient,,,40333,26216.45,,35493.04,88,,,percent of total billed charges,88% of total Billed charges,20166.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,20166.5,50,,,percent of total billed charges,50% of total Billed charges,25409.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7748.35,100,,,Fee Schedule,100% of WA Medicaid,6170.95,15.3,,,percent of total billed charges,15.3% of total billed charges,27829.77,69,,,percent of total billed charges,69% of total billed charges,40333,100,,,percent of total billed charges,100% of total billed charges,20166.5,50,,,percent of total billed charges,50% of total Billed charges,40333,100,,,percent of total billed charges,100% of total billed charges,20166.5,50,,,percent of total billed charges,50% of total Billed charges,40333,100,,,percent of total billed charges,100% of total billed charges,20166.5,50,,,percent of total billed charges,50% of total Billed charges,24945.96,61.85,,,percent of total billed charges,61.85% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20166.5,50,,,percent of total billed charges,50% of total Billed charges,20166.5,50,,,percent of total billed charges,50% of total Billed charges,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20166.5,50,,,percent of total billed charges,50% of total Billed charges,20166.5,50,,,percent of total billed charges,50% of total Billed charges,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,20166.5,50,,,percent of total billed charges,50% of total Billed charges,15205.54,37.7,,,percent of total billed charges,37.70% of total billed charges,15205.54,37.7,,,percent of total billed charges,37.70% of total billed charges,20166.5,50,,,percent of total billed charges,50% of total Billed charges,13672.89,33.9,,,percent of total billed charges,33.9% of total billed charges,20166.5,50,,,percent of total billed charges,50% of total Billed charges,31459.74,78,,,percent of total billed charges,78% of total billed charges,40333,100,,,percent of total billed charges,100% of total billed charges,33315.06,82.6,,,percent of total billed charges,82.6% of total billed charges,33315.06,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20166.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20166.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,40333,
PERC CARD ANGIO/ATHRECT 1 ART,84092924,CDM,481,RC,92924,HCPCS,Outpatient,,,69490,45168.50,,61151.2,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,43778.7,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,10631.97,15.3,,,percent of total billed charges,15.3% of total billed charges,47948.1,69,,,percent of total billed charges,69% of total billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,69490,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,69490,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,26197.73,37.7,,,percent of total billed charges,37.70% of total billed charges,26197.73,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,23557.11,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,54202.2,78,,,percent of total billed charges,78% of total billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,57398.74,82.6,,,percent of total billed charges,82.6% of total billed charges,57398.74,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,69490,
PERC CARD ANGIO/ATHREC ADD ART,84092925,CDM,481,RC,92925,HCPCS,Outpatient,,,69490,45168.50,,61151.2,88,,,percent of total billed charges,88% of total Billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,34745,50,,,percent of total billed charges,50% of total Billed charges,43778.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7748.35,100,,,Fee Schedule,100% of WA Medicaid,10631.97,15.3,,,percent of total billed charges,15.3% of total billed charges,47948.1,69,,,percent of total billed charges,69% of total billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,42979.57,61.85,,,percent of total billed charges,61.85% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34745,50,,,percent of total billed charges,50% of total Billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34745,50,,,percent of total billed charges,50% of total Billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,34745,50,,,percent of total billed charges,50% of total Billed charges,26197.73,37.7,,,percent of total billed charges,37.70% of total billed charges,26197.73,37.7,,,percent of total billed charges,37.70% of total billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,23557.11,33.9,,,percent of total billed charges,33.9% of total billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,54202.2,78,,,percent of total billed charges,78% of total billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,57398.74,82.6,,,percent of total billed charges,82.6% of total billed charges,57398.74,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34745,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34745,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,69490,
PERC CARD STENT/ANGIO 1 VSL,84092928,CDM,481,RC,92928,HCPCS,Outpatient,,,70923,46099.95,,62412.24,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,44681.49,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,10851.22,15.3,,,percent of total billed charges,15.3% of total billed charges,48936.87,69,,,percent of total billed charges,69% of total billed charges,70923,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,70923,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,70923,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,26737.97,37.7,,,percent of total billed charges,37.70% of total billed charges,26737.97,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,24042.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,55319.94,78,,,percent of total billed charges,78% of total billed charges,70923,100,,,percent of total billed charges,100% of total billed charges,58582.4,82.6,,,percent of total billed charges,82.6% of total billed charges,58582.4,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,70923,
PERC CARD STENT/ANGIO ADD VSL,84092929,CDM,481,RC,92929,HCPCS,Outpatient,,,17580,11427.00,,15470.4,88,,,percent of total billed charges,88% of total Billed charges,8790,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,8790,50,,,percent of total billed charges,50% of total Billed charges,11075.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7748.35,100,,,Fee Schedule,100% of WA Medicaid,2689.74,15.3,,,percent of total billed charges,15.3% of total billed charges,12130.2,69,,,percent of total billed charges,69% of total billed charges,17580,100,,,percent of total billed charges,100% of total billed charges,8790,50,,,percent of total billed charges,50% of total Billed charges,17580,100,,,percent of total billed charges,100% of total billed charges,8790,50,,,percent of total billed charges,50% of total Billed charges,17580,100,,,percent of total billed charges,100% of total billed charges,8790,50,,,percent of total billed charges,50% of total Billed charges,10873.23,61.85,,,percent of total billed charges,61.85% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8790,50,,,percent of total billed charges,50% of total Billed charges,8790,50,,,percent of total billed charges,50% of total Billed charges,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8790,50,,,percent of total billed charges,50% of total Billed charges,8790,50,,,percent of total billed charges,50% of total Billed charges,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,8790,50,,,percent of total billed charges,50% of total Billed charges,6627.66,37.7,,,percent of total billed charges,37.70% of total billed charges,6627.66,37.7,,,percent of total billed charges,37.70% of total billed charges,8790,50,,,percent of total billed charges,50% of total Billed charges,5959.62,33.9,,,percent of total billed charges,33.9% of total billed charges,8790,50,,,percent of total billed charges,50% of total Billed charges,13712.4,78,,,percent of total billed charges,78% of total billed charges,17580,100,,,percent of total billed charges,100% of total billed charges,14521.08,82.6,,,percent of total billed charges,82.6% of total billed charges,14521.08,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8790,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8790,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2689.74,17580,
PERC CARD STENT/ATH/ANG 1 VSL,84092933,CDM,481,RC,92933,HCPCS,Outpatient,,,90794,59016.10,,79898.72,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,57200.22,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,13891.48,15.3,,,percent of total billed charges,15.3% of total billed charges,62647.86,69,,,percent of total billed charges,69% of total billed charges,90794,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,90794,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,90794,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65260.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,34229.34,37.7,,,percent of total billed charges,37.70% of total billed charges,34229.34,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,30779.17,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,70819.32,78,,,percent of total billed charges,78% of total billed charges,90794,100,,,percent of total billed charges,100% of total billed charges,74995.84,82.6,,,percent of total billed charges,82.6% of total billed charges,74995.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,90794,
PERC CARD STNT/ATH/ANG ADD VSL,84092934,CDM,481,RC,92934,HCPCS,Outpatient,,,90794,59016.10,,79898.72,88,,,percent of total billed charges,88% of total Billed charges,45397,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,45397,50,,,percent of total billed charges,50% of total Billed charges,57200.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7748.35,100,,,Fee Schedule,100% of WA Medicaid,13891.48,15.3,,,percent of total billed charges,15.3% of total billed charges,62647.86,69,,,percent of total billed charges,69% of total billed charges,90794,100,,,percent of total billed charges,100% of total billed charges,45397,50,,,percent of total billed charges,50% of total Billed charges,90794,100,,,percent of total billed charges,100% of total billed charges,45397,50,,,percent of total billed charges,50% of total Billed charges,90794,100,,,percent of total billed charges,100% of total billed charges,45397,50,,,percent of total billed charges,50% of total Billed charges,56156.09,61.85,,,percent of total billed charges,61.85% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45397,50,,,percent of total billed charges,50% of total Billed charges,45397,50,,,percent of total billed charges,50% of total Billed charges,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45397,50,,,percent of total billed charges,50% of total Billed charges,45397,50,,,percent of total billed charges,50% of total Billed charges,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,45397,50,,,percent of total billed charges,50% of total Billed charges,34229.34,37.7,,,percent of total billed charges,37.70% of total billed charges,34229.34,37.7,,,percent of total billed charges,37.70% of total billed charges,45397,50,,,percent of total billed charges,50% of total Billed charges,30779.17,33.9,,,percent of total billed charges,33.9% of total billed charges,45397,50,,,percent of total billed charges,50% of total Billed charges,70819.32,78,,,percent of total billed charges,78% of total billed charges,90794,100,,,percent of total billed charges,100% of total billed charges,74995.84,82.6,,,percent of total billed charges,82.6% of total billed charges,74995.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45397,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45397,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,90794,
PERC REVASC BYPASS GRFT 1 VSL,84092937,CDM,481,RC,92937,HCPCS,Outpatient,,,70923,46099.95,,62412.24,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,44681.49,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,10851.22,15.3,,,percent of total billed charges,15.3% of total billed charges,48936.87,69,,,percent of total billed charges,69% of total billed charges,70923,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,70923,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,70923,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,26737.97,37.7,,,percent of total billed charges,37.70% of total billed charges,26737.97,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,24042.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,55319.94,78,,,percent of total billed charges,78% of total billed charges,70923,100,,,percent of total billed charges,100% of total billed charges,58582.4,82.6,,,percent of total billed charges,82.6% of total billed charges,58582.4,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,70923,
PERC REVASC BYPSS GRFT ADD VSL,84092938,CDM,481,RC,92938,HCPCS,Outpatient,,,70923,46099.95,,62412.24,88,,,percent of total billed charges,88% of total Billed charges,35461.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,35461.5,50,,,percent of total billed charges,50% of total Billed charges,44681.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7748.35,100,,,Fee Schedule,100% of WA Medicaid,10851.22,15.3,,,percent of total billed charges,15.3% of total billed charges,48936.87,69,,,percent of total billed charges,69% of total billed charges,70923,100,,,percent of total billed charges,100% of total billed charges,35461.5,50,,,percent of total billed charges,50% of total Billed charges,70923,100,,,percent of total billed charges,100% of total billed charges,35461.5,50,,,percent of total billed charges,50% of total Billed charges,70923,100,,,percent of total billed charges,100% of total billed charges,35461.5,50,,,percent of total billed charges,50% of total Billed charges,43865.88,61.85,,,percent of total billed charges,61.85% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35461.5,50,,,percent of total billed charges,50% of total Billed charges,35461.5,50,,,percent of total billed charges,50% of total Billed charges,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35461.5,50,,,percent of total billed charges,50% of total Billed charges,35461.5,50,,,percent of total billed charges,50% of total Billed charges,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,35461.5,50,,,percent of total billed charges,50% of total Billed charges,26737.97,37.7,,,percent of total billed charges,37.70% of total billed charges,26737.97,37.7,,,percent of total billed charges,37.70% of total billed charges,35461.5,50,,,percent of total billed charges,50% of total Billed charges,24042.9,33.9,,,percent of total billed charges,33.9% of total billed charges,35461.5,50,,,percent of total billed charges,50% of total Billed charges,55319.94,78,,,percent of total billed charges,78% of total billed charges,70923,100,,,percent of total billed charges,100% of total billed charges,58582.4,82.6,,,percent of total billed charges,82.6% of total billed charges,58582.4,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35461.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35461.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,70923,
PERC CARD REVASC MI 1 VSL,84092941,CDM,481,RC,92941,HCPCS,Outpatient,,,69490,45168.50,,61151.2,88,,,percent of total billed charges,88% of total Billed charges,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,43778.7,63,,,percent of total billed charges,63% of total billed charges,69490,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7748.35,100,,,Fee Schedule,100% of WA Medicaid,10631.97,15.3,,,percent of total billed charges,15.3% of total billed charges,47948.1,69,,,percent of total billed charges,69% of total billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,69490,100,,,percent of total billed charges,100% of total billed charges,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,69490,100,,,percent of total billed charges,100% of total billed charges,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,69490,100,,,Fee Schedule,Pays at line item charges due to status indicator C,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,26197.73,37.7,,,percent of total billed charges,37.70% of total billed charges,26197.73,37.7,,,percent of total billed charges,37.70% of total billed charges,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,23557.11,33.9,,,percent of total billed charges,33.9% of total billed charges,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,54202.2,78,,,percent of total billed charges,78% of total billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,57398.74,82.6,,,percent of total billed charges,82.6% of total billed charges,57398.74,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,69490,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,69490,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,69490,
PERC CARD REVASC CHRONIC 1 VSL,84092943,CDM,481,RC,92943,HCPCS,Outpatient,,,69490,45168.50,,61151.2,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,43778.7,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,10631.97,15.3,,,percent of total billed charges,15.3% of total billed charges,47948.1,69,,,percent of total billed charges,69% of total billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,69490,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,69490,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,26197.73,37.7,,,percent of total billed charges,37.70% of total billed charges,26197.73,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,23557.11,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,54202.2,78,,,percent of total billed charges,78% of total billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,57398.74,82.6,,,percent of total billed charges,82.6% of total billed charges,57398.74,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,69490,
PERC CARD REVASC CHRONIC ADD,84092944,CDM,481,RC,92944,HCPCS,Outpatient,,,69490,45168.50,,61151.2,88,,,percent of total billed charges,88% of total Billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,34745,50,,,percent of total billed charges,50% of total Billed charges,43778.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7748.35,100,,,Fee Schedule,100% of WA Medicaid,10631.97,15.3,,,percent of total billed charges,15.3% of total billed charges,47948.1,69,,,percent of total billed charges,69% of total billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,42979.57,61.85,,,percent of total billed charges,61.85% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34745,50,,,percent of total billed charges,50% of total Billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34745,50,,,percent of total billed charges,50% of total Billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,34745,50,,,percent of total billed charges,50% of total Billed charges,26197.73,37.7,,,percent of total billed charges,37.70% of total billed charges,26197.73,37.7,,,percent of total billed charges,37.70% of total billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,23557.11,33.9,,,percent of total billed charges,33.9% of total billed charges,34745,50,,,percent of total billed charges,50% of total Billed charges,54202.2,78,,,percent of total billed charges,78% of total billed charges,69490,100,,,percent of total billed charges,100% of total billed charges,57398.74,82.6,,,percent of total billed charges,82.6% of total billed charges,57398.74,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34745,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34745,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,69490,
CPR CATH LAB,84092950,CDM,481,RC,92950,HCPCS,Outpatient,,,963,625.95,,847.44,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,963,100,,,percent of total billed charges,100% of total billed charges,843.18,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,606.69,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,147.34,15.3,,,percent of total billed charges,15.3% of total billed charges,664.47,69,,,percent of total billed charges,69% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,606.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,834.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1064.21,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,363.05,37.7,,,percent of total billed charges,37.70% of total billed charges,363.05,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326.46,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,751.14,78,,,percent of total billed charges,78% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,147.34,1074.33,
CARDIOVERSION,84092960,CDM,480,RC,92960,HCPCS,Outpatient,,,2190,1423.50,,1927.2,88,,,percent of total billed charges,88% of total Billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,582.08,100,,,Fee Schedule,100% of WA Medicaid,2190,100,,,percent of total billed charges,100% of total billed charges,599.54,103,,,Fee Schedule,103% of WA Medicaid,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,1379.7,63,,,percent of total billed charges,63% of total billed charges,1161.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,582.08,100,,,Fee Schedule,100% of WA Medicaid,335.07,15.3,,,percent of total billed charges,15.3% of total billed charges,1511.1,69,,,percent of total billed charges,69% of total billed charges,2190,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2190,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2190,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2282.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,431.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,593.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,756.7,130,,,Fee Schedule,130% of WA Medicaid ,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,825.63,37.7,,,percent of total billed charges,37.70% of total billed charges,825.63,37.7,,,percent of total billed charges,37.70% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,742.41,33.9,,,percent of total billed charges,33.9% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,1708.2,78,,,percent of total billed charges,78% of total billed charges,2190,100,,,percent of total billed charges,100% of total billed charges,1808.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1808.94,82.6,,,percent of total billed charges,82.6% of total billed charges,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,670.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,335.07,2282.77,
CARDIOVERSION ELECTIVE INT,84092961,CDM,481,RC,92961,HCPCS,Outpatient,,,2008,1305.20,,1767.04,88,,,percent of total billed charges,88% of total Billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,582.08,100,,,Fee Schedule,100% of WA Medicaid,2008,100,,,percent of total billed charges,100% of total billed charges,599.54,103,,,Fee Schedule,103% of WA Medicaid,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,1265.04,63,,,percent of total billed charges,63% of total billed charges,1161.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,582.08,100,,,Fee Schedule,100% of WA Medicaid,307.22,15.3,,,percent of total billed charges,15.3% of total billed charges,1385.52,69,,,percent of total billed charges,69% of total billed charges,2008,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2008,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2008,100,,,percent of total billed charges,100% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,2282.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,431.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,593.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,756.7,130,,,Fee Schedule,130% of WA Medicaid ,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,757.02,37.7,,,percent of total billed charges,37.70% of total billed charges,757.02,37.7,,,percent of total billed charges,37.70% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,680.71,33.9,,,percent of total billed charges,33.9% of total billed charges,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,1566.24,78,,,percent of total billed charges,78% of total billed charges,2008,100,,,percent of total billed charges,100% of total billed charges,1658.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1658.61,82.6,,,percent of total billed charges,82.6% of total billed charges,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,670.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,663.81,100,,,Fee Schedule,100% of Medicare OPPS rate,582.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,307.22,2282.77,
CIRC ASSIST - IP ONLY,84092970,CDM,481,RC,92970,HCPCS,Outpatient,,,25160,16354.00,,22140.8,88,,,percent of total billed charges,88% of total Billed charges,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3222.02,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3318.68,103,,,Fee Schedule,103% of WA Medicaid,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,15850.8,63,,,percent of total billed charges,63% of total billed charges,25160,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3222.02,100,,,Fee Schedule,100% of WA Medicaid,3849.48,15.3,,,percent of total billed charges,15.3% of total billed charges,17360.4,69,,,percent of total billed charges,69% of total billed charges,25160,100,,,percent of total billed charges,100% of total billed charges,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,25160,100,,,percent of total billed charges,100% of total billed charges,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,25160,100,,,percent of total billed charges,100% of total billed charges,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,25160,100,,,Fee Schedule,Pays at line item charges due to status indicator C,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,2386.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3286.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4188.63,130,,,Fee Schedule,130% of WA Medicaid ,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,9485.32,37.7,,,percent of total billed charges,37.70% of total billed charges,9485.32,37.7,,,percent of total billed charges,37.70% of total billed charges,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,8529.24,33.9,,,percent of total billed charges,33.9% of total billed charges,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,19624.8,78,,,percent of total billed charges,78% of total billed charges,25160,100,,,percent of total billed charges,100% of total billed charges,20782.16,82.6,,,percent of total billed charges,82.6% of total billed charges,20782.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,25160,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,25160,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3222.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2386.68,25160,
PERCUT CORONARY THROMBECTOMY,84092973,CDM,481,RC,92973,HCPCS,Outpatient,,,12969,8429.85,,11412.72,88,,,percent of total billed charges,88% of total Billed charges,6484.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,6484.5,50,,,percent of total billed charges,50% of total Billed charges,8170.47,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7748.35,100,,,Fee Schedule,100% of WA Medicaid,1984.26,15.3,,,percent of total billed charges,15.3% of total billed charges,8948.61,69,,,percent of total billed charges,69% of total billed charges,12969,100,,,percent of total billed charges,100% of total billed charges,6484.5,50,,,percent of total billed charges,50% of total Billed charges,12969,100,,,percent of total billed charges,100% of total billed charges,6484.5,50,,,percent of total billed charges,50% of total Billed charges,12969,100,,,percent of total billed charges,100% of total billed charges,6484.5,50,,,percent of total billed charges,50% of total Billed charges,8021.33,61.85,,,percent of total billed charges,61.85% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6484.5,50,,,percent of total billed charges,50% of total Billed charges,6484.5,50,,,percent of total billed charges,50% of total Billed charges,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6484.5,50,,,percent of total billed charges,50% of total Billed charges,6484.5,50,,,percent of total billed charges,50% of total Billed charges,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,6484.5,50,,,percent of total billed charges,50% of total Billed charges,4889.31,37.7,,,percent of total billed charges,37.70% of total billed charges,4889.31,37.7,,,percent of total billed charges,37.70% of total billed charges,6484.5,50,,,percent of total billed charges,50% of total Billed charges,4396.49,33.9,,,percent of total billed charges,33.9% of total billed charges,6484.5,50,,,percent of total billed charges,50% of total Billed charges,10115.82,78,,,percent of total billed charges,78% of total billed charges,12969,100,,,percent of total billed charges,100% of total billed charges,10712.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10712.39,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6484.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6484.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1984.26,12969,
THROMBOL CORONARY INTRAC INFUS,84092975,CDM,481,RC,92975,HCPCS,Outpatient,,,953,619.45,,838.64,88,,,percent of total billed charges,88% of total Billed charges,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3709.23,100,,,Fee Schedule,100% of WA Medicaid,953,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,600.39,63,,,percent of total billed charges,63% of total billed charges,953,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3709.23,100,,,Fee Schedule,100% of WA Medicaid,145.81,15.3,,,percent of total billed charges,15.3% of total billed charges,657.57,69,,,percent of total billed charges,69% of total billed charges,953,100,,,percent of total billed charges,100% of total billed charges,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,953,100,,,percent of total billed charges,100% of total billed charges,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,953,100,,,percent of total billed charges,100% of total billed charges,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,953,100,,,Fee Schedule,Pays at line item charges due to status indicator C,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,323.07,33.9,,,percent of total billed charges,33.9% of total billed charges,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,743.34,78,,,percent of total billed charges,78% of total billed charges,953,100,,,percent of total billed charges,100% of total billed charges,787.18,82.6,,,percent of total billed charges,82.6% of total billed charges,787.18,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,953,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,953,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,145.81,4822.01,
CORONARY IVUS INTIAL VESSEL,84092978,CDM,481,RC,92978,HCPCS,Outpatient,,,7682,4993.30,,6760.16,88,,,percent of total billed charges,88% of total Billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,3841,50,,,percent of total billed charges,50% of total Billed charges,4839.66,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,1175.35,15.3,,,percent of total billed charges,15.3% of total billed charges,5300.58,69,,,percent of total billed charges,69% of total billed charges,7682,100,,,percent of total billed charges,100% of total billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,7682,100,,,percent of total billed charges,100% of total billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,7682,100,,,percent of total billed charges,100% of total billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,4751.32,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3841,50,,,percent of total billed charges,50% of total Billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3841,50,,,percent of total billed charges,50% of total Billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,3841,50,,,percent of total billed charges,50% of total Billed charges,2896.11,37.7,,,percent of total billed charges,37.70% of total billed charges,2896.11,37.7,,,percent of total billed charges,37.70% of total billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,2604.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,5991.96,78,,,percent of total billed charges,78% of total billed charges,7682,100,,,percent of total billed charges,100% of total billed charges,6345.33,82.6,,,percent of total billed charges,82.6% of total billed charges,6345.33,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3841,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3841,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,7682,
CORONARY IVUS SUB VESSEL,84092979,CDM,481,RC,92979,HCPCS,Outpatient,,,7682,4993.30,,6760.16,88,,,percent of total billed charges,88% of total Billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,3841,50,,,percent of total billed charges,50% of total Billed charges,4839.66,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,1175.35,15.3,,,percent of total billed charges,15.3% of total billed charges,5300.58,69,,,percent of total billed charges,69% of total billed charges,7682,100,,,percent of total billed charges,100% of total billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,7682,100,,,percent of total billed charges,100% of total billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,7682,100,,,percent of total billed charges,100% of total billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,4751.32,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3841,50,,,percent of total billed charges,50% of total Billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3841,50,,,percent of total billed charges,50% of total Billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,3841,50,,,percent of total billed charges,50% of total Billed charges,2896.11,37.7,,,percent of total billed charges,37.70% of total billed charges,2896.11,37.7,,,percent of total billed charges,37.70% of total billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,2604.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3841,50,,,percent of total billed charges,50% of total Billed charges,5991.96,78,,,percent of total billed charges,78% of total billed charges,7682,100,,,percent of total billed charges,100% of total billed charges,6345.33,82.6,,,percent of total billed charges,82.6% of total billed charges,6345.33,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3841,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3841,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,7682,
ELECTROCARDIOGRAM,84093005,CDM,730,RC,93005,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,24.47,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,302.4,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,73.44,15.3,,,percent of total billed charges,15.3% of total billed charges,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.89,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,162.72,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,480,
CARDIAC STRESS TEST,84093017,CDM,482,RC,93017,HCPCS,Outpatient,,,963,625.95,,847.44,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,963,100,,,percent of total billed charges,100% of total billed charges,155.52,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,606.69,63,,,percent of total billed charges,63% of total billed charges,560.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,147.34,15.3,,,percent of total billed charges,15.3% of total billed charges,664.47,69,,,percent of total billed charges,69% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,111.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,154.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.29,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,363.05,37.7,,,percent of total billed charges,37.70% of total billed charges,363.05,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326.46,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,751.14,78,,,percent of total billed charges,78% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.84,1074.33,
TRANSESOPHOGEAL ECHO,84093312,CDM,480,RC,93312,HCPCS,Outpatient,,,2403,1561.95,,2114.64,88,,,percent of total billed charges,88% of total Billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,2403,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1513.89,63,,,percent of total billed charges,63% of total billed charges,984.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,367.66,15.3,,,percent of total billed charges,15.3% of total billed charges,1658.07,69,,,percent of total billed charges,69% of total billed charges,2403,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2403,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2403,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,905.93,37.7,,,percent of total billed charges,37.70% of total billed charges,905.93,37.7,,,percent of total billed charges,37.70% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,814.62,33.9,,,percent of total billed charges,33.9% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1874.34,78,,,percent of total billed charges,78% of total billed charges,2403,100,,,percent of total billed charges,100% of total billed charges,1984.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1984.88,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,568.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,309.7,2403,
RIGHT HEART CATH,84093451,CDM,481,RC,93451,HCPCS,Outpatient,,,37224,24195.60,,32757.12,88,,,percent of total billed charges,88% of total Billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,23451.12,63,,,percent of total billed charges,63% of total billed charges,5816.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,5695.27,15.3,,,percent of total billed charges,15.3% of total billed charges,25684.56,69,,,percent of total billed charges,69% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,11777.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,12618.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,29034.72,78,,,percent of total billed charges,78% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4867.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,37224,
LEFT HRT CATH W/VENTRICLGRPHY,84093452,CDM,481,RC,93452,HCPCS,Outpatient,,,37224,24195.60,,32757.12,88,,,percent of total billed charges,88% of total Billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,23451.12,63,,,percent of total billed charges,63% of total billed charges,5816.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,5695.27,15.3,,,percent of total billed charges,15.3% of total billed charges,25684.56,69,,,percent of total billed charges,69% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,11777.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,12618.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,29034.72,78,,,percent of total billed charges,78% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4867.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,37224,
RL HRT CATH W/VENTRICLGRPHY,84093453,CDM,481,RC,93453,HCPCS,Outpatient,,,40089,26057.85,,35278.32,88,,,percent of total billed charges,88% of total Billed charges,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,25256.07,63,,,percent of total billed charges,63% of total billed charges,5816.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,6133.62,15.3,,,percent of total billed charges,15.3% of total billed charges,27661.41,69,,,percent of total billed charges,69% of total billed charges,40089,100,,,percent of total billed charges,100% of total billed charges,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,40089,100,,,percent of total billed charges,100% of total billed charges,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,40089,100,,,percent of total billed charges,100% of total billed charges,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,11777.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,15113.55,37.7,,,percent of total billed charges,37.70% of total billed charges,15113.55,37.7,,,percent of total billed charges,37.70% of total billed charges,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,13590.17,33.9,,,percent of total billed charges,33.9% of total billed charges,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,31269.42,78,,,percent of total billed charges,78% of total billed charges,40089,100,,,percent of total billed charges,100% of total billed charges,33113.51,82.6,,,percent of total billed charges,82.6% of total billed charges,33113.51,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,5210.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5206.09,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,40089,
CORONARY ARTERY ANGIO SI,84093454,CDM,481,RC,93454,HCPCS,Outpatient,,,37224,24195.60,,32757.12,88,,,percent of total billed charges,88% of total Billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,23451.12,63,,,percent of total billed charges,63% of total billed charges,5816.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,5695.27,15.3,,,percent of total billed charges,15.3% of total billed charges,25684.56,69,,,percent of total billed charges,69% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,11777.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,12618.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,29034.72,78,,,percent of total billed charges,78% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4867.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,37224,
CORONARY ART/GRFT ANGIO SI,84093455,CDM,481,RC,93455,HCPCS,Outpatient,,,37224,24195.60,,32757.12,88,,,percent of total billed charges,88% of total Billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,23451.12,63,,,percent of total billed charges,63% of total billed charges,5816.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,5695.27,15.3,,,percent of total billed charges,15.3% of total billed charges,25684.56,69,,,percent of total billed charges,69% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,11777.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,12618.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,29034.72,78,,,percent of total billed charges,78% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4867.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,37224,
R HRT CORONARY ARTERY ANGIO,84093456,CDM,481,RC,93456,HCPCS,Outpatient,,,37224,24195.60,,32757.12,88,,,percent of total billed charges,88% of total Billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,23451.12,63,,,percent of total billed charges,63% of total billed charges,5816.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,5695.27,15.3,,,percent of total billed charges,15.3% of total billed charges,25684.56,69,,,percent of total billed charges,69% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,11777.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,12618.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,29034.72,78,,,percent of total billed charges,78% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4867.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,37224,
R HRT AR/GRFT ANGIO,84093457,CDM,481,RC,93457,HCPCS,Outpatient,,,37224,24195.60,,32757.12,88,,,percent of total billed charges,88% of total Billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,23451.12,63,,,percent of total billed charges,63% of total billed charges,5816.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,5695.27,15.3,,,percent of total billed charges,15.3% of total billed charges,25684.56,69,,,percent of total billed charges,69% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,11777.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,12618.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,29034.72,78,,,percent of total billed charges,78% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4867.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,37224,
L HRT ARTERY/VENTRICLE ANGIO,84093458,CDM,481,RC,93458,HCPCS,Outpatient,,,37224,24195.60,,32757.12,88,,,percent of total billed charges,88% of total Billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,23451.12,63,,,percent of total billed charges,63% of total billed charges,5816.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,5695.27,15.3,,,percent of total billed charges,15.3% of total billed charges,25684.56,69,,,percent of total billed charges,69% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,11777.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,12618.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,29034.72,78,,,percent of total billed charges,78% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4867.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,37224,
L HRT ART/GRFT ANGIO,84093459,CDM,481,RC,93459,HCPCS,Outpatient,,,37224,24195.60,,32757.12,88,,,percent of total billed charges,88% of total Billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,23451.12,63,,,percent of total billed charges,63% of total billed charges,5816.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,5695.27,15.3,,,percent of total billed charges,15.3% of total billed charges,25684.56,69,,,percent of total billed charges,69% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,11777.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,12618.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,29034.72,78,,,percent of total billed charges,78% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4867.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,37224,
RL HRT ART/VENTRICLE ANGIO,84093460,CDM,481,RC,93460,HCPCS,Outpatient,,,37224,24195.60,,32757.12,88,,,percent of total billed charges,88% of total Billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,23451.12,63,,,percent of total billed charges,63% of total billed charges,5816.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,5695.27,15.3,,,percent of total billed charges,15.3% of total billed charges,25684.56,69,,,percent of total billed charges,69% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,11777.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,12618.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,29034.72,78,,,percent of total billed charges,78% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4867.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,37224,
RL HRT ART/VENT GRFT ANGIO,84093461,CDM,481,RC,93461,HCPCS,Outpatient,,,37224,24195.60,,32757.12,88,,,percent of total billed charges,88% of total Billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,23451.12,63,,,percent of total billed charges,63% of total billed charges,5816.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,5695.27,15.3,,,percent of total billed charges,15.3% of total billed charges,25684.56,69,,,percent of total billed charges,69% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,37224,100,,,percent of total billed charges,100% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,11777.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,14033.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,12618.94,33.9,,,percent of total billed charges,33.9% of total billed charges,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,29034.72,78,,,percent of total billed charges,78% of total billed charges,37224,100,,,percent of total billed charges,100% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,30747.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,4867.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4863.72,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,37224,
L HRT CATH TRSNSPTL PUNCTURE,84093462,CDM,481,RC,93462,HCPCS,Outpatient,,,10290,6688.50,,9055.2,88,,,percent of total billed charges,88% of total Billed charges,5145,50,,,percent of total billed charges,50% of total Billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,5145,50,,,percent of total billed charges,50% of total Billed charges,6482.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2120.96,100,,,Fee Schedule,100% of WA Medicaid,1574.37,15.3,,,percent of total billed charges,15.3% of total billed charges,7100.1,69,,,percent of total billed charges,69% of total billed charges,10290,100,,,percent of total billed charges,100% of total billed charges,5145,50,,,percent of total billed charges,50% of total Billed charges,10290,100,,,percent of total billed charges,100% of total billed charges,5145,50,,,percent of total billed charges,50% of total Billed charges,10290,100,,,percent of total billed charges,100% of total billed charges,5145,50,,,percent of total billed charges,50% of total Billed charges,6364.37,61.85,,,percent of total billed charges,61.85% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5145,50,,,percent of total billed charges,50% of total Billed charges,5145,50,,,percent of total billed charges,50% of total Billed charges,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5145,50,,,percent of total billed charges,50% of total Billed charges,5145,50,,,percent of total billed charges,50% of total Billed charges,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,5145,50,,,percent of total billed charges,50% of total Billed charges,3879.33,37.7,,,percent of total billed charges,37.70% of total billed charges,3879.33,37.7,,,percent of total billed charges,37.70% of total billed charges,5145,50,,,percent of total billed charges,50% of total Billed charges,3488.31,33.9,,,percent of total billed charges,33.9% of total billed charges,5145,50,,,percent of total billed charges,50% of total Billed charges,8026.2,78,,,percent of total billed charges,78% of total billed charges,10290,100,,,percent of total billed charges,100% of total billed charges,8499.54,82.6,,,percent of total billed charges,82.6% of total billed charges,8499.54,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5145,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5145,50,,,percent of total billed charges,50% of total Billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1571.08,10290,
DRUG ADMIN  HEMODYNMIC MEAS,84093463,CDM,481,RC,93463,HCPCS,Outpatient,,,472,306.80,,415.36,88,,,percent of total billed charges,88% of total Billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid,472,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,236,50,,,percent of total billed charges,50% of total Billed charges,297.36,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid,72.22,15.3,,,percent of total billed charges,15.3% of total billed charges,325.68,69,,,percent of total billed charges,69% of total billed charges,472,100,,,percent of total billed charges,100% of total billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,472,100,,,percent of total billed charges,100% of total billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,472,100,,,percent of total billed charges,100% of total billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,291.93,61.85,,,percent of total billed charges,61.85% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,236,50,,,percent of total billed charges,50% of total Billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,236,50,,,percent of total billed charges,50% of total Billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,236,50,,,percent of total billed charges,50% of total Billed charges,177.94,37.7,,,percent of total billed charges,37.70% of total billed charges,177.94,37.7,,,percent of total billed charges,37.70% of total billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,160.01,33.9,,,percent of total billed charges,33.9% of total billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,368.16,78,,,percent of total billed charges,78% of total billed charges,472,100,,,percent of total billed charges,100% of total billed charges,389.87,82.6,,,percent of total billed charges,82.6% of total billed charges,389.87,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,236,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,236,50,,,percent of total billed charges,50% of total Billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,472,
EXERCISE W/HEMODYNAMIC MEAS,84093464,CDM,481,RC,93464,HCPCS,Outpatient,,,446,289.90,,392.48,88,,,percent of total billed charges,88% of total Billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,150.99,100,,,Fee Schedule,100% of WA Medicaid,446,100,,,percent of total billed charges,100% of total billed charges,155.52,103,,,Fee Schedule,103% of WA Medicaid,223,50,,,percent of total billed charges,50% of total Billed charges,280.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,150.99,100,,,Fee Schedule,100% of WA Medicaid,68.24,15.3,,,percent of total billed charges,15.3% of total billed charges,307.74,69,,,percent of total billed charges,69% of total billed charges,446,100,,,percent of total billed charges,100% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,446,100,,,percent of total billed charges,100% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,446,100,,,percent of total billed charges,100% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,275.85,61.85,,,percent of total billed charges,61.85% of total billed charges,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,223,50,,,percent of total billed charges,50% of total Billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,111.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,223,50,,,percent of total billed charges,50% of total Billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,154.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.29,130,,,Fee Schedule,130% of WA Medicaid ,223,50,,,percent of total billed charges,50% of total Billed charges,168.14,37.7,,,percent of total billed charges,37.70% of total billed charges,168.14,37.7,,,percent of total billed charges,37.70% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,151.19,33.9,,,percent of total billed charges,33.9% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,347.88,78,,,percent of total billed charges,78% of total billed charges,446,100,,,percent of total billed charges,100% of total billed charges,368.4,82.6,,,percent of total billed charges,82.6% of total billed charges,368.4,82.6,,,percent of total billed charges,82.6% of total billed charges,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,223,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,223,50,,,percent of total billed charges,50% of total Billed charges,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.24,446,
SWAN GANZ INSERT,84093503,CDM,481,RC,93503,HCPCS,Outpatient,,,5668,3684.20,,4987.84,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1043.63,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3570.84,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid,867.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3910.92,69,,,percent of total billed charges,69% of total billed charges,5668,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5668,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5668,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,750.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1033.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.2,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2136.84,37.7,,,percent of total billed charges,37.70% of total billed charges,2136.84,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1921.45,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4421.04,78,,,percent of total billed charges,78% of total billed charges,5668,100,,,percent of total billed charges,100% of total billed charges,4681.77,82.6,,,percent of total billed charges,82.6% of total billed charges,4681.77,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,750.54,5712.48,
ENDOMYOCARDIAL BIOPSY,84093505,CDM,481,RC,93505,HCPCS,Outpatient,,,5666,3682.90,,4986.08,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2184.59,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3569.58,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid,866.9,15.3,,,percent of total billed charges,15.3% of total billed charges,3909.54,69,,,percent of total billed charges,69% of total billed charges,5666,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5666,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,5666,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2163.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2757.26,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2136.08,37.7,,,percent of total billed charges,37.70% of total billed charges,2136.08,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1920.77,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,4419.48,78,,,percent of total billed charges,78% of total billed charges,5666,100,,,percent of total billed charges,100% of total billed charges,4680.12,82.6,,,percent of total billed charges,82.6% of total billed charges,4680.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2120.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,866.9,11625.57,
INJECT CONGENITAL CARD CATH,84093563,CDM,481,RC,93563,HCPCS,Outpatient,,,207,134.55,,182.16,88,,,percent of total billed charges,88% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid,207,100,,,percent of total billed charges,100% of total billed charges,281.05,103,,,Fee Schedule,103% of WA Medicaid,103.5,50,,,percent of total billed charges,50% of total Billed charges,130.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,272.87,100,,,Fee Schedule,100% of WA Medicaid,31.67,15.3,,,percent of total billed charges,15.3% of total billed charges,142.83,69,,,percent of total billed charges,69% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,128.03,61.85,,,percent of total billed charges,61.85% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,202.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,278.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.73,130,,,Fee Schedule,130% of WA Medicaid ,103.5,50,,,percent of total billed charges,50% of total Billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,70.17,33.9,,,percent of total billed charges,33.9% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,161.46,78,,,percent of total billed charges,78% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,103.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.67,354.73,
INJECT L VENTR/ATRIAL ANGIO,84093565,CDM,481,RC,93565,HCPCS,Outpatient,,,207,134.55,,182.16,88,,,percent of total billed charges,88% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid,207,100,,,percent of total billed charges,100% of total billed charges,281.05,103,,,Fee Schedule,103% of WA Medicaid,103.5,50,,,percent of total billed charges,50% of total Billed charges,130.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,272.87,100,,,Fee Schedule,100% of WA Medicaid,31.67,15.3,,,percent of total billed charges,15.3% of total billed charges,142.83,69,,,percent of total billed charges,69% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,128.03,61.85,,,percent of total billed charges,61.85% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,202.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,278.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.73,130,,,Fee Schedule,130% of WA Medicaid ,103.5,50,,,percent of total billed charges,50% of total Billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,70.17,33.9,,,percent of total billed charges,33.9% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,161.46,78,,,percent of total billed charges,78% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,103.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.67,354.73,
INJECT SUPRVLV AORTOGRAPHY,84093567,CDM,481,RC,93567,HCPCS,Outpatient,,,207,134.55,,182.16,88,,,percent of total billed charges,88% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid,207,100,,,percent of total billed charges,100% of total billed charges,281.05,103,,,Fee Schedule,103% of WA Medicaid,103.5,50,,,percent of total billed charges,50% of total Billed charges,130.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,272.87,100,,,Fee Schedule,100% of WA Medicaid,31.67,15.3,,,percent of total billed charges,15.3% of total billed charges,142.83,69,,,percent of total billed charges,69% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,128.03,61.85,,,percent of total billed charges,61.85% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,202.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,278.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.73,130,,,Fee Schedule,130% of WA Medicaid ,103.5,50,,,percent of total billed charges,50% of total Billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,70.17,33.9,,,percent of total billed charges,33.9% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,161.46,78,,,percent of total billed charges,78% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,103.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.67,354.73,
INJECT PULM ART HRT CATH,84093568,CDM,481,RC,93568,HCPCS,Outpatient,,,207,134.55,,182.16,88,,,percent of total billed charges,88% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid,207,100,,,percent of total billed charges,100% of total billed charges,281.05,103,,,Fee Schedule,103% of WA Medicaid,103.5,50,,,percent of total billed charges,50% of total Billed charges,130.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,272.87,100,,,Fee Schedule,100% of WA Medicaid,31.67,15.3,,,percent of total billed charges,15.3% of total billed charges,142.83,69,,,percent of total billed charges,69% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,128.03,61.85,,,percent of total billed charges,61.85% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,202.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,278.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.73,130,,,Fee Schedule,130% of WA Medicaid ,103.5,50,,,percent of total billed charges,50% of total Billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,70.17,33.9,,,percent of total billed charges,33.9% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,161.46,78,,,percent of total billed charges,78% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,103.5,50,,,percent of total billed charges,50% of total Billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.67,354.73,
INTRAVASC DOPPLER FLOW MEASURE,84093571,CDM,481,RC,93571,HCPCS,Outpatient,,,10748,6986.20,,9458.24,88,,,percent of total billed charges,88% of total Billed charges,5374,50,,,percent of total billed charges,50% of total Billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,5374,50,,,percent of total billed charges,50% of total Billed charges,6771.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1644.44,15.3,,,percent of total billed charges,15.3% of total billed charges,7416.12,69,,,percent of total billed charges,69% of total billed charges,10748,100,,,percent of total billed charges,100% of total billed charges,5374,50,,,percent of total billed charges,50% of total Billed charges,10748,100,,,percent of total billed charges,100% of total billed charges,5374,50,,,percent of total billed charges,50% of total Billed charges,10748,100,,,percent of total billed charges,100% of total billed charges,5374,50,,,percent of total billed charges,50% of total Billed charges,6647.64,61.85,,,percent of total billed charges,61.85% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5374,50,,,percent of total billed charges,50% of total Billed charges,5374,50,,,percent of total billed charges,50% of total Billed charges,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5374,50,,,percent of total billed charges,50% of total Billed charges,5374,50,,,percent of total billed charges,50% of total Billed charges,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,5374,50,,,percent of total billed charges,50% of total Billed charges,4052,37.7,,,percent of total billed charges,37.70% of total billed charges,4052,37.7,,,percent of total billed charges,37.70% of total billed charges,5374,50,,,percent of total billed charges,50% of total Billed charges,3643.57,33.9,,,percent of total billed charges,33.9% of total billed charges,5374,50,,,percent of total billed charges,50% of total Billed charges,8383.44,78,,,percent of total billed charges,78% of total billed charges,10748,100,,,percent of total billed charges,100% of total billed charges,8877.85,82.6,,,percent of total billed charges,82.6% of total billed charges,8877.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5374,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5374,50,,,percent of total billed charges,50% of total Billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,10748,
INTRAVASCULAR DOPP EA ADD VESS,84093572,CDM,481,RC,93572,HCPCS,Outpatient,,,3429,2228.85,,3017.52,88,,,percent of total billed charges,88% of total Billed charges,1714.5,50,,,percent of total billed charges,50% of total Billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid,3429,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,1714.5,50,,,percent of total billed charges,50% of total Billed charges,2160.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1645.3,100,,,Fee Schedule,100% of WA Medicaid,524.64,15.3,,,percent of total billed charges,15.3% of total billed charges,2366.01,69,,,percent of total billed charges,69% of total billed charges,3429,100,,,percent of total billed charges,100% of total billed charges,1714.5,50,,,percent of total billed charges,50% of total Billed charges,3429,100,,,percent of total billed charges,100% of total billed charges,1714.5,50,,,percent of total billed charges,50% of total Billed charges,3429,100,,,percent of total billed charges,100% of total billed charges,1714.5,50,,,percent of total billed charges,50% of total Billed charges,2120.84,61.85,,,percent of total billed charges,61.85% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1714.5,50,,,percent of total billed charges,50% of total Billed charges,1714.5,50,,,percent of total billed charges,50% of total Billed charges,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1714.5,50,,,percent of total billed charges,50% of total Billed charges,1714.5,50,,,percent of total billed charges,50% of total Billed charges,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,1714.5,50,,,percent of total billed charges,50% of total Billed charges,1292.73,37.7,,,percent of total billed charges,37.70% of total billed charges,1292.73,37.7,,,percent of total billed charges,37.70% of total billed charges,1714.5,50,,,percent of total billed charges,50% of total Billed charges,1162.43,33.9,,,percent of total billed charges,33.9% of total billed charges,1714.5,50,,,percent of total billed charges,50% of total Billed charges,2674.62,78,,,percent of total billed charges,78% of total billed charges,3429,100,,,percent of total billed charges,100% of total billed charges,2832.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2832.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1714.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1714.5,50,,,percent of total billed charges,50% of total Billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,524.64,3429,
TRANSCATH CLOSURE OF ASD,84093580,CDM,481,RC,93580,HCPCS,Outpatient,,,93726,60921.90,,82478.88,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9106.04,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,9379.23,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,59047.38,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,9106.04,100,,,Fee Schedule,100% of WA Medicaid,14340.08,15.3,,,percent of total billed charges,15.3% of total billed charges,64670.94,69,,,percent of total billed charges,69% of total billed charges,93726,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,93726,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,93726,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65260.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9106.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,6745.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9288.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11837.86,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,35334.7,37.7,,,percent of total billed charges,37.70% of total billed charges,35334.7,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,31773.11,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,73106.28,78,,,percent of total billed charges,78% of total billed charges,93726,100,,,percent of total billed charges,100% of total billed charges,77417.68,82.6,,,percent of total billed charges,82.6% of total billed charges,77417.68,82.6,,,percent of total billed charges,82.6% of total billed charges,9106.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9106.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,93726,
HIS BUNDLE RECORDING,84093600,CDM,480,RC,93600,HCPCS,Outpatient,,,18293,11890.45,,16097.84,88,,,percent of total billed charges,88% of total Billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5750.89,103,,,Fee Schedule,103% of WA Medicaid,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,11524.59,63,,,percent of total billed charges,63% of total billed charges,13330.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid,2798.83,15.3,,,percent of total billed charges,15.3% of total billed charges,12622.17,69,,,percent of total billed charges,69% of total billed charges,18293,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,18293,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,18293,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,24694.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,4135.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5695.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7258.4,130,,,Fee Schedule,130% of WA Medicaid ,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,6896.46,37.7,,,percent of total billed charges,37.70% of total billed charges,6896.46,37.7,,,percent of total billed charges,37.70% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,6201.33,33.9,,,percent of total billed charges,33.9% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14268.54,78,,,percent of total billed charges,78% of total billed charges,18293,100,,,percent of total billed charges,100% of total billed charges,15110.02,82.6,,,percent of total billed charges,82.6% of total billed charges,15110.02,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7693.43,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2798.83,24694.01,
INTRA VENT  ART MAP MULT SITE,84093609,CDM,481,RC,93609,HCPCS,Outpatient,,,55303,35946.95,,48666.64,88,,,percent of total billed charges,88% of total Billed charges,27651.5,50,,,percent of total billed charges,50% of total Billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,15166.32,103,,,Fee Schedule,103% of WA Medicaid,27651.5,50,,,percent of total billed charges,50% of total Billed charges,34840.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14724.59,100,,,Fee Schedule,100% of WA Medicaid,8461.36,15.3,,,percent of total billed charges,15.3% of total billed charges,38159.07,69,,,percent of total billed charges,69% of total billed charges,55303,100,,,percent of total billed charges,100% of total billed charges,27651.5,50,,,percent of total billed charges,50% of total Billed charges,55303,100,,,percent of total billed charges,100% of total billed charges,27651.5,50,,,percent of total billed charges,50% of total Billed charges,55303,100,,,percent of total billed charges,100% of total billed charges,27651.5,50,,,percent of total billed charges,50% of total Billed charges,34204.91,61.85,,,percent of total billed charges,61.85% of total billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27651.5,50,,,percent of total billed charges,50% of total Billed charges,27651.5,50,,,percent of total billed charges,50% of total Billed charges,10907.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27651.5,50,,,percent of total billed charges,50% of total Billed charges,27651.5,50,,,percent of total billed charges,50% of total Billed charges,15019.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19141.96,130,,,Fee Schedule,130% of WA Medicaid ,27651.5,50,,,percent of total billed charges,50% of total Billed charges,20849.23,37.7,,,percent of total billed charges,37.70% of total billed charges,20849.23,37.7,,,percent of total billed charges,37.70% of total billed charges,27651.5,50,,,percent of total billed charges,50% of total Billed charges,18747.72,33.9,,,percent of total billed charges,33.9% of total billed charges,27651.5,50,,,percent of total billed charges,50% of total Billed charges,43136.34,78,,,percent of total billed charges,78% of total billed charges,55303,100,,,percent of total billed charges,100% of total billed charges,45680.28,82.6,,,percent of total billed charges,82.6% of total billed charges,45680.28,82.6,,,percent of total billed charges,82.6% of total billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27651.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27651.5,50,,,percent of total billed charges,50% of total Billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,55303,
EPS 3-D MAPING,84093613,CDM,481,RC,93613,HCPCS,Outpatient,,,1543,1002.95,,1357.84,88,,,percent of total billed charges,88% of total Billed charges,771.5,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid,1543,100,,,percent of total billed charges,100% of total billed charges,5750.89,103,,,Fee Schedule,103% of WA Medicaid,771.5,50,,,percent of total billed charges,50% of total Billed charges,972.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5583.39,100,,,Fee Schedule,100% of WA Medicaid,236.08,15.3,,,percent of total billed charges,15.3% of total billed charges,1064.67,69,,,percent of total billed charges,69% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,771.5,50,,,percent of total billed charges,50% of total Billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,771.5,50,,,percent of total billed charges,50% of total Billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,771.5,50,,,percent of total billed charges,50% of total Billed charges,954.35,61.85,,,percent of total billed charges,61.85% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,771.5,50,,,percent of total billed charges,50% of total Billed charges,771.5,50,,,percent of total billed charges,50% of total Billed charges,4135.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,771.5,50,,,percent of total billed charges,50% of total Billed charges,771.5,50,,,percent of total billed charges,50% of total Billed charges,5695.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7258.4,130,,,Fee Schedule,130% of WA Medicaid ,771.5,50,,,percent of total billed charges,50% of total Billed charges,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,771.5,50,,,percent of total billed charges,50% of total Billed charges,523.08,33.9,,,percent of total billed charges,33.9% of total billed charges,771.5,50,,,percent of total billed charges,50% of total Billed charges,1203.54,78,,,percent of total billed charges,78% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,771.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,771.5,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,236.08,7258.4,
EPS COMP W/O INDUCTION,84093619,CDM,480,RC,93619,HCPCS,Outpatient,,,23172,15061.80,,20391.36,88,,,percent of total billed charges,88% of total Billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5750.89,103,,,Fee Schedule,103% of WA Medicaid,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14598.36,63,,,percent of total billed charges,63% of total billed charges,13330.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid,3545.32,15.3,,,percent of total billed charges,15.3% of total billed charges,15988.68,69,,,percent of total billed charges,69% of total billed charges,23172,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,23172,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,23172,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,24694.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,4135.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5695.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7258.4,130,,,Fee Schedule,130% of WA Medicaid ,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8735.84,37.7,,,percent of total billed charges,37.70% of total billed charges,8735.84,37.7,,,percent of total billed charges,37.70% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7855.31,33.9,,,percent of total billed charges,33.9% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,18074.16,78,,,percent of total billed charges,78% of total billed charges,23172,100,,,percent of total billed charges,100% of total billed charges,19140.07,82.6,,,percent of total billed charges,82.6% of total billed charges,19140.07,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7693.43,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3545.32,24694.01,
COMPREHENSIVE EPS (3 WIRE),84093620,CDM,480,RC,93620,HCPCS,Outpatient,,,25749,16736.85,,22659.12,88,,,percent of total billed charges,88% of total Billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,5750.89,103,,,Fee Schedule,103% of WA Medicaid,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,16221.87,63,,,percent of total billed charges,63% of total billed charges,13330.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid,3939.6,15.3,,,percent of total billed charges,15.3% of total billed charges,17766.81,69,,,percent of total billed charges,69% of total billed charges,25749,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,25749,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,25749,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,24694.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,4135.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5695.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7258.4,130,,,Fee Schedule,130% of WA Medicaid ,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,9707.37,37.7,,,percent of total billed charges,37.70% of total billed charges,9707.37,37.7,,,percent of total billed charges,37.70% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,8728.91,33.9,,,percent of total billed charges,33.9% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,20084.22,78,,,percent of total billed charges,78% of total billed charges,25749,100,,,percent of total billed charges,100% of total billed charges,21268.67,82.6,,,percent of total billed charges,82.6% of total billed charges,21268.67,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7693.43,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3939.6,25749,
EPS COMP W LA/CS RECORD,84093621,CDM,481,RC,93621,HCPCS,Outpatient,,,463,300.95,,407.44,88,,,percent of total billed charges,88% of total Billed charges,231.5,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid,463,100,,,percent of total billed charges,100% of total billed charges,5750.89,103,,,Fee Schedule,103% of WA Medicaid,231.5,50,,,percent of total billed charges,50% of total Billed charges,291.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5583.39,100,,,Fee Schedule,100% of WA Medicaid,70.84,15.3,,,percent of total billed charges,15.3% of total billed charges,319.47,69,,,percent of total billed charges,69% of total billed charges,463,100,,,percent of total billed charges,100% of total billed charges,231.5,50,,,percent of total billed charges,50% of total Billed charges,463,100,,,percent of total billed charges,100% of total billed charges,231.5,50,,,percent of total billed charges,50% of total Billed charges,463,100,,,percent of total billed charges,100% of total billed charges,231.5,50,,,percent of total billed charges,50% of total Billed charges,286.37,61.85,,,percent of total billed charges,61.85% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,231.5,50,,,percent of total billed charges,50% of total Billed charges,231.5,50,,,percent of total billed charges,50% of total Billed charges,4135.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,231.5,50,,,percent of total billed charges,50% of total Billed charges,231.5,50,,,percent of total billed charges,50% of total Billed charges,5695.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7258.4,130,,,Fee Schedule,130% of WA Medicaid ,231.5,50,,,percent of total billed charges,50% of total Billed charges,174.55,37.7,,,percent of total billed charges,37.70% of total billed charges,174.55,37.7,,,percent of total billed charges,37.70% of total billed charges,231.5,50,,,percent of total billed charges,50% of total Billed charges,156.96,33.9,,,percent of total billed charges,33.9% of total billed charges,231.5,50,,,percent of total billed charges,50% of total Billed charges,361.14,78,,,percent of total billed charges,78% of total billed charges,463,100,,,percent of total billed charges,100% of total billed charges,382.44,82.6,,,percent of total billed charges,82.6% of total billed charges,382.44,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,231.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,231.5,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.84,7258.4,
LEFT VENTRICULAR RECORDING 02,84093622,CDM,481,RC,93622,HCPCS,Outpatient,,,679,441.35,,597.52,88,,,percent of total billed charges,88% of total Billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid,679,100,,,percent of total billed charges,100% of total billed charges,5750.89,103,,,Fee Schedule,103% of WA Medicaid,339.5,50,,,percent of total billed charges,50% of total Billed charges,427.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5583.39,100,,,Fee Schedule,100% of WA Medicaid,103.89,15.3,,,percent of total billed charges,15.3% of total billed charges,468.51,69,,,percent of total billed charges,69% of total billed charges,679,100,,,percent of total billed charges,100% of total billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,679,100,,,percent of total billed charges,100% of total billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,679,100,,,percent of total billed charges,100% of total billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,419.96,61.85,,,percent of total billed charges,61.85% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,339.5,50,,,percent of total billed charges,50% of total Billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,4135.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,339.5,50,,,percent of total billed charges,50% of total Billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,5695.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7258.4,130,,,Fee Schedule,130% of WA Medicaid ,339.5,50,,,percent of total billed charges,50% of total Billed charges,255.98,37.7,,,percent of total billed charges,37.70% of total billed charges,255.98,37.7,,,percent of total billed charges,37.70% of total billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,230.18,33.9,,,percent of total billed charges,33.9% of total billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,529.62,78,,,percent of total billed charges,78% of total billed charges,679,100,,,percent of total billed charges,100% of total billed charges,560.85,82.6,,,percent of total billed charges,82.6% of total billed charges,560.85,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,339.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,339.5,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,103.89,7258.4,
EPA DRUG INFUSION,84093623,CDM,481,RC,93623,HCPCS,Outpatient,,,629,408.85,,553.52,88,,,percent of total billed charges,88% of total Billed charges,314.5,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid,629,100,,,percent of total billed charges,100% of total billed charges,5750.89,103,,,Fee Schedule,103% of WA Medicaid,314.5,50,,,percent of total billed charges,50% of total Billed charges,396.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5583.39,100,,,Fee Schedule,100% of WA Medicaid,96.24,15.3,,,percent of total billed charges,15.3% of total billed charges,434.01,69,,,percent of total billed charges,69% of total billed charges,629,100,,,percent of total billed charges,100% of total billed charges,314.5,50,,,percent of total billed charges,50% of total Billed charges,629,100,,,percent of total billed charges,100% of total billed charges,314.5,50,,,percent of total billed charges,50% of total Billed charges,629,100,,,percent of total billed charges,100% of total billed charges,314.5,50,,,percent of total billed charges,50% of total Billed charges,389.04,61.85,,,percent of total billed charges,61.85% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,314.5,50,,,percent of total billed charges,50% of total Billed charges,314.5,50,,,percent of total billed charges,50% of total Billed charges,4135.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,314.5,50,,,percent of total billed charges,50% of total Billed charges,314.5,50,,,percent of total billed charges,50% of total Billed charges,5695.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7258.4,130,,,Fee Schedule,130% of WA Medicaid ,314.5,50,,,percent of total billed charges,50% of total Billed charges,237.13,37.7,,,percent of total billed charges,37.70% of total billed charges,237.13,37.7,,,percent of total billed charges,37.70% of total billed charges,314.5,50,,,percent of total billed charges,50% of total Billed charges,213.23,33.9,,,percent of total billed charges,33.9% of total billed charges,314.5,50,,,percent of total billed charges,50% of total Billed charges,490.62,78,,,percent of total billed charges,78% of total billed charges,629,100,,,percent of total billed charges,100% of total billed charges,519.55,82.6,,,percent of total billed charges,82.6% of total billed charges,519.55,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,314.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,314.5,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.24,7258.4,
"HEART PACING, MAPPING",84093631,CDM,480,RC,93631,HCPCS,Outpatient,,,1598,1038.70,,1406.24,88,,,percent of total billed charges,88% of total Billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid,1598,100,,,percent of total billed charges,100% of total billed charges,5750.89,103,,,Fee Schedule,103% of WA Medicaid,799,50,,,percent of total billed charges,50% of total Billed charges,1006.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5583.39,100,,,Fee Schedule,100% of WA Medicaid,244.49,15.3,,,percent of total billed charges,15.3% of total billed charges,1102.62,69,,,percent of total billed charges,69% of total billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,988.36,61.85,,,percent of total billed charges,61.85% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,799,50,,,percent of total billed charges,50% of total Billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,4135.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,799,50,,,percent of total billed charges,50% of total Billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,5695.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7258.4,130,,,Fee Schedule,130% of WA Medicaid ,799,50,,,percent of total billed charges,50% of total Billed charges,602.45,37.7,,,percent of total billed charges,37.70% of total billed charges,602.45,37.7,,,percent of total billed charges,37.70% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,541.72,33.9,,,percent of total billed charges,33.9% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,1246.44,78,,,percent of total billed charges,78% of total billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,1319.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1319.95,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,799,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,799,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,244.49,7258.4,
EP EVAL W/TESTING SGL/DUAL CH,84093641,CDM,480,RC,93641,HCPCS,Outpatient,,,2083,1353.95,,1833.04,88,,,percent of total billed charges,88% of total Billed charges,1041.5,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid,2083,100,,,percent of total billed charges,100% of total billed charges,5750.89,103,,,Fee Schedule,103% of WA Medicaid,1041.5,50,,,percent of total billed charges,50% of total Billed charges,1312.29,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5583.39,100,,,Fee Schedule,100% of WA Medicaid,318.7,15.3,,,percent of total billed charges,15.3% of total billed charges,1437.27,69,,,percent of total billed charges,69% of total billed charges,2083,100,,,percent of total billed charges,100% of total billed charges,1041.5,50,,,percent of total billed charges,50% of total Billed charges,2083,100,,,percent of total billed charges,100% of total billed charges,1041.5,50,,,percent of total billed charges,50% of total Billed charges,2083,100,,,percent of total billed charges,100% of total billed charges,1041.5,50,,,percent of total billed charges,50% of total Billed charges,1288.34,61.85,,,percent of total billed charges,61.85% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1041.5,50,,,percent of total billed charges,50% of total Billed charges,1041.5,50,,,percent of total billed charges,50% of total Billed charges,4135.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1041.5,50,,,percent of total billed charges,50% of total Billed charges,1041.5,50,,,percent of total billed charges,50% of total Billed charges,5695.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7258.4,130,,,Fee Schedule,130% of WA Medicaid ,1041.5,50,,,percent of total billed charges,50% of total Billed charges,785.29,37.7,,,percent of total billed charges,37.70% of total billed charges,785.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1041.5,50,,,percent of total billed charges,50% of total Billed charges,706.14,33.9,,,percent of total billed charges,33.9% of total billed charges,1041.5,50,,,percent of total billed charges,50% of total Billed charges,1624.74,78,,,percent of total billed charges,78% of total billed charges,2083,100,,,percent of total billed charges,100% of total billed charges,1720.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1720.56,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1041.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1041.5,50,,,percent of total billed charges,50% of total Billed charges,5583.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,318.7,7258.4,
INTRA CARDI ABLAT AV NODE,84093650,CDM,481,RC,93650,HCPCS,Outpatient,,,20595,13386.75,,18123.6,88,,,percent of total billed charges,88% of total Billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,15166.32,103,,,Fee Schedule,103% of WA Medicaid,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,12974.85,63,,,percent of total billed charges,63% of total billed charges,13330.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid,3151.04,15.3,,,percent of total billed charges,15.3% of total billed charges,14210.55,69,,,percent of total billed charges,69% of total billed charges,20595,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,20595,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,20595,100,,,percent of total billed charges,100% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,24694.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,10907.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,15019.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19141.96,130,,,Fee Schedule,130% of WA Medicaid ,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7764.32,37.7,,,percent of total billed charges,37.70% of total billed charges,7764.32,37.7,,,percent of total billed charges,37.70% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,6981.71,33.9,,,percent of total billed charges,33.9% of total billed charges,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,16064.1,78,,,percent of total billed charges,78% of total billed charges,20595,100,,,percent of total billed charges,100% of total billed charges,17011.47,82.6,,,percent of total billed charges,82.6% of total billed charges,17011.47,82.6,,,percent of total billed charges,82.6% of total billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,7693.43,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,7617.27,100,,,Fee Schedule,100% of Medicare OPPS rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3151.04,24694.01,
EP/ABLATE SUPRAVENT ARRYTH,84093653,CDM,481,RC,93653,HCPCS,Outpatient,,,51811,33677.15,,45593.68,88,,,percent of total billed charges,88% of total Billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,15166.32,103,,,Fee Schedule,103% of WA Medicaid,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,32640.93,63,,,percent of total billed charges,63% of total billed charges,42392.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid,7927.08,15.3,,,percent of total billed charges,15.3% of total billed charges,35749.59,69,,,percent of total billed charges,69% of total billed charges,51811,100,,,percent of total billed charges,100% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,51811,100,,,percent of total billed charges,100% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,51811,100,,,percent of total billed charges,100% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,87199.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,10907.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,15019.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19141.96,130,,,Fee Schedule,130% of WA Medicaid ,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,19532.75,37.7,,,percent of total billed charges,37.70% of total billed charges,19532.75,37.7,,,percent of total billed charges,37.70% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,17563.93,33.9,,,percent of total billed charges,33.9% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,40412.58,78,,,percent of total billed charges,78% of total billed charges,51811,100,,,percent of total billed charges,100% of total billed charges,42795.89,82.6,,,percent of total billed charges,82.6% of total billed charges,42795.89,82.6,,,percent of total billed charges,82.6% of total billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,24466.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,87199.85,
EP/ABLATE VENTRIC TACHY,84093654,CDM,481,RC,93654,HCPCS,Outpatient,,,48759,31693.35,,42907.92,88,,,percent of total billed charges,88% of total Billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,15166.32,103,,,Fee Schedule,103% of WA Medicaid,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,30718.17,63,,,percent of total billed charges,63% of total billed charges,42392.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid,7460.13,15.3,,,percent of total billed charges,15.3% of total billed charges,33643.71,69,,,percent of total billed charges,69% of total billed charges,48759,100,,,percent of total billed charges,100% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,48759,100,,,percent of total billed charges,100% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,48759,100,,,percent of total billed charges,100% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,87199.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,10907.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,15019.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19141.96,130,,,Fee Schedule,130% of WA Medicaid ,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,18382.14,37.7,,,percent of total billed charges,37.70% of total billed charges,18382.14,37.7,,,percent of total billed charges,37.70% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,16529.3,33.9,,,percent of total billed charges,33.9% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,38032.02,78,,,percent of total billed charges,78% of total billed charges,48759,100,,,percent of total billed charges,100% of total billed charges,40274.93,82.6,,,percent of total billed charges,82.6% of total billed charges,40274.93,82.6,,,percent of total billed charges,82.6% of total billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,24466.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,87199.85,
ABLATE ARRYTHMIA ADD ON,84093655,CDM,481,RC,93655,HCPCS,Outpatient,,,1655,1075.75,,1456.4,88,,,percent of total billed charges,88% of total Billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid,1655,100,,,percent of total billed charges,100% of total billed charges,15166.32,103,,,Fee Schedule,103% of WA Medicaid,827.5,50,,,percent of total billed charges,50% of total Billed charges,1042.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14724.59,100,,,Fee Schedule,100% of WA Medicaid,253.22,15.3,,,percent of total billed charges,15.3% of total billed charges,1141.95,69,,,percent of total billed charges,69% of total billed charges,1655,100,,,percent of total billed charges,100% of total billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,1655,100,,,percent of total billed charges,100% of total billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,1655,100,,,percent of total billed charges,100% of total billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,1023.62,61.85,,,percent of total billed charges,61.85% of total billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,827.5,50,,,percent of total billed charges,50% of total Billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,10907.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,827.5,50,,,percent of total billed charges,50% of total Billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,15019.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19141.96,130,,,Fee Schedule,130% of WA Medicaid ,827.5,50,,,percent of total billed charges,50% of total Billed charges,623.94,37.7,,,percent of total billed charges,37.70% of total billed charges,623.94,37.7,,,percent of total billed charges,37.70% of total billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,561.05,33.9,,,percent of total billed charges,33.9% of total billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,1290.9,78,,,percent of total billed charges,78% of total billed charges,1655,100,,,percent of total billed charges,100% of total billed charges,1367.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1367.03,82.6,,,percent of total billed charges,82.6% of total billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,827.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,827.5,50,,,percent of total billed charges,50% of total Billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,253.22,19141.96,
TX ATRIAL FIB PULM VEIN ISOL,84093656,CDM,481,RC,93656,HCPCS,Outpatient,,,48759,31693.35,,42907.92,88,,,percent of total billed charges,88% of total Billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,15166.32,103,,,Fee Schedule,103% of WA Medicaid,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,30718.17,63,,,percent of total billed charges,63% of total billed charges,42392.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid,7460.13,15.3,,,percent of total billed charges,15.3% of total billed charges,33643.71,69,,,percent of total billed charges,69% of total billed charges,48759,100,,,percent of total billed charges,100% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,48759,100,,,percent of total billed charges,100% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,48759,100,,,percent of total billed charges,100% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,87199.85,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,10907.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,15019.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19141.96,130,,,Fee Schedule,130% of WA Medicaid ,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,18382.14,37.7,,,percent of total billed charges,37.70% of total billed charges,18382.14,37.7,,,percent of total billed charges,37.70% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,16529.3,33.9,,,percent of total billed charges,33.9% of total billed charges,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,38032.02,78,,,percent of total billed charges,78% of total billed charges,48759,100,,,percent of total billed charges,100% of total billed charges,40274.93,82.6,,,percent of total billed charges,82.6% of total billed charges,40274.93,82.6,,,percent of total billed charges,82.6% of total billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,24466.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24224.54,100,,,Fee Schedule,100% of Medicare OPPS rate,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,87199.85,
TX L/R ATRIAL FIB ADDL,84093657,CDM,481,RC,93657,HCPCS,Outpatient,,,1655,1075.75,,1456.4,88,,,percent of total billed charges,88% of total Billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid,1655,100,,,percent of total billed charges,100% of total billed charges,15166.32,103,,,Fee Schedule,103% of WA Medicaid,827.5,50,,,percent of total billed charges,50% of total Billed charges,1042.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14724.59,100,,,Fee Schedule,100% of WA Medicaid,253.22,15.3,,,percent of total billed charges,15.3% of total billed charges,1141.95,69,,,percent of total billed charges,69% of total billed charges,1655,100,,,percent of total billed charges,100% of total billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,1655,100,,,percent of total billed charges,100% of total billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,1655,100,,,percent of total billed charges,100% of total billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,1023.62,61.85,,,percent of total billed charges,61.85% of total billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,827.5,50,,,percent of total billed charges,50% of total Billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,10907.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,827.5,50,,,percent of total billed charges,50% of total Billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,15019.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19141.96,130,,,Fee Schedule,130% of WA Medicaid ,827.5,50,,,percent of total billed charges,50% of total Billed charges,623.94,37.7,,,percent of total billed charges,37.70% of total billed charges,623.94,37.7,,,percent of total billed charges,37.70% of total billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,561.05,33.9,,,percent of total billed charges,33.9% of total billed charges,827.5,50,,,percent of total billed charges,50% of total Billed charges,1290.9,78,,,percent of total billed charges,78% of total billed charges,1655,100,,,percent of total billed charges,100% of total billed charges,1367.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1367.03,82.6,,,percent of total billed charges,82.6% of total billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,827.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,827.5,50,,,percent of total billed charges,50% of total Billed charges,14724.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,253.22,19141.96,
TILT TABLE TEST,84093660,CDM,481,RC,93660,HCPCS,Outpatient,,,1849,1201.85,,1627.12,88,,,percent of total billed charges,88% of total Billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,1849,100,,,percent of total billed charges,100% of total billed charges,155.52,103,,,Fee Schedule,103% of WA Medicaid,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.87,63,,,percent of total billed charges,63% of total billed charges,956.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,282.9,15.3,,,percent of total billed charges,15.3% of total billed charges,1275.81,69,,,percent of total billed charges,69% of total billed charges,1849,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1849,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1849,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1981.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,111.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,154.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.29,130,,,Fee Schedule,130% of WA Medicaid ,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,697.07,37.7,,,percent of total billed charges,37.70% of total billed charges,697.07,37.7,,,percent of total billed charges,37.70% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,626.81,33.9,,,percent of total billed charges,33.9% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1442.22,78,,,percent of total billed charges,78% of total billed charges,1849,100,,,percent of total billed charges,100% of total billed charges,1527.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1527.27,82.6,,,percent of total billed charges,82.6% of total billed charges,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,552.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.84,1981.61,
INTRACARDIAC ECHO DURING PRCDR,84093662,CDM,480,RC,93662,HCPCS,Outpatient,,,1933,1256.45,,1701.04,88,,,percent of total billed charges,88% of total Billed charges,966.5,50,,,percent of total billed charges,50% of total Billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid,1933,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,966.5,50,,,percent of total billed charges,50% of total Billed charges,1217.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,418.1,100,,,Fee Schedule,100% of WA Medicaid,295.75,15.3,,,percent of total billed charges,15.3% of total billed charges,1333.77,69,,,percent of total billed charges,69% of total billed charges,1933,100,,,percent of total billed charges,100% of total billed charges,966.5,50,,,percent of total billed charges,50% of total Billed charges,1933,100,,,percent of total billed charges,100% of total billed charges,966.5,50,,,percent of total billed charges,50% of total Billed charges,1933,100,,,percent of total billed charges,100% of total billed charges,966.5,50,,,percent of total billed charges,50% of total Billed charges,1195.56,61.85,,,percent of total billed charges,61.85% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,966.5,50,,,percent of total billed charges,50% of total Billed charges,966.5,50,,,percent of total billed charges,50% of total Billed charges,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,966.5,50,,,percent of total billed charges,50% of total Billed charges,966.5,50,,,percent of total billed charges,50% of total Billed charges,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,966.5,50,,,percent of total billed charges,50% of total Billed charges,728.74,37.7,,,percent of total billed charges,37.70% of total billed charges,728.74,37.7,,,percent of total billed charges,37.70% of total billed charges,966.5,50,,,percent of total billed charges,50% of total Billed charges,655.29,33.9,,,percent of total billed charges,33.9% of total billed charges,966.5,50,,,percent of total billed charges,50% of total Billed charges,1507.74,78,,,percent of total billed charges,78% of total billed charges,1933,100,,,percent of total billed charges,100% of total billed charges,1596.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1596.66,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,966.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,966.5,50,,,percent of total billed charges,50% of total Billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,295.75,1933,
PERCUSURGE PROCEDURE,84093799,CDM,480,RC,93799,HCPCS,Outpatient,,,937,609.05,,824.56,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,937,100,,,percent of total billed charges,100% of total billed charges,24.47,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,590.31,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,143.36,15.3,,,percent of total billed charges,15.3% of total billed charges,646.53,69,,,percent of total billed charges,69% of total billed charges,937,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,937,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,937,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,17.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,24.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.89,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,353.25,37.7,,,percent of total billed charges,37.70% of total billed charges,353.25,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,317.64,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,730.86,78,,,percent of total billed charges,78% of total billed charges,937,100,,,percent of total billed charges,100% of total billed charges,773.96,82.6,,,percent of total billed charges,82.6% of total billed charges,773.96,82.6,,,percent of total billed charges,82.6% of total billed charges,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,937,
IV INFUSION HYDRATION 31M-1HR,84096360,CDM,761,RC,96360,HCPCS,Outpatient,,,528,343.20,,464.64,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,528,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,80.78,15.3,,,percent of total billed charges,15.3% of total billed charges,364.32,69,,,percent of total billed charges,69% of total billed charges,528,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,528,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,528,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,199.06,37.7,,,percent of total billed charges,37.70% of total billed charges,199.06,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,178.99,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,411.84,78,,,percent of total billed charges,78% of total billed charges,528,100,,,percent of total billed charges,100% of total billed charges,436.13,82.6,,,percent of total billed charges,82.6% of total billed charges,436.13,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.78,826.71,
IV INFUSION HYDRATION ADDL HR,84096361,CDM,761,RC,96361,HCPCS,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,132,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,44.75,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.2,600.65,
IV INFUSION THX/PX/DX FIRST HR,84096365,CDM,761,RC,96365,HCPCS,Outpatient,,,702,456.30,,617.76,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,702,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,107.41,15.3,,,percent of total billed charges,15.3% of total billed charges,484.38,69,,,percent of total billed charges,69% of total billed charges,702,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,702,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,702,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,264.65,37.7,,,percent of total billed charges,37.70% of total billed charges,264.65,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,237.98,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,547.56,78,,,percent of total billed charges,78% of total billed charges,702,100,,,percent of total billed charges,100% of total billed charges,579.85,82.6,,,percent of total billed charges,82.6% of total billed charges,579.85,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.41,826.71,
IV INFUSION THX/PX/DX ADDL HR,84096366,CDM,761,RC,96366,HCPCS,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,132,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,84.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,132,100,,,percent of total billed charges,100% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,44.75,33.9,,,percent of total billed charges,33.9% of total billed charges,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,48.93,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,48.45,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.2,600.65,
IV INFUSION ADDL SEQ 1HR,84096367,CDM,761,RC,96367,HCPCS,Outpatient,,,447,290.55,,393.36,88,,,percent of total billed charges,88% of total Billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,447,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,68.39,15.3,,,percent of total billed charges,15.3% of total billed charges,308.43,69,,,percent of total billed charges,69% of total billed charges,447,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,447,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,447,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,251.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,168.52,37.7,,,percent of total billed charges,37.70% of total billed charges,168.52,37.7,,,percent of total billed charges,37.70% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,151.53,33.9,,,percent of total billed charges,33.9% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,348.66,78,,,percent of total billed charges,78% of total billed charges,447,100,,,percent of total billed charges,100% of total billed charges,369.22,82.6,,,percent of total billed charges,82.6% of total billed charges,369.22,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.39,447,
INJ THER/DX IM/SQ,84096372,CDM,761,RC,96372,HCPCS,Outpatient,,,302,196.30,,265.76,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,46.21,15.3,,,percent of total billed charges,15.3% of total billed charges,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,102.38,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,302,
"INTRA-ARTERIAL INJECTION,THER",84096373,CDM,940,RC,96373,HCPCS,Outpatient,,,1339,870.35,,1178.32,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,1339,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,204.87,15.3,,,percent of total billed charges,15.3% of total billed charges,923.91,69,,,percent of total billed charges,69% of total billed charges,1339,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1339,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1339,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,504.8,37.7,,,percent of total billed charges,37.70% of total billed charges,504.8,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,453.92,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1044.42,78,,,percent of total billed charges,78% of total billed charges,1339,100,,,percent of total billed charges,100% of total billed charges,1106.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1106.01,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,1339,
IV PUSH ONE/FIRST DRUG,84096374,CDM,761,RC,96374,HCPCS,Outpatient,,,438,284.70,,385.44,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,438,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,67.01,15.3,,,percent of total billed charges,15.3% of total billed charges,302.22,69,,,percent of total billed charges,69% of total billed charges,438,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,438,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,438,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,165.13,37.7,,,percent of total billed charges,37.70% of total billed charges,165.13,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,148.48,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,341.64,78,,,percent of total billed charges,78% of total billed charges,438,100,,,percent of total billed charges,100% of total billed charges,361.79,82.6,,,percent of total billed charges,82.6% of total billed charges,361.79,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,826.71,
IV PUSH SAME DRUG/SUB 31M,84096376,CDM,940,RC,96376,HCPCS,Outpatient,,,296,192.40,,260.48,88,,,percent of total billed charges,88% of total Billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid,296,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,148,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.8,100,,,Fee Schedule,100% of WA Medicaid,45.29,15.3,,,percent of total billed charges,15.3% of total billed charges,204.24,69,,,percent of total billed charges,69% of total billed charges,296,100,,,percent of total billed charges,100% of total billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,296,100,,,percent of total billed charges,100% of total billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,296,100,,,percent of total billed charges,100% of total billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,183.08,61.85,,,percent of total billed charges,61.85% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148,50,,,percent of total billed charges,50% of total Billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,148,50,,,percent of total billed charges,50% of total Billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,148,50,,,percent of total billed charges,50% of total Billed charges,111.59,37.7,,,percent of total billed charges,37.70% of total billed charges,111.59,37.7,,,percent of total billed charges,37.70% of total billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,100.34,33.9,,,percent of total billed charges,33.9% of total billed charges,148,50,,,percent of total billed charges,50% of total Billed charges,230.88,78,,,percent of total billed charges,78% of total billed charges,296,100,,,percent of total billed charges,100% of total billed charges,244.5,82.6,,,percent of total billed charges,82.6% of total billed charges,244.5,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,148,50,,,percent of total billed charges,50% of total Billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,296,
DEBRIDEMENT,84097597,CDM,360,RC,97597,HCPCS,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,87,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,54.81,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,87,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,29.49,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.49,3367,
MODSED OTH GT5 1ST15,84099156,CDM,370,RC,99156,HCPCS,Outpatient,,,464,301.60,,408.32,88,,,percent of total billed charges,88% of total Billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid,464,100,,,percent of total billed charges,100% of total billed charges,22.18,103,,,Fee Schedule,103% of WA Medicaid,232,50,,,percent of total billed charges,50% of total Billed charges,292.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.54,100,,,Fee Schedule,100% of WA Medicaid,70.99,15.3,,,percent of total billed charges,15.3% of total billed charges,320.16,69,,,percent of total billed charges,69% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,464,100,,,percent of total billed charges,100% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,464,100,,,percent of total billed charges,100% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,286.98,61.85,,,percent of total billed charges,61.85% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232,50,,,percent of total billed charges,50% of total Billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,15.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,232,50,,,percent of total billed charges,50% of total Billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,21.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28,130,,,Fee Schedule,130% of WA Medicaid ,232,50,,,percent of total billed charges,50% of total Billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,157.3,33.9,,,percent of total billed charges,33.9% of total billed charges,232,50,,,percent of total billed charges,50% of total Billed charges,361.92,78,,,percent of total billed charges,78% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,232,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.95,464,
KIT 6FR PIGTAIL PERICARDIOCENT,840C1729,CDM,270,RC,C1729,HCPCS,Outpatient,,,89,57.85,,78.32,88,,,percent of total billed charges,88% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,89,100,,,percent of total billed charges,100% of total billed charges,15.4,17.304,,,percent of total billed charges,17.304% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,13.62,15.3,,,percent of total billed charges,15.3% of total billed charges,61.41,69,,,percent of total billed charges,69% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,89,100,,,percent of total billed charges,100% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,89,100,,,percent of total billed charges,100% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,55.05,61.85,,,percent of total billed charges,61.85% of total billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,15.25,17.136,,,percent of total billed charges,17.136% of total billed charges,19.44,21.84,,,percent of total billed charges,21.84% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,44.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,44.5,50,,,percent of total billed charges,50% of total Billed charges,69.42,78,,,percent of total billed charges,78% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,44.5,50,,,percent of total billed charges,50% of total Billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,13.62,89,
KIT 6FR STRAIGHT PERICARDIOCEN,840C1769,CDM,270,RC,C1769,HCPCS,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,23.36,17.304,,,percent of total billed charges,17.304% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,61.85,,,percent of total billed charges,61.85% of total billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,23.13,17.136,,,percent of total billed charges,17.136% of total billed charges,29.48,21.84,,,percent of total billed charges,21.84% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,20.66,135,
PERC DE COR STENT SINGLE,840C9600,CDM,481,RC,C9600,HCPCS,Outpatient,,,70923,46099.95,,62412.24,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,44681.49,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,10851.22,15.3,,,percent of total billed charges,15.3% of total billed charges,48936.87,69,,,percent of total billed charges,69% of total billed charges,70923,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,70923,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,70923,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,26737.97,37.7,,,percent of total billed charges,37.70% of total billed charges,26737.97,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,24042.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,55319.94,78,,,percent of total billed charges,78% of total billed charges,70923,100,,,percent of total billed charges,100% of total billed charges,58582.4,82.6,,,percent of total billed charges,82.6% of total billed charges,58582.4,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,70923,
PERC DE COR STENT BRANCH,840C9601,CDM,481,RC,C9601,HCPCS,Outpatient,,,36087,23456.55,,31756.56,88,,,percent of total billed charges,88% of total Billed charges,18043.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,18043.5,50,,,percent of total billed charges,50% of total Billed charges,22734.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7748.35,100,,,Fee Schedule,100% of WA Medicaid,5521.31,15.3,,,percent of total billed charges,15.3% of total billed charges,24900.03,69,,,percent of total billed charges,69% of total billed charges,36087,100,,,percent of total billed charges,100% of total billed charges,18043.5,50,,,percent of total billed charges,50% of total Billed charges,36087,100,,,percent of total billed charges,100% of total billed charges,18043.5,50,,,percent of total billed charges,50% of total Billed charges,36087,100,,,percent of total billed charges,100% of total billed charges,18043.5,50,,,percent of total billed charges,50% of total Billed charges,22319.81,61.85,,,percent of total billed charges,61.85% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18043.5,50,,,percent of total billed charges,50% of total Billed charges,18043.5,50,,,percent of total billed charges,50% of total Billed charges,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18043.5,50,,,percent of total billed charges,50% of total Billed charges,18043.5,50,,,percent of total billed charges,50% of total Billed charges,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,18043.5,50,,,percent of total billed charges,50% of total Billed charges,13604.8,37.7,,,percent of total billed charges,37.70% of total billed charges,13604.8,37.7,,,percent of total billed charges,37.70% of total billed charges,18043.5,50,,,percent of total billed charges,50% of total Billed charges,12233.49,33.9,,,percent of total billed charges,33.9% of total billed charges,18043.5,50,,,percent of total billed charges,50% of total Billed charges,28147.86,78,,,percent of total billed charges,78% of total billed charges,36087,100,,,percent of total billed charges,100% of total billed charges,29807.86,82.6,,,percent of total billed charges,82.6% of total billed charges,29807.86,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18043.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18043.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,36087,
PERC DE COR STENT/ATHER SING,840C9602,CDM,481,RC,C9602,HCPCS,Outpatient,,,28870,18765.50,,25405.6,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18188.1,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4417.11,15.3,,,percent of total billed charges,15.3% of total billed charges,19920.3,69,,,percent of total billed charges,69% of total billed charges,28870,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,28870,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,28870,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65260.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,10883.99,37.7,,,percent of total billed charges,37.70% of total billed charges,10883.99,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9786.93,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,22518.6,78,,,percent of total billed charges,78% of total billed charges,28870,100,,,percent of total billed charges,100% of total billed charges,23846.62,82.6,,,percent of total billed charges,82.6% of total billed charges,23846.62,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4417.11,65260.52,
PERC DE COR STENT/ATHER BRANCH,840C9603,CDM,481,RC,C9603,HCPCS,Outpatient,,,32475,21108.75,,28578,88,,,percent of total billed charges,88% of total Billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,16237.5,50,,,percent of total billed charges,50% of total Billed charges,20459.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4968.68,15.3,,,percent of total billed charges,15.3% of total billed charges,22407.75,69,,,percent of total billed charges,69% of total billed charges,32475,100,,,percent of total billed charges,100% of total billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,32475,100,,,percent of total billed charges,100% of total billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,32475,100,,,percent of total billed charges,100% of total billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,20085.79,61.85,,,percent of total billed charges,61.85% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16237.5,50,,,percent of total billed charges,50% of total Billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16237.5,50,,,percent of total billed charges,50% of total Billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,16237.5,50,,,percent of total billed charges,50% of total Billed charges,12243.08,37.7,,,percent of total billed charges,37.70% of total billed charges,12243.08,37.7,,,percent of total billed charges,37.70% of total billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,11009.03,33.9,,,percent of total billed charges,33.9% of total billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,25330.5,78,,,percent of total billed charges,78% of total billed charges,32475,100,,,percent of total billed charges,100% of total billed charges,26824.35,82.6,,,percent of total billed charges,82.6% of total billed charges,26824.35,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16237.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16237.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,32475,
PERC DE COR STENT/CABG SING,840C9604,CDM,481,RC,C9604,HCPCS,Outpatient,,,28870,18765.50,,25405.6,88,,,percent of total billed charges,88% of total Billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,18188.1,63,,,percent of total billed charges,63% of total billed charges,19636.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4417.11,15.3,,,percent of total billed charges,15.3% of total billed charges,19920.3,69,,,percent of total billed charges,69% of total billed charges,28870,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,28870,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,28870,100,,,percent of total billed charges,100% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,40799.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,10883.99,37.7,,,percent of total billed charges,37.70% of total billed charges,10883.99,37.7,,,percent of total billed charges,37.70% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,9786.93,33.9,,,percent of total billed charges,33.9% of total billed charges,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,22518.6,78,,,percent of total billed charges,78% of total billed charges,28870,100,,,percent of total billed charges,100% of total billed charges,23846.62,82.6,,,percent of total billed charges,82.6% of total billed charges,23846.62,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,11332.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,11220.77,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4417.11,40799.76,
PERC DE COR STENT/CABG BRANCH,840C9605,CDM,481,RC,C9605,HCPCS,Outpatient,,,32475,21108.75,,28578,88,,,percent of total billed charges,88% of total Billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,16237.5,50,,,percent of total billed charges,50% of total Billed charges,20459.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4968.68,15.3,,,percent of total billed charges,15.3% of total billed charges,22407.75,69,,,percent of total billed charges,69% of total billed charges,32475,100,,,percent of total billed charges,100% of total billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,32475,100,,,percent of total billed charges,100% of total billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,32475,100,,,percent of total billed charges,100% of total billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,20085.79,61.85,,,percent of total billed charges,61.85% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16237.5,50,,,percent of total billed charges,50% of total Billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16237.5,50,,,percent of total billed charges,50% of total Billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,16237.5,50,,,percent of total billed charges,50% of total Billed charges,12243.08,37.7,,,percent of total billed charges,37.70% of total billed charges,12243.08,37.7,,,percent of total billed charges,37.70% of total billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,11009.03,33.9,,,percent of total billed charges,33.9% of total billed charges,16237.5,50,,,percent of total billed charges,50% of total Billed charges,25330.5,78,,,percent of total billed charges,78% of total billed charges,32475,100,,,percent of total billed charges,100% of total billed charges,26824.35,82.6,,,percent of total billed charges,82.6% of total billed charges,26824.35,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16237.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16237.5,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,32475,
PERC DE COR REVASC W AMI SING,840C9606,CDM,481,RC,C9606,HCPCS,Outpatient,,,33373,21692.45,,29368.24,88,,,percent of total billed charges,88% of total Billed charges,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,21024.99,63,,,percent of total billed charges,63% of total billed charges,33373,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7748.35,100,,,Fee Schedule,100% of WA Medicaid,5106.07,15.3,,,percent of total billed charges,15.3% of total billed charges,23027.37,69,,,percent of total billed charges,69% of total billed charges,33373,100,,,percent of total billed charges,100% of total billed charges,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,33373,100,,,percent of total billed charges,100% of total billed charges,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,33373,100,,,percent of total billed charges,100% of total billed charges,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,33373,100,,,Fee Schedule,Pays at line item charges due to status indicator C,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,12581.62,37.7,,,percent of total billed charges,37.70% of total billed charges,12581.62,37.7,,,percent of total billed charges,37.70% of total billed charges,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,11313.45,33.9,,,percent of total billed charges,33.9% of total billed charges,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,26030.94,78,,,percent of total billed charges,78% of total billed charges,33373,100,,,percent of total billed charges,100% of total billed charges,27566.1,82.6,,,percent of total billed charges,82.6% of total billed charges,27566.1,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,33373,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,33373,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,33373,
PERC DE COR REVASC CHRON SING,840C9607,CDM,481,RC,C9607,HCPCS,Outpatient,,,28870,18765.50,,25405.6,88,,,percent of total billed charges,88% of total Billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18188.1,63,,,percent of total billed charges,63% of total billed charges,31299.05,175,,,Fee Schedule,175% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4417.11,15.3,,,percent of total billed charges,15.3% of total billed charges,19920.3,69,,,percent of total billed charges,69% of total billed charges,28870,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,28870,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,28870,100,,,percent of total billed charges,100% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,65260.52,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,10883.99,37.7,,,percent of total billed charges,37.70% of total billed charges,10883.99,37.7,,,percent of total billed charges,37.70% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,9786.93,33.9,,,percent of total billed charges,33.9% of total billed charges,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,22518.6,78,,,percent of total billed charges,78% of total billed charges,28870,100,,,percent of total billed charges,100% of total billed charges,23846.62,82.6,,,percent of total billed charges,82.6% of total billed charges,23846.62,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,18064.02,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4417.11,65260.52,
PERC DE COR REVASC CHRON ADD,840C9608,CDM,481,RC,C9608,HCPCS,Outpatient,,,32466,21102.90,,28570.08,88,,,percent of total billed charges,88% of total Billed charges,16233,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,7980.8,103,,,Fee Schedule,103% of WA Medicaid,16233,50,,,percent of total billed charges,50% of total Billed charges,20453.58,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7748.35,100,,,Fee Schedule,100% of WA Medicaid,4967.3,15.3,,,percent of total billed charges,15.3% of total billed charges,22401.54,69,,,percent of total billed charges,69% of total billed charges,32466,100,,,percent of total billed charges,100% of total billed charges,16233,50,,,percent of total billed charges,50% of total Billed charges,32466,100,,,percent of total billed charges,100% of total billed charges,16233,50,,,percent of total billed charges,50% of total Billed charges,32466,100,,,percent of total billed charges,100% of total billed charges,16233,50,,,percent of total billed charges,50% of total Billed charges,20080.22,61.85,,,percent of total billed charges,61.85% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16233,50,,,percent of total billed charges,50% of total Billed charges,16233,50,,,percent of total billed charges,50% of total Billed charges,5739.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16233,50,,,percent of total billed charges,50% of total Billed charges,16233,50,,,percent of total billed charges,50% of total Billed charges,7903.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10072.86,130,,,Fee Schedule,130% of WA Medicaid ,16233,50,,,percent of total billed charges,50% of total Billed charges,12239.68,37.7,,,percent of total billed charges,37.70% of total billed charges,12239.68,37.7,,,percent of total billed charges,37.70% of total billed charges,16233,50,,,percent of total billed charges,50% of total Billed charges,11005.97,33.9,,,percent of total billed charges,33.9% of total billed charges,16233,50,,,percent of total billed charges,50% of total Billed charges,25323.48,78,,,percent of total billed charges,78% of total billed charges,32466,100,,,percent of total billed charges,100% of total billed charges,26816.92,82.6,,,percent of total billed charges,82.6% of total billed charges,26816.92,82.6,,,percent of total billed charges,82.6% of total billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16233,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16233,50,,,percent of total billed charges,50% of total Billed charges,7748.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4695,32466,
C9756 Intraop Near-Infrared Fluorescence Lymphatic Mapping,360C9756,CDM,360,RC,C9756,HCPCS,Outpatient,,,1067,693.55,,938.96,88,,,percent of total billed charges,88% of total Billed charges,533.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1067,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,533.5,50,,,percent of total billed charges,50% of total Billed charges,672.21,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",3367,15.3,,,percent of total billed charges,15.3% of total billed charges,736.23,69,,,percent of total billed charges,69% of total billed charges,1067,100,,,percent of total billed charges,100% of total billed charges,533.5,50,,,percent of total billed charges,50% of total Billed charges,1067,100,,,percent of total billed charges,100% of total billed charges,533.5,50,,,percent of total billed charges,50% of total Billed charges,1067,100,,,percent of total billed charges,100% of total billed charges,533.5,50,,,percent of total billed charges,50% of total Billed charges,659.94,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,533.5,50,,,percent of total billed charges,50% of total Billed charges,533.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,533.5,50,,,percent of total billed charges,50% of total Billed charges,533.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,533.5,50,,,percent of total billed charges,50% of total Billed charges,402.26,37.7,,,percent of total billed charges,37.70% of total billed charges,402.26,37.7,,,percent of total billed charges,37.70% of total billed charges,533.5,50,,,percent of total billed charges,50% of total Billed charges,361.71,33.9,,,percent of total billed charges,33.9% of total billed charges,533.5,50,,,percent of total billed charges,50% of total Billed charges,832.26,78,,,percent of total billed charges,78% of total billed charges,1067,100,,,percent of total billed charges,100% of total billed charges,881.34,82.6,,,percent of total billed charges,82.6% of total billed charges,881.34,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,533.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,533.5,50,,,percent of total billed charges,50% of total Billed charges,179.26,16.8,,,percent of total billed charges,16.8% of total billed charges,179.26,3367,
PLACE OCCLUSIVE DEVICE,840G0269,CDM,361,RC,G0269,HCPCS,Outpatient,,,7850,5102.50,,6908,88,,,percent of total billed charges,88% of total Billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,1318.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1358.36,17.304,,,percent of total billed charges,17.304% of total billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,4945.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1318.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1201.05,15.3,,,percent of total billed charges,15.3% of total billed charges,5416.5,69,,,percent of total billed charges,69% of total billed charges,7850,100,,,percent of total billed charges,100% of total billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,7850,100,,,percent of total billed charges,100% of total billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,7850,100,,,percent of total billed charges,100% of total billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,4855.23,61.85,,,percent of total billed charges,61.85% of total billed charges,1318.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,1318.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,1345.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1714.44,21.84,,,percent of total billed charges,21.84% of total billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,2959.45,37.7,,,percent of total billed charges,37.70% of total billed charges,2959.45,37.7,,,percent of total billed charges,37.70% of total billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,2661.15,33.9,,,percent of total billed charges,33.9% of total billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,6123,78,,,percent of total billed charges,78% of total billed charges,7850,100,,,percent of total billed charges,100% of total billed charges,6484.1,82.6,,,percent of total billed charges,82.6% of total billed charges,6484.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1318.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3925,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3925,50,,,percent of total billed charges,50% of total Billed charges,1318.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1201.05,7850,
ILIAC ANGIO W/CARDIAC CATH,840G0278,CDM,481,RC,G0278,HCPCS,Outpatient,,,6064,3941.60,,5336.32,88,,,percent of total billed charges,88% of total Billed charges,3032,50,,,percent of total billed charges,50% of total Billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,3032,50,,,percent of total billed charges,50% of total Billed charges,3820.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3709.23,100,,,Fee Schedule,100% of WA Medicaid,927.79,15.3,,,percent of total billed charges,15.3% of total billed charges,4184.16,69,,,percent of total billed charges,69% of total billed charges,6064,100,,,percent of total billed charges,100% of total billed charges,3032,50,,,percent of total billed charges,50% of total Billed charges,6064,100,,,percent of total billed charges,100% of total billed charges,3032,50,,,percent of total billed charges,50% of total Billed charges,6064,100,,,percent of total billed charges,100% of total billed charges,3032,50,,,percent of total billed charges,50% of total Billed charges,3750.58,61.85,,,percent of total billed charges,61.85% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3032,50,,,percent of total billed charges,50% of total Billed charges,3032,50,,,percent of total billed charges,50% of total Billed charges,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3032,50,,,percent of total billed charges,50% of total Billed charges,3032,50,,,percent of total billed charges,50% of total Billed charges,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,3032,50,,,percent of total billed charges,50% of total Billed charges,2286.13,37.7,,,percent of total billed charges,37.70% of total billed charges,2286.13,37.7,,,percent of total billed charges,37.70% of total billed charges,3032,50,,,percent of total billed charges,50% of total Billed charges,2055.7,33.9,,,percent of total billed charges,33.9% of total billed charges,3032,50,,,percent of total billed charges,50% of total Billed charges,4729.92,78,,,percent of total billed charges,78% of total billed charges,6064,100,,,percent of total billed charges,100% of total billed charges,5008.86,82.6,,,percent of total billed charges,82.6% of total billed charges,5008.86,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3032,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3032,50,,,percent of total billed charges,50% of total Billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,927.79,6064,
Venipuncture Routine,30036415,CDM,300,RC,36415,HCPCS,Outpatient,,,113,73.45,,,,,,Other,Not Separately reimbursable,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.1,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,2.16,103,,,Fee Schedule,103% of WA Medicaid,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,15.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.1,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,11.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,1.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2.73,130,,,Fee Schedule,130% of WA Medicaid ,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.55,113,
DIABETES SLF MANGMT INDV 30MIN,942G0108,CDM,942,RC,G0108,HCPCS,Outpatient,,,238,154.70,,209.44,88,,,percent of total billed charges,88% of total Billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,59.14,100,,,Fee Schedule,100% of WA Medicaid,238,100,,,percent of total billed charges,100% of total billed charges,60.91,103,,,Fee Schedule,103% of WA Medicaid,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,149.94,63,,,percent of total billed charges,63% of total billed charges,95.31,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.14,100,,,Fee Schedule,100% of WA Medicaid,36.41,15.3,,,percent of total billed charges,15.3% of total billed charges,164.22,69,,,percent of total billed charges,69% of total billed charges,238,100,,,percent of total billed charges,100% of total billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,238,100,,,percent of total billed charges,100% of total billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,238,100,,,percent of total billed charges,100% of total billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,214.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,60.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.88,130,,,Fee Schedule,130% of WA Medicaid ,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,89.73,37.7,,,percent of total billed charges,37.70% of total billed charges,89.73,37.7,,,percent of total billed charges,37.70% of total billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,80.68,33.9,,,percent of total billed charges,33.9% of total billed charges,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,185.64,78,,,percent of total billed charges,78% of total billed charges,238,100,,,percent of total billed charges,100% of total billed charges,196.59,82.6,,,percent of total billed charges,82.6% of total billed charges,196.59,82.6,,,percent of total billed charges,82.6% of total billed charges,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,55.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,55.12,100,,,Fee Schedule,100% of Medicare OPPS rate,59.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.41,238,
DIABETES SLF MANGMT GRP 30MIN,942G0109,CDM,942,RC,G0109,HCPCS,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,41.37,100,,,Fee Schedule,100% of WA Medicaid,72,100,,,percent of total billed charges,100% of total billed charges,42.61,103,,,Fee Schedule,103% of WA Medicaid,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,45.36,63,,,percent of total billed charges,63% of total billed charges,27.56,175,,,Fee Schedule,175% of Medicare OPPS Rate,41.37,100,,,Fee Schedule,100% of WA Medicaid,11.02,15.3,,,percent of total billed charges,15.3% of total billed charges,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,72,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,72,100,,,percent of total billed charges,100% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,60.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,42.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.79,130,,,Fee Schedule,130% of WA Medicaid ,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,24.41,33.9,,,percent of total billed charges,33.9% of total billed charges,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,16.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,15.91,100,,,Fee Schedule,100% of Medicare OPPS rate,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.02,72,
BIPAP/CPAP INIT  MGMT,41094660,CDM,410,RC,94660,HCPCS,Outpatient,,,824,535.60,,725.12,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,824,100,,,percent of total billed charges,100% of total billed charges,115.13,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,519.12,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,126.07,15.3,,,percent of total billed charges,15.3% of total billed charges,568.56,69,,,percent of total billed charges,69% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,824,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,824,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,82.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,114.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.31,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,279.34,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,642.72,78,,,percent of total billed charges,78% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.8,824,
CO/MEMBRANE DIFFUSE CAPACITY,46094729,CDM,460,RC,94729,HCPCS,Outpatient,,,299,194.35,,263.12,88,,,percent of total billed charges,88% of total Billed charges,149.5,50,,,percent of total billed charges,50% of total Billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid,299,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,149.5,50,,,percent of total billed charges,50% of total Billed charges,188.37,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,46.89,100,,,Fee Schedule,100% of WA Medicaid,45.75,15.3,,,percent of total billed charges,15.3% of total billed charges,206.31,69,,,percent of total billed charges,69% of total billed charges,299,100,,,percent of total billed charges,100% of total billed charges,149.5,50,,,percent of total billed charges,50% of total Billed charges,299,100,,,percent of total billed charges,100% of total billed charges,149.5,50,,,percent of total billed charges,50% of total Billed charges,299,100,,,percent of total billed charges,100% of total billed charges,149.5,50,,,percent of total billed charges,50% of total Billed charges,184.93,61.85,,,percent of total billed charges,61.85% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.5,50,,,percent of total billed charges,50% of total Billed charges,149.5,50,,,percent of total billed charges,50% of total Billed charges,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,149.5,50,,,percent of total billed charges,50% of total Billed charges,149.5,50,,,percent of total billed charges,50% of total Billed charges,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,149.5,50,,,percent of total billed charges,50% of total Billed charges,112.72,37.7,,,percent of total billed charges,37.70% of total billed charges,112.72,37.7,,,percent of total billed charges,37.70% of total billed charges,149.5,50,,,percent of total billed charges,50% of total Billed charges,101.36,33.9,,,percent of total billed charges,33.9% of total billed charges,149.5,50,,,percent of total billed charges,50% of total Billed charges,233.22,78,,,percent of total billed charges,78% of total billed charges,299,100,,,percent of total billed charges,100% of total billed charges,246.97,82.6,,,percent of total billed charges,82.6% of total billed charges,246.97,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,149.5,50,,,percent of total billed charges,50% of total Billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,299,
HELIOX INITIAL (hourly charge),41094640,CDM,410,RC,94640,HCPCS,Outpatient,,,633,411.45,,557.04,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,633,100,,,percent of total billed charges,100% of total billed charges,5.5,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,398.79,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,96.85,15.3,,,percent of total billed charges,15.3% of total billed charges,436.77,69,,,percent of total billed charges,69% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.15,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,214.59,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,493.74,78,,,percent of total billed charges,78% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.5,763.26,
INHALER MDI TX SUBSQ,41094640,CDM,410,RC,94640,HCPCS,Outpatient,,,633,411.45,,557.04,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,633,100,,,percent of total billed charges,100% of total billed charges,5.5,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,398.79,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,96.85,15.3,,,percent of total billed charges,15.3% of total billed charges,436.77,69,,,percent of total billed charges,69% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.15,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,214.59,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,493.74,78,,,percent of total billed charges,78% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.5,763.26,
BIPAP/CPAP INIT  MGMT,41094660,CDM,410,RC,94660,HCPCS,Outpatient,,,824,535.60,,725.12,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,824,100,,,percent of total billed charges,100% of total billed charges,115.13,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,519.12,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,126.07,15.3,,,percent of total billed charges,15.3% of total billed charges,568.56,69,,,percent of total billed charges,69% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,824,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,824,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,82.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,114.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.31,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,279.34,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,642.72,78,,,percent of total billed charges,78% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.8,824,
BIPAP/CPAP INIT  MGMT,41094660,CDM,410,RC,94660,HCPCS,Outpatient,,,824,535.60,,725.12,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,824,100,,,percent of total billed charges,100% of total billed charges,115.13,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,519.12,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,126.07,15.3,,,percent of total billed charges,15.3% of total billed charges,568.56,69,,,percent of total billed charges,69% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,824,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,824,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,82.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,114.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.31,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,279.34,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,642.72,78,,,percent of total billed charges,78% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.8,824,
CPT W PERCUS/VIBRATION SUB,41094668,CDM,410,RC,94668,HCPCS,Outpatient,,,379,246.35,,333.52,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,379,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,238.77,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,57.99,15.3,,,percent of total billed charges,15.3% of total billed charges,261.51,69,,,percent of total billed charges,69% of total billed charges,379,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,379,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,379,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,142.88,37.7,,,percent of total billed charges,37.70% of total billed charges,142.88,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,128.48,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,295.62,78,,,percent of total billed charges,78% of total billed charges,379,100,,,percent of total billed charges,100% of total billed charges,313.05,82.6,,,percent of total billed charges,82.6% of total billed charges,313.05,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,454.8,
CPT W PERCUS/VIBRATION INITIAL,41094667,CDM,410,RC,94667,HCPCS,Outpatient,,,633,411.45,,557.04,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicaid,633,100,,,percent of total billed charges,100% of total billed charges,14.24,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,398.79,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,14.24,100,,,Fee Schedule,100% of WA Medicaid,96.85,15.3,,,percent of total billed charges,15.3% of total billed charges,436.77,69,,,percent of total billed charges,69% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.51,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,214.59,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,493.74,78,,,percent of total billed charges,78% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.24,633,
MULTIPLE SLEEP LATENCY,92095805,CDM,920,RC,95805,HCPCS,Outpatient,,,3825,2486.25,,3366,88,,,percent of total billed charges,88% of total Billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,3825,100,,,percent of total billed charges,100% of total billed charges,707.12,103,,,Fee Schedule,103% of WA Medicaid,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2409.75,63,,,percent of total billed charges,63% of total billed charges,956.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,585.23,15.3,,,percent of total billed charges,15.3% of total billed charges,2639.25,69,,,percent of total billed charges,69% of total billed charges,3825,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3825,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3825,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1981.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,508.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,700.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,892.49,130,,,Fee Schedule,130% of WA Medicaid ,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1442.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1442.03,37.7,,,percent of total billed charges,37.70% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1296.68,33.9,,,percent of total billed charges,33.9% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2983.5,78,,,percent of total billed charges,78% of total billed charges,3825,100,,,percent of total billed charges,100% of total billed charges,3159.45,82.6,,,percent of total billed charges,82.6% of total billed charges,3159.45,82.6,,,percent of total billed charges,82.6% of total billed charges,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,552.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,508.54,3825,
NASOTRACHEAL ASPIRATION,94031720,CDM,940,RC,31720,HCPCS,Outpatient,,,633,411.45,,557.04,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,633,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,398.79,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,96.85,15.3,,,percent of total billed charges,15.3% of total billed charges,436.77,69,,,percent of total billed charges,69% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,214.59,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,493.74,78,,,percent of total billed charges,78% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,763.26,
PULSE OXIMETRY CONT OVERNIGHT,46094762,CDM,460,RC,94762,HCPCS,Outpatient,,,464,301.60,,408.32,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,464,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,292.32,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,70.99,15.3,,,percent of total billed charges,15.3% of total billed charges,320.16,69,,,percent of total billed charges,69% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,464,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,464,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,157.3,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,361.92,78,,,percent of total billed charges,78% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,566.91,
PULMONARY STRESS TEST COMPLX,46094621,CDM,460,RC,94621,HCPCS,Outpatient,,,906,588.90,,797.28,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,906,100,,,percent of total billed charges,100% of total billed charges,94.95,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,570.78,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,138.62,15.3,,,percent of total billed charges,15.3% of total billed charges,625.14,69,,,percent of total billed charges,69% of total billed charges,906,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,906,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,906,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,68.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,94.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.84,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,341.56,37.7,,,percent of total billed charges,37.70% of total billed charges,341.56,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,307.13,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,706.68,78,,,percent of total billed charges,78% of total billed charges,906,100,,,percent of total billed charges,100% of total billed charges,748.36,82.6,,,percent of total billed charges,82.6% of total billed charges,748.36,82.6,,,percent of total billed charges,82.6% of total billed charges,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.29,1074.33,
PULM FUNC TST PLESTHYSMOGRAPH,46094726,CDM,460,RC,94726,HCPCS,Outpatient,,,330,214.50,,290.4,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,330,100,,,percent of total billed charges,100% of total billed charges,94.95,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,207.9,63,,,percent of total billed charges,63% of total billed charges,560.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,50.49,15.3,,,percent of total billed charges,15.3% of total billed charges,227.7,69,,,percent of total billed charges,69% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,68.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,94.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.84,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,111.87,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,257.4,78,,,percent of total billed charges,78% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.49,1074.33,
PULM FUNCTION TEST BY GAS,46094727,CDM,460,RC,94727,HCPCS,Outpatient,,,330,214.50,,290.4,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,330,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,207.9,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,50.49,15.3,,,percent of total billed charges,15.3% of total billed charges,227.7,69,,,percent of total billed charges,69% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,111.87,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,257.4,78,,,percent of total billed charges,78% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,566.92,
INTUBATION ASSIST,41031500,CDM,410,RC,31500,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,843.18,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,606.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,834.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1064.21,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.13,1064.21,
TRACH TUBE CHANGE PRE FISTUAL,76131502,CDM,761,RC,31502,HCPCS,Outpatient,,,479,311.35,,421.52,88,,,percent of total billed charges,88% of total Billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,479,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,301.77,63,,,percent of total billed charges,63% of total billed charges,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,73.29,15.3,,,percent of total billed charges,15.3% of total billed charges,330.51,69,,,percent of total billed charges,69% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,479,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,479,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,180.58,37.7,,,percent of total billed charges,37.70% of total billed charges,180.58,37.7,,,percent of total billed charges,37.70% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,162.38,33.9,,,percent of total billed charges,33.9% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,373.62,78,,,percent of total billed charges,78% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.29,859.63,
INTUBATION EMERGENCY,92000001,CDM,410,RC,31500,HCPCS,Outpatient,,,552,358.80,,485.76,88,,,percent of total billed charges,88% of total Billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,552,100,,,percent of total billed charges,100% of total billed charges,843.18,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,347.76,63,,,percent of total billed charges,63% of total billed charges,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,84.46,15.3,,,percent of total billed charges,15.3% of total billed charges,380.88,69,,,percent of total billed charges,69% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,552,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,552,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,606.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,834.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1064.21,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,187.13,33.9,,,percent of total billed charges,33.9% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,430.56,78,,,percent of total billed charges,78% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84.46,1064.21,
Six Minute Walk,TMP600159,CDM,460,RC,94618,HCPCS,Outpatient,,,330,214.50,,290.4,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,330,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,207.9,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,50.49,15.3,,,percent of total billed charges,15.3% of total billed charges,227.7,69,,,percent of total billed charges,69% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,111.87,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,257.4,78,,,percent of total billed charges,78% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,454.8,
SLEEP STUDY UNATTENDED,92095806,CDM,920,RC,95806,HCPCS,Outpatient,,,661,429.65,,581.68,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,127.33,100,,,Fee Schedule,100% of WA Medicaid,661,100,,,percent of total billed charges,100% of total billed charges,131.15,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,416.43,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,127.33,100,,,Fee Schedule,100% of WA Medicaid,101.13,15.3,,,percent of total billed charges,15.3% of total billed charges,456.09,69,,,percent of total billed charges,69% of total billed charges,661,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,661,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,661,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,94.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,129.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,165.54,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,249.2,37.7,,,percent of total billed charges,37.70% of total billed charges,249.2,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,224.08,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,515.58,78,,,percent of total billed charges,78% of total billed charges,661,100,,,percent of total billed charges,100% of total billed charges,545.99,82.6,,,percent of total billed charges,82.6% of total billed charges,545.99,82.6,,,percent of total billed charges,82.6% of total billed charges,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.32,661,
Spirometry Pre and Post Exercise,46094618,CDM,460,RC,94618,HCPCS,Outpatient,,,330,214.50,,290.4,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,330,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,207.9,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,50.49,15.3,,,percent of total billed charges,15.3% of total billed charges,227.7,69,,,percent of total billed charges,69% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,111.87,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,257.4,78,,,percent of total billed charges,78% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,454.8,
SPUTUM INDUCTION INIT,41094640,CDM,410,RC,94640,HCPCS,Outpatient,,,633,411.45,,557.04,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,633,100,,,percent of total billed charges,100% of total billed charges,5.5,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,398.79,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,96.85,15.3,,,percent of total billed charges,15.3% of total billed charges,436.77,69,,,percent of total billed charges,69% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.15,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,214.59,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,493.74,78,,,percent of total billed charges,78% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.5,763.26,
AEROSOL NEBULIZER TX SUBSEQUEN,41094640,CDM,410,RC,94640,HCPCS,Outpatient,,,633,411.45,,557.04,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,633,100,,,percent of total billed charges,100% of total billed charges,5.5,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,398.79,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,96.85,15.3,,,percent of total billed charges,15.3% of total billed charges,436.77,69,,,percent of total billed charges,69% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.15,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,214.59,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,493.74,78,,,percent of total billed charges,78% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.5,763.26,
INITIAL INHALER (MDI) TX,41294640,CDM,412,RC,94640,HCPCS,Outpatient,,,633,411.45,,557.04,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,633,100,,,percent of total billed charges,100% of total billed charges,5.5,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,398.79,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,96.85,15.3,,,percent of total billed charges,15.3% of total billed charges,436.77,69,,,percent of total billed charges,69% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,633,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.15,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,214.59,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,493.74,78,,,percent of total billed charges,78% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.5,763.26,
SMOKE/TOBAC COUNSEL 3-10M,94299406,CDM,942,RC,99406,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,21.69,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,22.34,103,,,Fee Schedule,103% of WA Medicaid,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,63,63,,,percent of total billed charges,63% of total billed charges,51.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,21.69,100,,,Fee Schedule,100% of WA Medicaid,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,100,100,,,percent of total billed charges,100% of total billed charges,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,106.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,21.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,22.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.2,130,,,Fee Schedule,130% of WA Medicaid ,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,21.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,29.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,21.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.3,106.54,
VENTILATOR MGMT EA SUB DAY,41094003,CDM,410,RC,94003,HCPCS,Outpatient,,,2206,1433.90,,1941.28,88,,,percent of total billed charges,88% of total Billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,2206,100,,,percent of total billed charges,100% of total billed charges,597.3,103,,,Fee Schedule,103% of WA Medicaid,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1389.78,63,,,percent of total billed charges,63% of total billed charges,1118.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,337.52,15.3,,,percent of total billed charges,15.3% of total billed charges,1522.14,69,,,percent of total billed charges,69% of total billed charges,2206,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2206,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2206,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1971.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,429.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,591.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,753.87,130,,,Fee Schedule,130% of WA Medicaid ,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,831.66,37.7,,,percent of total billed charges,37.70% of total billed charges,831.66,37.7,,,percent of total billed charges,37.70% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,747.83,33.9,,,percent of total billed charges,33.9% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1720.68,78,,,percent of total billed charges,78% of total billed charges,2206,100,,,percent of total billed charges,100% of total billed charges,1822.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1822.16,82.6,,,percent of total billed charges,82.6% of total billed charges,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,645.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,337.52,2206,
OXYGEN DAILY,27200001,CDM,272,RC,,,Outpatient,,,928,603.20,,816.64,88,,,percent of total billed charges,88% of total Billed charges,464,50,,,percent of total billed charges,50% of total Billed charges,155.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,928,100,,,percent of total billed charges,100% of total billed charges,160.58,17.304,,,percent of total billed charges,17.304% of total billed charges,464,50,,,percent of total billed charges,50% of total Billed charges,584.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,155.9,16.8,,,percent of total billed charges,16.8% of total billed charges,141.98,15.3,,,percent of total billed charges,15.3% of total billed charges,640.32,69,,,percent of total billed charges,69% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,464,50,,,percent of total billed charges,50% of total Billed charges,928,100,,,percent of total billed charges,100% of total billed charges,464,50,,,percent of total billed charges,50% of total Billed charges,928,100,,,percent of total billed charges,100% of total billed charges,464,50,,,percent of total billed charges,50% of total Billed charges,573.97,61.85,,,percent of total billed charges,61.85% of total billed charges,155.9,16.8,,,percent of total billed charges,16.8% of total billed charges,464,50,,,percent of total billed charges,50% of total Billed charges,464,50,,,percent of total billed charges,50% of total Billed charges,155.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,464,50,,,percent of total billed charges,50% of total Billed charges,464,50,,,percent of total billed charges,50% of total Billed charges,159.02,17.136,,,percent of total billed charges,17.136% of total billed charges,202.68,21.84,,,percent of total billed charges,21.84% of total billed charges,464,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,464,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,464,50,,,percent of total billed charges,50% of total Billed charges,723.84,78,,,percent of total billed charges,78% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,155.9,16.8,,,percent of total billed charges,16.8% of total billed charges,464,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,464,50,,,percent of total billed charges,50% of total Billed charges,155.9,16.8,,,percent of total billed charges,16.8% of total billed charges,141.98,928,
UROGRAPHY ANTEGRADE,84074425,CDM,320,RC,74425,HCPCS,Outpatient,,,2938,1909.70,,2585.44,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2938,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1850.94,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,449.51,15.3,,,percent of total billed charges,15.3% of total billed charges,2027.22,69,,,percent of total billed charges,69% of total billed charges,2938,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2938,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2938,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1107.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1107.63,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,995.98,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2291.64,78,,,percent of total billed charges,78% of total billed charges,2938,100,,,percent of total billed charges,100% of total billed charges,2426.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2426.79,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2938,
CYSTOGRAM MIN 3V,84074430,CDM,360,RC,74430,HCPCS,Outpatient,,,1073,697.45,,944.24,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1073,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,675.99,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,740.37,69,,,percent of total billed charges,69% of total billed charges,1073,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1073,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1073,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,404.52,37.7,,,percent of total billed charges,37.70% of total billed charges,404.52,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,363.75,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,836.94,78,,,percent of total billed charges,78% of total billed charges,1073,100,,,percent of total billed charges,100% of total billed charges,886.3,82.6,,,percent of total billed charges,82.6% of total billed charges,886.3,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,3367,
CT ANGIO ABDOMINAL ARTERIES,84075635,CDM,360,RC,75635,HCPCS,Outpatient,,,7953,5169.45,,6998.64,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5010.39,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,5487.57,69,,,percent of total billed charges,69% of total billed charges,7953,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7953,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7953,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2998.28,37.7,,,percent of total billed charges,37.70% of total billed charges,2998.28,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2696.07,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6203.34,78,,,percent of total billed charges,78% of total billed charges,7953,100,,,percent of total billed charges,100% of total billed charges,6569.18,82.6,,,percent of total billed charges,82.6% of total billed charges,6569.18,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,7953,
ANGIO EXTREMITY UNILATERAL,84075710,CDM,323,RC,75710,HCPCS,Outpatient,,,10352,6728.80,,9109.76,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6521.76,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1583.86,15.3,,,percent of total billed charges,15.3% of total billed charges,7142.88,69,,,percent of total billed charges,69% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3509.33,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8074.56,78,,,percent of total billed charges,78% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
VENOGRAPHY EXTREMITY UNILAT,84075820,CDM,320,RC,75820,HCPCS,Outpatient,,,3346,2174.90,,2944.48,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,3346,100,,,percent of total billed charges,100% of total billed charges,781.83,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2107.98,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,511.94,15.3,,,percent of total billed charges,15.3% of total billed charges,2308.74,69,,,percent of total billed charges,69% of total billed charges,3346,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3346,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3346,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,562.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,774.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,986.78,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1261.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1261.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.29,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2609.88,78,,,percent of total billed charges,78% of total billed charges,3346,100,,,percent of total billed charges,100% of total billed charges,2763.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2763.8,82.6,,,percent of total billed charges,82.6% of total billed charges,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,511.94,5712.48,
ANGIO THRU EXIST CATH FOR F/U,84075898,CDM,323,RC,75898,HCPCS,Outpatient,,,3074,1998.10,,2705.12,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,3074,100,,,percent of total billed charges,100% of total billed charges,781.83,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1936.62,63,,,percent of total billed charges,63% of total billed charges,5689.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,470.32,15.3,,,percent of total billed charges,15.3% of total billed charges,2121.06,69,,,percent of total billed charges,69% of total billed charges,3074,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3074,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3074,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,562.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,774.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,986.78,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1158.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1158.9,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1042.09,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,2397.72,78,,,percent of total billed charges,78% of total billed charges,3074,100,,,percent of total billed charges,100% of total billed charges,2539.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2539.12,82.6,,,percent of total billed charges,82.6% of total billed charges,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,470.32,11625.57,
ENDOVASC REPR AORTIC ANEUR and or Iliac Artery,84034705,CDM,320,RC,34705,HCPCS,Outpatient,,,904,587.60,,795.52,88,,,percent of total billed charges,88% of total Billed charges,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,16110.1,100,,,Fee Schedule,100% of WA Medicaid,904,100,,,percent of total billed charges,100% of total billed charges,16593.41,103,,,Fee Schedule,103% of WA Medicaid,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,569.52,63,,,percent of total billed charges,63% of total billed charges,904,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,16110.1,100,,,Fee Schedule,100% of WA Medicaid,138.31,15.3,,,percent of total billed charges,15.3% of total billed charges,623.76,69,,,percent of total billed charges,69% of total billed charges,904,100,,,percent of total billed charges,100% of total billed charges,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,904,100,,,percent of total billed charges,100% of total billed charges,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,904,100,,,percent of total billed charges,100% of total billed charges,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,904,100,,,Fee Schedule,Pays at line item charges due to status indicator C,16110.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,11933.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,16432.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20943.14,130,,,Fee Schedule,130% of WA Medicaid ,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,340.81,37.7,,,percent of total billed charges,37.70% of total billed charges,340.81,37.7,,,percent of total billed charges,37.70% of total billed charges,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,306.46,33.9,,,percent of total billed charges,33.9% of total billed charges,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,705.12,78,,,percent of total billed charges,78% of total billed charges,904,100,,,percent of total billed charges,100% of total billed charges,746.7,82.6,,,percent of total billed charges,82.6% of total billed charges,746.7,82.6,,,percent of total billed charges,82.6% of total billed charges,16110.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,904,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,904,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,16110.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,138.31,20943.14,
Endovascular repair of iliac artery by deployment of an ilio,84034707,CDM,320,RC,34707,HCPCS,Outpatient,,,274,178.10,,241.12,88,,,percent of total billed charges,88% of total Billed charges,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,16110.1,100,,,Fee Schedule,100% of WA Medicaid,274,100,,,percent of total billed charges,100% of total billed charges,16593.41,103,,,Fee Schedule,103% of WA Medicaid,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,172.62,63,,,percent of total billed charges,63% of total billed charges,274,175,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,16110.1,100,,,Fee Schedule,100% of WA Medicaid,41.92,15.3,,,percent of total billed charges,15.3% of total billed charges,189.06,69,,,percent of total billed charges,69% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,274,100,,,percent of total billed charges,100% of total billed charges,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,274,100,,,percent of total billed charges,100% of total billed charges,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,274,100,,,Fee Schedule,Pays at line item charges due to status indicator C,16110.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,11933.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,16432.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20943.14,130,,,Fee Schedule,130% of WA Medicaid ,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,103.3,37.7,,,percent of total billed charges,37.70% of total billed charges,103.3,37.7,,,percent of total billed charges,37.70% of total billed charges,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,92.89,33.9,,,percent of total billed charges,33.9% of total billed charges,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,213.72,78,,,percent of total billed charges,78% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,16110.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,274,100,,,Fee Schedule,Pays at line item charges for Status Indicator C on Fee Schedule,274,100,,,Fee Schedule,Pays at line item charges due to Status Indicator C on the CMS APC fee schedule,16110.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.92,20943.14,
CHNG PERC HEP CATH SI,84075984,CDM,320,RC,75984,HCPCS,Outpatient,,,1598,1038.70,,1406.24,88,,,percent of total billed charges,88% of total Billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,1598,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,799,50,,,percent of total billed charges,50% of total Billed charges,1006.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,244.49,15.3,,,percent of total billed charges,15.3% of total billed charges,1102.62,69,,,percent of total billed charges,69% of total billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,988.36,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,799,50,,,percent of total billed charges,50% of total Billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,799,50,,,percent of total billed charges,50% of total Billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,799,50,,,percent of total billed charges,50% of total Billed charges,602.45,37.7,,,percent of total billed charges,37.70% of total billed charges,602.45,37.7,,,percent of total billed charges,37.70% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,541.72,33.9,,,percent of total billed charges,33.9% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,1246.44,78,,,percent of total billed charges,78% of total billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,1319.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1319.95,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,799,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,799,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,1598,
RADIO GUIDANCE PERCU DRAINAGE,84075989,CDM,320,RC,75989,HCPCS,Outpatient,,,1780,1157.00,,1566.4,88,,,percent of total billed charges,88% of total Billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,1780,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,890,50,,,percent of total billed charges,50% of total Billed charges,1121.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,272.34,15.3,,,percent of total billed charges,15.3% of total billed charges,1228.2,69,,,percent of total billed charges,69% of total billed charges,1780,100,,,percent of total billed charges,100% of total billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,1780,100,,,percent of total billed charges,100% of total billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,1780,100,,,percent of total billed charges,100% of total billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,1100.93,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,890,50,,,percent of total billed charges,50% of total Billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,890,50,,,percent of total billed charges,50% of total Billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,890,50,,,percent of total billed charges,50% of total Billed charges,671.06,37.7,,,percent of total billed charges,37.70% of total billed charges,671.06,37.7,,,percent of total billed charges,37.70% of total billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,603.42,33.9,,,percent of total billed charges,33.9% of total billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,1388.4,78,,,percent of total billed charges,78% of total billed charges,1780,100,,,percent of total billed charges,100% of total billed charges,1470.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1470.28,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,890,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,890,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,1780,
FLUORO W/O FILM,84076000,CDM,320,RC,76000,HCPCS,Outpatient,,,1664,1081.60,,1464.32,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1664,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1048.32,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,254.59,15.3,,,percent of total billed charges,15.3% of total billed charges,1148.16,69,,,percent of total billed charges,69% of total billed charges,1664,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1664,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1664,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,627.33,37.7,,,percent of total billed charges,37.70% of total billed charges,627.33,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,564.1,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1297.92,78,,,percent of total billed charges,78% of total billed charges,1664,100,,,percent of total billed charges,100% of total billed charges,1374.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1374.46,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1664,
RADIOL EXAM ABCESS/FISTU/SINUS,84076080,CDM,320,RC,76080,HCPCS,Outpatient,,,1848,1201.20,,1626.24,88,,,percent of total billed charges,88% of total Billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1848,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.24,63,,,percent of total billed charges,63% of total billed charges,984.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,282.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1275.12,69,,,percent of total billed charges,69% of total billed charges,1848,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1848,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1848,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,696.7,37.7,,,percent of total billed charges,37.70% of total billed charges,696.7,37.7,,,percent of total billed charges,37.70% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,626.47,33.9,,,percent of total billed charges,33.9% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1441.44,78,,,percent of total billed charges,78% of total billed charges,1848,100,,,percent of total billed charges,100% of total billed charges,1526.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1526.45,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,568.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1961.75,
ULS VASCULAR ACCCESS,84076937,CDM,402,RC,76937,HCPCS,Outpatient,,,1307,849.55,TC,1150.16,88,,,percent of total billed charges,88% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid,1307,100,,,percent of total billed charges,100% of total billed charges,105.01,103,,,Fee Schedule,103% of WA Medicaid,653.5,50,,,percent of total billed charges,50% of total Billed charges,823.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,101.95,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,901.83,69,,,percent of total billed charges,69% of total billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,808.38,61.85,,,percent of total billed charges,61.85% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,653.5,50,,,percent of total billed charges,50% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,75.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,653.5,50,,,percent of total billed charges,50% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,103.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.54,130,,,Fee Schedule,130% of WA Medicaid ,653.5,50,,,percent of total billed charges,50% of total Billed charges,492.74,37.7,,,percent of total billed charges,37.70% of total billed charges,492.74,37.7,,,percent of total billed charges,37.70% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,443.07,33.9,,,percent of total billed charges,33.9% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,1019.46,78,,,percent of total billed charges,78% of total billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,1079.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1079.58,82.6,,,percent of total billed charges,82.6% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,653.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,653.5,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.52,1307,
FLOURO CENTRAL VENUOUS ACCESS,84077001,CDM,320,RC,77001,HCPCS,Outpatient,,,1337,869.05,,1176.56,88,,,percent of total billed charges,88% of total Billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,1337,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,668.5,50,,,percent of total billed charges,50% of total Billed charges,842.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,204.56,15.3,,,percent of total billed charges,15.3% of total billed charges,922.53,69,,,percent of total billed charges,69% of total billed charges,1337,100,,,percent of total billed charges,100% of total billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,1337,100,,,percent of total billed charges,100% of total billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,1337,100,,,percent of total billed charges,100% of total billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,826.93,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,668.5,50,,,percent of total billed charges,50% of total Billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,668.5,50,,,percent of total billed charges,50% of total Billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,668.5,50,,,percent of total billed charges,50% of total Billed charges,504.05,37.7,,,percent of total billed charges,37.70% of total billed charges,504.05,37.7,,,percent of total billed charges,37.70% of total billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,453.24,33.9,,,percent of total billed charges,33.9% of total billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,1042.86,78,,,percent of total billed charges,78% of total billed charges,1337,100,,,percent of total billed charges,100% of total billed charges,1104.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1104.36,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,668.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,668.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,1337,
THYROID UPTAKE MEASUREMENT,84078012,CDM,360,RC,78012,HCPCS,Outpatient,,,1299,844.35,,1143.12,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,1299,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,818.37,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,896.31,69,,,percent of total billed charges,69% of total billed charges,1299,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1299,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1299,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,489.72,37.7,,,percent of total billed charges,37.70% of total billed charges,489.72,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,440.36,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1013.22,78,,,percent of total billed charges,78% of total billed charges,1299,100,,,percent of total billed charges,100% of total billed charges,1072.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1072.97,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,3367,
ULS VASCULAR ACCCESS,40276937,CDM,402,RC,76937,HCPCS,Outpatient,,,1307,849.55,TC,1150.16,88,,,percent of total billed charges,88% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid,1307,100,,,percent of total billed charges,100% of total billed charges,105.01,103,,,Fee Schedule,103% of WA Medicaid,653.5,50,,,percent of total billed charges,50% of total Billed charges,823.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,101.95,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,901.83,69,,,percent of total billed charges,69% of total billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,808.38,61.85,,,percent of total billed charges,61.85% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,653.5,50,,,percent of total billed charges,50% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,75.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,653.5,50,,,percent of total billed charges,50% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,103.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.54,130,,,Fee Schedule,130% of WA Medicaid ,653.5,50,,,percent of total billed charges,50% of total Billed charges,492.74,37.7,,,percent of total billed charges,37.70% of total billed charges,492.74,37.7,,,percent of total billed charges,37.70% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,443.07,33.9,,,percent of total billed charges,33.9% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,1019.46,78,,,percent of total billed charges,78% of total billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,1079.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1079.58,82.6,,,percent of total billed charges,82.6% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,653.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,653.5,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.52,1307,
NM IN-111 PENTETREOTIDE T,343A9572,CDM,343,RC,A9572,HCPCS,Outpatient,,,5273,3427.45,TC,4640.24,88,,,percent of total billed charges,88% of total Billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,885.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,912.44,17.304,,,percent of total billed charges,17.304% of total billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,885.86,16.8,,,percent of total billed charges,16.8% of total billed charges,806.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3638.37,69,,,percent of total billed charges,69% of total billed charges,5273,100,,,percent of total billed charges,100% of total billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,5273,100,,,percent of total billed charges,100% of total billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,5273,100,,,percent of total billed charges,100% of total billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,3261.35,61.85,,,percent of total billed charges,61.85% of total billed charges,885.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,885.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,903.58,17.136,,,percent of total billed charges,17.136% of total billed charges,1151.62,21.84,,,percent of total billed charges,21.84% of total billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,1987.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1987.92,37.7,,,percent of total billed charges,37.70% of total billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,1787.55,33.9,,,percent of total billed charges,33.9% of total billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,4112.94,78,,,percent of total billed charges,78% of total billed charges,5273,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,885.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2636.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2636.5,50,,,percent of total billed charges,50% of total Billed charges,885.86,16.8,,,percent of total billed charges,16.8% of total billed charges,806.77,5273,
NM PERTECHNETATE  PER MCI,343A9512,CDM,343,RC,A9512,HCPCS,Outpatient,,,259,168.35,TC,227.92,88,,,percent of total billed charges,88% of total Billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,43.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,259,100,,,percent of total billed charges,100% of total billed charges,44.82,17.304,,,percent of total billed charges,17.304% of total billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.51,16.8,,,percent of total billed charges,16.8% of total billed charges,39.63,15.3,,,percent of total billed charges,15.3% of total billed charges,178.71,69,,,percent of total billed charges,69% of total billed charges,259,100,,,percent of total billed charges,100% of total billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,259,100,,,percent of total billed charges,100% of total billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,259,100,,,percent of total billed charges,100% of total billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,160.19,61.85,,,percent of total billed charges,61.85% of total billed charges,43.51,16.8,,,percent of total billed charges,16.8% of total billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,43.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,44.38,17.136,,,percent of total billed charges,17.136% of total billed charges,56.57,21.84,,,percent of total billed charges,21.84% of total billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,97.64,37.7,,,percent of total billed charges,37.70% of total billed charges,97.64,37.7,,,percent of total billed charges,37.70% of total billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,87.8,33.9,,,percent of total billed charges,33.9% of total billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,202.02,78,,,percent of total billed charges,78% of total billed charges,259,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.51,16.8,,,percent of total billed charges,16.8% of total billed charges,129.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,129.5,50,,,percent of total billed charges,50% of total Billed charges,43.51,16.8,,,percent of total billed charges,16.8% of total billed charges,39.63,259,
I-123 PER 100 UCI,343A9516,CDM,343,RC,A9516,HCPCS,Outpatient,,,560,364.00,,492.8,88,,,percent of total billed charges,88% of total Billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,94.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,560,100,,,percent of total billed charges,100% of total billed charges,96.9,17.304,,,percent of total billed charges,17.304% of total billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,94.08,16.8,,,percent of total billed charges,16.8% of total billed charges,85.68,15.3,,,percent of total billed charges,15.3% of total billed charges,386.4,69,,,percent of total billed charges,69% of total billed charges,560,100,,,percent of total billed charges,100% of total billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,560,100,,,percent of total billed charges,100% of total billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,560,100,,,percent of total billed charges,100% of total billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,346.36,61.85,,,percent of total billed charges,61.85% of total billed charges,94.08,16.8,,,percent of total billed charges,16.8% of total billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,94.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,95.96,17.136,,,percent of total billed charges,17.136% of total billed charges,122.3,21.84,,,percent of total billed charges,21.84% of total billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,211.12,37.7,,,percent of total billed charges,37.70% of total billed charges,211.12,37.7,,,percent of total billed charges,37.70% of total billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,189.84,33.9,,,percent of total billed charges,33.9% of total billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,436.8,78,,,percent of total billed charges,78% of total billed charges,560,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,94.08,16.8,,,percent of total billed charges,16.8% of total billed charges,280,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,280,50,,,percent of total billed charges,50% of total Billed charges,94.08,16.8,,,percent of total billed charges,16.8% of total billed charges,85.68,560,
I-131 DIAGNOSTIC PER 5 MC,344A9528,CDM,344,RC,A9528,HCPCS,Outpatient,,,207,134.55,TC,182.16,88,,,percent of total billed charges,88% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,34.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,35.82,17.304,,,percent of total billed charges,17.304% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.78,16.8,,,percent of total billed charges,16.8% of total billed charges,31.67,15.3,,,percent of total billed charges,15.3% of total billed charges,142.83,69,,,percent of total billed charges,69% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,128.03,61.85,,,percent of total billed charges,61.85% of total billed charges,34.78,16.8,,,percent of total billed charges,16.8% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,34.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,35.47,17.136,,,percent of total billed charges,17.136% of total billed charges,45.21,21.84,,,percent of total billed charges,21.84% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,70.17,33.9,,,percent of total billed charges,33.9% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,161.46,78,,,percent of total billed charges,78% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.78,16.8,,,percent of total billed charges,16.8% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,103.5,50,,,percent of total billed charges,50% of total Billed charges,34.78,16.8,,,percent of total billed charges,16.8% of total billed charges,31.67,207,
I131 PER 0.5 MCI,343A9508,CDM,343,RC,A9508,HCPCS,Outpatient,,,14502,9426.30,TC,12761.76,88,,,percent of total billed charges,88% of total Billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,2436.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2509.43,17.304,,,percent of total billed charges,17.304% of total billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2436.34,16.8,,,percent of total billed charges,16.8% of total billed charges,2218.81,15.3,,,percent of total billed charges,15.3% of total billed charges,10006.38,69,,,percent of total billed charges,69% of total billed charges,14502,100,,,percent of total billed charges,100% of total billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,14502,100,,,percent of total billed charges,100% of total billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,14502,100,,,percent of total billed charges,100% of total billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,8969.49,61.85,,,percent of total billed charges,61.85% of total billed charges,2436.34,16.8,,,percent of total billed charges,16.8% of total billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,2436.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,2485.06,17.136,,,percent of total billed charges,17.136% of total billed charges,3167.24,21.84,,,percent of total billed charges,21.84% of total billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,5467.25,37.7,,,percent of total billed charges,37.70% of total billed charges,5467.25,37.7,,,percent of total billed charges,37.70% of total billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,4916.18,33.9,,,percent of total billed charges,33.9% of total billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,11311.56,78,,,percent of total billed charges,78% of total billed charges,14502,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2436.34,16.8,,,percent of total billed charges,16.8% of total billed charges,7251,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7251,50,,,percent of total billed charges,50% of total Billed charges,2436.34,16.8,,,percent of total billed charges,16.8% of total billed charges,2218.81,14502,
I131 SOD ID TX / MCI,344A9517,CDM,344,RC,A9517,HCPCS,Outpatient,,,161,104.65,TC,141.68,88,,,percent of total billed charges,88% of total Billed charges,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,408.22,100,,,Fee Schedule,100% of WA Medicaid,161,100,,,percent of total billed charges,100% of total billed charges,420.47,103,,,Fee Schedule,103% of WA Medicaid,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,101.43,63,,,percent of total billed charges,63% of total billed charges,37.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,408.22,100,,,Fee Schedule,100% of WA Medicaid,24.63,15.3,,,percent of total billed charges,15.3% of total billed charges,111.09,69,,,percent of total billed charges,69% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,161,100,,,percent of total billed charges,100% of total billed charges,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,161,100,,,percent of total billed charges,100% of total billed charges,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,76.95,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,408.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,302.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,416.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,530.69,130,,,Fee Schedule,130% of WA Medicaid ,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,60.7,37.7,,,percent of total billed charges,37.70% of total billed charges,60.7,37.7,,,percent of total billed charges,37.70% of total billed charges,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,54.58,33.9,,,percent of total billed charges,33.9% of total billed charges,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,125.58,78,,,percent of total billed charges,78% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,408.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,21.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.34,100,,,Fee Schedule,100% of Medicare OPPS rate,408.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.34,530.69,
IN111 CAPRO PEND/DO,343A9507,CDM,343,RC,A9507,HCPCS,Outpatient,,,21142,13742.30,TC,18604.96,88,,,percent of total billed charges,88% of total Billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,3551.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3658.41,17.304,,,percent of total billed charges,17.304% of total billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3551.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3234.73,15.3,,,percent of total billed charges,15.3% of total billed charges,14587.98,69,,,percent of total billed charges,69% of total billed charges,21142,100,,,percent of total billed charges,100% of total billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,21142,100,,,percent of total billed charges,100% of total billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,21142,100,,,percent of total billed charges,100% of total billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,13076.33,61.85,,,percent of total billed charges,61.85% of total billed charges,3551.86,16.8,,,percent of total billed charges,16.8% of total billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,3551.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,3622.89,17.136,,,percent of total billed charges,17.136% of total billed charges,4617.41,21.84,,,percent of total billed charges,21.84% of total billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,7970.53,37.7,,,percent of total billed charges,37.70% of total billed charges,7970.53,37.7,,,percent of total billed charges,37.70% of total billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,7167.14,33.9,,,percent of total billed charges,33.9% of total billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,16490.76,78,,,percent of total billed charges,78% of total billed charges,21142,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3551.86,16.8,,,percent of total billed charges,16.8% of total billed charges,10571,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10571,50,,,percent of total billed charges,50% of total Billed charges,3551.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3234.73,21142,
IN111 PENTETAT/.5MCI,343A9548,CDM,343,RC,A9548,HCPCS,Outpatient,,,2268,1474.20,TC,1995.84,88,,,percent of total billed charges,88% of total Billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,381.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,2268,100,,,percent of total billed charges,100% of total billed charges,392.45,17.304,,,percent of total billed charges,17.304% of total billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,381.02,16.8,,,percent of total billed charges,16.8% of total billed charges,347,15.3,,,percent of total billed charges,15.3% of total billed charges,1564.92,69,,,percent of total billed charges,69% of total billed charges,2268,100,,,percent of total billed charges,100% of total billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,2268,100,,,percent of total billed charges,100% of total billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,2268,100,,,percent of total billed charges,100% of total billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,1402.76,61.85,,,percent of total billed charges,61.85% of total billed charges,381.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,381.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,388.64,17.136,,,percent of total billed charges,17.136% of total billed charges,495.33,21.84,,,percent of total billed charges,21.84% of total billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,855.04,37.7,,,percent of total billed charges,37.70% of total billed charges,855.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,768.85,33.9,,,percent of total billed charges,33.9% of total billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,1769.04,78,,,percent of total billed charges,78% of total billed charges,2268,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,381.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1134,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1134,50,,,percent of total billed charges,50% of total Billed charges,381.02,16.8,,,percent of total billed charges,16.8% of total billed charges,347,2268,
GA67 GALLIUM/MCI,343A9556,CDM,343,RC,A9556,HCPCS,Outpatient,,,137,89.05,TC,120.56,88,,,percent of total billed charges,88% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,137,100,,,percent of total billed charges,100% of total billed charges,23.71,17.304,,,percent of total billed charges,17.304% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,20.96,15.3,,,percent of total billed charges,15.3% of total billed charges,94.53,69,,,percent of total billed charges,69% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,137,100,,,percent of total billed charges,100% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,137,100,,,percent of total billed charges,100% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,84.73,61.85,,,percent of total billed charges,61.85% of total billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.48,17.136,,,percent of total billed charges,17.136% of total billed charges,29.92,21.84,,,percent of total billed charges,21.84% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,46.44,33.9,,,percent of total billed charges,33.9% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,106.86,78,,,percent of total billed charges,78% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,20.96,137,
GALLIUM GA-67 10 MCI,343A9556,CDM,343,RC,A9556,HCPCS,Outpatient,,,1420,923.00,TC,1249.6,88,,,percent of total billed charges,88% of total Billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,238.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1420,100,,,percent of total billed charges,100% of total billed charges,245.72,17.304,,,percent of total billed charges,17.304% of total billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,238.56,16.8,,,percent of total billed charges,16.8% of total billed charges,217.26,15.3,,,percent of total billed charges,15.3% of total billed charges,979.8,69,,,percent of total billed charges,69% of total billed charges,1420,100,,,percent of total billed charges,100% of total billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,1420,100,,,percent of total billed charges,100% of total billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,1420,100,,,percent of total billed charges,100% of total billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,878.27,61.85,,,percent of total billed charges,61.85% of total billed charges,238.56,16.8,,,percent of total billed charges,16.8% of total billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,238.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,243.33,17.136,,,percent of total billed charges,17.136% of total billed charges,310.13,21.84,,,percent of total billed charges,21.84% of total billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,535.34,37.7,,,percent of total billed charges,37.70% of total billed charges,535.34,37.7,,,percent of total billed charges,37.70% of total billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,481.38,33.9,,,percent of total billed charges,33.9% of total billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,1107.6,78,,,percent of total billed charges,78% of total billed charges,1420,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,238.56,16.8,,,percent of total billed charges,16.8% of total billed charges,710,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,710,50,,,percent of total billed charges,50% of total Billed charges,238.56,16.8,,,percent of total billed charges,16.8% of total billed charges,217.26,1420,
GALLIUM GA-67 6 MCI,343A9556,CDM,343,RC,A9556,HCPCS,Outpatient,,,710,461.50,TC,624.8,88,,,percent of total billed charges,88% of total Billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,119.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,710,100,,,percent of total billed charges,100% of total billed charges,122.86,17.304,,,percent of total billed charges,17.304% of total billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,119.28,16.8,,,percent of total billed charges,16.8% of total billed charges,108.63,15.3,,,percent of total billed charges,15.3% of total billed charges,489.9,69,,,percent of total billed charges,69% of total billed charges,710,100,,,percent of total billed charges,100% of total billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,710,100,,,percent of total billed charges,100% of total billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,710,100,,,percent of total billed charges,100% of total billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,439.14,61.85,,,percent of total billed charges,61.85% of total billed charges,119.28,16.8,,,percent of total billed charges,16.8% of total billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,119.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,121.67,17.136,,,percent of total billed charges,17.136% of total billed charges,155.06,21.84,,,percent of total billed charges,21.84% of total billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,267.67,37.7,,,percent of total billed charges,37.70% of total billed charges,267.67,37.7,,,percent of total billed charges,37.70% of total billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,240.69,33.9,,,percent of total billed charges,33.9% of total billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,553.8,78,,,percent of total billed charges,78% of total billed charges,710,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,119.28,16.8,,,percent of total billed charges,16.8% of total billed charges,355,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,355,50,,,percent of total billed charges,50% of total Billed charges,119.28,16.8,,,percent of total billed charges,16.8% of total billed charges,108.63,710,
US OB TO 14 WEEKS ADDL,40276802,CDM,402,RC,76802,HCPCS,Outpatient,,,341,221.65,TC,300.08,88,,,percent of total billed charges,88% of total Billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid,341,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,170.5,50,,,percent of total billed charges,50% of total Billed charges,214.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,235.29,69,,,percent of total billed charges,69% of total billed charges,341,100,,,percent of total billed charges,100% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,341,100,,,percent of total billed charges,100% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,341,100,,,percent of total billed charges,100% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,210.91,61.85,,,percent of total billed charges,61.85% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,170.5,50,,,percent of total billed charges,50% of total Billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,170.5,50,,,percent of total billed charges,50% of total Billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,170.5,50,,,percent of total billed charges,50% of total Billed charges,128.56,37.7,,,percent of total billed charges,37.70% of total billed charges,128.56,37.7,,,percent of total billed charges,37.70% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,115.6,33.9,,,percent of total billed charges,33.9% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,265.98,78,,,percent of total billed charges,78% of total billed charges,341,100,,,percent of total billed charges,100% of total billed charges,281.67,82.6,,,percent of total billed charges,82.6% of total billed charges,281.67,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,170.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,170.5,50,,,percent of total billed charges,50% of total Billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,341,
SODIUM PHOSPH P-32 PER MC,344A9563,CDM,344,RC,A9563,HCPCS,Outpatient,,,894,581.10,TC,786.72,88,,,percent of total billed charges,88% of total Billed charges,447,50,,,percent of total billed charges,50% of total Billed charges,408.22,100,,,Fee Schedule,100% of WA Medicaid,894,100,,,percent of total billed charges,100% of total billed charges,420.47,103,,,Fee Schedule,103% of WA Medicaid,447,50,,,percent of total billed charges,50% of total Billed charges,563.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,408.22,100,,,Fee Schedule,100% of WA Medicaid,136.78,15.3,,,percent of total billed charges,15.3% of total billed charges,616.86,69,,,percent of total billed charges,69% of total billed charges,894,100,,,percent of total billed charges,100% of total billed charges,447,50,,,percent of total billed charges,50% of total Billed charges,894,100,,,percent of total billed charges,100% of total billed charges,447,50,,,percent of total billed charges,50% of total Billed charges,894,100,,,percent of total billed charges,100% of total billed charges,447,50,,,percent of total billed charges,50% of total Billed charges,1753.15,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,408.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,447,50,,,percent of total billed charges,50% of total Billed charges,447,50,,,percent of total billed charges,50% of total Billed charges,302.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,447,50,,,percent of total billed charges,50% of total Billed charges,447,50,,,percent of total billed charges,50% of total Billed charges,416.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,530.69,130,,,Fee Schedule,130% of WA Medicaid ,447,50,,,percent of total billed charges,50% of total Billed charges,337.04,37.7,,,percent of total billed charges,37.70% of total billed charges,337.04,37.7,,,percent of total billed charges,37.70% of total billed charges,447,50,,,percent of total billed charges,50% of total Billed charges,303.07,33.9,,,percent of total billed charges,33.9% of total billed charges,447,50,,,percent of total billed charges,50% of total Billed charges,697.32,78,,,percent of total billed charges,78% of total billed charges,894,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,408.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,447,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,447,50,,,percent of total billed charges,50% of total Billed charges,408.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,136.78,1753.15,
SATUM PEND / DOSE,343A4642,CDM,343,RC,A4642,HCPCS,Outpatient,,,7262,4720.30,TC,6390.56,88,,,percent of total billed charges,88% of total Billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,1220.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1256.62,17.304,,,percent of total billed charges,17.304% of total billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1220.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1111.09,15.3,,,percent of total billed charges,15.3% of total billed charges,5010.78,69,,,percent of total billed charges,69% of total billed charges,7262,100,,,percent of total billed charges,100% of total billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,7262,100,,,percent of total billed charges,100% of total billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,7262,100,,,percent of total billed charges,100% of total billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,4491.55,61.85,,,percent of total billed charges,61.85% of total billed charges,1220.02,16.8,,,percent of total billed charges,16.8% of total billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,2265.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3631,50,,,percent of total billed charges,50% of total Billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,1244.42,17.136,,,percent of total billed charges,17.136% of total billed charges,1586.02,21.84,,,percent of total billed charges,21.84% of total billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,2737.77,37.7,,,percent of total billed charges,37.70% of total billed charges,2737.77,37.7,,,percent of total billed charges,37.70% of total billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,2461.82,33.9,,,percent of total billed charges,33.9% of total billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,5664.36,78,,,percent of total billed charges,78% of total billed charges,7262,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1220.02,16.8,,,percent of total billed charges,16.8% of total billed charges,3631,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3631,50,,,percent of total billed charges,50% of total Billed charges,1220.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1111.09,7262,
THALLIUM PER MILICURIE,343A9505,CDM,343,RC,A9505,HCPCS,Outpatient,,,1182,768.30,TC,1040.16,88,,,percent of total billed charges,88% of total Billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,198.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,1182,100,,,percent of total billed charges,100% of total billed charges,204.53,17.304,,,percent of total billed charges,17.304% of total billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,198.58,16.8,,,percent of total billed charges,16.8% of total billed charges,180.85,15.3,,,percent of total billed charges,15.3% of total billed charges,815.58,69,,,percent of total billed charges,69% of total billed charges,1182,100,,,percent of total billed charges,100% of total billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,1182,100,,,percent of total billed charges,100% of total billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,1182,100,,,percent of total billed charges,100% of total billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,731.07,61.85,,,percent of total billed charges,61.85% of total billed charges,198.58,16.8,,,percent of total billed charges,16.8% of total billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,198.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,202.55,17.136,,,percent of total billed charges,17.136% of total billed charges,258.15,21.84,,,percent of total billed charges,21.84% of total billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,445.61,37.7,,,percent of total billed charges,37.70% of total billed charges,445.61,37.7,,,percent of total billed charges,37.70% of total billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,400.7,33.9,,,percent of total billed charges,33.9% of total billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,921.96,78,,,percent of total billed charges,78% of total billed charges,1182,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,198.58,16.8,,,percent of total billed charges,16.8% of total billed charges,591,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,591,50,,,percent of total billed charges,50% of total Billed charges,198.58,16.8,,,percent of total billed charges,16.8% of total billed charges,180.85,1182,
TC 99 OXIDRONATE TO 30 MC,343A9561,CDM,343,RC,A9561,HCPCS,Outpatient,,,113,73.45,TC,99.44,88,,,percent of total billed charges,88% of total Billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,18.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,113,100,,,percent of total billed charges,100% of total billed charges,19.55,17.304,,,percent of total billed charges,17.304% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.98,16.8,,,percent of total billed charges,16.8% of total billed charges,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,113,100,,,percent of total billed charges,100% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,113,100,,,percent of total billed charges,100% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,69.89,61.85,,,percent of total billed charges,61.85% of total billed charges,18.98,16.8,,,percent of total billed charges,16.8% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,18.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,19.36,17.136,,,percent of total billed charges,17.136% of total billed charges,24.68,21.84,,,percent of total billed charges,21.84% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.98,16.8,,,percent of total billed charges,16.8% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56.5,50,,,percent of total billed charges,50% of total Billed charges,18.98,16.8,,,percent of total billed charges,16.8% of total billed charges,17.29,113,
TC 99M APCITIDE < = 20 MC,343A9504,CDM,343,RC,A9504,HCPCS,Outpatient,,,2223,1444.95,TC,1956.24,88,,,percent of total billed charges,88% of total Billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,373.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,2223,100,,,percent of total billed charges,100% of total billed charges,384.67,17.304,,,percent of total billed charges,17.304% of total billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,373.46,16.8,,,percent of total billed charges,16.8% of total billed charges,340.12,15.3,,,percent of total billed charges,15.3% of total billed charges,1533.87,69,,,percent of total billed charges,69% of total billed charges,2223,100,,,percent of total billed charges,100% of total billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,2223,100,,,percent of total billed charges,100% of total billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,2223,100,,,percent of total billed charges,100% of total billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,1374.93,61.85,,,percent of total billed charges,61.85% of total billed charges,373.46,16.8,,,percent of total billed charges,16.8% of total billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,373.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,380.93,17.136,,,percent of total billed charges,17.136% of total billed charges,485.5,21.84,,,percent of total billed charges,21.84% of total billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,838.07,37.7,,,percent of total billed charges,37.70% of total billed charges,838.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,753.6,33.9,,,percent of total billed charges,33.9% of total billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,1733.94,78,,,percent of total billed charges,78% of total billed charges,2223,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,373.46,16.8,,,percent of total billed charges,16.8% of total billed charges,1111.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1111.5,50,,,percent of total billed charges,50% of total Billed charges,373.46,16.8,,,percent of total billed charges,16.8% of total billed charges,340.12,2223,
TC 99M DISOFENIN < = 15MC,343A9510,CDM,343,RC,A9510,HCPCS,Outpatient,,,593,385.45,TC,521.84,88,,,percent of total billed charges,88% of total Billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,99.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,593,100,,,percent of total billed charges,100% of total billed charges,102.61,17.304,,,percent of total billed charges,17.304% of total billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,99.62,16.8,,,percent of total billed charges,16.8% of total billed charges,90.73,15.3,,,percent of total billed charges,15.3% of total billed charges,409.17,69,,,percent of total billed charges,69% of total billed charges,593,100,,,percent of total billed charges,100% of total billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,593,100,,,percent of total billed charges,100% of total billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,593,100,,,percent of total billed charges,100% of total billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,366.77,61.85,,,percent of total billed charges,61.85% of total billed charges,99.62,16.8,,,percent of total billed charges,16.8% of total billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,99.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,101.62,17.136,,,percent of total billed charges,17.136% of total billed charges,129.51,21.84,,,percent of total billed charges,21.84% of total billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,223.56,37.7,,,percent of total billed charges,37.70% of total billed charges,223.56,37.7,,,percent of total billed charges,37.70% of total billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,201.03,33.9,,,percent of total billed charges,33.9% of total billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,462.54,78,,,percent of total billed charges,78% of total billed charges,593,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,99.62,16.8,,,percent of total billed charges,16.8% of total billed charges,296.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,296.5,50,,,percent of total billed charges,50% of total Billed charges,99.62,16.8,,,percent of total billed charges,16.8% of total billed charges,90.73,593,
TC 99M EXAMETAZIME TO 25,343A9521,CDM,343,RC,A9521,HCPCS,Outpatient,,,2382,1548.30,TC,2096.16,88,,,percent of total billed charges,88% of total Billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,400.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,2382,100,,,percent of total billed charges,100% of total billed charges,412.18,17.304,,,percent of total billed charges,17.304% of total billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400.18,16.8,,,percent of total billed charges,16.8% of total billed charges,364.45,15.3,,,percent of total billed charges,15.3% of total billed charges,1643.58,69,,,percent of total billed charges,69% of total billed charges,2382,100,,,percent of total billed charges,100% of total billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,2382,100,,,percent of total billed charges,100% of total billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,2382,100,,,percent of total billed charges,100% of total billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,1473.27,61.85,,,percent of total billed charges,61.85% of total billed charges,400.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,400.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,408.18,17.136,,,percent of total billed charges,17.136% of total billed charges,520.23,21.84,,,percent of total billed charges,21.84% of total billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,898.01,37.7,,,percent of total billed charges,37.70% of total billed charges,898.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,807.5,33.9,,,percent of total billed charges,33.9% of total billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,1857.96,78,,,percent of total billed charges,78% of total billed charges,2382,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1191,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1191,50,,,percent of total billed charges,50% of total Billed charges,400.18,16.8,,,percent of total billed charges,16.8% of total billed charges,364.45,2382,
TC 99M MEBROFENIN < = 15,343A9537,CDM,343,RC,A9537,HCPCS,Outpatient,,,372,241.80,TC,327.36,88,,,percent of total billed charges,88% of total Billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,62.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,372,100,,,percent of total billed charges,100% of total billed charges,64.37,17.304,,,percent of total billed charges,17.304% of total billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62.5,16.8,,,percent of total billed charges,16.8% of total billed charges,56.92,15.3,,,percent of total billed charges,15.3% of total billed charges,256.68,69,,,percent of total billed charges,69% of total billed charges,372,100,,,percent of total billed charges,100% of total billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,372,100,,,percent of total billed charges,100% of total billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,372,100,,,percent of total billed charges,100% of total billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,230.08,61.85,,,percent of total billed charges,61.85% of total billed charges,62.5,16.8,,,percent of total billed charges,16.8% of total billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,62.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,63.75,17.136,,,percent of total billed charges,17.136% of total billed charges,81.24,21.84,,,percent of total billed charges,21.84% of total billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,140.24,37.7,,,percent of total billed charges,37.70% of total billed charges,140.24,37.7,,,percent of total billed charges,37.70% of total billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,126.11,33.9,,,percent of total billed charges,33.9% of total billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,290.16,78,,,percent of total billed charges,78% of total billed charges,372,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62.5,16.8,,,percent of total billed charges,16.8% of total billed charges,186,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,186,50,,,percent of total billed charges,50% of total Billed charges,62.5,16.8,,,percent of total billed charges,16.8% of total billed charges,56.92,372,
TC 99M PENTETATE TO 25MCI,343A9539,CDM,343,RC,A9539,HCPCS,Outpatient,,,336,218.40,TC,295.68,88,,,percent of total billed charges,88% of total Billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,56.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,336,100,,,percent of total billed charges,100% of total billed charges,58.14,17.304,,,percent of total billed charges,17.304% of total billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.45,16.8,,,percent of total billed charges,16.8% of total billed charges,51.41,15.3,,,percent of total billed charges,15.3% of total billed charges,231.84,69,,,percent of total billed charges,69% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,336,100,,,percent of total billed charges,100% of total billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,336,100,,,percent of total billed charges,100% of total billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,207.82,61.85,,,percent of total billed charges,61.85% of total billed charges,56.45,16.8,,,percent of total billed charges,16.8% of total billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,56.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,57.58,17.136,,,percent of total billed charges,17.136% of total billed charges,73.38,21.84,,,percent of total billed charges,21.84% of total billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,113.9,33.9,,,percent of total billed charges,33.9% of total billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,262.08,78,,,percent of total billed charges,78% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.45,16.8,,,percent of total billed charges,16.8% of total billed charges,168,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,168,50,,,percent of total billed charges,50% of total Billed charges,56.45,16.8,,,percent of total billed charges,16.8% of total billed charges,51.41,336,
TC99 MAA DX TO 10MCI,343A9540,CDM,343,RC,A9540,HCPCS,Outpatient,,,431,280.15,TC,379.28,88,,,percent of total billed charges,88% of total Billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,72.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,431,100,,,percent of total billed charges,100% of total billed charges,74.58,17.304,,,percent of total billed charges,17.304% of total billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,72.41,16.8,,,percent of total billed charges,16.8% of total billed charges,65.94,15.3,,,percent of total billed charges,15.3% of total billed charges,297.39,69,,,percent of total billed charges,69% of total billed charges,431,100,,,percent of total billed charges,100% of total billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,431,100,,,percent of total billed charges,100% of total billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,431,100,,,percent of total billed charges,100% of total billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,266.57,61.85,,,percent of total billed charges,61.85% of total billed charges,72.41,16.8,,,percent of total billed charges,16.8% of total billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,72.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,73.86,17.136,,,percent of total billed charges,17.136% of total billed charges,94.13,21.84,,,percent of total billed charges,21.84% of total billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,162.49,37.7,,,percent of total billed charges,37.70% of total billed charges,162.49,37.7,,,percent of total billed charges,37.70% of total billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,146.11,33.9,,,percent of total billed charges,33.9% of total billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,336.18,78,,,percent of total billed charges,78% of total billed charges,431,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,72.41,16.8,,,percent of total billed charges,16.8% of total billed charges,215.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,215.5,50,,,percent of total billed charges,50% of total Billed charges,72.41,16.8,,,percent of total billed charges,16.8% of total billed charges,65.94,431,
TC99 MERTIATIDE DX TO 15M,343A9562,CDM,343,RC,A9562,HCPCS,Outpatient,,,991,644.15,TC,872.08,88,,,percent of total billed charges,88% of total Billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,166.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,991,100,,,percent of total billed charges,100% of total billed charges,171.48,17.304,,,percent of total billed charges,17.304% of total billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,166.49,16.8,,,percent of total billed charges,16.8% of total billed charges,151.62,15.3,,,percent of total billed charges,15.3% of total billed charges,683.79,69,,,percent of total billed charges,69% of total billed charges,991,100,,,percent of total billed charges,100% of total billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,991,100,,,percent of total billed charges,100% of total billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,991,100,,,percent of total billed charges,100% of total billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,612.93,61.85,,,percent of total billed charges,61.85% of total billed charges,166.49,16.8,,,percent of total billed charges,16.8% of total billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,166.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,169.82,17.136,,,percent of total billed charges,17.136% of total billed charges,216.43,21.84,,,percent of total billed charges,21.84% of total billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,373.61,37.7,,,percent of total billed charges,37.70% of total billed charges,373.61,37.7,,,percent of total billed charges,37.70% of total billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,335.95,33.9,,,percent of total billed charges,33.9% of total billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,772.98,78,,,percent of total billed charges,78% of total billed charges,991,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,166.49,16.8,,,percent of total billed charges,16.8% of total billed charges,495.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,495.5,50,,,percent of total billed charges,50% of total Billed charges,166.49,16.8,,,percent of total billed charges,16.8% of total billed charges,151.62,991,
TC99 PYROPHOS DX TO 25MCI,343A9538,CDM,343,RC,A9538,HCPCS,Outpatient,,,334,217.10,TC,293.92,88,,,percent of total billed charges,88% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,334,100,,,percent of total billed charges,100% of total billed charges,57.8,17.304,,,percent of total billed charges,17.304% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,51.1,15.3,,,percent of total billed charges,15.3% of total billed charges,230.46,69,,,percent of total billed charges,69% of total billed charges,334,100,,,percent of total billed charges,100% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,334,100,,,percent of total billed charges,100% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,334,100,,,percent of total billed charges,100% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,206.58,61.85,,,percent of total billed charges,61.85% of total billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,57.23,17.136,,,percent of total billed charges,17.136% of total billed charges,72.95,21.84,,,percent of total billed charges,21.84% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,125.92,37.7,,,percent of total billed charges,37.70% of total billed charges,125.92,37.7,,,percent of total billed charges,37.70% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,113.23,33.9,,,percent of total billed charges,33.9% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,260.52,78,,,percent of total billed charges,78% of total billed charges,334,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,167,50,,,percent of total billed charges,50% of total Billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,51.1,334,
TC99 SUL COL DX TO 20MCI,343A9541,CDM,343,RC,A9541,HCPCS,Outpatient,,,386,250.90,TC,339.68,88,,,percent of total billed charges,88% of total Billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,64.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,386,100,,,percent of total billed charges,100% of total billed charges,66.79,17.304,,,percent of total billed charges,17.304% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64.85,16.8,,,percent of total billed charges,16.8% of total billed charges,59.06,15.3,,,percent of total billed charges,15.3% of total billed charges,266.34,69,,,percent of total billed charges,69% of total billed charges,386,100,,,percent of total billed charges,100% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,386,100,,,percent of total billed charges,100% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,386,100,,,percent of total billed charges,100% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,238.74,61.85,,,percent of total billed charges,61.85% of total billed charges,64.85,16.8,,,percent of total billed charges,16.8% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,64.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,66.14,17.136,,,percent of total billed charges,17.136% of total billed charges,84.3,21.84,,,percent of total billed charges,21.84% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,145.52,37.7,,,percent of total billed charges,37.70% of total billed charges,145.52,37.7,,,percent of total billed charges,37.70% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,130.85,33.9,,,percent of total billed charges,33.9% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,301.08,78,,,percent of total billed charges,78% of total billed charges,386,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64.85,16.8,,,percent of total billed charges,16.8% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,193,50,,,percent of total billed charges,50% of total Billed charges,64.85,16.8,,,percent of total billed charges,16.8% of total billed charges,59.06,386,
TC99 TILMAN DX .5MCI,343A9520,CDM,343,RC,A9520,HCPCS,Outpatient,,,1795,1166.75,TC,1579.6,88,,,percent of total billed charges,88% of total Billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,301.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1795,100,,,percent of total billed charges,100% of total billed charges,310.61,17.304,,,percent of total billed charges,17.304% of total billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,301.56,16.8,,,percent of total billed charges,16.8% of total billed charges,274.64,15.3,,,percent of total billed charges,15.3% of total billed charges,1238.55,69,,,percent of total billed charges,69% of total billed charges,1795,100,,,percent of total billed charges,100% of total billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,1795,100,,,percent of total billed charges,100% of total billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,1795,100,,,percent of total billed charges,100% of total billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,1110.21,61.85,,,percent of total billed charges,61.85% of total billed charges,301.56,16.8,,,percent of total billed charges,16.8% of total billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,301.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,307.59,17.136,,,percent of total billed charges,17.136% of total billed charges,392.03,21.84,,,percent of total billed charges,21.84% of total billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,676.72,37.7,,,percent of total billed charges,37.70% of total billed charges,676.72,37.7,,,percent of total billed charges,37.70% of total billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,608.51,33.9,,,percent of total billed charges,33.9% of total billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,1400.1,78,,,percent of total billed charges,78% of total billed charges,1795,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,301.56,16.8,,,percent of total billed charges,16.8% of total billed charges,897.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,897.5,50,,,percent of total billed charges,50% of total Billed charges,301.56,16.8,,,percent of total billed charges,16.8% of total billed charges,274.64,1795,
TC99M GLUCEPTA/25MCI,343A9550,CDM,343,RC,A9550,HCPCS,Outpatient,,,3088,2007.20,TC,2717.44,88,,,percent of total billed charges,88% of total Billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,518.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,3088,100,,,percent of total billed charges,100% of total billed charges,534.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,518.78,16.8,,,percent of total billed charges,16.8% of total billed charges,472.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2130.72,69,,,percent of total billed charges,69% of total billed charges,3088,100,,,percent of total billed charges,100% of total billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,3088,100,,,percent of total billed charges,100% of total billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,3088,100,,,percent of total billed charges,100% of total billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,1909.93,61.85,,,percent of total billed charges,61.85% of total billed charges,518.78,16.8,,,percent of total billed charges,16.8% of total billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,518.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,529.16,17.136,,,percent of total billed charges,17.136% of total billed charges,674.42,21.84,,,percent of total billed charges,21.84% of total billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,1164.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1164.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,1046.83,33.9,,,percent of total billed charges,33.9% of total billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,2408.64,78,,,percent of total billed charges,78% of total billed charges,3088,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,518.78,16.8,,,percent of total billed charges,16.8% of total billed charges,1544,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1544,50,,,percent of total billed charges,50% of total Billed charges,518.78,16.8,,,percent of total billed charges,16.8% of total billed charges,472.46,3088,
TC99M LABLED RBC TO 30 MC,343A9560,CDM,343,RC,A9560,HCPCS,Outpatient,,,526,341.90,TC,462.88,88,,,percent of total billed charges,88% of total Billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,88.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,526,100,,,percent of total billed charges,100% of total billed charges,91.02,17.304,,,percent of total billed charges,17.304% of total billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88.37,16.8,,,percent of total billed charges,16.8% of total billed charges,80.48,15.3,,,percent of total billed charges,15.3% of total billed charges,362.94,69,,,percent of total billed charges,69% of total billed charges,526,100,,,percent of total billed charges,100% of total billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,526,100,,,percent of total billed charges,100% of total billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,526,100,,,percent of total billed charges,100% of total billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,325.33,61.85,,,percent of total billed charges,61.85% of total billed charges,88.37,16.8,,,percent of total billed charges,16.8% of total billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,88.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,90.14,17.136,,,percent of total billed charges,17.136% of total billed charges,114.88,21.84,,,percent of total billed charges,21.84% of total billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,198.3,37.7,,,percent of total billed charges,37.70% of total billed charges,198.3,37.7,,,percent of total billed charges,37.70% of total billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,178.31,33.9,,,percent of total billed charges,33.9% of total billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,410.28,78,,,percent of total billed charges,78% of total billed charges,526,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88.37,16.8,,,percent of total billed charges,16.8% of total billed charges,263,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,263,50,,,percent of total billed charges,50% of total Billed charges,88.37,16.8,,,percent of total billed charges,16.8% of total billed charges,80.48,526,
TC99M MEDRO TO 30MCI,343A9503,CDM,343,RC,A9503,HCPCS,Outpatient,,,428,278.20,TC,376.64,88,,,percent of total billed charges,88% of total Billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,71.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,428,100,,,percent of total billed charges,100% of total billed charges,74.06,17.304,,,percent of total billed charges,17.304% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71.9,16.8,,,percent of total billed charges,16.8% of total billed charges,65.48,15.3,,,percent of total billed charges,15.3% of total billed charges,295.32,69,,,percent of total billed charges,69% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,428,100,,,percent of total billed charges,100% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,428,100,,,percent of total billed charges,100% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,264.72,61.85,,,percent of total billed charges,61.85% of total billed charges,71.9,16.8,,,percent of total billed charges,16.8% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,71.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,73.34,17.136,,,percent of total billed charges,17.136% of total billed charges,93.48,21.84,,,percent of total billed charges,21.84% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,145.09,33.9,,,percent of total billed charges,33.9% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,333.84,78,,,percent of total billed charges,78% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71.9,16.8,,,percent of total billed charges,16.8% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,214,50,,,percent of total billed charges,50% of total Billed charges,71.9,16.8,,,percent of total billed charges,16.8% of total billed charges,65.48,428,
TC-99M SESTAMIBI DX PER S,343A9500,CDM,343,RC,A9500,HCPCS,Outpatient,,,1055,685.75,TC,928.4,88,,,percent of total billed charges,88% of total Billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,177.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,1055,100,,,percent of total billed charges,100% of total billed charges,182.56,17.304,,,percent of total billed charges,17.304% of total billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,177.24,16.8,,,percent of total billed charges,16.8% of total billed charges,161.42,15.3,,,percent of total billed charges,15.3% of total billed charges,727.95,69,,,percent of total billed charges,69% of total billed charges,1055,100,,,percent of total billed charges,100% of total billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,1055,100,,,percent of total billed charges,100% of total billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,1055,100,,,percent of total billed charges,100% of total billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,652.52,61.85,,,percent of total billed charges,61.85% of total billed charges,177.24,16.8,,,percent of total billed charges,16.8% of total billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,177.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,180.78,17.136,,,percent of total billed charges,17.136% of total billed charges,230.41,21.84,,,percent of total billed charges,21.84% of total billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,397.74,37.7,,,percent of total billed charges,37.70% of total billed charges,397.74,37.7,,,percent of total billed charges,37.70% of total billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,357.65,33.9,,,percent of total billed charges,33.9% of total billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,822.9,78,,,percent of total billed charges,78% of total billed charges,1055,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,177.24,16.8,,,percent of total billed charges,16.8% of total billed charges,527.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,527.5,50,,,percent of total billed charges,50% of total Billed charges,177.24,16.8,,,percent of total billed charges,16.8% of total billed charges,161.42,1055,
TC99M SUCCIMER/10MCI,343A9551,CDM,343,RC,A9551,HCPCS,Outpatient,,,1112,722.80,TC,978.56,88,,,percent of total billed charges,88% of total Billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,186.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,1112,100,,,percent of total billed charges,100% of total billed charges,192.42,17.304,,,percent of total billed charges,17.304% of total billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,186.82,16.8,,,percent of total billed charges,16.8% of total billed charges,170.14,15.3,,,percent of total billed charges,15.3% of total billed charges,767.28,69,,,percent of total billed charges,69% of total billed charges,1112,100,,,percent of total billed charges,100% of total billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,1112,100,,,percent of total billed charges,100% of total billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,1112,100,,,percent of total billed charges,100% of total billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,687.77,61.85,,,percent of total billed charges,61.85% of total billed charges,186.82,16.8,,,percent of total billed charges,16.8% of total billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,186.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,190.55,17.136,,,percent of total billed charges,17.136% of total billed charges,242.86,21.84,,,percent of total billed charges,21.84% of total billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,419.22,37.7,,,percent of total billed charges,37.70% of total billed charges,419.22,37.7,,,percent of total billed charges,37.70% of total billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,376.97,33.9,,,percent of total billed charges,33.9% of total billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,867.36,78,,,percent of total billed charges,78% of total billed charges,1112,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,186.82,16.8,,,percent of total billed charges,16.8% of total billed charges,556,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,556,50,,,percent of total billed charges,50% of total Billed charges,186.82,16.8,,,percent of total billed charges,16.8% of total billed charges,170.14,1112,
F18 FDG / 45 MCI,343A9552,CDM,343,RC,A9552,HCPCS,Outpatient,,,1459,948.35,,1283.92,88,,,percent of total billed charges,88% of total Billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,245.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,1459,100,,,percent of total billed charges,100% of total billed charges,252.47,17.304,,,percent of total billed charges,17.304% of total billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,245.11,16.8,,,percent of total billed charges,16.8% of total billed charges,223.23,15.3,,,percent of total billed charges,15.3% of total billed charges,1006.71,69,,,percent of total billed charges,69% of total billed charges,1459,100,,,percent of total billed charges,100% of total billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,1459,100,,,percent of total billed charges,100% of total billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,1459,100,,,percent of total billed charges,100% of total billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,902.39,61.85,,,percent of total billed charges,61.85% of total billed charges,245.11,16.8,,,percent of total billed charges,16.8% of total billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,245.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,250.01,17.136,,,percent of total billed charges,17.136% of total billed charges,318.65,21.84,,,percent of total billed charges,21.84% of total billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,550.04,37.7,,,percent of total billed charges,37.70% of total billed charges,550.04,37.7,,,percent of total billed charges,37.70% of total billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,494.6,33.9,,,percent of total billed charges,33.9% of total billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,1138.02,78,,,percent of total billed charges,78% of total billed charges,1459,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,245.11,16.8,,,percent of total billed charges,16.8% of total billed charges,729.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,729.5,50,,,percent of total billed charges,50% of total Billed charges,245.11,16.8,,,percent of total billed charges,16.8% of total billed charges,223.23,1459,
CT 3D RECONSTRUCT COMPLEX,35076377,CDM,350,RC,76376,HCPCS,Outpatient,,,393,255.45,TC,345.84,88,,,percent of total billed charges,88% of total Billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,66.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,393,100,,,percent of total billed charges,100% of total billed charges,68,17.304,,,percent of total billed charges,17.304% of total billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,247.59,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,66.02,16.8,,,percent of total billed charges,16.8% of total billed charges,358,100,,,Case rate,pays based on per visit rate,271.17,69,,,percent of total billed charges,69% of total billed charges,393,100,,,percent of total billed charges,100% of total billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,393,100,,,percent of total billed charges,100% of total billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,393,100,,,percent of total billed charges,100% of total billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,243.07,61.85,,,percent of total billed charges,61.85% of total billed charges,66.02,16.8,,,percent of total billed charges,16.8% of total billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,66.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,67.34,17.136,,,percent of total billed charges,17.136% of total billed charges,85.83,21.84,,,percent of total billed charges,21.84% of total billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,148.16,37.7,,,percent of total billed charges,37.70% of total billed charges,148.16,37.7,,,percent of total billed charges,37.70% of total billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,133.23,33.9,,,percent of total billed charges,33.9% of total billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,306.54,78,,,percent of total billed charges,78% of total billed charges,393,100,,,percent of total billed charges,100% of total billed charges,324.62,82.6,,,percent of total billed charges,82.6% of total billed charges,324.62,82.6,,,percent of total billed charges,82.6% of total billed charges,66.02,16.8,,,percent of total billed charges,16.8% of total billed charges,196.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,196.5,50,,,percent of total billed charges,50% of total Billed charges,66.02,16.8,,,percent of total billed charges,16.8% of total billed charges,66.02,393,
MRI 3D RECONSTRUCT SIMPLE,61076376,CDM,611,RC,76376,HCPCS,Outpatient,,,197,128.05,TC,173.36,88,,,percent of total billed charges,88% of total Billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,33.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,197,100,,,percent of total billed charges,100% of total billed charges,34.09,17.304,,,percent of total billed charges,17.304% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,124.11,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.1,16.8,,,percent of total billed charges,16.8% of total billed charges,620,100,,,Case rate,pays based on per visit rate,135.93,69,,,percent of total billed charges,69% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,197,100,,,percent of total billed charges,100% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,197,100,,,percent of total billed charges,100% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,121.84,61.85,,,percent of total billed charges,61.85% of total billed charges,33.1,16.8,,,percent of total billed charges,16.8% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,33.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,33.76,17.136,,,percent of total billed charges,17.136% of total billed charges,43.02,21.84,,,percent of total billed charges,21.84% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,74.27,37.7,,,percent of total billed charges,37.70% of total billed charges,74.27,37.7,,,percent of total billed charges,37.70% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,66.78,33.9,,,percent of total billed charges,33.9% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,153.66,78,,,percent of total billed charges,78% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,33.1,16.8,,,percent of total billed charges,16.8% of total billed charges,98.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,98.5,50,,,percent of total billed charges,50% of total Billed charges,33.1,16.8,,,percent of total billed charges,16.8% of total billed charges,33.1,620,
"Ultrasound, pregnant uterus",9727617,CDM,402,RC,76817,HCPCS,Outpatient,,,546,354.90,,480.48,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,546,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,343.98,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,376.74,69,,,percent of total billed charges,69% of total billed charges,546,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,546,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,546,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,205.84,37.7,,,percent of total billed charges,37.70% of total billed charges,205.84,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,185.09,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,425.88,78,,,percent of total billed charges,78% of total billed charges,546,100,,,percent of total billed charges,100% of total billed charges,451,82.6,,,percent of total billed charges,82.6% of total billed charges,451,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,546,
AST PELVIC TRANSVAGINAL,40276830,CDM,402,RC,76830,HCPCS,Outpatient,,,778,505.70,,684.64,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,778,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,490.14,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,536.82,69,,,percent of total billed charges,69% of total billed charges,778,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,778,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,778,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,293.31,37.7,,,percent of total billed charges,37.70% of total billed charges,293.31,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,263.74,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,606.84,78,,,percent of total billed charges,78% of total billed charges,778,100,,,percent of total billed charges,100% of total billed charges,642.63,82.6,,,percent of total billed charges,82.6% of total billed charges,642.63,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,778,
AST Stress Echo Contrast Admin,48393352,CDM,483,RC,93352,HCPCS,Outpatient,,,128,83.20,,112.64,88,,,percent of total billed charges,88% of total Billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid,128,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,64,50,,,percent of total billed charges,50% of total Billed charges,80.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,418.1,100,,,Fee Schedule,100% of WA Medicaid,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,128,100,,,percent of total billed charges,100% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,128,100,,,percent of total billed charges,100% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,79.17,61.85,,,percent of total billed charges,61.85% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64,50,,,percent of total billed charges,50% of total Billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64,50,,,percent of total billed charges,50% of total Billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,64,50,,,percent of total billed charges,50% of total Billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,43.39,33.9,,,percent of total billed charges,33.9% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,64,50,,,percent of total billed charges,50% of total Billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.58,543.53,
AST Treadmill Stress Test,48293017,CDM,482,RC,93017,HCPCS,Outpatient,,,962,625.30,,846.56,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,962,100,,,percent of total billed charges,100% of total billed charges,155.52,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,606.06,63,,,percent of total billed charges,63% of total billed charges,560.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,147.19,15.3,,,percent of total billed charges,15.3% of total billed charges,663.78,69,,,percent of total billed charges,69% of total billed charges,962,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,962,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,962,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,111.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,154.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.29,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,362.67,37.7,,,percent of total billed charges,37.70% of total billed charges,362.67,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326.12,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,750.36,78,,,percent of total billed charges,78% of total billed charges,962,100,,,percent of total billed charges,100% of total billed charges,794.61,82.6,,,percent of total billed charges,82.6% of total billed charges,794.61,82.6,,,percent of total billed charges,82.6% of total billed charges,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.84,1074.33,
BD Bone Density DEXA App Skeleton,32077081,CDM,320,RC,77081,HCPCS,Outpatient,,,240,156.00,TC,211.2,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,71.5,100,,,Fee Schedule,100% of WA Medicaid,240,100,,,percent of total billed charges,100% of total billed charges,73.65,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,151.2,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,71.5,100,,,Fee Schedule,100% of WA Medicaid,36.72,15.3,,,percent of total billed charges,15.3% of total billed charges,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,240,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,71.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,72.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,92.96,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,81.36,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,71.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,71.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.72,328.65,
BD Bone Density DEXA Axial Skeleton,32077080,CDM,320,RC,77080,HCPCS,Outpatient,,,554,360.10,TC,487.52,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,71.5,100,,,Fee Schedule,100% of WA Medicaid,554,100,,,percent of total billed charges,100% of total billed charges,73.65,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,349.02,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,71.5,100,,,Fee Schedule,100% of WA Medicaid,84.76,15.3,,,percent of total billed charges,15.3% of total billed charges,382.26,69,,,percent of total billed charges,69% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,554,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,554,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,71.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,72.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,92.96,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,187.81,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,432.12,78,,,percent of total billed charges,78% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,71.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,71.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.97,554,
BD Bone Density DEXA Body Composition,32076499,CDM,320,RC,76499,HCPCS,Outpatient,,,1006,653.90,TC,885.28,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1006,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,633.78,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,153.92,15.3,,,percent of total billed charges,15.3% of total billed charges,694.14,69,,,percent of total billed charges,69% of total billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1006,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1006,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,379.26,37.7,,,percent of total billed charges,37.70% of total billed charges,379.26,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,341.03,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,784.68,78,,,percent of total billed charges,78% of total billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,830.96,82.6,,,percent of total billed charges,82.6% of total billed charges,830.96,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1006,
BD Bone Density DEXA Axial w/Frac Assess,32077080,CDM,320,RC,77080,HCPCS,Outpatient,,,748,486.20,TC,658.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,71.5,100,,,Fee Schedule,100% of WA Medicaid,748,100,,,percent of total billed charges,100% of total billed charges,73.65,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,471.24,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,71.5,100,,,Fee Schedule,100% of WA Medicaid,114.44,15.3,,,percent of total billed charges,15.3% of total billed charges,516.12,69,,,percent of total billed charges,69% of total billed charges,748,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,748,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,748,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,71.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,72.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,92.96,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,282,37.7,,,percent of total billed charges,37.70% of total billed charges,282,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,253.57,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,583.44,78,,,percent of total billed charges,78% of total billed charges,748,100,,,percent of total billed charges,100% of total billed charges,617.85,82.6,,,percent of total billed charges,82.6% of total billed charges,617.85,82.6,,,percent of total billed charges,82.6% of total billed charges,71.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,71.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.97,748,
CT Abdomen w/ + w/o Contrast,35274170,CDM,352,RC,74170,HCPCS,Outpatient,,,5423,3524.95,TC,4772.24,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3416.49,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3741.87,69,,,percent of total billed charges,69% of total billed charges,5423,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5423,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5423,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2044.47,37.7,,,percent of total billed charges,37.70% of total billed charges,2044.47,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1838.4,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4229.94,78,,,percent of total billed charges,78% of total billed charges,5423,100,,,percent of total billed charges,100% of total billed charges,4479.4,82.6,,,percent of total billed charges,82.6% of total billed charges,4479.4,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5423,
CT Abdomen w/ Contrast,35274160,CDM,352,RC,74160,HCPCS,Outpatient,,,4568,2969.20,TC,4019.84,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4568,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2877.84,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3151.92,69,,,percent of total billed charges,69% of total billed charges,4568,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4568,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4568,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1722.14,37.7,,,percent of total billed charges,37.70% of total billed charges,1722.14,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1548.55,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3563.04,78,,,percent of total billed charges,78% of total billed charges,4568,100,,,percent of total billed charges,100% of total billed charges,3773.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3773.17,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4568,
CT Abdomen w/o Contrast,35274150,CDM,352,RC,74150,HCPCS,Outpatient,,,3182,2068.30,TC,2800.16,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3182,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2004.66,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2195.58,69,,,percent of total billed charges,69% of total billed charges,3182,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3182,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3182,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1199.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1199.61,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1078.7,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2481.96,78,,,percent of total billed charges,78% of total billed charges,3182,100,,,percent of total billed charges,100% of total billed charges,2628.33,82.6,,,percent of total billed charges,82.6% of total billed charges,2628.33,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3182,
CT Angio Abdomen Aorta + Iliofemoral,35275635,CDM,352,RC,75635,HCPCS,Outpatient,,,7953,5169.45,TC,6998.64,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5010.39,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,5487.57,69,,,percent of total billed charges,69% of total billed charges,7953,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7953,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7953,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2998.28,37.7,,,percent of total billed charges,37.70% of total billed charges,2998.28,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2696.07,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6203.34,78,,,percent of total billed charges,78% of total billed charges,7953,100,,,percent of total billed charges,100% of total billed charges,6569.18,82.6,,,percent of total billed charges,82.6% of total billed charges,6569.18,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,7953,
CT Angio Abdomen,35274175,CDM,352,RC,74175,HCPCS,Outpatient,,,6791,4414.15,TC,5976.08,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4278.33,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,4685.79,69,,,percent of total billed charges,69% of total billed charges,6791,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6791,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6791,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2560.21,37.7,,,percent of total billed charges,37.70% of total billed charges,2560.21,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2302.15,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5296.98,78,,,percent of total billed charges,78% of total billed charges,6791,100,,,percent of total billed charges,100% of total billed charges,5609.37,82.6,,,percent of total billed charges,82.6% of total billed charges,5609.37,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,6791,
CT Angio Chest,35271275,CDM,352,RC,71275,HCPCS,Outpatient,,,8217,5341.05,TC,7230.96,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5176.71,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,5669.73,69,,,percent of total billed charges,69% of total billed charges,8217,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,8217,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,8217,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3097.81,37.7,,,percent of total billed charges,37.70% of total billed charges,3097.81,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2785.56,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6409.26,78,,,percent of total billed charges,78% of total billed charges,8217,100,,,percent of total billed charges,100% of total billed charges,6787.24,82.6,,,percent of total billed charges,82.6% of total billed charges,6787.24,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,8217,
CT Angio Brain/Head,35170496,CDM,351,RC,70496,HCPCS,Outpatient,,,4905,3188.25,TC,4316.4,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3090.15,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3384.45,69,,,percent of total billed charges,69% of total billed charges,4905,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4905,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4905,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1849.19,37.7,,,percent of total billed charges,37.70% of total billed charges,1849.19,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1662.8,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3825.9,78,,,percent of total billed charges,78% of total billed charges,4905,100,,,percent of total billed charges,100% of total billed charges,4051.53,82.6,,,percent of total billed charges,82.6% of total billed charges,4051.53,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4905,
CT Angio Lower Extremity Left,32375710,CDM,352,RC,73706,HCPCS,Outpatient,,,9317,6056.05,TC|LT,8198.96,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5869.71,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,6428.73,69,,,percent of total billed charges,69% of total billed charges,9317,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9317,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9317,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3512.51,37.7,,,percent of total billed charges,37.70% of total billed charges,3512.51,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3158.46,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7267.26,78,,,percent of total billed charges,78% of total billed charges,9317,100,,,percent of total billed charges,100% of total billed charges,7695.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7695.84,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,9317,
CT Angio Lower Extremity Right,35273706,CDM,352,RC,73706,HCPCS,Outpatient,,,6541,4251.65,TC|RT,5756.08,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4120.83,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,4513.29,69,,,percent of total billed charges,69% of total billed charges,6541,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6541,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6541,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2465.96,37.7,,,percent of total billed charges,37.70% of total billed charges,2465.96,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2217.4,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5101.98,78,,,percent of total billed charges,78% of total billed charges,6541,100,,,percent of total billed charges,100% of total billed charges,5402.87,82.6,,,percent of total billed charges,82.6% of total billed charges,5402.87,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,6541,
CT Angio Neck,35170498,CDM,351,RC,70498,HCPCS,Outpatient,,,5213,3388.45,TC,4587.44,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3284.19,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3596.97,69,,,percent of total billed charges,69% of total billed charges,5213,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5213,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5213,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1965.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1965.3,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1767.21,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4066.14,78,,,percent of total billed charges,78% of total billed charges,5213,100,,,percent of total billed charges,100% of total billed charges,4305.94,82.6,,,percent of total billed charges,82.6% of total billed charges,4305.94,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5213,
CT Angio Pelvis,35272191,CDM,352,RC,72191,HCPCS,Outpatient,,,5367,3488.55,TC,4722.96,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3381.21,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3703.23,69,,,percent of total billed charges,69% of total billed charges,5367,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5367,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5367,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2023.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2023.36,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1819.41,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4186.26,78,,,percent of total billed charges,78% of total billed charges,5367,100,,,percent of total billed charges,100% of total billed charges,4433.14,82.6,,,percent of total billed charges,82.6% of total billed charges,4433.14,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5367,
CT Angio Upper Extremity Left,32375710,CDM,323,RC,73206,HCPCS,Outpatient,,,9317,6056.05,TC|LT,8198.96,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5869.71,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,1425.5,15.3,,,percent of total billed charges,15.3% of total billed charges,6428.73,69,,,percent of total billed charges,69% of total billed charges,9317,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9317,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,9317,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3512.51,37.7,,,percent of total billed charges,37.70% of total billed charges,3512.51,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3158.46,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7267.26,78,,,percent of total billed charges,78% of total billed charges,9317,100,,,percent of total billed charges,100% of total billed charges,7695.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7695.84,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,9317,
CT Angio Upper Extremity Right,35273206,CDM,352,RC,73206,HCPCS,Outpatient,,,6863,4460.95,TC|RT,6039.44,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4323.69,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,4735.47,69,,,percent of total billed charges,69% of total billed charges,6863,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6863,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6863,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2587.35,37.7,,,percent of total billed charges,37.70% of total billed charges,2587.35,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2326.56,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5353.14,78,,,percent of total billed charges,78% of total billed charges,6863,100,,,percent of total billed charges,100% of total billed charges,5668.84,82.6,,,percent of total billed charges,82.6% of total billed charges,5668.84,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,6863,
CT Abdomen and Pelvis w/ + w/o Contrast,35274178,CDM,352,RC,74178,HCPCS,Outpatient,,,8672,5636.80,TC,7631.36,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,5463.36,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,5983.68,69,,,percent of total billed charges,69% of total billed charges,8672,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8672,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8672,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3269.34,37.7,,,percent of total billed charges,37.70% of total billed charges,3269.34,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2939.81,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6764.16,78,,,percent of total billed charges,78% of total billed charges,8672,100,,,percent of total billed charges,100% of total billed charges,7163.07,82.6,,,percent of total billed charges,82.6% of total billed charges,7163.07,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.9,8672,
CT Abdomen and Pelvis w/ Contrast,35274177,CDM,352,RC,74177,HCPCS,Outpatient,,,8097,5263.05,TC,7125.36,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,5101.11,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,5586.93,69,,,percent of total billed charges,69% of total billed charges,8097,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8097,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,8097,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3052.57,37.7,,,percent of total billed charges,37.70% of total billed charges,3052.57,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2744.88,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,6315.66,78,,,percent of total billed charges,78% of total billed charges,8097,100,,,percent of total billed charges,100% of total billed charges,6688.12,82.6,,,percent of total billed charges,82.6% of total billed charges,6688.12,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.9,8097,
CT Abdomen and Pelvis w/o Contrast,35274176,CDM,352,RC,74176,HCPCS,Outpatient,,,5612,3647.80,TC,4938.56,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3535.56,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3872.28,69,,,percent of total billed charges,69% of total billed charges,5612,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,5612,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,5612,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2115.72,37.7,,,percent of total billed charges,37.70% of total billed charges,2115.72,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1902.47,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,4377.36,78,,,percent of total billed charges,78% of total billed charges,5612,100,,,percent of total billed charges,100% of total billed charges,4635.51,82.6,,,percent of total billed charges,82.6% of total billed charges,4635.51,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.9,5612,
CT Angio Abdomen and Pelvis,35274174,CDM,352,RC,74174,HCPCS,Outpatient,,,7175,4663.75,TC,6314,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4520.25,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,4950.75,69,,,percent of total billed charges,69% of total billed charges,7175,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,7175,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,7175,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2704.98,37.7,,,percent of total billed charges,37.70% of total billed charges,2704.98,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2432.33,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,5596.5,78,,,percent of total billed charges,78% of total billed charges,7175,100,,,percent of total billed charges,100% of total billed charges,5926.55,82.6,,,percent of total billed charges,82.6% of total billed charges,5926.55,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,258.21,7175,
CT Angio Coronary Artery w/ Ca Score,35275574,CDM,352,RC,75574,HCPCS,Outpatient,,,2010,1306.50,TC,1768.8,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,2010,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1266.3,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1386.9,69,,,percent of total billed charges,69% of total billed charges,2010,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2010,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2010,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,757.77,37.7,,,percent of total billed charges,37.70% of total billed charges,757.77,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,681.39,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1567.8,78,,,percent of total billed charges,78% of total billed charges,2010,100,,,percent of total billed charges,100% of total billed charges,1660.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1660.26,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,2010,
CT Angio Coronary Artery w/o Ca Score,35275574,CDM,352,RC,75574,HCPCS,Outpatient,,,2010,1306.50,TC,1768.8,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,2010,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1266.3,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1386.9,69,,,percent of total billed charges,69% of total billed charges,2010,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2010,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2010,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,757.77,37.7,,,percent of total billed charges,37.70% of total billed charges,757.77,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,681.39,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1567.8,78,,,percent of total billed charges,78% of total billed charges,2010,100,,,percent of total billed charges,100% of total billed charges,1660.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1660.26,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,2010,
CT Angio Lower Extremity Bilateral,35273706,CDM,352,RC,73706,HCPCS,Outpatient,,,6541,4251.65,TC|50,5756.08,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4120.83,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,4513.29,69,,,percent of total billed charges,69% of total billed charges,6541,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6541,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6541,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2465.96,37.7,,,percent of total billed charges,37.70% of total billed charges,2465.96,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2217.4,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5101.98,78,,,percent of total billed charges,78% of total billed charges,6541,100,,,percent of total billed charges,100% of total billed charges,5402.87,82.6,,,percent of total billed charges,82.6% of total billed charges,5402.87,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,6541,
CT Angio Upper Extremity Bilateral,32375716,CDM,323,RC,73206,HCPCS,Outpatient,,,6541,4251.65,TC|50,5756.08,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4120.83,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,1000.77,15.3,,,percent of total billed charges,15.3% of total billed charges,4513.29,69,,,percent of total billed charges,69% of total billed charges,6541,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6541,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6541,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2465.96,37.7,,,percent of total billed charges,37.70% of total billed charges,2465.96,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2217.4,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5101.98,78,,,percent of total billed charges,78% of total billed charges,6541,100,,,percent of total billed charges,100% of total billed charges,5402.87,82.6,,,percent of total billed charges,82.6% of total billed charges,5402.87,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,6541,
CT Angio Chest/Adbdomen/Pelvis w/ Runoff,35271275,CDM,352,RC,71275,HCPCS,Outpatient,,,8217,5341.05,TC,7230.96,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5176.71,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,5669.73,69,,,percent of total billed charges,69% of total billed charges,8217,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,8217,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,8217,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3097.81,37.7,,,percent of total billed charges,37.70% of total billed charges,3097.81,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2785.56,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6409.26,78,,,percent of total billed charges,78% of total billed charges,8217,100,,,percent of total billed charges,100% of total billed charges,6787.24,82.6,,,percent of total billed charges,82.6% of total billed charges,6787.24,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,8217,
CT Angio Head,35170496,CDM,351,RC,70496,HCPCS,Outpatient,,,4905,3188.25,TC,4316.4,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3090.15,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3384.45,69,,,percent of total billed charges,69% of total billed charges,4905,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4905,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4905,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1849.19,37.7,,,percent of total billed charges,37.70% of total billed charges,1849.19,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1662.8,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3825.9,78,,,percent of total billed charges,78% of total billed charges,4905,100,,,percent of total billed charges,100% of total billed charges,4051.53,82.6,,,percent of total billed charges,82.6% of total billed charges,4051.53,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4905,
CT Angio Chest,35271275,CDM,352,RC,71275,HCPCS,Outpatient,,,3829,2488.85,TC,3369.52,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,3829,100,,,percent of total billed charges,100% of total billed charges,359.04,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2412.27,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2642.01,69,,,percent of total billed charges,69% of total billed charges,3829,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3829,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3829,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,258.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,355.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,453.15,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1443.53,37.7,,,percent of total billed charges,37.70% of total billed charges,1443.53,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1298.03,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2986.62,78,,,percent of total billed charges,78% of total billed charges,3829,100,,,percent of total billed charges,100% of total billed charges,3162.75,82.6,,,percent of total billed charges,82.6% of total billed charges,3162.75,82.6,,,percent of total billed charges,82.6% of total billed charges,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,348.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,3829,
CT Biopsy Liver,35047000,CDM,350,RC,47000,HCPCS,Outpatient,,,3464,2251.60,,3048.32,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,3464,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2182.32,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2390.16,69,,,percent of total billed charges,69% of total billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1305.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1305.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1174.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2701.92,78,,,percent of total billed charges,78% of total billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,2861.26,82.6,,,percent of total billed charges,82.6% of total billed charges,2861.26,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,358,5715.97,
CT Biopsy Lung/Mediastinum,35032408,CDM,350,RC,32408,HCPCS,Outpatient,,,3464,2251.60,,3048.32,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,3464,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2182.32,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2390.16,69,,,percent of total billed charges,69% of total billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1305.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1305.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1174.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2701.92,78,,,percent of total billed charges,78% of total billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,2861.26,82.6,,,percent of total billed charges,82.6% of total billed charges,2861.26,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,358,5715.97,
CT Biopsy Pancreas,35048102,CDM,350,RC,48102,HCPCS,Outpatient,,,3464,2251.60,,3048.32,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,3464,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2182.32,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2390.16,69,,,percent of total billed charges,69% of total billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1305.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1305.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1174.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2701.92,78,,,percent of total billed charges,78% of total billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,2861.26,82.6,,,percent of total billed charges,82.6% of total billed charges,2861.26,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,358,5715.97,
CT Biopsy Renal,35050200,CDM,350,RC,50200,HCPCS,Outpatient,,,3464,2251.60,,3048.32,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,3464,100,,,percent of total billed charges,100% of total billed charges,1400.69,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2182.32,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2390.16,69,,,percent of total billed charges,69% of total billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3464,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1007.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1387.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1767.86,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1305.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1305.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1174.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2701.92,78,,,percent of total billed charges,78% of total billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,2861.26,82.6,,,percent of total billed charges,82.6% of total billed charges,2861.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,358,5715.97,
CT Brain/Head w/ + w/o Contrast,35170470,CDM,351,RC,70470,HCPCS,Outpatient,,,4118,2676.70,TC,3623.84,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4118,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2594.34,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2841.42,69,,,percent of total billed charges,69% of total billed charges,4118,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4118,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4118,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1552.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1552.49,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1396,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3212.04,78,,,percent of total billed charges,78% of total billed charges,4118,100,,,percent of total billed charges,100% of total billed charges,3401.47,82.6,,,percent of total billed charges,82.6% of total billed charges,3401.47,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4118,
CT Brain/Head w/ Contrast,35170460,CDM,351,RC,70460,HCPCS,Outpatient,,,3600,2340.00,TC,3168,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,3600,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2268,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2484,69,,,percent of total billed charges,69% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3600,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3600,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1357.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1357.2,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1220.4,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2808,78,,,percent of total billed charges,78% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,3600,
CT Brain/Head w/o Contrast,35170450,CDM,351,RC,70450,HCPCS,Outpatient,,,2656,1726.40,TC,2337.28,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,2656,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1673.28,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1832.64,69,,,percent of total billed charges,69% of total billed charges,2656,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2656,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2656,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1001.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1001.31,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,900.38,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2071.68,78,,,percent of total billed charges,78% of total billed charges,2656,100,,,percent of total billed charges,100% of total billed charges,2193.86,82.6,,,percent of total billed charges,82.6% of total billed charges,2193.86,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.13,2656,
CT Chest w/ + w/o Contrast,35071270,CDM,350,RC,71270,HCPCS,Outpatient,,,5926,3851.90,TC,5214.88,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3733.38,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,4088.94,69,,,percent of total billed charges,69% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2008.91,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4622.28,78,,,percent of total billed charges,78% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5926,
CT Chest w/ Contrast,35071260,CDM,350,RC,71260,HCPCS,Outpatient,,,4679,3041.35,TC,4117.52,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4679,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2947.77,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3228.51,69,,,percent of total billed charges,69% of total billed charges,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1763.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1763.98,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1586.18,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3649.62,78,,,percent of total billed charges,78% of total billed charges,4679,100,,,percent of total billed charges,100% of total billed charges,3864.85,82.6,,,percent of total billed charges,82.6% of total billed charges,3864.85,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4679,
CT Chest w/o Contrast,35071250,CDM,350,RC,71250,HCPCS,Outpatient,,,3344,2173.60,TC,2942.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3344,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2106.72,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2307.36,69,,,percent of total billed charges,69% of total billed charges,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1260.69,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1133.62,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2608.32,78,,,percent of total billed charges,78% of total billed charges,3344,100,,,percent of total billed charges,100% of total billed charges,2762.14,82.6,,,percent of total billed charges,82.6% of total billed charges,2762.14,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3344,
CT Chest/Adbomen/Pelvis w/ + w/o Contras,35071270,CDM,350,RC,71270,HCPCS,Outpatient,,,5926,3851.90,TC,5214.88,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3733.38,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,4088.94,69,,,percent of total billed charges,69% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2008.91,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4622.28,78,,,percent of total billed charges,78% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5926,
CT Chest/Adbomen/Pelvis w/ Contrast,35071260,CDM,350,RC,71260,HCPCS,Outpatient,,,4679,3041.35,TC,4117.52,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4679,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2947.77,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3228.51,69,,,percent of total billed charges,69% of total billed charges,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1763.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1763.98,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1586.18,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3649.62,78,,,percent of total billed charges,78% of total billed charges,4679,100,,,percent of total billed charges,100% of total billed charges,3864.85,82.6,,,percent of total billed charges,82.6% of total billed charges,3864.85,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4679,
CT Chest/Adbomen/Pelvis w/o Contrast,35071250,CDM,350,RC,71250,HCPCS,Outpatient,,,3344,2173.60,TC,2942.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3344,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2106.72,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2307.36,69,,,percent of total billed charges,69% of total billed charges,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1260.69,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1133.62,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2608.32,78,,,percent of total billed charges,78% of total billed charges,3344,100,,,percent of total billed charges,100% of total billed charges,2762.14,82.6,,,percent of total billed charges,82.6% of total billed charges,2762.14,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3344,
CT Chest/Abdomen w/ + w/o Contrast,35071270,CDM,350,RC,71270,HCPCS,Outpatient,,,5926,3851.90,TC,5214.88,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3733.38,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,4088.94,69,,,percent of total billed charges,69% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2008.91,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4622.28,78,,,percent of total billed charges,78% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5926,
CT Chest/Abdomen w/ Contrast,35071260,CDM,350,RC,71260,HCPCS,Outpatient,,,4679,3041.35,TC,4117.52,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4679,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2947.77,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3228.51,69,,,percent of total billed charges,69% of total billed charges,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1763.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1763.98,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1586.18,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3649.62,78,,,percent of total billed charges,78% of total billed charges,4679,100,,,percent of total billed charges,100% of total billed charges,3864.85,82.6,,,percent of total billed charges,82.6% of total billed charges,3864.85,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4679,
CT Chest/Abdomen w/o Contrast,35071250,CDM,350,RC,71250,HCPCS,Outpatient,,,3344,2173.60,TC,2942.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3344,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2106.72,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2307.36,69,,,percent of total billed charges,69% of total billed charges,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1260.69,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1133.62,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2608.32,78,,,percent of total billed charges,78% of total billed charges,3344,100,,,percent of total billed charges,100% of total billed charges,2762.14,82.6,,,percent of total billed charges,82.6% of total billed charges,2762.14,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3344,
CT Drain Soft Tissue Fluid w/Cath Perc,35010030,CDM,350,RC,10030,HCPCS,Outpatient,,,5699,3704.35,,5015.12,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,989.16,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1018.83,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,3590.37,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,989.16,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3932.31,69,,,percent of total billed charges,69% of total billed charges,5699,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,5699,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,5699,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,732.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1008.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1285.91,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2148.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2148.52,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1931.96,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,4445.22,78,,,percent of total billed charges,78% of total billed charges,5699,100,,,percent of total billed charges,100% of total billed charges,4707.37,82.6,,,percent of total billed charges,82.6% of total billed charges,4707.37,82.6,,,percent of total billed charges,82.6% of total billed charges,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,989.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,358,5699,
CT Drain Visceral Fluid w/Cath Perc,35075989,CDM,350,RC,75989,HCPCS,Outpatient,,,1602,1041.30,TC,1409.76,88,,,percent of total billed charges,88% of total Billed charges,801,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,1602,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,801,50,,,percent of total billed charges,50% of total Billed charges,1009.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1105.38,69,,,percent of total billed charges,69% of total billed charges,1602,100,,,percent of total billed charges,100% of total billed charges,801,50,,,percent of total billed charges,50% of total Billed charges,1602,100,,,percent of total billed charges,100% of total billed charges,801,50,,,percent of total billed charges,50% of total Billed charges,1602,100,,,percent of total billed charges,100% of total billed charges,801,50,,,percent of total billed charges,50% of total Billed charges,990.84,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,801,50,,,percent of total billed charges,50% of total Billed charges,801,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,801,50,,,percent of total billed charges,50% of total Billed charges,801,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,801,50,,,percent of total billed charges,50% of total Billed charges,603.95,37.7,,,percent of total billed charges,37.70% of total billed charges,603.95,37.7,,,percent of total billed charges,37.70% of total billed charges,801,50,,,percent of total billed charges,50% of total Billed charges,543.08,33.9,,,percent of total billed charges,33.9% of total billed charges,801,50,,,percent of total billed charges,50% of total Billed charges,1249.56,78,,,percent of total billed charges,78% of total billed charges,1602,100,,,percent of total billed charges,100% of total billed charges,1323.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1323.25,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,801,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,801,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,1602,
CT Guided Needle Placement,35077012,CDM,350,RC,77012,HCPCS,Outpatient,,,3464,2251.60,TC,3048.32,88,,,percent of total billed charges,88% of total Billed charges,1732,50,,,percent of total billed charges,50% of total Billed charges,83.84,100,,,Fee Schedule,100% of WA Medicaid,3464,100,,,percent of total billed charges,100% of total billed charges,86.36,103,,,Fee Schedule,103% of WA Medicaid,1732,50,,,percent of total billed charges,50% of total Billed charges,2182.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,83.84,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2390.16,69,,,percent of total billed charges,69% of total billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,1732,50,,,percent of total billed charges,50% of total Billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,1732,50,,,percent of total billed charges,50% of total Billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,1732,50,,,percent of total billed charges,50% of total Billed charges,2142.48,61.85,,,percent of total billed charges,61.85% of total billed charges,83.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1732,50,,,percent of total billed charges,50% of total Billed charges,1732,50,,,percent of total billed charges,50% of total Billed charges,62.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1732,50,,,percent of total billed charges,50% of total Billed charges,1732,50,,,percent of total billed charges,50% of total Billed charges,85.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,109,130,,,Fee Schedule,130% of WA Medicaid ,1732,50,,,percent of total billed charges,50% of total Billed charges,1305.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1305.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1732,50,,,percent of total billed charges,50% of total Billed charges,1174.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1732,50,,,percent of total billed charges,50% of total Billed charges,2701.92,78,,,percent of total billed charges,78% of total billed charges,3464,100,,,percent of total billed charges,100% of total billed charges,2861.26,82.6,,,percent of total billed charges,82.6% of total billed charges,2861.26,82.6,,,percent of total billed charges,82.6% of total billed charges,83.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1732,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1732,50,,,percent of total billed charges,50% of total Billed charges,83.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.1,3464,
CT Guided Cryoablation,35050593,CDM,350,RC,50593,HCPCS,Outpatient,,,2717,1766.05,TC,2390.96,88,,,percent of total billed charges,88% of total Billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,6248.26,100,,,Fee Schedule,100% of WA Medicaid,2717,100,,,percent of total billed charges,100% of total billed charges,6435.7,103,,,Fee Schedule,103% of WA Medicaid,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1711.71,63,,,percent of total billed charges,63% of total billed charges,18373.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,6248.26,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1874.73,69,,,percent of total billed charges,69% of total billed charges,2717,100,,,percent of total billed charges,100% of total billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2717,100,,,percent of total billed charges,100% of total billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2717,100,,,percent of total billed charges,100% of total billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,36187.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6248.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,4628.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,6373.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8122.73,130,,,Fee Schedule,130% of WA Medicaid ,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1024.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1024.31,37.7,,,percent of total billed charges,37.70% of total billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,921.06,33.9,,,percent of total billed charges,33.9% of total billed charges,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2119.26,78,,,percent of total billed charges,78% of total billed charges,2717,100,,,percent of total billed charges,100% of total billed charges,2244.24,82.6,,,percent of total billed charges,82.6% of total billed charges,2244.24,82.6,,,percent of total billed charges,82.6% of total billed charges,6248.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,10604.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,10499.2,100,,,Fee Schedule,100% of Medicare OPPS rate,6248.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,358,36187.64,
CT Guided Microablation,35047382,CDM,350,RC,47382,HCPCS,Outpatient,,,2717,1766.05,TC,2390.96,88,,,percent of total billed charges,88% of total Billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5749.65,100,,,Fee Schedule,100% of WA Medicaid,2717,100,,,percent of total billed charges,100% of total billed charges,5922.14,103,,,Fee Schedule,103% of WA Medicaid,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1711.71,63,,,percent of total billed charges,63% of total billed charges,10299.04,175,,,Fee Schedule,175% of Medicare OPPS Rate,5749.65,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1874.73,69,,,percent of total billed charges,69% of total billed charges,2717,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2717,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2717,100,,,percent of total billed charges,100% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,20558.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5749.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,4259,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5864.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7474.55,130,,,Fee Schedule,130% of WA Medicaid ,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1024.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1024.31,37.7,,,percent of total billed charges,37.70% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,921.06,33.9,,,percent of total billed charges,33.9% of total billed charges,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2119.26,78,,,percent of total billed charges,78% of total billed charges,2717,100,,,percent of total billed charges,100% of total billed charges,2244.24,82.6,,,percent of total billed charges,82.6% of total billed charges,2244.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5749.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5944.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5885.16,100,,,Fee Schedule,100% of Medicare OPPS rate,5749.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,358,20558.19,
CT Guided Bone Marrow Biopsy,68638222,CDM,761,RC,38222,HCPCS,Outpatient,,,1720,1118.00,,1513.6,88,,,percent of total billed charges,88% of total Billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,1720,100,,,percent of total billed charges,100% of total billed charges,1102.48,103,,,Fee Schedule,103% of WA Medicaid,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1083.6,63,,,percent of total billed charges,63% of total billed charges,5071.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid,263.16,15.3,,,percent of total billed charges,15.3% of total billed charges,1186.8,69,,,percent of total billed charges,69% of total billed charges,1720,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1720,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1720,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,9628.23,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,792.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1091.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1391.48,130,,,Fee Schedule,130% of WA Medicaid ,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,648.44,37.7,,,percent of total billed charges,37.70% of total billed charges,648.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,583.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1341.6,78,,,percent of total billed charges,78% of total billed charges,1720,100,,,percent of total billed charges,100% of total billed charges,1420.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1420.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2927.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,263.16,9628.23,
CT Heart + Eval w/ Contrast,35275572,CDM,352,RC,75572,HCPCS,Outpatient,,,850,552.50,TC,748,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,850,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,535.5,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,586.5,69,,,percent of total billed charges,69% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,850,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,850,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,288.15,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,663,78,,,percent of total billed charges,78% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,850,
CT Heart Congenital + Eval w/ Contrast,35275573,CDM,352,RC,75573,HCPCS,Outpatient,,,1679,1091.35,TC,1477.52,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,1679,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1057.77,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1158.51,69,,,percent of total billed charges,69% of total billed charges,1679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,632.98,37.7,,,percent of total billed charges,37.70% of total billed charges,632.98,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,569.18,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1309.62,78,,,percent of total billed charges,78% of total billed charges,1679,100,,,percent of total billed charges,100% of total billed charges,1386.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1386.85,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,1679,
CT Heart Calcium Scoring,35275571,CDM,352,RC,75571,HCPCS,Outpatient,,,2009,1305.85,TC,1767.92,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,2009,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1265.67,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1386.21,69,,,percent of total billed charges,69% of total billed charges,2009,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2009,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2009,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,757.39,37.7,,,percent of total billed charges,37.70% of total billed charges,757.39,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,681.05,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1567.02,78,,,percent of total billed charges,78% of total billed charges,2009,100,,,percent of total billed charges,100% of total billed charges,1659.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1659.43,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,2009,
CT Head/Neck w/ + w/o Contrast,35170470,CDM,351,RC,70470,HCPCS,Outpatient,,,4118,2676.70,TC,3623.84,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4118,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2594.34,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2841.42,69,,,percent of total billed charges,69% of total billed charges,4118,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4118,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4118,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1552.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1552.49,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1396,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3212.04,78,,,percent of total billed charges,78% of total billed charges,4118,100,,,percent of total billed charges,100% of total billed charges,3401.47,82.6,,,percent of total billed charges,82.6% of total billed charges,3401.47,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4118,
CT Head/Neck w/ Contrast,35170460,CDM,351,RC,70460,HCPCS,Outpatient,,,3600,2340.00,TC,3168,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,3600,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2268,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2484,69,,,percent of total billed charges,69% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3600,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3600,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1357.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1357.2,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1220.4,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2808,78,,,percent of total billed charges,78% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,3600,
CT Head/Neck w/o Contrast,35170450,CDM,351,RC,70450,HCPCS,Outpatient,,,2656,1726.40,TC,2337.28,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,2656,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1673.28,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1832.64,69,,,percent of total billed charges,69% of total billed charges,2656,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2656,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2656,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1001.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1001.31,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,900.38,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2071.68,78,,,percent of total billed charges,78% of total billed charges,2656,100,,,percent of total billed charges,100% of total billed charges,2193.86,82.6,,,percent of total billed charges,82.6% of total billed charges,2193.86,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.13,2656,
CT Head/Orbits w/ + w/o Contrast,35170470,CDM,351,RC,70470,HCPCS,Outpatient,,,4118,2676.70,TC|59,3623.84,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4118,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2594.34,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2841.42,69,,,percent of total billed charges,69% of total billed charges,4118,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4118,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4118,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1552.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1552.49,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1396,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3212.04,78,,,percent of total billed charges,78% of total billed charges,4118,100,,,percent of total billed charges,100% of total billed charges,3401.47,82.6,,,percent of total billed charges,82.6% of total billed charges,3401.47,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4118,
CT Head/Orbits w/ Contrast,35170460,CDM,351,RC,70460,HCPCS,Outpatient,,,3600,2340.00,TC|59,3168,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,3600,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2268,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2484,69,,,percent of total billed charges,69% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3600,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3600,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1357.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1357.2,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1220.4,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2808,78,,,percent of total billed charges,78% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,3600,
CT Head/Orbits w/o Contrast,35170450,CDM,351,RC,70450,HCPCS,Outpatient,,,2656,1726.40,TC|59,2337.28,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,2656,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1673.28,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1832.64,69,,,percent of total billed charges,69% of total billed charges,2656,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2656,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2656,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1001.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1001.31,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,900.38,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2071.68,78,,,percent of total billed charges,78% of total billed charges,2656,100,,,percent of total billed charges,100% of total billed charges,2193.86,82.6,,,percent of total billed charges,82.6% of total billed charges,2193.86,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.13,2656,
CT Lower Extremity w/ Contrast Bilat,35273701,CDM,352,RC,73701,HCPCS,Outpatient,,,6062,3940.30,TC|50,5334.56,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3819.06,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,4182.78,69,,,percent of total billed charges,69% of total billed charges,6062,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6062,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6062,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2285.37,37.7,,,percent of total billed charges,37.70% of total billed charges,2285.37,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2055.02,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4728.36,78,,,percent of total billed charges,78% of total billed charges,6062,100,,,percent of total billed charges,100% of total billed charges,5007.21,82.6,,,percent of total billed charges,82.6% of total billed charges,5007.21,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,6062,
CT Lower Extremity w/ Contrast Left,35273701,CDM,352,RC,73701,HCPCS,Outpatient,,,5705,3708.25,TC|LT,5020.4,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3594.15,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3936.45,69,,,percent of total billed charges,69% of total billed charges,5705,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5705,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5705,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2150.79,37.7,,,percent of total billed charges,37.70% of total billed charges,2150.79,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1934,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4449.9,78,,,percent of total billed charges,78% of total billed charges,5705,100,,,percent of total billed charges,100% of total billed charges,4712.33,82.6,,,percent of total billed charges,82.6% of total billed charges,4712.33,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5705,
CT Lower Extremity w/ Contrast Right,35273701,CDM,352,RC,73701,HCPCS,Outpatient,,,5705,3708.25,TC|RT,5020.4,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3594.15,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3936.45,69,,,percent of total billed charges,69% of total billed charges,5705,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5705,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5705,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2150.79,37.7,,,percent of total billed charges,37.70% of total billed charges,2150.79,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1934,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4449.9,78,,,percent of total billed charges,78% of total billed charges,5705,100,,,percent of total billed charges,100% of total billed charges,4712.33,82.6,,,percent of total billed charges,82.6% of total billed charges,4712.33,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5705,
CT Lower Extremity w/+w/o Contrast Bilat,35273702,CDM,352,RC,73702,HCPCS,Outpatient,,,4867,3163.55,TC|50,4282.96,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3066.21,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3358.23,69,,,percent of total billed charges,69% of total billed charges,4867,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4867,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4867,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1834.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1834.86,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.91,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3796.26,78,,,percent of total billed charges,78% of total billed charges,4867,100,,,percent of total billed charges,100% of total billed charges,4020.14,82.6,,,percent of total billed charges,82.6% of total billed charges,4020.14,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4867,
CT Lower Extremity w/+w/o Contrast Left,35273702,CDM,352,RC,73702,HCPCS,Outpatient,,,4867,3163.55,TC|LT,4282.96,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3066.21,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3358.23,69,,,percent of total billed charges,69% of total billed charges,4867,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4867,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4867,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1834.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1834.86,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.91,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3796.26,78,,,percent of total billed charges,78% of total billed charges,4867,100,,,percent of total billed charges,100% of total billed charges,4020.14,82.6,,,percent of total billed charges,82.6% of total billed charges,4020.14,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4867,
CT Lower Extremity w/+w/o Contrast Right,35273702,CDM,352,RC,73702,HCPCS,Outpatient,,,4867,3163.55,TC|RT,4282.96,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3066.21,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3358.23,69,,,percent of total billed charges,69% of total billed charges,4867,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4867,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4867,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1834.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1834.86,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.91,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3796.26,78,,,percent of total billed charges,78% of total billed charges,4867,100,,,percent of total billed charges,100% of total billed charges,4020.14,82.6,,,percent of total billed charges,82.6% of total billed charges,4020.14,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4867,
CT Lower Extremity w/o Contrast Bilat,35273700,CDM,352,RC,73700,HCPCS,Outpatient,,,4813,3128.45,TC|50,4235.44,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3032.19,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3320.97,69,,,percent of total billed charges,69% of total billed charges,4813,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,4813,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,4813,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1814.5,37.7,,,percent of total billed charges,37.70% of total billed charges,1814.5,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1631.61,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3754.14,78,,,percent of total billed charges,78% of total billed charges,4813,100,,,percent of total billed charges,100% of total billed charges,3975.54,82.6,,,percent of total billed charges,82.6% of total billed charges,3975.54,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,4813,
CT Lower Extremity w/o Contrast Left,35273700,CDM,352,RC,73700,HCPCS,Outpatient,,,3390,2203.50,TC|LT,2983.2,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3390,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2135.7,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2339.1,69,,,percent of total billed charges,69% of total billed charges,3390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1278.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1278.03,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1149.21,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2644.2,78,,,percent of total billed charges,78% of total billed charges,3390,100,,,percent of total billed charges,100% of total billed charges,2800.14,82.6,,,percent of total billed charges,82.6% of total billed charges,2800.14,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3390,
CT Lower Extremity w/o Contrast Right,35273700,CDM,352,RC,73700,HCPCS,Outpatient,,,3390,2203.50,TC|RT,2983.2,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3390,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2135.7,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2339.1,69,,,percent of total billed charges,69% of total billed charges,3390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1278.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1278.03,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1149.21,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2644.2,78,,,percent of total billed charges,78% of total billed charges,3390,100,,,percent of total billed charges,100% of total billed charges,2800.14,82.6,,,percent of total billed charges,82.6% of total billed charges,2800.14,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3390,
CT Limited or Localized F/U Study,35076380,CDM,350,RC,76380,HCPCS,Outpatient,,,2018,1311.70,TC,1775.84,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,2018,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1271.34,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1392.42,69,,,percent of total billed charges,69% of total billed charges,2018,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2018,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2018,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,760.79,37.7,,,percent of total billed charges,37.70% of total billed charges,760.79,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,684.1,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1574.04,78,,,percent of total billed charges,78% of total billed charges,2018,100,,,percent of total billed charges,100% of total billed charges,1666.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1666.87,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,2018,
CT Low Dose Lung Screening,35071271,CDM,350,RC,71271,HCPCS,Outpatient,,,1039,675.35,TC,914.32,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,1039,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,654.57,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,716.91,69,,,percent of total billed charges,69% of total billed charges,1039,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1039,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1039,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,391.7,37.7,,,percent of total billed charges,37.70% of total billed charges,391.7,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,352.22,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,810.42,78,,,percent of total billed charges,78% of total billed charges,1039,100,,,percent of total billed charges,100% of total billed charges,858.21,82.6,,,percent of total billed charges,82.6% of total billed charges,858.21,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,1039,
CT Maxillofacial w/ + w/o Contrast,35170488,CDM,351,RC,70488,HCPCS,Outpatient,,,2732,1775.80,TC,2404.16,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,2732,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1721.16,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1885.08,69,,,percent of total billed charges,69% of total billed charges,2732,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2732,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2732,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1029.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1029.96,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,926.15,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2130.96,78,,,percent of total billed charges,78% of total billed charges,2732,100,,,percent of total billed charges,100% of total billed charges,2256.63,82.6,,,percent of total billed charges,82.6% of total billed charges,2256.63,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,2732,
CT Maxillofacial w/ Contrast,35170487,CDM,351,RC,70487,HCPCS,Outpatient,,,2574,1673.10,TC,2265.12,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,2574,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1621.62,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,1776.06,69,,,percent of total billed charges,69% of total billed charges,2574,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2574,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2574,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,970.4,37.7,,,percent of total billed charges,37.70% of total billed charges,970.4,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,872.59,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2007.72,78,,,percent of total billed charges,78% of total billed charges,2574,100,,,percent of total billed charges,100% of total billed charges,2126.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2126.12,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,2574,
CT Maxillofacial w/o Contrast,35170486,CDM,351,RC,70486,HCPCS,Outpatient,,,1072,696.80,TC,943.36,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,1072,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,675.36,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,739.68,69,,,percent of total billed charges,69% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1072,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1072,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,363.41,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,836.16,78,,,percent of total billed charges,78% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,1072,
CT Neck Soft Tissue w/ + w/o Contrast,35170492,CDM,351,RC,70492,HCPCS,Outpatient,,,4232,2750.80,TC,3724.16,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4232,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2666.16,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2920.08,69,,,percent of total billed charges,69% of total billed charges,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1595.46,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1434.65,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3300.96,78,,,percent of total billed charges,78% of total billed charges,4232,100,,,percent of total billed charges,100% of total billed charges,3495.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3495.63,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4232,
CT Neck Soft Tissue w/ Contrast,35170491,CDM,351,RC,70491,HCPCS,Outpatient,,,3972,2581.80,TC,3495.36,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,3972,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2502.36,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2740.68,69,,,percent of total billed charges,69% of total billed charges,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1497.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1497.44,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1346.51,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3098.16,78,,,percent of total billed charges,78% of total billed charges,3972,100,,,percent of total billed charges,100% of total billed charges,3280.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3280.87,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,3972,
CT Neck Soft Tissue w/o Contrast,35170490,CDM,351,RC,70490,HCPCS,Outpatient,,,3058,1987.70,TC,2691.04,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3058,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1926.54,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2110.02,69,,,percent of total billed charges,69% of total billed charges,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1152.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1152.87,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1036.66,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2385.24,78,,,percent of total billed charges,78% of total billed charges,3058,100,,,percent of total billed charges,100% of total billed charges,2525.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2525.91,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3058,
CT Neck/Chest w/ + w/o Contrast,35070492,CDM,350,RC,70492,HCPCS,Outpatient,,,4232,2750.80,TC,3724.16,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4232,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2666.16,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2920.08,69,,,percent of total billed charges,69% of total billed charges,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1595.46,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1434.65,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3300.96,78,,,percent of total billed charges,78% of total billed charges,4232,100,,,percent of total billed charges,100% of total billed charges,3495.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3495.63,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4232,
CT Neck/Chest w/ Contrast,35170491,CDM,351,RC,70491,HCPCS,Outpatient,,,3972,2581.80,TC,3495.36,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,3972,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2502.36,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2740.68,69,,,percent of total billed charges,69% of total billed charges,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1497.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1497.44,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1346.51,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3098.16,78,,,percent of total billed charges,78% of total billed charges,3972,100,,,percent of total billed charges,100% of total billed charges,3280.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3280.87,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,3972,
CT Neck/Chest w/o Contrast,35170490,CDM,351,RC,70490,HCPCS,Outpatient,,,3058,1987.70,TC,2691.04,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3058,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1926.54,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2110.02,69,,,percent of total billed charges,69% of total billed charges,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1152.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1152.87,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1036.66,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2385.24,78,,,percent of total billed charges,78% of total billed charges,3058,100,,,percent of total billed charges,100% of total billed charges,2525.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2525.91,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3058,
CT Neck/Chest/Abdomen/Pelvis w/ + w/o Co,35170492,CDM,351,RC,70492,HCPCS,Outpatient,,,4232,2750.80,TC,3724.16,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4232,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2666.16,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2920.08,69,,,percent of total billed charges,69% of total billed charges,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4232,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1595.46,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1434.65,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3300.96,78,,,percent of total billed charges,78% of total billed charges,4232,100,,,percent of total billed charges,100% of total billed charges,3495.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3495.63,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4232,
CT Neck/Chest/Abdomen/Pelvis w/ Contrast,35170491,CDM,351,RC,70491,HCPCS,Outpatient,,,3972,2581.80,TC,3495.36,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,3972,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2502.36,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2740.68,69,,,percent of total billed charges,69% of total billed charges,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3972,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1497.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1497.44,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1346.51,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3098.16,78,,,percent of total billed charges,78% of total billed charges,3972,100,,,percent of total billed charges,100% of total billed charges,3280.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3280.87,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,3972,
CT Neck/Chest/Abdomen/Pelvis w/o Contras,35170490,CDM,351,RC,70490,HCPCS,Outpatient,,,3058,1987.70,TC,2691.04,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3058,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1926.54,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2110.02,69,,,percent of total billed charges,69% of total billed charges,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1152.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1152.87,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1036.66,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2385.24,78,,,percent of total billed charges,78% of total billed charges,3058,100,,,percent of total billed charges,100% of total billed charges,2525.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2525.91,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3058,
CT Orbits Sella w/ + w/o Contrast,35170482,CDM,351,RC,70482,HCPCS,Outpatient,,,4103,2666.95,TC,3610.64,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4103,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2584.89,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2831.07,69,,,percent of total billed charges,69% of total billed charges,4103,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4103,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4103,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1546.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1546.83,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1390.92,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3200.34,78,,,percent of total billed charges,78% of total billed charges,4103,100,,,percent of total billed charges,100% of total billed charges,3389.08,82.6,,,percent of total billed charges,82.6% of total billed charges,3389.08,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4103,
CT Orbits Sella w/ Contrast,35170481,CDM,351,RC,70481,HCPCS,Outpatient,,,3087,2006.55,TC,2716.56,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,3087,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1944.81,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2130.03,69,,,percent of total billed charges,69% of total billed charges,3087,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3087,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3087,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1163.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1163.8,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1046.49,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2407.86,78,,,percent of total billed charges,78% of total billed charges,3087,100,,,percent of total billed charges,100% of total billed charges,2549.86,82.6,,,percent of total billed charges,82.6% of total billed charges,2549.86,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,3087,
CT Orbits Sella w/o Contrast,35170480,CDM,351,RC,70480,HCPCS,Outpatient,,,3790,2463.50,TC,3335.2,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3790,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2387.7,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2615.1,69,,,percent of total billed charges,69% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3790,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3790,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1284.81,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2956.2,78,,,percent of total billed charges,78% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3790,
CT Orbit Sella etc. or IAC w/ + w/o Cont,35170482,CDM,351,RC,70482,HCPCS,Outpatient,,,4103,2666.95,TC,3610.64,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4103,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2584.89,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2831.07,69,,,percent of total billed charges,69% of total billed charges,4103,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4103,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4103,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1546.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1546.83,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1390.92,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3200.34,78,,,percent of total billed charges,78% of total billed charges,4103,100,,,percent of total billed charges,100% of total billed charges,3389.08,82.6,,,percent of total billed charges,82.6% of total billed charges,3389.08,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4103,
CT Orbit Sella etc. or IAC w/ Cont,35170481,CDM,351,RC,70481,HCPCS,Outpatient,,,3087,2006.55,TC,2716.56,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,3087,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1944.81,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2130.03,69,,,percent of total billed charges,69% of total billed charges,3087,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3087,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3087,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1163.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1163.8,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1046.49,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2407.86,78,,,percent of total billed charges,78% of total billed charges,3087,100,,,percent of total billed charges,100% of total billed charges,2549.86,82.6,,,percent of total billed charges,82.6% of total billed charges,2549.86,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,3087,
CT Pelvis w/ + w/o Contrast,35272194,CDM,352,RC,72194,HCPCS,Outpatient,,,4045,2629.25,TC,3559.6,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4045,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2548.35,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2791.05,69,,,percent of total billed charges,69% of total billed charges,4045,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4045,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4045,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1524.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1524.97,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1371.26,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3155.1,78,,,percent of total billed charges,78% of total billed charges,4045,100,,,percent of total billed charges,100% of total billed charges,3341.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3341.17,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4045,
CT Pelvis w/ Contrast,35272193,CDM,352,RC,72193,HCPCS,Outpatient,,,4491,2919.15,TC,3952.08,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4491,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2829.33,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3098.79,69,,,percent of total billed charges,69% of total billed charges,4491,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4491,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4491,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1693.11,37.7,,,percent of total billed charges,37.70% of total billed charges,1693.11,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1522.45,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3502.98,78,,,percent of total billed charges,78% of total billed charges,4491,100,,,percent of total billed charges,100% of total billed charges,3709.57,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.57,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4491,
CT Pelvis w/o Contrast,35272192,CDM,352,RC,72192,HCPCS,Outpatient,,,3198,2078.70,TC,2814.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3198,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2014.74,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2206.62,69,,,percent of total billed charges,69% of total billed charges,3198,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3198,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3198,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1205.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1205.65,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1084.12,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2494.44,78,,,percent of total billed charges,78% of total billed charges,3198,100,,,percent of total billed charges,100% of total billed charges,2641.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2641.55,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3198,
CT Sinus w/o Contrast,35170486,CDM,351,RC,70486,HCPCS,Outpatient,,,1072,696.80,TC,943.36,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,1072,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,675.36,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,739.68,69,,,percent of total billed charges,69% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1072,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1072,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,363.41,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,836.16,78,,,percent of total billed charges,78% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,1072,
CT Spine Cervical w/ + w/o Contrast,35272127,CDM,352,RC,72127,HCPCS,Outpatient,,,3880,2522.00,TC,3414.4,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,3880,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2444.4,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2677.2,69,,,percent of total billed charges,69% of total billed charges,3880,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3880,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3880,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.76,37.7,,,percent of total billed charges,37.70% of total billed charges,1462.76,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1315.32,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3026.4,78,,,percent of total billed charges,78% of total billed charges,3880,100,,,percent of total billed charges,100% of total billed charges,3204.88,82.6,,,percent of total billed charges,82.6% of total billed charges,3204.88,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,3880,
CT Spine Cervical w/ Contrast,35272126,CDM,352,RC,72126,HCPCS,Outpatient,,,3827,2487.55,TC,3367.76,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,3827,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2411.01,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2640.63,69,,,percent of total billed charges,69% of total billed charges,3827,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3827,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3827,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1442.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1442.78,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1297.35,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2985.06,78,,,percent of total billed charges,78% of total billed charges,3827,100,,,percent of total billed charges,100% of total billed charges,3161.1,82.6,,,percent of total billed charges,82.6% of total billed charges,3161.1,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.9,3827,
CT Spine Cervical w/o Contrast,35272125,CDM,352,RC,72125,HCPCS,Outpatient,,,2995,1946.75,TC,2635.6,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,2995,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1886.85,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2066.55,69,,,percent of total billed charges,69% of total billed charges,2995,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2995,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2995,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1129.12,37.7,,,percent of total billed charges,37.70% of total billed charges,1129.12,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1015.31,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2336.1,78,,,percent of total billed charges,78% of total billed charges,2995,100,,,percent of total billed charges,100% of total billed charges,2473.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2473.87,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,2995,
CT Spine Lumbar w/ + w/o Contrast,35272133,CDM,352,RC,72133,HCPCS,Outpatient,,,4030,2619.50,TC,3546.4,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4030,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2538.9,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2780.7,69,,,percent of total billed charges,69% of total billed charges,4030,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4030,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4030,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1519.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1519.31,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1366.17,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3143.4,78,,,percent of total billed charges,78% of total billed charges,4030,100,,,percent of total billed charges,100% of total billed charges,3328.78,82.6,,,percent of total billed charges,82.6% of total billed charges,3328.78,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4030,
CT Spine Lumbar w/ Contrast,35272132,CDM,352,RC,72132,HCPCS,Outpatient,,,4845,3149.25,TC,4263.6,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3052.35,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3343.05,69,,,percent of total billed charges,69% of total billed charges,4845,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4845,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4845,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1826.57,37.7,,,percent of total billed charges,37.70% of total billed charges,1826.57,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1642.46,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3779.1,78,,,percent of total billed charges,78% of total billed charges,4845,100,,,percent of total billed charges,100% of total billed charges,4001.97,82.6,,,percent of total billed charges,82.6% of total billed charges,4001.97,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.9,4845,
CT Spine Lumbar w/o Contrast,35272131,CDM,352,RC,72131,HCPCS,Outpatient,,,3392,2204.80,TC,2984.96,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3392,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2136.96,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2340.48,69,,,percent of total billed charges,69% of total billed charges,3392,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3392,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3392,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1278.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1278.78,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1149.89,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2645.76,78,,,percent of total billed charges,78% of total billed charges,3392,100,,,percent of total billed charges,100% of total billed charges,2801.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2801.79,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3392,
CT Spine Thoracic w/ + w/o Contrast,35272130,CDM,352,RC,72130,HCPCS,Outpatient,,,4031,2620.15,TC,3547.28,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4031,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2539.53,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2781.39,69,,,percent of total billed charges,69% of total billed charges,4031,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4031,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4031,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1519.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1519.69,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1366.51,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3144.18,78,,,percent of total billed charges,78% of total billed charges,4031,100,,,percent of total billed charges,100% of total billed charges,3329.61,82.6,,,percent of total billed charges,82.6% of total billed charges,3329.61,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4031,
CT Spine Thoracic w/ Contrast,35272129,CDM,352,RC,72129,HCPCS,Outpatient,,,4019,2612.35,TC,3536.72,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4019,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2531.97,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2773.11,69,,,percent of total billed charges,69% of total billed charges,4019,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4019,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4019,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1515.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1515.16,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1362.44,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3134.82,78,,,percent of total billed charges,78% of total billed charges,4019,100,,,percent of total billed charges,100% of total billed charges,3319.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3319.69,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4019,
CT Spine Thoracic w/o Contrast,35272128,CDM,352,RC,72128,HCPCS,Outpatient,,,4445,2889.25,TC,3911.6,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,4445,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2800.35,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3067.05,69,,,percent of total billed charges,69% of total billed charges,4445,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,4445,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,4445,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1675.77,37.7,,,percent of total billed charges,37.70% of total billed charges,1675.77,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1506.86,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3467.1,78,,,percent of total billed charges,78% of total billed charges,4445,100,,,percent of total billed charges,100% of total billed charges,3671.57,82.6,,,percent of total billed charges,82.6% of total billed charges,3671.57,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,4445,
CT Sinus w/o Contrast Ltd,35170486,CDM,351,RC,70486,HCPCS,Outpatient,,,1072,696.80,TC,943.36,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,1072,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,675.36,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,739.68,69,,,percent of total billed charges,69% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1072,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1072,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,363.41,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,836.16,78,,,percent of total billed charges,78% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,1072,
CT Thorax w/ + w/o Contrast,35271270,CDM,352,RC,71270,HCPCS,Outpatient,,,5926,3851.90,TC,5214.88,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3733.38,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,4088.94,69,,,percent of total billed charges,69% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5926,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2008.91,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4622.28,78,,,percent of total billed charges,78% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5926,
CT Thorax w/ Contrast,35271260,CDM,352,RC,71260,HCPCS,Outpatient,,,4679,3041.35,TC,4117.52,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4679,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2947.77,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3228.51,69,,,percent of total billed charges,69% of total billed charges,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4679,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1763.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1763.98,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1586.18,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3649.62,78,,,percent of total billed charges,78% of total billed charges,4679,100,,,percent of total billed charges,100% of total billed charges,3864.85,82.6,,,percent of total billed charges,82.6% of total billed charges,3864.85,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,4679,
CT Thorax w/o Contrast,35271250,CDM,352,RC,71250,HCPCS,Outpatient,,,3344,2173.60,TC,2942.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3344,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2106.72,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2307.36,69,,,percent of total billed charges,69% of total billed charges,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3344,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1260.69,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1133.62,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2608.32,78,,,percent of total billed charges,78% of total billed charges,3344,100,,,percent of total billed charges,100% of total billed charges,2762.14,82.6,,,percent of total billed charges,82.6% of total billed charges,2762.14,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3344,
CT Upper Extremity w/ Contrast Left,35273201,CDM,352,RC,73201,HCPCS,Outpatient,,,4688,3047.20,TC|LT,4125.44,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4688,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2953.44,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3234.72,69,,,percent of total billed charges,69% of total billed charges,4688,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4688,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4688,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1767.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1767.38,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1589.23,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3656.64,78,,,percent of total billed charges,78% of total billed charges,4688,100,,,percent of total billed charges,100% of total billed charges,3872.29,82.6,,,percent of total billed charges,82.6% of total billed charges,3872.29,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.9,4688,
CT Upper Extremity w/ Contrast Right,35273201,CDM,352,RC,73201,HCPCS,Outpatient,,,4688,3047.20,TC|RT,4125.44,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4688,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2953.44,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3234.72,69,,,percent of total billed charges,69% of total billed charges,4688,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4688,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4688,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1767.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1767.38,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1589.23,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3656.64,78,,,percent of total billed charges,78% of total billed charges,4688,100,,,percent of total billed charges,100% of total billed charges,3872.29,82.6,,,percent of total billed charges,82.6% of total billed charges,3872.29,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.9,4688,
CT Upper Extremity w/+w/o Contrast Left,35273202,CDM,352,RC,73202,HCPCS,Outpatient,,,5277,3430.05,TC|LT,4643.76,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3324.51,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3641.13,69,,,percent of total billed charges,69% of total billed charges,5277,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5277,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5277,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1989.43,37.7,,,percent of total billed charges,37.70% of total billed charges,1989.43,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1788.9,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4116.06,78,,,percent of total billed charges,78% of total billed charges,5277,100,,,percent of total billed charges,100% of total billed charges,4358.8,82.6,,,percent of total billed charges,82.6% of total billed charges,4358.8,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5277,
CT Upper Extremity w/+w/o Contrast Right,35273202,CDM,352,RC,73202,HCPCS,Outpatient,,,5277,3430.05,TC|RT,4643.76,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,293.26,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3324.51,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,3641.13,69,,,percent of total billed charges,69% of total billed charges,5277,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5277,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5277,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,210.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,290.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,370.14,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1989.43,37.7,,,percent of total billed charges,37.70% of total billed charges,1989.43,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1788.9,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4116.06,78,,,percent of total billed charges,78% of total billed charges,5277,100,,,percent of total billed charges,100% of total billed charges,4358.8,82.6,,,percent of total billed charges,82.6% of total billed charges,4358.8,82.6,,,percent of total billed charges,82.6% of total billed charges,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,284.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.4,5277,
CT Upper Extremity w/o Contrast Left,35273200,CDM,352,RC,73200,HCPCS,Outpatient,,,3945,2564.25,TC|LT,3471.6,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3945,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2485.35,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2722.05,69,,,percent of total billed charges,69% of total billed charges,3945,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3945,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3945,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1487.27,37.7,,,percent of total billed charges,37.70% of total billed charges,1487.27,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1337.36,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3077.1,78,,,percent of total billed charges,78% of total billed charges,3945,100,,,percent of total billed charges,100% of total billed charges,3258.57,82.6,,,percent of total billed charges,82.6% of total billed charges,3258.57,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3945,
CT Upper Extremity w/o Contrast Right,35273200,CDM,352,RC,73200,HCPCS,Outpatient,,,3945,2564.25,TC|RT,3471.6,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,3945,100,,,percent of total billed charges,100% of total billed charges,108.24,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2485.35,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid,358,100,,,Case rate,pays based on per visit rate,2722.05,69,,,percent of total billed charges,69% of total billed charges,3945,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3945,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3945,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,77.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,107.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.62,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1487.27,37.7,,,percent of total billed charges,37.70% of total billed charges,1487.27,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1337.36,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,3077.1,78,,,percent of total billed charges,78% of total billed charges,3945,100,,,percent of total billed charges,100% of total billed charges,3258.57,82.6,,,percent of total billed charges,82.6% of total billed charges,3258.57,82.6,,,percent of total billed charges,82.6% of total billed charges,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,105.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.84,3945,
ELECTROCARDIOGRAM,73093005,CDM,730,RC,93005,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,24.47,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,302.4,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,73.44,15.3,,,percent of total billed charges,15.3% of total billed charges,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.89,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,162.72,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,480,
IR Angio LE Right,32375710,CDM,323,RC,75710,HCPCS,Outpatient,,,10352,6728.80,TC|RT,9109.76,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6521.76,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1583.86,15.3,,,percent of total billed charges,15.3% of total billed charges,7142.88,69,,,percent of total billed charges,69% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3509.33,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8074.56,78,,,percent of total billed charges,78% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
IR Angio Internal Mammary,32375756,CDM,323,RC,75756,HCPCS,Outpatient,,,10552,6858.80,TC,9285.76,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6647.76,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1614.46,15.3,,,percent of total billed charges,15.3% of total billed charges,7280.88,69,,,percent of total billed charges,69% of total billed charges,10552,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10552,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10552,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3978.1,37.7,,,percent of total billed charges,37.70% of total billed charges,3978.1,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3577.13,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8230.56,78,,,percent of total billed charges,78% of total billed charges,10552,100,,,percent of total billed charges,100% of total billed charges,8715.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8715.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
IR Angio LE Bilateral,32075716,CDM,320,RC,75716,HCPCS,Outpatient,,,9581,6227.65,TC|50,8431.28,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6036.03,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1465.89,15.3,,,percent of total billed charges,15.3% of total billed charges,6610.89,69,,,percent of total billed charges,69% of total billed charges,9581,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9581,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9581,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3612.04,37.7,,,percent of total billed charges,37.70% of total billed charges,3612.04,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3247.96,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7473.18,78,,,percent of total billed charges,78% of total billed charges,9581,100,,,percent of total billed charges,100% of total billed charges,7913.91,82.6,,,percent of total billed charges,82.6% of total billed charges,7913.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
IR Angio LE Left,32375710,CDM,323,RC,75710,HCPCS,Outpatient,,,10352,6728.80,TC|LT,9109.76,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6521.76,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1583.86,15.3,,,percent of total billed charges,15.3% of total billed charges,7142.88,69,,,percent of total billed charges,69% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3509.33,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8074.56,78,,,percent of total billed charges,78% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
IR Angio Pelvis,32075736,CDM,320,RC,75736,HCPCS,Outpatient,,,9579,6226.35,TC,8429.52,88,,,percent of total billed charges,88% of total Billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6034.77,63,,,percent of total billed charges,63% of total billed charges,9808.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,1465.59,15.3,,,percent of total billed charges,15.3% of total billed charges,6609.51,69,,,percent of total billed charges,69% of total billed charges,9579,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9579,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9579,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19379.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3611.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3611.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3247.28,33.9,,,percent of total billed charges,33.9% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,7471.62,78,,,percent of total billed charges,78% of total billed charges,9579,100,,,percent of total billed charges,100% of total billed charges,7912.25,82.6,,,percent of total billed charges,82.6% of total billed charges,7912.25,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5661.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1465.59,19379.78,
IR Angio Pulmonary Bilateral,32375743,CDM,323,RC,75743,HCPCS,Outpatient,,,9579,6226.35,TC,8429.52,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6034.77,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1465.59,15.3,,,percent of total billed charges,15.3% of total billed charges,6609.51,69,,,percent of total billed charges,69% of total billed charges,9579,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9579,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9579,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3611.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3611.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3247.28,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7471.62,78,,,percent of total billed charges,78% of total billed charges,9579,100,,,percent of total billed charges,100% of total billed charges,7912.25,82.6,,,percent of total billed charges,82.6% of total billed charges,7912.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
IR Angio Pulmonary Right,32375741,CDM,323,RC,75741,HCPCS,Outpatient,,,9579,6226.35,TC|RT,8429.52,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6034.77,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1465.59,15.3,,,percent of total billed charges,15.3% of total billed charges,6609.51,69,,,percent of total billed charges,69% of total billed charges,9579,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9579,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9579,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3611.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3611.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3247.28,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7471.62,78,,,percent of total billed charges,78% of total billed charges,9579,100,,,percent of total billed charges,100% of total billed charges,7912.25,82.6,,,percent of total billed charges,82.6% of total billed charges,7912.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
IR Angio UE Bilateral,32075716,CDM,320,RC,75716,HCPCS,Outpatient,,,9581,6227.65,TC|50,8431.28,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6036.03,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1465.89,15.3,,,percent of total billed charges,15.3% of total billed charges,6610.89,69,,,percent of total billed charges,69% of total billed charges,9581,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9581,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9581,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3612.04,37.7,,,percent of total billed charges,37.70% of total billed charges,3612.04,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3247.96,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7473.18,78,,,percent of total billed charges,78% of total billed charges,9581,100,,,percent of total billed charges,100% of total billed charges,7913.91,82.6,,,percent of total billed charges,82.6% of total billed charges,7913.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
IR Angio UE Left,32375710,CDM,323,RC,75710,HCPCS,Outpatient,,,10352,6728.80,TC|LT,9109.76,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6521.76,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1583.86,15.3,,,percent of total billed charges,15.3% of total billed charges,7142.88,69,,,percent of total billed charges,69% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3509.33,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8074.56,78,,,percent of total billed charges,78% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
IR Angio UE Right,32375710,CDM,323,RC,75710,HCPCS,Outpatient,,,10352,6728.80,TC|RT,9109.76,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6521.76,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1583.86,15.3,,,percent of total billed charges,15.3% of total billed charges,7142.88,69,,,percent of total billed charges,69% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3509.33,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8074.56,78,,,percent of total billed charges,78% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
IR Angio Visceral Sel or Suprasel,32375726,CDM,323,RC,75726,HCPCS,Outpatient,,,16785,10910.25,TC,14770.8,88,,,percent of total billed charges,88% of total Billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,10574.55,63,,,percent of total billed charges,63% of total billed charges,9808.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,2568.11,15.3,,,percent of total billed charges,15.3% of total billed charges,11581.65,69,,,percent of total billed charges,69% of total billed charges,16785,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16785,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,16785,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19379.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6327.95,37.7,,,percent of total billed charges,37.70% of total billed charges,6327.95,37.7,,,percent of total billed charges,37.70% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5690.12,33.9,,,percent of total billed charges,33.9% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,13092.3,78,,,percent of total billed charges,78% of total billed charges,16785,100,,,percent of total billed charges,100% of total billed charges,13864.41,82.6,,,percent of total billed charges,82.6% of total billed charges,13864.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5661.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2568.11,19379.78,
IR Aortogram Thoracic w/ Serialography,32375605,CDM,323,RC,75605,HCPCS,Outpatient,,,9581,6227.65,TC,8431.28,88,,,percent of total billed charges,88% of total Billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6036.03,63,,,percent of total billed charges,63% of total billed charges,9808.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,1465.89,15.3,,,percent of total billed charges,15.3% of total billed charges,6610.89,69,,,percent of total billed charges,69% of total billed charges,9581,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9581,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9581,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19379.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3612.04,37.7,,,percent of total billed charges,37.70% of total billed charges,3612.04,37.7,,,percent of total billed charges,37.70% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3247.96,33.9,,,percent of total billed charges,33.9% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,7473.18,78,,,percent of total billed charges,78% of total billed charges,9581,100,,,percent of total billed charges,100% of total billed charges,7913.91,82.6,,,percent of total billed charges,82.6% of total billed charges,7913.91,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5661.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1465.89,19379.78,
IR Biliary Endoscopy,32074328,CDM,320,RC,74328,HCPCS,Outpatient,,,1711,1112.15,TC,1505.68,88,,,percent of total billed charges,88% of total Billed charges,855.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,1711,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,855.5,50,,,percent of total billed charges,50% of total Billed charges,1077.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,261.78,15.3,,,percent of total billed charges,15.3% of total billed charges,1180.59,69,,,percent of total billed charges,69% of total billed charges,1711,100,,,percent of total billed charges,100% of total billed charges,855.5,50,,,percent of total billed charges,50% of total Billed charges,1711,100,,,percent of total billed charges,100% of total billed charges,855.5,50,,,percent of total billed charges,50% of total Billed charges,1711,100,,,percent of total billed charges,100% of total billed charges,855.5,50,,,percent of total billed charges,50% of total Billed charges,1058.25,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,855.5,50,,,percent of total billed charges,50% of total Billed charges,855.5,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,855.5,50,,,percent of total billed charges,50% of total Billed charges,855.5,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,855.5,50,,,percent of total billed charges,50% of total Billed charges,645.05,37.7,,,percent of total billed charges,37.70% of total billed charges,645.05,37.7,,,percent of total billed charges,37.70% of total billed charges,855.5,50,,,percent of total billed charges,50% of total Billed charges,580.03,33.9,,,percent of total billed charges,33.9% of total billed charges,855.5,50,,,percent of total billed charges,50% of total Billed charges,1334.58,78,,,percent of total billed charges,78% of total billed charges,1711,100,,,percent of total billed charges,100% of total billed charges,1413.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1413.29,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,855.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,855.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,1711,
IR Biliary Stent Placement New w/ Drain,32074363,CDM,320,RC,74363,HCPCS,Outpatient,,,2434,1582.10,TC,2141.92,88,,,percent of total billed charges,88% of total Billed charges,1217,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,2434,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,1217,50,,,percent of total billed charges,50% of total Billed charges,1533.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,372.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1679.46,69,,,percent of total billed charges,69% of total billed charges,2434,100,,,percent of total billed charges,100% of total billed charges,1217,50,,,percent of total billed charges,50% of total Billed charges,2434,100,,,percent of total billed charges,100% of total billed charges,1217,50,,,percent of total billed charges,50% of total Billed charges,2434,100,,,percent of total billed charges,100% of total billed charges,1217,50,,,percent of total billed charges,50% of total Billed charges,1505.43,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1217,50,,,percent of total billed charges,50% of total Billed charges,1217,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1217,50,,,percent of total billed charges,50% of total Billed charges,1217,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,1217,50,,,percent of total billed charges,50% of total Billed charges,917.62,37.7,,,percent of total billed charges,37.70% of total billed charges,917.62,37.7,,,percent of total billed charges,37.70% of total billed charges,1217,50,,,percent of total billed charges,50% of total Billed charges,825.13,33.9,,,percent of total billed charges,33.9% of total billed charges,1217,50,,,percent of total billed charges,50% of total Billed charges,1898.52,78,,,percent of total billed charges,78% of total billed charges,2434,100,,,percent of total billed charges,100% of total billed charges,2010.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2010.48,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1217,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1217,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,2434,
IR CVC Removal,32936589,CDM,329,RC,36589,HCPCS,Outpatient,,,2230,1449.50,TC,1962.4,88,,,percent of total billed charges,88% of total Billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,2230,100,,,percent of total billed charges,100% of total billed charges,678.35,103,,,Fee Schedule,103% of WA Medicaid,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.9,63,,,percent of total billed charges,63% of total billed charges,1121.3,175,,,Fee Schedule,175% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid,341.19,15.3,,,percent of total billed charges,15.3% of total billed charges,1538.7,69,,,percent of total billed charges,69% of total billed charges,2230,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2230,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2230,100,,,percent of total billed charges,100% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,2200.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,487.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,671.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.17,130,,,Fee Schedule,130% of WA Medicaid ,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,840.71,37.7,,,percent of total billed charges,37.70% of total billed charges,840.71,37.7,,,percent of total billed charges,37.70% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,755.97,33.9,,,percent of total billed charges,33.9% of total billed charges,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,1739.4,78,,,percent of total billed charges,78% of total billed charges,2230,100,,,percent of total billed charges,100% of total billed charges,1841.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1841.98,82.6,,,percent of total billed charges,82.6% of total billed charges,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,647.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.74,100,,,Fee Schedule,100% of Medicare OPPS rate,658.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,341.19,2230,
IR Gastric Tube,32943752,CDM,329,RC,43752,HCPCS,Outpatient,,,1699,1104.35,TC,1495.12,88,,,percent of total billed charges,88% of total Billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,1699,100,,,percent of total billed charges,100% of total billed charges,624,103,,,Fee Schedule,103% of WA Medicaid,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1070.37,63,,,percent of total billed charges,63% of total billed charges,711.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,259.95,15.3,,,percent of total billed charges,15.3% of total billed charges,1172.31,69,,,percent of total billed charges,69% of total billed charges,1699,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1699,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1699,100,,,percent of total billed charges,100% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1097.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,617.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.58,130,,,Fee Schedule,130% of WA Medicaid ,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,640.52,37.7,,,percent of total billed charges,37.70% of total billed charges,640.52,37.7,,,percent of total billed charges,37.70% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,575.96,33.9,,,percent of total billed charges,33.9% of total billed charges,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,1325.22,78,,,percent of total billed charges,78% of total billed charges,1699,100,,,percent of total billed charges,100% of total billed charges,1403.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1403.37,82.6,,,percent of total billed charges,82.6% of total billed charges,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,410.45,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.39,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,259.95,1699,
IR Gastrostomy Tube Change,32075984,CDM,320,RC,75984,HCPCS,Outpatient,,,1598,1038.70,TC,1406.24,88,,,percent of total billed charges,88% of total Billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,1598,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,799,50,,,percent of total billed charges,50% of total Billed charges,1006.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,244.49,15.3,,,percent of total billed charges,15.3% of total billed charges,1102.62,69,,,percent of total billed charges,69% of total billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,988.36,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,799,50,,,percent of total billed charges,50% of total Billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,799,50,,,percent of total billed charges,50% of total Billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,799,50,,,percent of total billed charges,50% of total Billed charges,602.45,37.7,,,percent of total billed charges,37.70% of total billed charges,602.45,37.7,,,percent of total billed charges,37.70% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,541.72,33.9,,,percent of total billed charges,33.9% of total billed charges,799,50,,,percent of total billed charges,50% of total Billed charges,1246.44,78,,,percent of total billed charges,78% of total billed charges,1598,100,,,percent of total billed charges,100% of total billed charges,1319.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1319.95,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,799,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,799,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,1598,
IR Hepatic Venogram,32075889,CDM,320,RC,75889,HCPCS,Outpatient,,,9579,6226.35,TC,8429.52,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6034.77,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1465.59,15.3,,,percent of total billed charges,15.3% of total billed charges,6609.51,69,,,percent of total billed charges,69% of total billed charges,9579,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9579,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,9579,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3611.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3611.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3247.28,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,7471.62,78,,,percent of total billed charges,78% of total billed charges,9579,100,,,percent of total billed charges,100% of total billed charges,7912.25,82.6,,,percent of total billed charges,82.6% of total billed charges,7912.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
IR Insertion Gastrostomy Tube Perc,32074350,CDM,320,RC,74350,HCPCS,Outpatient,,,811,527.15,TC,713.68,88,,,percent of total billed charges,88% of total Billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,136.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,811,100,,,percent of total billed charges,100% of total billed charges,140.34,17.304,,,percent of total billed charges,17.304% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,510.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,136.25,16.8,,,percent of total billed charges,16.8% of total billed charges,124.08,15.3,,,percent of total billed charges,15.3% of total billed charges,559.59,69,,,percent of total billed charges,69% of total billed charges,811,100,,,percent of total billed charges,100% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,811,100,,,percent of total billed charges,100% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,811,100,,,percent of total billed charges,100% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,501.6,61.85,,,percent of total billed charges,61.85% of total billed charges,136.25,16.8,,,percent of total billed charges,16.8% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,136.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,138.97,17.136,,,percent of total billed charges,17.136% of total billed charges,177.12,21.84,,,percent of total billed charges,21.84% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,305.75,37.7,,,percent of total billed charges,37.70% of total billed charges,305.75,37.7,,,percent of total billed charges,37.70% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,274.93,33.9,,,percent of total billed charges,33.9% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,632.58,78,,,percent of total billed charges,78% of total billed charges,811,100,,,percent of total billed charges,100% of total billed charges,669.89,82.6,,,percent of total billed charges,82.6% of total billed charges,669.89,82.6,,,percent of total billed charges,82.6% of total billed charges,136.25,16.8,,,percent of total billed charges,16.8% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,405.5,50,,,percent of total billed charges,50% of total Billed charges,136.25,16.8,,,percent of total billed charges,16.8% of total billed charges,124.08,811,
IR Insertion Long GI Tube w/ Fluoro,32074340,CDM,320,RC,74340,HCPCS,Outpatient,,,811,527.15,TC,713.68,88,,,percent of total billed charges,88% of total Billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,811,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,405.5,50,,,percent of total billed charges,50% of total Billed charges,510.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,124.08,15.3,,,percent of total billed charges,15.3% of total billed charges,559.59,69,,,percent of total billed charges,69% of total billed charges,811,100,,,percent of total billed charges,100% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,811,100,,,percent of total billed charges,100% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,811,100,,,percent of total billed charges,100% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,501.6,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,405.5,50,,,percent of total billed charges,50% of total Billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,405.5,50,,,percent of total billed charges,50% of total Billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,405.5,50,,,percent of total billed charges,50% of total Billed charges,305.75,37.7,,,percent of total billed charges,37.70% of total billed charges,305.75,37.7,,,percent of total billed charges,37.70% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,274.93,33.9,,,percent of total billed charges,33.9% of total billed charges,405.5,50,,,percent of total billed charges,50% of total Billed charges,632.58,78,,,percent of total billed charges,78% of total billed charges,811,100,,,percent of total billed charges,100% of total billed charges,669.89,82.6,,,percent of total billed charges,82.6% of total billed charges,669.89,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,405.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,405.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,811,
IR Loopogram,32074425,CDM,320,RC,74425,HCPCS,Outpatient,,,2938,1909.70,TC,2585.44,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2938,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1850.94,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,449.51,15.3,,,percent of total billed charges,15.3% of total billed charges,2027.22,69,,,percent of total billed charges,69% of total billed charges,2938,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2938,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2938,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1107.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1107.63,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,995.98,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2291.64,78,,,percent of total billed charges,78% of total billed charges,2938,100,,,percent of total billed charges,100% of total billed charges,2426.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2426.79,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2938,
IR Pleural Drainage Perc,32932557,CDM,329,RC,32557,HCPCS,Outpatient,,,7466,4852.90,TC,6570.08,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,884,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,4703.58,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid,1142.3,15.3,,,percent of total billed charges,15.3% of total billed charges,5151.54,69,,,percent of total billed charges,69% of total billed charges,7466,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,7466,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,7466,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,635.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,875.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1115.74,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2814.68,37.7,,,percent of total billed charges,37.70% of total billed charges,2814.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2530.97,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5823.48,78,,,percent of total billed charges,78% of total billed charges,7466,100,,,percent of total billed charges,100% of total billed charges,6166.92,82.6,,,percent of total billed charges,82.6% of total billed charges,6166.92,82.6,,,percent of total billed charges,82.6% of total billed charges,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,858.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,635.74,7466,
IR Pyelostogram,32074420,CDM,320,RC,74420,HCPCS,Outpatient,,,2110,1371.50,TC,1856.8,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2110,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1329.3,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,322.83,15.3,,,percent of total billed charges,15.3% of total billed charges,1455.9,69,,,percent of total billed charges,69% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,715.29,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.8,78,,,percent of total billed charges,78% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2110,
IR Select Cath Placement External Carotid,32336227,CDM,323,RC,36227,HCPCS,Outpatient,,,26994,17546.10,TC,23754.72,88,,,percent of total billed charges,88% of total Billed charges,13497,50,,,percent of total billed charges,50% of total Billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,13497,50,,,percent of total billed charges,50% of total Billed charges,17006.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4130.08,15.3,,,percent of total billed charges,15.3% of total billed charges,18625.86,69,,,percent of total billed charges,69% of total billed charges,26994,100,,,percent of total billed charges,100% of total billed charges,13497,50,,,percent of total billed charges,50% of total Billed charges,26994,100,,,percent of total billed charges,100% of total billed charges,13497,50,,,percent of total billed charges,50% of total Billed charges,26994,100,,,percent of total billed charges,100% of total billed charges,13497,50,,,percent of total billed charges,50% of total Billed charges,16695.79,61.85,,,percent of total billed charges,61.85% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13497,50,,,percent of total billed charges,50% of total Billed charges,13497,50,,,percent of total billed charges,50% of total Billed charges,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13497,50,,,percent of total billed charges,50% of total Billed charges,13497,50,,,percent of total billed charges,50% of total Billed charges,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,13497,50,,,percent of total billed charges,50% of total Billed charges,10176.74,37.7,,,percent of total billed charges,37.70% of total billed charges,10176.74,37.7,,,percent of total billed charges,37.70% of total billed charges,13497,50,,,percent of total billed charges,50% of total Billed charges,9150.97,33.9,,,percent of total billed charges,33.9% of total billed charges,13497,50,,,percent of total billed charges,50% of total Billed charges,21055.32,78,,,percent of total billed charges,78% of total billed charges,26994,100,,,percent of total billed charges,100% of total billed charges,22297.04,82.6,,,percent of total billed charges,82.6% of total billed charges,22297.04,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13497,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13497,50,,,percent of total billed charges,50% of total Billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2747.58,26994,
IR Sialography,32070390,CDM,320,RC,70390,HCPCS,Outpatient,,,1463,950.95,TC,1287.44,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1463,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,921.69,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,223.84,15.3,,,percent of total billed charges,15.3% of total billed charges,1009.47,69,,,percent of total billed charges,69% of total billed charges,1463,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1463,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1463,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,551.55,37.7,,,percent of total billed charges,37.70% of total billed charges,551.55,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,495.96,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1141.14,78,,,percent of total billed charges,78% of total billed charges,1463,100,,,percent of total billed charges,100% of total billed charges,1208.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1208.44,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1463,
IR Venous Sampling,32075893,CDM,320,RC,75893,HCPCS,Outpatient,,,9579,6226.35,TC,8429.52,88,,,percent of total billed charges,88% of total Billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3820.51,103,,,Fee Schedule,103% of WA Medicaid,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,6034.77,63,,,percent of total billed charges,63% of total billed charges,9808.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid,1465.59,15.3,,,percent of total billed charges,15.3% of total billed charges,6609.51,69,,,percent of total billed charges,69% of total billed charges,9579,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9579,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,9579,100,,,percent of total billed charges,100% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,19379.78,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3783.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4822.01,130,,,Fee Schedule,130% of WA Medicaid ,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3611.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3611.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3247.28,33.9,,,percent of total billed charges,33.9% of total billed charges,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,7471.62,78,,,percent of total billed charges,78% of total billed charges,9579,100,,,percent of total billed charges,100% of total billed charges,7912.25,82.6,,,percent of total billed charges,82.6% of total billed charges,7912.25,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,5661.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5605.05,100,,,Fee Schedule,100% of Medicare OPPS rate,3709.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1465.59,19379.78,
IR Venogram Extremity Bilateral,32075822,CDM,320,RC,75822,HCPCS,Outpatient,,,2747,1785.55,TC,2417.36,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,2747,100,,,percent of total billed charges,100% of total billed charges,781.83,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1730.61,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,420.29,15.3,,,percent of total billed charges,15.3% of total billed charges,1895.43,69,,,percent of total billed charges,69% of total billed charges,2747,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2747,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2747,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,562.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,774.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,986.78,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.62,37.7,,,percent of total billed charges,37.70% of total billed charges,1035.62,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,931.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2142.66,78,,,percent of total billed charges,78% of total billed charges,2747,100,,,percent of total billed charges,100% of total billed charges,2269.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2269.02,82.6,,,percent of total billed charges,82.6% of total billed charges,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,420.29,5712.48,
IR Venogram Extremity Left,32075820,CDM,320,RC,75820,HCPCS,Outpatient,,,3346,2174.90,TC|LT,2944.48,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,3346,100,,,percent of total billed charges,100% of total billed charges,781.83,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2107.98,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,511.94,15.3,,,percent of total billed charges,15.3% of total billed charges,2308.74,69,,,percent of total billed charges,69% of total billed charges,3346,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3346,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3346,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,562.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,774.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,986.78,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1261.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1261.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.29,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2609.88,78,,,percent of total billed charges,78% of total billed charges,3346,100,,,percent of total billed charges,100% of total billed charges,2763.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2763.8,82.6,,,percent of total billed charges,82.6% of total billed charges,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,511.94,5712.48,
IR Venogram Extremity Right,32075820,CDM,320,RC,75820,HCPCS,Outpatient,,,3346,2174.90,TC|RT,2944.48,88,,,percent of total billed charges,88% of total Billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,3346,100,,,percent of total billed charges,100% of total billed charges,781.83,103,,,Fee Schedule,103% of WA Medicaid,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2107.98,63,,,percent of total billed charges,63% of total billed charges,2858.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid,511.94,15.3,,,percent of total billed charges,15.3% of total billed charges,2308.74,69,,,percent of total billed charges,69% of total billed charges,3346,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3346,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,3346,100,,,percent of total billed charges,100% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,5712.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,562.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,774.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,986.78,130,,,Fee Schedule,130% of WA Medicaid ,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1261.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1261.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.29,33.9,,,percent of total billed charges,33.9% of total billed charges,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,2609.88,78,,,percent of total billed charges,78% of total billed charges,3346,100,,,percent of total billed charges,100% of total billed charges,2763.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2763.8,82.6,,,percent of total billed charges,82.6% of total billed charges,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,1649.84,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1633.5,100,,,Fee Schedule,100% of Medicare OPPS rate,759.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,511.94,5712.48,
IR Venogram Sinus or Jugular,32075860,CDM,320,RC,75860,HCPCS,Outpatient,,,10552,6858.80,TC,9285.76,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6647.76,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1614.46,15.3,,,percent of total billed charges,15.3% of total billed charges,7280.88,69,,,percent of total billed charges,69% of total billed charges,10552,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10552,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10552,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3978.1,37.7,,,percent of total billed charges,37.70% of total billed charges,3978.1,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3577.13,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8230.56,78,,,percent of total billed charges,78% of total billed charges,10552,100,,,percent of total billed charges,100% of total billed charges,8715.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8715.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
MG Breast Tissue Specimen Surgical Left,32076098,CDM,320,RC,76098,HCPCS,Outpatient,,,2125,1381.25,TC|LT,1870,88,,,percent of total billed charges,88% of total Billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2125,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1338.75,63,,,percent of total billed charges,63% of total billed charges,984.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,325.13,15.3,,,percent of total billed charges,15.3% of total billed charges,1466.25,69,,,percent of total billed charges,69% of total billed charges,2125,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2125,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2125,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,801.13,37.7,,,percent of total billed charges,37.70% of total billed charges,801.13,37.7,,,percent of total billed charges,37.70% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,720.38,33.9,,,percent of total billed charges,33.9% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1657.5,78,,,percent of total billed charges,78% of total billed charges,2125,100,,,percent of total billed charges,100% of total billed charges,1755.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1755.25,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,568.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2125,
MG Breast Tissue Specimen Surgical Right,32076098,CDM,320,RC,76098,HCPCS,Outpatient,,,2125,1381.25,TC|RT,1870,88,,,percent of total billed charges,88% of total Billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2125,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1338.75,63,,,percent of total billed charges,63% of total billed charges,984.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,325.13,15.3,,,percent of total billed charges,15.3% of total billed charges,1466.25,69,,,percent of total billed charges,69% of total billed charges,2125,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2125,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2125,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,801.13,37.7,,,percent of total billed charges,37.70% of total billed charges,801.13,37.7,,,percent of total billed charges,37.70% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,720.38,33.9,,,percent of total billed charges,33.9% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1657.5,78,,,percent of total billed charges,78% of total billed charges,2125,100,,,percent of total billed charges,100% of total billed charges,1755.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1755.25,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,568.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2125,
MG Breast Tomo 3D Digital Diag Bilateral,40177062,CDM,401,RC,77062,HCPCS,Outpatient,,,153,99.45,TC,134.64,88,,,percent of total billed charges,88% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid,153,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,76.5,50,,,percent of total billed charges,50% of total Billed charges,96.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,45.62,100,,,Fee Schedule,100% of WA Medicaid,23.41,15.3,,,percent of total billed charges,15.3% of total billed charges,105.57,69,,,percent of total billed charges,69% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,94.63,61.85,,,percent of total billed charges,61.85% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.5,50,,,percent of total billed charges,50% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.5,50,,,percent of total billed charges,50% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,76.5,50,,,percent of total billed charges,50% of total Billed charges,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,51.87,33.9,,,percent of total billed charges,33.9% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,119.34,78,,,percent of total billed charges,78% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.5,50,,,percent of total billed charges,50% of total Billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.41,153,
MG Breast Biopsy w/ Stereo Guide Left,40119081,CDM,401,RC,19081,HCPCS,Outpatient,,,3100,2015.00,TC|LT,2728,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,3100,100,,,percent of total billed charges,100% of total billed charges,1298.41,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1953,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,474.3,15.3,,,percent of total billed charges,15.3% of total billed charges,2139,69,,,percent of total billed charges,69% of total billed charges,3100,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3100,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3100,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,933.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1285.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1638.77,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1168.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1168.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1050.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2418,78,,,percent of total billed charges,78% of total billed charges,3100,100,,,percent of total billed charges,100% of total billed charges,2560.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2560.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,474.3,5715.97,
MG Breast Biopsy w/ Stereo Guide Right,40119081,CDM,401,RC,19081,HCPCS,Outpatient,,,3100,2015.00,TC|RT,2728,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,3100,100,,,percent of total billed charges,100% of total billed charges,1298.41,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1953,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,474.3,15.3,,,percent of total billed charges,15.3% of total billed charges,2139,69,,,percent of total billed charges,69% of total billed charges,3100,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3100,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3100,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,933.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1285.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1638.77,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1168.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1168.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1050.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2418,78,,,percent of total billed charges,78% of total billed charges,3100,100,,,percent of total billed charges,100% of total billed charges,2560.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2560.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,474.3,5715.97,
MG Breast Tomo 3D Digital Screening,40377063,CDM,403,RC,77063,HCPCS,Outpatient,,,153,99.45,TC,134.64,88,,,percent of total billed charges,88% of total Billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,153,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,96.39,63,,,percent of total billed charges,63% of total billed charges,43.61,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,23.41,15.3,,,percent of total billed charges,15.3% of total billed charges,105.57,69,,,percent of total billed charges,69% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,153,100,,,percent of total billed charges,100% of total billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,98.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,51.87,33.9,,,percent of total billed charges,33.9% of total billed charges,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,119.34,78,,,percent of total billed charges,78% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,25.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.92,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.41,153,
MG Device Plcmnt w/ Mammo Guide Left,40119281,CDM,401,RC,19281,HCPCS,Outpatient,,,3221,2093.65,TC|LT,2834.48,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,3221,100,,,percent of total billed charges,100% of total billed charges,1298.41,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2029.23,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,492.81,15.3,,,percent of total billed charges,15.3% of total billed charges,2222.49,69,,,percent of total billed charges,69% of total billed charges,3221,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3221,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3221,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,933.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1285.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1638.77,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1214.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1214.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1091.92,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2512.38,78,,,percent of total billed charges,78% of total billed charges,3221,100,,,percent of total billed charges,100% of total billed charges,2660.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2660.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,492.81,3221,
MG Device Plcmnt w/ Mammo Guide Right,40119281,CDM,401,RC,19281,HCPCS,Outpatient,,,3221,2093.65,TC|RT,2834.48,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,3221,100,,,percent of total billed charges,100% of total billed charges,1298.41,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2029.23,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,492.81,15.3,,,percent of total billed charges,15.3% of total billed charges,2222.49,69,,,percent of total billed charges,69% of total billed charges,3221,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3221,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3221,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.77,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,933.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1285.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1638.77,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1214.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1214.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1091.92,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2512.38,78,,,percent of total billed charges,78% of total billed charges,3221,100,,,percent of total billed charges,100% of total billed charges,2660.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2660.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,492.81,3221,
MG Ductogram or Galactogram Single Left,32077053,CDM,320,RC,77053,HCPCS,Outpatient,,,1363,885.95,TC|LT,1199.44,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1363,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,858.69,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,208.54,15.3,,,percent of total billed charges,15.3% of total billed charges,940.47,69,,,percent of total billed charges,69% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1363,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1363,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,462.06,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1063.14,78,,,percent of total billed charges,78% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1363,
MG Ductogram or Galactogram Single Right,32077053,CDM,320,RC,77053,HCPCS,Outpatient,,,1363,885.95,TC|RT,1199.44,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1363,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,858.69,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,208.54,15.3,,,percent of total billed charges,15.3% of total billed charges,940.47,69,,,percent of total billed charges,69% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1363,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1363,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,462.06,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1063.14,78,,,percent of total billed charges,78% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1363,
MG Mammo Digital Diagnostic Bilat.,40177066,CDM,401,RC,77066,HCPCS,Outpatient,,,593,385.45,TC|50,521.84,88,,,percent of total billed charges,88% of total Billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,593,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,373.59,63,,,percent of total billed charges,63% of total billed charges,202.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,90.73,15.3,,,percent of total billed charges,15.3% of total billed charges,409.17,69,,,percent of total billed charges,69% of total billed charges,593,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,593,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,593,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,452.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,223.56,37.7,,,percent of total billed charges,37.70% of total billed charges,223.56,37.7,,,percent of total billed charges,37.70% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,201.03,33.9,,,percent of total billed charges,33.9% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,462.54,78,,,percent of total billed charges,78% of total billed charges,593,100,,,percent of total billed charges,100% of total billed charges,489.82,82.6,,,percent of total billed charges,82.6% of total billed charges,489.82,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,117.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,593,
MG Mammo Digital Diagnostic Left.,40177065,CDM,401,RC,77065,HCPCS,Outpatient,,,473,307.45,TC|LT,416.24,88,,,percent of total billed charges,88% of total Billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,473,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,297.99,63,,,percent of total billed charges,63% of total billed charges,158.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,72.37,15.3,,,percent of total billed charges,15.3% of total billed charges,326.37,69,,,percent of total billed charges,69% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,354.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,160.35,33.9,,,percent of total billed charges,33.9% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,368.94,78,,,percent of total billed charges,78% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,91.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,473,
MG Mammo Digital Diagnostic Right.,40177065,CDM,401,RC,77065,HCPCS,Outpatient,,,473,307.45,TC|RT,416.24,88,,,percent of total billed charges,88% of total Billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,473,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,297.99,63,,,percent of total billed charges,63% of total billed charges,158.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,72.37,15.3,,,percent of total billed charges,15.3% of total billed charges,326.37,69,,,percent of total billed charges,69% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,354.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,160.35,33.9,,,percent of total billed charges,33.9% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,368.94,78,,,percent of total billed charges,78% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,91.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,473,
MG Mammo Digital Screening Bilateral.,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,492,319.80,TC,432.96,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,492,
MG Mammo Digital Screening Left.,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,492,319.80,TC|LT,432.96,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,492,
MG Mammo Digital Screening Right.,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,492,319.80,TC|RT,432.96,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,492,
MG Mammo Diagnostic Bilateral w/ Tomo.,40177066,CDM,401,RC,77066,HCPCS,Outpatient,,,1363,885.95,TC,1199.44,88,,,percent of total billed charges,88% of total Billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,1363,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,858.69,63,,,percent of total billed charges,63% of total billed charges,202.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,208.54,15.3,,,percent of total billed charges,15.3% of total billed charges,940.47,69,,,percent of total billed charges,69% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1363,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1363,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,452.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,462.06,33.9,,,percent of total billed charges,33.9% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1063.14,78,,,percent of total billed charges,78% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,117.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,1363,
MG Mammo Diagnostic Left w/ Tomo.,40177065,CDM,401,RC,77065,HCPCS,Outpatient,,,1091,709.15,TC|LT,960.08,88,,,percent of total billed charges,88% of total Billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,1091,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,687.33,63,,,percent of total billed charges,63% of total billed charges,158.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,166.92,15.3,,,percent of total billed charges,15.3% of total billed charges,752.79,69,,,percent of total billed charges,69% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1091,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1091,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,354.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,369.85,33.9,,,percent of total billed charges,33.9% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,850.98,78,,,percent of total billed charges,78% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,91.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,1091,
MG Mammo Diagnostic Right w/ Tomo.,40177065,CDM,401,RC,77065,HCPCS,Outpatient,,,1091,709.15,TC|RT,960.08,88,,,percent of total billed charges,88% of total Billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,1091,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,687.33,63,,,percent of total billed charges,63% of total billed charges,158.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,166.92,15.3,,,percent of total billed charges,15.3% of total billed charges,752.79,69,,,percent of total billed charges,69% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1091,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1091,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,354.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,369.85,33.9,,,percent of total billed charges,33.9% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,850.98,78,,,percent of total billed charges,78% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,91.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,1091,
MG Mammo Implant Diag Bilateral w/ Tomo.,40177066,CDM,401,RC,77066,HCPCS,Outpatient,,,1363,885.95,TC,1199.44,88,,,percent of total billed charges,88% of total Billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,1363,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,858.69,63,,,percent of total billed charges,63% of total billed charges,202.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,208.54,15.3,,,percent of total billed charges,15.3% of total billed charges,940.47,69,,,percent of total billed charges,69% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1363,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1363,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,452.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,462.06,33.9,,,percent of total billed charges,33.9% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1063.14,78,,,percent of total billed charges,78% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,117.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,1363,
MG Mammo Implant Diag Left w/ Tomo.,40177065,CDM,401,RC,77065,HCPCS,Outpatient,,,1091,709.15,TC|LT,960.08,88,,,percent of total billed charges,88% of total Billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,1091,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,687.33,63,,,percent of total billed charges,63% of total billed charges,158.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,166.92,15.3,,,percent of total billed charges,15.3% of total billed charges,752.79,69,,,percent of total billed charges,69% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1091,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,1091,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,354.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,369.85,33.9,,,percent of total billed charges,33.9% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,850.98,78,,,percent of total billed charges,78% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,91.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,1091,
MG Mammo Implant Diag Right w/ Tomo.,40177061,CDM,401,RC,77061,HCPCS,Outpatient,,,1091,709.15,TC|RT,960.08,88,,,percent of total billed charges,88% of total Billed charges,545.5,50,,,percent of total billed charges,50% of total Billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid,1091,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,545.5,50,,,percent of total billed charges,50% of total Billed charges,687.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,45.62,100,,,Fee Schedule,100% of WA Medicaid,166.92,15.3,,,percent of total billed charges,15.3% of total billed charges,752.79,69,,,percent of total billed charges,69% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,545.5,50,,,percent of total billed charges,50% of total Billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,545.5,50,,,percent of total billed charges,50% of total Billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,545.5,50,,,percent of total billed charges,50% of total Billed charges,674.78,61.85,,,percent of total billed charges,61.85% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,545.5,50,,,percent of total billed charges,50% of total Billed charges,545.5,50,,,percent of total billed charges,50% of total Billed charges,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,545.5,50,,,percent of total billed charges,50% of total Billed charges,545.5,50,,,percent of total billed charges,50% of total Billed charges,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,545.5,50,,,percent of total billed charges,50% of total Billed charges,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,545.5,50,,,percent of total billed charges,50% of total Billed charges,369.85,33.9,,,percent of total billed charges,33.9% of total billed charges,545.5,50,,,percent of total billed charges,50% of total Billed charges,850.98,78,,,percent of total billed charges,78% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,545.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,545.5,50,,,percent of total billed charges,50% of total Billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,1091,
MG Mammo Implant Digital Diag Bilateral.,40177066,CDM,401,RC,77066,HCPCS,Outpatient,,,593,385.45,TC|50,521.84,88,,,percent of total billed charges,88% of total Billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,593,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,373.59,63,,,percent of total billed charges,63% of total billed charges,202.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,90.73,15.3,,,percent of total billed charges,15.3% of total billed charges,409.17,69,,,percent of total billed charges,69% of total billed charges,593,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,593,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,593,100,,,percent of total billed charges,100% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,452.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,223.56,37.7,,,percent of total billed charges,37.70% of total billed charges,223.56,37.7,,,percent of total billed charges,37.70% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,201.03,33.9,,,percent of total billed charges,33.9% of total billed charges,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,462.54,78,,,percent of total billed charges,78% of total billed charges,593,100,,,percent of total billed charges,100% of total billed charges,489.82,82.6,,,percent of total billed charges,82.6% of total billed charges,489.82,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,117.32,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,116.16,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,593,
MG Mammo Implant Digital Diag Left.,40177065,CDM,401,RC,77065,HCPCS,Outpatient,,,473,307.45,TC|LT,416.24,88,,,percent of total billed charges,88% of total Billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,473,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,297.99,63,,,percent of total billed charges,63% of total billed charges,158.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,72.37,15.3,,,percent of total billed charges,15.3% of total billed charges,326.37,69,,,percent of total billed charges,69% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,354.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,160.35,33.9,,,percent of total billed charges,33.9% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,368.94,78,,,percent of total billed charges,78% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,91.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,473,
MG Mammo Implant Digital Diag Right.,40177065,CDM,401,RC,77065,HCPCS,Outpatient,,,473,307.45,TC|RT,416.24,88,,,percent of total billed charges,88% of total Billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,473,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,297.99,63,,,percent of total billed charges,63% of total billed charges,158.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,72.37,15.3,,,percent of total billed charges,15.3% of total billed charges,326.37,69,,,percent of total billed charges,69% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,473,100,,,percent of total billed charges,100% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,354.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,160.35,33.9,,,percent of total billed charges,33.9% of total billed charges,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,368.94,78,,,percent of total billed charges,78% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,91.53,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,90.62,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,473,
MG Mammo Implant Digital Screening Bil.,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,593,385.45,TC,521.84,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,593,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,373.59,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,90.73,15.3,,,percent of total billed charges,15.3% of total billed charges,409.17,69,,,percent of total billed charges,69% of total billed charges,593,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,593,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,593,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,223.56,37.7,,,percent of total billed charges,37.70% of total billed charges,223.56,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,201.03,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,462.54,78,,,percent of total billed charges,78% of total billed charges,593,100,,,percent of total billed charges,100% of total billed charges,489.82,82.6,,,percent of total billed charges,82.6% of total billed charges,489.82,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,593,
MG Mammo Implant Digital Screening Lt.,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,492,319.80,TC|LT,432.96,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,492,
MG Mammo Implant Digital Screening Rt.,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,492,319.80,TC|RT,432.96,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,492,
MG Mammo Implant Screening Bil w/ Tomo.,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,492,319.80,TC,432.96,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,492,
MG Mammo Screening Bilateral,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,492,319.80,TC,432.96,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,492,
MG Mammo Implant Screening Lt w/ Tomo.,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,492,319.80,TC|LT,432.96,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,492,
MG Mammo Implant Screening Rt w/ Tomo.,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,492,319.80,TC|RT,432.96,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,492,
MG Mammo Screening Left w/ Tomo.,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,492,319.80,TC|LT,432.96,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,492,
MG Mammo Screening Right w/ Tomo.,40377067,CDM,403,RC,77067,HCPCS,Outpatient,,,492,319.80,TC|RT,432.96,88,,,percent of total billed charges,88% of total Billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,46.99,103,,,Fee Schedule,103% of WA Medicaid,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,167.39,175,,,Fee Schedule,175% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,374.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,33.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,46.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.31,130,,,Fee Schedule,130% of WA Medicaid ,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,96.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,95.81,100,,,Fee Schedule,100% of Medicare OPPS rate,45.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.79,492,
MRA Abdomen w/ + w/o Contrast,618C8902,CDM,618,RC,C8902,HCPCS,Outpatient,,,4703,3056.95,TC,4138.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2962.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,3245.07,69,,,percent of total billed charges,69% of total billed charges,4703,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4703,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4703,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1773.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1773.03,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1594.32,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3668.34,78,,,percent of total billed charges,78% of total billed charges,4703,100,,,percent of total billed charges,100% of total billed charges,3884.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3884.68,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,4703,
MRA Abdomen w/ Contrast,618C8900,CDM,618,RC,74185,HCPCS,Outpatient,,,3403,2211.95,TC,2994.64,88,,,percent of total billed charges,88% of total Billed charges,1701.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,3403,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,1701.5,50,,,percent of total billed charges,50% of total Billed charges,2143.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2348.07,69,,,percent of total billed charges,69% of total billed charges,3403,100,,,percent of total billed charges,100% of total billed charges,1701.5,50,,,percent of total billed charges,50% of total Billed charges,3403,100,,,percent of total billed charges,100% of total billed charges,1701.5,50,,,percent of total billed charges,50% of total Billed charges,3403,100,,,percent of total billed charges,100% of total billed charges,1701.5,50,,,percent of total billed charges,50% of total Billed charges,2104.76,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1701.5,50,,,percent of total billed charges,50% of total Billed charges,1701.5,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1701.5,50,,,percent of total billed charges,50% of total Billed charges,1701.5,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,1701.5,50,,,percent of total billed charges,50% of total Billed charges,1282.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1282.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1701.5,50,,,percent of total billed charges,50% of total Billed charges,1153.62,33.9,,,percent of total billed charges,33.9% of total billed charges,1701.5,50,,,percent of total billed charges,50% of total Billed charges,2654.34,78,,,percent of total billed charges,78% of total billed charges,3403,100,,,percent of total billed charges,100% of total billed charges,2810.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2810.88,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1701.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1701.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3403,
MRA Abdomen w/o Contrast,61874185,CDM,618,RC,74185,HCPCS,Outpatient,,,4703,3056.95,TC,4138.64,88,,,percent of total billed charges,88% of total Billed charges,2351.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,2351.5,50,,,percent of total billed charges,50% of total Billed charges,2962.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,3245.07,69,,,percent of total billed charges,69% of total billed charges,4703,100,,,percent of total billed charges,100% of total billed charges,2351.5,50,,,percent of total billed charges,50% of total Billed charges,4703,100,,,percent of total billed charges,100% of total billed charges,2351.5,50,,,percent of total billed charges,50% of total Billed charges,4703,100,,,percent of total billed charges,100% of total billed charges,2351.5,50,,,percent of total billed charges,50% of total Billed charges,2908.81,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2351.5,50,,,percent of total billed charges,50% of total Billed charges,2351.5,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2351.5,50,,,percent of total billed charges,50% of total Billed charges,2351.5,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,2351.5,50,,,percent of total billed charges,50% of total Billed charges,1773.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1773.03,37.7,,,percent of total billed charges,37.70% of total billed charges,2351.5,50,,,percent of total billed charges,50% of total Billed charges,1594.32,33.9,,,percent of total billed charges,33.9% of total billed charges,2351.5,50,,,percent of total billed charges,50% of total Billed charges,3668.34,78,,,percent of total billed charges,78% of total billed charges,4703,100,,,percent of total billed charges,100% of total billed charges,3884.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3884.68,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2351.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2351.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,4703,
MRA Chest w/ Contrast,618C8909,CDM,618,RC,C8909,HCPCS,Outpatient,,,2497,1623.05,TC,2197.36,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,2497,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1573.11,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1722.93,69,,,percent of total billed charges,69% of total billed charges,2497,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2497,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2497,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,941.37,37.7,,,percent of total billed charges,37.70% of total billed charges,941.37,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,846.48,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1947.66,78,,,percent of total billed charges,78% of total billed charges,2497,100,,,percent of total billed charges,100% of total billed charges,2062.52,82.6,,,percent of total billed charges,82.6% of total billed charges,2062.52,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,2497,
MRA Brain/Head w/ + w/o Contrast,61070546,CDM,610,RC,70546,HCPCS,Outpatient,,,3565,2317.25,TC,3137.2,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,3565,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2245.95,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2459.85,69,,,percent of total billed charges,69% of total billed charges,3565,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3565,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3565,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1344.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1344.01,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1208.54,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2780.7,78,,,percent of total billed charges,78% of total billed charges,3565,100,,,percent of total billed charges,100% of total billed charges,2944.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2944.69,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3565,
MRA Brain/Head w/ Contrast,61570545,CDM,615,RC,70545,HCPCS,Outpatient,,,3565,2317.25,TC,3137.2,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,3565,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2245.95,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2459.85,69,,,percent of total billed charges,69% of total billed charges,3565,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3565,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3565,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1344.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1344.01,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1208.54,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2780.7,78,,,percent of total billed charges,78% of total billed charges,3565,100,,,percent of total billed charges,100% of total billed charges,2944.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2944.69,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3565,
MRA Brain/Head w/o Contrast,61570544,CDM,615,RC,70544,HCPCS,Outpatient,,,2933,1906.45,TC,2581.04,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,2933,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1847.79,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2023.77,69,,,percent of total billed charges,69% of total billed charges,2933,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2933,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2933,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1105.74,37.7,,,percent of total billed charges,37.70% of total billed charges,1105.74,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,994.29,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2287.74,78,,,percent of total billed charges,78% of total billed charges,2933,100,,,percent of total billed charges,100% of total billed charges,2422.66,82.6,,,percent of total billed charges,82.6% of total billed charges,2422.66,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.92,2933,
MRA Lower Extremity w/ + w/o Cnt Left,616C8914,CDM,616,RC,73725,HCPCS,Outpatient,,,3304,2147.60,TC|LT,2907.52,88,,,percent of total billed charges,88% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,3304,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,1652,50,,,percent of total billed charges,50% of total Billed charges,2081.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2279.76,69,,,percent of total billed charges,69% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,2043.52,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,1652,50,,,percent of total billed charges,50% of total Billed charges,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,1120.06,33.9,,,percent of total billed charges,33.9% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,2577.12,78,,,percent of total billed charges,78% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1652,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3304,
MRA Lower Extremity w/ + w/o Cnt Right,616C8914,CDM,616,RC,73725,HCPCS,Outpatient,,,3304,2147.60,TC|RT,2907.52,88,,,percent of total billed charges,88% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,3304,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,1652,50,,,percent of total billed charges,50% of total Billed charges,2081.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2279.76,69,,,percent of total billed charges,69% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,2043.52,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,1652,50,,,percent of total billed charges,50% of total Billed charges,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,1120.06,33.9,,,percent of total billed charges,33.9% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,2577.12,78,,,percent of total billed charges,78% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1652,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3304,
MRA Lower Extremity w/ Contrast Left,61073725,CDM,610,RC,73725,HCPCS,Outpatient,,,3304,2147.60,TC|LT,2907.52,88,,,percent of total billed charges,88% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,3304,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,1652,50,,,percent of total billed charges,50% of total Billed charges,2081.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2279.76,69,,,percent of total billed charges,69% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,2043.52,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,1652,50,,,percent of total billed charges,50% of total Billed charges,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,1120.06,33.9,,,percent of total billed charges,33.9% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,2577.12,78,,,percent of total billed charges,78% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1652,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3304,
MRA Lower Extremity w/ Contrast Right,616C8912,CDM,616,RC,C8912,HCPCS,Outpatient,,,3304,2147.60,TC|RT,2907.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,3304,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2081.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2279.76,69,,,percent of total billed charges,69% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3304,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3304,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.06,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2577.12,78,,,percent of total billed charges,78% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3304,
MRA Lower Extremity w/o Contrast Left,61673725,CDM,616,RC,73725,HCPCS,Outpatient,,,3304,2147.60,TC|LT,2907.52,88,,,percent of total billed charges,88% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,3304,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,1652,50,,,percent of total billed charges,50% of total Billed charges,2081.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2279.76,69,,,percent of total billed charges,69% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,2043.52,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,1652,50,,,percent of total billed charges,50% of total Billed charges,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,1120.06,33.9,,,percent of total billed charges,33.9% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,2577.12,78,,,percent of total billed charges,78% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1652,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3304,
MRA Lower Extremity w/o Contrast Right,61073725,CDM,610,RC,73725,HCPCS,Outpatient,,,3304,2147.60,TC|RT,2907.52,88,,,percent of total billed charges,88% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,3304,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,1652,50,,,percent of total billed charges,50% of total Billed charges,2081.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2279.76,69,,,percent of total billed charges,69% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,2043.52,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,1652,50,,,percent of total billed charges,50% of total Billed charges,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1245.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,1120.06,33.9,,,percent of total billed charges,33.9% of total billed charges,1652,50,,,percent of total billed charges,50% of total Billed charges,2577.12,78,,,percent of total billed charges,78% of total billed charges,3304,100,,,percent of total billed charges,100% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,2729.1,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1652,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1652,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3304,
MRA Neck w/ + w/o Contrast,61570549,CDM,615,RC,70549,HCPCS,Outpatient,,,4078,2650.70,TC,3588.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,4078,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2569.14,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2813.82,69,,,percent of total billed charges,69% of total billed charges,4078,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4078,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,4078,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1537.41,37.7,,,percent of total billed charges,37.70% of total billed charges,1537.41,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1382.44,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3180.84,78,,,percent of total billed charges,78% of total billed charges,4078,100,,,percent of total billed charges,100% of total billed charges,3368.43,82.6,,,percent of total billed charges,82.6% of total billed charges,3368.43,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,4078,
MRA Neck w/ Contrast,61570548,CDM,615,RC,70548,HCPCS,Outpatient,,,3565,2317.25,TC,3137.2,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,3565,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2245.95,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2459.85,69,,,percent of total billed charges,69% of total billed charges,3565,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3565,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3565,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1344.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1344.01,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1208.54,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2780.7,78,,,percent of total billed charges,78% of total billed charges,3565,100,,,percent of total billed charges,100% of total billed charges,2944.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2944.69,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3565,
MRA Neck w/o Contrast,61570547,CDM,615,RC,70547,HCPCS,Outpatient,,,3241,2106.65,TC,2852.08,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,3241,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2041.83,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2236.29,69,,,percent of total billed charges,69% of total billed charges,3241,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3241,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,3241,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1221.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1221.86,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1098.7,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2527.98,78,,,percent of total billed charges,78% of total billed charges,3241,100,,,percent of total billed charges,100% of total billed charges,2677.07,82.6,,,percent of total billed charges,82.6% of total billed charges,2677.07,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.92,3241,
MRA Pelvis w/ + w/o Contrast,618C8920,CDM,618,RC,72198,HCPCS,Outpatient,,,3021,1963.65,TC,2658.48,88,,,percent of total billed charges,88% of total Billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,3021,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1903.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2084.49,69,,,percent of total billed charges,69% of total billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1868.49,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1138.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1138.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1024.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,2356.38,78,,,percent of total billed charges,78% of total billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,2495.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2495.35,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1510.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1510.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3021,
MRA Pelvis w/ Contrast,61872198,CDM,618,RC,C8920,HCPCS,Outpatient,,,3021,1963.65,TC,2658.48,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,3021,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1903.23,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2084.49,69,,,percent of total billed charges,69% of total billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3021,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,3021,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1138.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1138.92,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1024.12,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2356.38,78,,,percent of total billed charges,78% of total billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,2495.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2495.35,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3021,
MRA Pelvis w/o Contrast,61872198,CDM,618,RC,72198,HCPCS,Outpatient,,,3021,1963.65,TC,2658.48,88,,,percent of total billed charges,88% of total Billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,3021,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1903.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2084.49,69,,,percent of total billed charges,69% of total billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1868.49,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1138.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1138.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1024.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,2356.38,78,,,percent of total billed charges,78% of total billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,2495.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2495.35,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1510.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1510.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3021,
MRA Upper Extremity w/ + w/o Cnt Left,61073225,CDM,610,RC,73225,HCPCS,Outpatient,,,4943,3212.95,TC|LT,4349.84,88,,,percent of total billed charges,88% of total Billed charges,2471.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,2471.5,50,,,percent of total billed charges,50% of total Billed charges,3114.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,3410.67,69,,,percent of total billed charges,69% of total billed charges,4943,100,,,percent of total billed charges,100% of total billed charges,2471.5,50,,,percent of total billed charges,50% of total Billed charges,4943,100,,,percent of total billed charges,100% of total billed charges,2471.5,50,,,percent of total billed charges,50% of total Billed charges,4943,100,,,percent of total billed charges,100% of total billed charges,2471.5,50,,,percent of total billed charges,50% of total Billed charges,3057.25,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2471.5,50,,,percent of total billed charges,50% of total Billed charges,2471.5,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2471.5,50,,,percent of total billed charges,50% of total Billed charges,2471.5,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,2471.5,50,,,percent of total billed charges,50% of total Billed charges,1863.51,37.7,,,percent of total billed charges,37.70% of total billed charges,1863.51,37.7,,,percent of total billed charges,37.70% of total billed charges,2471.5,50,,,percent of total billed charges,50% of total Billed charges,1675.68,33.9,,,percent of total billed charges,33.9% of total billed charges,2471.5,50,,,percent of total billed charges,50% of total Billed charges,3855.54,78,,,percent of total billed charges,78% of total billed charges,4943,100,,,percent of total billed charges,100% of total billed charges,4082.92,82.6,,,percent of total billed charges,82.6% of total billed charges,4082.92,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2471.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2471.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,4943,
MRA Upper Extremity w/ + w/o Cnt Right,61073225,CDM,610,RC,73225,HCPCS,Outpatient,,,6085,3955.25,TC|RT,5354.8,88,,,percent of total billed charges,88% of total Billed charges,3042.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,3042.5,50,,,percent of total billed charges,50% of total Billed charges,3833.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,4198.65,69,,,percent of total billed charges,69% of total billed charges,6085,100,,,percent of total billed charges,100% of total billed charges,3042.5,50,,,percent of total billed charges,50% of total Billed charges,6085,100,,,percent of total billed charges,100% of total billed charges,3042.5,50,,,percent of total billed charges,50% of total Billed charges,6085,100,,,percent of total billed charges,100% of total billed charges,3042.5,50,,,percent of total billed charges,50% of total Billed charges,3763.57,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3042.5,50,,,percent of total billed charges,50% of total Billed charges,3042.5,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3042.5,50,,,percent of total billed charges,50% of total Billed charges,3042.5,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,3042.5,50,,,percent of total billed charges,50% of total Billed charges,2294.05,37.7,,,percent of total billed charges,37.70% of total billed charges,2294.05,37.7,,,percent of total billed charges,37.70% of total billed charges,3042.5,50,,,percent of total billed charges,50% of total Billed charges,2062.82,33.9,,,percent of total billed charges,33.9% of total billed charges,3042.5,50,,,percent of total billed charges,50% of total Billed charges,4746.3,78,,,percent of total billed charges,78% of total billed charges,6085,100,,,percent of total billed charges,100% of total billed charges,5026.21,82.6,,,percent of total billed charges,82.6% of total billed charges,5026.21,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3042.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3042.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,6085,
MRA Upper Extremity w/ Contrast Left,61073225,CDM,610,RC,73225,HCPCS,Outpatient,,,4742,3082.30,TC|LT,4172.96,88,,,percent of total billed charges,88% of total Billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,2371,50,,,percent of total billed charges,50% of total Billed charges,2987.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,3271.98,69,,,percent of total billed charges,69% of total billed charges,4742,100,,,percent of total billed charges,100% of total billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,4742,100,,,percent of total billed charges,100% of total billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,4742,100,,,percent of total billed charges,100% of total billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,2932.93,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2371,50,,,percent of total billed charges,50% of total Billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2371,50,,,percent of total billed charges,50% of total Billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,2371,50,,,percent of total billed charges,50% of total Billed charges,1787.73,37.7,,,percent of total billed charges,37.70% of total billed charges,1787.73,37.7,,,percent of total billed charges,37.70% of total billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,1607.54,33.9,,,percent of total billed charges,33.9% of total billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,3698.76,78,,,percent of total billed charges,78% of total billed charges,4742,100,,,percent of total billed charges,100% of total billed charges,3916.89,82.6,,,percent of total billed charges,82.6% of total billed charges,3916.89,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2371,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2371,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,4742,
MRA Upper Extremity w/ Contrast Right,61073225,CDM,610,RC,73225,HCPCS,Outpatient,,,4742,3082.30,TC|RT,4172.96,88,,,percent of total billed charges,88% of total Billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,2371,50,,,percent of total billed charges,50% of total Billed charges,2987.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,3271.98,69,,,percent of total billed charges,69% of total billed charges,4742,100,,,percent of total billed charges,100% of total billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,4742,100,,,percent of total billed charges,100% of total billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,4742,100,,,percent of total billed charges,100% of total billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,2932.93,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2371,50,,,percent of total billed charges,50% of total Billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2371,50,,,percent of total billed charges,50% of total Billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,2371,50,,,percent of total billed charges,50% of total Billed charges,1787.73,37.7,,,percent of total billed charges,37.70% of total billed charges,1787.73,37.7,,,percent of total billed charges,37.70% of total billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,1607.54,33.9,,,percent of total billed charges,33.9% of total billed charges,2371,50,,,percent of total billed charges,50% of total Billed charges,3698.76,78,,,percent of total billed charges,78% of total billed charges,4742,100,,,percent of total billed charges,100% of total billed charges,3916.89,82.6,,,percent of total billed charges,82.6% of total billed charges,3916.89,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2371,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2371,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,4742,
MRA Upper Extremity w/o Contrast Left,61073225,CDM,610,RC,73225,HCPCS,Outpatient,,,4440,2886.00,TC|LT,3907.2,88,,,percent of total billed charges,88% of total Billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,4440,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,2220,50,,,percent of total billed charges,50% of total Billed charges,2797.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,3063.6,69,,,percent of total billed charges,69% of total billed charges,4440,100,,,percent of total billed charges,100% of total billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,4440,100,,,percent of total billed charges,100% of total billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,4440,100,,,percent of total billed charges,100% of total billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,2746.14,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2220,50,,,percent of total billed charges,50% of total Billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2220,50,,,percent of total billed charges,50% of total Billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,2220,50,,,percent of total billed charges,50% of total Billed charges,1673.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1673.88,37.7,,,percent of total billed charges,37.70% of total billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,1505.16,33.9,,,percent of total billed charges,33.9% of total billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,3463.2,78,,,percent of total billed charges,78% of total billed charges,4440,100,,,percent of total billed charges,100% of total billed charges,3667.44,82.6,,,percent of total billed charges,82.6% of total billed charges,3667.44,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2220,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2220,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,4440,
MRA Upper Extremity w/o Contrast Right,61073225,CDM,610,RC,73225,HCPCS,Outpatient,,,4440,2886.00,TC|RT,3907.2,88,,,percent of total billed charges,88% of total Billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,4440,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,2220,50,,,percent of total billed charges,50% of total Billed charges,2797.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,3063.6,69,,,percent of total billed charges,69% of total billed charges,4440,100,,,percent of total billed charges,100% of total billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,4440,100,,,percent of total billed charges,100% of total billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,4440,100,,,percent of total billed charges,100% of total billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,2746.14,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2220,50,,,percent of total billed charges,50% of total Billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2220,50,,,percent of total billed charges,50% of total Billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,2220,50,,,percent of total billed charges,50% of total Billed charges,1673.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1673.88,37.7,,,percent of total billed charges,37.70% of total billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,1505.16,33.9,,,percent of total billed charges,33.9% of total billed charges,2220,50,,,percent of total billed charges,50% of total Billed charges,3463.2,78,,,percent of total billed charges,78% of total billed charges,4440,100,,,percent of total billed charges,100% of total billed charges,3667.44,82.6,,,percent of total billed charges,82.6% of total billed charges,3667.44,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2220,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2220,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,4440,
MRA Brain/Head w/o Contrast Ltd,61570544,CDM,615,RC,70544,HCPCS,Outpatient,,,2933,1906.45,TC,2581.04,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,2933,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1847.79,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2023.77,69,,,percent of total billed charges,69% of total billed charges,2933,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2933,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2933,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1105.74,37.7,,,percent of total billed charges,37.70% of total billed charges,1105.74,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,994.29,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2287.74,78,,,percent of total billed charges,78% of total billed charges,2933,100,,,percent of total billed charges,100% of total billed charges,2422.66,82.6,,,percent of total billed charges,82.6% of total billed charges,2422.66,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.92,2933,
MRI Abdomen w/ + w/o Contrast,61074183,CDM,610,RC,74183,HCPCS,Outpatient,,,1483,963.95,TC,1305.04,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1483,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,934.29,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1023.27,69,,,percent of total billed charges,69% of total billed charges,1483,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1483,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1483,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,559.09,37.7,,,percent of total billed charges,37.70% of total billed charges,559.09,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,502.74,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1156.74,78,,,percent of total billed charges,78% of total billed charges,1483,100,,,percent of total billed charges,100% of total billed charges,1224.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1224.96,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Abdomen w/ Contrast,61074182,CDM,610,RC,74182,HCPCS,Outpatient,,,1483,963.95,TC,1305.04,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1483,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,934.29,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1023.27,69,,,percent of total billed charges,69% of total billed charges,1483,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1483,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1483,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,559.09,37.7,,,percent of total billed charges,37.70% of total billed charges,559.09,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,502.74,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1156.74,78,,,percent of total billed charges,78% of total billed charges,1483,100,,,percent of total billed charges,100% of total billed charges,1224.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1224.96,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Abdomen w/o Contrast,61074181,CDM,610,RC,74181,HCPCS,Outpatient,,,1021,663.65,TC,898.48,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1021,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,643.23,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,704.49,69,,,percent of total billed charges,69% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1021,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1021,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,346.12,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,796.38,78,,,percent of total billed charges,78% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1021,
MRI Ankle w/ + w/o Contrast Left,61073723,CDM,610,RC,73723,HCPCS,Outpatient,,,1403,911.95,TC|LT,1234.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1403,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,883.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,968.07,69,,,percent of total billed charges,69% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,475.62,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1094.34,78,,,percent of total billed charges,78% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Ankle w/ + w/o Contrast Right,61073723,CDM,610,RC,73723,HCPCS,Outpatient,,,1403,911.95,TC|RT,1234.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1403,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,883.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,968.07,69,,,percent of total billed charges,69% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,475.62,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1094.34,78,,,percent of total billed charges,78% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Ankle w/ Contrast Left,61073722,CDM,610,RC,73722,HCPCS,Outpatient,,,1206,783.90,TC|LT,1061.28,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1206,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,759.78,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,832.14,69,,,percent of total billed charges,69% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,408.83,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,940.68,78,,,percent of total billed charges,78% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Ankle w/ Contrast Right,61073722,CDM,610,RC,73722,HCPCS,Outpatient,,,1206,783.90,TC|RT,1061.28,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1206,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,759.78,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,832.14,69,,,percent of total billed charges,69% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,408.83,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,940.68,78,,,percent of total billed charges,78% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Ankle w/o Contrast Left,61073721,CDM,610,RC,73721,HCPCS,Outpatient,,,995,646.75,TC|LT,875.6,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,995,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,626.85,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,686.55,69,,,percent of total billed charges,69% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,337.31,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,776.1,78,,,percent of total billed charges,78% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,995,
MRI Ankle w/o Contrast Right,61073721,CDM,610,RC,73721,HCPCS,Outpatient,,,995,646.75,TC|RT,875.6,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,995,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,626.85,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,686.55,69,,,percent of total billed charges,69% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,337.31,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,776.1,78,,,percent of total billed charges,78% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,995,
MRI Brain w/ + w/o Contrast,61170553,CDM,611,RC,70553,HCPCS,Outpatient,,,1543,1002.95,TC,1357.84,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1543,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,972.09,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1064.67,69,,,percent of total billed charges,69% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,523.08,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.54,78,,,percent of total billed charges,78% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1543,
MRI Brain w/ Contrast,61170552,CDM,611,RC,70552,HCPCS,Outpatient,,,810,526.50,TC,712.8,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,810,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,510.3,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,558.9,69,,,percent of total billed charges,69% of total billed charges,810,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,810,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,810,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,305.37,37.7,,,percent of total billed charges,37.70% of total billed charges,305.37,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,274.59,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,631.8,78,,,percent of total billed charges,78% of total billed charges,810,100,,,percent of total billed charges,100% of total billed charges,669.06,82.6,,,percent of total billed charges,82.6% of total billed charges,669.06,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,274.59,1495.48,
MRI Brain w/o Contrast,61170551,CDM,611,RC,70551,HCPCS,Outpatient,,,1062,690.30,TC,934.56,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1062,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,669.06,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,732.78,69,,,percent of total billed charges,69% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,360.02,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,828.36,78,,,percent of total billed charges,78% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1062,
MRI Breast w/ + w/o Contrast Bilateral,61077049,CDM,610,RC,77049,HCPCS,Outpatient,,,3272,2126.80,TC,2879.36,88,,,percent of total billed charges,88% of total Billed charges,1636,50,,,percent of total billed charges,50% of total Billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid,3272,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,1636,50,,,percent of total billed charges,50% of total Billed charges,2061.36,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2257.68,69,,,percent of total billed charges,69% of total billed charges,3272,100,,,percent of total billed charges,100% of total billed charges,1636,50,,,percent of total billed charges,50% of total Billed charges,3272,100,,,percent of total billed charges,100% of total billed charges,1636,50,,,percent of total billed charges,50% of total Billed charges,3272,100,,,percent of total billed charges,100% of total billed charges,1636,50,,,percent of total billed charges,50% of total Billed charges,2023.73,61.85,,,percent of total billed charges,61.85% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1636,50,,,percent of total billed charges,50% of total Billed charges,1636,50,,,percent of total billed charges,50% of total Billed charges,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1636,50,,,percent of total billed charges,50% of total Billed charges,1636,50,,,percent of total billed charges,50% of total Billed charges,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,1636,50,,,percent of total billed charges,50% of total Billed charges,1233.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1233.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1636,50,,,percent of total billed charges,50% of total Billed charges,1109.21,33.9,,,percent of total billed charges,33.9% of total billed charges,1636,50,,,percent of total billed charges,50% of total Billed charges,2552.16,78,,,percent of total billed charges,78% of total billed charges,3272,100,,,percent of total billed charges,100% of total billed charges,2702.67,82.6,,,percent of total billed charges,82.6% of total billed charges,2702.67,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1636,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1636,50,,,percent of total billed charges,50% of total Billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,3272,
MRI Breast w/o Contrast Bilateral,61077047,CDM,610,RC,77047,HCPCS,Outpatient,,,1625,1056.25,TC,1430,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1625,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1023.75,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1121.25,69,,,percent of total billed charges,69% of total billed charges,1625,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1625,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1625,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,612.63,37.7,,,percent of total billed charges,37.70% of total billed charges,612.63,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,550.88,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1267.5,78,,,percent of total billed charges,78% of total billed charges,1625,100,,,percent of total billed charges,100% of total billed charges,1342.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1342.25,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1625,
MRI Chest w/ + w/o Contrast,61071552,CDM,610,RC,71552,HCPCS,Outpatient,,,1543,1002.95,TC,1357.84,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1543,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,972.09,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1064.67,69,,,percent of total billed charges,69% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,523.08,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.54,78,,,percent of total billed charges,78% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1543,
MRI Chest w/ Contrast,61071550,CDM,610,RC,71550,HCPCS,Outpatient,,,1011,657.15,TC,889.68,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1011,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,636.93,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,697.59,69,,,percent of total billed charges,69% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1011,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1011,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,342.73,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,788.58,78,,,percent of total billed charges,78% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1011,
MRI Chest w/o Contrast,61071550,CDM,610,RC,71550,HCPCS,Outpatient,,,1011,657.15,TC,889.68,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1011,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,636.93,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,697.59,69,,,percent of total billed charges,69% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1011,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1011,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,342.73,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,788.58,78,,,percent of total billed charges,78% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1011,
MRI Elbow w/ + w/o Contrast Left,61073223,CDM,610,RC,73223,HCPCS,Outpatient,,,1472,956.80,TC|LT,1295.36,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1472,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,927.36,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1015.68,69,,,percent of total billed charges,69% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,499.01,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1148.16,78,,,percent of total billed charges,78% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Elbow w/ + w/o Contrast Right,61073223,CDM,610,RC,73223,HCPCS,Outpatient,,,1472,956.80,TC|RT,1295.36,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1472,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,927.36,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1015.68,69,,,percent of total billed charges,69% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,499.01,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1148.16,78,,,percent of total billed charges,78% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Elbow w/ Contrast Left,61073222,CDM,610,RC,73222,HCPCS,Outpatient,,,1266,822.90,TC|LT,1114.08,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1266,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,797.58,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,873.54,69,,,percent of total billed charges,69% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,429.17,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,987.48,78,,,percent of total billed charges,78% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Elbow w/ Contrast Right,61073222,CDM,610,RC,73222,HCPCS,Outpatient,,,1266,822.90,TC|RT,1114.08,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1266,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,797.58,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,873.54,69,,,percent of total billed charges,69% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,429.17,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,987.48,78,,,percent of total billed charges,78% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Elbow w/o Contrast Left,61073221,CDM,610,RC,73221,HCPCS,Outpatient,,,1044,678.60,TC|LT,918.72,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1044,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,657.72,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,720.36,69,,,percent of total billed charges,69% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,353.92,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,814.32,78,,,percent of total billed charges,78% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1044,
MRI Elbow w/o Contrast Right,61073221,CDM,610,RC,73221,HCPCS,Outpatient,,,1044,678.60,TC|RT,918.72,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1044,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,657.72,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,720.36,69,,,percent of total billed charges,69% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,353.92,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,814.32,78,,,percent of total billed charges,78% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1044,
MRI Face Neck Orbit w/ + w/o Contrast,61070543,CDM,610,RC,70543,HCPCS,Outpatient,,,1469,954.85,TC,1292.72,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1469,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,925.47,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1013.61,69,,,percent of total billed charges,69% of total billed charges,1469,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1469,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1469,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,553.81,37.7,,,percent of total billed charges,37.70% of total billed charges,553.81,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,497.99,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1145.82,78,,,percent of total billed charges,78% of total billed charges,1469,100,,,percent of total billed charges,100% of total billed charges,1213.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1213.39,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Face Neck Orbit w/ Contrast,61070542,CDM,610,RC,70542,HCPCS,Outpatient,,,1469,954.85,TC,1292.72,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1469,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,925.47,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1013.61,69,,,percent of total billed charges,69% of total billed charges,1469,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1469,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1469,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,553.81,37.7,,,percent of total billed charges,37.70% of total billed charges,553.81,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,497.99,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1145.82,78,,,percent of total billed charges,78% of total billed charges,1469,100,,,percent of total billed charges,100% of total billed charges,1213.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1213.39,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Face Neck Orbit w/o Contrast,61070540,CDM,610,RC,70540,HCPCS,Outpatient,,,1088,707.20,TC,957.44,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1088,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,685.44,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,750.72,69,,,percent of total billed charges,69% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1088,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1088,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,368.83,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,848.64,78,,,percent of total billed charges,78% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1088,
MRI Foot w/ + w/o Contrast Left,61073720,CDM,610,RC,73720,HCPCS,Outpatient,,,1062,690.30,TC|LT,934.56,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1062,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,669.06,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,732.78,69,,,percent of total billed charges,69% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,360.02,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,828.36,78,,,percent of total billed charges,78% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Foot w/ + w/o Contrast Right,61073720,CDM,610,RC,73720,HCPCS,Outpatient,,,1062,690.30,TC|RT,934.56,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1062,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,669.06,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,732.78,69,,,percent of total billed charges,69% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,360.02,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,828.36,78,,,percent of total billed charges,78% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Foot w/ Contrast Left,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC|LT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Foot w/ Contrast Right,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC|RT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Foot w/o Contrast Left,61073718,CDM,610,RC,73718,HCPCS,Outpatient,,,829,538.85,TC|LT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Foot w/o Contrast Right,61073718,CDM,610,RC,73718,HCPCS,Outpatient,,,829,538.85,TC|RT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Hand w/ + w/o Contrast Left,61073220,CDM,610,RC,73220,HCPCS,Outpatient,,,1303,846.95,TC|LT,1146.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1303,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,820.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,899.07,69,,,percent of total billed charges,69% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,441.72,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1016.34,78,,,percent of total billed charges,78% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Hand w/ + w/o Contrast Right,61073220,CDM,610,RC,73220,HCPCS,Outpatient,,,1303,846.95,TC|RT,1146.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1303,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,820.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,899.07,69,,,percent of total billed charges,69% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,441.72,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1016.34,78,,,percent of total billed charges,78% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Hand w/ Contrast Left,61073219,CDM,610,RC,73219,HCPCS,Outpatient,,,1104,717.60,TC|LT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Hand w/ Contrast Right,61073219,CDM,610,RC,73219,HCPCS,Outpatient,,,1104,717.60,TC|RT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Hand w/o Contrast Left,61073218,CDM,610,RC,73218,HCPCS,Outpatient,,,829,538.85,TC|LT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Hand w/o Contrast Right,61073218,CDM,610,RC,73218,HCPCS,Outpatient,,,829,538.85,TC|RT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Hip w/ + w/o Contrast Left,61073723,CDM,610,RC,73723,HCPCS,Outpatient,,,1403,911.95,TC|LT,1234.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1403,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,883.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,968.07,69,,,percent of total billed charges,69% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,475.62,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1094.34,78,,,percent of total billed charges,78% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Hip w/ + w/o Contrast Right,61073723,CDM,610,RC,73723,HCPCS,Outpatient,,,1403,911.95,TC|RT,1234.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1403,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,883.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,968.07,69,,,percent of total billed charges,69% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,475.62,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1094.34,78,,,percent of total billed charges,78% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Hip w/ Contrast Left,61073722,CDM,610,RC,73722,HCPCS,Outpatient,,,1206,783.90,TC|LT,1061.28,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1206,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,759.78,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,832.14,69,,,percent of total billed charges,69% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,408.83,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,940.68,78,,,percent of total billed charges,78% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Hip w/ Contrast Right,61073722,CDM,610,RC,73722,HCPCS,Outpatient,,,1206,783.90,TC|RT,1061.28,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1206,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,759.78,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,832.14,69,,,percent of total billed charges,69% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,408.83,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,940.68,78,,,percent of total billed charges,78% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Hip w/o Contrast Left,61073721,CDM,610,RC,73721,HCPCS,Outpatient,,,995,646.75,TC|LT,875.6,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,995,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,626.85,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,686.55,69,,,percent of total billed charges,69% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,337.31,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,776.1,78,,,percent of total billed charges,78% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,995,
MRI Hip w/o Contrast Right,61073721,CDM,610,RC,73721,HCPCS,Outpatient,,,995,646.75,TC|RT,875.6,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,995,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,626.85,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,686.55,69,,,percent of total billed charges,69% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,337.31,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,776.1,78,,,percent of total billed charges,78% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,995,
MRI Knee w/ + w/o Contrast Left,61073723,CDM,610,RC,73723,HCPCS,Outpatient,,,1403,911.95,TC|LT,1234.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1403,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,883.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,968.07,69,,,percent of total billed charges,69% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,475.62,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1094.34,78,,,percent of total billed charges,78% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Knee w/ + w/o Contrast Right,61073723,CDM,610,RC,73723,HCPCS,Outpatient,,,1403,911.95,TC|RT,1234.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1403,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,883.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,968.07,69,,,percent of total billed charges,69% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1403,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,475.62,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1094.34,78,,,percent of total billed charges,78% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Knee w/ Contrast Left,61073722,CDM,610,RC,73722,HCPCS,Outpatient,,,1206,783.90,TC|LT,1061.28,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1206,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,759.78,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,832.14,69,,,percent of total billed charges,69% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,408.83,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,940.68,78,,,percent of total billed charges,78% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Knee w/ Contrast Right,61073722,CDM,610,RC,73722,HCPCS,Outpatient,,,1206,783.90,TC|RT,1061.28,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1206,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,759.78,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,832.14,69,,,percent of total billed charges,69% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1206,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,408.83,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,940.68,78,,,percent of total billed charges,78% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Knee w/o Contrast Left,61073721,CDM,610,RC,73721,HCPCS,Outpatient,,,995,646.75,TC|LT,875.6,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,995,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,626.85,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,686.55,69,,,percent of total billed charges,69% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,337.31,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,776.1,78,,,percent of total billed charges,78% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,995,
MRI Knee w/o Contrast Right,61073721,CDM,610,RC,73721,HCPCS,Outpatient,,,995,646.75,TC|RT,875.6,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,995,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,626.85,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,686.55,69,,,percent of total billed charges,69% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,337.31,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,776.1,78,,,percent of total billed charges,78% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,995,
MRI Lower Extremity w/ + w/o Cnt Bilat,61073720,CDM,610,RC,73720,HCPCS,Outpatient,,,1062,690.30,TC|50,934.56,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1062,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,669.06,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,732.78,69,,,percent of total billed charges,69% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,360.02,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,828.36,78,,,percent of total billed charges,78% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Lower Extremity w/ Contrast Bilat,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Lower Extremity w/o Contrast Bilat,61073718,CDM,610,RC,73718,HCPCS,Outpatient,,,829,538.85,TC,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Pelvis w/ + w/o Contrast,61072197,CDM,610,RC,72197,HCPCS,Outpatient,,,1112,722.80,TC,978.56,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1112,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,700.56,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,767.28,69,,,percent of total billed charges,69% of total billed charges,1112,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1112,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1112,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,419.22,37.7,,,percent of total billed charges,37.70% of total billed charges,419.22,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,376.97,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,867.36,78,,,percent of total billed charges,78% of total billed charges,1112,100,,,percent of total billed charges,100% of total billed charges,918.51,82.6,,,percent of total billed charges,82.6% of total billed charges,918.51,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Pelvis w/ Contrast,61072196,CDM,610,RC,72196,HCPCS,Outpatient,,,1112,722.80,TC,978.56,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1112,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,700.56,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,767.28,69,,,percent of total billed charges,69% of total billed charges,1112,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1112,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1112,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,419.22,37.7,,,percent of total billed charges,37.70% of total billed charges,419.22,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,376.97,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,867.36,78,,,percent of total billed charges,78% of total billed charges,1112,100,,,percent of total billed charges,100% of total billed charges,918.51,82.6,,,percent of total billed charges,82.6% of total billed charges,918.51,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Pelvis w/o Contrast,61072195,CDM,610,RC,72195,HCPCS,Outpatient,,,1062,690.30,TC,934.56,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1062,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,669.06,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,732.78,69,,,percent of total billed charges,69% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,360.02,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,828.36,78,,,percent of total billed charges,78% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1062,
MRI Shoulder w/ + w/o Contrast Left,61073223,CDM,610,RC,73223,HCPCS,Outpatient,,,1472,956.80,TC|LT,1295.36,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1472,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,927.36,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1015.68,69,,,percent of total billed charges,69% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,499.01,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1148.16,78,,,percent of total billed charges,78% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Shoulder w/ + w/o Contrast Right,61073223,CDM,610,RC,73223,HCPCS,Outpatient,,,1472,956.80,TC|RT,1295.36,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1472,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,927.36,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1015.68,69,,,percent of total billed charges,69% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,499.01,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1148.16,78,,,percent of total billed charges,78% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Shoulder w/ Contrast Left,61073222,CDM,610,RC,73222,HCPCS,Outpatient,,,1266,822.90,TC|LT,1114.08,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1266,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,797.58,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,873.54,69,,,percent of total billed charges,69% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,429.17,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,987.48,78,,,percent of total billed charges,78% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Shoulder w/ Contrast Right,61073222,CDM,610,RC,73222,HCPCS,Outpatient,,,1266,822.90,TC|RT,1114.08,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1266,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,797.58,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,873.54,69,,,percent of total billed charges,69% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,429.17,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,987.48,78,,,percent of total billed charges,78% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Shoulder w/o Contrast Left,61073221,CDM,610,RC,73221,HCPCS,Outpatient,,,1044,678.60,TC|LT,918.72,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1044,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,657.72,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,720.36,69,,,percent of total billed charges,69% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,353.92,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,814.32,78,,,percent of total billed charges,78% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1044,
MRI Shoulder w/o Contrast Right,61073221,CDM,610,RC,73221,HCPCS,Outpatient,,,1044,678.60,TC|RT,918.72,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1044,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,657.72,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,720.36,69,,,percent of total billed charges,69% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,353.92,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,814.32,78,,,percent of total billed charges,78% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1044,
MRI Spine Cervical w/ + w/o Contrast,61272156,CDM,612,RC,72156,HCPCS,Outpatient,,,1775,1153.75,TC,1562,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1775,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1118.25,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1224.75,69,,,percent of total billed charges,69% of total billed charges,1775,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1775,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1775,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,669.18,37.7,,,percent of total billed charges,37.70% of total billed charges,669.18,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,601.73,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1384.5,78,,,percent of total billed charges,78% of total billed charges,1775,100,,,percent of total billed charges,100% of total billed charges,1466.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1466.15,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1775,
MRI Spine Cervical w/ Contrast,61272142,CDM,612,RC,72142,HCPCS,Outpatient,,,1616,1050.40,TC,1422.08,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1616,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1018.08,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1115.04,69,,,percent of total billed charges,69% of total billed charges,1616,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1616,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1616,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,609.23,37.7,,,percent of total billed charges,37.70% of total billed charges,609.23,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,547.82,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.48,78,,,percent of total billed charges,78% of total billed charges,1616,100,,,percent of total billed charges,100% of total billed charges,1334.82,82.6,,,percent of total billed charges,82.6% of total billed charges,1334.82,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1616,
MRI Spine Cervical w/o Contrast,61272141,CDM,612,RC,72141,HCPCS,Outpatient,,,1543,1002.95,TC,1357.84,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1543,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,972.09,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1064.67,69,,,percent of total billed charges,69% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1543,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1543,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,523.08,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.54,78,,,percent of total billed charges,78% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1543,
MRI Spine Lumbar w/ + w/o Contrast,61272158,CDM,612,RC,72158,HCPCS,Outpatient,,,1415,919.75,TC,1245.2,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1415,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,891.45,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,976.35,69,,,percent of total billed charges,69% of total billed charges,1415,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1415,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1415,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,533.46,37.7,,,percent of total billed charges,37.70% of total billed charges,533.46,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,479.69,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1103.7,78,,,percent of total billed charges,78% of total billed charges,1415,100,,,percent of total billed charges,100% of total billed charges,1168.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1168.79,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Spine Lumbar w/ Contrast,61272149,CDM,612,RC,72149,HCPCS,Outpatient,,,1271,826.15,TC,1118.48,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1271,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,800.73,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,876.99,69,,,percent of total billed charges,69% of total billed charges,1271,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1271,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1271,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,479.17,37.7,,,percent of total billed charges,37.70% of total billed charges,479.17,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,430.87,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,991.38,78,,,percent of total billed charges,78% of total billed charges,1271,100,,,percent of total billed charges,100% of total billed charges,1049.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1049.85,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Spine Lumbar w/o Contrast,61272148,CDM,612,RC,72148,HCPCS,Outpatient,,,1360,884.00,TC,1196.8,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1360,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,856.8,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,938.4,69,,,percent of total billed charges,69% of total billed charges,1360,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1360,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1360,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,512.72,37.7,,,percent of total billed charges,37.70% of total billed charges,512.72,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,461.04,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1060.8,78,,,percent of total billed charges,78% of total billed charges,1360,100,,,percent of total billed charges,100% of total billed charges,1123.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1123.36,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1360,
MRI Spine Thoracic w/ + w/o Contrast,61272157,CDM,612,RC,72157,HCPCS,Outpatient,,,1630,1059.50,TC,1434.4,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1630,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1026.9,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1124.7,69,,,percent of total billed charges,69% of total billed charges,1630,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1630,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1630,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,614.51,37.7,,,percent of total billed charges,37.70% of total billed charges,614.51,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,552.57,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1271.4,78,,,percent of total billed charges,78% of total billed charges,1630,100,,,percent of total billed charges,100% of total billed charges,1346.38,82.6,,,percent of total billed charges,82.6% of total billed charges,1346.38,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1630,
MRI Spine Thoracic w/ Contrast,61272147,CDM,612,RC,72147,HCPCS,Outpatient,,,1408,915.20,TC,1239.04,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1408,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,887.04,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,971.52,69,,,percent of total billed charges,69% of total billed charges,1408,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1408,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1408,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,530.82,37.7,,,percent of total billed charges,37.70% of total billed charges,530.82,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,477.31,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1098.24,78,,,percent of total billed charges,78% of total billed charges,1408,100,,,percent of total billed charges,100% of total billed charges,1163.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1163.01,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Spine Thoracic w/o Contrast,61272146,CDM,612,RC,72146,HCPCS,Outpatient,,,1415,919.75,TC,1245.2,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1415,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,891.45,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,976.35,69,,,percent of total billed charges,69% of total billed charges,1415,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1415,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1415,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,533.46,37.7,,,percent of total billed charges,37.70% of total billed charges,533.46,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,479.69,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1103.7,78,,,percent of total billed charges,78% of total billed charges,1415,100,,,percent of total billed charges,100% of total billed charges,1168.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1168.79,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1415,
MRI TMJ,61070336,CDM,610,RC,70336,HCPCS,Outpatient,,,615,399.75,TC,541.2,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,615,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,387.45,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,424.35,69,,,percent of total billed charges,69% of total billed charges,615,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,615,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,615,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,231.86,37.7,,,percent of total billed charges,37.70% of total billed charges,231.86,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,208.49,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,479.7,78,,,percent of total billed charges,78% of total billed charges,615,100,,,percent of total billed charges,100% of total billed charges,507.99,82.6,,,percent of total billed charges,82.6% of total billed charges,507.99,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Wrist w/ + w/o Contrast Left,61073223,CDM,610,RC,73223,HCPCS,Outpatient,,,1472,956.80,TC|LT,1295.36,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1472,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,927.36,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1015.68,69,,,percent of total billed charges,69% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,499.01,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1148.16,78,,,percent of total billed charges,78% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Wrist w/ + w/o Contrast Right,61073223,CDM,610,RC,73223,HCPCS,Outpatient,,,1472,956.80,TC|RT,1295.36,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1472,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,927.36,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1015.68,69,,,percent of total billed charges,69% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1472,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,499.01,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1148.16,78,,,percent of total billed charges,78% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Wrist w/ Contrast Left,61073222,CDM,610,RC,73222,HCPCS,Outpatient,,,1266,822.90,TC|LT,1114.08,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1266,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,797.58,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,873.54,69,,,percent of total billed charges,69% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,429.17,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,987.48,78,,,percent of total billed charges,78% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Wrist w/ Contrast Right,61073222,CDM,610,RC,73222,HCPCS,Outpatient,,,1266,822.90,TC|RT,1114.08,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1266,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,797.58,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,873.54,69,,,percent of total billed charges,69% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1266,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,429.17,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,987.48,78,,,percent of total billed charges,78% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,2905.43,
MRI Wrist w/o Contrast Left,61073221,CDM,610,RC,73221,HCPCS,Outpatient,,,1044,678.60,TC|LT,918.72,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1044,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,657.72,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,720.36,69,,,percent of total billed charges,69% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,353.92,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,814.32,78,,,percent of total billed charges,78% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1044,
MRI Wrist w/o Contrast Right,61073221,CDM,610,RC,73221,HCPCS,Outpatient,,,1044,678.60,TC|RT,918.72,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1044,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,657.72,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,720.36,69,,,percent of total billed charges,69% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1044,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,353.92,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,814.32,78,,,percent of total billed charges,78% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1044,
MRI Brachial Plexus w/ + w/o Contrast,61073220,CDM,610,RC,73220,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Breast w/ + w/o Contrast Left,61077048,CDM,610,RC,77048,HCPCS,Outpatient,,,1958,1272.70,TC|LT,1723.04,88,,,percent of total billed charges,88% of total Billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid,1958,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,979,50,,,percent of total billed charges,50% of total Billed charges,1233.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1351.02,69,,,percent of total billed charges,69% of total billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,1211.02,61.85,,,percent of total billed charges,61.85% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,979,50,,,percent of total billed charges,50% of total Billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,979,50,,,percent of total billed charges,50% of total Billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,979,50,,,percent of total billed charges,50% of total Billed charges,738.17,37.7,,,percent of total billed charges,37.70% of total billed charges,738.17,37.7,,,percent of total billed charges,37.70% of total billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,663.76,33.9,,,percent of total billed charges,33.9% of total billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,1527.24,78,,,percent of total billed charges,78% of total billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,1617.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1617.31,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,979,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,979,50,,,percent of total billed charges,50% of total Billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1958,
MRI Breast w/ + w/o Contrast Right,61077048,CDM,610,RC,77048,HCPCS,Outpatient,,,1958,1272.70,TC|RT,1723.04,88,,,percent of total billed charges,88% of total Billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid,1958,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,979,50,,,percent of total billed charges,50% of total Billed charges,1233.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1351.02,69,,,percent of total billed charges,69% of total billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,1211.02,61.85,,,percent of total billed charges,61.85% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,979,50,,,percent of total billed charges,50% of total Billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,979,50,,,percent of total billed charges,50% of total Billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,979,50,,,percent of total billed charges,50% of total Billed charges,738.17,37.7,,,percent of total billed charges,37.70% of total billed charges,738.17,37.7,,,percent of total billed charges,37.70% of total billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,663.76,33.9,,,percent of total billed charges,33.9% of total billed charges,979,50,,,percent of total billed charges,50% of total Billed charges,1527.24,78,,,percent of total billed charges,78% of total billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,1617.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1617.31,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,979,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,979,50,,,percent of total billed charges,50% of total Billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1958,
MRI Bone Marrow w/o Contrast,61077084,CDM,610,RC,77084,HCPCS,Outpatient,,,2548,1656.20,TC,2242.24,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,2548,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1605.24,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1758.12,69,,,percent of total billed charges,69% of total billed charges,2548,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2548,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,2548,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,960.6,37.7,,,percent of total billed charges,37.70% of total billed charges,960.6,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,863.77,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1987.44,78,,,percent of total billed charges,78% of total billed charges,2548,100,,,percent of total billed charges,100% of total billed charges,2104.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2104.65,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,2548,
MRI Brain w/ Contrast Ltd,61170552,CDM,611,RC,70552,HCPCS,Outpatient,,,810,526.50,TC,712.8,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,810,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,510.3,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,558.9,69,,,percent of total billed charges,69% of total billed charges,810,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,810,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,810,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,305.37,37.7,,,percent of total billed charges,37.70% of total billed charges,305.37,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,274.59,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,631.8,78,,,percent of total billed charges,78% of total billed charges,810,100,,,percent of total billed charges,100% of total billed charges,669.06,82.6,,,percent of total billed charges,82.6% of total billed charges,669.06,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,274.59,1495.48,
MRI Breast w/o Contrast Left,61077046,CDM,610,RC,77046,HCPCS,Outpatient,,,1265,822.25,TC|LT,1113.2,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1265,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,796.95,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,872.85,69,,,percent of total billed charges,69% of total billed charges,1265,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1265,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1265,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,476.91,37.7,,,percent of total billed charges,37.70% of total billed charges,476.91,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,428.84,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,986.7,78,,,percent of total billed charges,78% of total billed charges,1265,100,,,percent of total billed charges,100% of total billed charges,1044.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1044.89,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1265,
MRI Breast w/o Contrast Right,61077046,CDM,610,RC,77046,HCPCS,Outpatient,,,1265,822.25,TC|RT,1113.2,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,1265,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,796.95,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,872.85,69,,,percent of total billed charges,69% of total billed charges,1265,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1265,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1265,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,476.91,37.7,,,percent of total billed charges,37.70% of total billed charges,476.91,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,428.84,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,986.7,78,,,percent of total billed charges,78% of total billed charges,1265,100,,,percent of total billed charges,100% of total billed charges,1044.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1044.89,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,1265,
MRI Femur w/ + w/o Contrast Lt,61073720,CDM,610,RC,73720,HCPCS,Outpatient,,,1062,690.30,TC|LT,934.56,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1062,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,669.06,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,732.78,69,,,percent of total billed charges,69% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,360.02,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,828.36,78,,,percent of total billed charges,78% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Femur w/ + w/o Contrast Rt,61073720,CDM,610,RC,73720,HCPCS,Outpatient,,,1062,690.30,TC|RT,934.56,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1062,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,669.06,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,732.78,69,,,percent of total billed charges,69% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,360.02,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,828.36,78,,,percent of total billed charges,78% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Femur w/o Contrast Lt,61073718,CDM,610,RC,73718,HCPCS,Outpatient,,,829,538.85,TC|LT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Femur w/o Contrast Rt,61073718,CDM,610,RC,73718,HCPCS,Outpatient,,,829,538.85,TC|RT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Forearm w/ + w/o Contrast Lt,61073220,CDM,610,RC,73220,HCPCS,Outpatient,,,1303,846.95,TC|LT,1146.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1303,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,820.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,899.07,69,,,percent of total billed charges,69% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,441.72,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1016.34,78,,,percent of total billed charges,78% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Forearm w/ + w/o Contrast Rt,61073220,CDM,610,RC,73220,HCPCS,Outpatient,,,1303,846.95,TC|RT,1146.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1303,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,820.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,899.07,69,,,percent of total billed charges,69% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,441.72,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1016.34,78,,,percent of total billed charges,78% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Forearm w/o Contrast Lt,61073218,CDM,610,RC,73218,HCPCS,Outpatient,,,829,538.85,TC|LT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Forearm w/o Contrast Rt,61073218,CDM,610,RC,73218,HCPCS,Outpatient,,,829,538.85,TC|RT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Humerus w/ + w/o Contrast Rt,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC|RT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Humerus w/ + w/o Contrsat Lt,61073220,CDM,610,RC,73220,HCPCS,Outpatient,,,1303,846.95,TC|LT,1146.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1303,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,820.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,899.07,69,,,percent of total billed charges,69% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,441.72,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1016.34,78,,,percent of total billed charges,78% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Humerus w/o Contrast Lt,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC|LT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Humerus w/o Contrast Rt,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC|RT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI IAC w/ + w/o Contrast,61170553,CDM,611,RC,70553,HCPCS,Outpatient,,,1543,1002.95,TC,1357.84,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1543,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,972.09,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1064.67,69,,,percent of total billed charges,69% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,523.08,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.54,78,,,percent of total billed charges,78% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1543,
MRI Pituitary w/ + w/o Contrast,61170553,CDM,611,RC,70553,HCPCS,Outpatient,,,1543,1002.95,TC,1357.84,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1543,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,972.09,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,1064.67,69,,,percent of total billed charges,69% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1543,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,581.71,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,523.08,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.54,78,,,percent of total billed charges,78% of total billed charges,1543,100,,,percent of total billed charges,100% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1274.52,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1543,
MRI Tibia w/ + w/o Contrast Lt,61073720,CDM,610,RC,73720,HCPCS,Outpatient,,,1062,690.30,TC|LT,934.56,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1062,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,669.06,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,732.78,69,,,percent of total billed charges,69% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,360.02,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,828.36,78,,,percent of total billed charges,78% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Tibia w/ + w/o Contrast Rt,61073720,CDM,610,RC,73720,HCPCS,Outpatient,,,1062,690.30,TC|RT,934.56,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1062,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,669.06,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,732.78,69,,,percent of total billed charges,69% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1062,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,360.02,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,828.36,78,,,percent of total billed charges,78% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Tibia w/ Contrast Lt,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC|LT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Tibia w/ Contrast Rt,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC|RT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Tibia w/o Contrast Lt,61073718,CDM,610,RC,73718,HCPCS,Outpatient,,,829,538.85,TC|LT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Tibia w/o Contrast Rt,61073718,CDM,610,RC,73718,HCPCS,Outpatient,,,829,538.85,TC|RT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Femur w/ Contrast Lt,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC|LT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Femur w/ Contrast Rt,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC|RT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Forearm w/ Contrast Lt,61073219,CDM,610,RC,73219,HCPCS,Outpatient,,,1104,717.60,TC|LT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Forearm w/ Contrast Rt,61073219,CDM,610,RC,73219,HCPCS,Outpatient,,,1104,717.60,TC|RT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Humerus w/ Contrast Lt,61073219,CDM,610,RC,73219,HCPCS,Outpatient,,,1104,717.60,TC|LT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Humerus w/ Contrast Rt,61073219,CDM,610,RC,73219,HCPCS,Outpatient,,,1104,717.60,TC|RT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Humerus w/ + w/o Contrast Left,61073220,CDM,610,RC,73220,HCPCS,Outpatient,,,1303,846.95,TC|LT,1146.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1303,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,820.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,899.07,69,,,percent of total billed charges,69% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,441.72,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1016.34,78,,,percent of total billed charges,78% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Humerus w/ + w/o Contrast Right,61073220,CDM,610,RC,73220,HCPCS,Outpatient,,,1303,846.95,TC|RT,1146.64,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1303,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,820.89,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,899.07,69,,,percent of total billed charges,69% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1303,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,441.72,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1016.34,78,,,percent of total billed charges,78% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Humerus w/o Contrast Left,61073218,CDM,610,RC,73218,HCPCS,Outpatient,,,829,538.85,TC|LT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Humerus w/o Contrast Right,61073218,CDM,610,RC,73218,HCPCS,Outpatient,,,829,538.85,TC|RT,729.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,236.31,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,522.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,829,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,169.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,234.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.25,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,281.03,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,229.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,169.94,934.9,
MRI Femur w/ Contrast Left,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC|LT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Femur w/ Contrast Right,61073719,CDM,610,RC,73719,HCPCS,Outpatient,,,1104,717.60,TC|RT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Forearm w/ Contrast Left,61073219,CDM,610,RC,73219,HCPCS,Outpatient,,,1104,717.60,TC|LT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Forearm w/ Contrast Right,61073219,CDM,610,RC,73219,HCPCS,Outpatient,,,1104,717.60,TC|RT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Humerus w/ Contrast Left,61073219,CDM,610,RC,73219,HCPCS,Outpatient,,,1104,717.60,TC|LT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRI Humerus w/ Contrast Right,61073219,CDM,610,RC,73219,HCPCS,Outpatient,,,1104,717.60,TC|RT,971.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,1104,100,,,percent of total billed charges,100% of total billed charges,414.07,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,695.52,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,761.76,69,,,percent of total billed charges,69% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1104,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,297.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,410.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.62,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,416.21,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,374.26,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,861.12,78,,,percent of total billed charges,78% of total billed charges,1104,100,,,percent of total billed charges,100% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,911.9,82.6,,,percent of total billed charges,82.6% of total billed charges,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,402.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,297.79,1495.48,
MRV Pelvis w/ Contrast,61872198,CDM,618,RC,72198,HCPCS,Outpatient,,,3021,1963.65,TC,2658.48,88,,,percent of total billed charges,88% of total Billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid,3021,100,,,percent of total billed charges,100% of total billed charges,463.31,103,,,Fee Schedule,103% of WA Medicaid,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1903.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,449.81,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,Case rate,pays based on per visit rate,2084.49,69,,,percent of total billed charges,69% of total billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1868.49,61.85,,,percent of total billed charges,61.85% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,333.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,458.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.76,130,,,Fee Schedule,130% of WA Medicaid ,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1138.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1138.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,1024.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1510.5,50,,,percent of total billed charges,50% of total Billed charges,2356.38,78,,,percent of total billed charges,78% of total billed charges,3021,100,,,percent of total billed charges,100% of total billed charges,2495.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2495.35,82.6,,,percent of total billed charges,82.6% of total billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1510.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1510.5,50,,,percent of total billed charges,50% of total Billed charges,449.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,333.19,3021,
NM Bone Imaging Limited Injection,34178300,CDM,341,RC,78300,HCPCS,Outpatient,,,1832,1190.80,TC,1612.16,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,1832,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1154.16,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,280.3,15.3,,,percent of total billed charges,15.3% of total billed charges,1264.08,69,,,percent of total billed charges,69% of total billed charges,1832,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1832,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1832,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,690.66,37.7,,,percent of total billed charges,37.70% of total billed charges,690.66,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,621.05,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1428.96,78,,,percent of total billed charges,78% of total billed charges,1832,100,,,percent of total billed charges,100% of total billed charges,1513.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1513.23,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,1832,
NM Bone Imaging Multiple Areas Injection,34178305,CDM,341,RC,78305,HCPCS,Outpatient,,,2599,1689.35,TC,2287.12,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,2599,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1637.37,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,397.65,15.3,,,percent of total billed charges,15.3% of total billed charges,1793.31,69,,,percent of total billed charges,69% of total billed charges,2599,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2599,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2599,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,979.82,37.7,,,percent of total billed charges,37.70% of total billed charges,979.82,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,881.06,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2027.22,78,,,percent of total billed charges,78% of total billed charges,2599,100,,,percent of total billed charges,100% of total billed charges,2146.77,82.6,,,percent of total billed charges,82.6% of total billed charges,2146.77,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,2599,
NM Bone Imaging Whole Body Injection,34178306,CDM,341,RC,78306,HCPCS,Outpatient,,,3023,1964.95,TC,2660.24,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,3023,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1904.49,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,462.52,15.3,,,percent of total billed charges,15.3% of total billed charges,2085.87,69,,,percent of total billed charges,69% of total billed charges,3023,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3023,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3023,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1139.67,37.7,,,percent of total billed charges,37.70% of total billed charges,1139.67,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1024.8,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2357.94,78,,,percent of total billed charges,78% of total billed charges,3023,100,,,percent of total billed charges,100% of total billed charges,2497,82.6,,,percent of total billed charges,82.6% of total billed charges,2497,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,3023,
NM Bone Marrow Imaging Limited,34178102,CDM,341,RC,78102,HCPCS,Outpatient,,,1494,971.10,TC,1314.72,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,1494,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,941.22,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,228.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1030.86,69,,,percent of total billed charges,69% of total billed charges,1494,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1494,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1494,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,563.24,37.7,,,percent of total billed charges,37.70% of total billed charges,563.24,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,506.47,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1165.32,78,,,percent of total billed charges,78% of total billed charges,1494,100,,,percent of total billed charges,100% of total billed charges,1234.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.04,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,228.58,1532.05,
NM Bone Spect,34178803,CDM,341,RC,78803,HCPCS,Outpatient,,,3017,1961.05,TC,2654.96,88,,,percent of total billed charges,88% of total Billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,3017,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1900.71,63,,,percent of total billed charges,63% of total billed charges,2534.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,461.6,15.3,,,percent of total billed charges,15.3% of total billed charges,2081.73,69,,,percent of total billed charges,69% of total billed charges,3017,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3017,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3017,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1137.41,37.7,,,percent of total billed charges,37.70% of total billed charges,1137.41,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1022.76,33.9,,,percent of total billed charges,33.9% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2353.26,78,,,percent of total billed charges,78% of total billed charges,3017,100,,,percent of total billed charges,100% of total billed charges,2492.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2492.04,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,461.6,5305.42,
NM Bone Three Phase Study Injection/Scan,34178315,CDM,341,RC,78315,HCPCS,Outpatient,,,2880,1872.00,TC,2534.4,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,2880,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1814.4,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,440.64,15.3,,,percent of total billed charges,15.3% of total billed charges,1987.2,69,,,percent of total billed charges,69% of total billed charges,2880,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2880,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2880,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1085.76,37.7,,,percent of total billed charges,37.70% of total billed charges,1085.76,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,976.32,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2246.4,78,,,percent of total billed charges,78% of total billed charges,2880,100,,,percent of total billed charges,100% of total billed charges,2378.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2378.88,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,2880,
NM Brain Imaging Vascular Flow Only,34178601,CDM,341,RC,78601,HCPCS,Outpatient,,,3775,2453.75,TC,3322,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,3775,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2378.25,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,577.58,15.3,,,percent of total billed charges,15.3% of total billed charges,2604.75,69,,,percent of total billed charges,69% of total billed charges,3775,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3775,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3775,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1423.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1423.18,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1279.73,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2944.5,78,,,percent of total billed charges,78% of total billed charges,3775,100,,,percent of total billed charges,100% of total billed charges,3118.15,82.6,,,percent of total billed charges,82.6% of total billed charges,3118.15,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,3775,
NM Brain Spect,34178803,CDM,341,RC,78803,HCPCS,Outpatient,,,4806,3123.90,TC,4229.28,88,,,percent of total billed charges,88% of total Billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3027.78,63,,,percent of total billed charges,63% of total billed charges,2534.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,735.32,15.3,,,percent of total billed charges,15.3% of total billed charges,3316.14,69,,,percent of total billed charges,69% of total billed charges,4806,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,4806,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,4806,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1811.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1811.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1629.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3748.68,78,,,percent of total billed charges,78% of total billed charges,4806,100,,,percent of total billed charges,100% of total billed charges,3969.76,82.6,,,percent of total billed charges,82.6% of total billed charges,3969.76,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,643.53,5305.42,
NM Cardiac MUGA,34178472,CDM,341,RC,78472,HCPCS,Outpatient,,,2560,1664.00,TC,2252.8,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,2560,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1612.8,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,391.68,15.3,,,percent of total billed charges,15.3% of total billed charges,1766.4,69,,,percent of total billed charges,69% of total billed charges,2560,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2560,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2560,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,965.12,37.7,,,percent of total billed charges,37.70% of total billed charges,965.12,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,867.84,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1996.8,78,,,percent of total billed charges,78% of total billed charges,2560,100,,,percent of total billed charges,100% of total billed charges,2114.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2114.56,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,2560,
NM Cerebrospinal Fluid Leakage Detection,34178650,CDM,341,RC,78650,HCPCS,Outpatient,,,2901,1885.65,TC,2552.88,88,,,percent of total billed charges,88% of total Billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,2901,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1827.63,63,,,percent of total billed charges,63% of total billed charges,2534.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,443.85,15.3,,,percent of total billed charges,15.3% of total billed charges,2001.69,69,,,percent of total billed charges,69% of total billed charges,2901,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2901,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2901,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1093.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1093.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,983.44,33.9,,,percent of total billed charges,33.9% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2262.78,78,,,percent of total billed charges,78% of total billed charges,2901,100,,,percent of total billed charges,100% of total billed charges,2396.23,82.6,,,percent of total billed charges,82.6% of total billed charges,2396.23,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,443.85,5305.42,
NM CT Tumor Loc Multiple Areas Spect,34078832,CDM,340,RC,78832,HCPCS,Outpatient,,,4618,3001.70,TC,4063.84,88,,,percent of total billed charges,88% of total Billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4618,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2909.34,63,,,percent of total billed charges,63% of total billed charges,2792.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,706.55,15.3,,,percent of total billed charges,15.3% of total billed charges,3186.42,69,,,percent of total billed charges,69% of total billed charges,4618,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,4618,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,4618,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,6013.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1740.99,37.7,,,percent of total billed charges,37.70% of total billed charges,1740.99,37.7,,,percent of total billed charges,37.70% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1565.5,33.9,,,percent of total billed charges,33.9% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,3602.04,78,,,percent of total billed charges,78% of total billed charges,4618,100,,,percent of total billed charges,100% of total billed charges,3814.47,82.6,,,percent of total billed charges,82.6% of total billed charges,3814.47,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1611.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,643.53,6013.92,
NM CT Tumor Loc Single Area Spect,34078830,CDM,340,RC,78830,HCPCS,Outpatient,,,3523,2289.95,TC,3100.24,88,,,percent of total billed charges,88% of total Billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,3523,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2219.49,63,,,percent of total billed charges,63% of total billed charges,2534.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,539.02,15.3,,,percent of total billed charges,15.3% of total billed charges,2430.87,69,,,percent of total billed charges,69% of total billed charges,3523,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3523,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3523,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1328.17,37.7,,,percent of total billed charges,37.70% of total billed charges,1328.17,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1194.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.94,78,,,percent of total billed charges,78% of total billed charges,3523,100,,,percent of total billed charges,100% of total billed charges,2910,82.6,,,percent of total billed charges,82.6% of total billed charges,2910,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,539.02,5305.42,
NM Gastric Emptying Study,34178264,CDM,341,RC,78264,HCPCS,Outpatient,,,2794,1816.10,TC,2458.72,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,2794,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1760.22,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,427.48,15.3,,,percent of total billed charges,15.3% of total billed charges,1927.86,69,,,percent of total billed charges,69% of total billed charges,2794,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2794,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2794,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1053.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1053.34,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,947.17,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2179.32,78,,,percent of total billed charges,78% of total billed charges,2794,100,,,percent of total billed charges,100% of total billed charges,2307.84,82.6,,,percent of total billed charges,82.6% of total billed charges,2307.84,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,2794,
NM Gastroesophageal Reflux Study,34078262,CDM,340,RC,78262,HCPCS,Outpatient,,,2280,1482.00,TC,2006.4,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,2280,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1436.4,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,348.84,15.3,,,percent of total billed charges,15.3% of total billed charges,1573.2,69,,,percent of total billed charges,69% of total billed charges,2280,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2280,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2280,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,859.56,37.7,,,percent of total billed charges,37.70% of total billed charges,859.56,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,772.92,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1778.4,78,,,percent of total billed charges,78% of total billed charges,2280,100,,,percent of total billed charges,100% of total billed charges,1883.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1883.28,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,2280,
NM Gastrointestinal Blood Loss Imaging,34178278,CDM,341,RC,78278,HCPCS,Outpatient,,,2959,1923.35,TC,2603.92,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,2959,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1864.17,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,452.73,15.3,,,percent of total billed charges,15.3% of total billed charges,2041.71,69,,,percent of total billed charges,69% of total billed charges,2959,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2959,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2959,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1115.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1115.54,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1003.1,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2308.02,78,,,percent of total billed charges,78% of total billed charges,2959,100,,,percent of total billed charges,100% of total billed charges,2444.13,82.6,,,percent of total billed charges,82.6% of total billed charges,2444.13,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,420.67,2959,
NM Hepatobiliary Imaging Injection/Scan,34178227,CDM,341,RC,78227,HCPCS,Outpatient,,,5211,3387.15,TC|26,4585.68,88,,,percent of total billed charges,88% of total Billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3282.93,63,,,percent of total billed charges,63% of total billed charges,964.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,797.28,15.3,,,percent of total billed charges,15.3% of total billed charges,3595.59,69,,,percent of total billed charges,69% of total billed charges,5211,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,5211,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,5211,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1988.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1964.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1964.55,37.7,,,percent of total billed charges,37.70% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1766.53,33.9,,,percent of total billed charges,33.9% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4064.58,78,,,percent of total billed charges,78% of total billed charges,5211,100,,,percent of total billed charges,100% of total billed charges,4304.29,82.6,,,percent of total billed charges,82.6% of total billed charges,4304.29,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,556.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,5211,
NM Hepatobiliary Imaging w/ Drug,34178227,CDM,341,RC,78227,HCPCS,Outpatient,,,5211,3387.15,TC,4585.68,88,,,percent of total billed charges,88% of total Billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3282.93,63,,,percent of total billed charges,63% of total billed charges,964.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,797.28,15.3,,,percent of total billed charges,15.3% of total billed charges,3595.59,69,,,percent of total billed charges,69% of total billed charges,5211,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,5211,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,5211,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1988.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1964.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1964.55,37.7,,,percent of total billed charges,37.70% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1766.53,33.9,,,percent of total billed charges,33.9% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4064.58,78,,,percent of total billed charges,78% of total billed charges,5211,100,,,percent of total billed charges,100% of total billed charges,4304.29,82.6,,,percent of total billed charges,82.6% of total billed charges,4304.29,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,556.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,5211,
NM Intestine Imaging Meckels,34078290,CDM,340,RC,78290,HCPCS,Outpatient,,,2714,1764.10,TC,2388.32,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,2714,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1709.82,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,415.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1872.66,69,,,percent of total billed charges,69% of total billed charges,2714,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2714,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2714,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1023.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1023.18,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,920.05,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2116.92,78,,,percent of total billed charges,78% of total billed charges,2714,100,,,percent of total billed charges,100% of total billed charges,2241.76,82.6,,,percent of total billed charges,82.6% of total billed charges,2241.76,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,2714,
NM Kidney Imaging Single w/ Pharm,34078708,CDM,340,RC,78708,HCPCS,Outpatient,,,3604,2342.60,TC,3171.52,88,,,percent of total billed charges,88% of total Billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,3604,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2270.52,63,,,percent of total billed charges,63% of total billed charges,964.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,551.41,15.3,,,percent of total billed charges,15.3% of total billed charges,2486.76,69,,,percent of total billed charges,69% of total billed charges,3604,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3604,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3604,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1988.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1358.71,37.7,,,percent of total billed charges,37.70% of total billed charges,1358.71,37.7,,,percent of total billed charges,37.70% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1221.76,33.9,,,percent of total billed charges,33.9% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2811.12,78,,,percent of total billed charges,78% of total billed charges,3604,100,,,percent of total billed charges,100% of total billed charges,2976.9,82.6,,,percent of total billed charges,82.6% of total billed charges,2976.9,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,556.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,3604,
NM Liver Imaging Spect,34078803,CDM,340,RC,78803,HCPCS,Outpatient,,,3523,2289.95,TC,3100.24,88,,,percent of total billed charges,88% of total Billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,3523,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2219.49,63,,,percent of total billed charges,63% of total billed charges,2534.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,539.02,15.3,,,percent of total billed charges,15.3% of total billed charges,2430.87,69,,,percent of total billed charges,69% of total billed charges,3523,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3523,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3523,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1328.17,37.7,,,percent of total billed charges,37.70% of total billed charges,1328.17,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1194.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2747.94,78,,,percent of total billed charges,78% of total billed charges,3523,100,,,percent of total billed charges,100% of total billed charges,2910,82.6,,,percent of total billed charges,82.6% of total billed charges,2910,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,539.02,5305.42,
NM Liver Imaging Static,34178201,CDM,341,RC,78201,HCPCS,Outpatient,,,3108,2020.20,TC,2735.04,88,,,percent of total billed charges,88% of total Billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,3108,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1958.04,63,,,percent of total billed charges,63% of total billed charges,964.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,475.52,15.3,,,percent of total billed charges,15.3% of total billed charges,2144.52,69,,,percent of total billed charges,69% of total billed charges,3108,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3108,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3108,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1988.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1171.72,37.7,,,percent of total billed charges,37.70% of total billed charges,1171.72,37.7,,,percent of total billed charges,37.70% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1053.61,33.9,,,percent of total billed charges,33.9% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2424.24,78,,,percent of total billed charges,78% of total billed charges,3108,100,,,percent of total billed charges,100% of total billed charges,2567.21,82.6,,,percent of total billed charges,82.6% of total billed charges,2567.21,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,556.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,475.52,3108,
NM Lymphoscintigraphy,34178195,CDM,341,RC,78195,HCPCS,Outpatient,,,1615,1049.75,TC,1421.2,88,,,percent of total billed charges,88% of total Billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,1615,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1017.45,63,,,percent of total billed charges,63% of total billed charges,964.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,247.1,15.3,,,percent of total billed charges,15.3% of total billed charges,1114.35,69,,,percent of total billed charges,69% of total billed charges,1615,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1615,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1615,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1988.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,608.86,37.7,,,percent of total billed charges,37.70% of total billed charges,608.86,37.7,,,percent of total billed charges,37.70% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,547.49,33.9,,,percent of total billed charges,33.9% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1259.7,78,,,percent of total billed charges,78% of total billed charges,1615,100,,,percent of total billed charges,100% of total billed charges,1333.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1333.99,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,556.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,247.1,1988.19,
NM Lung Perfusion Imaging,34078580,CDM,340,RC,78580,HCPCS,Outpatient,,,662,430.30,TC,582.56,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,662,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,417.06,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,101.29,15.3,,,percent of total billed charges,15.3% of total billed charges,456.78,69,,,percent of total billed charges,69% of total billed charges,662,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,662,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,662,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,249.57,37.7,,,percent of total billed charges,37.70% of total billed charges,249.57,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,224.42,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,516.36,78,,,percent of total billed charges,78% of total billed charges,662,100,,,percent of total billed charges,100% of total billed charges,546.81,82.6,,,percent of total billed charges,82.6% of total billed charges,546.81,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.29,1532.05,
NM Lung Perfusion Differential Imaging,34178597,CDM,341,RC,78597,HCPCS,Outpatient,,,4491,2919.15,TC,3952.08,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4491,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2829.33,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,687.12,15.3,,,percent of total billed charges,15.3% of total billed charges,3098.79,69,,,percent of total billed charges,69% of total billed charges,4491,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4491,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4491,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1693.11,37.7,,,percent of total billed charges,37.70% of total billed charges,1693.11,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1522.45,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3502.98,78,,,percent of total billed charges,78% of total billed charges,4491,100,,,percent of total billed charges,100% of total billed charges,3709.57,82.6,,,percent of total billed charges,82.6% of total billed charges,3709.57,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,420.67,4491,
NM Lung Vent/Perf Differential Imaging,34178598,CDM,341,RC,78598,HCPCS,Outpatient,,,5489,3567.85,TC,4830.32,88,,,percent of total billed charges,88% of total Billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3458.07,63,,,percent of total billed charges,63% of total billed charges,964.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,839.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3787.41,69,,,percent of total billed charges,69% of total billed charges,5489,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,5489,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,5489,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1988.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2069.35,37.7,,,percent of total billed charges,37.70% of total billed charges,2069.35,37.7,,,percent of total billed charges,37.70% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.77,33.9,,,percent of total billed charges,33.9% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4281.42,78,,,percent of total billed charges,78% of total billed charges,5489,100,,,percent of total billed charges,100% of total billed charges,4533.91,82.6,,,percent of total billed charges,82.6% of total billed charges,4533.91,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,556.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,551.29,5489,
NM Lung Vent/Perf Imaging,34178582,CDM,341,RC,78582,HCPCS,Outpatient,,,4990,3243.50,TC,4391.2,88,,,percent of total billed charges,88% of total Billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3143.7,63,,,percent of total billed charges,63% of total billed charges,964.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,763.47,15.3,,,percent of total billed charges,15.3% of total billed charges,3443.1,69,,,percent of total billed charges,69% of total billed charges,4990,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4990,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4990,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1988.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1881.23,37.7,,,percent of total billed charges,37.70% of total billed charges,1881.23,37.7,,,percent of total billed charges,37.70% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1691.61,33.9,,,percent of total billed charges,33.9% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3892.2,78,,,percent of total billed charges,78% of total billed charges,4990,100,,,percent of total billed charges,100% of total billed charges,4121.74,82.6,,,percent of total billed charges,82.6% of total billed charges,4121.74,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,556.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,551.29,4990,
NM Myocardial SPECT Rest and Stress,34178452,CDM,340,RC,78452,HCPCS,Outpatient,,,5606,3643.90,TC,4933.28,88,,,percent of total billed charges,88% of total Billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3531.78,63,,,percent of total billed charges,63% of total billed charges,2534.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,857.72,15.3,,,percent of total billed charges,15.3% of total billed charges,3868.14,69,,,percent of total billed charges,69% of total billed charges,5606,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5606,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5606,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2113.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2113.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1900.43,33.9,,,percent of total billed charges,33.9% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,4372.68,78,,,percent of total billed charges,78% of total billed charges,5606,100,,,percent of total billed charges,100% of total billed charges,4630.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4630.56,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,643.53,5606,
NM Myocardial Planar Single Study,34178481,CDM,340,RC,78481,HCPCS,Outpatient,,,2462,1600.30,TC,2166.56,88,,,percent of total billed charges,88% of total Billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,2462,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1551.06,63,,,percent of total billed charges,63% of total billed charges,964.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,376.69,15.3,,,percent of total billed charges,15.3% of total billed charges,1698.78,69,,,percent of total billed charges,69% of total billed charges,2462,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2462,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2462,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1988.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,928.17,37.7,,,percent of total billed charges,37.70% of total billed charges,928.17,37.7,,,percent of total billed charges,37.70% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,834.62,33.9,,,percent of total billed charges,33.9% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1920.36,78,,,percent of total billed charges,78% of total billed charges,2462,100,,,percent of total billed charges,100% of total billed charges,2033.61,82.6,,,percent of total billed charges,82.6% of total billed charges,2033.61,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,556.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,2462,
NM Myocardial SPECT Single Study,34178451,CDM,340,RC,78451,HCPCS,Outpatient,,,4786,3110.90,TC,4211.68,88,,,percent of total billed charges,88% of total Billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3015.18,63,,,percent of total billed charges,63% of total billed charges,2534.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,732.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3302.34,69,,,percent of total billed charges,69% of total billed charges,4786,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,4786,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,4786,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1804.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1804.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1622.45,33.9,,,percent of total billed charges,33.9% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3733.08,78,,,percent of total billed charges,78% of total billed charges,4786,100,,,percent of total billed charges,100% of total billed charges,3953.24,82.6,,,percent of total billed charges,82.6% of total billed charges,3953.24,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,643.53,5305.42,
NM Parathyroid Imaging Injection/Scan,34178070,CDM,341,RC,78070,HCPCS,Outpatient,,,2496,1622.40,TC,2196.48,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,2496,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1572.48,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,381.89,15.3,,,percent of total billed charges,15.3% of total billed charges,1722.24,69,,,percent of total billed charges,69% of total billed charges,2496,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2496,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2496,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,940.99,37.7,,,percent of total billed charges,37.70% of total billed charges,940.99,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,846.14,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1946.88,78,,,percent of total billed charges,78% of total billed charges,2496,100,,,percent of total billed charges,100% of total billed charges,2061.7,82.6,,,percent of total billed charges,82.6% of total billed charges,2061.7,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,381.89,2496,
NM Parathyroid Imaging w/ Spect Inj/Scan,34078071,CDM,340,RC,78071,HCPCS,Outpatient,,,1893,1230.45,TC,1665.84,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,1893,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1192.59,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,289.63,15.3,,,percent of total billed charges,15.3% of total billed charges,1306.17,69,,,percent of total billed charges,69% of total billed charges,1893,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1893,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1893,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,713.66,37.7,,,percent of total billed charges,37.70% of total billed charges,713.66,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,641.73,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1476.54,78,,,percent of total billed charges,78% of total billed charges,1893,100,,,percent of total billed charges,100% of total billed charges,1563.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1563.62,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,1893,
NM Placement Interstitial Device/Marker,33377778,CDM,333,RC,77778,HCPCS,Outpatient,,,10607,6894.55,TC,9334.16,88,,,percent of total billed charges,88% of total Billed charges,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1299.09,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1338.06,103,,,Fee Schedule,103% of WA Medicaid,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,6682.41,63,,,percent of total billed charges,63% of total billed charges,1279.75,175,,,Fee Schedule,175% of Medicare OPPS Rate,1299.09,100,,,Fee Schedule,100% of WA Medicaid,1622.87,15.3,,,percent of total billed charges,15.3% of total billed charges,7318.83,69,,,percent of total billed charges,69% of total billed charges,10607,100,,,percent of total billed charges,100% of total billed charges,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,10607,100,,,percent of total billed charges,100% of total billed charges,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,10607,100,,,percent of total billed charges,100% of total billed charges,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,2878.13,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1299.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,962.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1325.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1688.81,130,,,Fee Schedule,130% of WA Medicaid ,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3998.84,37.7,,,percent of total billed charges,37.70% of total billed charges,3998.84,37.7,,,percent of total billed charges,37.70% of total billed charges,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3595.77,33.9,,,percent of total billed charges,33.9% of total billed charges,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,8273.46,78,,,percent of total billed charges,78% of total billed charges,10607,100,,,percent of total billed charges,100% of total billed charges,8761.38,82.6,,,percent of total billed charges,82.6% of total billed charges,8761.38,82.6,,,percent of total billed charges,82.6% of total billed charges,1299.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,738.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,731.28,100,,,Fee Schedule,100% of Medicare OPPS rate,1299.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,731.28,10607,
NM Radiopharm Therapy IV Admin,34279101,CDM,342,RC,79101,HCPCS,Outpatient,,,1788,1162.20,TC,1573.44,88,,,percent of total billed charges,88% of total Billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,281.42,100,,,Fee Schedule,100% of WA Medicaid,1788,100,,,percent of total billed charges,100% of total billed charges,289.87,103,,,Fee Schedule,103% of WA Medicaid,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1126.44,63,,,percent of total billed charges,63% of total billed charges,444.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,281.42,100,,,Fee Schedule,100% of WA Medicaid,273.56,15.3,,,percent of total billed charges,15.3% of total billed charges,1233.72,69,,,percent of total billed charges,69% of total billed charges,1788,100,,,percent of total billed charges,100% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1788,100,,,percent of total billed charges,100% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1788,100,,,percent of total billed charges,100% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1014.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,281.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,208.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,287.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,365.85,130,,,Fee Schedule,130% of WA Medicaid ,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,674.08,37.7,,,percent of total billed charges,37.70% of total billed charges,674.08,37.7,,,percent of total billed charges,37.70% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,606.13,33.9,,,percent of total billed charges,33.9% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1394.64,78,,,percent of total billed charges,78% of total billed charges,1788,100,,,percent of total billed charges,100% of total billed charges,1476.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1476.89,82.6,,,percent of total billed charges,82.6% of total billed charges,281.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,256.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,281.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,208.46,1788,
NM Radiopharm Therapy Oral Admin,34079005,CDM,340,RC,79005,HCPCS,Outpatient,,,1722,1119.30,TC,1515.36,88,,,percent of total billed charges,88% of total Billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,281.42,100,,,Fee Schedule,100% of WA Medicaid,1722,100,,,percent of total billed charges,100% of total billed charges,289.87,103,,,Fee Schedule,103% of WA Medicaid,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1084.86,63,,,percent of total billed charges,63% of total billed charges,444.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,281.42,100,,,Fee Schedule,100% of WA Medicaid,263.47,15.3,,,percent of total billed charges,15.3% of total billed charges,1188.18,69,,,percent of total billed charges,69% of total billed charges,1722,100,,,percent of total billed charges,100% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1722,100,,,percent of total billed charges,100% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1722,100,,,percent of total billed charges,100% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1014.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,281.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,208.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,287.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,365.85,130,,,Fee Schedule,130% of WA Medicaid ,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,649.19,37.7,,,percent of total billed charges,37.70% of total billed charges,649.19,37.7,,,percent of total billed charges,37.70% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,583.76,33.9,,,percent of total billed charges,33.9% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1343.16,78,,,percent of total billed charges,78% of total billed charges,1722,100,,,percent of total billed charges,100% of total billed charges,1422.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1422.37,82.6,,,percent of total billed charges,82.6% of total billed charges,281.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,256.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,281.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,208.46,1722,
NM Radiopharm Therapy Oral Admin EO,34079005,CDM,340,RC,79005,HCPCS,Outpatient,,,1722,1119.30,TC,1515.36,88,,,percent of total billed charges,88% of total Billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,281.42,100,,,Fee Schedule,100% of WA Medicaid,1722,100,,,percent of total billed charges,100% of total billed charges,289.87,103,,,Fee Schedule,103% of WA Medicaid,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1084.86,63,,,percent of total billed charges,63% of total billed charges,444.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,281.42,100,,,Fee Schedule,100% of WA Medicaid,263.47,15.3,,,percent of total billed charges,15.3% of total billed charges,1188.18,69,,,percent of total billed charges,69% of total billed charges,1722,100,,,percent of total billed charges,100% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1722,100,,,percent of total billed charges,100% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1722,100,,,percent of total billed charges,100% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1014.08,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,281.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,208.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,287.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,365.85,130,,,Fee Schedule,130% of WA Medicaid ,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,649.19,37.7,,,percent of total billed charges,37.70% of total billed charges,649.19,37.7,,,percent of total billed charges,37.70% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,583.76,33.9,,,percent of total billed charges,33.9% of total billed charges,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,1343.16,78,,,percent of total billed charges,78% of total billed charges,1722,100,,,percent of total billed charges,100% of total billed charges,1422.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1422.37,82.6,,,percent of total billed charges,82.6% of total billed charges,281.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,256.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,253.75,100,,,Fee Schedule,100% of Medicare OPPS rate,281.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,208.46,1722,
NM Shunt Evaluation CSF,34178645,CDM,341,RC,78645,HCPCS,Outpatient,,,2306,1498.90,TC,2029.28,88,,,percent of total billed charges,88% of total Billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,2306,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1452.78,63,,,percent of total billed charges,63% of total billed charges,964.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,352.82,15.3,,,percent of total billed charges,15.3% of total billed charges,1591.14,69,,,percent of total billed charges,69% of total billed charges,2306,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2306,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2306,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1988.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,869.36,37.7,,,percent of total billed charges,37.70% of total billed charges,869.36,37.7,,,percent of total billed charges,37.70% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,781.73,33.9,,,percent of total billed charges,33.9% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1798.68,78,,,percent of total billed charges,78% of total billed charges,2306,100,,,percent of total billed charges,100% of total billed charges,1904.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1904.76,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,556.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,352.82,2306,
NM Sentinel Node,34178195,CDM,341,RC,78195,HCPCS,Outpatient,,,1615,1049.75,TC,1421.2,88,,,percent of total billed charges,88% of total Billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,1615,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1017.45,63,,,percent of total billed charges,63% of total billed charges,964.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,247.1,15.3,,,percent of total billed charges,15.3% of total billed charges,1114.35,69,,,percent of total billed charges,69% of total billed charges,1615,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1615,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1615,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1988.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,608.86,37.7,,,percent of total billed charges,37.70% of total billed charges,608.86,37.7,,,percent of total billed charges,37.70% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,547.49,33.9,,,percent of total billed charges,33.9% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1259.7,78,,,percent of total billed charges,78% of total billed charges,1615,100,,,percent of total billed charges,100% of total billed charges,1333.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1333.99,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,556.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,247.1,1988.19,
NM Spleen Img w/ or w/o Vascular Flow,34178185,CDM,341,RC,78185,HCPCS,Outpatient,,,1577,1025.05,TC,1387.76,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,1577,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,993.51,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,241.28,15.3,,,percent of total billed charges,15.3% of total billed charges,1088.13,69,,,percent of total billed charges,69% of total billed charges,1577,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1577,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1577,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,594.53,37.7,,,percent of total billed charges,37.70% of total billed charges,594.53,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,534.6,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1230.06,78,,,percent of total billed charges,78% of total billed charges,1577,100,,,percent of total billed charges,100% of total billed charges,1302.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1302.6,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,241.28,1577,
NM Thyroid Cancer Imaging Whole Body,34178018,CDM,341,RC,78018,HCPCS,Outpatient,,,3658,2377.70,TC,3219.04,88,,,percent of total billed charges,88% of total Billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,3658,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2304.54,63,,,percent of total billed charges,63% of total billed charges,964.76,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,559.67,15.3,,,percent of total billed charges,15.3% of total billed charges,2524.02,69,,,percent of total billed charges,69% of total billed charges,3658,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3658,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3658,100,,,percent of total billed charges,100% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1988.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1379.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1379.07,37.7,,,percent of total billed charges,37.70% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,1240.06,33.9,,,percent of total billed charges,33.9% of total billed charges,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2853.24,78,,,percent of total billed charges,78% of total billed charges,3658,100,,,percent of total billed charges,100% of total billed charges,3021.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3021.51,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,556.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,551.29,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,3658,
NM Tumor Loc Spect,34178803,CDM,341,RC,78803,HCPCS,Outpatient,,,5675,3688.75,TC,4994,88,,,percent of total billed charges,88% of total Billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3575.25,63,,,percent of total billed charges,63% of total billed charges,2534.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,868.28,15.3,,,percent of total billed charges,15.3% of total billed charges,3915.75,69,,,percent of total billed charges,69% of total billed charges,5675,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5675,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5675,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2139.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2139.48,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1923.83,33.9,,,percent of total billed charges,33.9% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,4426.5,78,,,percent of total billed charges,78% of total billed charges,5675,100,,,percent of total billed charges,100% of total billed charges,4687.55,82.6,,,percent of total billed charges,82.6% of total billed charges,4687.55,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,643.53,5675,
NM Tumor Loc Limited,34178800,CDM,341,RC,78800,HCPCS,Outpatient,,,3792,2464.80,TC,3336.96,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,3792,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2388.96,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,580.18,15.3,,,percent of total billed charges,15.3% of total billed charges,2616.48,69,,,percent of total billed charges,69% of total billed charges,3792,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3792,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3792,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1429.58,37.7,,,percent of total billed charges,37.70% of total billed charges,1429.58,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1285.49,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2957.76,78,,,percent of total billed charges,78% of total billed charges,3792,100,,,percent of total billed charges,100% of total billed charges,3132.19,82.6,,,percent of total billed charges,82.6% of total billed charges,3132.19,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,420.67,3792,
NM Tumor Loc Multiple Areas,34178801,CDM,341,RC,78801,HCPCS,Outpatient,,,4392,2854.80,TC,3864.96,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4392,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2766.96,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,671.98,15.3,,,percent of total billed charges,15.3% of total billed charges,3030.48,69,,,percent of total billed charges,69% of total billed charges,4392,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4392,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4392,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1655.78,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1488.89,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3425.76,78,,,percent of total billed charges,78% of total billed charges,4392,100,,,percent of total billed charges,100% of total billed charges,3627.79,82.6,,,percent of total billed charges,82.6% of total billed charges,3627.79,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,420.67,4392,
NM Tumor Loc Whole Body 1 Day,34178802,CDM,341,RC,78802,HCPCS,Outpatient,,,4618,3001.70,TC,4063.84,88,,,percent of total billed charges,88% of total Billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4618,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2909.34,63,,,percent of total billed charges,63% of total billed charges,2534.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,706.55,15.3,,,percent of total billed charges,15.3% of total billed charges,3186.42,69,,,percent of total billed charges,69% of total billed charges,4618,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,4618,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,4618,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1740.99,37.7,,,percent of total billed charges,37.70% of total billed charges,1740.99,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1565.5,33.9,,,percent of total billed charges,33.9% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3602.04,78,,,percent of total billed charges,78% of total billed charges,4618,100,,,percent of total billed charges,100% of total billed charges,3814.47,82.6,,,percent of total billed charges,82.6% of total billed charges,3814.47,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,643.53,5305.42,
NM Tumor Loc Whole Body 2+ Days,34178804,CDM,341,RC,78804,HCPCS,Outpatient,,,17590,11433.50,TC,15479.2,88,,,percent of total billed charges,88% of total Billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,11081.7,63,,,percent of total billed charges,63% of total billed charges,2534.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,2691.27,15.3,,,percent of total billed charges,15.3% of total billed charges,12137.1,69,,,percent of total billed charges,69% of total billed charges,17590,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,17590,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,17590,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,6631.43,37.7,,,percent of total billed charges,37.70% of total billed charges,6631.43,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5963.01,33.9,,,percent of total billed charges,33.9% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,13720.2,78,,,percent of total billed charges,78% of total billed charges,17590,100,,,percent of total billed charges,100% of total billed charges,14529.34,82.6,,,percent of total billed charges,82.6% of total billed charges,14529.34,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,643.53,17590,
NM Thyroid Imaging,34078013,CDM,340,RC,78013,HCPCS,Outpatient,,,4135,2687.75,TC,3638.8,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,4135,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2605.05,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,632.66,15.3,,,percent of total billed charges,15.3% of total billed charges,2853.15,69,,,percent of total billed charges,69% of total billed charges,4135,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4135,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4135,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1558.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1558.9,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1401.77,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3225.3,78,,,percent of total billed charges,78% of total billed charges,4135,100,,,percent of total billed charges,100% of total billed charges,3415.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3415.51,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,4135,
NM Thyroid Uptake Single/Multi,34178014,CDM,341,RC,78014,HCPCS,Outpatient,,,4581,2977.65,TC,4031.28,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,4581,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2886.03,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,700.89,15.3,,,percent of total billed charges,15.3% of total billed charges,3160.89,69,,,percent of total billed charges,69% of total billed charges,4581,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4581,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4581,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1727.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1727.04,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1552.96,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3573.18,78,,,percent of total billed charges,78% of total billed charges,4581,100,,,percent of total billed charges,100% of total billed charges,3783.91,82.6,,,percent of total billed charges,82.6% of total billed charges,3783.91,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,4581,
NM Thyroid Image w/Uptk Sng/Mlt Scan,34178014,CDM,341,RC,78014,HCPCS,Outpatient,,,4581,2977.65,TC,4031.28,88,,,percent of total billed charges,88% of total Billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,4581,100,,,percent of total billed charges,100% of total billed charges,356.1,103,,,Fee Schedule,103% of WA Medicaid,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2886.03,63,,,percent of total billed charges,63% of total billed charges,736.17,175,,,Fee Schedule,175% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid,700.89,15.3,,,percent of total billed charges,15.3% of total billed charges,3160.89,69,,,percent of total billed charges,69% of total billed charges,4581,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4581,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4581,100,,,percent of total billed charges,100% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1532.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,256.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,352.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.45,130,,,Fee Schedule,130% of WA Medicaid ,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1727.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1727.04,37.7,,,percent of total billed charges,37.70% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1552.96,33.9,,,percent of total billed charges,33.9% of total billed charges,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3573.18,78,,,percent of total billed charges,78% of total billed charges,4581,100,,,percent of total billed charges,100% of total billed charges,3783.91,82.6,,,percent of total billed charges,82.6% of total billed charges,3783.91,82.6,,,percent of total billed charges,82.6% of total billed charges,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,424.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,420.67,100,,,Fee Schedule,100% of Medicare OPPS rate,345.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.1,4581,
NM Tumor Loc Multiple Areas Spect,34078831,CDM,340,RC,78831,HCPCS,Outpatient,,,4392,2854.80,TC,3864.96,88,,,percent of total billed charges,88% of total Billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,4392,100,,,percent of total billed charges,100% of total billed charges,894.83,103,,,Fee Schedule,103% of WA Medicaid,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,2766.96,63,,,percent of total billed charges,63% of total billed charges,2534.53,175,,,Fee Schedule,175% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid,671.98,15.3,,,percent of total billed charges,15.3% of total billed charges,3030.48,69,,,percent of total billed charges,69% of total billed charges,4392,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,4392,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,4392,100,,,percent of total billed charges,100% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,5305.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,643.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,886.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1129.4,130,,,Fee Schedule,130% of WA Medicaid ,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1655.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1655.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1488.89,33.9,,,percent of total billed charges,33.9% of total billed charges,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,3425.76,78,,,percent of total billed charges,78% of total billed charges,4392,100,,,percent of total billed charges,100% of total billed charges,3627.79,82.6,,,percent of total billed charges,82.6% of total billed charges,3627.79,82.6,,,percent of total billed charges,82.6% of total billed charges,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,1462.78,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1448.31,100,,,Fee Schedule,100% of Medicare OPPS rate,868.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,643.53,5305.42,
PET Brain Imaging Metabolic Evaluation,40478608,CDM,404,RC,78608,HCPCS,Outpatient,,,7123,4629.95,TC,6268.24,88,,,percent of total billed charges,88% of total Billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1215.02,103,,,Fee Schedule,103% of WA Medicaid,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,4487.49,63,,,percent of total billed charges,63% of total billed charges,2792.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid,1089.82,15.3,,,percent of total billed charges,15.3% of total billed charges,4914.87,69,,,percent of total billed charges,69% of total billed charges,7123,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,7123,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,7123,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,6013.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,873.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1533.52,130,,,Fee Schedule,130% of WA Medicaid ,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2685.37,37.7,,,percent of total billed charges,37.70% of total billed charges,2685.37,37.7,,,percent of total billed charges,37.70% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2414.7,33.9,,,percent of total billed charges,33.9% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,5555.94,78,,,percent of total billed charges,78% of total billed charges,7123,100,,,percent of total billed charges,100% of total billed charges,5883.6,82.6,,,percent of total billed charges,82.6% of total billed charges,5883.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1611.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,873.8,7123,
PET CT Limited Area,40478814,CDM,404,RC,78814,HCPCS,Outpatient,,,620,403.00,TC,545.6,88,,,percent of total billed charges,88% of total Billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,percent of total billed charges,100% of total billed charges,1215.02,103,,,Fee Schedule,103% of WA Medicaid,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,390.6,63,,,percent of total billed charges,63% of total billed charges,2792.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid,94.86,15.3,,,percent of total billed charges,15.3% of total billed charges,427.8,69,,,percent of total billed charges,69% of total billed charges,620,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,620,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,620,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,6013.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,873.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1533.52,130,,,Fee Schedule,130% of WA Medicaid ,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,233.74,37.7,,,percent of total billed charges,37.70% of total billed charges,233.74,37.7,,,percent of total billed charges,37.70% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,210.18,33.9,,,percent of total billed charges,33.9% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,483.6,78,,,percent of total billed charges,78% of total billed charges,620,100,,,percent of total billed charges,100% of total billed charges,512.12,82.6,,,percent of total billed charges,82.6% of total billed charges,512.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1611.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.86,6013.92,
PET CT Skull Base to Midthigh,40478815,CDM,404,RC,78815,HCPCS,Outpatient,,,7251,4713.15,TC,6380.88,88,,,percent of total billed charges,88% of total Billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1215.02,103,,,Fee Schedule,103% of WA Medicaid,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,4568.13,63,,,percent of total billed charges,63% of total billed charges,2792.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid,1109.4,15.3,,,percent of total billed charges,15.3% of total billed charges,5003.19,69,,,percent of total billed charges,69% of total billed charges,7251,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,7251,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,7251,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,6013.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,873.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1533.52,130,,,Fee Schedule,130% of WA Medicaid ,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2733.63,37.7,,,percent of total billed charges,37.70% of total billed charges,2733.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2458.09,33.9,,,percent of total billed charges,33.9% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,5655.78,78,,,percent of total billed charges,78% of total billed charges,7251,100,,,percent of total billed charges,100% of total billed charges,5989.33,82.6,,,percent of total billed charges,82.6% of total billed charges,5989.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1611.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,873.8,7251,
PET CT Whole Body,40478816,CDM,404,RC,78816,HCPCS,Outpatient,,,9329,6063.85,TC,8209.52,88,,,percent of total billed charges,88% of total Billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1215.02,103,,,Fee Schedule,103% of WA Medicaid,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,5877.27,63,,,percent of total billed charges,63% of total billed charges,2792.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid,1427.34,15.3,,,percent of total billed charges,15.3% of total billed charges,6437.01,69,,,percent of total billed charges,69% of total billed charges,9329,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,9329,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,9329,100,,,percent of total billed charges,100% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,6013.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,873.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1533.52,130,,,Fee Schedule,130% of WA Medicaid ,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,3517.03,37.7,,,percent of total billed charges,37.70% of total billed charges,3517.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,3162.53,33.9,,,percent of total billed charges,33.9% of total billed charges,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,7276.62,78,,,percent of total billed charges,78% of total billed charges,9329,100,,,percent of total billed charges,100% of total billed charges,7705.75,82.6,,,percent of total billed charges,82.6% of total billed charges,7705.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1611.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1595.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1179.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,873.8,9329,
US Abdomen Complete,40276700,CDM,402,RC,76700,HCPCS,Outpatient,,,1085,705.25,TC,954.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,1085,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,683.55,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,748.65,69,,,percent of total billed charges,69% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1085,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1085,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,367.82,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,846.3,78,,,percent of total billed charges,78% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,1085,
US Abdomen Limited,40276705,CDM,402,RC,76705,HCPCS,Outpatient,,,560,364.00,TC,492.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,560,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,352.8,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,386.4,69,,,percent of total billed charges,69% of total billed charges,560,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,560,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,560,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,211.12,37.7,,,percent of total billed charges,37.70% of total billed charges,211.12,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,189.84,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,436.8,78,,,percent of total billed charges,78% of total billed charges,560,100,,,percent of total billed charges,100% of total billed charges,462.56,82.6,,,percent of total billed charges,82.6% of total billed charges,462.56,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,560,
US Aorta IVC Iliac Duplex Complete,92193978,CDM,921,RC,93978,HCPCS,Outpatient,,,729,473.85,TC,641.52,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,729,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,459.27,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,111.54,15.3,,,percent of total billed charges,15.3% of total billed charges,503.01,69,,,percent of total billed charges,69% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,729,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,729,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,247.13,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,568.62,78,,,percent of total billed charges,78% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.54,934.9,
US Aorta IVC Iliac Duplex Limited,92193979,CDM,921,RC,93979,HCPCS,Outpatient,,,1014,659.10,TC,892.32,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1014,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,638.82,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,155.14,15.3,,,percent of total billed charges,15.3% of total billed charges,699.66,69,,,percent of total billed charges,69% of total billed charges,1014,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1014,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1014,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,382.28,37.7,,,percent of total billed charges,37.70% of total billed charges,382.28,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,343.75,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,790.92,78,,,percent of total billed charges,78% of total billed charges,1014,100,,,percent of total billed charges,100% of total billed charges,837.56,82.6,,,percent of total billed charges,82.6% of total billed charges,837.56,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1014,
US Art/Vein Abd/Pelvis/Scrotal Complete,92193975,CDM,921,RC,93975,HCPCS,Outpatient,,,858,557.70,TC,755.04,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,858,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,540.54,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,131.27,15.3,,,percent of total billed charges,15.3% of total billed charges,592.02,69,,,percent of total billed charges,69% of total billed charges,858,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,858,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,858,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,323.47,37.7,,,percent of total billed charges,37.70% of total billed charges,323.47,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,290.86,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,669.24,78,,,percent of total billed charges,78% of total billed charges,858,100,,,percent of total billed charges,100% of total billed charges,708.71,82.6,,,percent of total billed charges,82.6% of total billed charges,708.71,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,934.9,
US Art/Vein Abd/Pelvis/Scrotal Limited,92193976,CDM,921,RC,93976,HCPCS,Outpatient,,,729,473.85,TC,641.52,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,729,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,459.27,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,111.54,15.3,,,percent of total billed charges,15.3% of total billed charges,503.01,69,,,percent of total billed charges,69% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,729,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,729,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,247.13,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,568.62,78,,,percent of total billed charges,78% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.54,729,
US AAA Screening,40276706,CDM,402,RC,76706,HCPCS,Outpatient,,,1322,859.30,TC,1163.36,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1322,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,832.86,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,912.18,69,,,percent of total billed charges,69% of total billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1322,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1322,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,498.39,37.7,,,percent of total billed charges,37.70% of total billed charges,498.39,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,448.16,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1031.16,78,,,percent of total billed charges,78% of total billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,1091.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1091.97,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1322,
US Axilla,40276882,CDM,402,RC,76882,HCPCS,Outpatient,,,419,272.35,TC,368.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,419,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,263.97,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,289.11,69,,,percent of total billed charges,69% of total billed charges,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,157.96,37.7,,,percent of total billed charges,37.70% of total billed charges,157.96,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,142.04,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,326.82,78,,,percent of total billed charges,78% of total billed charges,419,100,,,percent of total billed charges,100% of total billed charges,346.09,82.6,,,percent of total billed charges,82.6% of total billed charges,346.09,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,442.69,
US Biopsy Renal Left,40250200,CDM,402,RC,50200,HCPCS,Outpatient,,,1520,988.00,TC|LT,1337.6,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,1520,100,,,percent of total billed charges,100% of total billed charges,1400.69,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,957.6,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,1048.8,69,,,percent of total billed charges,69% of total billed charges,1520,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1520,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1520,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1007.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1387.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1767.86,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,573.04,37.7,,,percent of total billed charges,37.70% of total billed charges,573.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,515.28,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1185.6,78,,,percent of total billed charges,78% of total billed charges,1520,100,,,percent of total billed charges,100% of total billed charges,1255.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1255.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,235,5715.97,
US Biopsy Renal Right,40250200,CDM,402,RC,50200,HCPCS,Outpatient,,,1520,988.00,TC|RT,1337.6,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,1520,100,,,percent of total billed charges,100% of total billed charges,1400.69,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,957.6,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,1048.8,69,,,percent of total billed charges,69% of total billed charges,1520,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1520,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1520,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1007.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1387.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1767.86,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,573.04,37.7,,,percent of total billed charges,37.70% of total billed charges,573.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,515.28,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1185.6,78,,,percent of total billed charges,78% of total billed charges,1520,100,,,percent of total billed charges,100% of total billed charges,1255.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1255.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1359.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,235,5715.97,
US Breast Complete Left,40276641,CDM,402,RC,76641,HCPCS,Outpatient,,,677,440.05,TC|LT,595.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Breast Complete Right,40276641,CDM,402,RC,76641,HCPCS,Outpatient,,,677,440.05,RT|TC,595.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Breast Limited Left,40276642,CDM,402,RC,76642,HCPCS,Outpatient,,,677,440.05,TC|LT,595.76,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Breast Limited Right,40276642,CDM,402,RC,76642,HCPCS,Outpatient,,,677,440.05,RT|TC,595.76,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Breast Complete Left.,40276641,CDM,402,RC,76641,HCPCS,Outpatient,,,677,440.05,TC|LT,595.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Breast Complete Right.,40276641,CDM,402,RC,76641,HCPCS,Outpatient,,,677,440.05,TC|RT,595.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Breast Limited Left.,40276641,CDM,402,RC,76641,HCPCS,Outpatient,,,677,440.05,TC|LT,595.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Breast Limited,40276641,CDM,402,RC,76641,HCPCS,Outpatient,,,677,440.05,TC|RT,595.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Breast Complete Left w/ BIRAD.,40276641,CDM,402,RC,76641,HCPCS,Outpatient,,,677,440.05,LT|TC,595.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Breast Complete Right w/ BIRAD.,40276641,CDM,402,RC,76641,HCPCS,Outpatient,,,677,440.05,RT,595.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Breast Limited Left w/ BIRAD.,40276642,CDM,402,RC,76642,HCPCS,Outpatient,,,677,440.05,LT|TC,595.76,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Breast Limited Right w/ BIRAD.,40276642,CDM,402,RC,76642,HCPCS,Outpatient,,,677,440.05,RT|TC,595.76,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,677,
US Carotid Duplex Bilateral,92193880,CDM,921,RC,93880,HCPCS,Outpatient,,,1420,923.00,TC,1249.6,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,1420,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,894.6,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,217.26,15.3,,,percent of total billed charges,15.3% of total billed charges,979.8,69,,,percent of total billed charges,69% of total billed charges,1420,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1420,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1420,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,535.34,37.7,,,percent of total billed charges,37.70% of total billed charges,535.34,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,481.38,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1107.6,78,,,percent of total billed charges,78% of total billed charges,1420,100,,,percent of total billed charges,100% of total billed charges,1172.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1172.92,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,1420,
US Chest,40276604,CDM,402,RC,76604,HCPCS,Outpatient,,,561,364.65,TC,493.68,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,561,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,353.43,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,387.09,69,,,percent of total billed charges,69% of total billed charges,561,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,561,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,561,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,211.5,37.7,,,percent of total billed charges,37.70% of total billed charges,211.5,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,190.18,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,437.58,78,,,percent of total billed charges,78% of total billed charges,561,100,,,percent of total billed charges,100% of total billed charges,463.39,82.6,,,percent of total billed charges,82.6% of total billed charges,463.39,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,561,
US Carotid Duplex Unilat/Limited,92193882,CDM,921,RC,93882,HCPCS,Outpatient,,,1264,821.60,TC,1112.32,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1264,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,796.32,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,193.39,15.3,,,percent of total billed charges,15.3% of total billed charges,872.16,69,,,percent of total billed charges,69% of total billed charges,1264,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1264,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1264,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,476.53,37.7,,,percent of total billed charges,37.70% of total billed charges,476.53,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,428.5,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,985.92,78,,,percent of total billed charges,78% of total billed charges,1264,100,,,percent of total billed charges,100% of total billed charges,1044.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1044.06,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1264,
US Duplex Hemodialysis Access,92193990,CDM,921,RC,93990,HCPCS,Outpatient,,,1197,778.05,TC,1053.36,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1197,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,754.11,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,183.14,15.3,,,percent of total billed charges,15.3% of total billed charges,825.93,69,,,percent of total billed charges,69% of total billed charges,1197,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1197,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,451.27,37.7,,,percent of total billed charges,37.70% of total billed charges,451.27,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,405.78,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,933.66,78,,,percent of total billed charges,78% of total billed charges,1197,100,,,percent of total billed charges,100% of total billed charges,988.72,82.6,,,percent of total billed charges,82.6% of total billed charges,988.72,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1197,
US Encephalogram,40276506,CDM,402,RC,76506,HCPCS,Outpatient,,,794,516.10,TC,698.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,794,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,500.22,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,547.86,69,,,percent of total billed charges,69% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,794,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,794,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,269.17,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,619.32,78,,,percent of total billed charges,78% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,794,
US Extremity Nonvascular Limited Left,40276882,CDM,402,RC,76882,HCPCS,Outpatient,,,419,272.35,TC|LT,368.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,419,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,263.97,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,289.11,69,,,percent of total billed charges,69% of total billed charges,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,157.96,37.7,,,percent of total billed charges,37.70% of total billed charges,157.96,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,142.04,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,326.82,78,,,percent of total billed charges,78% of total billed charges,419,100,,,percent of total billed charges,100% of total billed charges,346.09,82.6,,,percent of total billed charges,82.6% of total billed charges,346.09,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,442.69,
US Extremity Nonvascular Limited Right,40276882,CDM,402,RC,76882,HCPCS,Outpatient,,,419,272.35,TC|RT,368.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,419,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,263.97,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,289.11,69,,,percent of total billed charges,69% of total billed charges,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,157.96,37.7,,,percent of total billed charges,37.70% of total billed charges,157.96,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,142.04,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,326.82,78,,,percent of total billed charges,78% of total billed charges,419,100,,,percent of total billed charges,100% of total billed charges,346.09,82.6,,,percent of total billed charges,82.6% of total billed charges,346.09,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,442.69,
US Extremity Nonvascular Complete Bilat,40276881,CDM,402,RC,76881,HCPCS,Outpatient,,,635,412.75,TC,558.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,635,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,400.05,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,438.15,69,,,percent of total billed charges,69% of total billed charges,635,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,635,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,635,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,239.4,37.7,,,percent of total billed charges,37.70% of total billed charges,239.4,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,215.27,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,495.3,78,,,percent of total billed charges,78% of total billed charges,635,100,,,percent of total billed charges,100% of total billed charges,524.51,82.6,,,percent of total billed charges,82.6% of total billed charges,524.51,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,635,
US Extremity Nonvascular Limited Bilat,40276882,CDM,402,RC,76882,HCPCS,Outpatient,,,419,272.35,TC,368.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,419,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,263.97,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,289.11,69,,,percent of total billed charges,69% of total billed charges,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,419,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,157.96,37.7,,,percent of total billed charges,37.70% of total billed charges,157.96,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,142.04,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,326.82,78,,,percent of total billed charges,78% of total billed charges,419,100,,,percent of total billed charges,100% of total billed charges,346.09,82.6,,,percent of total billed charges,82.6% of total billed charges,346.09,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,442.69,
US Echo 2D Complete,48093306,CDM,480,RC,93306,HCPCS,Outpatient,,,3069,1994.85,TC,2700.72,88,,,percent of total billed charges,88% of total Billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,3069,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1933.47,63,,,percent of total billed charges,63% of total billed charges,984.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,469.56,15.3,,,percent of total billed charges,15.3% of total billed charges,2117.61,69,,,percent of total billed charges,69% of total billed charges,3069,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3069,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3069,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1157.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1157.01,37.7,,,percent of total billed charges,37.70% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1040.39,33.9,,,percent of total billed charges,33.9% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2393.82,78,,,percent of total billed charges,78% of total billed charges,3069,100,,,percent of total billed charges,100% of total billed charges,2534.99,82.6,,,percent of total billed charges,82.6% of total billed charges,2534.99,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,568.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,309.7,3069,
US Echo 2D Limited w/ Contrast,480C8924,CDM,480,RC,C8924,HCPCS,Outpatient,,,954,620.10,,839.52,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,954,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,601.02,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,145.96,15.3,,,percent of total billed charges,15.3% of total billed charges,658.26,69,,,percent of total billed charges,69% of total billed charges,954,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,954,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,954,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,359.66,37.7,,,percent of total billed charges,37.70% of total billed charges,359.66,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,323.41,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,744.12,78,,,percent of total billed charges,78% of total billed charges,954,100,,,percent of total billed charges,100% of total billed charges,788,82.6,,,percent of total billed charges,82.6% of total billed charges,788,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,145.96,1495.48,
US Echo Doppler Complete,48093320,CDM,480,RC,93320,HCPCS,Outpatient,,,607,394.55,TC,534.16,88,,,percent of total billed charges,88% of total Billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid,607,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,303.5,50,,,percent of total billed charges,50% of total Billed charges,382.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,418.1,100,,,Fee Schedule,100% of WA Medicaid,92.87,15.3,,,percent of total billed charges,15.3% of total billed charges,418.83,69,,,percent of total billed charges,69% of total billed charges,607,100,,,percent of total billed charges,100% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,607,100,,,percent of total billed charges,100% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,607,100,,,percent of total billed charges,100% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,375.43,61.85,,,percent of total billed charges,61.85% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,303.5,50,,,percent of total billed charges,50% of total Billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,303.5,50,,,percent of total billed charges,50% of total Billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,303.5,50,,,percent of total billed charges,50% of total Billed charges,228.84,37.7,,,percent of total billed charges,37.70% of total billed charges,228.84,37.7,,,percent of total billed charges,37.70% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,205.77,33.9,,,percent of total billed charges,33.9% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,473.46,78,,,percent of total billed charges,78% of total billed charges,607,100,,,percent of total billed charges,100% of total billed charges,501.38,82.6,,,percent of total billed charges,82.6% of total billed charges,501.38,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,303.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,303.5,50,,,percent of total billed charges,50% of total Billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,92.87,607,
US Echocardiogram Complete w/ Color,48093306,CDM,480,RC,93306,HCPCS,Outpatient,,,3069,1994.85,TC,2700.72,88,,,percent of total billed charges,88% of total Billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,3069,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1933.47,63,,,percent of total billed charges,63% of total billed charges,984.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,469.56,15.3,,,percent of total billed charges,15.3% of total billed charges,2117.61,69,,,percent of total billed charges,69% of total billed charges,3069,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3069,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3069,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1157.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1157.01,37.7,,,percent of total billed charges,37.70% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1040.39,33.9,,,percent of total billed charges,33.9% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2393.82,78,,,percent of total billed charges,78% of total billed charges,3069,100,,,percent of total billed charges,100% of total billed charges,2534.99,82.6,,,percent of total billed charges,82.6% of total billed charges,2534.99,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,568.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,309.7,3069,
US Echo 2D Limited,48093308,CDM,480,RC,93308,HCPCS,Outpatient,,,858,557.70,TC,755.04,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,858,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,540.54,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,131.27,15.3,,,percent of total billed charges,15.3% of total billed charges,592.02,69,,,percent of total billed charges,69% of total billed charges,858,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,858,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,858,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,323.47,37.7,,,percent of total billed charges,37.70% of total billed charges,323.47,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,290.86,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,669.24,78,,,percent of total billed charges,78% of total billed charges,858,100,,,percent of total billed charges,100% of total billed charges,708.71,82.6,,,percent of total billed charges,82.6% of total billed charges,708.71,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.27,934.9,
US Echo Congenital Complete,48393303,CDM,483,RC,93303,HCPCS,Outpatient,,,2283,1483.95,TC,2009.04,88,,,percent of total billed charges,88% of total Billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,2283,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1438.29,63,,,percent of total billed charges,63% of total billed charges,984.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,349.3,15.3,,,percent of total billed charges,15.3% of total billed charges,1575.27,69,,,percent of total billed charges,69% of total billed charges,2283,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2283,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2283,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,860.69,37.7,,,percent of total billed charges,37.70% of total billed charges,860.69,37.7,,,percent of total billed charges,37.70% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,773.94,33.9,,,percent of total billed charges,33.9% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1780.74,78,,,percent of total billed charges,78% of total billed charges,2283,100,,,percent of total billed charges,100% of total billed charges,1885.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1885.76,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,568.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,309.7,2283,
US Echo Congenital Limited,48093304,CDM,480,RC,93304,HCPCS,Outpatient,,,1873,1217.45,TC,1648.24,88,,,percent of total billed charges,88% of total Billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,1873,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1179.99,63,,,percent of total billed charges,63% of total billed charges,984.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,286.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1292.37,69,,,percent of total billed charges,69% of total billed charges,1873,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1873,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1873,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,706.12,37.7,,,percent of total billed charges,37.70% of total billed charges,706.12,37.7,,,percent of total billed charges,37.70% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,634.95,33.9,,,percent of total billed charges,33.9% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1460.94,78,,,percent of total billed charges,78% of total billed charges,1873,100,,,percent of total billed charges,100% of total billed charges,1547.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1547.1,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,568.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,286.57,1961.75,
US Echo Doppler Limited,48093321,CDM,480,RC,93321,HCPCS,Outpatient,,,416,270.40,TC,366.08,88,,,percent of total billed charges,88% of total Billed charges,208,50,,,percent of total billed charges,50% of total Billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid,416,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,208,50,,,percent of total billed charges,50% of total Billed charges,262.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,418.1,100,,,Fee Schedule,100% of WA Medicaid,63.65,15.3,,,percent of total billed charges,15.3% of total billed charges,287.04,69,,,percent of total billed charges,69% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,208,50,,,percent of total billed charges,50% of total Billed charges,416,100,,,percent of total billed charges,100% of total billed charges,208,50,,,percent of total billed charges,50% of total Billed charges,416,100,,,percent of total billed charges,100% of total billed charges,208,50,,,percent of total billed charges,50% of total Billed charges,257.3,61.85,,,percent of total billed charges,61.85% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,208,50,,,percent of total billed charges,50% of total Billed charges,208,50,,,percent of total billed charges,50% of total Billed charges,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,208,50,,,percent of total billed charges,50% of total Billed charges,208,50,,,percent of total billed charges,50% of total Billed charges,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,208,50,,,percent of total billed charges,50% of total Billed charges,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,208,50,,,percent of total billed charges,50% of total Billed charges,141.02,33.9,,,percent of total billed charges,33.9% of total billed charges,208,50,,,percent of total billed charges,50% of total Billed charges,324.48,78,,,percent of total billed charges,78% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,208,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,208,50,,,percent of total billed charges,50% of total Billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.65,543.53,
US Echo w/ Contrast Comp w/ Color Dopp,483C8929,CDM,483,RC,C8929,HCPCS,Outpatient,,,3328,2163.20,TC,2928.64,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,3328,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2096.64,63,,,percent of total billed charges,63% of total billed charges,1429.15,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,509.18,15.3,,,percent of total billed charges,15.3% of total billed charges,2296.32,69,,,percent of total billed charges,69% of total billed charges,3328,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3328,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3328,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.43,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1254.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1254.66,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1128.19,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2595.84,78,,,percent of total billed charges,78% of total billed charges,3328,100,,,percent of total billed charges,100% of total billed charges,2748.93,82.6,,,percent of total billed charges,82.6% of total billed charges,2748.93,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,309.7,3328,
US Echo TEE,48093312,CDM,480,RC,93312,HCPCS,Outpatient,,,2283,1483.95,TC,2009.04,88,,,percent of total billed charges,88% of total Billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,2283,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1438.29,63,,,percent of total billed charges,63% of total billed charges,984.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,349.3,15.3,,,percent of total billed charges,15.3% of total billed charges,1575.27,69,,,percent of total billed charges,69% of total billed charges,2283,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2283,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,2283,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,860.69,37.7,,,percent of total billed charges,37.70% of total billed charges,860.69,37.7,,,percent of total billed charges,37.70% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,773.94,33.9,,,percent of total billed charges,33.9% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1780.74,78,,,percent of total billed charges,78% of total billed charges,2283,100,,,percent of total billed charges,100% of total billed charges,1885.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1885.76,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,568.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,309.7,2283,
US Echo TEE Congenital Anomalie,48093315,CDM,480,RC,93315,HCPCS,Outpatient,,,1625,1056.25,TC,1430,88,,,percent of total billed charges,88% of total Billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,1625,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1023.75,63,,,percent of total billed charges,63% of total billed charges,984.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,248.63,15.3,,,percent of total billed charges,15.3% of total billed charges,1121.25,69,,,percent of total billed charges,69% of total billed charges,1625,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1625,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1625,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,612.63,37.7,,,percent of total billed charges,37.70% of total billed charges,612.63,37.7,,,percent of total billed charges,37.70% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,550.88,33.9,,,percent of total billed charges,33.9% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1267.5,78,,,percent of total billed charges,78% of total billed charges,1625,100,,,percent of total billed charges,100% of total billed charges,1342.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1342.25,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,568.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,248.63,1961.75,
US Fetal Biophysical Profile w/ Non-Str,40276818,CDM,402,RC,76818,HCPCS,Outpatient,,,519,337.35,TC,456.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,519,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,326.97,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,358.11,69,,,percent of total billed charges,69% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,175.94,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,404.82,78,,,percent of total billed charges,78% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,519,
US Fetal Biophysical Profile w/o N-Str,40276818,CDM,402,RC,76818,HCPCS,Outpatient,,,519,337.35,TC,456.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,519,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,326.97,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,358.11,69,,,percent of total billed charges,69% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,175.94,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,404.82,78,,,percent of total billed charges,78% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,519,
US Guided Vascular Access,40276937,CDM,402,RC,76937,HCPCS,Outpatient,,,1242,807.30,TC,1092.96,88,,,percent of total billed charges,88% of total Billed charges,621,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid,1242,100,,,percent of total billed charges,100% of total billed charges,105.01,103,,,Fee Schedule,103% of WA Medicaid,621,50,,,percent of total billed charges,50% of total Billed charges,782.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,101.95,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,856.98,69,,,percent of total billed charges,69% of total billed charges,1242,100,,,percent of total billed charges,100% of total billed charges,621,50,,,percent of total billed charges,50% of total Billed charges,1242,100,,,percent of total billed charges,100% of total billed charges,621,50,,,percent of total billed charges,50% of total Billed charges,1242,100,,,percent of total billed charges,100% of total billed charges,621,50,,,percent of total billed charges,50% of total Billed charges,768.18,61.85,,,percent of total billed charges,61.85% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,621,50,,,percent of total billed charges,50% of total Billed charges,621,50,,,percent of total billed charges,50% of total Billed charges,75.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,621,50,,,percent of total billed charges,50% of total Billed charges,621,50,,,percent of total billed charges,50% of total Billed charges,103.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.54,130,,,Fee Schedule,130% of WA Medicaid ,621,50,,,percent of total billed charges,50% of total Billed charges,468.23,37.7,,,percent of total billed charges,37.70% of total billed charges,468.23,37.7,,,percent of total billed charges,37.70% of total billed charges,621,50,,,percent of total billed charges,50% of total Billed charges,421.04,33.9,,,percent of total billed charges,33.9% of total billed charges,621,50,,,percent of total billed charges,50% of total Billed charges,968.76,78,,,percent of total billed charges,78% of total billed charges,1242,100,,,percent of total billed charges,100% of total billed charges,1025.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1025.89,82.6,,,percent of total billed charges,82.6% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,621,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,621,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.52,1242,
US Guided Amniocentesis,40276946,CDM,402,RC,76946,HCPCS,Outpatient,,,698,453.70,TC,614.24,88,,,percent of total billed charges,88% of total Billed charges,349,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid,698,100,,,percent of total billed charges,100% of total billed charges,105.01,103,,,Fee Schedule,103% of WA Medicaid,349,50,,,percent of total billed charges,50% of total Billed charges,439.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,101.95,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,481.62,69,,,percent of total billed charges,69% of total billed charges,698,100,,,percent of total billed charges,100% of total billed charges,349,50,,,percent of total billed charges,50% of total Billed charges,698,100,,,percent of total billed charges,100% of total billed charges,349,50,,,percent of total billed charges,50% of total Billed charges,698,100,,,percent of total billed charges,100% of total billed charges,349,50,,,percent of total billed charges,50% of total Billed charges,431.71,61.85,,,percent of total billed charges,61.85% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,349,50,,,percent of total billed charges,50% of total Billed charges,349,50,,,percent of total billed charges,50% of total Billed charges,75.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,349,50,,,percent of total billed charges,50% of total Billed charges,349,50,,,percent of total billed charges,50% of total Billed charges,103.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.54,130,,,Fee Schedule,130% of WA Medicaid ,349,50,,,percent of total billed charges,50% of total Billed charges,263.15,37.7,,,percent of total billed charges,37.70% of total billed charges,263.15,37.7,,,percent of total billed charges,37.70% of total billed charges,349,50,,,percent of total billed charges,50% of total Billed charges,236.62,33.9,,,percent of total billed charges,33.9% of total billed charges,349,50,,,percent of total billed charges,50% of total Billed charges,544.44,78,,,percent of total billed charges,78% of total billed charges,698,100,,,percent of total billed charges,100% of total billed charges,576.55,82.6,,,percent of total billed charges,82.6% of total billed charges,576.55,82.6,,,percent of total billed charges,82.6% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,349,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,349,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.52,698,
US Guided Needle Placement,40276942,CDM,402,RC,76942,HCPCS,Outpatient,,,1088,707.20,TC,957.44,88,,,percent of total billed charges,88% of total Billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid,1088,100,,,percent of total billed charges,100% of total billed charges,105.01,103,,,Fee Schedule,103% of WA Medicaid,544,50,,,percent of total billed charges,50% of total Billed charges,685.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,101.95,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,750.72,69,,,percent of total billed charges,69% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,672.93,61.85,,,percent of total billed charges,61.85% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,544,50,,,percent of total billed charges,50% of total Billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,75.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,544,50,,,percent of total billed charges,50% of total Billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,103.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.54,130,,,Fee Schedule,130% of WA Medicaid ,544,50,,,percent of total billed charges,50% of total Billed charges,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,368.83,33.9,,,percent of total billed charges,33.9% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,848.64,78,,,percent of total billed charges,78% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,544,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,544,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.52,1088,
US Guided Foreign Body Removal,40210120,CDM,402,RC,10120,HCPCS,Outpatient,,,1273,827.45,TC,1120.24,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,1273,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,801.99,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,878.37,69,,,percent of total billed charges,69% of total billed charges,1273,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1273,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1273,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,479.92,37.7,,,percent of total billed charges,37.70% of total billed charges,479.92,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,431.55,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,992.94,78,,,percent of total billed charges,78% of total billed charges,1273,100,,,percent of total billed charges,100% of total billed charges,1051.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1051.5,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,109.13,1404.97,
US Guided Breast Biopsy Left,40219083,CDM,402,RC,19083,HCPCS,Outpatient,,,4248,2761.20,LT,3738.24,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,4248,100,,,percent of total billed charges,100% of total billed charges,1298.41,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2676.24,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,2931.12,69,,,percent of total billed charges,69% of total billed charges,4248,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4248,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4248,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,933.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1285.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1638.77,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1601.5,37.7,,,percent of total billed charges,37.70% of total billed charges,1601.5,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1440.07,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3313.44,78,,,percent of total billed charges,78% of total billed charges,4248,100,,,percent of total billed charges,100% of total billed charges,3508.85,82.6,,,percent of total billed charges,82.6% of total billed charges,3508.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,235,5715.97,
US Guided Breast Biopsy Right,40219083,CDM,402,RC,19083,HCPCS,Outpatient,,,4248,2761.20,RT,3738.24,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,4248,100,,,percent of total billed charges,100% of total billed charges,1298.41,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2676.24,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,2931.12,69,,,percent of total billed charges,69% of total billed charges,4248,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4248,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4248,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,933.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1285.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1638.77,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1601.5,37.7,,,percent of total billed charges,37.70% of total billed charges,1601.5,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1440.07,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3313.44,78,,,percent of total billed charges,78% of total billed charges,4248,100,,,percent of total billed charges,100% of total billed charges,3508.85,82.6,,,percent of total billed charges,82.6% of total billed charges,3508.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1260.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,235,5715.97,
US Guided Liver Biopsy,92147000,CDM,921,RC,47000,HCPCS,Outpatient,,,4042,2627.30,TC,3556.96,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,4042,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,2546.46,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,618.43,15.3,,,percent of total billed charges,15.3% of total billed charges,2788.98,69,,,percent of total billed charges,69% of total billed charges,4042,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4042,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,4042,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1523.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1523.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1370.24,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,3152.76,78,,,percent of total billed charges,78% of total billed charges,4042,100,,,percent of total billed charges,100% of total billed charges,3338.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3338.69,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,493.23,5715.97,
US Guided Pancreas Biopsy,38648102,CDM,386,RC,48102,HCPCS,Outpatient,,,1276,829.40,TC,1122.88,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,1276,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,803.88,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,195.23,15.3,,,percent of total billed charges,15.3% of total billed charges,880.44,69,,,percent of total billed charges,69% of total billed charges,1276,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1276,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1276,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,481.05,37.7,,,percent of total billed charges,37.70% of total billed charges,481.05,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,432.56,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,995.28,78,,,percent of total billed charges,78% of total billed charges,1276,100,,,percent of total billed charges,100% of total billed charges,1053.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1053.98,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.23,5715.97,
US Guided Thyroid Biopsy,35260100,CDM,402,RC,60100,HCPCS,Outpatient,,,1936,1258.40,,1703.68,88,,,percent of total billed charges,88% of total Billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,568.92,100,,,Fee Schedule,100% of WA Medicaid,1936,100,,,percent of total billed charges,100% of total billed charges,585.99,103,,,Fee Schedule,103% of WA Medicaid,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1219.68,63,,,percent of total billed charges,63% of total billed charges,1255.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,568.92,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,1335.84,69,,,percent of total billed charges,69% of total billed charges,1936,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1936,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1936,100,,,percent of total billed charges,100% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2526.76,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,568.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,421.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,580.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,739.6,130,,,Fee Schedule,130% of WA Medicaid ,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,729.87,37.7,,,percent of total billed charges,37.70% of total billed charges,729.87,37.7,,,percent of total billed charges,37.70% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,656.3,33.9,,,percent of total billed charges,33.9% of total billed charges,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1510.08,78,,,percent of total billed charges,78% of total billed charges,1936,100,,,percent of total billed charges,100% of total billed charges,1599.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1599.14,82.6,,,percent of total billed charges,82.6% of total billed charges,568.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,724.79,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,717.61,100,,,Fee Schedule,100% of Medicare OPPS rate,568.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,235,2526.76,
US Head/Neck Soft Tissue,40276536,CDM,402,RC,76536,HCPCS,Outpatient,,,553,359.45,TC,486.64,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,553,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,348.39,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,381.57,69,,,percent of total billed charges,69% of total billed charges,553,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,553,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,553,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,208.48,37.7,,,percent of total billed charges,37.70% of total billed charges,208.48,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,187.47,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,431.34,78,,,percent of total billed charges,78% of total billed charges,553,100,,,percent of total billed charges,100% of total billed charges,456.78,82.6,,,percent of total billed charges,82.6% of total billed charges,456.78,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,553,
US Hips Infant Dynamic,40276885,CDM,402,RC,76885,HCPCS,Outpatient,,,572,371.80,TC,503.36,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,572,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,360.36,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,394.68,69,,,percent of total billed charges,69% of total billed charges,572,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,572,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,572,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,215.64,37.7,,,percent of total billed charges,37.70% of total billed charges,215.64,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,193.91,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,446.16,78,,,percent of total billed charges,78% of total billed charges,572,100,,,percent of total billed charges,100% of total billed charges,472.47,82.6,,,percent of total billed charges,82.6% of total billed charges,472.47,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,572,
US Hysterosonogram,40276831,CDM,402,RC,76831,HCPCS,Outpatient,,,599,389.35,TC,527.12,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,599,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,377.37,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,413.31,69,,,percent of total billed charges,69% of total billed charges,599,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,599,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,599,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,225.82,37.7,,,percent of total billed charges,37.70% of total billed charges,225.82,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,203.06,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,467.22,78,,,percent of total billed charges,78% of total billed charges,599,100,,,percent of total billed charges,100% of total billed charges,494.77,82.6,,,percent of total billed charges,82.6% of total billed charges,494.77,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,934.9,
US Intraoperative,40276998,CDM,402,RC,76998,HCPCS,Outpatient,,,1151,748.15,TC,1012.88,88,,,percent of total billed charges,88% of total Billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid,1151,100,,,percent of total billed charges,100% of total billed charges,105.01,103,,,Fee Schedule,103% of WA Medicaid,575.5,50,,,percent of total billed charges,50% of total Billed charges,725.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,101.95,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,794.19,69,,,percent of total billed charges,69% of total billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,711.89,61.85,,,percent of total billed charges,61.85% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,575.5,50,,,percent of total billed charges,50% of total Billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,75.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,575.5,50,,,percent of total billed charges,50% of total Billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,103.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.54,130,,,Fee Schedule,130% of WA Medicaid ,575.5,50,,,percent of total billed charges,50% of total Billed charges,433.93,37.7,,,percent of total billed charges,37.70% of total billed charges,433.93,37.7,,,percent of total billed charges,37.70% of total billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,390.19,33.9,,,percent of total billed charges,33.9% of total billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,897.78,78,,,percent of total billed charges,78% of total billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,950.73,82.6,,,percent of total billed charges,82.6% of total billed charges,950.73,82.6,,,percent of total billed charges,82.6% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,575.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575.5,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.52,1151,
US Intraoperative EO,40276998,CDM,402,RC,76998,HCPCS,Outpatient,,,1151,748.15,TC,1012.88,88,,,percent of total billed charges,88% of total Billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid,1151,100,,,percent of total billed charges,100% of total billed charges,105.01,103,,,Fee Schedule,103% of WA Medicaid,575.5,50,,,percent of total billed charges,50% of total Billed charges,725.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,101.95,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,794.19,69,,,percent of total billed charges,69% of total billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,711.89,61.85,,,percent of total billed charges,61.85% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,575.5,50,,,percent of total billed charges,50% of total Billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,75.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,575.5,50,,,percent of total billed charges,50% of total Billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,103.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.54,130,,,Fee Schedule,130% of WA Medicaid ,575.5,50,,,percent of total billed charges,50% of total Billed charges,433.93,37.7,,,percent of total billed charges,37.70% of total billed charges,433.93,37.7,,,percent of total billed charges,37.70% of total billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,390.19,33.9,,,percent of total billed charges,33.9% of total billed charges,575.5,50,,,percent of total billed charges,50% of total Billed charges,897.78,78,,,percent of total billed charges,78% of total billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,950.73,82.6,,,percent of total billed charges,82.6% of total billed charges,950.73,82.6,,,percent of total billed charges,82.6% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,575.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575.5,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.52,1151,
US Kidney Transplant w/ Doppler,40276776,CDM,402,RC,76776,HCPCS,Outpatient,,,519,337.35,TC,456.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,519,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,326.97,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,358.11,69,,,percent of total billed charges,69% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,175.94,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,404.82,78,,,percent of total billed charges,78% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,519,
US Lower Ext Arterial Duplex Bilateral,92193925,CDM,921,RC,93925,HCPCS,Outpatient,,,917,596.05,TC,806.96,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,917,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,577.71,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,140.3,15.3,,,percent of total billed charges,15.3% of total billed charges,632.73,69,,,percent of total billed charges,69% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,917,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,917,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,310.86,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,715.26,78,,,percent of total billed charges,78% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,934.9,
US Lower Ext Arterial Duplex Left,92193926,CDM,921,RC,93926,HCPCS,Outpatient,,,598,388.70,TC|LT,526.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,598,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,376.74,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,91.49,15.3,,,percent of total billed charges,15.3% of total billed charges,412.62,69,,,percent of total billed charges,69% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,598,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,598,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,202.72,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,466.44,78,,,percent of total billed charges,78% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,598,
US Lower Ext Arterial Duplex Right,40293926,CDM,921,RC,93926,HCPCS,Outpatient,,,598,388.70,TC|RT,526.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,598,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,376.74,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,91.49,15.3,,,percent of total billed charges,15.3% of total billed charges,412.62,69,,,percent of total billed charges,69% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,598,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,598,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,202.72,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,466.44,78,,,percent of total billed charges,78% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,598,
US Lower Ext Venous Duplex Bilateral,92193970,CDM,921,RC,93970,HCPCS,Outpatient,,,1870,1215.50,TC,1645.6,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,1870,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1178.1,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,286.11,15.3,,,percent of total billed charges,15.3% of total billed charges,1290.3,69,,,percent of total billed charges,69% of total billed charges,1870,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1870,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1870,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,704.99,37.7,,,percent of total billed charges,37.70% of total billed charges,704.99,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,633.93,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1458.6,78,,,percent of total billed charges,78% of total billed charges,1870,100,,,percent of total billed charges,100% of total billed charges,1544.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1544.62,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,1870,
US Lower Ext Venous Duplex Left,92193971,CDM,921,RC,93971,HCPCS,Outpatient,,,1377,895.05,TC|LT,1211.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1377,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,867.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,210.68,15.3,,,percent of total billed charges,15.3% of total billed charges,950.13,69,,,percent of total billed charges,69% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,466.8,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.06,78,,,percent of total billed charges,78% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1377,
US Lower Ext Venous Duplex Right,92193971,CDM,921,RC,93971,HCPCS,Outpatient,,,1377,895.05,TC|RT,1211.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1377,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,867.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,210.68,15.3,,,percent of total billed charges,15.3% of total billed charges,950.13,69,,,percent of total billed charges,69% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,466.8,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.06,78,,,percent of total billed charges,78% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1377,
US LE Eval Venous Insufficiency Bilat,92193970,CDM,921,RC,93970,HCPCS,Outpatient,,,1870,1215.50,TC,1645.6,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,1870,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1178.1,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,286.11,15.3,,,percent of total billed charges,15.3% of total billed charges,1290.3,69,,,percent of total billed charges,69% of total billed charges,1870,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1870,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1870,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,704.99,37.7,,,percent of total billed charges,37.70% of total billed charges,704.99,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,633.93,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1458.6,78,,,percent of total billed charges,78% of total billed charges,1870,100,,,percent of total billed charges,100% of total billed charges,1544.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1544.62,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,1870,
US LE Eval Venous Insufficiency Left,92193971,CDM,921,RC,93971,HCPCS,Outpatient,,,1377,895.05,LT,1211.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1377,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,867.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,210.68,15.3,,,percent of total billed charges,15.3% of total billed charges,950.13,69,,,percent of total billed charges,69% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,466.8,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.06,78,,,percent of total billed charges,78% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1377,
US LE Eval Venous Insufficiency Right,92193971,CDM,921,RC,93971,HCPCS,Outpatient,,,1377,895.05,RT|TC,1211.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1377,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,867.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,210.68,15.3,,,percent of total billed charges,15.3% of total billed charges,950.13,69,,,percent of total billed charges,69% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,466.8,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.06,78,,,percent of total billed charges,78% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1377,
US OB Less Thn 14 wks w/TVS if indicated,40276801,CDM,402,RC,76801,HCPCS,Outpatient,,,519,337.35,TC,456.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,519,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,326.97,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,358.11,69,,,percent of total billed charges,69% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,175.94,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,404.82,78,,,percent of total billed charges,78% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,519,
US OB Greater Than 14 Weeks,40276805,CDM,402,RC,76805,HCPCS,Outpatient,,,995,646.75,TC,875.6,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,995,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,626.85,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,686.55,69,,,percent of total billed charges,69% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,995,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,337.31,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,776.1,78,,,percent of total billed charges,78% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,995,
US OB Follow Up,40276816,CDM,402,RC,76816,HCPCS,Outpatient,,,962,625.30,TC,846.56,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,962,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,606.06,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,663.78,69,,,percent of total billed charges,69% of total billed charges,962,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,962,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,962,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,362.67,37.7,,,percent of total billed charges,37.70% of total billed charges,362.67,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,326.12,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,750.36,78,,,percent of total billed charges,78% of total billed charges,962,100,,,percent of total billed charges,100% of total billed charges,794.61,82.6,,,percent of total billed charges,82.6% of total billed charges,794.61,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,962,
US OB Limited,40276815,CDM,402,RC,76815,HCPCS,Outpatient,,,519,337.35,TC,456.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,519,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,326.97,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,358.11,69,,,percent of total billed charges,69% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,175.94,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,404.82,78,,,percent of total billed charges,78% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,519,
US OB Nuchal Measure 1st Trimester,40276813,CDM,402,RC,76813,HCPCS,Outpatient,,,920,598.00,TC,809.6,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,920,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,579.6,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,634.8,69,,,percent of total billed charges,69% of total billed charges,920,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,920,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,920,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,346.84,37.7,,,percent of total billed charges,37.70% of total billed charges,346.84,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,311.88,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,717.6,78,,,percent of total billed charges,78% of total billed charges,920,100,,,percent of total billed charges,100% of total billed charges,759.92,82.6,,,percent of total billed charges,82.6% of total billed charges,759.92,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,920,
US OB Limited w/ Biophysical Profile,40276815,CDM,402,RC,76815,HCPCS,Outpatient,,,675,438.75,TC,594,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,675,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,425.25,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,465.75,69,,,percent of total billed charges,69% of total billed charges,675,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,675,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,675,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,254.48,37.7,,,percent of total billed charges,37.70% of total billed charges,254.48,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,228.83,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,526.5,78,,,percent of total billed charges,78% of total billed charges,675,100,,,percent of total billed charges,100% of total billed charges,557.55,82.6,,,percent of total billed charges,82.6% of total billed charges,557.55,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,675,
US Paracentesis,40249083,CDM,402,RC,49083,HCPCS,Outpatient,,,1880,1222.00,TC,1654.4,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,1880,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1184.4,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,1297.2,69,,,percent of total billed charges,69% of total billed charges,1880,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1880,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1880,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,708.76,37.7,,,percent of total billed charges,37.70% of total billed charges,708.76,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,637.32,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1466.4,78,,,percent of total billed charges,78% of total billed charges,1880,100,,,percent of total billed charges,100% of total billed charges,1552.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1552.88,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,235,3289.02,
US Pelvis Comp w/Transvag if indicated,40276856,CDM,402,RC,76856,HCPCS,Outpatient,,,1010,656.50,TC,888.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,1010,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,636.3,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,696.9,69,,,percent of total billed charges,69% of total billed charges,1010,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1010,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1010,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,380.77,37.7,,,percent of total billed charges,37.70% of total billed charges,380.77,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,342.39,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,787.8,78,,,percent of total billed charges,78% of total billed charges,1010,100,,,percent of total billed charges,100% of total billed charges,834.26,82.6,,,percent of total billed charges,82.6% of total billed charges,834.26,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,1010,
US Pelvis Ltd w/Transvag if indicated,40276857,CDM,402,RC,76857,HCPCS,Outpatient,,,483,313.95,TC,425.04,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,483,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,304.29,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,333.27,69,,,percent of total billed charges,69% of total billed charges,483,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,483,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,483,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,182.09,37.7,,,percent of total billed charges,37.70% of total billed charges,182.09,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,163.74,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,376.74,78,,,percent of total billed charges,78% of total billed charges,483,100,,,percent of total billed charges,100% of total billed charges,398.96,82.6,,,percent of total billed charges,82.6% of total billed charges,398.96,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,483,
US Pseudoaneurysm Compression Repair,40276936,CDM,402,RC,76936,HCPCS,Outpatient,,,2872,1866.80,TC,2527.36,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,161.97,100,,,Fee Schedule,100% of WA Medicaid,2872,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1809.36,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,161.97,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,1981.68,69,,,percent of total billed charges,69% of total billed charges,2872,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,2872,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,2872,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1082.74,37.7,,,percent of total billed charges,37.70% of total billed charges,1082.74,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,973.61,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,2240.16,78,,,percent of total billed charges,78% of total billed charges,2872,100,,,percent of total billed charges,100% of total billed charges,2372.27,82.6,,,percent of total billed charges,82.6% of total billed charges,2372.27,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,2872,
US Retroperitoneal Complete,40276770,CDM,402,RC,76770,HCPCS,Outpatient,,,1289,837.85,TC,1134.32,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,1289,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,812.07,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,889.41,69,,,percent of total billed charges,69% of total billed charges,1289,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1289,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1289,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,485.95,37.7,,,percent of total billed charges,37.70% of total billed charges,485.95,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,436.97,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1005.42,78,,,percent of total billed charges,78% of total billed charges,1289,100,,,percent of total billed charges,100% of total billed charges,1064.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1064.71,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,1289,
US Retroperitoneal Limited,40276775,CDM,402,RC,76775,HCPCS,Outpatient,,,851,553.15,TC,748.88,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,851,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,536.13,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,587.19,69,,,percent of total billed charges,69% of total billed charges,851,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,851,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,851,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,320.83,37.7,,,percent of total billed charges,37.70% of total billed charges,320.83,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,288.49,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,663.78,78,,,percent of total billed charges,78% of total billed charges,851,100,,,percent of total billed charges,100% of total billed charges,702.93,82.6,,,percent of total billed charges,82.6% of total billed charges,702.93,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,851,
US Segmental Pressures LE 3+ Lvls Bilat,92193923,CDM,921,RC,93923,HCPCS,Outpatient,,,917,596.05,TC,806.96,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,917,100,,,percent of total billed charges,100% of total billed charges,155.52,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,577.71,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,140.3,15.3,,,percent of total billed charges,15.3% of total billed charges,632.73,69,,,percent of total billed charges,69% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,917,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,917,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,111.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,154.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.29,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,310.86,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,715.26,78,,,percent of total billed charges,78% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.84,917,
US Segmental Pressures LE 1-2 Lvls Bilat,92193922,CDM,921,RC,93922,HCPCS,Outpatient,,,637,414.05,TC,560.56,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,637,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,401.31,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,97.46,15.3,,,percent of total billed charges,15.3% of total billed charges,439.53,69,,,percent of total billed charges,69% of total billed charges,637,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,637,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,637,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,240.15,37.7,,,percent of total billed charges,37.70% of total billed charges,240.15,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,215.94,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,496.86,78,,,percent of total billed charges,78% of total billed charges,637,100,,,percent of total billed charges,100% of total billed charges,526.16,82.6,,,percent of total billed charges,82.6% of total billed charges,526.16,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,637,
US Scrotum (Contents) w/ Doppler if ind,40276870,CDM,402,RC,76870,HCPCS,Outpatient,,,968,629.20,TC,851.84,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,968,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,609.84,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,667.92,69,,,percent of total billed charges,69% of total billed charges,968,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,968,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,968,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,364.94,37.7,,,percent of total billed charges,37.70% of total billed charges,364.94,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,328.15,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,755.04,78,,,percent of total billed charges,78% of total billed charges,968,100,,,percent of total billed charges,100% of total billed charges,799.57,82.6,,,percent of total billed charges,82.6% of total billed charges,799.57,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,968,
US Spinal Canal,40276800,CDM,402,RC,76800,HCPCS,Outpatient,,,763,495.95,TC,671.44,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,763,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,480.69,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,526.47,69,,,percent of total billed charges,69% of total billed charges,763,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,763,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,763,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,287.65,37.7,,,percent of total billed charges,37.70% of total billed charges,287.65,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,258.66,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,595.14,78,,,percent of total billed charges,78% of total billed charges,763,100,,,percent of total billed charges,100% of total billed charges,630.24,82.6,,,percent of total billed charges,82.6% of total billed charges,630.24,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,763,
US Segmental Pressures (ABI) w/ Exercise,92193924,CDM,921,RC,93924,HCPCS,Outpatient,,,677,440.05,TC,595.76,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,426.51,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,103.58,15.3,,,percent of total billed charges,15.3% of total billed charges,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,677,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,229.5,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1074.33,
US Stress Echo Pharm,48093350,CDM,480,RC,93350,HCPCS,Outpatient,,,1779,1156.35,TC,1565.52,88,,,percent of total billed charges,88% of total Billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,1779,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.77,63,,,percent of total billed charges,63% of total billed charges,984.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,272.19,15.3,,,percent of total billed charges,15.3% of total billed charges,1227.51,69,,,percent of total billed charges,69% of total billed charges,1779,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1779,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1779,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,670.68,37.7,,,percent of total billed charges,37.70% of total billed charges,670.68,37.7,,,percent of total billed charges,37.70% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,603.08,33.9,,,percent of total billed charges,33.9% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1387.62,78,,,percent of total billed charges,78% of total billed charges,1779,100,,,percent of total billed charges,100% of total billed charges,1469.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1469.45,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,568.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,272.19,1961.75,
US Stress Echo Treadmill,48093350,CDM,480,RC,93350,HCPCS,Outpatient,,,1779,1156.35,TC,1565.52,88,,,percent of total billed charges,88% of total Billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,1779,100,,,percent of total billed charges,100% of total billed charges,430.64,103,,,Fee Schedule,103% of WA Medicaid,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.77,63,,,percent of total billed charges,63% of total billed charges,984.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid,272.19,15.3,,,percent of total billed charges,15.3% of total billed charges,1227.51,69,,,percent of total billed charges,69% of total billed charges,1779,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1779,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1779,100,,,percent of total billed charges,100% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,309.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,426.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.53,130,,,Fee Schedule,130% of WA Medicaid ,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,670.68,37.7,,,percent of total billed charges,37.70% of total billed charges,670.68,37.7,,,percent of total billed charges,37.70% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,603.08,33.9,,,percent of total billed charges,33.9% of total billed charges,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1387.62,78,,,percent of total billed charges,78% of total billed charges,1779,100,,,percent of total billed charges,100% of total billed charges,1469.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1469.45,82.6,,,percent of total billed charges,82.6% of total billed charges,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,568.29,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.67,100,,,Fee Schedule,100% of Medicare OPPS rate,418.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,272.19,1961.75,
US Stress Test,48093017,CDM,480,RC,93017,HCPCS,Outpatient,,,915,594.75,TC,805.2,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,915,100,,,percent of total billed charges,100% of total billed charges,155.52,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,576.45,63,,,percent of total billed charges,63% of total billed charges,560.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,140,15.3,,,percent of total billed charges,15.3% of total billed charges,631.35,69,,,percent of total billed charges,69% of total billed charges,915,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,915,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,915,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,111.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,154.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.29,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,344.96,37.7,,,percent of total billed charges,37.70% of total billed charges,344.96,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,310.19,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,713.7,78,,,percent of total billed charges,78% of total billed charges,915,100,,,percent of total billed charges,100% of total billed charges,755.79,82.6,,,percent of total billed charges,82.6% of total billed charges,755.79,82.6,,,percent of total billed charges,82.6% of total billed charges,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.84,1074.33,
US Head/Neck Soft Tissue,40276536,CDM,402,RC,76536,HCPCS,Outpatient,,,582,378.30,TC,512.16,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,582,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,366.66,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,401.58,69,,,percent of total billed charges,69% of total billed charges,582,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,582,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,582,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,219.41,37.7,,,percent of total billed charges,37.70% of total billed charges,219.41,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,197.3,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,453.96,78,,,percent of total billed charges,78% of total billed charges,582,100,,,percent of total billed charges,100% of total billed charges,480.73,82.6,,,percent of total billed charges,82.6% of total billed charges,480.73,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,582,
US Soft Tissue Abd/Pel,40276705,CDM,402,RC,76705,HCPCS,Outpatient,,,560,364.00,TC,492.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,560,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,352.8,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,386.4,69,,,percent of total billed charges,69% of total billed charges,560,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,560,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,560,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,211.12,37.7,,,percent of total billed charges,37.70% of total billed charges,211.12,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,189.84,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,436.8,78,,,percent of total billed charges,78% of total billed charges,560,100,,,percent of total billed charges,100% of total billed charges,462.56,82.6,,,percent of total billed charges,82.6% of total billed charges,462.56,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,560,
US Soft Tissue Thorax,40276604,CDM,402,RC,76604,HCPCS,Outpatient,,,561,364.65,TC,493.68,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,561,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,353.43,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,387.09,69,,,percent of total billed charges,69% of total billed charges,561,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,561,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,561,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,211.5,37.7,,,percent of total billed charges,37.70% of total billed charges,211.5,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,190.18,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,437.58,78,,,percent of total billed charges,78% of total billed charges,561,100,,,percent of total billed charges,100% of total billed charges,463.39,82.6,,,percent of total billed charges,82.6% of total billed charges,463.39,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,561,
US Thoracentesis,40276942,CDM,402,RC,76942,HCPCS,Outpatient,,,1088,707.20,TC,957.44,88,,,percent of total billed charges,88% of total Billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid,1088,100,,,percent of total billed charges,100% of total billed charges,105.01,103,,,Fee Schedule,103% of WA Medicaid,544,50,,,percent of total billed charges,50% of total Billed charges,685.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,101.95,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,750.72,69,,,percent of total billed charges,69% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,672.93,61.85,,,percent of total billed charges,61.85% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,544,50,,,percent of total billed charges,50% of total Billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,75.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,544,50,,,percent of total billed charges,50% of total Billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,103.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.54,130,,,Fee Schedule,130% of WA Medicaid ,544,50,,,percent of total billed charges,50% of total Billed charges,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,368.83,33.9,,,percent of total billed charges,33.9% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,848.64,78,,,percent of total billed charges,78% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,544,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,544,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.52,1088,
US Transcranial Doppler Complete,92193886,CDM,921,RC,93886,HCPCS,Outpatient,,,1256,816.40,TC,1105.28,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,1256,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,791.28,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,192.17,15.3,,,percent of total billed charges,15.3% of total billed charges,866.64,69,,,percent of total billed charges,69% of total billed charges,1256,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1256,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1256,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,473.51,37.7,,,percent of total billed charges,37.70% of total billed charges,473.51,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,425.78,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,979.68,78,,,percent of total billed charges,78% of total billed charges,1256,100,,,percent of total billed charges,100% of total billed charges,1037.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1037.46,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,1256,
US Transvaginal Non-OB,40276830,CDM,402,RC,76830,HCPCS,Outpatient,,,739,480.35,TC,650.32,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,739,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,465.57,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,509.91,69,,,percent of total billed charges,69% of total billed charges,739,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,739,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,739,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,278.6,37.7,,,percent of total billed charges,37.70% of total billed charges,278.6,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,250.52,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,576.42,78,,,percent of total billed charges,78% of total billed charges,739,100,,,percent of total billed charges,100% of total billed charges,610.41,82.6,,,percent of total billed charges,82.6% of total billed charges,610.41,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,739,
US Transcranial Doppler Limited,40293888,CDM,402,RC,93888,HCPCS,Outpatient,,,723,469.95,TC,636.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,723,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,455.49,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,498.87,69,,,percent of total billed charges,69% of total billed charges,723,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,723,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,723,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,272.57,37.7,,,percent of total billed charges,37.70% of total billed charges,272.57,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,245.1,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,563.94,78,,,percent of total billed charges,78% of total billed charges,723,100,,,percent of total billed charges,100% of total billed charges,597.2,82.6,,,percent of total billed charges,82.6% of total billed charges,597.2,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,723,
US Thyroid Biopsy,40276942,CDM,402,RC,76942,HCPCS,Outpatient,,,1088,707.20,TC,957.44,88,,,percent of total billed charges,88% of total Billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid,1088,100,,,percent of total billed charges,100% of total billed charges,105.01,103,,,Fee Schedule,103% of WA Medicaid,544,50,,,percent of total billed charges,50% of total Billed charges,685.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,101.95,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,750.72,69,,,percent of total billed charges,69% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,672.93,61.85,,,percent of total billed charges,61.85% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,544,50,,,percent of total billed charges,50% of total Billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,75.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,544,50,,,percent of total billed charges,50% of total Billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,103.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.54,130,,,Fee Schedule,130% of WA Medicaid ,544,50,,,percent of total billed charges,50% of total Billed charges,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,368.83,33.9,,,percent of total billed charges,33.9% of total billed charges,544,50,,,percent of total billed charges,50% of total Billed charges,848.64,78,,,percent of total billed charges,78% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,544,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,544,50,,,percent of total billed charges,50% of total Billed charges,101.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.52,1088,
US Upper Ext Arterial Duplex Bilateral,92193930,CDM,921,RC,93930,HCPCS,Outpatient,,,1011,657.15,TC,889.68,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1011,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,636.93,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,154.68,15.3,,,percent of total billed charges,15.3% of total billed charges,697.59,69,,,percent of total billed charges,69% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1011,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1011,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,342.73,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,788.58,78,,,percent of total billed charges,78% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1011,
US Upper Ext Arterial Duplex Left,92193931,CDM,921,RC,93931,HCPCS,Outpatient,,,815,529.75,TC|LT,717.2,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,815,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,513.45,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,124.7,15.3,,,percent of total billed charges,15.3% of total billed charges,562.35,69,,,percent of total billed charges,69% of total billed charges,815,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,815,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,815,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,307.26,37.7,,,percent of total billed charges,37.70% of total billed charges,307.26,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,276.29,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,635.7,78,,,percent of total billed charges,78% of total billed charges,815,100,,,percent of total billed charges,100% of total billed charges,673.19,82.6,,,percent of total billed charges,82.6% of total billed charges,673.19,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,815,
US Upper Ext Arterial Duplex Right,92193931,CDM,921,RC,93931,HCPCS,Outpatient,,,815,529.75,TC|RT,717.2,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,815,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,513.45,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,124.7,15.3,,,percent of total billed charges,15.3% of total billed charges,562.35,69,,,percent of total billed charges,69% of total billed charges,815,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,815,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,815,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,307.26,37.7,,,percent of total billed charges,37.70% of total billed charges,307.26,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,276.29,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,635.7,78,,,percent of total billed charges,78% of total billed charges,815,100,,,percent of total billed charges,100% of total billed charges,673.19,82.6,,,percent of total billed charges,82.6% of total billed charges,673.19,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,815,
US Upper Ext Venous Duplex Bilateral,92193970,CDM,921,RC,93970,HCPCS,Outpatient,,,1870,1215.50,TC,1645.6,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,1870,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1178.1,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,286.11,15.3,,,percent of total billed charges,15.3% of total billed charges,1290.3,69,,,percent of total billed charges,69% of total billed charges,1870,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1870,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1870,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,704.99,37.7,,,percent of total billed charges,37.70% of total billed charges,704.99,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,633.93,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1458.6,78,,,percent of total billed charges,78% of total billed charges,1870,100,,,percent of total billed charges,100% of total billed charges,1544.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1544.62,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,1870,
US Upper Ext Venous Duplex Left,92193971,CDM,921,RC,93971,HCPCS,Outpatient,,,1377,895.05,TC|LT,1211.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1377,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,867.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,210.68,15.3,,,percent of total billed charges,15.3% of total billed charges,950.13,69,,,percent of total billed charges,69% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,466.8,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.06,78,,,percent of total billed charges,78% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1377,
US Upper Ext Venous Duplex Right,92193971,CDM,921,RC,93971,HCPCS,Outpatient,,,1377,895.05,TC|RT,1211.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1377,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,867.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,210.68,15.3,,,percent of total billed charges,15.3% of total billed charges,950.13,69,,,percent of total billed charges,69% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,466.8,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.06,78,,,percent of total billed charges,78% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1377,
US Vessel Mapping for Dialysis,40293985,CDM,402,RC,93985,HCPCS,Outpatient,,,941,611.65,TC,828.08,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,941,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,592.83,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,649.29,69,,,percent of total billed charges,69% of total billed charges,941,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,941,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,941,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,354.76,37.7,,,percent of total billed charges,37.70% of total billed charges,354.76,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,319,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,733.98,78,,,percent of total billed charges,78% of total billed charges,941,100,,,percent of total billed charges,100% of total billed charges,777.27,82.6,,,percent of total billed charges,82.6% of total billed charges,777.27,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,941,
US Vessel Mapping for Hemo Access,40293985,CDM,402,RC,93985,HCPCS,Outpatient,,,1274,828.10,TC,1121.12,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,1274,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,802.62,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,879.06,69,,,percent of total billed charges,69% of total billed charges,1274,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1274,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1274,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,480.3,37.7,,,percent of total billed charges,37.70% of total billed charges,480.3,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,431.89,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,993.72,78,,,percent of total billed charges,78% of total billed charges,1274,100,,,percent of total billed charges,100% of total billed charges,1052.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1052.32,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,1274,
XR AC Joints Bilateral,32073050,CDM,320,RC,73050,HCPCS,Outpatient,,,1146,744.90,TC,1008.48,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1146,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,721.98,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,175.34,15.3,,,percent of total billed charges,15.3% of total billed charges,790.74,69,,,percent of total billed charges,69% of total billed charges,1146,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1146,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1146,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,432.04,37.7,,,percent of total billed charges,37.70% of total billed charges,432.04,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,388.49,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,893.88,78,,,percent of total billed charges,78% of total billed charges,1146,100,,,percent of total billed charges,100% of total billed charges,946.6,82.6,,,percent of total billed charges,82.6% of total billed charges,946.6,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1146,
XR Abdomen KUB 1 View,32074000,CDM,320,RC,74018,HCPCS,Outpatient,,,913,593.45,TC,803.44,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,913,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,575.19,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,139.69,15.3,,,percent of total billed charges,15.3% of total billed charges,629.97,69,,,percent of total billed charges,69% of total billed charges,913,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,913,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,913,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,344.2,37.7,,,percent of total billed charges,37.70% of total billed charges,344.2,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,309.51,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,712.14,78,,,percent of total billed charges,78% of total billed charges,913,100,,,percent of total billed charges,100% of total billed charges,754.14,82.6,,,percent of total billed charges,82.6% of total billed charges,754.14,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,913,
XR Abdomen Complete w Decub and/or Erect,32074020,CDM,320,RC,74019,HCPCS,Outpatient,,,1693,1100.45,TC,1489.84,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1693,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1066.59,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,259.03,15.3,,,percent of total billed charges,15.3% of total billed charges,1168.17,69,,,percent of total billed charges,69% of total billed charges,1693,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1693,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1693,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,638.26,37.7,,,percent of total billed charges,37.70% of total billed charges,638.26,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,573.93,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1320.54,78,,,percent of total billed charges,78% of total billed charges,1693,100,,,percent of total billed charges,100% of total billed charges,1398.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1398.42,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1693,
XR Abdomen Series + Chest 1 View,32074022,CDM,320,RC,74022,HCPCS,Outpatient,,,2187,1421.55,TC,1924.56,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,2187,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1377.81,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,334.61,15.3,,,percent of total billed charges,15.3% of total billed charges,1509.03,69,,,percent of total billed charges,69% of total billed charges,2187,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2187,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2187,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,824.5,37.7,,,percent of total billed charges,37.70% of total billed charges,824.5,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,741.39,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1705.86,78,,,percent of total billed charges,78% of total billed charges,2187,100,,,percent of total billed charges,100% of total billed charges,1806.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1806.46,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,2187,
XR Ankle 2 Views Left,32073600,CDM,320,RC,73600,HCPCS,Outpatient,,,632,410.80,TC|LT,556.16,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,398.16,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,96.7,15.3,,,percent of total billed charges,15.3% of total billed charges,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,214.25,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,632,
XR Ankle 2 Views Right,32073600,CDM,320,RC,73600,HCPCS,Outpatient,,,632,410.80,TC|RT,556.16,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,398.16,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,96.7,15.3,,,percent of total billed charges,15.3% of total billed charges,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,632,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,214.25,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,632,
XR Ankle Complete 3+ Views Bilateral,32073610,CDM,320,RC,73610,HCPCS,Outpatient,,,1106,718.90,TC,973.28,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1106,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,696.78,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,169.22,15.3,,,percent of total billed charges,15.3% of total billed charges,763.14,69,,,percent of total billed charges,69% of total billed charges,1106,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1106,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1106,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,416.96,37.7,,,percent of total billed charges,37.70% of total billed charges,416.96,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,374.93,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,862.68,78,,,percent of total billed charges,78% of total billed charges,1106,100,,,percent of total billed charges,100% of total billed charges,913.56,82.6,,,percent of total billed charges,82.6% of total billed charges,913.56,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1106,
XR Ankle Complete 3+ Views Left,32073610,CDM,320,RC,73610,HCPCS,Outpatient,,,1106,718.90,TC|LT,973.28,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1106,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,696.78,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,169.22,15.3,,,percent of total billed charges,15.3% of total billed charges,763.14,69,,,percent of total billed charges,69% of total billed charges,1106,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1106,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1106,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,416.96,37.7,,,percent of total billed charges,37.70% of total billed charges,416.96,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,374.93,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,862.68,78,,,percent of total billed charges,78% of total billed charges,1106,100,,,percent of total billed charges,100% of total billed charges,913.56,82.6,,,percent of total billed charges,82.6% of total billed charges,913.56,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1106,
XR Ankle Complete 3+ Views Right,32073610,CDM,320,RC,73610,HCPCS,Outpatient,,,1106,718.90,TC|RT,973.28,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1106,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,696.78,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,169.22,15.3,,,percent of total billed charges,15.3% of total billed charges,763.14,69,,,percent of total billed charges,69% of total billed charges,1106,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1106,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1106,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,416.96,37.7,,,percent of total billed charges,37.70% of total billed charges,416.96,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,374.93,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,862.68,78,,,percent of total billed charges,78% of total billed charges,1106,100,,,percent of total billed charges,100% of total billed charges,913.56,82.6,,,percent of total billed charges,82.6% of total billed charges,913.56,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1106,
XR Arthrogram Injection Hip Left,32273525,CDM,322,RC,73525,HCPCS,Outpatient,,,1643,1067.95,TC|LT,1445.84,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1643,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.09,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,251.38,15.3,,,percent of total billed charges,15.3% of total billed charges,1133.67,69,,,percent of total billed charges,69% of total billed charges,1643,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1643,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1643,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,619.41,37.7,,,percent of total billed charges,37.70% of total billed charges,619.41,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,556.98,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1281.54,78,,,percent of total billed charges,78% of total billed charges,1643,100,,,percent of total billed charges,100% of total billed charges,1357.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1357.12,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1643,
XR Arthrogram Injection Hip Right,32273525,CDM,322,RC,73525,HCPCS,Outpatient,,,1643,1067.95,TC|RT,1445.84,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1643,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1035.09,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,251.38,15.3,,,percent of total billed charges,15.3% of total billed charges,1133.67,69,,,percent of total billed charges,69% of total billed charges,1643,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1643,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1643,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,619.41,37.7,,,percent of total billed charges,37.70% of total billed charges,619.41,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,556.98,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1281.54,78,,,percent of total billed charges,78% of total billed charges,1643,100,,,percent of total billed charges,100% of total billed charges,1357.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1357.12,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1643,
XR Arthrogram Injection Knee Left,32273580,CDM,322,RC,73580,HCPCS,Outpatient,,,1369,889.85,TC|LT,1204.72,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1369,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,862.47,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,209.46,15.3,,,percent of total billed charges,15.3% of total billed charges,944.61,69,,,percent of total billed charges,69% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,464.09,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1067.82,78,,,percent of total billed charges,78% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1495.49,
XR Arthrogram Injection Knee Right,32273580,CDM,322,RC,73580,HCPCS,Outpatient,,,1369,889.85,TC|RT,1204.72,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1369,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,862.47,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,209.46,15.3,,,percent of total billed charges,15.3% of total billed charges,944.61,69,,,percent of total billed charges,69% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,464.09,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1067.82,78,,,percent of total billed charges,78% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1495.49,
XR Arthrogram Injection Shoulder Left,32273040,CDM,322,RC,73040,HCPCS,Outpatient,,,1369,889.85,TC|LT,1204.72,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1369,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,862.47,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,209.46,15.3,,,percent of total billed charges,15.3% of total billed charges,944.61,69,,,percent of total billed charges,69% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,464.09,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1067.82,78,,,percent of total billed charges,78% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1495.49,
XR Arthrogram Injection Shoulder Right,32273040,CDM,322,RC,73040,HCPCS,Outpatient,,,1369,889.85,TC|RT,1204.72,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1369,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,862.47,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,209.46,15.3,,,percent of total billed charges,15.3% of total billed charges,944.61,69,,,percent of total billed charges,69% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,464.09,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1067.82,78,,,percent of total billed charges,78% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1495.49,
XR Arthrogram Injection Wrist Left,32273115,CDM,322,RC,73115,HCPCS,Outpatient,,,1369,889.85,TC|LT,1204.72,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1369,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,862.47,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,209.46,15.3,,,percent of total billed charges,15.3% of total billed charges,944.61,69,,,percent of total billed charges,69% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,464.09,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1067.82,78,,,percent of total billed charges,78% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1495.49,
XR Arthrogram Injection Wrist Right,32273115,CDM,322,RC,73115,HCPCS,Outpatient,,,1369,889.85,TC|RT,1204.72,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1369,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,862.47,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,209.46,15.3,,,percent of total billed charges,15.3% of total billed charges,944.61,69,,,percent of total billed charges,69% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1369,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,516.11,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,464.09,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1067.82,78,,,percent of total billed charges,78% of total billed charges,1369,100,,,percent of total billed charges,100% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1130.79,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1495.49,
XR Angio Extremity in OR SI Left,32375710,CDM,323,RC,75710,HCPCS,Outpatient,,,10352,6728.80,TC|LT,9109.76,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6521.76,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,1583.86,15.3,,,percent of total billed charges,15.3% of total billed charges,7142.88,69,,,percent of total billed charges,69% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3509.33,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8074.56,78,,,percent of total billed charges,78% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
XR Angio Extremity in OR SI Right,36075710,CDM,360,RC,75710,HCPCS,Outpatient,,,10352,6728.80,TC|RT,9109.76,88,,,percent of total billed charges,88% of total Billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1694.66,103,,,Fee Schedule,103% of WA Medicaid,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,6521.76,63,,,percent of total billed charges,63% of total billed charges,5689.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,7142.88,69,,,percent of total billed charges,69% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,10352,100,,,percent of total billed charges,100% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,11625.58,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1218.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1678.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2138.89,130,,,Fee Schedule,130% of WA Medicaid ,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3902.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3509.33,33.9,,,percent of total billed charges,33.9% of total billed charges,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,8074.56,78,,,percent of total billed charges,78% of total billed charges,10352,100,,,percent of total billed charges,100% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,8550.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,3283.63,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3251.11,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1218.74,11625.58,
XR Abdomen 2 Views,32074019,CDM,320,RC,74019,HCPCS,Outpatient,,,1498,973.70,TC,1318.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1498,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,943.74,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,229.19,15.3,,,percent of total billed charges,15.3% of total billed charges,1033.62,69,,,percent of total billed charges,69% of total billed charges,1498,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1498,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1498,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,564.75,37.7,,,percent of total billed charges,37.70% of total billed charges,564.75,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,507.82,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1168.44,78,,,percent of total billed charges,78% of total billed charges,1498,100,,,percent of total billed charges,100% of total billed charges,1237.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1237.35,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1498,
XR Abdomen 3 Views,32074021,CDM,320,RC,74021,HCPCS,Outpatient,,,1777,1155.05,TC,1563.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1777,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1119.51,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,271.88,15.3,,,percent of total billed charges,15.3% of total billed charges,1226.13,69,,,percent of total billed charges,69% of total billed charges,1777,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1777,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1777,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,669.93,37.7,,,percent of total billed charges,37.70% of total billed charges,669.93,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,602.4,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1386.06,78,,,percent of total billed charges,78% of total billed charges,1777,100,,,percent of total billed charges,100% of total billed charges,1467.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1467.8,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1777,
XR Barium Enema Complete,32074270,CDM,320,RC,74270,HCPCS,Outpatient,,,2743,1782.95,TC,2413.84,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2743,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1728.09,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,419.68,15.3,,,percent of total billed charges,15.3% of total billed charges,1892.67,69,,,percent of total billed charges,69% of total billed charges,2743,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2743,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2743,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1034.11,37.7,,,percent of total billed charges,37.70% of total billed charges,1034.11,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,929.88,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2139.54,78,,,percent of total billed charges,78% of total billed charges,2743,100,,,percent of total billed charges,100% of total billed charges,2265.72,82.6,,,percent of total billed charges,82.6% of total billed charges,2265.72,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2743,
XR Barium Enema w/ Air Complete,32074280,CDM,320,RC,74280,HCPCS,Outpatient,,,3210,2086.50,TC,2824.8,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,3210,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2022.3,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,491.13,15.3,,,percent of total billed charges,15.3% of total billed charges,2214.9,69,,,percent of total billed charges,69% of total billed charges,3210,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3210,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3210,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1210.17,37.7,,,percent of total billed charges,37.70% of total billed charges,1210.17,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1088.19,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2503.8,78,,,percent of total billed charges,78% of total billed charges,3210,100,,,percent of total billed charges,100% of total billed charges,2651.46,82.6,,,percent of total billed charges,82.6% of total billed charges,2651.46,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,3210,
XR Bone Age Studies,32077072,CDM,320,RC,77072,HCPCS,Outpatient,,,1347,875.55,TC,1185.36,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1347,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,848.61,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,206.09,15.3,,,percent of total billed charges,15.3% of total billed charges,929.43,69,,,percent of total billed charges,69% of total billed charges,1347,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1347,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1347,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,507.82,37.7,,,percent of total billed charges,37.70% of total billed charges,507.82,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,456.63,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1050.66,78,,,percent of total billed charges,78% of total billed charges,1347,100,,,percent of total billed charges,100% of total billed charges,1112.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1112.62,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1347,
XR Bone Length Studies Scanograms,32077073,CDM,320,RC,77073,HCPCS,Outpatient,,,1017,661.05,TC,894.96,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1017,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,640.71,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,155.6,15.3,,,percent of total billed charges,15.3% of total billed charges,701.73,69,,,percent of total billed charges,69% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1017,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1017,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,344.76,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,793.26,78,,,percent of total billed charges,78% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1017,
XR Barium Enema Therapeutic,32074283,CDM,320,RC,74283,HCPCS,Outpatient,,,3068,1994.20,TC,2699.84,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,3068,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1932.84,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,469.4,15.3,,,percent of total billed charges,15.3% of total billed charges,2116.92,69,,,percent of total billed charges,69% of total billed charges,3068,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3068,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3068,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1156.64,37.7,,,percent of total billed charges,37.70% of total billed charges,1156.64,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1040.05,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2393.04,78,,,percent of total billed charges,78% of total billed charges,3068,100,,,percent of total billed charges,100% of total billed charges,2534.17,82.6,,,percent of total billed charges,82.6% of total billed charges,2534.17,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,3068,
XR Chest 2 Views,32471046,CDM,324,RC,71046,HCPCS,Outpatient,,,975,633.75,TC,858,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,975,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,614.25,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,149.18,15.3,,,percent of total billed charges,15.3% of total billed charges,672.75,69,,,percent of total billed charges,69% of total billed charges,975,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,975,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,975,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,367.58,37.7,,,percent of total billed charges,37.70% of total billed charges,367.58,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,330.53,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,760.5,78,,,percent of total billed charges,78% of total billed charges,975,100,,,percent of total billed charges,100% of total billed charges,805.35,82.6,,,percent of total billed charges,82.6% of total billed charges,805.35,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,975,
XR Calcaneous Bilateral,32073650,CDM,320,RC,73650,HCPCS,Outpatient,,,640,416.00,TC,563.2,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,640,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,403.2,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,97.92,15.3,,,percent of total billed charges,15.3% of total billed charges,441.6,69,,,percent of total billed charges,69% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,216.96,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,499.2,78,,,percent of total billed charges,78% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,640,
XR Calcaneous Left,32073650,CDM,320,RC,73650,HCPCS,Outpatient,,,640,416.00,TC|LT,563.2,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,640,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,403.2,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,97.92,15.3,,,percent of total billed charges,15.3% of total billed charges,441.6,69,,,percent of total billed charges,69% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,216.96,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,499.2,78,,,percent of total billed charges,78% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,640,
XR Calcaneous Right,32073650,CDM,320,RC,73650,HCPCS,Outpatient,,,640,416.00,TC|RT,563.2,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,640,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,403.2,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,97.92,15.3,,,percent of total billed charges,15.3% of total billed charges,441.6,69,,,percent of total billed charges,69% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,216.96,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,499.2,78,,,percent of total billed charges,78% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,640,
XR Chest 1 View Frontal,32471045,CDM,324,RC,71045,HCPCS,Outpatient,,,1169,759.85,TC,1028.72,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1169,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,736.47,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,178.86,15.3,,,percent of total billed charges,15.3% of total billed charges,806.61,69,,,percent of total billed charges,69% of total billed charges,1169,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1169,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1169,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,440.71,37.7,,,percent of total billed charges,37.70% of total billed charges,440.71,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,396.29,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,911.82,78,,,percent of total billed charges,78% of total billed charges,1169,100,,,percent of total billed charges,100% of total billed charges,965.59,82.6,,,percent of total billed charges,82.6% of total billed charges,965.59,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1169,
XR Chest 2 Views w/ Apical Lordotic,32071047,CDM,320,RC,71047,HCPCS,Outpatient,,,2089,1357.85,TC,1838.32,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,2089,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1316.07,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,319.62,15.3,,,percent of total billed charges,15.3% of total billed charges,1441.41,69,,,percent of total billed charges,69% of total billed charges,2089,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2089,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2089,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,787.55,37.7,,,percent of total billed charges,37.70% of total billed charges,787.55,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,708.17,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1629.42,78,,,percent of total billed charges,78% of total billed charges,2089,100,,,percent of total billed charges,100% of total billed charges,1725.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1725.51,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,2089,
XR Chest 2 Views w/ Fluoroscopy,32471046,CDM,324,RC,71046,HCPCS,Outpatient,,,975,633.75,TC,858,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,975,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,614.25,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,149.18,15.3,,,percent of total billed charges,15.3% of total billed charges,672.75,69,,,percent of total billed charges,69% of total billed charges,975,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,975,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,975,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,367.58,37.7,,,percent of total billed charges,37.70% of total billed charges,367.58,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,330.53,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,760.5,78,,,percent of total billed charges,78% of total billed charges,975,100,,,percent of total billed charges,100% of total billed charges,805.35,82.6,,,percent of total billed charges,82.6% of total billed charges,805.35,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,975,
XR Chest 2 Views w/ Obliques,32471022,CDM,324,RC,71048,HCPCS,Outpatient,,,1436,933.40,TC,1263.68,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1436,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,904.68,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,219.71,15.3,,,percent of total billed charges,15.3% of total billed charges,990.84,69,,,percent of total billed charges,69% of total billed charges,1436,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1436,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1436,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,541.37,37.7,,,percent of total billed charges,37.70% of total billed charges,541.37,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,486.8,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.08,78,,,percent of total billed charges,78% of total billed charges,1436,100,,,percent of total billed charges,100% of total billed charges,1186.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.14,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1436,
XR Chest Decubitus,32471045,CDM,324,RC,71045,HCPCS,Outpatient,,,975,633.75,TC,858,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,975,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,614.25,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,149.18,15.3,,,percent of total billed charges,15.3% of total billed charges,672.75,69,,,percent of total billed charges,69% of total billed charges,975,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,975,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,975,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,367.58,37.7,,,percent of total billed charges,37.70% of total billed charges,367.58,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,330.53,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,760.5,78,,,percent of total billed charges,78% of total billed charges,975,100,,,percent of total billed charges,100% of total billed charges,805.35,82.6,,,percent of total billed charges,82.6% of total billed charges,805.35,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,975,
XR Chest 4+ Views,32471048,CDM,324,RC,71048,HCPCS,Outpatient,,,1436,933.40,TC,1263.68,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1436,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,904.68,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,219.71,15.3,,,percent of total billed charges,15.3% of total billed charges,990.84,69,,,percent of total billed charges,69% of total billed charges,1436,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1436,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1436,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,541.37,37.7,,,percent of total billed charges,37.70% of total billed charges,541.37,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,486.8,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1120.08,78,,,percent of total billed charges,78% of total billed charges,1436,100,,,percent of total billed charges,100% of total billed charges,1186.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.14,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1436,
XR Cholangiogram in OR,32074300,CDM,320,RC,74300,HCPCS,Outpatient,,,3239,2105.35,TC,2850.32,88,,,percent of total billed charges,88% of total Billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,3239,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,1619.5,50,,,percent of total billed charges,50% of total Billed charges,2040.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,495.57,15.3,,,percent of total billed charges,15.3% of total billed charges,2234.91,69,,,percent of total billed charges,69% of total billed charges,3239,100,,,percent of total billed charges,100% of total billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,3239,100,,,percent of total billed charges,100% of total billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,3239,100,,,percent of total billed charges,100% of total billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,2003.32,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1619.5,50,,,percent of total billed charges,50% of total Billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1619.5,50,,,percent of total billed charges,50% of total Billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,1619.5,50,,,percent of total billed charges,50% of total Billed charges,1221.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1221.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,1098.02,33.9,,,percent of total billed charges,33.9% of total billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,2526.42,78,,,percent of total billed charges,78% of total billed charges,3239,100,,,percent of total billed charges,100% of total billed charges,2675.41,82.6,,,percent of total billed charges,82.6% of total billed charges,2675.41,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1619.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1619.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,3239,
XR Clavicle Left,32073000,CDM,320,RC,73000,HCPCS,Outpatient,,,951,618.15,TC|LT,836.88,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,951,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,599.13,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,145.5,15.3,,,percent of total billed charges,15.3% of total billed charges,656.19,69,,,percent of total billed charges,69% of total billed charges,951,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,951,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,951,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,358.53,37.7,,,percent of total billed charges,37.70% of total billed charges,358.53,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,322.39,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,741.78,78,,,percent of total billed charges,78% of total billed charges,951,100,,,percent of total billed charges,100% of total billed charges,785.53,82.6,,,percent of total billed charges,82.6% of total billed charges,785.53,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,951,
XR Clavicle Right,32073000,CDM,320,RC,73000,HCPCS,Outpatient,,,951,618.15,TC|RT,836.88,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,951,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,599.13,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,145.5,15.3,,,percent of total billed charges,15.3% of total billed charges,656.19,69,,,percent of total billed charges,69% of total billed charges,951,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,951,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,951,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,358.53,37.7,,,percent of total billed charges,37.70% of total billed charges,358.53,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,322.39,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,741.78,78,,,percent of total billed charges,78% of total billed charges,951,100,,,percent of total billed charges,100% of total billed charges,785.53,82.6,,,percent of total billed charges,82.6% of total billed charges,785.53,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,951,
XR Chest 1 View Frontal,32071010,CDM,320,RC,71045,HCPCS,Outpatient,,,1069,694.85,TC,940.72,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1069,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,673.47,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,163.56,15.3,,,percent of total billed charges,15.3% of total billed charges,737.61,69,,,percent of total billed charges,69% of total billed charges,1069,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1069,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1069,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,403.01,37.7,,,percent of total billed charges,37.70% of total billed charges,403.01,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,362.39,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,833.82,78,,,percent of total billed charges,78% of total billed charges,1069,100,,,percent of total billed charges,100% of total billed charges,882.99,82.6,,,percent of total billed charges,82.6% of total billed charges,882.99,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1069,
XR Cystogram,32074430,CDM,320,RC,74430,HCPCS,Outpatient,,,1073,697.45,TC,944.24,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1073,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,675.99,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,164.17,15.3,,,percent of total billed charges,15.3% of total billed charges,740.37,69,,,percent of total billed charges,69% of total billed charges,1073,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1073,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1073,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,404.52,37.7,,,percent of total billed charges,37.70% of total billed charges,404.52,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,363.75,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,836.94,78,,,percent of total billed charges,78% of total billed charges,1073,100,,,percent of total billed charges,100% of total billed charges,886.3,82.6,,,percent of total billed charges,82.6% of total billed charges,886.3,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1495.49,
XR Chest 1 View,32471045,CDM,324,RC,71045,HCPCS,Outpatient,,,1169,759.85,TC,1028.72,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1169,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,736.47,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,178.86,15.3,,,percent of total billed charges,15.3% of total billed charges,806.61,69,,,percent of total billed charges,69% of total billed charges,1169,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1169,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1169,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,440.71,37.7,,,percent of total billed charges,37.70% of total billed charges,440.71,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,396.29,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,911.82,78,,,percent of total billed charges,78% of total billed charges,1169,100,,,percent of total billed charges,100% of total billed charges,965.59,82.6,,,percent of total billed charges,82.6% of total billed charges,965.59,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1169,
XR Chest 1 View,32471045,CDM,324,RC,71045,HCPCS,Outpatient,,,1169,759.85,TC,1028.72,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1169,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,736.47,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,178.86,15.3,,,percent of total billed charges,15.3% of total billed charges,806.61,69,,,percent of total billed charges,69% of total billed charges,1169,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1169,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1169,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,440.71,37.7,,,percent of total billed charges,37.70% of total billed charges,440.71,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,396.29,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,911.82,78,,,percent of total billed charges,78% of total billed charges,1169,100,,,percent of total billed charges,100% of total billed charges,965.59,82.6,,,percent of total billed charges,82.6% of total billed charges,965.59,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.6,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1169,
XR Cholangiogram in OR EO,32074300,CDM,320,RC,74300,HCPCS,Outpatient,,,3239,2105.35,TC,2850.32,88,,,percent of total billed charges,88% of total Billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,3239,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,1619.5,50,,,percent of total billed charges,50% of total Billed charges,2040.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,495.57,15.3,,,percent of total billed charges,15.3% of total billed charges,2234.91,69,,,percent of total billed charges,69% of total billed charges,3239,100,,,percent of total billed charges,100% of total billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,3239,100,,,percent of total billed charges,100% of total billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,3239,100,,,percent of total billed charges,100% of total billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,2003.32,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1619.5,50,,,percent of total billed charges,50% of total Billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1619.5,50,,,percent of total billed charges,50% of total Billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,1619.5,50,,,percent of total billed charges,50% of total Billed charges,1221.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1221.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,1098.02,33.9,,,percent of total billed charges,33.9% of total billed charges,1619.5,50,,,percent of total billed charges,50% of total Billed charges,2526.42,78,,,percent of total billed charges,78% of total billed charges,3239,100,,,percent of total billed charges,100% of total billed charges,2675.41,82.6,,,percent of total billed charges,82.6% of total billed charges,2675.41,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1619.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1619.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,3239,
XR Drainage Perc Cath Placement,32075989,CDM,320,RC,75989,HCPCS,Outpatient,,,1780,1157.00,TC,1566.4,88,,,percent of total billed charges,88% of total Billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,1780,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,890,50,,,percent of total billed charges,50% of total Billed charges,1121.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,272.34,15.3,,,percent of total billed charges,15.3% of total billed charges,1228.2,69,,,percent of total billed charges,69% of total billed charges,1780,100,,,percent of total billed charges,100% of total billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,1780,100,,,percent of total billed charges,100% of total billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,1780,100,,,percent of total billed charges,100% of total billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,1100.93,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,890,50,,,percent of total billed charges,50% of total Billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,890,50,,,percent of total billed charges,50% of total Billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,890,50,,,percent of total billed charges,50% of total Billed charges,671.06,37.7,,,percent of total billed charges,37.70% of total billed charges,671.06,37.7,,,percent of total billed charges,37.70% of total billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,603.42,33.9,,,percent of total billed charges,33.9% of total billed charges,890,50,,,percent of total billed charges,50% of total Billed charges,1388.4,78,,,percent of total billed charges,78% of total billed charges,1780,100,,,percent of total billed charges,100% of total billed charges,1470.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1470.28,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,890,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,890,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,1780,
XR Elbow 2 Views Bilateral,32073070,CDM,320,RC,73070,HCPCS,Outpatient,,,727,472.55,TC,639.76,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,727,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,458.01,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,111.23,15.3,,,percent of total billed charges,15.3% of total billed charges,501.63,69,,,percent of total billed charges,69% of total billed charges,727,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,727,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,727,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,274.08,37.7,,,percent of total billed charges,37.70% of total billed charges,274.08,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,246.45,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,567.06,78,,,percent of total billed charges,78% of total billed charges,727,100,,,percent of total billed charges,100% of total billed charges,600.5,82.6,,,percent of total billed charges,82.6% of total billed charges,600.5,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,727,
XR Elbow 2 Views Left,32073070,CDM,320,RC,73070,HCPCS,Outpatient,,,727,472.55,TC|LT,639.76,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,727,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,458.01,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,111.23,15.3,,,percent of total billed charges,15.3% of total billed charges,501.63,69,,,percent of total billed charges,69% of total billed charges,727,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,727,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,727,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,274.08,37.7,,,percent of total billed charges,37.70% of total billed charges,274.08,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,246.45,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,567.06,78,,,percent of total billed charges,78% of total billed charges,727,100,,,percent of total billed charges,100% of total billed charges,600.5,82.6,,,percent of total billed charges,82.6% of total billed charges,600.5,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,727,
XR Elbow 2 Views Right,32073070,CDM,320,RC,73070,HCPCS,Outpatient,,,727,472.55,TC|RT,639.76,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,727,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,458.01,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,111.23,15.3,,,percent of total billed charges,15.3% of total billed charges,501.63,69,,,percent of total billed charges,69% of total billed charges,727,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,727,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,727,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,274.08,37.7,,,percent of total billed charges,37.70% of total billed charges,274.08,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,246.45,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,567.06,78,,,percent of total billed charges,78% of total billed charges,727,100,,,percent of total billed charges,100% of total billed charges,600.5,82.6,,,percent of total billed charges,82.6% of total billed charges,600.5,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,727,
XR Elbow Complete 3+ Views Bilateral,32073080,CDM,320,RC,73080,HCPCS,Outpatient,,,1021,663.65,TC,898.48,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1021,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,643.23,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,156.21,15.3,,,percent of total billed charges,15.3% of total billed charges,704.49,69,,,percent of total billed charges,69% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1021,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1021,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,346.12,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,796.38,78,,,percent of total billed charges,78% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1021,
XR Elbow Complete 3+ Views Left,32073080,CDM,320,RC,73080,HCPCS,Outpatient,,,1021,663.65,TC|LT,898.48,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1021,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,643.23,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,156.21,15.3,,,percent of total billed charges,15.3% of total billed charges,704.49,69,,,percent of total billed charges,69% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1021,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1021,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,346.12,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,796.38,78,,,percent of total billed charges,78% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1021,
XR Elbow Complete 3+ Views Right,32073080,CDM,320,RC,73080,HCPCS,Outpatient,,,1021,663.65,TC|RT,898.48,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1021,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,643.23,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,156.21,15.3,,,percent of total billed charges,15.3% of total billed charges,704.49,69,,,percent of total billed charges,69% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1021,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1021,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,346.12,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,796.38,78,,,percent of total billed charges,78% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1021,
XR Esophagus,32074220,CDM,320,RC,74220,HCPCS,Outpatient,,,1310,851.50,TC,1152.8,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1310,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,825.3,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,200.43,15.3,,,percent of total billed charges,15.3% of total billed charges,903.9,69,,,percent of total billed charges,69% of total billed charges,1310,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1310,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1310,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,493.87,37.7,,,percent of total billed charges,37.70% of total billed charges,493.87,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,444.09,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1021.8,78,,,percent of total billed charges,78% of total billed charges,1310,100,,,percent of total billed charges,100% of total billed charges,1082.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1082.06,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1310,
XR Esophagus Dilation,32074360,CDM,320,RC,74360,HCPCS,Outpatient,,,1533,996.45,TC,1349.04,88,,,percent of total billed charges,88% of total Billed charges,766.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,1533,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,766.5,50,,,percent of total billed charges,50% of total Billed charges,965.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,234.55,15.3,,,percent of total billed charges,15.3% of total billed charges,1057.77,69,,,percent of total billed charges,69% of total billed charges,1533,100,,,percent of total billed charges,100% of total billed charges,766.5,50,,,percent of total billed charges,50% of total Billed charges,1533,100,,,percent of total billed charges,100% of total billed charges,766.5,50,,,percent of total billed charges,50% of total Billed charges,1533,100,,,percent of total billed charges,100% of total billed charges,766.5,50,,,percent of total billed charges,50% of total Billed charges,948.16,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,766.5,50,,,percent of total billed charges,50% of total Billed charges,766.5,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,766.5,50,,,percent of total billed charges,50% of total Billed charges,766.5,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,766.5,50,,,percent of total billed charges,50% of total Billed charges,577.94,37.7,,,percent of total billed charges,37.70% of total billed charges,577.94,37.7,,,percent of total billed charges,37.70% of total billed charges,766.5,50,,,percent of total billed charges,50% of total Billed charges,519.69,33.9,,,percent of total billed charges,33.9% of total billed charges,766.5,50,,,percent of total billed charges,50% of total Billed charges,1195.74,78,,,percent of total billed charges,78% of total billed charges,1533,100,,,percent of total billed charges,100% of total billed charges,1266.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.26,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,766.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,766.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,1533,
XR Esophagus w/ Air Contrast,32074221,CDM,320,RC,74221,HCPCS,Outpatient,,,1310,851.50,TC,1152.8,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1310,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,825.3,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,200.43,15.3,,,percent of total billed charges,15.3% of total billed charges,903.9,69,,,percent of total billed charges,69% of total billed charges,1310,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1310,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1310,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,493.87,37.7,,,percent of total billed charges,37.70% of total billed charges,493.87,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,444.09,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1021.8,78,,,percent of total billed charges,78% of total billed charges,1310,100,,,percent of total billed charges,100% of total billed charges,1082.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1082.06,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1310,
XR Facial Bones < 3 Views,32070140,CDM,320,RC,70140,HCPCS,Outpatient,,,531,345.15,TC,467.28,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,531,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,334.53,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,81.24,15.3,,,percent of total billed charges,15.3% of total billed charges,366.39,69,,,percent of total billed charges,69% of total billed charges,531,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,531,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,531,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,200.19,37.7,,,percent of total billed charges,37.70% of total billed charges,200.19,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,180.01,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,414.18,78,,,percent of total billed charges,78% of total billed charges,531,100,,,percent of total billed charges,100% of total billed charges,438.61,82.6,,,percent of total billed charges,82.6% of total billed charges,438.61,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,531,
XR Facial Bones 3+ Views,32070150,CDM,320,RC,70150,HCPCS,Outpatient,,,1323,859.95,TC,1164.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1323,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,833.49,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,202.42,15.3,,,percent of total billed charges,15.3% of total billed charges,912.87,69,,,percent of total billed charges,69% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1323,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1323,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,448.5,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1031.94,78,,,percent of total billed charges,78% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1323,
XR Finger(s) 2+ Views Left,32073140,CDM,320,RC,73140,HCPCS,Outpatient,,,687,446.55,TC|LT,604.56,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,687,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,432.81,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,105.11,15.3,,,percent of total billed charges,15.3% of total billed charges,474.03,69,,,percent of total billed charges,69% of total billed charges,687,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,687,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,687,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,259,37.7,,,percent of total billed charges,37.70% of total billed charges,259,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,232.89,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,535.86,78,,,percent of total billed charges,78% of total billed charges,687,100,,,percent of total billed charges,100% of total billed charges,567.46,82.6,,,percent of total billed charges,82.6% of total billed charges,567.46,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,687,
XR Finger(s) 2+ Views Right,32073140,CDM,320,RC,73140,HCPCS,Outpatient,,,687,446.55,TC|RT,604.56,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,687,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,432.81,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,105.11,15.3,,,percent of total billed charges,15.3% of total billed charges,474.03,69,,,percent of total billed charges,69% of total billed charges,687,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,687,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,687,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,259,37.7,,,percent of total billed charges,37.70% of total billed charges,259,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,232.89,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,535.86,78,,,percent of total billed charges,78% of total billed charges,687,100,,,percent of total billed charges,100% of total billed charges,567.46,82.6,,,percent of total billed charges,82.6% of total billed charges,567.46,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,687,
XR Fluoro Guidance Needle Loc Spine,32077003,CDM,320,RC,77003,HCPCS,Outpatient,,,2696,1752.40,TC,2372.48,88,,,percent of total billed charges,88% of total Billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,2696,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,1348,50,,,percent of total billed charges,50% of total Billed charges,1698.48,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,412.49,15.3,,,percent of total billed charges,15.3% of total billed charges,1860.24,69,,,percent of total billed charges,69% of total billed charges,2696,100,,,percent of total billed charges,100% of total billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,2696,100,,,percent of total billed charges,100% of total billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,2696,100,,,percent of total billed charges,100% of total billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,1667.48,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1348,50,,,percent of total billed charges,50% of total Billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1348,50,,,percent of total billed charges,50% of total Billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,1348,50,,,percent of total billed charges,50% of total Billed charges,1016.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1016.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,913.94,33.9,,,percent of total billed charges,33.9% of total billed charges,1348,50,,,percent of total billed charges,50% of total Billed charges,2102.88,78,,,percent of total billed charges,78% of total billed charges,2696,100,,,percent of total billed charges,100% of total billed charges,2226.9,82.6,,,percent of total billed charges,82.6% of total billed charges,2226.9,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1348,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1348,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,2696,
XR Fluoro Guidance Needle Placement,32076000,CDM,320,RC,76000,HCPCS,Outpatient,,,1664,1081.60,TC,1464.32,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1664,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1048.32,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,254.59,15.3,,,percent of total billed charges,15.3% of total billed charges,1148.16,69,,,percent of total billed charges,69% of total billed charges,1664,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1664,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1664,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,627.33,37.7,,,percent of total billed charges,37.70% of total billed charges,627.33,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,564.1,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1297.92,78,,,percent of total billed charges,78% of total billed charges,1664,100,,,percent of total billed charges,100% of total billed charges,1374.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1374.46,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1664,
XR Foot 2 Views Bilateral,32073620,CDM,320,RC,73620,HCPCS,Outpatient,,,794,516.10,TC,698.72,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,794,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,500.22,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,121.48,15.3,,,percent of total billed charges,15.3% of total billed charges,547.86,69,,,percent of total billed charges,69% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,794,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,794,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,269.17,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,619.32,78,,,percent of total billed charges,78% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,794,
XR Foot 2 Views Left,32073620,CDM,320,RC,73620,HCPCS,Outpatient,,,794,516.10,TC|LT,698.72,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,794,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,500.22,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,121.48,15.3,,,percent of total billed charges,15.3% of total billed charges,547.86,69,,,percent of total billed charges,69% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,794,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,794,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,269.17,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,619.32,78,,,percent of total billed charges,78% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,794,
XR Foot 2 Views Right,32073620,CDM,320,RC,73620,HCPCS,Outpatient,,,794,516.10,TC|RT,698.72,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,794,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,500.22,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,121.48,15.3,,,percent of total billed charges,15.3% of total billed charges,547.86,69,,,percent of total billed charges,69% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,794,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,794,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,269.17,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,619.32,78,,,percent of total billed charges,78% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,794,
XR Foot Complete 3+ Views Bilateral,32073630,CDM,320,RC,73630,HCPCS,Outpatient,,,1098,713.70,TC|50,966.24,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1098,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,691.74,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,167.99,15.3,,,percent of total billed charges,15.3% of total billed charges,757.62,69,,,percent of total billed charges,69% of total billed charges,1098,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1098,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1098,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,413.95,37.7,,,percent of total billed charges,37.70% of total billed charges,413.95,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,372.22,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,856.44,78,,,percent of total billed charges,78% of total billed charges,1098,100,,,percent of total billed charges,100% of total billed charges,906.95,82.6,,,percent of total billed charges,82.6% of total billed charges,906.95,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1098,
XR Foot Complete 3+ Views Left,32073630,CDM,320,RC,73630,HCPCS,Outpatient,,,1098,713.70,TC|LT,966.24,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1098,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,691.74,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,167.99,15.3,,,percent of total billed charges,15.3% of total billed charges,757.62,69,,,percent of total billed charges,69% of total billed charges,1098,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1098,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1098,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,413.95,37.7,,,percent of total billed charges,37.70% of total billed charges,413.95,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,372.22,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,856.44,78,,,percent of total billed charges,78% of total billed charges,1098,100,,,percent of total billed charges,100% of total billed charges,906.95,82.6,,,percent of total billed charges,82.6% of total billed charges,906.95,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1098,
XR Foot Complete 3+ Views Right,32073630,CDM,320,RC,73630,HCPCS,Outpatient,,,1098,713.70,TC|RT,966.24,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1098,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,691.74,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,167.99,15.3,,,percent of total billed charges,15.3% of total billed charges,757.62,69,,,percent of total billed charges,69% of total billed charges,1098,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1098,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1098,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,413.95,37.7,,,percent of total billed charges,37.70% of total billed charges,413.95,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,372.22,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,856.44,78,,,percent of total billed charges,78% of total billed charges,1098,100,,,percent of total billed charges,100% of total billed charges,906.95,82.6,,,percent of total billed charges,82.6% of total billed charges,906.95,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1098,
XR Forearm 2 Views Bilateral,32073090,CDM,320,RC,73090,HCPCS,Outpatient,,,676,439.40,TC,594.88,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,676,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,425.88,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,103.43,15.3,,,percent of total billed charges,15.3% of total billed charges,466.44,69,,,percent of total billed charges,69% of total billed charges,676,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,676,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,676,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,254.85,37.7,,,percent of total billed charges,37.70% of total billed charges,254.85,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,229.16,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,527.28,78,,,percent of total billed charges,78% of total billed charges,676,100,,,percent of total billed charges,100% of total billed charges,558.38,82.6,,,percent of total billed charges,82.6% of total billed charges,558.38,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,676,
XR Forearm 2 Views Left,32073090,CDM,320,RC,73090,HCPCS,Outpatient,,,676,439.40,TC|LT,594.88,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,676,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,425.88,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,103.43,15.3,,,percent of total billed charges,15.3% of total billed charges,466.44,69,,,percent of total billed charges,69% of total billed charges,676,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,676,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,676,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,254.85,37.7,,,percent of total billed charges,37.70% of total billed charges,254.85,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,229.16,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,527.28,78,,,percent of total billed charges,78% of total billed charges,676,100,,,percent of total billed charges,100% of total billed charges,558.38,82.6,,,percent of total billed charges,82.6% of total billed charges,558.38,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,676,
XR Forearm 2 Views Right,32073090,CDM,320,RC,73090,HCPCS,Outpatient,,,676,439.40,TC|RT,594.88,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,676,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,425.88,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,103.43,15.3,,,percent of total billed charges,15.3% of total billed charges,466.44,69,,,percent of total billed charges,69% of total billed charges,676,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,676,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,676,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,254.85,37.7,,,percent of total billed charges,37.70% of total billed charges,254.85,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,229.16,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,527.28,78,,,percent of total billed charges,78% of total billed charges,676,100,,,percent of total billed charges,100% of total billed charges,558.38,82.6,,,percent of total billed charges,82.6% of total billed charges,558.38,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,676,
XR Foreign Body Localization Eye,32070030,CDM,320,RC,70030,HCPCS,Outpatient,,,1267,823.55,TC,1114.96,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1267,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,798.21,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,193.85,15.3,,,percent of total billed charges,15.3% of total billed charges,874.23,69,,,percent of total billed charges,69% of total billed charges,1267,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1267,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1267,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,477.66,37.7,,,percent of total billed charges,37.70% of total billed charges,477.66,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,429.51,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,988.26,78,,,percent of total billed charges,78% of total billed charges,1267,100,,,percent of total billed charges,100% of total billed charges,1046.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1046.54,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1267,
XR Foreign Body Localization Child 1 Vw,32076010,CDM,320,RC,76010,HCPCS,Outpatient,,,865,562.25,TC,761.2,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,865,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,544.95,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,132.35,15.3,,,percent of total billed charges,15.3% of total billed charges,596.85,69,,,percent of total billed charges,69% of total billed charges,865,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,865,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,865,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,326.11,37.7,,,percent of total billed charges,37.70% of total billed charges,326.11,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,293.24,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,674.7,78,,,percent of total billed charges,78% of total billed charges,865,100,,,percent of total billed charges,100% of total billed charges,714.49,82.6,,,percent of total billed charges,82.6% of total billed charges,714.49,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,865,
XR Fluoroscopy  per Hour,32076000,CDM,320,RC,76000,HCPCS,Outpatient,,,1664,1081.60,TC,1464.32,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1664,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1048.32,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,254.59,15.3,,,percent of total billed charges,15.3% of total billed charges,1148.16,69,,,percent of total billed charges,69% of total billed charges,1664,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1664,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1664,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.9,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,627.33,37.7,,,percent of total billed charges,37.70% of total billed charges,627.33,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,564.1,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1297.92,78,,,percent of total billed charges,78% of total billed charges,1664,100,,,percent of total billed charges,100% of total billed charges,1374.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1374.46,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1664,
XR Femur 2 Views Left,32073552,CDM,320,RC,73552,HCPCS,Outpatient,,,860,559.00,TC|LT,756.8,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,860,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,541.8,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,131.58,15.3,,,percent of total billed charges,15.3% of total billed charges,593.4,69,,,percent of total billed charges,69% of total billed charges,860,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,860,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,860,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,324.22,37.7,,,percent of total billed charges,37.70% of total billed charges,324.22,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,291.54,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,670.8,78,,,percent of total billed charges,78% of total billed charges,860,100,,,percent of total billed charges,100% of total billed charges,710.36,82.6,,,percent of total billed charges,82.6% of total billed charges,710.36,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,860,
XR Femur 2 Views Right,32073552,CDM,320,RC,73552,HCPCS,Outpatient,,,860,559.00,TC|RT,756.8,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,860,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,541.8,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,131.58,15.3,,,percent of total billed charges,15.3% of total billed charges,593.4,69,,,percent of total billed charges,69% of total billed charges,860,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,860,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,860,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,324.22,37.7,,,percent of total billed charges,37.70% of total billed charges,324.22,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,291.54,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,670.8,78,,,percent of total billed charges,78% of total billed charges,860,100,,,percent of total billed charges,100% of total billed charges,710.36,82.6,,,percent of total billed charges,82.6% of total billed charges,710.36,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,860,
XR Femur 2 Views Bilat,32073521,CDM,320,RC,73521,HCPCS,Outpatient,,,1148,746.20,TC,1010.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1148,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,723.24,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,175.64,15.3,,,percent of total billed charges,15.3% of total billed charges,792.12,69,,,percent of total billed charges,69% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,389.17,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,895.44,78,,,percent of total billed charges,78% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1148,
XR Hand 2 Views Bilateral,32073120,CDM,320,RC,73120,HCPCS,Outpatient,,,760,494.00,TC,668.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,760,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,478.8,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,116.28,15.3,,,percent of total billed charges,15.3% of total billed charges,524.4,69,,,percent of total billed charges,69% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,760,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,760,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,257.64,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,592.8,78,,,percent of total billed charges,78% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,760,
XR Hand 2 Views Left,32073120,CDM,320,RC,73120,HCPCS,Outpatient,,,760,494.00,TC|LT,668.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,760,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,478.8,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,116.28,15.3,,,percent of total billed charges,15.3% of total billed charges,524.4,69,,,percent of total billed charges,69% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,760,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,760,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,257.64,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,592.8,78,,,percent of total billed charges,78% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,760,
XR Hand 2 Views Right,32073120,CDM,320,RC,73120,HCPCS,Outpatient,,,760,494.00,TC|RT,668.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,760,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,478.8,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,116.28,15.3,,,percent of total billed charges,15.3% of total billed charges,524.4,69,,,percent of total billed charges,69% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,760,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,760,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,257.64,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,592.8,78,,,percent of total billed charges,78% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,760,
XR Hand Complete 3+ Views Bilateral,32073130,CDM,320,RC,73130,HCPCS,Outpatient,,,1033,671.45,TC|50,909.04,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1033,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,650.79,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,158.05,15.3,,,percent of total billed charges,15.3% of total billed charges,712.77,69,,,percent of total billed charges,69% of total billed charges,1033,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1033,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1033,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,389.44,37.7,,,percent of total billed charges,37.70% of total billed charges,389.44,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,350.19,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,805.74,78,,,percent of total billed charges,78% of total billed charges,1033,100,,,percent of total billed charges,100% of total billed charges,853.26,82.6,,,percent of total billed charges,82.6% of total billed charges,853.26,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1033,
XR Hand Complete 3+ Views Left,32073130,CDM,320,RC,73130,HCPCS,Outpatient,,,1033,671.45,TC|LT,909.04,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1033,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,650.79,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,158.05,15.3,,,percent of total billed charges,15.3% of total billed charges,712.77,69,,,percent of total billed charges,69% of total billed charges,1033,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1033,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1033,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,389.44,37.7,,,percent of total billed charges,37.70% of total billed charges,389.44,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,350.19,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,805.74,78,,,percent of total billed charges,78% of total billed charges,1033,100,,,percent of total billed charges,100% of total billed charges,853.26,82.6,,,percent of total billed charges,82.6% of total billed charges,853.26,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1033,
XR Hand Complete 3+ Views Right,32073130,CDM,320,RC,73130,HCPCS,Outpatient,,,1033,671.45,TC|RT,909.04,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1033,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,650.79,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,158.05,15.3,,,percent of total billed charges,15.3% of total billed charges,712.77,69,,,percent of total billed charges,69% of total billed charges,1033,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1033,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1033,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,389.44,37.7,,,percent of total billed charges,37.70% of total billed charges,389.44,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,350.19,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,805.74,78,,,percent of total billed charges,78% of total billed charges,1033,100,,,percent of total billed charges,100% of total billed charges,853.26,82.6,,,percent of total billed charges,82.6% of total billed charges,853.26,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1033,
XR Hip 1 View Left,32073501,CDM,320,RC,73501,HCPCS,Outpatient,,,737,479.05,TC|LT,648.56,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,737,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,464.31,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,112.76,15.3,,,percent of total billed charges,15.3% of total billed charges,508.53,69,,,percent of total billed charges,69% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,249.84,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,574.86,78,,,percent of total billed charges,78% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,737,
XR Hip 1 View Right,32073501,CDM,320,RC,73501,HCPCS,Outpatient,,,737,479.05,TC|RT,648.56,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,737,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,464.31,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,112.76,15.3,,,percent of total billed charges,15.3% of total billed charges,508.53,69,,,percent of total billed charges,69% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,737,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,277.85,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,249.84,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,574.86,78,,,percent of total billed charges,78% of total billed charges,737,100,,,percent of total billed charges,100% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,608.76,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,737,
XR Humerus Left,32073060,CDM,320,RC,73060,HCPCS,Outpatient,,,796,517.40,TC|LT,700.48,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,796,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,501.48,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,121.79,15.3,,,percent of total billed charges,15.3% of total billed charges,549.24,69,,,percent of total billed charges,69% of total billed charges,796,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,796,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,796,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,300.09,37.7,,,percent of total billed charges,37.70% of total billed charges,300.09,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,269.84,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,620.88,78,,,percent of total billed charges,78% of total billed charges,796,100,,,percent of total billed charges,100% of total billed charges,657.5,82.6,,,percent of total billed charges,82.6% of total billed charges,657.5,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,796,
XR Humerus Right,32073060,CDM,320,RC,73060,HCPCS,Outpatient,,,796,517.40,TC|RT,700.48,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,796,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,501.48,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,121.79,15.3,,,percent of total billed charges,15.3% of total billed charges,549.24,69,,,percent of total billed charges,69% of total billed charges,796,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,796,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,796,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,300.09,37.7,,,percent of total billed charges,37.70% of total billed charges,300.09,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,269.84,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,620.88,78,,,percent of total billed charges,78% of total billed charges,796,100,,,percent of total billed charges,100% of total billed charges,657.5,82.6,,,percent of total billed charges,82.6% of total billed charges,657.5,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,796,
XR Hip 2-3 Views Left,32073502,CDM,320,RC,73502,HCPCS,Outpatient,,,1092,709.80,LT,960.96,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1092,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,687.96,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,167.08,15.3,,,percent of total billed charges,15.3% of total billed charges,753.48,69,,,percent of total billed charges,69% of total billed charges,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,411.68,37.7,,,percent of total billed charges,37.70% of total billed charges,411.68,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,370.19,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,851.76,78,,,percent of total billed charges,78% of total billed charges,1092,100,,,percent of total billed charges,100% of total billed charges,901.99,82.6,,,percent of total billed charges,82.6% of total billed charges,901.99,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1092,
XR Hip 2-3 Views Right,32073502,CDM,320,RC,73502,HCPCS,Outpatient,,,1092,709.80,TC|RT,960.96,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1092,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,687.96,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,167.08,15.3,,,percent of total billed charges,15.3% of total billed charges,753.48,69,,,percent of total billed charges,69% of total billed charges,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,411.68,37.7,,,percent of total billed charges,37.70% of total billed charges,411.68,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,370.19,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,851.76,78,,,percent of total billed charges,78% of total billed charges,1092,100,,,percent of total billed charges,100% of total billed charges,901.99,82.6,,,percent of total billed charges,82.6% of total billed charges,901.99,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1092,
XR Hip 2-3 Views w/AP Pelvis Left,32073502,CDM,320,RC,73502,HCPCS,Outpatient,,,1092,709.80,TC|LT,960.96,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1092,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,687.96,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,167.08,15.3,,,percent of total billed charges,15.3% of total billed charges,753.48,69,,,percent of total billed charges,69% of total billed charges,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,411.68,37.7,,,percent of total billed charges,37.70% of total billed charges,411.68,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,370.19,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,851.76,78,,,percent of total billed charges,78% of total billed charges,1092,100,,,percent of total billed charges,100% of total billed charges,901.99,82.6,,,percent of total billed charges,82.6% of total billed charges,901.99,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1092,
XR Hip 2-3 Views w/AP Pelvis Right,32073502,CDM,320,RC,73502,HCPCS,Outpatient,,,1092,709.80,TC|RT,960.96,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1092,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,687.96,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,167.08,15.3,,,percent of total billed charges,15.3% of total billed charges,753.48,69,,,percent of total billed charges,69% of total billed charges,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1092,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,411.68,37.7,,,percent of total billed charges,37.70% of total billed charges,411.68,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,370.19,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,851.76,78,,,percent of total billed charges,78% of total billed charges,1092,100,,,percent of total billed charges,100% of total billed charges,901.99,82.6,,,percent of total billed charges,82.6% of total billed charges,901.99,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1092,
XR Hip 4+ Views w/AP Pelvis Left,32073503,CDM,320,RC,73503,HCPCS,Outpatient,,,1639,1065.35,TC|LT,1442.32,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1639,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1032.57,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,250.77,15.3,,,percent of total billed charges,15.3% of total billed charges,1130.91,69,,,percent of total billed charges,69% of total billed charges,1639,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1639,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1639,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,617.9,37.7,,,percent of total billed charges,37.70% of total billed charges,617.9,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,555.62,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1278.42,78,,,percent of total billed charges,78% of total billed charges,1639,100,,,percent of total billed charges,100% of total billed charges,1353.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1353.81,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1639,
XR Hips 2 Views Bilat,32073521,CDM,320,RC,73521,HCPCS,Outpatient,,,1148,746.20,TC,1010.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1148,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,723.24,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,175.64,15.3,,,percent of total billed charges,15.3% of total billed charges,792.12,69,,,percent of total billed charges,69% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,389.17,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,895.44,78,,,percent of total billed charges,78% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1148,
XR Hips 2 Views w/AP Pelvis Bilat,32073521,CDM,320,RC,73521,HCPCS,Outpatient,,,1148,746.20,TC,1010.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1148,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,723.24,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,175.64,15.3,,,percent of total billed charges,15.3% of total billed charges,792.12,69,,,percent of total billed charges,69% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,389.17,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,895.44,78,,,percent of total billed charges,78% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1148,
XR Hips 3-4 Views w/AP Pelvis Bilat,32073522,CDM,320,RC,73522,HCPCS,Outpatient,,,1148,746.20,TC,1010.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1148,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,723.24,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,175.64,15.3,,,percent of total billed charges,15.3% of total billed charges,792.12,69,,,percent of total billed charges,69% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1148,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,389.17,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,895.44,78,,,percent of total billed charges,78% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1148,
XR Hips 5+ Views w/AP Pelvis Bilat,32073523,CDM,320,RC,73523,HCPCS,Outpatient,,,2295,1491.75,TC,2019.6,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,2295,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1445.85,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,351.14,15.3,,,percent of total billed charges,15.3% of total billed charges,1583.55,69,,,percent of total billed charges,69% of total billed charges,2295,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2295,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2295,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,865.22,37.7,,,percent of total billed charges,37.70% of total billed charges,865.22,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,778.01,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1790.1,78,,,percent of total billed charges,78% of total billed charges,2295,100,,,percent of total billed charges,100% of total billed charges,1895.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1895.67,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,2295,
XR IVP,32074400,CDM,320,RC,74400,HCPCS,Outpatient,,,1120,728.00,TC,985.6,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1120,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,705.6,63,,,percent of total billed charges,63% of total billed charges,327.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,171.36,15.3,,,percent of total billed charges,15.3% of total billed charges,772.8,69,,,percent of total billed charges,69% of total billed charges,1120,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1120,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1120,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,422.24,37.7,,,percent of total billed charges,37.70% of total billed charges,422.24,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,379.68,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,873.6,78,,,percent of total billed charges,78% of total billed charges,1120,100,,,percent of total billed charges,100% of total billed charges,925.12,82.6,,,percent of total billed charges,82.6% of total billed charges,925.12,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1120,
XR Joint/Bursa Major Arthr/Asp/Inj Left,32027096,CDM,320,RC,27096,HCPCS,Outpatient,,,1303,846.95,LT,1146.64,88,,,percent of total billed charges,88% of total Billed charges,651.5,50,,,percent of total billed charges,50% of total Billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid,1303,100,,,percent of total billed charges,100% of total billed charges,457.07,103,,,Fee Schedule,103% of WA Medicaid,651.5,50,,,percent of total billed charges,50% of total Billed charges,820.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,443.75,100,,,Fee Schedule,100% of WA Medicaid,199.36,15.3,,,percent of total billed charges,15.3% of total billed charges,899.07,69,,,percent of total billed charges,69% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,651.5,50,,,percent of total billed charges,50% of total Billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,651.5,50,,,percent of total billed charges,50% of total Billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,651.5,50,,,percent of total billed charges,50% of total Billed charges,805.91,61.85,,,percent of total billed charges,61.85% of total billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,651.5,50,,,percent of total billed charges,50% of total Billed charges,651.5,50,,,percent of total billed charges,50% of total Billed charges,328.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,651.5,50,,,percent of total billed charges,50% of total Billed charges,651.5,50,,,percent of total billed charges,50% of total Billed charges,452.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,576.88,130,,,Fee Schedule,130% of WA Medicaid ,651.5,50,,,percent of total billed charges,50% of total Billed charges,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,651.5,50,,,percent of total billed charges,50% of total Billed charges,441.72,33.9,,,percent of total billed charges,33.9% of total billed charges,651.5,50,,,percent of total billed charges,50% of total Billed charges,1016.34,78,,,percent of total billed charges,78% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,651.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,651.5,50,,,percent of total billed charges,50% of total Billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,199.36,1303,
XR Knee 1 or 2 Views Bilateral,32073560,CDM,320,RC,73560,HCPCS,Outpatient,,,972,631.80,TC,855.36,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,972,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,612.36,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,148.72,15.3,,,percent of total billed charges,15.3% of total billed charges,670.68,69,,,percent of total billed charges,69% of total billed charges,972,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,972,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,972,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,366.44,37.7,,,percent of total billed charges,37.70% of total billed charges,366.44,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,329.51,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,758.16,78,,,percent of total billed charges,78% of total billed charges,972,100,,,percent of total billed charges,100% of total billed charges,802.87,82.6,,,percent of total billed charges,82.6% of total billed charges,802.87,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,972,
XR Knee 1 or 2 Views Left,32073560,CDM,320,RC,73560,HCPCS,Outpatient,,,972,631.80,TC|LT,855.36,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,972,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,612.36,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,148.72,15.3,,,percent of total billed charges,15.3% of total billed charges,670.68,69,,,percent of total billed charges,69% of total billed charges,972,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,972,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,972,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,366.44,37.7,,,percent of total billed charges,37.70% of total billed charges,366.44,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,329.51,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,758.16,78,,,percent of total billed charges,78% of total billed charges,972,100,,,percent of total billed charges,100% of total billed charges,802.87,82.6,,,percent of total billed charges,82.6% of total billed charges,802.87,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,972,
XR Knee 1 or 2 Views Right,32073560,CDM,320,RC,73560,HCPCS,Outpatient,,,972,631.80,TC|RT,855.36,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,972,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,612.36,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,148.72,15.3,,,percent of total billed charges,15.3% of total billed charges,670.68,69,,,percent of total billed charges,69% of total billed charges,972,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,972,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,972,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,366.44,37.7,,,percent of total billed charges,37.70% of total billed charges,366.44,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,329.51,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,758.16,78,,,percent of total billed charges,78% of total billed charges,972,100,,,percent of total billed charges,100% of total billed charges,802.87,82.6,,,percent of total billed charges,82.6% of total billed charges,802.87,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,972,
XR Knee 3 Views Bilateral,32073562,CDM,320,RC,73562,HCPCS,Outpatient,,,1201,780.65,TC|50,1056.88,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1201,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,756.63,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,183.75,15.3,,,percent of total billed charges,15.3% of total billed charges,828.69,69,,,percent of total billed charges,69% of total billed charges,1201,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1201,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1201,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,452.78,37.7,,,percent of total billed charges,37.70% of total billed charges,452.78,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,407.14,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,936.78,78,,,percent of total billed charges,78% of total billed charges,1201,100,,,percent of total billed charges,100% of total billed charges,992.03,82.6,,,percent of total billed charges,82.6% of total billed charges,992.03,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1201,
XR Knee 3 Views,32073562,CDM,320,RC,73562,HCPCS,Outpatient,,,1201,780.65,TC|LT,1056.88,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1201,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,756.63,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,183.75,15.3,,,percent of total billed charges,15.3% of total billed charges,828.69,69,,,percent of total billed charges,69% of total billed charges,1201,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1201,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1201,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,452.78,37.7,,,percent of total billed charges,37.70% of total billed charges,452.78,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,407.14,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,936.78,78,,,percent of total billed charges,78% of total billed charges,1201,100,,,percent of total billed charges,100% of total billed charges,992.03,82.6,,,percent of total billed charges,82.6% of total billed charges,992.03,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1201,
XR Knee 3 Views,32073562,CDM,320,RC,73562,HCPCS,Outpatient,,,1201,780.65,TC|LT,1056.88,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1201,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,756.63,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,183.75,15.3,,,percent of total billed charges,15.3% of total billed charges,828.69,69,,,percent of total billed charges,69% of total billed charges,1201,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1201,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1201,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,452.78,37.7,,,percent of total billed charges,37.70% of total billed charges,452.78,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,407.14,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,936.78,78,,,percent of total billed charges,78% of total billed charges,1201,100,,,percent of total billed charges,100% of total billed charges,992.03,82.6,,,percent of total billed charges,82.6% of total billed charges,992.03,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1201,
XR Knee Complete 4+ Views Bilateral,32073564,CDM,320,RC,73564,HCPCS,Outpatient,,,1383,898.95,50|TC,1217.04,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1383,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,871.29,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,211.6,15.3,,,percent of total billed charges,15.3% of total billed charges,954.27,69,,,percent of total billed charges,69% of total billed charges,1383,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1383,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1383,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,521.39,37.7,,,percent of total billed charges,37.70% of total billed charges,521.39,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,468.84,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1078.74,78,,,percent of total billed charges,78% of total billed charges,1383,100,,,percent of total billed charges,100% of total billed charges,1142.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1142.36,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1383,
XR Knee Complete 4+ Views Left,32073564,CDM,320,RC,73564,HCPCS,Outpatient,,,1383,898.95,TC|LT,1217.04,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1383,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,871.29,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,211.6,15.3,,,percent of total billed charges,15.3% of total billed charges,954.27,69,,,percent of total billed charges,69% of total billed charges,1383,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1383,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1383,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,521.39,37.7,,,percent of total billed charges,37.70% of total billed charges,521.39,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,468.84,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1078.74,78,,,percent of total billed charges,78% of total billed charges,1383,100,,,percent of total billed charges,100% of total billed charges,1142.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1142.36,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1383,
XR Knee Complete 4+ Views Right,32073564,CDM,320,RC,73564,HCPCS,Outpatient,,,1383,898.95,TC|RT,1217.04,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1383,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,871.29,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,211.6,15.3,,,percent of total billed charges,15.3% of total billed charges,954.27,69,,,percent of total billed charges,69% of total billed charges,1383,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1383,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1383,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,521.39,37.7,,,percent of total billed charges,37.70% of total billed charges,521.39,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,468.84,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1078.74,78,,,percent of total billed charges,78% of total billed charges,1383,100,,,percent of total billed charges,100% of total billed charges,1142.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1142.36,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1383,
XR Knee 1 View Standing AP Bilateral,32073565,CDM,320,RC,73565,HCPCS,Outpatient,,,1138,739.70,TC,1001.44,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1138,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,716.94,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,174.11,15.3,,,percent of total billed charges,15.3% of total billed charges,785.22,69,,,percent of total billed charges,69% of total billed charges,1138,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1138,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1138,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,429.03,37.7,,,percent of total billed charges,37.70% of total billed charges,429.03,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,385.78,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,887.64,78,,,percent of total billed charges,78% of total billed charges,1138,100,,,percent of total billed charges,100% of total billed charges,939.99,82.6,,,percent of total billed charges,82.6% of total billed charges,939.99,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1138,
XR Lower Extremity Infant (0-1yr) Bilat,32073592,CDM,320,RC,73592,HCPCS,Outpatient,,,385,250.25,TC|50,338.8,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,385,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,242.55,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,58.91,15.3,,,percent of total billed charges,15.3% of total billed charges,265.65,69,,,percent of total billed charges,69% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,130.52,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,300.3,78,,,percent of total billed charges,78% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,385,
XR Lower Extremity Infant (0-1yr) Left,32073592,CDM,320,RC,73592,HCPCS,Outpatient,,,385,250.25,TC|LT,338.8,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,385,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,242.55,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,58.91,15.3,,,percent of total billed charges,15.3% of total billed charges,265.65,69,,,percent of total billed charges,69% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,130.52,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,300.3,78,,,percent of total billed charges,78% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,385,
XR Lower Extremity Infant (0-1yr) Right,32073592,CDM,320,RC,73592,HCPCS,Outpatient,,,385,250.25,TC|RT,338.8,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,385,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,242.55,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,58.91,15.3,,,percent of total billed charges,15.3% of total billed charges,265.65,69,,,percent of total billed charges,69% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,130.52,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,300.3,78,,,percent of total billed charges,78% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,385,
"Spinal puncture, lumbar, diagnostic",32062270,CDM,320,RC,62270,HCPCS,Outpatient,,,1538,999.70,TC,1353.44,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1538,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,968.94,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,235.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1061.22,69,,,percent of total billed charges,69% of total billed charges,1538,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1538,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1538,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,579.83,37.7,,,percent of total billed charges,37.70% of total billed charges,579.83,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,521.38,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1199.64,78,,,percent of total billed charges,78% of total billed charges,1538,100,,,percent of total billed charges,100% of total billed charges,1270.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1270.39,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,235.31,2578.03,
XR Lumbar Puncture Diagnostic,32062328,CDM,320,RC,62328,HCPCS,Outpatient,,,1538,999.70,TC,1353.44,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1538,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,968.94,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,235.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1061.22,69,,,percent of total billed charges,69% of total billed charges,1538,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1538,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1538,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,579.83,37.7,,,percent of total billed charges,37.70% of total billed charges,579.83,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,521.38,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1199.64,78,,,percent of total billed charges,78% of total billed charges,1538,100,,,percent of total billed charges,100% of total billed charges,1270.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1270.39,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,235.31,2578.03,
XR Mandible Complete 4+ Views,32070110,CDM,320,RC,70110,HCPCS,Outpatient,,,1123,729.95,TC,988.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1123,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,707.49,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,171.82,15.3,,,percent of total billed charges,15.3% of total billed charges,774.87,69,,,percent of total billed charges,69% of total billed charges,1123,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1123,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1123,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,423.37,37.7,,,percent of total billed charges,37.70% of total billed charges,423.37,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,380.7,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,875.94,78,,,percent of total billed charges,78% of total billed charges,1123,100,,,percent of total billed charges,100% of total billed charges,927.6,82.6,,,percent of total billed charges,82.6% of total billed charges,927.6,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1123,
XR Mandible Less Than 4 Views,32070100,CDM,320,RC,70100,HCPCS,Outpatient,,,670,435.50,TC,589.6,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,670,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,422.1,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,102.51,15.3,,,percent of total billed charges,15.3% of total billed charges,462.3,69,,,percent of total billed charges,69% of total billed charges,670,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,670,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,670,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,252.59,37.7,,,percent of total billed charges,37.70% of total billed charges,252.59,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,227.13,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,522.6,78,,,percent of total billed charges,78% of total billed charges,670,100,,,percent of total billed charges,100% of total billed charges,553.42,82.6,,,percent of total billed charges,82.6% of total billed charges,553.42,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,670,
XR Mastoids Complete,32070130,CDM,320,RC,70130,HCPCS,Outpatient,,,1097,713.05,TC,965.36,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1097,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,691.11,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,167.84,15.3,,,percent of total billed charges,15.3% of total billed charges,756.93,69,,,percent of total billed charges,69% of total billed charges,1097,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1097,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1097,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,413.57,37.7,,,percent of total billed charges,37.70% of total billed charges,413.57,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,371.88,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,855.66,78,,,percent of total billed charges,78% of total billed charges,1097,100,,,percent of total billed charges,100% of total billed charges,906.12,82.6,,,percent of total billed charges,82.6% of total billed charges,906.12,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1097,
XR Myelogram Cervical Spine,32062302,CDM,320,RC,62302,HCPCS,Outpatient,,,4937,3209.05,TC,4344.56,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,544.08,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3110.31,63,,,percent of total billed charges,63% of total billed charges,1429.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,755.36,15.3,,,percent of total billed charges,15.3% of total billed charges,3406.53,69,,,percent of total billed charges,69% of total billed charges,4937,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,4937,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,4937,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.44,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,391.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,538.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,686.71,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1861.25,37.7,,,percent of total billed charges,37.70% of total billed charges,1861.25,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1673.64,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3850.86,78,,,percent of total billed charges,78% of total billed charges,4937,100,,,percent of total billed charges,100% of total billed charges,4077.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4077.96,82.6,,,percent of total billed charges,82.6% of total billed charges,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,391.29,4937,
XR Myelogram Lumbosacral Spine,32062304,CDM,320,RC,62304,HCPCS,Outpatient,,,4807,3124.55,TC,4230.16,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,544.08,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3028.41,63,,,percent of total billed charges,63% of total billed charges,1429.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,735.47,15.3,,,percent of total billed charges,15.3% of total billed charges,3316.83,69,,,percent of total billed charges,69% of total billed charges,4807,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,4807,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,4807,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.44,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,391.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,538.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,686.71,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1812.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1812.24,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1629.57,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3749.46,78,,,percent of total billed charges,78% of total billed charges,4807,100,,,percent of total billed charges,100% of total billed charges,3970.58,82.6,,,percent of total billed charges,82.6% of total billed charges,3970.58,82.6,,,percent of total billed charges,82.6% of total billed charges,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,391.29,4807,
XR Myelogram Thoracic Spine,32062303,CDM,320,RC,62303,HCPCS,Outpatient,,,3923,2549.95,TC,3452.24,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,3923,100,,,percent of total billed charges,100% of total billed charges,544.08,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2471.49,63,,,percent of total billed charges,63% of total billed charges,1429.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,600.22,15.3,,,percent of total billed charges,15.3% of total billed charges,2706.87,69,,,percent of total billed charges,69% of total billed charges,3923,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3923,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3923,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.44,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,391.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,538.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,686.71,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1478.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1478.97,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1329.9,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3059.94,78,,,percent of total billed charges,78% of total billed charges,3923,100,,,percent of total billed charges,100% of total billed charges,3240.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3240.4,82.6,,,percent of total billed charges,82.6% of total billed charges,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,391.29,3923,
XR Myelogram 2 or More Regions w/ Inject,32062305,CDM,320,RC,62305,HCPCS,Outpatient,,,4770,3100.50,TC,4197.6,88,,,percent of total billed charges,88% of total Billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,544.08,103,,,Fee Schedule,103% of WA Medicaid,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3005.1,63,,,percent of total billed charges,63% of total billed charges,1429.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid,729.81,15.3,,,percent of total billed charges,15.3% of total billed charges,3291.3,69,,,percent of total billed charges,69% of total billed charges,4770,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,4770,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,4770,100,,,percent of total billed charges,100% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,2905.44,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,391.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,538.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,686.71,130,,,Fee Schedule,130% of WA Medicaid ,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1798.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1798.29,37.7,,,percent of total billed charges,37.70% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,1617.03,33.9,,,percent of total billed charges,33.9% of total billed charges,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,3720.6,78,,,percent of total billed charges,78% of total billed charges,4770,100,,,percent of total billed charges,100% of total billed charges,3940.02,82.6,,,percent of total billed charges,82.6% of total billed charges,3940.02,82.6,,,percent of total billed charges,82.6% of total billed charges,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,824.82,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,816.66,100,,,Fee Schedule,100% of Medicare OPPS rate,528.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,391.29,4770,
XR Nasal Bones 3+ Views,32070160,CDM,320,RC,70160,HCPCS,Outpatient,,,1323,859.95,TC,1164.24,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1323,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,833.49,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,202.42,15.3,,,percent of total billed charges,15.3% of total billed charges,912.87,69,,,percent of total billed charges,69% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1323,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1323,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,448.5,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1031.94,78,,,percent of total billed charges,78% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1323,
XR Neck Soft Tissue,32070360,CDM,320,RC,70360,HCPCS,Outpatient,,,769,499.85,TC,676.72,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,769,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,484.47,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,117.66,15.3,,,percent of total billed charges,15.3% of total billed charges,530.61,69,,,percent of total billed charges,69% of total billed charges,769,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,769,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,769,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,289.91,37.7,,,percent of total billed charges,37.70% of total billed charges,289.91,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,260.69,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,599.82,78,,,percent of total billed charges,78% of total billed charges,769,100,,,percent of total billed charges,100% of total billed charges,635.19,82.6,,,percent of total billed charges,82.6% of total billed charges,635.19,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,769,
XR Nerve Block Inj,32064450,CDM,320,RC,64450,HCPCS,Outpatient,,,1646,1069.90,TC,1448.48,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,1646,100,,,percent of total billed charges,100% of total billed charges,403.97,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1036.98,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,251.84,15.3,,,percent of total billed charges,15.3% of total billed charges,1135.74,69,,,percent of total billed charges,69% of total billed charges,1646,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1646,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1646,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,290.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,400.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,620.54,37.7,,,percent of total billed charges,37.70% of total billed charges,620.54,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,557.99,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1283.88,78,,,percent of total billed charges,78% of total billed charges,1646,100,,,percent of total billed charges,100% of total billed charges,1359.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1359.6,82.6,,,percent of total billed charges,82.6% of total billed charges,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,251.84,2578.03,
XR Osseous Survey Complete,32077075,CDM,320,RC,77075,HCPCS,Outpatient,,,1639,1065.35,TC,1442.32,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1639,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1032.57,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,250.77,15.3,,,percent of total billed charges,15.3% of total billed charges,1130.91,69,,,percent of total billed charges,69% of total billed charges,1639,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1639,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1639,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,617.9,37.7,,,percent of total billed charges,37.70% of total billed charges,617.9,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,555.62,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1278.42,78,,,percent of total billed charges,78% of total billed charges,1639,100,,,percent of total billed charges,100% of total billed charges,1353.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1353.81,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1639,
XR Osseous Survey Infant,32077076,CDM,320,RC,77076,HCPCS,Outpatient,,,1880,1222.00,TC,1654.4,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1880,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1184.4,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,287.64,15.3,,,percent of total billed charges,15.3% of total billed charges,1297.2,69,,,percent of total billed charges,69% of total billed charges,1880,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1880,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1880,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,708.76,37.7,,,percent of total billed charges,37.70% of total billed charges,708.76,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,637.32,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1466.4,78,,,percent of total billed charges,78% of total billed charges,1880,100,,,percent of total billed charges,100% of total billed charges,1552.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1552.88,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1880,
XR Osseous Survey Limited,32077074,CDM,320,RC,77074,HCPCS,Outpatient,,,547,355.55,TC,481.36,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,547,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,344.61,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,83.69,15.3,,,percent of total billed charges,15.3% of total billed charges,377.43,69,,,percent of total billed charges,69% of total billed charges,547,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,547,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,547,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,206.22,37.7,,,percent of total billed charges,37.70% of total billed charges,206.22,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,185.43,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,426.66,78,,,percent of total billed charges,78% of total billed charges,547,100,,,percent of total billed charges,100% of total billed charges,451.82,82.6,,,percent of total billed charges,82.6% of total billed charges,451.82,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,547,
XR Orbits Complete,32070200,CDM,320,RC,70200,HCPCS,Outpatient,,,1329,863.85,TC,1169.52,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1329,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,837.27,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,203.34,15.3,,,percent of total billed charges,15.3% of total billed charges,917.01,69,,,percent of total billed charges,69% of total billed charges,1329,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1329,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1329,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,501.03,37.7,,,percent of total billed charges,37.70% of total billed charges,501.03,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,450.53,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1036.62,78,,,percent of total billed charges,78% of total billed charges,1329,100,,,percent of total billed charges,100% of total billed charges,1097.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1097.75,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1329,
XR Pelvis 1 or 2 Views,32072170,CDM,320,RC,72170,HCPCS,Outpatient,,,801,520.65,TC,704.88,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,801,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,504.63,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,122.55,15.3,,,percent of total billed charges,15.3% of total billed charges,552.69,69,,,percent of total billed charges,69% of total billed charges,801,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,801,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,801,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,301.98,37.7,,,percent of total billed charges,37.70% of total billed charges,301.98,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,271.54,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,624.78,78,,,percent of total billed charges,78% of total billed charges,801,100,,,percent of total billed charges,100% of total billed charges,661.63,82.6,,,percent of total billed charges,82.6% of total billed charges,661.63,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,801,
XR Pelvis Complete 3+ Views,32072190,CDM,320,RC,72190,HCPCS,Outpatient,,,1058,687.70,TC,931.04,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1058,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,666.54,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,161.87,15.3,,,percent of total billed charges,15.3% of total billed charges,730.02,69,,,percent of total billed charges,69% of total billed charges,1058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1058,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,398.87,37.7,,,percent of total billed charges,37.70% of total billed charges,398.87,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,358.66,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,825.24,78,,,percent of total billed charges,78% of total billed charges,1058,100,,,percent of total billed charges,100% of total billed charges,873.91,82.6,,,percent of total billed charges,82.6% of total billed charges,873.91,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1058,
XR Placement CVAD w/ Fluoro,32077001,CDM,320,RC,77001,HCPCS,Outpatient,,,1337,869.05,TC,1176.56,88,,,percent of total billed charges,88% of total Billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,1337,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,668.5,50,,,percent of total billed charges,50% of total Billed charges,842.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,204.56,15.3,,,percent of total billed charges,15.3% of total billed charges,922.53,69,,,percent of total billed charges,69% of total billed charges,1337,100,,,percent of total billed charges,100% of total billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,1337,100,,,percent of total billed charges,100% of total billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,1337,100,,,percent of total billed charges,100% of total billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,826.93,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,668.5,50,,,percent of total billed charges,50% of total Billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,668.5,50,,,percent of total billed charges,50% of total Billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,668.5,50,,,percent of total billed charges,50% of total Billed charges,504.05,37.7,,,percent of total billed charges,37.70% of total billed charges,504.05,37.7,,,percent of total billed charges,37.70% of total billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,453.24,33.9,,,percent of total billed charges,33.9% of total billed charges,668.5,50,,,percent of total billed charges,50% of total Billed charges,1042.86,78,,,percent of total billed charges,78% of total billed charges,1337,100,,,percent of total billed charges,100% of total billed charges,1104.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1104.36,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,668.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,668.5,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.98,1337,
XR Pyelostogram,32074425,CDM,320,RC,74425,HCPCS,Outpatient,,,2938,1909.70,TC,2585.44,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2938,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1850.94,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,449.51,15.3,,,percent of total billed charges,15.3% of total billed charges,2027.22,69,,,percent of total billed charges,69% of total billed charges,2938,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2938,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2938,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1107.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1107.63,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,995.98,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2291.64,78,,,percent of total billed charges,78% of total billed charges,2938,100,,,percent of total billed charges,100% of total billed charges,2426.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2426.79,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2938,
XR Ribs 2 Views Left,32071100,CDM,320,RC,71100,HCPCS,Outpatient,,,1232,800.80,TC|LT,1084.16,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1232,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,776.16,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,188.5,15.3,,,percent of total billed charges,15.3% of total billed charges,850.08,69,,,percent of total billed charges,69% of total billed charges,1232,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1232,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1232,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,464.46,37.7,,,percent of total billed charges,37.70% of total billed charges,464.46,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,417.65,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,960.96,78,,,percent of total billed charges,78% of total billed charges,1232,100,,,percent of total billed charges,100% of total billed charges,1017.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1017.63,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1232,
XR Ribs 2 Views Right,32071100,CDM,320,RC,71100,HCPCS,Outpatient,,,1587,1031.55,TC|RT,1396.56,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1587,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,999.81,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,242.81,15.3,,,percent of total billed charges,15.3% of total billed charges,1095.03,69,,,percent of total billed charges,69% of total billed charges,1587,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1587,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1587,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,598.3,37.7,,,percent of total billed charges,37.70% of total billed charges,598.3,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,537.99,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1237.86,78,,,percent of total billed charges,78% of total billed charges,1587,100,,,percent of total billed charges,100% of total billed charges,1310.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.86,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1587,
XR Ribs 3 Views Bilateral,32071110,CDM,320,RC,71110,HCPCS,Outpatient,,,1283,833.95,TC,1129.04,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1283,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,808.29,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,196.3,15.3,,,percent of total billed charges,15.3% of total billed charges,885.27,69,,,percent of total billed charges,69% of total billed charges,1283,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1283,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1283,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,483.69,37.7,,,percent of total billed charges,37.70% of total billed charges,483.69,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,434.94,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1000.74,78,,,percent of total billed charges,78% of total billed charges,1283,100,,,percent of total billed charges,100% of total billed charges,1059.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1059.76,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1283,
XR Ribs w/ PA Chest Left,32071101,CDM,320,RC,71101,HCPCS,Outpatient,,,1587,1031.55,TC|LT,1396.56,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1587,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,999.81,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,242.81,15.3,,,percent of total billed charges,15.3% of total billed charges,1095.03,69,,,percent of total billed charges,69% of total billed charges,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,598.3,37.7,,,percent of total billed charges,37.70% of total billed charges,598.3,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,537.99,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1237.86,78,,,percent of total billed charges,78% of total billed charges,1587,100,,,percent of total billed charges,100% of total billed charges,1310.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.86,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1587,
XR Ribs w/ PA Chest Right,32071101,CDM,320,RC,71101,HCPCS,Outpatient,,,1587,1031.55,TC|RT,1396.56,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1587,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,999.81,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,242.81,15.3,,,percent of total billed charges,15.3% of total billed charges,1095.03,69,,,percent of total billed charges,69% of total billed charges,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,598.3,37.7,,,percent of total billed charges,37.70% of total billed charges,598.3,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,537.99,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1237.86,78,,,percent of total billed charges,78% of total billed charges,1587,100,,,percent of total billed charges,100% of total billed charges,1310.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.86,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1587,
XR Ribs 3 Views Left,32071101,CDM,320,RC,71101,HCPCS,Outpatient,,,1587,1031.55,TC|LT,1396.56,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1587,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,999.81,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,242.81,15.3,,,percent of total billed charges,15.3% of total billed charges,1095.03,69,,,percent of total billed charges,69% of total billed charges,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,598.3,37.7,,,percent of total billed charges,37.70% of total billed charges,598.3,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,537.99,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1237.86,78,,,percent of total billed charges,78% of total billed charges,1587,100,,,percent of total billed charges,100% of total billed charges,1310.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.86,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1587,
XR Ribs 3 Views Right,32071101,CDM,320,RC,71101,HCPCS,Outpatient,,,1587,1031.55,TC|RT,1396.56,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1587,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,999.81,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,242.81,15.3,,,percent of total billed charges,15.3% of total billed charges,1095.03,69,,,percent of total billed charges,69% of total billed charges,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1587,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,598.3,37.7,,,percent of total billed charges,37.70% of total billed charges,598.3,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,537.99,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1237.86,78,,,percent of total billed charges,78% of total billed charges,1587,100,,,percent of total billed charges,100% of total billed charges,1310.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.86,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1587,
XR Stress Application Joint(s) Uni/Bilat,32077071,CDM,320,RC,77071,HCPCS,Outpatient,,,263,170.95,TC,231.44,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,44.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,263,100,,,percent of total billed charges,100% of total billed charges,45.51,17.304,,,percent of total billed charges,17.304% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,165.69,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,44.18,16.8,,,percent of total billed charges,16.8% of total billed charges,40.24,15.3,,,percent of total billed charges,15.3% of total billed charges,181.47,69,,,percent of total billed charges,69% of total billed charges,263,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,263,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,263,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,44.18,16.8,,,percent of total billed charges,16.8% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,44.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,45.07,17.136,,,percent of total billed charges,17.136% of total billed charges,57.44,21.84,,,percent of total billed charges,21.84% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,99.15,37.7,,,percent of total billed charges,37.70% of total billed charges,99.15,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,89.16,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,205.14,78,,,percent of total billed charges,78% of total billed charges,263,100,,,percent of total billed charges,100% of total billed charges,217.24,82.6,,,percent of total billed charges,82.6% of total billed charges,217.24,82.6,,,percent of total billed charges,82.6% of total billed charges,44.18,16.8,,,percent of total billed charges,16.8% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,44.18,16.8,,,percent of total billed charges,16.8% of total billed charges,40.24,328.65,
XR Sacroiliac Joints 3+ Views,32072202,CDM,320,RC,72202,HCPCS,Outpatient,,,888,577.20,TC,781.44,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,888,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,559.44,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,135.86,15.3,,,percent of total billed charges,15.3% of total billed charges,612.72,69,,,percent of total billed charges,69% of total billed charges,888,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,888,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,888,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,334.78,37.7,,,percent of total billed charges,37.70% of total billed charges,334.78,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,301.03,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,692.64,78,,,percent of total billed charges,78% of total billed charges,888,100,,,percent of total billed charges,100% of total billed charges,733.49,82.6,,,percent of total billed charges,82.6% of total billed charges,733.49,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,888,
XR Sacrum/Coccyx 2+ Views,32072220,CDM,320,RC,72220,HCPCS,Outpatient,,,1066,692.90,TC,938.08,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1066,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,671.58,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,163.1,15.3,,,percent of total billed charges,15.3% of total billed charges,735.54,69,,,percent of total billed charges,69% of total billed charges,1066,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1066,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1066,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,401.88,37.7,,,percent of total billed charges,37.70% of total billed charges,401.88,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,361.37,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,831.48,78,,,percent of total billed charges,78% of total billed charges,1066,100,,,percent of total billed charges,100% of total billed charges,880.52,82.6,,,percent of total billed charges,82.6% of total billed charges,880.52,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1066,
XR Scapula Left,32073010,CDM,320,RC,73010,HCPCS,Outpatient,,,952,618.80,TC|LT,837.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,952,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,599.76,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,145.66,15.3,,,percent of total billed charges,15.3% of total billed charges,656.88,69,,,percent of total billed charges,69% of total billed charges,952,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,952,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,952,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,358.9,37.7,,,percent of total billed charges,37.70% of total billed charges,358.9,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,322.73,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,742.56,78,,,percent of total billed charges,78% of total billed charges,952,100,,,percent of total billed charges,100% of total billed charges,786.35,82.6,,,percent of total billed charges,82.6% of total billed charges,786.35,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,952,
XR Scapula Right,32073010,CDM,320,RC,73010,HCPCS,Outpatient,,,952,618.80,TC|RT,837.76,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,952,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,599.76,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,145.66,15.3,,,percent of total billed charges,15.3% of total billed charges,656.88,69,,,percent of total billed charges,69% of total billed charges,952,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,952,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,952,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,358.9,37.7,,,percent of total billed charges,37.70% of total billed charges,358.9,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,322.73,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,742.56,78,,,percent of total billed charges,78% of total billed charges,952,100,,,percent of total billed charges,100% of total billed charges,786.35,82.6,,,percent of total billed charges,82.6% of total billed charges,786.35,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,952,
XR Shoulder 1 View Left,32073020,CDM,320,RC,73020,HCPCS,Outpatient,,,728,473.20,TC|LT,640.64,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,728,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,458.64,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,111.38,15.3,,,percent of total billed charges,15.3% of total billed charges,502.32,69,,,percent of total billed charges,69% of total billed charges,728,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,728,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,728,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,274.46,37.7,,,percent of total billed charges,37.70% of total billed charges,274.46,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,246.79,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,567.84,78,,,percent of total billed charges,78% of total billed charges,728,100,,,percent of total billed charges,100% of total billed charges,601.33,82.6,,,percent of total billed charges,82.6% of total billed charges,601.33,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,728,
XR Shoulder 1 View Right,32073020,CDM,320,RC,73020,HCPCS,Outpatient,,,728,473.20,TC|RT,640.64,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,728,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,458.64,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,111.38,15.3,,,percent of total billed charges,15.3% of total billed charges,502.32,69,,,percent of total billed charges,69% of total billed charges,728,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,728,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,728,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,274.46,37.7,,,percent of total billed charges,37.70% of total billed charges,274.46,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,246.79,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,567.84,78,,,percent of total billed charges,78% of total billed charges,728,100,,,percent of total billed charges,100% of total billed charges,601.33,82.6,,,percent of total billed charges,82.6% of total billed charges,601.33,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,728,
XR Shoulder Complete 2+ Views Left,32073030,CDM,320,RC,73030,HCPCS,Outpatient,,,1205,783.25,TC|LT,1060.4,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1205,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,759.15,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,184.37,15.3,,,percent of total billed charges,15.3% of total billed charges,831.45,69,,,percent of total billed charges,69% of total billed charges,1205,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1205,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1205,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,454.29,37.7,,,percent of total billed charges,37.70% of total billed charges,454.29,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,408.5,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,939.9,78,,,percent of total billed charges,78% of total billed charges,1205,100,,,percent of total billed charges,100% of total billed charges,995.33,82.6,,,percent of total billed charges,82.6% of total billed charges,995.33,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1205,
XR Shoulder Complete 2+ Views Right,32073030,CDM,320,RC,73030,HCPCS,Outpatient,,,1205,783.25,TC|RT,1060.4,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1205,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,759.15,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,184.37,15.3,,,percent of total billed charges,15.3% of total billed charges,831.45,69,,,percent of total billed charges,69% of total billed charges,1205,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1205,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1205,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,454.29,37.7,,,percent of total billed charges,37.70% of total billed charges,454.29,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,408.5,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,939.9,78,,,percent of total billed charges,78% of total billed charges,1205,100,,,percent of total billed charges,100% of total billed charges,995.33,82.6,,,percent of total billed charges,82.6% of total billed charges,995.33,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1205,
XR Sinuses Paranasal < 3 Views,32070210,CDM,320,RC,70210,HCPCS,Outpatient,,,330,214.50,TC,290.4,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,330,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,207.9,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,50.49,15.3,,,percent of total billed charges,15.3% of total billed charges,227.7,69,,,percent of total billed charges,69% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,330,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,111.87,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,257.4,78,,,percent of total billed charges,78% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,330,
XR Sinuses Paranasal Complete,32070220,CDM,320,RC,70220,HCPCS,Outpatient,,,1575,1023.75,TC,1386,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1575,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,992.25,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,240.98,15.3,,,percent of total billed charges,15.3% of total billed charges,1086.75,69,,,percent of total billed charges,69% of total billed charges,1575,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1575,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1575,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,593.78,37.7,,,percent of total billed charges,37.70% of total billed charges,593.78,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,533.93,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1228.5,78,,,percent of total billed charges,78% of total billed charges,1575,100,,,percent of total billed charges,100% of total billed charges,1300.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1300.95,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1575,
XR Skull < 4 Views,32070250,CDM,320,RC,70250,HCPCS,Outpatient,,,917,596.05,TC,806.96,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,917,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,577.71,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,140.3,15.3,,,percent of total billed charges,15.3% of total billed charges,632.73,69,,,percent of total billed charges,69% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,917,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,917,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,310.86,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,715.26,78,,,percent of total billed charges,78% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,917,
XR Skull Complete,32070260,CDM,320,RC,70260,HCPCS,Outpatient,,,1831,1190.15,TC,1611.28,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1831,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1153.53,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,280.14,15.3,,,percent of total billed charges,15.3% of total billed charges,1263.39,69,,,percent of total billed charges,69% of total billed charges,1831,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1831,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1831,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,690.29,37.7,,,percent of total billed charges,37.70% of total billed charges,690.29,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,620.71,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1428.18,78,,,percent of total billed charges,78% of total billed charges,1831,100,,,percent of total billed charges,100% of total billed charges,1512.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1512.41,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1831,
XR Small Bowel via Enteroclysis Tube,32074251,CDM,320,RC,74251,HCPCS,Outpatient,,,3212,2087.80,TC,2826.56,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,3212,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2023.56,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,491.44,15.3,,,percent of total billed charges,15.3% of total billed charges,2216.28,69,,,percent of total billed charges,69% of total billed charges,3212,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3212,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3212,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1210.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1210.92,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1088.87,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2505.36,78,,,percent of total billed charges,78% of total billed charges,3212,100,,,percent of total billed charges,100% of total billed charges,2653.11,82.6,,,percent of total billed charges,82.6% of total billed charges,2653.11,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,3212,
XR Small Bowel w/ Multiple Series,32074250,CDM,320,RC,74250,HCPCS,Outpatient,,,2735,1777.75,TC,2406.8,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2735,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1723.05,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,418.46,15.3,,,percent of total billed charges,15.3% of total billed charges,1887.15,69,,,percent of total billed charges,69% of total billed charges,2735,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2735,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2735,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1031.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1031.1,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,927.17,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2133.3,78,,,percent of total billed charges,78% of total billed charges,2735,100,,,percent of total billed charges,100% of total billed charges,2259.11,82.6,,,percent of total billed charges,82.6% of total billed charges,2259.11,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2735,
XR Spine Cervical 1 View,32072020,CDM,320,RC,72020,HCPCS,Outpatient,,,682,443.30,TC,600.16,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,682,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,429.66,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,104.35,15.3,,,percent of total billed charges,15.3% of total billed charges,470.58,69,,,percent of total billed charges,69% of total billed charges,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,257.11,37.7,,,percent of total billed charges,37.70% of total billed charges,257.11,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,231.2,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,531.96,78,,,percent of total billed charges,78% of total billed charges,682,100,,,percent of total billed charges,100% of total billed charges,563.33,82.6,,,percent of total billed charges,82.6% of total billed charges,563.33,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,682,
XR Spine Lumbar 1 View,32072020,CDM,320,RC,72020,HCPCS,Outpatient,,,682,443.30,TC,600.16,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,682,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,429.66,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,104.35,15.3,,,percent of total billed charges,15.3% of total billed charges,470.58,69,,,percent of total billed charges,69% of total billed charges,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,257.11,37.7,,,percent of total billed charges,37.70% of total billed charges,257.11,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,231.2,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,531.96,78,,,percent of total billed charges,78% of total billed charges,682,100,,,percent of total billed charges,100% of total billed charges,563.33,82.6,,,percent of total billed charges,82.6% of total billed charges,563.33,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,682,
XR Spine Cervical 2 or 3 Views,32072040,CDM,320,RC,72040,HCPCS,Outpatient,,,1385,900.25,TC,1218.8,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1385,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,872.55,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,211.91,15.3,,,percent of total billed charges,15.3% of total billed charges,955.65,69,,,percent of total billed charges,69% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1385,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,469.52,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1080.3,78,,,percent of total billed charges,78% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1385,
XR Spine Cervical 4 or 5 Views,32072050,CDM,320,RC,72050,HCPCS,Outpatient,,,1943,1262.95,TC,1709.84,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1943,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1224.09,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,297.28,15.3,,,percent of total billed charges,15.3% of total billed charges,1340.67,69,,,percent of total billed charges,69% of total billed charges,1943,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1943,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1943,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,732.51,37.7,,,percent of total billed charges,37.70% of total billed charges,732.51,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,658.68,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1515.54,78,,,percent of total billed charges,78% of total billed charges,1943,100,,,percent of total billed charges,100% of total billed charges,1604.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1604.92,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1943,
XR Spine Cervical 6+ Views,32072052,CDM,320,RC,72052,HCPCS,Outpatient,,,1774,1153.10,TC,1561.12,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1774,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1117.62,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,271.42,15.3,,,percent of total billed charges,15.3% of total billed charges,1224.06,69,,,percent of total billed charges,69% of total billed charges,1774,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1774,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1774,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,668.8,37.7,,,percent of total billed charges,37.70% of total billed charges,668.8,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,601.39,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1383.72,78,,,percent of total billed charges,78% of total billed charges,1774,100,,,percent of total billed charges,100% of total billed charges,1465.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1465.32,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1774,
XR Spine Lumbosacral 2 or 3 Views,32072100,CDM,320,RC,72100,HCPCS,Outpatient,,,1801,1170.65,TC,1584.88,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1801,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1134.63,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,275.55,15.3,,,percent of total billed charges,15.3% of total billed charges,1242.69,69,,,percent of total billed charges,69% of total billed charges,1801,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1801,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1801,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,678.98,37.7,,,percent of total billed charges,37.70% of total billed charges,678.98,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,610.54,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.78,78,,,percent of total billed charges,78% of total billed charges,1801,100,,,percent of total billed charges,100% of total billed charges,1487.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1487.63,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1801,
XR Spine Lumbosacral Bending 2-3 Views,32072120,CDM,320,RC,72120,HCPCS,Outpatient,,,1398,908.70,TC,1230.24,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1398,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,880.74,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,213.89,15.3,,,percent of total billed charges,15.3% of total billed charges,964.62,69,,,percent of total billed charges,69% of total billed charges,1398,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1398,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1398,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,527.05,37.7,,,percent of total billed charges,37.70% of total billed charges,527.05,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,473.92,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.44,78,,,percent of total billed charges,78% of total billed charges,1398,100,,,percent of total billed charges,100% of total billed charges,1154.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1154.75,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1398,
XR Spine Lumbosacral w/ Bending 6+ Views,32072114,CDM,320,RC,72114,HCPCS,Outpatient,,,2294,1491.10,TC,2018.72,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,2294,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1445.22,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,350.98,15.3,,,percent of total billed charges,15.3% of total billed charges,1582.86,69,,,percent of total billed charges,69% of total billed charges,2294,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2294,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2294,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,864.84,37.7,,,percent of total billed charges,37.70% of total billed charges,864.84,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,777.67,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1789.32,78,,,percent of total billed charges,78% of total billed charges,2294,100,,,percent of total billed charges,100% of total billed charges,1894.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1894.84,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,2294,
XR Spine Lumbosacral 4+ Views,32072110,CDM,320,RC,72110,HCPCS,Outpatient,,,2362,1535.30,TC,2078.56,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,2362,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1488.06,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,361.39,15.3,,,percent of total billed charges,15.3% of total billed charges,1629.78,69,,,percent of total billed charges,69% of total billed charges,2362,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2362,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2362,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,890.47,37.7,,,percent of total billed charges,37.70% of total billed charges,890.47,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,800.72,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1842.36,78,,,percent of total billed charges,78% of total billed charges,2362,100,,,percent of total billed charges,100% of total billed charges,1951.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1951.01,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,2362,
XR Spine Thoracic 2 Views,32072070,CDM,320,RC,72070,HCPCS,Outpatient,,,1211,787.15,TC,1065.68,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1211,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,762.93,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,185.28,15.3,,,percent of total billed charges,15.3% of total billed charges,835.59,69,,,percent of total billed charges,69% of total billed charges,1211,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1211,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1211,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,456.55,37.7,,,percent of total billed charges,37.70% of total billed charges,456.55,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,410.53,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,944.58,78,,,percent of total billed charges,78% of total billed charges,1211,100,,,percent of total billed charges,100% of total billed charges,1000.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1000.29,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1211,
XR Spine Thoracic 3 Views,32072072,CDM,320,RC,72072,HCPCS,Outpatient,,,1463,950.95,TC,1287.44,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1463,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,921.69,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,223.84,15.3,,,percent of total billed charges,15.3% of total billed charges,1009.47,69,,,percent of total billed charges,69% of total billed charges,1463,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1463,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1463,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,551.55,37.7,,,percent of total billed charges,37.70% of total billed charges,551.55,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,495.96,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1141.14,78,,,percent of total billed charges,78% of total billed charges,1463,100,,,percent of total billed charges,100% of total billed charges,1208.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1208.44,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1463,
XR Spine Thoracic 4+ Views,32072074,CDM,320,RC,72074,HCPCS,Outpatient,,,1625,1056.25,TC,1430,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1625,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1023.75,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,248.63,15.3,,,percent of total billed charges,15.3% of total billed charges,1121.25,69,,,percent of total billed charges,69% of total billed charges,1625,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1625,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1625,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,612.63,37.7,,,percent of total billed charges,37.70% of total billed charges,612.63,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,550.88,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1267.5,78,,,percent of total billed charges,78% of total billed charges,1625,100,,,percent of total billed charges,100% of total billed charges,1342.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1342.25,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1625,
XR Spine Thoracolumbar 2+ Views,32072080,CDM,320,RC,72080,HCPCS,Outpatient,,,1085,705.25,TC,954.8,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1085,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,683.55,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,166.01,15.3,,,percent of total billed charges,15.3% of total billed charges,748.65,69,,,percent of total billed charges,69% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1085,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1085,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,367.82,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,846.3,78,,,percent of total billed charges,78% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1085,
XR Sternoclavicular Joint(s),32071130,CDM,320,RC,71130,HCPCS,Outpatient,,,1567,1018.55,TC,1378.96,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1567,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,987.21,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,239.75,15.3,,,percent of total billed charges,15.3% of total billed charges,1081.23,69,,,percent of total billed charges,69% of total billed charges,1567,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1567,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1567,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,590.76,37.7,,,percent of total billed charges,37.70% of total billed charges,590.76,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,531.21,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1222.26,78,,,percent of total billed charges,78% of total billed charges,1567,100,,,percent of total billed charges,100% of total billed charges,1294.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1294.34,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1567,
XR Sternum 2+ Views,32071120,CDM,320,RC,71120,HCPCS,Outpatient,,,1085,705.25,TC,954.8,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1085,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,683.55,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,166.01,15.3,,,percent of total billed charges,15.3% of total billed charges,748.65,69,,,percent of total billed charges,69% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1085,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1085,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,367.82,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,846.3,78,,,percent of total billed charges,78% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1085,
"Swallowing function, with cineradiography/videoradiography",32074230,CDM,320,RC,74230,HCPCS,Outpatient,,,1242,807.30,TC,1092.96,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1242,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,782.46,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,190.03,15.3,,,percent of total billed charges,15.3% of total billed charges,856.98,69,,,percent of total billed charges,69% of total billed charges,1242,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1242,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1242,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,468.23,37.7,,,percent of total billed charges,37.70% of total billed charges,468.23,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,421.04,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,968.76,78,,,percent of total billed charges,78% of total billed charges,1242,100,,,percent of total billed charges,100% of total billed charges,1025.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1025.89,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1242,
XR Sinus Tract/Fistulagram,32076080,CDM,320,RC,76080,HCPCS,Outpatient,,,1848,1201.20,TC,1626.24,88,,,percent of total billed charges,88% of total Billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1848,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.24,63,,,percent of total billed charges,63% of total billed charges,984.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,282.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1275.12,69,,,percent of total billed charges,69% of total billed charges,1848,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1848,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1848,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,696.7,37.7,,,percent of total billed charges,37.70% of total billed charges,696.7,37.7,,,percent of total billed charges,37.70% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,626.47,33.9,,,percent of total billed charges,33.9% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1441.44,78,,,percent of total billed charges,78% of total billed charges,1848,100,,,percent of total billed charges,100% of total billed charges,1526.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1526.45,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,568.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1961.75,
XR Spine Scoliosis 4-5 Views,32072083,CDM,320,RC,72083,HCPCS,Outpatient,,,2390,1553.50,TC,2103.2,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,2390,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1505.7,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,365.67,15.3,,,percent of total billed charges,15.3% of total billed charges,1649.1,69,,,percent of total billed charges,69% of total billed charges,2390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,901.03,37.7,,,percent of total billed charges,37.70% of total billed charges,901.03,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,810.21,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1864.2,78,,,percent of total billed charges,78% of total billed charges,2390,100,,,percent of total billed charges,100% of total billed charges,1974.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1974.14,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,2390,
XR Spine Scoliosis 1 View,32072081,CDM,320,RC,72081,HCPCS,Outpatient,,,1195,776.75,TC,1051.6,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1195,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,752.85,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,182.84,15.3,,,percent of total billed charges,15.3% of total billed charges,824.55,69,,,percent of total billed charges,69% of total billed charges,1195,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1195,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1195,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,450.52,37.7,,,percent of total billed charges,37.70% of total billed charges,450.52,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,405.11,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,932.1,78,,,percent of total billed charges,78% of total billed charges,1195,100,,,percent of total billed charges,100% of total billed charges,987.07,82.6,,,percent of total billed charges,82.6% of total billed charges,987.07,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1195,
XR Spine Scoliosis 2-3 Views,32072082,CDM,320,RC,72082,HCPCS,Outpatient,,,1195,776.75,TC,1051.6,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1195,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,752.85,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,182.84,15.3,,,percent of total billed charges,15.3% of total billed charges,824.55,69,,,percent of total billed charges,69% of total billed charges,1195,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1195,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1195,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,450.52,37.7,,,percent of total billed charges,37.70% of total billed charges,450.52,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,405.11,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,932.1,78,,,percent of total billed charges,78% of total billed charges,1195,100,,,percent of total billed charges,100% of total billed charges,987.07,82.6,,,percent of total billed charges,82.6% of total billed charges,987.07,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1195,
XR Spine Scoliosis 6+ Views,32072084,CDM,320,RC,72084,HCPCS,Outpatient,,,2390,1553.50,TC,2103.2,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,2390,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1505.7,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,365.67,15.3,,,percent of total billed charges,15.3% of total billed charges,1649.1,69,,,percent of total billed charges,69% of total billed charges,2390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,2390,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,901.03,37.7,,,percent of total billed charges,37.70% of total billed charges,901.03,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,810.21,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,1864.2,78,,,percent of total billed charges,78% of total billed charges,2390,100,,,percent of total billed charges,100% of total billed charges,1974.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1974.14,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,2390,
XR Surgical Specimen,32076098,CDM,320,RC,76098,HCPCS,Outpatient,,,2125,1381.25,TC,1870,88,,,percent of total billed charges,88% of total Billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2125,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1338.75,63,,,percent of total billed charges,63% of total billed charges,984.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,325.13,15.3,,,percent of total billed charges,15.3% of total billed charges,1466.25,69,,,percent of total billed charges,69% of total billed charges,2125,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2125,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,2125,100,,,percent of total billed charges,100% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1961.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,801.13,37.7,,,percent of total billed charges,37.70% of total billed charges,801.13,37.7,,,percent of total billed charges,37.70% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,720.38,33.9,,,percent of total billed charges,33.9% of total billed charges,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1657.5,78,,,percent of total billed charges,78% of total billed charges,2125,100,,,percent of total billed charges,100% of total billed charges,1755.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1755.25,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,568.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,562.68,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2125,
XR Spine 1 View Specify Level,32072020,CDM,320,RC,72020,HCPCS,Outpatient,,,682,443.30,TC,600.16,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,682,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,429.66,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,104.35,15.3,,,percent of total billed charges,15.3% of total billed charges,470.58,69,,,percent of total billed charges,69% of total billed charges,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,257.11,37.7,,,percent of total billed charges,37.70% of total billed charges,257.11,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,231.2,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,531.96,78,,,percent of total billed charges,78% of total billed charges,682,100,,,percent of total billed charges,100% of total billed charges,563.33,82.6,,,percent of total billed charges,82.6% of total billed charges,563.33,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,682,
XR Spinal Puncture Diagnostic,32062270,CDM,320,RC,62270,HCPCS,Outpatient,,,1508,980.20,TC,1327.04,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1508,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,950.04,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,230.72,15.3,,,percent of total billed charges,15.3% of total billed charges,1040.52,69,,,percent of total billed charges,69% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,511.21,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1176.24,78,,,percent of total billed charges,78% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,230.72,2578.03,
XR Spinal Puncture Therapeutic,32062272,CDM,320,RC,62272,HCPCS,Outpatient,,,1508,980.20,TC,1327.04,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1508,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,950.04,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,230.72,15.3,,,percent of total billed charges,15.3% of total billed charges,1040.52,69,,,percent of total billed charges,69% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,511.21,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1176.24,78,,,percent of total billed charges,78% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,230.72,2578.03,
XR Shoulder Complete 2+ Views Bilat,32073050,CDM,320,RC,73050,HCPCS,Outpatient,,,1146,744.90,TC,1008.48,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1146,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,721.98,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,175.34,15.3,,,percent of total billed charges,15.3% of total billed charges,790.74,69,,,percent of total billed charges,69% of total billed charges,1146,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1146,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1146,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,432.04,37.7,,,percent of total billed charges,37.70% of total billed charges,432.04,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,388.49,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,893.88,78,,,percent of total billed charges,78% of total billed charges,1146,100,,,percent of total billed charges,100% of total billed charges,946.6,82.6,,,percent of total billed charges,82.6% of total billed charges,946.6,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1146,
XR Spine 1 View,32072020,CDM,320,RC,72020,HCPCS,Outpatient,,,682,443.30,TC,600.16,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,682,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,429.66,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,104.35,15.3,,,percent of total billed charges,15.3% of total billed charges,470.58,69,,,percent of total billed charges,69% of total billed charges,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,682,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,257.11,37.7,,,percent of total billed charges,37.70% of total billed charges,257.11,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,231.2,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,531.96,78,,,percent of total billed charges,78% of total billed charges,682,100,,,percent of total billed charges,100% of total billed charges,563.33,82.6,,,percent of total billed charges,82.6% of total billed charges,563.33,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,682,
XR SI Joint Inj,32027096,CDM,320,RC,27096,HCPCS,Outpatient,,,995,646.75,,875.6,88,,,percent of total billed charges,88% of total Billed charges,497.5,50,,,percent of total billed charges,50% of total Billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid,995,100,,,percent of total billed charges,100% of total billed charges,457.07,103,,,Fee Schedule,103% of WA Medicaid,497.5,50,,,percent of total billed charges,50% of total Billed charges,626.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,443.75,100,,,Fee Schedule,100% of WA Medicaid,152.24,15.3,,,percent of total billed charges,15.3% of total billed charges,686.55,69,,,percent of total billed charges,69% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,497.5,50,,,percent of total billed charges,50% of total Billed charges,995,100,,,percent of total billed charges,100% of total billed charges,497.5,50,,,percent of total billed charges,50% of total Billed charges,995,100,,,percent of total billed charges,100% of total billed charges,497.5,50,,,percent of total billed charges,50% of total Billed charges,615.41,61.85,,,percent of total billed charges,61.85% of total billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,497.5,50,,,percent of total billed charges,50% of total Billed charges,497.5,50,,,percent of total billed charges,50% of total Billed charges,328.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,497.5,50,,,percent of total billed charges,50% of total Billed charges,497.5,50,,,percent of total billed charges,50% of total Billed charges,452.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,576.88,130,,,Fee Schedule,130% of WA Medicaid ,497.5,50,,,percent of total billed charges,50% of total Billed charges,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,497.5,50,,,percent of total billed charges,50% of total Billed charges,337.31,33.9,,,percent of total billed charges,33.9% of total billed charges,497.5,50,,,percent of total billed charges,50% of total Billed charges,776.1,78,,,percent of total billed charges,78% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,497.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,497.5,50,,,percent of total billed charges,50% of total Billed charges,443.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,152.24,995,
XR Spine Puncture Therapeutic CSF Drain,32062329,CDM,320,RC,62329,HCPCS,Outpatient,,,1538,999.70,TC,1353.44,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1538,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,968.94,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,235.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1061.22,69,,,percent of total billed charges,69% of total billed charges,1538,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1538,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1538,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,579.83,37.7,,,percent of total billed charges,37.70% of total billed charges,579.83,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,521.38,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1199.64,78,,,percent of total billed charges,78% of total billed charges,1538,100,,,percent of total billed charges,100% of total billed charges,1270.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1270.39,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,235.31,2578.03,
XR TMJ Open and Closed Bilateral,32070330,CDM,320,RC,70330,HCPCS,Outpatient,,,1807,1174.55,TC,1590.16,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1807,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1138.41,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,276.47,15.3,,,percent of total billed charges,15.3% of total billed charges,1246.83,69,,,percent of total billed charges,69% of total billed charges,1807,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1807,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1807,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,681.24,37.7,,,percent of total billed charges,37.70% of total billed charges,681.24,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,612.57,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1409.46,78,,,percent of total billed charges,78% of total billed charges,1807,100,,,percent of total billed charges,100% of total billed charges,1492.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1492.58,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1807,
XR Tibia/Fibula Bilateral,32073590,CDM,320,RC,73590,HCPCS,Outpatient,,,1036,673.40,TC,911.68,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1036,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,652.68,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,158.51,15.3,,,percent of total billed charges,15.3% of total billed charges,714.84,69,,,percent of total billed charges,69% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1036,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1036,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,351.2,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,808.08,78,,,percent of total billed charges,78% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1036,
XR Tibia/Fibula Left,32073590,CDM,320,RC,73590,HCPCS,Outpatient,,,1036,673.40,TC|LT,911.68,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1036,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,652.68,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,158.51,15.3,,,percent of total billed charges,15.3% of total billed charges,714.84,69,,,percent of total billed charges,69% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1036,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1036,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,351.2,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,808.08,78,,,percent of total billed charges,78% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1036,
XR Tibia/Fibula Right,32073590,CDM,320,RC,73590,HCPCS,Outpatient,,,1036,673.40,TC|RT,911.68,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1036,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,652.68,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,158.51,15.3,,,percent of total billed charges,15.3% of total billed charges,714.84,69,,,percent of total billed charges,69% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1036,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1036,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,351.2,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,808.08,78,,,percent of total billed charges,78% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1036,
XR Toe(s) 2+ Views Left,32073660,CDM,320,RC,73660,HCPCS,Outpatient,,,738,479.70,TC|LT,649.44,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,738,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,464.94,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,112.91,15.3,,,percent of total billed charges,15.3% of total billed charges,509.22,69,,,percent of total billed charges,69% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,738,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,738,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,278.23,37.7,,,percent of total billed charges,37.70% of total billed charges,278.23,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,250.18,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,575.64,78,,,percent of total billed charges,78% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,738,
XR Toe(s) 2+ Views Right,32073660,CDM,320,RC,73660,HCPCS,Outpatient,,,738,479.70,TC|RT,649.44,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,738,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,464.94,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,112.91,15.3,,,percent of total billed charges,15.3% of total billed charges,509.22,69,,,percent of total billed charges,69% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,738,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,738,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,278.23,37.7,,,percent of total billed charges,37.70% of total billed charges,278.23,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,250.18,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,575.64,78,,,percent of total billed charges,78% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,738,
XR Toes 2+ Views 3rd Digit Left,32073660,CDM,320,RC,73660,HCPCS,Outpatient,,,915,594.75,TC|LT,805.2,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,915,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,576.45,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,140,15.3,,,percent of total billed charges,15.3% of total billed charges,631.35,69,,,percent of total billed charges,69% of total billed charges,915,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,915,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,915,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,344.96,37.7,,,percent of total billed charges,37.70% of total billed charges,344.96,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,310.19,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,713.7,78,,,percent of total billed charges,78% of total billed charges,915,100,,,percent of total billed charges,100% of total billed charges,755.79,82.6,,,percent of total billed charges,82.6% of total billed charges,755.79,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,915,
XR Transforaminal Inj C/T Spine 1L,76162321,CDM,761,RC,64479,HCPCS,Outpatient,,,1304,847.60,,1147.52,88,,,percent of total billed charges,88% of total Billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1304,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,821.52,63,,,percent of total billed charges,63% of total billed charges,1626.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,199.51,15.3,,,percent of total billed charges,15.3% of total billed charges,899.76,69,,,percent of total billed charges,69% of total billed charges,1304,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1304,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1304,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3341.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,491.61,37.7,,,percent of total billed charges,37.70% of total billed charges,491.61,37.7,,,percent of total billed charges,37.70% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,442.06,33.9,,,percent of total billed charges,33.9% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1017.12,78,,,percent of total billed charges,78% of total billed charges,1304,100,,,percent of total billed charges,100% of total billed charges,1077.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1077.1,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,938.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,199.51,3341.26,
XR Transforaminal Inj L/S Spine 1L,36062323,CDM,360,RC,64483,HCPCS,Outpatient,,,1304,847.60,,1147.52,88,,,percent of total billed charges,88% of total Billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1304,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,821.52,63,,,percent of total billed charges,63% of total billed charges,1626.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,899.76,69,,,percent of total billed charges,69% of total billed charges,1304,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1304,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1304,100,,,percent of total billed charges,100% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3341.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,491.61,37.7,,,percent of total billed charges,37.70% of total billed charges,491.61,37.7,,,percent of total billed charges,37.70% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,442.06,33.9,,,percent of total billed charges,33.9% of total billed charges,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1017.12,78,,,percent of total billed charges,78% of total billed charges,1304,100,,,percent of total billed charges,100% of total billed charges,1077.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1077.1,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,938.96,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,929.67,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,442.06,3367,
XR Upper Extremity Infant (0-1yr) Bilat,32073092,CDM,320,RC,73092,HCPCS,Outpatient,,,385,250.25,TC,338.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,385,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,242.55,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,58.91,15.3,,,percent of total billed charges,15.3% of total billed charges,265.65,69,,,percent of total billed charges,69% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,130.52,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,300.3,78,,,percent of total billed charges,78% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,442.69,
XR Upper Extremity Infant (0-1yr) Left,32073092,CDM,320,RC,73092,HCPCS,Outpatient,,,385,250.25,TC|LT,338.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,385,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,242.55,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,58.91,15.3,,,percent of total billed charges,15.3% of total billed charges,265.65,69,,,percent of total billed charges,69% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,130.52,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,300.3,78,,,percent of total billed charges,78% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,442.69,
XR Upper Extremity Infant (0-1yr) Right,32073092,CDM,320,RC,73092,HCPCS,Outpatient,,,385,250.25,TC|RT,338.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,385,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,242.55,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,58.91,15.3,,,percent of total billed charges,15.3% of total billed charges,265.65,69,,,percent of total billed charges,69% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,130.52,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,300.3,78,,,percent of total billed charges,78% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.25,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,442.69,
XR Upper GI,32074240,CDM,320,RC,74240,HCPCS,Outpatient,,,3140,2041.00,TC,2763.2,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,3140,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1978.2,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,480.42,15.3,,,percent of total billed charges,15.3% of total billed charges,2166.6,69,,,percent of total billed charges,69% of total billed charges,3140,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3140,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3140,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1183.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1183.78,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1064.46,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2449.2,78,,,percent of total billed charges,78% of total billed charges,3140,100,,,percent of total billed charges,100% of total billed charges,2593.64,82.6,,,percent of total billed charges,82.6% of total billed charges,2593.64,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,3140,
XR Upper GI + KUB,32074240,CDM,320,RC,74240,HCPCS,Outpatient,,,1055,685.75,TC,928.4,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1055,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,664.65,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,161.42,15.3,,,percent of total billed charges,15.3% of total billed charges,727.95,69,,,percent of total billed charges,69% of total billed charges,1055,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1055,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1055,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,397.74,37.7,,,percent of total billed charges,37.70% of total billed charges,397.74,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,357.65,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,822.9,78,,,percent of total billed charges,78% of total billed charges,1055,100,,,percent of total billed charges,100% of total billed charges,871.43,82.6,,,percent of total billed charges,82.6% of total billed charges,871.43,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1055,
XR Upper GI w/ Air Contrast,32074246,CDM,320,RC,74246,HCPCS,Outpatient,,,3195,2076.75,TC,2811.6,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,3195,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2012.85,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,488.84,15.3,,,percent of total billed charges,15.3% of total billed charges,2204.55,69,,,percent of total billed charges,69% of total billed charges,3195,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3195,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3195,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1204.52,37.7,,,percent of total billed charges,37.70% of total billed charges,1204.52,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1083.11,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2492.1,78,,,percent of total billed charges,78% of total billed charges,3195,100,,,percent of total billed charges,100% of total billed charges,2639.07,82.6,,,percent of total billed charges,82.6% of total billed charges,2639.07,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,3195,
XR Upper GI w/ Air Contrast + KUB,32074246,CDM,320,RC,74246,HCPCS,Outpatient,,,2875,1868.75,TC,2530,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2875,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1811.25,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,439.88,15.3,,,percent of total billed charges,15.3% of total billed charges,1983.75,69,,,percent of total billed charges,69% of total billed charges,2875,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2875,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2875,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1083.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1083.88,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,974.63,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2242.5,78,,,percent of total billed charges,78% of total billed charges,2875,100,,,percent of total billed charges,100% of total billed charges,2374.75,82.6,,,percent of total billed charges,82.6% of total billed charges,2374.75,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2875,
XR Upper GI w/ Air w/ Small Bowel,32074246,CDM,320,RC,74246,HCPCS,Outpatient,,,3257,2117.05,TC,2866.16,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,3257,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2051.91,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,498.32,15.3,,,percent of total billed charges,15.3% of total billed charges,2247.33,69,,,percent of total billed charges,69% of total billed charges,3257,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3257,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3257,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1227.89,37.7,,,percent of total billed charges,37.70% of total billed charges,1227.89,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1104.12,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2540.46,78,,,percent of total billed charges,78% of total billed charges,3257,100,,,percent of total billed charges,100% of total billed charges,2690.28,82.6,,,percent of total billed charges,82.6% of total billed charges,2690.28,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,3257,
XR Upper GI w/ Small Bowel,3207420,CDM,320,RC,74240,HCPCS,Outpatient,,,1740,1131.00,TC,1531.2,88,,,percent of total billed charges,88% of total Billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1740,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1096.2,63,,,percent of total billed charges,63% of total billed charges,327.95,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,266.22,15.3,,,percent of total billed charges,15.3% of total billed charges,1200.6,69,,,percent of total billed charges,69% of total billed charges,1740,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1740,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1740,100,,,percent of total billed charges,100% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,725.36,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,655.98,37.7,,,percent of total billed charges,37.70% of total billed charges,655.98,37.7,,,percent of total billed charges,37.70% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,589.86,33.9,,,percent of total billed charges,33.9% of total billed charges,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1357.2,78,,,percent of total billed charges,78% of total billed charges,1740,100,,,percent of total billed charges,100% of total billed charges,1437.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1437.24,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,189.27,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,187.4,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1740,
XR Urography Retrograde Left,32074420,CDM,320,RC,74420,HCPCS,Outpatient,,,2110,1371.50,TC|LT,1856.8,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2110,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1329.3,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,322.83,15.3,,,percent of total billed charges,15.3% of total billed charges,1455.9,69,,,percent of total billed charges,69% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,715.29,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.8,78,,,percent of total billed charges,78% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2110,
XR Urography Retrograde Right,32074420,CDM,320,RC,74420,HCPCS,Outpatient,,,2110,1371.50,TC|RT,1856.8,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2110,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1329.3,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,322.83,15.3,,,percent of total billed charges,15.3% of total billed charges,1455.9,69,,,percent of total billed charges,69% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,715.29,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.8,78,,,percent of total billed charges,78% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2110,
XR Urography Retrograde w/ or w/o KUB,32074420,CDM,320,RC,74420,HCPCS,Outpatient,,,2110,1371.50,TC,1856.8,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,2110,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1329.3,63,,,percent of total billed charges,63% of total billed charges,686.43,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,322.83,15.3,,,percent of total billed charges,15.3% of total billed charges,1455.9,69,,,percent of total billed charges,69% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,2110,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.48,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,715.29,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1645.8,78,,,percent of total billed charges,78% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.16,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,2110,
XR Voiding Urethrocystography,32074455,CDM,320,RC,74455,HCPCS,Outpatient,,,1321,858.65,TC,1162.48,88,,,percent of total billed charges,88% of total Billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1321,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,832.23,63,,,percent of total billed charges,63% of total billed charges,437.37,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,202.11,15.3,,,percent of total billed charges,15.3% of total billed charges,911.49,69,,,percent of total billed charges,69% of total billed charges,1321,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1321,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1321,100,,,percent of total billed charges,100% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,934.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,498.02,37.7,,,percent of total billed charges,37.70% of total billed charges,498.02,37.7,,,percent of total billed charges,37.70% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,447.82,33.9,,,percent of total billed charges,33.9% of total billed charges,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,1030.38,78,,,percent of total billed charges,78% of total billed charges,1321,100,,,percent of total billed charges,100% of total billed charges,1091.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1091.15,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,252.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.92,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1321,
XR Wrist 2 Views Bilateral,32073100,CDM,320,RC,73100,HCPCS,Outpatient,,,729,473.85,TC,641.52,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,729,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,459.27,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,111.54,15.3,,,percent of total billed charges,15.3% of total billed charges,503.01,69,,,percent of total billed charges,69% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,729,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,729,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,247.13,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,568.62,78,,,percent of total billed charges,78% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,729,
XR Wrist 2 Views Left,32073100,CDM,320,RC,73100,HCPCS,Outpatient,,,729,473.85,TC|LT,641.52,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,729,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,459.27,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,111.54,15.3,,,percent of total billed charges,15.3% of total billed charges,503.01,69,,,percent of total billed charges,69% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,729,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,729,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,247.13,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,568.62,78,,,percent of total billed charges,78% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,729,
XR Wrist 2 Views Right,32073100,CDM,320,RC,73100,HCPCS,Outpatient,,,729,473.85,TC|RT,641.52,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,729,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,459.27,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,111.54,15.3,,,percent of total billed charges,15.3% of total billed charges,503.01,69,,,percent of total billed charges,69% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,729,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,729,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,247.13,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,568.62,78,,,percent of total billed charges,78% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,729,
XR Wrist Complete 3+ Views Bilateral,32073110,CDM,320,RC,73110,HCPCS,Outpatient,,,1012,657.80,TC,890.56,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1012,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,637.56,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,154.84,15.3,,,percent of total billed charges,15.3% of total billed charges,698.28,69,,,percent of total billed charges,69% of total billed charges,1012,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1012,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1012,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,381.52,37.7,,,percent of total billed charges,37.70% of total billed charges,381.52,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,343.07,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,789.36,78,,,percent of total billed charges,78% of total billed charges,1012,100,,,percent of total billed charges,100% of total billed charges,835.91,82.6,,,percent of total billed charges,82.6% of total billed charges,835.91,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1012,
XR Wrist Complete 3+ Views Left,32073110,CDM,320,RC,73110,HCPCS,Outpatient,,,1012,657.80,TC|LT,890.56,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1012,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,637.56,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,154.84,15.3,,,percent of total billed charges,15.3% of total billed charges,698.28,69,,,percent of total billed charges,69% of total billed charges,1012,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1012,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1012,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,381.52,37.7,,,percent of total billed charges,37.70% of total billed charges,381.52,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,343.07,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,789.36,78,,,percent of total billed charges,78% of total billed charges,1012,100,,,percent of total billed charges,100% of total billed charges,835.91,82.6,,,percent of total billed charges,82.6% of total billed charges,835.91,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1012,
XR Wrist Complete 3+ Views Right,32073110,CDM,320,RC,73110,HCPCS,Outpatient,,,1012,657.80,TC|RT,890.56,88,,,percent of total billed charges,88% of total Billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,1012,100,,,percent of total billed charges,100% of total billed charges,53.13,103,,,Fee Schedule,103% of WA Medicaid,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,637.56,63,,,percent of total billed charges,63% of total billed charges,162.19,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid,154.84,15.3,,,percent of total billed charges,15.3% of total billed charges,698.28,69,,,percent of total billed charges,69% of total billed charges,1012,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1012,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1012,100,,,percent of total billed charges,100% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,328.65,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,38.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,52.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.05,130,,,Fee Schedule,130% of WA Medicaid ,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,381.52,37.7,,,percent of total billed charges,37.70% of total billed charges,381.52,37.7,,,percent of total billed charges,37.70% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,343.07,33.9,,,percent of total billed charges,33.9% of total billed charges,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,789.36,78,,,percent of total billed charges,78% of total billed charges,1012,100,,,percent of total billed charges,100% of total billed charges,835.91,82.6,,,percent of total billed charges,82.6% of total billed charges,835.91,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,93.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,92.68,100,,,Fee Schedule,100% of Medicare OPPS rate,51.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.21,1012,
BR-CAD MRI LESION,6100159T,CDM,610,RC,0159T,HCPCS,Outpatient,,,380,247.00,TC,334.4,88,,,percent of total billed charges,88% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,380,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,239.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",620,100,,,Case rate,pays based on per visit rate,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,380,100,,,percent of total billed charges,100% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,235.03,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,128.82,33.9,,,percent of total billed charges,33.9% of total billed charges,190,50,,,percent of total billed charges,50% of total Billed charges,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",128.82,620,
31575 BRONCHOSCOPY LARYNGOSCOPY CHARGE,76131575,CDM,761,RC,31575,HCPCS,Outpatient,,,707,459.55,,622.16,88,,,percent of total billed charges,88% of total Billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,707,100,,,percent of total billed charges,100% of total billed charges,103.1,103,,,Fee Schedule,103% of WA Medicaid,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,445.41,63,,,percent of total billed charges,63% of total billed charges,353.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,108.17,15.3,,,percent of total billed charges,15.3% of total billed charges,487.83,69,,,percent of total billed charges,69% of total billed charges,707,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,707,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,707,100,,,percent of total billed charges,100% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,667.83,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,266.54,37.7,,,percent of total billed charges,37.70% of total billed charges,266.54,37.7,,,percent of total billed charges,37.70% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,239.67,33.9,,,percent of total billed charges,33.9% of total billed charges,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,551.46,78,,,percent of total billed charges,78% of total billed charges,707,100,,,percent of total billed charges,100% of total billed charges,583.98,82.6,,,percent of total billed charges,82.6% of total billed charges,583.98,82.6,,,percent of total billed charges,82.6% of total billed charges,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,204.04,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,202.03,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.15,707,
BRONCHOSCOPY DIAGNOSTIC,36100000,CDM,361,RC,,,Outpatient,,,1801,1170.65,,1584.88,88,,,percent of total billed charges,88% of total Billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,302.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,1801,100,,,percent of total billed charges,100% of total billed charges,311.65,17.304,,,percent of total billed charges,17.304% of total billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,1134.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.57,16.8,,,percent of total billed charges,16.8% of total billed charges,275.55,15.3,,,percent of total billed charges,15.3% of total billed charges,1242.69,69,,,percent of total billed charges,69% of total billed charges,1801,100,,,percent of total billed charges,100% of total billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,1801,100,,,percent of total billed charges,100% of total billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,1801,100,,,percent of total billed charges,100% of total billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,1113.92,61.85,,,percent of total billed charges,61.85% of total billed charges,302.57,16.8,,,percent of total billed charges,16.8% of total billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,302.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,308.62,17.136,,,percent of total billed charges,17.136% of total billed charges,393.34,21.84,,,percent of total billed charges,21.84% of total billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,678.98,37.7,,,percent of total billed charges,37.70% of total billed charges,678.98,37.7,,,percent of total billed charges,37.70% of total billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,610.54,33.9,,,percent of total billed charges,33.9% of total billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,1404.78,78,,,percent of total billed charges,78% of total billed charges,1801,100,,,percent of total billed charges,100% of total billed charges,1487.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1487.63,82.6,,,percent of total billed charges,82.6% of total billed charges,302.57,16.8,,,percent of total billed charges,16.8% of total billed charges,900.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900.5,50,,,percent of total billed charges,50% of total Billed charges,302.57,16.8,,,percent of total billed charges,16.8% of total billed charges,275.55,1801,
BRONCHOSCOPY THERAPEUTIC,36100001,CDM,361,RC,,,Outpatient,,,758,492.70,,667.04,88,,,percent of total billed charges,88% of total Billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,127.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,758,100,,,percent of total billed charges,100% of total billed charges,131.16,17.304,,,percent of total billed charges,17.304% of total billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,477.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,127.34,16.8,,,percent of total billed charges,16.8% of total billed charges,115.97,15.3,,,percent of total billed charges,15.3% of total billed charges,523.02,69,,,percent of total billed charges,69% of total billed charges,758,100,,,percent of total billed charges,100% of total billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,758,100,,,percent of total billed charges,100% of total billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,758,100,,,percent of total billed charges,100% of total billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,468.82,61.85,,,percent of total billed charges,61.85% of total billed charges,127.34,16.8,,,percent of total billed charges,16.8% of total billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,127.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,129.89,17.136,,,percent of total billed charges,17.136% of total billed charges,165.55,21.84,,,percent of total billed charges,21.84% of total billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,285.77,37.7,,,percent of total billed charges,37.70% of total billed charges,285.77,37.7,,,percent of total billed charges,37.70% of total billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,256.96,33.9,,,percent of total billed charges,33.9% of total billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,591.24,78,,,percent of total billed charges,78% of total billed charges,758,100,,,percent of total billed charges,100% of total billed charges,626.11,82.6,,,percent of total billed charges,82.6% of total billed charges,626.11,82.6,,,percent of total billed charges,82.6% of total billed charges,127.34,16.8,,,percent of total billed charges,16.8% of total billed charges,379,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,379,50,,,percent of total billed charges,50% of total Billed charges,127.34,16.8,,,percent of total billed charges,16.8% of total billed charges,115.97,758,
PULSE OX SINGLE DETERMINATION,46094760,CDM,460,RC,94760,HCPCS,Outpatient,,,138,89.70,,121.44,88,,,percent of total billed charges,88% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,23.88,17.304,,,percent of total billed charges,17.304% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,86.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,21.11,15.3,,,percent of total billed charges,15.3% of total billed charges,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,85.35,61.85,,,percent of total billed charges,61.85% of total billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.65,17.136,,,percent of total billed charges,17.136% of total billed charges,30.14,21.84,,,percent of total billed charges,21.84% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,46.78,33.9,,,percent of total billed charges,33.9% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,21.11,138,
PULSE OX MULTIPLE DETERM,46094761,CDM,410,RC,94761,HCPCS,Outpatient,,,301,195.65,,264.88,88,,,percent of total billed charges,88% of total Billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,50.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,301,100,,,percent of total billed charges,100% of total billed charges,52.09,17.304,,,percent of total billed charges,17.304% of total billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,189.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.57,16.8,,,percent of total billed charges,16.8% of total billed charges,46.05,15.3,,,percent of total billed charges,15.3% of total billed charges,207.69,69,,,percent of total billed charges,69% of total billed charges,301,100,,,percent of total billed charges,100% of total billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,301,100,,,percent of total billed charges,100% of total billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,301,100,,,percent of total billed charges,100% of total billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,186.17,61.85,,,percent of total billed charges,61.85% of total billed charges,50.57,16.8,,,percent of total billed charges,16.8% of total billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,50.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,51.58,17.136,,,percent of total billed charges,17.136% of total billed charges,65.74,21.84,,,percent of total billed charges,21.84% of total billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,113.48,37.7,,,percent of total billed charges,37.70% of total billed charges,113.48,37.7,,,percent of total billed charges,37.70% of total billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,102.04,33.9,,,percent of total billed charges,33.9% of total billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,234.78,78,,,percent of total billed charges,78% of total billed charges,301,100,,,percent of total billed charges,100% of total billed charges,248.63,82.6,,,percent of total billed charges,82.6% of total billed charges,248.63,82.6,,,percent of total billed charges,82.6% of total billed charges,50.57,16.8,,,percent of total billed charges,16.8% of total billed charges,150.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150.5,50,,,percent of total billed charges,50% of total Billed charges,50.57,16.8,,,percent of total billed charges,16.8% of total billed charges,46.05,301,
ABG PUNCTURE,30036600,CDM,300,RC,36600,HCPCS,Outpatient,,,532,345.80,,468.16,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,532,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,335.16,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,81.4,15.3,,,percent of total billed charges,15.3% of total billed charges,367.08,69,,,percent of total billed charges,69% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,532,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,532,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,180.35,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,414.96,78,,,percent of total billed charges,78% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.15,532,
NASOTRACHEAL ASPIRATION,94031720,CDM,940,RC,31720,HCPCS,Outpatient,,,667,433.55,,586.96,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,667,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,420.21,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,102.05,15.3,,,percent of total billed charges,15.3% of total billed charges,460.23,69,,,percent of total billed charges,69% of total billed charges,667,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,667,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,667,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,251.46,37.7,,,percent of total billed charges,37.70% of total billed charges,251.46,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,226.11,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,520.26,78,,,percent of total billed charges,78% of total billed charges,667,100,,,percent of total billed charges,100% of total billed charges,550.94,82.6,,,percent of total billed charges,82.6% of total billed charges,550.94,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,763.26,
INITIAL SVN/MDI,41094640,CDM,410,RC,94640,HCPCS,Outpatient,,,760,494.00,,668.8,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,760,100,,,percent of total billed charges,100% of total billed charges,5.5,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,478.8,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,116.28,15.3,,,percent of total billed charges,15.3% of total billed charges,524.4,69,,,percent of total billed charges,69% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,760,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,760,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.15,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,257.64,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,592.8,78,,,percent of total billed charges,78% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.5,763.26,
VENT/BIPAP Subsequent DAY,41094003,CDM,410,RC,94003,HCPCS,Outpatient,,,2807,1824.55,,2470.16,88,,,percent of total billed charges,88% of total Billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,2807,100,,,percent of total billed charges,100% of total billed charges,597.3,103,,,Fee Schedule,103% of WA Medicaid,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1768.41,63,,,percent of total billed charges,63% of total billed charges,1118.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,429.47,15.3,,,percent of total billed charges,15.3% of total billed charges,1936.83,69,,,percent of total billed charges,69% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1971.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,429.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,591.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,753.87,130,,,Fee Schedule,130% of WA Medicaid ,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,951.57,33.9,,,percent of total billed charges,33.9% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2189.46,78,,,percent of total billed charges,78% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,645.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,429.47,2807,
INCENTIVE SPIROM INSTRUCTION,41094799,CDM,410,RC,94799,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,566.92,
BIPAP/CPAP INIT  MGMT,41094660,CDM,410,RC,94660,HCPCS,Outpatient,,,2807,1824.55,,2470.16,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,2807,100,,,percent of total billed charges,100% of total billed charges,115.13,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,1768.41,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,429.47,15.3,,,percent of total billed charges,15.3% of total billed charges,1936.83,69,,,percent of total billed charges,69% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,82.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,114.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.31,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,951.57,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2189.46,78,,,percent of total billed charges,78% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.8,2807,
SVN/MDI/IPPB SUBSEQUENT,41094640,CDM,410,RC,94640,HCPCS,Outpatient,,,666,432.90,76,586.08,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,5.5,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.15,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.5,763.26,
RT Carbon Monoxide Diffusion DLC CHARGE,46094729,CDM,460,RC,94729,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid,250,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,46.89,100,,,Fee Schedule,100% of WA Medicaid,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,125,50,,,percent of total billed charges,50% of total Billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,84.75,33.9,,,percent of total billed charges,33.9% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,250,
CPR,48192950,CDM,481,RC,92950,HCPCS,Outpatient,,,963,625.95,,847.44,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,963,100,,,percent of total billed charges,100% of total billed charges,843.18,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,606.69,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,147.34,15.3,,,percent of total billed charges,15.3% of total billed charges,664.47,69,,,percent of total billed charges,69% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,963,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,606.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,834.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1064.21,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,363.05,37.7,,,percent of total billed charges,37.70% of total billed charges,363.05,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,326.46,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,751.14,78,,,percent of total billed charges,78% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,147.34,1074.33,
CONT INHAL TX EA ADD HOUR,41094645,CDM,410,RC,94645,HCPCS,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid,700,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,46.89,100,,,Fee Schedule,100% of WA Medicaid,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,350,50,,,percent of total billed charges,50% of total Billed charges,263.9,37.7,,,percent of total billed charges,37.70% of total billed charges,263.9,37.7,,,percent of total billed charges,37.70% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,237.3,33.9,,,percent of total billed charges,33.9% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,700,
CPT PERC/VIBRATE INIT,41094667,CDM,410,RC,94667,HCPCS,Outpatient,,,666,432.90,,586.08,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,14.24,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,14.24,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.51,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.24,666,
RT CPAP Initial CHARGE,41094660,CDM,410,RC,94660,HCPCS,Outpatient,,,2807,1824.55,,2470.16,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,2807,100,,,percent of total billed charges,100% of total billed charges,115.13,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,1768.41,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,429.47,15.3,,,percent of total billed charges,15.3% of total billed charges,1936.83,69,,,percent of total billed charges,69% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,82.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,114.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.31,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,951.57,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,2189.46,78,,,percent of total billed charges,78% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.8,2807,
VENT/BIPAP SUBSEQUENT DAY,41094003,CDM,410,RC,94003,HCPCS,Outpatient,,,2807,1824.55,,2470.16,88,,,percent of total billed charges,88% of total Billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,2807,100,,,percent of total billed charges,100% of total billed charges,597.3,103,,,Fee Schedule,103% of WA Medicaid,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1768.41,63,,,percent of total billed charges,63% of total billed charges,1118.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,429.47,15.3,,,percent of total billed charges,15.3% of total billed charges,1936.83,69,,,percent of total billed charges,69% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1971.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,429.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,591.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,753.87,130,,,Fee Schedule,130% of WA Medicaid ,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,951.57,33.9,,,percent of total billed charges,33.9% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2189.46,78,,,percent of total billed charges,78% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,645.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,429.47,2807,
CONT INHAL TX FIRST HOUR,41094644,CDM,410,RC,94644,HCPCS,Outpatient,,,740,481.00,,651.2,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,740,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,466.2,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,113.22,15.3,,,percent of total billed charges,15.3% of total billed charges,510.6,69,,,percent of total billed charges,69% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,740,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,740,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,250.86,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,577.2,78,,,percent of total billed charges,78% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,740,
END TIDAL CO2 INITIAL DAY,46094770,CDM,460,RC,94799,HCPCS,Outpatient,,,958,622.70,,843.04,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,958,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,603.54,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,146.57,15.3,,,percent of total billed charges,15.3% of total billed charges,661.02,69,,,percent of total billed charges,69% of total billed charges,958,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,958,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,958,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,361.17,37.7,,,percent of total billed charges,37.70% of total billed charges,361.17,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,324.76,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,747.24,78,,,percent of total billed charges,78% of total billed charges,958,100,,,percent of total billed charges,100% of total billed charges,791.31,82.6,,,percent of total billed charges,82.6% of total billed charges,791.31,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,958,
RT EDUCATION/ INSTRUCTION (15 MIN),41098961,CDM,410,RC,98961,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,42.61,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.79,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.64,53.79,
RESP TX  RESP FUNCTION 15MIN,410G0238,CDM,410,RC,G0238,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,33.01,103,,,Fee Schedule,103% of WA Medicaid,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,53.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,100.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,23.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.67,130,,,Fee Schedule,130% of WA Medicaid ,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.34,146,
RESP TX  RESP FUNCTION 15MIN,410G0238,CDM,410,RC,G0238,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,33.01,103,,,Fee Schedule,103% of WA Medicaid,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,53.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,100.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,23.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.67,130,,,Fee Schedule,130% of WA Medicaid ,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.34,146,
FLUTTER VALVE INITIAL,41094667,CDM,410,RC,94667,HCPCS,Outpatient,,,666,432.90,,586.08,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,14.24,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,14.24,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.51,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,14.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.24,666,
FLUTTER VALVE SUB,41094668,CDM,410,RC,94668,HCPCS,Outpatient,,,399,259.35,,351.12,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,399,100,,,percent of total billed charges,100% of total billed charges,22.21,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,251.37,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid,61.05,15.3,,,percent of total billed charges,15.3% of total billed charges,275.31,69,,,percent of total billed charges,69% of total billed charges,399,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,399,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,399,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.87,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,150.42,37.7,,,percent of total billed charges,37.70% of total billed charges,150.42,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,135.26,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,311.22,78,,,percent of total billed charges,78% of total billed charges,399,100,,,percent of total billed charges,100% of total billed charges,329.57,82.6,,,percent of total billed charges,82.6% of total billed charges,329.57,82.6,,,percent of total billed charges,82.6% of total billed charges,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.21,454.8,
HGB QUANT TRANSCUTANEOUS,30088738,CDM,300,RC,88738,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,30.24,63,,,percent of total billed charges,63% of total billed charges,8.78,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,48,100,,,percent of total billed charges,100% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19.2,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,16.27,33.9,,,percent of total billed charges,33.9% of total billed charges,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.76,48,
INTUBATION EMERGENCY,92000001,CDM,410,RC,31500,HCPCS,Outpatient,,,579,376.35,,509.52,88,,,percent of total billed charges,88% of total Billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,579,100,,,percent of total billed charges,100% of total billed charges,843.18,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,364.77,63,,,percent of total billed charges,63% of total billed charges,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,88.59,15.3,,,percent of total billed charges,15.3% of total billed charges,399.51,69,,,percent of total billed charges,69% of total billed charges,579,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,579,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,579,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,606.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,834.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1064.21,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,218.28,37.7,,,percent of total billed charges,37.70% of total billed charges,218.28,37.7,,,percent of total billed charges,37.70% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,196.28,33.9,,,percent of total billed charges,33.9% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,451.62,78,,,percent of total billed charges,78% of total billed charges,579,100,,,percent of total billed charges,100% of total billed charges,478.25,82.6,,,percent of total billed charges,82.6% of total billed charges,478.25,82.6,,,percent of total billed charges,82.6% of total billed charges,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.59,1064.21,
RESP TX LUNG STRENGTH 15MIN,410G0237,CDM,410,RC,G0237,HCPCS,Outpatient,,,146,94.90,,128.48,88,,,percent of total billed charges,88% of total Billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,146,100,,,percent of total billed charges,100% of total billed charges,33.01,103,,,Fee Schedule,103% of WA Medicaid,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,91.98,63,,,percent of total billed charges,63% of total billed charges,53.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,22.34,15.3,,,percent of total billed charges,15.3% of total billed charges,100.74,69,,,percent of total billed charges,69% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,146,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,100.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,23.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.67,130,,,Fee Schedule,130% of WA Medicaid ,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,55.04,37.7,,,percent of total billed charges,37.70% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,49.49,33.9,,,percent of total billed charges,33.9% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,113.88,78,,,percent of total billed charges,78% of total billed charges,146,100,,,percent of total billed charges,100% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,120.6,82.6,,,percent of total billed charges,82.6% of total billed charges,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.34,146,
RESP TX LUNG STRENGTH 15MIN,410G0237,CDM,410,RC,G0237,HCPCS,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,33.01,103,,,Fee Schedule,103% of WA Medicaid,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,92.61,63,,,percent of total billed charges,63% of total billed charges,53.13,175,,,Fee Schedule,175% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,100.21,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,23.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.67,130,,,Fee Schedule,130% of WA Medicaid ,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,30.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.36,100,,,Fee Schedule,100% of Medicare OPPS rate,32.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.49,147,
INTUBATION ASSIST,41031500,CDM,410,RC,31500,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,843.18,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,435.98,175,,,Fee Schedule,175% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,859.63,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,606.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,834.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1064.21,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,251.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,249.13,100,,,Fee Schedule,100% of Medicare OPPS rate,818.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.13,1064.21,
DEMO/EVAL GEN/NEBUL/MDI/IPPB,41094664,CDM,410,RC,94664,HCPCS,Outpatient,,,666,432.90,,586.08,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,763.26,
BRONCHOSPASM CHALL/EXPOS,46094070,CDM,460,RC,94070,HCPCS,Outpatient,,,1101,715.65,,968.88,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,1101,100,,,percent of total billed charges,100% of total billed charges,94.95,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,693.63,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,168.45,15.3,,,percent of total billed charges,15.3% of total billed charges,759.69,69,,,percent of total billed charges,69% of total billed charges,1101,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1101,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1101,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,68.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,94.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.84,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,415.08,37.7,,,percent of total billed charges,37.70% of total billed charges,415.08,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,373.24,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,858.78,78,,,percent of total billed charges,78% of total billed charges,1101,100,,,percent of total billed charges,100% of total billed charges,909.43,82.6,,,percent of total billed charges,82.6% of total billed charges,909.43,82.6,,,percent of total billed charges,82.6% of total billed charges,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.29,1101,
AEROSOL HHN NEBTX INIT,41094640,CDM,410,RC,94640,HCPCS,Outpatient,,,666,432.90,,586.08,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,5.5,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.15,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.5,763.26,
PULSE OXIMETRY CONT OVERNIGHT,46094762,CDM,460,RC,94762,HCPCS,Outpatient,,,472,306.80,,415.36,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,472,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,297.36,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,72.22,15.3,,,percent of total billed charges,15.3% of total billed charges,325.68,69,,,percent of total billed charges,69% of total billed charges,472,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,472,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,472,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,177.94,37.7,,,percent of total billed charges,37.70% of total billed charges,177.94,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.01,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,368.16,78,,,percent of total billed charges,78% of total billed charges,472,100,,,percent of total billed charges,100% of total billed charges,389.87,82.6,,,percent of total billed charges,82.6% of total billed charges,389.87,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,566.91,
02 MANAGEMENT,41094799,CDM,410,RC,94799,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,566.92,
OXYGEN DAILY,27200001,CDM,272,RC,,,Outpatient,,,975,633.75,,858,88,,,percent of total billed charges,88% of total Billed charges,487.5,50,,,percent of total billed charges,50% of total Billed charges,163.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,975,100,,,percent of total billed charges,100% of total billed charges,168.71,17.304,,,percent of total billed charges,17.304% of total billed charges,487.5,50,,,percent of total billed charges,50% of total Billed charges,614.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,163.8,16.8,,,percent of total billed charges,16.8% of total billed charges,149.18,15.3,,,percent of total billed charges,15.3% of total billed charges,672.75,69,,,percent of total billed charges,69% of total billed charges,975,100,,,percent of total billed charges,100% of total billed charges,487.5,50,,,percent of total billed charges,50% of total Billed charges,975,100,,,percent of total billed charges,100% of total billed charges,487.5,50,,,percent of total billed charges,50% of total Billed charges,975,100,,,percent of total billed charges,100% of total billed charges,487.5,50,,,percent of total billed charges,50% of total Billed charges,603.04,61.85,,,percent of total billed charges,61.85% of total billed charges,163.8,16.8,,,percent of total billed charges,16.8% of total billed charges,487.5,50,,,percent of total billed charges,50% of total Billed charges,487.5,50,,,percent of total billed charges,50% of total Billed charges,163.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,487.5,50,,,percent of total billed charges,50% of total Billed charges,487.5,50,,,percent of total billed charges,50% of total Billed charges,167.08,17.136,,,percent of total billed charges,17.136% of total billed charges,212.94,21.84,,,percent of total billed charges,21.84% of total billed charges,487.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,487.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,487.5,50,,,percent of total billed charges,50% of total Billed charges,760.5,78,,,percent of total billed charges,78% of total billed charges,975,100,,,percent of total billed charges,100% of total billed charges,805.35,82.6,,,percent of total billed charges,82.6% of total billed charges,805.35,82.6,,,percent of total billed charges,82.6% of total billed charges,163.8,16.8,,,percent of total billed charges,16.8% of total billed charges,487.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,487.5,50,,,percent of total billed charges,50% of total Billed charges,163.8,16.8,,,percent of total billed charges,16.8% of total billed charges,149.18,975,
02 MANAGEMENT,41094799,CDM,410,RC,94799,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,566.92,
PULSE OX MULTIPLE DETERM,46094761,CDM,460,RC,94761,HCPCS,Outpatient,,,316,205.40,,278.08,88,,,percent of total billed charges,88% of total Billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,53.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,316,100,,,percent of total billed charges,100% of total billed charges,54.68,17.304,,,percent of total billed charges,17.304% of total billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,199.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,53.09,16.8,,,percent of total billed charges,16.8% of total billed charges,48.35,15.3,,,percent of total billed charges,15.3% of total billed charges,218.04,69,,,percent of total billed charges,69% of total billed charges,316,100,,,percent of total billed charges,100% of total billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,316,100,,,percent of total billed charges,100% of total billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,316,100,,,percent of total billed charges,100% of total billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,195.45,61.85,,,percent of total billed charges,61.85% of total billed charges,53.09,16.8,,,percent of total billed charges,16.8% of total billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,53.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,54.15,17.136,,,percent of total billed charges,17.136% of total billed charges,69.01,21.84,,,percent of total billed charges,21.84% of total billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,119.13,37.7,,,percent of total billed charges,37.70% of total billed charges,119.13,37.7,,,percent of total billed charges,37.70% of total billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,107.12,33.9,,,percent of total billed charges,33.9% of total billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,246.48,78,,,percent of total billed charges,78% of total billed charges,316,100,,,percent of total billed charges,100% of total billed charges,261.02,82.6,,,percent of total billed charges,82.6% of total billed charges,261.02,82.6,,,percent of total billed charges,82.6% of total billed charges,53.09,16.8,,,percent of total billed charges,16.8% of total billed charges,158,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,158,50,,,percent of total billed charges,50% of total Billed charges,53.09,16.8,,,percent of total billed charges,16.8% of total billed charges,48.35,316,
"RT Pulse Oximetry, Single Day CHARGE",46094760,CDM,460,RC,94760,HCPCS,Outpatient,,,145,94.25,,127.6,88,,,percent of total billed charges,88% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,25.09,17.304,,,percent of total billed charges,17.304% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,91.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,22.19,15.3,,,percent of total billed charges,15.3% of total billed charges,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,89.68,61.85,,,percent of total billed charges,61.85% of total billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.85,17.136,,,percent of total billed charges,17.136% of total billed charges,31.67,21.84,,,percent of total billed charges,21.84% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,49.16,33.9,,,percent of total billed charges,33.9% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,22.19,145,
Plethysmography/Body Box,46094726,CDM,460,RC,94726,HCPCS,Outpatient,,,327,212.55,,287.76,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,327,100,,,percent of total billed charges,100% of total billed charges,94.95,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,206.01,63,,,percent of total billed charges,63% of total billed charges,560.25,175,,,Fee Schedule,175% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,50.03,15.3,,,percent of total billed charges,15.3% of total billed charges,225.63,69,,,percent of total billed charges,69% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,327,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,327,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,68.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,94.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.84,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,110.85,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,255.06,78,,,percent of total billed charges,78% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.03,1074.33,
PULSE OX SINGLE DETERMINATION,46094760,CDM,460,RC,94760,HCPCS,Outpatient,,,145,94.25,,127.6,88,,,percent of total billed charges,88% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,25.09,17.304,,,percent of total billed charges,17.304% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,91.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,22.19,15.3,,,percent of total billed charges,15.3% of total billed charges,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,89.68,61.85,,,percent of total billed charges,61.85% of total billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.85,17.136,,,percent of total billed charges,17.136% of total billed charges,31.67,21.84,,,percent of total billed charges,21.84% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,49.16,33.9,,,percent of total billed charges,33.9% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,22.19,145,
SPIROM PP B-D P/F STUDY,46094060,CDM,460,RC,94060,HCPCS,Outpatient,,,1213,788.45,,1067.44,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,1213,100,,,percent of total billed charges,100% of total billed charges,94.95,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,764.19,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid,185.59,15.3,,,percent of total billed charges,15.3% of total billed charges,836.97,69,,,percent of total billed charges,69% of total billed charges,1213,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1213,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1213,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,68.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,94.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.84,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,457.3,37.7,,,percent of total billed charges,37.70% of total billed charges,457.3,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,411.21,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,946.14,78,,,percent of total billed charges,78% of total billed charges,1213,100,,,percent of total billed charges,100% of total billed charges,1001.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1001.94,82.6,,,percent of total billed charges,82.6% of total billed charges,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,92.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.29,1213,
SIMPLE SPIROMETRY,46094010,CDM,460,RC,94010,HCPCS,Outpatient,,,621,403.65,,546.48,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,621,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,391.23,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,95.01,15.3,,,percent of total billed charges,15.3% of total billed charges,428.49,69,,,percent of total billed charges,69% of total billed charges,621,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,621,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,621,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,234.12,37.7,,,percent of total billed charges,37.70% of total billed charges,234.12,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,210.52,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,484.38,78,,,percent of total billed charges,78% of total billed charges,621,100,,,percent of total billed charges,100% of total billed charges,512.95,82.6,,,percent of total billed charges,82.6% of total billed charges,512.95,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,621,
Pressurized or nonpressurized inhalation treatment for acute,41094640,CDM,410,RC,94640,HCPCS,Outpatient,,,199,129.35,76,175.12,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,199,100,,,percent of total billed charges,100% of total billed charges,5.5,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,125.37,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,30.45,15.3,,,percent of total billed charges,15.3% of total billed charges,137.31,69,,,percent of total billed charges,69% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,199,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,199,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.15,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,75.02,37.7,,,percent of total billed charges,37.70% of total billed charges,75.02,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,67.46,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,155.22,78,,,percent of total billed charges,78% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.5,763.26,
94640 AIRWAY INHALATION TREATMENT,TMP600138,CDM,410,RC,94640,HCPCS,Outpatient,,,666,432.90,,586.08,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,5.5,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.15,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,5.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.5,763.26,
VENTILATOR MGMT EA SUB DAY,41094003,CDM,410,RC,94003,HCPCS,Outpatient,,,2317,1506.05,,2038.96,88,,,percent of total billed charges,88% of total Billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,2317,100,,,percent of total billed charges,100% of total billed charges,597.3,103,,,Fee Schedule,103% of WA Medicaid,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1459.71,63,,,percent of total billed charges,63% of total billed charges,1118.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,354.5,15.3,,,percent of total billed charges,15.3% of total billed charges,1598.73,69,,,percent of total billed charges,69% of total billed charges,2317,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2317,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2317,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1971.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,429.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,591.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,753.87,130,,,Fee Schedule,130% of WA Medicaid ,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,873.51,37.7,,,percent of total billed charges,37.70% of total billed charges,873.51,37.7,,,percent of total billed charges,37.70% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,785.46,33.9,,,percent of total billed charges,33.9% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1807.26,78,,,percent of total billed charges,78% of total billed charges,2317,100,,,percent of total billed charges,100% of total billed charges,1913.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1913.84,82.6,,,percent of total billed charges,82.6% of total billed charges,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,645.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,354.5,2317,
TOTAL VITAL CAPACITY,46094150,CDM,460,RC,94150,HCPCS,Outpatient,,,652,423.80,,573.76,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,652,100,,,percent of total billed charges,100% of total billed charges,48.3,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid,99.76,15.3,,,percent of total billed charges,15.3% of total billed charges,449.88,69,,,percent of total billed charges,69% of total billed charges,652,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,652,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,652,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,47.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.96,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,245.8,37.7,,,percent of total billed charges,37.70% of total billed charges,245.8,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,221.03,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,508.56,78,,,percent of total billed charges,78% of total billed charges,652,100,,,percent of total billed charges,100% of total billed charges,538.55,82.6,,,percent of total billed charges,82.6% of total billed charges,538.55,82.6,,,percent of total billed charges,82.6% of total billed charges,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,46.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.73,652,
VENT MGMT FIRST DAY,41094002,CDM,410,RC,94002,HCPCS,Outpatient,,,2807,1824.55,,2470.16,88,,,percent of total billed charges,88% of total Billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,2807,100,,,percent of total billed charges,100% of total billed charges,597.3,103,,,Fee Schedule,103% of WA Medicaid,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1768.41,63,,,percent of total billed charges,63% of total billed charges,1118.55,175,,,Fee Schedule,175% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid,429.47,15.3,,,percent of total billed charges,15.3% of total billed charges,1936.83,69,,,percent of total billed charges,69% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2807,100,,,percent of total billed charges,100% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1971.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,429.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,591.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,753.87,130,,,Fee Schedule,130% of WA Medicaid ,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1058.24,37.7,,,percent of total billed charges,37.70% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,951.57,33.9,,,percent of total billed charges,33.9% of total billed charges,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,2189.46,78,,,percent of total billed charges,78% of total billed charges,2807,100,,,percent of total billed charges,100% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,2318.58,82.6,,,percent of total billed charges,82.6% of total billed charges,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,645.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,639.16,100,,,Fee Schedule,100% of Medicare OPPS rate,579.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,429.47,2807,
DYSPH ASSESS W/VIDEO FL,44092611X,CDM,440,RC,92611,HCPCS,Outpatient,,,1288,837.20,GN,1133.44,88,,,percent of total billed charges,88% of total Billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1288,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,811.44,63,,,percent of total billed charges,63% of total billed charges,161.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,197.06,15.3,,,percent of total billed charges,15.3% of total billed charges,888.72,69,,,percent of total billed charges,69% of total billed charges,1288,100,,,percent of total billed charges,100% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,1288,100,,,percent of total billed charges,100% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,1288,100,,,percent of total billed charges,100% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,358.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,485.58,37.7,,,percent of total billed charges,37.70% of total billed charges,485.58,37.7,,,percent of total billed charges,37.70% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,436.63,33.9,,,percent of total billed charges,33.9% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,1004.64,78,,,percent of total billed charges,78% of total billed charges,1288,100,,,percent of total billed charges,100% of total billed charges,1063.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1063.89,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,94.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1288,
SPEECH/LANG THERAPY/-GN,44092507X,CDM,440,RC,92507,HCPCS,Outpatient,,,426,276.90,GN,374.88,88,,,percent of total billed charges,88% of total Billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.79,100,,,Fee Schedule,100% of WA Medicaid,426,100,,,percent of total billed charges,100% of total billed charges,44.79,103,,,Fee Schedule,103% of WA Medicaid,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,268.38,63,,,percent of total billed charges,63% of total billed charges,134.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,44.79,100,,,Fee Schedule,100% of WA Medicaid,65.18,15.3,,,percent of total billed charges,15.3% of total billed charges,293.94,69,,,percent of total billed charges,69% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,426,100,,,percent of total billed charges,100% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,426,100,,,percent of total billed charges,100% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,298.89,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,44.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,45.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.23,130,,,Fee Schedule,130% of WA Medicaid ,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,160.6,37.7,,,percent of total billed charges,37.70% of total billed charges,160.6,37.7,,,percent of total billed charges,37.70% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,144.41,33.9,,,percent of total billed charges,33.9% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,332.28,78,,,percent of total billed charges,78% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,44.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,78.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.79,426,
DYSPH/FEED DYSFN TRMT/-GN,44092526X,CDM,440,RC,92526,HCPCS,Outpatient,,,426,276.90,GN,374.88,88,,,percent of total billed charges,88% of total Billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,426,100,,,percent of total billed charges,100% of total billed charges,49.92,103,,,Fee Schedule,103% of WA Medicaid,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,268.38,63,,,percent of total billed charges,63% of total billed charges,150.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,65.18,15.3,,,percent of total billed charges,15.3% of total billed charges,293.94,69,,,percent of total billed charges,69% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,426,100,,,percent of total billed charges,100% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,426,100,,,percent of total billed charges,100% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,331.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,50.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.9,130,,,Fee Schedule,130% of WA Medicaid ,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,160.6,37.7,,,percent of total billed charges,37.70% of total billed charges,160.6,37.7,,,percent of total billed charges,37.70% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,144.41,33.9,,,percent of total billed charges,33.9% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,332.28,78,,,percent of total billed charges,78% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,87.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.92,426,
DYSPH/ORAL FEED EVAL/-GN,44092610X,CDM,440,RC,92610,HCPCS,Outpatient,,,1353,879.45,GN,1190.64,88,,,percent of total billed charges,88% of total Billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,1353,100,,,percent of total billed charges,100% of total billed charges,49.92,103,,,Fee Schedule,103% of WA Medicaid,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,852.39,63,,,percent of total billed charges,63% of total billed charges,123.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,207.01,15.3,,,percent of total billed charges,15.3% of total billed charges,933.57,69,,,percent of total billed charges,69% of total billed charges,1353,100,,,percent of total billed charges,100% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,1353,100,,,percent of total billed charges,100% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,1353,100,,,percent of total billed charges,100% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,270.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,50.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.9,130,,,Fee Schedule,130% of WA Medicaid ,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,510.08,37.7,,,percent of total billed charges,37.70% of total billed charges,510.08,37.7,,,percent of total billed charges,37.70% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,458.67,33.9,,,percent of total billed charges,33.9% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,1055.34,78,,,percent of total billed charges,78% of total billed charges,1353,100,,,percent of total billed charges,100% of total billed charges,1117.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1117.58,82.6,,,percent of total billed charges,82.6% of total billed charges,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,71.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.92,1353,
EVAL SPEECH FLUENCY,44492521X,CDM,444,RC,92521,HCPCS,Outpatient,,,640,416.00,GN,563.2,88,,,percent of total billed charges,88% of total Billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicaid,640,100,,,percent of total billed charges,100% of total billed charges,78.01,103,,,Fee Schedule,103% of WA Medicaid,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403.2,63,,,percent of total billed charges,63% of total billed charges,234.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,78.01,100,,,Fee Schedule,100% of WA Medicaid,97.92,15.3,,,percent of total billed charges,15.3% of total billed charges,441.6,69,,,percent of total billed charges,69% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,523.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,79.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.41,130,,,Fee Schedule,130% of WA Medicaid ,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,216.96,33.9,,,percent of total billed charges,33.9% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,499.2,78,,,percent of total billed charges,78% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,136.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.01,640,
EVAL USE/FIT VOICE PROSTH/GN,44192597X,CDM,440,RC,92597,HCPCS,Outpatient,,,2199,1429.35,GN,1935.12,88,,,percent of total billed charges,88% of total Billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,41.95,100,,,Fee Schedule,100% of WA Medicaid,2199,100,,,percent of total billed charges,100% of total billed charges,41.95,103,,,Fee Schedule,103% of WA Medicaid,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1385.37,63,,,percent of total billed charges,63% of total billed charges,127.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,41.95,100,,,Fee Schedule,100% of WA Medicaid,336.45,15.3,,,percent of total billed charges,15.3% of total billed charges,1517.31,69,,,percent of total billed charges,69% of total billed charges,2199,100,,,percent of total billed charges,100% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,2199,100,,,percent of total billed charges,100% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,2199,100,,,percent of total billed charges,100% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,277.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,41.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,41.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,42.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,54.54,130,,,Fee Schedule,130% of WA Medicaid ,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,829.02,37.7,,,percent of total billed charges,37.70% of total billed charges,829.02,37.7,,,percent of total billed charges,37.70% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,745.46,33.9,,,percent of total billed charges,33.9% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1715.22,78,,,percent of total billed charges,78% of total billed charges,2199,100,,,percent of total billed charges,100% of total billed charges,1816.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1816.37,82.6,,,percent of total billed charges,82.6% of total billed charges,41.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,41.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.95,2199,
MODIFY/TRAIN VOICE PROSTHETIC,44092609X,CDM,440,RC,92609,HCPCS,Outpatient,,,479,311.35,GN,421.52,88,,,percent of total billed charges,88% of total Billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,60.93,100,,,Fee Schedule,100% of WA Medicaid,479,100,,,percent of total billed charges,100% of total billed charges,60.93,103,,,Fee Schedule,103% of WA Medicaid,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,301.77,63,,,percent of total billed charges,63% of total billed charges,183.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,60.93,100,,,Fee Schedule,100% of WA Medicaid,73.29,15.3,,,percent of total billed charges,15.3% of total billed charges,330.51,69,,,percent of total billed charges,69% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,479,100,,,percent of total billed charges,100% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,479,100,,,percent of total billed charges,100% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,409.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,60.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,60.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,62.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.21,130,,,Fee Schedule,130% of WA Medicaid ,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,180.58,37.7,,,percent of total billed charges,37.70% of total billed charges,180.58,37.7,,,percent of total billed charges,37.70% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,162.38,33.9,,,percent of total billed charges,33.9% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,373.62,78,,,percent of total billed charges,78% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,60.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,106.4,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,60.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.93,479,
SPEECH THERAPY GROUP,44092508X,CDM,440,RC,92508,HCPCS,Outpatient,,,205,133.25,GN,180.4,88,,,percent of total billed charges,88% of total Billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,14.05,100,,,Fee Schedule,100% of WA Medicaid,205,100,,,percent of total billed charges,100% of total billed charges,14.05,103,,,Fee Schedule,103% of WA Medicaid,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,129.15,63,,,percent of total billed charges,63% of total billed charges,43.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,14.05,100,,,Fee Schedule,100% of WA Medicaid,31.37,15.3,,,percent of total billed charges,15.3% of total billed charges,141.45,69,,,percent of total billed charges,69% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,205,100,,,percent of total billed charges,100% of total billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,205,100,,,percent of total billed charges,100% of total billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,92.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,14.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,14.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,14.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.27,130,,,Fee Schedule,130% of WA Medicaid ,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,77.29,37.7,,,percent of total billed charges,37.70% of total billed charges,77.29,37.7,,,percent of total billed charges,37.70% of total billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,69.5,33.9,,,percent of total billed charges,33.9% of total billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,159.9,78,,,percent of total billed charges,78% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,14.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,25.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,14.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.05,205,
EVAL SPEECH DEVICE ADD 30MIN,44092608X,CDM,440,RC,92608,HCPCS,Outpatient,,,315,204.75,GN,277.2,88,,,percent of total billed charges,88% of total Billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicaid,315,100,,,percent of total billed charges,100% of total billed charges,28.66,103,,,Fee Schedule,103% of WA Medicaid,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,198.45,63,,,percent of total billed charges,63% of total billed charges,86.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.66,100,,,Fee Schedule,100% of WA Medicaid,48.2,15.3,,,percent of total billed charges,15.3% of total billed charges,217.35,69,,,percent of total billed charges,69% of total billed charges,315,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,315,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,315,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,196.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.26,130,,,Fee Schedule,130% of WA Medicaid ,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,118.76,37.7,,,percent of total billed charges,37.70% of total billed charges,118.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,106.79,33.9,,,percent of total billed charges,33.9% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,245.7,78,,,percent of total billed charges,78% of total billed charges,315,100,,,percent of total billed charges,100% of total billed charges,260.19,82.6,,,percent of total billed charges,82.6% of total billed charges,260.19,82.6,,,percent of total billed charges,82.6% of total billed charges,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,50.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.66,315,
EVAL SPEECH DEVICE INITIAL HR,44092607X,CDM,440,RC,92607,HCPCS,Outpatient,,,698,453.70,GN,614.24,88,,,percent of total billed charges,88% of total Billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,73.07,100,,,Fee Schedule,100% of WA Medicaid,698,100,,,percent of total billed charges,100% of total billed charges,73.07,103,,,Fee Schedule,103% of WA Medicaid,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,439.74,63,,,percent of total billed charges,63% of total billed charges,219.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.07,100,,,Fee Schedule,100% of WA Medicaid,106.79,15.3,,,percent of total billed charges,15.3% of total billed charges,481.62,69,,,percent of total billed charges,69% of total billed charges,698,100,,,percent of total billed charges,100% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,698,100,,,percent of total billed charges,100% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,698,100,,,percent of total billed charges,100% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,489.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,73.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,74.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,94.99,130,,,Fee Schedule,130% of WA Medicaid ,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,263.15,37.7,,,percent of total billed charges,37.70% of total billed charges,263.15,37.7,,,percent of total billed charges,37.70% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,236.62,33.9,,,percent of total billed charges,33.9% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,544.44,78,,,percent of total billed charges,78% of total billed charges,698,100,,,percent of total billed charges,100% of total billed charges,576.55,82.6,,,percent of total billed charges,82.6% of total billed charges,576.55,82.6,,,percent of total billed charges,82.6% of total billed charges,73.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,127.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,73.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.07,698,
APHASIA ASSESS/REP/HR/-GN,44096105X,CDM,440,RC,96105,HCPCS,Outpatient,,,1615,1049.75,GN,1421.2,88,,,percent of total billed charges,88% of total Billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,1615,100,,,percent of total billed charges,100% of total billed charges,537.34,103,,,Fee Schedule,103% of WA Medicaid,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1017.45,63,,,percent of total billed charges,63% of total billed charges,168.12,175,,,Fee Schedule,175% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,247.1,15.3,,,percent of total billed charges,15.3% of total billed charges,1114.35,69,,,percent of total billed charges,69% of total billed charges,1615,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1615,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1615,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,386.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,386.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,532.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,678.2,130,,,Fee Schedule,130% of WA Medicaid ,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,608.86,37.7,,,percent of total billed charges,37.70% of total billed charges,608.86,37.7,,,percent of total billed charges,37.70% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,547.49,33.9,,,percent of total billed charges,33.9% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1259.7,78,,,percent of total billed charges,78% of total billed charges,1615,100,,,percent of total billed charges,100% of total billed charges,1333.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1333.99,82.6,,,percent of total billed charges,82.6% of total billed charges,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,98.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.22,1615,
EVAL SPEECH DEVICE ADD 30MIN,44092608X,CDM,440,RC,92608,HCPCS,Outpatient,,,315,204.75,GN,277.2,88,,,percent of total billed charges,88% of total Billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicaid,315,100,,,percent of total billed charges,100% of total billed charges,28.66,103,,,Fee Schedule,103% of WA Medicaid,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,198.45,63,,,percent of total billed charges,63% of total billed charges,86.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.66,100,,,Fee Schedule,100% of WA Medicaid,48.2,15.3,,,percent of total billed charges,15.3% of total billed charges,217.35,69,,,percent of total billed charges,69% of total billed charges,315,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,315,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,315,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,196.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.26,130,,,Fee Schedule,130% of WA Medicaid ,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,118.76,37.7,,,percent of total billed charges,37.70% of total billed charges,118.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,106.79,33.9,,,percent of total billed charges,33.9% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,245.7,78,,,percent of total billed charges,78% of total billed charges,315,100,,,percent of total billed charges,100% of total billed charges,260.19,82.6,,,percent of total billed charges,82.6% of total billed charges,260.19,82.6,,,percent of total billed charges,82.6% of total billed charges,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,50.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.66,315,
MODIFY/TRAIN VOICE PROSTHETIC,44092609X,CDM,440,RC,92609,HCPCS,Outpatient,,,479,311.35,GN,421.52,88,,,percent of total billed charges,88% of total Billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,60.93,100,,,Fee Schedule,100% of WA Medicaid,479,100,,,percent of total billed charges,100% of total billed charges,60.93,103,,,Fee Schedule,103% of WA Medicaid,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,301.77,63,,,percent of total billed charges,63% of total billed charges,183.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,60.93,100,,,Fee Schedule,100% of WA Medicaid,73.29,15.3,,,percent of total billed charges,15.3% of total billed charges,330.51,69,,,percent of total billed charges,69% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,479,100,,,percent of total billed charges,100% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,479,100,,,percent of total billed charges,100% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,409.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,60.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,60.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,62.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.21,130,,,Fee Schedule,130% of WA Medicaid ,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,180.58,37.7,,,percent of total billed charges,37.70% of total billed charges,180.58,37.7,,,percent of total billed charges,37.70% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,162.38,33.9,,,percent of total billed charges,33.9% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,373.62,78,,,percent of total billed charges,78% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,60.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,106.4,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,60.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.93,479,
COGNITIVE TEST PER HOUR,44096125X,CDM,440,RC,96125,HCPCS,Outpatient,,,1039,675.35,GN,914.32,88,,,percent of total billed charges,88% of total Billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,1039,100,,,percent of total billed charges,100% of total billed charges,537.34,103,,,Fee Schedule,103% of WA Medicaid,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,654.57,63,,,percent of total billed charges,63% of total billed charges,180.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,158.97,15.3,,,percent of total billed charges,15.3% of total billed charges,716.91,69,,,percent of total billed charges,69% of total billed charges,1039,100,,,percent of total billed charges,100% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,1039,100,,,percent of total billed charges,100% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,1039,100,,,percent of total billed charges,100% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,409.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,386.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,532.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,678.2,130,,,Fee Schedule,130% of WA Medicaid ,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,391.7,37.7,,,percent of total billed charges,37.70% of total billed charges,391.7,37.7,,,percent of total billed charges,37.70% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,352.22,33.9,,,percent of total billed charges,33.9% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,810.42,78,,,percent of total billed charges,78% of total billed charges,1039,100,,,percent of total billed charges,100% of total billed charges,858.21,82.6,,,percent of total billed charges,82.6% of total billed charges,858.21,82.6,,,percent of total billed charges,82.6% of total billed charges,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,104.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,103.93,1039,
EVAL SPEECH FLUENCY,44492521X,CDM,444,RC,92521,HCPCS,Outpatient,,,640,416.00,GN,563.2,88,,,percent of total billed charges,88% of total Billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicaid,640,100,,,percent of total billed charges,100% of total billed charges,78.01,103,,,Fee Schedule,103% of WA Medicaid,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,403.2,63,,,percent of total billed charges,63% of total billed charges,234.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,78.01,100,,,Fee Schedule,100% of WA Medicaid,97.92,15.3,,,percent of total billed charges,15.3% of total billed charges,441.6,69,,,percent of total billed charges,69% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,523.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,79.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.41,130,,,Fee Schedule,130% of WA Medicaid ,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,216.96,33.9,,,percent of total billed charges,33.9% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,499.2,78,,,percent of total billed charges,78% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,136.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.01,640,
EVAL SOUND PROD,44492522X,CDM,444,RC,92522,HCPCS,Outpatient,,,640,416.00,GN,563.2,88,,,percent of total billed charges,88% of total Billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,64.91,100,,,Fee Schedule,100% of WA Medicaid,640,100,,,percent of total billed charges,100% of total billed charges,64.91,103,,,Fee Schedule,103% of WA Medicaid,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,403.2,63,,,percent of total billed charges,63% of total billed charges,195.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.91,100,,,Fee Schedule,100% of WA Medicaid,97.92,15.3,,,percent of total billed charges,15.3% of total billed charges,441.6,69,,,percent of total billed charges,69% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,436.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,64.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,66.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.38,130,,,Fee Schedule,130% of WA Medicaid ,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,216.96,33.9,,,percent of total billed charges,33.9% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,499.2,78,,,percent of total billed charges,78% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,64.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,114.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,64.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.91,640,
EVAL SOUND PROD W/ LANG COMP,44492523X,CDM,444,RC,92523,HCPCS,Outpatient,,,824,535.60,GN,725.12,88,,,percent of total billed charges,88% of total Billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicaid,824,100,,,percent of total billed charges,100% of total billed charges,133.62,103,,,Fee Schedule,103% of WA Medicaid,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,519.12,63,,,percent of total billed charges,63% of total billed charges,402.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,133.62,100,,,Fee Schedule,100% of WA Medicaid,126.07,15.3,,,percent of total billed charges,15.3% of total billed charges,568.56,69,,,percent of total billed charges,69% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,824,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,824,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,899.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,136.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,173.71,130,,,Fee Schedule,130% of WA Medicaid ,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,279.34,33.9,,,percent of total billed charges,33.9% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,642.72,78,,,percent of total billed charges,78% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,234.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.07,899.56,
EVAL SOUND PROD W/ LANG COMP,44492523X,CDM,444,RC,92523,HCPCS,Outpatient,,,824,535.60,GN,725.12,88,,,percent of total billed charges,88% of total Billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicaid,824,100,,,percent of total billed charges,100% of total billed charges,133.62,103,,,Fee Schedule,103% of WA Medicaid,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,519.12,63,,,percent of total billed charges,63% of total billed charges,402.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,133.62,100,,,Fee Schedule,100% of WA Medicaid,126.07,15.3,,,percent of total billed charges,15.3% of total billed charges,568.56,69,,,percent of total billed charges,69% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,824,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,824,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,899.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,136.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,173.71,130,,,Fee Schedule,130% of WA Medicaid ,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,279.34,33.9,,,percent of total billed charges,33.9% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,642.72,78,,,percent of total billed charges,78% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,234.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.07,899.56,
ANALYSIS QUAL VOICE  RESONANC,44492524X,CDM,444,RC,92524,HCPCS,Outpatient,,,640,416.00,GN,563.2,88,,,percent of total billed charges,88% of total Billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,64.15,100,,,Fee Schedule,100% of WA Medicaid,640,100,,,percent of total billed charges,100% of total billed charges,64.15,103,,,Fee Schedule,103% of WA Medicaid,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,403.2,63,,,percent of total billed charges,63% of total billed charges,192.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.15,100,,,Fee Schedule,100% of WA Medicaid,97.92,15.3,,,percent of total billed charges,15.3% of total billed charges,441.6,69,,,percent of total billed charges,69% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,640,100,,,percent of total billed charges,100% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,427.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,64.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,65.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,83.4,130,,,Fee Schedule,130% of WA Medicaid ,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,216.96,33.9,,,percent of total billed charges,33.9% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,499.2,78,,,percent of total billed charges,78% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,64.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,112.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,64.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.15,640,
440,,,440,RC,,,Outpatient,,,241,156.65,,212.08,88,,,percent of total billed charges,88% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,41.7,17.304,,,percent of total billed charges,17.304% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,151.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,36.87,15.3,,,percent of total billed charges,15.3% of total billed charges,166.29,69,,,percent of total billed charges,69% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,149.06,61.85,,,percent of total billed charges,61.85% of total billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,41.3,17.136,,,percent of total billed charges,17.136% of total billed charges,52.63,21.84,,,percent of total billed charges,21.84% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,90.86,37.7,,,percent of total billed charges,37.70% of total billed charges,90.86,37.7,,,percent of total billed charges,37.70% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,81.7,33.9,,,percent of total billed charges,33.9% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,187.98,78,,,percent of total billed charges,78% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,36.87,241,
95782 POLYSOM <6 YEARS 4/>PARAMETERS,92095782,CDM,920,RC,95782,HCPCS,Outpatient,,,7718,5016.70,TC,6791.84,88,,,percent of total billed charges,88% of total Billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,707.12,103,,,Fee Schedule,103% of WA Medicaid,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4862.34,63,,,percent of total billed charges,63% of total billed charges,1866.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,1180.85,15.3,,,percent of total billed charges,15.3% of total billed charges,5325.42,69,,,percent of total billed charges,69% of total billed charges,7718,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7718,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7718,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3736.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,508.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,700.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,892.49,130,,,Fee Schedule,130% of WA Medicaid ,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2909.69,37.7,,,percent of total billed charges,37.70% of total billed charges,2909.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2616.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6020.04,78,,,percent of total billed charges,78% of total billed charges,7718,100,,,percent of total billed charges,100% of total billed charges,6375.07,82.6,,,percent of total billed charges,82.6% of total billed charges,6375.07,82.6,,,percent of total billed charges,82.6% of total billed charges,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1077.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,508.54,7718,
95783 POLYSOM <6YRS CPAP 4/> PARM,92095783,CDM,920,RC,95783,HCPCS,Outpatient,,,8115,5274.75,TC,7141.2,88,,,percent of total billed charges,88% of total Billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,707.12,103,,,Fee Schedule,103% of WA Medicaid,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5112.45,63,,,percent of total billed charges,63% of total billed charges,1866.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,1241.6,15.3,,,percent of total billed charges,15.3% of total billed charges,5599.35,69,,,percent of total billed charges,69% of total billed charges,8115,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,8115,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,8115,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3736.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,508.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,700.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,892.49,130,,,Fee Schedule,130% of WA Medicaid ,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3059.36,37.7,,,percent of total billed charges,37.70% of total billed charges,3059.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2750.99,33.9,,,percent of total billed charges,33.9% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6329.7,78,,,percent of total billed charges,78% of total billed charges,8115,100,,,percent of total billed charges,100% of total billed charges,6702.99,82.6,,,percent of total billed charges,82.6% of total billed charges,6702.99,82.6,,,percent of total billed charges,82.6% of total billed charges,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1077.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,508.54,8115,
95805 MULTIPLE SLEEP LATENCY STUDY- TECH CHARGE,92095805,CDM,920,RC,95805,HCPCS,Outpatient,,,5164,3356.60,TC,4544.32,88,,,percent of total billed charges,88% of total Billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,707.12,103,,,Fee Schedule,103% of WA Medicaid,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,3253.32,63,,,percent of total billed charges,63% of total billed charges,956.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,790.09,15.3,,,percent of total billed charges,15.3% of total billed charges,3563.16,69,,,percent of total billed charges,69% of total billed charges,5164,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5164,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,5164,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1981.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,508.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,700.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,892.49,130,,,Fee Schedule,130% of WA Medicaid ,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1946.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1946.83,37.7,,,percent of total billed charges,37.70% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1750.6,33.9,,,percent of total billed charges,33.9% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,4027.92,78,,,percent of total billed charges,78% of total billed charges,5164,100,,,percent of total billed charges,100% of total billed charges,4265.46,82.6,,,percent of total billed charges,82.6% of total billed charges,4265.46,82.6,,,percent of total billed charges,82.6% of total billed charges,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,552.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,508.54,5164,
95806 SLEEP STUDY UNATTENDED,92095806,CDM,920,RC,95806,HCPCS,Outpatient,,,892,579.80,,784.96,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,127.33,100,,,Fee Schedule,100% of WA Medicaid,892,100,,,percent of total billed charges,100% of total billed charges,131.15,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,561.96,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,127.33,100,,,Fee Schedule,100% of WA Medicaid,136.48,15.3,,,percent of total billed charges,15.3% of total billed charges,615.48,69,,,percent of total billed charges,69% of total billed charges,892,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,892,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,892,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,94.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,129.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,165.54,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,336.28,37.7,,,percent of total billed charges,37.70% of total billed charges,336.28,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,302.39,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,695.76,78,,,percent of total billed charges,78% of total billed charges,892,100,,,percent of total billed charges,100% of total billed charges,736.79,82.6,,,percent of total billed charges,82.6% of total billed charges,736.79,82.6,,,percent of total billed charges,82.6% of total billed charges,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.32,892,
95810 POLYSOMMOGRAPHY CHARGE,92095810,CDM,920,RC,95810,HCPCS,Outpatient,,,7718,5016.70,TC,6791.84,88,,,percent of total billed charges,88% of total Billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,707.12,103,,,Fee Schedule,103% of WA Medicaid,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,4862.34,63,,,percent of total billed charges,63% of total billed charges,1866.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,1180.85,15.3,,,percent of total billed charges,15.3% of total billed charges,5325.42,69,,,percent of total billed charges,69% of total billed charges,7718,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7718,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,7718,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3736.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,508.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,700.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,892.49,130,,,Fee Schedule,130% of WA Medicaid ,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2909.69,37.7,,,percent of total billed charges,37.70% of total billed charges,2909.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2616.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6020.04,78,,,percent of total billed charges,78% of total billed charges,7718,100,,,percent of total billed charges,100% of total billed charges,6375.07,82.6,,,percent of total billed charges,82.6% of total billed charges,6375.07,82.6,,,percent of total billed charges,82.6% of total billed charges,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1077.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,508.54,7718,
95811 POLYSOMMOGRAPHY w/ CPAP CHARGE,92095811,CDM,920,RC,95811,HCPCS,Outpatient,,,8115,5274.75,TC,7141.2,88,,,percent of total billed charges,88% of total Billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,707.12,103,,,Fee Schedule,103% of WA Medicaid,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,5112.45,63,,,percent of total billed charges,63% of total billed charges,1866.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid,1241.6,15.3,,,percent of total billed charges,15.3% of total billed charges,5599.35,69,,,percent of total billed charges,69% of total billed charges,8115,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,8115,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,8115,100,,,percent of total billed charges,100% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3736.79,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,508.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,700.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,892.49,130,,,Fee Schedule,130% of WA Medicaid ,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,3059.36,37.7,,,percent of total billed charges,37.70% of total billed charges,3059.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,2750.99,33.9,,,percent of total billed charges,33.9% of total billed charges,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,6329.7,78,,,percent of total billed charges,78% of total billed charges,8115,100,,,percent of total billed charges,100% of total billed charges,6702.99,82.6,,,percent of total billed charges,82.6% of total billed charges,6702.99,82.6,,,percent of total billed charges,82.6% of total billed charges,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,1077.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1066.4,100,,,Fee Schedule,100% of Medicare OPPS rate,686.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,508.54,8115,
"G0399 HOME SLEEP STUDY, CHARGE",920G0399,CDM,920,RC,G0399,HCPCS,Outpatient,,,892,579.80,,784.96,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,127.33,100,,,Fee Schedule,100% of WA Medicaid,892,100,,,percent of total billed charges,100% of total billed charges,131.15,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,561.96,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,127.33,100,,,Fee Schedule,100% of WA Medicaid,136.48,15.3,,,percent of total billed charges,15.3% of total billed charges,615.48,69,,,percent of total billed charges,69% of total billed charges,892,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,892,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,892,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,94.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,129.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,165.54,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,336.28,37.7,,,percent of total billed charges,37.70% of total billed charges,336.28,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,302.39,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,695.76,78,,,percent of total billed charges,78% of total billed charges,892,100,,,percent of total billed charges,100% of total billed charges,736.79,82.6,,,percent of total billed charges,82.6% of total billed charges,736.79,82.6,,,percent of total billed charges,82.6% of total billed charges,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.32,892,
HOME SLEEP TEST TYPE 3 UNATT,920G0399,CDM,920,RC,G0399,HCPCS,Outpatient,,,892,579.80,,784.96,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,127.33,100,,,Fee Schedule,100% of WA Medicaid,892,100,,,percent of total billed charges,100% of total billed charges,131.15,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,561.96,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,127.33,100,,,Fee Schedule,100% of WA Medicaid,136.48,15.3,,,percent of total billed charges,15.3% of total billed charges,615.48,69,,,percent of total billed charges,69% of total billed charges,892,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,892,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,892,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,94.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,129.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,165.54,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,336.28,37.7,,,percent of total billed charges,37.70% of total billed charges,336.28,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,302.39,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,695.76,78,,,percent of total billed charges,78% of total billed charges,892,100,,,percent of total billed charges,100% of total billed charges,736.79,82.6,,,percent of total billed charges,82.6% of total billed charges,736.79,82.6,,,percent of total billed charges,82.6% of total billed charges,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,127.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.32,892,
1 HA FIT FEE AUDIENT,470V5241,CDM,470,RC,V5241,HCPCS,Outpatient,,,196,127.40,,172.48,88,,,percent of total billed charges,88% of total Billed charges,98,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,196,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,98,50,,,percent of total billed charges,50% of total Billed charges,123.48,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,29.99,15.3,,,percent of total billed charges,15.3% of total billed charges,135.24,69,,,percent of total billed charges,69% of total billed charges,196,100,,,percent of total billed charges,100% of total billed charges,98,50,,,percent of total billed charges,50% of total Billed charges,196,100,,,percent of total billed charges,100% of total billed charges,98,50,,,percent of total billed charges,50% of total Billed charges,196,100,,,percent of total billed charges,100% of total billed charges,98,50,,,percent of total billed charges,50% of total Billed charges,121.23,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98,50,,,percent of total billed charges,50% of total Billed charges,98,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98,50,,,percent of total billed charges,50% of total Billed charges,98,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,98,50,,,percent of total billed charges,50% of total Billed charges,73.89,37.7,,,percent of total billed charges,37.70% of total billed charges,73.89,37.7,,,percent of total billed charges,37.70% of total billed charges,98,50,,,percent of total billed charges,50% of total Billed charges,66.44,33.9,,,percent of total billed charges,33.9% of total billed charges,98,50,,,percent of total billed charges,50% of total Billed charges,152.88,78,,,percent of total billed charges,78% of total billed charges,196,100,,,percent of total billed charges,100% of total billed charges,161.9,82.6,,,percent of total billed charges,82.6% of total billed charges,161.9,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,98,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,196,
1 HA FITTING/CHECKING,470V5011,CDM,470,RC,V5011,HCPCS,Outpatient,,,552,358.80,,485.76,88,,,percent of total billed charges,88% of total Billed charges,276,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,552,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,276,50,,,percent of total billed charges,50% of total Billed charges,347.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,84.46,15.3,,,percent of total billed charges,15.3% of total billed charges,380.88,69,,,percent of total billed charges,69% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,276,50,,,percent of total billed charges,50% of total Billed charges,552,100,,,percent of total billed charges,100% of total billed charges,276,50,,,percent of total billed charges,50% of total Billed charges,552,100,,,percent of total billed charges,100% of total billed charges,276,50,,,percent of total billed charges,50% of total Billed charges,341.41,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,276,50,,,percent of total billed charges,50% of total Billed charges,276,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,276,50,,,percent of total billed charges,50% of total Billed charges,276,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,276,50,,,percent of total billed charges,50% of total Billed charges,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,276,50,,,percent of total billed charges,50% of total Billed charges,187.13,33.9,,,percent of total billed charges,33.9% of total billed charges,276,50,,,percent of total billed charges,50% of total Billed charges,430.56,78,,,percent of total billed charges,78% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,276,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,276,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,552,
MONAURAL TRIAL FEE,47010100,CDM,470,RC,10100,HCPCS,Outpatient,,,208,135.20,,183.04,88,,,percent of total billed charges,88% of total Billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,34.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,208,100,,,percent of total billed charges,100% of total billed charges,35.99,17.304,,,percent of total billed charges,17.304% of total billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,131.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.94,16.8,,,percent of total billed charges,16.8% of total billed charges,31.82,15.3,,,percent of total billed charges,15.3% of total billed charges,143.52,69,,,percent of total billed charges,69% of total billed charges,208,100,,,percent of total billed charges,100% of total billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,208,100,,,percent of total billed charges,100% of total billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,208,100,,,percent of total billed charges,100% of total billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,128.65,61.85,,,percent of total billed charges,61.85% of total billed charges,34.94,16.8,,,percent of total billed charges,16.8% of total billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,34.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,35.64,17.136,,,percent of total billed charges,17.136% of total billed charges,45.43,21.84,,,percent of total billed charges,21.84% of total billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,78.42,37.7,,,percent of total billed charges,37.70% of total billed charges,78.42,37.7,,,percent of total billed charges,37.70% of total billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,70.51,33.9,,,percent of total billed charges,33.9% of total billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,162.24,78,,,percent of total billed charges,78% of total billed charges,208,100,,,percent of total billed charges,100% of total billed charges,171.81,82.6,,,percent of total billed charges,82.6% of total billed charges,171.81,82.6,,,percent of total billed charges,82.6% of total billed charges,34.94,16.8,,,percent of total billed charges,16.8% of total billed charges,104,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,104,50,,,percent of total billed charges,50% of total Billed charges,34.94,16.8,,,percent of total billed charges,16.8% of total billed charges,31.82,208,
BINAURAL TRIAL FEE,47010101,CDM,470,RC,10101,HCPCS,Outpatient,,,415,269.75,,365.2,88,,,percent of total billed charges,88% of total Billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,69.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,415,100,,,percent of total billed charges,100% of total billed charges,71.81,17.304,,,percent of total billed charges,17.304% of total billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,261.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,69.72,16.8,,,percent of total billed charges,16.8% of total billed charges,63.5,15.3,,,percent of total billed charges,15.3% of total billed charges,286.35,69,,,percent of total billed charges,69% of total billed charges,415,100,,,percent of total billed charges,100% of total billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,415,100,,,percent of total billed charges,100% of total billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,415,100,,,percent of total billed charges,100% of total billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,256.68,61.85,,,percent of total billed charges,61.85% of total billed charges,69.72,16.8,,,percent of total billed charges,16.8% of total billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,69.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,71.11,17.136,,,percent of total billed charges,17.136% of total billed charges,90.64,21.84,,,percent of total billed charges,21.84% of total billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,156.46,37.7,,,percent of total billed charges,37.70% of total billed charges,156.46,37.7,,,percent of total billed charges,37.70% of total billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,140.69,33.9,,,percent of total billed charges,33.9% of total billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,323.7,78,,,percent of total billed charges,78% of total billed charges,415,100,,,percent of total billed charges,100% of total billed charges,342.79,82.6,,,percent of total billed charges,82.6% of total billed charges,342.79,82.6,,,percent of total billed charges,82.6% of total billed charges,69.72,16.8,,,percent of total billed charges,16.8% of total billed charges,207.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,207.5,50,,,percent of total billed charges,50% of total Billed charges,69.72,16.8,,,percent of total billed charges,16.8% of total billed charges,63.5,415,
2 HA FITTING/CHECKING,470V5011,CDM,470,RC,V5011,HCPCS,Outpatient,,,929,603.85,,817.52,88,,,percent of total billed charges,88% of total Billed charges,464.5,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,929,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,464.5,50,,,percent of total billed charges,50% of total Billed charges,585.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,142.14,15.3,,,percent of total billed charges,15.3% of total billed charges,641.01,69,,,percent of total billed charges,69% of total billed charges,929,100,,,percent of total billed charges,100% of total billed charges,464.5,50,,,percent of total billed charges,50% of total Billed charges,929,100,,,percent of total billed charges,100% of total billed charges,464.5,50,,,percent of total billed charges,50% of total Billed charges,929,100,,,percent of total billed charges,100% of total billed charges,464.5,50,,,percent of total billed charges,50% of total Billed charges,574.59,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,464.5,50,,,percent of total billed charges,50% of total Billed charges,464.5,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,464.5,50,,,percent of total billed charges,50% of total Billed charges,464.5,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,464.5,50,,,percent of total billed charges,50% of total Billed charges,350.23,37.7,,,percent of total billed charges,37.70% of total billed charges,350.23,37.7,,,percent of total billed charges,37.70% of total billed charges,464.5,50,,,percent of total billed charges,50% of total Billed charges,314.93,33.9,,,percent of total billed charges,33.9% of total billed charges,464.5,50,,,percent of total billed charges,50% of total Billed charges,724.62,78,,,percent of total billed charges,78% of total billed charges,929,100,,,percent of total billed charges,100% of total billed charges,767.35,82.6,,,percent of total billed charges,82.6% of total billed charges,767.35,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,464.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,464.5,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,929,
2 HA'S FIT FEE AUDIENT,470V5160,CDM,470,RC,V5160,HCPCS,Outpatient,,,174,113.10,,153.12,88,,,percent of total billed charges,88% of total Billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,87,50,,,percent of total billed charges,50% of total Billed charges,109.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,174,100,,,percent of total billed charges,100% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,174,100,,,percent of total billed charges,100% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,107.62,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87,50,,,percent of total billed charges,50% of total Billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87,50,,,percent of total billed charges,50% of total Billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,87,50,,,percent of total billed charges,50% of total Billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,87,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,174,
SPEECH THERAPY GROUP,44092508,CDM,440,RC,92508,HCPCS,Outpatient,,,213,138.45,GN,187.44,88,,,percent of total billed charges,88% of total Billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,14.05,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,14.05,103,,,Fee Schedule,103% of WA Medicaid,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,134.19,63,,,percent of total billed charges,63% of total billed charges,43.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,14.05,100,,,Fee Schedule,100% of WA Medicaid,32.59,15.3,,,percent of total billed charges,15.3% of total billed charges,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,213,100,,,percent of total billed charges,100% of total billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,92.37,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,14.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,14.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,14.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.27,130,,,Fee Schedule,130% of WA Medicaid ,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,72.21,33.9,,,percent of total billed charges,33.9% of total billed charges,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,14.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,25.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,24.83,100,,,Fee Schedule,100% of Medicare OPPS rate,14.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.05,213,
SPEECH/LANG THERAPY/-GN,44092507,CDM,440,RC,92507,HCPCS,Outpatient,,,443,287.95,GN,389.84,88,,,percent of total billed charges,88% of total Billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.79,100,,,Fee Schedule,100% of WA Medicaid,443,100,,,percent of total billed charges,100% of total billed charges,44.79,103,,,Fee Schedule,103% of WA Medicaid,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,279.09,63,,,percent of total billed charges,63% of total billed charges,134.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,44.79,100,,,Fee Schedule,100% of WA Medicaid,67.78,15.3,,,percent of total billed charges,15.3% of total billed charges,305.67,69,,,percent of total billed charges,69% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,298.89,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,44.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,45.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.23,130,,,Fee Schedule,130% of WA Medicaid ,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,150.18,33.9,,,percent of total billed charges,33.9% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,345.54,78,,,percent of total billed charges,78% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,44.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,78.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.79,443,
EVAL SOUND PROD,44492522,CDM,444,RC,92522,HCPCS,Outpatient,,,666,432.90,GN,586.08,88,,,percent of total billed charges,88% of total Billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,64.91,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,64.91,103,,,Fee Schedule,103% of WA Medicaid,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,195.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.91,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,436.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,64.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,66.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.38,130,,,Fee Schedule,130% of WA Medicaid ,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,64.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,114.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,64.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.91,666,
EVAL SOUND PROD W/ LANG COMP,44492523,CDM,444,RC,92523,HCPCS,Outpatient,,,857,557.05,GN,754.16,88,,,percent of total billed charges,88% of total Billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicaid,857,100,,,percent of total billed charges,100% of total billed charges,133.62,103,,,Fee Schedule,103% of WA Medicaid,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,539.91,63,,,percent of total billed charges,63% of total billed charges,402.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,133.62,100,,,Fee Schedule,100% of WA Medicaid,131.12,15.3,,,percent of total billed charges,15.3% of total billed charges,591.33,69,,,percent of total billed charges,69% of total billed charges,857,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,857,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,857,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,899.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,136.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,173.71,130,,,Fee Schedule,130% of WA Medicaid ,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,323.09,37.7,,,percent of total billed charges,37.70% of total billed charges,323.09,37.7,,,percent of total billed charges,37.70% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,290.52,33.9,,,percent of total billed charges,33.9% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,668.46,78,,,percent of total billed charges,78% of total billed charges,857,100,,,percent of total billed charges,100% of total billed charges,707.88,82.6,,,percent of total billed charges,82.6% of total billed charges,707.88,82.6,,,percent of total billed charges,82.6% of total billed charges,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,234.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.12,899.56,
DYSPH/FEED DYSFN TRMT/-GN,44092526,CDM,440,RC,92526,HCPCS,Outpatient,,,443,287.95,GN,389.84,88,,,percent of total billed charges,88% of total Billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,443,100,,,percent of total billed charges,100% of total billed charges,49.92,103,,,Fee Schedule,103% of WA Medicaid,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,279.09,63,,,percent of total billed charges,63% of total billed charges,150.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,67.78,15.3,,,percent of total billed charges,15.3% of total billed charges,305.67,69,,,percent of total billed charges,69% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,331.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,50.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.9,130,,,Fee Schedule,130% of WA Medicaid ,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,150.18,33.9,,,percent of total billed charges,33.9% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,345.54,78,,,percent of total billed charges,78% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,87.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.92,443,
EVAL SPEECH FLUENCY,44492521,CDM,444,RC,92521,HCPCS,Outpatient,,,666,432.90,GN,586.08,88,,,percent of total billed charges,88% of total Billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,78.01,103,,,Fee Schedule,103% of WA Medicaid,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,234.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,78.01,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,523.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,79.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.41,130,,,Fee Schedule,130% of WA Medicaid ,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,136.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.01,666,
ANALYSIS QUAL VOICE  RESONANC,44492524,CDM,444,RC,92524,HCPCS,Outpatient,,,666,432.90,GN,586.08,88,,,percent of total billed charges,88% of total Billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,64.15,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,64.15,103,,,Fee Schedule,103% of WA Medicaid,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,192.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.15,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,427.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,64.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,65.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,83.4,130,,,Fee Schedule,130% of WA Medicaid ,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,64.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,112.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,64.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.15,666,
"PURE TONE,AIR/INDUSTRIAL",44092552,CDM,440,RC,92552,HCPCS,Outpatient,,,30,19.50,GN,26.4,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,18.9,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,10.17,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.59,454.8,
EVOKED OAE EMISSIONS SCREEN,44092558,CDM,440,RC,92558,HCPCS,Outpatient,,,50,32.50,GN,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,50,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,30.93,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,25,50,,,percent of total billed charges,50% of total Billed charges,18.85,37.7,,,percent of total billed charges,37.70% of total billed charges,18.85,37.7,,,percent of total billed charges,37.70% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,16.95,33.9,,,percent of total billed charges,33.9% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.65,50,
TYMPS ACOSTIC REFLEXES 15 MIN,47192550,CDM,471,RC,92550,HCPCS,Outpatient,,,232,150.80,,204.16,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,232,100,,,percent of total billed charges,100% of total billed charges,75.82,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,146.16,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,35.5,15.3,,,percent of total billed charges,15.3% of total billed charges,160.08,69,,,percent of total billed charges,69% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,232,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,75.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.7,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,78.65,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,78,,,percent of total billed charges,78% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.5,566.92,
PURE TONE HEARING TEST AIR,47092551,CDM,470,RC,92551,HCPCS,Outpatient,,,174,113.10,,153.12,88,,,percent of total billed charges,88% of total Billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,87,50,,,percent of total billed charges,50% of total Billed charges,109.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,26.62,15.3,,,percent of total billed charges,15.3% of total billed charges,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,174,100,,,percent of total billed charges,100% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,174,100,,,percent of total billed charges,100% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,107.62,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87,50,,,percent of total billed charges,50% of total Billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87,50,,,percent of total billed charges,50% of total Billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,87,50,,,percent of total billed charges,50% of total Billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,58.99,33.9,,,percent of total billed charges,33.9% of total billed charges,87,50,,,percent of total billed charges,50% of total Billed charges,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,87,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,174,
PT AIR ONLY THRESHOLD 15 MIN,47192552,CDM,471,RC,92552,HCPCS,Outpatient,,,348,226.20,,306.24,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,348,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,219.24,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,53.24,15.3,,,percent of total billed charges,15.3% of total billed charges,240.12,69,,,percent of total billed charges,69% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,348,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,348,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,117.97,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,271.44,78,,,percent of total billed charges,78% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,454.8,
PURE TONE AIR  BONE CONDUCT,47192553,CDM,471,RC,92553,HCPCS,Outpatient,,,348,226.20,,306.24,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,348,100,,,percent of total billed charges,100% of total billed charges,75.82,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,219.24,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,53.24,15.3,,,percent of total billed charges,15.3% of total billed charges,240.12,69,,,percent of total billed charges,69% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,348,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,348,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,75.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.7,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,117.97,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,271.44,78,,,percent of total billed charges,78% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.24,566.92,
SPEECH AUDIO THRESHOLD 15 MIN,47192555,CDM,471,RC,92555,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,113.4,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,180,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,61.02,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,180,
SP THRESHOLD/DISCRIM 15 MIN,47192556,CDM,471,RC,92556,HCPCS,Outpatient,,,286,185.90,,251.68,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,286,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,180.18,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,43.76,15.3,,,percent of total billed charges,15.3% of total billed charges,197.34,69,,,percent of total billed charges,69% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,286,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,286,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,107.82,37.7,,,percent of total billed charges,37.70% of total billed charges,107.82,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,96.95,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,223.08,78,,,percent of total billed charges,78% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,286,
"COMP AUDIO EVAL AIR,BONE,SPEEC",47192557,CDM,471,RC,92557,HCPCS,Outpatient,,,258,167.70,,227.04,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,258,100,,,percent of total billed charges,100% of total billed charges,75.82,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,162.54,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,39.47,15.3,,,percent of total billed charges,15.3% of total billed charges,178.02,69,,,percent of total billed charges,69% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,258,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,75.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.7,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,97.27,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,87.46,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,201.24,78,,,percent of total billed charges,78% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.47,566.92,
ACOUSTIC REFLEX DECAY TEST,44092569,CDM,440,RC,92569,HCPCS,Outpatient,,,111,72.15,GN,97.68,88,,,percent of total billed charges,88% of total Billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,18.65,16.8,,,percent of total billed charges,16.8% of total Billed charges,111,100,,,percent of total billed charges,100% of total billed charges,19.21,17.304,,,percent of total billed charges,17.304% of total billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,69.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.65,16.8,,,percent of total billed charges,16.8% of total billed charges,16.98,15.3,,,percent of total billed charges,15.3% of total billed charges,76.59,69,,,percent of total billed charges,69% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,111,100,,,percent of total billed charges,100% of total billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,111,100,,,percent of total billed charges,100% of total billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,68.65,61.85,,,percent of total billed charges,61.85% of total billed charges,18.65,16.8,,,percent of total billed charges,16.8% of total billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,18.65,16.8,,,percent of total billed charges,16.8% of total Billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,19.02,17.136,,,percent of total billed charges,17.136% of total billed charges,24.24,21.84,,,percent of total billed charges,21.84% of total billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,41.85,37.7,,,percent of total billed charges,37.70% of total billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,37.63,33.9,,,percent of total billed charges,33.9% of total billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,86.58,78,,,percent of total billed charges,78% of total billed charges,111,100,,,percent of total billed charges,100% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,91.69,82.6,,,percent of total billed charges,82.6% of total billed charges,18.65,16.8,,,percent of total billed charges,16.8% of total billed charges,55.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,55.5,50,,,percent of total billed charges,50% of total Billed charges,18.65,16.8,,,percent of total billed charges,16.8% of total billed charges,16.98,111,
"STENGER TEST, PURE TONE",47092565,CDM,470,RC,92565,HCPCS,Outpatient,,,129,83.85,,113.52,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,129,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,81.27,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,19.74,15.3,,,percent of total billed charges,15.3% of total billed charges,89.01,69,,,percent of total billed charges,69% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,129,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,129,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,48.63,37.7,,,percent of total billed charges,37.70% of total billed charges,48.63,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,43.73,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,100.62,78,,,percent of total billed charges,78% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.74,137.47,
TYMPANOMETRY (15 MINUTES),47192567,CDM,471,RC,92567,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,55.44,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,88,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,29.83,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.46,137.47,
TYMPS REFLEXES DECAY 15 MIN,47092570,CDM,470,RC,92570,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,75.82,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,150.57,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,36.57,15.3,,,percent of total billed charges,15.3% of total billed charges,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,239,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,75.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.7,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,81.02,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.57,566.92,
VISUAL REINFOR AUDIO 30 MIN,47192579,CDM,471,RC,92579,HCPCS,Outpatient,,,296,192.40,,260.48,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,296,100,,,percent of total billed charges,100% of total billed charges,75.82,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,186.48,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,45.29,15.3,,,percent of total billed charges,15.3% of total billed charges,204.24,69,,,percent of total billed charges,69% of total billed charges,296,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,296,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,296,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,75.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.7,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,111.59,37.7,,,percent of total billed charges,37.70% of total billed charges,111.59,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,100.34,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,230.88,78,,,percent of total billed charges,78% of total billed charges,296,100,,,percent of total billed charges,100% of total billed charges,244.5,82.6,,,percent of total billed charges,82.6% of total billed charges,244.5,82.6,,,percent of total billed charges,82.6% of total billed charges,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.29,566.92,
440,,,440,RC,,,Outpatient,,,461,299.65,,405.68,88,,,percent of total billed charges,88% of total Billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,77.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,461,100,,,percent of total billed charges,100% of total billed charges,79.77,17.304,,,percent of total billed charges,17.304% of total billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,290.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,77.45,16.8,,,percent of total billed charges,16.8% of total billed charges,70.53,15.3,,,percent of total billed charges,15.3% of total billed charges,318.09,69,,,percent of total billed charges,69% of total billed charges,461,100,,,percent of total billed charges,100% of total billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,461,100,,,percent of total billed charges,100% of total billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,461,100,,,percent of total billed charges,100% of total billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,285.13,61.85,,,percent of total billed charges,61.85% of total billed charges,77.45,16.8,,,percent of total billed charges,16.8% of total billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,77.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,79,17.136,,,percent of total billed charges,17.136% of total billed charges,100.68,21.84,,,percent of total billed charges,21.84% of total billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,173.8,37.7,,,percent of total billed charges,37.70% of total billed charges,173.8,37.7,,,percent of total billed charges,37.70% of total billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,156.28,33.9,,,percent of total billed charges,33.9% of total billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,359.58,78,,,percent of total billed charges,78% of total billed charges,461,100,,,percent of total billed charges,100% of total billed charges,380.79,82.6,,,percent of total billed charges,82.6% of total billed charges,380.79,82.6,,,percent of total billed charges,82.6% of total billed charges,77.45,16.8,,,percent of total billed charges,16.8% of total billed charges,230.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,230.5,50,,,percent of total billed charges,50% of total Billed charges,77.45,16.8,,,percent of total billed charges,16.8% of total billed charges,70.53,461,
DPOAE,44092588,CDM,440,RC,92588,HCPCS,Outpatient,,,497,323.05,GN,437.36,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,497,100,,,percent of total billed charges,100% of total billed charges,75.82,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,313.11,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,76.04,15.3,,,percent of total billed charges,15.3% of total billed charges,342.93,69,,,percent of total billed charges,69% of total billed charges,497,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,497,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,497,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,75.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.7,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,187.37,37.7,,,percent of total billed charges,37.70% of total billed charges,187.37,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,168.48,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,387.66,78,,,percent of total billed charges,78% of total billed charges,497,100,,,percent of total billed charges,100% of total billed charges,410.52,82.6,,,percent of total billed charges,82.6% of total billed charges,410.52,82.6,,,percent of total billed charges,82.6% of total billed charges,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.53,1074.33,
CENTRAL AUD FUNC TEST 1 HR,44092589,CDM,440,RC,92589,HCPCS,Outpatient,,,119,77.35,GN,104.72,88,,,percent of total billed charges,88% of total Billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,19.99,16.8,,,percent of total billed charges,16.8% of total Billed charges,119,100,,,percent of total billed charges,100% of total billed charges,20.59,17.304,,,percent of total billed charges,17.304% of total billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,74.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.99,16.8,,,percent of total billed charges,16.8% of total billed charges,18.21,15.3,,,percent of total billed charges,15.3% of total billed charges,82.11,69,,,percent of total billed charges,69% of total billed charges,119,100,,,percent of total billed charges,100% of total billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,119,100,,,percent of total billed charges,100% of total billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,119,100,,,percent of total billed charges,100% of total billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,73.6,61.85,,,percent of total billed charges,61.85% of total billed charges,19.99,16.8,,,percent of total billed charges,16.8% of total billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,19.99,16.8,,,percent of total billed charges,16.8% of total Billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,20.39,17.136,,,percent of total billed charges,17.136% of total billed charges,25.99,21.84,,,percent of total billed charges,21.84% of total billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,44.86,37.7,,,percent of total billed charges,37.70% of total billed charges,44.86,37.7,,,percent of total billed charges,37.70% of total billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,40.34,33.9,,,percent of total billed charges,33.9% of total billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,92.82,78,,,percent of total billed charges,78% of total billed charges,119,100,,,percent of total billed charges,100% of total billed charges,98.29,82.6,,,percent of total billed charges,82.6% of total billed charges,98.29,82.6,,,percent of total billed charges,82.6% of total billed charges,19.99,16.8,,,percent of total billed charges,16.8% of total billed charges,59.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,59.5,50,,,percent of total billed charges,50% of total Billed charges,19.99,16.8,,,percent of total billed charges,16.8% of total billed charges,18.21,119,
CONDITIONED PLAY AUDIO 30 MIN,47192582,CDM,471,RC,92582,HCPCS,Outpatient,,,531,345.15,,467.28,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,531,100,,,percent of total billed charges,100% of total billed charges,75.82,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,334.53,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,81.24,15.3,,,percent of total billed charges,15.3% of total billed charges,366.39,69,,,percent of total billed charges,69% of total billed charges,531,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,531,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,531,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,75.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.7,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,200.19,37.7,,,percent of total billed charges,37.70% of total billed charges,200.19,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,180.01,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,414.18,78,,,percent of total billed charges,78% of total billed charges,531,100,,,percent of total billed charges,100% of total billed charges,438.61,82.6,,,percent of total billed charges,82.6% of total billed charges,438.61,82.6,,,percent of total billed charges,82.6% of total billed charges,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.53,566.92,
INFANT HEARING SCREEN,47092587,CDM,470,RC,92587,HCPCS,Outpatient,,,302,196.30,,265.76,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,75.82,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,190.26,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,46.21,15.3,,,percent of total billed charges,15.3% of total billed charges,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,75.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.7,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,102.38,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.21,1074.33,
OTOACOUSTIC EMISSIONS 30 MIN,47192587,CDM,471,RC,92587,HCPCS,Outpatient,,,348,226.20,,306.24,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,348,100,,,percent of total billed charges,100% of total billed charges,75.82,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,219.24,63,,,percent of total billed charges,63% of total billed charges,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,53.24,15.3,,,percent of total billed charges,15.3% of total billed charges,240.12,69,,,percent of total billed charges,69% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,348,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,348,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,75.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.7,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,117.97,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,271.44,78,,,percent of total billed charges,78% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.24,1074.33,
1 HA EXAM  SELECTION,47092590,CDM,470,RC,92590,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,32.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,40.53,
2 HA'S EXAM  SELECTION,47092591,CDM,470,RC,92591,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,32.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,40.53,
EXTENSIVE CLEANING,47092592,CDM,470,RC,92592,HCPCS,Outpatient,,,348,226.20,,306.24,88,,,percent of total billed charges,88% of total Billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,348,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,174,50,,,percent of total billed charges,50% of total Billed charges,219.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,53.24,15.3,,,percent of total billed charges,15.3% of total billed charges,240.12,69,,,percent of total billed charges,69% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,348,100,,,percent of total billed charges,100% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,348,100,,,percent of total billed charges,100% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,215.24,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174,50,,,percent of total billed charges,50% of total Billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,174,50,,,percent of total billed charges,50% of total Billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,174,50,,,percent of total billed charges,50% of total Billed charges,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,117.97,33.9,,,percent of total billed charges,33.9% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,271.44,78,,,percent of total billed charges,78% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,174,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,174,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,348,
WALK IN/DROP OFF HA SERVICE,47092592,CDM,470,RC,92592,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,32.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,40.53,
ELECTRO ACOUSTIC EVAL HA MONAU,47092594,CDM,470,RC,92594,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,32.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,40.53,
ELECTROACOUSTICAL EVAL,47092595,CDM,470,RC,92595,HCPCS,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,104,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,52,50,,,percent of total billed charges,50% of total Billed charges,65.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,15.91,15.3,,,percent of total billed charges,15.3% of total billed charges,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,104,100,,,percent of total billed charges,100% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,104,100,,,percent of total billed charges,100% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,64.32,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52,50,,,percent of total billed charges,50% of total Billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52,50,,,percent of total billed charges,50% of total Billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,52,50,,,percent of total billed charges,50% of total Billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,35.26,33.9,,,percent of total billed charges,33.9% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,52,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.91,104,
EVAL USE/FIT VOICE PROSTH/GN,44192597,CDM,440,RC,92597,HCPCS,Outpatient,,,2287,1486.55,GN,2012.56,88,,,percent of total billed charges,88% of total Billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,41.95,100,,,Fee Schedule,100% of WA Medicaid,2287,100,,,percent of total billed charges,100% of total billed charges,41.95,103,,,Fee Schedule,103% of WA Medicaid,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1440.81,63,,,percent of total billed charges,63% of total billed charges,127.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,41.95,100,,,Fee Schedule,100% of WA Medicaid,349.91,15.3,,,percent of total billed charges,15.3% of total billed charges,1578.03,69,,,percent of total billed charges,69% of total billed charges,2287,100,,,percent of total billed charges,100% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,2287,100,,,percent of total billed charges,100% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,2287,100,,,percent of total billed charges,100% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,277.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,41.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,41.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,42.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,54.54,130,,,Fee Schedule,130% of WA Medicaid ,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,862.2,37.7,,,percent of total billed charges,37.70% of total billed charges,862.2,37.7,,,percent of total billed charges,37.70% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,775.29,33.9,,,percent of total billed charges,33.9% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1783.86,78,,,percent of total billed charges,78% of total billed charges,2287,100,,,percent of total billed charges,100% of total billed charges,1889.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1889.06,82.6,,,percent of total billed charges,82.6% of total billed charges,41.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,41.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.95,2287,
CI INIT STIM/UNDER 7 1 HR,44092601,CDM,440,RC,92601,HCPCS,Outpatient,,,974,633.10,GN,857.12,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,974,100,,,percent of total billed charges,100% of total billed charges,35.74,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,613.62,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,149.02,15.3,,,percent of total billed charges,15.3% of total billed charges,672.06,69,,,percent of total billed charges,69% of total billed charges,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,25.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,35.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.11,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,367.2,37.7,,,percent of total billed charges,37.70% of total billed charges,367.2,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,330.19,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,759.72,78,,,percent of total billed charges,78% of total billed charges,974,100,,,percent of total billed charges,100% of total billed charges,804.52,82.6,,,percent of total billed charges,82.6% of total billed charges,804.52,82.6,,,percent of total billed charges,82.6% of total billed charges,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.7,974,
CI PROGRAM UNDER 7 1HR,44092602,CDM,440,RC,92602,HCPCS,Outpatient,,,974,633.10,GN,857.12,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,974,100,,,percent of total billed charges,100% of total billed charges,35.74,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,613.62,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,149.02,15.3,,,percent of total billed charges,15.3% of total billed charges,672.06,69,,,percent of total billed charges,69% of total billed charges,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,25.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,35.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.11,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,367.2,37.7,,,percent of total billed charges,37.70% of total billed charges,367.2,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,330.19,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,759.72,78,,,percent of total billed charges,78% of total billed charges,974,100,,,percent of total billed charges,100% of total billed charges,804.52,82.6,,,percent of total billed charges,82.6% of total billed charges,804.52,82.6,,,percent of total billed charges,82.6% of total billed charges,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.7,974,
DIAG ANALYSIS COCH.IMPLANT,44092603,CDM,440,RC,92603,HCPCS,Outpatient,,,974,633.10,GN,857.12,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,974,100,,,percent of total billed charges,100% of total billed charges,35.74,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,613.62,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,149.02,15.3,,,percent of total billed charges,15.3% of total billed charges,672.06,69,,,percent of total billed charges,69% of total billed charges,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,25.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,35.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.11,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,367.2,37.7,,,percent of total billed charges,37.70% of total billed charges,367.2,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,330.19,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,759.72,78,,,percent of total billed charges,78% of total billed charges,974,100,,,percent of total billed charges,100% of total billed charges,804.52,82.6,,,percent of total billed charges,82.6% of total billed charges,804.52,82.6,,,percent of total billed charges,82.6% of total billed charges,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.7,974,
CI PROGRAM OVER 7 1HR,44092604,CDM,440,RC,92604,HCPCS,Outpatient,,,974,633.10,GN,857.12,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,974,100,,,percent of total billed charges,100% of total billed charges,35.74,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,613.62,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,149.02,15.3,,,percent of total billed charges,15.3% of total billed charges,672.06,69,,,percent of total billed charges,69% of total billed charges,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,974,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,25.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,35.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.11,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,367.2,37.7,,,percent of total billed charges,37.70% of total billed charges,367.2,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,330.19,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,759.72,78,,,percent of total billed charges,78% of total billed charges,974,100,,,percent of total billed charges,100% of total billed charges,804.52,82.6,,,percent of total billed charges,82.6% of total billed charges,804.52,82.6,,,percent of total billed charges,82.6% of total billed charges,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.7,974,
SUBSEQUENT PROGRAM AGE 7+,47092604,CDM,470,RC,92604,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,35.74,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,25.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,35.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.11,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.7,566.91,
MODIFY/TRAIN VOICE PROSTHETIC,44092609,CDM,440,RC,92609,HCPCS,Outpatient,,,498,323.70,GN,438.24,88,,,percent of total billed charges,88% of total Billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,60.93,100,,,Fee Schedule,100% of WA Medicaid,498,100,,,percent of total billed charges,100% of total billed charges,60.93,103,,,Fee Schedule,103% of WA Medicaid,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,313.74,63,,,percent of total billed charges,63% of total billed charges,183.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,60.93,100,,,Fee Schedule,100% of WA Medicaid,76.19,15.3,,,percent of total billed charges,15.3% of total billed charges,343.62,69,,,percent of total billed charges,69% of total billed charges,498,100,,,percent of total billed charges,100% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,498,100,,,percent of total billed charges,100% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,498,100,,,percent of total billed charges,100% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,409.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,60.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,60.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,62.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.21,130,,,Fee Schedule,130% of WA Medicaid ,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,187.75,37.7,,,percent of total billed charges,37.70% of total billed charges,187.75,37.7,,,percent of total billed charges,37.70% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,168.82,33.9,,,percent of total billed charges,33.9% of total billed charges,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,388.44,78,,,percent of total billed charges,78% of total billed charges,498,100,,,percent of total billed charges,100% of total billed charges,411.35,82.6,,,percent of total billed charges,82.6% of total billed charges,411.35,82.6,,,percent of total billed charges,82.6% of total billed charges,60.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,106.4,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,105.35,100,,,Fee Schedule,100% of Medicare OPPS rate,60.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.93,498,
EVAL SPEECH DEVICE INITIAL HR,44092607,CDM,440,RC,92607,HCPCS,Outpatient,,,726,471.90,GN,638.88,88,,,percent of total billed charges,88% of total Billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,73.07,100,,,Fee Schedule,100% of WA Medicaid,726,100,,,percent of total billed charges,100% of total billed charges,73.07,103,,,Fee Schedule,103% of WA Medicaid,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,457.38,63,,,percent of total billed charges,63% of total billed charges,219.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.07,100,,,Fee Schedule,100% of WA Medicaid,111.08,15.3,,,percent of total billed charges,15.3% of total billed charges,500.94,69,,,percent of total billed charges,69% of total billed charges,726,100,,,percent of total billed charges,100% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,726,100,,,percent of total billed charges,100% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,726,100,,,percent of total billed charges,100% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,489.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,73.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,74.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,94.99,130,,,Fee Schedule,130% of WA Medicaid ,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,273.7,37.7,,,percent of total billed charges,37.70% of total billed charges,273.7,37.7,,,percent of total billed charges,37.70% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,246.11,33.9,,,percent of total billed charges,33.9% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,566.28,78,,,percent of total billed charges,78% of total billed charges,726,100,,,percent of total billed charges,100% of total billed charges,599.68,82.6,,,percent of total billed charges,82.6% of total billed charges,599.68,82.6,,,percent of total billed charges,82.6% of total billed charges,73.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,127.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,73.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.07,726,
EVAL SPEECH DEVICE ADD 30MIN,44092608,CDM,440,RC,92608,HCPCS,Outpatient,,,328,213.20,GN,288.64,88,,,percent of total billed charges,88% of total Billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicaid,328,100,,,percent of total billed charges,100% of total billed charges,28.66,103,,,Fee Schedule,103% of WA Medicaid,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,206.64,63,,,percent of total billed charges,63% of total billed charges,86.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.66,100,,,Fee Schedule,100% of WA Medicaid,50.18,15.3,,,percent of total billed charges,15.3% of total billed charges,226.32,69,,,percent of total billed charges,69% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,328,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,328,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,196.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.26,130,,,Fee Schedule,130% of WA Medicaid ,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,123.66,37.7,,,percent of total billed charges,37.70% of total billed charges,123.66,37.7,,,percent of total billed charges,37.70% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,111.19,33.9,,,percent of total billed charges,33.9% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,255.84,78,,,percent of total billed charges,78% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,50.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.66,328,
"92603 CI Programming Initial, pt >7y.o.",47092603,CDM,470,RC,92603,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,35.74,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,25.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,35.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.11,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,34.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.7,566.91,
DYSPH/ORAL FEED EVAL/-GN,44092610,CDM,440,RC,92610,HCPCS,Outpatient,,,1407,914.55,GN,1238.16,88,,,percent of total billed charges,88% of total Billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,1407,100,,,percent of total billed charges,100% of total billed charges,49.92,103,,,Fee Schedule,103% of WA Medicaid,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,886.41,63,,,percent of total billed charges,63% of total billed charges,123.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,215.27,15.3,,,percent of total billed charges,15.3% of total billed charges,970.83,69,,,percent of total billed charges,69% of total billed charges,1407,100,,,percent of total billed charges,100% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,1407,100,,,percent of total billed charges,100% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,1407,100,,,percent of total billed charges,100% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,270.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,50.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.9,130,,,Fee Schedule,130% of WA Medicaid ,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,530.44,37.7,,,percent of total billed charges,37.70% of total billed charges,530.44,37.7,,,percent of total billed charges,37.70% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,476.97,33.9,,,percent of total billed charges,33.9% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,1097.46,78,,,percent of total billed charges,78% of total billed charges,1407,100,,,percent of total billed charges,100% of total billed charges,1162.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1162.18,82.6,,,percent of total billed charges,82.6% of total billed charges,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,71.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.92,1407,
DYSPH ASSESS W/VIDEO FL,44092611,CDM,440,RC,92611,HCPCS,Outpatient,,,1340,871.00,GN,1179.2,88,,,percent of total billed charges,88% of total Billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1340,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,844.2,63,,,percent of total billed charges,63% of total billed charges,161.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,205.02,15.3,,,percent of total billed charges,15.3% of total billed charges,924.6,69,,,percent of total billed charges,69% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,1340,100,,,percent of total billed charges,100% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,1340,100,,,percent of total billed charges,100% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,358.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,454.26,33.9,,,percent of total billed charges,33.9% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,1045.2,78,,,percent of total billed charges,78% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,94.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1340,
EVAL OF AUDITORY REHAB STATUS,44092626,CDM,440,RC,92626,HCPCS,Outpatient,,,439,285.35,GN,386.32,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,51.06,100,,,Fee Schedule,100% of WA Medicaid,439,100,,,percent of total billed charges,100% of total billed charges,51.06,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,276.57,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.06,100,,,Fee Schedule,100% of WA Medicaid,67.17,15.3,,,percent of total billed charges,15.3% of total billed charges,302.91,69,,,percent of total billed charges,69% of total billed charges,439,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,439,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,439,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,51.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,52.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,66.38,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,165.5,37.7,,,percent of total billed charges,37.70% of total billed charges,165.5,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,148.82,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,342.42,78,,,percent of total billed charges,78% of total billed charges,439,100,,,percent of total billed charges,100% of total billed charges,362.61,82.6,,,percent of total billed charges,82.6% of total billed charges,362.61,82.6,,,percent of total billed charges,82.6% of total billed charges,51.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,51.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.06,566.92,
AURAL REHAB EVAL ADDT 15 MIN,44092627,CDM,440,RC,92627,HCPCS,Outpatient,,,200,130.00,GN,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,11.96,100,,,Fee Schedule,100% of WA Medicaid,200,100,,,percent of total billed charges,100% of total billed charges,11.96,103,,,Fee Schedule,103% of WA Medicaid,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.96,100,,,Fee Schedule,100% of WA Medicaid,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,11.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,11.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,12.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.55,130,,,Fee Schedule,130% of WA Medicaid ,100,50,,,percent of total billed charges,50% of total Billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,67.8,33.9,,,percent of total billed charges,33.9% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,11.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,11.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.96,200,
AUDITORY FUNCTION TEST 1ST HR,47092620,CDM,470,RC,92620,HCPCS,Outpatient,,,659,428.35,,579.92,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,208.14,100,,,Fee Schedule,100% of WA Medicaid,659,100,,,percent of total billed charges,100% of total billed charges,214.38,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,415.17,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,208.14,100,,,Fee Schedule,100% of WA Medicaid,100.83,15.3,,,percent of total billed charges,15.3% of total billed charges,454.71,69,,,percent of total billed charges,69% of total billed charges,659,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,659,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,659,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,208.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,154.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,212.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,270.58,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,248.44,37.7,,,percent of total billed charges,37.70% of total billed charges,248.44,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,223.4,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,514.02,78,,,percent of total billed charges,78% of total billed charges,659,100,,,percent of total billed charges,100% of total billed charges,544.33,82.6,,,percent of total billed charges,82.6% of total billed charges,544.33,82.6,,,percent of total billed charges,82.6% of total billed charges,208.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,208.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,100.83,659,
AUD FUNCTION TEST/ADDL 15 MIN,47092621,CDM,470,RC,92621,HCPCS,Outpatient,,,154,100.10,,135.52,88,,,percent of total billed charges,88% of total Billed charges,77,50,,,percent of total billed charges,50% of total Billed charges,208.14,100,,,Fee Schedule,100% of WA Medicaid,154,100,,,percent of total billed charges,100% of total billed charges,214.38,103,,,Fee Schedule,103% of WA Medicaid,77,50,,,percent of total billed charges,50% of total Billed charges,97.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,208.14,100,,,Fee Schedule,100% of WA Medicaid,23.56,15.3,,,percent of total billed charges,15.3% of total billed charges,106.26,69,,,percent of total billed charges,69% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,77,50,,,percent of total billed charges,50% of total Billed charges,154,100,,,percent of total billed charges,100% of total billed charges,77,50,,,percent of total billed charges,50% of total Billed charges,154,100,,,percent of total billed charges,100% of total billed charges,77,50,,,percent of total billed charges,50% of total Billed charges,95.25,61.85,,,percent of total billed charges,61.85% of total billed charges,208.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77,50,,,percent of total billed charges,50% of total Billed charges,77,50,,,percent of total billed charges,50% of total Billed charges,154.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77,50,,,percent of total billed charges,50% of total Billed charges,77,50,,,percent of total billed charges,50% of total Billed charges,212.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,270.58,130,,,Fee Schedule,130% of WA Medicaid ,77,50,,,percent of total billed charges,50% of total Billed charges,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,77,50,,,percent of total billed charges,50% of total Billed charges,52.21,33.9,,,percent of total billed charges,33.9% of total billed charges,77,50,,,percent of total billed charges,50% of total Billed charges,120.12,78,,,percent of total billed charges,78% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,208.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,77,50,,,percent of total billed charges,50% of total Billed charges,208.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.56,270.58,
TINNITUS ASSESSMENT,47192625,CDM,471,RC,92625,HCPCS,Outpatient,,,492,319.80,,432.96,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,75.82,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,309.96,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid,75.28,15.3,,,percent of total billed charges,15.3% of total billed charges,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,492,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,75.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.7,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,166.79,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,73.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.53,566.92,
EVAL AURAL REHAB STATUS 1ST HR,47092626,CDM,470,RC,92626,HCPCS,Outpatient,,,468,304.20,,411.84,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,51.06,100,,,Fee Schedule,100% of WA Medicaid,468,100,,,percent of total billed charges,100% of total billed charges,51.06,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,294.84,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,51.06,100,,,Fee Schedule,100% of WA Medicaid,71.6,15.3,,,percent of total billed charges,15.3% of total billed charges,322.92,69,,,percent of total billed charges,69% of total billed charges,468,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,468,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,468,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,51.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,51.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,52.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,66.38,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,176.44,37.7,,,percent of total billed charges,37.70% of total billed charges,176.44,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,158.65,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,365.04,78,,,percent of total billed charges,78% of total billed charges,468,100,,,percent of total billed charges,100% of total billed charges,386.57,82.6,,,percent of total billed charges,82.6% of total billed charges,386.57,82.6,,,percent of total billed charges,82.6% of total billed charges,51.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,51.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.06,566.92,
EVAL AURAL REHAB STATUS ADD 15,47092627,CDM,470,RC,92627,HCPCS,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,11.96,100,,,Fee Schedule,100% of WA Medicaid,200,100,,,percent of total billed charges,100% of total billed charges,11.96,103,,,Fee Schedule,103% of WA Medicaid,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.96,100,,,Fee Schedule,100% of WA Medicaid,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,11.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,11.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,12.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.55,130,,,Fee Schedule,130% of WA Medicaid ,100,50,,,percent of total billed charges,50% of total Billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,67.8,33.9,,,percent of total billed charges,33.9% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,11.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,11.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.96,200,
AURAL REHAB PRE LINGUAL 1 HR,44092630,CDM,440,RC,92630,HCPCS,Outpatient,,,1490,968.50,GN,1311.2,88,,,percent of total billed charges,88% of total Billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid,1490,100,,,percent of total billed charges,100% of total billed charges,29.97,103,,,Fee Schedule,103% of WA Medicaid,745,50,,,percent of total billed charges,50% of total Billed charges,938.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,29.1,100,,,Fee Schedule,100% of WA Medicaid,227.97,15.3,,,percent of total billed charges,15.3% of total billed charges,1028.1,69,,,percent of total billed charges,69% of total billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,921.57,61.85,,,percent of total billed charges,61.85% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,745,50,,,percent of total billed charges,50% of total Billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,21.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,745,50,,,percent of total billed charges,50% of total Billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,29.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.83,130,,,Fee Schedule,130% of WA Medicaid ,745,50,,,percent of total billed charges,50% of total Billed charges,561.73,37.7,,,percent of total billed charges,37.70% of total billed charges,561.73,37.7,,,percent of total billed charges,37.70% of total billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,505.11,33.9,,,percent of total billed charges,33.9% of total billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,1162.2,78,,,percent of total billed charges,78% of total billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,1230.74,82.6,,,percent of total billed charges,82.6% of total billed charges,1230.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,745,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,745,50,,,percent of total billed charges,50% of total Billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.55,1490,
AURAL REHAB POST-LING 1HR,44092633,CDM,440,RC,92633,HCPCS,Outpatient,,,1490,968.50,GN,1311.2,88,,,percent of total billed charges,88% of total Billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid,1490,100,,,percent of total billed charges,100% of total billed charges,29.97,103,,,Fee Schedule,103% of WA Medicaid,745,50,,,percent of total billed charges,50% of total Billed charges,938.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,29.1,100,,,Fee Schedule,100% of WA Medicaid,227.97,15.3,,,percent of total billed charges,15.3% of total billed charges,1028.1,69,,,percent of total billed charges,69% of total billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,921.57,61.85,,,percent of total billed charges,61.85% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,745,50,,,percent of total billed charges,50% of total Billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,21.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,745,50,,,percent of total billed charges,50% of total Billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,29.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.83,130,,,Fee Schedule,130% of WA Medicaid ,745,50,,,percent of total billed charges,50% of total Billed charges,561.73,37.7,,,percent of total billed charges,37.70% of total billed charges,561.73,37.7,,,percent of total billed charges,37.70% of total billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,505.11,33.9,,,percent of total billed charges,33.9% of total billed charges,745,50,,,percent of total billed charges,50% of total Billed charges,1162.2,78,,,percent of total billed charges,78% of total billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,1230.74,82.6,,,percent of total billed charges,82.6% of total billed charges,1230.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,745,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,745,50,,,percent of total billed charges,50% of total Billed charges,29.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.55,1490,
FITTING OF BAHA,47092700,CDM,470,RC,92700,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,103.1,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,102.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.13,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.37,130.13,
APHASIA ASSESS/REP/HR/-GN,44096105,CDM,440,RC,96105,HCPCS,Outpatient,,,1680,1092.00,GN,1478.4,88,,,percent of total billed charges,88% of total Billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,1680,100,,,percent of total billed charges,100% of total billed charges,537.34,103,,,Fee Schedule,103% of WA Medicaid,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1058.4,63,,,percent of total billed charges,63% of total billed charges,168.12,175,,,Fee Schedule,175% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,257.04,15.3,,,percent of total billed charges,15.3% of total billed charges,1159.2,69,,,percent of total billed charges,69% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1680,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1680,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,386.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,386.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,532.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,678.2,130,,,Fee Schedule,130% of WA Medicaid ,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,569.52,33.9,,,percent of total billed charges,33.9% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1310.4,78,,,percent of total billed charges,78% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,98.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.22,1680,
COGNITIVE TEST PER HOUR,44096125,CDM,440,RC,96125,HCPCS,Outpatient,,,1081,702.65,GN,951.28,88,,,percent of total billed charges,88% of total Billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,1081,100,,,percent of total billed charges,100% of total billed charges,537.34,103,,,Fee Schedule,103% of WA Medicaid,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,681.03,63,,,percent of total billed charges,63% of total billed charges,180.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,165.39,15.3,,,percent of total billed charges,15.3% of total billed charges,745.89,69,,,percent of total billed charges,69% of total billed charges,1081,100,,,percent of total billed charges,100% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,1081,100,,,percent of total billed charges,100% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,1081,100,,,percent of total billed charges,100% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,409.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,386.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,532.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,678.2,130,,,Fee Schedule,130% of WA Medicaid ,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,407.54,37.7,,,percent of total billed charges,37.70% of total billed charges,407.54,37.7,,,percent of total billed charges,37.70% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,366.46,33.9,,,percent of total billed charges,33.9% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,843.18,78,,,percent of total billed charges,78% of total billed charges,1081,100,,,percent of total billed charges,100% of total billed charges,892.91,82.6,,,percent of total billed charges,82.6% of total billed charges,892.91,82.6,,,percent of total billed charges,82.6% of total billed charges,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,104.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,103.93,1081,
440,,,440,RC,,,Outpatient,,,251,163.15,,220.88,88,,,percent of total billed charges,88% of total Billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,42.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,251,100,,,percent of total billed charges,100% of total billed charges,43.43,17.304,,,percent of total billed charges,17.304% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,158.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42.17,16.8,,,percent of total billed charges,16.8% of total billed charges,38.4,15.3,,,percent of total billed charges,15.3% of total billed charges,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,251,100,,,percent of total billed charges,100% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,251,100,,,percent of total billed charges,100% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,155.24,61.85,,,percent of total billed charges,61.85% of total billed charges,42.17,16.8,,,percent of total billed charges,16.8% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,42.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,43.01,17.136,,,percent of total billed charges,17.136% of total billed charges,54.82,21.84,,,percent of total billed charges,21.84% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,85.09,33.9,,,percent of total billed charges,33.9% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,42.17,16.8,,,percent of total billed charges,16.8% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125.5,50,,,percent of total billed charges,50% of total Billed charges,42.17,16.8,,,percent of total billed charges,16.8% of total billed charges,38.4,251,
Cognitive Skills Development Intial 15 min,44097129,CDM,440,RC,97129,HCPCS,Outpatient,,,256,166.40,GN,225.28,88,,,percent of total billed charges,88% of total Billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,256,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,161.28,63,,,percent of total billed charges,63% of total billed charges,38.59,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,39.17,15.3,,,percent of total billed charges,15.3% of total billed charges,176.64,69,,,percent of total billed charges,69% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,256,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,256,100,,,percent of total billed charges,100% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,89.01,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,96.51,37.7,,,percent of total billed charges,37.70% of total billed charges,96.51,37.7,,,percent of total billed charges,37.70% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,86.78,33.9,,,percent of total billed charges,33.9% of total billed charges,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,199.68,78,,,percent of total billed charges,78% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,22.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,22.22,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.22,256,
"OT Cog Ther Intervent, Addl 15 Min Asst",44097130,CDM,440,RC,97130,HCPCS,Outpatient,,,149,96.85,CO|GO,131.12,88,,,percent of total billed charges,88% of total Billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,149,100,,,percent of total billed charges,100% of total billed charges,35.83,103,,,Fee Schedule,103% of WA Medicaid,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,93.87,63,,,percent of total billed charges,63% of total billed charges,36.8,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid,22.8,15.3,,,percent of total billed charges,15.3% of total billed charges,102.81,69,,,percent of total billed charges,69% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,149,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,149,100,,,percent of total billed charges,100% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,84.99,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,25.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,35.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.23,130,,,Fee Schedule,130% of WA Medicaid ,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,50.51,33.9,,,percent of total billed charges,33.9% of total billed charges,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,116.22,78,,,percent of total billed charges,78% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,21.41,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,21.2,100,,,Fee Schedule,100% of Medicare OPPS rate,34.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.2,149,
OFFICE VISIT LEVEL 2,47099202,CDM,470,RC,99202,HCPCS,Outpatient,,,205,133.25,,180.4,88,,,percent of total billed charges,88% of total Billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,34.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,205,100,,,percent of total billed charges,100% of total billed charges,35.47,17.304,,,percent of total billed charges,17.304% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,129.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.44,16.8,,,percent of total billed charges,16.8% of total billed charges,31.37,15.3,,,percent of total billed charges,15.3% of total billed charges,141.45,69,,,percent of total billed charges,69% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,205,100,,,percent of total billed charges,100% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,205,100,,,percent of total billed charges,100% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,126.79,61.85,,,percent of total billed charges,61.85% of total billed charges,34.44,16.8,,,percent of total billed charges,16.8% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,34.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,35.13,17.136,,,percent of total billed charges,17.136% of total billed charges,44.77,21.84,,,percent of total billed charges,21.84% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,77.29,37.7,,,percent of total billed charges,37.70% of total billed charges,77.29,37.7,,,percent of total billed charges,37.70% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,102.5,50,,,percent of total billed charges,50% of total Billed charges,159.9,78,,,percent of total billed charges,78% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,34.44,16.8,,,percent of total billed charges,16.8% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,102.5,50,,,percent of total billed charges,50% of total Billed charges,34.44,16.8,,,percent of total billed charges,16.8% of total billed charges,31.37,205,
ASSESSMENT FOR H A,470V5010,CDM,470,RC,V5010,HCPCS,Outpatient,,,189,122.85,,166.32,88,,,percent of total billed charges,88% of total Billed charges,94.5,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,189,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,94.5,50,,,percent of total billed charges,50% of total Billed charges,119.07,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,28.92,15.3,,,percent of total billed charges,15.3% of total billed charges,130.41,69,,,percent of total billed charges,69% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,94.5,50,,,percent of total billed charges,50% of total Billed charges,189,100,,,percent of total billed charges,100% of total billed charges,94.5,50,,,percent of total billed charges,50% of total Billed charges,189,100,,,percent of total billed charges,100% of total billed charges,94.5,50,,,percent of total billed charges,50% of total Billed charges,116.9,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.5,50,,,percent of total billed charges,50% of total Billed charges,94.5,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,94.5,50,,,percent of total billed charges,50% of total Billed charges,94.5,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,94.5,50,,,percent of total billed charges,50% of total Billed charges,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.5,50,,,percent of total billed charges,50% of total Billed charges,64.07,33.9,,,percent of total billed charges,33.9% of total billed charges,94.5,50,,,percent of total billed charges,50% of total Billed charges,147.42,78,,,percent of total billed charges,78% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,94.5,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,189,
BATTERIES 40 CELLS,470V5266,CDM,470,RC,V5266,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,85,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,42.5,50,,,percent of total billed charges,50% of total Billed charges,53.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,52.57,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,42.5,50,,,percent of total billed charges,50% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42.5,50,,,percent of total billed charges,50% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42.5,50,,,percent of total billed charges,50% of total Billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,42.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42.5,50,,,percent of total billed charges,50% of total Billed charges,14.28,16.8,,,percent of total billed charges,16.8% of total billed charges,13.01,85,
BINAURAL DISPENSING FEE,470V5160,CDM,470,RC,V5160,HCPCS,Outpatient,,,2110,1371.50,,1856.8,88,,,percent of total billed charges,88% of total Billed charges,1055,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,2110,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,1055,50,,,percent of total billed charges,50% of total Billed charges,1329.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,322.83,15.3,,,percent of total billed charges,15.3% of total billed charges,1455.9,69,,,percent of total billed charges,69% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,1055,50,,,percent of total billed charges,50% of total Billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,1055,50,,,percent of total billed charges,50% of total Billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,1055,50,,,percent of total billed charges,50% of total Billed charges,1305.04,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1055,50,,,percent of total billed charges,50% of total Billed charges,1055,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1055,50,,,percent of total billed charges,50% of total Billed charges,1055,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,1055,50,,,percent of total billed charges,50% of total Billed charges,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1055,50,,,percent of total billed charges,50% of total Billed charges,715.29,33.9,,,percent of total billed charges,33.9% of total billed charges,1055,50,,,percent of total billed charges,50% of total Billed charges,1645.8,78,,,percent of total billed charges,78% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1055,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1055,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,2110,
ANALYSIS QUAL VOICE  RESONANC,44492524X,CDM,444,RC,92524,HCPCS,Outpatient,,,666,432.90,GN,586.08,88,,,percent of total billed charges,88% of total Billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,64.15,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,64.15,103,,,Fee Schedule,103% of WA Medicaid,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,192.64,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.15,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,427.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,64.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,65.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,83.4,130,,,Fee Schedule,130% of WA Medicaid ,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,64.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,112.34,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,111.23,100,,,Fee Schedule,100% of Medicare OPPS rate,64.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.15,666,
CONFORMITY EVAL 1ST F/U,470V5020,CDM,470,RC,V5020,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,35,50,,,percent of total billed charges,50% of total Billed charges,44.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,35,50,,,percent of total billed charges,50% of total Billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,23.73,33.9,,,percent of total billed charges,33.9% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.71,70,
CONFORMITY EVALUATION,470V5020,CDM,470,RC,V5020,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,35,50,,,percent of total billed charges,50% of total Billed charges,44.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,35,50,,,percent of total billed charges,50% of total Billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,23.73,33.9,,,percent of total billed charges,33.9% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.71,70,
"EAR IMPRESSION, EACH EAR",470V5275,CDM,470,RC,V5275,HCPCS,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,62,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,39.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",9.49,15.3,,,percent of total billed charges,15.3% of total billed charges,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,38.35,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,21.02,33.9,,,percent of total billed charges,33.9% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,9.49,62,
DYSPH/ORAL FEED EVAL/-GN,44092610X,CDM,440,RC,92610,HCPCS,Outpatient,,,1407,914.55,GN,1238.16,88,,,percent of total billed charges,88% of total Billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,1407,100,,,percent of total billed charges,100% of total billed charges,49.92,103,,,Fee Schedule,103% of WA Medicaid,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,886.41,63,,,percent of total billed charges,63% of total billed charges,123.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,215.27,15.3,,,percent of total billed charges,15.3% of total billed charges,970.83,69,,,percent of total billed charges,69% of total billed charges,1407,100,,,percent of total billed charges,100% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,1407,100,,,percent of total billed charges,100% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,1407,100,,,percent of total billed charges,100% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,270.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,50.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.9,130,,,Fee Schedule,130% of WA Medicaid ,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,530.44,37.7,,,percent of total billed charges,37.70% of total billed charges,530.44,37.7,,,percent of total billed charges,37.70% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,476.97,33.9,,,percent of total billed charges,33.9% of total billed charges,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,1097.46,78,,,percent of total billed charges,78% of total billed charges,1407,100,,,percent of total billed charges,100% of total billed charges,1162.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1162.18,82.6,,,percent of total billed charges,82.6% of total billed charges,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,71.66,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,70.95,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.92,1407,
EVAL USE/FIT VOICE PROSTH/GN,44192597X,CDM,440,RC,92597,HCPCS,Outpatient,,,2287,1486.55,GN,2012.56,88,,,percent of total billed charges,88% of total Billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,41.95,100,,,Fee Schedule,100% of WA Medicaid,2287,100,,,percent of total billed charges,100% of total billed charges,41.95,103,,,Fee Schedule,103% of WA Medicaid,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1440.81,63,,,percent of total billed charges,63% of total billed charges,127.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,41.95,100,,,Fee Schedule,100% of WA Medicaid,349.91,15.3,,,percent of total billed charges,15.3% of total billed charges,1578.03,69,,,percent of total billed charges,69% of total billed charges,2287,100,,,percent of total billed charges,100% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,2287,100,,,percent of total billed charges,100% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,2287,100,,,percent of total billed charges,100% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,277.31,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,41.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,41.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,42.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,54.54,130,,,Fee Schedule,130% of WA Medicaid ,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,862.2,37.7,,,percent of total billed charges,37.70% of total billed charges,862.2,37.7,,,percent of total billed charges,37.70% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,775.29,33.9,,,percent of total billed charges,33.9% of total billed charges,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1783.86,78,,,percent of total billed charges,78% of total billed charges,2287,100,,,percent of total billed charges,100% of total billed charges,1889.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1889.06,82.6,,,percent of total billed charges,82.6% of total billed charges,41.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,74.15,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,73.42,100,,,Fee Schedule,100% of Medicare OPPS rate,41.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.95,2287,
FIT OF HA/MOLD 15 MIN,470V5011,CDM,470,RC,V5011,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,32.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,40.53,
DYSPH ASSESS W/VIDEO FL,44092611X,CDM,440,RC,92611,HCPCS,Outpatient,,,1340,871.00,GN,1179.2,88,,,percent of total billed charges,88% of total Billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,1340,100,,,percent of total billed charges,100% of total billed charges,112.02,103,,,Fee Schedule,103% of WA Medicaid,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,844.2,63,,,percent of total billed charges,63% of total billed charges,161.65,175,,,Fee Schedule,175% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid,205.02,15.3,,,percent of total billed charges,15.3% of total billed charges,924.6,69,,,percent of total billed charges,69% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,1340,100,,,percent of total billed charges,100% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,1340,100,,,percent of total billed charges,100% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,358.29,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,80.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,110.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.39,130,,,Fee Schedule,130% of WA Medicaid ,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,454.26,33.9,,,percent of total billed charges,33.9% of total billed charges,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,1045.2,78,,,percent of total billed charges,78% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,94.46,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,93.52,100,,,Fee Schedule,100% of Medicare OPPS rate,108.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.56,1340,
H A REPAIR VISIT LEFT,470V5014,CDM,470,RC,V5014,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,90,50,,,percent of total billed charges,50% of total Billed charges,113.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,180,100,,,percent of total billed charges,100% of total billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,180,100,,,percent of total billed charges,100% of total billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,111.33,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90,50,,,percent of total billed charges,50% of total Billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90,50,,,percent of total billed charges,50% of total Billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,90,50,,,percent of total billed charges,50% of total Billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,61.02,33.9,,,percent of total billed charges,33.9% of total billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,90,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,180,
H A REPAIR VISIT RIGHT,470V5014,CDM,470,RC,V5014,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,90,50,,,percent of total billed charges,50% of total Billed charges,113.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,180,100,,,percent of total billed charges,100% of total billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,180,100,,,percent of total billed charges,100% of total billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,111.33,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90,50,,,percent of total billed charges,50% of total Billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90,50,,,percent of total billed charges,50% of total Billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,90,50,,,percent of total billed charges,50% of total Billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,61.02,33.9,,,percent of total billed charges,33.9% of total billed charges,90,50,,,percent of total billed charges,50% of total Billed charges,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,90,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,180,
HA REPAIR/RECASE ALL MAKES,470V5299,CDM,470,RC,V5299,HCPCS,Outpatient,,,276,179.40,,242.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,276,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,173.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",42.23,15.3,,,percent of total billed charges,15.3% of total billed charges,190.44,69,,,percent of total billed charges,69% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,276,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,276,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,104.05,37.7,,,percent of total billed charges,37.70% of total billed charges,104.05,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,93.56,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,215.28,78,,,percent of total billed charges,78% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46.37,16.8,,,percent of total billed charges,16.8% of total billed charges,42.23,276,
HA REPAIR/RECASE MANUF,470V5299,CDM,470,RC,V5299,HCPCS,Outpatient,,,381,247.65,,335.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,381,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,240.03,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",58.29,15.3,,,percent of total billed charges,15.3% of total billed charges,262.89,69,,,percent of total billed charges,69% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,381,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,381,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,129.16,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,297.18,78,,,percent of total billed charges,78% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,58.29,381,
HEARING AID CLEANING L CHARGE,4705092V,CDM,470,RC,5092V,HCPCS,Outpatient,,,36,23.40,LT,31.68,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",5.51,36,
HEARING AID CLEANING R CHARGE,4705092V,CDM,470,RC,5092V,HCPCS,Outpatient,,,36,23.40,RT,31.68,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",5.51,36,
HEARING AID REPAIR/RECASE,470V5014,CDM,470,RC,V5014,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,32.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,40.53,
HEARING SCREENING,470V5008,CDM,470,RC,V5008,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,32.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,40.53,
MONAURAL DISPENSING FEE,470V5299,CDM,470,RC,V5299,HCPCS,Outpatient,,,2071,1346.15,,1822.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2071,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1304.73,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",316.86,15.3,,,percent of total billed charges,15.3% of total billed charges,1428.99,69,,,percent of total billed charges,69% of total billed charges,2071,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2071,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2071,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,646.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,780.77,37.7,,,percent of total billed charges,37.70% of total billed charges,780.77,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,702.07,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1615.38,78,,,percent of total billed charges,78% of total billed charges,2071,100,,,percent of total billed charges,100% of total billed charges,1710.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1710.65,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,347.93,16.8,,,percent of total billed charges,16.8% of total billed charges,316.86,2071,
REPLACEMENT EARMOLD,470V5264,CDM,470,RC,V5264,HCPCS,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,54,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,54,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,20.36,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,18.31,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
"RIC TUBES AND DOMES,AU",4705094V,CDM,470,RC,V5299,HCPCS,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
SPEECH RE-EVALUATION,440S9152,CDM,440,RC,S9152,HCPCS,Outpatient,,,318,206.70,GN,279.84,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,208.14,100,,,Fee Schedule,100% of WA Medicaid,318,100,,,percent of total billed charges,100% of total billed charges,214.38,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,200.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,208.14,100,,,Fee Schedule,100% of WA Medicaid,48.65,15.3,,,percent of total billed charges,15.3% of total billed charges,219.42,69,,,percent of total billed charges,69% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,318,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,318,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,208.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,154.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,212.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,270.58,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,119.89,37.7,,,percent of total billed charges,37.70% of total billed charges,119.89,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,107.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,248.04,78,,,percent of total billed charges,78% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,208.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,208.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.65,318,
SERVICE BEYOND COVERAGE,470V5299,CDM,470,RC,V5299,HCPCS,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
440,,,440,RC,,,Outpatient,,,251,163.15,,220.88,88,,,percent of total billed charges,88% of total Billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,42.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,251,100,,,percent of total billed charges,100% of total billed charges,43.43,17.304,,,percent of total billed charges,17.304% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,158.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42.17,16.8,,,percent of total billed charges,16.8% of total billed charges,38.4,15.3,,,percent of total billed charges,15.3% of total billed charges,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,251,100,,,percent of total billed charges,100% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,251,100,,,percent of total billed charges,100% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42.17,16.8,,,percent of total billed charges,16.8% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,42.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,43.01,17.136,,,percent of total billed charges,17.136% of total billed charges,54.82,21.84,,,percent of total billed charges,21.84% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,85.09,33.9,,,percent of total billed charges,33.9% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,42.17,16.8,,,percent of total billed charges,16.8% of total billed charges,125.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125.5,50,,,percent of total billed charges,50% of total Billed charges,42.17,16.8,,,percent of total billed charges,16.8% of total billed charges,38.4,251,
EVAL SPEECH DEVICE INITIAL HR,44092607X,CDM,440,RC,92607,HCPCS,Outpatient,,,726,471.90,GN,638.88,88,,,percent of total billed charges,88% of total Billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,73.07,100,,,Fee Schedule,100% of WA Medicaid,726,100,,,percent of total billed charges,100% of total billed charges,73.07,103,,,Fee Schedule,103% of WA Medicaid,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,457.38,63,,,percent of total billed charges,63% of total billed charges,219.68,175,,,Fee Schedule,175% of Medicare OPPS Rate,73.07,100,,,Fee Schedule,100% of WA Medicaid,111.08,15.3,,,percent of total billed charges,15.3% of total billed charges,500.94,69,,,percent of total billed charges,69% of total billed charges,726,100,,,percent of total billed charges,100% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,726,100,,,percent of total billed charges,100% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,726,100,,,percent of total billed charges,100% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,489.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,73.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,73.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,74.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,94.99,130,,,Fee Schedule,130% of WA Medicaid ,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,273.7,37.7,,,percent of total billed charges,37.70% of total billed charges,273.7,37.7,,,percent of total billed charges,37.70% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,246.11,33.9,,,percent of total billed charges,33.9% of total billed charges,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,566.28,78,,,percent of total billed charges,78% of total billed charges,726,100,,,percent of total billed charges,100% of total billed charges,599.68,82.6,,,percent of total billed charges,82.6% of total billed charges,599.68,82.6,,,percent of total billed charges,82.6% of total billed charges,73.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,127.61,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,126.35,100,,,Fee Schedule,100% of Medicare OPPS rate,73.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.07,726,
EVAL SPEECH DEVICE ADD 30MIN,44092608X,CDM,440,RC,92608,HCPCS,Outpatient,,,328,213.20,GN,288.64,88,,,percent of total billed charges,88% of total Billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicaid,328,100,,,percent of total billed charges,100% of total billed charges,28.66,103,,,Fee Schedule,103% of WA Medicaid,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,206.64,63,,,percent of total billed charges,63% of total billed charges,86.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,28.66,100,,,Fee Schedule,100% of WA Medicaid,50.18,15.3,,,percent of total billed charges,15.3% of total billed charges,226.32,69,,,percent of total billed charges,69% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,328,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,328,100,,,percent of total billed charges,100% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,196.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.26,130,,,Fee Schedule,130% of WA Medicaid ,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,123.66,37.7,,,percent of total billed charges,37.70% of total billed charges,123.66,37.7,,,percent of total billed charges,37.70% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,111.19,33.9,,,percent of total billed charges,33.9% of total billed charges,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,255.84,78,,,percent of total billed charges,78% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,50.11,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,49.61,100,,,Fee Schedule,100% of Medicare OPPS rate,28.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.66,328,
EVAL SPEECH FLUENCY,44492521X,CDM,444,RC,92521,HCPCS,Outpatient,,,666,432.90,GN,586.08,88,,,percent of total billed charges,88% of total Billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,78.01,103,,,Fee Schedule,103% of WA Medicaid,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,234.85,175,,,Fee Schedule,175% of Medicare OPPS Rate,78.01,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,523.07,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,79.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.41,130,,,Fee Schedule,130% of WA Medicaid ,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,136.54,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,135.19,100,,,Fee Schedule,100% of Medicare OPPS rate,78.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.01,666,
EVAL SOUND PROD,44492522X,CDM,444,RC,92522,HCPCS,Outpatient,,,666,432.90,GN,586.08,88,,,percent of total billed charges,88% of total Billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,64.91,100,,,Fee Schedule,100% of WA Medicaid,666,100,,,percent of total billed charges,100% of total billed charges,64.91,103,,,Fee Schedule,103% of WA Medicaid,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,419.58,63,,,percent of total billed charges,63% of total billed charges,195.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,64.91,100,,,Fee Schedule,100% of WA Medicaid,101.9,15.3,,,percent of total billed charges,15.3% of total billed charges,459.54,69,,,percent of total billed charges,69% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,666,100,,,percent of total billed charges,100% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,436.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,64.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,64.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,66.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.38,130,,,Fee Schedule,130% of WA Medicaid ,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,251.08,37.7,,,percent of total billed charges,37.70% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,225.77,33.9,,,percent of total billed charges,33.9% of total billed charges,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,519.48,78,,,percent of total billed charges,78% of total billed charges,666,100,,,percent of total billed charges,100% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,550.12,82.6,,,percent of total billed charges,82.6% of total billed charges,64.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,114.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.96,100,,,Fee Schedule,100% of Medicare OPPS rate,64.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.91,666,
EVAL SOUND PROD W/ LANG COMP,44492523X,CDM,444,RC,92523,HCPCS,Outpatient,,,857,557.05,GN,754.16,88,,,percent of total billed charges,88% of total Billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicaid,857,100,,,percent of total billed charges,100% of total billed charges,133.62,103,,,Fee Schedule,103% of WA Medicaid,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,539.91,63,,,percent of total billed charges,63% of total billed charges,402.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,133.62,100,,,Fee Schedule,100% of WA Medicaid,131.12,15.3,,,percent of total billed charges,15.3% of total billed charges,591.33,69,,,percent of total billed charges,69% of total billed charges,857,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,857,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,857,100,,,percent of total billed charges,100% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,899.56,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,136.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,173.71,130,,,Fee Schedule,130% of WA Medicaid ,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,323.09,37.7,,,percent of total billed charges,37.70% of total billed charges,323.09,37.7,,,percent of total billed charges,37.70% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,290.52,33.9,,,percent of total billed charges,33.9% of total billed charges,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,668.46,78,,,percent of total billed charges,78% of total billed charges,857,100,,,percent of total billed charges,100% of total billed charges,707.88,82.6,,,percent of total billed charges,82.6% of total billed charges,707.88,82.6,,,percent of total billed charges,82.6% of total billed charges,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,234.1,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,231.78,100,,,Fee Schedule,100% of Medicare OPPS rate,133.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.12,899.56,
APHASIA ASSESS/REP/HR/-GN,44096105X,CDM,440,RC,96105,HCPCS,Outpatient,,,1680,1092.00,GN,1478.4,88,,,percent of total billed charges,88% of total Billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,1680,100,,,percent of total billed charges,100% of total billed charges,537.34,103,,,Fee Schedule,103% of WA Medicaid,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1058.4,63,,,percent of total billed charges,63% of total billed charges,168.12,175,,,Fee Schedule,175% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,257.04,15.3,,,percent of total billed charges,15.3% of total billed charges,1159.2,69,,,percent of total billed charges,69% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1680,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1680,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,386.94,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,386.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,532.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,678.2,130,,,Fee Schedule,130% of WA Medicaid ,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,569.52,33.9,,,percent of total billed charges,33.9% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,1310.4,78,,,percent of total billed charges,78% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,98.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,97.22,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.22,1680,
COGNITIVE TEST PER HOUR,44096125X,CDM,440,RC,96125,HCPCS,Outpatient,,,1081,702.65,GN,951.28,88,,,percent of total billed charges,88% of total Billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,1081,100,,,percent of total billed charges,100% of total billed charges,537.34,103,,,Fee Schedule,103% of WA Medicaid,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,681.03,63,,,percent of total billed charges,63% of total billed charges,180.16,175,,,Fee Schedule,175% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid,165.39,15.3,,,percent of total billed charges,15.3% of total billed charges,745.89,69,,,percent of total billed charges,69% of total billed charges,1081,100,,,percent of total billed charges,100% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,1081,100,,,percent of total billed charges,100% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,1081,100,,,percent of total billed charges,100% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,409.05,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,386.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,532.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,678.2,130,,,Fee Schedule,130% of WA Medicaid ,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,407.54,37.7,,,percent of total billed charges,37.70% of total billed charges,407.54,37.7,,,percent of total billed charges,37.70% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,366.46,33.9,,,percent of total billed charges,33.9% of total billed charges,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,843.18,78,,,percent of total billed charges,78% of total billed charges,1081,100,,,percent of total billed charges,100% of total billed charges,892.91,82.6,,,percent of total billed charges,82.6% of total billed charges,892.91,82.6,,,percent of total billed charges,82.6% of total billed charges,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,104.97,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,103.93,100,,,Fee Schedule,100% of Medicare OPPS rate,521.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,103.93,1081,
DYSPH/FEED DYSFN TRMT/-GN,44092526X,CDM,440,RC,92526,HCPCS,Outpatient,,,443,287.95,GN,389.84,88,,,percent of total billed charges,88% of total Billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,443,100,,,percent of total billed charges,100% of total billed charges,49.92,103,,,Fee Schedule,103% of WA Medicaid,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,279.09,63,,,percent of total billed charges,63% of total billed charges,150.01,175,,,Fee Schedule,175% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid,67.78,15.3,,,percent of total billed charges,15.3% of total billed charges,305.67,69,,,percent of total billed charges,69% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,331.32,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,50.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.9,130,,,Fee Schedule,130% of WA Medicaid ,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,150.18,33.9,,,percent of total billed charges,33.9% of total billed charges,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,345.54,78,,,percent of total billed charges,78% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,87.08,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,86.22,100,,,Fee Schedule,100% of Medicare OPPS rate,49.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.92,443,
SPEECH/LANG THERAPY/-GN,44092507X,CDM,440,RC,92507,HCPCS,Outpatient,,,443,287.95,GN,389.84,88,,,percent of total billed charges,88% of total Billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.79,100,,,Fee Schedule,100% of WA Medicaid,443,100,,,percent of total billed charges,100% of total billed charges,44.79,103,,,Fee Schedule,103% of WA Medicaid,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,279.09,63,,,percent of total billed charges,63% of total billed charges,134.94,175,,,Fee Schedule,175% of Medicare OPPS Rate,44.79,100,,,Fee Schedule,100% of WA Medicaid,67.78,15.3,,,percent of total billed charges,15.3% of total billed charges,305.67,69,,,percent of total billed charges,69% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,443,100,,,percent of total billed charges,100% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,298.89,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,44.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,45.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.23,130,,,Fee Schedule,130% of WA Medicaid ,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,167.01,37.7,,,percent of total billed charges,37.70% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,150.18,33.9,,,percent of total billed charges,33.9% of total billed charges,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,345.54,78,,,percent of total billed charges,78% of total billed charges,443,100,,,percent of total billed charges,100% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,365.92,82.6,,,percent of total billed charges,82.6% of total billed charges,44.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,78.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,77.61,100,,,Fee Schedule,100% of Medicare OPPS rate,44.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.79,443,
V5260 Digital Binaural ITE Essential,470V5260ESS,CDM,470,RC,V5260,HCPCS,Outpatient,,,1448,941.20,,1274.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1448,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,912.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",221.54,15.3,,,percent of total billed charges,15.3% of total billed charges,999.12,69,,,percent of total billed charges,69% of total billed charges,1448,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1448,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1448,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,451.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,545.9,37.7,,,percent of total billed charges,37.70% of total billed charges,545.9,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,490.87,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1129.44,78,,,percent of total billed charges,78% of total billed charges,1448,100,,,percent of total billed charges,100% of total billed charges,1196.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1196.05,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,243.26,16.8,,,percent of total billed charges,16.8% of total billed charges,221.54,1448,
WAX GUARDS (5095V),4705095V,CDM,470,RC,5095V,HCPCS,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.38,37.7,,,percent of total billed charges,37.70% of total billed charges,0.38,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",0.15,1,
CIRCUIT ANESTHESIA BREATHING HOSE 96,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CLEAR W/ VENTS 1.50,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CONNECTOR PLEUR-EVAC CHEST DRAINAGE 3/8 Y CONNECTOR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRAPE FEMORAL ANGIOGRAPHY 80 X 159,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DRESSING KERRAMAX CARE 5 X 6IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING TEGADERM ABSORBENT ACRYLIC CLEAR 5-7/8 X 6,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRESSING TEGADERM CLEAR ACRYLIC 7.5 X 8,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
FLAT W/ VENTS CLEAR 1,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
FUSEID-DT-WO-WHITE 4X4.5  3,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
GENTAMICIN REAGENT EMIT 2000,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
NEEDLE SPINAL PECAN STERILE 25GAX6.1,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
OXYMASK ADULT 7FT 1-40 LPM,ORSUP0001,CDM,272,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,8.65,17.304,,,percent of total billed charges,17.304% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.57,17.136,,,percent of total billed charges,17.136% of total billed charges,10.92,21.84,,,percent of total billed charges,21.84% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,50,
OXYMASK ADULT 14 UNIVERSAL OXYGEN MASK,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ROUND W/ VENTS CLEAR .75,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SILICONE PENROSE DRAIN 12X0.25,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUTURE PROLENE MONO BLUE 6-0 18IN PC-3,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SYRINGE W/NEEDLE 22GX1.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TUBING PRESSURE MONITORING MALE/MALE 72,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
WATERPROOF TAPE 1X10YD,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
%A1C PERF VER I,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
%A1C PERF VER II,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
1-LAYER FOLEY CATH TRAY W/BAG 16FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
1-LAYER FOLY CATH TRAY W/URINE METER 16FR 10ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
1-LAYER FOLY CATH TRAY W/TEMP-SENSOR 16FR 10ML,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
1.0MM TI MF CORTEX SCREW SELF-TAPPING W/FLUTES 5MM,ORSUP0027,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3380,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3380,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
1.5MM TI ADAPTION PLATE 20 HOLES/90MM,ORSUP0026,CDM,278,RC,C1713,HCPCS,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3120,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3120,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,973.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1057.68,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
1.5MM TI MF CORTEX SCREW SELF-TAPPING W/FLUTES 4MM,ORSUP0022,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2340,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2340,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
1.5X4MM XDRIVE TF SD SCREW,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,390,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,390,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
10MM ROUNDED STIFF SNARE,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
12 MM AND STAPLER CANNULA LONG,ORSUP0041,CDM,272,RC,,,Outpatient,,,7800,5070.00,,6864,88,,,percent of total billed charges,88% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1349.71,17.304,,,percent of total billed charges,17.304% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4914,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,15.3,,,percent of total billed charges,15.3% of total billed charges,5382,69,,,percent of total billed charges,69% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1336.61,17.136,,,percent of total billed charges,17.136% of total billed charges,1703.52,21.84,,,percent of total billed charges,21.84% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,6084,78,,,percent of total billed charges,78% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,7800,
12 MM AND STAPLER CANNULA,ORSUP0040,CDM,272,RC,,,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
12 MM AND STAPLER BLUNT OBTURATOR LONG,ORSUP0030,CDM,272,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
12 MM AND STAPLER BLUNT OBTURATOR,ORSUP0029,CDM,272,RC,,,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
12-8 MM REDUCER,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
18.5 BURR PLATE,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
2 SARS ANTIGEN FLUORESCENT IMMUNOASSAY (FIA),ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
25 OH VITAMIN D TOTAL CAL,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
25 OH VITAMIN D TOTAL RGT,ORSUP0032,CDM,272,RC,,,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
4MM EMERGENCY SCREW,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,390,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,390,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
5-8 MM CANNULA SEAL,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
5.5MM XL PEAR BUR,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
8 MM HASSON CONE,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
8 MM INSTRUMENT CANNULA LONG,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
8 MM BLUNT OBTURATOR LONG,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
8 MM BLADELESS OBTURATOR,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
8 MM BLADELESS OBTURATOR LONG,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
8MM FORCE BIPOLAR IS4000,ORSUP0075,CDM,272,RC,,,Outpatient,,,16900,10985.00,,14872,88,,,percent of total billed charges,88% of total Billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2924.38,17.304,,,percent of total billed charges,17.304% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,10647,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2585.7,15.3,,,percent of total billed charges,15.3% of total billed charges,11661,69,,,percent of total billed charges,69% of total billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,2895.98,17.136,,,percent of total billed charges,17.136% of total billed charges,3690.96,21.84,,,percent of total billed charges,21.84% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8450,50,,,percent of total billed charges,50% of total Billed charges,13182,78,,,percent of total billed charges,78% of total billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,13959.4,82.6,,,percent of total billed charges,82.6% of total billed charges,13959.4,82.6,,,percent of total billed charges,82.6% of total billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8450,50,,,percent of total billed charges,50% of total Billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2585.7,16900,
A-HCV 100 WELLS US,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
A-HCV CAL BOX/1 SET,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
A-HIV 1+2 100 WELLS,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
A-HIV 1+2 CAL,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
A1C CONTROL (STRECK),ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
ABDOMINAL BINDER 12IN XXL,ORSUP0003,CDM,270,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
ABDOMINAL BINDER 12IN XL,ORSUP0003,CDM,270,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
ABDOMINAL BINDER 12IN LARGE,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ABDOMINAL BINDER 10IN UNIVERSAL,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ABL 90 SOLUTION PACK,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ABL-90 SC 800/30 BG LYT OXY MET QC,ORSUP0037,CDM,272,RC,,,Outpatient,,,6760,4394.00,,5948.8,88,,,percent of total billed charges,88% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1169.75,17.304,,,percent of total billed charges,17.304% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4258.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,15.3,,,percent of total billed charges,15.3% of total billed charges,4664.4,69,,,percent of total billed charges,69% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1158.39,17.136,,,percent of total billed charges,17.136% of total billed charges,1476.38,21.84,,,percent of total billed charges,21.84% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,5272.8,78,,,percent of total billed charges,78% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,6760,
ABLATOR ASPIRATING 90 DEG MULTI PORT,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ABLATOR COOLCUT 90 DEGREE,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
ABO/RH CONFIRMED LABELS,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
ABSORBER CO2,448248,CDM,270,RC,,,Outpatient,,,199,129.35,,175.12,88,,,percent of total billed charges,88% of total Billed charges,99.5,50,,,percent of total billed charges,50% of total Billed charges,33.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,199,100,,,percent of total billed charges,100% of total billed charges,34.43,17.304,,,percent of total billed charges,17.304% of total billed charges,99.5,50,,,percent of total billed charges,50% of total Billed charges,125.37,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.43,16.8,,,percent of total billed charges,16.8% of total billed charges,30.45,15.3,,,percent of total billed charges,15.3% of total billed charges,137.31,69,,,percent of total billed charges,69% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,99.5,50,,,percent of total billed charges,50% of total Billed charges,199,100,,,percent of total billed charges,100% of total billed charges,99.5,50,,,percent of total billed charges,50% of total Billed charges,199,100,,,percent of total billed charges,100% of total billed charges,99.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,33.43,16.8,,,percent of total billed charges,16.8% of total billed charges,99.5,50,,,percent of total billed charges,50% of total Billed charges,99.5,50,,,percent of total billed charges,50% of total Billed charges,33.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,99.5,50,,,percent of total billed charges,50% of total Billed charges,99.5,50,,,percent of total billed charges,50% of total Billed charges,34.1,17.136,,,percent of total billed charges,17.136% of total billed charges,43.46,21.84,,,percent of total billed charges,21.84% of total billed charges,99.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,99.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,99.5,50,,,percent of total billed charges,50% of total Billed charges,155.22,78,,,percent of total billed charges,78% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,33.43,16.8,,,percent of total billed charges,16.8% of total billed charges,99.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,99.5,50,,,percent of total billed charges,50% of total Billed charges,33.43,16.8,,,percent of total billed charges,16.8% of total billed charges,30.45,199,
ABSTACK FIXATION DEVICE 30TACK,ORSUP0026,CDM,270,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
ACAPELLA DH GREEN MTHPC,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ACAPELLA DM BLUE MTH PC,ORSUP0004,CDM,270,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
ACCESSRAIL PLATFORM (STANDARD BLADE),ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ACCESS CANNULA BIOPSY KIT 19GA,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
ACCESS FERRITN 2X50 DET,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
ACCESS CORTISOL 2X50 DET,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
ACCESS RUBELLA IGG 2X50 DET,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
ACCESS HYBERITECH PSA RGT KIT 2X50,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
ACCESS PTH 2X50 DET,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
ACCESS FOLATE 2X50 DET,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
ACCESS 25 OH VIT D,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
ACCESS B12 CAL,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
ACCESS FERRITAN CALS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
ACCESS TESTOSTERONE CAL S0-S5,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
ACCESS CORTISOL S0-S5,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
ACCESS RUBELLA IGG CALS,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ACCESS HYBERITECH PS CAL KIT,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
ACCESS PTH CAL S0-S5,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
ACCESS FOLATE CAL S0-S5,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
ACCESS FOLATE CAL S0,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ACCUCATH 18GA 2.25IN CATH,460860,CDM,272,RC,,,Outpatient,,,337,219.05,,296.56,88,,,percent of total billed charges,88% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,337,100,,,percent of total billed charges,100% of total billed charges,58.31,17.304,,,percent of total billed charges,17.304% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,212.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,51.56,15.3,,,percent of total billed charges,15.3% of total billed charges,232.53,69,,,percent of total billed charges,69% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,337,100,,,percent of total billed charges,100% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,337,100,,,percent of total billed charges,100% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,57.75,17.136,,,percent of total billed charges,17.136% of total billed charges,73.6,21.84,,,percent of total billed charges,21.84% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,168.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,168.5,50,,,percent of total billed charges,50% of total Billed charges,262.86,78,,,percent of total billed charges,78% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,168.5,50,,,percent of total billed charges,50% of total Billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,51.56,337,
ACCUCATH 18GA X 1.25,484409,CDM,272,RC,,,Outpatient,,,177,115.05,,155.76,88,,,percent of total billed charges,88% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,30.63,17.304,,,percent of total billed charges,17.304% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,111.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,15.3,,,percent of total billed charges,15.3% of total billed charges,122.13,69,,,percent of total billed charges,69% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,30.33,17.136,,,percent of total billed charges,17.136% of total billed charges,38.66,21.84,,,percent of total billed charges,21.84% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,138.06,78,,,percent of total billed charges,78% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,177,
ACCUCATH 20GA 1.25IN CATH,460859,CDM,272,RC,,,Outpatient,,,177,115.05,,155.76,88,,,percent of total billed charges,88% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,30.63,17.304,,,percent of total billed charges,17.304% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,111.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,15.3,,,percent of total billed charges,15.3% of total billed charges,122.13,69,,,percent of total billed charges,69% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,30.33,17.136,,,percent of total billed charges,17.136% of total billed charges,38.66,21.84,,,percent of total billed charges,21.84% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,138.06,78,,,percent of total billed charges,78% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,177,
ACCUCATH 22GA X1.25,484412,CDM,272,RC,,,Outpatient,,,177,115.05,,155.76,88,,,percent of total billed charges,88% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,30.63,17.304,,,percent of total billed charges,17.304% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,111.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,15.3,,,percent of total billed charges,15.3% of total billed charges,122.13,69,,,percent of total billed charges,69% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,30.33,17.136,,,percent of total billed charges,17.136% of total billed charges,38.66,21.84,,,percent of total billed charges,21.84% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,138.06,78,,,percent of total billed charges,78% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,177,
ACCUCHECK QC + LM2,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ACCUCHECK QC + LM3,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ACCUCATH 20GA X 2.25,484408,CDM,272,RC,,,Outpatient,,,337,219.05,,296.56,88,,,percent of total billed charges,88% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,337,100,,,percent of total billed charges,100% of total billed charges,58.31,17.304,,,percent of total billed charges,17.304% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,212.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,51.56,15.3,,,percent of total billed charges,15.3% of total billed charges,232.53,69,,,percent of total billed charges,69% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,337,100,,,percent of total billed charges,100% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,337,100,,,percent of total billed charges,100% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,57.75,17.136,,,percent of total billed charges,17.136% of total billed charges,73.6,21.84,,,percent of total billed charges,21.84% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,168.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,168.5,50,,,percent of total billed charges,50% of total Billed charges,262.86,78,,,percent of total billed charges,78% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,168.5,50,,,percent of total billed charges,50% of total Billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,51.56,337,
ACCUCHEK LINEARITY KIT,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ACE BANDAGE NS 4,490010,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
ACE BANDAGE NS DOUBLE 6,490011,CDM,270,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
ACE BANDAGE STERILE 2,490012,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
ACE BANDAGE STERILE 3,490013,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
ACE BANDAGE STERILE 4,490014,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
ACE BANDAGE STERILE 6,490015,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
ACETABULAR REAMER BASKET (ALL SIZES),ORSUP0011,CDM,278,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ACETONE-ALCOHOL,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
ACET / 5 PACK / 90 SLDS,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ACL KIT DISPOSABLE,ORSUP0016,CDM,272,RC,,,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,199,17.304,,,percent of total billed charges,17.304% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,724.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,15.3,,,percent of total billed charges,15.3% of total billed charges,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,197.06,17.136,,,percent of total billed charges,17.136% of total billed charges,251.16,21.84,,,percent of total billed charges,21.84% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,1150,
ACORN 9.0MM,ORSUP0012,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
ADAPTER PRN VALVE SAFSITE RV-1000NC,81445,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
ADAPTER SPK Y TYPE,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ADAPTER VIAL UNIVERSAL ACTIVATED,83500,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
ADAPTER BRONCHOSCOPE EDGE SINGLE PACK,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
ADAPTER MDI,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
ADAPTIC 3X3,139411,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
ADAPTER CELLULAR LATITUDE 3G USB,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
ADAPTER PERFUSION Y,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
ADAPTER PERITONEAL CATH 2 PART,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ADAPTIC NON-ADHERENT GAUZE 1 X 36,490017,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
ADAPTER MULTI-TAP A23 SIZE 3 AAC,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ADAPT BARRIER PASTE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ADHESIVE SURGICAL LIQUID 2/3CC UNIT DOSE STERILE,184569,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
ADHESIVE BENZOIN TINCTURE COMPOUND 'STERI-STRIP',158598,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
ADHESIVE DERMABOND HIGH VISOSITY TOPCIAL SKIN,83647,CDM,272,RC,,,Outpatient,,,145,94.25,,127.6,88,,,percent of total billed charges,88% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,25.09,17.304,,,percent of total billed charges,17.304% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,91.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,22.19,15.3,,,percent of total billed charges,15.3% of total billed charges,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,89.68,61.85,,,percent of total billed charges,61.85% of total billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.85,17.136,,,percent of total billed charges,17.136% of total billed charges,31.67,21.84,,,percent of total billed charges,21.84% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,72.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,72.5,50,,,percent of total billed charges,50% of total Billed charges,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,22.19,145,
ADHESIVE OCTYLBOND 0.7ML SURGICAL 6 BX/CS,326767,CDM,272,RC,,,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,20.76,17.304,,,percent of total billed charges,17.304% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.56,17.136,,,percent of total billed charges,17.136% of total billed charges,26.21,21.84,,,percent of total billed charges,21.84% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,120,
ADJUSTABLE COAXIAL BX  18GX11CM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ADMINISTRATION SET BLOOD AND FLUID,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
ADSON 4-3/4 1x2 TEETH,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ADULT ANESTHESIA BREATHING CIRCUIT,309181,CDM,272,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
ADVANCER ROTOBLASTER,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
ADVANTAGE FIT SYSTEM TVT,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ADVINCULA ALLY ADAPTER DRAPE,ORSUP0012,CDM,272,RC,,,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
AEROCHAMBER MASK SMALL,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
AEROSPRAY HEMATOLOGY STAT REAGENT A,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
AEROSPRAY HEMATOLOGY STAT REAGENT B THIAZIN STAIN,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
AEROSPRAY HEMATOLOGY STAT REAGENT C EOSIN STAIN,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
AEROSPRAYREAGENT GRADE METHANOL,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
AEROSOL TEE ADAPTER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
AF541 FACE MASK MEDIUM,ORSUP0010,CDM,272,RC,,,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
AF541 FACE MASK SMALL,ORSUP0010,CDM,272,RC,,,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
AF541 FACE MASK LARGE,ORSUP0010,CDM,272,RC,,,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
AFFIRMAGEN 3% 2X10ML,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
AFFIRMAGEN 0.08% 2X10ML,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
AFFIRMAGEN 0.8% 3X10ML,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
AGAR BRUCELLA WITH SHEEP BLOOD HEMIN VITAMIN K,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
AHB BIOCLONE GREEN 15X10ML,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
AICD SINGLE CHAMBER2,CATH00071,CDM,275,RC,C1722,HCPCS,Outpatient,,,195315,126954.75,,171877.2,88,,,percent of total billed charges,88% of total Billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,32812.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,33797.31,17.304,,,percent of total billed charges,17.304% of total billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,123048.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32812.92,16.8,,,percent of total billed charges,16.8% of total billed charges,29883.2,15.3,,,percent of total billed charges,15.3% of total billed charges,134767.35,69,,,percent of total billed charges,69% of total billed charges,195315,100,,,percent of total billed charges,100% of total billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,195315,100,,,percent of total billed charges,100% of total billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,195315,100,,,percent of total billed charges,100% of total billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,120802.33,61.85,,,percent of total billed charges,61.85% of total billed charges,32812.92,16.8,,,percent of total billed charges,16.8% of total billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,60938.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97657.5,50,,,percent of total billed charges,50% of total Billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,33469.18,17.136,,,percent of total billed charges,17.136% of total billed charges,42656.8,21.84,,,percent of total billed charges,21.84% of total billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,73633.76,37.7,,,percent of total billed charges,37.70% of total billed charges,73633.76,37.7,,,percent of total billed charges,37.70% of total billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,66211.79,33.9,,,percent of total billed charges,33.9% of total billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,152345.7,78,,,percent of total billed charges,78% of total billed charges,195315,100,,,percent of total billed charges,100% of total billed charges,161330.19,82.6,,,percent of total billed charges,82.6% of total billed charges,161330.19,82.6,,,percent of total billed charges,82.6% of total billed charges,32812.92,16.8,,,percent of total billed charges,16.8% of total billed charges,97657.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97657.5,50,,,percent of total billed charges,50% of total Billed charges,32812.92,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,195315,
AIR SHEET LAT COMFORT GLIDE BLEND 40X80,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
AIR REGULATOR W/HOSE BARB OUTLET,ORSUP0002,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
AIRWAY EXCHANGE CATHETER 19 FR,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
AIRWAY CATH-GUIDE 90MM,113109,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
AIRWAY CATH-GUIDE 80MM,57983,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
AIRWAY CATH-GUIDE 70MM,119055,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
AIRWAY CATH-GUIDE 60MM,119151,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
AIRWAY CATH-GUIDE 55MM,119767,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
AIRWAY NASOPHARYNGEAL 34 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
AIRWAY NASOPHARYNGEAL 32 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
AIRWAY NASOPHARYNGEAL 30 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
AIRWAY NASOPHARYNGEAL 28 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
AIRWAY CATH-GUIDE 120MM,119769,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
AIRWAY BERMAN 110MM CATH-GUIDE,119768,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
AIRWAY GUEDEL 100MM CATH-GUIDE,58076,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
AIRWAY ESOPHAGEAL 3 LMA SUPREME,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
AIRWAY ESOPHAGEAL 5 LMA SUPREME,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
AIRWAY EXCHANGER CATHETER,83141,CDM,272,RC,,,Outpatient,,,459,298.35,,403.92,88,,,percent of total billed charges,88% of total Billed charges,229.5,50,,,percent of total billed charges,50% of total Billed charges,77.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,459,100,,,percent of total billed charges,100% of total billed charges,79.43,17.304,,,percent of total billed charges,17.304% of total billed charges,229.5,50,,,percent of total billed charges,50% of total Billed charges,289.17,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,77.11,16.8,,,percent of total billed charges,16.8% of total billed charges,70.23,15.3,,,percent of total billed charges,15.3% of total billed charges,316.71,69,,,percent of total billed charges,69% of total billed charges,459,100,,,percent of total billed charges,100% of total billed charges,229.5,50,,,percent of total billed charges,50% of total Billed charges,459,100,,,percent of total billed charges,100% of total billed charges,229.5,50,,,percent of total billed charges,50% of total Billed charges,459,100,,,percent of total billed charges,100% of total billed charges,229.5,50,,,percent of total billed charges,50% of total Billed charges,283.89,61.85,,,percent of total billed charges,61.85% of total billed charges,77.11,16.8,,,percent of total billed charges,16.8% of total billed charges,229.5,50,,,percent of total billed charges,50% of total Billed charges,229.5,50,,,percent of total billed charges,50% of total Billed charges,77.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,229.5,50,,,percent of total billed charges,50% of total Billed charges,229.5,50,,,percent of total billed charges,50% of total Billed charges,78.65,17.136,,,percent of total billed charges,17.136% of total billed charges,100.25,21.84,,,percent of total billed charges,21.84% of total billed charges,229.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,229.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,229.5,50,,,percent of total billed charges,50% of total Billed charges,358.02,78,,,percent of total billed charges,78% of total billed charges,459,100,,,percent of total billed charges,100% of total billed charges,379.13,82.6,,,percent of total billed charges,82.6% of total billed charges,379.13,82.6,,,percent of total billed charges,82.6% of total billed charges,77.11,16.8,,,percent of total billed charges,16.8% of total billed charges,229.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,229.5,50,,,percent of total billed charges,50% of total Billed charges,77.11,16.8,,,percent of total billed charges,16.8% of total billed charges,70.23,459,
AIRWAY LMA CLASSIC 4,65463,CDM,272,RC,,,Outpatient,,,1750,1137.50,,1540,88,,,percent of total billed charges,88% of total Billed charges,875,50,,,percent of total billed charges,50% of total Billed charges,294,16.8,,,percent of total billed charges,16.8% of total Billed charges,1750,100,,,percent of total billed charges,100% of total billed charges,302.82,17.304,,,percent of total billed charges,17.304% of total billed charges,875,50,,,percent of total billed charges,50% of total Billed charges,1102.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,294,16.8,,,percent of total billed charges,16.8% of total billed charges,267.75,15.3,,,percent of total billed charges,15.3% of total billed charges,1207.5,69,,,percent of total billed charges,69% of total billed charges,1750,100,,,percent of total billed charges,100% of total billed charges,875,50,,,percent of total billed charges,50% of total Billed charges,1750,100,,,percent of total billed charges,100% of total billed charges,875,50,,,percent of total billed charges,50% of total Billed charges,1750,100,,,percent of total billed charges,100% of total billed charges,875,50,,,percent of total billed charges,50% of total Billed charges,1082.38,61.85,,,percent of total billed charges,61.85% of total billed charges,294,16.8,,,percent of total billed charges,16.8% of total billed charges,875,50,,,percent of total billed charges,50% of total Billed charges,875,50,,,percent of total billed charges,50% of total Billed charges,294,16.8,,,percent of total billed charges,16.8% of total Billed charges,875,50,,,percent of total billed charges,50% of total Billed charges,875,50,,,percent of total billed charges,50% of total Billed charges,299.88,17.136,,,percent of total billed charges,17.136% of total billed charges,382.2,21.84,,,percent of total billed charges,21.84% of total billed charges,875,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,875,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,875,50,,,percent of total billed charges,50% of total Billed charges,1365,78,,,percent of total billed charges,78% of total billed charges,1750,100,,,percent of total billed charges,100% of total billed charges,1445.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1445.5,82.6,,,percent of total billed charges,82.6% of total billed charges,294,16.8,,,percent of total billed charges,16.8% of total billed charges,875,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,875,50,,,percent of total billed charges,50% of total Billed charges,294,16.8,,,percent of total billed charges,16.8% of total billed charges,267.75,1750,
AIRWAY NASOPHARYNGEAL 24 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
AIRWAY NASOPHARYNGEAL 26 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
AIRWAY NASOPHARYNGEAL 36 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
AIRWAY ESOPHAGEAL 4 LMA SUPREME,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
AIRWAY NASOPHARYNGEAL  20 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
AIRWAY NASOPHARYNGEAL 22 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
AIRWAY LARYNGEAL FLEXIBLE SZ 4,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ALARM ELITE POSEY,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ALARIS IV EXT ANTI SIPHON FEMALE LUERS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ALBUMIN / 5 PACK / 250 SLIDES,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ALBUSTIX URINE STRIPS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
ALC/AMON CONTROL 1 6X3ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ALC/AMON CONTROL 3 6X3ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ALCOHOL PREP PAD STERILE,413928,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
ALCOHOL ISO GALLON,131026,CDM,272,RC,,,Outpatient,,,187,121.55,,164.56,88,,,percent of total billed charges,88% of total Billed charges,93.5,50,,,percent of total billed charges,50% of total Billed charges,31.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,187,100,,,percent of total billed charges,100% of total billed charges,32.36,17.304,,,percent of total billed charges,17.304% of total billed charges,93.5,50,,,percent of total billed charges,50% of total Billed charges,117.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.42,16.8,,,percent of total billed charges,16.8% of total billed charges,28.61,15.3,,,percent of total billed charges,15.3% of total billed charges,129.03,69,,,percent of total billed charges,69% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,93.5,50,,,percent of total billed charges,50% of total Billed charges,187,100,,,percent of total billed charges,100% of total billed charges,93.5,50,,,percent of total billed charges,50% of total Billed charges,187,100,,,percent of total billed charges,100% of total billed charges,93.5,50,,,percent of total billed charges,50% of total Billed charges,115.66,61.85,,,percent of total billed charges,61.85% of total billed charges,31.42,16.8,,,percent of total billed charges,16.8% of total billed charges,93.5,50,,,percent of total billed charges,50% of total Billed charges,93.5,50,,,percent of total billed charges,50% of total Billed charges,31.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,93.5,50,,,percent of total billed charges,50% of total Billed charges,93.5,50,,,percent of total billed charges,50% of total Billed charges,32.04,17.136,,,percent of total billed charges,17.136% of total billed charges,40.84,21.84,,,percent of total billed charges,21.84% of total billed charges,93.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,93.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93.5,50,,,percent of total billed charges,50% of total Billed charges,145.86,78,,,percent of total billed charges,78% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,31.42,16.8,,,percent of total billed charges,16.8% of total billed charges,93.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93.5,50,,,percent of total billed charges,50% of total Billed charges,31.42,16.8,,,percent of total billed charges,16.8% of total billed charges,28.61,187,
ALCOHOL / 5 PACK / 90 SLIDES,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ALCOHOL ETHYL 100%,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ALCOHOL WIPES MAMMO,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ALEXIS O WOUND PROTECTOR/RETRACTOR,ORSUP0007,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ALLEN BOW FRAME HEAD/ARM PROTECTORS (DISPOSABLE),490026,CDM,270,RC,,,Outpatient,,,401,260.65,,352.88,88,,,percent of total billed charges,88% of total Billed charges,200.5,50,,,percent of total billed charges,50% of total Billed charges,67.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,401,100,,,percent of total billed charges,100% of total billed charges,69.39,17.304,,,percent of total billed charges,17.304% of total billed charges,200.5,50,,,percent of total billed charges,50% of total Billed charges,252.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.37,16.8,,,percent of total billed charges,16.8% of total billed charges,61.35,15.3,,,percent of total billed charges,15.3% of total billed charges,276.69,69,,,percent of total billed charges,69% of total billed charges,401,100,,,percent of total billed charges,100% of total billed charges,200.5,50,,,percent of total billed charges,50% of total Billed charges,401,100,,,percent of total billed charges,100% of total billed charges,200.5,50,,,percent of total billed charges,50% of total Billed charges,401,100,,,percent of total billed charges,100% of total billed charges,200.5,50,,,percent of total billed charges,50% of total Billed charges,248.02,61.85,,,percent of total billed charges,61.85% of total billed charges,67.37,16.8,,,percent of total billed charges,16.8% of total billed charges,200.5,50,,,percent of total billed charges,50% of total Billed charges,200.5,50,,,percent of total billed charges,50% of total Billed charges,67.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,200.5,50,,,percent of total billed charges,50% of total Billed charges,200.5,50,,,percent of total billed charges,50% of total Billed charges,68.72,17.136,,,percent of total billed charges,17.136% of total billed charges,87.58,21.84,,,percent of total billed charges,21.84% of total billed charges,200.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200.5,50,,,percent of total billed charges,50% of total Billed charges,312.78,78,,,percent of total billed charges,78% of total billed charges,401,100,,,percent of total billed charges,100% of total billed charges,331.23,82.6,,,percent of total billed charges,82.6% of total billed charges,331.23,82.6,,,percent of total billed charges,82.6% of total billed charges,67.37,16.8,,,percent of total billed charges,16.8% of total billed charges,200.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200.5,50,,,percent of total billed charges,50% of total Billed charges,67.37,16.8,,,percent of total billed charges,16.8% of total billed charges,61.35,401,
ALLEN MEDICAL SHOULDER TABLE HEAD RESTRAINT (DISPOSABLE),490027,CDM,270,RC,,,Outpatient,,,177,115.05,,155.76,88,,,percent of total billed charges,88% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,30.63,17.304,,,percent of total billed charges,17.304% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,111.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,15.3,,,percent of total billed charges,15.3% of total billed charges,122.13,69,,,percent of total billed charges,69% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,109.47,61.85,,,percent of total billed charges,61.85% of total billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,30.33,17.136,,,percent of total billed charges,17.136% of total billed charges,38.66,21.84,,,percent of total billed charges,21.84% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,138.06,78,,,percent of total billed charges,78% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,177,
ALLODERM TISSUE THICK MED PERF,ORSUP0117,CDM,270,RC,,,Outpatient,,,29380,19097.00,,25854.4,88,,,percent of total billed charges,88% of total Billed charges,14690,50,,,percent of total billed charges,50% of total Billed charges,4935.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5083.92,17.304,,,percent of total billed charges,17.304% of total billed charges,14690,50,,,percent of total billed charges,50% of total Billed charges,18509.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4935.84,16.8,,,percent of total billed charges,16.8% of total billed charges,4495.14,15.3,,,percent of total billed charges,15.3% of total billed charges,20272.2,69,,,percent of total billed charges,69% of total billed charges,29380,100,,,percent of total billed charges,100% of total billed charges,14690,50,,,percent of total billed charges,50% of total Billed charges,29380,100,,,percent of total billed charges,100% of total billed charges,14690,50,,,percent of total billed charges,50% of total Billed charges,29380,100,,,percent of total billed charges,100% of total billed charges,14690,50,,,percent of total billed charges,50% of total Billed charges,18171.53,61.85,,,percent of total billed charges,61.85% of total billed charges,4935.84,16.8,,,percent of total billed charges,16.8% of total billed charges,14690,50,,,percent of total billed charges,50% of total Billed charges,14690,50,,,percent of total billed charges,50% of total Billed charges,4935.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,14690,50,,,percent of total billed charges,50% of total Billed charges,14690,50,,,percent of total billed charges,50% of total Billed charges,5034.56,17.136,,,percent of total billed charges,17.136% of total billed charges,6416.59,21.84,,,percent of total billed charges,21.84% of total billed charges,14690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14690,50,,,percent of total billed charges,50% of total Billed charges,22916.4,78,,,percent of total billed charges,78% of total billed charges,29380,100,,,percent of total billed charges,100% of total billed charges,24267.88,82.6,,,percent of total billed charges,82.6% of total billed charges,24267.88,82.6,,,percent of total billed charges,82.6% of total billed charges,4935.84,16.8,,,percent of total billed charges,16.8% of total billed charges,14690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14690,50,,,percent of total billed charges,50% of total Billed charges,4935.84,16.8,,,percent of total billed charges,16.8% of total billed charges,4495.14,29380,
ALLODERM MESH CONTOUR MED,ORSUP0139,CDM,278,RC,C1781,HCPCS,Outpatient,,,35360,22984.00,,31116.8,88,,,percent of total billed charges,88% of total Billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,5940.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,6118.69,17.304,,,percent of total billed charges,17.304% of total billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,22276.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5940.48,16.8,,,percent of total billed charges,16.8% of total billed charges,5410.08,15.3,,,percent of total billed charges,15.3% of total billed charges,24398.4,69,,,percent of total billed charges,69% of total billed charges,35360,100,,,percent of total billed charges,100% of total billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,35360,100,,,percent of total billed charges,100% of total billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,35360,100,,,percent of total billed charges,100% of total billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,21870.16,61.85,,,percent of total billed charges,61.85% of total billed charges,5940.48,16.8,,,percent of total billed charges,16.8% of total billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,11032.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17680,50,,,percent of total billed charges,50% of total Billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,6059.29,17.136,,,percent of total billed charges,17.136% of total billed charges,7722.62,21.84,,,percent of total billed charges,21.84% of total billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,13330.72,37.7,,,percent of total billed charges,37.70% of total billed charges,13330.72,37.7,,,percent of total billed charges,37.70% of total billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,11987.04,33.9,,,percent of total billed charges,33.9% of total billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,27580.8,78,,,percent of total billed charges,78% of total billed charges,35360,100,,,percent of total billed charges,100% of total billed charges,29207.36,82.6,,,percent of total billed charges,82.6% of total billed charges,29207.36,82.6,,,percent of total billed charges,82.6% of total billed charges,5940.48,16.8,,,percent of total billed charges,16.8% of total billed charges,17680,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17680,50,,,percent of total billed charges,50% of total Billed charges,5940.48,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,35360,
ALLODERM MESH RECTANGLE 8X200,ORSUP0016,CDM,278,RC,C1781,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ALLODERM MESH 4 X16 THIN,ORSUP0013,CDM,278,RC,C1781,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
ALLODERM MESH CONTOUR SM THIN,ORSUP0076,CDM,278,RC,C1781,HCPCS,Outpatient,,,17160,11154.00,,15100.8,88,,,percent of total billed charges,88% of total Billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,2882.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2969.37,17.304,,,percent of total billed charges,17.304% of total billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,10810.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2882.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2625.48,15.3,,,percent of total billed charges,15.3% of total billed charges,11840.4,69,,,percent of total billed charges,69% of total billed charges,17160,100,,,percent of total billed charges,100% of total billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,17160,100,,,percent of total billed charges,100% of total billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,17160,100,,,percent of total billed charges,100% of total billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,10613.46,61.85,,,percent of total billed charges,61.85% of total billed charges,2882.88,16.8,,,percent of total billed charges,16.8% of total billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,5353.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8580,50,,,percent of total billed charges,50% of total Billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,2940.54,17.136,,,percent of total billed charges,17.136% of total billed charges,3747.74,21.84,,,percent of total billed charges,21.84% of total billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,6469.32,37.7,,,percent of total billed charges,37.70% of total billed charges,6469.32,37.7,,,percent of total billed charges,37.70% of total billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,5817.24,33.9,,,percent of total billed charges,33.9% of total billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,13384.8,78,,,percent of total billed charges,78% of total billed charges,17160,100,,,percent of total billed charges,100% of total billed charges,14174.16,82.6,,,percent of total billed charges,82.6% of total billed charges,14174.16,82.6,,,percent of total billed charges,82.6% of total billed charges,2882.88,16.8,,,percent of total billed charges,16.8% of total billed charges,8580,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8580,50,,,percent of total billed charges,50% of total Billed charges,2882.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2625.48,17160,
ALLODERM MESH 6 X 16 THIN,ORSUP0094,CDM,278,RC,C1781,HCPCS,Outpatient,,,22100,14365.00,,19448,88,,,percent of total billed charges,88% of total Billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3824.18,17.304,,,percent of total billed charges,17.304% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,13923,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3381.3,15.3,,,percent of total billed charges,15.3% of total billed charges,15249,69,,,percent of total billed charges,69% of total billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,13668.85,61.85,,,percent of total billed charges,61.85% of total billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,6895.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11050,50,,,percent of total billed charges,50% of total Billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,3787.06,17.136,,,percent of total billed charges,17.136% of total billed charges,4826.64,21.84,,,percent of total billed charges,21.84% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,8331.7,37.7,,,percent of total billed charges,37.70% of total billed charges,8331.7,37.7,,,percent of total billed charges,37.70% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,7491.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,17238,78,,,percent of total billed charges,78% of total billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,18254.6,82.6,,,percent of total billed charges,82.6% of total billed charges,18254.6,82.6,,,percent of total billed charges,82.6% of total billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11050,50,,,percent of total billed charges,50% of total Billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3381.3,22100,
ALLOMATRIX-C 3CC,ORSUP0059,CDM,278,RC,C9362,HCPCS,Outpatient,,,9800,6370.00,,8624,88,,,percent of total billed charges,88% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1499.4,15.3,,,percent of total billed charges,15.3% of total billed charges,6762,69,,,percent of total billed charges,69% of total billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,6061.3,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,3057.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4900,50,,,percent of total billed charges,50% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,3694.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3694.6,37.7,,,percent of total billed charges,37.70% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,3322.2,33.9,,,percent of total billed charges,33.9% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,7644,78,,,percent of total billed charges,78% of total billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,8094.8,82.6,,,percent of total billed charges,82.6% of total billed charges,8094.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,1646.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1499.4,9800,
ALLOMATRIC-C 5CC,ORSUP0063,CDM,278,RC,C9359,HCPCS,Outpatient,,,6600,4290.00,,5808,88,,,percent of total billed charges,88% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1009.8,15.3,,,percent of total billed charges,15.3% of total billed charges,4554,69,,,percent of total billed charges,69% of total billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,4082.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,2059.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3300,50,,,percent of total billed charges,50% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,2488.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2488.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,2237.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,5148,78,,,percent of total billed charges,78% of total billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,5451.6,82.6,,,percent of total billed charges,82.6% of total billed charges,5451.6,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,1108.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1009.8,6600,
ALLOMATRIX-C 10CC,ORSUP0059,CDM,278,RC,C9362,HCPCS,Outpatient,,,9800,6370.00,,8624,88,,,percent of total billed charges,88% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1499.4,15.3,,,percent of total billed charges,15.3% of total billed charges,6762,69,,,percent of total billed charges,69% of total billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,6061.3,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,3057.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4900,50,,,percent of total billed charges,50% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,3694.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3694.6,37.7,,,percent of total billed charges,37.70% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,3322.2,33.9,,,percent of total billed charges,33.9% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,7644,78,,,percent of total billed charges,78% of total billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,8094.8,82.6,,,percent of total billed charges,82.6% of total billed charges,8094.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,1646.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1499.4,9800,
ALLOMATRIX-C 30CC,ORSUP0059,CDM,278,RC,C9362,HCPCS,Outpatient,,,9800,6370.00,,8624,88,,,percent of total billed charges,88% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1499.4,15.3,,,percent of total billed charges,15.3% of total billed charges,6762,69,,,percent of total billed charges,69% of total billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,6061.3,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,3057.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4900,50,,,percent of total billed charges,50% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,3694.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3694.6,37.7,,,percent of total billed charges,37.70% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,3322.2,33.9,,,percent of total billed charges,33.9% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,7644,78,,,percent of total billed charges,78% of total billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,8094.8,82.6,,,percent of total billed charges,82.6% of total billed charges,8094.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,1646.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1499.4,9800,
ALTV 300 SLIDES,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
AMBU BAG ADULT,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
AMBU BAG PEDIATRIC,490037,CDM,270,RC,,,Outpatient,,,230,149.50,,202.4,88,,,percent of total billed charges,88% of total Billed charges,115,50,,,percent of total billed charges,50% of total Billed charges,38.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,230,100,,,percent of total billed charges,100% of total billed charges,39.8,17.304,,,percent of total billed charges,17.304% of total billed charges,115,50,,,percent of total billed charges,50% of total Billed charges,144.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,38.64,16.8,,,percent of total billed charges,16.8% of total billed charges,35.19,15.3,,,percent of total billed charges,15.3% of total billed charges,158.7,69,,,percent of total billed charges,69% of total billed charges,230,100,,,percent of total billed charges,100% of total billed charges,115,50,,,percent of total billed charges,50% of total Billed charges,230,100,,,percent of total billed charges,100% of total billed charges,115,50,,,percent of total billed charges,50% of total Billed charges,230,100,,,percent of total billed charges,100% of total billed charges,115,50,,,percent of total billed charges,50% of total Billed charges,142.26,61.85,,,percent of total billed charges,61.85% of total billed charges,38.64,16.8,,,percent of total billed charges,16.8% of total billed charges,115,50,,,percent of total billed charges,50% of total Billed charges,115,50,,,percent of total billed charges,50% of total Billed charges,38.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,115,50,,,percent of total billed charges,50% of total Billed charges,115,50,,,percent of total billed charges,50% of total Billed charges,39.41,17.136,,,percent of total billed charges,17.136% of total billed charges,50.23,21.84,,,percent of total billed charges,21.84% of total billed charges,115,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,115,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,115,50,,,percent of total billed charges,50% of total Billed charges,179.4,78,,,percent of total billed charges,78% of total billed charges,230,100,,,percent of total billed charges,100% of total billed charges,189.98,82.6,,,percent of total billed charges,82.6% of total billed charges,189.98,82.6,,,percent of total billed charges,82.6% of total billed charges,38.64,16.8,,,percent of total billed charges,16.8% of total billed charges,115,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,115,50,,,percent of total billed charges,50% of total Billed charges,38.64,16.8,,,percent of total billed charges,16.8% of total billed charges,35.19,230,
AMNISURE TEST KIT,ORSUP0006,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
AMNISURE QC POS \\T\\ NEG,ORSUP0010,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
AMNIOCORD 3X5 CM,ORSUP0067,CDM,278,RC,C1762,HCPCS,Outpatient,,,11400,7410.00,,10032,88,,,percent of total billed charges,88% of total Billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,1915.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1972.66,17.304,,,percent of total billed charges,17.304% of total billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,7182,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1915.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1744.2,15.3,,,percent of total billed charges,15.3% of total billed charges,7866,69,,,percent of total billed charges,69% of total billed charges,11400,100,,,percent of total billed charges,100% of total billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,11400,100,,,percent of total billed charges,100% of total billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,11400,100,,,percent of total billed charges,100% of total billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,7050.9,61.85,,,percent of total billed charges,61.85% of total billed charges,1915.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,3556.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5700,50,,,percent of total billed charges,50% of total Billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,1953.5,17.136,,,percent of total billed charges,17.136% of total billed charges,2489.76,21.84,,,percent of total billed charges,21.84% of total billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,4297.8,37.7,,,percent of total billed charges,37.70% of total billed charges,4297.8,37.7,,,percent of total billed charges,37.70% of total billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,3864.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,8892,78,,,percent of total billed charges,78% of total billed charges,11400,100,,,percent of total billed charges,100% of total billed charges,9416.4,82.6,,,percent of total billed charges,82.6% of total billed charges,9416.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1915.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5700,50,,,percent of total billed charges,50% of total Billed charges,1915.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1744.2,11400,
AMPLATZ GUIDEWIRE 0.038X150CM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
AMSORB CO2,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
AMYLASE / 5 PACK / 300 SLIDES,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
ANAEROGEN OXOID 2.5L SACHET,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ANAEROBIC LKV BLOOD AGAR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ANCHOR WEDGE3.0MM WITH NO. 2 FORCE FIBER,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ANCHOR 2.9X12.5MM PUSH-LOCK BIO-COMP,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
ANCHOR BIOCOMPOSITE 5.5,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
ANCHOR PUSH LOCK 4.5MM,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
"ANCHOR SUTURE FASTAK WITH HANDLE AND #2 FIBERWIRE, 2.8X11.7MM",ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
ANCHOR SUTURE SWIVELOCK 4.75X19.1,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
ANCHOR W/ORTHOCORD HEALIX TI,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ANESTHESIA CIRCUIT ADULT,490040,CDM,270,RC,,,Outpatient,,,112,72.80,,98.56,88,,,percent of total billed charges,88% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,19.38,17.304,,,percent of total billed charges,17.304% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,70.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,15.3,,,percent of total billed charges,15.3% of total billed charges,77.28,69,,,percent of total billed charges,69% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,69.27,61.85,,,percent of total billed charges,61.85% of total billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,19.19,17.136,,,percent of total billed charges,17.136% of total billed charges,24.46,21.84,,,percent of total billed charges,21.84% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,87.36,78,,,percent of total billed charges,78% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,112,
ANESTHESIA CIRCUIT PEDIATRIC,490041,CDM,270,RC,,,Outpatient,,,57,37.05,,50.16,88,,,percent of total billed charges,88% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,9.86,17.304,,,percent of total billed charges,17.304% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,35.91,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,8.72,15.3,,,percent of total billed charges,15.3% of total billed charges,39.33,69,,,percent of total billed charges,69% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,35.25,61.85,,,percent of total billed charges,61.85% of total billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.77,17.136,,,percent of total billed charges,17.136% of total billed charges,12.45,21.84,,,percent of total billed charges,21.84% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,44.46,78,,,percent of total billed charges,78% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,8.72,57,
ANESTHESIA CO2 FILTER,490042,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
ANESTHESIA CO2 SAMPLING LINE,490043,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
ANESTHESIA MASK ADULT,490044,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
ANESTHESIA MASK PEDIATRIC,490045,CDM,270,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
ANGIOSEAL EVOLUTION 6FR,ORSUP0015,CDM,278,RC,C1760,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ANGIOTOUCH HAND CONTROLLER KIT,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
ANGIOJET ULTRA POWER PULSE KIT,ORSUP0015,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ANGIOJET SOLENT PROXI 6FR 90CM,ORSUP0093,CDM,272,RC,,,Outpatient,,,16800,10920.00,,14784,88,,,percent of total billed charges,88% of total Billed charges,8400,50,,,percent of total billed charges,50% of total Billed charges,2822.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2907.07,17.304,,,percent of total billed charges,17.304% of total billed charges,8400,50,,,percent of total billed charges,50% of total Billed charges,10584,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2822.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2570.4,15.3,,,percent of total billed charges,15.3% of total billed charges,11592,69,,,percent of total billed charges,69% of total billed charges,16800,100,,,percent of total billed charges,100% of total billed charges,8400,50,,,percent of total billed charges,50% of total Billed charges,16800,100,,,percent of total billed charges,100% of total billed charges,8400,50,,,percent of total billed charges,50% of total Billed charges,16800,100,,,percent of total billed charges,100% of total billed charges,8400,50,,,percent of total billed charges,50% of total Billed charges,10390.8,61.85,,,percent of total billed charges,61.85% of total billed charges,2822.4,16.8,,,percent of total billed charges,16.8% of total billed charges,8400,50,,,percent of total billed charges,50% of total Billed charges,8400,50,,,percent of total billed charges,50% of total Billed charges,2822.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,8400,50,,,percent of total billed charges,50% of total Billed charges,8400,50,,,percent of total billed charges,50% of total Billed charges,2878.85,17.136,,,percent of total billed charges,17.136% of total billed charges,3669.12,21.84,,,percent of total billed charges,21.84% of total billed charges,8400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8400,50,,,percent of total billed charges,50% of total Billed charges,13104,78,,,percent of total billed charges,78% of total billed charges,16800,100,,,percent of total billed charges,100% of total billed charges,13876.8,82.6,,,percent of total billed charges,82.6% of total billed charges,13876.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2822.4,16.8,,,percent of total billed charges,16.8% of total billed charges,8400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8400,50,,,percent of total billed charges,50% of total Billed charges,2822.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2570.4,16800,
ANGIOJET SOLENT PROXI 6FR X 90CM,ORSUP0059,CDM,272,RC,,,Outpatient,,,9800,6370.00,,8624,88,,,percent of total billed charges,88% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,1646.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1695.79,17.304,,,percent of total billed charges,17.304% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,6174,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1646.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1499.4,15.3,,,percent of total billed charges,15.3% of total billed charges,6762,69,,,percent of total billed charges,69% of total billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,6061.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1646.4,16.8,,,percent of total billed charges,16.8% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,1646.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,1679.33,17.136,,,percent of total billed charges,17.136% of total billed charges,2140.32,21.84,,,percent of total billed charges,21.84% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,7644,78,,,percent of total billed charges,78% of total billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,8094.8,82.6,,,percent of total billed charges,82.6% of total billed charges,8094.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1646.4,16.8,,,percent of total billed charges,16.8% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,1646.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1499.4,9800,
ANSPACH EMAX 2 HIGH FLOW IRRIGATION TUBE STERILE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ANTI KELL  MONOCLONIAL   1X5ML,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
ANTI D BIOCLONE 15/PK,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
ANTI E BIOCLONE  1X5ML,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
ANTI A BIOCLONE  15X10ML,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
ANTI- IGG  GREEN,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ANTI-A 1 LECTIN 3ML,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ANTI-FYA 3ML,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
ANTI-A BIOCLONE 3 X 10ML,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ANTI-B BIOCLONE 3 X 10ML,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ANTI-D BIOCLONE 3 X 10ML,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ANTI-HUMAN BIOCLONE GRN 15 X 10ML,ORSUP0032,CDM,272,RC,,,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
APOLLO PROBE MP50,ORSUP0016,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
APPLICATOR SEPP BENZOIN PEEL PK,120490,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
APPLICATOR BLOOD SMEAR,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
APPLIER MULTIPLE CLIP MED/LRG,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
APPLIER MULTIPLE CLIP LARGE WI,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
APPLIER CLIP SML LIGACLIP ENDO MULTI TI 20 MCS20,10299,CDM,272,RC,,,Outpatient,,,356,231.40,,313.28,88,,,percent of total billed charges,88% of total Billed charges,178,50,,,percent of total billed charges,50% of total Billed charges,59.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,356,100,,,percent of total billed charges,100% of total billed charges,61.6,17.304,,,percent of total billed charges,17.304% of total billed charges,178,50,,,percent of total billed charges,50% of total Billed charges,224.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,59.81,16.8,,,percent of total billed charges,16.8% of total billed charges,54.47,15.3,,,percent of total billed charges,15.3% of total billed charges,245.64,69,,,percent of total billed charges,69% of total billed charges,356,100,,,percent of total billed charges,100% of total billed charges,178,50,,,percent of total billed charges,50% of total Billed charges,356,100,,,percent of total billed charges,100% of total billed charges,178,50,,,percent of total billed charges,50% of total Billed charges,356,100,,,percent of total billed charges,100% of total billed charges,178,50,,,percent of total billed charges,50% of total Billed charges,220.19,61.85,,,percent of total billed charges,61.85% of total billed charges,59.81,16.8,,,percent of total billed charges,16.8% of total billed charges,178,50,,,percent of total billed charges,50% of total Billed charges,178,50,,,percent of total billed charges,50% of total Billed charges,59.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,178,50,,,percent of total billed charges,50% of total Billed charges,178,50,,,percent of total billed charges,50% of total Billed charges,61,17.136,,,percent of total billed charges,17.136% of total billed charges,77.75,21.84,,,percent of total billed charges,21.84% of total billed charges,178,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,178,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,178,50,,,percent of total billed charges,50% of total Billed charges,277.68,78,,,percent of total billed charges,78% of total billed charges,356,100,,,percent of total billed charges,100% of total billed charges,294.06,82.6,,,percent of total billed charges,82.6% of total billed charges,294.06,82.6,,,percent of total billed charges,82.6% of total billed charges,59.81,16.8,,,percent of total billed charges,16.8% of total billed charges,178,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,178,50,,,percent of total billed charges,50% of total Billed charges,59.81,16.8,,,percent of total billed charges,16.8% of total billed charges,54.47,356,
APPLIER CLIP ENDOSCOPIC ROTATING 5MM MED/LG ALLPORT,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
APPLIER CLIP MED LIGACLIP ENDO MULTI TI 20 MCM20,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
APPLICATOR FLOSEAL LAPSCP XLONG ENDO 5MM,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
APPLICATOR FLOSEAL LAP XLONG ENDO 5MM,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
APPLICATOR TISSEEL,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
APPLICATOR SILVER NITRATE/POTASSIUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING AQUAPLAST 6 X 9,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
AQUASONIC ULTRASOUND GEL THICK 0.25L,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
AQUAFLEX ULTRASOUND GEL PADS,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ARCTIC GEL UNIVERSAL PAD,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
ARCTIC GEL SMALL KIT,ORSUP0048,CDM,272,RC,,,Outpatient,,,9620,6253.00,,8465.6,88,,,percent of total billed charges,88% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1664.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,6060.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,15.3,,,percent of total billed charges,15.3% of total billed charges,6637.8,69,,,percent of total billed charges,69% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,5949.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1648.48,17.136,,,percent of total billed charges,17.136% of total billed charges,2101.01,21.84,,,percent of total billed charges,21.84% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,7503.6,78,,,percent of total billed charges,78% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,9620,
ARCTIC GEL MEDIUM KIT,ORSUP0048,CDM,272,RC,,,Outpatient,,,9620,6253.00,,8465.6,88,,,percent of total billed charges,88% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1664.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,6060.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,15.3,,,percent of total billed charges,15.3% of total billed charges,6637.8,69,,,percent of total billed charges,69% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,5949.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1648.48,17.136,,,percent of total billed charges,17.136% of total billed charges,2101.01,21.84,,,percent of total billed charges,21.84% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,7503.6,78,,,percent of total billed charges,78% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,9620,
ARCTIC GEL LARGE KIT,ORSUP0048,CDM,272,RC,,,Outpatient,,,9620,6253.00,,8465.6,88,,,percent of total billed charges,88% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1664.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,6060.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,15.3,,,percent of total billed charges,15.3% of total billed charges,6637.8,69,,,percent of total billed charges,69% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,5949.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1648.48,17.136,,,percent of total billed charges,17.136% of total billed charges,2101.01,21.84,,,percent of total billed charges,21.84% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,7503.6,78,,,percent of total billed charges,78% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,9620,
ARGYLE UMBILICAL CATH SINGLE LUMEN 5FR 15IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ARISTA AH 3G,ORSUP0017,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ARISTA AH 5G,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
ARROWS GENESIS FOR STERRAD,328037,CDM,272,RC,,,Outpatient,,,225,146.25,,198,88,,,percent of total billed charges,88% of total Billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,37.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,100,,,percent of total billed charges,100% of total billed charges,38.93,17.304,,,percent of total billed charges,17.304% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,141.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,37.8,16.8,,,percent of total billed charges,16.8% of total billed charges,34.43,15.3,,,percent of total billed charges,15.3% of total billed charges,155.25,69,,,percent of total billed charges,69% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,225,100,,,percent of total billed charges,100% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,225,100,,,percent of total billed charges,100% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,139.16,61.85,,,percent of total billed charges,61.85% of total billed charges,37.8,16.8,,,percent of total billed charges,16.8% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,37.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,38.56,17.136,,,percent of total billed charges,17.136% of total billed charges,49.14,21.84,,,percent of total billed charges,21.84% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,112.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,112.5,50,,,percent of total billed charges,50% of total Billed charges,175.5,78,,,percent of total billed charges,78% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,37.8,16.8,,,percent of total billed charges,16.8% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,112.5,50,,,percent of total billed charges,50% of total Billed charges,37.8,16.8,,,percent of total billed charges,16.8% of total billed charges,34.43,225,
ARTHROSCOPY PAK,441785,CDM,270,RC,,,Outpatient,,,987,641.55,,868.56,88,,,percent of total billed charges,88% of total Billed charges,493.5,50,,,percent of total billed charges,50% of total Billed charges,165.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,987,100,,,percent of total billed charges,100% of total billed charges,170.79,17.304,,,percent of total billed charges,17.304% of total billed charges,493.5,50,,,percent of total billed charges,50% of total Billed charges,621.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,165.82,16.8,,,percent of total billed charges,16.8% of total billed charges,151.01,15.3,,,percent of total billed charges,15.3% of total billed charges,681.03,69,,,percent of total billed charges,69% of total billed charges,987,100,,,percent of total billed charges,100% of total billed charges,493.5,50,,,percent of total billed charges,50% of total Billed charges,987,100,,,percent of total billed charges,100% of total billed charges,493.5,50,,,percent of total billed charges,50% of total Billed charges,987,100,,,percent of total billed charges,100% of total billed charges,493.5,50,,,percent of total billed charges,50% of total Billed charges,610.46,61.85,,,percent of total billed charges,61.85% of total billed charges,165.82,16.8,,,percent of total billed charges,16.8% of total billed charges,493.5,50,,,percent of total billed charges,50% of total Billed charges,493.5,50,,,percent of total billed charges,50% of total Billed charges,165.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,493.5,50,,,percent of total billed charges,50% of total Billed charges,493.5,50,,,percent of total billed charges,50% of total Billed charges,169.13,17.136,,,percent of total billed charges,17.136% of total billed charges,215.56,21.84,,,percent of total billed charges,21.84% of total billed charges,493.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,493.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,493.5,50,,,percent of total billed charges,50% of total Billed charges,769.86,78,,,percent of total billed charges,78% of total billed charges,987,100,,,percent of total billed charges,100% of total billed charges,815.26,82.6,,,percent of total billed charges,82.6% of total billed charges,815.26,82.6,,,percent of total billed charges,82.6% of total billed charges,165.82,16.8,,,percent of total billed charges,16.8% of total billed charges,493.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,493.5,50,,,percent of total billed charges,50% of total Billed charges,165.82,16.8,,,percent of total billed charges,16.8% of total billed charges,151.01,987,
ARTHREX AMNION MATRIX CORD 3CM X 6CM,ORSUP0094,CDM,270,RC,,,Outpatient,,,22100,14365.00,,19448,88,,,percent of total billed charges,88% of total Billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3824.18,17.304,,,percent of total billed charges,17.304% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,13923,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3381.3,15.3,,,percent of total billed charges,15.3% of total billed charges,15249,69,,,percent of total billed charges,69% of total billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,13668.85,61.85,,,percent of total billed charges,61.85% of total billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,3787.06,17.136,,,percent of total billed charges,17.136% of total billed charges,4826.64,21.84,,,percent of total billed charges,21.84% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11050,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11050,50,,,percent of total billed charges,50% of total Billed charges,17238,78,,,percent of total billed charges,78% of total billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,18254.6,82.6,,,percent of total billed charges,82.6% of total billed charges,18254.6,82.6,,,percent of total billed charges,82.6% of total billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11050,50,,,percent of total billed charges,50% of total Billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3381.3,22100,
ARTHREX AMNION MATRIX THICK 3CM X 4CM,ORSUP0065,CDM,270,RC,,,Outpatient,,,14300,9295.00,,12584,88,,,percent of total billed charges,88% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2474.47,17.304,,,percent of total billed charges,17.304% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,9009,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2187.9,15.3,,,percent of total billed charges,15.3% of total billed charges,9867,69,,,percent of total billed charges,69% of total billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,8844.55,61.85,,,percent of total billed charges,61.85% of total billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,2450.45,17.136,,,percent of total billed charges,17.136% of total billed charges,3123.12,21.84,,,percent of total billed charges,21.84% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7150,50,,,percent of total billed charges,50% of total Billed charges,11154,78,,,percent of total billed charges,78% of total billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,11811.8,82.6,,,percent of total billed charges,82.6% of total billed charges,11811.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7150,50,,,percent of total billed charges,50% of total Billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2187.9,14300,
ARTHREX ANGEL BMC KIT,ORSUP0034,CDM,270,RC,,,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
ARTHREX ANGEL SYSTEM CPRP PROCESSING SET,ORSUP0021,CDM,270,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
ARTHREX ANKLE DISTRACTOR STRAP (DISPOSABLE),ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ARTHREX BIOCARTILAGE 1CC,ORSUP0059,CDM,278,RC,C1763,HCPCS,Outpatient,,,6000,3900.00,,5280,88,,,percent of total billed charges,88% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,1008,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1038.24,17.304,,,percent of total billed charges,17.304% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,3780,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1008,16.8,,,percent of total billed charges,16.8% of total billed charges,918,15.3,,,percent of total billed charges,15.3% of total billed charges,4140,69,,,percent of total billed charges,69% of total billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,3711,61.85,,,percent of total billed charges,61.85% of total billed charges,1008,16.8,,,percent of total billed charges,16.8% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,1872,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3000,50,,,percent of total billed charges,50% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,1028.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1310.4,21.84,,,percent of total billed charges,21.84% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,2262,37.7,,,percent of total billed charges,37.70% of total billed charges,2262,37.7,,,percent of total billed charges,37.70% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,2034,33.9,,,percent of total billed charges,33.9% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,4680,78,,,percent of total billed charges,78% of total billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,4956,82.6,,,percent of total billed charges,82.6% of total billed charges,4956,82.6,,,percent of total billed charges,82.6% of total billed charges,1008,16.8,,,percent of total billed charges,16.8% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,1008,16.8,,,percent of total billed charges,16.8% of total billed charges,918,6000,
ARTHREX BIOCARTILAGE MIX DELIVERY SYSTEM,ORSUP0022,CDM,270,RC,,,Outpatient,,,2200,1430.00,,1936,88,,,percent of total billed charges,88% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,380.69,17.304,,,percent of total billed charges,17.304% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1386,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,15.3,,,percent of total billed charges,15.3% of total billed charges,1518,69,,,percent of total billed charges,69% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1360.7,61.85,,,percent of total billed charges,61.85% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,376.99,17.136,,,percent of total billed charges,17.136% of total billed charges,480.48,21.84,,,percent of total billed charges,21.84% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,1716,78,,,percent of total billed charges,78% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,2200,
ARTHREX STIMUBLAST GEL 1CC,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
ARTHREX STIMUBLAST PASTE 1CC,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
ARTHREX STIMUBLAST PUTTY 1CC,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
ARTHREX SUTURE LASSO 45 DEGREE CURVE RIGHT,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ASAHI  GRAN SLAM 0.14 X 180CM WIRE,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ASAHI CONFIANZA.014 X 180CM WIRE,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ASAHI SION STRAIGHT WIRE BLUE 014X190CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ASAHI FIELDER WIRE XT 014X190CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ASPEN PEDIATRIC COLLAR SHORT SZ PD1,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ASPEN PEDIATRIC COLLAR REGULAR SZ PD3,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ASPEN PEDIATRIC COLLAR SZ PD5,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ASPIRATION/ANTICOAGULATION SET,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
"ASPIRATION NEEDLE,BRONCOSCOPY",ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ASPIRATE PROBE (01-008409B),ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
ASPIRATION TUBING SET,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ASSURANCE CLIP 16MM,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
ATHLETIC SUPPORTER ADULT SMALL 26-32,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ATHLETIC SUPPORTER ADULT MED 33-38,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ATHLETIC SUPPORTER ADULT LRG 39-44,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ATRA SUMP,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ATTEST RAPID READOUT 1296F,10225,CDM,270,RC,,,Outpatient,,,1103,716.95,,970.64,88,,,percent of total billed charges,88% of total Billed charges,551.5,50,,,percent of total billed charges,50% of total Billed charges,185.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,1103,100,,,percent of total billed charges,100% of total billed charges,190.86,17.304,,,percent of total billed charges,17.304% of total billed charges,551.5,50,,,percent of total billed charges,50% of total Billed charges,694.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,185.3,16.8,,,percent of total billed charges,16.8% of total billed charges,168.76,15.3,,,percent of total billed charges,15.3% of total billed charges,761.07,69,,,percent of total billed charges,69% of total billed charges,1103,100,,,percent of total billed charges,100% of total billed charges,551.5,50,,,percent of total billed charges,50% of total Billed charges,1103,100,,,percent of total billed charges,100% of total billed charges,551.5,50,,,percent of total billed charges,50% of total Billed charges,1103,100,,,percent of total billed charges,100% of total billed charges,551.5,50,,,percent of total billed charges,50% of total Billed charges,682.21,61.85,,,percent of total billed charges,61.85% of total billed charges,185.3,16.8,,,percent of total billed charges,16.8% of total billed charges,551.5,50,,,percent of total billed charges,50% of total Billed charges,551.5,50,,,percent of total billed charges,50% of total Billed charges,185.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,551.5,50,,,percent of total billed charges,50% of total Billed charges,551.5,50,,,percent of total billed charges,50% of total Billed charges,189.01,17.136,,,percent of total billed charges,17.136% of total billed charges,240.9,21.84,,,percent of total billed charges,21.84% of total billed charges,551.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,551.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,551.5,50,,,percent of total billed charges,50% of total Billed charges,860.34,78,,,percent of total billed charges,78% of total billed charges,1103,100,,,percent of total billed charges,100% of total billed charges,911.08,82.6,,,percent of total billed charges,82.6% of total billed charges,911.08,82.6,,,percent of total billed charges,82.6% of total billed charges,185.3,16.8,,,percent of total billed charges,16.8% of total billed charges,551.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,551.5,50,,,percent of total billed charges,50% of total Billed charges,185.3,16.8,,,percent of total billed charges,16.8% of total billed charges,168.76,1103,
ATTENDS HEAVEY ABSORBENCY BRIEFS MED,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
AUTION CHECK PLUS(LOW\\T\\HIGH)25ML,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
AUTIONI 9EB STRIPS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
AUTOCLAVE TAPE,103688,CDM,270,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,8.65,17.304,,,percent of total billed charges,17.304% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,30.93,61.85,,,percent of total billed charges,61.85% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.57,17.136,,,percent of total billed charges,17.136% of total billed charges,10.92,21.84,,,percent of total billed charges,21.84% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,50,
AUTOTROL PLUS B LEVEL 1,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
AUTOTROL PLUS B LEVEL 2,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
AUTOTROL PLUS B LEVEL 3,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
AVANOS RAPID UREASE TEST,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
AVANOS CLO TEST,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
AVITENE 1 GRAM 6/BOX,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
AVITENE SHEETS 70MM X 70MM,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
AVOX-4 CO-OXIMETER CTRL LEVEL 3X10X1 7ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
Anesthesia Level 1 First 30 Min,ANES220006,CDM,370,RC,,,Outpatient,,,1122,729.30,,987.36,88,,,percent of total billed charges,88% of total Billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,188.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1122,100,,,percent of total billed charges,100% of total billed charges,194.15,17.304,,,percent of total billed charges,17.304% of total billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,706.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,188.5,16.8,,,percent of total billed charges,16.8% of total billed charges,171.67,15.3,,,percent of total billed charges,15.3% of total billed charges,774.18,69,,,percent of total billed charges,69% of total billed charges,1122,100,,,percent of total billed charges,100% of total billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,1122,100,,,percent of total billed charges,100% of total billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,1122,100,,,percent of total billed charges,100% of total billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,693.96,61.85,,,percent of total billed charges,61.85% of total billed charges,188.5,16.8,,,percent of total billed charges,16.8% of total billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,188.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,192.27,17.136,,,percent of total billed charges,17.136% of total billed charges,245.04,21.84,,,percent of total billed charges,21.84% of total billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,422.99,37.7,,,percent of total billed charges,37.70% of total billed charges,422.99,37.7,,,percent of total billed charges,37.70% of total billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,380.36,33.9,,,percent of total billed charges,33.9% of total billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,875.16,78,,,percent of total billed charges,78% of total billed charges,1122,100,,,percent of total billed charges,100% of total billed charges,926.77,82.6,,,percent of total billed charges,82.6% of total billed charges,926.77,82.6,,,percent of total billed charges,82.6% of total billed charges,188.5,16.8,,,percent of total billed charges,16.8% of total billed charges,561,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,561,50,,,percent of total billed charges,50% of total Billed charges,188.5,16.8,,,percent of total billed charges,16.8% of total billed charges,171.67,1122,
Anesthesia Level 1 Ea Addt'l 15 Min,ANES220007,CDM,370,RC,,,Outpatient,,,440,286.00,,387.2,88,,,percent of total billed charges,88% of total Billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,73.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,440,100,,,percent of total billed charges,100% of total billed charges,76.14,17.304,,,percent of total billed charges,17.304% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,277.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,73.92,16.8,,,percent of total billed charges,16.8% of total billed charges,67.32,15.3,,,percent of total billed charges,15.3% of total billed charges,303.6,69,,,percent of total billed charges,69% of total billed charges,440,100,,,percent of total billed charges,100% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,440,100,,,percent of total billed charges,100% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,440,100,,,percent of total billed charges,100% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,272.14,61.85,,,percent of total billed charges,61.85% of total billed charges,73.92,16.8,,,percent of total billed charges,16.8% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,73.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,75.4,17.136,,,percent of total billed charges,17.136% of total billed charges,96.1,21.84,,,percent of total billed charges,21.84% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,165.88,37.7,,,percent of total billed charges,37.70% of total billed charges,165.88,37.7,,,percent of total billed charges,37.70% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,149.16,33.9,,,percent of total billed charges,33.9% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,343.2,78,,,percent of total billed charges,78% of total billed charges,440,100,,,percent of total billed charges,100% of total billed charges,363.44,82.6,,,percent of total billed charges,82.6% of total billed charges,363.44,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,16.8,,,percent of total billed charges,16.8% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,220,50,,,percent of total billed charges,50% of total Billed charges,73.92,16.8,,,percent of total billed charges,16.8% of total billed charges,67.32,440,
Anesthesia Level 2 First 30 Min,ANES220008,CDM,370,RC,,,Outpatient,,,1769,1149.85,,1556.72,88,,,percent of total billed charges,88% of total Billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,297.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,1769,100,,,percent of total billed charges,100% of total billed charges,306.11,17.304,,,percent of total billed charges,17.304% of total billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,1114.47,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,297.19,16.8,,,percent of total billed charges,16.8% of total billed charges,270.66,15.3,,,percent of total billed charges,15.3% of total billed charges,1220.61,69,,,percent of total billed charges,69% of total billed charges,1769,100,,,percent of total billed charges,100% of total billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,1769,100,,,percent of total billed charges,100% of total billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,1769,100,,,percent of total billed charges,100% of total billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,1094.13,61.85,,,percent of total billed charges,61.85% of total billed charges,297.19,16.8,,,percent of total billed charges,16.8% of total billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,297.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,303.14,17.136,,,percent of total billed charges,17.136% of total billed charges,386.35,21.84,,,percent of total billed charges,21.84% of total billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,666.91,37.7,,,percent of total billed charges,37.70% of total billed charges,666.91,37.7,,,percent of total billed charges,37.70% of total billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,599.69,33.9,,,percent of total billed charges,33.9% of total billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,1379.82,78,,,percent of total billed charges,78% of total billed charges,1769,100,,,percent of total billed charges,100% of total billed charges,1461.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1461.19,82.6,,,percent of total billed charges,82.6% of total billed charges,297.19,16.8,,,percent of total billed charges,16.8% of total billed charges,884.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,884.5,50,,,percent of total billed charges,50% of total Billed charges,297.19,16.8,,,percent of total billed charges,16.8% of total billed charges,270.66,1769,
Anesthesia Level 2 Ea Addt'l 15 Min,ANES220009,CDM,370,RC,,,Outpatient,,,440,286.00,,387.2,88,,,percent of total billed charges,88% of total Billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,73.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,440,100,,,percent of total billed charges,100% of total billed charges,76.14,17.304,,,percent of total billed charges,17.304% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,277.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,73.92,16.8,,,percent of total billed charges,16.8% of total billed charges,67.32,15.3,,,percent of total billed charges,15.3% of total billed charges,303.6,69,,,percent of total billed charges,69% of total billed charges,440,100,,,percent of total billed charges,100% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,440,100,,,percent of total billed charges,100% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,440,100,,,percent of total billed charges,100% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,272.14,61.85,,,percent of total billed charges,61.85% of total billed charges,73.92,16.8,,,percent of total billed charges,16.8% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,73.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,75.4,17.136,,,percent of total billed charges,17.136% of total billed charges,96.1,21.84,,,percent of total billed charges,21.84% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,165.88,37.7,,,percent of total billed charges,37.70% of total billed charges,165.88,37.7,,,percent of total billed charges,37.70% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,149.16,33.9,,,percent of total billed charges,33.9% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,343.2,78,,,percent of total billed charges,78% of total billed charges,440,100,,,percent of total billed charges,100% of total billed charges,363.44,82.6,,,percent of total billed charges,82.6% of total billed charges,363.44,82.6,,,percent of total billed charges,82.6% of total billed charges,73.92,16.8,,,percent of total billed charges,16.8% of total billed charges,220,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,220,50,,,percent of total billed charges,50% of total Billed charges,73.92,16.8,,,percent of total billed charges,16.8% of total billed charges,67.32,440,
Anesthesia Level 3 First 30 Min,ANES220010,CDM,370,RC,,,Outpatient,,,2779,1806.35,,2445.52,88,,,percent of total billed charges,88% of total Billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,466.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,2779,100,,,percent of total billed charges,100% of total billed charges,480.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,1750.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,466.87,16.8,,,percent of total billed charges,16.8% of total billed charges,425.19,15.3,,,percent of total billed charges,15.3% of total billed charges,1917.51,69,,,percent of total billed charges,69% of total billed charges,2779,100,,,percent of total billed charges,100% of total billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,2779,100,,,percent of total billed charges,100% of total billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,2779,100,,,percent of total billed charges,100% of total billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,1718.81,61.85,,,percent of total billed charges,61.85% of total billed charges,466.87,16.8,,,percent of total billed charges,16.8% of total billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,466.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,476.21,17.136,,,percent of total billed charges,17.136% of total billed charges,606.93,21.84,,,percent of total billed charges,21.84% of total billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,1047.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1047.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,942.08,33.9,,,percent of total billed charges,33.9% of total billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,2167.62,78,,,percent of total billed charges,78% of total billed charges,2779,100,,,percent of total billed charges,100% of total billed charges,2295.45,82.6,,,percent of total billed charges,82.6% of total billed charges,2295.45,82.6,,,percent of total billed charges,82.6% of total billed charges,466.87,16.8,,,percent of total billed charges,16.8% of total billed charges,1389.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1389.5,50,,,percent of total billed charges,50% of total Billed charges,466.87,16.8,,,percent of total billed charges,16.8% of total billed charges,425.19,2779,
Anesthesia Level 3 Ea Addt'l 15 min,ANES220011,CDM,370,RC,,,Outpatient,,,734,477.10,,645.92,88,,,percent of total billed charges,88% of total Billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,123.31,16.8,,,percent of total billed charges,16.8% of total Billed charges,734,100,,,percent of total billed charges,100% of total billed charges,127.01,17.304,,,percent of total billed charges,17.304% of total billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,462.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,123.31,16.8,,,percent of total billed charges,16.8% of total billed charges,112.3,15.3,,,percent of total billed charges,15.3% of total billed charges,506.46,69,,,percent of total billed charges,69% of total billed charges,734,100,,,percent of total billed charges,100% of total billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,734,100,,,percent of total billed charges,100% of total billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,734,100,,,percent of total billed charges,100% of total billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,453.98,61.85,,,percent of total billed charges,61.85% of total billed charges,123.31,16.8,,,percent of total billed charges,16.8% of total billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,123.31,16.8,,,percent of total billed charges,16.8% of total Billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,125.78,17.136,,,percent of total billed charges,17.136% of total billed charges,160.31,21.84,,,percent of total billed charges,21.84% of total billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,276.72,37.7,,,percent of total billed charges,37.70% of total billed charges,276.72,37.7,,,percent of total billed charges,37.70% of total billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,248.83,33.9,,,percent of total billed charges,33.9% of total billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,572.52,78,,,percent of total billed charges,78% of total billed charges,734,100,,,percent of total billed charges,100% of total billed charges,606.28,82.6,,,percent of total billed charges,82.6% of total billed charges,606.28,82.6,,,percent of total billed charges,82.6% of total billed charges,123.31,16.8,,,percent of total billed charges,16.8% of total billed charges,367,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,367,50,,,percent of total billed charges,50% of total Billed charges,123.31,16.8,,,percent of total billed charges,16.8% of total billed charges,112.3,734,
B12 CALIBRATOR,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
B12 / FOLATE RGT PK3/200 TESTS,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
BABCOCK GRASPER TIP 5MM,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
BACITRACIN OINTMENT,490075,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
BACITRACIN B-10 (NOT TAXO),ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BACK TABLE COVER STERILE,490076,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
"BACK TABLE COVER, STERILE Z",490077,CDM,272,RC,,,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,20.76,17.304,,,percent of total billed charges,17.304% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.56,17.136,,,percent of total billed charges,17.136% of total billed charges,26.21,21.84,,,percent of total billed charges,21.84% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,120,
BACTOSHIELD CHLORHEXIDINE GLUCONATE 4%  4-OZ,130573,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
BACT/ALERT PF PLUS,ORSUP0001,CDM,270,RC,,,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,12.98,17.304,,,percent of total billed charges,17.304% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,47.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,46.39,61.85,,,percent of total billed charges,61.85% of total billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.85,17.136,,,percent of total billed charges,17.136% of total billed charges,16.38,21.84,,,percent of total billed charges,21.84% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11.48,75,
BACTISTAPH LATEX AGGLUTINATION TEST KIT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BACTERIAL VIRAL FILTERS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
BACT/ALERT FN PLUS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
BAG DRAIN METER URINE 350CC,151964,CDM,270,RC,,,Outpatient,,,44,28.60,,38.72,88,,,percent of total billed charges,88% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,7.61,17.304,,,percent of total billed charges,17.304% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,15.3,,,percent of total billed charges,15.3% of total billed charges,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.21,61.85,,,percent of total billed charges,61.85% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.54,17.136,,,percent of total billed charges,17.136% of total billed charges,9.61,21.84,,,percent of total billed charges,21.84% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,44,
BAG URINARY DRAINAGE 4000ML,151969,CDM,270,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
BAG EXTERNAL DRAINAGE NEURO,ORSUP0015,CDM,278,RC,C1729,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BAG CLEAR POLY 6519 1.25M,187664,CDM,270,RC,,,Outpatient,,,165,107.25,,145.2,88,,,percent of total billed charges,88% of total Billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,27.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,165,100,,,percent of total billed charges,100% of total billed charges,28.55,17.304,,,percent of total billed charges,17.304% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,103.95,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.72,16.8,,,percent of total billed charges,16.8% of total billed charges,25.25,15.3,,,percent of total billed charges,15.3% of total billed charges,113.85,69,,,percent of total billed charges,69% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,165,100,,,percent of total billed charges,100% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,165,100,,,percent of total billed charges,100% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,102.05,61.85,,,percent of total billed charges,61.85% of total billed charges,27.72,16.8,,,percent of total billed charges,16.8% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,27.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,28.27,17.136,,,percent of total billed charges,17.136% of total billed charges,36.04,21.84,,,percent of total billed charges,21.84% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,82.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,82.5,50,,,percent of total billed charges,50% of total Billed charges,128.7,78,,,percent of total billed charges,78% of total billed charges,165,100,,,percent of total billed charges,100% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,136.29,82.6,,,percent of total billed charges,82.6% of total billed charges,27.72,16.8,,,percent of total billed charges,16.8% of total billed charges,82.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,82.5,50,,,percent of total billed charges,50% of total Billed charges,27.72,16.8,,,percent of total billed charges,16.8% of total billed charges,25.25,165,
BAG CLEAR PATIENT SET-UP WITH DRAWSTING 12X16,282390,CDM,270,RC,,,Outpatient,,,341,221.65,,300.08,88,,,percent of total billed charges,88% of total Billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,57.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,341,100,,,percent of total billed charges,100% of total billed charges,59.01,17.304,,,percent of total billed charges,17.304% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,214.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,57.29,16.8,,,percent of total billed charges,16.8% of total billed charges,52.17,15.3,,,percent of total billed charges,15.3% of total billed charges,235.29,69,,,percent of total billed charges,69% of total billed charges,341,100,,,percent of total billed charges,100% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,341,100,,,percent of total billed charges,100% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,341,100,,,percent of total billed charges,100% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,210.91,61.85,,,percent of total billed charges,61.85% of total billed charges,57.29,16.8,,,percent of total billed charges,16.8% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,57.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,58.43,17.136,,,percent of total billed charges,17.136% of total billed charges,74.47,21.84,,,percent of total billed charges,21.84% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,170.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,170.5,50,,,percent of total billed charges,50% of total Billed charges,265.98,78,,,percent of total billed charges,78% of total billed charges,341,100,,,percent of total billed charges,100% of total billed charges,281.67,82.6,,,percent of total billed charges,82.6% of total billed charges,281.67,82.6,,,percent of total billed charges,82.6% of total billed charges,57.29,16.8,,,percent of total billed charges,16.8% of total billed charges,170.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,170.5,50,,,percent of total billed charges,50% of total Billed charges,57.29,16.8,,,percent of total billed charges,16.8% of total billed charges,52.17,341,
BAG AUTOCLAVE BIOHAZARD 25X35,311019,CDM,270,RC,,,Outpatient,,,1860,1209.00,,1636.8,88,,,percent of total billed charges,88% of total Billed charges,930,50,,,percent of total billed charges,50% of total Billed charges,312.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1860,100,,,percent of total billed charges,100% of total billed charges,321.85,17.304,,,percent of total billed charges,17.304% of total billed charges,930,50,,,percent of total billed charges,50% of total Billed charges,1171.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,312.48,16.8,,,percent of total billed charges,16.8% of total billed charges,284.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1283.4,69,,,percent of total billed charges,69% of total billed charges,1860,100,,,percent of total billed charges,100% of total billed charges,930,50,,,percent of total billed charges,50% of total Billed charges,1860,100,,,percent of total billed charges,100% of total billed charges,930,50,,,percent of total billed charges,50% of total Billed charges,1860,100,,,percent of total billed charges,100% of total billed charges,930,50,,,percent of total billed charges,50% of total Billed charges,1150.41,61.85,,,percent of total billed charges,61.85% of total billed charges,312.48,16.8,,,percent of total billed charges,16.8% of total billed charges,930,50,,,percent of total billed charges,50% of total Billed charges,930,50,,,percent of total billed charges,50% of total Billed charges,312.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,930,50,,,percent of total billed charges,50% of total Billed charges,930,50,,,percent of total billed charges,50% of total Billed charges,318.73,17.136,,,percent of total billed charges,17.136% of total billed charges,406.22,21.84,,,percent of total billed charges,21.84% of total billed charges,930,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,930,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,930,50,,,percent of total billed charges,50% of total Billed charges,1450.8,78,,,percent of total billed charges,78% of total billed charges,1860,100,,,percent of total billed charges,100% of total billed charges,1536.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1536.36,82.6,,,percent of total billed charges,82.6% of total billed charges,312.48,16.8,,,percent of total billed charges,16.8% of total billed charges,930,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,930,50,,,percent of total billed charges,50% of total Billed charges,312.48,16.8,,,percent of total billed charges,16.8% of total billed charges,284.58,1860,
BAG BEDSIDE,30760,CDM,270,RC,,,Outpatient,,,233,151.45,,205.04,88,,,percent of total billed charges,88% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,233,100,,,percent of total billed charges,100% of total billed charges,40.32,17.304,,,percent of total billed charges,17.304% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,146.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,35.65,15.3,,,percent of total billed charges,15.3% of total billed charges,160.77,69,,,percent of total billed charges,69% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,233,100,,,percent of total billed charges,100% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,233,100,,,percent of total billed charges,100% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,144.11,61.85,,,percent of total billed charges,61.85% of total billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.93,17.136,,,percent of total billed charges,17.136% of total billed charges,50.89,21.84,,,percent of total billed charges,21.84% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,116.5,50,,,percent of total billed charges,50% of total Billed charges,181.74,78,,,percent of total billed charges,78% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,35.65,233,
BAG CLEAR 30X12X8 1 MIL,225836,CDM,270,RC,,,Outpatient,,,286,185.90,,251.68,88,,,percent of total billed charges,88% of total Billed charges,143,50,,,percent of total billed charges,50% of total Billed charges,48.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,286,100,,,percent of total billed charges,100% of total billed charges,49.49,17.304,,,percent of total billed charges,17.304% of total billed charges,143,50,,,percent of total billed charges,50% of total Billed charges,180.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,48.05,16.8,,,percent of total billed charges,16.8% of total billed charges,43.76,15.3,,,percent of total billed charges,15.3% of total billed charges,197.34,69,,,percent of total billed charges,69% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,143,50,,,percent of total billed charges,50% of total Billed charges,286,100,,,percent of total billed charges,100% of total billed charges,143,50,,,percent of total billed charges,50% of total Billed charges,286,100,,,percent of total billed charges,100% of total billed charges,143,50,,,percent of total billed charges,50% of total Billed charges,176.89,61.85,,,percent of total billed charges,61.85% of total billed charges,48.05,16.8,,,percent of total billed charges,16.8% of total billed charges,143,50,,,percent of total billed charges,50% of total Billed charges,143,50,,,percent of total billed charges,50% of total Billed charges,48.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,143,50,,,percent of total billed charges,50% of total Billed charges,143,50,,,percent of total billed charges,50% of total Billed charges,49.01,17.136,,,percent of total billed charges,17.136% of total billed charges,62.46,21.84,,,percent of total billed charges,21.84% of total billed charges,143,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,143,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,143,50,,,percent of total billed charges,50% of total Billed charges,223.08,78,,,percent of total billed charges,78% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,48.05,16.8,,,percent of total billed charges,16.8% of total billed charges,143,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,143,50,,,percent of total billed charges,50% of total Billed charges,48.05,16.8,,,percent of total billed charges,16.8% of total billed charges,43.76,286,
"BAG DRAWSTRING, 40X40, 2.5MIL LIGHT BLUE",289071,CDM,270,RC,,,Outpatient,,,544,353.60,,478.72,88,,,percent of total billed charges,88% of total Billed charges,272,50,,,percent of total billed charges,50% of total Billed charges,91.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,544,100,,,percent of total billed charges,100% of total billed charges,94.13,17.304,,,percent of total billed charges,17.304% of total billed charges,272,50,,,percent of total billed charges,50% of total Billed charges,342.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,91.39,16.8,,,percent of total billed charges,16.8% of total billed charges,83.23,15.3,,,percent of total billed charges,15.3% of total billed charges,375.36,69,,,percent of total billed charges,69% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,272,50,,,percent of total billed charges,50% of total Billed charges,544,100,,,percent of total billed charges,100% of total billed charges,272,50,,,percent of total billed charges,50% of total Billed charges,544,100,,,percent of total billed charges,100% of total billed charges,272,50,,,percent of total billed charges,50% of total Billed charges,336.46,61.85,,,percent of total billed charges,61.85% of total billed charges,91.39,16.8,,,percent of total billed charges,16.8% of total billed charges,272,50,,,percent of total billed charges,50% of total Billed charges,272,50,,,percent of total billed charges,50% of total Billed charges,91.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,272,50,,,percent of total billed charges,50% of total Billed charges,272,50,,,percent of total billed charges,50% of total Billed charges,93.22,17.136,,,percent of total billed charges,17.136% of total billed charges,118.81,21.84,,,percent of total billed charges,21.84% of total billed charges,272,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,272,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,272,50,,,percent of total billed charges,50% of total Billed charges,424.32,78,,,percent of total billed charges,78% of total billed charges,544,100,,,percent of total billed charges,100% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,449.34,82.6,,,percent of total billed charges,82.6% of total billed charges,91.39,16.8,,,percent of total billed charges,16.8% of total billed charges,272,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,272,50,,,percent of total billed charges,50% of total Billed charges,91.39,16.8,,,percent of total billed charges,16.8% of total billed charges,83.23,544,
BAG EMESIS CLEAN UP TWIST,306408,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
BAG GARMENT STANDARD,187726,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
BAG HEMETRIC DRAIN REPLACEMENT,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
BAG LEG URINE MED STERILE,186571,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
BAG PERSONAL BELONGING 20X18 CLEAR,73244,CDM,270,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BAG PRESSURE INFUSER 500ML W/STOPCOCK,192422,CDM,270,RC,,,Outpatient,,,77,50.05,,67.76,88,,,percent of total billed charges,88% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,13.32,17.304,,,percent of total billed charges,17.304% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,48.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,11.78,15.3,,,percent of total billed charges,15.3% of total billed charges,53.13,69,,,percent of total billed charges,69% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,47.62,61.85,,,percent of total billed charges,61.85% of total billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,13.19,17.136,,,percent of total billed charges,17.136% of total billed charges,16.82,21.84,,,percent of total billed charges,21.84% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38.5,50,,,percent of total billed charges,50% of total Billed charges,60.06,78,,,percent of total billed charges,78% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38.5,50,,,percent of total billed charges,50% of total Billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,11.78,77,
BAG ZIPLOC 10 X 13 PLASTIC,188405,CDM,270,RC,,,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,7.27,17.304,,,percent of total billed charges,17.304% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,26.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,15.3,,,percent of total billed charges,15.3% of total billed charges,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.2,17.136,,,percent of total billed charges,17.136% of total billed charges,9.17,21.84,,,percent of total billed charges,21.84% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,42,
BAG ZIPLOCK,13913,CDM,270,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
BAG POLYPROPYLENE 19X23 IN RED,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BAG RETRIEVAL10MM SPECIMEN,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
BAG REFILL FLEXISEAL FECAL COLLECTOR,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
BAG 10MM RETRIEVAL ENDO,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BAG 5MM RETRIEVAL  ENDO,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BAG SET-UP LEMANS,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BAG BILE REG 19 OZ W/T-TUBE ADPT  RUBBER BELTS,167238,CDM,270,RC,,,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,10.56,17.304,,,percent of total billed charges,17.304% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,38.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,37.73,61.85,,,percent of total billed charges,61.85% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.45,17.136,,,percent of total billed charges,17.136% of total billed charges,13.32,21.84,,,percent of total billed charges,21.84% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,61,
BAG LEG MEDIUM,490080,CDM,270,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
BAG LEG LARGE,490079,CDM,270,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
BAG DECANTER IV FLUID SPIKE,490078,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
BAG PT BELONGINGS,490081,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
BAG ZIPLOCK 9 X 12,490083,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
BAG BIOHAZARD SPECIMEN TRANSPORT 6 X 9,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BAG BIOHAZARD SPECIMEN TRANSPORT 12 X 15,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BAG LEG TWIST VALVE MED 20 OZ,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BAG LEG TWIST VALVE LG 32 OZ,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BAG LEG EX-TUBING 18 MED 20OZ,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
"BAG,DRAWSTRING 40X40 2.5MIL RED",284320,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
BAIR HUGGER BLANKET,490085,CDM,272,RC,,,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,7.79,17.304,,,percent of total billed charges,17.304% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,27.83,61.85,,,percent of total billed charges,61.85% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.71,17.136,,,percent of total billed charges,17.136% of total billed charges,9.83,21.84,,,percent of total billed charges,21.84% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
BALLOON REPLACEMENT 18FR,ORSUP0006,CDM,278,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BALLOON CRE ESOPHAGEAL         5850,ORSUP0016,CDM,278,RC,C1726,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
BALLOON DILATION 10MM HURRICANE RX,ORSUP0015,CDM,278,RC,C1726,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BALLOON DILATION 8MM HURRICANE RX,ORSUP0015,CDM,278,RC,C1726,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BALLOON DILATION 4MM HURRICANE RX,ORSUP0015,CDM,278,RC,C1726,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BALLOON DILAT L2CM L180CM OD5.8FR ODSEC4MM INFL UP TO 12 ATM,ORSUP0015,CDM,278,RC,C1726,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BALLOON DILATION 6MM HURRICANE RX,ORSUP0015,CDM,278,RC,C1726,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BALLOON DILATION 6MM X 2 HURRICAN RX,ORSUP0015,CDM,278,RC,C1726,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BALLOON OCCLUSION CATH SET UPJ,ORSUP0010,CDM,278,RC,C2628,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON CATH TREK 4.0X20MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 4.0X12MM 1012278-12,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 3.0X20MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 3.0X12MM 1012274-12,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 3.5 X20MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 3.5X12MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 3.25X20MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 3.25X12MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH MINI TREK 2.0X20MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH MINI TREK 2.0X12MM 1012270-12,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON CATH TREK 2.75X20MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 2.75X15MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 2.75X12MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 2.5X20MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 2.5X15MM 1012405-15,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 2.5X12MM 1012272-12,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 2.25X20MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 2.25X15MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH TREK 2.25X12MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON CATH MINI TREK 1.20MM X 12MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  5.0 X 20MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  5.0 X 15MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  4.0 X 8MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  4.0 X 20MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  4.0 X 15MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  4.0 X 12MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  4.5 X 8MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  4.5 X 15MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.0 X 20MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.0 X 15MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.0 X 12MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.75 X 8MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.75 X 20MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.75 X 15MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.5 X 20MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.5 X 15MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.5 X 12MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.25 X 8MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.25 X 20MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.25 X 15MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  3.25 X 12MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC   2.0 X 8MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  2.0 X 15MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  2.0 X 12MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  2.75 X 15MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  2.75 X 12MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  2.5 X 20MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  2.5 X 15MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  2.5 X 12MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  2.25 X 8MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  2.25 X 15MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  2.25 X 12MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON TREK NC  1.5 X 8MM  RX,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON ATLAS 12X40X75,ORSUP0017,CDM,278,RC,C1725,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
BALLOON 12MMX2CMX75CM 6.5,ORSUP0018,CDM,278,RC,C1725,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
BALLOON EMERGE 3.00 X 12,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON EMERGE 3.5 X 12,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON EMERGE MR 2X12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON EMERGE MR 2.5X12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON EMERGE MR 2.25MMX15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON EMERGE MR 2.25 X 12,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON CATH TREK 3.0X30MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON COYOTE OTW  2.5X220MM  150CM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON MUSTANG  8.0X60MM 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG  9.0X40MM  135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG  9.0X20MM  135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG 7.0X60 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG .035 7.0X40 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG .035 7.0X20 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG .035 6.0X40 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG .035 6.0X20 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG 4.0 X 200 X 135,ORSUP0015,CDM,278,RC,C1725,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BALLOON MUSTANG  3.0X40MM  135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG  3.0X20MM  135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG  3.0X200MM  135CM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON MUSTANG  3.0X100MM  135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG  10.0X40MM  135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG  10.0X20MM  135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON XXL 12-2 5.8 75CM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON MUSTANG .035 5.0X40 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON PERIPHERAL CUTTING,ORSUP0026,CDM,278,RC,C1725,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
BALLOON 3.0X4MM 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
BALLOON STERLING 2.5X100X150,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
BALLOON 14MM X 2CM X 75CM,ORSUP0018,CDM,278,RC,C1725,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
BALLOON 30 ATM 7X4X50CM,ORSUP0016,CDM,278,RC,C1725,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
BALLOON ATLAS 14X40X75,ORSUP0017,CDM,278,RC,C1725,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
BALLOON CUTTING WOLVERINE 2.5 X 10,ORSUP0027,CDM,278,RC,C1725,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
BALLOON CUTTING WOLVERINE 2.75X15,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
BALLOON CUTTING WOLVERINE 3.0 X 10,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
BALLOON CUTTING WOLVERINE 3.0 X 15,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
BALLOON CUTTING WOLVERINE 3.5 X 15,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
BALLOON EMERGE 3.0 X 20MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON EMERGE MR 4.0MM X 8MM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON MUSTANG 7.0MM X 100 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON NC EMERGE 2.0 X 12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 2.0 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 2.25 X 12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 2.25 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 2.25 X 20MM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON NC EMERGE 2.25 X 8MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 2.5 X 12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 2.5 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 2.5 X 20MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 2.5 X 8MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 2.75 X 12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 2.75 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 2.75 X 8MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.0 X 12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.0 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.0 X 20MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.0 X 8MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.25 X 12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.25 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.25 X 8MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON NC EMERGE 3.5 X 12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.5 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.5 X 20MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.5 X 8MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.75 X 12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.75 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.75 X 20MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 3.75 X 8MM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BALLOON NC EMERGE 4.0 X 12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 4.0 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 4.0 X 20MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 4.0 X 8MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 4.5 X 12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 4.5 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 4.5 X 20MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 4.5 X 8MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 5.0 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 5.0 X 8MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 5.5 X 12MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 5.5 X 15MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON NC EMERGE 5.5 X 20MM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON STERLING 3.0X100MM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
BALLOON STERLING 4.0X100MM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
BALLOON PRE PERITIONEAL DISTENTION W BULB,ORSUP0025,CDM,278,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
BALLOON EXTRACTOR PRO RX 12-15 MM,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON EXTRACTOR PRO RX 15 - 18 MM ABOVE,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLOON KYPHOPLASTY KIT 15/3,ORSUP0084,CDM,278,RC,,,Outpatient,,,19240,12506.00,,16931.2,88,,,percent of total billed charges,88% of total Billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3329.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,12121.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,2943.72,15.3,,,percent of total billed charges,15.3% of total billed charges,13275.6,69,,,percent of total billed charges,69% of total billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,11899.94,61.85,,,percent of total billed charges,61.85% of total billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,6002.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9620,50,,,percent of total billed charges,50% of total Billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,3296.97,17.136,,,percent of total billed charges,17.136% of total billed charges,4202.02,21.84,,,percent of total billed charges,21.84% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,7253.48,37.7,,,percent of total billed charges,37.70% of total billed charges,7253.48,37.7,,,percent of total billed charges,37.70% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,6522.36,33.9,,,percent of total billed charges,33.9% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,15007.2,78,,,percent of total billed charges,78% of total billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,15892.24,82.6,,,percent of total billed charges,82.6% of total billed charges,15892.24,82.6,,,percent of total billed charges,82.6% of total billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9620,50,,,percent of total billed charges,50% of total Billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,2943.72,19240,
BALLOON SPACEMAKER PRO STRUCTURE,ORSUP0053,CDM,272,RC,,,Outpatient,,,10920,7098.00,,9609.6,88,,,percent of total billed charges,88% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1889.6,17.304,,,percent of total billed charges,17.304% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,6879.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,1670.76,15.3,,,percent of total billed charges,15.3% of total billed charges,7534.8,69,,,percent of total billed charges,69% of total billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,6754.02,61.85,,,percent of total billed charges,61.85% of total billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,1871.25,17.136,,,percent of total billed charges,17.136% of total billed charges,2384.93,21.84,,,percent of total billed charges,21.84% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5460,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5460,50,,,percent of total billed charges,50% of total Billed charges,8517.6,78,,,percent of total billed charges,78% of total billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,9019.92,82.6,,,percent of total billed charges,82.6% of total billed charges,9019.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5460,50,,,percent of total billed charges,50% of total Billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,1670.76,10920,
BALLOON DIAL URETERAL 7FR/10CM,ORSUP0016,CDM,278,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
BALLOON DIALATOR,ORSUP0014,CDM,278,RC,C1726,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BALLON CATH INFLATION DEVICE,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
BALLOON DILATOR CRE WG 10-12MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BALLOON EUPHORA RX 1.5 X 12,ORSUP0012,CDM,278,RC,C1726,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON EUPHORA RX 2.0 X 12,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON EUPHORA RX 2.0 X 15,ORSUP0012,CDM,278,RC,C1726,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON EUPHORA RX 2.5 X 12,ORSUP0012,CDM,278,RC,C1726,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON EUPHORA RX 2.5 X 15,ORSUP0009,CDM,278,RC,C1726,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
BALLOON EUPHORA RX 2.5 X 20,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON EUPHORA RX 3.0 X 12,ORSUP0012,CDM,278,RC,C1726,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON EUPHORA RX 3.0 X 15,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON EUPHORA RX 3.0 X 20,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON CRE ESOPHAGEAL         5850,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON EUPHORA RX 3.5 X 20,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON EUPHORA RX 4.0 X 15,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON EUPHORA RX 4.0 X 20,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON SPRINTER LEGEND 1.25 X 10,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON NC EUPHORA RX 2.0 X 12,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON NC EUPHORA RX 2.25 X 15,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON NC EUPHORA RX 2.5 X 15,ORSUP0012,CDM,278,RC,C1726,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON NC EUPHORA RX 2.5 X 20,ORSUP0012,CDM,278,RC,C1726,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON NC EUPHORA RX 2.75 X 12,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON NC EUPHORA RX 3.0 X 8,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON NC EUPHORA RX 3.0 X 12,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
BALLOON NC EUPHORA RX 3.0 X 15,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
BALLOON NC EUPHORA RX 3.0 X 20,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
ORSUP0010,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON NC EUPHORA RX 3.25 X 15,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON NC EUPHORA RX 3.25 X 20,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON NC EUPHORA RX 3.5 X 8,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON NC EUPHORA RX 3.5 X 12,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON NC EUPHORA RX 3.5 X 20,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON NC EUPHORA RX 3.75 X 15,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON NC EUPHORA RX 4.0 X 12,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ORSUP0012,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BALLOON NC EUPHORA RX 4.5 X 12,ORSUP0010,CDM,278,RC,C1726,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BALLOON DES STELLAREX 4 X 40 X 135CM,ORSUP0045,CDM,272,RC,,,Outpatient,,,6800,4420.00,,5984,88,,,percent of total billed charges,88% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1176.67,17.304,,,percent of total billed charges,17.304% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,4284,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1040.4,15.3,,,percent of total billed charges,15.3% of total billed charges,4692,69,,,percent of total billed charges,69% of total billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,4205.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,1165.25,17.136,,,percent of total billed charges,17.136% of total billed charges,1485.12,21.84,,,percent of total billed charges,21.84% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,5304,78,,,percent of total billed charges,78% of total billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,5616.8,82.6,,,percent of total billed charges,82.6% of total billed charges,5616.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1040.4,6800,
BALLOON DES STELLAREX 5 X 40 X 135CM,ORSUP0063,CDM,272,RC,,,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6715.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
BALLOON DES STELLAREX 5 X 80 X 135CM,ORSUP0045,CDM,272,RC,,,Outpatient,,,6800,4420.00,,5984,88,,,percent of total billed charges,88% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1176.67,17.304,,,percent of total billed charges,17.304% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,4284,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1040.4,15.3,,,percent of total billed charges,15.3% of total billed charges,4692,69,,,percent of total billed charges,69% of total billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,4205.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,1165.25,17.136,,,percent of total billed charges,17.136% of total billed charges,1485.12,21.84,,,percent of total billed charges,21.84% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,5304,78,,,percent of total billed charges,78% of total billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,5616.8,82.6,,,percent of total billed charges,82.6% of total billed charges,5616.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1040.4,6800,
BALLOON DES STELLAREX 6 X 40 X 135CM,ORSUP0052,CDM,272,RC,,,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6715.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
BALLOON DES STELLAREX 6 X 60 X 135CM,ORSUP0037,CDM,272,RC,,,Outpatient,,,6760,4394.00,,5948.8,88,,,percent of total billed charges,88% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1169.75,17.304,,,percent of total billed charges,17.304% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4258.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,15.3,,,percent of total billed charges,15.3% of total billed charges,4664.4,69,,,percent of total billed charges,69% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4181.06,61.85,,,percent of total billed charges,61.85% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1158.39,17.136,,,percent of total billed charges,17.136% of total billed charges,1476.38,21.84,,,percent of total billed charges,21.84% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,5272.8,78,,,percent of total billed charges,78% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,6760,
BALLOON DES STELLAREX 6 X 80 X 135CM,ORSUP0045,CDM,272,RC,,,Outpatient,,,6800,4420.00,,5984,88,,,percent of total billed charges,88% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1176.67,17.304,,,percent of total billed charges,17.304% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,4284,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1040.4,15.3,,,percent of total billed charges,15.3% of total billed charges,4692,69,,,percent of total billed charges,69% of total billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,4205.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,1165.25,17.136,,,percent of total billed charges,17.136% of total billed charges,1485.12,21.84,,,percent of total billed charges,21.84% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,5304,78,,,percent of total billed charges,78% of total billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,5616.8,82.6,,,percent of total billed charges,82.6% of total billed charges,5616.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1040.4,6800,
BALLOON DES STELLAREX 4 X 100 X 135CM,ORSUP0039,CDM,272,RC,,,Outpatient,,,5600,3640.00,,4928,88,,,percent of total billed charges,88% of total Billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,969.02,17.304,,,percent of total billed charges,17.304% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,3528,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,856.8,15.3,,,percent of total billed charges,15.3% of total billed charges,3864,69,,,percent of total billed charges,69% of total billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,3463.6,61.85,,,percent of total billed charges,61.85% of total billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,959.62,17.136,,,percent of total billed charges,17.136% of total billed charges,1223.04,21.84,,,percent of total billed charges,21.84% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2800,50,,,percent of total billed charges,50% of total Billed charges,4368,78,,,percent of total billed charges,78% of total billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,4625.6,82.6,,,percent of total billed charges,82.6% of total billed charges,4625.6,82.6,,,percent of total billed charges,82.6% of total billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2800,50,,,percent of total billed charges,50% of total Billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,856.8,5600,
ORSUP0048,ORSUP0048,CDM,272,RC,,,Outpatient,,,7400,4810.00,,6512,88,,,percent of total billed charges,88% of total Billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,1243.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1280.5,17.304,,,percent of total billed charges,17.304% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,4662,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1243.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1132.2,15.3,,,percent of total billed charges,15.3% of total billed charges,5106,69,,,percent of total billed charges,69% of total billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,4576.9,61.85,,,percent of total billed charges,61.85% of total billed charges,1243.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,1243.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,1268.06,17.136,,,percent of total billed charges,17.136% of total billed charges,1616.16,21.84,,,percent of total billed charges,21.84% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,5772,78,,,percent of total billed charges,78% of total billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,6112.4,82.6,,,percent of total billed charges,82.6% of total billed charges,6112.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1243.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,1243.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1132.2,7400,
BALLOON DES STELLAREX 6 X 100 X 135CM,ORSUP0048,CDM,272,RC,,,Outpatient,,,9620,6253.00,,8465.6,88,,,percent of total billed charges,88% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1664.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,6060.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,15.3,,,percent of total billed charges,15.3% of total billed charges,6637.8,69,,,percent of total billed charges,69% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,5949.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1648.48,17.136,,,percent of total billed charges,17.136% of total billed charges,2101.01,21.84,,,percent of total billed charges,21.84% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,7503.6,78,,,percent of total billed charges,78% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,9620,
ORSUP0056,ORSUP0056,CDM,272,RC,,,Outpatient,,,11960,7774.00,,10524.8,88,,,percent of total billed charges,88% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2069.56,17.304,,,percent of total billed charges,17.304% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7534.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,15.3,,,percent of total billed charges,15.3% of total billed charges,8252.4,69,,,percent of total billed charges,69% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7397.26,61.85,,,percent of total billed charges,61.85% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2049.47,17.136,,,percent of total billed charges,17.136% of total billed charges,2612.06,21.84,,,percent of total billed charges,21.84% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,9328.8,78,,,percent of total billed charges,78% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,11960,
BALLOON DES STELLAREX 5 X 120 X 135CM,ORSUP0044,CDM,272,RC,,,Outpatient,,,8580,5577.00,,7550.4,88,,,percent of total billed charges,88% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1484.68,17.304,,,percent of total billed charges,17.304% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5405.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,15.3,,,percent of total billed charges,15.3% of total billed charges,5920.2,69,,,percent of total billed charges,69% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5306.73,61.85,,,percent of total billed charges,61.85% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1470.27,17.136,,,percent of total billed charges,17.136% of total billed charges,1873.87,21.84,,,percent of total billed charges,21.84% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4290,50,,,percent of total billed charges,50% of total Billed charges,6692.4,78,,,percent of total billed charges,78% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,8580,
BALLOON DES STELLAREX 6 X 120 X 135CM,ORSUP0040,CDM,272,RC,,,Outpatient,,,5800,3770.00,,5104,88,,,percent of total billed charges,88% of total Billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,974.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1003.63,17.304,,,percent of total billed charges,17.304% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,3654,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,974.4,16.8,,,percent of total billed charges,16.8% of total billed charges,887.4,15.3,,,percent of total billed charges,15.3% of total billed charges,4002,69,,,percent of total billed charges,69% of total billed charges,5800,100,,,percent of total billed charges,100% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,5800,100,,,percent of total billed charges,100% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,5800,100,,,percent of total billed charges,100% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,3587.3,61.85,,,percent of total billed charges,61.85% of total billed charges,974.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,974.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,993.89,17.136,,,percent of total billed charges,17.136% of total billed charges,1266.72,21.84,,,percent of total billed charges,21.84% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2900,50,,,percent of total billed charges,50% of total Billed charges,4524,78,,,percent of total billed charges,78% of total billed charges,5800,100,,,percent of total billed charges,100% of total billed charges,4790.8,82.6,,,percent of total billed charges,82.6% of total billed charges,4790.8,82.6,,,percent of total billed charges,82.6% of total billed charges,974.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2900,50,,,percent of total billed charges,50% of total Billed charges,974.4,16.8,,,percent of total billed charges,16.8% of total billed charges,887.4,5800,
BALLOON BAKRI POSTPARTUM,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
BALLOON INFLATION DEVICE,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
BALLOON PROFILE PTA DIALATION CATH 5FR X 135CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
BALLOON COYOTE 3.0X60X150,ORSUP0018,CDM,278,RC,C1725,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
BALLOON COYOTE 4.0X60X150,ORSUP0018,CDM,278,RC,C1725,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
BALLOON COLPO PNEUMO OCCLUDER,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
BALL THERABAND PRO SERIES EXERCISE BALL BLUE 30IN,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BALLOON PTA 8MM X 4CM X 135CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
BALLOON COYOTE OTW 2.5X60X150,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
BALLOON COYOTE OTW 2X60X150,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
BALLOON COYOTE OTW 1.5X40X150,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
BALOON CATH MUSTANG OVER THE WIRE 6.0MM X 60MM  135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BANDAGE KLING 6IN STERILE,41529,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
BANDAGE KLING 4 INCH,41544,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
BANDAGE KLING 3IN STERILE,57215,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
BANDAGE KLING 2IN STERILE,41545,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
BANDAGE KERLIX ROLL 4.5IN STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BANDAGE ACE 6IN DOUBLE LENGTH,187186,CDM,270,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
BANDAGE ELASTIC  ACE 6 INCH STER S/CLOSE,10172,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
BAND ID SECURITY YELLOW,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
BAND ID TYPENEX SYSTEM GREEN,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
BAND ID W/LABEL ADULT INTELLIDOT,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
BANDAGE ELASTIC  ACE 2 INCH STER S/CLOSE,94538,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
BANDAGE ELASTIC 3 INCH NONSTER,10506,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
BANDAGE ELASTIC 4 INCH NONSTER,10507,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
BANDAGE ELASTIC 6 INCH NONSTER,10508,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
BANDAGE ESMARK 4IN X 9FT LATEX FREE,13902,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
BANDAGE ESMARK 6 INCH X 9 FEET LATEX FREE,80677,CDM,270,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
BANDAID 2X4,61479,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
BAND ELECTRODE FOR RESECTOSCOPE,ORSUP0041,CDM,272,RC,,,Outpatient,,,7800,5070.00,,6864,88,,,percent of total billed charges,88% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1349.71,17.304,,,percent of total billed charges,17.304% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4914,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,15.3,,,percent of total billed charges,15.3% of total billed charges,5382,69,,,percent of total billed charges,69% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4824.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1336.61,17.136,,,percent of total billed charges,17.136% of total billed charges,1703.52,21.84,,,percent of total billed charges,21.84% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,6084,78,,,percent of total billed charges,78% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,7800,
BANDAGE ESMARK 6'' X 9'',490092,CDM,270,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
BANDAGE ESMARK 4'' X 9'',490091,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
BANDAGE COBAN 2'',490090,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
BANDAGE ACE 2'',490089,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
BAND-AID 2 X 4,490094,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
BANDAGE KIT COMPR2 9.25 X 12.5,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
BANDAGING KIT COMPRIFORE LF  4 LAYER,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
BANDAGE KIT COMPRI2  LITE COMPRESSION 2 LAYER WRAP,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
BANDAGE 3IN ELASTIC SELF CLOSURE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BANDAGE 4IN ELASTIC SELF CLOSURE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BANDAGE 6IN ELASTIC SELF CLOSURE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BANDAGE KIT COMPRI2 7.08IN X 12.5IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
BANDAGE TUBULAR ELASTIC DRESSING 4IN X 25YD,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
BANDAGE NS SELF ADHERENT COHESIVE WRAP TAN 4IN X 5YD,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BANDAGE COFLEX COHESIVE HAND TEAR 2 RED,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BANDAGE COBAN NONSTERILE ASSORTED COLORS 1 INCH,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BANDAGE COBAN NONSTERILE ASSORTED COLORS 3 INCH,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BARD MONOPTY BIOPSY INSTRUMENT KIT - 16G NEEDLE,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
BARIUM-LIQUID POLIBAR,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
BARIUM STRAWS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
BARRIER FILM NO STING,9366,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
BASIN WASH,11864,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
BASIN EMESIS 500 CC 9IN MAUVE,152060,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
BASIN WASH 7.5QT GRAPHITE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BASIN SENSOR COVER FOR AER,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
BASKET ZERO TIP STONE 3.0 FR,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
BASKET ZERO TIP M0063901040,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
BASKET/CRUSHER GALLSTONE 3.0CM,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
BASKET TRAPEZOID 1.5 X 3,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
BASKET LITHOTRIPTOR TRAPEZOID RX 5.0CM/2.5CM/3.2MM,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
BASKET TRAPEZOID 2 X 4,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
BASKET STONE SEGURA 3FR,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
BASKET BAGLEY HELICAL STONE 340 122,ORSUP0021,CDM,270,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
BASKET FORCEP SPIRAL DISP 10MM,ORSUP0024,CDM,270,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
BATH PATIENT CARE FRAG-FREE,490097,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
BATTERY ALKALINE SIZE D,10415,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
BATTERY ALKALINE SIZE AA,10412,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
BATTERY # 72 1Q DISPOSABLE,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BATTERY N SIZE 1.5 V,490098,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
BAYONETTED ANNULOTOMY KNIFE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BD COLLECTION TUBE CLOT ACTIVATOR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BEAST INJECTABLE PUTTY 1.0CC,ORSUP0020,CDM,278,RC,C1763,HCPCS,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,561.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,610.2,33.9,,,percent of total billed charges,33.9% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
BEAVER BLADE 377081,490100,CDM,272,RC,,,Outpatient,,,86,55.90,,75.68,88,,,percent of total billed charges,88% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,14.88,17.304,,,percent of total billed charges,17.304% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,54.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,13.16,15.3,,,percent of total billed charges,15.3% of total billed charges,59.34,69,,,percent of total billed charges,69% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,53.19,61.85,,,percent of total billed charges,61.85% of total billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.74,17.136,,,percent of total billed charges,17.136% of total billed charges,18.78,21.84,,,percent of total billed charges,21.84% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,67.08,78,,,percent of total billed charges,78% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,13.16,86,
BEAVER  FLAT MINI-MINISCUS BLADE HANDLE 4MM,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
BEDPAN STACKABLE DISP MAUVE,10916,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
BEDPAN FRACTURE GRAPHITE,94599,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
BED PAN,490102,CDM,270,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
BELT 72 POSEY WHITE COTTON GAIT,68794,CDM,270,RC,,,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
BELT SANITARY,187177,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
BELT FETAL MONITOR TRANSDUCER 1.5IN X 36IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BENDALE ARMBOARDS,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
BENTSON WIRE GUIDE 20CM DISTAL FLEXIBILITY,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
"BENZOIN COMPOUND TINCTURE, 2 OZ",ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
BERMAN AIRWAYS 70MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
BETADINE SOLUTION 8OZ,185329,CDM,270,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
BETADINE 10% 2 OZ PREP SOLUTION,490104,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
BETADINE 5% PREP SOLUTION (EYES ONLY),490105,CDM,270,RC,,,Outpatient,,,108,70.20,,95.04,88,,,percent of total billed charges,88% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,18.69,17.304,,,percent of total billed charges,17.304% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,68.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,15.3,,,percent of total billed charges,15.3% of total billed charges,74.52,69,,,percent of total billed charges,69% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,66.8,61.85,,,percent of total billed charges,61.85% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.51,17.136,,,percent of total billed charges,17.136% of total billed charges,23.59,21.84,,,percent of total billed charges,21.84% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,84.24,78,,,percent of total billed charges,78% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,108,
BETADINE WET PREP,490106,CDM,270,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
BETA LACTAM REAGENT DISK,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BILE BAG,490107,CDM,270,RC,,,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.88,17.304,,,percent of total billed charges,17.304% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.83,17.136,,,percent of total billed charges,17.136% of total billed charges,7.43,21.84,,,percent of total billed charges,21.84% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,34,
BINDER ABDOMINAL 3XL 12INX82-100IN,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
BINDER ABDOMINAL SUPPORT 10IN,ORSUP0003,CDM,270,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
BINDER ABDOMINAL 9 IN 3 PANEL 45-62IN,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
BINDER ABDOMINAL 9IN 62-74 XL,ORSUP0003,CDM,270,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
BINDER LARGE BREAST,ORSUP0003,CDM,270,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BINDER ABDOMINAL 12IN XXL,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
BINDER ABDOMINAL 12IN XL,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
BIOCARTILEDGE 1CC,ORSUP0041,CDM,278,RC,C1762,HCPCS,Outpatient,,,6000,3900.00,,5280,88,,,percent of total billed charges,88% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,1008,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1038.24,17.304,,,percent of total billed charges,17.304% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,3780,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1008,16.8,,,percent of total billed charges,16.8% of total billed charges,918,15.3,,,percent of total billed charges,15.3% of total billed charges,4140,69,,,percent of total billed charges,69% of total billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,3711,61.85,,,percent of total billed charges,61.85% of total billed charges,1008,16.8,,,percent of total billed charges,16.8% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,1872,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3000,50,,,percent of total billed charges,50% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,1028.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1310.4,21.84,,,percent of total billed charges,21.84% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,2262,37.7,,,percent of total billed charges,37.70% of total billed charges,2262,37.7,,,percent of total billed charges,37.70% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,2034,33.9,,,percent of total billed charges,33.9% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,4680,78,,,percent of total billed charges,78% of total billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,4956,82.6,,,percent of total billed charges,82.6% of total billed charges,4956,82.6,,,percent of total billed charges,82.6% of total billed charges,1008,16.8,,,percent of total billed charges,16.8% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,1008,16.8,,,percent of total billed charges,16.8% of total billed charges,918,6000,
BOPCONNEKT WOUND MATRIX 1.5X1.5CM,636Q41611515,CDM,636,RC,Q4161,HCPCS,Outpatient,,,9200,5980.00,,8096,88,,,percent of total billed charges,88% of total Billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,5796,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1407.6,15.3,,,percent of total billed charges,15.3% of total billed charges,6348,69,,,percent of total billed charges,69% of total billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,5690.2,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,3468.4,37.7,,,percent of total billed charges,37.70% of total billed charges,3468.4,37.7,,,percent of total billed charges,37.70% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,3118.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,7176,78,,,percent of total billed charges,78% of total billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1407.6,9200,
COLLAGEN WOUND MATRIX 2X2CM,636Q416122,CDM,636,RC,Q4161,HCPCS,Outpatient,,,9200,5980.00,,8096,88,,,percent of total billed charges,88% of total Billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,5796,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1407.6,15.3,,,percent of total billed charges,15.3% of total billed charges,6348,69,,,percent of total billed charges,69% of total billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,5690.2,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,3468.4,37.7,,,percent of total billed charges,37.70% of total billed charges,3468.4,37.7,,,percent of total billed charges,37.70% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,3118.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,7176,78,,,percent of total billed charges,78% of total billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1407.6,9200,
BIOFILTER,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
BIOGLUE SYRINGE 10ML,ORSUP0031,CDM,278,RC,C1763,HCPCS,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
BIOGLUE SYRINGE 5ML,ORSUP0028,CDM,278,RC,C1763,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
BIOGEL GLOVS SZ 7,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
BIOHAZZARD LINER RED 24X24 13MIC ROLL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BIOLOGICAL INDICATORS BIOSIGN,490109,CDM,270,RC,,,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,745,100,,,percent of total billed charges,100% of total billed charges,128.91,17.304,,,percent of total billed charges,17.304% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,469.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,113.99,15.3,,,percent of total billed charges,15.3% of total billed charges,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,745,100,,,percent of total billed charges,100% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,745,100,,,percent of total billed charges,100% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,460.78,61.85,,,percent of total billed charges,61.85% of total billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,127.66,17.136,,,percent of total billed charges,17.136% of total billed charges,162.71,21.84,,,percent of total billed charges,21.84% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,372.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,372.5,50,,,percent of total billed charges,50% of total Billed charges,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,372.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,372.5,50,,,percent of total billed charges,50% of total Billed charges,125.16,16.8,,,percent of total billed charges,16.8% of total billed charges,113.99,745,
BIOLOGICAL GRAVITY ATTEST,490108,CDM,270,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
BIOLOGICAL STEAM ATTEST,490110,CDM,270,RC,,,Outpatient,,,79,51.35,,69.52,88,,,percent of total billed charges,88% of total Billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,13.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,79,100,,,percent of total billed charges,100% of total billed charges,13.67,17.304,,,percent of total billed charges,17.304% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,49.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,12.09,15.3,,,percent of total billed charges,15.3% of total billed charges,54.51,69,,,percent of total billed charges,69% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,79,100,,,percent of total billed charges,100% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,79,100,,,percent of total billed charges,100% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,48.86,61.85,,,percent of total billed charges,61.85% of total billed charges,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,13.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,13.54,17.136,,,percent of total billed charges,17.136% of total billed charges,17.25,21.84,,,percent of total billed charges,21.84% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39.5,50,,,percent of total billed charges,50% of total Billed charges,61.62,78,,,percent of total billed charges,78% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39.5,50,,,percent of total billed charges,50% of total Billed charges,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,12.09,79,
BIOMET ZIPTIGHT ANKLE FIXATOR,ORSUP0035,CDM,272,RC,,,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
BIOMET ACL LONG PINS,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
BIOMET JUGGERKNOT MINI 1.0MM,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
BIOMET JUGGERKNOT SOFT ANCHOR 1.4MM,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BIOMET JUGGERKNOT SOFT ANCHOR 2.9MM,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
BIOMET TOGGLELOC W/ZIPLOOP #7,ORSUP0030,CDM,278,RC,C1713,HCPCS,Outpatient,,,3800,2470.00,,3344,88,,,percent of total billed charges,88% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,657.55,17.304,,,percent of total billed charges,17.304% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,2394,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,581.4,15.3,,,percent of total billed charges,15.3% of total billed charges,2622,69,,,percent of total billed charges,69% of total billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,2350.3,61.85,,,percent of total billed charges,61.85% of total billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1185.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1900,50,,,percent of total billed charges,50% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,651.17,17.136,,,percent of total billed charges,17.136% of total billed charges,829.92,21.84,,,percent of total billed charges,21.84% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1432.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1432.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1288.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,2964,78,,,percent of total billed charges,78% of total billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,3138.8,82.6,,,percent of total billed charges,82.6% of total billed charges,3138.8,82.6,,,percent of total billed charges,82.6% of total billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1900,50,,,percent of total billed charges,50% of total Billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,581.4,3800,
BIOMET BURR HOLE COVER,ORSUP0021,CDM,278,RC,C1713,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
BIOPSY EXCISOR FISHER CONE,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BIOPSY PUNCH DISPOSABLE ASSORTED SIZES,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BIOPSY PUNCH DISPOSABLE 4MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BIOPSY PUNCH DISPOSABLE 5MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BIOPSY PUNCH DISPOSABLE 8MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BIOPSY PUNCH DERMAL 4MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BIOPSY PUNCH ARGENT DERMAL 3.5MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BIOSWIVELLOCK 4.5 CLOSED EYE,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BIPOLAR TUBE SET,ORSUP0009,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BIRKETT GRASPER/DISSECTOR TIP,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BIT 1.6MM DRILL,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
BIT DRILL 1.1MM,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
BIT DRILL 3.2MM  X 145MM  (QC),ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
BIT DRILL 3.2MM CANNULATED,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
BIT DRILL 90MMX1.8MM J LTCH,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BIT DRILL CANNULATED STAINLESS STEEL 7MM DIA,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
BIT DRILL CANNULTD 2.0MM QUIC COUPLNG 150MM/20MM,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
BIT DRILL J LATCH STRYKER 1.5MM 75MM/50MM,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
BIT DRILL LG L300MM OD7.3MM QC,ORSUP0040,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
BIT DRILL QUICK COUPLE 310.67,ORSUP0030,CDM,272,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
BIT DRILL QUICK COUPLING 2.5MM DIA 110/85MM L,ORSUP0016,CDM,272,RC,,,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,199,17.304,,,percent of total billed charges,17.304% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,724.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,15.3,,,percent of total billed charges,15.3% of total billed charges,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,711.28,61.85,,,percent of total billed charges,61.85% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,197.06,17.136,,,percent of total billed charges,17.136% of total billed charges,251.16,21.84,,,percent of total billed charges,21.84% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,1150,
BIT DRILL QUICK COUPLING 2.7MM DIA 125/100MM L,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BIT DRILL QUICK COUPLING 2.8MM DIA 165MM LENGTH,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BIT DRILL QUICK COUPLING 3.5MM DIA 110/85MM L N/S,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BIT DRILL QUICK COUPLING 4.5MM D 145/120MM L N/S,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BIT DRILL THREE FLUTED 4.0MM DIA 195MM/170MM L,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BIT DRILL THREE FLUTED CALIBRATED 4.0MM 260/65MM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
BIT DRILL 0.76MM W/STOP 10MM,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
BITE BLOCKS,308822,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
BITE BLOCK DENTAL PROP LARGE ADULT,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
BLACK CAN LINER .90 MIL 24X32 500/CS,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
BLADE 120MM HELICAL,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
BLADE HELICAL 115MM,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
BLADE HELICAL 11MM,ORSUP0022,CDM,278,RC,C1713,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
BLADE MICRO ST STRYKER,ORSUP0006,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
BLADE SAW 31.0X9.0,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BLADE MED BONE MILL 5.0MM,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
BLADE 12 SURG STAINLESS STEEL,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
BLADE SAW SAGITTAL DUAL STR 25MM X 1.27MM X 90MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BLADE AGGRESSIVE PLUS 5.0,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BLADE 2296-033-526,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
BLADE SAW NEXBEN KNEE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BLADE SAW SAGITTAL DUAL STR 18MM X 1.27MM X 90MM,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
BLADE SAW 18.5X9,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BLADE ARTHRO 4.5 SYNOVATOR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BLADE ARTHRO INCISER 3.5MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BLADE BONECUTTER FULL RADIUS 4.5MM,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
BLADE INCISOR PLUS ELITE 4.5MM,ORSUP0025,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
BLADE RAD 40,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
BLADE SAW SHORT NARROW 15MM X 7MM,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
BLADE SHAVER  4.0MM SINUS W/IRRIGATION,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
BLADE TRI-CUT XPS 4.0MM  5/BX,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
BLADE SURGICAL CLIPPER 3M,54459,CDM,272,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
BLADE SURGICAL SIZE 11,148397,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
BLADE SURGICAL SZ 10 RIB-BACK CARBON STEEL,10182,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
BLADE BEAVER TYMPANOPLATSTY,32669,CDM,272,RC,,,Outpatient,,,112,72.80,,98.56,88,,,percent of total billed charges,88% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,19.38,17.304,,,percent of total billed charges,17.304% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,70.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,15.3,,,percent of total billed charges,15.3% of total billed charges,77.28,69,,,percent of total billed charges,69% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,69.27,61.85,,,percent of total billed charges,61.85% of total billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,19.19,17.136,,,percent of total billed charges,17.136% of total billed charges,24.46,21.84,,,percent of total billed charges,21.84% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,87.36,78,,,percent of total billed charges,78% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,112,
BLADE BEAVER 6400,120153,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
BLADDER COMPRESSION,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
BLADE LARYN BRITEPRO SOLO MAC 4 DISP F/O 10/BX,424997,CDM,272,RC,,,Outpatient,,,98,63.70,,86.24,88,,,percent of total billed charges,88% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,16.96,17.304,,,percent of total billed charges,17.304% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,61.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.99,15.3,,,percent of total billed charges,15.3% of total billed charges,67.62,69,,,percent of total billed charges,69% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,60.61,61.85,,,percent of total billed charges,61.85% of total billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.79,17.136,,,percent of total billed charges,17.136% of total billed charges,21.4,21.84,,,percent of total billed charges,21.84% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,76.44,78,,,percent of total billed charges,78% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.99,98,
BLADE LARYN MAC SZ 3,461575,CDM,272,RC,,,Outpatient,,,381,247.65,,335.28,88,,,percent of total billed charges,88% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,381,100,,,percent of total billed charges,100% of total billed charges,65.93,17.304,,,percent of total billed charges,17.304% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,240.03,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,58.29,15.3,,,percent of total billed charges,15.3% of total billed charges,262.89,69,,,percent of total billed charges,69% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,381,100,,,percent of total billed charges,100% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,381,100,,,percent of total billed charges,100% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,235.65,61.85,,,percent of total billed charges,61.85% of total billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,65.29,17.136,,,percent of total billed charges,17.136% of total billed charges,83.21,21.84,,,percent of total billed charges,21.84% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,190.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190.5,50,,,percent of total billed charges,50% of total Billed charges,297.18,78,,,percent of total billed charges,78% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190.5,50,,,percent of total billed charges,50% of total Billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,58.29,381,
BLADE LARYNG DISP BRITE PRO FIBER OPTIC  MILLER 2,440193,CDM,272,RC,,,Outpatient,,,381,247.65,,335.28,88,,,percent of total billed charges,88% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,381,100,,,percent of total billed charges,100% of total billed charges,65.93,17.304,,,percent of total billed charges,17.304% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,240.03,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,58.29,15.3,,,percent of total billed charges,15.3% of total billed charges,262.89,69,,,percent of total billed charges,69% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,381,100,,,percent of total billed charges,100% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,381,100,,,percent of total billed charges,100% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,235.65,61.85,,,percent of total billed charges,61.85% of total billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,65.29,17.136,,,percent of total billed charges,17.136% of total billed charges,83.21,21.84,,,percent of total billed charges,21.84% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,190.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190.5,50,,,percent of total billed charges,50% of total Billed charges,297.18,78,,,percent of total billed charges,78% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190.5,50,,,percent of total billed charges,50% of total Billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,58.29,381,
BLADE LARYNG DISP BRITE PRO FIBER OPTIC MAC  2,440195,CDM,272,RC,,,Outpatient,,,334,217.10,,293.92,88,,,percent of total billed charges,88% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,334,100,,,percent of total billed charges,100% of total billed charges,57.8,17.304,,,percent of total billed charges,17.304% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,210.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,51.1,15.3,,,percent of total billed charges,15.3% of total billed charges,230.46,69,,,percent of total billed charges,69% of total billed charges,334,100,,,percent of total billed charges,100% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,334,100,,,percent of total billed charges,100% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,334,100,,,percent of total billed charges,100% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,206.58,61.85,,,percent of total billed charges,61.85% of total billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,57.23,17.136,,,percent of total billed charges,17.136% of total billed charges,72.95,21.84,,,percent of total billed charges,21.84% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,167,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,167,50,,,percent of total billed charges,50% of total Billed charges,260.52,78,,,percent of total billed charges,78% of total billed charges,334,100,,,percent of total billed charges,100% of total billed charges,275.88,82.6,,,percent of total billed charges,82.6% of total billed charges,275.88,82.6,,,percent of total billed charges,82.6% of total billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,167,50,,,percent of total billed charges,50% of total Billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,51.1,334,
BLADE OPTIC MILLER SIZE 3,442567,CDM,272,RC,,,Outpatient,,,381,247.65,,335.28,88,,,percent of total billed charges,88% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,381,100,,,percent of total billed charges,100% of total billed charges,65.93,17.304,,,percent of total billed charges,17.304% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,240.03,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,58.29,15.3,,,percent of total billed charges,15.3% of total billed charges,262.89,69,,,percent of total billed charges,69% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,381,100,,,percent of total billed charges,100% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,381,100,,,percent of total billed charges,100% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,235.65,61.85,,,percent of total billed charges,61.85% of total billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,65.29,17.136,,,percent of total billed charges,17.136% of total billed charges,83.21,21.84,,,percent of total billed charges,21.84% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,190.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190.5,50,,,percent of total billed charges,50% of total Billed charges,297.18,78,,,percent of total billed charges,78% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,190.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,190.5,50,,,percent of total billed charges,50% of total Billed charges,64.01,16.8,,,percent of total billed charges,16.8% of total billed charges,58.29,381,
"BLADE, LARYN, BRITEPRO SOLO , MAC 3, DISP, F/O 10/BX",420521,CDM,272,RC,,,Outpatient,,,98,63.70,,86.24,88,,,percent of total billed charges,88% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,16.96,17.304,,,percent of total billed charges,17.304% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,61.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.99,15.3,,,percent of total billed charges,15.3% of total billed charges,67.62,69,,,percent of total billed charges,69% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,60.61,61.85,,,percent of total billed charges,61.85% of total billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.79,17.136,,,percent of total billed charges,17.136% of total billed charges,21.4,21.84,,,percent of total billed charges,21.84% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,76.44,78,,,percent of total billed charges,78% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.99,98,
BLADE DERMATOME 252 PADGETT,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BLADDER SLING LYNX,ORSUP0051,CDM,278,RC,C1771,HCPCS,Outpatient,,,10400,6760.00,,9152,88,,,percent of total billed charges,88% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1799.62,17.304,,,percent of total billed charges,17.304% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,6552,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,15.3,,,percent of total billed charges,15.3% of total billed charges,7176,69,,,percent of total billed charges,69% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,6432.4,61.85,,,percent of total billed charges,61.85% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3244.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1782.14,17.136,,,percent of total billed charges,17.136% of total billed charges,2271.36,21.84,,,percent of total billed charges,21.84% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3920.8,37.7,,,percent of total billed charges,37.70% of total billed charges,3920.8,37.7,,,percent of total billed charges,37.70% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3525.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,8112,78,,,percent of total billed charges,78% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,10400,
BLADE SAGITTAL 18 X 1.27 X 100,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
BLADE SHAVER AGGRESSIVE ENT,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BLADE #15 SURGICAL SAFETY,490128,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
BLADE #11 SURGICAL SAFETY,490127,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
BLADE #10 SURGICAL SAFETY,490126,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
BLADE #20 SURGICAL SAFETY,490129,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
BLADE SAW 2296-33-125,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
BLADE SAW CRESCENTIC 38MM,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BLADE SAW CRESCENTIC 51MM,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BLADE SAGITTAL 6113-127-090,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
BLADE SAGITTAL 31MM X 9.0MM,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
BLADE SAGITTAL 25MM X 5.5MM,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
BLADE SAGITTAL 18MM X 5.5MM,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
BLADE SAGITTAL 18.5MM X 9.0MM,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
BLADE MYRINGOTOMY,490135,CDM,272,RC,,,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,7.27,17.304,,,percent of total billed charges,17.304% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,26.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,15.3,,,percent of total billed charges,15.3% of total billed charges,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.2,17.136,,,percent of total billed charges,17.136% of total billed charges,9.17,21.84,,,percent of total billed charges,21.84% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,42,
BLADE MAXI L124,490134,CDM,272,RC,,,Outpatient,,,554,360.10,,487.52,88,,,percent of total billed charges,88% of total Billed charges,277,50,,,percent of total billed charges,50% of total Billed charges,93.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,554,100,,,percent of total billed charges,100% of total billed charges,95.86,17.304,,,percent of total billed charges,17.304% of total billed charges,277,50,,,percent of total billed charges,50% of total Billed charges,349.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,93.07,16.8,,,percent of total billed charges,16.8% of total billed charges,84.76,15.3,,,percent of total billed charges,15.3% of total billed charges,382.26,69,,,percent of total billed charges,69% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,277,50,,,percent of total billed charges,50% of total Billed charges,554,100,,,percent of total billed charges,100% of total billed charges,277,50,,,percent of total billed charges,50% of total Billed charges,554,100,,,percent of total billed charges,100% of total billed charges,277,50,,,percent of total billed charges,50% of total Billed charges,342.65,61.85,,,percent of total billed charges,61.85% of total billed charges,93.07,16.8,,,percent of total billed charges,16.8% of total billed charges,277,50,,,percent of total billed charges,50% of total Billed charges,277,50,,,percent of total billed charges,50% of total Billed charges,93.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,277,50,,,percent of total billed charges,50% of total Billed charges,277,50,,,percent of total billed charges,50% of total Billed charges,94.93,17.136,,,percent of total billed charges,17.136% of total billed charges,120.99,21.84,,,percent of total billed charges,21.84% of total billed charges,277,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,277,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,277,50,,,percent of total billed charges,50% of total Billed charges,432.12,78,,,percent of total billed charges,78% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,93.07,16.8,,,percent of total billed charges,16.8% of total billed charges,277,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,277,50,,,percent of total billed charges,50% of total Billed charges,93.07,16.8,,,percent of total billed charges,16.8% of total billed charges,84.76,554,
BLADDER SLING OBTRYX II,ORSUP0049,CDM,278,RC,C1771,HCPCS,Outpatient,,,9880,6422.00,,8694.4,88,,,percent of total billed charges,88% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1709.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,6224.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1511.64,15.3,,,percent of total billed charges,15.3% of total billed charges,6817.2,69,,,percent of total billed charges,69% of total billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,6110.78,61.85,,,percent of total billed charges,61.85% of total billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,3082.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4940,50,,,percent of total billed charges,50% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,1693.04,17.136,,,percent of total billed charges,17.136% of total billed charges,2157.79,21.84,,,percent of total billed charges,21.84% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,3724.76,37.7,,,percent of total billed charges,37.70% of total billed charges,3724.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,3349.32,33.9,,,percent of total billed charges,33.9% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,7706.4,78,,,percent of total billed charges,78% of total billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,8160.88,82.6,,,percent of total billed charges,82.6% of total billed charges,8160.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4940,50,,,percent of total billed charges,50% of total Billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1511.64,9880,
BLADE BEAVER 9081,490132,CDM,272,RC,,,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,20.76,17.304,,,percent of total billed charges,17.304% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.56,17.136,,,percent of total billed charges,17.136% of total billed charges,26.21,21.84,,,percent of total billed charges,21.84% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,120,
BLADE BEAVER 6700,490131,CDM,272,RC,,,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,7.09,17.304,,,percent of total billed charges,17.304% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,15.3,,,percent of total billed charges,15.3% of total billed charges,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.36,61.85,,,percent of total billed charges,61.85% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,7.03,17.136,,,percent of total billed charges,17.136% of total billed charges,8.95,21.84,,,percent of total billed charges,21.84% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,41,
BLADE BEAVER MINI 6600,490133,CDM,272,RC,,,Outpatient,,,126,81.90,,110.88,88,,,percent of total billed charges,88% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,126,100,,,percent of total billed charges,100% of total billed charges,21.8,17.304,,,percent of total billed charges,17.304% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,79.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,19.28,15.3,,,percent of total billed charges,15.3% of total billed charges,86.94,69,,,percent of total billed charges,69% of total billed charges,126,100,,,percent of total billed charges,100% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,126,100,,,percent of total billed charges,100% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,126,100,,,percent of total billed charges,100% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,77.93,61.85,,,percent of total billed charges,61.85% of total billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,21.59,17.136,,,percent of total billed charges,17.136% of total billed charges,27.52,21.84,,,percent of total billed charges,21.84% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,63,50,,,percent of total billed charges,50% of total Billed charges,98.28,78,,,percent of total billed charges,78% of total billed charges,126,100,,,percent of total billed charges,100% of total billed charges,104.08,82.6,,,percent of total billed charges,82.6% of total billed charges,104.08,82.6,,,percent of total billed charges,82.6% of total billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,63,50,,,percent of total billed charges,50% of total Billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,19.28,126,
BLADE FULL RADIUS 2.5MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
BLADE SAW 18X5.5MM DUAL CUT HAMMERTOE,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
BLAKE DRAIN 15 FR ROUND,ORSUP0003,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
BLANKET CARDIAC BAIR HUGGER,14176,CDM,272,RC,,,Outpatient,,,242,157.30,,212.96,88,,,percent of total billed charges,88% of total Billed charges,121,50,,,percent of total billed charges,50% of total Billed charges,40.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,242,100,,,percent of total billed charges,100% of total billed charges,41.88,17.304,,,percent of total billed charges,17.304% of total billed charges,121,50,,,percent of total billed charges,50% of total Billed charges,152.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,40.66,16.8,,,percent of total billed charges,16.8% of total billed charges,37.03,15.3,,,percent of total billed charges,15.3% of total billed charges,166.98,69,,,percent of total billed charges,69% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,121,50,,,percent of total billed charges,50% of total Billed charges,242,100,,,percent of total billed charges,100% of total billed charges,121,50,,,percent of total billed charges,50% of total Billed charges,242,100,,,percent of total billed charges,100% of total billed charges,121,50,,,percent of total billed charges,50% of total Billed charges,149.68,61.85,,,percent of total billed charges,61.85% of total billed charges,40.66,16.8,,,percent of total billed charges,16.8% of total billed charges,121,50,,,percent of total billed charges,50% of total Billed charges,121,50,,,percent of total billed charges,50% of total Billed charges,40.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,121,50,,,percent of total billed charges,50% of total Billed charges,121,50,,,percent of total billed charges,50% of total Billed charges,41.47,17.136,,,percent of total billed charges,17.136% of total billed charges,52.85,21.84,,,percent of total billed charges,21.84% of total billed charges,121,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,121,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,121,50,,,percent of total billed charges,50% of total Billed charges,188.76,78,,,percent of total billed charges,78% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,40.66,16.8,,,percent of total billed charges,16.8% of total billed charges,121,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,121,50,,,percent of total billed charges,50% of total Billed charges,40.66,16.8,,,percent of total billed charges,16.8% of total billed charges,37.03,242,
BLANKET WARMING FULL BODY,11956,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
BLANKET WARMING UNDERBODY CARDIAC 188X91 CM,258716,CDM,272,RC,,,Outpatient,,,214,139.10,,188.32,88,,,percent of total billed charges,88% of total Billed charges,107,50,,,percent of total billed charges,50% of total Billed charges,35.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,214,100,,,percent of total billed charges,100% of total billed charges,37.03,17.304,,,percent of total billed charges,17.304% of total billed charges,107,50,,,percent of total billed charges,50% of total Billed charges,134.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,35.95,16.8,,,percent of total billed charges,16.8% of total billed charges,32.74,15.3,,,percent of total billed charges,15.3% of total billed charges,147.66,69,,,percent of total billed charges,69% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,107,50,,,percent of total billed charges,50% of total Billed charges,214,100,,,percent of total billed charges,100% of total billed charges,107,50,,,percent of total billed charges,50% of total Billed charges,214,100,,,percent of total billed charges,100% of total billed charges,107,50,,,percent of total billed charges,50% of total Billed charges,132.36,61.85,,,percent of total billed charges,61.85% of total billed charges,35.95,16.8,,,percent of total billed charges,16.8% of total billed charges,107,50,,,percent of total billed charges,50% of total Billed charges,107,50,,,percent of total billed charges,50% of total Billed charges,35.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,107,50,,,percent of total billed charges,50% of total Billed charges,107,50,,,percent of total billed charges,50% of total Billed charges,36.67,17.136,,,percent of total billed charges,17.136% of total billed charges,46.74,21.84,,,percent of total billed charges,21.84% of total billed charges,107,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,107,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,107,50,,,percent of total billed charges,50% of total Billed charges,166.92,78,,,percent of total billed charges,78% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,35.95,16.8,,,percent of total billed charges,16.8% of total billed charges,107,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,107,50,,,percent of total billed charges,50% of total Billed charges,35.95,16.8,,,percent of total billed charges,16.8% of total billed charges,32.74,214,
BLANKET HYPOTHERMIA LG,10742,CDM,272,RC,,,Outpatient,,,78,50.70,,68.64,88,,,percent of total billed charges,88% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,13.5,17.304,,,percent of total billed charges,17.304% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,49.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,15.3,,,percent of total billed charges,15.3% of total billed charges,53.82,69,,,percent of total billed charges,69% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,48.24,61.85,,,percent of total billed charges,61.85% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.37,17.136,,,percent of total billed charges,17.136% of total billed charges,17.04,21.84,,,percent of total billed charges,21.84% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,60.84,78,,,percent of total billed charges,78% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,78,
BLANKET WARMING BODY LOWER SINGLE USE 58IN X 34IN,12094,CDM,272,RC,,,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,9.69,17.304,,,percent of total billed charges,17.304% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,35.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.6,17.136,,,percent of total billed charges,17.136% of total billed charges,12.23,21.84,,,percent of total billed charges,21.84% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,56,
BLANKET COVERLET BELLA  9 X 11,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BLANKET TORSO BAIR HUGGER,490158,CDM,272,RC,,,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,7.27,17.304,,,percent of total billed charges,17.304% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,26.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,15.3,,,percent of total billed charges,15.3% of total billed charges,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.2,17.136,,,percent of total billed charges,17.136% of total billed charges,9.17,21.84,,,percent of total billed charges,21.84% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,42,
BLANKET LITHOTOMY UNDERBODY,490155,CDM,272,RC,,,Outpatient,,,1605,1043.25,,1412.4,88,,,percent of total billed charges,88% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,277.73,17.304,,,percent of total billed charges,17.304% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1011.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,245.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1107.45,69,,,percent of total billed charges,69% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,992.69,61.85,,,percent of total billed charges,61.85% of total billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,275.03,17.136,,,percent of total billed charges,17.136% of total billed charges,350.53,21.84,,,percent of total billed charges,21.84% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,1251.9,78,,,percent of total billed charges,78% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,245.57,1605,
BLANKET UNDERBODY ADULT,490159,CDM,272,RC,,,Outpatient,,,137,89.05,,120.56,88,,,percent of total billed charges,88% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,137,100,,,percent of total billed charges,100% of total billed charges,23.71,17.304,,,percent of total billed charges,17.304% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,86.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,20.96,15.3,,,percent of total billed charges,15.3% of total billed charges,94.53,69,,,percent of total billed charges,69% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,137,100,,,percent of total billed charges,100% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,137,100,,,percent of total billed charges,100% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,84.73,61.85,,,percent of total billed charges,61.85% of total billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.48,17.136,,,percent of total billed charges,17.136% of total billed charges,29.92,21.84,,,percent of total billed charges,21.84% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,68.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,68.5,50,,,percent of total billed charges,50% of total Billed charges,106.86,78,,,percent of total billed charges,78% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,20.96,137,
BLANKET SPINAL UNDERBODY,490157,CDM,272,RC,,,Outpatient,,,204,132.60,,179.52,88,,,percent of total billed charges,88% of total Billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,34.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,204,100,,,percent of total billed charges,100% of total billed charges,35.3,17.304,,,percent of total billed charges,17.304% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,128.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.27,16.8,,,percent of total billed charges,16.8% of total billed charges,31.21,15.3,,,percent of total billed charges,15.3% of total billed charges,140.76,69,,,percent of total billed charges,69% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,204,100,,,percent of total billed charges,100% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,204,100,,,percent of total billed charges,100% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,126.17,61.85,,,percent of total billed charges,61.85% of total billed charges,34.27,16.8,,,percent of total billed charges,16.8% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,34.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,34.96,17.136,,,percent of total billed charges,17.136% of total billed charges,44.55,21.84,,,percent of total billed charges,21.84% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,102,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,102,50,,,percent of total billed charges,50% of total Billed charges,159.12,78,,,percent of total billed charges,78% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,34.27,16.8,,,percent of total billed charges,16.8% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,102,50,,,percent of total billed charges,50% of total Billed charges,34.27,16.8,,,percent of total billed charges,16.8% of total billed charges,31.21,204,
BLANKET UPPER BODY,490160,CDM,272,RC,,,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,7.27,17.304,,,percent of total billed charges,17.304% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,26.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,15.3,,,percent of total billed charges,15.3% of total billed charges,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.2,17.136,,,percent of total billed charges,17.136% of total billed charges,9.17,21.84,,,percent of total billed charges,21.84% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,42,
BLANKET MULTI-ACCESS,490156,CDM,272,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
BLANKET WARMING UPPER BODY,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BLEACH CLOROX GERMICIDAL 121 OZ,182952,CDM,270,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
BLOCK ILIUM TRICORTICAL 16MM,ORSUP0028,CDM,278,RC,C1762,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
BLOCK BITE ENDOSCOPY W/ STRAP DISPOSABLE,184405,CDM,270,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
BLOCK ECHO 80MM,ORSUP0017,CDM,270,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
BLOCKER XIA 3 TI,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BLOODSTOP iX HEMOSTATIC 2 X 4,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
AGAR BLOOD SLANT WITH SHEEP BLOOD,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BLOX ENDOSCOPIC BITE BLOCK WITH ELASTIC STRAP 54FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BLUE FIBER CABLE KIT,ORSUP0068,CDM,272,RC,,,Outpatient,,,13260,8619.00,,11668.8,88,,,percent of total billed charges,88% of total Billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,2227.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2294.51,17.304,,,percent of total billed charges,17.304% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,8353.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2227.68,16.8,,,percent of total billed charges,16.8% of total billed charges,2028.78,15.3,,,percent of total billed charges,15.3% of total billed charges,9149.4,69,,,percent of total billed charges,69% of total billed charges,13260,100,,,percent of total billed charges,100% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,13260,100,,,percent of total billed charges,100% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,13260,100,,,percent of total billed charges,100% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,8201.31,61.85,,,percent of total billed charges,61.85% of total billed charges,2227.68,16.8,,,percent of total billed charges,16.8% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,2227.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,2272.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2895.98,21.84,,,percent of total billed charges,21.84% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6630,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6630,50,,,percent of total billed charges,50% of total Billed charges,10342.8,78,,,percent of total billed charges,78% of total billed charges,13260,100,,,percent of total billed charges,100% of total billed charges,10952.76,82.6,,,percent of total billed charges,82.6% of total billed charges,10952.76,82.6,,,percent of total billed charges,82.6% of total billed charges,2227.68,16.8,,,percent of total billed charges,16.8% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6630,50,,,percent of total billed charges,50% of total Billed charges,2227.68,16.8,,,percent of total billed charges,16.8% of total billed charges,2028.78,13260,
BNDG ELASTIC 4 INCH,56101,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
BNP REAGENT KIT,ORSUP0002,CDM,272,RC,,,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,12.11,17.304,,,percent of total billed charges,17.304% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,44.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,12,17.136,,,percent of total billed charges,17.136% of total billed charges,15.29,21.84,,,percent of total billed charges,21.84% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,70,
BNP CALIBRATOR,ORSUP0008,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
BODY WASH KINDEST KARE,202813,CDM,270,RC,,,Outpatient,,,44,28.60,,38.72,88,,,percent of total billed charges,88% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,7.61,17.304,,,percent of total billed charges,17.304% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,15.3,,,percent of total billed charges,15.3% of total billed charges,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.21,61.85,,,percent of total billed charges,61.85% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.54,17.136,,,percent of total billed charges,17.136% of total billed charges,9.61,21.84,,,percent of total billed charges,21.84% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,44,
BOLT LOCKING 4.9MMX34MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BOLT LOCKING 4.9MMX42MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BONE CEMET K11402PHX HVR,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
BONE SYNTHETIC CHRONOS BETA-TCP STRIP 100MM X 25MM X 3MM-STERILE 07.801.101.99S,ORSUP0036,CDM,278,RC,C1713,HCPCS,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4095,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
BONE COLLAGEN GRAFT MATRIX XL BLOCK LRG,ORSUP0037,CDM,278,RC,C1762,HCPCS,Outpatient,,,6760,4394.00,,5948.8,88,,,percent of total billed charges,88% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1169.75,17.304,,,percent of total billed charges,17.304% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4258.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,15.3,,,percent of total billed charges,15.3% of total billed charges,4664.4,69,,,percent of total billed charges,69% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4181.06,61.85,,,percent of total billed charges,61.85% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2109.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1158.39,17.136,,,percent of total billed charges,17.136% of total billed charges,1476.38,21.84,,,percent of total billed charges,21.84% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2291.64,33.9,,,percent of total billed charges,33.9% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,5272.8,78,,,percent of total billed charges,78% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,6760,
BONE GRAFT SUBSTITUTE  SM DFCT DBM ORTHOBLEN,ORSUP0031,CDM,278,RC,C1762,HCPCS,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
BONE SUB VITOSS STRIP 10CC,ORSUP0047,CDM,278,RC,C1763,HCPCS,Outpatient,,,9360,6084.00,,8236.8,88,,,percent of total billed charges,88% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1619.65,17.304,,,percent of total billed charges,17.304% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,5896.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1432.08,15.3,,,percent of total billed charges,15.3% of total billed charges,6458.4,69,,,percent of total billed charges,69% of total billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,5789.16,61.85,,,percent of total billed charges,61.85% of total billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,2920.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4680,50,,,percent of total billed charges,50% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,1603.93,17.136,,,percent of total billed charges,17.136% of total billed charges,2044.22,21.84,,,percent of total billed charges,21.84% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,3528.72,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.72,37.7,,,percent of total billed charges,37.70% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,3173.04,33.9,,,percent of total billed charges,33.9% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,7300.8,78,,,percent of total billed charges,78% of total billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,7731.36,82.6,,,percent of total billed charges,82.6% of total billed charges,7731.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4680,50,,,percent of total billed charges,50% of total Billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1432.08,9360,
BONE BIOPSY 11 GUAGE 306-115,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BONE BIOPSY 13 GUAGE 306-135,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BONE BIOPSY KYPHYX,ORSUP0015,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BONE TAMP KIT 20/3,ORSUP0092,CDM,272,RC,,,Outpatient,,,19240,12506.00,,16931.2,88,,,percent of total billed charges,88% of total Billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3329.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,12121.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,2943.72,15.3,,,percent of total billed charges,15.3% of total billed charges,13275.6,69,,,percent of total billed charges,69% of total billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,11899.94,61.85,,,percent of total billed charges,61.85% of total billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,3296.97,17.136,,,percent of total billed charges,17.136% of total billed charges,4202.02,21.84,,,percent of total billed charges,21.84% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9620,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9620,50,,,percent of total billed charges,50% of total Billed charges,15007.2,78,,,percent of total billed charges,78% of total billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,15892.24,82.6,,,percent of total billed charges,82.6% of total billed charges,15892.24,82.6,,,percent of total billed charges,82.6% of total billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9620,50,,,percent of total billed charges,50% of total Billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,2943.72,19240,
BONE TAMP KIT 15/3 1 STEP,ORSUP0098,CDM,272,RC,,,Outpatient,,,23140,15041.00,,20363.2,88,,,percent of total billed charges,88% of total Billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4004.15,17.304,,,percent of total billed charges,17.304% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,14578.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,3540.42,15.3,,,percent of total billed charges,15.3% of total billed charges,15966.6,69,,,percent of total billed charges,69% of total billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,14312.09,61.85,,,percent of total billed charges,61.85% of total billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,3965.27,17.136,,,percent of total billed charges,17.136% of total billed charges,5053.78,21.84,,,percent of total billed charges,21.84% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11570,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11570,50,,,percent of total billed charges,50% of total Billed charges,18049.2,78,,,percent of total billed charges,78% of total billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,19113.64,82.6,,,percent of total billed charges,82.6% of total billed charges,19113.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11570,50,,,percent of total billed charges,50% of total Billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,3540.42,23140,
BONE TAMP KIT 15/3,ORSUP0105,CDM,272,RC,,,Outpatient,,,19240,12506.00,,16931.2,88,,,percent of total billed charges,88% of total Billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3329.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,12121.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,2943.72,15.3,,,percent of total billed charges,15.3% of total billed charges,13275.6,69,,,percent of total billed charges,69% of total billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,11899.94,61.85,,,percent of total billed charges,61.85% of total billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,3296.97,17.136,,,percent of total billed charges,17.136% of total billed charges,4202.02,21.84,,,percent of total billed charges,21.84% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9620,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9620,50,,,percent of total billed charges,50% of total Billed charges,15007.2,78,,,percent of total billed charges,78% of total billed charges,19240,100,,,percent of total billed charges,100% of total billed charges,15892.24,82.6,,,percent of total billed charges,82.6% of total billed charges,15892.24,82.6,,,percent of total billed charges,82.6% of total billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,9620,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9620,50,,,percent of total billed charges,50% of total Billed charges,3232.32,16.8,,,percent of total billed charges,16.8% of total billed charges,2943.72,19240,
BONE WAX 2.5G,13777,CDM,272,RC,,,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.13,17.304,,,percent of total billed charges,17.304% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,8.05,17.136,,,percent of total billed charges,17.136% of total billed charges,10.26,21.84,,,percent of total billed charges,21.84% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,47,
BONE CEMENT,ORSUP0015,CDM,278,RC,C1763,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
BONE PUTTY DBX,ORSUP0011,CDM,278,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BONE TAMP KIT 20/3 1 STEP,ORSUP0125,CDM,272,RC,,,Outpatient,,,23200,15080.00,,20416,88,,,percent of total billed charges,88% of total Billed charges,11600,50,,,percent of total billed charges,50% of total Billed charges,3897.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4014.53,17.304,,,percent of total billed charges,17.304% of total billed charges,11600,50,,,percent of total billed charges,50% of total Billed charges,14616,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3897.6,16.8,,,percent of total billed charges,16.8% of total billed charges,3549.6,15.3,,,percent of total billed charges,15.3% of total billed charges,16008,69,,,percent of total billed charges,69% of total billed charges,23200,100,,,percent of total billed charges,100% of total billed charges,11600,50,,,percent of total billed charges,50% of total Billed charges,23200,100,,,percent of total billed charges,100% of total billed charges,11600,50,,,percent of total billed charges,50% of total Billed charges,23200,100,,,percent of total billed charges,100% of total billed charges,11600,50,,,percent of total billed charges,50% of total Billed charges,14349.2,61.85,,,percent of total billed charges,61.85% of total billed charges,3897.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11600,50,,,percent of total billed charges,50% of total Billed charges,11600,50,,,percent of total billed charges,50% of total Billed charges,3897.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,11600,50,,,percent of total billed charges,50% of total Billed charges,11600,50,,,percent of total billed charges,50% of total Billed charges,3975.55,17.136,,,percent of total billed charges,17.136% of total billed charges,5066.88,21.84,,,percent of total billed charges,21.84% of total billed charges,11600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11600,50,,,percent of total billed charges,50% of total Billed charges,18096,78,,,percent of total billed charges,78% of total billed charges,23200,100,,,percent of total billed charges,100% of total billed charges,19163.2,82.6,,,percent of total billed charges,82.6% of total billed charges,19163.2,82.6,,,percent of total billed charges,82.6% of total billed charges,3897.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11600,50,,,percent of total billed charges,50% of total Billed charges,3897.6,16.8,,,percent of total billed charges,16.8% of total billed charges,3549.6,23200,
BONE PIN 3.2 X 140MM,ORSUP0016,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BONE CEMENT WITH MIXER,ORSUP0023,CDM,278,RC,C1763,HCPCS,Outpatient,,,2400,1560.00,,2112,88,,,percent of total billed charges,88% of total Billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,403.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,2400,100,,,percent of total billed charges,100% of total billed charges,415.3,17.304,,,percent of total billed charges,17.304% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,1512,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,403.2,16.8,,,percent of total billed charges,16.8% of total billed charges,367.2,15.3,,,percent of total billed charges,15.3% of total billed charges,1656,69,,,percent of total billed charges,69% of total billed charges,2400,100,,,percent of total billed charges,100% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,2400,100,,,percent of total billed charges,100% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,2400,100,,,percent of total billed charges,100% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,1484.4,61.85,,,percent of total billed charges,61.85% of total billed charges,403.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,748.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1200,50,,,percent of total billed charges,50% of total Billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,411.26,17.136,,,percent of total billed charges,17.136% of total billed charges,524.16,21.84,,,percent of total billed charges,21.84% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,904.8,37.7,,,percent of total billed charges,37.70% of total billed charges,904.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,813.6,33.9,,,percent of total billed charges,33.9% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,1872,78,,,percent of total billed charges,78% of total billed charges,2400,100,,,percent of total billed charges,100% of total billed charges,1982.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1982.4,82.6,,,percent of total billed charges,82.6% of total billed charges,403.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1200,50,,,percent of total billed charges,50% of total Billed charges,403.2,16.8,,,percent of total billed charges,16.8% of total billed charges,367.2,2400,
BONE MATRIX VIVIGEN FORMABLE CELLULAR 5CC,ORSUP0087,CDM,278,RC,C1763,HCPCS,Outpatient,,,20020,13013.00,,17617.6,88,,,percent of total billed charges,88% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3464.26,17.304,,,percent of total billed charges,17.304% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,12612.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3063.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13813.8,69,,,percent of total billed charges,69% of total billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,12382.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,6246.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10010,50,,,percent of total billed charges,50% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,3430.63,17.136,,,percent of total billed charges,17.136% of total billed charges,4372.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,7547.54,37.7,,,percent of total billed charges,37.70% of total billed charges,7547.54,37.7,,,percent of total billed charges,37.70% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,6786.78,33.9,,,percent of total billed charges,33.9% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,15615.6,78,,,percent of total billed charges,78% of total billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,16536.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16536.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3063.06,20020,
BONE MATRIX 2.5CC V92,ORSUP0061,CDM,278,RC,C1762,HCPCS,Outpatient,,,13260,8619.00,,11668.8,88,,,percent of total billed charges,88% of total Billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,2227.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2294.51,17.304,,,percent of total billed charges,17.304% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,8353.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2227.68,16.8,,,percent of total billed charges,16.8% of total billed charges,2028.78,15.3,,,percent of total billed charges,15.3% of total billed charges,9149.4,69,,,percent of total billed charges,69% of total billed charges,13260,100,,,percent of total billed charges,100% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,13260,100,,,percent of total billed charges,100% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,13260,100,,,percent of total billed charges,100% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,8201.31,61.85,,,percent of total billed charges,61.85% of total billed charges,2227.68,16.8,,,percent of total billed charges,16.8% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,4137.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6630,50,,,percent of total billed charges,50% of total Billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,2272.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2895.98,21.84,,,percent of total billed charges,21.84% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,4999.02,37.7,,,percent of total billed charges,37.70% of total billed charges,4999.02,37.7,,,percent of total billed charges,37.70% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,4495.14,33.9,,,percent of total billed charges,33.9% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,10342.8,78,,,percent of total billed charges,78% of total billed charges,13260,100,,,percent of total billed charges,100% of total billed charges,10952.76,82.6,,,percent of total billed charges,82.6% of total billed charges,10952.76,82.6,,,percent of total billed charges,82.6% of total billed charges,2227.68,16.8,,,percent of total billed charges,16.8% of total billed charges,6630,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6630,50,,,percent of total billed charges,50% of total Billed charges,2227.68,16.8,,,percent of total billed charges,16.8% of total billed charges,2028.78,13260,
JAMSHIDI BONE MARROW TRAY 4 NEEDLE,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
BONE MATRIX 1.0CC,ORSUP0035,CDM,278,RC,C1713,HCPCS,Outpatient,,,4800,3120.00,,4224,88,,,percent of total billed charges,88% of total Billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,806.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,830.59,17.304,,,percent of total billed charges,17.304% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,3024,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,806.4,16.8,,,percent of total billed charges,16.8% of total billed charges,734.4,15.3,,,percent of total billed charges,15.3% of total billed charges,3312,69,,,percent of total billed charges,69% of total billed charges,4800,100,,,percent of total billed charges,100% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,4800,100,,,percent of total billed charges,100% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,4800,100,,,percent of total billed charges,100% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,2968.8,61.85,,,percent of total billed charges,61.85% of total billed charges,806.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,1497.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2400,50,,,percent of total billed charges,50% of total Billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,822.53,17.136,,,percent of total billed charges,17.136% of total billed charges,1048.32,21.84,,,percent of total billed charges,21.84% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,1809.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1809.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,1627.2,33.9,,,percent of total billed charges,33.9% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,3744,78,,,percent of total billed charges,78% of total billed charges,4800,100,,,percent of total billed charges,100% of total billed charges,3964.8,82.6,,,percent of total billed charges,82.6% of total billed charges,3964.8,82.6,,,percent of total billed charges,82.6% of total billed charges,806.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2400,50,,,percent of total billed charges,50% of total Billed charges,806.4,16.8,,,percent of total billed charges,16.8% of total billed charges,734.4,4800,
BOOK ATTEST LOG 1266,110250,CDM,270,RC,,,Outpatient,,,71,46.15,,62.48,88,,,percent of total billed charges,88% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,12.29,17.304,,,percent of total billed charges,17.304% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,44.73,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,10.86,15.3,,,percent of total billed charges,15.3% of total billed charges,48.99,69,,,percent of total billed charges,69% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,43.91,61.85,,,percent of total billed charges,61.85% of total billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,12.17,17.136,,,percent of total billed charges,17.136% of total billed charges,15.51,21.84,,,percent of total billed charges,21.84% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,55.38,78,,,percent of total billed charges,78% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,10.86,71,
BOOT CONTOUR 2 WALKER SM,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BOOT CONTOUR 2 WALKER MED,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BOOT CONTOUR 2 WALKER LRG,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BOOT CAST ROCKER XL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BOOT AIR WALKER PROCARE SMALL,ORSUP0005,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BOOT AIR WALKER PROCARE MEDIUM,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BOOT AIR WALKER PROCARE LARGE,ORSUP0005,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BOOT AIR WALKER PROCARE XLARGE,ORSUP0005,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BOOT BLACK DELUX LEG TALL SZ SM,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BOOT BLACK DELIX LEG TALL SZ MED,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BOOT BLACK DELUX LEG TALL SZ LRG,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BOTTLE MEDLINE SOLIDIFIER 16000 CC,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
BOUFFANT HAT WHITE 24,490169,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
BOWIE-DICK TEST,490171,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
BOX MEMBRANE  K,ORSUP0024,CDM,270,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
BOX MEMBRANE Ca,ORSUP0024,CDM,270,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
BOX MEMBRANE pCO2,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
BOX MEMBRANE pO2,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
BRACE KNEE POST OP TSCOPE PREMIER,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
BREAST EXPANDER ARTOURA HI PRO,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"BREAST IMPLANT, NATRELLE INSPIRA SCM ---",ORSUP0034,CDM,278,RC,C1789,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
BREATHING CIRCUITS W/MASK,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BREATHING CIRCUITS,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
BREIF CLOTHLIKE XXL,454639,CDM,270,RC,,,Outpatient,,,95,61.75,,83.6,88,,,percent of total billed charges,88% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,16.44,17.304,,,percent of total billed charges,17.304% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,59.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,14.54,15.3,,,percent of total billed charges,15.3% of total billed charges,65.55,69,,,percent of total billed charges,69% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,58.76,61.85,,,percent of total billed charges,61.85% of total billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,16.28,17.136,,,percent of total billed charges,17.136% of total billed charges,20.75,21.84,,,percent of total billed charges,21.84% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,74.1,78,,,percent of total billed charges,78% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,14.54,95,
BRIEFS ADULT,428709,CDM,270,RC,,,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,12.46,17.304,,,percent of total billed charges,17.304% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,45.36,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,15.3,,,percent of total billed charges,15.3% of total billed charges,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,44.53,61.85,,,percent of total billed charges,61.85% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.34,17.136,,,percent of total billed charges,17.136% of total billed charges,15.72,21.84,,,percent of total billed charges,21.84% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,72,
BRIEF ADULT ULTRAPLUS LARGE,271657,CDM,272,RC,,,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,10.56,17.304,,,percent of total billed charges,17.304% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,38.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,37.73,61.85,,,percent of total billed charges,61.85% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.45,17.136,,,percent of total billed charges,17.136% of total billed charges,13.32,21.84,,,percent of total billed charges,21.84% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,61,
BRIEF MESH PANTY LARGE,30390,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
BRIEFS  ADULT MEDIUM,129198,CDM,272,RC,,,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,7.79,17.304,,,percent of total billed charges,17.304% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,27.83,61.85,,,percent of total billed charges,61.85% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.71,17.136,,,percent of total billed charges,17.136% of total billed charges,9.83,21.84,,,percent of total billed charges,21.84% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
BRIEFS FIT RIGHT PLUS XL,443101,CDM,272,RC,,,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,12.11,17.304,,,percent of total billed charges,17.304% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,44.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,12,17.136,,,percent of total billed charges,17.136% of total billed charges,15.29,21.84,,,percent of total billed charges,21.84% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,70,
BRIEF ATTENTDS XL BREATHABLE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BRIEFS ATTENDS BREATHABLE SIDE PANELS MED,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BRIEF ATTENDS MED BREATHABLE 32-44,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
BRITEBLADE PRO S/USE FIBRE OPTIC MILLER 1.5,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BRUSH SCRUB E Z W/O DETERGENT,142531,CDM,270,RC,,,Outpatient,,,68,44.20,,59.84,88,,,percent of total billed charges,88% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,68,100,,,percent of total billed charges,100% of total billed charges,11.77,17.304,,,percent of total billed charges,17.304% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,42.84,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,10.4,15.3,,,percent of total billed charges,15.3% of total billed charges,46.92,69,,,percent of total billed charges,69% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,68,100,,,percent of total billed charges,100% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,68,100,,,percent of total billed charges,100% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,42.06,61.85,,,percent of total billed charges,61.85% of total billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,11.65,17.136,,,percent of total billed charges,17.136% of total billed charges,14.85,21.84,,,percent of total billed charges,21.84% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34,50,,,percent of total billed charges,50% of total Billed charges,53.04,78,,,percent of total billed charges,78% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34,50,,,percent of total billed charges,50% of total Billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,10.4,68,
BRUSH SCRUB EZ 4% CHG,22089,CDM,270,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
BRUSH SCRUB SURGICAL W/IODOPHOR,159107,CDM,270,RC,,,Outpatient,,,76,49.40,,66.88,88,,,percent of total billed charges,88% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,13.15,17.304,,,percent of total billed charges,17.304% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,47.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,11.63,15.3,,,percent of total billed charges,15.3% of total billed charges,52.44,69,,,percent of total billed charges,69% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,47.01,61.85,,,percent of total billed charges,61.85% of total billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,13.02,17.136,,,percent of total billed charges,17.136% of total billed charges,16.6,21.84,,,percent of total billed charges,21.84% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,59.28,78,,,percent of total billed charges,78% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,11.63,76,
BRUSH CLEANING LARGE COMBINATION,315811,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
BRUSH ALGER (COMP UNIT W/BURR),ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
BRUSH CHANNEL OPENING,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BRUSH CYTOLOGY BC-15C DISPOSABLE STERILE,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
BRUSH SURG SCRUB BD E-Z SCRUB NAIL CLEAN,357302,CDM,270,RC,,,Outpatient,,,78,50.70,,68.64,88,,,percent of total billed charges,88% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,13.5,17.304,,,percent of total billed charges,17.304% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,49.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,15.3,,,percent of total billed charges,15.3% of total billed charges,53.82,69,,,percent of total billed charges,69% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,48.24,61.85,,,percent of total billed charges,61.85% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.37,17.136,,,percent of total billed charges,17.136% of total billed charges,17.04,21.84,,,percent of total billed charges,21.84% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,60.84,78,,,percent of total billed charges,78% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,78,
BRUSH SURGICAL SCRUB DRY NAIL CLEANER WITHOUT DETERGENT STER,315288,CDM,272,RC,,,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,9.69,17.304,,,percent of total billed charges,17.304% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,35.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.6,17.136,,,percent of total billed charges,17.136% of total billed charges,12.23,21.84,,,percent of total billed charges,21.84% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,56,
BRUSH RX CYSTOLOGY,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BRUSH TOOTHETTE,186602,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
CLEANING TOOTHBRUSH,490343,CDM,270,RC,,,Outpatient,,,51,33.15,,44.88,88,,,percent of total billed charges,88% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,8.83,17.304,,,percent of total billed charges,17.304% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,32.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,15.3,,,percent of total billed charges,15.3% of total billed charges,35.19,69,,,percent of total billed charges,69% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,31.54,61.85,,,percent of total billed charges,61.85% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.74,17.136,,,percent of total billed charges,17.136% of total billed charges,11.14,21.84,,,percent of total billed charges,21.84% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,39.78,78,,,percent of total billed charges,78% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,51,
BRUSH ENDOSOPIC DUAL END CHANNEL,ORSUP0001,CDM,278,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,15.59,33.9,,,percent of total billed charges,33.9% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BTL .45%SALINE SOLUTION 1L,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
"BUBBLE HUMIDIFIERS, PREFILLED",ORSUP0001,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
BUBBLE CPAP SYSTEM INFANT,ORSUP0008,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
BUBC / 5 PACK / 300 SLIDES,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
BUCKETS PLASTER,119912,CDM,270,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
BULB LARYNGOSCOPE W/A 06000U,131122,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
BULB SYRINGE,490174,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
BULB SYRINGE 60ML STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
BULB HALOGEN MACROVIEW OTOSCOPE 3.5V,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
BUR 4.0MM OVAL SOLID CARBIDE  EXTRA LONG,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BUR ACROMIOBLASTER 4.0,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BUR OVAL 8 FLUTE 4.0 X 13CM,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
BUR ROUND FLUTED 4.0MM,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BUR ROUND TAPERED 1.0MM ELITE,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BUR ROUND FLUTED 6.0MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BUR ROUND FLUTED 3.0MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BUR ROUND FLUTED 2.0MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BUR ROUND DIAMOND 4.0MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BUR ROUND DIAMOND 3.0MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BUR ROUND DIAMOND 2.0MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BUR ROUND DIAMOND 1.0MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
BUR ROUND FLUTED DIAMOND 2.0,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
BUR ROUND 5.0MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
BUR ROUND FLUTED 4MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
BURR HOLE BENT 13MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BURR HOLE COVER 17MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
BURR TI LOW PROFILE NEURO HOLE COVER 12MM DIA,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BURR TI LOW PROFILE NEURO HOLE COVER 17MM DIA,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BURR TI LOW PROFILE NEURO HOLE COVER FOR SHUNT 17MM,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
BURR ROTABLATOR 2.0MM,ORSUP0031,CDM,278,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
BURR SURG L9CM OD6MM LEGEND BALL,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BURR SURG OD2.5MM TB T16 LEGEND,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BURR OVAL 4.0MM,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
BURR 5.0 MM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
BURR HOLE COVER CONTOURED NEURO 3MM 12MM DIA 1.5MM SYS CP TITANIUM,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
BURR OVAL 8 FLUTE 4.0MM X 13CM,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
BURR ROUND 8 FLUTE 5.0MM X 13CM,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
BURR BONE FLUTED 5MM ROUND,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
BURR OVAL 4.0MM 8-FLUTE,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BURR BARREL 4.0MM 6-FLUTE,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
BURR SYNOVIAL 6MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
BURR ROUND DIAMOND 4.5MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
BUTTON DOG BONE,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
BYPASS HEAT \\T\\ MOISTURE EXCHANGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
C DIFF QUIK CHEK,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
C- REAMER 11MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
"C-ARM DRAPE, COMPLETE COVERAGE",490205,CDM,270,RC,,,Outpatient,,,99,64.35,,87.12,88,,,percent of total billed charges,88% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,17.13,17.304,,,percent of total billed charges,17.304% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,62.37,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,15.15,15.3,,,percent of total billed charges,15.3% of total billed charges,68.31,69,,,percent of total billed charges,69% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,61.23,61.85,,,percent of total billed charges,61.85% of total billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.96,17.136,,,percent of total billed charges,17.136% of total billed charges,21.62,21.84,,,percent of total billed charges,21.84% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,77.22,78,,,percent of total billed charges,78% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,15.15,99,
C-ARM COVER BANDED BAG 30X30,490204,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
C-DIFF/EPI GX IVD CARTRIDGES,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
C-LINE VERI STIM III,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
C-REAMER 8MM ARTHREX,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
C-REAMER 7MM ARTHREX,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
C-REAMER 9MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
C-REAMER 10MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
C-Section Level 3 Charge First 30 Min,SUR200054,CDM,360,RC,,,Outpatient,,,8052,5233.80,,7085.76,88,,,percent of total billed charges,88% of total Billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,1352.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1393.32,17.304,,,percent of total billed charges,17.304% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,5072.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1352.74,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,5555.88,69,,,percent of total billed charges,69% of total billed charges,8052,100,,,percent of total billed charges,100% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,8052,100,,,percent of total billed charges,100% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,8052,100,,,percent of total billed charges,100% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,4980.16,61.85,,,percent of total billed charges,61.85% of total billed charges,1352.74,16.8,,,percent of total billed charges,16.8% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,1352.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,1379.79,17.136,,,percent of total billed charges,17.136% of total billed charges,1758.56,21.84,,,percent of total billed charges,21.84% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,3035.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3035.6,37.7,,,percent of total billed charges,37.70% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,2729.63,33.9,,,percent of total billed charges,33.9% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,6280.56,78,,,percent of total billed charges,78% of total billed charges,8052,100,,,percent of total billed charges,100% of total billed charges,6650.95,82.6,,,percent of total billed charges,82.6% of total billed charges,6650.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1352.74,16.8,,,percent of total billed charges,16.8% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4026,50,,,percent of total billed charges,50% of total Billed charges,1352.74,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.74,8052,
C-Section Level 3 Charge ea addt'l 15 min,SUR200055,CDM,360,RC,,,Outpatient,,,3222,2094.30,,2835.36,88,,,percent of total billed charges,88% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,557.53,17.304,,,percent of total billed charges,17.304% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,2029.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2223.18,69,,,percent of total billed charges,69% of total billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1992.81,61.85,,,percent of total billed charges,61.85% of total billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,552.12,17.136,,,percent of total billed charges,17.136% of total billed charges,703.68,21.84,,,percent of total billed charges,21.84% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1214.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1214.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1092.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,2513.16,78,,,percent of total billed charges,78% of total billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,2661.37,82.6,,,percent of total billed charges,82.6% of total billed charges,2661.37,82.6,,,percent of total billed charges,82.6% of total billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,541.3,3367,
C9733 Non-Ophthalmic Fluorescent Vascular Angiography,ORSUP0015,CDM,278,RC,C9733,HCPCS,Outpatient,,,1013,658.45,,891.44,88,,,percent of total billed charges,88% of total Billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,272.87,100,,,Fee Schedule,100% of WA Medicaid,1013,100,,,percent of total billed charges,100% of total billed charges,281.05,103,,,Fee Schedule,103% of WA Medicaid,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,638.19,63,,,percent of total billed charges,63% of total billed charges,686.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.87,100,,,Fee Schedule,100% of WA Medicaid,154.99,15.3,,,percent of total billed charges,15.3% of total billed charges,698.97,69,,,percent of total billed charges,69% of total billed charges,1013,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1013,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1013,100,,,percent of total billed charges,100% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,1495.49,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,518.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,278.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.73,130,,,Fee Schedule,130% of WA Medicaid ,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,381.9,37.7,,,percent of total billed charges,37.70% of total billed charges,381.9,37.7,,,percent of total billed charges,37.70% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,343.41,33.9,,,percent of total billed charges,33.9% of total billed charges,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,790.14,78,,,percent of total billed charges,78% of total billed charges,1013,100,,,percent of total billed charges,100% of total billed charges,836.74,82.6,,,percent of total billed charges,82.6% of total billed charges,836.74,82.6,,,percent of total billed charges,82.6% of total billed charges,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,396.17,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,392.25,100,,,Fee Schedule,100% of Medicare OPPS rate,272.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,154.99,1495.49,
CABLE W/CRIMP 1.7MM 750MM STERILE,ORSUP0021,CDM,278,RC,C1713,HCPCS,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,811.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,881.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
CABLE INTERFACE  FOR DX W/AUTO ID  CATHETERS,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
CABLE INTERFACE FOR CURRENT NAV THERAPEUTIC CATH,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
CABLE INTERFACE FOR VARIABLE LASSO NAV CATH,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
CABLE INTERFACE  FOR EXISTING DX CATHETER BLUE PORT,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
CABLE CATH 6FT 10PIN,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
CABLE INTERFACE FOR THEMCOOL SF CATHETER,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
CABLE ECO-LASSO,ORSUP0023,CDM,270,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
CABLE PACING 5FR,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CABLE SLEEVE 2.0,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CABLE SLEEVE HOW 1.6,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CABLE 1.6 DALL MILES,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CABLE COBALT CHROME 2.0MM,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CADD MEDICATION RESERVOIR CASSETTE 100ML,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CADD EXTENSION SET 60,ORSUP0001,CDM,278,RC,S1015,HCPCS,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,35,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,35,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,11.87,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CAGE CAPSTONE 8X22MM,ORSUP0073,CDM,278,RC,C1755,HCPCS,Outpatient,,,16380,10647.00,,14414.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,2751.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2834.4,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2751.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2506.14,15.3,,,percent of total billed charges,15.3% of total billed charges,11302.2,69,,,percent of total billed charges,69% of total billed charges,16380,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,16380,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,16380,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2751.84,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5110.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2806.88,17.136,,,percent of total billed charges,17.136% of total billed charges,3577.39,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,6175.26,37.7,,,percent of total billed charges,37.70% of total billed charges,6175.26,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,5552.82,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,12776.4,78,,,percent of total billed charges,78% of total billed charges,16380,100,,,percent of total billed charges,100% of total billed charges,13529.88,82.6,,,percent of total billed charges,82.6% of total billed charges,13529.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2751.84,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2751.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2506.14,16380,
CAGE CAPSTONE 8X26MM,ORSUP0073,CDM,278,RC,C1755,HCPCS,Outpatient,,,16380,10647.00,,14414.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,2751.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2834.4,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2751.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2506.14,15.3,,,percent of total billed charges,15.3% of total billed charges,11302.2,69,,,percent of total billed charges,69% of total billed charges,16380,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,16380,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,16380,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2751.84,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5110.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2806.88,17.136,,,percent of total billed charges,17.136% of total billed charges,3577.39,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,6175.26,37.7,,,percent of total billed charges,37.70% of total billed charges,6175.26,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,5552.82,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,12776.4,78,,,percent of total billed charges,78% of total billed charges,16380,100,,,percent of total billed charges,100% of total billed charges,13529.88,82.6,,,percent of total billed charges,82.6% of total billed charges,13529.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2751.84,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2751.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2506.14,16380,
CAGE WAVE D 9MM X 24MM 6 DEG,ORSUP0164,CDM,278,RC,C1713,HCPCS,Outpatient,,,36660,23829.00,,32260.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,6158.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,6343.65,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,23095.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6158.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5608.98,15.3,,,percent of total billed charges,15.3% of total billed charges,25295.4,69,,,percent of total billed charges,69% of total billed charges,36660,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36660,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36660,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6158.88,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11437.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6282.06,17.136,,,percent of total billed charges,17.136% of total billed charges,8006.54,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,13820.82,37.7,,,percent of total billed charges,37.70% of total billed charges,13820.82,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12427.74,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,28594.8,78,,,percent of total billed charges,78% of total billed charges,36660,100,,,percent of total billed charges,100% of total billed charges,30281.16,82.6,,,percent of total billed charges,82.6% of total billed charges,30281.16,82.6,,,percent of total billed charges,82.6% of total billed charges,6158.88,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6158.88,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,36660,
CAL 1 SOL 200 ML US,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CAL 2 SOLN,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CAL KIT 11 BX / 1 SET / 6 BTLS,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
CAL KIT 13 BOX / 1 SET / 6 BTLS,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
CAL KIT 24 BOX / 1 SET / 6 BTLS,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CAL ASSAY LVL 1 DILUENT,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CAL ASSAY LVL 2 DILUENT,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CALCIUM / 5 PACK / 300 SLIDES,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CALCIUM ARSENAZO R1 4X15ML,ORSUP0043,CDM,272,RC,,,Outpatient,,,8320,5408.00,,7321.6,88,,,percent of total billed charges,88% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1439.69,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5241.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,15.3,,,percent of total billed charges,15.3% of total billed charges,5740.8,69,,,percent of total billed charges,69% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1425.72,17.136,,,percent of total billed charges,17.136% of total billed charges,1817.09,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,6489.6,78,,,percent of total billed charges,78% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,8320,
CALIBRATOR S CAL FP,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CALIB SOLN Hb,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CALIBRATOR S-CAL FOR COULTER MODELS S-PLUS 45\\T\\ 6,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CALIBRATOR KIT 29,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CALIBRATOR INTACT PARATHYROID HORMONE,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CALIBRATOR TOTAL T4,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CALIBRATOR KIT,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CALIBRATOR KIT 31,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CALIBRATOR KIT 32 BX/3 SETS,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CALL KIT 12 BOX / 1 SET / 6 BTLS,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
CAMPY JEJUNI SUBSP ATCC CULTI LOOPS 33291,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CAMPYGEN COMPACT SACHET,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CANCELLOUS BONE CHIPS 30CC,ORSUP0031,CDM,278,RC,C1762,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3900,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3900,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
CANCELLOUS BONE CHIPS 15CC,ORSUP0017,CDM,278,RC,C1762,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1690,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1690,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CANCELLOUS BONE CHIPS 5CC,ORSUP0020,CDM,278,RC,C1762,HCPCS,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,199,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,724.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,15.3,,,percent of total billed charges,15.3% of total billed charges,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1150,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1150,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,358.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,197.06,17.136,,,percent of total billed charges,17.136% of total billed charges,251.16,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,389.85,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,1150,
CANCELLOUS CHIPS 10CC LIFENET,ORSUP0015,CDM,278,RC,C1762,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1300,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1300,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CANISTER DISP THIN WALL 1500CC,152483,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
CANISTER INFO VAC 500ML W/O GEL,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
CANNULA ARTERIAL FEMORAL 20FR,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CANNULA NASAL O2 INFANT 7FT,259257,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
CANNULA CORONARY STR 6MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CANNULA CVD NASAL TIPS PEDI,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CANNULA MEDTRONIC  METAL-TIP ARTERIAL 20FR,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CANNULA ART PU L32CM OD 12FR ODSEC18MM TXTRD BALN RETRGD ANTI,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CANNULA AORTIC REFUSION 22FR,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CANNULA VENOUS 38FR RT ANGLE,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
CANNULA PRFSN PU L32CM L18MM OD14FR RETROPLEGIA RETR RC2014M,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CANNULA RETROGRADE 14FR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CANNULA CARDIOPLEGIA 12FR,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
CANNULA ARTERIAL FEMORAL 22FR,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CANNULA ERCP RAPID EXCHANGE TAPERED TIP,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CANNULA RAPID EXC TAPER ERCP,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CANNULA RX XL,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CANNULA ERCP CONTOUR  ULTRA TPR 5FR 210CM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CANN 22FR AORTIC CURVED,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CANNULA 8MM INSTRUMENT,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
CANNULA AORTIC PERFUSION,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
CANNULA ARTERIAL EOPA 22FR,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CANNULA ARTERIAL EOPA 24FR,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CANNULA BTN 3CM 12MM ARTHX PSPRT BTN CANN,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CANNULA CORONARY PROFUSION,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CANNULA CORONARY RIGHT ANGLE 4MM,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
CANNULA CORONARY RT. ANGLE 6MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CANNULA CURVED 100MM 20G 10MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CANNULA CURVED 20G,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CANNULA DLP MALLEABLE SINGLE STAGE VENOUS 28FR,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CANNULA DLP MALLEABLE SINGLE STAGE VENOUS 30FR,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CANNULA DLP MALLEABLE SINGLE STAGE VENOUS 32FR,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CANNULA DUAL STAGE VENOUS DRAINAGE 32/40,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
CANNULA PASSPORT 10X3,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CANNULA PRFSN 11IN 22FR AOR 45D SHRT WRE REINFORCE SUT BMP,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
CANNISTER BERKLEY,490197,CDM,270,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,8.65,17.304,,,percent of total billed charges,17.304% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.57,17.136,,,percent of total billed charges,17.136% of total billed charges,10.92,21.84,,,percent of total billed charges,21.84% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,50,
CANNULA 7MM TWIST-IN ARTHREX,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
ORSUP0003,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CANNULA CO2 SAMPLING AND O2 DELIVERY,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CANNULA NASAL 14 FT,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CANNULAS 7 FT LUMEN TUBING,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CANNULAS 14 FT SOFT CUSHION,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
"CANNULAS, OPTIFLOW PLUS",ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CANNULA DRI-LOK THREADED 8.0MM X 75MM,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
CANNULA GATEWAY SILICONE  8MM X 30MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
CAP END,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,910,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,910,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CAP END TI T40 0 EXT STRDRV RECESS STRL TIB NAIL,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CAP END TI TIBIAL NAILS-EX T40 STARDRIVE GRAY/0MM EXT,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CAP END TI TIBIAL NAILS-EX T40 STARDRIVE GRAY/10MM EXT,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CAP END TI TIBIAL NAILS-EX T40 STARDRIVE GRAY/15MM EXT,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CAP END TI TIBIAL NAILS-EX T40 STARDRIVE GRAY/5MM EXT,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CAP PROTCT F/ FIX PIN SM 4.0MM,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,325,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,325,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CAP LOCKING,ORSUP0016,CDM,278,RC,C1755,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1495,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1495,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CAP LOCKING TI PANGEA,ORSUP0015,CDM,278,RC,C1755,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1300,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1300,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CAP FULL HEAD NON-ST.,188351,CDM,270,RC,,,Outpatient,,,345,224.25,,303.6,88,,,percent of total billed charges,88% of total Billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,57.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,345,100,,,percent of total billed charges,100% of total billed charges,59.7,17.304,,,percent of total billed charges,17.304% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,217.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,57.96,16.8,,,percent of total billed charges,16.8% of total billed charges,52.79,15.3,,,percent of total billed charges,15.3% of total billed charges,238.05,69,,,percent of total billed charges,69% of total billed charges,345,100,,,percent of total billed charges,100% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,345,100,,,percent of total billed charges,100% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,345,100,,,percent of total billed charges,100% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,57.96,16.8,,,percent of total billed charges,16.8% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,57.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,59.12,17.136,,,percent of total billed charges,17.136% of total billed charges,75.35,21.84,,,percent of total billed charges,21.84% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,172.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,172.5,50,,,percent of total billed charges,50% of total Billed charges,269.1,78,,,percent of total billed charges,78% of total billed charges,345,100,,,percent of total billed charges,100% of total billed charges,284.97,82.6,,,percent of total billed charges,82.6% of total billed charges,284.97,82.6,,,percent of total billed charges,82.6% of total billed charges,57.96,16.8,,,percent of total billed charges,16.8% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,172.5,50,,,percent of total billed charges,50% of total Billed charges,57.96,16.8,,,percent of total billed charges,16.8% of total billed charges,52.79,345,
CAP BOUF 24 INCH BTFLY,174257,CDM,272,RC,,,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,93,100,,,percent of total billed charges,100% of total billed charges,16.09,17.304,,,percent of total billed charges,17.304% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,58.59,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,93,100,,,percent of total billed charges,100% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,93,100,,,percent of total billed charges,100% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.94,17.136,,,percent of total billed charges,17.136% of total billed charges,20.31,21.84,,,percent of total billed charges,21.84% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46.5,50,,,percent of total billed charges,50% of total Billed charges,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,14.23,93,
CAP BOUF FLORAL LG,148400,CDM,272,RC,,,Outpatient,,,329,213.85,,289.52,88,,,percent of total billed charges,88% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,329,100,,,percent of total billed charges,100% of total billed charges,56.93,17.304,,,percent of total billed charges,17.304% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,207.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,50.34,15.3,,,percent of total billed charges,15.3% of total billed charges,227.01,69,,,percent of total billed charges,69% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,329,100,,,percent of total billed charges,100% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,329,100,,,percent of total billed charges,100% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,56.38,17.136,,,percent of total billed charges,17.136% of total billed charges,71.85,21.84,,,percent of total billed charges,21.84% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,164.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,164.5,50,,,percent of total billed charges,50% of total Billed charges,256.62,78,,,percent of total billed charges,78% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,164.5,50,,,percent of total billed charges,50% of total Billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,50.34,329,
CAP BOUFFANT 21 INCH,426171,CDM,272,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
CAP BOUFFANT 24 INCH,240620,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
CAP ENDO SMART,ORSUP0017,CDM,270,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CAP MEDC SURGEON BLUE TIES,484298,CDM,270,RC,,,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,14.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,85,100,,,percent of total billed charges,100% of total billed charges,14.71,17.304,,,percent of total billed charges,17.304% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,53.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.28,16.8,,,percent of total billed charges,16.8% of total billed charges,13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.28,16.8,,,percent of total billed charges,16.8% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,14.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,14.57,17.136,,,percent of total billed charges,17.136% of total billed charges,18.56,21.84,,,percent of total billed charges,21.84% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42.5,50,,,percent of total billed charges,50% of total Billed charges,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,14.28,16.8,,,percent of total billed charges,16.8% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42.5,50,,,percent of total billed charges,50% of total Billed charges,14.28,16.8,,,percent of total billed charges,16.8% of total billed charges,13.01,85,
CAP NURSE LRG 24 INCH,258009,CDM,270,RC,,,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,22.84,17.304,,,percent of total billed charges,17.304% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,83.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.62,17.136,,,percent of total billed charges,17.136% of total billed charges,28.83,21.84,,,percent of total billed charges,21.84% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,20.2,132,
CAP RED SURGERY BOUFFANT,318250,CDM,270,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
CAP SURGEON TIE BACK LF BLUE,411923,CDM,270,RC,,,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,10.56,17.304,,,percent of total billed charges,17.304% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,38.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.45,17.136,,,percent of total billed charges,17.136% of total billed charges,13.32,21.84,,,percent of total billed charges,21.84% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,61,
CAP 12/13MM BLD COL TB.GREEN,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CAP SURGICAL NURSE,490202,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
CAP BOUFFANT PINK RIBBON,490201,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
CAPE PATIENT DISPOSABLE ONE SIZE FITS MOST DARK BLUE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CAPS BOUFFANT GREEN,454884,CDM,270,RC,,,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,17.48,17.304,,,percent of total billed charges,17.304% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,63.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,15.45,15.3,,,percent of total billed charges,15.3% of total billed charges,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,17.31,17.136,,,percent of total billed charges,17.136% of total billed charges,22.06,21.84,,,percent of total billed charges,21.84% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,15.45,101,
CAPS FOR URINE TUBES,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CAPTIVATOR POLYPECTOMY SNARE,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CAPTIVATOR II 10MM ROUNDED STIFF,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CAPTIVATOR II 15MM ROUNDED STIFF,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CAPTIVATOR II 25MM ROUNDED STIFF,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CAPTIVATOR II 33MM EXTRA LARGE ROUNDED STIFF,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CARD FLASH STEAM INDICATOR,490203,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
CARDIAC MARKER LT+ 1C,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CARDIAC MARKER LT+ 3,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CARDIAC CONTROL 1,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CARDIAC CONTROL 2,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CAROTID BYPASS SHUNT 12FR,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CARTRIDGE SENSOR 02 FOR 7900 VENTILATOR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CARTRIDGE COLLAGEN/ADP PFA-100 20/PK,ORSUP0017,CDM,270,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CARTRIDGE  RED,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CART COVERS,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CARTRIDGE BLACK INK 108R00727,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CARTRIDGE REPRO TNR DELL BLK 1700 1700N 1710 1710N - UNIVERSAL TONER CARTRIDGE COMPATIBLE WITH IBM I,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CARTRIDGE REPRO TNR HIGH YIELD HP BLK M4555 MFP M601N M601DN M602DN M602N LSRJT ENTRP 600,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CARTRIDGE REPRO TNR HIGH YIELD HP BLK P4014 P4014DN P4014N P4015 P4015DN P4015N P4515 LSRJT,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CARTRIDGE TONER 460,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CARTRIDGE TONER LEXMARK E260DN 35000 PAGE YIELD,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CARTRIDGES TROPHON SONEX-HL,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CARTRIDGE EPI TEST,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CARTER THOMASON CLOSURE SYSTEM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CASE CART COVERS XL,490207,CDM,270,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,8.65,17.304,,,percent of total billed charges,17.304% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,30.93,61.85,,,percent of total billed charges,61.85% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.57,17.136,,,percent of total billed charges,17.136% of total billed charges,10.92,21.84,,,percent of total billed charges,21.84% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,50,
CASE CART COVER,490206,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
CASSETTES STERRAD             10113,37074,CDM,272,RC,,,Outpatient,,,634,412.10,,557.92,88,,,percent of total billed charges,88% of total Billed charges,317,50,,,percent of total billed charges,50% of total Billed charges,106.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,634,100,,,percent of total billed charges,100% of total billed charges,109.71,17.304,,,percent of total billed charges,17.304% of total billed charges,317,50,,,percent of total billed charges,50% of total Billed charges,399.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,106.51,16.8,,,percent of total billed charges,16.8% of total billed charges,97,15.3,,,percent of total billed charges,15.3% of total billed charges,437.46,69,,,percent of total billed charges,69% of total billed charges,634,100,,,percent of total billed charges,100% of total billed charges,317,50,,,percent of total billed charges,50% of total Billed charges,634,100,,,percent of total billed charges,100% of total billed charges,317,50,,,percent of total billed charges,50% of total Billed charges,634,100,,,percent of total billed charges,100% of total billed charges,317,50,,,percent of total billed charges,50% of total Billed charges,392.13,61.85,,,percent of total billed charges,61.85% of total billed charges,106.51,16.8,,,percent of total billed charges,16.8% of total billed charges,317,50,,,percent of total billed charges,50% of total Billed charges,317,50,,,percent of total billed charges,50% of total Billed charges,106.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,317,50,,,percent of total billed charges,50% of total Billed charges,317,50,,,percent of total billed charges,50% of total Billed charges,108.64,17.136,,,percent of total billed charges,17.136% of total billed charges,138.47,21.84,,,percent of total billed charges,21.84% of total billed charges,317,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,317,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,317,50,,,percent of total billed charges,50% of total Billed charges,494.52,78,,,percent of total billed charges,78% of total billed charges,634,100,,,percent of total billed charges,100% of total billed charges,523.68,82.6,,,percent of total billed charges,82.6% of total billed charges,523.68,82.6,,,percent of total billed charges,82.6% of total billed charges,106.51,16.8,,,percent of total billed charges,16.8% of total billed charges,317,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,317,50,,,percent of total billed charges,50% of total Billed charges,106.51,16.8,,,percent of total billed charges,16.8% of total billed charges,97,634,
CASSETTE STERIL 5 CYCLE STERRAD NX,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CASSETTE DRAPE,490208,CDM,270,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
CASTING TAPE 2'' PINK,490211,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
CASTING TAPE 2'' BLUE,490210,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
CAST PADDING 4'',490209,CDM,270,RC,,,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,22.84,17.304,,,percent of total billed charges,17.304% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,83.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,81.64,61.85,,,percent of total billed charges,61.85% of total billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.62,17.136,,,percent of total billed charges,17.136% of total billed charges,28.83,21.84,,,percent of total billed charges,21.84% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,20.2,132,
CAT 5FR TRANS 4.0 RADIAL,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATARRHAL IS TEST DISC,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATALASE REAGENT DROPPER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH IV AUTOGUARD PINK 20G X 1.16IN,66578,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
CATH IV 24G X .75 IN AUTOGUARD YELLOW,167583,CDM,272,RC,,,Outpatient,,,618,401.70,,543.84,88,,,percent of total billed charges,88% of total Billed charges,309,50,,,percent of total billed charges,50% of total Billed charges,103.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,618,100,,,percent of total billed charges,100% of total billed charges,106.94,17.304,,,percent of total billed charges,17.304% of total billed charges,309,50,,,percent of total billed charges,50% of total Billed charges,389.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,103.82,16.8,,,percent of total billed charges,16.8% of total billed charges,94.55,15.3,,,percent of total billed charges,15.3% of total billed charges,426.42,69,,,percent of total billed charges,69% of total billed charges,618,100,,,percent of total billed charges,100% of total billed charges,309,50,,,percent of total billed charges,50% of total Billed charges,618,100,,,percent of total billed charges,100% of total billed charges,309,50,,,percent of total billed charges,50% of total Billed charges,618,100,,,percent of total billed charges,100% of total billed charges,309,50,,,percent of total billed charges,50% of total Billed charges,382.23,61.85,,,percent of total billed charges,61.85% of total billed charges,103.82,16.8,,,percent of total billed charges,16.8% of total billed charges,309,50,,,percent of total billed charges,50% of total Billed charges,309,50,,,percent of total billed charges,50% of total Billed charges,103.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,309,50,,,percent of total billed charges,50% of total Billed charges,309,50,,,percent of total billed charges,50% of total Billed charges,105.9,17.136,,,percent of total billed charges,17.136% of total billed charges,134.97,21.84,,,percent of total billed charges,21.84% of total billed charges,309,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,309,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,309,50,,,percent of total billed charges,50% of total Billed charges,482.04,78,,,percent of total billed charges,78% of total billed charges,618,100,,,percent of total billed charges,100% of total billed charges,510.47,82.6,,,percent of total billed charges,82.6% of total billed charges,510.47,82.6,,,percent of total billed charges,82.6% of total billed charges,103.82,16.8,,,percent of total billed charges,16.8% of total billed charges,309,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,309,50,,,percent of total billed charges,50% of total Billed charges,103.82,16.8,,,percent of total billed charges,16.8% of total billed charges,94.55,618,
CATH IV AUTOGUARD BLUE 22GA X 1IN,142892,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
CATH IV 14G3.25IN ANGIOCATH,185920,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CATH IV AUTOGUARD GRN 18GA X 1.16IN,142894,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
CATH IV AUTOGUARD SHIELDED 14gx1.75,88087,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
CATH FOLEY 5CC 12FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH URETH RED RUBBER 8FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH URETH RED RUBBER 18FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH URETH RED RUBBER 14FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH ROBINSON 10 FR,8490,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
CATH COUNCIL 2W 5CC 18FR,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
CATH FOLEY 16FR 5CC 3 WAY,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH FOLEY 20FR 30CC 2WAY,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY LUB 18FR 5CC 2WAY COUDE TIP,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH UTILITY RED 8FR,39736,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
CATH BALLOON CRE 6-7-8 MM,ORSUP0014,CDM,278,RC,C1726,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH BALLOON DILATION CRE 8-9-10MM,ORSUP0014,CDM,278,RC,C1726,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH BALLOON DILATATION CRE WIRE GUIDED 15-18MM,ORSUP0016,CDM,278,RC,C1726,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATHERTER BALLOON L180CM L5.5CM OD 15-18MM,ORSUP0014,CDM,278,RC,C1726,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH BLN DILATATION CRE WIRE GD 12-15MM,ORSUP0014,CDM,278,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH BLN DILATATION CRE WIRE GD 10-12MM,ORSUP0014,CDM,278,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH SINUS BALLOON 7MM X 16MM,ORSUP0013,CDM,278,RC,C1726,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATHETER BALLOON DILATATION ULTRASOUND BRONCHOSCOPE,ORSUP0019,CDM,278,RC,C1726,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CATHETER BALLOON SINUS SOLO PRO RELIEVA 6MM D X 16MM L,ORSUP0025,CDM,278,RC,C1726,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
CATHETER SOUNDSTAR 8FR 90CM,ORSUP0063,CDM,278,RC,C1759,HCPCS,Outpatient,,,13780,8957.00,,12126.4,88,,,percent of total billed charges,88% of total Billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,2315.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2384.49,17.304,,,percent of total billed charges,17.304% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2315.04,16.8,,,percent of total billed charges,16.8% of total billed charges,2108.34,15.3,,,percent of total billed charges,15.3% of total billed charges,9508.2,69,,,percent of total billed charges,69% of total billed charges,13780,100,,,percent of total billed charges,100% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,13780,100,,,percent of total billed charges,100% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,13780,100,,,percent of total billed charges,100% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,8522.93,61.85,,,percent of total billed charges,61.85% of total billed charges,2315.04,16.8,,,percent of total billed charges,16.8% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,4299.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6890,50,,,percent of total billed charges,50% of total Billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,2361.34,17.136,,,percent of total billed charges,17.136% of total billed charges,3009.55,21.84,,,percent of total billed charges,21.84% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,5195.06,37.7,,,percent of total billed charges,37.70% of total billed charges,5195.06,37.7,,,percent of total billed charges,37.70% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,4671.42,33.9,,,percent of total billed charges,33.9% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,10748.4,78,,,percent of total billed charges,78% of total billed charges,13780,100,,,percent of total billed charges,100% of total billed charges,11382.28,82.6,,,percent of total billed charges,82.6% of total billed charges,11382.28,82.6,,,percent of total billed charges,82.6% of total billed charges,2315.04,16.8,,,percent of total billed charges,16.8% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6890,50,,,percent of total billed charges,50% of total Billed charges,2315.04,16.8,,,percent of total billed charges,16.8% of total billed charges,2108.34,13780,
CATH EP 5FR 120CM CRD-2 QUADRIPOLAR SUPREME,ORSUP0009,CDM,278,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CATH EP BLAZER DUODECAPOLAR SUPER LARGE,ORSUP0040,CDM,278,RC,,,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
CATH EZ STEER NAV D-F,ORSUP0054,CDM,278,RC,,,Outpatient,,,11180,7267.00,,9838.4,88,,,percent of total billed charges,88% of total Billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1934.59,17.304,,,percent of total billed charges,17.304% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,7043.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,1710.54,15.3,,,percent of total billed charges,15.3% of total billed charges,7714.2,69,,,percent of total billed charges,69% of total billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,6914.83,61.85,,,percent of total billed charges,61.85% of total billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,3488.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5590,50,,,percent of total billed charges,50% of total Billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,1915.8,17.136,,,percent of total billed charges,17.136% of total billed charges,2441.71,21.84,,,percent of total billed charges,21.84% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,4214.86,37.7,,,percent of total billed charges,37.70% of total billed charges,4214.86,37.7,,,percent of total billed charges,37.70% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,3790.02,33.9,,,percent of total billed charges,33.9% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,8720.4,78,,,percent of total billed charges,78% of total billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,9234.68,82.6,,,percent of total billed charges,82.6% of total billed charges,9234.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5590,50,,,percent of total billed charges,50% of total Billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,1710.54,11180,
CATH EP THMCL SMTCH SF BID TC D-F,ORSUP0083,CDM,278,RC,,,Outpatient,,,18980,12337.00,,16702.4,88,,,percent of total billed charges,88% of total Billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,3188.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3284.3,17.304,,,percent of total billed charges,17.304% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,11957.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3188.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2903.94,15.3,,,percent of total billed charges,15.3% of total billed charges,13096.2,69,,,percent of total billed charges,69% of total billed charges,18980,100,,,percent of total billed charges,100% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,18980,100,,,percent of total billed charges,100% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,18980,100,,,percent of total billed charges,100% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,11739.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3188.64,16.8,,,percent of total billed charges,16.8% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,5921.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9490,50,,,percent of total billed charges,50% of total Billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,3252.41,17.136,,,percent of total billed charges,17.136% of total billed charges,4145.23,21.84,,,percent of total billed charges,21.84% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,7155.46,37.7,,,percent of total billed charges,37.70% of total billed charges,7155.46,37.7,,,percent of total billed charges,37.70% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,6434.22,33.9,,,percent of total billed charges,33.9% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,14804.4,78,,,percent of total billed charges,78% of total billed charges,18980,100,,,percent of total billed charges,100% of total billed charges,15677.48,82.6,,,percent of total billed charges,82.6% of total billed charges,15677.48,82.6,,,percent of total billed charges,82.6% of total billed charges,3188.64,16.8,,,percent of total billed charges,16.8% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9490,50,,,percent of total billed charges,50% of total Billed charges,3188.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2903.94,18980,
CATHETER PENTARAY NAV ECO 2 F-CURVE,ORSUP0048,CDM,272,RC,,,Outpatient,,,9620,6253.00,,8465.6,88,,,percent of total billed charges,88% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1664.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,6060.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,15.3,,,percent of total billed charges,15.3% of total billed charges,6637.8,69,,,percent of total billed charges,69% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,5949.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1648.48,17.136,,,percent of total billed charges,17.136% of total billed charges,2101.01,21.84,,,percent of total billed charges,21.84% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,7503.6,78,,,percent of total billed charges,78% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,9620,
CATH GUIDE RADIAL TIGER 4.0 6FR,ORSUP0007,CDM,278,RC,C1887,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CATH GLIDE 5FR ST 038 100CM,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH ANGIO SPR TRQ HYDRO STR TPR 5F.038 65CM,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH 5FR 65CM ANGLED TIP     32 136,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GLIDE ANGLED TAPER 5FR,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GLIDE ANGLED 65CM,ORSUP0016,CDM,278,RC,C1887,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH GLIDE STRAIGHT 120CM 4F,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH DELIVERY PXSLIM ..025-90,ORSUP0029,CDM,278,RC,C1887,HCPCS,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1460.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1586.52,33.9,,,percent of total billed charges,33.9% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
CATH GUIDE 110 DEGREE SINUS RELIEVA,ORSUP0019,CDM,278,RC,C1887,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CATH GUIDE 6F EBU375,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE 70 DEGREE SINUS RELIEVA,ORSUP0019,CDM,278,RC,C1887,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CATH GUIDE LAUNCHER 5F IMA,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE LAUNCHER 6F AL.75,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE LAUNCHER 6F AL1.0,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE LAUNCHER 6F AL2.0,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE LAUNCHER 6F AR1.0,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE LAUNCHER 6F EBU3.0,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE LAUNCHER 6F EBU3.5,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE LAUNCHER 6F EBU4.0,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE LAUNCHER 6F IMA,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE LAUNCHER 6F JL3.5,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE LAUNCHER 6F JL4.0,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 6F JR4.0,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH GUIDE LAUNCHER 6F LCB,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH RITESITE,ORSUP0015,CDM,278,RC,C1887,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH TRAILBLAZER .014X135CM,ORSUP0012,CDM,278,RC,C1887,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH TRAILBLAZER .014X150CM,ORSUP0012,CDM,278,RC,C1887,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH TRAILBLAZER .035X135CM,ORSUP0012,CDM,278,RC,C1887,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH TRAILBLAZER .035X150CM,ORSUP0011,CDM,278,RC,C1887,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH TRAILBLAZER .035X90CM,ORSUP0012,CDM,278,RC,C1887,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATHETER GUIDELINER 5FR,ORSUP0020,CDM,278,RC,C1887,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
CATHETER GUIDELINER 6FR,ORSUP0022,CDM,278,RC,C1887,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CATHETER PIGTAIL SIZING 100CM,ORSUP0011,CDM,278,RC,C1887,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATHETER TURNPIKE GOLD 5FR 135CM,ORSUP0024,CDM,278,RC,C1887,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
CATH DIALYSIS 19FR,ORSUP0017,CDM,278,RC,C1750,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATH DIALYSIS 24FR,ORSUP0017,CDM,278,RC,C1750,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATH PERFORATOR RIGID,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
CATHETER CODMAN EXTERNAL DRAINAGE,ORSUP0014,CDM,278,RC,C1729,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH MEDI TECH FLEX APD 8FR,ORSUP0006,CDM,278,RC,C1729,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CATH MEDI TECH FLEX APD 12FR,ORSUP0007,CDM,278,RC,C1729,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CATH SET APD FLEXIMA REGULAR 10FR,ORSUP0007,CDM,278,RC,C1729,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CATHETER LAVAGE SINUS,ORSUP0011,CDM,278,RC,C1729,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATHETER INFUSION 4FR 135CM 10CM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH GROSHONG DUAL LUMEN 9.5 FR,ORSUP0020,CDM,278,RC,C1725,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
CATH SWAN-GANZ 5FR,ORSUP0005,CDM,278,RC,C1725,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH THERMODILUTION 7FR,ORSUP0006,CDM,278,RC,C1725,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CATH INFUSION TRELLIS 8FR 120CM,ORSUP0054,CDM,278,RC,C1725,HCPCS,Outpatient,,,11180,7267.00,,9838.4,88,,,percent of total billed charges,88% of total Billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1934.59,17.304,,,percent of total billed charges,17.304% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,1710.54,15.3,,,percent of total billed charges,15.3% of total billed charges,7714.2,69,,,percent of total billed charges,69% of total billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,6914.83,61.85,,,percent of total billed charges,61.85% of total billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,3488.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5590,50,,,percent of total billed charges,50% of total Billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,1915.8,17.136,,,percent of total billed charges,17.136% of total billed charges,2441.71,21.84,,,percent of total billed charges,21.84% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,4214.86,37.7,,,percent of total billed charges,37.70% of total billed charges,4214.86,37.7,,,percent of total billed charges,37.70% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,3790.02,33.9,,,percent of total billed charges,33.9% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,8720.4,78,,,percent of total billed charges,78% of total billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,9234.68,82.6,,,percent of total billed charges,82.6% of total billed charges,9234.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5590,50,,,percent of total billed charges,50% of total Billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,1710.54,11180,
CATH EAGLE EYE IVUS IMAGING,ORSUP0026,CDM,278,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
CATH INTRAVASCULAR ULTRASOUND IMAGING VISIONS PV 8.2F 90CM,ORSUP0031,CDM,278,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
CATH PIONEER 6FR 120CM,ORSUP0070,CDM,278,RC,,,Outpatient,,,15600,10140.00,,13728,88,,,percent of total billed charges,88% of total Billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,2620.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2699.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,9828,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2620.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2386.8,15.3,,,percent of total billed charges,15.3% of total billed charges,10764,69,,,percent of total billed charges,69% of total billed charges,15600,100,,,percent of total billed charges,100% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,15600,100,,,percent of total billed charges,100% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,15600,100,,,percent of total billed charges,100% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,9648.6,61.85,,,percent of total billed charges,61.85% of total billed charges,2620.8,16.8,,,percent of total billed charges,16.8% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,4867.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7800,50,,,percent of total billed charges,50% of total Billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,2673.22,17.136,,,percent of total billed charges,17.136% of total billed charges,3407.04,21.84,,,percent of total billed charges,21.84% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,5881.2,37.7,,,percent of total billed charges,37.70% of total billed charges,5881.2,37.7,,,percent of total billed charges,37.70% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,5288.4,33.9,,,percent of total billed charges,33.9% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,12168,78,,,percent of total billed charges,78% of total billed charges,15600,100,,,percent of total billed charges,100% of total billed charges,12885.6,82.6,,,percent of total billed charges,82.6% of total billed charges,12885.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2620.8,16.8,,,percent of total billed charges,16.8% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7800,50,,,percent of total billed charges,50% of total Billed charges,2620.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2386.8,15600,
CATH BALLOON CODA 10FR 32MM X 100CM,ORSUP0020,CDM,278,RC,C2628,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
CATH BALLOON 6FR DOUBLE LUMEN 90CM,ORSUP0005,CDM,278,RC,C2628,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH INTRODUCER HYDRPHL  6FR 90CM RADOPQ BND,ORSUP0009,CDM,278,RC,C1758,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CATH BALLOON INTRA AORT MEGA 7.5F 40CC,ORSUP0031,CDM,278,RC,C1769,HCPCS,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
CATHETER BALLOON 7.5FR 40CC INTRAATC LINEAR,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
CATH CORONARY DILAT RX  TREK 4.0MMX08MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT RX MINI TREK 4.0MM X 15MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT RX MINI TREK 3.0MM X 15MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT RX MINI TREK 3.50MM X 15MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT RX MINI TREK 2.0MM X 08MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT OTW TREK 2.0MMX06MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT RX MINI TREK 2.0MM X 20MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT RX MINI TREK 2.0MM X 15MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT OTW TREK 2.0MMX15MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT OTW TREK 2.0MMX12MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT RX MINI TREK 2.5MM X 20MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT RX MINI TREK 2.5MM X 15MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT RX MINI TREK 1.50MMX08MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT OTW 1.50 MMX06MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT RX MINI TREK 1.5MM X 12MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CORONARY DILAT OTW TREK 1.50MMX12MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH BALLOON MINI TREK OTW 1.20X8,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH BLN 135CM 2CM 8MM DORADO PERI NC 3 LUM PTCA DR13582,ORSUP0015,CDM,278,RC,C1725,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH BALLOON EMERGE RX 4.0X20,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATHETER BALLOON DIALATION 3.00MM X 15MM EMERGE,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH BALLOON EMERGE RX 2.0X20,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH BALLOON EMERGE RX 2.0X15,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH BALLOON DIL 6FR 2.5MM .07IN 144CM 20MM PTCA DL SHFT DSGN,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH BALLOON EMERGE 2.5X15,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH BALLOON EMERGE RX 2.25X20,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH BALLOON EMERGE RX 1.5X15,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH BALLOON STERLING OTW 9 X 3 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 8 X 10 80CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 7 X 10 80CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 6 X 10 80CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 5 X 15 80CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING 5.5X40X135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 4.5 X 30 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALN CTNG FLEXTOME 3.0 X 10MM DILATATION,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
CATH BALN CTNG FLEXTOME 3.5 X 10MM DILATATION,ORSUP0027,CDM,278,RC,C1725,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
CATH BALN CTNG FLEXTOME 3.25 X 15MM DILATATION,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
CATH BALN CTNG FLEXTOME 3.25 X 10MM DILATATION,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
CATH BALN CTNG FLEXTOME 2.75 X 15MM DILATATION,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
CATH BALN CTNG FLEXTOME 3.0 X 15MM DILATATION,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
CATH BALN CTNG FLEXTOME 2.0 X 15MM DILATATION,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
CATH BALN CTNG FLEXTOME 2.0 X 10MM DILATATION,ORSUP0027,CDM,278,RC,C1725,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
CATH BALN CTNG FLEXTOME 2.75 X 10MM DILATATION,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
CATH BALN CTNG FLEXTOME 2.5 X 15MM DILATATION,ORSUP0028,CDM,278,RC,C1725,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
CATH BALN CTNG FLEXTOME 2.5 X 10MM DILATATION,ORSUP0027,CDM,278,RC,C1725,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
CATH CONQUEST BALLOON 8 X 2,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH PTCA 50CM 2CM 5.5FR 7MM CONQUEST,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATHETER BALLOON MUSTANG DIL 8MM 100MM 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATHETER BALLOON MUSTANG 6X150,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATHETER BALLOON MUSTANG 6 X 100 X 135,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
"CATH BALLOON MUSTANG 5.0X80, 135CM",ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
"CATH BALLOON MUSTANG 5.0X60, 135CM",ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATHETER MUSTANG BALLOON 5X20MM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATHETER MUSTANG BALLOON 5X150,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH BALLOON MUSTANG 5 X 100 X 135,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
"CATH BALLOON MUSTANG 4.0X80, 135CM",ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
"CATH BALLOON MUSTANG 4.0X60, 135CM",ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
"CATH BALLOON MUSTANG 4.0X40, 135CM",ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH BALLOON MUSTANG 4.0 X 150 X 135,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
"CATH BALLOON MUSTANG 4.0X100, 135CM",ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATHETER BALLOON MUSTANG DIL 12MM 40MM 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATHETER BALLOON MUSTANG DIL 12MM 20MM 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH BALN 4CMX14MMX120CM 5.8FR .035IN 2XL STRL DI,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATHETER DILATATION XXL BLN 5.8F 14MM X 4CM 75CML,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON CUTTING 8 X 2 135CM,ORSUP0026,CDM,278,RC,C1725,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
CATH BALLOON CUTTING 7 X 2 135CM,ORSUP0027,CDM,278,RC,C1725,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
CATH BALLOON STERLING OTW 5 X 100 135CM L,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 6 X 60 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 5 X 30 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 5.5 X 20 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 4 X 30 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 6 X 40 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 8 X 20 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 7 X 30 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 7 X 20 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 6 X 20 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 6.5 X 40 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 6.5 X 20 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 4 X 20 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 5 X 60 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING 5.0X40X135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 4 X 60 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH BALLOON STERLING RX 4 X 40 135CM,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH CONQUEST BALLOON 5X4X50,ORSUP0016,CDM,278,RC,C1725,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH SOEHENDRA BIL DIL 8.5 FR    SBDC 8.5,ORSUP0005,CDM,278,RC,C1725,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH SOHENDRA BILIARY,ORSUP0005,CDM,278,RC,C1725,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH BALLOON ATLAS 14X2X120CM,ORSUP0017,CDM,278,RC,C1725,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATH BALLOON ATLAS 14X4X120CM,ORSUP0017,CDM,278,RC,C1725,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATH BALLOON CONQUEST 6X4,ORSUP0017,CDM,278,RC,C1725,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATH BALLOON CONQUEST 9X4X120,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH BALLOON EMERGE MR PUSH 8 X 1.50,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH BALLOON MUSTANG 10X60X135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH BALLOON MUSTANG 8.0 X 80 X 135,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH BALLOON MUSTANG 8.0X20X135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH BALLOON MUSTANG 8X40X135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH BALLOON MUSTANG 9X60X135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH BALLOON MUSTANG OTW 10X80X135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH CONQUEST 75 X 10MM X 4,ORSUP0016,CDM,278,RC,C1725,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH CONQUEST 75 X 9MM X 4,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH CONQUEST 7X4 BALLOON,ORSUP0016,CDM,278,RC,C1725,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH CONQUEST 8X4 BALLOON,ORSUP0016,CDM,278,RC,C1725,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH CONQUEST BALLOON 10X2X75,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH CONQUEST BALLOON 4X2X40,ORSUP0015,CDM,278,RC,C1725,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH CONQUEST BALLOON 4X2X80,ORSUP0015,CDM,278,RC,C1725,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH CONQUEST BALLOON 4X4X40,ORSUP0015,CDM,278,RC,C1725,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH CONQUEST BALLOON 5MM X 2CM X 50 CM,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH CONQUEST BALLOON 6X4X50,ORSUP0016,CDM,278,RC,C1725,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH CONQUEST BALLOON 7 X 2,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH CONQUEST BALLOON 8X2X50,ORSUP0016,CDM,278,RC,C1725,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH CONQUEST BALLOON 8X4X50,ORSUP0016,CDM,278,RC,C1725,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH CONQUEST BALLOON 9X2X75,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH CORONARY DILATION MINI TREK 1.5MM 20MM,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH MUSTANG OVER THE WIRE 6.00MM X 80MM 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH RELIANT 46 STENT,ORSUP0020,CDM,278,RC,C1725,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
CATHETER BALLOON DIALATION 4MM 75CM,ORSUP0017,CDM,278,RC,C1725,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATHETER CONQUEST 6F,ORSUP0017,CDM,278,RC,C1725,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATH ATHRCM 145CM 1.25MM DIAMONDBACK 360 MICRO CRWN 7MM,ORSUP0101,CDM,278,RC,C1724,HCPCS,Outpatient,,,18460,11999.00,,16244.8,88,,,percent of total billed charges,88% of total Billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,3101.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3194.32,17.304,,,percent of total billed charges,17.304% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3101.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2824.38,15.3,,,percent of total billed charges,15.3% of total billed charges,12737.4,69,,,percent of total billed charges,69% of total billed charges,18460,100,,,percent of total billed charges,100% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,18460,100,,,percent of total billed charges,100% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,18460,100,,,percent of total billed charges,100% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,11417.51,61.85,,,percent of total billed charges,61.85% of total billed charges,3101.28,16.8,,,percent of total billed charges,16.8% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,5759.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9230,50,,,percent of total billed charges,50% of total Billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,3163.31,17.136,,,percent of total billed charges,17.136% of total billed charges,4031.66,21.84,,,percent of total billed charges,21.84% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,6959.42,37.7,,,percent of total billed charges,37.70% of total billed charges,6959.42,37.7,,,percent of total billed charges,37.70% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,6257.94,33.9,,,percent of total billed charges,33.9% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,14398.8,78,,,percent of total billed charges,78% of total billed charges,18460,100,,,percent of total billed charges,100% of total billed charges,15247.96,82.6,,,percent of total billed charges,82.6% of total billed charges,15247.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3101.28,16.8,,,percent of total billed charges,16.8% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9230,50,,,percent of total billed charges,50% of total Billed charges,3101.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2824.38,18460,
CATH MICROCROWN 60CM 1.25X7MM 4FR DMDBACK PERPH,ORSUP0089,CDM,278,RC,,,Outpatient,,,20540,13351.00,,18075.2,88,,,percent of total billed charges,88% of total Billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,3450.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3554.24,17.304,,,percent of total billed charges,17.304% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,12940.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3450.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3142.62,15.3,,,percent of total billed charges,15.3% of total billed charges,14172.6,69,,,percent of total billed charges,69% of total billed charges,20540,100,,,percent of total billed charges,100% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,20540,100,,,percent of total billed charges,100% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,20540,100,,,percent of total billed charges,100% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,12703.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3450.72,16.8,,,percent of total billed charges,16.8% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,6408.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10270,50,,,percent of total billed charges,50% of total Billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,3519.73,17.136,,,percent of total billed charges,17.136% of total billed charges,4485.94,21.84,,,percent of total billed charges,21.84% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,7743.58,37.7,,,percent of total billed charges,37.70% of total billed charges,7743.58,37.7,,,percent of total billed charges,37.70% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,6963.06,33.9,,,percent of total billed charges,33.9% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,16021.2,78,,,percent of total billed charges,78% of total billed charges,20540,100,,,percent of total billed charges,100% of total billed charges,16966.04,82.6,,,percent of total billed charges,82.6% of total billed charges,16966.04,82.6,,,percent of total billed charges,82.6% of total billed charges,3450.72,16.8,,,percent of total billed charges,16.8% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10270,50,,,percent of total billed charges,50% of total Billed charges,3450.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3142.62,20540,
CATHETER STEALTH SOLID 1.50MM,ORSUP0080,CDM,278,RC,C1726,HCPCS,Outpatient,,,18200,11830.00,,16016,88,,,percent of total billed charges,88% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3149.33,17.304,,,percent of total billed charges,17.304% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2784.6,15.3,,,percent of total billed charges,15.3% of total billed charges,12558,69,,,percent of total billed charges,69% of total billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,11256.7,61.85,,,percent of total billed charges,61.85% of total billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,5678.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9100,50,,,percent of total billed charges,50% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,3118.75,17.136,,,percent of total billed charges,17.136% of total billed charges,3974.88,21.84,,,percent of total billed charges,21.84% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,6861.4,37.7,,,percent of total billed charges,37.70% of total billed charges,6861.4,37.7,,,percent of total billed charges,37.70% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,6169.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,14196,78,,,percent of total billed charges,78% of total billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,15033.2,82.6,,,percent of total billed charges,82.6% of total billed charges,15033.2,82.6,,,percent of total billed charges,82.6% of total billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9100,50,,,percent of total billed charges,50% of total Billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2784.6,18200,
CATHETER STEALTH SOLID 2.00MM,ORSUP0111,CDM,278,RC,C1887,HCPCS,Outpatient,,,20280,13182.00,,17846.4,88,,,percent of total billed charges,88% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3509.25,17.304,,,percent of total billed charges,17.304% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3102.84,15.3,,,percent of total billed charges,15.3% of total billed charges,13993.2,69,,,percent of total billed charges,69% of total billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,12543.18,61.85,,,percent of total billed charges,61.85% of total billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,6327.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10140,50,,,percent of total billed charges,50% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,3475.18,17.136,,,percent of total billed charges,17.136% of total billed charges,4429.15,21.84,,,percent of total billed charges,21.84% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,7645.56,37.7,,,percent of total billed charges,37.70% of total billed charges,7645.56,37.7,,,percent of total billed charges,37.70% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,6874.92,33.9,,,percent of total billed charges,33.9% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,15818.4,78,,,percent of total billed charges,78% of total billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,16751.28,82.6,,,percent of total billed charges,82.6% of total billed charges,16751.28,82.6,,,percent of total billed charges,82.6% of total billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10140,50,,,percent of total billed charges,50% of total Billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3102.84,20280,
CATH LUTONIX BALLOON DRUG COATED .035 130CM 5X40MM,ORSUP0045,CDM,278,RC,C2623,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
CATH LUTONIX BALLOON DRUG COATED .035 130CM 6X40MM,ORSUP0045,CDM,278,RC,C2623,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
CATH LUTONIX BALLOON DRUG COATED .035 130CM 6X60MM,ORSUP0045,CDM,278,RC,C2623,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
CATH LUTONIX BALLOON DRUG COATED .035 130CM 7X40MM,ORSUP0045,CDM,278,RC,C2623,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
CATH LUTONIX BALLOON DRUG COATED.035 130CM 4X100MM,ORSUP0045,CDM,278,RC,C2623,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
CATH LUTONIX BALLOON DRUG COATED.035 130CM 5X100MM,ORSUP0045,CDM,278,RC,C2623,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
CATH LUTONIX BALLOON DRUG COATED.035 130CM 5X150MM,ORSUP0051,CDM,278,RC,C2623,HCPCS,Outpatient,,,10400,6760.00,,9152,88,,,percent of total billed charges,88% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1799.62,17.304,,,percent of total billed charges,17.304% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,15.3,,,percent of total billed charges,15.3% of total billed charges,7176,69,,,percent of total billed charges,69% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,6432.4,61.85,,,percent of total billed charges,61.85% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3244.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1782.14,17.136,,,percent of total billed charges,17.136% of total billed charges,2271.36,21.84,,,percent of total billed charges,21.84% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3920.8,37.7,,,percent of total billed charges,37.70% of total billed charges,3920.8,37.7,,,percent of total billed charges,37.70% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3525.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,8112,78,,,percent of total billed charges,78% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,10400,
CATH LUTONIX BALLOON DRUG COATED.035 130CM 6X100MM,ORSUP0045,CDM,278,RC,C2623,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
CATH LUTONIX BALLOON DRUG COATED.035 130CM 6X150MM,ORSUP0051,CDM,278,RC,C2623,HCPCS,Outpatient,,,10400,6760.00,,9152,88,,,percent of total billed charges,88% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1799.62,17.304,,,percent of total billed charges,17.304% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,15.3,,,percent of total billed charges,15.3% of total billed charges,7176,69,,,percent of total billed charges,69% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,6432.4,61.85,,,percent of total billed charges,61.85% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3244.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1782.14,17.136,,,percent of total billed charges,17.136% of total billed charges,2271.36,21.84,,,percent of total billed charges,21.84% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3920.8,37.7,,,percent of total billed charges,37.70% of total billed charges,3920.8,37.7,,,percent of total billed charges,37.70% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3525.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,8112,78,,,percent of total billed charges,78% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,10400,
CATHETER INFUSION 5FR 135CM 50CM,ORSUP0012,CDM,278,RC,C1757,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH UNI-FUSE INFUSION 5FR 135CM X 30CM,ORSUP0012,CDM,278,RC,C1757,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH INFUSOR 5 FR 135 X 10CM,ORSUP0012,CDM,278,RC,C1757,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH INFUSION 4FR 135CM 20CM,ORSUP0012,CDM,278,RC,C1757,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATHETER FOGARTY THROMBECTOMY 8/10 8CM,ORSUP0005,CDM,278,RC,C1757,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATHETER VENOUS THOMBECTOMY 8FR 80CM L,ORSUP0005,CDM,278,RC,C1757,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH THROMBECTOMY FOGARTY GRAFT 5FR 50CM L,ORSUP0017,CDM,278,RC,C1757,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATHETER EMBOLECTOMY ARTERIAL PURPLE 2FR 60CM L,ORSUP0006,CDM,272,RC,C1757,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CATH CLOT ADHERENT 4F 6MM 80CM L,ORSUP0016,CDM,278,RC,C1757,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH EKOSONIC 1250CM-135CM,ORSUP0074,CDM,278,RC,C1757,HCPCS,Outpatient,,,16640,10816.00,,14643.2,88,,,percent of total billed charges,88% of total Billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,2795.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2879.39,17.304,,,percent of total billed charges,17.304% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2795.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2545.92,15.3,,,percent of total billed charges,15.3% of total billed charges,11481.6,69,,,percent of total billed charges,69% of total billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,10291.84,61.85,,,percent of total billed charges,61.85% of total billed charges,2795.52,16.8,,,percent of total billed charges,16.8% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,5191.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8320,50,,,percent of total billed charges,50% of total Billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,2851.43,17.136,,,percent of total billed charges,17.136% of total billed charges,3634.18,21.84,,,percent of total billed charges,21.84% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,6273.28,37.7,,,percent of total billed charges,37.70% of total billed charges,6273.28,37.7,,,percent of total billed charges,37.70% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,5640.96,33.9,,,percent of total billed charges,33.9% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,12979.2,78,,,percent of total billed charges,78% of total billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,13744.64,82.6,,,percent of total billed charges,82.6% of total billed charges,13744.64,82.6,,,percent of total billed charges,82.6% of total billed charges,2795.52,16.8,,,percent of total billed charges,16.8% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8320,50,,,percent of total billed charges,50% of total Billed charges,2795.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2545.92,16640,
CATH THROMBECTOMY #A4548,ORSUP0010,CDM,278,RC,C1757,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CATH CLOSED SUCTION 14FR 2205,10534,CDM,272,RC,,,Outpatient,,,108,70.20,,95.04,88,,,percent of total billed charges,88% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,18.69,17.304,,,percent of total billed charges,17.304% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,68.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,15.3,,,percent of total billed charges,15.3% of total billed charges,74.52,69,,,percent of total billed charges,69% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,66.8,61.85,,,percent of total billed charges,61.85% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.51,17.136,,,percent of total billed charges,17.136% of total billed charges,23.59,21.84,,,percent of total billed charges,21.84% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,84.24,78,,,percent of total billed charges,78% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,108,
CATH YANKAUER SUCTION OPEN TIP,184424,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
CATH SUCTION 14FR,184985,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
CATH  GLOVE 8FR,184982,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
CATHETER BALLOON INTRA AORTIC MEGA  IABP 50CC,ORSUP0035,CDM,272,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
CATHETER SILVER SOAKER 10 INCH,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATHETER PUSHING 3FR. 170CM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CATHETER VENTRICULAR HAKIM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH BILIARY DILATIN 6FR SBDC 6,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CATH EXCHANGE 8.0 X 45CM X 1.6,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CATH AIRWAY EXCHANGE 7MM AND UP,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CATH AIRWAY EXCHANGE 5MM AND UP,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CATH CEREBRAL SPR TRQ 20 MRK BND PGT 5F 110CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH DIAG JR4 4FR .038 125CM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATHER SZ AUROUS NYL L100CM OD5FR PGTL,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH PROBE ESCPC OD7FR ELCTCHMST,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATHETER ELECTROHEMOSTASIS/INJECT BIPLR 10F 210CM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATH CHOLANGIOGY 6FR 40CM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CATH 4FR X 40CM CHOLANGIOGRAPHY \\T\\ BILIARY,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CATH CANNULA ERCP 5 4 3,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CATH ANGIO 5FR PIGTAIL 125CM,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH ANGIO CS VERTBRAL 5F 75CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH ANGIO JL4 5F 125CM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH ASPIRATION PRIORTY ONE 7F,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
CATH DIAG 5F MPA,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH DIAG EP 120CM 2.5-2MM REPOSABLE,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH LT HEART VENT 18FR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH SUBCUTANEOUS PASSER 60MM DISPOSABLE,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH SYSTEM CSF LUMBOPERITONEAL,ORSUP0028,CDM,272,RC,,,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
CATH SYSTEM NEXIVA DIFFUSICS 22G X 1IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATHETER  6FR QUAD HIS F CURVE,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATHETER BIDIRECTIONAL CS D-F CURVE,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
CATHETER EDGE 180 EXTENDED WORKING CHANNEL,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
CATHETER EDGE 90 EXTENDED WORKING CHANNEL,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
CATHETER GUIDE SINUS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CATHETER KIT SNAP SHUNT VENTRICULAR,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATHETER RIVULET SNAP SHUNT VENTRICULAR  6CM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATHETER RIVULET SNAP SHUNT VENTRICULAR  7CM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CATHETER VENTRICULAR,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH BILIARY PROBE 5F,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CATH IV 20 X 1.88,79761,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
CATH TPN/BROVIAC DBL LUMEN,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH THORACIC 36FR RT ANGLE,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CATH THORASIC 32FR STRAIGHT,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CATH SUPRAPUBIC 18FR O'BRIEN,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH SUPRAPUBIC BALLOON 16FR,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CATH SUCTION 10FR DELEE,490265,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
CATH RIVAL PTA 135-5-10 5FR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH RIVAL PTA 135-4-10-5FR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH RIVAL PTA 135-3-10 5FR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH SWAN PERITONEAL DIALYSIS,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH PALINDROME HSI KIT 33CM,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH PALINDROME W/HEP 14FR 19M,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH OLIVE TIP 6FR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH MAHURKUR ELITE 12F X 20CM,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CATH MAHURKER 12FRX16CM CURVED,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CATH CHOLANGIO BALLOON,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH KUMPE 5FR X 40 X .035 NB,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CATH GROSHONG 8FR SINGLE LUMEN,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH GLIDEPATH 19CM DIALYSIS,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH GLIDEPATH 15 CM DIALYSIS,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH GLIDEPATH 14.5FR X 23CM,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH GLIDEPATH 14.5FR X 27CM,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CATH DRAINAGE DAWSON-MUELLER,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH CONQUEST40 PTA 75-4-4-6FR,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH CONQUEST 8MM X 4CM PTA,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CATH CONQUEST PTA 75-5-4-7F,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CATH CONQUEST PTA 75-6-4-6F,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CATH CLOSUREFAST PROC KIT,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CATH SECURE,490264,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
CATH PALINDROME SI KIT 55CM,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
"CATH,FOLEY SILICONE 16FR 30CC",ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH BALLOON SPACEMAKER PLUS,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH CARSON COUDE 22 FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH BERENSTEIN 5F/140CM/.035B,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
"CATH, FOLEY 16FR SILICONE",ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH-ANGIO LEVEL 5,CATH00052,CDM,278,RC,C1725,HCPCS,Outpatient,,,3613,2348.45,,3179.44,88,,,percent of total billed charges,88% of total Billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,606.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,3613,100,,,percent of total billed charges,100% of total billed charges,625.19,17.304,,,percent of total billed charges,17.304% of total billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,606.98,16.8,,,percent of total billed charges,16.8% of total billed charges,552.79,15.3,,,percent of total billed charges,15.3% of total billed charges,2492.97,69,,,percent of total billed charges,69% of total billed charges,3613,100,,,percent of total billed charges,100% of total billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,3613,100,,,percent of total billed charges,100% of total billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,3613,100,,,percent of total billed charges,100% of total billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,2234.64,61.85,,,percent of total billed charges,61.85% of total billed charges,606.98,16.8,,,percent of total billed charges,16.8% of total billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,1127.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1806.5,50,,,percent of total billed charges,50% of total Billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,619.12,17.136,,,percent of total billed charges,17.136% of total billed charges,789.08,21.84,,,percent of total billed charges,21.84% of total billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,1362.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1362.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,1224.81,33.9,,,percent of total billed charges,33.9% of total billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,2818.14,78,,,percent of total billed charges,78% of total billed charges,3613,100,,,percent of total billed charges,100% of total billed charges,2984.34,82.6,,,percent of total billed charges,82.6% of total billed charges,2984.34,82.6,,,percent of total billed charges,82.6% of total billed charges,606.98,16.8,,,percent of total billed charges,16.8% of total billed charges,1806.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1806.5,50,,,percent of total billed charges,50% of total Billed charges,606.98,16.8,,,percent of total billed charges,16.8% of total billed charges,552.79,3613,
CATH EP DIG/ABL 3D 2,CATH00068,CDM,272,RC,C1732,HCPCS,Outpatient,,,22374,14543.10,,19689.12,88,,,percent of total billed charges,88% of total Billed charges,11187,50,,,percent of total billed charges,50% of total Billed charges,3758.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3871.6,17.304,,,percent of total billed charges,17.304% of total billed charges,11187,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3758.83,16.8,,,percent of total billed charges,16.8% of total billed charges,3423.22,15.3,,,percent of total billed charges,15.3% of total billed charges,15438.06,69,,,percent of total billed charges,69% of total billed charges,22374,100,,,percent of total billed charges,100% of total billed charges,11187,50,,,percent of total billed charges,50% of total Billed charges,22374,100,,,percent of total billed charges,100% of total billed charges,11187,50,,,percent of total billed charges,50% of total Billed charges,22374,100,,,percent of total billed charges,100% of total billed charges,11187,50,,,percent of total billed charges,50% of total Billed charges,13838.32,61.85,,,percent of total billed charges,61.85% of total billed charges,3758.83,16.8,,,percent of total billed charges,16.8% of total billed charges,11187,50,,,percent of total billed charges,50% of total Billed charges,11187,50,,,percent of total billed charges,50% of total Billed charges,3758.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,11187,50,,,percent of total billed charges,50% of total Billed charges,11187,50,,,percent of total billed charges,50% of total Billed charges,3834.01,17.136,,,percent of total billed charges,17.136% of total billed charges,4886.48,21.84,,,percent of total billed charges,21.84% of total billed charges,11187,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11187,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11187,50,,,percent of total billed charges,50% of total Billed charges,17451.72,78,,,percent of total billed charges,78% of total billed charges,22374,100,,,percent of total billed charges,100% of total billed charges,18480.92,82.6,,,percent of total billed charges,82.6% of total billed charges,18480.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3758.83,16.8,,,percent of total billed charges,16.8% of total billed charges,11187,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11187,50,,,percent of total billed charges,50% of total Billed charges,3758.83,16.8,,,percent of total billed charges,16.8% of total billed charges,3423.22,22374,
CATH TROCAR 16IN 20FR  CS/10,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CATH WHISTLE TIP URET 7FR RT,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CATH GUIDE LAUNCHER 6F AR2.0,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATHETER STEALTH SOLID 1.25MM,ORSUP0087,CDM,278,RC,C1887,HCPCS,Outpatient,,,15340,9971.00,,13499.2,88,,,percent of total billed charges,88% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2654.43,17.304,,,percent of total billed charges,17.304% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,2347.02,15.3,,,percent of total billed charges,15.3% of total billed charges,10584.6,69,,,percent of total billed charges,69% of total billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,9487.79,61.85,,,percent of total billed charges,61.85% of total billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,4786.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7670,50,,,percent of total billed charges,50% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,2628.66,17.136,,,percent of total billed charges,17.136% of total billed charges,3350.26,21.84,,,percent of total billed charges,21.84% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,5783.18,37.7,,,percent of total billed charges,37.70% of total billed charges,5783.18,37.7,,,percent of total billed charges,37.70% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,5200.26,33.9,,,percent of total billed charges,33.9% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,11965.2,78,,,percent of total billed charges,78% of total billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,12670.84,82.6,,,percent of total billed charges,82.6% of total billed charges,12670.84,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7670,50,,,percent of total billed charges,50% of total Billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,2347.02,15340,
CATH PACING 5FR FLOW DIRECTED 5FR 110CM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH GUIDE LAUNCHER 6F HSI,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH CORONARY DILAT RX MINI TREK 2.5MM X 08MM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH MICRO GUIDE FINE CROSS 150CM,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
CATH CXI SUPPORT 2.3FR X 150CM STRAIGHT,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH CXI SUPPORT 4FR X 135CM,ORSUP0016,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH EXTRACTION PRONTO CATHETER V4 5.5FR,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
CATH GUIDE LAUNCHER 6F HSII,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH KIT INFANT/NEO 5 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATHETER KIT EXTENDED COIL,ORSUP0024,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
CATH RESOLVE LOCKING DRAIN 8FR X 25CM,ORSUP0010,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CATH 5FR PERFORMA CARDIAC IM,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 6FR PERFORMA CARDIAC IM,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CATH 5FR PERFORMA STRAIGHT PIG MIV RAD,ORSUP0007,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH THORACIC 28 FR TROCAR,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CATH SOS OMNI SOFT-VU 5FR X 80CM,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
VISIONS PV.014P IVUS CATH,ORSUP0033,CDM,272,RC,,,Outpatient,,,4400,2860.00,,3872,88,,,percent of total billed charges,88% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,761.38,17.304,,,percent of total billed charges,17.304% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2772,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3036,69,,,percent of total billed charges,69% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2721.4,61.85,,,percent of total billed charges,61.85% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,753.98,17.136,,,percent of total billed charges,17.136% of total billed charges,960.96,21.84,,,percent of total billed charges,21.84% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,3432,78,,,percent of total billed charges,78% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,4400,
CATH RESOLVE LOCKING DRAIN 6.5FR X 25CM,ORSUP0009,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CATH TRAY 16 FR SILICONE DRAIN BAG FOLEY LF,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH LUBRI-SIL FOLEY 3 WAY 16 FR 5ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH TORCON NB ADVANTAGE 5FR X 90CM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CATH LOW PROFILE PTA BALLOON 7MMX4CM,ORSUP0009,CDM,278,RC,C1726,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CATH LOW PROFILE PTA BALLOON 5MMX8CM,ORSUP0009,CDM,278,RC,C1726,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CATH KIT ORAL SUCTION,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CATH STATLOCK STABILIZER 6-8FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH LOCKING DRAINAGE 10FR,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CATH HYSTEROSALPINGOGRAM,ORSUP0003,CDM,278,RC,C2628,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CATH RIM 5FR TORCON,ORSUP0002,CDM,278,RC,A4353,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,130,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,130,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,130,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,130,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,percent of total billed charges,100% of total billed charges,130,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,percent of total billed charges,100% of total billed charges,130,100,,,Fee Schedule,100% of Medicare OPPS rate,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,130,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,130,100,,,Fee Schedule,100% of Medicare OPPS rate,130,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,100,,,Fee Schedule,100% of Medicare OPPS rate,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,130,100,,,Fee Schedule,100% of Medicare OPPS rate,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,130,100,,,Fee Schedule,100% of Medicare OPPS rate,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,130,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,130,100,,,Fee Schedule,100% of Medicare OPPS rate,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATHETER LOW PROFILE DIALATION 5FR,ORSUP0009,CDM,278,RC,C1725,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,152.55,33.9,,,percent of total billed charges,33.9% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
CATH DRAINAGE MULTI-PURPOSE 8.5FR X 25CM,ORSUP0015,CDM,278,RC,C1729,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH BERENSTEIN 4FR X 65CM,ORSUP0004,CDM,278,RC,C1752,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATHETER SAF-T-IMA Y ADAPTER PINK 20GA,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATHETER SAF-TIMA Y ADAPTER BLUE 22GA,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATHETER SAF-T-IMA Y ADAPTER YELLOW 24GA,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH ANGIOGRPAHIC 5FR X 65CM,ORSUP0002,CDM,278,RC,C1887,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH SOS OMNI 3 5FR .038 80CM,ORSUP0002,CDM,278,RC,C1887,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATHETER MICRO SUPERSELECTIVE CANTATA 2.8,ORSUP0021,CDM,278,RC,C1887,HCPCS,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,811.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,881.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
CATHETER INFUSION SET MULTI SIDE-PORT,ORSUP0010,CDM,278,RC,C1751,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CATH CXI SUPPORT 2.3FR,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH ANGIO RADIAL TIG 4.0 6FR,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CATH ANGIO SARAH RADIAL 6FR,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CATH DRAINAGE MALECOT SUPRAPUBIC SET 16FR,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
CATH BALLOON DIALTION LOW PROFILE 5FR,ORSUP0011,CDM,278,RC,C1726,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
CATHETER NAVVUS II MICRO335CM,ORSUP0029,CDM,278,RC,C1725,HCPCS,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1460.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1586.52,33.9,,,percent of total billed charges,33.9% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
CATHETER BALLOON DIALATION 18MM/19MM/20MM,ORSUP0019,CDM,278,RC,C1726,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CATH ARGYLE STRT 35 FR X 20,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH DIAG CARDIO 6FR 3DRC INFI,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH DIAG CARDIO 6FR MPA2 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH FOGARTY BILLIARY 5FR,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATH FOGARTY BILLIARY 6FR,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CATHETER EMBOLECTOMY FOGARTY 4FR,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CATHETER CXI SUPPORT 2.6FR ANGLED,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH PIGTAIL 5FR 65CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR JR  3.5 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR JR 4 125CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR JR 4.5 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR JR 4 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR AL 1.0 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR AL 2.0 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR AR 1.0 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR AR 2.0 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR MPA 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR MPA2 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR 3DRC 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR RCB 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR LCB 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR IM 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 5FR ANG PIGTAIL 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH 6FR ULTRA 4.0 RADIAL,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH 5FR TRANS 3.5 RADIAL,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH 5FR TRANS 4.0 RADIAL,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH 6FR ULTRA 3.50 RADIAL,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH 6FR TRANS 4.0 RADIAL,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH 5FR ULTRA 4.5 RADIAL,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH RF ABLATION 6FR 100CM,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CATHETER 3-WAY 22FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH FOLEY SIL-ELAST 14FR 10,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY  COUDE LATEX 16FR 10ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY COUDE LATEX 18FR 10ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY COUDE LATEX 20FR 10ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY SILICONE 12FR 10ML LF,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY SILICONE 16FR 10ML LF,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY SILICONE 18FR 10 ML LF,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY SILICONE 20FR 10 ML LF,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY SILICONE 22FR 10 ML LF,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY SILICONE 24FR 10 ML LF,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY SILICONE 8FR 3ML LF,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH FOLEY LATEX 8FR 3ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY LATEX 10FR 3ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY LATEX 24FR 10ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY LATEX 30FR 10ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH RED RUBBER STRL 10FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH RED RUBBER STRL 16FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH RED RUBBER STRL 20FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH FOLEY SIL-ELAST 14FR 17,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH SLIT SET,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CATH SET PLEURAL \\T\\ PERITONEAL,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
CATH ALL SILICON FOLEY 24FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CATH CARSON COUDE 18FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH FOLEY 2 WAY 20FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH FOLEY 2 WAY 22FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH FOLEY 2 WAY 24FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH COUDE 3 WAY 24FR 30CC,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH BIPOLAR TEMP W/ SHROUDED PINS,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH GUIDE LAUNCHER 6FR AL 1.75,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 6FR 3DRC,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 6FR JR 4.5,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 6FR MP1,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 6FR MP2,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 6FR MB2,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 5FR JL 4.0 SIDEHOLES,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 5FR AL 1.75,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 5FR JR 4.0 SIDEHOLES,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 5FR JR 4.5,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 5FR 3DRC,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 5FR AR 1.0,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 5FR AR 2.0,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 5FR MP1,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 5FR MP2,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH GUIDE LAUNCHER 5FR MB2,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CATH COBRA 2 5FRX90CM,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CATH PIGTAIL 5FRX65CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH ANGIO OMNI FLUSH5FRX90CM,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CATH HEADHUNTER 5FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH BERENSTEIN 6FRX65CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH THORACIC STRIAGHT 32FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATH GRAINAGE MULTIPURPOSE 14FR X 25,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH COBRA 5FR X 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CATHETER STRAIGHT MARKER 5FR X 100CM,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CATH INFUSION SET 5FR X 7CM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CATH CXI SUPPORT 018 2.6FR X 150CM ANG,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH CXI SUPPORT 014 2.3FR X 65CM STR,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CATH PTA BALLOON 6MM X 2CM X 135CM,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
CATH PTA BALLOON 4MM X 8CM X 135CM,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
CATH PTA BALLOON 5MM X 6CM X 135CM,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
CATH PTA BALLOON 5MM X 10CM X 135CM,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
CATH PTA BALLOON 6MM X 6CM X 135CM,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
CATH PTA BALLOON 7MM X 10CM X 135CM,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
CATH PTA BALLOON 6MM X 10CM X 135CM,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
CATH PTA BALLOON 8MM X 8CM X135CM,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
CATH PTA BALLOON 10MM X 4CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
CATH ANG CXI 135CM,ORSUP0013,CDM,272,RC,,,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,504,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
CATH OMNI FLUSH 5FRX80CM,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
CATH SIMMONS SIDEWINDER 2 X 100CM,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
CATH BERENSTEIN 5FR X 100CM,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
CATH DRAINAGE PIGTAIL 8FR X 30CM,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
CATH BERENSTEIN 6FR X 100CM,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
CATH CONQUEST 8MM X 60MM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH DIAG CARDIO 5FR MPB2 INFI,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CATH CHOLANGIOGRAM 11 DISP,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
CATH KIT CENTRAL VENOUS,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
CATH SERENITY DILATION BALLOON 2.0MMX100MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 20MMX220MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 2.0MMX40MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 2.0MMX60MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 3.0X100MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 3.0MMX20MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 3.0MMX220MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 3.0X40MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 3.0MMX60MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 4.0MMX40MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 4.0MMX60MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 4.0MMX100M,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH SERENITY DILATION BALLOON 4.0MM X 220MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CATH DIAMOND BACK EXCHANGE 2.00 SOLID,ORSUP0070,CDM,278,RC,C2625,HCPCS,Outpatient,,,12000,7800.00,,10560,88,,,percent of total billed charges,88% of total Billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,2016,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2076.48,17.304,,,percent of total billed charges,17.304% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,7560,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2016,16.8,,,percent of total billed charges,16.8% of total billed charges,1836,15.3,,,percent of total billed charges,15.3% of total billed charges,8280,69,,,percent of total billed charges,69% of total billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,7422,61.85,,,percent of total billed charges,61.85% of total billed charges,2016,16.8,,,percent of total billed charges,16.8% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,3744,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6000,50,,,percent of total billed charges,50% of total Billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,2056.32,17.136,,,percent of total billed charges,17.136% of total billed charges,2620.8,21.84,,,percent of total billed charges,21.84% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,4524,37.7,,,percent of total billed charges,37.70% of total billed charges,4524,37.7,,,percent of total billed charges,37.70% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,4068,33.9,,,percent of total billed charges,33.9% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,9360,78,,,percent of total billed charges,78% of total billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,9912,82.6,,,percent of total billed charges,82.6% of total billed charges,9912,82.6,,,percent of total billed charges,82.6% of total billed charges,2016,16.8,,,percent of total billed charges,16.8% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6000,50,,,percent of total billed charges,50% of total Billed charges,2016,16.8,,,percent of total billed charges,16.8% of total billed charges,1836,12000,
CATH DIAMOND BACK EXCHANGE 2.00 SOLID,ORSUP0070,CDM,278,RC,C2625,HCPCS,Outpatient,,,12000,7800.00,,10560,88,,,percent of total billed charges,88% of total Billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,2016,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2076.48,17.304,,,percent of total billed charges,17.304% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,7560,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2016,16.8,,,percent of total billed charges,16.8% of total billed charges,1836,15.3,,,percent of total billed charges,15.3% of total billed charges,8280,69,,,percent of total billed charges,69% of total billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,7422,61.85,,,percent of total billed charges,61.85% of total billed charges,2016,16.8,,,percent of total billed charges,16.8% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,3744,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6000,50,,,percent of total billed charges,50% of total Billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,2056.32,17.136,,,percent of total billed charges,17.136% of total billed charges,2620.8,21.84,,,percent of total billed charges,21.84% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,4524,37.7,,,percent of total billed charges,37.70% of total billed charges,4524,37.7,,,percent of total billed charges,37.70% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,4068,33.9,,,percent of total billed charges,33.9% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,9360,78,,,percent of total billed charges,78% of total billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,9912,82.6,,,percent of total billed charges,82.6% of total billed charges,9912,82.6,,,percent of total billed charges,82.6% of total billed charges,2016,16.8,,,percent of total billed charges,16.8% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6000,50,,,percent of total billed charges,50% of total Billed charges,2016,16.8,,,percent of total billed charges,16.8% of total billed charges,1836,12000,
CATH CONQUEST BALLOON 6X20X50,ORSUP0017,CDM,278,RC,C1725,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CATH CXI SUPPORT STRAIGHT 2.3X014X135,ORSUP0020,CDM,272,RC,,,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
CATH CXI SUPPORT ANGLED 2.6X018X135,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
CATH RDC 5FR X 65CM,ORSUP0002,CDM,278,RC,C1725,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CATH RADIOFOCUSED NON TAPER 4X65X0.38,ORSUP0010,CDM,272,RC,,,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
CATH ZELANTE DVT 8FR X 105CM,ORSUP0101,CDM,272,RC,,,Outpatient,,,18400,11960.00,,16192,88,,,percent of total billed charges,88% of total Billed charges,9200,50,,,percent of total billed charges,50% of total Billed charges,3091.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3183.94,17.304,,,percent of total billed charges,17.304% of total billed charges,9200,50,,,percent of total billed charges,50% of total Billed charges,11592,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3091.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2815.2,15.3,,,percent of total billed charges,15.3% of total billed charges,12696,69,,,percent of total billed charges,69% of total billed charges,18400,100,,,percent of total billed charges,100% of total billed charges,9200,50,,,percent of total billed charges,50% of total Billed charges,18400,100,,,percent of total billed charges,100% of total billed charges,9200,50,,,percent of total billed charges,50% of total Billed charges,18400,100,,,percent of total billed charges,100% of total billed charges,9200,50,,,percent of total billed charges,50% of total Billed charges,11380.4,61.85,,,percent of total billed charges,61.85% of total billed charges,3091.2,16.8,,,percent of total billed charges,16.8% of total billed charges,9200,50,,,percent of total billed charges,50% of total Billed charges,9200,50,,,percent of total billed charges,50% of total Billed charges,3091.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,9200,50,,,percent of total billed charges,50% of total Billed charges,9200,50,,,percent of total billed charges,50% of total Billed charges,3153.02,17.136,,,percent of total billed charges,17.136% of total billed charges,4018.56,21.84,,,percent of total billed charges,21.84% of total billed charges,9200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9200,50,,,percent of total billed charges,50% of total Billed charges,14352,78,,,percent of total billed charges,78% of total billed charges,18400,100,,,percent of total billed charges,100% of total billed charges,15198.4,82.6,,,percent of total billed charges,82.6% of total billed charges,15198.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3091.2,16.8,,,percent of total billed charges,16.8% of total billed charges,9200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9200,50,,,percent of total billed charges,50% of total Billed charges,3091.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2815.2,18400,
CATH THORACIC 24FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CATH ANGIO 5FR ROYALFLUSH PIG 70CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CATJ 5FR JR 4 100CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CAUTERY SCRATCH PAD,186960,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
CAUTERY ROCKERSWITCH PENCIL W/O HOLSTER STRL DISP.,187626,CDM,270,RC,,,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,7.09,17.304,,,percent of total billed charges,17.304% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,15.3,,,percent of total billed charges,15.3% of total billed charges,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.36,61.85,,,percent of total billed charges,61.85% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,7.03,17.136,,,percent of total billed charges,17.136% of total billed charges,8.95,21.84,,,percent of total billed charges,21.84% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,41,
CAUTERY ELECTRODE EXT,62315,CDM,270,RC,,,Outpatient,,,332,215.80,,292.16,88,,,percent of total billed charges,88% of total Billed charges,166,50,,,percent of total billed charges,50% of total Billed charges,55.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,332,100,,,percent of total billed charges,100% of total billed charges,57.45,17.304,,,percent of total billed charges,17.304% of total billed charges,166,50,,,percent of total billed charges,50% of total Billed charges,209.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,55.78,16.8,,,percent of total billed charges,16.8% of total billed charges,50.8,15.3,,,percent of total billed charges,15.3% of total billed charges,229.08,69,,,percent of total billed charges,69% of total billed charges,332,100,,,percent of total billed charges,100% of total billed charges,166,50,,,percent of total billed charges,50% of total Billed charges,332,100,,,percent of total billed charges,100% of total billed charges,166,50,,,percent of total billed charges,50% of total Billed charges,332,100,,,percent of total billed charges,100% of total billed charges,166,50,,,percent of total billed charges,50% of total Billed charges,205.34,61.85,,,percent of total billed charges,61.85% of total billed charges,55.78,16.8,,,percent of total billed charges,16.8% of total billed charges,166,50,,,percent of total billed charges,50% of total Billed charges,166,50,,,percent of total billed charges,50% of total Billed charges,55.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,166,50,,,percent of total billed charges,50% of total Billed charges,166,50,,,percent of total billed charges,50% of total Billed charges,56.89,17.136,,,percent of total billed charges,17.136% of total billed charges,72.51,21.84,,,percent of total billed charges,21.84% of total billed charges,166,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,166,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,166,50,,,percent of total billed charges,50% of total Billed charges,258.96,78,,,percent of total billed charges,78% of total billed charges,332,100,,,percent of total billed charges,100% of total billed charges,274.23,82.6,,,percent of total billed charges,82.6% of total billed charges,274.23,82.6,,,percent of total billed charges,82.6% of total billed charges,55.78,16.8,,,percent of total billed charges,16.8% of total billed charges,166,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,166,50,,,percent of total billed charges,50% of total Billed charges,55.78,16.8,,,percent of total billed charges,16.8% of total billed charges,50.8,332,
CAUTERY MONOPOLAR 5MM SINGLE SITE,ORSUP0039,CDM,272,RC,,,Outpatient,,,7280,4732.00,,6406.4,88,,,percent of total billed charges,88% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1259.73,17.304,,,percent of total billed charges,17.304% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4586.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,15.3,,,percent of total billed charges,15.3% of total billed charges,5023.2,69,,,percent of total billed charges,69% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4502.68,61.85,,,percent of total billed charges,61.85% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1247.5,17.136,,,percent of total billed charges,17.136% of total billed charges,1589.95,21.84,,,percent of total billed charges,21.84% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3640,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3640,50,,,percent of total billed charges,50% of total Billed charges,5678.4,78,,,percent of total billed charges,78% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,7280,
CAUTERY TIP ELECTRODE 0012,490312,CDM,270,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
CAUTERY TIPS NEEDLE POINT 0013,490316,CDM,272,RC,,,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.5,17.304,,,percent of total billed charges,17.304% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.08,61.85,,,percent of total billed charges,61.85% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.46,17.136,,,percent of total billed charges,17.136% of total billed charges,5.68,21.84,,,percent of total billed charges,21.84% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,26,
CAUTERY TIP CLEANER,490311,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
CAUTERY TIP ELECTRODE 0012M,490313,CDM,270,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
CAUTERY TIP ELECTRODE 0014M,490314,CDM,270,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
CAUTERY TIP NEEDLE PT. 0013MD,490315,CDM,272,RC,,,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,7.79,17.304,,,percent of total billed charges,17.304% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,27.83,61.85,,,percent of total billed charges,61.85% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.71,17.136,,,percent of total billed charges,17.136% of total billed charges,9.83,21.84,,,percent of total billed charges,21.84% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
CAUTERY PENCIL ROCKER W/HOLDER,490309,CDM,270,RC,,,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.4,17.304,,,percent of total billed charges,17.304% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,23.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.34,17.136,,,percent of total billed charges,17.136% of total billed charges,8.08,21.84,,,percent of total billed charges,21.84% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,37,
CAUTERY BLADE NONSTICK PTFE COATED 2.5,490304,CDM,272,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
CAUTERY BLADE NONSTICK PTFE COATED 6,490305,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
CAUTERY MICROSURGICAL NEEDLE TIP,490306,CDM,272,RC,,,Outpatient,,,177,115.05,,155.76,88,,,percent of total billed charges,88% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,30.63,17.304,,,percent of total billed charges,17.304% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,111.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,15.3,,,percent of total billed charges,15.3% of total billed charges,122.13,69,,,percent of total billed charges,69% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,177,100,,,percent of total billed charges,100% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,109.47,61.85,,,percent of total billed charges,61.85% of total billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,30.33,17.136,,,percent of total billed charges,17.136% of total billed charges,38.66,21.84,,,percent of total billed charges,21.84% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,138.06,78,,,percent of total billed charges,78% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,88.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88.5,50,,,percent of total billed charges,50% of total Billed charges,29.74,16.8,,,percent of total billed charges,16.8% of total billed charges,27.08,177,
CAUTERY NEEDLE TIP,490307,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
CAUTERY PENCIL W/ HOLDER,490310,CDM,270,RC,,,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,11.94,17.304,,,percent of total billed charges,17.304% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,43.47,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,42.68,61.85,,,percent of total billed charges,61.85% of total billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.82,17.136,,,percent of total billed charges,17.136% of total billed charges,15.07,21.84,,,percent of total billed charges,21.84% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,10.56,69,
CAYENNE MEDICAL APERFIX-II CANNULATED TIBIAL IMPLANT 10MM X,ORSUP0026,CDM,278,RC,C1713,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
CAYENNE MEDICAL APERFIX-II CANNULATED TIBIAL IMPLANT 11MM X,ORSUP0026,CDM,278,RC,C1713,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
CAYENNE MEDICAL APERFIX-II CANNULATED TIBIAL IMPLANT 9MM X 3,ORSUP0026,CDM,278,RC,C1713,HCPCS,Outpatient,,,3000,1950.00,,2640,88,,,percent of total billed charges,88% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,519.12,17.304,,,percent of total billed charges,17.304% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1890,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,15.3,,,percent of total billed charges,15.3% of total billed charges,2070,69,,,percent of total billed charges,69% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1855.5,61.85,,,percent of total billed charges,61.85% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,936,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,514.08,17.136,,,percent of total billed charges,17.136% of total billed charges,655.2,21.84,,,percent of total billed charges,21.84% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1017,33.9,,,percent of total billed charges,33.9% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,2340,78,,,percent of total billed charges,78% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,3000,
CAYENNE MEDICAL APERFIX-II TIBIAL IMPLANT 8MM X 30MM,ORSUP0026,CDM,278,RC,C1713,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
CBD FITZGIBBONS CATH SET,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CD HORIZON SOLERA 4.75MM SPINAL SYSTEM,ORSUP0031,CDM,278,RC,C1755,HCPCS,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
CD HORIZON X10 CROSSLINK MULTI-SPAN PLATE,ORSUP0029,CDM,278,RC,C1755,HCPCS,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1460.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1586.52,33.9,,,percent of total billed charges,33.9% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
CELL LYSE D X H FP,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CELL SAVER 5 FAST PACK          260,ORSUP0013,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CELL CHEX 4X2.OML LVL 1\\T\\2 (4/PK),ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CELL ADAPTER,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CELL SAVER TUBING HAR-A-1000,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CELLPACK DCL 20L,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CEMENT BONE RADIOPAQUE 40G. FULL DOSE STER 10/PK,ORSUP0014,CDM,278,RC,C1763,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CEMENT BONE SIMPLEX ANTIBIOTIC,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CEMENT BONE PALACOS,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CEMENT BONE PALACOS W/GENTIMICIN,ORSUP0018,CDM,278,RC,C1763,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
CEMENT BONE SIMPLEX HV US 10 PK,ORSUP0005,CDM,278,RC,C1763,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CEMENT BONE KYPHX SINGLE,ORSUP0008,CDM,278,RC,C1755,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CEMENT KYPHON MIXING BOWL,ORSUP0012,CDM,278,RC,C1755,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CEMENT MIXER W/FEMORAL NOZZEL,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CEMENT BONE SIMPLEX HV W/GENTAMICIM,ORSUP0016,CDM,278,RC,C1763,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CEMENT BONE BIOMET R 1X40US,ORSUP0014,CDM,278,RC,C1763,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CERVICAL DISC 6MM M ARTIFICIA,ORSUP0145,CDM,278,RC,C1713,HCPCS,Outpatient,,,35620,23153.00,,31345.6,88,,,percent of total billed charges,88% of total Billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,5984.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,6163.68,17.304,,,percent of total billed charges,17.304% of total billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,22440.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5984.16,16.8,,,percent of total billed charges,16.8% of total billed charges,5449.86,15.3,,,percent of total billed charges,15.3% of total billed charges,24577.8,69,,,percent of total billed charges,69% of total billed charges,35620,100,,,percent of total billed charges,100% of total billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,35620,100,,,percent of total billed charges,100% of total billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,35620,100,,,percent of total billed charges,100% of total billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,22030.97,61.85,,,percent of total billed charges,61.85% of total billed charges,5984.16,16.8,,,percent of total billed charges,16.8% of total billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,11113.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17810,50,,,percent of total billed charges,50% of total Billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,6103.84,17.136,,,percent of total billed charges,17.136% of total billed charges,7779.41,21.84,,,percent of total billed charges,21.84% of total billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,13428.74,37.7,,,percent of total billed charges,37.70% of total billed charges,13428.74,37.7,,,percent of total billed charges,37.70% of total billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,12075.18,33.9,,,percent of total billed charges,33.9% of total billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,27783.6,78,,,percent of total billed charges,78% of total billed charges,35620,100,,,percent of total billed charges,100% of total billed charges,29422.12,82.6,,,percent of total billed charges,82.6% of total billed charges,29422.12,82.6,,,percent of total billed charges,82.6% of total billed charges,5984.16,16.8,,,percent of total billed charges,16.8% of total billed charges,17810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17810,50,,,percent of total billed charges,50% of total Billed charges,5984.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,35620,
CHANNEL DRAIN ROUND 32FR,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CHANNEL BRUSH 16IN 18FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CHANNEL BRUSH 12IN 12FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CHANNEL BRUSH 8IN 19FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CHANNEL BRUSH 24IN 22.35MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CHANNEL BRUSH TAPERED 18IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CHANNEL BRUSH DIAG 6 LONG,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CHANNEL BRUSH 6 X 0.079,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CHANNEL BRUSH8,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CHARCOAL SELECTIVE MEDIUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CHECKPOINT 3.5MM HEX X 15 MM STERILE,ORSUP0009,CDM,278,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CHECK STRIP SET,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CHECK FLO HEMOSTASIS ASSEMBLY,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CHECKFLO ANSL1 6FR X 55CM SHEATH,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
CHEMSTRIP INFORM II METER,490327,CDM,270,RC,,,Outpatient,,,138,89.70,,121.44,88,,,percent of total billed charges,88% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,23.88,17.304,,,percent of total billed charges,17.304% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,86.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,21.11,15.3,,,percent of total billed charges,15.3% of total billed charges,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,85.35,61.85,,,percent of total billed charges,61.85% of total billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.65,17.136,,,percent of total billed charges,17.136% of total billed charges,30.14,21.84,,,percent of total billed charges,21.84% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,21.11,138,
CHEMO SPILL KITS,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CHEST TUBE AND TRAYS THAL-QUICK 20 FR,ORSUP0012,CDM,278,RC,C1729,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CHIPS CALCANEOUS 5CC RADIATED,ORSUP0013,CDM,278,RC,C1762,HCPCS,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,504,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,271.2,33.9,,,percent of total billed charges,33.9% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
CHIPS CANCELLOUS 15CC 1.7-10MM,ORSUP0019,CDM,278,RC,C1762,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CHLORAPREP WITH TINT 26ML APPLICATOR,227580,CDM,270,RC,,,Outpatient,,,1121,728.65,,986.48,88,,,percent of total billed charges,88% of total Billed charges,560.5,50,,,percent of total billed charges,50% of total Billed charges,188.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,1121,100,,,percent of total billed charges,100% of total billed charges,193.98,17.304,,,percent of total billed charges,17.304% of total billed charges,560.5,50,,,percent of total billed charges,50% of total Billed charges,706.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,188.33,16.8,,,percent of total billed charges,16.8% of total billed charges,171.51,15.3,,,percent of total billed charges,15.3% of total billed charges,773.49,69,,,percent of total billed charges,69% of total billed charges,1121,100,,,percent of total billed charges,100% of total billed charges,560.5,50,,,percent of total billed charges,50% of total Billed charges,1121,100,,,percent of total billed charges,100% of total billed charges,560.5,50,,,percent of total billed charges,50% of total Billed charges,1121,100,,,percent of total billed charges,100% of total billed charges,560.5,50,,,percent of total billed charges,50% of total Billed charges,693.34,61.85,,,percent of total billed charges,61.85% of total billed charges,188.33,16.8,,,percent of total billed charges,16.8% of total billed charges,560.5,50,,,percent of total billed charges,50% of total Billed charges,560.5,50,,,percent of total billed charges,50% of total Billed charges,188.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,560.5,50,,,percent of total billed charges,50% of total Billed charges,560.5,50,,,percent of total billed charges,50% of total Billed charges,192.09,17.136,,,percent of total billed charges,17.136% of total billed charges,244.83,21.84,,,percent of total billed charges,21.84% of total billed charges,560.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,560.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,560.5,50,,,percent of total billed charges,50% of total Billed charges,874.38,78,,,percent of total billed charges,78% of total billed charges,1121,100,,,percent of total billed charges,100% of total billed charges,925.95,82.6,,,percent of total billed charges,82.6% of total billed charges,925.95,82.6,,,percent of total billed charges,82.6% of total billed charges,188.33,16.8,,,percent of total billed charges,16.8% of total billed charges,560.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,560.5,50,,,percent of total billed charges,50% of total Billed charges,188.33,16.8,,,percent of total billed charges,16.8% of total billed charges,171.51,1121,
CHLORAPREP TINTED 10.5ML,225137,CDM,270,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
CHLORAPREP APPLICATOR 10.5ML ORG TINT,252154,CDM,270,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
CHLORAPREP APPLICATOR 26ML ORG TINT,252158,CDM,270,RC,,,Outpatient,,,79,51.35,,69.52,88,,,percent of total billed charges,88% of total Billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,13.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,79,100,,,percent of total billed charges,100% of total billed charges,13.67,17.304,,,percent of total billed charges,17.304% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,49.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,12.09,15.3,,,percent of total billed charges,15.3% of total billed charges,54.51,69,,,percent of total billed charges,69% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,79,100,,,percent of total billed charges,100% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,79,100,,,percent of total billed charges,100% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,48.86,61.85,,,percent of total billed charges,61.85% of total billed charges,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,13.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,13.54,17.136,,,percent of total billed charges,17.136% of total billed charges,17.25,21.84,,,percent of total billed charges,21.84% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39.5,50,,,percent of total billed charges,50% of total Billed charges,61.62,78,,,percent of total billed charges,78% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,39.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39.5,50,,,percent of total billed charges,50% of total Billed charges,13.27,16.8,,,percent of total billed charges,16.8% of total billed charges,12.09,79,
CHLORAPREP APPLICATOR 3ML,84585,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
CHLORHEXIDINE PREP 4% 4 OZ,490333,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
CHLORAPREP SWB STICK APPLICATOR 1.75ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CHLORIDE CL-/5 PK / 250 SLDS INCL URINE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CHLORIDE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CHLORAPREP 3ML HI-LITE ORANGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CHOCOLATE AGAR W BACITRACIN,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
AGAR MEDIUM CHOCOLATE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CHOLE TRAY,326392,CDM,270,RC,,,Outpatient,,,288,187.20,,253.44,88,,,percent of total billed charges,88% of total Billed charges,144,50,,,percent of total billed charges,50% of total Billed charges,48.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,288,100,,,percent of total billed charges,100% of total billed charges,49.84,17.304,,,percent of total billed charges,17.304% of total billed charges,144,50,,,percent of total billed charges,50% of total Billed charges,181.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,48.38,16.8,,,percent of total billed charges,16.8% of total billed charges,44.06,15.3,,,percent of total billed charges,15.3% of total billed charges,198.72,69,,,percent of total billed charges,69% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,144,50,,,percent of total billed charges,50% of total Billed charges,288,100,,,percent of total billed charges,100% of total billed charges,144,50,,,percent of total billed charges,50% of total Billed charges,288,100,,,percent of total billed charges,100% of total billed charges,144,50,,,percent of total billed charges,50% of total Billed charges,178.13,61.85,,,percent of total billed charges,61.85% of total billed charges,48.38,16.8,,,percent of total billed charges,16.8% of total billed charges,144,50,,,percent of total billed charges,50% of total Billed charges,144,50,,,percent of total billed charges,50% of total Billed charges,48.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,144,50,,,percent of total billed charges,50% of total Billed charges,144,50,,,percent of total billed charges,50% of total Billed charges,49.35,17.136,,,percent of total billed charges,17.136% of total billed charges,62.9,21.84,,,percent of total billed charges,21.84% of total billed charges,144,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,144,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,144,50,,,percent of total billed charges,50% of total Billed charges,224.64,78,,,percent of total billed charges,78% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,48.38,16.8,,,percent of total billed charges,16.8% of total billed charges,144,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,144,50,,,percent of total billed charges,50% of total Billed charges,48.38,16.8,,,percent of total billed charges,16.8% of total billed charges,44.06,288,
CHOLESTEROL /5 PACK / 300 SLDS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CHOLANGIOGRAM CATH 23CM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CINCHPAD ENDOSCOPE TRANSPORT BAG,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CIRCUIT ANES PEDIATRIC BREATHING LF,291739,CDM,270,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
CIRCUIT ADULT ANES. BREATHING,291740,CDM,272,RC,,,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,10.9,17.304,,,percent of total billed charges,17.304% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,39.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,38.97,61.85,,,percent of total billed charges,61.85% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.8,17.136,,,percent of total billed charges,17.136% of total billed charges,13.76,21.84,,,percent of total billed charges,21.84% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,63,
CIRCUIT HIGH FLOW DISPOSABLE INCLUDES WATER PATH,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
CIRCUIT VENT CV-4,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
CATH SUPRAPUBIC BALLOON 10FR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CK / 5 PACK / 90 SLIDES,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CLAMP ADJ  DISTAL RADIUS FIXATOR 4.0 MM,ORSUP0030,CDM,278,RC,C1713,HCPCS,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1541.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1674.66,33.9,,,percent of total billed charges,33.9% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
CLAMP COMBINATION FOR LARGE EXTERNAL FIXATORS,ORSUP0026,CDM,278,RC,C1713,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
CLAMP LARGE MULTI-PIN 4 POS MR SAFE,ORSUP0027,CDM,278,RC,C1713,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
CLAMP TUBE TI LOW PROFILE NEURO ADAPTION PLATE 20 HOLES,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
CLAMP TUBE TI LOW PROFILE NEURO BOX PLATE 10MM X 16MM/4 HOLES,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CLAMP--UMBILICAL CORD,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CLEANSER SKIN EXIDINE 4 OZ,185640,CDM,270,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
CLEANSER AVAGARD,44748,CDM,270,RC,,,Outpatient,,,280,182.00,,246.4,88,,,percent of total billed charges,88% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,280,100,,,percent of total billed charges,100% of total billed charges,48.45,17.304,,,percent of total billed charges,17.304% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,176.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,42.84,15.3,,,percent of total billed charges,15.3% of total billed charges,193.2,69,,,percent of total billed charges,69% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,280,100,,,percent of total billed charges,100% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,280,100,,,percent of total billed charges,100% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,173.18,61.85,,,percent of total billed charges,61.85% of total billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,47.98,17.136,,,percent of total billed charges,17.136% of total billed charges,61.15,21.84,,,percent of total billed charges,21.84% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,140,50,,,percent of total billed charges,50% of total Billed charges,218.4,78,,,percent of total billed charges,78% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,140,50,,,percent of total billed charges,50% of total Billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,42.84,280,
CLEANSER WOUND SUR CLENS,186980,CDM,270,RC,,,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,12.46,17.304,,,percent of total billed charges,17.304% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,45.36,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,15.3,,,percent of total billed charges,15.3% of total billed charges,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,44.53,61.85,,,percent of total billed charges,61.85% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.34,17.136,,,percent of total billed charges,17.136% of total billed charges,15.72,21.84,,,percent of total billed charges,21.84% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,72,
CLEANER DISINFECTANT CIDEX OPA SOLUTION GALLON,160748,CDM,270,RC,,,Outpatient,,,158,102.70,,139.04,88,,,percent of total billed charges,88% of total Billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,26.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,158,100,,,percent of total billed charges,100% of total billed charges,27.34,17.304,,,percent of total billed charges,17.304% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,99.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,26.54,16.8,,,percent of total billed charges,16.8% of total billed charges,24.17,15.3,,,percent of total billed charges,15.3% of total billed charges,109.02,69,,,percent of total billed charges,69% of total billed charges,158,100,,,percent of total billed charges,100% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,158,100,,,percent of total billed charges,100% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,158,100,,,percent of total billed charges,100% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,97.72,61.85,,,percent of total billed charges,61.85% of total billed charges,26.54,16.8,,,percent of total billed charges,16.8% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,26.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,27.07,17.136,,,percent of total billed charges,17.136% of total billed charges,34.51,21.84,,,percent of total billed charges,21.84% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,79,50,,,percent of total billed charges,50% of total Billed charges,123.24,78,,,percent of total billed charges,78% of total billed charges,158,100,,,percent of total billed charges,100% of total billed charges,130.51,82.6,,,percent of total billed charges,82.6% of total billed charges,130.51,82.6,,,percent of total billed charges,82.6% of total billed charges,26.54,16.8,,,percent of total billed charges,16.8% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,79,50,,,percent of total billed charges,50% of total Billed charges,26.54,16.8,,,percent of total billed charges,16.8% of total billed charges,24.17,158,
CLEAN B SOLUTION,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CLEANER OXYCIDE DISINFECTANT 96 OZ CS/2,442557,CDM,270,RC,,,Outpatient,,,417,271.05,,366.96,88,,,percent of total billed charges,88% of total Billed charges,208.5,50,,,percent of total billed charges,50% of total Billed charges,70.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,417,100,,,percent of total billed charges,100% of total billed charges,72.16,17.304,,,percent of total billed charges,17.304% of total billed charges,208.5,50,,,percent of total billed charges,50% of total Billed charges,262.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,70.06,16.8,,,percent of total billed charges,16.8% of total billed charges,63.8,15.3,,,percent of total billed charges,15.3% of total billed charges,287.73,69,,,percent of total billed charges,69% of total billed charges,417,100,,,percent of total billed charges,100% of total billed charges,208.5,50,,,percent of total billed charges,50% of total Billed charges,417,100,,,percent of total billed charges,100% of total billed charges,208.5,50,,,percent of total billed charges,50% of total Billed charges,417,100,,,percent of total billed charges,100% of total billed charges,208.5,50,,,percent of total billed charges,50% of total Billed charges,257.91,61.85,,,percent of total billed charges,61.85% of total billed charges,70.06,16.8,,,percent of total billed charges,16.8% of total billed charges,208.5,50,,,percent of total billed charges,50% of total Billed charges,208.5,50,,,percent of total billed charges,50% of total Billed charges,70.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,208.5,50,,,percent of total billed charges,50% of total Billed charges,208.5,50,,,percent of total billed charges,50% of total Billed charges,71.46,17.136,,,percent of total billed charges,17.136% of total billed charges,91.07,21.84,,,percent of total billed charges,21.84% of total billed charges,208.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,208.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,208.5,50,,,percent of total billed charges,50% of total Billed charges,325.26,78,,,percent of total billed charges,78% of total billed charges,417,100,,,percent of total billed charges,100% of total billed charges,344.44,82.6,,,percent of total billed charges,82.6% of total billed charges,344.44,82.6,,,percent of total billed charges,82.6% of total billed charges,70.06,16.8,,,percent of total billed charges,16.8% of total billed charges,208.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,208.5,50,,,percent of total billed charges,50% of total Billed charges,70.06,16.8,,,percent of total billed charges,16.8% of total billed charges,63.8,417,
CLEANING SOLUTION,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CLEAR DRAWSTRING BAG,285644,CDM,270,RC,,,Outpatient,,,510,331.50,,448.8,88,,,percent of total billed charges,88% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,88.25,17.304,,,percent of total billed charges,17.304% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,321.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,78.03,15.3,,,percent of total billed charges,15.3% of total billed charges,351.9,69,,,percent of total billed charges,69% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,315.44,61.85,,,percent of total billed charges,61.85% of total billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,87.39,17.136,,,percent of total billed charges,17.136% of total billed charges,111.38,21.84,,,percent of total billed charges,21.84% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,397.8,78,,,percent of total billed charges,78% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,78.03,510,
CLEARIFY VISUALIZATION SYSTEM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CLEARIFY VISUALIZATIOIN SYS,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CLEANING BRUSH ENDOSCOPE,490342,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
CLEANER AUTOCLAVE,490341,CDM,270,RC,,,Outpatient,,,262,170.30,,230.56,88,,,percent of total billed charges,88% of total Billed charges,131,50,,,percent of total billed charges,50% of total Billed charges,44.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,262,100,,,percent of total billed charges,100% of total billed charges,45.34,17.304,,,percent of total billed charges,17.304% of total billed charges,131,50,,,percent of total billed charges,50% of total Billed charges,165.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,44.02,16.8,,,percent of total billed charges,16.8% of total billed charges,40.09,15.3,,,percent of total billed charges,15.3% of total billed charges,180.78,69,,,percent of total billed charges,69% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,131,50,,,percent of total billed charges,50% of total Billed charges,262,100,,,percent of total billed charges,100% of total billed charges,131,50,,,percent of total billed charges,50% of total Billed charges,262,100,,,percent of total billed charges,100% of total billed charges,131,50,,,percent of total billed charges,50% of total Billed charges,162.05,61.85,,,percent of total billed charges,61.85% of total billed charges,44.02,16.8,,,percent of total billed charges,16.8% of total billed charges,131,50,,,percent of total billed charges,50% of total Billed charges,131,50,,,percent of total billed charges,50% of total Billed charges,44.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,131,50,,,percent of total billed charges,50% of total Billed charges,131,50,,,percent of total billed charges,50% of total Billed charges,44.9,17.136,,,percent of total billed charges,17.136% of total billed charges,57.22,21.84,,,percent of total billed charges,21.84% of total billed charges,131,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131,50,,,percent of total billed charges,50% of total Billed charges,204.36,78,,,percent of total billed charges,78% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,44.02,16.8,,,percent of total billed charges,16.8% of total billed charges,131,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,131,50,,,percent of total billed charges,50% of total Billed charges,44.02,16.8,,,percent of total billed charges,16.8% of total billed charges,40.09,262,
CLEANING BRUSH FAN TIP 12IN 15FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CLEANING BRUSH FAN TIP 18IN 12FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CLEAN BATH,ORSUP0010,CDM,272,RC,,,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
CLIPS FILSHIE,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CLIP VASC CLS W/ APPL STARCLOSE 6FR,ORSUP0014,CDM,278,RC,C1760,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CLIP RESOLUTION HEMOSTASIS CLIPPING DEVICE,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CLIP APPLIER MED/LRG 5MM DA VINCI,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
CLIP APPLIER MEDIUM LARGE HEM-O-LOK,ORSUP0038,CDM,272,RC,,,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
CLIP HEMOSTASIS RESOLUTION 360  11MM JAW SPAN,ORSUP0060,CDM,270,RC,,,Outpatient,,,13000,8450.00,,11440,88,,,percent of total billed charges,88% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,2184,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2249.52,17.304,,,percent of total billed charges,17.304% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,8190,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,1989,15.3,,,percent of total billed charges,15.3% of total billed charges,8970,69,,,percent of total billed charges,69% of total billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,8040.5,61.85,,,percent of total billed charges,61.85% of total billed charges,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,2184,16.8,,,percent of total billed charges,16.8% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,2227.68,17.136,,,percent of total billed charges,17.136% of total billed charges,2839.2,21.84,,,percent of total billed charges,21.84% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6500,50,,,percent of total billed charges,50% of total Billed charges,10140,78,,,percent of total billed charges,78% of total billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,10738,82.6,,,percent of total billed charges,82.6% of total billed charges,10738,82.6,,,percent of total billed charges,82.6% of total billed charges,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6500,50,,,percent of total billed charges,50% of total Billed charges,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,1989,13000,
CLIP M5,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
CLIP MED LG INTERN HEM-O-LOK POLYMER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CLIPS MINI (ZIM)             57 003,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CLIPS RESOLUTION 360,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CLIP APPLIER POLY SURGICLIP,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CLIP HEMOSTASIS INSTINCT 7FR,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CLIPPER BLADES DISP STANDARD,490350,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
CLIPPER BLADE (DISPOSABLE),490349,CDM,272,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
ORSUP0007,ORSUP0007,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
CLIPPER BLADES NARROW RED,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CLOSURE DEVICE MYNX GRIP VASULAR 5F (ORDER MULTIPLES OF 10 EA),ORSUP0015,CDM,278,RC,C1760,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CLOSURES SKIN STERI STRIP 1/8X,143131,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
CLOSURES SKIN STERI STRIP 1/4X,153087,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
CLOSURES SKIN STERI STRIP 1/2X,167683,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
CLOSURES SAFETY TAINER-TOPS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CLOSTRIDIUM DIFFICILE TOXIN AB,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CLOSURE DEVICE PERCLOSE PROSTYLE,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CLOSED SUCTION CATH 12FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CLOSED SUCTION CATH 10FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CLOSED SUCTION CATH 14FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CLOTH MICROFIBER CLEANING LT GREEN 12 X 12,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CLOT TRAC COAG CONTR. ABNORMAL,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CLOT TRAC COAG CONTR. NORMAL,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CO2 TRAP FOR MONITOR,ORSUP0020,CDM,270,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
CO2 GAS CAL I (34BAR),ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CO2 ANAEROPOACK GAS GENERATING SYSTEM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CO2 CANNISTER FOR NOVASURE,490353,CDM,270,RC,,,Outpatient,,,80,52.00,,70.4,88,,,percent of total billed charges,88% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,13.84,17.304,,,percent of total billed charges,17.304% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,50.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,12.24,15.3,,,percent of total billed charges,15.3% of total billed charges,55.2,69,,,percent of total billed charges,69% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,49.48,61.85,,,percent of total billed charges,61.85% of total billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.71,17.136,,,percent of total billed charges,17.136% of total billed charges,17.47,21.84,,,percent of total billed charges,21.84% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,62.4,78,,,percent of total billed charges,78% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,12.24,80,
CO2 INDICATOR 30MM,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
COAGULATING SHEARS LCS15,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
COAGUCHEK XS PT TEST STRIPS,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
COAG-SENSE PT2 PT/INR TEST STRIP KIT,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
COAXIAL ACHIEVE SZ11 AUTO BIOPSY SYS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
COBAN 1X5YDS TAN,434879,CDM,270,RC,,,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,17.48,17.304,,,percent of total billed charges,17.304% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,63.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,15.45,15.3,,,percent of total billed charges,15.3% of total billed charges,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,62.47,61.85,,,percent of total billed charges,61.85% of total billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,17.31,17.136,,,percent of total billed charges,17.136% of total billed charges,22.06,21.84,,,percent of total billed charges,21.84% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,15.45,101,
COBAN 2X5YDS TAN,434878,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
COBAN NS 1,490355,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
COBAN NS 4,490356,CDM,270,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
COBAN 2 LAYER COMPRESSION SYSTEM 2LAYER,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
COBAS FLUID PACK,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
COBLATOR WAND T\\T\\A,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
COBLATOR WAND TURBS,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
COBRA TOOTH GRASPER,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
COBRA TOOTH GRASPER DISPOSABLE,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
COBRA 3-PLATE EMG ENDOTRACHEAL NEUROMONITORING TUBE 7MM,ORSUP0020,CDM,272,RC,,,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
COBRA 3-PLATE EMG ENDOTRACHEAL NEUROMONITORING TUBE 6MM,ORSUP0020,CDM,272,RC,,,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
COBRA 3-PLATE EMG ENDOTRACHEAL NEUROMONITORING TUBE 8MM,ORSUP0020,CDM,272,RC,,,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
"CODMAN PERFORATOR, DISP",ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CODMAN PATTIES 1/2 X 1,490359,CDM,270,RC,,,Outpatient,,,116,75.40,,102.08,88,,,percent of total billed charges,88% of total Billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,19.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,116,100,,,percent of total billed charges,100% of total billed charges,20.07,17.304,,,percent of total billed charges,17.304% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,73.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.49,16.8,,,percent of total billed charges,16.8% of total billed charges,17.75,15.3,,,percent of total billed charges,15.3% of total billed charges,80.04,69,,,percent of total billed charges,69% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,116,100,,,percent of total billed charges,100% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,116,100,,,percent of total billed charges,100% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,71.75,61.85,,,percent of total billed charges,61.85% of total billed charges,19.49,16.8,,,percent of total billed charges,16.8% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,19.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,19.88,17.136,,,percent of total billed charges,17.136% of total billed charges,25.33,21.84,,,percent of total billed charges,21.84% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,58,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58,50,,,percent of total billed charges,50% of total Billed charges,90.48,78,,,percent of total billed charges,78% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.49,16.8,,,percent of total billed charges,16.8% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58,50,,,percent of total billed charges,50% of total Billed charges,19.49,16.8,,,percent of total billed charges,16.8% of total billed charges,17.75,116,
CODMAN SURGICAL STRIPS 1/2 X 6,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
COLLAR VISTA TX  SETADULT,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
COLLECTOR URINE/STOOL SPECIMEN 24OZ 700CC,143165,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
COLLAR PEDS SET PD2 ASPEN,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
COLLAR PEDS SET PD4 ASPEN,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
COLLAR PEDS SET PD5 ASPEN,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
COLLECTOR PIN WORM W/PADDLE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
COLONIC 18/20 BALLOON DIALATOR,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
COLONIC 15/18 BALLOON DIALATOR,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
COLORIMETER STANDARD SET,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
COLOR-CODED GUEDEL AIRWAY CHILD 60MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
COLORIMETRIC CO2 DETECTOR,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
AGAR COLUMBI CNA W/SHEEP BLOOD MEDIUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
COLUMN DRAPE,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CONCENTRATED WASHING SOLUTION 3(1L BTL),ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CONDOM CATH SMALL,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CONDOM CATH MED,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CONDOM CATH LARGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CONMED ULTRABLATOR 90 DEGREE,ORSUP0012,CDM,270,RC,,,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
CONNECTOR SYRINGE TIP,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CONNECTOR W/LL 3/8 X 3/8 X 3/8,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
CONNECTOR STRAIGHT,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CONNECTOR 5-IN-1,490379,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
CONNECTOR CROSS XIA 3 MULTI AXIAL,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CONNECTOR TUBING STERILE 5 IN 1 STRAIGHT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CONQUEST PTA BALLOON 9X2X50,ORSUP0016,CDM,278,RC,C1725,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CONTROL FLUID BODY 12 X 3.5 ML,ORSUP0021,CDM,270,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
CONTAINER GRADUATE 32OZ,12015,CDM,270,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
CONTAINER SHARP IN ROOM W/UNWINDER,313712,CDM,270,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
CONTRAST DEFINITY DE4,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CONTROL LATRON FP,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CONTROLS 6C,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CONTAINER SPECIMEN PREFILLED W/10% FORMALIN 90ML,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CONTROL D-DMR HI LO 1ML COAG,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CONTROL DIRECT CHECK - NORMAL,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CONTROL HEMOSIL CALIBRATION PLASMA,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CONTROL LIQUID UNASSAYED LEVEL I 25 X 10ML,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CONTROL LIQUID UNASSAYED LEVEL II 25 X 10ML,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CONTROL MULTIQUAL ASSAYED 1 3CC,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CONTROL MULTIQUAL ASSAYED LEVEL 3 3CC,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CONTROL URINE CHEMISTRY LIQUICHEK LEVEL 1 12X10ML,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CONTROL URINE CHEMISTRY LIQUICHEK LEVEL 2 12X10ML,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CONTRAST INJECTION LINE 10 HIGH PRESSURE,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CONTROLS HMS RED/YELLOW,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CONTAINER DENTURE,143701,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
CONTAINER SPECIMEN 32 OZ MED.,490392,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
CONTAINER SPECIMEN 165 OZ LG,490391,CDM,270,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
CONTOUR RELOAD CR40B REGULAR,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CONTOUR RELOAD CR40G THICK,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CONTAINER DENTURE CUP W/LID,490381,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
CONTAINER HAZARDOUS WASTE BLACK 2 GALLON,490382,CDM,270,RC,,,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,12.8,17.304,,,percent of total billed charges,17.304% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,46.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,45.77,61.85,,,percent of total billed charges,61.85% of total billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.68,17.136,,,percent of total billed charges,17.136% of total billed charges,16.16,21.84,,,percent of total billed charges,21.84% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,11.32,74,
CONTAINER SHARP (LIGHT RED),490384,CDM,270,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
CONTAINER SHARP 12 GALLON,490387,CDM,270,RC,,,Outpatient,,,179,116.35,,157.52,88,,,percent of total billed charges,88% of total Billed charges,89.5,50,,,percent of total billed charges,50% of total Billed charges,30.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,179,100,,,percent of total billed charges,100% of total billed charges,30.97,17.304,,,percent of total billed charges,17.304% of total billed charges,89.5,50,,,percent of total billed charges,50% of total Billed charges,112.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,30.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27.39,15.3,,,percent of total billed charges,15.3% of total billed charges,123.51,69,,,percent of total billed charges,69% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,89.5,50,,,percent of total billed charges,50% of total Billed charges,179,100,,,percent of total billed charges,100% of total billed charges,89.5,50,,,percent of total billed charges,50% of total Billed charges,179,100,,,percent of total billed charges,100% of total billed charges,89.5,50,,,percent of total billed charges,50% of total Billed charges,110.71,61.85,,,percent of total billed charges,61.85% of total billed charges,30.07,16.8,,,percent of total billed charges,16.8% of total billed charges,89.5,50,,,percent of total billed charges,50% of total Billed charges,89.5,50,,,percent of total billed charges,50% of total Billed charges,30.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,89.5,50,,,percent of total billed charges,50% of total Billed charges,89.5,50,,,percent of total billed charges,50% of total Billed charges,30.67,17.136,,,percent of total billed charges,17.136% of total billed charges,39.09,21.84,,,percent of total billed charges,21.84% of total billed charges,89.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,89.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,89.5,50,,,percent of total billed charges,50% of total Billed charges,139.62,78,,,percent of total billed charges,78% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,30.07,16.8,,,percent of total billed charges,16.8% of total billed charges,89.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,89.5,50,,,percent of total billed charges,50% of total Billed charges,30.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27.39,179,
CONTAINER SHARP O.R. STAND 18 GALLON,490388,CDM,270,RC,,,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,97,50,,,percent of total billed charges,50% of total Billed charges,32.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,194,100,,,percent of total billed charges,100% of total billed charges,33.57,17.304,,,percent of total billed charges,17.304% of total billed charges,97,50,,,percent of total billed charges,50% of total Billed charges,122.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.59,16.8,,,percent of total billed charges,16.8% of total billed charges,29.68,15.3,,,percent of total billed charges,15.3% of total billed charges,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,97,50,,,percent of total billed charges,50% of total Billed charges,194,100,,,percent of total billed charges,100% of total billed charges,97,50,,,percent of total billed charges,50% of total Billed charges,194,100,,,percent of total billed charges,100% of total billed charges,97,50,,,percent of total billed charges,50% of total Billed charges,119.99,61.85,,,percent of total billed charges,61.85% of total billed charges,32.59,16.8,,,percent of total billed charges,16.8% of total billed charges,97,50,,,percent of total billed charges,50% of total Billed charges,97,50,,,percent of total billed charges,50% of total Billed charges,32.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,97,50,,,percent of total billed charges,50% of total Billed charges,97,50,,,percent of total billed charges,50% of total Billed charges,33.24,17.136,,,percent of total billed charges,17.136% of total billed charges,42.37,21.84,,,percent of total billed charges,21.84% of total billed charges,97,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97,50,,,percent of total billed charges,50% of total Billed charges,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,32.59,16.8,,,percent of total billed charges,16.8% of total billed charges,97,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97,50,,,percent of total billed charges,50% of total Billed charges,32.59,16.8,,,percent of total billed charges,16.8% of total billed charges,29.68,194,
CONTAINER SPECIMAN NS W/LID 4 OZ,490389,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
CONTRAST SYRINGE DUAL-PORT KIT,ORSUP0004,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CONTAINER 24 HOUR URINE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CONTROL IMMUNOASSAY PLUS LIQUICHECK LVL 2 12X5ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CONTACT NIPPLE SHIELD STERILE 24MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CONTACT NIPPLE SHIELD NONSTERILE 20MM SZ SM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CONTROLS ALBA Q-CHEK SWB,ORSUP0012,CDM,272,RC,,,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
CONTROLS AVOX-4 CO-OXIMETER,ORSUP0025,CDM,272,RC,,,Outpatient,,,2800,1820.00,,2464,88,,,percent of total billed charges,88% of total Billed charges,1400,50,,,percent of total billed charges,50% of total Billed charges,470.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,2800,100,,,percent of total billed charges,100% of total billed charges,484.51,17.304,,,percent of total billed charges,17.304% of total billed charges,1400,50,,,percent of total billed charges,50% of total Billed charges,1764,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,470.4,16.8,,,percent of total billed charges,16.8% of total billed charges,428.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1932,69,,,percent of total billed charges,69% of total billed charges,2800,100,,,percent of total billed charges,100% of total billed charges,1400,50,,,percent of total billed charges,50% of total Billed charges,2800,100,,,percent of total billed charges,100% of total billed charges,1400,50,,,percent of total billed charges,50% of total Billed charges,2800,100,,,percent of total billed charges,100% of total billed charges,1400,50,,,percent of total billed charges,50% of total Billed charges,1731.8,61.85,,,percent of total billed charges,61.85% of total billed charges,470.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1400,50,,,percent of total billed charges,50% of total Billed charges,1400,50,,,percent of total billed charges,50% of total Billed charges,470.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1400,50,,,percent of total billed charges,50% of total Billed charges,1400,50,,,percent of total billed charges,50% of total Billed charges,479.81,17.136,,,percent of total billed charges,17.136% of total billed charges,611.52,21.84,,,percent of total billed charges,21.84% of total billed charges,1400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1400,50,,,percent of total billed charges,50% of total Billed charges,2184,78,,,percent of total billed charges,78% of total billed charges,2800,100,,,percent of total billed charges,100% of total billed charges,2312.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2312.8,82.6,,,percent of total billed charges,82.6% of total billed charges,470.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1400,50,,,percent of total billed charges,50% of total Billed charges,470.4,16.8,,,percent of total billed charges,16.8% of total billed charges,428.4,2800,
CONTROL FLU/RSV/SARS-COV-2 POSITIVE,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
CONTROL FLU/RSV/SARS-COV-2 NEGATIVE,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
CONTROL CT/NG EXTERNAL RUN NEGATIVE,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
CONTROL CT/NG EXTERNAL RUN POSITIVE,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
CONTROL MSRA/SA EXTERNAL RUN NEGATIVE,ORSUP0021,CDM,272,RC,,,Outpatient,,,2000,1300.00,,1760,88,,,percent of total billed charges,88% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,346.08,17.304,,,percent of total billed charges,17.304% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1260,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,336,16.8,,,percent of total billed charges,16.8% of total billed charges,306,15.3,,,percent of total billed charges,15.3% of total billed charges,1380,69,,,percent of total billed charges,69% of total billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1237,61.85,,,percent of total billed charges,61.85% of total billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,342.72,17.136,,,percent of total billed charges,17.136% of total billed charges,436.8,21.84,,,percent of total billed charges,21.84% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,1560,78,,,percent of total billed charges,78% of total billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1652,82.6,,,percent of total billed charges,82.6% of total billed charges,1652,82.6,,,percent of total billed charges,82.6% of total billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,306,2000,
CONTROL MSRA/SA EXTERNAL RUN POSITIVE,ORSUP0021,CDM,272,RC,,,Outpatient,,,2000,1300.00,,1760,88,,,percent of total billed charges,88% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,346.08,17.304,,,percent of total billed charges,17.304% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1260,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,336,16.8,,,percent of total billed charges,16.8% of total billed charges,306,15.3,,,percent of total billed charges,15.3% of total billed charges,1380,69,,,percent of total billed charges,69% of total billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1237,61.85,,,percent of total billed charges,61.85% of total billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,342.72,17.136,,,percent of total billed charges,17.136% of total billed charges,436.8,21.84,,,percent of total billed charges,21.84% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,1560,78,,,percent of total billed charges,78% of total billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1652,82.6,,,percent of total billed charges,82.6% of total billed charges,1652,82.6,,,percent of total billed charges,82.6% of total billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,306,2000,
CONTROL CLOSTRIDIUM DIFFICILE POSITIVE,ORSUP0018,CDM,272,RC,,,Outpatient,,,1450,942.50,,1276,88,,,percent of total billed charges,88% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,250.91,17.304,,,percent of total billed charges,17.304% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,913.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,221.85,15.3,,,percent of total billed charges,15.3% of total billed charges,1000.5,69,,,percent of total billed charges,69% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,896.83,61.85,,,percent of total billed charges,61.85% of total billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,248.47,17.136,,,percent of total billed charges,17.136% of total billed charges,316.68,21.84,,,percent of total billed charges,21.84% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,1131,78,,,percent of total billed charges,78% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,221.85,1450,
CONTROL CLOSTRIDIUM DIFFICILE NEGATIVE,ORSUP0018,CDM,272,RC,,,Outpatient,,,1450,942.50,,1276,88,,,percent of total billed charges,88% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,250.91,17.304,,,percent of total billed charges,17.304% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,913.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,221.85,15.3,,,percent of total billed charges,15.3% of total billed charges,1000.5,69,,,percent of total billed charges,69% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,896.83,61.85,,,percent of total billed charges,61.85% of total billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,248.47,17.136,,,percent of total billed charges,17.136% of total billed charges,316.68,21.84,,,percent of total billed charges,21.84% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,1131,78,,,percent of total billed charges,78% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,221.85,1450,
CONTROL GBS EXTERNAL RUN NEGATIVE,ORSUP0019,CDM,272,RC,,,Outpatient,,,1600,1040.00,,1408,88,,,percent of total billed charges,88% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,276.86,17.304,,,percent of total billed charges,17.304% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1008,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1104,69,,,percent of total billed charges,69% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,989.6,61.85,,,percent of total billed charges,61.85% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,274.18,17.136,,,percent of total billed charges,17.136% of total billed charges,349.44,21.84,,,percent of total billed charges,21.84% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,1248,78,,,percent of total billed charges,78% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,1600,
CONTROL GBS EXTERNAL RUN POSITIVE,ORSUP0019,CDM,272,RC,,,Outpatient,,,1600,1040.00,,1408,88,,,percent of total billed charges,88% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,276.86,17.304,,,percent of total billed charges,17.304% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1008,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1104,69,,,percent of total billed charges,69% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,989.6,61.85,,,percent of total billed charges,61.85% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,274.18,17.136,,,percent of total billed charges,17.136% of total billed charges,349.44,21.84,,,percent of total billed charges,21.84% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,1248,78,,,percent of total billed charges,78% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,1600,
CONTROL INFLUENZA/RSV NEGATIVE,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
CONTROL INFLUENZA/RSV POSITIVE,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
CONTROL INFLUENZA A/B POSITIVE,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
CONTROL NATROL RSV POSITIVE,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
CONTROL NATROL SARS-RELATED COVID 2,ORSUP0013,CDM,272,RC,,,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,504,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
COOLCUT 45 BALL ELECTRODE ARTHROSCOPY 45,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
COOMB CONTROL 1X10ML,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
COOX/MSS VERIFICATION MATERIAL,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
COPAN UTM VIRAL SPECIMEN COLLECTION KIT,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CORKSCREW BIO FT WITH FIBERWIRE 5.5,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CORKSCREW FT 4.5 X 14MM,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
CORKSCREW ANCHOR 4.5 PEEK,ORSUP0014,CDM,278,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CORNER PROTECTORS,412950,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
CORRECT MED LABELING SYSTEM,490396,CDM,270,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
CORTICAL SCREW 2.3MM 16MM TRX2.3-16,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CORTICAL SCREW 2.3MM 18MM TRX2.3-18,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
CORTICAL SCREW 2.3MM 20MM TRX2.3-20,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CORTEX SCREWS TITANIUM SELF TAPPING 1.3MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
REAGENT CORTISOL,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CALIBRATOR CORTISOL,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
COSTAL CARTILAGE TISSUE GRAFT,ORSUP0026,CDM,272,RC,,,Outpatient,,,3000,1950.00,,2640,88,,,percent of total billed charges,88% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,519.12,17.304,,,percent of total billed charges,17.304% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1890,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,15.3,,,percent of total billed charges,15.3% of total billed charges,2070,69,,,percent of total billed charges,69% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1855.5,61.85,,,percent of total billed charges,61.85% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,514.08,17.136,,,percent of total billed charges,17.136% of total billed charges,655.2,21.84,,,percent of total billed charges,21.84% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,2340,78,,,percent of total billed charges,78% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,3000,
COTTONOIDS 1/4 X 3,266544,CDM,270,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
COTTON BALL LARGE 2000/CS   2323,55284,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
COTTON ROLL STERILE LARGE 1LB,380401,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
COTTON UMBILICAL TAPE U-10T,490401,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
COTTON BALLS,490398,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
COTTON ROLL,490399,CDM,270,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
COTTON UMBILICAL TAPE (U11T),490400,CDM,270,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
COTTONOID 1 X 3,490402,CDM,270,RC,,,Outpatient,,,121,78.65,,106.48,88,,,percent of total billed charges,88% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,20.94,17.304,,,percent of total billed charges,17.304% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,76.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,18.51,15.3,,,percent of total billed charges,15.3% of total billed charges,83.49,69,,,percent of total billed charges,69% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,74.84,61.85,,,percent of total billed charges,61.85% of total billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.73,17.136,,,percent of total billed charges,17.136% of total billed charges,26.43,21.84,,,percent of total billed charges,21.84% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,94.38,78,,,percent of total billed charges,78% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,18.51,121,
COTTONOID 1/2 X 3,490403,CDM,270,RC,,,Outpatient,,,108,70.20,,95.04,88,,,percent of total billed charges,88% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,18.69,17.304,,,percent of total billed charges,17.304% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,68.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,15.3,,,percent of total billed charges,15.3% of total billed charges,74.52,69,,,percent of total billed charges,69% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,66.8,61.85,,,percent of total billed charges,61.85% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.51,17.136,,,percent of total billed charges,17.136% of total billed charges,23.59,21.84,,,percent of total billed charges,21.84% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,84.24,78,,,percent of total billed charges,78% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,108,
COTTON BALLS LARGE STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
COUNTER NEEDLE MAGNETIC SMALL,201025,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
COUNTER NEEDLE MAGNETIC LARGE,185522,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
COUNTER NEEDLE DOUBLE MAGNET 60CT LF,429240,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
COUNTER SPONGE 4050 CLEAR BACK,10440,CDM,270,RC,,,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,182,50,,,percent of total billed charges,50% of total Billed charges,61.15,16.8,,,percent of total billed charges,16.8% of total Billed charges,364,100,,,percent of total billed charges,100% of total billed charges,62.99,17.304,,,percent of total billed charges,17.304% of total billed charges,182,50,,,percent of total billed charges,50% of total Billed charges,229.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,61.15,16.8,,,percent of total billed charges,16.8% of total billed charges,55.69,15.3,,,percent of total billed charges,15.3% of total billed charges,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,182,50,,,percent of total billed charges,50% of total Billed charges,364,100,,,percent of total billed charges,100% of total billed charges,182,50,,,percent of total billed charges,50% of total Billed charges,364,100,,,percent of total billed charges,100% of total billed charges,182,50,,,percent of total billed charges,50% of total Billed charges,225.13,61.85,,,percent of total billed charges,61.85% of total billed charges,61.15,16.8,,,percent of total billed charges,16.8% of total billed charges,182,50,,,percent of total billed charges,50% of total Billed charges,182,50,,,percent of total billed charges,50% of total Billed charges,61.15,16.8,,,percent of total billed charges,16.8% of total Billed charges,182,50,,,percent of total billed charges,50% of total Billed charges,182,50,,,percent of total billed charges,50% of total Billed charges,62.38,17.136,,,percent of total billed charges,17.136% of total billed charges,79.5,21.84,,,percent of total billed charges,21.84% of total billed charges,182,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,182,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,182,50,,,percent of total billed charges,50% of total Billed charges,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,61.15,16.8,,,percent of total billed charges,16.8% of total billed charges,182,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,182,50,,,percent of total billed charges,50% of total Billed charges,61.15,16.8,,,percent of total billed charges,16.8% of total billed charges,55.69,364,
COVADERM 4 X 10,490404,CDM,271,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,8.67,37.7,,,percent of total billed charges,37.70% of total billed charges,8.67,37.7,,,percent of total billed charges,37.70% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,7.8,33.9,,,percent of total billed charges,33.9% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
COVADERM 6 X 8,490406,CDM,271,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,8.48,33.9,,,percent of total billed charges,33.9% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
COVER BOOT X-LARGE KNEE HI,91900,CDM,270,RC,,,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,45.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,271,100,,,percent of total billed charges,100% of total billed charges,46.89,17.304,,,percent of total billed charges,17.304% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,170.73,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,45.53,16.8,,,percent of total billed charges,16.8% of total billed charges,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,271,100,,,percent of total billed charges,100% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,271,100,,,percent of total billed charges,100% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,167.61,61.85,,,percent of total billed charges,61.85% of total billed charges,45.53,16.8,,,percent of total billed charges,16.8% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,45.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,46.44,17.136,,,percent of total billed charges,17.136% of total billed charges,59.19,21.84,,,percent of total billed charges,21.84% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,135.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,135.5,50,,,percent of total billed charges,50% of total Billed charges,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,45.53,16.8,,,percent of total billed charges,16.8% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,135.5,50,,,percent of total billed charges,50% of total Billed charges,45.53,16.8,,,percent of total billed charges,16.8% of total billed charges,41.46,271,
COVERALL XX-LRG ELASTIC CUFF/ANKLE,171680,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
COVER TABLE 44X90 STERILE,13992,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
COVER SHOE EXTRA LARGE,186774,CDM,270,RC,,,Outpatient,,,115,74.75,,101.2,88,,,percent of total billed charges,88% of total Billed charges,57.5,50,,,percent of total billed charges,50% of total Billed charges,19.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,115,100,,,percent of total billed charges,100% of total billed charges,19.9,17.304,,,percent of total billed charges,17.304% of total billed charges,57.5,50,,,percent of total billed charges,50% of total Billed charges,72.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.32,16.8,,,percent of total billed charges,16.8% of total billed charges,17.6,15.3,,,percent of total billed charges,15.3% of total billed charges,79.35,69,,,percent of total billed charges,69% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,57.5,50,,,percent of total billed charges,50% of total Billed charges,115,100,,,percent of total billed charges,100% of total billed charges,57.5,50,,,percent of total billed charges,50% of total Billed charges,115,100,,,percent of total billed charges,100% of total billed charges,57.5,50,,,percent of total billed charges,50% of total Billed charges,71.13,61.85,,,percent of total billed charges,61.85% of total billed charges,19.32,16.8,,,percent of total billed charges,16.8% of total billed charges,57.5,50,,,percent of total billed charges,50% of total Billed charges,57.5,50,,,percent of total billed charges,50% of total Billed charges,19.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,57.5,50,,,percent of total billed charges,50% of total Billed charges,57.5,50,,,percent of total billed charges,50% of total Billed charges,19.71,17.136,,,percent of total billed charges,17.136% of total billed charges,25.12,21.84,,,percent of total billed charges,21.84% of total billed charges,57.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,57.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,57.5,50,,,percent of total billed charges,50% of total Billed charges,89.7,78,,,percent of total billed charges,78% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,19.32,16.8,,,percent of total billed charges,16.8% of total billed charges,57.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,57.5,50,,,percent of total billed charges,50% of total Billed charges,19.32,16.8,,,percent of total billed charges,16.8% of total billed charges,17.6,115,
COVER MAYO STAND STERILE,151783,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
COVER LIGHT HANDLE PACK STRL,308949,CDM,270,RC,,,Outpatient,,,348,226.20,,306.24,88,,,percent of total billed charges,88% of total Billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,58.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,348,100,,,percent of total billed charges,100% of total billed charges,60.22,17.304,,,percent of total billed charges,17.304% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,219.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.46,16.8,,,percent of total billed charges,16.8% of total billed charges,53.24,15.3,,,percent of total billed charges,15.3% of total billed charges,240.12,69,,,percent of total billed charges,69% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,348,100,,,percent of total billed charges,100% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,348,100,,,percent of total billed charges,100% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,215.24,61.85,,,percent of total billed charges,61.85% of total billed charges,58.46,16.8,,,percent of total billed charges,16.8% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,58.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,59.63,17.136,,,percent of total billed charges,17.136% of total billed charges,76,21.84,,,percent of total billed charges,21.84% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,174,50,,,percent of total billed charges,50% of total Billed charges,271.44,78,,,percent of total billed charges,78% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,58.46,16.8,,,percent of total billed charges,16.8% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,174,50,,,percent of total billed charges,50% of total Billed charges,58.46,16.8,,,percent of total billed charges,16.8% of total billed charges,53.24,348,
COVER WARMING BODY UPPER DUAL PRT SGL USE 78INX21IN,161041,CDM,270,RC,,,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,9.69,17.304,,,percent of total billed charges,17.304% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,35.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.6,17.136,,,percent of total billed charges,17.136% of total billed charges,12.23,21.84,,,percent of total billed charges,21.84% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,56,
COVER ARMBOARD W STRAP,301783,CDM,270,RC,,,Outpatient,,,706,458.90,,621.28,88,,,percent of total billed charges,88% of total Billed charges,353,50,,,percent of total billed charges,50% of total Billed charges,118.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,706,100,,,percent of total billed charges,100% of total billed charges,122.17,17.304,,,percent of total billed charges,17.304% of total billed charges,353,50,,,percent of total billed charges,50% of total Billed charges,444.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,118.61,16.8,,,percent of total billed charges,16.8% of total billed charges,108.02,15.3,,,percent of total billed charges,15.3% of total billed charges,487.14,69,,,percent of total billed charges,69% of total billed charges,706,100,,,percent of total billed charges,100% of total billed charges,353,50,,,percent of total billed charges,50% of total Billed charges,706,100,,,percent of total billed charges,100% of total billed charges,353,50,,,percent of total billed charges,50% of total Billed charges,706,100,,,percent of total billed charges,100% of total billed charges,353,50,,,percent of total billed charges,50% of total Billed charges,436.66,61.85,,,percent of total billed charges,61.85% of total billed charges,118.61,16.8,,,percent of total billed charges,16.8% of total billed charges,353,50,,,percent of total billed charges,50% of total Billed charges,353,50,,,percent of total billed charges,50% of total Billed charges,118.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,353,50,,,percent of total billed charges,50% of total Billed charges,353,50,,,percent of total billed charges,50% of total Billed charges,120.98,17.136,,,percent of total billed charges,17.136% of total billed charges,154.19,21.84,,,percent of total billed charges,21.84% of total billed charges,353,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,353,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,353,50,,,percent of total billed charges,50% of total Billed charges,550.68,78,,,percent of total billed charges,78% of total billed charges,706,100,,,percent of total billed charges,100% of total billed charges,583.16,82.6,,,percent of total billed charges,82.6% of total billed charges,583.16,82.6,,,percent of total billed charges,82.6% of total billed charges,118.61,16.8,,,percent of total billed charges,16.8% of total billed charges,353,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,353,50,,,percent of total billed charges,50% of total Billed charges,118.61,16.8,,,percent of total billed charges,16.8% of total billed charges,108.02,706,
COVER BOOT FLUID SHIELD NSKID XLG,316668,CDM,270,RC,,,Outpatient,,,786,510.90,,691.68,88,,,percent of total billed charges,88% of total Billed charges,393,50,,,percent of total billed charges,50% of total Billed charges,132.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,786,100,,,percent of total billed charges,100% of total billed charges,136.01,17.304,,,percent of total billed charges,17.304% of total billed charges,393,50,,,percent of total billed charges,50% of total Billed charges,495.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,132.05,16.8,,,percent of total billed charges,16.8% of total billed charges,120.26,15.3,,,percent of total billed charges,15.3% of total billed charges,542.34,69,,,percent of total billed charges,69% of total billed charges,786,100,,,percent of total billed charges,100% of total billed charges,393,50,,,percent of total billed charges,50% of total Billed charges,786,100,,,percent of total billed charges,100% of total billed charges,393,50,,,percent of total billed charges,50% of total Billed charges,786,100,,,percent of total billed charges,100% of total billed charges,393,50,,,percent of total billed charges,50% of total Billed charges,486.14,61.85,,,percent of total billed charges,61.85% of total billed charges,132.05,16.8,,,percent of total billed charges,16.8% of total billed charges,393,50,,,percent of total billed charges,50% of total Billed charges,393,50,,,percent of total billed charges,50% of total Billed charges,132.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,393,50,,,percent of total billed charges,50% of total Billed charges,393,50,,,percent of total billed charges,50% of total Billed charges,134.69,17.136,,,percent of total billed charges,17.136% of total billed charges,171.66,21.84,,,percent of total billed charges,21.84% of total billed charges,393,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,393,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,393,50,,,percent of total billed charges,50% of total Billed charges,613.08,78,,,percent of total billed charges,78% of total billed charges,786,100,,,percent of total billed charges,100% of total billed charges,649.24,82.6,,,percent of total billed charges,82.6% of total billed charges,649.24,82.6,,,percent of total billed charges,82.6% of total billed charges,132.05,16.8,,,percent of total billed charges,16.8% of total billed charges,393,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,393,50,,,percent of total billed charges,50% of total Billed charges,132.05,16.8,,,percent of total billed charges,16.8% of total billed charges,120.26,786,
COVER GLIDESCOPE SZ 3 0574-0100,ORSUP0003,CDM,270,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
COVER HEAD THERMO-LITE TEC,186430,CDM,270,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
COVER PERINEAL POST,443453,CDM,270,RC,,,Outpatient,,,506,328.90,,445.28,88,,,percent of total billed charges,88% of total Billed charges,253,50,,,percent of total billed charges,50% of total Billed charges,85.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,506,100,,,percent of total billed charges,100% of total billed charges,87.56,17.304,,,percent of total billed charges,17.304% of total billed charges,253,50,,,percent of total billed charges,50% of total Billed charges,318.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,77.42,15.3,,,percent of total billed charges,15.3% of total billed charges,349.14,69,,,percent of total billed charges,69% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,253,50,,,percent of total billed charges,50% of total Billed charges,506,100,,,percent of total billed charges,100% of total billed charges,253,50,,,percent of total billed charges,50% of total Billed charges,506,100,,,percent of total billed charges,100% of total billed charges,253,50,,,percent of total billed charges,50% of total Billed charges,312.96,61.85,,,percent of total billed charges,61.85% of total billed charges,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,253,50,,,percent of total billed charges,50% of total Billed charges,253,50,,,percent of total billed charges,50% of total Billed charges,85.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,253,50,,,percent of total billed charges,50% of total Billed charges,253,50,,,percent of total billed charges,50% of total Billed charges,86.71,17.136,,,percent of total billed charges,17.136% of total billed charges,110.51,21.84,,,percent of total billed charges,21.84% of total billed charges,253,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,253,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,253,50,,,percent of total billed charges,50% of total Billed charges,394.68,78,,,percent of total billed charges,78% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,253,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,253,50,,,percent of total billed charges,50% of total Billed charges,85.01,16.8,,,percent of total billed charges,16.8% of total billed charges,77.42,506,
COVER PROBE DISP 5031,143309,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
COVER ROLL STRETCH 2'' X 10YDS,174440,CDM,270,RC,,,Outpatient,,,71,46.15,,62.48,88,,,percent of total billed charges,88% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,12.29,17.304,,,percent of total billed charges,17.304% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,44.73,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,10.86,15.3,,,percent of total billed charges,15.3% of total billed charges,48.99,69,,,percent of total billed charges,69% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,43.91,61.85,,,percent of total billed charges,61.85% of total billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,12.17,17.136,,,percent of total billed charges,17.136% of total billed charges,15.51,21.84,,,percent of total billed charges,21.84% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,55.38,78,,,percent of total billed charges,78% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,10.86,71,
COVER SHOE EXTRA TRACTION NON-CONDUCTIVE X-LARGE,227877,CDM,270,RC,,,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,10.9,17.304,,,percent of total billed charges,17.304% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,39.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,38.97,61.85,,,percent of total billed charges,61.85% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.8,17.136,,,percent of total billed charges,17.136% of total billed charges,13.76,21.84,,,percent of total billed charges,21.84% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,63,
COVER TIP CAPS TWIN W/ VENTS ORANGE,324314,CDM,270,RC,,,Outpatient,,,161,104.65,,141.68,88,,,percent of total billed charges,88% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,27.86,17.304,,,percent of total billed charges,17.304% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,101.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,24.63,15.3,,,percent of total billed charges,15.3% of total billed charges,111.09,69,,,percent of total billed charges,69% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,99.58,61.85,,,percent of total billed charges,61.85% of total billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.59,17.136,,,percent of total billed charges,17.136% of total billed charges,35.16,21.84,,,percent of total billed charges,21.84% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,125.58,78,,,percent of total billed charges,78% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,24.63,161,
COVER TIP CAPS TWIN W/ VENTS RED,324312,CDM,270,RC,,,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,23.36,17.304,,,percent of total billed charges,17.304% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,85.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,61.85,,,percent of total billed charges,61.85% of total billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,23.13,17.136,,,percent of total billed charges,17.136% of total billed charges,29.48,21.84,,,percent of total billed charges,21.84% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,20.66,135,
COVER TIP CAPS TWIN W/ VENTS YELLOW,324313,CDM,270,RC,,,Outpatient,,,161,104.65,,141.68,88,,,percent of total billed charges,88% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,27.86,17.304,,,percent of total billed charges,17.304% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,101.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,24.63,15.3,,,percent of total billed charges,15.3% of total billed charges,111.09,69,,,percent of total billed charges,69% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,99.58,61.85,,,percent of total billed charges,61.85% of total billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.59,17.136,,,percent of total billed charges,17.136% of total billed charges,35.16,21.84,,,percent of total billed charges,21.84% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,125.58,78,,,percent of total billed charges,78% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,24.63,161,
COVERALL DISP XL BLU,10270,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
COVERALL DISPOSABLE LARGE WHITE,277558,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
COVERALL DISPOSABLE XXXL WHITE,324993,CDM,270,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
COVERLET BELLA BLANKET,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
COVERS EAR SANITARY LARGE,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
COVERALL XL (BUNNYSUIT),490408,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
COVER ROLL STRETCH,490407,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
COVERALLS XL,490409,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
COVER GLASS,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
CPAP NASAL MASK INFANT MED,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CPAP NASAL MASK INFANT LARGE,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
CRBM/ 5 PACK / 90 SLIDES,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
CREAM HAND PETROLEUM BASED W/ALOE 2OZ,143336,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
CREAM SKIN REPAIR REMEDY 2 OZ TUBE,322110,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
CRICOTHYROTOMY KIT COOK,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CRICOTHYROTOMY KIT 4.0,ORSUP0021,CDM,272,RC,,,Outpatient,,,2000,1300.00,,1760,88,,,percent of total billed charges,88% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,346.08,17.304,,,percent of total billed charges,17.304% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1260,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,336,16.8,,,percent of total billed charges,16.8% of total billed charges,306,15.3,,,percent of total billed charges,15.3% of total billed charges,1380,69,,,percent of total billed charges,69% of total billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1237,61.85,,,percent of total billed charges,61.85% of total billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,342.72,17.136,,,percent of total billed charges,17.136% of total billed charges,436.8,21.84,,,percent of total billed charges,21.84% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,1560,78,,,percent of total billed charges,78% of total billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1652,82.6,,,percent of total billed charges,82.6% of total billed charges,1652,82.6,,,percent of total billed charges,82.6% of total billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,306,2000,
CRP PERF VERIFIER I BX / 6 SET,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CRP PERF VERIFIER II BX / 6 SET,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CRP / 5 PACK / 90 SLIDES,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CRUTCH ALUM ADJ ADULT MED 300LB CAP,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CRUTCH ALUM ADJ TALL ADULT 300LB CAP,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CRUTCH ALUM ADJ YOUTH 300LB CAP,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
"CS5 FAST PACK, 225ML BOWL",ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
"CS5 FAST PACK, 125ML BOWL",ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
CSF PROTEIN / 5 PACK / 90 SLIDES,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CT/NG GX IVD CARTRIDGES,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
CT/NG EXTERNAL RUN CONTROLS POSITIVE NG,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
CUFF B/P INFANT 1-TUBE BAYONET,241436,CDM,270,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
CUFF B/P CHILD 1-TUBE BAYONET,241434,CDM,270,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
CUFF B/P SM ADULT 1-TUBE BAYONET,241440,CDM,270,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
CUFF BLOOD PRESSURE ADULT LONG,260743,CDM,270,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
CUFF BP ADULT LARGE 1 TUBE DISPOSABLE,236638,CDM,270,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
CUFF BP ADULT REG 1 TUBE DISPOSABLE,236637,CDM,270,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
CUFF 24'' SINGLE TOURNIQUET,274458,CDM,270,RC,,,Outpatient,,,1738,1129.70,,1529.44,88,,,percent of total billed charges,88% of total Billed charges,869,50,,,percent of total billed charges,50% of total Billed charges,291.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,1738,100,,,percent of total billed charges,100% of total billed charges,300.74,17.304,,,percent of total billed charges,17.304% of total billed charges,869,50,,,percent of total billed charges,50% of total Billed charges,1094.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,291.98,16.8,,,percent of total billed charges,16.8% of total billed charges,265.91,15.3,,,percent of total billed charges,15.3% of total billed charges,1199.22,69,,,percent of total billed charges,69% of total billed charges,1738,100,,,percent of total billed charges,100% of total billed charges,869,50,,,percent of total billed charges,50% of total Billed charges,1738,100,,,percent of total billed charges,100% of total billed charges,869,50,,,percent of total billed charges,50% of total Billed charges,1738,100,,,percent of total billed charges,100% of total billed charges,869,50,,,percent of total billed charges,50% of total Billed charges,1074.95,61.85,,,percent of total billed charges,61.85% of total billed charges,291.98,16.8,,,percent of total billed charges,16.8% of total billed charges,869,50,,,percent of total billed charges,50% of total Billed charges,869,50,,,percent of total billed charges,50% of total Billed charges,291.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,869,50,,,percent of total billed charges,50% of total Billed charges,869,50,,,percent of total billed charges,50% of total Billed charges,297.82,17.136,,,percent of total billed charges,17.136% of total billed charges,379.58,21.84,,,percent of total billed charges,21.84% of total billed charges,869,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,869,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,869,50,,,percent of total billed charges,50% of total Billed charges,1355.64,78,,,percent of total billed charges,78% of total billed charges,1738,100,,,percent of total billed charges,100% of total billed charges,1435.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1435.59,82.6,,,percent of total billed charges,82.6% of total billed charges,291.98,16.8,,,percent of total billed charges,16.8% of total billed charges,869,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,869,50,,,percent of total billed charges,50% of total Billed charges,291.98,16.8,,,percent of total billed charges,16.8% of total billed charges,265.91,1738,
CUFF TOURNIQUET DL PRT SNGL BLDR 18 W/POSLINKCON,239720,CDM,270,RC,,,Outpatient,,,80,52.00,,70.4,88,,,percent of total billed charges,88% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,13.84,17.304,,,percent of total billed charges,17.304% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,50.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,12.24,15.3,,,percent of total billed charges,15.3% of total billed charges,55.2,69,,,percent of total billed charges,69% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,49.48,61.85,,,percent of total billed charges,61.85% of total billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.71,17.136,,,percent of total billed charges,17.136% of total billed charges,17.47,21.84,,,percent of total billed charges,21.84% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,62.4,78,,,percent of total billed charges,78% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,12.24,80,
CUFF TOURNIQUET DL PRT SNGL BLDR 34 W/POSLINKCON,239722R,CDM,270,RC,,,Outpatient,,,78,50.70,,68.64,88,,,percent of total billed charges,88% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,13.5,17.304,,,percent of total billed charges,17.304% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,49.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,15.3,,,percent of total billed charges,15.3% of total billed charges,53.82,69,,,percent of total billed charges,69% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,48.24,61.85,,,percent of total billed charges,61.85% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.37,17.136,,,percent of total billed charges,17.136% of total billed charges,17.04,21.84,,,percent of total billed charges,21.84% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,60.84,78,,,percent of total billed charges,78% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,78,
CUFF 12IN SINGLE TOURNIQUET,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CUFF 34IN SINGLE TOURNEQUET,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
CUFF 44IN SINGLE TOURNIQUET,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
CUFF BP SOFT ADULT LONG 2 TUBE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CUFFED ENDO TUBE W/STYLET 3.5MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CUFFED ENDO TUBE W/STYLET 3.0MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CUFFED ENDO TUBE W/STYLET 2.5MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
CULTURETTES BACTISWAB,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CUP SPECIMEN STERILE 4 OZ,89412,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
CUP TOOTH GRASPER TIP,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
CURETTE 9 CURV,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CURETTE EAR FLEX LOOP POLYPROP 4MM LEAD N/S DISP,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CURETTE SIZE 2,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
CURETTE LUSK SZ 4 DISP,490419,CDM,272,RC,,,Outpatient,,,494,321.10,,434.72,88,,,percent of total billed charges,88% of total Billed charges,247,50,,,percent of total billed charges,50% of total Billed charges,82.99,16.8,,,percent of total billed charges,16.8% of total Billed charges,494,100,,,percent of total billed charges,100% of total billed charges,85.48,17.304,,,percent of total billed charges,17.304% of total billed charges,247,50,,,percent of total billed charges,50% of total Billed charges,311.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,82.99,16.8,,,percent of total billed charges,16.8% of total billed charges,75.58,15.3,,,percent of total billed charges,15.3% of total billed charges,340.86,69,,,percent of total billed charges,69% of total billed charges,494,100,,,percent of total billed charges,100% of total billed charges,247,50,,,percent of total billed charges,50% of total Billed charges,494,100,,,percent of total billed charges,100% of total billed charges,247,50,,,percent of total billed charges,50% of total Billed charges,494,100,,,percent of total billed charges,100% of total billed charges,247,50,,,percent of total billed charges,50% of total Billed charges,305.54,61.85,,,percent of total billed charges,61.85% of total billed charges,82.99,16.8,,,percent of total billed charges,16.8% of total billed charges,247,50,,,percent of total billed charges,50% of total Billed charges,247,50,,,percent of total billed charges,50% of total Billed charges,82.99,16.8,,,percent of total billed charges,16.8% of total Billed charges,247,50,,,percent of total billed charges,50% of total Billed charges,247,50,,,percent of total billed charges,50% of total Billed charges,84.65,17.136,,,percent of total billed charges,17.136% of total billed charges,107.89,21.84,,,percent of total billed charges,21.84% of total billed charges,247,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,247,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,247,50,,,percent of total billed charges,50% of total Billed charges,385.32,78,,,percent of total billed charges,78% of total billed charges,494,100,,,percent of total billed charges,100% of total billed charges,408.04,82.6,,,percent of total billed charges,82.6% of total billed charges,408.04,82.6,,,percent of total billed charges,82.6% of total billed charges,82.99,16.8,,,percent of total billed charges,16.8% of total billed charges,247,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,247,50,,,percent of total billed charges,50% of total Billed charges,82.99,16.8,,,percent of total billed charges,16.8% of total billed charges,75.58,494,
CURETTE STERILE DISP DERMAL INTEGRA 4MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CURETTE EAR 4MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CURETTE EAR LIGHTED VERSALOOP 2.5MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CURETTE EAR INFANT(BLUE) SINGLE ENDED 2MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CURETTE EAR INFANT(GRN) SINGLE ENDED 3MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CURETTE EAR LIGHTED WAVE 2.5MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CURITY AMNIOCENTTESIS TRAY 20GAX3.5IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
CUROS STRIPS,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
CURRETTE LATITUDE,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
CURRETTE VACUUM 7MM FLEX,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CURRETTE EAR CERA SPOON ADULT 4MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CURRETTE EAR LIGHTED ASSORTED TIP SIZES,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CURRETTE BIOPSY ENDOCERVICAL RETANGULAR TIP,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CURRETTE EAR MICROLOOP 3MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CUSTOM PERFUSION PACK,ORSUP0028,CDM,270,RC,,,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
CUTTER FLIP 2-6.5MM,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CUTTER FLIP 9MM,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CUTTER MENISCUS FULLRADIUS 4.5,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CUTTER LINEAR TITANIUM 55MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
CUTTER RELOAD LINEAR BLUE 75MM,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CUTTER RELOAD LINEAR BLUE 55MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
CUTTER VASC/THIN ENDOPAT RELO,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CUTTER LINEAR THICK TISSUE 75M,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
CUTTER LINEAR ARTICULATING ECHELON 45,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
CUTTER ENDOSCOPIC LINEAR ARTICULATING 35MM WHITE,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
CUTTER DUAL EDGE 3.5MM,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CUTTER 4.0MM SERRATED,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
CUTTER 3.5MM SERRATED,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
CUTTER AGGRESSIVE 2.5MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
CUVETTES ACL TOP 2400/BX 600 STRIPS,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CUVETTES DISPOSABLE SQUARE,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
CUVETTES FS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
CVD  EXTENDED MICRO TIP 4/CS,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
CYTOMAX II CYTOLOGY BRUSH,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
D AND E CYLINDER ROLLING CART,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
D AND E OXYGEN WRENCH,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
D-DIMER HS,ORSUP0031,CDM,270,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
D-STAT KIT,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
D5W  ELECTROLYTE #48 500ML,56163,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
D5W IV SOL 500ml,CATH00005,CDM,250,RC,J7070,HCPCS,Outpatient,,,426,276.90,,374.88,88,,,percent of total billed charges,88% of total Billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,71.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,426,100,,,percent of total billed charges,100% of total billed charges,73.72,17.304,,,percent of total billed charges,17.304% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,268.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,71.57,16.8,,,percent of total billed charges,16.8% of total billed charges,65.18,15.3,,,percent of total billed charges,15.3% of total billed charges,293.94,69,,,percent of total billed charges,69% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,426,100,,,percent of total billed charges,100% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,426,100,,,percent of total billed charges,100% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,263.48,61.85,,,percent of total billed charges,61.85% of total billed charges,71.57,16.8,,,percent of total billed charges,16.8% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,71.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,73,17.136,,,percent of total billed charges,17.136% of total billed charges,93.04,21.84,,,percent of total billed charges,21.84% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,213,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,213,50,,,percent of total billed charges,50% of total Billed charges,332.28,78,,,percent of total billed charges,78% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,71.57,16.8,,,percent of total billed charges,16.8% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,213,50,,,percent of total billed charges,50% of total Billed charges,71.57,16.8,,,percent of total billed charges,16.8% of total billed charges,65.18,426,
DA VINCI ENDO WRIST SUCTION IRRIGATOR,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
DATASCOPE EKG PAPER,490423,CDM,270,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
DBM MATRIX 2.5CM X 5CM,ORSUP0044,CDM,278,RC,C1762,HCPCS,Outpatient,,,8580,5577.00,,7550.4,88,,,percent of total billed charges,88% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1484.68,17.304,,,percent of total billed charges,17.304% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5405.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,15.3,,,percent of total billed charges,15.3% of total billed charges,5920.2,69,,,percent of total billed charges,69% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5306.73,61.85,,,percent of total billed charges,61.85% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,2676.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1470.27,17.136,,,percent of total billed charges,17.136% of total billed charges,1873.87,21.84,,,percent of total billed charges,21.84% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,3234.66,37.7,,,percent of total billed charges,37.70% of total billed charges,3234.66,37.7,,,percent of total billed charges,37.70% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,2908.62,33.9,,,percent of total billed charges,33.9% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,6692.4,78,,,percent of total billed charges,78% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,8580,
DBM MATRIX 5CC ORTHOBLEND SMALL DEFGRAFTON,ORSUP0031,CDM,278,RC,C1762,HCPCS,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
DEBRISOFT WOUND DEBRIDEMENT 10X10CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DEBRISOFT LOLLY DEBRIDEMENT,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DECONTAMINANT RNASE DISPLACE,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
DECONTAM GLOVE SIZE SMALL,490424,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
DEFIB PADS,490425,CDM,270,RC,,,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,7.27,17.304,,,percent of total billed charges,17.304% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,26.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,15.3,,,percent of total billed charges,15.3% of total billed charges,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.2,17.136,,,percent of total billed charges,17.136% of total billed charges,9.17,21.84,,,percent of total billed charges,21.84% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,42,
DEFIB PADS ADULT RADIOLUCENT W/LEADS-OUT PACKAGING,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
DEFIB PADS PEDIATRIC RADIOLUCENT W/LEADS-OUT PACKAGING,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
DEIONIZED WATER FILTER,ORSUP0022,CDM,272,RC,,,Outpatient,,,2200,1430.00,,1936,88,,,percent of total billed charges,88% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,380.69,17.304,,,percent of total billed charges,17.304% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1386,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,15.3,,,percent of total billed charges,15.3% of total billed charges,1518,69,,,percent of total billed charges,69% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1360.7,61.85,,,percent of total billed charges,61.85% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,376.99,17.136,,,percent of total billed charges,17.136% of total billed charges,480.48,21.84,,,percent of total billed charges,21.84% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,1716,78,,,percent of total billed charges,78% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,2200,
DENSICHEK PLUS CALIBRARATION STANDARD,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
DENVER SPLINT 1500 SERIES MINI,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
DENVER NASAL SPLINT KIT LARGE LARGE,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
DEODORANT 1.5 OZ  ANTIPERSPIRANT LF,10194,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
DERMABOND,236127,CDM,272,RC,,,Outpatient,,,570,370.50,,501.6,88,,,percent of total billed charges,88% of total Billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,95.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,570,100,,,percent of total billed charges,100% of total billed charges,98.63,17.304,,,percent of total billed charges,17.304% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,359.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,95.76,16.8,,,percent of total billed charges,16.8% of total billed charges,87.21,15.3,,,percent of total billed charges,15.3% of total billed charges,393.3,69,,,percent of total billed charges,69% of total billed charges,570,100,,,percent of total billed charges,100% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,570,100,,,percent of total billed charges,100% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,570,100,,,percent of total billed charges,100% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,352.55,61.85,,,percent of total billed charges,61.85% of total billed charges,95.76,16.8,,,percent of total billed charges,16.8% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,95.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,97.68,17.136,,,percent of total billed charges,17.136% of total billed charges,124.49,21.84,,,percent of total billed charges,21.84% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,285,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,285,50,,,percent of total billed charges,50% of total Billed charges,444.6,78,,,percent of total billed charges,78% of total billed charges,570,100,,,percent of total billed charges,100% of total billed charges,470.82,82.6,,,percent of total billed charges,82.6% of total billed charges,470.82,82.6,,,percent of total billed charges,82.6% of total billed charges,95.76,16.8,,,percent of total billed charges,16.8% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,285,50,,,percent of total billed charges,50% of total Billed charges,95.76,16.8,,,percent of total billed charges,16.8% of total billed charges,87.21,570,
DERMACARRIERS 1.5:1,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
DERMABOND PRINEO SKIN CLOSURE,490427,CDM,270,RC,,,Outpatient,,,738,479.70,,649.44,88,,,percent of total billed charges,88% of total Billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,123.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,738,100,,,percent of total billed charges,100% of total billed charges,127.7,17.304,,,percent of total billed charges,17.304% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,464.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,123.98,16.8,,,percent of total billed charges,16.8% of total billed charges,112.91,15.3,,,percent of total billed charges,15.3% of total billed charges,509.22,69,,,percent of total billed charges,69% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,738,100,,,percent of total billed charges,100% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,738,100,,,percent of total billed charges,100% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,456.45,61.85,,,percent of total billed charges,61.85% of total billed charges,123.98,16.8,,,percent of total billed charges,16.8% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,123.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,126.46,17.136,,,percent of total billed charges,17.136% of total billed charges,161.18,21.84,,,percent of total billed charges,21.84% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,369,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,369,50,,,percent of total billed charges,50% of total Billed charges,575.64,78,,,percent of total billed charges,78% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,123.98,16.8,,,percent of total billed charges,16.8% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,369,50,,,percent of total billed charges,50% of total Billed charges,123.98,16.8,,,percent of total billed charges,16.8% of total billed charges,112.91,738,
DERMATOME BLADE,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
DERMABOND SKIN ADHESIVE,490428,CDM,270,RC,,,Outpatient,,,1856,1206.40,,1633.28,88,,,percent of total billed charges,88% of total Billed charges,928,50,,,percent of total billed charges,50% of total Billed charges,311.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,1856,100,,,percent of total billed charges,100% of total billed charges,321.16,17.304,,,percent of total billed charges,17.304% of total billed charges,928,50,,,percent of total billed charges,50% of total Billed charges,1169.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,311.81,16.8,,,percent of total billed charges,16.8% of total billed charges,283.97,15.3,,,percent of total billed charges,15.3% of total billed charges,1280.64,69,,,percent of total billed charges,69% of total billed charges,1856,100,,,percent of total billed charges,100% of total billed charges,928,50,,,percent of total billed charges,50% of total Billed charges,1856,100,,,percent of total billed charges,100% of total billed charges,928,50,,,percent of total billed charges,50% of total Billed charges,1856,100,,,percent of total billed charges,100% of total billed charges,928,50,,,percent of total billed charges,50% of total Billed charges,1147.94,61.85,,,percent of total billed charges,61.85% of total billed charges,311.81,16.8,,,percent of total billed charges,16.8% of total billed charges,928,50,,,percent of total billed charges,50% of total Billed charges,928,50,,,percent of total billed charges,50% of total Billed charges,311.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,928,50,,,percent of total billed charges,50% of total Billed charges,928,50,,,percent of total billed charges,50% of total Billed charges,318.04,17.136,,,percent of total billed charges,17.136% of total billed charges,405.35,21.84,,,percent of total billed charges,21.84% of total billed charges,928,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,928,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,928,50,,,percent of total billed charges,50% of total Billed charges,1447.68,78,,,percent of total billed charges,78% of total billed charges,1856,100,,,percent of total billed charges,100% of total billed charges,1533.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1533.06,82.6,,,percent of total billed charges,82.6% of total billed charges,311.81,16.8,,,percent of total billed charges,16.8% of total billed charges,928,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,928,50,,,percent of total billed charges,50% of total Billed charges,311.81,16.8,,,percent of total billed charges,16.8% of total billed charges,283.97,1856,
DESICCANT PACKS BX / 2 SETS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
DESICCANT STRG BX / 6 SACHETS,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
DESOXYCHOLATE BACTIDROP 10%,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DETERGENT INTERCEPT,311586,CDM,270,RC,,,Outpatient,,,883,573.95,,777.04,88,,,percent of total billed charges,88% of total Billed charges,441.5,50,,,percent of total billed charges,50% of total Billed charges,148.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,883,100,,,percent of total billed charges,100% of total billed charges,152.79,17.304,,,percent of total billed charges,17.304% of total billed charges,441.5,50,,,percent of total billed charges,50% of total Billed charges,556.29,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,148.34,16.8,,,percent of total billed charges,16.8% of total billed charges,135.1,15.3,,,percent of total billed charges,15.3% of total billed charges,609.27,69,,,percent of total billed charges,69% of total billed charges,883,100,,,percent of total billed charges,100% of total billed charges,441.5,50,,,percent of total billed charges,50% of total Billed charges,883,100,,,percent of total billed charges,100% of total billed charges,441.5,50,,,percent of total billed charges,50% of total Billed charges,883,100,,,percent of total billed charges,100% of total billed charges,441.5,50,,,percent of total billed charges,50% of total Billed charges,546.14,61.85,,,percent of total billed charges,61.85% of total billed charges,148.34,16.8,,,percent of total billed charges,16.8% of total billed charges,441.5,50,,,percent of total billed charges,50% of total Billed charges,441.5,50,,,percent of total billed charges,50% of total Billed charges,148.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,441.5,50,,,percent of total billed charges,50% of total Billed charges,441.5,50,,,percent of total billed charges,50% of total Billed charges,151.31,17.136,,,percent of total billed charges,17.136% of total billed charges,192.85,21.84,,,percent of total billed charges,21.84% of total billed charges,441.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,441.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,441.5,50,,,percent of total billed charges,50% of total Billed charges,688.74,78,,,percent of total billed charges,78% of total billed charges,883,100,,,percent of total billed charges,100% of total billed charges,729.36,82.6,,,percent of total billed charges,82.6% of total billed charges,729.36,82.6,,,percent of total billed charges,82.6% of total billed charges,148.34,16.8,,,percent of total billed charges,16.8% of total billed charges,441.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,441.5,50,,,percent of total billed charges,50% of total Billed charges,148.34,16.8,,,percent of total billed charges,16.8% of total billed charges,135.1,883,
DETERGENT LOW SUDS LIQUID,14272,CDM,270,RC,,,Outpatient,,,102,66.30,,89.76,88,,,percent of total billed charges,88% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,102,100,,,percent of total billed charges,100% of total billed charges,17.65,17.304,,,percent of total billed charges,17.304% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,64.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,15.61,15.3,,,percent of total billed charges,15.3% of total billed charges,70.38,69,,,percent of total billed charges,69% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,102,100,,,percent of total billed charges,100% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,102,100,,,percent of total billed charges,100% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,63.09,61.85,,,percent of total billed charges,61.85% of total billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,17.48,17.136,,,percent of total billed charges,17.136% of total billed charges,22.28,21.84,,,percent of total billed charges,21.84% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,51,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,51,50,,,percent of total billed charges,50% of total Billed charges,79.56,78,,,percent of total billed charges,78% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,51,50,,,percent of total billed charges,50% of total Billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,15.61,102,
DETERGENT NEPTUNE DOCKING,278934,CDM,270,RC,,,Outpatient,,,1610,1046.50,,1416.8,88,,,percent of total billed charges,88% of total Billed charges,805,50,,,percent of total billed charges,50% of total Billed charges,270.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1610,100,,,percent of total billed charges,100% of total billed charges,278.59,17.304,,,percent of total billed charges,17.304% of total billed charges,805,50,,,percent of total billed charges,50% of total Billed charges,1014.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,270.48,16.8,,,percent of total billed charges,16.8% of total billed charges,246.33,15.3,,,percent of total billed charges,15.3% of total billed charges,1110.9,69,,,percent of total billed charges,69% of total billed charges,1610,100,,,percent of total billed charges,100% of total billed charges,805,50,,,percent of total billed charges,50% of total Billed charges,1610,100,,,percent of total billed charges,100% of total billed charges,805,50,,,percent of total billed charges,50% of total Billed charges,1610,100,,,percent of total billed charges,100% of total billed charges,805,50,,,percent of total billed charges,50% of total Billed charges,995.79,61.85,,,percent of total billed charges,61.85% of total billed charges,270.48,16.8,,,percent of total billed charges,16.8% of total billed charges,805,50,,,percent of total billed charges,50% of total Billed charges,805,50,,,percent of total billed charges,50% of total Billed charges,270.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,805,50,,,percent of total billed charges,50% of total Billed charges,805,50,,,percent of total billed charges,50% of total Billed charges,275.89,17.136,,,percent of total billed charges,17.136% of total billed charges,351.62,21.84,,,percent of total billed charges,21.84% of total billed charges,805,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,805,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,805,50,,,percent of total billed charges,50% of total Billed charges,1255.8,78,,,percent of total billed charges,78% of total billed charges,1610,100,,,percent of total billed charges,100% of total billed charges,1329.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1329.86,82.6,,,percent of total billed charges,82.6% of total billed charges,270.48,16.8,,,percent of total billed charges,16.8% of total billed charges,805,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,805,50,,,percent of total billed charges,50% of total Billed charges,270.48,16.8,,,percent of total billed charges,16.8% of total billed charges,246.33,1610,
DEVICE BONE FILLER KYPHX,ORSUP0007,CDM,278,RC,C9359,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
DEVICE SPIDER EMB 40X320 FX,ORSUP0038,CDM,278,RC,C1884,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
DEVICE SPIDER EMB 70X320 FX,ORSUP0038,CDM,278,RC,C1884,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
DEVICE PROGRAMMER PATIENT,ORSUP0030,CDM,278,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1541.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1674.66,33.9,,,percent of total billed charges,33.9% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
DEVICE MRI POWERPORT W/ 8 FR ATTACHABLE CHRONOFLEX CATH,ORSUP0020,CDM,278,RC,C1788,HCPCS,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,561.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,610.2,33.9,,,percent of total billed charges,33.9% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
DEVICE XPOSE ACCESS,ORSUP0028,CDM,272,RC,,,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
DEVICE TYPE SAFE SEGMENT PIERCING,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
DEVICE ENDO STITCH SUTURING,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
DEVICE CATHETER SECUREMENT STATLOCK,257379,CDM,272,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
DEVICE FASTFIX 360 CURVED MENISCAL REPAIR SYS,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
DEVICE GELPORT HAND ACCESS,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
DEVICE LATERAL TRACTION,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
DEVICE SINUS BALLOON INFLATION,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
DEVICE HEMOSTATIC L38CM XL ARISTA AH,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DEX 5% LACTATED RINGERS POT CHR 20MEQ 1000ML PB,153419,CDM,272,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
DEXTROSE 5% INJECTION 250ML BAG,161239,CDM,258,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
DEXTROSE 5% INJECTION 500ML BAG,161241,CDM,258,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
DIAPERS LITTLE MOVERS SZ-3,184375,CDM,272,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
DIAPERS LITTLE MOVERS SZ-4,184376,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
DIESSE MINI-CUBE PAPER,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DIESSE MINICUBE TRNSPNDR 1000T,ORSUP0038,CDM,272,RC,,,Outpatient,,,5400,3510.00,,4752,88,,,percent of total billed charges,88% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,934.42,17.304,,,percent of total billed charges,17.304% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,3402,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,826.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3726,69,,,percent of total billed charges,69% of total billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,3339.9,61.85,,,percent of total billed charges,61.85% of total billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,925.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1179.36,21.84,,,percent of total billed charges,21.84% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2700,50,,,percent of total billed charges,50% of total Billed charges,4212,78,,,percent of total billed charges,78% of total billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,4460.4,82.6,,,percent of total billed charges,82.6% of total billed charges,4460.4,82.6,,,percent of total billed charges,82.6% of total billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2700,50,,,percent of total billed charges,50% of total Billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,826.2,5400,
DIESSE MINICUBE TRNSPNDR 500T,ORSUP0026,CDM,272,RC,,,Outpatient,,,3000,1950.00,,2640,88,,,percent of total billed charges,88% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,519.12,17.304,,,percent of total billed charges,17.304% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1890,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,15.3,,,percent of total billed charges,15.3% of total billed charges,2070,69,,,percent of total billed charges,69% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1855.5,61.85,,,percent of total billed charges,61.85% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,514.08,17.136,,,percent of total billed charges,17.136% of total billed charges,655.2,21.84,,,percent of total billed charges,21.84% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,2340,78,,,percent of total billed charges,78% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,3000,
DIFF D X H FP PACK,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
DIFF-SAFE 101,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DIGOXIN / 5 PACK / 90 SLIDES,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DILATOR NOTTINGHAM ON-STEP 12F-18F  X 70CM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
DILATOR 8FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DILATOR 6FR STANDARD,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DILATOR 5FR STANDARD,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DILATOR 18FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DILATOR 20FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DILATOR 16FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DILATOR 10 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DILATOR 12 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DILATOR 14 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DILUENT RED BLOOD CELL FOR MTS GEL SYSTEM 4X125ML,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DILUENT PACK 1 BX / 3 PACKS,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
DILUENT PACK 2 BX / 3 PACKS,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
DILUENT PACK 3 BX / 3 PACKS,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
DIRECT INJECTION 10CC,ORSUP0113,CDM,278,RC,C1713,HCPCS,Outpatient,,,23140,15041.00,,20363.2,88,,,percent of total billed charges,88% of total Billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4004.15,17.304,,,percent of total billed charges,17.304% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,14578.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,3540.42,15.3,,,percent of total billed charges,15.3% of total billed charges,15966.6,69,,,percent of total billed charges,69% of total billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,14312.09,61.85,,,percent of total billed charges,61.85% of total billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,7219.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11570,50,,,percent of total billed charges,50% of total Billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,3965.27,17.136,,,percent of total billed charges,17.136% of total billed charges,5053.78,21.84,,,percent of total billed charges,21.84% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,8723.78,37.7,,,percent of total billed charges,37.70% of total billed charges,8723.78,37.7,,,percent of total billed charges,37.70% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,7844.46,33.9,,,percent of total billed charges,33.9% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,18049.2,78,,,percent of total billed charges,78% of total billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,19113.64,82.6,,,percent of total billed charges,82.6% of total billed charges,19113.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11570,50,,,percent of total billed charges,50% of total Billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,3540.42,23140,
DIRECT HDL / 5 PACK / 300 SLDS,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
DISCONTINUED MESH DEXON 7979-00,ORSUP0011,CDM,278,RC,C1781,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
DISECTOR 3.5,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
DISINFECTANT TF-8 HIGH LEVEL,484299,CDM,270,RC,,,Outpatient,,,3042,1977.30,,2676.96,88,,,percent of total billed charges,88% of total Billed charges,1521,50,,,percent of total billed charges,50% of total Billed charges,511.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,3042,100,,,percent of total billed charges,100% of total billed charges,526.39,17.304,,,percent of total billed charges,17.304% of total billed charges,1521,50,,,percent of total billed charges,50% of total Billed charges,1916.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,511.06,16.8,,,percent of total billed charges,16.8% of total billed charges,465.43,15.3,,,percent of total billed charges,15.3% of total billed charges,2098.98,69,,,percent of total billed charges,69% of total billed charges,3042,100,,,percent of total billed charges,100% of total billed charges,1521,50,,,percent of total billed charges,50% of total Billed charges,3042,100,,,percent of total billed charges,100% of total billed charges,1521,50,,,percent of total billed charges,50% of total Billed charges,3042,100,,,percent of total billed charges,100% of total billed charges,1521,50,,,percent of total billed charges,50% of total Billed charges,1881.48,61.85,,,percent of total billed charges,61.85% of total billed charges,511.06,16.8,,,percent of total billed charges,16.8% of total billed charges,1521,50,,,percent of total billed charges,50% of total Billed charges,1521,50,,,percent of total billed charges,50% of total Billed charges,511.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,1521,50,,,percent of total billed charges,50% of total Billed charges,1521,50,,,percent of total billed charges,50% of total Billed charges,521.28,17.136,,,percent of total billed charges,17.136% of total billed charges,664.37,21.84,,,percent of total billed charges,21.84% of total billed charges,1521,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1521,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1521,50,,,percent of total billed charges,50% of total Billed charges,2372.76,78,,,percent of total billed charges,78% of total billed charges,3042,100,,,percent of total billed charges,100% of total billed charges,2512.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2512.69,82.6,,,percent of total billed charges,82.6% of total billed charges,511.06,16.8,,,percent of total billed charges,16.8% of total billed charges,1521,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1521,50,,,percent of total billed charges,50% of total Billed charges,511.06,16.8,,,percent of total billed charges,16.8% of total billed charges,465.43,3042,
DISINFECTANT SONEX-HL TROPHON 80 ML,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
DISPOSABLE NS OR TOWEL,490432,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
DISPOSABLE STERILE OR TOWELS,490433,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
DISPOSABLE FILTER CONCENTRATOR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DISPOSABLE INFUSION ABGS 1000ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DISP LARYNGOSCOPE BLADE \\T\\ HANDLE 30MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DISP LARYNGOSCOPE BLADE \\T\\ HANDLE #2,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DISP LARYNGOSCOPE BLADE \\T\\ HANDLE #00,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DISP LARYNGOSCOPE BLADE \\T\\ HANDLE #4,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DISP LARYNGOSCOPE BLADE \\T\\ HANDLE 20MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DISSECTING TOOL L9CM OD6MM LEGEND BALL,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
DISSECTING TOOL MIDAS REX  8TD114,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
DISSECTING TOOL #9BA75,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DISSECTING TOOL #9BA60,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DISSECTING TOOL #14MH30,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DISSECTING TOOL #26BA60,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
DISSECTING TOOL #T9MH25,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
DISSECTING TOOL #T9MH25D,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DISSECTING TOOL T12,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
DISSECTINT TOOLS M-8,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
DISSECTOR CURVED BLADE,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
DISSECTING TOOL #9BA40D,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
DISSECTING TOOL #F2/8TA23,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DISSECTING TOOL #9BA40,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DISSECTING TOOL #14BA40,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DISSECTOR MARYLAND 5MM DA VINCI,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
DISSECTOR TIP RIGHT ANGLE 5MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
DO NOT USE LABEL,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
DOC EXTN  WIRE,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
DOPPLER PENCIL 8.1,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DORNHOFFER TOTAL MIDDLE EAR,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
DOUBLECUT 4.0MM,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
DOUBLECUT CURVED 4.0MM,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
DOUBLE BASIN PACK,433366,CDM,270,RC,,,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,9.69,17.304,,,percent of total billed charges,17.304% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,35.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.6,17.136,,,percent of total billed charges,17.136% of total billed charges,12.23,21.84,,,percent of total billed charges,21.84% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,56,
DR DONS ARM CANOE FOAM,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
DRAIN BLAKE 24FR SILICONE 4 CHANNEL,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
DRAIN J P 10MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRAIN ROUND 10  0070210,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DRAIN ROUND FULL FLUTED 15FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRIAN BLAKE FLAT 7F,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
DRAIN PENROSE 5/8,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRAINAGE BAG W/ANTI RELUX VALVE FOR LIMITORR,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
DRAIN BLAKE RND FLUTED STR 19FR,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
DRAIN SILICONE FLAT 10MM FULL PERFORATION STRL,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
HEMOVAC MINI 7MM,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
DRAIN BAG 2000CC,490436,CDM,270,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
DRAIN BAG 4000CC,490437,CDM,270,RC,,,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,7.09,17.304,,,percent of total billed charges,17.304% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,15.3,,,percent of total billed charges,15.3% of total billed charges,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.36,61.85,,,percent of total billed charges,61.85% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,7.03,17.136,,,percent of total billed charges,17.136% of total billed charges,8.95,21.84,,,percent of total billed charges,21.84% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,41,
DRAIN BLAKE 7 MM FLAT,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRAIN BAG CYSTO/UROLOGY,490438,CDM,270,RC,,,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,13.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,83,100,,,percent of total billed charges,100% of total billed charges,14.36,17.304,,,percent of total billed charges,17.304% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,52.29,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.94,16.8,,,percent of total billed charges,16.8% of total billed charges,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,83,100,,,percent of total billed charges,100% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,83,100,,,percent of total billed charges,100% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,51.34,61.85,,,percent of total billed charges,61.85% of total billed charges,13.94,16.8,,,percent of total billed charges,16.8% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,13.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,14.22,17.136,,,percent of total billed charges,17.136% of total billed charges,18.13,21.84,,,percent of total billed charges,21.84% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,41.5,50,,,percent of total billed charges,50% of total Billed charges,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,13.94,16.8,,,percent of total billed charges,16.8% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,41.5,50,,,percent of total billed charges,50% of total Billed charges,13.94,16.8,,,percent of total billed charges,16.8% of total billed charges,12.7,83,
DRAIN BLAKE 10FR,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
DRAIN BLAKE 15FR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
DRAIN BLAKE 19FR,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
DRAIN BULB,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRAIN PENROSE,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRAIN CHEST VALVE SET,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
DRAINAGE SET 10.2FR X 25CM,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DRAIN CATTELL T-TUBE 20 FR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRAIN BAG ANTI-REFLUX L/F 2000ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRAIN BAG 4L A/R LL SLIDE TAP,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRAINAGE KIT PLEURAL W/Bottle,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
DRAPE TOP 102X53 STERILE,187597,CDM,272,RC,,,Outpatient,,,44,28.60,,38.72,88,,,percent of total billed charges,88% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,7.61,17.304,,,percent of total billed charges,17.304% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,15.3,,,percent of total billed charges,15.3% of total billed charges,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.21,61.85,,,percent of total billed charges,61.85% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.54,17.136,,,percent of total billed charges,17.136% of total billed charges,9.61,21.84,,,percent of total billed charges,21.84% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,44,
DRAPE T LAPARO TRANS STERILE,13980,CDM,272,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
DRAPE LAPAROTOMY PED STERILE,71070,CDM,272,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
DRAPE EYE PCH FEN INC STERILE,187598,CDM,272,RC,,,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,13.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,83,100,,,percent of total billed charges,100% of total billed charges,14.36,17.304,,,percent of total billed charges,17.304% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,52.29,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.94,16.8,,,percent of total billed charges,16.8% of total billed charges,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,83,100,,,percent of total billed charges,100% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,83,100,,,percent of total billed charges,100% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,51.34,61.85,,,percent of total billed charges,61.85% of total billed charges,13.94,16.8,,,percent of total billed charges,16.8% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,13.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,14.22,17.136,,,percent of total billed charges,17.136% of total billed charges,18.13,21.84,,,percent of total billed charges,21.84% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,41.5,50,,,percent of total billed charges,50% of total Billed charges,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,13.94,16.8,,,percent of total billed charges,16.8% of total billed charges,41.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,41.5,50,,,percent of total billed charges,50% of total Billed charges,13.94,16.8,,,percent of total billed charges,16.8% of total billed charges,12.7,83,
DRAPE EXTREMITY 89X128 STERILE,85013,CDM,272,RC,,,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,7.79,17.304,,,percent of total billed charges,17.304% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,27.83,61.85,,,percent of total billed charges,61.85% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.71,17.136,,,percent of total billed charges,17.136% of total billed charges,9.83,21.84,,,percent of total billed charges,21.84% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
DRAPE EENT SPLIT STERILE,76842,CDM,272,RC,,,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,9.69,17.304,,,percent of total billed charges,17.304% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,35.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.6,17.136,,,percent of total billed charges,17.136% of total billed charges,12.23,21.84,,,percent of total billed charges,21.84% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,56,
DRAPE SHEET CRANIOTOMY,45633,CDM,270,RC,,,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,16.27,17.304,,,percent of total billed charges,17.304% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,59.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,58.14,61.85,,,percent of total billed charges,61.85% of total billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,16.11,17.136,,,percent of total billed charges,17.136% of total billed charges,20.53,21.84,,,percent of total billed charges,21.84% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,14.38,94,
DRAPE EXTREMITY BLATRL STERILE,13983,CDM,272,RC,,,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,11.94,17.304,,,percent of total billed charges,17.304% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,43.47,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,42.68,61.85,,,percent of total billed charges,61.85% of total billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.82,17.136,,,percent of total billed charges,17.136% of total billed charges,15.07,21.84,,,percent of total billed charges,21.84% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,10.56,69,
DRAPE LAP CHOLE W/TROUGHS STERILE,44547,CDM,272,RC,,,Outpatient,,,102,66.30,,89.76,88,,,percent of total billed charges,88% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,102,100,,,percent of total billed charges,100% of total billed charges,17.65,17.304,,,percent of total billed charges,17.304% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,64.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,15.61,15.3,,,percent of total billed charges,15.3% of total billed charges,70.38,69,,,percent of total billed charges,69% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,102,100,,,percent of total billed charges,100% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,102,100,,,percent of total billed charges,100% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,63.09,61.85,,,percent of total billed charges,61.85% of total billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,17.48,17.136,,,percent of total billed charges,17.136% of total billed charges,22.28,21.84,,,percent of total billed charges,21.84% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,51,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,51,50,,,percent of total billed charges,50% of total Billed charges,79.56,78,,,percent of total billed charges,78% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,51,50,,,percent of total billed charges,50% of total Billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,15.61,102,
DRAPE STERI INCISE IOBAN 2 23IN X 33 IN,39549,CDM,272,RC,,,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,15.75,17.304,,,percent of total billed charges,17.304% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,57.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,15.3,,,percent of total billed charges,15.3% of total billed charges,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,56.28,61.85,,,percent of total billed charges,61.85% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.59,17.136,,,percent of total billed charges,17.136% of total billed charges,19.87,21.84,,,percent of total billed charges,21.84% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,91,
DRAPE ISO. 125-7/8IN  88-3/4IN,186728,CDM,270,RC,,,Outpatient,,,191,124.15,,168.08,88,,,percent of total billed charges,88% of total Billed charges,95.5,50,,,percent of total billed charges,50% of total Billed charges,32.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,191,100,,,percent of total billed charges,100% of total billed charges,33.05,17.304,,,percent of total billed charges,17.304% of total billed charges,95.5,50,,,percent of total billed charges,50% of total Billed charges,120.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.09,16.8,,,percent of total billed charges,16.8% of total billed charges,29.22,15.3,,,percent of total billed charges,15.3% of total billed charges,131.79,69,,,percent of total billed charges,69% of total billed charges,191,100,,,percent of total billed charges,100% of total billed charges,95.5,50,,,percent of total billed charges,50% of total Billed charges,191,100,,,percent of total billed charges,100% of total billed charges,95.5,50,,,percent of total billed charges,50% of total Billed charges,191,100,,,percent of total billed charges,100% of total billed charges,95.5,50,,,percent of total billed charges,50% of total Billed charges,118.13,61.85,,,percent of total billed charges,61.85% of total billed charges,32.09,16.8,,,percent of total billed charges,16.8% of total billed charges,95.5,50,,,percent of total billed charges,50% of total Billed charges,95.5,50,,,percent of total billed charges,50% of total Billed charges,32.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,95.5,50,,,percent of total billed charges,50% of total Billed charges,95.5,50,,,percent of total billed charges,50% of total Billed charges,32.73,17.136,,,percent of total billed charges,17.136% of total billed charges,41.71,21.84,,,percent of total billed charges,21.84% of total billed charges,95.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,95.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,95.5,50,,,percent of total billed charges,50% of total Billed charges,148.98,78,,,percent of total billed charges,78% of total billed charges,191,100,,,percent of total billed charges,100% of total billed charges,157.77,82.6,,,percent of total billed charges,82.6% of total billed charges,157.77,82.6,,,percent of total billed charges,82.6% of total billed charges,32.09,16.8,,,percent of total billed charges,16.8% of total billed charges,95.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,95.5,50,,,percent of total billed charges,50% of total Billed charges,32.09,16.8,,,percent of total billed charges,16.8% of total billed charges,29.22,191,
DRAPE STERI 16X16 3M,111107,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
DRAPE SURGICAL STERI INSTR PCH,184756,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
DRAPE SURGICAL STERI IRRG PCH,161359,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
DRAPE U-SHAPED  47 1/8 X 51 1/6,87955,CDM,270,RC,,,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,12.8,17.304,,,percent of total billed charges,17.304% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,46.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,45.77,61.85,,,percent of total billed charges,61.85% of total billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.68,17.136,,,percent of total billed charges,17.136% of total billed charges,16.16,21.84,,,percent of total billed charges,21.84% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,11.32,74,
DRAPE SURGICAL W/TWL 17 5/8X23,161364,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
DRAPE INSTRUMENT MAGNETIC 16 X 20 LARGE DISP,14368,CDM,270,RC,,,Outpatient,,,68,44.20,,59.84,88,,,percent of total billed charges,88% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,68,100,,,percent of total billed charges,100% of total billed charges,11.77,17.304,,,percent of total billed charges,17.304% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,42.84,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,10.4,15.3,,,percent of total billed charges,15.3% of total billed charges,46.92,69,,,percent of total billed charges,69% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,68,100,,,percent of total billed charges,100% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,68,100,,,percent of total billed charges,100% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,42.06,61.85,,,percent of total billed charges,61.85% of total billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,11.65,17.136,,,percent of total billed charges,17.136% of total billed charges,14.85,21.84,,,percent of total billed charges,21.84% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34,50,,,percent of total billed charges,50% of total Billed charges,53.04,78,,,percent of total billed charges,78% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34,50,,,percent of total billed charges,50% of total Billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,10.4,68,
DRAPE STERI 34X36,45598,CDM,272,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
DRAPE INCISE IOBAN 2 35,56110,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
DRAPE C-ARM IMAGE INTENSIFIER 18IN X 9IN X 20IN,153536,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
DRAPE U/ SHT SPLIT PLAS STERIL,11515,CDM,272,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
DRAPE FLUOROSCAN,185998,CDM,270,RC,,,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,12.46,17.304,,,percent of total billed charges,17.304% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,45.36,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,15.3,,,percent of total billed charges,15.3% of total billed charges,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,44.53,61.85,,,percent of total billed charges,61.85% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.34,17.136,,,percent of total billed charges,17.136% of total billed charges,15.72,21.84,,,percent of total billed charges,21.84% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,72,
DRAPE ARTHRO W/POUCH STERILE,71075,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
DRAPE SURGICAL STERI APERTURE,143573,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
DRAPE STERI 23IN X 17IN  #1050,35049,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
DRAPE STERI BAG ISOLATION 20IN X 20IN,137707,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
DRAPE C-ARM SUPER 96/98 12INCH,268542,CDM,270,RC,,,Outpatient,,,64,41.60,,56.32,88,,,percent of total billed charges,88% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,11.07,17.304,,,percent of total billed charges,17.304% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,40.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,9.79,15.3,,,percent of total billed charges,15.3% of total billed charges,44.16,69,,,percent of total billed charges,69% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,39.58,61.85,,,percent of total billed charges,61.85% of total billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.97,17.136,,,percent of total billed charges,17.136% of total billed charges,13.98,21.84,,,percent of total billed charges,21.84% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,49.92,78,,,percent of total billed charges,78% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,9.79,64,
DRAPE C-ARMOUR KIT,428695,CDM,270,RC,,,Outpatient,,,377,245.05,,331.76,88,,,percent of total billed charges,88% of total Billed charges,188.5,50,,,percent of total billed charges,50% of total Billed charges,63.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,377,100,,,percent of total billed charges,100% of total billed charges,65.24,17.304,,,percent of total billed charges,17.304% of total billed charges,188.5,50,,,percent of total billed charges,50% of total Billed charges,237.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,63.34,16.8,,,percent of total billed charges,16.8% of total billed charges,57.68,15.3,,,percent of total billed charges,15.3% of total billed charges,260.13,69,,,percent of total billed charges,69% of total billed charges,377,100,,,percent of total billed charges,100% of total billed charges,188.5,50,,,percent of total billed charges,50% of total Billed charges,377,100,,,percent of total billed charges,100% of total billed charges,188.5,50,,,percent of total billed charges,50% of total Billed charges,377,100,,,percent of total billed charges,100% of total billed charges,188.5,50,,,percent of total billed charges,50% of total Billed charges,233.17,61.85,,,percent of total billed charges,61.85% of total billed charges,63.34,16.8,,,percent of total billed charges,16.8% of total billed charges,188.5,50,,,percent of total billed charges,50% of total Billed charges,188.5,50,,,percent of total billed charges,50% of total Billed charges,63.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,188.5,50,,,percent of total billed charges,50% of total Billed charges,188.5,50,,,percent of total billed charges,50% of total Billed charges,64.6,17.136,,,percent of total billed charges,17.136% of total billed charges,82.34,21.84,,,percent of total billed charges,21.84% of total billed charges,188.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,188.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,188.5,50,,,percent of total billed charges,50% of total Billed charges,294.06,78,,,percent of total billed charges,78% of total billed charges,377,100,,,percent of total billed charges,100% of total billed charges,311.4,82.6,,,percent of total billed charges,82.6% of total billed charges,311.4,82.6,,,percent of total billed charges,82.6% of total billed charges,63.34,16.8,,,percent of total billed charges,16.8% of total billed charges,188.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,188.5,50,,,percent of total billed charges,50% of total Billed charges,63.34,16.8,,,percent of total billed charges,16.8% of total billed charges,57.68,377,
DRAPE CASSETTE XRAY,40176,CDM,270,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
DRAPE INSTRUMENT ARM DA VINCI,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
DRAPE LAP W/POUCH,301931,CDM,270,RC,,,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,12.11,17.304,,,percent of total billed charges,17.304% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,44.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,12,17.136,,,percent of total billed charges,17.136% of total billed charges,15.29,21.84,,,percent of total billed charges,21.84% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,70,
DRAPE LAP WITH FLUID POUCH,380111,CDM,270,RC,,,Outpatient,,,114,74.10,,100.32,88,,,percent of total billed charges,88% of total Billed charges,57,50,,,percent of total billed charges,50% of total Billed charges,19.15,16.8,,,percent of total billed charges,16.8% of total Billed charges,114,100,,,percent of total billed charges,100% of total billed charges,19.73,17.304,,,percent of total billed charges,17.304% of total billed charges,57,50,,,percent of total billed charges,50% of total Billed charges,71.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.15,16.8,,,percent of total billed charges,16.8% of total billed charges,17.44,15.3,,,percent of total billed charges,15.3% of total billed charges,78.66,69,,,percent of total billed charges,69% of total billed charges,114,100,,,percent of total billed charges,100% of total billed charges,57,50,,,percent of total billed charges,50% of total Billed charges,114,100,,,percent of total billed charges,100% of total billed charges,57,50,,,percent of total billed charges,50% of total Billed charges,114,100,,,percent of total billed charges,100% of total billed charges,57,50,,,percent of total billed charges,50% of total Billed charges,70.51,61.85,,,percent of total billed charges,61.85% of total billed charges,19.15,16.8,,,percent of total billed charges,16.8% of total billed charges,57,50,,,percent of total billed charges,50% of total Billed charges,57,50,,,percent of total billed charges,50% of total Billed charges,19.15,16.8,,,percent of total billed charges,16.8% of total Billed charges,57,50,,,percent of total billed charges,50% of total Billed charges,57,50,,,percent of total billed charges,50% of total Billed charges,19.54,17.136,,,percent of total billed charges,17.136% of total billed charges,24.9,21.84,,,percent of total billed charges,21.84% of total billed charges,57,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,57,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,57,50,,,percent of total billed charges,50% of total Billed charges,88.92,78,,,percent of total billed charges,78% of total billed charges,114,100,,,percent of total billed charges,100% of total billed charges,94.16,82.6,,,percent of total billed charges,82.6% of total billed charges,94.16,82.6,,,percent of total billed charges,82.6% of total billed charges,19.15,16.8,,,percent of total billed charges,16.8% of total billed charges,57,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,57,50,,,percent of total billed charges,50% of total Billed charges,19.15,16.8,,,percent of total billed charges,16.8% of total billed charges,17.44,114,
DRAPE LEICA MICROSCOPE,171791,CDM,270,RC,,,Outpatient,,,2524,1640.60,,2221.12,88,,,percent of total billed charges,88% of total Billed charges,1262,50,,,percent of total billed charges,50% of total Billed charges,424.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,2524,100,,,percent of total billed charges,100% of total billed charges,436.75,17.304,,,percent of total billed charges,17.304% of total billed charges,1262,50,,,percent of total billed charges,50% of total Billed charges,1590.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,424.03,16.8,,,percent of total billed charges,16.8% of total billed charges,386.17,15.3,,,percent of total billed charges,15.3% of total billed charges,1741.56,69,,,percent of total billed charges,69% of total billed charges,2524,100,,,percent of total billed charges,100% of total billed charges,1262,50,,,percent of total billed charges,50% of total Billed charges,2524,100,,,percent of total billed charges,100% of total billed charges,1262,50,,,percent of total billed charges,50% of total Billed charges,2524,100,,,percent of total billed charges,100% of total billed charges,1262,50,,,percent of total billed charges,50% of total Billed charges,1561.09,61.85,,,percent of total billed charges,61.85% of total billed charges,424.03,16.8,,,percent of total billed charges,16.8% of total billed charges,1262,50,,,percent of total billed charges,50% of total Billed charges,1262,50,,,percent of total billed charges,50% of total Billed charges,424.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,1262,50,,,percent of total billed charges,50% of total Billed charges,1262,50,,,percent of total billed charges,50% of total Billed charges,432.51,17.136,,,percent of total billed charges,17.136% of total billed charges,551.24,21.84,,,percent of total billed charges,21.84% of total billed charges,1262,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1262,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1262,50,,,percent of total billed charges,50% of total Billed charges,1968.72,78,,,percent of total billed charges,78% of total billed charges,2524,100,,,percent of total billed charges,100% of total billed charges,2084.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2084.82,82.6,,,percent of total billed charges,82.6% of total billed charges,424.03,16.8,,,percent of total billed charges,16.8% of total billed charges,1262,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1262,50,,,percent of total billed charges,50% of total Billed charges,424.03,16.8,,,percent of total billed charges,16.8% of total billed charges,386.17,2524,
DRAPE MICROSCOPE 326026 ZEISS IGS,101004,CDM,270,RC,,,Outpatient,,,221,143.65,,194.48,88,,,percent of total billed charges,88% of total Billed charges,110.5,50,,,percent of total billed charges,50% of total Billed charges,37.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,221,100,,,percent of total billed charges,100% of total billed charges,38.24,17.304,,,percent of total billed charges,17.304% of total billed charges,110.5,50,,,percent of total billed charges,50% of total Billed charges,139.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,37.13,16.8,,,percent of total billed charges,16.8% of total billed charges,33.81,15.3,,,percent of total billed charges,15.3% of total billed charges,152.49,69,,,percent of total billed charges,69% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,110.5,50,,,percent of total billed charges,50% of total Billed charges,221,100,,,percent of total billed charges,100% of total billed charges,110.5,50,,,percent of total billed charges,50% of total Billed charges,221,100,,,percent of total billed charges,100% of total billed charges,110.5,50,,,percent of total billed charges,50% of total Billed charges,136.69,61.85,,,percent of total billed charges,61.85% of total billed charges,37.13,16.8,,,percent of total billed charges,16.8% of total billed charges,110.5,50,,,percent of total billed charges,50% of total Billed charges,110.5,50,,,percent of total billed charges,50% of total Billed charges,37.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,110.5,50,,,percent of total billed charges,50% of total Billed charges,110.5,50,,,percent of total billed charges,50% of total Billed charges,37.87,17.136,,,percent of total billed charges,17.136% of total billed charges,48.27,21.84,,,percent of total billed charges,21.84% of total billed charges,110.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,110.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,110.5,50,,,percent of total billed charges,50% of total Billed charges,172.38,78,,,percent of total billed charges,78% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,37.13,16.8,,,percent of total billed charges,16.8% of total billed charges,110.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,110.5,50,,,percent of total billed charges,50% of total Billed charges,37.13,16.8,,,percent of total billed charges,16.8% of total billed charges,33.81,221,
DRAPE MICROSCOPE LEICA 54X120,205092,CDM,270,RC,,,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,32.19,17.304,,,percent of total billed charges,17.304% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,117.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,115.04,61.85,,,percent of total billed charges,61.85% of total billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.87,17.136,,,percent of total billed charges,17.136% of total billed charges,40.62,21.84,,,percent of total billed charges,21.84% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,28.46,186,
DRAPE SHOULDER ARTHROSCOPY DRAIN,30879,CDM,270,RC,,,Outpatient,,,207,134.55,,182.16,88,,,percent of total billed charges,88% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,34.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,35.82,17.304,,,percent of total billed charges,17.304% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,130.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.78,16.8,,,percent of total billed charges,16.8% of total billed charges,31.67,15.3,,,percent of total billed charges,15.3% of total billed charges,142.83,69,,,percent of total billed charges,69% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,207,100,,,percent of total billed charges,100% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,128.03,61.85,,,percent of total billed charges,61.85% of total billed charges,34.78,16.8,,,percent of total billed charges,16.8% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,34.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,35.47,17.136,,,percent of total billed charges,17.136% of total billed charges,45.21,21.84,,,percent of total billed charges,21.84% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,103.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,103.5,50,,,percent of total billed charges,50% of total Billed charges,161.46,78,,,percent of total billed charges,78% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,34.78,16.8,,,percent of total billed charges,16.8% of total billed charges,103.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,103.5,50,,,percent of total billed charges,50% of total Billed charges,34.78,16.8,,,percent of total billed charges,16.8% of total billed charges,31.67,207,
DRAPE SHOULDER BEACH CHAIR 159INX105IN,380103,CDM,270,RC,,,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,32.19,17.304,,,percent of total billed charges,17.304% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,117.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,115.04,61.85,,,percent of total billed charges,61.85% of total billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.87,17.136,,,percent of total billed charges,17.136% of total billed charges,40.62,21.84,,,percent of total billed charges,21.84% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,28.46,186,
DRAPE SPLIT CV CLR ANES STERILE,244839,CDM,272,RC,,,Outpatient,,,1477,960.05,,1299.76,88,,,percent of total billed charges,88% of total Billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,248.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,1477,100,,,percent of total billed charges,100% of total billed charges,255.58,17.304,,,percent of total billed charges,17.304% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,930.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,248.14,16.8,,,percent of total billed charges,16.8% of total billed charges,225.98,15.3,,,percent of total billed charges,15.3% of total billed charges,1019.13,69,,,percent of total billed charges,69% of total billed charges,1477,100,,,percent of total billed charges,100% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,1477,100,,,percent of total billed charges,100% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,1477,100,,,percent of total billed charges,100% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,913.52,61.85,,,percent of total billed charges,61.85% of total billed charges,248.14,16.8,,,percent of total billed charges,16.8% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,248.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,253.1,17.136,,,percent of total billed charges,17.136% of total billed charges,322.58,21.84,,,percent of total billed charges,21.84% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,738.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,738.5,50,,,percent of total billed charges,50% of total Billed charges,1152.06,78,,,percent of total billed charges,78% of total billed charges,1477,100,,,percent of total billed charges,100% of total billed charges,1220,82.6,,,percent of total billed charges,82.6% of total billed charges,1220,82.6,,,percent of total billed charges,82.6% of total billed charges,248.14,16.8,,,percent of total billed charges,16.8% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,738.5,50,,,percent of total billed charges,50% of total Billed charges,248.14,16.8,,,percent of total billed charges,16.8% of total billed charges,225.98,1477,
DRAPE SURG L26INXW18IN 2.75 IN FEN STRL,278796,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
DRAPE THYROID SOFT STERILE,13981,CDM,272,RC,,,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,10.21,17.304,,,percent of total billed charges,17.304% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,37.17,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,15.3,,,percent of total billed charges,15.3% of total billed charges,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,36.49,61.85,,,percent of total billed charges,61.85% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,10.11,17.136,,,percent of total billed charges,17.136% of total billed charges,12.89,21.84,,,percent of total billed charges,21.84% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,59,
DRAPE THYROID TIBURON,323746,CDM,270,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
DRAPE UNDERBUTTOCKS PCH STERILE,85055,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
DRAPE UTIL TAPE 15X26 2EA/PK,62237,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
DRAPE UNDER BUTTOCKS W/DRAIN,490460,CDM,270,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
DRAPE SPLIT SHEET W/ADHESIVE,490459,CDM,270,RC,,,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,7.79,17.304,,,percent of total billed charges,17.304% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,27.83,61.85,,,percent of total billed charges,61.85% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.71,17.136,,,percent of total billed charges,17.136% of total billed charges,9.83,21.84,,,percent of total billed charges,21.84% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
PACK SHOULDER ARTHROSCOPY,491017,CDM,270,RC,,,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,167,100,,,percent of total billed charges,100% of total billed charges,28.9,17.304,,,percent of total billed charges,17.304% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,105.21,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,25.55,15.3,,,percent of total billed charges,15.3% of total billed charges,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,167,100,,,percent of total billed charges,100% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,167,100,,,percent of total billed charges,100% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,103.29,61.85,,,percent of total billed charges,61.85% of total billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.62,17.136,,,percent of total billed charges,17.136% of total billed charges,36.47,21.84,,,percent of total billed charges,21.84% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,83.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,83.5,50,,,percent of total billed charges,50% of total Billed charges,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,25.55,167,
DRAPE SHEET PEDIATRIC,490458,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRAPE MICROSCOPE FOR LEICA,ORSUP0004,CDM,270,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
DRAPE MICROSCOPE,490455,CDM,270,RC,,,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,16.61,17.304,,,percent of total billed charges,17.304% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,60.48,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,59.38,61.85,,,percent of total billed charges,61.85% of total billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.45,17.136,,,percent of total billed charges,17.136% of total billed charges,20.97,21.84,,,percent of total billed charges,21.84% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,14.69,96,
DRAPE MAGNETIC,490453,CDM,270,RC,,,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,9.34,17.304,,,percent of total billed charges,17.304% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,33.4,61.85,,,percent of total billed charges,61.85% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.25,17.136,,,percent of total billed charges,17.136% of total billed charges,11.79,21.84,,,percent of total billed charges,21.84% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
DRAPE MAGNETIC 10 X 16,490454,CDM,270,RC,,,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.13,17.304,,,percent of total billed charges,17.304% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,8.05,17.136,,,percent of total billed charges,17.136% of total billed charges,10.26,21.84,,,percent of total billed charges,21.84% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,47,
DRAPE INCISE IOBAN 10.5 X 8,490451,CDM,270,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
DRAPE HIP W/ CLEAR LEG POCKETS,490450,CDM,270,RC,,,Outpatient,,,140,91.00,,123.2,88,,,percent of total billed charges,88% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,140,100,,,percent of total billed charges,100% of total billed charges,24.23,17.304,,,percent of total billed charges,17.304% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,88.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,21.42,15.3,,,percent of total billed charges,15.3% of total billed charges,96.6,69,,,percent of total billed charges,69% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,140,100,,,percent of total billed charges,100% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,140,100,,,percent of total billed charges,100% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,86.59,61.85,,,percent of total billed charges,61.85% of total billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,23.99,17.136,,,percent of total billed charges,17.136% of total billed charges,30.58,21.84,,,percent of total billed charges,21.84% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,70,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,70,50,,,percent of total billed charges,50% of total Billed charges,109.2,78,,,percent of total billed charges,78% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,70,50,,,percent of total billed charges,50% of total Billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,21.42,140,
DRAPE SHEET ARTHRO W/POUCH,490457,CDM,270,RC,,,Outpatient,,,231,150.15,,203.28,88,,,percent of total billed charges,88% of total Billed charges,115.5,50,,,percent of total billed charges,50% of total Billed charges,38.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,231,100,,,percent of total billed charges,100% of total billed charges,39.97,17.304,,,percent of total billed charges,17.304% of total billed charges,115.5,50,,,percent of total billed charges,50% of total Billed charges,145.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,38.81,16.8,,,percent of total billed charges,16.8% of total billed charges,35.34,15.3,,,percent of total billed charges,15.3% of total billed charges,159.39,69,,,percent of total billed charges,69% of total billed charges,231,100,,,percent of total billed charges,100% of total billed charges,115.5,50,,,percent of total billed charges,50% of total Billed charges,231,100,,,percent of total billed charges,100% of total billed charges,115.5,50,,,percent of total billed charges,50% of total Billed charges,231,100,,,percent of total billed charges,100% of total billed charges,115.5,50,,,percent of total billed charges,50% of total Billed charges,142.87,61.85,,,percent of total billed charges,61.85% of total billed charges,38.81,16.8,,,percent of total billed charges,16.8% of total billed charges,115.5,50,,,percent of total billed charges,50% of total Billed charges,115.5,50,,,percent of total billed charges,50% of total Billed charges,38.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,115.5,50,,,percent of total billed charges,50% of total Billed charges,115.5,50,,,percent of total billed charges,50% of total Billed charges,39.58,17.136,,,percent of total billed charges,17.136% of total billed charges,50.45,21.84,,,percent of total billed charges,21.84% of total billed charges,115.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,115.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,115.5,50,,,percent of total billed charges,50% of total Billed charges,180.18,78,,,percent of total billed charges,78% of total billed charges,231,100,,,percent of total billed charges,100% of total billed charges,190.81,82.6,,,percent of total billed charges,82.6% of total billed charges,190.81,82.6,,,percent of total billed charges,82.6% of total billed charges,38.81,16.8,,,percent of total billed charges,16.8% of total billed charges,115.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,115.5,50,,,percent of total billed charges,50% of total Billed charges,38.81,16.8,,,percent of total billed charges,16.8% of total billed charges,35.34,231,
DRAPE C-ARM COVER MINI,490447,CDM,270,RC,,,Outpatient,,,145,94.25,,127.6,88,,,percent of total billed charges,88% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,25.09,17.304,,,percent of total billed charges,17.304% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,91.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,22.19,15.3,,,percent of total billed charges,15.3% of total billed charges,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,145,100,,,percent of total billed charges,100% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,89.68,61.85,,,percent of total billed charges,61.85% of total billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.85,17.136,,,percent of total billed charges,17.136% of total billed charges,31.67,21.84,,,percent of total billed charges,21.84% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,72.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,72.5,50,,,percent of total billed charges,50% of total Billed charges,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,72.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,72.5,50,,,percent of total billed charges,50% of total Billed charges,24.36,16.8,,,percent of total billed charges,16.8% of total billed charges,22.19,145,
DRAPE C-ARMOR,490448,CDM,270,RC,,,Outpatient,,,321,208.65,,282.48,88,,,percent of total billed charges,88% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,321,100,,,percent of total billed charges,100% of total billed charges,55.55,17.304,,,percent of total billed charges,17.304% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,202.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,49.11,15.3,,,percent of total billed charges,15.3% of total billed charges,221.49,69,,,percent of total billed charges,69% of total billed charges,321,100,,,percent of total billed charges,100% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,321,100,,,percent of total billed charges,100% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,321,100,,,percent of total billed charges,100% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,198.54,61.85,,,percent of total billed charges,61.85% of total billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,55.01,17.136,,,percent of total billed charges,17.136% of total billed charges,70.11,21.84,,,percent of total billed charges,21.84% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,160.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,160.5,50,,,percent of total billed charges,50% of total Billed charges,250.38,78,,,percent of total billed charges,78% of total billed charges,321,100,,,percent of total billed charges,100% of total billed charges,265.15,82.6,,,percent of total billed charges,82.6% of total billed charges,265.15,82.6,,,percent of total billed charges,82.6% of total billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,160.5,50,,,percent of total billed charges,50% of total Billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,49.11,321,
DRAPE BILATERAL LIMB,490446,CDM,270,RC,,,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,10.21,17.304,,,percent of total billed charges,17.304% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,37.17,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,15.3,,,percent of total billed charges,15.3% of total billed charges,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,36.49,61.85,,,percent of total billed charges,61.85% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,10.11,17.136,,,percent of total billed charges,17.136% of total billed charges,12.89,21.84,,,percent of total billed charges,21.84% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,59,
DRAPE LARGE STERILE,490452,CDM,272,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
DRAPE C-ARM DELUXE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRAPE KIT RIO,ORSUP0008,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
DRAPE MICROSCOPE LEICA M690 M655,ORSUP0005,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
DRAPE SURGICAL FENESTRATED 18X26 STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRAPE NONFENESTRATED 18X26,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRAPE SHEET NONSTERILE 40X48,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRAPE HALD SHEET STERILE 60X44,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRAPE PACEMAKER 87 X 135,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DRESSING POLY MEM 4X5,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
DRESSING TRNSP TEGADERM 2 3/8X,147857,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
DRESSING TRANSPARENT WOUND STERILE 20CM X 15CM,11223,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
DRESSING ADAPTIC 3 X 16,100411,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
DRESSING TEGADERM 2X2 1/4,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING TEGADERM WINDOW3 X 3,143630,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
DRESSING TRANS TEGADERM 1.75X1.75,167972,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
DRESSING XEROFORM 1X8,33787,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
DRESSING GAUZE BORDER 4X4,204725,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
DRESSING PETROLATUM 3 X 36,329989,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
DRESSING TEGADERM CHG 4 X 4 3/4,423603,CDM,270,RC,,,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,9.34,17.304,,,percent of total billed charges,17.304% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,33.4,61.85,,,percent of total billed charges,61.85% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.25,17.136,,,percent of total billed charges,17.136% of total billed charges,11.79,21.84,,,percent of total billed charges,21.84% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
DRESSING MONTGOMERY STRAP 7 1/4IN X 11 1/8IN STERIL,161395,CDM,272,RC,,,Outpatient,,,95,61.75,,83.6,88,,,percent of total billed charges,88% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,16.44,17.304,,,percent of total billed charges,17.304% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,59.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,14.54,15.3,,,percent of total billed charges,15.3% of total billed charges,65.55,69,,,percent of total billed charges,69% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,58.76,61.85,,,percent of total billed charges,61.85% of total billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,16.28,17.136,,,percent of total billed charges,17.136% of total billed charges,20.75,21.84,,,percent of total billed charges,21.84% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,74.1,78,,,percent of total billed charges,78% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,14.54,95,
DRESSING XEROFORM 5X9,10129,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
AQUACEL FOAM DRESSING 4X4IN,402619,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
DRESSING SQUIBB DUODERM XTHIN,143629,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
DRESSING WOUND GEL DUODERM 15G,185219,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
DRESSING DUODERM SIGNAL 6 X 7,82767,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRESSING AQUACEL AG SURG HYDRFIBR W/SILVER 3.5X14IN,364599,CDM,272,RC,,,Outpatient,,,284,184.60,,249.92,88,,,percent of total billed charges,88% of total Billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,47.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,284,100,,,percent of total billed charges,100% of total billed charges,49.14,17.304,,,percent of total billed charges,17.304% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,178.92,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,47.71,16.8,,,percent of total billed charges,16.8% of total billed charges,43.45,15.3,,,percent of total billed charges,15.3% of total billed charges,195.96,69,,,percent of total billed charges,69% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,284,100,,,percent of total billed charges,100% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,284,100,,,percent of total billed charges,100% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,175.65,61.85,,,percent of total billed charges,61.85% of total billed charges,47.71,16.8,,,percent of total billed charges,16.8% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,47.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,48.67,17.136,,,percent of total billed charges,17.136% of total billed charges,62.03,21.84,,,percent of total billed charges,21.84% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,142,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,142,50,,,percent of total billed charges,50% of total Billed charges,221.52,78,,,percent of total billed charges,78% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,47.71,16.8,,,percent of total billed charges,16.8% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,142,50,,,percent of total billed charges,50% of total Billed charges,47.71,16.8,,,percent of total billed charges,16.8% of total billed charges,43.45,284,
DRESSING AQUACELL AG SURGICAL COVER 3.5 X 12'' W/SILVER,409666,CDM,270,RC,,,Outpatient,,,322,209.30,,283.36,88,,,percent of total billed charges,88% of total Billed charges,161,50,,,percent of total billed charges,50% of total Billed charges,54.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,322,100,,,percent of total billed charges,100% of total billed charges,55.72,17.304,,,percent of total billed charges,17.304% of total billed charges,161,50,,,percent of total billed charges,50% of total Billed charges,202.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.1,16.8,,,percent of total billed charges,16.8% of total billed charges,49.27,15.3,,,percent of total billed charges,15.3% of total billed charges,222.18,69,,,percent of total billed charges,69% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,161,50,,,percent of total billed charges,50% of total Billed charges,322,100,,,percent of total billed charges,100% of total billed charges,161,50,,,percent of total billed charges,50% of total Billed charges,322,100,,,percent of total billed charges,100% of total billed charges,161,50,,,percent of total billed charges,50% of total Billed charges,199.16,61.85,,,percent of total billed charges,61.85% of total billed charges,54.1,16.8,,,percent of total billed charges,16.8% of total billed charges,161,50,,,percent of total billed charges,50% of total Billed charges,161,50,,,percent of total billed charges,50% of total Billed charges,54.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,161,50,,,percent of total billed charges,50% of total Billed charges,161,50,,,percent of total billed charges,50% of total Billed charges,55.18,17.136,,,percent of total billed charges,17.136% of total billed charges,70.32,21.84,,,percent of total billed charges,21.84% of total billed charges,161,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,161,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,161,50,,,percent of total billed charges,50% of total Billed charges,251.16,78,,,percent of total billed charges,78% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,54.1,16.8,,,percent of total billed charges,16.8% of total billed charges,161,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,161,50,,,percent of total billed charges,50% of total Billed charges,54.1,16.8,,,percent of total billed charges,16.8% of total billed charges,49.27,322,
DRESSING AD AQUACEL SURG W/SILVER 3.5X6,364597,CDM,272,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
DRESSING COVADERM 4 X 4,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING COVADERM 4 X 14,184557,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
DRESSING COVADERM 4 X 10,184556,CDM,272,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
DRESSING ASSEMBLY WHITE LARGE,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DRESSING IV STR GUARDIVA HEOMSTATIC,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
DRESSING SINU-FOAM,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
DRESSING SORBAVIEW PERIPH 2.625 X 3.563,422645,CDM,272,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
DRESSING VAC ABTHERA SENSAT  R.A.C ABDOMINAL,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
DRESSING VAC LG SENSATRAC GRANUFOAM,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
DRESSING VAC MED SENSATRAC GRANUFOAM,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
DRESSING VAC SM SENSATRAC GRANUFOAM,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
DRESSING VAC XL SENSATRAC GRANUFOAM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
DRESSING VASELINE 3 X 9,490477,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
DRESSING VASELINE 1/2 X 72,490476,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
DRESSING OWENS SILK 3X8,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING MEROCEL DOYLE NASAL,490470,CDM,270,RC,,,Outpatient,,,205,133.25,,180.4,88,,,percent of total billed charges,88% of total Billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,34.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,205,100,,,percent of total billed charges,100% of total billed charges,35.47,17.304,,,percent of total billed charges,17.304% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,129.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.44,16.8,,,percent of total billed charges,16.8% of total billed charges,31.37,15.3,,,percent of total billed charges,15.3% of total billed charges,141.45,69,,,percent of total billed charges,69% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,205,100,,,percent of total billed charges,100% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,205,100,,,percent of total billed charges,100% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,126.79,61.85,,,percent of total billed charges,61.85% of total billed charges,34.44,16.8,,,percent of total billed charges,16.8% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,34.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,35.13,17.136,,,percent of total billed charges,17.136% of total billed charges,44.77,21.84,,,percent of total billed charges,21.84% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,102.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,102.5,50,,,percent of total billed charges,50% of total Billed charges,159.9,78,,,percent of total billed charges,78% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,34.44,16.8,,,percent of total billed charges,16.8% of total billed charges,102.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,102.5,50,,,percent of total billed charges,50% of total Billed charges,34.44,16.8,,,percent of total billed charges,16.8% of total billed charges,31.37,205,
DRESSING MEPITEL 3X4,490469,CDM,270,RC,,,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.13,17.304,,,percent of total billed charges,17.304% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,8.05,17.136,,,percent of total billed charges,17.136% of total billed charges,10.26,21.84,,,percent of total billed charges,21.84% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,47,
DRESSING MEPILEX LITE 4X4 FOAM,490468,CDM,270,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
DRESSING GRANUFOAM SILVER MED,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
DRESSING DUODERM XTHIN 3X3,ORSUP0001,CDM,270,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
DRESSING AQUACELL 10'' SLIM,490462,CDM,270,RC,,,Outpatient,,,376,244.40,,330.88,88,,,percent of total billed charges,88% of total Billed charges,188,50,,,percent of total billed charges,50% of total Billed charges,63.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,376,100,,,percent of total billed charges,100% of total billed charges,65.06,17.304,,,percent of total billed charges,17.304% of total billed charges,188,50,,,percent of total billed charges,50% of total Billed charges,236.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,63.17,16.8,,,percent of total billed charges,16.8% of total billed charges,57.53,15.3,,,percent of total billed charges,15.3% of total billed charges,259.44,69,,,percent of total billed charges,69% of total billed charges,376,100,,,percent of total billed charges,100% of total billed charges,188,50,,,percent of total billed charges,50% of total Billed charges,376,100,,,percent of total billed charges,100% of total billed charges,188,50,,,percent of total billed charges,50% of total Billed charges,376,100,,,percent of total billed charges,100% of total billed charges,188,50,,,percent of total billed charges,50% of total Billed charges,232.56,61.85,,,percent of total billed charges,61.85% of total billed charges,63.17,16.8,,,percent of total billed charges,16.8% of total billed charges,188,50,,,percent of total billed charges,50% of total Billed charges,188,50,,,percent of total billed charges,50% of total Billed charges,63.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,188,50,,,percent of total billed charges,50% of total Billed charges,188,50,,,percent of total billed charges,50% of total Billed charges,64.43,17.136,,,percent of total billed charges,17.136% of total billed charges,82.12,21.84,,,percent of total billed charges,21.84% of total billed charges,188,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,188,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,188,50,,,percent of total billed charges,50% of total Billed charges,293.28,78,,,percent of total billed charges,78% of total billed charges,376,100,,,percent of total billed charges,100% of total billed charges,310.58,82.6,,,percent of total billed charges,82.6% of total billed charges,310.58,82.6,,,percent of total billed charges,82.6% of total billed charges,63.17,16.8,,,percent of total billed charges,16.8% of total billed charges,188,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,188,50,,,percent of total billed charges,50% of total Billed charges,63.17,16.8,,,percent of total billed charges,16.8% of total billed charges,57.53,376,
DRESSING AQUACEL AG 4X4.7 XTRA,490461,CDM,270,RC,,,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,16.61,17.304,,,percent of total billed charges,17.304% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,60.48,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,59.38,61.85,,,percent of total billed charges,61.85% of total billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.45,17.136,,,percent of total billed charges,17.136% of total billed charges,20.97,21.84,,,percent of total billed charges,21.84% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,14.69,96,
COVADERM 4 X 4,490405,CDM,271,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,4.52,37.7,,,percent of total billed charges,37.70% of total billed charges,4.52,37.7,,,percent of total billed charges,37.70% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,4.07,33.9,,,percent of total billed charges,33.9% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
DRESSING HYDROFERA BLUE CLASSIC FOAM 4 X 4,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING CUTIMED SORBACT 4IN X 4IN PADS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING CUTIMED OFF-LOADERS,ORSUP0011,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
DRESSING PRIMASEAL POST OP 3.5 X 4,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DRESSING PROMOGRAN PRISMA AG 4.34IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING KERRAFOAM 6 X 6IN NO BOARDER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KERRAFOAM GENTLE BORDER 3X3,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KERRAFOAM GENTLE BORDER 5X5,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KERRAFOAM LRG SACRAL 9X10,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KERRAFOAM GENTLE BORDER HEEL,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KERRAMAX CARE 4X4,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KERRAMAX CARE 4X9,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KERRAMAX CARE 8X9,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING PURACOL ULTRA POWDER,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING PURACOL PLUS AG 2X2,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KERRALITE COOL 2X2,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KERRACEL AG 4X5,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING PURACOL PLUS 2X2,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING PROMOGRAN 4.34IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING CUTIMED SORBACT 2 3/4 X 3 3/8,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING AQUACEL AG ROPE 39IN X 18IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING KERRACONTACT AG3+ 4X8,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING KERRAMAX GENTLE 4X4  W/BORDER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING COVADERM PLUS 2IN X 2IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KIT COMPRIFORE COMPRESSION 4 LAYER,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING KERRAFOAM GENTLE BORDER 4X4IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING 4IN X 4IN ALLEVYN GENTLE BORDER LITE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING WOUND HONEY 2X2,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING 4IN X 4IN ALLEVYN GENTLE BORDER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING STERILE ISLAND WOUND,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING DERMATAC DRAPE,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING ALLEVYN SMALL SACRUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING ALLEVYN LARGE SACRUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING ENDOFORM COLLAGEN HIGH FLOW 2' X 2',ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING ANTIMICROBIALE ENDOFORM COLLAGEN4 X 5 HIGH FLOW,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
DRESSING HYDROFERA BLUE READY TRANSFER 4 X 5,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING HYDROFERA BLUE READY TRANSFER 8 X 8,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING HYDROFERA BLUE READY-BORDERED 2.5 X 2.5,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING HYDROFERA BLUE READY-BORDERED 3.9 X 3.9,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING FENESTRATED DERMAL TEMPLATE 2X2,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
DRESSING KERRAFOAM 4X10,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KERRAFOAM 4X12,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING ALLEVYIN GB LITE 2X2,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING ALLEVYIN GENTLE BORDER 3X3,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING HYPAFIX GENTLE TOUCH 5CMX5,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING AQUACEL AG ANTIMICROBIAL 4X5,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DRESSING TRANSPARENT IV3000 4X5.5CM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING KIT PICO 7 NEG PRESSURE WOUND THERAPY 10X20CM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
DRESSING TEGADERM IV 4X6-1/8,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING SORBAVIEW SHIELD SECURMENT 3.75X6.25,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DRESSING AQUACEL AG ADVANTAGE 3.5 X 4 IN,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
DRESSING AQUACEL AG ADVANTAGE 3.5 X 6 IN,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
DRESSING AQUACEL AG ADVANTAGE 3.5 X 10 IN,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
DRESSING AQUACEL AG ADVANTAGE 3.5 X 12 IN,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
DRESSING AQUACEL AG ADVANTAGE 3.5 X 14 IN,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
DRESSING SACHET SUPER 4X4,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRESSING HYDROFERA TUNNELING 9MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRESSING FOAM ANTIBACTERIAL 4X4,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DRESSING ANTIBACTERIAL HEAVEY DRAINAGE 6X6,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
DRESSING FOAM SACRAL  SM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRESSING FOAM ADHESIVE BORDER 12.5 1 12.5CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
DRESSING IODOPHOR FOAM WITH IODINE 6 X 9,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
DRESSING XEROFORM 2X2,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRESSING ALLEVYN LIFE ADHESIVE FOAM 5X5,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRESSING ALLEVYN LIFE ADHESIVE FOAM 4X4,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRESSING ALLEVYN LIFE ADHESIVE FOAM 6X6,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DRI LOK THREADED CANNULA 6.5X90,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
DRILL BIT 310.29,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
"DRILL MINI ACUTRAK 2, LONG",ORSUP0019,CDM,272,RC,,,Outpatient,,,1600,1040.00,,1408,88,,,percent of total billed charges,88% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,276.86,17.304,,,percent of total billed charges,17.304% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1008,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1104,69,,,percent of total billed charges,69% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,989.6,61.85,,,percent of total billed charges,61.85% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,274.18,17.136,,,percent of total billed charges,17.136% of total billed charges,349.44,21.84,,,percent of total billed charges,21.84% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,1248,78,,,percent of total billed charges,78% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,1600,
DRILL BIT  LONG 2.5MM GOLD,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
DRILL PRECISION NEURO 3.0MMX3.8MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
DRILL BIT F.A.S.T. 2.0MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
DRILL BIT 2.5,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DRILL 2.5MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DRILL BIT  1.5 X 6 W/STOP     317.16,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
DRILL BIT  1.5MM,ORSUP0012,CDM,272,RC,,,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
DRILL BIT  MINI QUICK COUPLING 1.8MM,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
DRILL BIT  QIK COUPLE 100MM X 2MM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
DRILL BIT 1.0MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
DRILL BIT 1.8MM X 110MM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
DRILL BIT 11MM,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
DRILL BIT 2.0MM 310.201,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
DRILL BIT 2.4MM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
DRILL BIT 4.3MM,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
DRILL BIT CANNULATED LARGE QC/300MM,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
DRILL BIT QC 1.5MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
DRILL BIT QC 2.0MM,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
DRILL BIT QC 3.2MM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
DRILL BIT STANDARD 1.9MM MFT-072-19,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
DRILL BIT STANDARD 2.4MM MFT-072-24,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
DRILL BIT STANDARD 2.7MM MFT-072-27,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
DRILL BIT W/DEPTH 2.0MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
DRILL BIT WITH STOP 0.70MM AND 0.76MM 3MM STRYKER J-LATCH 316.13,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
DRILLBIT FLUTED 3 2.7MM 125MM/100MM OSCILLATI,ORSUP0016,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
DRILL BIT,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
DRILL BIT RADIOLUCENT 4.2MM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
DRILL BIT 3FLUTE 4.2 145MM,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
DRILL STEP FOR PUSHLOCK,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
DRILL SET,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
DRILL BIT LEGEND TOOL 14CM 3MM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
DRILL BIT 3.3MM,490481,CDM,272,RC,,,Outpatient,,,430,279.50,,378.4,88,,,percent of total billed charges,88% of total Billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,72.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,430,100,,,percent of total billed charges,100% of total billed charges,74.41,17.304,,,percent of total billed charges,17.304% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,270.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,72.24,16.8,,,percent of total billed charges,16.8% of total billed charges,65.79,15.3,,,percent of total billed charges,15.3% of total billed charges,296.7,69,,,percent of total billed charges,69% of total billed charges,430,100,,,percent of total billed charges,100% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,430,100,,,percent of total billed charges,100% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,430,100,,,percent of total billed charges,100% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,265.96,61.85,,,percent of total billed charges,61.85% of total billed charges,72.24,16.8,,,percent of total billed charges,16.8% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,72.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,73.68,17.136,,,percent of total billed charges,17.136% of total billed charges,93.91,21.84,,,percent of total billed charges,21.84% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,215,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,215,50,,,percent of total billed charges,50% of total Billed charges,335.4,78,,,percent of total billed charges,78% of total billed charges,430,100,,,percent of total billed charges,100% of total billed charges,355.18,82.6,,,percent of total billed charges,82.6% of total billed charges,355.18,82.6,,,percent of total billed charges,82.6% of total billed charges,72.24,16.8,,,percent of total billed charges,16.8% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,215,50,,,percent of total billed charges,50% of total Billed charges,72.24,16.8,,,percent of total billed charges,16.8% of total billed charges,65.79,430,
DRILL BIT 2.9MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
DRIVER NEEDLE LARGE SUTURE CUT,ORSUP0057,CDM,272,RC,,,Outpatient,,,12220,7943.00,,10753.6,88,,,percent of total billed charges,88% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2114.55,17.304,,,percent of total billed charges,17.304% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,7698.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,1869.66,15.3,,,percent of total billed charges,15.3% of total billed charges,8431.8,69,,,percent of total billed charges,69% of total billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,7558.07,61.85,,,percent of total billed charges,61.85% of total billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2094.02,17.136,,,percent of total billed charges,17.136% of total billed charges,2668.85,21.84,,,percent of total billed charges,21.84% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6110,50,,,percent of total billed charges,50% of total Billed charges,9531.6,78,,,percent of total billed charges,78% of total billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,10093.72,82.6,,,percent of total billed charges,82.6% of total billed charges,10093.72,82.6,,,percent of total billed charges,82.6% of total billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,1869.66,12220,
DRIVER NEEDLE MEGA,ORSUP0053,CDM,272,RC,,,Outpatient,,,10920,7098.00,,9609.6,88,,,percent of total billed charges,88% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1889.6,17.304,,,percent of total billed charges,17.304% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,6879.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,1670.76,15.3,,,percent of total billed charges,15.3% of total billed charges,7534.8,69,,,percent of total billed charges,69% of total billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,6754.02,61.85,,,percent of total billed charges,61.85% of total billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,1871.25,17.136,,,percent of total billed charges,17.136% of total billed charges,2384.93,21.84,,,percent of total billed charges,21.84% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5460,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5460,50,,,percent of total billed charges,50% of total Billed charges,8517.6,78,,,percent of total billed charges,78% of total billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,9019.92,82.6,,,percent of total billed charges,82.6% of total billed charges,9019.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5460,50,,,percent of total billed charges,50% of total Billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,1670.76,10920,
DRUM UNIT,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
DRYLINE WATER TRAP,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
DSG TRANSPARENT TEGADERM 8X12,10521,CDM,270,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
DSG  ADAPTIC 3X3,73917,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
DSG ADAPTIC 3X3 50/BX,327635,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
DSG ELASTIC NET SIZE  6,81632,CDM,270,RC,,,Outpatient,,,137,89.05,,120.56,88,,,percent of total billed charges,88% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,137,100,,,percent of total billed charges,100% of total billed charges,23.71,17.304,,,percent of total billed charges,17.304% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,86.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,20.96,15.3,,,percent of total billed charges,15.3% of total billed charges,94.53,69,,,percent of total billed charges,69% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,137,100,,,percent of total billed charges,100% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,137,100,,,percent of total billed charges,100% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,84.73,61.85,,,percent of total billed charges,61.85% of total billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.48,17.136,,,percent of total billed charges,17.136% of total billed charges,29.92,21.84,,,percent of total billed charges,21.84% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,68.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,68.5,50,,,percent of total billed charges,50% of total Billed charges,106.86,78,,,percent of total billed charges,78% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,68.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,68.5,50,,,percent of total billed charges,50% of total Billed charges,23.02,16.8,,,percent of total billed charges,16.8% of total billed charges,20.96,137,
DSG GAUZE VASELINE 6X36 41316,56119,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
DSG AQUACEL AG HYDROFIBER 3.5X10,313292,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
DTIBC PERF VER 1 BOX / 6 VIALS,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
DTIBC PERF VER II BOX / 6 VIALS,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
DTIBC REAGENT BOX / 300T,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DUAL CUT BLADE   4125-127-090,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
DUAL ELECTRODE PAD ADULT,490487,CDM,270,RC,,,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,9.69,17.304,,,percent of total billed charges,17.304% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,35.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.6,17.136,,,percent of total billed charges,17.136% of total billed charges,12.23,21.84,,,percent of total billed charges,21.84% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,56,
DURASEAL DURAL SEALANT SYSTEM 5ML,ORSUP0028,CDM,278,RC,,,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
DURACLIP REPOSITIONABLE HEMOSTASIS CLIP,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
DURAPREP AND IODOPHOR REMOVER LOTION,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
DUREPAIR 1 X 3,ORSUP0019,CDM,278,RC,C1763,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
DUREPAIR 2 X 2,ORSUP0016,CDM,278,RC,C1763,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
DUREPAIR 3 X 3,ORSUP0032,CDM,278,RC,C1763,HCPCS,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1703.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1850.94,33.9,,,percent of total billed charges,33.9% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
DUREPAIR 4 X 5,ORSUP0036,CDM,278,RC,C1763,HCPCS,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4095,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
DUST COVER SELF SEAL 6X10,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DUST COVER SELF SEAL 8X12,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DUST COVER SELF SEAL 16X22,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DUST COVER SELF SEAL 24X30,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
DVR ANATOMIC SHORT LEFT,ORSUP0045,CDM,278,RC,C1713,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5569.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
DX FIXED 4 POLE,ORSUP0010,CDM,278,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
DXH RETIC PACK,ORSUP0021,CDM,270,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
DYNANITE NiTiSTAPLE W/INST 11X10L,ORSUP0047,CDM,278,RC,C1713,HCPCS,Outpatient,,,7200,4680.00,,6336,88,,,percent of total billed charges,88% of total Billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1245.89,17.304,,,percent of total billed charges,17.304% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,4536,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1101.6,15.3,,,percent of total billed charges,15.3% of total billed charges,4968,69,,,percent of total billed charges,69% of total billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,4453.2,61.85,,,percent of total billed charges,61.85% of total billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,2246.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3600,50,,,percent of total billed charges,50% of total Billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,1233.79,17.136,,,percent of total billed charges,17.136% of total billed charges,1572.48,21.84,,,percent of total billed charges,21.84% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,2714.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2714.4,37.7,,,percent of total billed charges,37.70% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,2440.8,33.9,,,percent of total billed charges,33.9% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,5616,78,,,percent of total billed charges,78% of total billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,5947.2,82.6,,,percent of total billed charges,82.6% of total billed charges,5947.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3600,50,,,percent of total billed charges,50% of total Billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1101.6,7200,
DYNANITE NiTiSTAPLE W/INST 15X15L,ORSUP0065,CDM,278,RC,C1713,HCPCS,Outpatient,,,11000,7150.00,,9680,88,,,percent of total billed charges,88% of total Billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,1848,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1903.44,17.304,,,percent of total billed charges,17.304% of total billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,6930,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1848,16.8,,,percent of total billed charges,16.8% of total billed charges,1683,15.3,,,percent of total billed charges,15.3% of total billed charges,7590,69,,,percent of total billed charges,69% of total billed charges,11000,100,,,percent of total billed charges,100% of total billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,11000,100,,,percent of total billed charges,100% of total billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,11000,100,,,percent of total billed charges,100% of total billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,6803.5,61.85,,,percent of total billed charges,61.85% of total billed charges,1848,16.8,,,percent of total billed charges,16.8% of total billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,3432,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5500,50,,,percent of total billed charges,50% of total Billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,1884.96,17.136,,,percent of total billed charges,17.136% of total billed charges,2402.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,4147,37.7,,,percent of total billed charges,37.70% of total billed charges,4147,37.7,,,percent of total billed charges,37.70% of total billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,3729,33.9,,,percent of total billed charges,33.9% of total billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,8580,78,,,percent of total billed charges,78% of total billed charges,11000,100,,,percent of total billed charges,100% of total billed charges,9086,82.6,,,percent of total billed charges,82.6% of total billed charges,9086,82.6,,,percent of total billed charges,82.6% of total billed charges,1848,16.8,,,percent of total billed charges,16.8% of total billed charges,5500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5500,50,,,percent of total billed charges,50% of total Billed charges,1848,16.8,,,percent of total billed charges,16.8% of total billed charges,1683,11000,
E-Z SCRUB MOUNTING SOAM DISPENSER,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
E-Z CLEAN DISP LAPAROSCOPIC ELECTRODE 13.5 INCH,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
EAR CURETTES DISP #4888,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
EAR TIP INFANT 5.0MM GREEN,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
EAR TIP INFANT 5.5MM BLUE,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
EAR TUBE 1.14 REUTER BOBBIN,ORSUP0004,CDM,270,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
EAR PROSTHESIS SHEEHY 1.17MM,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
EAR TUBE 1.27 REUTER BOBBIN,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
EAR WICK MEROCEL,490496,CDM,270,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
EAR TUBE SHEEHY 1.27MM VENT,ORSUP0004,CDM,270,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
EAR TUBE SHEEHY TOP 3ML,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
EAR TUBE ACTIVENT GOODE T,ORSUP0007,CDM,270,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
LIGHTED EAR CURETTE REPLACEMENT LIGHT,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
EAR/ULCER SYRINGE 3OZ STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
EARTIP KIT FLANGED MUSHROOM/UIMBRELLA SHAPED,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
EASY CAP II CO2 DETECTOR PEDIATRIC,ORSUP00002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ECG LEADS DISP (TELE),ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
ECHELON FLEX POWERED PLUS STAPLER 45MM SINGLE USE LATEX FREE,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
ECHELON STAPLER RELOAD 45MM BLUE,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
ECHELON STAPLER RELOAD 45MM GREEN,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
EIKENELLA CORRODENS ATCC CULTI LOOPS 1152,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
EKG BUTTONS,490497,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
ELECTRODE MENISCETOMY,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
ELECTRODE BLADE 2.5IN STRL DISP,153659,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
ELECTRODE BLADE EXTENDED 6.50IN STERILE DISPOSABLE,143721,CDM,272,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
ELECTRODE FETAL MONITOR SPIRAL,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ELECTRODE ECG ADLT SNAP RADIOLUCENT RT630,115654,CDM,270,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
ELECTRODE ECG TAB Q-TRACE VINYL GEL ADULT,11128,CDM,270,RC,,,Outpatient,,,805,523.25,,708.4,88,,,percent of total billed charges,88% of total Billed charges,402.5,50,,,percent of total billed charges,50% of total Billed charges,135.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,805,100,,,percent of total billed charges,100% of total billed charges,139.3,17.304,,,percent of total billed charges,17.304% of total billed charges,402.5,50,,,percent of total billed charges,50% of total Billed charges,507.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,135.24,16.8,,,percent of total billed charges,16.8% of total billed charges,123.17,15.3,,,percent of total billed charges,15.3% of total billed charges,555.45,69,,,percent of total billed charges,69% of total billed charges,805,100,,,percent of total billed charges,100% of total billed charges,402.5,50,,,percent of total billed charges,50% of total Billed charges,805,100,,,percent of total billed charges,100% of total billed charges,402.5,50,,,percent of total billed charges,50% of total Billed charges,805,100,,,percent of total billed charges,100% of total billed charges,402.5,50,,,percent of total billed charges,50% of total Billed charges,497.89,61.85,,,percent of total billed charges,61.85% of total billed charges,135.24,16.8,,,percent of total billed charges,16.8% of total billed charges,402.5,50,,,percent of total billed charges,50% of total Billed charges,402.5,50,,,percent of total billed charges,50% of total Billed charges,135.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,402.5,50,,,percent of total billed charges,50% of total Billed charges,402.5,50,,,percent of total billed charges,50% of total Billed charges,137.94,17.136,,,percent of total billed charges,17.136% of total billed charges,175.81,21.84,,,percent of total billed charges,21.84% of total billed charges,402.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,402.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,402.5,50,,,percent of total billed charges,50% of total Billed charges,627.9,78,,,percent of total billed charges,78% of total billed charges,805,100,,,percent of total billed charges,100% of total billed charges,664.93,82.6,,,percent of total billed charges,82.6% of total billed charges,664.93,82.6,,,percent of total billed charges,82.6% of total billed charges,135.24,16.8,,,percent of total billed charges,16.8% of total billed charges,402.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,402.5,50,,,percent of total billed charges,50% of total Billed charges,135.24,16.8,,,percent of total billed charges,16.8% of total billed charges,123.17,805,
ELECTRODE MULTIPURP FOAM,73396,CDM,270,RC,,,Outpatient,,,141,91.65,,124.08,88,,,percent of total billed charges,88% of total Billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,23.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,141,100,,,percent of total billed charges,100% of total billed charges,24.4,17.304,,,percent of total billed charges,17.304% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,88.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.69,16.8,,,percent of total billed charges,16.8% of total billed charges,21.57,15.3,,,percent of total billed charges,15.3% of total billed charges,97.29,69,,,percent of total billed charges,69% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,141,100,,,percent of total billed charges,100% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,141,100,,,percent of total billed charges,100% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,87.21,61.85,,,percent of total billed charges,61.85% of total billed charges,23.69,16.8,,,percent of total billed charges,16.8% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,23.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,24.16,17.136,,,percent of total billed charges,17.136% of total billed charges,30.79,21.84,,,percent of total billed charges,21.84% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,70.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,70.5,50,,,percent of total billed charges,50% of total Billed charges,109.98,78,,,percent of total billed charges,78% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,23.69,16.8,,,percent of total billed charges,16.8% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,70.5,50,,,percent of total billed charges,50% of total Billed charges,23.69,16.8,,,percent of total billed charges,16.8% of total billed charges,21.57,141,
ELECTRODES MONITORING ECG,202866,CDM,270,RC,,,Outpatient,,,507,329.55,,446.16,88,,,percent of total billed charges,88% of total Billed charges,253.5,50,,,percent of total billed charges,50% of total Billed charges,85.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,507,100,,,percent of total billed charges,100% of total billed charges,87.73,17.304,,,percent of total billed charges,17.304% of total billed charges,253.5,50,,,percent of total billed charges,50% of total Billed charges,319.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,85.18,16.8,,,percent of total billed charges,16.8% of total billed charges,77.57,15.3,,,percent of total billed charges,15.3% of total billed charges,349.83,69,,,percent of total billed charges,69% of total billed charges,507,100,,,percent of total billed charges,100% of total billed charges,253.5,50,,,percent of total billed charges,50% of total Billed charges,507,100,,,percent of total billed charges,100% of total billed charges,253.5,50,,,percent of total billed charges,50% of total Billed charges,507,100,,,percent of total billed charges,100% of total billed charges,253.5,50,,,percent of total billed charges,50% of total Billed charges,313.58,61.85,,,percent of total billed charges,61.85% of total billed charges,85.18,16.8,,,percent of total billed charges,16.8% of total billed charges,253.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,50,,,percent of total billed charges,50% of total Billed charges,85.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,253.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,50,,,percent of total billed charges,50% of total Billed charges,86.88,17.136,,,percent of total billed charges,17.136% of total billed charges,110.73,21.84,,,percent of total billed charges,21.84% of total billed charges,253.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,253.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,253.5,50,,,percent of total billed charges,50% of total Billed charges,395.46,78,,,percent of total billed charges,78% of total billed charges,507,100,,,percent of total billed charges,100% of total billed charges,418.78,82.6,,,percent of total billed charges,82.6% of total billed charges,418.78,82.6,,,percent of total billed charges,82.6% of total billed charges,85.18,16.8,,,percent of total billed charges,16.8% of total billed charges,253.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,253.5,50,,,percent of total billed charges,50% of total Billed charges,85.18,16.8,,,percent of total billed charges,16.8% of total billed charges,77.57,507,
ELECTRODE ECG FOAM RADIOTRANSLUCENT 855,172711,CDM,270,RC,,,Outpatient,,,483,313.95,,425.04,88,,,percent of total billed charges,88% of total Billed charges,241.5,50,,,percent of total billed charges,50% of total Billed charges,81.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,483,100,,,percent of total billed charges,100% of total billed charges,83.58,17.304,,,percent of total billed charges,17.304% of total billed charges,241.5,50,,,percent of total billed charges,50% of total Billed charges,304.29,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,81.14,16.8,,,percent of total billed charges,16.8% of total billed charges,73.9,15.3,,,percent of total billed charges,15.3% of total billed charges,333.27,69,,,percent of total billed charges,69% of total billed charges,483,100,,,percent of total billed charges,100% of total billed charges,241.5,50,,,percent of total billed charges,50% of total Billed charges,483,100,,,percent of total billed charges,100% of total billed charges,241.5,50,,,percent of total billed charges,50% of total Billed charges,483,100,,,percent of total billed charges,100% of total billed charges,241.5,50,,,percent of total billed charges,50% of total Billed charges,298.74,61.85,,,percent of total billed charges,61.85% of total billed charges,81.14,16.8,,,percent of total billed charges,16.8% of total billed charges,241.5,50,,,percent of total billed charges,50% of total Billed charges,241.5,50,,,percent of total billed charges,50% of total Billed charges,81.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,241.5,50,,,percent of total billed charges,50% of total Billed charges,241.5,50,,,percent of total billed charges,50% of total Billed charges,82.77,17.136,,,percent of total billed charges,17.136% of total billed charges,105.49,21.84,,,percent of total billed charges,21.84% of total billed charges,241.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,241.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,241.5,50,,,percent of total billed charges,50% of total Billed charges,376.74,78,,,percent of total billed charges,78% of total billed charges,483,100,,,percent of total billed charges,100% of total billed charges,398.96,82.6,,,percent of total billed charges,82.6% of total billed charges,398.96,82.6,,,percent of total billed charges,82.6% of total billed charges,81.14,16.8,,,percent of total billed charges,16.8% of total billed charges,241.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,241.5,50,,,percent of total billed charges,50% of total Billed charges,81.14,16.8,,,percent of total billed charges,16.8% of total billed charges,73.9,483,
ELECTRO LUBE ANTI STICK SOLUTION,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
ELECTRODE PEDIATRIC DEFIB RADIOLUCENT,448880,CDM,270,RC,,,Outpatient,,,106,68.90,,93.28,88,,,percent of total billed charges,88% of total Billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,17.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,106,100,,,percent of total billed charges,100% of total billed charges,18.34,17.304,,,percent of total billed charges,17.304% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,66.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,17.81,16.8,,,percent of total billed charges,16.8% of total billed charges,16.22,15.3,,,percent of total billed charges,15.3% of total billed charges,73.14,69,,,percent of total billed charges,69% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,106,100,,,percent of total billed charges,100% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,106,100,,,percent of total billed charges,100% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,65.56,61.85,,,percent of total billed charges,61.85% of total billed charges,17.81,16.8,,,percent of total billed charges,16.8% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,17.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,18.16,17.136,,,percent of total billed charges,17.136% of total billed charges,23.15,21.84,,,percent of total billed charges,21.84% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,53,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,53,50,,,percent of total billed charges,50% of total Billed charges,82.68,78,,,percent of total billed charges,78% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,17.81,16.8,,,percent of total billed charges,16.8% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,53,50,,,percent of total billed charges,50% of total Billed charges,17.81,16.8,,,percent of total billed charges,16.8% of total billed charges,16.22,106,
ELECTRODE QUADTODE,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ELECTRODE LOOP 26F,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
ELECTRD RESECTION CYLINDER VAPORTRODE,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ELECTRODE ROLLER 24-28FR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ELECTRODE BALL 5MM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ELECTRODE NIM STIMULATOR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ELECTRODE KNIFE 24FR,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
ELECTRODE ELECSURG LOP HI FREQ A22207C,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
ELECTRODES RFD,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
ELECTRODE ROLLER 24-28FR HF,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ELECTRODE NIMS NEEDLE SET,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ELECTRODE MEGAFINE NEEDLE 0118,490505,CDM,272,RC,,,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,15.75,17.304,,,percent of total billed charges,17.304% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,57.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,15.3,,,percent of total billed charges,15.3% of total billed charges,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,56.28,61.85,,,percent of total billed charges,61.85% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.59,17.136,,,percent of total billed charges,17.136% of total billed charges,19.87,21.84,,,percent of total billed charges,21.84% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,91,
ELECTRODE LOOP SMALL 24FR 0.2,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ELECTRODE LOOP LARGE 24FR 0.2,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
ELECTRODE 24FR CUTTING LOOP,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ELECTRODE PAIRED 4 CHANNEL,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
ELECTRODE 27FR CUTTING LOOP,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ELECTRODE BUTTON 24-28 FR,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ELECTRODE LOOP LLETZ 10 X 10MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ORSUP0001,ORSUP0001,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ELECTRODE CLEAN COAT L-HOOK,ORSUP0010,CDM,272,RC,,,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
ELECTRODE BALL JOIMAX LEGATO,ORSUP0018,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ELECTRODE ECG GENERAL MONITORING FOAM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ELECTRODE PEDI/NEONATOR FOAM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ELECTROD ECG STRESS/DIAPHORETIC FOAM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ELECTRODE VITAL STIM ADULT SIZE PK OF 12,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ELECTRODE PERFORMA CLOTH 2IN X 3.5IN PK OF 4,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ELECTRODE RADIOTRANSLUCENT FOAM MEDGEL,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ELECTRODE 24FR COAGULATING,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
ELECTRODE 24FR ROLLER 5MM,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
ELEVATOR LEG FOAM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ELEVIEW 5 AMP 10ML,ORSUP0008,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
ELITE IRRIGATION SLEEVE 7CM,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
EMBOLISM RETRACT DETACH COIL 14CM X 6MM,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
EMBOLISM RETRACT DETACH COIL 14CM X 8MM,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
EMBOLISM RETRACT DETACH COIL 14CM X 10MM,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
EMBOLISM RETRACT DETACH COIL 14CM 12MM,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
EMBOSPHERE 2ML SYRINGE BLUE,ORSUP0016,CDM,272,RC,,,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,199,17.304,,,percent of total billed charges,17.304% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,724.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,15.3,,,percent of total billed charges,15.3% of total billed charges,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,711.28,61.85,,,percent of total billed charges,61.85% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,197.06,17.136,,,percent of total billed charges,17.136% of total billed charges,251.16,21.84,,,percent of total billed charges,21.84% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,1150,
ENCORE 26 BALLOON INFLATION DEVICE W/ASSESSORIES,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ENCORE 26 INFLATOR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ENDO VIV SAFTEY PEG KIT 20FR,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
ENDO SCISSORS,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
ENDOSWABS,ORSUP0018,CDM,270,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
ENDOZYME SPONGE,109034,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
ENDOSCOPE 3D 8.5MM  0 DEGREE,ORSUP0271,CDM,272,RC,,,Outpatient,,,93080,60502.00,,81910.4,88,,,percent of total billed charges,88% of total Billed charges,46540,50,,,percent of total billed charges,50% of total Billed charges,15637.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,16106.56,17.304,,,percent of total billed charges,17.304% of total billed charges,46540,50,,,percent of total billed charges,50% of total Billed charges,58640.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15637.44,16.8,,,percent of total billed charges,16.8% of total billed charges,14241.24,15.3,,,percent of total billed charges,15.3% of total billed charges,64225.2,69,,,percent of total billed charges,69% of total billed charges,93080,100,,,percent of total billed charges,100% of total billed charges,46540,50,,,percent of total billed charges,50% of total Billed charges,93080,100,,,percent of total billed charges,100% of total billed charges,46540,50,,,percent of total billed charges,50% of total Billed charges,93080,100,,,percent of total billed charges,100% of total billed charges,46540,50,,,percent of total billed charges,50% of total Billed charges,57569.98,61.85,,,percent of total billed charges,61.85% of total billed charges,15637.44,16.8,,,percent of total billed charges,16.8% of total billed charges,46540,50,,,percent of total billed charges,50% of total Billed charges,46540,50,,,percent of total billed charges,50% of total Billed charges,15637.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,46540,50,,,percent of total billed charges,50% of total Billed charges,46540,50,,,percent of total billed charges,50% of total Billed charges,15950.19,17.136,,,percent of total billed charges,17.136% of total billed charges,20328.67,21.84,,,percent of total billed charges,21.84% of total billed charges,46540,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46540,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46540,50,,,percent of total billed charges,50% of total Billed charges,72602.4,78,,,percent of total billed charges,78% of total billed charges,93080,100,,,percent of total billed charges,100% of total billed charges,76884.08,82.6,,,percent of total billed charges,82.6% of total billed charges,76884.08,82.6,,,percent of total billed charges,82.6% of total billed charges,15637.44,16.8,,,percent of total billed charges,16.8% of total billed charges,46540,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46540,50,,,percent of total billed charges,50% of total Billed charges,15637.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,93080,
ENDOSCOPE 8.5MM  ALIGNMENT TARGET,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
ENDOSTITCH V-LOC 2-0  6LP,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ENDOTRACH TUBE 9.0 NIM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ENDOTRACH TUBE 8MM NIM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ENDOTRACH TUBE 7MM NIM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ENDOTRACH TUBE 6MM NIM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ENDOTRACH TUBE 5MM NIM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"ENDOGRASPER, ROTICULATING",ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ENDOBUTTON PAC ACCESSORY KIT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ENDO APPLICATOR FOR FLOSEAL,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
ENDO POUCH/BAG 5X7 10MM  750ML,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ENDOSTITCH POLYSORB ES9 DYED,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
ENDOSTITCH,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ENDO RETRACTOR FAN,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
ENDOCLOSE,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
ENDOAVITEVE PUSHER,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ENDOLOOP VICRYL 0 EJ10G,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
Echelon Linear Cutter Reload 60MM BUE,ORSUP0016,CDM,272,RC,,,Outpatient,,,1413,918.45,,1243.44,88,,,percent of total billed charges,88% of total Billed charges,706.5,50,,,percent of total billed charges,50% of total Billed charges,237.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,1413,100,,,percent of total billed charges,100% of total billed charges,244.51,17.304,,,percent of total billed charges,17.304% of total billed charges,706.5,50,,,percent of total billed charges,50% of total Billed charges,890.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,237.38,16.8,,,percent of total billed charges,16.8% of total billed charges,216.19,15.3,,,percent of total billed charges,15.3% of total billed charges,974.97,69,,,percent of total billed charges,69% of total billed charges,1413,100,,,percent of total billed charges,100% of total billed charges,706.5,50,,,percent of total billed charges,50% of total Billed charges,1413,100,,,percent of total billed charges,100% of total billed charges,706.5,50,,,percent of total billed charges,50% of total Billed charges,1413,100,,,percent of total billed charges,100% of total billed charges,706.5,50,,,percent of total billed charges,50% of total Billed charges,873.94,61.85,,,percent of total billed charges,61.85% of total billed charges,237.38,16.8,,,percent of total billed charges,16.8% of total billed charges,706.5,50,,,percent of total billed charges,50% of total Billed charges,706.5,50,,,percent of total billed charges,50% of total Billed charges,237.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,706.5,50,,,percent of total billed charges,50% of total Billed charges,706.5,50,,,percent of total billed charges,50% of total Billed charges,242.13,17.136,,,percent of total billed charges,17.136% of total billed charges,308.6,21.84,,,percent of total billed charges,21.84% of total billed charges,706.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,706.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,706.5,50,,,percent of total billed charges,50% of total Billed charges,1102.14,78,,,percent of total billed charges,78% of total billed charges,1413,100,,,percent of total billed charges,100% of total billed charges,1167.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1167.14,82.6,,,percent of total billed charges,82.6% of total billed charges,237.38,16.8,,,percent of total billed charges,16.8% of total billed charges,706.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,706.5,50,,,percent of total billed charges,50% of total Billed charges,237.38,16.8,,,percent of total billed charges,16.8% of total billed charges,216.19,1413,
ENDOARMOR GOWNS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ENDOPATH XCEL BLADELESS TROCAR 15MM X 100MM,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
ENFLOW FLUID WARMER CARTRIDGE,490525,CDM,270,RC,,,Outpatient,,,108,70.20,,95.04,88,,,percent of total billed charges,88% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,18.69,17.304,,,percent of total billed charges,17.304% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,68.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,15.3,,,percent of total billed charges,15.3% of total billed charges,74.52,69,,,percent of total billed charges,69% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,66.8,61.85,,,percent of total billed charges,61.85% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.51,17.136,,,percent of total billed charges,17.136% of total billed charges,23.59,21.84,,,percent of total billed charges,21.84% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,84.24,78,,,percent of total billed charges,78% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,108,
ENSEAL 5MM ART TISS SEALER,ORSUP0032,CDM,272,RC,,,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
ENSURE HIGH PROTEIN CHOCOLATE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ENSURE HIGH PROTEIN VANILLA,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ENTEROCOCCUS CASSELIFLAVUS ATCC 700327,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ENTERO FAECALIS ATCC CULTI LOOPS 29212,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ENTERO HORMAECHEI ATCC CULTI LOOPS 700323,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ENVELOPE NO 10 REGULAR,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ENVELOPE NO 10 WINDOW,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ENVELOPE YAKIMA REGIONAL WH,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ENZYMATIC SOLUTION B91,12171,CDM,270,RC,,,Outpatient,,,123,79.95,,108.24,88,,,percent of total billed charges,88% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,123,100,,,percent of total billed charges,100% of total billed charges,21.28,17.304,,,percent of total billed charges,17.304% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,77.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,18.82,15.3,,,percent of total billed charges,15.3% of total billed charges,84.87,69,,,percent of total billed charges,69% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,123,100,,,percent of total billed charges,100% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,123,100,,,percent of total billed charges,100% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,76.08,61.85,,,percent of total billed charges,61.85% of total billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,21.08,17.136,,,percent of total billed charges,17.136% of total billed charges,26.86,21.84,,,percent of total billed charges,21.84% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,61.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,61.5,50,,,percent of total billed charges,50% of total Billed charges,95.94,78,,,percent of total billed charges,78% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,61.5,50,,,percent of total billed charges,50% of total Billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,18.82,123,
ENZYMATIC CLEANING SPONGE,490526,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
ENZYMATIC DETERGENT NEPTUNE,490527,CDM,270,RC,,,Outpatient,,,428,278.20,,376.64,88,,,percent of total billed charges,88% of total Billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,71.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,428,100,,,percent of total billed charges,100% of total billed charges,74.06,17.304,,,percent of total billed charges,17.304% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,269.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,71.9,16.8,,,percent of total billed charges,16.8% of total billed charges,65.48,15.3,,,percent of total billed charges,15.3% of total billed charges,295.32,69,,,percent of total billed charges,69% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,428,100,,,percent of total billed charges,100% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,428,100,,,percent of total billed charges,100% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,264.72,61.85,,,percent of total billed charges,61.85% of total billed charges,71.9,16.8,,,percent of total billed charges,16.8% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,71.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,73.34,17.136,,,percent of total billed charges,17.136% of total billed charges,93.48,21.84,,,percent of total billed charges,21.84% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,214,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,214,50,,,percent of total billed charges,50% of total Billed charges,333.84,78,,,percent of total billed charges,78% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,71.9,16.8,,,percent of total billed charges,16.8% of total billed charges,214,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,214,50,,,percent of total billed charges,50% of total Billed charges,71.9,16.8,,,percent of total billed charges,16.8% of total billed charges,65.48,428,
ENZYME SPONGE,490529,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
EPICORD SHEET 2X3 CM,636Q418723,CDM,636,RC,Q4187,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",179.01,1170,
EPICORD SHEET 3X5 CM,636Q418735,CDM,636,RC,Q4187,HCPCS,Outpatient,,,16200,10530.00,,14256,88,,,percent of total billed charges,88% of total Billed charges,8100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,8100,50,,,percent of total billed charges,50% of total Billed charges,10206,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",2478.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11178,69,,,percent of total billed charges,69% of total billed charges,16200,100,,,percent of total billed charges,100% of total billed charges,8100,50,,,percent of total billed charges,50% of total Billed charges,16200,100,,,percent of total billed charges,100% of total billed charges,8100,50,,,percent of total billed charges,50% of total Billed charges,16200,100,,,percent of total billed charges,100% of total billed charges,8100,50,,,percent of total billed charges,50% of total Billed charges,10019.7,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,8100,50,,,percent of total billed charges,50% of total Billed charges,8100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8100,50,,,percent of total billed charges,50% of total Billed charges,8100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8100,50,,,percent of total billed charges,50% of total Billed charges,6107.4,37.7,,,percent of total billed charges,37.70% of total billed charges,6107.4,37.7,,,percent of total billed charges,37.70% of total billed charges,8100,50,,,percent of total billed charges,50% of total Billed charges,5491.8,33.9,,,percent of total billed charges,33.9% of total billed charges,8100,50,,,percent of total billed charges,50% of total Billed charges,12636,78,,,percent of total billed charges,78% of total billed charges,16200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",2478.6,16200,
EPICORD EXPANDABLE MEMBRANE 2X3 CM,636Q418723,CDM,636,RC,Q4187,HCPCS,Outpatient,,,7000,4550.00,,6160,88,,,percent of total billed charges,88% of total Billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3500,50,,,percent of total billed charges,50% of total Billed charges,4410,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1071,15.3,,,percent of total billed charges,15.3% of total billed charges,4830,69,,,percent of total billed charges,69% of total billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,4329.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3500,50,,,percent of total billed charges,50% of total Billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3500,50,,,percent of total billed charges,50% of total Billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3500,50,,,percent of total billed charges,50% of total Billed charges,2639,37.7,,,percent of total billed charges,37.70% of total billed charges,2639,37.7,,,percent of total billed charges,37.70% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,2373,33.9,,,percent of total billed charges,33.9% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,5460,78,,,percent of total billed charges,78% of total billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1071,7000,
EPICORD EXPANDABLE MEMBRANE 2X2 CM,636Q418722,CDM,636,RC,Q4187,HCPCS,Outpatient,,,5000,3250.00,,4400,88,,,percent of total billed charges,88% of total Billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2500,50,,,percent of total billed charges,50% of total Billed charges,3150,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",765,15.3,,,percent of total billed charges,15.3% of total billed charges,3450,69,,,percent of total billed charges,69% of total billed charges,5000,100,,,percent of total billed charges,100% of total billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,5000,100,,,percent of total billed charges,100% of total billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,5000,100,,,percent of total billed charges,100% of total billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,3092.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,2500,50,,,percent of total billed charges,50% of total Billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2500,50,,,percent of total billed charges,50% of total Billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2500,50,,,percent of total billed charges,50% of total Billed charges,1885,37.7,,,percent of total billed charges,37.70% of total billed charges,1885,37.7,,,percent of total billed charges,37.70% of total billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,1695,33.9,,,percent of total billed charges,33.9% of total billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,3900,78,,,percent of total billed charges,78% of total billed charges,5000,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",765,5000,
EPICORD SHEET 1X2 CM,636Q418712,CDM,636,RC,Q4187,HCPCS,Outpatient,,,4600,2990.00,,4048,88,,,percent of total billed charges,88% of total Billed charges,2300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2300,50,,,percent of total billed charges,50% of total Billed charges,2898,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",703.8,15.3,,,percent of total billed charges,15.3% of total billed charges,3174,69,,,percent of total billed charges,69% of total billed charges,4600,100,,,percent of total billed charges,100% of total billed charges,2300,50,,,percent of total billed charges,50% of total Billed charges,4600,100,,,percent of total billed charges,100% of total billed charges,2300,50,,,percent of total billed charges,50% of total Billed charges,4600,100,,,percent of total billed charges,100% of total billed charges,2300,50,,,percent of total billed charges,50% of total Billed charges,2845.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,2300,50,,,percent of total billed charges,50% of total Billed charges,2300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2300,50,,,percent of total billed charges,50% of total Billed charges,2300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2300,50,,,percent of total billed charges,50% of total Billed charges,1734.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1734.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2300,50,,,percent of total billed charges,50% of total Billed charges,1559.4,33.9,,,percent of total billed charges,33.9% of total billed charges,2300,50,,,percent of total billed charges,50% of total Billed charges,3588,78,,,percent of total billed charges,78% of total billed charges,4600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",703.8,4600,
EPIDISC CATHTER,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
EPIFIX MESH SHEET 4X4.5 CM,636Q4186445,CDM,636,RC,Q4186,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1074.06,7020,
EPIFIX SHEET 2X2 CM,636Q418622,CDM,636,RC,Q4186,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1495,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",228.74,1495,
EPIFIX SHEET 4X4 CM,636Q418644,CDM,636,RC,Q4186,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",159.12,1040,
EPIFIX SHEET 5X6 CM,636Q418656,CDM,636,RC,Q4186,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",159.12,1040,
EPIFIX MICRONIZED 160MG,636Q4145,CDM,636,RC,Q4145,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",19.89,130,
EPIFIX SHEET 3X4 CM,636Q418634,CDM,636,RC,Q4186,HCPCS,Outpatient,,,12000,7800.00,,10560,88,,,percent of total billed charges,88% of total Billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6000,50,,,percent of total billed charges,50% of total Billed charges,7560,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1836,15.3,,,percent of total billed charges,15.3% of total billed charges,8280,69,,,percent of total billed charges,69% of total billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,7422,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,6000,50,,,percent of total billed charges,50% of total Billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6000,50,,,percent of total billed charges,50% of total Billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6000,50,,,percent of total billed charges,50% of total Billed charges,4524,37.7,,,percent of total billed charges,37.70% of total billed charges,4524,37.7,,,percent of total billed charges,37.70% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,4068,33.9,,,percent of total billed charges,33.9% of total billed charges,6000,50,,,percent of total billed charges,50% of total Billed charges,9360,78,,,percent of total billed charges,78% of total billed charges,12000,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1836,12000,
EPIFIX SHEET 2X4 CM,636Q418624,CDM,636,RC,Q4186,HCPCS,Outpatient,,,6800,4420.00,,5984,88,,,percent of total billed charges,88% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,4284,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1040.4,15.3,,,percent of total billed charges,15.3% of total billed charges,4692,69,,,percent of total billed charges,69% of total billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,4205.8,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,2563.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2563.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,2305.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,5304,78,,,percent of total billed charges,78% of total billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1040.4,6800,
EPIFIX SHEET 2X3 CM,636Q418623,CDM,636,RC,Q4186,HCPCS,Outpatient,,,6000,3900.00,,5280,88,,,percent of total billed charges,88% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,3780,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",918,15.3,,,percent of total billed charges,15.3% of total billed charges,4140,69,,,percent of total billed charges,69% of total billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,3711,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,2262,37.7,,,percent of total billed charges,37.70% of total billed charges,2262,37.7,,,percent of total billed charges,37.70% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,2034,33.9,,,percent of total billed charges,33.9% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,4680,78,,,percent of total billed charges,78% of total billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",918,6000,
EPOC BGEM TEST CARDS,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
EPOC CARE-FILL CAPLRY,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ESCHERICHIA COLI ATCC CULTI LOOPS 25922,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ESCHERICHIA COLI ATCC CULTI LOOPS 35218,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ESMARK BANDAGE 4 X 9,490530,CDM,270,RC,,,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.5,17.304,,,percent of total billed charges,17.304% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.08,61.85,,,percent of total billed charges,61.85% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.46,17.136,,,percent of total billed charges,17.136% of total billed charges,5.68,21.84,,,percent of total billed charges,21.84% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,26,
ESOPHAGEAL DIALATOR 18MM,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
ESOPH BALLOON 8MM/24FR,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ESOPH BALL DILATOR 6-8MM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ESOPH BALL DILATOR 10-12MM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ESOPH BALL DILATOR 12-15MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ESR CONTROL CHEX (STRECK),ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ESR VACUUM TUBES (STRECK),ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ESR PAPER (STRECK),ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ET TAPE II HOLDER,184769,CDM,270,RC,,,Outpatient,,,1477,960.05,,1299.76,88,,,percent of total billed charges,88% of total Billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,248.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,1477,100,,,percent of total billed charges,100% of total billed charges,255.58,17.304,,,percent of total billed charges,17.304% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,930.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,248.14,16.8,,,percent of total billed charges,16.8% of total billed charges,225.98,15.3,,,percent of total billed charges,15.3% of total billed charges,1019.13,69,,,percent of total billed charges,69% of total billed charges,1477,100,,,percent of total billed charges,100% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,1477,100,,,percent of total billed charges,100% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,1477,100,,,percent of total billed charges,100% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,913.52,61.85,,,percent of total billed charges,61.85% of total billed charges,248.14,16.8,,,percent of total billed charges,16.8% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,248.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,253.1,17.136,,,percent of total billed charges,17.136% of total billed charges,322.58,21.84,,,percent of total billed charges,21.84% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,738.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,738.5,50,,,percent of total billed charges,50% of total Billed charges,1152.06,78,,,percent of total billed charges,78% of total billed charges,1477,100,,,percent of total billed charges,100% of total billed charges,1220,82.6,,,percent of total billed charges,82.6% of total billed charges,1220,82.6,,,percent of total billed charges,82.6% of total billed charges,248.14,16.8,,,percent of total billed charges,16.8% of total billed charges,738.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,738.5,50,,,percent of total billed charges,50% of total Billed charges,248.14,16.8,,,percent of total billed charges,16.8% of total billed charges,225.98,1477,
ET TUBE CUFFED 7.5MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ETCO2 NASAL CANNULAS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ETHB12LT TROCAR XCEL BLADELESS REPROCESSED,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ETHIBOND EXCEL 0 CT-1 30 (X424H),490536,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
ETHIBOND EXCEL 1 CT-1 (X425H),490537,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
ETHILON 2-0 FS (664H),490539,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
ETHILON 3-0 FSL (1671H),490540,CDM,270,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
ETHILON 3-0 PC-5 (1893G),490541,CDM,270,RC,,,Outpatient,,,109,70.85,,95.92,88,,,percent of total billed charges,88% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total Billed charges,109,100,,,percent of total billed charges,100% of total billed charges,18.86,17.304,,,percent of total billed charges,17.304% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,68.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,16.68,15.3,,,percent of total billed charges,15.3% of total billed charges,75.21,69,,,percent of total billed charges,69% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,109,100,,,percent of total billed charges,100% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,109,100,,,percent of total billed charges,100% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,67.42,61.85,,,percent of total billed charges,61.85% of total billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.68,17.136,,,percent of total billed charges,17.136% of total billed charges,23.81,21.84,,,percent of total billed charges,21.84% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.5,50,,,percent of total billed charges,50% of total Billed charges,85.02,78,,,percent of total billed charges,78% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,16.68,109,
ETHILON 5-0 PC-5 (1895G),490543,CDM,270,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
ETHILON 6-0 P-3 (1698G),490544,CDM,270,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
ETHYL ACETATE,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
EUROTROL GAS ISE LEVEL 1,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
EUROTROL HCT LEVEL A,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
EUROTROL HCT LEVEL B,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
EUROTROL CALIBRATION VERIF FLUID,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
EUROTROL HCT CAL VERIFICATION,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
EVAC 70 XTRA W/ INTEGRATED CABLE,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
EVACUATOR SILICONE 100CC 7MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
EVACUATION BOTTLE 1000ML,ORSUP0002,CDM,372,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
EVACUATION DRAINAGE BOTTLE 1000ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
EVIVA STEREOTATIC GUIDED BREAST BIOPSY SYS 9G X 13CM 20M,ORSUP0018,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
EVQ FLOW VALVE PROCESSING SENSOR,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
EXACTO COLD SNARE,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
EXCALIBUR 4.0,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
EXCYTE ESR TUBES,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
EXCYTE ESR CONTROL LOG,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
EXOSHAPE FEMORAL IMPLANT FASTENER 8MM X 21MM,ORSUP0031,CDM,272,RC,,,Outpatient,,,4000,2600.00,,3520,88,,,percent of total billed charges,88% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,692.16,17.304,,,percent of total billed charges,17.304% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2520,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,672,16.8,,,percent of total billed charges,16.8% of total billed charges,612,15.3,,,percent of total billed charges,15.3% of total billed charges,2760,69,,,percent of total billed charges,69% of total billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2474,61.85,,,percent of total billed charges,61.85% of total billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,685.44,17.136,,,percent of total billed charges,17.136% of total billed charges,873.6,21.84,,,percent of total billed charges,21.84% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,3120,78,,,percent of total billed charges,78% of total billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,3304,82.6,,,percent of total billed charges,82.6% of total billed charges,3304,82.6,,,percent of total billed charges,82.6% of total billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,612,4000,
EXOSHAPE FEMORAL IMPLANT FASTENER 10MM X 21MM,ORSUP0031,CDM,272,RC,,,Outpatient,,,4000,2600.00,,3520,88,,,percent of total billed charges,88% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,692.16,17.304,,,percent of total billed charges,17.304% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2520,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,672,16.8,,,percent of total billed charges,16.8% of total billed charges,612,15.3,,,percent of total billed charges,15.3% of total billed charges,2760,69,,,percent of total billed charges,69% of total billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2474,61.85,,,percent of total billed charges,61.85% of total billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,685.44,17.136,,,percent of total billed charges,17.136% of total billed charges,873.6,21.84,,,percent of total billed charges,21.84% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,3120,78,,,percent of total billed charges,78% of total billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,3304,82.6,,,percent of total billed charges,82.6% of total billed charges,3304,82.6,,,percent of total billed charges,82.6% of total billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,612,4000,
EXOSHAPE FEMORAL IMPLANT FASTENER 9MM X 21MM,ORSUP0031,CDM,272,RC,,,Outpatient,,,4000,2600.00,,3520,88,,,percent of total billed charges,88% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,692.16,17.304,,,percent of total billed charges,17.304% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2520,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,672,16.8,,,percent of total billed charges,16.8% of total billed charges,612,15.3,,,percent of total billed charges,15.3% of total billed charges,2760,69,,,percent of total billed charges,69% of total billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2474,61.85,,,percent of total billed charges,61.85% of total billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,685.44,17.136,,,percent of total billed charges,17.136% of total billed charges,873.6,21.84,,,percent of total billed charges,21.84% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,3120,78,,,percent of total billed charges,78% of total billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,3304,82.6,,,percent of total billed charges,82.6% of total billed charges,3304,82.6,,,percent of total billed charges,82.6% of total billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,612,4000,
EXOSHAPE FEMORAL IMPLANT FASTENER 11MM X 21MM,ORSUP0031,CDM,272,RC,,,Outpatient,,,4000,2600.00,,3520,88,,,percent of total billed charges,88% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,692.16,17.304,,,percent of total billed charges,17.304% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2520,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,672,16.8,,,percent of total billed charges,16.8% of total billed charges,612,15.3,,,percent of total billed charges,15.3% of total billed charges,2760,69,,,percent of total billed charges,69% of total billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2474,61.85,,,percent of total billed charges,61.85% of total billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,685.44,17.136,,,percent of total billed charges,17.136% of total billed charges,873.6,21.84,,,percent of total billed charges,21.84% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,3120,78,,,percent of total billed charges,78% of total billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,3304,82.6,,,percent of total billed charges,82.6% of total billed charges,3304,82.6,,,percent of total billed charges,82.6% of total billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,612,4000,
FILTRATION SYSTEM PEDIATRIC-ADULT EXPIRATORY,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
EXPRESS BONE BIOPSY DEVISE TAPERED SZ 2,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
EXTRACTOR RX 9-12MM,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
EXTRACTOR RX 12-15,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
EXTRACTOR RX 15-18MM,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
EXTREMITY ICE PACK,490549,CDM,270,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
EYE PROTECTOR,53731,CDM,270,RC,,,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,7.79,17.304,,,percent of total billed charges,17.304% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,27.83,61.85,,,percent of total billed charges,61.85% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.71,17.136,,,percent of total billed charges,17.136% of total billed charges,9.83,21.84,,,percent of total billed charges,21.84% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
EYE 1045 DRAPE,490550,CDM,270,RC,,,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,10.04,17.304,,,percent of total billed charges,17.304% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,36.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.94,17.136,,,percent of total billed charges,17.136% of total billed charges,12.67,21.84,,,percent of total billed charges,21.84% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,58,
EYE CAPSULAR TENSION RING,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
EYE CHROMIC GUT 7-0 TG100-8 (1744G),490555,CDM,270,RC,,,Outpatient,,,192,124.80,,168.96,88,,,percent of total billed charges,88% of total Billed charges,96,50,,,percent of total billed charges,50% of total Billed charges,32.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,192,100,,,percent of total billed charges,100% of total billed charges,33.22,17.304,,,percent of total billed charges,17.304% of total billed charges,96,50,,,percent of total billed charges,50% of total Billed charges,120.96,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,29.38,15.3,,,percent of total billed charges,15.3% of total billed charges,132.48,69,,,percent of total billed charges,69% of total billed charges,192,100,,,percent of total billed charges,100% of total billed charges,96,50,,,percent of total billed charges,50% of total Billed charges,192,100,,,percent of total billed charges,100% of total billed charges,96,50,,,percent of total billed charges,50% of total Billed charges,192,100,,,percent of total billed charges,100% of total billed charges,96,50,,,percent of total billed charges,50% of total Billed charges,118.75,61.85,,,percent of total billed charges,61.85% of total billed charges,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,96,50,,,percent of total billed charges,50% of total Billed charges,96,50,,,percent of total billed charges,50% of total Billed charges,32.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,96,50,,,percent of total billed charges,50% of total Billed charges,96,50,,,percent of total billed charges,50% of total Billed charges,32.9,17.136,,,percent of total billed charges,17.136% of total billed charges,41.93,21.84,,,percent of total billed charges,21.84% of total billed charges,96,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,96,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,96,50,,,percent of total billed charges,50% of total Billed charges,149.76,78,,,percent of total billed charges,78% of total billed charges,192,100,,,percent of total billed charges,100% of total billed charges,158.59,82.6,,,percent of total billed charges,82.6% of total billed charges,158.59,82.6,,,percent of total billed charges,82.6% of total billed charges,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,96,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,96,50,,,percent of total billed charges,50% of total Billed charges,32.26,16.8,,,percent of total billed charges,16.8% of total billed charges,29.38,192,
EYE INFINITY VITRECTOMY PAK 23G,490556,CDM,270,RC,,,Outpatient,,,1605,1043.25,,1412.4,88,,,percent of total billed charges,88% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,277.73,17.304,,,percent of total billed charges,17.304% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1011.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,245.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1107.45,69,,,percent of total billed charges,69% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,992.69,61.85,,,percent of total billed charges,61.85% of total billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,275.03,17.136,,,percent of total billed charges,17.136% of total billed charges,350.53,21.84,,,percent of total billed charges,21.84% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,1251.9,78,,,percent of total billed charges,78% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,245.57,1605,
EYE INSTRUMENT WIPE,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
EYE LENS (SN60WF),ORSUP0014,CDM,276,RC,V2632,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,1170,100,,,percent of total billed charges,100% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,1170,100,,,percent of total billed charges,100% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
EYE NYLON 10-0 AU-5,490561,CDM,270,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
EYE NYLON 10-0 CU-5,490562,CDM,270,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
EYE NYLON 9-0 CU-1,490563,CDM,270,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
EYE PACK,490564,CDM,270,RC,,,Outpatient,,,1058,687.70,,931.04,88,,,percent of total billed charges,88% of total Billed charges,529,50,,,percent of total billed charges,50% of total Billed charges,177.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,1058,100,,,percent of total billed charges,100% of total billed charges,183.08,17.304,,,percent of total billed charges,17.304% of total billed charges,529,50,,,percent of total billed charges,50% of total Billed charges,666.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,177.74,16.8,,,percent of total billed charges,16.8% of total billed charges,161.87,15.3,,,percent of total billed charges,15.3% of total billed charges,730.02,69,,,percent of total billed charges,69% of total billed charges,1058,100,,,percent of total billed charges,100% of total billed charges,529,50,,,percent of total billed charges,50% of total Billed charges,1058,100,,,percent of total billed charges,100% of total billed charges,529,50,,,percent of total billed charges,50% of total Billed charges,1058,100,,,percent of total billed charges,100% of total billed charges,529,50,,,percent of total billed charges,50% of total Billed charges,654.37,61.85,,,percent of total billed charges,61.85% of total billed charges,177.74,16.8,,,percent of total billed charges,16.8% of total billed charges,529,50,,,percent of total billed charges,50% of total Billed charges,529,50,,,percent of total billed charges,50% of total Billed charges,177.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,529,50,,,percent of total billed charges,50% of total Billed charges,529,50,,,percent of total billed charges,50% of total Billed charges,181.3,17.136,,,percent of total billed charges,17.136% of total billed charges,231.07,21.84,,,percent of total billed charges,21.84% of total billed charges,529,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,529,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,529,50,,,percent of total billed charges,50% of total Billed charges,825.24,78,,,percent of total billed charges,78% of total billed charges,1058,100,,,percent of total billed charges,100% of total billed charges,873.91,82.6,,,percent of total billed charges,82.6% of total billed charges,873.91,82.6,,,percent of total billed charges,82.6% of total billed charges,177.74,16.8,,,percent of total billed charges,16.8% of total billed charges,529,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,529,50,,,percent of total billed charges,50% of total Billed charges,177.74,16.8,,,percent of total billed charges,16.8% of total billed charges,161.87,1058,
EYE PLAIN GUT 6-0 TG140-8 (1735G),490566,CDM,270,RC,,,Outpatient,,,190,123.50,,167.2,88,,,percent of total billed charges,88% of total Billed charges,95,50,,,percent of total billed charges,50% of total Billed charges,31.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,190,100,,,percent of total billed charges,100% of total billed charges,32.88,17.304,,,percent of total billed charges,17.304% of total billed charges,95,50,,,percent of total billed charges,50% of total Billed charges,119.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.92,16.8,,,percent of total billed charges,16.8% of total billed charges,29.07,15.3,,,percent of total billed charges,15.3% of total billed charges,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,95,50,,,percent of total billed charges,50% of total Billed charges,190,100,,,percent of total billed charges,100% of total billed charges,95,50,,,percent of total billed charges,50% of total Billed charges,190,100,,,percent of total billed charges,100% of total billed charges,95,50,,,percent of total billed charges,50% of total Billed charges,117.52,61.85,,,percent of total billed charges,61.85% of total billed charges,31.92,16.8,,,percent of total billed charges,16.8% of total billed charges,95,50,,,percent of total billed charges,50% of total Billed charges,95,50,,,percent of total billed charges,50% of total Billed charges,31.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,95,50,,,percent of total billed charges,50% of total Billed charges,95,50,,,percent of total billed charges,50% of total Billed charges,32.56,17.136,,,percent of total billed charges,17.136% of total billed charges,41.5,21.84,,,percent of total billed charges,21.84% of total billed charges,95,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,95,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,95,50,,,percent of total billed charges,50% of total Billed charges,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,31.92,16.8,,,percent of total billed charges,16.8% of total billed charges,95,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,95,50,,,percent of total billed charges,50% of total Billed charges,31.92,16.8,,,percent of total billed charges,16.8% of total billed charges,29.07,190,
EYE POLY 10-0 SC-5,490567,CDM,270,RC,,,Outpatient,,,241,156.65,,212.08,88,,,percent of total billed charges,88% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,41.7,17.304,,,percent of total billed charges,17.304% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,151.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,36.87,15.3,,,percent of total billed charges,15.3% of total billed charges,166.29,69,,,percent of total billed charges,69% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,149.06,61.85,,,percent of total billed charges,61.85% of total billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,41.3,17.136,,,percent of total billed charges,17.136% of total billed charges,52.63,21.84,,,percent of total billed charges,21.84% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,187.98,78,,,percent of total billed charges,78% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,36.87,241,
EYE PROLENE 6-0 C-1 (8307H),490568,CDM,270,RC,,,Outpatient,,,95,61.75,,83.6,88,,,percent of total billed charges,88% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,16.44,17.304,,,percent of total billed charges,17.304% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,59.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,14.54,15.3,,,percent of total billed charges,15.3% of total billed charges,65.55,69,,,percent of total billed charges,69% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,58.76,61.85,,,percent of total billed charges,61.85% of total billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,16.28,17.136,,,percent of total billed charges,17.136% of total billed charges,20.75,21.84,,,percent of total billed charges,21.84% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,74.1,78,,,percent of total billed charges,78% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,14.54,95,
EYE SILK 6-0 PC-1,490569,CDM,270,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
EYE TORIC LENS (SN6AT3),ORSUP0027,CDM,276,RC,V2632,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
EYE TORIC LENS (SN6AT4),ORSUP0027,CDM,276,RC,V2632,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
EYE TORIC LENS (SN6AT5),ORSUP0027,CDM,276,RC,V2632,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
EYE TORIC LENS (SN6AT6),ORSUP0027,CDM,276,RC,V2632,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
EYE TORIC LENS (SN6AT7),ORSUP0027,CDM,276,RC,V2632,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,percent of total billed charges,100% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,4160,100,,,Fee Schedule,100% of Medicare OPPS rate,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
EYE TORIC LENS (SN6AT8),ORSUP0027,CDM,276,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
EYE TORIC LENS (SN6AT9),ORSUP0027,CDM,276,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
EYE VICRYL 6-0 P-1 (J489H),490577,CDM,270,RC,,,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.88,17.304,,,percent of total billed charges,17.304% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.83,17.136,,,percent of total billed charges,17.136% of total billed charges,7.43,21.84,,,percent of total billed charges,21.84% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,34,
EYE VICRYL 6-0 S-14 (J570G),490578,CDM,270,RC,,,Outpatient,,,105,68.25,,92.4,88,,,percent of total billed charges,88% of total Billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,17.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,105,100,,,percent of total billed charges,100% of total billed charges,18.17,17.304,,,percent of total billed charges,17.304% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,66.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,17.64,16.8,,,percent of total billed charges,16.8% of total billed charges,16.07,15.3,,,percent of total billed charges,15.3% of total billed charges,72.45,69,,,percent of total billed charges,69% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,105,100,,,percent of total billed charges,100% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,105,100,,,percent of total billed charges,100% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,64.94,61.85,,,percent of total billed charges,61.85% of total billed charges,17.64,16.8,,,percent of total billed charges,16.8% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,17.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,17.99,17.136,,,percent of total billed charges,17.136% of total billed charges,22.93,21.84,,,percent of total billed charges,21.84% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,52.5,50,,,percent of total billed charges,50% of total Billed charges,81.9,78,,,percent of total billed charges,78% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,17.64,16.8,,,percent of total billed charges,16.8% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,52.5,50,,,percent of total billed charges,50% of total Billed charges,17.64,16.8,,,percent of total billed charges,16.8% of total billed charges,16.07,105,
EYE VICRYL 7-0 TG140-8 (J566G),490579,CDM,270,RC,,,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,20.76,17.304,,,percent of total billed charges,17.304% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.56,17.136,,,percent of total billed charges,17.136% of total billed charges,26.21,21.84,,,percent of total billed charges,21.84% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,120,
EYE VICRYL 8-0 BV130-4 (J405G),490580,CDM,270,RC,,,Outpatient,,,139,90.35,,122.32,88,,,percent of total billed charges,88% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,23.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,139,100,,,percent of total billed charges,100% of total billed charges,24.05,17.304,,,percent of total billed charges,17.304% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,87.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.35,16.8,,,percent of total billed charges,16.8% of total billed charges,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,85.97,61.85,,,percent of total billed charges,61.85% of total billed charges,23.35,16.8,,,percent of total billed charges,16.8% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,23.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,23.82,17.136,,,percent of total billed charges,17.136% of total billed charges,30.36,21.84,,,percent of total billed charges,21.84% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,69.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69.5,50,,,percent of total billed charges,50% of total Billed charges,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,23.35,16.8,,,percent of total billed charges,16.8% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69.5,50,,,percent of total billed charges,50% of total Billed charges,23.35,16.8,,,percent of total billed charges,16.8% of total billed charges,21.27,139,
EYE VICRYL 8-0 TG140-6 (J974G),490581,CDM,270,RC,,,Outpatient,,,155,100.75,,136.4,88,,,percent of total billed charges,88% of total Billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,26.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,155,100,,,percent of total billed charges,100% of total billed charges,26.82,17.304,,,percent of total billed charges,17.304% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,97.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,26.04,16.8,,,percent of total billed charges,16.8% of total billed charges,23.72,15.3,,,percent of total billed charges,15.3% of total billed charges,106.95,69,,,percent of total billed charges,69% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,155,100,,,percent of total billed charges,100% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,155,100,,,percent of total billed charges,100% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,95.87,61.85,,,percent of total billed charges,61.85% of total billed charges,26.04,16.8,,,percent of total billed charges,16.8% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,26.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,26.56,17.136,,,percent of total billed charges,17.136% of total billed charges,33.85,21.84,,,percent of total billed charges,21.84% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,77.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,77.5,50,,,percent of total billed charges,50% of total Billed charges,120.9,78,,,percent of total billed charges,78% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,26.04,16.8,,,percent of total billed charges,16.8% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,77.5,50,,,percent of total billed charges,50% of total Billed charges,26.04,16.8,,,percent of total billed charges,16.8% of total billed charges,23.72,155,
EYE BURR 5MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
EYE BURR 10MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
EYE PATCH ADULT BLACK,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
EYESHEILDS DISPOSABLE,490582,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
EZ-FIL SEVOFLURANE VAPORIZER BOTTLE ADAPTER,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
EZDILATE BALLOON DILATORS 6X4,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
EZDILATE KIT URETERAL 12FRX10,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
F \\T\\ P WIGGLEPAD CANNULA,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
FABRIC SAUVAGE,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
FACTOR DILUENT,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
FALL RISK BAND,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
FALOPE RING 8MM W/TROCAR DISP,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
FAST FIND GRID,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
KIT FECAL COLLECTION FLEXISEAL FMS,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
FEEDING TUBE GASTROSTOMY MICKEY 20FR,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
FEMORAL CORTICAL STRUT HALVED M/L,ORSUP0037,CDM,278,RC,C1762,HCPCS,Outpatient,,,6760,4394.00,,5948.8,88,,,percent of total billed charges,88% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1169.75,17.304,,,percent of total billed charges,17.304% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4258.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,15.3,,,percent of total billed charges,15.3% of total billed charges,4664.4,69,,,percent of total billed charges,69% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4181.06,61.85,,,percent of total billed charges,61.85% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2109.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1158.39,17.136,,,percent of total billed charges,17.136% of total billed charges,1476.38,21.84,,,percent of total billed charges,21.84% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2291.64,33.9,,,percent of total billed charges,33.9% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,5272.8,78,,,percent of total billed charges,78% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,6760,
FEMORAL HEAD 44MM,ORSUP0032,CDM,278,RC,C1762,HCPCS,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1703.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1850.94,33.9,,,percent of total billed charges,33.9% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
FEMOSTOP GOLD COMPRESSION DEVICE,ORSUP0011,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
FENESTRATED BIPOLAR FORCEPS,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
REAGENT FERRITIN ORCLNL,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
FERRITIN CALIBRATOR ORCLNL,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
FETAL SCREEN II FMH KIT,ORSUP0016,CDM,272,RC,,,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,199,17.304,,,percent of total billed charges,17.304% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,724.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,15.3,,,percent of total billed charges,15.3% of total billed charges,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,711.28,61.85,,,percent of total billed charges,61.85% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,197.06,17.136,,,percent of total billed charges,17.136% of total billed charges,251.16,21.84,,,percent of total billed charges,21.84% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,1150,
FIBER LASER DISP 270 MICRONS,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
FIBERLINK 0 BLUE,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
FIBERSTICK #2 FIBERWIRE #2 50 INCH BLUE ONE END STIFF 12 INCH,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
FIBERWIRE,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
FIBERWIRE # 2 TAPER,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
FIBERWIRE 3-0,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
FIBERWIRE MENISCUS REPAIR SUTURE,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
FIBERLOOP WITH STRAIGHT NEEDLE #2,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
FIBERTAPE  2MM 7 INCH (BLUE) W/EA END TAPERED TO #2 FIBERWIRE,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
FIBERGLASS CAST 5,490597,CDM,270,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
FIBERLOOP 4-0 T-13 TAPERED NEEDLE,ORSUP0006,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
"FICHER CONE BIOSPY WIRE, LG",ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
FILLER CERAMENT BONE VOID 5CC,ORSUP0006,CDM,278,RC,C9359,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
FILL KIT UNIVERSAL,490600,CDM,270,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
FILSHIE CLIPS,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
FILTERWIRE 300CM,ORSUP0038,CDM,278,RC,C1884,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
FILTER FEMORAL DENALI,ORSUP0042,CDM,278,RC,C1880,HCPCS,Outpatient,,,8060,5239.00,,7092.8,88,,,percent of total billed charges,88% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1394.7,17.304,,,percent of total billed charges,17.304% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,5077.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,15.3,,,percent of total billed charges,15.3% of total billed charges,5561.4,69,,,percent of total billed charges,69% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4985.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2514.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1381.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1760.3,21.84,,,percent of total billed charges,21.84% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2732.34,33.9,,,percent of total billed charges,33.9% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,6286.8,78,,,percent of total billed charges,78% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,8060,
FILTER JUGULAR DENALI,ORSUP0040,CDM,278,RC,C1880,HCPCS,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
FILTER 1.2 MICRON EXT SET NON-DEHP,185667,CDM,270,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,8.65,17.304,,,percent of total billed charges,17.304% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,30.93,61.85,,,percent of total billed charges,61.85% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.57,17.136,,,percent of total billed charges,17.136% of total billed charges,10.92,21.84,,,percent of total billed charges,21.84% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,50,
FILTER GENESIS NON CELLULOSE,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
FILTER BACTERIA,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
FILTER AIR OLYMPUS SCOPE 8 PER CASE,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
FILTER DSD REPLACEMENT 0.45 MICRON WA,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
FILTER IRRIGATION TUBE,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
FILTER WATER OLYMPUS,ORSUP0018,CDM,270,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
FILTER CONCENTRATOR,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
FILTER PROBE CIRCUMFERENTIAL OD2.3MM X L220CM,ORSUP0053,CDM,272,RC,,,Outpatient,,,10920,7098.00,,9609.6,88,,,percent of total billed charges,88% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1889.6,17.304,,,percent of total billed charges,17.304% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,6879.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,1670.76,15.3,,,percent of total billed charges,15.3% of total billed charges,7534.8,69,,,percent of total billed charges,69% of total billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,6754.02,61.85,,,percent of total billed charges,61.85% of total billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,1871.25,17.136,,,percent of total billed charges,17.136% of total billed charges,2384.93,21.84,,,percent of total billed charges,21.84% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5460,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5460,50,,,percent of total billed charges,50% of total Billed charges,8517.6,78,,,percent of total billed charges,78% of total billed charges,10920,100,,,percent of total billed charges,100% of total billed charges,9019.92,82.6,,,percent of total billed charges,82.6% of total billed charges,9019.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,5460,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5460,50,,,percent of total billed charges,50% of total Billed charges,1834.56,16.8,,,percent of total billed charges,16.8% of total billed charges,1670.76,10920,
FILTER SET VENA CAVA,ORSUP0043,CDM,278,RC,C1880,HCPCS,Outpatient,,,8320,5408.00,,7321.6,88,,,percent of total billed charges,88% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1439.69,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5241.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,15.3,,,percent of total billed charges,15.3% of total billed charges,5740.8,69,,,percent of total billed charges,69% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5145.92,61.85,,,percent of total billed charges,61.85% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2595.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1425.72,17.136,,,percent of total billed charges,17.136% of total billed charges,1817.09,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2820.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,6489.6,78,,,percent of total billed charges,78% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,8320,
FILTER VMS CHARCOAL,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
FINGER SPLINT PADDED CURVED 6 SZ M,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
FINGER SPLINT PADDED CURVED 4,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
FINGER STAX ASSORTED SIZES,ORSUP0005,CDM,278,RC,A4570,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,84.75,33.9,,,percent of total billed charges,33.9% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
FIOS FIRST ENTRY KII 12MM X 100MM Z THREAD.,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
FIXATOR LOW PROFILE WRIST 3MM X 4MM,ORSUP0043,CDM,278,RC,C1713,HCPCS,Outpatient,,,8320,5408.00,,7321.6,88,,,percent of total billed charges,88% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1439.69,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5241.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,15.3,,,percent of total billed charges,15.3% of total billed charges,5740.8,69,,,percent of total billed charges,69% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5145.92,61.85,,,percent of total billed charges,61.85% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2595.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1425.72,17.136,,,percent of total billed charges,17.136% of total billed charges,1817.09,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2820.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,6489.6,78,,,percent of total billed charges,78% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,8320,
FIXED FLANGE PVC NASAL AIRWAY,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
FLEXOR ANSEL CATH 5FR X 90CM,ORSUP0010,CDM,278,RC,C1887,HCPCS,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,188.5,37.7,,,percent of total billed charges,37.70% of total billed charges,188.5,37.7,,,percent of total billed charges,37.70% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,169.5,33.9,,,percent of total billed charges,33.9% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
FLIPCUTTER II SU 10.0,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
FLIPCUTTER II SU 6.0MM,ORSUP0020,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
FLIPCUTTER II SU 7.0,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
FLIPCUTTER II SU 8.5MM,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
FLIPCUTTER II SU 9.5MM,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
FLIPCUTTER II SU 8.0,ORSUP0020,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
FLIPCUTTER II SU 10.5,ORSUP0020,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
FLIPCUTTER II SU 11.0,ORSUP0020,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
FLOLINK ACCESS DEVICE MP1000-C,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
FLOSEAL HEMOSTATIC MATRIX 10ML,ORSUP0011,CDM,278,RC,C1763,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
FLOSEAL HEMOSTATIC MATRIX 5ML,ORSUP0014,CDM,278,RC,C1763,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
FLOSEAL MATRIX FULL STERILE PREP 5ML,ORSUP0014,CDM,278,RC,C1763,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
FLOSEAL MALLEABLE TIP ENDO APPLICATOR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
FLOSEAL VHSD 10ML,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
FLOSTEADY DISP TUBE SET,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
FLOSEAL 5ML HEMOSTATIC MATRIX,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
FLOW SENSOR,ORSUP0017,CDM,270,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
FLOW CONTROL SWITCH HIGH PRESSURE 12000PSI,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
FLUID SILICONE .5OZ,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
FLUORESCENCE IMAGING PACK,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
FLYTE SURGICOOL HOOD,ORSUP0035,CDM,272,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
FLYTE POWER CABLE,ORSUP0012,CDM,272,RC,,,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
FOAM EXIDINE CHG SOLUTION 4% CHG,273722,CDM,270,RC,,,Outpatient,,,112,72.80,,98.56,88,,,percent of total billed charges,88% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,19.38,17.304,,,percent of total billed charges,17.304% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,70.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,15.3,,,percent of total billed charges,15.3% of total billed charges,77.28,69,,,percent of total billed charges,69% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,69.27,61.85,,,percent of total billed charges,61.85% of total billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,19.19,17.136,,,percent of total billed charges,17.136% of total billed charges,24.46,21.84,,,percent of total billed charges,21.84% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,87.36,78,,,percent of total billed charges,78% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,112,
FOAM HEAD POSITIONER ADULT,490609,CDM,270,RC,,,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.4,17.304,,,percent of total billed charges,17.304% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,23.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.34,17.136,,,percent of total billed charges,17.136% of total billed charges,8.08,21.84,,,percent of total billed charges,21.84% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,37,
FOLATE 100 WELLS,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
FOLATE CAL BOX / 1 SET,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
FOLEY CATHETER TRAY,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
FORCEPS PLATE HOLDING  1MM SYSTEM,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
FORCEPS ENDO LF HOT BIOP POLYPECT ENDO,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
FORCEPS BIOPSY,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
FORCEPS RADIAL JAW 2.8MM BIOSPY,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
FORCEP BIOPSY PRE-MARKED,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
FORCEP BIPOLAR MARYLAND DA VINCI,173497,CDM,272,RC,,,Outpatient,,,13351,8678.15,,11748.88,88,,,percent of total billed charges,88% of total Billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,2242.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2310.26,17.304,,,percent of total billed charges,17.304% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,8411.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2242.97,16.8,,,percent of total billed charges,16.8% of total billed charges,2042.7,15.3,,,percent of total billed charges,15.3% of total billed charges,9212.19,69,,,percent of total billed charges,69% of total billed charges,13351,100,,,percent of total billed charges,100% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,13351,100,,,percent of total billed charges,100% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,13351,100,,,percent of total billed charges,100% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,8257.59,61.85,,,percent of total billed charges,61.85% of total billed charges,2242.97,16.8,,,percent of total billed charges,16.8% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,2242.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,2287.83,17.136,,,percent of total billed charges,17.136% of total billed charges,2915.86,21.84,,,percent of total billed charges,21.84% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6675.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6675.5,50,,,percent of total billed charges,50% of total Billed charges,10413.78,78,,,percent of total billed charges,78% of total billed charges,13351,100,,,percent of total billed charges,100% of total billed charges,11027.93,82.6,,,percent of total billed charges,82.6% of total billed charges,11027.93,82.6,,,percent of total billed charges,82.6% of total billed charges,2242.97,16.8,,,percent of total billed charges,16.8% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6675.5,50,,,percent of total billed charges,50% of total Billed charges,2242.97,16.8,,,percent of total billed charges,16.8% of total billed charges,2042.7,13351,
FORCEP CADIERE ROBOTIC,280465,CDM,272,RC,,,Outpatient,,,1605,1043.25,,1412.4,88,,,percent of total billed charges,88% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,277.73,17.304,,,percent of total billed charges,17.304% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1011.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,245.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1107.45,69,,,percent of total billed charges,69% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,992.69,61.85,,,percent of total billed charges,61.85% of total billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,275.03,17.136,,,percent of total billed charges,17.136% of total billed charges,350.53,21.84,,,percent of total billed charges,21.84% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,1251.9,78,,,percent of total billed charges,78% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,245.57,1605,
FORCEP DEBAKEY ROBOTIC,280483,CDM,272,RC,,,Outpatient,,,9148,5946.20,,8050.24,88,,,percent of total billed charges,88% of total Billed charges,4574,50,,,percent of total billed charges,50% of total Billed charges,1536.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1582.97,17.304,,,percent of total billed charges,17.304% of total billed charges,4574,50,,,percent of total billed charges,50% of total Billed charges,5763.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1536.86,16.8,,,percent of total billed charges,16.8% of total billed charges,1399.64,15.3,,,percent of total billed charges,15.3% of total billed charges,6312.12,69,,,percent of total billed charges,69% of total billed charges,9148,100,,,percent of total billed charges,100% of total billed charges,4574,50,,,percent of total billed charges,50% of total Billed charges,9148,100,,,percent of total billed charges,100% of total billed charges,4574,50,,,percent of total billed charges,50% of total Billed charges,9148,100,,,percent of total billed charges,100% of total billed charges,4574,50,,,percent of total billed charges,50% of total Billed charges,5658.04,61.85,,,percent of total billed charges,61.85% of total billed charges,1536.86,16.8,,,percent of total billed charges,16.8% of total billed charges,4574,50,,,percent of total billed charges,50% of total Billed charges,4574,50,,,percent of total billed charges,50% of total Billed charges,1536.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,4574,50,,,percent of total billed charges,50% of total Billed charges,4574,50,,,percent of total billed charges,50% of total Billed charges,1567.6,17.136,,,percent of total billed charges,17.136% of total billed charges,1997.92,21.84,,,percent of total billed charges,21.84% of total billed charges,4574,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4574,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4574,50,,,percent of total billed charges,50% of total Billed charges,7135.44,78,,,percent of total billed charges,78% of total billed charges,9148,100,,,percent of total billed charges,100% of total billed charges,7556.25,82.6,,,percent of total billed charges,82.6% of total billed charges,7556.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1536.86,16.8,,,percent of total billed charges,16.8% of total billed charges,4574,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4574,50,,,percent of total billed charges,50% of total Billed charges,1536.86,16.8,,,percent of total billed charges,16.8% of total billed charges,1399.64,9148,
FORCEP FENESTRATED BIOPOLAR ROBOTIC,280455,CDM,272,RC,,,Outpatient,,,13351,8678.15,,11748.88,88,,,percent of total billed charges,88% of total Billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,2242.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2310.26,17.304,,,percent of total billed charges,17.304% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,8411.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2242.97,16.8,,,percent of total billed charges,16.8% of total billed charges,2042.7,15.3,,,percent of total billed charges,15.3% of total billed charges,9212.19,69,,,percent of total billed charges,69% of total billed charges,13351,100,,,percent of total billed charges,100% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,13351,100,,,percent of total billed charges,100% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,13351,100,,,percent of total billed charges,100% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,8257.59,61.85,,,percent of total billed charges,61.85% of total billed charges,2242.97,16.8,,,percent of total billed charges,16.8% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,2242.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,2287.83,17.136,,,percent of total billed charges,17.136% of total billed charges,2915.86,21.84,,,percent of total billed charges,21.84% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6675.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6675.5,50,,,percent of total billed charges,50% of total Billed charges,10413.78,78,,,percent of total billed charges,78% of total billed charges,13351,100,,,percent of total billed charges,100% of total billed charges,11027.93,82.6,,,percent of total billed charges,82.6% of total billed charges,11027.93,82.6,,,percent of total billed charges,82.6% of total billed charges,2242.97,16.8,,,percent of total billed charges,16.8% of total billed charges,6675.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6675.5,50,,,percent of total billed charges,50% of total Billed charges,2242.97,16.8,,,percent of total billed charges,16.8% of total billed charges,2042.7,13351,
FORCEP LONG TIP ROBOTIC,280488,CDM,272,RC,,,Outpatient,,,12115,7874.75,,10661.2,88,,,percent of total billed charges,88% of total Billed charges,6057.5,50,,,percent of total billed charges,50% of total Billed charges,2035.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2096.38,17.304,,,percent of total billed charges,17.304% of total billed charges,6057.5,50,,,percent of total billed charges,50% of total Billed charges,7632.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2035.32,16.8,,,percent of total billed charges,16.8% of total billed charges,1853.6,15.3,,,percent of total billed charges,15.3% of total billed charges,8359.35,69,,,percent of total billed charges,69% of total billed charges,12115,100,,,percent of total billed charges,100% of total billed charges,6057.5,50,,,percent of total billed charges,50% of total Billed charges,12115,100,,,percent of total billed charges,100% of total billed charges,6057.5,50,,,percent of total billed charges,50% of total Billed charges,12115,100,,,percent of total billed charges,100% of total billed charges,6057.5,50,,,percent of total billed charges,50% of total Billed charges,7493.13,61.85,,,percent of total billed charges,61.85% of total billed charges,2035.32,16.8,,,percent of total billed charges,16.8% of total billed charges,6057.5,50,,,percent of total billed charges,50% of total Billed charges,6057.5,50,,,percent of total billed charges,50% of total Billed charges,2035.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,6057.5,50,,,percent of total billed charges,50% of total Billed charges,6057.5,50,,,percent of total billed charges,50% of total Billed charges,2076.03,17.136,,,percent of total billed charges,17.136% of total billed charges,2645.92,21.84,,,percent of total billed charges,21.84% of total billed charges,6057.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6057.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6057.5,50,,,percent of total billed charges,50% of total Billed charges,9449.7,78,,,percent of total billed charges,78% of total billed charges,12115,100,,,percent of total billed charges,100% of total billed charges,10006.99,82.6,,,percent of total billed charges,82.6% of total billed charges,10006.99,82.6,,,percent of total billed charges,82.6% of total billed charges,2035.32,16.8,,,percent of total billed charges,16.8% of total billed charges,6057.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6057.5,50,,,percent of total billed charges,50% of total Billed charges,2035.32,16.8,,,percent of total billed charges,16.8% of total billed charges,1853.6,12115,
FORCEP TENACULUM DA VINCI,173505,CDM,272,RC,,,Outpatient,,,10878,7070.70,,9572.64,88,,,percent of total billed charges,88% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1882.33,17.304,,,percent of total billed charges,17.304% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,6853.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1664.33,15.3,,,percent of total billed charges,15.3% of total billed charges,7505.82,69,,,percent of total billed charges,69% of total billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,6728.04,61.85,,,percent of total billed charges,61.85% of total billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,1864.05,17.136,,,percent of total billed charges,17.136% of total billed charges,2375.76,21.84,,,percent of total billed charges,21.84% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5439,50,,,percent of total billed charges,50% of total Billed charges,8484.84,78,,,percent of total billed charges,78% of total billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,8985.23,82.6,,,percent of total billed charges,82.6% of total billed charges,8985.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5439,50,,,percent of total billed charges,50% of total Billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1664.33,10878,
FORCEPS 5MM CADIERE,408626,CDM,272,RC,,,Outpatient,,,3762,2445.30,,3310.56,88,,,percent of total billed charges,88% of total Billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,632.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,3762,100,,,percent of total billed charges,100% of total billed charges,650.98,17.304,,,percent of total billed charges,17.304% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,2370.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,632.02,16.8,,,percent of total billed charges,16.8% of total billed charges,575.59,15.3,,,percent of total billed charges,15.3% of total billed charges,2595.78,69,,,percent of total billed charges,69% of total billed charges,3762,100,,,percent of total billed charges,100% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,3762,100,,,percent of total billed charges,100% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,3762,100,,,percent of total billed charges,100% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,2326.8,61.85,,,percent of total billed charges,61.85% of total billed charges,632.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,632.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,644.66,17.136,,,percent of total billed charges,17.136% of total billed charges,821.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1881,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1881,50,,,percent of total billed charges,50% of total Billed charges,2934.36,78,,,percent of total billed charges,78% of total billed charges,3762,100,,,percent of total billed charges,100% of total billed charges,3107.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3107.41,82.6,,,percent of total billed charges,82.6% of total billed charges,632.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1881,50,,,percent of total billed charges,50% of total Billed charges,632.02,16.8,,,percent of total billed charges,16.8% of total billed charges,575.59,3762,
FORCEPS BIOPSY RADIAL JAW 23.8MM,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
FORCEPS RESCUE COMBO GRASPING,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
FORCEPS SUPER TRAX BIOPSY,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
FORCEPS MOLLY 5MM 33CM GYRUS,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
FORCEP BIPOLAR MOLLY 5MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
FORCEPS HOT BIOPSY OVAL CUP,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
FORCEPS CUTTING 5MM GYRUS,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
FORCEPS GRASPING TRIPOD 230CM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
FORCEPS BIOPSY BROCH DISP,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
FORCEP 33CM BIPOLAR CUTTING,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
FORCEP CUTTING 10MM GYRUS,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
FORCEP BIOPSY OVAL CUP DISP,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
FORCEPS HALSTED MOQUITO 5 CURVED MIRROR FINISH,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
FORCEPS HALSTED MOQUITO 5 STRAIGHT MIRROR FINISH,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
FORMULA VITAL AF 1.2 CAL VANILLA,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
FORMULA PIVOT 1.5 1000ML,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
FORMULA 1000ML VITAL HIGH PROTEIN,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
FORM PRE SURGERY INSTRUCTIONS OR-20S,ORSUP0001,CDM,271,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,11.87,33.9,,,percent of total billed charges,33.9% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
FRAME EYE SHIELD PLASTIC OPTICAL GRD ASSRT COLORS,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
FRANKLIN CHOLANGIOGRAPHY ST,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
FREE T3 100 WELLS,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
FREE T3 CAL BOX / 3 SETS,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
FREE T4 100 WELLS,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
FREE T4 CAL BOX / 3 SETS,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
FRIDGE TEMP RECORDER CHART BLOOD BANK,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
FS ASSAY DISPOSAL LINERS BX10,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
FS HUMIDIFICATION PACKS BOX / 6,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
FS MICROTIPS BX / 4096,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
FS SLIDE DISPOSAL LINERS BX10,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
FSH 100 WELLS,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
FSH CALIBRATOR BOX / 1 SET,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
FT-31 SENSITIVITY SOLUTION SWEET,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
FT-31 FIT TEST SOLUTION SWEET,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
G-TUBE REPLACEMENT 18F,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
G-TUBE REPLACEMENT 24FR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
G-TUBE PLACEMENT  KIT 14FR,ORSUP0014,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
G-TUBE PLACEMENT  KIT 16FR,ORSUP0014,CDM,272,RC,B4087,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,55.11,175,,,Fee Schedule,175% of Medicare OPPS Rate,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,780,100,,,percent of total billed charges,100% of total billed charges,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,780,100,,,percent of total billed charges,100% of total billed charges,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,122.86,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,31.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,31.49,100,,,Fee Schedule,100% of Medicare OPPS rate,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,31.49,780,
GAMMA ELU-KIT II,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
GARDNERELLA VAGNALIS ATCC CULTI LOOPS 14018,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GARMENT CALF 28 INCH,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
GASPAK EZ GAS GENERATING SYSTEM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GASTROSTOMY MIC-KEY TUBE 18FR,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GASTRIC LAVAGE,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GASTRIC BUTTON 18FR. 1.7CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GASTRIC BUTTON 24FR 2.4CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GASTRIC BUTTON 24FR 3.4CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GASTRIC BUTTON 24FR 1.7CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GASTROCULT APPLICATOR STICKS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GASTROINTESTINAL ANCHOR SET,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GAUZE SURGICOUNT 16 PLY 4X4 STERILE,428966,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
GAUZE XRAY DOUBLE 12 PLY 8X4 STERILE,429535,CDM,272,RC,,,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,8.31,17.304,,,percent of total billed charges,17.304% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,30.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,29.69,61.85,,,percent of total billed charges,61.85% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.23,17.136,,,percent of total billed charges,17.136% of total billed charges,10.48,21.84,,,percent of total billed charges,21.84% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,48,
GAUZE PACKING VAGINAL 2,201027,CDM,270,RC,,,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
GAUZE - 1   TUBE GAUZE,106492,CDM,270,RC,,,Outpatient,,,155,100.75,,136.4,88,,,percent of total billed charges,88% of total Billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,26.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,155,100,,,percent of total billed charges,100% of total billed charges,26.82,17.304,,,percent of total billed charges,17.304% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,97.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,26.04,16.8,,,percent of total billed charges,16.8% of total billed charges,23.72,15.3,,,percent of total billed charges,15.3% of total billed charges,106.95,69,,,percent of total billed charges,69% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,155,100,,,percent of total billed charges,100% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,155,100,,,percent of total billed charges,100% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,95.87,61.85,,,percent of total billed charges,61.85% of total billed charges,26.04,16.8,,,percent of total billed charges,16.8% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,26.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,26.56,17.136,,,percent of total billed charges,17.136% of total billed charges,33.85,21.84,,,percent of total billed charges,21.84% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,77.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,77.5,50,,,percent of total billed charges,50% of total Billed charges,120.9,78,,,percent of total billed charges,78% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,26.04,16.8,,,percent of total billed charges,16.8% of total billed charges,77.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,77.5,50,,,percent of total billed charges,50% of total Billed charges,26.04,16.8,,,percent of total billed charges,16.8% of total billed charges,23.72,155,
GAUZE - 5/8   TUBE GAUZE,106491,CDM,270,RC,,,Outpatient,,,124,80.60,,109.12,88,,,percent of total billed charges,88% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,21.46,17.304,,,percent of total billed charges,17.304% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,78.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,18.97,15.3,,,percent of total billed charges,15.3% of total billed charges,85.56,69,,,percent of total billed charges,69% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,76.69,61.85,,,percent of total billed charges,61.85% of total billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,21.25,17.136,,,percent of total billed charges,17.136% of total billed charges,27.08,21.84,,,percent of total billed charges,21.84% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,96.72,78,,,percent of total billed charges,78% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,18.97,124,
GAUZE 2X2 NON STERILE,204548,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
GAUZE BORDER 4 X 10,141608,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
GAUZE BORDER 4 X 14,141609,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
GAUZE PACKING 2X5 IODOFORM,11221,CDM,270,RC,,,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,6.92,17.304,,,percent of total billed charges,17.304% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,25.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,24.74,61.85,,,percent of total billed charges,61.85% of total billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.85,17.136,,,percent of total billed charges,17.136% of total billed charges,8.74,21.84,,,percent of total billed charges,21.84% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,6.12,40,
GAUZE PACKING IODOFORM 1 X 5 YD STERILE,41534,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
GAUZE TUBULAR #7,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
GBS GX IVD CARTRIDGES (GROUP B STREP),ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
GDWR ORTHO L450MM OD2.8MM THRD TROC PT,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GDWR WALLSTENT/WALLFLEX SUPER STIFF .035,ORSUP0009,CDM,278,RC,C1769,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
GDWR LUNDERQUIST 260CM,ORSUP0022,CDM,278,RC,C1769,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
GDWR MEIR 300CM,ORSUP0005,CDM,278,RC,C1769,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GDWR SURG L350 OD2.8MM ORTHO,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GECKO NASAL PADS ADULT S,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
GEL WOUND THERAHONEY 0.5 OZ,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GEL MEDIHONEY STERILE 0.5OZ,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GEL POINT MINI ADVANCED ACCESS PLATEFORM,ORSUP0029,CDM,272,RC,,,Outpatient,,,3600,2340.00,,3168,88,,,percent of total billed charges,88% of total Billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,622.94,17.304,,,percent of total billed charges,17.304% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,2268,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,550.8,15.3,,,percent of total billed charges,15.3% of total billed charges,2484,69,,,percent of total billed charges,69% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,2226.6,61.85,,,percent of total billed charges,61.85% of total billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,616.9,17.136,,,percent of total billed charges,17.136% of total billed charges,786.24,21.84,,,percent of total billed charges,21.84% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1800,50,,,percent of total billed charges,50% of total Billed charges,2808,78,,,percent of total billed charges,78% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1800,50,,,percent of total billed charges,50% of total Billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,550.8,3600,
GELPORT HAND ACCESS DEVICE,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
GELPORT POA,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GENERATOR ANAEROBIC ATMOSPHERE,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GENTAMICIN REAGENT BOX/300T,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GENTAMICIN CAL,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
GGT/5 PACK / 250 SLIDES,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
GIRDLE 3X,ORSUP0008,CDM,270,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
GIRDLE 4X,ORSUP0008,CDM,270,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
GIRDLE 2X,ORSUP0007,CDM,270,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
GIRDLE XL,ORSUP0007,CDM,270,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
GLASSES SAFETY POLYCARB CLEAR,284024,CDM,270,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
GLICESCOPE AVL LOPRO S4,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GLIDESCOPE BLADE MAC S3,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GLIDECATH 4FR AT 120CM,ORSUP0005,CDM,278,RC,C1887,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GLIDEWIRE 180CM STIFF AT,ORSUP0015,CDM,278,RC,C1769,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
GLIDEWIRE ADVANTAGE ANGLED 260CM,ORSUP0015,CDM,278,RC,C1769,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
GLIDEWIRE HYDROPHILIC COATED 0.035 150CM REF STR,ORSUP0005,CDM,278,RC,C1769,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GLIDEWIRE HYDROPHILIC COATED 0.035 3CM REF ANG,ORSUP0005,CDM,278,RC,C1769,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GLIDESHEATH SLENDER SS KIT,ORSUP0005,CDM,278,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GLIDEWIRE SURGLIDE .035X150,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
GLIDEWIRE ZIP .035X150CM STR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GLIDEWIRE ANGLED 0.035 X 80CM X 3CM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GLIDESHEATH SLENDER 6FR,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GLIDESHEATH SLENDER 5FR,ORSUP0007,CDM,278,RC,C1894,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GLIDEWIRE RADIOFOCUS 0.018 X 180CM,ORSUP0009,CDM,278,RC,C1769,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
GLIDESCOPE AVL LOPRO S3,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GLIDESCOPE BLADE STAT #2,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
GLIDEWIRE STIFF GLIDEWIRE 035 X 150,ORSUP0008,CDM,278,RC,C1769,HCPCS,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,150.8,37.7,,,percent of total billed charges,37.70% of total billed charges,150.8,37.7,,,percent of total billed charges,37.70% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,135.6,33.9,,,percent of total billed charges,33.9% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
CATH NON TAPER ANGLE 5FR X 90CM,ORSUP0007,CDM,278,RC,C1887,HCPCS,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,118.65,33.9,,,percent of total billed charges,33.9% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
GLOVE 16IN LONG TEXTURED AMBIDEXTROUS DECONTAM LARGE,426754,CDM,270,RC,,,Outpatient,,,329,213.85,,289.52,88,,,percent of total billed charges,88% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,329,100,,,percent of total billed charges,100% of total billed charges,56.93,17.304,,,percent of total billed charges,17.304% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,207.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,50.34,15.3,,,percent of total billed charges,15.3% of total billed charges,227.01,69,,,percent of total billed charges,69% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,329,100,,,percent of total billed charges,100% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,329,100,,,percent of total billed charges,100% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,203.49,61.85,,,percent of total billed charges,61.85% of total billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,56.38,17.136,,,percent of total billed charges,17.136% of total billed charges,71.85,21.84,,,percent of total billed charges,21.84% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,164.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,164.5,50,,,percent of total billed charges,50% of total Billed charges,256.62,78,,,percent of total billed charges,78% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,164.5,50,,,percent of total billed charges,50% of total Billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,50.34,329,
GLOVE 16IN LONG TEXTURED AMBIDEXTROUS DECONTAM MED,426743,CDM,270,RC,,,Outpatient,,,329,213.85,,289.52,88,,,percent of total billed charges,88% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,329,100,,,percent of total billed charges,100% of total billed charges,56.93,17.304,,,percent of total billed charges,17.304% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,207.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,50.34,15.3,,,percent of total billed charges,15.3% of total billed charges,227.01,69,,,percent of total billed charges,69% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,329,100,,,percent of total billed charges,100% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,329,100,,,percent of total billed charges,100% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,203.49,61.85,,,percent of total billed charges,61.85% of total billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,56.38,17.136,,,percent of total billed charges,17.136% of total billed charges,71.85,21.84,,,percent of total billed charges,21.84% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,164.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,164.5,50,,,percent of total billed charges,50% of total Billed charges,256.62,78,,,percent of total billed charges,78% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,164.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,164.5,50,,,percent of total billed charges,50% of total Billed charges,55.27,16.8,,,percent of total billed charges,16.8% of total billed charges,50.34,329,
GLOVE BIOGEL SURGEONS SZ 7,144141,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
GLOVE BIOGEL SURGEONS SZ 8,144143,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GLOVE EXAM LATEX PF LG 12IN EUDERMIC,173533,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
GLOVE EXAM LATEX PF MED 12IN EUDERMIC,161890,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
GLOVE EXAM LTX ALOE PF TXT MED,176506,CDM,270,RC,,,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.4,17.304,,,percent of total billed charges,17.304% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,23.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.34,17.136,,,percent of total billed charges,17.136% of total billed charges,8.08,21.84,,,percent of total billed charges,21.84% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,37,
GLOVE EXAM NITRILE ALOE PF TXT MED,426119,CDM,270,RC,,,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,10.04,17.304,,,percent of total billed charges,17.304% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,36.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.94,17.136,,,percent of total billed charges,17.136% of total billed charges,12.67,21.84,,,percent of total billed charges,21.84% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,58,
GLOVE EXAM NITRILE CSPRO EXT CUFF MED,445078,CDM,270,RC,,,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,22.84,17.304,,,percent of total billed charges,17.304% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,83.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,81.64,61.85,,,percent of total billed charges,61.85% of total billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.62,17.136,,,percent of total billed charges,17.136% of total billed charges,28.83,21.84,,,percent of total billed charges,21.84% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,20.2,132,
GLOVE EXAM NITRILE CSPRO EXT CUFF SM,445079,CDM,270,RC,,,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,22.84,17.304,,,percent of total billed charges,17.304% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,83.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,20.2,15.3,,,percent of total billed charges,15.3% of total billed charges,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,132,100,,,percent of total billed charges,100% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,81.64,61.85,,,percent of total billed charges,61.85% of total billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,22.62,17.136,,,percent of total billed charges,17.136% of total billed charges,28.83,21.84,,,percent of total billed charges,21.84% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,66,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,66,50,,,percent of total billed charges,50% of total Billed charges,22.18,16.8,,,percent of total billed charges,16.8% of total billed charges,20.2,132,
GLOVE EXAM NITRILE PF LF LARGE,410225,CDM,270,RC,,,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,10.21,17.304,,,percent of total billed charges,17.304% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,37.17,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,15.3,,,percent of total billed charges,15.3% of total billed charges,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,36.49,61.85,,,percent of total billed charges,61.85% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,10.11,17.136,,,percent of total billed charges,17.136% of total billed charges,12.89,21.84,,,percent of total billed charges,21.84% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,59,
GLOVE EXAM NITRILE PF LF MED,410231,CDM,270,RC,,,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,10.21,17.304,,,percent of total billed charges,17.304% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,37.17,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,15.3,,,percent of total billed charges,15.3% of total billed charges,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,36.49,61.85,,,percent of total billed charges,61.85% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,10.11,17.136,,,percent of total billed charges,17.136% of total billed charges,12.89,21.84,,,percent of total billed charges,21.84% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,59,
GLOVE EXAM NITRILE PF LF SMALL,410224,CDM,270,RC,,,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,10.21,17.304,,,percent of total billed charges,17.304% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,37.17,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,15.3,,,percent of total billed charges,15.3% of total billed charges,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,36.49,61.85,,,percent of total billed charges,61.85% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,10.11,17.136,,,percent of total billed charges,17.136% of total billed charges,12.89,21.84,,,percent of total billed charges,21.84% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,59,
GLOVE EXAM NITRILE PF LF X-LARGE,410223,CDM,270,RC,,,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,10.04,17.304,,,percent of total billed charges,17.304% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,36.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.94,17.136,,,percent of total billed charges,17.136% of total billed charges,12.67,21.84,,,percent of total billed charges,21.84% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,58,
GLOVE EXAM POWDER FREE X SMALL,418113,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLOVE EXAM STER SINGLE MD,10145,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
GLOVE RADIATION 8.0,286485,CDM,270,RC,,,Outpatient,,,241,156.65,,212.08,88,,,percent of total billed charges,88% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,41.7,17.304,,,percent of total billed charges,17.304% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,151.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,36.87,15.3,,,percent of total billed charges,15.3% of total billed charges,166.29,69,,,percent of total billed charges,69% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,149.06,61.85,,,percent of total billed charges,61.85% of total billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,41.3,17.136,,,percent of total billed charges,17.136% of total billed charges,52.63,21.84,,,percent of total billed charges,21.84% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,187.98,78,,,percent of total billed charges,78% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,36.87,241,
GLOVE SENSICARE NITRIL ICE XSMALL,317075,CDM,270,RC,,,Outpatient,,,73,47.45,,64.24,88,,,percent of total billed charges,88% of total Billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,12.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,73,100,,,percent of total billed charges,100% of total billed charges,12.63,17.304,,,percent of total billed charges,17.304% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,45.99,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.26,16.8,,,percent of total billed charges,16.8% of total billed charges,11.17,15.3,,,percent of total billed charges,15.3% of total billed charges,50.37,69,,,percent of total billed charges,69% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,73,100,,,percent of total billed charges,100% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,73,100,,,percent of total billed charges,100% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,45.15,61.85,,,percent of total billed charges,61.85% of total billed charges,12.26,16.8,,,percent of total billed charges,16.8% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,12.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,12.51,17.136,,,percent of total billed charges,17.136% of total billed charges,15.94,21.84,,,percent of total billed charges,21.84% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,36.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36.5,50,,,percent of total billed charges,50% of total Billed charges,56.94,78,,,percent of total billed charges,78% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,12.26,16.8,,,percent of total billed charges,16.8% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36.5,50,,,percent of total billed charges,50% of total Billed charges,12.26,16.8,,,percent of total billed charges,16.8% of total billed charges,11.17,73,
GLOVE SURG 6.0 PROTEXIS PI CLASSIC LF PF,361762,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
GLOVE SURG 6.0 PROTEXIS PI PF BLUE UNDERGLOVE,361782,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
GLOVE SURG 6.5 PROTEXIS PI MICRO PF,361799,CDM,270,RC,,,Outpatient,,,655,425.75,,576.4,88,,,percent of total billed charges,88% of total Billed charges,327.5,50,,,percent of total billed charges,50% of total Billed charges,110.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,655,100,,,percent of total billed charges,100% of total billed charges,113.34,17.304,,,percent of total billed charges,17.304% of total billed charges,327.5,50,,,percent of total billed charges,50% of total Billed charges,412.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,110.04,16.8,,,percent of total billed charges,16.8% of total billed charges,100.22,15.3,,,percent of total billed charges,15.3% of total billed charges,451.95,69,,,percent of total billed charges,69% of total billed charges,655,100,,,percent of total billed charges,100% of total billed charges,327.5,50,,,percent of total billed charges,50% of total Billed charges,655,100,,,percent of total billed charges,100% of total billed charges,327.5,50,,,percent of total billed charges,50% of total Billed charges,655,100,,,percent of total billed charges,100% of total billed charges,327.5,50,,,percent of total billed charges,50% of total Billed charges,405.12,61.85,,,percent of total billed charges,61.85% of total billed charges,110.04,16.8,,,percent of total billed charges,16.8% of total billed charges,327.5,50,,,percent of total billed charges,50% of total Billed charges,327.5,50,,,percent of total billed charges,50% of total Billed charges,110.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,327.5,50,,,percent of total billed charges,50% of total Billed charges,327.5,50,,,percent of total billed charges,50% of total Billed charges,112.24,17.136,,,percent of total billed charges,17.136% of total billed charges,143.05,21.84,,,percent of total billed charges,21.84% of total billed charges,327.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,327.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,327.5,50,,,percent of total billed charges,50% of total Billed charges,510.9,78,,,percent of total billed charges,78% of total billed charges,655,100,,,percent of total billed charges,100% of total billed charges,541.03,82.6,,,percent of total billed charges,82.6% of total billed charges,541.03,82.6,,,percent of total billed charges,82.6% of total billed charges,110.04,16.8,,,percent of total billed charges,16.8% of total billed charges,327.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,327.5,50,,,percent of total billed charges,50% of total Billed charges,110.04,16.8,,,percent of total billed charges,16.8% of total billed charges,100.22,655,
GLOVE SURG 6.5 PROTEXIS PI PF BLUE UNDERGLOVE,361784,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
GLOVE SURG 6.5 PROTEXIS PI PF LF,416801,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
GLOVE SURG 7.0 PROTEXIS PI CLASSIC LF PF,361763,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
GLOVE SURG 7.0 PROTEXIS PI PF LF,403840,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
GLOVE SURG 7.5 PROTEXIS PI CLASSIC LF PF,361764,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
GLOVE SURG 7.5 PROTEXIS PI ORTHO PF,188666,CDM,270,RC,,,Outpatient,,,489,317.85,,430.32,88,,,percent of total billed charges,88% of total Billed charges,244.5,50,,,percent of total billed charges,50% of total Billed charges,82.15,16.8,,,percent of total billed charges,16.8% of total Billed charges,489,100,,,percent of total billed charges,100% of total billed charges,84.62,17.304,,,percent of total billed charges,17.304% of total billed charges,244.5,50,,,percent of total billed charges,50% of total Billed charges,308.07,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,82.15,16.8,,,percent of total billed charges,16.8% of total billed charges,74.82,15.3,,,percent of total billed charges,15.3% of total billed charges,337.41,69,,,percent of total billed charges,69% of total billed charges,489,100,,,percent of total billed charges,100% of total billed charges,244.5,50,,,percent of total billed charges,50% of total Billed charges,489,100,,,percent of total billed charges,100% of total billed charges,244.5,50,,,percent of total billed charges,50% of total Billed charges,489,100,,,percent of total billed charges,100% of total billed charges,244.5,50,,,percent of total billed charges,50% of total Billed charges,302.45,61.85,,,percent of total billed charges,61.85% of total billed charges,82.15,16.8,,,percent of total billed charges,16.8% of total billed charges,244.5,50,,,percent of total billed charges,50% of total Billed charges,244.5,50,,,percent of total billed charges,50% of total Billed charges,82.15,16.8,,,percent of total billed charges,16.8% of total Billed charges,244.5,50,,,percent of total billed charges,50% of total Billed charges,244.5,50,,,percent of total billed charges,50% of total Billed charges,83.8,17.136,,,percent of total billed charges,17.136% of total billed charges,106.8,21.84,,,percent of total billed charges,21.84% of total billed charges,244.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,244.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,244.5,50,,,percent of total billed charges,50% of total Billed charges,381.42,78,,,percent of total billed charges,78% of total billed charges,489,100,,,percent of total billed charges,100% of total billed charges,403.91,82.6,,,percent of total billed charges,82.6% of total billed charges,403.91,82.6,,,percent of total billed charges,82.6% of total billed charges,82.15,16.8,,,percent of total billed charges,16.8% of total billed charges,244.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,244.5,50,,,percent of total billed charges,50% of total Billed charges,82.15,16.8,,,percent of total billed charges,16.8% of total billed charges,74.82,489,
GLOVE SURG 7.5 PROTEXIS PI PF BLUE UNDERGLOVE,361786,CDM,270,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
GLOVE SURG 7.5 PROTEXIS PI PF LF,414123,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
GLOVE SURG 8.0 PROTEXIS PI CLASSIC LF PF,361765,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
GLOVE SURG 8.0 PROTEXIS PI PF LF,403843,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
GLOVE SURG 8.5 PROTEXIS PI CLASSIC LF PF,361766,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
GLOVE SURG 8.5 PROTEXIS PI PF LF,403842,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
GLOVE SURG EUDERMIC 8.0,278962,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
GLOVE SURG SENSICARE ORTHO SZ 6,286359,CDM,270,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
GLOVE SURGEON LATEX TRI-FOLD SIZE 7,161967,CDM,270,RC,,,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,16.61,17.304,,,percent of total billed charges,17.304% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,60.48,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,59.38,61.85,,,percent of total billed charges,61.85% of total billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.45,17.136,,,percent of total billed charges,17.136% of total billed charges,20.97,21.84,,,percent of total billed charges,21.84% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,14.69,96,
GLOVE SURGICAL 7.5 LATEX STERILE BIOGEL POWDER FREE BEADED C,11254,CDM,272,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
GLOVES OATMEAL RESTORE NITRILE SMALL,484956,CDM,270,RC,,,Outpatient,,,84,54.60,,73.92,88,,,percent of total billed charges,88% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,14.54,17.304,,,percent of total billed charges,17.304% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,52.92,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,12.85,15.3,,,percent of total billed charges,15.3% of total billed charges,57.96,69,,,percent of total billed charges,69% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,51.95,61.85,,,percent of total billed charges,61.85% of total billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,14.39,17.136,,,percent of total billed charges,17.136% of total billed charges,18.35,21.84,,,percent of total billed charges,21.84% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42,50,,,percent of total billed charges,50% of total Billed charges,65.52,78,,,percent of total billed charges,78% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42,50,,,percent of total billed charges,50% of total Billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,12.85,84,
GLOVE ULTRADERM SIZE 7 1/2,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GLOVES ULTRADERM SIZE 6 1/2,490672,CDM,270,RC,,,Outpatient,,,433,281.45,,381.04,88,,,percent of total billed charges,88% of total Billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,72.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,433,100,,,percent of total billed charges,100% of total billed charges,74.93,17.304,,,percent of total billed charges,17.304% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,272.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,72.74,16.8,,,percent of total billed charges,16.8% of total billed charges,66.25,15.3,,,percent of total billed charges,15.3% of total billed charges,298.77,69,,,percent of total billed charges,69% of total billed charges,433,100,,,percent of total billed charges,100% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,433,100,,,percent of total billed charges,100% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,433,100,,,percent of total billed charges,100% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,267.81,61.85,,,percent of total billed charges,61.85% of total billed charges,72.74,16.8,,,percent of total billed charges,16.8% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,72.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,74.2,17.136,,,percent of total billed charges,17.136% of total billed charges,94.57,21.84,,,percent of total billed charges,21.84% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,216.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,216.5,50,,,percent of total billed charges,50% of total Billed charges,337.74,78,,,percent of total billed charges,78% of total billed charges,433,100,,,percent of total billed charges,100% of total billed charges,357.66,82.6,,,percent of total billed charges,82.6% of total billed charges,357.66,82.6,,,percent of total billed charges,82.6% of total billed charges,72.74,16.8,,,percent of total billed charges,16.8% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,216.5,50,,,percent of total billed charges,50% of total Billed charges,72.74,16.8,,,percent of total billed charges,16.8% of total billed charges,66.25,433,
"GLOVE, PROTEXIS PI SZ 8",490665,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
"GLOVE, PROTEXIS PI SZ 7",490664,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
"GLOVE, PROTEXIS SMT SZ 6",490668,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
"GLOVE, PROTEXIS PI SZ 9",490667,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
"GLOVE, BIOGEL SZ 9",490656,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
"GLOVE, SENSICARE SZ 8 W/ALOE",490671,CDM,270,RC,,,Outpatient,,,510,331.50,,448.8,88,,,percent of total billed charges,88% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,88.25,17.304,,,percent of total billed charges,17.304% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,321.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,78.03,15.3,,,percent of total billed charges,15.3% of total billed charges,351.9,69,,,percent of total billed charges,69% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,315.44,61.85,,,percent of total billed charges,61.85% of total billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,87.39,17.136,,,percent of total billed charges,17.136% of total billed charges,111.38,21.84,,,percent of total billed charges,21.84% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,397.8,78,,,percent of total billed charges,78% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,78.03,510,
"GLOVE, SENSICARE SZ 7 W/ALOE",490670,CDM,270,RC,,,Outpatient,,,510,331.50,,448.8,88,,,percent of total billed charges,88% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,88.25,17.304,,,percent of total billed charges,17.304% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,321.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,78.03,15.3,,,percent of total billed charges,15.3% of total billed charges,351.9,69,,,percent of total billed charges,69% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,315.44,61.85,,,percent of total billed charges,61.85% of total billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,87.39,17.136,,,percent of total billed charges,17.136% of total billed charges,111.38,21.84,,,percent of total billed charges,21.84% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,397.8,78,,,percent of total billed charges,78% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,78.03,510,
"GLOVE, SENSICARE SZ 6.5 W/ALOE",490669,CDM,270,RC,,,Outpatient,,,510,331.50,,448.8,88,,,percent of total billed charges,88% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,88.25,17.304,,,percent of total billed charges,17.304% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,321.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,78.03,15.3,,,percent of total billed charges,15.3% of total billed charges,351.9,69,,,percent of total billed charges,69% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,510,100,,,percent of total billed charges,100% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,315.44,61.85,,,percent of total billed charges,61.85% of total billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,87.39,17.136,,,percent of total billed charges,17.136% of total billed charges,111.38,21.84,,,percent of total billed charges,21.84% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,397.8,78,,,percent of total billed charges,78% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,255,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,255,50,,,percent of total billed charges,50% of total Billed charges,85.68,16.8,,,percent of total billed charges,16.8% of total billed charges,78.03,510,
GLOVE SENSICARE UNDERGLOVE 7.5,490653,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
GLOVE NEU-THERA 7 1/2 PROTEXIS,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
"GLOVE, ORTHOPEDIC SZ 8",490660,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
"GLOVE, PROTEXIS PI ORTHO SZ 7",490662,CDM,270,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
"GLOVE, PROTEXIS PI ORTHO 7 1/2",490661,CDM,270,RC,,,Outpatient,,,584,379.60,,513.92,88,,,percent of total billed charges,88% of total Billed charges,292,50,,,percent of total billed charges,50% of total Billed charges,98.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,584,100,,,percent of total billed charges,100% of total billed charges,101.06,17.304,,,percent of total billed charges,17.304% of total billed charges,292,50,,,percent of total billed charges,50% of total Billed charges,367.92,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.11,16.8,,,percent of total billed charges,16.8% of total billed charges,89.35,15.3,,,percent of total billed charges,15.3% of total billed charges,402.96,69,,,percent of total billed charges,69% of total billed charges,584,100,,,percent of total billed charges,100% of total billed charges,292,50,,,percent of total billed charges,50% of total Billed charges,584,100,,,percent of total billed charges,100% of total billed charges,292,50,,,percent of total billed charges,50% of total Billed charges,584,100,,,percent of total billed charges,100% of total billed charges,292,50,,,percent of total billed charges,50% of total Billed charges,361.2,61.85,,,percent of total billed charges,61.85% of total billed charges,98.11,16.8,,,percent of total billed charges,16.8% of total billed charges,292,50,,,percent of total billed charges,50% of total Billed charges,292,50,,,percent of total billed charges,50% of total Billed charges,98.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,292,50,,,percent of total billed charges,50% of total Billed charges,292,50,,,percent of total billed charges,50% of total Billed charges,100.07,17.136,,,percent of total billed charges,17.136% of total billed charges,127.55,21.84,,,percent of total billed charges,21.84% of total billed charges,292,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292,50,,,percent of total billed charges,50% of total Billed charges,455.52,78,,,percent of total billed charges,78% of total billed charges,584,100,,,percent of total billed charges,100% of total billed charges,482.38,82.6,,,percent of total billed charges,82.6% of total billed charges,482.38,82.6,,,percent of total billed charges,82.6% of total billed charges,98.11,16.8,,,percent of total billed charges,16.8% of total billed charges,292,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292,50,,,percent of total billed charges,50% of total Billed charges,98.11,16.8,,,percent of total billed charges,16.8% of total billed charges,89.35,584,
GLOVE NEU-THERA 8 PROTEXIS,490649,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
GLOVE NEU-THERA 7 PROTEXIS,490648,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
GLOVE BIOGLE PI ORTHO 7.5,490645,CDM,270,RC,,,Outpatient,,,664,431.60,,584.32,88,,,percent of total billed charges,88% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,114.9,17.304,,,percent of total billed charges,17.304% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,418.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,101.59,15.3,,,percent of total billed charges,15.3% of total billed charges,458.16,69,,,percent of total billed charges,69% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,410.68,61.85,,,percent of total billed charges,61.85% of total billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,113.78,17.136,,,percent of total billed charges,17.136% of total billed charges,145.02,21.84,,,percent of total billed charges,21.84% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,517.92,78,,,percent of total billed charges,78% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,101.59,664,
GLOVE SZ 8 PI ORTHO PRO BIOGEL,490654,CDM,270,RC,,,Outpatient,,,664,431.60,,584.32,88,,,percent of total billed charges,88% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,114.9,17.304,,,percent of total billed charges,17.304% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,418.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,101.59,15.3,,,percent of total billed charges,15.3% of total billed charges,458.16,69,,,percent of total billed charges,69% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,410.68,61.85,,,percent of total billed charges,61.85% of total billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,113.78,17.136,,,percent of total billed charges,17.136% of total billed charges,145.02,21.84,,,percent of total billed charges,21.84% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,517.92,78,,,percent of total billed charges,78% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,101.59,664,
GLOVE BIOGEL UNDERGLOVE SZ 8.5,490644,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
GLOVE NEU-THERA 8.5 PROTEXIS,490650,CDM,270,RC,,,Outpatient,,,365,237.25,,321.2,88,,,percent of total billed charges,88% of total Billed charges,182.5,50,,,percent of total billed charges,50% of total Billed charges,61.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,365,100,,,percent of total billed charges,100% of total billed charges,63.16,17.304,,,percent of total billed charges,17.304% of total billed charges,182.5,50,,,percent of total billed charges,50% of total Billed charges,229.95,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,61.32,16.8,,,percent of total billed charges,16.8% of total billed charges,55.85,15.3,,,percent of total billed charges,15.3% of total billed charges,251.85,69,,,percent of total billed charges,69% of total billed charges,365,100,,,percent of total billed charges,100% of total billed charges,182.5,50,,,percent of total billed charges,50% of total Billed charges,365,100,,,percent of total billed charges,100% of total billed charges,182.5,50,,,percent of total billed charges,50% of total Billed charges,365,100,,,percent of total billed charges,100% of total billed charges,182.5,50,,,percent of total billed charges,50% of total Billed charges,225.75,61.85,,,percent of total billed charges,61.85% of total billed charges,61.32,16.8,,,percent of total billed charges,16.8% of total billed charges,182.5,50,,,percent of total billed charges,50% of total Billed charges,182.5,50,,,percent of total billed charges,50% of total Billed charges,61.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,182.5,50,,,percent of total billed charges,50% of total Billed charges,182.5,50,,,percent of total billed charges,50% of total Billed charges,62.55,17.136,,,percent of total billed charges,17.136% of total billed charges,79.72,21.84,,,percent of total billed charges,21.84% of total billed charges,182.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,182.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,182.5,50,,,percent of total billed charges,50% of total Billed charges,284.7,78,,,percent of total billed charges,78% of total billed charges,365,100,,,percent of total billed charges,100% of total billed charges,301.49,82.6,,,percent of total billed charges,82.6% of total billed charges,301.49,82.6,,,percent of total billed charges,82.6% of total billed charges,61.32,16.8,,,percent of total billed charges,16.8% of total billed charges,182.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,182.5,50,,,percent of total billed charges,50% of total Billed charges,61.32,16.8,,,percent of total billed charges,16.8% of total billed charges,55.85,365,
"GLOVE, EXAM SMALL NITRILE",490659,CDM,270,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
"GLOVE, EXAM MEDIUM NITRILE",490658,CDM,270,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
"GLOVE, EXAM LARGE NITRILE",490657,CDM,270,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
GLOVE BIOGEL SYN SURG 6 1/2,490640,CDM,270,RC,,,Outpatient,,,166,107.90,,146.08,88,,,percent of total billed charges,88% of total Billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,27.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,166,100,,,percent of total billed charges,100% of total billed charges,28.72,17.304,,,percent of total billed charges,17.304% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,104.58,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.89,16.8,,,percent of total billed charges,16.8% of total billed charges,25.4,15.3,,,percent of total billed charges,15.3% of total billed charges,114.54,69,,,percent of total billed charges,69% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,166,100,,,percent of total billed charges,100% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,166,100,,,percent of total billed charges,100% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,102.67,61.85,,,percent of total billed charges,61.85% of total billed charges,27.89,16.8,,,percent of total billed charges,16.8% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,27.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,28.45,17.136,,,percent of total billed charges,17.136% of total billed charges,36.25,21.84,,,percent of total billed charges,21.84% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,83,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,83,50,,,percent of total billed charges,50% of total Billed charges,129.48,78,,,percent of total billed charges,78% of total billed charges,166,100,,,percent of total billed charges,100% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,137.12,82.6,,,percent of total billed charges,82.6% of total billed charges,27.89,16.8,,,percent of total billed charges,16.8% of total billed charges,83,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,83,50,,,percent of total billed charges,50% of total Billed charges,27.89,16.8,,,percent of total billed charges,16.8% of total billed charges,25.4,166,
GLOVE BIOGEL LTX FREE SZ 9,490639,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
GLOVE BIOGEL SZ 8 LTX FREE,490643,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
GLOVE BIOGEL SZ 7 SURGEON,490642,CDM,270,RC,,,Outpatient,,,452,293.80,,397.76,88,,,percent of total billed charges,88% of total Billed charges,226,50,,,percent of total billed charges,50% of total Billed charges,75.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,452,100,,,percent of total billed charges,100% of total billed charges,78.21,17.304,,,percent of total billed charges,17.304% of total billed charges,226,50,,,percent of total billed charges,50% of total Billed charges,284.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.94,16.8,,,percent of total billed charges,16.8% of total billed charges,69.16,15.3,,,percent of total billed charges,15.3% of total billed charges,311.88,69,,,percent of total billed charges,69% of total billed charges,452,100,,,percent of total billed charges,100% of total billed charges,226,50,,,percent of total billed charges,50% of total Billed charges,452,100,,,percent of total billed charges,100% of total billed charges,226,50,,,percent of total billed charges,50% of total Billed charges,452,100,,,percent of total billed charges,100% of total billed charges,226,50,,,percent of total billed charges,50% of total Billed charges,279.56,61.85,,,percent of total billed charges,61.85% of total billed charges,75.94,16.8,,,percent of total billed charges,16.8% of total billed charges,226,50,,,percent of total billed charges,50% of total Billed charges,226,50,,,percent of total billed charges,50% of total Billed charges,75.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,226,50,,,percent of total billed charges,50% of total Billed charges,226,50,,,percent of total billed charges,50% of total Billed charges,77.45,17.136,,,percent of total billed charges,17.136% of total billed charges,98.72,21.84,,,percent of total billed charges,21.84% of total billed charges,226,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,226,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,226,50,,,percent of total billed charges,50% of total Billed charges,352.56,78,,,percent of total billed charges,78% of total billed charges,452,100,,,percent of total billed charges,100% of total billed charges,373.35,82.6,,,percent of total billed charges,82.6% of total billed charges,373.35,82.6,,,percent of total billed charges,82.6% of total billed charges,75.94,16.8,,,percent of total billed charges,16.8% of total billed charges,226,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,226,50,,,percent of total billed charges,50% of total Billed charges,75.94,16.8,,,percent of total billed charges,16.8% of total billed charges,69.16,452,
GLOVE BIOGEL SZ 7 1/2 SURG LF,490641,CDM,270,RC,,,Outpatient,,,664,431.60,,584.32,88,,,percent of total billed charges,88% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,114.9,17.304,,,percent of total billed charges,17.304% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,418.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,101.59,15.3,,,percent of total billed charges,15.3% of total billed charges,458.16,69,,,percent of total billed charges,69% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,410.68,61.85,,,percent of total billed charges,61.85% of total billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,113.78,17.136,,,percent of total billed charges,17.136% of total billed charges,145.02,21.84,,,percent of total billed charges,21.84% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,517.92,78,,,percent of total billed charges,78% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,101.59,664,
GLOVE SURG SENSICARE ALOE LF SZ 8.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
GLOVE SENSICARE PI SURGICAL LF SIZE 9,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLOVE SENSICARE NEOPRENE SURGICAL PF LF SIZE9,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLOVE SENSICARE PI GREEN  PF LF SIZE 6,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLOVE SENSICARE PI GREEN PF LF SIZE 6.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLOVE SENSICARE PI GREEN PF LF SIZE 7,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLOVE SENSICARE PI GREEN PF LF SIZE 7.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLOVE SENSICARE PI GREEN PF LF SIZE 8,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLOVE SENSICARE PI GREEN PF LF SIZE 8.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLOVE SENSICARE PI SLT LF SIZE 6,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLOVE SENSICARE PI SLT LF SIZE 6.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
"GLOW AND TELL TAPE, VASCUTAPE",ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
GLUCOSE CONTROL INFORM II,490674,CDM,270,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
GLUCOSE DRINK 50GM ORANGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLUCOSE DRINK 75GM ORANGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLUCOSE DRINK 100GM ORANGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GLYCINE 1.5% 3000ML 2B7317,490675,CDM,270,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
"GOODE EAR T-TUBE MODIFIED,",ORSUP0007,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GOWN SLEEVE STERILE W/CSR WRAP 1/P,76844,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
GOWN SURG XL FABRIC REINFORCED AURORA,202422,CDM,270,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
GOWN SURG LG FABRIC REINFORCED AURORA,202423,CDM,270,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
GOWN REINFORCED XXLARGE,206807,CDM,270,RC,,,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
GOWN FLEXIBLE BLUE BAIR PAWS 51 X 64,312363,CDM,270,RC,,,Outpatient,,,129,83.85,,113.52,88,,,percent of total billed charges,88% of total Billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,21.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,129,100,,,percent of total billed charges,100% of total billed charges,22.32,17.304,,,percent of total billed charges,17.304% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,81.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.67,16.8,,,percent of total billed charges,16.8% of total billed charges,19.74,15.3,,,percent of total billed charges,15.3% of total billed charges,89.01,69,,,percent of total billed charges,69% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,129,100,,,percent of total billed charges,100% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,129,100,,,percent of total billed charges,100% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,79.79,61.85,,,percent of total billed charges,61.85% of total billed charges,21.67,16.8,,,percent of total billed charges,16.8% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,21.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,22.11,17.136,,,percent of total billed charges,17.136% of total billed charges,28.17,21.84,,,percent of total billed charges,21.84% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,64.5,50,,,percent of total billed charges,50% of total Billed charges,100.62,78,,,percent of total billed charges,78% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,21.67,16.8,,,percent of total billed charges,16.8% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,64.5,50,,,percent of total billed charges,50% of total Billed charges,21.67,16.8,,,percent of total billed charges,16.8% of total billed charges,19.74,129,
GOWN SURGICAL SMALL ECLIPSE,245422,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
GOWN PREVENTION PLUS XLONG/XLARGE STRL,13998,CDM,270,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
GOWN FLEXIBLE BLUE BAIR PAWS XL 51 X 122,313143,CDM,270,RC,,,Outpatient,,,158,102.70,,139.04,88,,,percent of total billed charges,88% of total Billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,26.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,158,100,,,percent of total billed charges,100% of total billed charges,27.34,17.304,,,percent of total billed charges,17.304% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,99.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,26.54,16.8,,,percent of total billed charges,16.8% of total billed charges,24.17,15.3,,,percent of total billed charges,15.3% of total billed charges,109.02,69,,,percent of total billed charges,69% of total billed charges,158,100,,,percent of total billed charges,100% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,158,100,,,percent of total billed charges,100% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,158,100,,,percent of total billed charges,100% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,97.72,61.85,,,percent of total billed charges,61.85% of total billed charges,26.54,16.8,,,percent of total billed charges,16.8% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,26.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,27.07,17.136,,,percent of total billed charges,17.136% of total billed charges,34.51,21.84,,,percent of total billed charges,21.84% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,79,50,,,percent of total billed charges,50% of total Billed charges,123.24,78,,,percent of total billed charges,78% of total billed charges,158,100,,,percent of total billed charges,100% of total billed charges,130.51,82.6,,,percent of total billed charges,82.6% of total billed charges,130.51,82.6,,,percent of total billed charges,82.6% of total billed charges,26.54,16.8,,,percent of total billed charges,16.8% of total billed charges,79,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,79,50,,,percent of total billed charges,50% of total Billed charges,26.54,16.8,,,percent of total billed charges,16.8% of total billed charges,24.17,158,
GOWN HYDROTHERAPY XL,188003,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
GOWN ISOLATION,443099,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
GOWN ISOLATION  SIDE TIES,464231,CDM,270,RC,,,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,10.21,17.304,,,percent of total billed charges,17.304% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,37.17,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,15.3,,,percent of total billed charges,15.3% of total billed charges,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,36.49,61.85,,,percent of total billed charges,61.85% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,10.11,17.136,,,percent of total billed charges,17.136% of total billed charges,12.89,21.84,,,percent of total billed charges,21.84% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,59,
GOWN ISOLATION BLUE X-LARGE,431549,CDM,270,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
GOWN ROYALSILK LARGE,321602,CDM,270,RC,,,Outpatient,,,370,240.50,,325.6,88,,,percent of total billed charges,88% of total Billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,62.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,370,100,,,percent of total billed charges,100% of total billed charges,64.02,17.304,,,percent of total billed charges,17.304% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,233.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,62.16,16.8,,,percent of total billed charges,16.8% of total billed charges,56.61,15.3,,,percent of total billed charges,15.3% of total billed charges,255.3,69,,,percent of total billed charges,69% of total billed charges,370,100,,,percent of total billed charges,100% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,370,100,,,percent of total billed charges,100% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,370,100,,,percent of total billed charges,100% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,228.85,61.85,,,percent of total billed charges,61.85% of total billed charges,62.16,16.8,,,percent of total billed charges,16.8% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,62.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,63.4,17.136,,,percent of total billed charges,17.136% of total billed charges,80.81,21.84,,,percent of total billed charges,21.84% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,185,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,185,50,,,percent of total billed charges,50% of total Billed charges,288.6,78,,,percent of total billed charges,78% of total billed charges,370,100,,,percent of total billed charges,100% of total billed charges,305.62,82.6,,,percent of total billed charges,82.6% of total billed charges,305.62,82.6,,,percent of total billed charges,82.6% of total billed charges,62.16,16.8,,,percent of total billed charges,16.8% of total billed charges,185,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,185,50,,,percent of total billed charges,50% of total Billed charges,62.16,16.8,,,percent of total billed charges,16.8% of total billed charges,56.61,370,
GOWN SURG XXL XLONG IMPERVIOUS BREATHABLE,9272,CDM,270,RC,,,Outpatient,,,71,46.15,,62.48,88,,,percent of total billed charges,88% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,12.29,17.304,,,percent of total billed charges,17.304% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,44.73,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,10.86,15.3,,,percent of total billed charges,15.3% of total billed charges,48.99,69,,,percent of total billed charges,69% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,43.91,61.85,,,percent of total billed charges,61.85% of total billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,12.17,17.136,,,percent of total billed charges,17.136% of total billed charges,15.51,21.84,,,percent of total billed charges,21.84% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,55.38,78,,,percent of total billed charges,78% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,10.86,71,
GOWNS LATEX-FREE ISOLATION,130657,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
"GOWN, SURGICAL XL STERILE",490685,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
"GOWN, LARGE STERILE",490683,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
"GOWN, MICROCOOL SPECIALTY XLG",490684,CDM,270,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
GOWN IMPERV XL ISOLATION,490677,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
GOWN ISOLATION YELLOW UNIVERSL,490679,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
GOWN IMPERVIOUS BLUE ISOLATION,490678,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
GOWN SIZE LARGE,490680,CDM,270,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
GOWN SIZE XL,490681,CDM,270,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
GOWN XLONG SIZE XL,490682,CDM,270,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
GOWN SURGICAL LRG STERILE AURORA,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GOWN SURGICAL XL STERILE AURORA,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GOWN CHEMO IMPERVIOUS BLUE UNIVERSAL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GOWN CHEMO IMPERVIOUS BLUE XLARGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GOWN CHEMOPLUS BLUE MED,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GOWN CHEMO BREATHABLE FILM KNIT CUFFS BLUE LRG,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
GRABBER GRASPER TIP,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
GRABBER TIP DISPOSABLE,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
GRAFTBOLT TIBIAL 8MM,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
GRAFT - GRAFTLINK,ORSUP0058,CDM,278,RC,C1762,HCPCS,Outpatient,,,12480,8112.00,,10982.4,88,,,percent of total billed charges,88% of total Billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,2096.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2159.54,17.304,,,percent of total billed charges,17.304% of total billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,7862.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2096.64,16.8,,,percent of total billed charges,16.8% of total billed charges,1909.44,15.3,,,percent of total billed charges,15.3% of total billed charges,8611.2,69,,,percent of total billed charges,69% of total billed charges,12480,100,,,percent of total billed charges,100% of total billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,12480,100,,,percent of total billed charges,100% of total billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,12480,100,,,percent of total billed charges,100% of total billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,7718.88,61.85,,,percent of total billed charges,61.85% of total billed charges,2096.64,16.8,,,percent of total billed charges,16.8% of total billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,3893.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6240,50,,,percent of total billed charges,50% of total Billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,2138.57,17.136,,,percent of total billed charges,17.136% of total billed charges,2725.63,21.84,,,percent of total billed charges,21.84% of total billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,4704.96,37.7,,,percent of total billed charges,37.70% of total billed charges,4704.96,37.7,,,percent of total billed charges,37.70% of total billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,4230.72,33.9,,,percent of total billed charges,33.9% of total billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,9734.4,78,,,percent of total billed charges,78% of total billed charges,12480,100,,,percent of total billed charges,100% of total billed charges,10308.48,82.6,,,percent of total billed charges,82.6% of total billed charges,10308.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2096.64,16.8,,,percent of total billed charges,16.8% of total billed charges,6240,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6240,50,,,percent of total billed charges,50% of total Billed charges,2096.64,16.8,,,percent of total billed charges,16.8% of total billed charges,1909.44,12480,
GRAFT BN FEM HD SM FRZDR ASEP 44MM,ORSUP0035,CDM,278,RC,C1762,HCPCS,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
GRAFT BN FRZDR CNFRM CB 17MM,ORSUP0027,CDM,278,RC,C1762,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
GRAFT VASC BOVINE COLLGN 7MMX40CM,ORSUP0036,CDM,278,RC,C1763,HCPCS,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4095,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
GRAFT CV FELT PTFE 6X6IN 15X15CM,ORSUP0020,CDM,278,RC,C1781,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
GRAFT TISSUE REPAIR XENFORM,ORSUP0042,CDM,278,RC,C1763,HCPCS,Outpatient,,,8060,5239.00,,7092.8,88,,,percent of total billed charges,88% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1394.7,17.304,,,percent of total billed charges,17.304% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,5077.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,15.3,,,percent of total billed charges,15.3% of total billed charges,5561.4,69,,,percent of total billed charges,69% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4985.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2514.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1381.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1760.3,21.84,,,percent of total billed charges,21.84% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2732.34,33.9,,,percent of total billed charges,33.9% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,6286.8,78,,,percent of total billed charges,78% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,8060,
GRAFT BONE BIOACTIVE SUBSITIUTE VITOSS BA,ORSUP0045,CDM,278,RC,C1763,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5569.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
GRAFT BOVINE 6 X 30 STANDARD,ORSUP0035,CDM,278,RC,C1763,HCPCS,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
GRAFT DISTAFLO 6MM X 80CM,ORSUP0047,CDM,278,RC,C1768,HCPCS,Outpatient,,,9360,6084.00,,8236.8,88,,,percent of total billed charges,88% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1619.65,17.304,,,percent of total billed charges,17.304% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,5896.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1432.08,15.3,,,percent of total billed charges,15.3% of total billed charges,6458.4,69,,,percent of total billed charges,69% of total billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,5789.16,61.85,,,percent of total billed charges,61.85% of total billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,2920.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4680,50,,,percent of total billed charges,50% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,1603.93,17.136,,,percent of total billed charges,17.136% of total billed charges,2044.22,21.84,,,percent of total billed charges,21.84% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,3528.72,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.72,37.7,,,percent of total billed charges,37.70% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,3173.04,33.9,,,percent of total billed charges,33.9% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,7300.8,78,,,percent of total billed charges,78% of total billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,7731.36,82.6,,,percent of total billed charges,82.6% of total billed charges,7731.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4680,50,,,percent of total billed charges,50% of total Billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1432.08,9360,
GRAFT FLEX 8X70 CM,ORSUP0036,CDM,278,RC,C1768,HCPCS,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4095,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
GRAFT FLEX 6MM,ORSUP0033,CDM,278,RC,C1768,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
GRAFT VASCULAR IMPRA 7 X 10,ORSUP0012,CDM,278,RC,C1768,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
GRAFT HEMASHIELD 28MMX15CM,ORSUP0017,CDM,278,RC,C1768,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
GRAFT 10MM X 15CM HEMASHIELD,ORSUP0017,CDM,278,RC,C1768,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
GRAFT 32MM X 15CM HEMASHIELD,ORSUP0017,CDM,278,RC,C1768,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
GRAFT CV 15CMX18MM HMSH G MCVL DBL VLR M002020951080,ORSUP0016,CDM,278,RC,C1768,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
GRAFT HEMASHIELD 14 X 8 AORTIC VASCULAR BIFUREATED,ORSUP0023,CDM,278,RC,C1768,HCPCS,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,973.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1057.68,33.9,,,percent of total billed charges,33.9% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
GRAFT HEMASHIELD 16 X 8,ORSUP0022,CDM,278,RC,C1768,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
GRAFT HEMASHIELD 18 X 9,ORSUP0025,CDM,278,RC,C1768,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
GRAFT HEMASHIELD 28MM X 10MM X 50CM,ORSUP0042,CDM,278,RC,C1768,HCPCS,Outpatient,,,8060,5239.00,,7092.8,88,,,percent of total billed charges,88% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1394.7,17.304,,,percent of total billed charges,17.304% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,5077.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,15.3,,,percent of total billed charges,15.3% of total billed charges,5561.4,69,,,percent of total billed charges,69% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4985.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2514.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1381.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1760.3,21.84,,,percent of total billed charges,21.84% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2732.34,33.9,,,percent of total billed charges,33.9% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,6286.8,78,,,percent of total billed charges,78% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,8060,
GRAFT HEMASHIELD 30MM X 10MM X 50CM,ORSUP0042,CDM,278,RC,C1768,HCPCS,Outpatient,,,8060,5239.00,,7092.8,88,,,percent of total billed charges,88% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1394.7,17.304,,,percent of total billed charges,17.304% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,5077.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,15.3,,,percent of total billed charges,15.3% of total billed charges,5561.4,69,,,percent of total billed charges,69% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4985.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2514.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1381.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1760.3,21.84,,,percent of total billed charges,21.84% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2732.34,33.9,,,percent of total billed charges,33.9% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,6286.8,78,,,percent of total billed charges,78% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,8060,
GRAFT HEMASHIELD 32MM X 10MM X 50CM,ORSUP0042,CDM,278,RC,C1768,HCPCS,Outpatient,,,8060,5239.00,,7092.8,88,,,percent of total billed charges,88% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1394.7,17.304,,,percent of total billed charges,17.304% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,5077.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,15.3,,,percent of total billed charges,15.3% of total billed charges,5561.4,69,,,percent of total billed charges,69% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4985.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2514.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1381.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1760.3,21.84,,,percent of total billed charges,21.84% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2732.34,33.9,,,percent of total billed charges,33.9% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,6286.8,78,,,percent of total billed charges,78% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,8060,
GRAFT HEMASHIELD 34MM X 10MM X50CM,ORSUP0042,CDM,278,RC,C1768,HCPCS,Outpatient,,,8060,5239.00,,7092.8,88,,,percent of total billed charges,88% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1394.7,17.304,,,percent of total billed charges,17.304% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,5077.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,15.3,,,percent of total billed charges,15.3% of total billed charges,5561.4,69,,,percent of total billed charges,69% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4985.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2514.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1381.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1760.3,21.84,,,percent of total billed charges,21.84% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2732.34,33.9,,,percent of total billed charges,33.9% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,6286.8,78,,,percent of total billed charges,78% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,8060,
GRAFT KNITTED DBL VELOUR 24MM X 15CM,ORSUP0017,CDM,278,RC,C1768,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
GRAFT VAS 8MM X 60CM HEMASHLD KNITTED DBL VLR,ORSUP0020,CDM,278,RC,C1768,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
GRAFT VAS BIF 20 X 10 X 40CM HEMASHLD KNITTED DBL VLR,ORSUP0029,CDM,278,RC,C1768,HCPCS,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1460.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1586.52,33.9,,,percent of total billed charges,33.9% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
GRAFT VASC WOVEN 30MM X 15CM,ORSUP0020,CDM,278,RC,C1768,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
GRAFT VASCULAR 6MM X 10CM,ORSUP0019,CDM,278,RC,C1768,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
GRAFT/STRIP DBX FLEX,ORSUP0015,CDM,278,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
GRAFT JACKET TENDON REPAIR,ORSUP0125,CDM,636,RC,Q4107,HCPCS,Outpatient,,,30160,19604.00,,26540.8,88,,,percent of total billed charges,88% of total Billed charges,15080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,15080,50,,,percent of total billed charges,50% of total Billed charges,19000.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",4614.48,15.3,,,percent of total billed charges,15.3% of total billed charges,20810.4,69,,,percent of total billed charges,69% of total billed charges,30160,100,,,percent of total billed charges,100% of total billed charges,15080,50,,,percent of total billed charges,50% of total Billed charges,30160,100,,,percent of total billed charges,100% of total billed charges,15080,50,,,percent of total billed charges,50% of total Billed charges,30160,100,,,percent of total billed charges,100% of total billed charges,15080,50,,,percent of total billed charges,50% of total Billed charges,18653.96,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,15080,50,,,percent of total billed charges,50% of total Billed charges,15080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15080,50,,,percent of total billed charges,50% of total Billed charges,15080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15080,50,,,percent of total billed charges,50% of total Billed charges,11370.32,37.7,,,percent of total billed charges,37.70% of total billed charges,11370.32,37.7,,,percent of total billed charges,37.70% of total billed charges,15080,50,,,percent of total billed charges,50% of total Billed charges,10224.24,33.9,,,percent of total billed charges,33.9% of total billed charges,15080,50,,,percent of total billed charges,50% of total Billed charges,23524.8,78,,,percent of total billed charges,78% of total billed charges,30160,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",4614.48,30160,
GRAFT SURGISIS GOLD 7 X 20,ORSUP0005,CDM,278,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GRAFT SURGISIS 20 X 20,ORSUP0009,CDM,278,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
GRAFT SURGISIS 7 X 10 1S,ORSUP0016,CDM,278,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
GRAFT SURGISIS GOLD 13 X 22,ORSUP0014,CDM,278,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
GRAFT JACKET MAXFORCE 4 X 7 CM,ORSUP0015,CDM,278,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
GRAFT HERNIA REPAIR COLLEMED,ORSUP0015,CDM,278,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
GRAFT GORTEX 8MM X 50CM,ORSUP0011,CDM,278,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GRAFT GORTEX 20MM X 40CM,ORSUP0015,CDM,278,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
GRAFT GORTEX 16MM X 40CM,ORSUP0015,CDM,278,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
GRAFT GORTEX 6MM X 70CM,ORSUP0011,CDM,278,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GRAFT BIODESIGN OTO 2.5 X 2.5,ORSUP0016,CDM,278,RC,C1763,HCPCS,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,199,17.304,,,percent of total billed charges,17.304% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,724.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,15.3,,,percent of total billed charges,15.3% of total billed charges,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,711.28,61.85,,,percent of total billed charges,61.85% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,358.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,197.06,17.136,,,percent of total billed charges,17.136% of total billed charges,251.16,21.84,,,percent of total billed charges,21.84% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,389.85,33.9,,,percent of total billed charges,33.9% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,1150,
GRAFT VITOSS BIMODAL FOAM PACK 10CC,ORSUP0054,CDM,278,RC,C1763,HCPCS,Outpatient,,,11180,7267.00,,9838.4,88,,,percent of total billed charges,88% of total Billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1934.59,17.304,,,percent of total billed charges,17.304% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,7043.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,1710.54,15.3,,,percent of total billed charges,15.3% of total billed charges,7714.2,69,,,percent of total billed charges,69% of total billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,6914.83,61.85,,,percent of total billed charges,61.85% of total billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,3488.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5590,50,,,percent of total billed charges,50% of total Billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,1915.8,17.136,,,percent of total billed charges,17.136% of total billed charges,2441.71,21.84,,,percent of total billed charges,21.84% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,4214.86,37.7,,,percent of total billed charges,37.70% of total billed charges,4214.86,37.7,,,percent of total billed charges,37.70% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,3790.02,33.9,,,percent of total billed charges,33.9% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,8720.4,78,,,percent of total billed charges,78% of total billed charges,11180,100,,,percent of total billed charges,100% of total billed charges,9234.68,82.6,,,percent of total billed charges,82.6% of total billed charges,9234.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,5590,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5590,50,,,percent of total billed charges,50% of total Billed charges,1878.24,16.8,,,percent of total billed charges,16.8% of total billed charges,1710.54,11180,
GRAFT IFUSE BONE MEDIUM,ORSUP0193,CDM,278,RC,C1762,HCPCS,Outpatient,,,32600,21190.00,,28688,88,,,percent of total billed charges,88% of total Billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,5476.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5641.1,17.304,,,percent of total billed charges,17.304% of total billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,20538,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5476.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4987.8,15.3,,,percent of total billed charges,15.3% of total billed charges,22494,69,,,percent of total billed charges,69% of total billed charges,32600,100,,,percent of total billed charges,100% of total billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,32600,100,,,percent of total billed charges,100% of total billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,32600,100,,,percent of total billed charges,100% of total billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,20163.1,61.85,,,percent of total billed charges,61.85% of total billed charges,5476.8,16.8,,,percent of total billed charges,16.8% of total billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,10171.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16300,50,,,percent of total billed charges,50% of total Billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,5586.34,17.136,,,percent of total billed charges,17.136% of total billed charges,7119.84,21.84,,,percent of total billed charges,21.84% of total billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,12290.2,37.7,,,percent of total billed charges,37.70% of total billed charges,12290.2,37.7,,,percent of total billed charges,37.70% of total billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,11051.4,33.9,,,percent of total billed charges,33.9% of total billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,25428,78,,,percent of total billed charges,78% of total billed charges,32600,100,,,percent of total billed charges,100% of total billed charges,26927.6,82.6,,,percent of total billed charges,82.6% of total billed charges,26927.6,82.6,,,percent of total billed charges,82.6% of total billed charges,5476.8,16.8,,,percent of total billed charges,16.8% of total billed charges,16300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16300,50,,,percent of total billed charges,50% of total Billed charges,5476.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,32600,
GRAFIX PRIME DISC 16 MM,636Q413316,CDM,636,RC,Q4133,HCPCS,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,881.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",397.8,2600,
GRAFIX PRIME 2X3 CM,636Q413323,CDM,636,RC,Q4133,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",875.16,5720,
GRAFIX PRIME 3X4 CM,636Q413334,CDM,636,RC,Q4133,HCPCS,Outpatient,,,6600,4290.00,,5808,88,,,percent of total billed charges,88% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,4158,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1009.8,15.3,,,percent of total billed charges,15.3% of total billed charges,4554,69,,,percent of total billed charges,69% of total billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,4082.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,2488.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2488.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,2237.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,5148,78,,,percent of total billed charges,78% of total billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1009.8,6600,
GRAFT GRACILIS D=5.5 L-280MM,ORSUP0037,CDM,278,RC,C1763,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
GRAFT VIVIGEN GRAFT,ORSUP0074,CDM,278,RC,C1763,HCPCS,Outpatient,,,14560,9464.00,,12812.8,88,,,percent of total billed charges,88% of total Billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,2446.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2519.46,17.304,,,percent of total billed charges,17.304% of total billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,9172.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2446.08,16.8,,,percent of total billed charges,16.8% of total billed charges,2227.68,15.3,,,percent of total billed charges,15.3% of total billed charges,10046.4,69,,,percent of total billed charges,69% of total billed charges,14560,100,,,percent of total billed charges,100% of total billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,14560,100,,,percent of total billed charges,100% of total billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,14560,100,,,percent of total billed charges,100% of total billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,9005.36,61.85,,,percent of total billed charges,61.85% of total billed charges,2446.08,16.8,,,percent of total billed charges,16.8% of total billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,4542.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7280,50,,,percent of total billed charges,50% of total Billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,2495,17.136,,,percent of total billed charges,17.136% of total billed charges,3179.9,21.84,,,percent of total billed charges,21.84% of total billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,5489.12,37.7,,,percent of total billed charges,37.70% of total billed charges,5489.12,37.7,,,percent of total billed charges,37.70% of total billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,4935.84,33.9,,,percent of total billed charges,33.9% of total billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,11356.8,78,,,percent of total billed charges,78% of total billed charges,14560,100,,,percent of total billed charges,100% of total billed charges,12026.56,82.6,,,percent of total billed charges,82.6% of total billed charges,12026.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2446.08,16.8,,,percent of total billed charges,16.8% of total billed charges,7280,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7280,50,,,percent of total billed charges,50% of total Billed charges,2446.08,16.8,,,percent of total billed charges,16.8% of total billed charges,2227.68,14560,
GRAFT INFUSE BONE SMALL,ORSUP0096,CDM,278,RC,C1762,HCPCS,Outpatient,,,22620,14703.00,,19905.6,88,,,percent of total billed charges,88% of total Billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,3800.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3914.16,17.304,,,percent of total billed charges,17.304% of total billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,14250.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3800.16,16.8,,,percent of total billed charges,16.8% of total billed charges,3460.86,15.3,,,percent of total billed charges,15.3% of total billed charges,15607.8,69,,,percent of total billed charges,69% of total billed charges,22620,100,,,percent of total billed charges,100% of total billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,22620,100,,,percent of total billed charges,100% of total billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,22620,100,,,percent of total billed charges,100% of total billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,13990.47,61.85,,,percent of total billed charges,61.85% of total billed charges,3800.16,16.8,,,percent of total billed charges,16.8% of total billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,7057.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11310,50,,,percent of total billed charges,50% of total Billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,3876.16,17.136,,,percent of total billed charges,17.136% of total billed charges,4940.21,21.84,,,percent of total billed charges,21.84% of total billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,8527.74,37.7,,,percent of total billed charges,37.70% of total billed charges,8527.74,37.7,,,percent of total billed charges,37.70% of total billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,7668.18,33.9,,,percent of total billed charges,33.9% of total billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,17643.6,78,,,percent of total billed charges,78% of total billed charges,22620,100,,,percent of total billed charges,100% of total billed charges,18684.12,82.6,,,percent of total billed charges,82.6% of total billed charges,18684.12,82.6,,,percent of total billed charges,82.6% of total billed charges,3800.16,16.8,,,percent of total billed charges,16.8% of total billed charges,11310,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11310,50,,,percent of total billed charges,50% of total Billed charges,3800.16,16.8,,,percent of total billed charges,16.8% of total billed charges,3460.86,22620,
GRAFT INFUSE BONE LARGE,ORSUP0141,CDM,278,RC,C1762,HCPCS,Outpatient,,,34320,22308.00,,30201.6,88,,,percent of total billed charges,88% of total Billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,5765.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5938.73,17.304,,,percent of total billed charges,17.304% of total billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,21621.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5765.76,16.8,,,percent of total billed charges,16.8% of total billed charges,5250.96,15.3,,,percent of total billed charges,15.3% of total billed charges,23680.8,69,,,percent of total billed charges,69% of total billed charges,34320,100,,,percent of total billed charges,100% of total billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,34320,100,,,percent of total billed charges,100% of total billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,34320,100,,,percent of total billed charges,100% of total billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,21226.92,61.85,,,percent of total billed charges,61.85% of total billed charges,5765.76,16.8,,,percent of total billed charges,16.8% of total billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,10707.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17160,50,,,percent of total billed charges,50% of total Billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,5881.08,17.136,,,percent of total billed charges,17.136% of total billed charges,7495.49,21.84,,,percent of total billed charges,21.84% of total billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,12938.64,37.7,,,percent of total billed charges,37.70% of total billed charges,12938.64,37.7,,,percent of total billed charges,37.70% of total billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,11634.48,33.9,,,percent of total billed charges,33.9% of total billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,26769.6,78,,,percent of total billed charges,78% of total billed charges,34320,100,,,percent of total billed charges,100% of total billed charges,28348.32,82.6,,,percent of total billed charges,82.6% of total billed charges,28348.32,82.6,,,percent of total billed charges,82.6% of total billed charges,5765.76,16.8,,,percent of total billed charges,16.8% of total billed charges,17160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17160,50,,,percent of total billed charges,50% of total Billed charges,5765.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,34320,
GRAFCO INFANT MEASURING TAPE PAPER 36IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GRAFIX PL PRIME 3X3 CM,636Q4133PL33,CDM,636,RC,Q4133,HCPCS,Outpatient,,,6000,3900.00,,5280,88,,,percent of total billed charges,88% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,3780,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",918,15.3,,,percent of total billed charges,15.3% of total billed charges,4140,69,,,percent of total billed charges,69% of total billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,3711,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,2262,37.7,,,percent of total billed charges,37.70% of total billed charges,2262,37.7,,,percent of total billed charges,37.70% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,2034,33.9,,,percent of total billed charges,33.9% of total billed charges,3000,50,,,percent of total billed charges,50% of total Billed charges,4680,78,,,percent of total billed charges,78% of total billed charges,6000,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",918,6000,
GRAFIX PL PRIME 3X4 CM,636Q4133PL34,CDM,636,RC,Q4133,HCPCS,Outpatient,,,6600,4290.00,,5808,88,,,percent of total billed charges,88% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,4158,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1009.8,15.3,,,percent of total billed charges,15.3% of total billed charges,4554,69,,,percent of total billed charges,69% of total billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,4082.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,2488.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2488.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,2237.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,5148,78,,,percent of total billed charges,78% of total billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1009.8,6600,
GRAFIX PL PRIME DISC 16 MM,636Q4133PL16,CDM,636,RC,Q4133,HCPCS,Outpatient,,,2400,1560.00,,2112,88,,,percent of total billed charges,88% of total Billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2400,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1200,50,,,percent of total billed charges,50% of total Billed charges,1512,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",367.2,15.3,,,percent of total billed charges,15.3% of total billed charges,1656,69,,,percent of total billed charges,69% of total billed charges,2400,100,,,percent of total billed charges,100% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,2400,100,,,percent of total billed charges,100% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,2400,100,,,percent of total billed charges,100% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,1484.4,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1200,50,,,percent of total billed charges,50% of total Billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1200,50,,,percent of total billed charges,50% of total Billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1200,50,,,percent of total billed charges,50% of total Billed charges,904.8,37.7,,,percent of total billed charges,37.70% of total billed charges,904.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,813.6,33.9,,,percent of total billed charges,33.9% of total billed charges,1200,50,,,percent of total billed charges,50% of total Billed charges,1872,78,,,percent of total billed charges,78% of total billed charges,2400,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",367.2,2400,
GRAM DECOLORIZER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION CRYSTAL VIOLET,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GRAM IODINE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
GRAM SAFRANIN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STOCKNG TED THIGH SM LNG,ORSUP0006,CDM,270,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
GRASPER SUT 30 DEGREE 1/EA,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
GRASPER 5MM FUNDUS,408634,CDM,272,RC,,,Outpatient,,,3762,2445.30,,3310.56,88,,,percent of total billed charges,88% of total Billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,632.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,3762,100,,,percent of total billed charges,100% of total billed charges,650.98,17.304,,,percent of total billed charges,17.304% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,2370.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,632.02,16.8,,,percent of total billed charges,16.8% of total billed charges,575.59,15.3,,,percent of total billed charges,15.3% of total billed charges,2595.78,69,,,percent of total billed charges,69% of total billed charges,3762,100,,,percent of total billed charges,100% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,3762,100,,,percent of total billed charges,100% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,3762,100,,,percent of total billed charges,100% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,2326.8,61.85,,,percent of total billed charges,61.85% of total billed charges,632.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,632.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,644.66,17.136,,,percent of total billed charges,17.136% of total billed charges,821.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1881,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1881,50,,,percent of total billed charges,50% of total Billed charges,2934.36,78,,,percent of total billed charges,78% of total billed charges,3762,100,,,percent of total billed charges,100% of total billed charges,3107.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3107.41,82.6,,,percent of total billed charges,82.6% of total billed charges,632.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1881,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1881,50,,,percent of total billed charges,50% of total Billed charges,632.02,16.8,,,percent of total billed charges,16.8% of total billed charges,575.59,3762,
GRASPER CROCODILE 5MM DA VINCI,337817,CDM,272,RC,,,Outpatient,,,3582,2328.30,,3152.16,88,,,percent of total billed charges,88% of total Billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,601.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,3582,100,,,percent of total billed charges,100% of total billed charges,619.83,17.304,,,percent of total billed charges,17.304% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,2256.66,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,601.78,16.8,,,percent of total billed charges,16.8% of total billed charges,548.05,15.3,,,percent of total billed charges,15.3% of total billed charges,2471.58,69,,,percent of total billed charges,69% of total billed charges,3582,100,,,percent of total billed charges,100% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,3582,100,,,percent of total billed charges,100% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,3582,100,,,percent of total billed charges,100% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,2215.47,61.85,,,percent of total billed charges,61.85% of total billed charges,601.78,16.8,,,percent of total billed charges,16.8% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,601.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,613.81,17.136,,,percent of total billed charges,17.136% of total billed charges,782.31,21.84,,,percent of total billed charges,21.84% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1791,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1791,50,,,percent of total billed charges,50% of total Billed charges,2793.96,78,,,percent of total billed charges,78% of total billed charges,3582,100,,,percent of total billed charges,100% of total billed charges,2958.73,82.6,,,percent of total billed charges,82.6% of total billed charges,2958.73,82.6,,,percent of total billed charges,82.6% of total billed charges,601.78,16.8,,,percent of total billed charges,16.8% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1791,50,,,percent of total billed charges,50% of total Billed charges,601.78,16.8,,,percent of total billed charges,16.8% of total billed charges,548.05,3582,
GRASPER ENDOWRIST PROGRASP DA VINCI,173496,CDM,272,RC,,,Outpatient,,,10878,7070.70,,9572.64,88,,,percent of total billed charges,88% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1882.33,17.304,,,percent of total billed charges,17.304% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,6853.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1664.33,15.3,,,percent of total billed charges,15.3% of total billed charges,7505.82,69,,,percent of total billed charges,69% of total billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,6728.04,61.85,,,percent of total billed charges,61.85% of total billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,1864.05,17.136,,,percent of total billed charges,17.136% of total billed charges,2375.76,21.84,,,percent of total billed charges,21.84% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5439,50,,,percent of total billed charges,50% of total Billed charges,8484.84,78,,,percent of total billed charges,78% of total billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,8985.23,82.6,,,percent of total billed charges,82.6% of total billed charges,8985.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5439,50,,,percent of total billed charges,50% of total Billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1664.33,10878,
GRASPER LAP SHORT ATRAUMATIC,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
GRASPER DELTA WIRE 3.2 FR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
"GRASPER CLUTCH , MINILAP",ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
"GRASPER ALLIGATOR , MINILAP",ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
GRASPER TIP LONG FENESTRATED,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
GRFT VASCULAR L1INXW1IN FLT STRL,ORSUP0001,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
GUIDE PIN 2.5MM DIA W/THREAD 230MM LENGTH,ORSUP0004,CDM,278,RC,C1713,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
GUIDE WIRE 2.8MM,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
GUIDE WIRE NON-THREADED 2.0MM X 230MM,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,118.65,33.9,,,percent of total billed charges,33.9% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
GUIDEWIRE CALIBRATED 3.2MM 300MM,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
GUIDEWIRE ALL STAR .014,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GUIDEWIRE HT PILOT.014X300CM,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GUIDEWIRE PILOT 50 300CM,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GUIDEWIRE PILOT 200 300CM,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GUIDEWIRE ASAHI MIRACLE BROS 6 300CM,ORSUP0011,CDM,278,RC,C1769,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GUIDEWIRE ASAHI CONFIANZA .014 X 300 CM,ORSUP0011,CDM,278,RC,C1769,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GUIDEWIRE FIELDER XT 300CM,ORSUP0011,CDM,278,RC,C1769,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GUIDEWIRE ASAHI MIRACLE BROS 12 300CM,ORSUP0012,CDM,278,RC,C1769,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
GUIDEWIRE ASAHI CONFIANZA PRO 9 300CM,ORSUP0011,CDM,278,RC,C1769,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GUIDE WIRE SUPER STIFF .035 /260,ORSUP0014,CDM,278,RC,C1769,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
GUIDEWIRE BENTSON STRAIGHT 0.35,ORSUP0009,CDM,278,RC,C1769,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
GUIDEWIRE HYDROPHILIC,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GUIDEWIRE BENTSON,ORSUP0002,CDM,278,RC,C1769,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDE WIRE PROWATER FLEX 180CM,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GUIDEWIRE FIXED J .025 X 150CM,ORSUP0008,CDM,278,RC,C1769,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
GUIDEWIRE RUNTHROUGH NS 0.014DIA 180CM,ORSUP0009,CDM,278,RC,C1769,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
GUIDEWIRE STIFF STRAIGHT .035X45,ORSUP0009,CDM,278,RC,C1769,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
GUIDEWIRE HYDRA JAGWIRE,ORSUP0012,CDM,278,RC,C1769,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
GUIDEWIRE .025/450 JAGWIRE,ORSUP0014,CDM,278,RC,C1769,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
GUIDEWIRE 300CM HITORQ,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GUIDEWIRE ROTABLATOR .014,ORSUP0012,CDM,278,RC,C1769,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
GUIDE EXTENSION GUIDEZILLA 6F,ORSUP0020,CDM,278,RC,C1769,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
GUIDEWIRE PRESSURE VERRATA 300CM J-TIP,ORSUP0025,CDM,278,RC,C1769,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
GUIDEWIRE TAD II 260CM,ORSUP0008,CDM,278,RC,C1769,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
GUIDEWIRE TIGER 300CM,ORSUP0006,CDM,278,RC,C1769,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
GUIDEWIRE VASC 200CM VIPER DIAMONDBACK,ORSUP0013,CDM,278,RC,C1769,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
GUIDEWIRE VASC VIPERWIRE FLEX .014 TIP,ORSUP0013,CDM,278,RC,C1769,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
GUIDE SOFT TISSUE 2.0/2.5,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
GUIDE PIN DRILL TIP 3.5MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
GUIDE WIRE BALL TIP,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
GUIDEWIRE J-WIRE .018 X 145CM,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
GUIDEWIRE STIFF SHAFT .035 150,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GUIDE WIRE 900.721 NON-THREAD,ORSUP0005,CDM,278,RC,C1769,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
GUIDEWIRE AMPLATZ 0.35 145CM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
GUIDEWIRE LEVEL 7,CATH00067,CDM,272,RC,C1769,HCPCS,Outpatient,,,2303,1496.95,,2026.64,88,,,percent of total billed charges,88% of total Billed charges,1151.5,50,,,percent of total billed charges,50% of total Billed charges,386.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,2303,100,,,percent of total billed charges,100% of total billed charges,398.51,17.304,,,percent of total billed charges,17.304% of total billed charges,1151.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,386.9,16.8,,,percent of total billed charges,16.8% of total billed charges,352.36,15.3,,,percent of total billed charges,15.3% of total billed charges,1589.07,69,,,percent of total billed charges,69% of total billed charges,2303,100,,,percent of total billed charges,100% of total billed charges,1151.5,50,,,percent of total billed charges,50% of total Billed charges,2303,100,,,percent of total billed charges,100% of total billed charges,1151.5,50,,,percent of total billed charges,50% of total Billed charges,2303,100,,,percent of total billed charges,100% of total billed charges,1151.5,50,,,percent of total billed charges,50% of total Billed charges,1424.41,61.85,,,percent of total billed charges,61.85% of total billed charges,386.9,16.8,,,percent of total billed charges,16.8% of total billed charges,1151.5,50,,,percent of total billed charges,50% of total Billed charges,1151.5,50,,,percent of total billed charges,50% of total Billed charges,386.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,1151.5,50,,,percent of total billed charges,50% of total Billed charges,1151.5,50,,,percent of total billed charges,50% of total Billed charges,394.64,17.136,,,percent of total billed charges,17.136% of total billed charges,502.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1151.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1151.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1151.5,50,,,percent of total billed charges,50% of total Billed charges,1796.34,78,,,percent of total billed charges,78% of total billed charges,2303,100,,,percent of total billed charges,100% of total billed charges,1902.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1902.28,82.6,,,percent of total billed charges,82.6% of total billed charges,386.9,16.8,,,percent of total billed charges,16.8% of total billed charges,1151.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1151.5,50,,,percent of total billed charges,50% of total Billed charges,386.9,16.8,,,percent of total billed charges,16.8% of total billed charges,352.36,2303,
GUIDE SHEATH A-KIT SLENDER 10CM,ORSUP0014,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
GUIDWIRE VASCULAR J TIP .025  PTFE COATED 150CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDEWIRE PILOT 50 0.014' X 300CM J,ORSUP0012,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GUIDEWIRE HI TOURQUE,ORSUP0003,CDM,278,RC,C1769,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDEWIRE 300CM HITORQ STRAIGHT TIP,ORSUP0012,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GUIDEWIRE W/TROCAR TIP 2.35MM X 200MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDEWIRE COPE 60CM 0.018,ORSUP0004,CDM,278,RC,C1769,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
GUIDEWIRE COBRA 1 5FR X 90CM SOFT-VU,ORSUP0003,CDM,278,RC,C1769,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
GUIDEWIRE VIPER WIRE 0.014 X 335CM,ORSUP0028,CDM,278,RC,C1769,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
GUIDEWIRE AMPLATZ .035 X 80,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
GUIDEWIRE FATHOM 14 STRIAGHT 200CMX10CM,ORSUP0018,CDM,278,RC,C1769,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
GUIDEWIRE FATHOM 14 STRAIGHT 300CMX10CM,ORSUP0018,CDM,278,RC,C1769,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
GUIDEWIRE HI-TORQUE 190CM,ORSUP0011,CDM,278,RC,C1769,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GUIDEWIRE HI-TORQUE PILOT 50 190CM,ORSUP0011,CDM,278,RC,C1769,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GUIDEWIRE STRAIGHT TIP SHORT TAPER,ORSUP0013,CDM,278,RC,C1769,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
GUIDEWIRE PTCA MIRACLEBROS 300,ORSUP0012,CDM,278,RC,C1769,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
GUIDEWIRE PTCA MIRABLEBROS 300CM X 0.014CM,ORSUP0013,CDM,278,RC,C1769,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
GUIDEWIRE HI TORQUE IRON MAN 190CM,ORSUP0011,CDM,278,RC,C1769,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GUIDEWIRE CLOSUREFAST DOUBLE ENDED 150CM,ORSUP0002,CDM,278,RC,C1769,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDEWIRE MAILMAN STRAIGHT CATH 0.014 X 182CM,ORSUP0021,CDM,278,RC,C1769,HCPCS,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,811.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,881.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
GUIDEWIRE J-TIP .035 175CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDEWIRE J-TIP .035 260CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDEWIRE J-TIP .035 150CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDEWIRE V-14 018X300CM SHORT TAPER STR TIP,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
GUIDEWIRE NITREX V04 80CM,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
GUIDEWIRE HYDROPHILIC UNIGLIDE .018 X 260CM,ORSUP0002,CDM,278,RC,C1769,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDEWIRE MICRO HYDROPHILIC COATING .014 X 13.5CM,ORSUP0015,CDM,278,RC,C1769,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
GUIDEWIRE ASAHI MIRABLE BROS 12 190CM,ORSUP0012,CDM,278,RC,C1769,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
GUIDEWIRE J 035X180CM,ORSUP0002,CDM,278,RC,C1769,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDEWIRE HIGH-TORQUE PILOT 014X190CM,ORSUP0011,CDM,278,RC,C1769,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
GUIDEWIRE HIGH-TORQUE COMMAND ES WIRE 014X300CM,ORSUP0025,CDM,278,RC,C1769,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
GUIDEWIRE VNUS 025 X 260CM,ORSUP0002,CDM,278,RC,C1769,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDEWIRE ROADRUNNER 0.014 X 300CM,ORSUP0009,CDM,278,RC,C1769,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
GUIDEWIRE CTO 25GA .014 X 300CM,ORSUP0013,CDM,278,RC,C1769,HCPCS,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,271.2,33.9,,,percent of total billed charges,33.9% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
GUIDEWIRE CTO 18GA .014 X 300CM,ORSUP0013,CDM,278,RC,C1769,HCPCS,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,271.2,33.9,,,percent of total billed charges,33.9% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
GUIDEWIRE AMPLATZ STIFF 035 X 260CM,ORSUP0002,CDM,278,RC,C1769,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
GUIDEWIRE AMPLATZ035 X 300CM,ORSUP0004,CDM,278,RC,C1769,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
GUIDEWIRE MARKED TIP REUSABLE TIP 210CM,ORSUP0011,CDM,278,RC,C1769,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
GUIDEWIRE BENTSON 035 X 145,ORSUP0002,CDM,278,RC,C1769,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
GUIDEWIRE 0.035 X 175CM J-TIP,ORSUP0002,CDM,278,RC,C1769,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
GYNEMESH PS SOFT MESH,ORSUP0026,CDM,278,RC,C1781,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
GYRUS SCISSOR,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
H-S PARTIAL 90 DEG ROUND OFFSET,ORSUP0027,CDM,278,RC,C1776,HCPCS,Outpatient,,,3200,2080.00,,2816,88,,,percent of total billed charges,88% of total Billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,537.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,3200,100,,,percent of total billed charges,100% of total billed charges,553.73,17.304,,,percent of total billed charges,17.304% of total billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,2016,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,537.6,16.8,,,percent of total billed charges,16.8% of total billed charges,489.6,15.3,,,percent of total billed charges,15.3% of total billed charges,2208,69,,,percent of total billed charges,69% of total billed charges,3200,100,,,percent of total billed charges,100% of total billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,3200,100,,,percent of total billed charges,100% of total billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,3200,100,,,percent of total billed charges,100% of total billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,1979.2,61.85,,,percent of total billed charges,61.85% of total billed charges,537.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,998.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1600,50,,,percent of total billed charges,50% of total Billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,548.35,17.136,,,percent of total billed charges,17.136% of total billed charges,698.88,21.84,,,percent of total billed charges,21.84% of total billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,1206.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1206.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,1084.8,33.9,,,percent of total billed charges,33.9% of total billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,2496,78,,,percent of total billed charges,78% of total billed charges,3200,100,,,percent of total billed charges,100% of total billed charges,2643.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2643.2,82.6,,,percent of total billed charges,82.6% of total billed charges,537.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1600,50,,,percent of total billed charges,50% of total Billed charges,537.6,16.8,,,percent of total billed charges,16.8% of total billed charges,489.6,3200,
H/A PARTIAL 90 DEG SQUARE,ORSUP0026,CDM,278,RC,C1776,HCPCS,Outpatient,,,3000,1950.00,,2640,88,,,percent of total billed charges,88% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,519.12,17.304,,,percent of total billed charges,17.304% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1890,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,15.3,,,percent of total billed charges,15.3% of total billed charges,2070,69,,,percent of total billed charges,69% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1855.5,61.85,,,percent of total billed charges,61.85% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,936,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,514.08,17.136,,,percent of total billed charges,17.136% of total billed charges,655.2,21.84,,,percent of total billed charges,21.84% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1017,33.9,,,percent of total billed charges,33.9% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,2340,78,,,percent of total billed charges,78% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,3000,
HAEMOPHILUS INFLUENZAE ATCC CULTI LOOPS 33533,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
HANDLE LARYNGOSCOPE LED REUSABLE,483466,CDM,272,RC,,,Outpatient,,,977,635.05,,859.76,88,,,percent of total billed charges,88% of total Billed charges,488.5,50,,,percent of total billed charges,50% of total Billed charges,164.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,977,100,,,percent of total billed charges,100% of total billed charges,169.06,17.304,,,percent of total billed charges,17.304% of total billed charges,488.5,50,,,percent of total billed charges,50% of total Billed charges,615.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,164.14,16.8,,,percent of total billed charges,16.8% of total billed charges,149.48,15.3,,,percent of total billed charges,15.3% of total billed charges,674.13,69,,,percent of total billed charges,69% of total billed charges,977,100,,,percent of total billed charges,100% of total billed charges,488.5,50,,,percent of total billed charges,50% of total Billed charges,977,100,,,percent of total billed charges,100% of total billed charges,488.5,50,,,percent of total billed charges,50% of total Billed charges,977,100,,,percent of total billed charges,100% of total billed charges,488.5,50,,,percent of total billed charges,50% of total Billed charges,604.27,61.85,,,percent of total billed charges,61.85% of total billed charges,164.14,16.8,,,percent of total billed charges,16.8% of total billed charges,488.5,50,,,percent of total billed charges,50% of total Billed charges,488.5,50,,,percent of total billed charges,50% of total Billed charges,164.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,488.5,50,,,percent of total billed charges,50% of total Billed charges,488.5,50,,,percent of total billed charges,50% of total Billed charges,167.42,17.136,,,percent of total billed charges,17.136% of total billed charges,213.38,21.84,,,percent of total billed charges,21.84% of total billed charges,488.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,488.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,488.5,50,,,percent of total billed charges,50% of total Billed charges,762.06,78,,,percent of total billed charges,78% of total billed charges,977,100,,,percent of total billed charges,100% of total billed charges,807,82.6,,,percent of total billed charges,82.6% of total billed charges,807,82.6,,,percent of total billed charges,82.6% of total billed charges,164.14,16.8,,,percent of total billed charges,16.8% of total billed charges,488.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,488.5,50,,,percent of total billed charges,50% of total Billed charges,164.14,16.8,,,percent of total billed charges,16.8% of total billed charges,149.48,977,
HANDLE SUCTION YANKAUER W/ BULB TIP,10343,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
HAND CONTROLLER ACIST,431981,CDM,270,RC,,,Outpatient,,,2247,1460.55,,1977.36,88,,,percent of total billed charges,88% of total Billed charges,1123.5,50,,,percent of total billed charges,50% of total Billed charges,377.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,2247,100,,,percent of total billed charges,100% of total billed charges,388.82,17.304,,,percent of total billed charges,17.304% of total billed charges,1123.5,50,,,percent of total billed charges,50% of total Billed charges,1415.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,377.5,16.8,,,percent of total billed charges,16.8% of total billed charges,343.79,15.3,,,percent of total billed charges,15.3% of total billed charges,1550.43,69,,,percent of total billed charges,69% of total billed charges,2247,100,,,percent of total billed charges,100% of total billed charges,1123.5,50,,,percent of total billed charges,50% of total Billed charges,2247,100,,,percent of total billed charges,100% of total billed charges,1123.5,50,,,percent of total billed charges,50% of total Billed charges,2247,100,,,percent of total billed charges,100% of total billed charges,1123.5,50,,,percent of total billed charges,50% of total Billed charges,1389.77,61.85,,,percent of total billed charges,61.85% of total billed charges,377.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1123.5,50,,,percent of total billed charges,50% of total Billed charges,1123.5,50,,,percent of total billed charges,50% of total Billed charges,377.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1123.5,50,,,percent of total billed charges,50% of total Billed charges,1123.5,50,,,percent of total billed charges,50% of total Billed charges,385.05,17.136,,,percent of total billed charges,17.136% of total billed charges,490.74,21.84,,,percent of total billed charges,21.84% of total billed charges,1123.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1123.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1123.5,50,,,percent of total billed charges,50% of total Billed charges,1752.66,78,,,percent of total billed charges,78% of total billed charges,2247,100,,,percent of total billed charges,100% of total billed charges,1856.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1856.02,82.6,,,percent of total billed charges,82.6% of total billed charges,377.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1123.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1123.5,50,,,percent of total billed charges,50% of total Billed charges,377.5,16.8,,,percent of total billed charges,16.8% of total billed charges,343.79,2247,
HAND DRAPE AURORA,277007,CDM,270,RC,,,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,10.9,17.304,,,percent of total billed charges,17.304% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,39.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,38.97,61.85,,,percent of total billed charges,61.85% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.8,17.136,,,percent of total billed charges,17.136% of total billed charges,13.76,21.84,,,percent of total billed charges,21.84% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,63,
HANDLE HARMONIC ACE 36CM ERG,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
HANDLE GUIDE CATHETER SIDEKICK LOW PROFILE,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
HANDPIECE MARCELLATOR GYRUS,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
HANDPIECE GSU,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
HAND LOTION 4 OZ,490722,CDM,270,RC,,,Outpatient,,,257,167.05,,226.16,88,,,percent of total billed charges,88% of total Billed charges,128.5,50,,,percent of total billed charges,50% of total Billed charges,43.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,257,100,,,percent of total billed charges,100% of total billed charges,44.47,17.304,,,percent of total billed charges,17.304% of total billed charges,128.5,50,,,percent of total billed charges,50% of total Billed charges,161.91,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.18,16.8,,,percent of total billed charges,16.8% of total billed charges,39.32,15.3,,,percent of total billed charges,15.3% of total billed charges,177.33,69,,,percent of total billed charges,69% of total billed charges,257,100,,,percent of total billed charges,100% of total billed charges,128.5,50,,,percent of total billed charges,50% of total Billed charges,257,100,,,percent of total billed charges,100% of total billed charges,128.5,50,,,percent of total billed charges,50% of total Billed charges,257,100,,,percent of total billed charges,100% of total billed charges,128.5,50,,,percent of total billed charges,50% of total Billed charges,158.95,61.85,,,percent of total billed charges,61.85% of total billed charges,43.18,16.8,,,percent of total billed charges,16.8% of total billed charges,128.5,50,,,percent of total billed charges,50% of total Billed charges,128.5,50,,,percent of total billed charges,50% of total Billed charges,43.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,128.5,50,,,percent of total billed charges,50% of total Billed charges,128.5,50,,,percent of total billed charges,50% of total Billed charges,44.04,17.136,,,percent of total billed charges,17.136% of total billed charges,56.13,21.84,,,percent of total billed charges,21.84% of total billed charges,128.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,128.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,128.5,50,,,percent of total billed charges,50% of total Billed charges,200.46,78,,,percent of total billed charges,78% of total billed charges,257,100,,,percent of total billed charges,100% of total billed charges,212.28,82.6,,,percent of total billed charges,82.6% of total billed charges,212.28,82.6,,,percent of total billed charges,82.6% of total billed charges,43.18,16.8,,,percent of total billed charges,16.8% of total billed charges,128.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,128.5,50,,,percent of total billed charges,50% of total Billed charges,43.18,16.8,,,percent of total billed charges,16.8% of total billed charges,39.32,257,
HAND SKIN PROTECTANT OINTMENT 2.5 OZ,490723,CDM,270,RC,,,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,9.69,17.304,,,percent of total billed charges,17.304% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,35.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.6,17.136,,,percent of total billed charges,17.136% of total billed charges,12.23,21.84,,,percent of total billed charges,21.84% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,56,
HARMONIC HAND SWITCHING ADAPTOR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
HARMONIC SCALPLE 36CM CVD WITH PISTOL HANKLE,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
HB CALIBRATOR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
HBA1C REAGENT,ORSUP0041,CDM,272,RC,,,Outpatient,,,7800,5070.00,,6864,88,,,percent of total billed charges,88% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1349.71,17.304,,,percent of total billed charges,17.304% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4914,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,15.3,,,percent of total billed charges,15.3% of total billed charges,5382,69,,,percent of total billed charges,69% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4824.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1336.61,17.136,,,percent of total billed charges,17.136% of total billed charges,1703.52,21.84,,,percent of total billed charges,21.84% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,6084,78,,,percent of total billed charges,78% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,7800,
HBA1C ADVANCED,ORSUP0046,CDM,272,RC,,,Outpatient,,,9100,5915.00,,8008,88,,,percent of total billed charges,88% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1574.66,17.304,,,percent of total billed charges,17.304% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5733,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,15.3,,,percent of total billed charges,15.3% of total billed charges,6279,69,,,percent of total billed charges,69% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5628.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1559.38,17.136,,,percent of total billed charges,17.136% of total billed charges,1987.44,21.84,,,percent of total billed charges,21.84% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,7098,78,,,percent of total billed charges,78% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,9100,
HBSAG CALIBRATOR,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
HCG CARDS TEST KIT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
HEAD MOP MICROFIBER DISPOSABLE,190318,CDM,270,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
HEART VALVE A \\T\\ B,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
HEAT EXCHANGER FOR LEVEL 1,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
HEATER WIRE ADAPTERS 850,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
HEATED WIRE CIRCUIT BIPAP/CPAP,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
HEGAR-BAUMGARTNER NEEDLE HOLDER 5-1/4,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
HEIMLICH VALVE,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
HELICAL STONE BASKET 3FR 5CM TIP,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
HELICAL STONE BASKET 3FR 14CM,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
HELIXED TRI-PORT 4.0 LIPO CANNULA,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
HEMA TK STN PK MDFD WRGHT GMS,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
HEMOCHRON CUVETTES TESTS,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
HEMOCONCENTRATOR PERFUSION PAK,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
HEMOSTASIS AVITENE 70 X 35MM,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
HEMOSPRAY ENDOSCOPY HEMOSTAT HEMO-7,ORSUP0067,CDM,272,RC,,,Outpatient,,,13000,8450.00,,11440,88,,,percent of total billed charges,88% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,2184,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2249.52,17.304,,,percent of total billed charges,17.304% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,8190,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,1989,15.3,,,percent of total billed charges,15.3% of total billed charges,8970,69,,,percent of total billed charges,69% of total billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,8040.5,61.85,,,percent of total billed charges,61.85% of total billed charges,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,2184,16.8,,,percent of total billed charges,16.8% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,2227.68,17.136,,,percent of total billed charges,17.136% of total billed charges,2839.2,21.84,,,percent of total billed charges,21.84% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6500,50,,,percent of total billed charges,50% of total Billed charges,10140,78,,,percent of total billed charges,78% of total billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,10738,82.6,,,percent of total billed charges,82.6% of total billed charges,10738,82.6,,,percent of total billed charges,82.6% of total billed charges,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6500,50,,,percent of total billed charges,50% of total Billed charges,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,1989,13000,
HEMOSIL SYNTHASIL REAGENT,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
HEMOSIL THROMBIN Q.F.A. REAG,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
HEMOSIL NORMAL CONTROL 1,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
HEMOSIL ABNORMAL CONTROL 3,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
HEMOSIL LOW FIBRINOGEN CONTROL,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
HEMOSIL CONTAINER WASTE,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
HEMOSIL CTS FILTER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
HEMOCUE FECAL OCCULT BLOOD SLIDE TEST SYSTEM,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
HEMO LOK WECK ENDO 5MM CLIP APPLIER,ORSUP0015,CDM,272,RC,,,Outpatient,,,16900,10985.00,,14872,88,,,percent of total billed charges,88% of total Billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2924.38,17.304,,,percent of total billed charges,17.304% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,10647,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2585.7,15.3,,,percent of total billed charges,15.3% of total billed charges,11661,69,,,percent of total billed charges,69% of total billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,10452.65,61.85,,,percent of total billed charges,61.85% of total billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,2895.98,17.136,,,percent of total billed charges,17.136% of total billed charges,3690.96,21.84,,,percent of total billed charges,21.84% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8450,50,,,percent of total billed charges,50% of total Billed charges,13182,78,,,percent of total billed charges,78% of total billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,13959.4,82.6,,,percent of total billed charges,82.6% of total billed charges,13959.4,82.6,,,percent of total billed charges,82.6% of total billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8450,50,,,percent of total billed charges,50% of total Billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2585.7,16900,
HEMOSIL HIGH ABNORMAL CONTROL - ASSAYED,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
HEMOSIL NORMAL CONTROL - ASSAYED,ORSUP0008,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
"HEMOSIL RECOMBIPLASTIN 2G, 5 X 20 ML",ORSUP0010,CDM,272,RC,,,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
ORSUP0001,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
HEPARIN SODIUM 2000,201580,CDM,272,RC,,,Outpatient,,,44,28.60,,38.72,88,,,percent of total billed charges,88% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,7.61,17.304,,,percent of total billed charges,17.304% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,15.3,,,percent of total billed charges,15.3% of total billed charges,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.21,61.85,,,percent of total billed charges,61.85% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.54,17.136,,,percent of total billed charges,17.136% of total billed charges,9.61,21.84,,,percent of total billed charges,21.84% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,44,
HEPARIN CALIBRATORS,ORSUP0025,CDM,270,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
HEX WRENCH 7-6CM,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
HI SAM DIL A (ON) 100WLS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
HI SAM DIL B (ON) 100WLS,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
HI-FI PASSING LOOP,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
HIBICLENS 4 OZ,490734,CDM,270,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
HIGH-FIDELITY FOAM EAR PLUGS MRI SAFE,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
HIP ACETABULAR DOME HOLE PLUG,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
HIP BIPOLAR UHR 28X47MM,ORSUP0056,CDM,278,RC,C1713,HCPCS,Outpatient,,,11960,7774.00,,10524.8,88,,,percent of total billed charges,88% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2069.56,17.304,,,percent of total billed charges,17.304% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7534.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,15.3,,,percent of total billed charges,15.3% of total billed charges,8252.4,69,,,percent of total billed charges,69% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7397.26,61.85,,,percent of total billed charges,61.85% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,3731.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2049.47,17.136,,,percent of total billed charges,17.136% of total billed charges,2612.06,21.84,,,percent of total billed charges,21.84% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4054.44,33.9,,,percent of total billed charges,33.9% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,9328.8,78,,,percent of total billed charges,78% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,11960,
HIP BIPOLAR UHR 28X51MM,ORSUP0056,CDM,278,RC,C1713,HCPCS,Outpatient,,,11960,7774.00,,10524.8,88,,,percent of total billed charges,88% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2069.56,17.304,,,percent of total billed charges,17.304% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7534.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,15.3,,,percent of total billed charges,15.3% of total billed charges,8252.4,69,,,percent of total billed charges,69% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7397.26,61.85,,,percent of total billed charges,61.85% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,3731.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2049.47,17.136,,,percent of total billed charges,17.136% of total billed charges,2612.06,21.84,,,percent of total billed charges,21.84% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4054.44,33.9,,,percent of total billed charges,33.9% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,9328.8,78,,,percent of total billed charges,78% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,11960,
HIP CUP PRIMARY TRITANIUM HEMI CLUSTER HOLE  58MM,ORSUP0040,CDM,278,RC,,,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
HIP HEAD C-TAPER COCR LFIT 28MM/+5,ORSUP0045,CDM,278,RC,C1713,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5569.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
HIP HEAD V40 BIOLOX DELTA 36MM/+7.6,ORSUP0035,CDM,278,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
HIP HEAD V40 BIOLOX DELTA 36MM/1,ORSUP0093,CDM,278,RC,C1713,HCPCS,Outpatient,,,21840,14196.00,,19219.2,88,,,percent of total billed charges,88% of total Billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3779.19,17.304,,,percent of total billed charges,17.304% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,13759.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,3341.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15069.6,69,,,percent of total billed charges,69% of total billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,13508.04,61.85,,,percent of total billed charges,61.85% of total billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,6814.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10920,50,,,percent of total billed charges,50% of total Billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,3742.5,17.136,,,percent of total billed charges,17.136% of total billed charges,4769.86,21.84,,,percent of total billed charges,21.84% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,8233.68,37.7,,,percent of total billed charges,37.70% of total billed charges,8233.68,37.7,,,percent of total billed charges,37.70% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,7403.76,33.9,,,percent of total billed charges,33.9% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,17035.2,78,,,percent of total billed charges,78% of total billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,18039.84,82.6,,,percent of total billed charges,82.6% of total billed charges,18039.84,82.6,,,percent of total billed charges,82.6% of total billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10920,50,,,percent of total billed charges,50% of total Billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,3341.52,21840,
HIP HEAD V40 BIOLOX DELTA 36MM/-2.6,ORSUP0035,CDM,278,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
HIP INSERT TRIDENT 0 DEG X3 32MM ID 623-00-32E,ORSUP0035,CDM,278,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
HIP INSERT TRIDENT 0 DEG X3 36MM ID 623-00-36F,ORSUP0086,CDM,278,RC,C1713,HCPCS,Outpatient,,,20020,13013.00,,17617.6,88,,,percent of total billed charges,88% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3464.26,17.304,,,percent of total billed charges,17.304% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,12612.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3063.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13813.8,69,,,percent of total billed charges,69% of total billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,12382.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,6246.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10010,50,,,percent of total billed charges,50% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,3430.63,17.136,,,percent of total billed charges,17.136% of total billed charges,4372.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,7547.54,37.7,,,percent of total billed charges,37.70% of total billed charges,7547.54,37.7,,,percent of total billed charges,37.70% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,6786.78,33.9,,,percent of total billed charges,33.9% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,15615.6,78,,,percent of total billed charges,78% of total billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,16536.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16536.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3063.06,20020,
HIP INSERT TRIDENT 10 DEG X3 36MM ID 623-10-36E,ORSUP0035,CDM,278,RC,C1713,HCPCS,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
HIP SHELL TRIDENT PSL HA CLUSTER 50MM,ORSUP0092,CDM,278,RC,C1776,HCPCS,Outpatient,,,21320,13858.00,,18761.6,88,,,percent of total billed charges,88% of total Billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,3581.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3689.21,17.304,,,percent of total billed charges,17.304% of total billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,13431.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3581.76,16.8,,,percent of total billed charges,16.8% of total billed charges,3261.96,15.3,,,percent of total billed charges,15.3% of total billed charges,14710.8,69,,,percent of total billed charges,69% of total billed charges,21320,100,,,percent of total billed charges,100% of total billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,21320,100,,,percent of total billed charges,100% of total billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,21320,100,,,percent of total billed charges,100% of total billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,13186.42,61.85,,,percent of total billed charges,61.85% of total billed charges,3581.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,6651.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10660,50,,,percent of total billed charges,50% of total Billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,3653.4,17.136,,,percent of total billed charges,17.136% of total billed charges,4656.29,21.84,,,percent of total billed charges,21.84% of total billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,8037.64,37.7,,,percent of total billed charges,37.70% of total billed charges,8037.64,37.7,,,percent of total billed charges,37.70% of total billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,7227.48,33.9,,,percent of total billed charges,33.9% of total billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,16629.6,78,,,percent of total billed charges,78% of total billed charges,21320,100,,,percent of total billed charges,100% of total billed charges,17610.32,82.6,,,percent of total billed charges,82.6% of total billed charges,17610.32,82.6,,,percent of total billed charges,82.6% of total billed charges,3581.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10660,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10660,50,,,percent of total billed charges,50% of total Billed charges,3581.76,16.8,,,percent of total billed charges,16.8% of total billed charges,3261.96,21320,
HIP SHELL TRIDENT PSL HA CLUSTER 52MM,ORSUP0030,CDM,278,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1541.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1674.66,33.9,,,percent of total billed charges,33.9% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
HIP SHELL TRIDENT PSL HA SOLID BACK 52MM,ORSUP0030,CDM,278,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1541.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1674.66,33.9,,,percent of total billed charges,33.9% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
HIP SHELL TRIDENT PSL HA SOLID BACK 54MM,ORSUP0030,CDM,278,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1541.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1674.66,33.9,,,percent of total billed charges,33.9% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
HIP SLEEVE CABLE SM W/BEAD,ORSUP0019,CDM,278,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
HIP STEM ACCOLADE II 127 DEG SIZE 3,ORSUP0075,CDM,278,RC,C1713,HCPCS,Outpatient,,,14820,9633.00,,13041.6,88,,,percent of total billed charges,88% of total Billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,2489.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2564.45,17.304,,,percent of total billed charges,17.304% of total billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,9336.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2489.76,16.8,,,percent of total billed charges,16.8% of total billed charges,2267.46,15.3,,,percent of total billed charges,15.3% of total billed charges,10225.8,69,,,percent of total billed charges,69% of total billed charges,14820,100,,,percent of total billed charges,100% of total billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,14820,100,,,percent of total billed charges,100% of total billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,14820,100,,,percent of total billed charges,100% of total billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,9166.17,61.85,,,percent of total billed charges,61.85% of total billed charges,2489.76,16.8,,,percent of total billed charges,16.8% of total billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,4623.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7410,50,,,percent of total billed charges,50% of total Billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,2539.56,17.136,,,percent of total billed charges,17.136% of total billed charges,3236.69,21.84,,,percent of total billed charges,21.84% of total billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,5587.14,37.7,,,percent of total billed charges,37.70% of total billed charges,5587.14,37.7,,,percent of total billed charges,37.70% of total billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,5023.98,33.9,,,percent of total billed charges,33.9% of total billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,11559.6,78,,,percent of total billed charges,78% of total billed charges,14820,100,,,percent of total billed charges,100% of total billed charges,12241.32,82.6,,,percent of total billed charges,82.6% of total billed charges,12241.32,82.6,,,percent of total billed charges,82.6% of total billed charges,2489.76,16.8,,,percent of total billed charges,16.8% of total billed charges,7410,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7410,50,,,percent of total billed charges,50% of total Billed charges,2489.76,16.8,,,percent of total billed charges,16.8% of total billed charges,2267.46,14820,
HIP STEM ACCOLADE II 127 DEG SIZE 4,ORSUP0069,CDM,278,RC,,,Outpatient,,,15340,9971.00,,13499.2,88,,,percent of total billed charges,88% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2654.43,17.304,,,percent of total billed charges,17.304% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,9664.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,2347.02,15.3,,,percent of total billed charges,15.3% of total billed charges,10584.6,69,,,percent of total billed charges,69% of total billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,9487.79,61.85,,,percent of total billed charges,61.85% of total billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,4786.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7670,50,,,percent of total billed charges,50% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,2628.66,17.136,,,percent of total billed charges,17.136% of total billed charges,3350.26,21.84,,,percent of total billed charges,21.84% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,5783.18,37.7,,,percent of total billed charges,37.70% of total billed charges,5783.18,37.7,,,percent of total billed charges,37.70% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,5200.26,33.9,,,percent of total billed charges,33.9% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,11965.2,78,,,percent of total billed charges,78% of total billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,12670.84,82.6,,,percent of total billed charges,82.6% of total billed charges,12670.84,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7670,50,,,percent of total billed charges,50% of total Billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,2347.02,15340,
HIP STEM ACCOLADE II 127 DEG SIZE 5,ORSUP0069,CDM,278,RC,,,Outpatient,,,15340,9971.00,,13499.2,88,,,percent of total billed charges,88% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2654.43,17.304,,,percent of total billed charges,17.304% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,9664.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,2347.02,15.3,,,percent of total billed charges,15.3% of total billed charges,10584.6,69,,,percent of total billed charges,69% of total billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,9487.79,61.85,,,percent of total billed charges,61.85% of total billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,4786.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7670,50,,,percent of total billed charges,50% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,2628.66,17.136,,,percent of total billed charges,17.136% of total billed charges,3350.26,21.84,,,percent of total billed charges,21.84% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,5783.18,37.7,,,percent of total billed charges,37.70% of total billed charges,5783.18,37.7,,,percent of total billed charges,37.70% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,5200.26,33.9,,,percent of total billed charges,33.9% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,11965.2,78,,,percent of total billed charges,78% of total billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,12670.84,82.6,,,percent of total billed charges,82.6% of total billed charges,12670.84,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7670,50,,,percent of total billed charges,50% of total Billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,2347.02,15340,
HIP STEM ACCOLADE II 127 DEG SIZE 6,ORSUP0069,CDM,278,RC,,,Outpatient,,,15340,9971.00,,13499.2,88,,,percent of total billed charges,88% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2654.43,17.304,,,percent of total billed charges,17.304% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,9664.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,2347.02,15.3,,,percent of total billed charges,15.3% of total billed charges,10584.6,69,,,percent of total billed charges,69% of total billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,9487.79,61.85,,,percent of total billed charges,61.85% of total billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,4786.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7670,50,,,percent of total billed charges,50% of total Billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,2628.66,17.136,,,percent of total billed charges,17.136% of total billed charges,3350.26,21.84,,,percent of total billed charges,21.84% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,5783.18,37.7,,,percent of total billed charges,37.70% of total billed charges,5783.18,37.7,,,percent of total billed charges,37.70% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,5200.26,33.9,,,percent of total billed charges,33.9% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,11965.2,78,,,percent of total billed charges,78% of total billed charges,15340,100,,,percent of total billed charges,100% of total billed charges,12670.84,82.6,,,percent of total billed charges,82.6% of total billed charges,12670.84,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,7670,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7670,50,,,percent of total billed charges,50% of total Billed charges,2577.12,16.8,,,percent of total billed charges,16.8% of total billed charges,2347.02,15340,
HIP STEM OMNIFIT HFX SIZE #10 6070-1035A,ORSUP0035,CDM,278,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
HIP STEM PRIMARY SECUR-FIT PLUS MAX #9 6054-0913S,ORSUP0195,CDM,278,RC,C1713,HCPCS,Outpatient,,,52000,33800.00,,45760,88,,,percent of total billed charges,88% of total Billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,8736,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,8998.08,17.304,,,percent of total billed charges,17.304% of total billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,32760,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8736,16.8,,,percent of total billed charges,16.8% of total billed charges,7956,15.3,,,percent of total billed charges,15.3% of total billed charges,35880,69,,,percent of total billed charges,69% of total billed charges,52000,100,,,percent of total billed charges,100% of total billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,52000,100,,,percent of total billed charges,100% of total billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,52000,100,,,percent of total billed charges,100% of total billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,32162,61.85,,,percent of total billed charges,61.85% of total billed charges,8736,16.8,,,percent of total billed charges,16.8% of total billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,16224,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26000,50,,,percent of total billed charges,50% of total Billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,8910.72,17.136,,,percent of total billed charges,17.136% of total billed charges,11356.8,21.84,,,percent of total billed charges,21.84% of total billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,19604,37.7,,,percent of total billed charges,37.70% of total billed charges,19604,37.7,,,percent of total billed charges,37.70% of total billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,17628,33.9,,,percent of total billed charges,33.9% of total billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,40560,78,,,percent of total billed charges,78% of total billed charges,52000,100,,,percent of total billed charges,100% of total billed charges,42952,82.6,,,percent of total billed charges,82.6% of total billed charges,42952,82.6,,,percent of total billed charges,82.6% of total billed charges,8736,16.8,,,percent of total billed charges,16.8% of total billed charges,26000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26000,50,,,percent of total billed charges,50% of total Billed charges,8736,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,52000,
HIP SHEET,490735,CDM,270,RC,,,Outpatient,,,117,76.05,,102.96,88,,,percent of total billed charges,88% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,117,100,,,percent of total billed charges,100% of total billed charges,20.25,17.304,,,percent of total billed charges,17.304% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,73.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,17.9,15.3,,,percent of total billed charges,15.3% of total billed charges,80.73,69,,,percent of total billed charges,69% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,117,100,,,percent of total billed charges,100% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,117,100,,,percent of total billed charges,100% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,72.36,61.85,,,percent of total billed charges,61.85% of total billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,20.05,17.136,,,percent of total billed charges,17.136% of total billed charges,25.55,21.84,,,percent of total billed charges,21.84% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,58.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58.5,50,,,percent of total billed charges,50% of total Billed charges,91.26,78,,,percent of total billed charges,78% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58.5,50,,,percent of total billed charges,50% of total Billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,17.9,117,
HIPPURATE DISC,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
HIV ALERE COMBO EXTERNAL CONTROL SET,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
HMS CARTRIDGE YELLOW ACT,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
HOLDER ENDOTRACHAEL TUBE,185461,CDM,272,RC,,,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,12.46,17.304,,,percent of total billed charges,17.304% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,45.36,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,15.3,,,percent of total billed charges,15.3% of total billed charges,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,44.53,61.85,,,percent of total billed charges,61.85% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.34,17.136,,,percent of total billed charges,17.136% of total billed charges,15.72,21.84,,,percent of total billed charges,21.84% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,72,
HOLDER TRACH TUBE MWH 686,154485,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
HOLMIUM MICRON LASER 600,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
HOLMIUM MICRON LASER FIBER 200,ORSUP0018,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
HOLMIUM MICRON LASER 1000,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
HOOD SURGICAL T5,266308,CDM,272,RC,,,Outpatient,,,204,132.60,,179.52,88,,,percent of total billed charges,88% of total Billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,34.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,204,100,,,percent of total billed charges,100% of total billed charges,35.3,17.304,,,percent of total billed charges,17.304% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,128.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.27,16.8,,,percent of total billed charges,16.8% of total billed charges,31.21,15.3,,,percent of total billed charges,15.3% of total billed charges,140.76,69,,,percent of total billed charges,69% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,204,100,,,percent of total billed charges,100% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,204,100,,,percent of total billed charges,100% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,126.17,61.85,,,percent of total billed charges,61.85% of total billed charges,34.27,16.8,,,percent of total billed charges,16.8% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,34.27,16.8,,,percent of total billed charges,16.8% of total Billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,34.96,17.136,,,percent of total billed charges,17.136% of total billed charges,44.55,21.84,,,percent of total billed charges,21.84% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,102,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,102,50,,,percent of total billed charges,50% of total Billed charges,159.12,78,,,percent of total billed charges,78% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,34.27,16.8,,,percent of total billed charges,16.8% of total billed charges,102,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,102,50,,,percent of total billed charges,50% of total Billed charges,34.27,16.8,,,percent of total billed charges,16.8% of total billed charges,31.21,204,
HOOK SHEPHERDS GREENBERG,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
HOOK CAUTERY MONOPOLAR 5MM DA VINCI,337819,CDM,272,RC,,,Outpatient,,,3913,2543.45,,3443.44,88,,,percent of total billed charges,88% of total Billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,657.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,3913,100,,,percent of total billed charges,100% of total billed charges,677.11,17.304,,,percent of total billed charges,17.304% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,2465.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,657.38,16.8,,,percent of total billed charges,16.8% of total billed charges,598.69,15.3,,,percent of total billed charges,15.3% of total billed charges,2699.97,69,,,percent of total billed charges,69% of total billed charges,3913,100,,,percent of total billed charges,100% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,3913,100,,,percent of total billed charges,100% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,3913,100,,,percent of total billed charges,100% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,2420.19,61.85,,,percent of total billed charges,61.85% of total billed charges,657.38,16.8,,,percent of total billed charges,16.8% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,657.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,670.53,17.136,,,percent of total billed charges,17.136% of total billed charges,854.6,21.84,,,percent of total billed charges,21.84% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1956.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1956.5,50,,,percent of total billed charges,50% of total Billed charges,3052.14,78,,,percent of total billed charges,78% of total billed charges,3913,100,,,percent of total billed charges,100% of total billed charges,3232.14,82.6,,,percent of total billed charges,82.6% of total billed charges,3232.14,82.6,,,percent of total billed charges,82.6% of total billed charges,657.38,16.8,,,percent of total billed charges,16.8% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1956.5,50,,,percent of total billed charges,50% of total Billed charges,657.38,16.8,,,percent of total billed charges,16.8% of total billed charges,598.69,3913,
HOOK CAUTERY PERMANENT DA VINCI,173500,CDM,272,RC,,,Outpatient,,,9889,6427.85,,8702.32,88,,,percent of total billed charges,88% of total Billed charges,4944.5,50,,,percent of total billed charges,50% of total Billed charges,1661.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1711.19,17.304,,,percent of total billed charges,17.304% of total billed charges,4944.5,50,,,percent of total billed charges,50% of total Billed charges,6230.07,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1661.35,16.8,,,percent of total billed charges,16.8% of total billed charges,1513.02,15.3,,,percent of total billed charges,15.3% of total billed charges,6823.41,69,,,percent of total billed charges,69% of total billed charges,9889,100,,,percent of total billed charges,100% of total billed charges,4944.5,50,,,percent of total billed charges,50% of total Billed charges,9889,100,,,percent of total billed charges,100% of total billed charges,4944.5,50,,,percent of total billed charges,50% of total Billed charges,9889,100,,,percent of total billed charges,100% of total billed charges,4944.5,50,,,percent of total billed charges,50% of total Billed charges,6116.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1661.35,16.8,,,percent of total billed charges,16.8% of total billed charges,4944.5,50,,,percent of total billed charges,50% of total Billed charges,4944.5,50,,,percent of total billed charges,50% of total Billed charges,1661.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,4944.5,50,,,percent of total billed charges,50% of total Billed charges,4944.5,50,,,percent of total billed charges,50% of total Billed charges,1694.58,17.136,,,percent of total billed charges,17.136% of total billed charges,2159.76,21.84,,,percent of total billed charges,21.84% of total billed charges,4944.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4944.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4944.5,50,,,percent of total billed charges,50% of total Billed charges,7713.42,78,,,percent of total billed charges,78% of total billed charges,9889,100,,,percent of total billed charges,100% of total billed charges,8168.31,82.6,,,percent of total billed charges,82.6% of total billed charges,8168.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1661.35,16.8,,,percent of total billed charges,16.8% of total billed charges,4944.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4944.5,50,,,percent of total billed charges,50% of total Billed charges,1661.35,16.8,,,percent of total billed charges,16.8% of total billed charges,1513.02,9889,
HOOK ELECTRODE,490739,CDM,270,RC,,,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,154,50,,,percent of total billed charges,50% of total Billed charges,51.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,308,100,,,percent of total billed charges,100% of total billed charges,53.3,17.304,,,percent of total billed charges,17.304% of total billed charges,154,50,,,percent of total billed charges,50% of total Billed charges,194.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,47.12,15.3,,,percent of total billed charges,15.3% of total billed charges,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,154,50,,,percent of total billed charges,50% of total Billed charges,308,100,,,percent of total billed charges,100% of total billed charges,154,50,,,percent of total billed charges,50% of total Billed charges,308,100,,,percent of total billed charges,100% of total billed charges,154,50,,,percent of total billed charges,50% of total Billed charges,190.5,61.85,,,percent of total billed charges,61.85% of total billed charges,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,154,50,,,percent of total billed charges,50% of total Billed charges,154,50,,,percent of total billed charges,50% of total Billed charges,51.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,154,50,,,percent of total billed charges,50% of total Billed charges,154,50,,,percent of total billed charges,50% of total Billed charges,52.78,17.136,,,percent of total billed charges,17.136% of total billed charges,67.27,21.84,,,percent of total billed charges,21.84% of total billed charges,154,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,154,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,154,50,,,percent of total billed charges,50% of total Billed charges,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,154,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,154,50,,,percent of total billed charges,50% of total Billed charges,51.74,16.8,,,percent of total billed charges,16.8% of total billed charges,47.12,308,
HOOK SCISSOR TIP,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
HOOP SHIMS,ORSUP0030,CDM,272,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
HOT PACK,490741,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
HOVERMATT,177695,CDM,272,RC,,,Outpatient,,,5785,3760.25,,5090.8,88,,,percent of total billed charges,88% of total Billed charges,2892.5,50,,,percent of total billed charges,50% of total Billed charges,971.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1001.04,17.304,,,percent of total billed charges,17.304% of total billed charges,2892.5,50,,,percent of total billed charges,50% of total Billed charges,3644.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,971.88,16.8,,,percent of total billed charges,16.8% of total billed charges,885.11,15.3,,,percent of total billed charges,15.3% of total billed charges,3991.65,69,,,percent of total billed charges,69% of total billed charges,5785,100,,,percent of total billed charges,100% of total billed charges,2892.5,50,,,percent of total billed charges,50% of total Billed charges,5785,100,,,percent of total billed charges,100% of total billed charges,2892.5,50,,,percent of total billed charges,50% of total Billed charges,5785,100,,,percent of total billed charges,100% of total billed charges,2892.5,50,,,percent of total billed charges,50% of total Billed charges,3578.02,61.85,,,percent of total billed charges,61.85% of total billed charges,971.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2892.5,50,,,percent of total billed charges,50% of total Billed charges,2892.5,50,,,percent of total billed charges,50% of total Billed charges,971.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2892.5,50,,,percent of total billed charges,50% of total Billed charges,2892.5,50,,,percent of total billed charges,50% of total Billed charges,991.32,17.136,,,percent of total billed charges,17.136% of total billed charges,1263.44,21.84,,,percent of total billed charges,21.84% of total billed charges,2892.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2892.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2892.5,50,,,percent of total billed charges,50% of total Billed charges,4512.3,78,,,percent of total billed charges,78% of total billed charges,5785,100,,,percent of total billed charges,100% of total billed charges,4778.41,82.6,,,percent of total billed charges,82.6% of total billed charges,4778.41,82.6,,,percent of total billed charges,82.6% of total billed charges,971.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2892.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2892.5,50,,,percent of total billed charges,50% of total Billed charges,971.88,16.8,,,percent of total billed charges,16.8% of total billed charges,885.11,5785,
HOVERMATT 39'' SINGLE USE,490742,CDM,270,RC,,,Outpatient,,,823,534.95,,724.24,88,,,percent of total billed charges,88% of total Billed charges,411.5,50,,,percent of total billed charges,50% of total Billed charges,138.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,823,100,,,percent of total billed charges,100% of total billed charges,142.41,17.304,,,percent of total billed charges,17.304% of total billed charges,411.5,50,,,percent of total billed charges,50% of total Billed charges,518.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,138.26,16.8,,,percent of total billed charges,16.8% of total billed charges,125.92,15.3,,,percent of total billed charges,15.3% of total billed charges,567.87,69,,,percent of total billed charges,69% of total billed charges,823,100,,,percent of total billed charges,100% of total billed charges,411.5,50,,,percent of total billed charges,50% of total Billed charges,823,100,,,percent of total billed charges,100% of total billed charges,411.5,50,,,percent of total billed charges,50% of total Billed charges,823,100,,,percent of total billed charges,100% of total billed charges,411.5,50,,,percent of total billed charges,50% of total Billed charges,509.03,61.85,,,percent of total billed charges,61.85% of total billed charges,138.26,16.8,,,percent of total billed charges,16.8% of total billed charges,411.5,50,,,percent of total billed charges,50% of total Billed charges,411.5,50,,,percent of total billed charges,50% of total Billed charges,138.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,411.5,50,,,percent of total billed charges,50% of total Billed charges,411.5,50,,,percent of total billed charges,50% of total Billed charges,141.03,17.136,,,percent of total billed charges,17.136% of total billed charges,179.74,21.84,,,percent of total billed charges,21.84% of total billed charges,411.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,411.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,411.5,50,,,percent of total billed charges,50% of total Billed charges,641.94,78,,,percent of total billed charges,78% of total billed charges,823,100,,,percent of total billed charges,100% of total billed charges,679.8,82.6,,,percent of total billed charges,82.6% of total billed charges,679.8,82.6,,,percent of total billed charges,82.6% of total billed charges,138.26,16.8,,,percent of total billed charges,16.8% of total billed charges,411.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,411.5,50,,,percent of total billed charges,50% of total Billed charges,138.26,16.8,,,percent of total billed charges,16.8% of total billed charges,125.92,823,
HOW BONE PLUG SMALL,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
HOW BONE PLUG LARGE,ORSUP0016,CDM,278,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
HOW BONE PLUG MEDIUM,ORSUP0008,CDM,278,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
HUMIDITY CONTROL PKS BX / 2 SETS,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
HUMIDIFIER BUBBLE AQUAPAK,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
HVLP CUFFED ORAL/NASAL W/MURPHY EYE 9.0,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
HY-TAPE 1,490749,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
HYCOIR KOVA SLIDES URINE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
HYDRATOME RX 44 W/450CM WIRE,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
HYDROGEN PEROXIDE 4 OZ,490748,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
HYDROGEN PEROXIDE,490747,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
HYDROCHLORIC ACID SOLUTION 1,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
HYDROGEN PEROXIDE 3% 4oz,ORSUP0001,CDM,250,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
I-GEL SUPRAGLOTTIC AIRWAY ADULT SZ 3,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
I-GEL SUPRAGLOTTIC AIRWAY ADULT SZ4,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
I-GEL SUPRAGLOTTIC AIRWAY ADULT SZ 5,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
I-GEL SUPRAGLOTTIC AIRWAY SZ 2,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
I-GEL SUPRAGLOTTIC AIRWAY INFANT,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
ICALCIUM ELECTRODE,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
ICE BAG LARGE FILLABLE,241613,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
ICE BAG SMALL FILLABLE,241612,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
ICONIX SPEED WITH 1 STRAND 1.2MM % 1 STRAND 2.0MM,ORSUP0030,CDM,278,RC,C1713,HCPCS,Outpatient,,,3800,2470.00,,3344,88,,,percent of total billed charges,88% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,657.55,17.304,,,percent of total billed charges,17.304% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,2394,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,581.4,15.3,,,percent of total billed charges,15.3% of total billed charges,2622,69,,,percent of total billed charges,69% of total billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,2350.3,61.85,,,percent of total billed charges,61.85% of total billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1185.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1900,50,,,percent of total billed charges,50% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,651.17,17.136,,,percent of total billed charges,17.136% of total billed charges,829.92,21.84,,,percent of total billed charges,21.84% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1432.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1432.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1288.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,2964,78,,,percent of total billed charges,78% of total billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,3138.8,82.6,,,percent of total billed charges,82.6% of total billed charges,3138.8,82.6,,,percent of total billed charges,82.6% of total billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1900,50,,,percent of total billed charges,50% of total Billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,581.4,3800,
ID BLOOD BANDS YELLOW,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ILLUMINATION SYSTEM GLOBUS,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
IMMERSION OIL,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
IMMOBILIZER SPECIALTY SHOULDER  LARGE,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
IMMOBILIZER SHOULDER LG FEMALE,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
IMMOBILIZER SLINGSHOPT 2 SHOULDER MED,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
IMMOBILIZER SLINGSHOPT 2 SHOULDER LARGE,ORSUP0006,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
IMMUNOSTAT EHEC,ORSUP0020,CDM,270,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
IMMUNOCARD GIARDIA CRYPTO,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
IMMUNO WASH FLUID BX / 30 BTLS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
IMMUNOASSAY PLUS CONTROL LVL 3,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
IMMUNOLOGY CONTROL LVL 1,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
IMMUNOLOGY CONTROL LVL 3,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
IMMUNOLOGY LEVEL 2,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
IMPLANT SCREW CORTICAL 2.5MM X 18MM L,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
IMPLANT SCREW CORTICAL 2.5MM X 22MM L,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
IMPLANT BLADE HELICAL 105MM TI NL NS,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
IMPLANT BLADE HELICAL TITANIUM 90MML,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
IMPLANT BLADE HELICAL TITANIUM 95MML,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
IMPLANT HEAD 3-D TITANIUM,ORSUP0022,CDM,278,RC,C1713,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
IMPLANT LOCKING CAP 3-D HEAD TITANIUM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
IMPLANT PEG SMOOTH 2.0MM X 16MM L,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
IMPLANT PEG SMOOTH 2.0MM X 24MM L,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
IMPLANT PLATE LCP 3.5MM 6 HOLES 85MM L,ORSUP0025,CDM,278,RC,C1713,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
IMPLANT PLATE LCP 3.5MM 8 HOLES 111MM L,ORSUP0022,CDM,278,RC,C1713,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
IMPLANT ROD SOFT TI CURVED 6MM X 45MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
IMPLANT ROD SOFT TI CURVED 6MM X 55MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
IMPLANT ROD SOFT TI CURVED 6MM X 65MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
IMPLANT ROD SOFT TI CURVED 6MM X 75MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
IMPLANT ROD SOFT TITANIUM 6MM X 50MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
IMPLANT ROUND SYNMESH 495.356,ORSUP0071,CDM,278,RC,C1713,HCPCS,Outpatient,,,15860,10309.00,,13956.8,88,,,percent of total billed charges,88% of total Billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,2664.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2744.41,17.304,,,percent of total billed charges,17.304% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,9991.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2664.48,16.8,,,percent of total billed charges,16.8% of total billed charges,2426.58,15.3,,,percent of total billed charges,15.3% of total billed charges,10943.4,69,,,percent of total billed charges,69% of total billed charges,15860,100,,,percent of total billed charges,100% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,15860,100,,,percent of total billed charges,100% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,15860,100,,,percent of total billed charges,100% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,9809.41,61.85,,,percent of total billed charges,61.85% of total billed charges,2664.48,16.8,,,percent of total billed charges,16.8% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,4948.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7930,50,,,percent of total billed charges,50% of total Billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,2717.77,17.136,,,percent of total billed charges,17.136% of total billed charges,3463.82,21.84,,,percent of total billed charges,21.84% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,5979.22,37.7,,,percent of total billed charges,37.70% of total billed charges,5979.22,37.7,,,percent of total billed charges,37.70% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,5376.54,33.9,,,percent of total billed charges,33.9% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,12370.8,78,,,percent of total billed charges,78% of total billed charges,15860,100,,,percent of total billed charges,100% of total billed charges,13100.36,82.6,,,percent of total billed charges,82.6% of total billed charges,13100.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2664.48,16.8,,,percent of total billed charges,16.8% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7930,50,,,percent of total billed charges,50% of total Billed charges,2664.48,16.8,,,percent of total billed charges,16.8% of total billed charges,2426.58,15860,
IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 40MM L,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 55MM L,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 60MM L,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 80MM L,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 85MM L,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 90MM L,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 100MML,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 105MML,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 110MML,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 115MML,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 80MML,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 90MML,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT SCREW CANNULATED LONG THREAD 4.0MM 42MM,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 28MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 30MM,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 34MM,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 36MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 40MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 44MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 50MM,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 14MM L,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 16MM L,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,263.9,37.7,,,percent of total billed charges,37.70% of total billed charges,263.9,37.7,,,percent of total billed charges,37.70% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,237.3,33.9,,,percent of total billed charges,33.9% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 18MM L,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 22MM L,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 24MM L,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 28MM L,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 32MM L,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 36MM L,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 45MM L,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 50MM L,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
IMPLANT SCREW CORTEX SLF TAP 3.5MMX55MML,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
IMPLANT SCREW CORTEX TITAN SELF-TAP 3.5MM X 14MML,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
IMPLANT SCREW CORTICAL 2.5MM X 14MM L,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
IMPLANT SCREW CORTICAL 2.5MM X 16MM L,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
IMPLANT SCREW CORTICAL 2.5MM X 24MM L,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
IMPLANT SCREW CORTICAL 2.5MM X 26MM L,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 10MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 12MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 14MM,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,561.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,610.2,33.9,,,percent of total billed charges,33.9% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 18MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 20MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 24MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 26MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 34MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 36MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
IMPLANT TRANSCONNECTOR LO PROFL 42-55MM 6MM ROD,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
IMPLANT WASHER 7MM DIA,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
IMPLANT BONE MATRIX DBX DEMINERALIZED 5CC,ORSUP0034,CDM,278,RC,C1762,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
IMPLANT BONE MATRIX DBX DEMINERALIZED 1CC,ORSUP0017,CDM,278,RC,C1762,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT BONE MATRIX DBX DEMINERALIZED 10CC,ORSUP0036,CDM,278,RC,C1762,HCPCS,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4095,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
IMPLANT BONE \\T\\ PUTTY MIX DBX 5CC BONE CHIP,ORSUP0032,CDM,278,RC,C1762,HCPCS,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1703.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1850.94,33.9,,,percent of total billed charges,33.9% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
IMPLANT BONE SPACER TPLIF 13MM,ORSUP0104,CDM,278,RC,C1762,HCPCS,Outpatient,,,24700,16055.00,,21736,88,,,percent of total billed charges,88% of total Billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,4149.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4274.09,17.304,,,percent of total billed charges,17.304% of total billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,15561,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4149.6,16.8,,,percent of total billed charges,16.8% of total billed charges,3779.1,15.3,,,percent of total billed charges,15.3% of total billed charges,17043,69,,,percent of total billed charges,69% of total billed charges,24700,100,,,percent of total billed charges,100% of total billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,24700,100,,,percent of total billed charges,100% of total billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,24700,100,,,percent of total billed charges,100% of total billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,15276.95,61.85,,,percent of total billed charges,61.85% of total billed charges,4149.6,16.8,,,percent of total billed charges,16.8% of total billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,7706.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12350,50,,,percent of total billed charges,50% of total Billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,4232.59,17.136,,,percent of total billed charges,17.136% of total billed charges,5394.48,21.84,,,percent of total billed charges,21.84% of total billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,9311.9,37.7,,,percent of total billed charges,37.70% of total billed charges,9311.9,37.7,,,percent of total billed charges,37.70% of total billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,8373.3,33.9,,,percent of total billed charges,33.9% of total billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,19266,78,,,percent of total billed charges,78% of total billed charges,24700,100,,,percent of total billed charges,100% of total billed charges,20402.2,82.6,,,percent of total billed charges,82.6% of total billed charges,20402.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4149.6,16.8,,,percent of total billed charges,16.8% of total billed charges,12350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12350,50,,,percent of total billed charges,50% of total Billed charges,4149.6,16.8,,,percent of total billed charges,16.8% of total billed charges,3779.1,24700,
IMPLANT DUREPAIR 1 X 1,ORSUP0011,CDM,278,RC,C1763,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
IMPLANT GAIT MEDIUM 30-100-02,ORSUP0026,CDM,278,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
IMPLANT ROD SOFT TI CURVED 6MM X 85MM,ORSUP0015,CDM,278,RC,C1755,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
IMPLANT ZERO-P 14MM SCREW 04.617.814,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
IMPLANT PIN GUIDE TIBIAL 2.4MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
IMPLANT PIN GUIDE W/SUTURE EYE 2.4MM,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
IMPLANT CPR MINI SCORPION DX,ORSUP0033,CDM,272,RC,,,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
IMPL DV INT PRC LVL1,CATH00069,CDM,278,RC,C1889,HCPCS,Outpatient,,,114704,74557.60,,100939.52,88,,,percent of total billed charges,88% of total Billed charges,57352,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,57352,50,,,percent of total billed charges,50% of total Billed charges,72263.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",17549.71,15.3,,,percent of total billed charges,15.3% of total billed charges,79145.76,69,,,percent of total billed charges,69% of total billed charges,114704,100,,,percent of total billed charges,100% of total billed charges,57352,50,,,percent of total billed charges,50% of total Billed charges,114704,100,,,percent of total billed charges,100% of total billed charges,57352,50,,,percent of total billed charges,50% of total Billed charges,114704,100,,,percent of total billed charges,100% of total billed charges,57352,50,,,percent of total billed charges,50% of total Billed charges,70944.42,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,57352,50,,,percent of total billed charges,50% of total Billed charges,57352,50,,,percent of total billed charges,50% of total Billed charges,35787.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57352,50,,,percent of total billed charges,50% of total Billed charges,57352,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,57352,50,,,percent of total billed charges,50% of total Billed charges,43243.41,37.7,,,percent of total billed charges,37.70% of total billed charges,43243.41,37.7,,,percent of total billed charges,37.70% of total billed charges,57352,50,,,percent of total billed charges,50% of total Billed charges,38884.66,33.9,,,percent of total billed charges,33.9% of total billed charges,57352,50,,,percent of total billed charges,50% of total Billed charges,89469.12,78,,,percent of total billed charges,78% of total billed charges,114704,100,,,percent of total billed charges,100% of total billed charges,94745.5,82.6,,,percent of total billed charges,82.6% of total billed charges,94745.5,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,57352,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,57352,50,,,percent of total billed charges,50% of total Billed charges,19270.27,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,114704,
IMPLANT SCREW CORTICAL 2.5MM X 20MM L,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
INCISOR PLUS ELITE POWER-MINI DISP 2.9,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
INCYTO C CHIP HEMACYTOMETER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
INDEFLATOR CATH,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
INDICATOR STEAM BOWIE-DICK TEST W/EARLY WARN SHT,53129,CDM,270,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
INDICATOR VERIFY ALL CLEAN TEST WASHER,ORSUP0001,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
INDICATOR STER CYCLESURE BIO STERRAD,151254,CDM,272,RC,,,Outpatient,,,105,68.25,,92.4,88,,,percent of total billed charges,88% of total Billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,17.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,105,100,,,percent of total billed charges,100% of total billed charges,18.17,17.304,,,percent of total billed charges,17.304% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,66.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,17.64,16.8,,,percent of total billed charges,16.8% of total billed charges,16.07,15.3,,,percent of total billed charges,15.3% of total billed charges,72.45,69,,,percent of total billed charges,69% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,105,100,,,percent of total billed charges,100% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,105,100,,,percent of total billed charges,100% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,64.94,61.85,,,percent of total billed charges,61.85% of total billed charges,17.64,16.8,,,percent of total billed charges,16.8% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,17.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,17.99,17.136,,,percent of total billed charges,17.136% of total billed charges,22.93,21.84,,,percent of total billed charges,21.84% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,52.5,50,,,percent of total billed charges,50% of total Billed charges,81.9,78,,,percent of total billed charges,78% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,17.64,16.8,,,percent of total billed charges,16.8% of total billed charges,52.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,52.5,50,,,percent of total billed charges,50% of total Billed charges,17.64,16.8,,,percent of total billed charges,16.8% of total billed charges,16.07,105,
INDICATOR STERILIZATION 'ATTEST' FOR STEAM 50/BX,151257,CDM,272,RC,,,Outpatient,,,709,460.85,,623.92,88,,,percent of total billed charges,88% of total Billed charges,354.5,50,,,percent of total billed charges,50% of total Billed charges,119.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,709,100,,,percent of total billed charges,100% of total billed charges,122.69,17.304,,,percent of total billed charges,17.304% of total billed charges,354.5,50,,,percent of total billed charges,50% of total Billed charges,446.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,119.11,16.8,,,percent of total billed charges,16.8% of total billed charges,108.48,15.3,,,percent of total billed charges,15.3% of total billed charges,489.21,69,,,percent of total billed charges,69% of total billed charges,709,100,,,percent of total billed charges,100% of total billed charges,354.5,50,,,percent of total billed charges,50% of total Billed charges,709,100,,,percent of total billed charges,100% of total billed charges,354.5,50,,,percent of total billed charges,50% of total Billed charges,709,100,,,percent of total billed charges,100% of total billed charges,354.5,50,,,percent of total billed charges,50% of total Billed charges,438.52,61.85,,,percent of total billed charges,61.85% of total billed charges,119.11,16.8,,,percent of total billed charges,16.8% of total billed charges,354.5,50,,,percent of total billed charges,50% of total Billed charges,354.5,50,,,percent of total billed charges,50% of total Billed charges,119.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,354.5,50,,,percent of total billed charges,50% of total Billed charges,354.5,50,,,percent of total billed charges,50% of total Billed charges,121.49,17.136,,,percent of total billed charges,17.136% of total billed charges,154.85,21.84,,,percent of total billed charges,21.84% of total billed charges,354.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,354.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,354.5,50,,,percent of total billed charges,50% of total Billed charges,553.02,78,,,percent of total billed charges,78% of total billed charges,709,100,,,percent of total billed charges,100% of total billed charges,585.63,82.6,,,percent of total billed charges,82.6% of total billed charges,585.63,82.6,,,percent of total billed charges,82.6% of total billed charges,119.11,16.8,,,percent of total billed charges,16.8% of total billed charges,354.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,354.5,50,,,percent of total billed charges,50% of total Billed charges,119.11,16.8,,,percent of total billed charges,16.8% of total billed charges,108.48,709,
INDICATOR STERILIZATION INTEGRATOR STEAM W/EXTEND,65209,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
INDICATOR STERILIZATION INTEGRATOR STEAM,ORSUP0001,CDM,272,RC,,,Outpatient,,,334,217.10,,293.92,88,,,percent of total billed charges,88% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,334,100,,,percent of total billed charges,100% of total billed charges,57.8,17.304,,,percent of total billed charges,17.304% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,210.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,51.1,15.3,,,percent of total billed charges,15.3% of total billed charges,230.46,69,,,percent of total billed charges,69% of total billed charges,334,100,,,percent of total billed charges,100% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,334,100,,,percent of total billed charges,100% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,334,100,,,percent of total billed charges,100% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,206.58,61.85,,,percent of total billed charges,61.85% of total billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,57.23,17.136,,,percent of total billed charges,17.136% of total billed charges,72.95,21.84,,,percent of total billed charges,21.84% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,167,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,167,50,,,percent of total billed charges,50% of total Billed charges,260.52,78,,,percent of total billed charges,78% of total billed charges,334,100,,,percent of total billed charges,100% of total billed charges,275.88,82.6,,,percent of total billed charges,82.6% of total billed charges,275.88,82.6,,,percent of total billed charges,82.6% of total billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,167,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,167,50,,,percent of total billed charges,50% of total Billed charges,56.11,16.8,,,percent of total billed charges,16.8% of total billed charges,51.1,334,
INDICATOR ANAEROBIC 100,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
INFANT TRANSPORT WARMER MATTRESS,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
INFANT HEARING TEST PREMIE CLEAR 3.5-5MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
INFANT ALRMING BANDS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
INFANT HEADGEAR 40-45CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
INFANT CHIN STRAP 38-44CM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
INFANT HEADGEAR 35-40CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
INFANT CHIN STRAP 32-38CM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
INFANT BONNET 17-22CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
INFANT CHIN STRAP 20-26CM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
INFANT BONNET 22-25CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
INFANT NASAL MASK SZ SMALL,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
INFLATION DEVICE ENCORE 26,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
INFLATION DEVICE HI-PRESSURE,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
RING INFLATABLE 17X15,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
INFUSION BAG 500ML DISPOSABLE,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
inkINK AND PAPER COMBO,179599,CDM,270,RC,,,Outpatient,,,2448,1591.20,,2154.24,88,,,percent of total billed charges,88% of total Billed charges,1224,50,,,percent of total billed charges,50% of total Billed charges,411.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,2448,100,,,percent of total billed charges,100% of total billed charges,423.6,17.304,,,percent of total billed charges,17.304% of total billed charges,1224,50,,,percent of total billed charges,50% of total Billed charges,1542.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,411.26,16.8,,,percent of total billed charges,16.8% of total billed charges,374.54,15.3,,,percent of total billed charges,15.3% of total billed charges,1689.12,69,,,percent of total billed charges,69% of total billed charges,2448,100,,,percent of total billed charges,100% of total billed charges,1224,50,,,percent of total billed charges,50% of total Billed charges,2448,100,,,percent of total billed charges,100% of total billed charges,1224,50,,,percent of total billed charges,50% of total Billed charges,2448,100,,,percent of total billed charges,100% of total billed charges,1224,50,,,percent of total billed charges,50% of total Billed charges,1514.09,61.85,,,percent of total billed charges,61.85% of total billed charges,411.26,16.8,,,percent of total billed charges,16.8% of total billed charges,1224,50,,,percent of total billed charges,50% of total Billed charges,1224,50,,,percent of total billed charges,50% of total Billed charges,411.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,1224,50,,,percent of total billed charges,50% of total Billed charges,1224,50,,,percent of total billed charges,50% of total Billed charges,419.49,17.136,,,percent of total billed charges,17.136% of total billed charges,534.64,21.84,,,percent of total billed charges,21.84% of total billed charges,1224,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1224,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1224,50,,,percent of total billed charges,50% of total Billed charges,1909.44,78,,,percent of total billed charges,78% of total billed charges,2448,100,,,percent of total billed charges,100% of total billed charges,2022.05,82.6,,,percent of total billed charges,82.6% of total billed charges,2022.05,82.6,,,percent of total billed charges,82.6% of total billed charges,411.26,16.8,,,percent of total billed charges,16.8% of total billed charges,1224,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1224,50,,,percent of total billed charges,50% of total Billed charges,411.26,16.8,,,percent of total billed charges,16.8% of total billed charges,374.54,2448,
INK SOLID MAGENTA 108R00724,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
INK SOLID YELLOW 108R00725,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
INLET GASKET,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PRECISION SYSTEMS STANDARD 100,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
INLET CONNECTOR GASKET-ABL-90,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
INLET GASKET W/ HOLDER,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
INNER AXON NUT,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
INSERTER TIP F/MEDIUM \\T\\ MEDIUM DEEP IMPLANTS 5MM HEIGHT-STER,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
INSERT SUTURE HOLDING,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
INSERTION KIT FIDELITY 7.5FR,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
INSERTION KIT 8FR,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
INSERTION KIT IAB 50CC,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
INSTRUMENT MAXTORQUE 2.7MM DRILL BIT (GOLD) CSS-072-27,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
INSTRUMENT WIPES MERCOCEL,490759,CDM,272,RC,,,Outpatient,,,433,281.45,,381.04,88,,,percent of total billed charges,88% of total Billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,72.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,433,100,,,percent of total billed charges,100% of total billed charges,74.93,17.304,,,percent of total billed charges,17.304% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,272.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,72.74,16.8,,,percent of total billed charges,16.8% of total billed charges,66.25,15.3,,,percent of total billed charges,15.3% of total billed charges,298.77,69,,,percent of total billed charges,69% of total billed charges,433,100,,,percent of total billed charges,100% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,433,100,,,percent of total billed charges,100% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,433,100,,,percent of total billed charges,100% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,267.81,61.85,,,percent of total billed charges,61.85% of total billed charges,72.74,16.8,,,percent of total billed charges,16.8% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,72.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,74.2,17.136,,,percent of total billed charges,17.136% of total billed charges,94.57,21.84,,,percent of total billed charges,21.84% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,216.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,216.5,50,,,percent of total billed charges,50% of total Billed charges,337.74,78,,,percent of total billed charges,78% of total billed charges,433,100,,,percent of total billed charges,100% of total billed charges,357.66,82.6,,,percent of total billed charges,82.6% of total billed charges,357.66,82.6,,,percent of total billed charges,82.6% of total billed charges,72.74,16.8,,,percent of total billed charges,16.8% of total billed charges,216.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,216.5,50,,,percent of total billed charges,50% of total Billed charges,72.74,16.8,,,percent of total billed charges,16.8% of total billed charges,66.25,433,
INSTRUMENT TRACKER EM ENT,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
INSTRUMENT MILK,490752,CDM,270,RC,,,Outpatient,,,240,156.00,,211.2,88,,,percent of total billed charges,88% of total Billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,40.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,240,100,,,percent of total billed charges,100% of total billed charges,41.53,17.304,,,percent of total billed charges,17.304% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,151.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,40.32,16.8,,,percent of total billed charges,16.8% of total billed charges,36.72,15.3,,,percent of total billed charges,15.3% of total billed charges,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,240,100,,,percent of total billed charges,100% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,240,100,,,percent of total billed charges,100% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,148.44,61.85,,,percent of total billed charges,61.85% of total billed charges,40.32,16.8,,,percent of total billed charges,16.8% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,40.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,41.13,17.136,,,percent of total billed charges,17.136% of total billed charges,52.42,21.84,,,percent of total billed charges,21.84% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120,50,,,percent of total billed charges,50% of total Billed charges,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,40.32,16.8,,,percent of total billed charges,16.8% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120,50,,,percent of total billed charges,50% of total Billed charges,40.32,16.8,,,percent of total billed charges,16.8% of total billed charges,36.72,240,
INSTRUMENT TIP PROTECTOR .50 W X 1,490753,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
INSTRUMENT TIP PROTECTOR 3/4 W X 1 L,490754,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
INSTRUMENT TIP PROTECTOR 3/8 W X 1 L,490755,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
INSTRUMENT TIP PROTECTOR 5/8 W X 1 L,490756,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
INSTRUMENT TIP PROTECTOR DUO ORANGE,490757,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
INSTRUMENT ARM DRAPE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
INSTURMENT BRIGHTNER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
INSTRUMENT TIP CAPS CLEAR 1.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
INSTRUMENT TRAY LABEL W/ MONTH/DATES,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
INSTANT HOT PACKS 4X9,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
INSTRUMENT POUCH 3-POCKET,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
INSUFFLATION NEEDLE,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
INSULATED BOVIE TIP ELECTRODE  50/CS,105187,CDM,272,RC,,,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.13,17.304,,,percent of total billed charges,17.304% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,8.05,17.136,,,percent of total billed charges,17.136% of total billed charges,10.26,21.84,,,percent of total billed charges,21.84% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,47,
INSULATED COATED BOVIE BLADE 50/CASE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
INSUFLATION TUBING HEATED,ORSUP0031,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
INTERCEED ABSORB ADHES BARR 3 X 4,ORSUP0018,CDM,278,RC,C1765,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
INTERJECT SCLEROTHERAPY NDL 23G,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
INTERCEPT DETERGENT WIPES,490761,CDM,270,RC,,,Outpatient,,,140,91.00,,123.2,88,,,percent of total billed charges,88% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,140,100,,,percent of total billed charges,100% of total billed charges,24.23,17.304,,,percent of total billed charges,17.304% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,88.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,21.42,15.3,,,percent of total billed charges,15.3% of total billed charges,96.6,69,,,percent of total billed charges,69% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,140,100,,,percent of total billed charges,100% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,140,100,,,percent of total billed charges,100% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,86.59,61.85,,,percent of total billed charges,61.85% of total billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,23.99,17.136,,,percent of total billed charges,17.136% of total billed charges,30.58,21.84,,,percent of total billed charges,21.84% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,70,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,70,50,,,percent of total billed charges,50% of total Billed charges,109.2,78,,,percent of total billed charges,78% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,70,50,,,percent of total billed charges,50% of total Billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,21.42,140,
INTERPULSE HANDPIECE W/SUCTION,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
INTERNAL BRACE (LISFRANC),ORSUP0046,CDM,278,RC,C1713,HCPCS,Outpatient,,,9100,5915.00,,8008,88,,,percent of total billed charges,88% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1574.66,17.304,,,percent of total billed charges,17.304% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5733,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,15.3,,,percent of total billed charges,15.3% of total billed charges,6279,69,,,percent of total billed charges,69% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5628.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,2839.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1559.38,17.136,,,percent of total billed charges,17.136% of total billed charges,1987.44,21.84,,,percent of total billed charges,21.84% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,3430.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3430.7,37.7,,,percent of total billed charges,37.70% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,3084.9,33.9,,,percent of total billed charges,33.9% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,7098,78,,,percent of total billed charges,78% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,9100,
INTRODUCER SHEATH 11.5 FR,ORSUP0030,CDM,278,RC,C1893,HCPCS,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1541.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1674.66,33.9,,,percent of total billed charges,33.9% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
INTRODUCER FAST-CATH 8.5F SL 1 80CM,ORSUP0013,CDM,278,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
INTRODUCER 6FR 14CM,ORSUP0003,CDM,278,RC,C1892,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
INTRO ANSEL2 7FR 45CM,ORSUP0005,CDM,278,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
INTRO ANSEL1 7FR 45CM,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
INTRO ANSEL3 6FR 45CM,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
INTRODUCER SHEATH ANSEL 1 5FR,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
INTRODUCER CATH SHEATH BRITE TIP 7F .035IN 90CM L,ORSUP0006,CDM,278,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
INTRODUCER CATH SHEATH BRITE TIP 7F .035IN 55CM L,ORSUP0005,CDM,278,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
INTRO RAABE 7FR 70CM,ORSUP0006,CDM,278,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
INTRO BALKIN 6FR 40CM,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
INTRODUCER CHECK-FLO  16FR X 30CM,ORSUP0011,CDM,278,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
INTRODUCER SHEATH FLEXOR 7FR 90CM X 100 IN,ORSUP0009,CDM,278,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
INTRODUCER FLEX RAABE 5FR,ORSUP0006,CDM,278,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
INTRO CHECK FLO XL 22FR 25CM,ORSUP0019,CDM,278,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
INTRODUCER 4FR LONG,ORSUP0002,CDM,278,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
INTRODUCER ACCESSORY 14 GUAGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
INTRODUCER FLEX-GLIDE ET TUBE,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ORSUP0003,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
INTRODUCER SHEATH AVANTI 5FR 23CM,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
INTRODUCER GLIDE SHEATH 6FR,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
INTRODUCER WITH MINI GUIDEWIRE 5.5CMCORDIS,ORSUP0003,CDM,278,RC,C1769,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
INTRODUCER CHECK FLO  6FR,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
INTRODUCER TUOHY BORST SIDE ARM 6FR,ORSUP0007,CDM,278,RC,C1766,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
INTRODUCER SHEATH SPLITTABLE 7FR X 13CM,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
INTRODUCER SERTERA (BREAST BX),ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
INTRODUCER PEELAWAY 5FR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
INTRODUCER MICRO SHEATH 6FR,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
IO STABELIZER KIT,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
IODINE SCRUB SOLUTION 4 OZ,490765,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
IODINE PREP SOLUTION 4 OZ.,490764,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
IOGONE IODINE REMOVER PREP PADS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
IPASS 3 DIAMOND TIP,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
IQ CAL PACK,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
IQ CONTROL/FOCUS SET,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
IQ LAMINA BOTTLES,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
IRIS DILUENT PACK,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
IRIS SYSTEM CLEANSER PACK,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
IRON / 5 PACK / 300 SLIDES,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
IRRIGATOR SUCTION W/TIP,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
IRRIGATOR ENDOWRIST,336598,CDM,272,RC,,,Outpatient,,,1766,1147.90,,1554.08,88,,,percent of total billed charges,88% of total Billed charges,883,50,,,percent of total billed charges,50% of total Billed charges,296.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,1766,100,,,percent of total billed charges,100% of total billed charges,305.59,17.304,,,percent of total billed charges,17.304% of total billed charges,883,50,,,percent of total billed charges,50% of total Billed charges,1112.58,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,296.69,16.8,,,percent of total billed charges,16.8% of total billed charges,270.2,15.3,,,percent of total billed charges,15.3% of total billed charges,1218.54,69,,,percent of total billed charges,69% of total billed charges,1766,100,,,percent of total billed charges,100% of total billed charges,883,50,,,percent of total billed charges,50% of total Billed charges,1766,100,,,percent of total billed charges,100% of total billed charges,883,50,,,percent of total billed charges,50% of total Billed charges,1766,100,,,percent of total billed charges,100% of total billed charges,883,50,,,percent of total billed charges,50% of total Billed charges,1092.27,61.85,,,percent of total billed charges,61.85% of total billed charges,296.69,16.8,,,percent of total billed charges,16.8% of total billed charges,883,50,,,percent of total billed charges,50% of total Billed charges,883,50,,,percent of total billed charges,50% of total Billed charges,296.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,883,50,,,percent of total billed charges,50% of total Billed charges,883,50,,,percent of total billed charges,50% of total Billed charges,302.62,17.136,,,percent of total billed charges,17.136% of total billed charges,385.69,21.84,,,percent of total billed charges,21.84% of total billed charges,883,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,883,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,883,50,,,percent of total billed charges,50% of total Billed charges,1377.48,78,,,percent of total billed charges,78% of total billed charges,1766,100,,,percent of total billed charges,100% of total billed charges,1458.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1458.72,82.6,,,percent of total billed charges,82.6% of total billed charges,296.69,16.8,,,percent of total billed charges,16.8% of total billed charges,883,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,883,50,,,percent of total billed charges,50% of total Billed charges,296.69,16.8,,,percent of total billed charges,16.8% of total billed charges,270.2,1766,
IRRIGATOR SUCTION 5MM DA VINCI,337821,CDM,272,RC,,,Outpatient,,,2287,1486.55,,2012.56,88,,,percent of total billed charges,88% of total Billed charges,1143.5,50,,,percent of total billed charges,50% of total Billed charges,384.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,2287,100,,,percent of total billed charges,100% of total billed charges,395.74,17.304,,,percent of total billed charges,17.304% of total billed charges,1143.5,50,,,percent of total billed charges,50% of total Billed charges,1440.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,384.22,16.8,,,percent of total billed charges,16.8% of total billed charges,349.91,15.3,,,percent of total billed charges,15.3% of total billed charges,1578.03,69,,,percent of total billed charges,69% of total billed charges,2287,100,,,percent of total billed charges,100% of total billed charges,1143.5,50,,,percent of total billed charges,50% of total Billed charges,2287,100,,,percent of total billed charges,100% of total billed charges,1143.5,50,,,percent of total billed charges,50% of total Billed charges,2287,100,,,percent of total billed charges,100% of total billed charges,1143.5,50,,,percent of total billed charges,50% of total Billed charges,1414.51,61.85,,,percent of total billed charges,61.85% of total billed charges,384.22,16.8,,,percent of total billed charges,16.8% of total billed charges,1143.5,50,,,percent of total billed charges,50% of total Billed charges,1143.5,50,,,percent of total billed charges,50% of total Billed charges,384.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,1143.5,50,,,percent of total billed charges,50% of total Billed charges,1143.5,50,,,percent of total billed charges,50% of total Billed charges,391.9,17.136,,,percent of total billed charges,17.136% of total billed charges,499.48,21.84,,,percent of total billed charges,21.84% of total billed charges,1143.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1143.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1143.5,50,,,percent of total billed charges,50% of total Billed charges,1783.86,78,,,percent of total billed charges,78% of total billed charges,2287,100,,,percent of total billed charges,100% of total billed charges,1889.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1889.06,82.6,,,percent of total billed charges,82.6% of total billed charges,384.22,16.8,,,percent of total billed charges,16.8% of total billed charges,1143.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1143.5,50,,,percent of total billed charges,50% of total Billed charges,384.22,16.8,,,percent of total billed charges,16.8% of total billed charges,349.91,2287,
IRRIGATION CASSETTE HUMMER DIS,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
IRRESEPT JET LAVAGE,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
IRRESEPT LAVAGE 150ML,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
ISE MID STANDARD 4X2000ML,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ISE REFERENCE 4X1000ML,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
ISE INTERNAL REFERENCE 2X25ML,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
ISE LOW SERUM STANDARD 4X100ML,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ISE HIGH SERUM STANDARD 4X100ML,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ISE LOW/HIHGH SERUM 4X100ML,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ISE NA+/K+ SELECTIVITY CHECK,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
ISOLATION DRAPE,490768,CDM,270,RC,,,Outpatient,,,351,228.15,,308.88,88,,,percent of total billed charges,88% of total Billed charges,175.5,50,,,percent of total billed charges,50% of total Billed charges,58.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,351,100,,,percent of total billed charges,100% of total billed charges,60.74,17.304,,,percent of total billed charges,17.304% of total billed charges,175.5,50,,,percent of total billed charges,50% of total Billed charges,221.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.97,16.8,,,percent of total billed charges,16.8% of total billed charges,53.7,15.3,,,percent of total billed charges,15.3% of total billed charges,242.19,69,,,percent of total billed charges,69% of total billed charges,351,100,,,percent of total billed charges,100% of total billed charges,175.5,50,,,percent of total billed charges,50% of total Billed charges,351,100,,,percent of total billed charges,100% of total billed charges,175.5,50,,,percent of total billed charges,50% of total Billed charges,351,100,,,percent of total billed charges,100% of total billed charges,175.5,50,,,percent of total billed charges,50% of total Billed charges,217.09,61.85,,,percent of total billed charges,61.85% of total billed charges,58.97,16.8,,,percent of total billed charges,16.8% of total billed charges,175.5,50,,,percent of total billed charges,50% of total Billed charges,175.5,50,,,percent of total billed charges,50% of total Billed charges,58.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,175.5,50,,,percent of total billed charges,50% of total Billed charges,175.5,50,,,percent of total billed charges,50% of total Billed charges,60.15,17.136,,,percent of total billed charges,17.136% of total billed charges,76.66,21.84,,,percent of total billed charges,21.84% of total billed charges,175.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175.5,50,,,percent of total billed charges,50% of total Billed charges,273.78,78,,,percent of total billed charges,78% of total billed charges,351,100,,,percent of total billed charges,100% of total billed charges,289.93,82.6,,,percent of total billed charges,82.6% of total billed charges,289.93,82.6,,,percent of total billed charges,82.6% of total billed charges,58.97,16.8,,,percent of total billed charges,16.8% of total billed charges,175.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175.5,50,,,percent of total billed charges,50% of total Billed charges,58.97,16.8,,,percent of total billed charges,16.8% of total billed charges,53.7,351,
ISOSORB LIQUID TREATMENT,490769,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
ISTAT KAOLIN ACT CARTRIDGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ISTAT ACT CONTROL LEVEL 1,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ISTAT ACT CONTROL LEVEL 2,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
IV CLEARLINK HAND PUMP BLOOD SET,84809,CDM,270,RC,,,Outpatient,,,76,49.40,,66.88,88,,,percent of total billed charges,88% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,13.15,17.304,,,percent of total billed charges,17.304% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,47.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,11.63,15.3,,,percent of total billed charges,15.3% of total billed charges,52.44,69,,,percent of total billed charges,69% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,47.01,61.85,,,percent of total billed charges,61.85% of total billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,13.02,17.136,,,percent of total billed charges,17.136% of total billed charges,16.6,21.84,,,percent of total billed charges,21.84% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,59.28,78,,,percent of total billed charges,78% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,11.63,76,
IV REPLACEMENT CAP,490773,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
IV START KIT W/ PVP PREP PAD AND DRESSING,432487,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
IV START KIT,490774,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
IV START KIT KIT NEONATAL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
JACKSON FRAME KIT,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
JACKSON REES MODIFICATION CIRCUITS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
JACKSON FRAME KIT W/O HEAD REST,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
JAGWIRE HYDRA ST .035 450 CM,ORSUP0012,CDM,278,RC,C1769,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
JAGWIRE HYDRA ANG 260 CM,ORSUP0012,CDM,278,RC,C1769,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
JAGWIRE .025 X 260CM,ORSUP0011,CDM,278,RC,C1769,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
JEWELERS FORCEPS,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
JOIMAX VAPOR FLEX PROBE 320,ORSUP0024,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
JOIMAX TESSYS ACCESS KIT,ORSUP0031,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
JOIMAX PUMP TUBING,ORSUP0011,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
JOIMAX HORIZONTAL DRAPE,ORSUP0011,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
JOIMAX CAMERA COVER,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
JOIMAX NDL AND GUIDEWIRE 150,ORSUP0007,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
JOIMAX DIAMOND ABRASSOR 3.5,ORSUP0023,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
JOIMAX VAPOR FLEX PROBE 250,ORSUP0024,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
JOIMAX NDL AND GUIDEWIRE 230,ORSUP0008,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
JOIMAX DIAMOND ABRASOR 4.5,ORSUP0026,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
JOIMAX OLIVE CUTTER,ORSUP0024,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
JOIMAX DEFLECTOR DIA ABRASOR,ORSUP0027,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
JST KIT,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
JUMPSUIT SURGICAL IMPERMEABLE PLYTHYLN W/TIE UNIV,168590,CDM,270,RC,,,Outpatient,,,86,55.90,,75.68,88,,,percent of total billed charges,88% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,14.88,17.304,,,percent of total billed charges,17.304% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,54.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,13.16,15.3,,,percent of total billed charges,15.3% of total billed charges,59.34,69,,,percent of total billed charges,69% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,53.19,61.85,,,percent of total billed charges,61.85% of total billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.74,17.136,,,percent of total billed charges,17.136% of total billed charges,18.78,21.84,,,percent of total billed charges,21.84% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,67.08,78,,,percent of total billed charges,78% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,13.16,86,
JURGAN PIN BALL W062,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
JURGAN PIN BALL W045,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
JURGEN BALL .062,ORSUP0002,CDM,278,RC,C1713,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
K WIRE 1.5MM,ORSUP0003,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
K WIRE 2.5MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
K-WIRE .028X4IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
K-WIRE .035X4IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
K-WIRE .045X4IN,ORSUP0003,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
K-WIRE .062 1/16X9IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
K-WIRE .062X4IN,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
K-WIRE 1.1 X 100MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
K-WIRE 1.60,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
K-WIRE PIN .062,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
K-WIRE PIN .045,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
K-WIRE .062 BRASSELER,ORSUP0003,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
K-WIRE .054 BRASSELER,ORSUP0003,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
K-WIRE .045 BRASSELER,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
K-WIRE .035 BRASSELER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
K-WIRE .045X9,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
K-WIRE 2MM SMOOTH,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
K-WIRE 0.054 X 6 NON STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
K-WIRE 0.045 X 6 NON STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
EPUMP 1000ML SAFETY SCREW SPIKE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
KELLER FUNNEL 2,ORSUP0012,CDM,272,RC,,,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
KERLIX 4.5,490777,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
KEY METER HT314 TRANSONIC,ORSUP0027,CDM,270,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
KIMWIPES,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
KIT GASTRO TUBE INITIAL PUSH 20FR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
KIT GASTROSTOMY INITIAL W/GASTRO INTRN BOLSTR 20F,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
KIT PERICARDIAL(PERI-VAC),ORSUP0010,CDM,278,RC,C1729,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
KIT LUMBAR EXTERNAL DRAINAGE,ORSUP0013,CDM,278,RC,C1729,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
KIT CATHETER PLEURAL 16F INTRODUCER 5 IN 1 CNNCTR,ORSUP0023,CDM,278,RC,C1729,HCPCS,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,973.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1057.68,33.9,,,percent of total billed charges,33.9% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
KIT DRAINAGE PLEURX W/500ML VACUUM BT \\T\\ PROCDR PK,ORSUP0005,CDM,278,RC,C1729,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
KIT MIDLINE POWERGLIDE FULL 18G 8CM,ORSUP0007,CDM,278,RC,C1725,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
KIT MIDLINE POWERGLIDE FULL 20G 8CM,ORSUP0007,CDM,278,RC,C1725,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
KIT TRACH BLUE RHINO PERCUTANEOUS 6MM,ORSUP0020,CDM,278,RC,C1769,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
KIT MICROPUNCTURE 4F G48002,ORSUP0005,CDM,278,RC,C1769,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
KIT CATH INSERTION IAB 8F 40CC W/DATASCOPE CONN,ORSUP0026,CDM,278,RC,C1725,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
KIT TUNNELER SHEATH 8INX17GA,ORSUP0011,CDM,278,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
KIT GYNECARE TVT ABD. GUIDE,ORSUP0027,CDM,278,RC,C2631,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
KIT TRANS-OBTURATOR TAPE ARIS SURGICAL,ORSUP0033,CDM,278,RC,C2631,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
KIT MICROSNARE 7MM,ORSUP0024,CDM,278,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
KIT PBP2 MRSA RAPID LATEX SLIDE AGGLUTINATION,ORSUP0024,CDM,270,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
KIT SUCTION CATH N GLOVE 10FR,11984,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
KIT BEDSIDE CARE ENDOSCOPY,320533,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
KIT BEDSIDE CLEANING INCL 16OZ BOWL  SPONGE,463127,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
KIT CHG,461921,CDM,270,RC,,,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
KIT DEFENDO SINGLE USE VALVE AND CONNECTOR,411911,CDM,272,RC,,,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,10.04,17.304,,,percent of total billed charges,17.304% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,36.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.94,17.136,,,percent of total billed charges,17.136% of total billed charges,12.67,21.84,,,percent of total billed charges,21.84% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,58,
KIT DISP ACCESSORY 3ARM IS3000 5P,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
KIT DISP ACCESSORY 4ARM IS3000 5P,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
KIT IV START CHLOROSCRUB TEGADERM,280796,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
KIT IV START W/CHLORAPREP AMPULE,324582,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
KIT PROCEDURE EDGE FT 90 DEGREE,ORSUP0035,CDM,270,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
KIT TURNOVER CUSTOM,431986,CDM,270,RC,,,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,17.48,17.304,,,percent of total billed charges,17.304% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,63.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,15.45,15.3,,,percent of total billed charges,15.3% of total billed charges,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,62.47,61.85,,,percent of total billed charges,61.85% of total billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,17.31,17.136,,,percent of total billed charges,17.136% of total billed charges,22.06,21.84,,,percent of total billed charges,21.84% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,15.45,101,
KIT TEST HCG COMBO QUICKVUE LATERAL FLOW PREGNANCY,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
KIT CALAS CRYPTOCOCCAL ANTIGEN,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
KIT FECAL CONCENTRATOE,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
KIT TUNNELER/SHEATH T11X12,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
KIT EXPANSION CATH ON Q SOAKER 3.25,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
KIT SURGIFOAM POWDER,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
KIT EPIDURAL CATH 19GA X 60CM CONT NRV BLK LTX FR,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
KIT CEMENT OPTIVAC  80GRAM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
KIT CRANIAL ACCESS,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
KIT VESSEL HARVEST HEMOPRO VH-3000,ORSUP0035,CDM,272,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
KIT GELFOAM THROMBIN PLUS,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
KIT GELFOAM PLUS,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
KIT EVAC 3-SPRING 400ML LRG 3/16 INCH W/TROCAR,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
KIT EVAC 3-SPRING 400ML MED 1/8 INCH W/TROCAR,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
KIT MIDSTREAM CATCH,1019,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
KIT ACP SERIES II,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
KIT ARTERIAL LINE KIT,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
KIT BIO-TENODESIS DISPOSABLE  STERILE,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
KIT BLOWER/MISTER,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
KIT BREAST PUMP W/FILTER UNIVERSAL REUSABLE,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
KIT EDGE 180 PROCEDURE,ORSUP0035,CDM,272,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
KIT EDGE 45 PROCEDURE,ORSUP0035,CDM,272,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
KIT EDGE 90 PROCEDURE,ORSUP0033,CDM,272,RC,,,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
KIT EMG NEEDLE,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
KIT ENT,ORSUP0051,CDM,272,RC,,,Outpatient,,,10400,6760.00,,9152,88,,,percent of total billed charges,88% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1799.62,17.304,,,percent of total billed charges,17.304% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,6552,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,15.3,,,percent of total billed charges,15.3% of total billed charges,7176,69,,,percent of total billed charges,69% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,6432.4,61.85,,,percent of total billed charges,61.85% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1782.14,17.136,,,percent of total billed charges,17.136% of total billed charges,2271.36,21.84,,,percent of total billed charges,21.84% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5200,50,,,percent of total billed charges,50% of total Billed charges,8112,78,,,percent of total billed charges,78% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,10400,
KIT FECAL MGMT FLEXI-SEAL FMS,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
KIT INTRA CRANIAL MONITOR 110-4B,ORSUP0029,CDM,272,RC,,,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
KIT KYPHO 15/3 ADDITIONAL FX,ORSUP0045,CDM,272,RC,,,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5569.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
KIT LOCATABLE GUIDE,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
KIT MAX ACCESS,ORSUP0044,CDM,272,RC,,,Outpatient,,,8580,5577.00,,7550.4,88,,,percent of total billed charges,88% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1484.68,17.304,,,percent of total billed charges,17.304% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5405.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,15.3,,,percent of total billed charges,15.3% of total billed charges,5920.2,69,,,percent of total billed charges,69% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5306.73,61.85,,,percent of total billed charges,61.85% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1470.27,17.136,,,percent of total billed charges,17.136% of total billed charges,1873.87,21.84,,,percent of total billed charges,21.84% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4290,50,,,percent of total billed charges,50% of total Billed charges,6692.4,78,,,percent of total billed charges,78% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,8580,
KIT MULTI LUMEN 7FR X 30CM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
KIT NUVASIVE XLIF,ORSUP0032,CDM,272,RC,,,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
KIT POSTCRANIAL PRESS.MONITOR,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
KIT ROBOT ACCESORY 3-ARM,308440,CDM,272,RC,,,Outpatient,,,1605,1043.25,,1412.4,88,,,percent of total billed charges,88% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,277.73,17.304,,,percent of total billed charges,17.304% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1011.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,245.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1107.45,69,,,percent of total billed charges,69% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,992.69,61.85,,,percent of total billed charges,61.85% of total billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,275.03,17.136,,,percent of total billed charges,17.136% of total billed charges,350.53,21.84,,,percent of total billed charges,21.84% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,1251.9,78,,,percent of total billed charges,78% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,245.57,1605,
KIT ROBOT ACCESORY 4-ARM,308441,CDM,272,RC,,,Outpatient,,,2087,1356.55,,1836.56,88,,,percent of total billed charges,88% of total Billed charges,1043.5,50,,,percent of total billed charges,50% of total Billed charges,350.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,2087,100,,,percent of total billed charges,100% of total billed charges,361.13,17.304,,,percent of total billed charges,17.304% of total billed charges,1043.5,50,,,percent of total billed charges,50% of total Billed charges,1314.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,350.62,16.8,,,percent of total billed charges,16.8% of total billed charges,319.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1440.03,69,,,percent of total billed charges,69% of total billed charges,2087,100,,,percent of total billed charges,100% of total billed charges,1043.5,50,,,percent of total billed charges,50% of total Billed charges,2087,100,,,percent of total billed charges,100% of total billed charges,1043.5,50,,,percent of total billed charges,50% of total Billed charges,2087,100,,,percent of total billed charges,100% of total billed charges,1043.5,50,,,percent of total billed charges,50% of total Billed charges,1290.81,61.85,,,percent of total billed charges,61.85% of total billed charges,350.62,16.8,,,percent of total billed charges,16.8% of total billed charges,1043.5,50,,,percent of total billed charges,50% of total Billed charges,1043.5,50,,,percent of total billed charges,50% of total Billed charges,350.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,1043.5,50,,,percent of total billed charges,50% of total Billed charges,1043.5,50,,,percent of total billed charges,50% of total Billed charges,357.63,17.136,,,percent of total billed charges,17.136% of total billed charges,455.8,21.84,,,percent of total billed charges,21.84% of total billed charges,1043.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1043.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1043.5,50,,,percent of total billed charges,50% of total Billed charges,1627.86,78,,,percent of total billed charges,78% of total billed charges,2087,100,,,percent of total billed charges,100% of total billed charges,1723.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1723.86,82.6,,,percent of total billed charges,82.6% of total billed charges,350.62,16.8,,,percent of total billed charges,16.8% of total billed charges,1043.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1043.5,50,,,percent of total billed charges,50% of total Billed charges,350.62,16.8,,,percent of total billed charges,16.8% of total billed charges,319.31,2087,
KIT RUMI KOH-EFFICIENT 3.0CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
KIT RUMI KOH-EFFICIENT 3.5CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
KIT SKIN CLOSURE DERMABOND PRINEO 22CM,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
KIT SNARE RETRIEVAL 30MM,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
KIT TRIMANO BEACH CHAIR BX/6,ORSUP0009,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
KIT TURNOVER,480705,CDM,272,RC,,,Outpatient,,,109,70.85,,95.92,88,,,percent of total billed charges,88% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total Billed charges,109,100,,,percent of total billed charges,100% of total billed charges,18.86,17.304,,,percent of total billed charges,17.304% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,68.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,16.68,15.3,,,percent of total billed charges,15.3% of total billed charges,75.21,69,,,percent of total billed charges,69% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,109,100,,,percent of total billed charges,100% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,109,100,,,percent of total billed charges,100% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,67.42,61.85,,,percent of total billed charges,61.85% of total billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.68,17.136,,,percent of total billed charges,17.136% of total billed charges,23.81,21.84,,,percent of total billed charges,21.84% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.5,50,,,percent of total billed charges,50% of total Billed charges,85.02,78,,,percent of total billed charges,78% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,16.68,109,
KIT VIZADISC HIP PROCEDURE TRACKING  STERILE (23 IN A PK),ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
KIT SHAVE PERSONAL,74775,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
KIT DISP INSTRUMENT SUTURETAK MINI,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
KIT ENDOVIVE STANDARD PEG  20F PULL,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
KIT ERGOPACK TRIPLE LUMEN 7FR,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
KIT MICROPUNTURE 4 FR,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
KIT MICROPUNCTURE 5FR,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
KIT PILLOW PRONEVIEW HELMENT,490793,CDM,270,RC,,,Outpatient,,,361,234.65,,317.68,88,,,percent of total billed charges,88% of total Billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,60.65,16.8,,,percent of total billed charges,16.8% of total Billed charges,361,100,,,percent of total billed charges,100% of total billed charges,62.47,17.304,,,percent of total billed charges,17.304% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,227.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,60.65,16.8,,,percent of total billed charges,16.8% of total billed charges,55.23,15.3,,,percent of total billed charges,15.3% of total billed charges,249.09,69,,,percent of total billed charges,69% of total billed charges,361,100,,,percent of total billed charges,100% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,361,100,,,percent of total billed charges,100% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,361,100,,,percent of total billed charges,100% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,223.28,61.85,,,percent of total billed charges,61.85% of total billed charges,60.65,16.8,,,percent of total billed charges,16.8% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,60.65,16.8,,,percent of total billed charges,16.8% of total Billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,61.86,17.136,,,percent of total billed charges,17.136% of total billed charges,78.84,21.84,,,percent of total billed charges,21.84% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,180.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,180.5,50,,,percent of total billed charges,50% of total Billed charges,281.58,78,,,percent of total billed charges,78% of total billed charges,361,100,,,percent of total billed charges,100% of total billed charges,298.19,82.6,,,percent of total billed charges,82.6% of total billed charges,298.19,82.6,,,percent of total billed charges,82.6% of total billed charges,60.65,16.8,,,percent of total billed charges,16.8% of total billed charges,180.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,180.5,50,,,percent of total billed charges,50% of total Billed charges,60.65,16.8,,,percent of total billed charges,16.8% of total billed charges,55.23,361,
KIT PICC 7 FR IMPREGNATED,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
KIT JEJUNOSTOMY FLEXIFLO 10 FR,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
"KIT INSERTION, PERITONEAL",ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
KIT INLET CLOSESURE DEVICE,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
KIT EAR DRESSING GLASSCOCK PED,490784,CDM,270,RC,,,Outpatient,,,71,46.15,,62.48,88,,,percent of total billed charges,88% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,12.29,17.304,,,percent of total billed charges,17.304% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,44.73,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,10.86,15.3,,,percent of total billed charges,15.3% of total billed charges,48.99,69,,,percent of total billed charges,69% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,71,100,,,percent of total billed charges,100% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,43.91,61.85,,,percent of total billed charges,61.85% of total billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,12.17,17.136,,,percent of total billed charges,17.136% of total billed charges,15.51,21.84,,,percent of total billed charges,21.84% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,55.38,78,,,percent of total billed charges,78% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,35.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35.5,50,,,percent of total billed charges,50% of total Billed charges,11.93,16.8,,,percent of total billed charges,16.8% of total billed charges,10.86,71,
KIT EAR DRESS GLASSCOCK ADULT,490783,CDM,270,RC,,,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,12.11,17.304,,,percent of total billed charges,17.304% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,44.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,12,17.136,,,percent of total billed charges,17.136% of total billed charges,15.29,21.84,,,percent of total billed charges,21.84% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,70,
KIT CHEST TUBE DISPOSABLE,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
KIT CATHETER MULTI LUMEN,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
KIT CATH SWAN NECK 2 CUFF LFT,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
KIT ANTI-FOG,490778,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
KIT BIOCARTILAGE SMALL JOINT,ORSUP0016,CDM,278,RC,C1763,HCPCS,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,199,17.304,,,percent of total billed charges,17.304% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,724.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,15.3,,,percent of total billed charges,15.3% of total billed charges,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,711.28,61.85,,,percent of total billed charges,61.85% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,358.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,197.06,17.136,,,percent of total billed charges,17.136% of total billed charges,251.16,21.84,,,percent of total billed charges,21.84% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,389.85,33.9,,,percent of total billed charges,33.9% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,1150,
KIT STAPH AUREUS ATTC 25923,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
KIT BLOOD GAS 3M W/POINT LOC,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
KIT MICROPUNTURE 5FR,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
KIT DISPOSABLE FOR 2.9MM SHORT PUSH LOCK,ORSUP0015,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
KIT SYNDN-EZ TITANIUM,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
KIT ESCHERICHIA COLI TEST LATEX,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
KIT FULL ALTRIX SMALL COLDER,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
KIT FULL ALTRIX LARGE COLDER,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
KIT PERICARDIOCEN STRAIGHT 6FR,ORSUP0014,CDM,278,RC,A4351,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,1170,100,,,percent of total billed charges,100% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,1170,100,,,percent of total billed charges,100% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,1170,100,,,Fee Schedule,100% of Medicare OPPS rate,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
KIT BLOOD GAS 1ML LUER SLIP SYRINGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
KIT SINGLE LUMEN 16G X 20CM CVC,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
KIT ANGIOPLASTY INSERTION TOOL,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
KIT URETHRAL RED RUBBER CATH W/O BAG,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
KIT ENDOVIVE STANDARD PEG 24FR,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
LAP KITTNER,490794,CDM,270,RC,,,Outpatient,,,112,72.80,,98.56,88,,,percent of total billed charges,88% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,19.38,17.304,,,percent of total billed charges,17.304% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,70.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,15.3,,,percent of total billed charges,15.3% of total billed charges,77.28,69,,,percent of total billed charges,69% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,69.27,61.85,,,percent of total billed charges,61.85% of total billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,19.19,17.136,,,percent of total billed charges,17.136% of total billed charges,24.46,21.84,,,percent of total billed charges,21.84% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,87.36,78,,,percent of total billed charges,78% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,112,
KIWI PROCUP VAGINAL SUCTION DEVICE,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
KIWI OMNICUP SUCTION SYSTEM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
KLEENSPEC VAGINAL LIGHTED,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
KLENZYME DETERGENT,490795,CDM,270,RC,,,Outpatient,,,541,351.65,,476.08,88,,,percent of total billed charges,88% of total Billed charges,270.5,50,,,percent of total billed charges,50% of total Billed charges,90.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,541,100,,,percent of total billed charges,100% of total billed charges,93.61,17.304,,,percent of total billed charges,17.304% of total billed charges,270.5,50,,,percent of total billed charges,50% of total Billed charges,340.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,90.89,16.8,,,percent of total billed charges,16.8% of total billed charges,82.77,15.3,,,percent of total billed charges,15.3% of total billed charges,373.29,69,,,percent of total billed charges,69% of total billed charges,541,100,,,percent of total billed charges,100% of total billed charges,270.5,50,,,percent of total billed charges,50% of total Billed charges,541,100,,,percent of total billed charges,100% of total billed charges,270.5,50,,,percent of total billed charges,50% of total Billed charges,541,100,,,percent of total billed charges,100% of total billed charges,270.5,50,,,percent of total billed charges,50% of total Billed charges,334.61,61.85,,,percent of total billed charges,61.85% of total billed charges,90.89,16.8,,,percent of total billed charges,16.8% of total billed charges,270.5,50,,,percent of total billed charges,50% of total Billed charges,270.5,50,,,percent of total billed charges,50% of total Billed charges,90.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,270.5,50,,,percent of total billed charges,50% of total Billed charges,270.5,50,,,percent of total billed charges,50% of total Billed charges,92.71,17.136,,,percent of total billed charges,17.136% of total billed charges,118.15,21.84,,,percent of total billed charges,21.84% of total billed charges,270.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,270.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,270.5,50,,,percent of total billed charges,50% of total Billed charges,421.98,78,,,percent of total billed charges,78% of total billed charges,541,100,,,percent of total billed charges,100% of total billed charges,446.87,82.6,,,percent of total billed charges,82.6% of total billed charges,446.87,82.6,,,percent of total billed charges,82.6% of total billed charges,90.89,16.8,,,percent of total billed charges,16.8% of total billed charges,270.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,270.5,50,,,percent of total billed charges,50% of total Billed charges,90.89,16.8,,,percent of total billed charges,16.8% of total billed charges,82.77,541,
KLING GAUZE STERILE 3,490796,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
KNEE BASEPLATE TIB TRIATHLON PRIM 4,ORSUP0088,CDM,278,RC,C1713,HCPCS,Outpatient,,,20280,13182.00,,17846.4,88,,,percent of total billed charges,88% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3509.25,17.304,,,percent of total billed charges,17.304% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,12776.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3102.84,15.3,,,percent of total billed charges,15.3% of total billed charges,13993.2,69,,,percent of total billed charges,69% of total billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,12543.18,61.85,,,percent of total billed charges,61.85% of total billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,6327.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10140,50,,,percent of total billed charges,50% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,3475.18,17.136,,,percent of total billed charges,17.136% of total billed charges,4429.15,21.84,,,percent of total billed charges,21.84% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,7645.56,37.7,,,percent of total billed charges,37.70% of total billed charges,7645.56,37.7,,,percent of total billed charges,37.70% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,6874.92,33.9,,,percent of total billed charges,33.9% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,15818.4,78,,,percent of total billed charges,78% of total billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,16751.28,82.6,,,percent of total billed charges,82.6% of total billed charges,16751.28,82.6,,,percent of total billed charges,82.6% of total billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10140,50,,,percent of total billed charges,50% of total Billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3102.84,20280,
KNEE BASEPLATE TIB TRIATHLON PRIM 5,ORSUP0088,CDM,278,RC,C1713,HCPCS,Outpatient,,,20280,13182.00,,17846.4,88,,,percent of total billed charges,88% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3509.25,17.304,,,percent of total billed charges,17.304% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,12776.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3102.84,15.3,,,percent of total billed charges,15.3% of total billed charges,13993.2,69,,,percent of total billed charges,69% of total billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,12543.18,61.85,,,percent of total billed charges,61.85% of total billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,6327.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10140,50,,,percent of total billed charges,50% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,3475.18,17.136,,,percent of total billed charges,17.136% of total billed charges,4429.15,21.84,,,percent of total billed charges,21.84% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,7645.56,37.7,,,percent of total billed charges,37.70% of total billed charges,7645.56,37.7,,,percent of total billed charges,37.70% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,6874.92,33.9,,,percent of total billed charges,33.9% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,15818.4,78,,,percent of total billed charges,78% of total billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,16751.28,82.6,,,percent of total billed charges,82.6% of total billed charges,16751.28,82.6,,,percent of total billed charges,82.6% of total billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10140,50,,,percent of total billed charges,50% of total Billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3102.84,20280,
KNEE BASEPLATE TIB TRIATHLON PRIM 6,ORSUP0088,CDM,278,RC,C1713,HCPCS,Outpatient,,,20280,13182.00,,17846.4,88,,,percent of total billed charges,88% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3509.25,17.304,,,percent of total billed charges,17.304% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,12776.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3102.84,15.3,,,percent of total billed charges,15.3% of total billed charges,13993.2,69,,,percent of total billed charges,69% of total billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,12543.18,61.85,,,percent of total billed charges,61.85% of total billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,6327.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10140,50,,,percent of total billed charges,50% of total Billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,3475.18,17.136,,,percent of total billed charges,17.136% of total billed charges,4429.15,21.84,,,percent of total billed charges,21.84% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,7645.56,37.7,,,percent of total billed charges,37.70% of total billed charges,7645.56,37.7,,,percent of total billed charges,37.70% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,6874.92,33.9,,,percent of total billed charges,33.9% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,15818.4,78,,,percent of total billed charges,78% of total billed charges,20280,100,,,percent of total billed charges,100% of total billed charges,16751.28,82.6,,,percent of total billed charges,82.6% of total billed charges,16751.28,82.6,,,percent of total billed charges,82.6% of total billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,10140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10140,50,,,percent of total billed charges,50% of total Billed charges,3407.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3102.84,20280,
KNEE FEMORAL TRIATHLON CR BEADED W/PA 5517-F-401,ORSUP0065,CDM,278,RC,,,Outpatient,,,14300,9295.00,,12584,88,,,percent of total billed charges,88% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2474.47,17.304,,,percent of total billed charges,17.304% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,9009,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2187.9,15.3,,,percent of total billed charges,15.3% of total billed charges,9867,69,,,percent of total billed charges,69% of total billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,8844.55,61.85,,,percent of total billed charges,61.85% of total billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,4461.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7150,50,,,percent of total billed charges,50% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,2450.45,17.136,,,percent of total billed charges,17.136% of total billed charges,3123.12,21.84,,,percent of total billed charges,21.84% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,5391.1,37.7,,,percent of total billed charges,37.70% of total billed charges,5391.1,37.7,,,percent of total billed charges,37.70% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,4847.7,33.9,,,percent of total billed charges,33.9% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,11154,78,,,percent of total billed charges,78% of total billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,11811.8,82.6,,,percent of total billed charges,82.6% of total billed charges,11811.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7150,50,,,percent of total billed charges,50% of total Billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2187.9,14300,
KNEE FEMORAL TRIATHLON CR BEADED W/PA 5517-F-402,ORSUP0065,CDM,278,RC,,,Outpatient,,,14300,9295.00,,12584,88,,,percent of total billed charges,88% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2474.47,17.304,,,percent of total billed charges,17.304% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,9009,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2187.9,15.3,,,percent of total billed charges,15.3% of total billed charges,9867,69,,,percent of total billed charges,69% of total billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,8844.55,61.85,,,percent of total billed charges,61.85% of total billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,4461.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7150,50,,,percent of total billed charges,50% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,2450.45,17.136,,,percent of total billed charges,17.136% of total billed charges,3123.12,21.84,,,percent of total billed charges,21.84% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,5391.1,37.7,,,percent of total billed charges,37.70% of total billed charges,5391.1,37.7,,,percent of total billed charges,37.70% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,4847.7,33.9,,,percent of total billed charges,33.9% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,11154,78,,,percent of total billed charges,78% of total billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,11811.8,82.6,,,percent of total billed charges,82.6% of total billed charges,11811.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7150,50,,,percent of total billed charges,50% of total Billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2187.9,14300,
KNEE FEMORAL TRIATHLON CR BEADED W/PA 5517-F-501,ORSUP0065,CDM,278,RC,,,Outpatient,,,14300,9295.00,,12584,88,,,percent of total billed charges,88% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2474.47,17.304,,,percent of total billed charges,17.304% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,9009,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2187.9,15.3,,,percent of total billed charges,15.3% of total billed charges,9867,69,,,percent of total billed charges,69% of total billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,8844.55,61.85,,,percent of total billed charges,61.85% of total billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,4461.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7150,50,,,percent of total billed charges,50% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,2450.45,17.136,,,percent of total billed charges,17.136% of total billed charges,3123.12,21.84,,,percent of total billed charges,21.84% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,5391.1,37.7,,,percent of total billed charges,37.70% of total billed charges,5391.1,37.7,,,percent of total billed charges,37.70% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,4847.7,33.9,,,percent of total billed charges,33.9% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,11154,78,,,percent of total billed charges,78% of total billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,11811.8,82.6,,,percent of total billed charges,82.6% of total billed charges,11811.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7150,50,,,percent of total billed charges,50% of total Billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2187.9,14300,
KNEE FEMORAL TRIATHLON CR BEADED W/PA 5517-F-601,ORSUP0065,CDM,278,RC,,,Outpatient,,,14300,9295.00,,12584,88,,,percent of total billed charges,88% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2474.47,17.304,,,percent of total billed charges,17.304% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,9009,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2187.9,15.3,,,percent of total billed charges,15.3% of total billed charges,9867,69,,,percent of total billed charges,69% of total billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,8844.55,61.85,,,percent of total billed charges,61.85% of total billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,4461.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7150,50,,,percent of total billed charges,50% of total Billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,2450.45,17.136,,,percent of total billed charges,17.136% of total billed charges,3123.12,21.84,,,percent of total billed charges,21.84% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,5391.1,37.7,,,percent of total billed charges,37.70% of total billed charges,5391.1,37.7,,,percent of total billed charges,37.70% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,4847.7,33.9,,,percent of total billed charges,33.9% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,11154,78,,,percent of total billed charges,78% of total billed charges,14300,100,,,percent of total billed charges,100% of total billed charges,11811.8,82.6,,,percent of total billed charges,82.6% of total billed charges,11811.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7150,50,,,percent of total billed charges,50% of total Billed charges,2402.4,16.8,,,percent of total billed charges,16.8% of total billed charges,2187.9,14300,
KNEE FEMORAL TRIATHLON CR CEMENTED #5 L,ORSUP0140,CDM,278,RC,C1713,HCPCS,Outpatient,,,34060,22139.00,,29972.8,88,,,percent of total billed charges,88% of total Billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,5722.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5893.74,17.304,,,percent of total billed charges,17.304% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,21457.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5722.08,16.8,,,percent of total billed charges,16.8% of total billed charges,5211.18,15.3,,,percent of total billed charges,15.3% of total billed charges,23501.4,69,,,percent of total billed charges,69% of total billed charges,34060,100,,,percent of total billed charges,100% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,34060,100,,,percent of total billed charges,100% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,34060,100,,,percent of total billed charges,100% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,21066.11,61.85,,,percent of total billed charges,61.85% of total billed charges,5722.08,16.8,,,percent of total billed charges,16.8% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,10626.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17030,50,,,percent of total billed charges,50% of total Billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,5836.52,17.136,,,percent of total billed charges,17.136% of total billed charges,7438.7,21.84,,,percent of total billed charges,21.84% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,12840.62,37.7,,,percent of total billed charges,37.70% of total billed charges,12840.62,37.7,,,percent of total billed charges,37.70% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,11546.34,33.9,,,percent of total billed charges,33.9% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,26566.8,78,,,percent of total billed charges,78% of total billed charges,34060,100,,,percent of total billed charges,100% of total billed charges,28133.56,82.6,,,percent of total billed charges,82.6% of total billed charges,28133.56,82.6,,,percent of total billed charges,82.6% of total billed charges,5722.08,16.8,,,percent of total billed charges,16.8% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17030,50,,,percent of total billed charges,50% of total Billed charges,5722.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,34060,
KNEE FEMORAL TRIATHLON CR CEMENTED #5 R,ORSUP0140,CDM,278,RC,C1713,HCPCS,Outpatient,,,34060,22139.00,,29972.8,88,,,percent of total billed charges,88% of total Billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,5722.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5893.74,17.304,,,percent of total billed charges,17.304% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,21457.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5722.08,16.8,,,percent of total billed charges,16.8% of total billed charges,5211.18,15.3,,,percent of total billed charges,15.3% of total billed charges,23501.4,69,,,percent of total billed charges,69% of total billed charges,34060,100,,,percent of total billed charges,100% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,34060,100,,,percent of total billed charges,100% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,34060,100,,,percent of total billed charges,100% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,21066.11,61.85,,,percent of total billed charges,61.85% of total billed charges,5722.08,16.8,,,percent of total billed charges,16.8% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,10626.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17030,50,,,percent of total billed charges,50% of total Billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,5836.52,17.136,,,percent of total billed charges,17.136% of total billed charges,7438.7,21.84,,,percent of total billed charges,21.84% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,12840.62,37.7,,,percent of total billed charges,37.70% of total billed charges,12840.62,37.7,,,percent of total billed charges,37.70% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,11546.34,33.9,,,percent of total billed charges,33.9% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,26566.8,78,,,percent of total billed charges,78% of total billed charges,34060,100,,,percent of total billed charges,100% of total billed charges,28133.56,82.6,,,percent of total billed charges,82.6% of total billed charges,28133.56,82.6,,,percent of total billed charges,82.6% of total billed charges,5722.08,16.8,,,percent of total billed charges,16.8% of total billed charges,17030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17030,50,,,percent of total billed charges,50% of total Billed charges,5722.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,34060,
KNEE PATELLA TRIATHLON ASYMMETRIC X3 5551-G-320,ORSUP0056,CDM,278,RC,C1713,HCPCS,Outpatient,,,11960,7774.00,,10524.8,88,,,percent of total billed charges,88% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2069.56,17.304,,,percent of total billed charges,17.304% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7534.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,15.3,,,percent of total billed charges,15.3% of total billed charges,8252.4,69,,,percent of total billed charges,69% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7397.26,61.85,,,percent of total billed charges,61.85% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,3731.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2049.47,17.136,,,percent of total billed charges,17.136% of total billed charges,2612.06,21.84,,,percent of total billed charges,21.84% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4054.44,33.9,,,percent of total billed charges,33.9% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,9328.8,78,,,percent of total billed charges,78% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,11960,
KNEE PATELLA TRIATHLON ASYMMETRIC X3 5551-G-350,ORSUP0056,CDM,278,RC,C1713,HCPCS,Outpatient,,,11960,7774.00,,10524.8,88,,,percent of total billed charges,88% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2069.56,17.304,,,percent of total billed charges,17.304% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7534.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,15.3,,,percent of total billed charges,15.3% of total billed charges,8252.4,69,,,percent of total billed charges,69% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7397.26,61.85,,,percent of total billed charges,61.85% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,3731.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2049.47,17.136,,,percent of total billed charges,17.136% of total billed charges,2612.06,21.84,,,percent of total billed charges,21.84% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4054.44,33.9,,,percent of total billed charges,33.9% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,9328.8,78,,,percent of total billed charges,78% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,11960,
KNEE PATELLA TRIATHLON ASYMMETRIC X3 5551-G-381,ORSUP0056,CDM,278,RC,C1713,HCPCS,Outpatient,,,11960,7774.00,,10524.8,88,,,percent of total billed charges,88% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2069.56,17.304,,,percent of total billed charges,17.304% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7534.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,15.3,,,percent of total billed charges,15.3% of total billed charges,8252.4,69,,,percent of total billed charges,69% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7397.26,61.85,,,percent of total billed charges,61.85% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,3731.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2049.47,17.136,,,percent of total billed charges,17.136% of total billed charges,2612.06,21.84,,,percent of total billed charges,21.84% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4054.44,33.9,,,percent of total billed charges,33.9% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,9328.8,78,,,percent of total billed charges,78% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,11960,
KNEE PATELLA TRIATHLON SYMMETRIC X3 5550-G-319,ORSUP0056,CDM,278,RC,C1713,HCPCS,Outpatient,,,11960,7774.00,,10524.8,88,,,percent of total billed charges,88% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2069.56,17.304,,,percent of total billed charges,17.304% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7534.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,15.3,,,percent of total billed charges,15.3% of total billed charges,8252.4,69,,,percent of total billed charges,69% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7397.26,61.85,,,percent of total billed charges,61.85% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,3731.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2049.47,17.136,,,percent of total billed charges,17.136% of total billed charges,2612.06,21.84,,,percent of total billed charges,21.84% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4054.44,33.9,,,percent of total billed charges,33.9% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,9328.8,78,,,percent of total billed charges,78% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,11960,
KNEE PATELLA TRIATHLON SYMMETRIC X3 5550-G-360,ORSUP0056,CDM,278,RC,C1713,HCPCS,Outpatient,,,11960,7774.00,,10524.8,88,,,percent of total billed charges,88% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2069.56,17.304,,,percent of total billed charges,17.304% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7534.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,15.3,,,percent of total billed charges,15.3% of total billed charges,8252.4,69,,,percent of total billed charges,69% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7397.26,61.85,,,percent of total billed charges,61.85% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,3731.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2049.47,17.136,,,percent of total billed charges,17.136% of total billed charges,2612.06,21.84,,,percent of total billed charges,21.84% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4054.44,33.9,,,percent of total billed charges,33.9% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,9328.8,78,,,percent of total billed charges,78% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,11960,
KNEE TIBIAL INSERT X3 TRIATHLON CS SIZE4 9MM,ORSUP0105,CDM,278,RC,C1776,HCPCS,Outpatient,,,24960,16224.00,,21964.8,88,,,percent of total billed charges,88% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4319.08,17.304,,,percent of total billed charges,17.304% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15724.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,15.3,,,percent of total billed charges,15.3% of total billed charges,17222.4,69,,,percent of total billed charges,69% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15437.76,61.85,,,percent of total billed charges,61.85% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,7787.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4277.15,17.136,,,percent of total billed charges,17.136% of total billed charges,5451.26,21.84,,,percent of total billed charges,21.84% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,8461.44,33.9,,,percent of total billed charges,33.9% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,19468.8,78,,,percent of total billed charges,78% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,24960,
KNEE TIBIAL INSERT X3 TRIATHLON CS SIZE5 11MM,ORSUP0105,CDM,278,RC,C1776,HCPCS,Outpatient,,,24960,16224.00,,21964.8,88,,,percent of total billed charges,88% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4319.08,17.304,,,percent of total billed charges,17.304% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15724.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,15.3,,,percent of total billed charges,15.3% of total billed charges,17222.4,69,,,percent of total billed charges,69% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15437.76,61.85,,,percent of total billed charges,61.85% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,7787.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4277.15,17.136,,,percent of total billed charges,17.136% of total billed charges,5451.26,21.84,,,percent of total billed charges,21.84% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,8461.44,33.9,,,percent of total billed charges,33.9% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,19468.8,78,,,percent of total billed charges,78% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,24960,
KNEE TIBIAL INSERT X3 TRIATHLON CS SIZE5 9MM,ORSUP0105,CDM,278,RC,C1776,HCPCS,Outpatient,,,24960,16224.00,,21964.8,88,,,percent of total billed charges,88% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4319.08,17.304,,,percent of total billed charges,17.304% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15724.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,15.3,,,percent of total billed charges,15.3% of total billed charges,17222.4,69,,,percent of total billed charges,69% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15437.76,61.85,,,percent of total billed charges,61.85% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,7787.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4277.15,17.136,,,percent of total billed charges,17.136% of total billed charges,5451.26,21.84,,,percent of total billed charges,21.84% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,8461.44,33.9,,,percent of total billed charges,33.9% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,19468.8,78,,,percent of total billed charges,78% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,24960,
KNEE TIBIAL INSERT X3 TRIATHLON CS SIZE6 13MM,ORSUP0105,CDM,278,RC,C1776,HCPCS,Outpatient,,,24960,16224.00,,21964.8,88,,,percent of total billed charges,88% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4319.08,17.304,,,percent of total billed charges,17.304% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15724.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,15.3,,,percent of total billed charges,15.3% of total billed charges,17222.4,69,,,percent of total billed charges,69% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15437.76,61.85,,,percent of total billed charges,61.85% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,7787.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4277.15,17.136,,,percent of total billed charges,17.136% of total billed charges,5451.26,21.84,,,percent of total billed charges,21.84% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,8461.44,33.9,,,percent of total billed charges,33.9% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,19468.8,78,,,percent of total billed charges,78% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,24960,
KNEE TIBIAL INSERT X3 TRIATHLON CS SIZE6 9MM,ORSUP0105,CDM,278,RC,C1776,HCPCS,Outpatient,,,24960,16224.00,,21964.8,88,,,percent of total billed charges,88% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4319.08,17.304,,,percent of total billed charges,17.304% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15724.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,15.3,,,percent of total billed charges,15.3% of total billed charges,17222.4,69,,,percent of total billed charges,69% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15437.76,61.85,,,percent of total billed charges,61.85% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,7787.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4277.15,17.136,,,percent of total billed charges,17.136% of total billed charges,5451.26,21.84,,,percent of total billed charges,21.84% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,8461.44,33.9,,,percent of total billed charges,33.9% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,19468.8,78,,,percent of total billed charges,78% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,24960,
KNEE ARTHROSCOPY,326390,CDM,270,RC,,,Outpatient,,,627,407.55,,551.76,88,,,percent of total billed charges,88% of total Billed charges,313.5,50,,,percent of total billed charges,50% of total Billed charges,105.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,627,100,,,percent of total billed charges,100% of total billed charges,108.5,17.304,,,percent of total billed charges,17.304% of total billed charges,313.5,50,,,percent of total billed charges,50% of total Billed charges,395.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,105.34,16.8,,,percent of total billed charges,16.8% of total billed charges,95.93,15.3,,,percent of total billed charges,15.3% of total billed charges,432.63,69,,,percent of total billed charges,69% of total billed charges,627,100,,,percent of total billed charges,100% of total billed charges,313.5,50,,,percent of total billed charges,50% of total Billed charges,627,100,,,percent of total billed charges,100% of total billed charges,313.5,50,,,percent of total billed charges,50% of total Billed charges,627,100,,,percent of total billed charges,100% of total billed charges,313.5,50,,,percent of total billed charges,50% of total Billed charges,387.8,61.85,,,percent of total billed charges,61.85% of total billed charges,105.34,16.8,,,percent of total billed charges,16.8% of total billed charges,313.5,50,,,percent of total billed charges,50% of total Billed charges,313.5,50,,,percent of total billed charges,50% of total Billed charges,105.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,313.5,50,,,percent of total billed charges,50% of total Billed charges,313.5,50,,,percent of total billed charges,50% of total Billed charges,107.44,17.136,,,percent of total billed charges,17.136% of total billed charges,136.94,21.84,,,percent of total billed charges,21.84% of total billed charges,313.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,313.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,313.5,50,,,percent of total billed charges,50% of total Billed charges,489.06,78,,,percent of total billed charges,78% of total billed charges,627,100,,,percent of total billed charges,100% of total billed charges,517.9,82.6,,,percent of total billed charges,82.6% of total billed charges,517.9,82.6,,,percent of total billed charges,82.6% of total billed charges,105.34,16.8,,,percent of total billed charges,16.8% of total billed charges,313.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,313.5,50,,,percent of total billed charges,50% of total Billed charges,105.34,16.8,,,percent of total billed charges,16.8% of total billed charges,95.93,627,
KNEE BRACE 22IN,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
KNEE VIZADISC,ORSUP0018,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
KNIFE MYRO DISP            14 11000,35489,CDM,272,RC,,,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,12.98,17.304,,,percent of total billed charges,17.304% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,47.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,46.39,61.85,,,percent of total billed charges,61.85% of total billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.85,17.136,,,percent of total billed charges,17.136% of total billed charges,16.38,21.84,,,percent of total billed charges,21.84% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11.48,75,
KNIFE MYRINGOTOMY SICKLE BLADE DISPOSABLE,50040,CDM,272,RC,,,Outpatient,,,134,87.10,,117.92,88,,,percent of total billed charges,88% of total Billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,22.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,134,100,,,percent of total billed charges,100% of total billed charges,23.19,17.304,,,percent of total billed charges,17.304% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,84.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.51,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,15.3,,,percent of total billed charges,15.3% of total billed charges,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,134,100,,,percent of total billed charges,100% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,134,100,,,percent of total billed charges,100% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,82.88,61.85,,,percent of total billed charges,61.85% of total billed charges,22.51,16.8,,,percent of total billed charges,16.8% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,22.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,22.96,17.136,,,percent of total billed charges,17.136% of total billed charges,29.27,21.84,,,percent of total billed charges,21.84% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,67,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67,50,,,percent of total billed charges,50% of total Billed charges,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,22.51,16.8,,,percent of total billed charges,16.8% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67,50,,,percent of total billed charges,50% of total Billed charges,22.51,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,134,
KNIFE HALF-ROUND,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
KNIFE COLD,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
KNOTLESS TIGHTROPE SS ARTHREX,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
KUMAR T-ANCHORS,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
KUMAR CATHETER 19G NEEDLE,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
KWIK STIK CAMPYLOBACTER FETUS SUBSP ATCC 27374,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
KWIRE 1.6MM SS,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
KWIRE,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
KY JELLY STERILE 2 OZ,490820,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
KYPHOPAK EXPR 1ST FRACTURE KIT BLN 10CC 15CC 20CC,ORSUP0081,CDM,272,RC,,,Outpatient,,,18460,11999.00,,16244.8,88,,,percent of total billed charges,88% of total Billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,3101.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3194.32,17.304,,,percent of total billed charges,17.304% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,11629.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3101.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2824.38,15.3,,,percent of total billed charges,15.3% of total billed charges,12737.4,69,,,percent of total billed charges,69% of total billed charges,18460,100,,,percent of total billed charges,100% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,18460,100,,,percent of total billed charges,100% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,18460,100,,,percent of total billed charges,100% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,11417.51,61.85,,,percent of total billed charges,61.85% of total billed charges,3101.28,16.8,,,percent of total billed charges,16.8% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,3101.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,3163.31,17.136,,,percent of total billed charges,17.136% of total billed charges,4031.66,21.84,,,percent of total billed charges,21.84% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9230,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9230,50,,,percent of total billed charges,50% of total Billed charges,14398.8,78,,,percent of total billed charges,78% of total billed charges,18460,100,,,percent of total billed charges,100% of total billed charges,15247.96,82.6,,,percent of total billed charges,82.6% of total billed charges,15247.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3101.28,16.8,,,percent of total billed charges,16.8% of total billed charges,9230,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9230,50,,,percent of total billed charges,50% of total Billed charges,3101.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2824.38,18460,
KYPHOPAK 15/3 ADD FX KIT,ORSUP0087,CDM,272,RC,,,Outpatient,,,20020,13013.00,,17617.6,88,,,percent of total billed charges,88% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3464.26,17.304,,,percent of total billed charges,17.304% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,12612.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3063.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13813.8,69,,,percent of total billed charges,69% of total billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,12382.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,3430.63,17.136,,,percent of total billed charges,17.136% of total billed charges,4372.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,15615.6,78,,,percent of total billed charges,78% of total billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,16536.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16536.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3063.06,20020,
KYPHOPAK 20/3 1ST FX,ORSUP0071,CDM,272,RC,,,Outpatient,,,15860,10309.00,,13956.8,88,,,percent of total billed charges,88% of total Billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,2664.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2744.41,17.304,,,percent of total billed charges,17.304% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,9991.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2664.48,16.8,,,percent of total billed charges,16.8% of total billed charges,2426.58,15.3,,,percent of total billed charges,15.3% of total billed charges,10943.4,69,,,percent of total billed charges,69% of total billed charges,15860,100,,,percent of total billed charges,100% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,15860,100,,,percent of total billed charges,100% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,15860,100,,,percent of total billed charges,100% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,9809.41,61.85,,,percent of total billed charges,61.85% of total billed charges,2664.48,16.8,,,percent of total billed charges,16.8% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,2664.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,2717.77,17.136,,,percent of total billed charges,17.136% of total billed charges,3463.82,21.84,,,percent of total billed charges,21.84% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7930,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7930,50,,,percent of total billed charges,50% of total Billed charges,12370.8,78,,,percent of total billed charges,78% of total billed charges,15860,100,,,percent of total billed charges,100% of total billed charges,13100.36,82.6,,,percent of total billed charges,82.6% of total billed charges,13100.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2664.48,16.8,,,percent of total billed charges,16.8% of total billed charges,7930,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7930,50,,,percent of total billed charges,50% of total Billed charges,2664.48,16.8,,,percent of total billed charges,16.8% of total billed charges,2426.58,15860,
KYPHON XPANDER II 20/3 ADDITIONAL FX,ORSUP0056,CDM,272,RC,,,Outpatient,,,9200,5980.00,,8096,88,,,percent of total billed charges,88% of total Billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,1545.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1591.97,17.304,,,percent of total billed charges,17.304% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,5796,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1545.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1407.6,15.3,,,percent of total billed charges,15.3% of total billed charges,6348,69,,,percent of total billed charges,69% of total billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,5690.2,61.85,,,percent of total billed charges,61.85% of total billed charges,1545.6,16.8,,,percent of total billed charges,16.8% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,1545.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,1576.51,17.136,,,percent of total billed charges,17.136% of total billed charges,2009.28,21.84,,,percent of total billed charges,21.84% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,7176,78,,,percent of total billed charges,78% of total billed charges,9200,100,,,percent of total billed charges,100% of total billed charges,7599.2,82.6,,,percent of total billed charges,82.6% of total billed charges,7599.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1545.6,16.8,,,percent of total billed charges,16.8% of total billed charges,4600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4600,50,,,percent of total billed charges,50% of total Billed charges,1545.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1407.6,9200,
LAB COAT XL BLUE,490821,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
LAB JACKET MEDIUM WHITE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LAB JACKET LARGE WHITE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LAB JACKET MEDIUM BLUE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LAB JACKET LARGE BLUE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LAB JACKET XL WHITE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LAB JACKET XXL WHITE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LAB COAT XXL BLUE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LAB JACKET SMALL WHITE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LABEL MEDICATION ADDED,187814,CDM,270,RC,,,Outpatient,,,157,102.05,,138.16,88,,,percent of total billed charges,88% of total Billed charges,78.5,50,,,percent of total billed charges,50% of total Billed charges,26.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,157,100,,,percent of total billed charges,100% of total billed charges,27.17,17.304,,,percent of total billed charges,17.304% of total billed charges,78.5,50,,,percent of total billed charges,50% of total Billed charges,98.91,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,26.38,16.8,,,percent of total billed charges,16.8% of total billed charges,24.02,15.3,,,percent of total billed charges,15.3% of total billed charges,108.33,69,,,percent of total billed charges,69% of total billed charges,157,100,,,percent of total billed charges,100% of total billed charges,78.5,50,,,percent of total billed charges,50% of total Billed charges,157,100,,,percent of total billed charges,100% of total billed charges,78.5,50,,,percent of total billed charges,50% of total Billed charges,157,100,,,percent of total billed charges,100% of total billed charges,78.5,50,,,percent of total billed charges,50% of total Billed charges,97.1,61.85,,,percent of total billed charges,61.85% of total billed charges,26.38,16.8,,,percent of total billed charges,16.8% of total billed charges,78.5,50,,,percent of total billed charges,50% of total Billed charges,78.5,50,,,percent of total billed charges,50% of total Billed charges,26.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,78.5,50,,,percent of total billed charges,50% of total Billed charges,78.5,50,,,percent of total billed charges,50% of total Billed charges,26.9,17.136,,,percent of total billed charges,17.136% of total billed charges,34.29,21.84,,,percent of total billed charges,21.84% of total billed charges,78.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,78.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,78.5,50,,,percent of total billed charges,50% of total Billed charges,122.46,78,,,percent of total billed charges,78% of total billed charges,157,100,,,percent of total billed charges,100% of total billed charges,129.68,82.6,,,percent of total billed charges,82.6% of total billed charges,129.68,82.6,,,percent of total billed charges,82.6% of total billed charges,26.38,16.8,,,percent of total billed charges,16.8% of total billed charges,78.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,78.5,50,,,percent of total billed charges,50% of total Billed charges,26.38,16.8,,,percent of total billed charges,16.8% of total billed charges,24.02,157,
LABEL ''ALLERGIC: ___ ___'' 5-1/2X1 WHITE/RED,131027,CDM,270,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
LABEL ALLERGIC 1X500IN WHITE/RED,9782,CDM,270,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
LABEL ANES LIDO L1.5INXW.5IN ST. JOHNS RL,44849,CDM,270,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
LABEL ANESTHESIA ST. JOHNS FENTANYL L1 1/2INXW1/2IN ROLL,44846,CDM,270,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
LABEL ANESTHESIA ST. JOHNS VERSED L1 1/2INXW1/2IN ROLL,44847,CDM,270,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
LABEL MEDPLUS 4X1/4X6 WHITE,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
LABEL MEDPLUS 4X1/4X6 YELLOW,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
LABEL DRUG SUFENTANIL,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LABEL  DRUG ______ MG/ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LABEL DRUG BUPIVICAINE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LABEL DRUG  LIDOCAINE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LABEL DRUG ROPIVACAINE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LABEL DRUG EPHEDRINE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LABEL DRUG FENTANYL,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LABEL 2-PART CLEAN/DIRTY,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LACTATE MEMBRANE,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
LANCET,490823,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
LAP SPONGE 36 X 36 X-RAY,490825,CDM,270,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
LAP RETRACTOR SMALL ALEXIS,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
LAPAROSCOPIC BLADE SYSTEM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
LARGE C-ARM DRAPE,490827,CDM,270,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
LARGE CLIP APPLIER,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
LARYNGECTOMY TUBE SHILEY SZ 10,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
LARYNGOSCOPE BRITEBLADE PRO MAC SIZE 4,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
LARYNGO SHEATH COVER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LARYNGEAL MASK SZ 1,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
LARYNGEAL MASK SZ 1.5,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
LARYNGEAL MASK SZ 2,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
LARYNGEAL MASK SZ 2.5,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
LARYNGOSCOPES BLADE MAC 3,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
LARYNGEAL AIRWAY TUBING SZ 5,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
LASER MICRON 400 SINGLE USE,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
LASSO RIGHT TIGHTCURVE 25DEG,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
LASSO LEFT 25DEG TIGHTCURVE,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
LAUNCHER PTCA GUIDE 6FR JR40 SIDE HOLE,ORSUP0004,CDM,278,RC,C1887,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
LBL CERNER GENERAL DT PB 2X1 YELLOW,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
LDH / 5 PACK / 250 SLDS,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
LEAD TENDRILL STS 65CM,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
LEAD WIRE SET 5,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
LEAD PMKR NON-TRN L3,CATH00033,CDM,275,RC,C1896,HCPCS,Outpatient,,,9667,6283.55,,8506.96,88,,,percent of total billed charges,88% of total Billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,1624.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1672.78,17.304,,,percent of total billed charges,17.304% of total billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,6090.21,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1624.06,16.8,,,percent of total billed charges,16.8% of total billed charges,1479.05,15.3,,,percent of total billed charges,15.3% of total billed charges,6670.23,69,,,percent of total billed charges,69% of total billed charges,9667,100,,,percent of total billed charges,100% of total billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,9667,100,,,percent of total billed charges,100% of total billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,9667,100,,,percent of total billed charges,100% of total billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,5979.04,61.85,,,percent of total billed charges,61.85% of total billed charges,1624.06,16.8,,,percent of total billed charges,16.8% of total billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,3016.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4833.5,50,,,percent of total billed charges,50% of total Billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,1656.54,17.136,,,percent of total billed charges,17.136% of total billed charges,2111.27,21.84,,,percent of total billed charges,21.84% of total billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,3644.46,37.7,,,percent of total billed charges,37.70% of total billed charges,3644.46,37.7,,,percent of total billed charges,37.70% of total billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,3277.11,33.9,,,percent of total billed charges,33.9% of total billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,7540.26,78,,,percent of total billed charges,78% of total billed charges,9667,100,,,percent of total billed charges,100% of total billed charges,7984.94,82.6,,,percent of total billed charges,82.6% of total billed charges,7984.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1624.06,16.8,,,percent of total billed charges,16.8% of total billed charges,4833.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4833.5,50,,,percent of total billed charges,50% of total Billed charges,1624.06,16.8,,,percent of total billed charges,16.8% of total billed charges,1479.05,9667,
LEADWIRE SPU 5-LEAD GRAB AHA 39,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
LEG HOLDER DISPOSABLE PAD,490830,CDM,270,RC,,,Outpatient,,,497,323.05,,437.36,88,,,percent of total billed charges,88% of total Billed charges,248.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,497,100,,,percent of total billed charges,100% of total billed charges,86,17.304,,,percent of total billed charges,17.304% of total billed charges,248.5,50,,,percent of total billed charges,50% of total Billed charges,313.11,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,83.5,16.8,,,percent of total billed charges,16.8% of total billed charges,76.04,15.3,,,percent of total billed charges,15.3% of total billed charges,342.93,69,,,percent of total billed charges,69% of total billed charges,497,100,,,percent of total billed charges,100% of total billed charges,248.5,50,,,percent of total billed charges,50% of total Billed charges,497,100,,,percent of total billed charges,100% of total billed charges,248.5,50,,,percent of total billed charges,50% of total Billed charges,497,100,,,percent of total billed charges,100% of total billed charges,248.5,50,,,percent of total billed charges,50% of total Billed charges,307.39,61.85,,,percent of total billed charges,61.85% of total billed charges,83.5,16.8,,,percent of total billed charges,16.8% of total billed charges,248.5,50,,,percent of total billed charges,50% of total Billed charges,248.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,248.5,50,,,percent of total billed charges,50% of total Billed charges,248.5,50,,,percent of total billed charges,50% of total Billed charges,85.17,17.136,,,percent of total billed charges,17.136% of total billed charges,108.54,21.84,,,percent of total billed charges,21.84% of total billed charges,248.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,248.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,248.5,50,,,percent of total billed charges,50% of total Billed charges,387.66,78,,,percent of total billed charges,78% of total billed charges,497,100,,,percent of total billed charges,100% of total billed charges,410.52,82.6,,,percent of total billed charges,82.6% of total billed charges,410.52,82.6,,,percent of total billed charges,82.6% of total billed charges,83.5,16.8,,,percent of total billed charges,16.8% of total billed charges,248.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,248.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,16.8,,,percent of total billed charges,16.8% of total billed charges,76.04,497,
LEGEND 8CM 1.1MM TAPERED,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
LEGEND BIT DRILL,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
LEGEND M-52 DISSECTING TOOL,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
LEGEND M-51 DISSECTING TOOL,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
LEGGING CLEAR 1PAIR STERILE,236095,CDM,272,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
LEGGINGS W/ 6CUFF 29X43 STERILE,31497,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
"PACK, LEGGINGS",491026,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
LEICA MICROSCOPE DRAPE,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
LENS PAPER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LH 100 WELLS,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
LH CALIBRATOR BOX / 1 SET,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
LIDOCAINE 0.4% HCL IN 5% DEXTROSE INJ 500ML PB,148080,CDM,272,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
LIGASURE TISSUE FUSION INSTRUMENT,ORSUP0102,CDM,272,RC,,,Outpatient,,,24180,15717.00,,21278.4,88,,,percent of total billed charges,88% of total Billed charges,12090,50,,,percent of total billed charges,50% of total Billed charges,4062.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4184.11,17.304,,,percent of total billed charges,17.304% of total billed charges,12090,50,,,percent of total billed charges,50% of total Billed charges,15233.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4062.24,16.8,,,percent of total billed charges,16.8% of total billed charges,3699.54,15.3,,,percent of total billed charges,15.3% of total billed charges,16684.2,69,,,percent of total billed charges,69% of total billed charges,24180,100,,,percent of total billed charges,100% of total billed charges,12090,50,,,percent of total billed charges,50% of total Billed charges,24180,100,,,percent of total billed charges,100% of total billed charges,12090,50,,,percent of total billed charges,50% of total Billed charges,24180,100,,,percent of total billed charges,100% of total billed charges,12090,50,,,percent of total billed charges,50% of total Billed charges,14955.33,61.85,,,percent of total billed charges,61.85% of total billed charges,4062.24,16.8,,,percent of total billed charges,16.8% of total billed charges,12090,50,,,percent of total billed charges,50% of total Billed charges,12090,50,,,percent of total billed charges,50% of total Billed charges,4062.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,12090,50,,,percent of total billed charges,50% of total Billed charges,12090,50,,,percent of total billed charges,50% of total Billed charges,4143.48,17.136,,,percent of total billed charges,17.136% of total billed charges,5280.91,21.84,,,percent of total billed charges,21.84% of total billed charges,12090,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12090,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12090,50,,,percent of total billed charges,50% of total Billed charges,18860.4,78,,,percent of total billed charges,78% of total billed charges,24180,100,,,percent of total billed charges,100% of total billed charges,19972.68,82.6,,,percent of total billed charges,82.6% of total billed charges,19972.68,82.6,,,percent of total billed charges,82.6% of total billed charges,4062.24,16.8,,,percent of total billed charges,16.8% of total billed charges,12090,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12090,50,,,percent of total billed charges,50% of total Billed charges,4062.24,16.8,,,percent of total billed charges,16.8% of total billed charges,3699.54,24180,
LIGASURE MARYLAND JAW 44CM,ORSUP0033,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
LIGASURE MARYLAND CURVED TIP,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
LIGATOR 9.5-13MM 6 SHOOTER SAEED,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
LIGATOR MULTIBAND SAEED SIX SHOOTR W/EXTD OPPI-VU,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
LIGATOR MULTI BAND,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
LIGATURE ENDOLOOP,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
LIGASURE TISSUE FUSION INSTRUM,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
LIGASURE 5MM BLUNT TIP,ORSUP0029,CDM,270,RC,,,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
LIGASURE ADVANCE PISTOL LF5544,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
LIGASURE 5MM BLUNT TIP LF1837,ORSUP0020,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
LIGHT CABLE,ORSUP0025,CDM,270,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
LIM BROTH/TODD HEWITT BROTH W/COLSTN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LIMITORR VOLUME LIMITING EVD 20ML,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
LINER SUCTION CANNISTER 3000CC,152487,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
LINER BIOHAZARD RED 24X23 1.3 MIL CS/500,104656,CDM,270,RC,,,Outpatient,,,258,167.70,,227.04,88,,,percent of total billed charges,88% of total Billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,43.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,258,100,,,percent of total billed charges,100% of total billed charges,44.64,17.304,,,percent of total billed charges,17.304% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,162.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.34,16.8,,,percent of total billed charges,16.8% of total billed charges,39.47,15.3,,,percent of total billed charges,15.3% of total billed charges,178.02,69,,,percent of total billed charges,69% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,258,100,,,percent of total billed charges,100% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,258,100,,,percent of total billed charges,100% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,159.57,61.85,,,percent of total billed charges,61.85% of total billed charges,43.34,16.8,,,percent of total billed charges,16.8% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,43.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,44.21,17.136,,,percent of total billed charges,17.136% of total billed charges,56.35,21.84,,,percent of total billed charges,21.84% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,129,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,129,50,,,percent of total billed charges,50% of total Billed charges,201.24,78,,,percent of total billed charges,78% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,43.34,16.8,,,percent of total billed charges,16.8% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,129,50,,,percent of total billed charges,50% of total Billed charges,43.34,16.8,,,percent of total billed charges,16.8% of total billed charges,39.47,258,
LINEAR CUTTER 75MM PROXIMATE,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
LINEAR CUTTER 55MM TLC55,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
LINED BREAST BINDER SMALL LAVENDER,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
LINED BREAST BINDER MED LIGHT BLUE,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
LINED BREAST BINER LRG PINK,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
LINK TIGER,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
LIP BALM,490840,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
LIPO SUCTION TUBING,490841,CDM,272,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
LIPO ASPIRATION TUBING SET,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
LIQ PERF VERIFIER I BX / 6 BTLS,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
LIQ PERF VERIFIER II BX / 6 BTLS,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
LIQUID DESCALER 1GL,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
LITHIUM / 5 PACK / 300 SLDS,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
LITHIUM,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
LIVER ACCESS AND BIOPSY SET,ORSUP0020,CDM,272,RC,,,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
LIVER ACCESS \\T\\ BIOPSY SET KIT,ORSUP0021,CDM,272,RC,,,Outpatient,,,2000,1300.00,,1760,88,,,percent of total billed charges,88% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,346.08,17.304,,,percent of total billed charges,17.304% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1260,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,336,16.8,,,percent of total billed charges,16.8% of total billed charges,306,15.3,,,percent of total billed charges,15.3% of total billed charges,1380,69,,,percent of total billed charges,69% of total billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1237,61.85,,,percent of total billed charges,61.85% of total billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,342.72,17.136,,,percent of total billed charges,17.136% of total billed charges,436.8,21.84,,,percent of total billed charges,21.84% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,1560,78,,,percent of total billed charges,78% of total billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1652,82.6,,,percent of total billed charges,82.6% of total billed charges,1652,82.6,,,percent of total billed charges,82.6% of total billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,306,2000,
LMA UNIQUE AIRWAY MASK NEONATE/INFANT SZ 1,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
LMA MASK  SIZE 2,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LMA MASK  SIZE 2.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LMA SZ 3,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
LMA MASK SZ 5,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
LOC POWER 19G X 3/4,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
LOOP ELECTRODE RESECTION 26F 30DEG,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
LOOP TIGER,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
LOOP INOCULATING BLUE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LOTION BABY  2 OZ,420393,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
LOW SUDS DETERGENT,490844,CDM,270,RC,,,Outpatient,,,228,148.20,,200.64,88,,,percent of total billed charges,88% of total Billed charges,114,50,,,percent of total billed charges,50% of total Billed charges,38.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,228,100,,,percent of total billed charges,100% of total billed charges,39.45,17.304,,,percent of total billed charges,17.304% of total billed charges,114,50,,,percent of total billed charges,50% of total Billed charges,143.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,38.3,16.8,,,percent of total billed charges,16.8% of total billed charges,34.88,15.3,,,percent of total billed charges,15.3% of total billed charges,157.32,69,,,percent of total billed charges,69% of total billed charges,228,100,,,percent of total billed charges,100% of total billed charges,114,50,,,percent of total billed charges,50% of total Billed charges,228,100,,,percent of total billed charges,100% of total billed charges,114,50,,,percent of total billed charges,50% of total Billed charges,228,100,,,percent of total billed charges,100% of total billed charges,114,50,,,percent of total billed charges,50% of total Billed charges,141.02,61.85,,,percent of total billed charges,61.85% of total billed charges,38.3,16.8,,,percent of total billed charges,16.8% of total billed charges,114,50,,,percent of total billed charges,50% of total Billed charges,114,50,,,percent of total billed charges,50% of total Billed charges,38.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,114,50,,,percent of total billed charges,50% of total Billed charges,114,50,,,percent of total billed charges,50% of total Billed charges,39.07,17.136,,,percent of total billed charges,17.136% of total billed charges,49.8,21.84,,,percent of total billed charges,21.84% of total billed charges,114,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,114,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,114,50,,,percent of total billed charges,50% of total Billed charges,177.84,78,,,percent of total billed charges,78% of total billed charges,228,100,,,percent of total billed charges,100% of total billed charges,188.33,82.6,,,percent of total billed charges,82.6% of total billed charges,188.33,82.6,,,percent of total billed charges,82.6% of total billed charges,38.3,16.8,,,percent of total billed charges,16.8% of total billed charges,114,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,114,50,,,percent of total billed charges,50% of total Billed charges,38.3,16.8,,,percent of total billed charges,16.8% of total billed charges,34.88,228,
LTS-D AIRWAY SZ 3,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
LTS-D AIRWAY SZ 4,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
LUBRICANT/DIFFUSER AIR PACK #PA100-A,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
LUBRICANT INSTRUMENT 1GL,ORSUP0004,CDM,270,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
LUBRICANT JELLY 4 OZ FLIP TOP TUBE,264030,CDM,270,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
LUBRICANT ROTAGLIDE (BX/6),ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
LUBRICANT VIPERSLIDE,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
LUBRICANT TYPE 2 LITHIUM (59-006981C),ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
LUER ADAPTER,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
LUGOL'S IODINE SOLUTION,490846,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
LUMBAR PUNCTURE TRAY INFANT/PED 22G X 1.5,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
LUMBAR PUNTURE TRAY ADULT 20 X 3.5,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
Laser Vaporization of Prostate Charge,SUR200053,CDM,360,RC,,,Outpatient,,,13528,8793.20,,11904.64,88,,,percent of total billed charges,88% of total Billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,2272.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2340.89,17.304,,,percent of total billed charges,17.304% of total billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,8522.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2272.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,9334.32,69,,,percent of total billed charges,69% of total billed charges,13528,100,,,percent of total billed charges,100% of total billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,13528,100,,,percent of total billed charges,100% of total billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,13528,100,,,percent of total billed charges,100% of total billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,8367.07,61.85,,,percent of total billed charges,61.85% of total billed charges,2272.7,16.8,,,percent of total billed charges,16.8% of total billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,2272.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,2318.16,17.136,,,percent of total billed charges,17.136% of total billed charges,2954.52,21.84,,,percent of total billed charges,21.84% of total billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,5100.06,37.7,,,percent of total billed charges,37.70% of total billed charges,5100.06,37.7,,,percent of total billed charges,37.70% of total billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,4585.99,33.9,,,percent of total billed charges,33.9% of total billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,10551.84,78,,,percent of total billed charges,78% of total billed charges,13528,100,,,percent of total billed charges,100% of total billed charges,11174.13,82.6,,,percent of total billed charges,82.6% of total billed charges,11174.13,82.6,,,percent of total billed charges,82.6% of total billed charges,2272.7,16.8,,,percent of total billed charges,16.8% of total billed charges,6764,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6764,50,,,percent of total billed charges,50% of total Billed charges,2272.7,16.8,,,percent of total billed charges,16.8% of total billed charges,2272.7,13528,
Lithotripsy Charge,SUR200016,CDM,360,RC,,,Outpatient,,,11274,7328.10,,9921.12,88,,,percent of total billed charges,88% of total Billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,1894.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1950.85,17.304,,,percent of total billed charges,17.304% of total billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,7102.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1894.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,7779.06,69,,,percent of total billed charges,69% of total billed charges,11274,100,,,percent of total billed charges,100% of total billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,11274,100,,,percent of total billed charges,100% of total billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,11274,100,,,percent of total billed charges,100% of total billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,6972.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1894.03,16.8,,,percent of total billed charges,16.8% of total billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,1894.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,1931.91,17.136,,,percent of total billed charges,17.136% of total billed charges,2462.24,21.84,,,percent of total billed charges,21.84% of total billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,4250.3,37.7,,,percent of total billed charges,37.70% of total billed charges,4250.3,37.7,,,percent of total billed charges,37.70% of total billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,3821.89,33.9,,,percent of total billed charges,33.9% of total billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,8793.72,78,,,percent of total billed charges,78% of total billed charges,11274,100,,,percent of total billed charges,100% of total billed charges,9312.32,82.6,,,percent of total billed charges,82.6% of total billed charges,9312.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1894.03,16.8,,,percent of total billed charges,16.8% of total billed charges,5637,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5637,50,,,percent of total billed charges,50% of total Billed charges,1894.03,16.8,,,percent of total billed charges,16.8% of total billed charges,1894.03,11274,
Lithotripsy Bilat Charge,SUR200017,CDM,360,RC,,,Outpatient,,,14817,9631.05,,13038.96,88,,,percent of total billed charges,88% of total Billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,2489.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2563.93,17.304,,,percent of total billed charges,17.304% of total billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,9334.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2489.26,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,10223.73,69,,,percent of total billed charges,69% of total billed charges,14817,100,,,percent of total billed charges,100% of total billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,14817,100,,,percent of total billed charges,100% of total billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,14817,100,,,percent of total billed charges,100% of total billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,9164.31,61.85,,,percent of total billed charges,61.85% of total billed charges,2489.26,16.8,,,percent of total billed charges,16.8% of total billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,2489.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,2539.04,17.136,,,percent of total billed charges,17.136% of total billed charges,3236.03,21.84,,,percent of total billed charges,21.84% of total billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,5586.01,37.7,,,percent of total billed charges,37.70% of total billed charges,5586.01,37.7,,,percent of total billed charges,37.70% of total billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,5022.96,33.9,,,percent of total billed charges,33.9% of total billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,11557.26,78,,,percent of total billed charges,78% of total billed charges,14817,100,,,percent of total billed charges,100% of total billed charges,12238.84,82.6,,,percent of total billed charges,82.6% of total billed charges,12238.84,82.6,,,percent of total billed charges,82.6% of total billed charges,2489.26,16.8,,,percent of total billed charges,16.8% of total billed charges,7408.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7408.5,50,,,percent of total billed charges,50% of total Billed charges,2489.26,16.8,,,percent of total billed charges,16.8% of total billed charges,2489.26,14817,
AGAR MEDIUM MACCONKEY,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MACINTOSH OPTIC LARNYGO BLADE DISP #0,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
MACINTOSH OPTIC LARNYGO BLADE DISP #1,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MACROPLASTIQUE ENDO NEEDLE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
MACROPLASTIQUE IMPLANT,ORSUP0008,CDM,278,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
MACROPLASTIQUE ADMIN DEVICE,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
MAGNETIC INSTRUMENT DRAPE 10 X 16,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MAINTENANCE KT,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
MAINTENANCE PK BOX / 2 PACKS,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
MALB PERF VER I BOX / 6 BTLS,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
MALB PERF VER II BOX / 6 BTLS,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
MALB REAGENT BOX / 300T,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MANIFOLD NEPTUNE 4- PORT,209202,CDM,272,RC,,,Outpatient,,,161,104.65,,141.68,88,,,percent of total billed charges,88% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,27.86,17.304,,,percent of total billed charges,17.304% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,101.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,24.63,15.3,,,percent of total billed charges,15.3% of total billed charges,111.09,69,,,percent of total billed charges,69% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,99.58,61.85,,,percent of total billed charges,61.85% of total billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.59,17.136,,,percent of total billed charges,17.136% of total billed charges,35.16,21.84,,,percent of total billed charges,21.84% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,125.58,78,,,percent of total billed charges,78% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,24.63,161,
MANIPULATOR UTERINE ENDOPATH ST,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
MANIFOLD 4 PORT,278531,CDM,272,RC,,,Outpatient,,,161,104.65,,141.68,88,,,percent of total billed charges,88% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,27.86,17.304,,,percent of total billed charges,17.304% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,101.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,24.63,15.3,,,percent of total billed charges,15.3% of total billed charges,111.09,69,,,percent of total billed charges,69% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,99.58,61.85,,,percent of total billed charges,61.85% of total billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.59,17.136,,,percent of total billed charges,17.136% of total billed charges,35.16,21.84,,,percent of total billed charges,21.84% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,125.58,78,,,percent of total billed charges,78% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,24.63,161,
MANIPULATOR UTERINE LAVENDER,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
MANIPULATOR UTERINE STANDARD RETRACTOR /ELEVATOR,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
MANIPULATOR VCARE UTERINE LARGE 37MM,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
MANIFOLD SINGLE PORT NEPTUNE,490851,CDM,272,RC,,,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,11.94,17.304,,,percent of total billed charges,17.304% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,43.47,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,42.68,61.85,,,percent of total billed charges,61.85% of total billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.82,17.136,,,percent of total billed charges,17.136% of total billed charges,15.07,21.84,,,percent of total billed charges,21.84% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,10.56,69,
MANIFOLD 4-PORT NEPTUNE,490850,CDM,272,RC,,,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,147,100,,,percent of total billed charges,100% of total billed charges,25.44,17.304,,,percent of total billed charges,17.304% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,92.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,90.92,61.85,,,percent of total billed charges,61.85% of total billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,25.19,17.136,,,percent of total billed charges,17.136% of total billed charges,32.1,21.84,,,percent of total billed charges,21.84% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,22.49,147,
MANIFOLD BT2000 KIT,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
MANIFOLD CUSTOM KITS,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
MAP BD MICROTUBE MAP,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
MARKER ENDOSCOPIC COLON SPOT BLACK,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
MARKER HYDRO-MARK 15 GA BUTTERFLY,ORSUP0008,CDM,278,RC,C1879,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
MARKER ULTRASOUND ULTRACLIP RIBBON,ORSUP0019,CDM,278,RC,C1879,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
MARKER ULTRASOUND ULTRACLIP WING,ORSUP0019,CDM,278,RC,C1879,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
MARKER DELIVER KIT,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
MARKER MOLE SPEED-D-RING 1/2 ID SEMI-OPAQUE 100/BX,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
MARKER SCAR SPEE-D-LINE 1MM SEMI-OPAQUE STRETCH 120/BX,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
MARKER SKIN SPOT INSIN SOFT \\T\\ STRETCHY 327CM,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
"MARKER,SKIN,PREP-RESISTANT,NON-STERILE",420398,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
MARKER COBRA FIDUCIAL,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
MARKING PEN NS,490852,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
MARKING PEN STERILE,490853,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
MARKER BIOPSY SITE TITANIUM FOR EVIVA 13CM,ORSUP0010,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
MARKER BIOPSY SITE TUMARK VISION 18G,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
MARKER NIPPLE 23MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MARKER SCAR,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
MARKER LUMP,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
MARKER CT GUIDELINE,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
MARLEX MESH PERFIX PLUG SMALL,ORSUP0010,CDM,278,RC,C1781,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
MARLEX MESH PERFIX PLUG LARGE,ORSUP0017,CDM,278,RC,C1781,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
MARLEX MESH 2 X 4,ORSUP0006,CDM,278,RC,C1781,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
MARLEX MESH 10 X 14,ORSUP0006,CDM,278,RC,C1781,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
MARLEX MESH 1 X 4,ORSUP0005,CDM,278,RC,C1781,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
MARLEX MESH 3 X 6,ORSUP0008,CDM,278,RC,C1781,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
MARYLAND FORCEP TIP SINGLE USE,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
MARYLAND BIPOLAR FORCEPS,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
MARYLAND JAW LAPAROSCOPIC DEVICE,ORSUP0029,CDM,272,RC,,,Outpatient,,,3600,2340.00,,3168,88,,,percent of total billed charges,88% of total Billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,622.94,17.304,,,percent of total billed charges,17.304% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,2268,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,550.8,15.3,,,percent of total billed charges,15.3% of total billed charges,2484,69,,,percent of total billed charges,69% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,2226.6,61.85,,,percent of total billed charges,61.85% of total billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,616.9,17.136,,,percent of total billed charges,17.136% of total billed charges,786.24,21.84,,,percent of total billed charges,21.84% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1800,50,,,percent of total billed charges,50% of total Billed charges,2808,78,,,percent of total billed charges,78% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1800,50,,,percent of total billed charges,50% of total Billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,550.8,3600,
MAS LIQUID ASSAY URINALYSIS CONTROLS #1,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
MAS LIQUID ASSAY URINALYSIS CONTROLS #3,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
MASIMO HEMOGLOBIN SENSOR,ORSUP0059,CDM,272,RC,,,Outpatient,,,12740,8281.00,,11211.2,88,,,percent of total billed charges,88% of total Billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,2140.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2204.53,17.304,,,percent of total billed charges,17.304% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,8026.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2140.32,16.8,,,percent of total billed charges,16.8% of total billed charges,1949.22,15.3,,,percent of total billed charges,15.3% of total billed charges,8790.6,69,,,percent of total billed charges,69% of total billed charges,12740,100,,,percent of total billed charges,100% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,12740,100,,,percent of total billed charges,100% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,12740,100,,,percent of total billed charges,100% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,7879.69,61.85,,,percent of total billed charges,61.85% of total billed charges,2140.32,16.8,,,percent of total billed charges,16.8% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,2140.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,2183.13,17.136,,,percent of total billed charges,17.136% of total billed charges,2782.42,21.84,,,percent of total billed charges,21.84% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6370,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6370,50,,,percent of total billed charges,50% of total Billed charges,9937.2,78,,,percent of total billed charges,78% of total billed charges,12740,100,,,percent of total billed charges,100% of total billed charges,10523.24,82.6,,,percent of total billed charges,82.6% of total billed charges,10523.24,82.6,,,percent of total billed charges,82.6% of total billed charges,2140.32,16.8,,,percent of total billed charges,16.8% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6370,50,,,percent of total billed charges,50% of total Billed charges,2140.32,16.8,,,percent of total billed charges,16.8% of total billed charges,1949.22,12740,
MASK FLUID SHIELD,184559,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
MASK ANTI-FOG,308741,CDM,270,RC,,,Outpatient,,,107,69.55,,94.16,88,,,percent of total billed charges,88% of total Billed charges,53.5,50,,,percent of total billed charges,50% of total Billed charges,17.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,107,100,,,percent of total billed charges,100% of total billed charges,18.52,17.304,,,percent of total billed charges,17.304% of total billed charges,53.5,50,,,percent of total billed charges,50% of total Billed charges,67.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,17.98,16.8,,,percent of total billed charges,16.8% of total billed charges,16.37,15.3,,,percent of total billed charges,15.3% of total billed charges,73.83,69,,,percent of total billed charges,69% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,53.5,50,,,percent of total billed charges,50% of total Billed charges,107,100,,,percent of total billed charges,100% of total billed charges,53.5,50,,,percent of total billed charges,50% of total Billed charges,107,100,,,percent of total billed charges,100% of total billed charges,53.5,50,,,percent of total billed charges,50% of total Billed charges,66.18,61.85,,,percent of total billed charges,61.85% of total billed charges,17.98,16.8,,,percent of total billed charges,16.8% of total billed charges,53.5,50,,,percent of total billed charges,50% of total Billed charges,53.5,50,,,percent of total billed charges,50% of total Billed charges,17.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,53.5,50,,,percent of total billed charges,50% of total Billed charges,53.5,50,,,percent of total billed charges,50% of total Billed charges,18.34,17.136,,,percent of total billed charges,17.136% of total billed charges,23.37,21.84,,,percent of total billed charges,21.84% of total billed charges,53.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,53.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,53.5,50,,,percent of total billed charges,50% of total Billed charges,83.46,78,,,percent of total billed charges,78% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,17.98,16.8,,,percent of total billed charges,16.8% of total billed charges,53.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,53.5,50,,,percent of total billed charges,50% of total Billed charges,17.98,16.8,,,percent of total billed charges,16.8% of total billed charges,16.37,107,
MASK BILI REG,279859,CDM,270,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
MASK CONE BLUE,331613,CDM,270,RC,,,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,9.52,17.304,,,percent of total billed charges,17.304% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.42,17.136,,,percent of total billed charges,17.136% of total billed charges,12.01,21.84,,,percent of total billed charges,21.84% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,55,
MASK CRANIAL,ORSUP0023,CDM,270,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
MASK FULL VENTED LARGE,451634,CDM,270,RC,,,Outpatient,,,1714,1114.10,,1508.32,88,,,percent of total billed charges,88% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,296.59,17.304,,,percent of total billed charges,17.304% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1079.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,262.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1182.66,69,,,percent of total billed charges,69% of total billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1060.11,61.85,,,percent of total billed charges,61.85% of total billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,293.71,17.136,,,percent of total billed charges,17.136% of total billed charges,374.34,21.84,,,percent of total billed charges,21.84% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,857,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,857,50,,,percent of total billed charges,50% of total Billed charges,1336.92,78,,,percent of total billed charges,78% of total billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,1415.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1415.76,82.6,,,percent of total billed charges,82.6% of total billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,857,50,,,percent of total billed charges,50% of total Billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,262.24,1714,
MASK FULL VENTED MEDIUM,451635,CDM,270,RC,,,Outpatient,,,1714,1114.10,,1508.32,88,,,percent of total billed charges,88% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,296.59,17.304,,,percent of total billed charges,17.304% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1079.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,262.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1182.66,69,,,percent of total billed charges,69% of total billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1060.11,61.85,,,percent of total billed charges,61.85% of total billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,293.71,17.136,,,percent of total billed charges,17.136% of total billed charges,374.34,21.84,,,percent of total billed charges,21.84% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,857,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,857,50,,,percent of total billed charges,50% of total Billed charges,1336.92,78,,,percent of total billed charges,78% of total billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,1415.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1415.76,82.6,,,percent of total billed charges,82.6% of total billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,857,50,,,percent of total billed charges,50% of total Billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,262.24,1714,
MASK FULL VENTED SMALL,451636,CDM,270,RC,,,Outpatient,,,1714,1114.10,,1508.32,88,,,percent of total billed charges,88% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,296.59,17.304,,,percent of total billed charges,17.304% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1079.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,262.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1182.66,69,,,percent of total billed charges,69% of total billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,1060.11,61.85,,,percent of total billed charges,61.85% of total billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,293.71,17.136,,,percent of total billed charges,17.136% of total billed charges,374.34,21.84,,,percent of total billed charges,21.84% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,857,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,857,50,,,percent of total billed charges,50% of total Billed charges,1336.92,78,,,percent of total billed charges,78% of total billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,1415.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1415.76,82.6,,,percent of total billed charges,82.6% of total billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,857,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,857,50,,,percent of total billed charges,50% of total Billed charges,287.95,16.8,,,percent of total billed charges,16.8% of total billed charges,262.24,1714,
MASK ISOLATION,114393,CDM,270,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
MASK OXY02 ADULT TUBE 7 FOOT LATEX FREE,192730,CDM,270,RC,,,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.13,17.304,,,percent of total billed charges,17.304% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,8.05,17.136,,,percent of total billed charges,17.136% of total billed charges,10.26,21.84,,,percent of total billed charges,21.84% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,47,
MASK RESP PARTICULATE REG TYPE N95,7775,CDM,270,RC,,,Outpatient,,,84,54.60,,73.92,88,,,percent of total billed charges,88% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,14.54,17.304,,,percent of total billed charges,17.304% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,52.92,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,12.85,15.3,,,percent of total billed charges,15.3% of total billed charges,57.96,69,,,percent of total billed charges,69% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,51.95,61.85,,,percent of total billed charges,61.85% of total billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,14.39,17.136,,,percent of total billed charges,17.136% of total billed charges,18.35,21.84,,,percent of total billed charges,21.84% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42,50,,,percent of total billed charges,50% of total Billed charges,65.52,78,,,percent of total billed charges,78% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42,50,,,percent of total billed charges,50% of total Billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,12.85,84,
MASK RESPIRATOR N95 SMALL,65630,CDM,270,RC,,,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,17.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,104,100,,,percent of total billed charges,100% of total billed charges,18,17.304,,,percent of total billed charges,17.304% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,65.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,17.47,16.8,,,percent of total billed charges,16.8% of total billed charges,15.91,15.3,,,percent of total billed charges,15.3% of total billed charges,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,104,100,,,percent of total billed charges,100% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,104,100,,,percent of total billed charges,100% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,64.32,61.85,,,percent of total billed charges,61.85% of total billed charges,17.47,16.8,,,percent of total billed charges,16.8% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,17.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,17.82,17.136,,,percent of total billed charges,17.136% of total billed charges,22.71,21.84,,,percent of total billed charges,21.84% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,52,50,,,percent of total billed charges,50% of total Billed charges,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,17.47,16.8,,,percent of total billed charges,16.8% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,52,50,,,percent of total billed charges,50% of total Billed charges,17.47,16.8,,,percent of total billed charges,16.8% of total billed charges,15.91,104,
MASK RESPIRATOR TB N-95 PLUS,429496,CDM,270,RC,,,Outpatient,,,121,78.65,,106.48,88,,,percent of total billed charges,88% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,20.94,17.304,,,percent of total billed charges,17.304% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,76.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,18.51,15.3,,,percent of total billed charges,15.3% of total billed charges,83.49,69,,,percent of total billed charges,69% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,74.84,61.85,,,percent of total billed charges,61.85% of total billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.73,17.136,,,percent of total billed charges,17.136% of total billed charges,26.43,21.84,,,percent of total billed charges,21.84% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,94.38,78,,,percent of total billed charges,78% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,18.51,121,
MASK SENTRI ADULT ETCO2,430817,CDM,270,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
MASK SURGICAL DUCKBILL BLUE,145390,CDM,270,RC,,,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,7.09,17.304,,,percent of total billed charges,17.304% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,15.3,,,percent of total billed charges,15.3% of total billed charges,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.36,61.85,,,percent of total billed charges,61.85% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,7.03,17.136,,,percent of total billed charges,17.136% of total billed charges,8.95,21.84,,,percent of total billed charges,21.84% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,41,
MASK SURGICAL HIGH FILTER HYPO-ALLERGENIC WHITE,163796,CDM,270,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,8.65,17.304,,,percent of total billed charges,17.304% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,30.93,61.85,,,percent of total billed charges,61.85% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.57,17.136,,,percent of total billed charges,17.136% of total billed charges,10.92,21.84,,,percent of total billed charges,21.84% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,50,
MASK SURGICAL TIE-ON,168884,CDM,270,RC,,,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.4,17.304,,,percent of total billed charges,17.304% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,23.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.34,17.136,,,percent of total billed charges,17.136% of total billed charges,8.08,21.84,,,percent of total billed charges,21.84% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,37,
MASK SURGICAL TIE-ON O.R.,155891,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
MASK W/FACE SHIELD AND EAR LOOPS L/F,48219,CDM,270,RC,,,Outpatient,,,138,89.70,,121.44,88,,,percent of total billed charges,88% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,23.88,17.304,,,percent of total billed charges,17.304% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,86.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,21.11,15.3,,,percent of total billed charges,15.3% of total billed charges,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,85.35,61.85,,,percent of total billed charges,61.85% of total billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.65,17.136,,,percent of total billed charges,17.136% of total billed charges,30.14,21.84,,,percent of total billed charges,21.84% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,21.11,138,
MASK OXYGEN PEDI MED 7FT ELONG,15903,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
MASK NON-REBREATHING W/SAFETY VENT,274295,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
MASK TRACHEOSTOMY ADULT DISP,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MASK FACE TODDLER   KING SYSTEMS,45801,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
MASK FACE MED ADULT SZ 5,42410,CDM,272,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
MASK LARYNGEAL DISP SZ 4 ADLT,268594,CDM,272,RC,,,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,9.52,17.304,,,percent of total billed charges,17.304% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.42,17.136,,,percent of total billed charges,17.136% of total billed charges,12.01,21.84,,,percent of total billed charges,21.84% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,55,
MASK LMA UNIQUE SZ 3 STD,223373,CDM,272,RC,,,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,9.34,17.304,,,percent of total billed charges,17.304% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,33.4,61.85,,,percent of total billed charges,61.85% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.25,17.136,,,percent of total billed charges,17.136% of total billed charges,11.79,21.84,,,percent of total billed charges,21.84% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
MASK LMA UNIQUE SZ 4 STD,223374,CDM,272,RC,,,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,9.34,17.304,,,percent of total billed charges,17.304% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,33.4,61.85,,,percent of total billed charges,61.85% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.25,17.136,,,percent of total billed charges,17.136% of total billed charges,11.79,21.84,,,percent of total billed charges,21.84% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
MASK LMA UNIQUE SZ 5 STD,223375,CDM,272,RC,,,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,9.34,17.304,,,percent of total billed charges,17.304% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,33.4,61.85,,,percent of total billed charges,61.85% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.25,17.136,,,percent of total billed charges,17.136% of total billed charges,11.79,21.84,,,percent of total billed charges,21.84% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
MASK OXYGEN ADULT MED 7FT ELONG,100485,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
MASK FACE SURGICAL W/ TIES,490864,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
MASK FACE MOLDED,490863,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
MASK SURGICAL ANTI-FOG,490865,CDM,270,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
MASK LARYNGEAL DISP SZ 3 PED/ADLT,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
MASK N95 PARTICULATE 9205+,ORSUP0001,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
MASK AEROSOL,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MASK FULL NONVENTED,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
MASK FULL NONVENTED SMALL,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
MASK FULL NONVENTED LARGE,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
MASK ANESTHESIA TOP VALVE CHILD SZ 3,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MASK ANESTHESIA TOP VALVE CHILD SZ 4,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MASTISOL APPLICATOR 2/3CC,490867,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
MASTISOL,490866,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
MAT ECP SUCTIONER,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
MAT MOBILE AIR TRANSFER 39IN X 81IN,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
MATCH HEAD LONG 3.0 X 16CM,ORSUP0022,CDM,272,RC,,,Outpatient,,,2200,1430.00,,1936,88,,,percent of total billed charges,88% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,380.69,17.304,,,percent of total billed charges,17.304% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1386,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,15.3,,,percent of total billed charges,15.3% of total billed charges,1518,69,,,percent of total billed charges,69% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1360.7,61.85,,,percent of total billed charges,61.85% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,376.99,17.136,,,percent of total billed charges,17.136% of total billed charges,480.48,21.84,,,percent of total billed charges,21.84% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,1716,78,,,percent of total billed charges,78% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,2200,
MATERNITY PACKS,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
MATRIX,ORSUP0044,CDM,278,RC,C1762,HCPCS,Outpatient,,,8580,5577.00,,7550.4,88,,,percent of total billed charges,88% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1484.68,17.304,,,percent of total billed charges,17.304% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5405.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,15.3,,,percent of total billed charges,15.3% of total billed charges,5920.2,69,,,percent of total billed charges,69% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5306.73,61.85,,,percent of total billed charges,61.85% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,2676.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1470.27,17.136,,,percent of total billed charges,17.136% of total billed charges,1873.87,21.84,,,percent of total billed charges,21.84% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,3234.66,37.7,,,percent of total billed charges,37.70% of total billed charges,3234.66,37.7,,,percent of total billed charges,37.70% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,2908.62,33.9,,,percent of total billed charges,33.9% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,6692.4,78,,,percent of total billed charges,78% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,8580,
MATRIX BONE CELLULAR OSTEOCEL 1CC,ORSUP0022,CDM,278,RC,C1762,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
MATRIX MICRO 200MG,ORSUP0030,CDM,272,RC,,,Outpatient,,,3800,2470.00,,3344,88,,,percent of total billed charges,88% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,657.55,17.304,,,percent of total billed charges,17.304% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,2394,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,581.4,15.3,,,percent of total billed charges,15.3% of total billed charges,2622,69,,,percent of total billed charges,69% of total billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,2350.3,61.85,,,percent of total billed charges,61.85% of total billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,651.17,17.136,,,percent of total billed charges,17.136% of total billed charges,829.92,21.84,,,percent of total billed charges,21.84% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1900,50,,,percent of total billed charges,50% of total Billed charges,2964,78,,,percent of total billed charges,78% of total billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,3138.8,82.6,,,percent of total billed charges,82.6% of total billed charges,3138.8,82.6,,,percent of total billed charges,82.6% of total billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1900,50,,,percent of total billed charges,50% of total Billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,581.4,3800,
MATRIX CYTAL WOUND 5 X 5CM,ORSUP0036,CDM,278,RC,Q4166,HCPCS,Outpatient,,,5000,3250.00,,4400,88,,,percent of total billed charges,88% of total Billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2500,50,,,percent of total billed charges,50% of total Billed charges,3150,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",765,15.3,,,percent of total billed charges,15.3% of total billed charges,3450,69,,,percent of total billed charges,69% of total billed charges,5000,100,,,percent of total billed charges,100% of total billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,5000,100,,,percent of total billed charges,100% of total billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,5000,100,,,percent of total billed charges,100% of total billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,3092.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,2500,50,,,percent of total billed charges,50% of total Billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,1560,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2500,50,,,percent of total billed charges,50% of total Billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2500,50,,,percent of total billed charges,50% of total Billed charges,1885,37.7,,,percent of total billed charges,37.70% of total billed charges,1885,37.7,,,percent of total billed charges,37.70% of total billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,1695,33.9,,,percent of total billed charges,33.9% of total billed charges,2500,50,,,percent of total billed charges,50% of total Billed charges,3900,78,,,percent of total billed charges,78% of total billed charges,5000,100,,,percent of total billed charges,100% of total billed charges,4130,82.6,,,percent of total billed charges,82.6% of total billed charges,4130,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,2500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",765,5000,
MATTING DYCEM NON-SLIP,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
MAXTRIX BONE CELLULAR 10CC,ORSUP0089,CDM,278,RC,C1762,HCPCS,Outpatient,,,20540,13351.00,,18075.2,88,,,percent of total billed charges,88% of total Billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,3450.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3554.24,17.304,,,percent of total billed charges,17.304% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,12940.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3450.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3142.62,15.3,,,percent of total billed charges,15.3% of total billed charges,14172.6,69,,,percent of total billed charges,69% of total billed charges,20540,100,,,percent of total billed charges,100% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,20540,100,,,percent of total billed charges,100% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,20540,100,,,percent of total billed charges,100% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,12703.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3450.72,16.8,,,percent of total billed charges,16.8% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,6408.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10270,50,,,percent of total billed charges,50% of total Billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,3519.73,17.136,,,percent of total billed charges,17.136% of total billed charges,4485.94,21.84,,,percent of total billed charges,21.84% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,7743.58,37.7,,,percent of total billed charges,37.70% of total billed charges,7743.58,37.7,,,percent of total billed charges,37.70% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,6963.06,33.9,,,percent of total billed charges,33.9% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,16021.2,78,,,percent of total billed charges,78% of total billed charges,20540,100,,,percent of total billed charges,100% of total billed charges,16966.04,82.6,,,percent of total billed charges,82.6% of total billed charges,16966.04,82.6,,,percent of total billed charges,82.6% of total billed charges,3450.72,16.8,,,percent of total billed charges,16.8% of total billed charges,10270,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10270,50,,,percent of total billed charges,50% of total Billed charges,3450.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3142.62,20540,
MDI INLINE ADAPTER 22MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MEASUREMENT CART RAPIDPOINT 500,ORSUP0028,CDM,272,RC,,,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
MEDIA PLATE SENSITIVITY MUELLER HINTON AGAR 150 X 15MM,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
MEDIA ILLUMIGENE C DIFF CTL,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
MEDIPORE TAPE 3,490869,CDM,270,RC,,,Outpatient,,,86,55.90,,75.68,88,,,percent of total billed charges,88% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,14.88,17.304,,,percent of total billed charges,17.304% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,54.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,13.16,15.3,,,percent of total billed charges,15.3% of total billed charges,59.34,69,,,percent of total billed charges,69% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,53.19,61.85,,,percent of total billed charges,61.85% of total billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.74,17.136,,,percent of total billed charges,17.136% of total billed charges,18.78,21.84,,,percent of total billed charges,21.84% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,67.08,78,,,percent of total billed charges,78% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,13.16,86,
MEDIA PLATE SENSITIVITY MUELLER HINTON AGAR W/5% SHEEP BLD 1,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MEDIGRIP E,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
MEDIGRIP F,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
MEDIGRIP G,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
MEDIUM LARGE CLIP APPLIER,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
MEDTOX PAPER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MEGATIP L-WIRE DISP 0620M,490872,CDM,272,RC,,,Outpatient,,,124,80.60,,109.12,88,,,percent of total billed charges,88% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,21.46,17.304,,,percent of total billed charges,17.304% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,78.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,18.97,15.3,,,percent of total billed charges,15.3% of total billed charges,85.56,69,,,percent of total billed charges,69% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,76.69,61.85,,,percent of total billed charges,61.85% of total billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,21.25,17.136,,,percent of total billed charges,17.136% of total billed charges,27.08,21.84,,,percent of total billed charges,21.84% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,96.72,78,,,percent of total billed charges,78% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,18.97,124,
MEGATIP CURVED BLADE DISP 0619,490871,CDM,272,RC,,,Outpatient,,,124,80.60,,109.12,88,,,percent of total billed charges,88% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,21.46,17.304,,,percent of total billed charges,17.304% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,78.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,18.97,15.3,,,percent of total billed charges,15.3% of total billed charges,85.56,69,,,percent of total billed charges,69% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,76.69,61.85,,,percent of total billed charges,61.85% of total billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,21.25,17.136,,,percent of total billed charges,17.136% of total billed charges,27.08,21.84,,,percent of total billed charges,21.84% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,96.72,78,,,percent of total billed charges,78% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,18.97,124,
MEGA SUTURE CUT NEEDLE DRIVER,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
MEGA NEEDLE DRIVER,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
MEMBRANING KIT FOR TC SENSORS,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
MEMBRANE RESTORE 1X1CM,ORSUP0020,CDM,270,RC,,,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
MEMBRANE RESTORE 2X2CM,ORSUP0020,CDM,270,RC,,,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
MEMBRANE RESTORE 2X3CM,ORSUP0020,CDM,270,RC,,,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
MERCEDES 4.0MM LIPO CANNNULA,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
MERSILENE 4-0 FS-2 (R633H),490873,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
MERSILENE 5 BP (RS20),490874,CDM,270,RC,,,Outpatient,,,295,191.75,,259.6,88,,,percent of total billed charges,88% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,51.05,17.304,,,percent of total billed charges,17.304% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,185.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,45.14,15.3,,,percent of total billed charges,15.3% of total billed charges,203.55,69,,,percent of total billed charges,69% of total billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,182.46,61.85,,,percent of total billed charges,61.85% of total billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,50.55,17.136,,,percent of total billed charges,17.136% of total billed charges,64.43,21.84,,,percent of total billed charges,21.84% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,230.1,78,,,percent of total billed charges,78% of total billed charges,295,100,,,percent of total billed charges,100% of total billed charges,243.67,82.6,,,percent of total billed charges,82.6% of total billed charges,243.67,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,45.14,295,
MESH VICRYL WOVEN 12 X 12,ORSUP0038,CDM,278,RC,C1781,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
MESH VENTRIO LRG OVAL,ORSUP0032,CDM,278,RC,C1781,HCPCS,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1703.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1850.94,33.9,,,percent of total billed charges,33.9% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
MESH PROGRIP LAPAROSCOPIC SELF-FIXATING  5.9 X 3.9,ORSUP0040,CDM,278,RC,C1781,HCPCS,Outpatient,,,3600,2340.00,,3168,88,,,percent of total billed charges,88% of total Billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,622.94,17.304,,,percent of total billed charges,17.304% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,2268,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,550.8,15.3,,,percent of total billed charges,15.3% of total billed charges,2484,69,,,percent of total billed charges,69% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,2226.6,61.85,,,percent of total billed charges,61.85% of total billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,1123.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1800,50,,,percent of total billed charges,50% of total Billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,616.9,17.136,,,percent of total billed charges,17.136% of total billed charges,786.24,21.84,,,percent of total billed charges,21.84% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,1357.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1357.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,1220.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,2808,78,,,percent of total billed charges,78% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1800,50,,,percent of total billed charges,50% of total Billed charges,604.8,16.8,,,percent of total billed charges,16.8% of total billed charges,550.8,3600,
MESH SURG PARIETX PROGRIP 15X10CM LAPSCP,ORSUP0026,CDM,278,RC,C1781,HCPCS,Outpatient,,,3000,1950.00,,2640,88,,,percent of total billed charges,88% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,519.12,17.304,,,percent of total billed charges,17.304% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1890,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,15.3,,,percent of total billed charges,15.3% of total billed charges,2070,69,,,percent of total billed charges,69% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1855.5,61.85,,,percent of total billed charges,61.85% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,936,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,514.08,17.136,,,percent of total billed charges,17.136% of total billed charges,655.2,21.84,,,percent of total billed charges,21.84% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1017,33.9,,,percent of total billed charges,33.9% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,2340,78,,,percent of total billed charges,78% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,3000,
MESH TEM3015G,ORSUP0024,CDM,278,RC,C1781,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
MESH MARLEX FLAT SHEET 10 X 14 STRL,ORSUP0008,CDM,278,RC,C1781,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
MESH VENTRIO MED OVAL,ORSUP0027,CDM,278,RC,C1781,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
MESH VENTRIO SM OVAL,ORSUP0022,CDM,278,RC,C1781,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
MESH HERNIA BARD 3D MAX  RIGHT MEDIUM,ORSUP0011,CDM,278,RC,C1781,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
MESH ATRIUM KEYHOLE      1010306 02,ORSUP0002,CDM,278,RC,C1781,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
MESH SURG VENTRALIGHT ST 6 IN HERNIA 4 CONN LOPRO LTWT MFL S,ORSUP0046,CDM,278,RC,C1781,HCPCS,Outpatient,,,7000,4550.00,,6160,88,,,percent of total billed charges,88% of total Billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,1176,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1211.28,17.304,,,percent of total billed charges,17.304% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,4410,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1176,16.8,,,percent of total billed charges,16.8% of total billed charges,1071,15.3,,,percent of total billed charges,15.3% of total billed charges,4830,69,,,percent of total billed charges,69% of total billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,4329.5,61.85,,,percent of total billed charges,61.85% of total billed charges,1176,16.8,,,percent of total billed charges,16.8% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,2184,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3500,50,,,percent of total billed charges,50% of total Billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,1199.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1528.8,21.84,,,percent of total billed charges,21.84% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,2639,37.7,,,percent of total billed charges,37.70% of total billed charges,2639,37.7,,,percent of total billed charges,37.70% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,2373,33.9,,,percent of total billed charges,33.9% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,5460,78,,,percent of total billed charges,78% of total billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,5782,82.6,,,percent of total billed charges,82.6% of total billed charges,5782,82.6,,,percent of total billed charges,82.6% of total billed charges,1176,16.8,,,percent of total billed charges,16.8% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3500,50,,,percent of total billed charges,50% of total Billed charges,1176,16.8,,,percent of total billed charges,16.8% of total billed charges,1071,7000,
MESH TITANIUM 3D  80MMX80MM 6MM 1.5MM SYS CP TITANIUM,ORSUP0034,CDM,278,RC,C1781,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
MESH VENTRALIGHT 10INX13IN ELLIPSE,ORSUP0075,CDM,278,RC,C1781,HCPCS,Outpatient,,,16900,10985.00,,14872,88,,,percent of total billed charges,88% of total Billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2924.38,17.304,,,percent of total billed charges,17.304% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,10647,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2585.7,15.3,,,percent of total billed charges,15.3% of total billed charges,11661,69,,,percent of total billed charges,69% of total billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,10452.65,61.85,,,percent of total billed charges,61.85% of total billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,5272.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8450,50,,,percent of total billed charges,50% of total Billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,2895.98,17.136,,,percent of total billed charges,17.136% of total billed charges,3690.96,21.84,,,percent of total billed charges,21.84% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,6371.3,37.7,,,percent of total billed charges,37.70% of total billed charges,6371.3,37.7,,,percent of total billed charges,37.70% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,5729.1,33.9,,,percent of total billed charges,33.9% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,13182,78,,,percent of total billed charges,78% of total billed charges,16900,100,,,percent of total billed charges,100% of total billed charges,13959.4,82.6,,,percent of total billed charges,82.6% of total billed charges,13959.4,82.6,,,percent of total billed charges,82.6% of total billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,8450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8450,50,,,percent of total billed charges,50% of total Billed charges,2839.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2585.7,16900,
MESH VENTRALIGHT ST 4.5IN HRN 2 CONN LOPRO LTWT MFL,ORSUP0033,CDM,278,RC,C1781,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
MESH VENTRALIGHT W/ ECHO 6 X 10,ORSUP0051,CDM,278,RC,C1781,HCPCS,Outpatient,,,10400,6760.00,,9152,88,,,percent of total billed charges,88% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1799.62,17.304,,,percent of total billed charges,17.304% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,6552,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,15.3,,,percent of total billed charges,15.3% of total billed charges,7176,69,,,percent of total billed charges,69% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,6432.4,61.85,,,percent of total billed charges,61.85% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3244.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1782.14,17.136,,,percent of total billed charges,17.136% of total billed charges,2271.36,21.84,,,percent of total billed charges,21.84% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3920.8,37.7,,,percent of total billed charges,37.70% of total billed charges,3920.8,37.7,,,percent of total billed charges,37.70% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3525.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,8112,78,,,percent of total billed charges,78% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,10400,
MESH PANITES,437611,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
MESH VENTRALIGHT ST 4.5IN CIRCL,ORSUP0031,CDM,278,RC,C1781,HCPCS,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
MESH SURGISIS 13 X 22,ORSUP0013,CDM,278,RC,C1781,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
MESH COMPOSITE PARIETEX 9CM RD,ORSUP0015,CDM,278,RC,C1781,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
MESH OVAL PATCH SMALL,ORSUP0025,CDM,278,RC,C1781,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
MESH OVAL 6X8 PROCEED,ORSUP0033,CDM,278,RC,C1781,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
MESH OVAL MEDIUM VENTRIO,ORSUP0009,CDM,278,RC,C1781,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
MESH OVAL 4X6 PROCEED,ORSUP0023,CDM,278,RC,C1781,HCPCS,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,973.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1057.68,33.9,,,percent of total billed charges,33.9% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
MESH MK PATCH 4IN MED CIRCLE,ORSUP0013,CDM,278,RC,C1781,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
MESH MK PATCH 3IN SM CIRCLE,ORSUP0012,CDM,278,RC,C1781,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
MESH OVAL PATCH LRG,ORSUP0015,CDM,278,RC,C1781,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
MESH DUAL 15 X 19 X 1,ORSUP0015,CDM,278,RC,C1781,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
MESH DUAL 7.5 X 10.0,ORSUP0015,CDM,278,RC,C1781,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
MESH DUAL 7.5 X 10.5 X 1.0,ORSUP0014,CDM,278,RC,C1781,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
MESH CIRCLE LARGE HERNIA PATCH,ORSUP0010,CDM,278,RC,C1781,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
MESH COMPOSITE PARIETEX 12CM,ORSUP0012,CDM,278,RC,C1781,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
MESH COMPOSEX EX 7 X 9,ORSUP0040,CDM,278,RC,C1781,HCPCS,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
MESH COMPOSEX EX 6 X 8,ORSUP0008,CDM,278,RC,C1781,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
MESH CIRCLE SMALL HERNIA REP,ORSUP0006,CDM,278,RC,C1781,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
MESH ALYTE Y,ORSUP0032,CDM,278,RC,C1781,HCPCS,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1703.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1850.94,33.9,,,percent of total billed charges,33.9% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
MESH 3D MAX LARGE LEFT,ORSUP0017,CDM,278,RC,C1781,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
MESH ATRIUM 2 X 4        1000204 00,ORSUP0004,CDM,278,RC,C1781,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
MESH PROGRIP 12 X 8CM LEFT,ORSUP0021,CDM,278,RC,C1781,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
MESH PROGRIP 12 X 8CM RIGHT,ORSUP0021,CDM,278,RC,C1781,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
MESH COMPOSITE PCO PARIETEX 20CM X 15CM,ORSUP0037,CDM,278,RC,C1781,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
MESH 2 X 4 RECTANGLE,ORSUP0012,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
MESH 3 X 6,ORSUP0012,CDM,278,RC,C1781,HCPCS,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,263.9,37.7,,,percent of total billed charges,37.70% of total billed charges,263.9,37.7,,,percent of total billed charges,37.70% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,237.3,33.9,,,percent of total billed charges,33.9% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
MESH PANTIES 2XL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MESH VENTRALEX SMALL,ORSUP0033,CDM,278,RC,C1781,HCPCS,Outpatient,,,4400,2860.00,,3872,88,,,percent of total billed charges,88% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,761.38,17.304,,,percent of total billed charges,17.304% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2772,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3036,69,,,percent of total billed charges,69% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2721.4,61.85,,,percent of total billed charges,61.85% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1372.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,753.98,17.136,,,percent of total billed charges,17.136% of total billed charges,960.96,21.84,,,percent of total billed charges,21.84% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1491.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,3432,78,,,percent of total billed charges,78% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,4400,
MESH VENTRALEX MED,ORSUP0031,CDM,278,RC,C1781,HCPCS,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
MESH VENTRALEX LARGE,ORSUP0056,CDM,278,RC,C1781,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
MESH VENTRALIGHT ST ECHO 2 4X6,ORSUP0035,CDM,278,RC,C1781,HCPCS,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
MESH COMPOSITE PARIETEX 30X20CM,ORSUP0070,CDM,278,RC,C1781,HCPCS,Outpatient,,,15600,10140.00,,13728,88,,,percent of total billed charges,88% of total Billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,2620.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2699.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,9828,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2620.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2386.8,15.3,,,percent of total billed charges,15.3% of total billed charges,10764,69,,,percent of total billed charges,69% of total billed charges,15600,100,,,percent of total billed charges,100% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,15600,100,,,percent of total billed charges,100% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,15600,100,,,percent of total billed charges,100% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,9648.6,61.85,,,percent of total billed charges,61.85% of total billed charges,2620.8,16.8,,,percent of total billed charges,16.8% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,4867.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7800,50,,,percent of total billed charges,50% of total Billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,2673.22,17.136,,,percent of total billed charges,17.136% of total billed charges,3407.04,21.84,,,percent of total billed charges,21.84% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,5881.2,37.7,,,percent of total billed charges,37.70% of total billed charges,5881.2,37.7,,,percent of total billed charges,37.70% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,5288.4,33.9,,,percent of total billed charges,33.9% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,12168,78,,,percent of total billed charges,78% of total billed charges,15600,100,,,percent of total billed charges,100% of total billed charges,12885.6,82.6,,,percent of total billed charges,82.6% of total billed charges,12885.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2620.8,16.8,,,percent of total billed charges,16.8% of total billed charges,7800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7800,50,,,percent of total billed charges,50% of total Billed charges,2620.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2386.8,15600,
MESH VENTRALIGHT 4X6,ORSUP0031,CDM,278,RC,C1781,HCPCS,Outpatient,,,4000,2600.00,,3520,88,,,percent of total billed charges,88% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,692.16,17.304,,,percent of total billed charges,17.304% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2520,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,672,16.8,,,percent of total billed charges,16.8% of total billed charges,612,15.3,,,percent of total billed charges,15.3% of total billed charges,2760,69,,,percent of total billed charges,69% of total billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2474,61.85,,,percent of total billed charges,61.85% of total billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,1248,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2000,50,,,percent of total billed charges,50% of total Billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,685.44,17.136,,,percent of total billed charges,17.136% of total billed charges,873.6,21.84,,,percent of total billed charges,21.84% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,1508,37.7,,,percent of total billed charges,37.70% of total billed charges,1508,37.7,,,percent of total billed charges,37.70% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,1356,33.9,,,percent of total billed charges,33.9% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,3120,78,,,percent of total billed charges,78% of total billed charges,4000,100,,,percent of total billed charges,100% of total billed charges,3304,82.6,,,percent of total billed charges,82.6% of total billed charges,3304,82.6,,,percent of total billed charges,82.6% of total billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,2000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2000,50,,,percent of total billed charges,50% of total Billed charges,672,16.8,,,percent of total billed charges,16.8% of total billed charges,612,4000,
METHANOL (CERTIFIED ACS),ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
METHANOL 70%,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
METRICIDE OPA SOLUTION,490898,CDM,270,RC,,,Outpatient,,,664,431.60,,584.32,88,,,percent of total billed charges,88% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,114.9,17.304,,,percent of total billed charges,17.304% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,418.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,101.59,15.3,,,percent of total billed charges,15.3% of total billed charges,458.16,69,,,percent of total billed charges,69% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,664,100,,,percent of total billed charges,100% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,410.68,61.85,,,percent of total billed charges,61.85% of total billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,113.78,17.136,,,percent of total billed charges,17.136% of total billed charges,145.02,21.84,,,percent of total billed charges,21.84% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,517.92,78,,,percent of total billed charges,78% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,332,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,332,50,,,percent of total billed charges,50% of total Billed charges,111.55,16.8,,,percent of total billed charges,16.8% of total billed charges,101.59,664,
METRIZYME ENZYMATIC CLEANER,490900,CDM,270,RC,,,Outpatient,,,279,181.35,,245.52,88,,,percent of total billed charges,88% of total Billed charges,139.5,50,,,percent of total billed charges,50% of total Billed charges,46.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,279,100,,,percent of total billed charges,100% of total billed charges,48.28,17.304,,,percent of total billed charges,17.304% of total billed charges,139.5,50,,,percent of total billed charges,50% of total Billed charges,175.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,46.87,16.8,,,percent of total billed charges,16.8% of total billed charges,42.69,15.3,,,percent of total billed charges,15.3% of total billed charges,192.51,69,,,percent of total billed charges,69% of total billed charges,279,100,,,percent of total billed charges,100% of total billed charges,139.5,50,,,percent of total billed charges,50% of total Billed charges,279,100,,,percent of total billed charges,100% of total billed charges,139.5,50,,,percent of total billed charges,50% of total Billed charges,279,100,,,percent of total billed charges,100% of total billed charges,139.5,50,,,percent of total billed charges,50% of total Billed charges,172.56,61.85,,,percent of total billed charges,61.85% of total billed charges,46.87,16.8,,,percent of total billed charges,16.8% of total billed charges,139.5,50,,,percent of total billed charges,50% of total Billed charges,139.5,50,,,percent of total billed charges,50% of total Billed charges,46.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,139.5,50,,,percent of total billed charges,50% of total Billed charges,139.5,50,,,percent of total billed charges,50% of total Billed charges,47.81,17.136,,,percent of total billed charges,17.136% of total billed charges,60.93,21.84,,,percent of total billed charges,21.84% of total billed charges,139.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,139.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,139.5,50,,,percent of total billed charges,50% of total Billed charges,217.62,78,,,percent of total billed charges,78% of total billed charges,279,100,,,percent of total billed charges,100% of total billed charges,230.45,82.6,,,percent of total billed charges,82.6% of total billed charges,230.45,82.6,,,percent of total billed charges,82.6% of total billed charges,46.87,16.8,,,percent of total billed charges,16.8% of total billed charges,139.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,139.5,50,,,percent of total billed charges,50% of total Billed charges,46.87,16.8,,,percent of total billed charges,16.8% of total billed charges,42.69,279,
METRICIDE TEST STRIPS,490899,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
METZEMBAUM SCISSOR TIP,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
MICKEY G TUBE 18 FR LAP KIT,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
MICROCATHETER THREADER OTW,ORSUP0032,CDM,278,RC,C1887,HCPCS,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1703.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1850.94,33.9,,,percent of total billed charges,33.9% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
MICROPUNCTURE PEDAL INTRO SET,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
MICRO METZENBAUM SCISSOR TIP,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
MICRO KILL BLEACH WIPE,490904,CDM,270,RC,,,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,93,100,,,percent of total billed charges,100% of total billed charges,16.09,17.304,,,percent of total billed charges,17.304% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,58.59,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,93,100,,,percent of total billed charges,100% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,93,100,,,percent of total billed charges,100% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,57.52,61.85,,,percent of total billed charges,61.85% of total billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.94,17.136,,,percent of total billed charges,17.136% of total billed charges,20.31,21.84,,,percent of total billed charges,21.84% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46.5,50,,,percent of total billed charges,50% of total Billed charges,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,14.23,93,
MICRO INTRODUCER SHEATH SET (CLOSURE FAST),ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
MICRONESTER COIL 14CM X 4MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
MICRONESTER15CM X 8MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
MICRONESTER 14CM X 6MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
MICROCATHETER CANTATA 2.9F/110,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
MICROPUNTURE SET 5FR,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
MICROTAINER CAPILARY BLOOD COLLECTOR GREEN EXTENDER,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
MICRO BLOOD COLLECTING TUBES,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
MICRO MATRIX 500MG,ORSUP0043,CDM,278,RC,Q4118,HCPCS,Outpatient,,,6400,4160.00,,5632,88,,,percent of total billed charges,88% of total Billed charges,3200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3200,50,,,percent of total billed charges,50% of total Billed charges,4032,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",979.2,15.3,,,percent of total billed charges,15.3% of total billed charges,4416,69,,,percent of total billed charges,69% of total billed charges,6400,100,,,percent of total billed charges,100% of total billed charges,3200,50,,,percent of total billed charges,50% of total Billed charges,6400,100,,,percent of total billed charges,100% of total billed charges,3200,50,,,percent of total billed charges,50% of total Billed charges,6400,100,,,percent of total billed charges,100% of total billed charges,3200,50,,,percent of total billed charges,50% of total Billed charges,3958.4,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3200,50,,,percent of total billed charges,50% of total Billed charges,3200,50,,,percent of total billed charges,50% of total Billed charges,1996.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3200,50,,,percent of total billed charges,50% of total Billed charges,3200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3200,50,,,percent of total billed charges,50% of total Billed charges,2412.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2412.8,37.7,,,percent of total billed charges,37.70% of total billed charges,3200,50,,,percent of total billed charges,50% of total Billed charges,2169.6,33.9,,,percent of total billed charges,33.9% of total billed charges,3200,50,,,percent of total billed charges,50% of total Billed charges,4992,78,,,percent of total billed charges,78% of total billed charges,6400,100,,,percent of total billed charges,100% of total billed charges,5286.4,82.6,,,percent of total billed charges,82.6% of total billed charges,5286.4,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,3200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",979.2,6400,
MICRO MATRIX 1000MG,ORSUP0072,CDM,278,RC,Q4118,HCPCS,Outpatient,,,12400,8060.00,,10912,88,,,percent of total billed charges,88% of total Billed charges,6200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6200,50,,,percent of total billed charges,50% of total Billed charges,7812,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1897.2,15.3,,,percent of total billed charges,15.3% of total billed charges,8556,69,,,percent of total billed charges,69% of total billed charges,12400,100,,,percent of total billed charges,100% of total billed charges,6200,50,,,percent of total billed charges,50% of total Billed charges,12400,100,,,percent of total billed charges,100% of total billed charges,6200,50,,,percent of total billed charges,50% of total Billed charges,12400,100,,,percent of total billed charges,100% of total billed charges,6200,50,,,percent of total billed charges,50% of total Billed charges,7669.4,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,6200,50,,,percent of total billed charges,50% of total Billed charges,6200,50,,,percent of total billed charges,50% of total Billed charges,3868.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6200,50,,,percent of total billed charges,50% of total Billed charges,6200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6200,50,,,percent of total billed charges,50% of total Billed charges,4674.8,37.7,,,percent of total billed charges,37.70% of total billed charges,4674.8,37.7,,,percent of total billed charges,37.70% of total billed charges,6200,50,,,percent of total billed charges,50% of total Billed charges,4203.6,33.9,,,percent of total billed charges,33.9% of total billed charges,6200,50,,,percent of total billed charges,50% of total Billed charges,9672,78,,,percent of total billed charges,78% of total billed charges,12400,100,,,percent of total billed charges,100% of total billed charges,10242.4,82.6,,,percent of total billed charges,82.6% of total billed charges,10242.4,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,6200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1897.2,12400,
MICROCENTRIFUGE TUBES,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MICROLARYNGEAL ENDO TRACH TUBE CUFFED 4.0MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MICROLARYNGEAL ENDO TRACH TUBE CUFFED 5.0MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MICROLARYNGEAL ENDOTRACHEAL TUBE 6MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MICROTOME CARTILAGE CUTTER,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
MICROSTREAM FILTER LINES,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
MIDLINE NASAL TUBING 100MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
MIDLINE NASAL TUBING 50MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
MIDLINE NASAL TUBING 70MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
MINITIP SWABS FLOCKED,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
MINI ENDOCUT SCISSORS,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
MINI C-ARM PAPER,490907,CDM,270,RC,,,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,147,100,,,percent of total billed charges,100% of total billed charges,25.44,17.304,,,percent of total billed charges,17.304% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,92.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,90.92,61.85,,,percent of total billed charges,61.85% of total billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,25.19,17.136,,,percent of total billed charges,17.136% of total billed charges,32.1,21.84,,,percent of total billed charges,21.84% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,22.49,147,
MISTY FAST SMALL-VOLUME NEBULIZER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MITRAL VALVE SS#81217115,ORSUP0080,CDM,278,RC,C1763,HCPCS,Outpatient,,,18200,11830.00,,16016,88,,,percent of total billed charges,88% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3149.33,17.304,,,percent of total billed charges,17.304% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,11466,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2784.6,15.3,,,percent of total billed charges,15.3% of total billed charges,12558,69,,,percent of total billed charges,69% of total billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,11256.7,61.85,,,percent of total billed charges,61.85% of total billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,5678.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9100,50,,,percent of total billed charges,50% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,3118.75,17.136,,,percent of total billed charges,17.136% of total billed charges,3974.88,21.84,,,percent of total billed charges,21.84% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,6861.4,37.7,,,percent of total billed charges,37.70% of total billed charges,6861.4,37.7,,,percent of total billed charges,37.70% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,6169.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,14196,78,,,percent of total billed charges,78% of total billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,15033.2,82.6,,,percent of total billed charges,82.6% of total billed charges,15033.2,82.6,,,percent of total billed charges,82.6% of total billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9100,50,,,percent of total billed charges,50% of total Billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2784.6,18200,
MIXING BOWL W/SPATULA,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
MIXING BOWL VACUUM,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
MIXING BAR SPIRAL,ORSUP0018,CDM,272,RC,,,Outpatient,,,1450,942.50,,1276,88,,,percent of total billed charges,88% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,250.91,17.304,,,percent of total billed charges,17.304% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,913.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,221.85,15.3,,,percent of total billed charges,15.3% of total billed charges,1000.5,69,,,percent of total billed charges,69% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,896.83,61.85,,,percent of total billed charges,61.85% of total billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,248.47,17.136,,,percent of total billed charges,17.136% of total billed charges,316.68,21.84,,,percent of total billed charges,21.84% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,1131,78,,,percent of total billed charges,78% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,221.85,1450,
MLA TIPS 1-5 ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MLA TIPS 10-200,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MLA TIPS 201-1000,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MODULE OPEN HEART,ORSUP0018,CDM,270,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
MOISTURIZER MOUTH .5 OZ,80175,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
MOLE MARKER,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
MONOCRYL 0 CT1 Y346H,207894,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
MONOCRYL PLUS UD 3-0 27 PS-1,241144,CDM,272,RC,,,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.13,17.304,,,percent of total billed charges,17.304% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,8.05,17.136,,,percent of total billed charges,17.136% of total billed charges,10.26,21.84,,,percent of total billed charges,21.84% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,47,
MONOCRYL 0 SH (Y318H),490910,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
MONOCRYL 3-0 PS-2 (Y427H),490911,CDM,272,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
MONOCRYL 3-0 SH (Y316H),490912,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
MONOCRYL 4-0 P-3 (Y494G),490913,CDM,272,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
MONOCRYL 4-0 PS-2 (Y496G),490914,CDM,272,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
MONODERM 2-0 (YA-2024Q),490915,CDM,272,RC,,,Outpatient,,,261,169.65,,229.68,88,,,percent of total billed charges,88% of total Billed charges,130.5,50,,,percent of total billed charges,50% of total Billed charges,43.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,261,100,,,percent of total billed charges,100% of total billed charges,45.16,17.304,,,percent of total billed charges,17.304% of total billed charges,130.5,50,,,percent of total billed charges,50% of total Billed charges,164.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.85,16.8,,,percent of total billed charges,16.8% of total billed charges,39.93,15.3,,,percent of total billed charges,15.3% of total billed charges,180.09,69,,,percent of total billed charges,69% of total billed charges,261,100,,,percent of total billed charges,100% of total billed charges,130.5,50,,,percent of total billed charges,50% of total Billed charges,261,100,,,percent of total billed charges,100% of total billed charges,130.5,50,,,percent of total billed charges,50% of total Billed charges,261,100,,,percent of total billed charges,100% of total billed charges,130.5,50,,,percent of total billed charges,50% of total Billed charges,161.43,61.85,,,percent of total billed charges,61.85% of total billed charges,43.85,16.8,,,percent of total billed charges,16.8% of total billed charges,130.5,50,,,percent of total billed charges,50% of total Billed charges,130.5,50,,,percent of total billed charges,50% of total Billed charges,43.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,130.5,50,,,percent of total billed charges,50% of total Billed charges,130.5,50,,,percent of total billed charges,50% of total Billed charges,44.72,17.136,,,percent of total billed charges,17.136% of total billed charges,57,21.84,,,percent of total billed charges,21.84% of total billed charges,130.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130.5,50,,,percent of total billed charges,50% of total Billed charges,203.58,78,,,percent of total billed charges,78% of total billed charges,261,100,,,percent of total billed charges,100% of total billed charges,215.59,82.6,,,percent of total billed charges,82.6% of total billed charges,215.59,82.6,,,percent of total billed charges,82.6% of total billed charges,43.85,16.8,,,percent of total billed charges,16.8% of total billed charges,130.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130.5,50,,,percent of total billed charges,50% of total Billed charges,43.85,16.8,,,percent of total billed charges,16.8% of total billed charges,39.93,261,
MONO RAPID TEST KIT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MONOPOLAR CURVED SCISSOR,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
MONOJECT TRACE CHEMOTHERAPY CONTAINER HINGED LID YELLOW 12GL,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
MONSEL'S SOLUTION,490916,CDM,270,RC,,,Outpatient,,,98,63.70,,86.24,88,,,percent of total billed charges,88% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,16.96,17.304,,,percent of total billed charges,17.304% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,61.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.99,15.3,,,percent of total billed charges,15.3% of total billed charges,67.62,69,,,percent of total billed charges,69% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,60.61,61.85,,,percent of total billed charges,61.85% of total billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.79,17.136,,,percent of total billed charges,17.136% of total billed charges,21.4,21.84,,,percent of total billed charges,21.84% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,76.44,78,,,percent of total billed charges,78% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.99,98,
"MOP HEAD, MICROFIBER",490917,CDM,270,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
MOUTHPIECE EZ GUARD,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
MOUTHWASH 2OZ  96/CS,175451,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
MOUTHWASH NON-ALCOHOLIC 4 OZ,168903,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
MOUTH PROP LARGE ADULT DISP,490918,CDM,270,RC,,,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
MRI DUAL SYRINGE PACK,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MRI MAGNA PLUS,ORSUP0021,CDM,272,RC,,,Outpatient,,,2000,1300.00,,1760,88,,,percent of total billed charges,88% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,346.08,17.304,,,percent of total billed charges,17.304% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1260,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,336,16.8,,,percent of total billed charges,16.8% of total billed charges,306,15.3,,,percent of total billed charges,15.3% of total billed charges,1380,69,,,percent of total billed charges,69% of total billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1237,61.85,,,percent of total billed charges,61.85% of total billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,342.72,17.136,,,percent of total billed charges,17.136% of total billed charges,436.8,21.84,,,percent of total billed charges,21.84% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,1560,78,,,percent of total billed charges,78% of total billed charges,2000,100,,,percent of total billed charges,100% of total billed charges,1652,82.6,,,percent of total billed charges,82.6% of total billed charges,1652,82.6,,,percent of total billed charges,82.6% of total billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,1000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1000,50,,,percent of total billed charges,50% of total Billed charges,336,16.8,,,percent of total billed charges,16.8% of total billed charges,306,2000,
MRSA SELECT,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
MRSA NXG IVD GX,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
MTS BUFFRD GEL CARD 5 X 20,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
MTS ABD MONO GROUP 5 X 20,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
MTS PROVUE ROUND DILUENT 2+,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
MUCOUS SPECIMEN TRAP SUCTION,490919,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
MUCOSAL ATOMIZER  3ML SYRINGE,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
MUCUS/SPECIMEN TRAP 10FR STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
MULTIQUAL UNASSYD 1,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MULTIQUAL UNASSYD 3,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MULTI HOLE 3.0 LIPO CANNULA,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
MULTI HOLE CANNULA,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
MUREX PYR W/REAGENT 100/PK,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
MUSTANG OVER THE WIRE 5FR 4.0MM X 20MM 135CM,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
MYCOBACTERIA ANTIBIOTIC SUPPLE,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
MYLAR CIAD HT TUBES,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
MYOSURE TISSUE REMOVAL,ORSUP0046,CDM,270,RC,,,Outpatient,,,7000,4550.00,,6160,88,,,percent of total billed charges,88% of total Billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,1176,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1211.28,17.304,,,percent of total billed charges,17.304% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,4410,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1176,16.8,,,percent of total billed charges,16.8% of total billed charges,1071,15.3,,,percent of total billed charges,15.3% of total billed charges,4830,69,,,percent of total billed charges,69% of total billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,4329.5,61.85,,,percent of total billed charges,61.85% of total billed charges,1176,16.8,,,percent of total billed charges,16.8% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,1176,16.8,,,percent of total billed charges,16.8% of total Billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,1199.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1528.8,21.84,,,percent of total billed charges,21.84% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3500,50,,,percent of total billed charges,50% of total Billed charges,5460,78,,,percent of total billed charges,78% of total billed charges,7000,100,,,percent of total billed charges,100% of total billed charges,5782,82.6,,,percent of total billed charges,82.6% of total billed charges,5782,82.6,,,percent of total billed charges,82.6% of total billed charges,1176,16.8,,,percent of total billed charges,16.8% of total billed charges,3500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3500,50,,,percent of total billed charges,50% of total Billed charges,1176,16.8,,,percent of total billed charges,16.8% of total billed charges,1071,7000,
NA MEMBRANE,ORSUP0024,CDM,270,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
NA+ ELECTRODE,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
NAIL 12MM TI CANNUL TIBIAL 300MM-STERILE,ORSUP0040,CDM,278,RC,C1713,HCPCS,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
NAIL CANN,ORSUP0048,CDM,278,RC,C1713,HCPCS,Outpatient,,,9620,6253.00,,8465.6,88,,,percent of total billed charges,88% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1664.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,6060.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,15.3,,,percent of total billed charges,15.3% of total billed charges,6637.8,69,,,percent of total billed charges,69% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,5949.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3001.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1648.48,17.136,,,percent of total billed charges,17.136% of total billed charges,2101.01,21.84,,,percent of total billed charges,21.84% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3626.74,37.7,,,percent of total billed charges,37.70% of total billed charges,3626.74,37.7,,,percent of total billed charges,37.70% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3261.18,33.9,,,percent of total billed charges,33.9% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,7503.6,78,,,percent of total billed charges,78% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,9620,
NAIL FIX 12MM /125 DEG 170MM,ORSUP0039,CDM,278,RC,C1713,HCPCS,Outpatient,,,7280,4732.00,,6406.4,88,,,percent of total billed charges,88% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1259.73,17.304,,,percent of total billed charges,17.304% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4586.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,15.3,,,percent of total billed charges,15.3% of total billed charges,5023.2,69,,,percent of total billed charges,69% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4502.68,61.85,,,percent of total billed charges,61.85% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2271.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1247.5,17.136,,,percent of total billed charges,17.136% of total billed charges,1589.95,21.84,,,percent of total billed charges,21.84% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2744.56,37.7,,,percent of total billed charges,37.70% of total billed charges,2744.56,37.7,,,percent of total billed charges,37.70% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2467.92,33.9,,,percent of total billed charges,33.9% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,5678.4,78,,,percent of total billed charges,78% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,7280,
NAIL FIXATION CANN TROCH TI 11MM/130 170MM,ORSUP0039,CDM,278,RC,C1713,HCPCS,Outpatient,,,7280,4732.00,,6406.4,88,,,percent of total billed charges,88% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1259.73,17.304,,,percent of total billed charges,17.304% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4586.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,15.3,,,percent of total billed charges,15.3% of total billed charges,5023.2,69,,,percent of total billed charges,69% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4502.68,61.85,,,percent of total billed charges,61.85% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2271.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1247.5,17.136,,,percent of total billed charges,17.136% of total billed charges,1589.95,21.84,,,percent of total billed charges,21.84% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2744.56,37.7,,,percent of total billed charges,37.70% of total billed charges,2744.56,37.7,,,percent of total billed charges,37.70% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2467.92,33.9,,,percent of total billed charges,33.9% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,5678.4,78,,,percent of total billed charges,78% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,7280,
NAIL IM L285MM OD9MM TIB,ORSUP0041,CDM,278,RC,C1713,HCPCS,Outpatient,,,7800,5070.00,,6864,88,,,percent of total billed charges,88% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1349.71,17.304,,,percent of total billed charges,17.304% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4914,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,15.3,,,percent of total billed charges,15.3% of total billed charges,5382,69,,,percent of total billed charges,69% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4824.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2433.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1336.61,17.136,,,percent of total billed charges,17.136% of total billed charges,1703.52,21.84,,,percent of total billed charges,21.84% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2644.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,6084,78,,,percent of total billed charges,78% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,7800,
NAIL IM L315MM OD11MM TIB,ORSUP0042,CDM,278,RC,C1713,HCPCS,Outpatient,,,8060,5239.00,,7092.8,88,,,percent of total billed charges,88% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1394.7,17.304,,,percent of total billed charges,17.304% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,5077.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,15.3,,,percent of total billed charges,15.3% of total billed charges,5561.4,69,,,percent of total billed charges,69% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4985.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2514.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1381.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1760.3,21.84,,,percent of total billed charges,21.84% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2732.34,33.9,,,percent of total billed charges,33.9% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,6286.8,78,,,percent of total billed charges,78% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,8060,
NAIL IM L315MM OD9MM TIB,ORSUP0043,CDM,278,RC,C1713,HCPCS,Outpatient,,,8320,5408.00,,7321.6,88,,,percent of total billed charges,88% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1439.69,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5241.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,15.3,,,percent of total billed charges,15.3% of total billed charges,5740.8,69,,,percent of total billed charges,69% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5145.92,61.85,,,percent of total billed charges,61.85% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2595.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1425.72,17.136,,,percent of total billed charges,17.136% of total billed charges,1817.09,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2820.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,6489.6,78,,,percent of total billed charges,78% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,8320,
NAIL IM L360MM OD9MM TIB,ORSUP0049,CDM,278,RC,C1713,HCPCS,Outpatient,,,9880,6422.00,,8694.4,88,,,percent of total billed charges,88% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1709.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,6224.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1511.64,15.3,,,percent of total billed charges,15.3% of total billed charges,6817.2,69,,,percent of total billed charges,69% of total billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,6110.78,61.85,,,percent of total billed charges,61.85% of total billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,3082.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4940,50,,,percent of total billed charges,50% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,1693.04,17.136,,,percent of total billed charges,17.136% of total billed charges,2157.79,21.84,,,percent of total billed charges,21.84% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,3724.76,37.7,,,percent of total billed charges,37.70% of total billed charges,3724.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,3349.32,33.9,,,percent of total billed charges,33.9% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,7706.4,78,,,percent of total billed charges,78% of total billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,8160.88,82.6,,,percent of total billed charges,82.6% of total billed charges,8160.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4940,50,,,percent of total billed charges,50% of total Billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1511.64,9880,
NAIL IM L375MM OD11MM TIB,ORSUP0040,CDM,278,RC,C1713,HCPCS,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
NAIL IM TI L270MM OD9MM NAIL-EX TIB CNULA STRL,ORSUP0040,CDM,278,RC,C1713,HCPCS,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
NAIL TIBIAL 10MM TI CANNULATED - EX/330MM,ORSUP0041,CDM,278,RC,C1713,HCPCS,Outpatient,,,7800,5070.00,,6864,88,,,percent of total billed charges,88% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1349.71,17.304,,,percent of total billed charges,17.304% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4914,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,15.3,,,percent of total billed charges,15.3% of total billed charges,5382,69,,,percent of total billed charges,69% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4824.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2433.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1336.61,17.136,,,percent of total billed charges,17.136% of total billed charges,1703.52,21.84,,,percent of total billed charges,21.84% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2644.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,6084,78,,,percent of total billed charges,78% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,7800,
NAIL TIBIAL 10MM TI CANNULATED - EX/360MM,ORSUP0041,CDM,278,RC,C1713,HCPCS,Outpatient,,,7800,5070.00,,6864,88,,,percent of total billed charges,88% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1349.71,17.304,,,percent of total billed charges,17.304% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4914,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,15.3,,,percent of total billed charges,15.3% of total billed charges,5382,69,,,percent of total billed charges,69% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4824.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2433.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1336.61,17.136,,,percent of total billed charges,17.136% of total billed charges,1703.52,21.84,,,percent of total billed charges,21.84% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2644.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,6084,78,,,percent of total billed charges,78% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,7800,
NAIL TROCHANTERIC 11MM X 380MM LT.,ORSUP0048,CDM,278,RC,C1713,HCPCS,Outpatient,,,9620,6253.00,,8465.6,88,,,percent of total billed charges,88% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1664.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,6060.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,15.3,,,percent of total billed charges,15.3% of total billed charges,6637.8,69,,,percent of total billed charges,69% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,5949.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3001.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1648.48,17.136,,,percent of total billed charges,17.136% of total billed charges,2101.01,21.84,,,percent of total billed charges,21.84% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3626.74,37.7,,,percent of total billed charges,37.70% of total billed charges,3626.74,37.7,,,percent of total billed charges,37.70% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3261.18,33.9,,,percent of total billed charges,33.9% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,7503.6,78,,,percent of total billed charges,78% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,9620,
NALC AMPUOLES,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
NAMIC CARDIO PRODUCURE KIT,ORSUP0006,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
NAMIC FLEXCIL TUBING 30,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NAMIC HIGH PRESSURE BRAIDED TUBING,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
NANOPASS SUTURE MANAGER REACH  CRESCENT,ORSUP0018,CDM,272,RC,,,Outpatient,,,1450,942.50,,1276,88,,,percent of total billed charges,88% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,250.91,17.304,,,percent of total billed charges,17.304% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,913.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,221.85,15.3,,,percent of total billed charges,15.3% of total billed charges,1000.5,69,,,percent of total billed charges,69% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,896.83,61.85,,,percent of total billed charges,61.85% of total billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,248.47,17.136,,,percent of total billed charges,17.136% of total billed charges,316.68,21.84,,,percent of total billed charges,21.84% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,1131,78,,,percent of total billed charges,78% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,221.85,1450,
NASAL OXYGEN CANNULA 7FT.,274766,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
NASAL TAMPON 5.5CM RR500,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NASAL SPLINT ENT DENVER SMALL,ORSUP0004,CDM,270,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
NASAL SPLINT ENT DENVER LARGE,ORSUP0004,CDM,270,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
NASAL CANNULA,490920,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
NASAL RAE ENDOTRACHEAL TUBE CUFFED SIZE 6.0MM,490921,CDM,272,RC,,,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,10.56,17.304,,,percent of total billed charges,17.304% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,38.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,37.73,61.85,,,percent of total billed charges,61.85% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.45,17.136,,,percent of total billed charges,17.136% of total billed charges,13.32,21.84,,,percent of total billed charges,21.84% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,61,
NASAL RAE ENDOTRACHEAL TUBE CUFFED SIZE 6.5MM,490922,CDM,272,RC,,,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,10.56,17.304,,,percent of total billed charges,17.304% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,38.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,37.73,61.85,,,percent of total billed charges,61.85% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.45,17.136,,,percent of total billed charges,17.136% of total billed charges,13.32,21.84,,,percent of total billed charges,21.84% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,61,
NASAL RAE ENDOTRACHEAL TUBE CUFFED SIZE 7.0MM,490923,CDM,272,RC,,,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,10.56,17.304,,,percent of total billed charges,17.304% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,38.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,37.73,61.85,,,percent of total billed charges,61.85% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.45,17.136,,,percent of total billed charges,17.136% of total billed charges,13.32,21.84,,,percent of total billed charges,21.84% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,61,
NASAL RAE ENDOTRACHEAL TUBE CUFFED SIZE 7.5MM,490924,CDM,272,RC,,,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,10.56,17.304,,,percent of total billed charges,17.304% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,38.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,37.73,61.85,,,percent of total billed charges,61.85% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.45,17.136,,,percent of total billed charges,17.136% of total billed charges,13.32,21.84,,,percent of total billed charges,21.84% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,61,
NASAL RAE ENDOTRACHEAL TUBE CUFFED SIZE 8.0MM,490925,CDM,272,RC,,,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,10.56,17.304,,,percent of total billed charges,17.304% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,38.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,37.73,61.85,,,percent of total billed charges,61.85% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.45,17.136,,,percent of total billed charges,17.136% of total billed charges,13.32,21.84,,,percent of total billed charges,21.84% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,61,
NASAL RAE ENDOTRACHEAL TUBE UNCUFFED SIZE 5.0MM,490926,CDM,272,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
NASAL RAE ENDOTRACHEAL TUBE UNCUFFED SIZE 6.0MM,490927,CDM,272,RC,,,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,7.09,17.304,,,percent of total billed charges,17.304% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,15.3,,,percent of total billed charges,15.3% of total billed charges,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.36,61.85,,,percent of total billed charges,61.85% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,7.03,17.136,,,percent of total billed charges,17.136% of total billed charges,8.95,21.84,,,percent of total billed charges,21.84% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,41,
NASAL ALAR FAST SPO2 SENSOR,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
NASAL MASK W/HEAD STRAP SM,ORSUP0008,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
NASAL MASK W/HEAD STRAP MED,ORSUP0008,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
NASAL MASK W/HEAD STRAP LG,ORSUP0008,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
NASAL MASK W/HEAD STRAP XL,ORSUP0008,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
NASOGASTRIC TUBE HOLDER ADULT,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NASOGASTRIC TUBE HOLDERS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NATELSON TUBE 250UL 150MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NATROL CT/NG PANEL,ORSUP0038,CDM,272,RC,,,Outpatient,,,5400,3510.00,,4752,88,,,percent of total billed charges,88% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,934.42,17.304,,,percent of total billed charges,17.304% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,3402,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,826.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3726,69,,,percent of total billed charges,69% of total billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,3339.9,61.85,,,percent of total billed charges,61.85% of total billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,925.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1179.36,21.84,,,percent of total billed charges,21.84% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2700,50,,,percent of total billed charges,50% of total Billed charges,4212,78,,,percent of total billed charges,78% of total billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,4460.4,82.6,,,percent of total billed charges,82.6% of total billed charges,4460.4,82.6,,,percent of total billed charges,82.6% of total billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2700,50,,,percent of total billed charges,50% of total Billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,826.2,5400,
NAVAIGATION PIN 3X100,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
NAVIGATION PIN 3MMX150MM 6007-003-150,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
NDL SYSTEM STERNAL CABLE W/CUTTING EDGE,ORSUP0015,CDM,278,RC,C1755,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
NDL SAFETY 25G X 1,24207,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
NDL 1/2 CIRC TAPER MAYO 216705,45111,CDM,270,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
NDL INJ 25G CARR-LOCKE ENDO,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
NDL SPINAL 22GX3.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NDL SPINAL WHITACRE 25G X 3.5,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
NDL QUICK CORE 18GAX15CM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NDLS BLUNT,54943,CDM,272,RC,,,Outpatient,,,138,89.70,,121.44,88,,,percent of total billed charges,88% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,23.88,17.304,,,percent of total billed charges,17.304% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,86.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,21.11,15.3,,,percent of total billed charges,15.3% of total billed charges,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,85.35,61.85,,,percent of total billed charges,61.85% of total billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.65,17.136,,,percent of total billed charges,17.136% of total billed charges,30.14,21.84,,,percent of total billed charges,21.84% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,21.11,138,
NEBULIZER MASK,490931,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
NEBULIZER TUBING,490932,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
NEBULIZER TUBING W/TEE ADAPTER AND MOUTHPIECE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEBULIZER MISTY W/MASK,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEBULIZER MISTY W/MOUTHPIECE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEBULIZER W/028 ADAPTER AND WATER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
"NEBULIZER, SIDESTREAM",ORSUP0001,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
NEEDLE PORT A CATH .75INX20GA POWERLOC,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
NEEDLE SPECIAL USE 27GX1-1/4,145558,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
NEEDLE 25G X 5/8IN SHIELDING SUBCUT SAFETY GLIDE,145466,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
NEEDLE 23G X 1IN SHIELDING IM SAFETY GLIDE,168913,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
NEEDLE 22G X 1 1/2IN SHIELDING IM SAFETY GLIDE,145464,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
NEEDLE SHIELDING SUBCUT SAFETY GLIDE 21G X 1IN,168956,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
NEEDLE REGULAR BEVEL 18GX1 1/2,168943,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
NEEDLE FILTER 1.5 19GAGE,156007,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
NEEDLE SPECIAL USE 16GAX1 1/2,145556,CDM,272,RC,,,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,20.76,17.304,,,percent of total billed charges,17.304% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.56,17.136,,,percent of total billed charges,17.136% of total billed charges,26.21,21.84,,,percent of total billed charges,21.84% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,120,
NEEDLE BLUNT 16G X 1 1/2 ALUMINUM HUB DISPOSABLE,155997,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
NEEDLE 24IN PROLENE SUTURE 7-0 BLUE MONO DOUBLE ARM BV175-6,453270,CDM,272,RC,,,Outpatient,,,386,250.90,,339.68,88,,,percent of total billed charges,88% of total Billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,64.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,386,100,,,percent of total billed charges,100% of total billed charges,66.79,17.304,,,percent of total billed charges,17.304% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,243.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,64.85,16.8,,,percent of total billed charges,16.8% of total billed charges,59.06,15.3,,,percent of total billed charges,15.3% of total billed charges,266.34,69,,,percent of total billed charges,69% of total billed charges,386,100,,,percent of total billed charges,100% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,386,100,,,percent of total billed charges,100% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,386,100,,,percent of total billed charges,100% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,238.74,61.85,,,percent of total billed charges,61.85% of total billed charges,64.85,16.8,,,percent of total billed charges,16.8% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,64.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,66.14,17.136,,,percent of total billed charges,17.136% of total billed charges,84.3,21.84,,,percent of total billed charges,21.84% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,193,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,193,50,,,percent of total billed charges,50% of total Billed charges,301.08,78,,,percent of total billed charges,78% of total billed charges,386,100,,,percent of total billed charges,100% of total billed charges,318.84,82.6,,,percent of total billed charges,82.6% of total billed charges,318.84,82.6,,,percent of total billed charges,82.6% of total billed charges,64.85,16.8,,,percent of total billed charges,16.8% of total billed charges,193,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,193,50,,,percent of total billed charges,50% of total Billed charges,64.85,16.8,,,percent of total billed charges,16.8% of total billed charges,59.06,386,
NEEDLE 30 TICRON SUTURE COATED BRAIDED POLYSTER BLUE 0 CV-300,453269,CDM,272,RC,,,Outpatient,,,86,55.90,,75.68,88,,,percent of total billed charges,88% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,14.88,17.304,,,percent of total billed charges,17.304% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,54.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,13.16,15.3,,,percent of total billed charges,15.3% of total billed charges,59.34,69,,,percent of total billed charges,69% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,53.19,61.85,,,percent of total billed charges,61.85% of total billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.74,17.136,,,percent of total billed charges,17.136% of total billed charges,18.78,21.84,,,percent of total billed charges,21.84% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,67.08,78,,,percent of total billed charges,78% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,13.16,86,
NEEDLE HYPO 30G 3/4,185489,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
NEEDLE POINT CAUTERY,446688,CDM,272,RC,,,Outpatient,,,297,193.05,,261.36,88,,,percent of total billed charges,88% of total Billed charges,148.5,50,,,percent of total billed charges,50% of total Billed charges,49.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,297,100,,,percent of total billed charges,100% of total billed charges,51.39,17.304,,,percent of total billed charges,17.304% of total billed charges,148.5,50,,,percent of total billed charges,50% of total Billed charges,187.11,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,49.9,16.8,,,percent of total billed charges,16.8% of total billed charges,45.44,15.3,,,percent of total billed charges,15.3% of total billed charges,204.93,69,,,percent of total billed charges,69% of total billed charges,297,100,,,percent of total billed charges,100% of total billed charges,148.5,50,,,percent of total billed charges,50% of total Billed charges,297,100,,,percent of total billed charges,100% of total billed charges,148.5,50,,,percent of total billed charges,50% of total Billed charges,297,100,,,percent of total billed charges,100% of total billed charges,148.5,50,,,percent of total billed charges,50% of total Billed charges,183.69,61.85,,,percent of total billed charges,61.85% of total billed charges,49.9,16.8,,,percent of total billed charges,16.8% of total billed charges,148.5,50,,,percent of total billed charges,50% of total Billed charges,148.5,50,,,percent of total billed charges,50% of total Billed charges,49.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,148.5,50,,,percent of total billed charges,50% of total Billed charges,148.5,50,,,percent of total billed charges,50% of total Billed charges,50.89,17.136,,,percent of total billed charges,17.136% of total billed charges,64.86,21.84,,,percent of total billed charges,21.84% of total billed charges,148.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,148.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,148.5,50,,,percent of total billed charges,50% of total Billed charges,231.66,78,,,percent of total billed charges,78% of total billed charges,297,100,,,percent of total billed charges,100% of total billed charges,245.32,82.6,,,percent of total billed charges,82.6% of total billed charges,245.32,82.6,,,percent of total billed charges,82.6% of total billed charges,49.9,16.8,,,percent of total billed charges,16.8% of total billed charges,148.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,148.5,50,,,percent of total billed charges,50% of total Billed charges,49.9,16.8,,,percent of total billed charges,16.8% of total billed charges,45.44,297,
NEEDLE SAFETY CART 21 X 1,180422,CDM,272,RC,,,Outpatient,,,153,99.45,,134.64,88,,,percent of total billed charges,88% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,153,100,,,percent of total billed charges,100% of total billed charges,26.48,17.304,,,percent of total billed charges,17.304% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,96.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,23.41,15.3,,,percent of total billed charges,15.3% of total billed charges,105.57,69,,,percent of total billed charges,69% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,94.63,61.85,,,percent of total billed charges,61.85% of total billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,26.22,17.136,,,percent of total billed charges,17.136% of total billed charges,33.42,21.84,,,percent of total billed charges,21.84% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.5,50,,,percent of total billed charges,50% of total Billed charges,119.34,78,,,percent of total billed charges,78% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.5,50,,,percent of total billed charges,50% of total Billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,23.41,153,
NEEDLE SAFETY CART 22 X 1,180420,CDM,272,RC,,,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,20.76,17.304,,,percent of total billed charges,17.304% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.56,17.136,,,percent of total billed charges,17.136% of total billed charges,26.21,21.84,,,percent of total billed charges,21.84% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,120,
NEEDLE SET EZ-IO PEDI 15MM 15GA,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
NEEDLE BLOOD COLLECTION W/LUER ADAPTER 21G 12,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
NEEDLE KNIFE ESCPC XL L5MM OD5FR ODSEC.035IN 3LUM C CHNL,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
NEEDLE 13GA 5IN,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
NEEDLE 18IN V-LOC 180 ABSORBABLE WOUND CLOSURE DEVICE 2-0 GREEN V-20,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
NEEDLE BRK 89CM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
NEEDLE DRIVER LARGE DA VINCI,173494,CDM,272,RC,,,Outpatient,,,10878,7070.70,,9572.64,88,,,percent of total billed charges,88% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1882.33,17.304,,,percent of total billed charges,17.304% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,6853.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1664.33,15.3,,,percent of total billed charges,15.3% of total billed charges,7505.82,69,,,percent of total billed charges,69% of total billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,6728.04,61.85,,,percent of total billed charges,61.85% of total billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,1864.05,17.136,,,percent of total billed charges,17.136% of total billed charges,2375.76,21.84,,,percent of total billed charges,21.84% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5439,50,,,percent of total billed charges,50% of total Billed charges,8484.84,78,,,percent of total billed charges,78% of total billed charges,10878,100,,,percent of total billed charges,100% of total billed charges,8985.23,82.6,,,percent of total billed charges,82.6% of total billed charges,8985.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,5439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5439,50,,,percent of total billed charges,50% of total Billed charges,1827.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1664.33,10878,
NEEDLE DRIVER SUTURE CUT DAVINGCI,312623,CDM,272,RC,,,Outpatient,,,11867,7713.55,,10442.96,88,,,percent of total billed charges,88% of total Billed charges,5933.5,50,,,percent of total billed charges,50% of total Billed charges,1993.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2053.47,17.304,,,percent of total billed charges,17.304% of total billed charges,5933.5,50,,,percent of total billed charges,50% of total Billed charges,7476.21,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1993.66,16.8,,,percent of total billed charges,16.8% of total billed charges,1815.65,15.3,,,percent of total billed charges,15.3% of total billed charges,8188.23,69,,,percent of total billed charges,69% of total billed charges,11867,100,,,percent of total billed charges,100% of total billed charges,5933.5,50,,,percent of total billed charges,50% of total Billed charges,11867,100,,,percent of total billed charges,100% of total billed charges,5933.5,50,,,percent of total billed charges,50% of total Billed charges,11867,100,,,percent of total billed charges,100% of total billed charges,5933.5,50,,,percent of total billed charges,50% of total Billed charges,7339.74,61.85,,,percent of total billed charges,61.85% of total billed charges,1993.66,16.8,,,percent of total billed charges,16.8% of total billed charges,5933.5,50,,,percent of total billed charges,50% of total Billed charges,5933.5,50,,,percent of total billed charges,50% of total Billed charges,1993.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,5933.5,50,,,percent of total billed charges,50% of total Billed charges,5933.5,50,,,percent of total billed charges,50% of total Billed charges,2033.53,17.136,,,percent of total billed charges,17.136% of total billed charges,2591.75,21.84,,,percent of total billed charges,21.84% of total billed charges,5933.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5933.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5933.5,50,,,percent of total billed charges,50% of total Billed charges,9256.26,78,,,percent of total billed charges,78% of total billed charges,11867,100,,,percent of total billed charges,100% of total billed charges,9802.14,82.6,,,percent of total billed charges,82.6% of total billed charges,9802.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1993.66,16.8,,,percent of total billed charges,16.8% of total billed charges,5933.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5933.5,50,,,percent of total billed charges,50% of total Billed charges,1993.66,16.8,,,percent of total billed charges,16.8% of total billed charges,1815.65,11867,
NEEDLE ELECTRODE EASY CLEAN 6 INCH,63742,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
NEEDLE KNEE SCORPION,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
NEEDLE MULTIFIRE SCORPION STRL,ORSUP0037,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
NEEDLE SUREFIRE SCORPION,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
NEEDLES SUPER TRAX BIOPSY,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
NEEDLE 5.0FRX25CM RNG BILI DISP,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE 16.5CM 5FR 15CM ENDO BILI RING,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
NEEDLE SPINAL SINGLE USE 20GX3,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE SPINAL DISP 20GA X 6 PLASTIC HUB,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
NEEDLE 11GAX6IN MARRW BULLET TP,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
NEEDLE BIOPSY COAXIAL ADJUST 20GX15CM W/19G INTRO,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
NEEDLE JAMSHIDI 8GA,185481,CDM,272,RC,,,Outpatient,,,152,98.80,,133.76,88,,,percent of total billed charges,88% of total Billed charges,76,50,,,percent of total billed charges,50% of total Billed charges,25.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,152,100,,,percent of total billed charges,100% of total billed charges,26.3,17.304,,,percent of total billed charges,17.304% of total billed charges,76,50,,,percent of total billed charges,50% of total Billed charges,95.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.54,16.8,,,percent of total billed charges,16.8% of total billed charges,23.26,15.3,,,percent of total billed charges,15.3% of total billed charges,104.88,69,,,percent of total billed charges,69% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,76,50,,,percent of total billed charges,50% of total Billed charges,152,100,,,percent of total billed charges,100% of total billed charges,76,50,,,percent of total billed charges,50% of total Billed charges,152,100,,,percent of total billed charges,100% of total billed charges,76,50,,,percent of total billed charges,50% of total Billed charges,94.01,61.85,,,percent of total billed charges,61.85% of total billed charges,25.54,16.8,,,percent of total billed charges,16.8% of total billed charges,76,50,,,percent of total billed charges,50% of total Billed charges,76,50,,,percent of total billed charges,50% of total Billed charges,25.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,76,50,,,percent of total billed charges,50% of total Billed charges,76,50,,,percent of total billed charges,50% of total Billed charges,26.05,17.136,,,percent of total billed charges,17.136% of total billed charges,33.2,21.84,,,percent of total billed charges,21.84% of total billed charges,76,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76,50,,,percent of total billed charges,50% of total Billed charges,118.56,78,,,percent of total billed charges,78% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,25.54,16.8,,,percent of total billed charges,16.8% of total billed charges,76,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76,50,,,percent of total billed charges,50% of total Billed charges,25.54,16.8,,,percent of total billed charges,16.8% of total billed charges,23.26,152,
NEEDLE 14GA X 120MM INSUFF DISP,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
NEEDLE LABORIE DIS200,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
NEEDLE QUICK-CORE BIOPSY 16G,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE SET EZ-IO ADULT 25MM 15GA,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
NEEDLE TRANSSEPTAL BRK-1 XS,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
NEEDLE FLEXITIP SCLEROTHERAPY,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE ELECTRODE 4'' 0016AM,490949,CDM,272,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
NEEDLE MAYO 1/2 CIRCLE TROCAR,490965,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
NEEDLE MAYO 1/2 TROCAR,490966,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
NEEDLE MAYO CATGUT 1/2 CIRCLE,490967,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
NEEDLE BIOPSY MAX CORE 18GX25C,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
NEEDLE BIOPSY MAX CORE 18G 20C,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE JAM SHIDI XIA PRECISION,ORSUP0012,CDM,272,RC,,,Outpatient,,,705,458.25,,620.4,88,,,percent of total billed charges,88% of total Billed charges,352.5,50,,,percent of total billed charges,50% of total Billed charges,118.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,705,100,,,percent of total billed charges,100% of total billed charges,121.99,17.304,,,percent of total billed charges,17.304% of total billed charges,352.5,50,,,percent of total billed charges,50% of total Billed charges,444.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,118.44,16.8,,,percent of total billed charges,16.8% of total billed charges,107.87,15.3,,,percent of total billed charges,15.3% of total billed charges,486.45,69,,,percent of total billed charges,69% of total billed charges,705,100,,,percent of total billed charges,100% of total billed charges,352.5,50,,,percent of total billed charges,50% of total Billed charges,705,100,,,percent of total billed charges,100% of total billed charges,352.5,50,,,percent of total billed charges,50% of total Billed charges,705,100,,,percent of total billed charges,100% of total billed charges,352.5,50,,,percent of total billed charges,50% of total Billed charges,436.04,61.85,,,percent of total billed charges,61.85% of total billed charges,118.44,16.8,,,percent of total billed charges,16.8% of total billed charges,352.5,50,,,percent of total billed charges,50% of total Billed charges,352.5,50,,,percent of total billed charges,50% of total Billed charges,118.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,352.5,50,,,percent of total billed charges,50% of total Billed charges,352.5,50,,,percent of total billed charges,50% of total Billed charges,120.81,17.136,,,percent of total billed charges,17.136% of total billed charges,153.97,21.84,,,percent of total billed charges,21.84% of total billed charges,352.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,352.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,352.5,50,,,percent of total billed charges,50% of total Billed charges,549.9,78,,,percent of total billed charges,78% of total billed charges,705,100,,,percent of total billed charges,100% of total billed charges,582.33,82.6,,,percent of total billed charges,82.6% of total billed charges,582.33,82.6,,,percent of total billed charges,82.6% of total billed charges,118.44,16.8,,,percent of total billed charges,16.8% of total billed charges,352.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,352.5,50,,,percent of total billed charges,50% of total Billed charges,118.44,16.8,,,percent of total billed charges,16.8% of total billed charges,107.87,705,
NEEDLE FLEXITIP COLONSCOPE 5MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE ECHOBLOCK 21X4,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
NEEDLE COUNTER,490947,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
NEEDLE ELECTRODE 6'' 0016M,490950,CDM,272,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
NEEDLE JAMSHIDI SOFT TIS BIOPS,490964,CDM,272,RC,,,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,10.9,17.304,,,percent of total billed charges,17.304% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,39.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,38.97,61.85,,,percent of total billed charges,61.85% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.8,17.136,,,percent of total billed charges,17.136% of total billed charges,13.76,21.84,,,percent of total billed charges,21.84% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,63,
NEEDLE 18 GA X 1 1/2''SAFTEY,490934,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
NEEDLE BOX 20 COUNT,490945,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
NEEDLE HYPO 21G (DEMILL),490958,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
NEEDLE HYPO 25G,490960,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
NEEDLE HYPO 30G,490962,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
NEEDLE PROTECTION DEVICE POINT-LOK,490970,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
NEEDLE PERCUTANEOUS 21G X 7CM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE PERCOUTANEOUS ENTRY 21G,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE BIOPSY 18G 9CM LONG QUICK CORE,ORSUP0007,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
NEEDLE SURGEON 1/2 CIRCLE TAPER .040,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE BIOPSY 20G X 15CM LNG,ORSUP0007,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE BIOPSY 20G X 9CM,ORSUP0007,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE BIOPSY 18G X 6 X 1,ORSUP0005,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
NEEDLE BIOPSY 20G X 9CM -10T,ORSUP0007,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE BIOPSY CORCA 18 X 25,ORSUP0007,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE SPINAL 25G X 4.69IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE #2 FIBERLOOP CURVED,ORSUP0006,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE TUOHY EPIDURAL 17G X 5,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE TUOHY EPIDURAL 20G X 3.5,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE TUOHY EPIDURAL 22G X 3.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE TUOHY EPIDURAL 22G X 5,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
NEEDLE EZ-IO PEDIATRIC 15G,ORSUP0013,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
NEEDLE HUBER 20G X .75 WHIN SAFE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE GUIDE 9G EVIVA,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
NEEDLE BIOPSY SYSTEM 20G X 15CM CORVOCET,ORSUP0007,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE BIOPSY SYSTEM 20G X 20CM CORVOCET,ORSUP0007,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE BIOPSY COAXIAL 20G X 20,ORSUP0006,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE BIOPSY COAXIAL 18 X 20 X 20MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE BIOPSY SET QUICK CORE 18 X 15 X 20MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE BIOPSY SYSTEM 18G X 15CM CORVOCET,ORSUP0007,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE BIOPSY ACHIEVE 18G X 11CM,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
NEEDLE BIOPSY SET QUICK CORE 20 X 15 X 10MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEEDLE SPINAL WHITCARE HIGH FLOW PENCIL POINT 25G X 5IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE ASPIRATION CHIBA,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE ULTRASOUND INSULATED 21X4,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
NEEDLE BIOPSY SET 13G X 10CM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
NEEDLE ULTRASOUND INSULATED 21G X 6,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
NEEDLE COAXIAL ADJUSTABLE 20GA,ORSUP0008,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
NEEDLE PERC ENTRY THIN WALL 21GAX15CM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE 360 DEGREE SUTURE PASSER,ORSUP0013,CDM,278,RC,A4215,HCPCS,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,271.2,33.9,,,percent of total billed charges,33.9% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
NEEDLE JAMSHIDI 10GA X 9,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
NEEDLE BIOPSY J-TYPE BONE MARROW 11GA 6IN,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
NEEDLE SAFTEY 3ML 25X1,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE SAFTEY 3ML 25X5/8,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE INFUSION SET 21GA (FOR USE WITH FILL KIT),ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
NEEDLE VENIPUNCTURE BLOOD COLLECTTION DECIVE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NEEDLE BIOPSY COAXIAL TEMNO (ACT) 19GA,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
NEEDLE MICROPUNTURE SET 4FR,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
NEEDLE HOLDER WEBSTER 15MM SMOOTH JAW,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
NEEDLE REGULAR BEVEL 20GX1 IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NEEDLE BIOPSY 20G X 9CM ECHO TIP,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
NEEDLE SPINAL WHITACRE GRAY 27GA,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
NEEDLE SPINAL QUINCKE BEVEL TAN 25GAX3.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NEEDLE PROBLOCK 22X50,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
NEEDLE PROBLOCK 22X80,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
NEEDLE ECHOTISMINSULATED 21X4,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
NEEDLE SPECIAL USE 27GX1.25,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NEEDLE NONINSULATED ULTRASND 21GX6,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
NEELDE MICROPUNCTURE 5FR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEISSERIA GONORRHOEAE ATCC CULTI LOOPS 49981,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
LAMP PENLON LARGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NEONATE MASK UNSCENTED SZ 2,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NEOSTIM TRIPLE LAYER 2X2CM,636Q426522,CDM,636,RC,Q4265,HCPCS,Outpatient,,,7400,4810.00,,6512,88,,,percent of total billed charges,88% of total Billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,4662,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1132.2,15.3,,,percent of total billed charges,15.3% of total billed charges,5106,69,,,percent of total billed charges,69% of total billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,4576.9,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,2789.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2789.8,37.7,,,percent of total billed charges,37.70% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,2508.6,33.9,,,percent of total billed charges,33.9% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,5772,78,,,percent of total billed charges,78% of total billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1132.2,7400,
NEOSTIM TRIPLE LAYER 2X3CM,636Q426523,CDM,636,RC,Q4265,HCPCS,Outpatient,,,7400,4810.00,,6512,88,,,percent of total billed charges,88% of total Billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,4662,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1132.2,15.3,,,percent of total billed charges,15.3% of total billed charges,5106,69,,,percent of total billed charges,69% of total billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,4576.9,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,2789.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2789.8,37.7,,,percent of total billed charges,37.70% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,2508.6,33.9,,,percent of total billed charges,33.9% of total billed charges,3700,50,,,percent of total billed charges,50% of total Billed charges,5772,78,,,percent of total billed charges,78% of total billed charges,7400,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1132.2,7400,
NEPTUNE E-SEP CAUTERY,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
NEPTUNE HEPA FILTER,ORSUP0013,CDM,272,RC,,,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,504,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
NESTER EMBOLIZATION COIL,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
NESTER EMBOLISM COIL 14CM X 8MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
NESTER EMBOLISM COIL 14CM X 6MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
NESTER EMBOLISM COIL 20CM X 14MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
NESTER EMBOLISM COIL 14CM X 4MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
NESTER EMBOLISM COIL 20CM X 10MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
NESTER EMBOLISM COIL 20CM X 16MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
NESTER EMBOLISM COIL 20CM X 12MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
NESTER EMBOLIZATION COIL 8MM X 7MCM,ORSUP0011,CDM,278,RC,C1889,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
NESTER EMBOLIZATION COIL 16MM X 20CM,ORSUP0011,CDM,278,RC,C1889,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
NESTER EMBOLISM COIL 8X7MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
NEURO PLATE 4X2 HOLES SQUARE SEG 6MM 1.5MM SYS CP TITANIUM,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
NEURO PLATE 5X2 HOLES CURVED SQUARE SEG 6MM 1.5MM SYS CP TITANIUM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
NEURO PLATE LOW PROF 3X2 HOLES SQUARE SEFMENT  6MM 1.5MM SYS CP TITANIUM,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
NEURO PLATE LOW PROFIELE STRAIGHT 16 HOLE CP TITANIUM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
NEURO PLATE LOW PROFILE  SQUARE 6MM 1.5MM SYSTEM CP TITANIUM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
NEURO PLATE LOW PROFILE  STRAIGHT 4 HOLE  REGULAR CP TITANIUM,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEURO PLATE LOW PROFILE NEURO PLATE  STRAIGHT 4HOLE  X-LONG  CP TITANIUM,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
NEURO,326391,CDM,270,RC,,,Outpatient,,,1207,784.55,,1062.16,88,,,percent of total billed charges,88% of total Billed charges,603.5,50,,,percent of total billed charges,50% of total Billed charges,202.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,1207,100,,,percent of total billed charges,100% of total billed charges,208.86,17.304,,,percent of total billed charges,17.304% of total billed charges,603.5,50,,,percent of total billed charges,50% of total Billed charges,760.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,202.78,16.8,,,percent of total billed charges,16.8% of total billed charges,184.67,15.3,,,percent of total billed charges,15.3% of total billed charges,832.83,69,,,percent of total billed charges,69% of total billed charges,1207,100,,,percent of total billed charges,100% of total billed charges,603.5,50,,,percent of total billed charges,50% of total Billed charges,1207,100,,,percent of total billed charges,100% of total billed charges,603.5,50,,,percent of total billed charges,50% of total Billed charges,1207,100,,,percent of total billed charges,100% of total billed charges,603.5,50,,,percent of total billed charges,50% of total Billed charges,746.53,61.85,,,percent of total billed charges,61.85% of total billed charges,202.78,16.8,,,percent of total billed charges,16.8% of total billed charges,603.5,50,,,percent of total billed charges,50% of total Billed charges,603.5,50,,,percent of total billed charges,50% of total Billed charges,202.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,603.5,50,,,percent of total billed charges,50% of total Billed charges,603.5,50,,,percent of total billed charges,50% of total Billed charges,206.83,17.136,,,percent of total billed charges,17.136% of total billed charges,263.61,21.84,,,percent of total billed charges,21.84% of total billed charges,603.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,603.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,603.5,50,,,percent of total billed charges,50% of total Billed charges,941.46,78,,,percent of total billed charges,78% of total billed charges,1207,100,,,percent of total billed charges,100% of total billed charges,996.98,82.6,,,percent of total billed charges,82.6% of total billed charges,996.98,82.6,,,percent of total billed charges,82.6% of total billed charges,202.78,16.8,,,percent of total billed charges,16.8% of total billed charges,603.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,603.5,50,,,percent of total billed charges,50% of total Billed charges,202.78,16.8,,,percent of total billed charges,16.8% of total billed charges,184.67,1207,
NEURO MODULE LOW PROFILE  COMPLETE,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
NEW LOT LABEL YELLOW,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
NEXIVA DIFFUSICS CLOSED IV CATH 20GX1,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NEXIVA DIFFUSICS CLOSED IV CATH 18GX1.25,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NEXIVA 22G X 1 W/MAX ZERO,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
BACTIDROP NINHYDRIN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NIO ADULT AUTOMATIC INTRAOSSEOUS DEVICE 15G,ORSUP0012,CDM,272,RC,,,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
NIO PEDIATRIC AUTOMATIC INTRAOSSEOUS DEVICE 18,ORSUP0012,CDM,272,RC,,,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
NIO GO IO INTRAOSSEOUS START KIT,ORSUP0012,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NIO INFANT INTRAOSSEOUS DEVICE,ORSUP0012,CDM,272,RC,,,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
NIPPLE \\T\\ NUT ADAPTERS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NITINOL GUIDE PIN 1.1MM,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
NITROCEFIN DISC,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
NO RINSE SHAMPOO (FRAGRANCE),95895,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
NONINVASIVE CIRCUIT,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
NOTTINGHAM 6/12F DILATOR,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
NOVASURE DISP DEVICE,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
NOVA TEMPERATURE PROBE 9FR 400 SERIES,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
NOVOSORB BTM 5X5,ORSUP0035,CDM,278,RC,A2006,HCPCS,Outpatient,,,4800,3120.00,,4224,88,,,percent of total billed charges,88% of total Billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2400,50,,,percent of total billed charges,50% of total Billed charges,3024,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",734.4,15.3,,,percent of total billed charges,15.3% of total billed charges,3312,69,,,percent of total billed charges,69% of total billed charges,4800,100,,,percent of total billed charges,100% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,4800,100,,,percent of total billed charges,100% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,4800,100,,,percent of total billed charges,100% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,2968.8,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,2400,50,,,percent of total billed charges,50% of total Billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,1497.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2400,50,,,percent of total billed charges,50% of total Billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2400,50,,,percent of total billed charges,50% of total Billed charges,1809.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1809.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,1627.2,33.9,,,percent of total billed charges,33.9% of total billed charges,2400,50,,,percent of total billed charges,50% of total Billed charges,3744,78,,,percent of total billed charges,78% of total billed charges,4800,100,,,percent of total billed charges,100% of total billed charges,3964.8,82.6,,,percent of total billed charges,82.6% of total billed charges,3964.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,2400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2400,50,,,percent of total billed charges,50% of total Billed charges,806.4,16.8,,,percent of total billed charges,16.8% of total billed charges,734.4,4800,
NOVOSORB BTM 10X10,ORSUP0044,CDM,278,RC,A2006,HCPCS,Outpatient,,,6600,4290.00,,5808,88,,,percent of total billed charges,88% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,4158,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1009.8,15.3,,,percent of total billed charges,15.3% of total billed charges,4554,69,,,percent of total billed charges,69% of total billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,4082.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,2059.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3300,50,,,percent of total billed charges,50% of total Billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,2488.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2488.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,2237.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3300,50,,,percent of total billed charges,50% of total Billed charges,5148,78,,,percent of total billed charges,78% of total billed charges,6600,100,,,percent of total billed charges,100% of total billed charges,5451.6,82.6,,,percent of total billed charges,82.6% of total billed charges,5451.6,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3300,50,,,percent of total billed charges,50% of total Billed charges,1108.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1009.8,6600,
NS IRRIGATION 1500ML 2F7125,490980,CDM,272,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
NS IRRIGATION 500ML 2F7123,490981,CDM,272,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
NUGAUZE IODINE 1'',490982,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
NUT PANGEA USS  499.294,ORSUP0021,CDM,278,RC,C1755,HCPCS,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,811.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,881.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
NUVASIVE CAGE 10 X 22 X 60,ORSUP0101,CDM,278,RC,C1755,HCPCS,Outpatient,,,23920,15548.00,,21049.6,88,,,percent of total billed charges,88% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4139.12,17.304,,,percent of total billed charges,17.304% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,3659.76,15.3,,,percent of total billed charges,15.3% of total billed charges,16504.8,69,,,percent of total billed charges,69% of total billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,14794.52,61.85,,,percent of total billed charges,61.85% of total billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,7463.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11960,50,,,percent of total billed charges,50% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,4098.93,17.136,,,percent of total billed charges,17.136% of total billed charges,5224.13,21.84,,,percent of total billed charges,21.84% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,9017.84,37.7,,,percent of total billed charges,37.70% of total billed charges,9017.84,37.7,,,percent of total billed charges,37.70% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,8108.88,33.9,,,percent of total billed charges,33.9% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,18657.6,78,,,percent of total billed charges,78% of total billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,19757.92,82.6,,,percent of total billed charges,82.6% of total billed charges,19757.92,82.6,,,percent of total billed charges,82.6% of total billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11960,50,,,percent of total billed charges,50% of total Billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,3659.76,23920,
NUVASIVE CAGE 13 X 45 X 12,ORSUP0101,CDM,278,RC,C1755,HCPCS,Outpatient,,,23920,15548.00,,21049.6,88,,,percent of total billed charges,88% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4139.12,17.304,,,percent of total billed charges,17.304% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,3659.76,15.3,,,percent of total billed charges,15.3% of total billed charges,16504.8,69,,,percent of total billed charges,69% of total billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,14794.52,61.85,,,percent of total billed charges,61.85% of total billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,7463.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11960,50,,,percent of total billed charges,50% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,4098.93,17.136,,,percent of total billed charges,17.136% of total billed charges,5224.13,21.84,,,percent of total billed charges,21.84% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,9017.84,37.7,,,percent of total billed charges,37.70% of total billed charges,9017.84,37.7,,,percent of total billed charges,37.70% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,8108.88,33.9,,,percent of total billed charges,33.9% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,18657.6,78,,,percent of total billed charges,78% of total billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,19757.92,82.6,,,percent of total billed charges,82.6% of total billed charges,19757.92,82.6,,,percent of total billed charges,82.6% of total billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11960,50,,,percent of total billed charges,50% of total Billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,3659.76,23920,
NUVASIVE CAGE 22 X 10 X 50,ORSUP0101,CDM,278,RC,C1755,HCPCS,Outpatient,,,23920,15548.00,,21049.6,88,,,percent of total billed charges,88% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4139.12,17.304,,,percent of total billed charges,17.304% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,3659.76,15.3,,,percent of total billed charges,15.3% of total billed charges,16504.8,69,,,percent of total billed charges,69% of total billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,14794.52,61.85,,,percent of total billed charges,61.85% of total billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,7463.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11960,50,,,percent of total billed charges,50% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,4098.93,17.136,,,percent of total billed charges,17.136% of total billed charges,5224.13,21.84,,,percent of total billed charges,21.84% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,9017.84,37.7,,,percent of total billed charges,37.70% of total billed charges,9017.84,37.7,,,percent of total billed charges,37.70% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,8108.88,33.9,,,percent of total billed charges,33.9% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,18657.6,78,,,percent of total billed charges,78% of total billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,19757.92,82.6,,,percent of total billed charges,82.6% of total billed charges,19757.92,82.6,,,percent of total billed charges,82.6% of total billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11960,50,,,percent of total billed charges,50% of total Billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,3659.76,23920,
NUVASIVE CAGE 22 X 12 X 50,ORSUP0101,CDM,278,RC,C1755,HCPCS,Outpatient,,,23920,15548.00,,21049.6,88,,,percent of total billed charges,88% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4139.12,17.304,,,percent of total billed charges,17.304% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,3659.76,15.3,,,percent of total billed charges,15.3% of total billed charges,16504.8,69,,,percent of total billed charges,69% of total billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,14794.52,61.85,,,percent of total billed charges,61.85% of total billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,7463.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11960,50,,,percent of total billed charges,50% of total Billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,4098.93,17.136,,,percent of total billed charges,17.136% of total billed charges,5224.13,21.84,,,percent of total billed charges,21.84% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,9017.84,37.7,,,percent of total billed charges,37.70% of total billed charges,9017.84,37.7,,,percent of total billed charges,37.70% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,8108.88,33.9,,,percent of total billed charges,33.9% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,18657.6,78,,,percent of total billed charges,78% of total billed charges,23920,100,,,percent of total billed charges,100% of total billed charges,19757.92,82.6,,,percent of total billed charges,82.6% of total billed charges,19757.92,82.6,,,percent of total billed charges,82.6% of total billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,11960,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11960,50,,,percent of total billed charges,50% of total Billed charges,4018.56,16.8,,,percent of total billed charges,16.8% of total billed charges,3659.76,23920,
Neuro Monitoring Charge,SUR200052,CDM,360,RC,,,Outpatient,,,19326,12561.90,,17006.88,88,,,percent of total billed charges,88% of total Billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,3246.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3344.17,17.304,,,percent of total billed charges,17.304% of total billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,12175.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3246.77,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,13334.94,69,,,percent of total billed charges,69% of total billed charges,19326,100,,,percent of total billed charges,100% of total billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,19326,100,,,percent of total billed charges,100% of total billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,19326,100,,,percent of total billed charges,100% of total billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,11953.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3246.77,16.8,,,percent of total billed charges,16.8% of total billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,3246.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,3311.7,17.136,,,percent of total billed charges,17.136% of total billed charges,4220.8,21.84,,,percent of total billed charges,21.84% of total billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,7285.9,37.7,,,percent of total billed charges,37.70% of total billed charges,7285.9,37.7,,,percent of total billed charges,37.70% of total billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,6551.51,33.9,,,percent of total billed charges,33.9% of total billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,15074.28,78,,,percent of total billed charges,78% of total billed charges,19326,100,,,percent of total billed charges,100% of total billed charges,15963.28,82.6,,,percent of total billed charges,82.6% of total billed charges,15963.28,82.6,,,percent of total billed charges,82.6% of total billed charges,3246.77,16.8,,,percent of total billed charges,16.8% of total billed charges,9663,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9663,50,,,percent of total billed charges,50% of total Billed charges,3246.77,16.8,,,percent of total billed charges,16.8% of total billed charges,3246.77,19326,
O2 HUMIDIFER,490983,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
O3 REGIONAL SENSOR LARGE,ORSUP0032,CDM,270,RC,,,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
OAES ENHANCEMENT ANTIBODY 15 X 10ML,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
OASIS WOUND MATRIX 3X3.5 CM,636Q4102335,CDM,636,RC,Q4102,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,910,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",139.23,910,
OASIS ULTRA TRI-LAYER MATRIX 3X3.5 CM,636Q4124335,CDM,636,RC,Q4124,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",198.9,1300,
OASYS BLOCKER,ORSUP0009,CDM,278,RC,C1755,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
OASYS DRILL BIT 2.5,ORSUP0016,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
OBTRYX TRANSOBTURATOR SLING,ORSUP0033,CDM,278,RC,C1771,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
OBTURATOR 8MM BLADELESS,267290,CDM,272,RC,,,Outpatient,,,201,130.65,,176.88,88,,,percent of total billed charges,88% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,201,100,,,percent of total billed charges,100% of total billed charges,34.78,17.304,,,percent of total billed charges,17.304% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,126.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,30.75,15.3,,,percent of total billed charges,15.3% of total billed charges,138.69,69,,,percent of total billed charges,69% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,201,100,,,percent of total billed charges,100% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,201,100,,,percent of total billed charges,100% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,124.32,61.85,,,percent of total billed charges,61.85% of total billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,34.44,17.136,,,percent of total billed charges,17.136% of total billed charges,43.9,21.84,,,percent of total billed charges,21.84% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100.5,50,,,percent of total billed charges,50% of total Billed charges,156.78,78,,,percent of total billed charges,78% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100.5,50,,,percent of total billed charges,50% of total Billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,30.75,201,
OBTURATOR W/LASER TVT,490984,CDM,270,RC,,,Outpatient,,,667,433.55,,586.96,88,,,percent of total billed charges,88% of total Billed charges,333.5,50,,,percent of total billed charges,50% of total Billed charges,112.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,667,100,,,percent of total billed charges,100% of total billed charges,115.42,17.304,,,percent of total billed charges,17.304% of total billed charges,333.5,50,,,percent of total billed charges,50% of total Billed charges,420.21,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,112.06,16.8,,,percent of total billed charges,16.8% of total billed charges,102.05,15.3,,,percent of total billed charges,15.3% of total billed charges,460.23,69,,,percent of total billed charges,69% of total billed charges,667,100,,,percent of total billed charges,100% of total billed charges,333.5,50,,,percent of total billed charges,50% of total Billed charges,667,100,,,percent of total billed charges,100% of total billed charges,333.5,50,,,percent of total billed charges,50% of total Billed charges,667,100,,,percent of total billed charges,100% of total billed charges,333.5,50,,,percent of total billed charges,50% of total Billed charges,412.54,61.85,,,percent of total billed charges,61.85% of total billed charges,112.06,16.8,,,percent of total billed charges,16.8% of total billed charges,333.5,50,,,percent of total billed charges,50% of total Billed charges,333.5,50,,,percent of total billed charges,50% of total Billed charges,112.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,333.5,50,,,percent of total billed charges,50% of total Billed charges,333.5,50,,,percent of total billed charges,50% of total Billed charges,114.3,17.136,,,percent of total billed charges,17.136% of total billed charges,145.67,21.84,,,percent of total billed charges,21.84% of total billed charges,333.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,333.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,333.5,50,,,percent of total billed charges,50% of total Billed charges,520.26,78,,,percent of total billed charges,78% of total billed charges,667,100,,,percent of total billed charges,100% of total billed charges,550.94,82.6,,,percent of total billed charges,82.6% of total billed charges,550.94,82.6,,,percent of total billed charges,82.6% of total billed charges,112.06,16.8,,,percent of total billed charges,16.8% of total billed charges,333.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,333.5,50,,,percent of total billed charges,50% of total Billed charges,112.06,16.8,,,percent of total billed charges,16.8% of total billed charges,102.05,667,
OCC FUSION SYSTEM 8MMX4.5MM 04.601.108,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
OCU-FILM COVERS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
OINTMENT BACITRACIN WITH ZINC 0.9GM FOIL PACKET,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
OLCOTT TORQUE DEVICE,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
OMEGA KNOTLESS ANCHOR SYSTEM SINGLE 4.75MM,ORSUP0030,CDM,278,RC,C1713,HCPCS,Outpatient,,,3800,2470.00,,3344,88,,,percent of total billed charges,88% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,657.55,17.304,,,percent of total billed charges,17.304% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,2394,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,581.4,15.3,,,percent of total billed charges,15.3% of total billed charges,2622,69,,,percent of total billed charges,69% of total billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,2350.3,61.85,,,percent of total billed charges,61.85% of total billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1185.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1900,50,,,percent of total billed charges,50% of total Billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,651.17,17.136,,,percent of total billed charges,17.136% of total billed charges,829.92,21.84,,,percent of total billed charges,21.84% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1432.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1432.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,1288.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,2964,78,,,percent of total billed charges,78% of total billed charges,3800,100,,,percent of total billed charges,100% of total billed charges,3138.8,82.6,,,percent of total billed charges,82.6% of total billed charges,3138.8,82.6,,,percent of total billed charges,82.6% of total billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1900,50,,,percent of total billed charges,50% of total Billed charges,638.4,16.8,,,percent of total billed charges,16.8% of total billed charges,581.4,3800,
OMNIPAQUE 350 50ML BOTTLE,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
OMNIPAQUE 350 75ML BOTTLE,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
OMNIPAQUE 350 100ML BOTTLE,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
OMNI FLUSH 5FR X 65CM,ORSUP0004,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
ON-Q C-BLOCK 600ML DUAL SELECT A FLOW,ORSUP0023,CDM,278,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,973.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1057.68,33.9,,,percent of total billed charges,33.9% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
ON-Q  PAINBUSTER 12.5CM,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
ON-Q C-BLOC CB6004,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
ONE TOUCH LIFESCAN CONTROL SOLUTION,490985,CDM,270,RC,,,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,12.98,17.304,,,percent of total billed charges,17.304% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,47.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,46.39,61.85,,,percent of total billed charges,61.85% of total billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.85,17.136,,,percent of total billed charges,17.136% of total billed charges,16.38,21.84,,,percent of total billed charges,21.84% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11.48,75,
OPTIVAC KIT 120 GRAM TRIPLE MIX,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
OPTICHAMBER DIAMOND SPACER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
OPTIFLOW JR BREATHING CIRCUIT,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
OPTIFLOW PLUS OXYGEN CANNULA SZ5,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
OPTIFLOW PLUS OXYGEN CANNULA SZ L,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
OR Level 1 First 30 Min,SUR200034,CDM,360,RC,,,Outpatient,,,4831,3140.15,,4251.28,88,,,percent of total billed charges,88% of total Billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,811.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,835.96,17.304,,,percent of total billed charges,17.304% of total billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,3043.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,811.61,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,3333.39,69,,,percent of total billed charges,69% of total billed charges,4831,100,,,percent of total billed charges,100% of total billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,4831,100,,,percent of total billed charges,100% of total billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,4831,100,,,percent of total billed charges,100% of total billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,2987.97,61.85,,,percent of total billed charges,61.85% of total billed charges,811.61,16.8,,,percent of total billed charges,16.8% of total billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,811.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,827.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1055.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,1821.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1821.29,37.7,,,percent of total billed charges,37.70% of total billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,1637.71,33.9,,,percent of total billed charges,33.9% of total billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,3768.18,78,,,percent of total billed charges,78% of total billed charges,4831,100,,,percent of total billed charges,100% of total billed charges,3990.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3990.41,82.6,,,percent of total billed charges,82.6% of total billed charges,811.61,16.8,,,percent of total billed charges,16.8% of total billed charges,2415.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2415.5,50,,,percent of total billed charges,50% of total Billed charges,811.61,16.8,,,percent of total billed charges,16.8% of total billed charges,811.61,4831,
OR Level 1 Ea Addt'l 15 Min,SUR200035,CDM,360,RC,,,Outpatient,,,3222,2094.30,,2835.36,88,,,percent of total billed charges,88% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,557.53,17.304,,,percent of total billed charges,17.304% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,2029.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2223.18,69,,,percent of total billed charges,69% of total billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1992.81,61.85,,,percent of total billed charges,61.85% of total billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,552.12,17.136,,,percent of total billed charges,17.136% of total billed charges,703.68,21.84,,,percent of total billed charges,21.84% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1214.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1214.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1092.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,2513.16,78,,,percent of total billed charges,78% of total billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,2661.37,82.6,,,percent of total billed charges,82.6% of total billed charges,2661.37,82.6,,,percent of total billed charges,82.6% of total billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,541.3,3367,
OR Level 2 First 30 Min,SUR200036,CDM,360,RC,,,Outpatient,,,6442,4187.30,,5668.96,88,,,percent of total billed charges,88% of total Billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,1082.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1114.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,4058.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1082.26,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4444.98,69,,,percent of total billed charges,69% of total billed charges,6442,100,,,percent of total billed charges,100% of total billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,6442,100,,,percent of total billed charges,100% of total billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,6442,100,,,percent of total billed charges,100% of total billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,3984.38,61.85,,,percent of total billed charges,61.85% of total billed charges,1082.26,16.8,,,percent of total billed charges,16.8% of total billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,1082.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,1103.9,17.136,,,percent of total billed charges,17.136% of total billed charges,1406.93,21.84,,,percent of total billed charges,21.84% of total billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,2428.63,37.7,,,percent of total billed charges,37.70% of total billed charges,2428.63,37.7,,,percent of total billed charges,37.70% of total billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,2183.84,33.9,,,percent of total billed charges,33.9% of total billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,5024.76,78,,,percent of total billed charges,78% of total billed charges,6442,100,,,percent of total billed charges,100% of total billed charges,5321.09,82.6,,,percent of total billed charges,82.6% of total billed charges,5321.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1082.26,16.8,,,percent of total billed charges,16.8% of total billed charges,3221,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3221,50,,,percent of total billed charges,50% of total Billed charges,1082.26,16.8,,,percent of total billed charges,16.8% of total billed charges,1082.26,6442,
OR Level 2 Ea Addt'l 15 Min,SUR200037,CDM,360,RC,,,Outpatient,,,3222,2094.30,,2835.36,88,,,percent of total billed charges,88% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,557.53,17.304,,,percent of total billed charges,17.304% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,2029.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2223.18,69,,,percent of total billed charges,69% of total billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1992.81,61.85,,,percent of total billed charges,61.85% of total billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,552.12,17.136,,,percent of total billed charges,17.136% of total billed charges,703.68,21.84,,,percent of total billed charges,21.84% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1214.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1214.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1092.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,2513.16,78,,,percent of total billed charges,78% of total billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,2661.37,82.6,,,percent of total billed charges,82.6% of total billed charges,2661.37,82.6,,,percent of total billed charges,82.6% of total billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,541.3,3367,
OR Level 3 First 30 Min,SUR200038,CDM,360,RC,,,Outpatient,,,8052,5233.80,,7085.76,88,,,percent of total billed charges,88% of total Billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,1352.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1393.32,17.304,,,percent of total billed charges,17.304% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,5072.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1352.74,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,5555.88,69,,,percent of total billed charges,69% of total billed charges,8052,100,,,percent of total billed charges,100% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,8052,100,,,percent of total billed charges,100% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,8052,100,,,percent of total billed charges,100% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,4980.16,61.85,,,percent of total billed charges,61.85% of total billed charges,1352.74,16.8,,,percent of total billed charges,16.8% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,1352.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,1379.79,17.136,,,percent of total billed charges,17.136% of total billed charges,1758.56,21.84,,,percent of total billed charges,21.84% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,3035.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3035.6,37.7,,,percent of total billed charges,37.70% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,2729.63,33.9,,,percent of total billed charges,33.9% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,6280.56,78,,,percent of total billed charges,78% of total billed charges,8052,100,,,percent of total billed charges,100% of total billed charges,6650.95,82.6,,,percent of total billed charges,82.6% of total billed charges,6650.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1352.74,16.8,,,percent of total billed charges,16.8% of total billed charges,4026,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4026,50,,,percent of total billed charges,50% of total Billed charges,1352.74,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.74,8052,
OR Level 3 Ea Addt'l 15 Min,SUR200039,CDM,360,RC,,,Outpatient,,,3222,2094.30,,2835.36,88,,,percent of total billed charges,88% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,557.53,17.304,,,percent of total billed charges,17.304% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,2029.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2223.18,69,,,percent of total billed charges,69% of total billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1992.81,61.85,,,percent of total billed charges,61.85% of total billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,552.12,17.136,,,percent of total billed charges,17.136% of total billed charges,703.68,21.84,,,percent of total billed charges,21.84% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1214.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1214.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1092.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,2513.16,78,,,percent of total billed charges,78% of total billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,2661.37,82.6,,,percent of total billed charges,82.6% of total billed charges,2661.37,82.6,,,percent of total billed charges,82.6% of total billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,541.3,3367,
OR Level 4 First 30 Min,SUR200040,CDM,360,RC,,,Outpatient,,,10791,7014.15,,9496.08,88,,,percent of total billed charges,88% of total Billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,1812.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1867.27,17.304,,,percent of total billed charges,17.304% of total billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,6798.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1812.89,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,7445.79,69,,,percent of total billed charges,69% of total billed charges,10791,100,,,percent of total billed charges,100% of total billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,10791,100,,,percent of total billed charges,100% of total billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,10791,100,,,percent of total billed charges,100% of total billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,6674.23,61.85,,,percent of total billed charges,61.85% of total billed charges,1812.89,16.8,,,percent of total billed charges,16.8% of total billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,1812.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,1849.15,17.136,,,percent of total billed charges,17.136% of total billed charges,2356.75,21.84,,,percent of total billed charges,21.84% of total billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,4068.21,37.7,,,percent of total billed charges,37.70% of total billed charges,4068.21,37.7,,,percent of total billed charges,37.70% of total billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,3658.15,33.9,,,percent of total billed charges,33.9% of total billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,8416.98,78,,,percent of total billed charges,78% of total billed charges,10791,100,,,percent of total billed charges,100% of total billed charges,8913.37,82.6,,,percent of total billed charges,82.6% of total billed charges,8913.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1812.89,16.8,,,percent of total billed charges,16.8% of total billed charges,5395.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5395.5,50,,,percent of total billed charges,50% of total Billed charges,1812.89,16.8,,,percent of total billed charges,16.8% of total billed charges,1812.89,10791,
OR Level 4 Ea Addt'l 15 Min,SUR200041,CDM,360,RC,,,Outpatient,,,3222,2094.30,,2835.36,88,,,percent of total billed charges,88% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,557.53,17.304,,,percent of total billed charges,17.304% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,2029.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2223.18,69,,,percent of total billed charges,69% of total billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1992.81,61.85,,,percent of total billed charges,61.85% of total billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,552.12,17.136,,,percent of total billed charges,17.136% of total billed charges,703.68,21.84,,,percent of total billed charges,21.84% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1214.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1214.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,1092.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,2513.16,78,,,percent of total billed charges,78% of total billed charges,3222,100,,,percent of total billed charges,100% of total billed charges,2661.37,82.6,,,percent of total billed charges,82.6% of total billed charges,2661.37,82.6,,,percent of total billed charges,82.6% of total billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,1611,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1611,50,,,percent of total billed charges,50% of total Billed charges,541.3,16.8,,,percent of total billed charges,16.8% of total billed charges,541.3,3367,
OR Level 5 First 30 Min,SUR200050,CDM,360,RC,,,Outpatient,,,16104,10467.60,,14171.52,88,,,percent of total billed charges,88% of total Billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,2705.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2786.64,17.304,,,percent of total billed charges,17.304% of total billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,10145.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2705.47,16.8,,,percent of total billed charges,16.8% of total billed charges,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,11111.76,69,,,percent of total billed charges,69% of total billed charges,16104,100,,,percent of total billed charges,100% of total billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,16104,100,,,percent of total billed charges,100% of total billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,16104,100,,,percent of total billed charges,100% of total billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,9960.32,61.85,,,percent of total billed charges,61.85% of total billed charges,2705.47,16.8,,,percent of total billed charges,16.8% of total billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,2705.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,2759.58,17.136,,,percent of total billed charges,17.136% of total billed charges,3517.11,21.84,,,percent of total billed charges,21.84% of total billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,6071.21,37.7,,,percent of total billed charges,37.70% of total billed charges,6071.21,37.7,,,percent of total billed charges,37.70% of total billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,5459.26,33.9,,,percent of total billed charges,33.9% of total billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,12561.12,78,,,percent of total billed charges,78% of total billed charges,16104,100,,,percent of total billed charges,100% of total billed charges,13301.9,82.6,,,percent of total billed charges,82.6% of total billed charges,13301.9,82.6,,,percent of total billed charges,82.6% of total billed charges,2705.47,16.8,,,percent of total billed charges,16.8% of total billed charges,8052,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8052,50,,,percent of total billed charges,50% of total Billed charges,2705.47,16.8,,,percent of total billed charges,16.8% of total billed charges,2705.47,16104,
ORAL AIRWAY SIZE 10,490986,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
ORAL AIRWAY SIZE 5,490987,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
ORAL AIRWAY SIZE 6,490988,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
ORAL AIRWAY SIZE 7,490989,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
ORAL AIRWAY SIZE 8,490990,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
ORAL AIRWAY SIZE 9,490991,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 6.0MM,490992,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 6.5MM,490993,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 7.0MM,490994,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 7.5MM,490995,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 8.0MM,490996,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 8.5MM,490997,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 9.0MM,490998,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
ORANGE TOP PARA-PAK C \\T\\ S STOOL TRNASPORT,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
ORBIS SURGICAL GOWN XL- XLONG,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ORGANIZER SUT GABBY FRATER F/ VLV,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ORTHO EXTREMITY,326417,CDM,270,RC,,,Outpatient,,,612,397.80,,538.56,88,,,percent of total billed charges,88% of total Billed charges,306,50,,,percent of total billed charges,50% of total Billed charges,102.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,612,100,,,percent of total billed charges,100% of total billed charges,105.9,17.304,,,percent of total billed charges,17.304% of total billed charges,306,50,,,percent of total billed charges,50% of total Billed charges,385.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,102.82,16.8,,,percent of total billed charges,16.8% of total billed charges,93.64,15.3,,,percent of total billed charges,15.3% of total billed charges,422.28,69,,,percent of total billed charges,69% of total billed charges,612,100,,,percent of total billed charges,100% of total billed charges,306,50,,,percent of total billed charges,50% of total Billed charges,612,100,,,percent of total billed charges,100% of total billed charges,306,50,,,percent of total billed charges,50% of total Billed charges,612,100,,,percent of total billed charges,100% of total billed charges,306,50,,,percent of total billed charges,50% of total Billed charges,378.52,61.85,,,percent of total billed charges,61.85% of total billed charges,102.82,16.8,,,percent of total billed charges,16.8% of total billed charges,306,50,,,percent of total billed charges,50% of total Billed charges,306,50,,,percent of total billed charges,50% of total Billed charges,102.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,306,50,,,percent of total billed charges,50% of total Billed charges,306,50,,,percent of total billed charges,50% of total Billed charges,104.87,17.136,,,percent of total billed charges,17.136% of total billed charges,133.66,21.84,,,percent of total billed charges,21.84% of total billed charges,306,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,306,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,306,50,,,percent of total billed charges,50% of total Billed charges,477.36,78,,,percent of total billed charges,78% of total billed charges,612,100,,,percent of total billed charges,100% of total billed charges,505.51,82.6,,,percent of total billed charges,82.6% of total billed charges,505.51,82.6,,,percent of total billed charges,82.6% of total billed charges,102.82,16.8,,,percent of total billed charges,16.8% of total billed charges,306,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,306,50,,,percent of total billed charges,50% of total Billed charges,102.82,16.8,,,percent of total billed charges,16.8% of total billed charges,93.64,612,
ORTHO-EVAC CB II W/ 3/16INDRAIN,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ORTHOLOCK EX-PIN 3X110 6007-103-110,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ORTHOPAT KIT,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
ORTHO-GLASS SPLINT 3,490999,CDM,270,RC,,,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,6.92,17.304,,,percent of total billed charges,17.304% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,25.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,24.74,61.85,,,percent of total billed charges,61.85% of total billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.85,17.136,,,percent of total billed charges,17.136% of total billed charges,8.74,21.84,,,percent of total billed charges,21.84% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,6.12,40,
ORTHO-GLASS SPLINT 4,491000,CDM,270,RC,,,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,8.31,17.304,,,percent of total billed charges,17.304% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,30.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,29.69,61.85,,,percent of total billed charges,61.85% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.23,17.136,,,percent of total billed charges,17.136% of total billed charges,10.48,21.84,,,percent of total billed charges,21.84% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,48,
ORTHO-GLASS SPLINT 5,491001,CDM,270,RC,,,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,9.34,17.304,,,percent of total billed charges,17.304% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,33.4,61.85,,,percent of total billed charges,61.85% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.25,17.136,,,percent of total billed charges,17.136% of total billed charges,11.79,21.84,,,percent of total billed charges,21.84% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
OSOM MONO RAPID TESTS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
OSSICULAR RECONSTRUCTION IMPLANT 9MMNON-MALLEABLE,ORSUP0028,CDM,278,RC,L8613,HCPCS,Outpatient,,,3400,2210.00,,2992,88,,,percent of total billed charges,88% of total Billed charges,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,571.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3400,100,,,percent of total billed charges,100% of total billed charges,588.34,17.304,,,percent of total billed charges,17.304% of total billed charges,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,2142,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,571.2,16.8,,,percent of total billed charges,16.8% of total billed charges,520.2,15.3,,,percent of total billed charges,15.3% of total billed charges,2346,69,,,percent of total billed charges,69% of total billed charges,3400,100,,,percent of total billed charges,100% of total billed charges,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,3400,100,,,percent of total billed charges,100% of total billed charges,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,3400,100,,,percent of total billed charges,100% of total billed charges,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,2102.9,61.85,,,percent of total billed charges,61.85% of total billed charges,571.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,2121.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,582.62,17.136,,,percent of total billed charges,17.136% of total billed charges,742.56,21.84,,,percent of total billed charges,21.84% of total billed charges,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,1281.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1281.8,37.7,,,percent of total billed charges,37.70% of total billed charges,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,1152.6,33.9,,,percent of total billed charges,33.9% of total billed charges,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,2652,78,,,percent of total billed charges,78% of total billed charges,3400,100,,,percent of total billed charges,100% of total billed charges,2808.4,82.6,,,percent of total billed charges,82.6% of total billed charges,2808.4,82.6,,,percent of total billed charges,82.6% of total billed charges,571.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,3400,100,,,Fee Schedule,100% of Medicare OPPS rate,571.2,16.8,,,percent of total billed charges,16.8% of total billed charges,520.2,3400,
OSSICULAR PROSTHESIS H/A NOTCHED,ORSUP0150,CDM,278,RC,L8613,HCPCS,Outpatient,,,28600,18590.00,,25168,88,,,percent of total billed charges,88% of total Billed charges,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,4804.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4948.94,17.304,,,percent of total billed charges,17.304% of total billed charges,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,18018,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4804.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4375.8,15.3,,,percent of total billed charges,15.3% of total billed charges,19734,69,,,percent of total billed charges,69% of total billed charges,28600,100,,,percent of total billed charges,100% of total billed charges,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,28600,100,,,percent of total billed charges,100% of total billed charges,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,28600,100,,,percent of total billed charges,100% of total billed charges,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,17689.1,61.85,,,percent of total billed charges,61.85% of total billed charges,4804.8,16.8,,,percent of total billed charges,16.8% of total billed charges,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,17846.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,4900.9,17.136,,,percent of total billed charges,17.136% of total billed charges,6246.24,21.84,,,percent of total billed charges,21.84% of total billed charges,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,10782.2,37.7,,,percent of total billed charges,37.70% of total billed charges,10782.2,37.7,,,percent of total billed charges,37.70% of total billed charges,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,9695.4,33.9,,,percent of total billed charges,33.9% of total billed charges,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,22308,78,,,percent of total billed charges,78% of total billed charges,28600,100,,,percent of total billed charges,100% of total billed charges,23623.6,82.6,,,percent of total billed charges,82.6% of total billed charges,23623.6,82.6,,,percent of total billed charges,82.6% of total billed charges,4804.8,16.8,,,percent of total billed charges,16.8% of total billed charges,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,28600,100,,,Fee Schedule,100% of Medicare OPPS rate,4804.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4375.8,28600,
OSTEOCEL 5CC,ORSUP0059,CDM,278,RC,C1762,HCPCS,Outpatient,,,12740,8281.00,,11211.2,88,,,percent of total billed charges,88% of total Billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,2140.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2204.53,17.304,,,percent of total billed charges,17.304% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,8026.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2140.32,16.8,,,percent of total billed charges,16.8% of total billed charges,1949.22,15.3,,,percent of total billed charges,15.3% of total billed charges,8790.6,69,,,percent of total billed charges,69% of total billed charges,12740,100,,,percent of total billed charges,100% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,12740,100,,,percent of total billed charges,100% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,12740,100,,,percent of total billed charges,100% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,7879.69,61.85,,,percent of total billed charges,61.85% of total billed charges,2140.32,16.8,,,percent of total billed charges,16.8% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,3974.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6370,50,,,percent of total billed charges,50% of total Billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,2183.13,17.136,,,percent of total billed charges,17.136% of total billed charges,2782.42,21.84,,,percent of total billed charges,21.84% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,4802.98,37.7,,,percent of total billed charges,37.70% of total billed charges,4802.98,37.7,,,percent of total billed charges,37.70% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,4318.86,33.9,,,percent of total billed charges,33.9% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,9937.2,78,,,percent of total billed charges,78% of total billed charges,12740,100,,,percent of total billed charges,100% of total billed charges,10523.24,82.6,,,percent of total billed charges,82.6% of total billed charges,10523.24,82.6,,,percent of total billed charges,82.6% of total billed charges,2140.32,16.8,,,percent of total billed charges,16.8% of total billed charges,6370,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6370,50,,,percent of total billed charges,50% of total Billed charges,2140.32,16.8,,,percent of total billed charges,16.8% of total billed charges,1949.22,12740,
OTH STER SUPP LVL 1,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
OTH STER SUPP LVL 2,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
OTH STER SUPP LVL 3,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
OTH STER SUPP LVL 4,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
OTH STER SUPP LVL 5,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
OTH STER SUPP LVL 6,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
OTH STER SUPP LVL 7,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
OTH STER SUPP LVL 8,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
OTH STER SUPP LVL 9,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
OTH STER SUPP LVL 10,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
OWENS DRESSING 8 X 12,491009,CDM,270,RC,,,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,167,100,,,percent of total billed charges,100% of total billed charges,28.9,17.304,,,percent of total billed charges,17.304% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,105.21,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,25.55,15.3,,,percent of total billed charges,15.3% of total billed charges,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,167,100,,,percent of total billed charges,100% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,167,100,,,percent of total billed charges,100% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,103.29,61.85,,,percent of total billed charges,61.85% of total billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.62,17.136,,,percent of total billed charges,17.136% of total billed charges,36.47,21.84,,,percent of total billed charges,21.84% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,83.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,83.5,50,,,percent of total billed charges,50% of total Billed charges,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,25.55,167,
OXICHROME REAGENT,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
OXISENSOR NEONATAL N25,9713,CDM,270,RC,,,Outpatient,,,81,52.65,,71.28,88,,,percent of total billed charges,88% of total Billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,13.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,81,100,,,percent of total billed charges,100% of total billed charges,14.02,17.304,,,percent of total billed charges,17.304% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,51.03,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.61,16.8,,,percent of total billed charges,16.8% of total billed charges,12.39,15.3,,,percent of total billed charges,15.3% of total billed charges,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,81,100,,,percent of total billed charges,100% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,81,100,,,percent of total billed charges,100% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,50.1,61.85,,,percent of total billed charges,61.85% of total billed charges,13.61,16.8,,,percent of total billed charges,16.8% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,13.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,13.88,17.136,,,percent of total billed charges,17.136% of total billed charges,17.69,21.84,,,percent of total billed charges,21.84% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40.5,50,,,percent of total billed charges,50% of total Billed charges,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,13.61,16.8,,,percent of total billed charges,16.8% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40.5,50,,,percent of total billed charges,50% of total Billed charges,13.61,16.8,,,percent of total billed charges,16.8% of total billed charges,12.39,81,
OXISENSOR PEDS MASIMO LNCS,491010,CDM,270,RC,,,Outpatient,,,76,49.40,,66.88,88,,,percent of total billed charges,88% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,13.15,17.304,,,percent of total billed charges,17.304% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,47.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,11.63,15.3,,,percent of total billed charges,15.3% of total billed charges,52.44,69,,,percent of total billed charges,69% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,47.01,61.85,,,percent of total billed charges,61.85% of total billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,13.02,17.136,,,percent of total billed charges,17.136% of total billed charges,16.6,21.84,,,percent of total billed charges,21.84% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,59.28,78,,,percent of total billed charges,78% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,11.63,76,
OXYGENATOR,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
OXYGEN MASK ADULT,491011,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
OXYGEN MASK PEDIATRIC,491012,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
OXYGEN PRESSURE REGULATORS,ORSUP0013,CDM,272,RC,,,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,504,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
OXYGEN REGULATOR,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
OXYSENSOR NEONATEL/ADULT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PACEMAKER PACKS,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
PACING LEAD TEMP TRANSVENOUS,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
PACKING NASAL 4.5CM MEROCEL 2000,85344,CDM,278,RC,C1763,HCPCS,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,17.63,33.9,,,percent of total billed charges,33.9% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
PACKING NASAL MEROCEL LONG   470404,36612,CDM,278,RC,C1763,HCPCS,Outpatient,,,60,39.00,,52.8,88,,,percent of total billed charges,88% of total Billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,10.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,60,100,,,percent of total billed charges,100% of total billed charges,10.38,17.304,,,percent of total billed charges,17.304% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,37.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.08,16.8,,,percent of total billed charges,16.8% of total billed charges,9.18,15.3,,,percent of total billed charges,15.3% of total billed charges,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,60,100,,,percent of total billed charges,100% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,60,100,,,percent of total billed charges,100% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,37.11,61.85,,,percent of total billed charges,61.85% of total billed charges,10.08,16.8,,,percent of total billed charges,16.8% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,10.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,10.28,17.136,,,percent of total billed charges,17.136% of total billed charges,13.1,21.84,,,percent of total billed charges,21.84% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,20.34,33.9,,,percent of total billed charges,33.9% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,10.08,16.8,,,percent of total billed charges,16.8% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30,50,,,percent of total billed charges,50% of total Billed charges,10.08,16.8,,,percent of total billed charges,16.8% of total billed charges,9.18,60,
PACK SHOULDER DRAPE POUCH,61523,CDM,270,RC,,,Outpatient,,,148,96.20,,130.24,88,,,percent of total billed charges,88% of total Billed charges,74,50,,,percent of total billed charges,50% of total Billed charges,24.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,148,100,,,percent of total billed charges,100% of total billed charges,25.61,17.304,,,percent of total billed charges,17.304% of total billed charges,74,50,,,percent of total billed charges,50% of total Billed charges,93.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.86,16.8,,,percent of total billed charges,16.8% of total billed charges,22.64,15.3,,,percent of total billed charges,15.3% of total billed charges,102.12,69,,,percent of total billed charges,69% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,74,50,,,percent of total billed charges,50% of total Billed charges,148,100,,,percent of total billed charges,100% of total billed charges,74,50,,,percent of total billed charges,50% of total Billed charges,148,100,,,percent of total billed charges,100% of total billed charges,74,50,,,percent of total billed charges,50% of total Billed charges,91.54,61.85,,,percent of total billed charges,61.85% of total billed charges,24.86,16.8,,,percent of total billed charges,16.8% of total billed charges,74,50,,,percent of total billed charges,50% of total Billed charges,74,50,,,percent of total billed charges,50% of total Billed charges,24.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,74,50,,,percent of total billed charges,50% of total Billed charges,74,50,,,percent of total billed charges,50% of total Billed charges,25.36,17.136,,,percent of total billed charges,17.136% of total billed charges,32.32,21.84,,,percent of total billed charges,21.84% of total billed charges,74,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,74,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,74,50,,,percent of total billed charges,50% of total Billed charges,115.44,78,,,percent of total billed charges,78% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,24.86,16.8,,,percent of total billed charges,16.8% of total billed charges,74,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,74,50,,,percent of total billed charges,50% of total Billed charges,24.86,16.8,,,percent of total billed charges,16.8% of total billed charges,22.64,148,
PACKING GAUZE IODOFORM 1/4 IN X 5 YARDS,8041,CDM,270,RC,,,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.5,17.304,,,percent of total billed charges,17.304% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.08,61.85,,,percent of total billed charges,61.85% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.46,17.136,,,percent of total billed charges,17.136% of total billed charges,5.68,21.84,,,percent of total billed charges,21.84% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,26,
PACK LITHOTOMY PK I,44967,CDM,270,RC,,,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,6.92,17.304,,,percent of total billed charges,17.304% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,25.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,24.74,61.85,,,percent of total billed charges,61.85% of total billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.85,17.136,,,percent of total billed charges,17.136% of total billed charges,8.74,21.84,,,percent of total billed charges,21.84% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,6.12,40,
PACK BOWIE DICK TEST,312427,CDM,270,RC,,,Outpatient,,,738,479.70,,649.44,88,,,percent of total billed charges,88% of total Billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,123.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,738,100,,,percent of total billed charges,100% of total billed charges,127.7,17.304,,,percent of total billed charges,17.304% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,464.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,123.98,16.8,,,percent of total billed charges,16.8% of total billed charges,112.91,15.3,,,percent of total billed charges,15.3% of total billed charges,509.22,69,,,percent of total billed charges,69% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,738,100,,,percent of total billed charges,100% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,738,100,,,percent of total billed charges,100% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,456.45,61.85,,,percent of total billed charges,61.85% of total billed charges,123.98,16.8,,,percent of total billed charges,16.8% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,123.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,126.46,17.136,,,percent of total billed charges,17.136% of total billed charges,161.18,21.84,,,percent of total billed charges,21.84% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,369,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,369,50,,,percent of total billed charges,50% of total Billed charges,575.64,78,,,percent of total billed charges,78% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,123.98,16.8,,,percent of total billed charges,16.8% of total billed charges,369,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,369,50,,,percent of total billed charges,50% of total Billed charges,123.98,16.8,,,percent of total billed charges,16.8% of total billed charges,112.91,738,
PACK TEST RAPID 5 STEAM PLUS,261315,CDM,270,RC,,,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,9.52,17.304,,,percent of total billed charges,17.304% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.42,17.136,,,percent of total billed charges,17.136% of total billed charges,12.01,21.84,,,percent of total billed charges,21.84% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,55,
PACK ANGIO,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
PACK BASIC CUSTOM,445080,CDM,270,RC,,,Outpatient,,,264,171.60,,232.32,88,,,percent of total billed charges,88% of total Billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,44.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,264,100,,,percent of total billed charges,100% of total billed charges,45.68,17.304,,,percent of total billed charges,17.304% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,166.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,44.35,16.8,,,percent of total billed charges,16.8% of total billed charges,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,264,100,,,percent of total billed charges,100% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,264,100,,,percent of total billed charges,100% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,163.28,61.85,,,percent of total billed charges,61.85% of total billed charges,44.35,16.8,,,percent of total billed charges,16.8% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,44.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,45.24,17.136,,,percent of total billed charges,17.136% of total billed charges,57.66,21.84,,,percent of total billed charges,21.84% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,132,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,132,50,,,percent of total billed charges,50% of total Billed charges,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,44.35,16.8,,,percent of total billed charges,16.8% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,132,50,,,percent of total billed charges,50% of total Billed charges,44.35,16.8,,,percent of total billed charges,16.8% of total billed charges,40.39,264,
PACK  TOWEL OR STERILE DISP GREEN DLX 20PK/CS,293791,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
PACK ARTHROSCOPY 29180,322036,CDM,270,RC,,,Outpatient,,,144,93.60,,126.72,88,,,percent of total billed charges,88% of total Billed charges,72,50,,,percent of total billed charges,50% of total Billed charges,24.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,144,100,,,percent of total billed charges,100% of total billed charges,24.92,17.304,,,percent of total billed charges,17.304% of total billed charges,72,50,,,percent of total billed charges,50% of total Billed charges,90.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.19,16.8,,,percent of total billed charges,16.8% of total billed charges,22.03,15.3,,,percent of total billed charges,15.3% of total billed charges,99.36,69,,,percent of total billed charges,69% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,72,50,,,percent of total billed charges,50% of total Billed charges,144,100,,,percent of total billed charges,100% of total billed charges,72,50,,,percent of total billed charges,50% of total Billed charges,144,100,,,percent of total billed charges,100% of total billed charges,72,50,,,percent of total billed charges,50% of total Billed charges,89.06,61.85,,,percent of total billed charges,61.85% of total billed charges,24.19,16.8,,,percent of total billed charges,16.8% of total billed charges,72,50,,,percent of total billed charges,50% of total Billed charges,72,50,,,percent of total billed charges,50% of total Billed charges,24.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,72,50,,,percent of total billed charges,50% of total Billed charges,72,50,,,percent of total billed charges,50% of total Billed charges,24.68,17.136,,,percent of total billed charges,17.136% of total billed charges,31.45,21.84,,,percent of total billed charges,21.84% of total billed charges,72,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,72,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,72,50,,,percent of total billed charges,50% of total Billed charges,112.32,78,,,percent of total billed charges,78% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,24.19,16.8,,,percent of total billed charges,16.8% of total billed charges,72,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,72,50,,,percent of total billed charges,50% of total Billed charges,24.19,16.8,,,percent of total billed charges,16.8% of total billed charges,22.03,144,
PACK ATTEST SUPER RAPID 5 STEAM-PLUS CHALLENGE,183381,CDM,270,RC,,,Outpatient,,,1597,1038.05,,1405.36,88,,,percent of total billed charges,88% of total Billed charges,798.5,50,,,percent of total billed charges,50% of total Billed charges,268.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,1597,100,,,percent of total billed charges,100% of total billed charges,276.34,17.304,,,percent of total billed charges,17.304% of total billed charges,798.5,50,,,percent of total billed charges,50% of total Billed charges,1006.11,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,268.3,16.8,,,percent of total billed charges,16.8% of total billed charges,244.34,15.3,,,percent of total billed charges,15.3% of total billed charges,1101.93,69,,,percent of total billed charges,69% of total billed charges,1597,100,,,percent of total billed charges,100% of total billed charges,798.5,50,,,percent of total billed charges,50% of total Billed charges,1597,100,,,percent of total billed charges,100% of total billed charges,798.5,50,,,percent of total billed charges,50% of total Billed charges,1597,100,,,percent of total billed charges,100% of total billed charges,798.5,50,,,percent of total billed charges,50% of total Billed charges,987.74,61.85,,,percent of total billed charges,61.85% of total billed charges,268.3,16.8,,,percent of total billed charges,16.8% of total billed charges,798.5,50,,,percent of total billed charges,50% of total Billed charges,798.5,50,,,percent of total billed charges,50% of total Billed charges,268.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,798.5,50,,,percent of total billed charges,50% of total Billed charges,798.5,50,,,percent of total billed charges,50% of total Billed charges,273.66,17.136,,,percent of total billed charges,17.136% of total billed charges,348.78,21.84,,,percent of total billed charges,21.84% of total billed charges,798.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,798.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,798.5,50,,,percent of total billed charges,50% of total Billed charges,1245.66,78,,,percent of total billed charges,78% of total billed charges,1597,100,,,percent of total billed charges,100% of total billed charges,1319.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1319.12,82.6,,,percent of total billed charges,82.6% of total billed charges,268.3,16.8,,,percent of total billed charges,16.8% of total billed charges,798.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,798.5,50,,,percent of total billed charges,50% of total Billed charges,268.3,16.8,,,percent of total billed charges,16.8% of total billed charges,244.34,1597,
PACK BASIC,81780,CDM,270,RC,,,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,7.09,17.304,,,percent of total billed charges,17.304% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,15.3,,,percent of total billed charges,15.3% of total billed charges,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.36,61.85,,,percent of total billed charges,61.85% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,7.03,17.136,,,percent of total billed charges,17.136% of total billed charges,8.95,21.84,,,percent of total billed charges,21.84% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,41,
PACK CHS CYSTO,432173,CDM,270,RC,,,Outpatient,,,241,156.65,,212.08,88,,,percent of total billed charges,88% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,41.7,17.304,,,percent of total billed charges,17.304% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,151.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,36.87,15.3,,,percent of total billed charges,15.3% of total billed charges,166.29,69,,,percent of total billed charges,69% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,149.06,61.85,,,percent of total billed charges,61.85% of total billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,41.3,17.136,,,percent of total billed charges,17.136% of total billed charges,52.63,21.84,,,percent of total billed charges,21.84% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,187.98,78,,,percent of total billed charges,78% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,36.87,241,
PACK CHS LARGE BASIN,432174,CDM,270,RC,,,Outpatient,,,212,137.80,,186.56,88,,,percent of total billed charges,88% of total Billed charges,106,50,,,percent of total billed charges,50% of total Billed charges,35.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,212,100,,,percent of total billed charges,100% of total billed charges,36.68,17.304,,,percent of total billed charges,17.304% of total billed charges,106,50,,,percent of total billed charges,50% of total Billed charges,133.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,35.62,16.8,,,percent of total billed charges,16.8% of total billed charges,32.44,15.3,,,percent of total billed charges,15.3% of total billed charges,146.28,69,,,percent of total billed charges,69% of total billed charges,212,100,,,percent of total billed charges,100% of total billed charges,106,50,,,percent of total billed charges,50% of total Billed charges,212,100,,,percent of total billed charges,100% of total billed charges,106,50,,,percent of total billed charges,50% of total Billed charges,212,100,,,percent of total billed charges,100% of total billed charges,106,50,,,percent of total billed charges,50% of total Billed charges,131.12,61.85,,,percent of total billed charges,61.85% of total billed charges,35.62,16.8,,,percent of total billed charges,16.8% of total billed charges,106,50,,,percent of total billed charges,50% of total Billed charges,106,50,,,percent of total billed charges,50% of total Billed charges,35.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,106,50,,,percent of total billed charges,50% of total Billed charges,106,50,,,percent of total billed charges,50% of total Billed charges,36.33,17.136,,,percent of total billed charges,17.136% of total billed charges,46.3,21.84,,,percent of total billed charges,21.84% of total billed charges,106,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,106,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,106,50,,,percent of total billed charges,50% of total Billed charges,165.36,78,,,percent of total billed charges,78% of total billed charges,212,100,,,percent of total billed charges,100% of total billed charges,175.11,82.6,,,percent of total billed charges,82.6% of total billed charges,175.11,82.6,,,percent of total billed charges,82.6% of total billed charges,35.62,16.8,,,percent of total billed charges,16.8% of total billed charges,106,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,106,50,,,percent of total billed charges,50% of total Billed charges,35.62,16.8,,,percent of total billed charges,16.8% of total billed charges,32.44,212,
PACK GI,182538,CDM,270,RC,,,Outpatient,,,545,354.25,,479.6,88,,,percent of total billed charges,88% of total Billed charges,272.5,50,,,percent of total billed charges,50% of total Billed charges,91.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,545,100,,,percent of total billed charges,100% of total billed charges,94.31,17.304,,,percent of total billed charges,17.304% of total billed charges,272.5,50,,,percent of total billed charges,50% of total Billed charges,343.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,91.56,16.8,,,percent of total billed charges,16.8% of total billed charges,83.39,15.3,,,percent of total billed charges,15.3% of total billed charges,376.05,69,,,percent of total billed charges,69% of total billed charges,545,100,,,percent of total billed charges,100% of total billed charges,272.5,50,,,percent of total billed charges,50% of total Billed charges,545,100,,,percent of total billed charges,100% of total billed charges,272.5,50,,,percent of total billed charges,50% of total Billed charges,545,100,,,percent of total billed charges,100% of total billed charges,272.5,50,,,percent of total billed charges,50% of total Billed charges,337.08,61.85,,,percent of total billed charges,61.85% of total billed charges,91.56,16.8,,,percent of total billed charges,16.8% of total billed charges,272.5,50,,,percent of total billed charges,50% of total Billed charges,272.5,50,,,percent of total billed charges,50% of total Billed charges,91.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,272.5,50,,,percent of total billed charges,50% of total Billed charges,272.5,50,,,percent of total billed charges,50% of total Billed charges,93.39,17.136,,,percent of total billed charges,17.136% of total billed charges,119.03,21.84,,,percent of total billed charges,21.84% of total billed charges,272.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,272.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,272.5,50,,,percent of total billed charges,50% of total Billed charges,425.1,78,,,percent of total billed charges,78% of total billed charges,545,100,,,percent of total billed charges,100% of total billed charges,450.17,82.6,,,percent of total billed charges,82.6% of total billed charges,450.17,82.6,,,percent of total billed charges,82.6% of total billed charges,91.56,16.8,,,percent of total billed charges,16.8% of total billed charges,272.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,272.5,50,,,percent of total billed charges,50% of total Billed charges,91.56,16.8,,,percent of total billed charges,16.8% of total billed charges,83.39,545,
PACK GYN CUSTOM,445081,CDM,270,RC,,,Outpatient,,,547,355.55,,481.36,88,,,percent of total billed charges,88% of total Billed charges,273.5,50,,,percent of total billed charges,50% of total Billed charges,91.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,547,100,,,percent of total billed charges,100% of total billed charges,94.65,17.304,,,percent of total billed charges,17.304% of total billed charges,273.5,50,,,percent of total billed charges,50% of total Billed charges,344.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,91.9,16.8,,,percent of total billed charges,16.8% of total billed charges,83.69,15.3,,,percent of total billed charges,15.3% of total billed charges,377.43,69,,,percent of total billed charges,69% of total billed charges,547,100,,,percent of total billed charges,100% of total billed charges,273.5,50,,,percent of total billed charges,50% of total Billed charges,547,100,,,percent of total billed charges,100% of total billed charges,273.5,50,,,percent of total billed charges,50% of total Billed charges,547,100,,,percent of total billed charges,100% of total billed charges,273.5,50,,,percent of total billed charges,50% of total Billed charges,338.32,61.85,,,percent of total billed charges,61.85% of total billed charges,91.9,16.8,,,percent of total billed charges,16.8% of total billed charges,273.5,50,,,percent of total billed charges,50% of total Billed charges,273.5,50,,,percent of total billed charges,50% of total Billed charges,91.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,273.5,50,,,percent of total billed charges,50% of total Billed charges,273.5,50,,,percent of total billed charges,50% of total Billed charges,93.73,17.136,,,percent of total billed charges,17.136% of total billed charges,119.46,21.84,,,percent of total billed charges,21.84% of total billed charges,273.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,273.5,50,,,percent of total billed charges,50% of total Billed charges,426.66,78,,,percent of total billed charges,78% of total billed charges,547,100,,,percent of total billed charges,100% of total billed charges,451.82,82.6,,,percent of total billed charges,82.6% of total billed charges,451.82,82.6,,,percent of total billed charges,82.6% of total billed charges,91.9,16.8,,,percent of total billed charges,16.8% of total billed charges,273.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,273.5,50,,,percent of total billed charges,50% of total Billed charges,91.9,16.8,,,percent of total billed charges,16.8% of total billed charges,83.69,547,
PACK HEART VALVE A  B,182555,CDM,272,RC,,,Outpatient,,,2700,1755.00,,2376,88,,,percent of total billed charges,88% of total Billed charges,1350,50,,,percent of total billed charges,50% of total Billed charges,453.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2700,100,,,percent of total billed charges,100% of total billed charges,467.21,17.304,,,percent of total billed charges,17.304% of total billed charges,1350,50,,,percent of total billed charges,50% of total Billed charges,1701,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,453.6,16.8,,,percent of total billed charges,16.8% of total billed charges,413.1,15.3,,,percent of total billed charges,15.3% of total billed charges,1863,69,,,percent of total billed charges,69% of total billed charges,2700,100,,,percent of total billed charges,100% of total billed charges,1350,50,,,percent of total billed charges,50% of total Billed charges,2700,100,,,percent of total billed charges,100% of total billed charges,1350,50,,,percent of total billed charges,50% of total Billed charges,2700,100,,,percent of total billed charges,100% of total billed charges,1350,50,,,percent of total billed charges,50% of total Billed charges,1669.95,61.85,,,percent of total billed charges,61.85% of total billed charges,453.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1350,50,,,percent of total billed charges,50% of total Billed charges,1350,50,,,percent of total billed charges,50% of total Billed charges,453.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,1350,50,,,percent of total billed charges,50% of total Billed charges,1350,50,,,percent of total billed charges,50% of total Billed charges,462.67,17.136,,,percent of total billed charges,17.136% of total billed charges,589.68,21.84,,,percent of total billed charges,21.84% of total billed charges,1350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1350,50,,,percent of total billed charges,50% of total Billed charges,2106,78,,,percent of total billed charges,78% of total billed charges,2700,100,,,percent of total billed charges,100% of total billed charges,2230.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2230.2,82.6,,,percent of total billed charges,82.6% of total billed charges,453.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1350,50,,,percent of total billed charges,50% of total Billed charges,453.6,16.8,,,percent of total billed charges,16.8% of total billed charges,413.1,2700,
PACK IV START,228636,CDM,270,RC,,,Outpatient,,,198,128.70,,174.24,88,,,percent of total billed charges,88% of total Billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,33.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,198,100,,,percent of total billed charges,100% of total billed charges,34.26,17.304,,,percent of total billed charges,17.304% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,124.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.26,16.8,,,percent of total billed charges,16.8% of total billed charges,30.29,15.3,,,percent of total billed charges,15.3% of total billed charges,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,198,100,,,percent of total billed charges,100% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,198,100,,,percent of total billed charges,100% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,122.46,61.85,,,percent of total billed charges,61.85% of total billed charges,33.26,16.8,,,percent of total billed charges,16.8% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,33.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,33.93,17.136,,,percent of total billed charges,17.136% of total billed charges,43.24,21.84,,,percent of total billed charges,21.84% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,99,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,99,50,,,percent of total billed charges,50% of total Billed charges,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,33.26,16.8,,,percent of total billed charges,16.8% of total billed charges,99,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,99,50,,,percent of total billed charges,50% of total Billed charges,33.26,16.8,,,percent of total billed charges,16.8% of total billed charges,30.29,198,
PACK LAPAROSCOPY,182454,CDM,270,RC,,,Outpatient,,,722,469.30,,635.36,88,,,percent of total billed charges,88% of total Billed charges,361,50,,,percent of total billed charges,50% of total Billed charges,121.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,722,100,,,percent of total billed charges,100% of total billed charges,124.93,17.304,,,percent of total billed charges,17.304% of total billed charges,361,50,,,percent of total billed charges,50% of total Billed charges,454.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,121.3,16.8,,,percent of total billed charges,16.8% of total billed charges,110.47,15.3,,,percent of total billed charges,15.3% of total billed charges,498.18,69,,,percent of total billed charges,69% of total billed charges,722,100,,,percent of total billed charges,100% of total billed charges,361,50,,,percent of total billed charges,50% of total Billed charges,722,100,,,percent of total billed charges,100% of total billed charges,361,50,,,percent of total billed charges,50% of total Billed charges,722,100,,,percent of total billed charges,100% of total billed charges,361,50,,,percent of total billed charges,50% of total Billed charges,446.56,61.85,,,percent of total billed charges,61.85% of total billed charges,121.3,16.8,,,percent of total billed charges,16.8% of total billed charges,361,50,,,percent of total billed charges,50% of total Billed charges,361,50,,,percent of total billed charges,50% of total Billed charges,121.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,361,50,,,percent of total billed charges,50% of total Billed charges,361,50,,,percent of total billed charges,50% of total Billed charges,123.72,17.136,,,percent of total billed charges,17.136% of total billed charges,157.68,21.84,,,percent of total billed charges,21.84% of total billed charges,361,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,361,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,361,50,,,percent of total billed charges,50% of total Billed charges,563.16,78,,,percent of total billed charges,78% of total billed charges,722,100,,,percent of total billed charges,100% of total billed charges,596.37,82.6,,,percent of total billed charges,82.6% of total billed charges,596.37,82.6,,,percent of total billed charges,82.6% of total billed charges,121.3,16.8,,,percent of total billed charges,16.8% of total billed charges,361,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,361,50,,,percent of total billed charges,50% of total Billed charges,121.3,16.8,,,percent of total billed charges,16.8% of total billed charges,110.47,722,
PACK LAVH,253188,CDM,270,RC,,,Outpatient,,,410,266.50,,360.8,88,,,percent of total billed charges,88% of total Billed charges,205,50,,,percent of total billed charges,50% of total Billed charges,68.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,410,100,,,percent of total billed charges,100% of total billed charges,70.95,17.304,,,percent of total billed charges,17.304% of total billed charges,205,50,,,percent of total billed charges,50% of total Billed charges,258.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,68.88,16.8,,,percent of total billed charges,16.8% of total billed charges,62.73,15.3,,,percent of total billed charges,15.3% of total billed charges,282.9,69,,,percent of total billed charges,69% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,205,50,,,percent of total billed charges,50% of total Billed charges,410,100,,,percent of total billed charges,100% of total billed charges,205,50,,,percent of total billed charges,50% of total Billed charges,410,100,,,percent of total billed charges,100% of total billed charges,205,50,,,percent of total billed charges,50% of total Billed charges,253.59,61.85,,,percent of total billed charges,61.85% of total billed charges,68.88,16.8,,,percent of total billed charges,16.8% of total billed charges,205,50,,,percent of total billed charges,50% of total Billed charges,205,50,,,percent of total billed charges,50% of total Billed charges,68.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,205,50,,,percent of total billed charges,50% of total Billed charges,205,50,,,percent of total billed charges,50% of total Billed charges,70.26,17.136,,,percent of total billed charges,17.136% of total billed charges,89.54,21.84,,,percent of total billed charges,21.84% of total billed charges,205,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,205,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,205,50,,,percent of total billed charges,50% of total Billed charges,319.8,78,,,percent of total billed charges,78% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,68.88,16.8,,,percent of total billed charges,16.8% of total billed charges,205,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,205,50,,,percent of total billed charges,50% of total Billed charges,68.88,16.8,,,percent of total billed charges,16.8% of total billed charges,62.73,410,
PACK NEURO,182542,CDM,270,RC,,,Outpatient,,,1345,874.25,,1183.6,88,,,percent of total billed charges,88% of total Billed charges,672.5,50,,,percent of total billed charges,50% of total Billed charges,225.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,1345,100,,,percent of total billed charges,100% of total billed charges,232.74,17.304,,,percent of total billed charges,17.304% of total billed charges,672.5,50,,,percent of total billed charges,50% of total Billed charges,847.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,225.96,16.8,,,percent of total billed charges,16.8% of total billed charges,205.79,15.3,,,percent of total billed charges,15.3% of total billed charges,928.05,69,,,percent of total billed charges,69% of total billed charges,1345,100,,,percent of total billed charges,100% of total billed charges,672.5,50,,,percent of total billed charges,50% of total Billed charges,1345,100,,,percent of total billed charges,100% of total billed charges,672.5,50,,,percent of total billed charges,50% of total Billed charges,1345,100,,,percent of total billed charges,100% of total billed charges,672.5,50,,,percent of total billed charges,50% of total Billed charges,831.88,61.85,,,percent of total billed charges,61.85% of total billed charges,225.96,16.8,,,percent of total billed charges,16.8% of total billed charges,672.5,50,,,percent of total billed charges,50% of total Billed charges,672.5,50,,,percent of total billed charges,50% of total Billed charges,225.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,672.5,50,,,percent of total billed charges,50% of total Billed charges,672.5,50,,,percent of total billed charges,50% of total Billed charges,230.48,17.136,,,percent of total billed charges,17.136% of total billed charges,293.75,21.84,,,percent of total billed charges,21.84% of total billed charges,672.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,672.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,672.5,50,,,percent of total billed charges,50% of total Billed charges,1049.1,78,,,percent of total billed charges,78% of total billed charges,1345,100,,,percent of total billed charges,100% of total billed charges,1110.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1110.97,82.6,,,percent of total billed charges,82.6% of total billed charges,225.96,16.8,,,percent of total billed charges,16.8% of total billed charges,672.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,672.5,50,,,percent of total billed charges,50% of total Billed charges,225.96,16.8,,,percent of total billed charges,16.8% of total billed charges,205.79,1345,
PACK OB MOM AND BABY,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
PACK OPEN HART 1  2,182556,CDM,270,RC,,,Outpatient,,,3309,2150.85,,2911.92,88,,,percent of total billed charges,88% of total Billed charges,1654.5,50,,,percent of total billed charges,50% of total Billed charges,555.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,3309,100,,,percent of total billed charges,100% of total billed charges,572.59,17.304,,,percent of total billed charges,17.304% of total billed charges,1654.5,50,,,percent of total billed charges,50% of total Billed charges,2084.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,555.91,16.8,,,percent of total billed charges,16.8% of total billed charges,506.28,15.3,,,percent of total billed charges,15.3% of total billed charges,2283.21,69,,,percent of total billed charges,69% of total billed charges,3309,100,,,percent of total billed charges,100% of total billed charges,1654.5,50,,,percent of total billed charges,50% of total Billed charges,3309,100,,,percent of total billed charges,100% of total billed charges,1654.5,50,,,percent of total billed charges,50% of total Billed charges,3309,100,,,percent of total billed charges,100% of total billed charges,1654.5,50,,,percent of total billed charges,50% of total Billed charges,2046.62,61.85,,,percent of total billed charges,61.85% of total billed charges,555.91,16.8,,,percent of total billed charges,16.8% of total billed charges,1654.5,50,,,percent of total billed charges,50% of total Billed charges,1654.5,50,,,percent of total billed charges,50% of total Billed charges,555.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,1654.5,50,,,percent of total billed charges,50% of total Billed charges,1654.5,50,,,percent of total billed charges,50% of total Billed charges,567.03,17.136,,,percent of total billed charges,17.136% of total billed charges,722.69,21.84,,,percent of total billed charges,21.84% of total billed charges,1654.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1654.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1654.5,50,,,percent of total billed charges,50% of total Billed charges,2581.02,78,,,percent of total billed charges,78% of total billed charges,3309,100,,,percent of total billed charges,100% of total billed charges,2733.23,82.6,,,percent of total billed charges,82.6% of total billed charges,2733.23,82.6,,,percent of total billed charges,82.6% of total billed charges,555.91,16.8,,,percent of total billed charges,16.8% of total billed charges,1654.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1654.5,50,,,percent of total billed charges,50% of total Billed charges,555.91,16.8,,,percent of total billed charges,16.8% of total billed charges,506.28,3309,
PACK ORTHO EXTREMITY,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
PACK PRINTING COLOR 8 1/2 X 11,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
PACK THORACIC TRAY,182550,CDM,270,RC,,,Outpatient,,,1448,941.20,,1274.24,88,,,percent of total billed charges,88% of total Billed charges,724,50,,,percent of total billed charges,50% of total Billed charges,243.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,1448,100,,,percent of total billed charges,100% of total billed charges,250.56,17.304,,,percent of total billed charges,17.304% of total billed charges,724,50,,,percent of total billed charges,50% of total Billed charges,912.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,243.26,16.8,,,percent of total billed charges,16.8% of total billed charges,221.54,15.3,,,percent of total billed charges,15.3% of total billed charges,999.12,69,,,percent of total billed charges,69% of total billed charges,1448,100,,,percent of total billed charges,100% of total billed charges,724,50,,,percent of total billed charges,50% of total Billed charges,1448,100,,,percent of total billed charges,100% of total billed charges,724,50,,,percent of total billed charges,50% of total Billed charges,1448,100,,,percent of total billed charges,100% of total billed charges,724,50,,,percent of total billed charges,50% of total Billed charges,895.59,61.85,,,percent of total billed charges,61.85% of total billed charges,243.26,16.8,,,percent of total billed charges,16.8% of total billed charges,724,50,,,percent of total billed charges,50% of total Billed charges,724,50,,,percent of total billed charges,50% of total Billed charges,243.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,724,50,,,percent of total billed charges,50% of total Billed charges,724,50,,,percent of total billed charges,50% of total Billed charges,248.13,17.136,,,percent of total billed charges,17.136% of total billed charges,316.24,21.84,,,percent of total billed charges,21.84% of total billed charges,724,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,724,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,724,50,,,percent of total billed charges,50% of total Billed charges,1129.44,78,,,percent of total billed charges,78% of total billed charges,1448,100,,,percent of total billed charges,100% of total billed charges,1196.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1196.05,82.6,,,percent of total billed charges,82.6% of total billed charges,243.26,16.8,,,percent of total billed charges,16.8% of total billed charges,724,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,724,50,,,percent of total billed charges,50% of total Billed charges,243.26,16.8,,,percent of total billed charges,16.8% of total billed charges,221.54,1448,
PACK TOTAL HIP,182548,CDM,270,RC,,,Outpatient,,,1342,872.30,,1180.96,88,,,percent of total billed charges,88% of total Billed charges,671,50,,,percent of total billed charges,50% of total Billed charges,225.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,1342,100,,,percent of total billed charges,100% of total billed charges,232.22,17.304,,,percent of total billed charges,17.304% of total billed charges,671,50,,,percent of total billed charges,50% of total Billed charges,845.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,225.46,16.8,,,percent of total billed charges,16.8% of total billed charges,205.33,15.3,,,percent of total billed charges,15.3% of total billed charges,925.98,69,,,percent of total billed charges,69% of total billed charges,1342,100,,,percent of total billed charges,100% of total billed charges,671,50,,,percent of total billed charges,50% of total Billed charges,1342,100,,,percent of total billed charges,100% of total billed charges,671,50,,,percent of total billed charges,50% of total Billed charges,1342,100,,,percent of total billed charges,100% of total billed charges,671,50,,,percent of total billed charges,50% of total Billed charges,830.03,61.85,,,percent of total billed charges,61.85% of total billed charges,225.46,16.8,,,percent of total billed charges,16.8% of total billed charges,671,50,,,percent of total billed charges,50% of total Billed charges,671,50,,,percent of total billed charges,50% of total Billed charges,225.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,671,50,,,percent of total billed charges,50% of total Billed charges,671,50,,,percent of total billed charges,50% of total Billed charges,229.97,17.136,,,percent of total billed charges,17.136% of total billed charges,293.09,21.84,,,percent of total billed charges,21.84% of total billed charges,671,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,671,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,671,50,,,percent of total billed charges,50% of total Billed charges,1046.76,78,,,percent of total billed charges,78% of total billed charges,1342,100,,,percent of total billed charges,100% of total billed charges,1108.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1108.49,82.6,,,percent of total billed charges,82.6% of total billed charges,225.46,16.8,,,percent of total billed charges,16.8% of total billed charges,671,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,671,50,,,percent of total billed charges,50% of total Billed charges,225.46,16.8,,,percent of total billed charges,16.8% of total billed charges,205.33,1342,
PACK TOTAL KNEE,182549,CDM,270,RC,,,Outpatient,,,1142,742.30,,1004.96,88,,,percent of total billed charges,88% of total Billed charges,571,50,,,percent of total billed charges,50% of total Billed charges,191.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,197.61,17.304,,,percent of total billed charges,17.304% of total billed charges,571,50,,,percent of total billed charges,50% of total Billed charges,719.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,191.86,16.8,,,percent of total billed charges,16.8% of total billed charges,174.73,15.3,,,percent of total billed charges,15.3% of total billed charges,787.98,69,,,percent of total billed charges,69% of total billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,571,50,,,percent of total billed charges,50% of total Billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,571,50,,,percent of total billed charges,50% of total Billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,571,50,,,percent of total billed charges,50% of total Billed charges,706.33,61.85,,,percent of total billed charges,61.85% of total billed charges,191.86,16.8,,,percent of total billed charges,16.8% of total billed charges,571,50,,,percent of total billed charges,50% of total Billed charges,571,50,,,percent of total billed charges,50% of total Billed charges,191.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,571,50,,,percent of total billed charges,50% of total Billed charges,571,50,,,percent of total billed charges,50% of total Billed charges,195.69,17.136,,,percent of total billed charges,17.136% of total billed charges,249.41,21.84,,,percent of total billed charges,21.84% of total billed charges,571,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,571,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,571,50,,,percent of total billed charges,50% of total Billed charges,890.76,78,,,percent of total billed charges,78% of total billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,943.29,82.6,,,percent of total billed charges,82.6% of total billed charges,943.29,82.6,,,percent of total billed charges,82.6% of total billed charges,191.86,16.8,,,percent of total billed charges,16.8% of total billed charges,571,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,571,50,,,percent of total billed charges,50% of total Billed charges,191.86,16.8,,,percent of total billed charges,16.8% of total billed charges,174.73,1142,
PACKET HOLTER MONITOR,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
PACKING IODOFORM 1/2X5,11219,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
PACKING IODOFORM 1/4 X 5,11218,CDM,270,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
PACK NASAL ANT STD RAPD RHINO 4.5CM,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
PACK PREMIUM CLOSURE FAST PROCEDURE,307951,CDM,272,RC,,,Outpatient,,,718,466.70,,631.84,88,,,percent of total billed charges,88% of total Billed charges,359,50,,,percent of total billed charges,50% of total Billed charges,120.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,718,100,,,percent of total billed charges,100% of total billed charges,124.24,17.304,,,percent of total billed charges,17.304% of total billed charges,359,50,,,percent of total billed charges,50% of total Billed charges,452.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,120.62,16.8,,,percent of total billed charges,16.8% of total billed charges,109.85,15.3,,,percent of total billed charges,15.3% of total billed charges,495.42,69,,,percent of total billed charges,69% of total billed charges,718,100,,,percent of total billed charges,100% of total billed charges,359,50,,,percent of total billed charges,50% of total Billed charges,718,100,,,percent of total billed charges,100% of total billed charges,359,50,,,percent of total billed charges,50% of total Billed charges,718,100,,,percent of total billed charges,100% of total billed charges,359,50,,,percent of total billed charges,50% of total Billed charges,444.08,61.85,,,percent of total billed charges,61.85% of total billed charges,120.62,16.8,,,percent of total billed charges,16.8% of total billed charges,359,50,,,percent of total billed charges,50% of total Billed charges,359,50,,,percent of total billed charges,50% of total Billed charges,120.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,359,50,,,percent of total billed charges,50% of total Billed charges,359,50,,,percent of total billed charges,50% of total Billed charges,123.04,17.136,,,percent of total billed charges,17.136% of total billed charges,156.81,21.84,,,percent of total billed charges,21.84% of total billed charges,359,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,359,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,359,50,,,percent of total billed charges,50% of total Billed charges,560.04,78,,,percent of total billed charges,78% of total billed charges,718,100,,,percent of total billed charges,100% of total billed charges,593.07,82.6,,,percent of total billed charges,82.6% of total billed charges,593.07,82.6,,,percent of total billed charges,82.6% of total billed charges,120.62,16.8,,,percent of total billed charges,16.8% of total billed charges,359,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,359,50,,,percent of total billed charges,50% of total Billed charges,120.62,16.8,,,percent of total billed charges,16.8% of total billed charges,109.85,718,
PACKING NASAL RAPID RHINO 7.5,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PACKING VAGINAL STER  2X6,30540,CDM,272,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
"PACK, LAPAROTOMY T-DRAPE",491025,CDM,270,RC,,,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,7.27,17.304,,,percent of total billed charges,17.304% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,26.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,15.3,,,percent of total billed charges,15.3% of total billed charges,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.2,17.136,,,percent of total billed charges,17.136% of total billed charges,9.17,21.84,,,percent of total billed charges,21.84% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,42,
"PACK, THYROID DRAPE",491030,CDM,270,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
PACK NEURO CUSTOM,491016,CDM,270,RC,,,Outpatient,,,1248,811.20,,1098.24,88,,,percent of total billed charges,88% of total Billed charges,624,50,,,percent of total billed charges,50% of total Billed charges,209.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,1248,100,,,percent of total billed charges,100% of total billed charges,215.95,17.304,,,percent of total billed charges,17.304% of total billed charges,624,50,,,percent of total billed charges,50% of total Billed charges,786.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,209.66,16.8,,,percent of total billed charges,16.8% of total billed charges,190.94,15.3,,,percent of total billed charges,15.3% of total billed charges,861.12,69,,,percent of total billed charges,69% of total billed charges,1248,100,,,percent of total billed charges,100% of total billed charges,624,50,,,percent of total billed charges,50% of total Billed charges,1248,100,,,percent of total billed charges,100% of total billed charges,624,50,,,percent of total billed charges,50% of total Billed charges,1248,100,,,percent of total billed charges,100% of total billed charges,624,50,,,percent of total billed charges,50% of total Billed charges,771.89,61.85,,,percent of total billed charges,61.85% of total billed charges,209.66,16.8,,,percent of total billed charges,16.8% of total billed charges,624,50,,,percent of total billed charges,50% of total Billed charges,624,50,,,percent of total billed charges,50% of total Billed charges,209.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,624,50,,,percent of total billed charges,50% of total Billed charges,624,50,,,percent of total billed charges,50% of total Billed charges,213.86,17.136,,,percent of total billed charges,17.136% of total billed charges,272.56,21.84,,,percent of total billed charges,21.84% of total billed charges,624,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,624,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,624,50,,,percent of total billed charges,50% of total Billed charges,973.44,78,,,percent of total billed charges,78% of total billed charges,1248,100,,,percent of total billed charges,100% of total billed charges,1030.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1030.85,82.6,,,percent of total billed charges,82.6% of total billed charges,209.66,16.8,,,percent of total billed charges,16.8% of total billed charges,624,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,624,50,,,percent of total billed charges,50% of total Billed charges,209.66,16.8,,,percent of total billed charges,16.8% of total billed charges,190.94,1248,
"PACK, MINOR ORTHO",491029,CDM,270,RC,,,Outpatient,,,539,350.35,,474.32,88,,,percent of total billed charges,88% of total Billed charges,269.5,50,,,percent of total billed charges,50% of total Billed charges,90.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,539,100,,,percent of total billed charges,100% of total billed charges,93.27,17.304,,,percent of total billed charges,17.304% of total billed charges,269.5,50,,,percent of total billed charges,50% of total Billed charges,339.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,90.55,16.8,,,percent of total billed charges,16.8% of total billed charges,82.47,15.3,,,percent of total billed charges,15.3% of total billed charges,371.91,69,,,percent of total billed charges,69% of total billed charges,539,100,,,percent of total billed charges,100% of total billed charges,269.5,50,,,percent of total billed charges,50% of total Billed charges,539,100,,,percent of total billed charges,100% of total billed charges,269.5,50,,,percent of total billed charges,50% of total Billed charges,539,100,,,percent of total billed charges,100% of total billed charges,269.5,50,,,percent of total billed charges,50% of total Billed charges,333.37,61.85,,,percent of total billed charges,61.85% of total billed charges,90.55,16.8,,,percent of total billed charges,16.8% of total billed charges,269.5,50,,,percent of total billed charges,50% of total Billed charges,269.5,50,,,percent of total billed charges,50% of total Billed charges,90.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,269.5,50,,,percent of total billed charges,50% of total Billed charges,269.5,50,,,percent of total billed charges,50% of total Billed charges,92.36,17.136,,,percent of total billed charges,17.136% of total billed charges,117.72,21.84,,,percent of total billed charges,21.84% of total billed charges,269.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,269.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,269.5,50,,,percent of total billed charges,50% of total Billed charges,420.42,78,,,percent of total billed charges,78% of total billed charges,539,100,,,percent of total billed charges,100% of total billed charges,445.21,82.6,,,percent of total billed charges,82.6% of total billed charges,445.21,82.6,,,percent of total billed charges,82.6% of total billed charges,90.55,16.8,,,percent of total billed charges,16.8% of total billed charges,269.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,269.5,50,,,percent of total billed charges,50% of total Billed charges,90.55,16.8,,,percent of total billed charges,16.8% of total billed charges,82.47,539,
"PACK, MAYO STAND COVER",491028,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
"PACK, LITHOTOMY (PERI/GYN)",491027,CDM,270,RC,,,Outpatient,,,57,37.05,,50.16,88,,,percent of total billed charges,88% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,9.86,17.304,,,percent of total billed charges,17.304% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,35.91,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,8.72,15.3,,,percent of total billed charges,15.3% of total billed charges,39.33,69,,,percent of total billed charges,69% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,35.25,61.85,,,percent of total billed charges,61.85% of total billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.77,17.136,,,percent of total billed charges,17.136% of total billed charges,12.45,21.84,,,percent of total billed charges,21.84% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,44.46,78,,,percent of total billed charges,78% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,8.72,57,
"PACK, LAPAROSCOPY/PELVISCOPY",491024,CDM,270,RC,,,Outpatient,,,138,89.70,,121.44,88,,,percent of total billed charges,88% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,23.88,17.304,,,percent of total billed charges,17.304% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,86.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,21.11,15.3,,,percent of total billed charges,15.3% of total billed charges,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,138,100,,,percent of total billed charges,100% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,85.35,61.85,,,percent of total billed charges,61.85% of total billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,23.65,17.136,,,percent of total billed charges,17.136% of total billed charges,30.14,21.84,,,percent of total billed charges,21.84% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,69,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69,50,,,percent of total billed charges,50% of total Billed charges,23.18,16.8,,,percent of total billed charges,16.8% of total billed charges,21.11,138,
"PACK, LAP CHOLE",491023,CDM,270,RC,,,Outpatient,,,384,249.60,,337.92,88,,,percent of total billed charges,88% of total Billed charges,192,50,,,percent of total billed charges,50% of total Billed charges,64.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,384,100,,,percent of total billed charges,100% of total billed charges,66.45,17.304,,,percent of total billed charges,17.304% of total billed charges,192,50,,,percent of total billed charges,50% of total Billed charges,241.92,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,64.51,16.8,,,percent of total billed charges,16.8% of total billed charges,58.75,15.3,,,percent of total billed charges,15.3% of total billed charges,264.96,69,,,percent of total billed charges,69% of total billed charges,384,100,,,percent of total billed charges,100% of total billed charges,192,50,,,percent of total billed charges,50% of total Billed charges,384,100,,,percent of total billed charges,100% of total billed charges,192,50,,,percent of total billed charges,50% of total Billed charges,384,100,,,percent of total billed charges,100% of total billed charges,192,50,,,percent of total billed charges,50% of total Billed charges,237.5,61.85,,,percent of total billed charges,61.85% of total billed charges,64.51,16.8,,,percent of total billed charges,16.8% of total billed charges,192,50,,,percent of total billed charges,50% of total Billed charges,192,50,,,percent of total billed charges,50% of total Billed charges,64.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,192,50,,,percent of total billed charges,50% of total Billed charges,192,50,,,percent of total billed charges,50% of total Billed charges,65.8,17.136,,,percent of total billed charges,17.136% of total billed charges,83.87,21.84,,,percent of total billed charges,21.84% of total billed charges,192,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,192,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,192,50,,,percent of total billed charges,50% of total Billed charges,299.52,78,,,percent of total billed charges,78% of total billed charges,384,100,,,percent of total billed charges,100% of total billed charges,317.18,82.6,,,percent of total billed charges,82.6% of total billed charges,317.18,82.6,,,percent of total billed charges,82.6% of total billed charges,64.51,16.8,,,percent of total billed charges,16.8% of total billed charges,192,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,192,50,,,percent of total billed charges,50% of total Billed charges,64.51,16.8,,,percent of total billed charges,16.8% of total billed charges,58.75,384,
"PACK, HEAD/NECK EENT IV",491022,CDM,270,RC,,,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,16.27,17.304,,,percent of total billed charges,17.304% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,59.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,58.14,61.85,,,percent of total billed charges,61.85% of total billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,16.11,17.136,,,percent of total billed charges,17.136% of total billed charges,20.53,21.84,,,percent of total billed charges,21.84% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,14.38,94,
"PACK, GENERAL LAP",491021,CDM,270,RC,,,Outpatient,,,391,254.15,,344.08,88,,,percent of total billed charges,88% of total Billed charges,195.5,50,,,percent of total billed charges,50% of total Billed charges,65.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,391,100,,,percent of total billed charges,100% of total billed charges,67.66,17.304,,,percent of total billed charges,17.304% of total billed charges,195.5,50,,,percent of total billed charges,50% of total Billed charges,246.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.69,16.8,,,percent of total billed charges,16.8% of total billed charges,59.82,15.3,,,percent of total billed charges,15.3% of total billed charges,269.79,69,,,percent of total billed charges,69% of total billed charges,391,100,,,percent of total billed charges,100% of total billed charges,195.5,50,,,percent of total billed charges,50% of total Billed charges,391,100,,,percent of total billed charges,100% of total billed charges,195.5,50,,,percent of total billed charges,50% of total Billed charges,391,100,,,percent of total billed charges,100% of total billed charges,195.5,50,,,percent of total billed charges,50% of total Billed charges,241.83,61.85,,,percent of total billed charges,61.85% of total billed charges,65.69,16.8,,,percent of total billed charges,16.8% of total billed charges,195.5,50,,,percent of total billed charges,50% of total Billed charges,195.5,50,,,percent of total billed charges,50% of total Billed charges,65.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,195.5,50,,,percent of total billed charges,50% of total Billed charges,195.5,50,,,percent of total billed charges,50% of total Billed charges,67,17.136,,,percent of total billed charges,17.136% of total billed charges,85.39,21.84,,,percent of total billed charges,21.84% of total billed charges,195.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195.5,50,,,percent of total billed charges,50% of total Billed charges,304.98,78,,,percent of total billed charges,78% of total billed charges,391,100,,,percent of total billed charges,100% of total billed charges,322.97,82.6,,,percent of total billed charges,82.6% of total billed charges,322.97,82.6,,,percent of total billed charges,82.6% of total billed charges,65.69,16.8,,,percent of total billed charges,16.8% of total billed charges,195.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195.5,50,,,percent of total billed charges,50% of total Billed charges,65.69,16.8,,,percent of total billed charges,16.8% of total billed charges,59.82,391,
"PACK, UNIVERSAL EXTREMITY DRAP",491031,CDM,270,RC,,,Outpatient,,,44,28.60,,38.72,88,,,percent of total billed charges,88% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,7.61,17.304,,,percent of total billed charges,17.304% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,15.3,,,percent of total billed charges,15.3% of total billed charges,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.21,61.85,,,percent of total billed charges,61.85% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.54,17.136,,,percent of total billed charges,17.136% of total billed charges,9.61,21.84,,,percent of total billed charges,21.84% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,44,
PACK ENDOSCOPY,491015,CDM,270,RC,,,Outpatient,,,76,49.40,,66.88,88,,,percent of total billed charges,88% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,13.15,17.304,,,percent of total billed charges,17.304% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,47.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,11.63,15.3,,,percent of total billed charges,15.3% of total billed charges,52.44,69,,,percent of total billed charges,69% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,47.01,61.85,,,percent of total billed charges,61.85% of total billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,13.02,17.136,,,percent of total billed charges,17.136% of total billed charges,16.6,21.84,,,percent of total billed charges,21.84% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,59.28,78,,,percent of total billed charges,78% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,11.63,76,
"PACK, C-SECTION STERILE",491019,CDM,272,RC,,,Outpatient,,,523,339.95,,460.24,88,,,percent of total billed charges,88% of total Billed charges,261.5,50,,,percent of total billed charges,50% of total Billed charges,87.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,523,100,,,percent of total billed charges,100% of total billed charges,90.5,17.304,,,percent of total billed charges,17.304% of total billed charges,261.5,50,,,percent of total billed charges,50% of total Billed charges,329.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.86,16.8,,,percent of total billed charges,16.8% of total billed charges,80.02,15.3,,,percent of total billed charges,15.3% of total billed charges,360.87,69,,,percent of total billed charges,69% of total billed charges,523,100,,,percent of total billed charges,100% of total billed charges,261.5,50,,,percent of total billed charges,50% of total Billed charges,523,100,,,percent of total billed charges,100% of total billed charges,261.5,50,,,percent of total billed charges,50% of total Billed charges,523,100,,,percent of total billed charges,100% of total billed charges,261.5,50,,,percent of total billed charges,50% of total Billed charges,323.48,61.85,,,percent of total billed charges,61.85% of total billed charges,87.86,16.8,,,percent of total billed charges,16.8% of total billed charges,261.5,50,,,percent of total billed charges,50% of total Billed charges,261.5,50,,,percent of total billed charges,50% of total Billed charges,87.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,261.5,50,,,percent of total billed charges,50% of total Billed charges,261.5,50,,,percent of total billed charges,50% of total Billed charges,89.62,17.136,,,percent of total billed charges,17.136% of total billed charges,114.22,21.84,,,percent of total billed charges,21.84% of total billed charges,261.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,261.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,261.5,50,,,percent of total billed charges,50% of total Billed charges,407.94,78,,,percent of total billed charges,78% of total billed charges,523,100,,,percent of total billed charges,100% of total billed charges,432,82.6,,,percent of total billed charges,82.6% of total billed charges,432,82.6,,,percent of total billed charges,82.6% of total billed charges,87.86,16.8,,,percent of total billed charges,16.8% of total billed charges,261.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,261.5,50,,,percent of total billed charges,50% of total Billed charges,87.86,16.8,,,percent of total billed charges,16.8% of total billed charges,80.02,523,
PACK DOUBLE BASIN,491014,CDM,270,RC,,,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,10.73,17.304,,,percent of total billed charges,17.304% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,39.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,9.49,15.3,,,percent of total billed charges,15.3% of total billed charges,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,38.35,61.85,,,percent of total billed charges,61.85% of total billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.62,17.136,,,percent of total billed charges,17.136% of total billed charges,13.54,21.84,,,percent of total billed charges,21.84% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,9.49,62,
"PACK, ARTHROSCOPY",491018,CDM,270,RC,,,Outpatient,,,368,239.20,,323.84,88,,,percent of total billed charges,88% of total Billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,61.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,368,100,,,percent of total billed charges,100% of total billed charges,63.68,17.304,,,percent of total billed charges,17.304% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,231.84,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,61.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56.3,15.3,,,percent of total billed charges,15.3% of total billed charges,253.92,69,,,percent of total billed charges,69% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,368,100,,,percent of total billed charges,100% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,368,100,,,percent of total billed charges,100% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,227.61,61.85,,,percent of total billed charges,61.85% of total billed charges,61.82,16.8,,,percent of total billed charges,16.8% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,61.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,63.06,17.136,,,percent of total billed charges,17.136% of total billed charges,80.37,21.84,,,percent of total billed charges,21.84% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,184,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,184,50,,,percent of total billed charges,50% of total Billed charges,287.04,78,,,percent of total billed charges,78% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,61.82,16.8,,,percent of total billed charges,16.8% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,184,50,,,percent of total billed charges,50% of total Billed charges,61.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56.3,368,
PACK LAPAROSCOPY NO GOWNS,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
PACK PERFUSION CUSTOM TERUMO,ORSUP0045,CDM,272,RC,,,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
PACK CAMPYLO,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PACK TOTAL KNEE SUNNYSIDE,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PACK CUSTOM TURNOVER ATH,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
PACK VARITHENA ADMIN,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
PAD R-2 ADULT 610,185683,CDM,270,RC,,,Outpatient,,,217,141.05,,190.96,88,,,percent of total billed charges,88% of total Billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,36.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,217,100,,,percent of total billed charges,100% of total billed charges,37.55,17.304,,,percent of total billed charges,17.304% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,136.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,36.46,16.8,,,percent of total billed charges,16.8% of total billed charges,33.2,15.3,,,percent of total billed charges,15.3% of total billed charges,149.73,69,,,percent of total billed charges,69% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,217,100,,,percent of total billed charges,100% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,217,100,,,percent of total billed charges,100% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,134.21,61.85,,,percent of total billed charges,61.85% of total billed charges,36.46,16.8,,,percent of total billed charges,16.8% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,36.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,37.19,17.136,,,percent of total billed charges,17.136% of total billed charges,47.39,21.84,,,percent of total billed charges,21.84% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,108.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,108.5,50,,,percent of total billed charges,50% of total Billed charges,169.26,78,,,percent of total billed charges,78% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,36.46,16.8,,,percent of total billed charges,16.8% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,108.5,50,,,percent of total billed charges,50% of total Billed charges,36.46,16.8,,,percent of total billed charges,16.8% of total billed charges,33.2,217,
PAD UNDERCAST CRIMPED FINISH 6IN X 4YDS NON-STER,164170,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
PAD UNDERCAST CRIMPED FINISH 4IN X 4YDS NON-STER,164169,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
PAD DEFIB 4 1/2X4 1/2,145669,CDM,270,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
PAD GROUNDING ADULT REM 9IN,10470,CDM,270,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
PAD GROUNDING SINGLE ADULT NON-REM 9FT,7879,CDM,270,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
PAD GROUNDING ARGON THERMOGARD,124820,CDM,270,RC,,,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.4,17.304,,,percent of total billed charges,17.304% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,23.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.34,17.136,,,percent of total billed charges,17.136% of total billed charges,8.08,21.84,,,percent of total billed charges,21.84% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,37,
PAD  POVIDONE IODINE PREP,109428,CDM,270,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
PAD ANTI-FOG MR CLEAR,82817,CDM,270,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
PAD ARCTIC GEL MEDIUM COOLING KIT,ORSUP0033,CDM,270,RC,,,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
PAD ARCTIC SUN LARGE,ORSUP0033,CDM,270,RC,,,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
PAD ARCTIC SUN SMALL,ORSUP0033,CDM,270,RC,,,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
PAD ARCTIC SUN UNIVERSAL,ORSUP0020,CDM,270,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
PAD ELECTRODE DEFIB ONE STEP COMPLETE ZOLL,283912,CDM,270,RC,,,Outpatient,,,3357,2182.05,,2954.16,88,,,percent of total billed charges,88% of total Billed charges,1678.5,50,,,percent of total billed charges,50% of total Billed charges,563.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,3357,100,,,percent of total billed charges,100% of total billed charges,580.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1678.5,50,,,percent of total billed charges,50% of total Billed charges,2114.91,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,563.98,16.8,,,percent of total billed charges,16.8% of total billed charges,513.62,15.3,,,percent of total billed charges,15.3% of total billed charges,2316.33,69,,,percent of total billed charges,69% of total billed charges,3357,100,,,percent of total billed charges,100% of total billed charges,1678.5,50,,,percent of total billed charges,50% of total Billed charges,3357,100,,,percent of total billed charges,100% of total billed charges,1678.5,50,,,percent of total billed charges,50% of total Billed charges,3357,100,,,percent of total billed charges,100% of total billed charges,1678.5,50,,,percent of total billed charges,50% of total Billed charges,2076.3,61.85,,,percent of total billed charges,61.85% of total billed charges,563.98,16.8,,,percent of total billed charges,16.8% of total billed charges,1678.5,50,,,percent of total billed charges,50% of total Billed charges,1678.5,50,,,percent of total billed charges,50% of total Billed charges,563.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,1678.5,50,,,percent of total billed charges,50% of total Billed charges,1678.5,50,,,percent of total billed charges,50% of total Billed charges,575.26,17.136,,,percent of total billed charges,17.136% of total billed charges,733.17,21.84,,,percent of total billed charges,21.84% of total billed charges,1678.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1678.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1678.5,50,,,percent of total billed charges,50% of total Billed charges,2618.46,78,,,percent of total billed charges,78% of total billed charges,3357,100,,,percent of total billed charges,100% of total billed charges,2772.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2772.88,82.6,,,percent of total billed charges,82.6% of total billed charges,563.98,16.8,,,percent of total billed charges,16.8% of total billed charges,1678.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1678.5,50,,,percent of total billed charges,50% of total Billed charges,563.98,16.8,,,percent of total billed charges,16.8% of total billed charges,513.62,3357,
PAD AND WRAP KNEE POSITIONER DEMAYO 294-P,172348,CDM,272,RC,,,Outpatient,,,491,319.15,,432.08,88,,,percent of total billed charges,88% of total Billed charges,245.5,50,,,percent of total billed charges,50% of total Billed charges,82.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,491,100,,,percent of total billed charges,100% of total billed charges,84.96,17.304,,,percent of total billed charges,17.304% of total billed charges,245.5,50,,,percent of total billed charges,50% of total Billed charges,309.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,82.49,16.8,,,percent of total billed charges,16.8% of total billed charges,75.12,15.3,,,percent of total billed charges,15.3% of total billed charges,338.79,69,,,percent of total billed charges,69% of total billed charges,491,100,,,percent of total billed charges,100% of total billed charges,245.5,50,,,percent of total billed charges,50% of total Billed charges,491,100,,,percent of total billed charges,100% of total billed charges,245.5,50,,,percent of total billed charges,50% of total Billed charges,491,100,,,percent of total billed charges,100% of total billed charges,245.5,50,,,percent of total billed charges,50% of total Billed charges,303.68,61.85,,,percent of total billed charges,61.85% of total billed charges,82.49,16.8,,,percent of total billed charges,16.8% of total billed charges,245.5,50,,,percent of total billed charges,50% of total Billed charges,245.5,50,,,percent of total billed charges,50% of total Billed charges,82.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,245.5,50,,,percent of total billed charges,50% of total Billed charges,245.5,50,,,percent of total billed charges,50% of total Billed charges,84.14,17.136,,,percent of total billed charges,17.136% of total billed charges,107.23,21.84,,,percent of total billed charges,21.84% of total billed charges,245.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,245.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,245.5,50,,,percent of total billed charges,50% of total Billed charges,382.98,78,,,percent of total billed charges,78% of total billed charges,491,100,,,percent of total billed charges,100% of total billed charges,405.57,82.6,,,percent of total billed charges,82.6% of total billed charges,405.57,82.6,,,percent of total billed charges,82.6% of total billed charges,82.49,16.8,,,percent of total billed charges,16.8% of total billed charges,245.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,245.5,50,,,percent of total billed charges,50% of total Billed charges,82.49,16.8,,,percent of total billed charges,16.8% of total billed charges,75.12,491,
PAD GROUNDING MONOPOLAR RETURN,288356,CDM,272,RC,,,Outpatient,,,209,135.85,,183.92,88,,,percent of total billed charges,88% of total Billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,35.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,209,100,,,percent of total billed charges,100% of total billed charges,36.17,17.304,,,percent of total billed charges,17.304% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,131.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,35.11,16.8,,,percent of total billed charges,16.8% of total billed charges,31.98,15.3,,,percent of total billed charges,15.3% of total billed charges,144.21,69,,,percent of total billed charges,69% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,209,100,,,percent of total billed charges,100% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,209,100,,,percent of total billed charges,100% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,129.27,61.85,,,percent of total billed charges,61.85% of total billed charges,35.11,16.8,,,percent of total billed charges,16.8% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,35.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,35.81,17.136,,,percent of total billed charges,17.136% of total billed charges,45.65,21.84,,,percent of total billed charges,21.84% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,104.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,104.5,50,,,percent of total billed charges,50% of total Billed charges,163.02,78,,,percent of total billed charges,78% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,35.11,16.8,,,percent of total billed charges,16.8% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,104.5,50,,,percent of total billed charges,50% of total Billed charges,35.11,16.8,,,percent of total billed charges,16.8% of total billed charges,31.98,209,
PAD KNEE INTELLI-FLO,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PAD SANITARY PK OB NON241280,10211,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
PAD POLAR KNEE/SHOULDER,ORSUP0004,CDM,270,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
PAD GROUNDING PEDIATRIC,491034,CDM,270,RC,,,Outpatient,,,57,37.05,,50.16,88,,,percent of total billed charges,88% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,9.86,17.304,,,percent of total billed charges,17.304% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,35.91,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,8.72,15.3,,,percent of total billed charges,15.3% of total billed charges,39.33,69,,,percent of total billed charges,69% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,35.25,61.85,,,percent of total billed charges,61.85% of total billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.77,17.136,,,percent of total billed charges,17.136% of total billed charges,12.45,21.84,,,percent of total billed charges,21.84% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,44.46,78,,,percent of total billed charges,78% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,8.72,57,
PAD GROUNDING ADULT,491033,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
PAD BLUE CHUX,491032,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
PAD ABDOMINAL NONWOVEN CELLULOSE 5X9 STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PADDING CAST 3X4YD STERILE 100 COTTON,258308,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
PADDING CAST 4 INCH STERILE,258307,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
PADDING CAST 6 INCH STERILE,258306,CDM,272,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
PADDING CAST SPLNT SYNTH RAYN 6INX4.0YD,361290,CDM,270,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
PADDING UNDERCAST WEBRIL 3 INCH,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
PAK CUSTOM PLEGIOX,ORSUP0017,CDM,270,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
PAK GI,326419,CDM,270,RC,,,Outpatient,,,392,254.80,,344.96,88,,,percent of total billed charges,88% of total Billed charges,196,50,,,percent of total billed charges,50% of total Billed charges,65.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,392,100,,,percent of total billed charges,100% of total billed charges,67.83,17.304,,,percent of total billed charges,17.304% of total billed charges,196,50,,,percent of total billed charges,50% of total Billed charges,246.96,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.86,16.8,,,percent of total billed charges,16.8% of total billed charges,59.98,15.3,,,percent of total billed charges,15.3% of total billed charges,270.48,69,,,percent of total billed charges,69% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,196,50,,,percent of total billed charges,50% of total Billed charges,392,100,,,percent of total billed charges,100% of total billed charges,196,50,,,percent of total billed charges,50% of total Billed charges,392,100,,,percent of total billed charges,100% of total billed charges,196,50,,,percent of total billed charges,50% of total Billed charges,242.45,61.85,,,percent of total billed charges,61.85% of total billed charges,65.86,16.8,,,percent of total billed charges,16.8% of total billed charges,196,50,,,percent of total billed charges,50% of total Billed charges,196,50,,,percent of total billed charges,50% of total Billed charges,65.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,196,50,,,percent of total billed charges,50% of total Billed charges,196,50,,,percent of total billed charges,50% of total Billed charges,67.17,17.136,,,percent of total billed charges,17.136% of total billed charges,85.61,21.84,,,percent of total billed charges,21.84% of total billed charges,196,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,196,50,,,percent of total billed charges,50% of total Billed charges,305.76,78,,,percent of total billed charges,78% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,65.86,16.8,,,percent of total billed charges,16.8% of total billed charges,196,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,196,50,,,percent of total billed charges,50% of total Billed charges,65.86,16.8,,,percent of total billed charges,16.8% of total billed charges,59.98,392,
PAK OPEN HEART  1  2,326407,CDM,270,RC,,,Outpatient,,,3741,2431.65,,3292.08,88,,,percent of total billed charges,88% of total Billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,628.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,3741,100,,,percent of total billed charges,100% of total billed charges,647.34,17.304,,,percent of total billed charges,17.304% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,2356.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,628.49,16.8,,,percent of total billed charges,16.8% of total billed charges,572.37,15.3,,,percent of total billed charges,15.3% of total billed charges,2581.29,69,,,percent of total billed charges,69% of total billed charges,3741,100,,,percent of total billed charges,100% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,3741,100,,,percent of total billed charges,100% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,3741,100,,,percent of total billed charges,100% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,2313.81,61.85,,,percent of total billed charges,61.85% of total billed charges,628.49,16.8,,,percent of total billed charges,16.8% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,628.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,641.06,17.136,,,percent of total billed charges,17.136% of total billed charges,817.03,21.84,,,percent of total billed charges,21.84% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1870.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1870.5,50,,,percent of total billed charges,50% of total Billed charges,2917.98,78,,,percent of total billed charges,78% of total billed charges,3741,100,,,percent of total billed charges,100% of total billed charges,3090.07,82.6,,,percent of total billed charges,82.6% of total billed charges,3090.07,82.6,,,percent of total billed charges,82.6% of total billed charges,628.49,16.8,,,percent of total billed charges,16.8% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1870.5,50,,,percent of total billed charges,50% of total Billed charges,628.49,16.8,,,percent of total billed charges,16.8% of total billed charges,572.37,3741,
PAKC CUSTOM TURNOVER AASC,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
PANEL RAPID NH,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
PAPER EKG HEAT SENS NO GRID DUAL CHANL 50MM 100',145755,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
PAPER DEFIB ZOLL 80MM PACK,180429,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
PAPER EKG THERMAL,242640,CDM,270,RC,,,Outpatient,,,65,42.25,,57.2,88,,,percent of total billed charges,88% of total Billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,10.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,100,,,percent of total billed charges,100% of total billed charges,11.25,17.304,,,percent of total billed charges,17.304% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,40.95,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.92,16.8,,,percent of total billed charges,16.8% of total billed charges,9.95,15.3,,,percent of total billed charges,15.3% of total billed charges,44.85,69,,,percent of total billed charges,69% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,65,100,,,percent of total billed charges,100% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,65,100,,,percent of total billed charges,100% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,40.2,61.85,,,percent of total billed charges,61.85% of total billed charges,10.92,16.8,,,percent of total billed charges,16.8% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,10.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,11.14,17.136,,,percent of total billed charges,17.136% of total billed charges,14.2,21.84,,,percent of total billed charges,21.84% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.5,50,,,percent of total billed charges,50% of total Billed charges,50.7,78,,,percent of total billed charges,78% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,10.92,16.8,,,percent of total billed charges,16.8% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.5,50,,,percent of total billed charges,50% of total Billed charges,10.92,16.8,,,percent of total billed charges,16.8% of total billed charges,9.95,65,
PAPER PRINTER THERMAL BAYER,171487,CDM,270,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
PAPER FETAL MONITOR,79905,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
PPR CPY 20# 92B LTR WE,156277,CDM,270,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
PAPER 112X45MM WHT RCD THRML,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PAPER TAPE 1,491040,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
PAPER TAPE 1/2,491041,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
PAPER TAPE 2,491042,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
"PAER,EXAM TABLE,SMOTTH,21X225",ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PAPER TABLE SMOOTH 18X225,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PARALLEL VENTROFIX,ORSUP0022,CDM,278,RC,C1755,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
PARTIAL IMMERSION THERMOMETER,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
PASTE ULTRASONIC COUPLING,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
PATCH VENTRALEX SMALL CIRCLE,ORSUP0026,CDM,278,RC,C1781,HCPCS,Outpatient,,,3000,1950.00,,2640,88,,,percent of total billed charges,88% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,519.12,17.304,,,percent of total billed charges,17.304% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1890,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,15.3,,,percent of total billed charges,15.3% of total billed charges,2070,69,,,percent of total billed charges,69% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1855.5,61.85,,,percent of total billed charges,61.85% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,936,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,514.08,17.136,,,percent of total billed charges,17.136% of total billed charges,655.2,21.84,,,percent of total billed charges,21.84% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1017,33.9,,,percent of total billed charges,33.9% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,2340,78,,,percent of total billed charges,78% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,3000,
PATCH HERNIA VENTRALEX MED CIRCLE W/STRAP,ORSUP0022,CDM,278,RC,C1781,HCPCS,Outpatient,,,2200,1430.00,,1936,88,,,percent of total billed charges,88% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,380.69,17.304,,,percent of total billed charges,17.304% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1386,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,15.3,,,percent of total billed charges,15.3% of total billed charges,1518,69,,,percent of total billed charges,69% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1360.7,61.85,,,percent of total billed charges,61.85% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,686.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,376.99,17.136,,,percent of total billed charges,17.136% of total billed charges,480.48,21.84,,,percent of total billed charges,21.84% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,829.4,37.7,,,percent of total billed charges,37.70% of total billed charges,829.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,745.8,33.9,,,percent of total billed charges,33.9% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1716,78,,,percent of total billed charges,78% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,2200,
PATCH PERICARD BOV 10MMX5MM MEDCL ENCAP,ORSUP0016,CDM,278,RC,C1763,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
PATCH GORTEX (CAROTIDS) 17025 15006,ORSUP0017,CDM,278,RC,C1768,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
PATCH PERICARD  BOVINE SHEET 2X9,ORSUP0017,CDM,278,RC,C1768,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
PATCH XENOSURE BOVINE  .8X8CM,ORSUP0014,CDM,278,RC,C1768,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PATCH CARTO 3 SYSTEM EXTERNAL 6/SET,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
PATCH THROMBIX HEMOSTASIS,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PATCH EVARREST 2X4 FIBRIN SEALANT,ORSUP0033,CDM,278,RC,C1763,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
PATCH THROMBIX HEMOSTASIS SILVER,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
PATHODX EXTRACTION REAG #2   R62055,ORSUP0004,CDM,270,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
KIT PATHODX STREP A LATEX,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
LATEX B (STREP GROUPING)PINK R62031,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
PATHO DX GP C,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PATHO DX GP F,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PATHO DX GP G,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PATHODX EXTRACTION REAG #3   R62060,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
PATHFINDER PLUS CONTINUOUS AND PULSATILEIRRIGATION BULB,ORSUP0005,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
PATHLOGY CONTAINER W/ LID 165oz,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PATIENT GARMENT BAGS W/HANGER,420932,CDM,270,RC,,,Outpatient,,,479,311.35,,421.52,88,,,percent of total billed charges,88% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,479,100,,,percent of total billed charges,100% of total billed charges,82.89,17.304,,,percent of total billed charges,17.304% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,301.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,73.29,15.3,,,percent of total billed charges,15.3% of total billed charges,330.51,69,,,percent of total billed charges,69% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,479,100,,,percent of total billed charges,100% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,479,100,,,percent of total billed charges,100% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,296.26,61.85,,,percent of total billed charges,61.85% of total billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,82.08,17.136,,,percent of total billed charges,17.136% of total billed charges,104.61,21.84,,,percent of total billed charges,21.84% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,239.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,239.5,50,,,percent of total billed charges,50% of total Billed charges,373.62,78,,,percent of total billed charges,78% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,239.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,239.5,50,,,percent of total billed charges,50% of total Billed charges,80.47,16.8,,,percent of total billed charges,16.8% of total billed charges,73.29,479,
PATIENT TRACKER AXIEM NON-INVA,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
PATIENT CARE KIT SPINAL JACKSO,491045,CDM,270,RC,,,Outpatient,,,435,282.75,,382.8,88,,,percent of total billed charges,88% of total Billed charges,217.5,50,,,percent of total billed charges,50% of total Billed charges,73.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,435,100,,,percent of total billed charges,100% of total billed charges,75.27,17.304,,,percent of total billed charges,17.304% of total billed charges,217.5,50,,,percent of total billed charges,50% of total Billed charges,274.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,73.08,16.8,,,percent of total billed charges,16.8% of total billed charges,66.56,15.3,,,percent of total billed charges,15.3% of total billed charges,300.15,69,,,percent of total billed charges,69% of total billed charges,435,100,,,percent of total billed charges,100% of total billed charges,217.5,50,,,percent of total billed charges,50% of total Billed charges,435,100,,,percent of total billed charges,100% of total billed charges,217.5,50,,,percent of total billed charges,50% of total Billed charges,435,100,,,percent of total billed charges,100% of total billed charges,217.5,50,,,percent of total billed charges,50% of total Billed charges,269.05,61.85,,,percent of total billed charges,61.85% of total billed charges,73.08,16.8,,,percent of total billed charges,16.8% of total billed charges,217.5,50,,,percent of total billed charges,50% of total Billed charges,217.5,50,,,percent of total billed charges,50% of total Billed charges,73.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,217.5,50,,,percent of total billed charges,50% of total Billed charges,217.5,50,,,percent of total billed charges,50% of total Billed charges,74.54,17.136,,,percent of total billed charges,17.136% of total billed charges,95,21.84,,,percent of total billed charges,21.84% of total billed charges,217.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,217.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,217.5,50,,,percent of total billed charges,50% of total Billed charges,339.3,78,,,percent of total billed charges,78% of total billed charges,435,100,,,percent of total billed charges,100% of total billed charges,359.31,82.6,,,percent of total billed charges,82.6% of total billed charges,359.31,82.6,,,percent of total billed charges,82.6% of total billed charges,73.08,16.8,,,percent of total billed charges,16.8% of total billed charges,217.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,217.5,50,,,percent of total billed charges,50% of total Billed charges,73.08,16.8,,,percent of total billed charges,16.8% of total billed charges,66.56,435,
PATTIES 1/4 X 1/4IN,186930,CDM,270,RC,,,Outpatient,,,57,37.05,,50.16,88,,,percent of total billed charges,88% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,9.86,17.304,,,percent of total billed charges,17.304% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,35.91,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,8.72,15.3,,,percent of total billed charges,15.3% of total billed charges,39.33,69,,,percent of total billed charges,69% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,35.25,61.85,,,percent of total billed charges,61.85% of total billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.77,17.136,,,percent of total billed charges,17.136% of total billed charges,12.45,21.84,,,percent of total billed charges,21.84% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,44.46,78,,,percent of total billed charges,78% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,8.72,57,
PATTIES SURGICAL 1/21/2,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PDS II 0 CT-1 (Z340H),491047,CDM,270,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
PEEL POUCH 3-1/2 X 22,491049,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
PEEL POUCH 8 X 16,491055,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
PEEL AND SEAL BUBBLE MAILER 6.75X9,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
"PEEP VALVE, W/O ADAPTER 65MMX45MM",ORSUP0001,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
PEEP VALVES DISP,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
PEG KIT PUSH,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
PEG KIT PUSH 20 FR SAFETY,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PEG FULLY THREAD 2.5MM X 26MM,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PEG FULLY THREAD 2.5MM X 24MM,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PEG FULLY THREAD 2.5MM X 22MM,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PEG FULLY THREAD 2.5MM X 20MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PEG WRIST THRD TI F/ DVR 2.5X18MM,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PEG FULLY THREAD 2.5MM X 18MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PEG FULLY THREAD 2.5MM X 16MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PEG FULLY THREAD 2.5MM X 14MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
PEG FULLY THREAD 2.5MM X 28MM,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PEG FULLY THREAD 2.5MM X 10MM,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PEG DRIVER F.A.S.T. INSERT 2.0,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
PEG KIT SAFETY 20FR PULL STYLE,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
PELVICOL 4X7,ORSUP0020,CDM,278,RC,C1763,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
PEN SKIN MARKING REG TIP,61203,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
PENROSE DRAIN 3/4 X 18,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PENROSE DRAIN 1/2 X 12,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PENROSE DRAIN 1/4 X 12,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PERCLOSE PROGLIDE 6FR,ORSUP0014,CDM,278,RC,C1760,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PERCARDIOCENTESIS KIT 8.5FR X 22CM,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
PERFORATOR DRILL 14MM DISP,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
PERFUSION PAK,401278,CDM,272,RC,,,Outpatient,,,3582,2328.30,,3152.16,88,,,percent of total billed charges,88% of total Billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,601.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,3582,100,,,percent of total billed charges,100% of total billed charges,619.83,17.304,,,percent of total billed charges,17.304% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,2256.66,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,601.78,16.8,,,percent of total billed charges,16.8% of total billed charges,548.05,15.3,,,percent of total billed charges,15.3% of total billed charges,2471.58,69,,,percent of total billed charges,69% of total billed charges,3582,100,,,percent of total billed charges,100% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,3582,100,,,percent of total billed charges,100% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,3582,100,,,percent of total billed charges,100% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,2215.47,61.85,,,percent of total billed charges,61.85% of total billed charges,601.78,16.8,,,percent of total billed charges,16.8% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,601.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,613.81,17.136,,,percent of total billed charges,17.136% of total billed charges,782.31,21.84,,,percent of total billed charges,21.84% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1791,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1791,50,,,percent of total billed charges,50% of total Billed charges,2793.96,78,,,percent of total billed charges,78% of total billed charges,3582,100,,,percent of total billed charges,100% of total billed charges,2958.73,82.6,,,percent of total billed charges,82.6% of total billed charges,2958.73,82.6,,,percent of total billed charges,82.6% of total billed charges,601.78,16.8,,,percent of total billed charges,16.8% of total billed charges,1791,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1791,50,,,percent of total billed charges,50% of total Billed charges,601.78,16.8,,,percent of total billed charges,16.8% of total billed charges,548.05,3582,
PERI STRIP DRY PROX 75,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
PERI STRIPS DRY STAPLE REINFORCEMENT,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
PERICARDIOCENTISIS TRAY LOCK,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
PERITONEAL DIALYSIS CATH 57CM,ORSUP0013,CDM,272,RC,,,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,504,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
PERITONEAL DIALYSIS CATH 62CM,ORSUP0013,CDM,272,RC,,,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,504,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
PERMANENT CAUTERY HOOK,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
PETRI DISH 100 X 15 STERILE,491060,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
PETRI DISH STACKABLE LID,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
PHENYTOIN,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PHOSPHORUS /5 PACK/300 SLDS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
PICC 5F DL FULL MAX 3CG,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PICC 4F SL FULL MAX 3SCG,ORSUP0014,CDM,278,RC,C1725,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PICC POWER  6FR TRIPLE LUMEN TRAY 3CG,ORSUP0015,CDM,278,RC,C1725,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PICC PROVENA 3F SL MAX 3CG,ORSUP0015,CDM,278,RC,C1725,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PICC PROVENA 5F SL MAX 3CG,ORSUP0016,CDM,278,RC,C1725,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
PICC 4 FR SPECTRUM TURBO-JECT,ORSUP0014,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
PICC LINE SINGLELUMEN 4FR,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
PILLOW HEART POST OP 3811,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PILLOW GENTLETOUCH 7 INCH HEADREST PILLOW WITH RIGHT INTUBATION SLOT,273324,CDM,270,RC,,,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,8.31,17.304,,,percent of total billed charges,17.304% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,30.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,29.69,61.85,,,percent of total billed charges,61.85% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.23,17.136,,,percent of total billed charges,17.136% of total billed charges,10.48,21.84,,,percent of total billed charges,21.84% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,48,
PILLOW PRONE POSITION ADULT,491063,CDM,270,RC,,,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,10.21,17.304,,,percent of total billed charges,17.304% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,37.17,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,15.3,,,percent of total billed charges,15.3% of total billed charges,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,36.49,61.85,,,percent of total billed charges,61.85% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,10.11,17.136,,,percent of total billed charges,17.136% of total billed charges,12.89,21.84,,,percent of total billed charges,21.84% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,59,
PILL CRUSHER,491062,CDM,270,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
PILL CUTTER BLUE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PIN GUIDE 230MM FOR 7MM,ORSUP00011,CDM,278,RC,C1769,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PIN MINI SPIKE DISPENSING,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PINK PAD POSITIONER STANDARD,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PINS DISP ADULT SKULL,ORSUP0004,CDM,278,RC,C1713,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
PIPETTES STANDARD DISPOSABLE TRANSFER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PISTON MCGEE 3.5MM,ORSUP0008,CDM,278,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
PISTON .6X.9X4.0MM CUPPED,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PISTON .6X1.0X4.0 CUPPED,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PISTON .4X1.0X4.5 CUPPED,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PISTON .4X1.0 X4.0MM CUPPED,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PISTON .4X.9X4.5MM CUPPED,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PISTON .4X.9X4.0MM CUPPED,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PLAIN GUT 3-0 FN-2 (N862H),491072,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
PLASMA SPATULA W/CORD 33CM,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PLASMA HOOK,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
PLASTER SPLINT 4 X 15,491076,CDM,270,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
PLASMA OVERWRAPS-STANDARD SIZE,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
PLASTIC SLIDE HOLDER MAILER TRANSPOTER,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
PLASMA LOOP ELECTRODE,ORSUP0068,CDM,272,RC,,,Outpatient,,,11600,7540.00,,10208,88,,,percent of total billed charges,88% of total Billed charges,5800,50,,,percent of total billed charges,50% of total Billed charges,1948.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2007.26,17.304,,,percent of total billed charges,17.304% of total billed charges,5800,50,,,percent of total billed charges,50% of total Billed charges,7308,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1948.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1774.8,15.3,,,percent of total billed charges,15.3% of total billed charges,8004,69,,,percent of total billed charges,69% of total billed charges,11600,100,,,percent of total billed charges,100% of total billed charges,5800,50,,,percent of total billed charges,50% of total Billed charges,11600,100,,,percent of total billed charges,100% of total billed charges,5800,50,,,percent of total billed charges,50% of total Billed charges,11600,100,,,percent of total billed charges,100% of total billed charges,5800,50,,,percent of total billed charges,50% of total Billed charges,7174.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1948.8,16.8,,,percent of total billed charges,16.8% of total billed charges,5800,50,,,percent of total billed charges,50% of total Billed charges,5800,50,,,percent of total billed charges,50% of total Billed charges,1948.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,5800,50,,,percent of total billed charges,50% of total Billed charges,5800,50,,,percent of total billed charges,50% of total Billed charges,1987.78,17.136,,,percent of total billed charges,17.136% of total billed charges,2533.44,21.84,,,percent of total billed charges,21.84% of total billed charges,5800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5800,50,,,percent of total billed charges,50% of total Billed charges,9048,78,,,percent of total billed charges,78% of total billed charges,11600,100,,,percent of total billed charges,100% of total billed charges,9581.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9581.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1948.8,16.8,,,percent of total billed charges,16.8% of total billed charges,5800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5800,50,,,percent of total billed charges,50% of total Billed charges,1948.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1774.8,11600,
PLASTIC BAGS ZIP CLOSURE 12 X 15 CLEAR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
PLASTIC BAGS ZIP CLOSURE 3 CLEAR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
PLASTIC BAGS WITH ZIP CLOSURE CLEAR 10X12,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
PLATE DVR ANATOMIC WIDE HEAD LEFT W/FAST GIDES,ORSUP0023,CDM,278,RC,C1713,HCPCS,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,973.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1057.68,33.9,,,percent of total billed charges,33.9% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
PLATE DVR ANATOMIC WIDE HEAD RIGHT W/FAST GIDES,ORSUP0023,CDM,278,RC,C1713,HCPCS,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,973.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1057.68,33.9,,,percent of total billed charges,33.9% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
PLATE DVR ANATOMIC STANDARD RIGHT,ORSUP0043,CDM,278,RC,C1713,HCPCS,Outpatient,,,8320,5408.00,,7321.6,88,,,percent of total billed charges,88% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1439.69,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5241.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,15.3,,,percent of total billed charges,15.3% of total billed charges,5740.8,69,,,percent of total billed charges,69% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5145.92,61.85,,,percent of total billed charges,61.85% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2595.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1425.72,17.136,,,percent of total billed charges,17.136% of total billed charges,1817.09,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2820.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,6489.6,78,,,percent of total billed charges,78% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,8320,
PLATE DVR ANATOMIC SHORT RIGHT,ORSUP0043,CDM,278,RC,C1713,HCPCS,Outpatient,,,8320,5408.00,,7321.6,88,,,percent of total billed charges,88% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1439.69,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5241.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,15.3,,,percent of total billed charges,15.3% of total billed charges,5740.8,69,,,percent of total billed charges,69% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5145.92,61.85,,,percent of total billed charges,61.85% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2595.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1425.72,17.136,,,percent of total billed charges,17.136% of total billed charges,1817.09,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2820.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,6489.6,78,,,percent of total billed charges,78% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,8320,
PLATE 1/3 TUB LCP 6H 69MM W/COLLAR,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
PLATE 1/3 TUB LCP 7H 81MM W/COLLAR,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
PLATE 1/3 TUB LCP 8H 93MM W/COLLAR,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
PLATE 1-2 TMT STANDARD LEFT TMT-002-12ML,ORSUP0044,CDM,278,RC,C1713,HCPCS,Outpatient,,,8580,5577.00,,7550.4,88,,,percent of total billed charges,88% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1484.68,17.304,,,percent of total billed charges,17.304% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5405.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,15.3,,,percent of total billed charges,15.3% of total billed charges,5920.2,69,,,percent of total billed charges,69% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5306.73,61.85,,,percent of total billed charges,61.85% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,2676.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1470.27,17.136,,,percent of total billed charges,17.136% of total billed charges,1873.87,21.84,,,percent of total billed charges,21.84% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,3234.66,37.7,,,percent of total billed charges,37.70% of total billed charges,3234.66,37.7,,,percent of total billed charges,37.70% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,2908.62,33.9,,,percent of total billed charges,33.9% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,6692.4,78,,,percent of total billed charges,78% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,8580,
PLATE 12-HOLE RIGHT SIDED 02.001.322,ORSUP0048,CDM,278,RC,C1713,HCPCS,Outpatient,,,9620,6253.00,,8465.6,88,,,percent of total billed charges,88% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1664.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,6060.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,15.3,,,percent of total billed charges,15.3% of total billed charges,6637.8,69,,,percent of total billed charges,69% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,5949.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3001.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1648.48,17.136,,,percent of total billed charges,17.136% of total billed charges,2101.01,21.84,,,percent of total billed charges,21.84% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3626.74,37.7,,,percent of total billed charges,37.70% of total billed charges,3626.74,37.7,,,percent of total billed charges,37.70% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3261.18,33.9,,,percent of total billed charges,33.9% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,7503.6,78,,,percent of total billed charges,78% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,9620,
PLATE 2 HOLE LOW PROFILE NEURO STRAIGHT,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PLATE 2.4MM STR  6 HOLE,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PLATE 2.7MM CONDYLAR LCP 7 HOLE,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
PLATE 3.5MM LCP PROXIMAL HUMERUS 6H HEAD/3H SHAFT 241.903 241.903,ORSUP0044,CDM,278,RC,C1713,HCPCS,Outpatient,,,8580,5577.00,,7550.4,88,,,percent of total billed charges,88% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1484.68,17.304,,,percent of total billed charges,17.304% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5405.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,15.3,,,percent of total billed charges,15.3% of total billed charges,5920.2,69,,,percent of total billed charges,69% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5306.73,61.85,,,percent of total billed charges,61.85% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,2676.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1470.27,17.136,,,percent of total billed charges,17.136% of total billed charges,1873.87,21.84,,,percent of total billed charges,21.84% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,3234.66,37.7,,,percent of total billed charges,37.70% of total billed charges,3234.66,37.7,,,percent of total billed charges,37.70% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,2908.62,33.9,,,percent of total billed charges,33.9% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,6692.4,78,,,percent of total billed charges,78% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,8580,
PLATE 4 HOLE Y,ORSUP0034,CDM,278,RC,C1713,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
PLATE 4.5MM CONDYLAR 6 HOLES/170MM-RIGHT,ORSUP0042,CDM,278,RC,C1713,HCPCS,Outpatient,,,8060,5239.00,,7092.8,88,,,percent of total billed charges,88% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1394.7,17.304,,,percent of total billed charges,17.304% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,5077.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,15.3,,,percent of total billed charges,15.3% of total billed charges,5561.4,69,,,percent of total billed charges,69% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4985.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2514.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1381.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1760.3,21.84,,,percent of total billed charges,21.84% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2732.34,33.9,,,percent of total billed charges,33.9% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,6286.8,78,,,percent of total billed charges,78% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,8060,
PLATE 4.5MM CONDYLAR 8 HOLES/206MM-LEFT,ORSUP0043,CDM,278,RC,C1713,HCPCS,Outpatient,,,8320,5408.00,,7321.6,88,,,percent of total billed charges,88% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1439.69,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5241.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,15.3,,,percent of total billed charges,15.3% of total billed charges,5740.8,69,,,percent of total billed charges,69% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5145.92,61.85,,,percent of total billed charges,61.85% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2595.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1425.72,17.136,,,percent of total billed charges,17.136% of total billed charges,1817.09,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2820.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,6489.6,78,,,percent of total billed charges,78% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,8320,
PLATE 9 HOLE 3.5MM,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
PLATE BNE 3.4MM T L133MM LCP LT PROX/TIB 8 HLE,ORSUP0041,CDM,278,RC,C1713,HCPCS,Outpatient,,,7800,5070.00,,6864,88,,,percent of total billed charges,88% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1349.71,17.304,,,percent of total billed charges,17.304% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4914,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,15.3,,,percent of total billed charges,15.3% of total billed charges,5382,69,,,percent of total billed charges,69% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4824.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2433.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1336.61,17.136,,,percent of total billed charges,17.136% of total billed charges,1703.52,21.84,,,percent of total billed charges,21.84% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2644.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,6084,78,,,percent of total billed charges,78% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,7800,
PLATE BNE SM-5DD H28-40MM SYNEX THOR/LMBR,ORSUP0125,CDM,278,RC,C1713,HCPCS,Outpatient,,,31460,20449.00,,27684.8,88,,,percent of total billed charges,88% of total Billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,5285.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5443.84,17.304,,,percent of total billed charges,17.304% of total billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,19819.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5285.28,16.8,,,percent of total billed charges,16.8% of total billed charges,4813.38,15.3,,,percent of total billed charges,15.3% of total billed charges,21707.4,69,,,percent of total billed charges,69% of total billed charges,31460,100,,,percent of total billed charges,100% of total billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,31460,100,,,percent of total billed charges,100% of total billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,31460,100,,,percent of total billed charges,100% of total billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,19458.01,61.85,,,percent of total billed charges,61.85% of total billed charges,5285.28,16.8,,,percent of total billed charges,16.8% of total billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,9815.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15730,50,,,percent of total billed charges,50% of total Billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,5390.99,17.136,,,percent of total billed charges,17.136% of total billed charges,6870.86,21.84,,,percent of total billed charges,21.84% of total billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,11860.42,37.7,,,percent of total billed charges,37.70% of total billed charges,11860.42,37.7,,,percent of total billed charges,37.70% of total billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,10664.94,33.9,,,percent of total billed charges,33.9% of total billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,24538.8,78,,,percent of total billed charges,78% of total billed charges,31460,100,,,percent of total billed charges,100% of total billed charges,25985.96,82.6,,,percent of total billed charges,82.6% of total billed charges,25985.96,82.6,,,percent of total billed charges,82.6% of total billed charges,5285.28,16.8,,,percent of total billed charges,16.8% of total billed charges,15730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15730,50,,,percent of total billed charges,50% of total Billed charges,5285.28,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,31460,
PLATE BNE SS LNG L47MM LCP RT DIST VOLR RADL 4 HD HLE/SHFT H,ORSUP0027,CDM,278,RC,C1713,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
PLATE BNE SS LNG L65MM LCP RT DIST VOLR RADL 4 HD HLE/SHFT H,ORSUP0026,CDM,278,RC,C1713,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
PLATE BNE SS LNG L66MM LCP RT DIST VOLR RADL 5 HD HLE/SHFT H,ORSUP0026,CDM,278,RC,C1713,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
PLATE BONE 3.5MM T L107MM LCP RT PROX TIB 6 HOLE,ORSUP0041,CDM,278,RC,C1713,HCPCS,Outpatient,,,7800,5070.00,,6864,88,,,percent of total billed charges,88% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1349.71,17.304,,,percent of total billed charges,17.304% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4914,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,15.3,,,percent of total billed charges,15.3% of total billed charges,5382,69,,,percent of total billed charges,69% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4824.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2433.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1336.61,17.136,,,percent of total billed charges,17.136% of total billed charges,1703.52,21.84,,,percent of total billed charges,21.84% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2644.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,6084,78,,,percent of total billed charges,78% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,7800,
PLATE BONE L350MM LCP LEFT CONDYLAR 4.5MM CRV 16H,ORSUP0049,CDM,278,RC,C1713,HCPCS,Outpatient,,,9880,6422.00,,8694.4,88,,,percent of total billed charges,88% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1709.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,6224.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1511.64,15.3,,,percent of total billed charges,15.3% of total billed charges,6817.2,69,,,percent of total billed charges,69% of total billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,6110.78,61.85,,,percent of total billed charges,61.85% of total billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,3082.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4940,50,,,percent of total billed charges,50% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,1693.04,17.136,,,percent of total billed charges,17.136% of total billed charges,2157.79,21.84,,,percent of total billed charges,21.84% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,3724.76,37.7,,,percent of total billed charges,37.70% of total billed charges,3724.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,3349.32,33.9,,,percent of total billed charges,33.9% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,7706.4,78,,,percent of total billed charges,78% of total billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,8160.88,82.6,,,percent of total billed charges,82.6% of total billed charges,8160.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4940,50,,,percent of total billed charges,50% of total Billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1511.64,9880,
PLATE BONE SS L116MM LCP MDL DIST TIB 4 HOLE F/3.5MM SCR,ORSUP0041,CDM,278,RC,C1713,HCPCS,Outpatient,,,7800,5070.00,,6864,88,,,percent of total billed charges,88% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1349.71,17.304,,,percent of total billed charges,17.304% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4914,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,15.3,,,percent of total billed charges,15.3% of total billed charges,5382,69,,,percent of total billed charges,69% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4824.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2433.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1336.61,17.136,,,percent of total billed charges,17.136% of total billed charges,1703.52,21.84,,,percent of total billed charges,21.84% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2644.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,6084,78,,,percent of total billed charges,78% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,7800,
PLATE BONE T 6.3 X 54MM 8 HOLE SHAFT 3 HOLE HEAD FOR 2.4MM SCREW,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PLATE BONE VECTRA TI L41MM L32MM ANT CERV 2 LVL,ORSUP0034,CDM,278,RC,C1713,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
PLATE BONE VECTRA TI L49MM L40MM ANT CERV 2 LVL,ORSUP0041,CDM,278,RC,C1713,HCPCS,Outpatient,,,7800,5070.00,,6864,88,,,percent of total billed charges,88% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1349.71,17.304,,,percent of total billed charges,17.304% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4914,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,15.3,,,percent of total billed charges,15.3% of total billed charges,5382,69,,,percent of total billed charges,69% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,4824.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2433.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3900,50,,,percent of total billed charges,50% of total Billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,1336.61,17.136,,,percent of total billed charges,17.136% of total billed charges,1703.52,21.84,,,percent of total billed charges,21.84% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2940.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,2644.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,6084,78,,,percent of total billed charges,78% of total billed charges,7800,100,,,percent of total billed charges,100% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6442.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3900,50,,,percent of total billed charges,50% of total Billed charges,1310.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1193.4,7800,
PLATE BONE VECTRA TI L57MM L48MM CERV 3 LVL,ORSUP0036,CDM,278,RC,C1713,HCPCS,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4095,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
PLATE BONE VECTRA TI L66MM L57MM ANT CERV 3 LVL,ORSUP0036,CDM,278,RC,C1713,HCPCS,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4095,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
PLATE BOX TI LOW PROFILE NEURO 14MM 4 HOLES,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
PLATE CANCANEAL LOCKING 241.623,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
PLATE DCP 2.4MM 6 HOLE,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PLATE DHS SHORT BARREL 135 DEGREE 4 HOLE,ORSUP0022,CDM,278,RC,C1713,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
PLATE DHS STANDARD BARREL 135 DEGREE 4 HOLE,ORSUP0022,CDM,278,RC,C1713,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
PLATE DHS STANDARD BARREL 135 DEGREE 5 HOLE,ORSUP0022,CDM,278,RC,C1713,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
PLATE LC-DCP TITANM 2.4MM X 31MM 4 HOLE,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
PLATE LCP 4.5MM 12 HOLE/224MM NARROW,ORSUP0025,CDM,278,RC,C1713,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
PLATE LCP 4.5MM 14 HOLE/260MM BROAD,ORSUP0028,CDM,278,RC,C1713,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
PLATE LCP 4.5MM 6 HOLE/116MM NARROW,ORSUP0022,CDM,278,RC,C1713,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
PLATE LCP NARROW 4.5 X 188MM X 10 HOLE,ORSUP0023,CDM,278,RC,C1713,HCPCS,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,973.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1057.68,33.9,,,percent of total billed charges,33.9% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
PLATE LCP RECON 12 HOLE 168MM,ORSUP0028,CDM,278,RC,C1713,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
PLATE LEVEL 2,ORSUP0042,CDM,278,RC,C1713,HCPCS,Outpatient,,,8060,5239.00,,7092.8,88,,,percent of total billed charges,88% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1394.7,17.304,,,percent of total billed charges,17.304% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,5077.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,15.3,,,percent of total billed charges,15.3% of total billed charges,5561.4,69,,,percent of total billed charges,69% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4985.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2514.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1381.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1760.3,21.84,,,percent of total billed charges,21.84% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2732.34,33.9,,,percent of total billed charges,33.9% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,6286.8,78,,,percent of total billed charges,78% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,8060,
PLATE LOCKING 5 HOLE TUBE,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
PLATE LOW PROFILE NEURO Y SHAPE,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
PLATE ONE LEVEL TITANIUM VECTRA 20MM,ORSUP0040,CDM,278,RC,C1713,HCPCS,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
PLATE PEANUT STANDARD MFT-002-PM,ORSUP0037,CDM,278,RC,C1713,HCPCS,Outpatient,,,6760,4394.00,,5948.8,88,,,percent of total billed charges,88% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1169.75,17.304,,,percent of total billed charges,17.304% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4258.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,15.3,,,percent of total billed charges,15.3% of total billed charges,4664.4,69,,,percent of total billed charges,69% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4181.06,61.85,,,percent of total billed charges,61.85% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2109.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1158.39,17.136,,,percent of total billed charges,17.136% of total billed charges,1476.38,21.84,,,percent of total billed charges,21.84% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2291.64,33.9,,,percent of total billed charges,33.9% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,5272.8,78,,,percent of total billed charges,78% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,6760,
PLATE RECON 3.5MM 5 HOLE,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
PLATE RECON 3.5MM 8H 112MM,ORSUP0029,CDM,278,RC,C1713,HCPCS,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1460.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1586.52,33.9,,,percent of total billed charges,33.9% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
PLATE RECON LCP 3.5MM 10H 140MM,ORSUP0027,CDM,278,RC,C1713,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
PLATE STANDARD LEFT MTP MTP-002-SL,ORSUP0040,CDM,278,RC,C1713,HCPCS,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
PLATE STANDARD RIGHT MTP MTP-002-SR,ORSUP0040,CDM,278,RC,C1713,HCPCS,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
PLATE STRUT TI LOW PROFILE NEURO 6 HOLES,ORSUP0022,CDM,278,RC,C1713,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
PLATE STRUT TI LOW PROFILE NEURO 8 HOLES,ORSUP0025,CDM,278,RC,C1713,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
PLATE T TITANIUM 1.5MM,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
PLATE T TITANM 2.4MM X 54MM 2 HOLE HEAD 8 HOLE SHAFT,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
PLATE THIN FLAP DBL Y,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PLATE TITANIUM 2.0MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PLATE TITANIUM 6 HOLE 1.5MM,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,811.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,881.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
PLATE TITANIUM DCP 4 HOLE,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
PLATE TITANIUM T 3 HEAD 8 SHAFT,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
PLATE TUBULAR 10 HOLE,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
PLATE TUBULAR 12 HOLE,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PLATE WIDE 2-HOLE,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PLATE Y MFT-002-Y,ORSUP0040,CDM,278,RC,C1713,HCPCS,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
PLATE Y TITANM 2.4MM X 56MM 3 HOLE HEAD 8 HOLE SHAFT,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PLATES UNIVERSAL ORBITAL FLOOR  FOR 1.0MM SCREWS 420.40,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
PLATE 25MM 1 LEVEL,ORSUP0037,CDM,278,RC,C1755,HCPCS,Outpatient,,,6760,4394.00,,5948.8,88,,,percent of total billed charges,88% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1169.75,17.304,,,percent of total billed charges,17.304% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,15.3,,,percent of total billed charges,15.3% of total billed charges,4664.4,69,,,percent of total billed charges,69% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4181.06,61.85,,,percent of total billed charges,61.85% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2109.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1158.39,17.136,,,percent of total billed charges,17.136% of total billed charges,1476.38,21.84,,,percent of total billed charges,21.84% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2291.64,33.9,,,percent of total billed charges,33.9% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,5272.8,78,,,percent of total billed charges,78% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,6760,
PLATE 3 LEVEL  57MM,ORSUP0043,CDM,278,RC,C1755,HCPCS,Outpatient,,,8320,5408.00,,7321.6,88,,,percent of total billed charges,88% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1439.69,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,15.3,,,percent of total billed charges,15.3% of total billed charges,5740.8,69,,,percent of total billed charges,69% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5145.92,61.85,,,percent of total billed charges,61.85% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2595.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1425.72,17.136,,,percent of total billed charges,17.136% of total billed charges,1817.09,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2820.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,6489.6,78,,,percent of total billed charges,78% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,8320,
PLATE BONE VECTRA TI L39MM L30MM ANT CERV 2 LVL,ORSUP0035,CDM,278,RC,C1755,HCPCS,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
PLATE BONE VECTRA TI L63MM L54MM ANT CERV 3 LVL,ORSUP0036,CDM,278,RC,C1755,HCPCS,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
PLATE SYNTHES VECTRA 14MM 04.613.154,ORSUP0047,CDM,278,RC,C1755,HCPCS,Outpatient,,,9360,6084.00,,8236.8,88,,,percent of total billed charges,88% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1619.65,17.304,,,percent of total billed charges,17.304% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1432.08,15.3,,,percent of total billed charges,15.3% of total billed charges,6458.4,69,,,percent of total billed charges,69% of total billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,5789.16,61.85,,,percent of total billed charges,61.85% of total billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,2920.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4680,50,,,percent of total billed charges,50% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,1603.93,17.136,,,percent of total billed charges,17.136% of total billed charges,2044.22,21.84,,,percent of total billed charges,21.84% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,3528.72,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.72,37.7,,,percent of total billed charges,37.70% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,3173.04,33.9,,,percent of total billed charges,33.9% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,7300.8,78,,,percent of total billed charges,78% of total billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,7731.36,82.6,,,percent of total billed charges,82.6% of total billed charges,7731.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4680,50,,,percent of total billed charges,50% of total Billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1432.08,9360,
PLATE LEFT,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
PLATE T TITANIUN  4X8,ORSUP0032,CDM,278,RC,C1713,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
PLATE 2.0 TITANIUM 6HL 36MM,ORSUP0034,CDM,278,RC,C1713,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
PLATE PROXIMAL HUMERUS 3.5MM 3HL 90MM LENGTH,ORSUP0082,CDM,278,RC,C1713,HCPCS,Outpatient,,,18720,12168.00,,16473.6,88,,,percent of total billed charges,88% of total Billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,3144.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3239.31,17.304,,,percent of total billed charges,17.304% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,11793.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3144.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2864.16,15.3,,,percent of total billed charges,15.3% of total billed charges,12916.8,69,,,percent of total billed charges,69% of total billed charges,18720,100,,,percent of total billed charges,100% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,18720,100,,,percent of total billed charges,100% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,18720,100,,,percent of total billed charges,100% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,11578.32,61.85,,,percent of total billed charges,61.85% of total billed charges,3144.96,16.8,,,percent of total billed charges,16.8% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,5840.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9360,50,,,percent of total billed charges,50% of total Billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,3207.86,17.136,,,percent of total billed charges,17.136% of total billed charges,4088.45,21.84,,,percent of total billed charges,21.84% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,7057.44,37.7,,,percent of total billed charges,37.70% of total billed charges,7057.44,37.7,,,percent of total billed charges,37.70% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,6346.08,33.9,,,percent of total billed charges,33.9% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,14601.6,78,,,percent of total billed charges,78% of total billed charges,18720,100,,,percent of total billed charges,100% of total billed charges,15462.72,82.6,,,percent of total billed charges,82.6% of total billed charges,15462.72,82.6,,,percent of total billed charges,82.6% of total billed charges,3144.96,16.8,,,percent of total billed charges,16.8% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9360,50,,,percent of total billed charges,50% of total Billed charges,3144.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2864.16,18720,
PLATELET ROTATOR TEMP CHART BLOOD BANK,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
PLEDGET POLYMER TFE SUT BUTTRESS 3/8 X 3/16 X 1/16,188053,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
PLEDGET TEFLON 1/4X1/8X1/16,120747,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
PLEUR-EVAC CHEST DRAIN DRY SUCTION SINGLE CHAMBER,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
PLIERS PLATE BENDING,408630,CDM,272,RC,,,Outpatient,,,1188,772.20,,1045.44,88,,,percent of total billed charges,88% of total Billed charges,594,50,,,percent of total billed charges,50% of total Billed charges,199.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,205.57,17.304,,,percent of total billed charges,17.304% of total billed charges,594,50,,,percent of total billed charges,50% of total Billed charges,748.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,199.58,16.8,,,percent of total billed charges,16.8% of total billed charges,181.76,15.3,,,percent of total billed charges,15.3% of total billed charges,819.72,69,,,percent of total billed charges,69% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,594,50,,,percent of total billed charges,50% of total Billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,594,50,,,percent of total billed charges,50% of total Billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,594,50,,,percent of total billed charges,50% of total Billed charges,734.78,61.85,,,percent of total billed charges,61.85% of total billed charges,199.58,16.8,,,percent of total billed charges,16.8% of total billed charges,594,50,,,percent of total billed charges,50% of total Billed charges,594,50,,,percent of total billed charges,50% of total Billed charges,199.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,594,50,,,percent of total billed charges,50% of total Billed charges,594,50,,,percent of total billed charges,50% of total Billed charges,203.58,17.136,,,percent of total billed charges,17.136% of total billed charges,259.46,21.84,,,percent of total billed charges,21.84% of total billed charges,594,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,594,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,594,50,,,percent of total billed charges,50% of total Billed charges,926.64,78,,,percent of total billed charges,78% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,199.58,16.8,,,percent of total billed charges,16.8% of total billed charges,594,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,594,50,,,percent of total billed charges,50% of total Billed charges,199.58,16.8,,,percent of total billed charges,16.8% of total billed charges,181.76,1188,
PLUG MARLEX LARGE 011297,ORSUP0013,CDM,278,RC,C1781,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
PLUG PERFIX MEDIUM,ORSUP0013,CDM,278,RC,C1781,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
PLUG CATHETER  CAP STERILE,145854,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
PLUGS EAR DISP PK/200,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
PLUG AMPLATZER VASCULAR 10MM,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
PLUG AMPLATZER VASCULAR 12MM,ORSUP0030,CDM,272,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
PLUG AMPLATZER VASCULAR 6MM,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
PLUG AMPLATZER VASCULAR 8MM,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
PLUGS EAR MAGNAPLUGS MRI,ORSUP0001,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
PLUMEPEN SMOKE EVAC PENCIL,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
PMKR SINGL RATE-RSL4,CATH00070,CDM,275,RC,C1786,HCPCS,Outpatient,,,53012,34457.80,,46650.56,88,,,percent of total billed charges,88% of total Billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,8906.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,9173.2,17.304,,,percent of total billed charges,17.304% of total billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,33397.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8906.02,16.8,,,percent of total billed charges,16.8% of total billed charges,8110.84,15.3,,,percent of total billed charges,15.3% of total billed charges,36578.28,69,,,percent of total billed charges,69% of total billed charges,53012,100,,,percent of total billed charges,100% of total billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,53012,100,,,percent of total billed charges,100% of total billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,53012,100,,,percent of total billed charges,100% of total billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,32787.92,61.85,,,percent of total billed charges,61.85% of total billed charges,8906.02,16.8,,,percent of total billed charges,16.8% of total billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,16539.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26506,50,,,percent of total billed charges,50% of total Billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,9084.14,17.136,,,percent of total billed charges,17.136% of total billed charges,11577.82,21.84,,,percent of total billed charges,21.84% of total billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,19985.52,37.7,,,percent of total billed charges,37.70% of total billed charges,19985.52,37.7,,,percent of total billed charges,37.70% of total billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,17971.07,33.9,,,percent of total billed charges,33.9% of total billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,41349.36,78,,,percent of total billed charges,78% of total billed charges,53012,100,,,percent of total billed charges,100% of total billed charges,43787.91,82.6,,,percent of total billed charges,82.6% of total billed charges,43787.91,82.6,,,percent of total billed charges,82.6% of total billed charges,8906.02,16.8,,,percent of total billed charges,16.8% of total billed charges,26506,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26506,50,,,percent of total billed charges,50% of total Billed charges,8906.02,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,53012,
PNEUMOTHORAX CATH TROCAR SET,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
PNEUMOTHORAX CATH  SET,ORSUP0016,CDM,272,RC,,,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,199,17.304,,,percent of total billed charges,17.304% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,724.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,15.3,,,percent of total billed charges,15.3% of total billed charges,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,711.28,61.85,,,percent of total billed charges,61.85% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,197.06,17.136,,,percent of total billed charges,17.136% of total billed charges,251.16,21.84,,,percent of total billed charges,21.84% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,1150,
PO2 ELECTRODE,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
POLAR CARE KODIAK,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
POLAR PUMP \\T\\ COOLER,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
POLAR CARE ANKLE PAD,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
POLAR CARE CUBE W/ KNEE \\T\\ SHOULDER PAD,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
POLYPSNARE LARGE             000472,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
POLYP ROTH NET,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
POLYVINYL ALCOHOL (PVA) FOAM PARTICLES,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
POOLED SCREEN 0.8% 2X10ML,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
POPE OTO-WICK 15MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PORT POWER  (GROSHONG CATH) IMPL INFSN ISP MRI 8FR 1808560,ORSUP0027,CDM,278,RC,,,Outpatient,,,1600,1040.00,,1408,88,,,percent of total billed charges,88% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,276.86,17.304,,,percent of total billed charges,17.304% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1008,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1104,69,,,percent of total billed charges,69% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,989.6,61.85,,,percent of total billed charges,61.85% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,499.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,274.18,17.136,,,percent of total billed charges,17.136% of total billed charges,349.44,21.84,,,percent of total billed charges,21.84% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,603.2,37.7,,,percent of total billed charges,37.70% of total billed charges,603.2,37.7,,,percent of total billed charges,37.70% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,542.4,33.9,,,percent of total billed charges,33.9% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1248,78,,,percent of total billed charges,78% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,1600,
PORT SEAL ADJUSTABLE BIOPSY  5 PK,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
PORT SINGLE-SITE FOR 8.5MM ENDOSCOPE DA VINCI (SINGLE USE),337818,CDM,272,RC,,,Outpatient,,,1144,743.60,,1006.72,88,,,percent of total billed charges,88% of total Billed charges,572,50,,,percent of total billed charges,50% of total Billed charges,192.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,1144,100,,,percent of total billed charges,100% of total billed charges,197.96,17.304,,,percent of total billed charges,17.304% of total billed charges,572,50,,,percent of total billed charges,50% of total Billed charges,720.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,192.19,16.8,,,percent of total billed charges,16.8% of total billed charges,175.03,15.3,,,percent of total billed charges,15.3% of total billed charges,789.36,69,,,percent of total billed charges,69% of total billed charges,1144,100,,,percent of total billed charges,100% of total billed charges,572,50,,,percent of total billed charges,50% of total Billed charges,1144,100,,,percent of total billed charges,100% of total billed charges,572,50,,,percent of total billed charges,50% of total Billed charges,1144,100,,,percent of total billed charges,100% of total billed charges,572,50,,,percent of total billed charges,50% of total Billed charges,707.56,61.85,,,percent of total billed charges,61.85% of total billed charges,192.19,16.8,,,percent of total billed charges,16.8% of total billed charges,572,50,,,percent of total billed charges,50% of total Billed charges,572,50,,,percent of total billed charges,50% of total Billed charges,192.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,572,50,,,percent of total billed charges,50% of total Billed charges,572,50,,,percent of total billed charges,50% of total Billed charges,196.04,17.136,,,percent of total billed charges,17.136% of total billed charges,249.85,21.84,,,percent of total billed charges,21.84% of total billed charges,572,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,572,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,572,50,,,percent of total billed charges,50% of total Billed charges,892.32,78,,,percent of total billed charges,78% of total billed charges,1144,100,,,percent of total billed charges,100% of total billed charges,944.94,82.6,,,percent of total billed charges,82.6% of total billed charges,944.94,82.6,,,percent of total billed charges,82.6% of total billed charges,192.19,16.8,,,percent of total billed charges,16.8% of total billed charges,572,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,572,50,,,percent of total billed charges,50% of total Billed charges,192.19,16.8,,,percent of total billed charges,16.8% of total billed charges,175.03,1144,
PORT SUTURE CLOSURE SUTURE PASSER II,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
PORT POWER SLIM,ORSUP0027,CDM,278,RC,C1788,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
POSITIONER LAMINECTOMY ARM CRADLE FOAM,179799,CDM,270,RC,,,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.88,17.304,,,percent of total billed charges,17.304% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.83,17.136,,,percent of total billed charges,17.136% of total billed charges,7.43,21.84,,,percent of total billed charges,21.84% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,34,
POST-OP SHOE WOMEN SMALL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
POST-OP SHOE WOMEN MEDIUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
POST-OP SHOE WOMEN LARGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
POST-OP SHOE MEN SMALL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
POST-OP SHOE MEN MEDIUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
POST-OP SHOE MEN LARGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
POST SURGICAL BREAST BINDER XLRG PINK FLORAL,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
POTASSIUM HYDROXIDE 10%,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
POTASSIUM /K+/5 PACK/250 SLDS,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
POTASSIUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
POUCH TYVEK W/STERRAD IND. SELF-SEAL  6 X 12.5    CS/500,232458,CDM,270,RC,,,Outpatient,,,580,377.00,,510.4,88,,,percent of total billed charges,88% of total Billed charges,290,50,,,percent of total billed charges,50% of total Billed charges,97.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,580,100,,,percent of total billed charges,100% of total billed charges,100.36,17.304,,,percent of total billed charges,17.304% of total billed charges,290,50,,,percent of total billed charges,50% of total Billed charges,365.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,97.44,16.8,,,percent of total billed charges,16.8% of total billed charges,88.74,15.3,,,percent of total billed charges,15.3% of total billed charges,400.2,69,,,percent of total billed charges,69% of total billed charges,580,100,,,percent of total billed charges,100% of total billed charges,290,50,,,percent of total billed charges,50% of total Billed charges,580,100,,,percent of total billed charges,100% of total billed charges,290,50,,,percent of total billed charges,50% of total Billed charges,580,100,,,percent of total billed charges,100% of total billed charges,290,50,,,percent of total billed charges,50% of total Billed charges,358.73,61.85,,,percent of total billed charges,61.85% of total billed charges,97.44,16.8,,,percent of total billed charges,16.8% of total billed charges,290,50,,,percent of total billed charges,50% of total Billed charges,290,50,,,percent of total billed charges,50% of total Billed charges,97.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,290,50,,,percent of total billed charges,50% of total Billed charges,290,50,,,percent of total billed charges,50% of total Billed charges,99.39,17.136,,,percent of total billed charges,17.136% of total billed charges,126.67,21.84,,,percent of total billed charges,21.84% of total billed charges,290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,290,50,,,percent of total billed charges,50% of total Billed charges,452.4,78,,,percent of total billed charges,78% of total billed charges,580,100,,,percent of total billed charges,100% of total billed charges,479.08,82.6,,,percent of total billed charges,82.6% of total billed charges,479.08,82.6,,,percent of total billed charges,82.6% of total billed charges,97.44,16.8,,,percent of total billed charges,16.8% of total billed charges,290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,290,50,,,percent of total billed charges,50% of total Billed charges,97.44,16.8,,,percent of total billed charges,16.8% of total billed charges,88.74,580,
POUCH  STERILE 11IN X 4IN,290571,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
POUCH STERILIZATION  4.5 INCH X 11 INCH,287630,CDM,272,RC,,,Outpatient,,,80,52.00,,70.4,88,,,percent of total billed charges,88% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,13.84,17.304,,,percent of total billed charges,17.304% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,50.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,12.24,15.3,,,percent of total billed charges,15.3% of total billed charges,55.2,69,,,percent of total billed charges,69% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,49.48,61.85,,,percent of total billed charges,61.85% of total billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.71,17.136,,,percent of total billed charges,17.136% of total billed charges,17.47,21.84,,,percent of total billed charges,21.84% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,62.4,78,,,percent of total billed charges,78% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,12.24,80,
POUCH STERILIZATION  5.25 X 10 SELF SEAL,288005,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
POUCH STERILIZATION  6 INCH X 15 INCH,287636,CDM,272,RC,,,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,17.48,17.304,,,percent of total billed charges,17.304% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,63.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,15.45,15.3,,,percent of total billed charges,15.3% of total billed charges,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,101,100,,,percent of total billed charges,100% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,62.47,61.85,,,percent of total billed charges,61.85% of total billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,17.31,17.136,,,percent of total billed charges,17.136% of total billed charges,22.06,21.84,,,percent of total billed charges,21.84% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,50.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50.5,50,,,percent of total billed charges,50% of total Billed charges,16.97,16.8,,,percent of total billed charges,16.8% of total billed charges,15.45,101,
POUCH STERILIZATION 4 X 22,171710,CDM,272,RC,,,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,23.36,17.304,,,percent of total billed charges,17.304% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,85.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,61.85,,,percent of total billed charges,61.85% of total billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,23.13,17.136,,,percent of total billed charges,17.136% of total billed charges,29.48,21.84,,,percent of total billed charges,21.84% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,20.66,135,
POUCH STERILIZATION 4 X 8,203171,CDM,272,RC,,,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,15.75,17.304,,,percent of total billed charges,17.304% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,57.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,15.3,,,percent of total billed charges,15.3% of total billed charges,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,56.28,61.85,,,percent of total billed charges,61.85% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.59,17.136,,,percent of total billed charges,17.136% of total billed charges,19.87,21.84,,,percent of total billed charges,21.84% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,91,
POUCH STERILIZATION 8 X 13,204987,CDM,272,RC,,,Outpatient,,,225,146.25,,198,88,,,percent of total billed charges,88% of total Billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,37.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,100,,,percent of total billed charges,100% of total billed charges,38.93,17.304,,,percent of total billed charges,17.304% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,141.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,37.8,16.8,,,percent of total billed charges,16.8% of total billed charges,34.43,15.3,,,percent of total billed charges,15.3% of total billed charges,155.25,69,,,percent of total billed charges,69% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,225,100,,,percent of total billed charges,100% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,225,100,,,percent of total billed charges,100% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,139.16,61.85,,,percent of total billed charges,61.85% of total billed charges,37.8,16.8,,,percent of total billed charges,16.8% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,37.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,38.56,17.136,,,percent of total billed charges,17.136% of total billed charges,49.14,21.84,,,percent of total billed charges,21.84% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,112.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,112.5,50,,,percent of total billed charges,50% of total Billed charges,175.5,78,,,percent of total billed charges,78% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,37.8,16.8,,,percent of total billed charges,16.8% of total billed charges,112.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,112.5,50,,,percent of total billed charges,50% of total Billed charges,37.8,16.8,,,percent of total billed charges,16.8% of total billed charges,34.43,225,
POUCH ANAEROBE GENERATOR SMALL,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
POUCH SELF SEAL 3.5X5.25,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
POUCH SELF SEAL 4X11,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
POUCH SELF SEAL 12X15,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
POUCH SELF SEAL 13X18,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
POVIDONE IODINE LIQUID POUCHES 3/4 oz,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
POWERGLIDE PRO 18 GA X 10CM BASIC,ORSUP0006,CDM,278,RC,C1725,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
POWERGLIDE PRO 18 GA X 10CM FULL,ORSUP0009,CDM,278,RC,C1725,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
POWERGLIDE PRO 18 GA X 8CM BASIC,ORSUP0006,CDM,278,RC,C1725,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
POWERGLIDE PRO 18GA X 8CM FULL,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
POWERGLIDE PRO 20 GA X 10CM BASIC,ORSUP0006,CDM,278,RC,C1725,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
POWERGLIDE PRO 20 GA X 18CM FULL,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
POWERGLIDE PRO 20 GA X 8CM BASIC,ORSUP0006,CDM,278,RC,C1725,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
POWERGLIDE PRO 20GA 10CM FULL,ORSUP0009,CDM,278,RC,C1725,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
POWERGLIDE PRO 22GA X 8CM BASIC,ORSUP0007,CDM,278,RC,C1725,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
POWERGLIDE PRO 22GA X 8CM FULL,ORSUP0011,CDM,278,RC,C1725,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
POWERLINE MIDLINE KITS 20GA 10CM,ORSUP0007,CDM,278,RC,C1725,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
POWER PORT MRI 8FR ATTACHABLE CATH,ORSUP0019,CDM,278,RC,,,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,504,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,271.2,33.9,,,percent of total billed charges,33.9% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
POWER PULSE KIT,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
POWER PORT 8FR SNGL LUMEN BARD,ORSUP0026,CDM,270,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
POWER PORT 8 FR CLEARVIEW MRI,ORSUP0027,CDM,278,RC,C1788,HCPCS,Outpatient,,,1600,1040.00,,1408,88,,,percent of total billed charges,88% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,276.86,17.304,,,percent of total billed charges,17.304% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1008,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1104,69,,,percent of total billed charges,69% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,989.6,61.85,,,percent of total billed charges,61.85% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,499.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,274.18,17.136,,,percent of total billed charges,17.136% of total billed charges,349.44,21.84,,,percent of total billed charges,21.84% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,603.2,37.7,,,percent of total billed charges,37.70% of total billed charges,603.2,37.7,,,percent of total billed charges,37.70% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,542.4,33.9,,,percent of total billed charges,33.9% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1248,78,,,percent of total billed charges,78% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,1600,
POWER PICC KIT 5 FR,ORSUP0013,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
POWERLOC 20G X 3/4 INFUSION SET,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
POWER PORT OPEN-ENDED,ORSUP0027,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
POWERLOC  20G X .75  SAFTEY INFUSION SET,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
POWERLOC INJECTABLE PORT ACCESS KIT 20GAX1,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
POWERLOC INJECTALE PORT ACCESS KIT 20GAX0.75,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
POWER DRIVER EZ-IO,ORSUP0019,CDM,272,RC,,,Outpatient,,,1600,1040.00,,1408,88,,,percent of total billed charges,88% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,276.86,17.304,,,percent of total billed charges,17.304% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1008,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1104,69,,,percent of total billed charges,69% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,989.6,61.85,,,percent of total billed charges,61.85% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,274.18,17.136,,,percent of total billed charges,17.136% of total billed charges,349.44,21.84,,,percent of total billed charges,21.84% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,1248,78,,,percent of total billed charges,78% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,1600,
POWERLOC PORT ACCESS 20G X 1.5,ORSUP0005,CDM,278,RC,S1015,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,84.75,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
POWERLOC PORT ACCESS 20G X 1,ORSUP0005,CDM,278,RC,S1015,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,84.75,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
PRE-OP HAIR REMOVAL MITT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PRECISION 75MM SQUARE HEADED,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
PRECISION SPEED TAC,ORSUP0033,CDM,272,RC,,,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
PRECISION NEURO DRILL (BURR),ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PRECISION SYSTEMS STANDARD 500,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
PRECISION SYSTEMS STANDARD 1500,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
PREEMIE HEARING TEST EARTIPS 3MM PINK,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
PRELOADED 10FR X 7CM CENTER BEND SYSTEM,ORSUP0016,CDM,278,RC,C2625,HCPCS,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,199,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,724.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,15.3,,,percent of total billed charges,15.3% of total billed charges,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1150,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1150,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,358.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,197.06,17.136,,,percent of total billed charges,17.136% of total billed charges,251.16,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,389.85,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,1150,
PREMIUM 40 CLIPPER BLADE ASSEMBLY 20 EA/CS,271045,CDM,272,RC,,,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,10.21,17.304,,,percent of total billed charges,17.304% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,37.17,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,15.3,,,percent of total billed charges,15.3% of total billed charges,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,10.11,17.136,,,percent of total billed charges,17.136% of total billed charges,12.89,21.84,,,percent of total billed charges,21.84% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,59,
PREP DURA PREP SURG SOL,169497,CDM,270,RC,,,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.88,17.304,,,percent of total billed charges,17.304% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.83,17.136,,,percent of total billed charges,17.136% of total billed charges,7.43,21.84,,,percent of total billed charges,21.84% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,34,
PRESOAK CLN PROLYSTICA ENZYM 4GL/CA,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PRESSURE MONITORING TRANSDUCER,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PRESSURE INFUSION BAG 3000ML,491089,CDM,270,RC,,,Outpatient,,,108,70.20,,95.04,88,,,percent of total billed charges,88% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,18.69,17.304,,,percent of total billed charges,17.304% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,68.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,15.3,,,percent of total billed charges,15.3% of total billed charges,74.52,69,,,percent of total billed charges,69% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.51,17.136,,,percent of total billed charges,17.136% of total billed charges,23.59,21.84,,,percent of total billed charges,21.84% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,84.24,78,,,percent of total billed charges,78% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,108,
PRESSURE INFUSION BAG DISP 500ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
PREVENA PEEL \\T\\ PLACE 20CM,ORSUP0027,CDM,270,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
PRIME ADVANCED STIMULATOR,ORSUP0174,CDM,278,RC,,,Outpatient,,,54600,35490.00,,48048,88,,,percent of total billed charges,88% of total Billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,9172.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,9447.98,17.304,,,percent of total billed charges,17.304% of total billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,34398,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9172.8,16.8,,,percent of total billed charges,16.8% of total billed charges,8353.8,15.3,,,percent of total billed charges,15.3% of total billed charges,37674,69,,,percent of total billed charges,69% of total billed charges,54600,100,,,percent of total billed charges,100% of total billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,54600,100,,,percent of total billed charges,100% of total billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,54600,100,,,percent of total billed charges,100% of total billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9172.8,16.8,,,percent of total billed charges,16.8% of total billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,17035.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27300,50,,,percent of total billed charges,50% of total Billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,9356.26,17.136,,,percent of total billed charges,17.136% of total billed charges,11924.64,21.84,,,percent of total billed charges,21.84% of total billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,20584.2,37.7,,,percent of total billed charges,37.70% of total billed charges,20584.2,37.7,,,percent of total billed charges,37.70% of total billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,18509.4,33.9,,,percent of total billed charges,33.9% of total billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,42588,78,,,percent of total billed charges,78% of total billed charges,54600,100,,,percent of total billed charges,100% of total billed charges,45099.6,82.6,,,percent of total billed charges,82.6% of total billed charges,45099.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9172.8,16.8,,,percent of total billed charges,16.8% of total billed charges,27300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27300,50,,,percent of total billed charges,50% of total Billed charges,9172.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,54600,
PRINT PACK THERMAL COLOR UPC-55,ORSUP0017,CDM,270,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
PRINTER PAPER THERMAL DSD/SSD,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PRIORITY ONE ASPIRATION CATHETER,ORSUP0020,CDM,278,RC,C1887,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
PRO-VENT PLUS 1ML DRY LITHIUM HEPARIN,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
PROBE RECTAL ESO 9FR,124296,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
PROBE BALL TIOP NUEROVISION,ORSUP0021,CDM,270,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
PROBE COVER 3-D 6 INCHX96 INCH WITH GEL,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
PROBE TEMP  ORAL/AXILLARY W/4' CORD,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
PROBE INCREMENTING 8225825,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
PROBE ARGON LAP HANDPIECE 5MM,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
PROBE ENDOSCOPIC INJECTION GOLD 7F 210CM L,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
PROBE GOLD 10FR (6016),ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
PROBE MUTING NIM SYSTEM,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
PROBE BICAP HEMOSTATIC 10 FR,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
PROBE BICAP HEMOSTATIC 7FR,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
PROBE-G RFID,ORSUP0017,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PROBE TEMPERATURE 9FR STERILE ESOPHAGEAL/RECTAL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PROBE COVERS ECLIPSE NONSTERILE ULTRASOUND,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
PROBE STRIKE SHEATH,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
PROCISE MAX,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
PROFILE V URINE DRUG SCREEN,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
PROGRIP 16X12 LAPAROSCOPIC ANATOMICAL LEFT,ORSUP0028,CDM,278,RC,C1713,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
PROGRIP 16X12 LAPAROSCOPIC ANATOMICAL RIGHT,ORSUP0028,CDM,278,RC,C1713,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
PROGRASP FORCEPS,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
PROLEX E. COLI 0157,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PROLENE 7-0 24 INCH BV-175-7,241018,CDM,272,RC,,,Outpatient,,,171,111.15,,150.48,88,,,percent of total billed charges,88% of total Billed charges,85.5,50,,,percent of total billed charges,50% of total Billed charges,28.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,171,100,,,percent of total billed charges,100% of total billed charges,29.59,17.304,,,percent of total billed charges,17.304% of total billed charges,85.5,50,,,percent of total billed charges,50% of total Billed charges,107.73,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,28.73,16.8,,,percent of total billed charges,16.8% of total billed charges,26.16,15.3,,,percent of total billed charges,15.3% of total billed charges,117.99,69,,,percent of total billed charges,69% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,85.5,50,,,percent of total billed charges,50% of total Billed charges,171,100,,,percent of total billed charges,100% of total billed charges,85.5,50,,,percent of total billed charges,50% of total Billed charges,171,100,,,percent of total billed charges,100% of total billed charges,85.5,50,,,percent of total billed charges,50% of total Billed charges,105.76,61.85,,,percent of total billed charges,61.85% of total billed charges,28.73,16.8,,,percent of total billed charges,16.8% of total billed charges,85.5,50,,,percent of total billed charges,50% of total Billed charges,85.5,50,,,percent of total billed charges,50% of total Billed charges,28.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,85.5,50,,,percent of total billed charges,50% of total Billed charges,85.5,50,,,percent of total billed charges,50% of total Billed charges,29.3,17.136,,,percent of total billed charges,17.136% of total billed charges,37.35,21.84,,,percent of total billed charges,21.84% of total billed charges,85.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,85.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,85.5,50,,,percent of total billed charges,50% of total Billed charges,133.38,78,,,percent of total billed charges,78% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,28.73,16.8,,,percent of total billed charges,16.8% of total billed charges,85.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,85.5,50,,,percent of total billed charges,50% of total Billed charges,28.73,16.8,,,percent of total billed charges,16.8% of total billed charges,26.16,171,
PROLENE 3-0 FSL (8675H),491098,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
PROLENE 5-0 C-1 (8890H),491099,CDM,272,RC,,,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,9.52,17.304,,,percent of total billed charges,17.304% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.42,17.136,,,percent of total billed charges,17.136% of total billed charges,12.01,21.84,,,percent of total billed charges,21.84% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,55,
PROLENE 5-0 PS-3 (8681G),491100,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
PROLENE 6-0 BV-1 (8806H),491101,CDM,272,RC,,,Outpatient,,,109,70.85,,95.92,88,,,percent of total billed charges,88% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total Billed charges,109,100,,,percent of total billed charges,100% of total billed charges,18.86,17.304,,,percent of total billed charges,17.304% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,68.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,16.68,15.3,,,percent of total billed charges,15.3% of total billed charges,75.21,69,,,percent of total billed charges,69% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,109,100,,,percent of total billed charges,100% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,109,100,,,percent of total billed charges,100% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,67.42,61.85,,,percent of total billed charges,61.85% of total billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.68,17.136,,,percent of total billed charges,17.136% of total billed charges,23.81,21.84,,,percent of total billed charges,21.84% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.5,50,,,percent of total billed charges,50% of total Billed charges,85.02,78,,,percent of total billed charges,78% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,54.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.5,50,,,percent of total billed charges,50% of total Billed charges,18.31,16.8,,,percent of total billed charges,16.8% of total billed charges,16.68,109,
PROLENE 6-0 P-3 (8695G),491102,CDM,272,RC,,,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,7.27,17.304,,,percent of total billed charges,17.304% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,26.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,15.3,,,percent of total billed charges,15.3% of total billed charges,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.2,17.136,,,percent of total billed charges,17.136% of total billed charges,9.17,21.84,,,percent of total billed charges,21.84% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,42,
PROSTHESIS H/R PARTIAL 90DEGRE,ORSUP0023,CDM,270,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
PROTECTOR INST 2IN RND .312IN RETR RADPQ STM STRL GLPI LF,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PROTACK FIXATION DEVICE BY COVIDIEN,ORSUP0026,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
PROTEUS MIRABILIS ATCC 12453 CULTI LOOPS,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
PROTOCOL C \\T\\ S KIT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
MESH PHASIX ST RECTANGLE 3X4 IN,ORSUP0097,CDM,278,RC,C1781,HCPCS,Outpatient,,,22880,14872.00,,20134.4,88,,,percent of total billed charges,88% of total Billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,3843.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3959.16,17.304,,,percent of total billed charges,17.304% of total billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,14414.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3843.84,16.8,,,percent of total billed charges,16.8% of total billed charges,3500.64,15.3,,,percent of total billed charges,15.3% of total billed charges,15787.2,69,,,percent of total billed charges,69% of total billed charges,22880,100,,,percent of total billed charges,100% of total billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,22880,100,,,percent of total billed charges,100% of total billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,22880,100,,,percent of total billed charges,100% of total billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,14151.28,61.85,,,percent of total billed charges,61.85% of total billed charges,3843.84,16.8,,,percent of total billed charges,16.8% of total billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,7138.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11440,50,,,percent of total billed charges,50% of total Billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,3920.72,17.136,,,percent of total billed charges,17.136% of total billed charges,4996.99,21.84,,,percent of total billed charges,21.84% of total billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,8625.76,37.7,,,percent of total billed charges,37.70% of total billed charges,8625.76,37.7,,,percent of total billed charges,37.70% of total billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,7756.32,33.9,,,percent of total billed charges,33.9% of total billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,17846.4,78,,,percent of total billed charges,78% of total billed charges,22880,100,,,percent of total billed charges,100% of total billed charges,18898.88,82.6,,,percent of total billed charges,82.6% of total billed charges,18898.88,82.6,,,percent of total billed charges,82.6% of total billed charges,3843.84,16.8,,,percent of total billed charges,16.8% of total billed charges,11440,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11440,50,,,percent of total billed charges,50% of total Billed charges,3843.84,16.8,,,percent of total billed charges,16.8% of total billed charges,3500.64,22880,
PSA 100 WELLS,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
PSA CALIBRATOR BOX /1 SET,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
PSI COMPACT REGULATORS,ORSUP0016,CDM,272,RC,,,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,199,17.304,,,percent of total billed charges,17.304% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,724.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,15.3,,,percent of total billed charges,15.3% of total billed charges,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,711.28,61.85,,,percent of total billed charges,61.85% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,197.06,17.136,,,percent of total billed charges,17.136% of total billed charges,251.16,21.84,,,percent of total billed charges,21.84% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,1150,
PT SLIPPER ADULT LARGE (BLUE),491104,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
PT SLIPPER ADULT X-LARGE (BEIGE),491105,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
PT SLIPPERS PEDIATRIC,491106,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
PUDDING VARIBAR MULTI DOSE F/ SWALLOW FUNC STDY 230ML,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
PULL UPS XXL,432709,CDM,272,RC,,,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,18.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,113,100,,,percent of total billed charges,100% of total billed charges,19.55,17.304,,,percent of total billed charges,17.304% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,71.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.98,16.8,,,percent of total billed charges,16.8% of total billed charges,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,113,100,,,percent of total billed charges,100% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,113,100,,,percent of total billed charges,100% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,69.89,61.85,,,percent of total billed charges,61.85% of total billed charges,18.98,16.8,,,percent of total billed charges,16.8% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,18.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,19.36,17.136,,,percent of total billed charges,17.136% of total billed charges,24.68,21.84,,,percent of total billed charges,21.84% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56.5,50,,,percent of total billed charges,50% of total Billed charges,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,18.98,16.8,,,percent of total billed charges,16.8% of total billed charges,56.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56.5,50,,,percent of total billed charges,50% of total Billed charges,18.98,16.8,,,percent of total billed charges,16.8% of total billed charges,17.29,113,
PULLUPS XLG,231386,CDM,272,RC,,,Outpatient,,,268,174.20,,235.84,88,,,percent of total billed charges,88% of total Billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,45.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,268,100,,,percent of total billed charges,100% of total billed charges,46.37,17.304,,,percent of total billed charges,17.304% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,168.84,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,41,15.3,,,percent of total billed charges,15.3% of total billed charges,184.92,69,,,percent of total billed charges,69% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,268,100,,,percent of total billed charges,100% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,268,100,,,percent of total billed charges,100% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,165.76,61.85,,,percent of total billed charges,61.85% of total billed charges,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,45.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,45.92,17.136,,,percent of total billed charges,17.136% of total billed charges,58.53,21.84,,,percent of total billed charges,21.84% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,134,50,,,percent of total billed charges,50% of total Billed charges,209.04,78,,,percent of total billed charges,78% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,134,50,,,percent of total billed charges,50% of total Billed charges,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,41,268,
PULMOGUARD KITS,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
PUMP TUBE SOLUTION,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PUMP TUBE WASTE,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PUMP TUBING ELECTRODE MODULE,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PUMP PAIN ON Q PM036-A,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
PUMP SYSTEM ACROBAT MECHANICAL OFF,ORSUP0034,CDM,272,RC,,,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
DRESSING PURAPLY MZ 100 MG,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
DRESSING PURAPLY MZ 500 MG,ORSUP0038,CDM,272,RC,,,Outpatient,,,5400,3510.00,,4752,88,,,percent of total billed charges,88% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,934.42,17.304,,,percent of total billed charges,17.304% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,3402,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,826.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3726,69,,,percent of total billed charges,69% of total billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,3339.9,61.85,,,percent of total billed charges,61.85% of total billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,925.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1179.36,21.84,,,percent of total billed charges,21.84% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2700,50,,,percent of total billed charges,50% of total Billed charges,4212,78,,,percent of total billed charges,78% of total billed charges,5400,100,,,percent of total billed charges,100% of total billed charges,4460.4,82.6,,,percent of total billed charges,82.6% of total billed charges,4460.4,82.6,,,percent of total billed charges,82.6% of total billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2700,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2700,50,,,percent of total billed charges,50% of total Billed charges,907.2,16.8,,,percent of total billed charges,16.8% of total billed charges,826.2,5400,
DRESSING PURAPLY MZ 1000 MG,ORSUP0063,CDM,272,RC,,,Outpatient,,,10600,6890.00,,9328,88,,,percent of total billed charges,88% of total Billed charges,5300,50,,,percent of total billed charges,50% of total Billed charges,1780.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1834.22,17.304,,,percent of total billed charges,17.304% of total billed charges,5300,50,,,percent of total billed charges,50% of total Billed charges,6678,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1780.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1621.8,15.3,,,percent of total billed charges,15.3% of total billed charges,7314,69,,,percent of total billed charges,69% of total billed charges,10600,100,,,percent of total billed charges,100% of total billed charges,5300,50,,,percent of total billed charges,50% of total Billed charges,10600,100,,,percent of total billed charges,100% of total billed charges,5300,50,,,percent of total billed charges,50% of total Billed charges,10600,100,,,percent of total billed charges,100% of total billed charges,5300,50,,,percent of total billed charges,50% of total Billed charges,6556.1,61.85,,,percent of total billed charges,61.85% of total billed charges,1780.8,16.8,,,percent of total billed charges,16.8% of total billed charges,5300,50,,,percent of total billed charges,50% of total Billed charges,5300,50,,,percent of total billed charges,50% of total Billed charges,1780.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,5300,50,,,percent of total billed charges,50% of total Billed charges,5300,50,,,percent of total billed charges,50% of total Billed charges,1816.42,17.136,,,percent of total billed charges,17.136% of total billed charges,2315.04,21.84,,,percent of total billed charges,21.84% of total billed charges,5300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5300,50,,,percent of total billed charges,50% of total Billed charges,8268,78,,,percent of total billed charges,78% of total billed charges,10600,100,,,percent of total billed charges,100% of total billed charges,8755.6,82.6,,,percent of total billed charges,82.6% of total billed charges,8755.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1780.8,16.8,,,percent of total billed charges,16.8% of total billed charges,5300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5300,50,,,percent of total billed charges,50% of total Billed charges,1780.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1621.8,10600,
PURAPLY AM XT EXTRA FENESTRATED 4.91X4.91 CM,636Q4197491,CDM,636,RC,Q4197,HCPCS,Outpatient,,,9875,6418.75,,8690,88,,,percent of total billed charges,88% of total Billed charges,4937.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4937.5,50,,,percent of total billed charges,50% of total Billed charges,6221.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1510.88,15.3,,,percent of total billed charges,15.3% of total billed charges,6813.75,69,,,percent of total billed charges,69% of total billed charges,9875,100,,,percent of total billed charges,100% of total billed charges,4937.5,50,,,percent of total billed charges,50% of total Billed charges,9875,100,,,percent of total billed charges,100% of total billed charges,4937.5,50,,,percent of total billed charges,50% of total Billed charges,9875,100,,,percent of total billed charges,100% of total billed charges,4937.5,50,,,percent of total billed charges,50% of total Billed charges,6107.69,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4937.5,50,,,percent of total billed charges,50% of total Billed charges,4937.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4937.5,50,,,percent of total billed charges,50% of total Billed charges,4937.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4937.5,50,,,percent of total billed charges,50% of total Billed charges,3722.88,37.7,,,percent of total billed charges,37.70% of total billed charges,3722.88,37.7,,,percent of total billed charges,37.70% of total billed charges,4937.5,50,,,percent of total billed charges,50% of total Billed charges,3347.63,33.9,,,percent of total billed charges,33.9% of total billed charges,4937.5,50,,,percent of total billed charges,50% of total Billed charges,7702.5,78,,,percent of total billed charges,78% of total billed charges,9875,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4937.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4937.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1510.88,9875,
PURAPLY AM DISC 16 MM,636Q419616,CDM,636,RC,Q4196,HCPCS,Outpatient,,,2200,1430.00,,1936,88,,,percent of total billed charges,88% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,1386,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",336.6,15.3,,,percent of total billed charges,15.3% of total billed charges,1518,69,,,percent of total billed charges,69% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1360.7,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,829.4,37.7,,,percent of total billed charges,37.70% of total billed charges,829.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,745.8,33.9,,,percent of total billed charges,33.9% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1716,78,,,percent of total billed charges,78% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",336.6,2200,
PURE ENZYMATIC DETERGENT-SPEARMINT FRESH SCENT,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PUSHLOCK 2.9 PEEK 12.5,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
PUSHLOCK BIO COMPOSITE 3.5,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
PUSHLOCK BIOCOMPOSITE-4.5MM,ORSUP0052,CDM,278,RC,C1713,HCPCS,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6715.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3325.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3613.74,33.9,,,percent of total billed charges,33.9% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
PUSHER CUTTER KNOT FASTFIX STR DISP,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
PUSHER STENT PANC 4/5FR,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
PUTTY DBX 0.5CC,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
PUTTY DBX MIX 10CC,ORSUP0044,CDM,278,RC,C1762,HCPCS,Outpatient,,,8580,5577.00,,7550.4,88,,,percent of total billed charges,88% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1484.68,17.304,,,percent of total billed charges,17.304% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5405.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,15.3,,,percent of total billed charges,15.3% of total billed charges,5920.2,69,,,percent of total billed charges,69% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,5306.73,61.85,,,percent of total billed charges,61.85% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,2676.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4290,50,,,percent of total billed charges,50% of total Billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,1470.27,17.136,,,percent of total billed charges,17.136% of total billed charges,1873.87,21.84,,,percent of total billed charges,21.84% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,3234.66,37.7,,,percent of total billed charges,37.70% of total billed charges,3234.66,37.7,,,percent of total billed charges,37.70% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,2908.62,33.9,,,percent of total billed charges,33.9% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,6692.4,78,,,percent of total billed charges,78% of total billed charges,8580,100,,,percent of total billed charges,100% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,7087.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,4290,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4290,50,,,percent of total billed charges,50% of total Billed charges,1441.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1312.74,8580,
PUTTY MASTERGRAFT 1.5CC,ORSUP0013,CDM,278,RC,C1762,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
PUTTY MASTERGRAFT 12CC,ORSUP0034,CDM,278,RC,C1762,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
PUTTY MASTERGRAFT 6CC,ORSUP0024,CDM,278,RC,C1762,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
PUTTY MASTERGRAFT 9CC,ORSUP0030,CDM,278,RC,C1762,HCPCS,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1541.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1674.66,33.9,,,percent of total billed charges,33.9% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
PUTTY NORIAN 5CC STERILE,ORSUP0045,CDM,278,RC,C1762,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5569.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
PVA EMBO PARTICLES 700,ORSUP0013,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
PVA FOAM EMBOLISM 300,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
PVC NASOPHARYNEAL AIRWAY 7MM 28FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
PYR DISC WITH REAGENT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
Q CARE ORAL CLEANSING AND SUCTION SYSTEM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
Q-TIPS,491107,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
QC ESR-CHEX LEVEL 1  2 CORE,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
QC+ LEVEL 1,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
QC5+ LEVEL 2,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
QC5+ LEVEL3,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
QUAD NAV,ORSUP0010,CDM,278,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
QUANTIFY ADVANCE LIQ CONTROL,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
QUEASE EASE,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
QUICK VUE HCG SERUM CONTROL,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
QUICK STIK,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
QUICK VUE CONTROL SOLUTION,491108,CDM,270,RC,,,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,32.19,17.304,,,percent of total billed charges,17.304% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,117.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,115.04,61.85,,,percent of total billed charges,61.85% of total billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.87,17.136,,,percent of total billed charges,17.136% of total billed charges,40.62,21.84,,,percent of total billed charges,21.84% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,28.46,186,
QUICK VUE TEST KIT,491109,CDM,270,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
QUICKSET 5CC KIT,ORSUP0047,CDM,278,RC,C1713,HCPCS,Outpatient,,,8060,5239.00,,7092.8,88,,,percent of total billed charges,88% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1394.7,17.304,,,percent of total billed charges,17.304% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,5077.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,15.3,,,percent of total billed charges,15.3% of total billed charges,5561.4,69,,,percent of total billed charges,69% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4985.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2514.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1381.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1760.3,21.84,,,percent of total billed charges,21.84% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2732.34,33.9,,,percent of total billed charges,33.9% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,6286.8,78,,,percent of total billed charges,78% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,8060,
QUICK CLEAR ASPIRATION DEVICE,ORSUP0060,CDM,272,RC,,,Outpatient,,,10000,6500.00,,8800,88,,,percent of total billed charges,88% of total Billed charges,5000,50,,,percent of total billed charges,50% of total Billed charges,1680,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1730.4,17.304,,,percent of total billed charges,17.304% of total billed charges,5000,50,,,percent of total billed charges,50% of total Billed charges,6300,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1680,16.8,,,percent of total billed charges,16.8% of total billed charges,1530,15.3,,,percent of total billed charges,15.3% of total billed charges,6900,69,,,percent of total billed charges,69% of total billed charges,10000,100,,,percent of total billed charges,100% of total billed charges,5000,50,,,percent of total billed charges,50% of total Billed charges,10000,100,,,percent of total billed charges,100% of total billed charges,5000,50,,,percent of total billed charges,50% of total Billed charges,10000,100,,,percent of total billed charges,100% of total billed charges,5000,50,,,percent of total billed charges,50% of total Billed charges,6185,61.85,,,percent of total billed charges,61.85% of total billed charges,1680,16.8,,,percent of total billed charges,16.8% of total billed charges,5000,50,,,percent of total billed charges,50% of total Billed charges,5000,50,,,percent of total billed charges,50% of total Billed charges,1680,16.8,,,percent of total billed charges,16.8% of total Billed charges,5000,50,,,percent of total billed charges,50% of total Billed charges,5000,50,,,percent of total billed charges,50% of total Billed charges,1713.6,17.136,,,percent of total billed charges,17.136% of total billed charges,2184,21.84,,,percent of total billed charges,21.84% of total billed charges,5000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5000,50,,,percent of total billed charges,50% of total Billed charges,7800,78,,,percent of total billed charges,78% of total billed charges,10000,100,,,percent of total billed charges,100% of total billed charges,8260,82.6,,,percent of total billed charges,82.6% of total billed charges,8260,82.6,,,percent of total billed charges,82.6% of total billed charges,1680,16.8,,,percent of total billed charges,16.8% of total billed charges,5000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5000,50,,,percent of total billed charges,50% of total Billed charges,1680,16.8,,,percent of total billed charges,16.8% of total billed charges,1530,10000,
R SYRINGE,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
R-X-FIX RAIL 2.75 INCH 03-5000,ORSUP0042,CDM,278,RC,C1713,HCPCS,Outpatient,,,8060,5239.00,,7092.8,88,,,percent of total billed charges,88% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1394.7,17.304,,,percent of total billed charges,17.304% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,5077.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,15.3,,,percent of total billed charges,15.3% of total billed charges,5561.4,69,,,percent of total billed charges,69% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4985.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2514.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4030,50,,,percent of total billed charges,50% of total Billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,1381.16,17.136,,,percent of total billed charges,17.136% of total billed charges,1760.3,21.84,,,percent of total billed charges,21.84% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3038.62,37.7,,,percent of total billed charges,37.70% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,2732.34,33.9,,,percent of total billed charges,33.9% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,6286.8,78,,,percent of total billed charges,78% of total billed charges,8060,100,,,percent of total billed charges,100% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6657.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4030,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4030,50,,,percent of total billed charges,50% of total Billed charges,1354.08,16.8,,,percent of total billed charges,16.8% of total billed charges,1233.18,8060,
RADIAL COLUMN PIN PLATE 3-HOLE RCP3,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
RADIAL JAW 4 STD W/NEEDLE 240X2.8,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
RADIESSE 8046M0K1,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
RADIAL JAW 4 JUMBO W NEEDLE,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
RAPID ANA II SYSTEM IDS,ORSUP0018,CDM,270,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
RAPID RHINO 5.5 BILATERAL,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
RAPICIDE HIGH LEVEL A/B,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
RAPICIDE PA TEST STRIPS,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
RASP TEAR CUT 11x5MM,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
RAZOR SHAVE PREP FIX HEAD LF,10956,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
RCI AQUAPAK BUBBLE PREFILLED,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
RCI AQUAPAK NEBULIZERS W/WATER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
RCI AQUAPAK NEBULIZERS W/028 ADAPTER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
RCI STRAIGHT VENT CIRCUIT,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
RCI OXYGEN TUBING CONNECTORS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
RCI NON-REBREATHER OXYGEN MASK PED,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
REAGENT ANTI JKA,ORSUP0024,CDM,270,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
REAGENT HYALURONIDASE TYPE I S 100MG,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
REAGENT PBS PH 6.8 DECONTAMINATION,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
REAGENT SPOT INDOLE  10ML,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
REAGENT ALKP,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
REAGENT AMMONIA,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
REAGENT AST,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
REAGENT B12,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
REAGENT BUN,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
REAGENT CREATININE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
REAGENT ENZYMATIC C02,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
REAGENT GLUCOSE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
REAGENT HBSAG,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
REAGENT LACTATE,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
REAGENT MAGNESIUM,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
REAGENT SALICYLATE,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
REAGENT TOTAL PROTEIN,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
REAGENT INTACT PARATHYROID HORMONE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
REAGENT LIPASE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
REAMER CONCAVE 20MM,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
REAMER CONVEX 24MM,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
REBELLA IGG 100 WELLS,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
RECORD PERIOPERATIVE,452430,CDM,270,RC,,,Outpatient,,,153,99.45,,134.64,88,,,percent of total billed charges,88% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,153,100,,,percent of total billed charges,100% of total billed charges,26.48,17.304,,,percent of total billed charges,17.304% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,96.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,23.41,15.3,,,percent of total billed charges,15.3% of total billed charges,105.57,69,,,percent of total billed charges,69% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,94.63,61.85,,,percent of total billed charges,61.85% of total billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,26.22,17.136,,,percent of total billed charges,17.136% of total billed charges,33.42,21.84,,,percent of total billed charges,21.84% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.5,50,,,percent of total billed charges,50% of total Billed charges,119.34,78,,,percent of total billed charges,78% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.5,50,,,percent of total billed charges,50% of total Billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,23.41,153,
RECONSTITUTION DIL BOX/12 BTLS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
REDUCER PLUG 8MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
REF MEMBRANE BOX,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
REFERENCE FLUID 300,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
REFERENCE FLUID 800,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
REFLEX HYBIRD CERVICAL PLATE GREEN 4.5X14MM,ORSUP0016,CDM,278,RC,C1755,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
REFLEX HYBIRD FIXED BONE SCREW SELF TAPPING MAGENTA 4.0X14MM,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
REFLEX HYBIRD TEMP FIX PIN LONG,ORSUP0011,CDM,278,RC,C1755,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
REFLEX HYBIRD VARIABLE BONE SCREWS SELF DRILLING  BLUE 4.0X14MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
REFLEX ULTRA 45 W/ INTREGRATED CABLE,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
RELOAD TRH90 LINEAR STAPLER 90MM HEAVY WIRE FOR TLH90,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
RELOAD TRH60 LINEAR STAPLER 60MM HEAVY WIRE FOR TLH60,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
RELOAD TRH30 LINEAR STAPLER 30MM HEAVY WIRE FOR TLH30,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
RELOAD TR60 LINEAR STAPLER 60MM FOR TL60,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
RELOAD ECR60G ENDO LINEAR CUTTER 60 GREEN FOR ECHELON EC60,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
RELOAD BLUE ECHELON ENDO,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
RELOAD WHITE FOR ECHELON 45,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
RELOAD GREEN FOR ECHELON 45,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
RELOAD ECR60W ENDO LINEAR CUTTER 60 0,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
RELOAD STAPLER 12 MM TROCAR L60 MM ECHELON 60 ENDOPATH LINEA,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
RELOAD TR45W ENDO LINEAR CUTTER WHITE VASCULAR FOR ATW45,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
RELOAD ECHELON POWERED VASC STAPLER 35MM WHITE,ORSUP0016,CDM,272,RC,,,Outpatient,,,1307,849.55,,1150.16,88,,,percent of total billed charges,88% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,219.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,226.16,17.304,,,percent of total billed charges,17.304% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,823.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,219.58,16.8,,,percent of total billed charges,16.8% of total billed charges,199.97,15.3,,,percent of total billed charges,15.3% of total billed charges,901.83,69,,,percent of total billed charges,69% of total billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,808.38,61.85,,,percent of total billed charges,61.85% of total billed charges,219.58,16.8,,,percent of total billed charges,16.8% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,219.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,223.97,17.136,,,percent of total billed charges,17.136% of total billed charges,285.45,21.84,,,percent of total billed charges,21.84% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,653.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,653.5,50,,,percent of total billed charges,50% of total Billed charges,1019.46,78,,,percent of total billed charges,78% of total billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,1079.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1079.58,82.6,,,percent of total billed charges,82.6% of total billed charges,219.58,16.8,,,percent of total billed charges,16.8% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,653.5,50,,,percent of total billed charges,50% of total Billed charges,219.58,16.8,,,percent of total billed charges,16.8% of total billed charges,199.97,1307,
"RELOAD, STAPLER STANDARD 6R45B",ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
RELOADS PROXIMATE CUTTER 75,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
RELOAD LINEAR 45MM WHITE,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
"RELOAD, LINEAR CUTTER 75MM",ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
RELOADS PROXIMATE LINEAR CUTTER GREEN 100MM,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
RELOAD SUREFORM 60 3.5 BLUE,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
RELOAD SUREFORM 4.3 GREEN,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
RELOAD SUREFORM 4.6 BLACK,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
RELOAD SUREFORM 45 3.5 BLUE,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
RELOAD SUREFORM 45 4.3 GREEN,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
RELOAD SUREFORM 45 4.6 BLACK,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
REMEDY ANTIFUNGAL POWDER 3OZ,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
REMEDY SKIN CREAM 2OZ,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
REMEDY ANTIFUNGAL OINTMENT,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
REMEDY SHAMPOO \\T\\ BODY WASH,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
REMOVER SKIN STAPLE,32122,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
REMOVER RESCUE NET FOREIGN BODY,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
REP BAND LF EXERCISE TUBING 100' BLUE,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
REP BAND LF EXERCISE TUBING 100' GREEN,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
REP BAND LF EXERCISE TUBING 100' ORANGE,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
REP BAND EXERCISE TUBING 100' PLUM,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
REP BAND BLUE LEVEL 4  4IN X 50YDS,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
REP BAND GREEN LEVEL 3 4IN X 50YDS,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
REP BAND PURPLE LEVEL 5 4IN X 50YDS,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
REPAIR KIT FYRITE CO2 AND O2 GAS ANALYZERS,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
RESECTOR 4.0MM,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
RESERVOIR  JACKSON-PRATT 100CC,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
RESERVOIR CSF OMMAYA 2.5CM,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
RESECTOR RADIUS 5.0MM STRYKER,ORSUP0003,CDM,270,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
RESECTOR 3.5MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
RESECTOR 2.5MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
RESERVOIR HARD SHELL,ORSUP0008,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
RESPIRATORY PATIENT SET-UP BAG,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
RESSECTOR ANGLED 4.5,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
RESTORIS TRINITY CANCELLOUS SCREW (ALL SIZES),ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
RESTORIS Z BONE SCREW (ALL SIZES),ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
RESTORIS METAFIX STANDARD FEMORAL STEM (ALL SIZES),ORSUP0034,CDM,278,RC,,,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
RESTORIS TRINITY HXLPE TAPER LINER (ALL SIZES),ORSUP0052,CDM,278,RC,,,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6715.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3325.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3613.74,33.9,,,percent of total billed charges,33.9% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
RESTORIS TRINITY TAPER CUP (ALL SIZES),ORSUP0057,CDM,278,RC,,,Outpatient,,,12220,7943.00,,10753.6,88,,,percent of total billed charges,88% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2114.55,17.304,,,percent of total billed charges,17.304% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,7698.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,1869.66,15.3,,,percent of total billed charges,15.3% of total billed charges,8431.8,69,,,percent of total billed charges,69% of total billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,7558.07,61.85,,,percent of total billed charges,61.85% of total billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,3812.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6110,50,,,percent of total billed charges,50% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2094.02,17.136,,,percent of total billed charges,17.136% of total billed charges,2668.85,21.84,,,percent of total billed charges,21.84% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,4606.94,37.7,,,percent of total billed charges,37.70% of total billed charges,4606.94,37.7,,,percent of total billed charges,37.70% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,4142.58,33.9,,,percent of total billed charges,33.9% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,9531.6,78,,,percent of total billed charges,78% of total billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,10093.72,82.6,,,percent of total billed charges,82.6% of total billed charges,10093.72,82.6,,,percent of total billed charges,82.6% of total billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,1869.66,12220,
RESTORIS METAFIX  LATERALIZED FEMORAL STEM (ALL SIZES),ORSUP0034,CDM,278,RC,,,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
RESTORIS METAFIX COCR MODULAR HEAD (ALL SIZES),ORSUP0018,CDM,278,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
RESTORIS Z ACETABULAR CUP (ALL SIZES),ORSUP0057,CDM,278,RC,,,Outpatient,,,12220,7943.00,,10753.6,88,,,percent of total billed charges,88% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2114.55,17.304,,,percent of total billed charges,17.304% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,7698.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,1869.66,15.3,,,percent of total billed charges,15.3% of total billed charges,8431.8,69,,,percent of total billed charges,69% of total billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,7558.07,61.85,,,percent of total billed charges,61.85% of total billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,3812.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6110,50,,,percent of total billed charges,50% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2094.02,17.136,,,percent of total billed charges,17.136% of total billed charges,2668.85,21.84,,,percent of total billed charges,21.84% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,4606.94,37.7,,,percent of total billed charges,37.70% of total billed charges,4606.94,37.7,,,percent of total billed charges,37.70% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,4142.58,33.9,,,percent of total billed charges,33.9% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,9531.6,78,,,percent of total billed charges,78% of total billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,10093.72,82.6,,,percent of total billed charges,82.6% of total billed charges,10093.72,82.6,,,percent of total billed charges,82.6% of total billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,1869.66,12220,
RESTORIS Z ACETABULAR LINER (ALL SIZES),ORSUP0052,CDM,278,RC,,,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6715.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3325.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3613.74,33.9,,,percent of total billed charges,33.9% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
RESTORIS Z FEMORAL HEAD (ALL SIZES),ORSUP0018,CDM,278,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
RESTORIS Z FEMORAL STEM (ALL SIZES),ORSUP0034,CDM,278,RC,,,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
RESTRAINT WITH QR BUCKLE STRAP NO LOCK WRIST,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
RESUS BAG INFANT w/MASK,111108,CDM,270,RC,,,Outpatient,,,92,59.80,,80.96,88,,,percent of total billed charges,88% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,92,100,,,percent of total billed charges,100% of total billed charges,15.92,17.304,,,percent of total billed charges,17.304% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,57.96,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.08,15.3,,,percent of total billed charges,15.3% of total billed charges,63.48,69,,,percent of total billed charges,69% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,92,100,,,percent of total billed charges,100% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,92,100,,,percent of total billed charges,100% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,56.9,61.85,,,percent of total billed charges,61.85% of total billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,15.77,17.136,,,percent of total billed charges,17.136% of total billed charges,20.09,21.84,,,percent of total billed charges,21.84% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46,50,,,percent of total billed charges,50% of total Billed charges,71.76,78,,,percent of total billed charges,78% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46,50,,,percent of total billed charges,50% of total Billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.08,92,
RETAINER VISCERA GLASSMAN,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
RETRIEVER SOHENDRA STENT 10 FR,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
RETRIEVER SOHENDRA STENT  11.5 FR,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
RETRIEVER SOHENDRA STENT  8.5 FR,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
RETRIEVER SOHENDRA STENT  7FR,ORSUP0013,CDM,278,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
RETRACTOR GRASPING,ORSUP0057,CDM,272,RC,,,Outpatient,,,12220,7943.00,,10753.6,88,,,percent of total billed charges,88% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2114.55,17.304,,,percent of total billed charges,17.304% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,7698.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,1869.66,15.3,,,percent of total billed charges,15.3% of total billed charges,8431.8,69,,,percent of total billed charges,69% of total billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,7558.07,61.85,,,percent of total billed charges,61.85% of total billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2094.02,17.136,,,percent of total billed charges,17.136% of total billed charges,2668.85,21.84,,,percent of total billed charges,21.84% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6110,50,,,percent of total billed charges,50% of total Billed charges,9531.6,78,,,percent of total billed charges,78% of total billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,10093.72,82.6,,,percent of total billed charges,82.6% of total billed charges,10093.72,82.6,,,percent of total billed charges,82.6% of total billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,1869.66,12220,
RETRIVER NET ROTH,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
RETRACTOR MED MOBIUS,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
RETRACTOR SML MOBIAS,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
RETROGRADE INTUBATION SET,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
RETRACTOR ALEXIS XLG MOBIUS,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
REV KNEE BASEPLATE TRI TS SIZE 4,ORSUP0040,CDM,278,RC,,,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
REV KNEE BASEPLATE TRI TS SIZE 6,ORSUP0040,CDM,278,RC,,,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
RHINO 7.5CM ANTERIOR/POSTERIOR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
RIGHT ANGLE DISSECTOR TIP 5MM,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
RIGID SUCTION CANISTER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
RING PYSIO CARPENTIER EDWARDS,ORSUP0064,CDM,278,RC,C1763,HCPCS,Outpatient,,,14040,9126.00,,12355.2,88,,,percent of total billed charges,88% of total Billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2429.48,17.304,,,percent of total billed charges,17.304% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,8845.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,2148.12,15.3,,,percent of total billed charges,15.3% of total billed charges,9687.6,69,,,percent of total billed charges,69% of total billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,8683.74,61.85,,,percent of total billed charges,61.85% of total billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,4380.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7020,50,,,percent of total billed charges,50% of total Billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,2405.89,17.136,,,percent of total billed charges,17.136% of total billed charges,3066.34,21.84,,,percent of total billed charges,21.84% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,5293.08,37.7,,,percent of total billed charges,37.70% of total billed charges,5293.08,37.7,,,percent of total billed charges,37.70% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,4759.56,33.9,,,percent of total billed charges,33.9% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,10951.2,78,,,percent of total billed charges,78% of total billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,11597.04,82.6,,,percent of total billed charges,82.6% of total billed charges,11597.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7020,50,,,percent of total billed charges,50% of total Billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,2148.12,14040,
RING PHYSIO CARPENTIER EDWARDS 28MM,ORSUP0064,CDM,278,RC,C1763,HCPCS,Outpatient,,,14040,9126.00,,12355.2,88,,,percent of total billed charges,88% of total Billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2429.48,17.304,,,percent of total billed charges,17.304% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,8845.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,2148.12,15.3,,,percent of total billed charges,15.3% of total billed charges,9687.6,69,,,percent of total billed charges,69% of total billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,8683.74,61.85,,,percent of total billed charges,61.85% of total billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,4380.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7020,50,,,percent of total billed charges,50% of total Billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,2405.89,17.136,,,percent of total billed charges,17.136% of total billed charges,3066.34,21.84,,,percent of total billed charges,21.84% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,5293.08,37.7,,,percent of total billed charges,37.70% of total billed charges,5293.08,37.7,,,percent of total billed charges,37.70% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,4759.56,33.9,,,percent of total billed charges,33.9% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,10951.2,78,,,percent of total billed charges,78% of total billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,11597.04,82.6,,,percent of total billed charges,82.6% of total billed charges,11597.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7020,50,,,percent of total billed charges,50% of total Billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,2148.12,14040,
RING PHYSIO CARPENTIER EDWARDS,ORSUP0064,CDM,278,RC,C1763,HCPCS,Outpatient,,,14040,9126.00,,12355.2,88,,,percent of total billed charges,88% of total Billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2429.48,17.304,,,percent of total billed charges,17.304% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,8845.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,2148.12,15.3,,,percent of total billed charges,15.3% of total billed charges,9687.6,69,,,percent of total billed charges,69% of total billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,8683.74,61.85,,,percent of total billed charges,61.85% of total billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,4380.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7020,50,,,percent of total billed charges,50% of total Billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,2405.89,17.136,,,percent of total billed charges,17.136% of total billed charges,3066.34,21.84,,,percent of total billed charges,21.84% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,5293.08,37.7,,,percent of total billed charges,37.70% of total billed charges,5293.08,37.7,,,percent of total billed charges,37.70% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,4759.56,33.9,,,percent of total billed charges,33.9% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,10951.2,78,,,percent of total billed charges,78% of total billed charges,14040,100,,,percent of total billed charges,100% of total billed charges,11597.04,82.6,,,percent of total billed charges,82.6% of total billed charges,11597.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,7020,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7020,50,,,percent of total billed charges,50% of total Billed charges,2358.72,16.8,,,percent of total billed charges,16.8% of total billed charges,2148.12,14040,
RING CONVEX ROUND 12MM  0 DEGREE 495.412,ORSUP0015,CDM,278,RC,C1755,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
RING END TI 2.5DD OD12MM SPNL CNVX RND,ORSUP0015,CDM,278,RC,C1755,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ROADRUNNER PC WIRE GUIDE 145CM,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
ROADRUNNER UNIGLIDE .035X15CM,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
PISTON .6X1.0X4.5MM CUPPED,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
PISTON .6X.9 X4.5MM CUPPED,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ROCKER CAST SHOE SMALL,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ROCKER CAST SHOE MEDIUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ROCKER CAST SHOE LARGE,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ROD CARBON FIBER 8.0MM X 220MM,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ROD CARBON FIBER 8.0MM X 200MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ROD 100MM VENTROFIX,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ROD 150MM VENTROFIX,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ROD 50MM VENTROFIX,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
ROD 75MM VENTROFIX,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
ROD 80MM CERVIFIX,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ROD CARBON FIBER  220MM,ORSUP0056,CDM,278,RC,C1713,HCPCS,Outpatient,,,11960,7774.00,,10524.8,88,,,percent of total billed charges,88% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2069.56,17.304,,,percent of total billed charges,17.304% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7534.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,15.3,,,percent of total billed charges,15.3% of total billed charges,8252.4,69,,,percent of total billed charges,69% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7397.26,61.85,,,percent of total billed charges,61.85% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,3731.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2049.47,17.136,,,percent of total billed charges,17.136% of total billed charges,2612.06,21.84,,,percent of total billed charges,21.84% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4054.44,33.9,,,percent of total billed charges,33.9% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,9328.8,78,,,percent of total billed charges,78% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,11960,
ROD CARBON FIBER  240MM,ORSUP0056,CDM,278,RC,C1713,HCPCS,Outpatient,,,11960,7774.00,,10524.8,88,,,percent of total billed charges,88% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2069.56,17.304,,,percent of total billed charges,17.304% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7534.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,15.3,,,percent of total billed charges,15.3% of total billed charges,8252.4,69,,,percent of total billed charges,69% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,7397.26,61.85,,,percent of total billed charges,61.85% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,3731.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5980,50,,,percent of total billed charges,50% of total Billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,2049.47,17.136,,,percent of total billed charges,17.136% of total billed charges,2612.06,21.84,,,percent of total billed charges,21.84% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,4508.92,37.7,,,percent of total billed charges,37.70% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,4054.44,33.9,,,percent of total billed charges,33.9% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,9328.8,78,,,percent of total billed charges,78% of total billed charges,11960,100,,,percent of total billed charges,100% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,9878.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,5980,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5980,50,,,percent of total billed charges,50% of total Billed charges,2009.28,16.8,,,percent of total billed charges,16.8% of total billed charges,1829.88,11960,
ROD CARBON FIBER11.0MM X 300MM,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ROD CONNECTOR TI PARALLEL OPEN 3.5MM/3.5MM 498.922,ORSUP0021,CDM,278,RC,C1713,HCPCS,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,811.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,881.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
ROD CURVED 3.5MM TI 80MM 498.137,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
ROD EXT FIX CARBN FIBR 8.0X240MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ROD TRANSCONNECTOR 49-69MM X 6MM PANGEA SPNL LPRO,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
ROD 125 MM,ORSUP0014,CDM,278,RC,C1755,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ROD 5 1/2 MM CURVED,ORSUP0015,CDM,278,RC,C1755,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ROD CURVED 3.5MM TI 40MM 498.136,ORSUP0014,CDM,278,RC,C1755,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ROD SPNL TI L125MM OD6.0MM HRD,ORSUP0015,CDM,278,RC,C1755,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ROD SPNL TI L50MM PANGEA PRECONTOURED,ORSUP0015,CDM,278,RC,C1755,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ROD SPNL TI L60MM PANGEA PRECONTOURED,ORSUP0015,CDM,278,RC,C1755,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ROD SPNL TI L70MM PANGEA PRECONTOURED,ORSUP0015,CDM,278,RC,C1755,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ROD SPNL TI L80MM PANGEA PRECONTOURED,ORSUP0015,CDM,278,RC,C1755,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
ROD SPNL TI OD3.5MM,ORSUP0012,CDM,278,RC,C1755,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ROD TI TRANSCONNECTOR 60MM FOR 3.5MM 04.614.513,ORSUP0025,CDM,278,RC,C1755,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
ROLLS CANDO SADDLE BLUE 31.5IN,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
ROLLER TUBE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ROM PLUS RUPTURE MEMBRANE TEST,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
ROM PLUS QUALITY CONTROLS,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
ROSEN WIRE GUIDE .035 X 180CM,ORSUP0002,CDM,278,RC,C1769,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ROSEN WIRE GUIDE 035 X 260CM,ORSUP0002,CDM,278,RC,C1769,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ROTALINK ROTABLASTER 2.0MM,ORSUP0028,CDM,278,RC,,,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
ROTALINK ROTABLASTER 1.75MM,ORSUP0030,CDM,278,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1541.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1674.66,33.9,,,percent of total billed charges,33.9% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
ROTALINK ROTABLASTER 1.5MM,ORSUP0030,CDM,278,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1541.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1674.66,33.9,,,percent of total billed charges,33.9% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
ROTH NET PEDIATRIC FOREIGN BODY SNARE,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
ROTOLINK PLUS 1.75,ORSUP0036,CDM,278,RC,,,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4095,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
ROUND W/ VENTS BLUE .75,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ROUND W/ VENTS PURPLE .75,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ROUTER SPRIAL 2.3 MM,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
ROYAL FLUSH HIGH FLOW CATH 6FR X 90CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
RUBBER BANDS STERILE,491128,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
RUBELLA IGG CAL BOX /1 SET,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
RUMI ARCH KOH EFFICIENT 4.0CM,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
RUMI ARCH 3.5CM Koh EFFICIENT,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
RUMI ARCH 3.0CM Koh-EFFICIENT,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
RUMI KOH-EFFICIENT  HANDLE 4.0CM,ORSUP0013,CDM,272,RC,,,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,504,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
S SYRINGE MODULE,ORSUP0030,CDM,272,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
S.G CAL (HIGH) 10ML BTL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
S/D BLADE 1.5MM  X/D  58MM  WIDE DIA. WS. 2.0MM/BOS/NEURO/RCT/USR DRIVER,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
S/D HANDLE NEURO BLUE BULB STYLE ONE FLAT SIDE 2.0/2.3/2.7 SYSTEMS,ORSUP0026,CDM,270,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
S7735 AUTOCHECK 5+ LEVEL 1,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SAFESTEP SPONGE 2MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SAFTEY NEEDLE 22GX1.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SAGITTAL SAW BLADE 4125-89-90,ORSUP0010,CDM,272,RC,,,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
SALEM SUMP NASOGASTRIC TUBE 14FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SALINE LOCK ADAPTOR,491133,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SALINE NORMAL 1000ML .45,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SANI CLOTH SUPER XL 55% ALCOHOL 8X14 PURPLE TOP,207902,CDM,272,RC,,,Outpatient,,,229,148.85,,201.52,88,,,percent of total billed charges,88% of total Billed charges,114.5,50,,,percent of total billed charges,50% of total Billed charges,38.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,229,100,,,percent of total billed charges,100% of total billed charges,39.63,17.304,,,percent of total billed charges,17.304% of total billed charges,114.5,50,,,percent of total billed charges,50% of total Billed charges,144.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,38.47,16.8,,,percent of total billed charges,16.8% of total billed charges,35.04,15.3,,,percent of total billed charges,15.3% of total billed charges,158.01,69,,,percent of total billed charges,69% of total billed charges,229,100,,,percent of total billed charges,100% of total billed charges,114.5,50,,,percent of total billed charges,50% of total Billed charges,229,100,,,percent of total billed charges,100% of total billed charges,114.5,50,,,percent of total billed charges,50% of total Billed charges,229,100,,,percent of total billed charges,100% of total billed charges,114.5,50,,,percent of total billed charges,50% of total Billed charges,141.64,61.85,,,percent of total billed charges,61.85% of total billed charges,38.47,16.8,,,percent of total billed charges,16.8% of total billed charges,114.5,50,,,percent of total billed charges,50% of total Billed charges,114.5,50,,,percent of total billed charges,50% of total Billed charges,38.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,114.5,50,,,percent of total billed charges,50% of total Billed charges,114.5,50,,,percent of total billed charges,50% of total Billed charges,39.24,17.136,,,percent of total billed charges,17.136% of total billed charges,50.01,21.84,,,percent of total billed charges,21.84% of total billed charges,114.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,114.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,114.5,50,,,percent of total billed charges,50% of total Billed charges,178.62,78,,,percent of total billed charges,78% of total billed charges,229,100,,,percent of total billed charges,100% of total billed charges,189.15,82.6,,,percent of total billed charges,82.6% of total billed charges,189.15,82.6,,,percent of total billed charges,82.6% of total billed charges,38.47,16.8,,,percent of total billed charges,16.8% of total billed charges,114.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,114.5,50,,,percent of total billed charges,50% of total Billed charges,38.47,16.8,,,percent of total billed charges,16.8% of total billed charges,35.04,229,
SANITIZER QC FOAM 6 - 750ML,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SARS-COV-2 REF MATERIAL,ORSUP0026,CDM,272,RC,,,Outpatient,,,3000,1950.00,,2640,88,,,percent of total billed charges,88% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,519.12,17.304,,,percent of total billed charges,17.304% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1890,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,15.3,,,percent of total billed charges,15.3% of total billed charges,2070,69,,,percent of total billed charges,69% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1855.5,61.85,,,percent of total billed charges,61.85% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,514.08,17.136,,,percent of total billed charges,17.136% of total billed charges,655.2,21.84,,,percent of total billed charges,21.84% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,2340,78,,,percent of total billed charges,78% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,3000,
SARS-COV-2 CARTRIDGES,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
SARSANTGN FIA NAS SW,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SAW BLADE STRYKER 2108-185,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
SAW BLADE STRYKER 2108-152,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
SAW BLADE RECIPROCATING,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SAW BLADE MINI K-124,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SAW BLADE MINI K121,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SAW BLADE MAXI L135,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SAW BLADE MAXI L122,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SAW BLADE GIGLI 12IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SCALPEL DISPOSABLE STERILE W/,156689,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
SCALPEL DISPOSABLE STERILE WIT,156690,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
SCANNER TEMPORAL TAT-5000 ARTERIAL,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
SCISSOR ROUND TIP ROBOTIC,280485,CDM,272,RC,,,Outpatient,,,9642,6267.30,,8484.96,88,,,percent of total billed charges,88% of total Billed charges,4821,50,,,percent of total billed charges,50% of total Billed charges,1619.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1668.45,17.304,,,percent of total billed charges,17.304% of total billed charges,4821,50,,,percent of total billed charges,50% of total Billed charges,6074.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1619.86,16.8,,,percent of total billed charges,16.8% of total billed charges,1475.23,15.3,,,percent of total billed charges,15.3% of total billed charges,6652.98,69,,,percent of total billed charges,69% of total billed charges,9642,100,,,percent of total billed charges,100% of total billed charges,4821,50,,,percent of total billed charges,50% of total Billed charges,9642,100,,,percent of total billed charges,100% of total billed charges,4821,50,,,percent of total billed charges,50% of total Billed charges,9642,100,,,percent of total billed charges,100% of total billed charges,4821,50,,,percent of total billed charges,50% of total Billed charges,5963.58,61.85,,,percent of total billed charges,61.85% of total billed charges,1619.86,16.8,,,percent of total billed charges,16.8% of total billed charges,4821,50,,,percent of total billed charges,50% of total Billed charges,4821,50,,,percent of total billed charges,50% of total Billed charges,1619.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,4821,50,,,percent of total billed charges,50% of total Billed charges,4821,50,,,percent of total billed charges,50% of total Billed charges,1652.25,17.136,,,percent of total billed charges,17.136% of total billed charges,2105.81,21.84,,,percent of total billed charges,21.84% of total billed charges,4821,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4821,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4821,50,,,percent of total billed charges,50% of total Billed charges,7520.76,78,,,percent of total billed charges,78% of total billed charges,9642,100,,,percent of total billed charges,100% of total billed charges,7964.29,82.6,,,percent of total billed charges,82.6% of total billed charges,7964.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1619.86,16.8,,,percent of total billed charges,16.8% of total billed charges,4821,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4821,50,,,percent of total billed charges,50% of total Billed charges,1619.86,16.8,,,percent of total billed charges,16.8% of total billed charges,1475.23,9642,
SCISSORS CURVED 5MM DA VINCI,337815,CDM,272,RC,,,Outpatient,,,3913,2543.45,,3443.44,88,,,percent of total billed charges,88% of total Billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,657.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,3913,100,,,percent of total billed charges,100% of total billed charges,677.11,17.304,,,percent of total billed charges,17.304% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,2465.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,657.38,16.8,,,percent of total billed charges,16.8% of total billed charges,598.69,15.3,,,percent of total billed charges,15.3% of total billed charges,2699.97,69,,,percent of total billed charges,69% of total billed charges,3913,100,,,percent of total billed charges,100% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,3913,100,,,percent of total billed charges,100% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,3913,100,,,percent of total billed charges,100% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,2420.19,61.85,,,percent of total billed charges,61.85% of total billed charges,657.38,16.8,,,percent of total billed charges,16.8% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,657.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,670.53,17.136,,,percent of total billed charges,17.136% of total billed charges,854.6,21.84,,,percent of total billed charges,21.84% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1956.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1956.5,50,,,percent of total billed charges,50% of total Billed charges,3052.14,78,,,percent of total billed charges,78% of total billed charges,3913,100,,,percent of total billed charges,100% of total billed charges,3232.14,82.6,,,percent of total billed charges,82.6% of total billed charges,3232.14,82.6,,,percent of total billed charges,82.6% of total billed charges,657.38,16.8,,,percent of total billed charges,16.8% of total billed charges,1956.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1956.5,50,,,percent of total billed charges,50% of total Billed charges,657.38,16.8,,,percent of total billed charges,16.8% of total billed charges,598.69,3913,
SCISSORS IRIS CARB-EDGE STRAIGHT SHARP,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
SCISSORS MAYO STRIAGHT ROUND BLADE 5-7/8,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SCLEROSOL INTRAPLEURAL AERSOSOL 4 GM  (10CANS/CS),ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCOPE DISPOSABLE FLEXIBLE - ASCOPE 3 SLIM,188550,CDM,272,RC,,,Outpatient,,,7762,5045.30,,6830.56,88,,,percent of total billed charges,88% of total Billed charges,3881,50,,,percent of total billed charges,50% of total Billed charges,1304.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1343.14,17.304,,,percent of total billed charges,17.304% of total billed charges,3881,50,,,percent of total billed charges,50% of total Billed charges,4890.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1304.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1187.59,15.3,,,percent of total billed charges,15.3% of total billed charges,5355.78,69,,,percent of total billed charges,69% of total billed charges,7762,100,,,percent of total billed charges,100% of total billed charges,3881,50,,,percent of total billed charges,50% of total Billed charges,7762,100,,,percent of total billed charges,100% of total billed charges,3881,50,,,percent of total billed charges,50% of total Billed charges,7762,100,,,percent of total billed charges,100% of total billed charges,3881,50,,,percent of total billed charges,50% of total Billed charges,4800.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1304.02,16.8,,,percent of total billed charges,16.8% of total billed charges,3881,50,,,percent of total billed charges,50% of total Billed charges,3881,50,,,percent of total billed charges,50% of total Billed charges,1304.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,3881,50,,,percent of total billed charges,50% of total Billed charges,3881,50,,,percent of total billed charges,50% of total Billed charges,1330.1,17.136,,,percent of total billed charges,17.136% of total billed charges,1695.22,21.84,,,percent of total billed charges,21.84% of total billed charges,3881,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3881,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3881,50,,,percent of total billed charges,50% of total Billed charges,6054.36,78,,,percent of total billed charges,78% of total billed charges,7762,100,,,percent of total billed charges,100% of total billed charges,6411.41,82.6,,,percent of total billed charges,82.6% of total billed charges,6411.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1304.02,16.8,,,percent of total billed charges,16.8% of total billed charges,3881,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3881,50,,,percent of total billed charges,50% of total Billed charges,1304.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1187.59,7762,
SCOPE FLEXIBLE DISPOSABLE - ASCOPE 3,188551,CDM,272,RC,,,Outpatient,,,2164,1406.60,,1904.32,88,,,percent of total billed charges,88% of total Billed charges,1082,50,,,percent of total billed charges,50% of total Billed charges,363.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,2164,100,,,percent of total billed charges,100% of total billed charges,374.46,17.304,,,percent of total billed charges,17.304% of total billed charges,1082,50,,,percent of total billed charges,50% of total Billed charges,1363.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,363.55,16.8,,,percent of total billed charges,16.8% of total billed charges,331.09,15.3,,,percent of total billed charges,15.3% of total billed charges,1493.16,69,,,percent of total billed charges,69% of total billed charges,2164,100,,,percent of total billed charges,100% of total billed charges,1082,50,,,percent of total billed charges,50% of total Billed charges,2164,100,,,percent of total billed charges,100% of total billed charges,1082,50,,,percent of total billed charges,50% of total Billed charges,2164,100,,,percent of total billed charges,100% of total billed charges,1082,50,,,percent of total billed charges,50% of total Billed charges,1338.43,61.85,,,percent of total billed charges,61.85% of total billed charges,363.55,16.8,,,percent of total billed charges,16.8% of total billed charges,1082,50,,,percent of total billed charges,50% of total Billed charges,1082,50,,,percent of total billed charges,50% of total Billed charges,363.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,1082,50,,,percent of total billed charges,50% of total Billed charges,1082,50,,,percent of total billed charges,50% of total Billed charges,370.82,17.136,,,percent of total billed charges,17.136% of total billed charges,472.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1082,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1082,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1082,50,,,percent of total billed charges,50% of total Billed charges,1687.92,78,,,percent of total billed charges,78% of total billed charges,2164,100,,,percent of total billed charges,100% of total billed charges,1787.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1787.46,82.6,,,percent of total billed charges,82.6% of total billed charges,363.55,16.8,,,percent of total billed charges,16.8% of total billed charges,1082,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1082,50,,,percent of total billed charges,50% of total Billed charges,363.55,16.8,,,percent of total billed charges,16.8% of total billed charges,331.09,2164,
SCREW SCHANZ TITANIUM 4.0X3.0  20MM THRD/80MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW CANN SS 4.0MM 28MM LT,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW CANN SS 4.0MM 34MM LT,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
SCREW CANN SS 4.0MM 46MM LT,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW CANN SS 4.0MM 50MM LT,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SCREW CORTICAL 3.5MM 16,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW CORTICAL 3.5MM 14,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW CORTICAL 3.5MM 12,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW CORTICAL 3.5MM 10,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW LOCKING  T7 2.7 X 12MM,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SCREW CORTEX 2.7MMX22MM,ORSUP0004,CDM,278,RC,C1713,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SCREW 1.3MM CORTEX SELF TAPPING W/FLUTES 4MM,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW 1.5 CORTEX 6MM,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW 10 X 25               AR-1401,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW 12.0MM (3.5),ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW 2.3 X 18MM THREADED LOCKING,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW 2.3 X 20MM THREADED LOCKING,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW 2.3 X 22MM THREADED LOCKING,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW 2.3 X 24MM,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW 2.3MM NON-LOCKING DISTAL CO-N2320,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW 2.3MM X 14MM LOCKING DISTAL CO-T2314,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW 2.4 X 10MM LOCKING,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SCREW 2.4 X 12MM LOCKING,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SCREW 2.4 X 12MM NON-LOCKING,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SCREW 2.7 X 14MM NON-LOCKING MFT-011-27-14,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 2.7 X 16MM NON-LOCKING  MFT-011-27-16,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 2.7 X 26MM NON-LOCKING MFT-011-27-26,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 10MM LOCKING MFT-021-35-10,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 12MM LOCKING,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW 3.5 X 12MM LOCKING MFT-021-35-12,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 14MM LOCKING MFT-021-35-14,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 14MM NON-LOCKING MFT-011-35-14,ORSUP006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW 3.5 X 16MM LOCKING SCREW MFT-021-35-16,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 16MM NON-LOCKING MFT-011-35-16,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 18MM LOCKING MFT-021-35-18,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 18MM NON-LOCKING MFT-011-35-18,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 20MM LOCKING MFT-021-35-20,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 20MM NON-LOCKING MFT-011-35-20,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 22MM LOCKING MFT-021-35-22,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 24MM NON-LOCKING MFT-011-35-24,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 24MMM LOCKING MFT-021-35-24,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 26MM LOCKING MFT-021-35-26,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 26MM NON-LOCKING MFT-001-35-26,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 3.5 X 28MM LOCKING MFT-021-35-28,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0 X 14MM NON-LOCKING MFT-011-40-14,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0 X 18MM NON-LOCKING MFT-011-40-18,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 26MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 28MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 30MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 34MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 36MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 38MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 40MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 42MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 46MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 48MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 50MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 62MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 70MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 72MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM CANNULATED LOCKING 25MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW 5.0MM CANNULATED LOCKING 30MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW 5.0MM TI LOCKING 36MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING 38MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING 40MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING 42MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING 44MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING 48MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING 54MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING 60MM,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 28MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 30MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 32MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 34MM,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 36MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 38MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 40MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 44MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 46MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 48MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 50MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 52MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 56MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 58MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 66MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 76MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW 7.3MM CANNULATED LOCKING 80MM,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SCREW ACL 8 X 25 ARTHREX    AR-1381,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW ACUTRAX FUSION 18MM,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW BIOCOMPOSITE TENODESIS 8X12,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
SCREW BIOTENODESIS PEEK 7MM,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
SCREW BIOTENODESIS PEEK 8MM,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
SCREW BIOTENODESIS PEEK 9MM,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
SCREW BIOTENODESIS ST 8.0X23MM,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
SCREW BN TI L30MM OD5MM NAIL-EX TIB 2 COR LOK STRDR RECESS N,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW BNE 316L SS L12MM OD2.4MM LCP CORTL/DIST RADL ST T8 ST,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW BNE 316L SS L12MM OD2.4MM LCP DIST RADL ST STRDRV RECE,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SCREW BNE 316L SS L14MM OD2.7MM LCP CORTL ST T8 STRDRV RECES,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW BNE 316L SS L16MM OD2.4MM LCP DIST RADL ST STRDRV RECE,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SCREW BNE 316L SS L16MM OD2.7MM LCP CORTL ST T8 STRDRV RECES,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SCREW BNE 316L SS L18MM OD2.4MM LCP DIST RADL ST STRDRV RECE,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SCREW BNE 316L SS L18MM OD2.7MM LCP CORTL ST T8 STRDRV RECES,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW BNE 316L SS L20MM OD2.4MM LCP DIST RADL ST STRDRV RECE,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SCREW BNE 316L SS L22MM OD2.4MM LCP DIST RADL ST STRDRV RECE,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW BNE 316L SS L24MM OD2.4MM LCP DIST RADL ST STRDRV RECE,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW BNE 316L SS L26MM OD2.4MM LCP DIST RADL ST STRDRV RECE,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW BNE SS L14MM OD2.4MM LCP STRDRV DIST RADL ST RECESS LO,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SCREW BNE TI L14MM OD3.5MM AXON CANC THRD,ORSUP0031,CDM,278,RC,C1713,HCPCS,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
SCREW BNE TI L16MM OD3.5MM AXON CANC THRD,ORSUP0031,CDM,278,RC,C1713,HCPCS,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
SCREW BNE TI L45MM OD5.2MM CLKX PDCL TP LD DL COR,ORSUP0023,CDM,278,RC,C1713,HCPCS,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,973.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1176.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1057.68,33.9,,,percent of total billed charges,33.9% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
SCREW BONE CANCELLOUS 6.5 X 25MM,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW BONE L65MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW BONE L70MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW BONE L75MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW BONE L85MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW BONE L90MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW BONE TITANIUM L60MM NAIL-EX,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW CANC SS 4.0MM 18MM FT,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SCREW CANCELLOUS POLYAXIAL 3.5MM TI 12MM 04.614.012,ORSUP0028,CDM,278,RC,C1713,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
SCREW CANCELLOUS POLYAXIAL 3.5MM TI 14MM 04.614.014,ORSUP0028,CDM,278,RC,C1713,HCPCS,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1379.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1666.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,1498.38,33.9,,,percent of total billed charges,33.9% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
SCREW CANCELLOUS POLYAXIAL 3.5MM TI 16MM 04.614.016,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW CANCELLOUS POLYAXIAL 3.5MM TI 24MM 04.614.024,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW CANCELLOUS POLYAXIAL 3.5MM TI 26MM 04.614.026,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW CANCELLOUS POLYAXIAL 3.5MM TI 30MM 04.614.030,ORSUP0036,CDM,278,RC,C1713,HCPCS,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4095,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
SCREW CANCELLOUS POLYAXIAL 4.0MM TI 14MM 04.614.114,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW CANCELLOUS POLYAXIAL 4.0MM TI 16MM 04.614.116,ORSUP0037,CDM,278,RC,C1713,HCPCS,Outpatient,,,6760,4394.00,,5948.8,88,,,percent of total billed charges,88% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1169.75,17.304,,,percent of total billed charges,17.304% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4258.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,15.3,,,percent of total billed charges,15.3% of total billed charges,4664.4,69,,,percent of total billed charges,69% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4181.06,61.85,,,percent of total billed charges,61.85% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2109.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1158.39,17.136,,,percent of total billed charges,17.136% of total billed charges,1476.38,21.84,,,percent of total billed charges,21.84% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2291.64,33.9,,,percent of total billed charges,33.9% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,5272.8,78,,,percent of total billed charges,78% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,6760,
SCREW CANCELLOUS POLYAXIAL 4.0MM TI 20MM 04.614.120,ORSUP0027,CDM,278,RC,C1713,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
SCREW CANCELLOUS POLYAXIAL 4.0MM TI 22MM 04.614.122,ORSUP0027,CDM,278,RC,C1713,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
SCREW CANCELLOUS POLYAXIAL 4.0MM TI 24MM 04.614.124,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW CANCELLOUS POLYAXIAL 4.0MM TI 26MM 04.614.126,ORSUP0037,CDM,278,RC,C1713,HCPCS,Outpatient,,,6760,4394.00,,5948.8,88,,,percent of total billed charges,88% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1169.75,17.304,,,percent of total billed charges,17.304% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4258.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,15.3,,,percent of total billed charges,15.3% of total billed charges,4664.4,69,,,percent of total billed charges,69% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4181.06,61.85,,,percent of total billed charges,61.85% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2109.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1158.39,17.136,,,percent of total billed charges,17.136% of total billed charges,1476.38,21.84,,,percent of total billed charges,21.84% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2291.64,33.9,,,percent of total billed charges,33.9% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,5272.8,78,,,percent of total billed charges,78% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,6760,
SCREW CANCELLOUS POLYAXIAL 4.0MM TI 28MM 04.614.128,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW CANCELLOUS POLYAXIAL 4.5MM TI 22MM 04.614.222,ORSUP0027,CDM,278,RC,C1713,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
SCREW CANCELLOUS POLYAXIAL 4.5MM TI 24MM 04.614.224,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW CANCELLOUS POLYAXIAL 4.5MM TI 26MM 04.614.226,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW CANCELLOUS POLYAXIAL 4.5MM TI 28MM 04.614.228,ORSUP0038,CDM,278,RC,C1713,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
SCREW CANN 32MM 6.5 X 100 THREAD,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW CANN 32MM 6.5 X 105 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 32MM 6.5 X 45 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 32MM 6.5 X 50 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 32MM 6.5 X 60 THREAD,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SCREW CANN 32MM 6.5 X 95 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 45MM 6.5,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 6.5 X  80 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 6.5 X  85 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 6.5 X  90 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 6.5 X  95 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 6.5 X 100 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 6.5 X 105 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 6.5 X 55 THREAD,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW CANN 6.5 X 65 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 6.5MM X 60 THREAD,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN 70MM 6.5,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN SS 4.0MM 24MM ST,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW CANN SS 4.0MM 26MM ST,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW CANN SS 4.0MM 30MM LT,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW CANN SS 4.0MM 36MM LT,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW CANN SS 4.0MM 38MM ST,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
SCREW CANN SS 4.0MM 40MM LT,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SCREW CANN SS 4.0MM 48MM LT,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
SCREW CANN SS 7.3MM 16MM THREAD 100MM,ORSUP0023,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN SS 7.3MM 16MM THREAD 45MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW CANN SS 7.3MM 16MM THREAD 50MM,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANN SS 7.3MM 16MM THREAD 75MM,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW CANNULATED 5.0MM LOCKING 45MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW CANNULATED 5.0MM LOCKING 65MM,ORSUP0021,CDM,278,RC,C1713,HCPCS,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,811.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,881.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
SCREW CANNULATED 5.0MM LOCKING 80MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW CANNULATED ACL INTERFERENCE 9X25MM,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW CANNULATED CONICAL 5.0X75MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW CANNULATED LOCKING 75MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCREW CORTCL CONGRUENT TI 3.5X16MM,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW CORTEX 1.3MMX10MM ST,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW CORTEX 1.3MMX11MM ST,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW CORTEX 1.3MMX12MM ST,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 1.3MMX13MM ST,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 1.3MMX14MM ST,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW CORTEX 1.3MMX16MM ST,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 1.3MMX18MM ST,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 2.0MMX20MM,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 2.0MMX24MM,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW CORTEX 2.0MMX32MM,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SCREW CORTEX 2.4 X 12 401.512,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 2.4MMX10MM ST,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 2.4MMX11MM ST,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 2.4MMX13MM ST,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW CORTEX 2.4MMX14MMST,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 2.4MMX18MM ST,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 2.4MMX20MM ST,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 2.4MMX22MM ST,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW CORTEX 2.4MMX24MM ST,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW CORTEX 2.4MMX26MM ST,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW CORTEX 2.4MMX28MM ST,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW CORTEX 2.4MMX30MM ST,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 2.4MMX32MMST,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW CORTEX 2.4MMX6MM ST,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 2.4MMX8MM ST,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX 2.7MMX12MM,ORSUP0004,CDM,278,RC,C1713,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SCREW CORTEX 2.7X14MM,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SCREW CORTEX 3.5X16MM  404.816,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SCREW CORTEX 3.5X18MM 404.818,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SCREW CORTEX POLYAXIAL SHAFT 3.5MM TI 24MM 04.614.324,ORSUP0038,CDM,278,RC,C1713,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
SCREW CORTEX SELFTAPPING 2.4MM X 16MM,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX SS 3.5MM 12MM SELF-TAP,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SCREW CORTEX SS 3.5MM 20MM SELF-TAP,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SCREW CORTEX SS 3.5MM 30MM SELF-TAP,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SCREW CORTEX SS 3.5MM 34MM SELF-TAP,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW CORTEX SS 3.5MM 40MM SELF-TAP,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW CORTEX SS 4.5MM 40MM SELF-TAP,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW CORTEX TIN 1.5MMX6MM,ORSUP0004,CDM,278,RC,C1713,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SCREW CORTEX TIN 1.5MMX7MM,ORSUP0004,CDM,278,RC,C1713,HCPCS,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,67.8,33.9,,,percent of total billed charges,33.9% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
SCREW CORTEX TITANIUM 1.5X14MM,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,84.75,33.9,,,percent of total billed charges,33.9% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
SCREW CORTEX TITANIUM 1.5X16MM,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW CORTEX TITANIUM 1.5X18MM,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,84.75,33.9,,,percent of total billed charges,33.9% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
SCREW CORTEX TITANIUM 1.5X8MM,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,188.5,37.7,,,percent of total billed charges,37.70% of total billed charges,188.5,37.7,,,percent of total billed charges,37.70% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,169.5,33.9,,,percent of total billed charges,33.9% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
SCREW CORTEX TITANIUM 2.0X10MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
SCREW CORTEX TITANIUM 2.0X12MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
SCREW CORTEX TITANIUM 2.0X14MM,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW CORTEX TITANIUM 2.0X18MM,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW CORTEX TITANIUM 2.7X20MM,ORSUP0004,CDM,278,RC,C1713,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,88.14,33.9,,,percent of total billed charges,33.9% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SCREW CORTEX TITANIUM 2.OX16MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
SCREW CORTEX TITANIUM 400.812,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW CORTEX TITANIUM 400.820,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW CORTEX TITANIUM 400.822,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW CORTEX TITATIUM 1.5X10MM,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,84.75,33.9,,,percent of total billed charges,33.9% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
SCREW CORTICAL 3.5 X 10MM,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW CORTICAL 3.5 X 14MM,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW CORTICAL 3.5 X 22MM,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW CORTICAL LOCKING  3.5 X 14MM,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW CORTICAL LOCKING 3.5 X 16MM,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW CORTICAL LOCKING 3.5 X 18MM,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW CORTICAL LOCKING 3.5 X 8MM,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW EMERGENCY 4MM MATRIXNEURO TI,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW HEX CORTICAL 3.2 X 14MM,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SCREW LOCKING 2.7MMX16MM,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SCREW LOCKING 2.7MMX18MM 202.218,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 12MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 16MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 18MM,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 22MM,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 28MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 30MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 32MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 36MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 38MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 40MM,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 45MM,ORSUP0018,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 50MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 55MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 60MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW LOCKING 5.0MM SLF-TAP W/STAR DRIVE 36MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW LOCKING 5.0MM X 42MM STARDRIVE,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW LOW PROFILE 400.844,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
"SCREW MAXTORQUE 4.0 X 20MM, SHORT THREAD MSD-010-40-020S",ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"SCREW MAXTORQUE 4.0 X 24MM, LONG THREAD MSD-010-40-024L",ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
"SCREW MAXTORQUE 4.0 X 24MM, SHORT THREAD MSD-010-40-024S",ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"SCREW MAXTORQUE 4.0 X 26MM, SHORT THREAD MSD-010-40-26S",ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"SCREW MAXTORQUE 4.0 X 28MM, LONG THREAD MSD-010-40-028L",ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"SCREW MAXTORQUE 4.0 X 28MM, SHORT THREAD MSD-010-40-28S",ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"SCREW MAXTORQUE 4.0 X 30MM, LONG THREAD MSD-010-40-030L",ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"SCREW MAXTORQUE 4.0 X 30MM, SHORT THREAD MSD-010-40-030S",ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"SCREW MAXTORQUE 4.0 X 32MM, LONG THREAD MSD-010-40-325L",ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"SCREW MAXTORQUE 4.0 X 35MM, LONG THREAD MSD-010-40-035L",ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"SCREW MAXTORQUE 4.0 X 37.5MM, LONG THREAD MSD-010-40-375L",ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"SCREW MAXTORQUE 4.0 X 42,5MM, LONG THREAD MSD-010-40-425L",ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"SCREW MAXTORQUE 5.5 X 37.5MM, SHORT THREAD MSD-010-55-375S",ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW SCHANZ 5.0MM BLUNT TROCAR POINT 170MM,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREW SCHANZ 5.0MM SELF-DRILL 80MM THREAD,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW SELF-DRILLING TI MATRIXNEURO 3MM 04.503.103.01,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW SELF-DRILLING TI MATRIXNEURO 4MM 04.503.104.01,ORSUP0006,CDM,278,RC,C1713,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SCREW SLF-TPNG WITH T25 STARDRIVE RECESS 28MM 5.0MM LOCKING,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW SLF-TPNG WITH T25 STARDRIVE RECESS 32MM 5.0MM LOCKING,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW SLF-TPNG WITH T25 STARDRIVE RECESS 38MM 5.0MM LOCKING,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SCREW SLF-TPNG WITH T25 STARDRIVE RECESS 40MM 5.0MM LOCKING,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW TI LOW PROFILE NEURO EMERGENCY SELF-TAP 4MM,ORSUP0007,CDM,278,RC,C1713,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SCREWS LOCKING 4 X 25MM,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
SCREW 14MM,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SCREW 16MM,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW 7 MM X 55MM,ORSUP0029,CDM,278,RC,C1713,HCPCS,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1460.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1586.52,33.9,,,percent of total billed charges,33.9% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
SCREW 7.5X45MM,ORSUP0035,CDM,278,RC,C1713,HCPCS,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
SCREW 7MM X 45 TITANIUM POLYAXIAL,ORSUP0035,CDM,278,RC,C1713,HCPCS,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
SCREW 7MM X 50 TITANIUM POLYAXIAL,ORSUP0029,CDM,278,RC,C1713,HCPCS,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1460.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1586.52,33.9,,,percent of total billed charges,33.9% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
SCREW 8 MM X 50MM,ORSUP0035,CDM,278,RC,C1713,HCPCS,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1946.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2352.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,2115.36,33.9,,,percent of total billed charges,33.9% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
SCREW BARIABLE SELF TAP 16MM,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW BONE TI L16MM OD4.5MM VECTRA CERV ST FA SLF RET,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW BONE TI L18MM OD4.5MM VECTRA CERV ST FA SLF RET,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW BONE TI L18MM OD4MM VECTRA CERV ST FA SLF RET,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW BONE TI L40MM OD7MM PANGEA PDCL 2 COR PA NS,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW BONE TI L40MM OD8MM PANGEA PDCL PA PREASSEMBLED,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW BONE TI L45MM OD6MM PANGEA PDCL PA PREASSEMBLED,ORSUP0034,CDM,278,RC,C1713,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
SCREW BONE TI L45MM OD7MM PANGEA PDCL 2 COR PA NS,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW BONE TI L45MM OD8MM PANGEA PDCL PA,ORSUP0034,CDM,278,RC,C1713,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
SCREW BONE TI L50MM OD5MM PANGEA PDCL PA PREASSEMBLED,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW BONE TI L50MM OD6MM PANGEA PDCL PA PREASSEMBLED,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW BONE TI L50MM OD7MM PANGEA PDCL 2 COR PA NS,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW BONE TI L50MM OD8MM PANGEA PDCL PA,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW BONE TI L55MM OD7MM PANGEA  PDCL PA PREASSEMBLED,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW BONE TI L55MM OD8MM PANGEA PDCL PA PREASSEMBLED,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW BONE TI L60MM OD7MM PANGEA PDCL PA PREASSEMBLED,ORSUP0033,CDM,278,RC,C1713,HCPCS,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1784.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2156.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,1939.08,33.9,,,percent of total billed charges,33.9% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
SCREW BONE TI L60MM OD8MM PANGEA PDCL PA PREASSEMBLED,ORSUP0032,CDM,278,RC,C1713,HCPCS,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1703.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1850.94,33.9,,,percent of total billed charges,33.9% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
SCREW BONE VECTRA TI L 16MM OD4MM ANT CERV SLF RET SLFDRL,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW BONE VECTRA TI L14MM OD4.5MM ANT CERV SLF RE,ORSUP0017,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SCREW BONE VECTRA TI L14MM OD4MM ANT CERV SLF RET SLFDRL VA,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW BONE VECTRA TI L16MM OD4.5MM ANT CERV SLF RET SLFDRL VA,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW BONE VECTRA TI L16MM OD4MM ANT CERV SLF RET SLFDRL FA,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW BONE VECTRA TI L18MM OD4.5MM ANT CERV SLF RET SLFDRL VA,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW BONE VECTRA TI L18MM OD4MM ANT CERV SLF RET SLFDRL FA,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW BONE VECTRA TI L18MM OD4MM ANT CERV SLF RET SLFDRL VA,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW SELF-TAPPING 45MM,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW TITANIUM SELF TAP 18MM,ORSUP0016,CDM,278,RC,C1713,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SCREW SYN LOCKING 5.0MM,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SCREW CONEPT 7 X 25,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW CONCEPT 7 X 20,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW 208.900 CANNULATED,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCREW BIO FEMOR INTER 7X20,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW CONCEPT 9 X 30,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW CONCEPT 9 X 25,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW CONCEPT 9 X 20,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW CONCEPT 7 X 30,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW BIO TIBIAL 7 X 20,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SCREW BIO TIBIAL 7 X 25,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SCREW CORTEX 1.3MM X 9MM ST,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW CORTEX 1.3MM X 6MM S-T,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW CORTEX 1.3MM X 7MM S-T,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SCREW COREX 1.0 X 8MM TITANIUM S-T,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SCREW CANNULATED 4.0 LONG THREAD,ORSUP0021,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
SCREW CANNULATED 8MM X 20MM,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
SCREW CANNULATED FULL THREAD 8 X 25,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,188.5,37.7,,,percent of total billed charges,37.70% of total billed charges,188.5,37.7,,,percent of total billed charges,37.70% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,169.5,33.9,,,percent of total billed charges,33.9% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
SCREW CANNULATED FULL THREAD 8 X 30,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,188.5,37.7,,,percent of total billed charges,37.70% of total billed charges,188.5,37.7,,,percent of total billed charges,37.70% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,169.5,33.9,,,percent of total billed charges,33.9% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
SCRUB SOLN EXIDINE-4 GAL,185641,CDM,270,RC,,,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,252,50,,,percent of total billed charges,50% of total Billed charges,84.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,504,100,,,percent of total billed charges,100% of total billed charges,87.21,17.304,,,percent of total billed charges,17.304% of total billed charges,252,50,,,percent of total billed charges,50% of total Billed charges,317.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84.67,16.8,,,percent of total billed charges,16.8% of total billed charges,77.11,15.3,,,percent of total billed charges,15.3% of total billed charges,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,252,50,,,percent of total billed charges,50% of total Billed charges,504,100,,,percent of total billed charges,100% of total billed charges,252,50,,,percent of total billed charges,50% of total Billed charges,504,100,,,percent of total billed charges,100% of total billed charges,252,50,,,percent of total billed charges,50% of total Billed charges,311.72,61.85,,,percent of total billed charges,61.85% of total billed charges,84.67,16.8,,,percent of total billed charges,16.8% of total billed charges,252,50,,,percent of total billed charges,50% of total Billed charges,252,50,,,percent of total billed charges,50% of total Billed charges,84.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,252,50,,,percent of total billed charges,50% of total Billed charges,252,50,,,percent of total billed charges,50% of total Billed charges,86.37,17.136,,,percent of total billed charges,17.136% of total billed charges,110.07,21.84,,,percent of total billed charges,21.84% of total billed charges,252,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,252,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,252,50,,,percent of total billed charges,50% of total Billed charges,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,84.67,16.8,,,percent of total billed charges,16.8% of total billed charges,252,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,252,50,,,percent of total billed charges,50% of total Billed charges,84.67,16.8,,,percent of total billed charges,16.8% of total billed charges,77.11,504,
SCRUB SITE IPA DEVICE W/ ISO ALCOHOL BX/100,323429,CDM,272,RC,,,Outpatient,,,201,130.65,,176.88,88,,,percent of total billed charges,88% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,201,100,,,percent of total billed charges,100% of total billed charges,34.78,17.304,,,percent of total billed charges,17.304% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,126.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,30.75,15.3,,,percent of total billed charges,15.3% of total billed charges,138.69,69,,,percent of total billed charges,69% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,201,100,,,percent of total billed charges,100% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,201,100,,,percent of total billed charges,100% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,124.32,61.85,,,percent of total billed charges,61.85% of total billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,34.44,17.136,,,percent of total billed charges,17.136% of total billed charges,43.9,21.84,,,percent of total billed charges,21.84% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100.5,50,,,percent of total billed charges,50% of total Billed charges,156.78,78,,,percent of total billed charges,78% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100.5,50,,,percent of total billed charges,50% of total Billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,30.75,201,
SCRUB BETASEPT 4% CHG 32OZ,216301,CDM,270,RC,,,Outpatient,,,68,44.20,,59.84,88,,,percent of total billed charges,88% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,68,100,,,percent of total billed charges,100% of total billed charges,11.77,17.304,,,percent of total billed charges,17.304% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,42.84,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,10.4,15.3,,,percent of total billed charges,15.3% of total billed charges,46.92,69,,,percent of total billed charges,69% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,68,100,,,percent of total billed charges,100% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,68,100,,,percent of total billed charges,100% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,42.06,61.85,,,percent of total billed charges,61.85% of total billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,11.65,17.136,,,percent of total billed charges,17.136% of total billed charges,14.85,21.84,,,percent of total billed charges,21.84% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34,50,,,percent of total billed charges,50% of total Billed charges,53.04,78,,,percent of total billed charges,78% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,34,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34,50,,,percent of total billed charges,50% of total Billed charges,11.42,16.8,,,percent of total billed charges,16.8% of total billed charges,10.4,68,
SCRUB BRUSH W/IODINE,491162,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
SCRUB BRUSH DRY,491158,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
SCRW 2.3 THREADED 16MM,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SCRW 2.7MM LOCKING SLF-TPNG W/T8 STARDRIVE RECESS 28MM 202.228,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SCRW 5.0MM CANNULATED LOCKING 85MM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SCRW BNE L130MM OD7.3MM CNULA FULTHRD,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SEALANT SURGICAL CO-SEAL 4ML,ORSUP0024,CDM,278,RC,C1763,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
SEALANT FLOSEAL HEMOSTATIC MATRIX 10ML,ORSUP0019,CDM,278,RC,C1763,HCPCS,Outpatient,,,1600,1040.00,,1408,88,,,percent of total billed charges,88% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,276.86,17.304,,,percent of total billed charges,17.304% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1008,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1104,69,,,percent of total billed charges,69% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,989.6,61.85,,,percent of total billed charges,61.85% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,499.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,800,50,,,percent of total billed charges,50% of total Billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,274.18,17.136,,,percent of total billed charges,17.136% of total billed charges,349.44,21.84,,,percent of total billed charges,21.84% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,603.2,37.7,,,percent of total billed charges,37.70% of total billed charges,603.2,37.7,,,percent of total billed charges,37.70% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,542.4,33.9,,,percent of total billed charges,33.9% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,1248,78,,,percent of total billed charges,78% of total billed charges,1600,100,,,percent of total billed charges,100% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1321.6,82.6,,,percent of total billed charges,82.6% of total billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,800,50,,,percent of total billed charges,50% of total Billed charges,268.8,16.8,,,percent of total billed charges,16.8% of total billed charges,244.8,1600,
SEAL ANGIO STS 6FR VIP,ORSUP0014,CDM,278,RC,C1760,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SEAL SYSTEM HEARTSTRING BX/5,ORSUP0023,CDM,270,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
SEALER CURVED LARGE JAW OPEN,ORSUP0093,CDM,272,RC,,,Outpatient,,,21840,14196.00,,19219.2,88,,,percent of total billed charges,88% of total Billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3779.19,17.304,,,percent of total billed charges,17.304% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,13759.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,3341.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15069.6,69,,,percent of total billed charges,69% of total billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,13508.04,61.85,,,percent of total billed charges,61.85% of total billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,3742.5,17.136,,,percent of total billed charges,17.136% of total billed charges,4769.86,21.84,,,percent of total billed charges,21.84% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10920,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10920,50,,,percent of total billed charges,50% of total Billed charges,17035.2,78,,,percent of total billed charges,78% of total billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,18039.84,82.6,,,percent of total billed charges,82.6% of total billed charges,18039.84,82.6,,,percent of total billed charges,82.6% of total billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10920,50,,,percent of total billed charges,50% of total Billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,3341.52,21840,
SEALANT EVICEL FIBRIN 5ML (1EA/BX),ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
SEALANT TISSEEL FIBRIN 10ML FROZEN,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
SEALENT TISSEEL FBRINOGEN 4ML,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SEAL 5MM DISPOSABLE GREEN,270727,CDM,272,RC,,,Outpatient,,,2729,1773.85,,2401.52,88,,,percent of total billed charges,88% of total Billed charges,1364.5,50,,,percent of total billed charges,50% of total Billed charges,458.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,2729,100,,,percent of total billed charges,100% of total billed charges,472.23,17.304,,,percent of total billed charges,17.304% of total billed charges,1364.5,50,,,percent of total billed charges,50% of total Billed charges,1719.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,458.47,16.8,,,percent of total billed charges,16.8% of total billed charges,417.54,15.3,,,percent of total billed charges,15.3% of total billed charges,1883.01,69,,,percent of total billed charges,69% of total billed charges,2729,100,,,percent of total billed charges,100% of total billed charges,1364.5,50,,,percent of total billed charges,50% of total Billed charges,2729,100,,,percent of total billed charges,100% of total billed charges,1364.5,50,,,percent of total billed charges,50% of total Billed charges,2729,100,,,percent of total billed charges,100% of total billed charges,1364.5,50,,,percent of total billed charges,50% of total Billed charges,1687.89,61.85,,,percent of total billed charges,61.85% of total billed charges,458.47,16.8,,,percent of total billed charges,16.8% of total billed charges,1364.5,50,,,percent of total billed charges,50% of total Billed charges,1364.5,50,,,percent of total billed charges,50% of total Billed charges,458.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,1364.5,50,,,percent of total billed charges,50% of total Billed charges,1364.5,50,,,percent of total billed charges,50% of total Billed charges,467.64,17.136,,,percent of total billed charges,17.136% of total billed charges,596.01,21.84,,,percent of total billed charges,21.84% of total billed charges,1364.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1364.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1364.5,50,,,percent of total billed charges,50% of total Billed charges,2128.62,78,,,percent of total billed charges,78% of total billed charges,2729,100,,,percent of total billed charges,100% of total billed charges,2254.15,82.6,,,percent of total billed charges,82.6% of total billed charges,2254.15,82.6,,,percent of total billed charges,82.6% of total billed charges,458.47,16.8,,,percent of total billed charges,16.8% of total billed charges,1364.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1364.5,50,,,percent of total billed charges,50% of total Billed charges,458.47,16.8,,,percent of total billed charges,16.8% of total billed charges,417.54,2729,
SEAL CANNULA 8.5 - 13MM,176843,CDM,272,RC,,,Outpatient,,,321,208.65,,282.48,88,,,percent of total billed charges,88% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,321,100,,,percent of total billed charges,100% of total billed charges,55.55,17.304,,,percent of total billed charges,17.304% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,202.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,49.11,15.3,,,percent of total billed charges,15.3% of total billed charges,221.49,69,,,percent of total billed charges,69% of total billed charges,321,100,,,percent of total billed charges,100% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,321,100,,,percent of total billed charges,100% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,321,100,,,percent of total billed charges,100% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,198.54,61.85,,,percent of total billed charges,61.85% of total billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,55.01,17.136,,,percent of total billed charges,17.136% of total billed charges,70.11,21.84,,,percent of total billed charges,21.84% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,160.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,160.5,50,,,percent of total billed charges,50% of total Billed charges,250.38,78,,,percent of total billed charges,78% of total billed charges,321,100,,,percent of total billed charges,100% of total billed charges,265.15,82.6,,,percent of total billed charges,82.6% of total billed charges,265.15,82.6,,,percent of total billed charges,82.6% of total billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,160.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,160.5,50,,,percent of total billed charges,50% of total Billed charges,53.93,16.8,,,percent of total billed charges,16.8% of total billed charges,49.11,321,
SEAL CANNULA 8MM,238235,CDM,272,RC,,,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,20.76,17.304,,,percent of total billed charges,17.304% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.56,17.136,,,percent of total billed charges,17.136% of total billed charges,26.21,21.84,,,percent of total billed charges,21.84% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,120,
SEALER AQUAMANTIS BIPOLAR 2.3,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
SEALER BIPOLAR 6.0,ORSUP0029,CDM,272,RC,,,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
SEALER ENDOWRIST ONE VESSEL,413063,CDM,272,RC,,,Outpatient,,,17653,11474.45,,15534.64,88,,,percent of total billed charges,88% of total Billed charges,8826.5,50,,,percent of total billed charges,50% of total Billed charges,2965.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3054.68,17.304,,,percent of total billed charges,17.304% of total billed charges,8826.5,50,,,percent of total billed charges,50% of total Billed charges,11121.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2965.7,16.8,,,percent of total billed charges,16.8% of total billed charges,2700.91,15.3,,,percent of total billed charges,15.3% of total billed charges,12180.57,69,,,percent of total billed charges,69% of total billed charges,17653,100,,,percent of total billed charges,100% of total billed charges,8826.5,50,,,percent of total billed charges,50% of total Billed charges,17653,100,,,percent of total billed charges,100% of total billed charges,8826.5,50,,,percent of total billed charges,50% of total Billed charges,17653,100,,,percent of total billed charges,100% of total billed charges,8826.5,50,,,percent of total billed charges,50% of total Billed charges,10918.38,61.85,,,percent of total billed charges,61.85% of total billed charges,2965.7,16.8,,,percent of total billed charges,16.8% of total billed charges,8826.5,50,,,percent of total billed charges,50% of total Billed charges,8826.5,50,,,percent of total billed charges,50% of total Billed charges,2965.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,8826.5,50,,,percent of total billed charges,50% of total Billed charges,8826.5,50,,,percent of total billed charges,50% of total Billed charges,3025.02,17.136,,,percent of total billed charges,17.136% of total billed charges,3855.42,21.84,,,percent of total billed charges,21.84% of total billed charges,8826.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8826.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8826.5,50,,,percent of total billed charges,50% of total Billed charges,13769.34,78,,,percent of total billed charges,78% of total billed charges,17653,100,,,percent of total billed charges,100% of total billed charges,14581.38,82.6,,,percent of total billed charges,82.6% of total billed charges,14581.38,82.6,,,percent of total billed charges,82.6% of total billed charges,2965.7,16.8,,,percent of total billed charges,16.8% of total billed charges,8826.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8826.5,50,,,percent of total billed charges,50% of total Billed charges,2965.7,16.8,,,percent of total billed charges,16.8% of total billed charges,2700.91,17653,
SEALER TISSUE LAPAROSCOPIC ARTICULATING,ORSUP0034,CDM,272,RC,,,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
SEALER TISSUE ENSEAL G2 35CM CURVED JAW,ORSUP0029,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
SEALER TISSUE ENSEAL G2 45CM CURVED JAW,ORSUP0031,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
SEAL SET SINGLE USE,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SECONDARY MED SET,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SECURESTRAP 12,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
SECURESTRAP 25,ORSUP0024,CDM,278,RC,C1713,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
SED-CHEK 2 ESR CONTROL,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SEDIPLAST AUTOZERO ESR SYSTEM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SYRINGE 10CC LL NON SAFETY,180427,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE ONLY LUER LOK 30CC,157837,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SEE ITEM #288701 KIT INTRODUCER MICROPUNCTURE 5F CATH NDL \\T\\ NIT GW,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
JELLY KY 4OZ FLIP TOP BOTTLE,11913,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
SEE ITEM #147499 VACU TUBE 6ML DRAW 367815,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SUTURE PROLENE 5-0 P3 8698G,491469,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
SEE ITEM 74721 JURGEN BALL .045,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUTURE VICRYL 4-0 J218H,491509,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SUTURE VICRYL 4-0 J662H,491514,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUTURE PROLENE 4-0 8557H,491460,CDM,272,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
SUTURE ETHILON 4-0 1629H,491407,CDM,272,RC,,,Outpatient,,,570,370.50,,501.6,88,,,percent of total billed charges,88% of total Billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,95.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,570,100,,,percent of total billed charges,100% of total billed charges,98.63,17.304,,,percent of total billed charges,17.304% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,359.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,95.76,16.8,,,percent of total billed charges,16.8% of total billed charges,87.21,15.3,,,percent of total billed charges,15.3% of total billed charges,393.3,69,,,percent of total billed charges,69% of total billed charges,570,100,,,percent of total billed charges,100% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,570,100,,,percent of total billed charges,100% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,570,100,,,percent of total billed charges,100% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,352.55,61.85,,,percent of total billed charges,61.85% of total billed charges,95.76,16.8,,,percent of total billed charges,16.8% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,95.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,97.68,17.136,,,percent of total billed charges,17.136% of total billed charges,124.49,21.84,,,percent of total billed charges,21.84% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,285,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,285,50,,,percent of total billed charges,50% of total Billed charges,444.6,78,,,percent of total billed charges,78% of total billed charges,570,100,,,percent of total billed charges,100% of total billed charges,470.82,82.6,,,percent of total billed charges,82.6% of total billed charges,470.82,82.6,,,percent of total billed charges,82.6% of total billed charges,95.76,16.8,,,percent of total billed charges,16.8% of total billed charges,285,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,285,50,,,percent of total billed charges,50% of total Billed charges,95.76,16.8,,,percent of total billed charges,16.8% of total billed charges,87.21,570,
SUTURE ETHILON 3-0 663H,491406,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SUTURE PROLENE 2-0 8411H,491453,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SUTURE CHROMIC GUT 2-0 G123H,491381,CDM,272,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
SEIZSURE BITE STICKS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SELECTROGEN 0.8% 2 X 10ML,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SELECTOGEN 3% 2 X 10ML,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SEMITENDINOSUS TENDON <+26CM LENGTH,ORSUP0057,CDM,278,RC,C1762,HCPCS,Outpatient,,,12220,7943.00,,10753.6,88,,,percent of total billed charges,88% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2114.55,17.304,,,percent of total billed charges,17.304% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,7698.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,1869.66,15.3,,,percent of total billed charges,15.3% of total billed charges,8431.8,69,,,percent of total billed charges,69% of total billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,7558.07,61.85,,,percent of total billed charges,61.85% of total billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,3812.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6110,50,,,percent of total billed charges,50% of total Billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,2094.02,17.136,,,percent of total billed charges,17.136% of total billed charges,2668.85,21.84,,,percent of total billed charges,21.84% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,4606.94,37.7,,,percent of total billed charges,37.70% of total billed charges,4606.94,37.7,,,percent of total billed charges,37.70% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,4142.58,33.9,,,percent of total billed charges,33.9% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,9531.6,78,,,percent of total billed charges,78% of total billed charges,12220,100,,,percent of total billed charges,100% of total billed charges,10093.72,82.6,,,percent of total billed charges,82.6% of total billed charges,10093.72,82.6,,,percent of total billed charges,82.6% of total billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,6110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6110,50,,,percent of total billed charges,50% of total Billed charges,2052.96,16.8,,,percent of total billed charges,16.8% of total billed charges,1869.66,12220,
SENSOR ELIBRA SOFT TISSUE FORCE SENSOR SMALL,ORSUP0022,CDM,270,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
SENSOR FLO-TRAC FOR VIGILEO,ORSUP0021,CDM,270,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
SENSOR SP02 FINGER ADULT DISP,267940,CDM,270,RC,,,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,12.11,17.304,,,percent of total billed charges,17.304% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,44.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,12,17.136,,,percent of total billed charges,17.136% of total billed charges,15.29,21.84,,,percent of total billed charges,21.84% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,70,
SENSOR SPO2 FINGER NEONATE/ADULT  DISP,177202,CDM,270,RC,,,Outpatient,,,89,57.85,,78.32,88,,,percent of total billed charges,88% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,89,100,,,percent of total billed charges,100% of total billed charges,15.4,17.304,,,percent of total billed charges,17.304% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,56.07,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,13.62,15.3,,,percent of total billed charges,15.3% of total billed charges,61.41,69,,,percent of total billed charges,69% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,89,100,,,percent of total billed charges,100% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,89,100,,,percent of total billed charges,100% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,55.05,61.85,,,percent of total billed charges,61.85% of total billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,15.25,17.136,,,percent of total billed charges,17.136% of total billed charges,19.44,21.84,,,percent of total billed charges,21.84% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,44.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,44.5,50,,,percent of total billed charges,50% of total Billed charges,69.42,78,,,percent of total billed charges,78% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,44.5,50,,,percent of total billed charges,50% of total Billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,13.62,89,
SENSOR NITINOL GUIDEWIRE,ORSUP0009,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SENSOR COVER,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SENSOR NEONATAL SPO2,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SEPARATOR TISS NON THRD W/ UNIV 12X100MM,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SEPERATOR ACCESS SYSTEM 15 X 100MM,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SEPRAFILM ADHESION BARRIER,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SERFAS ENERGY 90-S CRUISE,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
SERTERA BREAST BIOPSY DEVICE 14G X 11.5CM,ORSUP0008,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SERTERA BREAST BIOPSY INTRODUCER 14G,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SERUM ANTI JKB,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
SERUM PROTEIN MULTI CAL LVL 1-6,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SET EXTERNAL DRNAGE VENTRICULA,ORSUP0011,CDM,278,RC,C1729,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SET COLON DECOMPRESSION 14F 175CM 6SP,ORSUP0012,CDM,278,RC,C1729,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SET PNEUMOTHORAX 10.2FR X 29CM,ORSUP0013,CDM,278,RC,C1729,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SET ANGIOJET SPIROFLEX ULTRA,ORSUP0051,CDM,278,RC,C1757,HCPCS,Outpatient,,,10400,6760.00,,9152,88,,,percent of total billed charges,88% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1799.62,17.304,,,percent of total billed charges,17.304% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,15.3,,,percent of total billed charges,15.3% of total billed charges,7176,69,,,percent of total billed charges,69% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,6432.4,61.85,,,percent of total billed charges,61.85% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3244.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5200,50,,,percent of total billed charges,50% of total Billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,1782.14,17.136,,,percent of total billed charges,17.136% of total billed charges,2271.36,21.84,,,percent of total billed charges,21.84% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3920.8,37.7,,,percent of total billed charges,37.70% of total billed charges,3920.8,37.7,,,percent of total billed charges,37.70% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,3525.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,8112,78,,,percent of total billed charges,78% of total billed charges,10400,100,,,percent of total billed charges,100% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,8590.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,5200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5200,50,,,percent of total billed charges,50% of total Billed charges,1747.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1591.2,10400,
SET MICRO PUNCTURE 5FR,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SET MICROPUNCT  5FR,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SET EZ-IO 45MM NEEDLE \\T\\ STABILIZER,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SET EXT MICRO VOLUME W/LL ADAPTR  SLIDE CLMP 60,156763,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
SET IV 4 WAY STOPCOCK CLEARLINK,355174,CDM,270,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SET IV VENTED SOLUTION,82363,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
SET MICRODRIP LS VENTED 2Y'S,185655,CDM,270,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
SET CLEARLINK PRIMARY SET PUMP 2C8537,83497,CDM,270,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
SET CATH EXTENSION STD BORE,204589,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SET DECANTING 2C4014,10422,CDM,270,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
SET FLUID WARMING W/8' TUBING STRL FOR MDL HL90,149423,CDM,270,RC,,,Outpatient,,,136,88.40,,119.68,88,,,percent of total billed charges,88% of total Billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,22.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,136,100,,,percent of total billed charges,100% of total billed charges,23.53,17.304,,,percent of total billed charges,17.304% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,85.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.85,16.8,,,percent of total billed charges,16.8% of total billed charges,20.81,15.3,,,percent of total billed charges,15.3% of total billed charges,93.84,69,,,percent of total billed charges,69% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,136,100,,,percent of total billed charges,100% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,136,100,,,percent of total billed charges,100% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,84.12,61.85,,,percent of total billed charges,61.85% of total billed charges,22.85,16.8,,,percent of total billed charges,16.8% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,22.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,23.3,17.136,,,percent of total billed charges,17.136% of total billed charges,29.7,21.84,,,percent of total billed charges,21.84% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,68,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,68,50,,,percent of total billed charges,50% of total Billed charges,106.08,78,,,percent of total billed charges,78% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,22.85,16.8,,,percent of total billed charges,16.8% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,68,50,,,percent of total billed charges,50% of total Billed charges,22.85,16.8,,,percent of total billed charges,16.8% of total billed charges,20.81,136,
SET ANESTHESIA 72 INCH INFUSOR GREEN,8844,CDM,270,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SET SECONDARY UNIVERSAL VENTED,83498,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
SET EXTENSION CLEARLINK W/CONTROL-A-FLO,141785,CDM,270,RC,,,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.5,17.304,,,percent of total billed charges,17.304% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.08,61.85,,,percent of total billed charges,61.85% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.46,17.136,,,percent of total billed charges,17.136% of total billed charges,5.68,21.84,,,percent of total billed charges,21.84% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,26,
SET IV CATH FLO LINK STD BORE CATH EXT W/POS FLUID,355535,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SET EXT T CONECTOR 2N3339,10046,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
SET EXTENSION #3 W/ .22MIC FILTER,83495,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SET CLAVE LS TWIN SITE EXT 2C8612,185656,CDM,270,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SET IV DIAL A FLOW,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
SET SOLUTION BASIC W LL,216339,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SET IV BURETROL INLINE,185659,CDM,270,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SET IV BURETROL INLINE DEHP FREE,402456,CDM,270,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
SET IV SOLUTION PRIMARY 112IN CLEARLINK,81694,CDM,270,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
SET Y-TYPE BLOOD/SOLUTION 2C8750,83492,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET CARDIOPLEGIA,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SET BLOOD WARM LEVEL 1 NORMOTHERMIC,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SET CYSTOSCOPY,75573,CDM,270,RC,,,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,10.04,17.304,,,percent of total billed charges,17.304% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,36.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.94,17.136,,,percent of total billed charges,17.136% of total billed charges,12.67,21.84,,,percent of total billed charges,21.84% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,58,
SET EXTENSION 71 INCHES LF,283055,CDM,270,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
SET PROCEDURE FOR PROLAPSE AND HEMORRHOIDS 33MM,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
SET INFUSION SAFETY POWERLOC 20G X 1 W/Y SITE,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SET TISSEL EZ SPRAY 10/PK,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SET TISSEEL EZ SPRAY,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
SET INFUSION WING W/NDL SHIELD 12IN TB 19G X .88IN,164821,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
SET GASTROSTOMY FLEXIFLO 50190,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SET THROMBECTOMY AVX,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SET CATH CRICOTHYROTOMY E/R,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SET TUR 2 LEAD Y TYPE 2C4041,ORSUP0003,CDM,270,RC,,,Outpatient,,,99,64.35,,87.12,88,,,percent of total billed charges,88% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,17.13,17.304,,,percent of total billed charges,17.304% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,62.37,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,15.15,15.3,,,percent of total billed charges,15.3% of total billed charges,68.31,69,,,percent of total billed charges,69% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,61.23,61.85,,,percent of total billed charges,61.85% of total billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.96,17.136,,,percent of total billed charges,17.136% of total billed charges,21.62,21.84,,,percent of total billed charges,21.84% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,77.22,78,,,percent of total billed charges,78% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,15.15,99,
SET UP PACK,491170,CDM,270,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
SET BLOOD Y-TYPE TUBING,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET GRAVITY VENTED/NON VENTED WITH CECK VALVE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET ADMIN CADD YELLOW STRIPE 123IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET INFUSION GALACTOGRAPHY,ORSUP0011,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SET IV SOLUTION PRIMARY 117IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET IV SOLUTION GRAVITY 104IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET IV SOLUTION PRIMARY 20 DROP,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET IV SOLUTION GRAVITY MALE LL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET IV SOLUTION GRAVITY BACK CHECK VALVE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET IV BURETTES DEHP FREE,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET EXT 0.2 MICRON FILTER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET EXT MICROBORE SLIDE CLAMP FIXED MALE LL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET EXT STANDARD BORE 2 Y SITES,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET EXT T CONNECTOR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET EXT STANDARD BORE 5IN NON DEHP,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET EXT SPECIALTY LOW PRESSURE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET IV 4 WAY STOPCOCK  W WHITE TAB,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET EXTENSION SMALL BORE SLIDE CLAMPSPIN MALE LL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SET ULTRATHANE NEPHROSTOMY 8.5,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SET TUBING 2 SPIKE GRAVITY,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SET ADMIN EPIDURAL W/NONVENTED SPIKE TUBING,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SHAMPOO HAIR CARE READY BATH RINSE-FREE,156826,CDM,272,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
SHAMPOO AND BODY WASH,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SHARPS CONTAINER 2GL RED,491173,CDM,270,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
SHARPS CONTAINER 18 GL,491172,CDM,270,RC,,,Outpatient,,,123,79.95,,108.24,88,,,percent of total billed charges,88% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,123,100,,,percent of total billed charges,100% of total billed charges,21.28,17.304,,,percent of total billed charges,17.304% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,77.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,18.82,15.3,,,percent of total billed charges,15.3% of total billed charges,84.87,69,,,percent of total billed charges,69% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,123,100,,,percent of total billed charges,100% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,123,100,,,percent of total billed charges,100% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,76.08,61.85,,,percent of total billed charges,61.85% of total billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,21.08,17.136,,,percent of total billed charges,17.136% of total billed charges,26.86,21.84,,,percent of total billed charges,21.84% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,61.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,61.5,50,,,percent of total billed charges,50% of total Billed charges,95.94,78,,,percent of total billed charges,78% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,61.5,50,,,percent of total billed charges,50% of total Billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,18.82,123,
SHARPS CONTAINER CHEMOTHERAPY YELLOW 9GL,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SHARPS CONTAINER 3 GAL RED,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SHARPS CONTAINER 1 QT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SHARPS COLLECTOR CHEMOTHERAPY ABSORB PAD 3 GAL,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SHAVER 2344000,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
SHAVER EXCALIBER 4.0 MM,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SHAVER BLADE 3.5 AGGRESS PLUS,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SHAVER BLADE 4.0 AGGRESS PLUS,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SHEATH DEFL BI-DIR,ORSUP0027,CDM,278,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
SHEATH INTRO PINNACLE 6FR X 65CM STR,ORSUP0010,CDM,278,RC,C1887,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SHEATH INTRO 6FR X 45CM PINNACLE DESTINATION,ORSUP0009,CDM,278,RC,C1887,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SHEATH INTRO HEMOSTASIS CRV 8.5FRX60CM,ORSUP0012,CDM,278,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SHEATH INTRO TRANSSEPTAL SL1 8.5FRX62CM,ORSUP0012,CDM,278,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SHEATH ANSEL 6FR 45CM 2RENAL GUIDE,ORSUP0005,CDM,278,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SHEATH ANSEL 6FR 45CM 1RENAL GUIDE,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SHEATH ANSEL 4FR 45CM,ORSUP0005,CDM,278,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SHEATH 14FR X 30CM  BEACON TIP,ORSUP0005,CDM,278,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SHEATH 12FR X 30CM  BEACON TIP,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SHEATH GUIDING RAABE 8FR 70CM,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SHEATH 35CM 7FR,ORSUP0003,CDM,278,RC,C1713,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SHEATH RAABE  6X55,ORSUP0006,CDM,278,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SHEATH SHUTTLE 6FR FLEXOR,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SHEATH 18FRX30CMX38 BEACON TIP,ORSUP0009,CDM,278,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SHEATH ACC UROPASS 11/13FRX24 CM,ORSUP0009,CDM,278,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SHEATH BRAINPATH 13.5X60MM,ORSUP0052,CDM,278,RC,,,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6715.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3325.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3613.74,33.9,,,percent of total billed charges,33.9% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
SHEATH ENDOSCRUB STZ 4 MM 30D,ORSUP0005,CDM,278,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SHEATH ENDOSCRUB STZ 4MM 0 D 19-12000,ORSUP0005,CDM,278,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SHEATH GUIDING FLEXOR ANSEL 8FR 45CM,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SHEATH INTRO 5FR GLIDESHEATH,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SHEARS HARMONIC FOCUS CVD 9CM,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
SHEAR CURVED HARMONIC DAVINCI,173871,CDM,272,RC,,,Outpatient,,,5439,3535.35,,4786.32,88,,,percent of total billed charges,88% of total Billed charges,2719.5,50,,,percent of total billed charges,50% of total Billed charges,913.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,941.16,17.304,,,percent of total billed charges,17.304% of total billed charges,2719.5,50,,,percent of total billed charges,50% of total Billed charges,3426.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,913.75,16.8,,,percent of total billed charges,16.8% of total billed charges,832.17,15.3,,,percent of total billed charges,15.3% of total billed charges,3752.91,69,,,percent of total billed charges,69% of total billed charges,5439,100,,,percent of total billed charges,100% of total billed charges,2719.5,50,,,percent of total billed charges,50% of total Billed charges,5439,100,,,percent of total billed charges,100% of total billed charges,2719.5,50,,,percent of total billed charges,50% of total Billed charges,5439,100,,,percent of total billed charges,100% of total billed charges,2719.5,50,,,percent of total billed charges,50% of total Billed charges,3364.02,61.85,,,percent of total billed charges,61.85% of total billed charges,913.75,16.8,,,percent of total billed charges,16.8% of total billed charges,2719.5,50,,,percent of total billed charges,50% of total Billed charges,2719.5,50,,,percent of total billed charges,50% of total Billed charges,913.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,2719.5,50,,,percent of total billed charges,50% of total Billed charges,2719.5,50,,,percent of total billed charges,50% of total Billed charges,932.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1187.88,21.84,,,percent of total billed charges,21.84% of total billed charges,2719.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2719.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2719.5,50,,,percent of total billed charges,50% of total Billed charges,4242.42,78,,,percent of total billed charges,78% of total billed charges,5439,100,,,percent of total billed charges,100% of total billed charges,4492.61,82.6,,,percent of total billed charges,82.6% of total billed charges,4492.61,82.6,,,percent of total billed charges,82.6% of total billed charges,913.75,16.8,,,percent of total billed charges,16.8% of total billed charges,2719.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2719.5,50,,,percent of total billed charges,50% of total Billed charges,913.75,16.8,,,percent of total billed charges,16.8% of total billed charges,832.17,5439,
SHEAR HAMONIC ACE CVD,ORSUP0032,CDM,272,RC,,,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
SHEAR HARMONIC ACE 5MM 36CM 6/BX,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
SHEARS HOT ENDOWRIST DA VINCI,173499,CDM,272,RC,,,Outpatient,,,15823,10284.95,,13924.24,88,,,percent of total billed charges,88% of total Billed charges,7911.5,50,,,percent of total billed charges,50% of total Billed charges,2658.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2738.01,17.304,,,percent of total billed charges,17.304% of total billed charges,7911.5,50,,,percent of total billed charges,50% of total Billed charges,9968.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2658.26,16.8,,,percent of total billed charges,16.8% of total billed charges,2420.92,15.3,,,percent of total billed charges,15.3% of total billed charges,10917.87,69,,,percent of total billed charges,69% of total billed charges,15823,100,,,percent of total billed charges,100% of total billed charges,7911.5,50,,,percent of total billed charges,50% of total Billed charges,15823,100,,,percent of total billed charges,100% of total billed charges,7911.5,50,,,percent of total billed charges,50% of total Billed charges,15823,100,,,percent of total billed charges,100% of total billed charges,7911.5,50,,,percent of total billed charges,50% of total Billed charges,9786.53,61.85,,,percent of total billed charges,61.85% of total billed charges,2658.26,16.8,,,percent of total billed charges,16.8% of total billed charges,7911.5,50,,,percent of total billed charges,50% of total Billed charges,7911.5,50,,,percent of total billed charges,50% of total Billed charges,2658.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,7911.5,50,,,percent of total billed charges,50% of total Billed charges,7911.5,50,,,percent of total billed charges,50% of total Billed charges,2711.43,17.136,,,percent of total billed charges,17.136% of total billed charges,3455.74,21.84,,,percent of total billed charges,21.84% of total billed charges,7911.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7911.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7911.5,50,,,percent of total billed charges,50% of total Billed charges,12341.94,78,,,percent of total billed charges,78% of total billed charges,15823,100,,,percent of total billed charges,100% of total billed charges,13069.8,82.6,,,percent of total billed charges,82.6% of total billed charges,13069.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2658.26,16.8,,,percent of total billed charges,16.8% of total billed charges,7911.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7911.5,50,,,percent of total billed charges,50% of total Billed charges,2658.26,16.8,,,percent of total billed charges,16.8% of total billed charges,2420.92,15823,
SHEATH HOODLESS OVAL TPR BUR 5.0MM X 13CM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SHEATH MINI ACCESS 6F,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SHEATH INTRODUCER SHORT 7FR,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SHEATH INTRODUCER SHORT 6F.035,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SHEATH INTRODUCER 6F PERFORMER,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SHEATH INTRODUCER 5F PERFORMER,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SHEARS HARMONIC HAR36 LAPAR,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SHEATH INTRO 5FR 504-605X,ORSUP0002,CDM,278,RC,C2629,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,33.9,33.9,,,percent of total billed charges,33.9% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SHEATH HF ANSOCH 5FR X 55CM,ORSUP0008,CDM,272,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,69.22,17.304,,,percent of total billed charges,17.304% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,252,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,15.3,,,percent of total billed charges,15.3% of total billed charges,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,400,100,,,percent of total billed charges,100% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,68.54,17.136,,,percent of total billed charges,17.136% of total billed charges,87.36,21.84,,,percent of total billed charges,21.84% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,200,50,,,percent of total billed charges,50% of total Billed charges,67.2,16.8,,,percent of total billed charges,16.8% of total billed charges,61.2,400,
SHEATH PRELUDE 6FR X13CM,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SHEATH BALKIN 6FR X 40CM,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SHEATH CHECK-FLO ANSL1 7FR X 45CM,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SHEATH CHECK-FLO ANSL1 8FR X 55CM,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SHEATH HF 7FR,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
SHEATH ANSEL 8 FR,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
SHEATH INTRODUCER 6 FR,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
SHEET DRAPE 40X58 STERILE,8228,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
SHEET DRAPE 53X77 STERILE,156845,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SHEET T LAPAROTOMY STERILE,10273,CDM,272,RC,,,Outpatient,,,78,50.70,,68.64,88,,,percent of total billed charges,88% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,13.5,17.304,,,percent of total billed charges,17.304% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,49.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,15.3,,,percent of total billed charges,15.3% of total billed charges,53.82,69,,,percent of total billed charges,69% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,48.24,61.85,,,percent of total billed charges,61.85% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.37,17.136,,,percent of total billed charges,17.136% of total billed charges,17.04,21.84,,,percent of total billed charges,21.84% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,60.84,78,,,percent of total billed charges,78% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,78,
SHEET ORTHO SPLIT STERILE,187599,CDM,272,RC,,,Outpatient,,,77,50.05,,67.76,88,,,percent of total billed charges,88% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,13.32,17.304,,,percent of total billed charges,17.304% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,48.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,11.78,15.3,,,percent of total billed charges,15.3% of total billed charges,53.13,69,,,percent of total billed charges,69% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,47.62,61.85,,,percent of total billed charges,61.85% of total billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,13.19,17.136,,,percent of total billed charges,17.136% of total billed charges,16.82,21.84,,,percent of total billed charges,21.84% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38.5,50,,,percent of total billed charges,50% of total Billed charges,60.06,78,,,percent of total billed charges,78% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38.5,50,,,percent of total billed charges,50% of total Billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,11.78,77,
SHEET ABSORB 3X6,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SHILEY TRACH CUFFLESS PEDIATRIC  3.5MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
SHILEY TRACH CUFFLESS PEDIATRIC 3.0MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
SHILEY TRACH TAPERGUARD CUFF LONG 5.5MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
SHIPPER THERAPAK EXEMPT HUMAN SPECIMEN,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SHOE COVER IMPERVIOUS NONSKID,227878,CDM,270,RC,,,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,9.34,17.304,,,percent of total billed charges,17.304% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,33.4,61.85,,,percent of total billed charges,61.85% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.25,17.136,,,percent of total billed charges,17.136% of total billed charges,11.79,21.84,,,percent of total billed charges,21.84% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
SHOE POST-OP VELCRO CLOSURE WOMEN'S SMALL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SHOE POST-OP VELCRO CLOSURE MEN'S LARGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SHOE COVERS X-LG X-TRA TRACT,491189,CDM,270,RC,,,Outpatient,,,121,78.65,,106.48,88,,,percent of total billed charges,88% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,20.94,17.304,,,percent of total billed charges,17.304% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,76.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,18.51,15.3,,,percent of total billed charges,15.3% of total billed charges,83.49,69,,,percent of total billed charges,69% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,74.84,61.85,,,percent of total billed charges,61.85% of total billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.73,17.136,,,percent of total billed charges,17.136% of total billed charges,26.43,21.84,,,percent of total billed charges,21.84% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,94.38,78,,,percent of total billed charges,78% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,18.51,121,
SHOE COVERS X-TRA TRACTION,491190,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SHORT GUIDE PIN 2.4MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SHORTSHOT SAEED HEMORROID LIGATOR,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
SHOULDER ARTHROSCOPY,326413,CDM,270,RC,,,Outpatient,,,731,475.15,,643.28,88,,,percent of total billed charges,88% of total Billed charges,365.5,50,,,percent of total billed charges,50% of total Billed charges,122.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,731,100,,,percent of total billed charges,100% of total billed charges,126.49,17.304,,,percent of total billed charges,17.304% of total billed charges,365.5,50,,,percent of total billed charges,50% of total Billed charges,460.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,122.81,16.8,,,percent of total billed charges,16.8% of total billed charges,111.84,15.3,,,percent of total billed charges,15.3% of total billed charges,504.39,69,,,percent of total billed charges,69% of total billed charges,731,100,,,percent of total billed charges,100% of total billed charges,365.5,50,,,percent of total billed charges,50% of total Billed charges,731,100,,,percent of total billed charges,100% of total billed charges,365.5,50,,,percent of total billed charges,50% of total Billed charges,731,100,,,percent of total billed charges,100% of total billed charges,365.5,50,,,percent of total billed charges,50% of total Billed charges,452.12,61.85,,,percent of total billed charges,61.85% of total billed charges,122.81,16.8,,,percent of total billed charges,16.8% of total billed charges,365.5,50,,,percent of total billed charges,50% of total Billed charges,365.5,50,,,percent of total billed charges,50% of total Billed charges,122.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,365.5,50,,,percent of total billed charges,50% of total Billed charges,365.5,50,,,percent of total billed charges,50% of total Billed charges,125.26,17.136,,,percent of total billed charges,17.136% of total billed charges,159.65,21.84,,,percent of total billed charges,21.84% of total billed charges,365.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,365.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,365.5,50,,,percent of total billed charges,50% of total Billed charges,570.18,78,,,percent of total billed charges,78% of total billed charges,731,100,,,percent of total billed charges,100% of total billed charges,603.81,82.6,,,percent of total billed charges,82.6% of total billed charges,603.81,82.6,,,percent of total billed charges,82.6% of total billed charges,122.81,16.8,,,percent of total billed charges,16.8% of total billed charges,365.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,365.5,50,,,percent of total billed charges,50% of total Billed charges,122.81,16.8,,,percent of total billed charges,16.8% of total billed charges,111.84,731,
SHOULDER IMOB X-LG MENS,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SHOULDER IMOB LG MENS,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SHOULDER POSITIONER ARM CANOE,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SHOULDER IMMOBILIZER XL,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SHUNT 2.5MM FLOCOIL CORONARY,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SHUNT CAROTID 3X4X30,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
SHUNT CAROTID 3X5X30,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
SHUNT 1.5MM FLOCOIL CORONARY,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SHUNT 20MM TIP,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SHUNT CAROTID ENDART.3.5X5MM,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
SHUNT CAROTID 3X4X10,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
SHUNT CAROTID 3.5X5,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
SHUNT STRATA II SNAP ASSEMBLY REGULAR,ORSUP0098,CDM,272,RC,,,Outpatient,,,23140,15041.00,,20363.2,88,,,percent of total billed charges,88% of total Billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4004.15,17.304,,,percent of total billed charges,17.304% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,14578.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,3540.42,15.3,,,percent of total billed charges,15.3% of total billed charges,15966.6,69,,,percent of total billed charges,69% of total billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,14312.09,61.85,,,percent of total billed charges,61.85% of total billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,3965.27,17.136,,,percent of total billed charges,17.136% of total billed charges,5053.78,21.84,,,percent of total billed charges,21.84% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11570,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11570,50,,,percent of total billed charges,50% of total Billed charges,18049.2,78,,,percent of total billed charges,78% of total billed charges,23140,100,,,percent of total billed charges,100% of total billed charges,19113.64,82.6,,,percent of total billed charges,82.6% of total billed charges,19113.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,11570,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11570,50,,,percent of total billed charges,50% of total Billed charges,3887.52,16.8,,,percent of total billed charges,16.8% of total billed charges,3540.42,23140,
SIGMOIDOSCOPE DISPOSABLE,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SIGMOIDOSCOPE SUCTION,491207,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SIGNAL REAGENT BOX/2 PACKS,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SILASTIC SHEETING .030 MATT,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SILASTIC SHEETING .062 MATT,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SILASTIC SHEETING DRESSING,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SILICONE BITE LINERS,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SILK 2-0 FS (685H),491209,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SILK 2-0 STRANDS (A185H),491210,CDM,270,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SILK 3-0 STRANDS (A184H),491211,CDM,270,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SILK 4-0 STRANDS (A183H),491212,CDM,270,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SILK TAPE 1,491213,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
SILK TAPE 2,491214,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
SILK TAPE 3,491215,CDM,270,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
SILVASORB SILVER ANTIMICROBIAL WOUND GEL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SIMILAC MILK STORAGE BOTTLES W/CAP 4OZ,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SIMPLEX HV W/GENTAMICIN,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SINGLE-SITE ENERGIZED MARYLAND,ORSUP0039,CDM,272,RC,,,Outpatient,,,7280,4732.00,,6406.4,88,,,percent of total billed charges,88% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1259.73,17.304,,,percent of total billed charges,17.304% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4586.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,15.3,,,percent of total billed charges,15.3% of total billed charges,5023.2,69,,,percent of total billed charges,69% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4502.68,61.85,,,percent of total billed charges,61.85% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1247.5,17.136,,,percent of total billed charges,17.136% of total billed charges,1589.95,21.84,,,percent of total billed charges,21.84% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3640,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3640,50,,,percent of total billed charges,50% of total Billed charges,5678.4,78,,,percent of total billed charges,78% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,7280,
SINUS ILLUMINATION SYSTEM,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SINUS GUIDE CATH M-110,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SINUS GUIDE CATH S-0 0 DEGREE,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SINUS GUIDE CATH F-70,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SINUS DEPLOYMENT GUIDE FRONTAL,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SINUS SPACER FRONTAL,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SIS SLING,ORSUP0061,CDM,278,RC,C1771,HCPCS,Outpatient,,,10200,6630.00,,8976,88,,,percent of total billed charges,88% of total Billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,1713.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1765.01,17.304,,,percent of total billed charges,17.304% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,6426,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1713.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1560.6,15.3,,,percent of total billed charges,15.3% of total billed charges,7038,69,,,percent of total billed charges,69% of total billed charges,10200,100,,,percent of total billed charges,100% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,10200,100,,,percent of total billed charges,100% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,10200,100,,,percent of total billed charges,100% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,6308.7,61.85,,,percent of total billed charges,61.85% of total billed charges,1713.6,16.8,,,percent of total billed charges,16.8% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,3182.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5100,50,,,percent of total billed charges,50% of total Billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,1747.87,17.136,,,percent of total billed charges,17.136% of total billed charges,2227.68,21.84,,,percent of total billed charges,21.84% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,3845.4,37.7,,,percent of total billed charges,37.70% of total billed charges,3845.4,37.7,,,percent of total billed charges,37.70% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,3457.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,7956,78,,,percent of total billed charges,78% of total billed charges,10200,100,,,percent of total billed charges,100% of total billed charges,8425.2,82.6,,,percent of total billed charges,82.6% of total billed charges,8425.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1713.6,16.8,,,percent of total billed charges,16.8% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5100,50,,,percent of total billed charges,50% of total Billed charges,1713.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1560.6,10200,
SIZER GAIT LARGE 30-099-03,ORSUP0018,CDM,278,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
SIZER GAIT SMALL 30-099-01,ORSUP0018,CDM,278,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
SKIN AFFIX TISSUE ADHESIVE 0.4ML APPLICATORS,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SKIN MARKING PEN STERILE,491224,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
SKIN PROTECTANT CALMOSEPTINE 3.5GM PK,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SLEEVE FOR BLADELESS TROCAR 11MM X 100MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SLEEVE 5MM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SLEEVE SCD KNEE MEDIUM,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SLEEVE SCD THIGH LENGTH,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SLEEVE ARM SHOULDER SUSPENSION,ORSUP0010,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SLEEP CANNULAS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SLIDER SHEET,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SLIDES PLAIN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SLINGS DISPOSABLE ARJO MEDIUM,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SLINGS DISPOSABLE LARGE,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SLINGS PT LIFT XL DISP FLITES,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SLING ARM X-LRG,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SLING ARM MEDIUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SLING ARM LARGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SLING ARM SMALL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SLING ARM X-LARGE,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SLING S3 LATERAL TRACTION,ORSUP0008,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SLING DISPOSABLE W/HEAD SUPPORT XLRG,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SLING DISPOSABLE W/HEAD SUPPORT LRG,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SLING EZ LIFT SMALL,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SLING EZ LIFT MEDIUM,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SLIPPERS DUAL TREAD LARGE BLUE,ORSUP0001,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
SLIPPER GRIP YELLOW FALL PREVENTION STANDARD,255368,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
SLIPPER YELLOW LARGE,191408,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
SLIPPER YELLOW XL,312698,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
SLIPPERS DUAL TREAD MEDIUM GREEN,ORSUP0001,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
SLIPPERS DUAL TREAD XLARGE BEIGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
"SLIPPERS, FALL 2XL",ORSUP0001,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
"SLIPPERS, GRAY 2XL",ORSUP0001,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
SLIPPERS PATIENT XXXL BARIATRIC GRAY,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SMART NDL 18 GA  2 3/4,ORSUP0035,CDM,272,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
SMARTPORT CT,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SMITH PROVENT ABG SYRINGE 3ML,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SMOOTH PEGS LOCKING SZ 16MM,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SMOOTH PEGS LOCKING SZ 18MM,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SMOOTH PEGS LOCKING SZ 20MM,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SMOOTH PEGS LOCKING SZ22,ORSUP0008,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SNAP COVER BANDED BAG 20 X 20,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SNARE VASC RETRV FILT 6FRX15MMX120CM,ORSUP0017,CDM,278,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SNARE ROTATABLE 13MM MICRO OVAL,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SNARE POLYP JMBO HEX,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SNARE RETRIEVAL ULTRA CATCH NT,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SNARE RETRIVAL KIT,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SNARE DISPOSABLE,ORSUP0003,CDM,270,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SNARE RETRIEVAL X-CATCH NT,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SNARE KIT 4FR 10X120,ORSUP0014,CDM,272,RC,,,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,155.74,17.304,,,percent of total billed charges,17.304% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,567,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,15.3,,,percent of total billed charges,15.3% of total billed charges,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,900,100,,,percent of total billed charges,100% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,154.22,17.136,,,percent of total billed charges,17.136% of total billed charges,196.56,21.84,,,percent of total billed charges,21.84% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,450,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,450,50,,,percent of total billed charges,50% of total Billed charges,151.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.7,900,
SOAP CALGON VESTAL LOTION 1 LITER,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SOAP SKIN  SHAMPOO LIQUID CONCENTRATE 4OZ,146385,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
SODA SORB CANISTERS,491238,CDM,270,RC,,,Outpatient,,,217,141.05,,190.96,88,,,percent of total billed charges,88% of total Billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,36.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,217,100,,,percent of total billed charges,100% of total billed charges,37.55,17.304,,,percent of total billed charges,17.304% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,136.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,36.46,16.8,,,percent of total billed charges,16.8% of total billed charges,33.2,15.3,,,percent of total billed charges,15.3% of total billed charges,149.73,69,,,percent of total billed charges,69% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,217,100,,,percent of total billed charges,100% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,217,100,,,percent of total billed charges,100% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,134.21,61.85,,,percent of total billed charges,61.85% of total billed charges,36.46,16.8,,,percent of total billed charges,16.8% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,36.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,37.19,17.136,,,percent of total billed charges,17.136% of total billed charges,47.39,21.84,,,percent of total billed charges,21.84% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,108.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,108.5,50,,,percent of total billed charges,50% of total Billed charges,169.26,78,,,percent of total billed charges,78% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,36.46,16.8,,,percent of total billed charges,16.8% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,108.5,50,,,percent of total billed charges,50% of total Billed charges,36.46,16.8,,,percent of total billed charges,16.8% of total billed charges,33.2,217,
SODA SORB REFILL BAG,491239,CDM,270,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,8.65,17.304,,,percent of total billed charges,17.304% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,30.93,61.85,,,percent of total billed charges,61.85% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.57,17.136,,,percent of total billed charges,17.136% of total billed charges,10.92,21.84,,,percent of total billed charges,21.84% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,50,
SODIUM HYDROXIDE 4%,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SODIUM CHLORIDE 0.9%500ML,CATH00008,CDM,272,RC,,,Outpatient,,,388,252.20,,341.44,88,,,percent of total billed charges,88% of total Billed charges,194,50,,,percent of total billed charges,50% of total Billed charges,65.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,388,100,,,percent of total billed charges,100% of total billed charges,67.14,17.304,,,percent of total billed charges,17.304% of total billed charges,194,50,,,percent of total billed charges,50% of total Billed charges,244.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.18,16.8,,,percent of total billed charges,16.8% of total billed charges,59.36,15.3,,,percent of total billed charges,15.3% of total billed charges,267.72,69,,,percent of total billed charges,69% of total billed charges,388,100,,,percent of total billed charges,100% of total billed charges,194,50,,,percent of total billed charges,50% of total Billed charges,388,100,,,percent of total billed charges,100% of total billed charges,194,50,,,percent of total billed charges,50% of total Billed charges,388,100,,,percent of total billed charges,100% of total billed charges,194,50,,,percent of total billed charges,50% of total Billed charges,239.98,61.85,,,percent of total billed charges,61.85% of total billed charges,65.18,16.8,,,percent of total billed charges,16.8% of total billed charges,194,50,,,percent of total billed charges,50% of total Billed charges,194,50,,,percent of total billed charges,50% of total Billed charges,65.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,194,50,,,percent of total billed charges,50% of total Billed charges,194,50,,,percent of total billed charges,50% of total Billed charges,66.49,17.136,,,percent of total billed charges,17.136% of total billed charges,84.74,21.84,,,percent of total billed charges,21.84% of total billed charges,194,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,194,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,194,50,,,percent of total billed charges,50% of total Billed charges,302.64,78,,,percent of total billed charges,78% of total billed charges,388,100,,,percent of total billed charges,100% of total billed charges,320.49,82.6,,,percent of total billed charges,82.6% of total billed charges,320.49,82.6,,,percent of total billed charges,82.6% of total billed charges,65.18,16.8,,,percent of total billed charges,16.8% of total billed charges,194,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,194,50,,,percent of total billed charges,50% of total Billed charges,65.18,16.8,,,percent of total billed charges,16.8% of total billed charges,59.36,388,
SODIUM /NA+/5 PACK/250 SLDS,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SODIUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SODIUM HYPOCHLORITE 5% AVAILABLE CHLORINE,ORSUP0010,CDM,272,RC,,,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,86.52,17.304,,,percent of total billed charges,17.304% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,315,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,15.3,,,percent of total billed charges,15.3% of total billed charges,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,500,100,,,percent of total billed charges,100% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,85.68,17.136,,,percent of total billed charges,17.136% of total billed charges,109.2,21.84,,,percent of total billed charges,21.84% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,250,50,,,percent of total billed charges,50% of total Billed charges,84,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,500,
SODIUM HEPARIN VACUTAINER 13X75 4ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SOFIA FLU AB TEST KIT,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SOFIA RSV TEST KIT,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SOFIA STREP A WVD,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SOFIA2 FLUSRS ANTIGN NS,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SOFT GUEDEL AIRWAY 70MM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SOHENDRA CATH BILIARY,ORSUP0005,CDM,278,RC,C1725,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SOHENDRA BILIARY DIL CATH,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SOHENDRA CATH BILARY,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SOL IRRG H2O 1000ML 2F7114,10394,CDM,258,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SOL IRR NACL 0.9% 1000ML BOTTLE 2F7124,10388,CDM,258,RC,,,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,6.92,17.304,,,percent of total billed charges,17.304% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,25.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,6.12,15.3,,,percent of total billed charges,15.3% of total billed charges,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,40,100,,,percent of total billed charges,100% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,24.74,61.85,,,percent of total billed charges,61.85% of total billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,6.85,17.136,,,percent of total billed charges,17.136% of total billed charges,8.74,21.84,,,percent of total billed charges,21.84% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,20,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20,50,,,percent of total billed charges,50% of total Billed charges,6.72,16.8,,,percent of total billed charges,16.8% of total billed charges,6.12,40,
SOL IRR LACT RING 3000ML BAG 2B7487,10396,CDM,258,RC,,,Outpatient,,,123,79.95,,108.24,88,,,percent of total billed charges,88% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,123,100,,,percent of total billed charges,100% of total billed charges,21.28,17.304,,,percent of total billed charges,17.304% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,77.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,18.82,15.3,,,percent of total billed charges,15.3% of total billed charges,84.87,69,,,percent of total billed charges,69% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,123,100,,,percent of total billed charges,100% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,123,100,,,percent of total billed charges,100% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,76.08,61.85,,,percent of total billed charges,61.85% of total billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,21.08,17.136,,,percent of total billed charges,17.136% of total billed charges,26.86,21.84,,,percent of total billed charges,21.84% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,61.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,61.5,50,,,percent of total billed charges,50% of total Billed charges,95.94,78,,,percent of total billed charges,78% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,61.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,61.5,50,,,percent of total billed charges,50% of total Billed charges,20.66,16.8,,,percent of total billed charges,16.8% of total billed charges,18.82,123,
SOL IRR NACL 0.9% 3000ML BAG 2B7127,165076,CDM,258,RC,,,Outpatient,,,118,76.70,,103.84,88,,,percent of total billed charges,88% of total Billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,19.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,118,100,,,percent of total billed charges,100% of total billed charges,20.42,17.304,,,percent of total billed charges,17.304% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,74.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.82,16.8,,,percent of total billed charges,16.8% of total billed charges,18.05,15.3,,,percent of total billed charges,15.3% of total billed charges,81.42,69,,,percent of total billed charges,69% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,118,100,,,percent of total billed charges,100% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,118,100,,,percent of total billed charges,100% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,72.98,61.85,,,percent of total billed charges,61.85% of total billed charges,19.82,16.8,,,percent of total billed charges,16.8% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,19.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,20.22,17.136,,,percent of total billed charges,17.136% of total billed charges,25.77,21.84,,,percent of total billed charges,21.84% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,59,50,,,percent of total billed charges,50% of total Billed charges,92.04,78,,,percent of total billed charges,78% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,16.8,,,percent of total billed charges,16.8% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,59,50,,,percent of total billed charges,50% of total Billed charges,19.82,16.8,,,percent of total billed charges,16.8% of total billed charges,18.05,118,
SOL IV NACL 0.9% 500ML BAG 2B1323Q,10390,CDM,258,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SOL IV NACL 0.9% 1000ML BAG 2B1324X,10391,CDM,258,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SOL LACT RING INJ 1000ML 2B2324X,10384,CDM,258,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
SOL NACL 0.9% W/ KCL 40MEQ,75217,CDM,272,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
SOL D5 / LACT RINGERS 2B2074,10382,CDM,258,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
SOL IV D5W 1000ML,10541,CDM,258,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
SOL D5/.9%NACL INJ 1000ML 2B1064,10545,CDM,258,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SOL D5W .45NS 500ML 2B1073Q,11151,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SOL D5/.45NACL 1000ML 2B1074,10546,CDM,258,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SOL D-5  2% NACL 500ML 2B1093Q,11174,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SOL IV D5/.2NACL 1000ML 2B1094,10547,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
SOL D5NS WITH KCL 40 MEQ,80578,CDM,272,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
SOL KCI 40MEQ D5 AND 45NACL 2B1674,11173,CDM,272,RC,,,Outpatient,,,97,63.05,,85.36,88,,,percent of total billed charges,88% of total Billed charges,48.5,50,,,percent of total billed charges,50% of total Billed charges,16.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,97,100,,,percent of total billed charges,100% of total billed charges,16.78,17.304,,,percent of total billed charges,17.304% of total billed charges,48.5,50,,,percent of total billed charges,50% of total Billed charges,61.11,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.3,16.8,,,percent of total billed charges,16.8% of total billed charges,14.84,15.3,,,percent of total billed charges,15.3% of total billed charges,66.93,69,,,percent of total billed charges,69% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,48.5,50,,,percent of total billed charges,50% of total Billed charges,97,100,,,percent of total billed charges,100% of total billed charges,48.5,50,,,percent of total billed charges,50% of total Billed charges,97,100,,,percent of total billed charges,100% of total billed charges,48.5,50,,,percent of total billed charges,50% of total Billed charges,59.99,61.85,,,percent of total billed charges,61.85% of total billed charges,16.3,16.8,,,percent of total billed charges,16.8% of total billed charges,48.5,50,,,percent of total billed charges,50% of total Billed charges,48.5,50,,,percent of total billed charges,50% of total Billed charges,16.3,16.8,,,percent of total billed charges,16.8% of total Billed charges,48.5,50,,,percent of total billed charges,50% of total Billed charges,48.5,50,,,percent of total billed charges,50% of total Billed charges,16.62,17.136,,,percent of total billed charges,17.136% of total billed charges,21.18,21.84,,,percent of total billed charges,21.84% of total billed charges,48.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,48.5,50,,,percent of total billed charges,50% of total Billed charges,75.66,78,,,percent of total billed charges,78% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,16.3,16.8,,,percent of total billed charges,16.8% of total billed charges,48.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,48.5,50,,,percent of total billed charges,50% of total Billed charges,16.3,16.8,,,percent of total billed charges,16.8% of total billed charges,14.84,97,
SOL KCI 30MEQ D5  45 NACL 2B1664,11172,CDM,272,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
SOL D5W 0.9% NACL W/20MEQ KCL,39181,CDM,272,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
SOL IV D5/.45 NACL W/KCL 20MEQ 2B1654,10548,CDM,258,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SOL 1/2 NS W/20MEQ KCL/1000ML,84944,CDM,272,RC,,,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,12.46,17.304,,,percent of total billed charges,17.304% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,45.36,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,15.3,,,percent of total billed charges,15.3% of total billed charges,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,72,100,,,percent of total billed charges,100% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,44.53,61.85,,,percent of total billed charges,61.85% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,12.34,17.136,,,percent of total billed charges,17.136% of total billed charges,15.72,21.84,,,percent of total billed charges,21.84% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,36,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36,50,,,percent of total billed charges,50% of total Billed charges,12.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.02,72,
SOL IV D10W 1000ML,10379,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
SOL IV D5/45NACL W/10 MEQ KCL,10378,CDM,272,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
SOL IV 0.9% NACL MINI- BAG 100ML VIAFLEX LF,10538,CDM,270,RC,,,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,10.04,17.304,,,percent of total billed charges,17.304% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,36.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.94,17.136,,,percent of total billed charges,17.136% of total billed charges,12.67,21.84,,,percent of total billed charges,21.84% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,58,
SOL IV .45% NACL 1000ML 2B1314,10387,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SOL IV H2O 1000ML 2B0304,10393,CDM,272,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
SOL 3% NS 500ML 2B1353Q,11177,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SOL INJ 10MEQ POTASSIUM CHLORIDE INJ 10 MEQ,60575,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
SOL KCL 20 MEQ ST H20 100ML,74727,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
SOL 9% NACL W/ HEP 1000U 2B0953,7772,CDM,272,RC,,,Outpatient,,,142,92.30,,124.96,88,,,percent of total billed charges,88% of total Billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,23.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,142,100,,,percent of total billed charges,100% of total billed charges,24.57,17.304,,,percent of total billed charges,17.304% of total billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,89.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.86,16.8,,,percent of total billed charges,16.8% of total billed charges,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,142,100,,,percent of total billed charges,100% of total billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,142,100,,,percent of total billed charges,100% of total billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,87.83,61.85,,,percent of total billed charges,61.85% of total billed charges,23.86,16.8,,,percent of total billed charges,16.8% of total billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,23.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,24.33,17.136,,,percent of total billed charges,17.136% of total billed charges,31.01,21.84,,,percent of total billed charges,21.84% of total billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,71,50,,,percent of total billed charges,50% of total Billed charges,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,23.86,16.8,,,percent of total billed charges,16.8% of total billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,71,50,,,percent of total billed charges,50% of total Billed charges,23.86,16.8,,,percent of total billed charges,16.8% of total billed charges,21.73,142,
SOL SODIUM CITRATE,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SOL.9% NACL WITH KCL 20ME,73031,CDM,258,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
SOLIDIFIER 500C,400784,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
SOLN IRRIG H2O 3000ML STERILE,146429,CDM,258,RC,,,Outpatient,,,117,76.05,,102.96,88,,,percent of total billed charges,88% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,117,100,,,percent of total billed charges,100% of total billed charges,20.25,17.304,,,percent of total billed charges,17.304% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,73.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,17.9,15.3,,,percent of total billed charges,15.3% of total billed charges,80.73,69,,,percent of total billed charges,69% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,117,100,,,percent of total billed charges,100% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,117,100,,,percent of total billed charges,100% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,72.36,61.85,,,percent of total billed charges,61.85% of total billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,20.05,17.136,,,percent of total billed charges,17.136% of total billed charges,25.55,21.84,,,percent of total billed charges,21.84% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,58.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58.5,50,,,percent of total billed charges,50% of total Billed charges,91.26,78,,,percent of total billed charges,78% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,58.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58.5,50,,,percent of total billed charges,50% of total Billed charges,19.66,16.8,,,percent of total billed charges,16.8% of total billed charges,17.9,117,
SOLN IRRIG SORBITOL 3% 3000ML,41330,CDM,258,RC,,,Outpatient,,,89,57.85,,78.32,88,,,percent of total billed charges,88% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,89,100,,,percent of total billed charges,100% of total billed charges,15.4,17.304,,,percent of total billed charges,17.304% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,56.07,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,13.62,15.3,,,percent of total billed charges,15.3% of total billed charges,61.41,69,,,percent of total billed charges,69% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,89,100,,,percent of total billed charges,100% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,89,100,,,percent of total billed charges,100% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,55.05,61.85,,,percent of total billed charges,61.85% of total billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,15.25,17.136,,,percent of total billed charges,17.136% of total billed charges,19.44,21.84,,,percent of total billed charges,21.84% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,44.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,44.5,50,,,percent of total billed charges,50% of total Billed charges,69.42,78,,,percent of total billed charges,78% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,44.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,44.5,50,,,percent of total billed charges,50% of total Billed charges,14.95,16.8,,,percent of total billed charges,16.8% of total billed charges,13.62,89,
SOLN  LAC RINGERS 500 ML   2B2323Q,35738,CDM,258,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
SOLN  DEX INJ 5% 50 ML      2B0081,35723,CDM,272,RC,,,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,9.52,17.304,,,percent of total billed charges,17.304% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.42,17.136,,,percent of total billed charges,17.136% of total billed charges,12.01,21.84,,,percent of total billed charges,21.84% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,55,
SOLN  DEX INJ 5% 100 ML     2B0082,35724,CDM,272,RC,,,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,9.52,17.304,,,percent of total billed charges,17.304% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.42,17.136,,,percent of total billed charges,17.136% of total billed charges,12.01,21.84,,,percent of total billed charges,21.84% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,55,
SOLN D5W WITH KCL 20MEQ 1LTR,73036,CDM,272,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
SOLN D5W/.2% NACL W/ KCL 20,75218,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
SOLN  0.9% NACL  MINI-BAG 50ML VIAFLEX LF,36128,CDM,270,RC,,,Outpatient,,,121,78.65,,106.48,88,,,percent of total billed charges,88% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,20.94,17.304,,,percent of total billed charges,17.304% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,76.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,18.51,15.3,,,percent of total billed charges,15.3% of total billed charges,83.49,69,,,percent of total billed charges,69% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,121,100,,,percent of total billed charges,100% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,74.84,61.85,,,percent of total billed charges,61.85% of total billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.73,17.136,,,percent of total billed charges,17.136% of total billed charges,26.43,21.84,,,percent of total billed charges,21.84% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,94.38,78,,,percent of total billed charges,78% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,60.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60.5,50,,,percent of total billed charges,50% of total Billed charges,20.33,16.8,,,percent of total billed charges,16.8% of total billed charges,18.51,121,
SOLN .9% NACL 50ML 4 PK,73035,CDM,272,RC,,,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,9.52,17.304,,,percent of total billed charges,17.304% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.42,17.136,,,percent of total billed charges,17.136% of total billed charges,12.01,21.84,,,percent of total billed charges,21.84% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,55,
SOLN  0.9% SOD CHL 250ML   2B1322Q,35735,CDM,258,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SOLN  BETADINE 1/2 OZ,36364,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SOLN ANTISEPTIC 4PCT CHOLRHEXIDINE GLUCONATE,268468,CDM,270,RC,,,Outpatient,,,846,549.90,,744.48,88,,,percent of total billed charges,88% of total Billed charges,423,50,,,percent of total billed charges,50% of total Billed charges,142.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,846,100,,,percent of total billed charges,100% of total billed charges,146.39,17.304,,,percent of total billed charges,17.304% of total billed charges,423,50,,,percent of total billed charges,50% of total Billed charges,532.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,142.13,16.8,,,percent of total billed charges,16.8% of total billed charges,129.44,15.3,,,percent of total billed charges,15.3% of total billed charges,583.74,69,,,percent of total billed charges,69% of total billed charges,846,100,,,percent of total billed charges,100% of total billed charges,423,50,,,percent of total billed charges,50% of total Billed charges,846,100,,,percent of total billed charges,100% of total billed charges,423,50,,,percent of total billed charges,50% of total Billed charges,846,100,,,percent of total billed charges,100% of total billed charges,423,50,,,percent of total billed charges,50% of total Billed charges,523.25,61.85,,,percent of total billed charges,61.85% of total billed charges,142.13,16.8,,,percent of total billed charges,16.8% of total billed charges,423,50,,,percent of total billed charges,50% of total Billed charges,423,50,,,percent of total billed charges,50% of total Billed charges,142.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,423,50,,,percent of total billed charges,50% of total Billed charges,423,50,,,percent of total billed charges,50% of total Billed charges,144.97,17.136,,,percent of total billed charges,17.136% of total billed charges,184.77,21.84,,,percent of total billed charges,21.84% of total billed charges,423,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,423,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,423,50,,,percent of total billed charges,50% of total Billed charges,659.88,78,,,percent of total billed charges,78% of total billed charges,846,100,,,percent of total billed charges,100% of total billed charges,698.8,82.6,,,percent of total billed charges,82.6% of total billed charges,698.8,82.6,,,percent of total billed charges,82.6% of total billed charges,142.13,16.8,,,percent of total billed charges,16.8% of total billed charges,423,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,423,50,,,percent of total billed charges,50% of total Billed charges,142.13,16.8,,,percent of total billed charges,16.8% of total billed charges,129.44,846,
SOLUTION PLEGISOL 1000ML,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SOLUTION IRRIGATION STERILE WATER 1500ML PB,165087,CDM,272,RC,,,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,9.34,17.304,,,percent of total billed charges,17.304% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,33.4,61.85,,,percent of total billed charges,61.85% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.25,17.136,,,percent of total billed charges,17.136% of total billed charges,11.79,21.84,,,percent of total billed charges,21.84% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
SOLUTION IV DEXTROSE 5% LACT RINGERS INJ 500ML BG,165088,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SOLUTION IV 0.9% SODIUM CHL 100ML QUAD,35734,CDM,258,RC,,,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,9.52,17.304,,,percent of total billed charges,17.304% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.42,17.136,,,percent of total billed charges,17.136% of total billed charges,12.01,21.84,,,percent of total billed charges,21.84% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,55,
SOLUTION SCRUB CARE 2PCT FOAM CHG 30 OZ,176079,CDM,270,RC,,,Outpatient,,,106,68.90,,93.28,88,,,percent of total billed charges,88% of total Billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,17.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,106,100,,,percent of total billed charges,100% of total billed charges,18.34,17.304,,,percent of total billed charges,17.304% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,66.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,17.81,16.8,,,percent of total billed charges,16.8% of total billed charges,16.22,15.3,,,percent of total billed charges,15.3% of total billed charges,73.14,69,,,percent of total billed charges,69% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,106,100,,,percent of total billed charges,100% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,106,100,,,percent of total billed charges,100% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,65.56,61.85,,,percent of total billed charges,61.85% of total billed charges,17.81,16.8,,,percent of total billed charges,16.8% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,17.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,18.16,17.136,,,percent of total billed charges,17.136% of total billed charges,23.15,21.84,,,percent of total billed charges,21.84% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,53,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,53,50,,,percent of total billed charges,50% of total Billed charges,82.68,78,,,percent of total billed charges,78% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,17.81,16.8,,,percent of total billed charges,16.8% of total billed charges,53,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,53,50,,,percent of total billed charges,50% of total Billed charges,17.81,16.8,,,percent of total billed charges,16.8% of total billed charges,16.22,106,
SOLUTION ACL TOP RINSE  4L BOTTLE,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SOLUTION BETADINE 4OZ,383653,CDM,270,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SOLUTION HYPOCHLORITE S5362 100ML,165070,CDM,270,RC,,,Outpatient,,,270,175.50,,237.6,88,,,percent of total billed charges,88% of total Billed charges,135,50,,,percent of total billed charges,50% of total Billed charges,45.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,270,100,,,percent of total billed charges,100% of total billed charges,46.72,17.304,,,percent of total billed charges,17.304% of total billed charges,135,50,,,percent of total billed charges,50% of total Billed charges,170.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,45.36,16.8,,,percent of total billed charges,16.8% of total billed charges,41.31,15.3,,,percent of total billed charges,15.3% of total billed charges,186.3,69,,,percent of total billed charges,69% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,135,50,,,percent of total billed charges,50% of total Billed charges,270,100,,,percent of total billed charges,100% of total billed charges,135,50,,,percent of total billed charges,50% of total Billed charges,270,100,,,percent of total billed charges,100% of total billed charges,135,50,,,percent of total billed charges,50% of total Billed charges,167,61.85,,,percent of total billed charges,61.85% of total billed charges,45.36,16.8,,,percent of total billed charges,16.8% of total billed charges,135,50,,,percent of total billed charges,50% of total Billed charges,135,50,,,percent of total billed charges,50% of total Billed charges,45.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,135,50,,,percent of total billed charges,50% of total Billed charges,135,50,,,percent of total billed charges,50% of total Billed charges,46.27,17.136,,,percent of total billed charges,17.136% of total billed charges,58.97,21.84,,,percent of total billed charges,21.84% of total billed charges,135,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,135,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,135,50,,,percent of total billed charges,50% of total Billed charges,210.6,78,,,percent of total billed charges,78% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,45.36,16.8,,,percent of total billed charges,16.8% of total billed charges,135,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,135,50,,,percent of total billed charges,50% of total Billed charges,45.36,16.8,,,percent of total billed charges,16.8% of total billed charges,41.31,270,
SOLUTION RAPICIDE,19761,CDM,270,RC,,,Outpatient,,,762,495.30,,670.56,88,,,percent of total billed charges,88% of total Billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,128.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,762,100,,,percent of total billed charges,100% of total billed charges,131.86,17.304,,,percent of total billed charges,17.304% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,480.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,128.02,16.8,,,percent of total billed charges,16.8% of total billed charges,116.59,15.3,,,percent of total billed charges,15.3% of total billed charges,525.78,69,,,percent of total billed charges,69% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,762,100,,,percent of total billed charges,100% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,762,100,,,percent of total billed charges,100% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,471.3,61.85,,,percent of total billed charges,61.85% of total billed charges,128.02,16.8,,,percent of total billed charges,16.8% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,128.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,130.58,17.136,,,percent of total billed charges,17.136% of total billed charges,166.42,21.84,,,percent of total billed charges,21.84% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,381,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,381,50,,,percent of total billed charges,50% of total Billed charges,594.36,78,,,percent of total billed charges,78% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,128.02,16.8,,,percent of total billed charges,16.8% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,381,50,,,percent of total billed charges,50% of total Billed charges,128.02,16.8,,,percent of total billed charges,16.8% of total billed charges,116.59,762,
SOLUTION CALIBRATION VERIFICATION MATERAL 4X2.5ML,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SOLUTION STERILE SODIUM CHLORIDE BOTTLE 1000ML,491241,CDM,272,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
SOLUTION STERILE SODIUM CHLORIDE BOTTLE 500ML,491242,CDM,272,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
SOLUTION STERILE WATER BOTTLE 1000ML,491243,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
SOLUTION SALINE .9% 50ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION SALINE .9% 250ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION SALINE .9% 500ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION SALINE .9% 1000ML,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION LR INJ 500ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION LR INJ 1000ML,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION 5% DEXTROSE INJ 100ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION 5% DEXTROSE INJ 250ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION 5% DEXTROSE INJ 500ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION 5% DEXTROSE INJ 1000ML,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION 10 MEQ POTASIUM CHLORIDE 5% DEXT AND 0.45 SODIUM CH,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 10% DEXTROSE INJ 1000ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 5% DEXTROSE IN LR INJ 1000ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 0.45% SODIUM CHLORIDE INJ 1000ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 0.9% SODIUM CHLORIDE IR 1000ML POUR BOTTLE,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION STERILE WATER FOR INJ 1000ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION STERILE WATER FOR IR 1000ML POUR BOTTLE,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 5% DEXTROSE 0.9% SODIUM CHLORIDE INJ 1000ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 5% DEXTROSE 0.45% SODIUM CHLORIDE INJ 1000ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 5% DEXTROSE 0.225% SODIUM CHLORIDE INJ 1000ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 20 MEQ POTASSIUM CHLORIDE IN 5% DEXT 0.45% SODIUM C,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 5% DEXT 0.45% SODIUM CHLORIDE INJ 500ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 30 MEQ POTASSIUM CHLORIDE 5% DEXT 0.45% SODIUM CHLO,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 40 MEQ POTASSIUM CHLORIDE 5% DEXT 0.45% SODIUM CHLO,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 5% DEXT 0.225% SODIUM CHLORIDE INJ 500 ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 20 MEQ POTASSIUM CHLORIDE IN LR 5% DEXT INJ 1000ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 0.9% SODIUM CHLORIDE IR 3000ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION STERILE WATER IR 1500ML POUR BOTTLE,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 5% DEXT LR INJ 500ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 20 MEQ POTASSIUM CHLORIDE 5% DEXT 0.9% SODIUM CHLOR,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION SORBITOL-MANNITOL IR 3000ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION 0.9% SODIUM CHLORIDE IR 500ML POUR BOTTLE,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 10 MEQ POTASSIUM CHLORIDE IN WATER INJ 100ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 20 MEQ POTASSIUM CHLORIDE 0.9% SODIUM CHLORIDE INJ,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 20 MEQ POTASSIUM CHLORIDE 5% DEXT INJ 1000ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 20 MEQ POTASSIUM CHLORIDE IN WATER FOR INJ 100ML,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 40 MEQ POTASSIUM CHLORIDE IN 0.9% SODIUM CHLORIDE I,ORSUP0002,CDM,258,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION 20 MEQ POTASSIUM CHLORIDE 5% DEXT 0.22% SODIUM CHLO,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 40 MEQ POTASSIUM CHLORIDE 5% DEXTR 0.9% SODIUM CHLO,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 20 MEQ POTASSIUM CHLORIDE 0.45% SODIUM CHLORIDE INJ,ORSUP0002,CDM,258,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION (7% BSA) BOX/12 BTLS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION STERILE WATER FOR IR 3000ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SOLUTION STERILE WATER FOR IR 500ML POUR BOTTLE,ORSUP0002,CDM,271,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,15.59,33.9,,,percent of total billed charges,33.9% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 0.9% SODIUM CHLORIDE INJ 100ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION 10% DEXTROSE INJ 250ML,ORSUP0002,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLUTION IRRIGATION SODIUM CHLORIDE BTL 100ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SOLYX SKLING,ORSUP0061,CDM,278,RC,C1771,HCPCS,Outpatient,,,10200,6630.00,,8976,88,,,percent of total billed charges,88% of total Billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,1713.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1765.01,17.304,,,percent of total billed charges,17.304% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,6426,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1713.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1560.6,15.3,,,percent of total billed charges,15.3% of total billed charges,7038,69,,,percent of total billed charges,69% of total billed charges,10200,100,,,percent of total billed charges,100% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,10200,100,,,percent of total billed charges,100% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,10200,100,,,percent of total billed charges,100% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,6308.7,61.85,,,percent of total billed charges,61.85% of total billed charges,1713.6,16.8,,,percent of total billed charges,16.8% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,3182.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5100,50,,,percent of total billed charges,50% of total Billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,1747.87,17.136,,,percent of total billed charges,17.136% of total billed charges,2227.68,21.84,,,percent of total billed charges,21.84% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,3845.4,37.7,,,percent of total billed charges,37.70% of total billed charges,3845.4,37.7,,,percent of total billed charges,37.70% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,3457.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,7956,78,,,percent of total billed charges,78% of total billed charges,10200,100,,,percent of total billed charges,100% of total billed charges,8425.2,82.6,,,percent of total billed charges,82.6% of total billed charges,8425.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1713.6,16.8,,,percent of total billed charges,16.8% of total billed charges,5100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5100,50,,,percent of total billed charges,50% of total Billed charges,1713.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1560.6,10200,
SONOCHECK,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SONOPLEX II 22G X 50MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SONOPLEX II 22G X 80MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SONOPLEX II 22G X 100MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SONOPLEX II 22G X 150MM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SOOTHIE PACIFIER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SORBAVIEW SHIELD FOR PICCS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SPACER ADV ACF LORDOTIC 5MM,ORSUP0036,CDM,278,RC,C1762,HCPCS,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4095,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
SPACER ADV ACF LORDOTIC 6MM,ORSUP0038,CDM,278,RC,C1762,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
SPACER ADV ACF LORDOTIC 7MM,ORSUP0037,CDM,278,RC,C1762,HCPCS,Outpatient,,,6760,4394.00,,5948.8,88,,,percent of total billed charges,88% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1169.75,17.304,,,percent of total billed charges,17.304% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4258.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,15.3,,,percent of total billed charges,15.3% of total billed charges,4664.4,69,,,percent of total billed charges,69% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,4181.06,61.85,,,percent of total billed charges,61.85% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2109.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3380,50,,,percent of total billed charges,50% of total Billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,1158.39,17.136,,,percent of total billed charges,17.136% of total billed charges,1476.38,21.84,,,percent of total billed charges,21.84% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,2291.64,33.9,,,percent of total billed charges,33.9% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,5272.8,78,,,percent of total billed charges,78% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,3380,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3380,50,,,percent of total billed charges,50% of total Billed charges,1135.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1034.28,6760,
SPACER ADV ACF LORDOTIC 8MM,ORSUP0038,CDM,278,RC,C1762,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
SPACER 9MM LORDOTIC,ORSUP0038,CDM,278,RC,C1755,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
SPACER TPAL 12MM,ORSUP0114,CDM,278,RC,C1755,HCPCS,Outpatient,,,27300,17745.00,,24024,88,,,percent of total billed charges,88% of total Billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,4586.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4723.99,17.304,,,percent of total billed charges,17.304% of total billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4586.4,16.8,,,percent of total billed charges,16.8% of total billed charges,4176.9,15.3,,,percent of total billed charges,15.3% of total billed charges,18837,69,,,percent of total billed charges,69% of total billed charges,27300,100,,,percent of total billed charges,100% of total billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,27300,100,,,percent of total billed charges,100% of total billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,27300,100,,,percent of total billed charges,100% of total billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,16885.05,61.85,,,percent of total billed charges,61.85% of total billed charges,4586.4,16.8,,,percent of total billed charges,16.8% of total billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,8517.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13650,50,,,percent of total billed charges,50% of total Billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,4678.13,17.136,,,percent of total billed charges,17.136% of total billed charges,5962.32,21.84,,,percent of total billed charges,21.84% of total billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,10292.1,37.7,,,percent of total billed charges,37.70% of total billed charges,10292.1,37.7,,,percent of total billed charges,37.70% of total billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,9254.7,33.9,,,percent of total billed charges,33.9% of total billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,21294,78,,,percent of total billed charges,78% of total billed charges,27300,100,,,percent of total billed charges,100% of total billed charges,22549.8,82.6,,,percent of total billed charges,82.6% of total billed charges,22549.8,82.6,,,percent of total billed charges,82.6% of total billed charges,4586.4,16.8,,,percent of total billed charges,16.8% of total billed charges,13650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13650,50,,,percent of total billed charges,50% of total Billed charges,4586.4,16.8,,,percent of total billed charges,16.8% of total billed charges,4176.9,27300,
SPACER VERTEBRAL 9MM 889.845,ORSUP0052,CDM,278,RC,C1755,HCPCS,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3325.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3613.74,33.9,,,percent of total billed charges,33.9% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
SPACER VRTBRL 13MM PR,ORSUP0052,CDM,278,RC,C1755,HCPCS,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3325.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3613.74,33.9,,,percent of total billed charges,33.9% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
SPACR VERT H15MM PR,ORSUP0052,CDM,278,RC,C1755,HCPCS,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3325.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3613.74,33.9,,,percent of total billed charges,33.9% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
SPEAR  SURGICAL,129486,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
SPECIMEN MEDELA,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SPECIMEN CUP URINE 4 OZ STRL,491245,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SPECIMEN SOCK,491247,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SPECIMEN QUICK TRAP-NEPTUNE,491246,CDM,270,RC,,,Outpatient,,,944,613.60,,830.72,88,,,percent of total billed charges,88% of total Billed charges,472,50,,,percent of total billed charges,50% of total Billed charges,158.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,944,100,,,percent of total billed charges,100% of total billed charges,163.35,17.304,,,percent of total billed charges,17.304% of total billed charges,472,50,,,percent of total billed charges,50% of total Billed charges,594.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,158.59,16.8,,,percent of total billed charges,16.8% of total billed charges,144.43,15.3,,,percent of total billed charges,15.3% of total billed charges,651.36,69,,,percent of total billed charges,69% of total billed charges,944,100,,,percent of total billed charges,100% of total billed charges,472,50,,,percent of total billed charges,50% of total Billed charges,944,100,,,percent of total billed charges,100% of total billed charges,472,50,,,percent of total billed charges,50% of total Billed charges,944,100,,,percent of total billed charges,100% of total billed charges,472,50,,,percent of total billed charges,50% of total Billed charges,583.86,61.85,,,percent of total billed charges,61.85% of total billed charges,158.59,16.8,,,percent of total billed charges,16.8% of total billed charges,472,50,,,percent of total billed charges,50% of total Billed charges,472,50,,,percent of total billed charges,50% of total Billed charges,158.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,472,50,,,percent of total billed charges,50% of total Billed charges,472,50,,,percent of total billed charges,50% of total Billed charges,161.76,17.136,,,percent of total billed charges,17.136% of total billed charges,206.17,21.84,,,percent of total billed charges,21.84% of total billed charges,472,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,472,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,472,50,,,percent of total billed charges,50% of total Billed charges,736.32,78,,,percent of total billed charges,78% of total billed charges,944,100,,,percent of total billed charges,100% of total billed charges,779.74,82.6,,,percent of total billed charges,82.6% of total billed charges,779.74,82.6,,,percent of total billed charges,82.6% of total billed charges,158.59,16.8,,,percent of total billed charges,16.8% of total billed charges,472,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,472,50,,,percent of total billed charges,50% of total Billed charges,158.59,16.8,,,percent of total billed charges,16.8% of total billed charges,144.43,944,
SPECIMAN COLLECTOR ANER,491244,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
SPECIALTY IA 1 6X5ML,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SPECIALTY IA 2 6X5ML,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SPECI-CATH URINE COLEECTION KIT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SPECI-CATH NEONATAL KIT 5FR 9 IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SPECIMEN CONTAINER STERILE 4OZ,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SPEEDBRIDGE IMPL SYS W/BIOCOMPOSITE SWIVELOCK,ORSUP0048,CDM,278,RC,C1713,HCPCS,Outpatient,,,9360,6084.00,,8236.8,88,,,percent of total billed charges,88% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1619.65,17.304,,,percent of total billed charges,17.304% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,5896.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1432.08,15.3,,,percent of total billed charges,15.3% of total billed charges,6458.4,69,,,percent of total billed charges,69% of total billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,5789.16,61.85,,,percent of total billed charges,61.85% of total billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,2920.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4680,50,,,percent of total billed charges,50% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,1603.93,17.136,,,percent of total billed charges,17.136% of total billed charges,2044.22,21.84,,,percent of total billed charges,21.84% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,3528.72,37.7,,,percent of total billed charges,37.70% of total billed charges,3528.72,37.7,,,percent of total billed charges,37.70% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,3173.04,33.9,,,percent of total billed charges,33.9% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,7300.8,78,,,percent of total billed charges,78% of total billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,7731.36,82.6,,,percent of total billed charges,82.6% of total billed charges,7731.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4680,50,,,percent of total billed charges,50% of total Billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1432.08,9360,
SPEE-D-RING MAMMO SEMI OPAQUE 1/2 ID NO BURNOUT,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SPEEDBRIDGE WITH BIOCOMPOSITE,ORSUP0045,CDM,272,RC,,,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5569.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
SPEEDBRIDGE W/ COMPOSITE SWIVELOCK,ORSUP0052,CDM,272,RC,,,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6715.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
SPEEDBRIDGE IMPLANT SYSTEM,ORSUP0049,CDM,278,RC,C1713,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
SPG SUPER FLUFF 6X6.75 LATEX FREE,47750,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SPHERES REFLECTIVE DISP.,ORSUP0031,CDM,270,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
SPHINCTEROTOME HYDRATOME  4.4 X 260,ORSUP0019,CDM,278,RC,C1769,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
SPHINCTEROTOME ESCPC L30CM L260CM OD0.25IN JAGTOME/JGWR CAN,ORSUP0017,CDM,278,RC,C1769,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SPHINCTEROTOME ESCPC L30MM L5MM OD3.9FR,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SPIDER EMB 30X320 FX DEVICE,ORSUP0038,CDM,278,RC,C1884,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
SPIDER FX 6MM US DEVICE,ORSUP0031,CDM,278,RC,C1884,HCPCS,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
SPIDER PROTECTION DEVICE,ORSUP0038,CDM,278,RC,C1884,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
SPINAL TI L200MM OD6.0MM THRCLMBR HRD,ORSUP0016,CDM,278,RC,C1755,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
SPINAL FLUID CONTROL LVL 1,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SPINAL FLUID CONTROL LVL 2,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SPINNING SPIROS CONNECTOR CLOSED MALE LUER RED CAP,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SPIRAL PDO 14X14CM DBLE ARMED USP 3-0 FS,419628,CDM,272,RC,,,Outpatient,,,170,110.50,,149.6,88,,,percent of total billed charges,88% of total Billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,28.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,170,100,,,percent of total billed charges,100% of total billed charges,29.42,17.304,,,percent of total billed charges,17.304% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,107.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,28.56,16.8,,,percent of total billed charges,16.8% of total billed charges,26.01,15.3,,,percent of total billed charges,15.3% of total billed charges,117.3,69,,,percent of total billed charges,69% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,170,100,,,percent of total billed charges,100% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,170,100,,,percent of total billed charges,100% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,105.15,61.85,,,percent of total billed charges,61.85% of total billed charges,28.56,16.8,,,percent of total billed charges,16.8% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,28.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,29.13,17.136,,,percent of total billed charges,17.136% of total billed charges,37.13,21.84,,,percent of total billed charges,21.84% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,85,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,85,50,,,percent of total billed charges,50% of total Billed charges,132.6,78,,,percent of total billed charges,78% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,28.56,16.8,,,percent of total billed charges,16.8% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,85,50,,,percent of total billed charges,50% of total Billed charges,28.56,16.8,,,percent of total billed charges,16.8% of total billed charges,26.01,170,
SPIRAL PGA-PCL 30X30CM DBLE ARMED USP 3-0 FS-1,419619,CDM,272,RC,,,Outpatient,,,209,135.85,,183.92,88,,,percent of total billed charges,88% of total Billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,35.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,209,100,,,percent of total billed charges,100% of total billed charges,36.17,17.304,,,percent of total billed charges,17.304% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,131.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,35.11,16.8,,,percent of total billed charges,16.8% of total billed charges,31.98,15.3,,,percent of total billed charges,15.3% of total billed charges,144.21,69,,,percent of total billed charges,69% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,209,100,,,percent of total billed charges,100% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,209,100,,,percent of total billed charges,100% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,129.27,61.85,,,percent of total billed charges,61.85% of total billed charges,35.11,16.8,,,percent of total billed charges,16.8% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,35.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,35.81,17.136,,,percent of total billed charges,17.136% of total billed charges,45.65,21.84,,,percent of total billed charges,21.84% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,104.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,104.5,50,,,percent of total billed charges,50% of total Billed charges,163.02,78,,,percent of total billed charges,78% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,35.11,16.8,,,percent of total billed charges,16.8% of total billed charges,104.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,104.5,50,,,percent of total billed charges,50% of total Billed charges,35.11,16.8,,,percent of total billed charges,16.8% of total billed charges,31.98,209,
SPLASH SHIELD,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SPLASHCAP IRRIGATION SHIELD,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SPLINT FIBERGLASS PADDED 5IN X 20' ROLL CASE,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SPLINT SPECIALIST PLSTR 5IN X 30IN FAST,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SPLINT SPECIALIST PLSTR 4IN X 15IN  FAST,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SPLINT SPECIALIST PLSTR 3IN X 15IN  FAST,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SPLINT FIBERGLASS PADDED 5IN X 15' ROLL CASE,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SPLINT ORTHO GLASS FIBER PRE CUT 4X30,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SPLINT ORTHO GLASS ROLL 2 X15,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SPLINT PRE CUT ORTHO GLASS 4 INCH X 15 INCH,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SPLINT FINGER COT ALUM PADDED 1 1/5 L,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SPLINT DOYLE NASAL         15 24055,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SPLINT OCL 4IN,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SPLINT OCL 6IN,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SPLINT INTRANASAL POSISEP X,ORSUP0014,CDM,270,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SPLINT SPECIALIST PLSTR 5IN X 45IN  FAST,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SPLINT 3X35 SCOTCHCAST COMFORT,1374,CDM,270,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
SPLINT CONFORMABLE ROLL 5X15FT,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SPLINT CONFORMABLE 2X10,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SPLINT CONFORMABLE 3X12,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SPLINT CONFORMABLE 3X35,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SPLINT CONFORMABLE 4X30,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SPO2 OXIMETER DISP (SLEEP STUDY),ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
SPONGE TONSIL GAUZE FILLED W/STRING LARGE STERILE,165769,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
SPONGE LAP XRAY 18X18 STERILE,429533,CDM,272,RC,,,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,10.04,17.304,,,percent of total billed charges,17.304% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,36.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.94,17.136,,,percent of total billed charges,17.136% of total billed charges,12.67,21.84,,,percent of total billed charges,21.84% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,58,
ROSEBUDS 1/2IN,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SPONGE 4 X 4 10PLY STERILE,79591,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SPONGE NEURO PATTIES 1/2X1,75843,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
SPONGE PATTIE 13,91869,CDM,270,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
SPONGE PATTIE 11,91868,CDM,270,RC,,,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,10.9,17.304,,,percent of total billed charges,17.304% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,39.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,38.97,61.85,,,percent of total billed charges,61.85% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.8,17.136,,,percent of total billed charges,17.136% of total billed charges,13.76,21.84,,,percent of total billed charges,21.84% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,63,
SPONGE COVER 4 X 4 N/S         1792,35369,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
SPONGE COVER 4 X 4 STER,36531,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
SPONGE GAUZE 2 X 2 STERILE 21420,96097,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
SPONGE GZ DRN LF ST 6 PLY 4X4IN,133730,CDM,270,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
SPONGE X-RAY DETECT 8X4IN 16PLY 10 S TRAY DBL FILAMENT,328975,CDM,270,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
SPONGE SURGIFOAM 100 ABS GELATIN 80MM X 125MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SPONGE TRACH #8 BIVONA,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SPONGE TONSIL LG/XLG 1 1/4'',491262,CDM,270,RC,,,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,167,100,,,percent of total billed charges,100% of total billed charges,28.9,17.304,,,percent of total billed charges,17.304% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,105.21,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,25.55,15.3,,,percent of total billed charges,15.3% of total billed charges,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,167,100,,,percent of total billed charges,100% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,167,100,,,percent of total billed charges,100% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,103.29,61.85,,,percent of total billed charges,61.85% of total billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.62,17.136,,,percent of total billed charges,17.136% of total billed charges,36.47,21.84,,,percent of total billed charges,21.84% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,83.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,83.5,50,,,percent of total billed charges,50% of total Billed charges,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,83.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,83.5,50,,,percent of total billed charges,50% of total Billed charges,28.06,16.8,,,percent of total billed charges,16.8% of total billed charges,25.55,167,
SPONGE TONSIL SM/MED 7/8'',491263,CDM,270,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
SPONGE COUNTER BAG,491254,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SPONGE 4X4 10PK STR RFD XRAY,491251,CDM,270,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
SPONGE ROSEBUD DISSECTOR 5-PK,491261,CDM,270,RC,,,Outpatient,,,762,495.30,,670.56,88,,,percent of total billed charges,88% of total Billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,128.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,762,100,,,percent of total billed charges,100% of total billed charges,131.86,17.304,,,percent of total billed charges,17.304% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,480.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,128.02,16.8,,,percent of total billed charges,16.8% of total billed charges,116.59,15.3,,,percent of total billed charges,15.3% of total billed charges,525.78,69,,,percent of total billed charges,69% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,762,100,,,percent of total billed charges,100% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,762,100,,,percent of total billed charges,100% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,471.3,61.85,,,percent of total billed charges,61.85% of total billed charges,128.02,16.8,,,percent of total billed charges,16.8% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,128.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,130.58,17.136,,,percent of total billed charges,17.136% of total billed charges,166.42,21.84,,,percent of total billed charges,21.84% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,381,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,381,50,,,percent of total billed charges,50% of total Billed charges,594.36,78,,,percent of total billed charges,78% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,128.02,16.8,,,percent of total billed charges,16.8% of total billed charges,381,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,381,50,,,percent of total billed charges,50% of total Billed charges,128.02,16.8,,,percent of total billed charges,16.8% of total billed charges,116.59,762,
SPONGE ENT MICRO EYE,491255,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SPONGE LAP 18 X 18 XRAY RFD,491259,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
SPONGE LAP 18 X 4,491260,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
SPONGE 4X4 4PLY 10PK STERILE,491252,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SPONGE LAP,491258,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
SPONGE LAP XRAY 4X18 STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SPRAY SKIN CLEANSER REMEDY,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SPUR II PEDIATRIC RESUSCITATOR BAG NEONATEL,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SPY GLASS IRRIGATIN SYSTEM,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
"STABILIZING SPACER FOR LEVEL 1 INSERTS, TITANIUM PLATES",ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
STAIN TRICHROME BLUE 500ML,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
STAIN WRIGHT 16 OZ,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
STAINLESS STEEL REPROCESSING TRAY 2D CAM,ORSUP0030,CDM,272,RC,,,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
STANDARD BALLOON G-TUBE 14FR,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
STAPLER SKIN 35W PROXIMATE PLU,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STAPLER RELOADING UNIT 30MM FOR TL30,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
STAPLER RELOAD 45MM REG EZ45B,ORSUP0035,CDM,272,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
STAPLER TLV30 LINEAR INTERNAL 30MM VASCULAR RELOADABLE,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
STAPLER TLH30 LINEAR INTERNAL 30MM HEAVY WIRE RELOADABLE,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
STAPLER RELOAD LINEAR PROXIMAT,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
STAPLER TLH60 LINEAR INTERNAL 60MM HEAVY WIRE RELOADABLE,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
STAPLER TL60 LINEAR INTERNAL 60MM RELOADABLE,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
STAPLER TL30 LINEAR INTERNAL 30MM RELOADABLE,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
STAPLER POWER ARTICULATING ECHELON 45,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
STAPLER POWER STD FLEX 60MM-34CM SHAFT,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
STAPLER INT 28CM SHFT PWR ECHLN FLX 45MM,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
STAPLER ILS CURVED CIRCULAR 29MM,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
STAPLER CIRCULAR CURVED 33MM,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
STAPLER CIRCULAR CURVED 29MM 3,ORSUP0028,CDM,272,RC,,,Outpatient,,,4420,2873.00,,3889.6,88,,,percent of total billed charges,88% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,764.84,17.304,,,percent of total billed charges,17.304% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2784.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,15.3,,,percent of total billed charges,15.3% of total billed charges,3049.8,69,,,percent of total billed charges,69% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2733.77,61.85,,,percent of total billed charges,61.85% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,757.41,17.136,,,percent of total billed charges,17.136% of total billed charges,965.33,21.84,,,percent of total billed charges,21.84% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,3447.6,78,,,percent of total billed charges,78% of total billed charges,4420,100,,,percent of total billed charges,100% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.92,82.6,,,percent of total billed charges,82.6% of total billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,2210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2210,50,,,percent of total billed charges,50% of total Billed charges,742.56,16.8,,,percent of total billed charges,16.8% of total billed charges,676.26,4420,
STAPLER CIRCULAR CURVED 25MM 3,ORSUP0033,CDM,272,RC,,,Outpatient,,,4400,2860.00,,3872,88,,,percent of total billed charges,88% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,761.38,17.304,,,percent of total billed charges,17.304% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2772,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3036,69,,,percent of total billed charges,69% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2721.4,61.85,,,percent of total billed charges,61.85% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,753.98,17.136,,,percent of total billed charges,17.136% of total billed charges,960.96,21.84,,,percent of total billed charges,21.84% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,3432,78,,,percent of total billed charges,78% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,4400,
STAPLER CONTOUR CVD CUTTER GREEN THICK  CS40G,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
STAPLER CONTOUR CVD CUTTER BLUE STANDARD  CS40B,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
STAPLER ARTICULATING LINEAR ACCESS 55 THICK,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
STAPLER ENDO ROTICULATOR 45MM,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
STAPLER INTERNAL ARTICULATING 60MM LINEAR CUTTER,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
STAPLER ECHELON VASC POWERED W/TIP 35MM,ORSUP0021,CDM,272,RC,,,Outpatient,,,2375,1543.75,,2090,88,,,percent of total billed charges,88% of total Billed charges,1187.5,50,,,percent of total billed charges,50% of total Billed charges,399,16.8,,,percent of total billed charges,16.8% of total Billed charges,2375,100,,,percent of total billed charges,100% of total billed charges,410.97,17.304,,,percent of total billed charges,17.304% of total billed charges,1187.5,50,,,percent of total billed charges,50% of total Billed charges,1496.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,399,16.8,,,percent of total billed charges,16.8% of total billed charges,363.38,15.3,,,percent of total billed charges,15.3% of total billed charges,1638.75,69,,,percent of total billed charges,69% of total billed charges,2375,100,,,percent of total billed charges,100% of total billed charges,1187.5,50,,,percent of total billed charges,50% of total Billed charges,2375,100,,,percent of total billed charges,100% of total billed charges,1187.5,50,,,percent of total billed charges,50% of total Billed charges,2375,100,,,percent of total billed charges,100% of total billed charges,1187.5,50,,,percent of total billed charges,50% of total Billed charges,1468.94,61.85,,,percent of total billed charges,61.85% of total billed charges,399,16.8,,,percent of total billed charges,16.8% of total billed charges,1187.5,50,,,percent of total billed charges,50% of total Billed charges,1187.5,50,,,percent of total billed charges,50% of total Billed charges,399,16.8,,,percent of total billed charges,16.8% of total Billed charges,1187.5,50,,,percent of total billed charges,50% of total Billed charges,1187.5,50,,,percent of total billed charges,50% of total Billed charges,406.98,17.136,,,percent of total billed charges,17.136% of total billed charges,518.7,21.84,,,percent of total billed charges,21.84% of total billed charges,1187.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1187.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1187.5,50,,,percent of total billed charges,50% of total Billed charges,1852.5,78,,,percent of total billed charges,78% of total billed charges,2375,100,,,percent of total billed charges,100% of total billed charges,1961.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1961.75,82.6,,,percent of total billed charges,82.6% of total billed charges,399,16.8,,,percent of total billed charges,16.8% of total billed charges,1187.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1187.5,50,,,percent of total billed charges,50% of total Billed charges,399,16.8,,,percent of total billed charges,16.8% of total billed charges,363.38,2375,
STAPLER FLEX POWERED PLUS STD 340MM,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
STAPLER RELOAD ENDOWRIST 45 BLUE,ORSUP0052,CDM,272,RC,,,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6715.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
STAPLER ENDOWRIST SHEATH,429590,CDM,272,RC,,,Outpatient,,,1605,1043.25,,1412.4,88,,,percent of total billed charges,88% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,277.73,17.304,,,percent of total billed charges,17.304% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1011.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,245.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1107.45,69,,,percent of total billed charges,69% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,992.69,61.85,,,percent of total billed charges,61.85% of total billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,275.03,17.136,,,percent of total billed charges,17.136% of total billed charges,350.53,21.84,,,percent of total billed charges,21.84% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,1251.9,78,,,percent of total billed charges,78% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,802.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,802.5,50,,,percent of total billed charges,50% of total Billed charges,269.64,16.8,,,percent of total billed charges,16.8% of total billed charges,245.57,1605,
STAPLER SKIN INSORB 20,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
STAPLER PURSESTRING 65,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
STAPLER INTRALUMINAR 25MM,ORSUP0015,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
STAPLER LINEAR 55MM STANDARD,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
STAPLER ENDOSCOPIC MULTIFEED,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
STAPLER CONTOUR CR40B REGULAR,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
STAPLER CONTOUR CR40G THICK,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
KIT STAPH AUREUS ATTC 43300,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
STAPLER LINEAR PROXIMATE 30,ORSUP0011,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
STAPH SAPROPHYTICUS ATCC BAA-750,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
STAPH AUREUS CULTI LOOPS BAA-976,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
STAPH AUREUS ATCC CULTI LOOPS BAA-1026,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
STAPH AUREUS ATCC CULTI LOOPS 29213,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STAPH AUREUS ATCC CULTI LOOPS 33591,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
STAPLER PROXIMATE RELOAD LINEAR 60MM,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
STAPLER SUREFORM 60 SPU,ORSUP0024,CDM,272,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
STAPLER SUREFORM 45 SPU,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
STAPLER CANNULA SEAL 12MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
STAPLER CIRCULAR 25MM,ORSUP0020,CDM,270,RC,,,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
STAPLER CIRCULAR 33MM,ORSUP0020,CDM,270,RC,,,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
STATLOCK IAB,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
STAXX FINGER SPLINT CLEAR #1,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STAXX FINGER SPLINT CLEAR #2,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STAXX FINGER SPLINT CLEAR #3,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STAXX FINGER SPLINT CLEAR #4,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STAXX FINGER SPLINT CLEAR #5,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STAXX FINGER SPLINT CLEAR #6,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STAXX FINGER SPLINT CLEAR #7,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STAY HOOK BLUNT ELONGATED 12MM,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
STAY 3 FINGER 20MM X 20MM,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
STEAM ARROW,114876,CDM,270,RC,,,Outpatient,,,588,382.20,,517.44,88,,,percent of total billed charges,88% of total Billed charges,294,50,,,percent of total billed charges,50% of total Billed charges,98.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,588,100,,,percent of total billed charges,100% of total billed charges,101.75,17.304,,,percent of total billed charges,17.304% of total billed charges,294,50,,,percent of total billed charges,50% of total Billed charges,370.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.78,16.8,,,percent of total billed charges,16.8% of total billed charges,89.96,15.3,,,percent of total billed charges,15.3% of total billed charges,405.72,69,,,percent of total billed charges,69% of total billed charges,588,100,,,percent of total billed charges,100% of total billed charges,294,50,,,percent of total billed charges,50% of total Billed charges,588,100,,,percent of total billed charges,100% of total billed charges,294,50,,,percent of total billed charges,50% of total Billed charges,588,100,,,percent of total billed charges,100% of total billed charges,294,50,,,percent of total billed charges,50% of total Billed charges,363.68,61.85,,,percent of total billed charges,61.85% of total billed charges,98.78,16.8,,,percent of total billed charges,16.8% of total billed charges,294,50,,,percent of total billed charges,50% of total Billed charges,294,50,,,percent of total billed charges,50% of total Billed charges,98.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,294,50,,,percent of total billed charges,50% of total Billed charges,294,50,,,percent of total billed charges,50% of total Billed charges,100.76,17.136,,,percent of total billed charges,17.136% of total billed charges,128.42,21.84,,,percent of total billed charges,21.84% of total billed charges,294,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,294,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,294,50,,,percent of total billed charges,50% of total Billed charges,458.64,78,,,percent of total billed charges,78% of total billed charges,588,100,,,percent of total billed charges,100% of total billed charges,485.69,82.6,,,percent of total billed charges,82.6% of total billed charges,485.69,82.6,,,percent of total billed charges,82.6% of total billed charges,98.78,16.8,,,percent of total billed charges,16.8% of total billed charges,294,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,294,50,,,percent of total billed charges,50% of total Billed charges,98.78,16.8,,,percent of total billed charges,16.8% of total billed charges,89.96,588,
STEAM INDICATOR,491278,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
STEAM INDICATOR CARD,491279,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
STEAM TAPE BLUE,491280,CDM,270,RC,,,Outpatient,,,51,33.15,,44.88,88,,,percent of total billed charges,88% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,8.83,17.304,,,percent of total billed charges,17.304% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,32.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,15.3,,,percent of total billed charges,15.3% of total billed charges,35.19,69,,,percent of total billed charges,69% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,31.54,61.85,,,percent of total billed charges,61.85% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.74,17.136,,,percent of total billed charges,17.136% of total billed charges,11.14,21.84,,,percent of total billed charges,21.84% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,39.78,78,,,percent of total billed charges,78% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,51,
STEAM AND GAS STERILIZATION ROLL 8X100,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
STEAM/ GAS POUCH SELF SEAL 5.25 X 12,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
STEINMAN PIN 5/64,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
STEINMAN PIN 3/32,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STEINMANN PINS 3/16,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
STEINMANN PINS 5/32,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
STENT 2.25 x 12MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.25 x 18MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.25 x 22MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.25 x 26MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1877,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.25 x 30MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1877,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.50 x 14MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1877,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.50 x 18MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.50 x 22MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.50 x 30MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.75 x 12MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0033,CDM,278,RC,C1877,HCPCS,Outpatient,,,4400,2860.00,,3872,88,,,percent of total billed charges,88% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,761.38,17.304,,,percent of total billed charges,17.304% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2772,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3036,69,,,percent of total billed charges,69% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2721.4,61.85,,,percent of total billed charges,61.85% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1372.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,753.98,17.136,,,percent of total billed charges,17.136% of total billed charges,960.96,21.84,,,percent of total billed charges,21.84% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1491.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,3432,78,,,percent of total billed charges,78% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,4400,
STENT 2.75 x 14MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0033,CDM,278,RC,C1877,HCPCS,Outpatient,,,4400,2860.00,,3872,88,,,percent of total billed charges,88% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,761.38,17.304,,,percent of total billed charges,17.304% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2772,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3036,69,,,percent of total billed charges,69% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2721.4,61.85,,,percent of total billed charges,61.85% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1372.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,753.98,17.136,,,percent of total billed charges,17.136% of total billed charges,960.96,21.84,,,percent of total billed charges,21.84% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1491.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,3432,78,,,percent of total billed charges,78% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,4400,
STENT 2.75 x 18MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.75 x 22MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.75 x 26MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.75 x 30MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 3.0 x 15MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 3.0 x 18MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 3.0 x 22MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1877,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 3.0 x 30MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 3.5 x 18MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0039,CDM,278,RC,C1874,HCPCS,Outpatient,,,5600,3640.00,,4928,88,,,percent of total billed charges,88% of total Billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,969.02,17.304,,,percent of total billed charges,17.304% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,3528,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,856.8,15.3,,,percent of total billed charges,15.3% of total billed charges,3864,69,,,percent of total billed charges,69% of total billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,3463.6,61.85,,,percent of total billed charges,61.85% of total billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,1747.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2800,50,,,percent of total billed charges,50% of total Billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,959.62,17.136,,,percent of total billed charges,17.136% of total billed charges,1223.04,21.84,,,percent of total billed charges,21.84% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,2111.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2111.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,1898.4,33.9,,,percent of total billed charges,33.9% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,4368,78,,,percent of total billed charges,78% of total billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,4625.6,82.6,,,percent of total billed charges,82.6% of total billed charges,4625.6,82.6,,,percent of total billed charges,82.6% of total billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2800,50,,,percent of total billed charges,50% of total Billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,856.8,5600,
STENT 3.5 x 22MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 3.5 x 30MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0033,CDM,278,RC,C1874,HCPCS,Outpatient,,,4400,2860.00,,3872,88,,,percent of total billed charges,88% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,761.38,17.304,,,percent of total billed charges,17.304% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2772,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3036,69,,,percent of total billed charges,69% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2721.4,61.85,,,percent of total billed charges,61.85% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1372.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,753.98,17.136,,,percent of total billed charges,17.136% of total billed charges,960.96,21.84,,,percent of total billed charges,21.84% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1491.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,3432,78,,,percent of total billed charges,78% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,4400,
STENT 4.0 x 18MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 4.0 x 26MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0033,CDM,278,RC,C1874,HCPCS,Outpatient,,,4400,2860.00,,3872,88,,,percent of total billed charges,88% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,761.38,17.304,,,percent of total billed charges,17.304% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2772,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3036,69,,,percent of total billed charges,69% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2721.4,61.85,,,percent of total billed charges,61.85% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1372.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,753.98,17.136,,,percent of total billed charges,17.136% of total billed charges,960.96,21.84,,,percent of total billed charges,21.84% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1491.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,3432,78,,,percent of total billed charges,78% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,4400,
STENT RESOLUTE RX  3.5 X 38MM,ORSUP0040,CDM,278,RC,C1874,HCPCS,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2352.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2842.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,2556.06,33.9,,,percent of total billed charges,33.9% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
STENT VIABAHN W/MARKER 8MM X 15CM,ORSUP0105,CDM,278,RC,C1877,HCPCS,Outpatient,,,24960,16224.00,,21964.8,88,,,percent of total billed charges,88% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4319.08,17.304,,,percent of total billed charges,17.304% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15724.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,15.3,,,percent of total billed charges,15.3% of total billed charges,17222.4,69,,,percent of total billed charges,69% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,15437.76,61.85,,,percent of total billed charges,61.85% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,7787.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12480,50,,,percent of total billed charges,50% of total Billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,4277.15,17.136,,,percent of total billed charges,17.136% of total billed charges,5451.26,21.84,,,percent of total billed charges,21.84% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,9409.92,37.7,,,percent of total billed charges,37.70% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,8461.44,33.9,,,percent of total billed charges,33.9% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,19468.8,78,,,percent of total billed charges,78% of total billed charges,24960,100,,,percent of total billed charges,100% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,20616.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12480,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12480,50,,,percent of total billed charges,50% of total Billed charges,4193.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3818.88,24960,
STENT URETERAL 6 FR 22CM,ORSUP0008,CDM,278,RC,C1874,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
STENT URETERAL 6FR 24CM,ORSUP0010,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
STENT URETERAL 6FR 26CM,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
STENT URETERAL 6FR 28CM,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
STENT URETERAL 7FR 22CM,ORSUP0008,CDM,278,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
STENT GUIDE VIPER TRACK TAPE 30CM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
STENT TRACHEOBRONCIAL COVERED 12 X 20,ORSUP0050,CDM,278,RC,,,Outpatient,,,10140,6591.00,,8923.2,88,,,percent of total billed charges,88% of total Billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,1703.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1754.63,17.304,,,percent of total billed charges,17.304% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,6388.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1703.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1551.42,15.3,,,percent of total billed charges,15.3% of total billed charges,6996.6,69,,,percent of total billed charges,69% of total billed charges,10140,100,,,percent of total billed charges,100% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,10140,100,,,percent of total billed charges,100% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,10140,100,,,percent of total billed charges,100% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,6271.59,61.85,,,percent of total billed charges,61.85% of total billed charges,1703.52,16.8,,,percent of total billed charges,16.8% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,3163.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5070,50,,,percent of total billed charges,50% of total Billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,1737.59,17.136,,,percent of total billed charges,17.136% of total billed charges,2214.58,21.84,,,percent of total billed charges,21.84% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,3822.78,37.7,,,percent of total billed charges,37.70% of total billed charges,3822.78,37.7,,,percent of total billed charges,37.70% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,3437.46,33.9,,,percent of total billed charges,33.9% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,7909.2,78,,,percent of total billed charges,78% of total billed charges,10140,100,,,percent of total billed charges,100% of total billed charges,8375.64,82.6,,,percent of total billed charges,82.6% of total billed charges,8375.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1703.52,16.8,,,percent of total billed charges,16.8% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5070,50,,,percent of total billed charges,50% of total Billed charges,1703.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1551.42,10140,
STENT SOF-CURL URETERAL 4.5FR,ORSUP0012,CDM,278,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
STENT URETERAL SOF-CURL 4.5X26,ORSUP0012,CDM,278,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
STENT URETERAL SOF-CURL 4.5X28,ORSUP0011,CDM,278,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
STENT URETERAL SOF-CURL 4.5X22,ORSUP0011,CDM,278,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
STENT SET KWART 8.2FR 22-32CM,ORSUP0014,CDM,278,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
STENT SET KWART 7FR X 26CM,ORSUP0014,CDM,278,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
STENT GRAFT 8MMX70MM STRAIGHT,ORSUP0008,CDM,278,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
STENT GRAFT 9FR 7MMX70MM STRT,ORSUP0008,CDM,278,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
STENT GRAFT 9FR 6MMX70MM STRT,ORSUP0008,CDM,278,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
STENT GRAFT 9FR 7MMX70MM FLARD,ORSUP0016,CDM,278,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
STENT GRAFT 6MMX70MM FLARED,ORSUP0016,CDM,278,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
STENT GRAFT 8MMX70MM FLARED,ORSUP0016,CDM,278,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
STENT 6FR 28CM DBL PIGTAIL,ORSUP0009,CDM,278,RC,C1769,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
STENT 6FR 26CM DBL PIGTAIL,ORSUP0009,CDM,278,RC,C1769,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
STENT 6FR 24CM DBL PIGTAIL,ORSUP0009,CDM,278,RC,C1769,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
STENT 3.0 x 12MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0039,CDM,278,RC,C1877,HCPCS,Outpatient,,,5600,3640.00,,4928,88,,,percent of total billed charges,88% of total Billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,969.02,17.304,,,percent of total billed charges,17.304% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,3528,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,856.8,15.3,,,percent of total billed charges,15.3% of total billed charges,3864,69,,,percent of total billed charges,69% of total billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,3463.6,61.85,,,percent of total billed charges,61.85% of total billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,1747.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2800,50,,,percent of total billed charges,50% of total Billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,959.62,17.136,,,percent of total billed charges,17.136% of total billed charges,1223.04,21.84,,,percent of total billed charges,21.84% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,2111.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2111.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,1898.4,33.9,,,percent of total billed charges,33.9% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,4368,78,,,percent of total billed charges,78% of total billed charges,5600,100,,,percent of total billed charges,100% of total billed charges,4625.6,82.6,,,percent of total billed charges,82.6% of total billed charges,4625.6,82.6,,,percent of total billed charges,82.6% of total billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2800,50,,,percent of total billed charges,50% of total Billed charges,940.8,16.8,,,percent of total billed charges,16.8% of total billed charges,856.8,5600,
STENT 3.5 x 09MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0033,CDM,278,RC,C1874,HCPCS,Outpatient,,,4400,2860.00,,3872,88,,,percent of total billed charges,88% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,761.38,17.304,,,percent of total billed charges,17.304% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2772,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,15.3,,,percent of total billed charges,15.3% of total billed charges,3036,69,,,percent of total billed charges,69% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2721.4,61.85,,,percent of total billed charges,61.85% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1372.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2200,50,,,percent of total billed charges,50% of total Billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,753.98,17.136,,,percent of total billed charges,17.136% of total billed charges,960.96,21.84,,,percent of total billed charges,21.84% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1658.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,1491.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,3432,78,,,percent of total billed charges,78% of total billed charges,4400,100,,,percent of total billed charges,100% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3634.4,82.6,,,percent of total billed charges,82.6% of total billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,2200,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2200,50,,,percent of total billed charges,50% of total Billed charges,739.2,16.8,,,percent of total billed charges,16.8% of total billed charges,673.2,4400,
STENT 3.5 x 12MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 4.0 x 22MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
ORSUP0011,ORSUP0011,CDM,278,RC,C2617,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,203.4,33.9,,,percent of total billed charges,33.9% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
STENT 3.5 x 26MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.50 x 26MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 3.5 x 15MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT 2.50 x 12MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT ZILVER PTX 6 X 40 X 125CM,ORSUP0038,CDM,278,RC,C1877,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
STENT ZILVER PTX 7 X 40 X 125CM,ORSUP0056,CDM,278,RC,C1877,HCPCS,Outpatient,,,9100,5915.00,,8008,88,,,percent of total billed charges,88% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1574.66,17.304,,,percent of total billed charges,17.304% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5733,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,15.3,,,percent of total billed charges,15.3% of total billed charges,6279,69,,,percent of total billed charges,69% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5628.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,2839.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1559.38,17.136,,,percent of total billed charges,17.136% of total billed charges,1987.44,21.84,,,percent of total billed charges,21.84% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,3430.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3430.7,37.7,,,percent of total billed charges,37.70% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,3084.9,33.9,,,percent of total billed charges,33.9% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,7098,78,,,percent of total billed charges,78% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,9100,
STENT ZILVER PTX 8 X 40 X 125CM,ORSUP0038,CDM,278,RC,C1877,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4422.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
STENT ZILVER PTX 7 X 60 X 125CM,ORSUP0056,CDM,278,RC,C1877,HCPCS,Outpatient,,,9100,5915.00,,8008,88,,,percent of total billed charges,88% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1574.66,17.304,,,percent of total billed charges,17.304% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5733,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,15.3,,,percent of total billed charges,15.3% of total billed charges,6279,69,,,percent of total billed charges,69% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5628.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,2839.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1559.38,17.136,,,percent of total billed charges,17.136% of total billed charges,1987.44,21.84,,,percent of total billed charges,21.84% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,3430.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3430.7,37.7,,,percent of total billed charges,37.70% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,3084.9,33.9,,,percent of total billed charges,33.9% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,7098,78,,,percent of total billed charges,78% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,9100,
STENT ZILVER PTX 6 X 80 X 125CM,ORSUP0047,CDM,278,RC,C1877,HCPCS,Outpatient,,,7200,4680.00,,6336,88,,,percent of total billed charges,88% of total Billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1245.89,17.304,,,percent of total billed charges,17.304% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,4536,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1101.6,15.3,,,percent of total billed charges,15.3% of total billed charges,4968,69,,,percent of total billed charges,69% of total billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,4453.2,61.85,,,percent of total billed charges,61.85% of total billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,2246.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3600,50,,,percent of total billed charges,50% of total Billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,1233.79,17.136,,,percent of total billed charges,17.136% of total billed charges,1572.48,21.84,,,percent of total billed charges,21.84% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,2714.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2714.4,37.7,,,percent of total billed charges,37.70% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,2440.8,33.9,,,percent of total billed charges,33.9% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,5616,78,,,percent of total billed charges,78% of total billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,5947.2,82.6,,,percent of total billed charges,82.6% of total billed charges,5947.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3600,50,,,percent of total billed charges,50% of total Billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1101.6,7200,
STENT ZILVER PTX 6 X 100 X 125CM,ORSUP0047,CDM,272,RC,C1877,HCPCS,Outpatient,,,7200,4680.00,,6336,88,,,percent of total billed charges,88% of total Billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1245.89,17.304,,,percent of total billed charges,17.304% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,4536,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1101.6,15.3,,,percent of total billed charges,15.3% of total billed charges,4968,69,,,percent of total billed charges,69% of total billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,4453.2,61.85,,,percent of total billed charges,61.85% of total billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,1233.79,17.136,,,percent of total billed charges,17.136% of total billed charges,1572.48,21.84,,,percent of total billed charges,21.84% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3600,50,,,percent of total billed charges,50% of total Billed charges,5616,78,,,percent of total billed charges,78% of total billed charges,7200,100,,,percent of total billed charges,100% of total billed charges,5947.2,82.6,,,percent of total billed charges,82.6% of total billed charges,5947.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,3600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3600,50,,,percent of total billed charges,50% of total Billed charges,1209.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1101.6,7200,
STENT ZILVER PTX 7 X 100 X 125CM,ORSUP0053,CDM,278,RC,C1874,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5569.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
STENT ZILVER PTX 7 X 120 X 125CM,ORSUP0045,CDM,278,RC,C1874,HCPCS,Outpatient,,,6800,4420.00,,5984,88,,,percent of total billed charges,88% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1176.67,17.304,,,percent of total billed charges,17.304% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,4284,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1040.4,15.3,,,percent of total billed charges,15.3% of total billed charges,4692,69,,,percent of total billed charges,69% of total billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,4205.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,2121.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3400,50,,,percent of total billed charges,50% of total Billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,1165.25,17.136,,,percent of total billed charges,17.136% of total billed charges,1485.12,21.84,,,percent of total billed charges,21.84% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,2563.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2563.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,2305.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,5304,78,,,percent of total billed charges,78% of total billed charges,6800,100,,,percent of total billed charges,100% of total billed charges,5616.8,82.6,,,percent of total billed charges,82.6% of total billed charges,5616.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,3400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3400,50,,,percent of total billed charges,50% of total Billed charges,1142.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1040.4,6800,
STENT ZILVER PTX 6 X 140 X 125CM,ORSUP0047,CDM,278,RC,C1874,HCPCS,Outpatient,,,7280,4732.00,,6406.4,88,,,percent of total billed charges,88% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1259.73,17.304,,,percent of total billed charges,17.304% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4586.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,15.3,,,percent of total billed charges,15.3% of total billed charges,5023.2,69,,,percent of total billed charges,69% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4502.68,61.85,,,percent of total billed charges,61.85% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2271.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1247.5,17.136,,,percent of total billed charges,17.136% of total billed charges,1589.95,21.84,,,percent of total billed charges,21.84% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2744.56,37.7,,,percent of total billed charges,37.70% of total billed charges,2744.56,37.7,,,percent of total billed charges,37.70% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2467.92,33.9,,,percent of total billed charges,33.9% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,5678.4,78,,,percent of total billed charges,78% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,7280,
STENT ZILVER PTX 7 X 140 X 125CM,ORSUP0039,CDM,278,RC,C1874,HCPCS,Outpatient,,,7280,4732.00,,6406.4,88,,,percent of total billed charges,88% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1259.73,17.304,,,percent of total billed charges,17.304% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4586.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,15.3,,,percent of total billed charges,15.3% of total billed charges,5023.2,69,,,percent of total billed charges,69% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,4502.68,61.85,,,percent of total billed charges,61.85% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2271.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3640,50,,,percent of total billed charges,50% of total Billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,1247.5,17.136,,,percent of total billed charges,17.136% of total billed charges,1589.95,21.84,,,percent of total billed charges,21.84% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2744.56,37.7,,,percent of total billed charges,37.70% of total billed charges,2744.56,37.7,,,percent of total billed charges,37.70% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,2467.92,33.9,,,percent of total billed charges,33.9% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,5678.4,78,,,percent of total billed charges,78% of total billed charges,7280,100,,,percent of total billed charges,100% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,6013.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,3640,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3640,50,,,percent of total billed charges,50% of total Billed charges,1223.04,16.8,,,percent of total billed charges,16.8% of total billed charges,1113.84,7280,
MALTOPHILIA 5 LOOPS ATCC 17666,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
STENT RESOLUTE ONYX CORONARY,ORSUP0043,CDM,278,RC,C1874,HCPCS,Outpatient,,,8320,5408.00,,7321.6,88,,,percent of total billed charges,88% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1439.69,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5241.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,15.3,,,percent of total billed charges,15.3% of total billed charges,5740.8,69,,,percent of total billed charges,69% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5145.92,61.85,,,percent of total billed charges,61.85% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2595.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1425.72,17.136,,,percent of total billed charges,17.136% of total billed charges,1817.09,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2820.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,6489.6,78,,,percent of total billed charges,78% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,8320,
STENT 3.0 X26MM RESOLUTE INTEGRITY RX CORONARY,ORSUP0049,CDM,278,RC,C1874,HCPCS,Outpatient,,,7600,4940.00,,6688,88,,,percent of total billed charges,88% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1315.1,17.304,,,percent of total billed charges,17.304% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4788,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,15.3,,,percent of total billed charges,15.3% of total billed charges,5244,69,,,percent of total billed charges,69% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,4700.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2371.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3800,50,,,percent of total billed charges,50% of total Billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,1302.34,17.136,,,percent of total billed charges,17.136% of total billed charges,1659.84,21.84,,,percent of total billed charges,21.84% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,2865.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,5928,78,,,percent of total billed charges,78% of total billed charges,7600,100,,,percent of total billed charges,100% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,6277.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3800,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3800,50,,,percent of total billed charges,50% of total Billed charges,1276.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1162.8,7600,
STENT SOFT URETERAL 5FR X 22CM,ORSUP0009,CDM,278,RC,C1874,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
STENT SOFT URETERAL 5FR X 24CM,ORSUP0009,CDM,278,RC,C1874,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
STENT SOFT URETERAL 5FR X 26CM,ORSUP0009,CDM,278,RC,C1874,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
STERI-STRIP 1/4,86143,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
STERILE #32 RUBBER BANDS,437415,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
STERILIZATION WRAP GEMINI 54X54,415064,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
STERILIUM HAND RUB 1000ML,491304,CDM,270,RC,,,Outpatient,,,441,286.65,,388.08,88,,,percent of total billed charges,88% of total Billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,74.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,441,100,,,percent of total billed charges,100% of total billed charges,76.31,17.304,,,percent of total billed charges,17.304% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,277.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,74.09,16.8,,,percent of total billed charges,16.8% of total billed charges,67.47,15.3,,,percent of total billed charges,15.3% of total billed charges,304.29,69,,,percent of total billed charges,69% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,441,100,,,percent of total billed charges,100% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,441,100,,,percent of total billed charges,100% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,272.76,61.85,,,percent of total billed charges,61.85% of total billed charges,74.09,16.8,,,percent of total billed charges,16.8% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,74.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,75.57,17.136,,,percent of total billed charges,17.136% of total billed charges,96.31,21.84,,,percent of total billed charges,21.84% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,220.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,220.5,50,,,percent of total billed charges,50% of total Billed charges,343.98,78,,,percent of total billed charges,78% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,74.09,16.8,,,percent of total billed charges,16.8% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,220.5,50,,,percent of total billed charges,50% of total Billed charges,74.09,16.8,,,percent of total billed charges,16.8% of total billed charges,67.47,441,
STERI DRAPE 2045,491300,CDM,270,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
STERILIZATION INTEGRATOR,491305,CDM,270,RC,,,Outpatient,,,307,199.55,,270.16,88,,,percent of total billed charges,88% of total Billed charges,153.5,50,,,percent of total billed charges,50% of total Billed charges,51.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,307,100,,,percent of total billed charges,100% of total billed charges,53.12,17.304,,,percent of total billed charges,17.304% of total billed charges,153.5,50,,,percent of total billed charges,50% of total Billed charges,193.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,51.58,16.8,,,percent of total billed charges,16.8% of total billed charges,46.97,15.3,,,percent of total billed charges,15.3% of total billed charges,211.83,69,,,percent of total billed charges,69% of total billed charges,307,100,,,percent of total billed charges,100% of total billed charges,153.5,50,,,percent of total billed charges,50% of total Billed charges,307,100,,,percent of total billed charges,100% of total billed charges,153.5,50,,,percent of total billed charges,50% of total Billed charges,307,100,,,percent of total billed charges,100% of total billed charges,153.5,50,,,percent of total billed charges,50% of total Billed charges,189.88,61.85,,,percent of total billed charges,61.85% of total billed charges,51.58,16.8,,,percent of total billed charges,16.8% of total billed charges,153.5,50,,,percent of total billed charges,50% of total Billed charges,153.5,50,,,percent of total billed charges,50% of total Billed charges,51.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,153.5,50,,,percent of total billed charges,50% of total Billed charges,153.5,50,,,percent of total billed charges,50% of total Billed charges,52.61,17.136,,,percent of total billed charges,17.136% of total billed charges,67.05,21.84,,,percent of total billed charges,21.84% of total billed charges,153.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,153.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,153.5,50,,,percent of total billed charges,50% of total Billed charges,239.46,78,,,percent of total billed charges,78% of total billed charges,307,100,,,percent of total billed charges,100% of total billed charges,253.58,82.6,,,percent of total billed charges,82.6% of total billed charges,253.58,82.6,,,percent of total billed charges,82.6% of total billed charges,51.58,16.8,,,percent of total billed charges,16.8% of total billed charges,153.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,153.5,50,,,percent of total billed charges,50% of total Billed charges,51.58,16.8,,,percent of total billed charges,16.8% of total billed charges,46.97,307,
STERILE SLEEVE,491303,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
STERI DRAPE 1071,491299,CDM,270,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
STERIS NEW AUTOCLAVE PRINTER PAPER,491306,CDM,270,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
STERIS OLD AUTOCLAVE PRINTER PAPER,491307,CDM,270,RC,,,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,9.69,17.304,,,percent of total billed charges,17.304% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,35.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.6,17.136,,,percent of total billed charges,17.136% of total billed charges,12.23,21.84,,,percent of total billed charges,21.84% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,56,
STERIS WASHER PRINTER PAPER,491309,CDM,270,RC,,,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,12.8,17.304,,,percent of total billed charges,17.304% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,46.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,45.77,61.85,,,percent of total billed charges,61.85% of total billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.68,17.136,,,percent of total billed charges,17.136% of total billed charges,16.16,21.84,,,percent of total billed charges,21.84% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,11.32,74,
STERILLIUM RUB 1000ML SURGICAL HAND SPRAY,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
STERILIT DRIP FEED OILER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
"STERILE WATER, INHALATION 1000ML",ORSUP0001,CDM,272,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
STERILIZATION RECORD ENVELOPES 9X12,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
STERILE LUBRICATING JELLY,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
STETHOSCOPE ESOPHAGEAL 24 FR.,185997,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
STETHOSCOPE ESOPHAGEAL 18 FR.,185996,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
STETHOSCOPE ESOPHAGEAL W/TEMP SNSR 400 SERIES 12F,157309,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
STICK TIGERWIRE #2,ORSUP0005,CDM,278,RC,C1713,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
STICK BITE,12017,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
STIFF SNARE 15MM,491313,CDM,270,RC,,,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,15.75,17.304,,,percent of total billed charges,17.304% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,57.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,15.3,,,percent of total billed charges,15.3% of total billed charges,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,56.28,61.85,,,percent of total billed charges,61.85% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.59,17.136,,,percent of total billed charges,17.136% of total billed charges,19.87,21.84,,,percent of total billed charges,21.84% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,91,
STIMULATOR NERVE PRASS STD MONO W/PROTECTED LEAD HANDLE,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
STIRRUP STRAP,491316,CDM,270,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
STOCKING TED KNEE XL REG,36369,CDM,270,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
STOCKING TED XL REG W/BELT,12048,CDM,270,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
STOCKING TED KNEE SM LONG,89481,CDM,270,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
STOCKING TED THIGH MED REG,11862,CDM,270,RC,,,Outpatient,,,430,279.50,,378.4,88,,,percent of total billed charges,88% of total Billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,72.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,430,100,,,percent of total billed charges,100% of total billed charges,74.41,17.304,,,percent of total billed charges,17.304% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,270.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,72.24,16.8,,,percent of total billed charges,16.8% of total billed charges,65.79,15.3,,,percent of total billed charges,15.3% of total billed charges,296.7,69,,,percent of total billed charges,69% of total billed charges,430,100,,,percent of total billed charges,100% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,430,100,,,percent of total billed charges,100% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,430,100,,,percent of total billed charges,100% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,265.96,61.85,,,percent of total billed charges,61.85% of total billed charges,72.24,16.8,,,percent of total billed charges,16.8% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,72.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,73.68,17.136,,,percent of total billed charges,17.136% of total billed charges,93.91,21.84,,,percent of total billed charges,21.84% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,215,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,215,50,,,percent of total billed charges,50% of total Billed charges,335.4,78,,,percent of total billed charges,78% of total billed charges,430,100,,,percent of total billed charges,100% of total billed charges,355.18,82.6,,,percent of total billed charges,82.6% of total billed charges,355.18,82.6,,,percent of total billed charges,82.6% of total billed charges,72.24,16.8,,,percent of total billed charges,16.8% of total billed charges,215,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,215,50,,,percent of total billed charges,50% of total Billed charges,72.24,16.8,,,percent of total billed charges,16.8% of total billed charges,65.79,430,
STOCKING TED KNEE LG REG,36368,CDM,270,RC,,,Outpatient,,,517,336.05,,454.96,88,,,percent of total billed charges,88% of total Billed charges,258.5,50,,,percent of total billed charges,50% of total Billed charges,86.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,517,100,,,percent of total billed charges,100% of total billed charges,89.46,17.304,,,percent of total billed charges,17.304% of total billed charges,258.5,50,,,percent of total billed charges,50% of total Billed charges,325.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,86.86,16.8,,,percent of total billed charges,16.8% of total billed charges,79.1,15.3,,,percent of total billed charges,15.3% of total billed charges,356.73,69,,,percent of total billed charges,69% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,258.5,50,,,percent of total billed charges,50% of total Billed charges,517,100,,,percent of total billed charges,100% of total billed charges,258.5,50,,,percent of total billed charges,50% of total Billed charges,517,100,,,percent of total billed charges,100% of total billed charges,258.5,50,,,percent of total billed charges,50% of total Billed charges,319.76,61.85,,,percent of total billed charges,61.85% of total billed charges,86.86,16.8,,,percent of total billed charges,16.8% of total billed charges,258.5,50,,,percent of total billed charges,50% of total Billed charges,258.5,50,,,percent of total billed charges,50% of total Billed charges,86.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,258.5,50,,,percent of total billed charges,50% of total Billed charges,258.5,50,,,percent of total billed charges,50% of total Billed charges,88.59,17.136,,,percent of total billed charges,17.136% of total billed charges,112.91,21.84,,,percent of total billed charges,21.84% of total billed charges,258.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,258.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,258.5,50,,,percent of total billed charges,50% of total Billed charges,403.26,78,,,percent of total billed charges,78% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,86.86,16.8,,,percent of total billed charges,16.8% of total billed charges,258.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,258.5,50,,,percent of total billed charges,50% of total Billed charges,86.86,16.8,,,percent of total billed charges,16.8% of total billed charges,79.1,517,
STOCKINETTE TUBULAR 6IN X 25 YD,151801,CDM,270,RC,,,Outpatient,,,92,59.80,,80.96,88,,,percent of total billed charges,88% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,92,100,,,percent of total billed charges,100% of total billed charges,15.92,17.304,,,percent of total billed charges,17.304% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,57.96,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.08,15.3,,,percent of total billed charges,15.3% of total billed charges,63.48,69,,,percent of total billed charges,69% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,92,100,,,percent of total billed charges,100% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,92,100,,,percent of total billed charges,100% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,56.9,61.85,,,percent of total billed charges,61.85% of total billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,15.77,17.136,,,percent of total billed charges,17.136% of total billed charges,20.09,21.84,,,percent of total billed charges,21.84% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46,50,,,percent of total billed charges,50% of total Billed charges,71.76,78,,,percent of total billed charges,78% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46,50,,,percent of total billed charges,50% of total Billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.08,92,
STOCKINETTE TUBULAR 4IN 25YD,169635,CDM,270,RC,,,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
STOCKINETTE IMPERVIOUS LG,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STOCKINETTE IMPERVIOUS MD 9,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STOCKINETTE TUBULAR 3IN X 25 YD NON-STER,157328,CDM,270,RC,,,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,8.31,17.304,,,percent of total billed charges,17.304% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,30.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,29.69,61.85,,,percent of total billed charges,61.85% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.23,17.136,,,percent of total billed charges,17.136% of total billed charges,10.48,21.84,,,percent of total billed charges,21.84% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,48,
STOCKING TED THIGH LG LONG,165710,CDM,270,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
STOCKINETTE 4 STERILE,104478,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
STOCKINETTE 6 STERILE,104479,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
STOCKINETTE TUBULAR 2IN X 25YD,12135,CDM,270,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
STOCKINETTE TUBULAR 3IN,12136,CDM,270,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,8.65,17.304,,,percent of total billed charges,17.304% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,30.93,61.85,,,percent of total billed charges,61.85% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.57,17.136,,,percent of total billed charges,17.136% of total billed charges,10.92,21.84,,,percent of total billed charges,21.84% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,50,
STOCKINETTE TUBULAR 4IN,12133,CDM,270,RC,,,Outpatient,,,64,41.60,,56.32,88,,,percent of total billed charges,88% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,11.07,17.304,,,percent of total billed charges,17.304% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,40.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,9.79,15.3,,,percent of total billed charges,15.3% of total billed charges,44.16,69,,,percent of total billed charges,69% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,39.58,61.85,,,percent of total billed charges,61.85% of total billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.97,17.136,,,percent of total billed charges,17.136% of total billed charges,13.98,21.84,,,percent of total billed charges,21.84% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,49.92,78,,,percent of total billed charges,78% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,9.79,64,
STOCKING TED THIGH LG REG,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
STOCK THIGH XL REG,ORSUP0003,CDM,270,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
STOCKINETTE IMPERVIOUS STERILE 12 X 48 (LARGE),491324,CDM,272,RC,,,Outpatient,,,67,43.55,,58.96,88,,,percent of total billed charges,88% of total Billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,11.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,67,100,,,percent of total billed charges,100% of total billed charges,11.59,17.304,,,percent of total billed charges,17.304% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,42.21,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.26,16.8,,,percent of total billed charges,16.8% of total billed charges,10.25,15.3,,,percent of total billed charges,15.3% of total billed charges,46.23,69,,,percent of total billed charges,69% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,67,100,,,percent of total billed charges,100% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,67,100,,,percent of total billed charges,100% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,41.44,61.85,,,percent of total billed charges,61.85% of total billed charges,11.26,16.8,,,percent of total billed charges,16.8% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,11.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,11.48,17.136,,,percent of total billed charges,17.136% of total billed charges,14.63,21.84,,,percent of total billed charges,21.84% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,33.5,50,,,percent of total billed charges,50% of total Billed charges,52.26,78,,,percent of total billed charges,78% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,11.26,16.8,,,percent of total billed charges,16.8% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,33.5,50,,,percent of total billed charges,50% of total Billed charges,11.26,16.8,,,percent of total billed charges,16.8% of total billed charges,10.25,67,
STOCKINETTE IMPERVIOUS STERILE 9 X 48 (MEDIUM),491325,CDM,272,RC,,,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,11.94,17.304,,,percent of total billed charges,17.304% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,43.47,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,42.68,61.85,,,percent of total billed charges,61.85% of total billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.82,17.136,,,percent of total billed charges,17.136% of total billed charges,15.07,21.84,,,percent of total billed charges,21.84% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,10.56,69,
STOCKINETTE TUBULAR 2,491326,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
STOCKINETTE TUBULAR 3,491327,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
STONE RETRIEVAL BASKET ZEROTIP,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
STONE EXT HELICAL 2.8FR 4-WIRE,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
STONE EXTRACTOR 4-WIRE,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
STOPCOCK 3WAY LG BORE W/ROTATING MALE LUER LOCK,169671,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
STOPCOCK 3-3 WAY W/MLL,187968,CDM,270,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
STOPCOCK 3-WAY,491331,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
STOPCOCK 4 WAY (BACK UP),491332,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
STOPCOCK HIGH PRESSURE 1200PSI,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STRATTICE CONTOUR 2,ORSUP0063,CDM,272,RC,,,Outpatient,,,13780,8957.00,,12126.4,88,,,percent of total billed charges,88% of total Billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,2315.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2384.49,17.304,,,percent of total billed charges,17.304% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,8681.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2315.04,16.8,,,percent of total billed charges,16.8% of total billed charges,2108.34,15.3,,,percent of total billed charges,15.3% of total billed charges,9508.2,69,,,percent of total billed charges,69% of total billed charges,13780,100,,,percent of total billed charges,100% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,13780,100,,,percent of total billed charges,100% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,13780,100,,,percent of total billed charges,100% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,8522.93,61.85,,,percent of total billed charges,61.85% of total billed charges,2315.04,16.8,,,percent of total billed charges,16.8% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,2315.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,2361.34,17.136,,,percent of total billed charges,17.136% of total billed charges,3009.55,21.84,,,percent of total billed charges,21.84% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6890,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6890,50,,,percent of total billed charges,50% of total Billed charges,10748.4,78,,,percent of total billed charges,78% of total billed charges,13780,100,,,percent of total billed charges,100% of total billed charges,11382.28,82.6,,,percent of total billed charges,82.6% of total billed charges,11382.28,82.6,,,percent of total billed charges,82.6% of total billed charges,2315.04,16.8,,,percent of total billed charges,16.8% of total billed charges,6890,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6890,50,,,percent of total billed charges,50% of total Billed charges,2315.04,16.8,,,percent of total billed charges,16.8% of total billed charges,2108.34,13780,
STRAINER CALCULI,148479,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
STRAP TABLE PATIENT RESTRAINT,ORSUP0021,CDM,270,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
STRAP TAMPER RESISTANT SOFTTOUCH INFANT,ORSUP0020,CDM,270,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
STRAIGHT CATH 65CM 451-501V5 CORDIS,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
STRATAFIX 2-0 9,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
STRECK CELL-CHEX BODY FLUID CONTROL,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
STREPTOCOCCUS PYOGENES GROUP A,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
STREPTOCOCCUS PYOGENES ATCC 19615,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
STREPTOCOCCUS PNEUMONIAE ATCC 6305 CULTI LOOPS,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
STREP THERMOPHILUS ATCC CULTI LOOPS 19258,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
STREP GROUP A LATEX,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
STREP PATHODX POSITIVE CTL 3ML,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
STREP PNEUMO SENS (AST-74,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
STRIP  BETA-TCP  50MM X 25MM X 3MM STERILE 07.801.100.99S,ORSUP0022,CDM,278,RC,C1713,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
STRIP INDICATOR CHEMICAL STERRAD,151487,CDM,270,RC,,,Outpatient,,,170,110.50,,149.6,88,,,percent of total billed charges,88% of total Billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,28.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,170,100,,,percent of total billed charges,100% of total billed charges,29.42,17.304,,,percent of total billed charges,17.304% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,107.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,28.56,16.8,,,percent of total billed charges,16.8% of total billed charges,26.01,15.3,,,percent of total billed charges,15.3% of total billed charges,117.3,69,,,percent of total billed charges,69% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,170,100,,,percent of total billed charges,100% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,170,100,,,percent of total billed charges,100% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,105.15,61.85,,,percent of total billed charges,61.85% of total billed charges,28.56,16.8,,,percent of total billed charges,16.8% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,28.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,29.13,17.136,,,percent of total billed charges,17.136% of total billed charges,37.13,21.84,,,percent of total billed charges,21.84% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,85,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,85,50,,,percent of total billed charges,50% of total Billed charges,132.6,78,,,percent of total billed charges,78% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,28.56,16.8,,,percent of total billed charges,16.8% of total billed charges,85,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,85,50,,,percent of total billed charges,50% of total Billed charges,28.56,16.8,,,percent of total billed charges,16.8% of total billed charges,26.01,170,
STRIP STERI 15 IODOPHOR REIN,187244,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
STRIP PRECISION XCEED PRO G3CH,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
STRIPS RAPIDCIDE TEST,289499,CDM,270,RC,,,Outpatient,,,333,216.45,,293.04,88,,,percent of total billed charges,88% of total Billed charges,166.5,50,,,percent of total billed charges,50% of total Billed charges,55.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,333,100,,,percent of total billed charges,100% of total billed charges,57.62,17.304,,,percent of total billed charges,17.304% of total billed charges,166.5,50,,,percent of total billed charges,50% of total Billed charges,209.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,55.94,16.8,,,percent of total billed charges,16.8% of total billed charges,50.95,15.3,,,percent of total billed charges,15.3% of total billed charges,229.77,69,,,percent of total billed charges,69% of total billed charges,333,100,,,percent of total billed charges,100% of total billed charges,166.5,50,,,percent of total billed charges,50% of total Billed charges,333,100,,,percent of total billed charges,100% of total billed charges,166.5,50,,,percent of total billed charges,50% of total Billed charges,333,100,,,percent of total billed charges,100% of total billed charges,166.5,50,,,percent of total billed charges,50% of total Billed charges,205.96,61.85,,,percent of total billed charges,61.85% of total billed charges,55.94,16.8,,,percent of total billed charges,16.8% of total billed charges,166.5,50,,,percent of total billed charges,50% of total Billed charges,166.5,50,,,percent of total billed charges,50% of total Billed charges,55.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,166.5,50,,,percent of total billed charges,50% of total Billed charges,166.5,50,,,percent of total billed charges,50% of total Billed charges,57.06,17.136,,,percent of total billed charges,17.136% of total billed charges,72.73,21.84,,,percent of total billed charges,21.84% of total billed charges,166.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,166.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,166.5,50,,,percent of total billed charges,50% of total Billed charges,259.74,78,,,percent of total billed charges,78% of total billed charges,333,100,,,percent of total billed charges,100% of total billed charges,275.06,82.6,,,percent of total billed charges,82.6% of total billed charges,275.06,82.6,,,percent of total billed charges,82.6% of total billed charges,55.94,16.8,,,percent of total billed charges,16.8% of total billed charges,166.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,166.5,50,,,percent of total billed charges,50% of total Billed charges,55.94,16.8,,,percent of total billed charges,16.8% of total billed charges,50.95,333,
STRIPS CALIBRATION,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
STRYKER HOOD SWEAT BANDS,491335,CDM,270,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
STRYK SAW BLADE 6125-127-090,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
STRYKER PRINTER PAPER SEPC-110,491337,CDM,270,RC,,,Outpatient,,,1288,837.20,,1133.44,88,,,percent of total billed charges,88% of total Billed charges,644,50,,,percent of total billed charges,50% of total Billed charges,216.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,1288,100,,,percent of total billed charges,100% of total billed charges,222.88,17.304,,,percent of total billed charges,17.304% of total billed charges,644,50,,,percent of total billed charges,50% of total Billed charges,811.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,216.38,16.8,,,percent of total billed charges,16.8% of total billed charges,197.06,15.3,,,percent of total billed charges,15.3% of total billed charges,888.72,69,,,percent of total billed charges,69% of total billed charges,1288,100,,,percent of total billed charges,100% of total billed charges,644,50,,,percent of total billed charges,50% of total Billed charges,1288,100,,,percent of total billed charges,100% of total billed charges,644,50,,,percent of total billed charges,50% of total Billed charges,1288,100,,,percent of total billed charges,100% of total billed charges,644,50,,,percent of total billed charges,50% of total Billed charges,796.63,61.85,,,percent of total billed charges,61.85% of total billed charges,216.38,16.8,,,percent of total billed charges,16.8% of total billed charges,644,50,,,percent of total billed charges,50% of total Billed charges,644,50,,,percent of total billed charges,50% of total Billed charges,216.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,644,50,,,percent of total billed charges,50% of total Billed charges,644,50,,,percent of total billed charges,50% of total Billed charges,220.71,17.136,,,percent of total billed charges,17.136% of total billed charges,281.3,21.84,,,percent of total billed charges,21.84% of total billed charges,644,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,644,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,644,50,,,percent of total billed charges,50% of total Billed charges,1004.64,78,,,percent of total billed charges,78% of total billed charges,1288,100,,,percent of total billed charges,100% of total billed charges,1063.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1063.89,82.6,,,percent of total billed charges,82.6% of total billed charges,216.38,16.8,,,percent of total billed charges,16.8% of total billed charges,644,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,644,50,,,percent of total billed charges,50% of total Billed charges,216.38,16.8,,,percent of total billed charges,16.8% of total billed charges,197.06,1288,
STRYKER HOOD T-5/FACE SHIELD,491336,CDM,270,RC,,,Outpatient,,,348,226.20,,306.24,88,,,percent of total billed charges,88% of total Billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,58.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,348,100,,,percent of total billed charges,100% of total billed charges,60.22,17.304,,,percent of total billed charges,17.304% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,219.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.46,16.8,,,percent of total billed charges,16.8% of total billed charges,53.24,15.3,,,percent of total billed charges,15.3% of total billed charges,240.12,69,,,percent of total billed charges,69% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,348,100,,,percent of total billed charges,100% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,348,100,,,percent of total billed charges,100% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,215.24,61.85,,,percent of total billed charges,61.85% of total billed charges,58.46,16.8,,,percent of total billed charges,16.8% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,58.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,59.63,17.136,,,percent of total billed charges,17.136% of total billed charges,76,21.84,,,percent of total billed charges,21.84% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,174,50,,,percent of total billed charges,50% of total Billed charges,271.44,78,,,percent of total billed charges,78% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,58.46,16.8,,,percent of total billed charges,16.8% of total billed charges,174,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,174,50,,,percent of total billed charges,50% of total Billed charges,58.46,16.8,,,percent of total billed charges,16.8% of total billed charges,53.24,348,
STRYKER BONE DRILL,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
STRYKER ENDO AIR+,ORSUP0022,CDM,272,RC,,,Outpatient,,,2200,1430.00,,1936,88,,,percent of total billed charges,88% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,380.69,17.304,,,percent of total billed charges,17.304% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1386,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,15.3,,,percent of total billed charges,15.3% of total billed charges,1518,69,,,percent of total billed charges,69% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1360.7,61.85,,,percent of total billed charges,61.85% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,376.99,17.136,,,percent of total billed charges,17.136% of total billed charges,480.48,21.84,,,percent of total billed charges,21.84% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,1716,78,,,percent of total billed charges,78% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,2200,
STYLET INTUBATION 14FR SATIN SLIP,157379,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
STYLET INTUBATING 14FR,322960,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
STYLET TUBE ENDOTRACHEAL 6FR 2.5-4.5 OD,419618,CDM,270,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
STYLET CATH STRAIGHTENING 61CM,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
STYLET 14FR,491338,CDM,270,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SUBSTITUTE BNGF GRFTN + DBM PST SYR 1ML,ORSUP0014,CDM,278,RC,C1762,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
SUCTION POOLE TIP INSTRUMENT,54677,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
SUCTION/IRRIGATOR ESCPC TBG W/TIP DISP,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
"SUCTION MAT, LOW PROFILE 50 INCH X 34 INCH",422030,CDM,272,RC,,,Outpatient,,,436,283.40,,383.68,88,,,percent of total billed charges,88% of total Billed charges,218,50,,,percent of total billed charges,50% of total Billed charges,73.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,436,100,,,percent of total billed charges,100% of total billed charges,75.45,17.304,,,percent of total billed charges,17.304% of total billed charges,218,50,,,percent of total billed charges,50% of total Billed charges,274.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,73.25,16.8,,,percent of total billed charges,16.8% of total billed charges,66.71,15.3,,,percent of total billed charges,15.3% of total billed charges,300.84,69,,,percent of total billed charges,69% of total billed charges,436,100,,,percent of total billed charges,100% of total billed charges,218,50,,,percent of total billed charges,50% of total Billed charges,436,100,,,percent of total billed charges,100% of total billed charges,218,50,,,percent of total billed charges,50% of total Billed charges,436,100,,,percent of total billed charges,100% of total billed charges,218,50,,,percent of total billed charges,50% of total Billed charges,269.67,61.85,,,percent of total billed charges,61.85% of total billed charges,73.25,16.8,,,percent of total billed charges,16.8% of total billed charges,218,50,,,percent of total billed charges,50% of total Billed charges,218,50,,,percent of total billed charges,50% of total Billed charges,73.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,218,50,,,percent of total billed charges,50% of total Billed charges,218,50,,,percent of total billed charges,50% of total Billed charges,74.71,17.136,,,percent of total billed charges,17.136% of total billed charges,95.22,21.84,,,percent of total billed charges,21.84% of total billed charges,218,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,218,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,218,50,,,percent of total billed charges,50% of total Billed charges,340.08,78,,,percent of total billed charges,78% of total billed charges,436,100,,,percent of total billed charges,100% of total billed charges,360.14,82.6,,,percent of total billed charges,82.6% of total billed charges,360.14,82.6,,,percent of total billed charges,82.6% of total billed charges,73.25,16.8,,,percent of total billed charges,16.8% of total billed charges,218,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,218,50,,,percent of total billed charges,50% of total Billed charges,73.25,16.8,,,percent of total billed charges,16.8% of total billed charges,66.71,436,
SUCTION IRRIGATOR XL,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SUCTION IRRIGATOR STRYKER,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SUCTION TIP POOLE,491347,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
SUCTION CANN 1500CC WALL,491341,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
SUCTION CANISTER 1500ML,491340,CDM,270,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUCTION TIP ARGYLE,491346,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUCTION TIP YANKAUER,491348,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
SULFOLYSR,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SUPER-ATRAU RAPTOR GRASPER,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SUPER-ATRAU GRASPERS FENESTRAT,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SUPERFROST MICROSCOPE SLIDES,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUPPORTER ADULT LARGER,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SUPPORTER ADULT MEDIUM,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SUPPORTER ATHLETIC MEDIUM,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUPPORTER ATHLETIC X-LARGE,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUPPORTER ATHLETIC SMALL,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUPPLEMENT PROMOTE VANILLA 1500ML BTL READY TO HANG,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SUPPLEMENT PROMOTE VANILLA 1000ML BTL READY TO HANG,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SURESTEP ADD-A-FOLEY KIT,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SURE-VUE COLOR STAPH  300PK,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SURGICEL FIBRILLAR ABSORB HEMOSTAT 1 X 2,ORSUP0005,CDM,278,RC,C1765,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,110.18,33.9,,,percent of total billed charges,33.9% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SURGICEL ABSORBABLE HEMOSTAT 2X3,ORSUP0003,CDM,278,RC,C1765,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,66.11,33.9,,,percent of total billed charges,33.9% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SURGIFLO WITH THROMBIN,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
SURGICEL ABSORBABLE HEMOSTAT 4X8,ORSUP0010,CDM,278,RC,C1765,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
SURGICAL PATTIES 1/2'' X 3'',69301,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
SURGI STAIN,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SURGICEL SNOW ABS 2 X 4,ORSUP0021,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SURGICAL PATTIE 1 X 3,491365,CDM,270,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
SURGICAL PATTIES 1/2 X 3,491367,CDM,270,RC,,,Outpatient,,,108,70.20,,95.04,88,,,percent of total billed charges,88% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,18.69,17.304,,,percent of total billed charges,17.304% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,68.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,15.3,,,percent of total billed charges,15.3% of total billed charges,74.52,69,,,percent of total billed charges,69% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,66.8,61.85,,,percent of total billed charges,61.85% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.51,17.136,,,percent of total billed charges,17.136% of total billed charges,23.59,21.84,,,percent of total billed charges,21.84% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,84.24,78,,,percent of total billed charges,78% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,108,
SURGICAL PATTIES 1/2 X 2,491366,CDM,270,RC,,,Outpatient,,,108,70.20,,95.04,88,,,percent of total billed charges,88% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,18.69,17.304,,,percent of total billed charges,17.304% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,68.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,15.3,,,percent of total billed charges,15.3% of total billed charges,74.52,69,,,percent of total billed charges,69% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,108,100,,,percent of total billed charges,100% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,66.8,61.85,,,percent of total billed charges,61.85% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,18.51,17.136,,,percent of total billed charges,17.136% of total billed charges,23.59,21.84,,,percent of total billed charges,21.84% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,84.24,78,,,percent of total billed charges,78% of total billed charges,108,100,,,percent of total billed charges,100% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,89.21,82.6,,,percent of total billed charges,82.6% of total billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,54,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54,50,,,percent of total billed charges,50% of total Billed charges,18.14,16.8,,,percent of total billed charges,16.8% of total billed charges,16.52,108,
SURGEON CAP BLUE,491356,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SURGICAL BLADE #10,491357,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
SURGICAL BLADE #11,491358,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
SURGICAL BLADE #15,491359,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
SURGICAL MASK GREEN,491362,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SURGICAL MASK LIGHT  COOL,491363,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SURGICAL MASK PURPLE,491364,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SURGICAL SCRUB AVAGARD,491368,CDM,270,RC,,,Outpatient,,,418,271.70,,367.84,88,,,percent of total billed charges,88% of total Billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,70.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,418,100,,,percent of total billed charges,100% of total billed charges,72.33,17.304,,,percent of total billed charges,17.304% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,263.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,70.22,16.8,,,percent of total billed charges,16.8% of total billed charges,63.95,15.3,,,percent of total billed charges,15.3% of total billed charges,288.42,69,,,percent of total billed charges,69% of total billed charges,418,100,,,percent of total billed charges,100% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,418,100,,,percent of total billed charges,100% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,418,100,,,percent of total billed charges,100% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,258.53,61.85,,,percent of total billed charges,61.85% of total billed charges,70.22,16.8,,,percent of total billed charges,16.8% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,70.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,71.63,17.136,,,percent of total billed charges,17.136% of total billed charges,91.29,21.84,,,percent of total billed charges,21.84% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,209,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,209,50,,,percent of total billed charges,50% of total Billed charges,326.04,78,,,percent of total billed charges,78% of total billed charges,418,100,,,percent of total billed charges,100% of total billed charges,345.27,82.6,,,percent of total billed charges,82.6% of total billed charges,345.27,82.6,,,percent of total billed charges,82.6% of total billed charges,70.22,16.8,,,percent of total billed charges,16.8% of total billed charges,209,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,209,50,,,percent of total billed charges,50% of total Billed charges,70.22,16.8,,,percent of total billed charges,16.8% of total billed charges,63.95,418,
SURGICAL SCRUB DIAL SOAP,491369,CDM,270,RC,,,Outpatient,,,647,420.55,,569.36,88,,,percent of total billed charges,88% of total Billed charges,323.5,50,,,percent of total billed charges,50% of total Billed charges,108.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,647,100,,,percent of total billed charges,100% of total billed charges,111.96,17.304,,,percent of total billed charges,17.304% of total billed charges,323.5,50,,,percent of total billed charges,50% of total Billed charges,407.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,108.7,16.8,,,percent of total billed charges,16.8% of total billed charges,98.99,15.3,,,percent of total billed charges,15.3% of total billed charges,446.43,69,,,percent of total billed charges,69% of total billed charges,647,100,,,percent of total billed charges,100% of total billed charges,323.5,50,,,percent of total billed charges,50% of total Billed charges,647,100,,,percent of total billed charges,100% of total billed charges,323.5,50,,,percent of total billed charges,50% of total Billed charges,647,100,,,percent of total billed charges,100% of total billed charges,323.5,50,,,percent of total billed charges,50% of total Billed charges,400.17,61.85,,,percent of total billed charges,61.85% of total billed charges,108.7,16.8,,,percent of total billed charges,16.8% of total billed charges,323.5,50,,,percent of total billed charges,50% of total Billed charges,323.5,50,,,percent of total billed charges,50% of total Billed charges,108.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,323.5,50,,,percent of total billed charges,50% of total Billed charges,323.5,50,,,percent of total billed charges,50% of total Billed charges,110.87,17.136,,,percent of total billed charges,17.136% of total billed charges,141.3,21.84,,,percent of total billed charges,21.84% of total billed charges,323.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,323.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,323.5,50,,,percent of total billed charges,50% of total Billed charges,504.66,78,,,percent of total billed charges,78% of total billed charges,647,100,,,percent of total billed charges,100% of total billed charges,534.42,82.6,,,percent of total billed charges,82.6% of total billed charges,534.42,82.6,,,percent of total billed charges,82.6% of total billed charges,108.7,16.8,,,percent of total billed charges,16.8% of total billed charges,323.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,323.5,50,,,percent of total billed charges,50% of total Billed charges,108.7,16.8,,,percent of total billed charges,16.8% of total billed charges,98.99,647,
SURGICEL 1 X 1,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SURGICEL 3 X 4,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SURGIFLO 8ML,ORSUP0015,CDM,278,RC,C1763,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SURGIFLO ENDOSCOPIC APPLICATOR,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SURGICUTT BLEEDING TIME,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SURGICAL TRAY CORNER PROTECTOR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUT CAPRIO CAPTURING DEVICE,ORSUP0020,CDM,278,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
SUT DEVICE CAPIO DISP,ORSUP0018,CDM,278,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
SUT PASSER MEDIUM   9893,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SUT RETRIEVER HEWSON,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
SUT FIBERWIRE 2 T-5 36IN AR-7200,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SUT VICRYL RAPID 4-0,188339,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUT CTD VICRYL 3-0,149584,CDM,272,RC,,,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,12.11,17.304,,,percent of total billed charges,17.304% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,44.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,12,17.136,,,percent of total billed charges,17.136% of total billed charges,15.29,21.84,,,percent of total billed charges,21.84% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,70,
SUT VCRL 3-0 FS-1 27IN UND  J442H,13697,CDM,272,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
SUTURE COATED VICRYL UND BR 3-0 CLOSURE 27 CT-2,70812,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SUT CTD VICRYL 3-0 UND CR/C,157515,CDM,272,RC,,,Outpatient,,,122,79.30,,107.36,88,,,percent of total billed charges,88% of total Billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,20.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,122,100,,,percent of total billed charges,100% of total billed charges,21.11,17.304,,,percent of total billed charges,17.304% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,76.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.5,16.8,,,percent of total billed charges,16.8% of total billed charges,18.67,15.3,,,percent of total billed charges,15.3% of total billed charges,84.18,69,,,percent of total billed charges,69% of total billed charges,122,100,,,percent of total billed charges,100% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,122,100,,,percent of total billed charges,100% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,122,100,,,percent of total billed charges,100% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,75.46,61.85,,,percent of total billed charges,61.85% of total billed charges,20.5,16.8,,,percent of total billed charges,16.8% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,20.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,20.91,17.136,,,percent of total billed charges,17.136% of total billed charges,26.64,21.84,,,percent of total billed charges,21.84% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,61,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,61,50,,,percent of total billed charges,50% of total Billed charges,95.16,78,,,percent of total billed charges,78% of total billed charges,122,100,,,percent of total billed charges,100% of total billed charges,100.77,82.6,,,percent of total billed charges,82.6% of total billed charges,100.77,82.6,,,percent of total billed charges,82.6% of total billed charges,20.5,16.8,,,percent of total billed charges,16.8% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,61,50,,,percent of total billed charges,50% of total Billed charges,20.5,16.8,,,percent of total billed charges,16.8% of total billed charges,18.67,122,
SUT VCRL 3-0 SH 27IN UND  J416H,13693,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
SUT CTD VICRYL 2-0 VIL BR SH 27,13684,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUT VICRYL PLUS ANTIBACTERIAL CTXB 0,207899,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SUT VCRL 0 CTX 36IN UND  J978H,13602,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SUT TICRON 2-0 SH-2 3385-56,185777,CDM,272,RC,,,Outpatient,,,646,419.90,,568.48,88,,,percent of total billed charges,88% of total Billed charges,323,50,,,percent of total billed charges,50% of total Billed charges,108.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,646,100,,,percent of total billed charges,100% of total billed charges,111.78,17.304,,,percent of total billed charges,17.304% of total billed charges,323,50,,,percent of total billed charges,50% of total Billed charges,406.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,108.53,16.8,,,percent of total billed charges,16.8% of total billed charges,98.84,15.3,,,percent of total billed charges,15.3% of total billed charges,445.74,69,,,percent of total billed charges,69% of total billed charges,646,100,,,percent of total billed charges,100% of total billed charges,323,50,,,percent of total billed charges,50% of total Billed charges,646,100,,,percent of total billed charges,100% of total billed charges,323,50,,,percent of total billed charges,50% of total Billed charges,646,100,,,percent of total billed charges,100% of total billed charges,323,50,,,percent of total billed charges,50% of total Billed charges,399.55,61.85,,,percent of total billed charges,61.85% of total billed charges,108.53,16.8,,,percent of total billed charges,16.8% of total billed charges,323,50,,,percent of total billed charges,50% of total Billed charges,323,50,,,percent of total billed charges,50% of total Billed charges,108.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,323,50,,,percent of total billed charges,50% of total Billed charges,323,50,,,percent of total billed charges,50% of total Billed charges,110.7,17.136,,,percent of total billed charges,17.136% of total billed charges,141.09,21.84,,,percent of total billed charges,21.84% of total billed charges,323,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,323,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,323,50,,,percent of total billed charges,50% of total Billed charges,503.88,78,,,percent of total billed charges,78% of total billed charges,646,100,,,percent of total billed charges,100% of total billed charges,533.6,82.6,,,percent of total billed charges,82.6% of total billed charges,533.6,82.6,,,percent of total billed charges,82.6% of total billed charges,108.53,16.8,,,percent of total billed charges,16.8% of total billed charges,323,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,323,50,,,percent of total billed charges,50% of total Billed charges,108.53,16.8,,,percent of total billed charges,16.8% of total billed charges,98.84,646,
SUT TICRON 2 GC 3113-81,11430,CDM,272,RC,,,Outpatient,,,44,28.60,,38.72,88,,,percent of total billed charges,88% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,7.61,17.304,,,percent of total billed charges,17.304% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,15.3,,,percent of total billed charges,15.3% of total billed charges,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.21,61.85,,,percent of total billed charges,61.85% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.54,17.136,,,percent of total billed charges,17.136% of total billed charges,9.61,21.84,,,percent of total billed charges,21.84% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,44,
SUT CTD VICRYL 2-0 CR/CT-2 CT-2,11377,CDM,272,RC,,,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,15.75,17.304,,,percent of total billed charges,17.304% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,57.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,15.3,,,percent of total billed charges,15.3% of total billed charges,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,56.28,61.85,,,percent of total billed charges,61.85% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.59,17.136,,,percent of total billed charges,17.136% of total billed charges,19.87,21.84,,,percent of total billed charges,21.84% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,91,
SUT SILK 4-0 RB-1 C054D,35355,CDM,272,RC,,,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,10.9,17.304,,,percent of total billed charges,17.304% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,39.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,38.97,61.85,,,percent of total billed charges,61.85% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.8,17.136,,,percent of total billed charges,17.136% of total billed charges,13.76,21.84,,,percent of total billed charges,21.84% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,63,
SUT CAPIO 48IN BX/12 833-124,129719,CDM,272,RC,,,Outpatient,,,280,182.00,,246.4,88,,,percent of total billed charges,88% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,280,100,,,percent of total billed charges,100% of total billed charges,48.45,17.304,,,percent of total billed charges,17.304% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,176.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,42.84,15.3,,,percent of total billed charges,15.3% of total billed charges,193.2,69,,,percent of total billed charges,69% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,280,100,,,percent of total billed charges,100% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,280,100,,,percent of total billed charges,100% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,173.18,61.85,,,percent of total billed charges,61.85% of total billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,47.98,17.136,,,percent of total billed charges,17.136% of total billed charges,61.15,21.84,,,percent of total billed charges,21.84% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,140,50,,,percent of total billed charges,50% of total Billed charges,218.4,78,,,percent of total billed charges,78% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,140,50,,,percent of total billed charges,50% of total Billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,42.84,280,
SUT CAPIO CT BRD POLY N-ABSRB TC O CR 36 IDA,200039,CDM,272,RC,,,Outpatient,,,280,182.00,,246.4,88,,,percent of total billed charges,88% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,280,100,,,percent of total billed charges,100% of total billed charges,48.45,17.304,,,percent of total billed charges,17.304% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,176.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,42.84,15.3,,,percent of total billed charges,15.3% of total billed charges,193.2,69,,,percent of total billed charges,69% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,280,100,,,percent of total billed charges,100% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,280,100,,,percent of total billed charges,100% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,173.18,61.85,,,percent of total billed charges,61.85% of total billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,47.98,17.136,,,percent of total billed charges,17.136% of total billed charges,61.15,21.84,,,percent of total billed charges,21.84% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,140,50,,,percent of total billed charges,50% of total Billed charges,218.4,78,,,percent of total billed charges,78% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,140,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,140,50,,,percent of total billed charges,50% of total Billed charges,47.04,16.8,,,percent of total billed charges,16.8% of total billed charges,42.84,280,
SUT ETHILON BLK MONO 5-0 PS-2 18 INCH 1666G,13635,CDM,272,RC,,,Outpatient,,,241,156.65,,212.08,88,,,percent of total billed charges,88% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,41.7,17.304,,,percent of total billed charges,17.304% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,151.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,36.87,15.3,,,percent of total billed charges,15.3% of total billed charges,166.29,69,,,percent of total billed charges,69% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,241,100,,,percent of total billed charges,100% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,149.06,61.85,,,percent of total billed charges,61.85% of total billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,41.3,17.136,,,percent of total billed charges,17.136% of total billed charges,52.63,21.84,,,percent of total billed charges,21.84% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,187.98,78,,,percent of total billed charges,78% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,120.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120.5,50,,,percent of total billed charges,50% of total Billed charges,40.49,16.8,,,percent of total billed charges,16.8% of total billed charges,36.87,241,
SUT SILK 4-0 K571H,13805,CDM,272,RC,,,Outpatient,,,765,497.25,,673.2,88,,,percent of total billed charges,88% of total Billed charges,382.5,50,,,percent of total billed charges,50% of total Billed charges,128.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,765,100,,,percent of total billed charges,100% of total billed charges,132.38,17.304,,,percent of total billed charges,17.304% of total billed charges,382.5,50,,,percent of total billed charges,50% of total Billed charges,481.95,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,128.52,16.8,,,percent of total billed charges,16.8% of total billed charges,117.05,15.3,,,percent of total billed charges,15.3% of total billed charges,527.85,69,,,percent of total billed charges,69% of total billed charges,765,100,,,percent of total billed charges,100% of total billed charges,382.5,50,,,percent of total billed charges,50% of total Billed charges,765,100,,,percent of total billed charges,100% of total billed charges,382.5,50,,,percent of total billed charges,50% of total Billed charges,765,100,,,percent of total billed charges,100% of total billed charges,382.5,50,,,percent of total billed charges,50% of total Billed charges,473.15,61.85,,,percent of total billed charges,61.85% of total billed charges,128.52,16.8,,,percent of total billed charges,16.8% of total billed charges,382.5,50,,,percent of total billed charges,50% of total Billed charges,382.5,50,,,percent of total billed charges,50% of total Billed charges,128.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,382.5,50,,,percent of total billed charges,50% of total Billed charges,382.5,50,,,percent of total billed charges,50% of total Billed charges,131.09,17.136,,,percent of total billed charges,17.136% of total billed charges,167.08,21.84,,,percent of total billed charges,21.84% of total billed charges,382.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,382.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,382.5,50,,,percent of total billed charges,50% of total Billed charges,596.7,78,,,percent of total billed charges,78% of total billed charges,765,100,,,percent of total billed charges,100% of total billed charges,631.89,82.6,,,percent of total billed charges,82.6% of total billed charges,631.89,82.6,,,percent of total billed charges,82.6% of total billed charges,128.52,16.8,,,percent of total billed charges,16.8% of total billed charges,382.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,382.5,50,,,percent of total billed charges,50% of total Billed charges,128.52,16.8,,,percent of total billed charges,16.8% of total billed charges,117.05,765,
SUT SLK 3-0 SH 30IN K832H,11373,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
SUT SILK 3-0 CR/RB-1 8-18 BLK BR,83555,CDM,272,RC,,,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,10.73,17.304,,,percent of total billed charges,17.304% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,39.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,9.49,15.3,,,percent of total billed charges,15.3% of total billed charges,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,38.35,61.85,,,percent of total billed charges,61.85% of total billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.62,17.136,,,percent of total billed charges,17.136% of total billed charges,13.54,21.84,,,percent of total billed charges,21.84% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,9.49,62,
SUT SILK 1 K845H,13861,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUT SLK 0 MH 30IN K844H,13666,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
SUT PROLENE 7-0 BV175-7  2-24 INCH,80850,CDM,272,RC,,,Outpatient,,,328,213.20,,288.64,88,,,percent of total billed charges,88% of total Billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,55.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,328,100,,,percent of total billed charges,100% of total billed charges,56.76,17.304,,,percent of total billed charges,17.304% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,206.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,55.1,16.8,,,percent of total billed charges,16.8% of total billed charges,50.18,15.3,,,percent of total billed charges,15.3% of total billed charges,226.32,69,,,percent of total billed charges,69% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,328,100,,,percent of total billed charges,100% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,328,100,,,percent of total billed charges,100% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,202.87,61.85,,,percent of total billed charges,61.85% of total billed charges,55.1,16.8,,,percent of total billed charges,16.8% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,55.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,56.21,17.136,,,percent of total billed charges,17.136% of total billed charges,71.64,21.84,,,percent of total billed charges,21.84% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,164,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,164,50,,,percent of total billed charges,50% of total Billed charges,255.84,78,,,percent of total billed charges,78% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,55.1,16.8,,,percent of total billed charges,16.8% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,164,50,,,percent of total billed charges,50% of total Billed charges,55.1,16.8,,,percent of total billed charges,16.8% of total billed charges,50.18,328,
SUT PROLENE EB 175.7,187893,CDM,272,RC,,,Outpatient,,,656,426.40,,577.28,88,,,percent of total billed charges,88% of total Billed charges,328,50,,,percent of total billed charges,50% of total Billed charges,110.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,656,100,,,percent of total billed charges,100% of total billed charges,113.51,17.304,,,percent of total billed charges,17.304% of total billed charges,328,50,,,percent of total billed charges,50% of total Billed charges,413.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,110.21,16.8,,,percent of total billed charges,16.8% of total billed charges,100.37,15.3,,,percent of total billed charges,15.3% of total billed charges,452.64,69,,,percent of total billed charges,69% of total billed charges,656,100,,,percent of total billed charges,100% of total billed charges,328,50,,,percent of total billed charges,50% of total Billed charges,656,100,,,percent of total billed charges,100% of total billed charges,328,50,,,percent of total billed charges,50% of total Billed charges,656,100,,,percent of total billed charges,100% of total billed charges,328,50,,,percent of total billed charges,50% of total Billed charges,405.74,61.85,,,percent of total billed charges,61.85% of total billed charges,110.21,16.8,,,percent of total billed charges,16.8% of total billed charges,328,50,,,percent of total billed charges,50% of total Billed charges,328,50,,,percent of total billed charges,50% of total Billed charges,110.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,328,50,,,percent of total billed charges,50% of total Billed charges,328,50,,,percent of total billed charges,50% of total Billed charges,112.41,17.136,,,percent of total billed charges,17.136% of total billed charges,143.27,21.84,,,percent of total billed charges,21.84% of total billed charges,328,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,328,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,328,50,,,percent of total billed charges,50% of total Billed charges,511.68,78,,,percent of total billed charges,78% of total billed charges,656,100,,,percent of total billed charges,100% of total billed charges,541.86,82.6,,,percent of total billed charges,82.6% of total billed charges,541.86,82.6,,,percent of total billed charges,82.6% of total billed charges,110.21,16.8,,,percent of total billed charges,16.8% of total billed charges,328,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,328,50,,,percent of total billed charges,50% of total Billed charges,110.21,16.8,,,percent of total billed charges,16.8% of total billed charges,100.37,656,
SUT PROLENE 7-0 BV-1-BV-1,46500,CDM,272,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
SUT PRLN 5-0 RB-2 8710H,166140,CDM,272,RC,,,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.88,17.304,,,percent of total billed charges,17.304% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.83,17.136,,,percent of total billed charges,17.136% of total billed charges,7.43,21.84,,,percent of total billed charges,21.84% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,34,
SUT PROLENE BLU MONO 4-0 36   RB-1,106336,CDM,272,RC,,,Outpatient,,,139,90.35,,122.32,88,,,percent of total billed charges,88% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,23.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,139,100,,,percent of total billed charges,100% of total billed charges,24.05,17.304,,,percent of total billed charges,17.304% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,87.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.35,16.8,,,percent of total billed charges,16.8% of total billed charges,21.27,15.3,,,percent of total billed charges,15.3% of total billed charges,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,139,100,,,percent of total billed charges,100% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,85.97,61.85,,,percent of total billed charges,61.85% of total billed charges,23.35,16.8,,,percent of total billed charges,16.8% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,23.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,23.82,17.136,,,percent of total billed charges,17.136% of total billed charges,30.36,21.84,,,percent of total billed charges,21.84% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,69.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69.5,50,,,percent of total billed charges,50% of total Billed charges,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,23.35,16.8,,,percent of total billed charges,16.8% of total billed charges,69.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,69.5,50,,,percent of total billed charges,50% of total Billed charges,23.35,16.8,,,percent of total billed charges,16.8% of total billed charges,21.27,139,
SUT PROLENE 3-0 FSL BL MONO,157694,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUT PROLENE 2-0 FS BL MONO,147002,CDM,272,RC,,,Outpatient,,,201,130.65,,176.88,88,,,percent of total billed charges,88% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,201,100,,,percent of total billed charges,100% of total billed charges,34.78,17.304,,,percent of total billed charges,17.304% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,126.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,30.75,15.3,,,percent of total billed charges,15.3% of total billed charges,138.69,69,,,percent of total billed charges,69% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,201,100,,,percent of total billed charges,100% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,201,100,,,percent of total billed charges,100% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,124.32,61.85,,,percent of total billed charges,61.85% of total billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,34.44,17.136,,,percent of total billed charges,17.136% of total billed charges,43.9,21.84,,,percent of total billed charges,21.84% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100.5,50,,,percent of total billed charges,50% of total Billed charges,156.78,78,,,percent of total billed charges,78% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,100.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100.5,50,,,percent of total billed charges,50% of total Billed charges,33.77,16.8,,,percent of total billed charges,16.8% of total billed charges,30.75,201,
SUT PROLENE BLU MONO #0 SH 30 INCH       8834H,39815,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
SUTURE ETHLN 662H MONO 4-0FS-2,13734,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SUT ETHILON 4-0 PC5   1894G,82279,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
SUT ETHILON 2-0 BLK MONO FS,149618,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUT NYLON 2 460T,186277,CDM,272,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
SUT MERSILENE 4-0 P-3 WHT B,146953,CDM,272,RC,,,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.5,17.304,,,percent of total billed charges,17.304% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.08,61.85,,,percent of total billed charges,61.85% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.46,17.136,,,percent of total billed charges,17.136% of total billed charges,5.68,21.84,,,percent of total billed charges,21.84% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,26,
SUT ETHBND 2-0 SH-2 30IN W/PLEDGET DBL ARM WHITE PXX80,80846,CDM,272,RC,,,Outpatient,,,426,276.90,,374.88,88,,,percent of total billed charges,88% of total Billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,71.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,426,100,,,percent of total billed charges,100% of total billed charges,73.72,17.304,,,percent of total billed charges,17.304% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,268.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,71.57,16.8,,,percent of total billed charges,16.8% of total billed charges,65.18,15.3,,,percent of total billed charges,15.3% of total billed charges,293.94,69,,,percent of total billed charges,69% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,426,100,,,percent of total billed charges,100% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,426,100,,,percent of total billed charges,100% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,263.48,61.85,,,percent of total billed charges,61.85% of total billed charges,71.57,16.8,,,percent of total billed charges,16.8% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,71.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,73,17.136,,,percent of total billed charges,17.136% of total billed charges,93.04,21.84,,,percent of total billed charges,21.84% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,213,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,213,50,,,percent of total billed charges,50% of total Billed charges,332.28,78,,,percent of total billed charges,78% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,71.57,16.8,,,percent of total billed charges,16.8% of total billed charges,213,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,213,50,,,percent of total billed charges,50% of total Billed charges,71.57,16.8,,,percent of total billed charges,16.8% of total billed charges,65.18,426,
SUT ETHBND 2-0 SH 30IN DBL ARM WHITE PXX76,188085,CDM,272,RC,,,Outpatient,,,425,276.25,,374,88,,,percent of total billed charges,88% of total Billed charges,212.5,50,,,percent of total billed charges,50% of total Billed charges,71.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,425,100,,,percent of total billed charges,100% of total billed charges,73.54,17.304,,,percent of total billed charges,17.304% of total billed charges,212.5,50,,,percent of total billed charges,50% of total Billed charges,267.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,71.4,16.8,,,percent of total billed charges,16.8% of total billed charges,65.03,15.3,,,percent of total billed charges,15.3% of total billed charges,293.25,69,,,percent of total billed charges,69% of total billed charges,425,100,,,percent of total billed charges,100% of total billed charges,212.5,50,,,percent of total billed charges,50% of total Billed charges,425,100,,,percent of total billed charges,100% of total billed charges,212.5,50,,,percent of total billed charges,50% of total Billed charges,425,100,,,percent of total billed charges,100% of total billed charges,212.5,50,,,percent of total billed charges,50% of total Billed charges,262.86,61.85,,,percent of total billed charges,61.85% of total billed charges,71.4,16.8,,,percent of total billed charges,16.8% of total billed charges,212.5,50,,,percent of total billed charges,50% of total Billed charges,212.5,50,,,percent of total billed charges,50% of total Billed charges,71.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,212.5,50,,,percent of total billed charges,50% of total Billed charges,212.5,50,,,percent of total billed charges,50% of total Billed charges,72.83,17.136,,,percent of total billed charges,17.136% of total billed charges,92.82,21.84,,,percent of total billed charges,21.84% of total billed charges,212.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,212.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,212.5,50,,,percent of total billed charges,50% of total Billed charges,331.5,78,,,percent of total billed charges,78% of total billed charges,425,100,,,percent of total billed charges,100% of total billed charges,351.05,82.6,,,percent of total billed charges,82.6% of total billed charges,351.05,82.6,,,percent of total billed charges,82.6% of total billed charges,71.4,16.8,,,percent of total billed charges,16.8% of total billed charges,212.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,212.5,50,,,percent of total billed charges,50% of total Billed charges,71.4,16.8,,,percent of total billed charges,16.8% of total billed charges,65.03,425,
SUT CHR 4-0 SH 27IN  G121H,18509,CDM,272,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
SUT CHR GUT 2-0 STANDARD 54,157442,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUT 2-0 TI-CRON CV-316,185776,CDM,272,RC,,,Outpatient,,,81,52.65,,71.28,88,,,percent of total billed charges,88% of total Billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,13.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,81,100,,,percent of total billed charges,100% of total billed charges,14.02,17.304,,,percent of total billed charges,17.304% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,51.03,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.61,16.8,,,percent of total billed charges,16.8% of total billed charges,12.39,15.3,,,percent of total billed charges,15.3% of total billed charges,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,81,100,,,percent of total billed charges,100% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,81,100,,,percent of total billed charges,100% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,50.1,61.85,,,percent of total billed charges,61.85% of total billed charges,13.61,16.8,,,percent of total billed charges,16.8% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,13.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,13.88,17.136,,,percent of total billed charges,17.136% of total billed charges,17.69,21.84,,,percent of total billed charges,21.84% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40.5,50,,,percent of total billed charges,50% of total Billed charges,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,13.61,16.8,,,percent of total billed charges,16.8% of total billed charges,40.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40.5,50,,,percent of total billed charges,50% of total Billed charges,13.61,16.8,,,percent of total billed charges,16.8% of total billed charges,12.39,81,
SUT 4-0 NYLON PC-1  1854G,14989,CDM,272,RC,,,Outpatient,,,275,178.75,,242,88,,,percent of total billed charges,88% of total Billed charges,137.5,50,,,percent of total billed charges,50% of total Billed charges,46.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,275,100,,,percent of total billed charges,100% of total billed charges,47.59,17.304,,,percent of total billed charges,17.304% of total billed charges,137.5,50,,,percent of total billed charges,50% of total Billed charges,173.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,46.2,16.8,,,percent of total billed charges,16.8% of total billed charges,42.08,15.3,,,percent of total billed charges,15.3% of total billed charges,189.75,69,,,percent of total billed charges,69% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,137.5,50,,,percent of total billed charges,50% of total Billed charges,275,100,,,percent of total billed charges,100% of total billed charges,137.5,50,,,percent of total billed charges,50% of total Billed charges,275,100,,,percent of total billed charges,100% of total billed charges,137.5,50,,,percent of total billed charges,50% of total Billed charges,170.09,61.85,,,percent of total billed charges,61.85% of total billed charges,46.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.5,50,,,percent of total billed charges,50% of total Billed charges,137.5,50,,,percent of total billed charges,50% of total Billed charges,46.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,137.5,50,,,percent of total billed charges,50% of total Billed charges,137.5,50,,,percent of total billed charges,50% of total Billed charges,47.12,17.136,,,percent of total billed charges,17.136% of total billed charges,60.06,21.84,,,percent of total billed charges,21.84% of total billed charges,137.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,137.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,137.5,50,,,percent of total billed charges,50% of total Billed charges,214.5,78,,,percent of total billed charges,78% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,46.2,16.8,,,percent of total billed charges,16.8% of total billed charges,137.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,137.5,50,,,percent of total billed charges,50% of total Billed charges,46.2,16.8,,,percent of total billed charges,16.8% of total billed charges,42.08,275,
SUT CHR GUT 2-0 CT-1 36 INC,157440,CDM,272,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
SUT CTD VICRYL 0 VIL BR UR-5,13792,CDM,272,RC,,,Outpatient,,,453,294.45,,398.64,88,,,percent of total billed charges,88% of total Billed charges,226.5,50,,,percent of total billed charges,50% of total Billed charges,76.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,453,100,,,percent of total billed charges,100% of total billed charges,78.39,17.304,,,percent of total billed charges,17.304% of total billed charges,226.5,50,,,percent of total billed charges,50% of total Billed charges,285.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.1,16.8,,,percent of total billed charges,16.8% of total billed charges,69.31,15.3,,,percent of total billed charges,15.3% of total billed charges,312.57,69,,,percent of total billed charges,69% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,226.5,50,,,percent of total billed charges,50% of total Billed charges,453,100,,,percent of total billed charges,100% of total billed charges,226.5,50,,,percent of total billed charges,50% of total Billed charges,453,100,,,percent of total billed charges,100% of total billed charges,226.5,50,,,percent of total billed charges,50% of total Billed charges,280.18,61.85,,,percent of total billed charges,61.85% of total billed charges,76.1,16.8,,,percent of total billed charges,16.8% of total billed charges,226.5,50,,,percent of total billed charges,50% of total Billed charges,226.5,50,,,percent of total billed charges,50% of total Billed charges,76.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,226.5,50,,,percent of total billed charges,50% of total Billed charges,226.5,50,,,percent of total billed charges,50% of total Billed charges,77.63,17.136,,,percent of total billed charges,17.136% of total billed charges,98.94,21.84,,,percent of total billed charges,21.84% of total billed charges,226.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,226.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,226.5,50,,,percent of total billed charges,50% of total Billed charges,353.34,78,,,percent of total billed charges,78% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,76.1,16.8,,,percent of total billed charges,16.8% of total billed charges,226.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,226.5,50,,,percent of total billed charges,50% of total Billed charges,76.1,16.8,,,percent of total billed charges,16.8% of total billed charges,69.31,453,
SUT CTD VICRYL 1 UND BR CTX,146847,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUT CTD VICRYL 5-0 UND BR R,165962,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUT ETHIBOND TIES 4 0      X183H,36923,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
SUT ETHILON 6-0 BLK MONO PS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SUT INCHSUT 3-0 VICRYL 27 INCH INCH UNDYED RB-1 INCH,202604,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SUT NYLON 3-0 FS1 18IN,185116,CDM,272,RC,,,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,23.36,17.304,,,percent of total billed charges,17.304% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,85.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,20.66,15.3,,,percent of total billed charges,15.3% of total billed charges,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,135,100,,,percent of total billed charges,100% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,83.5,61.85,,,percent of total billed charges,61.85% of total billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,23.13,17.136,,,percent of total billed charges,17.136% of total billed charges,29.48,21.84,,,percent of total billed charges,21.84% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,67.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67.5,50,,,percent of total billed charges,50% of total Billed charges,22.68,16.8,,,percent of total billed charges,16.8% of total billed charges,20.66,135,
SUT PDS II 1 TP-1 96IN LOOP Z880G,166072,CDM,272,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
SUT PLAIN 3-0 N862H,13724,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
SUT PRLN 5-0 C-1 36IN DBL ARM 4/PK M8720H,85554,CDM,272,RC,,,Outpatient,,,256,166.40,,225.28,88,,,percent of total billed charges,88% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,256,100,,,percent of total billed charges,100% of total billed charges,44.3,17.304,,,percent of total billed charges,17.304% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,161.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,39.17,15.3,,,percent of total billed charges,15.3% of total billed charges,176.64,69,,,percent of total billed charges,69% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,256,100,,,percent of total billed charges,100% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,256,100,,,percent of total billed charges,100% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,158.34,61.85,,,percent of total billed charges,61.85% of total billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,43.87,17.136,,,percent of total billed charges,17.136% of total billed charges,55.91,21.84,,,percent of total billed charges,21.84% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,128,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,128,50,,,percent of total billed charges,50% of total Billed charges,199.68,78,,,percent of total billed charges,78% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,128,50,,,percent of total billed charges,50% of total Billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,39.17,256,
SUT PRLN 6-0 BV-1 30IN DBL ARM 8709H,13663,CDM,272,RC,,,Outpatient,,,2869,1864.85,,2524.72,88,,,percent of total billed charges,88% of total Billed charges,1434.5,50,,,percent of total billed charges,50% of total Billed charges,481.99,16.8,,,percent of total billed charges,16.8% of total Billed charges,2869,100,,,percent of total billed charges,100% of total billed charges,496.45,17.304,,,percent of total billed charges,17.304% of total billed charges,1434.5,50,,,percent of total billed charges,50% of total Billed charges,1807.47,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,481.99,16.8,,,percent of total billed charges,16.8% of total billed charges,438.96,15.3,,,percent of total billed charges,15.3% of total billed charges,1979.61,69,,,percent of total billed charges,69% of total billed charges,2869,100,,,percent of total billed charges,100% of total billed charges,1434.5,50,,,percent of total billed charges,50% of total Billed charges,2869,100,,,percent of total billed charges,100% of total billed charges,1434.5,50,,,percent of total billed charges,50% of total Billed charges,2869,100,,,percent of total billed charges,100% of total billed charges,1434.5,50,,,percent of total billed charges,50% of total Billed charges,1774.48,61.85,,,percent of total billed charges,61.85% of total billed charges,481.99,16.8,,,percent of total billed charges,16.8% of total billed charges,1434.5,50,,,percent of total billed charges,50% of total Billed charges,1434.5,50,,,percent of total billed charges,50% of total Billed charges,481.99,16.8,,,percent of total billed charges,16.8% of total Billed charges,1434.5,50,,,percent of total billed charges,50% of total Billed charges,1434.5,50,,,percent of total billed charges,50% of total Billed charges,491.63,17.136,,,percent of total billed charges,17.136% of total billed charges,626.59,21.84,,,percent of total billed charges,21.84% of total billed charges,1434.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1434.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1434.5,50,,,percent of total billed charges,50% of total Billed charges,2237.82,78,,,percent of total billed charges,78% of total billed charges,2869,100,,,percent of total billed charges,100% of total billed charges,2369.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2369.79,82.6,,,percent of total billed charges,82.6% of total billed charges,481.99,16.8,,,percent of total billed charges,16.8% of total billed charges,1434.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1434.5,50,,,percent of total billed charges,50% of total Billed charges,481.99,16.8,,,percent of total billed charges,16.8% of total billed charges,438.96,2869,
SUT PROLENE 4-0 FS-2 BL MON,166132,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
SUT SILK 0 C021D,17171050,CDM,272,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
SUT TI-CRON 3-0 3256-41,17110100,CDM,272,RC,,,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,12.8,17.304,,,percent of total billed charges,17.304% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,46.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,45.77,61.85,,,percent of total billed charges,61.85% of total billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.68,17.136,,,percent of total billed charges,17.136% of total billed charges,16.16,21.84,,,percent of total billed charges,21.84% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,11.32,74,
SUT TICRON 3-0 CV 3256-41,185764,CDM,272,RC,,,Outpatient,,,126,81.90,,110.88,88,,,percent of total billed charges,88% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,126,100,,,percent of total billed charges,100% of total billed charges,21.8,17.304,,,percent of total billed charges,17.304% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,79.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,19.28,15.3,,,percent of total billed charges,15.3% of total billed charges,86.94,69,,,percent of total billed charges,69% of total billed charges,126,100,,,percent of total billed charges,100% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,126,100,,,percent of total billed charges,100% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,126,100,,,percent of total billed charges,100% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,77.93,61.85,,,percent of total billed charges,61.85% of total billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,21.59,17.136,,,percent of total billed charges,17.136% of total billed charges,27.52,21.84,,,percent of total billed charges,21.84% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,63,50,,,percent of total billed charges,50% of total Billed charges,98.28,78,,,percent of total billed charges,78% of total billed charges,126,100,,,percent of total billed charges,100% of total billed charges,104.08,82.6,,,percent of total billed charges,82.6% of total billed charges,104.08,82.6,,,percent of total billed charges,82.6% of total billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,63,50,,,percent of total billed charges,50% of total Billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,19.28,126,
SUT VCRL 0 REEL 54IN UND  J287G,13797,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUT VICRYL 0 CT-1,9873,CDM,272,RC,,,Outpatient,,,860,559.00,,756.8,88,,,percent of total billed charges,88% of total Billed charges,430,50,,,percent of total billed charges,50% of total Billed charges,144.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,860,100,,,percent of total billed charges,100% of total billed charges,148.81,17.304,,,percent of total billed charges,17.304% of total billed charges,430,50,,,percent of total billed charges,50% of total Billed charges,541.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,144.48,16.8,,,percent of total billed charges,16.8% of total billed charges,131.58,15.3,,,percent of total billed charges,15.3% of total billed charges,593.4,69,,,percent of total billed charges,69% of total billed charges,860,100,,,percent of total billed charges,100% of total billed charges,430,50,,,percent of total billed charges,50% of total Billed charges,860,100,,,percent of total billed charges,100% of total billed charges,430,50,,,percent of total billed charges,50% of total Billed charges,860,100,,,percent of total billed charges,100% of total billed charges,430,50,,,percent of total billed charges,50% of total Billed charges,531.91,61.85,,,percent of total billed charges,61.85% of total billed charges,144.48,16.8,,,percent of total billed charges,16.8% of total billed charges,430,50,,,percent of total billed charges,50% of total Billed charges,430,50,,,percent of total billed charges,50% of total Billed charges,144.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,430,50,,,percent of total billed charges,50% of total Billed charges,430,50,,,percent of total billed charges,50% of total Billed charges,147.37,17.136,,,percent of total billed charges,17.136% of total billed charges,187.82,21.84,,,percent of total billed charges,21.84% of total billed charges,430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,430,50,,,percent of total billed charges,50% of total Billed charges,670.8,78,,,percent of total billed charges,78% of total billed charges,860,100,,,percent of total billed charges,100% of total billed charges,710.36,82.6,,,percent of total billed charges,82.6% of total billed charges,710.36,82.6,,,percent of total billed charges,82.6% of total billed charges,144.48,16.8,,,percent of total billed charges,16.8% of total billed charges,430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,430,50,,,percent of total billed charges,50% of total Billed charges,144.48,16.8,,,percent of total billed charges,16.8% of total billed charges,131.58,860,
SUT VICRYL 2 TP-1 J849G,34315,CDM,272,RC,,,Outpatient,,,67,43.55,,58.96,88,,,percent of total billed charges,88% of total Billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,11.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,67,100,,,percent of total billed charges,100% of total billed charges,11.59,17.304,,,percent of total billed charges,17.304% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,42.21,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.26,16.8,,,percent of total billed charges,16.8% of total billed charges,10.25,15.3,,,percent of total billed charges,15.3% of total billed charges,46.23,69,,,percent of total billed charges,69% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,67,100,,,percent of total billed charges,100% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,67,100,,,percent of total billed charges,100% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,41.44,61.85,,,percent of total billed charges,61.85% of total billed charges,11.26,16.8,,,percent of total billed charges,16.8% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,11.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,11.48,17.136,,,percent of total billed charges,17.136% of total billed charges,14.63,21.84,,,percent of total billed charges,21.84% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,33.5,50,,,percent of total billed charges,50% of total Billed charges,52.26,78,,,percent of total billed charges,78% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,11.26,16.8,,,percent of total billed charges,16.8% of total billed charges,33.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,33.5,50,,,percent of total billed charges,50% of total Billed charges,11.26,16.8,,,percent of total billed charges,16.8% of total billed charges,10.25,67,
SUT VICRYL 6 0 PC 1,66704,CDM,272,RC,,,Outpatient,,,343,222.95,,301.84,88,,,percent of total billed charges,88% of total Billed charges,171.5,50,,,percent of total billed charges,50% of total Billed charges,57.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,343,100,,,percent of total billed charges,100% of total billed charges,59.35,17.304,,,percent of total billed charges,17.304% of total billed charges,171.5,50,,,percent of total billed charges,50% of total Billed charges,216.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,57.62,16.8,,,percent of total billed charges,16.8% of total billed charges,52.48,15.3,,,percent of total billed charges,15.3% of total billed charges,236.67,69,,,percent of total billed charges,69% of total billed charges,343,100,,,percent of total billed charges,100% of total billed charges,171.5,50,,,percent of total billed charges,50% of total Billed charges,343,100,,,percent of total billed charges,100% of total billed charges,171.5,50,,,percent of total billed charges,50% of total Billed charges,343,100,,,percent of total billed charges,100% of total billed charges,171.5,50,,,percent of total billed charges,50% of total Billed charges,212.15,61.85,,,percent of total billed charges,61.85% of total billed charges,57.62,16.8,,,percent of total billed charges,16.8% of total billed charges,171.5,50,,,percent of total billed charges,50% of total Billed charges,171.5,50,,,percent of total billed charges,50% of total Billed charges,57.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,171.5,50,,,percent of total billed charges,50% of total Billed charges,171.5,50,,,percent of total billed charges,50% of total Billed charges,58.78,17.136,,,percent of total billed charges,17.136% of total billed charges,74.91,21.84,,,percent of total billed charges,21.84% of total billed charges,171.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,171.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,171.5,50,,,percent of total billed charges,50% of total Billed charges,267.54,78,,,percent of total billed charges,78% of total billed charges,343,100,,,percent of total billed charges,100% of total billed charges,283.32,82.6,,,percent of total billed charges,82.6% of total billed charges,283.32,82.6,,,percent of total billed charges,82.6% of total billed charges,57.62,16.8,,,percent of total billed charges,16.8% of total billed charges,171.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,171.5,50,,,percent of total billed charges,50% of total Billed charges,57.62,16.8,,,percent of total billed charges,16.8% of total billed charges,52.48,343,
SUT VICRYL PLUS ANTIMICROB VIL BR 0 8-18 CT-1,157779,CDM,272,RC,,,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,17.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,104,100,,,percent of total billed charges,100% of total billed charges,18,17.304,,,percent of total billed charges,17.304% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,65.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,17.47,16.8,,,percent of total billed charges,16.8% of total billed charges,15.91,15.3,,,percent of total billed charges,15.3% of total billed charges,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,104,100,,,percent of total billed charges,100% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,104,100,,,percent of total billed charges,100% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,64.32,61.85,,,percent of total billed charges,61.85% of total billed charges,17.47,16.8,,,percent of total billed charges,16.8% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,17.47,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,17.82,17.136,,,percent of total billed charges,17.136% of total billed charges,22.71,21.84,,,percent of total billed charges,21.84% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,52,50,,,percent of total billed charges,50% of total Billed charges,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,17.47,16.8,,,percent of total billed charges,16.8% of total billed charges,52,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,52,50,,,percent of total billed charges,50% of total Billed charges,17.47,16.8,,,percent of total billed charges,16.8% of total billed charges,15.91,104,
SUT VCRL + 2-0 CT-1 27IN VCP259H,85395,CDM,272,RC,,,Outpatient,,,397,258.05,,349.36,88,,,percent of total billed charges,88% of total Billed charges,198.5,50,,,percent of total billed charges,50% of total Billed charges,66.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,397,100,,,percent of total billed charges,100% of total billed charges,68.7,17.304,,,percent of total billed charges,17.304% of total billed charges,198.5,50,,,percent of total billed charges,50% of total Billed charges,250.11,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,66.7,16.8,,,percent of total billed charges,16.8% of total billed charges,60.74,15.3,,,percent of total billed charges,15.3% of total billed charges,273.93,69,,,percent of total billed charges,69% of total billed charges,397,100,,,percent of total billed charges,100% of total billed charges,198.5,50,,,percent of total billed charges,50% of total Billed charges,397,100,,,percent of total billed charges,100% of total billed charges,198.5,50,,,percent of total billed charges,50% of total Billed charges,397,100,,,percent of total billed charges,100% of total billed charges,198.5,50,,,percent of total billed charges,50% of total Billed charges,245.54,61.85,,,percent of total billed charges,61.85% of total billed charges,66.7,16.8,,,percent of total billed charges,16.8% of total billed charges,198.5,50,,,percent of total billed charges,50% of total Billed charges,198.5,50,,,percent of total billed charges,50% of total Billed charges,66.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,198.5,50,,,percent of total billed charges,50% of total Billed charges,198.5,50,,,percent of total billed charges,50% of total Billed charges,68.03,17.136,,,percent of total billed charges,17.136% of total billed charges,86.7,21.84,,,percent of total billed charges,21.84% of total billed charges,198.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,198.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,198.5,50,,,percent of total billed charges,50% of total Billed charges,309.66,78,,,percent of total billed charges,78% of total billed charges,397,100,,,percent of total billed charges,100% of total billed charges,327.92,82.6,,,percent of total billed charges,82.6% of total billed charges,327.92,82.6,,,percent of total billed charges,82.6% of total billed charges,66.7,16.8,,,percent of total billed charges,16.8% of total billed charges,198.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,198.5,50,,,percent of total billed charges,50% of total Billed charges,66.7,16.8,,,percent of total billed charges,16.8% of total billed charges,60.74,397,
SUT CTD VICRYL 2-0 UND BR C,165905,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SUT CTD VICRYL 2-0 UND BR S,146858,CDM,272,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
SUT CTD VICRYL 0 UND BR CR/,165879,CDM,272,RC,,,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,12.98,17.304,,,percent of total billed charges,17.304% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,47.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,46.39,61.85,,,percent of total billed charges,61.85% of total billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.85,17.136,,,percent of total billed charges,17.136% of total billed charges,16.38,21.84,,,percent of total billed charges,21.84% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11.48,75,
SUT MONOCRYL 0 CT-1 Y740D,50304,CDM,272,RC,,,Outpatient,,,84,54.60,,73.92,88,,,percent of total billed charges,88% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,14.54,17.304,,,percent of total billed charges,17.304% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,52.92,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,12.85,15.3,,,percent of total billed charges,15.3% of total billed charges,57.96,69,,,percent of total billed charges,69% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,84,100,,,percent of total billed charges,100% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,51.95,61.85,,,percent of total billed charges,61.85% of total billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,14.39,17.136,,,percent of total billed charges,17.136% of total billed charges,18.35,21.84,,,percent of total billed charges,21.84% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42,50,,,percent of total billed charges,50% of total Billed charges,65.52,78,,,percent of total billed charges,78% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,42,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42,50,,,percent of total billed charges,50% of total Billed charges,14.11,16.8,,,percent of total billed charges,16.8% of total billed charges,12.85,84,
SUT SILK 3-0 12-18 LABYRINT,147059,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUT PRLN 4-0 RB-1 36IN DBL ARM 8557H,166136,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUT PRLN 3-0 FS-2 18IN 8665G,11365,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
SUT PRLN 2-0 SH 30IN 8833H,11363,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUT ETHILON 2-0 1674H,13887,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUT MRSLN 5MM BP 12IN RS20,13826,CDM,272,RC,,,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,32.19,17.304,,,percent of total billed charges,17.304% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,117.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,115.04,61.85,,,percent of total billed charges,61.85% of total billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.87,17.136,,,percent of total billed charges,17.136% of total billed charges,40.62,21.84,,,percent of total billed charges,21.84% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,28.46,186,
SUT ETHBND 2-0 SH 30IN DBL ARM WHITE 10X82,184791,CDM,272,RC,,,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,220,100,,,percent of total billed charges,100% of total billed charges,38.07,17.304,,,percent of total billed charges,17.304% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,138.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,33.66,15.3,,,percent of total billed charges,15.3% of total billed charges,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,220,100,,,percent of total billed charges,100% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,220,100,,,percent of total billed charges,100% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,136.07,61.85,,,percent of total billed charges,61.85% of total billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,37.7,17.136,,,percent of total billed charges,17.136% of total billed charges,48.05,21.84,,,percent of total billed charges,21.84% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,110,50,,,percent of total billed charges,50% of total Billed charges,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,110,50,,,percent of total billed charges,50% of total Billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,33.66,220,
SUT CHR GUT 6 0 PS 4 18IN,56944,CDM,272,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
SUT 0 27 PDS PLUS VIO MONO CT-1,266013,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUT VICRYL 3-0 PS-1,84362,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUT VICRYL 3-0 SH 27 INCH,237411,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUT VICRYL 4-0 J494G,17162330,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
VICRYL 4-0 SH (J415H),491680,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
ANCHOR BIO-COMPOSITE SWIVELOCK,ORSUP0022,CDM,278,RC,C1713,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,892.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,969.54,33.9,,,percent of total billed charges,33.9% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
SUTURE ANCHOR 2.4 X 6.5MM,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SUTURE ANCHOR BIOCOMP SWIVELLOCK C VENTED 4.75 X 19.1MM,ORSUP0021,CDM,278,RC,C1713,HCPCS,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,811.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,881.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
SUTURE ANCHOR SWIVEL LOCK C 5.5X19.1 CLOSED EYELET,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
SUTURE TI-KNOT QUICK LOAD TK5 DEVICE,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
SUTURE TIE KNOT TITANIUM,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
SUTURE LASSO 25 DEGREE,ORSUP0013,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SUTURE LASSO 25 DEGREE TIGHT LEFT,ORSUP0013,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SUTURE LASSO CRESCENT,ORSUP0013,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SUTURE CTD VICRYL 5-0 UND BR P-3,13863,CDM,272,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
SUTURE VICRYL J284G 4-0 REEL UND,32399,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
SUTURE VICRYL J415H 4-0 SH UNDY,165951,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUTURE COATED VICRYL UND BR 4-0 URL. 27 RB-1,39366,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SUTURE VICRYL J783G 4-0 SH CR/8,80881,CDM,272,RC,,,Outpatient,,,80,52.00,,70.4,88,,,percent of total billed charges,88% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,13.84,17.304,,,percent of total billed charges,17.304% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,50.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,12.24,15.3,,,percent of total billed charges,15.3% of total billed charges,55.2,69,,,percent of total billed charges,69% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,49.48,61.85,,,percent of total billed charges,61.85% of total billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.71,17.136,,,percent of total billed charges,17.136% of total billed charges,17.47,21.84,,,percent of total billed charges,21.84% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,62.4,78,,,percent of total billed charges,78% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,12.24,80,
SUTURE VICRYL J823G 4-0 PC-5 UN,98932,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE COATED VICRYL UND BR 4-0 CUT. 27 FS-2,13696,CDM,272,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
SUTURE COATED VICRYL UND BR 3-0 CLOSURE 27 CT-1,13690,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUTURE VICRYL J824G 3-0 PC-5 UN,80859,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE VICRYL J869H 2-0 CP-2 UN,157497,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUTURE VICRYL J259H2-0CT-1UND27IN,165904,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SUTURE VICRYL J762D 2-0 CP-2 CR,ORSUP0001,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUTURE VICRYL J261H #1CT-1UND36IN,165893,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUTURE COATED VICRYL VIL BR 0 URL. 27 UR-6,32185,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUTURE VICRYL J270H #0 CT-2 UD,40253,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUTURE VICRYL J727D #0 CT-2 BR,165887,CDM,272,RC,,,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,16.27,17.304,,,percent of total billed charges,17.304% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,59.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,58.14,61.85,,,percent of total billed charges,61.85% of total billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,16.11,17.136,,,percent of total billed charges,17.136% of total billed charges,20.53,21.84,,,percent of total billed charges,21.84% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,14.38,94,
SUTURE COAT VICRYL UND BR 0 CLOSURE 27 CT-1,39367,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUTURE VICRYL PLUS CTD VCP946H,215819,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUTURE COATED VICRYL VIL BR 2-0 18 SH-1,70829,CDM,272,RC,,,Outpatient,,,92,59.80,,80.96,88,,,percent of total billed charges,88% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,92,100,,,percent of total billed charges,100% of total billed charges,15.92,17.304,,,percent of total billed charges,17.304% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,57.96,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.08,15.3,,,percent of total billed charges,15.3% of total billed charges,63.48,69,,,percent of total billed charges,69% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,92,100,,,percent of total billed charges,100% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,92,100,,,percent of total billed charges,100% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,56.9,61.85,,,percent of total billed charges,61.85% of total billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,15.77,17.136,,,percent of total billed charges,17.136% of total billed charges,20.09,21.84,,,percent of total billed charges,21.84% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46,50,,,percent of total billed charges,50% of total Billed charges,71.76,78,,,percent of total billed charges,78% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,46,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46,50,,,percent of total billed charges,50% of total Billed charges,15.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.08,92,
SUTURE PROLENE BL MONO 5-0 PLASTIC 18 P-3 12/BX,13660,CDM,272,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
SUTURE CHRMIC U203H 4-0 RB-1,169743,CDM,272,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
SUTURE CHRMIC 636H 3-0 FS-2 27,13806,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUTURE #2 QUILL PDO,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SUTURE 0 CT-1 QUILL,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SUTURE STEEL M655G#7CCS MS/4 18,57299,CDM,272,RC,,,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,15.75,17.304,,,percent of total billed charges,17.304% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,57.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,15.3,,,percent of total billed charges,15.3% of total billed charges,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,56.28,61.85,,,percent of total billed charges,61.85% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.59,17.136,,,percent of total billed charges,17.136% of total billed charges,19.87,21.84,,,percent of total billed charges,21.84% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,91,
SUTURE STEELM649G #6V-40MP/418,13884,CDM,272,RC,,,Outpatient,,,78,50.70,,68.64,88,,,percent of total billed charges,88% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,13.5,17.304,,,percent of total billed charges,17.304% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,49.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,15.3,,,percent of total billed charges,15.3% of total billed charges,53.82,69,,,percent of total billed charges,69% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,48.24,61.85,,,percent of total billed charges,61.85% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.37,17.136,,,percent of total billed charges,17.136% of total billed charges,17.04,21.84,,,percent of total billed charges,21.84% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,60.84,78,,,percent of total billed charges,78% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,78,
SUTURE SILK BLK BR 4-0 CUTICULAR 18 FS-2,13674,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUTURE SILK BLK BR 4-0 NEURO 18 TF-4,46115,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
SUTURE SILK BLK BR 3-0 CUTICULAR 18 FS-1,13672,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUTURE SILK BLK BR 2-0 G.I.CARDIO 30 SH,11372,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUTURE SLK A305H 2-0 STRND 30,157729,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
SUTURE SLK A306H #0 STRAND 30IN,147043,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
SUTURE PRLN M8706 6-0 C-1 M,13881,CDM,272,RC,,,Outpatient,,,255,165.75,,224.4,88,,,percent of total billed charges,88% of total Billed charges,127.5,50,,,percent of total billed charges,50% of total Billed charges,42.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,255,100,,,percent of total billed charges,100% of total billed charges,44.13,17.304,,,percent of total billed charges,17.304% of total billed charges,127.5,50,,,percent of total billed charges,50% of total Billed charges,160.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42.84,16.8,,,percent of total billed charges,16.8% of total billed charges,39.02,15.3,,,percent of total billed charges,15.3% of total billed charges,175.95,69,,,percent of total billed charges,69% of total billed charges,255,100,,,percent of total billed charges,100% of total billed charges,127.5,50,,,percent of total billed charges,50% of total Billed charges,255,100,,,percent of total billed charges,100% of total billed charges,127.5,50,,,percent of total billed charges,50% of total Billed charges,255,100,,,percent of total billed charges,100% of total billed charges,127.5,50,,,percent of total billed charges,50% of total Billed charges,157.72,61.85,,,percent of total billed charges,61.85% of total billed charges,42.84,16.8,,,percent of total billed charges,16.8% of total billed charges,127.5,50,,,percent of total billed charges,50% of total Billed charges,127.5,50,,,percent of total billed charges,50% of total Billed charges,42.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,127.5,50,,,percent of total billed charges,50% of total Billed charges,127.5,50,,,percent of total billed charges,50% of total Billed charges,43.7,17.136,,,percent of total billed charges,17.136% of total billed charges,55.69,21.84,,,percent of total billed charges,21.84% of total billed charges,127.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,127.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,127.5,50,,,percent of total billed charges,50% of total Billed charges,198.9,78,,,percent of total billed charges,78% of total billed charges,255,100,,,percent of total billed charges,100% of total billed charges,210.63,82.6,,,percent of total billed charges,82.6% of total billed charges,210.63,82.6,,,percent of total billed charges,82.6% of total billed charges,42.84,16.8,,,percent of total billed charges,16.8% of total billed charges,127.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,127.5,50,,,percent of total billed charges,50% of total Billed charges,42.84,16.8,,,percent of total billed charges,16.8% of total billed charges,39.02,255,
SUTURE PRLN 8706H 6-0 C-1 DA,147033,CDM,272,RC,,,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,10.9,17.304,,,percent of total billed charges,17.304% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,39.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,38.97,61.85,,,percent of total billed charges,61.85% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.8,17.136,,,percent of total billed charges,17.136% of total billed charges,13.76,21.84,,,percent of total billed charges,21.84% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,63,
SUTURE PROLENE BL MONO 6-0 PLASTIC 18 P-3 12/BX,13717,CDM,272,RC,,,Outpatient,,,396,257.40,,348.48,88,,,percent of total billed charges,88% of total Billed charges,198,50,,,percent of total billed charges,50% of total Billed charges,66.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,396,100,,,percent of total billed charges,100% of total billed charges,68.52,17.304,,,percent of total billed charges,17.304% of total billed charges,198,50,,,percent of total billed charges,50% of total Billed charges,249.48,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,66.53,16.8,,,percent of total billed charges,16.8% of total billed charges,60.59,15.3,,,percent of total billed charges,15.3% of total billed charges,273.24,69,,,percent of total billed charges,69% of total billed charges,396,100,,,percent of total billed charges,100% of total billed charges,198,50,,,percent of total billed charges,50% of total Billed charges,396,100,,,percent of total billed charges,100% of total billed charges,198,50,,,percent of total billed charges,50% of total Billed charges,396,100,,,percent of total billed charges,100% of total billed charges,198,50,,,percent of total billed charges,50% of total Billed charges,244.93,61.85,,,percent of total billed charges,61.85% of total billed charges,66.53,16.8,,,percent of total billed charges,16.8% of total billed charges,198,50,,,percent of total billed charges,50% of total Billed charges,198,50,,,percent of total billed charges,50% of total Billed charges,66.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,198,50,,,percent of total billed charges,50% of total Billed charges,198,50,,,percent of total billed charges,50% of total Billed charges,67.86,17.136,,,percent of total billed charges,17.136% of total billed charges,86.49,21.84,,,percent of total billed charges,21.84% of total billed charges,198,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,198,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,198,50,,,percent of total billed charges,50% of total Billed charges,308.88,78,,,percent of total billed charges,78% of total billed charges,396,100,,,percent of total billed charges,100% of total billed charges,327.1,82.6,,,percent of total billed charges,82.6% of total billed charges,327.1,82.6,,,percent of total billed charges,82.6% of total billed charges,66.53,16.8,,,percent of total billed charges,16.8% of total billed charges,198,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,198,50,,,percent of total billed charges,50% of total Billed charges,66.53,16.8,,,percent of total billed charges,16.8% of total billed charges,60.59,396,
SUTURE PRLN 8556H 5-0 RB-1 36IN,110818,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUTURE PRLN 8522H 3-0 SH DA36,166128,CDM,272,RC,,,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.88,17.304,,,percent of total billed charges,17.304% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.83,17.136,,,percent of total billed charges,17.136% of total billed charges,7.43,21.84,,,percent of total billed charges,21.84% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,34,
SUTURE PROLENE BL MONO 3-0 CARDIO 48 SHSH,13834,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUTURE PRLN 8558H 3-0 RB-1DA36,166127,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SUTURE PRLN 8824G #1 TP-1 60IN,14652,CDM,272,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
SUTURE PRLN 8435H #1 CT 30IN,11362,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SUTURE PRLN 8424H #0 CT-1 30IN,157679,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SUTURE GUT PL 2-0 STANDARD 54,46178,CDM,272,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
SUTURE PDS II 2-0 CT-1 VIL MON,157647,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SUTURE PDSII 0 TP-1 VIL MONO,157643,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
SUTURE PDSII 4-0 18 PS-2,13845,CDM,272,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
SUTURE PDSII 3-0 SH 27IN,46183,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SUTURE NYLN 1698G 6-0 P-3 18IN,13636,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
SUTURE NYLN 661G 5-0 FS-2,166021,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUTURE NYLN 1865G 5-0 PC-3 18IN,166024,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
SUTURE NYLN 1855G 5-0 PC-1 18IN,169832,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
SUTURE NYLN 1667G 4-0 PS-2 18IN,13634,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SUTURE ETHILON BLK MONO 3-0 CUTICULAR 30 FSL,44786,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUTURE NRLN  C584D 4-0 TF CR/8,187408,CDM,272,RC,,,Outpatient,,,140,91.00,,123.2,88,,,percent of total billed charges,88% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,140,100,,,percent of total billed charges,100% of total billed charges,24.23,17.304,,,percent of total billed charges,17.304% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,88.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,21.42,15.3,,,percent of total billed charges,15.3% of total billed charges,96.6,69,,,percent of total billed charges,69% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,140,100,,,percent of total billed charges,100% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,140,100,,,percent of total billed charges,100% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,86.59,61.85,,,percent of total billed charges,61.85% of total billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,23.99,17.136,,,percent of total billed charges,17.136% of total billed charges,30.58,21.84,,,percent of total billed charges,21.84% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,70,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,70,50,,,percent of total billed charges,50% of total Billed charges,109.2,78,,,percent of total billed charges,78% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,70,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,70,50,,,percent of total billed charges,50% of total Billed charges,23.52,16.8,,,percent of total billed charges,16.8% of total billed charges,21.42,140,
SUTURE MONO Y822G 5-0 PC-5 UND,188365,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUTURE MONOCRYL 4-0 PS-2,16867,CDM,272,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
SUTURE MONOCRYL 4-0 P-3 18'',20880,CDM,272,RC,,,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.88,17.304,,,percent of total billed charges,17.304% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.83,17.136,,,percent of total billed charges,17.136% of total billed charges,7.43,21.84,,,percent of total billed charges,21.84% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,34,
SUTURE ETHIBOND 2-0 SH 36IN,188357,CDM,272,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
SUTURE ETHBND CX21D #0 CT-1 CR,8190,CDM,272,RC,,,Outpatient,,,80,52.00,,70.4,88,,,percent of total billed charges,88% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,13.84,17.304,,,percent of total billed charges,17.304% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,50.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,12.24,15.3,,,percent of total billed charges,15.3% of total billed charges,55.2,69,,,percent of total billed charges,69% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,80,100,,,percent of total billed charges,100% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,49.48,61.85,,,percent of total billed charges,61.85% of total billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,13.71,17.136,,,percent of total billed charges,17.136% of total billed charges,17.47,21.84,,,percent of total billed charges,21.84% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,62.4,78,,,percent of total billed charges,78% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,40,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40,50,,,percent of total billed charges,50% of total Billed charges,13.44,16.8,,,percent of total billed charges,16.8% of total billed charges,12.24,80,
SUTURE VLOC 3-0,326023,CDM,272,RC,,,Outpatient,,,295,191.75,,259.6,88,,,percent of total billed charges,88% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,51.05,17.304,,,percent of total billed charges,17.304% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,185.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,45.14,15.3,,,percent of total billed charges,15.3% of total billed charges,203.55,69,,,percent of total billed charges,69% of total billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,182.46,61.85,,,percent of total billed charges,61.85% of total billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,50.55,17.136,,,percent of total billed charges,17.136% of total billed charges,64.43,21.84,,,percent of total billed charges,21.84% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,230.1,78,,,percent of total billed charges,78% of total billed charges,295,100,,,percent of total billed charges,100% of total billed charges,243.67,82.6,,,percent of total billed charges,82.6% of total billed charges,243.67,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,45.14,295,
SUTURE CHRMIC 635H 4-0 FS-2 27,146817,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUTURE RETENTION BOLSTER SURG LATEX TUBING 2.5,76181,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
SUTURE SILK 1 6-30 LABYRINTH NABSORB,45148,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
SUTURE  TICRON AORTIC VALVE 2-0,14187,CDM,272,RC,,,Outpatient,,,1307,849.55,,1150.16,88,,,percent of total billed charges,88% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,219.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,226.16,17.304,,,percent of total billed charges,17.304% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,823.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,219.58,16.8,,,percent of total billed charges,16.8% of total billed charges,199.97,15.3,,,percent of total billed charges,15.3% of total billed charges,901.83,69,,,percent of total billed charges,69% of total billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,808.38,61.85,,,percent of total billed charges,61.85% of total billed charges,219.58,16.8,,,percent of total billed charges,16.8% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,219.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,223.97,17.136,,,percent of total billed charges,17.136% of total billed charges,285.45,21.84,,,percent of total billed charges,21.84% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,653.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,653.5,50,,,percent of total billed charges,50% of total Billed charges,1019.46,78,,,percent of total billed charges,78% of total billed charges,1307,100,,,percent of total billed charges,100% of total billed charges,1079.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1079.58,82.6,,,percent of total billed charges,82.6% of total billed charges,219.58,16.8,,,percent of total billed charges,16.8% of total billed charges,653.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,653.5,50,,,percent of total billed charges,50% of total Billed charges,219.58,16.8,,,percent of total billed charges,16.8% of total billed charges,199.97,1307,
SUTURE 0 VICRYL CT-2,259395,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SUTURE 3-0 VICRYL CT-1,209738,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
SUTURE CHRMIC 904H #0 CTX 36IN,165829,CDM,272,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
SUTURE CHRMIC 905H #1 CTX 36IN,149534,CDM,272,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
SUTURE COATED VCRYL VL BR 0 CLS 8-18C/R CTX COMP,44993,CDM,272,RC,,,Outpatient,,,1125,731.25,,990,88,,,percent of total billed charges,88% of total Billed charges,562.5,50,,,percent of total billed charges,50% of total Billed charges,189,16.8,,,percent of total billed charges,16.8% of total Billed charges,1125,100,,,percent of total billed charges,100% of total billed charges,194.67,17.304,,,percent of total billed charges,17.304% of total billed charges,562.5,50,,,percent of total billed charges,50% of total Billed charges,708.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,189,16.8,,,percent of total billed charges,16.8% of total billed charges,172.13,15.3,,,percent of total billed charges,15.3% of total billed charges,776.25,69,,,percent of total billed charges,69% of total billed charges,1125,100,,,percent of total billed charges,100% of total billed charges,562.5,50,,,percent of total billed charges,50% of total Billed charges,1125,100,,,percent of total billed charges,100% of total billed charges,562.5,50,,,percent of total billed charges,50% of total Billed charges,1125,100,,,percent of total billed charges,100% of total billed charges,562.5,50,,,percent of total billed charges,50% of total Billed charges,695.81,61.85,,,percent of total billed charges,61.85% of total billed charges,189,16.8,,,percent of total billed charges,16.8% of total billed charges,562.5,50,,,percent of total billed charges,50% of total Billed charges,562.5,50,,,percent of total billed charges,50% of total Billed charges,189,16.8,,,percent of total billed charges,16.8% of total Billed charges,562.5,50,,,percent of total billed charges,50% of total Billed charges,562.5,50,,,percent of total billed charges,50% of total Billed charges,192.78,17.136,,,percent of total billed charges,17.136% of total billed charges,245.7,21.84,,,percent of total billed charges,21.84% of total billed charges,562.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,562.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,562.5,50,,,percent of total billed charges,50% of total Billed charges,877.5,78,,,percent of total billed charges,78% of total billed charges,1125,100,,,percent of total billed charges,100% of total billed charges,929.25,82.6,,,percent of total billed charges,82.6% of total billed charges,929.25,82.6,,,percent of total billed charges,82.6% of total billed charges,189,16.8,,,percent of total billed charges,16.8% of total billed charges,562.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,562.5,50,,,percent of total billed charges,50% of total Billed charges,189,16.8,,,percent of total billed charges,16.8% of total billed charges,172.13,1125,
SUTURE COATED VICRYL UND BR 2-0 OB-GYN 36 CT-1,165907,CDM,272,RC,,,Outpatient,,,395,256.75,,347.6,88,,,percent of total billed charges,88% of total Billed charges,197.5,50,,,percent of total billed charges,50% of total Billed charges,66.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,395,100,,,percent of total billed charges,100% of total billed charges,68.35,17.304,,,percent of total billed charges,17.304% of total billed charges,197.5,50,,,percent of total billed charges,50% of total Billed charges,248.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,66.36,16.8,,,percent of total billed charges,16.8% of total billed charges,60.44,15.3,,,percent of total billed charges,15.3% of total billed charges,272.55,69,,,percent of total billed charges,69% of total billed charges,395,100,,,percent of total billed charges,100% of total billed charges,197.5,50,,,percent of total billed charges,50% of total Billed charges,395,100,,,percent of total billed charges,100% of total billed charges,197.5,50,,,percent of total billed charges,50% of total Billed charges,395,100,,,percent of total billed charges,100% of total billed charges,197.5,50,,,percent of total billed charges,50% of total Billed charges,244.31,61.85,,,percent of total billed charges,61.85% of total billed charges,66.36,16.8,,,percent of total billed charges,16.8% of total billed charges,197.5,50,,,percent of total billed charges,50% of total Billed charges,197.5,50,,,percent of total billed charges,50% of total Billed charges,66.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,197.5,50,,,percent of total billed charges,50% of total Billed charges,197.5,50,,,percent of total billed charges,50% of total Billed charges,67.69,17.136,,,percent of total billed charges,17.136% of total billed charges,86.27,21.84,,,percent of total billed charges,21.84% of total billed charges,197.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,197.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,197.5,50,,,percent of total billed charges,50% of total Billed charges,308.1,78,,,percent of total billed charges,78% of total billed charges,395,100,,,percent of total billed charges,100% of total billed charges,326.27,82.6,,,percent of total billed charges,82.6% of total billed charges,326.27,82.6,,,percent of total billed charges,82.6% of total billed charges,66.36,16.8,,,percent of total billed charges,16.8% of total billed charges,197.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,197.5,50,,,percent of total billed charges,50% of total Billed charges,66.36,16.8,,,percent of total billed charges,16.8% of total billed charges,60.44,395,
SUTURE COATED VICRYL UND BR 3-0  RB-1,39901,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
SUTURE COATED VICRYL UND BR 4-0 PLASTIC 27 PS-2,165941,CDM,272,RC,,,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.5,17.304,,,percent of total billed charges,17.304% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.08,61.85,,,percent of total billed charges,61.85% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.46,17.136,,,percent of total billed charges,17.136% of total billed charges,5.68,21.84,,,percent of total billed charges,21.84% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,26,
SUTURE ETHILON BLK MONO 4-0 PLASTIC 18 P-3,40223,CDM,272,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
SUTURE ETHILON GRN MONO 5-0 PLASTIC 18 PS-2,14651,CDM,272,RC,,,Outpatient,,,248,161.20,,218.24,88,,,percent of total billed charges,88% of total Billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,41.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,248,100,,,percent of total billed charges,100% of total billed charges,42.91,17.304,,,percent of total billed charges,17.304% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,156.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,41.66,16.8,,,percent of total billed charges,16.8% of total billed charges,37.94,15.3,,,percent of total billed charges,15.3% of total billed charges,171.12,69,,,percent of total billed charges,69% of total billed charges,248,100,,,percent of total billed charges,100% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,248,100,,,percent of total billed charges,100% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,248,100,,,percent of total billed charges,100% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,153.39,61.85,,,percent of total billed charges,61.85% of total billed charges,41.66,16.8,,,percent of total billed charges,16.8% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,41.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,42.5,17.136,,,percent of total billed charges,17.136% of total billed charges,54.16,21.84,,,percent of total billed charges,21.84% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,124,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,124,50,,,percent of total billed charges,50% of total Billed charges,193.44,78,,,percent of total billed charges,78% of total billed charges,248,100,,,percent of total billed charges,100% of total billed charges,204.85,82.6,,,percent of total billed charges,82.6% of total billed charges,204.85,82.6,,,percent of total billed charges,82.6% of total billed charges,41.66,16.8,,,percent of total billed charges,16.8% of total billed charges,124,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,124,50,,,percent of total billed charges,50% of total Billed charges,41.66,16.8,,,percent of total billed charges,16.8% of total billed charges,37.94,248,
SUTURE GUT CHR 4-0 PLASTIC 18 P-3,35305,CDM,272,RC,,,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,9.34,17.304,,,percent of total billed charges,17.304% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,33.4,61.85,,,percent of total billed charges,61.85% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.25,17.136,,,percent of total billed charges,17.136% of total billed charges,11.79,21.84,,,percent of total billed charges,21.84% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
SUTURE LASSO 45 DEGREE CV LEFT,ORSUP0013,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SUTURE MONOCRYL UND MONO 3-0 G.I. 27 SH,76098,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
SUTURE NYLN 1663G 3-0 PS-1 18,146925,CDM,272,RC,,,Outpatient,,,274,178.10,,241.12,88,,,percent of total billed charges,88% of total Billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,46.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,274,100,,,percent of total billed charges,100% of total billed charges,47.41,17.304,,,percent of total billed charges,17.304% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,172.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,46.03,16.8,,,percent of total billed charges,16.8% of total billed charges,41.92,15.3,,,percent of total billed charges,15.3% of total billed charges,189.06,69,,,percent of total billed charges,69% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,274,100,,,percent of total billed charges,100% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,274,100,,,percent of total billed charges,100% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,169.47,61.85,,,percent of total billed charges,61.85% of total billed charges,46.03,16.8,,,percent of total billed charges,16.8% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,46.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,46.95,17.136,,,percent of total billed charges,17.136% of total billed charges,59.84,21.84,,,percent of total billed charges,21.84% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,137,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,137,50,,,percent of total billed charges,50% of total Billed charges,213.72,78,,,percent of total billed charges,78% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,46.03,16.8,,,percent of total billed charges,16.8% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,137,50,,,percent of total billed charges,50% of total Billed charges,46.03,16.8,,,percent of total billed charges,16.8% of total billed charges,41.92,274,
SUTURE NYLN 1696G 7-0 P-1 18IN,166042,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
SUTURE NYLN 662G FS-2 18IN,149622,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUTURE PDS 2-0 CP-2 CR-8,87946,CDM,272,RC,,,Outpatient,,,128,83.20,,112.64,88,,,percent of total billed charges,88% of total Billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,21.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,128,100,,,percent of total billed charges,100% of total billed charges,22.15,17.304,,,percent of total billed charges,17.304% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,80.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.5,16.8,,,percent of total billed charges,16.8% of total billed charges,19.58,15.3,,,percent of total billed charges,15.3% of total billed charges,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,128,100,,,percent of total billed charges,100% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,128,100,,,percent of total billed charges,100% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,79.17,61.85,,,percent of total billed charges,61.85% of total billed charges,21.5,16.8,,,percent of total billed charges,16.8% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,21.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,21.93,17.136,,,percent of total billed charges,17.136% of total billed charges,27.96,21.84,,,percent of total billed charges,21.84% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,64,50,,,percent of total billed charges,50% of total Billed charges,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,21.5,16.8,,,percent of total billed charges,16.8% of total billed charges,64,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,64,50,,,percent of total billed charges,50% of total Billed charges,21.5,16.8,,,percent of total billed charges,16.8% of total billed charges,19.58,128,
SUTURE PDS II 3-0 CR/CP-2 VIL MONO,280739,CDM,272,RC,,,Outpatient,,,129,83.85,,113.52,88,,,percent of total billed charges,88% of total Billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,21.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,129,100,,,percent of total billed charges,100% of total billed charges,22.32,17.304,,,percent of total billed charges,17.304% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,81.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.67,16.8,,,percent of total billed charges,16.8% of total billed charges,19.74,15.3,,,percent of total billed charges,15.3% of total billed charges,89.01,69,,,percent of total billed charges,69% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,129,100,,,percent of total billed charges,100% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,129,100,,,percent of total billed charges,100% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,79.79,61.85,,,percent of total billed charges,61.85% of total billed charges,21.67,16.8,,,percent of total billed charges,16.8% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,21.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,22.11,17.136,,,percent of total billed charges,17.136% of total billed charges,28.17,21.84,,,percent of total billed charges,21.84% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,64.5,50,,,percent of total billed charges,50% of total Billed charges,100.62,78,,,percent of total billed charges,78% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,21.67,16.8,,,percent of total billed charges,16.8% of total billed charges,64.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,64.5,50,,,percent of total billed charges,50% of total Billed charges,21.67,16.8,,,percent of total billed charges,16.8% of total billed charges,19.74,129,
SUTURE PDSII #0 CT-2 37IN,146971,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
SUTURE PDSII 0 CT-1 18 V,149651,CDM,272,RC,,,Outpatient,,,118,76.70,,103.84,88,,,percent of total billed charges,88% of total Billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,19.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,118,100,,,percent of total billed charges,100% of total billed charges,20.42,17.304,,,percent of total billed charges,17.304% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,74.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.82,16.8,,,percent of total billed charges,16.8% of total billed charges,18.05,15.3,,,percent of total billed charges,15.3% of total billed charges,81.42,69,,,percent of total billed charges,69% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,118,100,,,percent of total billed charges,100% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,118,100,,,percent of total billed charges,100% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,72.98,61.85,,,percent of total billed charges,61.85% of total billed charges,19.82,16.8,,,percent of total billed charges,16.8% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,19.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,20.22,17.136,,,percent of total billed charges,17.136% of total billed charges,25.77,21.84,,,percent of total billed charges,21.84% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,59,50,,,percent of total billed charges,50% of total Billed charges,92.04,78,,,percent of total billed charges,78% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,16.8,,,percent of total billed charges,16.8% of total billed charges,59,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,59,50,,,percent of total billed charges,50% of total Billed charges,19.82,16.8,,,percent of total billed charges,16.8% of total billed charges,18.05,118,
SUTURE PRLN 8631G 4-0 PC-5 18IN,187071,CDM,272,RC,,,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.88,17.304,,,percent of total billed charges,17.304% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.83,17.136,,,percent of total billed charges,17.136% of total billed charges,7.43,21.84,,,percent of total billed charges,21.84% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,34,
SUTURE PRLN 8635G 5-0 PC-3 18,166143,CDM,272,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
SUTURE PRLN 9702H 5-0 BV-1,147028,CDM,272,RC,,,Outpatient,,,116,75.40,,102.08,88,,,percent of total billed charges,88% of total Billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,19.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,116,100,,,percent of total billed charges,100% of total billed charges,20.07,17.304,,,percent of total billed charges,17.304% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,73.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,19.49,16.8,,,percent of total billed charges,16.8% of total billed charges,17.75,15.3,,,percent of total billed charges,15.3% of total billed charges,80.04,69,,,percent of total billed charges,69% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,116,100,,,percent of total billed charges,100% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,116,100,,,percent of total billed charges,100% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,71.75,61.85,,,percent of total billed charges,61.85% of total billed charges,19.49,16.8,,,percent of total billed charges,16.8% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,19.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,19.88,17.136,,,percent of total billed charges,17.136% of total billed charges,25.33,21.84,,,percent of total billed charges,21.84% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,58,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58,50,,,percent of total billed charges,50% of total Billed charges,90.48,78,,,percent of total billed charges,78% of total billed charges,116,100,,,percent of total billed charges,100% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,95.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.49,16.8,,,percent of total billed charges,16.8% of total billed charges,58,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58,50,,,percent of total billed charges,50% of total Billed charges,19.49,16.8,,,percent of total billed charges,16.8% of total billed charges,17.75,116,
SUTURE PROLENE BL MONO 3-0 CARDIO 30 SH,36465,CDM,272,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
SUTURE STRATAFIX 3.0 RB-1 16CM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SUTURE STRATAFIX SPIRAL PDO 2XMH,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SUTURE VIC COAT PLUS BR UND CT1 0 27IN,377694,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUTURE VICRYL 2-0,310901,CDM,272,RC,,,Outpatient,,,77,50.05,,67.76,88,,,percent of total billed charges,88% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,13.32,17.304,,,percent of total billed charges,17.304% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,48.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,11.78,15.3,,,percent of total billed charges,15.3% of total billed charges,53.13,69,,,percent of total billed charges,69% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,77,100,,,percent of total billed charges,100% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,47.62,61.85,,,percent of total billed charges,61.85% of total billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,13.19,17.136,,,percent of total billed charges,17.136% of total billed charges,16.82,21.84,,,percent of total billed charges,21.84% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38.5,50,,,percent of total billed charges,50% of total Billed charges,60.06,78,,,percent of total billed charges,78% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,38.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38.5,50,,,percent of total billed charges,50% of total Billed charges,12.94,16.8,,,percent of total billed charges,16.8% of total billed charges,11.78,77,
SUTURE VICRYL J946H #0 CT-1 UND,157480,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SUTURE VICRYL PLUS 0 8-18 IN VIL CR CT-2,262060,CDM,272,RC,,,Outpatient,,,1037,674.05,,912.56,88,,,percent of total billed charges,88% of total Billed charges,518.5,50,,,percent of total billed charges,50% of total Billed charges,174.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,1037,100,,,percent of total billed charges,100% of total billed charges,179.44,17.304,,,percent of total billed charges,17.304% of total billed charges,518.5,50,,,percent of total billed charges,50% of total Billed charges,653.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.22,16.8,,,percent of total billed charges,16.8% of total billed charges,158.66,15.3,,,percent of total billed charges,15.3% of total billed charges,715.53,69,,,percent of total billed charges,69% of total billed charges,1037,100,,,percent of total billed charges,100% of total billed charges,518.5,50,,,percent of total billed charges,50% of total Billed charges,1037,100,,,percent of total billed charges,100% of total billed charges,518.5,50,,,percent of total billed charges,50% of total Billed charges,1037,100,,,percent of total billed charges,100% of total billed charges,518.5,50,,,percent of total billed charges,50% of total Billed charges,641.38,61.85,,,percent of total billed charges,61.85% of total billed charges,174.22,16.8,,,percent of total billed charges,16.8% of total billed charges,518.5,50,,,percent of total billed charges,50% of total Billed charges,518.5,50,,,percent of total billed charges,50% of total Billed charges,174.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,518.5,50,,,percent of total billed charges,50% of total Billed charges,518.5,50,,,percent of total billed charges,50% of total Billed charges,177.7,17.136,,,percent of total billed charges,17.136% of total billed charges,226.48,21.84,,,percent of total billed charges,21.84% of total billed charges,518.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,518.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,518.5,50,,,percent of total billed charges,50% of total Billed charges,808.86,78,,,percent of total billed charges,78% of total billed charges,1037,100,,,percent of total billed charges,100% of total billed charges,856.56,82.6,,,percent of total billed charges,82.6% of total billed charges,856.56,82.6,,,percent of total billed charges,82.6% of total billed charges,174.22,16.8,,,percent of total billed charges,16.8% of total billed charges,518.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,518.5,50,,,percent of total billed charges,50% of total Billed charges,174.22,16.8,,,percent of total billed charges,16.8% of total billed charges,158.66,1037,
SUTURE VICRYL PLUS ANTIBACTERIAL 0 27IN,248187,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SUTURE V LOC 90 3/0 VIOLET 6 CV-23,329634,CDM,272,RC,,,Outpatient,,,281,182.65,,247.28,88,,,percent of total billed charges,88% of total Billed charges,140.5,50,,,percent of total billed charges,50% of total Billed charges,47.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,281,100,,,percent of total billed charges,100% of total billed charges,48.62,17.304,,,percent of total billed charges,17.304% of total billed charges,140.5,50,,,percent of total billed charges,50% of total Billed charges,177.03,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,47.21,16.8,,,percent of total billed charges,16.8% of total billed charges,42.99,15.3,,,percent of total billed charges,15.3% of total billed charges,193.89,69,,,percent of total billed charges,69% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,140.5,50,,,percent of total billed charges,50% of total Billed charges,281,100,,,percent of total billed charges,100% of total billed charges,140.5,50,,,percent of total billed charges,50% of total Billed charges,281,100,,,percent of total billed charges,100% of total billed charges,140.5,50,,,percent of total billed charges,50% of total Billed charges,173.8,61.85,,,percent of total billed charges,61.85% of total billed charges,47.21,16.8,,,percent of total billed charges,16.8% of total billed charges,140.5,50,,,percent of total billed charges,50% of total Billed charges,140.5,50,,,percent of total billed charges,50% of total Billed charges,47.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,140.5,50,,,percent of total billed charges,50% of total Billed charges,140.5,50,,,percent of total billed charges,50% of total Billed charges,48.15,17.136,,,percent of total billed charges,17.136% of total billed charges,61.37,21.84,,,percent of total billed charges,21.84% of total billed charges,140.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,140.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,140.5,50,,,percent of total billed charges,50% of total Billed charges,219.18,78,,,percent of total billed charges,78% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,47.21,16.8,,,percent of total billed charges,16.8% of total billed charges,140.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,140.5,50,,,percent of total billed charges,50% of total Billed charges,47.21,16.8,,,percent of total billed charges,16.8% of total billed charges,42.99,281,
SUTURE V LOC 90 3-0 UNDYED 6CY-23,329635,CDM,272,RC,,,Outpatient,,,253,164.45,,222.64,88,,,percent of total billed charges,88% of total Billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,42.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,253,100,,,percent of total billed charges,100% of total billed charges,43.78,17.304,,,percent of total billed charges,17.304% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,159.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42.5,16.8,,,percent of total billed charges,16.8% of total billed charges,38.71,15.3,,,percent of total billed charges,15.3% of total billed charges,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,253,100,,,percent of total billed charges,100% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,253,100,,,percent of total billed charges,100% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,156.48,61.85,,,percent of total billed charges,61.85% of total billed charges,42.5,16.8,,,percent of total billed charges,16.8% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,42.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,43.35,17.136,,,percent of total billed charges,17.136% of total billed charges,55.26,21.84,,,percent of total billed charges,21.84% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,126.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,126.5,50,,,percent of total billed charges,50% of total Billed charges,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,42.5,16.8,,,percent of total billed charges,16.8% of total billed charges,126.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,126.5,50,,,percent of total billed charges,50% of total Billed charges,42.5,16.8,,,percent of total billed charges,16.8% of total billed charges,38.71,253,
SUTURE SLK 685G 2-0 FS 18IN,147054,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SUTURE SILK 0 BLK BR CT-1 30 INCH,32128,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
SUTURE PROLENE BL MONO 5-0 CARDIO 36 C-1C-1,13661,CDM,272,RC,,,Outpatient,,,64,41.60,,56.32,88,,,percent of total billed charges,88% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,11.07,17.304,,,percent of total billed charges,17.304% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,40.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,9.79,15.3,,,percent of total billed charges,15.3% of total billed charges,44.16,69,,,percent of total billed charges,69% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,39.58,61.85,,,percent of total billed charges,61.85% of total billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.97,17.136,,,percent of total billed charges,17.136% of total billed charges,13.98,21.84,,,percent of total billed charges,21.84% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,49.92,78,,,percent of total billed charges,78% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,9.79,64,
SUTURE SLK A183H 4-0 STRND 18,166201,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
SUTURE SILK BLK BR 3-0 G.I.NEURO 8-18 COMPARTMNT,13718,CDM,272,RC,,,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,12.8,17.304,,,percent of total billed charges,17.304% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,46.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,45.77,61.85,,,percent of total billed charges,61.85% of total billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,12.68,17.136,,,percent of total billed charges,17.136% of total billed charges,16.16,21.84,,,percent of total billed charges,21.84% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,12.43,16.8,,,percent of total billed charges,16.8% of total billed charges,11.32,74,
SUTURE SILK 2-0 18 INCH BLK BR A185H,20886,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
SUTURE PRLN 8521H 4-0 SH DA 36,166137,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUTURE PLAIN 1824H 4-0 SC-1 18,ORSUP0001,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE PLAIN 53T 2-0 XLH,41042,CDM,272,RC,,,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,10.9,17.304,,,percent of total billed charges,17.304% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,39.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,38.97,61.85,,,percent of total billed charges,61.85% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.8,17.136,,,percent of total billed charges,17.136% of total billed charges,13.76,21.84,,,percent of total billed charges,21.84% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,63,
SUTURE PDSII 4-0 PC-5,70518,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUTURE PDSII #1 CTX NEEDLE,13847,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUTURE PDSII #1 CT-1 27IN,146972,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SUTURE NYLN 697G 6-0 P-1 18IN,157601,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SUTURE NYLN 698G 5-0 P-3 18IN,157596,CDM,272,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
SUTURE ETHILON BLK MONO 4-0 CUTICULAR 30 FSL,169823,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SUTURE NYLN 1864G 4-0 PC-3 18IN,39573,CDM,272,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
SUTURE NYLN 1893G 3-0 PC-5,166006,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
SUTURE V-LOC 2-0 180 ABSB WND CLSR DEVICE  GREEN,317787,CDM,272,RC,,,Outpatient,,,295,191.75,,259.6,88,,,percent of total billed charges,88% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,51.05,17.304,,,percent of total billed charges,17.304% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,185.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,45.14,15.3,,,percent of total billed charges,15.3% of total billed charges,203.55,69,,,percent of total billed charges,69% of total billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,182.46,61.85,,,percent of total billed charges,61.85% of total billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,50.55,17.136,,,percent of total billed charges,17.136% of total billed charges,64.43,21.84,,,percent of total billed charges,21.84% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,230.1,78,,,percent of total billed charges,78% of total billed charges,295,100,,,percent of total billed charges,100% of total billed charges,243.67,82.6,,,percent of total billed charges,82.6% of total billed charges,243.67,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,45.14,295,
SUTURE CHRMIC G122H 3-0 SH 27IN,165873,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE CHRMIC 636G 3-0 FS-2,157449,CDM,272,RC,,,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,10.04,17.304,,,percent of total billed charges,17.304% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,36.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.94,17.136,,,percent of total billed charges,17.136% of total billed charges,12.67,21.84,,,percent of total billed charges,21.84% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,58,
SUTURE 2-0 ETHIBOND EXCELL SH-2 30IN,330616,CDM,272,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
SUTURE COATED VICRYL UND BR 2-0 G.I. 27 SH,146859,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SUTURE ETHIBOND XTRA 2-0 SHSH,453272,CDM,272,RC,,,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,7.27,17.304,,,percent of total billed charges,17.304% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,26.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,15.3,,,percent of total billed charges,15.3% of total billed charges,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.2,17.136,,,percent of total billed charges,17.136% of total billed charges,9.17,21.84,,,percent of total billed charges,21.84% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,42,
SUTURE ETHILON BLK MONO 2-0 CUTICULAR 18 FS,166001,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SUTURE FIBERLINK CLS LP ST BL 2-0 12 AR-7235,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
SUTURE MONOCRYL PLUS 4-0 PS-1,240961,CDM,272,RC,,,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.4,17.304,,,percent of total billed charges,17.304% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,23.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.34,17.136,,,percent of total billed charges,17.136% of total billed charges,8.08,21.84,,,percent of total billed charges,21.84% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,37,
SUTURE PDSII 0 CTX VIL MONO,166067,CDM,272,RC,,,Outpatient,,,385,250.25,,338.8,88,,,percent of total billed charges,88% of total Billed charges,192.5,50,,,percent of total billed charges,50% of total Billed charges,64.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,385,100,,,percent of total billed charges,100% of total billed charges,66.62,17.304,,,percent of total billed charges,17.304% of total billed charges,192.5,50,,,percent of total billed charges,50% of total Billed charges,242.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,64.68,16.8,,,percent of total billed charges,16.8% of total billed charges,58.91,15.3,,,percent of total billed charges,15.3% of total billed charges,265.65,69,,,percent of total billed charges,69% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,192.5,50,,,percent of total billed charges,50% of total Billed charges,385,100,,,percent of total billed charges,100% of total billed charges,192.5,50,,,percent of total billed charges,50% of total Billed charges,385,100,,,percent of total billed charges,100% of total billed charges,192.5,50,,,percent of total billed charges,50% of total Billed charges,238.12,61.85,,,percent of total billed charges,61.85% of total billed charges,64.68,16.8,,,percent of total billed charges,16.8% of total billed charges,192.5,50,,,percent of total billed charges,50% of total Billed charges,192.5,50,,,percent of total billed charges,50% of total Billed charges,64.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,192.5,50,,,percent of total billed charges,50% of total Billed charges,192.5,50,,,percent of total billed charges,50% of total Billed charges,65.97,17.136,,,percent of total billed charges,17.136% of total billed charges,84.08,21.84,,,percent of total billed charges,21.84% of total billed charges,192.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,192.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,192.5,50,,,percent of total billed charges,50% of total Billed charges,300.3,78,,,percent of total billed charges,78% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,64.68,16.8,,,percent of total billed charges,16.8% of total billed charges,192.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,192.5,50,,,percent of total billed charges,50% of total Billed charges,64.68,16.8,,,percent of total billed charges,16.8% of total billed charges,58.91,385,
SUTURE PLN 3-0 FS-1 27IN MFL ABS,412947,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SUTURE STRATAFIX 2.0 SH 14CM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SUTURE WIRE SPOOL 24G,491519,CDM,270,RC,,,Outpatient,,,942,612.30,,828.96,88,,,percent of total billed charges,88% of total Billed charges,471,50,,,percent of total billed charges,50% of total Billed charges,158.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,942,100,,,percent of total billed charges,100% of total billed charges,163,17.304,,,percent of total billed charges,17.304% of total billed charges,471,50,,,percent of total billed charges,50% of total Billed charges,593.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,158.26,16.8,,,percent of total billed charges,16.8% of total billed charges,144.13,15.3,,,percent of total billed charges,15.3% of total billed charges,649.98,69,,,percent of total billed charges,69% of total billed charges,942,100,,,percent of total billed charges,100% of total billed charges,471,50,,,percent of total billed charges,50% of total Billed charges,942,100,,,percent of total billed charges,100% of total billed charges,471,50,,,percent of total billed charges,50% of total Billed charges,942,100,,,percent of total billed charges,100% of total billed charges,471,50,,,percent of total billed charges,50% of total Billed charges,582.63,61.85,,,percent of total billed charges,61.85% of total billed charges,158.26,16.8,,,percent of total billed charges,16.8% of total billed charges,471,50,,,percent of total billed charges,50% of total Billed charges,471,50,,,percent of total billed charges,50% of total Billed charges,158.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,471,50,,,percent of total billed charges,50% of total Billed charges,471,50,,,percent of total billed charges,50% of total Billed charges,161.42,17.136,,,percent of total billed charges,17.136% of total billed charges,205.73,21.84,,,percent of total billed charges,21.84% of total billed charges,471,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,471,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,471,50,,,percent of total billed charges,50% of total Billed charges,734.76,78,,,percent of total billed charges,78% of total billed charges,942,100,,,percent of total billed charges,100% of total billed charges,778.09,82.6,,,percent of total billed charges,82.6% of total billed charges,778.09,82.6,,,percent of total billed charges,82.6% of total billed charges,158.26,16.8,,,percent of total billed charges,16.8% of total billed charges,471,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,471,50,,,percent of total billed charges,50% of total Billed charges,158.26,16.8,,,percent of total billed charges,16.8% of total billed charges,144.13,942,
SUTURE VICRYL 3-0 SH J864D,491506,CDM,272,RC,,,Outpatient,,,95,61.75,,83.6,88,,,percent of total billed charges,88% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,16.44,17.304,,,percent of total billed charges,17.304% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,59.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,14.54,15.3,,,percent of total billed charges,15.3% of total billed charges,65.55,69,,,percent of total billed charges,69% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,95,100,,,percent of total billed charges,100% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,58.76,61.85,,,percent of total billed charges,61.85% of total billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,16.28,17.136,,,percent of total billed charges,17.136% of total billed charges,20.75,21.84,,,percent of total billed charges,21.84% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,74.1,78,,,percent of total billed charges,78% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,47.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47.5,50,,,percent of total billed charges,50% of total Billed charges,15.96,16.8,,,percent of total billed charges,16.8% of total billed charges,14.54,95,
SUTURE VICRYL 2-0 UR-6 J602H,491498,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
SUTURE VICRYL+ 2-0  VCPP42D,491518,CDM,272,RC,,,Outpatient,,,99,64.35,,87.12,88,,,percent of total billed charges,88% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,17.13,17.304,,,percent of total billed charges,17.304% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,62.37,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,15.15,15.3,,,percent of total billed charges,15.3% of total billed charges,68.31,69,,,percent of total billed charges,69% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,61.23,61.85,,,percent of total billed charges,61.85% of total billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.96,17.136,,,percent of total billed charges,17.136% of total billed charges,21.62,21.84,,,percent of total billed charges,21.84% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,77.22,78,,,percent of total billed charges,78% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,15.15,99,
SUTURE VICRYL 1-0 J650G,491494,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUTURE PDS II 1-0 CTX Z765D,491439,CDM,272,RC,,,Outpatient,,,162,105.30,,142.56,88,,,percent of total billed charges,88% of total Billed charges,81,50,,,percent of total billed charges,50% of total Billed charges,27.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,162,100,,,percent of total billed charges,100% of total billed charges,28.03,17.304,,,percent of total billed charges,17.304% of total billed charges,81,50,,,percent of total billed charges,50% of total Billed charges,102.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.22,16.8,,,percent of total billed charges,16.8% of total billed charges,24.79,15.3,,,percent of total billed charges,15.3% of total billed charges,111.78,69,,,percent of total billed charges,69% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,81,50,,,percent of total billed charges,50% of total Billed charges,162,100,,,percent of total billed charges,100% of total billed charges,81,50,,,percent of total billed charges,50% of total Billed charges,162,100,,,percent of total billed charges,100% of total billed charges,81,50,,,percent of total billed charges,50% of total Billed charges,100.2,61.85,,,percent of total billed charges,61.85% of total billed charges,27.22,16.8,,,percent of total billed charges,16.8% of total billed charges,81,50,,,percent of total billed charges,50% of total Billed charges,81,50,,,percent of total billed charges,50% of total Billed charges,27.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,81,50,,,percent of total billed charges,50% of total Billed charges,81,50,,,percent of total billed charges,50% of total Billed charges,27.76,17.136,,,percent of total billed charges,17.136% of total billed charges,35.38,21.84,,,percent of total billed charges,21.84% of total billed charges,81,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,81,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,81,50,,,percent of total billed charges,50% of total Billed charges,126.36,78,,,percent of total billed charges,78% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,27.22,16.8,,,percent of total billed charges,16.8% of total billed charges,81,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,81,50,,,percent of total billed charges,50% of total Billed charges,27.22,16.8,,,percent of total billed charges,16.8% of total billed charges,24.79,162,
SUTURE ABS VLOC 180 GS-21,491375,CDM,272,RC,,,Outpatient,,,256,166.40,,225.28,88,,,percent of total billed charges,88% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,256,100,,,percent of total billed charges,100% of total billed charges,44.3,17.304,,,percent of total billed charges,17.304% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,161.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,39.17,15.3,,,percent of total billed charges,15.3% of total billed charges,176.64,69,,,percent of total billed charges,69% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,256,100,,,percent of total billed charges,100% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,256,100,,,percent of total billed charges,100% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,158.34,61.85,,,percent of total billed charges,61.85% of total billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,43.87,17.136,,,percent of total billed charges,17.136% of total billed charges,55.91,21.84,,,percent of total billed charges,21.84% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,128,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,128,50,,,percent of total billed charges,50% of total Billed charges,199.68,78,,,percent of total billed charges,78% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,128,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,128,50,,,percent of total billed charges,50% of total Billed charges,43.01,16.8,,,percent of total billed charges,16.8% of total billed charges,39.17,256,
SUTURE VICRYL 3-0 J423H,491504,CDM,272,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
SUTURE ETHI-PACK STEEL  DS22,491412,CDM,272,RC,,,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,10.73,17.304,,,percent of total billed charges,17.304% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,39.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,9.49,15.3,,,percent of total billed charges,15.3% of total billed charges,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,38.35,61.85,,,percent of total billed charges,61.85% of total billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.62,17.136,,,percent of total billed charges,17.136% of total billed charges,13.54,21.84,,,percent of total billed charges,21.84% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,9.49,62,
SUTURE SILK 3-0 PS-2 1679H,491479,CDM,272,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
SUTURE SILK 2-0 BLK 583H,491477,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE PDS II 1 CT Z359T,491438,CDM,272,RC,,,Outpatient,,,591,384.15,,520.08,88,,,percent of total billed charges,88% of total Billed charges,295.5,50,,,percent of total billed charges,50% of total Billed charges,99.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,591,100,,,percent of total billed charges,100% of total billed charges,102.27,17.304,,,percent of total billed charges,17.304% of total billed charges,295.5,50,,,percent of total billed charges,50% of total Billed charges,372.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,99.29,16.8,,,percent of total billed charges,16.8% of total billed charges,90.42,15.3,,,percent of total billed charges,15.3% of total billed charges,407.79,69,,,percent of total billed charges,69% of total billed charges,591,100,,,percent of total billed charges,100% of total billed charges,295.5,50,,,percent of total billed charges,50% of total Billed charges,591,100,,,percent of total billed charges,100% of total billed charges,295.5,50,,,percent of total billed charges,50% of total Billed charges,591,100,,,percent of total billed charges,100% of total billed charges,295.5,50,,,percent of total billed charges,50% of total Billed charges,365.53,61.85,,,percent of total billed charges,61.85% of total billed charges,99.29,16.8,,,percent of total billed charges,16.8% of total billed charges,295.5,50,,,percent of total billed charges,50% of total Billed charges,295.5,50,,,percent of total billed charges,50% of total Billed charges,99.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,295.5,50,,,percent of total billed charges,50% of total Billed charges,295.5,50,,,percent of total billed charges,50% of total Billed charges,101.27,17.136,,,percent of total billed charges,17.136% of total billed charges,129.07,21.84,,,percent of total billed charges,21.84% of total billed charges,295.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,295.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,295.5,50,,,percent of total billed charges,50% of total Billed charges,460.98,78,,,percent of total billed charges,78% of total billed charges,591,100,,,percent of total billed charges,100% of total billed charges,488.17,82.6,,,percent of total billed charges,82.6% of total billed charges,488.17,82.6,,,percent of total billed charges,82.6% of total billed charges,99.29,16.8,,,percent of total billed charges,16.8% of total billed charges,295.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,295.5,50,,,percent of total billed charges,50% of total Billed charges,99.29,16.8,,,percent of total billed charges,16.8% of total billed charges,90.42,591,
SUTURE MAXON 1GR 60 BTP-X-LOOP,491417,CDM,272,RC,,,Outpatient,,,264,171.60,,232.32,88,,,percent of total billed charges,88% of total Billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,44.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,264,100,,,percent of total billed charges,100% of total billed charges,45.68,17.304,,,percent of total billed charges,17.304% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,166.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,44.35,16.8,,,percent of total billed charges,16.8% of total billed charges,40.39,15.3,,,percent of total billed charges,15.3% of total billed charges,182.16,69,,,percent of total billed charges,69% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,264,100,,,percent of total billed charges,100% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,264,100,,,percent of total billed charges,100% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,163.28,61.85,,,percent of total billed charges,61.85% of total billed charges,44.35,16.8,,,percent of total billed charges,16.8% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,44.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,45.24,17.136,,,percent of total billed charges,17.136% of total billed charges,57.66,21.84,,,percent of total billed charges,21.84% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,132,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,132,50,,,percent of total billed charges,50% of total Billed charges,205.92,78,,,percent of total billed charges,78% of total billed charges,264,100,,,percent of total billed charges,100% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,218.06,82.6,,,percent of total billed charges,82.6% of total billed charges,44.35,16.8,,,percent of total billed charges,16.8% of total billed charges,132,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,132,50,,,percent of total billed charges,50% of total Billed charges,44.35,16.8,,,percent of total billed charges,16.8% of total billed charges,40.39,264,
SUTURE VICRYL 5-0 PS2 J495G,491517,CDM,272,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
SUTURE SILK 5-0 P3 640G,491484,CDM,272,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
SUTURE PDS II 5-0 P3 Z493G,491442,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
SUTURE ETHILON 5-0 BLK 668G,491410,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SUTURE VICRYL 4-0 J496G PS2,491512,CDM,272,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
SUTURE VICRYL 4-0 J496H PS-2,491513,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
SUTURE SILK 4-0 PS2 1677G,491482,CDM,272,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
SUTURE MONOCRYL 4-0 Y823G PC-5,491428,CDM,272,RC,,,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.13,17.304,,,percent of total billed charges,17.304% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,8.05,17.136,,,percent of total billed charges,17.136% of total billed charges,10.26,21.84,,,percent of total billed charges,21.84% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,47,
SUTURE MONOCRYL 4-0 MCP415H SH,491426,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
SUTURE VICRYL 3-0 PS2 J497G,491505,CDM,272,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
SUTURE VICRYL 3-0 J205G,491500,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUTURE VICRYL 3-0 J219H,491501,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SUTURE MONOCRYL 3-0 PS2 Y497G,491424,CDM,272,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
SUTURE PLAIN GUT 5-0 686G,491450,CDM,272,RC,,,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,9.69,17.304,,,percent of total billed charges,17.304% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,35.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.6,17.136,,,percent of total billed charges,17.136% of total billed charges,12.23,21.84,,,percent of total billed charges,21.84% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,56,
SUTURE SILK 6-0 P3 1639G,491485,CDM,272,RC,,,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.88,17.304,,,percent of total billed charges,17.304% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.83,17.136,,,percent of total billed charges,17.136% of total billed charges,7.43,21.84,,,percent of total billed charges,21.84% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,34,
SUTURE PROLENE 6-0 P1 8697G,491472,CDM,272,RC,,,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,7.27,17.304,,,percent of total billed charges,17.304% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,26.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,15.3,,,percent of total billed charges,15.3% of total billed charges,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.2,17.136,,,percent of total billed charges,17.136% of total billed charges,9.17,21.84,,,percent of total billed charges,21.84% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,42,
SUTURE PROLENE 6-0 VB/C1 8318H,491473,CDM,272,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
SUTURE PROLENE 4-0 PS-2 8682G,491465,CDM,272,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
SUTURE PROLENE 4-0 8861H,491462,CDM,272,RC,,,Outpatient,,,51,33.15,,44.88,88,,,percent of total billed charges,88% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,8.83,17.304,,,percent of total billed charges,17.304% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,32.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,15.3,,,percent of total billed charges,15.3% of total billed charges,35.19,69,,,percent of total billed charges,69% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,31.54,61.85,,,percent of total billed charges,61.85% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.74,17.136,,,percent of total billed charges,17.136% of total billed charges,11.14,21.84,,,percent of total billed charges,21.84% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,39.78,78,,,percent of total billed charges,78% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,51,
SUTURE PROLENE 4-0 8871H,491463,CDM,272,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
SUTURE PROLENE 3-0 8687H PS2,491458,CDM,272,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
SUTURE PROLENE 2-0 FSLX 8689H,491455,CDM,272,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
SUTURE PROLENE 2-0 8423H CT-1,491454,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
SUTURE PROLENE 3-0 8534H,491456,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
SUTURE PROLENE 7-0 M8600,491474,CDM,272,RC,,,Outpatient,,,441,286.65,,388.08,88,,,percent of total billed charges,88% of total Billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,74.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,441,100,,,percent of total billed charges,100% of total billed charges,76.31,17.304,,,percent of total billed charges,17.304% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,277.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,74.09,16.8,,,percent of total billed charges,16.8% of total billed charges,67.47,15.3,,,percent of total billed charges,15.3% of total billed charges,304.29,69,,,percent of total billed charges,69% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,441,100,,,percent of total billed charges,100% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,441,100,,,percent of total billed charges,100% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,272.76,61.85,,,percent of total billed charges,61.85% of total billed charges,74.09,16.8,,,percent of total billed charges,16.8% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,74.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,75.57,17.136,,,percent of total billed charges,17.136% of total billed charges,96.31,21.84,,,percent of total billed charges,21.84% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,220.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,220.5,50,,,percent of total billed charges,50% of total Billed charges,343.98,78,,,percent of total billed charges,78% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,74.09,16.8,,,percent of total billed charges,16.8% of total billed charges,220.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,220.5,50,,,percent of total billed charges,50% of total Billed charges,74.09,16.8,,,percent of total billed charges,16.8% of total billed charges,67.47,441,
SUTURE PROLENE 6-0 M8610,491471,CDM,272,RC,,,Outpatient,,,432,280.80,,380.16,88,,,percent of total billed charges,88% of total Billed charges,216,50,,,percent of total billed charges,50% of total Billed charges,72.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,432,100,,,percent of total billed charges,100% of total billed charges,74.75,17.304,,,percent of total billed charges,17.304% of total billed charges,216,50,,,percent of total billed charges,50% of total Billed charges,272.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,72.58,16.8,,,percent of total billed charges,16.8% of total billed charges,66.1,15.3,,,percent of total billed charges,15.3% of total billed charges,298.08,69,,,percent of total billed charges,69% of total billed charges,432,100,,,percent of total billed charges,100% of total billed charges,216,50,,,percent of total billed charges,50% of total Billed charges,432,100,,,percent of total billed charges,100% of total billed charges,216,50,,,percent of total billed charges,50% of total Billed charges,432,100,,,percent of total billed charges,100% of total billed charges,216,50,,,percent of total billed charges,50% of total Billed charges,267.19,61.85,,,percent of total billed charges,61.85% of total billed charges,72.58,16.8,,,percent of total billed charges,16.8% of total billed charges,216,50,,,percent of total billed charges,50% of total Billed charges,216,50,,,percent of total billed charges,50% of total Billed charges,72.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,216,50,,,percent of total billed charges,50% of total Billed charges,216,50,,,percent of total billed charges,50% of total Billed charges,74.03,17.136,,,percent of total billed charges,17.136% of total billed charges,94.35,21.84,,,percent of total billed charges,21.84% of total billed charges,216,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,216,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,216,50,,,percent of total billed charges,50% of total Billed charges,336.96,78,,,percent of total billed charges,78% of total billed charges,432,100,,,percent of total billed charges,100% of total billed charges,356.83,82.6,,,percent of total billed charges,82.6% of total billed charges,356.83,82.6,,,percent of total billed charges,82.6% of total billed charges,72.58,16.8,,,percent of total billed charges,16.8% of total billed charges,216,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,216,50,,,percent of total billed charges,50% of total Billed charges,72.58,16.8,,,percent of total billed charges,16.8% of total billed charges,66.1,432,
SUTURE PROLENE 6-0 8714H,491470,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SUTURE PROLENE 5-0 8713H,491466,CDM,272,RC,,,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,7.79,17.304,,,percent of total billed charges,17.304% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,27.83,61.85,,,percent of total billed charges,61.85% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.71,17.136,,,percent of total billed charges,17.136% of total billed charges,9.83,21.84,,,percent of total billed charges,21.84% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
SUTURE PROLENE 5-0 8756H,491467,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SUTURE PROLENE 5-0 8860H,491468,CDM,272,RC,,,Outpatient,,,51,33.15,,44.88,88,,,percent of total billed charges,88% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,8.83,17.304,,,percent of total billed charges,17.304% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,32.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,15.3,,,percent of total billed charges,15.3% of total billed charges,35.19,69,,,percent of total billed charges,69% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,31.54,61.85,,,percent of total billed charges,61.85% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.74,17.136,,,percent of total billed charges,17.136% of total billed charges,11.14,21.84,,,percent of total billed charges,21.84% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,39.78,78,,,percent of total billed charges,78% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,51,
SUTURE PROLENE 4-0 8881H,491464,CDM,272,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
SUTURE PROLENE 4-0 8757H,491461,CDM,272,RC,,,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,7.79,17.304,,,percent of total billed charges,17.304% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,27.83,61.85,,,percent of total billed charges,61.85% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.71,17.136,,,percent of total billed charges,17.136% of total billed charges,9.83,21.84,,,percent of total billed charges,21.84% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
SUTURE PROLENE 3-0 8862H,491459,CDM,272,RC,,,Outpatient,,,53,34.45,,46.64,88,,,percent of total billed charges,88% of total Billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,53,100,,,percent of total billed charges,100% of total billed charges,9.17,17.304,,,percent of total billed charges,17.304% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,33.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,8.11,15.3,,,percent of total billed charges,15.3% of total billed charges,36.57,69,,,percent of total billed charges,69% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,53,100,,,percent of total billed charges,100% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,53,100,,,percent of total billed charges,100% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,32.78,61.85,,,percent of total billed charges,61.85% of total billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,9.08,17.136,,,percent of total billed charges,17.136% of total billed charges,11.58,21.84,,,percent of total billed charges,21.84% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.5,50,,,percent of total billed charges,50% of total Billed charges,41.34,78,,,percent of total billed charges,78% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.5,50,,,percent of total billed charges,50% of total Billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,8.11,53,
SUTURE PLAIN GUT CT-1 842H,491451,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE PDS II TP-1 Z880G,491443,CDM,272,RC,,,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,7.09,17.304,,,percent of total billed charges,17.304% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,15.3,,,percent of total billed charges,15.3% of total billed charges,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.36,61.85,,,percent of total billed charges,61.85% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,7.03,17.136,,,percent of total billed charges,17.136% of total billed charges,8.95,21.84,,,percent of total billed charges,21.84% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,41,
SUTURE PDS II 2-0 FS-1 Z443H,491440,CDM,272,RC,,,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.5,17.304,,,percent of total billed charges,17.304% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.08,61.85,,,percent of total billed charges,61.85% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.46,17.136,,,percent of total billed charges,17.136% of total billed charges,5.68,21.84,,,percent of total billed charges,21.84% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,26,
SUTURE PDS II 3-0 FS-2 Z423H,491441,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE ENDOLOOP 0-0 PDS EZ10,491394,CDM,272,RC,,,Outpatient,,,134,87.10,,117.92,88,,,percent of total billed charges,88% of total Billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,22.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,134,100,,,percent of total billed charges,100% of total billed charges,23.19,17.304,,,percent of total billed charges,17.304% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,84.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.51,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,15.3,,,percent of total billed charges,15.3% of total billed charges,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,134,100,,,percent of total billed charges,100% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,134,100,,,percent of total billed charges,100% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,82.88,61.85,,,percent of total billed charges,61.85% of total billed charges,22.51,16.8,,,percent of total billed charges,16.8% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,22.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,22.96,17.136,,,percent of total billed charges,17.136% of total billed charges,29.27,21.84,,,percent of total billed charges,21.84% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,67,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67,50,,,percent of total billed charges,50% of total Billed charges,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,22.51,16.8,,,percent of total billed charges,16.8% of total billed charges,67,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,67,50,,,percent of total billed charges,50% of total Billed charges,22.51,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,134,
SUTURE NUROLON 4-0 N104T,ORSUP0003,CDM,272,RC,,,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,147,100,,,percent of total billed charges,100% of total billed charges,25.44,17.304,,,percent of total billed charges,17.304% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,92.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,90.92,61.85,,,percent of total billed charges,61.85% of total billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,25.19,17.136,,,percent of total billed charges,17.136% of total billed charges,32.1,21.84,,,percent of total billed charges,21.84% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,24.7,16.8,,,percent of total billed charges,16.8% of total billed charges,22.49,147,
SUTURE MONCRYL 5-0 P-3 Y844G,491420,CDM,272,RC,,,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.13,17.304,,,percent of total billed charges,17.304% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,8.05,17.136,,,percent of total billed charges,17.136% of total billed charges,10.26,21.84,,,percent of total billed charges,21.84% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,47,
SUTURE MONOCRYL 4-0 Y426H,491427,CDM,272,RC,,,Outpatient,,,44,28.60,,38.72,88,,,percent of total billed charges,88% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,7.61,17.304,,,percent of total billed charges,17.304% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,15.3,,,percent of total billed charges,15.3% of total billed charges,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.21,61.85,,,percent of total billed charges,61.85% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.54,17.136,,,percent of total billed charges,17.136% of total billed charges,9.61,21.84,,,percent of total billed charges,21.84% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,44,
SUTURE MONOCRYL 0 CT MCP358H,491421,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SUTURE MONOCRYL 5-0 P-3 Y493G,491430,CDM,272,RC,,,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,7.44,17.304,,,percent of total billed charges,17.304% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,27.09,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,15.3,,,percent of total billed charges,15.3% of total billed charges,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,43,100,,,percent of total billed charges,100% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.37,17.136,,,percent of total billed charges,17.136% of total billed charges,9.39,21.84,,,percent of total billed charges,21.84% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,21.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21.5,50,,,percent of total billed charges,50% of total Billed charges,7.22,16.8,,,percent of total billed charges,16.8% of total billed charges,6.58,43,
SUTURE MONOCRYL 3-0 Y944H,491425,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
SUTURE MONOCRYL 3-0 CT1 Y3444H,491423,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SUTURE MONOCRYL 2-0 CT Y357H,491422,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SUTURE MONOCRYL 4-0 Y935H,491429,CDM,272,RC,,,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,10.56,17.304,,,percent of total billed charges,17.304% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,38.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,37.73,61.85,,,percent of total billed charges,61.85% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.45,17.136,,,percent of total billed charges,17.136% of total billed charges,13.32,21.84,,,percent of total billed charges,21.84% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,61,
SUTURE MERSILENE 36'' D9212,491418,CDM,272,RC,,,Outpatient,,,557,362.05,,490.16,88,,,percent of total billed charges,88% of total Billed charges,278.5,50,,,percent of total billed charges,50% of total Billed charges,93.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,557,100,,,percent of total billed charges,100% of total billed charges,96.38,17.304,,,percent of total billed charges,17.304% of total billed charges,278.5,50,,,percent of total billed charges,50% of total Billed charges,350.91,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,93.58,16.8,,,percent of total billed charges,16.8% of total billed charges,85.22,15.3,,,percent of total billed charges,15.3% of total billed charges,384.33,69,,,percent of total billed charges,69% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,278.5,50,,,percent of total billed charges,50% of total Billed charges,557,100,,,percent of total billed charges,100% of total billed charges,278.5,50,,,percent of total billed charges,50% of total Billed charges,557,100,,,percent of total billed charges,100% of total billed charges,278.5,50,,,percent of total billed charges,50% of total Billed charges,344.5,61.85,,,percent of total billed charges,61.85% of total billed charges,93.58,16.8,,,percent of total billed charges,16.8% of total billed charges,278.5,50,,,percent of total billed charges,50% of total Billed charges,278.5,50,,,percent of total billed charges,50% of total Billed charges,93.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,278.5,50,,,percent of total billed charges,50% of total Billed charges,278.5,50,,,percent of total billed charges,50% of total Billed charges,95.45,17.136,,,percent of total billed charges,17.136% of total billed charges,121.65,21.84,,,percent of total billed charges,21.84% of total billed charges,278.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,278.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,278.5,50,,,percent of total billed charges,50% of total Billed charges,434.46,78,,,percent of total billed charges,78% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,93.58,16.8,,,percent of total billed charges,16.8% of total billed charges,278.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,278.5,50,,,percent of total billed charges,50% of total Billed charges,93.58,16.8,,,percent of total billed charges,16.8% of total billed charges,85.22,557,
SUTURE MERSILENE RS22 TAPE,491419,CDM,272,RC,,,Outpatient,,,282,183.30,,248.16,88,,,percent of total billed charges,88% of total Billed charges,141,50,,,percent of total billed charges,50% of total Billed charges,47.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,282,100,,,percent of total billed charges,100% of total billed charges,48.8,17.304,,,percent of total billed charges,17.304% of total billed charges,141,50,,,percent of total billed charges,50% of total Billed charges,177.66,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,47.38,16.8,,,percent of total billed charges,16.8% of total billed charges,43.15,15.3,,,percent of total billed charges,15.3% of total billed charges,194.58,69,,,percent of total billed charges,69% of total billed charges,282,100,,,percent of total billed charges,100% of total billed charges,141,50,,,percent of total billed charges,50% of total Billed charges,282,100,,,percent of total billed charges,100% of total billed charges,141,50,,,percent of total billed charges,50% of total Billed charges,282,100,,,percent of total billed charges,100% of total billed charges,141,50,,,percent of total billed charges,50% of total Billed charges,174.42,61.85,,,percent of total billed charges,61.85% of total billed charges,47.38,16.8,,,percent of total billed charges,16.8% of total billed charges,141,50,,,percent of total billed charges,50% of total Billed charges,141,50,,,percent of total billed charges,50% of total Billed charges,47.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,141,50,,,percent of total billed charges,50% of total Billed charges,141,50,,,percent of total billed charges,50% of total Billed charges,48.32,17.136,,,percent of total billed charges,17.136% of total billed charges,61.59,21.84,,,percent of total billed charges,21.84% of total billed charges,141,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,141,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,141,50,,,percent of total billed charges,50% of total Billed charges,219.96,78,,,percent of total billed charges,78% of total billed charges,282,100,,,percent of total billed charges,100% of total billed charges,232.93,82.6,,,percent of total billed charges,82.6% of total billed charges,232.93,82.6,,,percent of total billed charges,82.6% of total billed charges,47.38,16.8,,,percent of total billed charges,16.8% of total billed charges,141,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,141,50,,,percent of total billed charges,50% of total Billed charges,47.38,16.8,,,percent of total billed charges,16.8% of total billed charges,43.15,282,
SUTURE LASSO 90DEG,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SUTURE RETRIEVER HEWSON,ORSUP0016,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SUTURE EHTI-PACK DS18 WIRE,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SUTURE ETHIBOND MX69G 2 V-37,491402,CDM,272,RC,,,Outpatient,,,141,91.65,,124.08,88,,,percent of total billed charges,88% of total Billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,23.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,141,100,,,percent of total billed charges,100% of total billed charges,24.4,17.304,,,percent of total billed charges,17.304% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,88.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,23.69,16.8,,,percent of total billed charges,16.8% of total billed charges,21.57,15.3,,,percent of total billed charges,15.3% of total billed charges,97.29,69,,,percent of total billed charges,69% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,141,100,,,percent of total billed charges,100% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,141,100,,,percent of total billed charges,100% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,87.21,61.85,,,percent of total billed charges,61.85% of total billed charges,23.69,16.8,,,percent of total billed charges,16.8% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,23.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,24.16,17.136,,,percent of total billed charges,17.136% of total billed charges,30.79,21.84,,,percent of total billed charges,21.84% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,70.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,70.5,50,,,percent of total billed charges,50% of total Billed charges,109.98,78,,,percent of total billed charges,78% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,23.69,16.8,,,percent of total billed charges,16.8% of total billed charges,70.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,70.5,50,,,percent of total billed charges,50% of total Billed charges,23.69,16.8,,,percent of total billed charges,16.8% of total billed charges,21.57,141,
SUTURE ETHIBOND MB47G 5 CCS,491401,CDM,272,RC,,,Outpatient,,,176,114.40,,154.88,88,,,percent of total billed charges,88% of total Billed charges,88,50,,,percent of total billed charges,50% of total Billed charges,29.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,176,100,,,percent of total billed charges,100% of total billed charges,30.46,17.304,,,percent of total billed charges,17.304% of total billed charges,88,50,,,percent of total billed charges,50% of total Billed charges,110.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,29.57,16.8,,,percent of total billed charges,16.8% of total billed charges,26.93,15.3,,,percent of total billed charges,15.3% of total billed charges,121.44,69,,,percent of total billed charges,69% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,88,50,,,percent of total billed charges,50% of total Billed charges,176,100,,,percent of total billed charges,100% of total billed charges,88,50,,,percent of total billed charges,50% of total Billed charges,176,100,,,percent of total billed charges,100% of total billed charges,88,50,,,percent of total billed charges,50% of total Billed charges,108.86,61.85,,,percent of total billed charges,61.85% of total billed charges,29.57,16.8,,,percent of total billed charges,16.8% of total billed charges,88,50,,,percent of total billed charges,50% of total Billed charges,88,50,,,percent of total billed charges,50% of total Billed charges,29.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,88,50,,,percent of total billed charges,50% of total Billed charges,88,50,,,percent of total billed charges,50% of total Billed charges,30.16,17.136,,,percent of total billed charges,17.136% of total billed charges,38.44,21.84,,,percent of total billed charges,21.84% of total billed charges,88,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88,50,,,percent of total billed charges,50% of total Billed charges,137.28,78,,,percent of total billed charges,78% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,29.57,16.8,,,percent of total billed charges,16.8% of total billed charges,88,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,88,50,,,percent of total billed charges,50% of total Billed charges,29.57,16.8,,,percent of total billed charges,16.8% of total billed charges,26.93,176,
SUTURE ETHIBOND O CR/MO CX45D,491403,CDM,272,RC,,,Outpatient,,,112,72.80,,98.56,88,,,percent of total billed charges,88% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,19.38,17.304,,,percent of total billed charges,17.304% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,70.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,15.3,,,percent of total billed charges,15.3% of total billed charges,77.28,69,,,percent of total billed charges,69% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,112,100,,,percent of total billed charges,100% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,69.27,61.85,,,percent of total billed charges,61.85% of total billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,19.19,17.136,,,percent of total billed charges,17.136% of total billed charges,24.46,21.84,,,percent of total billed charges,21.84% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,87.36,78,,,percent of total billed charges,78% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,56,50,,,percent of total billed charges,50% of total Billed charges,18.82,16.8,,,percent of total billed charges,16.8% of total billed charges,17.14,112,
SUTURE ENDOSTITCH 2-0 VLOC 180,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SUTURE ENDOLOOP 0 VICRYL EJ10G,491393,CDM,272,RC,,,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,12.98,17.304,,,percent of total billed charges,17.304% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,47.25,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11.48,15.3,,,percent of total billed charges,15.3% of total billed charges,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,75,100,,,percent of total billed charges,100% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,46.39,61.85,,,percent of total billed charges,61.85% of total billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.85,17.136,,,percent of total billed charges,17.136% of total billed charges,16.38,21.84,,,percent of total billed charges,21.84% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,37.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37.5,50,,,percent of total billed charges,50% of total Billed charges,12.6,16.8,,,percent of total billed charges,16.8% of total billed charges,11.48,75,
SUTURE ENDOLOOP 0-PDS II,491395,CDM,272,RC,,,Outpatient,,,345,224.25,,303.6,88,,,percent of total billed charges,88% of total Billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,57.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,345,100,,,percent of total billed charges,100% of total billed charges,59.7,17.304,,,percent of total billed charges,17.304% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,217.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,57.96,16.8,,,percent of total billed charges,16.8% of total billed charges,52.79,15.3,,,percent of total billed charges,15.3% of total billed charges,238.05,69,,,percent of total billed charges,69% of total billed charges,345,100,,,percent of total billed charges,100% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,345,100,,,percent of total billed charges,100% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,345,100,,,percent of total billed charges,100% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,213.38,61.85,,,percent of total billed charges,61.85% of total billed charges,57.96,16.8,,,percent of total billed charges,16.8% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,57.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,59.12,17.136,,,percent of total billed charges,17.136% of total billed charges,75.35,21.84,,,percent of total billed charges,21.84% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,172.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,172.5,50,,,percent of total billed charges,50% of total Billed charges,269.1,78,,,percent of total billed charges,78% of total billed charges,345,100,,,percent of total billed charges,100% of total billed charges,284.97,82.6,,,percent of total billed charges,82.6% of total billed charges,284.97,82.6,,,percent of total billed charges,82.6% of total billed charges,57.96,16.8,,,percent of total billed charges,16.8% of total billed charges,172.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,172.5,50,,,percent of total billed charges,50% of total Billed charges,57.96,16.8,,,percent of total billed charges,16.8% of total billed charges,52.79,345,
SUTURE ANCHOR CORKSCREW II,ORSUP0012,CDM,278,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SUTURE CHROMIC GUT 5-0 1658G,491390,CDM,272,RC,,,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,9.69,17.304,,,percent of total billed charges,17.304% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,35.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,15.3,,,percent of total billed charges,15.3% of total billed charges,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,56,100,,,percent of total billed charges,100% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,9.6,17.136,,,percent of total billed charges,17.136% of total billed charges,12.23,21.84,,,percent of total billed charges,21.84% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,28,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28,50,,,percent of total billed charges,50% of total Billed charges,9.41,16.8,,,percent of total billed charges,16.8% of total billed charges,8.57,56,
SUTURE CHROMIC GUT 4-0 1637G,491388,CDM,272,RC,,,Outpatient,,,57,37.05,,50.16,88,,,percent of total billed charges,88% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,9.86,17.304,,,percent of total billed charges,17.304% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,35.91,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,8.72,15.3,,,percent of total billed charges,15.3% of total billed charges,39.33,69,,,percent of total billed charges,69% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,57,100,,,percent of total billed charges,100% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,35.25,61.85,,,percent of total billed charges,61.85% of total billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.77,17.136,,,percent of total billed charges,17.136% of total billed charges,12.45,21.84,,,percent of total billed charges,21.84% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,44.46,78,,,percent of total billed charges,78% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,28.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,28.5,50,,,percent of total billed charges,50% of total Billed charges,9.58,16.8,,,percent of total billed charges,16.8% of total billed charges,8.72,57,
SUTURE CHROMIC GUT 3-0 U204H,491386,CDM,272,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
SUTURE CHROMIC GUT 3-0 810H,491385,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE CHROMIC GUT 0 884H,491378,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE CHROMIC GUT 0-0 47T,491379,CDM,272,RC,,,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,8.48,17.304,,,percent of total billed charges,17.304% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,15.3,,,percent of total billed charges,15.3% of total billed charges,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,49,100,,,percent of total billed charges,100% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.4,17.136,,,percent of total billed charges,17.136% of total billed charges,10.7,21.84,,,percent of total billed charges,21.84% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,24.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24.5,50,,,percent of total billed charges,50% of total Billed charges,8.23,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,49,
SUTURE CHROMIC GUT 1-0 813H,491380,CDM,272,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
SUTURE PLAIN 6-0 1916G,491449,CDM,272,RC,,,Outpatient,,,60,39.00,,52.8,88,,,percent of total billed charges,88% of total Billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,10.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,60,100,,,percent of total billed charges,100% of total billed charges,10.38,17.304,,,percent of total billed charges,17.304% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,37.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.08,16.8,,,percent of total billed charges,16.8% of total billed charges,9.18,15.3,,,percent of total billed charges,15.3% of total billed charges,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,60,100,,,percent of total billed charges,100% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,60,100,,,percent of total billed charges,100% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,37.11,61.85,,,percent of total billed charges,61.85% of total billed charges,10.08,16.8,,,percent of total billed charges,16.8% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,10.08,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,10.28,17.136,,,percent of total billed charges,17.136% of total billed charges,13.1,21.84,,,percent of total billed charges,21.84% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30,50,,,percent of total billed charges,50% of total Billed charges,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,10.08,16.8,,,percent of total billed charges,16.8% of total billed charges,30,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30,50,,,percent of total billed charges,50% of total Billed charges,10.08,16.8,,,percent of total billed charges,16.8% of total billed charges,9.18,60,
SUTURE PDS 6-0 Z489G,491437,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUTURE ETHILON 6-0 697H,491411,CDM,272,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
SUTURE VICRYL 5-0 J490G,491516,CDM,272,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
SUTURE SURGILENE 5-0 3412-23,491488,CDM,272,RC,,,Outpatient,,,44,28.60,,38.72,88,,,percent of total billed charges,88% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,7.61,17.304,,,percent of total billed charges,17.304% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,15.3,,,percent of total billed charges,15.3% of total billed charges,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.21,61.85,,,percent of total billed charges,61.85% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.54,17.136,,,percent of total billed charges,17.136% of total billed charges,9.61,21.84,,,percent of total billed charges,21.84% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,44,
SUTURE SURGILENE 5-0 3420-23,491489,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
SUTURE PLAIN 5-0 1915G,491448,CDM,272,RC,,,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,10.56,17.304,,,percent of total billed charges,17.304% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,38.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,37.73,61.85,,,percent of total billed charges,61.85% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.45,17.136,,,percent of total billed charges,17.136% of total billed charges,13.32,21.84,,,percent of total billed charges,21.84% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,30.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,30.5,50,,,percent of total billed charges,50% of total Billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,61,
SUTURE ETHILON 5-0 661H,491408,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
SUTURE ETHILON 5-0 695G,491409,CDM,272,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
SUTURE VICRYL 4-0 J441H,491511,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
SUTURE VICRYL 4-0 J337H,491510,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
SUTURE STEEL 4-0 539G,491486,CDM,272,RC,,,Outpatient,,,65,42.25,,57.2,88,,,percent of total billed charges,88% of total Billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,10.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,100,,,percent of total billed charges,100% of total billed charges,11.25,17.304,,,percent of total billed charges,17.304% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,40.95,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.92,16.8,,,percent of total billed charges,16.8% of total billed charges,9.95,15.3,,,percent of total billed charges,15.3% of total billed charges,44.85,69,,,percent of total billed charges,69% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,65,100,,,percent of total billed charges,100% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,65,100,,,percent of total billed charges,100% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,40.2,61.85,,,percent of total billed charges,61.85% of total billed charges,10.92,16.8,,,percent of total billed charges,16.8% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,10.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,11.14,17.136,,,percent of total billed charges,17.136% of total billed charges,14.2,21.84,,,percent of total billed charges,21.84% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.5,50,,,percent of total billed charges,50% of total Billed charges,50.7,78,,,percent of total billed charges,78% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,10.92,16.8,,,percent of total billed charges,16.8% of total billed charges,32.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32.5,50,,,percent of total billed charges,50% of total Billed charges,10.92,16.8,,,percent of total billed charges,16.8% of total billed charges,9.95,65,
SUTURE SILK 4-0 SA83H,491483,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
SUTURE SILK 4-0 C014D,491481,CDM,272,RC,,,Outpatient,,,73,47.45,,64.24,88,,,percent of total billed charges,88% of total Billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,12.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,73,100,,,percent of total billed charges,100% of total billed charges,12.63,17.304,,,percent of total billed charges,17.304% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,45.99,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.26,16.8,,,percent of total billed charges,16.8% of total billed charges,11.17,15.3,,,percent of total billed charges,15.3% of total billed charges,50.37,69,,,percent of total billed charges,69% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,73,100,,,percent of total billed charges,100% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,73,100,,,percent of total billed charges,100% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,45.15,61.85,,,percent of total billed charges,61.85% of total billed charges,12.26,16.8,,,percent of total billed charges,16.8% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,12.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,12.51,17.136,,,percent of total billed charges,17.136% of total billed charges,15.94,21.84,,,percent of total billed charges,21.84% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,36.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36.5,50,,,percent of total billed charges,50% of total Billed charges,56.94,78,,,percent of total billed charges,78% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,12.26,16.8,,,percent of total billed charges,16.8% of total billed charges,36.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,36.5,50,,,percent of total billed charges,50% of total Billed charges,12.26,16.8,,,percent of total billed charges,16.8% of total billed charges,11.17,73,
SUTURE PLAIN 4-0 1828H,491447,CDM,272,RC,,,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,7.09,17.304,,,percent of total billed charges,17.304% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,15.3,,,percent of total billed charges,15.3% of total billed charges,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,25.36,61.85,,,percent of total billed charges,61.85% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,7.03,17.136,,,percent of total billed charges,17.136% of total billed charges,8.95,21.84,,,percent of total billed charges,21.84% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,20.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,20.5,50,,,percent of total billed charges,50% of total Billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,41,
SUTURE PDS 4-0 Z494G,491436,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
SUTURE CHROMIC GUT 4-0 1634G,491387,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
SUTURE CHROMIC GUT 4-0 654G,491389,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
SUTURE VICRYL 3-0 J285G,491502,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUTURE VICRYL 3-0 VR497,491507,CDM,272,RC,,,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.13,17.304,,,percent of total billed charges,17.304% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,8.05,17.136,,,percent of total billed charges,17.136% of total billed charges,10.26,21.84,,,percent of total billed charges,21.84% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,47,
SUTURE VICRYL 3-0 VR944,491508,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE VICRYL 3-0 J338H,491503,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SUTURE SURGILENE 3-0 3422-43,491487,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
SUTURE SILK 3-0 SA84H,491480,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
SUTURE SILK 3-0 1177-42,491478,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
SUTURE PLAIN 3-0 G322H,491446,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE PLAIN 3-0 873H,491445,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE ETHILON 3-0 1669H,491404,CDM,272,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
SUTURE ETHILON 3-0 1673H,491405,CDM,272,RC,,,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,8.31,17.304,,,percent of total billed charges,17.304% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,30.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,29.69,61.85,,,percent of total billed charges,61.85% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.23,17.136,,,percent of total billed charges,17.136% of total billed charges,10.48,21.84,,,percent of total billed charges,21.84% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,48,
SUTURE DEXON 3-0 9608-41,491391,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
SUTURE CHROMIC GUT 3-0 1638G,491384,CDM,272,RC,,,Outpatient,,,54,35.10,,47.52,88,,,percent of total billed charges,88% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,9.34,17.304,,,percent of total billed charges,17.304% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,34.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,15.3,,,percent of total billed charges,15.3% of total billed charges,37.26,69,,,percent of total billed charges,69% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,54,100,,,percent of total billed charges,100% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,33.4,61.85,,,percent of total billed charges,61.85% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,9.25,17.136,,,percent of total billed charges,17.136% of total billed charges,11.79,21.84,,,percent of total billed charges,21.84% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,42.12,78,,,percent of total billed charges,78% of total billed charges,54,100,,,percent of total billed charges,100% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,44.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,27,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27,50,,,percent of total billed charges,50% of total Billed charges,9.07,16.8,,,percent of total billed charges,16.8% of total billed charges,8.26,54,
SUTURE VICRYL 2-0 J286G,491496,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
SUTURE ENDOSTITCH 2-0,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SUTURE VICRYL 2-0 VR417,491499,CDM,272,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
SUTURE PDS 2-0 Z-997G,491435,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUTURE PDS 2-0 Z-333H,491434,CDM,272,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
SUTURE CHROMIC GUT 2-0 N-878H,491382,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
SUTURE CHROMIC GUT 2-0 U255H,491383,CDM,272,RC,,,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.88,17.304,,,percent of total billed charges,17.304% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.83,17.136,,,percent of total billed charges,17.136% of total billed charges,7.43,21.84,,,percent of total billed charges,21.84% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,34,
SUTURE ETHIBOND 2-0 X-519H,491400,CDM,272,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
SUTURE PDS 1-0 Z-347H,491432,CDM,272,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
SUTURE ETHIBOND 1-0 C-X30G,491399,CDM,272,RC,,,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,16.27,17.304,,,percent of total billed charges,17.304% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,59.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,58.14,61.85,,,percent of total billed charges,61.85% of total billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,16.11,17.136,,,percent of total billed charges,17.136% of total billed charges,20.53,21.84,,,percent of total billed charges,21.84% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,14.38,94,
SUTURE VICRYL 1-0 J741D,491495,CDM,272,RC,,,Outpatient,,,98,63.70,,86.24,88,,,percent of total billed charges,88% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,16.96,17.304,,,percent of total billed charges,17.304% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,61.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.99,15.3,,,percent of total billed charges,15.3% of total billed charges,67.62,69,,,percent of total billed charges,69% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,98,100,,,percent of total billed charges,100% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,60.61,61.85,,,percent of total billed charges,61.85% of total billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,16.79,17.136,,,percent of total billed charges,17.136% of total billed charges,21.4,21.84,,,percent of total billed charges,21.84% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,76.44,78,,,percent of total billed charges,78% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,49,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49,50,,,percent of total billed charges,50% of total Billed charges,16.46,16.8,,,percent of total billed charges,16.8% of total billed charges,14.99,98,
SUTURE VICRYL 1-0 J347H CT-1,491493,CDM,272,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
SUTURE PDS 1-0 Z-741D,491433,CDM,272,RC,,,Outpatient,,,161,104.65,,141.68,88,,,percent of total billed charges,88% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,27.86,17.304,,,percent of total billed charges,17.304% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,101.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,24.63,15.3,,,percent of total billed charges,15.3% of total billed charges,111.09,69,,,percent of total billed charges,69% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,161,100,,,percent of total billed charges,100% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,99.58,61.85,,,percent of total billed charges,61.85% of total billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.59,17.136,,,percent of total billed charges,17.136% of total billed charges,35.16,21.84,,,percent of total billed charges,21.84% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,125.58,78,,,percent of total billed charges,78% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,80.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,80.5,50,,,percent of total billed charges,50% of total Billed charges,27.05,16.8,,,percent of total billed charges,16.8% of total billed charges,24.63,161,
SUTURE VICRYL 0-0 J724D CR CTX,491491,CDM,272,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,8.65,17.304,,,percent of total billed charges,17.304% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,30.93,61.85,,,percent of total billed charges,61.85% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.57,17.136,,,percent of total billed charges,17.136% of total billed charges,10.92,21.84,,,percent of total billed charges,21.84% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,50,
SUTURE VICRYL 0-0 J334H CT-2,491490,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SUTURE VICRYL 0-0 J74OD,491492,CDM,272,RC,,,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,16.27,17.304,,,percent of total billed charges,17.304% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,59.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,94,100,,,percent of total billed charges,100% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,58.14,61.85,,,percent of total billed charges,61.85% of total billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,16.11,17.136,,,percent of total billed charges,17.136% of total billed charges,20.53,21.84,,,percent of total billed charges,21.84% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,47,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,47,50,,,percent of total billed charges,50% of total Billed charges,15.79,16.8,,,percent of total billed charges,16.8% of total billed charges,14.38,94,
SUTURE SILK 0-0 SA86G,491476,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
SUTURE PROLENE 0-0 8418H,491452,CDM,272,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
SUTURE PLAIN 0 L-104G,491444,CDM,272,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
SUTURE MAXON 0 6319-62,491416,CDM,272,RC,,,Outpatient,,,53,34.45,,46.64,88,,,percent of total billed charges,88% of total Billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,53,100,,,percent of total billed charges,100% of total billed charges,9.17,17.304,,,percent of total billed charges,17.304% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,33.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,8.11,15.3,,,percent of total billed charges,15.3% of total billed charges,36.57,69,,,percent of total billed charges,69% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,53,100,,,percent of total billed charges,100% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,53,100,,,percent of total billed charges,100% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,32.78,61.85,,,percent of total billed charges,61.85% of total billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,9.08,17.136,,,percent of total billed charges,17.136% of total billed charges,11.58,21.84,,,percent of total billed charges,21.84% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.5,50,,,percent of total billed charges,50% of total Billed charges,41.34,78,,,percent of total billed charges,78% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,26.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.5,50,,,percent of total billed charges,50% of total Billed charges,8.9,16.8,,,percent of total billed charges,16.8% of total billed charges,8.11,53,
SUTURE ETHIBOND 0 EC11,491398,CDM,272,RC,,,Outpatient,,,1918,1246.70,,1687.84,88,,,percent of total billed charges,88% of total Billed charges,959,50,,,percent of total billed charges,50% of total Billed charges,322.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,1918,100,,,percent of total billed charges,100% of total billed charges,331.89,17.304,,,percent of total billed charges,17.304% of total billed charges,959,50,,,percent of total billed charges,50% of total Billed charges,1208.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,322.22,16.8,,,percent of total billed charges,16.8% of total billed charges,293.45,15.3,,,percent of total billed charges,15.3% of total billed charges,1323.42,69,,,percent of total billed charges,69% of total billed charges,1918,100,,,percent of total billed charges,100% of total billed charges,959,50,,,percent of total billed charges,50% of total Billed charges,1918,100,,,percent of total billed charges,100% of total billed charges,959,50,,,percent of total billed charges,50% of total Billed charges,1918,100,,,percent of total billed charges,100% of total billed charges,959,50,,,percent of total billed charges,50% of total Billed charges,1186.28,61.85,,,percent of total billed charges,61.85% of total billed charges,322.22,16.8,,,percent of total billed charges,16.8% of total billed charges,959,50,,,percent of total billed charges,50% of total Billed charges,959,50,,,percent of total billed charges,50% of total Billed charges,322.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,959,50,,,percent of total billed charges,50% of total Billed charges,959,50,,,percent of total billed charges,50% of total Billed charges,328.67,17.136,,,percent of total billed charges,17.136% of total billed charges,418.89,21.84,,,percent of total billed charges,21.84% of total billed charges,959,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,959,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,959,50,,,percent of total billed charges,50% of total Billed charges,1496.04,78,,,percent of total billed charges,78% of total billed charges,1918,100,,,percent of total billed charges,100% of total billed charges,1584.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1584.27,82.6,,,percent of total billed charges,82.6% of total billed charges,322.22,16.8,,,percent of total billed charges,16.8% of total billed charges,959,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,959,50,,,percent of total billed charges,50% of total Billed charges,322.22,16.8,,,percent of total billed charges,16.8% of total billed charges,293.45,1918,
SUTURE CHROMIC GUT 0 812H,491377,CDM,272,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
ETHILON 5-0 PC-3 (1965G),490542,CDM,270,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
ETHILON 6-0 PC-1 (1856G),490545,CDM,270,RC,,,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.4,17.304,,,percent of total billed charges,17.304% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,23.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.34,17.136,,,percent of total billed charges,17.136% of total billed charges,8.08,21.84,,,percent of total billed charges,21.84% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,37,
ETHILON 8-0 BV130-5 (2808G),490546,CDM,270,RC,,,Outpatient,,,127,82.55,,111.76,88,,,percent of total billed charges,88% of total Billed charges,63.5,50,,,percent of total billed charges,50% of total Billed charges,21.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,127,100,,,percent of total billed charges,100% of total billed charges,21.98,17.304,,,percent of total billed charges,17.304% of total billed charges,63.5,50,,,percent of total billed charges,50% of total Billed charges,80.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.34,16.8,,,percent of total billed charges,16.8% of total billed charges,19.43,15.3,,,percent of total billed charges,15.3% of total billed charges,87.63,69,,,percent of total billed charges,69% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,63.5,50,,,percent of total billed charges,50% of total Billed charges,127,100,,,percent of total billed charges,100% of total billed charges,63.5,50,,,percent of total billed charges,50% of total Billed charges,127,100,,,percent of total billed charges,100% of total billed charges,63.5,50,,,percent of total billed charges,50% of total Billed charges,78.55,61.85,,,percent of total billed charges,61.85% of total billed charges,21.34,16.8,,,percent of total billed charges,16.8% of total billed charges,63.5,50,,,percent of total billed charges,50% of total Billed charges,63.5,50,,,percent of total billed charges,50% of total Billed charges,21.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,63.5,50,,,percent of total billed charges,50% of total Billed charges,63.5,50,,,percent of total billed charges,50% of total Billed charges,21.76,17.136,,,percent of total billed charges,17.136% of total billed charges,27.74,21.84,,,percent of total billed charges,21.84% of total billed charges,63.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,63.5,50,,,percent of total billed charges,50% of total Billed charges,99.06,78,,,percent of total billed charges,78% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,21.34,16.8,,,percent of total billed charges,16.8% of total billed charges,63.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,63.5,50,,,percent of total billed charges,50% of total Billed charges,21.34,16.8,,,percent of total billed charges,16.8% of total billed charges,19.43,127,
SUTURE VICRYL 2-0 J581G,491497,CDM,272,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
VICRYL 1 CT-2 (J335H),491676,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
VICRYL UNDYED 0 CT-2 (J270H),491686,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
SUTURE LASSO 45 DEGREE CV RT,ORSUP0013,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
SUTURE PROLENE BLACK CT-2 NEEDLE SIZE 0 8-18,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUTURE VLOC PBT 0 BLU 9 GS-22,ORSUP0005,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
ORSUP0007,ORSUP0007,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SUTURE VLOC 180 2-0 GR 6 GS-21,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SUTURE 6-0 18 CTD VIC UND BR PC,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SUTURE STRATAFIX SPIRAL MONOCRYL + 2-0 CT-2,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SUTURE STRATAFIX SYNNETRIC PDS + SZ0 18IN CTX,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SUTURE STRATAFIX SPIRAL MONOCRYL PLUS CT-1 2-0 27IN,ORSUP0004,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SUTURE VIOLET COATED VICRYL 4-0 P-3,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SUTURE VICRYL SZ 0 D-SPECIAL C-T2 NDL,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SUTURE PROLENE BLUE BV-1 NDL SZ 7-0,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUTURE V-LOC 180 ABSORBABLE VIOLET SZ 3-0 9IN V-20 NDLE,ORSUP0006,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SUTURE V-LOC 180 ABSORBABLE VIOLET SZ 3 6IN V-20 NDLE,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SUTURE ABSOBABLE CT-2 2-0 VIOLET 26MM CT-2,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SUTURE TAPER POINT REVERSE CUTTING 3-0 CT-1,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SUTURE UNDYED VICRYL O CTX 8-18IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUTURE 4-0 ETHILON 1611G,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SUTURE 0 PROLENE BLUE 8690H,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUTURE 0 VICRYL ENDOKNOT D9920,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SUTURE 2-0 STRATAFIX SPIRAL CT-1,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
SUTURE 4-0 STRATAFIX  MONOCRYL PS-2,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
SUTURE CT-1 STRATAFIX PDS PLUS 0,ORSUP0006,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SUTURE V-LOC 180 SZ 2 GRN,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SUTURE V-LOC 90 SZ 2 VIOLET,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SUTURE V-LOC SZ 2 BLUE NONABSORBABLE,ORSUP0006,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
SUTURE TRI-CRON WHITE SZ 0 CV-305,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
SUTURE V-LOC PBT NONABSORBABLE BLUE SZ0,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SUTURE ANCHOR PEEK 3MMX12.4MM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SUTURE ANCHOR CORKSCREW 4.5X14MM,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
SUTURE PS-3 NONABSORBABLE 1668H,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUTURE STRATAFIX TAPER POINT SXPP1A435,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
SUTURE TRAY DISPOSABLE,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
SUTURE NONABSORBABLE V-LOC SZ 2 GS-22 NEEDLE,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
SUTURE VLOC ABSORBABLE P-14 SZ 3-0,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
SUTURE VICRYL COATED UNDYED SZ 2/0 54,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUTURE VICRYL COATED PS-2 SZ 5-0,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUTURE V-LOV UNDYEDSZ PS-12 SZ 3-0,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
SUTURE REMOVAL TRAY,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SUTURE MONOCRYL PLUS P-3 UNDYED SIZE 4-0 18,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SWABSTICK POVIDONE PREP SWAB,12071,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SWABSTICK CHLORAPREP TRIPLE APPLICATOR 5.25ML,231194,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
SWAB POVIDONE IODINE 10% PREP .65CC AMPULES,166244,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SWAB PROCTO 16IN X 1 1/2IN STERILE 2/PK,147097,CDM,272,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
SWABSTICK CHLORASCRUB 1.6ML,176704,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SWAB BACTI NPG,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SWAG BOGYN RAYON TIP STERILE 8,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SWAN GANZ CCO/SVO2,ORSUP0013,CDM,278,RC,C1725,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SWIVELOCK TENODESIS BIOCOMPOSITE 8MM,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
"SWIVELOCK TENODESIS BIOCOMPOSITE, 8MM",ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
SWIVEL BALLARD SX14F,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
SWIVELOCK 4.75 PEEK W/ FIBERTAPE,ORSUP0052,CDM,272,RC,,,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6715.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
SWVLK TENO BIO -COMP 7X19.1MM,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
SYNDESMOSIS REPAIR IMPLANT KNOTLESS TIGHTROPE ST STEEL,ORSUP0029,CDM,278,RC,C1713,HCPCS,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1460.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1586.52,33.9,,,percent of total billed charges,33.9% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
SYNTHETIC CAST PADDING NS 6,491521,CDM,270,RC,,,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,3.46,17.304,,,percent of total billed charges,17.304% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,20,100,,,percent of total billed charges,100% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,3.43,17.136,,,percent of total billed charges,17.136% of total billed charges,4.37,21.84,,,percent of total billed charges,21.84% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,10,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10,50,,,percent of total billed charges,50% of total Billed charges,3.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3.06,20,
SYRINGE SALINE FLUSH 10ML,310300,CDM,272,RC,,,Outpatient,,,498,323.70,,438.24,88,,,percent of total billed charges,88% of total Billed charges,249,50,,,percent of total billed charges,50% of total Billed charges,83.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,498,100,,,percent of total billed charges,100% of total billed charges,86.17,17.304,,,percent of total billed charges,17.304% of total billed charges,249,50,,,percent of total billed charges,50% of total Billed charges,313.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,83.66,16.8,,,percent of total billed charges,16.8% of total billed charges,76.19,15.3,,,percent of total billed charges,15.3% of total billed charges,343.62,69,,,percent of total billed charges,69% of total billed charges,498,100,,,percent of total billed charges,100% of total billed charges,249,50,,,percent of total billed charges,50% of total Billed charges,498,100,,,percent of total billed charges,100% of total billed charges,249,50,,,percent of total billed charges,50% of total Billed charges,498,100,,,percent of total billed charges,100% of total billed charges,249,50,,,percent of total billed charges,50% of total Billed charges,308.01,61.85,,,percent of total billed charges,61.85% of total billed charges,83.66,16.8,,,percent of total billed charges,16.8% of total billed charges,249,50,,,percent of total billed charges,50% of total Billed charges,249,50,,,percent of total billed charges,50% of total Billed charges,83.66,16.8,,,percent of total billed charges,16.8% of total Billed charges,249,50,,,percent of total billed charges,50% of total Billed charges,249,50,,,percent of total billed charges,50% of total Billed charges,85.34,17.136,,,percent of total billed charges,17.136% of total billed charges,108.76,21.84,,,percent of total billed charges,21.84% of total billed charges,249,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,249,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,249,50,,,percent of total billed charges,50% of total Billed charges,388.44,78,,,percent of total billed charges,78% of total billed charges,498,100,,,percent of total billed charges,100% of total billed charges,411.35,82.6,,,percent of total billed charges,82.6% of total billed charges,411.35,82.6,,,percent of total billed charges,82.6% of total billed charges,83.66,16.8,,,percent of total billed charges,16.8% of total billed charges,249,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,249,50,,,percent of total billed charges,50% of total Billed charges,83.66,16.8,,,percent of total billed charges,16.8% of total billed charges,76.19,498,
SYRINGE 1CC LUER TIP W/O NDL,186393,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE TOOMY 60CC,186504,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SYRINGE ONLY SLIP TIP 20CC,147154,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE 10CC LUER SLIP NO NEEDLE,157799,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE LUER LOK 60ML,12349,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SYRINGE ONLY LUER LOK 20CC,169956,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE 3CC 23X1 SAFETY,10475,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SYRINGE 3CC W/SAFETY GLIDE NEEDLE 25G X 5/8IN,169938,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SYRINGE ONLY LUER LOK CONTROL,157840,CDM,272,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
SYRINGE BULB-IRRIGATION,81466,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SYRINGE 3CC W/SAFETY GLIDE NEEDLE 22G X 1 1/2IN,147112,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SYRINGE 1CC TUBERCULIN SAFETY GLIDE 27GX1/2IN NDL,147109,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SYRINGE CATH 60CC TIP 2 OZ,122872,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
SYRINGE 1CC LL W/O NDL,67357,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SYRINGE ORAL 10ML. CLEAR,119777,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE 5ML LL SYRINGE ONLY,312502,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE 5CC LL LAB/NUC/PHARM,180426,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE 10ML MEDICAL LUER SLIP LOR,394223,CDM,272,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
SYRINGE EAR/ULCER STRL 2 OZ(41814670),61304,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SYRINGE LUER TIP CAP SUB#358381682101,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SYRINGE 10ML SLIP TIP,457924,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE 1ML LUER SLIP,320289,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE 20ML LL NO NDL,409460,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SYRINGE 20ML LS NO NDL,409463,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SYRINGE 30ML LL NO NDL,409461,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SYRINGE 3CC KIT BLOOD GAS 23G,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SYRINGE 10CC L-L NO NDL CS/2,456870,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE ANGIO MANUAL INJ 10ML ROTATING ADPT,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
SYRINGE  TOOMEY 70CC,491526,CDM,272,RC,,,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.5,17.304,,,percent of total billed charges,17.304% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.08,61.85,,,percent of total billed charges,61.85% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.46,17.136,,,percent of total billed charges,17.136% of total billed charges,5.68,21.84,,,percent of total billed charges,21.84% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,26,
SYRINGE TOOMEY 60CC,491541,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SYRINGE 60CC CATH TIP,491533,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
SYRINGE RING PLUNGER 20CC,491539,CDM,272,RC,,,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
SYRINGE RING PLUNGER 10CC,491538,CDM,272,RC,,,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,8.31,17.304,,,percent of total billed charges,17.304% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,30.24,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,15.3,,,percent of total billed charges,15.3% of total billed charges,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,48,100,,,percent of total billed charges,100% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,29.69,61.85,,,percent of total billed charges,61.85% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,8.23,17.136,,,percent of total billed charges,17.136% of total billed charges,10.48,21.84,,,percent of total billed charges,21.84% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,24,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,24,50,,,percent of total billed charges,50% of total Billed charges,8.06,16.8,,,percent of total billed charges,16.8% of total billed charges,7.34,48,
SYRINGE ASEPTO,491535,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
SYRINGE 10ML,491527,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE 20ML,491529,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SYRINGE 30ML,491530,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
SYRINGE 3ML,491531,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
SYRINGE 5ML,491532,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
SYRINGE 60ML,491534,CDM,272,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
SYRINGE TB W/O NEEDLE,491540,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
SYRINGE CONTROL 10CC,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SYRINGE 20ML STERILE LUER LOCK,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SYRINGE MONOJECT 1ML LUER LOCK,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SYRINGE MONOJECT 1ML LUER LOCK ORANGE CAP TIP,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SYRINGE SLIP TIP STERILE 1ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
"SYRINGE, PRO-VENT 3ML LITHIUM HEPARIN",ORSUP0001,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
SYRINGE SURE-SNAP SAFTEY 27G X 1.25,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
SYSTEM BONE MARROW ASPIRATION  W/ 11 GUAGE/15CM NEEDLE,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
SYSTEM CEMENT COMPACT VACUUM MIXING,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SYSTEM CSF DRAINAGE EXTERNAL,ORSUP0013,CDM,278,RC,C1729,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
SYSTEM EMBOSHIELD 7.2MM X 4-7MM,ORSUP0043,CDM,278,RC,C1884,HCPCS,Outpatient,,,8320,5408.00,,7321.6,88,,,percent of total billed charges,88% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1439.69,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5241.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,15.3,,,percent of total billed charges,15.3% of total billed charges,5740.8,69,,,percent of total billed charges,69% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5145.92,61.85,,,percent of total billed charges,61.85% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2595.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1425.72,17.136,,,percent of total billed charges,17.136% of total billed charges,1817.09,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2820.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,6489.6,78,,,percent of total billed charges,78% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,8320,
SYSTEM FLTR REMOV RECOV CONE VENA CAVA,ORSUP0031,CDM,278,RC,C1880,HCPCS,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1622.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
SYSTEM PROLENE 4 MESH HERNIA MEDIUM,ORSUP0018,CDM,278,RC,C1781,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
SYSTEM PROLENE POLY LARGE HERNIA,ORSUP0018,CDM,278,RC,C1781,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
SYSTEM VERTE-STACK SPINAL  END CAP 6MM X 14MM X 11MM,ORSUP0032,CDM,278,RC,C1755,HCPCS,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1703.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1850.94,33.9,,,percent of total billed charges,33.9% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
SYSTEM ROTALINK PLUS 1.5,ORSUP0036,CDM,278,RC,,,Outpatient,,,6500,4225.00,,5720,88,,,percent of total billed charges,88% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1124.76,17.304,,,percent of total billed charges,17.304% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4095,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,15.3,,,percent of total billed charges,15.3% of total billed charges,4485,69,,,percent of total billed charges,69% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,4020.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2028,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3250,50,,,percent of total billed charges,50% of total Billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,1113.84,17.136,,,percent of total billed charges,17.136% of total billed charges,1419.6,21.84,,,percent of total billed charges,21.84% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2450.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,5070,78,,,percent of total billed charges,78% of total billed charges,6500,100,,,percent of total billed charges,100% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,5369,82.6,,,percent of total billed charges,82.6% of total billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,3250,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3250,50,,,percent of total billed charges,50% of total Billed charges,1092,16.8,,,percent of total billed charges,16.8% of total billed charges,994.5,6500,
SYSTEM PAIN PUMP SOAKER CATH EXPANSION 5IN,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
SYSTEM HEARTSTRINGS III PROXIMAL  4.3MM,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
SYSTEM SPY SCOPE ACCESS AND DELIVERY,ORSUP0029,CDM,272,RC,,,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
SYSTEM 3 DOSE COMPACT MIXING,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
SYSTEM AERO AIRWAY STENT,ORSUP0050,CDM,278,RC,,,Outpatient,,,10140,6591.00,,8923.2,88,,,percent of total billed charges,88% of total Billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,1703.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1754.63,17.304,,,percent of total billed charges,17.304% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,6388.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1703.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1551.42,15.3,,,percent of total billed charges,15.3% of total billed charges,6996.6,69,,,percent of total billed charges,69% of total billed charges,10140,100,,,percent of total billed charges,100% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,10140,100,,,percent of total billed charges,100% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,10140,100,,,percent of total billed charges,100% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,6271.59,61.85,,,percent of total billed charges,61.85% of total billed charges,1703.52,16.8,,,percent of total billed charges,16.8% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,3163.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5070,50,,,percent of total billed charges,50% of total Billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,1737.59,17.136,,,percent of total billed charges,17.136% of total billed charges,2214.58,21.84,,,percent of total billed charges,21.84% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,3822.78,37.7,,,percent of total billed charges,37.70% of total billed charges,3822.78,37.7,,,percent of total billed charges,37.70% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,3437.46,33.9,,,percent of total billed charges,33.9% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,7909.2,78,,,percent of total billed charges,78% of total billed charges,10140,100,,,percent of total billed charges,100% of total billed charges,8375.64,82.6,,,percent of total billed charges,82.6% of total billed charges,8375.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1703.52,16.8,,,percent of total billed charges,16.8% of total billed charges,5070,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5070,50,,,percent of total billed charges,50% of total Billed charges,1703.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1551.42,10140,
SYSTEM SINUS ILLUMINATION SIS-100A,ORSUP0052,CDM,272,RC,,,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6715.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
SYSTEM SINUS ILLUMINATION SIS-100B,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
CATH SUPRAPUBIC BALLOON 12FR,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
SYSTEM REPAIR BICEPS DISTAL,ORSUP0018,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
Stnt NO-COA/COV W/02,CATH00072,CDM,278,RC,C1877,HCPCS,Outpatient,,,78260,50869.00,,68868.8,88,,,percent of total billed charges,88% of total Billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,13147.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,13542.11,17.304,,,percent of total billed charges,17.304% of total billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,49303.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13147.68,16.8,,,percent of total billed charges,16.8% of total billed charges,11973.78,15.3,,,percent of total billed charges,15.3% of total billed charges,53999.4,69,,,percent of total billed charges,69% of total billed charges,78260,100,,,percent of total billed charges,100% of total billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,78260,100,,,percent of total billed charges,100% of total billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,78260,100,,,percent of total billed charges,100% of total billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,48403.81,61.85,,,percent of total billed charges,61.85% of total billed charges,13147.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,24417.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39130,50,,,percent of total billed charges,50% of total Billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,13410.63,17.136,,,percent of total billed charges,17.136% of total billed charges,17091.98,21.84,,,percent of total billed charges,21.84% of total billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,29504.02,37.7,,,percent of total billed charges,37.70% of total billed charges,29504.02,37.7,,,percent of total billed charges,37.70% of total billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,26530.14,33.9,,,percent of total billed charges,33.9% of total billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,61042.8,78,,,percent of total billed charges,78% of total billed charges,78260,100,,,percent of total billed charges,100% of total billed charges,64642.76,82.6,,,percent of total billed charges,82.6% of total billed charges,64642.76,82.6,,,percent of total billed charges,82.6% of total billed charges,13147.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39130,50,,,percent of total billed charges,50% of total Billed charges,13147.68,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,78260,
T-PIECE NEONATAL CURCUIT,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
T-TUBE 3 FRENCH,ORSUP0025,CDM,272,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
TACHOSIL FIBRIN SEALANT PATCH,ORSUP0019,CDM,270,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
TACHOSIL PATCH 4.8CM X 4.8CM,ORSUP0021,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
TACKY MATS BLUE 34X18,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
TACTILE BASELINE MONOFILAMENT DISPOSABLE 10G,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
TAG HUGS,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
TAGS VENDOR TEAL GREEN,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
TAMP INFLAT KYPHX EXACT 15X3.0MM,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
TAMPER EVIDENT SEAL,491544,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
TAP CANN 4.0MM 147MM,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
TAPE GLOW AND TELL,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
TAPE TRANSPORE 2IN,185034,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
TAPE TRANSPORE 1IN,185033,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
TAPE MICROPORE 2IN,185038,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
TAPE MICROPORE 1/2IN,13922,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
TAPE MICROPORE 1IN,185037,CDM,270,RC,,,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,10.04,17.304,,,percent of total billed charges,17.304% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,36.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.94,17.136,,,percent of total billed charges,17.136% of total billed charges,12.67,21.84,,,percent of total billed charges,21.84% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,58,
TAPE MICROFOAM 3IN,185036,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TAPE SURGICAL DURAPORE 2 INCH,185040,CDM,270,RC,,,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,90,100,,,percent of total billed charges,100% of total billed charges,15.57,17.304,,,percent of total billed charges,17.304% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,56.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,90,100,,,percent of total billed charges,100% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,90,100,,,percent of total billed charges,100% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,55.67,61.85,,,percent of total billed charges,61.85% of total billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,15.42,17.136,,,percent of total billed charges,17.136% of total billed charges,19.66,21.84,,,percent of total billed charges,21.84% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45,50,,,percent of total billed charges,50% of total Billed charges,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45,50,,,percent of total billed charges,50% of total Billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,13.77,90,
TAPE ADHESIVE 3IN,185635,CDM,270,RC,,,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,10.73,17.304,,,percent of total billed charges,17.304% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,39.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,9.49,15.3,,,percent of total billed charges,15.3% of total billed charges,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,38.35,61.85,,,percent of total billed charges,61.85% of total billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.62,17.136,,,percent of total billed charges,17.136% of total billed charges,13.54,21.84,,,percent of total billed charges,21.84% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,9.49,62,
TAPE STERRAD SEALSURE,317198,CDM,270,RC,,,Outpatient,,,78,50.70,,68.64,88,,,percent of total billed charges,88% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,13.5,17.304,,,percent of total billed charges,17.304% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,49.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,15.3,,,percent of total billed charges,15.3% of total billed charges,53.82,69,,,percent of total billed charges,69% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,78,100,,,percent of total billed charges,100% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,48.24,61.85,,,percent of total billed charges,61.85% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,13.37,17.136,,,percent of total billed charges,17.136% of total billed charges,17.04,21.84,,,percent of total billed charges,21.84% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,60.84,78,,,percent of total billed charges,78% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,39,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,39,50,,,percent of total billed charges,50% of total Billed charges,13.1,16.8,,,percent of total billed charges,16.8% of total billed charges,11.93,78,
TAPE SURGICAL DURAPORE 1 INCH,11490,CDM,270,RC,,,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,90,100,,,percent of total billed charges,100% of total billed charges,15.57,17.304,,,percent of total billed charges,17.304% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,56.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,90,100,,,percent of total billed charges,100% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,90,100,,,percent of total billed charges,100% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,55.67,61.85,,,percent of total billed charges,61.85% of total billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,15.42,17.136,,,percent of total billed charges,17.136% of total billed charges,19.66,21.84,,,percent of total billed charges,21.84% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45,50,,,percent of total billed charges,50% of total Billed charges,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45,50,,,percent of total billed charges,50% of total Billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,13.77,90,
TAPE TRANSPORE 1/2 INCH,9954,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
TAPE SURG MEDIPORE 2IN X 10YD,166425,CDM,270,RC,,,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
TAPE MEDIPORE 1 IN SOFT CLOTH,139642,CDM,270,RC,,,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,5.36,17.304,,,percent of total billed charges,17.304% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,31,100,,,percent of total billed charges,100% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.31,17.136,,,percent of total billed charges,17.136% of total billed charges,6.77,21.84,,,percent of total billed charges,21.84% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,15.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15.5,50,,,percent of total billed charges,50% of total Billed charges,5.21,16.8,,,percent of total billed charges,16.8% of total billed charges,4.74,31,
TAPE SURGICAL DURAPORE 3,166430,CDM,270,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
TAPE BLENDERM 1X5YDS,58965,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
TAPE HEPARIN ANESTHESIA 1/2,446806,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
TAPE HY-TAPE 1/2 LATEX FREE,42089,CDM,270,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
TAPE HY-TAPE 1X5 LATEX FREE,45393,CDM,270,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
TAPE MEASURE PAPER 72 IN,310363,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
TAPE MICROPORE 3'',491550,CDM,270,RC,,,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,10.04,17.304,,,percent of total billed charges,17.304% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,36.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,15.3,,,percent of total billed charges,15.3% of total billed charges,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,58,100,,,percent of total billed charges,100% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,9.94,17.136,,,percent of total billed charges,17.136% of total billed charges,12.67,21.84,,,percent of total billed charges,21.84% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,29,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29,50,,,percent of total billed charges,50% of total Billed charges,9.74,16.8,,,percent of total billed charges,16.8% of total billed charges,8.87,58,
TAPE MICROFOAM 2'',491549,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
TAPE MEDIPORE SOFT CLOTH 4'',491548,CDM,270,RC,,,Outpatient,,,64,41.60,,56.32,88,,,percent of total billed charges,88% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,11.07,17.304,,,percent of total billed charges,17.304% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,40.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,9.79,15.3,,,percent of total billed charges,15.3% of total billed charges,44.16,69,,,percent of total billed charges,69% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,39.58,61.85,,,percent of total billed charges,61.85% of total billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.97,17.136,,,percent of total billed charges,17.136% of total billed charges,13.98,21.84,,,percent of total billed charges,21.84% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,49.92,78,,,percent of total billed charges,78% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,9.79,64,
TAPE MEDIPORE 2'' SKIN SENSITIV,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TAPE ELASTOCON 3'',491546,CDM,270,RC,,,Outpatient,,,153,99.45,,134.64,88,,,percent of total billed charges,88% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,153,100,,,percent of total billed charges,100% of total billed charges,26.48,17.304,,,percent of total billed charges,17.304% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,96.39,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,23.41,15.3,,,percent of total billed charges,15.3% of total billed charges,105.57,69,,,percent of total billed charges,69% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,153,100,,,percent of total billed charges,100% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,94.63,61.85,,,percent of total billed charges,61.85% of total billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,26.22,17.136,,,percent of total billed charges,17.136% of total billed charges,33.42,21.84,,,percent of total billed charges,21.84% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.5,50,,,percent of total billed charges,50% of total Billed charges,119.34,78,,,percent of total billed charges,78% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,76.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,76.5,50,,,percent of total billed charges,50% of total Billed charges,25.7,16.8,,,percent of total billed charges,16.8% of total billed charges,23.41,153,
TAPE ADHESIVE POUROUS 1''X10YDS,491545,CDM,270,RC,,,Outpatient,,,76,49.40,,66.88,88,,,percent of total billed charges,88% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,13.15,17.304,,,percent of total billed charges,17.304% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,47.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,11.63,15.3,,,percent of total billed charges,15.3% of total billed charges,52.44,69,,,percent of total billed charges,69% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,76,100,,,percent of total billed charges,100% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,47.01,61.85,,,percent of total billed charges,61.85% of total billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,13.02,17.136,,,percent of total billed charges,17.136% of total billed charges,16.6,21.84,,,percent of total billed charges,21.84% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,59.28,78,,,percent of total billed charges,78% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,38,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,38,50,,,percent of total billed charges,50% of total Billed charges,12.77,16.8,,,percent of total billed charges,16.8% of total billed charges,11.63,76,
TAPE KINESIO CLASSIC BLACK 2IN X 16.4IN BX OF 6,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TAPE MICROFOAM 1 INCH,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TAPE STEAM INDICATOR LEAD FREE  GREEN,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TAPERED W/ VENTS PURPLE 1.5,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TAPERED W/ VENTS GREEN 2,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TAXO P 5.0,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TB AURAMINE RHODAMINE  6/PK,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
FIXATION RING AND CONTACT SOLUTION SET FOR TCPO2/CO2,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TDM PERF VERIFIER I BX/6 BTLS,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TDM PERF VERIFIER II BX/6 BTLS,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TDM PERF VERIFIER III BX/6 BTLS,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TECHNOWIPES LINT FREE WIPE,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TED HOSE STOCKING KNEE HIGH REG. MEDIUM,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TED HOSE STOCKING KNEE HIGH LONG SMALL,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TED HOSE STOCKING KNEE HIGH LONG MEDIUM,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TED HOSE STOCKING KNEE HIGH REGULAR 2XL,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING KNEE HIGH LONG 2XL,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TED HOSE STOCKING KNEE HIGH REGULAR 3XL,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING KNEE HIGH LONG 3XL,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TED HOSE STOCKING THIGH HIGH SHORT SMALL,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH SHORT MED,ORSUP0001,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH SHORT LG,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH REGULAR SMALL,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH REGULAR MED,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH REGULAR LG,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH REGULAR XL,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH REGULAR X2XL,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH LONG SMALL,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH LONG MED,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH LONG LG,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH LONG XL,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING THIGH HIGH LONG 2XL,ORSUP0002,CDM,270,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TED HOSE STOCKING KNEE HIGH LG LONG,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TED HOSE STOCKING KNEE HIGH XL LONG,ORSUP0001,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TEMNO ELITE BIOSPY SYSTEM 18X10,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
TEMNO ELITE BIOSPY SYSTEM 18X15,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
TEMNO ELITE BIOSPY SYSTEM 18X20,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
TEMNO ELITE BIOSPY SYSTEM 20X10,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
TEMNO ELITE BIOSPY SYSTEM 20X15,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
TEMNO ELITE BIOSPY SYSTEM 20X20,ORSUP0017,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
"TEMPERATURE PROBE, RIGHT ANGLE 850",ORSUP0012,CDM,272,RC,,,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,121.13,17.304,,,percent of total billed charges,17.304% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,441,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,15.3,,,percent of total billed charges,15.3% of total billed charges,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,700,100,,,percent of total billed charges,100% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,119.95,17.136,,,percent of total billed charges,17.136% of total billed charges,152.88,21.84,,,percent of total billed charges,21.84% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,350,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,350,50,,,percent of total billed charges,50% of total Billed charges,117.6,16.8,,,percent of total billed charges,16.8% of total billed charges,107.1,700,
TEST STRIP CIDEX OPA SOLUTION 60 STRIP/BT,166476,CDM,270,RC,,,Outpatient,,,291,189.15,,256.08,88,,,percent of total billed charges,88% of total Billed charges,145.5,50,,,percent of total billed charges,50% of total Billed charges,48.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,291,100,,,percent of total billed charges,100% of total billed charges,50.35,17.304,,,percent of total billed charges,17.304% of total billed charges,145.5,50,,,percent of total billed charges,50% of total Billed charges,183.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,48.89,16.8,,,percent of total billed charges,16.8% of total billed charges,44.52,15.3,,,percent of total billed charges,15.3% of total billed charges,200.79,69,,,percent of total billed charges,69% of total billed charges,291,100,,,percent of total billed charges,100% of total billed charges,145.5,50,,,percent of total billed charges,50% of total Billed charges,291,100,,,percent of total billed charges,100% of total billed charges,145.5,50,,,percent of total billed charges,50% of total Billed charges,291,100,,,percent of total billed charges,100% of total billed charges,145.5,50,,,percent of total billed charges,50% of total Billed charges,179.98,61.85,,,percent of total billed charges,61.85% of total billed charges,48.89,16.8,,,percent of total billed charges,16.8% of total billed charges,145.5,50,,,percent of total billed charges,50% of total Billed charges,145.5,50,,,percent of total billed charges,50% of total Billed charges,48.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,145.5,50,,,percent of total billed charges,50% of total Billed charges,145.5,50,,,percent of total billed charges,50% of total Billed charges,49.87,17.136,,,percent of total billed charges,17.136% of total billed charges,63.55,21.84,,,percent of total billed charges,21.84% of total billed charges,145.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,145.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,145.5,50,,,percent of total billed charges,50% of total Billed charges,226.98,78,,,percent of total billed charges,78% of total billed charges,291,100,,,percent of total billed charges,100% of total billed charges,240.37,82.6,,,percent of total billed charges,82.6% of total billed charges,240.37,82.6,,,percent of total billed charges,82.6% of total billed charges,48.89,16.8,,,percent of total billed charges,16.8% of total billed charges,145.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,145.5,50,,,percent of total billed charges,50% of total Billed charges,48.89,16.8,,,percent of total billed charges,16.8% of total billed charges,44.52,291,
TEST STRIPS METRICIDE OPA,491559,CDM,270,RC,,,Outpatient,,,398,258.70,,350.24,88,,,percent of total billed charges,88% of total Billed charges,199,50,,,percent of total billed charges,50% of total Billed charges,66.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,398,100,,,percent of total billed charges,100% of total billed charges,68.87,17.304,,,percent of total billed charges,17.304% of total billed charges,199,50,,,percent of total billed charges,50% of total Billed charges,250.74,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,66.86,16.8,,,percent of total billed charges,16.8% of total billed charges,60.89,15.3,,,percent of total billed charges,15.3% of total billed charges,274.62,69,,,percent of total billed charges,69% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,199,50,,,percent of total billed charges,50% of total Billed charges,398,100,,,percent of total billed charges,100% of total billed charges,199,50,,,percent of total billed charges,50% of total Billed charges,398,100,,,percent of total billed charges,100% of total billed charges,199,50,,,percent of total billed charges,50% of total Billed charges,246.16,61.85,,,percent of total billed charges,61.85% of total billed charges,66.86,16.8,,,percent of total billed charges,16.8% of total billed charges,199,50,,,percent of total billed charges,50% of total Billed charges,199,50,,,percent of total billed charges,50% of total Billed charges,66.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,199,50,,,percent of total billed charges,50% of total Billed charges,199,50,,,percent of total billed charges,50% of total Billed charges,68.2,17.136,,,percent of total billed charges,17.136% of total billed charges,86.92,21.84,,,percent of total billed charges,21.84% of total billed charges,199,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,199,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,199,50,,,percent of total billed charges,50% of total Billed charges,310.44,78,,,percent of total billed charges,78% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,66.86,16.8,,,percent of total billed charges,16.8% of total billed charges,199,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,199,50,,,percent of total billed charges,50% of total Billed charges,66.86,16.8,,,percent of total billed charges,16.8% of total billed charges,60.89,398,
TEST STREP A QUICKVUE+,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TESTOSTERONE 100 WELLS,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
TESTOSTERONE CAL BX/1 SET,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
TESTOSTERONE REAGENT KIT2X5,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
THERMOMETER CAPS RESPOSABLE,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
THERMOMETER SKIN STRIP,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
THERMO SCIENTIFIC NERL REAG GRADE WATER,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
THERMASPLINT MED NASAL SPLINT,491561,CDM,270,RC,,,Outpatient,,,238,154.70,,209.44,88,,,percent of total billed charges,88% of total Billed charges,119,50,,,percent of total billed charges,50% of total Billed charges,39.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,238,100,,,percent of total billed charges,100% of total billed charges,41.18,17.304,,,percent of total billed charges,17.304% of total billed charges,119,50,,,percent of total billed charges,50% of total Billed charges,149.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,39.98,16.8,,,percent of total billed charges,16.8% of total billed charges,36.41,15.3,,,percent of total billed charges,15.3% of total billed charges,164.22,69,,,percent of total billed charges,69% of total billed charges,238,100,,,percent of total billed charges,100% of total billed charges,119,50,,,percent of total billed charges,50% of total Billed charges,238,100,,,percent of total billed charges,100% of total billed charges,119,50,,,percent of total billed charges,50% of total Billed charges,238,100,,,percent of total billed charges,100% of total billed charges,119,50,,,percent of total billed charges,50% of total Billed charges,147.2,61.85,,,percent of total billed charges,61.85% of total billed charges,39.98,16.8,,,percent of total billed charges,16.8% of total billed charges,119,50,,,percent of total billed charges,50% of total Billed charges,119,50,,,percent of total billed charges,50% of total Billed charges,39.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,119,50,,,percent of total billed charges,50% of total Billed charges,119,50,,,percent of total billed charges,50% of total Billed charges,40.78,17.136,,,percent of total billed charges,17.136% of total billed charges,51.98,21.84,,,percent of total billed charges,21.84% of total billed charges,119,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,119,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,119,50,,,percent of total billed charges,50% of total Billed charges,185.64,78,,,percent of total billed charges,78% of total billed charges,238,100,,,percent of total billed charges,100% of total billed charges,196.59,82.6,,,percent of total billed charges,82.6% of total billed charges,196.59,82.6,,,percent of total billed charges,82.6% of total billed charges,39.98,16.8,,,percent of total billed charges,16.8% of total billed charges,119,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,119,50,,,percent of total billed charges,50% of total Billed charges,39.98,16.8,,,percent of total billed charges,16.8% of total billed charges,36.41,238,
THERMASPLINT LRG NASAL SPLINT,491560,CDM,270,RC,,,Outpatient,,,233,151.45,,205.04,88,,,percent of total billed charges,88% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,233,100,,,percent of total billed charges,100% of total billed charges,40.32,17.304,,,percent of total billed charges,17.304% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,146.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,35.65,15.3,,,percent of total billed charges,15.3% of total billed charges,160.77,69,,,percent of total billed charges,69% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,233,100,,,percent of total billed charges,100% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,233,100,,,percent of total billed charges,100% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,144.11,61.85,,,percent of total billed charges,61.85% of total billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.93,17.136,,,percent of total billed charges,17.136% of total billed charges,50.89,21.84,,,percent of total billed charges,21.84% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,116.5,50,,,percent of total billed charges,50% of total Billed charges,181.74,78,,,percent of total billed charges,78% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,35.65,233,
THERMOMETER FOREHEAD STRIPS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
THERMAL PAPER Z-FOLD RED GRID 8.5IN X 11IN,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
THERMAL PRINTER PAPER,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
THERMOMETER DIGITAL DISPOSABLE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
THERMAL PAPER,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
THERMAL PAPER ROLL HEARING TEST MACHINE,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
THIOGLYCOLLATE MEDIUM WITH DEXTROSE HEMIN VITAMIN K,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
THIS LOT READY LABERL GREEN,ORSUP0006,CDM,272,RC,C1729,HCPCS,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
THREADER FG OTW 1.2MMX12MM,ORSUP0032,CDM,278,RC,C1725,HCPCS,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1703.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1850.94,33.9,,,percent of total billed charges,33.9% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
THROMB SET ANGIOJET 120CM SOLE,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
THUMBS UP GOWN,491563,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
THYROID DRAPE,491564,CDM,270,RC,,,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,15.05,17.304,,,percent of total billed charges,17.304% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,54.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,15.3,,,percent of total billed charges,15.3% of total billed charges,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,87,100,,,percent of total billed charges,100% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.91,17.136,,,percent of total billed charges,17.136% of total billed charges,19,21.84,,,percent of total billed charges,21.84% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,43.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43.5,50,,,percent of total billed charges,50% of total Billed charges,14.62,16.8,,,percent of total billed charges,16.8% of total billed charges,13.31,87,
TI LOCKING SCREW 04.614.508,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TI WRIST FUSION PLATE,ORSUP0034,CDM,278,RC,C1713,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
ORSUP0009,ORSUP0009,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TIGHTROPE ABS BUTTON,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TIGHTROPE ACL RT AR-1588RT,ORSUP0019,CDM,278,RC,C1713,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
TIGHTROPE BTB,ORSUP0020,CDM,278,RC,C1713,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,730.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,793.26,33.9,,,percent of total billed charges,33.9% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
TIGHTROPE BUTTON EXTENDER,ORSUP0015,CDM,278,RC,C1713,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
TIGHTROPE ABS IMPLANT,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TIGHTROPE ABS IMPLANT OPEN,ORSUP0013,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TIP DRILL 2.5MM GUIDEWIRE 200MM L,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TIP SUCT YANKAUER BULL TIP,76442,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
TIP EAR INFANT 4.5MM RED BROWN,ORSUP0008,CDM,270,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TIP PIPETTE RACKED FOR ID-MICRO TYPING SYS 4/PK,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
TIP MLA ECON-PAK LARGE,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TIP CAUTERY HOOK 5MM  DA VINCI (SINGLE USE),337820,CDM,272,RC,,,Outpatient,,,5418,3521.70,,4767.84,88,,,percent of total billed charges,88% of total Billed charges,2709,50,,,percent of total billed charges,50% of total Billed charges,910.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,937.53,17.304,,,percent of total billed charges,17.304% of total billed charges,2709,50,,,percent of total billed charges,50% of total Billed charges,3413.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,910.22,16.8,,,percent of total billed charges,16.8% of total billed charges,828.95,15.3,,,percent of total billed charges,15.3% of total billed charges,3738.42,69,,,percent of total billed charges,69% of total billed charges,5418,100,,,percent of total billed charges,100% of total billed charges,2709,50,,,percent of total billed charges,50% of total Billed charges,5418,100,,,percent of total billed charges,100% of total billed charges,2709,50,,,percent of total billed charges,50% of total Billed charges,5418,100,,,percent of total billed charges,100% of total billed charges,2709,50,,,percent of total billed charges,50% of total Billed charges,3351.03,61.85,,,percent of total billed charges,61.85% of total billed charges,910.22,16.8,,,percent of total billed charges,16.8% of total billed charges,2709,50,,,percent of total billed charges,50% of total Billed charges,2709,50,,,percent of total billed charges,50% of total Billed charges,910.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,2709,50,,,percent of total billed charges,50% of total Billed charges,2709,50,,,percent of total billed charges,50% of total Billed charges,928.43,17.136,,,percent of total billed charges,17.136% of total billed charges,1183.29,21.84,,,percent of total billed charges,21.84% of total billed charges,2709,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2709,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2709,50,,,percent of total billed charges,50% of total Billed charges,4226.04,78,,,percent of total billed charges,78% of total billed charges,5418,100,,,percent of total billed charges,100% of total billed charges,4475.27,82.6,,,percent of total billed charges,82.6% of total billed charges,4475.27,82.6,,,percent of total billed charges,82.6% of total billed charges,910.22,16.8,,,percent of total billed charges,16.8% of total billed charges,2709,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2709,50,,,percent of total billed charges,50% of total Billed charges,910.22,16.8,,,percent of total billed charges,16.8% of total billed charges,828.95,5418,
TIP COVER ACCESSORY HOT SHEAR DA VINCI,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TIP RUMI ORANGE 6.7MM X 12CM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TIP RUMI YELLOW 5.1MM X 3.75CM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TIP UP FENESTRATED GRASPER,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
TIPS MALLEABLE FOR FLOSEAL,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TISSUE MORCELLATOR,ORSUP0027,CDM,278,RC,C1782,HCPCS,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1297.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1568.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,1410.24,33.9,,,percent of total billed charges,33.9% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
TISSUE FACIAL,202443,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
TISSUE STABILIZER OCTOPUS 4,ORSUP0031,CDM,272,RC,,,Outpatient,,,5200,3380.00,,4576,88,,,percent of total billed charges,88% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,899.81,17.304,,,percent of total billed charges,17.304% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3276,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,15.3,,,percent of total billed charges,15.3% of total billed charges,3588,69,,,percent of total billed charges,69% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,3216.2,61.85,,,percent of total billed charges,61.85% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,891.07,17.136,,,percent of total billed charges,17.136% of total billed charges,1135.68,21.84,,,percent of total billed charges,21.84% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,4056,78,,,percent of total billed charges,78% of total billed charges,5200,100,,,percent of total billed charges,100% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4295.2,82.6,,,percent of total billed charges,82.6% of total billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2600,50,,,percent of total billed charges,50% of total Billed charges,873.6,16.8,,,percent of total billed charges,16.8% of total billed charges,795.6,5200,
TISSUE EXPANDER 133MX-11T,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
TISSUE TRAP FOR BERKLEY CANNIS,491573,CDM,270,RC,,,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,12.11,17.304,,,percent of total billed charges,17.304% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,44.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,70,100,,,percent of total billed charges,100% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,12,17.136,,,percent of total billed charges,17.136% of total billed charges,15.29,21.84,,,percent of total billed charges,21.84% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,35,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,35,50,,,percent of total billed charges,50% of total Billed charges,11.76,16.8,,,percent of total billed charges,16.8% of total billed charges,10.71,70,
TISSUE ANCHOR 2.7MM,ORSUP0007,CDM,278,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
TISSUE ANCHOR 3.5MM,ORSUP0008,CDM,278,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TISSEEL PRE-FILLED SYR 2 ML,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
TISSUE EXPANDER 133FX-12-T,ORSUP0040,CDM,270,RC,,,Outpatient,,,7540,4901.00,,6635.2,88,,,percent of total billed charges,88% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1304.72,17.304,,,percent of total billed charges,17.304% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4750.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,15.3,,,percent of total billed charges,15.3% of total billed charges,5202.6,69,,,percent of total billed charges,69% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,4663.49,61.85,,,percent of total billed charges,61.85% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,1292.05,17.136,,,percent of total billed charges,17.136% of total billed charges,1646.74,21.84,,,percent of total billed charges,21.84% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,5881.2,78,,,percent of total billed charges,78% of total billed charges,7540,100,,,percent of total billed charges,100% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,6228.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,3770,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3770,50,,,percent of total billed charges,50% of total Billed charges,1266.72,16.8,,,percent of total billed charges,16.8% of total billed charges,1153.62,7540,
TISSUE TRAP/CANNISTER,491574,CDM,270,RC,,,Outpatient,,,86,55.90,,75.68,88,,,percent of total billed charges,88% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,14.88,17.304,,,percent of total billed charges,17.304% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,54.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,13.16,15.3,,,percent of total billed charges,15.3% of total billed charges,59.34,69,,,percent of total billed charges,69% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,86,100,,,percent of total billed charges,100% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,53.19,61.85,,,percent of total billed charges,61.85% of total billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,14.74,17.136,,,percent of total billed charges,17.136% of total billed charges,18.78,21.84,,,percent of total billed charges,21.84% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,67.08,78,,,percent of total billed charges,78% of total billed charges,86,100,,,percent of total billed charges,100% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,71.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,43,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,43,50,,,percent of total billed charges,50% of total Billed charges,14.45,16.8,,,percent of total billed charges,16.8% of total billed charges,13.16,86,
TISSUE GRAFT ACHILLES TENDON,ORSUP0082,CDM,278,RC,Q4107,HCPCS,Outpatient,,,18720,12168.00,,16473.6,88,,,percent of total billed charges,88% of total Billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,9360,50,,,percent of total billed charges,50% of total Billed charges,11793.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",2864.16,15.3,,,percent of total billed charges,15.3% of total billed charges,12916.8,69,,,percent of total billed charges,69% of total billed charges,18720,100,,,percent of total billed charges,100% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,18720,100,,,percent of total billed charges,100% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,18720,100,,,percent of total billed charges,100% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,11578.32,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,9360,50,,,percent of total billed charges,50% of total Billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,5840.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9360,50,,,percent of total billed charges,50% of total Billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9360,50,,,percent of total billed charges,50% of total Billed charges,7057.44,37.7,,,percent of total billed charges,37.70% of total billed charges,7057.44,37.7,,,percent of total billed charges,37.70% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,6346.08,33.9,,,percent of total billed charges,33.9% of total billed charges,9360,50,,,percent of total billed charges,50% of total Billed charges,14601.6,78,,,percent of total billed charges,78% of total billed charges,18720,100,,,percent of total billed charges,100% of total billed charges,15462.72,82.6,,,percent of total billed charges,82.6% of total billed charges,15462.72,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,9360,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9360,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",2864.16,18720,
TISSEEL FROZEN 2 ML,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
TISSEEL PRE-FILLED SYR 2ML FROZEN,ORSUP0019,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
TISSUE GRINDER 15ML DISPOSABLE,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TONER CARTRIDGE T650,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
TONER CARTRIDGE,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TONER 81A FOR HP LASERJET M604/M605,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TONER CARTRIDGE HP,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TONER CTRG DELL 1720 BK,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
TONER FOR HP LASERJET PRO M402N,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
TONER HP CF226X BLACK PG YLD 9000,ORSUP0021,CDM,270,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
TONER HP LASER JET PRO 400,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TONER HP M602,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TONER HP P2035/2055DN 2300,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
TONER MAGENTA FOR HP LASERJET CP2025,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
TONER YELLOW FOR HP LASERJET CP2025,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
TONSIL WIRE #8,491577,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
TOOL GENCUT CORING,ORSUP0023,CDM,270,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
TOOL SNAP ASSEMBLY,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
TOOTHPASTE .85oz,86938,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
TOOTHPASTE FLUORIDE .85 OZ SPARKLE FRESH,174738,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
TORPEDO SHAVER COOLCUT 4MM,ORSUP0023,CDM,272,RC,,,Outpatient,,,3120,2028.00,,2745.6,88,,,percent of total billed charges,88% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,539.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1965.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,15.3,,,percent of total billed charges,15.3% of total billed charges,2152.8,69,,,percent of total billed charges,69% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1929.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,534.64,17.136,,,percent of total billed charges,17.136% of total billed charges,681.41,21.84,,,percent of total billed charges,21.84% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,2433.6,78,,,percent of total billed charges,78% of total billed charges,3120,100,,,percent of total billed charges,100% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2577.12,82.6,,,percent of total billed charges,82.6% of total billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1560,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1560,50,,,percent of total billed charges,50% of total Billed charges,524.16,16.8,,,percent of total billed charges,16.8% of total billed charges,477.36,3120,
REAGENT TOTAL T4,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TOT B-HCG CAL II BX/3 SET,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
TOT B-HCG II 100 WELLS,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
TOT BILIRUBIN /5 PACK/ 300 SLDS,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TOTAL HIP,326411,CDM,270,RC,,,Outpatient,,,1096,712.40,,964.48,88,,,percent of total billed charges,88% of total Billed charges,548,50,,,percent of total billed charges,50% of total Billed charges,184.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,1096,100,,,percent of total billed charges,100% of total billed charges,189.65,17.304,,,percent of total billed charges,17.304% of total billed charges,548,50,,,percent of total billed charges,50% of total Billed charges,690.48,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,184.13,16.8,,,percent of total billed charges,16.8% of total billed charges,167.69,15.3,,,percent of total billed charges,15.3% of total billed charges,756.24,69,,,percent of total billed charges,69% of total billed charges,1096,100,,,percent of total billed charges,100% of total billed charges,548,50,,,percent of total billed charges,50% of total Billed charges,1096,100,,,percent of total billed charges,100% of total billed charges,548,50,,,percent of total billed charges,50% of total Billed charges,1096,100,,,percent of total billed charges,100% of total billed charges,548,50,,,percent of total billed charges,50% of total Billed charges,677.88,61.85,,,percent of total billed charges,61.85% of total billed charges,184.13,16.8,,,percent of total billed charges,16.8% of total billed charges,548,50,,,percent of total billed charges,50% of total Billed charges,548,50,,,percent of total billed charges,50% of total Billed charges,184.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,548,50,,,percent of total billed charges,50% of total Billed charges,548,50,,,percent of total billed charges,50% of total Billed charges,187.81,17.136,,,percent of total billed charges,17.136% of total billed charges,239.37,21.84,,,percent of total billed charges,21.84% of total billed charges,548,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,548,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,548,50,,,percent of total billed charges,50% of total Billed charges,854.88,78,,,percent of total billed charges,78% of total billed charges,1096,100,,,percent of total billed charges,100% of total billed charges,905.3,82.6,,,percent of total billed charges,82.6% of total billed charges,905.3,82.6,,,percent of total billed charges,82.6% of total billed charges,184.13,16.8,,,percent of total billed charges,16.8% of total billed charges,548,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,548,50,,,percent of total billed charges,50% of total Billed charges,184.13,16.8,,,percent of total billed charges,16.8% of total billed charges,167.69,1096,
TOTAL KNEE,326388,CDM,270,RC,,,Outpatient,,,1050,682.50,,924,88,,,percent of total billed charges,88% of total Billed charges,525,50,,,percent of total billed charges,50% of total Billed charges,176.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1050,100,,,percent of total billed charges,100% of total billed charges,181.69,17.304,,,percent of total billed charges,17.304% of total billed charges,525,50,,,percent of total billed charges,50% of total Billed charges,661.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,176.4,16.8,,,percent of total billed charges,16.8% of total billed charges,160.65,15.3,,,percent of total billed charges,15.3% of total billed charges,724.5,69,,,percent of total billed charges,69% of total billed charges,1050,100,,,percent of total billed charges,100% of total billed charges,525,50,,,percent of total billed charges,50% of total Billed charges,1050,100,,,percent of total billed charges,100% of total billed charges,525,50,,,percent of total billed charges,50% of total Billed charges,1050,100,,,percent of total billed charges,100% of total billed charges,525,50,,,percent of total billed charges,50% of total Billed charges,649.43,61.85,,,percent of total billed charges,61.85% of total billed charges,176.4,16.8,,,percent of total billed charges,16.8% of total billed charges,525,50,,,percent of total billed charges,50% of total Billed charges,525,50,,,percent of total billed charges,50% of total Billed charges,176.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,525,50,,,percent of total billed charges,50% of total Billed charges,525,50,,,percent of total billed charges,50% of total Billed charges,179.93,17.136,,,percent of total billed charges,17.136% of total billed charges,229.32,21.84,,,percent of total billed charges,21.84% of total billed charges,525,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,525,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,525,50,,,percent of total billed charges,50% of total Billed charges,819,78,,,percent of total billed charges,78% of total billed charges,1050,100,,,percent of total billed charges,100% of total billed charges,867.3,82.6,,,percent of total billed charges,82.6% of total billed charges,867.3,82.6,,,percent of total billed charges,82.6% of total billed charges,176.4,16.8,,,percent of total billed charges,16.8% of total billed charges,525,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,525,50,,,percent of total billed charges,50% of total Billed charges,176.4,16.8,,,percent of total billed charges,16.8% of total billed charges,160.65,1050,
TOTAL 5 CALIBRATION VERIFICATION,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TOTAL KNEE PACK,ORSUP0013,CDM,272,RC,,,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,504,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
TOURNI-COT FINGER LARGE,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TOURNIQUET 18IN DISPOSABLE,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TOURNIQUET 24IN DISP. REPROCESSED,ORSUP0003,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TOURNIQUET 30IN DISPOSABLE,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TOURNIQUET DISPOSABLE 18 INCH,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TOURNIQUET EXTENSION TUBING,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TOURNIQUET LF 1 X 18 BLUE,ORSUP0003,CDM,270,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
TOURNIQUET 12IN,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TOURNIQUET 12,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TOURNIQUET CUFF 9X1.75 DISP,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TOURNIQUET CUFF 44X4 DISP,ORSUP0004,CDM,270,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
TOURNIQUET CUFF 34X4 DISP,ORSUP0003,CDM,270,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
TOURNIQUET CUFF 30X4 DISP,ORSUP0003,CDM,270,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
TOURNIQUET CUFF 24X5.5 DISP,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TOURNIQUET CUFF 24X4 DISP,ORSUP0003,CDM,270,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
TOURNIQUET CUFF 18X5.2 DISP,ORSUP0004,CDM,270,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
TOURNIQUET CUFF 12X2 DISP,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TOURNIQUET CUFF 18X3 DISP,ORSUP0003,CDM,270,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
TOURNIQUET PADDING 4,491587,CDM,270,RC,,,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,15.75,17.304,,,percent of total billed charges,17.304% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,57.33,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,15.3,,,percent of total billed charges,15.3% of total billed charges,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,91,100,,,percent of total billed charges,100% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,56.28,61.85,,,percent of total billed charges,61.85% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.59,17.136,,,percent of total billed charges,17.136% of total billed charges,19.87,21.84,,,percent of total billed charges,21.84% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,45.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45.5,50,,,percent of total billed charges,50% of total Billed charges,15.29,16.8,,,percent of total billed charges,16.8% of total billed charges,13.92,91,
TOURNIQUET STERILE 18,491588,CDM,272,RC,,,Outpatient,,,3311,2152.15,,2913.68,88,,,percent of total billed charges,88% of total Billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,556.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,3311,100,,,percent of total billed charges,100% of total billed charges,572.94,17.304,,,percent of total billed charges,17.304% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,2085.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,556.25,16.8,,,percent of total billed charges,16.8% of total billed charges,506.58,15.3,,,percent of total billed charges,15.3% of total billed charges,2284.59,69,,,percent of total billed charges,69% of total billed charges,3311,100,,,percent of total billed charges,100% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,3311,100,,,percent of total billed charges,100% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,3311,100,,,percent of total billed charges,100% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,2047.85,61.85,,,percent of total billed charges,61.85% of total billed charges,556.25,16.8,,,percent of total billed charges,16.8% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,556.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,567.37,17.136,,,percent of total billed charges,17.136% of total billed charges,723.12,21.84,,,percent of total billed charges,21.84% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1655.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1655.5,50,,,percent of total billed charges,50% of total Billed charges,2582.58,78,,,percent of total billed charges,78% of total billed charges,3311,100,,,percent of total billed charges,100% of total billed charges,2734.89,82.6,,,percent of total billed charges,82.6% of total billed charges,2734.89,82.6,,,percent of total billed charges,82.6% of total billed charges,556.25,16.8,,,percent of total billed charges,16.8% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1655.5,50,,,percent of total billed charges,50% of total Billed charges,556.25,16.8,,,percent of total billed charges,16.8% of total billed charges,506.58,3311,
TOURNIQUET STERILE 34,491589,CDM,272,RC,,,Outpatient,,,3311,2152.15,,2913.68,88,,,percent of total billed charges,88% of total Billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,556.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,3311,100,,,percent of total billed charges,100% of total billed charges,572.94,17.304,,,percent of total billed charges,17.304% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,2085.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,556.25,16.8,,,percent of total billed charges,16.8% of total billed charges,506.58,15.3,,,percent of total billed charges,15.3% of total billed charges,2284.59,69,,,percent of total billed charges,69% of total billed charges,3311,100,,,percent of total billed charges,100% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,3311,100,,,percent of total billed charges,100% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,3311,100,,,percent of total billed charges,100% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,2047.85,61.85,,,percent of total billed charges,61.85% of total billed charges,556.25,16.8,,,percent of total billed charges,16.8% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,556.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,567.37,17.136,,,percent of total billed charges,17.136% of total billed charges,723.12,21.84,,,percent of total billed charges,21.84% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1655.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1655.5,50,,,percent of total billed charges,50% of total Billed charges,2582.58,78,,,percent of total billed charges,78% of total billed charges,3311,100,,,percent of total billed charges,100% of total billed charges,2734.89,82.6,,,percent of total billed charges,82.6% of total billed charges,2734.89,82.6,,,percent of total billed charges,82.6% of total billed charges,556.25,16.8,,,percent of total billed charges,16.8% of total billed charges,1655.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1655.5,50,,,percent of total billed charges,50% of total Billed charges,556.25,16.8,,,percent of total billed charges,16.8% of total billed charges,506.58,3311,
TOURNIQUET PNEUM TOURNI-COT XLG BLUE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TOURNI-COT DIGITAL TOURNIQUESTS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TOWEL DISP NON STERILE 27 X 17 IN WHITE,451804,CDM,272,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
TOWEL OR BLUE ST 8/PK,274814,CDM,270,RC,,,Outpatient,,,29,18.85,,25.52,88,,,percent of total billed charges,88% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,5.02,17.304,,,percent of total billed charges,17.304% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,18.27,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,15.3,,,percent of total billed charges,15.3% of total billed charges,20.01,69,,,percent of total billed charges,69% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,29,100,,,percent of total billed charges,100% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,61.85,,,percent of total billed charges,61.85% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.97,17.136,,,percent of total billed charges,17.136% of total billed charges,6.33,21.84,,,percent of total billed charges,21.84% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,22.62,78,,,percent of total billed charges,78% of total billed charges,29,100,,,percent of total billed charges,100% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,23.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,14.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14.5,50,,,percent of total billed charges,50% of total Billed charges,4.87,16.8,,,percent of total billed charges,16.8% of total billed charges,4.44,29,
TOWEL OR DISP BLUE 4/PK STERILE,327290,CDM,272,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
TOWEL PAPER ABSORBENT STERILE 13X26,107424,CDM,272,RC,,,Outpatient,,,17,11.05,,14.96,88,,,percent of total billed charges,88% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,2.94,17.304,,,percent of total billed charges,17.304% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,15.3,,,percent of total billed charges,15.3% of total billed charges,11.73,69,,,percent of total billed charges,69% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,17,100,,,percent of total billed charges,100% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,10.51,61.85,,,percent of total billed charges,61.85% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.91,17.136,,,percent of total billed charges,17.136% of total billed charges,3.71,21.84,,,percent of total billed charges,21.84% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,13.26,78,,,percent of total billed charges,78% of total billed charges,17,100,,,percent of total billed charges,100% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,14.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,8.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.5,50,,,percent of total billed charges,50% of total Billed charges,2.86,16.8,,,percent of total billed charges,16.8% of total billed charges,2.6,17,
TOWEL NON STERILE OR DISPOSABLE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TOWEL CLAMP STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TR BAND REG COMPRESSION DEVICE,ORSUP0006,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
TRABEXUS EB 3CC,ORSUP0051,CDM,278,RC,C9362,HCPCS,Outpatient,,,8000,5200.00,,7040,88,,,percent of total billed charges,88% of total Billed charges,4000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1224,15.3,,,percent of total billed charges,15.3% of total billed charges,5520,69,,,percent of total billed charges,69% of total billed charges,8000,100,,,percent of total billed charges,100% of total billed charges,4000,50,,,percent of total billed charges,50% of total Billed charges,8000,100,,,percent of total billed charges,100% of total billed charges,4000,50,,,percent of total billed charges,50% of total Billed charges,8000,100,,,percent of total billed charges,100% of total billed charges,4000,50,,,percent of total billed charges,50% of total Billed charges,4948,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4000,50,,,percent of total billed charges,50% of total Billed charges,4000,50,,,percent of total billed charges,50% of total Billed charges,2496,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4000,50,,,percent of total billed charges,50% of total Billed charges,4000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4000,50,,,percent of total billed charges,50% of total Billed charges,3016,37.7,,,percent of total billed charges,37.70% of total billed charges,3016,37.7,,,percent of total billed charges,37.70% of total billed charges,4000,50,,,percent of total billed charges,50% of total Billed charges,2712,33.9,,,percent of total billed charges,33.9% of total billed charges,4000,50,,,percent of total billed charges,50% of total Billed charges,6240,78,,,percent of total billed charges,78% of total billed charges,8000,100,,,percent of total billed charges,100% of total billed charges,6608,82.6,,,percent of total billed charges,82.6% of total billed charges,6608,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4000,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4000,50,,,percent of total billed charges,50% of total Billed charges,1344,16.8,,,percent of total billed charges,16.8% of total billed charges,1224,8000,
TRABEXUS ED 5CC,ORSUP0071,CDM,278,RC,C9362,HCPCS,Outpatient,,,12200,7930.00,,10736,88,,,percent of total billed charges,88% of total Billed charges,6100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1866.6,15.3,,,percent of total billed charges,15.3% of total billed charges,8418,69,,,percent of total billed charges,69% of total billed charges,12200,100,,,percent of total billed charges,100% of total billed charges,6100,50,,,percent of total billed charges,50% of total Billed charges,12200,100,,,percent of total billed charges,100% of total billed charges,6100,50,,,percent of total billed charges,50% of total Billed charges,12200,100,,,percent of total billed charges,100% of total billed charges,6100,50,,,percent of total billed charges,50% of total Billed charges,7545.7,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,6100,50,,,percent of total billed charges,50% of total Billed charges,6100,50,,,percent of total billed charges,50% of total Billed charges,3806.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6100,50,,,percent of total billed charges,50% of total Billed charges,6100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6100,50,,,percent of total billed charges,50% of total Billed charges,4599.4,37.7,,,percent of total billed charges,37.70% of total billed charges,4599.4,37.7,,,percent of total billed charges,37.70% of total billed charges,6100,50,,,percent of total billed charges,50% of total Billed charges,4135.8,33.9,,,percent of total billed charges,33.9% of total billed charges,6100,50,,,percent of total billed charges,50% of total Billed charges,9516,78,,,percent of total billed charges,78% of total billed charges,12200,100,,,percent of total billed charges,100% of total billed charges,10077.2,82.6,,,percent of total billed charges,82.6% of total billed charges,10077.2,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,6100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6100,50,,,percent of total billed charges,50% of total Billed charges,2049.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1866.6,12200,
TRACH TUBE CUFFLESS/FEN SZ 6,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TRACH TUBE FOME CUFF BIVONA 8,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
TRACH SHILEY ADULT SZ. 10,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TRACH SHILEY 6.0 CUFFLESS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
TRADITIONAL MARYLAND DISS. TIP,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TRANSVAGINAL TAPE ADVANTAGE FIT,ORSUP0043,CDM,278,RC,C2631,HCPCS,Outpatient,,,8320,5408.00,,7321.6,88,,,percent of total billed charges,88% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1439.69,17.304,,,percent of total billed charges,17.304% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5241.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,15.3,,,percent of total billed charges,15.3% of total billed charges,5740.8,69,,,percent of total billed charges,69% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,5145.92,61.85,,,percent of total billed charges,61.85% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2595.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4160,50,,,percent of total billed charges,50% of total Billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,1425.72,17.136,,,percent of total billed charges,17.136% of total billed charges,1817.09,21.84,,,percent of total billed charges,21.84% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3136.64,37.7,,,percent of total billed charges,37.70% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,2820.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,6489.6,78,,,percent of total billed charges,78% of total billed charges,8320,100,,,percent of total billed charges,100% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6872.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,4160,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4160,50,,,percent of total billed charges,50% of total Billed charges,1397.76,16.8,,,percent of total billed charges,16.8% of total billed charges,1272.96,8320,
TRANFUSION SERVICE RECORD,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TRANSDUCER PRESSURE DISPOSABLE,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
TRANS RADIAL BAND LGR 29CM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TRANS RADIAL BAND REG,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TRANSPORE TAPE 1,491596,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
TRANSPORE TAPE 2,491597,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
TRANSDUCER CMI INTRAN PLUS INTRAUTERINE PRESSURE,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
TRANSPORTATION IDENTIFICATION TAG CLEAN/DIRTY,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TRAP MUCUS SPECIMEN COLLECTOR   40CC,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TRAP POLYP,491598,CDM,270,RC,,,Outpatient,,,66,42.90,,58.08,88,,,percent of total billed charges,88% of total Billed charges,33,50,,,percent of total billed charges,50% of total Billed charges,11.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,66,100,,,percent of total billed charges,100% of total billed charges,11.42,17.304,,,percent of total billed charges,17.304% of total billed charges,33,50,,,percent of total billed charges,50% of total Billed charges,41.58,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,10.1,15.3,,,percent of total billed charges,15.3% of total billed charges,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,33,50,,,percent of total billed charges,50% of total Billed charges,66,100,,,percent of total billed charges,100% of total billed charges,33,50,,,percent of total billed charges,50% of total Billed charges,66,100,,,percent of total billed charges,100% of total billed charges,33,50,,,percent of total billed charges,50% of total Billed charges,40.82,61.85,,,percent of total billed charges,61.85% of total billed charges,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,33,50,,,percent of total billed charges,50% of total Billed charges,33,50,,,percent of total billed charges,50% of total Billed charges,11.09,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,50,,,percent of total billed charges,50% of total Billed charges,33,50,,,percent of total billed charges,50% of total Billed charges,11.31,17.136,,,percent of total billed charges,17.136% of total billed charges,14.41,21.84,,,percent of total billed charges,21.84% of total billed charges,33,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,33,50,,,percent of total billed charges,50% of total Billed charges,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,33,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,33,50,,,percent of total billed charges,50% of total Billed charges,11.09,16.8,,,percent of total billed charges,16.8% of total billed charges,10.1,66,
TRAPESE SINGLE CHAMBER POLYP TRAP,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TRAY CATHETER FOLEY 5CC 16FR,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
TRAY CATH BRD 16FR 2L DRNBG FOLEY STLK SIL STRL LATEX FREE,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TRAY SURESTEP 16 FR,ORSUP0005,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TRAY URINE DRAIN METER 153202,39774,CDM,272,RC,,,Outpatient,,,44,28.60,,38.72,88,,,percent of total billed charges,88% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,7.61,17.304,,,percent of total billed charges,17.304% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,15.3,,,percent of total billed charges,15.3% of total billed charges,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,44,100,,,percent of total billed charges,100% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,27.21,61.85,,,percent of total billed charges,61.85% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,7.54,17.136,,,percent of total billed charges,17.136% of total billed charges,9.61,21.84,,,percent of total billed charges,21.84% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,22,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22,50,,,percent of total billed charges,50% of total Billed charges,7.39,16.8,,,percent of total billed charges,16.8% of total billed charges,6.73,44,
TRAY CATH HEMODIALYSIS NIAGRA TEMP 24CM STRAIGHT,ORSUP0009,CDM,278,RC,C1752,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
TRAY CATH DIALYSIS TEMP 15CM DUAL CRV (OLD#5696150),ORSUP0010,CDM,278,RC,C1752,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TRAY PERIVAC W/DRUGS 8.3F,ORSUP0010,CDM,278,RC,C1729,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TRAY CHEST TUBE THAL-QUICK 28F,ORSUP0012,CDM,278,RC,C1729,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
TRAY CHEST TUBE 24FR COOK,ORSUP0012,CDM,278,RC,C1729,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
TRAY  CATH SWAN-GANZ VIP 7.5FR,ORSUP0012,CDM,278,RC,C1725,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
TRAY SURG PREP PVP LF 2FO SKN W/SOL,266545,CDM,270,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
TRAY SKIN SCRUB DRY PREP,14121,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
TRAY DRESSING CHANGE,ORSUP0002,CDM,270,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TRAY BASIC,326408,CDM,270,RC,,,Outpatient,,,304,197.60,,267.52,88,,,percent of total billed charges,88% of total Billed charges,152,50,,,percent of total billed charges,50% of total Billed charges,51.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,304,100,,,percent of total billed charges,100% of total billed charges,52.6,17.304,,,percent of total billed charges,17.304% of total billed charges,152,50,,,percent of total billed charges,50% of total Billed charges,191.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,51.07,16.8,,,percent of total billed charges,16.8% of total billed charges,46.51,15.3,,,percent of total billed charges,15.3% of total billed charges,209.76,69,,,percent of total billed charges,69% of total billed charges,304,100,,,percent of total billed charges,100% of total billed charges,152,50,,,percent of total billed charges,50% of total Billed charges,304,100,,,percent of total billed charges,100% of total billed charges,152,50,,,percent of total billed charges,50% of total Billed charges,304,100,,,percent of total billed charges,100% of total billed charges,152,50,,,percent of total billed charges,50% of total Billed charges,188.02,61.85,,,percent of total billed charges,61.85% of total billed charges,51.07,16.8,,,percent of total billed charges,16.8% of total billed charges,152,50,,,percent of total billed charges,50% of total Billed charges,152,50,,,percent of total billed charges,50% of total Billed charges,51.07,16.8,,,percent of total billed charges,16.8% of total Billed charges,152,50,,,percent of total billed charges,50% of total Billed charges,152,50,,,percent of total billed charges,50% of total Billed charges,52.09,17.136,,,percent of total billed charges,17.136% of total billed charges,66.39,21.84,,,percent of total billed charges,21.84% of total billed charges,152,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,152,50,,,percent of total billed charges,50% of total Billed charges,237.12,78,,,percent of total billed charges,78% of total billed charges,304,100,,,percent of total billed charges,100% of total billed charges,251.1,82.6,,,percent of total billed charges,82.6% of total billed charges,251.1,82.6,,,percent of total billed charges,82.6% of total billed charges,51.07,16.8,,,percent of total billed charges,16.8% of total billed charges,152,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,152,50,,,percent of total billed charges,50% of total Billed charges,51.07,16.8,,,percent of total billed charges,16.8% of total billed charges,46.51,304,
TRAY C SECTION,182456,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
TRAY ENT,326409,CDM,270,RC,,,Outpatient,,,311,202.15,,273.68,88,,,percent of total billed charges,88% of total Billed charges,155.5,50,,,percent of total billed charges,50% of total Billed charges,52.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,311,100,,,percent of total billed charges,100% of total billed charges,53.82,17.304,,,percent of total billed charges,17.304% of total billed charges,155.5,50,,,percent of total billed charges,50% of total Billed charges,195.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,52.25,16.8,,,percent of total billed charges,16.8% of total billed charges,47.58,15.3,,,percent of total billed charges,15.3% of total billed charges,214.59,69,,,percent of total billed charges,69% of total billed charges,311,100,,,percent of total billed charges,100% of total billed charges,155.5,50,,,percent of total billed charges,50% of total Billed charges,311,100,,,percent of total billed charges,100% of total billed charges,155.5,50,,,percent of total billed charges,50% of total Billed charges,311,100,,,percent of total billed charges,100% of total billed charges,155.5,50,,,percent of total billed charges,50% of total Billed charges,192.35,61.85,,,percent of total billed charges,61.85% of total billed charges,52.25,16.8,,,percent of total billed charges,16.8% of total billed charges,155.5,50,,,percent of total billed charges,50% of total Billed charges,155.5,50,,,percent of total billed charges,50% of total Billed charges,52.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,155.5,50,,,percent of total billed charges,50% of total Billed charges,155.5,50,,,percent of total billed charges,50% of total Billed charges,53.29,17.136,,,percent of total billed charges,17.136% of total billed charges,67.92,21.84,,,percent of total billed charges,21.84% of total billed charges,155.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,155.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,155.5,50,,,percent of total billed charges,50% of total Billed charges,242.58,78,,,percent of total billed charges,78% of total billed charges,311,100,,,percent of total billed charges,100% of total billed charges,256.89,82.6,,,percent of total billed charges,82.6% of total billed charges,256.89,82.6,,,percent of total billed charges,82.6% of total billed charges,52.25,16.8,,,percent of total billed charges,16.8% of total billed charges,155.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,155.5,50,,,percent of total billed charges,50% of total Billed charges,52.25,16.8,,,percent of total billed charges,16.8% of total billed charges,47.58,311,
TRAY GENERAL PURPOSE 20/CS,42176,CDM,270,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
TRAY THORACIC,326395,CDM,270,RC,,,Outpatient,,,1331,865.15,,1171.28,88,,,percent of total billed charges,88% of total Billed charges,665.5,50,,,percent of total billed charges,50% of total Billed charges,223.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,1331,100,,,percent of total billed charges,100% of total billed charges,230.32,17.304,,,percent of total billed charges,17.304% of total billed charges,665.5,50,,,percent of total billed charges,50% of total Billed charges,838.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,223.61,16.8,,,percent of total billed charges,16.8% of total billed charges,203.64,15.3,,,percent of total billed charges,15.3% of total billed charges,918.39,69,,,percent of total billed charges,69% of total billed charges,1331,100,,,percent of total billed charges,100% of total billed charges,665.5,50,,,percent of total billed charges,50% of total Billed charges,1331,100,,,percent of total billed charges,100% of total billed charges,665.5,50,,,percent of total billed charges,50% of total Billed charges,1331,100,,,percent of total billed charges,100% of total billed charges,665.5,50,,,percent of total billed charges,50% of total Billed charges,823.22,61.85,,,percent of total billed charges,61.85% of total billed charges,223.61,16.8,,,percent of total billed charges,16.8% of total billed charges,665.5,50,,,percent of total billed charges,50% of total Billed charges,665.5,50,,,percent of total billed charges,50% of total Billed charges,223.61,16.8,,,percent of total billed charges,16.8% of total Billed charges,665.5,50,,,percent of total billed charges,50% of total Billed charges,665.5,50,,,percent of total billed charges,50% of total Billed charges,228.08,17.136,,,percent of total billed charges,17.136% of total billed charges,290.69,21.84,,,percent of total billed charges,21.84% of total billed charges,665.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,665.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,665.5,50,,,percent of total billed charges,50% of total Billed charges,1038.18,78,,,percent of total billed charges,78% of total billed charges,1331,100,,,percent of total billed charges,100% of total billed charges,1099.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1099.41,82.6,,,percent of total billed charges,82.6% of total billed charges,223.61,16.8,,,percent of total billed charges,16.8% of total billed charges,665.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,665.5,50,,,percent of total billed charges,50% of total Billed charges,223.61,16.8,,,percent of total billed charges,16.8% of total billed charges,203.64,1331,
TRAY OASIS SCOPE TRANSPORT,420935,CDM,272,RC,,,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.5,17.304,,,percent of total billed charges,17.304% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.08,61.85,,,percent of total billed charges,61.85% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.46,17.136,,,percent of total billed charges,17.136% of total billed charges,5.68,21.84,,,percent of total billed charges,21.84% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,26,
TRAY PARACENTESIS/THORCENTESIS,ORSUP0003,CDM,272,RC,,,Outpatient,,,318,206.70,,279.84,88,,,percent of total billed charges,88% of total Billed charges,159,50,,,percent of total billed charges,50% of total Billed charges,53.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,318,100,,,percent of total billed charges,100% of total billed charges,55.03,17.304,,,percent of total billed charges,17.304% of total billed charges,159,50,,,percent of total billed charges,50% of total Billed charges,200.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,53.42,16.8,,,percent of total billed charges,16.8% of total billed charges,48.65,15.3,,,percent of total billed charges,15.3% of total billed charges,219.42,69,,,percent of total billed charges,69% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,159,50,,,percent of total billed charges,50% of total Billed charges,318,100,,,percent of total billed charges,100% of total billed charges,159,50,,,percent of total billed charges,50% of total Billed charges,318,100,,,percent of total billed charges,100% of total billed charges,159,50,,,percent of total billed charges,50% of total Billed charges,196.68,61.85,,,percent of total billed charges,61.85% of total billed charges,53.42,16.8,,,percent of total billed charges,16.8% of total billed charges,159,50,,,percent of total billed charges,50% of total Billed charges,159,50,,,percent of total billed charges,50% of total Billed charges,53.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,159,50,,,percent of total billed charges,50% of total Billed charges,159,50,,,percent of total billed charges,50% of total Billed charges,54.49,17.136,,,percent of total billed charges,17.136% of total billed charges,69.45,21.84,,,percent of total billed charges,21.84% of total billed charges,159,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,159,50,,,percent of total billed charges,50% of total Billed charges,248.04,78,,,percent of total billed charges,78% of total billed charges,318,100,,,percent of total billed charges,100% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,262.67,82.6,,,percent of total billed charges,82.6% of total billed charges,53.42,16.8,,,percent of total billed charges,16.8% of total billed charges,159,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,159,50,,,percent of total billed charges,50% of total Billed charges,53.42,16.8,,,percent of total billed charges,16.8% of total billed charges,48.65,318,
TRAY BONE MARROW BIOPSY AND ASPIRATION,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TRAY CHOLECYSTECTOMY,258031,CDM,272,RC,,,Outpatient,,,1681,1092.65,,1479.28,88,,,percent of total billed charges,88% of total Billed charges,840.5,50,,,percent of total billed charges,50% of total Billed charges,282.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,1681,100,,,percent of total billed charges,100% of total billed charges,290.88,17.304,,,percent of total billed charges,17.304% of total billed charges,840.5,50,,,percent of total billed charges,50% of total Billed charges,1059.03,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,282.41,16.8,,,percent of total billed charges,16.8% of total billed charges,257.19,15.3,,,percent of total billed charges,15.3% of total billed charges,1159.89,69,,,percent of total billed charges,69% of total billed charges,1681,100,,,percent of total billed charges,100% of total billed charges,840.5,50,,,percent of total billed charges,50% of total Billed charges,1681,100,,,percent of total billed charges,100% of total billed charges,840.5,50,,,percent of total billed charges,50% of total Billed charges,1681,100,,,percent of total billed charges,100% of total billed charges,840.5,50,,,percent of total billed charges,50% of total Billed charges,1039.7,61.85,,,percent of total billed charges,61.85% of total billed charges,282.41,16.8,,,percent of total billed charges,16.8% of total billed charges,840.5,50,,,percent of total billed charges,50% of total Billed charges,840.5,50,,,percent of total billed charges,50% of total Billed charges,282.41,16.8,,,percent of total billed charges,16.8% of total Billed charges,840.5,50,,,percent of total billed charges,50% of total Billed charges,840.5,50,,,percent of total billed charges,50% of total Billed charges,288.06,17.136,,,percent of total billed charges,17.136% of total billed charges,367.13,21.84,,,percent of total billed charges,21.84% of total billed charges,840.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,840.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,840.5,50,,,percent of total billed charges,50% of total Billed charges,1311.18,78,,,percent of total billed charges,78% of total billed charges,1681,100,,,percent of total billed charges,100% of total billed charges,1388.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1388.51,82.6,,,percent of total billed charges,82.6% of total billed charges,282.41,16.8,,,percent of total billed charges,16.8% of total billed charges,840.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,840.5,50,,,percent of total billed charges,50% of total Billed charges,282.41,16.8,,,percent of total billed charges,16.8% of total billed charges,257.19,1681,
TRAY EXPANDER 15/3,ORSUP0072,CDM,272,RC,,,Outpatient,,,16120,10478.00,,14185.6,88,,,percent of total billed charges,88% of total Billed charges,8060,50,,,percent of total billed charges,50% of total Billed charges,2708.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2789.4,17.304,,,percent of total billed charges,17.304% of total billed charges,8060,50,,,percent of total billed charges,50% of total Billed charges,10155.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2708.16,16.8,,,percent of total billed charges,16.8% of total billed charges,2466.36,15.3,,,percent of total billed charges,15.3% of total billed charges,11122.8,69,,,percent of total billed charges,69% of total billed charges,16120,100,,,percent of total billed charges,100% of total billed charges,8060,50,,,percent of total billed charges,50% of total Billed charges,16120,100,,,percent of total billed charges,100% of total billed charges,8060,50,,,percent of total billed charges,50% of total Billed charges,16120,100,,,percent of total billed charges,100% of total billed charges,8060,50,,,percent of total billed charges,50% of total Billed charges,9970.22,61.85,,,percent of total billed charges,61.85% of total billed charges,2708.16,16.8,,,percent of total billed charges,16.8% of total billed charges,8060,50,,,percent of total billed charges,50% of total Billed charges,8060,50,,,percent of total billed charges,50% of total Billed charges,2708.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,8060,50,,,percent of total billed charges,50% of total Billed charges,8060,50,,,percent of total billed charges,50% of total Billed charges,2762.32,17.136,,,percent of total billed charges,17.136% of total billed charges,3520.61,21.84,,,percent of total billed charges,21.84% of total billed charges,8060,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8060,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8060,50,,,percent of total billed charges,50% of total Billed charges,12573.6,78,,,percent of total billed charges,78% of total billed charges,16120,100,,,percent of total billed charges,100% of total billed charges,13315.12,82.6,,,percent of total billed charges,82.6% of total billed charges,13315.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2708.16,16.8,,,percent of total billed charges,16.8% of total billed charges,8060,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8060,50,,,percent of total billed charges,50% of total Billed charges,2708.16,16.8,,,percent of total billed charges,16.8% of total billed charges,2466.36,16120,
TRAY EXPANDER 20/3,ORSUP0074,CDM,272,RC,,,Outpatient,,,16640,10816.00,,14643.2,88,,,percent of total billed charges,88% of total Billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,2795.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2879.39,17.304,,,percent of total billed charges,17.304% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,10483.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2795.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2545.92,15.3,,,percent of total billed charges,15.3% of total billed charges,11481.6,69,,,percent of total billed charges,69% of total billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,10291.84,61.85,,,percent of total billed charges,61.85% of total billed charges,2795.52,16.8,,,percent of total billed charges,16.8% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,2795.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,2851.43,17.136,,,percent of total billed charges,17.136% of total billed charges,3634.18,21.84,,,percent of total billed charges,21.84% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8320,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8320,50,,,percent of total billed charges,50% of total Billed charges,12979.2,78,,,percent of total billed charges,78% of total billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,13744.64,82.6,,,percent of total billed charges,82.6% of total billed charges,13744.64,82.6,,,percent of total billed charges,82.6% of total billed charges,2795.52,16.8,,,percent of total billed charges,16.8% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8320,50,,,percent of total billed charges,50% of total Billed charges,2795.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2545.92,16640,
TRAY KYPHO PAK XPANDER II 15/3 ADD FRACTURE,ORSUP0075,CDM,272,RC,,,Outpatient,,,13000,8450.00,,11440,88,,,percent of total billed charges,88% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,2184,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2249.52,17.304,,,percent of total billed charges,17.304% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,8190,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,1989,15.3,,,percent of total billed charges,15.3% of total billed charges,8970,69,,,percent of total billed charges,69% of total billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,8040.5,61.85,,,percent of total billed charges,61.85% of total billed charges,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,2184,16.8,,,percent of total billed charges,16.8% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,2227.68,17.136,,,percent of total billed charges,17.136% of total billed charges,2839.2,21.84,,,percent of total billed charges,21.84% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6500,50,,,percent of total billed charges,50% of total Billed charges,10140,78,,,percent of total billed charges,78% of total billed charges,13000,100,,,percent of total billed charges,100% of total billed charges,10738,82.6,,,percent of total billed charges,82.6% of total billed charges,10738,82.6,,,percent of total billed charges,82.6% of total billed charges,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,6500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6500,50,,,percent of total billed charges,50% of total Billed charges,2184,16.8,,,percent of total billed charges,16.8% of total billed charges,1989,13000,
TRAY SPINAL,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TRAY UROLOGIST,ORSUP0010,CDM,270,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TRAY CATH 16FR W/ DRAIN BAG,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TRAY CATH 16FR W/URINE METER,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TRAY LINER,491601,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
TRAY CATH FOLEY 16FR W/TEMP SENSOR,ORSUP0007,CDM,272,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
TRAY ENDO TRANSPORT,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TRAY PNEUMOPERICARDIAL,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
TRAY FOLEY CATH SILICONE 1 LAYER W/DRAIN BAG,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TRAY STANDARD TUBE,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
TRAY LACERATION STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TRAY URETHRAL CLOSED SYS 14FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TRAY KYPHON PAK XPANDER II 20/2 KIT,ORSUP0073,CDM,272,RC,,,Outpatient,,,12600,8190.00,,11088,88,,,percent of total billed charges,88% of total Billed charges,6300,50,,,percent of total billed charges,50% of total Billed charges,2116.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2180.3,17.304,,,percent of total billed charges,17.304% of total billed charges,6300,50,,,percent of total billed charges,50% of total Billed charges,7938,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2116.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1927.8,15.3,,,percent of total billed charges,15.3% of total billed charges,8694,69,,,percent of total billed charges,69% of total billed charges,12600,100,,,percent of total billed charges,100% of total billed charges,6300,50,,,percent of total billed charges,50% of total Billed charges,12600,100,,,percent of total billed charges,100% of total billed charges,6300,50,,,percent of total billed charges,50% of total Billed charges,12600,100,,,percent of total billed charges,100% of total billed charges,6300,50,,,percent of total billed charges,50% of total Billed charges,7793.1,61.85,,,percent of total billed charges,61.85% of total billed charges,2116.8,16.8,,,percent of total billed charges,16.8% of total billed charges,6300,50,,,percent of total billed charges,50% of total Billed charges,6300,50,,,percent of total billed charges,50% of total Billed charges,2116.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,6300,50,,,percent of total billed charges,50% of total Billed charges,6300,50,,,percent of total billed charges,50% of total Billed charges,2159.14,17.136,,,percent of total billed charges,17.136% of total billed charges,2751.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6300,50,,,percent of total billed charges,50% of total Billed charges,9828,78,,,percent of total billed charges,78% of total billed charges,12600,100,,,percent of total billed charges,100% of total billed charges,10407.6,82.6,,,percent of total billed charges,82.6% of total billed charges,10407.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2116.8,16.8,,,percent of total billed charges,16.8% of total billed charges,6300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6300,50,,,percent of total billed charges,50% of total Billed charges,2116.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1927.8,12600,
TRIAGE METERPRO CARDIAC PANEL TROPONIN CK-MB,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
TRIAGE METERPRO CARDIAC PANEL TROPONIN,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
TRIGLYCERIDES /5 PACK /300 SLDS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
TRIPLE TRANSDUCER WITH VAMP PLUS,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TROCAR NAIL FIX CANNLTED 11MM 130D 40MM LEFT STRL,ORSUP0048,CDM,278,RC,C1713,HCPCS,Outpatient,,,9620,6253.00,,8465.6,88,,,percent of total billed charges,88% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1664.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,6060.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,15.3,,,percent of total billed charges,15.3% of total billed charges,6637.8,69,,,percent of total billed charges,69% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,5949.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3001.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,1648.48,17.136,,,percent of total billed charges,17.136% of total billed charges,2101.01,21.84,,,percent of total billed charges,21.84% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3626.74,37.7,,,percent of total billed charges,37.70% of total billed charges,3626.74,37.7,,,percent of total billed charges,37.70% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3261.18,33.9,,,percent of total billed charges,33.9% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,7503.6,78,,,percent of total billed charges,78% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,9620,
TROCAR W/SLEEVE BLUNT TIP 12MM X 100MM,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TROCAR W/SLEEVE BLADELESS 5MM X 100MM,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TROCAR W/SLEEVE BLADELESS 12MM X 150MM  XLONG,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
TROCAR W/SLEEVE BLADELESS 12MM X 100MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TROCAR LAPSCP 100MM X 5MM EPATH EXCEL BLDLS OPTCL SMOOTH SLEEVE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TROCAR EXCEL W/BLADE 5MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
TROCAR EXCEL W/BLADE 12MM,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
TROCAR LAPAROSCOPIC L100 MM OD11 MM ENDOPATH XCEL BLADELESS,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TROCAR W/SLEEVE BLADELESS 11MM X 100MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TROCAR EXCEL W/BLADE 11MM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TROCAR  5X100MM Z-THR OPTICAL SEP SYS,ORSUP0026,CDM,272,RC,,,Outpatient,,,3000,1950.00,,2640,88,,,percent of total billed charges,88% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,519.12,17.304,,,percent of total billed charges,17.304% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1890,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,15.3,,,percent of total billed charges,15.3% of total billed charges,2070,69,,,percent of total billed charges,69% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1855.5,61.85,,,percent of total billed charges,61.85% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,514.08,17.136,,,percent of total billed charges,17.136% of total billed charges,655.2,21.84,,,percent of total billed charges,21.84% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,2340,78,,,percent of total billed charges,78% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,1500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1500,50,,,percent of total billed charges,50% of total Billed charges,504,16.8,,,percent of total billed charges,16.8% of total billed charges,459,3000,
TROCAR ADVANCED FIXATION 12 X 150 MM,331933,CDM,272,RC,,,Outpatient,,,963,625.95,,847.44,88,,,percent of total billed charges,88% of total Billed charges,481.5,50,,,percent of total billed charges,50% of total Billed charges,161.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,963,100,,,percent of total billed charges,100% of total billed charges,166.64,17.304,,,percent of total billed charges,17.304% of total billed charges,481.5,50,,,percent of total billed charges,50% of total Billed charges,606.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.78,16.8,,,percent of total billed charges,16.8% of total billed charges,147.34,15.3,,,percent of total billed charges,15.3% of total billed charges,664.47,69,,,percent of total billed charges,69% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,481.5,50,,,percent of total billed charges,50% of total Billed charges,963,100,,,percent of total billed charges,100% of total billed charges,481.5,50,,,percent of total billed charges,50% of total Billed charges,963,100,,,percent of total billed charges,100% of total billed charges,481.5,50,,,percent of total billed charges,50% of total Billed charges,595.62,61.85,,,percent of total billed charges,61.85% of total billed charges,161.78,16.8,,,percent of total billed charges,16.8% of total billed charges,481.5,50,,,percent of total billed charges,50% of total Billed charges,481.5,50,,,percent of total billed charges,50% of total Billed charges,161.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,481.5,50,,,percent of total billed charges,50% of total Billed charges,481.5,50,,,percent of total billed charges,50% of total Billed charges,165.02,17.136,,,percent of total billed charges,17.136% of total billed charges,210.32,21.84,,,percent of total billed charges,21.84% of total billed charges,481.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,481.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,481.5,50,,,percent of total billed charges,50% of total Billed charges,751.14,78,,,percent of total billed charges,78% of total billed charges,963,100,,,percent of total billed charges,100% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,795.44,82.6,,,percent of total billed charges,82.6% of total billed charges,161.78,16.8,,,percent of total billed charges,16.8% of total billed charges,481.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,481.5,50,,,percent of total billed charges,50% of total Billed charges,161.78,16.8,,,percent of total billed charges,16.8% of total billed charges,147.34,963,
TROCAR BLADELESS 15MM,187505,CDM,272,RC,,,Outpatient,,,3130,2034.50,,2754.4,88,,,percent of total billed charges,88% of total Billed charges,1565,50,,,percent of total billed charges,50% of total Billed charges,525.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3130,100,,,percent of total billed charges,100% of total billed charges,541.62,17.304,,,percent of total billed charges,17.304% of total billed charges,1565,50,,,percent of total billed charges,50% of total Billed charges,1971.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,525.84,16.8,,,percent of total billed charges,16.8% of total billed charges,478.89,15.3,,,percent of total billed charges,15.3% of total billed charges,2159.7,69,,,percent of total billed charges,69% of total billed charges,3130,100,,,percent of total billed charges,100% of total billed charges,1565,50,,,percent of total billed charges,50% of total Billed charges,3130,100,,,percent of total billed charges,100% of total billed charges,1565,50,,,percent of total billed charges,50% of total Billed charges,3130,100,,,percent of total billed charges,100% of total billed charges,1565,50,,,percent of total billed charges,50% of total Billed charges,1935.91,61.85,,,percent of total billed charges,61.85% of total billed charges,525.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1565,50,,,percent of total billed charges,50% of total Billed charges,1565,50,,,percent of total billed charges,50% of total Billed charges,525.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1565,50,,,percent of total billed charges,50% of total Billed charges,1565,50,,,percent of total billed charges,50% of total Billed charges,536.36,17.136,,,percent of total billed charges,17.136% of total billed charges,683.59,21.84,,,percent of total billed charges,21.84% of total billed charges,1565,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1565,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1565,50,,,percent of total billed charges,50% of total Billed charges,2441.4,78,,,percent of total billed charges,78% of total billed charges,3130,100,,,percent of total billed charges,100% of total billed charges,2585.38,82.6,,,percent of total billed charges,82.6% of total billed charges,2585.38,82.6,,,percent of total billed charges,82.6% of total billed charges,525.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1565,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1565,50,,,percent of total billed charges,50% of total Billed charges,525.84,16.8,,,percent of total billed charges,16.8% of total billed charges,478.89,3130,
TROCAR BLADELESS EXCEL B11LT REPROCESSED,255655R,CDM,272,RC,,,Outpatient,,,268,174.20,,235.84,88,,,percent of total billed charges,88% of total Billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,45.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,268,100,,,percent of total billed charges,100% of total billed charges,46.37,17.304,,,percent of total billed charges,17.304% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,168.84,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,41,15.3,,,percent of total billed charges,15.3% of total billed charges,184.92,69,,,percent of total billed charges,69% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,268,100,,,percent of total billed charges,100% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,268,100,,,percent of total billed charges,100% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,165.76,61.85,,,percent of total billed charges,61.85% of total billed charges,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,45.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,45.92,17.136,,,percent of total billed charges,17.136% of total billed charges,58.53,21.84,,,percent of total billed charges,21.84% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,134,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,134,50,,,percent of total billed charges,50% of total Billed charges,209.04,78,,,percent of total billed charges,78% of total billed charges,268,100,,,percent of total billed charges,100% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,221.37,82.6,,,percent of total billed charges,82.6% of total billed charges,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,134,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,134,50,,,percent of total billed charges,50% of total Billed charges,45.02,16.8,,,percent of total billed charges,16.8% of total billed charges,41,268,
TROCAR FIOS KII OPTIMA  12X150MM,353966,CDM,272,RC,,,Outpatient,,,562,365.30,,494.56,88,,,percent of total billed charges,88% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,562,100,,,percent of total billed charges,100% of total billed charges,97.25,17.304,,,percent of total billed charges,17.304% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,354.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,85.99,15.3,,,percent of total billed charges,15.3% of total billed charges,387.78,69,,,percent of total billed charges,69% of total billed charges,562,100,,,percent of total billed charges,100% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,562,100,,,percent of total billed charges,100% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,562,100,,,percent of total billed charges,100% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,347.6,61.85,,,percent of total billed charges,61.85% of total billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,96.3,17.136,,,percent of total billed charges,17.136% of total billed charges,122.74,21.84,,,percent of total billed charges,21.84% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,281,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,281,50,,,percent of total billed charges,50% of total Billed charges,438.36,78,,,percent of total billed charges,78% of total billed charges,562,100,,,percent of total billed charges,100% of total billed charges,464.21,82.6,,,percent of total billed charges,82.6% of total billed charges,464.21,82.6,,,percent of total billed charges,82.6% of total billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,281,50,,,percent of total billed charges,50% of total Billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,85.99,562,
TROCAR GELPORT BALLOON 12MMX100MM,311644,CDM,272,RC,,,Outpatient,,,233,151.45,,205.04,88,,,percent of total billed charges,88% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,233,100,,,percent of total billed charges,100% of total billed charges,40.32,17.304,,,percent of total billed charges,17.304% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,146.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,35.65,15.3,,,percent of total billed charges,15.3% of total billed charges,160.77,69,,,percent of total billed charges,69% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,233,100,,,percent of total billed charges,100% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,233,100,,,percent of total billed charges,100% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,144.11,61.85,,,percent of total billed charges,61.85% of total billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.93,17.136,,,percent of total billed charges,17.136% of total billed charges,50.89,21.84,,,percent of total billed charges,21.84% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,116.5,50,,,percent of total billed charges,50% of total Billed charges,181.74,78,,,percent of total billed charges,78% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,116.5,50,,,percent of total billed charges,50% of total Billed charges,39.14,16.8,,,percent of total billed charges,16.8% of total billed charges,35.65,233,
TROCAR HASSON 12 X 100MM,189090,CDM,272,RC,,,Outpatient,,,562,365.30,,494.56,88,,,percent of total billed charges,88% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,562,100,,,percent of total billed charges,100% of total billed charges,97.25,17.304,,,percent of total billed charges,17.304% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,354.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,85.99,15.3,,,percent of total billed charges,15.3% of total billed charges,387.78,69,,,percent of total billed charges,69% of total billed charges,562,100,,,percent of total billed charges,100% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,562,100,,,percent of total billed charges,100% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,562,100,,,percent of total billed charges,100% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,347.6,61.85,,,percent of total billed charges,61.85% of total billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,96.3,17.136,,,percent of total billed charges,17.136% of total billed charges,122.74,21.84,,,percent of total billed charges,21.84% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,281,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,281,50,,,percent of total billed charges,50% of total Billed charges,438.36,78,,,percent of total billed charges,78% of total billed charges,562,100,,,percent of total billed charges,100% of total billed charges,464.21,82.6,,,percent of total billed charges,82.6% of total billed charges,464.21,82.6,,,percent of total billed charges,82.6% of total billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,281,50,,,percent of total billed charges,50% of total Billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,85.99,562,
TROCAR KII FIOS 1ST ENTRY Z THREAD 12 X 100MM,353967,CDM,272,RC,,,Outpatient,,,3371,2191.15,,2966.48,88,,,percent of total billed charges,88% of total Billed charges,1685.5,50,,,percent of total billed charges,50% of total Billed charges,566.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,3371,100,,,percent of total billed charges,100% of total billed charges,583.32,17.304,,,percent of total billed charges,17.304% of total billed charges,1685.5,50,,,percent of total billed charges,50% of total Billed charges,2123.73,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,566.33,16.8,,,percent of total billed charges,16.8% of total billed charges,515.76,15.3,,,percent of total billed charges,15.3% of total billed charges,2325.99,69,,,percent of total billed charges,69% of total billed charges,3371,100,,,percent of total billed charges,100% of total billed charges,1685.5,50,,,percent of total billed charges,50% of total Billed charges,3371,100,,,percent of total billed charges,100% of total billed charges,1685.5,50,,,percent of total billed charges,50% of total Billed charges,3371,100,,,percent of total billed charges,100% of total billed charges,1685.5,50,,,percent of total billed charges,50% of total Billed charges,2084.96,61.85,,,percent of total billed charges,61.85% of total billed charges,566.33,16.8,,,percent of total billed charges,16.8% of total billed charges,1685.5,50,,,percent of total billed charges,50% of total Billed charges,1685.5,50,,,percent of total billed charges,50% of total Billed charges,566.33,16.8,,,percent of total billed charges,16.8% of total Billed charges,1685.5,50,,,percent of total billed charges,50% of total Billed charges,1685.5,50,,,percent of total billed charges,50% of total Billed charges,577.65,17.136,,,percent of total billed charges,17.136% of total billed charges,736.23,21.84,,,percent of total billed charges,21.84% of total billed charges,1685.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1685.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1685.5,50,,,percent of total billed charges,50% of total Billed charges,2629.38,78,,,percent of total billed charges,78% of total billed charges,3371,100,,,percent of total billed charges,100% of total billed charges,2784.45,82.6,,,percent of total billed charges,82.6% of total billed charges,2784.45,82.6,,,percent of total billed charges,82.6% of total billed charges,566.33,16.8,,,percent of total billed charges,16.8% of total billed charges,1685.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1685.5,50,,,percent of total billed charges,50% of total Billed charges,566.33,16.8,,,percent of total billed charges,16.8% of total billed charges,515.76,3371,
TROCAR WITH SLEEVE 12X100MM KII FIOS,291568,CDM,272,RC,,,Outpatient,,,562,365.30,,494.56,88,,,percent of total billed charges,88% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,562,100,,,percent of total billed charges,100% of total billed charges,97.25,17.304,,,percent of total billed charges,17.304% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,354.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,85.99,15.3,,,percent of total billed charges,15.3% of total billed charges,387.78,69,,,percent of total billed charges,69% of total billed charges,562,100,,,percent of total billed charges,100% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,562,100,,,percent of total billed charges,100% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,562,100,,,percent of total billed charges,100% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,347.6,61.85,,,percent of total billed charges,61.85% of total billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,96.3,17.136,,,percent of total billed charges,17.136% of total billed charges,122.74,21.84,,,percent of total billed charges,21.84% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,281,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,281,50,,,percent of total billed charges,50% of total Billed charges,438.36,78,,,percent of total billed charges,78% of total billed charges,562,100,,,percent of total billed charges,100% of total billed charges,464.21,82.6,,,percent of total billed charges,82.6% of total billed charges,464.21,82.6,,,percent of total billed charges,82.6% of total billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,281,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,281,50,,,percent of total billed charges,50% of total Billed charges,94.42,16.8,,,percent of total billed charges,16.8% of total billed charges,85.99,562,
TROCAR WITH SLEEVE 5X100MM KII FIOS,291564,CDM,272,RC,,,Outpatient,,,136,88.40,,119.68,88,,,percent of total billed charges,88% of total Billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,22.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,136,100,,,percent of total billed charges,100% of total billed charges,23.53,17.304,,,percent of total billed charges,17.304% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,85.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.85,16.8,,,percent of total billed charges,16.8% of total billed charges,20.81,15.3,,,percent of total billed charges,15.3% of total billed charges,93.84,69,,,percent of total billed charges,69% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,136,100,,,percent of total billed charges,100% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,136,100,,,percent of total billed charges,100% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,84.12,61.85,,,percent of total billed charges,61.85% of total billed charges,22.85,16.8,,,percent of total billed charges,16.8% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,22.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,23.3,17.136,,,percent of total billed charges,17.136% of total billed charges,29.7,21.84,,,percent of total billed charges,21.84% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,68,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,68,50,,,percent of total billed charges,50% of total Billed charges,106.08,78,,,percent of total billed charges,78% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,22.85,16.8,,,percent of total billed charges,16.8% of total billed charges,68,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,68,50,,,percent of total billed charges,50% of total Billed charges,22.85,16.8,,,percent of total billed charges,16.8% of total billed charges,20.81,136,
TROCAR XCEL 11MM BLADELESS W/HANDLE,376256,CDM,272,RC,,,Outpatient,,,446,289.90,,392.48,88,,,percent of total billed charges,88% of total Billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,74.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,446,100,,,percent of total billed charges,100% of total billed charges,77.18,17.304,,,percent of total billed charges,17.304% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,280.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,74.93,16.8,,,percent of total billed charges,16.8% of total billed charges,68.24,15.3,,,percent of total billed charges,15.3% of total billed charges,307.74,69,,,percent of total billed charges,69% of total billed charges,446,100,,,percent of total billed charges,100% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,446,100,,,percent of total billed charges,100% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,446,100,,,percent of total billed charges,100% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,275.85,61.85,,,percent of total billed charges,61.85% of total billed charges,74.93,16.8,,,percent of total billed charges,16.8% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,74.93,16.8,,,percent of total billed charges,16.8% of total Billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,76.43,17.136,,,percent of total billed charges,17.136% of total billed charges,97.41,21.84,,,percent of total billed charges,21.84% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,223,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,223,50,,,percent of total billed charges,50% of total Billed charges,347.88,78,,,percent of total billed charges,78% of total billed charges,446,100,,,percent of total billed charges,100% of total billed charges,368.4,82.6,,,percent of total billed charges,82.6% of total billed charges,368.4,82.6,,,percent of total billed charges,82.6% of total billed charges,74.93,16.8,,,percent of total billed charges,16.8% of total billed charges,223,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,223,50,,,percent of total billed charges,50% of total Billed charges,74.93,16.8,,,percent of total billed charges,16.8% of total billed charges,68.24,446,
TROCAR XCEL ENDO REPROCESSED,270875,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
TROCAR ZTHREAD OPTICAL 5X150 MM,419277,CDM,272,RC,,,Outpatient,,,482,313.30,,424.16,88,,,percent of total billed charges,88% of total Billed charges,241,50,,,percent of total billed charges,50% of total Billed charges,80.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,482,100,,,percent of total billed charges,100% of total billed charges,83.41,17.304,,,percent of total billed charges,17.304% of total billed charges,241,50,,,percent of total billed charges,50% of total Billed charges,303.66,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,80.98,16.8,,,percent of total billed charges,16.8% of total billed charges,73.75,15.3,,,percent of total billed charges,15.3% of total billed charges,332.58,69,,,percent of total billed charges,69% of total billed charges,482,100,,,percent of total billed charges,100% of total billed charges,241,50,,,percent of total billed charges,50% of total Billed charges,482,100,,,percent of total billed charges,100% of total billed charges,241,50,,,percent of total billed charges,50% of total Billed charges,482,100,,,percent of total billed charges,100% of total billed charges,241,50,,,percent of total billed charges,50% of total Billed charges,298.12,61.85,,,percent of total billed charges,61.85% of total billed charges,80.98,16.8,,,percent of total billed charges,16.8% of total billed charges,241,50,,,percent of total billed charges,50% of total Billed charges,241,50,,,percent of total billed charges,50% of total Billed charges,80.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,241,50,,,percent of total billed charges,50% of total Billed charges,241,50,,,percent of total billed charges,50% of total Billed charges,82.6,17.136,,,percent of total billed charges,17.136% of total billed charges,105.27,21.84,,,percent of total billed charges,21.84% of total billed charges,241,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,241,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,241,50,,,percent of total billed charges,50% of total Billed charges,375.96,78,,,percent of total billed charges,78% of total billed charges,482,100,,,percent of total billed charges,100% of total billed charges,398.13,82.6,,,percent of total billed charges,82.6% of total billed charges,398.13,82.6,,,percent of total billed charges,82.6% of total billed charges,80.98,16.8,,,percent of total billed charges,16.8% of total billed charges,241,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,241,50,,,percent of total billed charges,50% of total Billed charges,80.98,16.8,,,percent of total billed charges,16.8% of total billed charges,73.75,482,
TROCAR 5MM B5XT BLADELESS,491609,CDM,272,RC,,,Outpatient,,,328,213.20,,288.64,88,,,percent of total billed charges,88% of total Billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,55.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,328,100,,,percent of total billed charges,100% of total billed charges,56.76,17.304,,,percent of total billed charges,17.304% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,206.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,55.1,16.8,,,percent of total billed charges,16.8% of total billed charges,50.18,15.3,,,percent of total billed charges,15.3% of total billed charges,226.32,69,,,percent of total billed charges,69% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,328,100,,,percent of total billed charges,100% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,328,100,,,percent of total billed charges,100% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,202.87,61.85,,,percent of total billed charges,61.85% of total billed charges,55.1,16.8,,,percent of total billed charges,16.8% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,55.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,56.21,17.136,,,percent of total billed charges,17.136% of total billed charges,71.64,21.84,,,percent of total billed charges,21.84% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,164,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,164,50,,,percent of total billed charges,50% of total Billed charges,255.84,78,,,percent of total billed charges,78% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,55.1,16.8,,,percent of total billed charges,16.8% of total billed charges,164,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,164,50,,,percent of total billed charges,50% of total Billed charges,55.1,16.8,,,percent of total billed charges,16.8% of total billed charges,50.18,328,
TROCAR 5MM 2B5LT BLADELESS,491608,CDM,272,RC,,,Outpatient,,,368,239.20,,323.84,88,,,percent of total billed charges,88% of total Billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,61.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,368,100,,,percent of total billed charges,100% of total billed charges,63.68,17.304,,,percent of total billed charges,17.304% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,231.84,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,61.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56.3,15.3,,,percent of total billed charges,15.3% of total billed charges,253.92,69,,,percent of total billed charges,69% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,368,100,,,percent of total billed charges,100% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,368,100,,,percent of total billed charges,100% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,227.61,61.85,,,percent of total billed charges,61.85% of total billed charges,61.82,16.8,,,percent of total billed charges,16.8% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,61.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,63.06,17.136,,,percent of total billed charges,17.136% of total billed charges,80.37,21.84,,,percent of total billed charges,21.84% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,184,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,184,50,,,percent of total billed charges,50% of total Billed charges,287.04,78,,,percent of total billed charges,78% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,61.82,16.8,,,percent of total billed charges,16.8% of total billed charges,184,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,184,50,,,percent of total billed charges,50% of total Billed charges,61.82,16.8,,,percent of total billed charges,16.8% of total billed charges,56.3,368,
TROCAR 12MM D12XT DILATING TIP,491607,CDM,270,RC,,,Outpatient,,,573,372.45,,504.24,88,,,percent of total billed charges,88% of total Billed charges,286.5,50,,,percent of total billed charges,50% of total Billed charges,96.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,573,100,,,percent of total billed charges,100% of total billed charges,99.15,17.304,,,percent of total billed charges,17.304% of total billed charges,286.5,50,,,percent of total billed charges,50% of total Billed charges,360.99,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,96.26,16.8,,,percent of total billed charges,16.8% of total billed charges,87.67,15.3,,,percent of total billed charges,15.3% of total billed charges,395.37,69,,,percent of total billed charges,69% of total billed charges,573,100,,,percent of total billed charges,100% of total billed charges,286.5,50,,,percent of total billed charges,50% of total Billed charges,573,100,,,percent of total billed charges,100% of total billed charges,286.5,50,,,percent of total billed charges,50% of total Billed charges,573,100,,,percent of total billed charges,100% of total billed charges,286.5,50,,,percent of total billed charges,50% of total Billed charges,354.4,61.85,,,percent of total billed charges,61.85% of total billed charges,96.26,16.8,,,percent of total billed charges,16.8% of total billed charges,286.5,50,,,percent of total billed charges,50% of total Billed charges,286.5,50,,,percent of total billed charges,50% of total Billed charges,96.26,16.8,,,percent of total billed charges,16.8% of total Billed charges,286.5,50,,,percent of total billed charges,50% of total Billed charges,286.5,50,,,percent of total billed charges,50% of total Billed charges,98.19,17.136,,,percent of total billed charges,17.136% of total billed charges,125.14,21.84,,,percent of total billed charges,21.84% of total billed charges,286.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,286.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,286.5,50,,,percent of total billed charges,50% of total Billed charges,446.94,78,,,percent of total billed charges,78% of total billed charges,573,100,,,percent of total billed charges,100% of total billed charges,473.3,82.6,,,percent of total billed charges,82.6% of total billed charges,473.3,82.6,,,percent of total billed charges,82.6% of total billed charges,96.26,16.8,,,percent of total billed charges,16.8% of total billed charges,286.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,286.5,50,,,percent of total billed charges,50% of total Billed charges,96.26,16.8,,,percent of total billed charges,16.8% of total billed charges,87.67,573,
TROCAR 10/12MM H12LP BLUNT TIP,491606,CDM,270,RC,,,Outpatient,,,481,312.65,,423.28,88,,,percent of total billed charges,88% of total Billed charges,240.5,50,,,percent of total billed charges,50% of total Billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,481,100,,,percent of total billed charges,100% of total billed charges,83.23,17.304,,,percent of total billed charges,17.304% of total billed charges,240.5,50,,,percent of total billed charges,50% of total Billed charges,303.03,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,15.3,,,percent of total billed charges,15.3% of total billed charges,331.89,69,,,percent of total billed charges,69% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,240.5,50,,,percent of total billed charges,50% of total Billed charges,481,100,,,percent of total billed charges,100% of total billed charges,240.5,50,,,percent of total billed charges,50% of total Billed charges,481,100,,,percent of total billed charges,100% of total billed charges,240.5,50,,,percent of total billed charges,50% of total Billed charges,297.5,61.85,,,percent of total billed charges,61.85% of total billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,240.5,50,,,percent of total billed charges,50% of total Billed charges,240.5,50,,,percent of total billed charges,50% of total Billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total Billed charges,240.5,50,,,percent of total billed charges,50% of total Billed charges,240.5,50,,,percent of total billed charges,50% of total Billed charges,82.42,17.136,,,percent of total billed charges,17.136% of total billed charges,105.05,21.84,,,percent of total billed charges,21.84% of total billed charges,240.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,240.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,240.5,50,,,percent of total billed charges,50% of total Billed charges,375.18,78,,,percent of total billed charges,78% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,240.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,240.5,50,,,percent of total billed charges,50% of total Billed charges,80.81,16.8,,,percent of total billed charges,16.8% of total billed charges,73.59,481,
TROCAR 10/12MM B12LT BLADELESS,491605,CDM,272,RC,,,Outpatient,,,374,243.10,,329.12,88,,,percent of total billed charges,88% of total Billed charges,187,50,,,percent of total billed charges,50% of total Billed charges,62.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,374,100,,,percent of total billed charges,100% of total billed charges,64.72,17.304,,,percent of total billed charges,17.304% of total billed charges,187,50,,,percent of total billed charges,50% of total Billed charges,235.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,62.83,16.8,,,percent of total billed charges,16.8% of total billed charges,57.22,15.3,,,percent of total billed charges,15.3% of total billed charges,258.06,69,,,percent of total billed charges,69% of total billed charges,374,100,,,percent of total billed charges,100% of total billed charges,187,50,,,percent of total billed charges,50% of total Billed charges,374,100,,,percent of total billed charges,100% of total billed charges,187,50,,,percent of total billed charges,50% of total Billed charges,374,100,,,percent of total billed charges,100% of total billed charges,187,50,,,percent of total billed charges,50% of total Billed charges,231.32,61.85,,,percent of total billed charges,61.85% of total billed charges,62.83,16.8,,,percent of total billed charges,16.8% of total billed charges,187,50,,,percent of total billed charges,50% of total Billed charges,187,50,,,percent of total billed charges,50% of total Billed charges,62.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,187,50,,,percent of total billed charges,50% of total Billed charges,187,50,,,percent of total billed charges,50% of total Billed charges,64.09,17.136,,,percent of total billed charges,17.136% of total billed charges,81.68,21.84,,,percent of total billed charges,21.84% of total billed charges,187,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,187,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,187,50,,,percent of total billed charges,50% of total Billed charges,291.72,78,,,percent of total billed charges,78% of total billed charges,374,100,,,percent of total billed charges,100% of total billed charges,308.92,82.6,,,percent of total billed charges,82.6% of total billed charges,308.92,82.6,,,percent of total billed charges,82.6% of total billed charges,62.83,16.8,,,percent of total billed charges,16.8% of total billed charges,187,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,187,50,,,percent of total billed charges,50% of total Billed charges,62.83,16.8,,,percent of total billed charges,16.8% of total billed charges,57.22,374,
TROCAR KII BLUNT 5X100 C0Q20,ORSUP0006,CDM,270,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
TROCAR KII BLUNT TIP C0R47 12,491611,CDM,270,RC,,,Outpatient,,,337,219.05,,296.56,88,,,percent of total billed charges,88% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,337,100,,,percent of total billed charges,100% of total billed charges,58.31,17.304,,,percent of total billed charges,17.304% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,212.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,51.56,15.3,,,percent of total billed charges,15.3% of total billed charges,232.53,69,,,percent of total billed charges,69% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,337,100,,,percent of total billed charges,100% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,337,100,,,percent of total billed charges,100% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,208.43,61.85,,,percent of total billed charges,61.85% of total billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,57.75,17.136,,,percent of total billed charges,17.136% of total billed charges,73.6,21.84,,,percent of total billed charges,21.84% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,168.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,168.5,50,,,percent of total billed charges,50% of total Billed charges,262.86,78,,,percent of total billed charges,78% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,168.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,168.5,50,,,percent of total billed charges,50% of total Billed charges,56.62,16.8,,,percent of total billed charges,16.8% of total billed charges,51.56,337,
TROCAR SLEEVE 12MM CB12LT,491612,CDM,270,RC,,,Outpatient,,,284,184.60,,249.92,88,,,percent of total billed charges,88% of total Billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,47.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,284,100,,,percent of total billed charges,100% of total billed charges,49.14,17.304,,,percent of total billed charges,17.304% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,178.92,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,47.71,16.8,,,percent of total billed charges,16.8% of total billed charges,43.45,15.3,,,percent of total billed charges,15.3% of total billed charges,195.96,69,,,percent of total billed charges,69% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,284,100,,,percent of total billed charges,100% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,284,100,,,percent of total billed charges,100% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,175.65,61.85,,,percent of total billed charges,61.85% of total billed charges,47.71,16.8,,,percent of total billed charges,16.8% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,47.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,48.67,17.136,,,percent of total billed charges,17.136% of total billed charges,62.03,21.84,,,percent of total billed charges,21.84% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,142,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,142,50,,,percent of total billed charges,50% of total Billed charges,221.52,78,,,percent of total billed charges,78% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,47.71,16.8,,,percent of total billed charges,16.8% of total billed charges,142,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,142,50,,,percent of total billed charges,50% of total Billed charges,47.71,16.8,,,percent of total billed charges,16.8% of total billed charges,43.45,284,
TROCAR DILATING 12MM,ORSUP0004,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TROCAR SHIELDED BLADE  KII 8X100,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
TROCAR ENDOPATH BLUNT TIP 10 X 100MM,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
TROPONIN I ES 100 WELLS,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
TROPONIN I ES CAL BX/ 1 SET,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
TRYPTIC SOY BROTH 15% GLYCEROL,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
AGAR SETTLING PLATE TRYPTIC SOY,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
REAGENT TSH 100 WELLS,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
TSH CALIBRATOR,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
TUBE TRACH SZ 8 LOW PRES CUFFED SHILEYDISP CANN,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TUBE TRACH LOW PRESSURE CUFFED CANNULA 7.0MM SZ 6,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TUBE ENDO INTRMD HIGH LOW 6.0,166661,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
TUBE LOPRO MURPHY CUFF 4.0,12506,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
TUBE ENDO CUFFED 3.0,11074,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
TUBE NASAL JEJUNAL FEEDING 8FR/240 CM,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
TUBE SALEM SUMP 10F,12441,CDM,272,RC,,,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,7.27,17.304,,,percent of total billed charges,17.304% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,26.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,15.3,,,percent of total billed charges,15.3% of total billed charges,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,42,100,,,percent of total billed charges,100% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,7.2,17.136,,,percent of total billed charges,17.136% of total billed charges,9.17,21.84,,,percent of total billed charges,21.84% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,21,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,21,50,,,percent of total billed charges,50% of total Billed charges,7.06,16.8,,,percent of total billed charges,16.8% of total billed charges,6.43,42,
TUBE  TRANSGASTRIC JEJUNAL FEEDING 18FR,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
TUBE FEEDING JEJUNAL/GAST POLYURTHN W/STYT 9F 36,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TUBE FEEDING 3.5FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBE ENDO CUF ORAL/NASAL HI VOL W/CON 9.0MM,148031,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
TUBE ET ORAL RAE CUFFED 7.0,12470,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
TUBE ET ORAL RAE CUFFED 6.5,12471,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
TUBE ENDO CUF ORAL/NASAL HI VOL W/CON 8.5MM,148030,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
TUBE TRACH ORAL MURPHY EYE CUFFED 6.0MM,12472,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
TUBE ENDO EMG 7.0MM,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
TUBE ENDO CUF ORAL/NASAL HI VOL W/CON 7.0MM,158182,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
TUBE INTRMD HIGH LOW ENDO 7.5,148016,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
TUBE ENDO EMG 6.0MM,ORSUP0020,CDM,272,RC,,,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,404.91,17.304,,,percent of total billed charges,17.304% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1474.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,15.3,,,percent of total billed charges,15.3% of total billed charges,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,400.98,17.136,,,percent of total billed charges,17.136% of total billed charges,511.06,21.84,,,percent of total billed charges,21.84% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1170,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1170,50,,,percent of total billed charges,50% of total Billed charges,393.12,16.8,,,percent of total billed charges,16.8% of total billed charges,358.02,2340,
TUBE ENDO CUF ORAL/NASAL HI VOL W/CON 6.5MM,158181,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
TUBE ENDO CUFFED 5.0MM,11072,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
TUBE ENDO CUFFED 5.5MM,11071,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
TUBE ENDO CUFFED 4.5,11073,CDM,272,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
TUBE ET ORAL RAE CUFFED 4.5,12475,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
TUBE ET ORAL RAE CUFFED 7.5,12469,CDM,272,RC,,,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
TUBE ENDOBRONCH 37FR RT ANG 126037,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TUBE ENDOBRONCHIAL LEFT 37FR,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TUBE BRONCHO CATH 35FR LEFT,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TUBE TRACH XL PROX CUFFED 6.0,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TUBE TRACH LOW PRESSURE CUFF CANNULA 9.0MM SZ 10,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TUBE TRACH LOW PRESS CUFFED REUSABLE CANNULA SZ 6,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TUBE TRACH LOW PRESS CUFFED REUSABLE CANNULA SZ 8,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TUBE TRACH LOW PRESS CUFFED REUSALBE CANNULA SZ 4,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TUBE TRACH LOW PRESS CUFFLESS FEN REUS CANN SZ 4,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
TUBE TRACH NEONATL W/OBTRTR 3.5MMI.D.X5.2MMX32MML,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TUBE GASTROSTOMY 20FR STRAIGHT REPL,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TUBE GASTROSTOMY 18FR STRAIGHT REPL,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TUBE GASTROSTOMY 16FR STRAIGHT REPL,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TUBE TRACH XL PROX CUFFED 8.0,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
TUBE TRACH XL DISTAL CUFFED 8.0,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
TUBE E.T.5.5 CUFFED,186426,CDM,272,RC,,,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,32.19,17.304,,,percent of total billed charges,17.304% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,117.18,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,28.46,15.3,,,percent of total billed charges,15.3% of total billed charges,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,186,100,,,percent of total billed charges,100% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,115.04,61.85,,,percent of total billed charges,61.85% of total billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,31.87,17.136,,,percent of total billed charges,17.136% of total billed charges,40.62,21.84,,,percent of total billed charges,21.84% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,93,50,,,percent of total billed charges,50% of total Billed charges,31.25,16.8,,,percent of total billed charges,16.8% of total billed charges,28.46,186,
TUBE FEEDING 5FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBE PEG REPLACEMENT 20FR,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TUBE E.T.3.5 W/STYLETTE,186868,CDM,272,RC,,,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,5.88,17.304,,,percent of total billed charges,17.304% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,15.3,,,percent of total billed charges,15.3% of total billed charges,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,34,100,,,percent of total billed charges,100% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,5.83,17.136,,,percent of total billed charges,17.136% of total billed charges,7.43,21.84,,,percent of total billed charges,21.84% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,17,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17,50,,,percent of total billed charges,50% of total Billed charges,5.71,16.8,,,percent of total billed charges,16.8% of total billed charges,5.2,34,
TUBE E.T.6.5 CUFFED,186422,CDM,272,RC,,,Outpatient,,,131,85.15,,115.28,88,,,percent of total billed charges,88% of total Billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,22.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,131,100,,,percent of total billed charges,100% of total billed charges,22.67,17.304,,,percent of total billed charges,17.304% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,82.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.01,16.8,,,percent of total billed charges,16.8% of total billed charges,20.04,15.3,,,percent of total billed charges,15.3% of total billed charges,90.39,69,,,percent of total billed charges,69% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,131,100,,,percent of total billed charges,100% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,131,100,,,percent of total billed charges,100% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,81.02,61.85,,,percent of total billed charges,61.85% of total billed charges,22.01,16.8,,,percent of total billed charges,16.8% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,22.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,22.45,17.136,,,percent of total billed charges,17.136% of total billed charges,28.61,21.84,,,percent of total billed charges,21.84% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.5,50,,,percent of total billed charges,50% of total Billed charges,102.18,78,,,percent of total billed charges,78% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,22.01,16.8,,,percent of total billed charges,16.8% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.5,50,,,percent of total billed charges,50% of total Billed charges,22.01,16.8,,,percent of total billed charges,16.8% of total billed charges,20.04,131,
TUBE E.T.7.0 CUFFED,186423,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
TUBE E.T.8.0 CUFFED,186428,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
TUBE ET UNCUFF 4.0,113985,CDM,272,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
TUBE MINNESOTA,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
TUBE NIM TRIVANTAGE EMG ENDOTACH 7MM,ORSUP0021,CDM,272,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
TUBE TRACH ADJUSTABLE 6.0MM HYPERFLEX,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
TUBE TRACH ADJUSTABLE 7.0MM HYPERFLEX,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
TUBE TRACH ADJUSTABLE 9.0MM HYPERFLEX,ORSUP0017,CDM,272,RC,,,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1064.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
TUBE TRACH FOME CUFF 7.0,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
TUBE TRACH LOW PRESSURE CUFFED FENESTRATED SZ 8,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TUBE VENTILATION SHEELY TYPE ACTIVANT ANTIMICROBIAL 10-26145,ORSUP0008,CDM,278,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TUBE SET DUALWAVE OUTFLOW  CS/10,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TUBE SUCT CONNECT 3/16IN X 20IN STERILE LF,61328,CDM,272,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
TUBE YANKAUER SUCTION (REG) OR,47879,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
TUBE SET BIPOLAR SCP INTL INTG IRR 1000,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TUBE VAC +  PST W/HGARD POLYMER G,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TUBE MICROTAINER GRN LITHM HEP W/MICROGUARD CLSR,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TUBE SERUM PLSTC RED SILICN CT 6ML 13X100 HEMOGRD,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
TUBE HOLDERS LAB,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBES POLYSTERENE,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TUBE CONNECTING 6MM X 12,100560,CDM,272,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
TUBE FLOSTEADY ARTHROSCOPY,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TUBE NASOPHARYNGEAL AIRWAY 26FR,9976,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
TUBE TRACH ADJUSTABLE 8.0MM HYPERFLEX,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
TUBE TRACH SZ 4 CUFFED DISP CANNULA,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TUBE FEEDING 8FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBE FEEDING W/S/L 10FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBE ET ORAL RAE CUFFED 5.5,12473,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
TUBE ET ORAL RAE CUFFED 5.0,12474,CDM,272,RC,,,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,9.52,17.304,,,percent of total billed charges,17.304% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,15.3,,,percent of total billed charges,15.3% of total billed charges,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,55,100,,,percent of total billed charges,100% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.42,17.136,,,percent of total billed charges,17.136% of total billed charges,12.01,21.84,,,percent of total billed charges,21.84% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,27.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.5,50,,,percent of total billed charges,50% of total Billed charges,9.24,16.8,,,percent of total billed charges,16.8% of total billed charges,8.42,55,
TUBE TRACH RAE NASAL UNCUFFED 4.0,158301,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
TUBE ENDO 'RAE' PED UNCUFFED NASAL 4.5MM,158188,CDM,272,RC,,,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,3.63,17.304,,,percent of total billed charges,17.304% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,13.23,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,15.3,,,percent of total billed charges,15.3% of total billed charges,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,21,100,,,percent of total billed charges,100% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.6,17.136,,,percent of total billed charges,17.136% of total billed charges,4.59,21.84,,,percent of total billed charges,21.84% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,10.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.5,50,,,percent of total billed charges,50% of total Billed charges,3.53,16.8,,,percent of total billed charges,16.8% of total billed charges,3.21,21,
TUBE ET ORAL RAE CUFFED 8.0 MURPHY TIP,12468,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
TUBE BRONCHO CATH 41FR LEFT,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TUBE BRONCHO CATH 39FR LEFT,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TUBE BRONCHO-CATH ENDOBRONCHIAL  LEFT 32 FR,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TUBE TRACH XL DISTAL CUFFED 6.0,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TUBE TRACH CUFFLESS SIZE 8,9255,CDM,272,RC,,,Outpatient,,,237,154.05,,208.56,88,,,percent of total billed charges,88% of total Billed charges,118.5,50,,,percent of total billed charges,50% of total Billed charges,39.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,237,100,,,percent of total billed charges,100% of total billed charges,41.01,17.304,,,percent of total billed charges,17.304% of total billed charges,118.5,50,,,percent of total billed charges,50% of total Billed charges,149.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,39.82,16.8,,,percent of total billed charges,16.8% of total billed charges,36.26,15.3,,,percent of total billed charges,15.3% of total billed charges,163.53,69,,,percent of total billed charges,69% of total billed charges,237,100,,,percent of total billed charges,100% of total billed charges,118.5,50,,,percent of total billed charges,50% of total Billed charges,237,100,,,percent of total billed charges,100% of total billed charges,118.5,50,,,percent of total billed charges,50% of total Billed charges,237,100,,,percent of total billed charges,100% of total billed charges,118.5,50,,,percent of total billed charges,50% of total Billed charges,146.58,61.85,,,percent of total billed charges,61.85% of total billed charges,39.82,16.8,,,percent of total billed charges,16.8% of total billed charges,118.5,50,,,percent of total billed charges,50% of total Billed charges,118.5,50,,,percent of total billed charges,50% of total Billed charges,39.82,16.8,,,percent of total billed charges,16.8% of total Billed charges,118.5,50,,,percent of total billed charges,50% of total Billed charges,118.5,50,,,percent of total billed charges,50% of total Billed charges,40.61,17.136,,,percent of total billed charges,17.136% of total billed charges,51.76,21.84,,,percent of total billed charges,21.84% of total billed charges,118.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,118.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,118.5,50,,,percent of total billed charges,50% of total Billed charges,184.86,78,,,percent of total billed charges,78% of total billed charges,237,100,,,percent of total billed charges,100% of total billed charges,195.76,82.6,,,percent of total billed charges,82.6% of total billed charges,195.76,82.6,,,percent of total billed charges,82.6% of total billed charges,39.82,16.8,,,percent of total billed charges,16.8% of total billed charges,118.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,118.5,50,,,percent of total billed charges,50% of total Billed charges,39.82,16.8,,,percent of total billed charges,16.8% of total billed charges,36.26,237,
TUBE TRACH SZ 8 UNCUFFED DISP CANNULA,98934,CDM,272,RC,,,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,220,100,,,percent of total billed charges,100% of total billed charges,38.07,17.304,,,percent of total billed charges,17.304% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,138.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,33.66,15.3,,,percent of total billed charges,15.3% of total billed charges,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,220,100,,,percent of total billed charges,100% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,220,100,,,percent of total billed charges,100% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,136.07,61.85,,,percent of total billed charges,61.85% of total billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,37.7,17.136,,,percent of total billed charges,17.136% of total billed charges,48.05,21.84,,,percent of total billed charges,21.84% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,110,50,,,percent of total billed charges,50% of total Billed charges,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,110,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,110,50,,,percent of total billed charges,50% of total Billed charges,36.96,16.8,,,percent of total billed charges,16.8% of total billed charges,33.66,220,
TUBE TRACH SZ 6 CUFFLESS SHILEY DISP CANN,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TUBE TRACH NEO 3.0,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TUBE E.T.6.0 CUFFED,186421,CDM,272,RC,,,Outpatient,,,131,85.15,,115.28,88,,,percent of total billed charges,88% of total Billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,22.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,131,100,,,percent of total billed charges,100% of total billed charges,22.67,17.304,,,percent of total billed charges,17.304% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,82.53,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,22.01,16.8,,,percent of total billed charges,16.8% of total billed charges,20.04,15.3,,,percent of total billed charges,15.3% of total billed charges,90.39,69,,,percent of total billed charges,69% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,131,100,,,percent of total billed charges,100% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,131,100,,,percent of total billed charges,100% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,81.02,61.85,,,percent of total billed charges,61.85% of total billed charges,22.01,16.8,,,percent of total billed charges,16.8% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,22.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,22.45,17.136,,,percent of total billed charges,17.136% of total billed charges,28.61,21.84,,,percent of total billed charges,21.84% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.5,50,,,percent of total billed charges,50% of total Billed charges,102.18,78,,,percent of total billed charges,78% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,22.01,16.8,,,percent of total billed charges,16.8% of total billed charges,65.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65.5,50,,,percent of total billed charges,50% of total Billed charges,22.01,16.8,,,percent of total billed charges,16.8% of total billed charges,20.04,131,
TUBE ET 7.5,221213,CDM,272,RC,,,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,2.25,17.304,,,percent of total billed charges,17.304% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.19,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,15.3,,,percent of total billed charges,15.3% of total billed charges,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,13,100,,,percent of total billed charges,100% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.23,17.136,,,percent of total billed charges,17.136% of total billed charges,2.84,21.84,,,percent of total billed charges,21.84% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,6.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.5,50,,,percent of total billed charges,50% of total Billed charges,2.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.99,13,
TUBE CONNECTING 12',491620,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
FEEDING TUBE 8FR.IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBE GAUZE 1,491621,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
TUBE FEEDING ENTUIT 14 FR GASTROSTOMY,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TUBE FEEDING ENTUIT 16 FR GASTROSTOMY,ORSUP0011,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
TUBE FEEDING ENTUIT 18 FR GASTROSTOMY,ORSUP0011,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
TUBE FEEDING ENTUIT 20 FR GASTROSTOMY,ORSUP0013,CDM,272,RC,,,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,138.43,17.304,,,percent of total billed charges,17.304% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,504,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,15.3,,,percent of total billed charges,15.3% of total billed charges,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,800,100,,,percent of total billed charges,100% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,137.09,17.136,,,percent of total billed charges,17.136% of total billed charges,174.72,21.84,,,percent of total billed charges,21.84% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,400,50,,,percent of total billed charges,50% of total Billed charges,134.4,16.8,,,percent of total billed charges,16.8% of total billed charges,122.4,800,
TUBE FEEDING 10FR SALEM SUMP,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBE FEEDING 12FR SALEM SUMP,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBE SALEM SUMP 8 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBE VINYL CONNECTING 30CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
TUBE VAC K2EDTA PINK 13 X 100ML,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBE 12 X 75,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBEGAUZE 10X25,ORSUP0003,CDM,272,RC,,,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,25.96,17.304,,,percent of total billed charges,17.304% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,94.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,15.3,,,percent of total billed charges,15.3% of total billed charges,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,150,100,,,percent of total billed charges,100% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,25.7,17.136,,,percent of total billed charges,17.136% of total billed charges,32.76,21.84,,,percent of total billed charges,21.84% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,75,50,,,percent of total billed charges,50% of total Billed charges,25.2,16.8,,,percent of total billed charges,16.8% of total billed charges,22.95,150,
TUBING SUCTION (STERILE) 6',81478,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
TUBING CONNECTING 6MM X 10FT,56496,CDM,272,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
TUBING OXYGEN 7 FT VINYL TIP,151702,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
TUBING OXYGEN 7FT,104745,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
TUBING HEATED INSUFLATION,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
TUBING CORRUGATED 6'' 100 FT DISP,274674,CDM,272,RC,,,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,44,50,,,percent of total billed charges,50% of total Billed charges,14.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,88,100,,,percent of total billed charges,100% of total billed charges,15.23,17.304,,,percent of total billed charges,17.304% of total billed charges,44,50,,,percent of total billed charges,50% of total Billed charges,55.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,14.78,16.8,,,percent of total billed charges,16.8% of total billed charges,13.46,15.3,,,percent of total billed charges,15.3% of total billed charges,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,44,50,,,percent of total billed charges,50% of total Billed charges,88,100,,,percent of total billed charges,100% of total billed charges,44,50,,,percent of total billed charges,50% of total Billed charges,88,100,,,percent of total billed charges,100% of total billed charges,44,50,,,percent of total billed charges,50% of total Billed charges,54.43,61.85,,,percent of total billed charges,61.85% of total billed charges,14.78,16.8,,,percent of total billed charges,16.8% of total billed charges,44,50,,,percent of total billed charges,50% of total Billed charges,44,50,,,percent of total billed charges,50% of total Billed charges,14.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,44,50,,,percent of total billed charges,50% of total Billed charges,44,50,,,percent of total billed charges,50% of total Billed charges,15.08,17.136,,,percent of total billed charges,17.136% of total billed charges,19.22,21.84,,,percent of total billed charges,21.84% of total billed charges,44,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,44,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,44,50,,,percent of total billed charges,50% of total Billed charges,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,14.78,16.8,,,percent of total billed charges,16.8% of total billed charges,44,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,44,50,,,percent of total billed charges,50% of total Billed charges,14.78,16.8,,,percent of total billed charges,16.8% of total billed charges,13.46,88,
TUBING GAS SAMPLE,246634,CDM,270,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
TUBING  HYDRA IRRIGATION,484762,CDM,272,RC,,,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,20.76,17.304,,,percent of total billed charges,17.304% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,20.56,17.136,,,percent of total billed charges,17.136% of total billed charges,26.21,21.84,,,percent of total billed charges,21.84% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,20.16,16.8,,,percent of total billed charges,16.8% of total billed charges,18.36,120,
TUBING  INTERSEPT 1/4 X 3/32 X 6 FT,272371,CDM,272,RC,,,Outpatient,,,39,25.35,,34.32,88,,,percent of total billed charges,88% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,6.75,17.304,,,percent of total billed charges,17.304% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.57,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,15.3,,,percent of total billed charges,15.3% of total billed charges,26.91,69,,,percent of total billed charges,69% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,39,100,,,percent of total billed charges,100% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,24.12,61.85,,,percent of total billed charges,61.85% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.68,17.136,,,percent of total billed charges,17.136% of total billed charges,8.52,21.84,,,percent of total billed charges,21.84% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,30.42,78,,,percent of total billed charges,78% of total billed charges,39,100,,,percent of total billed charges,100% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,32.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,19.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19.5,50,,,percent of total billed charges,50% of total Billed charges,6.55,16.8,,,percent of total billed charges,16.8% of total billed charges,5.97,39,
TUBING 5/16 ID CLEAR 100 RL,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
TUBING INTERSEPT 3/8 X 3/32 X 6 FT,272373,CDM,270,RC,,,Outpatient,,,51,33.15,,44.88,88,,,percent of total billed charges,88% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,8.83,17.304,,,percent of total billed charges,17.304% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,32.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,15.3,,,percent of total billed charges,15.3% of total billed charges,35.19,69,,,percent of total billed charges,69% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,51,100,,,percent of total billed charges,100% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,31.54,61.85,,,percent of total billed charges,61.85% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.74,17.136,,,percent of total billed charges,17.136% of total billed charges,11.14,21.84,,,percent of total billed charges,21.84% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,39.78,78,,,percent of total billed charges,78% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,25.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25.5,50,,,percent of total billed charges,50% of total Billed charges,8.57,16.8,,,percent of total billed charges,16.8% of total billed charges,7.8,51,
TUBING IRRIGATION 7501669,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TUBING PATIENT REDEUCE,ORSUP0024,CDM,270,RC,,,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
TUBING PUMP REDEUCE,ORSUP0026,CDM,270,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
TUBING DUAL PROBE,ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
TUBING PNEUMATIC KAIRISON FK888SU,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
TUBING SMARTABLATE PUMP,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
TUBING VACUUM FOR LEEP(OB/GYN),491641,CDM,270,RC,,,Outpatient,,,124,80.60,,109.12,88,,,percent of total billed charges,88% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,21.46,17.304,,,percent of total billed charges,17.304% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,78.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,18.97,15.3,,,percent of total billed charges,15.3% of total billed charges,85.56,69,,,percent of total billed charges,69% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,124,100,,,percent of total billed charges,100% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,76.69,61.85,,,percent of total billed charges,61.85% of total billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,21.25,17.136,,,percent of total billed charges,17.136% of total billed charges,27.08,21.84,,,percent of total billed charges,21.84% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,96.72,78,,,percent of total billed charges,78% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,62,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,62,50,,,percent of total billed charges,50% of total Billed charges,20.83,16.8,,,percent of total billed charges,16.8% of total billed charges,18.97,124,
TUBING INFLOW,ORSUP0013,CDM,270,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
TUBING LEG BAG W/CONNECTOR,491634,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
TUBING CROSSFLOW INFLO CASSET,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
TUBING 60GTT/ML,491625,CDM,272,RC,,,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,6.4,17.304,,,percent of total billed charges,17.304% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,23.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,37,100,,,percent of total billed charges,100% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.34,17.136,,,percent of total billed charges,17.136% of total billed charges,8.08,21.84,,,percent of total billed charges,21.84% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,18.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18.5,50,,,percent of total billed charges,50% of total Billed charges,6.22,16.8,,,percent of total billed charges,16.8% of total billed charges,5.66,37,
TUBING ADMINISTRATION SET 15GTT/ML,491626,CDM,272,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
TUBING CYSTO IRRIGATION,491628,CDM,270,RC,,,Outpatient,,,26,16.90,,22.88,88,,,percent of total billed charges,88% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,4.5,17.304,,,percent of total billed charges,17.304% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,15.3,,,percent of total billed charges,15.3% of total billed charges,17.94,69,,,percent of total billed charges,69% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,26,100,,,percent of total billed charges,100% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,16.08,61.85,,,percent of total billed charges,61.85% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,4.46,17.136,,,percent of total billed charges,17.136% of total billed charges,5.68,21.84,,,percent of total billed charges,21.84% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,20.28,78,,,percent of total billed charges,78% of total billed charges,26,100,,,percent of total billed charges,100% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,13,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13,50,,,percent of total billed charges,50% of total Billed charges,4.37,16.8,,,percent of total billed charges,16.8% of total billed charges,3.98,26,
TUBING IV BURETROL,491632,CDM,270,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TUBING IV SECONDARY,491633,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
TUBING MICROBORE 60GTT/ML,491635,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
TUBING OXYGEN 7' EXTENSION,491636,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
TUBING SALINE LOCK EXT 8,491637,CDM,270,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
TUBING SMALL BORE EXT SET 6,491638,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
TUBING SUCTION,491639,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
TUBING MAIN PUMP,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
TUBING CTA CONNECTING,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBING MALE TO MALE 72 IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
TUBING CORE IRRIGATION,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TUBING HIGH PRESSURE NAMIC FLEXCIL 48IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TUBING CONNECTING 7FR-10FR X 30CM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
TUBING PRESSURE MONITORING MALE/FEMALE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
TUBING EPIDURAL ADMIN FILTER 0.2 MICRON FILTER(CURLIN PUMP),ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
490153,490153,CDM,272,RC,,,Outpatient,,,1450,942.50,,1276,88,,,percent of total billed charges,88% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,250.91,17.304,,,percent of total billed charges,17.304% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,913.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,221.85,15.3,,,percent of total billed charges,15.3% of total billed charges,1000.5,69,,,percent of total billed charges,69% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,896.83,61.85,,,percent of total billed charges,61.85% of total billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,248.47,17.136,,,percent of total billed charges,17.136% of total billed charges,316.68,21.84,,,percent of total billed charges,21.84% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,1131,78,,,percent of total billed charges,78% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,725,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,725,50,,,percent of total billed charges,50% of total Billed charges,243.6,16.8,,,percent of total billed charges,16.8% of total billed charges,221.85,1450,
TWIST DRILL 1.1MM X 50MM W/NOTCH 5MM STOP,ORSUP0005,CDM,272,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
TWIST DRILL 2.30 MM DRILL-2.30,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
TWISTER 25MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TWISTER 13MM,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
TYPESAFE 2.0 SEGMENT PIERCING DEVICE,ORSUP0022,CDM,272,RC,,,Outpatient,,,2200,1430.00,,1936,88,,,percent of total billed charges,88% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,380.69,17.304,,,percent of total billed charges,17.304% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1386,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,15.3,,,percent of total billed charges,15.3% of total billed charges,1518,69,,,percent of total billed charges,69% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1360.7,61.85,,,percent of total billed charges,61.85% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,376.99,17.136,,,percent of total billed charges,17.136% of total billed charges,480.48,21.84,,,percent of total billed charges,21.84% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,1716,78,,,percent of total billed charges,78% of total billed charges,2200,100,,,percent of total billed charges,100% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1817.2,82.6,,,percent of total billed charges,82.6% of total billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,1100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1100,50,,,percent of total billed charges,50% of total Billed charges,369.6,16.8,,,percent of total billed charges,16.8% of total billed charges,336.6,2200,
UIBC,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
ULTIMATE CHAIR SENSOR,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ULTRACLIP II COIL TISSUE MARKER,ORSUP0019,CDM,278,RC,C1879,HCPCS,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,648.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,784.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,705.12,33.9,,,percent of total billed charges,33.9% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
ULTRASNAP ATP SWABS,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
ULTRASLING LRG,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
ULTRASOUND GEL,491644,CDM,270,RC,,,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,3.11,17.304,,,percent of total billed charges,17.304% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,3.08,17.136,,,percent of total billed charges,17.136% of total billed charges,3.93,21.84,,,percent of total billed charges,21.84% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,3.02,16.8,,,percent of total billed charges,16.8% of total billed charges,2.75,18,
ULTRASONIC TESTERS,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ULTRA-SLIP STYLETS,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
UMBILICAL CORD CLAMP PLASTIC OFF-WHITE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
UMBILICAL VESSEL CATH DUAL LUMEN 3.5FR,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
UNCROSSMATCHED BLOOD LABELS,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
UNDERWEAR PROTECTIVE PULL-UP LARGE,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
UNDER WEAR PULL UP SM,329909,CDM,272,RC,,,Outpatient,,,389,252.85,,342.32,88,,,percent of total billed charges,88% of total Billed charges,194.5,50,,,percent of total billed charges,50% of total Billed charges,65.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,389,100,,,percent of total billed charges,100% of total billed charges,67.31,17.304,,,percent of total billed charges,17.304% of total billed charges,194.5,50,,,percent of total billed charges,50% of total Billed charges,245.07,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.35,16.8,,,percent of total billed charges,16.8% of total billed charges,59.52,15.3,,,percent of total billed charges,15.3% of total billed charges,268.41,69,,,percent of total billed charges,69% of total billed charges,389,100,,,percent of total billed charges,100% of total billed charges,194.5,50,,,percent of total billed charges,50% of total Billed charges,389,100,,,percent of total billed charges,100% of total billed charges,194.5,50,,,percent of total billed charges,50% of total Billed charges,389,100,,,percent of total billed charges,100% of total billed charges,194.5,50,,,percent of total billed charges,50% of total Billed charges,240.6,61.85,,,percent of total billed charges,61.85% of total billed charges,65.35,16.8,,,percent of total billed charges,16.8% of total billed charges,194.5,50,,,percent of total billed charges,50% of total Billed charges,194.5,50,,,percent of total billed charges,50% of total Billed charges,65.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,194.5,50,,,percent of total billed charges,50% of total Billed charges,194.5,50,,,percent of total billed charges,50% of total Billed charges,66.66,17.136,,,percent of total billed charges,17.136% of total billed charges,84.96,21.84,,,percent of total billed charges,21.84% of total billed charges,194.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,194.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,194.5,50,,,percent of total billed charges,50% of total Billed charges,303.42,78,,,percent of total billed charges,78% of total billed charges,389,100,,,percent of total billed charges,100% of total billed charges,321.31,82.6,,,percent of total billed charges,82.6% of total billed charges,321.31,82.6,,,percent of total billed charges,82.6% of total billed charges,65.35,16.8,,,percent of total billed charges,16.8% of total billed charges,194.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,194.5,50,,,percent of total billed charges,50% of total Billed charges,65.35,16.8,,,percent of total billed charges,16.8% of total billed charges,59.52,389,
UNDERPAD 20.5X36IN,193403,CDM,272,RC,,,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,3.98,17.304,,,percent of total billed charges,17.304% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.49,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,23,100,,,percent of total billed charges,100% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.94,17.136,,,percent of total billed charges,17.136% of total billed charges,5.02,21.84,,,percent of total billed charges,21.84% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,11.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.5,50,,,percent of total billed charges,50% of total Billed charges,3.86,16.8,,,percent of total billed charges,16.8% of total billed charges,3.52,23,
UNDERPAD LARGE 30X30,76648,CDM,272,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
UNDERWEAR PROTECTIVE PULLUP DISPOS MEDIUM,240857,CDM,272,RC,,,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,45.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,271,100,,,percent of total billed charges,100% of total billed charges,46.89,17.304,,,percent of total billed charges,17.304% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,170.73,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,45.53,16.8,,,percent of total billed charges,16.8% of total billed charges,41.46,15.3,,,percent of total billed charges,15.3% of total billed charges,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,271,100,,,percent of total billed charges,100% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,271,100,,,percent of total billed charges,100% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,167.61,61.85,,,percent of total billed charges,61.85% of total billed charges,45.53,16.8,,,percent of total billed charges,16.8% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,45.53,16.8,,,percent of total billed charges,16.8% of total Billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,46.44,17.136,,,percent of total billed charges,17.136% of total billed charges,59.19,21.84,,,percent of total billed charges,21.84% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,135.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,135.5,50,,,percent of total billed charges,50% of total Billed charges,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,45.53,16.8,,,percent of total billed charges,16.8% of total billed charges,135.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,135.5,50,,,percent of total billed charges,50% of total Billed charges,45.53,16.8,,,percent of total billed charges,16.8% of total billed charges,41.46,271,
UNDERGLOVE SZ 9 SURGEON,491645,CDM,270,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
UNDERPADS,491646,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
UNDERPAD COMFORT GLIDE DRYPAD 36 X 57,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
UNDERPAD 17X24 DISPOSABLE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
UNDERWEAR ATTENDS PULL ON 22-34 SM,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
UNDERWEAR ATTENDS PULL ON 34-44 MED,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
UNDERWEAR ATTENDS PULL ON 44-58 LRG,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
UNDERGLOVES GAMMEX PI,ORSUP0001,CDM,272,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
UNIGLIDE ROADRUNNER .018X320CM,ORSUP0002,CDM,278,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
UNIT PREVENA PLUS 125 THERAPY,ORSUP0022,CDM,272,RC,,,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,494.89,17.304,,,percent of total billed charges,17.304% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1801.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,15.3,,,percent of total billed charges,15.3% of total billed charges,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,490.09,17.136,,,percent of total billed charges,17.136% of total billed charges,624.62,21.84,,,percent of total billed charges,21.84% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1430,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1430,50,,,percent of total billed charges,50% of total Billed charges,480.48,16.8,,,percent of total billed charges,16.8% of total billed charges,437.58,2860,
UNIVERSAL ECG CLIPS,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
UNIVERSAL VIRAL TRANSPORT 1ML,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
UNIVERSAL HOSE RED 60401800100,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
UNIVERSAL HOSE BLUE 60401700100,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
FACIAL WRAP UNIVERSAL,490585,CDM,270,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
UNIV WASH RESERVOIR FILTR,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
UNIVERSAL LIGHT COVER HANDLE COVER PURPLE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
UNIVERSAL NUT NIPPLE ADAPTER,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
UNIVERSAL FLAT SYLE CLIPPER BLADE GREY,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
UNNA BOOT 4 INCH GELOCAST,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
UPLUG 406,ORSUP0011,CDM,278,RC,C1781,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
UPRO PERF VERIFIER II,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
UPRO PERF VERIFIER I BX / 6BTLS,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
URETERAL CATH 5 FR,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
URETHRAL DILATOR SET 24FR,ORSUP0016,CDM,272,RC,,,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,199,17.304,,,percent of total billed charges,17.304% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,724.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,15.3,,,percent of total billed charges,15.3% of total billed charges,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,711.28,61.85,,,percent of total billed charges,61.85% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,197.06,17.136,,,percent of total billed charges,17.136% of total billed charges,251.16,21.84,,,percent of total billed charges,21.84% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,575,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,575,50,,,percent of total billed charges,50% of total Billed charges,193.2,16.8,,,percent of total billed charges,16.8% of total billed charges,175.95,1150,
URIC ACID /5 PACK / 300 SLDS,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
URINE METER,491649,CDM,270,RC,,,Outpatient,,,64,41.60,,56.32,88,,,percent of total billed charges,88% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,11.07,17.304,,,percent of total billed charges,17.304% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,40.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,9.79,15.3,,,percent of total billed charges,15.3% of total billed charges,44.16,69,,,percent of total billed charges,69% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,64,100,,,percent of total billed charges,100% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,39.58,61.85,,,percent of total billed charges,61.85% of total billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,10.97,17.136,,,percent of total billed charges,17.136% of total billed charges,13.98,21.84,,,percent of total billed charges,21.84% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,49.92,78,,,percent of total billed charges,78% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,32,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,32,50,,,percent of total billed charges,50% of total Billed charges,10.75,16.8,,,percent of total billed charges,16.8% of total billed charges,9.79,64,
URINAL W/ HANDLE,491648,CDM,270,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
URINE MANAGEMENT SYSTEM FEMALE EXTERNAL,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
URINE MANAGEMENT PRIMOFIT EXTERNAL,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
URINE ELEC DILUENT / BOX /12 BTLS,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
URINE PROTEINS / 5 PACK/ 90 SLDS,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
URINE COLLECTION PEDS STERILE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
URINE CAL 6X5ML,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
URINE CREATINE CAL,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
URINE COLLECTION KIT A-CT/NG,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
URISYS CALIBRATIONS STRIPS 50,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
UROPASS SHEATH 12/14FR x 46CM,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
UROPASS SHEATH 12/14FR X 54CM,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
UROPASS SHEATH 12/14FR X 38CM,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
UROPASS SHEATH 12/14FR X 24CM,ORSUP0015,CDM,270,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
UROPASS URETERAL ACCESS SHEATH 11/13FR 54CM,ORSUP0013,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
UROPASS URETERAL ACCESS SHEATH 11/13FR 46CM,ORSUP0012,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
URYSIS 1800 PAPER,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
1050 STERI DRAPE,490000,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
ADAPTIC NON-ADHERENT GAUZE 3 X 16,490018,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
ADAPTIC NON-ADHERENT GAUZE 3 X 3,490019,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
ADULT LAPAROTOMY DRAPE,490021,CDM,270,RC,,,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,10.21,17.304,,,percent of total billed charges,17.304% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,37.17,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,15.3,,,percent of total billed charges,15.3% of total billed charges,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,59,100,,,percent of total billed charges,100% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,36.49,61.85,,,percent of total billed charges,61.85% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,10.11,17.136,,,percent of total billed charges,17.136% of total billed charges,12.89,21.84,,,percent of total billed charges,21.84% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,29.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.5,50,,,percent of total billed charges,50% of total Billed charges,9.91,16.8,,,percent of total billed charges,16.8% of total billed charges,9.03,59,
USE ITEM #1008 ARM SLING LARGE,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
USE ITEM #79590 ARM SLING XL,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
COBAN STERILE 4,490357,CDM,272,RC,,,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,6.58,17.304,,,percent of total billed charges,17.304% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,38,100,,,percent of total billed charges,100% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,6.51,17.136,,,percent of total billed charges,17.136% of total billed charges,8.3,21.84,,,percent of total billed charges,21.84% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,19,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,19,50,,,percent of total billed charges,50% of total Billed charges,6.38,16.8,,,percent of total billed charges,16.8% of total billed charges,5.81,38,
EXTREMITY DRAPE,490548,CDM,270,RC,,,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,10.73,17.304,,,percent of total billed charges,17.304% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,39.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,9.49,15.3,,,percent of total billed charges,15.3% of total billed charges,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,62,100,,,percent of total billed charges,100% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,38.35,61.85,,,percent of total billed charges,61.85% of total billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,10.62,17.136,,,percent of total billed charges,17.136% of total billed charges,13.54,21.84,,,percent of total billed charges,21.84% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,31,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31,50,,,percent of total billed charges,50% of total Billed charges,10.42,16.8,,,percent of total billed charges,16.8% of total billed charges,9.49,62,
IOBAN INCISE DRAPE W/POUCH 129 W X 100 L,490763,CDM,270,RC,,,Outpatient,,,258,167.70,,227.04,88,,,percent of total billed charges,88% of total Billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,43.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,258,100,,,percent of total billed charges,100% of total billed charges,44.64,17.304,,,percent of total billed charges,17.304% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,162.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.34,16.8,,,percent of total billed charges,16.8% of total billed charges,39.47,15.3,,,percent of total billed charges,15.3% of total billed charges,178.02,69,,,percent of total billed charges,69% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,258,100,,,percent of total billed charges,100% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,258,100,,,percent of total billed charges,100% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,159.57,61.85,,,percent of total billed charges,61.85% of total billed charges,43.34,16.8,,,percent of total billed charges,16.8% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,43.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,44.21,17.136,,,percent of total billed charges,17.136% of total billed charges,56.35,21.84,,,percent of total billed charges,21.84% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,129,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,129,50,,,percent of total billed charges,50% of total Billed charges,201.24,78,,,percent of total billed charges,78% of total billed charges,258,100,,,percent of total billed charges,100% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,213.11,82.6,,,percent of total billed charges,82.6% of total billed charges,43.34,16.8,,,percent of total billed charges,16.8% of total billed charges,129,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,129,50,,,percent of total billed charges,50% of total Billed charges,43.34,16.8,,,percent of total billed charges,16.8% of total billed charges,39.47,258,
KLING GAUZE STERILE 6,490797,CDM,272,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
MAYO STAND COVER,490868,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
PEDIATRIC LAPAROTOMY DRAPE,491048,CDM,270,RC,,,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,11.94,17.304,,,percent of total billed charges,17.304% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,43.47,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,10.56,15.3,,,percent of total billed charges,15.3% of total billed charges,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,69,100,,,percent of total billed charges,100% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,42.68,61.85,,,percent of total billed charges,61.85% of total billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.82,17.136,,,percent of total billed charges,17.136% of total billed charges,15.07,21.84,,,percent of total billed charges,21.84% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,34.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,34.5,50,,,percent of total billed charges,50% of total Billed charges,11.59,16.8,,,percent of total billed charges,16.8% of total billed charges,10.56,69,
PLASTER SPLINT 3 X 15,491075,CDM,270,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
PLASTER SPLINT 5 X 30,491077,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
SHOULDER ARTHROSCOPY DRAPE,491192,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
STERI STRIP 1,491301,CDM,270,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
STERI STRIP 1/4,491302,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
STERIS WASHER INDICATOR,491308,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
STERRAD CASSETTES,491310,CDM,270,RC,,,Outpatient,,,878,570.70,,772.64,88,,,percent of total billed charges,88% of total Billed charges,439,50,,,percent of total billed charges,50% of total Billed charges,147.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,878,100,,,percent of total billed charges,100% of total billed charges,151.93,17.304,,,percent of total billed charges,17.304% of total billed charges,439,50,,,percent of total billed charges,50% of total Billed charges,553.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,147.5,16.8,,,percent of total billed charges,16.8% of total billed charges,134.33,15.3,,,percent of total billed charges,15.3% of total billed charges,605.82,69,,,percent of total billed charges,69% of total billed charges,878,100,,,percent of total billed charges,100% of total billed charges,439,50,,,percent of total billed charges,50% of total Billed charges,878,100,,,percent of total billed charges,100% of total billed charges,439,50,,,percent of total billed charges,50% of total Billed charges,878,100,,,percent of total billed charges,100% of total billed charges,439,50,,,percent of total billed charges,50% of total Billed charges,543.04,61.85,,,percent of total billed charges,61.85% of total billed charges,147.5,16.8,,,percent of total billed charges,16.8% of total billed charges,439,50,,,percent of total billed charges,50% of total Billed charges,439,50,,,percent of total billed charges,50% of total Billed charges,147.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,439,50,,,percent of total billed charges,50% of total Billed charges,439,50,,,percent of total billed charges,50% of total Billed charges,150.45,17.136,,,percent of total billed charges,17.136% of total billed charges,191.76,21.84,,,percent of total billed charges,21.84% of total billed charges,439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,439,50,,,percent of total billed charges,50% of total Billed charges,684.84,78,,,percent of total billed charges,78% of total billed charges,878,100,,,percent of total billed charges,100% of total billed charges,725.23,82.6,,,percent of total billed charges,82.6% of total billed charges,725.23,82.6,,,percent of total billed charges,82.6% of total billed charges,147.5,16.8,,,percent of total billed charges,16.8% of total billed charges,439,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,439,50,,,percent of total billed charges,50% of total Billed charges,147.5,16.8,,,percent of total billed charges,16.8% of total billed charges,134.33,878,
STERRAD INDICATOR TAPE,491311,CDM,270,RC,,,Outpatient,,,236,153.40,,207.68,88,,,percent of total billed charges,88% of total Billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,39.65,16.8,,,percent of total billed charges,16.8% of total Billed charges,236,100,,,percent of total billed charges,100% of total billed charges,40.84,17.304,,,percent of total billed charges,17.304% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,148.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,39.65,16.8,,,percent of total billed charges,16.8% of total billed charges,36.11,15.3,,,percent of total billed charges,15.3% of total billed charges,162.84,69,,,percent of total billed charges,69% of total billed charges,236,100,,,percent of total billed charges,100% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,236,100,,,percent of total billed charges,100% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,236,100,,,percent of total billed charges,100% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,145.97,61.85,,,percent of total billed charges,61.85% of total billed charges,39.65,16.8,,,percent of total billed charges,16.8% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,39.65,16.8,,,percent of total billed charges,16.8% of total Billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,40.44,17.136,,,percent of total billed charges,17.136% of total billed charges,51.54,21.84,,,percent of total billed charges,21.84% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,118,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,118,50,,,percent of total billed charges,50% of total Billed charges,184.08,78,,,percent of total billed charges,78% of total billed charges,236,100,,,percent of total billed charges,100% of total billed charges,194.94,82.6,,,percent of total billed charges,82.6% of total billed charges,194.94,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,16.8,,,percent of total billed charges,16.8% of total billed charges,118,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,118,50,,,percent of total billed charges,50% of total Billed charges,39.65,16.8,,,percent of total billed charges,16.8% of total billed charges,36.11,236,
STERRAD INDICATORS,491312,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
TABLE COVER,491542,CDM,270,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
TUBE GAUZE 5/8,491622,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
UTERINE MANIPULATOR TIP GREEN,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
UTERINE MANIPULATOR TIP BLUE,ORSUP0007,CDM,270,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
V-AGAR MONOPLATE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
VAC VIA THERAPY SYSTEM,ORSUP0027,CDM,272,RC,,,Outpatient,,,4160,2704.00,,3660.8,88,,,percent of total billed charges,88% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,719.85,17.304,,,percent of total billed charges,17.304% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2620.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,15.3,,,percent of total billed charges,15.3% of total billed charges,2870.4,69,,,percent of total billed charges,69% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2572.96,61.85,,,percent of total billed charges,61.85% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,712.86,17.136,,,percent of total billed charges,17.136% of total billed charges,908.54,21.84,,,percent of total billed charges,21.84% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,3244.8,78,,,percent of total billed charges,78% of total billed charges,4160,100,,,percent of total billed charges,100% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3436.16,82.6,,,percent of total billed charges,82.6% of total billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,2080,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2080,50,,,percent of total billed charges,50% of total Billed charges,698.88,16.8,,,percent of total billed charges,16.8% of total billed charges,636.48,4160,
VACUUM CURETTE 10MM CURVED,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
VACURETTE CVD  8MM      40789 308,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
VACUTAINER BLOOD COLLECTION SET 21G X 0.75 NEEDLE 12 TUBING,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
VACUTAINER VENOUS BLOOD COLLECTION SERUM SEPARATION TUBE,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
VACUTAINER BLOOD COLLECTION SET 23G X 0.75 NEEDLE 12 TUBING,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
VACUUM \\T\\ GAS WYE FITTING,ORSUP0015,CDM,272,RC,,,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,173.04,17.304,,,percent of total billed charges,17.304% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,630,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,15.3,,,percent of total billed charges,15.3% of total billed charges,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,171.36,17.136,,,percent of total billed charges,17.136% of total billed charges,218.4,21.84,,,percent of total billed charges,21.84% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,500,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,500,50,,,percent of total billed charges,50% of total Billed charges,168,16.8,,,percent of total billed charges,16.8% of total billed charges,153,1000,
VACUTAINER BLOOD COLLECTION SET WITH LUER ADAPTER 25G X 0.75,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
VAGINAL/CERVICAL RETRACTOR SM,ORSUP0011,CDM,270,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
VAGINAL/CERVICAL RETRACTOR MED,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
VAGINAL/CERVICAL RETRACTOR LG,ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
VAGINAL PACKING XRAY,491664,CDM,270,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
VAGINAL SPECULUMS LIGHTED MEDIUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
VAGINAL SPECULUM (CORDED) NONSTERLE MD,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
VAGINAL SPECULUM BUILT IN LIGHT MED,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
ER-SPEC LIGHTED VAGINAL SPECULUM LRG,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
ER-SPEC LIGHTED VAGINAL SPECULUM XLRG,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
VAGINAL SPECULUMS LIGHTED SMALL,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
VALLEYLAB LAPAROSCOPE WIRE L-HOOK ELECTRODE SOLID 45CM,484955,CDM,272,RC,,,Outpatient,,,3741,2431.65,,3292.08,88,,,percent of total billed charges,88% of total Billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,628.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,3741,100,,,percent of total billed charges,100% of total billed charges,647.34,17.304,,,percent of total billed charges,17.304% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,2356.83,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,628.49,16.8,,,percent of total billed charges,16.8% of total billed charges,572.37,15.3,,,percent of total billed charges,15.3% of total billed charges,2581.29,69,,,percent of total billed charges,69% of total billed charges,3741,100,,,percent of total billed charges,100% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,3741,100,,,percent of total billed charges,100% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,3741,100,,,percent of total billed charges,100% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,2313.81,61.85,,,percent of total billed charges,61.85% of total billed charges,628.49,16.8,,,percent of total billed charges,16.8% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,628.49,16.8,,,percent of total billed charges,16.8% of total Billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,641.06,17.136,,,percent of total billed charges,17.136% of total billed charges,817.03,21.84,,,percent of total billed charges,21.84% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1870.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1870.5,50,,,percent of total billed charges,50% of total Billed charges,2917.98,78,,,percent of total billed charges,78% of total billed charges,3741,100,,,percent of total billed charges,100% of total billed charges,3090.07,82.6,,,percent of total billed charges,82.6% of total billed charges,3090.07,82.6,,,percent of total billed charges,82.6% of total billed charges,628.49,16.8,,,percent of total billed charges,16.8% of total billed charges,1870.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1870.5,50,,,percent of total billed charges,50% of total Billed charges,628.49,16.8,,,percent of total billed charges,16.8% of total billed charges,572.37,3741,
VALPROIC REAGENT BOX / 300T,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
VALVE AIR SALEM SUMP WITH TUBE 16FR,42447,CDM,272,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
VALVE PERIMOUNT TFX 27MM,ORSUP0134,CDM,278,RC,C1763,HCPCS,Outpatient,,,33800,21970.00,,29744,88,,,percent of total billed charges,88% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5848.75,17.304,,,percent of total billed charges,17.304% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,21294,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,5171.4,15.3,,,percent of total billed charges,15.3% of total billed charges,23322,69,,,percent of total billed charges,69% of total billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,20905.3,61.85,,,percent of total billed charges,61.85% of total billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,10545.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16900,50,,,percent of total billed charges,50% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,5791.97,17.136,,,percent of total billed charges,17.136% of total billed charges,7381.92,21.84,,,percent of total billed charges,21.84% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,12742.6,37.7,,,percent of total billed charges,37.70% of total billed charges,12742.6,37.7,,,percent of total billed charges,37.70% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,11458.2,33.9,,,percent of total billed charges,33.9% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,26364,78,,,percent of total billed charges,78% of total billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,27918.8,82.6,,,percent of total billed charges,82.6% of total billed charges,27918.8,82.6,,,percent of total billed charges,82.6% of total billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16900,50,,,percent of total billed charges,50% of total Billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,33800,
VALVE PERICARDIAL TISSUE HEART 25MM 3000TFX,ORSUP0134,CDM,278,RC,C1763,HCPCS,Outpatient,,,33800,21970.00,,29744,88,,,percent of total billed charges,88% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5848.75,17.304,,,percent of total billed charges,17.304% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,21294,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,5171.4,15.3,,,percent of total billed charges,15.3% of total billed charges,23322,69,,,percent of total billed charges,69% of total billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,20905.3,61.85,,,percent of total billed charges,61.85% of total billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,10545.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16900,50,,,percent of total billed charges,50% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,5791.97,17.136,,,percent of total billed charges,17.136% of total billed charges,7381.92,21.84,,,percent of total billed charges,21.84% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,12742.6,37.7,,,percent of total billed charges,37.70% of total billed charges,12742.6,37.7,,,percent of total billed charges,37.70% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,11458.2,33.9,,,percent of total billed charges,33.9% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,26364,78,,,percent of total billed charges,78% of total billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,27918.8,82.6,,,percent of total billed charges,82.6% of total billed charges,27918.8,82.6,,,percent of total billed charges,82.6% of total billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16900,50,,,percent of total billed charges,50% of total Billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,33800,
VALVE PERIMOUNT TFX 23MM,ORSUP0134,CDM,278,RC,C1763,HCPCS,Outpatient,,,33800,21970.00,,29744,88,,,percent of total billed charges,88% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5848.75,17.304,,,percent of total billed charges,17.304% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,21294,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,5171.4,15.3,,,percent of total billed charges,15.3% of total billed charges,23322,69,,,percent of total billed charges,69% of total billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,20905.3,61.85,,,percent of total billed charges,61.85% of total billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,10545.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16900,50,,,percent of total billed charges,50% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,5791.97,17.136,,,percent of total billed charges,17.136% of total billed charges,7381.92,21.84,,,percent of total billed charges,21.84% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,12742.6,37.7,,,percent of total billed charges,37.70% of total billed charges,12742.6,37.7,,,percent of total billed charges,37.70% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,11458.2,33.9,,,percent of total billed charges,33.9% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,26364,78,,,percent of total billed charges,78% of total billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,27918.8,82.6,,,percent of total billed charges,82.6% of total billed charges,27918.8,82.6,,,percent of total billed charges,82.6% of total billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16900,50,,,percent of total billed charges,50% of total Billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,33800,
VALVE PERIMOUNT TFX 21MM,ORSUP0134,CDM,278,RC,C1763,HCPCS,Outpatient,,,33800,21970.00,,29744,88,,,percent of total billed charges,88% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5848.75,17.304,,,percent of total billed charges,17.304% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,21294,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,5171.4,15.3,,,percent of total billed charges,15.3% of total billed charges,23322,69,,,percent of total billed charges,69% of total billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,20905.3,61.85,,,percent of total billed charges,61.85% of total billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,10545.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16900,50,,,percent of total billed charges,50% of total Billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,5791.97,17.136,,,percent of total billed charges,17.136% of total billed charges,7381.92,21.84,,,percent of total billed charges,21.84% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,12742.6,37.7,,,percent of total billed charges,37.70% of total billed charges,12742.6,37.7,,,percent of total billed charges,37.70% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,11458.2,33.9,,,percent of total billed charges,33.9% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,26364,78,,,percent of total billed charges,78% of total billed charges,33800,100,,,percent of total billed charges,100% of total billed charges,27918.8,82.6,,,percent of total billed charges,82.6% of total billed charges,27918.8,82.6,,,percent of total billed charges,82.6% of total billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,16900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16900,50,,,percent of total billed charges,50% of total Billed charges,5678.4,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,33800,
VALVE AORTIC HI PROFILE HEART FLEX CUFF 19MM,ORSUP0100,CDM,278,RC,C1763,HCPCS,Outpatient,,,23660,15379.00,,20820.8,88,,,percent of total billed charges,88% of total Billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,3974.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,4094.13,17.304,,,percent of total billed charges,17.304% of total billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,14905.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3974.88,16.8,,,percent of total billed charges,16.8% of total billed charges,3619.98,15.3,,,percent of total billed charges,15.3% of total billed charges,16325.4,69,,,percent of total billed charges,69% of total billed charges,23660,100,,,percent of total billed charges,100% of total billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,23660,100,,,percent of total billed charges,100% of total billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,23660,100,,,percent of total billed charges,100% of total billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,14633.71,61.85,,,percent of total billed charges,61.85% of total billed charges,3974.88,16.8,,,percent of total billed charges,16.8% of total billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,7381.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11830,50,,,percent of total billed charges,50% of total Billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,4054.38,17.136,,,percent of total billed charges,17.136% of total billed charges,5167.34,21.84,,,percent of total billed charges,21.84% of total billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,8919.82,37.7,,,percent of total billed charges,37.70% of total billed charges,8919.82,37.7,,,percent of total billed charges,37.70% of total billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,8020.74,33.9,,,percent of total billed charges,33.9% of total billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,18454.8,78,,,percent of total billed charges,78% of total billed charges,23660,100,,,percent of total billed charges,100% of total billed charges,19543.16,82.6,,,percent of total billed charges,82.6% of total billed charges,19543.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3974.88,16.8,,,percent of total billed charges,16.8% of total billed charges,11830,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11830,50,,,percent of total billed charges,50% of total Billed charges,3974.88,16.8,,,percent of total billed charges,16.8% of total billed charges,3619.98,23660,
VALVE AORTIC HI PROFILE HEART FLEX CUFF 21MM,ORSUP0080,CDM,278,RC,C1763,HCPCS,Outpatient,,,18200,11830.00,,16016,88,,,percent of total billed charges,88% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3149.33,17.304,,,percent of total billed charges,17.304% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,11466,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2784.6,15.3,,,percent of total billed charges,15.3% of total billed charges,12558,69,,,percent of total billed charges,69% of total billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,11256.7,61.85,,,percent of total billed charges,61.85% of total billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,5678.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9100,50,,,percent of total billed charges,50% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,3118.75,17.136,,,percent of total billed charges,17.136% of total billed charges,3974.88,21.84,,,percent of total billed charges,21.84% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,6861.4,37.7,,,percent of total billed charges,37.70% of total billed charges,6861.4,37.7,,,percent of total billed charges,37.70% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,6169.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,14196,78,,,percent of total billed charges,78% of total billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,15033.2,82.6,,,percent of total billed charges,82.6% of total billed charges,15033.2,82.6,,,percent of total billed charges,82.6% of total billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9100,50,,,percent of total billed charges,50% of total Billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2784.6,18200,
VALVE AORTIC HI PROFILE HEART FLEX CUFF 25MM,ORSUP0080,CDM,278,RC,C1763,HCPCS,Outpatient,,,18200,11830.00,,16016,88,,,percent of total billed charges,88% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3149.33,17.304,,,percent of total billed charges,17.304% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,11466,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2784.6,15.3,,,percent of total billed charges,15.3% of total billed charges,12558,69,,,percent of total billed charges,69% of total billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,11256.7,61.85,,,percent of total billed charges,61.85% of total billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,5678.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9100,50,,,percent of total billed charges,50% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,3118.75,17.136,,,percent of total billed charges,17.136% of total billed charges,3974.88,21.84,,,percent of total billed charges,21.84% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,6861.4,37.7,,,percent of total billed charges,37.70% of total billed charges,6861.4,37.7,,,percent of total billed charges,37.70% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,6169.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,14196,78,,,percent of total billed charges,78% of total billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,15033.2,82.6,,,percent of total billed charges,82.6% of total billed charges,15033.2,82.6,,,percent of total billed charges,82.6% of total billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9100,50,,,percent of total billed charges,50% of total Billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2784.6,18200,
VALVE AORTIC HI PROFILE HEART FLEX CUFF 27MM,ORSUP0080,CDM,278,RC,C1763,HCPCS,Outpatient,,,18200,11830.00,,16016,88,,,percent of total billed charges,88% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3149.33,17.304,,,percent of total billed charges,17.304% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,11466,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2784.6,15.3,,,percent of total billed charges,15.3% of total billed charges,12558,69,,,percent of total billed charges,69% of total billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,11256.7,61.85,,,percent of total billed charges,61.85% of total billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,5678.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9100,50,,,percent of total billed charges,50% of total Billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,3118.75,17.136,,,percent of total billed charges,17.136% of total billed charges,3974.88,21.84,,,percent of total billed charges,21.84% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,6861.4,37.7,,,percent of total billed charges,37.70% of total billed charges,6861.4,37.7,,,percent of total billed charges,37.70% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,6169.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,14196,78,,,percent of total billed charges,78% of total billed charges,18200,100,,,percent of total billed charges,100% of total billed charges,15033.2,82.6,,,percent of total billed charges,82.6% of total billed charges,15033.2,82.6,,,percent of total billed charges,82.6% of total billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,9100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9100,50,,,percent of total billed charges,50% of total Billed charges,3057.6,16.8,,,percent of total billed charges,16.8% of total billed charges,2784.6,18200,
VALVE EPIC MITRAL 29MM,ORSUP0094,CDM,278,RC,C1763,HCPCS,Outpatient,,,22100,14365.00,,19448,88,,,percent of total billed charges,88% of total Billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3824.18,17.304,,,percent of total billed charges,17.304% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,13923,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3381.3,15.3,,,percent of total billed charges,15.3% of total billed charges,15249,69,,,percent of total billed charges,69% of total billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,13668.85,61.85,,,percent of total billed charges,61.85% of total billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,6895.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11050,50,,,percent of total billed charges,50% of total Billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,3787.06,17.136,,,percent of total billed charges,17.136% of total billed charges,4826.64,21.84,,,percent of total billed charges,21.84% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,8331.7,37.7,,,percent of total billed charges,37.70% of total billed charges,8331.7,37.7,,,percent of total billed charges,37.70% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,7491.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,17238,78,,,percent of total billed charges,78% of total billed charges,22100,100,,,percent of total billed charges,100% of total billed charges,18254.6,82.6,,,percent of total billed charges,82.6% of total billed charges,18254.6,82.6,,,percent of total billed charges,82.6% of total billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,11050,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11050,50,,,percent of total billed charges,50% of total Billed charges,3712.8,16.8,,,percent of total billed charges,16.8% of total billed charges,3381.3,22100,
VALVE HEART MITRAL 31MM ROTATABLE,ORSUP0083,CDM,278,RC,C1763,HCPCS,Outpatient,,,18980,12337.00,,16702.4,88,,,percent of total billed charges,88% of total Billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,3188.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3284.3,17.304,,,percent of total billed charges,17.304% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,11957.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3188.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2903.94,15.3,,,percent of total billed charges,15.3% of total billed charges,13096.2,69,,,percent of total billed charges,69% of total billed charges,18980,100,,,percent of total billed charges,100% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,18980,100,,,percent of total billed charges,100% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,18980,100,,,percent of total billed charges,100% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,11739.13,61.85,,,percent of total billed charges,61.85% of total billed charges,3188.64,16.8,,,percent of total billed charges,16.8% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,5921.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9490,50,,,percent of total billed charges,50% of total Billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,3252.41,17.136,,,percent of total billed charges,17.136% of total billed charges,4145.23,21.84,,,percent of total billed charges,21.84% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,7155.46,37.7,,,percent of total billed charges,37.70% of total billed charges,7155.46,37.7,,,percent of total billed charges,37.70% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,6434.22,33.9,,,percent of total billed charges,33.9% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,14804.4,78,,,percent of total billed charges,78% of total billed charges,18980,100,,,percent of total billed charges,100% of total billed charges,15677.48,82.6,,,percent of total billed charges,82.6% of total billed charges,15677.48,82.6,,,percent of total billed charges,82.6% of total billed charges,3188.64,16.8,,,percent of total billed charges,16.8% of total billed charges,9490,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9490,50,,,percent of total billed charges,50% of total Billed charges,3188.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2903.94,18980,
VALVE MITRAL 27MM MEDTRONICS,ORSUP0093,CDM,278,RC,C1763,HCPCS,Outpatient,,,21840,14196.00,,19219.2,88,,,percent of total billed charges,88% of total Billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,3779.19,17.304,,,percent of total billed charges,17.304% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,13759.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,3341.52,15.3,,,percent of total billed charges,15.3% of total billed charges,15069.6,69,,,percent of total billed charges,69% of total billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,13508.04,61.85,,,percent of total billed charges,61.85% of total billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,6814.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10920,50,,,percent of total billed charges,50% of total Billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,3742.5,17.136,,,percent of total billed charges,17.136% of total billed charges,4769.86,21.84,,,percent of total billed charges,21.84% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,8233.68,37.7,,,percent of total billed charges,37.70% of total billed charges,8233.68,37.7,,,percent of total billed charges,37.70% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,7403.76,33.9,,,percent of total billed charges,33.9% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,17035.2,78,,,percent of total billed charges,78% of total billed charges,21840,100,,,percent of total billed charges,100% of total billed charges,18039.84,82.6,,,percent of total billed charges,82.6% of total billed charges,18039.84,82.6,,,percent of total billed charges,82.6% of total billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,10920,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10920,50,,,percent of total billed charges,50% of total Billed charges,3669.12,16.8,,,percent of total billed charges,16.8% of total billed charges,3341.52,21840,
VALVE TRIFECTA GLIDE  19MM,ORSUP0124,CDM,278,RC,C1763,HCPCS,Outpatient,,,31200,20280.00,,27456,88,,,percent of total billed charges,88% of total Billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5398.85,17.304,,,percent of total billed charges,17.304% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,19656,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,4773.6,15.3,,,percent of total billed charges,15.3% of total billed charges,21528,69,,,percent of total billed charges,69% of total billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,19297.2,61.85,,,percent of total billed charges,61.85% of total billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,9734.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15600,50,,,percent of total billed charges,50% of total Billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,5346.43,17.136,,,percent of total billed charges,17.136% of total billed charges,6814.08,21.84,,,percent of total billed charges,21.84% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,11762.4,37.7,,,percent of total billed charges,37.70% of total billed charges,11762.4,37.7,,,percent of total billed charges,37.70% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,10576.8,33.9,,,percent of total billed charges,33.9% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,24336,78,,,percent of total billed charges,78% of total billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,25771.2,82.6,,,percent of total billed charges,82.6% of total billed charges,25771.2,82.6,,,percent of total billed charges,82.6% of total billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15600,50,,,percent of total billed charges,50% of total Billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,31200,
VALVE TRIFECTA GLIDE  21MM,ORSUP0121,CDM,278,RC,C1763,HCPCS,Outpatient,,,30420,19773.00,,26769.6,88,,,percent of total billed charges,88% of total Billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,5110.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5263.88,17.304,,,percent of total billed charges,17.304% of total billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,19164.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5110.56,16.8,,,percent of total billed charges,16.8% of total billed charges,4654.26,15.3,,,percent of total billed charges,15.3% of total billed charges,20989.8,69,,,percent of total billed charges,69% of total billed charges,30420,100,,,percent of total billed charges,100% of total billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,30420,100,,,percent of total billed charges,100% of total billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,30420,100,,,percent of total billed charges,100% of total billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,18814.77,61.85,,,percent of total billed charges,61.85% of total billed charges,5110.56,16.8,,,percent of total billed charges,16.8% of total billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,9491.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15210,50,,,percent of total billed charges,50% of total Billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,5212.77,17.136,,,percent of total billed charges,17.136% of total billed charges,6643.73,21.84,,,percent of total billed charges,21.84% of total billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,11468.34,37.7,,,percent of total billed charges,37.70% of total billed charges,11468.34,37.7,,,percent of total billed charges,37.70% of total billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,10312.38,33.9,,,percent of total billed charges,33.9% of total billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,23727.6,78,,,percent of total billed charges,78% of total billed charges,30420,100,,,percent of total billed charges,100% of total billed charges,25126.92,82.6,,,percent of total billed charges,82.6% of total billed charges,25126.92,82.6,,,percent of total billed charges,82.6% of total billed charges,5110.56,16.8,,,percent of total billed charges,16.8% of total billed charges,15210,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15210,50,,,percent of total billed charges,50% of total Billed charges,5110.56,16.8,,,percent of total billed charges,16.8% of total billed charges,4654.26,30420,
VALVE TRIFECTA GLIDE  23MM,ORSUP0124,CDM,278,RC,C1763,HCPCS,Outpatient,,,31200,20280.00,,27456,88,,,percent of total billed charges,88% of total Billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5398.85,17.304,,,percent of total billed charges,17.304% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,19656,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,4773.6,15.3,,,percent of total billed charges,15.3% of total billed charges,21528,69,,,percent of total billed charges,69% of total billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,19297.2,61.85,,,percent of total billed charges,61.85% of total billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,9734.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15600,50,,,percent of total billed charges,50% of total Billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,5346.43,17.136,,,percent of total billed charges,17.136% of total billed charges,6814.08,21.84,,,percent of total billed charges,21.84% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,11762.4,37.7,,,percent of total billed charges,37.70% of total billed charges,11762.4,37.7,,,percent of total billed charges,37.70% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,10576.8,33.9,,,percent of total billed charges,33.9% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,24336,78,,,percent of total billed charges,78% of total billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,25771.2,82.6,,,percent of total billed charges,82.6% of total billed charges,25771.2,82.6,,,percent of total billed charges,82.6% of total billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15600,50,,,percent of total billed charges,50% of total Billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,31200,
VALVE TRIFECTA GLIDE  25MM,ORSUP0124,CDM,278,RC,C1763,HCPCS,Outpatient,,,31200,20280.00,,27456,88,,,percent of total billed charges,88% of total Billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,5398.85,17.304,,,percent of total billed charges,17.304% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,19656,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,4773.6,15.3,,,percent of total billed charges,15.3% of total billed charges,21528,69,,,percent of total billed charges,69% of total billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,19297.2,61.85,,,percent of total billed charges,61.85% of total billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,9734.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15600,50,,,percent of total billed charges,50% of total Billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,5346.43,17.136,,,percent of total billed charges,17.136% of total billed charges,6814.08,21.84,,,percent of total billed charges,21.84% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,11762.4,37.7,,,percent of total billed charges,37.70% of total billed charges,11762.4,37.7,,,percent of total billed charges,37.70% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,10576.8,33.9,,,percent of total billed charges,33.9% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,24336,78,,,percent of total billed charges,78% of total billed charges,31200,100,,,percent of total billed charges,100% of total billed charges,25771.2,82.6,,,percent of total billed charges,82.6% of total billed charges,25771.2,82.6,,,percent of total billed charges,82.6% of total billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,15600,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15600,50,,,percent of total billed charges,50% of total Billed charges,5241.6,16.8,,,percent of total billed charges,16.8% of total billed charges,4695,31200,
VALVE SPEAKING LOW PROFILE PURPLE,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
VALVE FIXED PRESSURE 40MM,ORSUP0035,CDM,272,RC,,,Outpatient,,,6240,4056.00,,5491.2,88,,,percent of total billed charges,88% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1079.77,17.304,,,percent of total billed charges,17.304% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3931.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,15.3,,,percent of total billed charges,15.3% of total billed charges,4305.6,69,,,percent of total billed charges,69% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3859.44,61.85,,,percent of total billed charges,61.85% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,1069.29,17.136,,,percent of total billed charges,17.136% of total billed charges,1362.82,21.84,,,percent of total billed charges,21.84% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,4867.2,78,,,percent of total billed charges,78% of total billed charges,6240,100,,,percent of total billed charges,100% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5154.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,3120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3120,50,,,percent of total billed charges,50% of total Billed charges,1048.32,16.8,,,percent of total billed charges,16.8% of total billed charges,954.72,6240,
VALVE FIXED PRESSURE 100MM,ORSUP0033,CDM,272,RC,,,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
VANCOMYCIN REAGENT BOX / 300T,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
VANTEX 7FR 20CM 3L CVC PLUS KIT,ORSUP0015,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
VAPOR-TRAL(FORMALDEHYDE DOSIMETER),ORSUP0019,CDM,272,RC,,,Outpatient,,,2080,1352.00,,1830.4,88,,,percent of total billed charges,88% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,359.92,17.304,,,percent of total billed charges,17.304% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1310.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,15.3,,,percent of total billed charges,15.3% of total billed charges,1435.2,69,,,percent of total billed charges,69% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1286.48,61.85,,,percent of total billed charges,61.85% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,356.43,17.136,,,percent of total billed charges,17.136% of total billed charges,454.27,21.84,,,percent of total billed charges,21.84% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,1622.4,78,,,percent of total billed charges,78% of total billed charges,2080,100,,,percent of total billed charges,100% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1718.08,82.6,,,percent of total billed charges,82.6% of total billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,1040,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1040,50,,,percent of total billed charges,50% of total Billed charges,349.44,16.8,,,percent of total billed charges,16.8% of total billed charges,318.24,2080,
VAPOR ADSORPTION CARTRIDGE,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
VAPR PREMIERE 50 ELECTRODE,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
VAPR PREMIERE 90 ELECTRODE,ORSUP0018,CDM,272,RC,,,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1187.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
VARIBAR NECTAR D115,ORSUP0021,CDM,270,RC,,,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1638,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
VARIBAR THIN LIQUID,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
VARITHENA CANNISTER 18 LITER,ORSUP0083,CDM,272,RC,,,Outpatient,,,14600,9490.00,,12848,88,,,percent of total billed charges,88% of total Billed charges,7300,50,,,percent of total billed charges,50% of total Billed charges,2452.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,2526.38,17.304,,,percent of total billed charges,17.304% of total billed charges,7300,50,,,percent of total billed charges,50% of total Billed charges,9198,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2452.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2233.8,15.3,,,percent of total billed charges,15.3% of total billed charges,10074,69,,,percent of total billed charges,69% of total billed charges,14600,100,,,percent of total billed charges,100% of total billed charges,7300,50,,,percent of total billed charges,50% of total Billed charges,14600,100,,,percent of total billed charges,100% of total billed charges,7300,50,,,percent of total billed charges,50% of total Billed charges,14600,100,,,percent of total billed charges,100% of total billed charges,7300,50,,,percent of total billed charges,50% of total Billed charges,9030.1,61.85,,,percent of total billed charges,61.85% of total billed charges,2452.8,16.8,,,percent of total billed charges,16.8% of total billed charges,7300,50,,,percent of total billed charges,50% of total Billed charges,7300,50,,,percent of total billed charges,50% of total Billed charges,2452.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,7300,50,,,percent of total billed charges,50% of total Billed charges,7300,50,,,percent of total billed charges,50% of total Billed charges,2501.86,17.136,,,percent of total billed charges,17.136% of total billed charges,3188.64,21.84,,,percent of total billed charges,21.84% of total billed charges,7300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7300,50,,,percent of total billed charges,50% of total Billed charges,11388,78,,,percent of total billed charges,78% of total billed charges,14600,100,,,percent of total billed charges,100% of total billed charges,12059.6,82.6,,,percent of total billed charges,82.6% of total billed charges,12059.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2452.8,16.8,,,percent of total billed charges,16.8% of total billed charges,7300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7300,50,,,percent of total billed charges,50% of total Billed charges,2452.8,16.8,,,percent of total billed charges,16.8% of total billed charges,2233.8,14600,
VASCULAR CLOSURE DEVICE 6FT MANX GNP,ORSUP0015,CDM,278,RC,C1760,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
VASCU-GUARD VG-0209N,ORSUP0016,CDM,278,RC,C1768,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
VASCU-GUARD VG-0108N,ORSUP0015,CDM,278,RC,C1768,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,405.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
VASCULAR GRAFT IMPRA FLEX 8MM X 30,ORSUP0026,CDM,278,RC,C1768,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
VASCULAR FLORESTER 1.75,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
VASHE WOUND SOLUTION BOTTLE 4oz,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
VASHE WOUND SOLUTION BOTTLE 8.5 FL.OZ,ORSUP0002,CDM,272,RC,,,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,17.3,17.304,,,percent of total billed charges,17.304% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,100,100,,,percent of total billed charges,100% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,17.14,17.136,,,percent of total billed charges,17.136% of total billed charges,21.84,21.84,,,percent of total billed charges,21.84% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,50,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50,50,,,percent of total billed charges,50% of total Billed charges,16.8,16.8,,,percent of total billed charges,16.8% of total billed charges,15.3,100,
"VENA CAVA FILTER, JUGULAR",ORSUP0012,CDM,270,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
VENASEAL,ORSUP0046,CDM,272,RC,,,Outpatient,,,9100,5915.00,,8008,88,,,percent of total billed charges,88% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1574.66,17.304,,,percent of total billed charges,17.304% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5733,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,15.3,,,percent of total billed charges,15.3% of total billed charges,6279,69,,,percent of total billed charges,69% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5628.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1559.38,17.136,,,percent of total billed charges,17.136% of total billed charges,1987.44,21.84,,,percent of total billed charges,21.84% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,7098,78,,,percent of total billed charges,78% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,9100,
VENCLOSE PACKS W/ SHEATH 7CM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
VENOUS CATH PERIPHERAL 18G X 1.88,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
VENTRALIGHT CIRCLE MESH 8,ORSUP0064,CDM,278,RC,C1781,HCPCS,Outpatient,,,10800,7020.00,,9504,88,,,percent of total billed charges,88% of total Billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,1814.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1868.83,17.304,,,percent of total billed charges,17.304% of total billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,6804,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1814.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1652.4,15.3,,,percent of total billed charges,15.3% of total billed charges,7452,69,,,percent of total billed charges,69% of total billed charges,10800,100,,,percent of total billed charges,100% of total billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,10800,100,,,percent of total billed charges,100% of total billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,10800,100,,,percent of total billed charges,100% of total billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,6679.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1814.4,16.8,,,percent of total billed charges,16.8% of total billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,3369.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5400,50,,,percent of total billed charges,50% of total Billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,1850.69,17.136,,,percent of total billed charges,17.136% of total billed charges,2358.72,21.84,,,percent of total billed charges,21.84% of total billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,4071.6,37.7,,,percent of total billed charges,37.70% of total billed charges,4071.6,37.7,,,percent of total billed charges,37.70% of total billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,3661.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,8424,78,,,percent of total billed charges,78% of total billed charges,10800,100,,,percent of total billed charges,100% of total billed charges,8920.8,82.6,,,percent of total billed charges,82.6% of total billed charges,8920.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1814.4,16.8,,,percent of total billed charges,16.8% of total billed charges,5400,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5400,50,,,percent of total billed charges,50% of total Billed charges,1814.4,16.8,,,percent of total billed charges,16.8% of total billed charges,1652.4,10800,
VENUS CLOSURE FAST 7 X 100 CF7-7-100,ORSUP0033,CDM,272,RC,,,Outpatient,,,5720,3718.00,,5033.6,88,,,percent of total billed charges,88% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,989.79,17.304,,,percent of total billed charges,17.304% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3603.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,15.3,,,percent of total billed charges,15.3% of total billed charges,3946.8,69,,,percent of total billed charges,69% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,3537.82,61.85,,,percent of total billed charges,61.85% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,980.18,17.136,,,percent of total billed charges,17.136% of total billed charges,1249.25,21.84,,,percent of total billed charges,21.84% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,4461.6,78,,,percent of total billed charges,78% of total billed charges,5720,100,,,percent of total billed charges,100% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,4724.72,82.6,,,percent of total billed charges,82.6% of total billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,2860,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2860,50,,,percent of total billed charges,50% of total Billed charges,960.96,16.8,,,percent of total billed charges,16.8% of total billed charges,875.16,5720,
VERAFLO CLEANSE CHOICE MEDIUM,ORSUP0025,CDM,270,RC,,,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
VERF KIT ABL-90/80 COOX VK KIT,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
VERIFICATION THERMOMETER -5C to +20C,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
VERIFICATION THERMOMETER -90C TO +25C,ORSUP0005,CDM,272,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
VERSETTE FEMALE EXTERNAL CATHETER MESH,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
VERTEBRAL SPACER CR LORDOTIC 10MM 889..926,ORSUP0038,CDM,278,RC,C1755,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
VERTEBRAL SPACER CR LORDOTIC 7MM 889.923,ORSUP0038,CDM,278,RC,C1755,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
VERTEBRAL SPACER CR LORDOTIC 8MM 889.924,ORSUP0038,CDM,278,RC,C1755,HCPCS,Outpatient,,,7020,4563.00,,6177.6,88,,,percent of total billed charges,88% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1214.74,17.304,,,percent of total billed charges,17.304% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,15.3,,,percent of total billed charges,15.3% of total billed charges,4843.8,69,,,percent of total billed charges,69% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,4341.87,61.85,,,percent of total billed charges,61.85% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2190.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3510,50,,,percent of total billed charges,50% of total Billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,1202.95,17.136,,,percent of total billed charges,17.136% of total billed charges,1533.17,21.84,,,percent of total billed charges,21.84% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2646.54,37.7,,,percent of total billed charges,37.70% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,2379.78,33.9,,,percent of total billed charges,33.9% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,5475.6,78,,,percent of total billed charges,78% of total billed charges,7020,100,,,percent of total billed charges,100% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,5798.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3510,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3510,50,,,percent of total billed charges,50% of total Billed charges,1179.36,16.8,,,percent of total billed charges,16.8% of total billed charges,1074.06,7020,
VERTEBRAL SPACERS PR,ORSUP0052,CDM,278,RC,C1755,HCPCS,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3325.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3613.74,33.9,,,percent of total billed charges,33.9% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
VERTEBROPLASTY 11G 4 FACETTE NEEDLE,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
VERTICAL DRAIN/TUBE ATTACHMENT 5-40 FR,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
VESSEL SEALER EXTEND,ORSUP0026,CDM,272,RC,,,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
VEST TALL,ORSUP0047,CDM,272,RC,,,Outpatient,,,9360,6084.00,,8236.8,88,,,percent of total billed charges,88% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1619.65,17.304,,,percent of total billed charges,17.304% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,5896.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1432.08,15.3,,,percent of total billed charges,15.3% of total billed charges,6458.4,69,,,percent of total billed charges,69% of total billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,5789.16,61.85,,,percent of total billed charges,61.85% of total billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,1603.93,17.136,,,percent of total billed charges,17.136% of total billed charges,2044.22,21.84,,,percent of total billed charges,21.84% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4680,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4680,50,,,percent of total billed charges,50% of total Billed charges,7300.8,78,,,percent of total billed charges,78% of total billed charges,9360,100,,,percent of total billed charges,100% of total billed charges,7731.36,82.6,,,percent of total billed charges,82.6% of total billed charges,7731.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,4680,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4680,50,,,percent of total billed charges,50% of total Billed charges,1572.48,16.8,,,percent of total billed charges,16.8% of total billed charges,1432.08,9360,
VEST SAFETY SMALL,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
VEST SAFETY MEDIUM,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
VEST SAFETY LARGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
VEST SAFETY X-LARGE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
VIAL ADAPTER PINSYNC VENTED,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
VICRYL 0 CT-1 (J260H),491674,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
VICRYL 1 CT-1 (J261H),491675,CDM,272,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
VICRYL 3-0 SH (J784G),491677,CDM,272,RC,,,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,93,100,,,percent of total billed charges,100% of total billed charges,16.09,17.304,,,percent of total billed charges,17.304% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,58.59,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,14.23,15.3,,,percent of total billed charges,15.3% of total billed charges,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,93,100,,,percent of total billed charges,100% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,93,100,,,percent of total billed charges,100% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,57.52,61.85,,,percent of total billed charges,61.85% of total billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.94,17.136,,,percent of total billed charges,17.136% of total billed charges,20.31,21.84,,,percent of total billed charges,21.84% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46.5,50,,,percent of total billed charges,50% of total Billed charges,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,46.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,46.5,50,,,percent of total billed charges,50% of total Billed charges,15.62,16.8,,,percent of total billed charges,16.8% of total billed charges,14.23,93,
VICRYL 4-0 P-3 (J494G),491678,CDM,272,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
VICRYL 4-0 PC-5 (J823G),491679,CDM,272,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
VICRYL 6-0 P-3 (J492G),491681,CDM,272,RC,,,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,5.71,17.304,,,percent of total billed charges,17.304% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,33,100,,,percent of total billed charges,100% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,20.41,61.85,,,percent of total billed charges,61.85% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.65,17.136,,,percent of total billed charges,17.136% of total billed charges,7.21,21.84,,,percent of total billed charges,21.84% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,16.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.5,50,,,percent of total billed charges,50% of total Billed charges,5.54,16.8,,,percent of total billed charges,16.8% of total billed charges,5.05,33,
VICRYL PLUS 0 CT-1 (VCP840D),491682,CDM,272,RC,,,Outpatient,,,102,66.30,,89.76,88,,,percent of total billed charges,88% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,102,100,,,percent of total billed charges,100% of total billed charges,17.65,17.304,,,percent of total billed charges,17.304% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,64.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,15.61,15.3,,,percent of total billed charges,15.3% of total billed charges,70.38,69,,,percent of total billed charges,69% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,102,100,,,percent of total billed charges,100% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,102,100,,,percent of total billed charges,100% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,63.09,61.85,,,percent of total billed charges,61.85% of total billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,17.48,17.136,,,percent of total billed charges,17.136% of total billed charges,22.28,21.84,,,percent of total billed charges,21.84% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,51,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,51,50,,,percent of total billed charges,50% of total Billed charges,79.56,78,,,percent of total billed charges,78% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,51,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,51,50,,,percent of total billed charges,50% of total Billed charges,17.14,16.8,,,percent of total billed charges,16.8% of total billed charges,15.61,102,
VICRYL PLUS 2-0 CT-1 (VCP839D),491683,CDM,272,RC,,,Outpatient,,,99,64.35,,87.12,88,,,percent of total billed charges,88% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,17.13,17.304,,,percent of total billed charges,17.304% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,62.37,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,15.15,15.3,,,percent of total billed charges,15.3% of total billed charges,68.31,69,,,percent of total billed charges,69% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,99,100,,,percent of total billed charges,100% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,61.23,61.85,,,percent of total billed charges,61.85% of total billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.96,17.136,,,percent of total billed charges,17.136% of total billed charges,21.62,21.84,,,percent of total billed charges,21.84% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,77.22,78,,,percent of total billed charges,78% of total billed charges,99,100,,,percent of total billed charges,100% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,81.77,82.6,,,percent of total billed charges,82.6% of total billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,49.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,49.5,50,,,percent of total billed charges,50% of total Billed charges,16.63,16.8,,,percent of total billed charges,16.8% of total billed charges,15.15,99,
VICRYL RAPIDE 2-0 SH (UR417),491684,CDM,272,RC,,,Outpatient,,,27,17.55,,23.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,4.67,17.304,,,percent of total billed charges,17.304% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,17.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,15.3,,,percent of total billed charges,15.3% of total billed charges,18.63,69,,,percent of total billed charges,69% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,27,100,,,percent of total billed charges,100% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,16.7,61.85,,,percent of total billed charges,61.85% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.63,17.136,,,percent of total billed charges,17.136% of total billed charges,5.9,21.84,,,percent of total billed charges,21.84% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,21.06,78,,,percent of total billed charges,78% of total billed charges,27,100,,,percent of total billed charges,100% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,22.3,82.6,,,percent of total billed charges,82.6% of total billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,13.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13.5,50,,,percent of total billed charges,50% of total Billed charges,4.54,16.8,,,percent of total billed charges,16.8% of total billed charges,4.13,27,
VICRYL RAPIDE 4-0 P-3 (UR494),491685,CDM,272,RC,,,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,8.13,17.304,,,percent of total billed charges,17.304% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,15.3,,,percent of total billed charges,15.3% of total billed charges,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,47,100,,,percent of total billed charges,100% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,8.05,17.136,,,percent of total billed charges,17.136% of total billed charges,10.26,21.84,,,percent of total billed charges,21.84% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,23.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23.5,50,,,percent of total billed charges,50% of total Billed charges,7.9,16.8,,,percent of total billed charges,16.8% of total billed charges,7.19,47,
VIDAS BRAHAMS PCT PROCALCITONIN,ORSUP0002,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
VIPERWIRE ADVANCED PERIPHERAL GUIDE,ORSUP0013,CDM,278,RC,C1769,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,324.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,352.56,33.9,,,percent of total billed charges,33.9% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
VIROCLEAR SINGLE LVL,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
VIROTROL SINGLE LVL,ORSUP0015,CDM,272,RC,,,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,224.95,17.304,,,percent of total billed charges,17.304% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,819,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,15.3,,,percent of total billed charges,15.3% of total billed charges,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,222.77,17.136,,,percent of total billed charges,17.136% of total billed charges,283.92,21.84,,,percent of total billed charges,21.84% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,650,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,650,50,,,percent of total billed charges,50% of total Billed charges,218.4,16.8,,,percent of total billed charges,16.8% of total billed charges,198.9,1300,
VIROCLEAR TRCH SINGLE LVL,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
VIROTROL TRCH SINGLE LVL,ORSUP0016,CDM,272,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
VIROTROL HIV-2,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
VISAIRO NIV UNDER NOSE MASK,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
VISAIRO NIV UNDER NOSE MASK SZ B,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
VISAIRO NIV UNDER NOSE MASK SZ C,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
VISITECMINI MINISCUS FLAT BLADE HANDLE 4MM,ORSUP0004,CDM,272,RC,,,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
VISTASEAL FIBRIN SEALANT 2ML,ORSUP0012,CDM,278,RC,C1762,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
VISTASEAL FIBRIN SEALANT 4ML,ORSUP0020,CDM,278,RC,C1762,HCPCS,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,561.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,610.2,33.9,,,percent of total billed charges,33.9% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
VISTASEAL RIDGID LAP DUAL APPLICATOR 35CM,ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
VIT D (25 OH) CAL,ORSUP0011,CDM,272,RC,,,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,103.82,17.304,,,percent of total billed charges,17.304% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,378,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,15.3,,,percent of total billed charges,15.3% of total billed charges,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,600,100,,,percent of total billed charges,100% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,102.82,17.136,,,percent of total billed charges,17.136% of total billed charges,131.04,21.84,,,percent of total billed charges,21.84% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,300,50,,,percent of total billed charges,50% of total Billed charges,100.8,16.8,,,percent of total billed charges,16.8% of total billed charges,91.8,600,
GRAM NEG SENS (AST-84),ORSUP0007,CDM,272,RC,,,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,286.65,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
VITEK 2 AST-N809,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
VITOSS BA 10CC FOAM STRIP,ORSUP0052,CDM,278,RC,C1763,HCPCS,Outpatient,,,10660,6929.00,,9380.8,88,,,percent of total billed charges,88% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1844.61,17.304,,,percent of total billed charges,17.304% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6715.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,15.3,,,percent of total billed charges,15.3% of total billed charges,7355.4,69,,,percent of total billed charges,69% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,6593.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3325.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5330,50,,,percent of total billed charges,50% of total Billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,1826.7,17.136,,,percent of total billed charges,17.136% of total billed charges,2328.14,21.84,,,percent of total billed charges,21.84% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,4018.82,37.7,,,percent of total billed charges,37.70% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,3613.74,33.9,,,percent of total billed charges,33.9% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,8314.8,78,,,percent of total billed charges,78% of total billed charges,10660,100,,,percent of total billed charges,100% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,8805.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5330,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5330,50,,,percent of total billed charges,50% of total Billed charges,1790.88,16.8,,,percent of total billed charges,16.8% of total billed charges,1630.98,10660,
VITOSS 2.5CC,ORSUP0024,CDM,278,RC,C1763,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
VITROSS BONE GRAFT SUBSTITUTE 5CC,ORSUP0034,CDM,278,RC,C1763,HCPCS,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,809.83,17.304,,,percent of total billed charges,17.304% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2948.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,15.3,,,percent of total billed charges,15.3% of total billed charges,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1460.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2340,50,,,percent of total billed charges,50% of total Billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,801.96,17.136,,,percent of total billed charges,17.136% of total billed charges,1022.11,21.84,,,percent of total billed charges,21.84% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,1586.52,33.9,,,percent of total billed charges,33.9% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,2340,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2340,50,,,percent of total billed charges,50% of total Billed charges,786.24,16.8,,,percent of total billed charges,16.8% of total billed charges,716.04,4680,
VIZISHOT 21G,ORSUP0012,CDM,272,RC,,,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
VOLAR LOCKING DISTAL RADIUS PLATE 9 HOLE,ORSUP0044,CDM,278,RC,C1713,HCPCS,Outpatient,,,4940,3211.00,,4347.2,88,,,percent of total billed charges,88% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,854.82,17.304,,,percent of total billed charges,17.304% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3112.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,15.3,,,percent of total billed charges,15.3% of total billed charges,3408.6,69,,,percent of total billed charges,69% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3055.39,61.85,,,percent of total billed charges,61.85% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1541.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2470,50,,,percent of total billed charges,50% of total Billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,846.52,17.136,,,percent of total billed charges,17.136% of total billed charges,1078.9,21.84,,,percent of total billed charges,21.84% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1862.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,1674.66,33.9,,,percent of total billed charges,33.9% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,3853.2,78,,,percent of total billed charges,78% of total billed charges,4940,100,,,percent of total billed charges,100% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,4080.44,82.6,,,percent of total billed charges,82.6% of total billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,2470,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2470,50,,,percent of total billed charges,50% of total Billed charges,829.92,16.8,,,percent of total billed charges,16.8% of total billed charges,755.82,4940,
VOLAR PEG THREADED 18MM TPEG-18,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
VOLAR PEG THREADED 22MM TPEG-22,ORSUP0011,CDM,278,RC,C1713,HCPCS,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,294.06,37.7,,,percent of total billed charges,37.70% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,264.42,33.9,,,percent of total billed charges,33.9% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
WALKER CAST FOAM SZ MED     01F M,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
WALKER CAST FOAM SZ SM     01F S,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
WALKER CAST FOAM SZ LARGE     01F L,ORSUP0006,CDM,270,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
WALKER BOOT MID-CALF XLARGE,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
WALKER BOOT MID-CALF LARGE,ORSUP0014,CDM,272,RC,,,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
WALKER BOOT MID-CALF MEDIUM,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
WALKER BOOT MID-CALF SMALL,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
WALKER BOOT MID-CALF XSMALL,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
WASHER MAXTORQUE 4.0 CONTOURED (GOLD) CSS-500-40B,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
WASH REAGENT BOX / 2 BOTTLES,ORSUP0010,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
WATER NERL REAGENT 5 GAL,ORSUP0011,CDM,272,RC,,,Outpatient,,,780,507.00,,686.4,88,,,percent of total billed charges,88% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,134.97,17.304,,,percent of total billed charges,17.304% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,491.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,15.3,,,percent of total billed charges,15.3% of total billed charges,538.2,69,,,percent of total billed charges,69% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,780,100,,,percent of total billed charges,100% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,482.43,61.85,,,percent of total billed charges,61.85% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,133.66,17.136,,,percent of total billed charges,17.136% of total billed charges,170.35,21.84,,,percent of total billed charges,21.84% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,608.4,78,,,percent of total billed charges,78% of total billed charges,780,100,,,percent of total billed charges,100% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,644.28,82.6,,,percent of total billed charges,82.6% of total billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,390,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,390,50,,,percent of total billed charges,50% of total Billed charges,131.04,16.8,,,percent of total billed charges,16.8% of total billed charges,119.34,780,
WAX MAXX,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
WEBRIL STERILE 4IN,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
WEBRIL 4'' NON-STERILE,491688,CDM,272,RC,,,Outpatient,,,607,394.55,,534.16,88,,,percent of total billed charges,88% of total Billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,101.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,607,100,,,percent of total billed charges,100% of total billed charges,105.04,17.304,,,percent of total billed charges,17.304% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,382.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,101.98,16.8,,,percent of total billed charges,16.8% of total billed charges,92.87,15.3,,,percent of total billed charges,15.3% of total billed charges,418.83,69,,,percent of total billed charges,69% of total billed charges,607,100,,,percent of total billed charges,100% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,607,100,,,percent of total billed charges,100% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,607,100,,,percent of total billed charges,100% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,375.43,61.85,,,percent of total billed charges,61.85% of total billed charges,101.98,16.8,,,percent of total billed charges,16.8% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,101.98,16.8,,,percent of total billed charges,16.8% of total Billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,104.02,17.136,,,percent of total billed charges,17.136% of total billed charges,132.57,21.84,,,percent of total billed charges,21.84% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,303.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,303.5,50,,,percent of total billed charges,50% of total Billed charges,473.46,78,,,percent of total billed charges,78% of total billed charges,607,100,,,percent of total billed charges,100% of total billed charges,501.38,82.6,,,percent of total billed charges,82.6% of total billed charges,501.38,82.6,,,percent of total billed charges,82.6% of total billed charges,101.98,16.8,,,percent of total billed charges,16.8% of total billed charges,303.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,303.5,50,,,percent of total billed charges,50% of total Billed charges,101.98,16.8,,,percent of total billed charges,16.8% of total billed charges,92.87,607,
WEBRIL NS 3,491689,CDM,270,RC,,,Outpatient,,,10,6.50,,8.8,88,,,percent of total billed charges,88% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,1.73,17.304,,,percent of total billed charges,17.304% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,15.3,,,percent of total billed charges,15.3% of total billed charges,6.9,69,,,percent of total billed charges,69% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,10,100,,,percent of total billed charges,100% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,6.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,1.71,17.136,,,percent of total billed charges,17.136% of total billed charges,2.18,21.84,,,percent of total billed charges,21.84% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,7.8,78,,,percent of total billed charges,78% of total billed charges,10,100,,,percent of total billed charges,100% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,8.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5,50,,,percent of total billed charges,50% of total Billed charges,1.68,16.8,,,percent of total billed charges,16.8% of total billed charges,1.53,10,
WEBRIL NS 4,491690,CDM,270,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
WEBRIL NS 6,491691,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
WEBRIL STERILE 3,491692,CDM,272,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
WEBRIL STERILE 4,491693,CDM,272,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
WEBRIL STERILE 6,491695,CDM,272,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
WECK CLIPS MEDIUM,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
WECK CLIPS LARGE,ORSUP0013,CDM,272,RC,,,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,179.96,17.304,,,percent of total billed charges,17.304% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,655.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,15.3,,,percent of total billed charges,15.3% of total billed charges,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,178.21,17.136,,,percent of total billed charges,17.136% of total billed charges,227.14,21.84,,,percent of total billed charges,21.84% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,520,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,520,50,,,percent of total billed charges,50% of total Billed charges,174.72,16.8,,,percent of total billed charges,16.8% of total billed charges,159.12,1040,
WEDGE ANCHOR 5.0,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
WEDGE ANCHOR 3.0 TITANIUM,ORSUP0014,CDM,278,RC,C1713,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,737.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
WICK EAR 24MM LONG,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
WIPE DEODORANT TOPICAL SKIN USE,ORSUP0009,CDM,270,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
WIPES PREOP SKIN 2% CHG,384423,CDM,270,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,8.65,17.304,,,percent of total billed charges,17.304% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,31.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,15.3,,,percent of total billed charges,15.3% of total billed charges,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,50,100,,,percent of total billed charges,100% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,30.93,61.85,,,percent of total billed charges,61.85% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,8.57,17.136,,,percent of total billed charges,17.136% of total billed charges,10.92,21.84,,,percent of total billed charges,21.84% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,25,50,,,percent of total billed charges,50% of total Billed charges,8.4,16.8,,,percent of total billed charges,16.8% of total billed charges,7.65,50,
WIPES SATPAX CLEANROOM,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
WIPE ADHESIVE REMOVE STING FRE,491696,CDM,270,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
WIPE MAMMO,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
WIRE GUIDE 3.2MM X 400MM L,ORSUP0010,CDM,278,RC,C1713,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,220.35,33.9,,,percent of total billed charges,33.9% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
WIRE K NON STER  .054X4,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
WIRE KIRSCHNER SINGLE TROCAR .045IN DIA 6IN L N/S,ORSUP0004,CDM,278,RC,C1769,HCPCS,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,34.61,17.304,,,percent of total billed charges,17.304% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,200,100,,,percent of total billed charges,100% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,34.27,17.136,,,percent of total billed charges,17.136% of total billed charges,43.68,21.84,,,percent of total billed charges,21.84% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,67.8,33.9,,,percent of total billed charges,33.9% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,100,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,100,50,,,percent of total billed charges,50% of total Billed charges,33.6,16.8,,,percent of total billed charges,16.8% of total billed charges,30.6,200,
WIRE KIRSCHNER TROCAR POINT 1.25MM DIA 150MM L,ORSUP0002,CDM,278,RC,C1713,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
WIRE KIRSCHNER TROCAR POINT 1.6MM DIA 150MM L,ORSUP0002,CDM,278,RC,C1713,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,44.07,33.9,,,percent of total billed charges,33.9% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
WIRE KIRSCHNER TROCAR POINT 2.5MM DIA 285MM L,ORSUP0009,CDM,278,RC,C1713,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
WIRE SMALL VESSEL V-18 300/8CM TIP .018,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
WIRE CORE 14WR 300 10MM,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
WIRE GUIDE GRAND SLAM .014X300CM,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
WIRE GUIDE AMPLATZ SUPER STIFF 1CM STTP.035 260CM,ORSUP0014,CDM,278,RC,C1769,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
WIRE .035 HYDROPHILIC  260 CM,ORSUP0012,CDM,278,RC,C1769,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
WIRE GUIDE ANGIO V-18 .018IN TIP 8CM 200CM L,ORSUP0007,CDM,278,RC,C1769,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,78.73,17.304,,,percent of total billed charges,17.304% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,15.3,,,percent of total billed charges,15.3% of total billed charges,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,455,100,,,percent of total billed charges,100% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,77.97,17.136,,,percent of total billed charges,17.136% of total billed charges,99.37,21.84,,,percent of total billed charges,21.84% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,154.25,33.9,,,percent of total billed charges,33.9% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,227.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,227.5,50,,,percent of total billed charges,50% of total Billed charges,76.44,16.8,,,percent of total billed charges,16.8% of total billed charges,69.62,455,
WIRE CORE .014 190CM 10CM,ORSUP0006,CDM,278,RC,C1769,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
WIRE RUNTHROUGH EXTENSION .014 300CM,ORSUP0009,CDM,278,RC,C1769,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,198.32,33.9,,,percent of total billed charges,33.9% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
WIRE GUIDE JAGWIRE .035X260CM,ORSUP0014,CDM,278,RC,C1769,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,202.46,17.304,,,percent of total billed charges,17.304% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,15.3,,,percent of total billed charges,15.3% of total billed charges,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,365.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,585,50,,,percent of total billed charges,50% of total Billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,200.49,17.136,,,percent of total billed charges,17.136% of total billed charges,255.53,21.84,,,percent of total billed charges,21.84% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,396.63,33.9,,,percent of total billed charges,33.9% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,585,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,585,50,,,percent of total billed charges,50% of total Billed charges,196.56,16.8,,,percent of total billed charges,16.8% of total billed charges,179.01,1170,
WIRE ACUITY WHISPER VIEW,ORSUP0021,CDM,278,RC,C1769,HCPCS,Outpatient,,,2600,1690.00,,2288,88,,,percent of total billed charges,88% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,449.9,17.304,,,percent of total billed charges,17.304% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,15.3,,,percent of total billed charges,15.3% of total billed charges,1794,69,,,percent of total billed charges,69% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1608.1,61.85,,,percent of total billed charges,61.85% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,811.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1300,50,,,percent of total billed charges,50% of total Billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,445.54,17.136,,,percent of total billed charges,17.136% of total billed charges,567.84,21.84,,,percent of total billed charges,21.84% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,980.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,881.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,2028,78,,,percent of total billed charges,78% of total billed charges,2600,100,,,percent of total billed charges,100% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2147.6,82.6,,,percent of total billed charges,82.6% of total billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1300,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1300,50,,,percent of total billed charges,50% of total Billed charges,436.8,16.8,,,percent of total billed charges,16.8% of total billed charges,397.8,2600,
WIRE HYBRID .035,ORSUP0008,CDM,278,RC,C1769,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,176.28,33.9,,,percent of total billed charges,33.9% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
WIRE TIGER 180CM,ORSUP0018,CDM,278,RC,C1769,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,326.18,17.304,,,percent of total billed charges,17.304% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,15.3,,,percent of total billed charges,15.3% of total billed charges,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,588.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,942.5,50,,,percent of total billed charges,50% of total Billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,323.01,17.136,,,percent of total billed charges,17.136% of total billed charges,411.68,21.84,,,percent of total billed charges,21.84% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,639.02,33.9,,,percent of total billed charges,33.9% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,942.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,942.5,50,,,percent of total billed charges,50% of total Billed charges,316.68,16.8,,,percent of total billed charges,16.8% of total billed charges,288.41,1885,
WIRE TIGER 260CM,ORSUP0006,CDM,278,RC,C1769,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,132.21,33.9,,,percent of total billed charges,33.9% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
WIRE 1.25MM THREADED GUIDE,ORSUP0004,CDM,272,RC,,,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,44.99,17.304,,,percent of total billed charges,17.304% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,163.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,15.3,,,percent of total billed charges,15.3% of total billed charges,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,260,100,,,percent of total billed charges,100% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,44.55,17.136,,,percent of total billed charges,17.136% of total billed charges,56.78,21.84,,,percent of total billed charges,21.84% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,130,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,130,50,,,percent of total billed charges,50% of total Billed charges,43.68,16.8,,,percent of total billed charges,16.8% of total billed charges,39.78,260,
WIRE SUT PASSING STL 18GA,ORSUP0017,CDM,272,RC,,,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,112.48,17.304,,,percent of total billed charges,17.304% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,409.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,15.3,,,percent of total billed charges,15.3% of total billed charges,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,650,100,,,percent of total billed charges,100% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,111.38,17.136,,,percent of total billed charges,17.136% of total billed charges,141.96,21.84,,,percent of total billed charges,21.84% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,325,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,325,50,,,percent of total billed charges,50% of total Billed charges,109.2,16.8,,,percent of total billed charges,16.8% of total billed charges,99.45,650,
WIRE GUIDE NITINOL .035/150/3,ORSUP0008,CDM,272,RC,,,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,89.98,17.304,,,percent of total billed charges,17.304% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,327.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,15.3,,,percent of total billed charges,15.3% of total billed charges,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,520,100,,,percent of total billed charges,100% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,89.11,17.136,,,percent of total billed charges,17.136% of total billed charges,113.57,21.84,,,percent of total billed charges,21.84% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,260,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,260,50,,,percent of total billed charges,50% of total Billed charges,87.36,16.8,,,percent of total billed charges,16.8% of total billed charges,79.56,520,
WIRE GUIDE STIFF .035X150 NITI,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
WIRE GUIDE STIFF .025X150 NITI,ORSUP0009,CDM,272,RC,,,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,101.23,17.304,,,percent of total billed charges,17.304% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,368.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,15.3,,,percent of total billed charges,15.3% of total billed charges,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,585,100,,,percent of total billed charges,100% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,100.25,17.136,,,percent of total billed charges,17.136% of total billed charges,127.76,21.84,,,percent of total billed charges,21.84% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,292.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,292.5,50,,,percent of total billed charges,50% of total Billed charges,98.28,16.8,,,percent of total billed charges,16.8% of total billed charges,89.51,585,
WIRE GUIDE MOV CORE .035X145,ORSUP0006,CDM,272,RC,,,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,67.49,17.304,,,percent of total billed charges,17.304% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,245.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,15.3,,,percent of total billed charges,15.3% of total billed charges,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,390,100,,,percent of total billed charges,100% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,66.83,17.136,,,percent of total billed charges,17.136% of total billed charges,85.18,21.84,,,percent of total billed charges,21.84% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,195,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,195,50,,,percent of total billed charges,50% of total Billed charges,65.52,16.8,,,percent of total billed charges,16.8% of total billed charges,59.67,390,
WIRE SUTURE PASSER,ORSUP0009,CDM,272,RC,,,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,77.87,17.304,,,percent of total billed charges,17.304% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,283.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,15.3,,,percent of total billed charges,15.3% of total billed charges,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,450,100,,,percent of total billed charges,100% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,77.11,17.136,,,percent of total billed charges,17.136% of total billed charges,98.28,21.84,,,percent of total billed charges,21.84% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,225,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,225,50,,,percent of total billed charges,50% of total Billed charges,75.6,16.8,,,percent of total billed charges,16.8% of total billed charges,68.85,450,
WIRE FILTER EMBOLICEZ 190X1.25-3.5CM,ORSUP0049,CDM,272,RC,,,Outpatient,,,9880,6422.00,,8694.4,88,,,percent of total billed charges,88% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1709.64,17.304,,,percent of total billed charges,17.304% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,6224.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1511.64,15.3,,,percent of total billed charges,15.3% of total billed charges,6817.2,69,,,percent of total billed charges,69% of total billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,6110.78,61.85,,,percent of total billed charges,61.85% of total billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,1693.04,17.136,,,percent of total billed charges,17.136% of total billed charges,2157.79,21.84,,,percent of total billed charges,21.84% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4940,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4940,50,,,percent of total billed charges,50% of total Billed charges,7706.4,78,,,percent of total billed charges,78% of total billed charges,9880,100,,,percent of total billed charges,100% of total billed charges,8160.88,82.6,,,percent of total billed charges,82.6% of total billed charges,8160.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,4940,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4940,50,,,percent of total billed charges,50% of total Billed charges,1659.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1511.64,9880,
WNAVICROSS 150CM STRAIGHT,ORSUP0016,CDM,278,RC,C1887,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,466.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,506.81,33.9,,,percent of total billed charges,33.9% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
WOUND CLOSURE DEVICE V LOC 180,366887,CDM,272,RC,,,Outpatient,,,295,191.75,,259.6,88,,,percent of total billed charges,88% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,51.05,17.304,,,percent of total billed charges,17.304% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,185.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,45.14,15.3,,,percent of total billed charges,15.3% of total billed charges,203.55,69,,,percent of total billed charges,69% of total billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,295,100,,,percent of total billed charges,100% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,182.46,61.85,,,percent of total billed charges,61.85% of total billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,50.55,17.136,,,percent of total billed charges,17.136% of total billed charges,64.43,21.84,,,percent of total billed charges,21.84% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,230.1,78,,,percent of total billed charges,78% of total billed charges,295,100,,,percent of total billed charges,100% of total billed charges,243.67,82.6,,,percent of total billed charges,82.6% of total billed charges,243.67,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,147.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,147.5,50,,,percent of total billed charges,50% of total Billed charges,49.56,16.8,,,percent of total billed charges,16.8% of total billed charges,45.14,295,
WOUND SUCTION KIT 100ML J-VAC,ORSUP0001,CDM,270,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
WOUND MATRIX RESTRATA 2.5CM X 2.5CM,ORSUP0034,CDM,272,RC,A6460,HCPCS,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
WOUND MATRIX RESTRATA 2.5CM X 5.0CM,ORSUP0048,CDM,272,RC,A6460,HCPCS,Outpatient,,,9620,6253.00,,8465.6,88,,,percent of total billed charges,88% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1471.86,15.3,,,percent of total billed charges,15.3% of total billed charges,6637.8,69,,,percent of total billed charges,69% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,5949.97,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,3001.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4810,50,,,percent of total billed charges,50% of total Billed charges,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,7503.6,78,,,percent of total billed charges,78% of total billed charges,9620,100,,,percent of total billed charges,100% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,7946.12,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4810,50,,,percent of total billed charges,50% of total Billed charges,1616.16,16.8,,,percent of total billed charges,16.8% of total billed charges,1471.86,9620,
WOUND MATRIX RESTRATA 2.5CM X 7.5CM,ORSUP0062,CDM,272,RC,A6460,HCPCS,Outpatient,,,13520,8788.00,,11897.6,88,,,percent of total billed charges,88% of total Billed charges,6760,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6760,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",2068.56,15.3,,,percent of total billed charges,15.3% of total billed charges,9328.8,69,,,percent of total billed charges,69% of total billed charges,13520,100,,,percent of total billed charges,100% of total billed charges,6760,50,,,percent of total billed charges,50% of total Billed charges,13520,100,,,percent of total billed charges,100% of total billed charges,6760,50,,,percent of total billed charges,50% of total Billed charges,13520,100,,,percent of total billed charges,100% of total billed charges,6760,50,,,percent of total billed charges,50% of total Billed charges,8362.12,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,6760,50,,,percent of total billed charges,50% of total Billed charges,6760,50,,,percent of total billed charges,50% of total Billed charges,4218.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6760,50,,,percent of total billed charges,50% of total Billed charges,6760,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6760,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6760,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6760,50,,,percent of total billed charges,50% of total Billed charges,10545.6,78,,,percent of total billed charges,78% of total billed charges,13520,100,,,percent of total billed charges,100% of total billed charges,11167.52,82.6,,,percent of total billed charges,82.6% of total billed charges,11167.52,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,6760,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6760,50,,,percent of total billed charges,50% of total Billed charges,2271.36,16.8,,,percent of total billed charges,16.8% of total billed charges,2068.56,13520,
WOUND MATRIX RESTRATA 5.0CM X 5.0CM,ORSUP0074,CDM,272,RC,A6460,HCPCS,Outpatient,,,16640,10816.00,,14643.2,88,,,percent of total billed charges,88% of total Billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,8320,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",2545.92,15.3,,,percent of total billed charges,15.3% of total billed charges,11481.6,69,,,percent of total billed charges,69% of total billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,10291.84,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,8320,50,,,percent of total billed charges,50% of total Billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,5191.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8320,50,,,percent of total billed charges,50% of total Billed charges,8320,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8320,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8320,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8320,50,,,percent of total billed charges,50% of total Billed charges,12979.2,78,,,percent of total billed charges,78% of total billed charges,16640,100,,,percent of total billed charges,100% of total billed charges,13744.64,82.6,,,percent of total billed charges,82.6% of total billed charges,13744.64,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,8320,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8320,50,,,percent of total billed charges,50% of total Billed charges,2795.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2545.92,16640,
WOUND MATRIX RESTRATA 7.5CM X 7.5CM,ORSUP0087,CDM,272,RC,A6461,HCPCS,Outpatient,,,20020,13013.00,,17617.6,88,,,percent of total billed charges,88% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",3063.06,15.3,,,percent of total billed charges,15.3% of total billed charges,13813.8,69,,,percent of total billed charges,69% of total billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,12382.37,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,6246.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10010,50,,,percent of total billed charges,50% of total Billed charges,10010,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,15615.6,78,,,percent of total billed charges,78% of total billed charges,20020,100,,,percent of total billed charges,100% of total billed charges,16536.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16536.52,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10010,50,,,percent of total billed charges,50% of total Billed charges,3363.36,16.8,,,percent of total billed charges,16.8% of total billed charges,3063.06,20020,
WOUND MATRIX RESTRATA 10.0CM X 12.5CM,ORSUP0115,CDM,272,RC,A6461,HCPCS,Outpatient,,,27560,17914.00,,24252.8,88,,,percent of total billed charges,88% of total Billed charges,13780,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,13780,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",4216.68,15.3,,,percent of total billed charges,15.3% of total billed charges,19016.4,69,,,percent of total billed charges,69% of total billed charges,27560,100,,,percent of total billed charges,100% of total billed charges,13780,50,,,percent of total billed charges,50% of total Billed charges,27560,100,,,percent of total billed charges,100% of total billed charges,13780,50,,,percent of total billed charges,50% of total Billed charges,27560,100,,,percent of total billed charges,100% of total billed charges,13780,50,,,percent of total billed charges,50% of total Billed charges,17045.86,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,13780,50,,,percent of total billed charges,50% of total Billed charges,13780,50,,,percent of total billed charges,50% of total Billed charges,8598.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13780,50,,,percent of total billed charges,50% of total Billed charges,13780,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13780,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13780,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13780,50,,,percent of total billed charges,50% of total Billed charges,21496.8,78,,,percent of total billed charges,78% of total billed charges,27560,100,,,percent of total billed charges,100% of total billed charges,22764.56,82.6,,,percent of total billed charges,82.6% of total billed charges,22764.56,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,13780,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,13780,50,,,percent of total billed charges,50% of total Billed charges,4630.08,16.8,,,percent of total billed charges,16.8% of total billed charges,4216.68,27560,
WOUND MEASURING STICK,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
WOUND MATRIX 2-LAYER 10X15CM,ORSUP0059,CDM,278,RC,Q4166,HCPCS,Outpatient,,,9800,6370.00,,8624,88,,,percent of total billed charges,88% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,6174,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1499.4,15.3,,,percent of total billed charges,15.3% of total billed charges,6762,69,,,percent of total billed charges,69% of total billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,6061.3,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,3057.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4900,50,,,percent of total billed charges,50% of total Billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,3694.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3694.6,37.7,,,percent of total billed charges,37.70% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,3322.2,33.9,,,percent of total billed charges,33.9% of total billed charges,4900,50,,,percent of total billed charges,50% of total Billed charges,7644,78,,,percent of total billed charges,78% of total billed charges,9800,100,,,percent of total billed charges,100% of total billed charges,8094.8,82.6,,,percent of total billed charges,82.6% of total billed charges,8094.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1499.4,9800,
WOUND MATRIX 2-LAYER 7X10CM,ORSUP0040,CDM,278,RC,Q4166,HCPCS,Outpatient,,,5800,3770.00,,5104,88,,,percent of total billed charges,88% of total Billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2900,50,,,percent of total billed charges,50% of total Billed charges,3654,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",887.4,15.3,,,percent of total billed charges,15.3% of total billed charges,4002,69,,,percent of total billed charges,69% of total billed charges,5800,100,,,percent of total billed charges,100% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,5800,100,,,percent of total billed charges,100% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,5800,100,,,percent of total billed charges,100% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,3587.3,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,2900,50,,,percent of total billed charges,50% of total Billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,1809.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2900,50,,,percent of total billed charges,50% of total Billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2900,50,,,percent of total billed charges,50% of total Billed charges,2186.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2186.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,1966.2,33.9,,,percent of total billed charges,33.9% of total billed charges,2900,50,,,percent of total billed charges,50% of total Billed charges,4524,78,,,percent of total billed charges,78% of total billed charges,5800,100,,,percent of total billed charges,100% of total billed charges,4790.8,82.6,,,percent of total billed charges,82.6% of total billed charges,4790.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,2900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",887.4,5800,
WRAP ONE-STEP QUICK CHECK 48X48 KC500,419656,CDM,270,RC,,,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,3.29,17.304,,,percent of total billed charges,17.304% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.26,17.136,,,percent of total billed charges,17.136% of total billed charges,4.15,21.84,,,percent of total billed charges,21.84% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,3.19,16.8,,,percent of total billed charges,16.8% of total billed charges,2.91,19,
WRAP STRL 36X36 KMGRD KC600 QUICK CHECK,414461,CDM,270,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
WRAP ONE-STEP QUICK CHECK 30X30 KC500,419653,CDM,270,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
WRAP ONE-STEP QUICK CHECK 24X24 KC200,402886,CDM,270,RC,,,Outpatient,,,249,161.85,,219.12,88,,,percent of total billed charges,88% of total Billed charges,124.5,50,,,percent of total billed charges,50% of total Billed charges,41.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,249,100,,,percent of total billed charges,100% of total billed charges,43.09,17.304,,,percent of total billed charges,17.304% of total billed charges,124.5,50,,,percent of total billed charges,50% of total Billed charges,156.87,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,41.83,16.8,,,percent of total billed charges,16.8% of total billed charges,38.1,15.3,,,percent of total billed charges,15.3% of total billed charges,171.81,69,,,percent of total billed charges,69% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,124.5,50,,,percent of total billed charges,50% of total Billed charges,249,100,,,percent of total billed charges,100% of total billed charges,124.5,50,,,percent of total billed charges,50% of total Billed charges,249,100,,,percent of total billed charges,100% of total billed charges,124.5,50,,,percent of total billed charges,50% of total Billed charges,154.01,61.85,,,percent of total billed charges,61.85% of total billed charges,41.83,16.8,,,percent of total billed charges,16.8% of total billed charges,124.5,50,,,percent of total billed charges,50% of total Billed charges,124.5,50,,,percent of total billed charges,50% of total Billed charges,41.83,16.8,,,percent of total billed charges,16.8% of total Billed charges,124.5,50,,,percent of total billed charges,50% of total Billed charges,124.5,50,,,percent of total billed charges,50% of total Billed charges,42.67,17.136,,,percent of total billed charges,17.136% of total billed charges,54.38,21.84,,,percent of total billed charges,21.84% of total billed charges,124.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,124.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,124.5,50,,,percent of total billed charges,50% of total Billed charges,194.22,78,,,percent of total billed charges,78% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,41.83,16.8,,,percent of total billed charges,16.8% of total billed charges,124.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,124.5,50,,,percent of total billed charges,50% of total Billed charges,41.83,16.8,,,percent of total billed charges,16.8% of total billed charges,38.1,249,
WRAP ONE-STEP QUICK CHECK 24X24 KC500,417805,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% 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,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
WRAP KIMGUARD 18 X 18,491705,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
WRAP KIMGUARD 24 X 24,491706,CDM,270,RC,,,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2.47,61.85,,,percent of total billed charges,61.85% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,2,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2,50,,,percent of total billed charges,50% of total Billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
WRAP KIMGUARD 30 X 30,491707,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
WRAP KIMGUARD 36 X 36,491708,CDM,270,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
WRAP KIMGUARD 48 X 48,491709,CDM,270,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
WRIST FIXATOR LOW-PROFILE,ORSUP0016,CDM,270,RC,,,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,258.69,17.304,,,percent of total billed charges,17.304% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,941.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,15.3,,,percent of total billed charges,15.3% of total billed charges,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,256.18,17.136,,,percent of total billed charges,17.136% of total billed charges,326.51,21.84,,,percent of total billed charges,21.84% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,747.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,747.5,50,,,percent of total billed charges,50% of total Billed charges,251.16,16.8,,,percent of total billed charges,16.8% of total billed charges,228.74,1495,
WRIST BAND ALLERGY ALERT,491710,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
WRIST BAND FALL RISK,491711,CDM,270,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
WRIST BAND PT IDENTIFICATION,491712,CDM,270,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
WRISTJACK SYSTEM STERILE,ORSUP0046,CDM,272,RC,,,Outpatient,,,9100,5915.00,,8008,88,,,percent of total billed charges,88% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1574.66,17.304,,,percent of total billed charges,17.304% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5733,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,15.3,,,percent of total billed charges,15.3% of total billed charges,6279,69,,,percent of total billed charges,69% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,5628.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,1559.38,17.136,,,percent of total billed charges,17.136% of total billed charges,1987.44,21.84,,,percent of total billed charges,21.84% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,7098,78,,,percent of total billed charges,78% of total billed charges,9100,100,,,percent of total billed charges,100% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,7516.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,4550,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4550,50,,,percent of total billed charges,50% of total Billed charges,1528.8,16.8,,,percent of total billed charges,16.8% of total billed charges,1392.3,9100,
XCELA PLUS PORT 5FR,ORSUP0020,CDM,272,RC,,,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,311.47,17.304,,,percent of total billed charges,17.304% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1134,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,15.3,,,percent of total billed charges,15.3% of total billed charges,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,308.45,17.136,,,percent of total billed charges,17.136% of total billed charges,393.12,21.84,,,percent of total billed charges,21.84% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,900,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,900,50,,,percent of total billed charges,50% of total Billed charges,302.4,16.8,,,percent of total billed charges,16.8% of total billed charges,275.4,1800,
XCISE CORLESS MORCELLATOR,ORSUP0026,CDM,278,RC,C1782,HCPCS,Outpatient,,,3900,2535.00,,3432,88,,,percent of total billed charges,88% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,674.86,17.304,,,percent of total billed charges,17.304% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2457,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,15.3,,,percent of total billed charges,15.3% of total billed charges,2691,69,,,percent of total billed charges,69% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,2412.15,61.85,,,percent of total billed charges,61.85% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1216.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1950,50,,,percent of total billed charges,50% of total Billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,668.3,17.136,,,percent of total billed charges,17.136% of total billed charges,851.76,21.84,,,percent of total billed charges,21.84% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1470.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,1322.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,3042,78,,,percent of total billed charges,78% of total billed charges,3900,100,,,percent of total billed charges,100% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3221.4,82.6,,,percent of total billed charges,82.6% of total billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,1950,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1950,50,,,percent of total billed charges,50% of total Billed charges,655.2,16.8,,,percent of total billed charges,16.8% of total billed charges,596.7,3900,
XENFORM 4X7 MATRIX,ORSUP0025,CDM,278,RC,C1763,HCPCS,Outpatient,,,3640,2366.00,,3203.2,88,,,percent of total billed charges,88% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,629.87,17.304,,,percent of total billed charges,17.304% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2293.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,15.3,,,percent of total billed charges,15.3% of total billed charges,2511.6,69,,,percent of total billed charges,69% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2251.34,61.85,,,percent of total billed charges,61.85% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1135.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1820,50,,,percent of total billed charges,50% of total Billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,623.75,17.136,,,percent of total billed charges,17.136% of total billed charges,794.98,21.84,,,percent of total billed charges,21.84% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1372.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,1233.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,2839.2,78,,,percent of total billed charges,78% of total billed charges,3640,100,,,percent of total billed charges,100% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3006.64,82.6,,,percent of total billed charges,82.6% of total billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,1820,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1820,50,,,percent of total billed charges,50% of total Billed charges,611.52,16.8,,,percent of total billed charges,16.8% of total billed charges,556.92,3640,
XEROFORM 5 X 9,491714,CDM,270,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
AGAR XLD,ORSUP0001,CDM,272,RC,,,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,7.96,17.304,,,percent of total billed charges,17.304% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.98,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,15.3,,,percent of total billed charges,15.3% of total billed charges,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,46,100,,,percent of total billed charges,100% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,7.88,17.136,,,percent of total billed charges,17.136% of total billed charges,10.05,21.84,,,percent of total billed charges,21.84% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,23,50,,,percent of total billed charges,50% of total Billed charges,7.73,16.8,,,percent of total billed charges,16.8% of total billed charges,7.04,46,
XN CHECK,ORSUP0003,CDM,272,RC,,,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,33.74,17.304,,,percent of total billed charges,17.304% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,122.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,15.3,,,percent of total billed charges,15.3% of total billed charges,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,195,100,,,percent of total billed charges,100% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,33.42,17.136,,,percent of total billed charges,17.136% of total billed charges,42.59,21.84,,,percent of total billed charges,21.84% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,97.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,97.5,50,,,percent of total billed charges,50% of total Billed charges,32.76,16.8,,,percent of total billed charges,16.8% of total billed charges,29.84,195,
Y SILICONE STENTS 14-10-10 X 110-50-50,ORSUP0032,CDM,278,RC,,,Outpatient,,,5460,3549.00,,4804.8,88,,,percent of total billed charges,88% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,944.8,17.304,,,percent of total billed charges,17.304% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3439.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,15.3,,,percent of total billed charges,15.3% of total billed charges,3767.4,69,,,percent of total billed charges,69% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,3377.01,61.85,,,percent of total billed charges,61.85% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1703.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2730,50,,,percent of total billed charges,50% of total Billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,935.63,17.136,,,percent of total billed charges,17.136% of total billed charges,1192.46,21.84,,,percent of total billed charges,21.84% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2058.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,1850.94,33.9,,,percent of total billed charges,33.9% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,4258.8,78,,,percent of total billed charges,78% of total billed charges,5460,100,,,percent of total billed charges,100% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4509.96,82.6,,,percent of total billed charges,82.6% of total billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,2730,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2730,50,,,percent of total billed charges,50% of total Billed charges,917.28,16.8,,,percent of total billed charges,16.8% of total billed charges,835.38,5460,
Y SILICONE STENTS 15-12-12 X 110-50-50,ORSUP0034,CDM,278,RC,,,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
Y SILICONE STENTS 16-13-13 X 110-50-50,ORSUP0034,CDM,278,RC,,,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
Y SILICONE STENTS 18-14-14 X 110-50-50,ORSUP0034,CDM,278,RC,,,Outpatient,,,5980,3887.00,,5262.4,88,,,percent of total billed charges,88% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1034.78,17.304,,,percent of total billed charges,17.304% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3767.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,15.3,,,percent of total billed charges,15.3% of total billed charges,4126.2,69,,,percent of total billed charges,69% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,3698.63,61.85,,,percent of total billed charges,61.85% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1865.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2990,50,,,percent of total billed charges,50% of total Billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,1024.73,17.136,,,percent of total billed charges,17.136% of total billed charges,1306.03,21.84,,,percent of total billed charges,21.84% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2254.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,2027.22,33.9,,,percent of total billed charges,33.9% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,4664.4,78,,,percent of total billed charges,78% of total billed charges,5980,100,,,percent of total billed charges,100% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4939.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,2990,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2990,50,,,percent of total billed charges,50% of total Billed charges,1004.64,16.8,,,percent of total billed charges,16.8% of total billed charges,914.94,5980,
Y-ADAPTOR MORSE OPTION .125,ORSUP0005,CDM,270,RC,,,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,56.24,17.304,,,percent of total billed charges,17.304% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,204.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,15.3,,,percent of total billed charges,15.3% of total billed charges,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,325,100,,,percent of total billed charges,100% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,55.69,17.136,,,percent of total billed charges,17.136% of total billed charges,70.98,21.84,,,percent of total billed charges,21.84% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,162.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,162.5,50,,,percent of total billed charges,50% of total Billed charges,54.6,16.8,,,percent of total billed charges,16.8% of total billed charges,49.73,325,
Y-PLATE 2X,ORSUP0012,CDM,278,RC,C1713,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,157.47,17.304,,,percent of total billed charges,17.304% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,573.3,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,15.3,,,percent of total billed charges,15.3% of total billed charges,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,910,100,,,percent of total billed charges,100% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,155.94,17.136,,,percent of total billed charges,17.136% of total billed charges,198.74,21.84,,,percent of total billed charges,21.84% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,308.49,33.9,,,percent of total billed charges,33.9% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,455,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,455,50,,,percent of total billed charges,50% of total Billed charges,152.88,16.8,,,percent of total billed charges,16.8% of total billed charges,139.23,910,
Y-PLATE 3 X 8,ORSUP0054,CDM,278,RC,C1713,HCPCS,Outpatient,,,8840,5746.00,,7779.2,88,,,percent of total billed charges,88% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1529.67,17.304,,,percent of total billed charges,17.304% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5569.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,15.3,,,percent of total billed charges,15.3% of total billed charges,6099.6,69,,,percent of total billed charges,69% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,5467.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2758.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4420,50,,,percent of total billed charges,50% of total Billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,1514.82,17.136,,,percent of total billed charges,17.136% of total billed charges,1930.66,21.84,,,percent of total billed charges,21.84% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3332.68,37.7,,,percent of total billed charges,37.70% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,2996.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,6895.2,78,,,percent of total billed charges,78% of total billed charges,8840,100,,,percent of total billed charges,100% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,7301.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,4420,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4420,50,,,percent of total billed charges,50% of total Billed charges,1485.12,16.8,,,percent of total billed charges,16.8% of total billed charges,1352.52,8840,
YANKAUER FLEXIBLE,ORSUP0001,CDM,272,RC,,,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,6.06,17.304,,,percent of total billed charges,17.304% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,6,17.136,,,percent of total billed charges,17.136% of total billed charges,7.64,21.84,,,percent of total billed charges,21.84% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,5.88,16.8,,,percent of total billed charges,16.8% of total billed charges,5.36,35,
YSC Level 5 Ea Addt'l 15 Min,SUR200051,CDM,360,RC,,,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",3367,15.3,,,percent of total billed charges,15.3% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",3367,3367,
YUEH 5.0 CENTESIS CATH NEEDLE,ORSUP0003,CDM,272,RC,,,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,22.5,17.304,,,percent of total billed charges,17.304% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,81.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,15.3,,,percent of total billed charges,15.3% of total billed charges,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,130,100,,,percent of total billed charges,100% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,22.28,17.136,,,percent of total billed charges,17.136% of total billed charges,28.39,21.84,,,percent of total billed charges,21.84% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,65,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,65,50,,,percent of total billed charges,50% of total Billed charges,21.84,16.8,,,percent of total billed charges,16.8% of total billed charges,19.89,130,
ZEISS MICROSCOPE PROJECTION BULB,491715,CDM,270,RC,,,Outpatient,,,202,131.30,,177.76,88,,,percent of total billed charges,88% of total Billed charges,101,50,,,percent of total billed charges,50% of total Billed charges,33.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,202,100,,,percent of total billed charges,100% of total billed charges,34.95,17.304,,,percent of total billed charges,17.304% of total billed charges,101,50,,,percent of total billed charges,50% of total Billed charges,127.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,33.94,16.8,,,percent of total billed charges,16.8% of total billed charges,30.91,15.3,,,percent of total billed charges,15.3% of total billed charges,139.38,69,,,percent of total billed charges,69% of total billed charges,202,100,,,percent of total billed charges,100% of total billed charges,101,50,,,percent of total billed charges,50% of total Billed charges,202,100,,,percent of total billed charges,100% of total billed charges,101,50,,,percent of total billed charges,50% of total Billed charges,202,100,,,percent of total billed charges,100% of total billed charges,101,50,,,percent of total billed charges,50% of total Billed charges,124.94,61.85,,,percent of total billed charges,61.85% of total billed charges,33.94,16.8,,,percent of total billed charges,16.8% of total billed charges,101,50,,,percent of total billed charges,50% of total Billed charges,101,50,,,percent of total billed charges,50% of total Billed charges,33.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,101,50,,,percent of total billed charges,50% of total Billed charges,101,50,,,percent of total billed charges,50% of total Billed charges,34.61,17.136,,,percent of total billed charges,17.136% of total billed charges,44.12,21.84,,,percent of total billed charges,21.84% of total billed charges,101,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,101,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,101,50,,,percent of total billed charges,50% of total Billed charges,157.56,78,,,percent of total billed charges,78% of total billed charges,202,100,,,percent of total billed charges,100% of total billed charges,166.85,82.6,,,percent of total billed charges,82.6% of total billed charges,166.85,82.6,,,percent of total billed charges,82.6% of total billed charges,33.94,16.8,,,percent of total billed charges,16.8% of total billed charges,101,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,101,50,,,percent of total billed charges,50% of total Billed charges,33.94,16.8,,,percent of total billed charges,16.8% of total billed charges,30.91,202,
ZEPTOMETRIX NATROL CT/NG/TV POSITIVE CONTROL,ORSUP0006,CDM,272,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
"ZIPTIGHT FIXATION DEVICE , ANKLE",ORSUP0024,CDM,278,RC,C1776,HCPCS,Outpatient,,,3380,2197.00,,2974.4,88,,,percent of total billed charges,88% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,584.88,17.304,,,percent of total billed charges,17.304% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2129.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,15.3,,,percent of total billed charges,15.3% of total billed charges,2332.2,69,,,percent of total billed charges,69% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2090.53,61.85,,,percent of total billed charges,61.85% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1054.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1690,50,,,percent of total billed charges,50% of total Billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,579.2,17.136,,,percent of total billed charges,17.136% of total billed charges,738.19,21.84,,,percent of total billed charges,21.84% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1274.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,1145.82,33.9,,,percent of total billed charges,33.9% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,2636.4,78,,,percent of total billed charges,78% of total billed charges,3380,100,,,percent of total billed charges,100% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2791.88,82.6,,,percent of total billed charges,82.6% of total billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,1690,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1690,50,,,percent of total billed charges,50% of total Billed charges,567.84,16.8,,,percent of total billed charges,16.8% of total billed charges,517.14,3380,
ZIPWIRE STRAIGHT TIP AND STD SHAFT .035,ORSUP0017,CDM,278,RC,C1769,HCPCS,Outpatient,,,1690,1098.50,,1487.2,88,,,percent of total billed charges,88% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,292.44,17.304,,,percent of total billed charges,17.304% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,15.3,,,percent of total billed charges,15.3% of total billed charges,1166.1,69,,,percent of total billed charges,69% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1045.27,61.85,,,percent of total billed charges,61.85% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,527.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,845,50,,,percent of total billed charges,50% of total Billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,289.6,17.136,,,percent of total billed charges,17.136% of total billed charges,369.1,21.84,,,percent of total billed charges,21.84% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,637.13,37.7,,,percent of total billed charges,37.70% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,572.91,33.9,,,percent of total billed charges,33.9% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,1318.2,78,,,percent of total billed charges,78% of total billed charges,1690,100,,,percent of total billed charges,100% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.94,82.6,,,percent of total billed charges,82.6% of total billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,845,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,845,50,,,percent of total billed charges,50% of total Billed charges,283.92,16.8,,,percent of total billed charges,16.8% of total billed charges,258.57,1690,
43202 ESOPHAGOSCOPY FLEX BIOPSYY CHARGE,75043202,CDM,750,RC,43202,HCPCS,Outpatient,,,6345,4124.25,,5583.6,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3997.35,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4378.05,69,,,percent of total billed charges,69% of total billed charges,6345,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6345,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6345,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2392.07,37.7,,,percent of total billed charges,37.70% of total billed charges,2392.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2150.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4949.1,78,,,percent of total billed charges,78% of total billed charges,6345,100,,,percent of total billed charges,100% of total billed charges,5240.97,82.6,,,percent of total billed charges,82.6% of total billed charges,5240.97,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH BAND LIGATION OF E",76143205,CDM,750,RC,43205,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF FOREIGN",76143215,CDM,750,RC,43215,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH DILATION OF ESOPHAG",76143213,CDM,750,RC,43213,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH INSERTION OF GUIDE",76143226,CDM,750,RC,43226,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH TRANSENDOSCOPIC BAL",76143220,CDM,750,RC,43220,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH CONTROL OF BLEEDIN",76143227,CDM,750,RC,43227,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
GASTROSCOPY DIAGNOSTIC W/WO BRUSHING SURG,76143235,CDM,750,RC,43235,HCPCS,Outpatient,,,2892,1879.80,,2544.96,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,2892,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1821.96,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1995.48,69,,,percent of total billed charges,69% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,980.39,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2255.76,78,,,percent of total billed charges,78% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,3367,
GASTROSCOPY W/BX,76143239,CDM,750,RC,43239,HCPCS,Outpatient,,,2892,1879.80,,2544.96,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,2892,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1821.96,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1995.48,69,,,percent of total billed charges,69% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,980.39,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2255.76,78,,,percent of total billed charges,78% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,3367,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; W/ DIRECTED",76143236,CDM,750,RC,43236,HCPCS,Outpatient,,,2892,1879.80,,2544.96,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,2892,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1821.96,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1995.48,69,,,percent of total billed charges,69% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,980.39,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2255.76,78,,,percent of total billed charges,78% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,3367,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH DILATI",76143233,CDM,750,RC,43233,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
GASTROSCOPY DIAGNOSTIC W/WO BRUSHING SURG SU,76143235,CDM,750,RC,43235,HCPCS,Outpatient,,,2892,1879.80,,2544.96,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,2892,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1821.96,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1995.48,69,,,percent of total billed charges,69% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,980.39,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2255.76,78,,,percent of total billed charges,78% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,3367,
GASTROSCOPY WITH PEG TUBE PLACEMENT SURG,76143246,CDM,750,RC,43246,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
GASTROSCOPY W REMOVAL FOREIGN BODY SURG,76143247,CDM,750,RC,43247,HCPCS,Outpatient,,,2892,1879.80,,2544.96,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,2892,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1821.96,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1995.48,69,,,percent of total billed charges,69% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,980.39,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2255.76,78,,,percent of total billed charges,78% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,3367,
GASTROSCOPY W DILATION GASTRIC/DUODENUM SURG,76143245,CDM,750,RC,43245,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSO",76143248,CDM,750,RC,43248,HCPCS,Outpatient,,,2892,1879.80,,2544.96,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,2892,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1821.96,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1995.48,69,,,percent of total billed charges,69% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,980.39,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2255.76,78,,,percent of total billed charges,78% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,3367,
EGD W/DILATION (ANY METHOD) SURG,76143249,CDM,750,RC,43249,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; W/ BAND LIG",76143244,CDM,750,RC,43244,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
GASTROSCOPY W/CONTROLL OF BLEED SURG,76143255,CDM,750,RC,43255,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
Esophagogastroduodenoscopy removal of tumor(s) w/ snare tec,75043251,CDM,750,RC,43251,HCPCS,Outpatient,,,5803,3771.95,,5106.64,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3655.89,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4004.07,69,,,percent of total billed charges,69% of total billed charges,5803,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5803,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5803,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2187.73,37.7,,,percent of total billed charges,37.70% of total billed charges,2187.73,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1967.22,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4526.34,78,,,percent of total billed charges,78% of total billed charges,5803,100,,,percent of total billed charges,100% of total billed charges,4793.28,82.6,,,percent of total billed charges,82.6% of total billed charges,4793.28,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAP,76143262,CDM,750,RC,43262,HCPCS,Outpatient,,,10976,7134.40,,9658.88,88,,,percent of total billed charges,88% of total Billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2368.49,103,,,Fee Schedule,103% of WA Medicaid,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,6914.88,63,,,percent of total billed charges,63% of total billed charges,6835.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,7573.44,69,,,percent of total billed charges,69% of total billed charges,10976,100,,,percent of total billed charges,100% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,10976,100,,,percent of total billed charges,100% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,10976,100,,,percent of total billed charges,100% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,12515.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1703.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2345.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2989.36,130,,,Fee Schedule,130% of WA Medicaid ,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,4137.95,37.7,,,percent of total billed charges,37.70% of total billed charges,4137.95,37.7,,,percent of total billed charges,37.70% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3720.86,33.9,,,percent of total billed charges,33.9% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,8561.28,78,,,percent of total billed charges,78% of total billed charges,10976,100,,,percent of total billed charges,100% of total billed charges,9066.18,82.6,,,percent of total billed charges,82.6% of total billed charges,9066.18,82.6,,,percent of total billed charges,82.6% of total billed charges,2299.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3945.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1703.33,12515.8,
43264 ERCP; WITH REMVOAL OF CALCULI/DEBRIS FROM BI,76143264,CDM,750,RC,43264,HCPCS,Outpatient,,,10976,7134.40,,9658.88,88,,,percent of total billed charges,88% of total Billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2368.49,103,,,Fee Schedule,103% of WA Medicaid,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,6914.88,63,,,percent of total billed charges,63% of total billed charges,6835.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,7573.44,69,,,percent of total billed charges,69% of total billed charges,10976,100,,,percent of total billed charges,100% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,10976,100,,,percent of total billed charges,100% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,10976,100,,,percent of total billed charges,100% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,12515.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1703.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2345.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2989.36,130,,,Fee Schedule,130% of WA Medicaid ,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,4137.95,37.7,,,percent of total billed charges,37.70% of total billed charges,4137.95,37.7,,,percent of total billed charges,37.70% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3720.86,33.9,,,percent of total billed charges,33.9% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,8561.28,78,,,percent of total billed charges,78% of total billed charges,10976,100,,,percent of total billed charges,100% of total billed charges,9066.18,82.6,,,percent of total billed charges,82.6% of total billed charges,9066.18,82.6,,,percent of total billed charges,82.6% of total billed charges,2299.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3945.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1703.33,12515.8,
(ERCP); with removal of foreign body(s) or stent(s) SURG,76143275,CDM,750,RC,43275,HCPCS,Outpatient,,,10976,7134.40,,9658.88,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,2368.49,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6914.88,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,7573.44,69,,,percent of total billed charges,69% of total billed charges,10976,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10976,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,10976,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,12515.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1703.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2345.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2989.36,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4137.95,37.7,,,percent of total billed charges,37.70% of total billed charges,4137.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3720.86,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,8561.28,78,,,percent of total billed charges,78% of total billed charges,10976,100,,,percent of total billed charges,100% of total billed charges,9066.18,82.6,,,percent of total billed charges,82.6% of total billed charges,9066.18,82.6,,,percent of total billed charges,82.6% of total billed charges,2299.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2299.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1703.33,12515.8,
(ERCP); with placement of endoscopic stent into biliary SUR,76143274,CDM,750,RC,43274,HCPCS,Outpatient,,,17993,11695.45,,15833.84,88,,,percent of total billed charges,88% of total Billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3987.05,103,,,Fee Schedule,103% of WA Medicaid,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,11335.59,63,,,percent of total billed charges,63% of total billed charges,10172.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,12415.17,69,,,percent of total billed charges,69% of total billed charges,17993,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,17993,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,17993,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,20428.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,2867.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3948.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5032.19,130,,,Fee Schedule,130% of WA Medicaid ,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6783.36,37.7,,,percent of total billed charges,37.70% of total billed charges,6783.36,37.7,,,percent of total billed charges,37.70% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6099.63,33.9,,,percent of total billed charges,33.9% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,14034.54,78,,,percent of total billed charges,78% of total billed charges,17993,100,,,percent of total billed charges,100% of total billed charges,14862.22,82.6,,,percent of total billed charges,82.6% of total billed charges,14862.22,82.6,,,percent of total billed charges,82.6% of total billed charges,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5871.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2867.35,20428.51,
(ERCP); with trans-endoscopic balloon dilation of SURG,76143277,CDM,750,RC,43277,HCPCS,Outpatient,,,10976,7134.40,,9658.88,88,,,percent of total billed charges,88% of total Billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3987.05,103,,,Fee Schedule,103% of WA Medicaid,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,6914.88,63,,,percent of total billed charges,63% of total billed charges,6835.86,175,,,Fee Schedule,175% of Medicare OPPS Rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,7573.44,69,,,percent of total billed charges,69% of total billed charges,10976,100,,,percent of total billed charges,100% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,10976,100,,,percent of total billed charges,100% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,10976,100,,,percent of total billed charges,100% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,12515.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2867.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3948.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5032.19,130,,,Fee Schedule,130% of WA Medicaid ,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,4137.95,37.7,,,percent of total billed charges,37.70% of total billed charges,4137.95,37.7,,,percent of total billed charges,37.70% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3720.86,33.9,,,percent of total billed charges,33.9% of total billed charges,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,8561.28,78,,,percent of total billed charges,78% of total billed charges,10976,100,,,percent of total billed charges,100% of total billed charges,9066.18,82.6,,,percent of total billed charges,82.6% of total billed charges,9066.18,82.6,,,percent of total billed charges,82.6% of total billed charges,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3945.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3906.21,100,,,Fee Schedule,100% of Medicare OPPS rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2867.35,12515.8,
GASTROSCOPY W ABLATION ANY KIND SURG,76143270,CDM,750,RC,43270,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1923.69,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1383.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1905.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2427.97,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1383.45,6601.69,
ERCP with removal/exchange of stent(s) of pancreatic duct SU,76143276,CDM,750,RC,43276,HCPCS,Outpatient,,,17993,11695.45,,15833.84,88,,,percent of total billed charges,88% of total Billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,3987.05,103,,,Fee Schedule,103% of WA Medicaid,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,11335.59,63,,,percent of total billed charges,63% of total billed charges,10172.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,12415.17,69,,,percent of total billed charges,69% of total billed charges,17993,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,17993,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,17993,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,20428.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,2867.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3948.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5032.19,130,,,Fee Schedule,130% of WA Medicaid ,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6783.36,37.7,,,percent of total billed charges,37.70% of total billed charges,6783.36,37.7,,,percent of total billed charges,37.70% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6099.63,33.9,,,percent of total billed charges,33.9% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,14034.54,78,,,percent of total billed charges,78% of total billed charges,17993,100,,,percent of total billed charges,100% of total billed charges,14862.22,82.6,,,percent of total billed charges,82.6% of total billed charges,14862.22,82.6,,,percent of total billed charges,82.6% of total billed charges,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5871.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3870.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2867.35,20428.51,
"Replacement of gastrostomy tube, percutaneous, includes rem",76143763,CDM,750,RC,43763,HCPCS,Outpatient,,,951,618.15,,836.88,88,,,percent of total billed charges,88% of total Billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,951,100,,,percent of total billed charges,100% of total billed charges,624,103,,,Fee Schedule,103% of WA Medicaid,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,599.13,63,,,percent of total billed charges,63% of total billed charges,441.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,656.19,69,,,percent of total billed charges,69% of total billed charges,951,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,951,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,951,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1081.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,617.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.58,130,,,Fee Schedule,130% of WA Medicaid ,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,358.53,37.7,,,percent of total billed charges,37.70% of total billed charges,358.53,37.7,,,percent of total billed charges,37.70% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,322.39,33.9,,,percent of total billed charges,33.9% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,741.78,78,,,percent of total billed charges,78% of total billed charges,951,100,,,percent of total billed charges,100% of total billed charges,785.53,82.6,,,percent of total billed charges,82.6% of total billed charges,785.53,82.6,,,percent of total billed charges,82.6% of total billed charges,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,254.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,252.08,3367,
Replace Gastrostomy Tube SURG,76143762,CDM,750,RC,43762,HCPCS,Outpatient,,,951,618.15,,836.88,88,,,percent of total billed charges,88% of total Billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,951,100,,,percent of total billed charges,100% of total billed charges,624,103,,,Fee Schedule,103% of WA Medicaid,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,599.13,63,,,percent of total billed charges,63% of total billed charges,441.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,656.19,69,,,percent of total billed charges,69% of total billed charges,951,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,951,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,951,100,,,percent of total billed charges,100% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,1081.19,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,448.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,617.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.58,130,,,Fee Schedule,130% of WA Medicaid ,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,358.53,37.7,,,percent of total billed charges,37.70% of total billed charges,358.53,37.7,,,percent of total billed charges,37.70% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,322.39,33.9,,,percent of total billed charges,33.9% of total billed charges,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,741.78,78,,,percent of total billed charges,78% of total billed charges,951,100,,,percent of total billed charges,100% of total billed charges,785.53,82.6,,,percent of total billed charges,82.6% of total billed charges,785.53,82.6,,,percent of total billed charges,82.6% of total billed charges,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,254.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,252.08,100,,,Fee Schedule,100% of Medicare OPPS rate,605.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,252.08,3367,
"Smll Intestinal Endscpy, Entrscpy Bynd Scnd Port Of Duodenu",76144361,CDM,750,RC,44361,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTI",76144366,CDM,750,RC,44366,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1923.69,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1383.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1905.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2427.97,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1383.45,6601.69,
"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTIO",76144369,CDM,750,RC,44369,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"SMALL BOWEL ENDOSCOPY, DIAG NOT INCLUDING",76144360,CDM,750,RC,44360,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTI",76144364,CDM,750,RC,44364,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1923.69,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1383.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1905.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2427.97,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1383.45,6601.69,
"Small intestinal endoscopy, enteroscopy beyond second portio",76144373,CDM,750,RC,44373,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"SMALL BOWEL ENDOSCOPY, BEYOND SECOND PORTION W BIOPSY,",76144377,CDM,750,RC,44377,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,887.66,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,638.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,879.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.34,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,861.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,638.37,6601.69,
"Smll Intstnl Endscpy, Entrscpy Bynd Scnd Portion Of Duodenum",76144378,CDM,750,RC,44378,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1923.69,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1383.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1905.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2427.97,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1867.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1383.45,6601.69,
"Colonoscopy through stoma; with biopsy, single or multiple",44389,CDM,750,RC,44389,HCPCS,Outpatient,,,3790,2463.50,,3335.2,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3790,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2387.7,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2615.1,69,,,percent of total billed charges,69% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3790,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3790,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1284.81,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2956.2,78,,,percent of total billed charges,78% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
"Ileoscopy, Through Stoma; With Biopsy, Single Or Multiple",76144382,CDM,750,RC,44382,HCPCS,Outpatient,,,2892,1879.80,,2544.96,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,2892,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1821.96,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1995.48,69,,,percent of total billed charges,69% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,980.39,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2255.76,78,,,percent of total billed charges,78% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,3367,
COLONOSCOPY THRU STOMA,76144388,CDM,750,RC,44388,HCPCS,Outpatient,,,2837,1844.05,,2496.56,88,,,percent of total billed charges,88% of total Billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,2837,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1787.31,63,,,percent of total billed charges,63% of total billed charges,1631.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1957.53,69,,,percent of total billed charges,69% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3224.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,961.74,33.9,,,percent of total billed charges,33.9% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2212.86,78,,,percent of total billed charges,78% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,941.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,3367,
"ILEOSCOPY, THROUGH STOMA; WITH TRANSENDOSCOPIC BALLOON DILA",76144381,CDM,750,RC,44381,HCPCS,Outpatient,,,5806,3773.90,,5109.28,88,,,percent of total billed charges,88% of total Billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,3657.78,63,,,percent of total billed charges,63% of total billed charges,3396.4,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,4006.14,69,,,percent of total billed charges,69% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,5806,100,,,percent of total billed charges,100% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,6601.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2188.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1968.23,33.9,,,percent of total billed charges,33.9% of total billed charges,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,4528.68,78,,,percent of total billed charges,78% of total billed charges,5806,100,,,percent of total billed charges,100% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4795.76,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,1960.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1940.8,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,6601.69,
Ileoxopy thru Stoma,76144380,CDM,750,RC,44380,HCPCS,Outpatient,,,2892,1879.80,,2544.96,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,2892,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1821.96,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1995.48,69,,,percent of total billed charges,69% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,980.39,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2255.76,78,,,percent of total billed charges,78% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,3367,
"COLONOSCOPY THROUGH STOMA; WITH CONTROL OF BLEEDING, ANY ME",76144391,CDM,750,RC,44391,HCPCS,Outpatient,,,3707,2409.55,,3262.16,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3707,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2335.41,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2557.83,69,,,percent of total billed charges,69% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1256.67,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2891.46,78,,,percent of total billed charges,78% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
"COLONOSCOPY THROUGH STOMA; REMOVAL OF TUMOR/POLYP, SNARE TE",76144394,CDM,750,RC,44394,HCPCS,Outpatient,,,3707,2409.55,,3262.16,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3707,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2335.41,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2557.83,69,,,percent of total billed charges,69% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1256.67,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2891.46,78,,,percent of total billed charges,78% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
"COLONOSCOPY THROUGH STOMA; WITH ABLATION OF TUMOR(S), POLYP",76144401,CDM,750,RC,44401,HCPCS,Outpatient,,,3707,2409.55,,3262.16,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3707,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2335.41,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2557.83,69,,,percent of total billed charges,69% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1256.67,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2891.46,78,,,percent of total billed charges,78% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
COLONOSCOPY THROUGH STOMA; WITH DIRECTED SUBMUCOSAL INJECTIO,76144404,CDM,750,RC,44404,HCPCS,Outpatient,,,3707,2409.55,,3262.16,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3707,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2335.41,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2557.83,69,,,percent of total billed charges,69% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1256.67,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2891.46,78,,,percent of total billed charges,78% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
COLONOSCOPY THROUGH STOMA; WITH TRANSENDOSCOPIC BALLOON DIL,76144405,CDM,750,RC,44405,HCPCS,Outpatient,,,2837,1844.05,,2496.56,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,2837,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1787.31,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1957.53,69,,,percent of total billed charges,69% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,961.74,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2212.86,78,,,percent of total billed charges,78% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
FLEX SIG SURG,76145330,CDM,750,RC,45330,HCPCS,Outpatient,,,2837,1844.05,,2496.56,88,,,percent of total billed charges,88% of total Billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,2837,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1787.31,63,,,percent of total billed charges,63% of total billed charges,1631.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1957.53,69,,,percent of total billed charges,69% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3224.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,961.74,33.9,,,percent of total billed charges,33.9% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2212.86,78,,,percent of total billed charges,78% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,941.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,3367,
FLEX SIG W/BX,76145331,CDM,750,RC,45331,HCPCS,Outpatient,,,2837,1844.05,,2496.56,88,,,percent of total billed charges,88% of total Billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,2837,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1787.31,63,,,percent of total billed charges,63% of total billed charges,1631.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1957.53,69,,,percent of total billed charges,69% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3224.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,961.74,33.9,,,percent of total billed charges,33.9% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2212.86,78,,,percent of total billed charges,78% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,941.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,3367,
FLEX SIG W/REMOVAL POLYP/SNARE,76145338,CDM,750,RC,45338,HCPCS,Outpatient,,,3706,2408.90,,3261.28,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3706,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2334.78,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2557.14,69,,,percent of total billed charges,69% of total billed charges,3706,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3706,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3706,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1397.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1397.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1256.33,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2890.68,78,,,percent of total billed charges,78% of total billed charges,3706,100,,,percent of total billed charges,100% of total billed charges,3061.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3061.16,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
"IGMOIDOSCOPY, FLEXIBLE",76145335,CDM,750,RC,45335,HCPCS,Outpatient,,,2837,1844.05,,2496.56,88,,,percent of total billed charges,88% of total Billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,2837,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1787.31,63,,,percent of total billed charges,63% of total billed charges,1631.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1957.53,69,,,percent of total billed charges,69% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3224.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,961.74,33.9,,,percent of total billed charges,33.9% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2212.86,78,,,percent of total billed charges,78% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,941.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,3367,
"Sigmoidoscopy,flexible w/ctrl bleeding",76145334,CDM,750,RC,45334,HCPCS,Outpatient,,,3707,2409.55,,3262.16,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3707,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2335.41,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2557.83,69,,,percent of total billed charges,69% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1256.67,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2891.46,78,,,percent of total billed charges,78% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
"SIGMOIDOSCOPY, FLEXIBLE; WITH PLACEMENT OF ENDOSCOPIC STENT",76145347,CDM,761,RC,45347,HCPCS,Outpatient,,,3707,2409.55,,3262.16,88,,,percent of total billed charges,88% of total Billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid,3707,100,,,percent of total billed charges,100% of total billed charges,1899.25,103,,,Fee Schedule,103% of WA Medicaid,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,2335.41,63,,,percent of total billed charges,63% of total billed charges,10172.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid,567.17,15.3,,,percent of total billed charges,15.3% of total billed charges,2557.83,69,,,percent of total billed charges,69% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,20428.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1365.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1880.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2397.11,130,,,Fee Schedule,130% of WA Medicaid ,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1256.67,33.9,,,percent of total billed charges,33.9% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,2891.46,78,,,percent of total billed charges,78% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1843.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5871.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,567.17,20428.51,
"SIGMOIDOSCOPY, FLEXIBLE",76145340,CDM,750,RC,45340,HCPCS,Outpatient,,,3707,2409.55,,3262.16,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3707,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2335.41,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2557.83,69,,,percent of total billed charges,69% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1256.67,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2891.46,78,,,percent of total billed charges,78% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
"Sigmoidoscopy, flexible w/ablation of tumors SURG",76145346,CDM,750,RC,45346,HCPCS,Outpatient,,,3707,2409.55,,3262.16,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3707,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2335.41,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2557.83,69,,,percent of total billed charges,69% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3707,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1397.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1256.67,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2891.46,78,,,percent of total billed charges,78% of total billed charges,3707,100,,,percent of total billed charges,100% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,3061.98,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
DIAGNOSTIC COLONOSCOPY SURG,76145378,CDM,750,RC,45378,HCPCS,Outpatient,,,2837,1844.05,,2496.56,88,,,percent of total billed charges,88% of total Billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,2837,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1787.31,63,,,percent of total billed charges,63% of total billed charges,1631.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1957.53,69,,,percent of total billed charges,69% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3224.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,961.74,33.9,,,percent of total billed charges,33.9% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2212.86,78,,,percent of total billed charges,78% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,941.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,3367,
COLONOSCOPY W/CONTROL BLEED SURG,76145382,CDM,750,RC,45382,HCPCS,Outpatient,,,3709,2410.85,,3263.92,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3709,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2336.67,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2559.21,69,,,percent of total billed charges,69% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1257.35,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2893.02,78,,,percent of total billed charges,78% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
COLONOSCOPY W/POLYPECTOMY SURG,76145385,CDM,750,RC,45385,HCPCS,Outpatient,,,3709,2410.85,,3263.92,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3709,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2336.67,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2559.21,69,,,percent of total billed charges,69% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1257.35,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2893.02,78,,,percent of total billed charges,78% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
COLONOSCOPY ABLATION TUMOR POLYP LESION,76145388,CDM,750,RC,45388,HCPCS,Outpatient,,,3709,2410.85,,3263.92,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3709,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2336.67,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2559.21,69,,,percent of total billed charges,69% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1257.35,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2893.02,78,,,percent of total billed charges,78% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
COLONOSCOPY SUB INJ SURG,76145381,CDM,750,RC,45381,HCPCS,Outpatient,,,3709,2410.85,,3263.92,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3709,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2336.67,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2559.21,69,,,percent of total billed charges,69% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1257.35,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2893.02,78,,,percent of total billed charges,78% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
"COLONOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC BALLOON DILATIO",76145386,CDM,750,RC,45386,HCPCS,Outpatient,,,3709,2410.85,,3263.92,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3709,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2336.67,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2559.21,69,,,percent of total billed charges,69% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1257.35,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2893.02,78,,,percent of total billed charges,78% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
COLONOSCOPY W/BX SURG,76145380,CDM,750,RC,45380,HCPCS,Outpatient,,,3709,2410.85,,3263.92,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3709,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2336.67,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2559.21,69,,,percent of total billed charges,69% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3709,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1398.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1257.35,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2893.02,78,,,percent of total billed charges,78% of total billed charges,3709,100,,,percent of total billed charges,100% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3063.63,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
"45389 Colonoscopy, flexible; with endoscopic stent placement",75045389,CDM,750,RC,45389,HCPCS,Outpatient,,,19005,12353.25,,16724.4,88,,,percent of total billed charges,88% of total Billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1899.25,103,,,Fee Schedule,103% of WA Medicaid,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,11973.15,63,,,percent of total billed charges,63% of total billed charges,10172.77,175,,,Fee Schedule,175% of Medicare OPPS Rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,13113.45,69,,,percent of total billed charges,69% of total billed charges,19005,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19005,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,19005,100,,,percent of total billed charges,100% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,20428.51,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1365.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1880.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2397.11,130,,,Fee Schedule,130% of WA Medicaid ,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,7164.89,37.7,,,percent of total billed charges,37.70% of total billed charges,7164.89,37.7,,,percent of total billed charges,37.70% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,6442.7,33.9,,,percent of total billed charges,33.9% of total billed charges,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,14823.9,78,,,percent of total billed charges,78% of total billed charges,19005,100,,,percent of total billed charges,100% of total billed charges,15698.13,82.6,,,percent of total billed charges,82.6% of total billed charges,15698.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1843.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,5871.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,5813.01,100,,,Fee Schedule,100% of Medicare OPPS rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1365.87,20428.51,
45390 COLONOSCOPY W/ EMR of POLYP,75045390,CDM,750,RC,45390,HCPCS,Outpatient,,,9373,6092.45,,8248.24,88,,,percent of total billed charges,88% of total Billed charges,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1899.25,103,,,Fee Schedule,103% of WA Medicaid,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,5904.99,63,,,percent of total billed charges,63% of total billed charges,5011.71,175,,,Fee Schedule,175% of Medicare OPPS Rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,6467.37,69,,,percent of total billed charges,69% of total billed charges,9373,100,,,percent of total billed charges,100% of total billed charges,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,9373,100,,,percent of total billed charges,100% of total billed charges,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,9373,100,,,percent of total billed charges,100% of total billed charges,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,9926.34,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1365.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1880.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2397.11,130,,,Fee Schedule,130% of WA Medicaid ,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,3533.62,37.7,,,percent of total billed charges,37.70% of total billed charges,3533.62,37.7,,,percent of total billed charges,37.70% of total billed charges,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,3177.45,33.9,,,percent of total billed charges,33.9% of total billed charges,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,7310.94,78,,,percent of total billed charges,78% of total billed charges,9373,100,,,percent of total billed charges,100% of total billed charges,7742.1,82.6,,,percent of total billed charges,82.6% of total billed charges,7742.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1843.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,2892.47,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2863.84,100,,,Fee Schedule,100% of Medicare OPPS rate,1843.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1365.87,9926.34,
"45398 Colonoscopy, flexible; with band ligation(s) (eg, hemo",75045398,CDM,750,RC,45398,HCPCS,Outpatient,,,3790,2463.50,,3335.2,88,,,percent of total billed charges,88% of total Billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3790,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2387.7,63,,,percent of total billed charges,63% of total billed charges,2106.33,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,2615.1,69,,,percent of total billed charges,69% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3790,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,3790,100,,,percent of total billed charges,100% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,4212.68,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1284.81,33.9,,,percent of total billed charges,33.9% of total billed charges,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,2956.2,78,,,percent of total billed charges,78% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,1215.65,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1203.6,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,4212.68,
Abdominal Paracentesis Diagnostic/Therapeutic W/Imaging,76149083,CDM,750,RC,49083,HCPCS,Outpatient,,,2893,1880.45,,2545.84,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,2893,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1822.59,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1996.17,69,,,percent of total billed charges,69% of total billed charges,2893,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2893,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2893,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.66,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,980.73,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2256.54,78,,,percent of total billed charges,78% of total billed charges,2893,100,,,percent of total billed charges,100% of total billed charges,2389.62,82.6,,,percent of total billed charges,82.6% of total billed charges,2389.62,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,493.23,3367,
"Peritoneal lavage, including imaging guidance, when performe",76149084,CDM,750,RC,49084,HCPCS,Outpatient,,,2892,1879.80,,2544.96,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,2892,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1821.96,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1995.48,69,,,percent of total billed charges,69% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,980.39,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2255.76,78,,,percent of total billed charges,78% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,493.23,3367,
ABD PARACENTESIS W/O IMAGING CHARGE,76149082,CDM,750,RC,49082,HCPCS,Outpatient,,,2892,1879.80,,2544.96,88,,,percent of total billed charges,88% of total Billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,2892,100,,,percent of total billed charges,100% of total billed charges,685.84,103,,,Fee Schedule,103% of WA Medicaid,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1821.96,63,,,percent of total billed charges,63% of total billed charges,1618,175,,,Fee Schedule,175% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1995.48,69,,,percent of total billed charges,69% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2892,100,,,percent of total billed charges,100% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,3289.02,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,493.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,679.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,865.63,130,,,Fee Schedule,130% of WA Medicaid ,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.28,37.7,,,percent of total billed charges,37.70% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,980.39,33.9,,,percent of total billed charges,33.9% of total billed charges,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,2255.76,78,,,percent of total billed charges,78% of total billed charges,2892,100,,,percent of total billed charges,100% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2388.79,82.6,,,percent of total billed charges,82.6% of total billed charges,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,933.81,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,924.57,100,,,Fee Schedule,100% of Medicare OPPS rate,665.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,493.23,3367,
SPINAL FLUID TAP DIAGNOSTIC,AMB820040,CDM,761,RC,62270,HCPCS,Outpatient,,,1508,980.20,,1327.04,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,1508,100,,,percent of total billed charges,100% of total billed charges,793.79,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,950.04,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid,230.72,15.3,,,percent of total billed charges,15.3% of total billed charges,1040.52,69,,,percent of total billed charges,69% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1508,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,570.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,786.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,511.21,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1176.24,78,,,percent of total billed charges,78% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,770.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,230.72,2578.03,
"Injection, anesthetic agent; sciatic nerve",76164445,CDM,761,RC,64445,HCPCS,Outpatient,,,1942,1262.30,,1708.96,88,,,percent of total billed charges,88% of total Billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,1942,100,,,percent of total billed charges,100% of total billed charges,403.97,103,,,Fee Schedule,103% of WA Medicaid,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1223.46,63,,,percent of total billed charges,63% of total billed charges,1234.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,297.13,15.3,,,percent of total billed charges,15.3% of total billed charges,1339.98,69,,,percent of total billed charges,69% of total billed charges,1942,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1942,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1942,100,,,percent of total billed charges,100% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,2578.03,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,290.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,400.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.87,130,,,Fee Schedule,130% of WA Medicaid ,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,732.13,37.7,,,percent of total billed charges,37.70% of total billed charges,732.13,37.7,,,percent of total billed charges,37.70% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,658.34,33.9,,,percent of total billed charges,33.9% of total billed charges,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,1514.76,78,,,percent of total billed charges,78% of total billed charges,1942,100,,,percent of total billed charges,100% of total billed charges,1604.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1604.09,82.6,,,percent of total billed charges,82.6% of total billed charges,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,712.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,705.35,100,,,Fee Schedule,100% of Medicare OPPS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,290.52,2578.03,
95926 SSEP LOWER LIMBS,36095926,CDM,922,RC,95926,HCPCS,Outpatient,,,675,438.75,,594,88,,,percent of total billed charges,88% of total Billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,122.9,100,,,Fee Schedule,100% of WA Medicaid,675,100,,,percent of total billed charges,100% of total billed charges,126.58,103,,,Fee Schedule,103% of WA Medicaid,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,560.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,122.9,100,,,Fee Schedule,100% of WA Medicaid,103.28,15.3,,,percent of total billed charges,15.3% of total billed charges,465.75,69,,,percent of total billed charges,69% of total billed charges,675,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,675,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,675,100,,,percent of total billed charges,100% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,1074.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,122.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,91.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,125.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,159.77,130,,,Fee Schedule,130% of WA Medicaid ,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,254.48,37.7,,,percent of total billed charges,37.70% of total billed charges,254.48,37.7,,,percent of total billed charges,37.70% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,228.83,33.9,,,percent of total billed charges,33.9% of total billed charges,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,526.5,78,,,percent of total billed charges,78% of total billed charges,675,100,,,percent of total billed charges,100% of total billed charges,557.55,82.6,,,percent of total billed charges,82.6% of total billed charges,557.55,82.6,,,percent of total billed charges,82.6% of total billed charges,122.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,323.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,320.14,100,,,Fee Schedule,100% of Medicare OPPS rate,122.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.03,1074.33,
95929 CMEP Lower Limbs,36095929,CDM,920,RC,95929,HCPCS,Outpatient,,,1218,791.70,,1071.84,88,,,percent of total billed charges,88% of total Billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,122.9,100,,,Fee Schedule,100% of WA Medicaid,1218,100,,,percent of total billed charges,100% of total billed charges,126.58,103,,,Fee Schedule,103% of WA Medicaid,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,956.69,175,,,Fee Schedule,175% of Medicare OPPS Rate,122.9,100,,,Fee Schedule,100% of WA Medicaid,186.35,15.3,,,percent of total billed charges,15.3% of total billed charges,840.42,69,,,percent of total billed charges,69% of total billed charges,1218,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1218,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1218,100,,,percent of total billed charges,100% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,1981.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,122.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,91.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,125.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,159.77,130,,,Fee Schedule,130% of WA Medicaid ,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,459.19,37.7,,,percent of total billed charges,37.70% of total billed charges,459.19,37.7,,,percent of total billed charges,37.70% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,412.9,33.9,,,percent of total billed charges,33.9% of total billed charges,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,950.04,78,,,percent of total billed charges,78% of total billed charges,1218,100,,,percent of total billed charges,100% of total billed charges,1006.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1006.07,82.6,,,percent of total billed charges,82.6% of total billed charges,122.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,552.14,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,546.67,100,,,Fee Schedule,100% of Medicare OPPS rate,122.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.03,1981.61,
96413 CHEMO ADM IV INF 1HR SGL INIT,AMB820083,CDM,335,RC,96413,HCPCS,Outpatient,,,1153,749.45,,1014.64,88,,,percent of total billed charges,88% of total Billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,1153,100,,,percent of total billed charges,100% of total billed charges,281.17,103,,,Fee Schedule,103% of WA Medicaid,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,726.39,63,,,percent of total billed charges,63% of total billed charges,604.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid,176.41,15.3,,,percent of total billed charges,15.3% of total billed charges,795.57,69,,,percent of total billed charges,69% of total billed charges,1153,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1153,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1153,100,,,percent of total billed charges,100% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,1262.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,202.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,278.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.88,130,,,Fee Schedule,130% of WA Medicaid ,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,434.68,37.7,,,percent of total billed charges,37.70% of total billed charges,434.68,37.7,,,percent of total billed charges,37.70% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,390.87,33.9,,,percent of total billed charges,33.9% of total billed charges,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,899.34,78,,,percent of total billed charges,78% of total billed charges,1153,100,,,percent of total billed charges,100% of total billed charges,952.38,82.6,,,percent of total billed charges,82.6% of total billed charges,952.38,82.6,,,percent of total billed charges,82.6% of total billed charges,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,348.87,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,345.42,100,,,Fee Schedule,100% of Medicare OPPS rate,272.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,176.41,1262.42,
96415 CHEMO ADM IV INF EA ADDT'L HR,AMB820084,CDM,335,RC,96415,HCPCS,Outpatient,,,216,140.40,,190.08,88,,,percent of total billed charges,88% of total Billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,216,100,,,percent of total billed charges,100% of total billed charges,475.9,103,,,Fee Schedule,103% of WA Medicaid,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,136.08,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid,33.05,15.3,,,percent of total billed charges,15.3% of total billed charges,149.04,69,,,percent of total billed charges,69% of total billed charges,216,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,216,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,216,100,,,percent of total billed charges,100% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,251.74,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,342.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,471.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.65,130,,,Fee Schedule,130% of WA Medicaid ,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,81.43,37.7,,,percent of total billed charges,37.70% of total billed charges,81.43,37.7,,,percent of total billed charges,37.70% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,73.22,33.9,,,percent of total billed charges,33.9% of total billed charges,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,168.48,78,,,percent of total billed charges,78% of total billed charges,216,100,,,percent of total billed charges,100% of total billed charges,178.42,82.6,,,percent of total billed charges,82.6% of total billed charges,178.42,82.6,,,percent of total billed charges,82.6% of total billed charges,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,72.56,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.84,100,,,Fee Schedule,100% of Medicare OPPS rate,462.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.05,600.65,
Moderate Sedation (1st 15) Charge Surg,76199152,CDM,750,RC,99152,HCPCS,Outpatient,,,465,302.25,59,409.2,88,,,percent of total billed charges,88% of total Billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid,465,100,,,percent of total billed charges,100% of total billed charges,22.18,103,,,Fee Schedule,103% of WA Medicaid,232.5,50,,,percent of total billed charges,50% of total Billed charges,292.95,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.54,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,320.85,69,,,percent of total billed charges,69% of total billed charges,465,100,,,percent of total billed charges,100% of total billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,465,100,,,percent of total billed charges,100% of total billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,465,100,,,percent of total billed charges,100% of total billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,287.6,61.85,,,percent of total billed charges,61.85% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232.5,50,,,percent of total billed charges,50% of total Billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,15.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,232.5,50,,,percent of total billed charges,50% of total Billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,21.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28,130,,,Fee Schedule,130% of WA Medicaid ,232.5,50,,,percent of total billed charges,50% of total Billed charges,175.31,37.7,,,percent of total billed charges,37.70% of total billed charges,175.31,37.7,,,percent of total billed charges,37.70% of total billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,157.64,33.9,,,percent of total billed charges,33.9% of total billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,362.7,78,,,percent of total billed charges,78% of total billed charges,465,100,,,percent of total billed charges,100% of total billed charges,384.09,82.6,,,percent of total billed charges,82.6% of total billed charges,384.09,82.6,,,percent of total billed charges,82.6% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,232.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.95,3367,
COLONOSCOPY-DX HIGH RISK,750G0105,CDM,750,RC,G0105,HCPCS,Outpatient,,,2837,1844.05,,2496.56,88,,,percent of total billed charges,88% of total Billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,2837,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1787.31,63,,,percent of total billed charges,63% of total billed charges,1631.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1957.53,69,,,percent of total billed charges,69% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3224.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,961.74,33.9,,,percent of total billed charges,33.9% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2212.86,78,,,percent of total billed charges,78% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,941.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,3367,
G0121 Colorectal Cancer Screen,750G0121,CDM,750,RC,G0121,HCPCS,Outpatient,,,2837,1844.05,,2496.56,88,,,percent of total billed charges,88% of total Billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,2837,100,,,percent of total billed charges,100% of total billed charges,900.92,103,,,Fee Schedule,103% of WA Medicaid,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1787.31,63,,,percent of total billed charges,63% of total billed charges,1631.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,1957.53,69,,,percent of total billed charges,69% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2837,100,,,percent of total billed charges,100% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,3224.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,647.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,892.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1137.08,130,,,Fee Schedule,130% of WA Medicaid ,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1069.55,37.7,,,percent of total billed charges,37.70% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,961.74,33.9,,,percent of total billed charges,33.9% of total billed charges,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,2212.86,78,,,percent of total billed charges,78% of total billed charges,2837,100,,,percent of total billed charges,100% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2343.36,82.6,,,percent of total billed charges,82.6% of total billed charges,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,941.51,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,932.2,100,,,Fee Schedule,100% of Medicare OPPS rate,874.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,647.91,3367,
MOD SED ENDO/GT SERVICE 5/>YRS CHARGE SURG,750G0500,CDM,750,RC,G0500,HCPCS,Outpatient,,,465,302.25,,409.2,88,,,percent of total billed charges,88% of total Billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid,465,100,,,percent of total billed charges,100% of total billed charges,22.18,103,,,Fee Schedule,103% of WA Medicaid,232.5,50,,,percent of total billed charges,50% of total Billed charges,292.95,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.54,100,,,Fee Schedule,100% of WA Medicaid,3367,15.3,,,percent of total billed charges,15.3% of total billed charges,320.85,69,,,percent of total billed charges,69% of total billed charges,465,100,,,percent of total billed charges,100% of total billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,465,100,,,percent of total billed charges,100% of total billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,465,100,,,percent of total billed charges,100% of total billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,287.6,61.85,,,percent of total billed charges,61.85% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232.5,50,,,percent of total billed charges,50% of total Billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,15.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,232.5,50,,,percent of total billed charges,50% of total Billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,21.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28,130,,,Fee Schedule,130% of WA Medicaid ,232.5,50,,,percent of total billed charges,50% of total Billed charges,175.31,37.7,,,percent of total billed charges,37.70% of total billed charges,175.31,37.7,,,percent of total billed charges,37.70% of total billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,157.64,33.9,,,percent of total billed charges,33.9% of total billed charges,232.5,50,,,percent of total billed charges,50% of total Billed charges,362.7,78,,,percent of total billed charges,78% of total billed charges,465,100,,,percent of total billed charges,100% of total billed charges,384.09,82.6,,,percent of total billed charges,82.6% of total billed charges,384.09,82.6,,,percent of total billed charges,82.6% of total billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,232.5,50,,,percent of total billed charges,50% of total Billed charges,21.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.95,3367,
BLOOD ADMIN,39136430,CDM,391,RC,36430,HCPCS,Outpatient,,,1723,1119.95,,1516.24,88,,,percent of total billed charges,88% of total Billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,414.73,100,,,Fee Schedule,100% of WA Medicaid,1723,100,,,percent of total billed charges,100% of total billed charges,427.18,103,,,Fee Schedule,103% of WA Medicaid,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,1085.49,63,,,percent of total billed charges,63% of total billed charges,774.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,414.73,100,,,Fee Schedule,100% of WA Medicaid,263.62,15.3,,,percent of total billed charges,15.3% of total billed charges,1188.87,69,,,percent of total billed charges,69% of total billed charges,1723,100,,,percent of total billed charges,100% of total billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,1723,100,,,percent of total billed charges,100% of total billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,1723,100,,,percent of total billed charges,100% of total billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,1613.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,414.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,307.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,423.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,539.16,130,,,Fee Schedule,130% of WA Medicaid ,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,649.57,37.7,,,percent of total billed charges,37.70% of total billed charges,649.57,37.7,,,percent of total billed charges,37.70% of total billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,584.1,33.9,,,percent of total billed charges,33.9% of total billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,1343.94,78,,,percent of total billed charges,78% of total billed charges,1723,100,,,percent of total billed charges,100% of total billed charges,1423.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1423.2,82.6,,,percent of total billed charges,82.6% of total billed charges,414.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,447.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,414.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,263.62,1723,
BLOOD ADMIN,39136430,CDM,391,RC,36430,HCPCS,Outpatient,,,1723,1119.95,,1516.24,88,,,percent of total billed charges,88% of total Billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,414.73,100,,,Fee Schedule,100% of WA Medicaid,1723,100,,,percent of total billed charges,100% of total billed charges,427.18,103,,,Fee Schedule,103% of WA Medicaid,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,1085.49,63,,,percent of total billed charges,63% of total billed charges,774.83,175,,,Fee Schedule,175% of Medicare OPPS Rate,414.73,100,,,Fee Schedule,100% of WA Medicaid,263.62,15.3,,,percent of total billed charges,15.3% of total billed charges,1188.87,69,,,percent of total billed charges,69% of total billed charges,1723,100,,,percent of total billed charges,100% of total billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,1723,100,,,percent of total billed charges,100% of total billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,1723,100,,,percent of total billed charges,100% of total billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,1613.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,414.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,307.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,423.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,539.16,130,,,Fee Schedule,130% of WA Medicaid ,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,649.57,37.7,,,percent of total billed charges,37.70% of total billed charges,649.57,37.7,,,percent of total billed charges,37.70% of total billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,584.1,33.9,,,percent of total billed charges,33.9% of total billed charges,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,1343.94,78,,,percent of total billed charges,78% of total billed charges,1723,100,,,percent of total billed charges,100% of total billed charges,1423.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1423.2,82.6,,,percent of total billed charges,82.6% of total billed charges,414.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,447.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,442.76,100,,,Fee Schedule,100% of Medicare OPPS rate,414.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,263.62,1723,
ABG PUNCTURE,30036600,CDM,300,RC,36600,HCPCS,Outpatient,,,507,329.55,,446.16,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,507,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,319.41,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,77.57,15.3,,,percent of total billed charges,15.3% of total billed charges,349.83,69,,,percent of total billed charges,69% of total billed charges,507,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,507,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,507,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,191.14,37.7,,,percent of total billed charges,37.70% of total billed charges,191.14,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,171.87,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,395.46,78,,,percent of total billed charges,78% of total billed charges,507,100,,,percent of total billed charges,100% of total billed charges,418.78,82.6,,,percent of total billed charges,82.6% of total billed charges,418.78,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.15,507,
Electrocardiogram,73093005,CDM,730,RC,93005,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,24.47,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,302.4,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid,73.44,15.3,,,percent of total billed charges,15.3% of total billed charges,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,480,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,24.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.89,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,162.72,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.6,480,
FETAL NON-STRESS TEST,59025,CDM,761,RC,59025,HCPCS,Outpatient,,,529,343.85,,465.52,88,,,percent of total billed charges,88% of total Billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,165.98,100,,,Fee Schedule,100% of WA Medicaid,529,100,,,percent of total billed charges,100% of total billed charges,170.96,103,,,Fee Schedule,103% of WA Medicaid,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,333.27,63,,,percent of total billed charges,63% of total billed charges,355.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,165.98,100,,,Fee Schedule,100% of WA Medicaid,80.94,15.3,,,percent of total billed charges,15.3% of total billed charges,365.01,69,,,percent of total billed charges,69% of total billed charges,529,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,529,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,529,100,,,percent of total billed charges,100% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,691.92,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,122.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,169.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,215.77,130,,,Fee Schedule,130% of WA Medicaid ,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,199.43,37.7,,,percent of total billed charges,37.70% of total billed charges,199.43,37.7,,,percent of total billed charges,37.70% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,179.33,33.9,,,percent of total billed charges,33.9% of total billed charges,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,412.62,78,,,percent of total billed charges,78% of total billed charges,529,100,,,percent of total billed charges,100% of total billed charges,436.95,82.6,,,percent of total billed charges,82.6% of total billed charges,436.95,82.6,,,percent of total billed charges,82.6% of total billed charges,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,205.26,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,203.24,100,,,Fee Schedule,100% of Medicare OPPS rate,165.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.94,691.92,
HEARING SCREEN AUDITORY EVOKED,47192258,CDM,471,RC,92558,HCPCS,Outpatient,,,926,601.90,,814.88,88,,,percent of total billed charges,88% of total Billed charges,463,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid,926,100,,,percent of total billed charges,100% of total billed charges,32.11,103,,,Fee Schedule,103% of WA Medicaid,463,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.18,100,,,Fee Schedule,100% of WA Medicaid,141.68,15.3,,,percent of total billed charges,15.3% of total billed charges,638.94,69,,,percent of total billed charges,69% of total billed charges,926,100,,,percent of total billed charges,100% of total billed charges,463,50,,,percent of total billed charges,50% of total Billed charges,926,100,,,percent of total billed charges,100% of total billed charges,463,50,,,percent of total billed charges,50% of total Billed charges,926,100,,,percent of total billed charges,100% of total billed charges,463,50,,,percent of total billed charges,50% of total Billed charges,572.73,61.85,,,percent of total billed charges,61.85% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,463,50,,,percent of total billed charges,50% of total Billed charges,463,50,,,percent of total billed charges,50% of total Billed charges,23.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,463,50,,,percent of total billed charges,50% of total Billed charges,463,50,,,percent of total billed charges,50% of total Billed charges,31.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.53,130,,,Fee Schedule,130% of WA Medicaid ,463,50,,,percent of total billed charges,50% of total Billed charges,349.1,37.7,,,percent of total billed charges,37.70% of total billed charges,349.1,37.7,,,percent of total billed charges,37.70% of total billed charges,463,50,,,percent of total billed charges,50% of total Billed charges,313.91,33.9,,,percent of total billed charges,33.9% of total billed charges,463,50,,,percent of total billed charges,50% of total Billed charges,722.28,78,,,percent of total billed charges,78% of total billed charges,926,100,,,percent of total billed charges,100% of total billed charges,764.88,82.6,,,percent of total billed charges,82.6% of total billed charges,764.88,82.6,,,percent of total billed charges,82.6% of total billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,463,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,463,50,,,percent of total billed charges,50% of total Billed charges,31.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,926,
Phototherapy,MED120045,CDM,290,RC,E0202,HCPCS,Outpatient,,,644,418.60,,566.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,644,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,405.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",98.53,15.3,,,percent of total billed charges,15.3% of total billed charges,444.36,69,,,percent of total billed charges,69% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,644,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,644,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,218.32,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,502.32,78,,,percent of total billed charges,78% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,108.19,16.8,,,percent of total billed charges,16.8% of total billed charges,98.53,644,
SMOKE/TOBAC COUNSEL 3-10M,94299406,CDM,942,RC,99406,HCPCS,Outpatient,,,105,68.25,,92.4,88,,,percent of total billed charges,88% of total Billed charges,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,21.69,100,,,Fee Schedule,100% of WA Medicaid,105,100,,,percent of total billed charges,100% of total billed charges,22.34,103,,,Fee Schedule,103% of WA Medicaid,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,66.15,63,,,percent of total billed charges,63% of total billed charges,51.21,175,,,Fee Schedule,175% of Medicare OPPS Rate,21.69,100,,,Fee Schedule,100% of WA Medicaid,16.07,15.3,,,percent of total billed charges,15.3% of total billed charges,72.45,69,,,percent of total billed charges,69% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,105,100,,,percent of total billed charges,100% of total billed charges,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,106.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,21.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,22.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.2,130,,,Fee Schedule,130% of WA Medicaid ,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,39.59,37.7,,,percent of total billed charges,37.70% of total billed charges,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,81.9,78,,,percent of total billed charges,78% of total billed charges,105,100,,,percent of total billed charges,100% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,86.73,82.6,,,percent of total billed charges,82.6% of total billed charges,21.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,29.55,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,29.26,100,,,Fee Schedule,100% of Medicare OPPS rate,21.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.07,106.54,
THERAPEUTIC PHLEBOTOMY ONC.,90499195,CDM,904,RC,99195,HCPCS,Outpatient,,,331,215.15,,291.28,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,331,100,,,percent of total billed charges,100% of total billed charges,54.44,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,208.53,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid,50.64,15.3,,,percent of total billed charges,15.3% of total billed charges,228.39,69,,,percent of total billed charges,69% of total billed charges,331,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,331,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,331,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,39.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,53.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.72,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,124.79,37.7,,,percent of total billed charges,37.70% of total billed charges,124.79,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,112.21,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,258.18,78,,,percent of total billed charges,78% of total billed charges,331,100,,,percent of total billed charges,100% of total billed charges,273.41,82.6,,,percent of total billed charges,82.6% of total billed charges,273.41,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,52.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.15,454.8,
Continuous Positive Airway Pressure (CPAP),41094660,CDM,410,RC,94660,HCPCS,Outpatient,,,513,333.45,,451.44,88,,,percent of total billed charges,88% of total Billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,513,100,,,percent of total billed charges,100% of total billed charges,115.13,103,,,Fee Schedule,103% of WA Medicaid,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,323.19,63,,,percent of total billed charges,63% of total billed charges,380.7,175,,,Fee Schedule,175% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid,78.49,15.3,,,percent of total billed charges,15.3% of total billed charges,353.97,69,,,percent of total billed charges,69% of total billed charges,513,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,513,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,513,100,,,percent of total billed charges,100% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,763.26,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,82.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,114.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.31,130,,,Fee Schedule,130% of WA Medicaid ,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,193.4,37.7,,,percent of total billed charges,37.70% of total billed charges,193.4,37.7,,,percent of total billed charges,37.70% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,173.91,33.9,,,percent of total billed charges,33.9% of total billed charges,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,400.14,78,,,percent of total billed charges,78% of total billed charges,513,100,,,percent of total billed charges,100% of total billed charges,423.74,82.6,,,percent of total billed charges,82.6% of total billed charges,423.74,82.6,,,percent of total billed charges,82.6% of total billed charges,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,219.72,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,217.54,100,,,Fee Schedule,100% of Medicare OPPS rate,111.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.49,763.26,
ID ABSCESS SINGLE OR SIMPLE,76110060,CDM,761,RC,10060,HCPCS,Outpatient,,,353,229.45,,310.64,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,353,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,222.39,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,54.01,15.3,,,percent of total billed charges,15.3% of total billed charges,243.57,69,,,percent of total billed charges,69% of total billed charges,353,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,353,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,353,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,133.08,37.7,,,percent of total billed charges,37.70% of total billed charges,133.08,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,119.67,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,275.34,78,,,percent of total billed charges,78% of total billed charges,353,100,,,percent of total billed charges,100% of total billed charges,291.58,82.6,,,percent of total billed charges,82.6% of total billed charges,291.58,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.01,729.41,
ID ABSCESS MULTIPLE OR COMPLI,76110061,CDM,761,RC,10061,HCPCS,Outpatient,,,485,315.25,,426.8,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,485,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,305.55,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,74.21,15.3,,,percent of total billed charges,15.3% of total billed charges,334.65,69,,,percent of total billed charges,69% of total billed charges,485,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,485,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,485,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,182.85,37.7,,,percent of total billed charges,37.70% of total billed charges,182.85,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,164.42,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,378.3,78,,,percent of total billed charges,78% of total billed charges,485,100,,,percent of total billed charges,100% of total billed charges,400.61,82.6,,,percent of total billed charges,82.6% of total billed charges,400.61,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.21,1404.97,
DEBRID EXT ECZEMAT/INFEC SKIN,76111000,CDM,761,RC,11000,HCPCS,Outpatient,,,361,234.65,,317.68,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,361,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,227.43,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,55.23,15.3,,,percent of total billed charges,15.3% of total billed charges,249.09,69,,,percent of total billed charges,69% of total billed charges,361,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,361,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,361,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,136.1,37.7,,,percent of total billed charges,37.70% of total billed charges,136.1,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,122.38,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,281.58,78,,,percent of total billed charges,78% of total billed charges,361,100,,,percent of total billed charges,100% of total billed charges,298.19,82.6,,,percent of total billed charges,82.6% of total billed charges,298.19,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.23,2129.45,
DEBRID MUSCLE/FASCIA FIRST 20S,76111043,CDM,761,RC,11043,HCPCS,Outpatient,,,742,482.30,,652.96,88,,,percent of total billed charges,88% of total Billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,742,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,467.46,63,,,percent of total billed charges,63% of total billed charges,1121.02,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,113.53,15.3,,,percent of total billed charges,15.3% of total billed charges,511.98,69,,,percent of total billed charges,69% of total billed charges,742,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,742,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,742,100,,,percent of total billed charges,100% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,2129.45,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,279.73,37.7,,,percent of total billed charges,37.70% of total billed charges,279.73,37.7,,,percent of total billed charges,37.70% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,251.54,33.9,,,percent of total billed charges,33.9% of total billed charges,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,578.76,78,,,percent of total billed charges,78% of total billed charges,742,100,,,percent of total billed charges,100% of total billed charges,612.89,82.6,,,percent of total billed charges,82.6% of total billed charges,612.89,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,646.98,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,640.58,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.53,2129.45,
DEBRID SUBQ FIRST 20 SQCM OR <,76111042,CDM,761,RC,11042,HCPCS,Outpatient,,,298,193.70,,262.24,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,298,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,187.74,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,45.59,15.3,,,percent of total billed charges,15.3% of total billed charges,205.62,69,,,percent of total billed charges,69% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,298,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,298,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,101.02,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,232.44,78,,,percent of total billed charges,78% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.59,1404.97,
DEBRID BONE FIRST 20SQ CM OR <,76111044,CDM,761,RC,11044,HCPCS,Outpatient,,,1095,711.75,,963.6,88,,,percent of total billed charges,88% of total Billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,903.83,100,,,Fee Schedule,100% of WA Medicaid,1095,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,689.85,63,,,percent of total billed charges,63% of total billed charges,2893.89,175,,,Fee Schedule,175% of Medicare OPPS Rate,903.83,100,,,Fee Schedule,100% of WA Medicaid,167.54,15.3,,,percent of total billed charges,15.3% of total billed charges,755.55,69,,,percent of total billed charges,69% of total billed charges,1095,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1095,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1095,100,,,percent of total billed charges,100% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,5715.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,412.82,37.7,,,percent of total billed charges,37.70% of total billed charges,412.82,37.7,,,percent of total billed charges,37.70% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,371.21,33.9,,,percent of total billed charges,33.9% of total billed charges,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,854.1,78,,,percent of total billed charges,78% of total billed charges,1095,100,,,percent of total billed charges,100% of total billed charges,904.47,82.6,,,percent of total billed charges,82.6% of total billed charges,904.47,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,1670.18,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1653.65,100,,,Fee Schedule,100% of Medicare OPPS rate,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,167.54,5715.97,
DEBRID MUSCLE/FASCIA EA ADD 20,76111046,CDM,761,RC,11046,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,134.5,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,134.5,50,,,percent of total billed charges,50% of total Billed charges,169.47,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid,41.16,15.3,,,percent of total billed charges,15.3% of total billed charges,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,134.5,50,,,percent of total billed charges,50% of total Billed charges,269,100,,,percent of total billed charges,100% of total billed charges,134.5,50,,,percent of total billed charges,50% of total Billed charges,269,100,,,percent of total billed charges,100% of total billed charges,134.5,50,,,percent of total billed charges,50% of total Billed charges,166.38,61.85,,,percent of total billed charges,61.85% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.5,50,,,percent of total billed charges,50% of total Billed charges,134.5,50,,,percent of total billed charges,50% of total Billed charges,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,134.5,50,,,percent of total billed charges,50% of total Billed charges,134.5,50,,,percent of total billed charges,50% of total Billed charges,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,134.5,50,,,percent of total billed charges,50% of total Billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,134.5,50,,,percent of total billed charges,50% of total Billed charges,91.19,33.9,,,percent of total billed charges,33.9% of total billed charges,134.5,50,,,percent of total billed charges,50% of total Billed charges,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,134.5,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.16,1174.99,
DEBRID BONE EA ADDL 20 SQ CM,76111047,CDM,761,RC,11047,HCPCS,Outpatient,,,472,306.80,,415.36,88,,,percent of total billed charges,88% of total Billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid,472,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,236,50,,,percent of total billed charges,50% of total Billed charges,297.36,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid,72.22,15.3,,,percent of total billed charges,15.3% of total billed charges,325.68,69,,,percent of total billed charges,69% of total billed charges,472,100,,,percent of total billed charges,100% of total billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,472,100,,,percent of total billed charges,100% of total billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,472,100,,,percent of total billed charges,100% of total billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,291.93,61.85,,,percent of total billed charges,61.85% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,236,50,,,percent of total billed charges,50% of total Billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,236,50,,,percent of total billed charges,50% of total Billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,236,50,,,percent of total billed charges,50% of total Billed charges,177.94,37.7,,,percent of total billed charges,37.70% of total billed charges,177.94,37.7,,,percent of total billed charges,37.70% of total billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,160.01,33.9,,,percent of total billed charges,33.9% of total billed charges,236,50,,,percent of total billed charges,50% of total Billed charges,368.16,78,,,percent of total billed charges,78% of total billed charges,472,100,,,percent of total billed charges,100% of total billed charges,389.87,82.6,,,percent of total billed charges,82.6% of total billed charges,389.87,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,236,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,236,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.22,1174.99,
DEBRIDE SUBQ EA ADDL 20 SQ CM,76111045,CDM,761,RC,11045,HCPCS,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid,16,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,8,50,,,percent of total billed charges,50% of total Billed charges,6.03,37.7,,,percent of total billed charges,37.70% of total billed charges,6.03,37.7,,,percent of total billed charges,37.70% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,5.42,33.9,,,percent of total billed charges,33.9% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.45,1174.99,
PARING/CUT BENIGN HYPER LES 1,76111055,CDM,761,RC,11055,HCPCS,Outpatient,,,81,52.65,,71.28,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,81,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,51.03,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,12.39,15.3,,,percent of total billed charges,15.3% of total billed charges,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,81,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,27.46,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.39,729.42,
PARING/CUT BENIGN HYPERLES 2-4,76111056,CDM,761,RC,11056,HCPCS,Outpatient,,,109,70.85,,95.92,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,109,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,68.67,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,16.68,15.3,,,percent of total billed charges,15.3% of total billed charges,75.21,69,,,percent of total billed charges,69% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,36.95,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,85.02,78,,,percent of total billed charges,78% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.68,729.42,
PARING/CUT BENIGN HYPER LES >4,76111057,CDM,761,RC,11057,HCPCS,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,92.61,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.49,729.41,
TRIM NONDYSTROPHIC NAILS ANY #,76111719,CDM,761,RC,11719,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,60.86,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,70,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,70,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,43.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,60.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.81,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.73,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.71,226.12,
DEBRIDE NAIL 1-5,76111720,CDM,761,RC,11720,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,60.86,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,44.1,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,10.71,15.3,,,percent of total billed charges,15.3% of total billed charges,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,70,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,70,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,43.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,60.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.81,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23.73,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.71,226.12,
DEBRIDE NAIL > 5,76111721,CDM,761,RC,11721,HCPCS,Outpatient,,,118,76.70,,103.84,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,118,100,,,percent of total billed charges,100% of total billed charges,60.86,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,74.34,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid,18.05,15.3,,,percent of total billed charges,15.3% of total billed charges,81.42,69,,,percent of total billed charges,69% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,118,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,118,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,43.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,60.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.81,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,44.49,37.7,,,percent of total billed charges,37.70% of total billed charges,44.49,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,40,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,92.04,78,,,percent of total billed charges,78% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.05,226.12,
AVULSION OF NAIL PLATE > 1,76111732,CDM,761,RC,11732,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,60.86,103,,,Fee Schedule,103% of WA Medicaid,42.5,50,,,percent of total billed charges,50% of total Billed charges,53.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,59.09,100,,,Fee Schedule,100% of WA Medicaid,13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,52.57,61.85,,,percent of total billed charges,61.85% of total billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.5,50,,,percent of total billed charges,50% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,43.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.5,50,,,percent of total billed charges,50% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,60.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.81,130,,,Fee Schedule,130% of WA Medicaid ,42.5,50,,,percent of total billed charges,50% of total Billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42.5,50,,,percent of total billed charges,50% of total Billed charges,59.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.01,85,
EXCISION OF NAIL PART OR COMP,76111750,CDM,761,RC,11750,HCPCS,Outpatient,,,1672,1086.80,,1471.36,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,1672,100,,,percent of total billed charges,100% of total billed charges,413.49,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1053.36,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid,255.82,15.3,,,percent of total billed charges,15.3% of total billed charges,1153.68,69,,,percent of total billed charges,69% of total billed charges,1672,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1672,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1672,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,297.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,409.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.88,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,630.34,37.7,,,percent of total billed charges,37.70% of total billed charges,630.34,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,566.81,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1304.16,78,,,percent of total billed charges,78% of total billed charges,1672,100,,,percent of total billed charges,100% of total billed charges,1381.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1381.07,82.6,,,percent of total billed charges,82.6% of total billed charges,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,401.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,255.82,1672,
APPLY SKIN SUB LEGS 1ST 25SQCM,76115271,CDM,761,RC,15271,HCPCS,Outpatient,,,6081,3952.65,,5351.28,88,,,percent of total billed charges,88% of total Billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1817.34,103,,,Fee Schedule,103% of WA Medicaid,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3831.03,63,,,percent of total billed charges,63% of total billed charges,3255.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid,930.39,15.3,,,percent of total billed charges,15.3% of total billed charges,4195.89,69,,,percent of total billed charges,69% of total billed charges,6081,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6081,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6081,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6968.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1306.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1799.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2293.73,130,,,Fee Schedule,130% of WA Medicaid ,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,2292.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2292.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,2061.46,33.9,,,percent of total billed charges,33.9% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,4743.18,78,,,percent of total billed charges,78% of total billed charges,6081,100,,,percent of total billed charges,100% of total billed charges,5022.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5022.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1878.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,930.39,6968.7,
APPLY SKIN SUB LEGS ADDL25SQCM,76115272,CDM,761,RC,15272,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,1817.34,103,,,Fee Schedule,103% of WA Medicaid,42.5,50,,,percent of total billed charges,50% of total Billed charges,53.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1764.4,100,,,Fee Schedule,100% of WA Medicaid,13.01,15.3,,,percent of total billed charges,15.3% of total billed charges,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,85,100,,,percent of total billed charges,100% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,52.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.5,50,,,percent of total billed charges,50% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,1306.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.5,50,,,percent of total billed charges,50% of total Billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,1799.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2293.73,130,,,Fee Schedule,130% of WA Medicaid ,42.5,50,,,percent of total billed charges,50% of total Billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,28.82,33.9,,,percent of total billed charges,33.9% of total billed charges,42.5,50,,,percent of total billed charges,50% of total Billed charges,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,42.5,50,,,percent of total billed charges,50% of total Billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.01,2293.73,
APPLY SKIN SUB LEGS 1ST 100SQC,76115273,CDM,761,RC,15273,HCPCS,Outpatient,,,11963,7775.95,,10527.44,88,,,percent of total billed charges,88% of total Billed charges,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1817.34,103,,,Fee Schedule,103% of WA Medicaid,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,7536.69,63,,,percent of total billed charges,63% of total billed charges,6403.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid,1830.34,15.3,,,percent of total billed charges,15.3% of total billed charges,8254.47,69,,,percent of total billed charges,69% of total billed charges,11963,100,,,percent of total billed charges,100% of total billed charges,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,11963,100,,,percent of total billed charges,100% of total billed charges,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,11963,100,,,percent of total billed charges,100% of total billed charges,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,14308.84,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,1306.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,1799.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2293.73,130,,,Fee Schedule,130% of WA Medicaid ,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,4510.05,37.7,,,percent of total billed charges,37.70% of total billed charges,4510.05,37.7,,,percent of total billed charges,37.70% of total billed charges,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,4055.46,33.9,,,percent of total billed charges,33.9% of total billed charges,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,9331.14,78,,,percent of total billed charges,78% of total billed charges,11963,100,,,percent of total billed charges,100% of total billed charges,9881.44,82.6,,,percent of total billed charges,82.6% of total billed charges,9881.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,3695.83,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3659.24,100,,,Fee Schedule,100% of Medicare OPPS rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1306.97,14308.84,
APPLY SKIN SUB LEG EA ADDL 100,76115274,CDM,761,RC,15274,HCPCS,Outpatient,,,217,141.05,,190.96,88,,,percent of total billed charges,88% of total Billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid,217,100,,,percent of total billed charges,100% of total billed charges,1817.34,103,,,Fee Schedule,103% of WA Medicaid,108.5,50,,,percent of total billed charges,50% of total Billed charges,136.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1764.4,100,,,Fee Schedule,100% of WA Medicaid,33.2,15.3,,,percent of total billed charges,15.3% of total billed charges,149.73,69,,,percent of total billed charges,69% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,217,100,,,percent of total billed charges,100% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,217,100,,,percent of total billed charges,100% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,134.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.5,50,,,percent of total billed charges,50% of total Billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,1306.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.5,50,,,percent of total billed charges,50% of total Billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,1799.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2293.73,130,,,Fee Schedule,130% of WA Medicaid ,108.5,50,,,percent of total billed charges,50% of total Billed charges,81.81,37.7,,,percent of total billed charges,37.70% of total billed charges,81.81,37.7,,,percent of total billed charges,37.70% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,73.56,33.9,,,percent of total billed charges,33.9% of total billed charges,108.5,50,,,percent of total billed charges,50% of total Billed charges,169.26,78,,,percent of total billed charges,78% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,108.5,50,,,percent of total billed charges,50% of total Billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.2,2293.73,
APPLY SKIN SUB FEET 1ST 25SQCM,76115275,CDM,761,RC,15275,HCPCS,Outpatient,,,463,300.95,,407.44,88,,,percent of total billed charges,88% of total Billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid,463,100,,,percent of total billed charges,100% of total billed charges,1817.34,103,,,Fee Schedule,103% of WA Medicaid,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,291.69,63,,,percent of total billed charges,63% of total billed charges,3255.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid,70.84,15.3,,,percent of total billed charges,15.3% of total billed charges,319.47,69,,,percent of total billed charges,69% of total billed charges,463,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,463,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,463,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6968.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1306.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1799.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2293.73,130,,,Fee Schedule,130% of WA Medicaid ,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,174.55,37.7,,,percent of total billed charges,37.70% of total billed charges,174.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,156.96,33.9,,,percent of total billed charges,33.9% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,361.14,78,,,percent of total billed charges,78% of total billed charges,463,100,,,percent of total billed charges,100% of total billed charges,382.44,82.6,,,percent of total billed charges,82.6% of total billed charges,382.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1878.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.84,6968.7,
APPLY SKIN SUB FEET ADDL25SQCM,76115276,CDM,761,RC,15276,HCPCS,Outpatient,,,122,79.30,,107.36,88,,,percent of total billed charges,88% of total Billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid,122,100,,,percent of total billed charges,100% of total billed charges,1817.34,103,,,Fee Schedule,103% of WA Medicaid,61,50,,,percent of total billed charges,50% of total Billed charges,76.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1764.4,100,,,Fee Schedule,100% of WA Medicaid,18.67,15.3,,,percent of total billed charges,15.3% of total billed charges,84.18,69,,,percent of total billed charges,69% of total billed charges,122,100,,,percent of total billed charges,100% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,122,100,,,percent of total billed charges,100% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,122,100,,,percent of total billed charges,100% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,75.46,61.85,,,percent of total billed charges,61.85% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61,50,,,percent of total billed charges,50% of total Billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,1306.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61,50,,,percent of total billed charges,50% of total Billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,1799.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2293.73,130,,,Fee Schedule,130% of WA Medicaid ,61,50,,,percent of total billed charges,50% of total Billed charges,45.99,37.7,,,percent of total billed charges,37.70% of total billed charges,45.99,37.7,,,percent of total billed charges,37.70% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,41.36,33.9,,,percent of total billed charges,33.9% of total billed charges,61,50,,,percent of total billed charges,50% of total Billed charges,95.16,78,,,percent of total billed charges,78% of total billed charges,122,100,,,percent of total billed charges,100% of total billed charges,100.77,82.6,,,percent of total billed charges,82.6% of total billed charges,100.77,82.6,,,percent of total billed charges,82.6% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,61,50,,,percent of total billed charges,50% of total Billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.67,2293.73,
APPLY SKIN SUB FEET 1ST 100SQC,76115277,CDM,761,RC,15277,HCPCS,Outpatient,,,6081,3952.65,,5351.28,88,,,percent of total billed charges,88% of total Billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid,4695,100,,,percent of total billed charges,100% of total billed charges,1817.34,103,,,Fee Schedule,103% of WA Medicaid,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,3831.03,63,,,percent of total billed charges,63% of total billed charges,3255.03,175,,,Fee Schedule,175% of Medicare OPPS Rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid,930.39,15.3,,,percent of total billed charges,15.3% of total billed charges,4195.89,69,,,percent of total billed charges,69% of total billed charges,6081,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6081,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6081,100,,,percent of total billed charges,100% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,6968.7,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1306.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1799.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2293.73,130,,,Fee Schedule,130% of WA Medicaid ,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,2292.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2292.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,2061.46,33.9,,,percent of total billed charges,33.9% of total billed charges,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,4743.18,78,,,percent of total billed charges,78% of total billed charges,6081,100,,,percent of total billed charges,100% of total billed charges,5022.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5022.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1878.62,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,1860.02,100,,,Fee Schedule,100% of Medicare OPPS rate,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,930.39,6968.7,
APPLY SKIN SUB FEET EA ADDL100,76115278,CDM,761,RC,15278,HCPCS,Outpatient,,,274,178.10,,241.12,88,,,percent of total billed charges,88% of total Billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid,274,100,,,percent of total billed charges,100% of total billed charges,1817.34,103,,,Fee Schedule,103% of WA Medicaid,137,50,,,percent of total billed charges,50% of total Billed charges,172.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1764.4,100,,,Fee Schedule,100% of WA Medicaid,41.92,15.3,,,percent of total billed charges,15.3% of total billed charges,189.06,69,,,percent of total billed charges,69% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,274,100,,,percent of total billed charges,100% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,274,100,,,percent of total billed charges,100% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,169.47,61.85,,,percent of total billed charges,61.85% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137,50,,,percent of total billed charges,50% of total Billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,1306.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,137,50,,,percent of total billed charges,50% of total Billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,1799.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2293.73,130,,,Fee Schedule,130% of WA Medicaid ,137,50,,,percent of total billed charges,50% of total Billed charges,103.3,37.7,,,percent of total billed charges,37.70% of total billed charges,103.3,37.7,,,percent of total billed charges,37.70% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,92.89,33.9,,,percent of total billed charges,33.9% of total billed charges,137,50,,,percent of total billed charges,50% of total Billed charges,213.72,78,,,percent of total billed charges,78% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,137,50,,,percent of total billed charges,50% of total Billed charges,1764.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.92,2293.73,
DRESS AN/OR DEBMT BURN INI MED,76116025,CDM,761,RC,16025,HCPCS,Outpatient,,,533,346.45,,469.04,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,533,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,335.79,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,81.55,15.3,,,percent of total billed charges,15.3% of total billed charges,367.77,69,,,percent of total billed charges,69% of total billed charges,533,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,533,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,533,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,200.94,37.7,,,percent of total billed charges,37.70% of total billed charges,200.94,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,180.69,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,415.74,78,,,percent of total billed charges,78% of total billed charges,533,100,,,percent of total billed charges,100% of total billed charges,440.26,82.6,,,percent of total billed charges,82.6% of total billed charges,440.26,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.55,729.41,
DRESS AN/OR DEBMT BURN INI SM,76116020,CDM,761,RC,16020,HCPCS,Outpatient,,,346,224.90,,304.48,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,346,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,217.98,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,52.94,15.3,,,percent of total billed charges,15.3% of total billed charges,238.74,69,,,percent of total billed charges,69% of total billed charges,346,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,346,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,346,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,130.44,37.7,,,percent of total billed charges,37.70% of total billed charges,130.44,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,117.29,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,269.88,78,,,percent of total billed charges,78% of total billed charges,346,100,,,percent of total billed charges,100% of total billed charges,285.8,82.6,,,percent of total billed charges,82.6% of total billed charges,285.8,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.94,729.42,
DRESS AN/OR DEBMT BURN INI LG,76116030,CDM,761,RC,16030,HCPCS,Outpatient,,,638,414.70,,561.44,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,638,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,401.94,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,97.61,15.3,,,percent of total billed charges,15.3% of total billed charges,440.22,69,,,percent of total billed charges,69% of total billed charges,638,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,638,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,638,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,216.28,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,497.64,78,,,percent of total billed charges,78% of total billed charges,638,100,,,percent of total billed charges,100% of total billed charges,526.99,82.6,,,percent of total billed charges,82.6% of total billed charges,526.99,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.61,1404.97,
CHEM CAUTERIZ GRANU TISSUE,76117250,CDM,761,RC,17250,HCPCS,Outpatient,,,426,276.90,,374.88,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,426,100,,,percent of total billed charges,100% of total billed charges,151.74,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,268.38,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid,65.18,15.3,,,percent of total billed charges,15.3% of total billed charges,293.94,69,,,percent of total billed charges,69% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,426,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,426,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,109.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,150.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.52,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,160.6,37.7,,,percent of total billed charges,37.70% of total billed charges,160.6,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,144.41,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,332.28,78,,,percent of total billed charges,78% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,147.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.18,729.42,
BIOPSY BONE EXCISIONAL SUPERFI,76120240,CDM,761,RC,20240,HCPCS,Outpatient,,,731,475.15,,643.28,88,,,percent of total billed charges,88% of total Billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,731,100,,,percent of total billed charges,100% of total billed charges,1618.96,103,,,Fee Schedule,103% of WA Medicaid,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,460.53,63,,,percent of total billed charges,63% of total billed charges,5071.87,175,,,Fee Schedule,175% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid,111.84,15.3,,,percent of total billed charges,15.3% of total billed charges,504.39,69,,,percent of total billed charges,69% of total billed charges,731,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,731,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,731,100,,,percent of total billed charges,100% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,9628.23,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1164.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1603.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2043.35,130,,,Fee Schedule,130% of WA Medicaid ,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,275.59,37.7,,,percent of total billed charges,37.70% of total billed charges,275.59,37.7,,,percent of total billed charges,37.70% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,247.81,33.9,,,percent of total billed charges,33.9% of total billed charges,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,570.18,78,,,percent of total billed charges,78% of total billed charges,731,100,,,percent of total billed charges,100% of total billed charges,603.81,82.6,,,percent of total billed charges,82.6% of total billed charges,603.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,2927.19,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2898.21,100,,,Fee Schedule,100% of Medicare OPPS rate,1571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.84,9628.23,
APPLY TOTAL CONT LEG CAST LT,76129445LT,CDM,761,RC,29445,HCPCS,Outpatient,,,501,325.65,LT,440.88,88,,,percent of total billed charges,88% of total Billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,501,100,,,percent of total billed charges,100% of total billed charges,174.75,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,315.63,63,,,percent of total billed charges,63% of total billed charges,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,76.65,15.3,,,percent of total billed charges,15.3% of total billed charges,345.69,69,,,percent of total billed charges,69% of total billed charges,501,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,501,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,501,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,125.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,173.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.57,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,188.88,37.7,,,percent of total billed charges,37.70% of total billed charges,188.88,37.7,,,percent of total billed charges,37.70% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,169.84,33.9,,,percent of total billed charges,33.9% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,390.78,78,,,percent of total billed charges,78% of total billed charges,501,100,,,percent of total billed charges,100% of total billed charges,413.83,82.6,,,percent of total billed charges,82.6% of total billed charges,413.83,82.6,,,percent of total billed charges,82.6% of total billed charges,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.65,979.75,
APPLY TOTAL CONT LEG CAST RT,76129445RT,CDM,761,RC,29445,HCPCS,Outpatient,,,501,325.65,RT,440.88,88,,,percent of total billed charges,88% of total Billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,501,100,,,percent of total billed charges,100% of total billed charges,174.75,103,,,Fee Schedule,103% of WA Medicaid,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,315.63,63,,,percent of total billed charges,63% of total billed charges,479.35,175,,,Fee Schedule,175% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,76.65,15.3,,,percent of total billed charges,15.3% of total billed charges,345.69,69,,,percent of total billed charges,69% of total billed charges,501,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,501,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,501,100,,,percent of total billed charges,100% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,979.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,125.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,173.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.57,130,,,Fee Schedule,130% of WA Medicaid ,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,188.88,37.7,,,percent of total billed charges,37.70% of total billed charges,188.88,37.7,,,percent of total billed charges,37.70% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,169.84,33.9,,,percent of total billed charges,33.9% of total billed charges,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,390.78,78,,,percent of total billed charges,78% of total billed charges,501,100,,,percent of total billed charges,100% of total billed charges,413.83,82.6,,,percent of total billed charges,82.6% of total billed charges,413.83,82.6,,,percent of total billed charges,82.6% of total billed charges,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,276.64,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,273.91,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.65,979.75,
APPLY MULTI COMP ANKLE/FOOT,76129581,CDM,761,RC,29581,HCPCS,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,62,100,,,percent of total billed charges,100% of total billed charges,174.75,103,,,Fee Schedule,103% of WA Medicaid,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,39.06,63,,,percent of total billed charges,63% of total billed charges,281.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,9.49,15.3,,,percent of total billed charges,15.3% of total billed charges,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,62,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,62,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,573.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,125.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,173.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.57,130,,,Fee Schedule,130% of WA Medicaid ,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,21.02,33.9,,,percent of total billed charges,33.9% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,162.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.49,573.54,
APPLY BILATERAL UNNA BOOT,76129580,CDM,761,RC,29580,HCPCS,Outpatient,,,170,110.50,50,149.6,88,,,percent of total billed charges,88% of total Billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,170,100,,,percent of total billed charges,100% of total billed charges,174.75,103,,,Fee Schedule,103% of WA Medicaid,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,107.1,63,,,percent of total billed charges,63% of total billed charges,281.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,26.01,15.3,,,percent of total billed charges,15.3% of total billed charges,117.3,69,,,percent of total billed charges,69% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,573.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,125.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,173.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.57,130,,,Fee Schedule,130% of WA Medicaid ,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,57.63,33.9,,,percent of total billed charges,33.9% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,132.6,78,,,percent of total billed charges,78% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,162.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.01,573.54,
APPLY UNNA BOOT LT,76129580,CDM,761,RC,29580,HCPCS,Outpatient,,,170,110.50,LT,149.6,88,,,percent of total billed charges,88% of total Billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,170,100,,,percent of total billed charges,100% of total billed charges,174.75,103,,,Fee Schedule,103% of WA Medicaid,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,107.1,63,,,percent of total billed charges,63% of total billed charges,281.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,26.01,15.3,,,percent of total billed charges,15.3% of total billed charges,117.3,69,,,percent of total billed charges,69% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,573.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,125.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,173.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.57,130,,,Fee Schedule,130% of WA Medicaid ,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,57.63,33.9,,,percent of total billed charges,33.9% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,132.6,78,,,percent of total billed charges,78% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,162.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.01,573.54,
APPLY UNNA BOOT RT,76129580,CDM,761,RC,29580,HCPCS,Outpatient,,,170,110.50,RT,149.6,88,,,percent of total billed charges,88% of total Billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,170,100,,,percent of total billed charges,100% of total billed charges,174.75,103,,,Fee Schedule,103% of WA Medicaid,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,107.1,63,,,percent of total billed charges,63% of total billed charges,281.24,175,,,Fee Schedule,175% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid,26.01,15.3,,,percent of total billed charges,15.3% of total billed charges,117.3,69,,,percent of total billed charges,69% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,170,100,,,percent of total billed charges,100% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,573.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,125.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,173.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.57,130,,,Fee Schedule,130% of WA Medicaid ,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,57.63,33.9,,,percent of total billed charges,33.9% of total billed charges,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,132.6,78,,,percent of total billed charges,78% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,162.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,160.71,100,,,Fee Schedule,100% of Medicare OPPS rate,169.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.01,573.54,
REM IMPACT CERUMEN REQ IRRIGAT,76169209,CDM,761,RC,69209,HCPCS,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,61,100,,,percent of total billed charges,100% of total billed charges,10.56,17.304,,,percent of total billed charges,17.304% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,38.43,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,15.3,,,percent of total billed charges,15.3% of total billed charges,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,61,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,10.45,17.136,,,percent of total billed charges,17.136% of total billed charges,13.32,21.84,,,percent of total billed charges,21.84% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,23,37.7,,,percent of total billed charges,37.70% of total billed charges,23,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,20.68,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,10.25,16.8,,,percent of total billed charges,16.8% of total billed charges,9.33,226.12,
REM IMPACT CERUMEN REQ INSTRU,76169210,CDM,761,RC,69210,HCPCS,Outpatient,,,156,101.40,,137.28,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,26.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,156,100,,,percent of total billed charges,100% of total billed charges,26.99,17.304,,,percent of total billed charges,17.304% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,98.28,63,,,percent of total billed charges,63% of total billed charges,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,26.21,16.8,,,percent of total billed charges,16.8% of total billed charges,23.87,15.3,,,percent of total billed charges,15.3% of total billed charges,107.64,69,,,percent of total billed charges,69% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,156,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,26.21,16.8,,,percent of total billed charges,16.8% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,26.21,16.8,,,percent of total billed charges,16.8% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,26.73,17.136,,,percent of total billed charges,17.136% of total billed charges,34.07,21.84,,,percent of total billed charges,21.84% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,58.81,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,52.88,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,121.68,78,,,percent of total billed charges,78% of total billed charges,156,100,,,percent of total billed charges,100% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,128.86,82.6,,,percent of total billed charges,82.6% of total billed charges,26.21,16.8,,,percent of total billed charges,16.8% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,26.21,16.8,,,percent of total billed charges,16.8% of total billed charges,23.87,226.12,
BLOOD GLUCOSE CHECK,30082962,CDM,300,RC,82962,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,45,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,28.35,63,,,percent of total billed charges,63% of total billed charges,5.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,45,100,,,percent of total billed charges,100% of total billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,45,100,,,percent of total billed charges,100% of total billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,12.54,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,15.26,33.9,,,percent of total billed charges,33.9% of total billed charges,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,3.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.28,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,45,
TCPO/ABI BILAT 1-2 OR UNILAT>3,76193922,CDM,761,RC,93922,HCPCS,Outpatient,,,670,435.50,,589.6,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,670,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,422.1,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,102.51,15.3,,,percent of total billed charges,15.3% of total billed charges,462.3,69,,,percent of total billed charges,69% of total billed charges,670,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,670,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,670,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,454.8,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,252.59,37.7,,,percent of total billed charges,37.70% of total billed charges,252.59,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,227.13,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,522.6,78,,,percent of total billed charges,78% of total billed charges,670,100,,,percent of total billed charges,100% of total billed charges,553.42,82.6,,,percent of total billed charges,82.6% of total billed charges,553.42,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,670,
TCPO/ABI BILAT >3 OR BILAT SGL,76193923,CDM,921,RC,93923,HCPCS,Outpatient,,,965,627.25,,849.2,88,,,percent of total billed charges,88% of total Billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,965,100,,,percent of total billed charges,100% of total billed charges,155.52,103,,,Fee Schedule,103% of WA Medicaid,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,607.95,63,,,percent of total billed charges,63% of total billed charges,278.81,175,,,Fee Schedule,175% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid,147.65,15.3,,,percent of total billed charges,15.3% of total billed charges,665.85,69,,,percent of total billed charges,69% of total billed charges,965,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,965,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,965,100,,,percent of total billed charges,100% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,566.91,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,111.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,154.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.29,130,,,Fee Schedule,130% of WA Medicaid ,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,363.81,37.7,,,percent of total billed charges,37.70% of total billed charges,363.81,37.7,,,percent of total billed charges,37.70% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,327.14,33.9,,,percent of total billed charges,33.9% of total billed charges,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,752.7,78,,,percent of total billed charges,78% of total billed charges,965,100,,,percent of total billed charges,100% of total billed charges,797.09,82.6,,,percent of total billed charges,82.6% of total billed charges,797.09,82.6,,,percent of total billed charges,82.6% of total billed charges,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,160.9,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,159.32,100,,,Fee Schedule,100% of Medicare OPPS rate,150.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.84,965,
INJECTION SUBQ/IM WOUND CARE,76196372X,CDM,761,RC,96372,HCPCS,Outpatient,,,302,196.30,,265.76,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,46.21,15.3,,,percent of total billed charges,15.3% of total billed charges,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,302,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,102.38,33.9,,,percent of total billed charges,33.9% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.48,302,
DEBRIDE OPEN WD FIRST 20SQCM,76197597,CDM,761,RC,97597,HCPCS,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,71.19,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,17.29,15.3,,,percent of total billed charges,15.3% of total billed charges,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,113,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.41,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,38.31,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.29,729.41,
DEBRID OPEN WD EA ADDL 20SQ CM,76197598,CDM,761,RC,97598,HCPCS,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid,52,100,,,percent of total billed charges,100% of total billed charges,930.95,103,,,Fee Schedule,103% of WA Medicaid,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,903.83,100,,,Fee Schedule,100% of WA Medicaid,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,669.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,921.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1174.99,130,,,Fee Schedule,130% of WA Medicaid ,26,50,,,percent of total billed charges,50% of total Billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,17.63,33.9,,,percent of total billed charges,33.9% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,903.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.96,1174.99,
NONSELECTIVE DEBRIDEMENT,76197602,CDM,761,RC,97602,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,250,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,157.5,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,250,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,250,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,84.75,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.25,729.42,
NPWT < 50 SQ CM,76197605,CDM,761,RC,97605,HCPCS,Outpatient,,,557,362.05,,490.16,88,,,percent of total billed charges,88% of total Billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,557,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,350.91,63,,,percent of total billed charges,63% of total billed charges,357.34,175,,,Fee Schedule,175% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid,85.22,15.3,,,percent of total billed charges,15.3% of total billed charges,384.33,69,,,percent of total billed charges,69% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,729.42,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,124.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,171.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,188.82,33.9,,,percent of total billed charges,33.9% of total billed charges,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,434.46,78,,,percent of total billed charges,78% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,206.23,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,204.19,100,,,Fee Schedule,100% of Medicare OPPS rate,168.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.22,729.42,
NPWT > 50 SQ CM,76197606,CDM,761,RC,97606,HCPCS,Outpatient,,,557,362.05,,490.16,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,557,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,350.91,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,85.22,15.3,,,percent of total billed charges,15.3% of total billed charges,384.33,69,,,percent of total billed charges,69% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,557,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.98,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,188.82,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,434.46,78,,,percent of total billed charges,78% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.77,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.22,1404.98,
NPWT < 50 SQ CM DISPOSABLE,76197607,CDM,761,RC,97607,HCPCS,Outpatient,,,367,238.55,,322.96,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,367,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,231.21,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,56.15,15.3,,,percent of total billed charges,15.3% of total billed charges,253.23,69,,,percent of total billed charges,69% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,367,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,367,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,124.41,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,286.26,78,,,percent of total billed charges,78% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.15,1404.97,
NPWT > 50 SQ CM DISPOSABLE,76197608,CDM,761,RC,97608,HCPCS,Outpatient,,,367,238.55,,322.96,88,,,percent of total billed charges,88% of total Billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,367,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,231.21,63,,,percent of total billed charges,63% of total billed charges,711.73,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,56.15,15.3,,,percent of total billed charges,15.3% of total billed charges,253.23,69,,,percent of total billed charges,69% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,367,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,367,100,,,percent of total billed charges,100% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,1404.97,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,124.41,33.9,,,percent of total billed charges,33.9% of total billed charges,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,286.26,78,,,percent of total billed charges,78% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,410.76,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,406.7,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.15,1404.97,
EM LEVEL 1,51099201,CDM,510,RC,99211,HCPCS,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,9,17.304,,,percent of total billed charges,17.304% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.76,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,15.3,,,percent of total billed charges,15.3% of total billed charges,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,52,100,,,percent of total billed charges,100% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,8.91,17.136,,,percent of total billed charges,17.136% of total billed charges,11.36,21.84,,,percent of total billed charges,21.84% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,26,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26,50,,,percent of total billed charges,50% of total Billed charges,8.74,16.8,,,percent of total billed charges,16.8% of total billed charges,7.96,52,
APILGRAF PER 1 SQ CM,636Q4101,CDM,636,RC,Q4101,HCPCS,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,147,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,92.61,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,147,100,,,percent of total billed charges,100% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,90.92,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,73.5,50,,,percent of total billed charges,50% of total Billed charges,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,73.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",22.49,147,
EPIFIX 18MM DISK,636Q4186,CDM,636,RC,Q4186,HCPCS,Outpatient,,,1084,704.60,,953.92,88,,,percent of total billed charges,88% of total Billed charges,542,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1084,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,542,50,,,percent of total billed charges,50% of total Billed charges,682.92,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",165.85,15.3,,,percent of total billed charges,15.3% of total billed charges,747.96,69,,,percent of total billed charges,69% of total billed charges,1084,100,,,percent of total billed charges,100% of total billed charges,542,50,,,percent of total billed charges,50% of total Billed charges,1084,100,,,percent of total billed charges,100% of total billed charges,542,50,,,percent of total billed charges,50% of total Billed charges,1084,100,,,percent of total billed charges,100% of total billed charges,542,50,,,percent of total billed charges,50% of total Billed charges,670.45,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,542,50,,,percent of total billed charges,50% of total Billed charges,542,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,542,50,,,percent of total billed charges,50% of total Billed charges,542,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,542,50,,,percent of total billed charges,50% of total Billed charges,408.67,37.7,,,percent of total billed charges,37.70% of total billed charges,408.67,37.7,,,percent of total billed charges,37.70% of total billed charges,542,50,,,percent of total billed charges,50% of total Billed charges,367.48,33.9,,,percent of total billed charges,33.9% of total billed charges,542,50,,,percent of total billed charges,50% of total Billed charges,845.52,78,,,percent of total billed charges,78% of total billed charges,1084,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,542,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,542,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",165.85,1084,
EPIFIX 2 MC X 2 CM,636Q4186,CDM,636,RC,Q4186,HCPCS,Outpatient,,,1162,755.30,,1022.56,88,,,percent of total billed charges,88% of total Billed charges,581,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1162,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,581,50,,,percent of total billed charges,50% of total Billed charges,732.06,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",177.79,15.3,,,percent of total billed charges,15.3% of total billed charges,801.78,69,,,percent of total billed charges,69% of total billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,581,50,,,percent of total billed charges,50% of total Billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,581,50,,,percent of total billed charges,50% of total Billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,581,50,,,percent of total billed charges,50% of total Billed charges,718.7,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,581,50,,,percent of total billed charges,50% of total Billed charges,581,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,581,50,,,percent of total billed charges,50% of total Billed charges,581,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,581,50,,,percent of total billed charges,50% of total Billed charges,438.07,37.7,,,percent of total billed charges,37.70% of total billed charges,438.07,37.7,,,percent of total billed charges,37.70% of total billed charges,581,50,,,percent of total billed charges,50% of total Billed charges,393.92,33.9,,,percent of total billed charges,33.9% of total billed charges,581,50,,,percent of total billed charges,50% of total Billed charges,906.36,78,,,percent of total billed charges,78% of total billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,581,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,581,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",177.79,1162,
EPIFIX 2 CM X 3 CM,636Q4186,CDM,636,RC,Q4186,HCPCS,Outpatient,,,478,310.70,,420.64,88,,,percent of total billed charges,88% of total Billed charges,239,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,478,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,239,50,,,percent of total billed charges,50% of total Billed charges,301.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",73.13,15.3,,,percent of total billed charges,15.3% of total billed charges,329.82,69,,,percent of total billed charges,69% of total billed charges,478,100,,,percent of total billed charges,100% of total billed charges,239,50,,,percent of total billed charges,50% of total Billed charges,478,100,,,percent of total billed charges,100% of total billed charges,239,50,,,percent of total billed charges,50% of total Billed charges,478,100,,,percent of total billed charges,100% of total billed charges,239,50,,,percent of total billed charges,50% of total Billed charges,295.64,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,239,50,,,percent of total billed charges,50% of total Billed charges,239,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,239,50,,,percent of total billed charges,50% of total Billed charges,239,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,239,50,,,percent of total billed charges,50% of total Billed charges,180.21,37.7,,,percent of total billed charges,37.70% of total billed charges,180.21,37.7,,,percent of total billed charges,37.70% of total billed charges,239,50,,,percent of total billed charges,50% of total Billed charges,162.04,33.9,,,percent of total billed charges,33.9% of total billed charges,239,50,,,percent of total billed charges,50% of total Billed charges,372.84,78,,,percent of total billed charges,78% of total billed charges,478,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,239,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,239,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",73.13,478,
EPIFIX MESH 3.5 CM X 3.5 CM,636Q4186,CDM,636,RC,Q4186,HCPCS,Outpatient,,,679,441.35,,597.52,88,,,percent of total billed charges,88% of total Billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,679,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,339.5,50,,,percent of total billed charges,50% of total Billed charges,427.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",103.89,15.3,,,percent of total billed charges,15.3% of total billed charges,468.51,69,,,percent of total billed charges,69% of total billed charges,679,100,,,percent of total billed charges,100% of total billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,679,100,,,percent of total billed charges,100% of total billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,679,100,,,percent of total billed charges,100% of total billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,419.96,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,339.5,50,,,percent of total billed charges,50% of total Billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,339.5,50,,,percent of total billed charges,50% of total Billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,339.5,50,,,percent of total billed charges,50% of total Billed charges,255.98,37.7,,,percent of total billed charges,37.70% of total billed charges,255.98,37.7,,,percent of total billed charges,37.70% of total billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,230.18,33.9,,,percent of total billed charges,33.9% of total billed charges,339.5,50,,,percent of total billed charges,50% of total Billed charges,529.62,78,,,percent of total billed charges,78% of total billed charges,679,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,339.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,339.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",103.89,679,
EPIFIX MESH 4CMX4.5CM,636Q4186,CDM,636,RC,Q4186,HCPCS,Outpatient,,,508,330.20,,447.04,88,,,percent of total billed charges,88% of total Billed charges,254,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,508,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,254,50,,,percent of total billed charges,50% of total Billed charges,320.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",77.72,15.3,,,percent of total billed charges,15.3% of total billed charges,350.52,69,,,percent of total billed charges,69% of total billed charges,508,100,,,percent of total billed charges,100% of total billed charges,254,50,,,percent of total billed charges,50% of total Billed charges,508,100,,,percent of total billed charges,100% of total billed charges,254,50,,,percent of total billed charges,50% of total Billed charges,508,100,,,percent of total billed charges,100% of total billed charges,254,50,,,percent of total billed charges,50% of total Billed charges,314.2,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,254,50,,,percent of total billed charges,50% of total Billed charges,254,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,254,50,,,percent of total billed charges,50% of total Billed charges,254,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,254,50,,,percent of total billed charges,50% of total Billed charges,191.52,37.7,,,percent of total billed charges,37.70% of total billed charges,191.52,37.7,,,percent of total billed charges,37.70% of total billed charges,254,50,,,percent of total billed charges,50% of total Billed charges,172.21,33.9,,,percent of total billed charges,33.9% of total billed charges,254,50,,,percent of total billed charges,50% of total Billed charges,396.24,78,,,percent of total billed charges,78% of total billed charges,508,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,254,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,254,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",77.72,508,
"Hyperbaric oxygen under pressure, full body chamber, per 30",413G0277,CDM,413,RC,G0277,HCPCS,Outpatient,,,519,337.35,,456.72,88,,,percent of total billed charges,88% of total Billed charges,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,519,100,,,percent of total billed charges,100% of total billed charges,348.89,103,,,Fee Schedule,103% of WA Medicaid,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,326.97,63,,,percent of total billed charges,63% of total billed charges,247.67,175,,,Fee Schedule,175% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid,79.41,15.3,,,percent of total billed charges,15.3% of total billed charges,358.11,69,,,percent of total billed charges,69% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,519,100,,,percent of total billed charges,100% of total billed charges,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,484.57,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,250.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,345.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.34,130,,,Fee Schedule,130% of WA Medicaid ,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,175.94,33.9,,,percent of total billed charges,33.9% of total billed charges,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,404.82,78,,,percent of total billed charges,78% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,142.94,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,141.53,100,,,Fee Schedule,100% of Medicare OPPS rate,338.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.41,519,
PURAPLY 2 X 4,636Q4195,CDM,636,RC,Q4195,HCPCS,Outpatient,,,3601,2340.65,,3168.88,88,,,percent of total billed charges,88% of total Billed charges,1800.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3601,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1800.5,50,,,percent of total billed charges,50% of total Billed charges,2268.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",550.95,15.3,,,percent of total billed charges,15.3% of total billed charges,2484.69,69,,,percent of total billed charges,69% of total billed charges,3601,100,,,percent of total billed charges,100% of total billed charges,1800.5,50,,,percent of total billed charges,50% of total Billed charges,3601,100,,,percent of total billed charges,100% of total billed charges,1800.5,50,,,percent of total billed charges,50% of total Billed charges,3601,100,,,percent of total billed charges,100% of total billed charges,1800.5,50,,,percent of total billed charges,50% of total Billed charges,2227.22,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1800.5,50,,,percent of total billed charges,50% of total Billed charges,1800.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1800.5,50,,,percent of total billed charges,50% of total Billed charges,1800.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1800.5,50,,,percent of total billed charges,50% of total Billed charges,1357.58,37.7,,,percent of total billed charges,37.70% of total billed charges,1357.58,37.7,,,percent of total billed charges,37.70% of total billed charges,1800.5,50,,,percent of total billed charges,50% of total Billed charges,1220.74,33.9,,,percent of total billed charges,33.9% of total billed charges,1800.5,50,,,percent of total billed charges,50% of total Billed charges,2808.78,78,,,percent of total billed charges,78% of total billed charges,3601,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1800.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1800.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",550.95,3601,
PURAPLY 5 X 5,636Q4195,CDM,636,RC,Q4195,HCPCS,Outpatient,,,11251,7313.15,,9900.88,88,,,percent of total billed charges,88% of total Billed charges,5625.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5625.5,50,,,percent of total billed charges,50% of total Billed charges,7088.13,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1721.4,15.3,,,percent of total billed charges,15.3% of total billed charges,7763.19,69,,,percent of total billed charges,69% of total billed charges,11251,100,,,percent of total billed charges,100% of total billed charges,5625.5,50,,,percent of total billed charges,50% of total Billed charges,11251,100,,,percent of total billed charges,100% of total billed charges,5625.5,50,,,percent of total billed charges,50% of total Billed charges,11251,100,,,percent of total billed charges,100% of total billed charges,5625.5,50,,,percent of total billed charges,50% of total Billed charges,6958.74,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,5625.5,50,,,percent of total billed charges,50% of total Billed charges,5625.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5625.5,50,,,percent of total billed charges,50% of total Billed charges,5625.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5625.5,50,,,percent of total billed charges,50% of total Billed charges,4241.63,37.7,,,percent of total billed charges,37.70% of total billed charges,4241.63,37.7,,,percent of total billed charges,37.70% of total billed charges,5625.5,50,,,percent of total billed charges,50% of total Billed charges,3814.09,33.9,,,percent of total billed charges,33.9% of total billed charges,5625.5,50,,,percent of total billed charges,50% of total Billed charges,8775.78,78,,,percent of total billed charges,78% of total billed charges,11251,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5625.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5625.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1721.4,11251,
PURAPLY 6 X 9,636Q4195,CDM,636,RC,Q4195,HCPCS,Outpatient,,,22658,14727.70,,19939.04,88,,,percent of total billed charges,88% of total Billed charges,11329,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,11329,50,,,percent of total billed charges,50% of total Billed charges,14274.54,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",3466.67,15.3,,,percent of total billed charges,15.3% of total billed charges,15634.02,69,,,percent of total billed charges,69% of total billed charges,22658,100,,,percent of total billed charges,100% of total billed charges,11329,50,,,percent of total billed charges,50% of total Billed charges,22658,100,,,percent of total billed charges,100% of total billed charges,11329,50,,,percent of total billed charges,50% of total Billed charges,22658,100,,,percent of total billed charges,100% of total billed charges,11329,50,,,percent of total billed charges,50% of total Billed charges,14013.97,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,11329,50,,,percent of total billed charges,50% of total Billed charges,11329,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11329,50,,,percent of total billed charges,50% of total Billed charges,11329,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11329,50,,,percent of total billed charges,50% of total Billed charges,8542.07,37.7,,,percent of total billed charges,37.70% of total billed charges,8542.07,37.7,,,percent of total billed charges,37.70% of total billed charges,11329,50,,,percent of total billed charges,50% of total Billed charges,7681.06,33.9,,,percent of total billed charges,33.9% of total billed charges,11329,50,,,percent of total billed charges,50% of total Billed charges,17673.24,78,,,percent of total billed charges,78% of total billed charges,22658,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11329,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11329,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",3466.67,22658,
PURAPLY AM 2 X 2,636Q4196,CDM,636,RC,Q4196,HCPCS,Outpatient,,,2587,1681.55,,2276.56,88,,,percent of total billed charges,88% of total Billed charges,1293.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2587,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1293.5,50,,,percent of total billed charges,50% of total Billed charges,1629.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",395.81,15.3,,,percent of total billed charges,15.3% of total billed charges,1785.03,69,,,percent of total billed charges,69% of total billed charges,2587,100,,,percent of total billed charges,100% of total billed charges,1293.5,50,,,percent of total billed charges,50% of total Billed charges,2587,100,,,percent of total billed charges,100% of total billed charges,1293.5,50,,,percent of total billed charges,50% of total Billed charges,2587,100,,,percent of total billed charges,100% of total billed charges,1293.5,50,,,percent of total billed charges,50% of total Billed charges,1600.06,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1293.5,50,,,percent of total billed charges,50% of total Billed charges,1293.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1293.5,50,,,percent of total billed charges,50% of total Billed charges,1293.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1293.5,50,,,percent of total billed charges,50% of total Billed charges,975.3,37.7,,,percent of total billed charges,37.70% of total billed charges,975.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1293.5,50,,,percent of total billed charges,50% of total Billed charges,876.99,33.9,,,percent of total billed charges,33.9% of total billed charges,1293.5,50,,,percent of total billed charges,50% of total Billed charges,2017.86,78,,,percent of total billed charges,78% of total billed charges,2587,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1293.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1293.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",395.81,2587,
PURAPLY AM 2 X 4,636Q4196,CDM,636,RC,Q4196,HCPCS,Outpatient,,,3915,2544.75,,3445.2,88,,,percent of total billed charges,88% of total Billed charges,1957.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3915,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1957.5,50,,,percent of total billed charges,50% of total Billed charges,2466.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",599,15.3,,,percent of total billed charges,15.3% of total billed charges,2701.35,69,,,percent of total billed charges,69% of total billed charges,3915,100,,,percent of total billed charges,100% of total billed charges,1957.5,50,,,percent of total billed charges,50% of total Billed charges,3915,100,,,percent of total billed charges,100% of total billed charges,1957.5,50,,,percent of total billed charges,50% of total Billed charges,3915,100,,,percent of total billed charges,100% of total billed charges,1957.5,50,,,percent of total billed charges,50% of total Billed charges,2421.43,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1957.5,50,,,percent of total billed charges,50% of total Billed charges,1957.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1957.5,50,,,percent of total billed charges,50% of total Billed charges,1957.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1957.5,50,,,percent of total billed charges,50% of total Billed charges,1475.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1475.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1957.5,50,,,percent of total billed charges,50% of total Billed charges,1327.19,33.9,,,percent of total billed charges,33.9% of total billed charges,1957.5,50,,,percent of total billed charges,50% of total Billed charges,3053.7,78,,,percent of total billed charges,78% of total billed charges,3915,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1957.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1957.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",599,3915,
PURAPLY AM 5 X 5,636Q4196,CDM,636,RC,Q4196,HCPCS,Outpatient,,,12233,7951.45,,10765.04,88,,,percent of total billed charges,88% of total Billed charges,6116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6116.5,50,,,percent of total billed charges,50% of total Billed charges,7706.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1871.65,15.3,,,percent of total billed charges,15.3% of total billed charges,8440.77,69,,,percent of total billed charges,69% of total billed charges,12233,100,,,percent of total billed charges,100% of total billed charges,6116.5,50,,,percent of total billed charges,50% of total Billed charges,12233,100,,,percent of total billed charges,100% of total billed charges,6116.5,50,,,percent of total billed charges,50% of total Billed charges,12233,100,,,percent of total billed charges,100% of total billed charges,6116.5,50,,,percent of total billed charges,50% of total Billed charges,7566.11,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,6116.5,50,,,percent of total billed charges,50% of total Billed charges,6116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6116.5,50,,,percent of total billed charges,50% of total Billed charges,6116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6116.5,50,,,percent of total billed charges,50% of total Billed charges,4611.84,37.7,,,percent of total billed charges,37.70% of total billed charges,4611.84,37.7,,,percent of total billed charges,37.70% of total billed charges,6116.5,50,,,percent of total billed charges,50% of total Billed charges,4146.99,33.9,,,percent of total billed charges,33.9% of total billed charges,6116.5,50,,,percent of total billed charges,50% of total Billed charges,9541.74,78,,,percent of total billed charges,78% of total billed charges,12233,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6116.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",1871.65,12233,
PURAPLY AM 6 X 9,636Q4196,CDM,636,RC,Q4196,HCPCS,Outpatient,,,24625,16006.25,,21670,88,,,percent of total billed charges,88% of total Billed charges,12312.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,12312.5,50,,,percent of total billed charges,50% of total Billed charges,15513.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",3767.63,15.3,,,percent of total billed charges,15.3% of total billed charges,16991.25,69,,,percent of total billed charges,69% of total billed charges,24625,100,,,percent of total billed charges,100% of total billed charges,12312.5,50,,,percent of total billed charges,50% of total Billed charges,24625,100,,,percent of total billed charges,100% of total billed charges,12312.5,50,,,percent of total billed charges,50% of total Billed charges,24625,100,,,percent of total billed charges,100% of total billed charges,12312.5,50,,,percent of total billed charges,50% of total Billed charges,15230.56,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,12312.5,50,,,percent of total billed charges,50% of total Billed charges,12312.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12312.5,50,,,percent of total billed charges,50% of total Billed charges,12312.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12312.5,50,,,percent of total billed charges,50% of total Billed charges,9283.63,37.7,,,percent of total billed charges,37.70% of total billed charges,9283.63,37.7,,,percent of total billed charges,37.70% of total billed charges,12312.5,50,,,percent of total billed charges,50% of total Billed charges,8347.88,33.9,,,percent of total billed charges,33.9% of total billed charges,12312.5,50,,,percent of total billed charges,50% of total Billed charges,19207.5,78,,,percent of total billed charges,78% of total billed charges,24625,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12312.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12312.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",3767.63,24625,
PURAPLY AM 8 X 16,636Q4196,CDM,636,RC,Q4196,HCPCS,Outpatient,,,54994,35746.10,,48394.72,88,,,percent of total billed charges,88% of total Billed charges,27497,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4695,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,27497,50,,,percent of total billed charges,50% of total Billed charges,34646.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",8414.08,15.3,,,percent of total billed charges,15.3% of total billed charges,37945.86,69,,,percent of total billed charges,69% of total billed charges,54994,100,,,percent of total billed charges,100% of total billed charges,27497,50,,,percent of total billed charges,50% of total Billed charges,54994,100,,,percent of total billed charges,100% of total billed charges,27497,50,,,percent of total billed charges,50% of total Billed charges,54994,100,,,percent of total billed charges,100% of total billed charges,27497,50,,,percent of total billed charges,50% of total Billed charges,34013.79,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,27497,50,,,percent of total billed charges,50% of total Billed charges,27497,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27497,50,,,percent of total billed charges,50% of total Billed charges,27497,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27497,50,,,percent of total billed charges,50% of total Billed charges,20732.74,37.7,,,percent of total billed charges,37.70% of total billed charges,20732.74,37.7,,,percent of total billed charges,37.70% of total billed charges,27497,50,,,percent of total billed charges,50% of total Billed charges,18642.97,33.9,,,percent of total billed charges,33.9% of total billed charges,27497,50,,,percent of total billed charges,50% of total Billed charges,42895.32,78,,,percent of total billed charges,78% of total billed charges,54994,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27497,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27497,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",4695,54994,
Injection of non-compounded foam sclerosant with ultrasound,36465,CDM,972,RC,36465,HCPCS,Outpatient,,,339,220.35,,298.32,88,,,percent of total billed charges,88% of total Billed charges,15.37,100,,,Fee Schedule,100% of Medicare rate,64.72,100,,,Fee Schedule,100% of WA Medicaid,339,100,,,percent of total billed charges,100% of total billed charges,66.66,103,,,Fee Schedule,103% of WA Medicaid,15.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,64.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,233.91,69,,,percent of total billed charges,69% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,339,100,,,percent of total billed charges,100% of total billed charges,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,339,100,,,percent of total billed charges,100% of total billed charges,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.67,61.85,,,percent of total billed charges,61.85% of total billed charges,64.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.14,130,,,Fee Schedule,130% of WA Medicaid ,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,11492.1,33.9,,,percent of total billed charges,33.9% of total billed charges,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.42,78,,,percent of total billed charges,78% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,64.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.37,11492.1,
78013 Thyroid Imaging Profee only,78013,CDM,972,RC,78013,HCPCS,Outpatient,,,403,261.95,26,354.64,88,,,percent of total billed charges,88% of total Billed charges,6.87,100,,,Fee Schedule,100% of Medicare rate,9.7,100,,,Fee Schedule,100% of WA Medicaid,403,100,,,percent of total billed charges,100% of total billed charges,9.99,103,,,Fee Schedule,103% of WA Medicaid,6.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,278.07,69,,,percent of total billed charges,69% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,403,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,403,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.26,61.85,,,percent of total billed charges,61.85% of total billed charges,9.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.61,130,,,Fee Schedule,130% of WA Medicaid ,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,13661.7,33.9,,,percent of total billed charges,33.9% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.34,78,,,percent of total billed charges,78% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,9.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.87,13661.7,
G0121 Colorectal Cancer Screen,G0121,CDM,975,RC,,,Outpatient,,,552,358.80,,485.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,380.88,69,,,percent of total billed charges,69% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,341.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,18712.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,430.56,78,,,percent of total billed charges,78% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",208.1,18712.8,
"90833 Psychotherapy, 30 minutes with patient when performed",96090833,CDM,960,RC,90833,HCPCS,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,3.74,100,,,Fee Schedule,100% of Medicare rate,44.75,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,46.09,103,,,Fee Schedule,103% of WA Medicaid,3.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,44.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,135,100,,,percent of total billed charges,100% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,135,100,,,percent of total billed charges,100% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.5,61.85,,,percent of total billed charges,61.85% of total billed charges,44.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.18,130,,,Fee Schedule,130% of WA Medicaid ,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4576.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,44.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.74,4576.5,
"99238 Hospital Discharge Day, <30 Minutes",99238,CDM,960,RC,99238,HCPCS,Outpatient,,,193,125.45,,169.84,88,,,percent of total billed charges,88% of total Billed charges,5.28,100,,,Fee Schedule,100% of Medicare rate,46.07,100,,,Fee Schedule,100% of WA Medicaid,193,100,,,percent of total billed charges,100% of total billed charges,47.45,103,,,Fee Schedule,103% of WA Medicaid,5.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,133.17,69,,,percent of total billed charges,69% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,193,100,,,percent of total billed charges,100% of total billed charges,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,193,100,,,percent of total billed charges,100% of total billed charges,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.37,61.85,,,percent of total billed charges,61.85% of total billed charges,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.89,130,,,Fee Schedule,130% of WA Medicaid ,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,6542.7,33.9,,,percent of total billed charges,33.9% of total billed charges,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.54,78,,,percent of total billed charges,78% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.28,6542.7,
"99460 Initial Hospital Care, Per Day, Normal Newborn",99460,CDM,960,RC,99460,HCPCS,Outpatient,,,257,167.05,,226.16,88,,,percent of total billed charges,88% of total Billed charges,6.14,100,,,Fee Schedule,100% of Medicare rate,63.76,100,,,Fee Schedule,100% of WA Medicaid,257,100,,,percent of total billed charges,100% of total billed charges,65.67,103,,,Fee Schedule,103% of WA Medicaid,6.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,177.33,69,,,percent of total billed charges,69% of total billed charges,257,100,,,percent of total billed charges,100% of total billed charges,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,257,100,,,percent of total billed charges,100% of total billed charges,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,257,100,,,percent of total billed charges,100% of total billed charges,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.95,61.85,,,percent of total billed charges,61.85% of total billed charges,63.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.89,130,,,Fee Schedule,130% of WA Medicaid ,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.89,37.7,,,percent of total billed charges,37.70% of total billed charges,96.89,37.7,,,percent of total billed charges,37.70% of total billed charges,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,8712.3,33.9,,,percent of total billed charges,33.9% of total billed charges,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.46,78,,,percent of total billed charges,78% of total billed charges,257,100,,,percent of total billed charges,100% of total billed charges,212.28,82.6,,,percent of total billed charges,82.6% of total billed charges,212.28,82.6,,,percent of total billed charges,82.6% of total billed charges,63.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.14,8712.3,
10030 IMAGE-GUIDED FLUID COLLECTION DRAINAGE BY CATHETER (EG,97510030,CDM,975,RC,10030,HCPCS,Outpatient,,,297,193.05,,261.36,88,,,percent of total billed charges,88% of total Billed charges,12,100,,,Fee Schedule,100% of Medicare rate,74.79,100,,,Fee Schedule,100% of WA Medicaid,297,100,,,percent of total billed charges,100% of total billed charges,77.03,103,,,Fee Schedule,103% of WA Medicaid,12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,204.93,69,,,percent of total billed charges,69% of total billed charges,297,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,297,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,297,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.69,61.85,,,percent of total billed charges,61.85% of total billed charges,74.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,97.23,130,,,Fee Schedule,130% of WA Medicaid ,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.97,37.7,,,percent of total billed charges,37.70% of total billed charges,111.97,37.7,,,percent of total billed charges,37.70% of total billed charges,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,10068.3,33.9,,,percent of total billed charges,33.9% of total billed charges,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.66,78,,,percent of total billed charges,78% of total billed charges,297,100,,,percent of total billed charges,100% of total billed charges,245.32,82.6,,,percent of total billed charges,82.6% of total billed charges,245.32,82.6,,,percent of total billed charges,82.6% of total billed charges,74.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12,10068.3,
ID ABSCESS:SIMPLE,96010060,CDM,960,RC,10060,HCPCS,Outpatient,,,246,159.90,,216.48,88,,,percent of total billed charges,88% of total Billed charges,6.65,100,,,Fee Schedule,100% of Medicare rate,62.48,100,,,Fee Schedule,100% of WA Medicaid,246,100,,,percent of total billed charges,100% of total billed charges,64.35,103,,,Fee Schedule,103% of WA Medicaid,6.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,62.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,169.74,69,,,percent of total billed charges,69% of total billed charges,246,100,,,percent of total billed charges,100% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,246,100,,,percent of total billed charges,100% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,246,100,,,percent of total billed charges,100% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.15,61.85,,,percent of total billed charges,61.85% of total billed charges,62.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,81.22,130,,,Fee Schedule,130% of WA Medicaid ,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.74,37.7,,,percent of total billed charges,37.70% of total billed charges,92.74,37.7,,,percent of total billed charges,37.70% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,8339.4,33.9,,,percent of total billed charges,33.9% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.88,78,,,percent of total billed charges,78% of total billed charges,246,100,,,percent of total billed charges,100% of total billed charges,203.2,82.6,,,percent of total billed charges,82.6% of total billed charges,203.2,82.6,,,percent of total billed charges,82.6% of total billed charges,62.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.65,8339.4,
ID ABSCESS MULTIPLE OR COMPLI,96010061,CDM,960,RC,10061,HCPCS,Outpatient,,,574,373.10,,505.12,88,,,percent of total billed charges,88% of total Billed charges,13.92,100,,,Fee Schedule,100% of Medicare rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,574,100,,,percent of total billed charges,100% of total billed charges,110.26,103,,,Fee Schedule,103% of WA Medicaid,13.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,396.06,69,,,percent of total billed charges,69% of total billed charges,574,100,,,percent of total billed charges,100% of total billed charges,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,574,100,,,percent of total billed charges,100% of total billed charges,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,574,100,,,percent of total billed charges,100% of total billed charges,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.02,61.85,,,percent of total billed charges,61.85% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.17,130,,,Fee Schedule,130% of WA Medicaid ,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.4,37.7,,,percent of total billed charges,37.70% of total billed charges,216.4,37.7,,,percent of total billed charges,37.70% of total billed charges,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,19458.6,33.9,,,percent of total billed charges,33.9% of total billed charges,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.72,78,,,percent of total billed charges,78% of total billed charges,574,100,,,percent of total billed charges,100% of total billed charges,474.12,82.6,,,percent of total billed charges,82.6% of total billed charges,474.12,82.6,,,percent of total billed charges,82.6% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.92,19458.6,
ID PILONIDAL CYST;SIMPLE,96010080,CDM,960,RC,10080,HCPCS,Outpatient,,,381,247.65,,335.28,88,,,percent of total billed charges,88% of total Billed charges,8.4,100,,,Fee Schedule,100% of Medicare rate,61.36,100,,,Fee Schedule,100% of WA Medicaid,381,100,,,percent of total billed charges,100% of total billed charges,63.2,103,,,Fee Schedule,103% of WA Medicaid,8.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,61.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,262.89,69,,,percent of total billed charges,69% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,381,100,,,percent of total billed charges,100% of total billed charges,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,381,100,,,percent of total billed charges,100% of total billed charges,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.65,61.85,,,percent of total billed charges,61.85% of total billed charges,61.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.77,130,,,Fee Schedule,130% of WA Medicaid ,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,12915.9,33.9,,,percent of total billed charges,33.9% of total billed charges,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.18,78,,,percent of total billed charges,78% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,61.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.4,12915.9,
INCISION  REMOVAL OF FB;SUBQ,97510120,CDM,975,RC,10120,HCPCS,Outpatient,,,337,219.05,,296.56,88,,,percent of total billed charges,88% of total Billed charges,7.13,100,,,Fee Schedule,100% of Medicare rate,61.92,100,,,Fee Schedule,100% of WA Medicaid,337,100,,,percent of total billed charges,100% of total billed charges,63.78,103,,,Fee Schedule,103% of WA Medicaid,7.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,61.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,232.53,69,,,percent of total billed charges,69% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,337,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,337,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.43,61.85,,,percent of total billed charges,61.85% of total billed charges,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,80.5,130,,,Fee Schedule,130% of WA Medicaid ,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.05,37.7,,,percent of total billed charges,37.70% of total billed charges,127.05,37.7,,,percent of total billed charges,37.70% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,11424.3,33.9,,,percent of total billed charges,33.9% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.86,78,,,percent of total billed charges,78% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.13,11424.3,
10121 Incision  and Removal Foreign Body Comp Profee,97510121,CDM,975,RC,10121,HCPCS,Outpatient,,,1934,1257.10,,1701.92,88,,,percent of total billed charges,88% of total Billed charges,15.93,100,,,Fee Schedule,100% of Medicare rate,105.56,100,,,Fee Schedule,100% of WA Medicaid,1934,100,,,percent of total billed charges,100% of total billed charges,108.73,103,,,Fee Schedule,103% of WA Medicaid,15.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,105.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1334.46,69,,,percent of total billed charges,69% of total billed charges,1934,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1934,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1934,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1196.18,61.85,,,percent of total billed charges,61.85% of total billed charges,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,137.23,130,,,Fee Schedule,130% of WA Medicaid ,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.12,37.7,,,percent of total billed charges,37.70% of total billed charges,729.12,37.7,,,percent of total billed charges,37.70% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,65562.6,33.9,,,percent of total billed charges,33.9% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1508.52,78,,,percent of total billed charges,78% of total billed charges,1934,100,,,percent of total billed charges,100% of total billed charges,1597.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1597.48,82.6,,,percent of total billed charges,82.6% of total billed charges,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.93,65562.6,
ID HEMATOMA,96010140,CDM,960,RC,10140,HCPCS,Outpatient,,,282,183.30,,248.16,88,,,percent of total billed charges,88% of total Billed charges,9.06,100,,,Fee Schedule,100% of Medicare rate,68.63,100,,,Fee Schedule,100% of WA Medicaid,282,100,,,percent of total billed charges,100% of total billed charges,70.69,103,,,Fee Schedule,103% of WA Medicaid,9.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,194.58,69,,,percent of total billed charges,69% of total billed charges,282,100,,,percent of total billed charges,100% of total billed charges,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,282,100,,,percent of total billed charges,100% of total billed charges,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,282,100,,,percent of total billed charges,100% of total billed charges,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.42,61.85,,,percent of total billed charges,61.85% of total billed charges,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.22,130,,,Fee Schedule,130% of WA Medicaid ,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.31,37.7,,,percent of total billed charges,37.70% of total billed charges,106.31,37.7,,,percent of total billed charges,37.70% of total billed charges,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,9559.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.96,78,,,percent of total billed charges,78% of total billed charges,282,100,,,percent of total billed charges,100% of total billed charges,232.93,82.6,,,percent of total billed charges,82.6% of total billed charges,232.93,82.6,,,percent of total billed charges,82.6% of total billed charges,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.06,9559.8,
PUNC ASPRN ABSCESS/HEMATOMA,96010160,CDM,960,RC,10160,HCPCS,Outpatient,,,237,154.05,,208.56,88,,,percent of total billed charges,88% of total Billed charges,7.1,100,,,Fee Schedule,100% of Medicare rate,56.14,100,,,Fee Schedule,100% of WA Medicaid,237,100,,,percent of total billed charges,100% of total billed charges,57.82,103,,,Fee Schedule,103% of WA Medicaid,7.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,163.53,69,,,percent of total billed charges,69% of total billed charges,237,100,,,percent of total billed charges,100% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,237,100,,,percent of total billed charges,100% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,237,100,,,percent of total billed charges,100% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.58,61.85,,,percent of total billed charges,61.85% of total billed charges,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,72.98,130,,,Fee Schedule,130% of WA Medicaid ,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.35,37.7,,,percent of total billed charges,37.70% of total billed charges,89.35,37.7,,,percent of total billed charges,37.70% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,8034.3,33.9,,,percent of total billed charges,33.9% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.86,78,,,percent of total billed charges,78% of total billed charges,237,100,,,percent of total billed charges,100% of total billed charges,195.76,82.6,,,percent of total billed charges,82.6% of total billed charges,195.76,82.6,,,percent of total billed charges,82.6% of total billed charges,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.1,8034.3,
ID COMPLEX PO WOUND INFECTION,96010180,CDM,960,RC,10180,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,18.63,100,,,Fee Schedule,100% of Medicare rate,102.76,100,,,Fee Schedule,100% of WA Medicaid,520,100,,,percent of total billed charges,100% of total billed charges,105.84,103,,,Fee Schedule,103% of WA Medicaid,18.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,520,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,520,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,133.59,130,,,Fee Schedule,130% of WA Medicaid ,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,17628,33.9,,,percent of total billed charges,33.9% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.63,17628,
DEBRIDEMENT; SUBQ TISSUE,96011004,CDM,960,RC,11004,HCPCS,Outpatient,,,1219,792.35,,1072.72,88,,,percent of total billed charges,88% of total Billed charges,70.59,100,,,Fee Schedule,100% of Medicare rate,314.07,100,,,Fee Schedule,100% of WA Medicaid,1219,100,,,percent of total billed charges,100% of total billed charges,323.49,103,,,Fee Schedule,103% of WA Medicaid,70.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,123.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,314.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,841.11,69,,,percent of total billed charges,69% of total billed charges,1219,100,,,percent of total billed charges,100% of total billed charges,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1219,100,,,percent of total billed charges,100% of total billed charges,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1219,100,,,percent of total billed charges,100% of total billed charges,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,753.95,61.85,,,percent of total billed charges,61.85% of total billed charges,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,408.29,130,,,Fee Schedule,130% of WA Medicaid ,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.56,37.7,,,percent of total billed charges,37.70% of total billed charges,459.56,37.7,,,percent of total billed charges,37.70% of total billed charges,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,41324.1,33.9,,,percent of total billed charges,33.9% of total billed charges,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,950.82,78,,,percent of total billed charges,78% of total billed charges,1219,100,,,percent of total billed charges,100% of total billed charges,1006.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1006.89,82.6,,,percent of total billed charges,82.6% of total billed charges,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.59,41324.1,
DEBRIDE OF ABDO WALL W OR WO C,96011005,CDM,960,RC,11005,HCPCS,Outpatient,,,1633,1061.45,,1437.04,88,,,percent of total billed charges,88% of total Billed charges,111.26,100,,,Fee Schedule,100% of Medicare rate,425.41,100,,,Fee Schedule,100% of WA Medicaid,1633,100,,,percent of total billed charges,100% of total billed charges,438.17,103,,,Fee Schedule,103% of WA Medicaid,111.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,194.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,425.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1126.77,69,,,percent of total billed charges,69% of total billed charges,1633,100,,,percent of total billed charges,100% of total billed charges,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1633,100,,,percent of total billed charges,100% of total billed charges,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1633,100,,,percent of total billed charges,100% of total billed charges,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1010.01,61.85,,,percent of total billed charges,61.85% of total billed charges,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,553.03,130,,,Fee Schedule,130% of WA Medicaid ,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.64,37.7,,,percent of total billed charges,37.70% of total billed charges,615.64,37.7,,,percent of total billed charges,37.70% of total billed charges,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,55358.7,33.9,,,percent of total billed charges,33.9% of total billed charges,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1273.74,78,,,percent of total billed charges,78% of total billed charges,1633,100,,,percent of total billed charges,100% of total billed charges,1348.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1348.86,82.6,,,percent of total billed charges,82.6% of total billed charges,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.26,55358.7,
DEBRID SUBQ FIRST 20 SQCM OR <,97511042,CDM,975,RC,11042,HCPCS,Outpatient,,,124,80.60,,109.12,88,,,percent of total billed charges,88% of total Billed charges,5.19,100,,,Fee Schedule,100% of Medicare rate,34.5,100,,,Fee Schedule,100% of WA Medicaid,124,100,,,percent of total billed charges,100% of total billed charges,35.54,103,,,Fee Schedule,103% of WA Medicaid,5.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,34.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,85.56,69,,,percent of total billed charges,69% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,124,100,,,percent of total billed charges,100% of total billed charges,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,124,100,,,percent of total billed charges,100% of total billed charges,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.69,61.85,,,percent of total billed charges,61.85% of total billed charges,34.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,44.85,130,,,Fee Schedule,130% of WA Medicaid ,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,4203.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.72,78,,,percent of total billed charges,78% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,34.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.19,4203.6,
DEBRID MUSCLE/FACIA < 20SQ CM,96011043,CDM,960,RC,11043,HCPCS,Outpatient,,,486,315.90,,427.68,88,,,percent of total billed charges,88% of total Billed charges,14.95,100,,,Fee Schedule,100% of Medicare rate,86.54,100,,,Fee Schedule,100% of WA Medicaid,486,100,,,percent of total billed charges,100% of total billed charges,89.14,103,,,Fee Schedule,103% of WA Medicaid,14.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,86.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,335.34,69,,,percent of total billed charges,69% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.59,61.85,,,percent of total billed charges,61.85% of total billed charges,86.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,112.5,130,,,Fee Schedule,130% of WA Medicaid ,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,16475.4,33.9,,,percent of total billed charges,33.9% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.08,78,,,percent of total billed charges,78% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,86.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.95,16475.4,
DEBRIDEMENT;BONE,96011044,CDM,960,RC,11044,HCPCS,Outpatient,,,671,436.15,,590.48,88,,,percent of total billed charges,88% of total Billed charges,23.81,100,,,Fee Schedule,100% of Medicare rate,126.45,100,,,Fee Schedule,100% of WA Medicaid,671,100,,,percent of total billed charges,100% of total billed charges,130.24,103,,,Fee Schedule,103% of WA Medicaid,23.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,126.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,462.99,69,,,percent of total billed charges,69% of total billed charges,671,100,,,percent of total billed charges,100% of total billed charges,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,671,100,,,percent of total billed charges,100% of total billed charges,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,671,100,,,percent of total billed charges,100% of total billed charges,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.01,61.85,,,percent of total billed charges,61.85% of total billed charges,126.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,164.39,130,,,Fee Schedule,130% of WA Medicaid ,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.97,37.7,,,percent of total billed charges,37.70% of total billed charges,252.97,37.7,,,percent of total billed charges,37.70% of total billed charges,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,22746.9,33.9,,,percent of total billed charges,33.9% of total billed charges,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,523.38,78,,,percent of total billed charges,78% of total billed charges,671,100,,,percent of total billed charges,100% of total billed charges,554.25,82.6,,,percent of total billed charges,82.6% of total billed charges,554.25,82.6,,,percent of total billed charges,82.6% of total billed charges,126.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.81,22746.9,
DEBRIDE SUBCUT TISS ADD'L 20CM,97511045,CDM,975,RC,11045,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,2.82,100,,,Fee Schedule,100% of Medicare rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,75,100,,,percent of total billed charges,100% of total billed charges,14.41,103,,,Fee Schedule,103% of WA Medicaid,2.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,75,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,75,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.39,61.85,,,percent of total billed charges,61.85% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.19,130,,,Fee Schedule,130% of WA Medicaid ,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2542.5,33.9,,,percent of total billed charges,33.9% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.82,2542.5,
DEBRIDEMENT EA ADD'L 20 SQ CM,96011046,CDM,960,RC,11046,HCPCS,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,6.54,100,,,Fee Schedule,100% of Medicare rate,30.4,100,,,Fee Schedule,100% of WA Medicaid,87,100,,,percent of total billed charges,100% of total billed charges,31.31,103,,,Fee Schedule,103% of WA Medicaid,6.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,87,100,,,percent of total billed charges,100% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,87,100,,,percent of total billed charges,100% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,39.52,130,,,Fee Schedule,130% of WA Medicaid ,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2949.3,33.9,,,percent of total billed charges,33.9% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.54,2949.3,
DEBRIDEMENT BONE ADD-ON,96011047,CDM,960,RC,11047,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,11.93,100,,,Fee Schedule,100% of Medicare rate,53.9,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,55.52,103,,,Fee Schedule,103% of WA Medicaid,11.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,53.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,224,100,,,percent of total billed charges,100% of total billed charges,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,224,100,,,percent of total billed charges,100% of total billed charges,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.54,61.85,,,percent of total billed charges,61.85% of total billed charges,53.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,70.07,130,,,Fee Schedule,130% of WA Medicaid ,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,7593.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,53.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.93,7593.6,
PARING/CUT BENIGN HYPER LES 1,96011055,CDM,975,RC,11055,HCPCS,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,1.24,100,,,Fee Schedule,100% of Medicare rate,8.58,100,,,Fee Schedule,100% of WA Medicaid,55,100,,,percent of total billed charges,100% of total billed charges,8.84,103,,,Fee Schedule,103% of WA Medicaid,1.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,55,100,,,percent of total billed charges,100% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,55,100,,,percent of total billed charges,100% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,8.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.15,130,,,Fee Schedule,130% of WA Medicaid ,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1864.5,33.9,,,percent of total billed charges,33.9% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,8.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.24,1864.5,
11104 Punch Biopsy of Skin; Single Lesion ProFee,97511104,CDM,975,RC,11104,HCPCS,Outpatient,,,107,69.55,,94.16,88,,,percent of total billed charges,88% of total Billed charges,3.99,100,,,Fee Schedule,100% of Medicare rate,26.48,100,,,Fee Schedule,100% of WA Medicaid,107,100,,,percent of total billed charges,100% of total billed charges,27.27,103,,,Fee Schedule,103% of WA Medicaid,3.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,26.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,73.83,69,,,percent of total billed charges,69% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,107,100,,,percent of total billed charges,100% of total billed charges,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,107,100,,,percent of total billed charges,100% of total billed charges,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.18,61.85,,,percent of total billed charges,61.85% of total billed charges,26.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,34.42,130,,,Fee Schedule,130% of WA Medicaid ,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3627.3,33.9,,,percent of total billed charges,33.9% of total billed charges,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.46,78,,,percent of total billed charges,78% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,26.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.99,3627.3,
11106 - Incisional Biopsy of Skin Single Lesion ProFee,97511106,CDM,975,RC,11106,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,5.05,100,,,Fee Schedule,100% of Medicare rate,31.89,100,,,Fee Schedule,100% of WA Medicaid,130,100,,,percent of total billed charges,100% of total billed charges,32.85,103,,,Fee Schedule,103% of WA Medicaid,5.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,31.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,130,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,130,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,31.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.46,130,,,Fee Schedule,130% of WA Medicaid ,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,4407,33.9,,,percent of total billed charges,33.9% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,31.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.05,4407,
REMOVAL OF SKIN TAGS,96011200,CDM,960,RC,11200,HCPCS,Outpatient,,,193,125.45,,169.84,88,,,percent of total billed charges,88% of total Billed charges,4.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,133.17,69,,,percent of total billed charges,69% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,193,100,,,percent of total billed charges,100% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,193,100,,,percent of total billed charges,100% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.37,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,6542.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.54,78,,,percent of total billed charges,78% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",4.69,6542.7,
"EX BEN LES TRNK,ARM,LEG < 0.5",96011400,CDM,975,RC,11400,HCPCS,Outpatient,,,270,175.50,,237.6,88,,,percent of total billed charges,88% of total Billed charges,5.71,100,,,Fee Schedule,100% of Medicare rate,49.61,100,,,Fee Schedule,100% of WA Medicaid,270,100,,,percent of total billed charges,100% of total billed charges,51.1,103,,,Fee Schedule,103% of WA Medicaid,5.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,186.3,69,,,percent of total billed charges,69% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,270,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,270,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,167,61.85,,,percent of total billed charges,61.85% of total billed charges,49.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.49,130,,,Fee Schedule,130% of WA Medicaid ,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,9153,33.9,,,percent of total billed charges,33.9% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.6,78,,,percent of total billed charges,78% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,49.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.71,9153,
"EX BEN LES TRNK,ARM,LEG .5-1.0",96011401,CDM,975,RC,11401,HCPCS,Outpatient,,,326,211.90,,286.88,88,,,percent of total billed charges,88% of total Billed charges,7.39,100,,,Fee Schedule,100% of Medicare rate,61.73,100,,,Fee Schedule,100% of WA Medicaid,326,100,,,percent of total billed charges,100% of total billed charges,63.58,103,,,Fee Schedule,103% of WA Medicaid,7.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,61.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,224.94,69,,,percent of total billed charges,69% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,326,100,,,percent of total billed charges,100% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,326,100,,,percent of total billed charges,100% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.63,61.85,,,percent of total billed charges,61.85% of total billed charges,61.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,80.25,130,,,Fee Schedule,130% of WA Medicaid ,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,122.9,37.7,,,percent of total billed charges,37.70% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,11051.4,33.9,,,percent of total billed charges,33.9% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.28,78,,,percent of total billed charges,78% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,61.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.39,11051.4,
"EX BEN LES TRNK,ARM,LEG 1.0-2.",96011402,CDM,975,RC,11402,HCPCS,Outpatient,,,348,226.20,,306.24,88,,,percent of total billed charges,88% of total Billed charges,8.46,100,,,Fee Schedule,100% of Medicare rate,67.33,100,,,Fee Schedule,100% of WA Medicaid,348,100,,,percent of total billed charges,100% of total billed charges,69.35,103,,,Fee Schedule,103% of WA Medicaid,8.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,67.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,240.12,69,,,percent of total billed charges,69% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,348,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,348,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.24,61.85,,,percent of total billed charges,61.85% of total billed charges,67.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,87.53,130,,,Fee Schedule,130% of WA Medicaid ,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,11797.2,33.9,,,percent of total billed charges,33.9% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.44,78,,,percent of total billed charges,78% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,67.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.46,11797.2,
"EX BEN LES TRN,ARMS,LEG 2.0-3.",96011403,CDM,960,RC,11403,HCPCS,Outpatient,,,402,261.30,,353.76,88,,,percent of total billed charges,88% of total Billed charges,11.58,100,,,Fee Schedule,100% of Medicare rate,87.1,100,,,Fee Schedule,100% of WA Medicaid,402,100,,,percent of total billed charges,100% of total billed charges,89.71,103,,,Fee Schedule,103% of WA Medicaid,11.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,87.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,277.38,69,,,percent of total billed charges,69% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,402,100,,,percent of total billed charges,100% of total billed charges,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,402,100,,,percent of total billed charges,100% of total billed charges,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.64,61.85,,,percent of total billed charges,61.85% of total billed charges,87.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,113.23,130,,,Fee Schedule,130% of WA Medicaid ,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,13627.8,33.9,,,percent of total billed charges,33.9% of total billed charges,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.56,78,,,percent of total billed charges,78% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,87.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.58,13627.8,
"EX BEN LES TRK,ARM,LEG 3.0-4.0",97511404,CDM,975,RC,11404,HCPCS,Outpatient,,,473,307.45,,416.24,88,,,percent of total billed charges,88% of total Billed charges,14.09,100,,,Fee Schedule,100% of Medicare rate,95.49,100,,,Fee Schedule,100% of WA Medicaid,473,100,,,percent of total billed charges,100% of total billed charges,98.35,103,,,Fee Schedule,103% of WA Medicaid,14.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,95.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,326.37,69,,,percent of total billed charges,69% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,473,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,473,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.55,61.85,,,percent of total billed charges,61.85% of total billed charges,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,124.14,130,,,Fee Schedule,130% of WA Medicaid ,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,16034.7,33.9,,,percent of total billed charges,33.9% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.94,78,,,percent of total billed charges,78% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.09,16034.7,
"EX BEN LES TRK,ARM,LEG > 4.0CM",96011406,CDM,960,RC,11406,HCPCS,Outpatient,,,655,425.75,,576.4,88,,,percent of total billed charges,88% of total Billed charges,24.63,100,,,Fee Schedule,100% of Medicare rate,142.67,100,,,Fee Schedule,100% of WA Medicaid,655,100,,,percent of total billed charges,100% of total billed charges,146.95,103,,,Fee Schedule,103% of WA Medicaid,24.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,142.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,451.95,69,,,percent of total billed charges,69% of total billed charges,655,100,,,percent of total billed charges,100% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,655,100,,,percent of total billed charges,100% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,655,100,,,percent of total billed charges,100% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.12,61.85,,,percent of total billed charges,61.85% of total billed charges,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,185.47,130,,,Fee Schedule,130% of WA Medicaid ,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.94,37.7,,,percent of total billed charges,37.70% of total billed charges,246.94,37.7,,,percent of total billed charges,37.70% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,22204.5,33.9,,,percent of total billed charges,33.9% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.9,78,,,percent of total billed charges,78% of total billed charges,655,100,,,percent of total billed charges,100% of total billed charges,541.03,82.6,,,percent of total billed charges,82.6% of total billed charges,541.03,82.6,,,percent of total billed charges,82.6% of total billed charges,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.63,22204.5,
"EXC BEN LES SCALP,HD,HAN,FT<.5",96011420,CDM,960,RC,11420,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,5.11,100,,,Fee Schedule,100% of Medicare rate,48.12,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,49.56,103,,,Fee Schedule,103% of WA Medicaid,5.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,269,100,,,percent of total billed charges,100% of total billed charges,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,269,100,,,percent of total billed charges,100% of total billed charges,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.38,61.85,,,percent of total billed charges,61.85% of total billed charges,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.56,130,,,Fee Schedule,130% of WA Medicaid ,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,9119.1,33.9,,,percent of total billed charges,33.9% of total billed charges,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.11,9119.1,
"EX BEN LES SC,HD,HN,FT0.5-1.0",96011421,CDM,972,RC,11421,HCPCS,Outpatient,,,344,223.60,,302.72,88,,,percent of total billed charges,88% of total Billed charges,7.74,100,,,Fee Schedule,100% of Medicare rate,63.41,100,,,Fee Schedule,100% of WA Medicaid,344,100,,,percent of total billed charges,100% of total billed charges,65.31,103,,,Fee Schedule,103% of WA Medicaid,7.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,237.36,69,,,percent of total billed charges,69% of total billed charges,344,100,,,percent of total billed charges,100% of total billed charges,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,344,100,,,percent of total billed charges,100% of total billed charges,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,344,100,,,percent of total billed charges,100% of total billed charges,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.76,61.85,,,percent of total billed charges,61.85% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.43,130,,,Fee Schedule,130% of WA Medicaid ,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.69,37.7,,,percent of total billed charges,37.70% of total billed charges,129.69,37.7,,,percent of total billed charges,37.70% of total billed charges,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,11661.6,33.9,,,percent of total billed charges,33.9% of total billed charges,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.32,78,,,percent of total billed charges,78% of total billed charges,344,100,,,percent of total billed charges,100% of total billed charges,284.14,82.6,,,percent of total billed charges,82.6% of total billed charges,284.14,82.6,,,percent of total billed charges,82.6% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.74,11661.6,
"EX BEN LES SC,HD,HAN,FT1.0-2.0",97511422,CDM,975,RC,11422,HCPCS,Outpatient,,,384,249.60,,337.92,88,,,percent of total billed charges,88% of total Billed charges,9.6,100,,,Fee Schedule,100% of Medicare rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,384,100,,,percent of total billed charges,100% of total billed charges,81.64,103,,,Fee Schedule,103% of WA Medicaid,9.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,264.96,69,,,percent of total billed charges,69% of total billed charges,384,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,384,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,384,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.5,61.85,,,percent of total billed charges,61.85% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.04,130,,,Fee Schedule,130% of WA Medicaid ,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.77,37.7,,,percent of total billed charges,37.70% of total billed charges,144.77,37.7,,,percent of total billed charges,37.70% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,13017.6,33.9,,,percent of total billed charges,33.9% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.52,78,,,percent of total billed charges,78% of total billed charges,384,100,,,percent of total billed charges,100% of total billed charges,317.18,82.6,,,percent of total billed charges,82.6% of total billed charges,317.18,82.6,,,percent of total billed charges,82.6% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.6,13017.6,
"EX BEN LES SC,HD,HN,FT2.0-3.0",96011423,CDM,960,RC,11423,HCPCS,Outpatient,,,441,286.65,,388.08,88,,,percent of total billed charges,88% of total Billed charges,11.8,100,,,Fee Schedule,100% of Medicare rate,91.39,100,,,Fee Schedule,100% of WA Medicaid,441,100,,,percent of total billed charges,100% of total billed charges,94.13,103,,,Fee Schedule,103% of WA Medicaid,11.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,91.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,304.29,69,,,percent of total billed charges,69% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,441,100,,,percent of total billed charges,100% of total billed charges,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,441,100,,,percent of total billed charges,100% of total billed charges,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.76,61.85,,,percent of total billed charges,61.85% of total billed charges,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,118.81,130,,,Fee Schedule,130% of WA Medicaid ,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.26,37.7,,,percent of total billed charges,37.70% of total billed charges,166.26,37.7,,,percent of total billed charges,37.70% of total billed charges,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,14949.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.98,78,,,percent of total billed charges,78% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.8,14949.9,
"EX BEN LES SC,HD,FT,HN3.0-4.0",96011424,CDM,960,RC,11424,HCPCS,Outpatient,,,510,331.50,,448.8,88,,,percent of total billed charges,88% of total Billed charges,15.1,100,,,Fee Schedule,100% of Medicare rate,104.81,100,,,Fee Schedule,100% of WA Medicaid,510,100,,,percent of total billed charges,100% of total billed charges,107.95,103,,,Fee Schedule,103% of WA Medicaid,15.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,104.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,351.9,69,,,percent of total billed charges,69% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,510,100,,,percent of total billed charges,100% of total billed charges,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,510,100,,,percent of total billed charges,100% of total billed charges,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.44,61.85,,,percent of total billed charges,61.85% of total billed charges,104.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.25,130,,,Fee Schedule,130% of WA Medicaid ,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,17289,33.9,,,percent of total billed charges,33.9% of total billed charges,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.8,78,,,percent of total billed charges,78% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,104.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.1,17289,
"EX BEN LES FACE,HEAD <0.5CM",96011440,CDM,960,RC,11440,HCPCS,Outpatient,,,298,193.70,,262.24,88,,,percent of total billed charges,88% of total Billed charges,6.16,100,,,Fee Schedule,100% of Medicare rate,63.22,100,,,Fee Schedule,100% of WA Medicaid,298,100,,,percent of total billed charges,100% of total billed charges,65.12,103,,,Fee Schedule,103% of WA Medicaid,6.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,205.62,69,,,percent of total billed charges,69% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,298,100,,,percent of total billed charges,100% of total billed charges,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,298,100,,,percent of total billed charges,100% of total billed charges,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.31,61.85,,,percent of total billed charges,61.85% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.19,130,,,Fee Schedule,130% of WA Medicaid ,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,10102.2,33.9,,,percent of total billed charges,33.9% of total billed charges,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.44,78,,,percent of total billed charges,78% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.16,10102.2,
"EX BEN LES FACE, HEAD 0.5-1.0",97511441,CDM,975,RC,11441,HCPCS,Outpatient,,,369,239.85,,324.72,88,,,percent of total billed charges,88% of total Billed charges,9.28,100,,,Fee Schedule,100% of Medicare rate,78.14,100,,,Fee Schedule,100% of WA Medicaid,369,100,,,percent of total billed charges,100% of total billed charges,80.48,103,,,Fee Schedule,103% of WA Medicaid,9.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,78.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,254.61,69,,,percent of total billed charges,69% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,369,100,,,percent of total billed charges,100% of total billed charges,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,369,100,,,percent of total billed charges,100% of total billed charges,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.23,61.85,,,percent of total billed charges,61.85% of total billed charges,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.58,130,,,Fee Schedule,130% of WA Medicaid ,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,12509.1,33.9,,,percent of total billed charges,33.9% of total billed charges,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.82,78,,,percent of total billed charges,78% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.28,12509.1,
"EX BEN LES FACE, HEAD 1.0-2.0",97511442,CDM,975,RC,11442,HCPCS,Outpatient,,,396,257.40,,348.48,88,,,percent of total billed charges,88% of total Billed charges,10.72,100,,,Fee Schedule,100% of Medicare rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,396,100,,,percent of total billed charges,100% of total billed charges,88.36,103,,,Fee Schedule,103% of WA Medicaid,10.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,273.24,69,,,percent of total billed charges,69% of total billed charges,396,100,,,percent of total billed charges,100% of total billed charges,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,396,100,,,percent of total billed charges,100% of total billed charges,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,396,100,,,percent of total billed charges,100% of total billed charges,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.93,61.85,,,percent of total billed charges,61.85% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.53,130,,,Fee Schedule,130% of WA Medicaid ,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.29,37.7,,,percent of total billed charges,37.70% of total billed charges,149.29,37.7,,,percent of total billed charges,37.70% of total billed charges,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,13424.4,33.9,,,percent of total billed charges,33.9% of total billed charges,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.88,78,,,percent of total billed charges,78% of total billed charges,396,100,,,percent of total billed charges,100% of total billed charges,327.1,82.6,,,percent of total billed charges,82.6% of total billed charges,327.1,82.6,,,percent of total billed charges,82.6% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.72,13424.4,
"EX BEN LES FACE, HEAD 2.0-3.0",96011443,CDM,975,RC,11443,HCPCS,Outpatient,,,490,318.50,,431.2,88,,,percent of total billed charges,88% of total Billed charges,13.76,100,,,Fee Schedule,100% of Medicare rate,104.07,100,,,Fee Schedule,100% of WA Medicaid,490,100,,,percent of total billed charges,100% of total billed charges,107.19,103,,,Fee Schedule,103% of WA Medicaid,13.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,104.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,338.1,69,,,percent of total billed charges,69% of total billed charges,490,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,490,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,490,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.07,61.85,,,percent of total billed charges,61.85% of total billed charges,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,135.29,130,,,Fee Schedule,130% of WA Medicaid ,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.73,37.7,,,percent of total billed charges,37.70% of total billed charges,184.73,37.7,,,percent of total billed charges,37.70% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,16611,33.9,,,percent of total billed charges,33.9% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.2,78,,,percent of total billed charges,78% of total billed charges,490,100,,,percent of total billed charges,100% of total billed charges,404.74,82.6,,,percent of total billed charges,82.6% of total billed charges,404.74,82.6,,,percent of total billed charges,82.6% of total billed charges,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.76,16611,
"EX BEN LES FACE, HEAD 3.0-4.0",96011444,CDM,975,RC,11444,HCPCS,Outpatient,,,618,401.70,,543.84,88,,,percent of total billed charges,88% of total Billed charges,18.26,100,,,Fee Schedule,100% of Medicare rate,130.18,100,,,Fee Schedule,100% of WA Medicaid,618,100,,,percent of total billed charges,100% of total billed charges,134.09,103,,,Fee Schedule,103% of WA Medicaid,18.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,130.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,426.42,69,,,percent of total billed charges,69% of total billed charges,618,100,,,percent of total billed charges,100% of total billed charges,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,618,100,,,percent of total billed charges,100% of total billed charges,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,618,100,,,percent of total billed charges,100% of total billed charges,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.23,61.85,,,percent of total billed charges,61.85% of total billed charges,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,169.23,130,,,Fee Schedule,130% of WA Medicaid ,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.99,37.7,,,percent of total billed charges,37.70% of total billed charges,232.99,37.7,,,percent of total billed charges,37.70% of total billed charges,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,20950.2,33.9,,,percent of total billed charges,33.9% of total billed charges,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.04,78,,,percent of total billed charges,78% of total billed charges,618,100,,,percent of total billed charges,100% of total billed charges,510.47,82.6,,,percent of total billed charges,82.6% of total billed charges,510.47,82.6,,,percent of total billed charges,82.6% of total billed charges,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.26,20950.2,
"EX BEN LES FACE, HEAD > 4.0CM",96011446,CDM,960,RC,11446,HCPCS,Outpatient,,,856,556.40,,753.28,88,,,percent of total billed charges,88% of total Billed charges,27.22,100,,,Fee Schedule,100% of Medicare rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,856,100,,,percent of total billed charges,100% of total billed charges,187.48,103,,,Fee Schedule,103% of WA Medicaid,27.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,590.64,69,,,percent of total billed charges,69% of total billed charges,856,100,,,percent of total billed charges,100% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,856,100,,,percent of total billed charges,100% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,856,100,,,percent of total billed charges,100% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,529.44,61.85,,,percent of total billed charges,61.85% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,236.63,130,,,Fee Schedule,130% of WA Medicaid ,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.71,37.7,,,percent of total billed charges,37.70% of total billed charges,322.71,37.7,,,percent of total billed charges,37.70% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,29018.4,33.9,,,percent of total billed charges,33.9% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.68,78,,,percent of total billed charges,78% of total billed charges,856,100,,,percent of total billed charges,100% of total billed charges,707.06,82.6,,,percent of total billed charges,82.6% of total billed charges,707.06,82.6,,,percent of total billed charges,82.6% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.22,29018.4,
11470 EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENI,97511470,CDM,975,RC,11470,HCPCS,Outpatient,,,936,608.40,,823.68,88,,,percent of total billed charges,88% of total Billed charges,28.94,100,,,Fee Schedule,100% of Medicare rate,165.8,100,,,Fee Schedule,100% of WA Medicaid,936,100,,,percent of total billed charges,100% of total billed charges,170.77,103,,,Fee Schedule,103% of WA Medicaid,28.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,50.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,165.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,645.84,69,,,percent of total billed charges,69% of total billed charges,936,100,,,percent of total billed charges,100% of total billed charges,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,936,100,,,percent of total billed charges,100% of total billed charges,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,936,100,,,percent of total billed charges,100% of total billed charges,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,578.92,61.85,,,percent of total billed charges,61.85% of total billed charges,165.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,215.54,130,,,Fee Schedule,130% of WA Medicaid ,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.87,37.7,,,percent of total billed charges,37.70% of total billed charges,352.87,37.7,,,percent of total billed charges,37.70% of total billed charges,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,31730.4,33.9,,,percent of total billed charges,33.9% of total billed charges,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.08,78,,,percent of total billed charges,78% of total billed charges,936,100,,,percent of total billed charges,100% of total billed charges,773.14,82.6,,,percent of total billed charges,82.6% of total billed charges,773.14,82.6,,,percent of total billed charges,82.6% of total billed charges,165.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.94,31730.4,
"EX MAL LES FACE, HEAD > 4.0CM",96011646,CDM,960,RC,11646,HCPCS,Outpatient,,,1085,705.25,,954.8,88,,,percent of total billed charges,88% of total Billed charges,37.3,100,,,Fee Schedule,100% of Medicare rate,220.44,100,,,Fee Schedule,100% of WA Medicaid,1085,100,,,percent of total billed charges,100% of total billed charges,227.05,103,,,Fee Schedule,103% of WA Medicaid,37.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,220.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,748.65,69,,,percent of total billed charges,69% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085,100,,,percent of total billed charges,100% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085,100,,,percent of total billed charges,100% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.07,61.85,,,percent of total billed charges,61.85% of total billed charges,220.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,286.57,130,,,Fee Schedule,130% of WA Medicaid ,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,36781.5,33.9,,,percent of total billed charges,33.9% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.3,78,,,percent of total billed charges,78% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,220.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.3,36781.5,
TRIM NAIL ANY NUMBER NONDYSTRO,96011719,CDM,960,RC,11719,HCPCS,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,0.48,100,,,Fee Schedule,100% of Medicare rate,4.1,100,,,Fee Schedule,100% of WA Medicaid,41,100,,,percent of total billed charges,100% of total billed charges,4.22,103,,,Fee Schedule,103% of WA Medicaid,0.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,4.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,41,100,,,percent of total billed charges,100% of total billed charges,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,41,100,,,percent of total billed charges,100% of total billed charges,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.36,61.85,,,percent of total billed charges,61.85% of total billed charges,4.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.33,130,,,Fee Schedule,130% of WA Medicaid ,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.46,37.7,,,percent of total billed charges,37.70% of total billed charges,15.46,37.7,,,percent of total billed charges,37.70% of total billed charges,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1389.9,33.9,,,percent of total billed charges,33.9% of total billed charges,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,4.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.48,1389.9,
DEBRIDEMENT OF NAIL 1-5,96011720,CDM,960,RC,11720,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,1.2,100,,,Fee Schedule,100% of Medicare rate,7.83,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,8.06,103,,,Fee Schedule,103% of WA Medicaid,1.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,7.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69,100,,,percent of total billed charges,100% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69,100,,,percent of total billed charges,100% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.68,61.85,,,percent of total billed charges,61.85% of total billed charges,7.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.18,130,,,Fee Schedule,130% of WA Medicaid ,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2339.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,7.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.2,2339.1,
DEBRIDEMENT OF NAILS/6 OR MORE,96011721,CDM,960,RC,11721,HCPCS,Outpatient,,,79,51.35,,69.52,88,,,percent of total billed charges,88% of total Billed charges,1.74,100,,,Fee Schedule,100% of Medicare rate,13.24,100,,,Fee Schedule,100% of WA Medicaid,79,100,,,percent of total billed charges,100% of total billed charges,13.64,103,,,Fee Schedule,103% of WA Medicaid,1.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,54.51,69,,,percent of total billed charges,69% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,79,100,,,percent of total billed charges,100% of total billed charges,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,79,100,,,percent of total billed charges,100% of total billed charges,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.86,61.85,,,percent of total billed charges,61.85% of total billed charges,13.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,17.21,130,,,Fee Schedule,130% of WA Medicaid ,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.78,37.7,,,percent of total billed charges,37.70% of total billed charges,29.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2678.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.62,78,,,percent of total billed charges,78% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,13.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.74,2678.1,
AVULSION NAILPLT SIM/SIN;PART,96011730,CDM,975,RC,11730,HCPCS,Outpatient,,,202,131.30,,177.76,88,,,percent of total billed charges,88% of total Billed charges,3.94,100,,,Fee Schedule,100% of Medicare rate,30.4,100,,,Fee Schedule,100% of WA Medicaid,202,100,,,percent of total billed charges,100% of total billed charges,31.31,103,,,Fee Schedule,103% of WA Medicaid,3.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,139.38,69,,,percent of total billed charges,69% of total billed charges,202,100,,,percent of total billed charges,100% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,202,100,,,percent of total billed charges,100% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,202,100,,,percent of total billed charges,100% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.94,61.85,,,percent of total billed charges,61.85% of total billed charges,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,39.52,130,,,Fee Schedule,130% of WA Medicaid ,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.15,37.7,,,percent of total billed charges,37.70% of total billed charges,76.15,37.7,,,percent of total billed charges,37.70% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,6847.8,33.9,,,percent of total billed charges,33.9% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.56,78,,,percent of total billed charges,78% of total billed charges,202,100,,,percent of total billed charges,100% of total billed charges,166.85,82.6,,,percent of total billed charges,82.6% of total billed charges,166.85,82.6,,,percent of total billed charges,82.6% of total billed charges,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.94,6847.8,
"11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE",97511750,CDM,975,RC,11750,HCPCS,Outpatient,,,1159,753.35,,1019.92,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,1159,100,,,percent of total billed charges,100% of total billed charges,60.7,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,799.71,69,,,percent of total billed charges,69% of total billed charges,1159,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1159,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1159,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,716.84,61.85,,,percent of total billed charges,61.85% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.61,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.94,37.7,,,percent of total billed charges,37.70% of total billed charges,436.94,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,39290.1,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.02,78,,,percent of total billed charges,78% of total billed charges,1159,100,,,percent of total billed charges,100% of total billed charges,957.33,82.6,,,percent of total billed charges,82.6% of total billed charges,957.33,82.6,,,percent of total billed charges,82.6% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.47,39290.1,
REPAIR OF NAIL BED,96011760,CDM,960,RC,11760,HCPCS,Outpatient,,,444,288.60,,390.72,88,,,percent of total billed charges,88% of total Billed charges,8.25,100,,,Fee Schedule,100% of Medicare rate,63.22,100,,,Fee Schedule,100% of WA Medicaid,444,100,,,percent of total billed charges,100% of total billed charges,65.12,103,,,Fee Schedule,103% of WA Medicaid,8.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,306.36,69,,,percent of total billed charges,69% of total billed charges,444,100,,,percent of total billed charges,100% of total billed charges,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,444,100,,,percent of total billed charges,100% of total billed charges,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,444,100,,,percent of total billed charges,100% of total billed charges,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.61,61.85,,,percent of total billed charges,61.85% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.19,130,,,Fee Schedule,130% of WA Medicaid ,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.39,37.7,,,percent of total billed charges,37.70% of total billed charges,167.39,37.7,,,percent of total billed charges,37.70% of total billed charges,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,15051.6,33.9,,,percent of total billed charges,33.9% of total billed charges,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.32,78,,,percent of total billed charges,78% of total billed charges,444,100,,,percent of total billed charges,100% of total billed charges,366.74,82.6,,,percent of total billed charges,82.6% of total billed charges,366.74,82.6,,,percent of total billed charges,82.6% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.25,15051.6,
EXCISION PILONIDAL CYST;SIMPLE,97511770,CDM,975,RC,11770,HCPCS,Outpatient,,,608,395.20,,535.04,88,,,percent of total billed charges,88% of total Billed charges,21.15,100,,,Fee Schedule,100% of Medicare rate,106.12,100,,,Fee Schedule,100% of WA Medicaid,608,100,,,percent of total billed charges,100% of total billed charges,109.3,103,,,Fee Schedule,103% of WA Medicaid,21.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,106.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,419.52,69,,,percent of total billed charges,69% of total billed charges,608,100,,,percent of total billed charges,100% of total billed charges,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,608,100,,,percent of total billed charges,100% of total billed charges,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,608,100,,,percent of total billed charges,100% of total billed charges,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.05,61.85,,,percent of total billed charges,61.85% of total billed charges,106.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,137.96,130,,,Fee Schedule,130% of WA Medicaid ,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.22,37.7,,,percent of total billed charges,37.70% of total billed charges,229.22,37.7,,,percent of total billed charges,37.70% of total billed charges,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,20611.2,33.9,,,percent of total billed charges,33.9% of total billed charges,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.24,78,,,percent of total billed charges,78% of total billed charges,608,100,,,percent of total billed charges,100% of total billed charges,502.21,82.6,,,percent of total billed charges,82.6% of total billed charges,502.21,82.6,,,percent of total billed charges,82.6% of total billed charges,106.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.15,20611.2,
EXCISION PILONIDAL CYST;EXTENS,96011771,CDM,960,RC,11771,HCPCS,Outpatient,,,1198,778.70,,1054.24,88,,,percent of total billed charges,88% of total Billed charges,49.93,100,,,Fee Schedule,100% of Medicare rate,258.86,100,,,Fee Schedule,100% of WA Medicaid,1198,100,,,percent of total billed charges,100% of total billed charges,266.63,103,,,Fee Schedule,103% of WA Medicaid,49.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,258.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,826.62,69,,,percent of total billed charges,69% of total billed charges,1198,100,,,percent of total billed charges,100% of total billed charges,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198,100,,,percent of total billed charges,100% of total billed charges,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198,100,,,percent of total billed charges,100% of total billed charges,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,740.96,61.85,,,percent of total billed charges,61.85% of total billed charges,258.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,336.52,130,,,Fee Schedule,130% of WA Medicaid ,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.65,37.7,,,percent of total billed charges,37.70% of total billed charges,451.65,37.7,,,percent of total billed charges,37.70% of total billed charges,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,40612.2,33.9,,,percent of total billed charges,33.9% of total billed charges,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,934.44,78,,,percent of total billed charges,78% of total billed charges,1198,100,,,percent of total billed charges,100% of total billed charges,989.55,82.6,,,percent of total billed charges,82.6% of total billed charges,989.55,82.6,,,percent of total billed charges,82.6% of total billed charges,258.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.93,40612.2,
EXCISION PILONIDAL CYST;COMPLI,96011772,CDM,960,RC,11772,HCPCS,Outpatient,,,1457,947.05,,1282.16,88,,,percent of total billed charges,88% of total Billed charges,60.61,100,,,Fee Schedule,100% of Medicare rate,334.02,100,,,Fee Schedule,100% of WA Medicaid,1457,100,,,percent of total billed charges,100% of total billed charges,344.04,103,,,Fee Schedule,103% of WA Medicaid,60.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,106.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,334.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1005.33,69,,,percent of total billed charges,69% of total billed charges,1457,100,,,percent of total billed charges,100% of total billed charges,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457,100,,,percent of total billed charges,100% of total billed charges,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457,100,,,percent of total billed charges,100% of total billed charges,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,901.15,61.85,,,percent of total billed charges,61.85% of total billed charges,334.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,434.23,130,,,Fee Schedule,130% of WA Medicaid ,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.29,37.7,,,percent of total billed charges,37.70% of total billed charges,549.29,37.7,,,percent of total billed charges,37.70% of total billed charges,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,49392.3,33.9,,,percent of total billed charges,33.9% of total billed charges,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1136.46,78,,,percent of total billed charges,78% of total billed charges,1457,100,,,percent of total billed charges,100% of total billed charges,1203.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1203.48,82.6,,,percent of total billed charges,82.6% of total billed charges,334.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.61,49392.3,
"11900 INJECTION, INTRALESIONAL; UP TO AND INCLUDING 7 LESION",97511900,CDM,975,RC,11900,HCPCS,Outpatient,,,127,82.55,,111.76,88,,,percent of total billed charges,88% of total Billed charges,2.45,100,,,Fee Schedule,100% of Medicare rate,16.97,100,,,Fee Schedule,100% of WA Medicaid,127,100,,,percent of total billed charges,100% of total billed charges,17.48,103,,,Fee Schedule,103% of WA Medicaid,2.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,87.63,69,,,percent of total billed charges,69% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,127,100,,,percent of total billed charges,100% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,127,100,,,percent of total billed charges,100% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.55,61.85,,,percent of total billed charges,61.85% of total billed charges,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.06,130,,,Fee Schedule,130% of WA Medicaid ,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.88,37.7,,,percent of total billed charges,37.70% of total billed charges,47.88,37.7,,,percent of total billed charges,37.70% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,4305.3,33.9,,,percent of total billed charges,33.9% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.06,78,,,percent of total billed charges,78% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.45,4305.3,
11971 REMOVAL OF TISSUE EXPANDER(S) WITHOUT INSERTION OF PRO,97511971,CDM,975,RC,11971,HCPCS,Outpatient,,,676,439.40,,594.88,88,,,percent of total billed charges,88% of total Billed charges,50.52,100,,,Fee Schedule,100% of Medicare rate,319.85,100,,,Fee Schedule,100% of WA Medicaid,676,100,,,percent of total billed charges,100% of total billed charges,329.45,103,,,Fee Schedule,103% of WA Medicaid,50.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,88.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,319.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,466.44,69,,,percent of total billed charges,69% of total billed charges,676,100,,,percent of total billed charges,100% of total billed charges,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,676,100,,,percent of total billed charges,100% of total billed charges,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,676,100,,,percent of total billed charges,100% of total billed charges,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.11,61.85,,,percent of total billed charges,61.85% of total billed charges,319.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,415.81,130,,,Fee Schedule,130% of WA Medicaid ,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.85,37.7,,,percent of total billed charges,37.70% of total billed charges,254.85,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,22916.4,33.9,,,percent of total billed charges,33.9% of total billed charges,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.28,78,,,percent of total billed charges,78% of total billed charges,676,100,,,percent of total billed charges,100% of total billed charges,558.38,82.6,,,percent of total billed charges,82.6% of total billed charges,558.38,82.6,,,percent of total billed charges,82.6% of total billed charges,319.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.52,22916.4,
"11982 REMOVAL, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT ProFe",97511982,CDM,975,RC,11982,HCPCS,Outpatient,,,484,314.60,,425.92,88,,,percent of total billed charges,88% of total Billed charges,8.39,100,,,Fee Schedule,100% of Medicare rate,40.84,100,,,Fee Schedule,100% of WA Medicaid,484,100,,,percent of total billed charges,100% of total billed charges,42.07,103,,,Fee Schedule,103% of WA Medicaid,8.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,333.96,69,,,percent of total billed charges,69% of total billed charges,484,100,,,percent of total billed charges,100% of total billed charges,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,484,100,,,percent of total billed charges,100% of total billed charges,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,484,100,,,percent of total billed charges,100% of total billed charges,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.35,61.85,,,percent of total billed charges,61.85% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.09,130,,,Fee Schedule,130% of WA Medicaid ,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.47,37.7,,,percent of total billed charges,37.70% of total billed charges,182.47,37.7,,,percent of total billed charges,37.70% of total billed charges,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,16407.6,33.9,,,percent of total billed charges,33.9% of total billed charges,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.52,78,,,percent of total billed charges,78% of total billed charges,484,100,,,percent of total billed charges,100% of total billed charges,399.78,82.6,,,percent of total billed charges,82.6% of total billed charges,399.78,82.6,,,percent of total billed charges,82.6% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,16407.6,
SIMPLE REPAIR OF SF WOUND <2.5,96012001,CDM,960,RC,12001,HCPCS,Outpatient,,,190,123.50,,167.2,88,,,percent of total billed charges,88% of total Billed charges,5.48,100,,,Fee Schedule,100% of Medicare rate,24.99,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,25.74,103,,,Fee Schedule,103% of WA Medicaid,5.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,24.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.52,61.85,,,percent of total billed charges,61.85% of total billed charges,24.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.49,130,,,Fee Schedule,130% of WA Medicaid ,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,6441,33.9,,,percent of total billed charges,33.9% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,24.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.48,6441,
"SIMP REP SCALP,NECK,AXIL,EXT G",96012002,CDM,960,RC,12002,HCPCS,Outpatient,,,231,150.15,,203.28,88,,,percent of total billed charges,88% of total Billed charges,7.44,100,,,Fee Schedule,100% of Medicare rate,32.82,100,,,Fee Schedule,100% of WA Medicaid,231,100,,,percent of total billed charges,100% of total billed charges,33.8,103,,,Fee Schedule,103% of WA Medicaid,7.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,159.39,69,,,percent of total billed charges,69% of total billed charges,231,100,,,percent of total billed charges,100% of total billed charges,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,231,100,,,percent of total billed charges,100% of total billed charges,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,231,100,,,percent of total billed charges,100% of total billed charges,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.87,61.85,,,percent of total billed charges,61.85% of total billed charges,32.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.67,130,,,Fee Schedule,130% of WA Medicaid ,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.09,37.7,,,percent of total billed charges,37.70% of total billed charges,87.09,37.7,,,percent of total billed charges,37.70% of total billed charges,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,7830.9,33.9,,,percent of total billed charges,33.9% of total billed charges,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.18,78,,,percent of total billed charges,78% of total billed charges,231,100,,,percent of total billed charges,100% of total billed charges,190.81,82.6,,,percent of total billed charges,82.6% of total billed charges,190.81,82.6,,,percent of total billed charges,82.6% of total billed charges,32.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.44,7830.9,
REPAIR SIMPLE,96012004,CDM,960,RC,12004,HCPCS,Outpatient,,,282,183.30,,248.16,88,,,percent of total billed charges,88% of total Billed charges,9.69,100,,,Fee Schedule,100% of Medicare rate,40.84,100,,,Fee Schedule,100% of WA Medicaid,282,100,,,percent of total billed charges,100% of total billed charges,42.07,103,,,Fee Schedule,103% of WA Medicaid,9.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,194.58,69,,,percent of total billed charges,69% of total billed charges,282,100,,,percent of total billed charges,100% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,282,100,,,percent of total billed charges,100% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,282,100,,,percent of total billed charges,100% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.42,61.85,,,percent of total billed charges,61.85% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.09,130,,,Fee Schedule,130% of WA Medicaid ,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.31,37.7,,,percent of total billed charges,37.70% of total billed charges,106.31,37.7,,,percent of total billed charges,37.70% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,9559.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.96,78,,,percent of total billed charges,78% of total billed charges,282,100,,,percent of total billed charges,100% of total billed charges,232.93,82.6,,,percent of total billed charges,82.6% of total billed charges,232.93,82.6,,,percent of total billed charges,82.6% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.69,9559.8,
"12005 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AX",97512005,CDM,975,RC,12005,HCPCS,Outpatient,,,451,293.15,,396.88,88,,,percent of total billed charges,88% of total Billed charges,13.15,100,,,Fee Schedule,100% of Medicare rate,52.41,100,,,Fee Schedule,100% of WA Medicaid,451,100,,,percent of total billed charges,100% of total billed charges,53.98,103,,,Fee Schedule,103% of WA Medicaid,13.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,52.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,311.19,69,,,percent of total billed charges,69% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,451,100,,,percent of total billed charges,100% of total billed charges,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,451,100,,,percent of total billed charges,100% of total billed charges,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.94,61.85,,,percent of total billed charges,61.85% of total billed charges,52.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.13,130,,,Fee Schedule,130% of WA Medicaid ,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,15288.9,33.9,,,percent of total billed charges,33.9% of total billed charges,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.78,78,,,percent of total billed charges,78% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,52.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.15,15288.9,
LACERATION SIMPLE < 2.5CM FACE,96012011,CDM,960,RC,12011,HCPCS,Outpatient,,,133,86.45,,117.04,88,,,percent of total billed charges,88% of total Billed charges,7.09,100,,,Fee Schedule,100% of Medicare rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,133,100,,,percent of total billed charges,100% of total billed charges,31.89,103,,,Fee Schedule,103% of WA Medicaid,7.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,91.77,69,,,percent of total billed charges,69% of total billed charges,133,100,,,percent of total billed charges,100% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,133,100,,,percent of total billed charges,100% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,133,100,,,percent of total billed charges,100% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.26,61.85,,,percent of total billed charges,61.85% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.25,130,,,Fee Schedule,130% of WA Medicaid ,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.14,37.7,,,percent of total billed charges,37.70% of total billed charges,50.14,37.7,,,percent of total billed charges,37.70% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4508.7,33.9,,,percent of total billed charges,33.9% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.74,78,,,percent of total billed charges,78% of total billed charges,133,100,,,percent of total billed charges,100% of total billed charges,109.86,82.6,,,percent of total billed charges,82.6% of total billed charges,109.86,82.6,,,percent of total billed charges,82.6% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.09,4508.7,
RPR F/E/E/N/L/M 2.6-5.0 CM,96012013,CDM,960,RC,12013,HCPCS,Outpatient,,,243,157.95,,213.84,88,,,percent of total billed charges,88% of total Billed charges,7.92,100,,,Fee Schedule,100% of Medicare rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,243,100,,,percent of total billed charges,100% of total billed charges,33.04,103,,,Fee Schedule,103% of WA Medicaid,7.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,167.67,69,,,percent of total billed charges,69% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,243,100,,,percent of total billed charges,100% of total billed charges,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,243,100,,,percent of total billed charges,100% of total billed charges,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.3,61.85,,,percent of total billed charges,61.85% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.7,130,,,Fee Schedule,130% of WA Medicaid ,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,8237.7,33.9,,,percent of total billed charges,33.9% of total billed charges,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.54,78,,,percent of total billed charges,78% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,8,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.92,8237.7,
REPAIR INTERMEDIATE,97512031,CDM,975,RC,12031,HCPCS,Outpatient,,,519,337.35,,456.72,88,,,percent of total billed charges,88% of total Billed charges,11.08,100,,,Fee Schedule,100% of Medicare rate,87.47,100,,,Fee Schedule,100% of WA Medicaid,519,100,,,percent of total billed charges,100% of total billed charges,90.09,103,,,Fee Schedule,103% of WA Medicaid,11.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,87.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,358.11,69,,,percent of total billed charges,69% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,519,100,,,percent of total billed charges,100% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,519,100,,,percent of total billed charges,100% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,321,61.85,,,percent of total billed charges,61.85% of total billed charges,87.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,113.71,130,,,Fee Schedule,130% of WA Medicaid ,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,17594.1,33.9,,,percent of total billed charges,33.9% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.82,78,,,percent of total billed charges,78% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,87.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.08,17594.1,
REPAIR INTERMED 2.6-7.5CM,96012032,CDM,975,RC,12032,HCPCS,Outpatient,,,636,413.40,,559.68,88,,,percent of total billed charges,88% of total Billed charges,13.29,100,,,Fee Schedule,100% of Medicare rate,110.04,100,,,Fee Schedule,100% of WA Medicaid,636,100,,,percent of total billed charges,100% of total billed charges,113.34,103,,,Fee Schedule,103% of WA Medicaid,13.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,110.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,438.84,69,,,percent of total billed charges,69% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,636,100,,,percent of total billed charges,100% of total billed charges,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,636,100,,,percent of total billed charges,100% of total billed charges,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.37,61.85,,,percent of total billed charges,61.85% of total billed charges,110.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,143.05,130,,,Fee Schedule,130% of WA Medicaid ,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,21560.4,33.9,,,percent of total billed charges,33.9% of total billed charges,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.08,78,,,percent of total billed charges,78% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,110.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.29,21560.4,
REPAIR INTERMEDS/A/T/E12.60-20,96012035,CDM,960,RC,12035,HCPCS,Outpatient,,,530,344.50,,466.4,88,,,percent of total billed charges,88% of total Billed charges,23.6,100,,,Fee Schedule,100% of Medicare rate,137.82,100,,,Fee Schedule,100% of WA Medicaid,530,100,,,percent of total billed charges,100% of total billed charges,141.95,103,,,Fee Schedule,103% of WA Medicaid,23.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,137.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,365.7,69,,,percent of total billed charges,69% of total billed charges,530,100,,,percent of total billed charges,100% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,530,100,,,percent of total billed charges,100% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,530,100,,,percent of total billed charges,100% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.81,61.85,,,percent of total billed charges,61.85% of total billed charges,137.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,179.17,130,,,Fee Schedule,130% of WA Medicaid ,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.81,37.7,,,percent of total billed charges,37.70% of total billed charges,199.81,37.7,,,percent of total billed charges,37.70% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,17967,33.9,,,percent of total billed charges,33.9% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.4,78,,,percent of total billed charges,78% of total billed charges,530,100,,,percent of total billed charges,100% of total billed charges,437.78,82.6,,,percent of total billed charges,82.6% of total billed charges,437.78,82.6,,,percent of total billed charges,82.6% of total billed charges,137.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.6,17967,
LAYER CLSR OF WOUND 20.1-30cm,96012036,CDM,960,RC,12036,HCPCS,Outpatient,,,1072,696.80,,943.36,88,,,percent of total billed charges,88% of total Billed charges,31.28,100,,,Fee Schedule,100% of Medicare rate,160.39,100,,,Fee Schedule,100% of WA Medicaid,1072,100,,,percent of total billed charges,100% of total billed charges,165.2,103,,,Fee Schedule,103% of WA Medicaid,31.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,160.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,739.68,69,,,percent of total billed charges,69% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1072,100,,,percent of total billed charges,100% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1072,100,,,percent of total billed charges,100% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.03,61.85,,,percent of total billed charges,61.85% of total billed charges,160.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,208.51,130,,,Fee Schedule,130% of WA Medicaid ,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,36340.8,33.9,,,percent of total billed charges,33.9% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,836.16,78,,,percent of total billed charges,78% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,160.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.28,36340.8,
"REP WND NECK,HAND,FEET,GEN<2.5",96012041,CDM,960,RC,12041,HCPCS,Outpatient,,,528,343.20,,464.64,88,,,percent of total billed charges,88% of total Billed charges,11.13,100,,,Fee Schedule,100% of Medicare rate,83.55,100,,,Fee Schedule,100% of WA Medicaid,528,100,,,percent of total billed charges,100% of total billed charges,86.06,103,,,Fee Schedule,103% of WA Medicaid,11.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,83.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,364.32,69,,,percent of total billed charges,69% of total billed charges,528,100,,,percent of total billed charges,100% of total billed charges,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,528,100,,,percent of total billed charges,100% of total billed charges,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,528,100,,,percent of total billed charges,100% of total billed charges,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.57,61.85,,,percent of total billed charges,61.85% of total billed charges,83.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,108.62,130,,,Fee Schedule,130% of WA Medicaid ,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.06,37.7,,,percent of total billed charges,37.70% of total billed charges,199.06,37.7,,,percent of total billed charges,37.70% of total billed charges,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,17899.2,33.9,,,percent of total billed charges,33.9% of total billed charges,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.84,78,,,percent of total billed charges,78% of total billed charges,528,100,,,percent of total billed charges,100% of total billed charges,436.13,82.6,,,percent of total billed charges,82.6% of total billed charges,436.13,82.6,,,percent of total billed charges,82.6% of total billed charges,83.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.13,17899.2,
REPAIR WOUND;2.6-7.5CM,96012042,CDM,960,RC,12042,HCPCS,Outpatient,,,630,409.50,,554.4,88,,,percent of total billed charges,88% of total Billed charges,14.48,100,,,Fee Schedule,100% of Medicare rate,112.65,100,,,Fee Schedule,100% of WA Medicaid,630,100,,,percent of total billed charges,100% of total billed charges,116.03,103,,,Fee Schedule,103% of WA Medicaid,14.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,434.7,69,,,percent of total billed charges,69% of total billed charges,630,100,,,percent of total billed charges,100% of total billed charges,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,630,100,,,percent of total billed charges,100% of total billed charges,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,630,100,,,percent of total billed charges,100% of total billed charges,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.66,61.85,,,percent of total billed charges,61.85% of total billed charges,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,146.45,130,,,Fee Schedule,130% of WA Medicaid ,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.51,37.7,,,percent of total billed charges,37.70% of total billed charges,237.51,37.7,,,percent of total billed charges,37.70% of total billed charges,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,21357,33.9,,,percent of total billed charges,33.9% of total billed charges,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.4,78,,,percent of total billed charges,78% of total billed charges,630,100,,,percent of total billed charges,100% of total billed charges,520.38,82.6,,,percent of total billed charges,82.6% of total billed charges,520.38,82.6,,,percent of total billed charges,82.6% of total billed charges,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.48,21357,
REPAIR WOUNDS FACE,96012051,CDM,960,RC,12051,HCPCS,Outpatient,,,508,330.20,,447.04,88,,,percent of total billed charges,88% of total Billed charges,13.17,100,,,Fee Schedule,100% of Medicare rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,508,100,,,percent of total billed charges,100% of total billed charges,100.47,103,,,Fee Schedule,103% of WA Medicaid,13.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,350.52,69,,,percent of total billed charges,69% of total billed charges,508,100,,,percent of total billed charges,100% of total billed charges,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,508,100,,,percent of total billed charges,100% of total billed charges,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,508,100,,,percent of total billed charges,100% of total billed charges,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.2,61.85,,,percent of total billed charges,61.85% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.8,130,,,Fee Schedule,130% of WA Medicaid ,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.52,37.7,,,percent of total billed charges,37.70% of total billed charges,191.52,37.7,,,percent of total billed charges,37.70% of total billed charges,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,17221.2,33.9,,,percent of total billed charges,33.9% of total billed charges,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.24,78,,,percent of total billed charges,78% of total billed charges,508,100,,,percent of total billed charges,100% of total billed charges,419.61,82.6,,,percent of total billed charges,82.6% of total billed charges,419.61,82.6,,,percent of total billed charges,82.6% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.17,17221.2,
REPAIR WOUND;FACE,97512052,CDM,975,RC,12052,HCPCS,Outpatient,,,727,472.55,,639.76,88,,,percent of total billed charges,88% of total Billed charges,15.11,100,,,Fee Schedule,100% of Medicare rate,114.7,100,,,Fee Schedule,100% of WA Medicaid,727,100,,,percent of total billed charges,100% of total billed charges,118.14,103,,,Fee Schedule,103% of WA Medicaid,15.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,114.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,501.63,69,,,percent of total billed charges,69% of total billed charges,727,100,,,percent of total billed charges,100% of total billed charges,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,727,100,,,percent of total billed charges,100% of total billed charges,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,727,100,,,percent of total billed charges,100% of total billed charges,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.65,61.85,,,percent of total billed charges,61.85% of total billed charges,114.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,149.11,130,,,Fee Schedule,130% of WA Medicaid ,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.08,37.7,,,percent of total billed charges,37.70% of total billed charges,274.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,24645.3,33.9,,,percent of total billed charges,33.9% of total billed charges,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.06,78,,,percent of total billed charges,78% of total billed charges,727,100,,,percent of total billed charges,100% of total billed charges,600.5,82.6,,,percent of total billed charges,82.6% of total billed charges,600.5,82.6,,,percent of total billed charges,82.6% of total billed charges,114.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.11,24645.3,
REP LAC 5.1cm-7.5cm,96012053,CDM,975,RC,12053,HCPCS,Outpatient,,,756,491.40,,665.28,88,,,percent of total billed charges,88% of total Billed charges,16.87,100,,,Fee Schedule,100% of Medicare rate,123.46,100,,,Fee Schedule,100% of WA Medicaid,756,100,,,percent of total billed charges,100% of total billed charges,127.16,103,,,Fee Schedule,103% of WA Medicaid,16.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,123.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,521.64,69,,,percent of total billed charges,69% of total billed charges,756,100,,,percent of total billed charges,100% of total billed charges,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,756,100,,,percent of total billed charges,100% of total billed charges,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,756,100,,,percent of total billed charges,100% of total billed charges,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,467.59,61.85,,,percent of total billed charges,61.85% of total billed charges,123.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,160.5,130,,,Fee Schedule,130% of WA Medicaid ,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.01,37.7,,,percent of total billed charges,37.70% of total billed charges,285.01,37.7,,,percent of total billed charges,37.70% of total billed charges,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,25628.4,33.9,,,percent of total billed charges,33.9% of total billed charges,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,589.68,78,,,percent of total billed charges,78% of total billed charges,756,100,,,percent of total billed charges,100% of total billed charges,624.46,82.6,,,percent of total billed charges,82.6% of total billed charges,624.46,82.6,,,percent of total billed charges,82.6% of total billed charges,123.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.87,25628.4,
REP INTMD 7.6-12.5CM WOUND,96012054,CDM,960,RC,12054,HCPCS,Outpatient,,,728,473.20,,640.64,88,,,percent of total billed charges,88% of total Billed charges,20.1,100,,,Fee Schedule,100% of Medicare rate,125.33,100,,,Fee Schedule,100% of WA Medicaid,728,100,,,percent of total billed charges,100% of total billed charges,129.09,103,,,Fee Schedule,103% of WA Medicaid,20.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,125.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,502.32,69,,,percent of total billed charges,69% of total billed charges,728,100,,,percent of total billed charges,100% of total billed charges,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,728,100,,,percent of total billed charges,100% of total billed charges,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,728,100,,,percent of total billed charges,100% of total billed charges,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.27,61.85,,,percent of total billed charges,61.85% of total billed charges,125.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,162.93,130,,,Fee Schedule,130% of WA Medicaid ,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.46,37.7,,,percent of total billed charges,37.70% of total billed charges,274.46,37.7,,,percent of total billed charges,37.70% of total billed charges,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,24679.2,33.9,,,percent of total billed charges,33.9% of total billed charges,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.84,78,,,percent of total billed charges,78% of total billed charges,728,100,,,percent of total billed charges,100% of total billed charges,601.33,82.6,,,percent of total billed charges,82.6% of total billed charges,601.33,82.6,,,percent of total billed charges,82.6% of total billed charges,125.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.1,24679.2,
REPAIR COMPLEX TRUNK 2.6-7.5CM,96013101,CDM,975,RC,13101,HCPCS,Outpatient,,,868,564.20,,763.84,88,,,percent of total billed charges,88% of total Billed charges,18.33,100,,,Fee Schedule,100% of Medicare rate,141.37,100,,,Fee Schedule,100% of WA Medicaid,868,100,,,percent of total billed charges,100% of total billed charges,145.61,103,,,Fee Schedule,103% of WA Medicaid,18.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,141.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,598.92,69,,,percent of total billed charges,69% of total billed charges,868,100,,,percent of total billed charges,100% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,868,100,,,percent of total billed charges,100% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,868,100,,,percent of total billed charges,100% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,536.86,61.85,,,percent of total billed charges,61.85% of total billed charges,141.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,183.78,130,,,Fee Schedule,130% of WA Medicaid ,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.24,37.7,,,percent of total billed charges,37.70% of total billed charges,327.24,37.7,,,percent of total billed charges,37.70% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,29425.2,33.9,,,percent of total billed charges,33.9% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.04,78,,,percent of total billed charges,78% of total billed charges,868,100,,,percent of total billed charges,100% of total billed charges,716.97,82.6,,,percent of total billed charges,82.6% of total billed charges,716.97,82.6,,,percent of total billed charges,82.6% of total billed charges,141.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,29425.2,
EA ADDT'L 5CM OR LESS,96013102,CDM,960,RC,13102,HCPCS,Outpatient,,,257,167.05,,226.16,88,,,percent of total billed charges,88% of total Billed charges,7.31,100,,,Fee Schedule,100% of Medicare rate,40.28,100,,,Fee Schedule,100% of WA Medicaid,257,100,,,percent of total billed charges,100% of total billed charges,41.49,103,,,Fee Schedule,103% of WA Medicaid,7.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,177.33,69,,,percent of total billed charges,69% of total billed charges,257,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,257,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,257,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.95,61.85,,,percent of total billed charges,61.85% of total billed charges,40.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,52.36,130,,,Fee Schedule,130% of WA Medicaid ,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.89,37.7,,,percent of total billed charges,37.70% of total billed charges,96.89,37.7,,,percent of total billed charges,37.70% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,8712.3,33.9,,,percent of total billed charges,33.9% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.46,78,,,percent of total billed charges,78% of total billed charges,257,100,,,percent of total billed charges,100% of total billed charges,212.28,82.6,,,percent of total billed charges,82.6% of total billed charges,212.28,82.6,,,percent of total billed charges,82.6% of total billed charges,40.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.31,8712.3,
CMPLX RPR 2.6-7.5cm ARM/LG/SCA,96013121,CDM,960,RC,13121,HCPCS,Outpatient,,,953,619.45,,838.64,88,,,percent of total billed charges,88% of total Billed charges,19.93,100,,,Fee Schedule,100% of Medicare rate,146.96,100,,,Fee Schedule,100% of WA Medicaid,953,100,,,percent of total billed charges,100% of total billed charges,151.37,103,,,Fee Schedule,103% of WA Medicaid,19.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,146.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,657.57,69,,,percent of total billed charges,69% of total billed charges,953,100,,,percent of total billed charges,100% of total billed charges,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,953,100,,,percent of total billed charges,100% of total billed charges,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,953,100,,,percent of total billed charges,100% of total billed charges,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,589.43,61.85,,,percent of total billed charges,61.85% of total billed charges,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.05,130,,,Fee Schedule,130% of WA Medicaid ,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,32306.7,33.9,,,percent of total billed charges,33.9% of total billed charges,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,743.34,78,,,percent of total billed charges,78% of total billed charges,953,100,,,percent of total billed charges,100% of total billed charges,787.18,82.6,,,percent of total billed charges,82.6% of total billed charges,787.18,82.6,,,percent of total billed charges,82.6% of total billed charges,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.93,32306.7,
"13151 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 1.1",97513151,CDM,975,RC,13151,HCPCS,Outpatient,,,875,568.75,,770,88,,,percent of total billed charges,88% of total Billed charges,22.34,100,,,Fee Schedule,100% of Medicare rate,158.34,100,,,Fee Schedule,100% of WA Medicaid,875,100,,,percent of total billed charges,100% of total billed charges,163.09,103,,,Fee Schedule,103% of WA Medicaid,22.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,158.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,603.75,69,,,percent of total billed charges,69% of total billed charges,875,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,875,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,875,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.19,61.85,,,percent of total billed charges,61.85% of total billed charges,158.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,205.84,130,,,Fee Schedule,130% of WA Medicaid ,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.88,37.7,,,percent of total billed charges,37.70% of total billed charges,329.88,37.7,,,percent of total billed charges,37.70% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,29662.5,33.9,,,percent of total billed charges,33.9% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.5,78,,,percent of total billed charges,78% of total billed charges,875,100,,,percent of total billed charges,100% of total billed charges,722.75,82.6,,,percent of total billed charges,82.6% of total billed charges,722.75,82.6,,,percent of total billed charges,82.6% of total billed charges,158.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.34,29662.5,
CMPLX RPR E/N/E/L 2.6-7.5 CM,96013152,CDM,960,RC,13152,HCPCS,Outpatient,,,1064,691.60,,936.32,88,,,percent of total billed charges,88% of total Billed charges,27.16,100,,,Fee Schedule,100% of Medicare rate,190.6,100,,,Fee Schedule,100% of WA Medicaid,1064,100,,,percent of total billed charges,100% of total billed charges,196.32,103,,,Fee Schedule,103% of WA Medicaid,27.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,190.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,734.16,69,,,percent of total billed charges,69% of total billed charges,1064,100,,,percent of total billed charges,100% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064,100,,,percent of total billed charges,100% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064,100,,,percent of total billed charges,100% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.08,61.85,,,percent of total billed charges,61.85% of total billed charges,190.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,247.78,130,,,Fee Schedule,130% of WA Medicaid ,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.13,37.7,,,percent of total billed charges,37.70% of total billed charges,401.13,37.7,,,percent of total billed charges,37.70% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,36069.6,33.9,,,percent of total billed charges,33.9% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.92,78,,,percent of total billed charges,78% of total billed charges,1064,100,,,percent of total billed charges,100% of total billed charges,878.86,82.6,,,percent of total billed charges,82.6% of total billed charges,878.86,82.6,,,percent of total billed charges,82.6% of total billed charges,190.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.16,36069.6,
SECONDARY CLOSURE OF SURG WND,96013160,CDM,960,RC,13160,HCPCS,Outpatient,,,1865,1212.25,,1641.2,88,,,percent of total billed charges,88% of total Billed charges,77.63,100,,,Fee Schedule,100% of Medicare rate,454.31,100,,,Fee Schedule,100% of WA Medicaid,1865,100,,,percent of total billed charges,100% of total billed charges,467.94,103,,,Fee Schedule,103% of WA Medicaid,77.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,454.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1286.85,69,,,percent of total billed charges,69% of total billed charges,1865,100,,,percent of total billed charges,100% of total billed charges,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1865,100,,,percent of total billed charges,100% of total billed charges,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1865,100,,,percent of total billed charges,100% of total billed charges,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1153.5,61.85,,,percent of total billed charges,61.85% of total billed charges,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,590.6,130,,,Fee Schedule,130% of WA Medicaid ,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,703.11,37.7,,,percent of total billed charges,37.70% of total billed charges,703.11,37.7,,,percent of total billed charges,37.70% of total billed charges,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,63223.5,33.9,,,percent of total billed charges,33.9% of total billed charges,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1454.7,78,,,percent of total billed charges,78% of total billed charges,1865,100,,,percent of total billed charges,100% of total billed charges,1540.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1540.49,82.6,,,percent of total billed charges,82.6% of total billed charges,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.63,63223.5,
ADJ.TISSUE TRANS TRUNK <10SQCM,96014000,CDM,960,RC,14000,HCPCS,Outpatient,,,1312,852.80,,1154.56,88,,,percent of total billed charges,88% of total Billed charges,44.88,100,,,Fee Schedule,100% of Medicare rate,291.69,100,,,Fee Schedule,100% of WA Medicaid,1312,100,,,percent of total billed charges,100% of total billed charges,300.44,103,,,Fee Schedule,103% of WA Medicaid,44.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,291.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,905.28,69,,,percent of total billed charges,69% of total billed charges,1312,100,,,percent of total billed charges,100% of total billed charges,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1312,100,,,percent of total billed charges,100% of total billed charges,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1312,100,,,percent of total billed charges,100% of total billed charges,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.47,61.85,,,percent of total billed charges,61.85% of total billed charges,291.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,379.2,130,,,Fee Schedule,130% of WA Medicaid ,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.62,37.7,,,percent of total billed charges,37.70% of total billed charges,494.62,37.7,,,percent of total billed charges,37.70% of total billed charges,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,44476.8,33.9,,,percent of total billed charges,33.9% of total billed charges,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1023.36,78,,,percent of total billed charges,78% of total billed charges,1312,100,,,percent of total billed charges,100% of total billed charges,1083.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1083.71,82.6,,,percent of total billed charges,82.6% of total billed charges,291.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.88,44476.8,
ADJ.TISSUE TRANS TRUNK>10.1-30,96014001,CDM,960,RC,14001,HCPCS,Outpatient,,,1680,1092.00,,1478.4,88,,,percent of total billed charges,88% of total Billed charges,62.54,100,,,Fee Schedule,100% of Medicare rate,375.61,100,,,Fee Schedule,100% of WA Medicaid,1680,100,,,percent of total billed charges,100% of total billed charges,386.88,103,,,Fee Schedule,103% of WA Medicaid,62.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,375.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1159.2,69,,,percent of total billed charges,69% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1680,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1680,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1039.08,61.85,,,percent of total billed charges,61.85% of total billed charges,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,488.29,130,,,Fee Schedule,130% of WA Medicaid ,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,56952,33.9,,,percent of total billed charges,33.9% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1310.4,78,,,percent of total billed charges,78% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.54,56952,
ADJACENT TISSUE TRANSFER,96014020,CDM,960,RC,14020,HCPCS,Outpatient,,,1283,833.95,,1129.04,88,,,percent of total billed charges,88% of total Billed charges,44.48,100,,,Fee Schedule,100% of Medicare rate,328.43,100,,,Fee Schedule,100% of WA Medicaid,1283,100,,,percent of total billed charges,100% of total billed charges,338.28,103,,,Fee Schedule,103% of WA Medicaid,44.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,328.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,885.27,69,,,percent of total billed charges,69% of total billed charges,1283,100,,,percent of total billed charges,100% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1283,100,,,percent of total billed charges,100% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1283,100,,,percent of total billed charges,100% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,793.54,61.85,,,percent of total billed charges,61.85% of total billed charges,328.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,335,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,426.96,130,,,Fee Schedule,130% of WA Medicaid ,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,483.69,37.7,,,percent of total billed charges,37.70% of total billed charges,483.69,37.7,,,percent of total billed charges,37.70% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,43493.7,33.9,,,percent of total billed charges,33.9% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1000.74,78,,,percent of total billed charges,78% of total billed charges,1283,100,,,percent of total billed charges,100% of total billed charges,1059.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1059.76,82.6,,,percent of total billed charges,82.6% of total billed charges,328.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.48,43493.7,
ADJACENT TISSUE TRANS/REARRANG,96014040,CDM,960,RC,14040,HCPCS,Outpatient,,,1453,944.45,,1278.64,88,,,percent of total billed charges,88% of total Billed charges,47.97,100,,,Fee Schedule,100% of Medicare rate,359.95,100,,,Fee Schedule,100% of WA Medicaid,1453,100,,,percent of total billed charges,100% of total billed charges,370.75,103,,,Fee Schedule,103% of WA Medicaid,47.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,359.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1002.57,69,,,percent of total billed charges,69% of total billed charges,1453,100,,,percent of total billed charges,100% of total billed charges,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1453,100,,,percent of total billed charges,100% of total billed charges,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1453,100,,,percent of total billed charges,100% of total billed charges,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,898.68,61.85,,,percent of total billed charges,61.85% of total billed charges,359.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,467.94,130,,,Fee Schedule,130% of WA Medicaid ,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.78,37.7,,,percent of total billed charges,37.70% of total billed charges,547.78,37.7,,,percent of total billed charges,37.70% of total billed charges,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,49256.7,33.9,,,percent of total billed charges,33.9% of total billed charges,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1133.34,78,,,percent of total billed charges,78% of total billed charges,1453,100,,,percent of total billed charges,100% of total billed charges,1200.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1200.18,82.6,,,percent of total billed charges,82.6% of total billed charges,359.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.97,49256.7,
"14041 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, C",97514041,CDM,975,RC,14041,HCPCS,Outpatient,,,2233,1451.45,,1965.04,88,,,percent of total billed charges,88% of total Billed charges,57.82,100,,,Fee Schedule,100% of Medicare rate,438.65,100,,,Fee Schedule,100% of WA Medicaid,2233,100,,,percent of total billed charges,100% of total billed charges,451.81,103,,,Fee Schedule,103% of WA Medicaid,57.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,438.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1540.77,69,,,percent of total billed charges,69% of total billed charges,2233,100,,,percent of total billed charges,100% of total billed charges,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2233,100,,,percent of total billed charges,100% of total billed charges,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2233,100,,,percent of total billed charges,100% of total billed charges,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1381.11,61.85,,,percent of total billed charges,61.85% of total billed charges,438.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,570.25,130,,,Fee Schedule,130% of WA Medicaid ,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.84,37.7,,,percent of total billed charges,37.70% of total billed charges,841.84,37.7,,,percent of total billed charges,37.70% of total billed charges,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,75698.7,33.9,,,percent of total billed charges,33.9% of total billed charges,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1741.74,78,,,percent of total billed charges,78% of total billed charges,2233,100,,,percent of total billed charges,100% of total billed charges,1844.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1844.46,82.6,,,percent of total billed charges,82.6% of total billed charges,438.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.82,75698.7,
"14060 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, E",97514060,CDM,975,RC,14060,HCPCS,Outpatient,,,1940,1261.00,,1707.2,88,,,percent of total billed charges,88% of total Billed charges,49.73,100,,,Fee Schedule,100% of Medicare rate,383.63,100,,,Fee Schedule,100% of WA Medicaid,1940,100,,,percent of total billed charges,100% of total billed charges,395.14,103,,,Fee Schedule,103% of WA Medicaid,49.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,383.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1338.6,69,,,percent of total billed charges,69% of total billed charges,1940,100,,,percent of total billed charges,100% of total billed charges,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1940,100,,,percent of total billed charges,100% of total billed charges,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1940,100,,,percent of total billed charges,100% of total billed charges,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1199.89,61.85,,,percent of total billed charges,61.85% of total billed charges,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,498.72,130,,,Fee Schedule,130% of WA Medicaid ,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.38,37.7,,,percent of total billed charges,37.70% of total billed charges,731.38,37.7,,,percent of total billed charges,37.70% of total billed charges,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,65766,33.9,,,percent of total billed charges,33.9% of total billed charges,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1513.2,78,,,percent of total billed charges,78% of total billed charges,1940,100,,,percent of total billed charges,100% of total billed charges,1602.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1602.44,82.6,,,percent of total billed charges,82.6% of total billed charges,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.73,65766,
ADJACENT TISSUE TRANSFER,96014301,CDM,960,RC,14301,HCPCS,Outpatient,,,2271,1476.15,,1998.48,88,,,percent of total billed charges,88% of total Billed charges,79.34,100,,,Fee Schedule,100% of Medicare rate,497.21,100,,,Fee Schedule,100% of WA Medicaid,2271,100,,,percent of total billed charges,100% of total billed charges,512.13,103,,,Fee Schedule,103% of WA Medicaid,79.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,497.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1566.99,69,,,percent of total billed charges,69% of total billed charges,2271,100,,,percent of total billed charges,100% of total billed charges,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2271,100,,,percent of total billed charges,100% of total billed charges,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2271,100,,,percent of total billed charges,100% of total billed charges,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1404.61,61.85,,,percent of total billed charges,61.85% of total billed charges,497.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,646.37,130,,,Fee Schedule,130% of WA Medicaid ,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,856.17,37.7,,,percent of total billed charges,37.70% of total billed charges,856.17,37.7,,,percent of total billed charges,37.70% of total billed charges,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,76986.9,33.9,,,percent of total billed charges,33.9% of total billed charges,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1771.38,78,,,percent of total billed charges,78% of total billed charges,2271,100,,,percent of total billed charges,100% of total billed charges,1875.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1875.85,82.6,,,percent of total billed charges,82.6% of total billed charges,497.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.34,76986.9,
SURG PREP OF RECIPIENT SITE,96015002,CDM,960,RC,15002,HCPCS,Outpatient,,,728,473.20,,640.64,88,,,percent of total billed charges,88% of total Billed charges,23.63,100,,,Fee Schedule,100% of Medicare rate,123.28,100,,,Fee Schedule,100% of WA Medicaid,728,100,,,percent of total billed charges,100% of total billed charges,126.98,103,,,Fee Schedule,103% of WA Medicaid,23.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,123.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,502.32,69,,,percent of total billed charges,69% of total billed charges,728,100,,,percent of total billed charges,100% of total billed charges,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,728,100,,,percent of total billed charges,100% of total billed charges,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,728,100,,,percent of total billed charges,100% of total billed charges,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.27,61.85,,,percent of total billed charges,61.85% of total billed charges,123.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,160.26,130,,,Fee Schedule,130% of WA Medicaid ,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.46,37.7,,,percent of total billed charges,37.70% of total billed charges,274.46,37.7,,,percent of total billed charges,37.70% of total billed charges,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24679.2,33.9,,,percent of total billed charges,33.9% of total billed charges,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.84,78,,,percent of total billed charges,78% of total billed charges,728,100,,,percent of total billed charges,100% of total billed charges,601.33,82.6,,,percent of total billed charges,82.6% of total billed charges,601.33,82.6,,,percent of total billed charges,82.6% of total billed charges,123.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.63,24679.2,
SPLIT THICKNESS AUTOGRAFT,96015100,CDM,960,RC,15100,HCPCS,Outpatient,,,1813,1178.45,,1595.44,88,,,percent of total billed charges,88% of total Billed charges,71.63,100,,,Fee Schedule,100% of Medicare rate,409.93,100,,,Fee Schedule,100% of WA Medicaid,1813,100,,,percent of total billed charges,100% of total billed charges,422.23,103,,,Fee Schedule,103% of WA Medicaid,71.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,125.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,409.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1250.97,69,,,percent of total billed charges,69% of total billed charges,1813,100,,,percent of total billed charges,100% of total billed charges,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1813,100,,,percent of total billed charges,100% of total billed charges,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1813,100,,,percent of total billed charges,100% of total billed charges,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1121.34,61.85,,,percent of total billed charges,61.85% of total billed charges,409.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,532.91,130,,,Fee Schedule,130% of WA Medicaid ,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.5,37.7,,,percent of total billed charges,37.70% of total billed charges,683.5,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,61460.7,33.9,,,percent of total billed charges,33.9% of total billed charges,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1414.14,78,,,percent of total billed charges,78% of total billed charges,1813,100,,,percent of total billed charges,100% of total billed charges,1497.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1497.54,82.6,,,percent of total billed charges,82.6% of total billed charges,409.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.63,61460.7,
SPLIT THICKNESS AUTOGRAFT 100<,96015120,CDM,960,RC,15120,HCPCS,Outpatient,,,1102,716.30,,969.76,88,,,percent of total billed charges,88% of total Billed charges,64.13,100,,,Fee Schedule,100% of Medicare rate,395.38,100,,,Fee Schedule,100% of WA Medicaid,1102,100,,,percent of total billed charges,100% of total billed charges,407.24,103,,,Fee Schedule,103% of WA Medicaid,64.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,395.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,760.38,69,,,percent of total billed charges,69% of total billed charges,1102,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1102,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1102,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,681.59,61.85,,,percent of total billed charges,61.85% of total billed charges,395.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,513.99,130,,,Fee Schedule,130% of WA Medicaid ,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.45,37.7,,,percent of total billed charges,37.70% of total billed charges,415.45,37.7,,,percent of total billed charges,37.70% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,37357.8,33.9,,,percent of total billed charges,33.9% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.56,78,,,percent of total billed charges,78% of total billed charges,1102,100,,,percent of total billed charges,100% of total billed charges,910.25,82.6,,,percent of total billed charges,82.6% of total billed charges,910.25,82.6,,,percent of total billed charges,82.6% of total billed charges,395.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.13,37357.8,
DERMAL AUTOGRAFT TRUNK EXTR 1%,96015130,CDM,960,RC,15130,HCPCS,Outpatient,,,1219,792.35,,1072.72,88,,,percent of total billed charges,88% of total Billed charges,54.15,100,,,Fee Schedule,100% of Medicare rate,344.47,100,,,Fee Schedule,100% of WA Medicaid,1219,100,,,percent of total billed charges,100% of total billed charges,354.8,103,,,Fee Schedule,103% of WA Medicaid,54.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,344.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,841.11,69,,,percent of total billed charges,69% of total billed charges,1219,100,,,percent of total billed charges,100% of total billed charges,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1219,100,,,percent of total billed charges,100% of total billed charges,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1219,100,,,percent of total billed charges,100% of total billed charges,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,753.95,61.85,,,percent of total billed charges,61.85% of total billed charges,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,447.81,130,,,Fee Schedule,130% of WA Medicaid ,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.56,37.7,,,percent of total billed charges,37.70% of total billed charges,459.56,37.7,,,percent of total billed charges,37.70% of total billed charges,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,41324.1,33.9,,,percent of total billed charges,33.9% of total billed charges,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,950.82,78,,,percent of total billed charges,78% of total billed charges,1219,100,,,percent of total billed charges,100% of total billed charges,1006.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1006.89,82.6,,,percent of total billed charges,82.6% of total billed charges,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.15,41324.1,
FULL THICKNESS GRAFT,96015240,CDM,960,RC,15240,HCPCS,Outpatient,,,1971,1281.15,,1734.48,88,,,percent of total billed charges,88% of total Billed charges,61.53,100,,,Fee Schedule,100% of Medicare rate,460.47,100,,,Fee Schedule,100% of WA Medicaid,1971,100,,,percent of total billed charges,100% of total billed charges,474.28,103,,,Fee Schedule,103% of WA Medicaid,61.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,107.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,460.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1359.99,69,,,percent of total billed charges,69% of total billed charges,1971,100,,,percent of total billed charges,100% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1971,100,,,percent of total billed charges,100% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1971,100,,,percent of total billed charges,100% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1219.06,61.85,,,percent of total billed charges,61.85% of total billed charges,460.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,598.61,130,,,Fee Schedule,130% of WA Medicaid ,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,743.07,37.7,,,percent of total billed charges,37.70% of total billed charges,743.07,37.7,,,percent of total billed charges,37.70% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,66816.9,33.9,,,percent of total billed charges,33.9% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1537.38,78,,,percent of total billed charges,78% of total billed charges,1971,100,,,percent of total billed charges,100% of total billed charges,1628.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1628.05,82.6,,,percent of total billed charges,82.6% of total billed charges,460.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.53,66816.9,
"15260 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT",97515260,CDM,975,RC,15260,HCPCS,Outpatient,,,1295,841.75,,1139.6,88,,,percent of total billed charges,88% of total Billed charges,61.69,100,,,Fee Schedule,100% of Medicare rate,487.88,100,,,Fee Schedule,100% of WA Medicaid,1295,100,,,percent of total billed charges,100% of total billed charges,502.52,103,,,Fee Schedule,103% of WA Medicaid,61.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,107.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,487.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,893.55,69,,,percent of total billed charges,69% of total billed charges,1295,100,,,percent of total billed charges,100% of total billed charges,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1295,100,,,percent of total billed charges,100% of total billed charges,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1295,100,,,percent of total billed charges,100% of total billed charges,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,800.96,61.85,,,percent of total billed charges,61.85% of total billed charges,487.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,634.24,130,,,Fee Schedule,130% of WA Medicaid ,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.22,37.7,,,percent of total billed charges,37.70% of total billed charges,488.22,37.7,,,percent of total billed charges,37.70% of total billed charges,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,43900.5,33.9,,,percent of total billed charges,33.9% of total billed charges,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1010.1,78,,,percent of total billed charges,78% of total billed charges,1295,100,,,percent of total billed charges,100% of total billed charges,1069.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1069.67,82.6,,,percent of total billed charges,82.6% of total billed charges,487.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.69,43900.5,
APP SKIN SUB GRAFT TRUNK 100,96015271,CDM,960,RC,15271,HCPCS,Outpatient,,,291,189.15,,256.08,88,,,percent of total billed charges,88% of total Billed charges,8.2,100,,,Fee Schedule,100% of Medicare rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,291,100,,,percent of total billed charges,100% of total billed charges,48.6,103,,,Fee Schedule,103% of WA Medicaid,8.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,200.79,69,,,percent of total billed charges,69% of total billed charges,291,100,,,percent of total billed charges,100% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,291,100,,,percent of total billed charges,100% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,291,100,,,percent of total billed charges,100% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.98,61.85,,,percent of total billed charges,61.85% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.33,130,,,Fee Schedule,130% of WA Medicaid ,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.71,37.7,,,percent of total billed charges,37.70% of total billed charges,109.71,37.7,,,percent of total billed charges,37.70% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,9864.9,33.9,,,percent of total billed charges,33.9% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.98,78,,,percent of total billed charges,78% of total billed charges,291,100,,,percent of total billed charges,100% of total billed charges,240.37,82.6,,,percent of total billed charges,82.6% of total billed charges,240.37,82.6,,,percent of total billed charges,82.6% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.2,9864.9,
APP SKIN SUB GRAFT TRUNK EA AD,96015272,CDM,960,RC,15272,HCPCS,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,1.79,100,,,Fee Schedule,100% of Medicare rate,9.33,100,,,Fee Schedule,100% of WA Medicaid,38,100,,,percent of total billed charges,100% of total billed charges,9.61,103,,,Fee Schedule,103% of WA Medicaid,1.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,38,100,,,percent of total billed charges,100% of total billed charges,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,38,100,,,percent of total billed charges,100% of total billed charges,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,61.85,,,percent of total billed charges,61.85% of total billed charges,9.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.13,130,,,Fee Schedule,130% of WA Medicaid ,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.33,37.7,,,percent of total billed charges,37.70% of total billed charges,14.33,37.7,,,percent of total billed charges,37.70% of total billed charges,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1288.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,9.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.79,1288.2,
APPLY SKIN SUB FEET 1ST 25SQCM,96015275,CDM,960,RC,15275,HCPCS,Outpatient,,,323,209.95,,284.24,88,,,percent of total billed charges,88% of total Billed charges,7.7,100,,,Fee Schedule,100% of Medicare rate,52.41,100,,,Fee Schedule,100% of WA Medicaid,323,100,,,percent of total billed charges,100% of total billed charges,53.98,103,,,Fee Schedule,103% of WA Medicaid,7.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,52.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,222.87,69,,,percent of total billed charges,69% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,323,100,,,percent of total billed charges,100% of total billed charges,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,323,100,,,percent of total billed charges,100% of total billed charges,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.78,61.85,,,percent of total billed charges,61.85% of total billed charges,52.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.13,130,,,Fee Schedule,130% of WA Medicaid ,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,10949.7,33.9,,,percent of total billed charges,33.9% of total billed charges,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.94,78,,,percent of total billed charges,78% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,52.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.7,10949.7,
WOUND RECONST/SKIN FLAP TRUNK,96015734,CDM,960,RC,15734,HCPCS,Outpatient,,,3165,2057.25,,2785.2,88,,,percent of total billed charges,88% of total Billed charges,173.99,100,,,Fee Schedule,100% of Medicare rate,849.88,100,,,Fee Schedule,100% of WA Medicaid,3165,100,,,percent of total billed charges,100% of total billed charges,875.38,103,,,Fee Schedule,103% of WA Medicaid,173.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,304.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,849.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2183.85,69,,,percent of total billed charges,69% of total billed charges,3165,100,,,percent of total billed charges,100% of total billed charges,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3165,100,,,percent of total billed charges,100% of total billed charges,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3165,100,,,percent of total billed charges,100% of total billed charges,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1957.55,61.85,,,percent of total billed charges,61.85% of total billed charges,849.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,849.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,866.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1104.84,130,,,Fee Schedule,130% of WA Medicaid ,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193.21,37.7,,,percent of total billed charges,37.70% of total billed charges,1193.21,37.7,,,percent of total billed charges,37.70% of total billed charges,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,107293.5,33.9,,,percent of total billed charges,33.9% of total billed charges,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2468.7,78,,,percent of total billed charges,78% of total billed charges,3165,100,,,percent of total billed charges,100% of total billed charges,2614.29,82.6,,,percent of total billed charges,82.6% of total billed charges,2614.29,82.6,,,percent of total billed charges,82.6% of total billed charges,849.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,849.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,173.99,107293.5,
15769 GRFG AUTOL SOFT TISS DIR EXC PRO,97515769,CDM,975,RC,15769,HCPCS,Outpatient,,,3092,2009.80,,2720.96,88,,,percent of total billed charges,88% of total Billed charges,47.21,100,,,Fee Schedule,100% of Medicare rate,276.21,100,,,Fee Schedule,100% of WA Medicaid,3092,100,,,percent of total billed charges,100% of total billed charges,284.5,103,,,Fee Schedule,103% of WA Medicaid,47.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,82.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,276.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2133.48,69,,,percent of total billed charges,69% of total billed charges,3092,100,,,percent of total billed charges,100% of total billed charges,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3092,100,,,percent of total billed charges,100% of total billed charges,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3092,100,,,percent of total billed charges,100% of total billed charges,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1912.4,61.85,,,percent of total billed charges,61.85% of total billed charges,276.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,359.07,130,,,Fee Schedule,130% of WA Medicaid ,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1165.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1165.68,37.7,,,percent of total billed charges,37.70% of total billed charges,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,104818.8,33.9,,,percent of total billed charges,33.9% of total billed charges,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2411.76,78,,,percent of total billed charges,78% of total billed charges,3092,100,,,percent of total billed charges,100% of total billed charges,2553.99,82.6,,,percent of total billed charges,82.6% of total billed charges,2553.99,82.6,,,percent of total billed charges,82.6% of total billed charges,276.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.21,104818.8,
BLEPHAROPLASTY LOWER EYELID,15820,CDM,975,RC,15820,HCPCS,Outpatient,,,1033,671.45,,909.04,88,,,percent of total billed charges,88% of total Billed charges,28.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1033,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,28.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,712.77,69,,,percent of total billed charges,69% of total billed charges,1033,100,,,percent of total billed charges,100% of total billed charges,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1033,100,,,percent of total billed charges,100% of total billed charges,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1033,100,,,percent of total billed charges,100% of total billed charges,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,638.91,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.44,37.7,,,percent of total billed charges,37.70% of total billed charges,389.44,37.7,,,percent of total billed charges,37.70% of total billed charges,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,35018.7,33.9,,,percent of total billed charges,33.9% of total billed charges,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,805.74,78,,,percent of total billed charges,78% of total billed charges,1033,100,,,percent of total billed charges,100% of total billed charges,853.26,82.6,,,percent of total billed charges,82.6% of total billed charges,853.26,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",28.48,35018.7,
"15821 BLEPHAROPLASTY, LOWER EYELID; WITH EXTENSIVE HERNIATED",97515821,CDM,975,RC,15821,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",33.39,58.43,
BLEPHAROPLASTY UPPER EYELID PROFEE,15822,CDM,975,RC,15822,HCPCS,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,25.68,100,,,Fee Schedule,100% of Medicare rate,232.57,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,239.55,103,,,Fee Schedule,103% of WA Medicaid,25.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,232.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,232.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,302.34,130,,,Fee Schedule,130% of WA Medicaid ,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,30510,33.9,,,percent of total billed charges,33.9% of total billed charges,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,232.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.68,30510,
"15823 BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN WEIG",97515823,CDM,975,RC,15823,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,32.11,100,,,Fee Schedule,100% of Medicare rate,320.59,100,,,Fee Schedule,100% of WA Medicaid,1300,100,,,percent of total billed charges,100% of total billed charges,330.21,103,,,Fee Schedule,103% of WA Medicaid,32.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,320.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,320.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,327,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,416.77,130,,,Fee Schedule,130% of WA Medicaid ,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,44070,33.9,,,percent of total billed charges,33.9% of total billed charges,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,320.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.11,44070,
RHYTICEDTOMY NECK WITH PLATSYMAL FLAP,15825,CDM,975,RC,15825,HCPCS,Outpatient,,,1957,1272.05,,1722.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1957,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1350.33,69,,,percent of total billed charges,69% of total billed charges,1957,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1957,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1957,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1210.4,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,737.79,37.7,,,percent of total billed charges,37.70% of total billed charges,737.79,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,66342.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1526.46,78,,,percent of total billed charges,78% of total billed charges,1957,100,,,percent of total billed charges,100% of total billed charges,1616.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1616.48,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",737.79,66342.3,
RHYTIDECTOMY CHEEK CHIN AND NECK,97515828,CDM,975,RC,15828,HCPCS,Outpatient,,,5926,3851.90,,5214.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5926,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,4088.94,69,,,percent of total billed charges,69% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5926,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5926,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3665.23,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2234.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,200891.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,4622.28,78,,,percent of total billed charges,78% of total billed charges,5926,100,,,percent of total billed charges,100% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,4894.88,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",2234.1,200891.4,
"15830 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TI",97515830,CDM,975,RC,15830,HCPCS,Outpatient,,,2306,1498.90,,2029.28,88,,,percent of total billed charges,88% of total Billed charges,122.86,100,,,Fee Schedule,100% of Medicare rate,668.23,100,,,Fee Schedule,100% of WA Medicaid,2306,100,,,percent of total billed charges,100% of total billed charges,688.28,103,,,Fee Schedule,103% of WA Medicaid,122.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,215.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,668.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1591.14,69,,,percent of total billed charges,69% of total billed charges,2306,100,,,percent of total billed charges,100% of total billed charges,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2306,100,,,percent of total billed charges,100% of total billed charges,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2306,100,,,percent of total billed charges,100% of total billed charges,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1426.26,61.85,,,percent of total billed charges,61.85% of total billed charges,668.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,681.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,868.7,130,,,Fee Schedule,130% of WA Medicaid ,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,869.36,37.7,,,percent of total billed charges,37.70% of total billed charges,869.36,37.7,,,percent of total billed charges,37.70% of total billed charges,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,78173.4,33.9,,,percent of total billed charges,33.9% of total billed charges,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1798.68,78,,,percent of total billed charges,78% of total billed charges,2306,100,,,percent of total billed charges,100% of total billed charges,1904.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1904.76,82.6,,,percent of total billed charges,82.6% of total billed charges,668.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,122.86,78173.4,
"Excision, excessive skin and subcutaneous tissue (includes l",97515832,CDM,975,RC,15832,HCPCS,Outpatient,,,3252,2113.80,,2861.76,88,,,percent of total billed charges,88% of total Billed charges,91.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3252,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,91.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,159.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2243.88,69,,,percent of total billed charges,69% of total billed charges,3252,100,,,percent of total billed charges,100% of total billed charges,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,3252,100,,,percent of total billed charges,100% of total billed charges,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,3252,100,,,percent of total billed charges,100% of total billed charges,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2011.36,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1226,37.7,,,percent of total billed charges,37.70% of total billed charges,1226,37.7,,,percent of total billed charges,37.70% of total billed charges,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,110242.8,33.9,,,percent of total billed charges,33.9% of total billed charges,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2536.56,78,,,percent of total billed charges,78% of total billed charges,3252,100,,,percent of total billed charges,100% of total billed charges,2686.15,82.6,,,percent of total billed charges,82.6% of total billed charges,2686.15,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",91.1,110242.8,
"15834 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCL",97515834,CDM,975,RC,15834,HCPCS,Outpatient,,,3155,2050.75,,2776.4,88,,,percent of total billed charges,88% of total Billed charges,85.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3155,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,85.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,148.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2176.95,69,,,percent of total billed charges,69% of total billed charges,3155,100,,,percent of total billed charges,100% of total billed charges,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,3155,100,,,percent of total billed charges,100% of total billed charges,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,3155,100,,,percent of total billed charges,100% of total billed charges,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1951.37,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1189.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1189.44,37.7,,,percent of total billed charges,37.70% of total billed charges,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,106954.5,33.9,,,percent of total billed charges,33.9% of total billed charges,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2460.9,78,,,percent of total billed charges,78% of total billed charges,3155,100,,,percent of total billed charges,100% of total billed charges,2606.03,82.6,,,percent of total billed charges,82.6% of total billed charges,2606.03,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,85.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",85.08,106954.5,
EXCIS EXCESS SKIN/SUBC INCL LIPECTOMY ARM PROF,15836,CDM,960,RC,15836,HCPCS,Outpatient,,,1692,1099.80,,1488.96,88,,,percent of total billed charges,88% of total Billed charges,74.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1692,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,74.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,131.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1167.48,69,,,percent of total billed charges,69% of total billed charges,1692,100,,,percent of total billed charges,100% of total billed charges,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1692,100,,,percent of total billed charges,100% of total billed charges,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1692,100,,,percent of total billed charges,100% of total billed charges,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.88,37.7,,,percent of total billed charges,37.70% of total billed charges,637.88,37.7,,,percent of total billed charges,37.70% of total billed charges,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,57358.8,33.9,,,percent of total billed charges,33.9% of total billed charges,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319.76,78,,,percent of total billed charges,78% of total billed charges,1692,100,,,percent of total billed charges,100% of total billed charges,1397.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.59,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,74.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",74.96,57358.8,
"EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES L",97515838,CDM,975,RC,15838,HCPCS,Outpatient,,,1983,1288.95,,1745.04,88,,,percent of total billed charges,88% of total Billed charges,59.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1983,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1368.27,69,,,percent of total billed charges,69% of total billed charges,1983,100,,,percent of total billed charges,100% of total billed charges,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1983,100,,,percent of total billed charges,100% of total billed charges,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1983,100,,,percent of total billed charges,100% of total billed charges,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1226.49,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,747.59,37.7,,,percent of total billed charges,37.70% of total billed charges,747.59,37.7,,,percent of total billed charges,37.70% of total billed charges,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,67223.7,33.9,,,percent of total billed charges,33.9% of total billed charges,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1546.74,78,,,percent of total billed charges,78% of total billed charges,1983,100,,,percent of total billed charges,100% of total billed charges,1637.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1637.96,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",59.14,67223.7,
"EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES L",15839,CDM,975,RC,15839,HCPCS,Outpatient,,,1650,1072.50,,1452,88,,,percent of total billed charges,88% of total Billed charges,72.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1650,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1138.5,69,,,percent of total billed charges,69% of total billed charges,1650,100,,,percent of total billed charges,100% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650,100,,,percent of total billed charges,100% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650,100,,,percent of total billed charges,100% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.53,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.05,37.7,,,percent of total billed charges,37.70% of total billed charges,622.05,37.7,,,percent of total billed charges,37.70% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,55935,33.9,,,percent of total billed charges,33.9% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1287,78,,,percent of total billed charges,78% of total billed charges,1650,100,,,percent of total billed charges,100% of total billed charges,1362.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1362.9,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",72.39,55935,
"15847 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TI",97515847,CDM,975,RC,15847,HCPCS,Outpatient,,,562,365.30,,494.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,562,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,387.78,69,,,percent of total billed charges,69% of total billed charges,562,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,562,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,562,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,347.6,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,211.87,37.7,,,percent of total billed charges,37.70% of total billed charges,211.87,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,19051.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,438.36,78,,,percent of total billed charges,78% of total billed charges,562,100,,,percent of total billed charges,100% of total billed charges,464.21,82.6,,,percent of total billed charges,82.6% of total billed charges,464.21,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",211.87,19051.8,
15876 SUCTION ASSISTED LIPECTOMY; HEAD AND NECK ProFee,97515876,CDM,975,RC,15876,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15255,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",169.65,15255,
Suction assisted lipectomy; trunk,15877,CDM,975,RC,15877,HCPCS,Outpatient,,,2995,1946.75,,2635.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2066.55,69,,,percent of total billed charges,69% of total billed charges,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1852.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1129.12,37.7,,,percent of total billed charges,37.70% of total billed charges,1129.12,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,101530.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2336.1,78,,,percent of total billed charges,78% of total billed charges,2995,100,,,percent of total billed charges,100% of total billed charges,2473.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2473.87,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1129.12,101530.5,
15879 SUCTION ASSISTED LIPECTOMY; LOWER EXTREMITY ProFee,97515879,CDM,975,RC,15879,HCPCS,Outpatient,,,1692,1099.80,,1488.96,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1692,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1167.48,69,,,percent of total billed charges,69% of total billed charges,1692,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1692,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1692,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1046.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,637.88,37.7,,,percent of total billed charges,37.70% of total billed charges,637.88,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,57358.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1319.76,78,,,percent of total billed charges,78% of total billed charges,1692,100,,,percent of total billed charges,100% of total billed charges,1397.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.59,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",637.88,57358.8,
"15933 EXCISION, SACRAL PRESSURE ULCER, WITH PRIMAR",96015933,CDM,975,RC,15933,HCPCS,Outpatient,,,3070,1995.50,,2701.6,88,,,percent of total billed charges,88% of total Billed charges,94.54,100,,,Fee Schedule,100% of Medicare rate,500.38,100,,,Fee Schedule,100% of WA Medicaid,3070,100,,,percent of total billed charges,100% of total billed charges,515.39,103,,,Fee Schedule,103% of WA Medicaid,94.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,165.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,500.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2118.3,69,,,percent of total billed charges,69% of total billed charges,3070,100,,,percent of total billed charges,100% of total billed charges,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,3070,100,,,percent of total billed charges,100% of total billed charges,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,3070,100,,,percent of total billed charges,100% of total billed charges,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1898.8,61.85,,,percent of total billed charges,61.85% of total billed charges,500.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,650.49,130,,,Fee Schedule,130% of WA Medicaid ,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1157.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1157.39,37.7,,,percent of total billed charges,37.70% of total billed charges,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,104073,33.9,,,percent of total billed charges,33.9% of total billed charges,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2394.6,78,,,percent of total billed charges,78% of total billed charges,3070,100,,,percent of total billed charges,100% of total billed charges,2535.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2535.82,82.6,,,percent of total billed charges,82.6% of total billed charges,500.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,94.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.54,104073,
"15937 EXCISION, SACRAL PRESSURE ULCER, IN PREPARATION FOR MU",97515937,CDM,975,RC,15937,HCPCS,Outpatient,,,2210,1436.50,,1944.8,88,,,percent of total billed charges,88% of total Billed charges,110.76,100,,,Fee Schedule,100% of Medicare rate,591.21,100,,,Fee Schedule,100% of WA Medicaid,2210,100,,,percent of total billed charges,100% of total billed charges,608.95,103,,,Fee Schedule,103% of WA Medicaid,110.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,591.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1524.9,69,,,percent of total billed charges,69% of total billed charges,2210,100,,,percent of total billed charges,100% of total billed charges,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2210,100,,,percent of total billed charges,100% of total billed charges,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2210,100,,,percent of total billed charges,100% of total billed charges,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1366.89,61.85,,,percent of total billed charges,61.85% of total billed charges,591.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,603.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,768.57,130,,,Fee Schedule,130% of WA Medicaid ,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,833.17,37.7,,,percent of total billed charges,37.70% of total billed charges,833.17,37.7,,,percent of total billed charges,37.70% of total billed charges,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,74919,33.9,,,percent of total billed charges,33.9% of total billed charges,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1723.8,78,,,percent of total billed charges,78% of total billed charges,2210,100,,,percent of total billed charges,100% of total billed charges,1825.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1825.46,82.6,,,percent of total billed charges,82.6% of total billed charges,591.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.76,74919,
DRESS/DEBRID P-THICK BURN S,96016020,CDM,960,RC,16020,HCPCS,Outpatient,,,174,113.10,,153.12,88,,,percent of total billed charges,88% of total Billed charges,4.81,100,,,Fee Schedule,100% of Medicare rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,174,100,,,percent of total billed charges,100% of total billed charges,33.23,103,,,Fee Schedule,103% of WA Medicaid,4.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,120.06,69,,,percent of total billed charges,69% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,174,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,174,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.62,61.85,,,percent of total billed charges,61.85% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.94,130,,,Fee Schedule,130% of WA Medicaid ,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,65.6,37.7,,,percent of total billed charges,37.70% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,5898.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.72,78,,,percent of total billed charges,78% of total billed charges,174,100,,,percent of total billed charges,100% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,143.72,82.6,,,percent of total billed charges,82.6% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,5898.6,
DRESS/DEBRIDE OF BURNS INI/SUB,96016025,CDM,960,RC,16025,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,10.87,100,,,Fee Schedule,100% of Medicare rate,63.41,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,65.31,103,,,Fee Schedule,103% of WA Medicaid,10.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,239,100,,,percent of total billed charges,100% of total billed charges,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,239,100,,,percent of total billed charges,100% of total billed charges,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.82,61.85,,,percent of total billed charges,61.85% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.43,130,,,Fee Schedule,130% of WA Medicaid ,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,8102.1,33.9,,,percent of total billed charges,33.9% of total billed charges,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.87,8102.1,
ESCHAROTOMY INITIAL INCISION,96016035,CDM,960,RC,16035,HCPCS,Outpatient,,,397,258.05,,349.36,88,,,percent of total billed charges,88% of total Billed charges,21.35,100,,,Fee Schedule,100% of Medicare rate,109.48,100,,,Fee Schedule,100% of WA Medicaid,397,100,,,percent of total billed charges,100% of total billed charges,112.76,103,,,Fee Schedule,103% of WA Medicaid,21.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,109.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,273.93,69,,,percent of total billed charges,69% of total billed charges,397,100,,,percent of total billed charges,100% of total billed charges,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,397,100,,,percent of total billed charges,100% of total billed charges,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,397,100,,,percent of total billed charges,100% of total billed charges,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.54,61.85,,,percent of total billed charges,61.85% of total billed charges,109.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,142.32,130,,,Fee Schedule,130% of WA Medicaid ,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.67,37.7,,,percent of total billed charges,37.70% of total billed charges,149.67,37.7,,,percent of total billed charges,37.70% of total billed charges,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,13458.3,33.9,,,percent of total billed charges,33.9% of total billed charges,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.66,78,,,percent of total billed charges,78% of total billed charges,397,100,,,percent of total billed charges,100% of total billed charges,327.92,82.6,,,percent of total billed charges,82.6% of total billed charges,327.92,82.6,,,percent of total billed charges,82.6% of total billed charges,109.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.35,13458.3,
CHEMICAL CAUT OF GRANULAT TISS,96017250,CDM,960,RC,17250,HCPCS,Outpatient,,,149,96.85,,131.12,88,,,percent of total billed charges,88% of total Billed charges,3.21,100,,,Fee Schedule,100% of Medicare rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,149,100,,,percent of total billed charges,100% of total billed charges,22.28,103,,,Fee Schedule,103% of WA Medicaid,3.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,102.81,69,,,percent of total billed charges,69% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,149,100,,,percent of total billed charges,100% of total billed charges,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,149,100,,,percent of total billed charges,100% of total billed charges,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.16,61.85,,,percent of total billed charges,61.85% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.12,130,,,Fee Schedule,130% of WA Medicaid ,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,5051.1,33.9,,,percent of total billed charges,33.9% of total billed charges,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.22,78,,,percent of total billed charges,78% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.21,5051.1,
MASTOTOMY W/ ABSCESS DRAINAGE,96019020,CDM,975,RC,19020,HCPCS,Outpatient,,,1034,672.10,,909.92,88,,,percent of total billed charges,88% of total Billed charges,33.67,100,,,Fee Schedule,100% of Medicare rate,181.65,100,,,Fee Schedule,100% of WA Medicaid,1034,100,,,percent of total billed charges,100% of total billed charges,187.1,103,,,Fee Schedule,103% of WA Medicaid,33.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,181.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,713.46,69,,,percent of total billed charges,69% of total billed charges,1034,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.53,61.85,,,percent of total billed charges,61.85% of total billed charges,181.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,236.15,130,,,Fee Schedule,130% of WA Medicaid ,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.82,37.7,,,percent of total billed charges,37.70% of total billed charges,389.82,37.7,,,percent of total billed charges,37.70% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,35052.6,33.9,,,percent of total billed charges,33.9% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.52,78,,,percent of total billed charges,78% of total billed charges,1034,100,,,percent of total billed charges,100% of total billed charges,854.08,82.6,,,percent of total billed charges,82.6% of total billed charges,854.08,82.6,,,percent of total billed charges,82.6% of total billed charges,181.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.67,35052.6,
BIOPSY OF BREAST OPEN,96019101,CDM,960,RC,19101,HCPCS,Outpatient,,,744,483.60,,654.72,88,,,percent of total billed charges,88% of total Billed charges,27.2,100,,,Fee Schedule,100% of Medicare rate,127.19,100,,,Fee Schedule,100% of WA Medicaid,744,100,,,percent of total billed charges,100% of total billed charges,131.01,103,,,Fee Schedule,103% of WA Medicaid,27.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,127.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,513.36,69,,,percent of total billed charges,69% of total billed charges,744,100,,,percent of total billed charges,100% of total billed charges,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,744,100,,,percent of total billed charges,100% of total billed charges,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,744,100,,,percent of total billed charges,100% of total billed charges,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.16,61.85,,,percent of total billed charges,61.85% of total billed charges,127.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,165.35,130,,,Fee Schedule,130% of WA Medicaid ,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.49,37.7,,,percent of total billed charges,37.70% of total billed charges,280.49,37.7,,,percent of total billed charges,37.70% of total billed charges,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,25221.6,33.9,,,percent of total billed charges,33.9% of total billed charges,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,580.32,78,,,percent of total billed charges,78% of total billed charges,744,100,,,percent of total billed charges,100% of total billed charges,614.54,82.6,,,percent of total billed charges,82.6% of total billed charges,614.54,82.6,,,percent of total billed charges,82.6% of total billed charges,127.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.2,25221.6,
EXCISION BREAST MASS,96019120,CDM,960,RC,19120,HCPCS,Outpatient,,,1031,670.15,,907.28,88,,,percent of total billed charges,88% of total Billed charges,50.74,100,,,Fee Schedule,100% of Medicare rate,239.28,100,,,Fee Schedule,100% of WA Medicaid,1031,100,,,percent of total billed charges,100% of total billed charges,246.46,103,,,Fee Schedule,103% of WA Medicaid,50.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,88.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,239.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,711.39,69,,,percent of total billed charges,69% of total billed charges,1031,100,,,percent of total billed charges,100% of total billed charges,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031,100,,,percent of total billed charges,100% of total billed charges,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031,100,,,percent of total billed charges,100% of total billed charges,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.67,61.85,,,percent of total billed charges,61.85% of total billed charges,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,311.06,130,,,Fee Schedule,130% of WA Medicaid ,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.69,37.7,,,percent of total billed charges,37.70% of total billed charges,388.69,37.7,,,percent of total billed charges,37.70% of total billed charges,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,34950.9,33.9,,,percent of total billed charges,33.9% of total billed charges,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.18,78,,,percent of total billed charges,78% of total billed charges,1031,100,,,percent of total billed charges,100% of total billed charges,851.61,82.6,,,percent of total billed charges,82.6% of total billed charges,851.61,82.6,,,percent of total billed charges,82.6% of total billed charges,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.74,34950.9,
EXCISION BRST LES W/ NEEDLE LO,96019125,CDM,960,RC,19125,HCPCS,Outpatient,,,1142,742.30,,1004.96,88,,,percent of total billed charges,88% of total Billed charges,57.76,100,,,Fee Schedule,100% of Medicare rate,264.08,100,,,Fee Schedule,100% of WA Medicaid,1142,100,,,percent of total billed charges,100% of total billed charges,272,103,,,Fee Schedule,103% of WA Medicaid,57.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,787.98,69,,,percent of total billed charges,69% of total billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1142,100,,,percent of total billed charges,100% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1142,100,,,percent of total billed charges,100% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,706.33,61.85,,,percent of total billed charges,61.85% of total billed charges,264.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,343.3,130,,,Fee Schedule,130% of WA Medicaid ,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.53,37.7,,,percent of total billed charges,37.70% of total billed charges,430.53,37.7,,,percent of total billed charges,37.70% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,38713.8,33.9,,,percent of total billed charges,33.9% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,890.76,78,,,percent of total billed charges,78% of total billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,943.29,82.6,,,percent of total billed charges,82.6% of total billed charges,943.29,82.6,,,percent of total billed charges,82.6% of total billed charges,264.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.76,38713.8,
EXCISION OF CHEST WALL TUMOR INCLUDING RIBS,96021601,CDM,960,RC,21601,HCPCS,Outpatient,,,2640,1716.00,,2323.2,88,,,percent of total billed charges,88% of total Billed charges,150.09,100,,,Fee Schedule,100% of Medicare rate,646.78,100,,,Fee Schedule,100% of WA Medicaid,2640,100,,,percent of total billed charges,100% of total billed charges,666.18,103,,,Fee Schedule,103% of WA Medicaid,150.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,262.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,646.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1821.6,69,,,percent of total billed charges,69% of total billed charges,2640,100,,,percent of total billed charges,100% of total billed charges,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2640,100,,,percent of total billed charges,100% of total billed charges,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2640,100,,,percent of total billed charges,100% of total billed charges,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1632.84,61.85,,,percent of total billed charges,61.85% of total billed charges,646.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,840.81,130,,,Fee Schedule,130% of WA Medicaid ,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,995.28,37.7,,,percent of total billed charges,37.70% of total billed charges,995.28,37.7,,,percent of total billed charges,37.70% of total billed charges,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,89496,33.9,,,percent of total billed charges,33.9% of total billed charges,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2059.2,78,,,percent of total billed charges,78% of total billed charges,2640,100,,,percent of total billed charges,100% of total billed charges,2180.64,82.6,,,percent of total billed charges,82.6% of total billed charges,2180.64,82.6,,,percent of total billed charges,82.6% of total billed charges,646.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,150.09,89496,
MASTECTOMY FOR GYNECOMASTIA,96019300,CDM,975,RC,19300,HCPCS,Outpatient,,,1097,713.05,,965.36,88,,,percent of total billed charges,88% of total Billed charges,45.27,100,,,Fee Schedule,100% of Medicare rate,249.54,100,,,Fee Schedule,100% of WA Medicaid,1097,100,,,percent of total billed charges,100% of total billed charges,257.03,103,,,Fee Schedule,103% of WA Medicaid,45.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,249.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,756.93,69,,,percent of total billed charges,69% of total billed charges,1097,100,,,percent of total billed charges,100% of total billed charges,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1097,100,,,percent of total billed charges,100% of total billed charges,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1097,100,,,percent of total billed charges,100% of total billed charges,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.49,61.85,,,percent of total billed charges,61.85% of total billed charges,249.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,324.4,130,,,Fee Schedule,130% of WA Medicaid ,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.57,37.7,,,percent of total billed charges,37.70% of total billed charges,413.57,37.7,,,percent of total billed charges,37.70% of total billed charges,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,37188.3,33.9,,,percent of total billed charges,33.9% of total billed charges,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,855.66,78,,,percent of total billed charges,78% of total billed charges,1097,100,,,percent of total billed charges,100% of total billed charges,906.12,82.6,,,percent of total billed charges,82.6% of total billed charges,906.12,82.6,,,percent of total billed charges,82.6% of total billed charges,249.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.27,37188.3,
MASTECTOMY;PARTIAL,96019301,CDM,960,RC,19301,HCPCS,Outpatient,,,1357,882.05,,1194.16,88,,,percent of total billed charges,88% of total Billed charges,86.16,100,,,Fee Schedule,100% of Medicare rate,374.49,100,,,Fee Schedule,100% of WA Medicaid,1357,100,,,percent of total billed charges,100% of total billed charges,385.72,103,,,Fee Schedule,103% of WA Medicaid,86.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,150.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,374.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,936.33,69,,,percent of total billed charges,69% of total billed charges,1357,100,,,percent of total billed charges,100% of total billed charges,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357,100,,,percent of total billed charges,100% of total billed charges,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357,100,,,percent of total billed charges,100% of total billed charges,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,839.3,61.85,,,percent of total billed charges,61.85% of total billed charges,374.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,486.84,130,,,Fee Schedule,130% of WA Medicaid ,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,511.59,37.7,,,percent of total billed charges,37.70% of total billed charges,511.59,37.7,,,percent of total billed charges,37.70% of total billed charges,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,46002.3,33.9,,,percent of total billed charges,33.9% of total billed charges,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1058.46,78,,,percent of total billed charges,78% of total billed charges,1357,100,,,percent of total billed charges,100% of total billed charges,1120.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1120.88,82.6,,,percent of total billed charges,82.6% of total billed charges,374.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.16,46002.3,
MASTECTOMY;PARTIAL,96019302,CDM,960,RC,19302,HCPCS,Outpatient,,,1868,1214.20,,1643.84,88,,,percent of total billed charges,88% of total Billed charges,118.93,100,,,Fee Schedule,100% of Medicare rate,513.81,100,,,Fee Schedule,100% of WA Medicaid,1868,100,,,percent of total billed charges,100% of total billed charges,529.22,103,,,Fee Schedule,103% of WA Medicaid,118.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,208.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,513.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1288.92,69,,,percent of total billed charges,69% of total billed charges,1868,100,,,percent of total billed charges,100% of total billed charges,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1868,100,,,percent of total billed charges,100% of total billed charges,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1868,100,,,percent of total billed charges,100% of total billed charges,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1155.36,61.85,,,percent of total billed charges,61.85% of total billed charges,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,667.95,130,,,Fee Schedule,130% of WA Medicaid ,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,704.24,37.7,,,percent of total billed charges,37.70% of total billed charges,704.24,37.7,,,percent of total billed charges,37.70% of total billed charges,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,63325.2,33.9,,,percent of total billed charges,33.9% of total billed charges,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.04,78,,,percent of total billed charges,78% of total billed charges,1868,100,,,percent of total billed charges,100% of total billed charges,1542.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1542.97,82.6,,,percent of total billed charges,82.6% of total billed charges,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,118.93,63325.2,
MASTECTOMY; SIMPLE,96019303,CDM,960,RC,19303,HCPCS,Outpatient,,,2100,1365.00,,1848,88,,,percent of total billed charges,88% of total Billed charges,126.39,100,,,Fee Schedule,100% of Medicare rate,541.78,100,,,Fee Schedule,100% of WA Medicaid,2100,100,,,percent of total billed charges,100% of total billed charges,558.03,103,,,Fee Schedule,103% of WA Medicaid,126.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,221.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,541.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1449,69,,,percent of total billed charges,69% of total billed charges,2100,100,,,percent of total billed charges,100% of total billed charges,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2100,100,,,percent of total billed charges,100% of total billed charges,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2100,100,,,percent of total billed charges,100% of total billed charges,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1298.85,61.85,,,percent of total billed charges,61.85% of total billed charges,541.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,704.31,130,,,Fee Schedule,130% of WA Medicaid ,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,791.7,37.7,,,percent of total billed charges,37.70% of total billed charges,791.7,37.7,,,percent of total billed charges,37.70% of total billed charges,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,71190,33.9,,,percent of total billed charges,33.9% of total billed charges,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1638,78,,,percent of total billed charges,78% of total billed charges,2100,100,,,percent of total billed charges,100% of total billed charges,1734.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1734.6,82.6,,,percent of total billed charges,82.6% of total billed charges,541.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.39,71190,
RADICAL MASTECTOMY,96019305,CDM,960,RC,19305,HCPCS,Outpatient,,,2353,1529.45,,2070.64,88,,,percent of total billed charges,88% of total Billed charges,148.47,100,,,Fee Schedule,100% of Medicare rate,651.07,100,,,Fee Schedule,100% of WA Medicaid,2353,100,,,percent of total billed charges,100% of total billed charges,670.6,103,,,Fee Schedule,103% of WA Medicaid,148.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,259.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,651.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1623.57,69,,,percent of total billed charges,69% of total billed charges,2353,100,,,percent of total billed charges,100% of total billed charges,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,2353,100,,,percent of total billed charges,100% of total billed charges,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,2353,100,,,percent of total billed charges,100% of total billed charges,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1455.33,61.85,,,percent of total billed charges,61.85% of total billed charges,651.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,651.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,846.39,130,,,Fee Schedule,130% of WA Medicaid ,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,887.08,37.7,,,percent of total billed charges,37.70% of total billed charges,887.08,37.7,,,percent of total billed charges,37.70% of total billed charges,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,79766.7,33.9,,,percent of total billed charges,33.9% of total billed charges,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1835.34,78,,,percent of total billed charges,78% of total billed charges,2353,100,,,percent of total billed charges,100% of total billed charges,1943.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1943.58,82.6,,,percent of total billed charges,82.6% of total billed charges,651.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,651.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,148.47,79766.7,
"MASTECTOMY,RADICAL",96019306,CDM,960,RC,19306,HCPCS,Outpatient,,,5390,3503.50,,4743.2,88,,,percent of total billed charges,88% of total Billed charges,157.39,100,,,Fee Schedule,100% of Medicare rate,692.47,100,,,Fee Schedule,100% of WA Medicaid,5390,100,,,percent of total billed charges,100% of total billed charges,713.24,103,,,Fee Schedule,103% of WA Medicaid,157.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,275.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,692.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3719.1,69,,,percent of total billed charges,69% of total billed charges,5390,100,,,percent of total billed charges,100% of total billed charges,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,5390,100,,,percent of total billed charges,100% of total billed charges,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,5390,100,,,percent of total billed charges,100% of total billed charges,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,3333.72,61.85,,,percent of total billed charges,61.85% of total billed charges,692.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,706.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,900.21,130,,,Fee Schedule,130% of WA Medicaid ,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2032.03,37.7,,,percent of total billed charges,37.70% of total billed charges,2032.03,37.7,,,percent of total billed charges,37.70% of total billed charges,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,182721,33.9,,,percent of total billed charges,33.9% of total billed charges,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,4204.2,78,,,percent of total billed charges,78% of total billed charges,5390,100,,,percent of total billed charges,100% of total billed charges,4452.14,82.6,,,percent of total billed charges,82.6% of total billed charges,4452.14,82.6,,,percent of total billed charges,82.6% of total billed charges,692.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,157.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,157.39,182721,
MASTECTOMY;MODIFIED RADICAL,96019307,CDM,960,RC,19307,HCPCS,Outpatient,,,2489,1617.85,,2190.32,88,,,percent of total billed charges,88% of total Billed charges,153.27,100,,,Fee Schedule,100% of Medicare rate,668.04,100,,,Fee Schedule,100% of WA Medicaid,2489,100,,,percent of total billed charges,100% of total billed charges,688.08,103,,,Fee Schedule,103% of WA Medicaid,153.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,268.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,668.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1717.41,69,,,percent of total billed charges,69% of total billed charges,2489,100,,,percent of total billed charges,100% of total billed charges,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2489,100,,,percent of total billed charges,100% of total billed charges,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2489,100,,,percent of total billed charges,100% of total billed charges,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1539.45,61.85,,,percent of total billed charges,61.85% of total billed charges,668.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,681.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,868.45,130,,,Fee Schedule,130% of WA Medicaid ,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,938.35,37.7,,,percent of total billed charges,37.70% of total billed charges,938.35,37.7,,,percent of total billed charges,37.70% of total billed charges,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,84377.1,33.9,,,percent of total billed charges,33.9% of total billed charges,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1941.42,78,,,percent of total billed charges,78% of total billed charges,2489,100,,,percent of total billed charges,100% of total billed charges,2055.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2055.91,82.6,,,percent of total billed charges,82.6% of total billed charges,668.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,153.27,84377.1,
19316 MASTOPEXY BREAST LIFT ProFee,97519316,CDM,975,RC,19316,HCPCS,Outpatient,,,1654,1075.10,,1455.52,88,,,percent of total billed charges,88% of total Billed charges,80.45,100,,,Fee Schedule,100% of Medicare rate,454.31,100,,,Fee Schedule,100% of WA Medicaid,1654,100,,,percent of total billed charges,100% of total billed charges,467.94,103,,,Fee Schedule,103% of WA Medicaid,80.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,454.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1141.26,69,,,percent of total billed charges,69% of total billed charges,1654,100,,,percent of total billed charges,100% of total billed charges,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1654,100,,,percent of total billed charges,100% of total billed charges,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1654,100,,,percent of total billed charges,100% of total billed charges,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1023,61.85,,,percent of total billed charges,61.85% of total billed charges,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,590.6,130,,,Fee Schedule,130% of WA Medicaid ,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,623.56,37.7,,,percent of total billed charges,37.70% of total billed charges,623.56,37.7,,,percent of total billed charges,37.70% of total billed charges,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,56070.6,33.9,,,percent of total billed charges,33.9% of total billed charges,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1290.12,78,,,percent of total billed charges,78% of total billed charges,1654,100,,,percent of total billed charges,100% of total billed charges,1366.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1366.2,82.6,,,percent of total billed charges,82.6% of total billed charges,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.45,56070.6,
Breast reduction,19318,CDM,975,RC,19318,HCPCS,Outpatient,,,7995,5196.75,,7035.6,88,,,percent of total billed charges,88% of total Billed charges,110.68,100,,,Fee Schedule,100% of Medicare rate,624.22,100,,,Fee Schedule,100% of WA Medicaid,7995,100,,,percent of total billed charges,100% of total billed charges,642.95,103,,,Fee Schedule,103% of WA Medicaid,110.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,624.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5516.55,69,,,percent of total billed charges,69% of total billed charges,7995,100,,,percent of total billed charges,100% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,7995,100,,,percent of total billed charges,100% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,7995,100,,,percent of total billed charges,100% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,4944.91,61.85,,,percent of total billed charges,61.85% of total billed charges,624.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,636.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,811.49,130,,,Fee Schedule,130% of WA Medicaid ,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,3014.12,37.7,,,percent of total billed charges,37.70% of total billed charges,3014.12,37.7,,,percent of total billed charges,37.70% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,271030.5,33.9,,,percent of total billed charges,33.9% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,6236.1,78,,,percent of total billed charges,78% of total billed charges,7995,100,,,percent of total billed charges,100% of total billed charges,6603.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6603.87,82.6,,,percent of total billed charges,82.6% of total billed charges,624.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.68,271030.5,
"19325 MAMMAPLASTY, AUGMENTATION; WITH PROSTHETIC IMPLANT Pro",97519325,CDM,975,RC,19325,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,57.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1300,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,57.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,44070,33.9,,,percent of total billed charges,33.9% of total billed charges,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",57.83,44070,
REMOVAL OF INTACT MAMMARY IMPLANT ProFee,97519328,CDM,975,RC,19328,HCPCS,Outpatient,,,1061,689.65,,933.68,88,,,percent of total billed charges,88% of total Billed charges,53.61,100,,,Fee Schedule,100% of Medicare rate,319.1,100,,,Fee Schedule,100% of WA Medicaid,1061,100,,,percent of total billed charges,100% of total billed charges,328.67,103,,,Fee Schedule,103% of WA Medicaid,53.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,319.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,732.09,69,,,percent of total billed charges,69% of total billed charges,1061,100,,,percent of total billed charges,100% of total billed charges,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1061,100,,,percent of total billed charges,100% of total billed charges,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1061,100,,,percent of total billed charges,100% of total billed charges,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,656.23,61.85,,,percent of total billed charges,61.85% of total billed charges,319.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,414.83,130,,,Fee Schedule,130% of WA Medicaid ,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,400,37.7,,,percent of total billed charges,37.70% of total billed charges,400,37.7,,,percent of total billed charges,37.70% of total billed charges,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,35967.9,33.9,,,percent of total billed charges,33.9% of total billed charges,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,827.58,78,,,percent of total billed charges,78% of total billed charges,1061,100,,,percent of total billed charges,100% of total billed charges,876.39,82.6,,,percent of total billed charges,82.6% of total billed charges,876.39,82.6,,,percent of total billed charges,82.6% of total billed charges,319.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.61,35967.9,
19330 REMOVAL OF MAMMARY IMPLANT MATERIAL ProFee,97519330,CDM,975,RC,19330,HCPCS,Outpatient,,,1281,832.65,,1127.28,88,,,percent of total billed charges,88% of total Billed charges,63.87,100,,,Fee Schedule,100% of Medicare rate,370.95,100,,,Fee Schedule,100% of WA Medicaid,1281,100,,,percent of total billed charges,100% of total billed charges,382.08,103,,,Fee Schedule,103% of WA Medicaid,63.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,111.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,370.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,883.89,69,,,percent of total billed charges,69% of total billed charges,1281,100,,,percent of total billed charges,100% of total billed charges,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1281,100,,,percent of total billed charges,100% of total billed charges,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1281,100,,,percent of total billed charges,100% of total billed charges,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,792.3,61.85,,,percent of total billed charges,61.85% of total billed charges,370.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,482.24,130,,,Fee Schedule,130% of WA Medicaid ,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.94,37.7,,,percent of total billed charges,37.70% of total billed charges,482.94,37.7,,,percent of total billed charges,37.70% of total billed charges,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,43425.9,33.9,,,percent of total billed charges,33.9% of total billed charges,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,999.18,78,,,percent of total billed charges,78% of total billed charges,1281,100,,,percent of total billed charges,100% of total billed charges,1058.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1058.11,82.6,,,percent of total billed charges,82.6% of total billed charges,370.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.87,43425.9,
19340 IMMEDIATE INSERTION OF BREAST PROSTHESIS FOL,97519340,CDM,975,RC,19340,HCPCS,Outpatient,,,2153,1399.45,,1894.64,88,,,percent of total billed charges,88% of total Billed charges,76.36,100,,,Fee Schedule,100% of Medicare rate,435.85,100,,,Fee Schedule,100% of WA Medicaid,2153,100,,,percent of total billed charges,100% of total billed charges,448.93,103,,,Fee Schedule,103% of WA Medicaid,76.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,133.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,435.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1485.57,69,,,percent of total billed charges,69% of total billed charges,2153,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2153,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2153,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1331.63,61.85,,,percent of total billed charges,61.85% of total billed charges,435.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,566.61,130,,,Fee Schedule,130% of WA Medicaid ,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.68,37.7,,,percent of total billed charges,37.70% of total billed charges,811.68,37.7,,,percent of total billed charges,37.70% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,72986.7,33.9,,,percent of total billed charges,33.9% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1679.34,78,,,percent of total billed charges,78% of total billed charges,2153,100,,,percent of total billed charges,100% of total billed charges,1778.38,82.6,,,percent of total billed charges,82.6% of total billed charges,1778.38,82.6,,,percent of total billed charges,82.6% of total billed charges,435.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.36,72986.7,
NIPPLE/AREOLA RECONSTRUCTION ProFee,97519350,CDM,975,RC,19350,HCPCS,Outpatient,,,1418,921.70,,1247.84,88,,,percent of total billed charges,88% of total Billed charges,64.47,100,,,Fee Schedule,100% of Medicare rate,387.55,100,,,Fee Schedule,100% of WA Medicaid,1418,100,,,percent of total billed charges,100% of total billed charges,399.18,103,,,Fee Schedule,103% of WA Medicaid,64.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,387.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,978.42,69,,,percent of total billed charges,69% of total billed charges,1418,100,,,percent of total billed charges,100% of total billed charges,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1418,100,,,percent of total billed charges,100% of total billed charges,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1418,100,,,percent of total billed charges,100% of total billed charges,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,877.03,61.85,,,percent of total billed charges,61.85% of total billed charges,387.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,503.82,130,,,Fee Schedule,130% of WA Medicaid ,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.59,37.7,,,percent of total billed charges,37.70% of total billed charges,534.59,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,48070.2,33.9,,,percent of total billed charges,33.9% of total billed charges,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1106.04,78,,,percent of total billed charges,78% of total billed charges,1418,100,,,percent of total billed charges,100% of total billed charges,1171.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1171.27,82.6,,,percent of total billed charges,82.6% of total billed charges,387.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.47,48070.2,
"19370 OPEN PERIPROSTHETIC CAPSULOTOMY, BREAST ProF",97519370,CDM,975,RC,19370,HCPCS,Outpatient,,,1466,952.90,,1290.08,88,,,percent of total billed charges,88% of total Billed charges,64.69,100,,,Fee Schedule,100% of Medicare rate,386.61,100,,,Fee Schedule,100% of WA Medicaid,1466,100,,,percent of total billed charges,100% of total billed charges,398.21,103,,,Fee Schedule,103% of WA Medicaid,64.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,113.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,386.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1011.54,69,,,percent of total billed charges,69% of total billed charges,1466,100,,,percent of total billed charges,100% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1466,100,,,percent of total billed charges,100% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1466,100,,,percent of total billed charges,100% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,906.72,61.85,,,percent of total billed charges,61.85% of total billed charges,386.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,502.59,130,,,Fee Schedule,130% of WA Medicaid ,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.68,37.7,,,percent of total billed charges,37.70% of total billed charges,552.68,37.7,,,percent of total billed charges,37.70% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,49697.4,33.9,,,percent of total billed charges,33.9% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1143.48,78,,,percent of total billed charges,78% of total billed charges,1466,100,,,percent of total billed charges,100% of total billed charges,1210.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1210.92,82.6,,,percent of total billed charges,82.6% of total billed charges,386.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.69,49697.4,
"19371 PERIPROSTHETIC CAPSULECTOMY, BREAST ProFee",97519371,CDM,975,RC,19371,HCPCS,Outpatient,,,1674,1088.10,,1473.12,88,,,percent of total billed charges,88% of total Billed charges,69.74,100,,,Fee Schedule,100% of Medicare rate,408.62,100,,,Fee Schedule,100% of WA Medicaid,1674,100,,,percent of total billed charges,100% of total billed charges,420.88,103,,,Fee Schedule,103% of WA Medicaid,69.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,122.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,408.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1155.06,69,,,percent of total billed charges,69% of total billed charges,1674,100,,,percent of total billed charges,100% of total billed charges,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1674,100,,,percent of total billed charges,100% of total billed charges,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1674,100,,,percent of total billed charges,100% of total billed charges,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035.37,61.85,,,percent of total billed charges,61.85% of total billed charges,408.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,531.21,130,,,Fee Schedule,130% of WA Medicaid ,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,631.1,37.7,,,percent of total billed charges,37.70% of total billed charges,631.1,37.7,,,percent of total billed charges,37.70% of total billed charges,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,56748.6,33.9,,,percent of total billed charges,33.9% of total billed charges,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1305.72,78,,,percent of total billed charges,78% of total billed charges,1674,100,,,percent of total billed charges,100% of total billed charges,1382.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1382.72,82.6,,,percent of total billed charges,82.6% of total billed charges,408.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.74,56748.6,
19380 REVISION OF RECONSTRUCTED BREAST ProFee,97519380,CDM,975,RC,19380,HCPCS,Outpatient,,,1590,1033.50,,1399.2,88,,,percent of total billed charges,88% of total Billed charges,78.35,100,,,Fee Schedule,100% of Medicare rate,463.83,100,,,Fee Schedule,100% of WA Medicaid,1590,100,,,percent of total billed charges,100% of total billed charges,477.74,103,,,Fee Schedule,103% of WA Medicaid,78.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,463.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1097.1,69,,,percent of total billed charges,69% of total billed charges,1590,100,,,percent of total billed charges,100% of total billed charges,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1590,100,,,percent of total billed charges,100% of total billed charges,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1590,100,,,percent of total billed charges,100% of total billed charges,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,983.42,61.85,,,percent of total billed charges,61.85% of total billed charges,463.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,602.98,130,,,Fee Schedule,130% of WA Medicaid ,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.43,37.7,,,percent of total billed charges,37.70% of total billed charges,599.43,37.7,,,percent of total billed charges,37.70% of total billed charges,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,53901,33.9,,,percent of total billed charges,33.9% of total billed charges,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240.2,78,,,percent of total billed charges,78% of total billed charges,1590,100,,,percent of total billed charges,100% of total billed charges,1313.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1313.34,82.6,,,percent of total billed charges,82.6% of total billed charges,463.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.35,53901,
EXPLOR PENETRATING NECK WOUND,96020100,CDM,960,RC,20100,HCPCS,Outpatient,,,1274,828.10,,1121.12,88,,,percent of total billed charges,88% of total Billed charges,75.14,100,,,Fee Schedule,100% of Medicare rate,337.01,100,,,Fee Schedule,100% of WA Medicaid,1274,100,,,percent of total billed charges,100% of total billed charges,347.12,103,,,Fee Schedule,103% of WA Medicaid,75.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,131.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,337.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,879.06,69,,,percent of total billed charges,69% of total billed charges,1274,100,,,percent of total billed charges,100% of total billed charges,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1274,100,,,percent of total billed charges,100% of total billed charges,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1274,100,,,percent of total billed charges,100% of total billed charges,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,787.97,61.85,,,percent of total billed charges,61.85% of total billed charges,337.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,438.11,130,,,Fee Schedule,130% of WA Medicaid ,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.3,37.7,,,percent of total billed charges,37.70% of total billed charges,480.3,37.7,,,percent of total billed charges,37.70% of total billed charges,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,43188.6,33.9,,,percent of total billed charges,33.9% of total billed charges,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,993.72,78,,,percent of total billed charges,78% of total billed charges,1274,100,,,percent of total billed charges,100% of total billed charges,1052.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1052.32,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.14,43188.6,
EXPLORE PENETRATING ABD WOUND,96020102,CDM,960,RC,20102,HCPCS,Outpatient,,,1041,676.65,,916.08,88,,,percent of total billed charges,88% of total Billed charges,32.81,100,,,Fee Schedule,100% of Medicare rate,144.91,100,,,Fee Schedule,100% of WA Medicaid,1041,100,,,percent of total billed charges,100% of total billed charges,149.26,103,,,Fee Schedule,103% of WA Medicaid,32.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,144.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,718.29,69,,,percent of total billed charges,69% of total billed charges,1041,100,,,percent of total billed charges,100% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1041,100,,,percent of total billed charges,100% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1041,100,,,percent of total billed charges,100% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,643.86,61.85,,,percent of total billed charges,61.85% of total billed charges,144.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,188.38,130,,,Fee Schedule,130% of WA Medicaid ,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.46,37.7,,,percent of total billed charges,37.70% of total billed charges,392.46,37.7,,,percent of total billed charges,37.70% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,35289.9,33.9,,,percent of total billed charges,33.9% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.98,78,,,percent of total billed charges,78% of total billed charges,1041,100,,,percent of total billed charges,100% of total billed charges,859.87,82.6,,,percent of total billed charges,82.6% of total billed charges,859.87,82.6,,,percent of total billed charges,82.6% of total billed charges,144.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.81,35289.9,
EXPLORATION OF PENTR WOUND;EXT,96020103,CDM,960,RC,20103,HCPCS,Outpatient,,,1235,802.75,,1086.8,88,,,percent of total billed charges,88% of total Billed charges,37.08,100,,,Fee Schedule,100% of Medicare rate,196.57,100,,,Fee Schedule,100% of WA Medicaid,1235,100,,,percent of total billed charges,100% of total billed charges,202.47,103,,,Fee Schedule,103% of WA Medicaid,37.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,196.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,852.15,69,,,percent of total billed charges,69% of total billed charges,1235,100,,,percent of total billed charges,100% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1235,100,,,percent of total billed charges,100% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1235,100,,,percent of total billed charges,100% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.85,61.85,,,percent of total billed charges,61.85% of total billed charges,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,255.54,130,,,Fee Schedule,130% of WA Medicaid ,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.6,37.7,,,percent of total billed charges,37.70% of total billed charges,465.6,37.7,,,percent of total billed charges,37.70% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,41866.5,33.9,,,percent of total billed charges,33.9% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,963.3,78,,,percent of total billed charges,78% of total billed charges,1235,100,,,percent of total billed charges,100% of total billed charges,1020.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1020.11,82.6,,,percent of total billed charges,82.6% of total billed charges,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.08,41866.5,
BIOPSY BONE EXCISIONAL SUPERFI,97520240,CDM,975,RC,20240,HCPCS,Outpatient,,,322,209.30,,283.36,88,,,percent of total billed charges,88% of total Billed charges,11.97,100,,,Fee Schedule,100% of Medicare rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,322,100,,,percent of total billed charges,100% of total billed charges,81.64,103,,,Fee Schedule,103% of WA Medicaid,11.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,222.18,69,,,percent of total billed charges,69% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,322,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,322,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.16,61.85,,,percent of total billed charges,61.85% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.04,130,,,Fee Schedule,130% of WA Medicaid ,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.39,37.7,,,percent of total billed charges,37.70% of total billed charges,121.39,37.7,,,percent of total billed charges,37.70% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,10915.8,33.9,,,percent of total billed charges,33.9% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.16,78,,,percent of total billed charges,78% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.97,10915.8,
BONE BIOPSY EXCISIONAL,96020245,CDM,960,RC,20245,HCPCS,Outpatient,,,1247,810.55,,1097.36,88,,,percent of total billed charges,88% of total Billed charges,37.44,100,,,Fee Schedule,100% of Medicare rate,193.03,100,,,Fee Schedule,100% of WA Medicaid,1247,100,,,percent of total billed charges,100% of total billed charges,198.82,103,,,Fee Schedule,103% of WA Medicaid,37.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,193.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,860.43,69,,,percent of total billed charges,69% of total billed charges,1247,100,,,percent of total billed charges,100% of total billed charges,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1247,100,,,percent of total billed charges,100% of total billed charges,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1247,100,,,percent of total billed charges,100% of total billed charges,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,771.27,61.85,,,percent of total billed charges,61.85% of total billed charges,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,250.94,130,,,Fee Schedule,130% of WA Medicaid ,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.12,37.7,,,percent of total billed charges,37.70% of total billed charges,470.12,37.7,,,percent of total billed charges,37.70% of total billed charges,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,42273.3,33.9,,,percent of total billed charges,33.9% of total billed charges,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,972.66,78,,,percent of total billed charges,78% of total billed charges,1247,100,,,percent of total billed charges,100% of total billed charges,1030.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1030.02,82.6,,,percent of total billed charges,82.6% of total billed charges,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.44,42273.3,
REM FOREIGN BODY MUSCLE/TENDON,96020520,CDM,960,RC,20520,HCPCS,Outpatient,,,183,118.95,,161.04,88,,,percent of total billed charges,88% of total Billed charges,12.04,100,,,Fee Schedule,100% of Medicare rate,85.98,100,,,Fee Schedule,100% of WA Medicaid,183,100,,,percent of total billed charges,100% of total billed charges,88.56,103,,,Fee Schedule,103% of WA Medicaid,12.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,126.27,69,,,percent of total billed charges,69% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,183,100,,,percent of total billed charges,100% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,183,100,,,percent of total billed charges,100% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.19,61.85,,,percent of total billed charges,61.85% of total billed charges,85.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.77,130,,,Fee Schedule,130% of WA Medicaid ,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,68.99,37.7,,,percent of total billed charges,37.70% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,6203.7,33.9,,,percent of total billed charges,33.9% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.74,78,,,percent of total billed charges,78% of total billed charges,183,100,,,percent of total billed charges,100% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,151.16,82.6,,,percent of total billed charges,82.6% of total billed charges,85.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.04,6203.7,
"20526 INJECTION, THERAPEUTIC (EG, LOCAL ANESTHETIC, CORTICOS",97520526,CDM,975,RC,20526,HCPCS,Outpatient,,,198,128.70,,174.24,88,,,percent of total billed charges,88% of total Billed charges,6.1,100,,,Fee Schedule,100% of Medicare rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,33.04,103,,,Fee Schedule,103% of WA Medicaid,6.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,198,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,198,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.46,61.85,,,percent of total billed charges,61.85% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.7,130,,,Fee Schedule,130% of WA Medicaid ,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6712.2,33.9,,,percent of total billed charges,33.9% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.1,6712.2,
INJ TENDON SHEATH;LIG GANGCYST,96020550,CDM,960,RC,20550,HCPCS,Outpatient,,,126,81.90,,110.88,88,,,percent of total billed charges,88% of total Billed charges,3.75,100,,,Fee Schedule,100% of Medicare rate,21.82,100,,,Fee Schedule,100% of WA Medicaid,126,100,,,percent of total billed charges,100% of total billed charges,22.47,103,,,Fee Schedule,103% of WA Medicaid,3.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,86.94,69,,,percent of total billed charges,69% of total billed charges,126,100,,,percent of total billed charges,100% of total billed charges,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,126,100,,,percent of total billed charges,100% of total billed charges,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,126,100,,,percent of total billed charges,100% of total billed charges,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.93,61.85,,,percent of total billed charges,61.85% of total billed charges,21.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.37,130,,,Fee Schedule,130% of WA Medicaid ,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.5,37.7,,,percent of total billed charges,37.70% of total billed charges,47.5,37.7,,,percent of total billed charges,37.70% of total billed charges,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,4271.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.28,78,,,percent of total billed charges,78% of total billed charges,126,100,,,percent of total billed charges,100% of total billed charges,104.08,82.6,,,percent of total billed charges,82.6% of total billed charges,104.08,82.6,,,percent of total billed charges,82.6% of total billed charges,21.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.75,4271.4,
TRIGGER POINT INJECTION,96020552,CDM,960,RC,20552,HCPCS,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,3.18,100,,,Fee Schedule,100% of Medicare rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,21.52,103,,,Fee Schedule,103% of WA Medicaid,3.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,113,100,,,percent of total billed charges,100% of total billed charges,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,113,100,,,percent of total billed charges,100% of total billed charges,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.89,61.85,,,percent of total billed charges,61.85% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.16,130,,,Fee Schedule,130% of WA Medicaid ,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3830.7,33.9,,,percent of total billed charges,33.9% of total billed charges,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.18,3830.7,
ARTHRO/ASPIR/INJ MAJOR JOINT,96020610,CDM,960,RC,20610,HCPCS,Outpatient,,,168,109.20,,147.84,88,,,percent of total billed charges,88% of total Billed charges,4.73,100,,,Fee Schedule,100% of Medicare rate,25.74,100,,,Fee Schedule,100% of WA Medicaid,168,100,,,percent of total billed charges,100% of total billed charges,26.51,103,,,Fee Schedule,103% of WA Medicaid,4.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,115.92,69,,,percent of total billed charges,69% of total billed charges,168,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,168,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,168,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.91,61.85,,,percent of total billed charges,61.85% of total billed charges,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.46,130,,,Fee Schedule,130% of WA Medicaid ,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.34,37.7,,,percent of total billed charges,37.70% of total billed charges,63.34,37.7,,,percent of total billed charges,37.70% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,5695.2,33.9,,,percent of total billed charges,33.9% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.04,78,,,percent of total billed charges,78% of total billed charges,168,100,,,percent of total billed charges,100% of total billed charges,138.77,82.6,,,percent of total billed charges,82.6% of total billed charges,138.77,82.6,,,percent of total billed charges,82.6% of total billed charges,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.73,5695.2,
ARTHROCENTESIS W/US GUIDANCE,96020611,CDM,960,RC,20611,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,5.65,100,,,Fee Schedule,100% of Medicare rate,33.2,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,34.2,103,,,Fee Schedule,103% of WA Medicaid,5.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,100,100,,,percent of total billed charges,100% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,100,100,,,percent of total billed charges,100% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.16,130,,,Fee Schedule,130% of WA Medicaid ,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3390,33.9,,,percent of total billed charges,33.9% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.65,3390,
REMOVAL OF SUPPORT IMPLANT,96020680,CDM,975,RC,20680,HCPCS,Outpatient,,,1581,1027.65,,1391.28,88,,,percent of total billed charges,88% of total Billed charges,40.25,100,,,Fee Schedule,100% of Medicare rate,242.45,100,,,Fee Schedule,100% of WA Medicaid,1581,100,,,percent of total billed charges,100% of total billed charges,249.72,103,,,Fee Schedule,103% of WA Medicaid,40.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,242.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1090.89,69,,,percent of total billed charges,69% of total billed charges,1581,100,,,percent of total billed charges,100% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1581,100,,,percent of total billed charges,100% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1581,100,,,percent of total billed charges,100% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,977.85,61.85,,,percent of total billed charges,61.85% of total billed charges,242.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,315.19,130,,,Fee Schedule,130% of WA Medicaid ,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.04,37.7,,,percent of total billed charges,37.70% of total billed charges,596.04,37.7,,,percent of total billed charges,37.70% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,53595.9,33.9,,,percent of total billed charges,33.9% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1233.18,78,,,percent of total billed charges,78% of total billed charges,1581,100,,,percent of total billed charges,100% of total billed charges,1305.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1305.91,82.6,,,percent of total billed charges,82.6% of total billed charges,242.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.25,53595.9,
APPLICATION OF UNIPLANE,96020690,CDM,960,RC,20690,HCPCS,Outpatient,,,1473,957.45,,1296.24,88,,,percent of total billed charges,88% of total Billed charges,62.66,100,,,Fee Schedule,100% of Medicare rate,342.6,100,,,Fee Schedule,100% of WA Medicaid,1473,100,,,percent of total billed charges,100% of total billed charges,352.88,103,,,Fee Schedule,103% of WA Medicaid,62.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,342.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1016.37,69,,,percent of total billed charges,69% of total billed charges,1473,100,,,percent of total billed charges,100% of total billed charges,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1473,100,,,percent of total billed charges,100% of total billed charges,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1473,100,,,percent of total billed charges,100% of total billed charges,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,911.05,61.85,,,percent of total billed charges,61.85% of total billed charges,342.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,445.38,130,,,Fee Schedule,130% of WA Medicaid ,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,555.32,37.7,,,percent of total billed charges,37.70% of total billed charges,555.32,37.7,,,percent of total billed charges,37.70% of total billed charges,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,49934.7,33.9,,,percent of total billed charges,33.9% of total billed charges,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1148.94,78,,,percent of total billed charges,78% of total billed charges,1473,100,,,percent of total billed charges,100% of total billed charges,1216.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1216.7,82.6,,,percent of total billed charges,82.6% of total billed charges,342.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.66,49934.7,
"APPLICATION MULTI PINS,WIRES",96020692,CDM,960,RC,20692,HCPCS,Outpatient,,,2791,1814.15,,2456.08,88,,,percent of total billed charges,88% of total Billed charges,108.9,100,,,Fee Schedule,100% of Medicare rate,649.95,100,,,Fee Schedule,100% of WA Medicaid,2791,100,,,percent of total billed charges,100% of total billed charges,669.45,103,,,Fee Schedule,103% of WA Medicaid,108.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,190.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,649.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1925.79,69,,,percent of total billed charges,69% of total billed charges,2791,100,,,percent of total billed charges,100% of total billed charges,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2791,100,,,percent of total billed charges,100% of total billed charges,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2791,100,,,percent of total billed charges,100% of total billed charges,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1726.23,61.85,,,percent of total billed charges,61.85% of total billed charges,649.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,649.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,662.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,844.94,130,,,Fee Schedule,130% of WA Medicaid ,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1052.21,37.7,,,percent of total billed charges,37.70% of total billed charges,1052.21,37.7,,,percent of total billed charges,37.70% of total billed charges,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,94614.9,33.9,,,percent of total billed charges,33.9% of total billed charges,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2176.98,78,,,percent of total billed charges,78% of total billed charges,2791,100,,,percent of total billed charges,100% of total billed charges,2305.37,82.6,,,percent of total billed charges,82.6% of total billed charges,2305.37,82.6,,,percent of total billed charges,82.6% of total billed charges,649.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,649.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.9,94614.9,
ADJUST BONE FIXATION DEVICE,96020693,CDM,960,RC,20693,HCPCS,Outpatient,,,2988,1942.20,,2629.44,88,,,percent of total billed charges,88% of total Billed charges,40.13,100,,,Fee Schedule,100% of Medicare rate,260.17,100,,,Fee Schedule,100% of WA Medicaid,2988,100,,,percent of total billed charges,100% of total billed charges,267.98,103,,,Fee Schedule,103% of WA Medicaid,40.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,260.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2061.72,69,,,percent of total billed charges,69% of total billed charges,2988,100,,,percent of total billed charges,100% of total billed charges,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2988,100,,,percent of total billed charges,100% of total billed charges,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2988,100,,,percent of total billed charges,100% of total billed charges,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1848.08,61.85,,,percent of total billed charges,61.85% of total billed charges,260.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,338.22,130,,,Fee Schedule,130% of WA Medicaid ,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1126.48,37.7,,,percent of total billed charges,37.70% of total billed charges,1126.48,37.7,,,percent of total billed charges,37.70% of total billed charges,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,101293.2,33.9,,,percent of total billed charges,33.9% of total billed charges,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2330.64,78,,,percent of total billed charges,78% of total billed charges,2988,100,,,percent of total billed charges,100% of total billed charges,2468.09,82.6,,,percent of total billed charges,82.6% of total billed charges,2468.09,82.6,,,percent of total billed charges,82.6% of total billed charges,260.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.13,101293.2,
REMOVAL UNDER ANESTHESIA EFS,96020694,CDM,960,RC,20694,HCPCS,Outpatient,,,1074,698.10,,945.12,88,,,percent of total billed charges,88% of total Billed charges,30.73,100,,,Fee Schedule,100% of Medicare rate,200.11,100,,,Fee Schedule,100% of WA Medicaid,1074,100,,,percent of total billed charges,100% of total billed charges,206.11,103,,,Fee Schedule,103% of WA Medicaid,30.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,741.06,69,,,percent of total billed charges,69% of total billed charges,1074,100,,,percent of total billed charges,100% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074,100,,,percent of total billed charges,100% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074,100,,,percent of total billed charges,100% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.27,61.85,,,percent of total billed charges,61.85% of total billed charges,200.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,260.14,130,,,Fee Schedule,130% of WA Medicaid ,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.9,37.7,,,percent of total billed charges,37.70% of total billed charges,404.9,37.7,,,percent of total billed charges,37.70% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,36408.6,33.9,,,percent of total billed charges,33.9% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,837.72,78,,,percent of total billed charges,78% of total billed charges,1074,100,,,percent of total billed charges,100% of total billed charges,887.12,82.6,,,percent of total billed charges,82.6% of total billed charges,887.12,82.6,,,percent of total billed charges,82.6% of total billed charges,200.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.73,36408.6,
SP BONE ALGRFT MORSEL ADD-ON,96020930,CDM,960,RC,20930,HCPCS,Outpatient,,,598,388.70,,526.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,598,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,412.62,69,,,percent of total billed charges,69% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,598,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,598,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,369.86,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,20272.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,466.44,78,,,percent of total billed charges,78% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",225.45,20272.2,
AUTOGRAFT FOR SPINE SURG ONLY,96020936,CDM,960,RC,20936,HCPCS,Outpatient,,,1272,826.80,,1119.36,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1272,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,877.68,69,,,percent of total billed charges,69% of total billed charges,1272,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1272,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1272,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,786.73,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,479.54,37.7,,,percent of total billed charges,37.70% of total billed charges,479.54,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,43120.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,992.16,78,,,percent of total billed charges,78% of total billed charges,1272,100,,,percent of total billed charges,100% of total billed charges,1050.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1050.67,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",479.54,43120.8,
20939 Bone Marrow Aspir Bone Grfg Profee,97520939,CDM,975,RC,20939,HCPCS,Outpatient,,,433,281.45,,381.04,88,,,percent of total billed charges,88% of total Billed charges,10.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,433,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,10.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,298.77,69,,,percent of total billed charges,69% of total billed charges,433,100,,,percent of total billed charges,100% of total billed charges,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,433,100,,,percent of total billed charges,100% of total billed charges,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,433,100,,,percent of total billed charges,100% of total billed charges,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.81,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.24,37.7,,,percent of total billed charges,37.70% of total billed charges,163.24,37.7,,,percent of total billed charges,37.70% of total billed charges,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,14678.7,33.9,,,percent of total billed charges,33.9% of total billed charges,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.74,78,,,percent of total billed charges,78% of total billed charges,433,100,,,percent of total billed charges,100% of total billed charges,357.66,82.6,,,percent of total billed charges,82.6% of total billed charges,357.66,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",10.86,14678.7,
"20999 UNLISTED PROCEDURE, MUSCULOSKELETAL SYSTEM,",97520999,CDM,975,RC,20999,HCPCS,Outpatient,,,1024,665.60,,901.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1024,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,706.56,69,,,percent of total billed charges,69% of total billed charges,1024,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1024,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1024,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,633.34,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,386.05,37.7,,,percent of total billed charges,37.70% of total billed charges,386.05,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,34713.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,798.72,78,,,percent of total billed charges,78% of total billed charges,1024,100,,,percent of total billed charges,100% of total billed charges,845.82,82.6,,,percent of total billed charges,82.6% of total billed charges,845.82,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",386.05,34713.6,
EXCISION TUMOR FACE/SCALP 2CM,96021012,CDM,960,RC,21012,HCPCS,Outpatient,,,554,360.10,,487.52,88,,,percent of total billed charges,88% of total Billed charges,33.93,100,,,Fee Schedule,100% of Medicare rate,196.57,100,,,Fee Schedule,100% of WA Medicaid,554,100,,,percent of total billed charges,100% of total billed charges,202.47,103,,,Fee Schedule,103% of WA Medicaid,33.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,196.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,382.26,69,,,percent of total billed charges,69% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,554,100,,,percent of total billed charges,100% of total billed charges,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,554,100,,,percent of total billed charges,100% of total billed charges,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.65,61.85,,,percent of total billed charges,61.85% of total billed charges,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,255.54,130,,,Fee Schedule,130% of WA Medicaid ,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,18780.6,33.9,,,percent of total billed charges,33.9% of total billed charges,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.12,78,,,percent of total billed charges,78% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.93,18780.6,
21029 REMOVAL BY CONTOURING OF BENIGN TUMOR OF FACIAL BONE (,97521029,CDM,975,RC,21029,HCPCS,Outpatient,,,1620,1053.00,,1425.6,88,,,percent of total billed charges,88% of total Billed charges,54.29,100,,,Fee Schedule,100% of Medicare rate,361.81,100,,,Fee Schedule,100% of WA Medicaid,1620,100,,,percent of total billed charges,100% of total billed charges,372.66,103,,,Fee Schedule,103% of WA Medicaid,54.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,361.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1117.8,69,,,percent of total billed charges,69% of total billed charges,1620,100,,,percent of total billed charges,100% of total billed charges,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1620,100,,,percent of total billed charges,100% of total billed charges,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1620,100,,,percent of total billed charges,100% of total billed charges,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1001.97,61.85,,,percent of total billed charges,61.85% of total billed charges,361.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,470.35,130,,,Fee Schedule,130% of WA Medicaid ,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.74,37.7,,,percent of total billed charges,37.70% of total billed charges,610.74,37.7,,,percent of total billed charges,37.70% of total billed charges,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,54918,33.9,,,percent of total billed charges,33.9% of total billed charges,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1263.6,78,,,percent of total billed charges,78% of total billed charges,1620,100,,,percent of total billed charges,100% of total billed charges,1338.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1338.12,82.6,,,percent of total billed charges,82.6% of total billed charges,361.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.29,54918,
GENIOPLASTY AUGMENT-ALLO/AUTO/PROST,21120,CDM,975,RC,21120,HCPCS,Outpatient,,,1172,761.80,,1031.36,88,,,percent of total billed charges,88% of total Billed charges,40.16,100,,,Fee Schedule,100% of Medicare rate,296.35,100,,,Fee Schedule,100% of WA Medicaid,1172,100,,,percent of total billed charges,100% of total billed charges,305.24,103,,,Fee Schedule,103% of WA Medicaid,40.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,296.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,808.68,69,,,percent of total billed charges,69% of total billed charges,1172,100,,,percent of total billed charges,100% of total billed charges,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1172,100,,,percent of total billed charges,100% of total billed charges,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1172,100,,,percent of total billed charges,100% of total billed charges,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.88,61.85,,,percent of total billed charges,61.85% of total billed charges,296.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,385.26,130,,,Fee Schedule,130% of WA Medicaid ,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.84,37.7,,,percent of total billed charges,37.70% of total billed charges,441.84,37.7,,,percent of total billed charges,37.70% of total billed charges,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,39730.8,33.9,,,percent of total billed charges,33.9% of total billed charges,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,914.16,78,,,percent of total billed charges,78% of total billed charges,1172,100,,,percent of total billed charges,100% of total billed charges,968.07,82.6,,,percent of total billed charges,82.6% of total billed charges,968.07,82.6,,,percent of total billed charges,82.6% of total billed charges,296.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.16,39730.8,
EAR CARTILAGE AUTO GRAFT PROFEE,21235,CDM,975,RC,21235,HCPCS,Outpatient,,,1227,797.55,,1079.76,88,,,percent of total billed charges,88% of total Billed charges,44.91,100,,,Fee Schedule,100% of Medicare rate,331.78,100,,,Fee Schedule,100% of WA Medicaid,1227,100,,,percent of total billed charges,100% of total billed charges,341.73,103,,,Fee Schedule,103% of WA Medicaid,44.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,331.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,846.63,69,,,percent of total billed charges,69% of total billed charges,1227,100,,,percent of total billed charges,100% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1227,100,,,percent of total billed charges,100% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1227,100,,,percent of total billed charges,100% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,758.9,61.85,,,percent of total billed charges,61.85% of total billed charges,331.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,431.31,130,,,Fee Schedule,130% of WA Medicaid ,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,462.58,37.7,,,percent of total billed charges,37.70% of total billed charges,462.58,37.7,,,percent of total billed charges,37.70% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,41595.3,33.9,,,percent of total billed charges,33.9% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,957.06,78,,,percent of total billed charges,78% of total billed charges,1227,100,,,percent of total billed charges,100% of total billed charges,1013.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.5,82.6,,,percent of total billed charges,82.6% of total billed charges,331.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.91,41595.3,
MEDIAL CANTHOPEXY (SEPARATE PROCEDURE) ProFee,97521280,CDM,975,RC,21280,HCPCS,Outpatient,,,1763,1145.95,,1551.44,88,,,percent of total billed charges,88% of total Billed charges,37.18,100,,,Fee Schedule,100% of Medicare rate,343.16,100,,,Fee Schedule,100% of WA Medicaid,1763,100,,,percent of total billed charges,100% of total billed charges,353.45,103,,,Fee Schedule,103% of WA Medicaid,37.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,343.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1216.47,69,,,percent of total billed charges,69% of total billed charges,1763,100,,,percent of total billed charges,100% of total billed charges,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1763,100,,,percent of total billed charges,100% of total billed charges,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1763,100,,,percent of total billed charges,100% of total billed charges,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1090.42,61.85,,,percent of total billed charges,61.85% of total billed charges,343.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,446.11,130,,,Fee Schedule,130% of WA Medicaid ,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.65,37.7,,,percent of total billed charges,37.70% of total billed charges,664.65,37.7,,,percent of total billed charges,37.70% of total billed charges,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,59765.7,33.9,,,percent of total billed charges,33.9% of total billed charges,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1375.14,78,,,percent of total billed charges,78% of total billed charges,1763,100,,,percent of total billed charges,100% of total billed charges,1456.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1456.24,82.6,,,percent of total billed charges,82.6% of total billed charges,343.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.18,59765.7,
21299 UNLISTED CRANIOFACIAL AND MAXILLOFACIAL PROCEDURE ProF,97521299,CDM,975,RC,21299,HCPCS,Outpatient,,,727,472.55,,639.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,727,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,501.63,69,,,percent of total billed charges,69% of total billed charges,727,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,727,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,727,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,449.65,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,274.08,37.7,,,percent of total billed charges,37.70% of total billed charges,274.08,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,24645.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,567.06,78,,,percent of total billed charges,78% of total billed charges,727,100,,,percent of total billed charges,100% of total billed charges,600.5,82.6,,,percent of total billed charges,82.6% of total billed charges,600.5,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",274.08,24645.3,
21320 CLOSED TREATMENT OF NASAL BONE FRACTURE; WIT,97521320,CDM,975,RC,21320,HCPCS,Outpatient,,,457,297.05,,402.16,88,,,percent of total billed charges,88% of total Billed charges,9.08,100,,,Fee Schedule,100% of Medicare rate,54.09,100,,,Fee Schedule,100% of WA Medicaid,457,100,,,percent of total billed charges,100% of total billed charges,55.71,103,,,Fee Schedule,103% of WA Medicaid,9.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,54.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,315.33,69,,,percent of total billed charges,69% of total billed charges,457,100,,,percent of total billed charges,100% of total billed charges,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,457,100,,,percent of total billed charges,100% of total billed charges,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,457,100,,,percent of total billed charges,100% of total billed charges,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.65,61.85,,,percent of total billed charges,61.85% of total billed charges,54.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,70.32,130,,,Fee Schedule,130% of WA Medicaid ,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.29,37.7,,,percent of total billed charges,37.70% of total billed charges,172.29,37.7,,,percent of total billed charges,37.70% of total billed charges,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,15492.3,33.9,,,percent of total billed charges,33.9% of total billed charges,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.46,78,,,percent of total billed charges,78% of total billed charges,457,100,,,percent of total billed charges,100% of total billed charges,377.48,82.6,,,percent of total billed charges,82.6% of total billed charges,377.48,82.6,,,percent of total billed charges,82.6% of total billed charges,54.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.08,15492.3,
"21336 OPEN TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR WITHO",97521336,CDM,975,RC,21336,HCPCS,Outpatient,,,1362,885.30,,1198.56,88,,,percent of total billed charges,88% of total Billed charges,45.21,100,,,Fee Schedule,100% of Medicare rate,373,100,,,Fee Schedule,100% of WA Medicaid,1362,100,,,percent of total billed charges,100% of total billed charges,384.19,103,,,Fee Schedule,103% of WA Medicaid,45.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,373,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,939.78,69,,,percent of total billed charges,69% of total billed charges,1362,100,,,percent of total billed charges,100% of total billed charges,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1362,100,,,percent of total billed charges,100% of total billed charges,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1362,100,,,percent of total billed charges,100% of total billed charges,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.4,61.85,,,percent of total billed charges,61.85% of total billed charges,373,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,373,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,484.9,130,,,Fee Schedule,130% of WA Medicaid ,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.47,37.7,,,percent of total billed charges,37.70% of total billed charges,513.47,37.7,,,percent of total billed charges,37.70% of total billed charges,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,46171.8,33.9,,,percent of total billed charges,33.9% of total billed charges,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1062.36,78,,,percent of total billed charges,78% of total billed charges,1362,100,,,percent of total billed charges,100% of total billed charges,1125.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1125.01,82.6,,,percent of total billed charges,82.6% of total billed charges,373,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,373,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.21,46171.8,
"21337 CLOSED TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR WIT",97521337,CDM,975,RC,21337,HCPCS,Outpatient,,,571,371.15,,502.48,88,,,percent of total billed charges,88% of total Billed charges,22.75,100,,,Fee Schedule,100% of Medicare rate,176.8,100,,,Fee Schedule,100% of WA Medicaid,571,100,,,percent of total billed charges,100% of total billed charges,182.1,103,,,Fee Schedule,103% of WA Medicaid,22.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,176.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,393.99,69,,,percent of total billed charges,69% of total billed charges,571,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,571,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,571,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.16,61.85,,,percent of total billed charges,61.85% of total billed charges,176.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,229.84,130,,,Fee Schedule,130% of WA Medicaid ,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.27,37.7,,,percent of total billed charges,37.70% of total billed charges,215.27,37.7,,,percent of total billed charges,37.70% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,19356.9,33.9,,,percent of total billed charges,33.9% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.38,78,,,percent of total billed charges,78% of total billed charges,571,100,,,percent of total billed charges,100% of total billed charges,471.65,82.6,,,percent of total billed charges,82.6% of total billed charges,471.65,82.6,,,percent of total billed charges,82.6% of total billed charges,176.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.75,19356.9,
"21501 INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT",97521501,CDM,975,RC,21501,HCPCS,Outpatient,,,896,582.40,,788.48,88,,,percent of total billed charges,88% of total Billed charges,31.59,100,,,Fee Schedule,100% of Medicare rate,196.76,100,,,Fee Schedule,100% of WA Medicaid,896,100,,,percent of total billed charges,100% of total billed charges,202.66,103,,,Fee Schedule,103% of WA Medicaid,31.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,55.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,196.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,618.24,69,,,percent of total billed charges,69% of total billed charges,896,100,,,percent of total billed charges,100% of total billed charges,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,896,100,,,percent of total billed charges,100% of total billed charges,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,896,100,,,percent of total billed charges,100% of total billed charges,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.18,61.85,,,percent of total billed charges,61.85% of total billed charges,196.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,255.79,130,,,Fee Schedule,130% of WA Medicaid ,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.79,37.7,,,percent of total billed charges,37.70% of total billed charges,337.79,37.7,,,percent of total billed charges,37.70% of total billed charges,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,30374.4,33.9,,,percent of total billed charges,33.9% of total billed charges,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.88,78,,,percent of total billed charges,78% of total billed charges,896,100,,,percent of total billed charges,100% of total billed charges,740.1,82.6,,,percent of total billed charges,82.6% of total billed charges,740.1,82.6,,,percent of total billed charges,82.6% of total billed charges,196.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.59,30374.4,
EXE TUMOR NECK OR ANTHOR 3CM >,97521552,CDM,975,RC,21552,HCPCS,Outpatient,,,850,552.50,,748,88,,,percent of total billed charges,88% of total Billed charges,52.68,100,,,Fee Schedule,100% of Medicare rate,256.44,100,,,Fee Schedule,100% of WA Medicaid,850,100,,,percent of total billed charges,100% of total billed charges,264.13,103,,,Fee Schedule,103% of WA Medicaid,52.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,256.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,586.5,69,,,percent of total billed charges,69% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,850,100,,,percent of total billed charges,100% of total billed charges,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,850,100,,,percent of total billed charges,100% of total billed charges,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.73,61.85,,,percent of total billed charges,61.85% of total billed charges,256.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,333.37,130,,,Fee Schedule,130% of WA Medicaid ,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,28815,33.9,,,percent of total billed charges,33.9% of total billed charges,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,663,78,,,percent of total billed charges,78% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,256.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.68,28815,
"21554 EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORA",97521554,CDM,975,RC,21554,HCPCS,Outpatient,,,1937,1259.05,,1704.56,88,,,percent of total billed charges,88% of total Billed charges,84.02,100,,,Fee Schedule,100% of Medicare rate,417.76,100,,,Fee Schedule,100% of WA Medicaid,1937,100,,,percent of total billed charges,100% of total billed charges,430.29,103,,,Fee Schedule,103% of WA Medicaid,84.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,147.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,417.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1336.53,69,,,percent of total billed charges,69% of total billed charges,1937,100,,,percent of total billed charges,100% of total billed charges,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1937,100,,,percent of total billed charges,100% of total billed charges,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1937,100,,,percent of total billed charges,100% of total billed charges,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198.03,61.85,,,percent of total billed charges,61.85% of total billed charges,417.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.09,130,,,Fee Schedule,130% of WA Medicaid ,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.25,37.7,,,percent of total billed charges,37.70% of total billed charges,730.25,37.7,,,percent of total billed charges,37.70% of total billed charges,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,65664.3,33.9,,,percent of total billed charges,33.9% of total billed charges,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1510.86,78,,,percent of total billed charges,78% of total billed charges,1937,100,,,percent of total billed charges,100% of total billed charges,1599.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1599.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84.02,65664.3,
EXC TUMOR;S.T NECK <3 CM,97521555,CDM,975,RC,21555,HCPCS,Outpatient,,,916,595.40,,806.08,88,,,percent of total billed charges,88% of total Billed charges,30.39,100,,,Fee Schedule,100% of Medicare rate,178.48,100,,,Fee Schedule,100% of WA Medicaid,916,100,,,percent of total billed charges,100% of total billed charges,183.83,103,,,Fee Schedule,103% of WA Medicaid,30.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,178.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,632.04,69,,,percent of total billed charges,69% of total billed charges,916,100,,,percent of total billed charges,100% of total billed charges,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,916,100,,,percent of total billed charges,100% of total billed charges,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,916,100,,,percent of total billed charges,100% of total billed charges,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,566.55,61.85,,,percent of total billed charges,61.85% of total billed charges,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,232.02,130,,,Fee Schedule,130% of WA Medicaid ,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.33,37.7,,,percent of total billed charges,37.70% of total billed charges,345.33,37.7,,,percent of total billed charges,37.70% of total billed charges,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,31052.4,33.9,,,percent of total billed charges,33.9% of total billed charges,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.48,78,,,percent of total billed charges,78% of total billed charges,916,100,,,percent of total billed charges,100% of total billed charges,756.62,82.6,,,percent of total billed charges,82.6% of total billed charges,756.62,82.6,,,percent of total billed charges,82.6% of total billed charges,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.39,31052.4,
"21557 RADICAL RESECTION OF TUMOR (EG, SARCOMA), SO",97521557,CDM,975,RC,21557,HCPCS,Outpatient,,,3646,2369.90,,3208.48,88,,,percent of total billed charges,88% of total Billed charges,110.99,100,,,Fee Schedule,100% of Medicare rate,545.51,100,,,Fee Schedule,100% of WA Medicaid,3646,100,,,percent of total billed charges,100% of total billed charges,561.88,103,,,Fee Schedule,103% of WA Medicaid,110.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,194.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,545.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2515.74,69,,,percent of total billed charges,69% of total billed charges,3646,100,,,percent of total billed charges,100% of total billed charges,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3646,100,,,percent of total billed charges,100% of total billed charges,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3646,100,,,percent of total billed charges,100% of total billed charges,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2255.05,61.85,,,percent of total billed charges,61.85% of total billed charges,545.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,709.16,130,,,Fee Schedule,130% of WA Medicaid ,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1374.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1374.54,37.7,,,percent of total billed charges,37.70% of total billed charges,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,123599.4,33.9,,,percent of total billed charges,33.9% of total billed charges,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2843.88,78,,,percent of total billed charges,78% of total billed charges,3646,100,,,percent of total billed charges,100% of total billed charges,3011.6,82.6,,,percent of total billed charges,82.6% of total billed charges,3011.6,82.6,,,percent of total billed charges,82.6% of total billed charges,545.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.99,123599.4,
"EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLAN",97521930,CDM,975,RC,21930,HCPCS,Outpatient,,,1777,1155.05,,1563.76,88,,,percent of total billed charges,88% of total Billed charges,39.13,100,,,Fee Schedule,100% of Medicare rate,211.3,100,,,Fee Schedule,100% of WA Medicaid,1777,100,,,percent of total billed charges,100% of total billed charges,217.64,103,,,Fee Schedule,103% of WA Medicaid,39.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,211.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1226.13,69,,,percent of total billed charges,69% of total billed charges,1777,100,,,percent of total billed charges,100% of total billed charges,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1777,100,,,percent of total billed charges,100% of total billed charges,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1777,100,,,percent of total billed charges,100% of total billed charges,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1099.07,61.85,,,percent of total billed charges,61.85% of total billed charges,211.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,274.69,130,,,Fee Schedule,130% of WA Medicaid ,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,669.93,37.7,,,percent of total billed charges,37.70% of total billed charges,669.93,37.7,,,percent of total billed charges,37.70% of total billed charges,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,60240.3,33.9,,,percent of total billed charges,33.9% of total billed charges,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1386.06,78,,,percent of total billed charges,78% of total billed charges,1777,100,,,percent of total billed charges,100% of total billed charges,1467.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1467.8,82.6,,,percent of total billed charges,82.6% of total billed charges,211.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.13,60240.3,
EXC BACK LES SC 3 CM/>,97521931,CDM,975,RC,21931,HCPCS,Outpatient,,,985,640.25,,866.8,88,,,percent of total billed charges,88% of total Billed charges,56.71,100,,,Fee Schedule,100% of Medicare rate,268.93,100,,,Fee Schedule,100% of WA Medicaid,985,100,,,percent of total billed charges,100% of total billed charges,277,103,,,Fee Schedule,103% of WA Medicaid,56.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,268.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,679.65,69,,,percent of total billed charges,69% of total billed charges,985,100,,,percent of total billed charges,100% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,985,100,,,percent of total billed charges,100% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,985,100,,,percent of total billed charges,100% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,609.22,61.85,,,percent of total billed charges,61.85% of total billed charges,268.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,349.61,130,,,Fee Schedule,130% of WA Medicaid ,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.35,37.7,,,percent of total billed charges,37.70% of total billed charges,371.35,37.7,,,percent of total billed charges,37.70% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,33391.5,33.9,,,percent of total billed charges,33.9% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,768.3,78,,,percent of total billed charges,78% of total billed charges,985,100,,,percent of total billed charges,100% of total billed charges,813.61,82.6,,,percent of total billed charges,82.6% of total billed charges,813.61,82.6,,,percent of total billed charges,82.6% of total billed charges,268.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.71,33391.5,
"EXC TUMOR S.T;BACK,FLANK <5CM",96021932,CDM,960,RC,21932,HCPCS,Outpatient,,,1384,899.60,,1217.92,88,,,percent of total billed charges,88% of total Billed charges,77.55,100,,,Fee Schedule,100% of Medicare rate,378.78,100,,,Fee Schedule,100% of WA Medicaid,1384,100,,,percent of total billed charges,100% of total billed charges,390.14,103,,,Fee Schedule,103% of WA Medicaid,77.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,378.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,954.96,69,,,percent of total billed charges,69% of total billed charges,1384,100,,,percent of total billed charges,100% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1384,100,,,percent of total billed charges,100% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1384,100,,,percent of total billed charges,100% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,856,61.85,,,percent of total billed charges,61.85% of total billed charges,378.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,492.41,130,,,Fee Schedule,130% of WA Medicaid ,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,521.77,37.7,,,percent of total billed charges,37.70% of total billed charges,521.77,37.7,,,percent of total billed charges,37.70% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,46917.6,33.9,,,percent of total billed charges,33.9% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079.52,78,,,percent of total billed charges,78% of total billed charges,1384,100,,,percent of total billed charges,100% of total billed charges,1143.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1143.18,82.6,,,percent of total billed charges,82.6% of total billed charges,378.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.55,46917.6,
EXCISION TUMOR BACK FLANK,96021933,CDM,960,RC,21933,HCPCS,Outpatient,,,1540,1001.00,,1355.2,88,,,percent of total billed charges,88% of total Billed charges,90.12,100,,,Fee Schedule,100% of Medicare rate,420.37,100,,,Fee Schedule,100% of WA Medicaid,1540,100,,,percent of total billed charges,100% of total billed charges,432.98,103,,,Fee Schedule,103% of WA Medicaid,90.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,420.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1062.6,69,,,percent of total billed charges,69% of total billed charges,1540,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1540,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1540,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,952.49,61.85,,,percent of total billed charges,61.85% of total billed charges,420.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,546.48,130,,,Fee Schedule,130% of WA Medicaid ,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,580.58,37.7,,,percent of total billed charges,37.70% of total billed charges,580.58,37.7,,,percent of total billed charges,37.70% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,52206,33.9,,,percent of total billed charges,33.9% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1201.2,78,,,percent of total billed charges,78% of total billed charges,1540,100,,,percent of total billed charges,100% of total billed charges,1272.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1272.04,82.6,,,percent of total billed charges,82.6% of total billed charges,420.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.12,52206,
RADIATION RESECT SOFT TISS TUM,96021936,CDM,960,RC,21936,HCPCS,Outpatient,,,2587,1681.55,,2276.56,88,,,percent of total billed charges,88% of total Billed charges,180.68,100,,,Fee Schedule,100% of Medicare rate,798.78,100,,,Fee Schedule,100% of WA Medicaid,2587,100,,,percent of total billed charges,100% of total billed charges,822.74,103,,,Fee Schedule,103% of WA Medicaid,180.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,316.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,798.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1785.03,69,,,percent of total billed charges,69% of total billed charges,2587,100,,,percent of total billed charges,100% of total billed charges,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2587,100,,,percent of total billed charges,100% of total billed charges,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2587,100,,,percent of total billed charges,100% of total billed charges,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1600.06,61.85,,,percent of total billed charges,61.85% of total billed charges,798.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,798.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,814.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1038.41,130,,,Fee Schedule,130% of WA Medicaid ,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,975.3,37.7,,,percent of total billed charges,37.70% of total billed charges,975.3,37.7,,,percent of total billed charges,37.70% of total billed charges,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,87699.3,33.9,,,percent of total billed charges,33.9% of total billed charges,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2017.86,78,,,percent of total billed charges,78% of total billed charges,2587,100,,,percent of total billed charges,100% of total billed charges,2136.86,82.6,,,percent of total billed charges,82.6% of total billed charges,2136.86,82.6,,,percent of total billed charges,82.6% of total billed charges,798.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,180.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,798.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,180.68,87699.3,
"22015 INCISION AND DRAINAGE, OPEN, OF DEEP ABSCESS (SUBFASCI",97522015,CDM,975,RC,22015,HCPCS,Outpatient,,,2929,1903.85,,2577.52,88,,,percent of total billed charges,88% of total Billed charges,121.54,100,,,Fee Schedule,100% of Medicare rate,544.77,100,,,Fee Schedule,100% of WA Medicaid,2929,100,,,percent of total billed charges,100% of total billed charges,561.11,103,,,Fee Schedule,103% of WA Medicaid,121.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,212.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,544.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2021.01,69,,,percent of total billed charges,69% of total billed charges,2929,100,,,percent of total billed charges,100% of total billed charges,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2929,100,,,percent of total billed charges,100% of total billed charges,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2929,100,,,percent of total billed charges,100% of total billed charges,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1811.59,61.85,,,percent of total billed charges,61.85% of total billed charges,544.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,555.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,708.2,130,,,Fee Schedule,130% of WA Medicaid ,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1104.23,37.7,,,percent of total billed charges,37.70% of total billed charges,1104.23,37.7,,,percent of total billed charges,37.70% of total billed charges,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,99293.1,33.9,,,percent of total billed charges,33.9% of total billed charges,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2284.62,78,,,percent of total billed charges,78% of total billed charges,2929,100,,,percent of total billed charges,100% of total billed charges,2419.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2419.35,82.6,,,percent of total billed charges,82.6% of total billed charges,544.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.54,99293.1,
OPTX/RDCTJ/VERT FX/DISLC PST 1,96022325,CDM,960,RC,22325,HCPCS,Outpatient,,,3180,2067.00,,2798.4,88,,,percent of total billed charges,88% of total Billed charges,221.04,100,,,Fee Schedule,100% of Medicare rate,842.42,100,,,Fee Schedule,100% of WA Medicaid,3180,100,,,percent of total billed charges,100% of total billed charges,867.69,103,,,Fee Schedule,103% of WA Medicaid,221.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,386.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,842.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2194.2,69,,,percent of total billed charges,69% of total billed charges,3180,100,,,percent of total billed charges,100% of total billed charges,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3180,100,,,percent of total billed charges,100% of total billed charges,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3180,100,,,percent of total billed charges,100% of total billed charges,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1966.83,61.85,,,percent of total billed charges,61.85% of total billed charges,842.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1095.15,130,,,Fee Schedule,130% of WA Medicaid ,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1198.86,37.7,,,percent of total billed charges,37.70% of total billed charges,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,107802,33.9,,,percent of total billed charges,33.9% of total billed charges,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2480.4,78,,,percent of total billed charges,78% of total billed charges,3180,100,,,percent of total billed charges,100% of total billed charges,2626.68,82.6,,,percent of total billed charges,82.6% of total billed charges,2626.68,82.6,,,percent of total billed charges,82.6% of total billed charges,842.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,221.04,107802,
22327 OPEN TREATMENT AND/OR REDUCTION OF VERTEBRAL FRACTURE(,97522327,CDM,975,RC,22327,HCPCS,Outpatient,,,3943,2562.95,,3469.84,88,,,percent of total billed charges,88% of total Billed charges,235.05,100,,,Fee Schedule,100% of Medicare rate,876.74,100,,,Fee Schedule,100% of WA Medicaid,3943,100,,,percent of total billed charges,100% of total billed charges,903.04,103,,,Fee Schedule,103% of WA Medicaid,235.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,411.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,876.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2720.67,69,,,percent of total billed charges,69% of total billed charges,3943,100,,,percent of total billed charges,100% of total billed charges,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3943,100,,,percent of total billed charges,100% of total billed charges,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3943,100,,,percent of total billed charges,100% of total billed charges,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2438.75,61.85,,,percent of total billed charges,61.85% of total billed charges,876.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1139.76,130,,,Fee Schedule,130% of WA Medicaid ,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1486.51,37.7,,,percent of total billed charges,37.70% of total billed charges,1486.51,37.7,,,percent of total billed charges,37.70% of total billed charges,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,133667.7,33.9,,,percent of total billed charges,33.9% of total billed charges,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3075.54,78,,,percent of total billed charges,78% of total billed charges,3943,100,,,percent of total billed charges,100% of total billed charges,3256.92,82.6,,,percent of total billed charges,82.6% of total billed charges,3256.92,82.6,,,percent of total billed charges,82.6% of total billed charges,876.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,235.05,133667.7,
22328 OPEN TREATMENT AND/OR REDUCTION OF VERTEBRAL FRACTURE(,97522328,CDM,975,RC,22328,HCPCS,Outpatient,,,968,629.20,,851.84,88,,,percent of total billed charges,88% of total Billed charges,48.68,100,,,Fee Schedule,100% of Medicare rate,155.17,100,,,Fee Schedule,100% of WA Medicaid,968,100,,,percent of total billed charges,100% of total billed charges,159.83,103,,,Fee Schedule,103% of WA Medicaid,48.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,155.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,667.92,69,,,percent of total billed charges,69% of total billed charges,968,100,,,percent of total billed charges,100% of total billed charges,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,968,100,,,percent of total billed charges,100% of total billed charges,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,968,100,,,percent of total billed charges,100% of total billed charges,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.71,61.85,,,percent of total billed charges,61.85% of total billed charges,155.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,201.72,130,,,Fee Schedule,130% of WA Medicaid ,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.94,37.7,,,percent of total billed charges,37.70% of total billed charges,364.94,37.7,,,percent of total billed charges,37.70% of total billed charges,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,32815.2,33.9,,,percent of total billed charges,33.9% of total billed charges,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,755.04,78,,,percent of total billed charges,78% of total billed charges,968,100,,,percent of total billed charges,100% of total billed charges,799.57,82.6,,,percent of total billed charges,82.6% of total billed charges,799.57,82.6,,,percent of total billed charges,82.6% of total billed charges,155.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.68,32815.2,
PERCUT KYPHOPLASTY LUMBAR,96022514,CDM,960,RC,22514,HCPCS,Outpatient,,,1431,930.15,,1259.28,88,,,percent of total billed charges,88% of total Billed charges,53.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1431,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,53.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,987.39,69,,,percent of total billed charges,69% of total billed charges,1431,100,,,percent of total billed charges,100% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1431,100,,,percent of total billed charges,100% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1431,100,,,percent of total billed charges,100% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.07,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.49,37.7,,,percent of total billed charges,37.70% of total billed charges,539.49,37.7,,,percent of total billed charges,37.70% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,48510.9,33.9,,,percent of total billed charges,33.9% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116.18,78,,,percent of total billed charges,78% of total billed charges,1431,100,,,percent of total billed charges,100% of total billed charges,1182.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1182.01,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",53.02,48510.9,
NECK SPINE FUSE  REMOV BEL C2,96022551,CDM,960,RC,22551,HCPCS,Outpatient,,,3564,2316.60,,3136.32,88,,,percent of total billed charges,88% of total Billed charges,266.73,100,,,Fee Schedule,100% of Medicare rate,959.54,100,,,Fee Schedule,100% of WA Medicaid,3564,100,,,percent of total billed charges,100% of total billed charges,988.33,103,,,Fee Schedule,103% of WA Medicaid,266.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,466.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,959.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2459.16,69,,,percent of total billed charges,69% of total billed charges,3564,100,,,percent of total billed charges,100% of total billed charges,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3564,100,,,percent of total billed charges,100% of total billed charges,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3564,100,,,percent of total billed charges,100% of total billed charges,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2204.33,61.85,,,percent of total billed charges,61.85% of total billed charges,959.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,959.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,978.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1247.4,130,,,Fee Schedule,130% of WA Medicaid ,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1343.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1343.63,37.7,,,percent of total billed charges,37.70% of total billed charges,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,120819.6,33.9,,,percent of total billed charges,33.9% of total billed charges,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2779.92,78,,,percent of total billed charges,78% of total billed charges,3564,100,,,percent of total billed charges,100% of total billed charges,2943.86,82.6,,,percent of total billed charges,82.6% of total billed charges,2943.86,82.6,,,percent of total billed charges,82.6% of total billed charges,959.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,266.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,959.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,266.73,120819.6,
ARTHRODESIS ANTERIOR,96022554,CDM,960,RC,22554,HCPCS,Outpatient,,,2311,1502.15,,2033.68,88,,,percent of total billed charges,88% of total Billed charges,190.09,100,,,Fee Schedule,100% of Medicare rate,717.28,100,,,Fee Schedule,100% of WA Medicaid,2311,100,,,percent of total billed charges,100% of total billed charges,738.8,103,,,Fee Schedule,103% of WA Medicaid,190.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,332.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,717.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1594.59,69,,,percent of total billed charges,69% of total billed charges,2311,100,,,percent of total billed charges,100% of total billed charges,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2311,100,,,percent of total billed charges,100% of total billed charges,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2311,100,,,percent of total billed charges,100% of total billed charges,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1429.35,61.85,,,percent of total billed charges,61.85% of total billed charges,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,932.46,130,,,Fee Schedule,130% of WA Medicaid ,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,871.25,37.7,,,percent of total billed charges,37.70% of total billed charges,871.25,37.7,,,percent of total billed charges,37.70% of total billed charges,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,78342.9,33.9,,,percent of total billed charges,33.9% of total billed charges,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1802.58,78,,,percent of total billed charges,78% of total billed charges,2311,100,,,percent of total billed charges,100% of total billed charges,1908.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1908.89,82.6,,,percent of total billed charges,82.6% of total billed charges,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,190.09,78342.9,
"22556 ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING M",97522556,CDM,975,RC,22556,HCPCS,Outpatient,,,8106,5268.90,,7133.28,88,,,percent of total billed charges,88% of total Billed charges,253.43,100,,,Fee Schedule,100% of Medicare rate,953.57,100,,,Fee Schedule,100% of WA Medicaid,8106,100,,,percent of total billed charges,100% of total billed charges,982.18,103,,,Fee Schedule,103% of WA Medicaid,253.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,443.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,953.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5593.14,69,,,percent of total billed charges,69% of total billed charges,8106,100,,,percent of total billed charges,100% of total billed charges,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,8106,100,,,percent of total billed charges,100% of total billed charges,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,8106,100,,,percent of total billed charges,100% of total billed charges,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,5013.56,61.85,,,percent of total billed charges,61.85% of total billed charges,953.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,953.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,972.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1239.64,130,,,Fee Schedule,130% of WA Medicaid ,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3055.96,37.7,,,percent of total billed charges,37.70% of total billed charges,3055.96,37.7,,,percent of total billed charges,37.70% of total billed charges,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,274793.4,33.9,,,percent of total billed charges,33.9% of total billed charges,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6322.68,78,,,percent of total billed charges,78% of total billed charges,8106,100,,,percent of total billed charges,100% of total billed charges,6695.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6695.56,82.6,,,percent of total billed charges,82.6% of total billed charges,953.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,953.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,253.43,274793.4,
ANTERIOR APPROACH CERV FUS;LUM,96022558,CDM,960,RC,22558,HCPCS,Outpatient,,,2905,1888.25,,2556.4,88,,,percent of total billed charges,88% of total Billed charges,214.61,100,,,Fee Schedule,100% of Medicare rate,861.63,100,,,Fee Schedule,100% of WA Medicaid,2905,100,,,percent of total billed charges,100% of total billed charges,887.48,103,,,Fee Schedule,103% of WA Medicaid,214.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,375.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,861.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2004.45,69,,,percent of total billed charges,69% of total billed charges,2905,100,,,percent of total billed charges,100% of total billed charges,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2905,100,,,percent of total billed charges,100% of total billed charges,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2905,100,,,percent of total billed charges,100% of total billed charges,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1796.74,61.85,,,percent of total billed charges,61.85% of total billed charges,861.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,878.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.12,130,,,Fee Schedule,130% of WA Medicaid ,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1095.19,37.7,,,percent of total billed charges,37.70% of total billed charges,1095.19,37.7,,,percent of total billed charges,37.70% of total billed charges,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,98479.5,33.9,,,percent of total billed charges,33.9% of total billed charges,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2265.9,78,,,percent of total billed charges,78% of total billed charges,2905,100,,,percent of total billed charges,100% of total billed charges,2399.53,82.6,,,percent of total billed charges,82.6% of total billed charges,2399.53,82.6,,,percent of total billed charges,82.6% of total billed charges,861.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,214.61,98479.5,
ARTHODESIS POSTERIOR/POSTEROLA,96022600,CDM,960,RC,22600,HCPCS,Outpatient,,,2354,1530.10,,2071.52,88,,,percent of total billed charges,88% of total Billed charges,197.94,100,,,Fee Schedule,100% of Medicare rate,743.58,100,,,Fee Schedule,100% of WA Medicaid,2354,100,,,percent of total billed charges,100% of total billed charges,765.89,103,,,Fee Schedule,103% of WA Medicaid,197.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,346.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,743.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1624.26,69,,,percent of total billed charges,69% of total billed charges,2354,100,,,percent of total billed charges,100% of total billed charges,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2354,100,,,percent of total billed charges,100% of total billed charges,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2354,100,,,percent of total billed charges,100% of total billed charges,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1455.95,61.85,,,percent of total billed charges,61.85% of total billed charges,743.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,743.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,758.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,966.65,130,,,Fee Schedule,130% of WA Medicaid ,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,887.46,37.7,,,percent of total billed charges,37.70% of total billed charges,887.46,37.7,,,percent of total billed charges,37.70% of total billed charges,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,79800.6,33.9,,,percent of total billed charges,33.9% of total billed charges,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836.12,78,,,percent of total billed charges,78% of total billed charges,2354,100,,,percent of total billed charges,100% of total billed charges,1944.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1944.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,743.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,197.94,79800.6,
ARTHRODESIS;THORACIC,96022610,CDM,960,RC,22610,HCPCS,Outpatient,,,2375,1543.75,,2090,88,,,percent of total billed charges,88% of total Billed charges,187.96,100,,,Fee Schedule,100% of Medicare rate,731.64,100,,,Fee Schedule,100% of WA Medicaid,2375,100,,,percent of total billed charges,100% of total billed charges,753.59,103,,,Fee Schedule,103% of WA Medicaid,187.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,328.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,731.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1638.75,69,,,percent of total billed charges,69% of total billed charges,2375,100,,,percent of total billed charges,100% of total billed charges,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2375,100,,,percent of total billed charges,100% of total billed charges,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2375,100,,,percent of total billed charges,100% of total billed charges,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1468.94,61.85,,,percent of total billed charges,61.85% of total billed charges,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,951.13,130,,,Fee Schedule,130% of WA Medicaid ,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,895.38,37.7,,,percent of total billed charges,37.70% of total billed charges,895.38,37.7,,,percent of total billed charges,37.70% of total billed charges,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,80512.5,33.9,,,percent of total billed charges,33.9% of total billed charges,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1852.5,78,,,percent of total billed charges,78% of total billed charges,2375,100,,,percent of total billed charges,100% of total billed charges,1961.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1961.75,82.6,,,percent of total billed charges,82.6% of total billed charges,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.96,80512.5,
ARTHRODESIS;LUMBAR,96022612,CDM,960,RC,22612,HCPCS,Outpatient,,,3000,1950.00,,2640,88,,,percent of total billed charges,88% of total Billed charges,222.07,100,,,Fee Schedule,100% of Medicare rate,895.39,100,,,Fee Schedule,100% of WA Medicaid,3000,100,,,percent of total billed charges,100% of total billed charges,922.25,103,,,Fee Schedule,103% of WA Medicaid,222.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,388.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,895.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2070,69,,,percent of total billed charges,69% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3000,100,,,percent of total billed charges,100% of total billed charges,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3000,100,,,percent of total billed charges,100% of total billed charges,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1855.5,61.85,,,percent of total billed charges,61.85% of total billed charges,895.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,895.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1164.01,130,,,Fee Schedule,130% of WA Medicaid ,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,101700,33.9,,,percent of total billed charges,33.9% of total billed charges,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2340,78,,,percent of total billed charges,78% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,895.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,895.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,222.07,101700,
"ARTHODESIS,POSTERIOR INTERBODY",96022630,CDM,960,RC,22630,HCPCS,Outpatient,,,2912,1892.80,,2562.56,88,,,percent of total billed charges,88% of total Billed charges,251.76,100,,,Fee Schedule,100% of Medicare rate,882.7,100,,,Fee Schedule,100% of WA Medicaid,2912,100,,,percent of total billed charges,100% of total billed charges,909.18,103,,,Fee Schedule,103% of WA Medicaid,251.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,440.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,882.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2009.28,69,,,percent of total billed charges,69% of total billed charges,2912,100,,,percent of total billed charges,100% of total billed charges,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2912,100,,,percent of total billed charges,100% of total billed charges,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2912,100,,,percent of total billed charges,100% of total billed charges,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1801.07,61.85,,,percent of total billed charges,61.85% of total billed charges,882.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,882.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,900.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1147.51,130,,,Fee Schedule,130% of WA Medicaid ,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1097.82,37.7,,,percent of total billed charges,37.70% of total billed charges,1097.82,37.7,,,percent of total billed charges,37.70% of total billed charges,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,98716.8,33.9,,,percent of total billed charges,33.9% of total billed charges,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2271.36,78,,,percent of total billed charges,78% of total billed charges,2912,100,,,percent of total billed charges,100% of total billed charges,2405.31,82.6,,,percent of total billed charges,82.6% of total billed charges,2405.31,82.6,,,percent of total billed charges,82.6% of total billed charges,882.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,882.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,251.76,98716.8,
ARTHRODESIS INCL LAMIN/DISCECT,96022633,CDM,960,RC,22633,HCPCS,Outpatient,,,3371,2191.15,,2966.48,88,,,percent of total billed charges,88% of total Billed charges,273.07,100,,,Fee Schedule,100% of Medicare rate,1020.9,100,,,Fee Schedule,100% of WA Medicaid,3371,100,,,percent of total billed charges,100% of total billed charges,1051.53,103,,,Fee Schedule,103% of WA Medicaid,273.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,477.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1020.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2325.99,69,,,percent of total billed charges,69% of total billed charges,3371,100,,,percent of total billed charges,100% of total billed charges,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3371,100,,,percent of total billed charges,100% of total billed charges,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3371,100,,,percent of total billed charges,100% of total billed charges,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2084.96,61.85,,,percent of total billed charges,61.85% of total billed charges,1020.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1041.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1327.17,130,,,Fee Schedule,130% of WA Medicaid ,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1270.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1270.87,37.7,,,percent of total billed charges,37.70% of total billed charges,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,114276.9,33.9,,,percent of total billed charges,33.9% of total billed charges,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2629.38,78,,,percent of total billed charges,78% of total billed charges,3371,100,,,percent of total billed charges,100% of total billed charges,2784.45,82.6,,,percent of total billed charges,82.6% of total billed charges,2784.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1020.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,273.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.07,114276.9,
22830 EXPLORATION OF SPINAL FUSION ProFee,97522830,CDM,975,RC,22830,HCPCS,Outpatient,,,4696,3052.40,,4132.48,88,,,percent of total billed charges,88% of total Billed charges,112.48,100,,,Fee Schedule,100% of Medicare rate,470.91,100,,,Fee Schedule,100% of WA Medicaid,4696,100,,,percent of total billed charges,100% of total billed charges,485.04,103,,,Fee Schedule,103% of WA Medicaid,112.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,196.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,470.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3240.24,69,,,percent of total billed charges,69% of total billed charges,4696,100,,,percent of total billed charges,100% of total billed charges,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4696,100,,,percent of total billed charges,100% of total billed charges,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4696,100,,,percent of total billed charges,100% of total billed charges,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2904.48,61.85,,,percent of total billed charges,61.85% of total billed charges,470.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,612.18,130,,,Fee Schedule,130% of WA Medicaid ,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1770.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1770.39,37.7,,,percent of total billed charges,37.70% of total billed charges,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,159194.4,33.9,,,percent of total billed charges,33.9% of total billed charges,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3662.88,78,,,percent of total billed charges,78% of total billed charges,4696,100,,,percent of total billed charges,100% of total billed charges,3878.9,82.6,,,percent of total billed charges,82.6% of total billed charges,3878.9,82.6,,,percent of total billed charges,82.6% of total billed charges,470.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.48,159194.4,
POSTERIOR NON-SEGMENTAL INSTRU,96022840,CDM,960,RC,22840,HCPCS,Outpatient,,,1431,930.15,,1259.28,88,,,percent of total billed charges,88% of total Billed charges,122,100,,,Fee Schedule,100% of Medicare rate,418.13,100,,,Fee Schedule,100% of WA Medicaid,1431,100,,,percent of total billed charges,100% of total billed charges,430.67,103,,,Fee Schedule,103% of WA Medicaid,122,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,213.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,418.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,987.39,69,,,percent of total billed charges,69% of total billed charges,1431,100,,,percent of total billed charges,100% of total billed charges,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,1431,100,,,percent of total billed charges,100% of total billed charges,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,1431,100,,,percent of total billed charges,100% of total billed charges,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.07,61.85,,,percent of total billed charges,61.85% of total billed charges,418.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.57,130,,,Fee Schedule,130% of WA Medicaid ,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.49,37.7,,,percent of total billed charges,37.70% of total billed charges,539.49,37.7,,,percent of total billed charges,37.70% of total billed charges,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,48510.9,33.9,,,percent of total billed charges,33.9% of total billed charges,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116.18,78,,,percent of total billed charges,78% of total billed charges,1431,100,,,percent of total billed charges,100% of total billed charges,1182.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1182.01,82.6,,,percent of total billed charges,82.6% of total billed charges,418.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,122,48510.9,
22841 INTERNAL SPINAL FIXATION BY WIRING OF SPINOUS PROCESSE,97522841,CDM,975,RC,22841,HCPCS,Outpatient,,,1563,1015.95,,1375.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1563,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1078.47,69,,,percent of total billed charges,69% of total billed charges,1563,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1563,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1563,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,966.72,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,589.25,37.7,,,percent of total billed charges,37.70% of total billed charges,589.25,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,52985.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1219.14,78,,,percent of total billed charges,78% of total billed charges,1563,100,,,percent of total billed charges,100% of total billed charges,1291.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1291.04,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",589.25,52985.7,
POSTERIOR SEG INSTRUM 3-6 VERT,96022842,CDM,960,RC,22842,HCPCS,Outpatient,,,1357,882.05,,1194.16,88,,,percent of total billed charges,88% of total Billed charges,126.32,100,,,Fee Schedule,100% of Medicare rate,421.49,100,,,Fee Schedule,100% of WA Medicaid,1357,100,,,percent of total billed charges,100% of total billed charges,434.13,103,,,Fee Schedule,103% of WA Medicaid,126.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,221.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,421.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,936.33,69,,,percent of total billed charges,69% of total billed charges,1357,100,,,percent of total billed charges,100% of total billed charges,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357,100,,,percent of total billed charges,100% of total billed charges,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357,100,,,percent of total billed charges,100% of total billed charges,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,839.3,61.85,,,percent of total billed charges,61.85% of total billed charges,421.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,547.94,130,,,Fee Schedule,130% of WA Medicaid ,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,511.59,37.7,,,percent of total billed charges,37.70% of total billed charges,511.59,37.7,,,percent of total billed charges,37.70% of total billed charges,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,46002.3,33.9,,,percent of total billed charges,33.9% of total billed charges,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1058.46,78,,,percent of total billed charges,78% of total billed charges,1357,100,,,percent of total billed charges,100% of total billed charges,1120.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1120.88,82.6,,,percent of total billed charges,82.6% of total billed charges,421.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.32,46002.3,
POST SEG INSTRU 7-12 VER SEG,96022843,CDM,960,RC,22843,HCPCS,Outpatient,,,1818,1181.70,,1599.84,88,,,percent of total billed charges,88% of total Billed charges,135.69,100,,,Fee Schedule,100% of Medicare rate,451.33,100,,,Fee Schedule,100% of WA Medicaid,1818,100,,,percent of total billed charges,100% of total billed charges,464.87,103,,,Fee Schedule,103% of WA Medicaid,135.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,237.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,451.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1254.42,69,,,percent of total billed charges,69% of total billed charges,1818,100,,,percent of total billed charges,100% of total billed charges,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1818,100,,,percent of total billed charges,100% of total billed charges,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1818,100,,,percent of total billed charges,100% of total billed charges,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1124.43,61.85,,,percent of total billed charges,61.85% of total billed charges,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,586.73,130,,,Fee Schedule,130% of WA Medicaid ,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.39,37.7,,,percent of total billed charges,37.70% of total billed charges,685.39,37.7,,,percent of total billed charges,37.70% of total billed charges,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,61630.2,33.9,,,percent of total billed charges,33.9% of total billed charges,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1418.04,78,,,percent of total billed charges,78% of total billed charges,1818,100,,,percent of total billed charges,100% of total billed charges,1501.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1501.67,82.6,,,percent of total billed charges,82.6% of total billed charges,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,135.69,61630.2,
INSERT SPINE FIXATION DEVICE,96022845,CDM,960,RC,22845,HCPCS,Outpatient,,,1527,992.55,,1343.76,88,,,percent of total billed charges,88% of total Billed charges,121.87,100,,,Fee Schedule,100% of Medicare rate,400.98,100,,,Fee Schedule,100% of WA Medicaid,1527,100,,,percent of total billed charges,100% of total billed charges,413.01,103,,,Fee Schedule,103% of WA Medicaid,121.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,213.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,400.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1053.63,69,,,percent of total billed charges,69% of total billed charges,1527,100,,,percent of total billed charges,100% of total billed charges,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1527,100,,,percent of total billed charges,100% of total billed charges,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1527,100,,,percent of total billed charges,100% of total billed charges,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,944.45,61.85,,,percent of total billed charges,61.85% of total billed charges,400.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,409,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.27,130,,,Fee Schedule,130% of WA Medicaid ,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.68,37.7,,,percent of total billed charges,37.70% of total billed charges,575.68,37.7,,,percent of total billed charges,37.70% of total billed charges,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,51765.3,33.9,,,percent of total billed charges,33.9% of total billed charges,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191.06,78,,,percent of total billed charges,78% of total billed charges,1527,100,,,percent of total billed charges,100% of total billed charges,1261.3,82.6,,,percent of total billed charges,82.6% of total billed charges,1261.3,82.6,,,percent of total billed charges,82.6% of total billed charges,400.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.87,51765.3,
ANTERIOR INSTRUMENT 4-7 VERTEB,96022846,CDM,960,RC,22846,HCPCS,Outpatient,,,1272,826.80,,1119.36,88,,,percent of total billed charges,88% of total Billed charges,127.66,100,,,Fee Schedule,100% of Medicare rate,417.39,100,,,Fee Schedule,100% of WA Medicaid,1272,100,,,percent of total billed charges,100% of total billed charges,429.91,103,,,Fee Schedule,103% of WA Medicaid,127.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,223.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,417.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,877.68,69,,,percent of total billed charges,69% of total billed charges,1272,100,,,percent of total billed charges,100% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272,100,,,percent of total billed charges,100% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272,100,,,percent of total billed charges,100% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.73,61.85,,,percent of total billed charges,61.85% of total billed charges,417.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,542.61,130,,,Fee Schedule,130% of WA Medicaid ,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.54,37.7,,,percent of total billed charges,37.70% of total billed charges,479.54,37.7,,,percent of total billed charges,37.70% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,43120.8,33.9,,,percent of total billed charges,33.9% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,992.16,78,,,percent of total billed charges,78% of total billed charges,1272,100,,,percent of total billed charges,100% of total billed charges,1050.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1050.67,82.6,,,percent of total billed charges,82.6% of total billed charges,417.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,127.66,43120.8,
REINSERT SPINAL FIXATION DEVIC,96022849,CDM,960,RC,22849,HCPCS,Outpatient,,,2667,1733.55,,2346.96,88,,,percent of total billed charges,88% of total Billed charges,188.97,100,,,Fee Schedule,100% of Medicare rate,739.85,100,,,Fee Schedule,100% of WA Medicaid,2667,100,,,percent of total billed charges,100% of total billed charges,762.05,103,,,Fee Schedule,103% of WA Medicaid,188.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,330.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,739.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1840.23,69,,,percent of total billed charges,69% of total billed charges,2667,100,,,percent of total billed charges,100% of total billed charges,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2667,100,,,percent of total billed charges,100% of total billed charges,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2667,100,,,percent of total billed charges,100% of total billed charges,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1649.54,61.85,,,percent of total billed charges,61.85% of total billed charges,739.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,739.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,754.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,961.81,130,,,Fee Schedule,130% of WA Medicaid ,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1005.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1005.46,37.7,,,percent of total billed charges,37.70% of total billed charges,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,90411.3,33.9,,,percent of total billed charges,33.9% of total billed charges,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2080.26,78,,,percent of total billed charges,78% of total billed charges,2667,100,,,percent of total billed charges,100% of total billed charges,2202.94,82.6,,,percent of total billed charges,82.6% of total billed charges,2202.94,82.6,,,percent of total billed charges,82.6% of total billed charges,739.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,739.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,188.97,90411.3,
REMOVAL SPINAL INSTRUMENTATION,96022850,CDM,960,RC,22850,HCPCS,Outpatient,,,1368,889.20,,1203.84,88,,,percent of total billed charges,88% of total Billed charges,99.25,100,,,Fee Schedule,100% of Medicare rate,421.86,100,,,Fee Schedule,100% of WA Medicaid,1368,100,,,percent of total billed charges,100% of total billed charges,434.52,103,,,Fee Schedule,103% of WA Medicaid,99.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,421.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,943.92,69,,,percent of total billed charges,69% of total billed charges,1368,100,,,percent of total billed charges,100% of total billed charges,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368,100,,,percent of total billed charges,100% of total billed charges,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368,100,,,percent of total billed charges,100% of total billed charges,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.11,61.85,,,percent of total billed charges,61.85% of total billed charges,421.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,548.42,130,,,Fee Schedule,130% of WA Medicaid ,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.74,37.7,,,percent of total billed charges,37.70% of total billed charges,515.74,37.7,,,percent of total billed charges,37.70% of total billed charges,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,46375.2,33.9,,,percent of total billed charges,33.9% of total billed charges,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067.04,78,,,percent of total billed charges,78% of total billed charges,1368,100,,,percent of total billed charges,100% of total billed charges,1129.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1129.97,82.6,,,percent of total billed charges,82.6% of total billed charges,421.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.25,46375.2,
22852 REMOVAL OF POSTERIOR SEGMENTAL INSTRUMENTATION ProFee,97522852,CDM,975,RC,22852,HCPCS,Outpatient,,,2875,1868.75,,2530,88,,,percent of total billed charges,88% of total Billed charges,95.09,100,,,Fee Schedule,100% of Medicare rate,406.94,100,,,Fee Schedule,100% of WA Medicaid,2875,100,,,percent of total billed charges,100% of total billed charges,419.15,103,,,Fee Schedule,103% of WA Medicaid,95.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,166.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,406.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1983.75,69,,,percent of total billed charges,69% of total billed charges,2875,100,,,percent of total billed charges,100% of total billed charges,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2875,100,,,percent of total billed charges,100% of total billed charges,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2875,100,,,percent of total billed charges,100% of total billed charges,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1778.19,61.85,,,percent of total billed charges,61.85% of total billed charges,406.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,529.02,130,,,Fee Schedule,130% of WA Medicaid ,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1083.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1083.88,37.7,,,percent of total billed charges,37.70% of total billed charges,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,97462.5,33.9,,,percent of total billed charges,33.9% of total billed charges,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2242.5,78,,,percent of total billed charges,78% of total billed charges,2875,100,,,percent of total billed charges,100% of total billed charges,2374.75,82.6,,,percent of total billed charges,82.6% of total billed charges,2374.75,82.6,,,percent of total billed charges,82.6% of total billed charges,406.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.09,97462.5,
"CAGE,MESH,W/ARTHRO ANCSCREW EA",96022853,CDM,960,RC,22853,HCPCS,Outpatient,,,1015,659.75,,893.2,88,,,percent of total billed charges,88% of total Billed charges,42.29,100,,,Fee Schedule,100% of Medicare rate,142.3,100,,,Fee Schedule,100% of WA Medicaid,1015,100,,,percent of total billed charges,100% of total billed charges,146.57,103,,,Fee Schedule,103% of WA Medicaid,42.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,142.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,700.35,69,,,percent of total billed charges,69% of total billed charges,1015,100,,,percent of total billed charges,100% of total billed charges,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1015,100,,,percent of total billed charges,100% of total billed charges,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1015,100,,,percent of total billed charges,100% of total billed charges,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,627.78,61.85,,,percent of total billed charges,61.85% of total billed charges,142.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,184.99,130,,,Fee Schedule,130% of WA Medicaid ,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.66,37.7,,,percent of total billed charges,37.70% of total billed charges,382.66,37.7,,,percent of total billed charges,37.70% of total billed charges,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,34408.5,33.9,,,percent of total billed charges,33.9% of total billed charges,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,791.7,78,,,percent of total billed charges,78% of total billed charges,1015,100,,,percent of total billed charges,100% of total billed charges,838.39,82.6,,,percent of total billed charges,82.6% of total billed charges,838.39,82.6,,,percent of total billed charges,82.6% of total billed charges,142.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.29,34408.5,
INSERTION OF INTERVERTEBRAL BIOMECHANICAL DE,96022854,CDM,960,RC,22854,HCPCS,Outpatient,,,1262,820.30,,1110.56,88,,,percent of total billed charges,88% of total Billed charges,57.26,100,,,Fee Schedule,100% of Medicare rate,185.01,100,,,Fee Schedule,100% of WA Medicaid,1262,100,,,percent of total billed charges,100% of total billed charges,190.56,103,,,Fee Schedule,103% of WA Medicaid,57.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,185.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,870.78,69,,,percent of total billed charges,69% of total billed charges,1262,100,,,percent of total billed charges,100% of total billed charges,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262,100,,,percent of total billed charges,100% of total billed charges,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262,100,,,percent of total billed charges,100% of total billed charges,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.55,61.85,,,percent of total billed charges,61.85% of total billed charges,185.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,240.51,130,,,Fee Schedule,130% of WA Medicaid ,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.77,37.7,,,percent of total billed charges,37.70% of total billed charges,475.77,37.7,,,percent of total billed charges,37.70% of total billed charges,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,42781.8,33.9,,,percent of total billed charges,33.9% of total billed charges,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,984.36,78,,,percent of total billed charges,78% of total billed charges,1262,100,,,percent of total billed charges,100% of total billed charges,1042.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1042.41,82.6,,,percent of total billed charges,82.6% of total billed charges,185.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.26,42781.8,
REMOVAL ANTERIOR INSTRUMENTAT,96022855,CDM,960,RC,22855,HCPCS,Outpatient,,,2036,1323.40,,1791.68,88,,,percent of total billed charges,88% of total Billed charges,161.86,100,,,Fee Schedule,100% of Medicare rate,629.62,100,,,Fee Schedule,100% of WA Medicaid,2036,100,,,percent of total billed charges,100% of total billed charges,648.51,103,,,Fee Schedule,103% of WA Medicaid,161.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,283.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,629.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1404.84,69,,,percent of total billed charges,69% of total billed charges,2036,100,,,percent of total billed charges,100% of total billed charges,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2036,100,,,percent of total billed charges,100% of total billed charges,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2036,100,,,percent of total billed charges,100% of total billed charges,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259.27,61.85,,,percent of total billed charges,61.85% of total billed charges,629.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,818.51,130,,,Fee Schedule,130% of WA Medicaid ,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,767.57,37.7,,,percent of total billed charges,37.70% of total billed charges,767.57,37.7,,,percent of total billed charges,37.70% of total billed charges,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,69020.4,33.9,,,percent of total billed charges,33.9% of total billed charges,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1588.08,78,,,percent of total billed charges,78% of total billed charges,2036,100,,,percent of total billed charges,100% of total billed charges,1681.74,82.6,,,percent of total billed charges,82.6% of total billed charges,1681.74,82.6,,,percent of total billed charges,82.6% of total billed charges,629.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,161.86,69020.4,
"DISC ARTHROPLASTY, CERVICAL",96022856,CDM,975,RC,22856,HCPCS,Outpatient,,,3106,2018.90,,2733.28,88,,,percent of total billed charges,88% of total Billed charges,243.48,100,,,Fee Schedule,100% of Medicare rate,917.21,100,,,Fee Schedule,100% of WA Medicaid,3106,100,,,percent of total billed charges,100% of total billed charges,944.73,103,,,Fee Schedule,103% of WA Medicaid,243.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,426.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,917.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2143.14,69,,,percent of total billed charges,69% of total billed charges,3106,100,,,percent of total billed charges,100% of total billed charges,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3106,100,,,percent of total billed charges,100% of total billed charges,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3106,100,,,percent of total billed charges,100% of total billed charges,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1921.06,61.85,,,percent of total billed charges,61.85% of total billed charges,917.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,917.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,935.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1192.37,130,,,Fee Schedule,130% of WA Medicaid ,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1170.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1170.96,37.7,,,percent of total billed charges,37.70% of total billed charges,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,105293.4,33.9,,,percent of total billed charges,33.9% of total billed charges,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2422.68,78,,,percent of total billed charges,78% of total billed charges,3106,100,,,percent of total billed charges,100% of total billed charges,2565.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2565.56,82.6,,,percent of total billed charges,82.6% of total billed charges,917.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,917.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,243.48,105293.4,
DISC ARTHROPLASTY SEC LEV CERV,96022858,CDM,975,RC,22858,HCPCS,Outpatient,,,880,572.00,,774.4,88,,,percent of total billed charges,88% of total Billed charges,80.69,100,,,Fee Schedule,100% of Medicare rate,279.75,100,,,Fee Schedule,100% of WA Medicaid,880,100,,,percent of total billed charges,100% of total billed charges,288.14,103,,,Fee Schedule,103% of WA Medicaid,80.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,141.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,279.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,607.2,69,,,percent of total billed charges,69% of total billed charges,880,100,,,percent of total billed charges,100% of total billed charges,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,880,100,,,percent of total billed charges,100% of total billed charges,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,880,100,,,percent of total billed charges,100% of total billed charges,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.28,61.85,,,percent of total billed charges,61.85% of total billed charges,279.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,363.68,130,,,Fee Schedule,130% of WA Medicaid ,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.76,37.7,,,percent of total billed charges,37.70% of total billed charges,331.76,37.7,,,percent of total billed charges,37.70% of total billed charges,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,29832,33.9,,,percent of total billed charges,33.9% of total billed charges,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.4,78,,,percent of total billed charges,78% of total billed charges,880,100,,,percent of total billed charges,100% of total billed charges,726.88,82.6,,,percent of total billed charges,82.6% of total billed charges,726.88,82.6,,,percent of total billed charges,82.6% of total billed charges,279.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.69,29832,
"CAGE,MESH ANC SCREW N/OTH PROC",96022859,CDM,960,RC,22859,HCPCS,Outpatient,,,1262,820.30,,1110.56,88,,,percent of total billed charges,88% of total Billed charges,54.88,100,,,Fee Schedule,100% of Medicare rate,184.08,100,,,Fee Schedule,100% of WA Medicaid,1262,100,,,percent of total billed charges,100% of total billed charges,189.6,103,,,Fee Schedule,103% of WA Medicaid,54.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,96.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,184.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,870.78,69,,,percent of total billed charges,69% of total billed charges,1262,100,,,percent of total billed charges,100% of total billed charges,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262,100,,,percent of total billed charges,100% of total billed charges,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262,100,,,percent of total billed charges,100% of total billed charges,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.55,61.85,,,percent of total billed charges,61.85% of total billed charges,184.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,239.3,130,,,Fee Schedule,130% of WA Medicaid ,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.77,37.7,,,percent of total billed charges,37.70% of total billed charges,475.77,37.7,,,percent of total billed charges,37.70% of total billed charges,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,42781.8,33.9,,,percent of total billed charges,33.9% of total billed charges,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,984.36,78,,,percent of total billed charges,78% of total billed charges,1262,100,,,percent of total billed charges,100% of total billed charges,1042.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1042.41,82.6,,,percent of total billed charges,82.6% of total billed charges,184.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.88,42781.8,
INS INTER W/O FUS W/OPEN DEC L,96022867,CDM,960,RC,22867,HCPCS,Outpatient,,,2290,1488.50,,2015.2,88,,,percent of total billed charges,88% of total Billed charges,154.27,100,,,Fee Schedule,100% of Medicare rate,608.92,100,,,Fee Schedule,100% of WA Medicaid,2290,100,,,percent of total billed charges,100% of total billed charges,627.19,103,,,Fee Schedule,103% of WA Medicaid,154.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,269.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,608.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1580.1,69,,,percent of total billed charges,69% of total billed charges,2290,100,,,percent of total billed charges,100% of total billed charges,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2290,100,,,percent of total billed charges,100% of total billed charges,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2290,100,,,percent of total billed charges,100% of total billed charges,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1416.37,61.85,,,percent of total billed charges,61.85% of total billed charges,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,791.6,130,,,Fee Schedule,130% of WA Medicaid ,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.33,37.7,,,percent of total billed charges,37.70% of total billed charges,863.33,37.7,,,percent of total billed charges,37.70% of total billed charges,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,77631,33.9,,,percent of total billed charges,33.9% of total billed charges,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786.2,78,,,percent of total billed charges,78% of total billed charges,2290,100,,,percent of total billed charges,100% of total billed charges,1891.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1891.54,82.6,,,percent of total billed charges,82.6% of total billed charges,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,154.27,77631,
INS INTER W/OFUS W/O DEC LUMB,96022869,CDM,960,RC,22869,HCPCS,Outpatient,,,1193,775.45,,1049.84,88,,,percent of total billed charges,88% of total Billed charges,31.28,100,,,Fee Schedule,100% of Medicare rate,249.16,100,,,Fee Schedule,100% of WA Medicaid,1193,100,,,percent of total billed charges,100% of total billed charges,256.63,103,,,Fee Schedule,103% of WA Medicaid,31.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,249.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,823.17,69,,,percent of total billed charges,69% of total billed charges,1193,100,,,percent of total billed charges,100% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193,100,,,percent of total billed charges,100% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193,100,,,percent of total billed charges,100% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,737.87,61.85,,,percent of total billed charges,61.85% of total billed charges,249.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,323.91,130,,,Fee Schedule,130% of WA Medicaid ,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.76,37.7,,,percent of total billed charges,37.70% of total billed charges,449.76,37.7,,,percent of total billed charges,37.70% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,40442.7,33.9,,,percent of total billed charges,33.9% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,930.54,78,,,percent of total billed charges,78% of total billed charges,1193,100,,,percent of total billed charges,100% of total billed charges,985.42,82.6,,,percent of total billed charges,82.6% of total billed charges,985.42,82.6,,,percent of total billed charges,82.6% of total billed charges,249.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.28,40442.7,
UNLISTED SPINE PROCEDURE,96022899,CDM,960,RC,22899,HCPCS,Outpatient,,,1389,902.85,,1222.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1389,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,958.41,69,,,percent of total billed charges,69% of total billed charges,1389,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1389,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1389,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,859.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,523.65,37.7,,,percent of total billed charges,37.70% of total billed charges,523.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,47087.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1083.42,78,,,percent of total billed charges,78% of total billed charges,1389,100,,,percent of total billed charges,100% of total billed charges,1147.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1147.31,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",523.65,47087.1,
"EXC,TUMOR,ST OF ABDO WA,SUBFAC",96022900,CDM,960,RC,22900,HCPCS,Outpatient,,,1180,767.00,,1038.4,88,,,percent of total billed charges,88% of total Billed charges,67.66,100,,,Fee Schedule,100% of Medicare rate,324.14,100,,,Fee Schedule,100% of WA Medicaid,1180,100,,,percent of total billed charges,100% of total billed charges,333.86,103,,,Fee Schedule,103% of WA Medicaid,67.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,118.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,324.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,814.2,69,,,percent of total billed charges,69% of total billed charges,1180,100,,,percent of total billed charges,100% of total billed charges,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1180,100,,,percent of total billed charges,100% of total billed charges,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1180,100,,,percent of total billed charges,100% of total billed charges,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.83,61.85,,,percent of total billed charges,61.85% of total billed charges,324.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,421.38,130,,,Fee Schedule,130% of WA Medicaid ,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.86,37.7,,,percent of total billed charges,37.70% of total billed charges,444.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,40002,33.9,,,percent of total billed charges,33.9% of total billed charges,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,920.4,78,,,percent of total billed charges,78% of total billed charges,1180,100,,,percent of total billed charges,100% of total billed charges,974.68,82.6,,,percent of total billed charges,82.6% of total billed charges,974.68,82.6,,,percent of total billed charges,82.6% of total billed charges,324.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.66,40002,
"EXC TUMOR, S.T. ABD WALL >5CM",96022901,CDM,960,RC,22901,HCPCS,Outpatient,,,1385,900.25,,1218.8,88,,,percent of total billed charges,88% of total Billed charges,82.53,100,,,Fee Schedule,100% of Medicare rate,379.71,100,,,Fee Schedule,100% of WA Medicaid,1385,100,,,percent of total billed charges,100% of total billed charges,391.1,103,,,Fee Schedule,103% of WA Medicaid,82.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,144.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,379.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,955.65,69,,,percent of total billed charges,69% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385,100,,,percent of total billed charges,100% of total billed charges,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385,100,,,percent of total billed charges,100% of total billed charges,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,856.62,61.85,,,percent of total billed charges,61.85% of total billed charges,379.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,493.62,130,,,Fee Schedule,130% of WA Medicaid ,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,46951.5,33.9,,,percent of total billed charges,33.9% of total billed charges,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080.3,78,,,percent of total billed charges,78% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,379.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.53,46951.5,
EXC TUMOR;SOFT TIS ABDOM WALL,96022902,CDM,960,RC,22902,HCPCS,Outpatient,,,915,594.75,,805.2,88,,,percent of total billed charges,88% of total Billed charges,37.65,100,,,Fee Schedule,100% of Medicare rate,193.03,100,,,Fee Schedule,100% of WA Medicaid,915,100,,,percent of total billed charges,100% of total billed charges,198.82,103,,,Fee Schedule,103% of WA Medicaid,37.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,193.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,631.35,69,,,percent of total billed charges,69% of total billed charges,915,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,915,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,915,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.93,61.85,,,percent of total billed charges,61.85% of total billed charges,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,250.94,130,,,Fee Schedule,130% of WA Medicaid ,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.96,37.7,,,percent of total billed charges,37.70% of total billed charges,344.96,37.7,,,percent of total billed charges,37.70% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,31018.5,33.9,,,percent of total billed charges,33.9% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,713.7,78,,,percent of total billed charges,78% of total billed charges,915,100,,,percent of total billed charges,100% of total billed charges,755.79,82.6,,,percent of total billed charges,82.6% of total billed charges,755.79,82.6,,,percent of total billed charges,82.6% of total billed charges,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.65,31018.5,
EXE TUMOR ABD WALL 3CM OR LGR,97522903,CDM,975,RC,22903,HCPCS,Outpatient,,,827,537.55,,727.76,88,,,percent of total billed charges,88% of total Billed charges,53.75,100,,,Fee Schedule,100% of Medicare rate,252.15,100,,,Fee Schedule,100% of WA Medicaid,827,100,,,percent of total billed charges,100% of total billed charges,259.71,103,,,Fee Schedule,103% of WA Medicaid,53.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,252.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,570.63,69,,,percent of total billed charges,69% of total billed charges,827,100,,,percent of total billed charges,100% of total billed charges,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,827,100,,,percent of total billed charges,100% of total billed charges,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,827,100,,,percent of total billed charges,100% of total billed charges,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,511.5,61.85,,,percent of total billed charges,61.85% of total billed charges,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,327.8,130,,,Fee Schedule,130% of WA Medicaid ,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.78,37.7,,,percent of total billed charges,37.70% of total billed charges,311.78,37.7,,,percent of total billed charges,37.70% of total billed charges,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,28035.3,33.9,,,percent of total billed charges,33.9% of total billed charges,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.06,78,,,percent of total billed charges,78% of total billed charges,827,100,,,percent of total billed charges,100% of total billed charges,683.1,82.6,,,percent of total billed charges,82.6% of total billed charges,683.1,82.6,,,percent of total billed charges,82.6% of total billed charges,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.75,28035.3,
RAD RESEC S TISSUE ABDWALL>5CM,96022905,CDM,960,RC,22905,HCPCS,Outpatient,,,2926,1901.90,,2574.88,88,,,percent of total billed charges,88% of total Billed charges,170.84,100,,,Fee Schedule,100% of Medicare rate,749.54,100,,,Fee Schedule,100% of WA Medicaid,2926,100,,,percent of total billed charges,100% of total billed charges,772.03,103,,,Fee Schedule,103% of WA Medicaid,170.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,298.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,749.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2018.94,69,,,percent of total billed charges,69% of total billed charges,2926,100,,,percent of total billed charges,100% of total billed charges,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2926,100,,,percent of total billed charges,100% of total billed charges,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2926,100,,,percent of total billed charges,100% of total billed charges,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1809.73,61.85,,,percent of total billed charges,61.85% of total billed charges,749.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,749.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,764.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,974.4,130,,,Fee Schedule,130% of WA Medicaid ,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1103.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1103.1,37.7,,,percent of total billed charges,37.70% of total billed charges,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,99191.4,33.9,,,percent of total billed charges,33.9% of total billed charges,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2282.28,78,,,percent of total billed charges,78% of total billed charges,2926,100,,,percent of total billed charges,100% of total billed charges,2416.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2416.88,82.6,,,percent of total billed charges,82.6% of total billed charges,749.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,170.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,749.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,170.84,99191.4,
UNLISTED ABDOMEN PROCEDURE,96022999,CDM,960,RC,22999,HCPCS,Outpatient,,,1696,1102.40,,1492.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1696,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1170.24,69,,,percent of total billed charges,69% of total billed charges,1696,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1696,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1696,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1048.98,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,639.39,37.7,,,percent of total billed charges,37.70% of total billed charges,639.39,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,57494.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1322.88,78,,,percent of total billed charges,78% of total billed charges,1696,100,,,percent of total billed charges,100% of total billed charges,1400.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1400.9,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",639.39,57494.4,
EXC TUMOR S.T. SHLDR;SUBF >5CM,96023073,CDM,960,RC,23073,HCPCS,Outpatient,,,1454,945.10,,1279.52,88,,,percent of total billed charges,88% of total Billed charges,79.93,100,,,Fee Schedule,100% of Medicare rate,399.48,100,,,Fee Schedule,100% of WA Medicaid,1454,100,,,percent of total billed charges,100% of total billed charges,411.46,103,,,Fee Schedule,103% of WA Medicaid,79.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,139.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,399.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1003.26,69,,,percent of total billed charges,69% of total billed charges,1454,100,,,percent of total billed charges,100% of total billed charges,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1454,100,,,percent of total billed charges,100% of total billed charges,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1454,100,,,percent of total billed charges,100% of total billed charges,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,899.3,61.85,,,percent of total billed charges,61.85% of total billed charges,399.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,519.32,130,,,Fee Schedule,130% of WA Medicaid ,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.16,37.7,,,percent of total billed charges,37.70% of total billed charges,548.16,37.7,,,percent of total billed charges,37.70% of total billed charges,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,49290.6,33.9,,,percent of total billed charges,33.9% of total billed charges,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1134.12,78,,,percent of total billed charges,78% of total billed charges,1454,100,,,percent of total billed charges,100% of total billed charges,1201,82.6,,,percent of total billed charges,82.6% of total billed charges,1201,82.6,,,percent of total billed charges,82.6% of total billed charges,399.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.93,49290.6,
"23075 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTA",97523075,CDM,975,RC,23075,HCPCS,Outpatient,,,1149,746.85,,1011.12,88,,,percent of total billed charges,88% of total Billed charges,33.68,100,,,Fee Schedule,100% of Medicare rate,191.72,100,,,Fee Schedule,100% of WA Medicaid,1149,100,,,percent of total billed charges,100% of total billed charges,197.47,103,,,Fee Schedule,103% of WA Medicaid,33.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,191.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,792.81,69,,,percent of total billed charges,69% of total billed charges,1149,100,,,percent of total billed charges,100% of total billed charges,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1149,100,,,percent of total billed charges,100% of total billed charges,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1149,100,,,percent of total billed charges,100% of total billed charges,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,710.66,61.85,,,percent of total billed charges,61.85% of total billed charges,191.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,249.24,130,,,Fee Schedule,130% of WA Medicaid ,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.17,37.7,,,percent of total billed charges,37.70% of total billed charges,433.17,37.7,,,percent of total billed charges,37.70% of total billed charges,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,38951.1,33.9,,,percent of total billed charges,33.9% of total billed charges,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,896.22,78,,,percent of total billed charges,78% of total billed charges,1149,100,,,percent of total billed charges,100% of total billed charges,949.07,82.6,,,percent of total billed charges,82.6% of total billed charges,949.07,82.6,,,percent of total billed charges,82.6% of total billed charges,191.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.68,38951.1,
23120 CLAVICULECTOMY; PARTIAL ProFee,97523120,CDM,975,RC,23120,HCPCS,Outpatient,,,1923,1249.95,,1692.24,88,,,percent of total billed charges,88% of total Billed charges,57.27,100,,,Fee Schedule,100% of Medicare rate,344.65,100,,,Fee Schedule,100% of WA Medicaid,1923,100,,,percent of total billed charges,100% of total billed charges,354.99,103,,,Fee Schedule,103% of WA Medicaid,57.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,344.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1326.87,69,,,percent of total billed charges,69% of total billed charges,1923,100,,,percent of total billed charges,100% of total billed charges,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1923,100,,,percent of total billed charges,100% of total billed charges,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1923,100,,,percent of total billed charges,100% of total billed charges,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1189.38,61.85,,,percent of total billed charges,61.85% of total billed charges,344.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,448.05,130,,,Fee Schedule,130% of WA Medicaid ,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.97,37.7,,,percent of total billed charges,37.70% of total billed charges,724.97,37.7,,,percent of total billed charges,37.70% of total billed charges,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,65189.7,33.9,,,percent of total billed charges,33.9% of total billed charges,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1499.94,78,,,percent of total billed charges,78% of total billed charges,1923,100,,,percent of total billed charges,100% of total billed charges,1588.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1588.4,82.6,,,percent of total billed charges,82.6% of total billed charges,344.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.27,65189.7,
REMOVAL OF HUMERUS LESION,96023156,CDM,960,RC,23156,HCPCS,Outpatient,,,1132,735.80,,996.16,88,,,percent of total billed charges,88% of total Billed charges,69.27,100,,,Fee Schedule,100% of Medicare rate,394.82,100,,,Fee Schedule,100% of WA Medicaid,1132,100,,,percent of total billed charges,100% of total billed charges,406.66,103,,,Fee Schedule,103% of WA Medicaid,69.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,121.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,394.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,781.08,69,,,percent of total billed charges,69% of total billed charges,1132,100,,,percent of total billed charges,100% of total billed charges,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1132,100,,,percent of total billed charges,100% of total billed charges,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1132,100,,,percent of total billed charges,100% of total billed charges,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.14,61.85,,,percent of total billed charges,61.85% of total billed charges,394.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,513.27,130,,,Fee Schedule,130% of WA Medicaid ,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.76,37.7,,,percent of total billed charges,37.70% of total billed charges,426.76,37.7,,,percent of total billed charges,37.70% of total billed charges,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,38374.8,33.9,,,percent of total billed charges,33.9% of total billed charges,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,882.96,78,,,percent of total billed charges,78% of total billed charges,1132,100,,,percent of total billed charges,100% of total billed charges,935.03,82.6,,,percent of total billed charges,82.6% of total billed charges,935.03,82.6,,,percent of total billed charges,82.6% of total billed charges,394.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.27,38374.8,
23410 REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG,97523410,CDM,975,RC,23410,HCPCS,Outpatient,,,3152,2048.80,,2773.76,88,,,percent of total billed charges,88% of total Billed charges,84.05,100,,,Fee Schedule,100% of Medicare rate,473.52,100,,,Fee Schedule,100% of WA Medicaid,3152,100,,,percent of total billed charges,100% of total billed charges,487.73,103,,,Fee Schedule,103% of WA Medicaid,84.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,147.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,473.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2174.88,69,,,percent of total billed charges,69% of total billed charges,3152,100,,,percent of total billed charges,100% of total billed charges,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3152,100,,,percent of total billed charges,100% of total billed charges,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3152,100,,,percent of total billed charges,100% of total billed charges,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1949.51,61.85,,,percent of total billed charges,61.85% of total billed charges,473.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,615.58,130,,,Fee Schedule,130% of WA Medicaid ,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1188.3,37.7,,,percent of total billed charges,37.70% of total billed charges,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,106852.8,33.9,,,percent of total billed charges,33.9% of total billed charges,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2458.56,78,,,percent of total billed charges,78% of total billed charges,3152,100,,,percent of total billed charges,100% of total billed charges,2603.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2603.55,82.6,,,percent of total billed charges,82.6% of total billed charges,473.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84.05,106852.8,
"23412 REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR",97523412,CDM,975,RC,23412,HCPCS,Outpatient,,,2970,1930.50,,2613.6,88,,,percent of total billed charges,88% of total Billed charges,88.14,100,,,Fee Schedule,100% of Medicare rate,491.99,100,,,Fee Schedule,100% of WA Medicaid,2970,100,,,percent of total billed charges,100% of total billed charges,506.75,103,,,Fee Schedule,103% of WA Medicaid,88.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,154.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,491.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2049.3,69,,,percent of total billed charges,69% of total billed charges,2970,100,,,percent of total billed charges,100% of total billed charges,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2970,100,,,percent of total billed charges,100% of total billed charges,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2970,100,,,percent of total billed charges,100% of total billed charges,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836.95,61.85,,,percent of total billed charges,61.85% of total billed charges,491.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,501.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,639.59,130,,,Fee Schedule,130% of WA Medicaid ,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1119.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1119.69,37.7,,,percent of total billed charges,37.70% of total billed charges,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,100683,33.9,,,percent of total billed charges,33.9% of total billed charges,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2316.6,78,,,percent of total billed charges,78% of total billed charges,2970,100,,,percent of total billed charges,100% of total billed charges,2453.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2453.22,82.6,,,percent of total billed charges,82.6% of total billed charges,491.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.14,100683,
REPAIR OF SHOULDER,96023420,CDM,960,RC,23420,HCPCS,Outpatient,,,2326,1511.90,,2046.88,88,,,percent of total billed charges,88% of total Billed charges,101.17,100,,,Fee Schedule,100% of Medicare rate,562.11,100,,,Fee Schedule,100% of WA Medicaid,2326,100,,,percent of total billed charges,100% of total billed charges,578.97,103,,,Fee Schedule,103% of WA Medicaid,101.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,177.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,562.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1604.94,69,,,percent of total billed charges,69% of total billed charges,2326,100,,,percent of total billed charges,100% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2326,100,,,percent of total billed charges,100% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2326,100,,,percent of total billed charges,100% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1438.63,61.85,,,percent of total billed charges,61.85% of total billed charges,562.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,573.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,730.74,130,,,Fee Schedule,130% of WA Medicaid ,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.9,37.7,,,percent of total billed charges,37.70% of total billed charges,876.9,37.7,,,percent of total billed charges,37.70% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,78851.4,33.9,,,percent of total billed charges,33.9% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1814.28,78,,,percent of total billed charges,78% of total billed charges,2326,100,,,percent of total billed charges,100% of total billed charges,1921.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1921.28,82.6,,,percent of total billed charges,82.6% of total billed charges,562.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.17,78851.4,
REPAIR BICEPS TENDON,96023430,CDM,960,RC,23430,HCPCS,Outpatient,,,1795,1166.75,,1579.6,88,,,percent of total billed charges,88% of total Billed charges,74.84,100,,,Fee Schedule,100% of Medicare rate,431.75,100,,,Fee Schedule,100% of WA Medicaid,1795,100,,,percent of total billed charges,100% of total billed charges,444.7,103,,,Fee Schedule,103% of WA Medicaid,74.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,130.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,431.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1238.55,69,,,percent of total billed charges,69% of total billed charges,1795,100,,,percent of total billed charges,100% of total billed charges,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1795,100,,,percent of total billed charges,100% of total billed charges,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1795,100,,,percent of total billed charges,100% of total billed charges,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1110.21,61.85,,,percent of total billed charges,61.85% of total billed charges,431.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,431.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,561.28,130,,,Fee Schedule,130% of WA Medicaid ,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,676.72,37.7,,,percent of total billed charges,37.70% of total billed charges,676.72,37.7,,,percent of total billed charges,37.70% of total billed charges,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,60850.5,33.9,,,percent of total billed charges,33.9% of total billed charges,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1400.1,78,,,percent of total billed charges,78% of total billed charges,1795,100,,,percent of total billed charges,100% of total billed charges,1482.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1482.67,82.6,,,percent of total billed charges,82.6% of total billed charges,431.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,431.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.84,60850.5,
REPAIR SHOULDER CAPSULE,96023455,CDM,960,RC,23455,HCPCS,Outpatient,,,2409,1565.85,,2119.92,88,,,percent of total billed charges,88% of total Billed charges,104.75,100,,,Fee Schedule,100% of Medicare rate,565.47,100,,,Fee Schedule,100% of WA Medicaid,2409,100,,,percent of total billed charges,100% of total billed charges,582.43,103,,,Fee Schedule,103% of WA Medicaid,104.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,183.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,565.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1662.21,69,,,percent of total billed charges,69% of total billed charges,2409,100,,,percent of total billed charges,100% of total billed charges,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2409,100,,,percent of total billed charges,100% of total billed charges,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2409,100,,,percent of total billed charges,100% of total billed charges,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1489.97,61.85,,,percent of total billed charges,61.85% of total billed charges,565.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,576.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,735.11,130,,,Fee Schedule,130% of WA Medicaid ,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,908.19,37.7,,,percent of total billed charges,37.70% of total billed charges,908.19,37.7,,,percent of total billed charges,37.70% of total billed charges,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,81665.1,33.9,,,percent of total billed charges,33.9% of total billed charges,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1879.02,78,,,percent of total billed charges,78% of total billed charges,2409,100,,,percent of total billed charges,100% of total billed charges,1989.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1989.83,82.6,,,percent of total billed charges,82.6% of total billed charges,565.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,104.75,81665.1,
REPAIR SHOULDER CAPSULE,96023466,CDM,960,RC,23466,HCPCS,Outpatient,,,2046,1329.90,,1800.48,88,,,percent of total billed charges,88% of total Billed charges,117.27,100,,,Fee Schedule,100% of Medicare rate,646.22,100,,,Fee Schedule,100% of WA Medicaid,2046,100,,,percent of total billed charges,100% of total billed charges,665.61,103,,,Fee Schedule,103% of WA Medicaid,117.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,205.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,646.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1411.74,69,,,percent of total billed charges,69% of total billed charges,2046,100,,,percent of total billed charges,100% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2046,100,,,percent of total billed charges,100% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2046,100,,,percent of total billed charges,100% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1265.45,61.85,,,percent of total billed charges,61.85% of total billed charges,646.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,840.09,130,,,Fee Schedule,130% of WA Medicaid ,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,771.34,37.7,,,percent of total billed charges,37.70% of total billed charges,771.34,37.7,,,percent of total billed charges,37.70% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,69359.4,33.9,,,percent of total billed charges,33.9% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1595.88,78,,,percent of total billed charges,78% of total billed charges,2046,100,,,percent of total billed charges,100% of total billed charges,1690,82.6,,,percent of total billed charges,82.6% of total billed charges,1690,82.6,,,percent of total billed charges,82.6% of total billed charges,646.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.27,69359.4,
RECONSTRUCT SHOULDER JOINT,96023472,CDM,960,RC,23472,HCPCS,Outpatient,,,2211,1437.15,,1945.68,88,,,percent of total billed charges,88% of total Billed charges,156.96,100,,,Fee Schedule,100% of Medicare rate,822.47,100,,,Fee Schedule,100% of WA Medicaid,2211,100,,,percent of total billed charges,100% of total billed charges,847.14,103,,,Fee Schedule,103% of WA Medicaid,156.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,274.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,822.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1525.59,69,,,percent of total billed charges,69% of total billed charges,2211,100,,,percent of total billed charges,100% of total billed charges,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2211,100,,,percent of total billed charges,100% of total billed charges,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2211,100,,,percent of total billed charges,100% of total billed charges,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1367.5,61.85,,,percent of total billed charges,61.85% of total billed charges,822.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,822.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,838.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1069.21,130,,,Fee Schedule,130% of WA Medicaid ,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,833.55,37.7,,,percent of total billed charges,37.70% of total billed charges,833.55,37.7,,,percent of total billed charges,37.70% of total billed charges,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,74952.9,33.9,,,percent of total billed charges,33.9% of total billed charges,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1724.58,78,,,percent of total billed charges,78% of total billed charges,2211,100,,,percent of total billed charges,100% of total billed charges,1826.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1826.29,82.6,,,percent of total billed charges,82.6% of total billed charges,822.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,822.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,156.96,74952.9,
REVIS RECONSTRUCT SHOULDER JT,96023474,CDM,960,RC,23474,HCPCS,Outpatient,,,3763,2445.95,,3311.44,88,,,percent of total billed charges,88% of total Billed charges,191.52,100,,,Fee Schedule,100% of Medicare rate,985.47,100,,,Fee Schedule,100% of WA Medicaid,3763,100,,,percent of total billed charges,100% of total billed charges,1015.03,103,,,Fee Schedule,103% of WA Medicaid,191.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,335.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,985.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2596.47,69,,,percent of total billed charges,69% of total billed charges,3763,100,,,percent of total billed charges,100% of total billed charges,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,3763,100,,,percent of total billed charges,100% of total billed charges,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,3763,100,,,percent of total billed charges,100% of total billed charges,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2327.42,61.85,,,percent of total billed charges,61.85% of total billed charges,985.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,985.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1005.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1281.11,130,,,Fee Schedule,130% of WA Medicaid ,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1418.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1418.65,37.7,,,percent of total billed charges,37.70% of total billed charges,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,127565.7,33.9,,,percent of total billed charges,33.9% of total billed charges,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2935.14,78,,,percent of total billed charges,78% of total billed charges,3763,100,,,percent of total billed charges,100% of total billed charges,3108.24,82.6,,,percent of total billed charges,82.6% of total billed charges,3108.24,82.6,,,percent of total billed charges,82.6% of total billed charges,985.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,985.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,191.52,127565.7,
"OPEN TX CLAVICLE FX,FIXATION",96023515,CDM,960,RC,23515,HCPCS,Outpatient,,,1316,855.40,,1158.08,88,,,percent of total billed charges,88% of total Billed charges,72.07,100,,,Fee Schedule,100% of Medicare rate,418.69,100,,,Fee Schedule,100% of WA Medicaid,1316,100,,,percent of total billed charges,100% of total billed charges,431.25,103,,,Fee Schedule,103% of WA Medicaid,72.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,418.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,908.04,69,,,percent of total billed charges,69% of total billed charges,1316,100,,,percent of total billed charges,100% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1316,100,,,percent of total billed charges,100% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1316,100,,,percent of total billed charges,100% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.95,61.85,,,percent of total billed charges,61.85% of total billed charges,418.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,544.3,130,,,Fee Schedule,130% of WA Medicaid ,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.13,37.7,,,percent of total billed charges,37.70% of total billed charges,496.13,37.7,,,percent of total billed charges,37.70% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,44612.4,33.9,,,percent of total billed charges,33.9% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1026.48,78,,,percent of total billed charges,78% of total billed charges,1316,100,,,percent of total billed charges,100% of total billed charges,1087.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1087.02,82.6,,,percent of total billed charges,82.6% of total billed charges,418.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.07,44612.4,
"23552 OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE",97523552,CDM,975,RC,23552,HCPCS,Outpatient,,,1744,1133.60,,1534.72,88,,,percent of total billed charges,88% of total Billed charges,64.22,100,,,Fee Schedule,100% of Medicare rate,377.85,100,,,Fee Schedule,100% of WA Medicaid,1744,100,,,percent of total billed charges,100% of total billed charges,389.19,103,,,Fee Schedule,103% of WA Medicaid,64.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,377.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1203.36,69,,,percent of total billed charges,69% of total billed charges,1744,100,,,percent of total billed charges,100% of total billed charges,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1744,100,,,percent of total billed charges,100% of total billed charges,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1744,100,,,percent of total billed charges,100% of total billed charges,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1078.66,61.85,,,percent of total billed charges,61.85% of total billed charges,377.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,491.21,130,,,Fee Schedule,130% of WA Medicaid ,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,657.49,37.7,,,percent of total billed charges,37.70% of total billed charges,657.49,37.7,,,percent of total billed charges,37.70% of total billed charges,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,59121.6,33.9,,,percent of total billed charges,33.9% of total billed charges,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1360.32,78,,,percent of total billed charges,78% of total billed charges,1744,100,,,percent of total billed charges,100% of total billed charges,1440.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1440.54,82.6,,,percent of total billed charges,82.6% of total billed charges,377.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.22,59121.6,
TREAT HUMERUS FRACTURE,96023615,CDM,960,RC,23615,HCPCS,Outpatient,,,2143,1392.95,,1885.84,88,,,percent of total billed charges,88% of total Billed charges,90.91,100,,,Fee Schedule,100% of Medicare rate,510.26,100,,,Fee Schedule,100% of WA Medicaid,2143,100,,,percent of total billed charges,100% of total billed charges,525.57,103,,,Fee Schedule,103% of WA Medicaid,90.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,159.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,510.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1478.67,69,,,percent of total billed charges,69% of total billed charges,2143,100,,,percent of total billed charges,100% of total billed charges,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2143,100,,,percent of total billed charges,100% of total billed charges,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2143,100,,,percent of total billed charges,100% of total billed charges,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1325.45,61.85,,,percent of total billed charges,61.85% of total billed charges,510.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,663.34,130,,,Fee Schedule,130% of WA Medicaid ,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,807.91,37.7,,,percent of total billed charges,37.70% of total billed charges,807.91,37.7,,,percent of total billed charges,37.70% of total billed charges,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,72647.7,33.9,,,percent of total billed charges,33.9% of total billed charges,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1671.54,78,,,percent of total billed charges,78% of total billed charges,2143,100,,,percent of total billed charges,100% of total billed charges,1770.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1770.12,82.6,,,percent of total billed charges,82.6% of total billed charges,510.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.91,72647.7,
TX HUMERUS FX,96023616,CDM,960,RC,23616,HCPCS,Outpatient,,,2988,1942.20,,2629.44,88,,,percent of total billed charges,88% of total Billed charges,134.26,100,,,Fee Schedule,100% of Medicare rate,707.02,100,,,Fee Schedule,100% of WA Medicaid,2988,100,,,percent of total billed charges,100% of total billed charges,728.23,103,,,Fee Schedule,103% of WA Medicaid,134.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,234.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,707.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2061.72,69,,,percent of total billed charges,69% of total billed charges,2988,100,,,percent of total billed charges,100% of total billed charges,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2988,100,,,percent of total billed charges,100% of total billed charges,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2988,100,,,percent of total billed charges,100% of total billed charges,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1848.08,61.85,,,percent of total billed charges,61.85% of total billed charges,707.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,707.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,721.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,919.13,130,,,Fee Schedule,130% of WA Medicaid ,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1126.48,37.7,,,percent of total billed charges,37.70% of total billed charges,1126.48,37.7,,,percent of total billed charges,37.70% of total billed charges,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,101293.2,33.9,,,percent of total billed charges,33.9% of total billed charges,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2330.64,78,,,percent of total billed charges,78% of total billed charges,2988,100,,,percent of total billed charges,100% of total billed charges,2468.09,82.6,,,percent of total billed charges,82.6% of total billed charges,2468.09,82.6,,,percent of total billed charges,82.6% of total billed charges,707.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,707.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,134.26,101293.2,
TREAT SHOULDER DISLOCATION,96023660,CDM,960,RC,23660,HCPCS,Outpatient,,,1171,761.15,,1030.48,88,,,percent of total billed charges,88% of total Billed charges,57.9,100,,,Fee Schedule,100% of Medicare rate,341.85,100,,,Fee Schedule,100% of WA Medicaid,1171,100,,,percent of total billed charges,100% of total billed charges,352.11,103,,,Fee Schedule,103% of WA Medicaid,57.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,341.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,807.99,69,,,percent of total billed charges,69% of total billed charges,1171,100,,,percent of total billed charges,100% of total billed charges,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1171,100,,,percent of total billed charges,100% of total billed charges,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1171,100,,,percent of total billed charges,100% of total billed charges,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.26,61.85,,,percent of total billed charges,61.85% of total billed charges,341.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,444.41,130,,,Fee Schedule,130% of WA Medicaid ,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.47,37.7,,,percent of total billed charges,37.70% of total billed charges,441.47,37.7,,,percent of total billed charges,37.70% of total billed charges,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,39696.9,33.9,,,percent of total billed charges,33.9% of total billed charges,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.38,78,,,percent of total billed charges,78% of total billed charges,1171,100,,,percent of total billed charges,100% of total billed charges,967.25,82.6,,,percent of total billed charges,82.6% of total billed charges,967.25,82.6,,,percent of total billed charges,82.6% of total billed charges,341.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.9,39696.9,
FIXATION OF SHOULDER,96023700,CDM,960,RC,23700,HCPCS,Outpatient,,,360,234.00,,316.8,88,,,percent of total billed charges,88% of total Billed charges,18.96,100,,,Fee Schedule,100% of Medicare rate,113.95,100,,,Fee Schedule,100% of WA Medicaid,360,100,,,percent of total billed charges,100% of total billed charges,117.37,103,,,Fee Schedule,103% of WA Medicaid,18.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,113.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,248.4,69,,,percent of total billed charges,69% of total billed charges,360,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,360,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,360,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.66,61.85,,,percent of total billed charges,61.85% of total billed charges,113.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,148.14,130,,,Fee Schedule,130% of WA Medicaid ,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.72,37.7,,,percent of total billed charges,37.70% of total billed charges,135.72,37.7,,,percent of total billed charges,37.70% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,12204,33.9,,,percent of total billed charges,33.9% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.8,78,,,percent of total billed charges,78% of total billed charges,360,100,,,percent of total billed charges,100% of total billed charges,297.36,82.6,,,percent of total billed charges,82.6% of total billed charges,297.36,82.6,,,percent of total billed charges,82.6% of total billed charges,113.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.96,12204,
"ID UPPER ARM,ELBOW",96023930,CDM,960,RC,23930,HCPCS,Outpatient,,,747,485.55,,657.36,88,,,percent of total billed charges,88% of total Billed charges,22.88,100,,,Fee Schedule,100% of Medicare rate,124.21,100,,,Fee Schedule,100% of WA Medicaid,747,100,,,percent of total billed charges,100% of total billed charges,127.94,103,,,Fee Schedule,103% of WA Medicaid,22.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,124.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,515.43,69,,,percent of total billed charges,69% of total billed charges,747,100,,,percent of total billed charges,100% of total billed charges,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,747,100,,,percent of total billed charges,100% of total billed charges,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,747,100,,,percent of total billed charges,100% of total billed charges,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,462.02,61.85,,,percent of total billed charges,61.85% of total billed charges,124.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,161.47,130,,,Fee Schedule,130% of WA Medicaid ,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.62,37.7,,,percent of total billed charges,37.70% of total billed charges,281.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,25323.3,33.9,,,percent of total billed charges,33.9% of total billed charges,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,582.66,78,,,percent of total billed charges,78% of total billed charges,747,100,,,percent of total billed charges,100% of total billed charges,617.02,82.6,,,percent of total billed charges,82.6% of total billed charges,617.02,82.6,,,percent of total billed charges,82.6% of total billed charges,124.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.88,25323.3,
DRAINAGE OF ARM BURSA,96023931,CDM,960,RC,23931,HCPCS,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,14.05,100,,,Fee Schedule,100% of Medicare rate,94.74,100,,,Fee Schedule,100% of WA Medicaid,364,100,,,percent of total billed charges,100% of total billed charges,97.58,103,,,Fee Schedule,103% of WA Medicaid,14.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,94.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,364,100,,,percent of total billed charges,100% of total billed charges,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,364,100,,,percent of total billed charges,100% of total billed charges,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.13,61.85,,,percent of total billed charges,61.85% of total billed charges,94.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,123.16,130,,,Fee Schedule,130% of WA Medicaid ,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,12339.6,33.9,,,percent of total billed charges,33.9% of total billed charges,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,94.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.05,12339.6,
"24071 EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW ARE",97524071,CDM,975,RC,24071,HCPCS,Outpatient,,,1134,737.10,,997.92,88,,,percent of total billed charges,88% of total Billed charges,45.76,100,,,Fee Schedule,100% of Medicare rate,233.68,100,,,Fee Schedule,100% of WA Medicaid,1134,100,,,percent of total billed charges,100% of total billed charges,240.69,103,,,Fee Schedule,103% of WA Medicaid,45.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,233.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,782.46,69,,,percent of total billed charges,69% of total billed charges,1134,100,,,percent of total billed charges,100% of total billed charges,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1134,100,,,percent of total billed charges,100% of total billed charges,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1134,100,,,percent of total billed charges,100% of total billed charges,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.38,61.85,,,percent of total billed charges,61.85% of total billed charges,233.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,303.78,130,,,Fee Schedule,130% of WA Medicaid ,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.52,37.7,,,percent of total billed charges,37.70% of total billed charges,427.52,37.7,,,percent of total billed charges,37.70% of total billed charges,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,38442.6,33.9,,,percent of total billed charges,33.9% of total billed charges,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,884.52,78,,,percent of total billed charges,78% of total billed charges,1134,100,,,percent of total billed charges,100% of total billed charges,936.68,82.6,,,percent of total billed charges,82.6% of total billed charges,936.68,82.6,,,percent of total billed charges,82.6% of total billed charges,233.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.76,38442.6,
EXCISION ARM/ELBOW TUMOR 5CM>,96024073,CDM,960,RC,24073,HCPCS,Outpatient,,,1516,985.40,,1334.08,88,,,percent of total billed charges,88% of total Billed charges,79.03,100,,,Fee Schedule,100% of Medicare rate,397.25,100,,,Fee Schedule,100% of WA Medicaid,1516,100,,,percent of total billed charges,100% of total billed charges,409.17,103,,,Fee Schedule,103% of WA Medicaid,79.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,397.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1046.04,69,,,percent of total billed charges,69% of total billed charges,1516,100,,,percent of total billed charges,100% of total billed charges,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1516,100,,,percent of total billed charges,100% of total billed charges,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1516,100,,,percent of total billed charges,100% of total billed charges,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,937.65,61.85,,,percent of total billed charges,61.85% of total billed charges,397.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,516.43,130,,,Fee Schedule,130% of WA Medicaid ,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.53,37.7,,,percent of total billed charges,37.70% of total billed charges,571.53,37.7,,,percent of total billed charges,37.70% of total billed charges,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,51392.4,33.9,,,percent of total billed charges,33.9% of total billed charges,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1182.48,78,,,percent of total billed charges,78% of total billed charges,1516,100,,,percent of total billed charges,100% of total billed charges,1252.22,82.6,,,percent of total billed charges,82.6% of total billed charges,1252.22,82.6,,,percent of total billed charges,82.6% of total billed charges,397.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.03,51392.4,
"EXCISION,TUMOR,SOFT TISSUE",96024075,CDM,960,RC,24075,HCPCS,Outpatient,,,860,559.00,,756.8,88,,,percent of total billed charges,88% of total Billed charges,33.43,100,,,Fee Schedule,100% of Medicare rate,191.91,100,,,Fee Schedule,100% of WA Medicaid,860,100,,,percent of total billed charges,100% of total billed charges,197.67,103,,,Fee Schedule,103% of WA Medicaid,33.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,191.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,593.4,69,,,percent of total billed charges,69% of total billed charges,860,100,,,percent of total billed charges,100% of total billed charges,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,860,100,,,percent of total billed charges,100% of total billed charges,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,860,100,,,percent of total billed charges,100% of total billed charges,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,531.91,61.85,,,percent of total billed charges,61.85% of total billed charges,191.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,249.48,130,,,Fee Schedule,130% of WA Medicaid ,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.22,37.7,,,percent of total billed charges,37.70% of total billed charges,324.22,37.7,,,percent of total billed charges,37.70% of total billed charges,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,29154,33.9,,,percent of total billed charges,33.9% of total billed charges,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,670.8,78,,,percent of total billed charges,78% of total billed charges,860,100,,,percent of total billed charges,100% of total billed charges,710.36,82.6,,,percent of total billed charges,82.6% of total billed charges,710.36,82.6,,,percent of total billed charges,82.6% of total billed charges,191.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.43,29154,
EXC TUM SFTISS UPARM/ELBOW<5CM,96024076,CDM,960,RC,24076,HCPCS,Outpatient,,,1193,775.45,,1049.84,88,,,percent of total billed charges,88% of total Billed charges,56.88,100,,,Fee Schedule,100% of Medicare rate,317.05,100,,,Fee Schedule,100% of WA Medicaid,1193,100,,,percent of total billed charges,100% of total billed charges,326.56,103,,,Fee Schedule,103% of WA Medicaid,56.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,317.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,823.17,69,,,percent of total billed charges,69% of total billed charges,1193,100,,,percent of total billed charges,100% of total billed charges,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193,100,,,percent of total billed charges,100% of total billed charges,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193,100,,,percent of total billed charges,100% of total billed charges,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,737.87,61.85,,,percent of total billed charges,61.85% of total billed charges,317.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,412.17,130,,,Fee Schedule,130% of WA Medicaid ,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.76,37.7,,,percent of total billed charges,37.70% of total billed charges,449.76,37.7,,,percent of total billed charges,37.70% of total billed charges,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,40442.7,33.9,,,percent of total billed charges,33.9% of total billed charges,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,930.54,78,,,percent of total billed charges,78% of total billed charges,1193,100,,,percent of total billed charges,100% of total billed charges,985.42,82.6,,,percent of total billed charges,82.6% of total billed charges,985.42,82.6,,,percent of total billed charges,82.6% of total billed charges,317.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.88,40442.7,
"24101 ARTHROTOMY, ELBOW; WITH JOINT EXPLORATION, WITH OR WIT",97524101,CDM,975,RC,24101,HCPCS,Outpatient,,,2584,1679.60,,2273.92,88,,,percent of total billed charges,88% of total Billed charges,47.43,100,,,Fee Schedule,100% of Medicare rate,295.6,100,,,Fee Schedule,100% of WA Medicaid,2584,100,,,percent of total billed charges,100% of total billed charges,304.47,103,,,Fee Schedule,103% of WA Medicaid,47.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,295.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1782.96,69,,,percent of total billed charges,69% of total billed charges,2584,100,,,percent of total billed charges,100% of total billed charges,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2584,100,,,percent of total billed charges,100% of total billed charges,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2584,100,,,percent of total billed charges,100% of total billed charges,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1598.2,61.85,,,percent of total billed charges,61.85% of total billed charges,295.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,384.28,130,,,Fee Schedule,130% of WA Medicaid ,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,974.17,37.7,,,percent of total billed charges,37.70% of total billed charges,974.17,37.7,,,percent of total billed charges,37.70% of total billed charges,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,87597.6,33.9,,,percent of total billed charges,33.9% of total billed charges,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2015.52,78,,,percent of total billed charges,78% of total billed charges,2584,100,,,percent of total billed charges,100% of total billed charges,2134.38,82.6,,,percent of total billed charges,82.6% of total billed charges,2134.38,82.6,,,percent of total billed charges,82.6% of total billed charges,295.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.43,87597.6,
REMOVAL OF ELBOW BURSA,96024105,CDM,960,RC,24105,HCPCS,Outpatient,,,708,460.20,,623.04,88,,,percent of total billed charges,88% of total Billed charges,30.71,100,,,Fee Schedule,100% of Medicare rate,214.85,100,,,Fee Schedule,100% of WA Medicaid,708,100,,,percent of total billed charges,100% of total billed charges,221.3,103,,,Fee Schedule,103% of WA Medicaid,30.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,214.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,488.52,69,,,percent of total billed charges,69% of total billed charges,708,100,,,percent of total billed charges,100% of total billed charges,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,708,100,,,percent of total billed charges,100% of total billed charges,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,708,100,,,percent of total billed charges,100% of total billed charges,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,437.9,61.85,,,percent of total billed charges,61.85% of total billed charges,214.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,279.31,130,,,Fee Schedule,130% of WA Medicaid ,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.92,37.7,,,percent of total billed charges,37.70% of total billed charges,266.92,37.7,,,percent of total billed charges,37.70% of total billed charges,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,24001.2,33.9,,,percent of total billed charges,33.9% of total billed charges,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.24,78,,,percent of total billed charges,78% of total billed charges,708,100,,,percent of total billed charges,100% of total billed charges,584.81,82.6,,,percent of total billed charges,82.6% of total billed charges,584.81,82.6,,,percent of total billed charges,82.6% of total billed charges,214.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.71,24001.2,
REMOVE FB UPPER ARM/ELBOW SUBQ,96024200,CDM,960,RC,24200,HCPCS,Outpatient,,,454,295.10,,399.52,88,,,percent of total billed charges,88% of total Billed charges,12.89,100,,,Fee Schedule,100% of Medicare rate,82.43,100,,,Fee Schedule,100% of WA Medicaid,454,100,,,percent of total billed charges,100% of total billed charges,84.9,103,,,Fee Schedule,103% of WA Medicaid,12.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,82.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,313.26,69,,,percent of total billed charges,69% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,454,100,,,percent of total billed charges,100% of total billed charges,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,454,100,,,percent of total billed charges,100% of total billed charges,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.8,61.85,,,percent of total billed charges,61.85% of total billed charges,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.16,130,,,Fee Schedule,130% of WA Medicaid ,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,15390.6,33.9,,,percent of total billed charges,33.9% of total billed charges,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.12,78,,,percent of total billed charges,78% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.89,15390.6,
REPAIR ARM TENDON/MUSCLE,96024341,CDM,960,RC,24341,HCPCS,Outpatient,,,1505,978.25,,1324.4,88,,,percent of total billed charges,88% of total Billed charges,71.01,100,,,Fee Schedule,100% of Medicare rate,438.46,100,,,Fee Schedule,100% of WA Medicaid,1505,100,,,percent of total billed charges,100% of total billed charges,451.61,103,,,Fee Schedule,103% of WA Medicaid,71.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,438.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1038.45,69,,,percent of total billed charges,69% of total billed charges,1505,100,,,percent of total billed charges,100% of total billed charges,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1505,100,,,percent of total billed charges,100% of total billed charges,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1505,100,,,percent of total billed charges,100% of total billed charges,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,930.84,61.85,,,percent of total billed charges,61.85% of total billed charges,438.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,570,130,,,Fee Schedule,130% of WA Medicaid ,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.39,37.7,,,percent of total billed charges,37.70% of total billed charges,567.39,37.7,,,percent of total billed charges,37.70% of total billed charges,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,51019.5,33.9,,,percent of total billed charges,33.9% of total billed charges,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1173.9,78,,,percent of total billed charges,78% of total billed charges,1505,100,,,percent of total billed charges,100% of total billed charges,1243.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1243.13,82.6,,,percent of total billed charges,82.6% of total billed charges,438.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.01,51019.5,
"24342 REINSERTION OF RUPTURED BICEPS OR TRICEPS TENDON, DIST",97524342,CDM,975,RC,24342,HCPCS,Outpatient,,,3029,1968.85,,2665.52,88,,,percent of total billed charges,88% of total Billed charges,78.55,100,,,Fee Schedule,100% of Medicare rate,447.97,100,,,Fee Schedule,100% of WA Medicaid,3029,100,,,percent of total billed charges,100% of total billed charges,461.41,103,,,Fee Schedule,103% of WA Medicaid,78.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,447.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2090.01,69,,,percent of total billed charges,69% of total billed charges,3029,100,,,percent of total billed charges,100% of total billed charges,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3029,100,,,percent of total billed charges,100% of total billed charges,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3029,100,,,percent of total billed charges,100% of total billed charges,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1873.44,61.85,,,percent of total billed charges,61.85% of total billed charges,447.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,582.36,130,,,Fee Schedule,130% of WA Medicaid ,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1141.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1141.93,37.7,,,percent of total billed charges,37.70% of total billed charges,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,102683.1,33.9,,,percent of total billed charges,33.9% of total billed charges,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2362.62,78,,,percent of total billed charges,78% of total billed charges,3029,100,,,percent of total billed charges,100% of total billed charges,2501.95,82.6,,,percent of total billed charges,82.6% of total billed charges,2501.95,82.6,,,percent of total billed charges,82.6% of total billed charges,447.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.55,102683.1,
"REPAIR LATERAL COLLATERAL LIGAMENT, ELBOW, W",24343,CDM,975,RC,24343,HCPCS,Outpatient,,,2539,1650.35,,2234.32,88,,,percent of total billed charges,88% of total Billed charges,68.36,100,,,Fee Schedule,100% of Medicare rate,417.57,100,,,Fee Schedule,100% of WA Medicaid,2539,100,,,percent of total billed charges,100% of total billed charges,430.1,103,,,Fee Schedule,103% of WA Medicaid,68.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,119.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,417.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1751.91,69,,,percent of total billed charges,69% of total billed charges,2539,100,,,percent of total billed charges,100% of total billed charges,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2539,100,,,percent of total billed charges,100% of total billed charges,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2539,100,,,percent of total billed charges,100% of total billed charges,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1570.37,61.85,,,percent of total billed charges,61.85% of total billed charges,417.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,542.84,130,,,Fee Schedule,130% of WA Medicaid ,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,957.2,37.7,,,percent of total billed charges,37.70% of total billed charges,957.2,37.7,,,percent of total billed charges,37.70% of total billed charges,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,86072.1,33.9,,,percent of total billed charges,33.9% of total billed charges,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1980.42,78,,,percent of total billed charges,78% of total billed charges,2539,100,,,percent of total billed charges,100% of total billed charges,2097.21,82.6,,,percent of total billed charges,82.6% of total billed charges,2097.21,82.6,,,percent of total billed charges,82.6% of total billed charges,417.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.36,86072.1,
97524345,97524345,CDM,975,RC,24345,HCPCS,Outpatient,,,2546,1654.90,,2240.48,88,,,percent of total billed charges,88% of total Billed charges,68.52,100,,,Fee Schedule,100% of Medicare rate,415.52,100,,,Fee Schedule,100% of WA Medicaid,2546,100,,,percent of total billed charges,100% of total billed charges,427.99,103,,,Fee Schedule,103% of WA Medicaid,68.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,119.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,415.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1756.74,69,,,percent of total billed charges,69% of total billed charges,2546,100,,,percent of total billed charges,100% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2546,100,,,percent of total billed charges,100% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2546,100,,,percent of total billed charges,100% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1574.7,61.85,,,percent of total billed charges,61.85% of total billed charges,415.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,540.18,130,,,Fee Schedule,130% of WA Medicaid ,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,959.84,37.7,,,percent of total billed charges,37.70% of total billed charges,959.84,37.7,,,percent of total billed charges,37.70% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,86309.4,33.9,,,percent of total billed charges,33.9% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1985.88,78,,,percent of total billed charges,78% of total billed charges,2546,100,,,percent of total billed charges,100% of total billed charges,2103,82.6,,,percent of total billed charges,82.6% of total billed charges,2103,82.6,,,percent of total billed charges,82.6% of total billed charges,415.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.52,86309.4,
REPAIR OF HUMERUS,96024430,CDM,960,RC,24430,HCPCS,Outpatient,,,2332,1515.80,,2052.16,88,,,percent of total billed charges,88% of total Billed charges,111.29,100,,,Fee Schedule,100% of Medicare rate,606.31,100,,,Fee Schedule,100% of WA Medicaid,2332,100,,,percent of total billed charges,100% of total billed charges,624.5,103,,,Fee Schedule,103% of WA Medicaid,111.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,194.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,606.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1609.08,69,,,percent of total billed charges,69% of total billed charges,2332,100,,,percent of total billed charges,100% of total billed charges,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2332,100,,,percent of total billed charges,100% of total billed charges,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2332,100,,,percent of total billed charges,100% of total billed charges,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1442.34,61.85,,,percent of total billed charges,61.85% of total billed charges,606.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,788.2,130,,,Fee Schedule,130% of WA Medicaid ,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,879.16,37.7,,,percent of total billed charges,37.70% of total billed charges,879.16,37.7,,,percent of total billed charges,37.70% of total billed charges,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,79054.8,33.9,,,percent of total billed charges,33.9% of total billed charges,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1818.96,78,,,percent of total billed charges,78% of total billed charges,2332,100,,,percent of total billed charges,100% of total billed charges,1926.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1926.23,82.6,,,percent of total billed charges,82.6% of total billed charges,606.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.29,79054.8,
"24495 DECOMPRESSION FASCIOTOMY, FOREARM, WITH BRACHIAL ARTER",97524495,CDM,975,RC,24495,HCPCS,Outpatient,,,2355,1530.75,,2072.4,88,,,percent of total billed charges,88% of total Billed charges,72.91,100,,,Fee Schedule,100% of Medicare rate,541.04,100,,,Fee Schedule,100% of WA Medicaid,2355,100,,,percent of total billed charges,100% of total billed charges,557.27,103,,,Fee Schedule,103% of WA Medicaid,72.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,127.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,541.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1624.95,69,,,percent of total billed charges,69% of total billed charges,2355,100,,,percent of total billed charges,100% of total billed charges,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2355,100,,,percent of total billed charges,100% of total billed charges,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2355,100,,,percent of total billed charges,100% of total billed charges,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1456.57,61.85,,,percent of total billed charges,61.85% of total billed charges,541.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,703.35,130,,,Fee Schedule,130% of WA Medicaid ,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,887.84,37.7,,,percent of total billed charges,37.70% of total billed charges,887.84,37.7,,,percent of total billed charges,37.70% of total billed charges,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,79834.5,33.9,,,percent of total billed charges,33.9% of total billed charges,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836.9,78,,,percent of total billed charges,78% of total billed charges,2355,100,,,percent of total billed charges,100% of total billed charges,1945.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1945.23,82.6,,,percent of total billed charges,82.6% of total billed charges,541.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.91,79834.5,
TREATMENT HUMERUS FRACTURE,96024515,CDM,960,RC,24515,HCPCS,Outpatient,,,2122,1379.30,,1867.36,88,,,percent of total billed charges,88% of total Billed charges,90.07,100,,,Fee Schedule,100% of Medicare rate,509.15,100,,,Fee Schedule,100% of WA Medicaid,2122,100,,,percent of total billed charges,100% of total billed charges,524.42,103,,,Fee Schedule,103% of WA Medicaid,90.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,509.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1464.18,69,,,percent of total billed charges,69% of total billed charges,2122,100,,,percent of total billed charges,100% of total billed charges,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2122,100,,,percent of total billed charges,100% of total billed charges,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2122,100,,,percent of total billed charges,100% of total billed charges,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1312.46,61.85,,,percent of total billed charges,61.85% of total billed charges,509.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,661.9,130,,,Fee Schedule,130% of WA Medicaid ,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.99,37.7,,,percent of total billed charges,37.70% of total billed charges,799.99,37.7,,,percent of total billed charges,37.70% of total billed charges,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,71935.8,33.9,,,percent of total billed charges,33.9% of total billed charges,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.16,78,,,percent of total billed charges,78% of total billed charges,2122,100,,,percent of total billed charges,100% of total billed charges,1752.77,82.6,,,percent of total billed charges,82.6% of total billed charges,1752.77,82.6,,,percent of total billed charges,82.6% of total billed charges,509.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.07,71935.8,
TX OF HUMERAL SHAFT FX WINSERT,97524516,CDM,975,RC,24516,HCPCS,Outpatient,,,2147,1395.55,,1889.36,88,,,percent of total billed charges,88% of total Billed charges,90.12,100,,,Fee Schedule,100% of Medicare rate,494.97,100,,,Fee Schedule,100% of WA Medicaid,2147,100,,,percent of total billed charges,100% of total billed charges,509.82,103,,,Fee Schedule,103% of WA Medicaid,90.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,494.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1481.43,69,,,percent of total billed charges,69% of total billed charges,2147,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2147,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2147,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1327.92,61.85,,,percent of total billed charges,61.85% of total billed charges,494.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,643.46,130,,,Fee Schedule,130% of WA Medicaid ,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,809.42,37.7,,,percent of total billed charges,37.70% of total billed charges,809.42,37.7,,,percent of total billed charges,37.70% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,72783.3,33.9,,,percent of total billed charges,33.9% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1674.66,78,,,percent of total billed charges,78% of total billed charges,2147,100,,,percent of total billed charges,100% of total billed charges,1773.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1773.42,82.6,,,percent of total billed charges,82.6% of total billed charges,494.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.12,72783.3,
PERCUTANEIOUS SKELETAL/HUM FX,96024538,CDM,960,RC,24538,HCPCS,Outpatient,,,1861,1209.65,,1637.68,88,,,percent of total billed charges,88% of total Billed charges,76.58,100,,,Fee Schedule,100% of Medicare rate,460.66,100,,,Fee Schedule,100% of WA Medicaid,1861,100,,,percent of total billed charges,100% of total billed charges,474.48,103,,,Fee Schedule,103% of WA Medicaid,76.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,134.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,460.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1284.09,69,,,percent of total billed charges,69% of total billed charges,1861,100,,,percent of total billed charges,100% of total billed charges,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1861,100,,,percent of total billed charges,100% of total billed charges,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1861,100,,,percent of total billed charges,100% of total billed charges,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1151.03,61.85,,,percent of total billed charges,61.85% of total billed charges,460.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,598.86,130,,,Fee Schedule,130% of WA Medicaid ,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.6,37.7,,,percent of total billed charges,37.70% of total billed charges,701.6,37.7,,,percent of total billed charges,37.70% of total billed charges,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,63087.9,33.9,,,percent of total billed charges,33.9% of total billed charges,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1451.58,78,,,percent of total billed charges,78% of total billed charges,1861,100,,,percent of total billed charges,100% of total billed charges,1537.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1537.19,82.6,,,percent of total billed charges,82.6% of total billed charges,460.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.58,63087.9,
24546 OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYL,97524546,CDM,975,RC,24546,HCPCS,Outpatient,,,4376,2844.40,,3850.88,88,,,percent of total billed charges,88% of total Billed charges,108.69,100,,,Fee Schedule,100% of Medicare rate,596.24,100,,,Fee Schedule,100% of WA Medicaid,4376,100,,,percent of total billed charges,100% of total billed charges,614.13,103,,,Fee Schedule,103% of WA Medicaid,108.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,190.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,596.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3019.44,69,,,percent of total billed charges,69% of total billed charges,4376,100,,,percent of total billed charges,100% of total billed charges,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4376,100,,,percent of total billed charges,100% of total billed charges,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4376,100,,,percent of total billed charges,100% of total billed charges,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2706.56,61.85,,,percent of total billed charges,61.85% of total billed charges,596.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,775.11,130,,,Fee Schedule,130% of WA Medicaid ,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1649.75,37.7,,,percent of total billed charges,37.70% of total billed charges,1649.75,37.7,,,percent of total billed charges,37.70% of total billed charges,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,148346.4,33.9,,,percent of total billed charges,33.9% of total billed charges,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3413.28,78,,,percent of total billed charges,78% of total billed charges,4376,100,,,percent of total billed charges,100% of total billed charges,3614.58,82.6,,,percent of total billed charges,82.6% of total billed charges,3614.58,82.6,,,percent of total billed charges,82.6% of total billed charges,596.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.69,148346.4,
TREAT HUMERUS FRACTURE,96024575,CDM,975,RC,24575,HCPCS,Outpatient,,,1574,1023.10,,1385.12,88,,,percent of total billed charges,88% of total Billed charges,72.49,100,,,Fee Schedule,100% of Medicare rate,426.9,100,,,Fee Schedule,100% of WA Medicaid,1574,100,,,percent of total billed charges,100% of total billed charges,439.71,103,,,Fee Schedule,103% of WA Medicaid,72.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,426.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1086.06,69,,,percent of total billed charges,69% of total billed charges,1574,100,,,percent of total billed charges,100% of total billed charges,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1574,100,,,percent of total billed charges,100% of total billed charges,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1574,100,,,percent of total billed charges,100% of total billed charges,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,973.52,61.85,,,percent of total billed charges,61.85% of total billed charges,426.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,554.97,130,,,Fee Schedule,130% of WA Medicaid ,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,593.4,37.7,,,percent of total billed charges,37.70% of total billed charges,593.4,37.7,,,percent of total billed charges,37.70% of total billed charges,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,53358.6,33.9,,,percent of total billed charges,33.9% of total billed charges,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1227.72,78,,,percent of total billed charges,78% of total billed charges,1574,100,,,percent of total billed charges,100% of total billed charges,1300.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1300.12,82.6,,,percent of total billed charges,82.6% of total billed charges,426.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.49,53358.6,
TREAT HUMERUS FRACTURE,96024582,CDM,960,RC,24582,HCPCS,Outpatient,,,1353,879.45,,1190.64,88,,,percent of total billed charges,88% of total Billed charges,79.28,100,,,Fee Schedule,100% of Medicare rate,477.44,100,,,Fee Schedule,100% of WA Medicaid,1353,100,,,percent of total billed charges,100% of total billed charges,491.76,103,,,Fee Schedule,103% of WA Medicaid,79.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,477.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,933.57,69,,,percent of total billed charges,69% of total billed charges,1353,100,,,percent of total billed charges,100% of total billed charges,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1353,100,,,percent of total billed charges,100% of total billed charges,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1353,100,,,percent of total billed charges,100% of total billed charges,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,836.83,61.85,,,percent of total billed charges,61.85% of total billed charges,477.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,477.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,620.67,130,,,Fee Schedule,130% of WA Medicaid ,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.08,37.7,,,percent of total billed charges,37.70% of total billed charges,510.08,37.7,,,percent of total billed charges,37.70% of total billed charges,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,45866.7,33.9,,,percent of total billed charges,33.9% of total billed charges,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1055.34,78,,,percent of total billed charges,78% of total billed charges,1353,100,,,percent of total billed charges,100% of total billed charges,1117.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1117.58,82.6,,,percent of total billed charges,82.6% of total billed charges,477.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,477.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.28,45866.7,
CLOSED TX OF ELBOW DISLOCW/ANE,96024605,CDM,960,RC,24605,HCPCS,Outpatient,,,3052,1983.80,,2685.76,88,,,percent of total billed charges,88% of total Billed charges,44.94,100,,,Fee Schedule,100% of Medicare rate,283.11,100,,,Fee Schedule,100% of WA Medicaid,3052,100,,,percent of total billed charges,100% of total billed charges,291.6,103,,,Fee Schedule,103% of WA Medicaid,44.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,283.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2105.88,69,,,percent of total billed charges,69% of total billed charges,3052,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3052,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3052,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1887.66,61.85,,,percent of total billed charges,61.85% of total billed charges,283.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,368.04,130,,,Fee Schedule,130% of WA Medicaid ,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1150.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1150.6,37.7,,,percent of total billed charges,37.70% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,103462.8,33.9,,,percent of total billed charges,33.9% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2380.56,78,,,percent of total billed charges,78% of total billed charges,3052,100,,,percent of total billed charges,100% of total billed charges,2520.95,82.6,,,percent of total billed charges,82.6% of total billed charges,2520.95,82.6,,,percent of total billed charges,82.6% of total billed charges,283.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.94,103462.8,
OPEN TX OF RAD HD OR NECK FX,96024665,CDM,960,RC,24665,HCPCS,Outpatient,,,1632,1060.80,,1436.16,88,,,percent of total billed charges,88% of total Billed charges,62.74,100,,,Fee Schedule,100% of Medicare rate,384.56,100,,,Fee Schedule,100% of WA Medicaid,1632,100,,,percent of total billed charges,100% of total billed charges,396.1,103,,,Fee Schedule,103% of WA Medicaid,62.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,384.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1126.08,69,,,percent of total billed charges,69% of total billed charges,1632,100,,,percent of total billed charges,100% of total billed charges,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1632,100,,,percent of total billed charges,100% of total billed charges,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1632,100,,,percent of total billed charges,100% of total billed charges,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1009.39,61.85,,,percent of total billed charges,61.85% of total billed charges,384.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,499.93,130,,,Fee Schedule,130% of WA Medicaid ,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.26,37.7,,,percent of total billed charges,37.70% of total billed charges,615.26,37.7,,,percent of total billed charges,37.70% of total billed charges,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,55324.8,33.9,,,percent of total billed charges,33.9% of total billed charges,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272.96,78,,,percent of total billed charges,78% of total billed charges,1632,100,,,percent of total billed charges,100% of total billed charges,1348.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1348.03,82.6,,,percent of total billed charges,82.6% of total billed charges,384.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.74,55324.8,
TREATMENT FOR RADIUS FRACTURE,96024666,CDM,960,RC,24666,HCPCS,Outpatient,,,1601,1040.65,,1408.88,88,,,percent of total billed charges,88% of total Billed charges,73.21,100,,,Fee Schedule,100% of Medicare rate,425.41,100,,,Fee Schedule,100% of WA Medicaid,1601,100,,,percent of total billed charges,100% of total billed charges,438.17,103,,,Fee Schedule,103% of WA Medicaid,73.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,128.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,425.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1104.69,69,,,percent of total billed charges,69% of total billed charges,1601,100,,,percent of total billed charges,100% of total billed charges,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1601,100,,,percent of total billed charges,100% of total billed charges,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1601,100,,,percent of total billed charges,100% of total billed charges,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,990.22,61.85,,,percent of total billed charges,61.85% of total billed charges,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,553.03,130,,,Fee Schedule,130% of WA Medicaid ,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,603.58,37.7,,,percent of total billed charges,37.70% of total billed charges,603.58,37.7,,,percent of total billed charges,37.70% of total billed charges,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,54273.9,33.9,,,percent of total billed charges,33.9% of total billed charges,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1248.78,78,,,percent of total billed charges,78% of total billed charges,1601,100,,,percent of total billed charges,100% of total billed charges,1322.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1322.43,82.6,,,percent of total billed charges,82.6% of total billed charges,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.21,54273.9,
"Closed treatment of ulnar fracture, proximal end (eg, olecra",97526475,CDM,975,RC,24675,HCPCS,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,38.76,100,,,Fee Schedule,100% of Medicare rate,249.35,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,256.83,103,,,Fee Schedule,103% of WA Medicaid,38.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,249.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,249.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,324.16,130,,,Fee Schedule,130% of WA Medicaid ,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,30510,33.9,,,percent of total billed charges,33.9% of total billed charges,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,249.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.76,30510,
TX ULNAR FX,96024685,CDM,960,RC,24685,HCPCS,Outpatient,,,1640,1066.00,,1443.2,88,,,percent of total billed charges,88% of total Billed charges,63.39,100,,,Fee Schedule,100% of Medicare rate,382.14,100,,,Fee Schedule,100% of WA Medicaid,1640,100,,,percent of total billed charges,100% of total billed charges,393.6,103,,,Fee Schedule,103% of WA Medicaid,63.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,110.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,382.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1131.6,69,,,percent of total billed charges,69% of total billed charges,1640,100,,,percent of total billed charges,100% of total billed charges,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1640,100,,,percent of total billed charges,100% of total billed charges,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1640,100,,,percent of total billed charges,100% of total billed charges,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014.34,61.85,,,percent of total billed charges,61.85% of total billed charges,382.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,496.78,130,,,Fee Schedule,130% of WA Medicaid ,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.28,37.7,,,percent of total billed charges,37.70% of total billed charges,618.28,37.7,,,percent of total billed charges,37.70% of total billed charges,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,55596,33.9,,,percent of total billed charges,33.9% of total billed charges,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1279.2,78,,,percent of total billed charges,78% of total billed charges,1640,100,,,percent of total billed charges,100% of total billed charges,1354.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1354.64,82.6,,,percent of total billed charges,82.6% of total billed charges,382.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.39,55596,
"24999 UNLISTED PROCEDURE, HUMERUS OR ELBOW ProFee",97524999,CDM,975,RC,24999,HCPCS,Outpatient,,,725,471.25,,638,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,725,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,500.25,69,,,percent of total billed charges,69% of total billed charges,725,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,725,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,725,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,448.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273.33,37.7,,,percent of total billed charges,37.70% of total billed charges,273.33,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,24577.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,565.5,78,,,percent of total billed charges,78% of total billed charges,725,100,,,percent of total billed charges,100% of total billed charges,598.85,82.6,,,percent of total billed charges,82.6% of total billed charges,598.85,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",273.33,24577.5,
INCIS EXT TENDON SHEATH WRIST,96025000,CDM,960,RC,25000,HCPCS,Outpatient,,,845,549.25,,743.6,88,,,percent of total billed charges,88% of total Billed charges,28.46,100,,,Fee Schedule,100% of Medicare rate,206.64,100,,,Fee Schedule,100% of WA Medicaid,845,100,,,percent of total billed charges,100% of total billed charges,212.84,103,,,Fee Schedule,103% of WA Medicaid,28.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,206.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,583.05,69,,,percent of total billed charges,69% of total billed charges,845,100,,,percent of total billed charges,100% of total billed charges,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,845,100,,,percent of total billed charges,100% of total billed charges,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,845,100,,,percent of total billed charges,100% of total billed charges,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.63,61.85,,,percent of total billed charges,61.85% of total billed charges,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,268.63,130,,,Fee Schedule,130% of WA Medicaid ,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.57,37.7,,,percent of total billed charges,37.70% of total billed charges,318.57,37.7,,,percent of total billed charges,37.70% of total billed charges,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,28645.5,33.9,,,percent of total billed charges,33.9% of total billed charges,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.1,78,,,percent of total billed charges,78% of total billed charges,845,100,,,percent of total billed charges,100% of total billed charges,697.97,82.6,,,percent of total billed charges,82.6% of total billed charges,697.97,82.6,,,percent of total billed charges,82.6% of total billed charges,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.46,28645.5,
DECOMPRESS FOREARM 2 SPACES,96025024,CDM,960,RC,25024,HCPCS,Outpatient,,,1686,1095.90,,1483.68,88,,,percent of total billed charges,88% of total Billed charges,80.03,100,,,Fee Schedule,100% of Medicare rate,451.33,100,,,Fee Schedule,100% of WA Medicaid,1686,100,,,percent of total billed charges,100% of total billed charges,464.87,103,,,Fee Schedule,103% of WA Medicaid,80.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,451.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1163.34,69,,,percent of total billed charges,69% of total billed charges,1686,100,,,percent of total billed charges,100% of total billed charges,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1686,100,,,percent of total billed charges,100% of total billed charges,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1686,100,,,percent of total billed charges,100% of total billed charges,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1042.79,61.85,,,percent of total billed charges,61.85% of total billed charges,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,586.73,130,,,Fee Schedule,130% of WA Medicaid ,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,635.62,37.7,,,percent of total billed charges,37.70% of total billed charges,635.62,37.7,,,percent of total billed charges,37.70% of total billed charges,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,57155.4,33.9,,,percent of total billed charges,33.9% of total billed charges,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1315.08,78,,,percent of total billed charges,78% of total billed charges,1686,100,,,percent of total billed charges,100% of total billed charges,1392.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1392.64,82.6,,,percent of total billed charges,82.6% of total billed charges,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.03,57155.4,
ID FOREARM/WRIST DEEP ABS/HEM,96025028,CDM,960,RC,25028,HCPCS,Outpatient,,,1243,807.95,,1093.84,88,,,percent of total billed charges,88% of total Billed charges,49.66,100,,,Fee Schedule,100% of Medicare rate,409.74,100,,,Fee Schedule,100% of WA Medicaid,1243,100,,,percent of total billed charges,100% of total billed charges,422.03,103,,,Fee Schedule,103% of WA Medicaid,49.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,409.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,857.67,69,,,percent of total billed charges,69% of total billed charges,1243,100,,,percent of total billed charges,100% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1243,100,,,percent of total billed charges,100% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1243,100,,,percent of total billed charges,100% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,768.8,61.85,,,percent of total billed charges,61.85% of total billed charges,409.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,532.66,130,,,Fee Schedule,130% of WA Medicaid ,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.61,37.7,,,percent of total billed charges,37.70% of total billed charges,468.61,37.7,,,percent of total billed charges,37.70% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,42137.7,33.9,,,percent of total billed charges,33.9% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,969.54,78,,,percent of total billed charges,78% of total billed charges,1243,100,,,percent of total billed charges,100% of total billed charges,1026.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1026.72,82.6,,,percent of total billed charges,82.6% of total billed charges,409.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.66,42137.7,
BIOPSY FOREARM SOFT TISSUES,96025066,CDM,960,RC,25066,HCPCS,Outpatient,,,785,510.25,,690.8,88,,,percent of total billed charges,88% of total Billed charges,32.66,100,,,Fee Schedule,100% of Medicare rate,217.09,100,,,Fee Schedule,100% of WA Medicaid,785,100,,,percent of total billed charges,100% of total billed charges,223.6,103,,,Fee Schedule,103% of WA Medicaid,32.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,217.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,541.65,69,,,percent of total billed charges,69% of total billed charges,785,100,,,percent of total billed charges,100% of total billed charges,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,785,100,,,percent of total billed charges,100% of total billed charges,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,785,100,,,percent of total billed charges,100% of total billed charges,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.52,61.85,,,percent of total billed charges,61.85% of total billed charges,217.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,282.22,130,,,Fee Schedule,130% of WA Medicaid ,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.95,37.7,,,percent of total billed charges,37.70% of total billed charges,295.95,37.7,,,percent of total billed charges,37.70% of total billed charges,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,26611.5,33.9,,,percent of total billed charges,33.9% of total billed charges,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.3,78,,,percent of total billed charges,78% of total billed charges,785,100,,,percent of total billed charges,100% of total billed charges,648.41,82.6,,,percent of total billed charges,82.6% of total billed charges,648.41,82.6,,,percent of total billed charges,82.6% of total billed charges,217.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.66,26611.5,
EXC FOREARM LES SC < 3 CM,96025075,CDM,960,RC,25075,HCPCS,Outpatient,,,679,441.35,,597.52,88,,,percent of total billed charges,88% of total Billed charges,30.2,100,,,Fee Schedule,100% of Medicare rate,184.82,100,,,Fee Schedule,100% of WA Medicaid,679,100,,,percent of total billed charges,100% of total billed charges,190.36,103,,,Fee Schedule,103% of WA Medicaid,30.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,184.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,468.51,69,,,percent of total billed charges,69% of total billed charges,679,100,,,percent of total billed charges,100% of total billed charges,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,679,100,,,percent of total billed charges,100% of total billed charges,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,679,100,,,percent of total billed charges,100% of total billed charges,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.96,61.85,,,percent of total billed charges,61.85% of total billed charges,184.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,240.27,130,,,Fee Schedule,130% of WA Medicaid ,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.98,37.7,,,percent of total billed charges,37.70% of total billed charges,255.98,37.7,,,percent of total billed charges,37.70% of total billed charges,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,23018.1,33.9,,,percent of total billed charges,33.9% of total billed charges,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,529.62,78,,,percent of total billed charges,78% of total billed charges,679,100,,,percent of total billed charges,100% of total billed charges,560.85,82.6,,,percent of total billed charges,82.6% of total billed charges,560.85,82.6,,,percent of total billed charges,82.6% of total billed charges,184.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.2,23018.1,
"25076 EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST A",97525076,CDM,975,RC,25076,HCPCS,Outpatient,,,1692,1099.80,,1488.96,88,,,percent of total billed charges,88% of total Billed charges,49.9,100,,,Fee Schedule,100% of Medicare rate,303.06,100,,,Fee Schedule,100% of WA Medicaid,1692,100,,,percent of total billed charges,100% of total billed charges,312.15,103,,,Fee Schedule,103% of WA Medicaid,49.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,303.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1167.48,69,,,percent of total billed charges,69% of total billed charges,1692,100,,,percent of total billed charges,100% of total billed charges,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1692,100,,,percent of total billed charges,100% of total billed charges,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1692,100,,,percent of total billed charges,100% of total billed charges,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046.5,61.85,,,percent of total billed charges,61.85% of total billed charges,303.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,393.98,130,,,Fee Schedule,130% of WA Medicaid ,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.88,37.7,,,percent of total billed charges,37.70% of total billed charges,637.88,37.7,,,percent of total billed charges,37.70% of total billed charges,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,57358.8,33.9,,,percent of total billed charges,33.9% of total billed charges,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319.76,78,,,percent of total billed charges,78% of total billed charges,1692,100,,,percent of total billed charges,100% of total billed charges,1397.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.59,82.6,,,percent of total billed charges,82.6% of total billed charges,303.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.9,57358.8,
EXCISION OF GANGLION CYST,96025111,CDM,960,RC,25111,HCPCS,Outpatient,,,677,440.05,,595.76,88,,,percent of total billed charges,88% of total Billed charges,27.79,100,,,Fee Schedule,100% of Medicare rate,193.77,100,,,Fee Schedule,100% of WA Medicaid,677,100,,,percent of total billed charges,100% of total billed charges,199.58,103,,,Fee Schedule,103% of WA Medicaid,27.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,193.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,467.13,69,,,percent of total billed charges,69% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,677,100,,,percent of total billed charges,100% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,677,100,,,percent of total billed charges,100% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.72,61.85,,,percent of total billed charges,61.85% of total billed charges,193.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,251.9,130,,,Fee Schedule,130% of WA Medicaid ,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,255.23,37.7,,,percent of total billed charges,37.70% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,22950.3,33.9,,,percent of total billed charges,33.9% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.06,78,,,percent of total billed charges,78% of total billed charges,677,100,,,percent of total billed charges,100% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,559.2,82.6,,,percent of total billed charges,82.6% of total billed charges,193.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.79,22950.3,
"25118 SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE COM",97525118,CDM,975,RC,25118,HCPCS,Outpatient,,,864,561.60,,760.32,88,,,percent of total billed charges,88% of total Billed charges,33.96,100,,,Fee Schedule,100% of Medicare rate,227.16,100,,,Fee Schedule,100% of WA Medicaid,864,100,,,percent of total billed charges,100% of total billed charges,233.97,103,,,Fee Schedule,103% of WA Medicaid,33.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,227.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,596.16,69,,,percent of total billed charges,69% of total billed charges,864,100,,,percent of total billed charges,100% of total billed charges,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,864,100,,,percent of total billed charges,100% of total billed charges,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,864,100,,,percent of total billed charges,100% of total billed charges,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.38,61.85,,,percent of total billed charges,61.85% of total billed charges,227.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,295.31,130,,,Fee Schedule,130% of WA Medicaid ,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.73,37.7,,,percent of total billed charges,37.70% of total billed charges,325.73,37.7,,,percent of total billed charges,37.70% of total billed charges,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,29289.6,33.9,,,percent of total billed charges,33.9% of total billed charges,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,673.92,78,,,percent of total billed charges,78% of total billed charges,864,100,,,percent of total billed charges,100% of total billed charges,713.66,82.6,,,percent of total billed charges,82.6% of total billed charges,713.66,82.6,,,percent of total billed charges,82.6% of total billed charges,227.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.96,29289.6,
REMOVE FOREARM FOREIGN BODY,96025248,CDM,960,RC,25248,HCPCS,Outpatient,,,1033,671.45,,909.04,88,,,percent of total billed charges,88% of total Billed charges,42.65,100,,,Fee Schedule,100% of Medicare rate,249.16,100,,,Fee Schedule,100% of WA Medicaid,1033,100,,,percent of total billed charges,100% of total billed charges,256.63,103,,,Fee Schedule,103% of WA Medicaid,42.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,249.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,712.77,69,,,percent of total billed charges,69% of total billed charges,1033,100,,,percent of total billed charges,100% of total billed charges,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1033,100,,,percent of total billed charges,100% of total billed charges,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1033,100,,,percent of total billed charges,100% of total billed charges,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,638.91,61.85,,,percent of total billed charges,61.85% of total billed charges,249.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,323.91,130,,,Fee Schedule,130% of WA Medicaid ,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.44,37.7,,,percent of total billed charges,37.70% of total billed charges,389.44,37.7,,,percent of total billed charges,37.70% of total billed charges,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,35018.7,33.9,,,percent of total billed charges,33.9% of total billed charges,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,805.74,78,,,percent of total billed charges,78% of total billed charges,1033,100,,,percent of total billed charges,100% of total billed charges,853.26,82.6,,,percent of total billed charges,82.6% of total billed charges,853.26,82.6,,,percent of total billed charges,82.6% of total billed charges,249.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.65,35018.7,
REPAIR FOREARM TENDON,96025260,CDM,960,RC,25260,HCPCS,Outpatient,,,1508,980.20,,1327.04,88,,,percent of total billed charges,88% of total Billed charges,59.47,100,,,Fee Schedule,100% of Medicare rate,371.88,100,,,Fee Schedule,100% of WA Medicaid,1508,100,,,percent of total billed charges,100% of total billed charges,383.04,103,,,Fee Schedule,103% of WA Medicaid,59.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,104.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,371.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1040.52,69,,,percent of total billed charges,69% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1508,100,,,percent of total billed charges,100% of total billed charges,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1508,100,,,percent of total billed charges,100% of total billed charges,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,932.7,61.85,,,percent of total billed charges,61.85% of total billed charges,371.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,483.44,130,,,Fee Schedule,130% of WA Medicaid ,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,568.52,37.7,,,percent of total billed charges,37.70% of total billed charges,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,51121.2,33.9,,,percent of total billed charges,33.9% of total billed charges,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1176.24,78,,,percent of total billed charges,78% of total billed charges,1508,100,,,percent of total billed charges,100% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1245.61,82.6,,,percent of total billed charges,82.6% of total billed charges,371.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.47,51121.2,
REPAIR FOREARM TENDON/MUSCLE,96025274,CDM,960,RC,25274,HCPCS,Outpatient,,,1453,944.45,,1278.64,88,,,percent of total billed charges,88% of total Billed charges,63.17,100,,,Fee Schedule,100% of Medicare rate,387.73,100,,,Fee Schedule,100% of WA Medicaid,1453,100,,,percent of total billed charges,100% of total billed charges,399.36,103,,,Fee Schedule,103% of WA Medicaid,63.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,110.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,387.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1002.57,69,,,percent of total billed charges,69% of total billed charges,1453,100,,,percent of total billed charges,100% of total billed charges,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1453,100,,,percent of total billed charges,100% of total billed charges,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1453,100,,,percent of total billed charges,100% of total billed charges,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,898.68,61.85,,,percent of total billed charges,61.85% of total billed charges,387.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,504.05,130,,,Fee Schedule,130% of WA Medicaid ,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.78,37.7,,,percent of total billed charges,37.70% of total billed charges,547.78,37.7,,,percent of total billed charges,37.70% of total billed charges,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,49256.7,33.9,,,percent of total billed charges,33.9% of total billed charges,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1133.34,78,,,percent of total billed charges,78% of total billed charges,1453,100,,,percent of total billed charges,100% of total billed charges,1200.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1200.18,82.6,,,percent of total billed charges,82.6% of total billed charges,387.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.17,49256.7,
"REPAIR TENDON SHEATH, EXT FOREARM/WRIST W/FREE GRAFT",25275,CDM,960,RC,25275,HCPCS,Outpatient,,,1440,936.00,,1267.2,88,,,percent of total billed charges,88% of total Billed charges,64.96,100,,,Fee Schedule,100% of Medicare rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,1440,100,,,percent of total billed charges,100% of total billed charges,403.98,103,,,Fee Schedule,103% of WA Medicaid,64.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,113.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,392.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,993.6,69,,,percent of total billed charges,69% of total billed charges,1440,100,,,percent of total billed charges,100% of total billed charges,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1440,100,,,percent of total billed charges,100% of total billed charges,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1440,100,,,percent of total billed charges,100% of total billed charges,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,890.64,61.85,,,percent of total billed charges,61.85% of total billed charges,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.87,130,,,Fee Schedule,130% of WA Medicaid ,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,542.88,37.7,,,percent of total billed charges,37.70% of total billed charges,542.88,37.7,,,percent of total billed charges,37.70% of total billed charges,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,48816,33.9,,,percent of total billed charges,33.9% of total billed charges,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1123.2,78,,,percent of total billed charges,78% of total billed charges,1440,100,,,percent of total billed charges,100% of total billed charges,1189.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1189.44,82.6,,,percent of total billed charges,82.6% of total billed charges,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.96,48816,
REPAIR/GRAFT WRIST BONE,96025440,CDM,960,RC,25440,HCPCS,Outpatient,,,1908,1240.20,,1679.04,88,,,percent of total billed charges,88% of total Billed charges,76.36,100,,,Fee Schedule,100% of Medicare rate,445.74,100,,,Fee Schedule,100% of WA Medicaid,1908,100,,,percent of total billed charges,100% of total billed charges,459.11,103,,,Fee Schedule,103% of WA Medicaid,76.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,133.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,445.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1316.52,69,,,percent of total billed charges,69% of total billed charges,1908,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1908,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1908,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1180.1,61.85,,,percent of total billed charges,61.85% of total billed charges,445.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,579.46,130,,,Fee Schedule,130% of WA Medicaid ,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,719.32,37.7,,,percent of total billed charges,37.70% of total billed charges,719.32,37.7,,,percent of total billed charges,37.70% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,64681.2,33.9,,,percent of total billed charges,33.9% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1488.24,78,,,percent of total billed charges,78% of total billed charges,1908,100,,,percent of total billed charges,100% of total billed charges,1576.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1576.01,82.6,,,percent of total billed charges,82.6% of total billed charges,445.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.36,64681.2,
"ARTHROPLASTY, INTERPOSITION, INTERCARPAL OR CARPOMETACARPAL",25447,CDM,975,RC,25447,HCPCS,Outpatient,,,2363,1535.95,,2079.44,88,,,percent of total billed charges,88% of total Billed charges,80.17,100,,,Fee Schedule,100% of Medicare rate,483.97,100,,,Fee Schedule,100% of WA Medicaid,2363,100,,,percent of total billed charges,100% of total billed charges,498.49,103,,,Fee Schedule,103% of WA Medicaid,80.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,483.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1630.47,69,,,percent of total billed charges,69% of total billed charges,2363,100,,,percent of total billed charges,100% of total billed charges,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2363,100,,,percent of total billed charges,100% of total billed charges,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2363,100,,,percent of total billed charges,100% of total billed charges,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1461.52,61.85,,,percent of total billed charges,61.85% of total billed charges,483.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,483.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,493.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,629.16,130,,,Fee Schedule,130% of WA Medicaid ,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,890.85,37.7,,,percent of total billed charges,37.70% of total billed charges,890.85,37.7,,,percent of total billed charges,37.70% of total billed charges,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,80105.7,33.9,,,percent of total billed charges,33.9% of total billed charges,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1843.14,78,,,percent of total billed charges,78% of total billed charges,2363,100,,,percent of total billed charges,100% of total billed charges,1951.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1951.84,82.6,,,percent of total billed charges,82.6% of total billed charges,483.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,483.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.17,80105.7,
TREAT FRACTURE OF RADIUS,96025515,CDM,960,RC,25515,HCPCS,Outpatient,,,1620,1053.00,,1425.6,88,,,percent of total billed charges,88% of total Billed charges,65.72,100,,,Fee Schedule,100% of Medicare rate,391.84,100,,,Fee Schedule,100% of WA Medicaid,1620,100,,,percent of total billed charges,100% of total billed charges,403.6,103,,,Fee Schedule,103% of WA Medicaid,65.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,115.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,391.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1117.8,69,,,percent of total billed charges,69% of total billed charges,1620,100,,,percent of total billed charges,100% of total billed charges,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1620,100,,,percent of total billed charges,100% of total billed charges,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1620,100,,,percent of total billed charges,100% of total billed charges,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1001.97,61.85,,,percent of total billed charges,61.85% of total billed charges,391.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.39,130,,,Fee Schedule,130% of WA Medicaid ,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.74,37.7,,,percent of total billed charges,37.70% of total billed charges,610.74,37.7,,,percent of total billed charges,37.70% of total billed charges,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,54918,33.9,,,percent of total billed charges,33.9% of total billed charges,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1263.6,78,,,percent of total billed charges,78% of total billed charges,1620,100,,,percent of total billed charges,100% of total billed charges,1338.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1338.12,82.6,,,percent of total billed charges,82.6% of total billed charges,391.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.72,54918,
TREAT FRACTURE OF RADIUS,96025526,CDM,960,RC,25526,HCPCS,Outpatient,,,1494,971.10,,1314.72,88,,,percent of total billed charges,88% of total Billed charges,99.4,100,,,Fee Schedule,100% of Medicare rate,553.35,100,,,Fee Schedule,100% of WA Medicaid,1494,100,,,percent of total billed charges,100% of total billed charges,569.95,103,,,Fee Schedule,103% of WA Medicaid,99.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,553.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1030.86,69,,,percent of total billed charges,69% of total billed charges,1494,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1494,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1494,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,924.04,61.85,,,percent of total billed charges,61.85% of total billed charges,553.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,719.36,130,,,Fee Schedule,130% of WA Medicaid ,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,563.24,37.7,,,percent of total billed charges,37.70% of total billed charges,563.24,37.7,,,percent of total billed charges,37.70% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,50646.6,33.9,,,percent of total billed charges,33.9% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1165.32,78,,,percent of total billed charges,78% of total billed charges,1494,100,,,percent of total billed charges,100% of total billed charges,1234.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.04,82.6,,,percent of total billed charges,82.6% of total billed charges,553.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.4,50646.6,
TREAT FRACTURE OF ULNA,96025545,CDM,960,RC,25545,HCPCS,Outpatient,,,1378,895.70,,1212.64,88,,,percent of total billed charges,88% of total Billed charges,59.7,100,,,Fee Schedule,100% of Medicare rate,366.29,100,,,Fee Schedule,100% of WA Medicaid,1378,100,,,percent of total billed charges,100% of total billed charges,377.28,103,,,Fee Schedule,103% of WA Medicaid,59.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,104.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,366.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,950.82,69,,,percent of total billed charges,69% of total billed charges,1378,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1378,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1378,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,852.29,61.85,,,percent of total billed charges,61.85% of total billed charges,366.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,476.18,130,,,Fee Schedule,130% of WA Medicaid ,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.51,37.7,,,percent of total billed charges,37.70% of total billed charges,519.51,37.7,,,percent of total billed charges,37.70% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,46714.2,33.9,,,percent of total billed charges,33.9% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.84,78,,,percent of total billed charges,78% of total billed charges,1378,100,,,percent of total billed charges,100% of total billed charges,1138.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1138.23,82.6,,,percent of total billed charges,82.6% of total billed charges,366.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.7,46714.2,
25560 CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES;,97525560,CDM,975,RC,25560,HCPCS,Outpatient,,,745,484.25,,655.6,88,,,percent of total billed charges,88% of total Billed charges,21.49,100,,,Fee Schedule,100% of Medicare rate,157.97,100,,,Fee Schedule,100% of WA Medicaid,745,100,,,percent of total billed charges,100% of total billed charges,162.71,103,,,Fee Schedule,103% of WA Medicaid,21.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,157.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,514.05,69,,,percent of total billed charges,69% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,745,100,,,percent of total billed charges,100% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,745,100,,,percent of total billed charges,100% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.78,61.85,,,percent of total billed charges,61.85% of total billed charges,157.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,205.36,130,,,Fee Schedule,130% of WA Medicaid ,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,280.87,37.7,,,percent of total billed charges,37.70% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,25255.5,33.9,,,percent of total billed charges,33.9% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,581.1,78,,,percent of total billed charges,78% of total billed charges,745,100,,,percent of total billed charges,100% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,615.37,82.6,,,percent of total billed charges,82.6% of total billed charges,157.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.49,25255.5,
25565 CLOSED TREATME,97525565,CDM,975,RC,25565,HCPCS,Outpatient,,,1745,1134.25,,1535.6,88,,,percent of total billed charges,88% of total Billed charges,45.88,100,,,Fee Schedule,100% of Medicare rate,276.02,100,,,Fee Schedule,100% of WA Medicaid,1745,100,,,percent of total billed charges,100% of total billed charges,284.3,103,,,Fee Schedule,103% of WA Medicaid,45.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,276.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1204.05,69,,,percent of total billed charges,69% of total billed charges,1745,100,,,percent of total billed charges,100% of total billed charges,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1745,100,,,percent of total billed charges,100% of total billed charges,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1745,100,,,percent of total billed charges,100% of total billed charges,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079.28,61.85,,,percent of total billed charges,61.85% of total billed charges,276.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,358.83,130,,,Fee Schedule,130% of WA Medicaid ,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,657.87,37.7,,,percent of total billed charges,37.70% of total billed charges,657.87,37.7,,,percent of total billed charges,37.70% of total billed charges,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,59155.5,33.9,,,percent of total billed charges,33.9% of total billed charges,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1361.1,78,,,percent of total billed charges,78% of total billed charges,1745,100,,,percent of total billed charges,100% of total billed charges,1441.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1441.37,82.6,,,percent of total billed charges,82.6% of total billed charges,276.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.88,59155.5,
TX FRACTURE RADIUS/ULNA,96025575,CDM,960,RC,25575,HCPCS,Outpatient,,,2158,1402.70,,1899.04,88,,,percent of total billed charges,88% of total Billed charges,91.37,100,,,Fee Schedule,100% of Medicare rate,524.07,100,,,Fee Schedule,100% of WA Medicaid,2158,100,,,percent of total billed charges,100% of total billed charges,539.79,103,,,Fee Schedule,103% of WA Medicaid,91.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,159.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,524.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1489.02,69,,,percent of total billed charges,69% of total billed charges,2158,100,,,percent of total billed charges,100% of total billed charges,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2158,100,,,percent of total billed charges,100% of total billed charges,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2158,100,,,percent of total billed charges,100% of total billed charges,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1334.72,61.85,,,percent of total billed charges,61.85% of total billed charges,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,681.29,130,,,Fee Schedule,130% of WA Medicaid ,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.57,37.7,,,percent of total billed charges,37.70% of total billed charges,813.57,37.7,,,percent of total billed charges,37.70% of total billed charges,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,73156.2,33.9,,,percent of total billed charges,33.9% of total billed charges,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1683.24,78,,,percent of total billed charges,78% of total billed charges,2158,100,,,percent of total billed charges,100% of total billed charges,1782.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1782.51,82.6,,,percent of total billed charges,82.6% of total billed charges,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.37,73156.2,
CLOSED TX OF DISTRADIAL FX W/M,96025605,CDM,960,RC,25605,HCPCS,Outpatient,,,1368,889.20,,1203.84,88,,,percent of total billed charges,88% of total Billed charges,49.13,100,,,Fee Schedule,100% of Medicare rate,303.44,100,,,Fee Schedule,100% of WA Medicaid,1368,100,,,percent of total billed charges,100% of total billed charges,312.54,103,,,Fee Schedule,103% of WA Medicaid,49.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,303.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,943.92,69,,,percent of total billed charges,69% of total billed charges,1368,100,,,percent of total billed charges,100% of total billed charges,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368,100,,,percent of total billed charges,100% of total billed charges,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368,100,,,percent of total billed charges,100% of total billed charges,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.11,61.85,,,percent of total billed charges,61.85% of total billed charges,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,394.47,130,,,Fee Schedule,130% of WA Medicaid ,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.74,37.7,,,percent of total billed charges,37.70% of total billed charges,515.74,37.7,,,percent of total billed charges,37.70% of total billed charges,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,46375.2,33.9,,,percent of total billed charges,33.9% of total billed charges,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067.04,78,,,percent of total billed charges,78% of total billed charges,1368,100,,,percent of total billed charges,100% of total billed charges,1129.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1129.97,82.6,,,percent of total billed charges,82.6% of total billed charges,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.13,46375.2,
PERCUTANE SKELETAL FX DISTALRA,96025606,CDM,960,RC,25606,HCPCS,Outpatient,,,1635,1062.75,,1438.8,88,,,percent of total billed charges,88% of total Billed charges,64.18,100,,,Fee Schedule,100% of Medicare rate,392.58,100,,,Fee Schedule,100% of WA Medicaid,1635,100,,,percent of total billed charges,100% of total billed charges,404.36,103,,,Fee Schedule,103% of WA Medicaid,64.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,392.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1128.15,69,,,percent of total billed charges,69% of total billed charges,1635,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1635,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1635,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1011.25,61.85,,,percent of total billed charges,61.85% of total billed charges,392.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,510.35,130,,,Fee Schedule,130% of WA Medicaid ,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,616.4,37.7,,,percent of total billed charges,37.70% of total billed charges,616.4,37.7,,,percent of total billed charges,37.70% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,55426.5,33.9,,,percent of total billed charges,33.9% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1275.3,78,,,percent of total billed charges,78% of total billed charges,1635,100,,,percent of total billed charges,100% of total billed charges,1350.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1350.51,82.6,,,percent of total billed charges,82.6% of total billed charges,392.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.18,55426.5,
OPEN TX DISTAL RADW/INTER FIXA,96025607,CDM,960,RC,25607,HCPCS,Outpatient,,,1344,873.60,,1182.72,88,,,percent of total billed charges,88% of total Billed charges,71.23,100,,,Fee Schedule,100% of Medicare rate,432.49,100,,,Fee Schedule,100% of WA Medicaid,1344,100,,,percent of total billed charges,100% of total billed charges,445.46,103,,,Fee Schedule,103% of WA Medicaid,71.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,432.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,927.36,69,,,percent of total billed charges,69% of total billed charges,1344,100,,,percent of total billed charges,100% of total billed charges,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1344,100,,,percent of total billed charges,100% of total billed charges,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1344,100,,,percent of total billed charges,100% of total billed charges,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,831.26,61.85,,,percent of total billed charges,61.85% of total billed charges,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562.24,130,,,Fee Schedule,130% of WA Medicaid ,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,506.69,37.7,,,percent of total billed charges,37.70% of total billed charges,506.69,37.7,,,percent of total billed charges,37.70% of total billed charges,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,45561.6,33.9,,,percent of total billed charges,33.9% of total billed charges,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1048.32,78,,,percent of total billed charges,78% of total billed charges,1344,100,,,percent of total billed charges,100% of total billed charges,1110.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1110.14,82.6,,,percent of total billed charges,82.6% of total billed charges,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.23,45561.6,
25608 OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTU,97525608,CDM,975,RC,25608,HCPCS,Outpatient,,,2706,1758.90,,2381.28,88,,,percent of total billed charges,88% of total Billed charges,81.88,100,,,Fee Schedule,100% of Medicare rate,481.92,100,,,Fee Schedule,100% of WA Medicaid,2706,100,,,percent of total billed charges,100% of total billed charges,496.38,103,,,Fee Schedule,103% of WA Medicaid,81.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,143.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,481.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1867.14,69,,,percent of total billed charges,69% of total billed charges,2706,100,,,percent of total billed charges,100% of total billed charges,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2706,100,,,percent of total billed charges,100% of total billed charges,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2706,100,,,percent of total billed charges,100% of total billed charges,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1673.66,61.85,,,percent of total billed charges,61.85% of total billed charges,481.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,626.5,130,,,Fee Schedule,130% of WA Medicaid ,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1020.16,37.7,,,percent of total billed charges,37.70% of total billed charges,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,91733.4,33.9,,,percent of total billed charges,33.9% of total billed charges,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2110.68,78,,,percent of total billed charges,78% of total billed charges,2706,100,,,percent of total billed charges,100% of total billed charges,2235.16,82.6,,,percent of total billed charges,82.6% of total billed charges,2235.16,82.6,,,percent of total billed charges,82.6% of total billed charges,481.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.88,91733.4,
OPEN TREAT DISTAL RAD INTRA AR,96025609,CDM,960,RC,25609,HCPCS,Outpatient,,,2610,1696.50,,2296.8,88,,,percent of total billed charges,88% of total Billed charges,104.16,100,,,Fee Schedule,100% of Medicare rate,609.48,100,,,Fee Schedule,100% of WA Medicaid,2610,100,,,percent of total billed charges,100% of total billed charges,627.76,103,,,Fee Schedule,103% of WA Medicaid,104.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,182.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,609.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1800.9,69,,,percent of total billed charges,69% of total billed charges,2610,100,,,percent of total billed charges,100% of total billed charges,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2610,100,,,percent of total billed charges,100% of total billed charges,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2610,100,,,percent of total billed charges,100% of total billed charges,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1614.29,61.85,,,percent of total billed charges,61.85% of total billed charges,609.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,609.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,792.32,130,,,Fee Schedule,130% of WA Medicaid ,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,983.97,37.7,,,percent of total billed charges,37.70% of total billed charges,983.97,37.7,,,percent of total billed charges,37.70% of total billed charges,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,88479,33.9,,,percent of total billed charges,33.9% of total billed charges,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2035.8,78,,,percent of total billed charges,78% of total billed charges,2610,100,,,percent of total billed charges,100% of total billed charges,2155.86,82.6,,,percent of total billed charges,82.6% of total billed charges,2155.86,82.6,,,percent of total billed charges,82.6% of total billed charges,609.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,609.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,104.16,88479,
TREAT WRISTBONE FRACTURE OPEN,96025628,CDM,960,RC,25628,HCPCS,Outpatient,,,1722,1119.30,,1515.36,88,,,percent of total billed charges,88% of total Billed charges,68.97,100,,,Fee Schedule,100% of Medicare rate,418.88,100,,,Fee Schedule,100% of WA Medicaid,1722,100,,,percent of total billed charges,100% of total billed charges,431.45,103,,,Fee Schedule,103% of WA Medicaid,68.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,120.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,418.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1188.18,69,,,percent of total billed charges,69% of total billed charges,1722,100,,,percent of total billed charges,100% of total billed charges,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1722,100,,,percent of total billed charges,100% of total billed charges,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1722,100,,,percent of total billed charges,100% of total billed charges,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1065.06,61.85,,,percent of total billed charges,61.85% of total billed charges,418.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,544.54,130,,,Fee Schedule,130% of WA Medicaid ,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,649.19,37.7,,,percent of total billed charges,37.70% of total billed charges,649.19,37.7,,,percent of total billed charges,37.70% of total billed charges,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,58375.8,33.9,,,percent of total billed charges,33.9% of total billed charges,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1343.16,78,,,percent of total billed charges,78% of total billed charges,1722,100,,,percent of total billed charges,100% of total billed charges,1422.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1422.37,82.6,,,percent of total billed charges,82.6% of total billed charges,418.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.97,58375.8,
25651 PERCUTANEOUS SKELETAL FIXATION OF ULNAR STYLOID FRACTU,97525651,CDM,975,RC,25651,HCPCS,Outpatient,,,1247,810.55,,1097.36,88,,,percent of total billed charges,88% of total Billed charges,44.81,100,,,Fee Schedule,100% of Medicare rate,290.57,100,,,Fee Schedule,100% of WA Medicaid,1247,100,,,percent of total billed charges,100% of total billed charges,299.29,103,,,Fee Schedule,103% of WA Medicaid,44.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,290.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,860.43,69,,,percent of total billed charges,69% of total billed charges,1247,100,,,percent of total billed charges,100% of total billed charges,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1247,100,,,percent of total billed charges,100% of total billed charges,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1247,100,,,percent of total billed charges,100% of total billed charges,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,771.27,61.85,,,percent of total billed charges,61.85% of total billed charges,290.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,377.74,130,,,Fee Schedule,130% of WA Medicaid ,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.12,37.7,,,percent of total billed charges,37.70% of total billed charges,470.12,37.7,,,percent of total billed charges,37.70% of total billed charges,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,42273.3,33.9,,,percent of total billed charges,33.9% of total billed charges,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,972.66,78,,,percent of total billed charges,78% of total billed charges,1247,100,,,percent of total billed charges,100% of total billed charges,1030.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1030.02,82.6,,,percent of total billed charges,82.6% of total billed charges,290.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.81,42273.3,
OPEN TX ULNAR STYLOID FX,96025652,CDM,960,RC,25652,HCPCS,Outpatient,,,1140,741.00,,1003.2,88,,,percent of total billed charges,88% of total Billed charges,60.4,100,,,Fee Schedule,100% of Medicare rate,364.79,100,,,Fee Schedule,100% of WA Medicaid,1140,100,,,percent of total billed charges,100% of total billed charges,375.73,103,,,Fee Schedule,103% of WA Medicaid,60.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,364.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,786.6,69,,,percent of total billed charges,69% of total billed charges,1140,100,,,percent of total billed charges,100% of total billed charges,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1140,100,,,percent of total billed charges,100% of total billed charges,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1140,100,,,percent of total billed charges,100% of total billed charges,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,705.09,61.85,,,percent of total billed charges,61.85% of total billed charges,364.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,474.23,130,,,Fee Schedule,130% of WA Medicaid ,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.78,37.7,,,percent of total billed charges,37.70% of total billed charges,429.78,37.7,,,percent of total billed charges,37.70% of total billed charges,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,38646,33.9,,,percent of total billed charges,33.9% of total billed charges,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,889.2,78,,,percent of total billed charges,78% of total billed charges,1140,100,,,percent of total billed charges,100% of total billed charges,941.64,82.6,,,percent of total billed charges,82.6% of total billed charges,941.64,82.6,,,percent of total billed charges,82.6% of total billed charges,364.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,61,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.4,38646,
TREAT WRIST DISLOCATION,96025676,CDM,960,RC,25676,HCPCS,Outpatient,,,1265,822.25,,1113.2,88,,,percent of total billed charges,88% of total Billed charges,60.37,100,,,Fee Schedule,100% of Medicare rate,368.9,100,,,Fee Schedule,100% of WA Medicaid,1265,100,,,percent of total billed charges,100% of total billed charges,379.97,103,,,Fee Schedule,103% of WA Medicaid,60.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,368.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,872.85,69,,,percent of total billed charges,69% of total billed charges,1265,100,,,percent of total billed charges,100% of total billed charges,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1265,100,,,percent of total billed charges,100% of total billed charges,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1265,100,,,percent of total billed charges,100% of total billed charges,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,782.4,61.85,,,percent of total billed charges,61.85% of total billed charges,368.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,479.57,130,,,Fee Schedule,130% of WA Medicaid ,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,476.91,37.7,,,percent of total billed charges,37.70% of total billed charges,476.91,37.7,,,percent of total billed charges,37.70% of total billed charges,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,42883.5,33.9,,,percent of total billed charges,33.9% of total billed charges,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,986.7,78,,,percent of total billed charges,78% of total billed charges,1265,100,,,percent of total billed charges,100% of total billed charges,1044.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1044.89,82.6,,,percent of total billed charges,82.6% of total billed charges,368.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.37,42883.5,
DRAINAGE ABSCESS;FINGER COMPLI,96026011,CDM,960,RC,26011,HCPCS,Outpatient,,,829,538.85,,729.52,88,,,percent of total billed charges,88% of total Billed charges,16.31,100,,,Fee Schedule,100% of Medicare rate,108.17,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,111.42,103,,,Fee Schedule,103% of WA Medicaid,16.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,108.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,829,100,,,percent of total billed charges,100% of total billed charges,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,829,100,,,percent of total billed charges,100% of total billed charges,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.74,61.85,,,percent of total billed charges,61.85% of total billed charges,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,140.62,130,,,Fee Schedule,130% of WA Medicaid ,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,28103.1,33.9,,,percent of total billed charges,33.9% of total billed charges,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.31,28103.1,
"DRAIN TENDONSHEATH DIG,PALM EA",96026020,CDM,960,RC,26020,HCPCS,Outpatient,,,1089,707.85,,958.32,88,,,percent of total billed charges,88% of total Billed charges,51.12,100,,,Fee Schedule,100% of Medicare rate,326.56,100,,,Fee Schedule,100% of WA Medicaid,1089,100,,,percent of total billed charges,100% of total billed charges,336.36,103,,,Fee Schedule,103% of WA Medicaid,51.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,326.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,751.41,69,,,percent of total billed charges,69% of total billed charges,1089,100,,,percent of total billed charges,100% of total billed charges,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1089,100,,,percent of total billed charges,100% of total billed charges,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1089,100,,,percent of total billed charges,100% of total billed charges,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,673.55,61.85,,,percent of total billed charges,61.85% of total billed charges,326.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,424.53,130,,,Fee Schedule,130% of WA Medicaid ,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.55,37.7,,,percent of total billed charges,37.70% of total billed charges,410.55,37.7,,,percent of total billed charges,37.70% of total billed charges,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,36917.1,33.9,,,percent of total billed charges,33.9% of total billed charges,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,849.42,78,,,percent of total billed charges,78% of total billed charges,1089,100,,,percent of total billed charges,100% of total billed charges,899.51,82.6,,,percent of total billed charges,82.6% of total billed charges,899.51,82.6,,,percent of total billed charges,82.6% of total billed charges,326.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.12,36917.1,
TREAT HAND BONE LESION,96026034,CDM,960,RC,26034,HCPCS,Outpatient,,,1349,876.85,,1187.12,88,,,percent of total billed charges,88% of total Billed charges,49.71,100,,,Fee Schedule,100% of Medicare rate,324.51,100,,,Fee Schedule,100% of WA Medicaid,1349,100,,,percent of total billed charges,100% of total billed charges,334.25,103,,,Fee Schedule,103% of WA Medicaid,49.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,324.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,930.81,69,,,percent of total billed charges,69% of total billed charges,1349,100,,,percent of total billed charges,100% of total billed charges,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1349,100,,,percent of total billed charges,100% of total billed charges,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1349,100,,,percent of total billed charges,100% of total billed charges,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,834.36,61.85,,,percent of total billed charges,61.85% of total billed charges,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,331,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,421.86,130,,,Fee Schedule,130% of WA Medicaid ,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,508.57,37.7,,,percent of total billed charges,37.70% of total billed charges,508.57,37.7,,,percent of total billed charges,37.70% of total billed charges,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,45731.1,33.9,,,percent of total billed charges,33.9% of total billed charges,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1052.22,78,,,percent of total billed charges,78% of total billed charges,1349,100,,,percent of total billed charges,100% of total billed charges,1114.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1114.27,82.6,,,percent of total billed charges,82.6% of total billed charges,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.71,45731.1,
"26045 FASCIOTOMY, PALMAR (EG, DUPUYTREN'S CONTRACTURE); OPEN",97526045,CDM,975,RC,26045,HCPCS,Outpatient,,,2195,1426.75,,1931.6,88,,,percent of total billed charges,88% of total Billed charges,43.93,100,,,Fee Schedule,100% of Medicare rate,278.63,100,,,Fee Schedule,100% of WA Medicaid,2195,100,,,percent of total billed charges,100% of total billed charges,286.99,103,,,Fee Schedule,103% of WA Medicaid,43.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,278.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1514.55,69,,,percent of total billed charges,69% of total billed charges,2195,100,,,percent of total billed charges,100% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2195,100,,,percent of total billed charges,100% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2195,100,,,percent of total billed charges,100% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357.61,61.85,,,percent of total billed charges,61.85% of total billed charges,278.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,362.22,130,,,Fee Schedule,130% of WA Medicaid ,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,827.52,37.7,,,percent of total billed charges,37.70% of total billed charges,827.52,37.7,,,percent of total billed charges,37.70% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,74410.5,33.9,,,percent of total billed charges,33.9% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1712.1,78,,,percent of total billed charges,78% of total billed charges,2195,100,,,percent of total billed charges,100% of total billed charges,1813.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1813.07,82.6,,,percent of total billed charges,82.6% of total billed charges,278.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.93,74410.5,
TENDON SHEATH INCISION,96026055,CDM,975,RC,26055,HCPCS,Outpatient,,,1431,930.15,,1259.28,88,,,percent of total billed charges,88% of total Billed charges,24.39,100,,,Fee Schedule,100% of Medicare rate,173.63,100,,,Fee Schedule,100% of WA Medicaid,1431,100,,,percent of total billed charges,100% of total billed charges,178.84,103,,,Fee Schedule,103% of WA Medicaid,24.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,173.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,987.39,69,,,percent of total billed charges,69% of total billed charges,1431,100,,,percent of total billed charges,100% of total billed charges,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1431,100,,,percent of total billed charges,100% of total billed charges,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1431,100,,,percent of total billed charges,100% of total billed charges,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.07,61.85,,,percent of total billed charges,61.85% of total billed charges,173.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,225.72,130,,,Fee Schedule,130% of WA Medicaid ,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.49,37.7,,,percent of total billed charges,37.70% of total billed charges,539.49,37.7,,,percent of total billed charges,37.70% of total billed charges,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,48510.9,33.9,,,percent of total billed charges,33.9% of total billed charges,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116.18,78,,,percent of total billed charges,78% of total billed charges,1431,100,,,percent of total billed charges,100% of total billed charges,1182.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1182.01,82.6,,,percent of total billed charges,82.6% of total billed charges,173.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.39,48510.9,
EXCISION HND/FNGR LESION1.5CM+,96026111,CDM,960,RC,26111,HCPCS,Outpatient,,,661,429.65,,581.68,88,,,percent of total billed charges,88% of total Billed charges,40.01,100,,,Fee Schedule,100% of Medicare rate,243.2,100,,,Fee Schedule,100% of WA Medicaid,661,100,,,percent of total billed charges,100% of total billed charges,250.5,103,,,Fee Schedule,103% of WA Medicaid,40.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,243.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,456.09,69,,,percent of total billed charges,69% of total billed charges,661,100,,,percent of total billed charges,100% of total billed charges,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,661,100,,,percent of total billed charges,100% of total billed charges,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,661,100,,,percent of total billed charges,100% of total billed charges,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.83,61.85,,,percent of total billed charges,61.85% of total billed charges,243.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,316.16,130,,,Fee Schedule,130% of WA Medicaid ,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.2,37.7,,,percent of total billed charges,37.70% of total billed charges,249.2,37.7,,,percent of total billed charges,37.70% of total billed charges,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,22407.9,33.9,,,percent of total billed charges,33.9% of total billed charges,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.58,78,,,percent of total billed charges,78% of total billed charges,661,100,,,percent of total billed charges,100% of total billed charges,545.99,82.6,,,percent of total billed charges,82.6% of total billed charges,545.99,82.6,,,percent of total billed charges,82.6% of total billed charges,243.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.01,22407.9,
EXC HAND TUMOR DEEP > 1.5CM,96026113,CDM,960,RC,26113,HCPCS,Outpatient,,,1188,772.20,,1045.44,88,,,percent of total billed charges,88% of total Billed charges,51.57,100,,,Fee Schedule,100% of Medicare rate,320.03,100,,,Fee Schedule,100% of WA Medicaid,1188,100,,,percent of total billed charges,100% of total billed charges,329.63,103,,,Fee Schedule,103% of WA Medicaid,51.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,320.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,819.72,69,,,percent of total billed charges,69% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188,100,,,percent of total billed charges,100% of total billed charges,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188,100,,,percent of total billed charges,100% of total billed charges,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.78,61.85,,,percent of total billed charges,61.85% of total billed charges,320.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,416.04,130,,,Fee Schedule,130% of WA Medicaid ,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.88,37.7,,,percent of total billed charges,37.70% of total billed charges,447.88,37.7,,,percent of total billed charges,37.70% of total billed charges,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,40273.2,33.9,,,percent of total billed charges,33.9% of total billed charges,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,926.64,78,,,percent of total billed charges,78% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,320.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.57,40273.2,
REM HAND LESION < 1.5CM SUBQ,96026115,CDM,960,RC,26115,HCPCS,Outpatient,,,1067,693.55,,938.96,88,,,percent of total billed charges,88% of total Billed charges,29.74,100,,,Fee Schedule,100% of Medicare rate,196.2,100,,,Fee Schedule,100% of WA Medicaid,1067,100,,,percent of total billed charges,100% of total billed charges,202.09,103,,,Fee Schedule,103% of WA Medicaid,29.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,196.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,736.23,69,,,percent of total billed charges,69% of total billed charges,1067,100,,,percent of total billed charges,100% of total billed charges,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067,100,,,percent of total billed charges,100% of total billed charges,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067,100,,,percent of total billed charges,100% of total billed charges,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.94,61.85,,,percent of total billed charges,61.85% of total billed charges,196.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,255.06,130,,,Fee Schedule,130% of WA Medicaid ,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.26,37.7,,,percent of total billed charges,37.70% of total billed charges,402.26,37.7,,,percent of total billed charges,37.70% of total billed charges,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,36171.3,33.9,,,percent of total billed charges,33.9% of total billed charges,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,832.26,78,,,percent of total billed charges,78% of total billed charges,1067,100,,,percent of total billed charges,100% of total billed charges,881.34,82.6,,,percent of total billed charges,82.6% of total billed charges,881.34,82.6,,,percent of total billed charges,82.6% of total billed charges,196.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.74,36171.3,
EXC HAND TUM DEEP < 1.5 CM,97526116,CDM,975,RC,26116,HCPCS,Outpatient,,,2148,1396.20,,1890.24,88,,,percent of total billed charges,88% of total Billed charges,48.84,100,,,Fee Schedule,100% of Medicare rate,307.54,100,,,Fee Schedule,100% of WA Medicaid,2148,100,,,percent of total billed charges,100% of total billed charges,316.77,103,,,Fee Schedule,103% of WA Medicaid,48.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,307.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1482.12,69,,,percent of total billed charges,69% of total billed charges,2148,100,,,percent of total billed charges,100% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2148,100,,,percent of total billed charges,100% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2148,100,,,percent of total billed charges,100% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1328.54,61.85,,,percent of total billed charges,61.85% of total billed charges,307.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,399.8,130,,,Fee Schedule,130% of WA Medicaid ,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,809.8,37.7,,,percent of total billed charges,37.70% of total billed charges,809.8,37.7,,,percent of total billed charges,37.70% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,72817.2,33.9,,,percent of total billed charges,33.9% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1675.44,78,,,percent of total billed charges,78% of total billed charges,2148,100,,,percent of total billed charges,100% of total billed charges,1774.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1774.25,82.6,,,percent of total billed charges,82.6% of total billed charges,307.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.84,72817.2,
"26121 FASCIECTOMY, PALM ONLY, WITH OR WITHOUT Z-PLASTY, OTHE",97526121,CDM,975,RC,26121,HCPCS,Outpatient,,,1650,1072.50,,1452,88,,,percent of total billed charges,88% of total Billed charges,56.83,100,,,Fee Schedule,100% of Medicare rate,350.99,100,,,Fee Schedule,100% of WA Medicaid,1650,100,,,percent of total billed charges,100% of total billed charges,361.52,103,,,Fee Schedule,103% of WA Medicaid,56.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,350.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1138.5,69,,,percent of total billed charges,69% of total billed charges,1650,100,,,percent of total billed charges,100% of total billed charges,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650,100,,,percent of total billed charges,100% of total billed charges,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650,100,,,percent of total billed charges,100% of total billed charges,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.53,61.85,,,percent of total billed charges,61.85% of total billed charges,350.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,456.29,130,,,Fee Schedule,130% of WA Medicaid ,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.05,37.7,,,percent of total billed charges,37.70% of total billed charges,622.05,37.7,,,percent of total billed charges,37.70% of total billed charges,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,55935,33.9,,,percent of total billed charges,33.9% of total billed charges,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1287,78,,,percent of total billed charges,78% of total billed charges,1650,100,,,percent of total billed charges,100% of total billed charges,1362.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1362.9,82.6,,,percent of total billed charges,82.6% of total billed charges,350.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.83,55935,
RELEASE PALM CONTRACTURE,96026123,CDM,960,RC,26123,HCPCS,Outpatient,,,1981,1287.65,,1743.28,88,,,percent of total billed charges,88% of total Billed charges,78.87,100,,,Fee Schedule,100% of Medicare rate,489,100,,,Fee Schedule,100% of WA Medicaid,1981,100,,,percent of total billed charges,100% of total billed charges,503.67,103,,,Fee Schedule,103% of WA Medicaid,78.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,489,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1366.89,69,,,percent of total billed charges,69% of total billed charges,1981,100,,,percent of total billed charges,100% of total billed charges,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1981,100,,,percent of total billed charges,100% of total billed charges,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1981,100,,,percent of total billed charges,100% of total billed charges,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1225.25,61.85,,,percent of total billed charges,61.85% of total billed charges,489,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,489,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,498.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,635.7,130,,,Fee Schedule,130% of WA Medicaid ,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.84,37.7,,,percent of total billed charges,37.70% of total billed charges,746.84,37.7,,,percent of total billed charges,37.70% of total billed charges,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,67155.9,33.9,,,percent of total billed charges,33.9% of total billed charges,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1545.18,78,,,percent of total billed charges,78% of total billed charges,1981,100,,,percent of total billed charges,100% of total billed charges,1636.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1636.31,82.6,,,percent of total billed charges,82.6% of total billed charges,489,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,489,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.87,67155.9,
TENDON EXCISION PALM/FINGER,96026145,CDM,960,RC,26145,HCPCS,Outpatient,,,1233,801.45,,1085.04,88,,,percent of total billed charges,88% of total Billed charges,47.84,100,,,Fee Schedule,100% of Medicare rate,303.44,100,,,Fee Schedule,100% of WA Medicaid,1233,100,,,percent of total billed charges,100% of total billed charges,312.54,103,,,Fee Schedule,103% of WA Medicaid,47.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,303.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,850.77,69,,,percent of total billed charges,69% of total billed charges,1233,100,,,percent of total billed charges,100% of total billed charges,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1233,100,,,percent of total billed charges,100% of total billed charges,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1233,100,,,percent of total billed charges,100% of total billed charges,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,762.61,61.85,,,percent of total billed charges,61.85% of total billed charges,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,394.47,130,,,Fee Schedule,130% of WA Medicaid ,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.84,37.7,,,percent of total billed charges,37.70% of total billed charges,464.84,37.7,,,percent of total billed charges,37.70% of total billed charges,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,41798.7,33.9,,,percent of total billed charges,33.9% of total billed charges,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,961.74,78,,,percent of total billed charges,78% of total billed charges,1233,100,,,percent of total billed charges,100% of total billed charges,1018.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1018.46,82.6,,,percent of total billed charges,82.6% of total billed charges,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.84,41798.7,
EXC LESION TENDON SHEATH,96026160,CDM,960,RC,26160,HCPCS,Outpatient,,,1218,791.70,,1071.84,88,,,percent of total billed charges,88% of total Billed charges,27.48,100,,,Fee Schedule,100% of Medicare rate,187.81,100,,,Fee Schedule,100% of WA Medicaid,1218,100,,,percent of total billed charges,100% of total billed charges,193.44,103,,,Fee Schedule,103% of WA Medicaid,27.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,187.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,840.42,69,,,percent of total billed charges,69% of total billed charges,1218,100,,,percent of total billed charges,100% of total billed charges,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1218,100,,,percent of total billed charges,100% of total billed charges,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1218,100,,,percent of total billed charges,100% of total billed charges,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,753.33,61.85,,,percent of total billed charges,61.85% of total billed charges,187.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,244.15,130,,,Fee Schedule,130% of WA Medicaid ,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.19,37.7,,,percent of total billed charges,37.70% of total billed charges,459.19,37.7,,,percent of total billed charges,37.70% of total billed charges,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,41290.2,33.9,,,percent of total billed charges,33.9% of total billed charges,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,950.04,78,,,percent of total billed charges,78% of total billed charges,1218,100,,,percent of total billed charges,100% of total billed charges,1006.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1006.07,82.6,,,percent of total billed charges,82.6% of total billed charges,187.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.48,41290.2,
REMOVAL OF FINGER LESION,96026210,CDM,975,RC,26210,HCPCS,Outpatient,,,984,639.60,,865.92,88,,,percent of total billed charges,88% of total Billed charges,40.1,100,,,Fee Schedule,100% of Medicare rate,265.02,100,,,Fee Schedule,100% of WA Medicaid,984,100,,,percent of total billed charges,100% of total billed charges,272.97,103,,,Fee Schedule,103% of WA Medicaid,40.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,265.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,678.96,69,,,percent of total billed charges,69% of total billed charges,984,100,,,percent of total billed charges,100% of total billed charges,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,984,100,,,percent of total billed charges,100% of total billed charges,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,984,100,,,percent of total billed charges,100% of total billed charges,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.6,61.85,,,percent of total billed charges,61.85% of total billed charges,265.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,344.53,130,,,Fee Schedule,130% of WA Medicaid ,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.97,37.7,,,percent of total billed charges,37.70% of total billed charges,370.97,37.7,,,percent of total billed charges,37.70% of total billed charges,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,33357.6,33.9,,,percent of total billed charges,33.9% of total billed charges,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,767.52,78,,,percent of total billed charges,78% of total billed charges,984,100,,,percent of total billed charges,100% of total billed charges,812.78,82.6,,,percent of total billed charges,82.6% of total billed charges,812.78,82.6,,,percent of total billed charges,82.6% of total billed charges,265.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.1,33357.6,
"26236 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIA",97526236,CDM,975,RC,26236,HCPCS,Outpatient,,,981,637.65,,863.28,88,,,percent of total billed charges,88% of total Billed charges,41.16,100,,,Fee Schedule,100% of Medicare rate,260.35,100,,,Fee Schedule,100% of WA Medicaid,981,100,,,percent of total billed charges,100% of total billed charges,268.16,103,,,Fee Schedule,103% of WA Medicaid,41.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,260.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,676.89,69,,,percent of total billed charges,69% of total billed charges,981,100,,,percent of total billed charges,100% of total billed charges,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,981,100,,,percent of total billed charges,100% of total billed charges,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,981,100,,,percent of total billed charges,100% of total billed charges,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.75,61.85,,,percent of total billed charges,61.85% of total billed charges,260.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,338.46,130,,,Fee Schedule,130% of WA Medicaid ,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.84,37.7,,,percent of total billed charges,37.70% of total billed charges,369.84,37.7,,,percent of total billed charges,37.70% of total billed charges,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,33255.9,33.9,,,percent of total billed charges,33.9% of total billed charges,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.18,78,,,percent of total billed charges,78% of total billed charges,981,100,,,percent of total billed charges,100% of total billed charges,810.31,82.6,,,percent of total billed charges,82.6% of total billed charges,810.31,82.6,,,percent of total billed charges,82.6% of total billed charges,260.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.16,33255.9,
REPAIR FINGER/HAND TENDON,96026356,CDM,960,RC,26356,HCPCS,Outpatient,,,2571,1671.15,,2262.48,88,,,percent of total billed charges,88% of total Billed charges,70.89,100,,,Fee Schedule,100% of Medicare rate,466.25,100,,,Fee Schedule,100% of WA Medicaid,2571,100,,,percent of total billed charges,100% of total billed charges,480.24,103,,,Fee Schedule,103% of WA Medicaid,70.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,466.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1773.99,69,,,percent of total billed charges,69% of total billed charges,2571,100,,,percent of total billed charges,100% of total billed charges,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2571,100,,,percent of total billed charges,100% of total billed charges,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2571,100,,,percent of total billed charges,100% of total billed charges,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1590.16,61.85,,,percent of total billed charges,61.85% of total billed charges,466.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,606.13,130,,,Fee Schedule,130% of WA Medicaid ,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,969.27,37.7,,,percent of total billed charges,37.70% of total billed charges,969.27,37.7,,,percent of total billed charges,37.70% of total billed charges,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,87156.9,33.9,,,percent of total billed charges,33.9% of total billed charges,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2005.38,78,,,percent of total billed charges,78% of total billed charges,2571,100,,,percent of total billed charges,100% of total billed charges,2123.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2123.65,82.6,,,percent of total billed charges,82.6% of total billed charges,466.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.89,87156.9,
REPAIR FINGER/HAND TENDON,96026357,CDM,960,RC,26357,HCPCS,Outpatient,,,2047,1330.55,,1801.36,88,,,percent of total billed charges,88% of total Billed charges,85.93,100,,,Fee Schedule,100% of Medicare rate,520.15,100,,,Fee Schedule,100% of WA Medicaid,2047,100,,,percent of total billed charges,100% of total billed charges,535.75,103,,,Fee Schedule,103% of WA Medicaid,85.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,150.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,520.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1412.43,69,,,percent of total billed charges,69% of total billed charges,2047,100,,,percent of total billed charges,100% of total billed charges,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2047,100,,,percent of total billed charges,100% of total billed charges,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2047,100,,,percent of total billed charges,100% of total billed charges,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1266.07,61.85,,,percent of total billed charges,61.85% of total billed charges,520.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,676.2,130,,,Fee Schedule,130% of WA Medicaid ,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,771.72,37.7,,,percent of total billed charges,37.70% of total billed charges,771.72,37.7,,,percent of total billed charges,37.70% of total billed charges,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,69393.3,33.9,,,percent of total billed charges,33.9% of total billed charges,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1596.66,78,,,percent of total billed charges,78% of total billed charges,2047,100,,,percent of total billed charges,100% of total billed charges,1690.82,82.6,,,percent of total billed charges,82.6% of total billed charges,1690.82,82.6,,,percent of total billed charges,82.6% of total billed charges,520.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.93,69393.3,
"26370 REPAIR OR ADVANCEMENT OF PROFUNDUS TENDON, W",97526370,CDM,975,RC,26370,HCPCS,Outpatient,,,1856,1206.40,,1633.28,88,,,percent of total billed charges,88% of total Billed charges,59.7,100,,,Fee Schedule,100% of Medicare rate,461.96,100,,,Fee Schedule,100% of WA Medicaid,1856,100,,,percent of total billed charges,100% of total billed charges,475.82,103,,,Fee Schedule,103% of WA Medicaid,59.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,104.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,461.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1280.64,69,,,percent of total billed charges,69% of total billed charges,1856,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1856,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1856,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1147.94,61.85,,,percent of total billed charges,61.85% of total billed charges,461.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.55,130,,,Fee Schedule,130% of WA Medicaid ,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.71,37.7,,,percent of total billed charges,37.70% of total billed charges,699.71,37.7,,,percent of total billed charges,37.70% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,62918.4,33.9,,,percent of total billed charges,33.9% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1447.68,78,,,percent of total billed charges,78% of total billed charges,1856,100,,,percent of total billed charges,100% of total billed charges,1533.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1533.06,82.6,,,percent of total billed charges,82.6% of total billed charges,461.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.7,62918.4,
REPAIR FINGER/HAND TENDON,96026373,CDM,960,RC,26373,HCPCS,Outpatient,,,1309,850.85,,1151.92,88,,,percent of total billed charges,88% of total Billed charges,71.71,100,,,Fee Schedule,100% of Medicare rate,517.72,100,,,Fee Schedule,100% of WA Medicaid,1309,100,,,percent of total billed charges,100% of total billed charges,533.25,103,,,Fee Schedule,103% of WA Medicaid,71.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,125.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,517.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,903.21,69,,,percent of total billed charges,69% of total billed charges,1309,100,,,percent of total billed charges,100% of total billed charges,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1309,100,,,percent of total billed charges,100% of total billed charges,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1309,100,,,percent of total billed charges,100% of total billed charges,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,809.62,61.85,,,percent of total billed charges,61.85% of total billed charges,517.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,673.04,130,,,Fee Schedule,130% of WA Medicaid ,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,493.49,37.7,,,percent of total billed charges,37.70% of total billed charges,493.49,37.7,,,percent of total billed charges,37.70% of total billed charges,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,44375.1,33.9,,,percent of total billed charges,33.9% of total billed charges,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1021.02,78,,,percent of total billed charges,78% of total billed charges,1309,100,,,percent of total billed charges,100% of total billed charges,1081.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1081.23,82.6,,,percent of total billed charges,82.6% of total billed charges,517.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.71,44375.1,
REPAIR HAND TENDON,96026410,CDM,960,RC,26410,HCPCS,Outpatient,,,1200,780.00,,1056,88,,,percent of total billed charges,88% of total Billed charges,42.52,100,,,Fee Schedule,100% of Medicare rate,357.33,100,,,Fee Schedule,100% of WA Medicaid,1200,100,,,percent of total billed charges,100% of total billed charges,368.05,103,,,Fee Schedule,103% of WA Medicaid,42.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,357.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,828,69,,,percent of total billed charges,69% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,742.2,61.85,,,percent of total billed charges,61.85% of total billed charges,357.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,464.53,130,,,Fee Schedule,130% of WA Medicaid ,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,40680,33.9,,,percent of total billed charges,33.9% of total billed charges,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,936,78,,,percent of total billed charges,78% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,357.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.52,40680,
"26418 REPAIR, EXTENSOR TENDON, FINGER, PRIMARY OR",97526418,CDM,975,RC,26418,HCPCS,Outpatient,,,2328,1513.20,,2048.64,88,,,percent of total billed charges,88% of total Billed charges,41.75,100,,,Fee Schedule,100% of Medicare rate,372.63,100,,,Fee Schedule,100% of WA Medicaid,2328,100,,,percent of total billed charges,100% of total billed charges,383.81,103,,,Fee Schedule,103% of WA Medicaid,41.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,372.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1606.32,69,,,percent of total billed charges,69% of total billed charges,2328,100,,,percent of total billed charges,100% of total billed charges,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2328,100,,,percent of total billed charges,100% of total billed charges,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2328,100,,,percent of total billed charges,100% of total billed charges,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1439.87,61.85,,,percent of total billed charges,61.85% of total billed charges,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,484.42,130,,,Fee Schedule,130% of WA Medicaid ,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,877.66,37.7,,,percent of total billed charges,37.70% of total billed charges,877.66,37.7,,,percent of total billed charges,37.70% of total billed charges,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,78919.2,33.9,,,percent of total billed charges,33.9% of total billed charges,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1815.84,78,,,percent of total billed charges,78% of total billed charges,2328,100,,,percent of total billed charges,100% of total billed charges,1922.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1922.93,82.6,,,percent of total billed charges,82.6% of total billed charges,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.75,78919.2,
REPAIR OF EXT TENDON W/O GRAFT,96026433,CDM,960,RC,26433,HCPCS,Outpatient,,,1329,863.85,,1169.52,88,,,percent of total billed charges,88% of total Billed charges,40.82,100,,,Fee Schedule,100% of Medicare rate,339.43,100,,,Fee Schedule,100% of WA Medicaid,1329,100,,,percent of total billed charges,100% of total billed charges,349.61,103,,,Fee Schedule,103% of WA Medicaid,40.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,71.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,339.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,917.01,69,,,percent of total billed charges,69% of total billed charges,1329,100,,,percent of total billed charges,100% of total billed charges,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329,100,,,percent of total billed charges,100% of total billed charges,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329,100,,,percent of total billed charges,100% of total billed charges,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,821.99,61.85,,,percent of total billed charges,61.85% of total billed charges,339.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,441.26,130,,,Fee Schedule,130% of WA Medicaid ,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,501.03,37.7,,,percent of total billed charges,37.70% of total billed charges,501.03,37.7,,,percent of total billed charges,37.70% of total billed charges,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,45053.1,33.9,,,percent of total billed charges,33.9% of total billed charges,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1036.62,78,,,percent of total billed charges,78% of total billed charges,1329,100,,,percent of total billed charges,100% of total billed charges,1097.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1097.75,82.6,,,percent of total billed charges,82.6% of total billed charges,339.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.82,45053.1,
"26440 TENOLYSIS, FLEXOR TENDON; PALM OR FINGER, EACH TENDON",97526440,CDM,975,RC,26440,HCPCS,Outpatient,,,2312,1502.80,,2034.56,88,,,percent of total billed charges,88% of total Billed charges,45.32,100,,,Fee Schedule,100% of Medicare rate,386.06,100,,,Fee Schedule,100% of WA Medicaid,2312,100,,,percent of total billed charges,100% of total billed charges,397.64,103,,,Fee Schedule,103% of WA Medicaid,45.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,386.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1595.28,69,,,percent of total billed charges,69% of total billed charges,2312,100,,,percent of total billed charges,100% of total billed charges,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2312,100,,,percent of total billed charges,100% of total billed charges,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2312,100,,,percent of total billed charges,100% of total billed charges,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1429.97,61.85,,,percent of total billed charges,61.85% of total billed charges,386.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,501.88,130,,,Fee Schedule,130% of WA Medicaid ,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,871.62,37.7,,,percent of total billed charges,37.70% of total billed charges,871.62,37.7,,,percent of total billed charges,37.70% of total billed charges,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,78376.8,33.9,,,percent of total billed charges,33.9% of total billed charges,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1803.36,78,,,percent of total billed charges,78% of total billed charges,2312,100,,,percent of total billed charges,100% of total billed charges,1909.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1909.71,82.6,,,percent of total billed charges,82.6% of total billed charges,386.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.32,78376.8,
"26445 TENOLYSIS, EXTENSOR TENDON, HAND OR FINGER, EACH TENDO",97526445,CDM,975,RC,26445,HCPCS,Outpatient,,,1964,1276.60,,1728.32,88,,,percent of total billed charges,88% of total Billed charges,40.29,100,,,Fee Schedule,100% of Medicare rate,359.57,100,,,Fee Schedule,100% of WA Medicaid,1964,100,,,percent of total billed charges,100% of total billed charges,370.36,103,,,Fee Schedule,103% of WA Medicaid,40.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,359.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1355.16,69,,,percent of total billed charges,69% of total billed charges,1964,100,,,percent of total billed charges,100% of total billed charges,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1964,100,,,percent of total billed charges,100% of total billed charges,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1964,100,,,percent of total billed charges,100% of total billed charges,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1214.73,61.85,,,percent of total billed charges,61.85% of total billed charges,359.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,467.44,130,,,Fee Schedule,130% of WA Medicaid ,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,740.43,37.7,,,percent of total billed charges,37.70% of total billed charges,740.43,37.7,,,percent of total billed charges,37.70% of total billed charges,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,66579.6,33.9,,,percent of total billed charges,33.9% of total billed charges,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1531.92,78,,,percent of total billed charges,78% of total billed charges,1964,100,,,percent of total billed charges,100% of total billed charges,1622.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1622.26,82.6,,,percent of total billed charges,82.6% of total billed charges,359.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.29,66579.6,
"26530 ARTHROPLASTY, METACARPOPHALANGEAL JOINT; EACH JOINT Pr",97526530,CDM,975,RC,26530,HCPCS,Outpatient,,,1935,1257.75,,1702.8,88,,,percent of total billed charges,88% of total Billed charges,50.19,100,,,Fee Schedule,100% of Medicare rate,318.54,100,,,Fee Schedule,100% of WA Medicaid,1935,100,,,percent of total billed charges,100% of total billed charges,328.1,103,,,Fee Schedule,103% of WA Medicaid,50.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,318.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1335.15,69,,,percent of total billed charges,69% of total billed charges,1935,100,,,percent of total billed charges,100% of total billed charges,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1935,100,,,percent of total billed charges,100% of total billed charges,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1935,100,,,percent of total billed charges,100% of total billed charges,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1196.8,61.85,,,percent of total billed charges,61.85% of total billed charges,318.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,414.1,130,,,Fee Schedule,130% of WA Medicaid ,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.5,37.7,,,percent of total billed charges,37.70% of total billed charges,729.5,37.7,,,percent of total billed charges,37.70% of total billed charges,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,65596.5,33.9,,,percent of total billed charges,33.9% of total billed charges,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1509.3,78,,,percent of total billed charges,78% of total billed charges,1935,100,,,percent of total billed charges,100% of total billed charges,1598.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1598.31,82.6,,,percent of total billed charges,82.6% of total billed charges,318.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.19,65596.5,
"26535 ARTHROPLASTY, INTERPHALANGEAL JOINT; EACH JOINT ProFee",97526535,CDM,975,RC,26535,HCPCS,Outpatient,,,983,638.95,,865.04,88,,,percent of total billed charges,88% of total Billed charges,39,100,,,Fee Schedule,100% of Medicare rate,258.68,100,,,Fee Schedule,100% of WA Medicaid,983,100,,,percent of total billed charges,100% of total billed charges,266.44,103,,,Fee Schedule,103% of WA Medicaid,39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,258.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,678.27,69,,,percent of total billed charges,69% of total billed charges,983,100,,,percent of total billed charges,100% of total billed charges,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,983,100,,,percent of total billed charges,100% of total billed charges,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,983,100,,,percent of total billed charges,100% of total billed charges,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,607.99,61.85,,,percent of total billed charges,61.85% of total billed charges,258.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,336.28,130,,,Fee Schedule,130% of WA Medicaid ,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.59,37.7,,,percent of total billed charges,37.70% of total billed charges,370.59,37.7,,,percent of total billed charges,37.70% of total billed charges,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,33323.7,33.9,,,percent of total billed charges,33.9% of total billed charges,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.74,78,,,percent of total billed charges,78% of total billed charges,983,100,,,percent of total billed charges,100% of total billed charges,811.96,82.6,,,percent of total billed charges,82.6% of total billed charges,811.96,82.6,,,percent of total billed charges,82.6% of total billed charges,258.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39,33323.7,
RECON OF POLYDACTYLOUS DIGIT,96026587,CDM,960,RC,26587,HCPCS,Outpatient,,,1969,1279.85,,1732.72,88,,,percent of total billed charges,88% of total Billed charges,108.98,100,,,Fee Schedule,100% of Medicare rate,602.21,100,,,Fee Schedule,100% of WA Medicaid,1969,100,,,percent of total billed charges,100% of total billed charges,620.28,103,,,Fee Schedule,103% of WA Medicaid,108.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,190.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,602.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1358.61,69,,,percent of total billed charges,69% of total billed charges,1969,100,,,percent of total billed charges,100% of total billed charges,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1969,100,,,percent of total billed charges,100% of total billed charges,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1969,100,,,percent of total billed charges,100% of total billed charges,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1217.83,61.85,,,percent of total billed charges,61.85% of total billed charges,602.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,782.87,130,,,Fee Schedule,130% of WA Medicaid ,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,742.31,37.7,,,percent of total billed charges,37.70% of total billed charges,742.31,37.7,,,percent of total billed charges,37.70% of total billed charges,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,66749.1,33.9,,,percent of total billed charges,33.9% of total billed charges,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1535.82,78,,,percent of total billed charges,78% of total billed charges,1969,100,,,percent of total billed charges,100% of total billed charges,1626.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1626.39,82.6,,,percent of total billed charges,82.6% of total billed charges,602.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,108.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.98,66749.1,
TREAT METACARPAL FRACTURE,96026608,CDM,960,RC,26608,HCPCS,Outpatient,,,1034,672.10,,909.92,88,,,percent of total billed charges,88% of total Billed charges,43.25,100,,,Fee Schedule,100% of Medicare rate,285.72,100,,,Fee Schedule,100% of WA Medicaid,1034,100,,,percent of total billed charges,100% of total billed charges,294.29,103,,,Fee Schedule,103% of WA Medicaid,43.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,285.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,713.46,69,,,percent of total billed charges,69% of total billed charges,1034,100,,,percent of total billed charges,100% of total billed charges,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034,100,,,percent of total billed charges,100% of total billed charges,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034,100,,,percent of total billed charges,100% of total billed charges,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.53,61.85,,,percent of total billed charges,61.85% of total billed charges,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,371.44,130,,,Fee Schedule,130% of WA Medicaid ,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.82,37.7,,,percent of total billed charges,37.70% of total billed charges,389.82,37.7,,,percent of total billed charges,37.70% of total billed charges,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,35052.6,33.9,,,percent of total billed charges,33.9% of total billed charges,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.52,78,,,percent of total billed charges,78% of total billed charges,1034,100,,,percent of total billed charges,100% of total billed charges,854.08,82.6,,,percent of total billed charges,82.6% of total billed charges,854.08,82.6,,,percent of total billed charges,82.6% of total billed charges,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.25,35052.6,
OPEN TX OF METACARPAL FX SGL,96026615,CDM,960,RC,26615,HCPCS,Outpatient,,,1441,936.65,,1268.08,88,,,percent of total billed charges,88% of total Billed charges,52.78,100,,,Fee Schedule,100% of Medicare rate,338.5,100,,,Fee Schedule,100% of WA Medicaid,1441,100,,,percent of total billed charges,100% of total billed charges,348.66,103,,,Fee Schedule,103% of WA Medicaid,52.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,338.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,994.29,69,,,percent of total billed charges,69% of total billed charges,1441,100,,,percent of total billed charges,100% of total billed charges,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1441,100,,,percent of total billed charges,100% of total billed charges,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1441,100,,,percent of total billed charges,100% of total billed charges,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,891.26,61.85,,,percent of total billed charges,61.85% of total billed charges,338.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.05,130,,,Fee Schedule,130% of WA Medicaid ,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,543.26,37.7,,,percent of total billed charges,37.70% of total billed charges,543.26,37.7,,,percent of total billed charges,37.70% of total billed charges,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,48849.9,33.9,,,percent of total billed charges,33.9% of total billed charges,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1123.98,78,,,percent of total billed charges,78% of total billed charges,1441,100,,,percent of total billed charges,100% of total billed charges,1190.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1190.27,82.6,,,percent of total billed charges,82.6% of total billed charges,338.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.78,48849.9,
TX THUMB FX,96026665,CDM,960,RC,26665,HCPCS,Outpatient,,,1501,975.65,,1320.88,88,,,percent of total billed charges,88% of total Billed charges,54.6,100,,,Fee Schedule,100% of Medicare rate,368.15,100,,,Fee Schedule,100% of WA Medicaid,1501,100,,,percent of total billed charges,100% of total billed charges,379.19,103,,,Fee Schedule,103% of WA Medicaid,54.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,368.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1035.69,69,,,percent of total billed charges,69% of total billed charges,1501,100,,,percent of total billed charges,100% of total billed charges,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1501,100,,,percent of total billed charges,100% of total billed charges,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1501,100,,,percent of total billed charges,100% of total billed charges,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,928.37,61.85,,,percent of total billed charges,61.85% of total billed charges,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,478.6,130,,,Fee Schedule,130% of WA Medicaid ,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.88,37.7,,,percent of total billed charges,37.70% of total billed charges,565.88,37.7,,,percent of total billed charges,37.70% of total billed charges,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,50883.9,33.9,,,percent of total billed charges,33.9% of total billed charges,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1170.78,78,,,percent of total billed charges,78% of total billed charges,1501,100,,,percent of total billed charges,100% of total billed charges,1239.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1239.83,82.6,,,percent of total billed charges,82.6% of total billed charges,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.6,50883.9,
TREAT HAND DISLOCATION EA JT,96026685,CDM,960,RC,26685,HCPCS,Outpatient,,,1385,900.25,,1218.8,88,,,percent of total billed charges,88% of total Billed charges,49.46,100,,,Fee Schedule,100% of Medicare rate,339.62,100,,,Fee Schedule,100% of WA Medicaid,1385,100,,,percent of total billed charges,100% of total billed charges,349.81,103,,,Fee Schedule,103% of WA Medicaid,49.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,339.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,955.65,69,,,percent of total billed charges,69% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,856.62,61.85,,,percent of total billed charges,61.85% of total billed charges,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,441.51,130,,,Fee Schedule,130% of WA Medicaid ,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,46951.5,33.9,,,percent of total billed charges,33.9% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080.3,78,,,percent of total billed charges,78% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.46,46951.5,
TREATMENT FINGER FRACTURE EA,96026727,CDM,960,RC,26727,HCPCS,Outpatient,,,1004,652.60,,883.52,88,,,percent of total billed charges,88% of total Billed charges,42.01,100,,,Fee Schedule,100% of Medicare rate,281.8,100,,,Fee Schedule,100% of WA Medicaid,1004,100,,,percent of total billed charges,100% of total billed charges,290.25,103,,,Fee Schedule,103% of WA Medicaid,42.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,281.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,692.76,69,,,percent of total billed charges,69% of total billed charges,1004,100,,,percent of total billed charges,100% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1004,100,,,percent of total billed charges,100% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1004,100,,,percent of total billed charges,100% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,620.97,61.85,,,percent of total billed charges,61.85% of total billed charges,281.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,366.34,130,,,Fee Schedule,130% of WA Medicaid ,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.51,37.7,,,percent of total billed charges,37.70% of total billed charges,378.51,37.7,,,percent of total billed charges,37.70% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,34035.6,33.9,,,percent of total billed charges,33.9% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,783.12,78,,,percent of total billed charges,78% of total billed charges,1004,100,,,percent of total billed charges,100% of total billed charges,829.3,82.6,,,percent of total billed charges,82.6% of total billed charges,829.3,82.6,,,percent of total billed charges,82.6% of total billed charges,281.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.01,34035.6,
OPEN TX OF PHALANGEAL SHAFT FX,96026735,CDM,960,RC,26735,HCPCS,Outpatient,,,1423,924.95,,1252.24,88,,,percent of total billed charges,88% of total Billed charges,55.44,100,,,Fee Schedule,100% of Medicare rate,349.5,100,,,Fee Schedule,100% of WA Medicaid,1423,100,,,percent of total billed charges,100% of total billed charges,359.99,103,,,Fee Schedule,103% of WA Medicaid,55.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,349.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,981.87,69,,,percent of total billed charges,69% of total billed charges,1423,100,,,percent of total billed charges,100% of total billed charges,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423,100,,,percent of total billed charges,100% of total billed charges,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423,100,,,percent of total billed charges,100% of total billed charges,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,880.13,61.85,,,percent of total billed charges,61.85% of total billed charges,349.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,454.35,130,,,Fee Schedule,130% of WA Medicaid ,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,536.47,37.7,,,percent of total billed charges,37.70% of total billed charges,536.47,37.7,,,percent of total billed charges,37.70% of total billed charges,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,48239.7,33.9,,,percent of total billed charges,33.9% of total billed charges,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1109.94,78,,,percent of total billed charges,78% of total billed charges,1423,100,,,percent of total billed charges,100% of total billed charges,1175.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1175.4,82.6,,,percent of total billed charges,82.6% of total billed charges,349.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.44,48239.7,
"26742 CLOSED TREATMENT OF ARTICULAR FRACTURE, INVOLVING META",97526742,CDM,975,RC,26742,HCPCS,Outpatient,,,1159,753.35,,1019.92,88,,,percent of total billed charges,88% of total Billed charges,30.76,100,,,Fee Schedule,100% of Medicare rate,200.86,100,,,Fee Schedule,100% of WA Medicaid,1159,100,,,percent of total billed charges,100% of total billed charges,206.89,103,,,Fee Schedule,103% of WA Medicaid,30.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,799.71,69,,,percent of total billed charges,69% of total billed charges,1159,100,,,percent of total billed charges,100% of total billed charges,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1159,100,,,percent of total billed charges,100% of total billed charges,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1159,100,,,percent of total billed charges,100% of total billed charges,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,716.84,61.85,,,percent of total billed charges,61.85% of total billed charges,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,261.12,130,,,Fee Schedule,130% of WA Medicaid ,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.94,37.7,,,percent of total billed charges,37.70% of total billed charges,436.94,37.7,,,percent of total billed charges,37.70% of total billed charges,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,39290.1,33.9,,,percent of total billed charges,33.9% of total billed charges,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.02,78,,,percent of total billed charges,78% of total billed charges,1159,100,,,percent of total billed charges,100% of total billed charges,957.33,82.6,,,percent of total billed charges,82.6% of total billed charges,957.33,82.6,,,percent of total billed charges,82.6% of total billed charges,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.76,39290.1,
TREAT FINGER FRACT EACH,96026746,CDM,960,RC,26746,HCPCS,Outpatient,,,1847,1200.55,,1625.36,88,,,percent of total billed charges,88% of total Billed charges,70.44,100,,,Fee Schedule,100% of Medicare rate,432.31,100,,,Fee Schedule,100% of WA Medicaid,1847,100,,,percent of total billed charges,100% of total billed charges,445.28,103,,,Fee Schedule,103% of WA Medicaid,70.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,123.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,432.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1274.43,69,,,percent of total billed charges,69% of total billed charges,1847,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1847,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1847,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1142.37,61.85,,,percent of total billed charges,61.85% of total billed charges,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562,130,,,Fee Schedule,130% of WA Medicaid ,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.32,37.7,,,percent of total billed charges,37.70% of total billed charges,696.32,37.7,,,percent of total billed charges,37.70% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,62613.3,33.9,,,percent of total billed charges,33.9% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1440.66,78,,,percent of total billed charges,78% of total billed charges,1847,100,,,percent of total billed charges,100% of total billed charges,1525.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1525.62,82.6,,,percent of total billed charges,82.6% of total billed charges,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.44,62613.3,
OPEN TRMNT DISTAL PHALNGEAL FR,96026765,CDM,960,RC,26765,HCPCS,Outpatient,,,1087,706.55,,956.56,88,,,percent of total billed charges,88% of total Billed charges,44.94,100,,,Fee Schedule,100% of Medicare rate,298.03,100,,,Fee Schedule,100% of WA Medicaid,1087,100,,,percent of total billed charges,100% of total billed charges,306.97,103,,,Fee Schedule,103% of WA Medicaid,44.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,298.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,750.03,69,,,percent of total billed charges,69% of total billed charges,1087,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1087,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1087,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,672.31,61.85,,,percent of total billed charges,61.85% of total billed charges,298.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,387.44,130,,,Fee Schedule,130% of WA Medicaid ,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.8,37.7,,,percent of total billed charges,37.70% of total billed charges,409.8,37.7,,,percent of total billed charges,37.70% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,36849.3,33.9,,,percent of total billed charges,33.9% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.86,78,,,percent of total billed charges,78% of total billed charges,1087,100,,,percent of total billed charges,100% of total billed charges,897.86,82.6,,,percent of total billed charges,82.6% of total billed charges,897.86,82.6,,,percent of total billed charges,82.6% of total billed charges,298.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.94,36849.3,
ARTHRODESIS CARPOMETA JT THUMB,96026841,CDM,960,RC,26841,HCPCS,Outpatient,,,1817,1181.05,,1598.96,88,,,percent of total billed charges,88% of total Billed charges,61.28,100,,,Fee Schedule,100% of Medicare rate,457.48,100,,,Fee Schedule,100% of WA Medicaid,1817,100,,,percent of total billed charges,100% of total billed charges,471.2,103,,,Fee Schedule,103% of WA Medicaid,61.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,107.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,457.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1253.73,69,,,percent of total billed charges,69% of total billed charges,1817,100,,,percent of total billed charges,100% of total billed charges,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1817,100,,,percent of total billed charges,100% of total billed charges,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1817,100,,,percent of total billed charges,100% of total billed charges,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1123.81,61.85,,,percent of total billed charges,61.85% of total billed charges,457.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,594.72,130,,,Fee Schedule,130% of WA Medicaid ,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.01,37.7,,,percent of total billed charges,37.70% of total billed charges,685.01,37.7,,,percent of total billed charges,37.70% of total billed charges,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,61596.3,33.9,,,percent of total billed charges,33.9% of total billed charges,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1417.26,78,,,percent of total billed charges,78% of total billed charges,1817,100,,,percent of total billed charges,100% of total billed charges,1500.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1500.84,82.6,,,percent of total billed charges,82.6% of total billed charges,457.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.28,61596.3,
FUSION FINGER JOINT,96026860,CDM,960,RC,26860,HCPCS,Outpatient,,,1315,854.75,,1157.2,88,,,percent of total billed charges,88% of total Billed charges,43.15,100,,,Fee Schedule,100% of Medicare rate,364.42,100,,,Fee Schedule,100% of WA Medicaid,1315,100,,,percent of total billed charges,100% of total billed charges,375.35,103,,,Fee Schedule,103% of WA Medicaid,43.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,364.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,907.35,69,,,percent of total billed charges,69% of total billed charges,1315,100,,,percent of total billed charges,100% of total billed charges,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1315,100,,,percent of total billed charges,100% of total billed charges,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1315,100,,,percent of total billed charges,100% of total billed charges,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.33,61.85,,,percent of total billed charges,61.85% of total billed charges,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,473.75,130,,,Fee Schedule,130% of WA Medicaid ,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.76,37.7,,,percent of total billed charges,37.70% of total billed charges,495.76,37.7,,,percent of total billed charges,37.70% of total billed charges,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,44578.5,33.9,,,percent of total billed charges,33.9% of total billed charges,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1025.7,78,,,percent of total billed charges,78% of total billed charges,1315,100,,,percent of total billed charges,100% of total billed charges,1086.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1086.19,82.6,,,percent of total billed charges,82.6% of total billed charges,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.15,44578.5,
"26861 ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT IN",97526861,CDM,975,RC,26861,HCPCS,Outpatient,,,376,244.40,,330.88,88,,,percent of total billed charges,88% of total Billed charges,11.57,100,,,Fee Schedule,100% of Medicare rate,57.07,100,,,Fee Schedule,100% of WA Medicaid,376,100,,,percent of total billed charges,100% of total billed charges,58.78,103,,,Fee Schedule,103% of WA Medicaid,11.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,57.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,259.44,69,,,percent of total billed charges,69% of total billed charges,376,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,376,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,376,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.56,61.85,,,percent of total billed charges,61.85% of total billed charges,57.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,74.19,130,,,Fee Schedule,130% of WA Medicaid ,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.75,37.7,,,percent of total billed charges,37.70% of total billed charges,141.75,37.7,,,percent of total billed charges,37.70% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,12746.4,33.9,,,percent of total billed charges,33.9% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.28,78,,,percent of total billed charges,78% of total billed charges,376,100,,,percent of total billed charges,100% of total billed charges,310.58,82.6,,,percent of total billed charges,82.6% of total billed charges,310.58,82.6,,,percent of total billed charges,82.6% of total billed charges,57.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.57,12746.4,
AMP FINGER/THUMB DIRECT CLOSUR,96026951,CDM,960,RC,26951,HCPCS,Outpatient,,,1632,1060.80,,1436.16,88,,,percent of total billed charges,88% of total Billed charges,52.88,100,,,Fee Schedule,100% of Medicare rate,416.45,100,,,Fee Schedule,100% of WA Medicaid,1632,100,,,percent of total billed charges,100% of total billed charges,428.94,103,,,Fee Schedule,103% of WA Medicaid,52.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,416.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1126.08,69,,,percent of total billed charges,69% of total billed charges,1632,100,,,percent of total billed charges,100% of total billed charges,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1632,100,,,percent of total billed charges,100% of total billed charges,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1632,100,,,percent of total billed charges,100% of total billed charges,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1009.39,61.85,,,percent of total billed charges,61.85% of total billed charges,416.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,541.39,130,,,Fee Schedule,130% of WA Medicaid ,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.26,37.7,,,percent of total billed charges,37.70% of total billed charges,615.26,37.7,,,percent of total billed charges,37.70% of total billed charges,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,55324.8,33.9,,,percent of total billed charges,33.9% of total billed charges,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272.96,78,,,percent of total billed charges,78% of total billed charges,1632,100,,,percent of total billed charges,100% of total billed charges,1348.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1348.03,82.6,,,percent of total billed charges,82.6% of total billed charges,416.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.88,55324.8,
AMP FINGER/THUMB LOC ADV FLAPS,96026952,CDM,960,RC,26952,HCPCS,Outpatient,,,1517,986.05,,1334.96,88,,,percent of total billed charges,88% of total Billed charges,53.02,100,,,Fee Schedule,100% of Medicare rate,403.59,100,,,Fee Schedule,100% of WA Medicaid,1517,100,,,percent of total billed charges,100% of total billed charges,415.7,103,,,Fee Schedule,103% of WA Medicaid,53.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,403.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1046.73,69,,,percent of total billed charges,69% of total billed charges,1517,100,,,percent of total billed charges,100% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1517,100,,,percent of total billed charges,100% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1517,100,,,percent of total billed charges,100% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,938.26,61.85,,,percent of total billed charges,61.85% of total billed charges,403.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,524.67,130,,,Fee Schedule,130% of WA Medicaid ,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.91,37.7,,,percent of total billed charges,37.70% of total billed charges,571.91,37.7,,,percent of total billed charges,37.70% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,51426.3,33.9,,,percent of total billed charges,33.9% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1183.26,78,,,percent of total billed charges,78% of total billed charges,1517,100,,,percent of total billed charges,100% of total billed charges,1253.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1253.04,82.6,,,percent of total billed charges,82.6% of total billed charges,403.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.02,51426.3,
"26989 UNLISTED PROCEDURE, HANDS OR FINGERS ProFee",97526989,CDM,975,RC,26989,HCPCS,Outpatient,,,2484,1614.60,,2185.92,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2484,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1713.96,69,,,percent of total billed charges,69% of total billed charges,2484,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2484,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2484,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1536.35,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,936.47,37.7,,,percent of total billed charges,37.70% of total billed charges,936.47,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,84207.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1937.52,78,,,percent of total billed charges,78% of total billed charges,2484,100,,,percent of total billed charges,100% of total billed charges,2051.78,82.6,,,percent of total billed charges,82.6% of total billed charges,2051.78,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",936.47,84207.6,
INCISION  DRAINAGE PELVIS-HIP,96026990,CDM,960,RC,26990,HCPCS,Outpatient,,,1188,772.20,,1045.44,88,,,percent of total billed charges,88% of total Billed charges,64.66,100,,,Fee Schedule,100% of Medicare rate,396.87,100,,,Fee Schedule,100% of WA Medicaid,1188,100,,,percent of total billed charges,100% of total billed charges,408.78,103,,,Fee Schedule,103% of WA Medicaid,64.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,113.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,396.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,819.72,69,,,percent of total billed charges,69% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188,100,,,percent of total billed charges,100% of total billed charges,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188,100,,,percent of total billed charges,100% of total billed charges,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.78,61.85,,,percent of total billed charges,61.85% of total billed charges,396.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,515.93,130,,,Fee Schedule,130% of WA Medicaid ,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.88,37.7,,,percent of total billed charges,37.70% of total billed charges,447.88,37.7,,,percent of total billed charges,37.70% of total billed charges,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,40273.2,33.9,,,percent of total billed charges,33.9% of total billed charges,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,926.64,78,,,percent of total billed charges,78% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,396.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.66,40273.2,
"26991 INCISION AND DRAINAGE, PELVIS OR HIP JOINT AREA; INFEC",97526991,CDM,975,RC,26991,HCPCS,Outpatient,,,1611,1047.15,,1417.68,88,,,percent of total billed charges,88% of total Billed charges,55,100,,,Fee Schedule,100% of Medicare rate,306.05,100,,,Fee Schedule,100% of WA Medicaid,1611,100,,,percent of total billed charges,100% of total billed charges,315.23,103,,,Fee Schedule,103% of WA Medicaid,55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,96.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,306.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1111.59,69,,,percent of total billed charges,69% of total billed charges,1611,100,,,percent of total billed charges,100% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1611,100,,,percent of total billed charges,100% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1611,100,,,percent of total billed charges,100% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,996.4,61.85,,,percent of total billed charges,61.85% of total billed charges,306.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,397.87,130,,,Fee Schedule,130% of WA Medicaid ,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,607.35,37.7,,,percent of total billed charges,37.70% of total billed charges,607.35,37.7,,,percent of total billed charges,37.70% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,54612.9,33.9,,,percent of total billed charges,33.9% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1256.58,78,,,percent of total billed charges,78% of total billed charges,1611,100,,,percent of total billed charges,100% of total billed charges,1330.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1330.69,82.6,,,percent of total billed charges,82.6% of total billed charges,306.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55,54612.9,
DRAINAGE OF BONE LESION,96026992,CDM,960,RC,26992,HCPCS,Outpatient,,,1932,1255.80,,1700.16,88,,,percent of total billed charges,88% of total Billed charges,102.53,100,,,Fee Schedule,100% of Medicare rate,583.56,100,,,Fee Schedule,100% of WA Medicaid,1932,100,,,percent of total billed charges,100% of total billed charges,601.07,103,,,Fee Schedule,103% of WA Medicaid,102.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,179.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,583.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1333.08,69,,,percent of total billed charges,69% of total billed charges,1932,100,,,percent of total billed charges,100% of total billed charges,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1932,100,,,percent of total billed charges,100% of total billed charges,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1932,100,,,percent of total billed charges,100% of total billed charges,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1194.94,61.85,,,percent of total billed charges,61.85% of total billed charges,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,595.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,758.63,130,,,Fee Schedule,130% of WA Medicaid ,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,728.36,37.7,,,percent of total billed charges,37.70% of total billed charges,728.36,37.7,,,percent of total billed charges,37.70% of total billed charges,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,65494.8,33.9,,,percent of total billed charges,33.9% of total billed charges,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1506.96,78,,,percent of total billed charges,78% of total billed charges,1932,100,,,percent of total billed charges,100% of total billed charges,1595.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1595.83,82.6,,,percent of total billed charges,82.6% of total billed charges,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,102.53,65494.8,
"FASCIOTOMY, HIP OR THIGH",96027025,CDM,960,RC,27025,HCPCS,Outpatient,,,1937,1259.05,,1704.56,88,,,percent of total billed charges,88% of total Billed charges,96.38,100,,,Fee Schedule,100% of Medicare rate,535.26,100,,,Fee Schedule,100% of WA Medicaid,1937,100,,,percent of total billed charges,100% of total billed charges,551.32,103,,,Fee Schedule,103% of WA Medicaid,96.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,168.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,535.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1336.53,69,,,percent of total billed charges,69% of total billed charges,1937,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1937,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1937,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198.03,61.85,,,percent of total billed charges,61.85% of total billed charges,535.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,695.84,130,,,Fee Schedule,130% of WA Medicaid ,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.25,37.7,,,percent of total billed charges,37.70% of total billed charges,730.25,37.7,,,percent of total billed charges,37.70% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,65664.3,33.9,,,percent of total billed charges,33.9% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1510.86,78,,,percent of total billed charges,78% of total billed charges,1937,100,,,percent of total billed charges,100% of total billed charges,1599.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1599.96,82.6,,,percent of total billed charges,82.6% of total billed charges,535.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.38,65664.3,
DRAINAGE OF HIP JOINT,96027030,CDM,960,RC,27030,HCPCS,Outpatient,,,1561,1014.65,,1373.68,88,,,percent of total billed charges,88% of total Billed charges,100.66,100,,,Fee Schedule,100% of Medicare rate,537.12,100,,,Fee Schedule,100% of WA Medicaid,1561,100,,,percent of total billed charges,100% of total billed charges,553.23,103,,,Fee Schedule,103% of WA Medicaid,100.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,176.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,537.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1077.09,69,,,percent of total billed charges,69% of total billed charges,1561,100,,,percent of total billed charges,100% of total billed charges,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1561,100,,,percent of total billed charges,100% of total billed charges,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1561,100,,,percent of total billed charges,100% of total billed charges,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,965.48,61.85,,,percent of total billed charges,61.85% of total billed charges,537.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,698.26,130,,,Fee Schedule,130% of WA Medicaid ,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.5,37.7,,,percent of total billed charges,37.70% of total billed charges,588.5,37.7,,,percent of total billed charges,37.70% of total billed charges,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,52917.9,33.9,,,percent of total billed charges,33.9% of total billed charges,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1217.58,78,,,percent of total billed charges,78% of total billed charges,1561,100,,,percent of total billed charges,100% of total billed charges,1289.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1289.39,82.6,,,percent of total billed charges,82.6% of total billed charges,537.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,100.66,52917.9,
EXPLORATION OF HIP JOINT,96027033,CDM,960,RC,27033,HCPCS,Outpatient,,,1957,1272.05,,1722.16,88,,,percent of total billed charges,88% of total Billed charges,103.8,100,,,Fee Schedule,100% of Medicare rate,557.45,100,,,Fee Schedule,100% of WA Medicaid,1957,100,,,percent of total billed charges,100% of total billed charges,574.17,103,,,Fee Schedule,103% of WA Medicaid,103.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,181.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,557.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1350.33,69,,,percent of total billed charges,69% of total billed charges,1957,100,,,percent of total billed charges,100% of total billed charges,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1957,100,,,percent of total billed charges,100% of total billed charges,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1957,100,,,percent of total billed charges,100% of total billed charges,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1210.4,61.85,,,percent of total billed charges,61.85% of total billed charges,557.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,568.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,724.69,130,,,Fee Schedule,130% of WA Medicaid ,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,737.79,37.7,,,percent of total billed charges,37.70% of total billed charges,737.79,37.7,,,percent of total billed charges,37.70% of total billed charges,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,66342.3,33.9,,,percent of total billed charges,33.9% of total billed charges,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1526.46,78,,,percent of total billed charges,78% of total billed charges,1957,100,,,percent of total billed charges,100% of total billed charges,1616.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1616.48,82.6,,,percent of total billed charges,82.6% of total billed charges,557.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,103.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,103.8,66342.3,
"27047 EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, S",97527047,CDM,975,RC,27047,HCPCS,Outpatient,,,1739,1130.35,,1530.32,88,,,percent of total billed charges,88% of total Billed charges,40.06,100,,,Fee Schedule,100% of Medicare rate,209.25,100,,,Fee Schedule,100% of WA Medicaid,1739,100,,,percent of total billed charges,100% of total billed charges,215.53,103,,,Fee Schedule,103% of WA Medicaid,40.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,209.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1199.91,69,,,percent of total billed charges,69% of total billed charges,1739,100,,,percent of total billed charges,100% of total billed charges,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1739,100,,,percent of total billed charges,100% of total billed charges,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1739,100,,,percent of total billed charges,100% of total billed charges,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1075.57,61.85,,,percent of total billed charges,61.85% of total billed charges,209.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,272.03,130,,,Fee Schedule,130% of WA Medicaid ,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,655.6,37.7,,,percent of total billed charges,37.70% of total billed charges,655.6,37.7,,,percent of total billed charges,37.70% of total billed charges,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,58952.1,33.9,,,percent of total billed charges,33.9% of total billed charges,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1356.42,78,,,percent of total billed charges,78% of total billed charges,1739,100,,,percent of total billed charges,100% of total billed charges,1436.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1436.41,82.6,,,percent of total billed charges,82.6% of total billed charges,209.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.06,58952.1,
27062 EXCISION; TROCHANTERIC BURSA OR CALCIFICATION ProFee,975,CDM,975,RC,27062,HCPCS,Outpatient,,,1470,955.50,,1293.6,88,,,percent of total billed charges,88% of total Billed charges,44.07,100,,,Fee Schedule,100% of Medicare rate,266.14,100,,,Fee Schedule,100% of WA Medicaid,1470,100,,,percent of total billed charges,100% of total billed charges,274.12,103,,,Fee Schedule,103% of WA Medicaid,44.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,266.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1014.3,69,,,percent of total billed charges,69% of total billed charges,1470,100,,,percent of total billed charges,100% of total billed charges,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1470,100,,,percent of total billed charges,100% of total billed charges,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1470,100,,,percent of total billed charges,100% of total billed charges,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,909.2,61.85,,,percent of total billed charges,61.85% of total billed charges,266.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,345.98,130,,,Fee Schedule,130% of WA Medicaid ,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.19,37.7,,,percent of total billed charges,37.70% of total billed charges,554.19,37.7,,,percent of total billed charges,37.70% of total billed charges,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,49833,33.9,,,percent of total billed charges,33.9% of total billed charges,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1146.6,78,,,percent of total billed charges,78% of total billed charges,1470,100,,,percent of total billed charges,100% of total billed charges,1214.22,82.6,,,percent of total billed charges,82.6% of total billed charges,1214.22,82.6,,,percent of total billed charges,82.6% of total billed charges,266.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.07,49833,
COCCYGECTOMY PRIMARY BIOPSY,96027080,CDM,975,RC,27080,HCPCS,Outpatient,,,808,525.20,,711.04,88,,,percent of total billed charges,88% of total Billed charges,58.77,100,,,Fee Schedule,100% of Medicare rate,293.74,100,,,Fee Schedule,100% of WA Medicaid,808,100,,,percent of total billed charges,100% of total billed charges,302.55,103,,,Fee Schedule,103% of WA Medicaid,58.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,293.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,557.52,69,,,percent of total billed charges,69% of total billed charges,808,100,,,percent of total billed charges,100% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,808,100,,,percent of total billed charges,100% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,808,100,,,percent of total billed charges,100% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.75,61.85,,,percent of total billed charges,61.85% of total billed charges,293.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,381.86,130,,,Fee Schedule,130% of WA Medicaid ,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.62,37.7,,,percent of total billed charges,37.70% of total billed charges,304.62,37.7,,,percent of total billed charges,37.70% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,27391.2,33.9,,,percent of total billed charges,33.9% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,630.24,78,,,percent of total billed charges,78% of total billed charges,808,100,,,percent of total billed charges,100% of total billed charges,667.41,82.6,,,percent of total billed charges,82.6% of total billed charges,667.41,82.6,,,percent of total billed charges,82.6% of total billed charges,293.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.77,27391.2,
REMOVAL OF HIP PROTHESIS,96027091,CDM,960,RC,27091,HCPCS,Outpatient,,,3407,2214.55,,2998.16,88,,,percent of total billed charges,88% of total Billed charges,177.66,100,,,Fee Schedule,100% of Medicare rate,904.9,100,,,Fee Schedule,100% of WA Medicaid,3407,100,,,percent of total billed charges,100% of total billed charges,932.05,103,,,Fee Schedule,103% of WA Medicaid,177.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,310.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,904.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2350.83,69,,,percent of total billed charges,69% of total billed charges,3407,100,,,percent of total billed charges,100% of total billed charges,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,3407,100,,,percent of total billed charges,100% of total billed charges,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,3407,100,,,percent of total billed charges,100% of total billed charges,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2107.23,61.85,,,percent of total billed charges,61.85% of total billed charges,904.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,923,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1176.37,130,,,Fee Schedule,130% of WA Medicaid ,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1284.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1284.44,37.7,,,percent of total billed charges,37.70% of total billed charges,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,115497.3,33.9,,,percent of total billed charges,33.9% of total billed charges,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2657.46,78,,,percent of total billed charges,78% of total billed charges,3407,100,,,percent of total billed charges,100% of total billed charges,2814.18,82.6,,,percent of total billed charges,82.6% of total billed charges,2814.18,82.6,,,percent of total billed charges,82.6% of total billed charges,904.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,177.66,115497.3,
27093 INJECTION PROCEDURE FOR HIP ARTHROGRAPHY; WITHOUT ANES,97527093,CDM,975,RC,27093,HCPCS,Outpatient,,,285,185.25,,250.8,88,,,percent of total billed charges,88% of total Billed charges,5.9,100,,,Fee Schedule,100% of Medicare rate,38.05,100,,,Fee Schedule,100% of WA Medicaid,285,100,,,percent of total billed charges,100% of total billed charges,39.19,103,,,Fee Schedule,103% of WA Medicaid,5.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,196.65,69,,,percent of total billed charges,69% of total billed charges,285,100,,,percent of total billed charges,100% of total billed charges,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,285,100,,,percent of total billed charges,100% of total billed charges,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,285,100,,,percent of total billed charges,100% of total billed charges,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.27,61.85,,,percent of total billed charges,61.85% of total billed charges,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.47,130,,,Fee Schedule,130% of WA Medicaid ,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.45,37.7,,,percent of total billed charges,37.70% of total billed charges,107.45,37.7,,,percent of total billed charges,37.70% of total billed charges,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,9661.5,33.9,,,percent of total billed charges,33.9% of total billed charges,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.3,78,,,percent of total billed charges,78% of total billed charges,285,100,,,percent of total billed charges,100% of total billed charges,235.41,82.6,,,percent of total billed charges,82.6% of total billed charges,235.41,82.6,,,percent of total billed charges,82.6% of total billed charges,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.9,9661.5,
INJ PROCEDURE SACROILIAC JT,97527096,CDM,975,RC,27096,HCPCS,Outpatient,,,293,190.45,,257.84,88,,,percent of total billed charges,88% of total Billed charges,6.12,100,,,Fee Schedule,100% of Medicare rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,293,100,,,percent of total billed charges,100% of total billed charges,48.6,103,,,Fee Schedule,103% of WA Medicaid,6.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,202.17,69,,,percent of total billed charges,69% of total billed charges,293,100,,,percent of total billed charges,100% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,293,100,,,percent of total billed charges,100% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,293,100,,,percent of total billed charges,100% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.22,61.85,,,percent of total billed charges,61.85% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.33,130,,,Fee Schedule,130% of WA Medicaid ,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.46,37.7,,,percent of total billed charges,37.70% of total billed charges,110.46,37.7,,,percent of total billed charges,37.70% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,9932.7,33.9,,,percent of total billed charges,33.9% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.54,78,,,percent of total billed charges,78% of total billed charges,293,100,,,percent of total billed charges,100% of total billed charges,242.02,82.6,,,percent of total billed charges,82.6% of total billed charges,242.02,82.6,,,percent of total billed charges,82.6% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.12,9932.7,
RECONSTRUCTION OF HIP SOCKET,96027120,CDM,960,RC,27120,HCPCS,Outpatient,,,2763,1795.95,,2431.44,88,,,percent of total billed charges,88% of total Billed charges,142.05,100,,,Fee Schedule,100% of Medicare rate,741.71,100,,,Fee Schedule,100% of WA Medicaid,2763,100,,,percent of total billed charges,100% of total billed charges,763.96,103,,,Fee Schedule,103% of WA Medicaid,142.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,248.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,741.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1906.47,69,,,percent of total billed charges,69% of total billed charges,2763,100,,,percent of total billed charges,100% of total billed charges,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2763,100,,,percent of total billed charges,100% of total billed charges,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2763,100,,,percent of total billed charges,100% of total billed charges,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1708.92,61.85,,,percent of total billed charges,61.85% of total billed charges,741.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,741.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,756.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,964.22,130,,,Fee Schedule,130% of WA Medicaid ,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1041.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1041.65,37.7,,,percent of total billed charges,37.70% of total billed charges,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,93665.7,33.9,,,percent of total billed charges,33.9% of total billed charges,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2155.14,78,,,percent of total billed charges,78% of total billed charges,2763,100,,,percent of total billed charges,100% of total billed charges,2282.24,82.6,,,percent of total billed charges,82.6% of total billed charges,2282.24,82.6,,,percent of total billed charges,82.6% of total billed charges,741.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,142.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,741.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,142.05,93665.7,
RECONSTRUCTION OF HIP SOCKET,96027122,CDM,960,RC,27122,HCPCS,Outpatient,,,2216,1440.40,,1950.08,88,,,percent of total billed charges,88% of total Billed charges,119.4,100,,,Fee Schedule,100% of Medicare rate,632.05,100,,,Fee Schedule,100% of WA Medicaid,2216,100,,,percent of total billed charges,100% of total billed charges,651.01,103,,,Fee Schedule,103% of WA Medicaid,119.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,208.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,632.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1529.04,69,,,percent of total billed charges,69% of total billed charges,2216,100,,,percent of total billed charges,100% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2216,100,,,percent of total billed charges,100% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2216,100,,,percent of total billed charges,100% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1370.6,61.85,,,percent of total billed charges,61.85% of total billed charges,632.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,632.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,644.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,821.67,130,,,Fee Schedule,130% of WA Medicaid ,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.43,37.7,,,percent of total billed charges,37.70% of total billed charges,835.43,37.7,,,percent of total billed charges,37.70% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,75122.4,33.9,,,percent of total billed charges,33.9% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1728.48,78,,,percent of total billed charges,78% of total billed charges,2216,100,,,percent of total billed charges,100% of total billed charges,1830.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1830.42,82.6,,,percent of total billed charges,82.6% of total billed charges,632.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,632.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.4,75122.4,
TOTAL HIP ARTHROPLASTY,96027130,CDM,960,RC,27130,HCPCS,Outpatient,,,1382,898.30,,1216.16,88,,,percent of total billed charges,88% of total Billed charges,143.06,100,,,Fee Schedule,100% of Medicare rate,730.89,100,,,Fee Schedule,100% of WA Medicaid,1382,100,,,percent of total billed charges,100% of total billed charges,752.82,103,,,Fee Schedule,103% of WA Medicaid,143.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,250.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,730.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,953.58,69,,,percent of total billed charges,69% of total billed charges,1382,100,,,percent of total billed charges,100% of total billed charges,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1382,100,,,percent of total billed charges,100% of total billed charges,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1382,100,,,percent of total billed charges,100% of total billed charges,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,854.77,61.85,,,percent of total billed charges,61.85% of total billed charges,730.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,950.16,130,,,Fee Schedule,130% of WA Medicaid ,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,521.01,37.7,,,percent of total billed charges,37.70% of total billed charges,521.01,37.7,,,percent of total billed charges,37.70% of total billed charges,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,46849.8,33.9,,,percent of total billed charges,33.9% of total billed charges,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1077.96,78,,,percent of total billed charges,78% of total billed charges,1382,100,,,percent of total billed charges,100% of total billed charges,1141.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1141.53,82.6,,,percent of total billed charges,82.6% of total billed charges,730.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,143.06,46849.8,
CONVERSION PREV HIP OR TO TOTL,96027132,CDM,960,RC,27132,HCPCS,Outpatient,,,4181,2717.65,,3679.28,88,,,percent of total billed charges,88% of total Billed charges,186.96,100,,,Fee Schedule,100% of Medicare rate,948.54,100,,,Fee Schedule,100% of WA Medicaid,4181,100,,,percent of total billed charges,100% of total billed charges,977,103,,,Fee Schedule,103% of WA Medicaid,186.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,327.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,948.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2884.89,69,,,percent of total billed charges,69% of total billed charges,4181,100,,,percent of total billed charges,100% of total billed charges,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4181,100,,,percent of total billed charges,100% of total billed charges,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4181,100,,,percent of total billed charges,100% of total billed charges,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2585.95,61.85,,,percent of total billed charges,61.85% of total billed charges,948.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,948.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,967.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1233.1,130,,,Fee Schedule,130% of WA Medicaid ,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1576.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1576.24,37.7,,,percent of total billed charges,37.70% of total billed charges,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,141735.9,33.9,,,percent of total billed charges,33.9% of total billed charges,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3261.18,78,,,percent of total billed charges,78% of total billed charges,4181,100,,,percent of total billed charges,100% of total billed charges,3453.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3453.51,82.6,,,percent of total billed charges,82.6% of total billed charges,948.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,948.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,186.96,141735.9,
27138 REVISION OF TOTAL HIP ARTHROPLASTY; FEMORAL COMPONENT,97527138,CDM,975,RC,27138,HCPCS,Outpatient,,,2572,1671.80,,2263.36,88,,,percent of total billed charges,88% of total Billed charges,171.83,100,,,Fee Schedule,100% of Medicare rate,863.12,100,,,Fee Schedule,100% of WA Medicaid,2572,100,,,percent of total billed charges,100% of total billed charges,889.01,103,,,Fee Schedule,103% of WA Medicaid,171.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,300.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,863.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1774.68,69,,,percent of total billed charges,69% of total billed charges,2572,100,,,percent of total billed charges,100% of total billed charges,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2572,100,,,percent of total billed charges,100% of total billed charges,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2572,100,,,percent of total billed charges,100% of total billed charges,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1590.78,61.85,,,percent of total billed charges,61.85% of total billed charges,863.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,880.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1122.06,130,,,Fee Schedule,130% of WA Medicaid ,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,969.64,37.7,,,percent of total billed charges,37.70% of total billed charges,969.64,37.7,,,percent of total billed charges,37.70% of total billed charges,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,87190.8,33.9,,,percent of total billed charges,33.9% of total billed charges,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2006.16,78,,,percent of total billed charges,78% of total billed charges,2572,100,,,percent of total billed charges,100% of total billed charges,2124.47,82.6,,,percent of total billed charges,82.6% of total billed charges,2124.47,82.6,,,percent of total billed charges,82.6% of total billed charges,863.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,171.83,87190.8,
27176 TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY S,97527176,CDM,975,RC,27176,HCPCS,Outpatient,,,3262,2120.30,,2870.56,88,,,percent of total billed charges,88% of total Billed charges,97.22,100,,,Fee Schedule,100% of Medicare rate,531.53,100,,,Fee Schedule,100% of WA Medicaid,3262,100,,,percent of total billed charges,100% of total billed charges,547.48,103,,,Fee Schedule,103% of WA Medicaid,97.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,170.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,531.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2250.78,69,,,percent of total billed charges,69% of total billed charges,3262,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,3262,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,3262,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2017.55,61.85,,,percent of total billed charges,61.85% of total billed charges,531.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,531.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,542.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,690.99,130,,,Fee Schedule,130% of WA Medicaid ,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1229.77,37.7,,,percent of total billed charges,37.70% of total billed charges,1229.77,37.7,,,percent of total billed charges,37.70% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,110581.8,33.9,,,percent of total billed charges,33.9% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2544.36,78,,,percent of total billed charges,78% of total billed charges,3262,100,,,percent of total billed charges,100% of total billed charges,2694.41,82.6,,,percent of total billed charges,82.6% of total billed charges,2694.41,82.6,,,percent of total billed charges,82.6% of total billed charges,531.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,531.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.22,110581.8,
CLSD TMT PEVIC RING FRACTURE,96027197,CDM,960,RC,27197,HCPCS,Outpatient,,,1034,672.10,,909.92,88,,,percent of total billed charges,88% of total Billed charges,12.11,100,,,Fee Schedule,100% of Medicare rate,77.58,100,,,Fee Schedule,100% of WA Medicaid,1034,100,,,percent of total billed charges,100% of total billed charges,79.91,103,,,Fee Schedule,103% of WA Medicaid,12.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,713.46,69,,,percent of total billed charges,69% of total billed charges,1034,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034,100,,,percent of total billed charges,100% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.53,61.85,,,percent of total billed charges,61.85% of total billed charges,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,100.85,130,,,Fee Schedule,130% of WA Medicaid ,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.82,37.7,,,percent of total billed charges,37.70% of total billed charges,389.82,37.7,,,percent of total billed charges,37.70% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,35052.6,33.9,,,percent of total billed charges,33.9% of total billed charges,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.52,78,,,percent of total billed charges,78% of total billed charges,1034,100,,,percent of total billed charges,100% of total billed charges,854.08,82.6,,,percent of total billed charges,82.6% of total billed charges,854.08,82.6,,,percent of total billed charges,82.6% of total billed charges,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.11,35052.6,
CLSD TMT PEVIC RING FRACW/MANI,96027198,CDM,975,RC,27198,HCPCS,Outpatient,,,1739,1130.35,,1530.32,88,,,percent of total billed charges,88% of total Billed charges,32.33,100,,,Fee Schedule,100% of Medicare rate,180.35,100,,,Fee Schedule,100% of WA Medicaid,1739,100,,,percent of total billed charges,100% of total billed charges,185.76,103,,,Fee Schedule,103% of WA Medicaid,32.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,180.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1199.91,69,,,percent of total billed charges,69% of total billed charges,1739,100,,,percent of total billed charges,100% of total billed charges,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1739,100,,,percent of total billed charges,100% of total billed charges,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1739,100,,,percent of total billed charges,100% of total billed charges,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1075.57,61.85,,,percent of total billed charges,61.85% of total billed charges,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,234.46,130,,,Fee Schedule,130% of WA Medicaid ,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,655.6,37.7,,,percent of total billed charges,37.70% of total billed charges,655.6,37.7,,,percent of total billed charges,37.70% of total billed charges,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,58952.1,33.9,,,percent of total billed charges,33.9% of total billed charges,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1356.42,78,,,percent of total billed charges,78% of total billed charges,1739,100,,,percent of total billed charges,100% of total billed charges,1436.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1436.41,82.6,,,percent of total billed charges,82.6% of total billed charges,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.33,58952.1,
"27232 CLOSED TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, NE",97527232,CDM,975,RC,27232,HCPCS,Outpatient,,,2508,1630.20,,2207.04,88,,,percent of total billed charges,88% of total Billed charges,83.85,100,,,Fee Schedule,100% of Medicare rate,414.22,100,,,Fee Schedule,100% of WA Medicaid,2508,100,,,percent of total billed charges,100% of total billed charges,426.65,103,,,Fee Schedule,103% of WA Medicaid,83.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,146.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,414.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1730.52,69,,,percent of total billed charges,69% of total billed charges,2508,100,,,percent of total billed charges,100% of total billed charges,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2508,100,,,percent of total billed charges,100% of total billed charges,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2508,100,,,percent of total billed charges,100% of total billed charges,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1551.2,61.85,,,percent of total billed charges,61.85% of total billed charges,414.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,538.49,130,,,Fee Schedule,130% of WA Medicaid ,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,945.52,37.7,,,percent of total billed charges,37.70% of total billed charges,945.52,37.7,,,percent of total billed charges,37.70% of total billed charges,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,85021.2,33.9,,,percent of total billed charges,33.9% of total billed charges,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1956.24,78,,,percent of total billed charges,78% of total billed charges,2508,100,,,percent of total billed charges,100% of total billed charges,2071.61,82.6,,,percent of total billed charges,82.6% of total billed charges,2071.61,82.6,,,percent of total billed charges,82.6% of total billed charges,414.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.85,85021.2,
HIP ARTHROPLASTY,96027236,CDM,960,RC,27236,HCPCS,Outpatient,,,1815,1179.75,,1597.2,88,,,percent of total billed charges,88% of total Billed charges,129.33,100,,,Fee Schedule,100% of Medicare rate,682.59,100,,,Fee Schedule,100% of WA Medicaid,1815,100,,,percent of total billed charges,100% of total billed charges,703.07,103,,,Fee Schedule,103% of WA Medicaid,129.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,226.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,682.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1252.35,69,,,percent of total billed charges,69% of total billed charges,1815,100,,,percent of total billed charges,100% of total billed charges,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1815,100,,,percent of total billed charges,100% of total billed charges,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1815,100,,,percent of total billed charges,100% of total billed charges,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1122.58,61.85,,,percent of total billed charges,61.85% of total billed charges,682.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,887.37,130,,,Fee Schedule,130% of WA Medicaid ,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,684.26,37.7,,,percent of total billed charges,37.70% of total billed charges,684.26,37.7,,,percent of total billed charges,37.70% of total billed charges,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,61528.5,33.9,,,percent of total billed charges,33.9% of total billed charges,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1415.7,78,,,percent of total billed charges,78% of total billed charges,1815,100,,,percent of total billed charges,100% of total billed charges,1499.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1499.19,82.6,,,percent of total billed charges,82.6% of total billed charges,682.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,129.33,61528.5,
TREAT THIGH FRACTURE,96027244,CDM,960,RC,27244,HCPCS,Outpatient,,,2480,1612.00,,2182.4,88,,,percent of total billed charges,88% of total Billed charges,133.45,100,,,Fee Schedule,100% of Medicare rate,701.43,100,,,Fee Schedule,100% of WA Medicaid,2480,100,,,percent of total billed charges,100% of total billed charges,722.47,103,,,Fee Schedule,103% of WA Medicaid,133.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,233.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,701.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1711.2,69,,,percent of total billed charges,69% of total billed charges,2480,100,,,percent of total billed charges,100% of total billed charges,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2480,100,,,percent of total billed charges,100% of total billed charges,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2480,100,,,percent of total billed charges,100% of total billed charges,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1533.88,61.85,,,percent of total billed charges,61.85% of total billed charges,701.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,715.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,911.86,130,,,Fee Schedule,130% of WA Medicaid ,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,934.96,37.7,,,percent of total billed charges,37.70% of total billed charges,934.96,37.7,,,percent of total billed charges,37.70% of total billed charges,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,84072,33.9,,,percent of total billed charges,33.9% of total billed charges,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1934.4,78,,,percent of total billed charges,78% of total billed charges,2480,100,,,percent of total billed charges,100% of total billed charges,2048.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2048.48,82.6,,,percent of total billed charges,82.6% of total billed charges,701.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,133.45,84072,
OPEN TRT FEMOR FX W/INTRAM IMP,96027245,CDM,960,RC,27245,HCPCS,Outpatient,,,3072,1996.80,,2703.36,88,,,percent of total billed charges,88% of total Billed charges,132.88,100,,,Fee Schedule,100% of Medicare rate,700.68,100,,,Fee Schedule,100% of WA Medicaid,3072,100,,,percent of total billed charges,100% of total billed charges,721.7,103,,,Fee Schedule,103% of WA Medicaid,132.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,232.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,700.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2119.68,69,,,percent of total billed charges,69% of total billed charges,3072,100,,,percent of total billed charges,100% of total billed charges,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,3072,100,,,percent of total billed charges,100% of total billed charges,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,3072,100,,,percent of total billed charges,100% of total billed charges,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1900.03,61.85,,,percent of total billed charges,61.85% of total billed charges,700.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,910.88,130,,,Fee Schedule,130% of WA Medicaid ,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1158.14,37.7,,,percent of total billed charges,37.70% of total billed charges,1158.14,37.7,,,percent of total billed charges,37.70% of total billed charges,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,104140.8,33.9,,,percent of total billed charges,33.9% of total billed charges,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2396.16,78,,,percent of total billed charges,78% of total billed charges,3072,100,,,percent of total billed charges,100% of total billed charges,2537.47,82.6,,,percent of total billed charges,82.6% of total billed charges,2537.47,82.6,,,percent of total billed charges,82.6% of total billed charges,700.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,132.88,104140.8,
TREAT HIP DISLOCATION CLOSED,96027252,CDM,960,RC,27252,HCPCS,Outpatient,,,1824,1185.60,,1605.12,88,,,percent of total billed charges,88% of total Billed charges,81.3,100,,,Fee Schedule,100% of Medicare rate,430.63,100,,,Fee Schedule,100% of WA Medicaid,1824,100,,,percent of total billed charges,100% of total billed charges,443.55,103,,,Fee Schedule,103% of WA Medicaid,81.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,142.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,430.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1258.56,69,,,percent of total billed charges,69% of total billed charges,1824,100,,,percent of total billed charges,100% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1824,100,,,percent of total billed charges,100% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1824,100,,,percent of total billed charges,100% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128.14,61.85,,,percent of total billed charges,61.85% of total billed charges,430.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,559.82,130,,,Fee Schedule,130% of WA Medicaid ,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,687.65,37.7,,,percent of total billed charges,37.70% of total billed charges,687.65,37.7,,,percent of total billed charges,37.70% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,61833.6,33.9,,,percent of total billed charges,33.9% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1422.72,78,,,percent of total billed charges,78% of total billed charges,1824,100,,,percent of total billed charges,100% of total billed charges,1506.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1506.62,82.6,,,percent of total billed charges,82.6% of total billed charges,430.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.3,61833.6,
TREATMENT HIP DISLOCATION,96027266,CDM,960,RC,27266,HCPCS,Outpatient,,,1454,945.10,,1279.52,88,,,percent of total billed charges,88% of total Billed charges,59.09,100,,,Fee Schedule,100% of Medicare rate,339.62,100,,,Fee Schedule,100% of WA Medicaid,1454,100,,,percent of total billed charges,100% of total billed charges,349.81,103,,,Fee Schedule,103% of WA Medicaid,59.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,339.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1003.26,69,,,percent of total billed charges,69% of total billed charges,1454,100,,,percent of total billed charges,100% of total billed charges,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1454,100,,,percent of total billed charges,100% of total billed charges,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1454,100,,,percent of total billed charges,100% of total billed charges,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,899.3,61.85,,,percent of total billed charges,61.85% of total billed charges,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,441.51,130,,,Fee Schedule,130% of WA Medicaid ,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.16,37.7,,,percent of total billed charges,37.70% of total billed charges,548.16,37.7,,,percent of total billed charges,37.70% of total billed charges,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,49290.6,33.9,,,percent of total billed charges,33.9% of total billed charges,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1134.12,78,,,percent of total billed charges,78% of total billed charges,1454,100,,,percent of total billed charges,100% of total billed charges,1201,82.6,,,percent of total billed charges,82.6% of total billed charges,1201,82.6,,,percent of total billed charges,82.6% of total billed charges,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.09,49290.6,
"ARTHRODESIS,OPEN,SACROILIAC JT",96027280,CDM,960,RC,27280,HCPCS,Outpatient,,,1766,1147.90,,1554.08,88,,,percent of total billed charges,88% of total Billed charges,195.75,100,,,Fee Schedule,100% of Medicare rate,770.25,100,,,Fee Schedule,100% of WA Medicaid,1766,100,,,percent of total billed charges,100% of total billed charges,793.36,103,,,Fee Schedule,103% of WA Medicaid,195.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,342.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,770.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1218.54,69,,,percent of total billed charges,69% of total billed charges,1766,100,,,percent of total billed charges,100% of total billed charges,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1766,100,,,percent of total billed charges,100% of total billed charges,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1766,100,,,percent of total billed charges,100% of total billed charges,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1092.27,61.85,,,percent of total billed charges,61.85% of total billed charges,770.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,770.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,785.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1001.33,130,,,Fee Schedule,130% of WA Medicaid ,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,665.78,37.7,,,percent of total billed charges,37.70% of total billed charges,665.78,37.7,,,percent of total billed charges,37.70% of total billed charges,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,59867.4,33.9,,,percent of total billed charges,33.9% of total billed charges,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377.48,78,,,percent of total billed charges,78% of total billed charges,1766,100,,,percent of total billed charges,100% of total billed charges,1458.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1458.72,82.6,,,percent of total billed charges,82.6% of total billed charges,770.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,195.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,770.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.75,59867.4,
"27299 UNLISTED PROCEDURE, PELVIS OR HIP JOINT ProFee",97527299,CDM,975,RC,27299,HCPCS,Outpatient,,,2341,1521.65,,2060.08,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2341,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1615.29,69,,,percent of total billed charges,69% of total billed charges,2341,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2341,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2341,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1447.91,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,882.56,37.7,,,percent of total billed charges,37.70% of total billed charges,882.56,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,79359.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1825.98,78,,,percent of total billed charges,78% of total billed charges,2341,100,,,percent of total billed charges,100% of total billed charges,1933.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1933.67,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",882.56,79359.9,
ID DP ABSBURSA/HEMA THIGH/KNE,96027301,CDM,960,RC,27301,HCPCS,Outpatient,,,1705,1108.25,,1500.4,88,,,percent of total billed charges,88% of total Billed charges,53.14,100,,,Fee Schedule,100% of Medicare rate,295.23,100,,,Fee Schedule,100% of WA Medicaid,1705,100,,,percent of total billed charges,100% of total billed charges,304.09,103,,,Fee Schedule,103% of WA Medicaid,53.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,295.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1176.45,69,,,percent of total billed charges,69% of total billed charges,1705,100,,,percent of total billed charges,100% of total billed charges,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1705,100,,,percent of total billed charges,100% of total billed charges,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1705,100,,,percent of total billed charges,100% of total billed charges,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1054.54,61.85,,,percent of total billed charges,61.85% of total billed charges,295.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,383.8,130,,,Fee Schedule,130% of WA Medicaid ,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.79,37.7,,,percent of total billed charges,37.70% of total billed charges,642.79,37.7,,,percent of total billed charges,37.70% of total billed charges,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,57799.5,33.9,,,percent of total billed charges,33.9% of total billed charges,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329.9,78,,,percent of total billed charges,78% of total billed charges,1705,100,,,percent of total billed charges,100% of total billed charges,1408.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1408.33,82.6,,,percent of total billed charges,82.6% of total billed charges,295.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.14,57799.5,
EXPLORATION OF KNEE JOINT,96027310,CDM,960,RC,27310,HCPCS,Outpatient,,,1828,1188.20,,1608.64,88,,,percent of total billed charges,88% of total Billed charges,75.26,100,,,Fee Schedule,100% of Medicare rate,424.85,100,,,Fee Schedule,100% of WA Medicaid,1828,100,,,percent of total billed charges,100% of total billed charges,437.6,103,,,Fee Schedule,103% of WA Medicaid,75.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,131.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,424.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1261.32,69,,,percent of total billed charges,69% of total billed charges,1828,100,,,percent of total billed charges,100% of total billed charges,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1828,100,,,percent of total billed charges,100% of total billed charges,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1828,100,,,percent of total billed charges,100% of total billed charges,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1130.62,61.85,,,percent of total billed charges,61.85% of total billed charges,424.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,552.31,130,,,Fee Schedule,130% of WA Medicaid ,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,689.16,37.7,,,percent of total billed charges,37.70% of total billed charges,689.16,37.7,,,percent of total billed charges,37.70% of total billed charges,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,61969.2,33.9,,,percent of total billed charges,33.9% of total billed charges,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1425.84,78,,,percent of total billed charges,78% of total billed charges,1828,100,,,percent of total billed charges,100% of total billed charges,1509.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1509.93,82.6,,,percent of total billed charges,82.6% of total billed charges,424.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.26,61969.2,
"27327 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SU",97527327,CDM,975,RC,27327,HCPCS,Outpatient,,,720,468.00,,633.6,88,,,percent of total billed charges,88% of total Billed charges,32.22,100,,,Fee Schedule,100% of Medicare rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,720,100,,,percent of total billed charges,100% of total billed charges,189.41,103,,,Fee Schedule,103% of WA Medicaid,32.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,496.8,69,,,percent of total billed charges,69% of total billed charges,720,100,,,percent of total billed charges,100% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,720,100,,,percent of total billed charges,100% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,720,100,,,percent of total billed charges,100% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.32,61.85,,,percent of total billed charges,61.85% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,239.06,130,,,Fee Schedule,130% of WA Medicaid ,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.44,37.7,,,percent of total billed charges,37.70% of total billed charges,271.44,37.7,,,percent of total billed charges,37.70% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,24408,33.9,,,percent of total billed charges,33.9% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.6,78,,,percent of total billed charges,78% of total billed charges,720,100,,,percent of total billed charges,100% of total billed charges,594.72,82.6,,,percent of total billed charges,82.6% of total billed charges,594.72,82.6,,,percent of total billed charges,82.6% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.22,24408,
"27328 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SU",97527328,CDM,975,RC,27328,HCPCS,Outpatient,,,1340,871.00,,1179.2,88,,,percent of total billed charges,88% of total Billed charges,70.27,100,,,Fee Schedule,100% of Medicare rate,359.2,100,,,Fee Schedule,100% of WA Medicaid,1340,100,,,percent of total billed charges,100% of total billed charges,369.98,103,,,Fee Schedule,103% of WA Medicaid,70.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,122.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,359.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,924.6,69,,,percent of total billed charges,69% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340,100,,,percent of total billed charges,100% of total billed charges,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340,100,,,percent of total billed charges,100% of total billed charges,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,828.79,61.85,,,percent of total billed charges,61.85% of total billed charges,359.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,466.96,130,,,Fee Schedule,130% of WA Medicaid ,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,45426,33.9,,,percent of total billed charges,33.9% of total billed charges,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045.2,78,,,percent of total billed charges,78% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,359.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.27,45426,
"27337 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SU",97527337,CDM,975,RC,27337,HCPCS,Outpatient,,,869,564.85,,764.72,88,,,percent of total billed charges,88% of total Billed charges,48.51,100,,,Fee Schedule,100% of Medicare rate,241.52,100,,,Fee Schedule,100% of WA Medicaid,869,100,,,percent of total billed charges,100% of total billed charges,248.77,103,,,Fee Schedule,103% of WA Medicaid,48.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,84.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,241.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,599.61,69,,,percent of total billed charges,69% of total billed charges,869,100,,,percent of total billed charges,100% of total billed charges,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,869,100,,,percent of total billed charges,100% of total billed charges,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,869,100,,,percent of total billed charges,100% of total billed charges,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.48,61.85,,,percent of total billed charges,61.85% of total billed charges,241.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,313.98,130,,,Fee Schedule,130% of WA Medicaid ,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.61,37.7,,,percent of total billed charges,37.70% of total billed charges,327.61,37.7,,,percent of total billed charges,37.70% of total billed charges,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,29459.1,33.9,,,percent of total billed charges,33.9% of total billed charges,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.82,78,,,percent of total billed charges,78% of total billed charges,869,100,,,percent of total billed charges,100% of total billed charges,717.79,82.6,,,percent of total billed charges,82.6% of total billed charges,717.79,82.6,,,percent of total billed charges,82.6% of total billed charges,241.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,49,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.51,29459.1,
"27339 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SU",97527339,CDM,975,RC,27339,HCPCS,Outpatient,,,1753,1139.45,,1542.64,88,,,percent of total billed charges,88% of total Billed charges,87.9,100,,,Fee Schedule,100% of Medicare rate,432.49,100,,,Fee Schedule,100% of WA Medicaid,1753,100,,,percent of total billed charges,100% of total billed charges,445.46,103,,,Fee Schedule,103% of WA Medicaid,87.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,153.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,432.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1209.57,69,,,percent of total billed charges,69% of total billed charges,1753,100,,,percent of total billed charges,100% of total billed charges,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1753,100,,,percent of total billed charges,100% of total billed charges,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1753,100,,,percent of total billed charges,100% of total billed charges,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1084.23,61.85,,,percent of total billed charges,61.85% of total billed charges,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562.24,130,,,Fee Schedule,130% of WA Medicaid ,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,660.88,37.7,,,percent of total billed charges,37.70% of total billed charges,660.88,37.7,,,percent of total billed charges,37.70% of total billed charges,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,59426.7,33.9,,,percent of total billed charges,33.9% of total billed charges,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1367.34,78,,,percent of total billed charges,78% of total billed charges,1753,100,,,percent of total billed charges,100% of total billed charges,1447.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1447.98,82.6,,,percent of total billed charges,82.6% of total billed charges,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.9,59426.7,
"27340 EXCISION, PREPATELLAR BURSA ProFee",97527340,CDM,975,RC,27340,HCPCS,Outpatient,,,998,648.70,,878.24,88,,,percent of total billed charges,88% of total Billed charges,34.48,100,,,Fee Schedule,100% of Medicare rate,222.12,100,,,Fee Schedule,100% of WA Medicaid,998,100,,,percent of total billed charges,100% of total billed charges,228.78,103,,,Fee Schedule,103% of WA Medicaid,34.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,222.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,688.62,69,,,percent of total billed charges,69% of total billed charges,998,100,,,percent of total billed charges,100% of total billed charges,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,998,100,,,percent of total billed charges,100% of total billed charges,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,998,100,,,percent of total billed charges,100% of total billed charges,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.26,61.85,,,percent of total billed charges,61.85% of total billed charges,222.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,288.76,130,,,Fee Schedule,130% of WA Medicaid ,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.25,37.7,,,percent of total billed charges,37.70% of total billed charges,376.25,37.7,,,percent of total billed charges,37.70% of total billed charges,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,33832.2,33.9,,,percent of total billed charges,33.9% of total billed charges,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.44,78,,,percent of total billed charges,78% of total billed charges,998,100,,,percent of total billed charges,100% of total billed charges,824.35,82.6,,,percent of total billed charges,82.6% of total billed charges,824.35,82.6,,,percent of total billed charges,82.6% of total billed charges,222.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.48,33832.2,
EXCISION OF SYNOVIAL CYST,96027345,CDM,960,RC,27345,HCPCS,Outpatient,,,830,539.50,,730.4,88,,,percent of total billed charges,88% of total Billed charges,46.64,100,,,Fee Schedule,100% of Medicare rate,285.53,100,,,Fee Schedule,100% of WA Medicaid,830,100,,,percent of total billed charges,100% of total billed charges,294.1,103,,,Fee Schedule,103% of WA Medicaid,46.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,285.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,572.7,69,,,percent of total billed charges,69% of total billed charges,830,100,,,percent of total billed charges,100% of total billed charges,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,830,100,,,percent of total billed charges,100% of total billed charges,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,830,100,,,percent of total billed charges,100% of total billed charges,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.36,61.85,,,percent of total billed charges,61.85% of total billed charges,285.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,371.19,130,,,Fee Schedule,130% of WA Medicaid ,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.91,37.7,,,percent of total billed charges,37.70% of total billed charges,312.91,37.7,,,percent of total billed charges,37.70% of total billed charges,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,28137,33.9,,,percent of total billed charges,33.9% of total billed charges,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.4,78,,,percent of total billed charges,78% of total billed charges,830,100,,,percent of total billed charges,100% of total billed charges,685.58,82.6,,,percent of total billed charges,82.6% of total billed charges,685.58,82.6,,,percent of total billed charges,82.6% of total billed charges,285.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.64,28137,
REMOVE KNEE CYST,97527347,CDM,975,RC,27347,HCPCS,Outpatient,,,1112,722.80,,978.56,88,,,percent of total billed charges,88% of total Billed charges,50.99,100,,,Fee Schedule,100% of Medicare rate,309.03,100,,,Fee Schedule,100% of WA Medicaid,1112,100,,,percent of total billed charges,100% of total billed charges,318.3,103,,,Fee Schedule,103% of WA Medicaid,50.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,309.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,767.28,69,,,percent of total billed charges,69% of total billed charges,1112,100,,,percent of total billed charges,100% of total billed charges,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1112,100,,,percent of total billed charges,100% of total billed charges,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1112,100,,,percent of total billed charges,100% of total billed charges,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,687.77,61.85,,,percent of total billed charges,61.85% of total billed charges,309.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,401.74,130,,,Fee Schedule,130% of WA Medicaid ,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.22,37.7,,,percent of total billed charges,37.70% of total billed charges,419.22,37.7,,,percent of total billed charges,37.70% of total billed charges,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,37696.8,33.9,,,percent of total billed charges,33.9% of total billed charges,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,867.36,78,,,percent of total billed charges,78% of total billed charges,1112,100,,,percent of total billed charges,100% of total billed charges,918.51,82.6,,,percent of total billed charges,82.6% of total billed charges,918.51,82.6,,,percent of total billed charges,82.6% of total billed charges,309.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.99,37696.8,
REMOVAL OF KNEE CAP,96027350,CDM,960,RC,27350,HCPCS,Outpatient,,,1191,774.15,,1048.08,88,,,percent of total billed charges,88% of total Billed charges,65.17,100,,,Fee Schedule,100% of Medicare rate,381.21,100,,,Fee Schedule,100% of WA Medicaid,1191,100,,,percent of total billed charges,100% of total billed charges,392.65,103,,,Fee Schedule,103% of WA Medicaid,65.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,381.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,821.79,69,,,percent of total billed charges,69% of total billed charges,1191,100,,,percent of total billed charges,100% of total billed charges,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191,100,,,percent of total billed charges,100% of total billed charges,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191,100,,,percent of total billed charges,100% of total billed charges,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.63,61.85,,,percent of total billed charges,61.85% of total billed charges,381.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,495.57,130,,,Fee Schedule,130% of WA Medicaid ,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.01,37.7,,,percent of total billed charges,37.70% of total billed charges,449.01,37.7,,,percent of total billed charges,37.70% of total billed charges,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,40374.9,33.9,,,percent of total billed charges,33.9% of total billed charges,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,928.98,78,,,percent of total billed charges,78% of total billed charges,1191,100,,,percent of total billed charges,100% of total billed charges,983.77,82.6,,,percent of total billed charges,82.6% of total billed charges,983.77,82.6,,,percent of total billed charges,82.6% of total billed charges,381.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.17,40374.9,
27380 SUTURE OF INFRAPATELLAR TENDON; PRIMARY ProFee,97527380,CDM,975,RC,27380,HCPCS,Outpatient,,,1652,1073.80,,1453.76,88,,,percent of total billed charges,88% of total Billed charges,58.3,100,,,Fee Schedule,100% of Medicare rate,364.42,100,,,Fee Schedule,100% of WA Medicaid,1652,100,,,percent of total billed charges,100% of total billed charges,375.35,103,,,Fee Schedule,103% of WA Medicaid,58.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,364.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1139.88,69,,,percent of total billed charges,69% of total billed charges,1652,100,,,percent of total billed charges,100% of total billed charges,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1652,100,,,percent of total billed charges,100% of total billed charges,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1652,100,,,percent of total billed charges,100% of total billed charges,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1021.76,61.85,,,percent of total billed charges,61.85% of total billed charges,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,473.75,130,,,Fee Schedule,130% of WA Medicaid ,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.8,37.7,,,percent of total billed charges,37.70% of total billed charges,622.8,37.7,,,percent of total billed charges,37.70% of total billed charges,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,56002.8,33.9,,,percent of total billed charges,33.9% of total billed charges,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1288.56,78,,,percent of total billed charges,78% of total billed charges,1652,100,,,percent of total billed charges,100% of total billed charges,1364.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1364.55,82.6,,,percent of total billed charges,82.6% of total billed charges,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.3,56002.8,
27385 SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; PRIM,97527385,CDM,975,RC,27385,HCPCS,Outpatient,,,1647,1070.55,,1449.36,88,,,percent of total billed charges,88% of total Billed charges,54.49,100,,,Fee Schedule,100% of Medicare rate,356.59,100,,,Fee Schedule,100% of WA Medicaid,1647,100,,,percent of total billed charges,100% of total billed charges,367.29,103,,,Fee Schedule,103% of WA Medicaid,54.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,356.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1136.43,69,,,percent of total billed charges,69% of total billed charges,1647,100,,,percent of total billed charges,100% of total billed charges,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1647,100,,,percent of total billed charges,100% of total billed charges,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1647,100,,,percent of total billed charges,100% of total billed charges,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1018.67,61.85,,,percent of total billed charges,61.85% of total billed charges,356.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,463.57,130,,,Fee Schedule,130% of WA Medicaid ,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,620.92,37.7,,,percent of total billed charges,37.70% of total billed charges,620.92,37.7,,,percent of total billed charges,37.70% of total billed charges,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,55833.3,33.9,,,percent of total billed charges,33.9% of total billed charges,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1284.66,78,,,percent of total billed charges,78% of total billed charges,1647,100,,,percent of total billed charges,100% of total billed charges,1360.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1360.42,82.6,,,percent of total billed charges,82.6% of total billed charges,356.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.49,55833.3,
27386 SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUP,97527386,CDM,975,RC,27386,HCPCS,Outpatient,,,2374,1543.10,,2089.12,88,,,percent of total billed charges,88% of total Billed charges,83.96,100,,,Fee Schedule,100% of Medicare rate,497.02,100,,,Fee Schedule,100% of WA Medicaid,2374,100,,,percent of total billed charges,100% of total billed charges,511.93,103,,,Fee Schedule,103% of WA Medicaid,83.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,146.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,497.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1638.06,69,,,percent of total billed charges,69% of total billed charges,2374,100,,,percent of total billed charges,100% of total billed charges,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2374,100,,,percent of total billed charges,100% of total billed charges,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2374,100,,,percent of total billed charges,100% of total billed charges,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1468.32,61.85,,,percent of total billed charges,61.85% of total billed charges,497.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,506.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,646.13,130,,,Fee Schedule,130% of WA Medicaid ,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,895,37.7,,,percent of total billed charges,37.70% of total billed charges,895,37.7,,,percent of total billed charges,37.70% of total billed charges,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,80478.6,33.9,,,percent of total billed charges,33.9% of total billed charges,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1851.72,78,,,percent of total billed charges,78% of total billed charges,2374,100,,,percent of total billed charges,100% of total billed charges,1960.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1960.92,82.6,,,percent of total billed charges,82.6% of total billed charges,497.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.96,80478.6,
"27403 ARTHROTOMY WITH MENISCUS REPAIR, KNEE ProFee",97527403,CDM,975,RC,27403,HCPCS,Outpatient,,,1719,1117.35,,1512.72,88,,,percent of total billed charges,88% of total Billed charges,65.4,100,,,Fee Schedule,100% of Medicare rate,375.61,100,,,Fee Schedule,100% of WA Medicaid,1719,100,,,percent of total billed charges,100% of total billed charges,386.88,103,,,Fee Schedule,103% of WA Medicaid,65.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,375.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1186.11,69,,,percent of total billed charges,69% of total billed charges,1719,100,,,percent of total billed charges,100% of total billed charges,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1719,100,,,percent of total billed charges,100% of total billed charges,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1719,100,,,percent of total billed charges,100% of total billed charges,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.2,61.85,,,percent of total billed charges,61.85% of total billed charges,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,488.29,130,,,Fee Schedule,130% of WA Medicaid ,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,648.06,37.7,,,percent of total billed charges,37.70% of total billed charges,648.06,37.7,,,percent of total billed charges,37.70% of total billed charges,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,58274.1,33.9,,,percent of total billed charges,33.9% of total billed charges,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340.82,78,,,percent of total billed charges,78% of total billed charges,1719,100,,,percent of total billed charges,100% of total billed charges,1419.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1419.89,82.6,,,percent of total billed charges,82.6% of total billed charges,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.4,58274.1,
RECONSTRUCTION KNEE,96027427,CDM,960,RC,27427,HCPCS,Outpatient,,,1432,930.80,,1260.16,88,,,percent of total billed charges,88% of total Billed charges,71.16,100,,,Fee Schedule,100% of Medicare rate,410.86,100,,,Fee Schedule,100% of WA Medicaid,1432,100,,,percent of total billed charges,100% of total billed charges,423.19,103,,,Fee Schedule,103% of WA Medicaid,71.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,410.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,988.08,69,,,percent of total billed charges,69% of total billed charges,1432,100,,,percent of total billed charges,100% of total billed charges,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1432,100,,,percent of total billed charges,100% of total billed charges,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1432,100,,,percent of total billed charges,100% of total billed charges,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.69,61.85,,,percent of total billed charges,61.85% of total billed charges,410.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,534.12,130,,,Fee Schedule,130% of WA Medicaid ,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.86,37.7,,,percent of total billed charges,37.70% of total billed charges,539.86,37.7,,,percent of total billed charges,37.70% of total billed charges,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,48544.8,33.9,,,percent of total billed charges,33.9% of total billed charges,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116.96,78,,,percent of total billed charges,78% of total billed charges,1432,100,,,percent of total billed charges,100% of total billed charges,1182.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1182.83,82.6,,,percent of total billed charges,82.6% of total billed charges,410.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.16,48544.8,
ARTHROSCOPY KNEE,96027447,CDM,960,RC,27447,HCPCS,Outpatient,,,2968,1929.20,,2611.84,88,,,percent of total billed charges,88% of total Billed charges,142.48,100,,,Fee Schedule,100% of Medicare rate,729.77,100,,,Fee Schedule,100% of WA Medicaid,2968,100,,,percent of total billed charges,100% of total billed charges,751.66,103,,,Fee Schedule,103% of WA Medicaid,142.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,249.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,729.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2047.92,69,,,percent of total billed charges,69% of total billed charges,2968,100,,,percent of total billed charges,100% of total billed charges,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2968,100,,,percent of total billed charges,100% of total billed charges,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2968,100,,,percent of total billed charges,100% of total billed charges,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1835.71,61.85,,,percent of total billed charges,61.85% of total billed charges,729.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,744.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,948.7,130,,,Fee Schedule,130% of WA Medicaid ,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1118.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1118.94,37.7,,,percent of total billed charges,37.70% of total billed charges,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,100615.2,33.9,,,percent of total billed charges,33.9% of total billed charges,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2315.04,78,,,percent of total billed charges,78% of total billed charges,2968,100,,,percent of total billed charges,100% of total billed charges,2451.57,82.6,,,percent of total billed charges,82.6% of total billed charges,2451.57,82.6,,,percent of total billed charges,82.6% of total billed charges,729.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,142.48,100615.2,
TOTAL KNEE REVIS/FEM TIBIAL CP,96027487,CDM,960,RC,27487,HCPCS,Outpatient,,,3017,1961.05,,2654.96,88,,,percent of total billed charges,88% of total Billed charges,197.17,100,,,Fee Schedule,100% of Medicare rate,994.42,100,,,Fee Schedule,100% of WA Medicaid,3017,100,,,percent of total billed charges,100% of total billed charges,1024.25,103,,,Fee Schedule,103% of WA Medicaid,197.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,345.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,994.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2081.73,69,,,percent of total billed charges,69% of total billed charges,3017,100,,,percent of total billed charges,100% of total billed charges,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3017,100,,,percent of total billed charges,100% of total billed charges,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3017,100,,,percent of total billed charges,100% of total billed charges,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1866.01,61.85,,,percent of total billed charges,61.85% of total billed charges,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,994.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1292.75,130,,,Fee Schedule,130% of WA Medicaid ,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1137.41,37.7,,,percent of total billed charges,37.70% of total billed charges,1137.41,37.7,,,percent of total billed charges,37.70% of total billed charges,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,102276.3,33.9,,,percent of total billed charges,33.9% of total billed charges,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2353.26,78,,,percent of total billed charges,78% of total billed charges,3017,100,,,percent of total billed charges,100% of total billed charges,2492.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2492.04,82.6,,,percent of total billed charges,82.6% of total billed charges,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,197.17,102276.3,
REMOVAL OF KNEE PROTHESIS,96027488,CDM,960,RC,27488,HCPCS,Outpatient,,,2190,1423.50,,1927.2,88,,,percent of total billed charges,88% of total Billed charges,129.82,100,,,Fee Schedule,100% of Medicare rate,686.88,100,,,Fee Schedule,100% of WA Medicaid,2190,100,,,percent of total billed charges,100% of total billed charges,707.49,103,,,Fee Schedule,103% of WA Medicaid,129.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,227.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,686.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1511.1,69,,,percent of total billed charges,69% of total billed charges,2190,100,,,percent of total billed charges,100% of total billed charges,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2190,100,,,percent of total billed charges,100% of total billed charges,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2190,100,,,percent of total billed charges,100% of total billed charges,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1354.52,61.85,,,percent of total billed charges,61.85% of total billed charges,686.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,892.94,130,,,Fee Schedule,130% of WA Medicaid ,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,825.63,37.7,,,percent of total billed charges,37.70% of total billed charges,825.63,37.7,,,percent of total billed charges,37.70% of total billed charges,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,74241,33.9,,,percent of total billed charges,33.9% of total billed charges,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1708.2,78,,,percent of total billed charges,78% of total billed charges,2190,100,,,percent of total billed charges,100% of total billed charges,1808.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1808.94,82.6,,,percent of total billed charges,82.6% of total billed charges,686.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,129.82,74241,
"27498 DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, MULTIPLE",97527498,CDM,975,RC,27498,HCPCS,Outpatient,,,2341,1521.65,,2060.08,88,,,percent of total billed charges,88% of total Billed charges,66.29,100,,,Fee Schedule,100% of Medicare rate,382.88,100,,,Fee Schedule,100% of WA Medicaid,2341,100,,,percent of total billed charges,100% of total billed charges,394.37,103,,,Fee Schedule,103% of WA Medicaid,66.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,116.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,382.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1615.29,69,,,percent of total billed charges,69% of total billed charges,2341,100,,,percent of total billed charges,100% of total billed charges,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2341,100,,,percent of total billed charges,100% of total billed charges,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2341,100,,,percent of total billed charges,100% of total billed charges,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1447.91,61.85,,,percent of total billed charges,61.85% of total billed charges,382.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,497.74,130,,,Fee Schedule,130% of WA Medicaid ,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,882.56,37.7,,,percent of total billed charges,37.70% of total billed charges,882.56,37.7,,,percent of total billed charges,37.70% of total billed charges,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,79359.9,33.9,,,percent of total billed charges,33.9% of total billed charges,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825.98,78,,,percent of total billed charges,78% of total billed charges,2341,100,,,percent of total billed charges,100% of total billed charges,1933.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1933.67,82.6,,,percent of total billed charges,82.6% of total billed charges,382.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,66.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.29,79359.9,
"27502 CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITH MANIP",97527502,CDM,975,RC,27502,HCPCS,Outpatient,,,2431,1580.15,,2139.28,88,,,percent of total billed charges,88% of total Billed charges,83.5,100,,,Fee Schedule,100% of Medicare rate,432.87,100,,,Fee Schedule,100% of WA Medicaid,2431,100,,,percent of total billed charges,100% of total billed charges,445.86,103,,,Fee Schedule,103% of WA Medicaid,83.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,146.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,432.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1677.39,69,,,percent of total billed charges,69% of total billed charges,2431,100,,,percent of total billed charges,100% of total billed charges,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2431,100,,,percent of total billed charges,100% of total billed charges,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2431,100,,,percent of total billed charges,100% of total billed charges,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1503.57,61.85,,,percent of total billed charges,61.85% of total billed charges,432.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562.73,130,,,Fee Schedule,130% of WA Medicaid ,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.49,37.7,,,percent of total billed charges,37.70% of total billed charges,916.49,37.7,,,percent of total billed charges,37.70% of total billed charges,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,82410.9,33.9,,,percent of total billed charges,33.9% of total billed charges,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1896.18,78,,,percent of total billed charges,78% of total billed charges,2431,100,,,percent of total billed charges,100% of total billed charges,2008.01,82.6,,,percent of total billed charges,82.6% of total billed charges,2008.01,82.6,,,percent of total billed charges,82.6% of total billed charges,432.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.5,82410.9,
OPEN TX OF FEMORAL SHAFT FX,96027506,CDM,960,RC,27506,HCPCS,Outpatient,,,3342,2172.30,,2940.96,88,,,percent of total billed charges,88% of total Billed charges,144.58,100,,,Fee Schedule,100% of Medicare rate,765.21,100,,,Fee Schedule,100% of WA Medicaid,3342,100,,,percent of total billed charges,100% of total billed charges,788.17,103,,,Fee Schedule,103% of WA Medicaid,144.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,253.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,765.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2305.98,69,,,percent of total billed charges,69% of total billed charges,3342,100,,,percent of total billed charges,100% of total billed charges,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3342,100,,,percent of total billed charges,100% of total billed charges,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3342,100,,,percent of total billed charges,100% of total billed charges,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2067.03,61.85,,,percent of total billed charges,61.85% of total billed charges,765.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,994.77,130,,,Fee Schedule,130% of WA Medicaid ,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1259.93,37.7,,,percent of total billed charges,37.70% of total billed charges,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,113293.8,33.9,,,percent of total billed charges,33.9% of total billed charges,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2606.76,78,,,percent of total billed charges,78% of total billed charges,3342,100,,,percent of total billed charges,100% of total billed charges,2760.49,82.6,,,percent of total billed charges,82.6% of total billed charges,2760.49,82.6,,,percent of total billed charges,82.6% of total billed charges,765.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,144.58,113293.8,
OPEN REDUC IN FX FEMUR,96027507,CDM,960,RC,27507,HCPCS,Outpatient,,,1802,1171.30,,1585.76,88,,,percent of total billed charges,88% of total Billed charges,105.63,100,,,Fee Schedule,100% of Medicare rate,552.6,100,,,Fee Schedule,100% of WA Medicaid,1802,100,,,percent of total billed charges,100% of total billed charges,569.18,103,,,Fee Schedule,103% of WA Medicaid,105.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,184.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,552.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1243.38,69,,,percent of total billed charges,69% of total billed charges,1802,100,,,percent of total billed charges,100% of total billed charges,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1802,100,,,percent of total billed charges,100% of total billed charges,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1802,100,,,percent of total billed charges,100% of total billed charges,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1114.54,61.85,,,percent of total billed charges,61.85% of total billed charges,552.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,563.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,718.38,130,,,Fee Schedule,130% of WA Medicaid ,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,679.35,37.7,,,percent of total billed charges,37.70% of total billed charges,679.35,37.7,,,percent of total billed charges,37.70% of total billed charges,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,61087.8,33.9,,,percent of total billed charges,33.9% of total billed charges,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1405.56,78,,,percent of total billed charges,78% of total billed charges,1802,100,,,percent of total billed charges,100% of total billed charges,1488.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1488.45,82.6,,,percent of total billed charges,82.6% of total billed charges,552.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105.63,61087.8,
"27509 PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, DI",97527509,CDM,975,RC,27509,HCPCS,Outpatient,,,2085,1355.25,,1834.8,88,,,percent of total billed charges,88% of total Billed charges,63.26,100,,,Fee Schedule,100% of Medicare rate,394.63,100,,,Fee Schedule,100% of WA Medicaid,2085,100,,,percent of total billed charges,100% of total billed charges,406.47,103,,,Fee Schedule,103% of WA Medicaid,63.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,110.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,394.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1438.65,69,,,percent of total billed charges,69% of total billed charges,2085,100,,,percent of total billed charges,100% of total billed charges,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2085,100,,,percent of total billed charges,100% of total billed charges,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2085,100,,,percent of total billed charges,100% of total billed charges,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1289.57,61.85,,,percent of total billed charges,61.85% of total billed charges,394.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,513.02,130,,,Fee Schedule,130% of WA Medicaid ,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.05,37.7,,,percent of total billed charges,37.70% of total billed charges,786.05,37.7,,,percent of total billed charges,37.70% of total billed charges,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,70681.5,33.9,,,percent of total billed charges,33.9% of total billed charges,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1626.3,78,,,percent of total billed charges,78% of total billed charges,2085,100,,,percent of total billed charges,100% of total billed charges,1722.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1722.21,82.6,,,percent of total billed charges,82.6% of total billed charges,394.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.26,70681.5,
TREATMENT OF THIGH FRACTURE,96027511,CDM,960,RC,27511,HCPCS,Outpatient,,,2006,1303.90,,1765.28,88,,,percent of total billed charges,88% of total Billed charges,110.33,100,,,Fee Schedule,100% of Medicare rate,567.71,100,,,Fee Schedule,100% of WA Medicaid,2006,100,,,percent of total billed charges,100% of total billed charges,584.74,103,,,Fee Schedule,103% of WA Medicaid,110.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,567.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1384.14,69,,,percent of total billed charges,69% of total billed charges,2006,100,,,percent of total billed charges,100% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2006,100,,,percent of total billed charges,100% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2006,100,,,percent of total billed charges,100% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240.71,61.85,,,percent of total billed charges,61.85% of total billed charges,567.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,579.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,738.02,130,,,Fee Schedule,130% of WA Medicaid ,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,756.26,37.7,,,percent of total billed charges,37.70% of total billed charges,756.26,37.7,,,percent of total billed charges,37.70% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,68003.4,33.9,,,percent of total billed charges,33.9% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1564.68,78,,,percent of total billed charges,78% of total billed charges,2006,100,,,percent of total billed charges,100% of total billed charges,1656.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1656.96,82.6,,,percent of total billed charges,82.6% of total billed charges,567.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.33,68003.4,
TREATMENT OF THIGH FRACTURE,96027513,CDM,960,RC,27513,HCPCS,Outpatient,,,1879,1221.35,,1653.52,88,,,percent of total billed charges,88% of total Billed charges,139.16,100,,,Fee Schedule,100% of Medicare rate,700.87,100,,,Fee Schedule,100% of WA Medicaid,1879,100,,,percent of total billed charges,100% of total billed charges,721.9,103,,,Fee Schedule,103% of WA Medicaid,139.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,243.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,700.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1296.51,69,,,percent of total billed charges,69% of total billed charges,1879,100,,,percent of total billed charges,100% of total billed charges,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1879,100,,,percent of total billed charges,100% of total billed charges,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1879,100,,,percent of total billed charges,100% of total billed charges,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162.16,61.85,,,percent of total billed charges,61.85% of total billed charges,700.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,911.13,130,,,Fee Schedule,130% of WA Medicaid ,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,708.38,37.7,,,percent of total billed charges,37.70% of total billed charges,708.38,37.7,,,percent of total billed charges,37.70% of total billed charges,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,63698.1,33.9,,,percent of total billed charges,33.9% of total billed charges,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1465.62,78,,,percent of total billed charges,78% of total billed charges,1879,100,,,percent of total billed charges,100% of total billed charges,1552.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1552.05,82.6,,,percent of total billed charges,82.6% of total billed charges,700.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,139.16,63698.1,
"27514 OPEN TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL",97527514,CDM,975,RC,27514,HCPCS,Outpatient,,,4321,2808.65,,3802.48,88,,,percent of total billed charges,88% of total Billed charges,106.06,100,,,Fee Schedule,100% of Medicare rate,550.73,100,,,Fee Schedule,100% of WA Medicaid,4321,100,,,percent of total billed charges,100% of total billed charges,567.25,103,,,Fee Schedule,103% of WA Medicaid,106.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,185.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,550.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2981.49,69,,,percent of total billed charges,69% of total billed charges,4321,100,,,percent of total billed charges,100% of total billed charges,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4321,100,,,percent of total billed charges,100% of total billed charges,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4321,100,,,percent of total billed charges,100% of total billed charges,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2672.54,61.85,,,percent of total billed charges,61.85% of total billed charges,550.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,715.95,130,,,Fee Schedule,130% of WA Medicaid ,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1629.02,37.7,,,percent of total billed charges,37.70% of total billed charges,1629.02,37.7,,,percent of total billed charges,37.70% of total billed charges,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,146481.9,33.9,,,percent of total billed charges,33.9% of total billed charges,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,3370.38,78,,,percent of total billed charges,78% of total billed charges,4321,100,,,percent of total billed charges,100% of total billed charges,3569.15,82.6,,,percent of total billed charges,82.6% of total billed charges,3569.15,82.6,,,percent of total billed charges,82.6% of total billed charges,550.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.06,146481.9,
OPEN TREATMENT PATELLAR FRACT,96027524,CDM,960,RC,27524,HCPCS,Outpatient,,,1375,893.75,,1210,88,,,percent of total billed charges,88% of total Billed charges,77.67,100,,,Fee Schedule,100% of Medicare rate,436.04,100,,,Fee Schedule,100% of WA Medicaid,1375,100,,,percent of total billed charges,100% of total billed charges,449.12,103,,,Fee Schedule,103% of WA Medicaid,77.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,436.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,948.75,69,,,percent of total billed charges,69% of total billed charges,1375,100,,,percent of total billed charges,100% of total billed charges,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1375,100,,,percent of total billed charges,100% of total billed charges,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1375,100,,,percent of total billed charges,100% of total billed charges,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,850.44,61.85,,,percent of total billed charges,61.85% of total billed charges,436.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,566.85,130,,,Fee Schedule,130% of WA Medicaid ,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,518.38,37.7,,,percent of total billed charges,37.70% of total billed charges,518.38,37.7,,,percent of total billed charges,37.70% of total billed charges,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,46612.5,33.9,,,percent of total billed charges,33.9% of total billed charges,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1072.5,78,,,percent of total billed charges,78% of total billed charges,1375,100,,,percent of total billed charges,100% of total billed charges,1135.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1135.75,82.6,,,percent of total billed charges,82.6% of total billed charges,436.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.67,46612.5,
TREATMENT OF KNEE FRACTURE,96027535,CDM,960,RC,27535,HCPCS,Outpatient,,,1540,1001.00,,1355.2,88,,,percent of total billed charges,88% of total Billed charges,98.07,100,,,Fee Schedule,100% of Medicare rate,512.32,100,,,Fee Schedule,100% of WA Medicaid,1540,100,,,percent of total billed charges,100% of total billed charges,527.69,103,,,Fee Schedule,103% of WA Medicaid,98.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,171.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,512.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1062.6,69,,,percent of total billed charges,69% of total billed charges,1540,100,,,percent of total billed charges,100% of total billed charges,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1540,100,,,percent of total billed charges,100% of total billed charges,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1540,100,,,percent of total billed charges,100% of total billed charges,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,952.49,61.85,,,percent of total billed charges,61.85% of total billed charges,512.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,666.02,130,,,Fee Schedule,130% of WA Medicaid ,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,580.58,37.7,,,percent of total billed charges,37.70% of total billed charges,580.58,37.7,,,percent of total billed charges,37.70% of total billed charges,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,52206,33.9,,,percent of total billed charges,33.9% of total billed charges,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1201.2,78,,,percent of total billed charges,78% of total billed charges,1540,100,,,percent of total billed charges,100% of total billed charges,1272.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1272.04,82.6,,,percent of total billed charges,82.6% of total billed charges,512.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.07,52206,
"27536 OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU);",97527536,CDM,975,RC,27536,HCPCS,Outpatient,,,3622,2354.30,,3187.36,88,,,percent of total billed charges,88% of total Billed charges,128.41,100,,,Fee Schedule,100% of Medicare rate,679.98,100,,,Fee Schedule,100% of WA Medicaid,3622,100,,,percent of total billed charges,100% of total billed charges,700.38,103,,,Fee Schedule,103% of WA Medicaid,128.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,224.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,679.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2499.18,69,,,percent of total billed charges,69% of total billed charges,3622,100,,,percent of total billed charges,100% of total billed charges,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,3622,100,,,percent of total billed charges,100% of total billed charges,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,3622,100,,,percent of total billed charges,100% of total billed charges,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2240.21,61.85,,,percent of total billed charges,61.85% of total billed charges,679.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,679.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,693.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,883.97,130,,,Fee Schedule,130% of WA Medicaid ,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1365.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1365.49,37.7,,,percent of total billed charges,37.70% of total billed charges,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,122785.8,33.9,,,percent of total billed charges,33.9% of total billed charges,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2825.16,78,,,percent of total billed charges,78% of total billed charges,3622,100,,,percent of total billed charges,100% of total billed charges,2991.77,82.6,,,percent of total billed charges,82.6% of total billed charges,2991.77,82.6,,,percent of total billed charges,82.6% of total billed charges,679.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,679.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.41,122785.8,
TREAT KNEE DISLOCATION,96027550,CDM,960,RC,27550,HCPCS,Outpatient,,,1004,652.60,,883.52,88,,,percent of total billed charges,88% of total Billed charges,46.49,100,,,Fee Schedule,100% of Medicare rate,277.7,100,,,Fee Schedule,100% of WA Medicaid,1004,100,,,percent of total billed charges,100% of total billed charges,286.03,103,,,Fee Schedule,103% of WA Medicaid,46.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,277.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,692.76,69,,,percent of total billed charges,69% of total billed charges,1004,100,,,percent of total billed charges,100% of total billed charges,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1004,100,,,percent of total billed charges,100% of total billed charges,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1004,100,,,percent of total billed charges,100% of total billed charges,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,620.97,61.85,,,percent of total billed charges,61.85% of total billed charges,277.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,361.01,130,,,Fee Schedule,130% of WA Medicaid ,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.51,37.7,,,percent of total billed charges,37.70% of total billed charges,378.51,37.7,,,percent of total billed charges,37.70% of total billed charges,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,34035.6,33.9,,,percent of total billed charges,33.9% of total billed charges,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,783.12,78,,,percent of total billed charges,78% of total billed charges,1004,100,,,percent of total billed charges,100% of total billed charges,829.3,82.6,,,percent of total billed charges,82.6% of total billed charges,829.3,82.6,,,percent of total billed charges,82.6% of total billed charges,277.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.49,34035.6,
FUSION OF KNEE,96027580,CDM,960,RC,27580,HCPCS,Outpatient,,,2616,1700.40,,2302.08,88,,,percent of total billed charges,88% of total Billed charges,157.59,100,,,Fee Schedule,100% of Medicare rate,845.22,100,,,Fee Schedule,100% of WA Medicaid,2616,100,,,percent of total billed charges,100% of total billed charges,870.58,103,,,Fee Schedule,103% of WA Medicaid,157.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,275.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,845.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1805.04,69,,,percent of total billed charges,69% of total billed charges,2616,100,,,percent of total billed charges,100% of total billed charges,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2616,100,,,percent of total billed charges,100% of total billed charges,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2616,100,,,percent of total billed charges,100% of total billed charges,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1618,61.85,,,percent of total billed charges,61.85% of total billed charges,845.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,845.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,862.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1098.79,130,,,Fee Schedule,130% of WA Medicaid ,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,986.23,37.7,,,percent of total billed charges,37.70% of total billed charges,986.23,37.7,,,percent of total billed charges,37.70% of total billed charges,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,88682.4,33.9,,,percent of total billed charges,33.9% of total billed charges,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2040.48,78,,,percent of total billed charges,78% of total billed charges,2616,100,,,percent of total billed charges,100% of total billed charges,2160.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2160.82,82.6,,,percent of total billed charges,82.6% of total billed charges,845.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,845.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,157.59,88682.4,
"27590 AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; ProFee",97527590,CDM,975,RC,27590,HCPCS,Outpatient,,,2820,1833.00,,2481.6,88,,,percent of total billed charges,88% of total Billed charges,107.94,100,,,Fee Schedule,100% of Medicare rate,436.97,100,,,Fee Schedule,100% of WA Medicaid,2820,100,,,percent of total billed charges,100% of total billed charges,450.08,103,,,Fee Schedule,103% of WA Medicaid,107.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,188.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,436.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1945.8,69,,,percent of total billed charges,69% of total billed charges,2820,100,,,percent of total billed charges,100% of total billed charges,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2820,100,,,percent of total billed charges,100% of total billed charges,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2820,100,,,percent of total billed charges,100% of total billed charges,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1744.17,61.85,,,percent of total billed charges,61.85% of total billed charges,436.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,568.06,130,,,Fee Schedule,130% of WA Medicaid ,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.14,37.7,,,percent of total billed charges,37.70% of total billed charges,1063.14,37.7,,,percent of total billed charges,37.70% of total billed charges,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,95598,33.9,,,percent of total billed charges,33.9% of total billed charges,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2199.6,78,,,percent of total billed charges,78% of total billed charges,2820,100,,,percent of total billed charges,100% of total billed charges,2329.32,82.6,,,percent of total billed charges,82.6% of total billed charges,2329.32,82.6,,,percent of total billed charges,82.6% of total billed charges,436.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.94,95598,
"27602 DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL",97527602,CDM,975,RC,27602,HCPCS,Outpatient,,,1781,1157.65,,1567.28,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare rate,267.44,100,,,Fee Schedule,100% of WA Medicaid,1781,100,,,percent of total billed charges,100% of total billed charges,275.46,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,267.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1228.89,69,,,percent of total billed charges,69% of total billed charges,1781,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1781,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1781,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1101.55,61.85,,,percent of total billed charges,61.85% of total billed charges,267.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,347.67,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.44,37.7,,,percent of total billed charges,37.70% of total billed charges,671.44,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,60375.9,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1389.18,78,,,percent of total billed charges,78% of total billed charges,1781,100,,,percent of total billed charges,100% of total billed charges,1471.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1471.11,82.6,,,percent of total billed charges,82.6% of total billed charges,267.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,63,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.38,60375.9,
ID LEG/ANKLE DEEP ABSCESS,96027603,CDM,960,RC,27603,HCPCS,Outpatient,,,1122,729.30,,987.36,88,,,percent of total billed charges,88% of total Billed charges,36.53,100,,,Fee Schedule,100% of Medicare rate,226.04,100,,,Fee Schedule,100% of WA Medicaid,1122,100,,,percent of total billed charges,100% of total billed charges,232.82,103,,,Fee Schedule,103% of WA Medicaid,36.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,226.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,774.18,69,,,percent of total billed charges,69% of total billed charges,1122,100,,,percent of total billed charges,100% of total billed charges,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1122,100,,,percent of total billed charges,100% of total billed charges,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1122,100,,,percent of total billed charges,100% of total billed charges,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,693.96,61.85,,,percent of total billed charges,61.85% of total billed charges,226.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,293.85,130,,,Fee Schedule,130% of WA Medicaid ,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.99,37.7,,,percent of total billed charges,37.70% of total billed charges,422.99,37.7,,,percent of total billed charges,37.70% of total billed charges,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,38035.8,33.9,,,percent of total billed charges,33.9% of total billed charges,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,875.16,78,,,percent of total billed charges,78% of total billed charges,1122,100,,,percent of total billed charges,100% of total billed charges,926.77,82.6,,,percent of total billed charges,82.6% of total billed charges,926.77,82.6,,,percent of total billed charges,82.6% of total billed charges,226.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.53,38035.8,
INCISION OF ACHILLE TENDON,96027607,CDM,960,RC,27607,HCPCS,Outpatient,,,1331,865.15,,1171.28,88,,,percent of total billed charges,88% of total Billed charges,58.16,100,,,Fee Schedule,100% of Medicare rate,346.14,100,,,Fee Schedule,100% of WA Medicaid,1331,100,,,percent of total billed charges,100% of total billed charges,356.52,103,,,Fee Schedule,103% of WA Medicaid,58.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,346.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,918.39,69,,,percent of total billed charges,69% of total billed charges,1331,100,,,percent of total billed charges,100% of total billed charges,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1331,100,,,percent of total billed charges,100% of total billed charges,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1331,100,,,percent of total billed charges,100% of total billed charges,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,823.22,61.85,,,percent of total billed charges,61.85% of total billed charges,346.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.98,130,,,Fee Schedule,130% of WA Medicaid ,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,501.79,37.7,,,percent of total billed charges,37.70% of total billed charges,501.79,37.7,,,percent of total billed charges,37.70% of total billed charges,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,45120.9,33.9,,,percent of total billed charges,33.9% of total billed charges,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1038.18,78,,,percent of total billed charges,78% of total billed charges,1331,100,,,percent of total billed charges,100% of total billed charges,1099.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1099.41,82.6,,,percent of total billed charges,82.6% of total billed charges,346.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.16,45120.9,
"27618 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA, SUB",97527618,CDM,975,RC,27618,HCPCS,Outpatient,,,1072,696.80,,943.36,88,,,percent of total billed charges,88% of total Billed charges,29.09,100,,,Fee Schedule,100% of Medicare rate,178.48,100,,,Fee Schedule,100% of WA Medicaid,1072,100,,,percent of total billed charges,100% of total billed charges,183.83,103,,,Fee Schedule,103% of WA Medicaid,29.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,50.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,178.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,739.68,69,,,percent of total billed charges,69% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1072,100,,,percent of total billed charges,100% of total billed charges,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1072,100,,,percent of total billed charges,100% of total billed charges,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.03,61.85,,,percent of total billed charges,61.85% of total billed charges,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,232.02,130,,,Fee Schedule,130% of WA Medicaid ,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,36340.8,33.9,,,percent of total billed charges,33.9% of total billed charges,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,836.16,78,,,percent of total billed charges,78% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.09,36340.8,
"27620 ARTHROTOMY, ANKLE, WITH JOINT EXPLORATION, WITH OR WIT",96027620,CDM,975,RC,27620,HCPCS,Outpatient,,,1169,759.85,,1028.72,88,,,percent of total billed charges,88% of total Billed charges,38.13,100,,,Fee Schedule,100% of Medicare rate,261.66,100,,,Fee Schedule,100% of WA Medicaid,1169,100,,,percent of total billed charges,100% of total billed charges,269.51,103,,,Fee Schedule,103% of WA Medicaid,38.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,261.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,806.61,69,,,percent of total billed charges,69% of total billed charges,1169,100,,,percent of total billed charges,100% of total billed charges,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1169,100,,,percent of total billed charges,100% of total billed charges,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1169,100,,,percent of total billed charges,100% of total billed charges,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.03,61.85,,,percent of total billed charges,61.85% of total billed charges,261.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,340.16,130,,,Fee Schedule,130% of WA Medicaid ,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.71,37.7,,,percent of total billed charges,37.70% of total billed charges,440.71,37.7,,,percent of total billed charges,37.70% of total billed charges,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,39629.1,33.9,,,percent of total billed charges,33.9% of total billed charges,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,911.82,78,,,percent of total billed charges,78% of total billed charges,1169,100,,,percent of total billed charges,100% of total billed charges,965.59,82.6,,,percent of total billed charges,82.6% of total billed charges,965.59,82.6,,,percent of total billed charges,82.6% of total billed charges,261.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.13,39629.1,
EXC TENDON SHEATH LEG/ANKLE,96027630,CDM,960,RC,27630,HCPCS,Outpatient,,,1207,784.55,,1062.16,88,,,percent of total billed charges,88% of total Billed charges,29.39,100,,,Fee Schedule,100% of Medicare rate,208.88,100,,,Fee Schedule,100% of WA Medicaid,1207,100,,,percent of total billed charges,100% of total billed charges,215.15,103,,,Fee Schedule,103% of WA Medicaid,29.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,208.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,832.83,69,,,percent of total billed charges,69% of total billed charges,1207,100,,,percent of total billed charges,100% of total billed charges,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1207,100,,,percent of total billed charges,100% of total billed charges,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1207,100,,,percent of total billed charges,100% of total billed charges,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.53,61.85,,,percent of total billed charges,61.85% of total billed charges,208.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,271.54,130,,,Fee Schedule,130% of WA Medicaid ,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.04,37.7,,,percent of total billed charges,37.70% of total billed charges,455.04,37.7,,,percent of total billed charges,37.70% of total billed charges,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,40917.3,33.9,,,percent of total billed charges,33.9% of total billed charges,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,941.46,78,,,percent of total billed charges,78% of total billed charges,1207,100,,,percent of total billed charges,100% of total billed charges,996.98,82.6,,,percent of total billed charges,82.6% of total billed charges,996.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.39,40917.3,
97527632,97527632,CDM,975,RC,27632,HCPCS,Outpatient,,,1174.75,763.59,,1033.78,88,,,percent of total billed charges,88% of total Billed charges,44.29,100,,,Fee Schedule,100% of Medicare rate,235.18,100,,,Fee Schedule,100% of WA Medicaid,1174.75,100,,,percent of total billed charges,100% of total billed charges,242.24,103,,,Fee Schedule,103% of WA Medicaid,44.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,235.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,810.58,69,,,percent of total billed charges,69% of total billed charges,1174.75,100,,,percent of total billed charges,100% of total billed charges,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1174.75,100,,,percent of total billed charges,100% of total billed charges,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1174.75,100,,,percent of total billed charges,100% of total billed charges,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.58,61.85,,,percent of total billed charges,61.85% of total billed charges,235.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,305.73,130,,,Fee Schedule,130% of WA Medicaid ,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.88,37.7,,,percent of total billed charges,37.70% of total billed charges,442.88,37.7,,,percent of total billed charges,37.70% of total billed charges,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,39824.03,33.9,,,percent of total billed charges,33.9% of total billed charges,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.31,78,,,percent of total billed charges,78% of total billed charges,1174.75,100,,,percent of total billed charges,100% of total billed charges,970.34,82.6,,,percent of total billed charges,82.6% of total billed charges,970.34,82.6,,,percent of total billed charges,82.6% of total billed charges,235.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.29,39824.03,
REPAIR ACHILLES TENDON PRIMARY,96027650,CDM,960,RC,27650,HCPCS,Outpatient,,,1416,920.40,,1246.08,88,,,percent of total billed charges,88% of total Billed charges,57.17,100,,,Fee Schedule,100% of Medicare rate,381.95,100,,,Fee Schedule,100% of WA Medicaid,1416,100,,,percent of total billed charges,100% of total billed charges,393.41,103,,,Fee Schedule,103% of WA Medicaid,57.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,381.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,977.04,69,,,percent of total billed charges,69% of total billed charges,1416,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1416,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1416,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,875.8,61.85,,,percent of total billed charges,61.85% of total billed charges,381.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,496.54,130,,,Fee Schedule,130% of WA Medicaid ,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,533.83,37.7,,,percent of total billed charges,37.70% of total billed charges,533.83,37.7,,,percent of total billed charges,37.70% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,48002.4,33.9,,,percent of total billed charges,33.9% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1104.48,78,,,percent of total billed charges,78% of total billed charges,1416,100,,,percent of total billed charges,100% of total billed charges,1169.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1169.62,82.6,,,percent of total billed charges,82.6% of total billed charges,381.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.17,48002.4,
"27652 REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILL",97527652,CDM,975,RC,27652,HCPCS,Outpatient,,,2382,1548.30,,2096.16,88,,,percent of total billed charges,88% of total Billed charges,56.49,100,,,Fee Schedule,100% of Medicare rate,387.92,100,,,Fee Schedule,100% of WA Medicaid,2382,100,,,percent of total billed charges,100% of total billed charges,399.56,103,,,Fee Schedule,103% of WA Medicaid,56.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,98.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,387.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1643.58,69,,,percent of total billed charges,69% of total billed charges,2382,100,,,percent of total billed charges,100% of total billed charges,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2382,100,,,percent of total billed charges,100% of total billed charges,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2382,100,,,percent of total billed charges,100% of total billed charges,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1473.27,61.85,,,percent of total billed charges,61.85% of total billed charges,387.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,504.3,130,,,Fee Schedule,130% of WA Medicaid ,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,898.01,37.7,,,percent of total billed charges,37.70% of total billed charges,898.01,37.7,,,percent of total billed charges,37.70% of total billed charges,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,80749.8,33.9,,,percent of total billed charges,33.9% of total billed charges,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1857.96,78,,,percent of total billed charges,78% of total billed charges,2382,100,,,percent of total billed charges,100% of total billed charges,1967.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1967.53,82.6,,,percent of total billed charges,82.6% of total billed charges,387.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.49,80749.8,
REPAIR OF ACHILLES TENDON,96027654,CDM,960,RC,27654,HCPCS,Outpatient,,,1548,1006.20,,1362.24,88,,,percent of total billed charges,88% of total Billed charges,62.54,100,,,Fee Schedule,100% of Medicare rate,414.78,100,,,Fee Schedule,100% of WA Medicaid,1548,100,,,percent of total billed charges,100% of total billed charges,427.22,103,,,Fee Schedule,103% of WA Medicaid,62.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,414.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1068.12,69,,,percent of total billed charges,69% of total billed charges,1548,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1548,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1548,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,957.44,61.85,,,percent of total billed charges,61.85% of total billed charges,414.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,539.21,130,,,Fee Schedule,130% of WA Medicaid ,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.6,37.7,,,percent of total billed charges,37.70% of total billed charges,583.6,37.7,,,percent of total billed charges,37.70% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,52477.2,33.9,,,percent of total billed charges,33.9% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1207.44,78,,,percent of total billed charges,78% of total billed charges,1548,100,,,percent of total billed charges,100% of total billed charges,1278.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1278.65,82.6,,,percent of total billed charges,82.6% of total billed charges,414.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.54,52477.2,
"27658 REPAIR, FLEXOR TENDON, LEG; PRIMARY, WITHOUT",97527658,CDM,975,RC,27658,HCPCS,Outpatient,,,1570,1020.50,,1381.6,88,,,percent of total billed charges,88% of total Billed charges,30.27,100,,,Fee Schedule,100% of Medicare rate,215.78,100,,,Fee Schedule,100% of WA Medicaid,1570,100,,,percent of total billed charges,100% of total billed charges,222.25,103,,,Fee Schedule,103% of WA Medicaid,30.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,215.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1083.3,69,,,percent of total billed charges,69% of total billed charges,1570,100,,,percent of total billed charges,100% of total billed charges,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1570,100,,,percent of total billed charges,100% of total billed charges,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1570,100,,,percent of total billed charges,100% of total billed charges,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,971.05,61.85,,,percent of total billed charges,61.85% of total billed charges,215.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,280.51,130,,,Fee Schedule,130% of WA Medicaid ,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.89,37.7,,,percent of total billed charges,37.70% of total billed charges,591.89,37.7,,,percent of total billed charges,37.70% of total billed charges,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,53223,33.9,,,percent of total billed charges,33.9% of total billed charges,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1224.6,78,,,percent of total billed charges,78% of total billed charges,1570,100,,,percent of total billed charges,100% of total billed charges,1296.82,82.6,,,percent of total billed charges,82.6% of total billed charges,1296.82,82.6,,,percent of total billed charges,82.6% of total billed charges,215.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.27,53223,
"27685 LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE; SIN",97527685,CDM,975,RC,27685,HCPCS,Outpatient,,,1891,1229.15,,1664.08,88,,,percent of total billed charges,88% of total Billed charges,38.41,100,,,Fee Schedule,100% of Medicare rate,271.73,100,,,Fee Schedule,100% of WA Medicaid,1891,100,,,percent of total billed charges,100% of total billed charges,279.88,103,,,Fee Schedule,103% of WA Medicaid,38.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,271.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1304.79,69,,,percent of total billed charges,69% of total billed charges,1891,100,,,percent of total billed charges,100% of total billed charges,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1891,100,,,percent of total billed charges,100% of total billed charges,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1891,100,,,percent of total billed charges,100% of total billed charges,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1169.58,61.85,,,percent of total billed charges,61.85% of total billed charges,271.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,353.25,130,,,Fee Schedule,130% of WA Medicaid ,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.91,37.7,,,percent of total billed charges,37.70% of total billed charges,712.91,37.7,,,percent of total billed charges,37.70% of total billed charges,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,64104.9,33.9,,,percent of total billed charges,33.9% of total billed charges,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1474.98,78,,,percent of total billed charges,78% of total billed charges,1891,100,,,percent of total billed charges,100% of total billed charges,1561.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1561.97,82.6,,,percent of total billed charges,82.6% of total billed charges,271.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.41,64104.9,
"27687 GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE) ProFee",97527687,CDM,975,RC,27687,HCPCS,Outpatient,,,1670,1085.50,,1469.6,88,,,percent of total billed charges,88% of total Billed charges,38.56,100,,,Fee Schedule,100% of Medicare rate,264.64,100,,,Fee Schedule,100% of WA Medicaid,1670,100,,,percent of total billed charges,100% of total billed charges,272.58,103,,,Fee Schedule,103% of WA Medicaid,38.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1152.3,69,,,percent of total billed charges,69% of total billed charges,1670,100,,,percent of total billed charges,100% of total billed charges,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1670,100,,,percent of total billed charges,100% of total billed charges,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1670,100,,,percent of total billed charges,100% of total billed charges,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032.9,61.85,,,percent of total billed charges,61.85% of total billed charges,264.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,344.03,130,,,Fee Schedule,130% of WA Medicaid ,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.59,37.7,,,percent of total billed charges,37.70% of total billed charges,629.59,37.7,,,percent of total billed charges,37.70% of total billed charges,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,56613,33.9,,,percent of total billed charges,33.9% of total billed charges,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1302.6,78,,,percent of total billed charges,78% of total billed charges,1670,100,,,percent of total billed charges,100% of total billed charges,1379.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1379.42,82.6,,,percent of total billed charges,82.6% of total billed charges,264.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.56,56613,
"27695 REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL",97527695,CDM,975,RC,27695,HCPCS,Outpatient,,,2168,1409.20,,1907.84,88,,,percent of total billed charges,88% of total Billed charges,42.39,100,,,Fee Schedule,100% of Medicare rate,283.48,100,,,Fee Schedule,100% of WA Medicaid,2168,100,,,percent of total billed charges,100% of total billed charges,291.98,103,,,Fee Schedule,103% of WA Medicaid,42.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,283.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1495.92,69,,,percent of total billed charges,69% of total billed charges,2168,100,,,percent of total billed charges,100% of total billed charges,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2168,100,,,percent of total billed charges,100% of total billed charges,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2168,100,,,percent of total billed charges,100% of total billed charges,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340.91,61.85,,,percent of total billed charges,61.85% of total billed charges,283.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,368.52,130,,,Fee Schedule,130% of WA Medicaid ,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,817.34,37.7,,,percent of total billed charges,37.70% of total billed charges,817.34,37.7,,,percent of total billed charges,37.70% of total billed charges,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,73495.2,33.9,,,percent of total billed charges,33.9% of total billed charges,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1691.04,78,,,percent of total billed charges,78% of total billed charges,2168,100,,,percent of total billed charges,100% of total billed charges,1790.77,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.77,82.6,,,percent of total billed charges,82.6% of total billed charges,283.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.39,73495.2,
"27698 REPAIR, SECONDARY, DISRUPTED LIGAMENT, ANKLE, COLLATER",97527698,CDM,975,RC,27698,HCPCS,Outpatient,,,3173,2062.45,,2792.24,88,,,percent of total billed charges,88% of total Billed charges,58.04,100,,,Fee Schedule,100% of Medicare rate,368.34,100,,,Fee Schedule,100% of WA Medicaid,3173,100,,,percent of total billed charges,100% of total billed charges,379.39,103,,,Fee Schedule,103% of WA Medicaid,58.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,368.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2189.37,69,,,percent of total billed charges,69% of total billed charges,3173,100,,,percent of total billed charges,100% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3173,100,,,percent of total billed charges,100% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3173,100,,,percent of total billed charges,100% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1962.5,61.85,,,percent of total billed charges,61.85% of total billed charges,368.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,478.84,130,,,Fee Schedule,130% of WA Medicaid ,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1196.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1196.22,37.7,,,percent of total billed charges,37.70% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,107564.7,33.9,,,percent of total billed charges,33.9% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2474.94,78,,,percent of total billed charges,78% of total billed charges,3173,100,,,percent of total billed charges,100% of total billed charges,2620.9,82.6,,,percent of total billed charges,82.6% of total billed charges,2620.9,82.6,,,percent of total billed charges,82.6% of total billed charges,368.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.04,107564.7,
REMVL ANKLE IMPL REPAIR HMROUS,96027704,CDM,960,RC,27704,HCPCS,Outpatient,,,1272,826.80,,1119.36,88,,,percent of total billed charges,88% of total Billed charges,52.59,100,,,Fee Schedule,100% of Medicare rate,329.36,100,,,Fee Schedule,100% of WA Medicaid,1272,100,,,percent of total billed charges,100% of total billed charges,339.24,103,,,Fee Schedule,103% of WA Medicaid,52.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,329.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,877.68,69,,,percent of total billed charges,69% of total billed charges,1272,100,,,percent of total billed charges,100% of total billed charges,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272,100,,,percent of total billed charges,100% of total billed charges,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272,100,,,percent of total billed charges,100% of total billed charges,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.73,61.85,,,percent of total billed charges,61.85% of total billed charges,329.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,428.17,130,,,Fee Schedule,130% of WA Medicaid ,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.54,37.7,,,percent of total billed charges,37.70% of total billed charges,479.54,37.7,,,percent of total billed charges,37.70% of total billed charges,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,43120.8,33.9,,,percent of total billed charges,33.9% of total billed charges,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,992.16,78,,,percent of total billed charges,78% of total billed charges,1272,100,,,percent of total billed charges,100% of total billed charges,1050.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1050.67,82.6,,,percent of total billed charges,82.6% of total billed charges,329.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.59,43120.8,
27726 REPAIR OF FIBULA NONUNION AND/OR MALUNION WITH INTERNA,97527726,CDM,975,RC,27726,HCPCS,Outpatient,,,2888,1877.20,,2541.44,88,,,percent of total billed charges,88% of total Billed charges,99.92,100,,,Fee Schedule,100% of Medicare rate,547.75,100,,,Fee Schedule,100% of WA Medicaid,2888,100,,,percent of total billed charges,100% of total billed charges,564.18,103,,,Fee Schedule,103% of WA Medicaid,99.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,174.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,547.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1992.72,69,,,percent of total billed charges,69% of total billed charges,2888,100,,,percent of total billed charges,100% of total billed charges,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2888,100,,,percent of total billed charges,100% of total billed charges,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2888,100,,,percent of total billed charges,100% of total billed charges,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786.23,61.85,,,percent of total billed charges,61.85% of total billed charges,547.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,712.08,130,,,Fee Schedule,130% of WA Medicaid ,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1088.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1088.78,37.7,,,percent of total billed charges,37.70% of total billed charges,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,97903.2,33.9,,,percent of total billed charges,33.9% of total billed charges,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2252.64,78,,,percent of total billed charges,78% of total billed charges,2888,100,,,percent of total billed charges,100% of total billed charges,2385.49,82.6,,,percent of total billed charges,82.6% of total billed charges,2385.49,82.6,,,percent of total billed charges,82.6% of total billed charges,547.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.92,97903.2,
"27745 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR W",97527745,CDM,975,RC,27745,HCPCS,Outpatient,,,2677,1740.05,,2355.76,88,,,percent of total billed charges,88% of total Billed charges,75.06,100,,,Fee Schedule,100% of Medicare rate,430.82,100,,,Fee Schedule,100% of WA Medicaid,2677,100,,,percent of total billed charges,100% of total billed charges,443.74,103,,,Fee Schedule,103% of WA Medicaid,75.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,131.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,430.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1847.13,69,,,percent of total billed charges,69% of total billed charges,2677,100,,,percent of total billed charges,100% of total billed charges,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2677,100,,,percent of total billed charges,100% of total billed charges,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2677,100,,,percent of total billed charges,100% of total billed charges,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.72,61.85,,,percent of total billed charges,61.85% of total billed charges,430.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,560.07,130,,,Fee Schedule,130% of WA Medicaid ,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1009.23,37.7,,,percent of total billed charges,37.70% of total billed charges,1009.23,37.7,,,percent of total billed charges,37.70% of total billed charges,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,90750.3,33.9,,,percent of total billed charges,33.9% of total billed charges,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2088.06,78,,,percent of total billed charges,78% of total billed charges,2677,100,,,percent of total billed charges,100% of total billed charges,2211.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2211.2,82.6,,,percent of total billed charges,82.6% of total billed charges,430.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.06,90750.3,
27758 OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHO,97527758,CDM,975,RC,27758,HCPCS,Outpatient,,,3790,2463.50,,3335.2,88,,,percent of total billed charges,88% of total Billed charges,93.61,100,,,Fee Schedule,100% of Medicare rate,516.98,100,,,Fee Schedule,100% of WA Medicaid,3790,100,,,percent of total billed charges,100% of total billed charges,532.49,103,,,Fee Schedule,103% of WA Medicaid,93.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,163.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,516.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2615.1,69,,,percent of total billed charges,69% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,3790,100,,,percent of total billed charges,100% of total billed charges,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,3790,100,,,percent of total billed charges,100% of total billed charges,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2344.12,61.85,,,percent of total billed charges,61.85% of total billed charges,516.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,672.07,130,,,Fee Schedule,130% of WA Medicaid ,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,128481,33.9,,,percent of total billed charges,33.9% of total billed charges,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2956.2,78,,,percent of total billed charges,78% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,516.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,93.61,128481,
TREATMENT OF TIBIA FRACTURE,96027759,CDM,960,RC,27759,HCPCS,Outpatient,,,2402,1561.30,,2113.76,88,,,percent of total billed charges,88% of total Billed charges,106.39,100,,,Fee Schedule,100% of Medicare rate,572.18,100,,,Fee Schedule,100% of WA Medicaid,2402,100,,,percent of total billed charges,100% of total billed charges,589.35,103,,,Fee Schedule,103% of WA Medicaid,106.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,186.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,572.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1657.38,69,,,percent of total billed charges,69% of total billed charges,2402,100,,,percent of total billed charges,100% of total billed charges,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2402,100,,,percent of total billed charges,100% of total billed charges,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2402,100,,,percent of total billed charges,100% of total billed charges,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1485.64,61.85,,,percent of total billed charges,61.85% of total billed charges,572.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,572.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,743.83,130,,,Fee Schedule,130% of WA Medicaid ,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,905.55,37.7,,,percent of total billed charges,37.70% of total billed charges,905.55,37.7,,,percent of total billed charges,37.70% of total billed charges,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,81427.8,33.9,,,percent of total billed charges,33.9% of total billed charges,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1873.56,78,,,percent of total billed charges,78% of total billed charges,2402,100,,,percent of total billed charges,100% of total billed charges,1984.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1984.05,82.6,,,percent of total billed charges,82.6% of total billed charges,572.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,572.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.39,81427.8,
27762 CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITH MA,97527762,CDM,975,RC,27762,HCPCS,Outpatient,,,1228,798.20,,1080.64,88,,,percent of total billed charges,88% of total Billed charges,43.06,100,,,Fee Schedule,100% of Medicare rate,261.85,100,,,Fee Schedule,100% of WA Medicaid,1228,100,,,percent of total billed charges,100% of total billed charges,269.71,103,,,Fee Schedule,103% of WA Medicaid,43.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,261.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,847.32,69,,,percent of total billed charges,69% of total billed charges,1228,100,,,percent of total billed charges,100% of total billed charges,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1228,100,,,percent of total billed charges,100% of total billed charges,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1228,100,,,percent of total billed charges,100% of total billed charges,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,759.52,61.85,,,percent of total billed charges,61.85% of total billed charges,261.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,340.41,130,,,Fee Schedule,130% of WA Medicaid ,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,462.96,37.7,,,percent of total billed charges,37.70% of total billed charges,462.96,37.7,,,percent of total billed charges,37.70% of total billed charges,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,41629.2,33.9,,,percent of total billed charges,33.9% of total billed charges,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,957.84,78,,,percent of total billed charges,78% of total billed charges,1228,100,,,percent of total billed charges,100% of total billed charges,1014.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1014.33,82.6,,,percent of total billed charges,82.6% of total billed charges,261.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.06,41629.2,
OPTX MEDIAL ANKLE FX,96027766,CDM,960,RC,27766,HCPCS,Outpatient,,,1462,950.30,,1286.56,88,,,percent of total billed charges,88% of total Billed charges,57.17,100,,,Fee Schedule,100% of Medicare rate,352.67,100,,,Fee Schedule,100% of WA Medicaid,1462,100,,,percent of total billed charges,100% of total billed charges,363.25,103,,,Fee Schedule,103% of WA Medicaid,57.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,352.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1008.78,69,,,percent of total billed charges,69% of total billed charges,1462,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1462,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1462,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.25,61.85,,,percent of total billed charges,61.85% of total billed charges,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,458.47,130,,,Fee Schedule,130% of WA Medicaid ,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.17,37.7,,,percent of total billed charges,37.70% of total billed charges,551.17,37.7,,,percent of total billed charges,37.70% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,49561.8,33.9,,,percent of total billed charges,33.9% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1140.36,78,,,percent of total billed charges,78% of total billed charges,1462,100,,,percent of total billed charges,100% of total billed charges,1207.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1207.61,82.6,,,percent of total billed charges,82.6% of total billed charges,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.17,49561.8,
OPEN TREATMENT POST ANKLE FX,96027769,CDM,960,RC,27769,HCPCS,Outpatient,,,1760,1144.00,,1548.8,88,,,percent of total billed charges,88% of total Billed charges,73.46,100,,,Fee Schedule,100% of Medicare rate,420.18,100,,,Fee Schedule,100% of WA Medicaid,1760,100,,,percent of total billed charges,100% of total billed charges,432.79,103,,,Fee Schedule,103% of WA Medicaid,73.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,128.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,420.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1214.4,69,,,percent of total billed charges,69% of total billed charges,1760,100,,,percent of total billed charges,100% of total billed charges,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1760,100,,,percent of total billed charges,100% of total billed charges,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1760,100,,,percent of total billed charges,100% of total billed charges,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1088.56,61.85,,,percent of total billed charges,61.85% of total billed charges,420.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,546.23,130,,,Fee Schedule,130% of WA Medicaid ,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.52,37.7,,,percent of total billed charges,37.70% of total billed charges,663.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,59664,33.9,,,percent of total billed charges,33.9% of total billed charges,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1372.8,78,,,percent of total billed charges,78% of total billed charges,1760,100,,,percent of total billed charges,100% of total billed charges,1453.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1453.76,82.6,,,percent of total billed charges,82.6% of total billed charges,420.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.46,59664,
"27784 OPEN TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE, I",97527784,CDM,975,RC,27784,HCPCS,Outpatient,,,2291,1489.15,,2016.08,88,,,percent of total billed charges,88% of total Billed charges,70.87,100,,,Fee Schedule,100% of Medicare rate,415.34,100,,,Fee Schedule,100% of WA Medicaid,2291,100,,,percent of total billed charges,100% of total billed charges,427.8,103,,,Fee Schedule,103% of WA Medicaid,70.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,415.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1580.79,69,,,percent of total billed charges,69% of total billed charges,2291,100,,,percent of total billed charges,100% of total billed charges,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2291,100,,,percent of total billed charges,100% of total billed charges,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2291,100,,,percent of total billed charges,100% of total billed charges,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1416.98,61.85,,,percent of total billed charges,61.85% of total billed charges,415.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,539.94,130,,,Fee Schedule,130% of WA Medicaid ,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.71,37.7,,,percent of total billed charges,37.70% of total billed charges,863.71,37.7,,,percent of total billed charges,37.70% of total billed charges,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,77664.9,33.9,,,percent of total billed charges,33.9% of total billed charges,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786.98,78,,,percent of total billed charges,78% of total billed charges,2291,100,,,percent of total billed charges,100% of total billed charges,1892.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1892.37,82.6,,,percent of total billed charges,82.6% of total billed charges,415.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.87,77664.9,
OPEN TX DISTAL FIBULAR FX INCL,96027792,CDM,975,RC,27792,HCPCS,Outpatient,,,1198,778.70,,1054.24,88,,,percent of total billed charges,88% of total Billed charges,61.73,100,,,Fee Schedule,100% of Medicare rate,375.05,100,,,Fee Schedule,100% of WA Medicaid,1198,100,,,percent of total billed charges,100% of total billed charges,386.3,103,,,Fee Schedule,103% of WA Medicaid,61.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,375.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,826.62,69,,,percent of total billed charges,69% of total billed charges,1198,100,,,percent of total billed charges,100% of total billed charges,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198,100,,,percent of total billed charges,100% of total billed charges,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198,100,,,percent of total billed charges,100% of total billed charges,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,740.96,61.85,,,percent of total billed charges,61.85% of total billed charges,375.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,487.57,130,,,Fee Schedule,130% of WA Medicaid ,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.65,37.7,,,percent of total billed charges,37.70% of total billed charges,451.65,37.7,,,percent of total billed charges,37.70% of total billed charges,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,40612.2,33.9,,,percent of total billed charges,33.9% of total billed charges,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,934.44,78,,,percent of total billed charges,78% of total billed charges,1198,100,,,percent of total billed charges,100% of total billed charges,989.55,82.6,,,percent of total billed charges,82.6% of total billed charges,989.55,82.6,,,percent of total billed charges,82.6% of total billed charges,375.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.73,40612.2,
OPEN TRTM BIMALLEOLAR ANKLE FX,96027814,CDM,960,RC,27814,HCPCS,Outpatient,,,1914,1244.10,,1684.32,88,,,percent of total billed charges,88% of total Billed charges,76.17,100,,,Fee Schedule,100% of Medicare rate,442.19,100,,,Fee Schedule,100% of WA Medicaid,1914,100,,,percent of total billed charges,100% of total billed charges,455.46,103,,,Fee Schedule,103% of WA Medicaid,76.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,133.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,442.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1320.66,69,,,percent of total billed charges,69% of total billed charges,1914,100,,,percent of total billed charges,100% of total billed charges,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1914,100,,,percent of total billed charges,100% of total billed charges,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1914,100,,,percent of total billed charges,100% of total billed charges,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1183.81,61.85,,,percent of total billed charges,61.85% of total billed charges,442.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,574.85,130,,,Fee Schedule,130% of WA Medicaid ,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,721.58,37.7,,,percent of total billed charges,37.70% of total billed charges,721.58,37.7,,,percent of total billed charges,37.70% of total billed charges,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,64884.6,33.9,,,percent of total billed charges,33.9% of total billed charges,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1492.92,78,,,percent of total billed charges,78% of total billed charges,1914,100,,,percent of total billed charges,100% of total billed charges,1580.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1580.96,82.6,,,percent of total billed charges,82.6% of total billed charges,442.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.17,64884.6,
OPEN TREAT TRIMALLEOLAR ANKFRC,96027822,CDM,960,RC,27822,HCPCS,Outpatient,,,2014,1309.10,,1772.32,88,,,percent of total billed charges,88% of total Billed charges,82.15,100,,,Fee Schedule,100% of Medicare rate,507.09,100,,,Fee Schedule,100% of WA Medicaid,2014,100,,,percent of total billed charges,100% of total billed charges,522.3,103,,,Fee Schedule,103% of WA Medicaid,82.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,143.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,507.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1389.66,69,,,percent of total billed charges,69% of total billed charges,2014,100,,,percent of total billed charges,100% of total billed charges,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2014,100,,,percent of total billed charges,100% of total billed charges,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2014,100,,,percent of total billed charges,100% of total billed charges,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1245.66,61.85,,,percent of total billed charges,61.85% of total billed charges,507.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,659.22,130,,,Fee Schedule,130% of WA Medicaid ,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,759.28,37.7,,,percent of total billed charges,37.70% of total billed charges,759.28,37.7,,,percent of total billed charges,37.70% of total billed charges,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,68274.6,33.9,,,percent of total billed charges,33.9% of total billed charges,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1570.92,78,,,percent of total billed charges,78% of total billed charges,2014,100,,,percent of total billed charges,100% of total billed charges,1663.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1663.56,82.6,,,percent of total billed charges,82.6% of total billed charges,507.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.15,68274.6,
OPEN TRT TRIMALLEOLAR ANKLE FX,96027823,CDM,960,RC,27823,HCPCS,Outpatient,,,2393,1555.45,,2105.84,88,,,percent of total billed charges,88% of total Billed charges,95.82,100,,,Fee Schedule,100% of Medicare rate,569.57,100,,,Fee Schedule,100% of WA Medicaid,2393,100,,,percent of total billed charges,100% of total billed charges,586.66,103,,,Fee Schedule,103% of WA Medicaid,95.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,167.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,569.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1651.17,69,,,percent of total billed charges,69% of total billed charges,2393,100,,,percent of total billed charges,100% of total billed charges,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2393,100,,,percent of total billed charges,100% of total billed charges,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2393,100,,,percent of total billed charges,100% of total billed charges,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1480.07,61.85,,,percent of total billed charges,61.85% of total billed charges,569.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,569.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,580.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,740.44,130,,,Fee Schedule,130% of WA Medicaid ,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.16,37.7,,,percent of total billed charges,37.70% of total billed charges,902.16,37.7,,,percent of total billed charges,37.70% of total billed charges,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,81122.7,33.9,,,percent of total billed charges,33.9% of total billed charges,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1866.54,78,,,percent of total billed charges,78% of total billed charges,2393,100,,,percent of total billed charges,100% of total billed charges,1976.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1976.62,82.6,,,percent of total billed charges,82.6% of total billed charges,569.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,569.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.82,81122.7,
OPEN TRT DISTAL TIBIOFIB JTDIS,96027829,CDM,960,RC,27829,HCPCS,Outpatient,,,1724,1120.60,,1517.12,88,,,percent of total billed charges,88% of total Billed charges,64.18,100,,,Fee Schedule,100% of Medicare rate,412.17,100,,,Fee Schedule,100% of WA Medicaid,1724,100,,,percent of total billed charges,100% of total billed charges,424.54,103,,,Fee Schedule,103% of WA Medicaid,64.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,412.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1189.56,69,,,percent of total billed charges,69% of total billed charges,1724,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1724,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1724,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1066.29,61.85,,,percent of total billed charges,61.85% of total billed charges,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,535.82,130,,,Fee Schedule,130% of WA Medicaid ,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,649.95,37.7,,,percent of total billed charges,37.70% of total billed charges,649.95,37.7,,,percent of total billed charges,37.70% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,58443.6,33.9,,,percent of total billed charges,33.9% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1344.72,78,,,percent of total billed charges,78% of total billed charges,1724,100,,,percent of total billed charges,100% of total billed charges,1424.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1424.02,82.6,,,percent of total billed charges,82.6% of total billed charges,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.18,58443.6,
AMPUTATE LEG THROUGH TIB  FIB,96027880,CDM,960,RC,27880,HCPCS,Outpatient,,,1707,1109.55,,1502.16,88,,,percent of total billed charges,88% of total Billed charges,121.43,100,,,Fee Schedule,100% of Medicare rate,500.94,100,,,Fee Schedule,100% of WA Medicaid,1707,100,,,percent of total billed charges,100% of total billed charges,515.97,103,,,Fee Schedule,103% of WA Medicaid,121.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,212.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,500.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1177.83,69,,,percent of total billed charges,69% of total billed charges,1707,100,,,percent of total billed charges,100% of total billed charges,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1707,100,,,percent of total billed charges,100% of total billed charges,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1707,100,,,percent of total billed charges,100% of total billed charges,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1055.78,61.85,,,percent of total billed charges,61.85% of total billed charges,500.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,651.22,130,,,Fee Schedule,130% of WA Medicaid ,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,643.54,37.7,,,percent of total billed charges,37.70% of total billed charges,643.54,37.7,,,percent of total billed charges,37.70% of total billed charges,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,57867.3,33.9,,,percent of total billed charges,33.9% of total billed charges,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1331.46,78,,,percent of total billed charges,78% of total billed charges,1707,100,,,percent of total billed charges,100% of total billed charges,1409.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1409.98,82.6,,,percent of total billed charges,82.6% of total billed charges,500.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.43,57867.3,
"Amputation, leg, through tibia and fibula; with immediate fi",97527881,CDM,975,RC,27881,HCPCS,Outpatient,,,2241,1456.65,,1972.08,88,,,percent of total billed charges,88% of total Billed charges,105.67,100,,,Fee Schedule,100% of Medicare rate,473.52,100,,,Fee Schedule,100% of WA Medicaid,2241,100,,,percent of total billed charges,100% of total billed charges,487.73,103,,,Fee Schedule,103% of WA Medicaid,105.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,184.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,473.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1546.29,69,,,percent of total billed charges,69% of total billed charges,2241,100,,,percent of total billed charges,100% of total billed charges,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2241,100,,,percent of total billed charges,100% of total billed charges,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2241,100,,,percent of total billed charges,100% of total billed charges,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1386.06,61.85,,,percent of total billed charges,61.85% of total billed charges,473.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,615.58,130,,,Fee Schedule,130% of WA Medicaid ,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,844.86,37.7,,,percent of total billed charges,37.70% of total billed charges,844.86,37.7,,,percent of total billed charges,37.70% of total billed charges,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,75969.9,33.9,,,percent of total billed charges,33.9% of total billed charges,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1747.98,78,,,percent of total billed charges,78% of total billed charges,2241,100,,,percent of total billed charges,100% of total billed charges,1851.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1851.07,82.6,,,percent of total billed charges,82.6% of total billed charges,473.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105.67,75969.9,
AMPUTATION OF LOWER LEG,97527882,CDM,975,RC,27882,HCPCS,Outpatient,,,1705,1108.25,,1500.4,88,,,percent of total billed charges,88% of total Billed charges,78.96,100,,,Fee Schedule,100% of Medicare rate,330.85,100,,,Fee Schedule,100% of WA Medicaid,1705,100,,,percent of total billed charges,100% of total billed charges,340.78,103,,,Fee Schedule,103% of WA Medicaid,78.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,330.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1176.45,69,,,percent of total billed charges,69% of total billed charges,1705,100,,,percent of total billed charges,100% of total billed charges,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1705,100,,,percent of total billed charges,100% of total billed charges,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1705,100,,,percent of total billed charges,100% of total billed charges,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1054.54,61.85,,,percent of total billed charges,61.85% of total billed charges,330.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,430.11,130,,,Fee Schedule,130% of WA Medicaid ,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.79,37.7,,,percent of total billed charges,37.70% of total billed charges,642.79,37.7,,,percent of total billed charges,37.70% of total billed charges,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,57799.5,33.9,,,percent of total billed charges,33.9% of total billed charges,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329.9,78,,,percent of total billed charges,78% of total billed charges,1705,100,,,percent of total billed charges,100% of total billed charges,1408.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1408.33,82.6,,,percent of total billed charges,82.6% of total billed charges,330.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.96,57799.5,
"27886 AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; RE-AMPUTATI",97527886,CDM,975,RC,27886,HCPCS,Outpatient,,,4224,2745.60,,3717.12,88,,,percent of total billed charges,88% of total Billed charges,79.78,100,,,Fee Schedule,100% of Medicare rate,366.47,100,,,Fee Schedule,100% of WA Medicaid,4224,100,,,percent of total billed charges,100% of total billed charges,377.46,103,,,Fee Schedule,103% of WA Medicaid,79.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,139.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,366.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2914.56,69,,,percent of total billed charges,69% of total billed charges,4224,100,,,percent of total billed charges,100% of total billed charges,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,4224,100,,,percent of total billed charges,100% of total billed charges,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,4224,100,,,percent of total billed charges,100% of total billed charges,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2612.54,61.85,,,percent of total billed charges,61.85% of total billed charges,366.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,476.41,130,,,Fee Schedule,130% of WA Medicaid ,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1592.45,37.7,,,percent of total billed charges,37.70% of total billed charges,1592.45,37.7,,,percent of total billed charges,37.70% of total billed charges,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,143193.6,33.9,,,percent of total billed charges,33.9% of total billed charges,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,3294.72,78,,,percent of total billed charges,78% of total billed charges,4224,100,,,percent of total billed charges,100% of total billed charges,3489.02,82.6,,,percent of total billed charges,82.6% of total billed charges,3489.02,82.6,,,percent of total billed charges,82.6% of total billed charges,366.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.78,143193.6,
"27899 UNLISTED PROCEDURE, LEG OR ANKLE ProFee",97527899,CDM,975,RC,27899,HCPCS,Outpatient,,,2329,1513.85,,2049.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2329,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1607.01,69,,,percent of total billed charges,69% of total billed charges,2329,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2329,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2329,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1440.49,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,878.03,37.7,,,percent of total billed charges,37.70% of total billed charges,878.03,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,78953.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1816.62,78,,,percent of total billed charges,78% of total billed charges,2329,100,,,percent of total billed charges,100% of total billed charges,1923.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1923.75,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",878.03,78953.1,
TREATMENT OF FOOT INFECTION,96028002,CDM,960,RC,28002,HCPCS,Outpatient,,,1075,698.75,,946,88,,,percent of total billed charges,88% of total Billed charges,10.69,100,,,Fee Schedule,100% of Medicare rate,79.45,100,,,Fee Schedule,100% of WA Medicaid,1075,100,,,percent of total billed charges,100% of total billed charges,81.83,103,,,Fee Schedule,103% of WA Medicaid,10.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,741.75,69,,,percent of total billed charges,69% of total billed charges,1075,100,,,percent of total billed charges,100% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1075,100,,,percent of total billed charges,100% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1075,100,,,percent of total billed charges,100% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.89,61.85,,,percent of total billed charges,61.85% of total billed charges,79.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.29,130,,,Fee Schedule,130% of WA Medicaid ,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.28,37.7,,,percent of total billed charges,37.70% of total billed charges,405.28,37.7,,,percent of total billed charges,37.70% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,36442.5,33.9,,,percent of total billed charges,33.9% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,838.5,78,,,percent of total billed charges,78% of total billed charges,1075,100,,,percent of total billed charges,100% of total billed charges,887.95,82.6,,,percent of total billed charges,82.6% of total billed charges,887.95,82.6,,,percent of total billed charges,82.6% of total billed charges,79.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.69,36442.5,
ID BELOW FASCIA W W/O TENDSHE,96028003,CDM,960,RC,28003,HCPCS,Outpatient,,,1852,1203.80,,1629.76,88,,,percent of total billed charges,88% of total Billed charges,22.49,100,,,Fee Schedule,100% of Medicare rate,145.47,100,,,Fee Schedule,100% of WA Medicaid,1852,100,,,percent of total billed charges,100% of total billed charges,149.83,103,,,Fee Schedule,103% of WA Medicaid,22.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,145.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1277.88,69,,,percent of total billed charges,69% of total billed charges,1852,100,,,percent of total billed charges,100% of total billed charges,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1852,100,,,percent of total billed charges,100% of total billed charges,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1852,100,,,percent of total billed charges,100% of total billed charges,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1145.46,61.85,,,percent of total billed charges,61.85% of total billed charges,145.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,189.11,130,,,Fee Schedule,130% of WA Medicaid ,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.2,37.7,,,percent of total billed charges,37.70% of total billed charges,698.2,37.7,,,percent of total billed charges,37.70% of total billed charges,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,62782.8,33.9,,,percent of total billed charges,33.9% of total billed charges,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1444.56,78,,,percent of total billed charges,78% of total billed charges,1852,100,,,percent of total billed charges,100% of total billed charges,1529.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1529.75,82.6,,,percent of total billed charges,82.6% of total billed charges,145.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.49,62782.8,
"28008 FASCIOTOMY, FOOT AND/OR TOE ProFee",97528008,CDM,975,RC,28008,HCPCS,Outpatient,,,1302,846.30,,1145.76,88,,,percent of total billed charges,88% of total Billed charges,19.65,100,,,Fee Schedule,100% of Medicare rate,171.39,100,,,Fee Schedule,100% of WA Medicaid,1302,100,,,percent of total billed charges,100% of total billed charges,176.53,103,,,Fee Schedule,103% of WA Medicaid,19.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,171.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,898.38,69,,,percent of total billed charges,69% of total billed charges,1302,100,,,percent of total billed charges,100% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1302,100,,,percent of total billed charges,100% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1302,100,,,percent of total billed charges,100% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,805.29,61.85,,,percent of total billed charges,61.85% of total billed charges,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,222.81,130,,,Fee Schedule,130% of WA Medicaid ,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.85,37.7,,,percent of total billed charges,37.70% of total billed charges,490.85,37.7,,,percent of total billed charges,37.70% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,44137.8,33.9,,,percent of total billed charges,33.9% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1015.56,78,,,percent of total billed charges,78% of total billed charges,1302,100,,,percent of total billed charges,100% of total billed charges,1075.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1075.45,82.6,,,percent of total billed charges,82.6% of total billed charges,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.65,44137.8,
"28035 RELEASE, TARSAL TUNNEL (POSTERIOR TIBIAL NERVE DECOMPR",97528035,CDM,975,RC,28035,HCPCS,Outpatient,,,1254,815.10,,1103.52,88,,,percent of total billed charges,88% of total Billed charges,27.57,100,,,Fee Schedule,100% of Medicare rate,208.69,100,,,Fee Schedule,100% of WA Medicaid,1254,100,,,percent of total billed charges,100% of total billed charges,214.95,103,,,Fee Schedule,103% of WA Medicaid,27.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,208.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,865.26,69,,,percent of total billed charges,69% of total billed charges,1254,100,,,percent of total billed charges,100% of total billed charges,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1254,100,,,percent of total billed charges,100% of total billed charges,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1254,100,,,percent of total billed charges,100% of total billed charges,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,775.6,61.85,,,percent of total billed charges,61.85% of total billed charges,208.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,271.3,130,,,Fee Schedule,130% of WA Medicaid ,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,472.76,37.7,,,percent of total billed charges,37.70% of total billed charges,472.76,37.7,,,percent of total billed charges,37.70% of total billed charges,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,42510.6,33.9,,,percent of total billed charges,33.9% of total billed charges,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,978.12,78,,,percent of total billed charges,78% of total billed charges,1254,100,,,percent of total billed charges,100% of total billed charges,1035.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1035.8,82.6,,,percent of total billed charges,82.6% of total billed charges,208.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.57,42510.6,
"28039 EXCISION, TUMOR, SOFT TISSUE OF FOOT OR TOE, SUBCUTANE",97528039,CDM,975,RC,28039,HCPCS,Outpatient,,,1120,728.00,,985.6,88,,,percent of total billed charges,88% of total Billed charges,26.13,100,,,Fee Schedule,100% of Medicare rate,195.83,100,,,Fee Schedule,100% of WA Medicaid,1120,100,,,percent of total billed charges,100% of total billed charges,201.7,103,,,Fee Schedule,103% of WA Medicaid,26.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,195.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,772.8,69,,,percent of total billed charges,69% of total billed charges,1120,100,,,percent of total billed charges,100% of total billed charges,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1120,100,,,percent of total billed charges,100% of total billed charges,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1120,100,,,percent of total billed charges,100% of total billed charges,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.72,61.85,,,percent of total billed charges,61.85% of total billed charges,195.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,254.58,130,,,Fee Schedule,130% of WA Medicaid ,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.24,37.7,,,percent of total billed charges,37.70% of total billed charges,422.24,37.7,,,percent of total billed charges,37.70% of total billed charges,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,37968,33.9,,,percent of total billed charges,33.9% of total billed charges,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,873.6,78,,,percent of total billed charges,78% of total billed charges,1120,100,,,percent of total billed charges,100% of total billed charges,925.12,82.6,,,percent of total billed charges,82.6% of total billed charges,925.12,82.6,,,percent of total billed charges,82.6% of total billed charges,195.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.13,37968,
"EX TUMOR SOFT TIS FT/TOE, SUBFASC. DEP 1.5CM/>",28041,CDM,975,RC,28041,HCPCS,Outpatient,,,982,638.30,,864.16,88,,,percent of total billed charges,88% of total Billed charges,35.78,100,,,Fee Schedule,100% of Medicare rate,260.73,100,,,Fee Schedule,100% of WA Medicaid,982,100,,,percent of total billed charges,100% of total billed charges,268.55,103,,,Fee Schedule,103% of WA Medicaid,35.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,62.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,260.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,677.58,69,,,percent of total billed charges,69% of total billed charges,982,100,,,percent of total billed charges,100% of total billed charges,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,982,100,,,percent of total billed charges,100% of total billed charges,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,982,100,,,percent of total billed charges,100% of total billed charges,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,607.37,61.85,,,percent of total billed charges,61.85% of total billed charges,260.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,338.95,130,,,Fee Schedule,130% of WA Medicaid ,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.21,37.7,,,percent of total billed charges,37.70% of total billed charges,370.21,37.7,,,percent of total billed charges,37.70% of total billed charges,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,33289.8,33.9,,,percent of total billed charges,33.9% of total billed charges,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.96,78,,,percent of total billed charges,78% of total billed charges,982,100,,,percent of total billed charges,100% of total billed charges,811.13,82.6,,,percent of total billed charges,82.6% of total billed charges,811.13,82.6,,,percent of total billed charges,82.6% of total billed charges,260.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.78,33289.8,
"28043 EXCISION, TUMOR, SOFT TISSUE OF FOOT OR TOE, SUBCUTANE",97528043,CDM,975,RC,28043,HCPCS,Outpatient,,,937,609.05,,824.56,88,,,percent of total billed charges,88% of total Billed charges,18.11,100,,,Fee Schedule,100% of Medicare rate,152.18,100,,,Fee Schedule,100% of WA Medicaid,937,100,,,percent of total billed charges,100% of total billed charges,156.75,103,,,Fee Schedule,103% of WA Medicaid,18.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,152.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,646.53,69,,,percent of total billed charges,69% of total billed charges,937,100,,,percent of total billed charges,100% of total billed charges,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,937,100,,,percent of total billed charges,100% of total billed charges,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,937,100,,,percent of total billed charges,100% of total billed charges,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,579.53,61.85,,,percent of total billed charges,61.85% of total billed charges,152.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,197.83,130,,,Fee Schedule,130% of WA Medicaid ,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.25,37.7,,,percent of total billed charges,37.70% of total billed charges,353.25,37.7,,,percent of total billed charges,37.70% of total billed charges,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,31764.3,33.9,,,percent of total billed charges,33.9% of total billed charges,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.86,78,,,percent of total billed charges,78% of total billed charges,937,100,,,percent of total billed charges,100% of total billed charges,773.96,82.6,,,percent of total billed charges,82.6% of total billed charges,773.96,82.6,,,percent of total billed charges,82.6% of total billed charges,152.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.11,31764.3,
"28045 EXCISION, TUMOR, SOFT TISSUE OF FOOT OR TOE",97528045,CDM,975,RC,28045,HCPCS,Outpatient,,,1175,763.75,,1034,88,,,percent of total billed charges,88% of total Billed charges,24.1,100,,,Fee Schedule,100% of Medicare rate,201.61,100,,,Fee Schedule,100% of WA Medicaid,1175,100,,,percent of total billed charges,100% of total billed charges,207.66,103,,,Fee Schedule,103% of WA Medicaid,24.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,201.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,810.75,69,,,percent of total billed charges,69% of total billed charges,1175,100,,,percent of total billed charges,100% of total billed charges,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1175,100,,,percent of total billed charges,100% of total billed charges,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1175,100,,,percent of total billed charges,100% of total billed charges,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.74,61.85,,,percent of total billed charges,61.85% of total billed charges,201.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,262.09,130,,,Fee Schedule,130% of WA Medicaid ,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.98,37.7,,,percent of total billed charges,37.70% of total billed charges,442.98,37.7,,,percent of total billed charges,37.70% of total billed charges,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,39832.5,33.9,,,percent of total billed charges,33.9% of total billed charges,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.5,78,,,percent of total billed charges,78% of total billed charges,1175,100,,,percent of total billed charges,100% of total billed charges,970.55,82.6,,,percent of total billed charges,82.6% of total billed charges,970.55,82.6,,,percent of total billed charges,82.6% of total billed charges,201.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.1,39832.5,
28054 ARTHROTOMY WITH BIOPSY; INTERPHALANGEAL JOINT ProFee,28054,CDM,975,RC,28054,HCPCS,Outpatient,,,7231,4700.15,,6363.28,88,,,percent of total billed charges,88% of total Billed charges,14.19,100,,,Fee Schedule,100% of Medicare rate,136.7,100,,,Fee Schedule,100% of WA Medicaid,7231,100,,,percent of total billed charges,100% of total billed charges,140.8,103,,,Fee Schedule,103% of WA Medicaid,14.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,136.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4989.39,69,,,percent of total billed charges,69% of total billed charges,7231,100,,,percent of total billed charges,100% of total billed charges,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,7231,100,,,percent of total billed charges,100% of total billed charges,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,7231,100,,,percent of total billed charges,100% of total billed charges,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,4472.37,61.85,,,percent of total billed charges,61.85% of total billed charges,136.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,177.71,130,,,Fee Schedule,130% of WA Medicaid ,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2726.09,37.7,,,percent of total billed charges,37.70% of total billed charges,2726.09,37.7,,,percent of total billed charges,37.70% of total billed charges,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,245130.9,33.9,,,percent of total billed charges,33.9% of total billed charges,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,5640.18,78,,,percent of total billed charges,78% of total billed charges,7231,100,,,percent of total billed charges,100% of total billed charges,5972.81,82.6,,,percent of total billed charges,82.6% of total billed charges,5972.81,82.6,,,percent of total billed charges,82.6% of total billed charges,136.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.19,245130.9,
"28060 FASCIECTOMY, PLANTAR FASCIA; PARTIAL (SEPARA",97528060,CDM,975,RC,28060,HCPCS,Outpatient,,,1175,763.75,,1034,88,,,percent of total billed charges,88% of total Billed charges,26.08,100,,,Fee Schedule,100% of Medicare rate,209.81,100,,,Fee Schedule,100% of WA Medicaid,1175,100,,,percent of total billed charges,100% of total billed charges,216.1,103,,,Fee Schedule,103% of WA Medicaid,26.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,209.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,810.75,69,,,percent of total billed charges,69% of total billed charges,1175,100,,,percent of total billed charges,100% of total billed charges,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1175,100,,,percent of total billed charges,100% of total billed charges,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1175,100,,,percent of total billed charges,100% of total billed charges,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.74,61.85,,,percent of total billed charges,61.85% of total billed charges,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,272.75,130,,,Fee Schedule,130% of WA Medicaid ,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.98,37.7,,,percent of total billed charges,37.70% of total billed charges,442.98,37.7,,,percent of total billed charges,37.70% of total billed charges,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,39832.5,33.9,,,percent of total billed charges,33.9% of total billed charges,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.5,78,,,percent of total billed charges,78% of total billed charges,1175,100,,,percent of total billed charges,100% of total billed charges,970.55,82.6,,,percent of total billed charges,82.6% of total billed charges,970.55,82.6,,,percent of total billed charges,82.6% of total billed charges,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.08,39832.5,
"28080 EXCISION, INTERDIGITAL (MORTON) NEUROMA, SINGLE, EACH",97528080,CDM,975,RC,28080,HCPCS,Outpatient,,,1341,871.65,,1180.08,88,,,percent of total billed charges,88% of total Billed charges,24.89,100,,,Fee Schedule,100% of Medicare rate,222.31,100,,,Fee Schedule,100% of WA Medicaid,1341,100,,,percent of total billed charges,100% of total billed charges,228.98,103,,,Fee Schedule,103% of WA Medicaid,24.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,222.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,925.29,69,,,percent of total billed charges,69% of total billed charges,1341,100,,,percent of total billed charges,100% of total billed charges,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1341,100,,,percent of total billed charges,100% of total billed charges,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1341,100,,,percent of total billed charges,100% of total billed charges,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.41,61.85,,,percent of total billed charges,61.85% of total billed charges,222.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,289,130,,,Fee Schedule,130% of WA Medicaid ,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.56,37.7,,,percent of total billed charges,37.70% of total billed charges,505.56,37.7,,,percent of total billed charges,37.70% of total billed charges,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,45459.9,33.9,,,percent of total billed charges,33.9% of total billed charges,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045.98,78,,,percent of total billed charges,78% of total billed charges,1341,100,,,percent of total billed charges,100% of total billed charges,1107.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1107.67,82.6,,,percent of total billed charges,82.6% of total billed charges,222.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.89,45459.9,
"28092 EXCISION OF LESION, TENDON, TENDON SHEATH, O",97528092,CDM,975,RC,28092,HCPCS,Outpatient,,,559,363.35,,491.92,88,,,percent of total billed charges,88% of total Billed charges,18.51,100,,,Fee Schedule,100% of Medicare rate,159.83,100,,,Fee Schedule,100% of WA Medicaid,559,100,,,percent of total billed charges,100% of total billed charges,164.62,103,,,Fee Schedule,103% of WA Medicaid,18.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,159.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,385.71,69,,,percent of total billed charges,69% of total billed charges,559,100,,,percent of total billed charges,100% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,559,100,,,percent of total billed charges,100% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,559,100,,,percent of total billed charges,100% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.74,61.85,,,percent of total billed charges,61.85% of total billed charges,159.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,207.78,130,,,Fee Schedule,130% of WA Medicaid ,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.74,37.7,,,percent of total billed charges,37.70% of total billed charges,210.74,37.7,,,percent of total billed charges,37.70% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18950.1,33.9,,,percent of total billed charges,33.9% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.02,78,,,percent of total billed charges,78% of total billed charges,559,100,,,percent of total billed charges,100% of total billed charges,461.73,82.6,,,percent of total billed charges,82.6% of total billed charges,461.73,82.6,,,percent of total billed charges,82.6% of total billed charges,159.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.51,18950.1,
OSTECTOMY PART EXCI 5TH METATARSAL HEAD,97528110,CDM,975,RC,28110,HCPCS,Outpatient,,,601,390.65,,528.88,88,,,percent of total billed charges,88% of total Billed charges,20.43,100,,,Fee Schedule,100% of Medicare rate,171.58,100,,,Fee Schedule,100% of WA Medicaid,601,100,,,percent of total billed charges,100% of total billed charges,176.73,103,,,Fee Schedule,103% of WA Medicaid,20.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,171.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,414.69,69,,,percent of total billed charges,69% of total billed charges,601,100,,,percent of total billed charges,100% of total billed charges,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,601,100,,,percent of total billed charges,100% of total billed charges,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,601,100,,,percent of total billed charges,100% of total billed charges,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.72,61.85,,,percent of total billed charges,61.85% of total billed charges,171.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,223.05,130,,,Fee Schedule,130% of WA Medicaid ,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.58,37.7,,,percent of total billed charges,37.70% of total billed charges,226.58,37.7,,,percent of total billed charges,37.70% of total billed charges,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,20373.9,33.9,,,percent of total billed charges,33.9% of total billed charges,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.78,78,,,percent of total billed charges,78% of total billed charges,601,100,,,percent of total billed charges,100% of total billed charges,496.43,82.6,,,percent of total billed charges,82.6% of total billed charges,496.43,82.6,,,percent of total billed charges,82.6% of total billed charges,171.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.43,20373.9,
"28112 OSTECTOMY, COMPLETE EXCISION; OTHER METATARSAL HEAD (S",97528112,CDM,975,RC,28112,HCPCS,Outpatient,,,1506,978.90,,1325.28,88,,,percent of total billed charges,88% of total Billed charges,22.56,100,,,Fee Schedule,100% of Medicare rate,182.4,100,,,Fee Schedule,100% of WA Medicaid,1506,100,,,percent of total billed charges,100% of total billed charges,187.87,103,,,Fee Schedule,103% of WA Medicaid,22.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,182.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1039.14,69,,,percent of total billed charges,69% of total billed charges,1506,100,,,percent of total billed charges,100% of total billed charges,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1506,100,,,percent of total billed charges,100% of total billed charges,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1506,100,,,percent of total billed charges,100% of total billed charges,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.46,61.85,,,percent of total billed charges,61.85% of total billed charges,182.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,237.12,130,,,Fee Schedule,130% of WA Medicaid ,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.76,37.7,,,percent of total billed charges,37.70% of total billed charges,567.76,37.7,,,percent of total billed charges,37.70% of total billed charges,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,51053.4,33.9,,,percent of total billed charges,33.9% of total billed charges,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1174.68,78,,,percent of total billed charges,78% of total billed charges,1506,100,,,percent of total billed charges,100% of total billed charges,1243.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1243.96,82.6,,,percent of total billed charges,82.6% of total billed charges,182.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.56,51053.4,
"28113 OSTECTOMY, COMPLETE EXCISION; FIFTH METATARSAL HEAD Pr",97528113,CDM,975,RC,28113,HCPCS,Outpatient,,,1505,978.25,,1324.4,88,,,percent of total billed charges,88% of total Billed charges,28.4,100,,,Fee Schedule,100% of Medicare rate,249.35,100,,,Fee Schedule,100% of WA Medicaid,1505,100,,,percent of total billed charges,100% of total billed charges,256.83,103,,,Fee Schedule,103% of WA Medicaid,28.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,249.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1038.45,69,,,percent of total billed charges,69% of total billed charges,1505,100,,,percent of total billed charges,100% of total billed charges,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1505,100,,,percent of total billed charges,100% of total billed charges,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1505,100,,,percent of total billed charges,100% of total billed charges,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,930.84,61.85,,,percent of total billed charges,61.85% of total billed charges,249.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,324.16,130,,,Fee Schedule,130% of WA Medicaid ,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.39,37.7,,,percent of total billed charges,37.70% of total billed charges,567.39,37.7,,,percent of total billed charges,37.70% of total billed charges,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,51019.5,33.9,,,percent of total billed charges,33.9% of total billed charges,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1173.9,78,,,percent of total billed charges,78% of total billed charges,1505,100,,,percent of total billed charges,100% of total billed charges,1243.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1243.13,82.6,,,percent of total billed charges,82.6% of total billed charges,249.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.4,51019.5,
"28114 OSTECTOMY, COMPLETE EXCISION; ALL METATARSAL HEADS, WI",97528114,CDM,975,RC,28114,HCPCS,Outpatient,,,3732,2425.80,,3284.16,88,,,percent of total billed charges,88% of total Billed charges,67.8,100,,,Fee Schedule,100% of Medicare rate,485.46,100,,,Fee Schedule,100% of WA Medicaid,3732,100,,,percent of total billed charges,100% of total billed charges,500.02,103,,,Fee Schedule,103% of WA Medicaid,67.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,118.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,485.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2575.08,69,,,percent of total billed charges,69% of total billed charges,3732,100,,,percent of total billed charges,100% of total billed charges,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3732,100,,,percent of total billed charges,100% of total billed charges,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3732,100,,,percent of total billed charges,100% of total billed charges,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2308.24,61.85,,,percent of total billed charges,61.85% of total billed charges,485.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,631.1,130,,,Fee Schedule,130% of WA Medicaid ,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1406.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1406.96,37.7,,,percent of total billed charges,37.70% of total billed charges,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,126514.8,33.9,,,percent of total billed charges,33.9% of total billed charges,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2910.96,78,,,percent of total billed charges,78% of total billed charges,3732,100,,,percent of total billed charges,100% of total billed charges,3082.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3082.63,82.6,,,percent of total billed charges,82.6% of total billed charges,485.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.8,126514.8,
OSTECTOMY CALCANEUS,28118,CDM,975,RC,28118,HCPCS,Outpatient,,,892,579.80,,784.96,88,,,percent of total billed charges,88% of total Billed charges,34.2,100,,,Fee Schedule,100% of Medicare rate,245.81,100,,,Fee Schedule,100% of WA Medicaid,892,100,,,percent of total billed charges,100% of total billed charges,253.18,103,,,Fee Schedule,103% of WA Medicaid,34.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,245.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,615.48,69,,,percent of total billed charges,69% of total billed charges,892,100,,,percent of total billed charges,100% of total billed charges,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,892,100,,,percent of total billed charges,100% of total billed charges,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,892,100,,,percent of total billed charges,100% of total billed charges,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.7,61.85,,,percent of total billed charges,61.85% of total billed charges,245.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,319.55,130,,,Fee Schedule,130% of WA Medicaid ,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.28,37.7,,,percent of total billed charges,37.70% of total billed charges,336.28,37.7,,,percent of total billed charges,37.70% of total billed charges,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,30238.8,33.9,,,percent of total billed charges,33.9% of total billed charges,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,695.76,78,,,percent of total billed charges,78% of total billed charges,892,100,,,percent of total billed charges,100% of total billed charges,736.79,82.6,,,percent of total billed charges,82.6% of total billed charges,736.79,82.6,,,percent of total billed charges,82.6% of total billed charges,245.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.2,30238.8,
"28119 OSTECTOMY, CALCANEUS; FOR SPUR, WITH OR WITHOUT PLANTA",97528119,CDM,975,RC,28119,HCPCS,Outpatient,,,1810,1176.50,,1592.8,88,,,percent of total billed charges,88% of total Billed charges,25.95,100,,,Fee Schedule,100% of Medicare rate,212.24,100,,,Fee Schedule,100% of WA Medicaid,1810,100,,,percent of total billed charges,100% of total billed charges,218.61,103,,,Fee Schedule,103% of WA Medicaid,25.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,212.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1248.9,69,,,percent of total billed charges,69% of total billed charges,1810,100,,,percent of total billed charges,100% of total billed charges,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1810,100,,,percent of total billed charges,100% of total billed charges,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1810,100,,,percent of total billed charges,100% of total billed charges,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1119.49,61.85,,,percent of total billed charges,61.85% of total billed charges,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,275.91,130,,,Fee Schedule,130% of WA Medicaid ,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.37,37.7,,,percent of total billed charges,37.70% of total billed charges,682.37,37.7,,,percent of total billed charges,37.70% of total billed charges,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,61359,33.9,,,percent of total billed charges,33.9% of total billed charges,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1411.8,78,,,percent of total billed charges,78% of total billed charges,1810,100,,,percent of total billed charges,100% of total billed charges,1495.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1495.06,82.6,,,percent of total billed charges,82.6% of total billed charges,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.95,61359,
"28120 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUES",97528120,CDM,975,RC,28120,HCPCS,Outpatient,,,1999,1299.35,,1759.12,88,,,percent of total billed charges,88% of total Billed charges,40.03,100,,,Fee Schedule,100% of Medicare rate,287.58,100,,,Fee Schedule,100% of WA Medicaid,1999,100,,,percent of total billed charges,100% of total billed charges,296.21,103,,,Fee Schedule,103% of WA Medicaid,40.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,287.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1379.31,69,,,percent of total billed charges,69% of total billed charges,1999,100,,,percent of total billed charges,100% of total billed charges,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1999,100,,,percent of total billed charges,100% of total billed charges,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1999,100,,,percent of total billed charges,100% of total billed charges,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1236.38,61.85,,,percent of total billed charges,61.85% of total billed charges,287.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,373.85,130,,,Fee Schedule,130% of WA Medicaid ,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,753.62,37.7,,,percent of total billed charges,37.70% of total billed charges,753.62,37.7,,,percent of total billed charges,37.70% of total billed charges,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,67766.1,33.9,,,percent of total billed charges,33.9% of total billed charges,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559.22,78,,,percent of total billed charges,78% of total billed charges,1999,100,,,percent of total billed charges,100% of total billed charges,1651.17,82.6,,,percent of total billed charges,82.6% of total billed charges,1651.17,82.6,,,percent of total billed charges,82.6% of total billed charges,287.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.03,67766.1,
"28122 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATI",97528122,CDM,975,RC,28122,HCPCS,Outpatient,,,1680,1092.00,,1478.4,88,,,percent of total billed charges,88% of total Billed charges,32.36,100,,,Fee Schedule,100% of Medicare rate,255.13,100,,,Fee Schedule,100% of WA Medicaid,1680,100,,,percent of total billed charges,100% of total billed charges,262.78,103,,,Fee Schedule,103% of WA Medicaid,32.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,255.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1159.2,69,,,percent of total billed charges,69% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1680,100,,,percent of total billed charges,100% of total billed charges,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1680,100,,,percent of total billed charges,100% of total billed charges,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1039.08,61.85,,,percent of total billed charges,61.85% of total billed charges,255.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,331.67,130,,,Fee Schedule,130% of WA Medicaid ,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,56952,33.9,,,percent of total billed charges,33.9% of total billed charges,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1310.4,78,,,percent of total billed charges,78% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,255.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.36,56952,
"RESECTION, PARTIAL OR COMPLETE, PHALANGEAL BASE, EACH TOE",97528126,CDM,975,RC,28126,HCPCS,Outpatient,,,668,434.20,,587.84,88,,,percent of total billed charges,88% of total Billed charges,18.33,100,,,Fee Schedule,100% of Medicare rate,146.4,100,,,Fee Schedule,100% of WA Medicaid,668,100,,,percent of total billed charges,100% of total billed charges,150.79,103,,,Fee Schedule,103% of WA Medicaid,18.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,146.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,460.92,69,,,percent of total billed charges,69% of total billed charges,668,100,,,percent of total billed charges,100% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,668,100,,,percent of total billed charges,100% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,668,100,,,percent of total billed charges,100% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.16,61.85,,,percent of total billed charges,61.85% of total billed charges,146.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,190.32,130,,,Fee Schedule,130% of WA Medicaid ,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.84,37.7,,,percent of total billed charges,37.70% of total billed charges,251.84,37.7,,,percent of total billed charges,37.70% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,22645.2,33.9,,,percent of total billed charges,33.9% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,521.04,78,,,percent of total billed charges,78% of total billed charges,668,100,,,percent of total billed charges,100% of total billed charges,551.77,82.6,,,percent of total billed charges,82.6% of total billed charges,551.77,82.6,,,percent of total billed charges,82.6% of total billed charges,146.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,22645.2,
RESEC COND DIST END PHA EA TOE,96028153,CDM,975,RC,28153,HCPCS,Outpatient,,,601,390.65,,528.88,88,,,percent of total billed charges,88% of total Billed charges,17.2,100,,,Fee Schedule,100% of Medicare rate,154.61,100,,,Fee Schedule,100% of WA Medicaid,601,100,,,percent of total billed charges,100% of total billed charges,159.25,103,,,Fee Schedule,103% of WA Medicaid,17.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,154.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,414.69,69,,,percent of total billed charges,69% of total billed charges,601,100,,,percent of total billed charges,100% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,601,100,,,percent of total billed charges,100% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,601,100,,,percent of total billed charges,100% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.72,61.85,,,percent of total billed charges,61.85% of total billed charges,154.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,200.99,130,,,Fee Schedule,130% of WA Medicaid ,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.58,37.7,,,percent of total billed charges,37.70% of total billed charges,226.58,37.7,,,percent of total billed charges,37.70% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,20373.9,33.9,,,percent of total billed charges,33.9% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.78,78,,,percent of total billed charges,78% of total billed charges,601,100,,,percent of total billed charges,100% of total billed charges,496.43,82.6,,,percent of total billed charges,82.6% of total billed charges,496.43,82.6,,,percent of total billed charges,82.6% of total billed charges,154.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.2,20373.9,
"28160 HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISION, T",97528160,CDM,975,RC,28160,HCPCS,Outpatient,,,1370,890.50,,1205.6,88,,,percent of total billed charges,88% of total Billed charges,17.8,100,,,Fee Schedule,100% of Medicare rate,156.1,100,,,Fee Schedule,100% of WA Medicaid,1370,100,,,percent of total billed charges,100% of total billed charges,160.78,103,,,Fee Schedule,103% of WA Medicaid,17.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,156.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,945.3,69,,,percent of total billed charges,69% of total billed charges,1370,100,,,percent of total billed charges,100% of total billed charges,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1370,100,,,percent of total billed charges,100% of total billed charges,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1370,100,,,percent of total billed charges,100% of total billed charges,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.35,61.85,,,percent of total billed charges,61.85% of total billed charges,156.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,202.93,130,,,Fee Schedule,130% of WA Medicaid ,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.49,37.7,,,percent of total billed charges,37.70% of total billed charges,516.49,37.7,,,percent of total billed charges,37.70% of total billed charges,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,46443,33.9,,,percent of total billed charges,33.9% of total billed charges,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1068.6,78,,,percent of total billed charges,78% of total billed charges,1370,100,,,percent of total billed charges,100% of total billed charges,1131.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1131.62,82.6,,,percent of total billed charges,82.6% of total billed charges,156.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.8,46443,
FB REMOVAL,96028190,CDM,960,RC,28190,HCPCS,Outpatient,,,502,326.30,,441.76,88,,,percent of total billed charges,88% of total Billed charges,9.23,100,,,Fee Schedule,100% of Medicare rate,76.84,100,,,Fee Schedule,100% of WA Medicaid,502,100,,,percent of total billed charges,100% of total billed charges,79.15,103,,,Fee Schedule,103% of WA Medicaid,9.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,76.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,346.38,69,,,percent of total billed charges,69% of total billed charges,502,100,,,percent of total billed charges,100% of total billed charges,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,502,100,,,percent of total billed charges,100% of total billed charges,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,502,100,,,percent of total billed charges,100% of total billed charges,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.49,61.85,,,percent of total billed charges,61.85% of total billed charges,76.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,99.89,130,,,Fee Schedule,130% of WA Medicaid ,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.25,37.7,,,percent of total billed charges,37.70% of total billed charges,189.25,37.7,,,percent of total billed charges,37.70% of total billed charges,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,17017.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.56,78,,,percent of total billed charges,78% of total billed charges,502,100,,,percent of total billed charges,100% of total billed charges,414.65,82.6,,,percent of total billed charges,82.6% of total billed charges,414.65,82.6,,,percent of total billed charges,82.6% of total billed charges,76.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.23,17017.8,
REM FOREIGN BODY FOOT SUCUTANE,96028192,CDM,960,RC,28192,HCPCS,Outpatient,,,1214,789.10,,1068.32,88,,,percent of total billed charges,88% of total Billed charges,21.16,100,,,Fee Schedule,100% of Medicare rate,180.35,100,,,Fee Schedule,100% of WA Medicaid,1214,100,,,percent of total billed charges,100% of total billed charges,185.76,103,,,Fee Schedule,103% of WA Medicaid,21.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,180.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,837.66,69,,,percent of total billed charges,69% of total billed charges,1214,100,,,percent of total billed charges,100% of total billed charges,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1214,100,,,percent of total billed charges,100% of total billed charges,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1214,100,,,percent of total billed charges,100% of total billed charges,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,750.86,61.85,,,percent of total billed charges,61.85% of total billed charges,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,234.46,130,,,Fee Schedule,130% of WA Medicaid ,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.68,37.7,,,percent of total billed charges,37.70% of total billed charges,457.68,37.7,,,percent of total billed charges,37.70% of total billed charges,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,41154.6,33.9,,,percent of total billed charges,33.9% of total billed charges,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,946.92,78,,,percent of total billed charges,78% of total billed charges,1214,100,,,percent of total billed charges,100% of total billed charges,1002.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1002.76,82.6,,,percent of total billed charges,82.6% of total billed charges,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.16,41154.6,
"28208 REPAIR, TENDON, EXTENSOR, FOOT; PRIMARY OR S",97528208,CDM,975,RC,28208,HCPCS,Outpatient,,,2034,1322.10,,1789.92,88,,,percent of total billed charges,88% of total Billed charges,23.86,100,,,Fee Schedule,100% of Medicare rate,187.62,100,,,Fee Schedule,100% of WA Medicaid,2034,100,,,percent of total billed charges,100% of total billed charges,193.25,103,,,Fee Schedule,103% of WA Medicaid,23.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,187.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1403.46,69,,,percent of total billed charges,69% of total billed charges,2034,100,,,percent of total billed charges,100% of total billed charges,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2034,100,,,percent of total billed charges,100% of total billed charges,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2034,100,,,percent of total billed charges,100% of total billed charges,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1258.03,61.85,,,percent of total billed charges,61.85% of total billed charges,187.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,243.91,130,,,Fee Schedule,130% of WA Medicaid ,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.82,37.7,,,percent of total billed charges,37.70% of total billed charges,766.82,37.7,,,percent of total billed charges,37.70% of total billed charges,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,68952.6,33.9,,,percent of total billed charges,33.9% of total billed charges,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1586.52,78,,,percent of total billed charges,78% of total billed charges,2034,100,,,percent of total billed charges,100% of total billed charges,1680.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1680.08,82.6,,,percent of total billed charges,82.6% of total billed charges,187.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.86,68952.6,
"28270 CAPSULOTOMY; METATARSOPHALANGEAL JOINT, WITH OR WITHOU",97528270,CDM,975,RC,28270,HCPCS,Outpatient,,,1043,677.95,,917.84,88,,,percent of total billed charges,88% of total Billed charges,22.96,100,,,Fee Schedule,100% of Medicare rate,195.08,100,,,Fee Schedule,100% of WA Medicaid,1043,100,,,percent of total billed charges,100% of total billed charges,200.93,103,,,Fee Schedule,103% of WA Medicaid,22.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,195.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,719.67,69,,,percent of total billed charges,69% of total billed charges,1043,100,,,percent of total billed charges,100% of total billed charges,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1043,100,,,percent of total billed charges,100% of total billed charges,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1043,100,,,percent of total billed charges,100% of total billed charges,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.1,61.85,,,percent of total billed charges,61.85% of total billed charges,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,253.6,130,,,Fee Schedule,130% of WA Medicaid ,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.21,37.7,,,percent of total billed charges,37.70% of total billed charges,393.21,37.7,,,percent of total billed charges,37.70% of total billed charges,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,35357.7,33.9,,,percent of total billed charges,33.9% of total billed charges,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.54,78,,,percent of total billed charges,78% of total billed charges,1043,100,,,percent of total billed charges,100% of total billed charges,861.52,82.6,,,percent of total billed charges,82.6% of total billed charges,861.52,82.6,,,percent of total billed charges,82.6% of total billed charges,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.96,35357.7,
REPAIR OF HAMMERTOE,96028285,CDM,960,RC,28285,HCPCS,Outpatient,,,1363,885.95,,1199.44,88,,,percent of total billed charges,88% of total Billed charges,27.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1363,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,27.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,940.47,69,,,percent of total billed charges,69% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1363,100,,,percent of total billed charges,100% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1363,100,,,percent of total billed charges,100% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,843.02,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,46205.7,33.9,,,percent of total billed charges,33.9% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.14,78,,,percent of total billed charges,78% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",27.17,46205.7,
"Ostectomy, partial, exostectomy or condylectomy, metatarsal",97528288,CDM,975,RC,28288,HCPCS,Outpatient,,,1486,965.90,,1307.68,88,,,percent of total billed charges,88% of total Billed charges,30.5,100,,,Fee Schedule,100% of Medicare rate,254.76,100,,,Fee Schedule,100% of WA Medicaid,1486,100,,,percent of total billed charges,100% of total billed charges,262.4,103,,,Fee Schedule,103% of WA Medicaid,30.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,254.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1025.34,69,,,percent of total billed charges,69% of total billed charges,1486,100,,,percent of total billed charges,100% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1486,100,,,percent of total billed charges,100% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1486,100,,,percent of total billed charges,100% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,919.09,61.85,,,percent of total billed charges,61.85% of total billed charges,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,331.19,130,,,Fee Schedule,130% of WA Medicaid ,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,560.22,37.7,,,percent of total billed charges,37.70% of total billed charges,560.22,37.7,,,percent of total billed charges,37.70% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,50375.4,33.9,,,percent of total billed charges,33.9% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1159.08,78,,,percent of total billed charges,78% of total billed charges,1486,100,,,percent of total billed charges,100% of total billed charges,1227.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1227.44,82.6,,,percent of total billed charges,82.6% of total billed charges,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.5,50375.4,
"28292 CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESA",97528292,CDM,975,RC,28292,HCPCS,Outpatient,,,2134,1387.10,,1877.92,88,,,percent of total billed charges,88% of total Billed charges,34.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2134,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1472.46,69,,,percent of total billed charges,69% of total billed charges,2134,100,,,percent of total billed charges,100% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2134,100,,,percent of total billed charges,100% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2134,100,,,percent of total billed charges,100% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319.88,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.52,37.7,,,percent of total billed charges,37.70% of total billed charges,804.52,37.7,,,percent of total billed charges,37.70% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72342.6,33.9,,,percent of total billed charges,33.9% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1664.52,78,,,percent of total billed charges,78% of total billed charges,2134,100,,,percent of total billed charges,100% of total billed charges,1762.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1762.68,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",34.07,72342.6,
CORRECTION OF HALLUX VALGUS,96028295,CDM,960,RC,28295,HCPCS,Outpatient,,,1162,755.30,,1022.56,88,,,percent of total billed charges,88% of total Billed charges,50.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1162,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,50.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,801.78,69,,,percent of total billed charges,69% of total billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162,100,,,percent of total billed charges,100% of total billed charges,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162,100,,,percent of total billed charges,100% of total billed charges,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,718.7,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.07,37.7,,,percent of total billed charges,37.70% of total billed charges,438.07,37.7,,,percent of total billed charges,37.70% of total billed charges,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,39391.8,33.9,,,percent of total billed charges,33.9% of total billed charges,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,906.36,78,,,percent of total billed charges,78% of total billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,959.81,82.6,,,percent of total billed charges,82.6% of total billed charges,959.81,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",50.27,39391.8,
"28296 CORRECTION, HALLUX VALGUS (BUNIONECTOMY), WITH SESAMOI",975,CDM,975,RC,28296,HCPCS,Outpatient,,,2830,1839.50,,2490.4,88,,,percent of total billed charges,88% of total Billed charges,35.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2830,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,35.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,62.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1952.7,69,,,percent of total billed charges,69% of total billed charges,2830,100,,,percent of total billed charges,100% of total billed charges,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2830,100,,,percent of total billed charges,100% of total billed charges,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2830,100,,,percent of total billed charges,100% of total billed charges,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1750.36,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1066.91,37.7,,,percent of total billed charges,37.70% of total billed charges,1066.91,37.7,,,percent of total billed charges,37.70% of total billed charges,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,95937,33.9,,,percent of total billed charges,33.9% of total billed charges,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2207.4,78,,,percent of total billed charges,78% of total billed charges,2830,100,,,percent of total billed charges,100% of total billed charges,2337.58,82.6,,,percent of total billed charges,82.6% of total billed charges,2337.58,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",35.66,95937,
"28297 CORRECTION, HALLUX VALGUS (BUNIONECTOMY), WITH SESAMOI",97528297,CDM,975,RC,28297,HCPCS,Outpatient,,,2712,1762.80,,2386.56,88,,,percent of total billed charges,88% of total Billed charges,47.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2712,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,47.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1871.28,69,,,percent of total billed charges,69% of total billed charges,2712,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2712,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2712,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1677.37,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1022.42,37.7,,,percent of total billed charges,37.70% of total billed charges,1022.42,37.7,,,percent of total billed charges,37.70% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,91936.8,33.9,,,percent of total billed charges,33.9% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2115.36,78,,,percent of total billed charges,78% of total billed charges,2712,100,,,percent of total billed charges,100% of total billed charges,2240.11,82.6,,,percent of total billed charges,82.6% of total billed charges,2240.11,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",47.64,91936.8,
CORRECTION OF BUNION,96028299,CDM,960,RC,28299,HCPCS,Outpatient,,,2153,1399.45,,1894.64,88,,,percent of total billed charges,88% of total Billed charges,46.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2153,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,46.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1485.57,69,,,percent of total billed charges,69% of total billed charges,2153,100,,,percent of total billed charges,100% of total billed charges,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2153,100,,,percent of total billed charges,100% of total billed charges,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2153,100,,,percent of total billed charges,100% of total billed charges,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1331.63,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.68,37.7,,,percent of total billed charges,37.70% of total billed charges,811.68,37.7,,,percent of total billed charges,37.70% of total billed charges,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,72986.7,33.9,,,percent of total billed charges,33.9% of total billed charges,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1679.34,78,,,percent of total billed charges,78% of total billed charges,2153,100,,,percent of total billed charges,100% of total billed charges,1778.38,82.6,,,percent of total billed charges,82.6% of total billed charges,1778.38,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",46.17,72986.7,
"28300 OSTEOTOMY; CALCANEUS (EG, DWYER OR CHAMBERS TYPE PROCE",975,CDM,975,RC,28300,HCPCS,Outpatient,,,2581,1677.65,,2271.28,88,,,percent of total billed charges,88% of total Billed charges,60.24,100,,,Fee Schedule,100% of Medicare rate,375.8,100,,,Fee Schedule,100% of WA Medicaid,2581,100,,,percent of total billed charges,100% of total billed charges,387.07,103,,,Fee Schedule,103% of WA Medicaid,60.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,375.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1780.89,69,,,percent of total billed charges,69% of total billed charges,2581,100,,,percent of total billed charges,100% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2581,100,,,percent of total billed charges,100% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2581,100,,,percent of total billed charges,100% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1596.35,61.85,,,percent of total billed charges,61.85% of total billed charges,375.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,488.54,130,,,Fee Schedule,130% of WA Medicaid ,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,973.04,37.7,,,percent of total billed charges,37.70% of total billed charges,973.04,37.7,,,percent of total billed charges,37.70% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,87495.9,33.9,,,percent of total billed charges,33.9% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2013.18,78,,,percent of total billed charges,78% of total billed charges,2581,100,,,percent of total billed charges,100% of total billed charges,2131.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2131.91,82.6,,,percent of total billed charges,82.6% of total billed charges,375.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.24,87495.9,
"28308 OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENING OR",97528308,CDM,975,RC,28308,HCPCS,Outpatient,,,2583,1678.95,,2273.04,88,,,percent of total billed charges,88% of total Billed charges,29.28,100,,,Fee Schedule,100% of Medicare rate,226.6,100,,,Fee Schedule,100% of WA Medicaid,2583,100,,,percent of total billed charges,100% of total billed charges,233.4,103,,,Fee Schedule,103% of WA Medicaid,29.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,226.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1782.27,69,,,percent of total billed charges,69% of total billed charges,2583,100,,,percent of total billed charges,100% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2583,100,,,percent of total billed charges,100% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2583,100,,,percent of total billed charges,100% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1597.59,61.85,,,percent of total billed charges,61.85% of total billed charges,226.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,294.58,130,,,Fee Schedule,130% of WA Medicaid ,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,973.79,37.7,,,percent of total billed charges,37.70% of total billed charges,973.79,37.7,,,percent of total billed charges,37.70% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,87563.7,33.9,,,percent of total billed charges,33.9% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2014.74,78,,,percent of total billed charges,78% of total billed charges,2583,100,,,percent of total billed charges,100% of total billed charges,2133.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2133.56,82.6,,,percent of total billed charges,82.6% of total billed charges,226.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.28,87563.7,
"28313 RECONSTRUCTION, ANGULAR DEFORMITY OF TOE, SOFT TISSUE",97528313,CDM,975,RC,28313,HCPCS,Outpatient,,,1258,817.70,,1107.04,88,,,percent of total billed charges,88% of total Billed charges,29.23,100,,,Fee Schedule,100% of Medicare rate,210.75,100,,,Fee Schedule,100% of WA Medicaid,1258,100,,,percent of total billed charges,100% of total billed charges,217.07,103,,,Fee Schedule,103% of WA Medicaid,29.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,210.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,868.02,69,,,percent of total billed charges,69% of total billed charges,1258,100,,,percent of total billed charges,100% of total billed charges,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1258,100,,,percent of total billed charges,100% of total billed charges,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1258,100,,,percent of total billed charges,100% of total billed charges,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.07,61.85,,,percent of total billed charges,61.85% of total billed charges,210.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,273.98,130,,,Fee Schedule,130% of WA Medicaid ,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.27,37.7,,,percent of total billed charges,37.70% of total billed charges,474.27,37.7,,,percent of total billed charges,37.70% of total billed charges,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,42646.2,33.9,,,percent of total billed charges,33.9% of total billed charges,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,981.24,78,,,percent of total billed charges,78% of total billed charges,1258,100,,,percent of total billed charges,100% of total billed charges,1039.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1039.11,82.6,,,percent of total billed charges,82.6% of total billed charges,210.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.23,42646.2,
"28322 REPAIR, NONUNION OR MALUNION; METATARSAL, WITH OR WITH",96028322,CDM,975,RC,28322,HCPCS,Outpatient,,,1240,806.00,,1091.2,88,,,percent of total billed charges,88% of total Billed charges,51.6,100,,,Fee Schedule,100% of Medicare rate,334.95,100,,,Fee Schedule,100% of WA Medicaid,1240,100,,,percent of total billed charges,100% of total billed charges,345,103,,,Fee Schedule,103% of WA Medicaid,51.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,334.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,855.6,69,,,percent of total billed charges,69% of total billed charges,1240,100,,,percent of total billed charges,100% of total billed charges,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240,100,,,percent of total billed charges,100% of total billed charges,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240,100,,,percent of total billed charges,100% of total billed charges,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.94,61.85,,,percent of total billed charges,61.85% of total billed charges,334.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,435.44,130,,,Fee Schedule,130% of WA Medicaid ,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,467.48,37.7,,,percent of total billed charges,37.70% of total billed charges,467.48,37.7,,,percent of total billed charges,37.70% of total billed charges,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,42036,33.9,,,percent of total billed charges,33.9% of total billed charges,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,967.2,78,,,percent of total billed charges,78% of total billed charges,1240,100,,,percent of total billed charges,100% of total billed charges,1024.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1024.24,82.6,,,percent of total billed charges,82.6% of total billed charges,334.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.6,42036,
"Reconstruction, toe(s); syndactyly, w/ w/out skin graft",97528345,CDM,975,RC,28345,HCPCS,Outpatient,,,755,490.75,,664.4,88,,,percent of total billed charges,88% of total Billed charges,23.51,100,,,Fee Schedule,100% of Medicare rate,210,100,,,Fee Schedule,100% of WA Medicaid,755,100,,,percent of total billed charges,100% of total billed charges,216.3,103,,,Fee Schedule,103% of WA Medicaid,23.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,210,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,520.95,69,,,percent of total billed charges,69% of total billed charges,755,100,,,percent of total billed charges,100% of total billed charges,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,755,100,,,percent of total billed charges,100% of total billed charges,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,755,100,,,percent of total billed charges,100% of total billed charges,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.97,61.85,,,percent of total billed charges,61.85% of total billed charges,210,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,210,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,273,130,,,Fee Schedule,130% of WA Medicaid ,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.64,37.7,,,percent of total billed charges,37.70% of total billed charges,284.64,37.7,,,percent of total billed charges,37.70% of total billed charges,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,25594.5,33.9,,,percent of total billed charges,33.9% of total billed charges,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.9,78,,,percent of total billed charges,78% of total billed charges,755,100,,,percent of total billed charges,100% of total billed charges,623.63,82.6,,,percent of total billed charges,82.6% of total billed charges,623.63,82.6,,,percent of total billed charges,82.6% of total billed charges,210,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,210,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.51,25594.5,
TREATMENT OF HEEL FRACTURE,96028406,CDM,960,RC,28406,HCPCS,Outpatient,,,1276,829.40,,1122.88,88,,,percent of total billed charges,88% of total Billed charges,53.26,100,,,Fee Schedule,100% of Medicare rate,348.01,100,,,Fee Schedule,100% of WA Medicaid,1276,100,,,percent of total billed charges,100% of total billed charges,358.45,103,,,Fee Schedule,103% of WA Medicaid,53.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,348.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,880.44,69,,,percent of total billed charges,69% of total billed charges,1276,100,,,percent of total billed charges,100% of total billed charges,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1276,100,,,percent of total billed charges,100% of total billed charges,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1276,100,,,percent of total billed charges,100% of total billed charges,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,789.21,61.85,,,percent of total billed charges,61.85% of total billed charges,348.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,452.41,130,,,Fee Schedule,130% of WA Medicaid ,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.05,37.7,,,percent of total billed charges,37.70% of total billed charges,481.05,37.7,,,percent of total billed charges,37.70% of total billed charges,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,43256.4,33.9,,,percent of total billed charges,33.9% of total billed charges,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,995.28,78,,,percent of total billed charges,78% of total billed charges,1276,100,,,percent of total billed charges,100% of total billed charges,1053.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1053.98,82.6,,,percent of total billed charges,82.6% of total billed charges,348.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.26,43256.4,
TREATMENT HEEL FRACTURE,96028415,CDM,960,RC,28415,HCPCS,Outpatient,,,2684,1744.60,,2361.92,88,,,percent of total billed charges,88% of total Billed charges,103.54,100,,,Fee Schedule,100% of Medicare rate,646.6,100,,,Fee Schedule,100% of WA Medicaid,2684,100,,,percent of total billed charges,100% of total billed charges,666,103,,,Fee Schedule,103% of WA Medicaid,103.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,181.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,646.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1851.96,69,,,percent of total billed charges,69% of total billed charges,2684,100,,,percent of total billed charges,100% of total billed charges,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2684,100,,,percent of total billed charges,100% of total billed charges,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2684,100,,,percent of total billed charges,100% of total billed charges,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1660.05,61.85,,,percent of total billed charges,61.85% of total billed charges,646.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,840.58,130,,,Fee Schedule,130% of WA Medicaid ,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1011.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1011.87,37.7,,,percent of total billed charges,37.70% of total billed charges,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,90987.6,33.9,,,percent of total billed charges,33.9% of total billed charges,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2093.52,78,,,percent of total billed charges,78% of total billed charges,2684,100,,,percent of total billed charges,100% of total billed charges,2216.98,82.6,,,percent of total billed charges,82.6% of total billed charges,2216.98,82.6,,,percent of total billed charges,82.6% of total billed charges,646.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,103.54,90987.6,
OPEN TRTMT OF METATARSAL INTEA,96028485,CDM,960,RC,28485,HCPCS,Outpatient,,,1306,848.90,,1149.28,88,,,percent of total billed charges,88% of total Billed charges,42.76,100,,,Fee Schedule,100% of Medicare rate,330.29,100,,,Fee Schedule,100% of WA Medicaid,1306,100,,,percent of total billed charges,100% of total billed charges,340.2,103,,,Fee Schedule,103% of WA Medicaid,42.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,330.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,901.14,69,,,percent of total billed charges,69% of total billed charges,1306,100,,,percent of total billed charges,100% of total billed charges,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1306,100,,,percent of total billed charges,100% of total billed charges,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1306,100,,,percent of total billed charges,100% of total billed charges,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,807.76,61.85,,,percent of total billed charges,61.85% of total billed charges,330.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,429.38,130,,,Fee Schedule,130% of WA Medicaid ,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.36,37.7,,,percent of total billed charges,37.70% of total billed charges,492.36,37.7,,,percent of total billed charges,37.70% of total billed charges,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,44273.4,33.9,,,percent of total billed charges,33.9% of total billed charges,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1018.68,78,,,percent of total billed charges,78% of total billed charges,1306,100,,,percent of total billed charges,100% of total billed charges,1078.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1078.76,82.6,,,percent of total billed charges,82.6% of total billed charges,330.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.76,44273.4,
TREATMENT BIG TOE FRACTURE,96028505,CDM,960,RC,28505,HCPCS,Outpatient,,,1162,755.30,,1022.56,88,,,percent of total billed charges,88% of total Billed charges,39.04,100,,,Fee Schedule,100% of Medicare rate,288.52,100,,,Fee Schedule,100% of WA Medicaid,1162,100,,,percent of total billed charges,100% of total billed charges,297.18,103,,,Fee Schedule,103% of WA Medicaid,39.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,288.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,801.78,69,,,percent of total billed charges,69% of total billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162,100,,,percent of total billed charges,100% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162,100,,,percent of total billed charges,100% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,718.7,61.85,,,percent of total billed charges,61.85% of total billed charges,288.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,294.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,375.08,130,,,Fee Schedule,130% of WA Medicaid ,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.07,37.7,,,percent of total billed charges,37.70% of total billed charges,438.07,37.7,,,percent of total billed charges,37.70% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,39391.8,33.9,,,percent of total billed charges,33.9% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,906.36,78,,,percent of total billed charges,78% of total billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,959.81,82.6,,,percent of total billed charges,82.6% of total billed charges,959.81,82.6,,,percent of total billed charges,82.6% of total billed charges,288.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.04,39391.8,
REPAIR TOE DISLOCATION,96028645,CDM,960,RC,28645,HCPCS,Outpatient,,,1580,1027.00,,1390.4,88,,,percent of total billed charges,88% of total Billed charges,37.21,100,,,Fee Schedule,100% of Medicare rate,283.29,100,,,Fee Schedule,100% of WA Medicaid,1580,100,,,percent of total billed charges,100% of total billed charges,291.79,103,,,Fee Schedule,103% of WA Medicaid,37.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,283.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1090.2,69,,,percent of total billed charges,69% of total billed charges,1580,100,,,percent of total billed charges,100% of total billed charges,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1580,100,,,percent of total billed charges,100% of total billed charges,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1580,100,,,percent of total billed charges,100% of total billed charges,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,977.23,61.85,,,percent of total billed charges,61.85% of total billed charges,283.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,368.28,130,,,Fee Schedule,130% of WA Medicaid ,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,595.66,37.7,,,percent of total billed charges,37.70% of total billed charges,595.66,37.7,,,percent of total billed charges,37.70% of total billed charges,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,53562,33.9,,,percent of total billed charges,33.9% of total billed charges,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1232.4,78,,,percent of total billed charges,78% of total billed charges,1580,100,,,percent of total billed charges,100% of total billed charges,1305.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1305.08,82.6,,,percent of total billed charges,82.6% of total billed charges,283.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.21,53562,
FUSION OF FOOT BONES,96028705,CDM,960,RC,28705,HCPCS,Outpatient,,,3052,1983.80,,2685.76,88,,,percent of total billed charges,88% of total Billed charges,117.16,100,,,Fee Schedule,100% of Medicare rate,696.58,100,,,Fee Schedule,100% of WA Medicaid,3052,100,,,percent of total billed charges,100% of total billed charges,717.48,103,,,Fee Schedule,103% of WA Medicaid,117.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,205.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,696.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2105.88,69,,,percent of total billed charges,69% of total billed charges,3052,100,,,percent of total billed charges,100% of total billed charges,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,3052,100,,,percent of total billed charges,100% of total billed charges,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,3052,100,,,percent of total billed charges,100% of total billed charges,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1887.66,61.85,,,percent of total billed charges,61.85% of total billed charges,696.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,710.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,905.55,130,,,Fee Schedule,130% of WA Medicaid ,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1150.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1150.6,37.7,,,percent of total billed charges,37.70% of total billed charges,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,103462.8,33.9,,,percent of total billed charges,33.9% of total billed charges,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2380.56,78,,,percent of total billed charges,78% of total billed charges,3052,100,,,percent of total billed charges,100% of total billed charges,2520.95,82.6,,,percent of total billed charges,82.6% of total billed charges,2520.95,82.6,,,percent of total billed charges,82.6% of total billed charges,696.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.16,103462.8,
FUSION OF FOOT BONES,97528725,CDM,975,RC,28725,HCPCS,Outpatient,,,1671,1086.15,,1470.48,88,,,percent of total billed charges,88% of total Billed charges,71.4,100,,,Fee Schedule,100% of Medicare rate,450.02,100,,,Fee Schedule,100% of WA Medicaid,1671,100,,,percent of total billed charges,100% of total billed charges,463.52,103,,,Fee Schedule,103% of WA Medicaid,71.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,450.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1152.99,69,,,percent of total billed charges,69% of total billed charges,1671,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1671,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1671,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1033.51,61.85,,,percent of total billed charges,61.85% of total billed charges,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,585.03,130,,,Fee Schedule,130% of WA Medicaid ,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.97,37.7,,,percent of total billed charges,37.70% of total billed charges,629.97,37.7,,,percent of total billed charges,37.70% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,56646.9,33.9,,,percent of total billed charges,33.9% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1303.38,78,,,percent of total billed charges,78% of total billed charges,1671,100,,,percent of total billed charges,100% of total billed charges,1380.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1380.25,82.6,,,percent of total billed charges,82.6% of total billed charges,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.4,56646.9,
"28730 ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR",97528730,CDM,975,RC,28730,HCPCS,Outpatient,,,3034,1972.10,,2669.92,88,,,percent of total billed charges,88% of total Billed charges,63.56,100,,,Fee Schedule,100% of Medicare rate,419.25,100,,,Fee Schedule,100% of WA Medicaid,3034,100,,,percent of total billed charges,100% of total billed charges,431.83,103,,,Fee Schedule,103% of WA Medicaid,63.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,111.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,419.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2093.46,69,,,percent of total billed charges,69% of total billed charges,3034,100,,,percent of total billed charges,100% of total billed charges,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3034,100,,,percent of total billed charges,100% of total billed charges,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3034,100,,,percent of total billed charges,100% of total billed charges,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1876.53,61.85,,,percent of total billed charges,61.85% of total billed charges,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,545.03,130,,,Fee Schedule,130% of WA Medicaid ,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1143.82,37.7,,,percent of total billed charges,37.70% of total billed charges,1143.82,37.7,,,percent of total billed charges,37.70% of total billed charges,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,102852.6,33.9,,,percent of total billed charges,33.9% of total billed charges,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2366.52,78,,,percent of total billed charges,78% of total billed charges,3034,100,,,percent of total billed charges,100% of total billed charges,2506.08,82.6,,,percent of total billed charges,82.6% of total billed charges,2506.08,82.6,,,percent of total billed charges,82.6% of total billed charges,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.56,102852.6,
FUSION OF FOOT BONES,96028735,CDM,960,RC,28735,HCPCS,Outpatient,,,1589,1032.85,,1398.32,88,,,percent of total billed charges,88% of total Billed charges,68.92,100,,,Fee Schedule,100% of Medicare rate,446.67,100,,,Fee Schedule,100% of WA Medicaid,1589,100,,,percent of total billed charges,100% of total billed charges,460.07,103,,,Fee Schedule,103% of WA Medicaid,68.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,120.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,446.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1096.41,69,,,percent of total billed charges,69% of total billed charges,1589,100,,,percent of total billed charges,100% of total billed charges,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1589,100,,,percent of total billed charges,100% of total billed charges,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1589,100,,,percent of total billed charges,100% of total billed charges,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,982.8,61.85,,,percent of total billed charges,61.85% of total billed charges,446.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,580.67,130,,,Fee Schedule,130% of WA Medicaid ,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.05,37.7,,,percent of total billed charges,37.70% of total billed charges,599.05,37.7,,,percent of total billed charges,37.70% of total billed charges,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,53867.1,33.9,,,percent of total billed charges,33.9% of total billed charges,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1239.42,78,,,percent of total billed charges,78% of total billed charges,1589,100,,,percent of total billed charges,100% of total billed charges,1312.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1312.51,82.6,,,percent of total billed charges,82.6% of total billed charges,446.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.92,53867.1,
"28737 ARTHRODESIS, WITH TENDON LENGTHENING AND ADVANCEMENT,",28737,CDM,975,RC,28737,HCPCS,Outpatient,,,1439,935.35,,1266.32,88,,,percent of total billed charges,88% of total Billed charges,60.15,100,,,Fee Schedule,100% of Medicare rate,398.36,100,,,Fee Schedule,100% of WA Medicaid,1439,100,,,percent of total billed charges,100% of total billed charges,410.31,103,,,Fee Schedule,103% of WA Medicaid,60.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,398.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,992.91,69,,,percent of total billed charges,69% of total billed charges,1439,100,,,percent of total billed charges,100% of total billed charges,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1439,100,,,percent of total billed charges,100% of total billed charges,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1439,100,,,percent of total billed charges,100% of total billed charges,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,890.02,61.85,,,percent of total billed charges,61.85% of total billed charges,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,517.87,130,,,Fee Schedule,130% of WA Medicaid ,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,542.5,37.7,,,percent of total billed charges,37.70% of total billed charges,542.5,37.7,,,percent of total billed charges,37.70% of total billed charges,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,48782.1,33.9,,,percent of total billed charges,33.9% of total billed charges,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1122.42,78,,,percent of total billed charges,78% of total billed charges,1439,100,,,percent of total billed charges,100% of total billed charges,1188.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1188.61,82.6,,,percent of total billed charges,82.6% of total billed charges,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.15,48782.1,
"28740 ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOIN",97528740,CDM,975,RC,28740,HCPCS,Outpatient,,,2348,1526.20,,2066.24,88,,,percent of total billed charges,88% of total Billed charges,51.72,100,,,Fee Schedule,100% of Medicare rate,356.77,100,,,Fee Schedule,100% of WA Medicaid,2348,100,,,percent of total billed charges,100% of total billed charges,367.47,103,,,Fee Schedule,103% of WA Medicaid,51.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,356.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1620.12,69,,,percent of total billed charges,69% of total billed charges,2348,100,,,percent of total billed charges,100% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2348,100,,,percent of total billed charges,100% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2348,100,,,percent of total billed charges,100% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1452.24,61.85,,,percent of total billed charges,61.85% of total billed charges,356.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,463.8,130,,,Fee Schedule,130% of WA Medicaid ,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.2,37.7,,,percent of total billed charges,37.70% of total billed charges,885.2,37.7,,,percent of total billed charges,37.70% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,79597.2,33.9,,,percent of total billed charges,33.9% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1831.44,78,,,percent of total billed charges,78% of total billed charges,2348,100,,,percent of total billed charges,100% of total billed charges,1939.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1939.45,82.6,,,percent of total billed charges,82.6% of total billed charges,356.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.72,79597.2,
"Arthrodesis, great toe; metatarsophalangeal joint",28750,CDM,975,RC,28750,HCPCS,Outpatient,,,2402,1561.30,,2113.76,88,,,percent of total billed charges,88% of total Billed charges,47.64,100,,,Fee Schedule,100% of Medicare rate,333.65,100,,,Fee Schedule,100% of WA Medicaid,2402,100,,,percent of total billed charges,100% of total billed charges,343.66,103,,,Fee Schedule,103% of WA Medicaid,47.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,333.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1657.38,69,,,percent of total billed charges,69% of total billed charges,2402,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2402,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2402,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1485.64,61.85,,,percent of total billed charges,61.85% of total billed charges,333.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,433.75,130,,,Fee Schedule,130% of WA Medicaid ,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,905.55,37.7,,,percent of total billed charges,37.70% of total billed charges,905.55,37.7,,,percent of total billed charges,37.70% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,81427.8,33.9,,,percent of total billed charges,33.9% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1873.56,78,,,percent of total billed charges,78% of total billed charges,2402,100,,,percent of total billed charges,100% of total billed charges,1984.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1984.05,82.6,,,percent of total billed charges,82.6% of total billed charges,333.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.64,81427.8,
FUSION OF BIG TOE JOINT,96028755,CDM,975,RC,28755,HCPCS,Outpatient,,,1113,723.45,,979.44,88,,,percent of total billed charges,88% of total Billed charges,25.04,100,,,Fee Schedule,100% of Medicare rate,195.08,100,,,Fee Schedule,100% of WA Medicaid,1113,100,,,percent of total billed charges,100% of total billed charges,200.93,103,,,Fee Schedule,103% of WA Medicaid,25.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,195.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,767.97,69,,,percent of total billed charges,69% of total billed charges,1113,100,,,percent of total billed charges,100% of total billed charges,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1113,100,,,percent of total billed charges,100% of total billed charges,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1113,100,,,percent of total billed charges,100% of total billed charges,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,688.39,61.85,,,percent of total billed charges,61.85% of total billed charges,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,253.6,130,,,Fee Schedule,130% of WA Medicaid ,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.6,37.7,,,percent of total billed charges,37.70% of total billed charges,419.6,37.7,,,percent of total billed charges,37.70% of total billed charges,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,37730.7,33.9,,,percent of total billed charges,33.9% of total billed charges,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,868.14,78,,,percent of total billed charges,78% of total billed charges,1113,100,,,percent of total billed charges,100% of total billed charges,919.34,82.6,,,percent of total billed charges,82.6% of total billed charges,919.34,82.6,,,percent of total billed charges,82.6% of total billed charges,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.04,37730.7,
"28805 AMPUTATION, FOOT; TRANSMETATARSAL ProFee",97528805,CDM,975,RC,28805,HCPCS,Outpatient,,,2285,1485.25,,2010.8,88,,,percent of total billed charges,88% of total Billed charges,62.44,100,,,Fee Schedule,100% of Medicare rate,401.53,100,,,Fee Schedule,100% of WA Medicaid,2285,100,,,percent of total billed charges,100% of total billed charges,413.58,103,,,Fee Schedule,103% of WA Medicaid,62.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,401.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1576.65,69,,,percent of total billed charges,69% of total billed charges,2285,100,,,percent of total billed charges,100% of total billed charges,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2285,100,,,percent of total billed charges,100% of total billed charges,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2285,100,,,percent of total billed charges,100% of total billed charges,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1413.27,61.85,,,percent of total billed charges,61.85% of total billed charges,401.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.99,130,,,Fee Schedule,130% of WA Medicaid ,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.45,37.7,,,percent of total billed charges,37.70% of total billed charges,861.45,37.7,,,percent of total billed charges,37.70% of total billed charges,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,77461.5,33.9,,,percent of total billed charges,33.9% of total billed charges,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1782.3,78,,,percent of total billed charges,78% of total billed charges,2285,100,,,percent of total billed charges,100% of total billed charges,1887.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1887.41,82.6,,,percent of total billed charges,82.6% of total billed charges,401.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.44,77461.5,
AMPUTATION METATARSAL W/TOE SG,96028810,CDM,960,RC,28810,HCPCS,Outpatient,,,909,590.85,,799.92,88,,,percent of total billed charges,88% of total Billed charges,38.46,100,,,Fee Schedule,100% of Medicare rate,242.64,100,,,Fee Schedule,100% of WA Medicaid,909,100,,,percent of total billed charges,100% of total billed charges,249.92,103,,,Fee Schedule,103% of WA Medicaid,38.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,242.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,627.21,69,,,percent of total billed charges,69% of total billed charges,909,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,909,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,909,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.22,61.85,,,percent of total billed charges,61.85% of total billed charges,242.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,315.43,130,,,Fee Schedule,130% of WA Medicaid ,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.69,37.7,,,percent of total billed charges,37.70% of total billed charges,342.69,37.7,,,percent of total billed charges,37.70% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,30815.1,33.9,,,percent of total billed charges,33.9% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.02,78,,,percent of total billed charges,78% of total billed charges,909,100,,,percent of total billed charges,100% of total billed charges,750.83,82.6,,,percent of total billed charges,82.6% of total billed charges,750.83,82.6,,,percent of total billed charges,82.6% of total billed charges,242.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.46,30815.1,
AMPUTATION; TOE,96028820,CDM,975,RC,28820,HCPCS,Outpatient,,,1173,762.45,,1032.24,88,,,percent of total billed charges,88% of total Billed charges,15.93,100,,,Fee Schedule,100% of Medicare rate,100.15,100,,,Fee Schedule,100% of WA Medicaid,1173,100,,,percent of total billed charges,100% of total billed charges,103.15,103,,,Fee Schedule,103% of WA Medicaid,15.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,100.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,809.37,69,,,percent of total billed charges,69% of total billed charges,1173,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1173,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1173,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,725.5,61.85,,,percent of total billed charges,61.85% of total billed charges,100.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.2,130,,,Fee Schedule,130% of WA Medicaid ,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.22,37.7,,,percent of total billed charges,37.70% of total billed charges,442.22,37.7,,,percent of total billed charges,37.70% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,39764.7,33.9,,,percent of total billed charges,33.9% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,914.94,78,,,percent of total billed charges,78% of total billed charges,1173,100,,,percent of total billed charges,100% of total billed charges,968.9,82.6,,,percent of total billed charges,82.6% of total billed charges,968.9,82.6,,,percent of total billed charges,82.6% of total billed charges,100.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.93,39764.7,
PARTIAL AMPUTATION OF TOE,96028825,CDM,975,RC,28825,HCPCS,Outpatient,,,850,552.50,,748,88,,,percent of total billed charges,88% of total Billed charges,15.54,100,,,Fee Schedule,100% of Medicare rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,850,100,,,percent of total billed charges,100% of total billed charges,100.47,103,,,Fee Schedule,103% of WA Medicaid,15.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,586.5,69,,,percent of total billed charges,69% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,850,100,,,percent of total billed charges,100% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,850,100,,,percent of total billed charges,100% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.73,61.85,,,percent of total billed charges,61.85% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.8,130,,,Fee Schedule,130% of WA Medicaid ,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,28815,33.9,,,percent of total billed charges,33.9% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,663,78,,,percent of total billed charges,78% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.54,28815,
SHORT ARM SPLINT APPLICATION,96029125,CDM,960,RC,29125,HCPCS,Outpatient,,,131,85.15,,115.28,88,,,percent of total billed charges,88% of total Billed charges,3.56,100,,,Fee Schedule,100% of Medicare rate,23.5,100,,,Fee Schedule,100% of WA Medicaid,131,100,,,percent of total billed charges,100% of total billed charges,24.21,103,,,Fee Schedule,103% of WA Medicaid,3.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,90.39,69,,,percent of total billed charges,69% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,131,100,,,percent of total billed charges,100% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,131,100,,,percent of total billed charges,100% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.02,61.85,,,percent of total billed charges,61.85% of total billed charges,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.55,130,,,Fee Schedule,130% of WA Medicaid ,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.39,37.7,,,percent of total billed charges,37.70% of total billed charges,49.39,37.7,,,percent of total billed charges,37.70% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4440.9,33.9,,,percent of total billed charges,33.9% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.18,78,,,percent of total billed charges,78% of total billed charges,131,100,,,percent of total billed charges,100% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,108.21,82.6,,,percent of total billed charges,82.6% of total billed charges,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.56,4440.9,
APPLY FINGER SPLINT,96029130,CDM,960,RC,29130,HCPCS,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,3.2,100,,,Fee Schedule,100% of Medicare rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,104,100,,,percent of total billed charges,100% of total billed charges,16.9,103,,,Fee Schedule,103% of WA Medicaid,3.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,104,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,104,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.32,61.85,,,percent of total billed charges,61.85% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.33,130,,,Fee Schedule,130% of WA Medicaid ,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3525.6,33.9,,,percent of total billed charges,33.9% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.2,3525.6,
APPLY TOTAL CONT LEG CAST LT,96029445,CDM,960,RC,29445,HCPCS,Outpatient,,,214.62,139.50,LT,188.87,88,,,percent of total billed charges,88% of total Billed charges,8.15,100,,,Fee Schedule,100% of Medicare rate,56.14,100,,,Fee Schedule,100% of WA Medicaid,214.62,100,,,percent of total billed charges,100% of total billed charges,57.82,103,,,Fee Schedule,103% of WA Medicaid,8.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,148.09,69,,,percent of total billed charges,69% of total billed charges,214.62,100,,,percent of total billed charges,100% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.62,100,,,percent of total billed charges,100% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.62,100,,,percent of total billed charges,100% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.74,61.85,,,percent of total billed charges,61.85% of total billed charges,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,72.98,130,,,Fee Schedule,130% of WA Medicaid ,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.91,37.7,,,percent of total billed charges,37.70% of total billed charges,80.91,37.7,,,percent of total billed charges,37.70% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,7275.62,33.9,,,percent of total billed charges,33.9% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.4,78,,,percent of total billed charges,78% of total billed charges,214.62,100,,,percent of total billed charges,100% of total billed charges,177.28,82.6,,,percent of total billed charges,82.6% of total billed charges,177.28,82.6,,,percent of total billed charges,82.6% of total billed charges,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.15,7275.62,
APPLICATION LONG LEG SPLINT,96029505,CDM,960,RC,29505,HCPCS,Outpatient,,,215,139.75,,189.2,88,,,percent of total billed charges,88% of total Billed charges,4.7,100,,,Fee Schedule,100% of Medicare rate,30.21,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,31.12,103,,,Fee Schedule,103% of WA Medicaid,4.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.98,61.85,,,percent of total billed charges,61.85% of total billed charges,30.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,39.27,130,,,Fee Schedule,130% of WA Medicaid ,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,7288.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,30.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.7,7288.5,
APPLY BILATERAL UNNA BOOT,96029580,CDM,960,RC,29580,HCPCS,Outpatient,,,146.44,95.19,50,128.87,88,,,percent of total billed charges,88% of total Billed charges,2.59,100,,,Fee Schedule,100% of Medicare rate,14.55,100,,,Fee Schedule,100% of WA Medicaid,146.44,100,,,percent of total billed charges,100% of total billed charges,14.99,103,,,Fee Schedule,103% of WA Medicaid,2.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,14.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,101.04,69,,,percent of total billed charges,69% of total billed charges,146.44,100,,,percent of total billed charges,100% of total billed charges,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.44,100,,,percent of total billed charges,100% of total billed charges,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.44,100,,,percent of total billed charges,100% of total billed charges,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.57,61.85,,,percent of total billed charges,61.85% of total billed charges,14.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.92,130,,,Fee Schedule,130% of WA Medicaid ,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.21,37.7,,,percent of total billed charges,37.70% of total billed charges,55.21,37.7,,,percent of total billed charges,37.70% of total billed charges,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,4964.32,33.9,,,percent of total billed charges,33.9% of total billed charges,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.22,78,,,percent of total billed charges,78% of total billed charges,146.44,100,,,percent of total billed charges,100% of total billed charges,120.96,82.6,,,percent of total billed charges,82.6% of total billed charges,120.96,82.6,,,percent of total billed charges,82.6% of total billed charges,14.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.59,4964.32,
APP BILATERAL MULTICOMP LOWLEG,96029581,CDM,960,RC,29581,HCPCS,Outpatient,,,53.12,34.53,,46.75,88,,,percent of total billed charges,88% of total Billed charges,1.06,100,,,Fee Schedule,100% of Medicare rate,15.11,100,,,Fee Schedule,100% of WA Medicaid,53.12,100,,,percent of total billed charges,100% of total billed charges,15.56,103,,,Fee Schedule,103% of WA Medicaid,1.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,15.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,36.65,69,,,percent of total billed charges,69% of total billed charges,53.12,100,,,percent of total billed charges,100% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.12,100,,,percent of total billed charges,100% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.12,100,,,percent of total billed charges,100% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.85,61.85,,,percent of total billed charges,61.85% of total billed charges,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19.64,130,,,Fee Schedule,130% of WA Medicaid ,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.03,37.7,,,percent of total billed charges,37.70% of total billed charges,20.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1800.77,33.9,,,percent of total billed charges,33.9% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.43,78,,,percent of total billed charges,78% of total billed charges,53.12,100,,,percent of total billed charges,100% of total billed charges,43.88,82.6,,,percent of total billed charges,82.6% of total billed charges,43.88,82.6,,,percent of total billed charges,82.6% of total billed charges,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.06,1800.77,
"29806 ARTHROSCOPY, SHOULDER, SURGICAL; CAPSULORRHAPHY ProFee",97529806,CDM,975,RC,29806,HCPCS,Outpatient,,,2957,1922.05,,2602.16,88,,,percent of total billed charges,88% of total Billed charges,110.38,100,,,Fee Schedule,100% of Medicare rate,608.92,100,,,Fee Schedule,100% of WA Medicaid,2957,100,,,percent of total billed charges,100% of total billed charges,627.19,103,,,Fee Schedule,103% of WA Medicaid,110.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,608.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2040.33,69,,,percent of total billed charges,69% of total billed charges,2957,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2957,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2957,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1828.9,61.85,,,percent of total billed charges,61.85% of total billed charges,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,791.6,130,,,Fee Schedule,130% of WA Medicaid ,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1114.79,37.7,,,percent of total billed charges,37.70% of total billed charges,1114.79,37.7,,,percent of total billed charges,37.70% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,100242.3,33.9,,,percent of total billed charges,33.9% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2306.46,78,,,percent of total billed charges,78% of total billed charges,2957,100,,,percent of total billed charges,100% of total billed charges,2442.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2442.48,82.6,,,percent of total billed charges,82.6% of total billed charges,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.38,100242.3,
SHOULDER ARTHROSCOPY SURGERY,96029807,CDM,960,RC,29807,HCPCS,Outpatient,,,2486,1615.90,,2187.68,88,,,percent of total billed charges,88% of total Billed charges,107.31,100,,,Fee Schedule,100% of Medicare rate,594.94,100,,,Fee Schedule,100% of WA Medicaid,2486,100,,,percent of total billed charges,100% of total billed charges,612.79,103,,,Fee Schedule,103% of WA Medicaid,107.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,187.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,594.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1715.34,69,,,percent of total billed charges,69% of total billed charges,2486,100,,,percent of total billed charges,100% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2486,100,,,percent of total billed charges,100% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2486,100,,,percent of total billed charges,100% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1537.59,61.85,,,percent of total billed charges,61.85% of total billed charges,594.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,773.42,130,,,Fee Schedule,130% of WA Medicaid ,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,937.22,37.7,,,percent of total billed charges,37.70% of total billed charges,937.22,37.7,,,percent of total billed charges,37.70% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,84275.4,33.9,,,percent of total billed charges,33.9% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1939.08,78,,,percent of total billed charges,78% of total billed charges,2486,100,,,percent of total billed charges,100% of total billed charges,2053.44,82.6,,,percent of total billed charges,82.6% of total billed charges,2053.44,82.6,,,percent of total billed charges,82.6% of total billed charges,594.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.31,84275.4,
"29820 ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, PARTIAL",97529820,CDM,975,RC,29820,HCPCS,Outpatient,,,1990,1293.50,,1751.2,88,,,percent of total billed charges,88% of total Billed charges,52.35,100,,,Fee Schedule,100% of Medicare rate,309.96,100,,,Fee Schedule,100% of WA Medicaid,1990,100,,,percent of total billed charges,100% of total billed charges,319.26,103,,,Fee Schedule,103% of WA Medicaid,52.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,91.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,309.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1373.1,69,,,percent of total billed charges,69% of total billed charges,1990,100,,,percent of total billed charges,100% of total billed charges,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1990,100,,,percent of total billed charges,100% of total billed charges,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1990,100,,,percent of total billed charges,100% of total billed charges,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1230.82,61.85,,,percent of total billed charges,61.85% of total billed charges,309.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,402.95,130,,,Fee Schedule,130% of WA Medicaid ,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,750.23,37.7,,,percent of total billed charges,37.70% of total billed charges,750.23,37.7,,,percent of total billed charges,37.70% of total billed charges,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,67461,33.9,,,percent of total billed charges,33.9% of total billed charges,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1552.2,78,,,percent of total billed charges,78% of total billed charges,1990,100,,,percent of total billed charges,100% of total billed charges,1643.74,82.6,,,percent of total billed charges,82.6% of total billed charges,1643.74,82.6,,,percent of total billed charges,82.6% of total billed charges,309.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.35,67461,
ARTHRO SHOULDER SURG DEBRIDE,96029822,CDM,975,RC,29822,HCPCS,Outpatient,,,1044,678.60,,918.72,88,,,percent of total billed charges,88% of total Billed charges,52.89,100,,,Fee Schedule,100% of Medicare rate,315.56,100,,,Fee Schedule,100% of WA Medicaid,1044,100,,,percent of total billed charges,100% of total billed charges,325.03,103,,,Fee Schedule,103% of WA Medicaid,52.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,315.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,720.36,69,,,percent of total billed charges,69% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1044,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1044,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.71,61.85,,,percent of total billed charges,61.85% of total billed charges,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,410.23,130,,,Fee Schedule,130% of WA Medicaid ,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,393.59,37.7,,,percent of total billed charges,37.70% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,35391.6,33.9,,,percent of total billed charges,33.9% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,814.32,78,,,percent of total billed charges,78% of total billed charges,1044,100,,,percent of total billed charges,100% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,862.34,82.6,,,percent of total billed charges,82.6% of total billed charges,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.89,35391.6,
SHOULDER ARTHROSCOPY SURGERY,96029823,CDM,960,RC,29823,HCPCS,Outpatient,,,1506,978.90,,1325.28,88,,,percent of total billed charges,88% of total Billed charges,58.83,100,,,Fee Schedule,100% of Medicare rate,344.47,100,,,Fee Schedule,100% of WA Medicaid,1506,100,,,percent of total billed charges,100% of total billed charges,354.8,103,,,Fee Schedule,103% of WA Medicaid,58.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,344.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1039.14,69,,,percent of total billed charges,69% of total billed charges,1506,100,,,percent of total billed charges,100% of total billed charges,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1506,100,,,percent of total billed charges,100% of total billed charges,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1506,100,,,percent of total billed charges,100% of total billed charges,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.46,61.85,,,percent of total billed charges,61.85% of total billed charges,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,447.81,130,,,Fee Schedule,130% of WA Medicaid ,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.76,37.7,,,percent of total billed charges,37.70% of total billed charges,567.76,37.7,,,percent of total billed charges,37.70% of total billed charges,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,51053.4,33.9,,,percent of total billed charges,33.9% of total billed charges,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1174.68,78,,,percent of total billed charges,78% of total billed charges,1506,100,,,percent of total billed charges,100% of total billed charges,1243.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1243.96,82.6,,,percent of total billed charges,82.6% of total billed charges,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.83,51053.4,
"ARTHROSCOPY, SHOULDER, SURGICAL; DISTAL CLAV",975298241,CDM,975,RC,29824,HCPCS,Outpatient,,,1555,1010.75,,1368.4,88,,,percent of total billed charges,88% of total Billed charges,66.59,100,,,Fee Schedule,100% of Medicare rate,393.33,100,,,Fee Schedule,100% of WA Medicaid,1555,100,,,percent of total billed charges,100% of total billed charges,405.13,103,,,Fee Schedule,103% of WA Medicaid,66.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,116.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,393.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1072.95,69,,,percent of total billed charges,69% of total billed charges,1555,100,,,percent of total billed charges,100% of total billed charges,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1555,100,,,percent of total billed charges,100% of total billed charges,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1555,100,,,percent of total billed charges,100% of total billed charges,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,961.77,61.85,,,percent of total billed charges,61.85% of total billed charges,393.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,511.33,130,,,Fee Schedule,130% of WA Medicaid ,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,586.24,37.7,,,percent of total billed charges,37.70% of total billed charges,586.24,37.7,,,percent of total billed charges,37.70% of total billed charges,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,52714.5,33.9,,,percent of total billed charges,33.9% of total billed charges,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1212.9,78,,,percent of total billed charges,78% of total billed charges,1555,100,,,percent of total billed charges,100% of total billed charges,1284.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1284.43,82.6,,,percent of total billed charges,82.6% of total billed charges,393.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.59,52714.5,
"29825 ARTHROSCOPY, SHOULDER, SURGICAL; WITH LYSIS AND RESECT",97529825,CDM,975,RC,29825,HCPCS,Outpatient,,,2321,1508.65,,2042.48,88,,,percent of total billed charges,88% of total Billed charges,57.33,100,,,Fee Schedule,100% of Medicare rate,340.74,100,,,Fee Schedule,100% of WA Medicaid,2321,100,,,percent of total billed charges,100% of total billed charges,350.96,103,,,Fee Schedule,103% of WA Medicaid,57.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,340.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1601.49,69,,,percent of total billed charges,69% of total billed charges,2321,100,,,percent of total billed charges,100% of total billed charges,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2321,100,,,percent of total billed charges,100% of total billed charges,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2321,100,,,percent of total billed charges,100% of total billed charges,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1435.54,61.85,,,percent of total billed charges,61.85% of total billed charges,340.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,347.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,442.96,130,,,Fee Schedule,130% of WA Medicaid ,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,875.02,37.7,,,percent of total billed charges,37.70% of total billed charges,875.02,37.7,,,percent of total billed charges,37.70% of total billed charges,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,78681.9,33.9,,,percent of total billed charges,33.9% of total billed charges,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1810.38,78,,,percent of total billed charges,78% of total billed charges,2321,100,,,percent of total billed charges,100% of total billed charges,1917.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1917.15,82.6,,,percent of total billed charges,82.6% of total billed charges,340.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.33,78681.9,
DECOMPRESS OF SUBACROMIAL SPAC,96029826,CDM,975,RC,29826,HCPCS,Outpatient,,,694,451.10,,610.72,88,,,percent of total billed charges,88% of total Billed charges,20.11,100,,,Fee Schedule,100% of Medicare rate,95.67,100,,,Fee Schedule,100% of WA Medicaid,694,100,,,percent of total billed charges,100% of total billed charges,98.54,103,,,Fee Schedule,103% of WA Medicaid,20.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,95.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,478.86,69,,,percent of total billed charges,69% of total billed charges,694,100,,,percent of total billed charges,100% of total billed charges,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,694,100,,,percent of total billed charges,100% of total billed charges,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,694,100,,,percent of total billed charges,100% of total billed charges,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.24,61.85,,,percent of total billed charges,61.85% of total billed charges,95.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,124.37,130,,,Fee Schedule,130% of WA Medicaid ,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.64,37.7,,,percent of total billed charges,37.70% of total billed charges,261.64,37.7,,,percent of total billed charges,37.70% of total billed charges,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,23526.6,33.9,,,percent of total billed charges,33.9% of total billed charges,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.32,78,,,percent of total billed charges,78% of total billed charges,694,100,,,percent of total billed charges,100% of total billed charges,573.24,82.6,,,percent of total billed charges,82.6% of total billed charges,573.24,82.6,,,percent of total billed charges,82.6% of total billed charges,95.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.11,23526.6,
ARTHROSCOP ROTATOR CUFF REPR,29827,CDM,975,RC,29827,HCPCS,Outpatient,,,2652,1723.80,,2333.76,88,,,percent of total billed charges,88% of total Billed charges,111.9,100,,,Fee Schedule,100% of Medicare rate,612.84,100,,,Fee Schedule,100% of WA Medicaid,2652,100,,,percent of total billed charges,100% of total billed charges,631.23,103,,,Fee Schedule,103% of WA Medicaid,111.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,195.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,612.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1829.88,69,,,percent of total billed charges,69% of total billed charges,2652,100,,,percent of total billed charges,100% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2652,100,,,percent of total billed charges,100% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2652,100,,,percent of total billed charges,100% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1640.26,61.85,,,percent of total billed charges,61.85% of total billed charges,612.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,796.69,130,,,Fee Schedule,130% of WA Medicaid ,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,999.8,37.7,,,percent of total billed charges,37.70% of total billed charges,999.8,37.7,,,percent of total billed charges,37.70% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,89902.8,33.9,,,percent of total billed charges,33.9% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2068.56,78,,,percent of total billed charges,78% of total billed charges,2652,100,,,percent of total billed charges,100% of total billed charges,2190.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2190.55,82.6,,,percent of total billed charges,82.6% of total billed charges,612.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.9,89902.8,
"29828 ARTHROSCOPY, SHOULDER, SURGICAL; BICEPS TENO",97529828,CDM,975,RC,29828,HCPCS,Outpatient,,,3009,1955.85,,2647.92,88,,,percent of total billed charges,88% of total Billed charges,94.92,100,,,Fee Schedule,100% of Medicare rate,527.05,100,,,Fee Schedule,100% of WA Medicaid,3009,100,,,percent of total billed charges,100% of total billed charges,542.86,103,,,Fee Schedule,103% of WA Medicaid,94.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,166.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,527.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2076.21,69,,,percent of total billed charges,69% of total billed charges,3009,100,,,percent of total billed charges,100% of total billed charges,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,3009,100,,,percent of total billed charges,100% of total billed charges,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,3009,100,,,percent of total billed charges,100% of total billed charges,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1861.07,61.85,,,percent of total billed charges,61.85% of total billed charges,527.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,685.17,130,,,Fee Schedule,130% of WA Medicaid ,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1134.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1134.39,37.7,,,percent of total billed charges,37.70% of total billed charges,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,102005.1,33.9,,,percent of total billed charges,33.9% of total billed charges,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2347.02,78,,,percent of total billed charges,78% of total billed charges,3009,100,,,percent of total billed charges,100% of total billed charges,2485.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2485.43,82.6,,,percent of total billed charges,82.6% of total billed charges,527.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.92,102005.1,
ARTHO WRIST SYNOVECTOMY PART,96029844,CDM,960,RC,29844,HCPCS,Outpatient,,,1064,691.60,,936.32,88,,,percent of total billed charges,88% of total Billed charges,47.48,100,,,Fee Schedule,100% of Medicare rate,291.5,100,,,Fee Schedule,100% of WA Medicaid,1064,100,,,percent of total billed charges,100% of total billed charges,300.25,103,,,Fee Schedule,103% of WA Medicaid,47.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,291.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,734.16,69,,,percent of total billed charges,69% of total billed charges,1064,100,,,percent of total billed charges,100% of total billed charges,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064,100,,,percent of total billed charges,100% of total billed charges,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064,100,,,percent of total billed charges,100% of total billed charges,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.08,61.85,,,percent of total billed charges,61.85% of total billed charges,291.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,378.95,130,,,Fee Schedule,130% of WA Medicaid ,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.13,37.7,,,percent of total billed charges,37.70% of total billed charges,401.13,37.7,,,percent of total billed charges,37.70% of total billed charges,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,36069.6,33.9,,,percent of total billed charges,33.9% of total billed charges,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.92,78,,,percent of total billed charges,78% of total billed charges,1064,100,,,percent of total billed charges,100% of total billed charges,878.86,82.6,,,percent of total billed charges,82.6% of total billed charges,878.86,82.6,,,percent of total billed charges,82.6% of total billed charges,291.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.48,36069.6,
ARTHO WRIST EXC/REPAIR TRI FIB,96029846,CDM,960,RC,29846,HCPCS,Outpatient,,,1115,724.75,,981.2,88,,,percent of total billed charges,88% of total Billed charges,49.75,100,,,Fee Schedule,100% of Medicare rate,304.93,100,,,Fee Schedule,100% of WA Medicaid,1115,100,,,percent of total billed charges,100% of total billed charges,314.08,103,,,Fee Schedule,103% of WA Medicaid,49.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,304.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,769.35,69,,,percent of total billed charges,69% of total billed charges,1115,100,,,percent of total billed charges,100% of total billed charges,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1115,100,,,percent of total billed charges,100% of total billed charges,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1115,100,,,percent of total billed charges,100% of total billed charges,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,689.63,61.85,,,percent of total billed charges,61.85% of total billed charges,304.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,396.41,130,,,Fee Schedule,130% of WA Medicaid ,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.36,37.7,,,percent of total billed charges,37.70% of total billed charges,420.36,37.7,,,percent of total billed charges,37.70% of total billed charges,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,37798.5,33.9,,,percent of total billed charges,33.9% of total billed charges,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,869.7,78,,,percent of total billed charges,78% of total billed charges,1115,100,,,percent of total billed charges,100% of total billed charges,920.99,82.6,,,percent of total billed charges,82.6% of total billed charges,920.99,82.6,,,percent of total billed charges,82.6% of total billed charges,304.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.75,37798.5,
"29848 ENDOSCOPY, WRIST, SURGICAL, WITH RELEASE OF TRANSVERSE",97529848,CDM,975,RC,29848,HCPCS,Outpatient,,,1371,891.15,,1206.48,88,,,percent of total billed charges,88% of total Billed charges,47.69,100,,,Fee Schedule,100% of Medicare rate,300.82,100,,,Fee Schedule,100% of WA Medicaid,1371,100,,,percent of total billed charges,100% of total billed charges,309.84,103,,,Fee Schedule,103% of WA Medicaid,47.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,300.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,945.99,69,,,percent of total billed charges,69% of total billed charges,1371,100,,,percent of total billed charges,100% of total billed charges,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1371,100,,,percent of total billed charges,100% of total billed charges,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1371,100,,,percent of total billed charges,100% of total billed charges,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.96,61.85,,,percent of total billed charges,61.85% of total billed charges,300.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,391.07,130,,,Fee Schedule,130% of WA Medicaid ,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.87,37.7,,,percent of total billed charges,37.70% of total billed charges,516.87,37.7,,,percent of total billed charges,37.70% of total billed charges,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,46476.9,33.9,,,percent of total billed charges,33.9% of total billed charges,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1069.38,78,,,percent of total billed charges,78% of total billed charges,1371,100,,,percent of total billed charges,100% of total billed charges,1132.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1132.45,82.6,,,percent of total billed charges,82.6% of total billed charges,300.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.69,46476.9,
"29855 ARTHROSCOPICALLY AIDED TREATMENT OF TIBIAL FRACTURE, P",96029855,CDM,975,RC,29855,HCPCS,Outpatient,,,2374,1543.10,,2089.12,88,,,percent of total billed charges,88% of total Billed charges,79.48,100,,,Fee Schedule,100% of Medicare rate,450.96,100,,,Fee Schedule,100% of WA Medicaid,2374,100,,,percent of total billed charges,100% of total billed charges,464.49,103,,,Fee Schedule,103% of WA Medicaid,79.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,139.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,450.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1638.06,69,,,percent of total billed charges,69% of total billed charges,2374,100,,,percent of total billed charges,100% of total billed charges,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2374,100,,,percent of total billed charges,100% of total billed charges,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2374,100,,,percent of total billed charges,100% of total billed charges,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1468.32,61.85,,,percent of total billed charges,61.85% of total billed charges,450.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,586.25,130,,,Fee Schedule,130% of WA Medicaid ,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,895,37.7,,,percent of total billed charges,37.70% of total billed charges,895,37.7,,,percent of total billed charges,37.70% of total billed charges,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,80478.6,33.9,,,percent of total billed charges,33.9% of total billed charges,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1851.72,78,,,percent of total billed charges,78% of total billed charges,2374,100,,,percent of total billed charges,100% of total billed charges,1960.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1960.92,82.6,,,percent of total billed charges,82.6% of total billed charges,450.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.48,80478.6,
KNEE ARTHROSCOPY DRAINAGE,96029871,CDM,960,RC,29871,HCPCS,Outpatient,,,1234,802.10,,1085.92,88,,,percent of total billed charges,88% of total Billed charges,50.81,100,,,Fee Schedule,100% of Medicare rate,300.64,100,,,Fee Schedule,100% of WA Medicaid,1234,100,,,percent of total billed charges,100% of total billed charges,309.66,103,,,Fee Schedule,103% of WA Medicaid,50.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,88.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,300.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,851.46,69,,,percent of total billed charges,69% of total billed charges,1234,100,,,percent of total billed charges,100% of total billed charges,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1234,100,,,percent of total billed charges,100% of total billed charges,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1234,100,,,percent of total billed charges,100% of total billed charges,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.23,61.85,,,percent of total billed charges,61.85% of total billed charges,300.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,390.83,130,,,Fee Schedule,130% of WA Medicaid ,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.22,37.7,,,percent of total billed charges,37.70% of total billed charges,465.22,37.7,,,percent of total billed charges,37.70% of total billed charges,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,41832.6,33.9,,,percent of total billed charges,33.9% of total billed charges,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,962.52,78,,,percent of total billed charges,78% of total billed charges,1234,100,,,percent of total billed charges,100% of total billed charges,1019.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1019.28,82.6,,,percent of total billed charges,82.6% of total billed charges,300.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.81,41832.6,
ARTHROSCOPY KNEE SURG INFECTIO,96029873,CDM,960,RC,29873,HCPCS,Outpatient,,,1322,859.30,,1163.36,88,,,percent of total billed charges,88% of total Billed charges,49.26,100,,,Fee Schedule,100% of Medicare rate,316.12,100,,,Fee Schedule,100% of WA Medicaid,1322,100,,,percent of total billed charges,100% of total billed charges,325.6,103,,,Fee Schedule,103% of WA Medicaid,49.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,316.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,912.18,69,,,percent of total billed charges,69% of total billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1322,100,,,percent of total billed charges,100% of total billed charges,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1322,100,,,percent of total billed charges,100% of total billed charges,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,817.66,61.85,,,percent of total billed charges,61.85% of total billed charges,316.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,410.96,130,,,Fee Schedule,130% of WA Medicaid ,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,498.39,37.7,,,percent of total billed charges,37.70% of total billed charges,498.39,37.7,,,percent of total billed charges,37.70% of total billed charges,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,44815.8,33.9,,,percent of total billed charges,33.9% of total billed charges,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031.16,78,,,percent of total billed charges,78% of total billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,1091.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1091.97,82.6,,,percent of total billed charges,82.6% of total billed charges,316.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.26,44815.8,
ARTHROSCOPY KNEE SURG REMOVAL,96029874,CDM,960,RC,29874,HCPCS,Outpatient,,,1292,839.80,,1136.96,88,,,percent of total billed charges,88% of total Billed charges,54.07,100,,,Fee Schedule,100% of Medicare rate,313.13,100,,,Fee Schedule,100% of WA Medicaid,1292,100,,,percent of total billed charges,100% of total billed charges,322.52,103,,,Fee Schedule,103% of WA Medicaid,54.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,313.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,891.48,69,,,percent of total billed charges,69% of total billed charges,1292,100,,,percent of total billed charges,100% of total billed charges,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1292,100,,,percent of total billed charges,100% of total billed charges,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1292,100,,,percent of total billed charges,100% of total billed charges,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.1,61.85,,,percent of total billed charges,61.85% of total billed charges,313.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,407.07,130,,,Fee Schedule,130% of WA Medicaid ,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.08,37.7,,,percent of total billed charges,37.70% of total billed charges,487.08,37.7,,,percent of total billed charges,37.70% of total billed charges,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,43798.8,33.9,,,percent of total billed charges,33.9% of total billed charges,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1007.76,78,,,percent of total billed charges,78% of total billed charges,1292,100,,,percent of total billed charges,100% of total billed charges,1067.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1067.19,82.6,,,percent of total billed charges,82.6% of total billed charges,313.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.07,43798.8,
ARTHROSCOPY KNEE SURGICAL,96029875,CDM,960,RC,29875,HCPCS,Outpatient,,,1245,809.25,,1095.6,88,,,percent of total billed charges,88% of total Billed charges,48.94,100,,,Fee Schedule,100% of Medicare rate,289.63,100,,,Fee Schedule,100% of WA Medicaid,1245,100,,,percent of total billed charges,100% of total billed charges,298.32,103,,,Fee Schedule,103% of WA Medicaid,48.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,289.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,859.05,69,,,percent of total billed charges,69% of total billed charges,1245,100,,,percent of total billed charges,100% of total billed charges,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1245,100,,,percent of total billed charges,100% of total billed charges,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1245,100,,,percent of total billed charges,100% of total billed charges,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,770.03,61.85,,,percent of total billed charges,61.85% of total billed charges,289.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,376.52,130,,,Fee Schedule,130% of WA Medicaid ,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.37,37.7,,,percent of total billed charges,37.70% of total billed charges,469.37,37.7,,,percent of total billed charges,37.70% of total billed charges,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,42205.5,33.9,,,percent of total billed charges,33.9% of total billed charges,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,971.1,78,,,percent of total billed charges,78% of total billed charges,1245,100,,,percent of total billed charges,100% of total billed charges,1028.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1028.37,82.6,,,percent of total billed charges,82.6% of total billed charges,289.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.94,42205.5,
KNEE ARTHROSCOPY/SURGERY,96029876,CDM,960,RC,29876,HCPCS,Outpatient,,,1578,1025.70,,1388.64,88,,,percent of total billed charges,88% of total Billed charges,65.82,100,,,Fee Schedule,100% of Medicare rate,378.6,100,,,Fee Schedule,100% of WA Medicaid,1578,100,,,percent of total billed charges,100% of total billed charges,389.96,103,,,Fee Schedule,103% of WA Medicaid,65.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,115.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,378.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1088.82,69,,,percent of total billed charges,69% of total billed charges,1578,100,,,percent of total billed charges,100% of total billed charges,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1578,100,,,percent of total billed charges,100% of total billed charges,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1578,100,,,percent of total billed charges,100% of total billed charges,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,975.99,61.85,,,percent of total billed charges,61.85% of total billed charges,378.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,492.18,130,,,Fee Schedule,130% of WA Medicaid ,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.91,37.7,,,percent of total billed charges,37.70% of total billed charges,594.91,37.7,,,percent of total billed charges,37.70% of total billed charges,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,53494.2,33.9,,,percent of total billed charges,33.9% of total billed charges,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1230.84,78,,,percent of total billed charges,78% of total billed charges,1578,100,,,percent of total billed charges,100% of total billed charges,1303.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1303.43,82.6,,,percent of total billed charges,82.6% of total billed charges,378.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.82,53494.2,
KNEE ARTHROSCOPY CHONDROPLASTY,96029877,CDM,960,RC,29877,HCPCS,Outpatient,,,1497,973.05,,1317.36,88,,,percent of total billed charges,88% of total Billed charges,62.02,100,,,Fee Schedule,100% of Medicare rate,360.69,100,,,Fee Schedule,100% of WA Medicaid,1497,100,,,percent of total billed charges,100% of total billed charges,371.51,103,,,Fee Schedule,103% of WA Medicaid,62.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,360.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1032.93,69,,,percent of total billed charges,69% of total billed charges,1497,100,,,percent of total billed charges,100% of total billed charges,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1497,100,,,percent of total billed charges,100% of total billed charges,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1497,100,,,percent of total billed charges,100% of total billed charges,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,925.89,61.85,,,percent of total billed charges,61.85% of total billed charges,360.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,468.9,130,,,Fee Schedule,130% of WA Medicaid ,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.37,37.7,,,percent of total billed charges,37.70% of total billed charges,564.37,37.7,,,percent of total billed charges,37.70% of total billed charges,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,50748.3,33.9,,,percent of total billed charges,33.9% of total billed charges,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1167.66,78,,,percent of total billed charges,78% of total billed charges,1497,100,,,percent of total billed charges,100% of total billed charges,1236.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1236.52,82.6,,,percent of total billed charges,82.6% of total billed charges,360.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.02,50748.3,
KNEE ARTHROSCOPY/SURGERY,96029879,CDM,960,RC,29879,HCPCS,Outpatient,,,1609,1045.85,,1415.92,88,,,percent of total billed charges,88% of total Billed charges,67.13,100,,,Fee Schedule,100% of Medicare rate,383.63,100,,,Fee Schedule,100% of WA Medicaid,1609,100,,,percent of total billed charges,100% of total billed charges,395.14,103,,,Fee Schedule,103% of WA Medicaid,67.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,117.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,383.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1110.21,69,,,percent of total billed charges,69% of total billed charges,1609,100,,,percent of total billed charges,100% of total billed charges,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1609,100,,,percent of total billed charges,100% of total billed charges,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1609,100,,,percent of total billed charges,100% of total billed charges,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,995.17,61.85,,,percent of total billed charges,61.85% of total billed charges,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,498.72,130,,,Fee Schedule,130% of WA Medicaid ,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.59,37.7,,,percent of total billed charges,37.70% of total billed charges,606.59,37.7,,,percent of total billed charges,37.70% of total billed charges,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,54545.1,33.9,,,percent of total billed charges,33.9% of total billed charges,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1255.02,78,,,percent of total billed charges,78% of total billed charges,1609,100,,,percent of total billed charges,100% of total billed charges,1329.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1329.03,82.6,,,percent of total billed charges,82.6% of total billed charges,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.13,54545.1,
ARTHOSCOPY KNEE SURG W/MENISCE,96029880,CDM,960,RC,29880,HCPCS,Outpatient,,,1417,921.05,,1246.96,88,,,percent of total billed charges,88% of total Billed charges,55.58,100,,,Fee Schedule,100% of Medicare rate,327.12,100,,,Fee Schedule,100% of WA Medicaid,1417,100,,,percent of total billed charges,100% of total billed charges,336.93,103,,,Fee Schedule,103% of WA Medicaid,55.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,327.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,977.73,69,,,percent of total billed charges,69% of total billed charges,1417,100,,,percent of total billed charges,100% of total billed charges,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1417,100,,,percent of total billed charges,100% of total billed charges,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1417,100,,,percent of total billed charges,100% of total billed charges,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.41,61.85,,,percent of total billed charges,61.85% of total billed charges,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,425.26,130,,,Fee Schedule,130% of WA Medicaid ,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.21,37.7,,,percent of total billed charges,37.70% of total billed charges,534.21,37.7,,,percent of total billed charges,37.70% of total billed charges,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,48036.3,33.9,,,percent of total billed charges,33.9% of total billed charges,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105.26,78,,,percent of total billed charges,78% of total billed charges,1417,100,,,percent of total billed charges,100% of total billed charges,1170.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1170.44,82.6,,,percent of total billed charges,82.6% of total billed charges,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.58,48036.3,
ARTHROSCOPY KNEE SURGICAL,96029881,CDM,960,RC,29881,HCPCS,Outpatient,,,1364,886.60,,1200.32,88,,,percent of total billed charges,88% of total Billed charges,52.89,100,,,Fee Schedule,100% of Medicare rate,315.56,100,,,Fee Schedule,100% of WA Medicaid,1364,100,,,percent of total billed charges,100% of total billed charges,325.03,103,,,Fee Schedule,103% of WA Medicaid,52.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,315.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,941.16,69,,,percent of total billed charges,69% of total billed charges,1364,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1364,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1364,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,843.63,61.85,,,percent of total billed charges,61.85% of total billed charges,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,410.23,130,,,Fee Schedule,130% of WA Medicaid ,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,514.23,37.7,,,percent of total billed charges,37.70% of total billed charges,514.23,37.7,,,percent of total billed charges,37.70% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,46239.6,33.9,,,percent of total billed charges,33.9% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.92,78,,,percent of total billed charges,78% of total billed charges,1364,100,,,percent of total billed charges,100% of total billed charges,1126.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1126.66,82.6,,,percent of total billed charges,82.6% of total billed charges,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.89,46239.6,
KNEE ARTHROSCOPY/SURGERY,96029882,CDM,960,RC,29882,HCPCS,Outpatient,,,1683,1093.95,,1481.04,88,,,percent of total billed charges,88% of total Billed charges,69.2,100,,,Fee Schedule,100% of Medicare rate,398.36,100,,,Fee Schedule,100% of WA Medicaid,1683,100,,,percent of total billed charges,100% of total billed charges,410.31,103,,,Fee Schedule,103% of WA Medicaid,69.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,121.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,398.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1161.27,69,,,percent of total billed charges,69% of total billed charges,1683,100,,,percent of total billed charges,100% of total billed charges,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1683,100,,,percent of total billed charges,100% of total billed charges,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1683,100,,,percent of total billed charges,100% of total billed charges,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1040.94,61.85,,,percent of total billed charges,61.85% of total billed charges,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,517.87,130,,,Fee Schedule,130% of WA Medicaid ,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.49,37.7,,,percent of total billed charges,37.70% of total billed charges,634.49,37.7,,,percent of total billed charges,37.70% of total billed charges,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,57053.7,33.9,,,percent of total billed charges,33.9% of total billed charges,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1312.74,78,,,percent of total billed charges,78% of total billed charges,1683,100,,,percent of total billed charges,100% of total billed charges,1390.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1390.16,82.6,,,percent of total billed charges,82.6% of total billed charges,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.2,57053.7,
ARTHRSOCOPY KNEE W/MENISCUSREP,96029883,CDM,960,RC,29883,HCPCS,Outpatient,,,1348,876.20,,1186.24,88,,,percent of total billed charges,88% of total Billed charges,88.11,100,,,Fee Schedule,100% of Medicare rate,486.39,100,,,Fee Schedule,100% of WA Medicaid,1348,100,,,percent of total billed charges,100% of total billed charges,500.98,103,,,Fee Schedule,103% of WA Medicaid,88.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,154.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,486.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,930.12,69,,,percent of total billed charges,69% of total billed charges,1348,100,,,percent of total billed charges,100% of total billed charges,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1348,100,,,percent of total billed charges,100% of total billed charges,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1348,100,,,percent of total billed charges,100% of total billed charges,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,833.74,61.85,,,percent of total billed charges,61.85% of total billed charges,486.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,632.31,130,,,Fee Schedule,130% of WA Medicaid ,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,508.2,37.7,,,percent of total billed charges,37.70% of total billed charges,508.2,37.7,,,percent of total billed charges,37.70% of total billed charges,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,45697.2,33.9,,,percent of total billed charges,33.9% of total billed charges,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1051.44,78,,,percent of total billed charges,78% of total billed charges,1348,100,,,percent of total billed charges,100% of total billed charges,1113.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1113.45,82.6,,,percent of total billed charges,82.6% of total billed charges,486.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.11,45697.2,
KNEE ARTHROSCOPY/SURGERY,96029888,CDM,960,RC,29888,HCPCS,Outpatient,,,2391,1554.15,,2104.08,88,,,percent of total billed charges,88% of total Billed charges,101.29,100,,,Fee Schedule,100% of Medicare rate,558.94,100,,,Fee Schedule,100% of WA Medicaid,2391,100,,,percent of total billed charges,100% of total billed charges,575.71,103,,,Fee Schedule,103% of WA Medicaid,101.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,177.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,558.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1649.79,69,,,percent of total billed charges,69% of total billed charges,2391,100,,,percent of total billed charges,100% of total billed charges,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2391,100,,,percent of total billed charges,100% of total billed charges,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2391,100,,,percent of total billed charges,100% of total billed charges,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1478.83,61.85,,,percent of total billed charges,61.85% of total billed charges,558.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,570.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,726.62,130,,,Fee Schedule,130% of WA Medicaid ,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,901.41,37.7,,,percent of total billed charges,37.70% of total billed charges,901.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,81054.9,33.9,,,percent of total billed charges,33.9% of total billed charges,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1864.98,78,,,percent of total billed charges,78% of total billed charges,2391,100,,,percent of total billed charges,100% of total billed charges,1974.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1974.97,82.6,,,percent of total billed charges,82.6% of total billed charges,558.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.29,81054.9,
KNEE ARTHROSCOPY/SURGERY,96029889,CDM,960,RC,29889,HCPCS,Outpatient,,,2463,1600.95,,2167.44,88,,,percent of total billed charges,88% of total Billed charges,130.43,100,,,Fee Schedule,100% of Medicare rate,703.85,100,,,Fee Schedule,100% of WA Medicaid,2463,100,,,percent of total billed charges,100% of total billed charges,724.97,103,,,Fee Schedule,103% of WA Medicaid,130.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,228.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,703.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1699.47,69,,,percent of total billed charges,69% of total billed charges,2463,100,,,percent of total billed charges,100% of total billed charges,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2463,100,,,percent of total billed charges,100% of total billed charges,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2463,100,,,percent of total billed charges,100% of total billed charges,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1523.37,61.85,,,percent of total billed charges,61.85% of total billed charges,703.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,703.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,915.01,130,,,Fee Schedule,130% of WA Medicaid ,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,928.55,37.7,,,percent of total billed charges,37.70% of total billed charges,928.55,37.7,,,percent of total billed charges,37.70% of total billed charges,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,83495.7,33.9,,,percent of total billed charges,33.9% of total billed charges,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1921.14,78,,,percent of total billed charges,78% of total billed charges,2463,100,,,percent of total billed charges,100% of total billed charges,2034.44,82.6,,,percent of total billed charges,82.6% of total billed charges,2034.44,82.6,,,percent of total billed charges,82.6% of total billed charges,703.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,703.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,130.43,83495.7,
29891,29891,CDM,975,RC,29891,HCPCS,Outpatient,,,1388,902.20,,1221.44,88,,,percent of total billed charges,88% of total Billed charges,61.53,100,,,Fee Schedule,100% of Medicare rate,390.53,100,,,Fee Schedule,100% of WA Medicaid,1388,100,,,percent of total billed charges,100% of total billed charges,402.25,103,,,Fee Schedule,103% of WA Medicaid,61.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,107.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,390.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,957.72,69,,,percent of total billed charges,69% of total billed charges,1388,100,,,percent of total billed charges,100% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1388,100,,,percent of total billed charges,100% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1388,100,,,percent of total billed charges,100% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,858.48,61.85,,,percent of total billed charges,61.85% of total billed charges,390.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,507.69,130,,,Fee Schedule,130% of WA Medicaid ,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,523.28,37.7,,,percent of total billed charges,37.70% of total billed charges,523.28,37.7,,,percent of total billed charges,37.70% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,47053.2,33.9,,,percent of total billed charges,33.9% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1082.64,78,,,percent of total billed charges,78% of total billed charges,1388,100,,,percent of total billed charges,100% of total billed charges,1146.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1146.49,82.6,,,percent of total billed charges,82.6% of total billed charges,390.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.53,47053.2,
"29894 ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS)",97529894,CDM,975,RC,29894,HCPCS,Outpatient,,,1015,659.75,,893.2,88,,,percent of total billed charges,88% of total Billed charges,46.5,100,,,Fee Schedule,100% of Medicare rate,292.06,100,,,Fee Schedule,100% of WA Medicaid,1015,100,,,percent of total billed charges,100% of total billed charges,300.82,103,,,Fee Schedule,103% of WA Medicaid,46.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,292.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,700.35,69,,,percent of total billed charges,69% of total billed charges,1015,100,,,percent of total billed charges,100% of total billed charges,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1015,100,,,percent of total billed charges,100% of total billed charges,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1015,100,,,percent of total billed charges,100% of total billed charges,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,627.78,61.85,,,percent of total billed charges,61.85% of total billed charges,292.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,379.68,130,,,Fee Schedule,130% of WA Medicaid ,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.66,37.7,,,percent of total billed charges,37.70% of total billed charges,382.66,37.7,,,percent of total billed charges,37.70% of total billed charges,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,34408.5,33.9,,,percent of total billed charges,33.9% of total billed charges,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,791.7,78,,,percent of total billed charges,78% of total billed charges,1015,100,,,percent of total billed charges,100% of total billed charges,838.39,82.6,,,percent of total billed charges,82.6% of total billed charges,838.39,82.6,,,percent of total billed charges,82.6% of total billed charges,292.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.5,34408.5,
ANKLE ARTHROSCOPY,96029898,CDM,960,RC,29898,HCPCS,Outpatient,,,1987,1291.55,,1748.56,88,,,percent of total billed charges,88% of total Billed charges,49.21,100,,,Fee Schedule,100% of Medicare rate,323.95,100,,,Fee Schedule,100% of WA Medicaid,1987,100,,,percent of total billed charges,100% of total billed charges,333.67,103,,,Fee Schedule,103% of WA Medicaid,49.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,323.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1371.03,69,,,percent of total billed charges,69% of total billed charges,1987,100,,,percent of total billed charges,100% of total billed charges,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1987,100,,,percent of total billed charges,100% of total billed charges,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1987,100,,,percent of total billed charges,100% of total billed charges,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1228.96,61.85,,,percent of total billed charges,61.85% of total billed charges,323.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,421.14,130,,,Fee Schedule,130% of WA Medicaid ,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,749.1,37.7,,,percent of total billed charges,37.70% of total billed charges,749.1,37.7,,,percent of total billed charges,37.70% of total billed charges,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,67359.3,33.9,,,percent of total billed charges,33.9% of total billed charges,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1549.86,78,,,percent of total billed charges,78% of total billed charges,1987,100,,,percent of total billed charges,100% of total billed charges,1641.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1641.26,82.6,,,percent of total billed charges,82.6% of total billed charges,323.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.21,67359.3,
"30100 BIOPSY, INTRANASAL ProFee",97530100,CDM,975,RC,30100,HCPCS,Outpatient,,,251,163.15,,220.88,88,,,percent of total billed charges,88% of total Billed charges,5.45,100,,,Fee Schedule,100% of Medicare rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,251,100,,,percent of total billed charges,100% of total billed charges,40.73,103,,,Fee Schedule,103% of WA Medicaid,5.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,251,100,,,percent of total billed charges,100% of total billed charges,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,251,100,,,percent of total billed charges,100% of total billed charges,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.24,61.85,,,percent of total billed charges,61.85% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.4,130,,,Fee Schedule,130% of WA Medicaid ,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,8508.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.45,8508.9,
"30130 EXCISION INFERIOR TURBINATE, PARTIAL OR COMPLETE, ANY",97530130,CDM,975,RC,30130,HCPCS,Outpatient,,,720,468.00,,633.6,88,,,percent of total billed charges,88% of total Billed charges,25.58,100,,,Fee Schedule,100% of Medicare rate,246.37,100,,,Fee Schedule,100% of WA Medicaid,720,100,,,percent of total billed charges,100% of total billed charges,253.76,103,,,Fee Schedule,103% of WA Medicaid,25.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,246.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,496.8,69,,,percent of total billed charges,69% of total billed charges,720,100,,,percent of total billed charges,100% of total billed charges,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,720,100,,,percent of total billed charges,100% of total billed charges,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,720,100,,,percent of total billed charges,100% of total billed charges,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.32,61.85,,,percent of total billed charges,61.85% of total billed charges,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,320.28,130,,,Fee Schedule,130% of WA Medicaid ,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.44,37.7,,,percent of total billed charges,37.70% of total billed charges,271.44,37.7,,,percent of total billed charges,37.70% of total billed charges,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,24408,33.9,,,percent of total billed charges,33.9% of total billed charges,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.6,78,,,percent of total billed charges,78% of total billed charges,720,100,,,percent of total billed charges,100% of total billed charges,594.72,82.6,,,percent of total billed charges,82.6% of total billed charges,594.72,82.6,,,percent of total billed charges,82.6% of total billed charges,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.58,24408,
"30400 RHINOPLASTY, PRIMARY; LATERAL AND ALAR CARTILAGES AND/",97530400,CDM,975,RC,30400,HCPCS,Outpatient,,,2075,1348.75,,1826,88,,,percent of total billed charges,88% of total Billed charges,89.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2075,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,89.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1431.75,69,,,percent of total billed charges,69% of total billed charges,2075,100,,,percent of total billed charges,100% of total billed charges,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2075,100,,,percent of total billed charges,100% of total billed charges,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2075,100,,,percent of total billed charges,100% of total billed charges,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1283.39,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,782.28,37.7,,,percent of total billed charges,37.70% of total billed charges,782.28,37.7,,,percent of total billed charges,37.70% of total billed charges,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,70342.5,33.9,,,percent of total billed charges,33.9% of total billed charges,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1618.5,78,,,percent of total billed charges,78% of total billed charges,2075,100,,,percent of total billed charges,100% of total billed charges,1713.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1713.95,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",89.8,70342.5,
"Rhinoplasty, primary; complete, external parts including bon",97530410,CDM,975,RC,30410,HCPCS,Outpatient,,,3164,2056.60,,2784.32,88,,,percent of total billed charges,88% of total Billed charges,110.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3164,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,110.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2183.16,69,,,percent of total billed charges,69% of total billed charges,3164,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3164,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3164,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1956.93,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1192.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1192.83,37.7,,,percent of total billed charges,37.70% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,107259.6,33.9,,,percent of total billed charges,33.9% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2467.92,78,,,percent of total billed charges,78% of total billed charges,3164,100,,,percent of total billed charges,100% of total billed charges,2613.46,82.6,,,percent of total billed charges,82.6% of total billed charges,2613.46,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",110.38,107259.6,
"30420 RHINOPLASTY, PRIMARY; INCLUDING MAJOR SEPTAL",97530420,CDM,975,RC,30420,HCPCS,Outpatient,,,2850,1852.50,,2508,88,,,percent of total billed charges,88% of total Billed charges,109.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2850,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,109.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,191.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1966.5,69,,,percent of total billed charges,69% of total billed charges,2850,100,,,percent of total billed charges,100% of total billed charges,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2850,100,,,percent of total billed charges,100% of total billed charges,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2850,100,,,percent of total billed charges,100% of total billed charges,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1762.73,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.45,37.7,,,percent of total billed charges,37.70% of total billed charges,1074.45,37.7,,,percent of total billed charges,37.70% of total billed charges,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,96615,33.9,,,percent of total billed charges,33.9% of total billed charges,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2223,78,,,percent of total billed charges,78% of total billed charges,2850,100,,,percent of total billed charges,100% of total billed charges,2354.1,82.6,,,percent of total billed charges,82.6% of total billed charges,2354.1,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",109.22,96615,
"30430 RHINOPLASTY, SECONDARY; MINOR REVISION (SMALL AMOUNT O",97530430,CDM,975,RC,30430,HCPCS,Outpatient,,,3852,2503.80,,3389.76,88,,,percent of total billed charges,88% of total Billed charges,72.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3852,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,72.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2657.88,69,,,percent of total billed charges,69% of total billed charges,3852,100,,,percent of total billed charges,100% of total billed charges,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,3852,100,,,percent of total billed charges,100% of total billed charges,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,3852,100,,,percent of total billed charges,100% of total billed charges,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,2382.46,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1452.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1452.2,37.7,,,percent of total billed charges,37.70% of total billed charges,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,130582.8,33.9,,,percent of total billed charges,33.9% of total billed charges,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,3004.56,78,,,percent of total billed charges,78% of total billed charges,3852,100,,,percent of total billed charges,100% of total billed charges,3181.75,82.6,,,percent of total billed charges,82.6% of total billed charges,3181.75,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",72.47,130582.8,
"30450 RHINOPLASTY, SECONDARY; MAJOR REVISION (NASAL TIP WORK",97530450,CDM,975,RC,30450,HCPCS,Outpatient,,,3116,2025.40,,2742.08,88,,,percent of total billed charges,88% of total Billed charges,147.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3116,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,147.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,257.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2150.04,69,,,percent of total billed charges,69% of total billed charges,3116,100,,,percent of total billed charges,100% of total billed charges,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3116,100,,,percent of total billed charges,100% of total billed charges,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3116,100,,,percent of total billed charges,100% of total billed charges,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1927.25,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1174.73,37.7,,,percent of total billed charges,37.70% of total billed charges,1174.73,37.7,,,percent of total billed charges,37.70% of total billed charges,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,105632.4,33.9,,,percent of total billed charges,33.9% of total billed charges,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2430.48,78,,,percent of total billed charges,78% of total billed charges,3116,100,,,percent of total billed charges,100% of total billed charges,2573.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2573.82,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",147.33,105632.4,
30460 RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGENITA,97530460,CDM,975,RC,30460,HCPCS,Outpatient,,,1701,1105.65,,1496.88,88,,,percent of total billed charges,88% of total Billed charges,74.42,100,,,Fee Schedule,100% of Medicare rate,478.75,100,,,Fee Schedule,100% of WA Medicaid,1701,100,,,percent of total billed charges,100% of total billed charges,493.11,103,,,Fee Schedule,103% of WA Medicaid,74.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,130.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,478.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1173.69,69,,,percent of total billed charges,69% of total billed charges,1701,100,,,percent of total billed charges,100% of total billed charges,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1701,100,,,percent of total billed charges,100% of total billed charges,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1701,100,,,percent of total billed charges,100% of total billed charges,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1052.07,61.85,,,percent of total billed charges,61.85% of total billed charges,478.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,622.38,130,,,Fee Schedule,130% of WA Medicaid ,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,641.28,37.7,,,percent of total billed charges,37.70% of total billed charges,641.28,37.7,,,percent of total billed charges,37.70% of total billed charges,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,57663.9,33.9,,,percent of total billed charges,33.9% of total billed charges,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1326.78,78,,,percent of total billed charges,78% of total billed charges,1701,100,,,percent of total billed charges,100% of total billed charges,1405.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1405.03,82.6,,,percent of total billed charges,82.6% of total billed charges,478.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.42,57663.9,
30462 RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO,97530462,CDM,975,RC,30462,HCPCS,Outpatient,,,2937,1909.05,,2584.56,88,,,percent of total billed charges,88% of total Billed charges,145.49,100,,,Fee Schedule,100% of Medicare rate,918.14,100,,,Fee Schedule,100% of WA Medicaid,2937,100,,,percent of total billed charges,100% of total billed charges,945.68,103,,,Fee Schedule,103% of WA Medicaid,145.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,254.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,918.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2026.53,69,,,percent of total billed charges,69% of total billed charges,2937,100,,,percent of total billed charges,100% of total billed charges,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2937,100,,,percent of total billed charges,100% of total billed charges,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2937,100,,,percent of total billed charges,100% of total billed charges,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1816.53,61.85,,,percent of total billed charges,61.85% of total billed charges,918.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,918.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,936.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1193.58,130,,,Fee Schedule,130% of WA Medicaid ,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1107.25,37.7,,,percent of total billed charges,37.70% of total billed charges,1107.25,37.7,,,percent of total billed charges,37.70% of total billed charges,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,99564.3,33.9,,,percent of total billed charges,33.9% of total billed charges,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2290.86,78,,,percent of total billed charges,78% of total billed charges,2937,100,,,percent of total billed charges,100% of total billed charges,2425.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2425.96,82.6,,,percent of total billed charges,82.6% of total billed charges,918.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,918.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,145.49,99564.3,
"30465 REPAIR OF NASAL VESTIBULAR STENOSIS (EG, SPREADER GRAF",97530465,CDM,975,RC,30465,HCPCS,Outpatient,,,2106,1368.90,,1853.28,88,,,percent of total billed charges,88% of total Billed charges,78.59,100,,,Fee Schedule,100% of Medicare rate,598.29,100,,,Fee Schedule,100% of WA Medicaid,2106,100,,,percent of total billed charges,100% of total billed charges,616.24,103,,,Fee Schedule,103% of WA Medicaid,78.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,598.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1453.14,69,,,percent of total billed charges,69% of total billed charges,2106,100,,,percent of total billed charges,100% of total billed charges,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2106,100,,,percent of total billed charges,100% of total billed charges,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2106,100,,,percent of total billed charges,100% of total billed charges,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1302.56,61.85,,,percent of total billed charges,61.85% of total billed charges,598.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,777.78,130,,,Fee Schedule,130% of WA Medicaid ,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,793.96,37.7,,,percent of total billed charges,37.70% of total billed charges,793.96,37.7,,,percent of total billed charges,37.70% of total billed charges,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,71393.4,33.9,,,percent of total billed charges,33.9% of total billed charges,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1642.68,78,,,percent of total billed charges,78% of total billed charges,2106,100,,,percent of total billed charges,100% of total billed charges,1739.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1739.56,82.6,,,percent of total billed charges,82.6% of total billed charges,598.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.59,71393.4,
"30520 SEPTOPLASTY OR SUBMUCOUS RESECTION, WITH OR",97530520,CDM,975,RC,30520,HCPCS,Outpatient,,,1259,818.35,,1107.92,88,,,percent of total billed charges,88% of total Billed charges,47.73,100,,,Fee Schedule,100% of Medicare rate,396.5,100,,,Fee Schedule,100% of WA Medicaid,1259,100,,,percent of total billed charges,100% of total billed charges,408.4,103,,,Fee Schedule,103% of WA Medicaid,47.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,396.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,868.71,69,,,percent of total billed charges,69% of total billed charges,1259,100,,,percent of total billed charges,100% of total billed charges,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259,100,,,percent of total billed charges,100% of total billed charges,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259,100,,,percent of total billed charges,100% of total billed charges,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.69,61.85,,,percent of total billed charges,61.85% of total billed charges,396.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,515.45,130,,,Fee Schedule,130% of WA Medicaid ,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.64,37.7,,,percent of total billed charges,37.70% of total billed charges,474.64,37.7,,,percent of total billed charges,37.70% of total billed charges,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,42680.1,33.9,,,percent of total billed charges,33.9% of total billed charges,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,982.02,78,,,percent of total billed charges,78% of total billed charges,1259,100,,,percent of total billed charges,100% of total billed charges,1039.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1039.93,82.6,,,percent of total billed charges,82.6% of total billed charges,396.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.73,42680.1,
30560 LYSIS INTRANASAL SYNECHIA ProFee,97530560,CDM,975,RC,30560,HCPCS,Outpatient,,,545,354.25,,479.6,88,,,percent of total billed charges,88% of total Billed charges,9.86,100,,,Fee Schedule,100% of Medicare rate,89.33,100,,,Fee Schedule,100% of WA Medicaid,545,100,,,percent of total billed charges,100% of total billed charges,92.01,103,,,Fee Schedule,103% of WA Medicaid,9.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,89.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,376.05,69,,,percent of total billed charges,69% of total billed charges,545,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,545,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,545,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.08,61.85,,,percent of total billed charges,61.85% of total billed charges,89.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,116.13,130,,,Fee Schedule,130% of WA Medicaid ,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.47,37.7,,,percent of total billed charges,37.70% of total billed charges,205.47,37.7,,,percent of total billed charges,37.70% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,18475.5,33.9,,,percent of total billed charges,33.9% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.1,78,,,percent of total billed charges,78% of total billed charges,545,100,,,percent of total billed charges,100% of total billed charges,450.17,82.6,,,percent of total billed charges,82.6% of total billed charges,450.17,82.6,,,percent of total billed charges,82.6% of total billed charges,89.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.86,18475.5,
"30905 CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NA",30905,CDM,975,RC,30905,HCPCS,Outpatient,,,336,218.40,,295.68,88,,,percent of total billed charges,88% of total Billed charges,12.21,100,,,Fee Schedule,100% of Medicare rate,59.31,100,,,Fee Schedule,100% of WA Medicaid,336,100,,,percent of total billed charges,100% of total billed charges,61.09,103,,,Fee Schedule,103% of WA Medicaid,12.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,231.84,69,,,percent of total billed charges,69% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.82,61.85,,,percent of total billed charges,61.85% of total billed charges,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,77.1,130,,,Fee Schedule,130% of WA Medicaid ,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,11390.4,33.9,,,percent of total billed charges,33.9% of total billed charges,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.08,78,,,percent of total billed charges,78% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.21,11390.4,
"30930 FRACTURE NASAL INFERIOR TURBINATE(S), THERAP",30930,CDM,975,RC,30930,HCPCS,Outpatient,,,270,175.50,,237.6,88,,,percent of total billed charges,88% of total Billed charges,8.57,100,,,Fee Schedule,100% of Medicare rate,69.56,100,,,Fee Schedule,100% of WA Medicaid,270,100,,,percent of total billed charges,100% of total billed charges,71.65,103,,,Fee Schedule,103% of WA Medicaid,8.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,186.3,69,,,percent of total billed charges,69% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,270,100,,,percent of total billed charges,100% of total billed charges,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,270,100,,,percent of total billed charges,100% of total billed charges,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,167,61.85,,,percent of total billed charges,61.85% of total billed charges,69.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,90.43,130,,,Fee Schedule,130% of WA Medicaid ,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,9153,33.9,,,percent of total billed charges,33.9% of total billed charges,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.6,78,,,percent of total billed charges,78% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,69.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.57,9153,
"30999 UNLISTED PROCEDURE, NOSE ProFee",97530999,CDM,975,RC,30999,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15255,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",169.65,15255,
"31231 NASAL ENDOSCOPY, DIAGNOSTIC, UNILATERAL OR BILATERAL (",97531231,CDM,975,RC,31231,HCPCS,Outpatient,,,398,258.70,,350.24,88,,,percent of total billed charges,88% of total Billed charges,6.08,100,,,Fee Schedule,100% of Medicare rate,36.55,100,,,Fee Schedule,100% of WA Medicaid,398,100,,,percent of total billed charges,100% of total billed charges,37.65,103,,,Fee Schedule,103% of WA Medicaid,6.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,36.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,274.62,69,,,percent of total billed charges,69% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,398,100,,,percent of total billed charges,100% of total billed charges,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,398,100,,,percent of total billed charges,100% of total billed charges,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.16,61.85,,,percent of total billed charges,61.85% of total billed charges,36.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.52,130,,,Fee Schedule,130% of WA Medicaid ,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,13492.2,33.9,,,percent of total billed charges,33.9% of total billed charges,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.44,78,,,percent of total billed charges,78% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,36.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.08,13492.2,
"31237 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH BIOPSY, POLYPECT",97531237,CDM,975,RC,31237,HCPCS,Outpatient,,,605,393.25,,532.4,88,,,percent of total billed charges,88% of total Billed charges,14.66,100,,,Fee Schedule,100% of Medicare rate,91.01,100,,,Fee Schedule,100% of WA Medicaid,605,100,,,percent of total billed charges,100% of total billed charges,93.74,103,,,Fee Schedule,103% of WA Medicaid,14.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,91.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,417.45,69,,,percent of total billed charges,69% of total billed charges,605,100,,,percent of total billed charges,100% of total billed charges,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,605,100,,,percent of total billed charges,100% of total billed charges,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,605,100,,,percent of total billed charges,100% of total billed charges,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.19,61.85,,,percent of total billed charges,61.85% of total billed charges,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,118.31,130,,,Fee Schedule,130% of WA Medicaid ,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.09,37.7,,,percent of total billed charges,37.70% of total billed charges,228.09,37.7,,,percent of total billed charges,37.70% of total billed charges,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20509.5,33.9,,,percent of total billed charges,33.9% of total billed charges,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.9,78,,,percent of total billed charges,78% of total billed charges,605,100,,,percent of total billed charges,100% of total billed charges,499.73,82.6,,,percent of total billed charges,82.6% of total billed charges,499.73,82.6,,,percent of total billed charges,82.6% of total billed charges,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.66,20509.5,
"31238 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONTROL OF NASAL",97531238,CDM,975,RC,31238,HCPCS,Outpatient,,,419,272.35,,368.72,88,,,percent of total billed charges,88% of total Billed charges,15.4,100,,,Fee Schedule,100% of Medicare rate,95.3,100,,,Fee Schedule,100% of WA Medicaid,419,100,,,percent of total billed charges,100% of total billed charges,98.16,103,,,Fee Schedule,103% of WA Medicaid,15.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,95.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,289.11,69,,,percent of total billed charges,69% of total billed charges,419,100,,,percent of total billed charges,100% of total billed charges,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,419,100,,,percent of total billed charges,100% of total billed charges,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,419,100,,,percent of total billed charges,100% of total billed charges,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.15,61.85,,,percent of total billed charges,61.85% of total billed charges,95.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,123.89,130,,,Fee Schedule,130% of WA Medicaid ,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.96,37.7,,,percent of total billed charges,37.70% of total billed charges,157.96,37.7,,,percent of total billed charges,37.70% of total billed charges,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,14204.1,33.9,,,percent of total billed charges,33.9% of total billed charges,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.82,78,,,percent of total billed charges,78% of total billed charges,419,100,,,percent of total billed charges,100% of total billed charges,346.09,82.6,,,percent of total billed charges,82.6% of total billed charges,346.09,82.6,,,percent of total billed charges,82.6% of total billed charges,95.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.4,14204.1,
"31240 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONCHA",97531240,CDM,975,RC,31240,HCPCS,Outpatient,,,395,256.75,,347.6,88,,,percent of total billed charges,88% of total Billed charges,14.63,100,,,Fee Schedule,100% of Medicare rate,90.45,100,,,Fee Schedule,100% of WA Medicaid,395,100,,,percent of total billed charges,100% of total billed charges,93.16,103,,,Fee Schedule,103% of WA Medicaid,14.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,90.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,272.55,69,,,percent of total billed charges,69% of total billed charges,395,100,,,percent of total billed charges,100% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,395,100,,,percent of total billed charges,100% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,395,100,,,percent of total billed charges,100% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.31,61.85,,,percent of total billed charges,61.85% of total billed charges,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,117.59,130,,,Fee Schedule,130% of WA Medicaid ,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.92,37.7,,,percent of total billed charges,37.70% of total billed charges,148.92,37.7,,,percent of total billed charges,37.70% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,13390.5,33.9,,,percent of total billed charges,33.9% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.1,78,,,percent of total billed charges,78% of total billed charges,395,100,,,percent of total billed charges,100% of total billed charges,326.27,82.6,,,percent of total billed charges,82.6% of total billed charges,326.27,82.6,,,percent of total billed charges,82.6% of total billed charges,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.63,13390.5,
"31254 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH ETHMOIDECTOMY, P",97531254,CDM,975,RC,31254,HCPCS,Outpatient,,,616,400.40,,542.08,88,,,percent of total billed charges,88% of total Billed charges,23.07,100,,,Fee Schedule,100% of Medicare rate,137.26,100,,,Fee Schedule,100% of WA Medicaid,616,100,,,percent of total billed charges,100% of total billed charges,141.38,103,,,Fee Schedule,103% of WA Medicaid,23.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,137.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,425.04,69,,,percent of total billed charges,69% of total billed charges,616,100,,,percent of total billed charges,100% of total billed charges,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,616,100,,,percent of total billed charges,100% of total billed charges,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,616,100,,,percent of total billed charges,100% of total billed charges,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,381,61.85,,,percent of total billed charges,61.85% of total billed charges,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,178.44,130,,,Fee Schedule,130% of WA Medicaid ,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.23,37.7,,,percent of total billed charges,37.70% of total billed charges,232.23,37.7,,,percent of total billed charges,37.70% of total billed charges,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,20882.4,33.9,,,percent of total billed charges,33.9% of total billed charges,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.48,78,,,percent of total billed charges,78% of total billed charges,616,100,,,percent of total billed charges,100% of total billed charges,508.82,82.6,,,percent of total billed charges,82.6% of total billed charges,508.82,82.6,,,percent of total billed charges,82.6% of total billed charges,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.07,20882.4,
"31255 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH ETHMOI",97531255,CDM,975,RC,31255,HCPCS,Outpatient,,,906,588.90,,797.28,88,,,percent of total billed charges,88% of total Billed charges,31.15,100,,,Fee Schedule,100% of Medicare rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,906,100,,,percent of total billed charges,100% of total billed charges,187.48,103,,,Fee Schedule,103% of WA Medicaid,31.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,625.14,69,,,percent of total billed charges,69% of total billed charges,906,100,,,percent of total billed charges,100% of total billed charges,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,906,100,,,percent of total billed charges,100% of total billed charges,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,906,100,,,percent of total billed charges,100% of total billed charges,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,560.36,61.85,,,percent of total billed charges,61.85% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,236.63,130,,,Fee Schedule,130% of WA Medicaid ,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.56,37.7,,,percent of total billed charges,37.70% of total billed charges,341.56,37.7,,,percent of total billed charges,37.70% of total billed charges,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,30713.4,33.9,,,percent of total billed charges,33.9% of total billed charges,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,706.68,78,,,percent of total billed charges,78% of total billed charges,906,100,,,percent of total billed charges,100% of total billed charges,748.36,82.6,,,percent of total billed charges,82.6% of total billed charges,748.36,82.6,,,percent of total billed charges,82.6% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.15,30713.4,
"31256 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILL",96031256,CDM,975,RC,31256,HCPCS,Outpatient,,,428,278.20,,376.64,88,,,percent of total billed charges,88% of total Billed charges,16.79,100,,,Fee Schedule,100% of Medicare rate,101.83,100,,,Fee Schedule,100% of WA Medicaid,428,100,,,percent of total billed charges,100% of total billed charges,104.88,103,,,Fee Schedule,103% of WA Medicaid,16.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,101.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,295.32,69,,,percent of total billed charges,69% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,428,100,,,percent of total billed charges,100% of total billed charges,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,428,100,,,percent of total billed charges,100% of total billed charges,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.72,61.85,,,percent of total billed charges,61.85% of total billed charges,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.38,130,,,Fee Schedule,130% of WA Medicaid ,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14509.2,33.9,,,percent of total billed charges,33.9% of total billed charges,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.84,78,,,percent of total billed charges,78% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.79,14509.2,
96031257,96031257,CDM,975,RC,31257,HCPCS,Outpatient,,,1108,720.20,,975.04,88,,,percent of total billed charges,88% of total Billed charges,43.86,100,,,Fee Schedule,100% of Medicare rate,250.84,100,,,Fee Schedule,100% of WA Medicaid,1108,100,,,percent of total billed charges,100% of total billed charges,258.37,103,,,Fee Schedule,103% of WA Medicaid,43.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,250.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,764.52,69,,,percent of total billed charges,69% of total billed charges,1108,100,,,percent of total billed charges,100% of total billed charges,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1108,100,,,percent of total billed charges,100% of total billed charges,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1108,100,,,percent of total billed charges,100% of total billed charges,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.3,61.85,,,percent of total billed charges,61.85% of total billed charges,250.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,326.09,130,,,Fee Schedule,130% of WA Medicaid ,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.72,37.7,,,percent of total billed charges,37.70% of total billed charges,417.72,37.7,,,percent of total billed charges,37.70% of total billed charges,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,37561.2,33.9,,,percent of total billed charges,33.9% of total billed charges,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,864.24,78,,,percent of total billed charges,78% of total billed charges,1108,100,,,percent of total billed charges,100% of total billed charges,915.21,82.6,,,percent of total billed charges,82.6% of total billed charges,915.21,82.6,,,percent of total billed charges,82.6% of total billed charges,250.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.86,37561.2,
31253 NSL/SINS NDSC TOTAL,97531253,CDM,975,RC,31253,HCPCS,Outpatient,,,1747,1135.55,,1537.36,88,,,percent of total billed charges,88% of total Billed charges,48.83,100,,,Fee Schedule,100% of Medicare rate,281.06,100,,,Fee Schedule,100% of WA Medicaid,1747,100,,,percent of total billed charges,100% of total billed charges,289.49,103,,,Fee Schedule,103% of WA Medicaid,48.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,281.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1205.43,69,,,percent of total billed charges,69% of total billed charges,1747,100,,,percent of total billed charges,100% of total billed charges,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1747,100,,,percent of total billed charges,100% of total billed charges,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1747,100,,,percent of total billed charges,100% of total billed charges,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080.52,61.85,,,percent of total billed charges,61.85% of total billed charges,281.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,365.38,130,,,Fee Schedule,130% of WA Medicaid ,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.62,37.7,,,percent of total billed charges,37.70% of total billed charges,658.62,37.7,,,percent of total billed charges,37.70% of total billed charges,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,59223.3,33.9,,,percent of total billed charges,33.9% of total billed charges,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1362.66,78,,,percent of total billed charges,78% of total billed charges,1747,100,,,percent of total billed charges,100% of total billed charges,1443.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1443.02,82.6,,,percent of total billed charges,82.6% of total billed charges,281.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.83,59223.3,
"31259 Nasal/sinus endoscopy, surgical with ethmoidectomy; t",97531259,CDM,975,RC,31259,HCPCS,Outpatient,,,1017,661.05,,894.96,88,,,percent of total billed charges,88% of total Billed charges,45.91,100,,,Fee Schedule,100% of Medicare rate,265.02,100,,,Fee Schedule,100% of WA Medicaid,1017,100,,,percent of total billed charges,100% of total billed charges,272.97,103,,,Fee Schedule,103% of WA Medicaid,45.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,265.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,701.73,69,,,percent of total billed charges,69% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,100,,,percent of total billed charges,100% of total billed charges,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,100,,,percent of total billed charges,100% of total billed charges,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.01,61.85,,,percent of total billed charges,61.85% of total billed charges,265.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,344.53,130,,,Fee Schedule,130% of WA Medicaid ,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,34476.3,33.9,,,percent of total billed charges,33.9% of total billed charges,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,793.26,78,,,percent of total billed charges,78% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,265.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.91,34476.3,
"31267 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILL",97531267,CDM,975,RC,31267,HCPCS,Outpatient,,,718,466.70,,631.84,88,,,percent of total billed charges,88% of total Billed charges,25.81,100,,,Fee Schedule,100% of Medicare rate,149.76,100,,,Fee Schedule,100% of WA Medicaid,718,100,,,percent of total billed charges,100% of total billed charges,154.25,103,,,Fee Schedule,103% of WA Medicaid,25.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,149.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,495.42,69,,,percent of total billed charges,69% of total billed charges,718,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,718,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,718,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.08,61.85,,,percent of total billed charges,61.85% of total billed charges,149.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,194.69,130,,,Fee Schedule,130% of WA Medicaid ,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.69,37.7,,,percent of total billed charges,37.70% of total billed charges,270.69,37.7,,,percent of total billed charges,37.70% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,24340.2,33.9,,,percent of total billed charges,33.9% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,560.04,78,,,percent of total billed charges,78% of total billed charges,718,100,,,percent of total billed charges,100% of total billed charges,593.07,82.6,,,percent of total billed charges,82.6% of total billed charges,593.07,82.6,,,percent of total billed charges,82.6% of total billed charges,149.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.81,24340.2,
"31276 NASAL/SINUS ENDOSCOPY, SURGICAL WITH FRONTAL SINUS EXP",97531276,CDM,975,RC,31276,HCPCS,Outpatient,,,1713,1113.45,,1507.44,88,,,percent of total billed charges,88% of total Billed charges,36.93,100,,,Fee Schedule,100% of Medicare rate,212.98,100,,,Fee Schedule,100% of WA Medicaid,1713,100,,,percent of total billed charges,100% of total billed charges,219.37,103,,,Fee Schedule,103% of WA Medicaid,36.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,212.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1181.97,69,,,percent of total billed charges,69% of total billed charges,1713,100,,,percent of total billed charges,100% of total billed charges,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1713,100,,,percent of total billed charges,100% of total billed charges,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1713,100,,,percent of total billed charges,100% of total billed charges,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1059.49,61.85,,,percent of total billed charges,61.85% of total billed charges,212.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,276.87,130,,,Fee Schedule,130% of WA Medicaid ,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.8,37.7,,,percent of total billed charges,37.70% of total billed charges,645.8,37.7,,,percent of total billed charges,37.70% of total billed charges,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,58070.7,33.9,,,percent of total billed charges,33.9% of total billed charges,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1336.14,78,,,percent of total billed charges,78% of total billed charges,1713,100,,,percent of total billed charges,100% of total billed charges,1414.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1414.94,82.6,,,percent of total billed charges,82.6% of total billed charges,212.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.93,58070.7,
"31287 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY; P",97531287,CDM,975,RC,31287,HCPCS,Outpatient,,,524,340.60,,461.12,88,,,percent of total billed charges,88% of total Billed charges,18.97,100,,,Fee Schedule,100% of Medicare rate,113.58,100,,,Fee Schedule,100% of WA Medicaid,524,100,,,percent of total billed charges,100% of total billed charges,116.99,103,,,Fee Schedule,103% of WA Medicaid,18.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,113.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,361.56,69,,,percent of total billed charges,69% of total billed charges,524,100,,,percent of total billed charges,100% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,524,100,,,percent of total billed charges,100% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,524,100,,,percent of total billed charges,100% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.09,61.85,,,percent of total billed charges,61.85% of total billed charges,113.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,147.65,130,,,Fee Schedule,130% of WA Medicaid ,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.55,37.7,,,percent of total billed charges,37.70% of total billed charges,197.55,37.7,,,percent of total billed charges,37.70% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,17763.6,33.9,,,percent of total billed charges,33.9% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.72,78,,,percent of total billed charges,78% of total billed charges,524,100,,,percent of total billed charges,100% of total billed charges,432.82,82.6,,,percent of total billed charges,82.6% of total billed charges,432.82,82.6,,,percent of total billed charges,82.6% of total billed charges,113.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.97,17763.6,
"31299 UNLISTED PROCEDURE, ACCESSORY SINUSES ProFee",97531299,CDM,975,RC,31299,HCPCS,Outpatient,,,1489,967.85,,1310.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1489,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1027.41,69,,,percent of total billed charges,69% of total billed charges,1489,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1489,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1489,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,920.95,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,561.35,37.7,,,percent of total billed charges,37.70% of total billed charges,561.35,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,50477.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1161.42,78,,,percent of total billed charges,78% of total billed charges,1489,100,,,percent of total billed charges,100% of total billed charges,1229.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1229.91,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",561.35,50477.1,
ENDOTRACHEAL INTUBATION,98731500,CDM,987,RC,31500,HCPCS,Outpatient,,,590.5,383.83,,519.64,88,,,percent of total billed charges,88% of total Billed charges,15.28,100,,,Fee Schedule,100% of Medicare rate,77.77,100,,,Fee Schedule,100% of WA Medicaid,590.5,100,,,percent of total billed charges,100% of total billed charges,80.1,103,,,Fee Schedule,103% of WA Medicaid,15.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,407.45,69,,,percent of total billed charges,69% of total billed charges,590.5,100,,,percent of total billed charges,100% of total billed charges,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.5,100,,,percent of total billed charges,100% of total billed charges,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.5,100,,,percent of total billed charges,100% of total billed charges,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,365.22,61.85,,,percent of total billed charges,61.85% of total billed charges,77.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.1,130,,,Fee Schedule,130% of WA Medicaid ,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.62,37.7,,,percent of total billed charges,37.70% of total billed charges,222.62,37.7,,,percent of total billed charges,37.70% of total billed charges,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,20017.95,33.9,,,percent of total billed charges,33.9% of total billed charges,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.59,78,,,percent of total billed charges,78% of total billed charges,590.5,100,,,percent of total billed charges,100% of total billed charges,487.75,82.6,,,percent of total billed charges,82.6% of total billed charges,487.75,82.6,,,percent of total billed charges,82.6% of total billed charges,77.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.28,20017.95,
"31535 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY",97531535,CDM,975,RC,31535,HCPCS,Outpatient,,,428,278.20,,376.64,88,,,percent of total billed charges,88% of total Billed charges,17.58,100,,,Fee Schedule,100% of Medicare rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,428,100,,,percent of total billed charges,100% of total billed charges,110.26,103,,,Fee Schedule,103% of WA Medicaid,17.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,295.32,69,,,percent of total billed charges,69% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,428,100,,,percent of total billed charges,100% of total billed charges,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,428,100,,,percent of total billed charges,100% of total billed charges,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.72,61.85,,,percent of total billed charges,61.85% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.17,130,,,Fee Schedule,130% of WA Medicaid ,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,14509.2,33.9,,,percent of total billed charges,33.9% of total billed charges,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.84,78,,,percent of total billed charges,78% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.58,14509.2,
"31536 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY",97531536,CDM,975,RC,31536,HCPCS,Outpatient,,,486,315.90,,427.68,88,,,percent of total billed charges,88% of total Billed charges,19.5,100,,,Fee Schedule,100% of Medicare rate,118.8,100,,,Fee Schedule,100% of WA Medicaid,486,100,,,percent of total billed charges,100% of total billed charges,122.36,103,,,Fee Schedule,103% of WA Medicaid,19.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,118.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,335.34,69,,,percent of total billed charges,69% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.59,61.85,,,percent of total billed charges,61.85% of total billed charges,118.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,154.44,130,,,Fee Schedule,130% of WA Medicaid ,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,16475.4,33.9,,,percent of total billed charges,33.9% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.08,78,,,percent of total billed charges,78% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,118.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.5,16475.4,
"31541 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMO",97531541,CDM,975,RC,31541,HCPCS,Outpatient,,,577,375.05,,507.76,88,,,percent of total billed charges,88% of total Billed charges,24.95,100,,,Fee Schedule,100% of Medicare rate,148.27,100,,,Fee Schedule,100% of WA Medicaid,577,100,,,percent of total billed charges,100% of total billed charges,152.72,103,,,Fee Schedule,103% of WA Medicaid,24.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,148.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,398.13,69,,,percent of total billed charges,69% of total billed charges,577,100,,,percent of total billed charges,100% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,577,100,,,percent of total billed charges,100% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,577,100,,,percent of total billed charges,100% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.87,61.85,,,percent of total billed charges,61.85% of total billed charges,148.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,192.75,130,,,Fee Schedule,130% of WA Medicaid ,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.53,37.7,,,percent of total billed charges,37.70% of total billed charges,217.53,37.7,,,percent of total billed charges,37.70% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,19560.3,33.9,,,percent of total billed charges,33.9% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.06,78,,,percent of total billed charges,78% of total billed charges,577,100,,,percent of total billed charges,100% of total billed charges,476.6,82.6,,,percent of total billed charges,82.6% of total billed charges,476.6,82.6,,,percent of total billed charges,82.6% of total billed charges,148.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.95,19560.3,
"31600 TRACHEOSTOMY, PLANNED (SEPARATE PROCEDURE); ProFee",97531600,CDM,975,RC,31600,HCPCS,Outpatient,,,1440,936.00,,1267.2,88,,,percent of total billed charges,88% of total Billed charges,36.99,100,,,Fee Schedule,100% of Medicare rate,169.72,100,,,Fee Schedule,100% of WA Medicaid,1440,100,,,percent of total billed charges,100% of total billed charges,174.81,103,,,Fee Schedule,103% of WA Medicaid,36.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,169.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,993.6,69,,,percent of total billed charges,69% of total billed charges,1440,100,,,percent of total billed charges,100% of total billed charges,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1440,100,,,percent of total billed charges,100% of total billed charges,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1440,100,,,percent of total billed charges,100% of total billed charges,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,890.64,61.85,,,percent of total billed charges,61.85% of total billed charges,169.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.64,130,,,Fee Schedule,130% of WA Medicaid ,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,542.88,37.7,,,percent of total billed charges,37.70% of total billed charges,542.88,37.7,,,percent of total billed charges,37.70% of total billed charges,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,48816,33.9,,,percent of total billed charges,33.9% of total billed charges,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1123.2,78,,,percent of total billed charges,78% of total billed charges,1440,100,,,percent of total billed charges,100% of total billed charges,1189.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1189.44,82.6,,,percent of total billed charges,82.6% of total billed charges,169.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.99,48816,
INSERTION CHEST TUBE,96032551,CDM,960,RC,32551,HCPCS,Outpatient,,,389,252.85,,342.32,88,,,percent of total billed charges,88% of total Billed charges,18.29,100,,,Fee Schedule,100% of Medicare rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,389,100,,,percent of total billed charges,100% of total billed charges,88.36,103,,,Fee Schedule,103% of WA Medicaid,18.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,268.41,69,,,percent of total billed charges,69% of total billed charges,389,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,389,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,389,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.6,61.85,,,percent of total billed charges,61.85% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.53,130,,,Fee Schedule,130% of WA Medicaid ,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.65,37.7,,,percent of total billed charges,37.70% of total billed charges,146.65,37.7,,,percent of total billed charges,37.70% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,13187.1,33.9,,,percent of total billed charges,33.9% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.42,78,,,percent of total billed charges,78% of total billed charges,389,100,,,percent of total billed charges,100% of total billed charges,321.31,82.6,,,percent of total billed charges,82.6% of total billed charges,321.31,82.6,,,percent of total billed charges,82.6% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.29,13187.1,
THORACENTESIS,96032554,CDM,960,RC,32554,HCPCS,Outpatient,,,638,414.70,,561.44,88,,,percent of total billed charges,88% of total Billed charges,8.05,100,,,Fee Schedule,100% of Medicare rate,49.05,100,,,Fee Schedule,100% of WA Medicaid,638,100,,,percent of total billed charges,100% of total billed charges,50.52,103,,,Fee Schedule,103% of WA Medicaid,8.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,440.22,69,,,percent of total billed charges,69% of total billed charges,638,100,,,percent of total billed charges,100% of total billed charges,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,638,100,,,percent of total billed charges,100% of total billed charges,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,638,100,,,percent of total billed charges,100% of total billed charges,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.6,61.85,,,percent of total billed charges,61.85% of total billed charges,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.77,130,,,Fee Schedule,130% of WA Medicaid ,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.53,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,37.7,,,percent of total billed charges,37.70% of total billed charges,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,21628.2,33.9,,,percent of total billed charges,33.9% of total billed charges,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.64,78,,,percent of total billed charges,78% of total billed charges,638,100,,,percent of total billed charges,100% of total billed charges,526.99,82.6,,,percent of total billed charges,82.6% of total billed charges,526.99,82.6,,,percent of total billed charges,82.6% of total billed charges,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.05,21628.2,
THORACENTESIS;IMAGING GUIDED,96032555,CDM,960,RC,32555,HCPCS,Outpatient,,,773,502.45,,680.24,88,,,percent of total billed charges,88% of total Billed charges,8.9,100,,,Fee Schedule,100% of Medicare rate,60.43,100,,,Fee Schedule,100% of WA Medicaid,773,100,,,percent of total billed charges,100% of total billed charges,62.24,103,,,Fee Schedule,103% of WA Medicaid,8.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,533.37,69,,,percent of total billed charges,69% of total billed charges,773,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,773,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,773,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.1,61.85,,,percent of total billed charges,61.85% of total billed charges,60.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,78.56,130,,,Fee Schedule,130% of WA Medicaid ,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.42,37.7,,,percent of total billed charges,37.70% of total billed charges,291.42,37.7,,,percent of total billed charges,37.70% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,26204.7,33.9,,,percent of total billed charges,33.9% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.94,78,,,percent of total billed charges,78% of total billed charges,773,100,,,percent of total billed charges,100% of total billed charges,638.5,82.6,,,percent of total billed charges,82.6% of total billed charges,638.5,82.6,,,percent of total billed charges,82.6% of total billed charges,60.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.9,26204.7,
PLEURAL DRAINAGE,96032556,CDM,960,RC,32556,HCPCS,Outpatient,,,205,133.25,,180.4,88,,,percent of total billed charges,88% of total Billed charges,13.23,100,,,Fee Schedule,100% of Medicare rate,68.45,100,,,Fee Schedule,100% of WA Medicaid,205,100,,,percent of total billed charges,100% of total billed charges,70.5,103,,,Fee Schedule,103% of WA Medicaid,13.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,141.45,69,,,percent of total billed charges,69% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,205,100,,,percent of total billed charges,100% of total billed charges,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,205,100,,,percent of total billed charges,100% of total billed charges,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.79,61.85,,,percent of total billed charges,61.85% of total billed charges,68.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,88.99,130,,,Fee Schedule,130% of WA Medicaid ,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.29,37.7,,,percent of total billed charges,37.70% of total billed charges,77.29,37.7,,,percent of total billed charges,37.70% of total billed charges,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,6949.5,33.9,,,percent of total billed charges,33.9% of total billed charges,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.9,78,,,percent of total billed charges,78% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,68.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.23,6949.5,
"32557 PLEURAL DRAINAGE, PERCUTANEOUS, WITH INSERTI",97532557,CDM,975,RC,32557,HCPCS,Outpatient,,,469,304.85,,412.72,88,,,percent of total billed charges,88% of total Billed charges,12.41,100,,,Fee Schedule,100% of Medicare rate,82.43,100,,,Fee Schedule,100% of WA Medicaid,469,100,,,percent of total billed charges,100% of total billed charges,84.9,103,,,Fee Schedule,103% of WA Medicaid,12.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,82.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,323.61,69,,,percent of total billed charges,69% of total billed charges,469,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,469,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,469,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.08,61.85,,,percent of total billed charges,61.85% of total billed charges,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.16,130,,,Fee Schedule,130% of WA Medicaid ,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.81,37.7,,,percent of total billed charges,37.70% of total billed charges,176.81,37.7,,,percent of total billed charges,37.70% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,15899.1,33.9,,,percent of total billed charges,33.9% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,365.82,78,,,percent of total billed charges,78% of total billed charges,469,100,,,percent of total billed charges,100% of total billed charges,387.39,82.6,,,percent of total billed charges,82.6% of total billed charges,387.39,82.6,,,percent of total billed charges,82.6% of total billed charges,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.41,15899.1,
"32560 INSTILLATION, VIA CHEST TUBE/CATHETER, AGENT FOR PLEUR",97532560,CDM,975,RC,32560,HCPCS,Outpatient,,,610,396.50,,536.8,88,,,percent of total billed charges,88% of total Billed charges,8.44,100,,,Fee Schedule,100% of Medicare rate,41.78,100,,,Fee Schedule,100% of WA Medicaid,610,100,,,percent of total billed charges,100% of total billed charges,43.03,103,,,Fee Schedule,103% of WA Medicaid,8.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,41.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,420.9,69,,,percent of total billed charges,69% of total billed charges,610,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,610,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,610,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.29,61.85,,,percent of total billed charges,61.85% of total billed charges,41.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,54.31,130,,,Fee Schedule,130% of WA Medicaid ,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.97,37.7,,,percent of total billed charges,37.70% of total billed charges,229.97,37.7,,,percent of total billed charges,37.70% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,20679,33.9,,,percent of total billed charges,33.9% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.8,78,,,percent of total billed charges,78% of total billed charges,610,100,,,percent of total billed charges,100% of total billed charges,503.86,82.6,,,percent of total billed charges,82.6% of total billed charges,503.86,82.6,,,percent of total billed charges,82.6% of total billed charges,41.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.44,20679,
32607 THORACOSCOPY; WITH DIAGNOSTIC BIOPSY(IES) OF LUNG INFI,97532607,CDM,975,RC,32607,HCPCS,Outpatient,,,769,499.85,,676.72,88,,,percent of total billed charges,88% of total Billed charges,43.16,100,,,Fee Schedule,100% of Medicare rate,168.41,100,,,Fee Schedule,100% of WA Medicaid,769,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,43.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,168.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,530.61,69,,,percent of total billed charges,69% of total billed charges,769,100,,,percent of total billed charges,100% of total billed charges,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,769,100,,,percent of total billed charges,100% of total billed charges,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,769,100,,,percent of total billed charges,100% of total billed charges,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.63,61.85,,,percent of total billed charges,61.85% of total billed charges,168.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.91,37.7,,,percent of total billed charges,37.70% of total billed charges,289.91,37.7,,,percent of total billed charges,37.70% of total billed charges,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,26069.1,33.9,,,percent of total billed charges,33.9% of total billed charges,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.82,78,,,percent of total billed charges,78% of total billed charges,769,100,,,percent of total billed charges,100% of total billed charges,635.19,82.6,,,percent of total billed charges,82.6% of total billed charges,635.19,82.6,,,percent of total billed charges,82.6% of total billed charges,168.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.16,26069.1,
"32652 THORACOSCOPY, SURGICAL; WITH TOTAL PULMONARY DECORTICA",97532652,CDM,975,RC,32652,HCPCS,Outpatient,,,6147,3995.55,,5409.36,88,,,percent of total billed charges,88% of total Billed charges,233.56,100,,,Fee Schedule,100% of Medicare rate,913.48,100,,,Fee Schedule,100% of WA Medicaid,6147,100,,,percent of total billed charges,100% of total billed charges,940.88,103,,,Fee Schedule,103% of WA Medicaid,233.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,408.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,913.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4241.43,69,,,percent of total billed charges,69% of total billed charges,6147,100,,,percent of total billed charges,100% of total billed charges,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,6147,100,,,percent of total billed charges,100% of total billed charges,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,6147,100,,,percent of total billed charges,100% of total billed charges,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3801.92,61.85,,,percent of total billed charges,61.85% of total billed charges,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1187.52,130,,,Fee Schedule,130% of WA Medicaid ,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2317.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2317.42,37.7,,,percent of total billed charges,37.70% of total billed charges,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,208383.3,33.9,,,percent of total billed charges,33.9% of total billed charges,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4794.66,78,,,percent of total billed charges,78% of total billed charges,6147,100,,,percent of total billed charges,100% of total billed charges,5077.42,82.6,,,percent of total billed charges,82.6% of total billed charges,5077.42,82.6,,,percent of total billed charges,82.6% of total billed charges,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,233.56,208383.3,
INSERT NEW/REPL PERMAN PACEMAK,96033208,CDM,960,RC,33208,HCPCS,Outpatient,,,1110,721.50,,976.8,88,,,percent of total billed charges,88% of total Billed charges,65.16,100,,,Fee Schedule,100% of Medicare rate,285.72,100,,,Fee Schedule,100% of WA Medicaid,1110,100,,,percent of total billed charges,100% of total billed charges,294.29,103,,,Fee Schedule,103% of WA Medicaid,65.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,285.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,765.9,69,,,percent of total billed charges,69% of total billed charges,1110,100,,,percent of total billed charges,100% of total billed charges,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1110,100,,,percent of total billed charges,100% of total billed charges,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1110,100,,,percent of total billed charges,100% of total billed charges,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.54,61.85,,,percent of total billed charges,61.85% of total billed charges,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,371.44,130,,,Fee Schedule,130% of WA Medicaid ,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.47,37.7,,,percent of total billed charges,37.70% of total billed charges,418.47,37.7,,,percent of total billed charges,37.70% of total billed charges,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,37629,33.9,,,percent of total billed charges,33.9% of total billed charges,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,865.8,78,,,percent of total billed charges,78% of total billed charges,1110,100,,,percent of total billed charges,100% of total billed charges,916.86,82.6,,,percent of total billed charges,82.6% of total billed charges,916.86,82.6,,,percent of total billed charges,82.6% of total billed charges,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.16,37629,
34703 Endovascular repair of infrarenal aorta and/or iliac a,34703,CDM,975,RC,34703,HCPCS,Outpatient,,,3928,2553.20,,3456.64,88,,,percent of total billed charges,88% of total Billed charges,206.03,100,,,Fee Schedule,100% of Medicare rate,739.1,100,,,Fee Schedule,100% of WA Medicaid,3928,100,,,percent of total billed charges,100% of total billed charges,761.27,103,,,Fee Schedule,103% of WA Medicaid,206.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,360.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,739.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2710.32,69,,,percent of total billed charges,69% of total billed charges,3928,100,,,percent of total billed charges,100% of total billed charges,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3928,100,,,percent of total billed charges,100% of total billed charges,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3928,100,,,percent of total billed charges,100% of total billed charges,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2429.47,61.85,,,percent of total billed charges,61.85% of total billed charges,739.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,739.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,753.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,960.83,130,,,Fee Schedule,130% of WA Medicaid ,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1480.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1480.86,37.7,,,percent of total billed charges,37.70% of total billed charges,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,133159.2,33.9,,,percent of total billed charges,33.9% of total billed charges,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3063.84,78,,,percent of total billed charges,78% of total billed charges,3928,100,,,percent of total billed charges,100% of total billed charges,3244.53,82.6,,,percent of total billed charges,82.6% of total billed charges,3244.53,82.6,,,percent of total billed charges,82.6% of total billed charges,739.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,206.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,739.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,206.03,133159.2,
34705 Endovascular repair of infrarenal aorta and/or iliac a,34705,CDM,975,RC,34705,HCPCS,Outpatient,,,4330,2814.50,,3810.4,88,,,percent of total billed charges,88% of total Billed charges,229.6,100,,,Fee Schedule,100% of Medicare rate,821.72,100,,,Fee Schedule,100% of WA Medicaid,4330,100,,,percent of total billed charges,100% of total billed charges,846.37,103,,,Fee Schedule,103% of WA Medicaid,229.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,401.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,821.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2987.7,69,,,percent of total billed charges,69% of total billed charges,4330,100,,,percent of total billed charges,100% of total billed charges,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4330,100,,,percent of total billed charges,100% of total billed charges,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4330,100,,,percent of total billed charges,100% of total billed charges,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,2678.11,61.85,,,percent of total billed charges,61.85% of total billed charges,821.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,821.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,838.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1068.24,130,,,Fee Schedule,130% of WA Medicaid ,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1632.41,37.7,,,percent of total billed charges,37.70% of total billed charges,1632.41,37.7,,,percent of total billed charges,37.70% of total billed charges,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,146787,33.9,,,percent of total billed charges,33.9% of total billed charges,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,3377.4,78,,,percent of total billed charges,78% of total billed charges,4330,100,,,percent of total billed charges,100% of total billed charges,3576.58,82.6,,,percent of total billed charges,82.6% of total billed charges,3576.58,82.6,,,percent of total billed charges,82.6% of total billed charges,821.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,229.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,821.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,229.6,146787,
34709 Placement of extension prosthesis(es) for endovascular,34709,CDM,975,RC,34709,HCPCS,Outpatient,,,915,594.75,,805.2,88,,,percent of total billed charges,88% of total Billed charges,49.88,100,,,Fee Schedule,100% of Medicare rate,172.33,100,,,Fee Schedule,100% of WA Medicaid,915,100,,,percent of total billed charges,100% of total billed charges,177.5,103,,,Fee Schedule,103% of WA Medicaid,49.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,172.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,631.35,69,,,percent of total billed charges,69% of total billed charges,915,100,,,percent of total billed charges,100% of total billed charges,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,915,100,,,percent of total billed charges,100% of total billed charges,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,915,100,,,percent of total billed charges,100% of total billed charges,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.93,61.85,,,percent of total billed charges,61.85% of total billed charges,172.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,224.03,130,,,Fee Schedule,130% of WA Medicaid ,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.96,37.7,,,percent of total billed charges,37.70% of total billed charges,344.96,37.7,,,percent of total billed charges,37.70% of total billed charges,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,31018.5,33.9,,,percent of total billed charges,33.9% of total billed charges,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,713.7,78,,,percent of total billed charges,78% of total billed charges,915,100,,,percent of total billed charges,100% of total billed charges,755.79,82.6,,,percent of total billed charges,82.6% of total billed charges,755.79,82.6,,,percent of total billed charges,82.6% of total billed charges,172.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.88,31018.5,
REPAIR BLOOD VESSEL;INTRA ABDO,96035221,CDM,960,RC,35221,HCPCS,Outpatient,,,3083,2003.95,,2713.04,88,,,percent of total billed charges,88% of total Billed charges,211.87,100,,,Fee Schedule,100% of Medicare rate,806.8,100,,,Fee Schedule,100% of WA Medicaid,3083,100,,,percent of total billed charges,100% of total billed charges,831,103,,,Fee Schedule,103% of WA Medicaid,211.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,370.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,806.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2127.27,69,,,percent of total billed charges,69% of total billed charges,3083,100,,,percent of total billed charges,100% of total billed charges,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3083,100,,,percent of total billed charges,100% of total billed charges,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3083,100,,,percent of total billed charges,100% of total billed charges,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1906.84,61.85,,,percent of total billed charges,61.85% of total billed charges,806.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,822.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1048.84,130,,,Fee Schedule,130% of WA Medicaid ,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1162.29,37.7,,,percent of total billed charges,37.70% of total billed charges,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,104513.7,33.9,,,percent of total billed charges,33.9% of total billed charges,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2404.74,78,,,percent of total billed charges,78% of total billed charges,3083,100,,,percent of total billed charges,100% of total billed charges,2546.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2546.56,82.6,,,percent of total billed charges,82.6% of total billed charges,806.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,211.87,104513.7,
"35301 THROMBOENDARTERECTOMY, INCLUDING PATCH GRAFT",97535301,CDM,975,RC,35301,HCPCS,Outpatient,,,4763,3095.95,,4191.44,88,,,percent of total billed charges,88% of total Billed charges,171.17,100,,,Fee Schedule,100% of Medicare rate,610.6,100,,,Fee Schedule,100% of WA Medicaid,4763,100,,,percent of total billed charges,100% of total billed charges,628.92,103,,,Fee Schedule,103% of WA Medicaid,171.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,299.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,610.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3286.47,69,,,percent of total billed charges,69% of total billed charges,4763,100,,,percent of total billed charges,100% of total billed charges,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4763,100,,,percent of total billed charges,100% of total billed charges,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4763,100,,,percent of total billed charges,100% of total billed charges,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2945.92,61.85,,,percent of total billed charges,61.85% of total billed charges,610.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,793.78,130,,,Fee Schedule,130% of WA Medicaid ,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1795.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1795.65,37.7,,,percent of total billed charges,37.70% of total billed charges,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,161465.7,33.9,,,percent of total billed charges,33.9% of total billed charges,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3715.14,78,,,percent of total billed charges,78% of total billed charges,4763,100,,,percent of total billed charges,100% of total billed charges,3934.24,82.6,,,percent of total billed charges,82.6% of total billed charges,3934.24,82.6,,,percent of total billed charges,82.6% of total billed charges,610.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,171.17,161465.7,
"35371 THROMBOENDARTERECTOMY, INCLUDING PATCH GRAFT, IF PERFO",975,CDM,975,RC,35371,HCPCS,Outpatient,,,2216,1440.40,,1950.08,88,,,percent of total billed charges,88% of total Billed charges,121.68,100,,,Fee Schedule,100% of Medicare rate,440.7,100,,,Fee Schedule,100% of WA Medicaid,2216,100,,,percent of total billed charges,100% of total billed charges,453.92,103,,,Fee Schedule,103% of WA Medicaid,121.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,212.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,440.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1529.04,69,,,percent of total billed charges,69% of total billed charges,2216,100,,,percent of total billed charges,100% of total billed charges,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2216,100,,,percent of total billed charges,100% of total billed charges,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2216,100,,,percent of total billed charges,100% of total billed charges,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1370.6,61.85,,,percent of total billed charges,61.85% of total billed charges,440.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,572.91,130,,,Fee Schedule,130% of WA Medicaid ,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.43,37.7,,,percent of total billed charges,37.70% of total billed charges,835.43,37.7,,,percent of total billed charges,37.70% of total billed charges,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,75122.4,33.9,,,percent of total billed charges,33.9% of total billed charges,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1728.48,78,,,percent of total billed charges,78% of total billed charges,2216,100,,,percent of total billed charges,100% of total billed charges,1830.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1830.42,82.6,,,percent of total billed charges,82.6% of total billed charges,440.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.68,75122.4,
REPAIR ARTERIAL BLOCKAGE,96035475,CDM,960,RC,35475,HCPCS,Outpatient,,,3000,1950.00,,2640,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3000,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2070,69,,,percent of total billed charges,69% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3000,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3000,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1855.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,1131,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,101700,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2340,78,,,percent of total billed charges,78% of total billed charges,3000,100,,,percent of total billed charges,100% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,2478,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1131,101700,
"EXPLOR FOR PO HEM,THROM,INF AB",96035840,CDM,960,RC,35840,HCPCS,Outpatient,,,2516,1635.40,,2214.08,88,,,percent of total billed charges,88% of total Billed charges,166.44,100,,,Fee Schedule,100% of Medicare rate,675.13,100,,,Fee Schedule,100% of WA Medicaid,2516,100,,,percent of total billed charges,100% of total billed charges,695.38,103,,,Fee Schedule,103% of WA Medicaid,166.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,291.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,675.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1736.04,69,,,percent of total billed charges,69% of total billed charges,2516,100,,,percent of total billed charges,100% of total billed charges,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2516,100,,,percent of total billed charges,100% of total billed charges,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2516,100,,,percent of total billed charges,100% of total billed charges,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1556.15,61.85,,,percent of total billed charges,61.85% of total billed charges,675.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,675.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,688.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,877.67,130,,,Fee Schedule,130% of WA Medicaid ,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,948.53,37.7,,,percent of total billed charges,37.70% of total billed charges,948.53,37.7,,,percent of total billed charges,37.70% of total billed charges,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,85292.4,33.9,,,percent of total billed charges,33.9% of total billed charges,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1962.48,78,,,percent of total billed charges,78% of total billed charges,2516,100,,,percent of total billed charges,100% of total billed charges,2078.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2078.22,82.6,,,percent of total billed charges,82.6% of total billed charges,675.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,675.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,166.44,85292.4,
INTRODUCTION OF CATHETER AORTA,96036200,CDM,960,RC,36200,HCPCS,Outpatient,,,254,165.10,,223.52,88,,,percent of total billed charges,88% of total Billed charges,19.81,100,,,Fee Schedule,100% of Medicare rate,75.16,100,,,Fee Schedule,100% of WA Medicaid,254,100,,,percent of total billed charges,100% of total billed charges,77.41,103,,,Fee Schedule,103% of WA Medicaid,19.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,75.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,175.26,69,,,percent of total billed charges,69% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.1,61.85,,,percent of total billed charges,61.85% of total billed charges,75.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,97.71,130,,,Fee Schedule,130% of WA Medicaid ,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,8610.6,33.9,,,percent of total billed charges,33.9% of total billed charges,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.12,78,,,percent of total billed charges,78% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,75.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.81,8610.6,
SELECTIVE CATH PLCMT ARTER SYS,97236245,CDM,972,RC,36245,HCPCS,Outpatient,,,2809,1825.85,,2471.92,88,,,percent of total billed charges,88% of total Billed charges,28.32,100,,,Fee Schedule,100% of Medicare rate,128.13,100,,,Fee Schedule,100% of WA Medicaid,2809,100,,,percent of total billed charges,100% of total billed charges,131.97,103,,,Fee Schedule,103% of WA Medicaid,28.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,128.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1938.21,69,,,percent of total billed charges,69% of total billed charges,2809,100,,,percent of total billed charges,100% of total billed charges,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2809,100,,,percent of total billed charges,100% of total billed charges,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2809,100,,,percent of total billed charges,100% of total billed charges,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1737.37,61.85,,,percent of total billed charges,61.85% of total billed charges,128.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,166.57,130,,,Fee Schedule,130% of WA Medicaid ,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1058.99,37.7,,,percent of total billed charges,37.70% of total billed charges,1058.99,37.7,,,percent of total billed charges,37.70% of total billed charges,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,95225.1,33.9,,,percent of total billed charges,33.9% of total billed charges,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2191.02,78,,,percent of total billed charges,78% of total billed charges,2809,100,,,percent of total billed charges,100% of total billed charges,2320.23,82.6,,,percent of total billed charges,82.6% of total billed charges,2320.23,82.6,,,percent of total billed charges,82.6% of total billed charges,128.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.32,95225.1,
INITIAL SECOND ORDER,96036246,CDM,960,RC,36246,HCPCS,Outpatient,,,1832,1190.80,,1612.16,88,,,percent of total billed charges,88% of total Billed charges,34.23,100,,,Fee Schedule,100% of Medicare rate,136.52,100,,,Fee Schedule,100% of WA Medicaid,1832,100,,,percent of total billed charges,100% of total billed charges,140.62,103,,,Fee Schedule,103% of WA Medicaid,34.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,136.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1264.08,69,,,percent of total billed charges,69% of total billed charges,1832,100,,,percent of total billed charges,100% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1832,100,,,percent of total billed charges,100% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1832,100,,,percent of total billed charges,100% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1133.09,61.85,,,percent of total billed charges,61.85% of total billed charges,136.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,177.48,130,,,Fee Schedule,130% of WA Medicaid ,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,690.66,37.7,,,percent of total billed charges,37.70% of total billed charges,690.66,37.7,,,percent of total billed charges,37.70% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,62104.8,33.9,,,percent of total billed charges,33.9% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1428.96,78,,,percent of total billed charges,78% of total billed charges,1832,100,,,percent of total billed charges,100% of total billed charges,1513.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1513.23,82.6,,,percent of total billed charges,82.6% of total billed charges,136.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.23,62104.8,
INITIAL THIRD ORDER,96036247,CDM,960,RC,36247,HCPCS,Outpatient,,,3259,2118.35,,2867.92,88,,,percent of total billed charges,88% of total Billed charges,35.3,100,,,Fee Schedule,100% of Medicare rate,161.7,100,,,Fee Schedule,100% of WA Medicaid,3259,100,,,percent of total billed charges,100% of total billed charges,166.55,103,,,Fee Schedule,103% of WA Medicaid,35.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,161.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2248.71,69,,,percent of total billed charges,69% of total billed charges,3259,100,,,percent of total billed charges,100% of total billed charges,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3259,100,,,percent of total billed charges,100% of total billed charges,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3259,100,,,percent of total billed charges,100% of total billed charges,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2015.69,61.85,,,percent of total billed charges,61.85% of total billed charges,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.21,130,,,Fee Schedule,130% of WA Medicaid ,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1228.64,37.7,,,percent of total billed charges,37.70% of total billed charges,1228.64,37.7,,,percent of total billed charges,37.70% of total billed charges,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,110480.1,33.9,,,percent of total billed charges,33.9% of total billed charges,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2542.02,78,,,percent of total billed charges,78% of total billed charges,3259,100,,,percent of total billed charges,100% of total billed charges,2691.93,82.6,,,percent of total billed charges,82.6% of total billed charges,2691.93,82.6,,,percent of total billed charges,82.6% of total billed charges,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.3,110480.1,
36466 Injection of non-compounded foam sclerosant,96036466,CDM,975,RC,36466,HCPCS,Outpatient,,,6122,3979.30,,5387.36,88,,,percent of total billed charges,88% of total Billed charges,19.69,100,,,Fee Schedule,100% of Medicare rate,82.62,100,,,Fee Schedule,100% of WA Medicaid,6122,100,,,percent of total billed charges,100% of total billed charges,85.1,103,,,Fee Schedule,103% of WA Medicaid,19.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,82.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4224.18,69,,,percent of total billed charges,69% of total billed charges,6122,100,,,percent of total billed charges,100% of total billed charges,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,6122,100,,,percent of total billed charges,100% of total billed charges,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,6122,100,,,percent of total billed charges,100% of total billed charges,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3786.46,61.85,,,percent of total billed charges,61.85% of total billed charges,82.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.41,130,,,Fee Schedule,130% of WA Medicaid ,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2307.99,37.7,,,percent of total billed charges,37.70% of total billed charges,2307.99,37.7,,,percent of total billed charges,37.70% of total billed charges,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,207535.8,33.9,,,percent of total billed charges,33.9% of total billed charges,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4775.16,78,,,percent of total billed charges,78% of total billed charges,6122,100,,,percent of total billed charges,100% of total billed charges,5056.77,82.6,,,percent of total billed charges,82.6% of total billed charges,5056.77,82.6,,,percent of total billed charges,82.6% of total billed charges,82.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.69,207535.8,
36465 Injection of non-compounded foam sclerosant w/ ultraso,97536465,CDM,975,RC,36465,HCPCS,Outpatient,,,353,229.45,,310.64,88,,,percent of total billed charges,88% of total Billed charges,15.37,100,,,Fee Schedule,100% of Medicare rate,64.72,100,,,Fee Schedule,100% of WA Medicaid,353,100,,,percent of total billed charges,100% of total billed charges,66.66,103,,,Fee Schedule,103% of WA Medicaid,15.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,64.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,243.57,69,,,percent of total billed charges,69% of total billed charges,353,100,,,percent of total billed charges,100% of total billed charges,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,353,100,,,percent of total billed charges,100% of total billed charges,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,353,100,,,percent of total billed charges,100% of total billed charges,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.33,61.85,,,percent of total billed charges,61.85% of total billed charges,64.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.14,130,,,Fee Schedule,130% of WA Medicaid ,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.08,37.7,,,percent of total billed charges,37.70% of total billed charges,133.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,11966.7,33.9,,,percent of total billed charges,33.9% of total billed charges,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.34,78,,,percent of total billed charges,78% of total billed charges,353,100,,,percent of total billed charges,100% of total billed charges,291.58,82.6,,,percent of total billed charges,82.6% of total billed charges,291.58,82.6,,,percent of total billed charges,82.6% of total billed charges,64.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.37,11966.7,
36482 Endoven Therm Chem Ad First Vein,97536482,CDM,975,RC,36482,HCPCS,Outpatient,,,1139,740.35,,1002.32,88,,,percent of total billed charges,88% of total Billed charges,23.85,100,,,Fee Schedule,100% of Medicare rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,1139,100,,,percent of total billed charges,100% of total billed charges,100.47,103,,,Fee Schedule,103% of WA Medicaid,23.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,785.91,69,,,percent of total billed charges,69% of total billed charges,1139,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1139,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1139,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,704.47,61.85,,,percent of total billed charges,61.85% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.8,130,,,Fee Schedule,130% of WA Medicaid ,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.4,37.7,,,percent of total billed charges,37.70% of total billed charges,429.4,37.7,,,percent of total billed charges,37.70% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,38612.1,33.9,,,percent of total billed charges,33.9% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,888.42,78,,,percent of total billed charges,78% of total billed charges,1139,100,,,percent of total billed charges,100% of total billed charges,940.81,82.6,,,percent of total billed charges,82.6% of total billed charges,940.81,82.6,,,percent of total billed charges,82.6% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.85,38612.1,
"Endovenous ablation therapy of incompetent vein, extremity,",97536483,CDM,975,RC,36483,HCPCS,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,12.65,100,,,Fee Schedule,100% of Medicare rate,47.74,100,,,Fee Schedule,100% of WA Medicaid,300,100,,,percent of total billed charges,100% of total billed charges,49.17,103,,,Fee Schedule,103% of WA Medicaid,12.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,300,100,,,percent of total billed charges,100% of total billed charges,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,300,100,,,percent of total billed charges,100% of total billed charges,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,47.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.06,130,,,Fee Schedule,130% of WA Medicaid ,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.1,37.7,,,percent of total billed charges,37.70% of total billed charges,113.1,37.7,,,percent of total billed charges,37.70% of total billed charges,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,10170,33.9,,,percent of total billed charges,33.9% of total billed charges,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,47.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.65,10170,
36556 Insertion of non-tunneled centrally inserted,97536556,CDM,975,RC,36556,HCPCS,Outpatient,,,1266,822.90,,1114.08,88,,,percent of total billed charges,88% of total Billed charges,8.44,100,,,Fee Schedule,100% of Medicare rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,1266,100,,,percent of total billed charges,100% of total billed charges,48.03,103,,,Fee Schedule,103% of WA Medicaid,8.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,873.54,69,,,percent of total billed charges,69% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1266,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1266,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,783.02,61.85,,,percent of total billed charges,61.85% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.62,130,,,Fee Schedule,130% of WA Medicaid ,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,477.28,37.7,,,percent of total billed charges,37.70% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,42917.4,33.9,,,percent of total billed charges,33.9% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,987.48,78,,,percent of total billed charges,78% of total billed charges,1266,100,,,percent of total billed charges,100% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.72,82.6,,,percent of total billed charges,82.6% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.44,42917.4,
INSERTION CENTRAL VENOUS ACCES,96036561,CDM,975,RC,36561,HCPCS,Outpatient,,,2542,1652.30,,2236.96,88,,,percent of total billed charges,88% of total Billed charges,34.67,100,,,Fee Schedule,100% of Medicare rate,185.01,100,,,Fee Schedule,100% of WA Medicaid,2542,100,,,percent of total billed charges,100% of total billed charges,190.56,103,,,Fee Schedule,103% of WA Medicaid,34.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,185.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1753.98,69,,,percent of total billed charges,69% of total billed charges,2542,100,,,percent of total billed charges,100% of total billed charges,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2542,100,,,percent of total billed charges,100% of total billed charges,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2542,100,,,percent of total billed charges,100% of total billed charges,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1572.23,61.85,,,percent of total billed charges,61.85% of total billed charges,185.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,240.51,130,,,Fee Schedule,130% of WA Medicaid ,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,958.33,37.7,,,percent of total billed charges,37.70% of total billed charges,958.33,37.7,,,percent of total billed charges,37.70% of total billed charges,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,86173.8,33.9,,,percent of total billed charges,33.9% of total billed charges,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1982.76,78,,,percent of total billed charges,78% of total billed charges,2542,100,,,percent of total billed charges,100% of total billed charges,2099.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2099.69,82.6,,,percent of total billed charges,82.6% of total billed charges,185.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.67,86173.8,
INSERT OF PERI CENTRAL VENOUS,96036571,CDM,960,RC,36571,HCPCS,Outpatient,,,2325,1511.25,,2046,88,,,percent of total billed charges,88% of total Billed charges,36.72,100,,,Fee Schedule,100% of Medicare rate,174.75,100,,,Fee Schedule,100% of WA Medicaid,2325,100,,,percent of total billed charges,100% of total billed charges,179.99,103,,,Fee Schedule,103% of WA Medicaid,36.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,174.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1604.25,69,,,percent of total billed charges,69% of total billed charges,2325,100,,,percent of total billed charges,100% of total billed charges,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2325,100,,,percent of total billed charges,100% of total billed charges,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2325,100,,,percent of total billed charges,100% of total billed charges,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1438.01,61.85,,,percent of total billed charges,61.85% of total billed charges,174.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,227.18,130,,,Fee Schedule,130% of WA Medicaid ,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.53,37.7,,,percent of total billed charges,37.70% of total billed charges,876.53,37.7,,,percent of total billed charges,37.70% of total billed charges,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,78817.5,33.9,,,percent of total billed charges,33.9% of total billed charges,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1813.5,78,,,percent of total billed charges,78% of total billed charges,2325,100,,,percent of total billed charges,100% of total billed charges,1920.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1920.45,82.6,,,percent of total billed charges,82.6% of total billed charges,174.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.72,78817.5,
REPLACEMENT CVP LINE,96036580,CDM,960,RC,36580,HCPCS,Outpatient,,,483,313.95,,425.04,88,,,percent of total billed charges,88% of total Billed charges,6.31,100,,,Fee Schedule,100% of Medicare rate,35.81,100,,,Fee Schedule,100% of WA Medicaid,483,100,,,percent of total billed charges,100% of total billed charges,36.88,103,,,Fee Schedule,103% of WA Medicaid,6.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,333.27,69,,,percent of total billed charges,69% of total billed charges,483,100,,,percent of total billed charges,100% of total billed charges,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,483,100,,,percent of total billed charges,100% of total billed charges,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,483,100,,,percent of total billed charges,100% of total billed charges,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.74,61.85,,,percent of total billed charges,61.85% of total billed charges,35.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.55,130,,,Fee Schedule,130% of WA Medicaid ,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.09,37.7,,,percent of total billed charges,37.70% of total billed charges,182.09,37.7,,,percent of total billed charges,37.70% of total billed charges,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,16373.7,33.9,,,percent of total billed charges,33.9% of total billed charges,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.74,78,,,percent of total billed charges,78% of total billed charges,483,100,,,percent of total billed charges,100% of total billed charges,398.96,82.6,,,percent of total billed charges,82.6% of total billed charges,398.96,82.6,,,percent of total billed charges,82.6% of total billed charges,35.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.31,16373.7,
REPLACE TUNNELED CV CATH,96036581,CDM,960,RC,36581,HCPCS,Outpatient,,,1453,944.45,,1278.64,88,,,percent of total billed charges,88% of total Billed charges,16.28,100,,,Fee Schedule,100% of Medicare rate,102.02,100,,,Fee Schedule,100% of WA Medicaid,1453,100,,,percent of total billed charges,100% of total billed charges,105.08,103,,,Fee Schedule,103% of WA Medicaid,16.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1002.57,69,,,percent of total billed charges,69% of total billed charges,1453,100,,,percent of total billed charges,100% of total billed charges,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1453,100,,,percent of total billed charges,100% of total billed charges,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1453,100,,,percent of total billed charges,100% of total billed charges,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,898.68,61.85,,,percent of total billed charges,61.85% of total billed charges,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.63,130,,,Fee Schedule,130% of WA Medicaid ,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.78,37.7,,,percent of total billed charges,37.70% of total billed charges,547.78,37.7,,,percent of total billed charges,37.70% of total billed charges,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,49256.7,33.9,,,percent of total billed charges,33.9% of total billed charges,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1133.34,78,,,percent of total billed charges,78% of total billed charges,1453,100,,,percent of total billed charges,100% of total billed charges,1200.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1200.18,82.6,,,percent of total billed charges,82.6% of total billed charges,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.28,49256.7,
REMOVAL OF SUBCUTANEOUS PORT,96036590,CDM,975,RC,36590,HCPCS,Outpatient,,,627,407.55,,551.76,88,,,percent of total billed charges,88% of total Billed charges,19.62,100,,,Fee Schedule,100% of Medicare rate,106.31,100,,,Fee Schedule,100% of WA Medicaid,627,100,,,percent of total billed charges,100% of total billed charges,109.5,103,,,Fee Schedule,103% of WA Medicaid,19.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,106.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,432.63,69,,,percent of total billed charges,69% of total billed charges,627,100,,,percent of total billed charges,100% of total billed charges,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,627,100,,,percent of total billed charges,100% of total billed charges,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,627,100,,,percent of total billed charges,100% of total billed charges,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.8,61.85,,,percent of total billed charges,61.85% of total billed charges,106.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,138.2,130,,,Fee Schedule,130% of WA Medicaid ,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.38,37.7,,,percent of total billed charges,37.70% of total billed charges,236.38,37.7,,,percent of total billed charges,37.70% of total billed charges,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,21255.3,33.9,,,percent of total billed charges,33.9% of total billed charges,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.06,78,,,percent of total billed charges,78% of total billed charges,627,100,,,percent of total billed charges,100% of total billed charges,517.9,82.6,,,percent of total billed charges,82.6% of total billed charges,517.9,82.6,,,percent of total billed charges,82.6% of total billed charges,106.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.62,21255.3,
ARTERIOVENOUS ANASTROMOSIS,96036818,CDM,960,RC,36818,HCPCS,Outpatient,,,1189,772.85,,1046.32,88,,,percent of total billed charges,88% of total Billed charges,99.02,100,,,Fee Schedule,100% of Medicare rate,375.61,100,,,Fee Schedule,100% of WA Medicaid,1189,100,,,percent of total billed charges,100% of total billed charges,386.88,103,,,Fee Schedule,103% of WA Medicaid,99.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,375.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,820.41,69,,,percent of total billed charges,69% of total billed charges,1189,100,,,percent of total billed charges,100% of total billed charges,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1189,100,,,percent of total billed charges,100% of total billed charges,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1189,100,,,percent of total billed charges,100% of total billed charges,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,735.4,61.85,,,percent of total billed charges,61.85% of total billed charges,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,488.29,130,,,Fee Schedule,130% of WA Medicaid ,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,448.25,37.7,,,percent of total billed charges,37.70% of total billed charges,448.25,37.7,,,percent of total billed charges,37.70% of total billed charges,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,40307.1,33.9,,,percent of total billed charges,33.9% of total billed charges,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,927.42,78,,,percent of total billed charges,78% of total billed charges,1189,100,,,percent of total billed charges,100% of total billed charges,982.11,82.6,,,percent of total billed charges,82.6% of total billed charges,982.11,82.6,,,percent of total billed charges,82.6% of total billed charges,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.02,40307.1,
ARTERIOVENOUS ANASTOMOSIS,96036820,CDM,960,RC,36820,HCPCS,Outpatient,,,1506,978.90,,1325.28,88,,,percent of total billed charges,88% of total Billed charges,104.74,100,,,Fee Schedule,100% of Medicare rate,395.57,100,,,Fee Schedule,100% of WA Medicaid,1506,100,,,percent of total billed charges,100% of total billed charges,407.44,103,,,Fee Schedule,103% of WA Medicaid,104.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,183.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,395.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1039.14,69,,,percent of total billed charges,69% of total billed charges,1506,100,,,percent of total billed charges,100% of total billed charges,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1506,100,,,percent of total billed charges,100% of total billed charges,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1506,100,,,percent of total billed charges,100% of total billed charges,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.46,61.85,,,percent of total billed charges,61.85% of total billed charges,395.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,514.24,130,,,Fee Schedule,130% of WA Medicaid ,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.76,37.7,,,percent of total billed charges,37.70% of total billed charges,567.76,37.7,,,percent of total billed charges,37.70% of total billed charges,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,51053.4,33.9,,,percent of total billed charges,33.9% of total billed charges,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1174.68,78,,,percent of total billed charges,78% of total billed charges,1506,100,,,percent of total billed charges,100% of total billed charges,1243.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1243.96,82.6,,,percent of total billed charges,82.6% of total billed charges,395.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,104.74,51053.4,
"36821 ARTERIOVENOUS ANASTOMOSIS, OPEN; DIRECT, ANY SITE (EG,",97536821,CDM,975,RC,36821,HCPCS,Outpatient,,,1961,1274.65,,1725.68,88,,,percent of total billed charges,88% of total Billed charges,95.04,100,,,Fee Schedule,100% of Medicare rate,359.39,100,,,Fee Schedule,100% of WA Medicaid,1961,100,,,percent of total billed charges,100% of total billed charges,370.17,103,,,Fee Schedule,103% of WA Medicaid,95.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,166.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,359.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1353.09,69,,,percent of total billed charges,69% of total billed charges,1961,100,,,percent of total billed charges,100% of total billed charges,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1961,100,,,percent of total billed charges,100% of total billed charges,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1961,100,,,percent of total billed charges,100% of total billed charges,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1212.88,61.85,,,percent of total billed charges,61.85% of total billed charges,359.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,467.21,130,,,Fee Schedule,130% of WA Medicaid ,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,739.3,37.7,,,percent of total billed charges,37.70% of total billed charges,739.3,37.7,,,percent of total billed charges,37.70% of total billed charges,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,66477.9,33.9,,,percent of total billed charges,33.9% of total billed charges,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1529.58,78,,,percent of total billed charges,78% of total billed charges,1961,100,,,percent of total billed charges,100% of total billed charges,1619.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1619.79,82.6,,,percent of total billed charges,82.6% of total billed charges,359.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.04,66477.9,
36830 CREATION OF ARTERIOVENOUS FISTULA BY OTHER THAN DIRECT,97536830,CDM,975,RC,36830,HCPCS,Outpatient,,,2470,1605.50,,2173.6,88,,,percent of total billed charges,88% of total Billed charges,96.27,100,,,Fee Schedule,100% of Medicare rate,362.93,100,,,Fee Schedule,100% of WA Medicaid,2470,100,,,percent of total billed charges,100% of total billed charges,373.82,103,,,Fee Schedule,103% of WA Medicaid,96.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,168.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,362.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1704.3,69,,,percent of total billed charges,69% of total billed charges,2470,100,,,percent of total billed charges,100% of total billed charges,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2470,100,,,percent of total billed charges,100% of total billed charges,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2470,100,,,percent of total billed charges,100% of total billed charges,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1527.7,61.85,,,percent of total billed charges,61.85% of total billed charges,362.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,471.81,130,,,Fee Schedule,130% of WA Medicaid ,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.19,37.7,,,percent of total billed charges,37.70% of total billed charges,931.19,37.7,,,percent of total billed charges,37.70% of total billed charges,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,83733,33.9,,,percent of total billed charges,33.9% of total billed charges,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1926.6,78,,,percent of total billed charges,78% of total billed charges,2470,100,,,percent of total billed charges,100% of total billed charges,2040.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2040.22,82.6,,,percent of total billed charges,82.6% of total billed charges,362.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.27,83733,
THROMBECTOMY ARTERIOVEN FISTUL,96036870,CDM,960,RC,36870,HCPCS,Outpatient,,,3708,2410.20,,3263.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3708,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2558.52,69,,,percent of total billed charges,69% of total billed charges,3708,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3708,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3708,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2293.4,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1397.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1397.92,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,125701.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2892.24,78,,,percent of total billed charges,78% of total billed charges,3708,100,,,percent of total billed charges,100% of total billed charges,3062.81,82.6,,,percent of total billed charges,82.6% of total billed charges,3062.81,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1397.92,125701.2,
THRMBC/ANY METHOD PERCUTANEOUS,96036904,CDM,960,RC,36904,HCPCS,Outpatient,,,1145,744.25,,1007.6,88,,,percent of total billed charges,88% of total Billed charges,39.67,100,,,Fee Schedule,100% of Medicare rate,200.3,100,,,Fee Schedule,100% of WA Medicaid,1145,100,,,percent of total billed charges,100% of total billed charges,206.31,103,,,Fee Schedule,103% of WA Medicaid,39.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,790.05,69,,,percent of total billed charges,69% of total billed charges,1145,100,,,percent of total billed charges,100% of total billed charges,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1145,100,,,percent of total billed charges,100% of total billed charges,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1145,100,,,percent of total billed charges,100% of total billed charges,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,708.18,61.85,,,percent of total billed charges,61.85% of total billed charges,200.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,260.39,130,,,Fee Schedule,130% of WA Medicaid ,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,431.67,37.7,,,percent of total billed charges,37.70% of total billed charges,431.67,37.7,,,percent of total billed charges,37.70% of total billed charges,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,38815.5,33.9,,,percent of total billed charges,33.9% of total billed charges,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,893.1,78,,,percent of total billed charges,78% of total billed charges,1145,100,,,percent of total billed charges,100% of total billed charges,945.77,82.6,,,percent of total billed charges,82.6% of total billed charges,945.77,82.6,,,percent of total billed charges,82.6% of total billed charges,200.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.67,38815.5,
THRMBC W/BALLOON ANGIO/PERC,96036905,CDM,960,RC,36905,HCPCS,Outpatient,,,1442,937.30,,1268.96,88,,,percent of total billed charges,88% of total Billed charges,44.94,100,,,Fee Schedule,100% of Medicare rate,241.14,100,,,Fee Schedule,100% of WA Medicaid,1442,100,,,percent of total billed charges,100% of total billed charges,248.37,103,,,Fee Schedule,103% of WA Medicaid,44.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,241.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,994.98,69,,,percent of total billed charges,69% of total billed charges,1442,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1442,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1442,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,891.88,61.85,,,percent of total billed charges,61.85% of total billed charges,241.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,313.48,130,,,Fee Schedule,130% of WA Medicaid ,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,543.63,37.7,,,percent of total billed charges,37.70% of total billed charges,543.63,37.7,,,percent of total billed charges,37.70% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,48883.8,33.9,,,percent of total billed charges,33.9% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1124.76,78,,,percent of total billed charges,78% of total billed charges,1442,100,,,percent of total billed charges,100% of total billed charges,1191.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1191.09,82.6,,,percent of total billed charges,82.6% of total billed charges,241.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.94,48883.8,
THRMBC W/BALLOON ANGIO/ST/PERC,96036906,CDM,960,RC,36906,HCPCS,Outpatient,,,1681,1092.65,,1479.28,88,,,percent of total billed charges,88% of total Billed charges,53.9,100,,,Fee Schedule,100% of Medicare rate,277.89,100,,,Fee Schedule,100% of WA Medicaid,1681,100,,,percent of total billed charges,100% of total billed charges,286.23,103,,,Fee Schedule,103% of WA Medicaid,53.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,277.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1159.89,69,,,percent of total billed charges,69% of total billed charges,1681,100,,,percent of total billed charges,100% of total billed charges,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1681,100,,,percent of total billed charges,100% of total billed charges,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1681,100,,,percent of total billed charges,100% of total billed charges,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1039.7,61.85,,,percent of total billed charges,61.85% of total billed charges,277.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,361.26,130,,,Fee Schedule,130% of WA Medicaid ,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.74,37.7,,,percent of total billed charges,37.70% of total billed charges,633.74,37.7,,,percent of total billed charges,37.70% of total billed charges,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,56985.9,33.9,,,percent of total billed charges,33.9% of total billed charges,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1311.18,78,,,percent of total billed charges,78% of total billed charges,1681,100,,,percent of total billed charges,100% of total billed charges,1388.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1388.51,82.6,,,percent of total billed charges,82.6% of total billed charges,277.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.9,56985.9,
37184 PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECT,97537184,CDM,975,RC,37184,HCPCS,Outpatient,,,7991,5194.15,,7032.08,88,,,percent of total billed charges,88% of total Billed charges,53.11,100,,,Fee Schedule,100% of Medicare rate,233.5,100,,,Fee Schedule,100% of WA Medicaid,7991,100,,,percent of total billed charges,100% of total billed charges,240.51,103,,,Fee Schedule,103% of WA Medicaid,53.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,233.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5513.79,69,,,percent of total billed charges,69% of total billed charges,7991,100,,,percent of total billed charges,100% of total billed charges,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,7991,100,,,percent of total billed charges,100% of total billed charges,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,7991,100,,,percent of total billed charges,100% of total billed charges,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,4942.43,61.85,,,percent of total billed charges,61.85% of total billed charges,233.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,303.55,130,,,Fee Schedule,130% of WA Medicaid ,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,3012.61,37.7,,,percent of total billed charges,37.70% of total billed charges,3012.61,37.7,,,percent of total billed charges,37.70% of total billed charges,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,270894.9,33.9,,,percent of total billed charges,33.9% of total billed charges,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,6232.98,78,,,percent of total billed charges,78% of total billed charges,7991,100,,,percent of total billed charges,100% of total billed charges,6600.57,82.6,,,percent of total billed charges,82.6% of total billed charges,6600.57,82.6,,,percent of total billed charges,82.6% of total billed charges,233.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.11,270894.9,
PERCUTANE TRANSLUM MECH THROMB,96037187,CDM,960,RC,37187,HCPCS,Outpatient,,,4158,2702.70,,3659.04,88,,,percent of total billed charges,88% of total Billed charges,44.28,100,,,Fee Schedule,100% of Medicare rate,213.92,100,,,Fee Schedule,100% of WA Medicaid,4158,100,,,percent of total billed charges,100% of total billed charges,220.34,103,,,Fee Schedule,103% of WA Medicaid,44.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,213.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2869.02,69,,,percent of total billed charges,69% of total billed charges,4158,100,,,percent of total billed charges,100% of total billed charges,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4158,100,,,percent of total billed charges,100% of total billed charges,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4158,100,,,percent of total billed charges,100% of total billed charges,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2571.72,61.85,,,percent of total billed charges,61.85% of total billed charges,213.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,278.1,130,,,Fee Schedule,130% of WA Medicaid ,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1567.57,37.7,,,percent of total billed charges,37.70% of total billed charges,1567.57,37.7,,,percent of total billed charges,37.70% of total billed charges,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,140956.2,33.9,,,percent of total billed charges,33.9% of total billed charges,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,3243.24,78,,,percent of total billed charges,78% of total billed charges,4158,100,,,percent of total billed charges,100% of total billed charges,3434.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3434.51,82.6,,,percent of total billed charges,82.6% of total billed charges,213.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.28,140956.2,
INTERVASCULAR REMOVAL,96037197,CDM,960,RC,37197,HCPCS,Outpatient,,,3058,1987.70,,2691.04,88,,,percent of total billed charges,88% of total Billed charges,34.86,100,,,Fee Schedule,100% of Medicare rate,163.19,100,,,Fee Schedule,100% of WA Medicaid,3058,100,,,percent of total billed charges,100% of total billed charges,168.09,103,,,Fee Schedule,103% of WA Medicaid,34.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,163.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2110.02,69,,,percent of total billed charges,69% of total billed charges,3058,100,,,percent of total billed charges,100% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,3058,100,,,percent of total billed charges,100% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,3058,100,,,percent of total billed charges,100% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1891.37,61.85,,,percent of total billed charges,61.85% of total billed charges,163.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,212.15,130,,,Fee Schedule,130% of WA Medicaid ,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1152.87,37.7,,,percent of total billed charges,37.70% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,103666.2,33.9,,,percent of total billed charges,33.9% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2385.24,78,,,percent of total billed charges,78% of total billed charges,3058,100,,,percent of total billed charges,100% of total billed charges,2525.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2525.91,82.6,,,percent of total billed charges,82.6% of total billed charges,163.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.86,103666.2,
REVAS ILIAC ART W/STENT PLACE,96037221,CDM,960,RC,37221,HCPCS,Outpatient,,,1063,690.95,,935.44,88,,,percent of total billed charges,88% of total Billed charges,71.37,100,,,Fee Schedule,100% of Medicare rate,264.46,100,,,Fee Schedule,100% of WA Medicaid,1063,100,,,percent of total billed charges,100% of total billed charges,272.39,103,,,Fee Schedule,103% of WA Medicaid,71.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,733.47,69,,,percent of total billed charges,69% of total billed charges,1063,100,,,percent of total billed charges,100% of total billed charges,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063,100,,,percent of total billed charges,100% of total billed charges,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063,100,,,percent of total billed charges,100% of total billed charges,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,657.47,61.85,,,percent of total billed charges,61.85% of total billed charges,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,343.8,130,,,Fee Schedule,130% of WA Medicaid ,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.75,37.7,,,percent of total billed charges,37.70% of total billed charges,400.75,37.7,,,percent of total billed charges,37.70% of total billed charges,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,36035.7,33.9,,,percent of total billed charges,33.9% of total billed charges,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.14,78,,,percent of total billed charges,78% of total billed charges,1063,100,,,percent of total billed charges,100% of total billed charges,878.04,82.6,,,percent of total billed charges,82.6% of total billed charges,878.04,82.6,,,percent of total billed charges,82.6% of total billed charges,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.37,36035.7,
REVASCULARIZATION ENDO OR OPEN,96037225,CDM,960,RC,37225,HCPCS,Outpatient,,,1056,686.40,,929.28,88,,,percent of total billed charges,88% of total Billed charges,82.97,100,,,Fee Schedule,100% of Medicare rate,321.9,100,,,Fee Schedule,100% of WA Medicaid,1056,100,,,percent of total billed charges,100% of total billed charges,331.56,103,,,Fee Schedule,103% of WA Medicaid,82.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,145.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,321.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,728.64,69,,,percent of total billed charges,69% of total billed charges,1056,100,,,percent of total billed charges,100% of total billed charges,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1056,100,,,percent of total billed charges,100% of total billed charges,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1056,100,,,percent of total billed charges,100% of total billed charges,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,653.14,61.85,,,percent of total billed charges,61.85% of total billed charges,321.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,418.47,130,,,Fee Schedule,130% of WA Medicaid ,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.11,37.7,,,percent of total billed charges,37.70% of total billed charges,398.11,37.7,,,percent of total billed charges,37.70% of total billed charges,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,35798.4,33.9,,,percent of total billed charges,33.9% of total billed charges,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,823.68,78,,,percent of total billed charges,78% of total billed charges,1056,100,,,percent of total billed charges,100% of total billed charges,872.26,82.6,,,percent of total billed charges,82.6% of total billed charges,872.26,82.6,,,percent of total billed charges,82.6% of total billed charges,321.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.97,35798.4,
REVASCULARIZATION ENDO POPLITE,96037227,CDM,960,RC,37227,HCPCS,Outpatient,,,1270,825.50,,1117.6,88,,,percent of total billed charges,88% of total Billed charges,100.06,100,,,Fee Schedule,100% of Medicare rate,384.75,100,,,Fee Schedule,100% of WA Medicaid,1270,100,,,percent of total billed charges,100% of total billed charges,396.29,103,,,Fee Schedule,103% of WA Medicaid,100.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,175.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,384.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,876.3,69,,,percent of total billed charges,69% of total billed charges,1270,100,,,percent of total billed charges,100% of total billed charges,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1270,100,,,percent of total billed charges,100% of total billed charges,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1270,100,,,percent of total billed charges,100% of total billed charges,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,785.5,61.85,,,percent of total billed charges,61.85% of total billed charges,384.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,500.18,130,,,Fee Schedule,130% of WA Medicaid ,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.79,37.7,,,percent of total billed charges,37.70% of total billed charges,478.79,37.7,,,percent of total billed charges,37.70% of total billed charges,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,43053,33.9,,,percent of total billed charges,33.9% of total billed charges,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,990.6,78,,,percent of total billed charges,78% of total billed charges,1270,100,,,percent of total billed charges,100% of total billed charges,1049.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1049.02,82.6,,,percent of total billed charges,82.6% of total billed charges,384.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,100.06,43053,
REVASCULARIZATION ENDO PERONEA,96037229,CDM,960,RC,37229,HCPCS,Outpatient,,,1233,801.45,,1085.04,88,,,percent of total billed charges,88% of total Billed charges,92.18,100,,,Fee Schedule,100% of Medicare rate,373.19,100,,,Fee Schedule,100% of WA Medicaid,1233,100,,,percent of total billed charges,100% of total billed charges,384.39,103,,,Fee Schedule,103% of WA Medicaid,92.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,161.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,373.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,850.77,69,,,percent of total billed charges,69% of total billed charges,1233,100,,,percent of total billed charges,100% of total billed charges,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1233,100,,,percent of total billed charges,100% of total billed charges,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1233,100,,,percent of total billed charges,100% of total billed charges,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,762.61,61.85,,,percent of total billed charges,61.85% of total billed charges,373.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,485.15,130,,,Fee Schedule,130% of WA Medicaid ,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.84,37.7,,,percent of total billed charges,37.70% of total billed charges,464.84,37.7,,,percent of total billed charges,37.70% of total billed charges,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,41798.7,33.9,,,percent of total billed charges,33.9% of total billed charges,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,961.74,78,,,percent of total billed charges,78% of total billed charges,1233,100,,,percent of total billed charges,100% of total billed charges,1018.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1018.46,82.6,,,percent of total billed charges,82.6% of total billed charges,373.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,92.18,41798.7,
"37232 REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS,",97537232,CDM,975,RC,37232,HCPCS,Outpatient,,,620,403.00,,545.6,88,,,percent of total billed charges,88% of total Billed charges,26.96,100,,,Fee Schedule,100% of Medicare rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,percent of total billed charges,100% of total billed charges,110.26,103,,,Fee Schedule,103% of WA Medicaid,26.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,427.8,69,,,percent of total billed charges,69% of total billed charges,620,100,,,percent of total billed charges,100% of total billed charges,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,620,100,,,percent of total billed charges,100% of total billed charges,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,620,100,,,percent of total billed charges,100% of total billed charges,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.47,61.85,,,percent of total billed charges,61.85% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.17,130,,,Fee Schedule,130% of WA Medicaid ,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.74,37.7,,,percent of total billed charges,37.70% of total billed charges,233.74,37.7,,,percent of total billed charges,37.70% of total billed charges,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,21018,33.9,,,percent of total billed charges,33.9% of total billed charges,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,483.6,78,,,percent of total billed charges,78% of total billed charges,620,100,,,percent of total billed charges,100% of total billed charges,512.12,82.6,,,percent of total billed charges,82.6% of total billed charges,512.12,82.6,,,percent of total billed charges,82.6% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.96,21018,
37236 TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR,97537236,CDM,975,RC,37236,HCPCS,Outpatient,,,1485,965.25,,1306.8,88,,,percent of total billed charges,88% of total Billed charges,62.13,100,,,Fee Schedule,100% of Medicare rate,237.04,100,,,Fee Schedule,100% of WA Medicaid,1485,100,,,percent of total billed charges,100% of total billed charges,244.15,103,,,Fee Schedule,103% of WA Medicaid,62.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,237.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1024.65,69,,,percent of total billed charges,69% of total billed charges,1485,100,,,percent of total billed charges,100% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1485,100,,,percent of total billed charges,100% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1485,100,,,percent of total billed charges,100% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,918.47,61.85,,,percent of total billed charges,61.85% of total billed charges,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,308.15,130,,,Fee Schedule,130% of WA Medicaid ,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,559.85,37.7,,,percent of total billed charges,37.70% of total billed charges,559.85,37.7,,,percent of total billed charges,37.70% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,50341.5,33.9,,,percent of total billed charges,33.9% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1158.3,78,,,percent of total billed charges,78% of total billed charges,1485,100,,,percent of total billed charges,100% of total billed charges,1226.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1226.61,82.6,,,percent of total billed charges,82.6% of total billed charges,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.13,50341.5,
VAC EMBOL OCCLU IMAGE VENOUS,96037241,CDM,960,RC,37241,HCPCS,Outpatient,,,1007,654.55,,886.16,88,,,percent of total billed charges,88% of total Billed charges,45.78,100,,,Fee Schedule,100% of Medicare rate,232.19,100,,,Fee Schedule,100% of WA Medicaid,1007,100,,,percent of total billed charges,100% of total billed charges,239.16,103,,,Fee Schedule,103% of WA Medicaid,45.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,232.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,694.83,69,,,percent of total billed charges,69% of total billed charges,1007,100,,,percent of total billed charges,100% of total billed charges,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1007,100,,,percent of total billed charges,100% of total billed charges,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1007,100,,,percent of total billed charges,100% of total billed charges,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.83,61.85,,,percent of total billed charges,61.85% of total billed charges,232.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,301.85,130,,,Fee Schedule,130% of WA Medicaid ,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.64,37.7,,,percent of total billed charges,37.70% of total billed charges,379.64,37.7,,,percent of total billed charges,37.70% of total billed charges,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,34137.3,33.9,,,percent of total billed charges,33.9% of total billed charges,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,785.46,78,,,percent of total billed charges,78% of total billed charges,1007,100,,,percent of total billed charges,100% of total billed charges,831.78,82.6,,,percent of total billed charges,82.6% of total billed charges,831.78,82.6,,,percent of total billed charges,82.6% of total billed charges,232.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.78,34137.3,
VAC EMBOL OCCLU IMAGE ARTERIAL,96037242,CDM,960,RC,37242,HCPCS,Outpatient,,,1071,696.15,,942.48,88,,,percent of total billed charges,88% of total Billed charges,53.63,100,,,Fee Schedule,100% of Medicare rate,257.93,100,,,Fee Schedule,100% of WA Medicaid,1071,100,,,percent of total billed charges,100% of total billed charges,265.67,103,,,Fee Schedule,103% of WA Medicaid,53.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,257.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,738.99,69,,,percent of total billed charges,69% of total billed charges,1071,100,,,percent of total billed charges,100% of total billed charges,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1071,100,,,percent of total billed charges,100% of total billed charges,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1071,100,,,percent of total billed charges,100% of total billed charges,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,662.41,61.85,,,percent of total billed charges,61.85% of total billed charges,257.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,335.31,130,,,Fee Schedule,130% of WA Medicaid ,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.77,37.7,,,percent of total billed charges,37.70% of total billed charges,403.77,37.7,,,percent of total billed charges,37.70% of total billed charges,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,36306.9,33.9,,,percent of total billed charges,33.9% of total billed charges,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.38,78,,,percent of total billed charges,78% of total billed charges,1071,100,,,percent of total billed charges,100% of total billed charges,884.65,82.6,,,percent of total billed charges,82.6% of total billed charges,884.65,82.6,,,percent of total billed charges,82.6% of total billed charges,257.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.63,36306.9,
EBOLIZATION UTERINE FIBROID,96037243,CDM,960,RC,37243,HCPCS,Outpatient,,,1000,650.00,,880,88,,,percent of total billed charges,88% of total Billed charges,48.12,100,,,Fee Schedule,100% of Medicare rate,305.86,100,,,Fee Schedule,100% of WA Medicaid,1000,100,,,percent of total billed charges,100% of total billed charges,315.04,103,,,Fee Schedule,103% of WA Medicaid,48.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,84.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,305.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,690,69,,,percent of total billed charges,69% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1000,100,,,percent of total billed charges,100% of total billed charges,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1000,100,,,percent of total billed charges,100% of total billed charges,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.5,61.85,,,percent of total billed charges,61.85% of total billed charges,305.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,397.62,130,,,Fee Schedule,130% of WA Medicaid ,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,377,37.7,,,percent of total billed charges,37.70% of total billed charges,377,37.7,,,percent of total billed charges,37.70% of total billed charges,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,33900,33.9,,,percent of total billed charges,33.9% of total billed charges,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,780,78,,,percent of total billed charges,78% of total billed charges,1000,100,,,percent of total billed charges,100% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,826,82.6,,,percent of total billed charges,82.6% of total billed charges,305.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.12,33900,
EMBOLIZATION ACTIVE HEMORRHAGE,96037244,CDM,960,RC,37244,HCPCS,Outpatient,,,1128,733.20,,992.64,88,,,percent of total billed charges,88% of total Billed charges,58.02,100,,,Fee Schedule,100% of Medicare rate,360.5,100,,,Fee Schedule,100% of WA Medicaid,1128,100,,,percent of total billed charges,100% of total billed charges,371.32,103,,,Fee Schedule,103% of WA Medicaid,58.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,360.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,778.32,69,,,percent of total billed charges,69% of total billed charges,1128,100,,,percent of total billed charges,100% of total billed charges,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128,100,,,percent of total billed charges,100% of total billed charges,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128,100,,,percent of total billed charges,100% of total billed charges,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.67,61.85,,,percent of total billed charges,61.85% of total billed charges,360.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,468.65,130,,,Fee Schedule,130% of WA Medicaid ,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.26,37.7,,,percent of total billed charges,37.70% of total billed charges,425.26,37.7,,,percent of total billed charges,37.70% of total billed charges,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,38239.2,33.9,,,percent of total billed charges,33.9% of total billed charges,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,879.84,78,,,percent of total billed charges,78% of total billed charges,1128,100,,,percent of total billed charges,100% of total billed charges,931.73,82.6,,,percent of total billed charges,82.6% of total billed charges,931.73,82.6,,,percent of total billed charges,82.6% of total billed charges,360.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.02,38239.2,
TRLUML BALO ANGIOP 1ST ART,96037246,CDM,960,RC,37246,HCPCS,Outpatient,,,1188,772.20,,1045.44,88,,,percent of total billed charges,88% of total Billed charges,43.97,100,,,Fee Schedule,100% of Medicare rate,188.18,100,,,Fee Schedule,100% of WA Medicaid,1188,100,,,percent of total billed charges,100% of total billed charges,193.83,103,,,Fee Schedule,103% of WA Medicaid,43.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,188.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,819.72,69,,,percent of total billed charges,69% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188,100,,,percent of total billed charges,100% of total billed charges,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188,100,,,percent of total billed charges,100% of total billed charges,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.78,61.85,,,percent of total billed charges,61.85% of total billed charges,188.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,244.63,130,,,Fee Schedule,130% of WA Medicaid ,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.88,37.7,,,percent of total billed charges,37.70% of total billed charges,447.88,37.7,,,percent of total billed charges,37.70% of total billed charges,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,40273.2,33.9,,,percent of total billed charges,33.9% of total billed charges,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,926.64,78,,,percent of total billed charges,78% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,188.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.97,40273.2,
TRLUML BALO ANGIOP 1ST VEIN,96037248,CDM,960,RC,37248,HCPCS,Outpatient,,,1018,661.70,,895.84,88,,,percent of total billed charges,88% of total Billed charges,32.18,100,,,Fee Schedule,100% of Medicare rate,161.7,100,,,Fee Schedule,100% of WA Medicaid,1018,100,,,percent of total billed charges,100% of total billed charges,166.55,103,,,Fee Schedule,103% of WA Medicaid,32.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,161.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,702.42,69,,,percent of total billed charges,69% of total billed charges,1018,100,,,percent of total billed charges,100% of total billed charges,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1018,100,,,percent of total billed charges,100% of total billed charges,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1018,100,,,percent of total billed charges,100% of total billed charges,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.63,61.85,,,percent of total billed charges,61.85% of total billed charges,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.21,130,,,Fee Schedule,130% of WA Medicaid ,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.79,37.7,,,percent of total billed charges,37.70% of total billed charges,383.79,37.7,,,percent of total billed charges,37.70% of total billed charges,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,34510.2,33.9,,,percent of total billed charges,33.9% of total billed charges,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,794.04,78,,,percent of total billed charges,78% of total billed charges,1018,100,,,percent of total billed charges,100% of total billed charges,840.87,82.6,,,percent of total billed charges,82.6% of total billed charges,840.87,82.6,,,percent of total billed charges,82.6% of total billed charges,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.18,34510.2,
37253 INTRAVASCULAR ULTRASOUND (NONCORONARY VESSEL) DURING D,97537253,CDM,975,RC,37253,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,9.03,100,,,Fee Schedule,100% of Medicare rate,38.23,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,39.38,103,,,Fee Schedule,103% of WA Medicaid,9.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,186,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,186,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.04,61.85,,,percent of total billed charges,61.85% of total billed charges,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.7,130,,,Fee Schedule,130% of WA Medicaid ,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6305.4,33.9,,,percent of total billed charges,33.9% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.03,6305.4,
37607 LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS FISTU,97537607,CDM,975,RC,37607,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,49.84,100,,,Fee Schedule,100% of Medicare rate,206.83,100,,,Fee Schedule,100% of WA Medicaid,1300,100,,,percent of total billed charges,100% of total billed charges,213.03,103,,,Fee Schedule,103% of WA Medicaid,49.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,206.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,206.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,268.88,130,,,Fee Schedule,130% of WA Medicaid ,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,44070,33.9,,,percent of total billed charges,33.9% of total billed charges,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,206.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.84,44070,
"37617 LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE);",97537617,CDM,975,RC,37617,HCPCS,Outpatient,,,3823,2484.95,,3364.24,88,,,percent of total billed charges,88% of total Billed charges,180.62,100,,,Fee Schedule,100% of Medicare rate,731.64,100,,,Fee Schedule,100% of WA Medicaid,3823,100,,,percent of total billed charges,100% of total billed charges,753.59,103,,,Fee Schedule,103% of WA Medicaid,180.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,316.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,731.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2637.87,69,,,percent of total billed charges,69% of total billed charges,3823,100,,,percent of total billed charges,100% of total billed charges,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,3823,100,,,percent of total billed charges,100% of total billed charges,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,3823,100,,,percent of total billed charges,100% of total billed charges,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2364.53,61.85,,,percent of total billed charges,61.85% of total billed charges,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,951.13,130,,,Fee Schedule,130% of WA Medicaid ,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1441.27,37.7,,,percent of total billed charges,37.70% of total billed charges,1441.27,37.7,,,percent of total billed charges,37.70% of total billed charges,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,129599.7,33.9,,,percent of total billed charges,33.9% of total billed charges,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2981.94,78,,,percent of total billed charges,78% of total billed charges,3823,100,,,percent of total billed charges,100% of total billed charges,3157.8,82.6,,,percent of total billed charges,82.6% of total billed charges,3157.8,82.6,,,percent of total billed charges,82.6% of total billed charges,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,180.62,129599.7,
"37765 STAB PHLEBECTOMY OF VARICOSE VEINS, 1 EXTREMITY; 10-20",97537765,CDM,975,RC,37765,HCPCS,Outpatient,,,1280,832.00,,1126.4,88,,,percent of total billed charges,88% of total Billed charges,36.14,100,,,Fee Schedule,100% of Medicare rate,148.64,100,,,Fee Schedule,100% of WA Medicaid,1280,100,,,percent of total billed charges,100% of total billed charges,153.1,103,,,Fee Schedule,103% of WA Medicaid,36.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,148.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,883.2,69,,,percent of total billed charges,69% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1280,100,,,percent of total billed charges,100% of total billed charges,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1280,100,,,percent of total billed charges,100% of total billed charges,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,791.68,61.85,,,percent of total billed charges,61.85% of total billed charges,148.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,193.23,130,,,Fee Schedule,130% of WA Medicaid ,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,43392,33.9,,,percent of total billed charges,33.9% of total billed charges,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,998.4,78,,,percent of total billed charges,78% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,148.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.14,43392,
"37766 STAB PHLEBECTOMY OF VARICOSE VEINS, 1 EXTREM",97537766,CDM,975,RC,37766,HCPCS,Outpatient,,,1637,1064.05,,1440.56,88,,,percent of total billed charges,88% of total Billed charges,44.65,100,,,Fee Schedule,100% of Medicare rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,1637,100,,,percent of total billed charges,100% of total billed charges,187.48,103,,,Fee Schedule,103% of WA Medicaid,44.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1129.53,69,,,percent of total billed charges,69% of total billed charges,1637,100,,,percent of total billed charges,100% of total billed charges,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1637,100,,,percent of total billed charges,100% of total billed charges,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1637,100,,,percent of total billed charges,100% of total billed charges,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1012.48,61.85,,,percent of total billed charges,61.85% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,236.63,130,,,Fee Schedule,130% of WA Medicaid ,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.15,37.7,,,percent of total billed charges,37.70% of total billed charges,617.15,37.7,,,percent of total billed charges,37.70% of total billed charges,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,55494.3,33.9,,,percent of total billed charges,33.9% of total billed charges,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1276.86,78,,,percent of total billed charges,78% of total billed charges,1637,100,,,percent of total billed charges,100% of total billed charges,1352.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1352.16,82.6,,,percent of total billed charges,82.6% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.65,55494.3,
SPLENECTOMY,96038100,CDM,960,RC,38100,HCPCS,Outpatient,,,2408,1565.20,,2119.04,88,,,percent of total billed charges,88% of total Billed charges,155.93,100,,,Fee Schedule,100% of Medicare rate,643.24,100,,,Fee Schedule,100% of WA Medicaid,2408,100,,,percent of total billed charges,100% of total billed charges,662.54,103,,,Fee Schedule,103% of WA Medicaid,155.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,272.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,643.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1661.52,69,,,percent of total billed charges,69% of total billed charges,2408,100,,,percent of total billed charges,100% of total billed charges,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2408,100,,,percent of total billed charges,100% of total billed charges,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2408,100,,,percent of total billed charges,100% of total billed charges,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1489.35,61.85,,,percent of total billed charges,61.85% of total billed charges,643.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,643.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,656.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,836.21,130,,,Fee Schedule,130% of WA Medicaid ,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,907.82,37.7,,,percent of total billed charges,37.70% of total billed charges,907.82,37.7,,,percent of total billed charges,37.70% of total billed charges,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,81631.2,33.9,,,percent of total billed charges,33.9% of total billed charges,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1878.24,78,,,percent of total billed charges,78% of total billed charges,2408,100,,,percent of total billed charges,100% of total billed charges,1989.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1989.01,82.6,,,percent of total billed charges,82.6% of total billed charges,643.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,643.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,155.93,81631.2,
REPAIR RUP SPLEEN W/W/O SPLENO,96038115,CDM,960,RC,38115,HCPCS,Outpatient,,,2799,1819.35,,2463.12,88,,,percent of total billed charges,88% of total Billed charges,184.41,100,,,Fee Schedule,100% of Medicare rate,720.45,100,,,Fee Schedule,100% of WA Medicaid,2799,100,,,percent of total billed charges,100% of total billed charges,742.06,103,,,Fee Schedule,103% of WA Medicaid,184.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,322.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,720.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1931.31,69,,,percent of total billed charges,69% of total billed charges,2799,100,,,percent of total billed charges,100% of total billed charges,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2799,100,,,percent of total billed charges,100% of total billed charges,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2799,100,,,percent of total billed charges,100% of total billed charges,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1731.18,61.85,,,percent of total billed charges,61.85% of total billed charges,720.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,720.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,936.59,130,,,Fee Schedule,130% of WA Medicaid ,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1055.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1055.22,37.7,,,percent of total billed charges,37.70% of total billed charges,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,94886.1,33.9,,,percent of total billed charges,33.9% of total billed charges,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2183.22,78,,,percent of total billed charges,78% of total billed charges,2799,100,,,percent of total billed charges,100% of total billed charges,2311.97,82.6,,,percent of total billed charges,82.6% of total billed charges,2311.97,82.6,,,percent of total billed charges,82.6% of total billed charges,720.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,720.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,184.41,94886.1,
BONE MARROW ASPIRATION,96038220,CDM,960,RC,38220,HCPCS,Outpatient,,,359,233.35,,315.92,88,,,percent of total billed charges,88% of total Billed charges,4.6,100,,,Fee Schedule,100% of Medicare rate,38.05,100,,,Fee Schedule,100% of WA Medicaid,359,100,,,percent of total billed charges,100% of total billed charges,39.19,103,,,Fee Schedule,103% of WA Medicaid,4.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,247.71,69,,,percent of total billed charges,69% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,359,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,359,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.04,61.85,,,percent of total billed charges,61.85% of total billed charges,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.47,130,,,Fee Schedule,130% of WA Medicaid ,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,12170.1,33.9,,,percent of total billed charges,33.9% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.02,78,,,percent of total billed charges,78% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.6,12170.1,
38222 Diagnostic bone marrow; biopsy(ies) and aspiration(s),97538222,CDM,975,RC,38222,HCPCS,Outpatient,,,162,105.30,,142.56,88,,,percent of total billed charges,88% of total Billed charges,5.34,100,,,Fee Schedule,100% of Medicare rate,42.15,100,,,Fee Schedule,100% of WA Medicaid,162,100,,,percent of total billed charges,100% of total billed charges,43.41,103,,,Fee Schedule,103% of WA Medicaid,5.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,111.78,69,,,percent of total billed charges,69% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,162,100,,,percent of total billed charges,100% of total billed charges,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,162,100,,,percent of total billed charges,100% of total billed charges,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.2,61.85,,,percent of total billed charges,61.85% of total billed charges,42.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,54.8,130,,,Fee Schedule,130% of WA Medicaid ,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,61.07,37.7,,,percent of total billed charges,37.70% of total billed charges,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,5491.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.36,78,,,percent of total billed charges,78% of total billed charges,162,100,,,percent of total billed charges,100% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,133.81,82.6,,,percent of total billed charges,82.6% of total billed charges,42.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.34,5491.8,
INCISION OF LYMPH CHANNELS,96038308,CDM,960,RC,38308,HCPCS,Outpatient,,,1790,1163.50,,1575.2,88,,,percent of total billed charges,88% of total Billed charges,56.16,100,,,Fee Schedule,100% of Medicare rate,268.37,100,,,Fee Schedule,100% of WA Medicaid,1790,100,,,percent of total billed charges,100% of total billed charges,276.42,103,,,Fee Schedule,103% of WA Medicaid,56.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,98.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,268.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1235.1,69,,,percent of total billed charges,69% of total billed charges,1790,100,,,percent of total billed charges,100% of total billed charges,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1790,100,,,percent of total billed charges,100% of total billed charges,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1790,100,,,percent of total billed charges,100% of total billed charges,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1107.12,61.85,,,percent of total billed charges,61.85% of total billed charges,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,348.88,130,,,Fee Schedule,130% of WA Medicaid ,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.83,37.7,,,percent of total billed charges,37.70% of total billed charges,674.83,37.7,,,percent of total billed charges,37.70% of total billed charges,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,60681,33.9,,,percent of total billed charges,33.9% of total billed charges,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1396.2,78,,,percent of total billed charges,78% of total billed charges,1790,100,,,percent of total billed charges,100% of total billed charges,1478.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1478.54,82.6,,,percent of total billed charges,82.6% of total billed charges,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.16,60681,
BIOPSY/EXCISION CERV NODE,96038510,CDM,960,RC,38510,HCPCS,Outpatient,,,1105,718.25,,972.4,88,,,percent of total billed charges,88% of total Billed charges,46,100,,,Fee Schedule,100% of Medicare rate,237.79,100,,,Fee Schedule,100% of WA Medicaid,1105,100,,,percent of total billed charges,100% of total billed charges,244.92,103,,,Fee Schedule,103% of WA Medicaid,46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,237.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,762.45,69,,,percent of total billed charges,69% of total billed charges,1105,100,,,percent of total billed charges,100% of total billed charges,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105,100,,,percent of total billed charges,100% of total billed charges,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105,100,,,percent of total billed charges,100% of total billed charges,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.44,61.85,,,percent of total billed charges,61.85% of total billed charges,237.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,309.13,130,,,Fee Schedule,130% of WA Medicaid ,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.59,37.7,,,percent of total billed charges,37.70% of total billed charges,416.59,37.7,,,percent of total billed charges,37.70% of total billed charges,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,37459.5,33.9,,,percent of total billed charges,33.9% of total billed charges,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.9,78,,,percent of total billed charges,78% of total billed charges,1105,100,,,percent of total billed charges,100% of total billed charges,912.73,82.6,,,percent of total billed charges,82.6% of total billed charges,912.73,82.6,,,percent of total billed charges,82.6% of total billed charges,237.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46,37459.5,
"38531 Biopsy or excision of lymph node(s); open, inguinofemo",96038531,CDM,975,RC,38531,HCPCS,Outpatient,,,1340,871.00,,1179.2,88,,,percent of total billed charges,88% of total Billed charges,55.46,100,,,Fee Schedule,100% of Medicare rate,254.76,100,,,Fee Schedule,100% of WA Medicaid,1340,100,,,percent of total billed charges,100% of total billed charges,262.4,103,,,Fee Schedule,103% of WA Medicaid,55.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,254.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,924.6,69,,,percent of total billed charges,69% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340,100,,,percent of total billed charges,100% of total billed charges,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340,100,,,percent of total billed charges,100% of total billed charges,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,828.79,61.85,,,percent of total billed charges,61.85% of total billed charges,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,331.19,130,,,Fee Schedule,130% of WA Medicaid ,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,45426,33.9,,,percent of total billed charges,33.9% of total billed charges,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045.2,78,,,percent of total billed charges,78% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.46,45426,
CERVICAL LYMPHADECTOMY,96038720,CDM,960,RC,38720,HCPCS,Outpatient,,,2885,1875.25,,2538.8,88,,,percent of total billed charges,88% of total Billed charges,139.17,100,,,Fee Schedule,100% of Medicare rate,764.84,100,,,Fee Schedule,100% of WA Medicaid,2885,100,,,percent of total billed charges,100% of total billed charges,787.79,103,,,Fee Schedule,103% of WA Medicaid,139.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,243.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,764.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1990.65,69,,,percent of total billed charges,69% of total billed charges,2885,100,,,percent of total billed charges,100% of total billed charges,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2885,100,,,percent of total billed charges,100% of total billed charges,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2885,100,,,percent of total billed charges,100% of total billed charges,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1784.37,61.85,,,percent of total billed charges,61.85% of total billed charges,764.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,764.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,994.29,130,,,Fee Schedule,130% of WA Medicaid ,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1087.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1087.65,37.7,,,percent of total billed charges,37.70% of total billed charges,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,97801.5,33.9,,,percent of total billed charges,33.9% of total billed charges,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2250.3,78,,,percent of total billed charges,78% of total billed charges,2885,100,,,percent of total billed charges,100% of total billed charges,2383.01,82.6,,,percent of total billed charges,82.6% of total billed charges,2383.01,82.6,,,percent of total billed charges,82.6% of total billed charges,764.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,764.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,139.17,97801.5,
38724 CERVICAL LYMPHADENECTOMY (MODIFIED RADICAL N,97538724,CDM,975,RC,38724,HCPCS,Outpatient,,,3173,2062.45,,2792.24,88,,,percent of total billed charges,88% of total Billed charges,140.38,100,,,Fee Schedule,100% of Medicare rate,827.13,100,,,Fee Schedule,100% of WA Medicaid,3173,100,,,percent of total billed charges,100% of total billed charges,851.94,103,,,Fee Schedule,103% of WA Medicaid,140.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,245.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,827.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2189.37,69,,,percent of total billed charges,69% of total billed charges,3173,100,,,percent of total billed charges,100% of total billed charges,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3173,100,,,percent of total billed charges,100% of total billed charges,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3173,100,,,percent of total billed charges,100% of total billed charges,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1962.5,61.85,,,percent of total billed charges,61.85% of total billed charges,827.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,827.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,843.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1075.27,130,,,Fee Schedule,130% of WA Medicaid ,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1196.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1196.22,37.7,,,percent of total billed charges,37.70% of total billed charges,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,107564.7,33.9,,,percent of total billed charges,33.9% of total billed charges,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2474.94,78,,,percent of total billed charges,78% of total billed charges,3173,100,,,percent of total billed charges,100% of total billed charges,2620.9,82.6,,,percent of total billed charges,82.6% of total billed charges,2620.9,82.6,,,percent of total billed charges,82.6% of total billed charges,827.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,827.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.38,107564.7,
AXIL LYMPHADENECTOMY;COMPLETE,96038745,CDM,960,RC,38745,HCPCS,Outpatient,,,1830,1189.50,,1610.4,88,,,percent of total billed charges,88% of total Billed charges,116.63,100,,,Fee Schedule,100% of Medicare rate,499.45,100,,,Fee Schedule,100% of WA Medicaid,1830,100,,,percent of total billed charges,100% of total billed charges,514.43,103,,,Fee Schedule,103% of WA Medicaid,116.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,204.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,499.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1262.7,69,,,percent of total billed charges,69% of total billed charges,1830,100,,,percent of total billed charges,100% of total billed charges,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1830,100,,,percent of total billed charges,100% of total billed charges,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1830,100,,,percent of total billed charges,100% of total billed charges,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131.86,61.85,,,percent of total billed charges,61.85% of total billed charges,499.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,649.29,130,,,Fee Schedule,130% of WA Medicaid ,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,689.91,37.7,,,percent of total billed charges,37.70% of total billed charges,689.91,37.7,,,percent of total billed charges,37.70% of total billed charges,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,62037,33.9,,,percent of total billed charges,33.9% of total billed charges,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1427.4,78,,,percent of total billed charges,78% of total billed charges,1830,100,,,percent of total billed charges,100% of total billed charges,1511.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1511.58,82.6,,,percent of total billed charges,82.6% of total billed charges,499.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,116.63,62037,
"38900 INTRAOPERATIVE IDENTIFICATION (EG, MAPPING) OF SENTINE",97538900,CDM,975,RC,38900,HCPCS,Outpatient,,,367,238.55,,322.96,88,,,percent of total billed charges,88% of total Billed charges,19.33,100,,,Fee Schedule,100% of Medicare rate,75.91,100,,,Fee Schedule,100% of WA Medicaid,367,100,,,percent of total billed charges,100% of total billed charges,78.19,103,,,Fee Schedule,103% of WA Medicaid,19.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,75.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,253.23,69,,,percent of total billed charges,69% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,367,100,,,percent of total billed charges,100% of total billed charges,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,367,100,,,percent of total billed charges,100% of total billed charges,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.99,61.85,,,percent of total billed charges,61.85% of total billed charges,75.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,98.68,130,,,Fee Schedule,130% of WA Medicaid ,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,12441.3,33.9,,,percent of total billed charges,33.9% of total billed charges,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.26,78,,,percent of total billed charges,78% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,75.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.33,12441.3,
REPAIR LAC DIAPHRAGM,96039501,CDM,960,RC,39501,HCPCS,Outpatient,,,1786,1160.90,,1571.68,88,,,percent of total billed charges,88% of total Billed charges,112.17,100,,,Fee Schedule,100% of Medicare rate,478.37,100,,,Fee Schedule,100% of WA Medicaid,1786,100,,,percent of total billed charges,100% of total billed charges,492.72,103,,,Fee Schedule,103% of WA Medicaid,112.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,196.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,478.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1232.34,69,,,percent of total billed charges,69% of total billed charges,1786,100,,,percent of total billed charges,100% of total billed charges,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786,100,,,percent of total billed charges,100% of total billed charges,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786,100,,,percent of total billed charges,100% of total billed charges,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1104.64,61.85,,,percent of total billed charges,61.85% of total billed charges,478.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,621.88,130,,,Fee Schedule,130% of WA Medicaid ,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,673.32,37.7,,,percent of total billed charges,37.70% of total billed charges,673.32,37.7,,,percent of total billed charges,37.70% of total billed charges,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,60545.4,33.9,,,percent of total billed charges,33.9% of total billed charges,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1393.08,78,,,percent of total billed charges,78% of total billed charges,1786,100,,,percent of total billed charges,100% of total billed charges,1475.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1475.24,82.6,,,percent of total billed charges,82.6% of total billed charges,478.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.17,60545.4,
"39540 REPAIR, DIAPHRAGMATIC HERNIA (OTHER THAN NEONATAL), TR",96039540,CDM,960,RC,39540,HCPCS,Outpatient,,,2472.91,1607.39,,2176.16,88,,,percent of total billed charges,88% of total Billed charges,117.71,100,,,Fee Schedule,100% of Medicare rate,484.71,100,,,Fee Schedule,100% of WA Medicaid,2472.91,100,,,percent of total billed charges,100% of total billed charges,499.25,103,,,Fee Schedule,103% of WA Medicaid,117.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,205.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,484.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1706.31,69,,,percent of total billed charges,69% of total billed charges,2472.91,100,,,percent of total billed charges,100% of total billed charges,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2472.91,100,,,percent of total billed charges,100% of total billed charges,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2472.91,100,,,percent of total billed charges,100% of total billed charges,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1529.49,61.85,,,percent of total billed charges,61.85% of total billed charges,484.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,484.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,630.12,130,,,Fee Schedule,130% of WA Medicaid ,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,932.29,37.7,,,percent of total billed charges,37.70% of total billed charges,932.29,37.7,,,percent of total billed charges,37.70% of total billed charges,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,83831.65,33.9,,,percent of total billed charges,33.9% of total billed charges,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1928.87,78,,,percent of total billed charges,78% of total billed charges,2472.91,100,,,percent of total billed charges,100% of total billed charges,2042.62,82.6,,,percent of total billed charges,82.6% of total billed charges,2042.62,82.6,,,percent of total billed charges,82.6% of total billed charges,484.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,484.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.71,83831.65,
"40654 REPAIR LIP, FULL THICKNESS; OVER ONE-HALF VERTICAL HEI",97540654,CDM,975,RC,40654,HCPCS,Outpatient,,,1128,733.20,,992.64,88,,,percent of total billed charges,88% of total Billed charges,35.35,100,,,Fee Schedule,100% of Medicare rate,248.42,100,,,Fee Schedule,100% of WA Medicaid,1128,100,,,percent of total billed charges,100% of total billed charges,255.87,103,,,Fee Schedule,103% of WA Medicaid,35.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,248.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,778.32,69,,,percent of total billed charges,69% of total billed charges,1128,100,,,percent of total billed charges,100% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128,100,,,percent of total billed charges,100% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128,100,,,percent of total billed charges,100% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.67,61.85,,,percent of total billed charges,61.85% of total billed charges,248.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,322.95,130,,,Fee Schedule,130% of WA Medicaid ,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.26,37.7,,,percent of total billed charges,37.70% of total billed charges,425.26,37.7,,,percent of total billed charges,37.70% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,38239.2,33.9,,,percent of total billed charges,33.9% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,879.84,78,,,percent of total billed charges,78% of total billed charges,1128,100,,,percent of total billed charges,100% of total billed charges,931.73,82.6,,,percent of total billed charges,82.6% of total billed charges,931.73,82.6,,,percent of total billed charges,82.6% of total billed charges,248.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.35,38239.2,
"40799 UNLISTED PROCEDURE, LIPS ProFee",97540799,CDM,975,RC,40799,HCPCS,Outpatient,,,289,187.85,,254.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,289,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,199.41,69,,,percent of total billed charges,69% of total billed charges,289,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,289,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,289,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,178.75,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,108.95,37.7,,,percent of total billed charges,37.70% of total billed charges,108.95,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,9797.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,225.42,78,,,percent of total billed charges,78% of total billed charges,289,100,,,percent of total billed charges,100% of total billed charges,238.71,82.6,,,percent of total billed charges,82.6% of total billed charges,238.71,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",108.95,9797.1,
"41008 INTRAORAL INCISION AND DRAINAGE OF ABSCESS,",97541008,CDM,975,RC,41008,HCPCS,Outpatient,,,1412,917.80,,1242.56,88,,,percent of total billed charges,88% of total Billed charges,18.76,100,,,Fee Schedule,100% of Medicare rate,149.76,100,,,Fee Schedule,100% of WA Medicaid,1412,100,,,percent of total billed charges,100% of total billed charges,154.25,103,,,Fee Schedule,103% of WA Medicaid,18.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,149.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,974.28,69,,,percent of total billed charges,69% of total billed charges,1412,100,,,percent of total billed charges,100% of total billed charges,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1412,100,,,percent of total billed charges,100% of total billed charges,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1412,100,,,percent of total billed charges,100% of total billed charges,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,873.32,61.85,,,percent of total billed charges,61.85% of total billed charges,149.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,194.69,130,,,Fee Schedule,130% of WA Medicaid ,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,532.32,37.7,,,percent of total billed charges,37.70% of total billed charges,532.32,37.7,,,percent of total billed charges,37.70% of total billed charges,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,47866.8,33.9,,,percent of total billed charges,33.9% of total billed charges,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1101.36,78,,,percent of total billed charges,78% of total billed charges,1412,100,,,percent of total billed charges,100% of total billed charges,1166.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1166.31,82.6,,,percent of total billed charges,82.6% of total billed charges,149.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.76,47866.8,
41113 EXCISION OF LESION OF TONGUE WITH CLOSURE; POSTERIOR O,97541113,CDM,975,RC,41113,HCPCS,Outpatient,,,516,335.40,,454.08,88,,,percent of total billed charges,88% of total Billed charges,18.18,100,,,Fee Schedule,100% of Medicare rate,153.68,100,,,Fee Schedule,100% of WA Medicaid,516,100,,,percent of total billed charges,100% of total billed charges,158.29,103,,,Fee Schedule,103% of WA Medicaid,18.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,153.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,356.04,69,,,percent of total billed charges,69% of total billed charges,516,100,,,percent of total billed charges,100% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,516,100,,,percent of total billed charges,100% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,516,100,,,percent of total billed charges,100% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.15,61.85,,,percent of total billed charges,61.85% of total billed charges,153.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,199.78,130,,,Fee Schedule,130% of WA Medicaid ,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.53,37.7,,,percent of total billed charges,37.70% of total billed charges,194.53,37.7,,,percent of total billed charges,37.70% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,17492.4,33.9,,,percent of total billed charges,33.9% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.48,78,,,percent of total billed charges,78% of total billed charges,516,100,,,percent of total billed charges,100% of total billed charges,426.22,82.6,,,percent of total billed charges,82.6% of total billed charges,426.22,82.6,,,percent of total billed charges,82.6% of total billed charges,153.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.18,17492.4,
"41800 DRAINAGE OF ABSCESS, CYST, HEMATOMA FROM DENTOALVEOLAR",97541800,CDM,975,RC,41800,HCPCS,Outpatient,,,556,361.40,,489.28,88,,,percent of total billed charges,88% of total Billed charges,10.46,100,,,Fee Schedule,100% of Medicare rate,91.01,100,,,Fee Schedule,100% of WA Medicaid,556,100,,,percent of total billed charges,100% of total billed charges,93.74,103,,,Fee Schedule,103% of WA Medicaid,10.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,91.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,383.64,69,,,percent of total billed charges,69% of total billed charges,556,100,,,percent of total billed charges,100% of total billed charges,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,556,100,,,percent of total billed charges,100% of total billed charges,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,556,100,,,percent of total billed charges,100% of total billed charges,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.89,61.85,,,percent of total billed charges,61.85% of total billed charges,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,118.31,130,,,Fee Schedule,130% of WA Medicaid ,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.61,37.7,,,percent of total billed charges,37.70% of total billed charges,209.61,37.7,,,percent of total billed charges,37.70% of total billed charges,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,18848.4,33.9,,,percent of total billed charges,33.9% of total billed charges,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.68,78,,,percent of total billed charges,78% of total billed charges,556,100,,,percent of total billed charges,100% of total billed charges,459.26,82.6,,,percent of total billed charges,82.6% of total billed charges,459.26,82.6,,,percent of total billed charges,82.6% of total billed charges,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.46,18848.4,
"42145 PALATOPHARYNGOPLASTY (EG, UVULOPALATOPHARYNGOPLASTY, U",97542145,CDM,975,RC,42145,HCPCS,Outpatient,,,1486,965.90,,1307.68,88,,,percent of total billed charges,88% of total Billed charges,58.29,100,,,Fee Schedule,100% of Medicare rate,398.18,100,,,Fee Schedule,100% of WA Medicaid,1486,100,,,percent of total billed charges,100% of total billed charges,410.13,103,,,Fee Schedule,103% of WA Medicaid,58.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,398.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1025.34,69,,,percent of total billed charges,69% of total billed charges,1486,100,,,percent of total billed charges,100% of total billed charges,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1486,100,,,percent of total billed charges,100% of total billed charges,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1486,100,,,percent of total billed charges,100% of total billed charges,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,919.09,61.85,,,percent of total billed charges,61.85% of total billed charges,398.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,517.63,130,,,Fee Schedule,130% of WA Medicaid ,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,560.22,37.7,,,percent of total billed charges,37.70% of total billed charges,560.22,37.7,,,percent of total billed charges,37.70% of total billed charges,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,50375.4,33.9,,,percent of total billed charges,33.9% of total billed charges,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1159.08,78,,,percent of total billed charges,78% of total billed charges,1486,100,,,percent of total billed charges,100% of total billed charges,1227.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1227.44,82.6,,,percent of total billed charges,82.6% of total billed charges,398.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.29,50375.4,
PALATOPLASTY FOR CLEFT PALATE MAJOR REVI,42215,CDM,960,RC,42215,HCPCS,Outpatient,,,1566,1017.90,,1378.08,88,,,percent of total billed charges,88% of total Billed charges,64.34,100,,,Fee Schedule,100% of Medicare rate,405.26,100,,,Fee Schedule,100% of WA Medicaid,1566,100,,,percent of total billed charges,100% of total billed charges,417.42,103,,,Fee Schedule,103% of WA Medicaid,64.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,405.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1080.54,69,,,percent of total billed charges,69% of total billed charges,1566,100,,,percent of total billed charges,100% of total billed charges,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1566,100,,,percent of total billed charges,100% of total billed charges,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1566,100,,,percent of total billed charges,100% of total billed charges,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,968.57,61.85,,,percent of total billed charges,61.85% of total billed charges,405.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,526.84,130,,,Fee Schedule,130% of WA Medicaid ,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.38,37.7,,,percent of total billed charges,37.70% of total billed charges,590.38,37.7,,,percent of total billed charges,37.70% of total billed charges,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,53087.4,33.9,,,percent of total billed charges,33.9% of total billed charges,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1221.48,78,,,percent of total billed charges,78% of total billed charges,1566,100,,,percent of total billed charges,100% of total billed charges,1293.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1293.52,82.6,,,percent of total billed charges,82.6% of total billed charges,405.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.34,53087.4,
42220 PALATOPLASTY FOR CLEFT PALATE; SECONDARY LENGTHENING P,97542220,CDM,975,RC,42220,HCPCS,Outpatient,,,1243,807.95,,1093.84,88,,,percent of total billed charges,88% of total Billed charges,51.81,100,,,Fee Schedule,100% of Medicare rate,334.77,100,,,Fee Schedule,100% of WA Medicaid,1243,100,,,percent of total billed charges,100% of total billed charges,344.81,103,,,Fee Schedule,103% of WA Medicaid,51.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,334.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,857.67,69,,,percent of total billed charges,69% of total billed charges,1243,100,,,percent of total billed charges,100% of total billed charges,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1243,100,,,percent of total billed charges,100% of total billed charges,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1243,100,,,percent of total billed charges,100% of total billed charges,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,768.8,61.85,,,percent of total billed charges,61.85% of total billed charges,334.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,435.2,130,,,Fee Schedule,130% of WA Medicaid ,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.61,37.7,,,percent of total billed charges,37.70% of total billed charges,468.61,37.7,,,percent of total billed charges,37.70% of total billed charges,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,42137.7,33.9,,,percent of total billed charges,33.9% of total billed charges,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,969.54,78,,,percent of total billed charges,78% of total billed charges,1243,100,,,percent of total billed charges,100% of total billed charges,1026.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1026.72,82.6,,,percent of total billed charges,82.6% of total billed charges,334.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.81,42137.7,
"42226 LENGTHENING OF PALATE, AND PHARYNGEAL FLAP ProFee",98242226,CDM,982,RC,42226,HCPCS,Outpatient,,,1825,1186.25,,1606,88,,,percent of total billed charges,88% of total Billed charges,67.07,100,,,Fee Schedule,100% of Medicare rate,527.42,100,,,Fee Schedule,100% of WA Medicaid,1825,100,,,percent of total billed charges,100% of total billed charges,543.24,103,,,Fee Schedule,103% of WA Medicaid,67.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,117.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,527.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1259.25,69,,,percent of total billed charges,69% of total billed charges,1825,100,,,percent of total billed charges,100% of total billed charges,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825,100,,,percent of total billed charges,100% of total billed charges,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825,100,,,percent of total billed charges,100% of total billed charges,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128.76,61.85,,,percent of total billed charges,61.85% of total billed charges,527.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,685.65,130,,,Fee Schedule,130% of WA Medicaid ,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,688.03,37.7,,,percent of total billed charges,37.70% of total billed charges,688.03,37.7,,,percent of total billed charges,37.70% of total billed charges,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,61867.5,33.9,,,percent of total billed charges,33.9% of total billed charges,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.5,78,,,percent of total billed charges,78% of total billed charges,1825,100,,,percent of total billed charges,100% of total billed charges,1507.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1507.45,82.6,,,percent of total billed charges,82.6% of total billed charges,527.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.07,61867.5,
42330 SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY)  Profee,97542330,CDM,975,RC,42330,HCPCS,Outpatient,,,579,376.35,,509.52,88,,,percent of total billed charges,88% of total Billed charges,13.36,100,,,Fee Schedule,100% of Medicare rate,96.23,100,,,Fee Schedule,100% of WA Medicaid,579,100,,,percent of total billed charges,100% of total billed charges,99.12,103,,,Fee Schedule,103% of WA Medicaid,13.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,96.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,399.51,69,,,percent of total billed charges,69% of total billed charges,579,100,,,percent of total billed charges,100% of total billed charges,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,579,100,,,percent of total billed charges,100% of total billed charges,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,579,100,,,percent of total billed charges,100% of total billed charges,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.11,61.85,,,percent of total billed charges,61.85% of total billed charges,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,125.1,130,,,Fee Schedule,130% of WA Medicaid ,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.28,37.7,,,percent of total billed charges,37.70% of total billed charges,218.28,37.7,,,percent of total billed charges,37.70% of total billed charges,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,19628.1,33.9,,,percent of total billed charges,33.9% of total billed charges,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.62,78,,,percent of total billed charges,78% of total billed charges,579,100,,,percent of total billed charges,100% of total billed charges,478.25,82.6,,,percent of total billed charges,82.6% of total billed charges,478.25,82.6,,,percent of total billed charges,82.6% of total billed charges,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.36,19628.1,
42408 EXCISION OF SUBLINGUAL SALIVARY CYST (RANULA) ProFee,97542408,CDM,975,RC,42408,HCPCS,Outpatient,,,966,627.90,,850.08,88,,,percent of total billed charges,88% of total Billed charges,22.83,100,,,Fee Schedule,100% of Medicare rate,202.73,100,,,Fee Schedule,100% of WA Medicaid,966,100,,,percent of total billed charges,100% of total billed charges,208.81,103,,,Fee Schedule,103% of WA Medicaid,22.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,202.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,666.54,69,,,percent of total billed charges,69% of total billed charges,966,100,,,percent of total billed charges,100% of total billed charges,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,966,100,,,percent of total billed charges,100% of total billed charges,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,966,100,,,percent of total billed charges,100% of total billed charges,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.47,61.85,,,percent of total billed charges,61.85% of total billed charges,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,263.55,130,,,Fee Schedule,130% of WA Medicaid ,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.18,37.7,,,percent of total billed charges,37.70% of total billed charges,364.18,37.7,,,percent of total billed charges,37.70% of total billed charges,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,32747.4,33.9,,,percent of total billed charges,33.9% of total billed charges,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,753.48,78,,,percent of total billed charges,78% of total billed charges,966,100,,,percent of total billed charges,100% of total billed charges,797.92,82.6,,,percent of total billed charges,82.6% of total billed charges,797.92,82.6,,,percent of total billed charges,82.6% of total billed charges,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.83,32747.4,
EXC PAROTID TUMOR SF LOBE PROS,96042415,CDM,960,RC,42415,HCPCS,Outpatient,,,2281,1482.65,,2007.28,88,,,percent of total billed charges,88% of total Billed charges,98.63,100,,,Fee Schedule,100% of Medicare rate,606.5,100,,,Fee Schedule,100% of WA Medicaid,2281,100,,,percent of total billed charges,100% of total billed charges,624.7,103,,,Fee Schedule,103% of WA Medicaid,98.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,172.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,606.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1573.89,69,,,percent of total billed charges,69% of total billed charges,2281,100,,,percent of total billed charges,100% of total billed charges,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2281,100,,,percent of total billed charges,100% of total billed charges,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2281,100,,,percent of total billed charges,100% of total billed charges,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1410.8,61.85,,,percent of total billed charges,61.85% of total billed charges,606.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,788.45,130,,,Fee Schedule,130% of WA Medicaid ,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.94,37.7,,,percent of total billed charges,37.70% of total billed charges,859.94,37.7,,,percent of total billed charges,37.70% of total billed charges,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,77325.9,33.9,,,percent of total billed charges,33.9% of total billed charges,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1779.18,78,,,percent of total billed charges,78% of total billed charges,2281,100,,,percent of total billed charges,100% of total billed charges,1884.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1884.11,82.6,,,percent of total billed charges,82.6% of total billed charges,606.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.63,77325.9,
EXC PAROTID TUMOR W/ TOT DISEC,96042420,CDM,960,RC,42420,HCPCS,Outpatient,,,2558,1662.70,,2251.04,88,,,percent of total billed charges,88% of total Billed charges,110.7,100,,,Fee Schedule,100% of Medicare rate,677.74,100,,,Fee Schedule,100% of WA Medicaid,2558,100,,,percent of total billed charges,100% of total billed charges,698.07,103,,,Fee Schedule,103% of WA Medicaid,110.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,677.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1765.02,69,,,percent of total billed charges,69% of total billed charges,2558,100,,,percent of total billed charges,100% of total billed charges,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2558,100,,,percent of total billed charges,100% of total billed charges,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2558,100,,,percent of total billed charges,100% of total billed charges,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1582.12,61.85,,,percent of total billed charges,61.85% of total billed charges,677.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,691.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,881.06,130,,,Fee Schedule,130% of WA Medicaid ,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,964.37,37.7,,,percent of total billed charges,37.70% of total billed charges,964.37,37.7,,,percent of total billed charges,37.70% of total billed charges,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,86716.2,33.9,,,percent of total billed charges,33.9% of total billed charges,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1995.24,78,,,percent of total billed charges,78% of total billed charges,2558,100,,,percent of total billed charges,100% of total billed charges,2112.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2112.91,82.6,,,percent of total billed charges,82.6% of total billed charges,677.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.7,86716.2,
42820 TONSILLECTOMY AND ADENOIDECTOMY; YOUNGER TH,97542820,CDM,975,RC,42820,HCPCS,Outpatient,,,644,418.60,,566.72,88,,,percent of total billed charges,88% of total Billed charges,24.74,100,,,Fee Schedule,100% of Medicare rate,169.53,100,,,Fee Schedule,100% of WA Medicaid,644,100,,,percent of total billed charges,100% of total billed charges,174.62,103,,,Fee Schedule,103% of WA Medicaid,24.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,169.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,444.36,69,,,percent of total billed charges,69% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,644,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,644,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.31,61.85,,,percent of total billed charges,61.85% of total billed charges,169.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.39,130,,,Fee Schedule,130% of WA Medicaid ,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,21831.6,33.9,,,percent of total billed charges,33.9% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.32,78,,,percent of total billed charges,78% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,169.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.74,21831.6,
42821 TONSILLECTOMY AND ADENOIDECTOMY; AGE 12 OR OVER ProFee,97542821,CDM,975,RC,42821,HCPCS,Outpatient,,,644,418.60,,566.72,88,,,percent of total billed charges,88% of total Billed charges,25.65,100,,,Fee Schedule,100% of Medicare rate,176.99,100,,,Fee Schedule,100% of WA Medicaid,644,100,,,percent of total billed charges,100% of total billed charges,182.3,103,,,Fee Schedule,103% of WA Medicaid,25.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,176.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,444.36,69,,,percent of total billed charges,69% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,644,100,,,percent of total billed charges,100% of total billed charges,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,644,100,,,percent of total billed charges,100% of total billed charges,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.31,61.85,,,percent of total billed charges,61.85% of total billed charges,176.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,230.09,130,,,Fee Schedule,130% of WA Medicaid ,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,21831.6,33.9,,,percent of total billed charges,33.9% of total billed charges,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.32,78,,,percent of total billed charges,78% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,176.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.65,21831.6,
"42825 TONSILLECTOMY, PRIMARY OR SECONDARY; YOUNGER THAN AGE",42825,CDM,975,RC,42825,HCPCS,Outpatient,,,576,374.40,,506.88,88,,,percent of total billed charges,88% of total Billed charges,21.23,100,,,Fee Schedule,100% of Medicare rate,157.22,100,,,Fee Schedule,100% of WA Medicaid,576,100,,,percent of total billed charges,100% of total billed charges,161.94,103,,,Fee Schedule,103% of WA Medicaid,21.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,157.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,397.44,69,,,percent of total billed charges,69% of total billed charges,576,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,576,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,576,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.26,61.85,,,percent of total billed charges,61.85% of total billed charges,157.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,204.39,130,,,Fee Schedule,130% of WA Medicaid ,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.15,37.7,,,percent of total billed charges,37.70% of total billed charges,217.15,37.7,,,percent of total billed charges,37.70% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,19526.4,33.9,,,percent of total billed charges,33.9% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.28,78,,,percent of total billed charges,78% of total billed charges,576,100,,,percent of total billed charges,100% of total billed charges,475.78,82.6,,,percent of total billed charges,82.6% of total billed charges,475.78,82.6,,,percent of total billed charges,82.6% of total billed charges,157.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.23,19526.4,
"42826 TONSILLECTOMY, PRIMARY OR SECONDARY; AGE 12",97542826,CDM,975,RC,42826,HCPCS,Outpatient,,,555,360.75,,488.4,88,,,percent of total billed charges,88% of total Billed charges,20.82,100,,,Fee Schedule,100% of Medicare rate,149.57,100,,,Fee Schedule,100% of WA Medicaid,555,100,,,percent of total billed charges,100% of total billed charges,154.06,103,,,Fee Schedule,103% of WA Medicaid,20.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,149.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,382.95,69,,,percent of total billed charges,69% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,555,100,,,percent of total billed charges,100% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,555,100,,,percent of total billed charges,100% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.27,61.85,,,percent of total billed charges,61.85% of total billed charges,149.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,194.44,130,,,Fee Schedule,130% of WA Medicaid ,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,18814.5,33.9,,,percent of total billed charges,33.9% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.9,78,,,percent of total billed charges,78% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,149.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.82,18814.5,
"42830 ADENOIDECTOMY, PRIMARY; YOUNGER THAN AGE 12",97542830,CDM,975,RC,42830,HCPCS,Outpatient,,,454,295.10,,399.52,88,,,percent of total billed charges,88% of total Billed charges,16.68,100,,,Fee Schedule,100% of Medicare rate,125.14,100,,,Fee Schedule,100% of WA Medicaid,454,100,,,percent of total billed charges,100% of total billed charges,128.89,103,,,Fee Schedule,103% of WA Medicaid,16.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,125.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,313.26,69,,,percent of total billed charges,69% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,454,100,,,percent of total billed charges,100% of total billed charges,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,454,100,,,percent of total billed charges,100% of total billed charges,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.8,61.85,,,percent of total billed charges,61.85% of total billed charges,125.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,162.68,130,,,Fee Schedule,130% of WA Medicaid ,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,15390.6,33.9,,,percent of total billed charges,33.9% of total billed charges,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.12,78,,,percent of total billed charges,78% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,125.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.68,15390.6,
"RADICAL RESECTION TONSIL,PIL",96042842,CDM,960,RC,42842,HCPCS,Outpatient,,,2161,1404.65,,1901.68,88,,,percent of total billed charges,88% of total Billed charges,77.92,100,,,Fee Schedule,100% of Medicare rate,585.42,100,,,Fee Schedule,100% of WA Medicaid,2161,100,,,percent of total billed charges,100% of total billed charges,602.98,103,,,Fee Schedule,103% of WA Medicaid,77.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,136.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,585.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1491.09,69,,,percent of total billed charges,69% of total billed charges,2161,100,,,percent of total billed charges,100% of total billed charges,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2161,100,,,percent of total billed charges,100% of total billed charges,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2161,100,,,percent of total billed charges,100% of total billed charges,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1336.58,61.85,,,percent of total billed charges,61.85% of total billed charges,585.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,761.05,130,,,Fee Schedule,130% of WA Medicaid ,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,814.7,37.7,,,percent of total billed charges,37.70% of total billed charges,814.7,37.7,,,percent of total billed charges,37.70% of total billed charges,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,73257.9,33.9,,,percent of total billed charges,33.9% of total billed charges,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1685.58,78,,,percent of total billed charges,78% of total billed charges,2161,100,,,percent of total billed charges,100% of total billed charges,1784.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1784.99,82.6,,,percent of total billed charges,82.6% of total billed charges,585.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.92,73257.9,
"CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG,",42960,CDM,975,RC,42960,HCPCS,Outpatient,,,555,360.75,,488.4,88,,,percent of total billed charges,88% of total Billed charges,14.23,100,,,Fee Schedule,100% of Medicare rate,93.06,100,,,Fee Schedule,100% of WA Medicaid,555,100,,,percent of total billed charges,100% of total billed charges,95.85,103,,,Fee Schedule,103% of WA Medicaid,14.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,93.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,382.95,69,,,percent of total billed charges,69% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,555,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,555,100,,,percent of total billed charges,100% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.27,61.85,,,percent of total billed charges,61.85% of total billed charges,93.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,120.98,130,,,Fee Schedule,130% of WA Medicaid ,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,18814.5,33.9,,,percent of total billed charges,33.9% of total billed charges,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.9,78,,,percent of total billed charges,78% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,93.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.23,18814.5,
UNLISTED PROCEDURE PHARYNX,96042999,CDM,960,RC,42999,HCPCS,Outpatient,,,1755,1140.75,,1544.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1755,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1210.95,69,,,percent of total billed charges,69% of total billed charges,1755,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1755,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1755,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1085.47,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,661.64,37.7,,,percent of total billed charges,37.70% of total billed charges,661.64,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,59494.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1368.9,78,,,percent of total billed charges,78% of total billed charges,1755,100,,,percent of total billed charges,100% of total billed charges,1449.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1449.63,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",661.64,59494.5,
"43135 DIVERTICULECTOMY OF HYPOPHARYNX OR ESOPHAGUS, WITH OR",96043135,CDM,960,RC,43135,HCPCS,Outpatient,,,4169.96,2710.47,,3669.56,88,,,percent of total billed charges,88% of total Billed charges,210.59,100,,,Fee Schedule,100% of Medicare rate,807.55,100,,,Fee Schedule,100% of WA Medicaid,4169.96,100,,,percent of total billed charges,100% of total billed charges,831.78,103,,,Fee Schedule,103% of WA Medicaid,210.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,368.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,807.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2877.27,69,,,percent of total billed charges,69% of total billed charges,4169.96,100,,,percent of total billed charges,100% of total billed charges,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,4169.96,100,,,percent of total billed charges,100% of total billed charges,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,4169.96,100,,,percent of total billed charges,100% of total billed charges,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2579.12,61.85,,,percent of total billed charges,61.85% of total billed charges,807.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,807.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,823.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1049.82,130,,,Fee Schedule,130% of WA Medicaid ,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1572.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1572.07,37.7,,,percent of total billed charges,37.70% of total billed charges,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,141361.64,33.9,,,percent of total billed charges,33.9% of total billed charges,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3252.57,78,,,percent of total billed charges,78% of total billed charges,4169.96,100,,,percent of total billed charges,100% of total billed charges,3444.39,82.6,,,percent of total billed charges,82.6% of total billed charges,3444.39,82.6,,,percent of total billed charges,82.6% of total billed charges,807.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,210.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,807.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.59,141361.64,
"43202 ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGL",97543202,CDM,975,RC,43202,HCPCS,Outpatient,,,1017,661.05,,894.96,88,,,percent of total billed charges,88% of total Billed charges,9.03,100,,,Fee Schedule,100% of Medicare rate,58.19,100,,,Fee Schedule,100% of WA Medicaid,1017,100,,,percent of total billed charges,100% of total billed charges,59.94,103,,,Fee Schedule,103% of WA Medicaid,9.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,701.73,69,,,percent of total billed charges,69% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.01,61.85,,,percent of total billed charges,61.85% of total billed charges,58.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,75.65,130,,,Fee Schedule,130% of WA Medicaid ,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,34476.3,33.9,,,percent of total billed charges,33.9% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,793.26,78,,,percent of total billed charges,78% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,58.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.03,34476.3,
"43206 ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH OPTICAL ENDOM",97543206,CDM,975,RC,43206,HCPCS,Outpatient,,,966,627.90,,850.08,88,,,percent of total billed charges,88% of total Billed charges,10.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,966,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,10.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,666.54,69,,,percent of total billed charges,69% of total billed charges,966,100,,,percent of total billed charges,100% of total billed charges,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,966,100,,,percent of total billed charges,100% of total billed charges,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,966,100,,,percent of total billed charges,100% of total billed charges,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.47,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.18,37.7,,,percent of total billed charges,37.70% of total billed charges,364.18,37.7,,,percent of total billed charges,37.70% of total billed charges,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,32747.4,33.9,,,percent of total billed charges,33.9% of total billed charges,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,753.48,78,,,percent of total billed charges,78% of total billed charges,966,100,,,percent of total billed charges,100% of total billed charges,797.92,82.6,,,percent of total billed charges,82.6% of total billed charges,797.92,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",10.68,32747.4,
"ESOPHAGEAL ENDOSCOPY,DILATION",96043220,CDM,960,RC,43220,HCPCS,Outpatient,,,2184,1419.60,,1921.92,88,,,percent of total billed charges,88% of total Billed charges,10.51,100,,,Fee Schedule,100% of Medicare rate,66.39,100,,,Fee Schedule,100% of WA Medicaid,2184,100,,,percent of total billed charges,100% of total billed charges,68.38,103,,,Fee Schedule,103% of WA Medicaid,10.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1506.96,69,,,percent of total billed charges,69% of total billed charges,2184,100,,,percent of total billed charges,100% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2184,100,,,percent of total billed charges,100% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2184,100,,,percent of total billed charges,100% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1350.8,61.85,,,percent of total billed charges,61.85% of total billed charges,66.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,86.31,130,,,Fee Schedule,130% of WA Medicaid ,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,823.37,37.7,,,percent of total billed charges,37.70% of total billed charges,823.37,37.7,,,percent of total billed charges,37.70% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,74037.6,33.9,,,percent of total billed charges,33.9% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1703.52,78,,,percent of total billed charges,78% of total billed charges,2184,100,,,percent of total billed charges,100% of total billed charges,1803.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1803.98,82.6,,,percent of total billed charges,82.6% of total billed charges,66.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.51,74037.6,
EGD,96043235,CDM,960,RC,43235,HCPCS,Outpatient,,,700,455.00,,616,88,,,percent of total billed charges,88% of total Billed charges,10.39,100,,,Fee Schedule,100% of Medicare rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,700,100,,,percent of total billed charges,100% of total billed charges,71.08,103,,,Fee Schedule,103% of WA Medicaid,10.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,483,69,,,percent of total billed charges,69% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,700,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,700,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.95,61.85,,,percent of total billed charges,61.85% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.71,130,,,Fee Schedule,130% of WA Medicaid ,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.9,37.7,,,percent of total billed charges,37.70% of total billed charges,263.9,37.7,,,percent of total billed charges,37.70% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,23730,33.9,,,percent of total billed charges,33.9% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,546,78,,,percent of total billed charges,78% of total billed charges,700,100,,,percent of total billed charges,100% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,578.2,82.6,,,percent of total billed charges,82.6% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.39,23730,
EGD W/ BIOPSY,97543239,CDM,975,RC,43239,HCPCS,Outpatient,,,1125,731.25,,990,88,,,percent of total billed charges,88% of total Billed charges,11.89,100,,,Fee Schedule,100% of Medicare rate,77.96,100,,,Fee Schedule,100% of WA Medicaid,1125,100,,,percent of total billed charges,100% of total billed charges,80.3,103,,,Fee Schedule,103% of WA Medicaid,11.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,776.25,69,,,percent of total billed charges,69% of total billed charges,1125,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1125,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1125,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,695.81,61.85,,,percent of total billed charges,61.85% of total billed charges,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.35,130,,,Fee Schedule,130% of WA Medicaid ,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.13,37.7,,,percent of total billed charges,37.70% of total billed charges,424.13,37.7,,,percent of total billed charges,37.70% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,38137.5,33.9,,,percent of total billed charges,33.9% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,877.5,78,,,percent of total billed charges,78% of total billed charges,1125,100,,,percent of total billed charges,100% of total billed charges,929.25,82.6,,,percent of total billed charges,82.6% of total billed charges,929.25,82.6,,,percent of total billed charges,82.6% of total billed charges,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.89,38137.5,
UPPER GE W/ PLACE OF GAST TUBE,96043246,CDM,960,RC,43246,HCPCS,Outpatient,,,473,307.45,,416.24,88,,,percent of total billed charges,88% of total Billed charges,20.17,100,,,Fee Schedule,100% of Medicare rate,111.71,100,,,Fee Schedule,100% of WA Medicaid,473,100,,,percent of total billed charges,100% of total billed charges,115.06,103,,,Fee Schedule,103% of WA Medicaid,20.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,111.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,326.37,69,,,percent of total billed charges,69% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,473,100,,,percent of total billed charges,100% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,473,100,,,percent of total billed charges,100% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.55,61.85,,,percent of total billed charges,61.85% of total billed charges,111.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.22,130,,,Fee Schedule,130% of WA Medicaid ,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,16034.7,33.9,,,percent of total billed charges,33.9% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.94,78,,,percent of total billed charges,78% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,111.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.17,16034.7,
EGD W/ BALLOON DILATION,96043249,CDM,960,RC,43249,HCPCS,Outpatient,,,2281,1482.65,,2007.28,88,,,percent of total billed charges,88% of total Billed charges,13.37,100,,,Fee Schedule,100% of Medicare rate,86.16,100,,,Fee Schedule,100% of WA Medicaid,2281,100,,,percent of total billed charges,100% of total billed charges,88.74,103,,,Fee Schedule,103% of WA Medicaid,13.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,86.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1573.89,69,,,percent of total billed charges,69% of total billed charges,2281,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2281,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2281,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1410.8,61.85,,,percent of total billed charges,61.85% of total billed charges,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,112.01,130,,,Fee Schedule,130% of WA Medicaid ,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.94,37.7,,,percent of total billed charges,37.70% of total billed charges,859.94,37.7,,,percent of total billed charges,37.70% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,77325.9,33.9,,,percent of total billed charges,33.9% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1779.18,78,,,percent of total billed charges,78% of total billed charges,2281,100,,,percent of total billed charges,100% of total billed charges,1884.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1884.11,82.6,,,percent of total billed charges,82.6% of total billed charges,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.37,77325.9,
UPPER GE W/REM TUM/POLY BY SNA,96043251,CDM,960,RC,43251,HCPCS,Outpatient,,,1085,705.25,,954.8,88,,,percent of total billed charges,88% of total Billed charges,16.69,100,,,Fee Schedule,100% of Medicare rate,109.66,100,,,Fee Schedule,100% of WA Medicaid,1085,100,,,percent of total billed charges,100% of total billed charges,112.95,103,,,Fee Schedule,103% of WA Medicaid,16.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,109.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,748.65,69,,,percent of total billed charges,69% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085,100,,,percent of total billed charges,100% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085,100,,,percent of total billed charges,100% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.07,61.85,,,percent of total billed charges,61.85% of total billed charges,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,142.56,130,,,Fee Schedule,130% of WA Medicaid ,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,36781.5,33.9,,,percent of total billed charges,33.9% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.3,78,,,percent of total billed charges,78% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.69,36781.5,
"43252 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSO Profee",97543252,CDM,975,RC,43252,HCPCS,Outpatient,,,511,332.15,,449.68,88,,,percent of total billed charges,88% of total Billed charges,14.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,511,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,14.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,352.59,69,,,percent of total billed charges,69% of total billed charges,511,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,511,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,511,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.05,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.65,37.7,,,percent of total billed charges,37.70% of total billed charges,192.65,37.7,,,percent of total billed charges,37.70% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,17322.9,33.9,,,percent of total billed charges,33.9% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.58,78,,,percent of total billed charges,78% of total billed charges,511,100,,,percent of total billed charges,100% of total billed charges,422.09,82.6,,,percent of total billed charges,82.6% of total billed charges,422.09,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",14.32,17322.9,
EGD W/LESION ABLATION,96043270,CDM,960,RC,43270,HCPCS,Outpatient,,,1368,889.20,,1203.84,88,,,percent of total billed charges,88% of total Billed charges,18.82,100,,,Fee Schedule,100% of Medicare rate,125.51,100,,,Fee Schedule,100% of WA Medicaid,1368,100,,,percent of total billed charges,100% of total billed charges,129.28,103,,,Fee Schedule,103% of WA Medicaid,18.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,125.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,943.92,69,,,percent of total billed charges,69% of total billed charges,1368,100,,,percent of total billed charges,100% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368,100,,,percent of total billed charges,100% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368,100,,,percent of total billed charges,100% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.11,61.85,,,percent of total billed charges,61.85% of total billed charges,125.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,163.16,130,,,Fee Schedule,130% of WA Medicaid ,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.74,37.7,,,percent of total billed charges,37.70% of total billed charges,515.74,37.7,,,percent of total billed charges,37.70% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,46375.2,33.9,,,percent of total billed charges,33.9% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067.04,78,,,percent of total billed charges,78% of total billed charges,1368,100,,,percent of total billed charges,100% of total billed charges,1129.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1129.97,82.6,,,percent of total billed charges,82.6% of total billed charges,125.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.82,46375.2,
43275 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP);,97543275,CDM,975,RC,43275,HCPCS,Outpatient,,,1123,729.95,,988.24,88,,,percent of total billed charges,88% of total Billed charges,32.1,100,,,Fee Schedule,100% of Medicare rate,209.81,100,,,Fee Schedule,100% of WA Medicaid,1123,100,,,percent of total billed charges,100% of total billed charges,216.1,103,,,Fee Schedule,103% of WA Medicaid,32.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,209.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,774.87,69,,,percent of total billed charges,69% of total billed charges,1123,100,,,percent of total billed charges,100% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1123,100,,,percent of total billed charges,100% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1123,100,,,percent of total billed charges,100% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,694.58,61.85,,,percent of total billed charges,61.85% of total billed charges,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,272.75,130,,,Fee Schedule,130% of WA Medicaid ,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.37,37.7,,,percent of total billed charges,37.70% of total billed charges,423.37,37.7,,,percent of total billed charges,37.70% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,38069.7,33.9,,,percent of total billed charges,33.9% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,875.94,78,,,percent of total billed charges,78% of total billed charges,1123,100,,,percent of total billed charges,100% of total billed charges,927.6,82.6,,,percent of total billed charges,82.6% of total billed charges,927.6,82.6,,,percent of total billed charges,82.6% of total billed charges,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.1,38069.7,
"LAPAROSCOPY,FUNDOPLASTY",96043280,CDM,960,RC,43280,HCPCS,Outpatient,,,2259,1468.35,,1987.92,88,,,percent of total billed charges,88% of total Billed charges,149.9,100,,,Fee Schedule,100% of Medicare rate,602.95,100,,,Fee Schedule,100% of WA Medicaid,2259,100,,,percent of total billed charges,100% of total billed charges,621.04,103,,,Fee Schedule,103% of WA Medicaid,149.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,262.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,602.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1558.71,69,,,percent of total billed charges,69% of total billed charges,2259,100,,,percent of total billed charges,100% of total billed charges,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2259,100,,,percent of total billed charges,100% of total billed charges,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2259,100,,,percent of total billed charges,100% of total billed charges,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1397.19,61.85,,,percent of total billed charges,61.85% of total billed charges,602.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,783.84,130,,,Fee Schedule,130% of WA Medicaid ,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.64,37.7,,,percent of total billed charges,37.70% of total billed charges,851.64,37.7,,,percent of total billed charges,37.70% of total billed charges,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,76580.1,33.9,,,percent of total billed charges,33.9% of total billed charges,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1762.02,78,,,percent of total billed charges,78% of total billed charges,2259,100,,,percent of total billed charges,100% of total billed charges,1865.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1865.93,82.6,,,percent of total billed charges,82.6% of total billed charges,602.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,149.9,76580.1,
REPAIR PARAESOPHAGEAL HERNIA,96043281,CDM,960,RC,43281,HCPCS,Outpatient,,,2820,1833.00,,2481.6,88,,,percent of total billed charges,88% of total Billed charges,219.54,100,,,Fee Schedule,100% of Medicare rate,854.73,100,,,Fee Schedule,100% of WA Medicaid,2820,100,,,percent of total billed charges,100% of total billed charges,880.37,103,,,Fee Schedule,103% of WA Medicaid,219.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,384.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,854.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1945.8,69,,,percent of total billed charges,69% of total billed charges,2820,100,,,percent of total billed charges,100% of total billed charges,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2820,100,,,percent of total billed charges,100% of total billed charges,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2820,100,,,percent of total billed charges,100% of total billed charges,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1744.17,61.85,,,percent of total billed charges,61.85% of total billed charges,854.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,854.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,871.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1111.15,130,,,Fee Schedule,130% of WA Medicaid ,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.14,37.7,,,percent of total billed charges,37.70% of total billed charges,1063.14,37.7,,,percent of total billed charges,37.70% of total billed charges,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,95598,33.9,,,percent of total billed charges,33.9% of total billed charges,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2199.6,78,,,percent of total billed charges,78% of total billed charges,2820,100,,,percent of total billed charges,100% of total billed charges,2329.32,82.6,,,percent of total billed charges,82.6% of total billed charges,2329.32,82.6,,,percent of total billed charges,82.6% of total billed charges,854.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,219.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,854.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,219.54,95598,
"43282 LAPAROSCOPY, SURGICAL, REPAIR OF PARAESOPHAG Profee",97543282,CDM,975,RC,43282,HCPCS,Outpatient,,,4544,2953.60,,3998.72,88,,,percent of total billed charges,88% of total Billed charges,248.57,100,,,Fee Schedule,100% of Medicare rate,962.15,100,,,Fee Schedule,100% of WA Medicaid,4544,100,,,percent of total billed charges,100% of total billed charges,991.01,103,,,Fee Schedule,103% of WA Medicaid,248.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,435,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,962.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3135.36,69,,,percent of total billed charges,69% of total billed charges,4544,100,,,percent of total billed charges,100% of total billed charges,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,4544,100,,,percent of total billed charges,100% of total billed charges,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,4544,100,,,percent of total billed charges,100% of total billed charges,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2810.46,61.85,,,percent of total billed charges,61.85% of total billed charges,962.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,962.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,981.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1250.8,130,,,Fee Schedule,130% of WA Medicaid ,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1713.09,37.7,,,percent of total billed charges,37.70% of total billed charges,1713.09,37.7,,,percent of total billed charges,37.70% of total billed charges,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,154041.6,33.9,,,percent of total billed charges,33.9% of total billed charges,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3544.32,78,,,percent of total billed charges,78% of total billed charges,4544,100,,,percent of total billed charges,100% of total billed charges,3753.34,82.6,,,percent of total billed charges,82.6% of total billed charges,3753.34,82.6,,,percent of total billed charges,82.6% of total billed charges,962.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,962.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,248.57,154041.6,
"REPAIR, PARAESOPHAGEAL HIATAL HERNIA (INCLUD",43335,CDM,975,RC,43335,HCPCS,Outpatient,,,4380,2847.00,,3854.4,88,,,percent of total billed charges,88% of total Billed charges,192.82,100,,,Fee Schedule,100% of Medicare rate,731.45,100,,,Fee Schedule,100% of WA Medicaid,4380,100,,,percent of total billed charges,100% of total billed charges,753.39,103,,,Fee Schedule,103% of WA Medicaid,192.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,337.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,731.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3022.2,69,,,percent of total billed charges,69% of total billed charges,4380,100,,,percent of total billed charges,100% of total billed charges,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4380,100,,,percent of total billed charges,100% of total billed charges,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4380,100,,,percent of total billed charges,100% of total billed charges,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2709.03,61.85,,,percent of total billed charges,61.85% of total billed charges,731.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,950.89,130,,,Fee Schedule,130% of WA Medicaid ,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1651.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1651.26,37.7,,,percent of total billed charges,37.70% of total billed charges,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,148482,33.9,,,percent of total billed charges,33.9% of total billed charges,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,3416.4,78,,,percent of total billed charges,78% of total billed charges,4380,100,,,percent of total billed charges,100% of total billed charges,3617.88,82.6,,,percent of total billed charges,82.6% of total billed charges,3617.88,82.6,,,percent of total billed charges,82.6% of total billed charges,731.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,192.82,148482,
"43450 DILATION OF ESOPHAGUS, BY UNGUIDED SOUND OR BOUGIE, SI",97543450,CDM,975,RC,43450,HCPCS,Outpatient,,,237,154.05,,208.56,88,,,percent of total billed charges,88% of total Billed charges,6.53,100,,,Fee Schedule,100% of Medicare rate,45.13,100,,,Fee Schedule,100% of WA Medicaid,237,100,,,percent of total billed charges,100% of total billed charges,46.48,103,,,Fee Schedule,103% of WA Medicaid,6.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,45.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,163.53,69,,,percent of total billed charges,69% of total billed charges,237,100,,,percent of total billed charges,100% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,237,100,,,percent of total billed charges,100% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,237,100,,,percent of total billed charges,100% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.58,61.85,,,percent of total billed charges,61.85% of total billed charges,45.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.67,130,,,Fee Schedule,130% of WA Medicaid ,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.35,37.7,,,percent of total billed charges,37.70% of total billed charges,89.35,37.7,,,percent of total billed charges,37.70% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,8034.3,33.9,,,percent of total billed charges,33.9% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.86,78,,,percent of total billed charges,78% of total billed charges,237,100,,,percent of total billed charges,100% of total billed charges,195.76,82.6,,,percent of total billed charges,82.6% of total billed charges,195.76,82.6,,,percent of total billed charges,82.6% of total billed charges,45.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.53,8034.3,
GASTOMY W/EXPL FOREIGN BOD REM,96043500,CDM,960,RC,43500,HCPCS,Outpatient,,,1728,1123.20,,1520.64,88,,,percent of total billed charges,88% of total Billed charges,106.16,100,,,Fee Schedule,100% of Medicare rate,443.12,100,,,Fee Schedule,100% of WA Medicaid,1728,100,,,percent of total billed charges,100% of total billed charges,456.41,103,,,Fee Schedule,103% of WA Medicaid,106.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,185.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,443.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1192.32,69,,,percent of total billed charges,69% of total billed charges,1728,100,,,percent of total billed charges,100% of total billed charges,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1728,100,,,percent of total billed charges,100% of total billed charges,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1728,100,,,percent of total billed charges,100% of total billed charges,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1068.77,61.85,,,percent of total billed charges,61.85% of total billed charges,443.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,576.06,130,,,Fee Schedule,130% of WA Medicaid ,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,651.46,37.7,,,percent of total billed charges,37.70% of total billed charges,651.46,37.7,,,percent of total billed charges,37.70% of total billed charges,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,58579.2,33.9,,,percent of total billed charges,33.9% of total billed charges,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1347.84,78,,,percent of total billed charges,78% of total billed charges,1728,100,,,percent of total billed charges,100% of total billed charges,1427.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1427.33,82.6,,,percent of total billed charges,82.6% of total billed charges,443.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.16,58579.2,
GASTROSTOMY W/SUT REP BL ULCER,96043501,CDM,960,RC,43501,HCPCS,Outpatient,,,2534,1647.10,,2229.92,88,,,percent of total billed charges,88% of total Billed charges,187.38,100,,,Fee Schedule,100% of Medicare rate,757.38,100,,,Fee Schedule,100% of WA Medicaid,2534,100,,,percent of total billed charges,100% of total billed charges,780.1,103,,,Fee Schedule,103% of WA Medicaid,187.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,327.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,757.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1748.46,69,,,percent of total billed charges,69% of total billed charges,2534,100,,,percent of total billed charges,100% of total billed charges,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2534,100,,,percent of total billed charges,100% of total billed charges,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2534,100,,,percent of total billed charges,100% of total billed charges,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1567.28,61.85,,,percent of total billed charges,61.85% of total billed charges,757.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,757.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,772.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,984.59,130,,,Fee Schedule,130% of WA Medicaid ,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,955.32,37.7,,,percent of total billed charges,37.70% of total billed charges,955.32,37.7,,,percent of total billed charges,37.70% of total billed charges,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,85902.6,33.9,,,percent of total billed charges,33.9% of total billed charges,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1976.52,78,,,percent of total billed charges,78% of total billed charges,2534,100,,,percent of total billed charges,100% of total billed charges,2093.08,82.6,,,percent of total billed charges,82.6% of total billed charges,2093.08,82.6,,,percent of total billed charges,82.6% of total billed charges,757.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,757.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.38,85902.6,
GASTRECTOMY;PART W/GASTRODUODE,96043631,CDM,960,RC,43631,HCPCS,Outpatient,,,3025,1966.25,,2662,88,,,percent of total billed charges,88% of total Billed charges,200.59,100,,,Fee Schedule,100% of Medicare rate,811.09,100,,,Fee Schedule,100% of WA Medicaid,3025,100,,,percent of total billed charges,100% of total billed charges,835.42,103,,,Fee Schedule,103% of WA Medicaid,200.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,351.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,811.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2087.25,69,,,percent of total billed charges,69% of total billed charges,3025,100,,,percent of total billed charges,100% of total billed charges,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3025,100,,,percent of total billed charges,100% of total billed charges,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3025,100,,,percent of total billed charges,100% of total billed charges,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1870.96,61.85,,,percent of total billed charges,61.85% of total billed charges,811.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,827.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1054.42,130,,,Fee Schedule,130% of WA Medicaid ,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1140.43,37.7,,,percent of total billed charges,37.70% of total billed charges,1140.43,37.7,,,percent of total billed charges,37.70% of total billed charges,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,102547.5,33.9,,,percent of total billed charges,33.9% of total billed charges,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2359.5,78,,,percent of total billed charges,78% of total billed charges,3025,100,,,percent of total billed charges,100% of total billed charges,2498.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2498.65,82.6,,,percent of total billed charges,82.6% of total billed charges,811.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,200.59,102547.5,
VAGOTOMY INCLUDING PYLOROPLAST,96043640,CDM,960,RC,43640,HCPCS,Outpatient,,,2466,1602.90,,2170.08,88,,,percent of total billed charges,88% of total Billed charges,166.07,100,,,Fee Schedule,100% of Medicare rate,668.79,100,,,Fee Schedule,100% of WA Medicaid,2466,100,,,percent of total billed charges,100% of total billed charges,688.85,103,,,Fee Schedule,103% of WA Medicaid,166.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,290.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,668.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1701.54,69,,,percent of total billed charges,69% of total billed charges,2466,100,,,percent of total billed charges,100% of total billed charges,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2466,100,,,percent of total billed charges,100% of total billed charges,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2466,100,,,percent of total billed charges,100% of total billed charges,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1525.22,61.85,,,percent of total billed charges,61.85% of total billed charges,668.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,869.43,130,,,Fee Schedule,130% of WA Medicaid ,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,929.68,37.7,,,percent of total billed charges,37.70% of total billed charges,929.68,37.7,,,percent of total billed charges,37.70% of total billed charges,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,83597.4,33.9,,,percent of total billed charges,33.9% of total billed charges,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1923.48,78,,,percent of total billed charges,78% of total billed charges,2466,100,,,percent of total billed charges,100% of total billed charges,2036.92,82.6,,,percent of total billed charges,82.6% of total billed charges,2036.92,82.6,,,percent of total billed charges,82.6% of total billed charges,668.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,166.07,83597.4,
LAPAROSCOPIC GASTROSTOMY,96043653,CDM,960,RC,43653,HCPCS,Outpatient,,,1200,780.00,,1056,88,,,percent of total billed charges,88% of total Billed charges,72.88,100,,,Fee Schedule,100% of Medicare rate,329.55,100,,,Fee Schedule,100% of WA Medicaid,1200,100,,,percent of total billed charges,100% of total billed charges,339.44,103,,,Fee Schedule,103% of WA Medicaid,72.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,127.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,329.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,828,69,,,percent of total billed charges,69% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,742.2,61.85,,,percent of total billed charges,61.85% of total billed charges,329.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,428.42,130,,,Fee Schedule,130% of WA Medicaid ,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,40680,33.9,,,percent of total billed charges,33.9% of total billed charges,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,936,78,,,percent of total billed charges,78% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,329.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.88,40680,
GASTROJEJUNOSTOMY W/VAGOTOMY,96043825,CDM,960,RC,43825,HCPCS,Outpatient,,,2460,1599.00,,2164.8,88,,,percent of total billed charges,88% of total Billed charges,184.37,100,,,Fee Schedule,100% of Medicare rate,734.81,100,,,Fee Schedule,100% of WA Medicaid,2460,100,,,percent of total billed charges,100% of total billed charges,756.85,103,,,Fee Schedule,103% of WA Medicaid,184.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,322.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,734.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1697.4,69,,,percent of total billed charges,69% of total billed charges,2460,100,,,percent of total billed charges,100% of total billed charges,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2460,100,,,percent of total billed charges,100% of total billed charges,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2460,100,,,percent of total billed charges,100% of total billed charges,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1521.51,61.85,,,percent of total billed charges,61.85% of total billed charges,734.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,749.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,955.25,130,,,Fee Schedule,130% of WA Medicaid ,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,927.42,37.7,,,percent of total billed charges,37.70% of total billed charges,927.42,37.7,,,percent of total billed charges,37.70% of total billed charges,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,83394,33.9,,,percent of total billed charges,33.9% of total billed charges,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1918.8,78,,,percent of total billed charges,78% of total billed charges,2460,100,,,percent of total billed charges,100% of total billed charges,2031.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2031.96,82.6,,,percent of total billed charges,82.6% of total billed charges,734.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,184.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,184.37,83394,
"GASTROSTOMY, OPEN",96043830,CDM,960,RC,43830,HCPCS,Outpatient,,,1464,951.60,,1288.32,88,,,percent of total billed charges,88% of total Billed charges,90.27,100,,,Fee Schedule,100% of Medicare rate,398.36,100,,,Fee Schedule,100% of WA Medicaid,1464,100,,,percent of total billed charges,100% of total billed charges,410.31,103,,,Fee Schedule,103% of WA Medicaid,90.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,398.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1010.16,69,,,percent of total billed charges,69% of total billed charges,1464,100,,,percent of total billed charges,100% of total billed charges,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1464,100,,,percent of total billed charges,100% of total billed charges,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1464,100,,,percent of total billed charges,100% of total billed charges,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,905.48,61.85,,,percent of total billed charges,61.85% of total billed charges,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,517.87,130,,,Fee Schedule,130% of WA Medicaid ,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.93,37.7,,,percent of total billed charges,37.70% of total billed charges,551.93,37.7,,,percent of total billed charges,37.70% of total billed charges,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,49629.6,33.9,,,percent of total billed charges,33.9% of total billed charges,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1141.92,78,,,percent of total billed charges,78% of total billed charges,1464,100,,,percent of total billed charges,100% of total billed charges,1209.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1209.26,82.6,,,percent of total billed charges,82.6% of total billed charges,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.27,49629.6,
GASTRORRHAPHY SUTURE PERF DUOD,96043840,CDM,960,RC,43840,HCPCS,Outpatient,,,2517,1636.05,,2214.96,88,,,percent of total billed charges,88% of total Billed charges,187.34,100,,,Fee Schedule,100% of Medicare rate,761.67,100,,,Fee Schedule,100% of WA Medicaid,2517,100,,,percent of total billed charges,100% of total billed charges,784.52,103,,,Fee Schedule,103% of WA Medicaid,187.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,327.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,761.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1736.73,69,,,percent of total billed charges,69% of total billed charges,2517,100,,,percent of total billed charges,100% of total billed charges,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2517,100,,,percent of total billed charges,100% of total billed charges,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2517,100,,,percent of total billed charges,100% of total billed charges,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1556.76,61.85,,,percent of total billed charges,61.85% of total billed charges,761.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,761.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,776.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,990.17,130,,,Fee Schedule,130% of WA Medicaid ,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,948.91,37.7,,,percent of total billed charges,37.70% of total billed charges,948.91,37.7,,,percent of total billed charges,37.70% of total billed charges,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,85326.3,33.9,,,percent of total billed charges,33.9% of total billed charges,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1963.26,78,,,percent of total billed charges,78% of total billed charges,2517,100,,,percent of total billed charges,100% of total billed charges,2079.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2079.04,82.6,,,percent of total billed charges,82.6% of total billed charges,761.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,761.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.34,85326.3,
CLOSURE GASTROSTOMY;SURGICAL,96043870,CDM,960,RC,43870,HCPCS,Outpatient,,,1489,967.85,,1310.32,88,,,percent of total billed charges,88% of total Billed charges,91.95,100,,,Fee Schedule,100% of Medicare rate,400.23,100,,,Fee Schedule,100% of WA Medicaid,1489,100,,,percent of total billed charges,100% of total billed charges,412.24,103,,,Fee Schedule,103% of WA Medicaid,91.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,160.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,400.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1027.41,69,,,percent of total billed charges,69% of total billed charges,1489,100,,,percent of total billed charges,100% of total billed charges,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1489,100,,,percent of total billed charges,100% of total billed charges,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1489,100,,,percent of total billed charges,100% of total billed charges,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,920.95,61.85,,,percent of total billed charges,61.85% of total billed charges,400.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.3,130,,,Fee Schedule,130% of WA Medicaid ,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.35,37.7,,,percent of total billed charges,37.70% of total billed charges,561.35,37.7,,,percent of total billed charges,37.70% of total billed charges,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,50477.1,33.9,,,percent of total billed charges,33.9% of total billed charges,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1161.42,78,,,percent of total billed charges,78% of total billed charges,1489,100,,,percent of total billed charges,100% of total billed charges,1229.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1229.91,82.6,,,percent of total billed charges,82.6% of total billed charges,400.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.95,50477.1,
ENTEROLYSIS,96044005,CDM,960,RC,44005,HCPCS,Outpatient,,,2284,1484.60,,2009.92,88,,,percent of total billed charges,88% of total Billed charges,148.5,100,,,Fee Schedule,100% of Medicare rate,610.79,100,,,Fee Schedule,100% of WA Medicaid,2284,100,,,percent of total billed charges,100% of total billed charges,629.11,103,,,Fee Schedule,103% of WA Medicaid,148.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,259.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,610.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1575.96,69,,,percent of total billed charges,69% of total billed charges,2284,100,,,percent of total billed charges,100% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2284,100,,,percent of total billed charges,100% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2284,100,,,percent of total billed charges,100% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1412.65,61.85,,,percent of total billed charges,61.85% of total billed charges,610.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,623.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,794.03,130,,,Fee Schedule,130% of WA Medicaid ,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.07,37.7,,,percent of total billed charges,37.70% of total billed charges,861.07,37.7,,,percent of total billed charges,37.70% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,77427.6,33.9,,,percent of total billed charges,33.9% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1781.52,78,,,percent of total billed charges,78% of total billed charges,2284,100,,,percent of total billed charges,100% of total billed charges,1886.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1886.58,82.6,,,percent of total billed charges,82.6% of total billed charges,610.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,148.5,77427.6,
ENTEROLYSIS FOR DECOMPRESSION,96044021,CDM,960,RC,44021,HCPCS,Outpatient,,,2051,1333.15,,1804.88,88,,,percent of total billed charges,88% of total Billed charges,131.48,100,,,Fee Schedule,100% of Medicare rate,544.02,100,,,Fee Schedule,100% of WA Medicaid,2051,100,,,percent of total billed charges,100% of total billed charges,560.34,103,,,Fee Schedule,103% of WA Medicaid,131.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,230.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,544.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1415.19,69,,,percent of total billed charges,69% of total billed charges,2051,100,,,percent of total billed charges,100% of total billed charges,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2051,100,,,percent of total billed charges,100% of total billed charges,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2051,100,,,percent of total billed charges,100% of total billed charges,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1268.54,61.85,,,percent of total billed charges,61.85% of total billed charges,544.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,707.23,130,,,Fee Schedule,130% of WA Medicaid ,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,773.23,37.7,,,percent of total billed charges,37.70% of total billed charges,773.23,37.7,,,percent of total billed charges,37.70% of total billed charges,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,69528.9,33.9,,,percent of total billed charges,33.9% of total billed charges,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1599.78,78,,,percent of total billed charges,78% of total billed charges,2051,100,,,percent of total billed charges,100% of total billed charges,1694.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1694.13,82.6,,,percent of total billed charges,82.6% of total billed charges,544.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,131.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.48,69528.9,
COLOTOMY FOR EXPL FOREIGN BODY,96044025,CDM,960,RC,44025,HCPCS,Outpatient,,,2070,1345.50,,1821.6,88,,,percent of total billed charges,88% of total Billed charges,131.03,100,,,Fee Schedule,100% of Medicare rate,550.36,100,,,Fee Schedule,100% of WA Medicaid,2070,100,,,percent of total billed charges,100% of total billed charges,566.87,103,,,Fee Schedule,103% of WA Medicaid,131.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,229.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,550.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1428.3,69,,,percent of total billed charges,69% of total billed charges,2070,100,,,percent of total billed charges,100% of total billed charges,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2070,100,,,percent of total billed charges,100% of total billed charges,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2070,100,,,percent of total billed charges,100% of total billed charges,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1280.3,61.85,,,percent of total billed charges,61.85% of total billed charges,550.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,715.47,130,,,Fee Schedule,130% of WA Medicaid ,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.39,37.7,,,percent of total billed charges,37.70% of total billed charges,780.39,37.7,,,percent of total billed charges,37.70% of total billed charges,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,70173,33.9,,,percent of total billed charges,33.9% of total billed charges,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1614.6,78,,,percent of total billed charges,78% of total billed charges,2070,100,,,percent of total billed charges,100% of total billed charges,1709.82,82.6,,,percent of total billed charges,82.6% of total billed charges,1709.82,82.6,,,percent of total billed charges,82.6% of total billed charges,550.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.03,70173,
REDUCE BOWEL OBSTRUCTION,96044050,CDM,960,RC,44050,HCPCS,Outpatient,,,1955,1270.75,,1720.4,88,,,percent of total billed charges,88% of total Billed charges,126.87,100,,,Fee Schedule,100% of Medicare rate,525.74,100,,,Fee Schedule,100% of WA Medicaid,1955,100,,,percent of total billed charges,100% of total billed charges,541.51,103,,,Fee Schedule,103% of WA Medicaid,126.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,222.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,525.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1348.95,69,,,percent of total billed charges,69% of total billed charges,1955,100,,,percent of total billed charges,100% of total billed charges,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1955,100,,,percent of total billed charges,100% of total billed charges,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1955,100,,,percent of total billed charges,100% of total billed charges,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1209.17,61.85,,,percent of total billed charges,61.85% of total billed charges,525.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,536.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,683.46,130,,,Fee Schedule,130% of WA Medicaid ,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,737.04,37.7,,,percent of total billed charges,37.70% of total billed charges,737.04,37.7,,,percent of total billed charges,37.70% of total billed charges,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,66274.5,33.9,,,percent of total billed charges,33.9% of total billed charges,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1524.9,78,,,percent of total billed charges,78% of total billed charges,1955,100,,,percent of total billed charges,100% of total billed charges,1614.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1614.83,82.6,,,percent of total billed charges,82.6% of total billed charges,525.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.87,66274.5,
EXC LESIONS SM OR LG INTESTINE,96044110,CDM,960,RC,44110,HCPCS,Outpatient,,,1784,1159.60,,1569.92,88,,,percent of total billed charges,88% of total Billed charges,104.44,100,,,Fee Schedule,100% of Medicare rate,479.68,100,,,Fee Schedule,100% of WA Medicaid,1784,100,,,percent of total billed charges,100% of total billed charges,494.07,103,,,Fee Schedule,103% of WA Medicaid,104.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,182.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,479.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1230.96,69,,,percent of total billed charges,69% of total billed charges,1784,100,,,percent of total billed charges,100% of total billed charges,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1784,100,,,percent of total billed charges,100% of total billed charges,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1784,100,,,percent of total billed charges,100% of total billed charges,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1103.4,61.85,,,percent of total billed charges,61.85% of total billed charges,479.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,623.58,130,,,Fee Schedule,130% of WA Medicaid ,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,672.57,37.7,,,percent of total billed charges,37.70% of total billed charges,672.57,37.7,,,percent of total billed charges,37.70% of total billed charges,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,60477.6,33.9,,,percent of total billed charges,33.9% of total billed charges,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1391.52,78,,,percent of total billed charges,78% of total billed charges,1784,100,,,percent of total billed charges,100% of total billed charges,1473.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1473.58,82.6,,,percent of total billed charges,82.6% of total billed charges,479.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,104.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,104.44,60477.6,
ENTERECTOMY;SMALL INTEST SINGL,96044120,CDM,960,RC,44120,HCPCS,Outpatient,,,2555,1660.75,,2248.4,88,,,percent of total billed charges,88% of total Billed charges,167.36,100,,,Fee Schedule,100% of Medicare rate,682.78,100,,,Fee Schedule,100% of WA Medicaid,2555,100,,,percent of total billed charges,100% of total billed charges,703.26,103,,,Fee Schedule,103% of WA Medicaid,167.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,292.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,682.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1762.95,69,,,percent of total billed charges,69% of total billed charges,2555,100,,,percent of total billed charges,100% of total billed charges,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2555,100,,,percent of total billed charges,100% of total billed charges,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2555,100,,,percent of total billed charges,100% of total billed charges,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1580.27,61.85,,,percent of total billed charges,61.85% of total billed charges,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,887.61,130,,,Fee Schedule,130% of WA Medicaid ,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,963.24,37.7,,,percent of total billed charges,37.70% of total billed charges,963.24,37.7,,,percent of total billed charges,37.70% of total billed charges,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,86614.5,33.9,,,percent of total billed charges,33.9% of total billed charges,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1992.9,78,,,percent of total billed charges,78% of total billed charges,2555,100,,,percent of total billed charges,100% of total billed charges,2110.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2110.43,82.6,,,percent of total billed charges,82.6% of total billed charges,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,167.36,86614.5,
"44125 ENTERECTOMY, RESECTION OF SMALL INTESTINE; WITH ENTERO",97544125,CDM,975,RC,44125,HCPCS,Outpatient,,,4061,2639.65,,3573.68,88,,,percent of total billed charges,88% of total Billed charges,153.86,100,,,Fee Schedule,100% of Medicare rate,658.35,100,,,Fee Schedule,100% of WA Medicaid,4061,100,,,percent of total billed charges,100% of total billed charges,678.1,103,,,Fee Schedule,103% of WA Medicaid,153.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,269.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,658.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2802.09,69,,,percent of total billed charges,69% of total billed charges,4061,100,,,percent of total billed charges,100% of total billed charges,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,4061,100,,,percent of total billed charges,100% of total billed charges,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,4061,100,,,percent of total billed charges,100% of total billed charges,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2511.73,61.85,,,percent of total billed charges,61.85% of total billed charges,658.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,855.86,130,,,Fee Schedule,130% of WA Medicaid ,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1531,37.7,,,percent of total billed charges,37.70% of total billed charges,1531,37.7,,,percent of total billed charges,37.70% of total billed charges,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,137667.9,33.9,,,percent of total billed charges,33.9% of total billed charges,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,3167.58,78,,,percent of total billed charges,78% of total billed charges,4061,100,,,percent of total billed charges,100% of total billed charges,3354.39,82.6,,,percent of total billed charges,82.6% of total billed charges,3354.39,82.6,,,percent of total billed charges,82.6% of total billed charges,658.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,153.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,153.86,137667.9,
ENTEROENTEROSTOMY ANAST OF INT,96044130,CDM,960,RC,44130,HCPCS,Outpatient,,,2749,1786.85,,2419.12,88,,,percent of total billed charges,88% of total Billed charges,175.65,100,,,Fee Schedule,100% of Medicare rate,736.86,100,,,Fee Schedule,100% of WA Medicaid,2749,100,,,percent of total billed charges,100% of total billed charges,758.97,103,,,Fee Schedule,103% of WA Medicaid,175.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,307.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,736.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1896.81,69,,,percent of total billed charges,69% of total billed charges,2749,100,,,percent of total billed charges,100% of total billed charges,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2749,100,,,percent of total billed charges,100% of total billed charges,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2749,100,,,percent of total billed charges,100% of total billed charges,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1700.26,61.85,,,percent of total billed charges,61.85% of total billed charges,736.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,957.92,130,,,Fee Schedule,130% of WA Medicaid ,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1036.37,37.7,,,percent of total billed charges,37.70% of total billed charges,1036.37,37.7,,,percent of total billed charges,37.70% of total billed charges,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,93191.1,33.9,,,percent of total billed charges,33.9% of total billed charges,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2144.22,78,,,percent of total billed charges,78% of total billed charges,2749,100,,,percent of total billed charges,100% of total billed charges,2270.67,82.6,,,percent of total billed charges,82.6% of total billed charges,2270.67,82.6,,,percent of total billed charges,82.6% of total billed charges,736.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,175.65,93191.1,
COLECTOMY PARTIAL W/ ANASTOMOS,96044140,CDM,960,RC,44140,HCPCS,Outpatient,,,2806,1823.90,,2469.28,88,,,percent of total billed charges,88% of total Billed charges,178.48,100,,,Fee Schedule,100% of Medicare rate,751.22,100,,,Fee Schedule,100% of WA Medicaid,2806,100,,,percent of total billed charges,100% of total billed charges,773.76,103,,,Fee Schedule,103% of WA Medicaid,178.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,312.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,751.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1936.14,69,,,percent of total billed charges,69% of total billed charges,2806,100,,,percent of total billed charges,100% of total billed charges,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2806,100,,,percent of total billed charges,100% of total billed charges,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2806,100,,,percent of total billed charges,100% of total billed charges,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1735.51,61.85,,,percent of total billed charges,61.85% of total billed charges,751.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,976.59,130,,,Fee Schedule,130% of WA Medicaid ,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1057.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1057.86,37.7,,,percent of total billed charges,37.70% of total billed charges,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,95123.4,33.9,,,percent of total billed charges,33.9% of total billed charges,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2188.68,78,,,percent of total billed charges,78% of total billed charges,2806,100,,,percent of total billed charges,100% of total billed charges,2317.76,82.6,,,percent of total billed charges,82.6% of total billed charges,2317.76,82.6,,,percent of total billed charges,82.6% of total billed charges,751.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,178.48,95123.4,
COLECTOMY W/ COLOSTOMY,96044141,CDM,960,RC,44141,HCPCS,Outpatient,,,3828,2488.20,,3368.64,88,,,percent of total billed charges,88% of total Billed charges,237.49,100,,,Fee Schedule,100% of Medicare rate,1014,100,,,Fee Schedule,100% of WA Medicaid,3828,100,,,percent of total billed charges,100% of total billed charges,1044.42,103,,,Fee Schedule,103% of WA Medicaid,237.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,415.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1014,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2641.32,69,,,percent of total billed charges,69% of total billed charges,3828,100,,,percent of total billed charges,100% of total billed charges,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3828,100,,,percent of total billed charges,100% of total billed charges,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3828,100,,,percent of total billed charges,100% of total billed charges,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2367.62,61.85,,,percent of total billed charges,61.85% of total billed charges,1014,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,100,,,Fee Schedule,100% of WA Medicare OPPS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1318.2,130,,,Fee Schedule,130% of WA Medicaid ,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1443.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1443.16,37.7,,,percent of total billed charges,37.70% of total billed charges,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,129769.2,33.9,,,percent of total billed charges,33.9% of total billed charges,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2985.84,78,,,percent of total billed charges,78% of total billed charges,3828,100,,,percent of total billed charges,100% of total billed charges,3161.93,82.6,,,percent of total billed charges,82.6% of total billed charges,3161.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1014,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,237.49,129769.2,
COLECTOMY W/ END COLOSTOMY,96044143,CDM,960,RC,44143,HCPCS,Outpatient,,,3486,2265.90,,3067.68,88,,,percent of total billed charges,88% of total Billed charges,218.67,100,,,Fee Schedule,100% of Medicare rate,922.43,100,,,Fee Schedule,100% of WA Medicaid,3486,100,,,percent of total billed charges,100% of total billed charges,950.1,103,,,Fee Schedule,103% of WA Medicaid,218.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,382.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,922.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2405.34,69,,,percent of total billed charges,69% of total billed charges,3486,100,,,percent of total billed charges,100% of total billed charges,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,3486,100,,,percent of total billed charges,100% of total billed charges,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,3486,100,,,percent of total billed charges,100% of total billed charges,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2156.09,61.85,,,percent of total billed charges,61.85% of total billed charges,922.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,922.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,940.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1199.16,130,,,Fee Schedule,130% of WA Medicaid ,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1314.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1314.22,37.7,,,percent of total billed charges,37.70% of total billed charges,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,118175.4,33.9,,,percent of total billed charges,33.9% of total billed charges,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2719.08,78,,,percent of total billed charges,78% of total billed charges,3486,100,,,percent of total billed charges,100% of total billed charges,2879.44,82.6,,,percent of total billed charges,82.6% of total billed charges,2879.44,82.6,,,percent of total billed charges,82.6% of total billed charges,922.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,922.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,218.67,118175.4,
COLECTOMY W/ RESECTION,96044144,CDM,960,RC,44144,HCPCS,Outpatient,,,3708,2410.20,,3263.04,88,,,percent of total billed charges,88% of total Billed charges,232.07,100,,,Fee Schedule,100% of Medicare rate,984.53,100,,,Fee Schedule,100% of WA Medicaid,3708,100,,,percent of total billed charges,100% of total billed charges,1014.07,103,,,Fee Schedule,103% of WA Medicaid,232.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,406.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,984.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2558.52,69,,,percent of total billed charges,69% of total billed charges,3708,100,,,percent of total billed charges,100% of total billed charges,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3708,100,,,percent of total billed charges,100% of total billed charges,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3708,100,,,percent of total billed charges,100% of total billed charges,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2293.4,61.85,,,percent of total billed charges,61.85% of total billed charges,984.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,984.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1004.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1279.89,130,,,Fee Schedule,130% of WA Medicaid ,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1397.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1397.92,37.7,,,percent of total billed charges,37.70% of total billed charges,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,125701.2,33.9,,,percent of total billed charges,33.9% of total billed charges,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2892.24,78,,,percent of total billed charges,78% of total billed charges,3708,100,,,percent of total billed charges,100% of total billed charges,3062.81,82.6,,,percent of total billed charges,82.6% of total billed charges,3062.81,82.6,,,percent of total billed charges,82.6% of total billed charges,984.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,984.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,232.07,125701.2,
COLECTOMY W/ COLOPROCTOSTOMY,96044145,CDM,960,RC,44145,HCPCS,Outpatient,,,3484,2264.60,,3065.92,88,,,percent of total billed charges,88% of total Billed charges,207.72,100,,,Fee Schedule,100% of Medicare rate,921.5,100,,,Fee Schedule,100% of WA Medicaid,3484,100,,,percent of total billed charges,100% of total billed charges,949.15,103,,,Fee Schedule,103% of WA Medicaid,207.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,363.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,921.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2403.96,69,,,percent of total billed charges,69% of total billed charges,3484,100,,,percent of total billed charges,100% of total billed charges,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3484,100,,,percent of total billed charges,100% of total billed charges,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3484,100,,,percent of total billed charges,100% of total billed charges,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2154.85,61.85,,,percent of total billed charges,61.85% of total billed charges,921.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,921.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,939.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1197.95,130,,,Fee Schedule,130% of WA Medicaid ,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1313.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1313.47,37.7,,,percent of total billed charges,37.70% of total billed charges,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,118107.6,33.9,,,percent of total billed charges,33.9% of total billed charges,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2717.52,78,,,percent of total billed charges,78% of total billed charges,3484,100,,,percent of total billed charges,100% of total billed charges,2877.78,82.6,,,percent of total billed charges,82.6% of total billed charges,2877.78,82.6,,,percent of total billed charges,82.6% of total billed charges,921.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,921.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,207.72,118107.6,
"44146 COLECTOMY, PARTIAL; WITH COLOPROCTOSTOMY (LO",97544146,CDM,975,RC,44146,HCPCS,Outpatient,,,5700,3705.00,,5016,88,,,percent of total billed charges,88% of total Billed charges,263,100,,,Fee Schedule,100% of Medicare rate,1172.9,100,,,Fee Schedule,100% of WA Medicaid,5700,100,,,percent of total billed charges,100% of total billed charges,1208.09,103,,,Fee Schedule,103% of WA Medicaid,263,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,460.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1172.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3933,69,,,percent of total billed charges,69% of total billed charges,5700,100,,,percent of total billed charges,100% of total billed charges,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,5700,100,,,percent of total billed charges,100% of total billed charges,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,5700,100,,,percent of total billed charges,100% of total billed charges,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,3525.45,61.85,,,percent of total billed charges,61.85% of total billed charges,1172.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,1172.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,1196.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1524.77,130,,,Fee Schedule,130% of WA Medicaid ,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,2148.9,37.7,,,percent of total billed charges,37.70% of total billed charges,2148.9,37.7,,,percent of total billed charges,37.70% of total billed charges,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,193230,33.9,,,percent of total billed charges,33.9% of total billed charges,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,4446,78,,,percent of total billed charges,78% of total billed charges,5700,100,,,percent of total billed charges,100% of total billed charges,4708.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4708.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1172.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,263,100,,,Fee Schedule,100% of Medicare RBRVS rate,1172.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,263,193230,
"COLECTOMY,PARTIAL W/ ILEOCOLOS",96044160,CDM,960,RC,44160,HCPCS,Outpatient,,,2602,1691.30,,2289.76,88,,,percent of total billed charges,88% of total Billed charges,162.56,100,,,Fee Schedule,100% of Medicare rate,695.46,100,,,Fee Schedule,100% of WA Medicaid,2602,100,,,percent of total billed charges,100% of total billed charges,716.32,103,,,Fee Schedule,103% of WA Medicaid,162.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,284.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,695.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1795.38,69,,,percent of total billed charges,69% of total billed charges,2602,100,,,percent of total billed charges,100% of total billed charges,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2602,100,,,percent of total billed charges,100% of total billed charges,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2602,100,,,percent of total billed charges,100% of total billed charges,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1609.34,61.85,,,percent of total billed charges,61.85% of total billed charges,695.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,695.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,904.1,130,,,Fee Schedule,130% of WA Medicaid ,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,980.95,37.7,,,percent of total billed charges,37.70% of total billed charges,980.95,37.7,,,percent of total billed charges,37.70% of total billed charges,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,88207.8,33.9,,,percent of total billed charges,33.9% of total billed charges,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2029.56,78,,,percent of total billed charges,78% of total billed charges,2602,100,,,percent of total billed charges,100% of total billed charges,2149.25,82.6,,,percent of total billed charges,82.6% of total billed charges,2149.25,82.6,,,percent of total billed charges,82.6% of total billed charges,695.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,695.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,162.56,88207.8,
"44188 LAPAROSCOPY, SURGICAL, COLOSTOMY OR SKIN LEVEL CECOSTO",97544188,CDM,975,RC,44188,HCPCS,Outpatient,,,3363,2185.95,,2959.44,88,,,percent of total billed charges,88% of total Billed charges,144.73,100,,,Fee Schedule,100% of Medicare rate,682.96,100,,,Fee Schedule,100% of WA Medicaid,3363,100,,,percent of total billed charges,100% of total billed charges,703.45,103,,,Fee Schedule,103% of WA Medicaid,144.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,253.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,682.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2320.47,69,,,percent of total billed charges,69% of total billed charges,3363,100,,,percent of total billed charges,100% of total billed charges,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3363,100,,,percent of total billed charges,100% of total billed charges,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3363,100,,,percent of total billed charges,100% of total billed charges,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2080.02,61.85,,,percent of total billed charges,61.85% of total billed charges,682.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,887.85,130,,,Fee Schedule,130% of WA Medicaid ,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1267.85,37.7,,,percent of total billed charges,37.70% of total billed charges,1267.85,37.7,,,percent of total billed charges,37.70% of total billed charges,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,114005.7,33.9,,,percent of total billed charges,33.9% of total billed charges,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2623.14,78,,,percent of total billed charges,78% of total billed charges,3363,100,,,percent of total billed charges,100% of total billed charges,2777.84,82.6,,,percent of total billed charges,82.6% of total billed charges,2777.84,82.6,,,percent of total billed charges,82.6% of total billed charges,682.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,144.73,114005.7,
LAPAROSCOPY SURG ENTEROLYSIS,96044180,CDM,960,RC,44180,HCPCS,Outpatient,,,1558,1012.70,,1371.04,88,,,percent of total billed charges,88% of total Billed charges,124.3,100,,,Fee Schedule,100% of Medicare rate,516.42,100,,,Fee Schedule,100% of WA Medicaid,1558,100,,,percent of total billed charges,100% of total billed charges,531.91,103,,,Fee Schedule,103% of WA Medicaid,124.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,217.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,516.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1075.02,69,,,percent of total billed charges,69% of total billed charges,1558,100,,,percent of total billed charges,100% of total billed charges,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1558,100,,,percent of total billed charges,100% of total billed charges,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1558,100,,,percent of total billed charges,100% of total billed charges,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,963.62,61.85,,,percent of total billed charges,61.85% of total billed charges,516.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,526.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,671.35,130,,,Fee Schedule,130% of WA Medicaid ,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,587.37,37.7,,,percent of total billed charges,37.70% of total billed charges,587.37,37.7,,,percent of total billed charges,37.70% of total billed charges,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,52816.2,33.9,,,percent of total billed charges,33.9% of total billed charges,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1215.24,78,,,percent of total billed charges,78% of total billed charges,1558,100,,,percent of total billed charges,100% of total billed charges,1286.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1286.91,82.6,,,percent of total billed charges,82.6% of total billed charges,516.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.3,52816.2,
LAPAROSCOPIC RESECT SM INTEST,96044202,CDM,960,RC,44202,HCPCS,Outpatient,,,2356,1531.40,,2073.28,88,,,percent of total billed charges,88% of total Billed charges,184.71,100,,,Fee Schedule,100% of Medicare rate,775.65,100,,,Fee Schedule,100% of WA Medicaid,2356,100,,,percent of total billed charges,100% of total billed charges,798.92,103,,,Fee Schedule,103% of WA Medicaid,184.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,323.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,775.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1625.64,69,,,percent of total billed charges,69% of total billed charges,2356,100,,,percent of total billed charges,100% of total billed charges,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2356,100,,,percent of total billed charges,100% of total billed charges,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2356,100,,,percent of total billed charges,100% of total billed charges,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.19,61.85,,,percent of total billed charges,61.85% of total billed charges,775.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,775.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,791.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1008.35,130,,,Fee Schedule,130% of WA Medicaid ,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,888.21,37.7,,,percent of total billed charges,37.70% of total billed charges,888.21,37.7,,,percent of total billed charges,37.70% of total billed charges,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,79868.4,33.9,,,percent of total billed charges,33.9% of total billed charges,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1837.68,78,,,percent of total billed charges,78% of total billed charges,2356,100,,,percent of total billed charges,100% of total billed charges,1946.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1946.06,82.6,,,percent of total billed charges,82.6% of total billed charges,775.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,775.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,184.71,79868.4,
LAP COLECTOMY PARTIAL W/ANASTO,96044204,CDM,960,RC,44204,HCPCS,Outpatient,,,3303,2146.95,,2906.64,88,,,percent of total billed charges,88% of total Billed charges,193.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3303,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,193.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,339.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2279.07,69,,,percent of total billed charges,69% of total billed charges,3303,100,,,percent of total billed charges,100% of total billed charges,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3303,100,,,percent of total billed charges,100% of total billed charges,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3303,100,,,percent of total billed charges,100% of total billed charges,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2042.91,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1245.23,37.7,,,percent of total billed charges,37.70% of total billed charges,1245.23,37.7,,,percent of total billed charges,37.70% of total billed charges,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,111971.7,33.9,,,percent of total billed charges,33.9% of total billed charges,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2576.34,78,,,percent of total billed charges,78% of total billed charges,3303,100,,,percent of total billed charges,100% of total billed charges,2728.28,82.6,,,percent of total billed charges,82.6% of total billed charges,2728.28,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",193.96,111971.7,
"44205 LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH REMOVA",97544205,CDM,975,RC,44205,HCPCS,Outpatient,,,3663,2380.95,,3223.44,88,,,percent of total billed charges,88% of total Billed charges,163.65,100,,,Fee Schedule,100% of Medicare rate,745.44,100,,,Fee Schedule,100% of WA Medicaid,3663,100,,,percent of total billed charges,100% of total billed charges,767.8,103,,,Fee Schedule,103% of WA Medicaid,163.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,286.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,745.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2527.47,69,,,percent of total billed charges,69% of total billed charges,3663,100,,,percent of total billed charges,100% of total billed charges,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3663,100,,,percent of total billed charges,100% of total billed charges,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3663,100,,,percent of total billed charges,100% of total billed charges,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2265.57,61.85,,,percent of total billed charges,61.85% of total billed charges,745.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,760.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,969.07,130,,,Fee Schedule,130% of WA Medicaid ,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1380.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1380.95,37.7,,,percent of total billed charges,37.70% of total billed charges,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,124175.7,33.9,,,percent of total billed charges,33.9% of total billed charges,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2857.14,78,,,percent of total billed charges,78% of total billed charges,3663,100,,,percent of total billed charges,100% of total billed charges,3025.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3025.64,82.6,,,percent of total billed charges,82.6% of total billed charges,745.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,163.65,124175.7,
"44207 LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, W",97544207,CDM,975,RC,44207,HCPCS,Outpatient,,,4716,3065.40,,4150.08,88,,,percent of total billed charges,88% of total Billed charges,218.58,100,,,Fee Schedule,100% of Medicare rate,1008.97,100,,,Fee Schedule,100% of WA Medicaid,4716,100,,,percent of total billed charges,100% of total billed charges,1039.24,103,,,Fee Schedule,103% of WA Medicaid,218.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,382.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1008.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3254.04,69,,,percent of total billed charges,69% of total billed charges,4716,100,,,percent of total billed charges,100% of total billed charges,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4716,100,,,percent of total billed charges,100% of total billed charges,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4716,100,,,percent of total billed charges,100% of total billed charges,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2916.85,61.85,,,percent of total billed charges,61.85% of total billed charges,1008.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1029.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1311.66,130,,,Fee Schedule,130% of WA Medicaid ,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1777.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1777.93,37.7,,,percent of total billed charges,37.70% of total billed charges,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,159872.4,33.9,,,percent of total billed charges,33.9% of total billed charges,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3678.48,78,,,percent of total billed charges,78% of total billed charges,4716,100,,,percent of total billed charges,100% of total billed charges,3895.42,82.6,,,percent of total billed charges,82.6% of total billed charges,3895.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1008.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,218.58,159872.4,
"Laparoscopy, surgical; colectomy, partial, with anastomosis,",97544208,CDM,975,RC,44208,HCPCS,Outpatient,,,4237,2754.05,,3728.56,88,,,percent of total billed charges,88% of total Billed charges,234.28,100,,,Fee Schedule,100% of Medicare rate,1100.16,100,,,Fee Schedule,100% of WA Medicaid,4237,100,,,percent of total billed charges,100% of total billed charges,1133.16,103,,,Fee Schedule,103% of WA Medicaid,234.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,409.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1100.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2923.53,69,,,percent of total billed charges,69% of total billed charges,4237,100,,,percent of total billed charges,100% of total billed charges,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4237,100,,,percent of total billed charges,100% of total billed charges,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4237,100,,,percent of total billed charges,100% of total billed charges,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2620.58,61.85,,,percent of total billed charges,61.85% of total billed charges,1100.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1100.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1122.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1430.21,130,,,Fee Schedule,130% of WA Medicaid ,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1597.35,37.7,,,percent of total billed charges,37.70% of total billed charges,1597.35,37.7,,,percent of total billed charges,37.70% of total billed charges,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,143634.3,33.9,,,percent of total billed charges,33.9% of total billed charges,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,3304.86,78,,,percent of total billed charges,78% of total billed charges,4237,100,,,percent of total billed charges,100% of total billed charges,3499.76,82.6,,,percent of total billed charges,82.6% of total billed charges,3499.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1100.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,234.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1100.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,234.28,143634.3,
"44213 LAPAROSCOPY, SURGICAL, MOBILIZATION (TAKE-DOWN) OF SPL",97544213,CDM,975,RC,44213,HCPCS,Outpatient,,,530,344.50,,466.4,88,,,percent of total billed charges,88% of total Billed charges,23.85,100,,,Fee Schedule,100% of Medicare rate,102.58,100,,,Fee Schedule,100% of WA Medicaid,530,100,,,percent of total billed charges,100% of total billed charges,105.66,103,,,Fee Schedule,103% of WA Medicaid,23.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,365.7,69,,,percent of total billed charges,69% of total billed charges,530,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,530,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,530,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.81,61.85,,,percent of total billed charges,61.85% of total billed charges,102.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,133.35,130,,,Fee Schedule,130% of WA Medicaid ,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.81,37.7,,,percent of total billed charges,37.70% of total billed charges,199.81,37.7,,,percent of total billed charges,37.70% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,17967,33.9,,,percent of total billed charges,33.9% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.4,78,,,percent of total billed charges,78% of total billed charges,530,100,,,percent of total billed charges,100% of total billed charges,437.78,82.6,,,percent of total billed charges,82.6% of total billed charges,437.78,82.6,,,percent of total billed charges,82.6% of total billed charges,102.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.85,17967,
"44227 LAPAROSCOPY, SURGICAL, CLOSURE OF ENTEROSTOMY, LARGE O",97544227,CDM,975,RC,44227,HCPCS,Outpatient,,,4731,3075.15,,4163.28,88,,,percent of total billed charges,88% of total Billed charges,210.96,100,,,Fee Schedule,100% of Medicare rate,923.73,100,,,Fee Schedule,100% of WA Medicaid,4731,100,,,percent of total billed charges,100% of total billed charges,951.44,103,,,Fee Schedule,103% of WA Medicaid,210.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,369.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,923.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3264.39,69,,,percent of total billed charges,69% of total billed charges,4731,100,,,percent of total billed charges,100% of total billed charges,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4731,100,,,percent of total billed charges,100% of total billed charges,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4731,100,,,percent of total billed charges,100% of total billed charges,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2926.12,61.85,,,percent of total billed charges,61.85% of total billed charges,923.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,923.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,942.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1200.85,130,,,Fee Schedule,130% of WA Medicaid ,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1783.59,37.7,,,percent of total billed charges,37.70% of total billed charges,1783.59,37.7,,,percent of total billed charges,37.70% of total billed charges,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,160380.9,33.9,,,percent of total billed charges,33.9% of total billed charges,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3690.18,78,,,percent of total billed charges,78% of total billed charges,4731,100,,,percent of total billed charges,100% of total billed charges,3907.81,82.6,,,percent of total billed charges,82.6% of total billed charges,3907.81,82.6,,,percent of total billed charges,82.6% of total billed charges,923.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,923.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.96,160380.9,
UNLISTED LAPOROSCOPY PROC;INTE,96044238,CDM,960,RC,44238,HCPCS,Outpatient,,,1182,768.30,,1040.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1182,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,815.58,69,,,percent of total billed charges,69% of total billed charges,1182,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1182,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1182,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,731.07,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,445.61,37.7,,,percent of total billed charges,37.70% of total billed charges,445.61,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,40069.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,921.96,78,,,percent of total billed charges,78% of total billed charges,1182,100,,,percent of total billed charges,100% of total billed charges,976.33,82.6,,,percent of total billed charges,82.6% of total billed charges,976.33,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",445.61,40069.8,
ILEOSTOMY/JEJUOSTOMY NO TUBE,96044310,CDM,960,RC,44310,HCPCS,Outpatient,,,2301,1495.65,,2024.88,88,,,percent of total billed charges,88% of total Billed charges,129.64,100,,,Fee Schedule,100% of Medicare rate,583.19,100,,,Fee Schedule,100% of WA Medicaid,2301,100,,,percent of total billed charges,100% of total billed charges,600.69,103,,,Fee Schedule,103% of WA Medicaid,129.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,226.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,583.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1587.69,69,,,percent of total billed charges,69% of total billed charges,2301,100,,,percent of total billed charges,100% of total billed charges,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2301,100,,,percent of total billed charges,100% of total billed charges,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2301,100,,,percent of total billed charges,100% of total billed charges,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.17,61.85,,,percent of total billed charges,61.85% of total billed charges,583.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,758.15,130,,,Fee Schedule,130% of WA Medicaid ,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,867.48,37.7,,,percent of total billed charges,37.70% of total billed charges,867.48,37.7,,,percent of total billed charges,37.70% of total billed charges,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,78003.9,33.9,,,percent of total billed charges,33.9% of total billed charges,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1794.78,78,,,percent of total billed charges,78% of total billed charges,2301,100,,,percent of total billed charges,100% of total billed charges,1900.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1900.63,82.6,,,percent of total billed charges,82.6% of total billed charges,583.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,129.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,129.64,78003.9,
REV OF ILEOSTOMY COMP SEP PROC,96044314,CDM,960,RC,44314,HCPCS,Outpatient,,,2226,1446.90,,1958.88,88,,,percent of total billed charges,88% of total Billed charges,115.51,100,,,Fee Schedule,100% of Medicare rate,566.4,100,,,Fee Schedule,100% of WA Medicaid,2226,100,,,percent of total billed charges,100% of total billed charges,583.39,103,,,Fee Schedule,103% of WA Medicaid,115.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,202.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,566.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1535.94,69,,,percent of total billed charges,69% of total billed charges,2226,100,,,percent of total billed charges,100% of total billed charges,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2226,100,,,percent of total billed charges,100% of total billed charges,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2226,100,,,percent of total billed charges,100% of total billed charges,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1376.78,61.85,,,percent of total billed charges,61.85% of total billed charges,566.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,566.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,736.32,130,,,Fee Schedule,130% of WA Medicaid ,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,839.2,37.7,,,percent of total billed charges,37.70% of total billed charges,839.2,37.7,,,percent of total billed charges,37.70% of total billed charges,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,75461.4,33.9,,,percent of total billed charges,33.9% of total billed charges,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1736.28,78,,,percent of total billed charges,78% of total billed charges,2226,100,,,percent of total billed charges,100% of total billed charges,1838.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1838.68,82.6,,,percent of total billed charges,82.6% of total billed charges,566.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,566.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,115.51,75461.4,
COLOSTOMY,96044320,CDM,960,RC,44320,HCPCS,Outpatient,,,2524,1640.60,,2221.12,88,,,percent of total billed charges,88% of total Billed charges,151.82,100,,,Fee Schedule,100% of Medicare rate,674.2,100,,,Fee Schedule,100% of WA Medicaid,2524,100,,,percent of total billed charges,100% of total billed charges,694.43,103,,,Fee Schedule,103% of WA Medicaid,151.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,265.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,674.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1741.56,69,,,percent of total billed charges,69% of total billed charges,2524,100,,,percent of total billed charges,100% of total billed charges,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2524,100,,,percent of total billed charges,100% of total billed charges,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2524,100,,,percent of total billed charges,100% of total billed charges,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1561.09,61.85,,,percent of total billed charges,61.85% of total billed charges,674.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,687.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,876.46,130,,,Fee Schedule,130% of WA Medicaid ,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,951.55,37.7,,,percent of total billed charges,37.70% of total billed charges,951.55,37.7,,,percent of total billed charges,37.70% of total billed charges,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,85563.6,33.9,,,percent of total billed charges,33.9% of total billed charges,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1968.72,78,,,percent of total billed charges,78% of total billed charges,2524,100,,,percent of total billed charges,100% of total billed charges,2084.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2084.82,82.6,,,percent of total billed charges,82.6% of total billed charges,674.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,151.82,85563.6,
44345 REVISION OF COLOSTOMY; COMPLICATED (RECONSTRUCTION IN-,97544345,CDM,975,RC,44345,HCPCS,Outpatient,,,2937,1909.05,,2584.56,88,,,percent of total billed charges,88% of total Billed charges,127.22,100,,,Fee Schedule,100% of Medicare rate,591.76,100,,,Fee Schedule,100% of WA Medicaid,2937,100,,,percent of total billed charges,100% of total billed charges,609.51,103,,,Fee Schedule,103% of WA Medicaid,127.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,222.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,591.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2026.53,69,,,percent of total billed charges,69% of total billed charges,2937,100,,,percent of total billed charges,100% of total billed charges,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2937,100,,,percent of total billed charges,100% of total billed charges,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2937,100,,,percent of total billed charges,100% of total billed charges,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1816.53,61.85,,,percent of total billed charges,61.85% of total billed charges,591.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,603.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,769.29,130,,,Fee Schedule,130% of WA Medicaid ,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1107.25,37.7,,,percent of total billed charges,37.70% of total billed charges,1107.25,37.7,,,percent of total billed charges,37.70% of total billed charges,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,99564.3,33.9,,,percent of total billed charges,33.9% of total billed charges,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2290.86,78,,,percent of total billed charges,78% of total billed charges,2937,100,,,percent of total billed charges,100% of total billed charges,2425.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2425.96,82.6,,,percent of total billed charges,82.6% of total billed charges,591.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,127.22,99564.3,
COLONOSCOPY VIA STOMA W/BIOPSY,96044389,CDM,960,RC,44389,HCPCS,Outpatient,,,882,573.30,,776.16,88,,,percent of total billed charges,88% of total Billed charges,15.45,100,,,Fee Schedule,100% of Medicare rate,96.05,100,,,Fee Schedule,100% of WA Medicaid,882,100,,,percent of total billed charges,100% of total billed charges,98.93,103,,,Fee Schedule,103% of WA Medicaid,15.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,96.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,608.58,69,,,percent of total billed charges,69% of total billed charges,882,100,,,percent of total billed charges,100% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,882,100,,,percent of total billed charges,100% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,882,100,,,percent of total billed charges,100% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.52,61.85,,,percent of total billed charges,61.85% of total billed charges,96.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,124.87,130,,,Fee Schedule,130% of WA Medicaid ,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.51,37.7,,,percent of total billed charges,37.70% of total billed charges,332.51,37.7,,,percent of total billed charges,37.70% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,29899.8,33.9,,,percent of total billed charges,33.9% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,687.96,78,,,percent of total billed charges,78% of total billed charges,882,100,,,percent of total billed charges,100% of total billed charges,728.53,82.6,,,percent of total billed charges,82.6% of total billed charges,728.53,82.6,,,percent of total billed charges,82.6% of total billed charges,96.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.45,29899.8,
COLONOSCOPY VIA STOMA W/POLYP,96044394,CDM,960,RC,44394,HCPCS,Outpatient,,,1062,690.30,,934.56,88,,,percent of total billed charges,88% of total Billed charges,20.66,100,,,Fee Schedule,100% of Medicare rate,125.89,100,,,Fee Schedule,100% of WA Medicaid,1062,100,,,percent of total billed charges,100% of total billed charges,129.67,103,,,Fee Schedule,103% of WA Medicaid,20.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,125.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,732.78,69,,,percent of total billed charges,69% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1062,100,,,percent of total billed charges,100% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1062,100,,,percent of total billed charges,100% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,656.85,61.85,,,percent of total billed charges,61.85% of total billed charges,125.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,163.66,130,,,Fee Schedule,130% of WA Medicaid ,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,36001.8,33.9,,,percent of total billed charges,33.9% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,828.36,78,,,percent of total billed charges,78% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,125.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.66,36001.8,
SUTURE OF SM INTEST,96044602,CDM,960,RC,44602,HCPCS,Outpatient,,,2948,1916.20,,2594.24,88,,,percent of total billed charges,88% of total Billed charges,195.99,100,,,Fee Schedule,100% of Medicare rate,781.99,100,,,Fee Schedule,100% of WA Medicaid,2948,100,,,percent of total billed charges,100% of total billed charges,805.45,103,,,Fee Schedule,103% of WA Medicaid,195.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,342.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,781.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2034.12,69,,,percent of total billed charges,69% of total billed charges,2948,100,,,percent of total billed charges,100% of total billed charges,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2948,100,,,percent of total billed charges,100% of total billed charges,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2948,100,,,percent of total billed charges,100% of total billed charges,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1823.34,61.85,,,percent of total billed charges,61.85% of total billed charges,781.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,781.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,797.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1016.59,130,,,Fee Schedule,130% of WA Medicaid ,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1111.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1111.4,37.7,,,percent of total billed charges,37.70% of total billed charges,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,99937.2,33.9,,,percent of total billed charges,33.9% of total billed charges,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2299.44,78,,,percent of total billed charges,78% of total billed charges,2948,100,,,percent of total billed charges,100% of total billed charges,2435.05,82.6,,,percent of total billed charges,82.6% of total billed charges,2435.05,82.6,,,percent of total billed charges,82.6% of total billed charges,781.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,781.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.99,99937.2,
SUTURE MULT PERF SMALL INTEST,96044603,CDM,960,RC,44603,HCPCS,Outpatient,,,3383,2198.95,,2977.04,88,,,percent of total billed charges,88% of total Billed charges,216.26,100,,,Fee Schedule,100% of Medicare rate,900.8,100,,,Fee Schedule,100% of WA Medicaid,3383,100,,,percent of total billed charges,100% of total billed charges,927.82,103,,,Fee Schedule,103% of WA Medicaid,216.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,378.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,900.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2334.27,69,,,percent of total billed charges,69% of total billed charges,3383,100,,,percent of total billed charges,100% of total billed charges,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,3383,100,,,percent of total billed charges,100% of total billed charges,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,3383,100,,,percent of total billed charges,100% of total billed charges,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2092.39,61.85,,,percent of total billed charges,61.85% of total billed charges,900.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,900.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,918.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1171.04,130,,,Fee Schedule,130% of WA Medicaid ,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1275.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1275.39,37.7,,,percent of total billed charges,37.70% of total billed charges,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,114683.7,33.9,,,percent of total billed charges,33.9% of total billed charges,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2638.74,78,,,percent of total billed charges,78% of total billed charges,3383,100,,,percent of total billed charges,100% of total billed charges,2794.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2794.36,82.6,,,percent of total billed charges,82.6% of total billed charges,900.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,216.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,900.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,216.26,114683.7,
SUTURE LG INTEST FOR PERF ULC,96044604,CDM,960,RC,44604,HCPCS,Outpatient,,,2211,1437.15,,1945.68,88,,,percent of total billed charges,88% of total Billed charges,140.09,100,,,Fee Schedule,100% of Medicare rate,588.97,100,,,Fee Schedule,100% of WA Medicaid,2211,100,,,percent of total billed charges,100% of total billed charges,606.64,103,,,Fee Schedule,103% of WA Medicaid,140.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,245.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,588.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1525.59,69,,,percent of total billed charges,69% of total billed charges,2211,100,,,percent of total billed charges,100% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2211,100,,,percent of total billed charges,100% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2211,100,,,percent of total billed charges,100% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1367.5,61.85,,,percent of total billed charges,61.85% of total billed charges,588.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,600.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,765.66,130,,,Fee Schedule,130% of WA Medicaid ,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,833.55,37.7,,,percent of total billed charges,37.70% of total billed charges,833.55,37.7,,,percent of total billed charges,37.70% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,74952.9,33.9,,,percent of total billed charges,33.9% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1724.58,78,,,percent of total billed charges,78% of total billed charges,2211,100,,,percent of total billed charges,100% of total billed charges,1826.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1826.29,82.6,,,percent of total billed charges,82.6% of total billed charges,588.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.09,74952.9,
ENTEROTOMY,96044615,CDM,960,RC,44615,HCPCS,Outpatient,,,2025,1316.25,,1782,88,,,percent of total billed charges,88% of total Billed charges,135.89,100,,,Fee Schedule,100% of Medicare rate,598.11,100,,,Fee Schedule,100% of WA Medicaid,2025,100,,,percent of total billed charges,100% of total billed charges,616.05,103,,,Fee Schedule,103% of WA Medicaid,135.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,237.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,598.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1397.25,69,,,percent of total billed charges,69% of total billed charges,2025,100,,,percent of total billed charges,100% of total billed charges,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2025,100,,,percent of total billed charges,100% of total billed charges,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2025,100,,,percent of total billed charges,100% of total billed charges,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1252.46,61.85,,,percent of total billed charges,61.85% of total billed charges,598.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,777.54,130,,,Fee Schedule,130% of WA Medicaid ,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.43,37.7,,,percent of total billed charges,37.70% of total billed charges,763.43,37.7,,,percent of total billed charges,37.70% of total billed charges,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,68647.5,33.9,,,percent of total billed charges,33.9% of total billed charges,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1579.5,78,,,percent of total billed charges,78% of total billed charges,2025,100,,,percent of total billed charges,100% of total billed charges,1672.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1672.65,82.6,,,percent of total billed charges,82.6% of total billed charges,598.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,135.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,135.89,68647.5,
CLOSURE ENTEROSTOMY INTESTINE,96044620,CDM,960,RC,44620,HCPCS,Outpatient,,,1827,1187.55,,1607.76,88,,,percent of total billed charges,88% of total Billed charges,105.29,100,,,Fee Schedule,100% of Medicare rate,485.65,100,,,Fee Schedule,100% of WA Medicaid,1827,100,,,percent of total billed charges,100% of total billed charges,500.22,103,,,Fee Schedule,103% of WA Medicaid,105.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,184.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,485.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1260.63,69,,,percent of total billed charges,69% of total billed charges,1827,100,,,percent of total billed charges,100% of total billed charges,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1827,100,,,percent of total billed charges,100% of total billed charges,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1827,100,,,percent of total billed charges,100% of total billed charges,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1130,61.85,,,percent of total billed charges,61.85% of total billed charges,485.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,631.35,130,,,Fee Schedule,130% of WA Medicaid ,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,688.78,37.7,,,percent of total billed charges,37.70% of total billed charges,688.78,37.7,,,percent of total billed charges,37.70% of total billed charges,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,61935.3,33.9,,,percent of total billed charges,33.9% of total billed charges,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1425.06,78,,,percent of total billed charges,78% of total billed charges,1827,100,,,percent of total billed charges,100% of total billed charges,1509.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1509.1,82.6,,,percent of total billed charges,82.6% of total billed charges,485.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105.29,61935.3,
CLOSE ENTEROSTOMY W/ RESECT,96044626,CDM,960,RC,44626,HCPCS,Outpatient,,,3362,2185.30,,2958.56,88,,,percent of total billed charges,88% of total Billed charges,207.91,100,,,Fee Schedule,100% of Medicare rate,885.13,100,,,Fee Schedule,100% of WA Medicaid,3362,100,,,percent of total billed charges,100% of total billed charges,911.68,103,,,Fee Schedule,103% of WA Medicaid,207.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,363.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,885.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2319.78,69,,,percent of total billed charges,69% of total billed charges,3362,100,,,percent of total billed charges,100% of total billed charges,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3362,100,,,percent of total billed charges,100% of total billed charges,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3362,100,,,percent of total billed charges,100% of total billed charges,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2079.4,61.85,,,percent of total billed charges,61.85% of total billed charges,885.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1150.67,130,,,Fee Schedule,130% of WA Medicaid ,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1267.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1267.47,37.7,,,percent of total billed charges,37.70% of total billed charges,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,113971.8,33.9,,,percent of total billed charges,33.9% of total billed charges,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2622.36,78,,,percent of total billed charges,78% of total billed charges,3362,100,,,percent of total billed charges,100% of total billed charges,2777.01,82.6,,,percent of total billed charges,82.6% of total billed charges,2777.01,82.6,,,percent of total billed charges,82.6% of total billed charges,885.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,207.91,113971.8,
44680 INTESTINAL PLICATION (SEPARATE PROCEDURE) ProFee,96044680,CDM,975,RC,44680,HCPCS,Outpatient,,,3235,2102.75,,2846.8,88,,,percent of total billed charges,88% of total Billed charges,151.44,100,,,Fee Schedule,100% of Medicare rate,602.58,100,,,Fee Schedule,100% of WA Medicaid,3235,100,,,percent of total billed charges,100% of total billed charges,620.66,103,,,Fee Schedule,103% of WA Medicaid,151.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,265.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,602.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2232.15,69,,,percent of total billed charges,69% of total billed charges,3235,100,,,percent of total billed charges,100% of total billed charges,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,3235,100,,,percent of total billed charges,100% of total billed charges,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,3235,100,,,percent of total billed charges,100% of total billed charges,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2000.85,61.85,,,percent of total billed charges,61.85% of total billed charges,602.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,783.35,130,,,Fee Schedule,130% of WA Medicaid ,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1219.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1219.6,37.7,,,percent of total billed charges,37.70% of total billed charges,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,109666.5,33.9,,,percent of total billed charges,33.9% of total billed charges,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2523.3,78,,,percent of total billed charges,78% of total billed charges,3235,100,,,percent of total billed charges,100% of total billed charges,2672.11,82.6,,,percent of total billed charges,82.6% of total billed charges,2672.11,82.6,,,percent of total billed charges,82.6% of total billed charges,602.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,151.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,151.44,109666.5,
EXC MECKEL'S DIVERTICULUM,96044800,CDM,960,RC,44800,HCPCS,Outpatient,,,1601,1040.65,,1408.88,88,,,percent of total billed charges,88% of total Billed charges,98.46,100,,,Fee Schedule,100% of Medicare rate,440.33,100,,,Fee Schedule,100% of WA Medicaid,1601,100,,,percent of total billed charges,100% of total billed charges,453.54,103,,,Fee Schedule,103% of WA Medicaid,98.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,172.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,440.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1104.69,69,,,percent of total billed charges,69% of total billed charges,1601,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1601,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1601,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,990.22,61.85,,,percent of total billed charges,61.85% of total billed charges,440.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,572.43,130,,,Fee Schedule,130% of WA Medicaid ,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,603.58,37.7,,,percent of total billed charges,37.70% of total billed charges,603.58,37.7,,,percent of total billed charges,37.70% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,54273.9,33.9,,,percent of total billed charges,33.9% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1248.78,78,,,percent of total billed charges,78% of total billed charges,1601,100,,,percent of total billed charges,100% of total billed charges,1322.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1322.43,82.6,,,percent of total billed charges,82.6% of total billed charges,440.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.46,54273.9,
EXCISION OF LESION MESENTERY,96044820,CDM,960,RC,44820,HCPCS,Outpatient,,,1762,1145.30,,1550.56,88,,,percent of total billed charges,88% of total Billed charges,117.15,100,,,Fee Schedule,100% of Medicare rate,479.49,100,,,Fee Schedule,100% of WA Medicaid,1762,100,,,percent of total billed charges,100% of total billed charges,493.87,103,,,Fee Schedule,103% of WA Medicaid,117.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,205.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,479.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1215.78,69,,,percent of total billed charges,69% of total billed charges,1762,100,,,percent of total billed charges,100% of total billed charges,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1762,100,,,percent of total billed charges,100% of total billed charges,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1762,100,,,percent of total billed charges,100% of total billed charges,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1089.8,61.85,,,percent of total billed charges,61.85% of total billed charges,479.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,623.34,130,,,Fee Schedule,130% of WA Medicaid ,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.27,37.7,,,percent of total billed charges,37.70% of total billed charges,664.27,37.7,,,percent of total billed charges,37.70% of total billed charges,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,59731.8,33.9,,,percent of total billed charges,33.9% of total billed charges,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1374.36,78,,,percent of total billed charges,78% of total billed charges,1762,100,,,percent of total billed charges,100% of total billed charges,1455.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1455.41,82.6,,,percent of total billed charges,82.6% of total billed charges,479.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.15,59731.8,
SUTURE OF MESENTERY (SEP PRO),96044850,CDM,960,RC,44850,HCPCS,Outpatient,,,1570,1020.50,,1381.6,88,,,percent of total billed charges,88% of total Billed charges,96.48,100,,,Fee Schedule,100% of Medicare rate,422.24,100,,,Fee Schedule,100% of WA Medicaid,1570,100,,,percent of total billed charges,100% of total billed charges,434.91,103,,,Fee Schedule,103% of WA Medicaid,96.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,168.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,422.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1083.3,69,,,percent of total billed charges,69% of total billed charges,1570,100,,,percent of total billed charges,100% of total billed charges,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1570,100,,,percent of total billed charges,100% of total billed charges,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1570,100,,,percent of total billed charges,100% of total billed charges,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,971.05,61.85,,,percent of total billed charges,61.85% of total billed charges,422.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,548.91,130,,,Fee Schedule,130% of WA Medicaid ,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.89,37.7,,,percent of total billed charges,37.70% of total billed charges,591.89,37.7,,,percent of total billed charges,37.70% of total billed charges,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,53223,33.9,,,percent of total billed charges,33.9% of total billed charges,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1224.6,78,,,percent of total billed charges,78% of total billed charges,1570,100,,,percent of total billed charges,100% of total billed charges,1296.82,82.6,,,percent of total billed charges,82.6% of total billed charges,1296.82,82.6,,,percent of total billed charges,82.6% of total billed charges,422.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.48,53223,
ID APPENDICEAL ABSCESS,96044900,CDM,960,RC,44900,HCPCS,Outpatient,,,1620,1053.00,,1425.6,88,,,percent of total billed charges,88% of total Billed charges,107.12,100,,,Fee Schedule,100% of Medicare rate,441.82,100,,,Fee Schedule,100% of WA Medicaid,1620,100,,,percent of total billed charges,100% of total billed charges,455.07,103,,,Fee Schedule,103% of WA Medicaid,107.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,187.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,441.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1117.8,69,,,percent of total billed charges,69% of total billed charges,1620,100,,,percent of total billed charges,100% of total billed charges,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1620,100,,,percent of total billed charges,100% of total billed charges,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1620,100,,,percent of total billed charges,100% of total billed charges,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1001.97,61.85,,,percent of total billed charges,61.85% of total billed charges,441.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,574.37,130,,,Fee Schedule,130% of WA Medicaid ,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.74,37.7,,,percent of total billed charges,37.70% of total billed charges,610.74,37.7,,,percent of total billed charges,37.70% of total billed charges,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,54918,33.9,,,percent of total billed charges,33.9% of total billed charges,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1263.6,78,,,percent of total billed charges,78% of total billed charges,1620,100,,,percent of total billed charges,100% of total billed charges,1338.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1338.12,82.6,,,percent of total billed charges,82.6% of total billed charges,441.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.12,54918,
APPENDECTOMY,96044950,CDM,960,RC,44950,HCPCS,Outpatient,,,1340,871.00,,1179.2,88,,,percent of total billed charges,88% of total Billed charges,86.79,100,,,Fee Schedule,100% of Medicare rate,361.25,100,,,Fee Schedule,100% of WA Medicaid,1340,100,,,percent of total billed charges,100% of total billed charges,372.09,103,,,Fee Schedule,103% of WA Medicaid,86.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,151.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,361.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,924.6,69,,,percent of total billed charges,69% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340,100,,,percent of total billed charges,100% of total billed charges,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340,100,,,percent of total billed charges,100% of total billed charges,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,828.79,61.85,,,percent of total billed charges,61.85% of total billed charges,361.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,469.63,130,,,Fee Schedule,130% of WA Medicaid ,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,45426,33.9,,,percent of total billed charges,33.9% of total billed charges,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045.2,78,,,percent of total billed charges,78% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,361.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.79,45426,
PERFORATED APPENDECTOMY,96044960,CDM,960,RC,44960,HCPCS,Outpatient,,,1825,1186.25,,1606,88,,,percent of total billed charges,88% of total Billed charges,120.18,100,,,Fee Schedule,100% of Medicare rate,492.36,100,,,Fee Schedule,100% of WA Medicaid,1825,100,,,percent of total billed charges,100% of total billed charges,507.13,103,,,Fee Schedule,103% of WA Medicaid,120.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,210.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,492.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1259.25,69,,,percent of total billed charges,69% of total billed charges,1825,100,,,percent of total billed charges,100% of total billed charges,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825,100,,,percent of total billed charges,100% of total billed charges,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825,100,,,percent of total billed charges,100% of total billed charges,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128.76,61.85,,,percent of total billed charges,61.85% of total billed charges,492.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,640.07,130,,,Fee Schedule,130% of WA Medicaid ,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,688.03,37.7,,,percent of total billed charges,37.70% of total billed charges,688.03,37.7,,,percent of total billed charges,37.70% of total billed charges,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,61867.5,33.9,,,percent of total billed charges,33.9% of total billed charges,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.5,78,,,percent of total billed charges,78% of total billed charges,1825,100,,,percent of total billed charges,100% of total billed charges,1507.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1507.45,82.6,,,percent of total billed charges,82.6% of total billed charges,492.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,120.18,61867.5,
LAP APPENDECTOMY,96044970,CDM,960,RC,44970,HCPCS,Outpatient,,,1254,815.10,,1103.52,88,,,percent of total billed charges,88% of total Billed charges,78.71,100,,,Fee Schedule,100% of Medicare rate,341.3,100,,,Fee Schedule,100% of WA Medicaid,1254,100,,,percent of total billed charges,100% of total billed charges,351.54,103,,,Fee Schedule,103% of WA Medicaid,78.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,341.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,865.26,69,,,percent of total billed charges,69% of total billed charges,1254,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1254,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1254,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,775.6,61.85,,,percent of total billed charges,61.85% of total billed charges,341.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,443.69,130,,,Fee Schedule,130% of WA Medicaid ,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,472.76,37.7,,,percent of total billed charges,37.70% of total billed charges,472.76,37.7,,,percent of total billed charges,37.70% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,42510.6,33.9,,,percent of total billed charges,33.9% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,978.12,78,,,percent of total billed charges,78% of total billed charges,1254,100,,,percent of total billed charges,100% of total billed charges,1035.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1035.8,82.6,,,percent of total billed charges,82.6% of total billed charges,341.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.71,42510.6,
"44979 UNLISTED LAPAROSCOPY PROCEDURE, APPENDIX ProFee",97544979,CDM,975,RC,44979,HCPCS,Outpatient,,,1148,746.20,,1010.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,792.12,69,,,percent of total billed charges,69% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,710.04,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,38917.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,895.44,78,,,percent of total billed charges,78% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",432.8,38917.2,
PROCTECTOMY;COMPLETE W/COLOSTO,96045110,CDM,960,RC,45110,HCPCS,Outpatient,,,3915,2544.75,,3445.2,88,,,percent of total billed charges,88% of total Billed charges,196.79,100,,,Fee Schedule,100% of Medicare rate,1020.16,100,,,Fee Schedule,100% of WA Medicaid,3915,100,,,percent of total billed charges,100% of total billed charges,1050.76,103,,,Fee Schedule,103% of WA Medicaid,196.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,344.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1020.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2701.35,69,,,percent of total billed charges,69% of total billed charges,3915,100,,,percent of total billed charges,100% of total billed charges,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3915,100,,,percent of total billed charges,100% of total billed charges,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3915,100,,,percent of total billed charges,100% of total billed charges,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2421.43,61.85,,,percent of total billed charges,61.85% of total billed charges,1020.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1040.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1326.21,130,,,Fee Schedule,130% of WA Medicaid ,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1475.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1475.96,37.7,,,percent of total billed charges,37.70% of total billed charges,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,132718.5,33.9,,,percent of total billed charges,33.9% of total billed charges,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3053.7,78,,,percent of total billed charges,78% of total billed charges,3915,100,,,percent of total billed charges,100% of total billed charges,3233.79,82.6,,,percent of total billed charges,82.6% of total billed charges,3233.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1020.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,196.79,132718.5,
EXCISION RECTAL TUMOR,96045171,CDM,960,RC,45171,HCPCS,Outpatient,,,1277,830.05,,1123.76,88,,,percent of total billed charges,88% of total Billed charges,58.88,100,,,Fee Schedule,100% of Medicare rate,355.47,100,,,Fee Schedule,100% of WA Medicaid,1277,100,,,percent of total billed charges,100% of total billed charges,366.13,103,,,Fee Schedule,103% of WA Medicaid,58.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,355.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,881.13,69,,,percent of total billed charges,69% of total billed charges,1277,100,,,percent of total billed charges,100% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1277,100,,,percent of total billed charges,100% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1277,100,,,percent of total billed charges,100% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,789.82,61.85,,,percent of total billed charges,61.85% of total billed charges,355.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,462.11,130,,,Fee Schedule,130% of WA Medicaid ,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.43,37.7,,,percent of total billed charges,37.70% of total billed charges,481.43,37.7,,,percent of total billed charges,37.70% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,43290.3,33.9,,,percent of total billed charges,33.9% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,996.06,78,,,percent of total billed charges,78% of total billed charges,1277,100,,,percent of total billed charges,100% of total billed charges,1054.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1054.8,82.6,,,percent of total billed charges,82.6% of total billed charges,355.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.88,43290.3,
"45190 DESTRUCTION OF RECTAL TUMOR (EG, ELECTRODESICCATION, E",97545190,CDM,975,RC,45190,HCPCS,Outpatient,,,2462,1600.30,,2166.56,88,,,percent of total billed charges,88% of total Billed charges,62.05,100,,,Fee Schedule,100% of Medicare rate,400.42,100,,,Fee Schedule,100% of WA Medicaid,2462,100,,,percent of total billed charges,100% of total billed charges,412.43,103,,,Fee Schedule,103% of WA Medicaid,62.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,400.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1698.78,69,,,percent of total billed charges,69% of total billed charges,2462,100,,,percent of total billed charges,100% of total billed charges,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2462,100,,,percent of total billed charges,100% of total billed charges,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2462,100,,,percent of total billed charges,100% of total billed charges,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1522.75,61.85,,,percent of total billed charges,61.85% of total billed charges,400.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.55,130,,,Fee Schedule,130% of WA Medicaid ,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,928.17,37.7,,,percent of total billed charges,37.70% of total billed charges,928.17,37.7,,,percent of total billed charges,37.70% of total billed charges,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,83461.8,33.9,,,percent of total billed charges,33.9% of total billed charges,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1920.36,78,,,percent of total billed charges,78% of total billed charges,2462,100,,,percent of total billed charges,100% of total billed charges,2033.61,82.6,,,percent of total billed charges,82.6% of total billed charges,2033.61,82.6,,,percent of total billed charges,82.6% of total billed charges,400.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.05,83461.8,
SIGMOIDOSCOPY W/ BIOPSY,96045331,CDM,960,RC,45331,HCPCS,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,6.05,100,,,Fee Schedule,100% of Medicare rate,41.03,100,,,Fee Schedule,100% of WA Medicaid,350,100,,,percent of total billed charges,100% of total billed charges,42.26,103,,,Fee Schedule,103% of WA Medicaid,6.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,41.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,350,100,,,percent of total billed charges,100% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,350,100,,,percent of total billed charges,100% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,41.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.34,130,,,Fee Schedule,130% of WA Medicaid ,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,11865,33.9,,,percent of total billed charges,33.9% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,41.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.05,11865,
"SIGMOIDOSCOPY, FLEXIBLE; WITH DIRECTED SUBMU",45335,CDM,975,RC,45335,HCPCS,Outpatient,,,928,603.20,,816.64,88,,,percent of total billed charges,88% of total Billed charges,5.63,100,,,Fee Schedule,100% of Medicare rate,38.05,100,,,Fee Schedule,100% of WA Medicaid,928,100,,,percent of total billed charges,100% of total billed charges,39.19,103,,,Fee Schedule,103% of WA Medicaid,5.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,640.32,69,,,percent of total billed charges,69% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,928,100,,,percent of total billed charges,100% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,928,100,,,percent of total billed charges,100% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,573.97,61.85,,,percent of total billed charges,61.85% of total billed charges,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.47,130,,,Fee Schedule,130% of WA Medicaid ,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.86,37.7,,,percent of total billed charges,37.70% of total billed charges,349.86,37.7,,,percent of total billed charges,37.70% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,31459.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.84,78,,,percent of total billed charges,78% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.63,31459.2,
FLEXIBLE SIG BY SNARE TECH,96045338,CDM,960,RC,45338,HCPCS,Outpatient,,,684,444.60,,601.92,88,,,percent of total billed charges,88% of total Billed charges,10.31,100,,,Fee Schedule,100% of Medicare rate,67.7,100,,,Fee Schedule,100% of WA Medicaid,684,100,,,percent of total billed charges,100% of total billed charges,69.73,103,,,Fee Schedule,103% of WA Medicaid,10.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,67.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,471.96,69,,,percent of total billed charges,69% of total billed charges,684,100,,,percent of total billed charges,100% of total billed charges,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,684,100,,,percent of total billed charges,100% of total billed charges,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,684,100,,,percent of total billed charges,100% of total billed charges,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.05,61.85,,,percent of total billed charges,61.85% of total billed charges,67.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,88.01,130,,,Fee Schedule,130% of WA Medicaid ,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.87,37.7,,,percent of total billed charges,37.70% of total billed charges,257.87,37.7,,,percent of total billed charges,37.70% of total billed charges,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,23187.6,33.9,,,percent of total billed charges,33.9% of total billed charges,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,533.52,78,,,percent of total billed charges,78% of total billed charges,684,100,,,percent of total billed charges,100% of total billed charges,564.98,82.6,,,percent of total billed charges,82.6% of total billed charges,564.98,82.6,,,percent of total billed charges,82.6% of total billed charges,67.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.31,23187.6,
SIGMOIDOSCOPY; FLEX,97545330,CDM,975,RC,45330,HCPCS,Outpatient,,,305,198.25,,268.4,88,,,percent of total billed charges,88% of total Billed charges,4.81,100,,,Fee Schedule,100% of Medicare rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,305,100,,,percent of total billed charges,100% of total billed charges,33.23,103,,,Fee Schedule,103% of WA Medicaid,4.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,210.45,69,,,percent of total billed charges,69% of total billed charges,305,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,305,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,305,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.64,61.85,,,percent of total billed charges,61.85% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.94,130,,,Fee Schedule,130% of WA Medicaid ,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.99,37.7,,,percent of total billed charges,37.70% of total billed charges,114.99,37.7,,,percent of total billed charges,37.70% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,10339.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.9,78,,,percent of total billed charges,78% of total billed charges,305,100,,,percent of total billed charges,100% of total billed charges,251.93,82.6,,,percent of total billed charges,82.6% of total billed charges,251.93,82.6,,,percent of total billed charges,82.6% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,10339.5,
COLONOSCOPY,97545378,CDM,975,RC,45378,HCPCS,Outpatient,,,832,540.80,,732.16,88,,,percent of total billed charges,88% of total Billed charges,16.35,100,,,Fee Schedule,100% of Medicare rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,832,100,,,percent of total billed charges,100% of total billed charges,53.41,103,,,Fee Schedule,103% of WA Medicaid,16.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,574.08,69,,,percent of total billed charges,69% of total billed charges,832,100,,,percent of total billed charges,100% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,832,100,,,percent of total billed charges,100% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,832,100,,,percent of total billed charges,100% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,514.59,61.85,,,percent of total billed charges,61.85% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.41,130,,,Fee Schedule,130% of WA Medicaid ,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.66,37.7,,,percent of total billed charges,37.70% of total billed charges,313.66,37.7,,,percent of total billed charges,37.70% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,28204.8,33.9,,,percent of total billed charges,33.9% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,648.96,78,,,percent of total billed charges,78% of total billed charges,832,100,,,percent of total billed charges,100% of total billed charges,687.23,82.6,,,percent of total billed charges,82.6% of total billed charges,687.23,82.6,,,percent of total billed charges,82.6% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.35,28204.8,
COLONOSCOPY W/ BIOPSY,97545380,CDM,975,RC,45380,HCPCS,Outpatient,,,991,644.15,,872.08,88,,,percent of total billed charges,88% of total Billed charges,17.34,100,,,Fee Schedule,100% of Medicare rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,991,100,,,percent of total billed charges,100% of total billed charges,115.64,103,,,Fee Schedule,103% of WA Medicaid,17.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,683.79,69,,,percent of total billed charges,69% of total billed charges,991,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,991,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,991,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.93,61.85,,,percent of total billed charges,61.85% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.95,130,,,Fee Schedule,130% of WA Medicaid ,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.61,37.7,,,percent of total billed charges,37.70% of total billed charges,373.61,37.7,,,percent of total billed charges,37.70% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,33594.9,33.9,,,percent of total billed charges,33.9% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,772.98,78,,,percent of total billed charges,78% of total billed charges,991,100,,,percent of total billed charges,100% of total billed charges,818.57,82.6,,,percent of total billed charges,82.6% of total billed charges,818.57,82.6,,,percent of total billed charges,82.6% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.34,33594.9,
COLONOSCOPY W/ INJECTION,96045381,CDM,960,RC,45381,HCPCS,Outpatient,,,1035,672.75,,910.8,88,,,percent of total billed charges,88% of total Billed charges,17.33,100,,,Fee Schedule,100% of Medicare rate,112.09,100,,,Fee Schedule,100% of WA Medicaid,1035,100,,,percent of total billed charges,100% of total billed charges,115.45,103,,,Fee Schedule,103% of WA Medicaid,17.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,714.15,69,,,percent of total billed charges,69% of total billed charges,1035,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.15,61.85,,,percent of total billed charges,61.85% of total billed charges,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.72,130,,,Fee Schedule,130% of WA Medicaid ,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.2,37.7,,,percent of total billed charges,37.70% of total billed charges,390.2,37.7,,,percent of total billed charges,37.70% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,35086.5,33.9,,,percent of total billed charges,33.9% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,807.3,78,,,percent of total billed charges,78% of total billed charges,1035,100,,,percent of total billed charges,100% of total billed charges,854.91,82.6,,,percent of total billed charges,82.6% of total billed charges,854.91,82.6,,,percent of total billed charges,82.6% of total billed charges,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.33,35086.5,
COLONOSCOPY W/ HEMORRHAGE CONT,96045382,CDM,960,RC,45382,HCPCS,Outpatient,,,1287,836.55,,1132.56,88,,,percent of total billed charges,88% of total Billed charges,21.9,100,,,Fee Schedule,100% of Medicare rate,144.54,100,,,Fee Schedule,100% of WA Medicaid,1287,100,,,percent of total billed charges,100% of total billed charges,148.88,103,,,Fee Schedule,103% of WA Medicaid,21.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,144.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,888.03,69,,,percent of total billed charges,69% of total billed charges,1287,100,,,percent of total billed charges,100% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1287,100,,,percent of total billed charges,100% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1287,100,,,percent of total billed charges,100% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,796.01,61.85,,,percent of total billed charges,61.85% of total billed charges,144.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,187.9,130,,,Fee Schedule,130% of WA Medicaid ,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.2,37.7,,,percent of total billed charges,37.70% of total billed charges,485.2,37.7,,,percent of total billed charges,37.70% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,43629.3,33.9,,,percent of total billed charges,33.9% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1003.86,78,,,percent of total billed charges,78% of total billed charges,1287,100,,,percent of total billed charges,100% of total billed charges,1063.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1063.06,82.6,,,percent of total billed charges,82.6% of total billed charges,144.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.9,43629.3,
COLONOSCOPY W/ POLYP,96045385,CDM,960,RC,45385,HCPCS,Outpatient,,,1116,725.40,,982.08,88,,,percent of total billed charges,88% of total Billed charges,22.03,100,,,Fee Schedule,100% of Medicare rate,141.93,100,,,Fee Schedule,100% of WA Medicaid,1116,100,,,percent of total billed charges,100% of total billed charges,146.19,103,,,Fee Schedule,103% of WA Medicaid,22.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,141.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,770.04,69,,,percent of total billed charges,69% of total billed charges,1116,100,,,percent of total billed charges,100% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116,100,,,percent of total billed charges,100% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116,100,,,percent of total billed charges,100% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,690.25,61.85,,,percent of total billed charges,61.85% of total billed charges,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,184.51,130,,,Fee Schedule,130% of WA Medicaid ,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.73,37.7,,,percent of total billed charges,37.70% of total billed charges,420.73,37.7,,,percent of total billed charges,37.70% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,37832.4,33.9,,,percent of total billed charges,33.9% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,870.48,78,,,percent of total billed charges,78% of total billed charges,1116,100,,,percent of total billed charges,100% of total billed charges,921.82,82.6,,,percent of total billed charges,82.6% of total billed charges,921.82,82.6,,,percent of total billed charges,82.6% of total billed charges,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.03,37832.4,
COLONOSCOPY W/ ABLATION,96045388,CDM,960,RC,45388,HCPCS,Outpatient,,,1200,780.00,,1056,88,,,percent of total billed charges,88% of total Billed charges,24.31,100,,,Fee Schedule,100% of Medicare rate,150.88,100,,,Fee Schedule,100% of WA Medicaid,1200,100,,,percent of total billed charges,100% of total billed charges,155.41,103,,,Fee Schedule,103% of WA Medicaid,24.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,150.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,828,69,,,percent of total billed charges,69% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,742.2,61.85,,,percent of total billed charges,61.85% of total billed charges,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.14,130,,,Fee Schedule,130% of WA Medicaid ,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,40680,33.9,,,percent of total billed charges,33.9% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,936,78,,,percent of total billed charges,78% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.31,40680,
"45390 COLONOSCOPY, FLEXIBLE; WITH ENDOSCOPIC MUCOSAL RESECTI",97545390,CDM,975,RC,45390,HCPCS,Outpatient,,,1148,746.20,,1010.24,88,,,percent of total billed charges,88% of total Billed charges,28.48,100,,,Fee Schedule,100% of Medicare rate,185.57,100,,,Fee Schedule,100% of WA Medicaid,1148,100,,,percent of total billed charges,100% of total billed charges,191.14,103,,,Fee Schedule,103% of WA Medicaid,28.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,185.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,792.12,69,,,percent of total billed charges,69% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1148,100,,,percent of total billed charges,100% of total billed charges,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1148,100,,,percent of total billed charges,100% of total billed charges,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,710.04,61.85,,,percent of total billed charges,61.85% of total billed charges,185.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,241.24,130,,,Fee Schedule,130% of WA Medicaid ,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,432.8,37.7,,,percent of total billed charges,37.70% of total billed charges,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,38917.2,33.9,,,percent of total billed charges,33.9% of total billed charges,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,895.44,78,,,percent of total billed charges,78% of total billed charges,1148,100,,,percent of total billed charges,100% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,948.25,82.6,,,percent of total billed charges,82.6% of total billed charges,185.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.48,38917.2,
PROCTOPLASTY FOR STENOSIS,96045500,CDM,960,RC,45500,HCPCS,Outpatient,,,1064,691.60,,936.32,88,,,percent of total billed charges,88% of total Billed charges,69.03,100,,,Fee Schedule,100% of Medicare rate,325.82,100,,,Fee Schedule,100% of WA Medicaid,1064,100,,,percent of total billed charges,100% of total billed charges,335.59,103,,,Fee Schedule,103% of WA Medicaid,69.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,120.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,325.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,734.16,69,,,percent of total billed charges,69% of total billed charges,1064,100,,,percent of total billed charges,100% of total billed charges,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064,100,,,percent of total billed charges,100% of total billed charges,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064,100,,,percent of total billed charges,100% of total billed charges,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.08,61.85,,,percent of total billed charges,61.85% of total billed charges,325.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,423.57,130,,,Fee Schedule,130% of WA Medicaid ,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.13,37.7,,,percent of total billed charges,37.70% of total billed charges,401.13,37.7,,,percent of total billed charges,37.70% of total billed charges,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,36069.6,33.9,,,percent of total billed charges,33.9% of total billed charges,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.92,78,,,percent of total billed charges,78% of total billed charges,1064,100,,,percent of total billed charges,100% of total billed charges,878.86,82.6,,,percent of total billed charges,82.6% of total billed charges,878.86,82.6,,,percent of total billed charges,82.6% of total billed charges,325.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.03,36069.6,
PROC FOR PROLAP OF MUC MEMBRAN,96045505,CDM,960,RC,45505,HCPCS,Outpatient,,,1272,826.80,,1119.36,88,,,percent of total billed charges,88% of total Billed charges,56.36,100,,,Fee Schedule,100% of Medicare rate,346.7,100,,,Fee Schedule,100% of WA Medicaid,1272,100,,,percent of total billed charges,100% of total billed charges,357.1,103,,,Fee Schedule,103% of WA Medicaid,56.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,98.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,346.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,877.68,69,,,percent of total billed charges,69% of total billed charges,1272,100,,,percent of total billed charges,100% of total billed charges,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272,100,,,percent of total billed charges,100% of total billed charges,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272,100,,,percent of total billed charges,100% of total billed charges,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.73,61.85,,,percent of total billed charges,61.85% of total billed charges,346.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,450.71,130,,,Fee Schedule,130% of WA Medicaid ,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.54,37.7,,,percent of total billed charges,37.70% of total billed charges,479.54,37.7,,,percent of total billed charges,37.70% of total billed charges,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,43120.8,33.9,,,percent of total billed charges,33.9% of total billed charges,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,992.16,78,,,percent of total billed charges,78% of total billed charges,1272,100,,,percent of total billed charges,100% of total billed charges,1050.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1050.67,82.6,,,percent of total billed charges,82.6% of total billed charges,346.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.36,43120.8,
PROCTOPEXY ABDOM APPROACH,96045550,CDM,960,RC,45550,HCPCS,Outpatient,,,3108,2020.20,,2735.04,88,,,percent of total billed charges,88% of total Billed charges,155.69,100,,,Fee Schedule,100% of Medicare rate,816.31,100,,,Fee Schedule,100% of WA Medicaid,3108,100,,,percent of total billed charges,100% of total billed charges,840.8,103,,,Fee Schedule,103% of WA Medicaid,155.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,272.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,816.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2144.52,69,,,percent of total billed charges,69% of total billed charges,3108,100,,,percent of total billed charges,100% of total billed charges,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3108,100,,,percent of total billed charges,100% of total billed charges,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3108,100,,,percent of total billed charges,100% of total billed charges,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1922.3,61.85,,,percent of total billed charges,61.85% of total billed charges,816.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,816.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,832.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1061.2,130,,,Fee Schedule,130% of WA Medicaid ,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1171.72,37.7,,,percent of total billed charges,37.70% of total billed charges,1171.72,37.7,,,percent of total billed charges,37.70% of total billed charges,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,105361.2,33.9,,,percent of total billed charges,33.9% of total billed charges,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2424.24,78,,,percent of total billed charges,78% of total billed charges,3108,100,,,percent of total billed charges,100% of total billed charges,2567.21,82.6,,,percent of total billed charges,82.6% of total billed charges,2567.21,82.6,,,percent of total billed charges,82.6% of total billed charges,816.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,155.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,816.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,155.69,105361.2,
EXPLORATION REPAIR;RECTAL INJU,96045562,CDM,960,RC,45562,HCPCS,Outpatient,,,2357,1532.05,,2074.16,88,,,percent of total billed charges,88% of total Billed charges,154.62,100,,,Fee Schedule,100% of Medicare rate,659.09,100,,,Fee Schedule,100% of WA Medicaid,2357,100,,,percent of total billed charges,100% of total billed charges,678.86,103,,,Fee Schedule,103% of WA Medicaid,154.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,270.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,659.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1626.33,69,,,percent of total billed charges,69% of total billed charges,2357,100,,,percent of total billed charges,100% of total billed charges,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2357,100,,,percent of total billed charges,100% of total billed charges,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2357,100,,,percent of total billed charges,100% of total billed charges,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.8,61.85,,,percent of total billed charges,61.85% of total billed charges,659.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,672.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.82,130,,,Fee Schedule,130% of WA Medicaid ,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,888.59,37.7,,,percent of total billed charges,37.70% of total billed charges,888.59,37.7,,,percent of total billed charges,37.70% of total billed charges,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,79902.3,33.9,,,percent of total billed charges,33.9% of total billed charges,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1838.46,78,,,percent of total billed charges,78% of total billed charges,2357,100,,,percent of total billed charges,100% of total billed charges,1946.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1946.88,82.6,,,percent of total billed charges,82.6% of total billed charges,659.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,154.62,79902.3,
REMOVAL RECTAL OBSTRUCTION,96045915,CDM,960,RC,45915,HCPCS,Outpatient,,,731,475.15,,643.28,88,,,percent of total billed charges,88% of total Billed charges,22.47,100,,,Fee Schedule,100% of Medicare rate,131.3,100,,,Fee Schedule,100% of WA Medicaid,731,100,,,percent of total billed charges,100% of total billed charges,135.24,103,,,Fee Schedule,103% of WA Medicaid,22.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,131.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,504.39,69,,,percent of total billed charges,69% of total billed charges,731,100,,,percent of total billed charges,100% of total billed charges,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,731,100,,,percent of total billed charges,100% of total billed charges,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,731,100,,,percent of total billed charges,100% of total billed charges,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.12,61.85,,,percent of total billed charges,61.85% of total billed charges,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,170.69,130,,,Fee Schedule,130% of WA Medicaid ,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.59,37.7,,,percent of total billed charges,37.70% of total billed charges,275.59,37.7,,,percent of total billed charges,37.70% of total billed charges,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,24780.9,33.9,,,percent of total billed charges,33.9% of total billed charges,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,570.18,78,,,percent of total billed charges,78% of total billed charges,731,100,,,percent of total billed charges,100% of total billed charges,603.81,82.6,,,percent of total billed charges,82.6% of total billed charges,603.81,82.6,,,percent of total billed charges,82.6% of total billed charges,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.47,24780.9,
PLACEMENT OF SETON,96046020,CDM,960,RC,46020,HCPCS,Outpatient,,,374,243.10,,329.12,88,,,percent of total billed charges,88% of total Billed charges,12.57,100,,,Fee Schedule,100% of Medicare rate,66.21,100,,,Fee Schedule,100% of WA Medicaid,374,100,,,percent of total billed charges,100% of total billed charges,68.2,103,,,Fee Schedule,103% of WA Medicaid,12.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,258.06,69,,,percent of total billed charges,69% of total billed charges,374,100,,,percent of total billed charges,100% of total billed charges,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,374,100,,,percent of total billed charges,100% of total billed charges,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,374,100,,,percent of total billed charges,100% of total billed charges,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.32,61.85,,,percent of total billed charges,61.85% of total billed charges,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,86.07,130,,,Fee Schedule,130% of WA Medicaid ,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,141,37.7,,,percent of total billed charges,37.70% of total billed charges,141,37.7,,,percent of total billed charges,37.70% of total billed charges,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,12678.6,33.9,,,percent of total billed charges,33.9% of total billed charges,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.72,78,,,percent of total billed charges,78% of total billed charges,374,100,,,percent of total billed charges,100% of total billed charges,308.92,82.6,,,percent of total billed charges,82.6% of total billed charges,308.92,82.6,,,percent of total billed charges,82.6% of total billed charges,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.57,12678.6,
"46030 REMOVAL OF ANAL SETON, OTHER MARKER ProFee",97546030,CDM,975,RC,46030,HCPCS,Outpatient,,,398,258.70,,350.24,88,,,percent of total billed charges,88% of total Billed charges,8.81,100,,,Fee Schedule,100% of Medicare rate,49.05,100,,,Fee Schedule,100% of WA Medicaid,398,100,,,percent of total billed charges,100% of total billed charges,50.52,103,,,Fee Schedule,103% of WA Medicaid,8.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,274.62,69,,,percent of total billed charges,69% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,398,100,,,percent of total billed charges,100% of total billed charges,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,398,100,,,percent of total billed charges,100% of total billed charges,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.16,61.85,,,percent of total billed charges,61.85% of total billed charges,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.77,130,,,Fee Schedule,130% of WA Medicaid ,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,13492.2,33.9,,,percent of total billed charges,33.9% of total billed charges,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.44,78,,,percent of total billed charges,78% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.81,13492.2,
ID OF PERIRECTAL ABSCESS,96046040,CDM,960,RC,46040,HCPCS,Outpatient,,,1126,731.90,,990.88,88,,,percent of total billed charges,88% of total Billed charges,43.3,100,,,Fee Schedule,100% of Medicare rate,246.37,100,,,Fee Schedule,100% of WA Medicaid,1126,100,,,percent of total billed charges,100% of total billed charges,253.76,103,,,Fee Schedule,103% of WA Medicaid,43.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,246.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,776.94,69,,,percent of total billed charges,69% of total billed charges,1126,100,,,percent of total billed charges,100% of total billed charges,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1126,100,,,percent of total billed charges,100% of total billed charges,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1126,100,,,percent of total billed charges,100% of total billed charges,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.43,61.85,,,percent of total billed charges,61.85% of total billed charges,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,320.28,130,,,Fee Schedule,130% of WA Medicaid ,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.5,37.7,,,percent of total billed charges,37.70% of total billed charges,424.5,37.7,,,percent of total billed charges,37.70% of total billed charges,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,38171.4,33.9,,,percent of total billed charges,33.9% of total billed charges,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,878.28,78,,,percent of total billed charges,78% of total billed charges,1126,100,,,percent of total billed charges,100% of total billed charges,930.08,82.6,,,percent of total billed charges,82.6% of total billed charges,930.08,82.6,,,percent of total billed charges,82.6% of total billed charges,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.3,38171.4,
ID PERIANAL ABSCESS,97546050,CDM,975,RC,46050,HCPCS,Outpatient,,,449,291.85,,395.12,88,,,percent of total billed charges,88% of total Billed charges,9.32,100,,,Fee Schedule,100% of Medicare rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,449,100,,,percent of total billed charges,100% of total billed charges,60.7,103,,,Fee Schedule,103% of WA Medicaid,9.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,309.81,69,,,percent of total billed charges,69% of total billed charges,449,100,,,percent of total billed charges,100% of total billed charges,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,449,100,,,percent of total billed charges,100% of total billed charges,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,449,100,,,percent of total billed charges,100% of total billed charges,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.71,61.85,,,percent of total billed charges,61.85% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.61,130,,,Fee Schedule,130% of WA Medicaid ,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.27,37.7,,,percent of total billed charges,37.70% of total billed charges,169.27,37.7,,,percent of total billed charges,37.70% of total billed charges,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,15221.1,33.9,,,percent of total billed charges,33.9% of total billed charges,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.22,78,,,percent of total billed charges,78% of total billed charges,449,100,,,percent of total billed charges,100% of total billed charges,370.87,82.6,,,percent of total billed charges,82.6% of total billed charges,370.87,82.6,,,percent of total billed charges,82.6% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.32,15221.1,
REMOVAL OF ANAL FISSURE,97546200,CDM,975,RC,46200,HCPCS,Outpatient,,,1268,824.20,,1115.84,88,,,percent of total billed charges,88% of total Billed charges,26.22,100,,,Fee Schedule,100% of Medicare rate,198.62,100,,,Fee Schedule,100% of WA Medicaid,1268,100,,,percent of total billed charges,100% of total billed charges,204.58,103,,,Fee Schedule,103% of WA Medicaid,26.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,198.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,874.92,69,,,percent of total billed charges,69% of total billed charges,1268,100,,,percent of total billed charges,100% of total billed charges,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1268,100,,,percent of total billed charges,100% of total billed charges,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1268,100,,,percent of total billed charges,100% of total billed charges,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,784.26,61.85,,,percent of total billed charges,61.85% of total billed charges,198.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,258.21,130,,,Fee Schedule,130% of WA Medicaid ,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.04,37.7,,,percent of total billed charges,37.70% of total billed charges,478.04,37.7,,,percent of total billed charges,37.70% of total billed charges,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,42985.2,33.9,,,percent of total billed charges,33.9% of total billed charges,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,989.04,78,,,percent of total billed charges,78% of total billed charges,1268,100,,,percent of total billed charges,100% of total billed charges,1047.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1047.37,82.6,,,percent of total billed charges,82.6% of total billed charges,198.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.22,42985.2,
RUBBERBAND HEMORR,96046221,CDM,960,RC,46221,HCPCS,Outpatient,,,1242,807.30,,1092.96,88,,,percent of total billed charges,88% of total Billed charges,14.95,100,,,Fee Schedule,100% of Medicare rate,111.9,100,,,Fee Schedule,100% of WA Medicaid,1242,100,,,percent of total billed charges,100% of total billed charges,115.26,103,,,Fee Schedule,103% of WA Medicaid,14.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,111.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,856.98,69,,,percent of total billed charges,69% of total billed charges,1242,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1242,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1242,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,768.18,61.85,,,percent of total billed charges,61.85% of total billed charges,111.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.47,130,,,Fee Schedule,130% of WA Medicaid ,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.23,37.7,,,percent of total billed charges,37.70% of total billed charges,468.23,37.7,,,percent of total billed charges,37.70% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,42103.8,33.9,,,percent of total billed charges,33.9% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,968.76,78,,,percent of total billed charges,78% of total billed charges,1242,100,,,percent of total billed charges,100% of total billed charges,1025.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1025.89,82.6,,,percent of total billed charges,82.6% of total billed charges,111.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.95,42103.8,
EXC MULT EXT PAPILLAE  TAGS,96046230,CDM,960,RC,46230,HCPCS,Outpatient,,,609,395.85,,535.92,88,,,percent of total billed charges,88% of total Billed charges,17.44,100,,,Fee Schedule,100% of Medicare rate,99.59,100,,,Fee Schedule,100% of WA Medicaid,609,100,,,percent of total billed charges,100% of total billed charges,102.58,103,,,Fee Schedule,103% of WA Medicaid,17.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,99.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,420.21,69,,,percent of total billed charges,69% of total billed charges,609,100,,,percent of total billed charges,100% of total billed charges,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,609,100,,,percent of total billed charges,100% of total billed charges,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,609,100,,,percent of total billed charges,100% of total billed charges,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.67,61.85,,,percent of total billed charges,61.85% of total billed charges,99.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.47,130,,,Fee Schedule,130% of WA Medicaid ,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.59,37.7,,,percent of total billed charges,37.70% of total billed charges,229.59,37.7,,,percent of total billed charges,37.70% of total billed charges,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,20645.1,33.9,,,percent of total billed charges,33.9% of total billed charges,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.02,78,,,percent of total billed charges,78% of total billed charges,609,100,,,percent of total billed charges,100% of total billed charges,503.03,82.6,,,percent of total billed charges,82.6% of total billed charges,503.03,82.6,,,percent of total billed charges,82.6% of total billed charges,99.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.44,20645.1,
EXTERNAL HEMORRHOIDECTOMY,97546250,CDM,975,RC,46250,HCPCS,Outpatient,,,1018,661.70,,895.84,88,,,percent of total billed charges,88% of total Billed charges,30.94,100,,,Fee Schedule,100% of Medicare rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,1018,100,,,percent of total billed charges,100% of total billed charges,189.41,103,,,Fee Schedule,103% of WA Medicaid,30.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,702.42,69,,,percent of total billed charges,69% of total billed charges,1018,100,,,percent of total billed charges,100% of total billed charges,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1018,100,,,percent of total billed charges,100% of total billed charges,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1018,100,,,percent of total billed charges,100% of total billed charges,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.63,61.85,,,percent of total billed charges,61.85% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,239.06,130,,,Fee Schedule,130% of WA Medicaid ,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.79,37.7,,,percent of total billed charges,37.70% of total billed charges,383.79,37.7,,,percent of total billed charges,37.70% of total billed charges,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,34510.2,33.9,,,percent of total billed charges,33.9% of total billed charges,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,794.04,78,,,percent of total billed charges,78% of total billed charges,1018,100,,,percent of total billed charges,100% of total billed charges,840.87,82.6,,,percent of total billed charges,82.6% of total billed charges,840.87,82.6,,,percent of total billed charges,82.6% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.94,34510.2,
HEMORRHOIDECTOMY,96046255,CDM,975,RC,46255,HCPCS,Outpatient,,,1069,694.85,,940.72,88,,,percent of total billed charges,88% of total Billed charges,34.88,100,,,Fee Schedule,100% of Medicare rate,204.4,100,,,Fee Schedule,100% of WA Medicaid,1069,100,,,percent of total billed charges,100% of total billed charges,210.53,103,,,Fee Schedule,103% of WA Medicaid,34.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,204.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,737.61,69,,,percent of total billed charges,69% of total billed charges,1069,100,,,percent of total billed charges,100% of total billed charges,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1069,100,,,percent of total billed charges,100% of total billed charges,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1069,100,,,percent of total billed charges,100% of total billed charges,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,661.18,61.85,,,percent of total billed charges,61.85% of total billed charges,204.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,265.72,130,,,Fee Schedule,130% of WA Medicaid ,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.01,37.7,,,percent of total billed charges,37.70% of total billed charges,403.01,37.7,,,percent of total billed charges,37.70% of total billed charges,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,36239.1,33.9,,,percent of total billed charges,33.9% of total billed charges,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,833.82,78,,,percent of total billed charges,78% of total billed charges,1069,100,,,percent of total billed charges,100% of total billed charges,882.99,82.6,,,percent of total billed charges,82.6% of total billed charges,882.99,82.6,,,percent of total billed charges,82.6% of total billed charges,204.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.88,36239.1,
HEMORRHOIDECTOMY,96046260,CDM,960,RC,46260,HCPCS,Outpatient,,,1002,651.30,,881.76,88,,,percent of total billed charges,88% of total Billed charges,49.09,100,,,Fee Schedule,100% of Medicare rate,277.33,100,,,Fee Schedule,100% of WA Medicaid,1002,100,,,percent of total billed charges,100% of total billed charges,285.65,103,,,Fee Schedule,103% of WA Medicaid,49.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,277.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,691.38,69,,,percent of total billed charges,69% of total billed charges,1002,100,,,percent of total billed charges,100% of total billed charges,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1002,100,,,percent of total billed charges,100% of total billed charges,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1002,100,,,percent of total billed charges,100% of total billed charges,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,619.74,61.85,,,percent of total billed charges,61.85% of total billed charges,277.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,360.53,130,,,Fee Schedule,130% of WA Medicaid ,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.75,37.7,,,percent of total billed charges,37.70% of total billed charges,377.75,37.7,,,percent of total billed charges,37.70% of total billed charges,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,33967.8,33.9,,,percent of total billed charges,33.9% of total billed charges,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,781.56,78,,,percent of total billed charges,78% of total billed charges,1002,100,,,percent of total billed charges,100% of total billed charges,827.65,82.6,,,percent of total billed charges,82.6% of total billed charges,827.65,82.6,,,percent of total billed charges,82.6% of total billed charges,277.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.09,33967.8,
SURG TRMT ANAL FISTULA,96046270,CDM,960,RC,46270,HCPCS,Outpatient,,,1073,697.45,,944.24,88,,,percent of total billed charges,88% of total Billed charges,37.65,100,,,Fee Schedule,100% of Medicare rate,232.94,100,,,Fee Schedule,100% of WA Medicaid,1073,100,,,percent of total billed charges,100% of total billed charges,239.93,103,,,Fee Schedule,103% of WA Medicaid,37.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,232.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,740.37,69,,,percent of total billed charges,69% of total billed charges,1073,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1073,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1073,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.65,61.85,,,percent of total billed charges,61.85% of total billed charges,232.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,302.82,130,,,Fee Schedule,130% of WA Medicaid ,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.52,37.7,,,percent of total billed charges,37.70% of total billed charges,404.52,37.7,,,percent of total billed charges,37.70% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,36374.7,33.9,,,percent of total billed charges,33.9% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,836.94,78,,,percent of total billed charges,78% of total billed charges,1073,100,,,percent of total billed charges,100% of total billed charges,886.3,82.6,,,percent of total billed charges,82.6% of total billed charges,886.3,82.6,,,percent of total billed charges,82.6% of total billed charges,232.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.65,36374.7,
SURG TRMT OF ANAL FIST;INTSPHI,96046275,CDM,960,RC,46275,HCPCS,Outpatient,,,1142,742.30,,1004.96,88,,,percent of total billed charges,88% of total Billed charges,37.79,100,,,Fee Schedule,100% of Medicare rate,245.25,100,,,Fee Schedule,100% of WA Medicaid,1142,100,,,percent of total billed charges,100% of total billed charges,252.61,103,,,Fee Schedule,103% of WA Medicaid,37.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,245.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,787.98,69,,,percent of total billed charges,69% of total billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1142,100,,,percent of total billed charges,100% of total billed charges,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1142,100,,,percent of total billed charges,100% of total billed charges,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,706.33,61.85,,,percent of total billed charges,61.85% of total billed charges,245.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,318.83,130,,,Fee Schedule,130% of WA Medicaid ,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.53,37.7,,,percent of total billed charges,37.70% of total billed charges,430.53,37.7,,,percent of total billed charges,37.70% of total billed charges,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,38713.8,33.9,,,percent of total billed charges,33.9% of total billed charges,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,890.76,78,,,percent of total billed charges,78% of total billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,943.29,82.6,,,percent of total billed charges,82.6% of total billed charges,943.29,82.6,,,percent of total billed charges,82.6% of total billed charges,245.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.79,38713.8,
EXC THROMBOSED EXT HERNIA,97546320,CDM,975,RC,46320,HCPCS,Outpatient,,,409,265.85,,359.92,88,,,percent of total billed charges,88% of total Billed charges,10.96,100,,,Fee Schedule,100% of Medicare rate,65.46,100,,,Fee Schedule,100% of WA Medicaid,409,100,,,percent of total billed charges,100% of total billed charges,67.42,103,,,Fee Schedule,103% of WA Medicaid,10.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,65.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,282.21,69,,,percent of total billed charges,69% of total billed charges,409,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,409,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,409,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.97,61.85,,,percent of total billed charges,61.85% of total billed charges,65.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.1,130,,,Fee Schedule,130% of WA Medicaid ,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.19,37.7,,,percent of total billed charges,37.70% of total billed charges,154.19,37.7,,,percent of total billed charges,37.70% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,13865.1,33.9,,,percent of total billed charges,33.9% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.02,78,,,percent of total billed charges,78% of total billed charges,409,100,,,percent of total billed charges,100% of total billed charges,337.83,82.6,,,percent of total billed charges,82.6% of total billed charges,337.83,82.6,,,percent of total billed charges,82.6% of total billed charges,65.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.96,13865.1,
DESTRUCTION SURG EXC LESION,97546922,CDM,975,RC,46922,HCPCS,Outpatient,,,594,386.10,,522.72,88,,,percent of total billed charges,88% of total Billed charges,13.52,100,,,Fee Schedule,100% of Medicare rate,79.64,100,,,Fee Schedule,100% of WA Medicaid,594,100,,,percent of total billed charges,100% of total billed charges,82.03,103,,,Fee Schedule,103% of WA Medicaid,13.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,409.86,69,,,percent of total billed charges,69% of total billed charges,594,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,594,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,594,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.39,61.85,,,percent of total billed charges,61.85% of total billed charges,79.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.53,130,,,Fee Schedule,130% of WA Medicaid ,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.94,37.7,,,percent of total billed charges,37.70% of total billed charges,223.94,37.7,,,percent of total billed charges,37.70% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,20136.6,33.9,,,percent of total billed charges,33.9% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.32,78,,,percent of total billed charges,78% of total billed charges,594,100,,,percent of total billed charges,100% of total billed charges,490.64,82.6,,,percent of total billed charges,82.6% of total billed charges,490.64,82.6,,,percent of total billed charges,82.6% of total billed charges,79.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.52,20136.6,
DESTRUCTION OF LESION;ANAL,96046924,CDM,960,RC,46924,HCPCS,Outpatient,,,1152,748.80,,1013.76,88,,,percent of total billed charges,88% of total Billed charges,16.63,100,,,Fee Schedule,100% of Medicare rate,104.07,100,,,Fee Schedule,100% of WA Medicaid,1152,100,,,percent of total billed charges,100% of total billed charges,107.19,103,,,Fee Schedule,103% of WA Medicaid,16.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,104.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,794.88,69,,,percent of total billed charges,69% of total billed charges,1152,100,,,percent of total billed charges,100% of total billed charges,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152,100,,,percent of total billed charges,100% of total billed charges,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152,100,,,percent of total billed charges,100% of total billed charges,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.51,61.85,,,percent of total billed charges,61.85% of total billed charges,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,135.29,130,,,Fee Schedule,130% of WA Medicaid ,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.3,37.7,,,percent of total billed charges,37.70% of total billed charges,434.3,37.7,,,percent of total billed charges,37.70% of total billed charges,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,39052.8,33.9,,,percent of total billed charges,33.9% of total billed charges,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,898.56,78,,,percent of total billed charges,78% of total billed charges,1152,100,,,percent of total billed charges,100% of total billed charges,951.55,82.6,,,percent of total billed charges,82.6% of total billed charges,951.55,82.6,,,percent of total billed charges,82.6% of total billed charges,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.63,39052.8,
"46946 HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUB",97546946,CDM,975,RC,46946,HCPCS,Outpatient,,,621,403.65,,546.48,88,,,percent of total billed charges,88% of total Billed charges,30.03,100,,,Fee Schedule,100% of Medicare rate,221.38,100,,,Fee Schedule,100% of WA Medicaid,621,100,,,percent of total billed charges,100% of total billed charges,228.02,103,,,Fee Schedule,103% of WA Medicaid,30.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,221.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,428.49,69,,,percent of total billed charges,69% of total billed charges,621,100,,,percent of total billed charges,100% of total billed charges,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,621,100,,,percent of total billed charges,100% of total billed charges,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,621,100,,,percent of total billed charges,100% of total billed charges,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.09,61.85,,,percent of total billed charges,61.85% of total billed charges,221.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,287.79,130,,,Fee Schedule,130% of WA Medicaid ,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.12,37.7,,,percent of total billed charges,37.70% of total billed charges,234.12,37.7,,,percent of total billed charges,37.70% of total billed charges,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,21051.9,33.9,,,percent of total billed charges,33.9% of total billed charges,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,484.38,78,,,percent of total billed charges,78% of total billed charges,621,100,,,percent of total billed charges,100% of total billed charges,512.95,82.6,,,percent of total billed charges,82.6% of total billed charges,512.95,82.6,,,percent of total billed charges,82.6% of total billed charges,221.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.03,21051.9,
"46947 HEMORRHOIDOPEXY (EG, FOR PROLAPSING INTERNAL",97546947,CDM,975,RC,46947,HCPCS,Outpatient,,,1376,894.40,,1210.88,88,,,percent of total billed charges,88% of total Billed charges,43.41,100,,,Fee Schedule,100% of Medicare rate,223.43,100,,,Fee Schedule,100% of WA Medicaid,1376,100,,,percent of total billed charges,100% of total billed charges,230.13,103,,,Fee Schedule,103% of WA Medicaid,43.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,223.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,949.44,69,,,percent of total billed charges,69% of total billed charges,1376,100,,,percent of total billed charges,100% of total billed charges,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1376,100,,,percent of total billed charges,100% of total billed charges,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1376,100,,,percent of total billed charges,100% of total billed charges,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.06,61.85,,,percent of total billed charges,61.85% of total billed charges,223.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,290.46,130,,,Fee Schedule,130% of WA Medicaid ,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,518.75,37.7,,,percent of total billed charges,37.70% of total billed charges,518.75,37.7,,,percent of total billed charges,37.70% of total billed charges,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,46646.4,33.9,,,percent of total billed charges,33.9% of total billed charges,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1073.28,78,,,percent of total billed charges,78% of total billed charges,1376,100,,,percent of total billed charges,100% of total billed charges,1136.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1136.58,82.6,,,percent of total billed charges,82.6% of total billed charges,223.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.41,46646.4,
"UNLISTED PROCEDURE, ANUS",97546999,CDM,975,RC,46999,HCPCS,Outpatient,,,882,573.30,,776.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,882,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,608.58,69,,,percent of total billed charges,69% of total billed charges,882,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,882,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,882,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,545.52,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,332.51,37.7,,,percent of total billed charges,37.70% of total billed charges,332.51,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,29899.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,687.96,78,,,percent of total billed charges,78% of total billed charges,882,100,,,percent of total billed charges,100% of total billed charges,728.53,82.6,,,percent of total billed charges,82.6% of total billed charges,728.53,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",332.51,29899.8,
OPEN DRAINAGE LIVER LESION,96047010,CDM,960,RC,47010,HCPCS,Outpatient,,,5125,3331.25,,4510,88,,,percent of total billed charges,88% of total Billed charges,161.83,100,,,Fee Schedule,100% of Medicare rate,682.22,100,,,Fee Schedule,100% of WA Medicaid,5125,100,,,percent of total billed charges,100% of total billed charges,702.69,103,,,Fee Schedule,103% of WA Medicaid,161.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,283.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,682.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3536.25,69,,,percent of total billed charges,69% of total billed charges,5125,100,,,percent of total billed charges,100% of total billed charges,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,5125,100,,,percent of total billed charges,100% of total billed charges,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,5125,100,,,percent of total billed charges,100% of total billed charges,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3169.81,61.85,,,percent of total billed charges,61.85% of total billed charges,682.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,695.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,886.89,130,,,Fee Schedule,130% of WA Medicaid ,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1932.13,37.7,,,percent of total billed charges,37.70% of total billed charges,1932.13,37.7,,,percent of total billed charges,37.70% of total billed charges,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,173737.5,33.9,,,percent of total billed charges,33.9% of total billed charges,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3997.5,78,,,percent of total billed charges,78% of total billed charges,5125,100,,,percent of total billed charges,100% of total billed charges,4233.25,82.6,,,percent of total billed charges,82.6% of total billed charges,4233.25,82.6,,,percent of total billed charges,82.6% of total billed charges,682.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,161.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,161.83,173737.5,
BIOPSY OF LIVER WEDGE,96047100,CDM,960,RC,47100,HCPCS,Outpatient,,,1796,1167.40,,1580.48,88,,,percent of total billed charges,88% of total Billed charges,108.4,100,,,Fee Schedule,100% of Medicare rate,481.36,100,,,Fee Schedule,100% of WA Medicaid,1796,100,,,percent of total billed charges,100% of total billed charges,495.8,103,,,Fee Schedule,103% of WA Medicaid,108.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,189.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,481.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1239.24,69,,,percent of total billed charges,69% of total billed charges,1796,100,,,percent of total billed charges,100% of total billed charges,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1796,100,,,percent of total billed charges,100% of total billed charges,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1796,100,,,percent of total billed charges,100% of total billed charges,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1110.83,61.85,,,percent of total billed charges,61.85% of total billed charges,481.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,625.77,130,,,Fee Schedule,130% of WA Medicaid ,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.09,37.7,,,percent of total billed charges,37.70% of total billed charges,677.09,37.7,,,percent of total billed charges,37.70% of total billed charges,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,60884.4,33.9,,,percent of total billed charges,33.9% of total billed charges,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1400.88,78,,,percent of total billed charges,78% of total billed charges,1796,100,,,percent of total billed charges,100% of total billed charges,1483.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1483.5,82.6,,,percent of total billed charges,82.6% of total billed charges,481.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.4,60884.4,
MARSUPIALIZATION OF CYST;LIVER,96047300,CDM,960,RC,47300,HCPCS,Outpatient,,,2355,1530.75,,2072.4,88,,,percent of total billed charges,88% of total Billed charges,151.81,100,,,Fee Schedule,100% of Medicare rate,639.7,100,,,Fee Schedule,100% of WA Medicaid,2355,100,,,percent of total billed charges,100% of total billed charges,658.89,103,,,Fee Schedule,103% of WA Medicaid,151.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,265.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,639.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1624.95,69,,,percent of total billed charges,69% of total billed charges,2355,100,,,percent of total billed charges,100% of total billed charges,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2355,100,,,percent of total billed charges,100% of total billed charges,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2355,100,,,percent of total billed charges,100% of total billed charges,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1456.57,61.85,,,percent of total billed charges,61.85% of total billed charges,639.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,652.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,831.61,130,,,Fee Schedule,130% of WA Medicaid ,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,887.84,37.7,,,percent of total billed charges,37.70% of total billed charges,887.84,37.7,,,percent of total billed charges,37.70% of total billed charges,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,79834.5,33.9,,,percent of total billed charges,33.9% of total billed charges,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836.9,78,,,percent of total billed charges,78% of total billed charges,2355,100,,,percent of total billed charges,100% of total billed charges,1945.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1945.23,82.6,,,percent of total billed charges,82.6% of total billed charges,639.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,151.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,151.81,79834.5,
MANAGE OF LIVER HEMORRAGE CMPX,96047360,CDM,960,RC,47360,HCPCS,Outpatient,,,4097,2663.05,,3605.36,88,,,percent of total billed charges,88% of total Billed charges,264.37,100,,,Fee Schedule,100% of Medicare rate,1045.89,100,,,Fee Schedule,100% of WA Medicaid,4097,100,,,percent of total billed charges,100% of total billed charges,1077.27,103,,,Fee Schedule,103% of WA Medicaid,264.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,462.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1045.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2826.93,69,,,percent of total billed charges,69% of total billed charges,4097,100,,,percent of total billed charges,100% of total billed charges,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,4097,100,,,percent of total billed charges,100% of total billed charges,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,4097,100,,,percent of total billed charges,100% of total billed charges,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2533.99,61.85,,,percent of total billed charges,61.85% of total billed charges,1045.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1066.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1359.66,130,,,Fee Schedule,130% of WA Medicaid ,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1544.57,37.7,,,percent of total billed charges,37.70% of total billed charges,1544.57,37.7,,,percent of total billed charges,37.70% of total billed charges,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,138888.3,33.9,,,percent of total billed charges,33.9% of total billed charges,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,3195.66,78,,,percent of total billed charges,78% of total billed charges,4097,100,,,percent of total billed charges,100% of total billed charges,3384.12,82.6,,,percent of total billed charges,82.6% of total billed charges,3384.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,264.37,138888.3,
MGMT LIVER HEMORRHAGE,96047361,CDM,960,RC,47361,HCPCS,Outpatient,,,6657,4327.05,,5858.16,88,,,percent of total billed charges,88% of total Billed charges,417.31,100,,,Fee Schedule,100% of Medicare rate,1670.48,100,,,Fee Schedule,100% of WA Medicaid,6657,100,,,percent of total billed charges,100% of total billed charges,1720.59,103,,,Fee Schedule,103% of WA Medicaid,417.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,730.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1670.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4593.33,69,,,percent of total billed charges,69% of total billed charges,6657,100,,,percent of total billed charges,100% of total billed charges,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,6657,100,,,percent of total billed charges,100% of total billed charges,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,6657,100,,,percent of total billed charges,100% of total billed charges,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,4117.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1670.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1670.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1703.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2171.62,130,,,Fee Schedule,130% of WA Medicaid ,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2509.69,37.7,,,percent of total billed charges,37.70% of total billed charges,2509.69,37.7,,,percent of total billed charges,37.70% of total billed charges,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,225672.3,33.9,,,percent of total billed charges,33.9% of total billed charges,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,5192.46,78,,,percent of total billed charges,78% of total billed charges,6657,100,,,percent of total billed charges,100% of total billed charges,5498.68,82.6,,,percent of total billed charges,82.6% of total billed charges,5498.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1670.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1670.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,417.31,225672.3,
PERCUT ABLATE LIVER RF,96047382,CDM,960,RC,47382,HCPCS,Outpatient,,,20882,13573.30,,18376.16,88,,,percent of total billed charges,88% of total Billed charges,62.47,100,,,Fee Schedule,100% of Medicare rate,405.64,100,,,Fee Schedule,100% of WA Medicaid,20882,100,,,percent of total billed charges,100% of total billed charges,417.81,103,,,Fee Schedule,103% of WA Medicaid,62.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,405.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,14408.58,69,,,percent of total billed charges,69% of total billed charges,20882,100,,,percent of total billed charges,100% of total billed charges,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,20882,100,,,percent of total billed charges,100% of total billed charges,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,20882,100,,,percent of total billed charges,100% of total billed charges,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,12915.52,61.85,,,percent of total billed charges,61.85% of total billed charges,405.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,527.33,130,,,Fee Schedule,130% of WA Medicaid ,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,7872.51,37.7,,,percent of total billed charges,37.70% of total billed charges,7872.51,37.7,,,percent of total billed charges,37.70% of total billed charges,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,707899.8,33.9,,,percent of total billed charges,33.9% of total billed charges,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,16287.96,78,,,percent of total billed charges,78% of total billed charges,20882,100,,,percent of total billed charges,100% of total billed charges,17248.53,82.6,,,percent of total billed charges,82.6% of total billed charges,17248.53,82.6,,,percent of total billed charges,82.6% of total billed charges,405.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.47,707899.8,
CHOLEDOCHOTOMY W/ EXPL  DRAIN,96047420,CDM,960,RC,47420,HCPCS,Outpatient,,,2801,1820.65,,2464.88,88,,,percent of total billed charges,88% of total Billed charges,181.32,100,,,Fee Schedule,100% of Medicare rate,751.04,100,,,Fee Schedule,100% of WA Medicaid,2801,100,,,percent of total billed charges,100% of total billed charges,773.57,103,,,Fee Schedule,103% of WA Medicaid,181.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,317.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,751.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1932.69,69,,,percent of total billed charges,69% of total billed charges,2801,100,,,percent of total billed charges,100% of total billed charges,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2801,100,,,percent of total billed charges,100% of total billed charges,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2801,100,,,percent of total billed charges,100% of total billed charges,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1732.42,61.85,,,percent of total billed charges,61.85% of total billed charges,751.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,976.35,130,,,Fee Schedule,130% of WA Medicaid ,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1055.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1055.98,37.7,,,percent of total billed charges,37.70% of total billed charges,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,94953.9,33.9,,,percent of total billed charges,33.9% of total billed charges,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2184.78,78,,,percent of total billed charges,78% of total billed charges,2801,100,,,percent of total billed charges,100% of total billed charges,2313.63,82.6,,,percent of total billed charges,82.6% of total billed charges,2313.63,82.6,,,percent of total billed charges,82.6% of total billed charges,751.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,181.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,181.32,94953.9,
"47490 CHOLECYSTOSTOMY, PERCUTANEOUS, COMPLETE PROCEDURE, INC",96047490,CDM,975,RC,47490,HCPCS,Outpatient,,,1170,760.50,,1029.6,88,,,percent of total billed charges,88% of total Billed charges,22.1,100,,,Fee Schedule,100% of Medicare rate,188.55,100,,,Fee Schedule,100% of WA Medicaid,1170,100,,,percent of total billed charges,100% of total billed charges,194.21,103,,,Fee Schedule,103% of WA Medicaid,22.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,188.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,807.3,69,,,percent of total billed charges,69% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1170,100,,,percent of total billed charges,100% of total billed charges,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1170,100,,,percent of total billed charges,100% of total billed charges,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.65,61.85,,,percent of total billed charges,61.85% of total billed charges,188.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,245.12,130,,,Fee Schedule,130% of WA Medicaid ,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,441.09,37.7,,,percent of total billed charges,37.70% of total billed charges,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,39663,33.9,,,percent of total billed charges,33.9% of total billed charges,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,912.6,78,,,percent of total billed charges,78% of total billed charges,1170,100,,,percent of total billed charges,100% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,966.42,82.6,,,percent of total billed charges,82.6% of total billed charges,188.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.1,39663,
"INJECTION PROCEDURE FOR CHOLANGIOGRAPHY, PER",97547531,CDM,975,RC,47531,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,5.44,100,,,Fee Schedule,100% of Medicare rate,39.17,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,40.35,103,,,Fee Schedule,103% of WA Medicaid,5.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,244,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,244,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.91,61.85,,,percent of total billed charges,61.85% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.92,130,,,Fee Schedule,130% of WA Medicaid ,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8271.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.44,8271.6,
NEW CHOLE PTA/STENT W/O DRAIN,96047539,CDM,960,RC,47539,HCPCS,Outpatient,,,1051,683.15,,924.88,88,,,percent of total billed charges,88% of total Billed charges,36.7,100,,,Fee Schedule,100% of Medicare rate,232.57,100,,,Fee Schedule,100% of WA Medicaid,1051,100,,,percent of total billed charges,100% of total billed charges,239.55,103,,,Fee Schedule,103% of WA Medicaid,36.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,232.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,725.19,69,,,percent of total billed charges,69% of total billed charges,1051,100,,,percent of total billed charges,100% of total billed charges,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1051,100,,,percent of total billed charges,100% of total billed charges,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1051,100,,,percent of total billed charges,100% of total billed charges,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,650.04,61.85,,,percent of total billed charges,61.85% of total billed charges,232.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,302.34,130,,,Fee Schedule,130% of WA Medicaid ,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.23,37.7,,,percent of total billed charges,37.70% of total billed charges,396.23,37.7,,,percent of total billed charges,37.70% of total billed charges,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,35628.9,33.9,,,percent of total billed charges,33.9% of total billed charges,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,819.78,78,,,percent of total billed charges,78% of total billed charges,1051,100,,,percent of total billed charges,100% of total billed charges,868.13,82.6,,,percent of total billed charges,82.6% of total billed charges,868.13,82.6,,,percent of total billed charges,82.6% of total billed charges,232.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.7,35628.9,
NEW CHOLE PTA/STENT W/DRAIN,96047540,CDM,960,RC,47540,HCPCS,Outpatient,,,1255,815.75,,1104.4,88,,,percent of total billed charges,88% of total Billed charges,37.59,100,,,Fee Schedule,100% of Medicare rate,239.47,100,,,Fee Schedule,100% of WA Medicaid,1255,100,,,percent of total billed charges,100% of total billed charges,246.65,103,,,Fee Schedule,103% of WA Medicaid,37.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,239.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,865.95,69,,,percent of total billed charges,69% of total billed charges,1255,100,,,percent of total billed charges,100% of total billed charges,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1255,100,,,percent of total billed charges,100% of total billed charges,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1255,100,,,percent of total billed charges,100% of total billed charges,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,776.22,61.85,,,percent of total billed charges,61.85% of total billed charges,239.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,311.31,130,,,Fee Schedule,130% of WA Medicaid ,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.14,37.7,,,percent of total billed charges,37.70% of total billed charges,473.14,37.7,,,percent of total billed charges,37.70% of total billed charges,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,42544.5,33.9,,,percent of total billed charges,33.9% of total billed charges,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,978.9,78,,,percent of total billed charges,78% of total billed charges,1255,100,,,percent of total billed charges,100% of total billed charges,1036.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1036.63,82.6,,,percent of total billed charges,82.6% of total billed charges,239.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.59,42544.5,
"LAPAROSCOPY;SURG,CHOLECYSTECT",96047562,CDM,960,RC,47562,HCPCS,Outpatient,,,1373,892.45,,1208.24,88,,,percent of total billed charges,88% of total Billed charges,88.19,100,,,Fee Schedule,100% of Medicare rate,373.37,100,,,Fee Schedule,100% of WA Medicaid,1373,100,,,percent of total billed charges,100% of total billed charges,384.57,103,,,Fee Schedule,103% of WA Medicaid,88.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,154.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,373.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,947.37,69,,,percent of total billed charges,69% of total billed charges,1373,100,,,percent of total billed charges,100% of total billed charges,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1373,100,,,percent of total billed charges,100% of total billed charges,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1373,100,,,percent of total billed charges,100% of total billed charges,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,849.2,61.85,,,percent of total billed charges,61.85% of total billed charges,373.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,485.38,130,,,Fee Schedule,130% of WA Medicaid ,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.62,37.7,,,percent of total billed charges,37.70% of total billed charges,517.62,37.7,,,percent of total billed charges,37.70% of total billed charges,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,46544.7,33.9,,,percent of total billed charges,33.9% of total billed charges,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1070.94,78,,,percent of total billed charges,78% of total billed charges,1373,100,,,percent of total billed charges,100% of total billed charges,1134.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1134.1,82.6,,,percent of total billed charges,82.6% of total billed charges,373.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.19,46544.7,
LAP CHOLECYSTECTOMY,97547563,CDM,975,RC,47563,HCPCS,Outpatient,,,1491,969.15,,1312.08,88,,,percent of total billed charges,88% of total Billed charges,96.38,100,,,Fee Schedule,100% of Medicare rate,405.64,100,,,Fee Schedule,100% of WA Medicaid,1491,100,,,percent of total billed charges,100% of total billed charges,417.81,103,,,Fee Schedule,103% of WA Medicaid,96.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,168.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,405.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1028.79,69,,,percent of total billed charges,69% of total billed charges,1491,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1491,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1491,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,922.18,61.85,,,percent of total billed charges,61.85% of total billed charges,405.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,527.33,130,,,Fee Schedule,130% of WA Medicaid ,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.11,37.7,,,percent of total billed charges,37.70% of total billed charges,562.11,37.7,,,percent of total billed charges,37.70% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,50544.9,33.9,,,percent of total billed charges,33.9% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162.98,78,,,percent of total billed charges,78% of total billed charges,1491,100,,,percent of total billed charges,100% of total billed charges,1231.57,82.6,,,percent of total billed charges,82.6% of total billed charges,1231.57,82.6,,,percent of total billed charges,82.6% of total billed charges,405.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.38,50544.9,
CHOLECYSTECTOMY,96047600,CDM,960,RC,47600,HCPCS,Outpatient,,,2230,1449.50,,1962.4,88,,,percent of total billed charges,88% of total Billed charges,144.37,100,,,Fee Schedule,100% of Medicare rate,601.84,100,,,Fee Schedule,100% of WA Medicaid,2230,100,,,percent of total billed charges,100% of total billed charges,619.9,103,,,Fee Schedule,103% of WA Medicaid,144.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,252.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,601.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1538.7,69,,,percent of total billed charges,69% of total billed charges,2230,100,,,percent of total billed charges,100% of total billed charges,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2230,100,,,percent of total billed charges,100% of total billed charges,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2230,100,,,percent of total billed charges,100% of total billed charges,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1379.26,61.85,,,percent of total billed charges,61.85% of total billed charges,601.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,601.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,613.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,782.39,130,,,Fee Schedule,130% of WA Medicaid ,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,840.71,37.7,,,percent of total billed charges,37.70% of total billed charges,840.71,37.7,,,percent of total billed charges,37.70% of total billed charges,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,75597,33.9,,,percent of total billed charges,33.9% of total billed charges,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1739.4,78,,,percent of total billed charges,78% of total billed charges,2230,100,,,percent of total billed charges,100% of total billed charges,1841.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1841.98,82.6,,,percent of total billed charges,82.6% of total billed charges,601.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,601.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,144.37,75597,
CHOLECYSTECTOMY W/ GRAMS,96047605,CDM,960,RC,47605,HCPCS,Outpatient,,,2345,1524.25,,2063.6,88,,,percent of total billed charges,88% of total Billed charges,153.82,100,,,Fee Schedule,100% of Medicare rate,633.17,100,,,Fee Schedule,100% of WA Medicaid,2345,100,,,percent of total billed charges,100% of total billed charges,652.17,103,,,Fee Schedule,103% of WA Medicaid,153.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,269.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,633.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1618.05,69,,,percent of total billed charges,69% of total billed charges,2345,100,,,percent of total billed charges,100% of total billed charges,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2345,100,,,percent of total billed charges,100% of total billed charges,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2345,100,,,percent of total billed charges,100% of total billed charges,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1450.38,61.85,,,percent of total billed charges,61.85% of total billed charges,633.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,823.12,130,,,Fee Schedule,130% of WA Medicaid ,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,884.07,37.7,,,percent of total billed charges,37.70% of total billed charges,884.07,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,79495.5,33.9,,,percent of total billed charges,33.9% of total billed charges,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1829.1,78,,,percent of total billed charges,78% of total billed charges,2345,100,,,percent of total billed charges,100% of total billed charges,1936.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1936.97,82.6,,,percent of total billed charges,82.6% of total billed charges,633.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,153.82,79495.5,
EXPLORATORY LAPAROTOMY,96049000,CDM,960,RC,49000,HCPCS,Outpatient,,,1615,1049.75,,1421.2,88,,,percent of total billed charges,88% of total Billed charges,99.4,100,,,Fee Schedule,100% of Medicare rate,433.05,100,,,Fee Schedule,100% of WA Medicaid,1615,100,,,percent of total billed charges,100% of total billed charges,446.04,103,,,Fee Schedule,103% of WA Medicaid,99.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,433.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1114.35,69,,,percent of total billed charges,69% of total billed charges,1615,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1615,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1615,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,998.88,61.85,,,percent of total billed charges,61.85% of total billed charges,433.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562.97,130,,,Fee Schedule,130% of WA Medicaid ,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.86,37.7,,,percent of total billed charges,37.70% of total billed charges,608.86,37.7,,,percent of total billed charges,37.70% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,54748.5,33.9,,,percent of total billed charges,33.9% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259.7,78,,,percent of total billed charges,78% of total billed charges,1615,100,,,percent of total billed charges,100% of total billed charges,1333.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1333.99,82.6,,,percent of total billed charges,82.6% of total billed charges,433.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.4,54748.5,
REOPENING OF RECENT LAPAROTOMY,96049002,CDM,960,RC,49002,HCPCS,Outpatient,,,2187,1421.55,,1924.56,88,,,percent of total billed charges,88% of total Billed charges,140.83,100,,,Fee Schedule,100% of Medicare rate,583.56,100,,,Fee Schedule,100% of WA Medicaid,2187,100,,,percent of total billed charges,100% of total billed charges,601.07,103,,,Fee Schedule,103% of WA Medicaid,140.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,246.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,583.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1509.03,69,,,percent of total billed charges,69% of total billed charges,2187,100,,,percent of total billed charges,100% of total billed charges,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2187,100,,,percent of total billed charges,100% of total billed charges,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2187,100,,,percent of total billed charges,100% of total billed charges,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1352.66,61.85,,,percent of total billed charges,61.85% of total billed charges,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,595.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,758.63,130,,,Fee Schedule,130% of WA Medicaid ,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,824.5,37.7,,,percent of total billed charges,37.70% of total billed charges,824.5,37.7,,,percent of total billed charges,37.70% of total billed charges,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,74139.3,33.9,,,percent of total billed charges,33.9% of total billed charges,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1705.86,78,,,percent of total billed charges,78% of total billed charges,2187,100,,,percent of total billed charges,100% of total billed charges,1806.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1806.46,82.6,,,percent of total billed charges,82.6% of total billed charges,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.83,74139.3,
EXPLORATION RETROPERITONEAL AR,96049010,CDM,960,RC,49010,HCPCS,Outpatient,,,1958,1272.70,,1723.04,88,,,percent of total billed charges,88% of total Billed charges,124.52,100,,,Fee Schedule,100% of Medicare rate,515.11,100,,,Fee Schedule,100% of WA Medicaid,1958,100,,,percent of total billed charges,100% of total billed charges,530.56,103,,,Fee Schedule,103% of WA Medicaid,124.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,217.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,515.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1351.02,69,,,percent of total billed charges,69% of total billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1958,100,,,percent of total billed charges,100% of total billed charges,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1958,100,,,percent of total billed charges,100% of total billed charges,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1211.02,61.85,,,percent of total billed charges,61.85% of total billed charges,515.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,669.64,130,,,Fee Schedule,130% of WA Medicaid ,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,738.17,37.7,,,percent of total billed charges,37.70% of total billed charges,738.17,37.7,,,percent of total billed charges,37.70% of total billed charges,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,66376.2,33.9,,,percent of total billed charges,33.9% of total billed charges,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1527.24,78,,,percent of total billed charges,78% of total billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,1617.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1617.31,82.6,,,percent of total billed charges,82.6% of total billed charges,515.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.52,66376.2,
DRAINAGE OF PERITONEAL ABSCESS,96049020,CDM,960,RC,49020,HCPCS,Outpatient,,,3326,2161.90,,2926.88,88,,,percent of total billed charges,88% of total Billed charges,210.67,100,,,Fee Schedule,100% of Medicare rate,894.08,100,,,Fee Schedule,100% of WA Medicaid,3326,100,,,percent of total billed charges,100% of total billed charges,920.9,103,,,Fee Schedule,103% of WA Medicaid,210.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,368.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,894.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2294.94,69,,,percent of total billed charges,69% of total billed charges,3326,100,,,percent of total billed charges,100% of total billed charges,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,3326,100,,,percent of total billed charges,100% of total billed charges,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,3326,100,,,percent of total billed charges,100% of total billed charges,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2057.13,61.85,,,percent of total billed charges,61.85% of total billed charges,894.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,911.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1162.3,130,,,Fee Schedule,130% of WA Medicaid ,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1253.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1253.9,37.7,,,percent of total billed charges,37.70% of total billed charges,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,112751.4,33.9,,,percent of total billed charges,33.9% of total billed charges,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2594.28,78,,,percent of total billed charges,78% of total billed charges,3326,100,,,percent of total billed charges,100% of total billed charges,2747.28,82.6,,,percent of total billed charges,82.6% of total billed charges,2747.28,82.6,,,percent of total billed charges,82.6% of total billed charges,894.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.67,112751.4,
"49040 DRAINAGE OF SUBDIAPHRAGMATIC OR SUBPHRENIC ABSCESS, OP",97549040,CDM,975,RC,49040,HCPCS,Outpatient,,,2107,1369.55,,1854.16,88,,,percent of total billed charges,88% of total Billed charges,132.5,100,,,Fee Schedule,100% of Medicare rate,563.6,100,,,Fee Schedule,100% of WA Medicaid,2107,100,,,percent of total billed charges,100% of total billed charges,580.51,103,,,Fee Schedule,103% of WA Medicaid,132.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,231.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,563.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1453.83,69,,,percent of total billed charges,69% of total billed charges,2107,100,,,percent of total billed charges,100% of total billed charges,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2107,100,,,percent of total billed charges,100% of total billed charges,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2107,100,,,percent of total billed charges,100% of total billed charges,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1303.18,61.85,,,percent of total billed charges,61.85% of total billed charges,563.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,563.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,732.68,130,,,Fee Schedule,130% of WA Medicaid ,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,794.34,37.7,,,percent of total billed charges,37.70% of total billed charges,794.34,37.7,,,percent of total billed charges,37.70% of total billed charges,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,71427.3,33.9,,,percent of total billed charges,33.9% of total billed charges,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1643.46,78,,,percent of total billed charges,78% of total billed charges,2107,100,,,percent of total billed charges,100% of total billed charges,1740.38,82.6,,,percent of total billed charges,82.6% of total billed charges,1740.38,82.6,,,percent of total billed charges,82.6% of total billed charges,563.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,563.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,132.5,71427.3,
DRAINAGE RETROPERITONEAL ABSC,96049060,CDM,960,RC,49060,HCPCS,Outpatient,,,2306,1498.90,,2029.28,88,,,percent of total billed charges,88% of total Billed charges,141.15,100,,,Fee Schedule,100% of Medicare rate,614.33,100,,,Fee Schedule,100% of WA Medicaid,2306,100,,,percent of total billed charges,100% of total billed charges,632.76,103,,,Fee Schedule,103% of WA Medicaid,141.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,247.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,614.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1591.14,69,,,percent of total billed charges,69% of total billed charges,2306,100,,,percent of total billed charges,100% of total billed charges,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2306,100,,,percent of total billed charges,100% of total billed charges,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2306,100,,,percent of total billed charges,100% of total billed charges,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1426.26,61.85,,,percent of total billed charges,61.85% of total billed charges,614.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,626.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,798.63,130,,,Fee Schedule,130% of WA Medicaid ,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,869.36,37.7,,,percent of total billed charges,37.70% of total billed charges,869.36,37.7,,,percent of total billed charges,37.70% of total billed charges,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,78173.4,33.9,,,percent of total billed charges,33.9% of total billed charges,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1798.68,78,,,percent of total billed charges,78% of total billed charges,2306,100,,,percent of total billed charges,100% of total billed charges,1904.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1904.76,82.6,,,percent of total billed charges,82.6% of total billed charges,614.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,141.15,78173.4,
PARACENTESIS: IMAGING GUIDED,96049083,CDM,975,RC,49083,HCPCS,Outpatient,,,773,502.45,,680.24,88,,,percent of total billed charges,88% of total Billed charges,8.32,100,,,Fee Schedule,100% of Medicare rate,59.12,100,,,Fee Schedule,100% of WA Medicaid,773,100,,,percent of total billed charges,100% of total billed charges,60.89,103,,,Fee Schedule,103% of WA Medicaid,8.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,533.37,69,,,percent of total billed charges,69% of total billed charges,773,100,,,percent of total billed charges,100% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,773,100,,,percent of total billed charges,100% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,773,100,,,percent of total billed charges,100% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.1,61.85,,,percent of total billed charges,61.85% of total billed charges,59.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.86,130,,,Fee Schedule,130% of WA Medicaid ,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.42,37.7,,,percent of total billed charges,37.70% of total billed charges,291.42,37.7,,,percent of total billed charges,37.70% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,26204.7,33.9,,,percent of total billed charges,33.9% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.94,78,,,percent of total billed charges,78% of total billed charges,773,100,,,percent of total billed charges,100% of total billed charges,638.5,82.6,,,percent of total billed charges,82.6% of total billed charges,638.5,82.6,,,percent of total billed charges,82.6% of total billed charges,59.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.32,26204.7,
CT GUIDANCE BIOPSY ABD,96049180,CDM,960,RC,49180,HCPCS,Outpatient,,,410,266.50,,360.8,88,,,percent of total billed charges,88% of total Billed charges,6.83,100,,,Fee Schedule,100% of Medicare rate,45.69,100,,,Fee Schedule,100% of WA Medicaid,410,100,,,percent of total billed charges,100% of total billed charges,47.06,103,,,Fee Schedule,103% of WA Medicaid,6.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,45.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,282.9,69,,,percent of total billed charges,69% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,410,100,,,percent of total billed charges,100% of total billed charges,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,410,100,,,percent of total billed charges,100% of total billed charges,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.59,61.85,,,percent of total billed charges,61.85% of total billed charges,45.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.4,130,,,Fee Schedule,130% of WA Medicaid ,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.57,37.7,,,percent of total billed charges,37.70% of total billed charges,154.57,37.7,,,percent of total billed charges,37.70% of total billed charges,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,13899,33.9,,,percent of total billed charges,33.9% of total billed charges,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.8,78,,,percent of total billed charges,78% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,45.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.83,13899,
"49185 SCLEROTHERAPY OF A FLUID COLLECTION (EG, LYM",97549185,CDM,975,RC,49185,HCPCS,Outpatient,,,410,266.50,,360.8,88,,,percent of total billed charges,88% of total Billed charges,10.49,100,,,Fee Schedule,100% of Medicare rate,65.83,100,,,Fee Schedule,100% of WA Medicaid,410,100,,,percent of total billed charges,100% of total billed charges,67.8,103,,,Fee Schedule,103% of WA Medicaid,10.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,65.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,282.9,69,,,percent of total billed charges,69% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,410,100,,,percent of total billed charges,100% of total billed charges,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,410,100,,,percent of total billed charges,100% of total billed charges,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.59,61.85,,,percent of total billed charges,61.85% of total billed charges,65.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.58,130,,,Fee Schedule,130% of WA Medicaid ,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.57,37.7,,,percent of total billed charges,37.70% of total billed charges,154.57,37.7,,,percent of total billed charges,37.70% of total billed charges,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,13899,33.9,,,percent of total billed charges,33.9% of total billed charges,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.8,78,,,percent of total billed charges,78% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,65.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.49,13899,
EXC ABD TUM 5CM OR LESS,96049203,CDM,960,RC,49203,HCPCS,Outpatient,,,1860,1209.00,,1636.8,88,,,percent of total billed charges,88% of total Billed charges,150.94,100,,,Fee Schedule,100% of Medicare rate,671.96,100,,,Fee Schedule,100% of WA Medicaid,1860,100,,,percent of total billed charges,100% of total billed charges,692.12,103,,,Fee Schedule,103% of WA Medicaid,150.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,264.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,671.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1283.4,69,,,percent of total billed charges,69% of total billed charges,1860,100,,,percent of total billed charges,100% of total billed charges,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1860,100,,,percent of total billed charges,100% of total billed charges,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1860,100,,,percent of total billed charges,100% of total billed charges,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1150.41,61.85,,,percent of total billed charges,61.85% of total billed charges,671.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,873.55,130,,,Fee Schedule,130% of WA Medicaid ,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.22,37.7,,,percent of total billed charges,37.70% of total billed charges,701.22,37.7,,,percent of total billed charges,37.70% of total billed charges,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,63054,33.9,,,percent of total billed charges,33.9% of total billed charges,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1450.8,78,,,percent of total billed charges,78% of total billed charges,1860,100,,,percent of total billed charges,100% of total billed charges,1536.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1536.36,82.6,,,percent of total billed charges,82.6% of total billed charges,671.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,150.94,63054,
EXE/DEST OPEN ABD LESION>10CM,96049205,CDM,960,RC,49205,HCPCS,Outpatient,,,3869,2514.85,,3404.72,88,,,percent of total billed charges,88% of total Billed charges,224.84,100,,,Fee Schedule,100% of Medicare rate,980.24,100,,,Fee Schedule,100% of WA Medicaid,3869,100,,,percent of total billed charges,100% of total billed charges,1009.65,103,,,Fee Schedule,103% of WA Medicaid,224.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,393.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,980.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2669.61,69,,,percent of total billed charges,69% of total billed charges,3869,100,,,percent of total billed charges,100% of total billed charges,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3869,100,,,percent of total billed charges,100% of total billed charges,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3869,100,,,percent of total billed charges,100% of total billed charges,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2392.98,61.85,,,percent of total billed charges,61.85% of total billed charges,980.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,980.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,999.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1274.31,130,,,Fee Schedule,130% of WA Medicaid ,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1458.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1458.61,37.7,,,percent of total billed charges,37.70% of total billed charges,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,131159.1,33.9,,,percent of total billed charges,33.9% of total billed charges,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3017.82,78,,,percent of total billed charges,78% of total billed charges,3869,100,,,percent of total billed charges,100% of total billed charges,3195.79,82.6,,,percent of total billed charges,82.6% of total billed charges,3195.79,82.6,,,percent of total billed charges,82.6% of total billed charges,980.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,980.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,224.84,131159.1,
EXCISION PRE-SACRAL TUMOR,96049215,CDM,960,RC,49215,HCPCS,Outpatient,,,4655,3025.75,,4096.4,88,,,percent of total billed charges,88% of total Billed charges,280.81,100,,,Fee Schedule,100% of Medicare rate,1244.33,100,,,Fee Schedule,100% of WA Medicaid,4655,100,,,percent of total billed charges,100% of total billed charges,1281.66,103,,,Fee Schedule,103% of WA Medicaid,280.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,491.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1244.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3211.95,69,,,percent of total billed charges,69% of total billed charges,4655,100,,,percent of total billed charges,100% of total billed charges,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4655,100,,,percent of total billed charges,100% of total billed charges,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4655,100,,,percent of total billed charges,100% of total billed charges,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2879.12,61.85,,,percent of total billed charges,61.85% of total billed charges,1244.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1244.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1269.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1617.63,130,,,Fee Schedule,130% of WA Medicaid ,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1754.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1754.94,37.7,,,percent of total billed charges,37.70% of total billed charges,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,157804.5,33.9,,,percent of total billed charges,33.9% of total billed charges,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,3630.9,78,,,percent of total billed charges,78% of total billed charges,4655,100,,,percent of total billed charges,100% of total billed charges,3845.03,82.6,,,percent of total billed charges,82.6% of total billed charges,3845.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1244.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1244.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,280.81,157804.5,
OMENTECTOMY,96049255,CDM,960,RC,49255,HCPCS,Outpatient,,,1664,1081.60,,1464.32,88,,,percent of total billed charges,88% of total Billed charges,94.55,100,,,Fee Schedule,100% of Medicare rate,450.02,100,,,Fee Schedule,100% of WA Medicaid,1664,100,,,percent of total billed charges,100% of total billed charges,463.52,103,,,Fee Schedule,103% of WA Medicaid,94.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,165.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,450.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1148.16,69,,,percent of total billed charges,69% of total billed charges,1664,100,,,percent of total billed charges,100% of total billed charges,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1664,100,,,percent of total billed charges,100% of total billed charges,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1664,100,,,percent of total billed charges,100% of total billed charges,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1029.18,61.85,,,percent of total billed charges,61.85% of total billed charges,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,585.03,130,,,Fee Schedule,130% of WA Medicaid ,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,627.33,37.7,,,percent of total billed charges,37.70% of total billed charges,627.33,37.7,,,percent of total billed charges,37.70% of total billed charges,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,56409.6,33.9,,,percent of total billed charges,33.9% of total billed charges,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1297.92,78,,,percent of total billed charges,78% of total billed charges,1664,100,,,percent of total billed charges,100% of total billed charges,1374.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1374.46,82.6,,,percent of total billed charges,82.6% of total billed charges,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.55,56409.6,
DIAGNOSTIC LAPAROSCOPY,97549320,CDM,975,RC,49320,HCPCS,Outpatient,,,717,466.05,,630.96,88,,,percent of total billed charges,88% of total Billed charges,41.51,100,,,Fee Schedule,100% of Medicare rate,186.87,100,,,Fee Schedule,100% of WA Medicaid,717,100,,,percent of total billed charges,100% of total billed charges,192.48,103,,,Fee Schedule,103% of WA Medicaid,41.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,186.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,494.73,69,,,percent of total billed charges,69% of total billed charges,717,100,,,percent of total billed charges,100% of total billed charges,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,717,100,,,percent of total billed charges,100% of total billed charges,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,717,100,,,percent of total billed charges,100% of total billed charges,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.46,61.85,,,percent of total billed charges,61.85% of total billed charges,186.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,242.93,130,,,Fee Schedule,130% of WA Medicaid ,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.31,37.7,,,percent of total billed charges,37.70% of total billed charges,270.31,37.7,,,percent of total billed charges,37.70% of total billed charges,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,24306.3,33.9,,,percent of total billed charges,33.9% of total billed charges,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,559.26,78,,,percent of total billed charges,78% of total billed charges,717,100,,,percent of total billed charges,100% of total billed charges,592.24,82.6,,,percent of total billed charges,82.6% of total billed charges,592.24,82.6,,,percent of total billed charges,82.6% of total billed charges,186.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.51,24306.3,
"49325 LAPAROSCOPY, SURGICAL; WITH REVISION OF PREVIOUSLY PLA",97549325,CDM,975,RC,49325,HCPCS,Outpatient,,,1220,793.00,,1073.6,88,,,percent of total billed charges,88% of total Billed charges,56.86,100,,,Fee Schedule,100% of Medicare rate,231.63,100,,,Fee Schedule,100% of WA Medicaid,1220,100,,,percent of total billed charges,100% of total billed charges,238.58,103,,,Fee Schedule,103% of WA Medicaid,56.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,231.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,841.8,69,,,percent of total billed charges,69% of total billed charges,1220,100,,,percent of total billed charges,100% of total billed charges,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1220,100,,,percent of total billed charges,100% of total billed charges,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1220,100,,,percent of total billed charges,100% of total billed charges,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,754.57,61.85,,,percent of total billed charges,61.85% of total billed charges,231.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,301.12,130,,,Fee Schedule,130% of WA Medicaid ,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.94,37.7,,,percent of total billed charges,37.70% of total billed charges,459.94,37.7,,,percent of total billed charges,37.70% of total billed charges,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,41358,33.9,,,percent of total billed charges,33.9% of total billed charges,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,951.6,78,,,percent of total billed charges,78% of total billed charges,1220,100,,,percent of total billed charges,100% of total billed charges,1007.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1007.72,82.6,,,percent of total billed charges,82.6% of total billed charges,231.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.86,41358,
LAPAROSCOPY ABDO;UNLISTED PROC,96049329,CDM,960,RC,49329,HCPCS,Outpatient,,,1439,935.35,,1266.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1439,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,992.91,69,,,percent of total billed charges,69% of total billed charges,1439,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1439,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1439,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,890.02,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,542.5,37.7,,,percent of total billed charges,37.70% of total billed charges,542.5,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,48782.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1122.42,78,,,percent of total billed charges,78% of total billed charges,1439,100,,,percent of total billed charges,100% of total billed charges,1188.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1188.61,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",542.5,48782.1,
LAPAROSCOPY W/ ASPIRATION,96049322,CDM,960,RC,49322,HCPCS,Outpatient,,,812,527.80,,714.56,88,,,percent of total billed charges,88% of total Billed charges,47.26,100,,,Fee Schedule,100% of Medicare rate,212.24,100,,,Fee Schedule,100% of WA Medicaid,812,100,,,percent of total billed charges,100% of total billed charges,218.61,103,,,Fee Schedule,103% of WA Medicaid,47.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,82.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,212.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,560.28,69,,,percent of total billed charges,69% of total billed charges,812,100,,,percent of total billed charges,100% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,812,100,,,percent of total billed charges,100% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,812,100,,,percent of total billed charges,100% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.22,61.85,,,percent of total billed charges,61.85% of total billed charges,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,275.91,130,,,Fee Schedule,130% of WA Medicaid ,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.12,37.7,,,percent of total billed charges,37.70% of total billed charges,306.12,37.7,,,percent of total billed charges,37.70% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,27526.8,33.9,,,percent of total billed charges,33.9% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.36,78,,,percent of total billed charges,78% of total billed charges,812,100,,,percent of total billed charges,100% of total billed charges,670.71,82.6,,,percent of total billed charges,82.6% of total billed charges,670.71,82.6,,,percent of total billed charges,82.6% of total billed charges,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.26,27526.8,
REM PERITONEAL FB PERITO CAVIT,96049402,CDM,960,RC,49402,HCPCS,Outpatient,,,1787,1161.55,,1572.56,88,,,percent of total billed charges,88% of total Billed charges,114.36,100,,,Fee Schedule,100% of Medicare rate,480.42,100,,,Fee Schedule,100% of WA Medicaid,1787,100,,,percent of total billed charges,100% of total billed charges,494.83,103,,,Fee Schedule,103% of WA Medicaid,114.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,200.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,480.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1233.03,69,,,percent of total billed charges,69% of total billed charges,1787,100,,,percent of total billed charges,100% of total billed charges,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1787,100,,,percent of total billed charges,100% of total billed charges,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1787,100,,,percent of total billed charges,100% of total billed charges,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105.26,61.85,,,percent of total billed charges,61.85% of total billed charges,480.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,624.55,130,,,Fee Schedule,130% of WA Medicaid ,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,673.7,37.7,,,percent of total billed charges,37.70% of total billed charges,673.7,37.7,,,percent of total billed charges,37.70% of total billed charges,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,60579.3,33.9,,,percent of total billed charges,33.9% of total billed charges,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1393.86,78,,,percent of total billed charges,78% of total billed charges,1787,100,,,percent of total billed charges,100% of total billed charges,1476.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1476.06,82.6,,,percent of total billed charges,82.6% of total billed charges,480.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.36,60579.3,
INSERTION PD CATHETER,96049418,CDM,960,RC,49418,HCPCS,Outpatient,,,2956,1921.40,,2601.28,88,,,percent of total billed charges,88% of total Billed charges,17,100,,,Fee Schedule,100% of Medicare rate,110.41,100,,,Fee Schedule,100% of WA Medicaid,2956,100,,,percent of total billed charges,100% of total billed charges,113.72,103,,,Fee Schedule,103% of WA Medicaid,17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,110.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2039.64,69,,,percent of total billed charges,69% of total billed charges,2956,100,,,percent of total billed charges,100% of total billed charges,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2956,100,,,percent of total billed charges,100% of total billed charges,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2956,100,,,percent of total billed charges,100% of total billed charges,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1828.29,61.85,,,percent of total billed charges,61.85% of total billed charges,110.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,143.53,130,,,Fee Schedule,130% of WA Medicaid ,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1114.41,37.7,,,percent of total billed charges,37.70% of total billed charges,1114.41,37.7,,,percent of total billed charges,37.70% of total billed charges,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,100208.4,33.9,,,percent of total billed charges,33.9% of total billed charges,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2305.68,78,,,percent of total billed charges,78% of total billed charges,2956,100,,,percent of total billed charges,100% of total billed charges,2441.66,82.6,,,percent of total billed charges,82.6% of total billed charges,2441.66,82.6,,,percent of total billed charges,82.6% of total billed charges,110.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,17,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17,100208.4,
"49441 INSERTION OF DUODENOSTOMY OR JEJUNOSTOMY TUBE, PERCUTA",49441,CDM,975,RC,49441,HCPCS,Outpatient,,,4147,2695.55,,3649.36,88,,,percent of total billed charges,88% of total Billed charges,23.65,100,,,Fee Schedule,100% of Medicare rate,133.16,100,,,Fee Schedule,100% of WA Medicaid,4147,100,,,percent of total billed charges,100% of total billed charges,137.15,103,,,Fee Schedule,103% of WA Medicaid,23.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,133.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2861.43,69,,,percent of total billed charges,69% of total billed charges,4147,100,,,percent of total billed charges,100% of total billed charges,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,4147,100,,,percent of total billed charges,100% of total billed charges,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,4147,100,,,percent of total billed charges,100% of total billed charges,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2564.92,61.85,,,percent of total billed charges,61.85% of total billed charges,133.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,173.11,130,,,Fee Schedule,130% of WA Medicaid ,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1563.42,37.7,,,percent of total billed charges,37.70% of total billed charges,1563.42,37.7,,,percent of total billed charges,37.70% of total billed charges,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,140583.3,33.9,,,percent of total billed charges,33.9% of total billed charges,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3234.66,78,,,percent of total billed charges,78% of total billed charges,4147,100,,,percent of total billed charges,100% of total billed charges,3425.42,82.6,,,percent of total billed charges,82.6% of total billed charges,3425.42,82.6,,,percent of total billed charges,82.6% of total billed charges,133.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.65,140583.3,
"49451 REPLACEMENT OF DUODENOSTOMY OR JEJUNOSTOMY TUBE, PERCU",97549451,CDM,975,RC,49451,HCPCS,Outpatient,,,2068,1344.20,,1819.84,88,,,percent of total billed charges,88% of total Billed charges,7.76,100,,,Fee Schedule,100% of Medicare rate,48.49,100,,,Fee Schedule,100% of WA Medicaid,2068,100,,,percent of total billed charges,100% of total billed charges,49.94,103,,,Fee Schedule,103% of WA Medicaid,7.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1426.92,69,,,percent of total billed charges,69% of total billed charges,2068,100,,,percent of total billed charges,100% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2068,100,,,percent of total billed charges,100% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2068,100,,,percent of total billed charges,100% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1279.06,61.85,,,percent of total billed charges,61.85% of total billed charges,48.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.04,130,,,Fee Schedule,130% of WA Medicaid ,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,779.64,37.7,,,percent of total billed charges,37.70% of total billed charges,779.64,37.7,,,percent of total billed charges,37.70% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,70105.2,33.9,,,percent of total billed charges,33.9% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1613.04,78,,,percent of total billed charges,78% of total billed charges,2068,100,,,percent of total billed charges,100% of total billed charges,1708.17,82.6,,,percent of total billed charges,82.6% of total billed charges,1708.17,82.6,,,percent of total billed charges,82.6% of total billed charges,48.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.76,70105.2,
REP INCARC ING HERNIA < 5 YRS,96049501,CDM,960,RC,49501,HCPCS,Outpatient,,,1262,820.30,,1110.56,88,,,percent of total billed charges,88% of total Billed charges,80.43,100,,,Fee Schedule,100% of Medicare rate,344.47,100,,,Fee Schedule,100% of WA Medicaid,1262,100,,,percent of total billed charges,100% of total billed charges,354.8,103,,,Fee Schedule,103% of WA Medicaid,80.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,344.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,870.78,69,,,percent of total billed charges,69% of total billed charges,1262,100,,,percent of total billed charges,100% of total billed charges,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262,100,,,percent of total billed charges,100% of total billed charges,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262,100,,,percent of total billed charges,100% of total billed charges,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.55,61.85,,,percent of total billed charges,61.85% of total billed charges,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,447.81,130,,,Fee Schedule,130% of WA Medicaid ,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.77,37.7,,,percent of total billed charges,37.70% of total billed charges,475.77,37.7,,,percent of total billed charges,37.70% of total billed charges,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,42781.8,33.9,,,percent of total billed charges,33.9% of total billed charges,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,984.36,78,,,percent of total billed charges,78% of total billed charges,1262,100,,,percent of total billed charges,100% of total billed charges,1042.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1042.41,82.6,,,percent of total billed charges,82.6% of total billed charges,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.43,42781.8,
INGUINAL HERNIA REPAIR,97549505,CDM,975,RC,49505,HCPCS,Outpatient,,,1088,707.20,,957.44,88,,,percent of total billed charges,88% of total Billed charges,67.83,100,,,Fee Schedule,100% of Medicare rate,297.47,100,,,Fee Schedule,100% of WA Medicaid,1088,100,,,percent of total billed charges,100% of total billed charges,306.39,103,,,Fee Schedule,103% of WA Medicaid,67.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,118.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,297.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,750.72,69,,,percent of total billed charges,69% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1088,100,,,percent of total billed charges,100% of total billed charges,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1088,100,,,percent of total billed charges,100% of total billed charges,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,672.93,61.85,,,percent of total billed charges,61.85% of total billed charges,297.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,386.71,130,,,Fee Schedule,130% of WA Medicaid ,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,410.18,37.7,,,percent of total billed charges,37.70% of total billed charges,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,36883.2,33.9,,,percent of total billed charges,33.9% of total billed charges,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,848.64,78,,,percent of total billed charges,78% of total billed charges,1088,100,,,percent of total billed charges,100% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,898.69,82.6,,,percent of total billed charges,82.6% of total billed charges,297.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.83,36883.2,
ING HERNIA REPAIR;INCARCERATED,96049507,CDM,960,RC,49507,HCPCS,Outpatient,,,1223,794.95,,1076.24,88,,,percent of total billed charges,88% of total Billed charges,76.75,100,,,Fee Schedule,100% of Medicare rate,333.84,100,,,Fee Schedule,100% of WA Medicaid,1223,100,,,percent of total billed charges,100% of total billed charges,343.86,103,,,Fee Schedule,103% of WA Medicaid,76.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,134.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,333.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,843.87,69,,,percent of total billed charges,69% of total billed charges,1223,100,,,percent of total billed charges,100% of total billed charges,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1223,100,,,percent of total billed charges,100% of total billed charges,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1223,100,,,percent of total billed charges,100% of total billed charges,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,756.43,61.85,,,percent of total billed charges,61.85% of total billed charges,333.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,433.99,130,,,Fee Schedule,130% of WA Medicaid ,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.07,37.7,,,percent of total billed charges,37.70% of total billed charges,461.07,37.7,,,percent of total billed charges,37.70% of total billed charges,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,41459.7,33.9,,,percent of total billed charges,33.9% of total billed charges,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,953.94,78,,,percent of total billed charges,78% of total billed charges,1223,100,,,percent of total billed charges,100% of total billed charges,1010.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1010.2,82.6,,,percent of total billed charges,82.6% of total billed charges,333.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.75,41459.7,
REPAIR RECURRENT HERNIA,96049520,CDM,960,RC,49520,HCPCS,Outpatient,,,1318,856.70,,1159.84,88,,,percent of total billed charges,88% of total Billed charges,84.57,100,,,Fee Schedule,100% of Medicare rate,358.83,100,,,Fee Schedule,100% of WA Medicaid,1318,100,,,percent of total billed charges,100% of total billed charges,369.59,103,,,Fee Schedule,103% of WA Medicaid,84.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,148,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,358.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,909.42,69,,,percent of total billed charges,69% of total billed charges,1318,100,,,percent of total billed charges,100% of total billed charges,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1318,100,,,percent of total billed charges,100% of total billed charges,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1318,100,,,percent of total billed charges,100% of total billed charges,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.18,61.85,,,percent of total billed charges,61.85% of total billed charges,358.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,466.48,130,,,Fee Schedule,130% of WA Medicaid ,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.89,37.7,,,percent of total billed charges,37.70% of total billed charges,496.89,37.7,,,percent of total billed charges,37.70% of total billed charges,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,44680.2,33.9,,,percent of total billed charges,33.9% of total billed charges,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1028.04,78,,,percent of total billed charges,78% of total billed charges,1318,100,,,percent of total billed charges,100% of total billed charges,1088.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1088.67,82.6,,,percent of total billed charges,82.6% of total billed charges,358.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84.57,44680.2,
REPAIR LUMBAR HERNIA,96049540,CDM,960,RC,49540,HCPCS,Outpatient,,,1484,964.60,,1305.92,88,,,percent of total billed charges,88% of total Billed charges,88.02,100,,,Fee Schedule,100% of Medicare rate,379.9,100,,,Fee Schedule,100% of WA Medicaid,1484,100,,,percent of total billed charges,100% of total billed charges,391.3,103,,,Fee Schedule,103% of WA Medicaid,88.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,154.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,379.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1023.96,69,,,percent of total billed charges,69% of total billed charges,1484,100,,,percent of total billed charges,100% of total billed charges,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1484,100,,,percent of total billed charges,100% of total billed charges,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1484,100,,,percent of total billed charges,100% of total billed charges,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,917.85,61.85,,,percent of total billed charges,61.85% of total billed charges,379.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,493.87,130,,,Fee Schedule,130% of WA Medicaid ,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,559.47,37.7,,,percent of total billed charges,37.70% of total billed charges,559.47,37.7,,,percent of total billed charges,37.70% of total billed charges,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,50307.6,33.9,,,percent of total billed charges,33.9% of total billed charges,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1157.52,78,,,percent of total billed charges,78% of total billed charges,1484,100,,,percent of total billed charges,100% of total billed charges,1225.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1225.78,82.6,,,percent of total billed charges,82.6% of total billed charges,379.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.02,50307.6,
REPAIR FEMORAL HERNIA,96049550,CDM,960,RC,49550,HCPCS,Outpatient,,,1200,780.00,,1056,88,,,percent of total billed charges,88% of total Billed charges,75.93,100,,,Fee Schedule,100% of Medicare rate,328.05,100,,,Fee Schedule,100% of WA Medicaid,1200,100,,,percent of total billed charges,100% of total billed charges,337.89,103,,,Fee Schedule,103% of WA Medicaid,75.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,132.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,328.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,828,69,,,percent of total billed charges,69% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,742.2,61.85,,,percent of total billed charges,61.85% of total billed charges,328.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,426.47,130,,,Fee Schedule,130% of WA Medicaid ,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,40680,33.9,,,percent of total billed charges,33.9% of total billed charges,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,936,78,,,percent of total billed charges,78% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,328.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.93,40680,
REPAIR INC FEMORAL HERNIA,96049553,CDM,960,RC,49553,HCPCS,Outpatient,,,1318,856.70,,1159.84,88,,,percent of total billed charges,88% of total Billed charges,83.25,100,,,Fee Schedule,100% of Medicare rate,358.45,100,,,Fee Schedule,100% of WA Medicaid,1318,100,,,percent of total billed charges,100% of total billed charges,369.2,103,,,Fee Schedule,103% of WA Medicaid,83.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,145.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,358.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,909.42,69,,,percent of total billed charges,69% of total billed charges,1318,100,,,percent of total billed charges,100% of total billed charges,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1318,100,,,percent of total billed charges,100% of total billed charges,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1318,100,,,percent of total billed charges,100% of total billed charges,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.18,61.85,,,percent of total billed charges,61.85% of total billed charges,358.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,365.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,465.99,130,,,Fee Schedule,130% of WA Medicaid ,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.89,37.7,,,percent of total billed charges,37.70% of total billed charges,496.89,37.7,,,percent of total billed charges,37.70% of total billed charges,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,44680.2,33.9,,,percent of total billed charges,33.9% of total billed charges,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1028.04,78,,,percent of total billed charges,78% of total billed charges,1318,100,,,percent of total billed charges,100% of total billed charges,1088.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1088.67,82.6,,,percent of total billed charges,82.6% of total billed charges,358.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.25,44680.2,
REPAIR RECURRENT FEMORAL HERNI,96049555,CDM,960,RC,49555,HCPCS,Outpatient,,,1243,807.95,,1093.84,88,,,percent of total billed charges,88% of total Billed charges,80.61,100,,,Fee Schedule,100% of Medicare rate,342.97,100,,,Fee Schedule,100% of WA Medicaid,1243,100,,,percent of total billed charges,100% of total billed charges,353.26,103,,,Fee Schedule,103% of WA Medicaid,80.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,141.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,342.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,857.67,69,,,percent of total billed charges,69% of total billed charges,1243,100,,,percent of total billed charges,100% of total billed charges,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1243,100,,,percent of total billed charges,100% of total billed charges,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1243,100,,,percent of total billed charges,100% of total billed charges,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,768.8,61.85,,,percent of total billed charges,61.85% of total billed charges,342.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,445.86,130,,,Fee Schedule,130% of WA Medicaid ,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.61,37.7,,,percent of total billed charges,37.70% of total billed charges,468.61,37.7,,,percent of total billed charges,37.70% of total billed charges,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,42137.7,33.9,,,percent of total billed charges,33.9% of total billed charges,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,969.54,78,,,percent of total billed charges,78% of total billed charges,1243,100,,,percent of total billed charges,100% of total billed charges,1026.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1026.72,82.6,,,percent of total billed charges,82.6% of total billed charges,342.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.61,42137.7,
REPAIR RECUR INCARN FEMOR HERN,96049557,CDM,960,RC,49557,HCPCS,Outpatient,,,1509,980.85,,1327.92,88,,,percent of total billed charges,88% of total Billed charges,97.05,100,,,Fee Schedule,100% of Medicare rate,408.25,100,,,Fee Schedule,100% of WA Medicaid,1509,100,,,percent of total billed charges,100% of total billed charges,420.5,103,,,Fee Schedule,103% of WA Medicaid,97.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,169.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,408.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1041.21,69,,,percent of total billed charges,69% of total billed charges,1509,100,,,percent of total billed charges,100% of total billed charges,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1509,100,,,percent of total billed charges,100% of total billed charges,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1509,100,,,percent of total billed charges,100% of total billed charges,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,933.32,61.85,,,percent of total billed charges,61.85% of total billed charges,408.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,530.73,130,,,Fee Schedule,130% of WA Medicaid ,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,568.89,37.7,,,percent of total billed charges,37.70% of total billed charges,568.89,37.7,,,percent of total billed charges,37.70% of total billed charges,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,51155.1,33.9,,,percent of total billed charges,33.9% of total billed charges,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1177.02,78,,,percent of total billed charges,78% of total billed charges,1509,100,,,percent of total billed charges,100% of total billed charges,1246.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1246.43,82.6,,,percent of total billed charges,82.6% of total billed charges,408.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.05,51155.1,
975,,,975,RC,,,Outpatient,,,1539,1000.35,,1354.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1539,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1061.91,69,,,percent of total billed charges,69% of total billed charges,1539,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1539,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1539,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,951.87,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,580.2,37.7,,,percent of total billed charges,37.70% of total billed charges,580.2,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,52172.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1200.42,78,,,percent of total billed charges,78% of total billed charges,1539,100,,,percent of total billed charges,100% of total billed charges,1271.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1271.21,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",580.2,52172.1,
960,,,960,RC,,,Outpatient,,,1606,1043.90,,1413.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1606,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1108.14,69,,,percent of total billed charges,69% of total billed charges,1606,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1606,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1606,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,993.31,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,605.46,37.7,,,percent of total billed charges,37.70% of total billed charges,605.46,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,54443.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1252.68,78,,,percent of total billed charges,78% of total billed charges,1606,100,,,percent of total billed charges,100% of total billed charges,1326.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1326.56,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",605.46,54443.4,
975,,,975,RC,,,Outpatient,,,557,362.05,,490.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,557,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,384.33,69,,,percent of total billed charges,69% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,557,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,557,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,344.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,18882.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,434.46,78,,,percent of total billed charges,78% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",209.99,18882.3,
960,,,960,RC,,,Outpatient,,,1715,1114.75,,1509.2,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1715,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1183.35,69,,,percent of total billed charges,69% of total billed charges,1715,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1715,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1715,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1060.73,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,646.56,37.7,,,percent of total billed charges,37.70% of total billed charges,646.56,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,58138.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1337.7,78,,,percent of total billed charges,78% of total billed charges,1715,100,,,percent of total billed charges,100% of total billed charges,1416.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1416.59,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",646.56,58138.5,
960,,,960,RC,,,Outpatient,,,1198,778.70,,1054.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1198,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,826.62,69,,,percent of total billed charges,69% of total billed charges,1198,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1198,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1198,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,740.96,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,451.65,37.7,,,percent of total billed charges,37.70% of total billed charges,451.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,40612.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,934.44,78,,,percent of total billed charges,78% of total billed charges,1198,100,,,percent of total billed charges,100% of total billed charges,989.55,82.6,,,percent of total billed charges,82.6% of total billed charges,989.55,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",451.65,40612.2,
RPR AA HRN 1ST < 3 NCR/STRN,49592,CDM,975,RC,49592,HCPCS,Outpatient,,,1586,1030.90,,1395.68,88,,,percent of total billed charges,88% of total Billed charges,69.25,100,,,Fee Schedule,100% of Medicare rate,264.46,100,,,Fee Schedule,100% of WA Medicaid,1586,100,,,percent of total billed charges,100% of total billed charges,272.39,103,,,Fee Schedule,103% of WA Medicaid,69.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,121.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1094.34,69,,,percent of total billed charges,69% of total billed charges,1586,100,,,percent of total billed charges,100% of total billed charges,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1586,100,,,percent of total billed charges,100% of total billed charges,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1586,100,,,percent of total billed charges,100% of total billed charges,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,980.94,61.85,,,percent of total billed charges,61.85% of total billed charges,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,343.8,130,,,Fee Schedule,130% of WA Medicaid ,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.92,37.7,,,percent of total billed charges,37.70% of total billed charges,597.92,37.7,,,percent of total billed charges,37.70% of total billed charges,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,53765.4,33.9,,,percent of total billed charges,33.9% of total billed charges,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1237.08,78,,,percent of total billed charges,78% of total billed charges,1586,100,,,percent of total billed charges,100% of total billed charges,1310.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.04,82.6,,,percent of total billed charges,82.6% of total billed charges,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.25,53765.4,
RPR AA HRN 1ST 3-10 NCR/STRN,49594,CDM,975,RC,49594,HCPCS,Outpatient,,,2486,1615.90,,2187.68,88,,,percent of total billed charges,88% of total Billed charges,109.6,100,,,Fee Schedule,100% of Medicare rate,414.03,100,,,Fee Schedule,100% of WA Medicaid,2486,100,,,percent of total billed charges,100% of total billed charges,426.45,103,,,Fee Schedule,103% of WA Medicaid,109.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,191.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,414.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1715.34,69,,,percent of total billed charges,69% of total billed charges,2486,100,,,percent of total billed charges,100% of total billed charges,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,2486,100,,,percent of total billed charges,100% of total billed charges,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,2486,100,,,percent of total billed charges,100% of total billed charges,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1537.59,61.85,,,percent of total billed charges,61.85% of total billed charges,414.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,538.24,130,,,Fee Schedule,130% of WA Medicaid ,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,937.22,37.7,,,percent of total billed charges,37.70% of total billed charges,937.22,37.7,,,percent of total billed charges,37.70% of total billed charges,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,84275.4,33.9,,,percent of total billed charges,33.9% of total billed charges,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1939.08,78,,,percent of total billed charges,78% of total billed charges,2486,100,,,percent of total billed charges,100% of total billed charges,2053.44,82.6,,,percent of total billed charges,82.6% of total billed charges,2053.44,82.6,,,percent of total billed charges,82.6% of total billed charges,414.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,109.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,109.6,84275.4,
RPR AA HRN 1ST < 3 CM RDC,97549591,CDM,975,RC,49591,HCPCS,Outpatient,,,1142,742.30,,1004.96,88,,,percent of total billed charges,88% of total Billed charges,48.74,100,,,Fee Schedule,100% of Medicare rate,190.79,100,,,Fee Schedule,100% of WA Medicaid,1142,100,,,percent of total billed charges,100% of total billed charges,196.51,103,,,Fee Schedule,103% of WA Medicaid,48.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,190.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,787.98,69,,,percent of total billed charges,69% of total billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1142,100,,,percent of total billed charges,100% of total billed charges,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1142,100,,,percent of total billed charges,100% of total billed charges,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,706.33,61.85,,,percent of total billed charges,61.85% of total billed charges,190.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,248.03,130,,,Fee Schedule,130% of WA Medicaid ,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.53,37.7,,,percent of total billed charges,37.70% of total billed charges,430.53,37.7,,,percent of total billed charges,37.70% of total billed charges,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,38713.8,33.9,,,percent of total billed charges,33.9% of total billed charges,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,890.76,78,,,percent of total billed charges,78% of total billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,943.29,82.6,,,percent of total billed charges,82.6% of total billed charges,943.29,82.6,,,percent of total billed charges,82.6% of total billed charges,190.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.74,38713.8,
LAPAROSCOPIC INITIAL ING HERN,96049650,CDM,960,RC,49650,HCPCS,Outpatient,,,838,544.70,,737.44,88,,,percent of total billed charges,88% of total Billed charges,54.8,100,,,Fee Schedule,100% of Medicare rate,247.3,100,,,Fee Schedule,100% of WA Medicaid,838,100,,,percent of total billed charges,100% of total billed charges,254.72,103,,,Fee Schedule,103% of WA Medicaid,54.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,247.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,578.22,69,,,percent of total billed charges,69% of total billed charges,838,100,,,percent of total billed charges,100% of total billed charges,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,838,100,,,percent of total billed charges,100% of total billed charges,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,838,100,,,percent of total billed charges,100% of total billed charges,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,518.3,61.85,,,percent of total billed charges,61.85% of total billed charges,247.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,321.49,130,,,Fee Schedule,130% of WA Medicaid ,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.93,37.7,,,percent of total billed charges,37.70% of total billed charges,315.93,37.7,,,percent of total billed charges,37.70% of total billed charges,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,28408.2,33.9,,,percent of total billed charges,33.9% of total billed charges,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,653.64,78,,,percent of total billed charges,78% of total billed charges,838,100,,,percent of total billed charges,100% of total billed charges,692.19,82.6,,,percent of total billed charges,82.6% of total billed charges,692.19,82.6,,,percent of total billed charges,82.6% of total billed charges,247.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.8,28408.2,
"LAPAROSCOPY, SURGICAL; REPAIR RECURRENT INGUINAL HERNIA ProF",97549651,CDM,975,RC,49651,HCPCS,Outpatient,,,1576,1024.40,,1386.88,88,,,percent of total billed charges,88% of total Billed charges,72.25,100,,,Fee Schedule,100% of Medicare rate,322.46,100,,,Fee Schedule,100% of WA Medicaid,1576,100,,,percent of total billed charges,100% of total billed charges,332.13,103,,,Fee Schedule,103% of WA Medicaid,72.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,322.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1087.44,69,,,percent of total billed charges,69% of total billed charges,1576,100,,,percent of total billed charges,100% of total billed charges,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1576,100,,,percent of total billed charges,100% of total billed charges,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1576,100,,,percent of total billed charges,100% of total billed charges,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,974.76,61.85,,,percent of total billed charges,61.85% of total billed charges,322.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,419.2,130,,,Fee Schedule,130% of WA Medicaid ,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.15,37.7,,,percent of total billed charges,37.70% of total billed charges,594.15,37.7,,,percent of total billed charges,37.70% of total billed charges,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,53426.4,33.9,,,percent of total billed charges,33.9% of total billed charges,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1229.28,78,,,percent of total billed charges,78% of total billed charges,1576,100,,,percent of total billed charges,100% of total billed charges,1301.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1301.78,82.6,,,percent of total billed charges,82.6% of total billed charges,322.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.25,53426.4,
960,,,960,RC,,,Outpatient,,,1472,956.80,,1295.36,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1472,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1015.68,69,,,percent of total billed charges,69% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1472,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1472,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,910.43,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,49900.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1148.16,78,,,percent of total billed charges,78% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",554.94,49900.8,
960,,,960,RC,,,Outpatient,,,1671,1086.15,,1470.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1671,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1152.99,69,,,percent of total billed charges,69% of total billed charges,1671,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1671,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1671,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1033.51,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,629.97,37.7,,,percent of total billed charges,37.70% of total billed charges,629.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,56646.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1303.38,78,,,percent of total billed charges,78% of total billed charges,1671,100,,,percent of total billed charges,100% of total billed charges,1380.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1380.25,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",629.97,56646.9,
960,,,960,RC,,,Outpatient,,,2603,1691.95,,2290.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2603,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1796.07,69,,,percent of total billed charges,69% of total billed charges,2603,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2603,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2603,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1609.96,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,981.33,37.7,,,percent of total billed charges,37.70% of total billed charges,981.33,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,88241.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2030.34,78,,,percent of total billed charges,78% of total billed charges,2603,100,,,percent of total billed charges,100% of total billed charges,2150.08,82.6,,,percent of total billed charges,82.6% of total billed charges,2150.08,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",981.33,88241.7,
"49659 UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORR",97549659,CDM,975,RC,49659,HCPCS,Outpatient,,,1087,706.55,,956.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1087,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,750.03,69,,,percent of total billed charges,69% of total billed charges,1087,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1087,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1087,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,672.31,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,409.8,37.7,,,percent of total billed charges,37.70% of total billed charges,409.8,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,36849.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,847.86,78,,,percent of total billed charges,78% of total billed charges,1087,100,,,percent of total billed charges,100% of total billed charges,897.86,82.6,,,percent of total billed charges,82.6% of total billed charges,897.86,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",409.8,36849.3,
SUT SECOND OF ABDOMINAL WALL,96049900,CDM,960,RC,49900,HCPCS,Outpatient,,,1389,902.85,,1222.32,88,,,percent of total billed charges,88% of total Billed charges,101.22,100,,,Fee Schedule,100% of Medicare rate,468.49,100,,,Fee Schedule,100% of WA Medicaid,1389,100,,,percent of total billed charges,100% of total billed charges,482.54,103,,,Fee Schedule,103% of WA Medicaid,101.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,177.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,468.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,958.41,69,,,percent of total billed charges,69% of total billed charges,1389,100,,,percent of total billed charges,100% of total billed charges,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1389,100,,,percent of total billed charges,100% of total billed charges,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1389,100,,,percent of total billed charges,100% of total billed charges,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.1,61.85,,,percent of total billed charges,61.85% of total billed charges,468.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,477.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,609.04,130,,,Fee Schedule,130% of WA Medicaid ,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,523.65,37.7,,,percent of total billed charges,37.70% of total billed charges,523.65,37.7,,,percent of total billed charges,37.70% of total billed charges,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,47087.1,33.9,,,percent of total billed charges,33.9% of total billed charges,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1083.42,78,,,percent of total billed charges,78% of total billed charges,1389,100,,,percent of total billed charges,100% of total billed charges,1147.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1147.31,82.6,,,percent of total billed charges,82.6% of total billed charges,468.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.22,47087.1,
"49905 OMENTAL FLAP, INTRA-ABDOMINAL (LIST SEPARATELY IN ADDI",97549905,CDM,975,RC,49905,HCPCS,Outpatient,,,942,612.30,,828.96,88,,,percent of total billed charges,88% of total Billed charges,49.46,100,,,Fee Schedule,100% of Medicare rate,194.33,100,,,Fee Schedule,100% of WA Medicaid,942,100,,,percent of total billed charges,100% of total billed charges,200.16,103,,,Fee Schedule,103% of WA Medicaid,49.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,194.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,649.98,69,,,percent of total billed charges,69% of total billed charges,942,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,942,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,942,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,582.63,61.85,,,percent of total billed charges,61.85% of total billed charges,194.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,252.63,130,,,Fee Schedule,130% of WA Medicaid ,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.13,37.7,,,percent of total billed charges,37.70% of total billed charges,355.13,37.7,,,percent of total billed charges,37.70% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,31933.8,33.9,,,percent of total billed charges,33.9% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.76,78,,,percent of total billed charges,78% of total billed charges,942,100,,,percent of total billed charges,100% of total billed charges,778.09,82.6,,,percent of total billed charges,82.6% of total billed charges,778.09,82.6,,,percent of total billed charges,82.6% of total billed charges,194.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.46,31933.8,
RENAL BIOPSY;PERCUTANEOUS,96050200,CDM,960,RC,50200,HCPCS,Outpatient,,,1129,733.85,,993.52,88,,,percent of total billed charges,88% of total Billed charges,9.96,100,,,Fee Schedule,100% of Medicare rate,70.68,100,,,Fee Schedule,100% of WA Medicaid,1129,100,,,percent of total billed charges,100% of total billed charges,72.8,103,,,Fee Schedule,103% of WA Medicaid,9.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,779.01,69,,,percent of total billed charges,69% of total billed charges,1129,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1129,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1129,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.29,61.85,,,percent of total billed charges,61.85% of total billed charges,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,91.88,130,,,Fee Schedule,130% of WA Medicaid ,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.63,37.7,,,percent of total billed charges,37.70% of total billed charges,425.63,37.7,,,percent of total billed charges,37.70% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,38273.1,33.9,,,percent of total billed charges,33.9% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,880.62,78,,,percent of total billed charges,78% of total billed charges,1129,100,,,percent of total billed charges,100% of total billed charges,932.55,82.6,,,percent of total billed charges,82.6% of total billed charges,932.55,82.6,,,percent of total billed charges,82.6% of total billed charges,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.96,38273.1,
CT PERC CYRO ABLATE RENAL TUM,96050593,CDM,960,RC,50593,HCPCS,Outpatient,,,19557,12712.05,,17210.16,88,,,percent of total billed charges,88% of total Billed charges,37.27,100,,,Fee Schedule,100% of Medicare rate,253.45,100,,,Fee Schedule,100% of WA Medicaid,19557,100,,,percent of total billed charges,100% of total billed charges,261.05,103,,,Fee Schedule,103% of WA Medicaid,37.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,253.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,13494.33,69,,,percent of total billed charges,69% of total billed charges,19557,100,,,percent of total billed charges,100% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,19557,100,,,percent of total billed charges,100% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,19557,100,,,percent of total billed charges,100% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,12096,61.85,,,percent of total billed charges,61.85% of total billed charges,253.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,329.49,130,,,Fee Schedule,130% of WA Medicaid ,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,7372.99,37.7,,,percent of total billed charges,37.70% of total billed charges,7372.99,37.7,,,percent of total billed charges,37.70% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,662982.3,33.9,,,percent of total billed charges,33.9% of total billed charges,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,15254.46,78,,,percent of total billed charges,78% of total billed charges,19557,100,,,percent of total billed charges,100% of total billed charges,16154.08,82.6,,,percent of total billed charges,82.6% of total billed charges,16154.08,82.6,,,percent of total billed charges,82.6% of total billed charges,253.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.27,662982.3,
"CYSTOSTOMY, CYSTO W/DRAINAGE",96051040,CDM,960,RC,51040,HCPCS,Outpatient,,,1182,768.30,,1040.16,88,,,percent of total billed charges,88% of total Billed charges,23.13,100,,,Fee Schedule,100% of Medicare rate,168.41,100,,,Fee Schedule,100% of WA Medicaid,1182,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,23.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,168.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,815.58,69,,,percent of total billed charges,69% of total billed charges,1182,100,,,percent of total billed charges,100% of total billed charges,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1182,100,,,percent of total billed charges,100% of total billed charges,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1182,100,,,percent of total billed charges,100% of total billed charges,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.07,61.85,,,percent of total billed charges,61.85% of total billed charges,168.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.61,37.7,,,percent of total billed charges,37.70% of total billed charges,445.61,37.7,,,percent of total billed charges,37.70% of total billed charges,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,40069.8,33.9,,,percent of total billed charges,33.9% of total billed charges,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,921.96,78,,,percent of total billed charges,78% of total billed charges,1182,100,,,percent of total billed charges,100% of total billed charges,976.33,82.6,,,percent of total billed charges,82.6% of total billed charges,976.33,82.6,,,percent of total billed charges,82.6% of total billed charges,168.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.13,40069.8,
"51050 CYSTOLITHOTOMY, CYSTOTOMY WITH REMOVAL OF CALCULUS, WI",97551050,CDM,975,RC,51050,HCPCS,Outpatient,,,1649,1071.85,,1451.12,88,,,percent of total billed charges,88% of total Billed charges,39.66,100,,,Fee Schedule,100% of Medicare rate,270.05,100,,,Fee Schedule,100% of WA Medicaid,1649,100,,,percent of total billed charges,100% of total billed charges,278.15,103,,,Fee Schedule,103% of WA Medicaid,39.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,270.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1137.81,69,,,percent of total billed charges,69% of total billed charges,1649,100,,,percent of total billed charges,100% of total billed charges,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1649,100,,,percent of total billed charges,100% of total billed charges,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1649,100,,,percent of total billed charges,100% of total billed charges,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1019.91,61.85,,,percent of total billed charges,61.85% of total billed charges,270.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,351.07,130,,,Fee Schedule,130% of WA Medicaid ,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.67,37.7,,,percent of total billed charges,37.70% of total billed charges,621.67,37.7,,,percent of total billed charges,37.70% of total billed charges,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,55901.1,33.9,,,percent of total billed charges,33.9% of total billed charges,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1286.22,78,,,percent of total billed charges,78% of total billed charges,1649,100,,,percent of total billed charges,100% of total billed charges,1362.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1362.07,82.6,,,percent of total billed charges,82.6% of total billed charges,270.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.66,55901.1,
BLADDER INSTILL ANTICARC AGENT,96051720,CDM,960,RC,51720,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,4.14,100,,,Fee Schedule,100% of Medicare rate,24.25,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,24.98,103,,,Fee Schedule,103% of WA Medicaid,4.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,24.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,239,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,239,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.82,61.85,,,percent of total billed charges,61.85% of total billed charges,24.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.53,130,,,Fee Schedule,130% of WA Medicaid ,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,8102.1,33.9,,,percent of total billed charges,33.9% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,24.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.14,8102.1,
ATTACH BLADDER/URETHRA,96051840,CDM,960,RC,51840,HCPCS,Outpatient,,,1335,867.75,,1174.8,88,,,percent of total billed charges,88% of total Billed charges,60.89,100,,,Fee Schedule,100% of Medicare rate,397.43,100,,,Fee Schedule,100% of WA Medicaid,1335,100,,,percent of total billed charges,100% of total billed charges,409.35,103,,,Fee Schedule,103% of WA Medicaid,60.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,106.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,397.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,921.15,69,,,percent of total billed charges,69% of total billed charges,1335,100,,,percent of total billed charges,100% of total billed charges,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1335,100,,,percent of total billed charges,100% of total billed charges,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1335,100,,,percent of total billed charges,100% of total billed charges,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,825.7,61.85,,,percent of total billed charges,61.85% of total billed charges,397.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,516.66,130,,,Fee Schedule,130% of WA Medicaid ,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,503.3,37.7,,,percent of total billed charges,37.70% of total billed charges,503.3,37.7,,,percent of total billed charges,37.70% of total billed charges,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,45256.5,33.9,,,percent of total billed charges,33.9% of total billed charges,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1041.3,78,,,percent of total billed charges,78% of total billed charges,1335,100,,,percent of total billed charges,100% of total billed charges,1102.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1102.71,82.6,,,percent of total billed charges,82.6% of total billed charges,397.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.89,45256.5,
CYSTOURETHROSCOPY SEP PROCEDUR,96052000,CDM,960,RC,52000,HCPCS,Outpatient,,,1256,816.40,,1105.28,88,,,percent of total billed charges,88% of total Billed charges,7.31,100,,,Fee Schedule,100% of Medicare rate,44.95,100,,,Fee Schedule,100% of WA Medicaid,1256,100,,,percent of total billed charges,100% of total billed charges,46.3,103,,,Fee Schedule,103% of WA Medicaid,7.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,44.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,866.64,69,,,percent of total billed charges,69% of total billed charges,1256,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1256,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1256,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,776.84,61.85,,,percent of total billed charges,61.85% of total billed charges,44.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.44,130,,,Fee Schedule,130% of WA Medicaid ,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.51,37.7,,,percent of total billed charges,37.70% of total billed charges,473.51,37.7,,,percent of total billed charges,37.70% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,42578.4,33.9,,,percent of total billed charges,33.9% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,979.68,78,,,percent of total billed charges,78% of total billed charges,1256,100,,,percent of total billed charges,100% of total billed charges,1037.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1037.46,82.6,,,percent of total billed charges,82.6% of total billed charges,44.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.31,42578.4,
CYSTOURETHROSCOPY W/FLUGURATIO,96052214,CDM,960,RC,52214,HCPCS,Outpatient,,,1165,757.25,,1025.2,88,,,percent of total billed charges,88% of total Billed charges,16.03,100,,,Fee Schedule,100% of Medicare rate,96.98,100,,,Fee Schedule,100% of WA Medicaid,1165,100,,,percent of total billed charges,100% of total billed charges,99.89,103,,,Fee Schedule,103% of WA Medicaid,16.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,96.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,803.85,69,,,percent of total billed charges,69% of total billed charges,1165,100,,,percent of total billed charges,100% of total billed charges,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1165,100,,,percent of total billed charges,100% of total billed charges,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1165,100,,,percent of total billed charges,100% of total billed charges,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,720.55,61.85,,,percent of total billed charges,61.85% of total billed charges,96.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.07,130,,,Fee Schedule,130% of WA Medicaid ,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.21,37.7,,,percent of total billed charges,37.70% of total billed charges,439.21,37.7,,,percent of total billed charges,37.70% of total billed charges,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,39493.5,33.9,,,percent of total billed charges,33.9% of total billed charges,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,908.7,78,,,percent of total billed charges,78% of total billed charges,1165,100,,,percent of total billed charges,100% of total billed charges,962.29,82.6,,,percent of total billed charges,82.6% of total billed charges,962.29,82.6,,,percent of total billed charges,82.6% of total billed charges,96.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.03,39493.5,
CYSTOURETHROSCOPY WITH FLUGURA,96052224,CDM,960,RC,52224,HCPCS,Outpatient,,,1218,791.70,,1071.84,88,,,percent of total billed charges,88% of total Billed charges,18.65,100,,,Fee Schedule,100% of Medicare rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,1218,100,,,percent of total billed charges,100% of total billed charges,115.64,103,,,Fee Schedule,103% of WA Medicaid,18.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,840.42,69,,,percent of total billed charges,69% of total billed charges,1218,100,,,percent of total billed charges,100% of total billed charges,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1218,100,,,percent of total billed charges,100% of total billed charges,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1218,100,,,percent of total billed charges,100% of total billed charges,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,753.33,61.85,,,percent of total billed charges,61.85% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.95,130,,,Fee Schedule,130% of WA Medicaid ,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.19,37.7,,,percent of total billed charges,37.70% of total billed charges,459.19,37.7,,,percent of total billed charges,37.70% of total billed charges,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,41290.2,33.9,,,percent of total billed charges,33.9% of total billed charges,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,950.04,78,,,percent of total billed charges,78% of total billed charges,1218,100,,,percent of total billed charges,100% of total billed charges,1006.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1006.07,82.6,,,percent of total billed charges,82.6% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.65,41290.2,
"52351 CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY",97552351,CDM,975,RC,52351,HCPCS,Outpatient,,,1040,676.00,,915.2,88,,,percent of total billed charges,88% of total Billed charges,27.34,100,,,Fee Schedule,100% of Medicare rate,168.6,100,,,Fee Schedule,100% of WA Medicaid,1040,100,,,percent of total billed charges,100% of total billed charges,173.66,103,,,Fee Schedule,103% of WA Medicaid,27.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,168.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,717.6,69,,,percent of total billed charges,69% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1040,100,,,percent of total billed charges,100% of total billed charges,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1040,100,,,percent of total billed charges,100% of total billed charges,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,643.24,61.85,,,percent of total billed charges,61.85% of total billed charges,168.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,219.18,130,,,Fee Schedule,130% of WA Medicaid ,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,392.08,37.7,,,percent of total billed charges,37.70% of total billed charges,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,35256,33.9,,,percent of total billed charges,33.9% of total billed charges,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.2,78,,,percent of total billed charges,78% of total billed charges,1040,100,,,percent of total billed charges,100% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,859.04,82.6,,,percent of total billed charges,82.6% of total billed charges,168.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.34,35256,
TRANSUR ELECTRO RESEC PROSTATE,96052601,CDM,960,RC,52601,HCPCS,Outpatient,,,1786,1160.90,,1571.68,88,,,percent of total billed charges,88% of total Billed charges,63.53,100,,,Fee Schedule,100% of Medicare rate,412.17,100,,,Fee Schedule,100% of WA Medicaid,1786,100,,,percent of total billed charges,100% of total billed charges,424.54,103,,,Fee Schedule,103% of WA Medicaid,63.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,111.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,412.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1232.34,69,,,percent of total billed charges,69% of total billed charges,1786,100,,,percent of total billed charges,100% of total billed charges,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786,100,,,percent of total billed charges,100% of total billed charges,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786,100,,,percent of total billed charges,100% of total billed charges,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1104.64,61.85,,,percent of total billed charges,61.85% of total billed charges,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,535.82,130,,,Fee Schedule,130% of WA Medicaid ,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,673.32,37.7,,,percent of total billed charges,37.70% of total billed charges,673.32,37.7,,,percent of total billed charges,37.70% of total billed charges,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,60545.4,33.9,,,percent of total billed charges,33.9% of total billed charges,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1393.08,78,,,percent of total billed charges,78% of total billed charges,1786,100,,,percent of total billed charges,100% of total billed charges,1475.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1475.24,82.6,,,percent of total billed charges,82.6% of total billed charges,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.53,60545.4,
LASER VAPORIZATION OF PROSTATE,96052648,CDM,960,RC,52648,HCPCS,Outpatient,,,1163,755.95,,1023.44,88,,,percent of total billed charges,88% of total Billed charges,59.43,100,,,Fee Schedule,100% of Medicare rate,393.7,100,,,Fee Schedule,100% of WA Medicaid,1163,100,,,percent of total billed charges,100% of total billed charges,405.51,103,,,Fee Schedule,103% of WA Medicaid,59.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,104,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,393.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,802.47,69,,,percent of total billed charges,69% of total billed charges,1163,100,,,percent of total billed charges,100% of total billed charges,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163,100,,,percent of total billed charges,100% of total billed charges,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163,100,,,percent of total billed charges,100% of total billed charges,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,719.32,61.85,,,percent of total billed charges,61.85% of total billed charges,393.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,511.81,130,,,Fee Schedule,130% of WA Medicaid ,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.45,37.7,,,percent of total billed charges,37.70% of total billed charges,438.45,37.7,,,percent of total billed charges,37.70% of total billed charges,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,39425.7,33.9,,,percent of total billed charges,33.9% of total billed charges,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,907.14,78,,,percent of total billed charges,78% of total billed charges,1163,100,,,percent of total billed charges,100% of total billed charges,960.64,82.6,,,percent of total billed charges,82.6% of total billed charges,960.64,82.6,,,percent of total billed charges,82.6% of total billed charges,393.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.43,39425.7,
EXC OF URETHRAL DIVERT FEMAIL,96053230,CDM,960,RC,53230,HCPCS,Outpatient,,,1281,832.65,,1127.28,88,,,percent of total billed charges,88% of total Billed charges,55.42,100,,,Fee Schedule,100% of Medicare rate,347.45,100,,,Fee Schedule,100% of WA Medicaid,1281,100,,,percent of total billed charges,100% of total billed charges,357.87,103,,,Fee Schedule,103% of WA Medicaid,55.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,96.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,347.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,883.89,69,,,percent of total billed charges,69% of total billed charges,1281,100,,,percent of total billed charges,100% of total billed charges,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1281,100,,,percent of total billed charges,100% of total billed charges,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1281,100,,,percent of total billed charges,100% of total billed charges,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,792.3,61.85,,,percent of total billed charges,61.85% of total billed charges,347.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,347.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,451.69,130,,,Fee Schedule,130% of WA Medicaid ,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.94,37.7,,,percent of total billed charges,37.70% of total billed charges,482.94,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,43425.9,33.9,,,percent of total billed charges,33.9% of total billed charges,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,999.18,78,,,percent of total billed charges,78% of total billed charges,1281,100,,,percent of total billed charges,100% of total billed charges,1058.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1058.11,82.6,,,percent of total billed charges,82.6% of total billed charges,347.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,347.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.42,43425.9,
"53899 UNLISTED PROCEDURE, URINARY SYSTEM ProFee",97553899,CDM,975,RC,53899,HCPCS,Outpatient,,,824,535.60,,725.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,824,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,568.56,69,,,percent of total billed charges,69% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,824,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,824,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,509.64,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,310.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,27933.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,642.72,78,,,percent of total billed charges,78% of total billed charges,824,100,,,percent of total billed charges,100% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,680.62,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",310.65,27933.6,
"54015 INCISION AND DRAINAGE OF PENIS, DEEP ProFee",97554015,CDM,975,RC,54015,HCPCS,Outpatient,,,1066,692.90,,938.08,88,,,percent of total billed charges,88% of total Billed charges,26.26,100,,,Fee Schedule,100% of Medicare rate,173.26,100,,,Fee Schedule,100% of WA Medicaid,1066,100,,,percent of total billed charges,100% of total billed charges,178.46,103,,,Fee Schedule,103% of WA Medicaid,26.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,173.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,735.54,69,,,percent of total billed charges,69% of total billed charges,1066,100,,,percent of total billed charges,100% of total billed charges,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1066,100,,,percent of total billed charges,100% of total billed charges,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1066,100,,,percent of total billed charges,100% of total billed charges,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.32,61.85,,,percent of total billed charges,61.85% of total billed charges,173.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,225.24,130,,,Fee Schedule,130% of WA Medicaid ,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.88,37.7,,,percent of total billed charges,37.70% of total billed charges,401.88,37.7,,,percent of total billed charges,37.70% of total billed charges,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,36137.4,33.9,,,percent of total billed charges,33.9% of total billed charges,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,831.48,78,,,percent of total billed charges,78% of total billed charges,1066,100,,,percent of total billed charges,100% of total billed charges,880.52,82.6,,,percent of total billed charges,82.6% of total billed charges,880.52,82.6,,,percent of total billed charges,82.6% of total billed charges,173.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.26,36137.4,
"54150 CIRCUMCISION, USING CLAMP OR OTHER DEVICE WITH REGIONA",97554150,CDM,975,RC,54150,HCPCS,Outpatient,,,322,209.30,,283.36,88,,,percent of total billed charges,88% of total Billed charges,9.07,100,,,Fee Schedule,100% of Medicare rate,53.71,100,,,Fee Schedule,100% of WA Medicaid,322,100,,,percent of total billed charges,100% of total billed charges,55.32,103,,,Fee Schedule,103% of WA Medicaid,9.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,53.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,222.18,69,,,percent of total billed charges,69% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,322,100,,,percent of total billed charges,100% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,322,100,,,percent of total billed charges,100% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.16,61.85,,,percent of total billed charges,61.85% of total billed charges,53.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,69.82,130,,,Fee Schedule,130% of WA Medicaid ,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.39,37.7,,,percent of total billed charges,37.70% of total billed charges,121.39,37.7,,,percent of total billed charges,37.70% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,10915.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.16,78,,,percent of total billed charges,78% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,53.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.07,10915.8,
"54160 CIRCUMCISION, SURGICAL EXCISION OTHER THAN CLAMP, DEVI",97554160,CDM,975,RC,54160,HCPCS,Outpatient,,,420,273.00,,369.6,88,,,percent of total billed charges,88% of total Billed charges,12.41,100,,,Fee Schedule,100% of Medicare rate,82.81,100,,,Fee Schedule,100% of WA Medicaid,420,100,,,percent of total billed charges,100% of total billed charges,85.29,103,,,Fee Schedule,103% of WA Medicaid,12.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,82.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,289.8,69,,,percent of total billed charges,69% of total billed charges,420,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,420,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,420,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.77,61.85,,,percent of total billed charges,61.85% of total billed charges,82.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.65,130,,,Fee Schedule,130% of WA Medicaid ,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.34,37.7,,,percent of total billed charges,37.70% of total billed charges,158.34,37.7,,,percent of total billed charges,37.70% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,14238,33.9,,,percent of total billed charges,33.9% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.6,78,,,percent of total billed charges,78% of total billed charges,420,100,,,percent of total billed charges,100% of total billed charges,346.92,82.6,,,percent of total billed charges,82.6% of total billed charges,346.92,82.6,,,percent of total billed charges,82.6% of total billed charges,82.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.41,14238,
REPAIR TRUAMATIC CORPOREALTEAR,96054437,CDM,960,RC,54437,HCPCS,Outpatient,,,1484,964.60,,1305.92,88,,,percent of total billed charges,88% of total Billed charges,56.76,100,,,Fee Schedule,100% of Medicare rate,387.73,100,,,Fee Schedule,100% of WA Medicaid,1484,100,,,percent of total billed charges,100% of total billed charges,399.36,103,,,Fee Schedule,103% of WA Medicaid,56.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,387.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1023.96,69,,,percent of total billed charges,69% of total billed charges,1484,100,,,percent of total billed charges,100% of total billed charges,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1484,100,,,percent of total billed charges,100% of total billed charges,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1484,100,,,percent of total billed charges,100% of total billed charges,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,917.85,61.85,,,percent of total billed charges,61.85% of total billed charges,387.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,504.05,130,,,Fee Schedule,130% of WA Medicaid ,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,559.47,37.7,,,percent of total billed charges,37.70% of total billed charges,559.47,37.7,,,percent of total billed charges,37.70% of total billed charges,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,50307.6,33.9,,,percent of total billed charges,33.9% of total billed charges,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1157.52,78,,,percent of total billed charges,78% of total billed charges,1484,100,,,percent of total billed charges,100% of total billed charges,1225.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1225.78,82.6,,,percent of total billed charges,82.6% of total billed charges,387.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.76,50307.6,
REMOVAL OF TESTIS,97554530,CDM,975,RC,54530,HCPCS,Outpatient,,,2229,1448.85,,1961.52,88,,,percent of total billed charges,88% of total Billed charges,43.38,100,,,Fee Schedule,100% of Medicare rate,291.5,100,,,Fee Schedule,100% of WA Medicaid,2229,100,,,percent of total billed charges,100% of total billed charges,300.25,103,,,Fee Schedule,103% of WA Medicaid,43.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,291.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1538.01,69,,,percent of total billed charges,69% of total billed charges,2229,100,,,percent of total billed charges,100% of total billed charges,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2229,100,,,percent of total billed charges,100% of total billed charges,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2229,100,,,percent of total billed charges,100% of total billed charges,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1378.64,61.85,,,percent of total billed charges,61.85% of total billed charges,291.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,378.95,130,,,Fee Schedule,130% of WA Medicaid ,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,840.33,37.7,,,percent of total billed charges,37.70% of total billed charges,840.33,37.7,,,percent of total billed charges,37.70% of total billed charges,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,75563.1,33.9,,,percent of total billed charges,33.9% of total billed charges,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1738.62,78,,,percent of total billed charges,78% of total billed charges,2229,100,,,percent of total billed charges,100% of total billed charges,1841.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1841.15,82.6,,,percent of total billed charges,82.6% of total billed charges,291.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.38,75563.1,
"54600 REDUCTION OF TORSION OF TESTIS, SURGICAL, WITH OR WITH",97554600,CDM,975,RC,54600,HCPCS,Outpatient,,,1584,1029.60,,1393.92,88,,,percent of total billed charges,88% of total Billed charges,38.06,100,,,Fee Schedule,100% of Medicare rate,259.42,100,,,Fee Schedule,100% of WA Medicaid,1584,100,,,percent of total billed charges,100% of total billed charges,267.2,103,,,Fee Schedule,103% of WA Medicaid,38.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,259.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1092.96,69,,,percent of total billed charges,69% of total billed charges,1584,100,,,percent of total billed charges,100% of total billed charges,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1584,100,,,percent of total billed charges,100% of total billed charges,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1584,100,,,percent of total billed charges,100% of total billed charges,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,979.7,61.85,,,percent of total billed charges,61.85% of total billed charges,259.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,337.25,130,,,Fee Schedule,130% of WA Medicaid ,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.17,37.7,,,percent of total billed charges,37.70% of total billed charges,597.17,37.7,,,percent of total billed charges,37.70% of total billed charges,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,53697.6,33.9,,,percent of total billed charges,33.9% of total billed charges,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1235.52,78,,,percent of total billed charges,78% of total billed charges,1584,100,,,percent of total billed charges,100% of total billed charges,1308.38,82.6,,,percent of total billed charges,82.6% of total billed charges,1308.38,82.6,,,percent of total billed charges,82.6% of total billed charges,259.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.06,53697.6,
"54700 INCISION AND DRAINAGE OF EPIDIDYMIS, TESTIS AND/OR SCR",97554700,CDM,975,RC,54700,HCPCS,Outpatient,,,699,454.35,,615.12,88,,,percent of total billed charges,88% of total Billed charges,18.63,100,,,Fee Schedule,100% of Medicare rate,122.16,100,,,Fee Schedule,100% of WA Medicaid,699,100,,,percent of total billed charges,100% of total billed charges,125.82,103,,,Fee Schedule,103% of WA Medicaid,18.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,122.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,482.31,69,,,percent of total billed charges,69% of total billed charges,699,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,699,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,699,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.33,61.85,,,percent of total billed charges,61.85% of total billed charges,122.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,158.81,130,,,Fee Schedule,130% of WA Medicaid ,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.52,37.7,,,percent of total billed charges,37.70% of total billed charges,263.52,37.7,,,percent of total billed charges,37.70% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,23696.1,33.9,,,percent of total billed charges,33.9% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.22,78,,,percent of total billed charges,78% of total billed charges,699,100,,,percent of total billed charges,100% of total billed charges,577.37,82.6,,,percent of total billed charges,82.6% of total billed charges,577.37,82.6,,,percent of total billed charges,82.6% of total billed charges,122.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.63,23696.1,
54830 EXCISION OF LOCAL LESION OF EPIDIDYMIS ProFee,97554830,CDM,975,RC,54830,HCPCS,Outpatient,,,1317,856.05,,1158.96,88,,,percent of total billed charges,88% of total Billed charges,30.49,100,,,Fee Schedule,100% of Medicare rate,214.48,100,,,Fee Schedule,100% of WA Medicaid,1317,100,,,percent of total billed charges,100% of total billed charges,220.91,103,,,Fee Schedule,103% of WA Medicaid,30.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,214.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,908.73,69,,,percent of total billed charges,69% of total billed charges,1317,100,,,percent of total billed charges,100% of total billed charges,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1317,100,,,percent of total billed charges,100% of total billed charges,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1317,100,,,percent of total billed charges,100% of total billed charges,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,814.56,61.85,,,percent of total billed charges,61.85% of total billed charges,214.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,278.82,130,,,Fee Schedule,130% of WA Medicaid ,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.51,37.7,,,percent of total billed charges,37.70% of total billed charges,496.51,37.7,,,percent of total billed charges,37.70% of total billed charges,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,44646.3,33.9,,,percent of total billed charges,33.9% of total billed charges,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1027.26,78,,,percent of total billed charges,78% of total billed charges,1317,100,,,percent of total billed charges,100% of total billed charges,1087.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1087.84,82.6,,,percent of total billed charges,82.6% of total billed charges,214.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.49,44646.3,
55041 EXCISION OF HYDROCELE; BILATERAL ProFee,97555041,CDM,975,RC,55041,HCPCS,Outpatient,,,1919,1247.35,,1688.72,88,,,percent of total billed charges,88% of total Billed charges,43.47,100,,,Fee Schedule,100% of Medicare rate,293.18,100,,,Fee Schedule,100% of WA Medicaid,1919,100,,,percent of total billed charges,100% of total billed charges,301.98,103,,,Fee Schedule,103% of WA Medicaid,43.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,293.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1324.11,69,,,percent of total billed charges,69% of total billed charges,1919,100,,,percent of total billed charges,100% of total billed charges,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1919,100,,,percent of total billed charges,100% of total billed charges,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1919,100,,,percent of total billed charges,100% of total billed charges,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1186.9,61.85,,,percent of total billed charges,61.85% of total billed charges,293.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,381.13,130,,,Fee Schedule,130% of WA Medicaid ,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.46,37.7,,,percent of total billed charges,37.70% of total billed charges,723.46,37.7,,,percent of total billed charges,37.70% of total billed charges,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,65054.1,33.9,,,percent of total billed charges,33.9% of total billed charges,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1496.82,78,,,percent of total billed charges,78% of total billed charges,1919,100,,,percent of total billed charges,100% of total billed charges,1585.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1585.09,82.6,,,percent of total billed charges,82.6% of total billed charges,293.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.47,65054.1,
VASECTOMY,96055250,CDM,960,RC,55250,HCPCS,Outpatient,,,882,573.30,,776.16,88,,,percent of total billed charges,88% of total Billed charges,17.37,100,,,Fee Schedule,100% of Medicare rate,132.97,100,,,Fee Schedule,100% of WA Medicaid,882,100,,,percent of total billed charges,100% of total billed charges,136.96,103,,,Fee Schedule,103% of WA Medicaid,17.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,132.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,608.58,69,,,percent of total billed charges,69% of total billed charges,882,100,,,percent of total billed charges,100% of total billed charges,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,882,100,,,percent of total billed charges,100% of total billed charges,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,882,100,,,percent of total billed charges,100% of total billed charges,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.52,61.85,,,percent of total billed charges,61.85% of total billed charges,132.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,172.86,130,,,Fee Schedule,130% of WA Medicaid ,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.51,37.7,,,percent of total billed charges,37.70% of total billed charges,332.51,37.7,,,percent of total billed charges,37.70% of total billed charges,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,29899.8,33.9,,,percent of total billed charges,33.9% of total billed charges,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,687.96,78,,,percent of total billed charges,78% of total billed charges,882,100,,,percent of total billed charges,100% of total billed charges,728.53,82.6,,,percent of total billed charges,82.6% of total billed charges,728.53,82.6,,,percent of total billed charges,82.6% of total billed charges,132.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.37,29899.8,
ID OF VULVA OR PERINEAL ABSCE,96056405,CDM,960,RC,56405,HCPCS,Outpatient,,,235,152.75,,206.8,88,,,percent of total billed charges,88% of total Billed charges,10.38,100,,,Fee Schedule,100% of Medicare rate,74.23,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,percent of total billed charges,100% of total billed charges,76.46,103,,,Fee Schedule,103% of WA Medicaid,10.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,162.15,69,,,percent of total billed charges,69% of total billed charges,235,100,,,percent of total billed charges,100% of total billed charges,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,235,100,,,percent of total billed charges,100% of total billed charges,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,235,100,,,percent of total billed charges,100% of total billed charges,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.35,61.85,,,percent of total billed charges,61.85% of total billed charges,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,96.5,130,,,Fee Schedule,130% of WA Medicaid ,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.6,37.7,,,percent of total billed charges,37.70% of total billed charges,88.6,37.7,,,percent of total billed charges,37.70% of total billed charges,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,7966.5,33.9,,,percent of total billed charges,33.9% of total billed charges,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.3,78,,,percent of total billed charges,78% of total billed charges,235,100,,,percent of total billed charges,100% of total billed charges,194.11,82.6,,,percent of total billed charges,82.6% of total billed charges,194.11,82.6,,,percent of total billed charges,82.6% of total billed charges,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.38,7966.5,
"56442 HYMENOTOMY, SIMPLE INCISION ProFee",96056442,CDM,975,RC,56442,HCPCS,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,4.55,100,,,Fee Schedule,100% of Medicare rate,27.23,100,,,Fee Schedule,100% of WA Medicaid,167,100,,,percent of total billed charges,100% of total billed charges,28.05,103,,,Fee Schedule,103% of WA Medicaid,4.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,167,100,,,percent of total billed charges,100% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,167,100,,,percent of total billed charges,100% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.29,61.85,,,percent of total billed charges,61.85% of total billed charges,27.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.4,130,,,Fee Schedule,130% of WA Medicaid ,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,5661.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,27.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.55,5661.3,
56605 BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LE,97556605,CDM,975,RC,56605,HCPCS,Outpatient,,,202,131.30,,177.76,88,,,percent of total billed charges,88% of total Billed charges,6.43,100,,,Fee Schedule,100% of Medicare rate,33.2,100,,,Fee Schedule,100% of WA Medicaid,202,100,,,percent of total billed charges,100% of total billed charges,34.2,103,,,Fee Schedule,103% of WA Medicaid,6.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,139.38,69,,,percent of total billed charges,69% of total billed charges,202,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,202,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,202,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.94,61.85,,,percent of total billed charges,61.85% of total billed charges,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.16,130,,,Fee Schedule,130% of WA Medicaid ,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.15,37.7,,,percent of total billed charges,37.70% of total billed charges,76.15,37.7,,,percent of total billed charges,37.70% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6847.8,33.9,,,percent of total billed charges,33.9% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.56,78,,,percent of total billed charges,78% of total billed charges,202,100,,,percent of total billed charges,100% of total billed charges,166.85,82.6,,,percent of total billed charges,82.6% of total billed charges,166.85,82.6,,,percent of total billed charges,82.6% of total billed charges,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.43,6847.8,
56605 BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LE,97556606,CDM,975,RC,56606,HCPCS,Outpatient,,,92,59.80,,80.96,88,,,percent of total billed charges,88% of total Billed charges,3.2,100,,,Fee Schedule,100% of Medicare rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,92,100,,,percent of total billed charges,100% of total billed charges,16.9,103,,,Fee Schedule,103% of WA Medicaid,3.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,63.48,69,,,percent of total billed charges,69% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,92,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,92,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.9,61.85,,,percent of total billed charges,61.85% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.33,130,,,Fee Schedule,130% of WA Medicaid ,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3118.8,33.9,,,percent of total billed charges,33.9% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.76,78,,,percent of total billed charges,78% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.2,3118.8,
56620 VULVECTOMY (LABIOPLASTY)- SIMPLE/PARTIAL ProFee,97556620,CDM,975,RC,56620,HCPCS,Outpatient,,,2832,1840.80,,2492.16,88,,,percent of total billed charges,88% of total Billed charges,50.9,100,,,Fee Schedule,100% of Medicare rate,342.04,100,,,Fee Schedule,100% of WA Medicaid,2832,100,,,percent of total billed charges,100% of total billed charges,352.3,103,,,Fee Schedule,103% of WA Medicaid,50.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,342.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1954.08,69,,,percent of total billed charges,69% of total billed charges,2832,100,,,percent of total billed charges,100% of total billed charges,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2832,100,,,percent of total billed charges,100% of total billed charges,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2832,100,,,percent of total billed charges,100% of total billed charges,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1751.59,61.85,,,percent of total billed charges,61.85% of total billed charges,342.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,444.65,130,,,Fee Schedule,130% of WA Medicaid ,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1067.66,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,96004.8,33.9,,,percent of total billed charges,33.9% of total billed charges,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2208.96,78,,,percent of total billed charges,78% of total billed charges,2832,100,,,percent of total billed charges,100% of total billed charges,2339.23,82.6,,,percent of total billed charges,82.6% of total billed charges,2339.23,82.6,,,percent of total billed charges,82.6% of total billed charges,342.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.9,96004.8,
REMOVE VAGINA GLAND LESION,96056740,CDM,960,RC,56740,HCPCS,Outpatient,,,573,372.45,,504.24,88,,,percent of total billed charges,88% of total Billed charges,31.06,100,,,Fee Schedule,100% of Medicare rate,180.91,100,,,Fee Schedule,100% of WA Medicaid,573,100,,,percent of total billed charges,100% of total billed charges,186.34,103,,,Fee Schedule,103% of WA Medicaid,31.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,180.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,395.37,69,,,percent of total billed charges,69% of total billed charges,573,100,,,percent of total billed charges,100% of total billed charges,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,573,100,,,percent of total billed charges,100% of total billed charges,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,573,100,,,percent of total billed charges,100% of total billed charges,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.4,61.85,,,percent of total billed charges,61.85% of total billed charges,180.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,235.18,130,,,Fee Schedule,130% of WA Medicaid ,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.02,37.7,,,percent of total billed charges,37.70% of total billed charges,216.02,37.7,,,percent of total billed charges,37.70% of total billed charges,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,19424.7,33.9,,,percent of total billed charges,33.9% of total billed charges,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.94,78,,,percent of total billed charges,78% of total billed charges,573,100,,,percent of total billed charges,100% of total billed charges,473.3,82.6,,,percent of total billed charges,82.6% of total billed charges,473.3,82.6,,,percent of total billed charges,82.6% of total billed charges,180.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.06,19424.7,
ANTERIOR COLPURRHAPHY,96057240,CDM,960,RC,57240,HCPCS,Outpatient,,,1400,910.00,,1232,88,,,percent of total billed charges,88% of total Billed charges,59.25,100,,,Fee Schedule,100% of Medicare rate,351.37,100,,,Fee Schedule,100% of WA Medicaid,1400,100,,,percent of total billed charges,100% of total billed charges,361.91,103,,,Fee Schedule,103% of WA Medicaid,59.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,351.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,966,69,,,percent of total billed charges,69% of total billed charges,1400,100,,,percent of total billed charges,100% of total billed charges,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1400,100,,,percent of total billed charges,100% of total billed charges,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1400,100,,,percent of total billed charges,100% of total billed charges,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,865.9,61.85,,,percent of total billed charges,61.85% of total billed charges,351.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,456.78,130,,,Fee Schedule,130% of WA Medicaid ,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.8,37.7,,,percent of total billed charges,37.70% of total billed charges,527.8,37.7,,,percent of total billed charges,37.70% of total billed charges,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,47460,33.9,,,percent of total billed charges,33.9% of total billed charges,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1092,78,,,percent of total billed charges,78% of total billed charges,1400,100,,,percent of total billed charges,100% of total billed charges,1156.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1156.4,82.6,,,percent of total billed charges,82.6% of total billed charges,351.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.25,47460,
57260 COMBINED ANTEROPOSTERIOR COLPORRHAPHY; ProFee,97557260,CDM,975,RC,57260,HCPCS,Outpatient,,,2415,1569.75,,2125.2,88,,,percent of total billed charges,88% of total Billed charges,79.2,100,,,Fee Schedule,100% of Medicare rate,444.06,100,,,Fee Schedule,100% of WA Medicaid,2415,100,,,percent of total billed charges,100% of total billed charges,457.38,103,,,Fee Schedule,103% of WA Medicaid,79.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,444.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1666.35,69,,,percent of total billed charges,69% of total billed charges,2415,100,,,percent of total billed charges,100% of total billed charges,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2415,100,,,percent of total billed charges,100% of total billed charges,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2415,100,,,percent of total billed charges,100% of total billed charges,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1493.68,61.85,,,percent of total billed charges,61.85% of total billed charges,444.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,577.28,130,,,Fee Schedule,130% of WA Medicaid ,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,910.46,37.7,,,percent of total billed charges,37.70% of total billed charges,910.46,37.7,,,percent of total billed charges,37.70% of total billed charges,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,81868.5,33.9,,,percent of total billed charges,33.9% of total billed charges,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1883.7,78,,,percent of total billed charges,78% of total billed charges,2415,100,,,percent of total billed charges,100% of total billed charges,1994.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1994.79,82.6,,,percent of total billed charges,82.6% of total billed charges,444.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.2,81868.5,
SLING OPERATION STRESS INCONT,96057288,CDM,960,RC,57288,HCPCS,Outpatient,,,1085,705.25,,954.8,88,,,percent of total billed charges,88% of total Billed charges,70.44,100,,,Fee Schedule,100% of Medicare rate,425.97,100,,,Fee Schedule,100% of WA Medicaid,1085,100,,,percent of total billed charges,100% of total billed charges,438.75,103,,,Fee Schedule,103% of WA Medicaid,70.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,123.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,425.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,748.65,69,,,percent of total billed charges,69% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.07,61.85,,,percent of total billed charges,61.85% of total billed charges,425.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,553.76,130,,,Fee Schedule,130% of WA Medicaid ,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,36781.5,33.9,,,percent of total billed charges,33.9% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.3,78,,,percent of total billed charges,78% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,425.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.44,36781.5,
57320 CLOSURE OF VESICOVAGINAL FISTULA; VAGINAL APPROACH Pro,97557320,CDM,975,RC,57320,HCPCS,Outpatient,,,1247,810.55,,1097.36,88,,,percent of total billed charges,88% of total Billed charges,56.27,100,,,Fee Schedule,100% of Medicare rate,324.51,100,,,Fee Schedule,100% of WA Medicaid,1247,100,,,percent of total billed charges,100% of total billed charges,334.25,103,,,Fee Schedule,103% of WA Medicaid,56.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,98.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,324.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,860.43,69,,,percent of total billed charges,69% of total billed charges,1247,100,,,percent of total billed charges,100% of total billed charges,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1247,100,,,percent of total billed charges,100% of total billed charges,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1247,100,,,percent of total billed charges,100% of total billed charges,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,771.27,61.85,,,percent of total billed charges,61.85% of total billed charges,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,331,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,421.86,130,,,Fee Schedule,130% of WA Medicaid ,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.12,37.7,,,percent of total billed charges,37.70% of total billed charges,470.12,37.7,,,percent of total billed charges,37.70% of total billed charges,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,42273.3,33.9,,,percent of total billed charges,33.9% of total billed charges,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,972.66,78,,,percent of total billed charges,78% of total billed charges,1247,100,,,percent of total billed charges,100% of total billed charges,1030.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1030.02,82.6,,,percent of total billed charges,82.6% of total billed charges,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.27,42273.3,
"57425 LAPAROSCOPY, SURGICAL, COLPOPEXY (SUSPENSION",97557425,CDM,975,RC,57425,HCPCS,Outpatient,,,2808,1825.20,,2471.04,88,,,percent of total billed charges,88% of total Billed charges,98.46,100,,,Fee Schedule,100% of Medicare rate,552.97,100,,,Fee Schedule,100% of WA Medicaid,2808,100,,,percent of total billed charges,100% of total billed charges,569.56,103,,,Fee Schedule,103% of WA Medicaid,98.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,172.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,552.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1937.52,69,,,percent of total billed charges,69% of total billed charges,2808,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2808,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2808,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1736.75,61.85,,,percent of total billed charges,61.85% of total billed charges,552.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,718.86,130,,,Fee Schedule,130% of WA Medicaid ,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1058.62,37.7,,,percent of total billed charges,37.70% of total billed charges,1058.62,37.7,,,percent of total billed charges,37.70% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,95191.2,33.9,,,percent of total billed charges,33.9% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2190.24,78,,,percent of total billed charges,78% of total billed charges,2808,100,,,percent of total billed charges,100% of total billed charges,2319.41,82.6,,,percent of total billed charges,82.6% of total billed charges,2319.41,82.6,,,percent of total billed charges,82.6% of total billed charges,552.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.46,95191.2,
"57520 CONIZATION OF CERVIX, WITH OR WITHOUT FULGURATION, WIT",97557520,CDM,975,RC,57520,HCPCS,Outpatient,,,1586,1030.90,,1395.68,88,,,percent of total billed charges,88% of total Billed charges,27.21,100,,,Fee Schedule,100% of Medicare rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,1586,100,,,percent of total billed charges,100% of total billed charges,177.3,103,,,Fee Schedule,103% of WA Medicaid,27.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1094.34,69,,,percent of total billed charges,69% of total billed charges,1586,100,,,percent of total billed charges,100% of total billed charges,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1586,100,,,percent of total billed charges,100% of total billed charges,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1586,100,,,percent of total billed charges,100% of total billed charges,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,980.94,61.85,,,percent of total billed charges,61.85% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,223.78,130,,,Fee Schedule,130% of WA Medicaid ,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.92,37.7,,,percent of total billed charges,37.70% of total billed charges,597.92,37.7,,,percent of total billed charges,37.70% of total billed charges,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,53765.4,33.9,,,percent of total billed charges,33.9% of total billed charges,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1237.08,78,,,percent of total billed charges,78% of total billed charges,1586,100,,,percent of total billed charges,100% of total billed charges,1310.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.04,82.6,,,percent of total billed charges,82.6% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.21,53765.4,
58100 ENDOMETRIAL SAMPLING (BIOPSY) WITH OR WITHOUT ENDOCERV,97558100,CDM,975,RC,58100,HCPCS,Outpatient,,,307,199.55,,270.16,88,,,percent of total billed charges,88% of total Billed charges,7.06,100,,,Fee Schedule,100% of Medicare rate,35.44,100,,,Fee Schedule,100% of WA Medicaid,307,100,,,percent of total billed charges,100% of total billed charges,36.5,103,,,Fee Schedule,103% of WA Medicaid,7.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,211.83,69,,,percent of total billed charges,69% of total billed charges,307,100,,,percent of total billed charges,100% of total billed charges,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,307,100,,,percent of total billed charges,100% of total billed charges,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,307,100,,,percent of total billed charges,100% of total billed charges,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.88,61.85,,,percent of total billed charges,61.85% of total billed charges,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.07,130,,,Fee Schedule,130% of WA Medicaid ,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.74,37.7,,,percent of total billed charges,37.70% of total billed charges,115.74,37.7,,,percent of total billed charges,37.70% of total billed charges,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,10407.3,33.9,,,percent of total billed charges,33.9% of total billed charges,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.46,78,,,percent of total billed charges,78% of total billed charges,307,100,,,percent of total billed charges,100% of total billed charges,253.58,82.6,,,percent of total billed charges,82.6% of total billed charges,253.58,82.6,,,percent of total billed charges,82.6% of total billed charges,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.06,10407.3,
"58120 DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC",97558120,CDM,975,RC,58120,HCPCS,Outpatient,,,1222,794.30,,1075.36,88,,,percent of total billed charges,88% of total Billed charges,22.64,100,,,Fee Schedule,100% of Medicare rate,134.28,100,,,Fee Schedule,100% of WA Medicaid,1222,100,,,percent of total billed charges,100% of total billed charges,138.31,103,,,Fee Schedule,103% of WA Medicaid,22.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,134.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,843.18,69,,,percent of total billed charges,69% of total billed charges,1222,100,,,percent of total billed charges,100% of total billed charges,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1222,100,,,percent of total billed charges,100% of total billed charges,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1222,100,,,percent of total billed charges,100% of total billed charges,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,755.81,61.85,,,percent of total billed charges,61.85% of total billed charges,134.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.56,130,,,Fee Schedule,130% of WA Medicaid ,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.69,37.7,,,percent of total billed charges,37.70% of total billed charges,460.69,37.7,,,percent of total billed charges,37.70% of total billed charges,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,41425.8,33.9,,,percent of total billed charges,33.9% of total billed charges,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,953.16,78,,,percent of total billed charges,78% of total billed charges,1222,100,,,percent of total billed charges,100% of total billed charges,1009.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1009.37,82.6,,,percent of total billed charges,82.6% of total billed charges,134.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.64,41425.8,
"58145 MYOMECTOMY, EXCISION OF FIBROID TUMOR(S) OF UTERUS, 1",97558145,CDM,975,RC,58145,HCPCS,Outpatient,,,814,529.10,,716.32,88,,,percent of total billed charges,88% of total Billed charges,56.66,100,,,Fee Schedule,100% of Medicare rate,327.12,100,,,Fee Schedule,100% of WA Medicaid,814,100,,,percent of total billed charges,100% of total billed charges,336.93,103,,,Fee Schedule,103% of WA Medicaid,56.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,327.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,561.66,69,,,percent of total billed charges,69% of total billed charges,814,100,,,percent of total billed charges,100% of total billed charges,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,814,100,,,percent of total billed charges,100% of total billed charges,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,814,100,,,percent of total billed charges,100% of total billed charges,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,503.46,61.85,,,percent of total billed charges,61.85% of total billed charges,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,425.26,130,,,Fee Schedule,130% of WA Medicaid ,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.88,37.7,,,percent of total billed charges,37.70% of total billed charges,306.88,37.7,,,percent of total billed charges,37.70% of total billed charges,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,27594.6,33.9,,,percent of total billed charges,33.9% of total billed charges,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.92,78,,,percent of total billed charges,78% of total billed charges,814,100,,,percent of total billed charges,100% of total billed charges,672.36,82.6,,,percent of total billed charges,82.6% of total billed charges,672.36,82.6,,,percent of total billed charges,82.6% of total billed charges,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.66,27594.6,
TOTAL ABDOM HYSTERECTOMY,96058150,CDM,960,RC,58150,HCPCS,Outpatient,,,2147,1395.55,,1889.36,88,,,percent of total billed charges,88% of total Billed charges,106.03,100,,,Fee Schedule,100% of Medicare rate,578.71,100,,,Fee Schedule,100% of WA Medicaid,2147,100,,,percent of total billed charges,100% of total billed charges,596.07,103,,,Fee Schedule,103% of WA Medicaid,106.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,185.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,578.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1481.43,69,,,percent of total billed charges,69% of total billed charges,2147,100,,,percent of total billed charges,100% of total billed charges,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2147,100,,,percent of total billed charges,100% of total billed charges,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2147,100,,,percent of total billed charges,100% of total billed charges,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1327.92,61.85,,,percent of total billed charges,61.85% of total billed charges,578.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,578.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,752.32,130,,,Fee Schedule,130% of WA Medicaid ,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,809.42,37.7,,,percent of total billed charges,37.70% of total billed charges,809.42,37.7,,,percent of total billed charges,37.70% of total billed charges,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,72783.3,33.9,,,percent of total billed charges,33.9% of total billed charges,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1674.66,78,,,percent of total billed charges,78% of total billed charges,2147,100,,,percent of total billed charges,100% of total billed charges,1773.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1773.42,82.6,,,percent of total billed charges,82.6% of total billed charges,578.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,578.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.03,72783.3,
SUPRACERV ABD HYSTERECTOMY,96058180,CDM,960,RC,58180,HCPCS,Outpatient,,,2057,1337.05,,1810.16,88,,,percent of total billed charges,88% of total Billed charges,102.02,100,,,Fee Schedule,100% of Medicare rate,546.63,100,,,Fee Schedule,100% of WA Medicaid,2057,100,,,percent of total billed charges,100% of total billed charges,563.03,103,,,Fee Schedule,103% of WA Medicaid,102.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,178.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,546.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1419.33,69,,,percent of total billed charges,69% of total billed charges,2057,100,,,percent of total billed charges,100% of total billed charges,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2057,100,,,percent of total billed charges,100% of total billed charges,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2057,100,,,percent of total billed charges,100% of total billed charges,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272.25,61.85,,,percent of total billed charges,61.85% of total billed charges,546.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,710.62,130,,,Fee Schedule,130% of WA Medicaid ,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,775.49,37.7,,,percent of total billed charges,37.70% of total billed charges,775.49,37.7,,,percent of total billed charges,37.70% of total billed charges,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,69732.3,33.9,,,percent of total billed charges,33.9% of total billed charges,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1604.46,78,,,percent of total billed charges,78% of total billed charges,2057,100,,,percent of total billed charges,100% of total billed charges,1699.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1699.08,82.6,,,percent of total billed charges,82.6% of total billed charges,546.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,102.02,69732.3,
58300 INSERTION OF INTRAUTERINE DEVICE (IUD) ProFe,97558300,CDM,975,RC,58300,HCPCS,Outpatient,,,178,115.70,,156.64,88,,,percent of total billed charges,88% of total Billed charges,4.1,100,,,Fee Schedule,100% of Medicare rate,327.35,100,,,Fee Schedule,100% of WA Medicaid,178,100,,,percent of total billed charges,100% of total billed charges,337.17,103,,,Fee Schedule,103% of WA Medicaid,4.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,327.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,122.82,69,,,percent of total billed charges,69% of total billed charges,178,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,178,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,178,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.09,61.85,,,percent of total billed charges,61.85% of total billed charges,327.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,425.56,130,,,Fee Schedule,130% of WA Medicaid ,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.11,37.7,,,percent of total billed charges,37.70% of total billed charges,67.11,37.7,,,percent of total billed charges,37.70% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6034.2,33.9,,,percent of total billed charges,33.9% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.84,78,,,percent of total billed charges,78% of total billed charges,178,100,,,percent of total billed charges,100% of total billed charges,147.03,82.6,,,percent of total billed charges,82.6% of total billed charges,147.03,82.6,,,percent of total billed charges,82.6% of total billed charges,327.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.1,6034.2,
58301 REMOVAL OF INTRAUTERINE DEVICE (IUD) ProFee,96058301,CDM,960,RC,58301,HCPCS,Outpatient,,,221,143.65,,194.48,88,,,percent of total billed charges,88% of total Billed charges,7.41,100,,,Fee Schedule,100% of Medicare rate,37.11,100,,,Fee Schedule,100% of WA Medicaid,221,100,,,percent of total billed charges,100% of total billed charges,38.22,103,,,Fee Schedule,103% of WA Medicaid,7.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,37.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,152.49,69,,,percent of total billed charges,69% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,221,100,,,percent of total billed charges,100% of total billed charges,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,221,100,,,percent of total billed charges,100% of total billed charges,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.69,61.85,,,percent of total billed charges,61.85% of total billed charges,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,48.24,130,,,Fee Schedule,130% of WA Medicaid ,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7491.9,33.9,,,percent of total billed charges,33.9% of total billed charges,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.38,78,,,percent of total billed charges,78% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.41,7491.9,
LAP SUPRACERVICAL HYSTERECTOMY,96058541,CDM,960,RC,58541,HCPCS,Outpatient,,,1852,1203.80,,1629.76,88,,,percent of total billed charges,88% of total Billed charges,72.87,100,,,Fee Schedule,100% of Medicare rate,417.57,100,,,Fee Schedule,100% of WA Medicaid,1852,100,,,percent of total billed charges,100% of total billed charges,430.1,103,,,Fee Schedule,103% of WA Medicaid,72.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,127.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,417.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1277.88,69,,,percent of total billed charges,69% of total billed charges,1852,100,,,percent of total billed charges,100% of total billed charges,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1852,100,,,percent of total billed charges,100% of total billed charges,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1852,100,,,percent of total billed charges,100% of total billed charges,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1145.46,61.85,,,percent of total billed charges,61.85% of total billed charges,417.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,542.84,130,,,Fee Schedule,130% of WA Medicaid ,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.2,37.7,,,percent of total billed charges,37.70% of total billed charges,698.2,37.7,,,percent of total billed charges,37.70% of total billed charges,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,62782.8,33.9,,,percent of total billed charges,33.9% of total billed charges,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1444.56,78,,,percent of total billed charges,78% of total billed charges,1852,100,,,percent of total billed charges,100% of total billed charges,1529.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1529.75,82.6,,,percent of total billed charges,82.6% of total billed charges,417.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.87,62782.8,
"LAPAROSCOPY,SURG,W/VAG HYST",96058550,CDM,960,RC,58550,HCPCS,Outpatient,,,1894,1231.10,,1666.72,88,,,percent of total billed charges,88% of total Billed charges,92.42,100,,,Fee Schedule,100% of Medicare rate,502.62,100,,,Fee Schedule,100% of WA Medicaid,1894,100,,,percent of total billed charges,100% of total billed charges,517.7,103,,,Fee Schedule,103% of WA Medicaid,92.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,161.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,502.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1306.86,69,,,percent of total billed charges,69% of total billed charges,1894,100,,,percent of total billed charges,100% of total billed charges,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1894,100,,,percent of total billed charges,100% of total billed charges,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1894,100,,,percent of total billed charges,100% of total billed charges,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1171.44,61.85,,,percent of total billed charges,61.85% of total billed charges,502.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,653.41,130,,,Fee Schedule,130% of WA Medicaid ,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.04,37.7,,,percent of total billed charges,37.70% of total billed charges,714.04,37.7,,,percent of total billed charges,37.70% of total billed charges,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,64206.6,33.9,,,percent of total billed charges,33.9% of total billed charges,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1477.32,78,,,percent of total billed charges,78% of total billed charges,1894,100,,,percent of total billed charges,100% of total billed charges,1564.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1564.44,82.6,,,percent of total billed charges,82.6% of total billed charges,502.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,92.42,64206.6,
HYSTEROSCOPY W/BX,96058558,CDM,960,RC,58558,HCPCS,Outpatient,,,795,516.75,,699.6,88,,,percent of total billed charges,88% of total Billed charges,25.3,100,,,Fee Schedule,100% of Medicare rate,130.18,100,,,Fee Schedule,100% of WA Medicaid,795,100,,,percent of total billed charges,100% of total billed charges,134.09,103,,,Fee Schedule,103% of WA Medicaid,25.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,130.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,548.55,69,,,percent of total billed charges,69% of total billed charges,795,100,,,percent of total billed charges,100% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,795,100,,,percent of total billed charges,100% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,795,100,,,percent of total billed charges,100% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.71,61.85,,,percent of total billed charges,61.85% of total billed charges,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,169.23,130,,,Fee Schedule,130% of WA Medicaid ,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.72,37.7,,,percent of total billed charges,37.70% of total billed charges,299.72,37.7,,,percent of total billed charges,37.70% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,26950.5,33.9,,,percent of total billed charges,33.9% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,620.1,78,,,percent of total billed charges,78% of total billed charges,795,100,,,percent of total billed charges,100% of total billed charges,656.67,82.6,,,percent of total billed charges,82.6% of total billed charges,656.67,82.6,,,percent of total billed charges,82.6% of total billed charges,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.3,26950.5,
"58563 HYSTEROSCOPY, SURGICAL; WITH ENDOMETRIAL ABL",97558563,CDM,975,RC,58563,HCPCS,Outpatient,,,3882,2523.30,,3416.16,88,,,percent of total billed charges,88% of total Billed charges,26.76,100,,,Fee Schedule,100% of Medicare rate,138.2,100,,,Fee Schedule,100% of WA Medicaid,3882,100,,,percent of total billed charges,100% of total billed charges,142.35,103,,,Fee Schedule,103% of WA Medicaid,26.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,46.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,138.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2678.58,69,,,percent of total billed charges,69% of total billed charges,3882,100,,,percent of total billed charges,100% of total billed charges,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,3882,100,,,percent of total billed charges,100% of total billed charges,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,3882,100,,,percent of total billed charges,100% of total billed charges,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2401.02,61.85,,,percent of total billed charges,61.85% of total billed charges,138.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,179.66,130,,,Fee Schedule,130% of WA Medicaid ,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1463.51,37.7,,,percent of total billed charges,37.70% of total billed charges,1463.51,37.7,,,percent of total billed charges,37.70% of total billed charges,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,131599.8,33.9,,,percent of total billed charges,33.9% of total billed charges,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,3027.96,78,,,percent of total billed charges,78% of total billed charges,3882,100,,,percent of total billed charges,100% of total billed charges,3206.53,82.6,,,percent of total billed charges,82.6% of total billed charges,3206.53,82.6,,,percent of total billed charges,82.6% of total billed charges,138.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.76,131599.8,
TLH W/T/O 250 G OR LESS,58571,CDM,975,RC,58571,HCPCS,Outpatient,,,2901,1885.65,,2552.88,88,,,percent of total billed charges,88% of total Billed charges,93.28,100,,,Fee Schedule,100% of Medicare rate,519.4,100,,,Fee Schedule,100% of WA Medicaid,2901,100,,,percent of total billed charges,100% of total billed charges,534.98,103,,,Fee Schedule,103% of WA Medicaid,93.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,163.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,519.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2001.69,69,,,percent of total billed charges,69% of total billed charges,2901,100,,,percent of total billed charges,100% of total billed charges,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2901,100,,,percent of total billed charges,100% of total billed charges,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2901,100,,,percent of total billed charges,100% of total billed charges,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1794.27,61.85,,,percent of total billed charges,61.85% of total billed charges,519.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,529.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,675.22,130,,,Fee Schedule,130% of WA Medicaid ,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1093.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1093.68,37.7,,,percent of total billed charges,37.70% of total billed charges,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,98343.9,33.9,,,percent of total billed charges,33.9% of total billed charges,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2262.78,78,,,percent of total billed charges,78% of total billed charges,2901,100,,,percent of total billed charges,100% of total billed charges,2396.23,82.6,,,percent of total billed charges,82.6% of total billed charges,2396.23,82.6,,,percent of total billed charges,82.6% of total billed charges,519.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,93.28,98343.9,
"58573 LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTO",97558573,CDM,975,RC,58573,HCPCS,Outpatient,,,3718,2416.70,,3271.84,88,,,percent of total billed charges,88% of total Billed charges,128.19,100,,,Fee Schedule,100% of Medicare rate,693.78,100,,,Fee Schedule,100% of WA Medicaid,3718,100,,,percent of total billed charges,100% of total billed charges,714.59,103,,,Fee Schedule,103% of WA Medicaid,128.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,224.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,693.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2565.42,69,,,percent of total billed charges,69% of total billed charges,3718,100,,,percent of total billed charges,100% of total billed charges,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,3718,100,,,percent of total billed charges,100% of total billed charges,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,3718,100,,,percent of total billed charges,100% of total billed charges,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2299.58,61.85,,,percent of total billed charges,61.85% of total billed charges,693.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,693.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,707.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,901.91,130,,,Fee Schedule,130% of WA Medicaid ,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1401.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1401.69,37.7,,,percent of total billed charges,37.70% of total billed charges,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,126040.2,33.9,,,percent of total billed charges,33.9% of total billed charges,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2900.04,78,,,percent of total billed charges,78% of total billed charges,3718,100,,,percent of total billed charges,100% of total billed charges,3071.07,82.6,,,percent of total billed charges,82.6% of total billed charges,3071.07,82.6,,,percent of total billed charges,82.6% of total billed charges,693.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,693.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.19,126040.2,
97558579,97558579,CDM,975,RC,58579,HCPCS,Outpatient,,,154,100.10,,135.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,154,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,106.26,69,,,percent of total billed charges,69% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,154,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,154,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,95.25,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,5220.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,120.12,78,,,percent of total billed charges,78% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",58.06,5220.6,
58611 TUBAL AT TIME OF C-SECT,97558611,CDM,975,RC,58611,HCPCS,Outpatient,,,844,548.60,,742.72,88,,,percent of total billed charges,88% of total Billed charges,8.46,100,,,Fee Schedule,100% of Medicare rate,42.15,100,,,Fee Schedule,100% of WA Medicaid,844,100,,,percent of total billed charges,100% of total billed charges,43.41,103,,,Fee Schedule,103% of WA Medicaid,8.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,582.36,69,,,percent of total billed charges,69% of total billed charges,844,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,844,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,844,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.01,61.85,,,percent of total billed charges,61.85% of total billed charges,42.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,54.8,130,,,Fee Schedule,130% of WA Medicaid ,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.19,37.7,,,percent of total billed charges,37.70% of total billed charges,318.19,37.7,,,percent of total billed charges,37.70% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,28611.6,33.9,,,percent of total billed charges,33.9% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.32,78,,,percent of total billed charges,78% of total billed charges,844,100,,,percent of total billed charges,100% of total billed charges,697.14,82.6,,,percent of total billed charges,82.6% of total billed charges,697.14,82.6,,,percent of total billed charges,82.6% of total billed charges,42.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.46,28611.6,
LAPROSC W/ LYSIS OF ADHESIONS,96058660,CDM,960,RC,58660,HCPCS,Outpatient,,,1439,935.35,,1266.32,88,,,percent of total billed charges,88% of total Billed charges,78.9,100,,,Fee Schedule,100% of Medicare rate,388.85,100,,,Fee Schedule,100% of WA Medicaid,1439,100,,,percent of total billed charges,100% of total billed charges,400.52,103,,,Fee Schedule,103% of WA Medicaid,78.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,388.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,992.91,69,,,percent of total billed charges,69% of total billed charges,1439,100,,,percent of total billed charges,100% of total billed charges,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1439,100,,,percent of total billed charges,100% of total billed charges,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1439,100,,,percent of total billed charges,100% of total billed charges,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,890.02,61.85,,,percent of total billed charges,61.85% of total billed charges,388.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,505.51,130,,,Fee Schedule,130% of WA Medicaid ,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,542.5,37.7,,,percent of total billed charges,37.70% of total billed charges,542.5,37.7,,,percent of total billed charges,37.70% of total billed charges,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,48782.1,33.9,,,percent of total billed charges,33.9% of total billed charges,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1122.42,78,,,percent of total billed charges,78% of total billed charges,1439,100,,,percent of total billed charges,100% of total billed charges,1188.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1188.61,82.6,,,percent of total billed charges,82.6% of total billed charges,388.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.9,48782.1,
LAP SUR W/FULGUR EXC LES OVARY,96058662,CDM,960,RC,58662,HCPCS,Outpatient,,,1507,979.55,,1326.16,88,,,percent of total billed charges,88% of total Billed charges,75.66,100,,,Fee Schedule,100% of Medicare rate,406.38,100,,,Fee Schedule,100% of WA Medicaid,1507,100,,,percent of total billed charges,100% of total billed charges,418.57,103,,,Fee Schedule,103% of WA Medicaid,75.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,132.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,406.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1039.83,69,,,percent of total billed charges,69% of total billed charges,1507,100,,,percent of total billed charges,100% of total billed charges,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1507,100,,,percent of total billed charges,100% of total billed charges,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1507,100,,,percent of total billed charges,100% of total billed charges,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,932.08,61.85,,,percent of total billed charges,61.85% of total billed charges,406.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,528.29,130,,,Fee Schedule,130% of WA Medicaid ,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,568.14,37.7,,,percent of total billed charges,37.70% of total billed charges,568.14,37.7,,,percent of total billed charges,37.70% of total billed charges,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,51087.3,33.9,,,percent of total billed charges,33.9% of total billed charges,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1175.46,78,,,percent of total billed charges,78% of total billed charges,1507,100,,,percent of total billed charges,100% of total billed charges,1244.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1244.78,82.6,,,percent of total billed charges,82.6% of total billed charges,406.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.66,51087.3,
58661 LAP W/REMOVAL OF ADNEXAL STRUCTURES,97558661,CDM,975,RC,58661,HCPCS,Outpatient,,,1862,1210.30,,1638.56,88,,,percent of total billed charges,88% of total Billed charges,69.39,100,,,Fee Schedule,100% of Medicare rate,370.76,100,,,Fee Schedule,100% of WA Medicaid,1862,100,,,percent of total billed charges,100% of total billed charges,381.88,103,,,Fee Schedule,103% of WA Medicaid,69.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,121.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,370.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1284.78,69,,,percent of total billed charges,69% of total billed charges,1862,100,,,percent of total billed charges,100% of total billed charges,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1862,100,,,percent of total billed charges,100% of total billed charges,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1862,100,,,percent of total billed charges,100% of total billed charges,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1151.65,61.85,,,percent of total billed charges,61.85% of total billed charges,370.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,481.99,130,,,Fee Schedule,130% of WA Medicaid ,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.97,37.7,,,percent of total billed charges,37.70% of total billed charges,701.97,37.7,,,percent of total billed charges,37.70% of total billed charges,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,63121.8,33.9,,,percent of total billed charges,33.9% of total billed charges,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1452.36,78,,,percent of total billed charges,78% of total billed charges,1862,100,,,percent of total billed charges,100% of total billed charges,1538.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1538.01,82.6,,,percent of total billed charges,82.6% of total billed charges,370.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.39,63121.8,
"58679 UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT, OVARY ProFee",97558679,CDM,975,RC,58679,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2860,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2860,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2860,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,96954,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1078.22,96954,
LAPAROSCOPY W/ FULG OF OVIDUCT,97558670,CDM,975,RC,58670,HCPCS,Outpatient,,,815,529.75,,717.2,88,,,percent of total billed charges,88% of total Billed charges,37.45,100,,,Fee Schedule,100% of Medicare rate,213.54,100,,,Fee Schedule,100% of WA Medicaid,815,100,,,percent of total billed charges,100% of total billed charges,219.95,103,,,Fee Schedule,103% of WA Medicaid,37.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,213.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,562.35,69,,,percent of total billed charges,69% of total billed charges,815,100,,,percent of total billed charges,100% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,815,100,,,percent of total billed charges,100% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,815,100,,,percent of total billed charges,100% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.08,61.85,,,percent of total billed charges,61.85% of total billed charges,213.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,277.6,130,,,Fee Schedule,130% of WA Medicaid ,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.26,37.7,,,percent of total billed charges,37.70% of total billed charges,307.26,37.7,,,percent of total billed charges,37.70% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,27628.5,33.9,,,percent of total billed charges,33.9% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,635.7,78,,,percent of total billed charges,78% of total billed charges,815,100,,,percent of total billed charges,100% of total billed charges,673.19,82.6,,,percent of total billed charges,82.6% of total billed charges,673.19,82.6,,,percent of total billed charges,82.6% of total billed charges,213.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.45,27628.5,
SALPINGO-OOPHORECTOMY,96058720,CDM,960,RC,58720,HCPCS,Outpatient,,,1553,1009.45,,1366.64,88,,,percent of total billed charges,88% of total Billed charges,78.71,100,,,Fee Schedule,100% of Medicare rate,435.1,100,,,Fee Schedule,100% of WA Medicaid,1553,100,,,percent of total billed charges,100% of total billed charges,448.15,103,,,Fee Schedule,103% of WA Medicaid,78.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,435.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1071.57,69,,,percent of total billed charges,69% of total billed charges,1553,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1553,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1553,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,960.53,61.85,,,percent of total billed charges,61.85% of total billed charges,435.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,565.63,130,,,Fee Schedule,130% of WA Medicaid ,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.48,37.7,,,percent of total billed charges,37.70% of total billed charges,585.48,37.7,,,percent of total billed charges,37.70% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,52646.7,33.9,,,percent of total billed charges,33.9% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1211.34,78,,,percent of total billed charges,78% of total billed charges,1553,100,,,percent of total billed charges,100% of total billed charges,1282.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1282.78,82.6,,,percent of total billed charges,82.6% of total billed charges,435.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.71,52646.7,
LYSIS IF ADHESIONS,96058740,CDM,960,RC,58740,HCPCS,Outpatient,,,1872,1216.80,,1647.36,88,,,percent of total billed charges,88% of total Billed charges,98.44,100,,,Fee Schedule,100% of Medicare rate,513.81,100,,,Fee Schedule,100% of WA Medicaid,1872,100,,,percent of total billed charges,100% of total billed charges,529.22,103,,,Fee Schedule,103% of WA Medicaid,98.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,172.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,513.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1291.68,69,,,percent of total billed charges,69% of total billed charges,1872,100,,,percent of total billed charges,100% of total billed charges,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1872,100,,,percent of total billed charges,100% of total billed charges,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1872,100,,,percent of total billed charges,100% of total billed charges,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1157.83,61.85,,,percent of total billed charges,61.85% of total billed charges,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,667.95,130,,,Fee Schedule,130% of WA Medicaid ,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,705.74,37.7,,,percent of total billed charges,37.70% of total billed charges,705.74,37.7,,,percent of total billed charges,37.70% of total billed charges,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,63460.8,33.9,,,percent of total billed charges,33.9% of total billed charges,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1460.16,78,,,percent of total billed charges,78% of total billed charges,1872,100,,,percent of total billed charges,100% of total billed charges,1546.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1546.27,82.6,,,percent of total billed charges,82.6% of total billed charges,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.44,63460.8,
OVARIAN CYSTECTOMY,96058925,CDM,960,RC,58925,HCPCS,Outpatient,,,1584,1029.60,,1393.92,88,,,percent of total billed charges,88% of total Billed charges,83.53,100,,,Fee Schedule,100% of Medicare rate,437.9,100,,,Fee Schedule,100% of WA Medicaid,1584,100,,,percent of total billed charges,100% of total billed charges,451.04,103,,,Fee Schedule,103% of WA Medicaid,83.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,146.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,437.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1092.96,69,,,percent of total billed charges,69% of total billed charges,1584,100,,,percent of total billed charges,100% of total billed charges,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1584,100,,,percent of total billed charges,100% of total billed charges,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1584,100,,,percent of total billed charges,100% of total billed charges,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,979.7,61.85,,,percent of total billed charges,61.85% of total billed charges,437.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,437.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,569.27,130,,,Fee Schedule,130% of WA Medicaid ,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.17,37.7,,,percent of total billed charges,37.70% of total billed charges,597.17,37.7,,,percent of total billed charges,37.70% of total billed charges,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,53697.6,33.9,,,percent of total billed charges,33.9% of total billed charges,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1235.52,78,,,percent of total billed charges,78% of total billed charges,1584,100,,,percent of total billed charges,100% of total billed charges,1308.38,82.6,,,percent of total billed charges,82.6% of total billed charges,1308.38,82.6,,,percent of total billed charges,82.6% of total billed charges,437.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,437.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.53,53697.6,
OOPHORECTOMY,96058940,CDM,960,RC,58940,HCPCS,Outpatient,,,1110,721.50,,976.8,88,,,percent of total billed charges,88% of total Billed charges,57.28,100,,,Fee Schedule,100% of Medicare rate,319.29,100,,,Fee Schedule,100% of WA Medicaid,1110,100,,,percent of total billed charges,100% of total billed charges,328.87,103,,,Fee Schedule,103% of WA Medicaid,57.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,319.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,765.9,69,,,percent of total billed charges,69% of total billed charges,1110,100,,,percent of total billed charges,100% of total billed charges,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1110,100,,,percent of total billed charges,100% of total billed charges,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1110,100,,,percent of total billed charges,100% of total billed charges,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.54,61.85,,,percent of total billed charges,61.85% of total billed charges,319.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,415.08,130,,,Fee Schedule,130% of WA Medicaid ,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.47,37.7,,,percent of total billed charges,37.70% of total billed charges,418.47,37.7,,,percent of total billed charges,37.70% of total billed charges,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,37629,33.9,,,percent of total billed charges,33.9% of total billed charges,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,865.8,78,,,percent of total billed charges,78% of total billed charges,1110,100,,,percent of total billed charges,100% of total billed charges,916.86,82.6,,,percent of total billed charges,82.6% of total billed charges,916.86,82.6,,,percent of total billed charges,82.6% of total billed charges,319.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.28,37629,
SURGICAL TRMT OF ECTOPIC PREG,96059120,CDM,960,RC,59120,HCPCS,Outpatient,,,1682,1093.30,,1480.16,88,,,percent of total billed charges,88% of total Billed charges,125.01,100,,,Fee Schedule,100% of Medicare rate,812.64,100,,,Fee Schedule,100% of WA Medicaid,1682,100,,,percent of total billed charges,100% of total billed charges,837.02,103,,,Fee Schedule,103% of WA Medicaid,125.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,218.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,812.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1160.58,69,,,percent of total billed charges,69% of total billed charges,1682,100,,,percent of total billed charges,100% of total billed charges,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1682,100,,,percent of total billed charges,100% of total billed charges,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1682,100,,,percent of total billed charges,100% of total billed charges,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1040.32,61.85,,,percent of total billed charges,61.85% of total billed charges,812.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,812.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,828.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1056.43,130,,,Fee Schedule,130% of WA Medicaid ,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.11,37.7,,,percent of total billed charges,37.70% of total billed charges,634.11,37.7,,,percent of total billed charges,37.70% of total billed charges,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,57019.8,33.9,,,percent of total billed charges,33.9% of total billed charges,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1311.96,78,,,percent of total billed charges,78% of total billed charges,1682,100,,,percent of total billed charges,100% of total billed charges,1389.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1389.33,82.6,,,percent of total billed charges,82.6% of total billed charges,812.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,812.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,125.01,57019.8,
97559121,97559121,CDM,975,RC,59121,HCPCS,Outpatient,,,2849,1851.85,,2507.12,88,,,percent of total billed charges,88% of total Billed charges,125.53,100,,,Fee Schedule,100% of Medicare rate,812.75,100,,,Fee Schedule,100% of WA Medicaid,2849,100,,,percent of total billed charges,100% of total billed charges,837.13,103,,,Fee Schedule,103% of WA Medicaid,125.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,219.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,812.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1965.81,69,,,percent of total billed charges,69% of total billed charges,2849,100,,,percent of total billed charges,100% of total billed charges,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2849,100,,,percent of total billed charges,100% of total billed charges,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2849,100,,,percent of total billed charges,100% of total billed charges,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1762.11,61.85,,,percent of total billed charges,61.85% of total billed charges,812.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,812.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1056.58,130,,,Fee Schedule,130% of WA Medicaid ,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1074.07,37.7,,,percent of total billed charges,37.70% of total billed charges,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,96581.1,33.9,,,percent of total billed charges,33.9% of total billed charges,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2222.22,78,,,percent of total billed charges,78% of total billed charges,2849,100,,,percent of total billed charges,100% of total billed charges,2353.27,82.6,,,percent of total billed charges,82.6% of total billed charges,2353.27,82.6,,,percent of total billed charges,82.6% of total billed charges,812.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,125.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,812.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,125.53,96581.1,
LAP TRMT OF ECTOP PREGNANCY,96059151,CDM,960,RC,59151,HCPCS,Outpatient,,,1583,1028.95,,1393.04,88,,,percent of total billed charges,88% of total Billed charges,119.35,100,,,Fee Schedule,100% of Medicare rate,770.98,100,,,Fee Schedule,100% of WA Medicaid,1583,100,,,percent of total billed charges,100% of total billed charges,794.11,103,,,Fee Schedule,103% of WA Medicaid,119.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,208.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,770.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1092.27,69,,,percent of total billed charges,69% of total billed charges,1583,100,,,percent of total billed charges,100% of total billed charges,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1583,100,,,percent of total billed charges,100% of total billed charges,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1583,100,,,percent of total billed charges,100% of total billed charges,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,979.09,61.85,,,percent of total billed charges,61.85% of total billed charges,770.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,770.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1002.27,130,,,Fee Schedule,130% of WA Medicaid ,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.79,37.7,,,percent of total billed charges,37.70% of total billed charges,596.79,37.7,,,percent of total billed charges,37.70% of total billed charges,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,53663.7,33.9,,,percent of total billed charges,33.9% of total billed charges,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1234.74,78,,,percent of total billed charges,78% of total billed charges,1583,100,,,percent of total billed charges,100% of total billed charges,1307.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1307.56,82.6,,,percent of total billed charges,82.6% of total billed charges,770.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,770.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.35,53663.7,
"59160 CURETTAGE, POSTPARTUM ProFee",97559160,CDM,975,RC,59160,HCPCS,Outpatient,,,1117,726.05,,982.96,88,,,percent of total billed charges,88% of total Billed charges,27.69,100,,,Fee Schedule,100% of Medicare rate,188.28,100,,,Fee Schedule,100% of WA Medicaid,1117,100,,,percent of total billed charges,100% of total billed charges,193.93,103,,,Fee Schedule,103% of WA Medicaid,27.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,188.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,770.73,69,,,percent of total billed charges,69% of total billed charges,1117,100,,,percent of total billed charges,100% of total billed charges,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117,100,,,percent of total billed charges,100% of total billed charges,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117,100,,,percent of total billed charges,100% of total billed charges,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,690.86,61.85,,,percent of total billed charges,61.85% of total billed charges,188.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,244.76,130,,,Fee Schedule,130% of WA Medicaid ,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.11,37.7,,,percent of total billed charges,37.70% of total billed charges,421.11,37.7,,,percent of total billed charges,37.70% of total billed charges,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,37866.3,33.9,,,percent of total billed charges,33.9% of total billed charges,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,871.26,78,,,percent of total billed charges,78% of total billed charges,1117,100,,,percent of total billed charges,100% of total billed charges,922.64,82.6,,,percent of total billed charges,82.6% of total billed charges,922.64,82.6,,,percent of total billed charges,82.6% of total billed charges,188.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.69,37866.3,
"59320 CERCLAGE OF CERVIX, DURING PREGNANCY; VAGINAL ProFe",97559320,CDM,975,RC,59320,HCPCS,Outpatient,,,1363,885.95,,1199.44,88,,,percent of total billed charges,88% of total Billed charges,23.93,100,,,Fee Schedule,100% of Medicare rate,149.22,100,,,Fee Schedule,100% of WA Medicaid,1363,100,,,percent of total billed charges,100% of total billed charges,153.7,103,,,Fee Schedule,103% of WA Medicaid,23.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,149.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,940.47,69,,,percent of total billed charges,69% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1363,100,,,percent of total billed charges,100% of total billed charges,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1363,100,,,percent of total billed charges,100% of total billed charges,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,843.02,61.85,,,percent of total billed charges,61.85% of total billed charges,149.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,193.99,130,,,Fee Schedule,130% of WA Medicaid ,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,46205.7,33.9,,,percent of total billed charges,33.9% of total billed charges,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.14,78,,,percent of total billed charges,78% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,149.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.93,46205.7,
59350 HYSTERORRHAPHY OF RUPTURED UTERUS ProFee,97559350,CDM,975,RC,59350,HCPCS,Outpatient,,,1540,1001.00,,1355.2,88,,,percent of total billed charges,88% of total Billed charges,47.58,100,,,Fee Schedule,100% of Medicare rate,272,100,,,Fee Schedule,100% of WA Medicaid,1540,100,,,percent of total billed charges,100% of total billed charges,280.16,103,,,Fee Schedule,103% of WA Medicaid,47.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,272,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1062.6,69,,,percent of total billed charges,69% of total billed charges,1540,100,,,percent of total billed charges,100% of total billed charges,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1540,100,,,percent of total billed charges,100% of total billed charges,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1540,100,,,percent of total billed charges,100% of total billed charges,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,952.49,61.85,,,percent of total billed charges,61.85% of total billed charges,272,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,272,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,353.6,130,,,Fee Schedule,130% of WA Medicaid ,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,580.58,37.7,,,percent of total billed charges,37.70% of total billed charges,580.58,37.7,,,percent of total billed charges,37.70% of total billed charges,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,52206,33.9,,,percent of total billed charges,33.9% of total billed charges,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1201.2,78,,,percent of total billed charges,78% of total billed charges,1540,100,,,percent of total billed charges,100% of total billed charges,1272.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1272.04,82.6,,,percent of total billed charges,82.6% of total billed charges,272,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,272,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.58,52206,
59409 VAGINAL DELIVERY ONLY (WITH OR WITHOUT EPISI,97559409,CDM,975,RC,59409,HCPCS,Outpatient,,,2549,1656.85,,2243.12,88,,,percent of total billed charges,88% of total Billed charges,124.94,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,2549,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,124.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,218.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1758.81,69,,,percent of total billed charges,69% of total billed charges,2549,100,,,percent of total billed charges,100% of total billed charges,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2549,100,,,percent of total billed charges,100% of total billed charges,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2549,100,,,percent of total billed charges,100% of total billed charges,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1576.56,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,960.97,37.7,,,percent of total billed charges,37.70% of total billed charges,960.97,37.7,,,percent of total billed charges,37.70% of total billed charges,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,86411.1,33.9,,,percent of total billed charges,33.9% of total billed charges,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1988.22,78,,,percent of total billed charges,78% of total billed charges,2549,100,,,percent of total billed charges,100% of total billed charges,2105.47,82.6,,,percent of total billed charges,82.6% of total billed charges,2105.47,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.94,86411.1,
59510 ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM,96059510,CDM,960,RC,59510,HCPCS,Outpatient,,,4362,2835.30,,3838.56,88,,,percent of total billed charges,88% of total Billed charges,403.93,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,4362,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,403.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,706.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3009.78,69,,,percent of total billed charges,69% of total billed charges,4362,100,,,percent of total billed charges,100% of total billed charges,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4362,100,,,percent of total billed charges,100% of total billed charges,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4362,100,,,percent of total billed charges,100% of total billed charges,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2697.9,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1644.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1644.47,37.7,,,percent of total billed charges,37.70% of total billed charges,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,147871.8,33.9,,,percent of total billed charges,33.9% of total billed charges,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3402.36,78,,,percent of total billed charges,78% of total billed charges,4362,100,,,percent of total billed charges,100% of total billed charges,3603.01,82.6,,,percent of total billed charges,82.6% of total billed charges,3603.01,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,282.81,147871.8,
CESAREAN SECTION,96059514,CDM,960,RC,59514,HCPCS,Outpatient,,,1943,1262.95,,1709.84,88,,,percent of total billed charges,88% of total Billed charges,150.58,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,1943,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,150.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,263.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1340.67,69,,,percent of total billed charges,69% of total billed charges,1943,100,,,percent of total billed charges,100% of total billed charges,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1943,100,,,percent of total billed charges,100% of total billed charges,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1943,100,,,percent of total billed charges,100% of total billed charges,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1201.75,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,732.51,37.7,,,percent of total billed charges,37.70% of total billed charges,732.51,37.7,,,percent of total billed charges,37.70% of total billed charges,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,65867.7,33.9,,,percent of total billed charges,33.9% of total billed charges,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1515.54,78,,,percent of total billed charges,78% of total billed charges,1943,100,,,percent of total billed charges,100% of total billed charges,1604.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1604.92,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,150.58,65867.7,
59515 CESAREAN DELIVERY ONLY; INCLUDING POSTPARTUM CARE ProF,97559515,CDM,975,RC,59515,HCPCS,Outpatient,,,3753,2439.45,,3302.64,88,,,percent of total billed charges,88% of total Billed charges,218.24,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,3753,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,218.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,381.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2589.57,69,,,percent of total billed charges,69% of total billed charges,3753,100,,,percent of total billed charges,100% of total billed charges,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,3753,100,,,percent of total billed charges,100% of total billed charges,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,3753,100,,,percent of total billed charges,100% of total billed charges,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2321.23,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1414.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1414.88,37.7,,,percent of total billed charges,37.70% of total billed charges,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,127226.7,33.9,,,percent of total billed charges,33.9% of total billed charges,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2927.34,78,,,percent of total billed charges,78% of total billed charges,3753,100,,,percent of total billed charges,100% of total billed charges,3099.98,82.6,,,percent of total billed charges,82.6% of total billed charges,3099.98,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,218.24,127226.7,
"59812 TREATMENT OF INCOMPLETE ABORTION, ANY TRIMES",97559812,CDM,975,RC,59812,HCPCS,Outpatient,,,794,516.10,,698.72,88,,,percent of total billed charges,88% of total Billed charges,44.26,100,,,Fee Schedule,100% of Medicare rate,308.16,100,,,Fee Schedule,100% of WA Medicaid,794,100,,,percent of total billed charges,100% of total billed charges,317.4,103,,,Fee Schedule,103% of WA Medicaid,44.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,308.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,547.86,69,,,percent of total billed charges,69% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,794,100,,,percent of total billed charges,100% of total billed charges,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,794,100,,,percent of total billed charges,100% of total billed charges,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.09,61.85,,,percent of total billed charges,61.85% of total billed charges,308.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,400.61,130,,,Fee Schedule,130% of WA Medicaid ,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,26916.6,33.9,,,percent of total billed charges,33.9% of total billed charges,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,619.32,78,,,percent of total billed charges,78% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,308.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.26,26916.6,
"59820 TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FI",97559820,CDM,975,RC,59820,HCPCS,Outpatient,,,1337,869.05,,1176.56,88,,,percent of total billed charges,88% of total Billed charges,49.85,100,,,Fee Schedule,100% of Medicare rate,390.55,100,,,Fee Schedule,100% of WA Medicaid,1337,100,,,percent of total billed charges,100% of total billed charges,402.27,103,,,Fee Schedule,103% of WA Medicaid,49.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,390.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,922.53,69,,,percent of total billed charges,69% of total billed charges,1337,100,,,percent of total billed charges,100% of total billed charges,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1337,100,,,percent of total billed charges,100% of total billed charges,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1337,100,,,percent of total billed charges,100% of total billed charges,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,826.93,61.85,,,percent of total billed charges,61.85% of total billed charges,390.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,507.72,130,,,Fee Schedule,130% of WA Medicaid ,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.05,37.7,,,percent of total billed charges,37.70% of total billed charges,504.05,37.7,,,percent of total billed charges,37.70% of total billed charges,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,45324.3,33.9,,,percent of total billed charges,33.9% of total billed charges,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1042.86,78,,,percent of total billed charges,78% of total billed charges,1337,100,,,percent of total billed charges,100% of total billed charges,1104.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1104.36,82.6,,,percent of total billed charges,82.6% of total billed charges,390.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.85,45324.3,
"59821 TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; SE",97559821,CDM,975,RC,59821,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,51.87,100,,,Fee Schedule,100% of Medicare rate,380.22,100,,,Fee Schedule,100% of WA Medicaid,520,100,,,percent of total billed charges,100% of total billed charges,391.63,103,,,Fee Schedule,103% of WA Medicaid,51.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,380.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,520,100,,,percent of total billed charges,100% of total billed charges,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,520,100,,,percent of total billed charges,100% of total billed charges,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,380.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,494.29,130,,,Fee Schedule,130% of WA Medicaid ,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,17628,33.9,,,percent of total billed charges,33.9% of total billed charges,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,380.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.87,17628,
59870 UTERINE EVACUATION AND CURETTAGE FOR HYDATIDIFORM MOLE,97559870,CDM,975,RC,59870,HCPCS,Outpatient,,,1567,1018.55,,1378.96,88,,,percent of total billed charges,88% of total Billed charges,68.39,100,,,Fee Schedule,100% of Medicare rate,541.91,100,,,Fee Schedule,100% of WA Medicaid,1567,100,,,percent of total billed charges,100% of total billed charges,558.17,103,,,Fee Schedule,103% of WA Medicaid,68.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,119.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,541.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1081.23,69,,,percent of total billed charges,69% of total billed charges,1567,100,,,percent of total billed charges,100% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1567,100,,,percent of total billed charges,100% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1567,100,,,percent of total billed charges,100% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,969.19,61.85,,,percent of total billed charges,61.85% of total billed charges,541.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,704.48,130,,,Fee Schedule,130% of WA Medicaid ,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.76,37.7,,,percent of total billed charges,37.70% of total billed charges,590.76,37.7,,,percent of total billed charges,37.70% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,53121.3,33.9,,,percent of total billed charges,33.9% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1222.26,78,,,percent of total billed charges,78% of total billed charges,1567,100,,,percent of total billed charges,100% of total billed charges,1294.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1294.34,82.6,,,percent of total billed charges,82.6% of total billed charges,541.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.39,53121.3,
"60100 BIOPSY THYROID, PERCUTANEOUS CORE NEEDLE Pro",97560100,CDM,975,RC,60100,HCPCS,Outpatient,,,340,221.00,,299.2,88,,,percent of total billed charges,88% of total Billed charges,6.67,100,,,Fee Schedule,100% of Medicare rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,340,100,,,percent of total billed charges,100% of total billed charges,43.99,103,,,Fee Schedule,103% of WA Medicaid,6.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,234.6,69,,,percent of total billed charges,69% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.29,61.85,,,percent of total billed charges,61.85% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.52,130,,,Fee Schedule,130% of WA Medicaid ,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,11526,33.9,,,percent of total billed charges,33.9% of total billed charges,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.2,78,,,percent of total billed charges,78% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.67,11526,
"60210 PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUT",97560210,CDM,975,RC,60210,HCPCS,Outpatient,,,2293,1490.45,,2017.84,88,,,percent of total billed charges,88% of total Billed charges,80.39,100,,,Fee Schedule,100% of Medicare rate,402.84,100,,,Fee Schedule,100% of WA Medicaid,2293,100,,,percent of total billed charges,100% of total billed charges,414.93,103,,,Fee Schedule,103% of WA Medicaid,80.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,402.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1582.17,69,,,percent of total billed charges,69% of total billed charges,2293,100,,,percent of total billed charges,100% of total billed charges,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2293,100,,,percent of total billed charges,100% of total billed charges,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2293,100,,,percent of total billed charges,100% of total billed charges,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1418.22,61.85,,,percent of total billed charges,61.85% of total billed charges,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,523.69,130,,,Fee Schedule,130% of WA Medicaid ,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,864.46,37.7,,,percent of total billed charges,37.70% of total billed charges,864.46,37.7,,,percent of total billed charges,37.70% of total billed charges,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,77732.7,33.9,,,percent of total billed charges,33.9% of total billed charges,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1788.54,78,,,percent of total billed charges,78% of total billed charges,2293,100,,,percent of total billed charges,100% of total billed charges,1894.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1894.02,82.6,,,percent of total billed charges,82.6% of total billed charges,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.39,77732.7,
TOTAL THYROID LOBECTOMY,96060220,CDM,960,RC,60220,HCPCS,Outpatient,,,1506,978.90,,1325.28,88,,,percent of total billed charges,88% of total Billed charges,76.77,100,,,Fee Schedule,100% of Medicare rate,403.21,100,,,Fee Schedule,100% of WA Medicaid,1506,100,,,percent of total billed charges,100% of total billed charges,415.31,103,,,Fee Schedule,103% of WA Medicaid,76.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,134.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,403.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1039.14,69,,,percent of total billed charges,69% of total billed charges,1506,100,,,percent of total billed charges,100% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1506,100,,,percent of total billed charges,100% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1506,100,,,percent of total billed charges,100% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.46,61.85,,,percent of total billed charges,61.85% of total billed charges,403.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,524.17,130,,,Fee Schedule,130% of WA Medicaid ,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.76,37.7,,,percent of total billed charges,37.70% of total billed charges,567.76,37.7,,,percent of total billed charges,37.70% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,51053.4,33.9,,,percent of total billed charges,33.9% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1174.68,78,,,percent of total billed charges,78% of total billed charges,1506,100,,,percent of total billed charges,100% of total billed charges,1243.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1243.96,82.6,,,percent of total billed charges,82.6% of total billed charges,403.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.77,51053.4,
"60240 THYROIDECTOMY, TOTAL OR COMPLETE ProFee",97560240,CDM,975,RC,60240,HCPCS,Outpatient,,,2574,1673.10,,2265.12,88,,,percent of total billed charges,88% of total Billed charges,106.55,100,,,Fee Schedule,100% of Medicare rate,519.78,100,,,Fee Schedule,100% of WA Medicaid,2574,100,,,percent of total billed charges,100% of total billed charges,535.37,103,,,Fee Schedule,103% of WA Medicaid,106.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,186.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,519.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1776.06,69,,,percent of total billed charges,69% of total billed charges,2574,100,,,percent of total billed charges,100% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2574,100,,,percent of total billed charges,100% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2574,100,,,percent of total billed charges,100% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1592.02,61.85,,,percent of total billed charges,61.85% of total billed charges,519.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,675.71,130,,,Fee Schedule,130% of WA Medicaid ,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,970.4,37.7,,,percent of total billed charges,37.70% of total billed charges,970.4,37.7,,,percent of total billed charges,37.70% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,87258.6,33.9,,,percent of total billed charges,33.9% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2007.72,78,,,percent of total billed charges,78% of total billed charges,2574,100,,,percent of total billed charges,100% of total billed charges,2126.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2126.12,82.6,,,percent of total billed charges,82.6% of total billed charges,519.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.55,87258.6,
THYROIDECTOMY;FOR MALIGNANCY,96060252,CDM,960,RC,60252,HCPCS,Outpatient,,,2789,1812.85,,2454.32,88,,,percent of total billed charges,88% of total Billed charges,152.51,100,,,Fee Schedule,100% of Medicare rate,746.37,100,,,Fee Schedule,100% of WA Medicaid,2789,100,,,percent of total billed charges,100% of total billed charges,768.76,103,,,Fee Schedule,103% of WA Medicaid,152.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,266.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,746.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1924.41,69,,,percent of total billed charges,69% of total billed charges,2789,100,,,percent of total billed charges,100% of total billed charges,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2789,100,,,percent of total billed charges,100% of total billed charges,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2789,100,,,percent of total billed charges,100% of total billed charges,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1725,61.85,,,percent of total billed charges,61.85% of total billed charges,746.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,761.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,970.28,130,,,Fee Schedule,130% of WA Medicaid ,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1051.45,37.7,,,percent of total billed charges,37.70% of total billed charges,1051.45,37.7,,,percent of total billed charges,37.70% of total billed charges,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,94547.1,33.9,,,percent of total billed charges,33.9% of total billed charges,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2175.42,78,,,percent of total billed charges,78% of total billed charges,2789,100,,,percent of total billed charges,100% of total billed charges,2303.71,82.6,,,percent of total billed charges,82.6% of total billed charges,2303.71,82.6,,,percent of total billed charges,82.6% of total billed charges,746.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,152.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,152.51,94547.1,
60512 PARATHYROID AUTOTRANSPLANTATION (LIST SEPARATELY IN AD,97560512,CDM,975,RC,60512,HCPCS,Outpatient,,,505,328.25,,444.4,88,,,percent of total billed charges,88% of total Billed charges,31.22,100,,,Fee Schedule,100% of Medicare rate,134.09,100,,,Fee Schedule,100% of WA Medicaid,505,100,,,percent of total billed charges,100% of total billed charges,138.11,103,,,Fee Schedule,103% of WA Medicaid,31.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,134.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,348.45,69,,,percent of total billed charges,69% of total billed charges,505,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,505,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,505,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.34,61.85,,,percent of total billed charges,61.85% of total billed charges,134.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.32,130,,,Fee Schedule,130% of WA Medicaid ,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.39,37.7,,,percent of total billed charges,37.70% of total billed charges,190.39,37.7,,,percent of total billed charges,37.70% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,17119.5,33.9,,,percent of total billed charges,33.9% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.9,78,,,percent of total billed charges,78% of total billed charges,505,100,,,percent of total billed charges,100% of total billed charges,417.13,82.6,,,percent of total billed charges,82.6% of total billed charges,417.13,82.6,,,percent of total billed charges,82.6% of total billed charges,134.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.22,17119.5,
61782 STEREOTACTIC COMPUTER-ASSISTED (NAVIGATIONAL,96061782,CDM,975,RC,61782,HCPCS,Outpatient,,,603,391.95,,530.64,88,,,percent of total billed charges,88% of total Billed charges,17.3,100,,,Fee Schedule,100% of Medicare rate,96.79,100,,,Fee Schedule,100% of WA Medicaid,603,100,,,percent of total billed charges,100% of total billed charges,99.69,103,,,Fee Schedule,103% of WA Medicaid,17.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,96.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,416.07,69,,,percent of total billed charges,69% of total billed charges,603,100,,,percent of total billed charges,100% of total billed charges,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,603,100,,,percent of total billed charges,100% of total billed charges,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,603,100,,,percent of total billed charges,100% of total billed charges,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.96,61.85,,,percent of total billed charges,61.85% of total billed charges,96.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,125.83,130,,,Fee Schedule,130% of WA Medicaid ,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.33,37.7,,,percent of total billed charges,37.70% of total billed charges,227.33,37.7,,,percent of total billed charges,37.70% of total billed charges,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,20441.7,33.9,,,percent of total billed charges,33.9% of total billed charges,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.34,78,,,percent of total billed charges,78% of total billed charges,603,100,,,percent of total billed charges,100% of total billed charges,498.08,82.6,,,percent of total billed charges,82.6% of total billed charges,498.08,82.6,,,percent of total billed charges,82.6% of total billed charges,96.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.3,20441.7,
62258 REMOVAL OF COMPLETE CEREBROSPINAL FLUID SHUNT SYSTEM;,97562258,CDM,975,RC,62258,HCPCS,Outpatient,,,5679,3691.35,,4997.52,88,,,percent of total billed charges,88% of total Billed charges,191.84,100,,,Fee Schedule,100% of Medicare rate,631.86,100,,,Fee Schedule,100% of WA Medicaid,5679,100,,,percent of total billed charges,100% of total billed charges,650.82,103,,,Fee Schedule,103% of WA Medicaid,191.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,335.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,631.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3918.51,69,,,percent of total billed charges,69% of total billed charges,5679,100,,,percent of total billed charges,100% of total billed charges,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5679,100,,,percent of total billed charges,100% of total billed charges,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5679,100,,,percent of total billed charges,100% of total billed charges,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3512.46,61.85,,,percent of total billed charges,61.85% of total billed charges,631.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,631.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,644.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,821.42,130,,,Fee Schedule,130% of WA Medicaid ,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2140.98,37.7,,,percent of total billed charges,37.70% of total billed charges,2140.98,37.7,,,percent of total billed charges,37.70% of total billed charges,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,192518.1,33.9,,,percent of total billed charges,33.9% of total billed charges,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,4429.62,78,,,percent of total billed charges,78% of total billed charges,5679,100,,,percent of total billed charges,100% of total billed charges,4690.85,82.6,,,percent of total billed charges,82.6% of total billed charges,4690.85,82.6,,,percent of total billed charges,82.6% of total billed charges,631.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,631.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,191.84,192518.1,
SPINAL FLUID TAP,96062270,CDM,960,RC,62270,HCPCS,Outpatient,,,315,204.75,,277.2,88,,,percent of total billed charges,88% of total Billed charges,8.87,100,,,Fee Schedule,100% of Medicare rate,35.25,100,,,Fee Schedule,100% of WA Medicaid,315,100,,,percent of total billed charges,100% of total billed charges,36.31,103,,,Fee Schedule,103% of WA Medicaid,8.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,217.35,69,,,percent of total billed charges,69% of total billed charges,315,100,,,percent of total billed charges,100% of total billed charges,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,315,100,,,percent of total billed charges,100% of total billed charges,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,315,100,,,percent of total billed charges,100% of total billed charges,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.83,61.85,,,percent of total billed charges,61.85% of total billed charges,35.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.83,130,,,Fee Schedule,130% of WA Medicaid ,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.76,37.7,,,percent of total billed charges,37.70% of total billed charges,118.76,37.7,,,percent of total billed charges,37.70% of total billed charges,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,10678.5,33.9,,,percent of total billed charges,33.9% of total billed charges,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.7,78,,,percent of total billed charges,78% of total billed charges,315,100,,,percent of total billed charges,100% of total billed charges,260.19,82.6,,,percent of total billed charges,82.6% of total billed charges,260.19,82.6,,,percent of total billed charges,82.6% of total billed charges,35.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.87,10678.5,
62284 INJECTION PROCEDURE FOR MYELOGRAPHY AND/OR COMPUTED TO,97562284,CDM,975,RC,62284,HCPCS,Outpatient,,,262,170.30,,230.56,88,,,percent of total billed charges,88% of total Billed charges,6.87,100,,,Fee Schedule,100% of Medicare rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,262,100,,,percent of total billed charges,100% of total billed charges,48.03,103,,,Fee Schedule,103% of WA Medicaid,6.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,180.78,69,,,percent of total billed charges,69% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,262,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,262,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.05,61.85,,,percent of total billed charges,61.85% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.62,130,,,Fee Schedule,130% of WA Medicaid ,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,8881.8,33.9,,,percent of total billed charges,33.9% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.36,78,,,percent of total billed charges,78% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.87,8881.8,
"62303 MYELOGRAPHY VIA LUMBAR INJECTION, INCLUDING RADIOLOGIC",97562303,CDM,975,RC,62303,HCPCS,Outpatient,,,254,165.10,,223.52,88,,,percent of total billed charges,88% of total Billed charges,8.97,100,,,Fee Schedule,100% of Medicare rate,66.58,100,,,Fee Schedule,100% of WA Medicaid,254,100,,,percent of total billed charges,100% of total billed charges,68.58,103,,,Fee Schedule,103% of WA Medicaid,8.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,175.26,69,,,percent of total billed charges,69% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.1,61.85,,,percent of total billed charges,61.85% of total billed charges,66.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,86.55,130,,,Fee Schedule,130% of WA Medicaid ,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,8610.6,33.9,,,percent of total billed charges,33.9% of total billed charges,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.12,78,,,percent of total billed charges,78% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,66.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.97,8610.6,
"Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT",97562328,CDM,975,RC,62328,HCPCS,Outpatient,,,243,157.95,,213.84,88,,,percent of total billed charges,88% of total Billed charges,6.93,100,,,Fee Schedule,100% of Medicare rate,47.56,100,,,Fee Schedule,100% of WA Medicaid,243,100,,,percent of total billed charges,100% of total billed charges,48.99,103,,,Fee Schedule,103% of WA Medicaid,6.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,167.67,69,,,percent of total billed charges,69% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,243,100,,,percent of total billed charges,100% of total billed charges,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,243,100,,,percent of total billed charges,100% of total billed charges,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.3,61.85,,,percent of total billed charges,61.85% of total billed charges,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.83,130,,,Fee Schedule,130% of WA Medicaid ,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,8237.7,33.9,,,percent of total billed charges,33.9% of total billed charges,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.54,78,,,percent of total billed charges,78% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,7,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.93,8237.7,
ENDO DECOMPRESS OF NERVE ROOT,96062380,CDM,960,RC,62380,HCPCS,Outpatient,,,1378,895.70,,1212.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,950.82,69,,,percent of total billed charges,69% of total billed charges,1378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,852.29,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,519.51,37.7,,,percent of total billed charges,37.70% of total billed charges,519.51,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,46714.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1074.84,78,,,percent of total billed charges,78% of total billed charges,1378,100,,,percent of total billed charges,100% of total billed charges,1138.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1138.23,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",519.51,46714.2,
63003 LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF S,9753003,CDM,975,RC,63003,HCPCS,Outpatient,,,5019,3262.35,,4416.72,88,,,percent of total billed charges,88% of total Billed charges,202.66,100,,,Fee Schedule,100% of Medicare rate,699.19,100,,,Fee Schedule,100% of WA Medicaid,5019,100,,,percent of total billed charges,100% of total billed charges,720.17,103,,,Fee Schedule,103% of WA Medicaid,202.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,354.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,699.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3463.11,69,,,percent of total billed charges,69% of total billed charges,5019,100,,,percent of total billed charges,100% of total billed charges,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,5019,100,,,percent of total billed charges,100% of total billed charges,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,5019,100,,,percent of total billed charges,100% of total billed charges,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,3104.25,61.85,,,percent of total billed charges,61.85% of total billed charges,699.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,713.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,908.95,130,,,Fee Schedule,130% of WA Medicaid ,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1892.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1892.16,37.7,,,percent of total billed charges,37.70% of total billed charges,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,170144.1,33.9,,,percent of total billed charges,33.9% of total billed charges,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,3914.82,78,,,percent of total billed charges,78% of total billed charges,5019,100,,,percent of total billed charges,100% of total billed charges,4145.69,82.6,,,percent of total billed charges,82.6% of total billed charges,4145.69,82.6,,,percent of total billed charges,82.6% of total billed charges,699.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,202.66,170144.1,
LUMBAR LAMINECTOMY,96063005,CDM,960,RC,63005,HCPCS,Outpatient,,,2217,1441.05,,1950.96,88,,,percent of total billed charges,88% of total Billed charges,192.95,100,,,Fee Schedule,100% of Medicare rate,682.78,100,,,Fee Schedule,100% of WA Medicaid,2217,100,,,percent of total billed charges,100% of total billed charges,703.26,103,,,Fee Schedule,103% of WA Medicaid,192.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,337.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,682.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1529.73,69,,,percent of total billed charges,69% of total billed charges,2217,100,,,percent of total billed charges,100% of total billed charges,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2217,100,,,percent of total billed charges,100% of total billed charges,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2217,100,,,percent of total billed charges,100% of total billed charges,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1371.21,61.85,,,percent of total billed charges,61.85% of total billed charges,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,887.61,130,,,Fee Schedule,130% of WA Medicaid ,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.81,37.7,,,percent of total billed charges,37.70% of total billed charges,835.81,37.7,,,percent of total billed charges,37.70% of total billed charges,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,75156.3,33.9,,,percent of total billed charges,33.9% of total billed charges,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1729.26,78,,,percent of total billed charges,78% of total billed charges,2217,100,,,percent of total billed charges,100% of total billed charges,1831.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1831.24,82.6,,,percent of total billed charges,82.6% of total billed charges,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,192.95,75156.3,
LAMINECTOMY W/EXPLOR/COMPRESS,96063011,CDM,960,RC,63011,HCPCS,Outpatient,,,2258,1467.70,,1987.04,88,,,percent of total billed charges,88% of total Billed charges,142.22,100,,,Fee Schedule,100% of Medicare rate,621.23,100,,,Fee Schedule,100% of WA Medicaid,2258,100,,,percent of total billed charges,100% of total billed charges,639.87,103,,,Fee Schedule,103% of WA Medicaid,142.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,248.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,621.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1558.02,69,,,percent of total billed charges,69% of total billed charges,2258,100,,,percent of total billed charges,100% of total billed charges,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2258,100,,,percent of total billed charges,100% of total billed charges,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2258,100,,,percent of total billed charges,100% of total billed charges,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1396.57,61.85,,,percent of total billed charges,61.85% of total billed charges,621.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,807.6,130,,,Fee Schedule,130% of WA Medicaid ,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.27,37.7,,,percent of total billed charges,37.70% of total billed charges,851.27,37.7,,,percent of total billed charges,37.70% of total billed charges,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,76546.2,33.9,,,percent of total billed charges,33.9% of total billed charges,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1761.24,78,,,percent of total billed charges,78% of total billed charges,2258,100,,,percent of total billed charges,100% of total billed charges,1865.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1865.11,82.6,,,percent of total billed charges,82.6% of total billed charges,621.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,142.22,76546.2,
LAMINECTOMY W/REM ABNOR FACETS,96063012,CDM,960,RC,63012,HCPCS,Outpatient,,,2006,1303.90,,1765.28,88,,,percent of total billed charges,88% of total Billed charges,184.15,100,,,Fee Schedule,100% of Medicare rate,678.3,100,,,Fee Schedule,100% of WA Medicaid,2006,100,,,percent of total billed charges,100% of total billed charges,698.65,103,,,Fee Schedule,103% of WA Medicaid,184.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,322.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,678.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1384.14,69,,,percent of total billed charges,69% of total billed charges,2006,100,,,percent of total billed charges,100% of total billed charges,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2006,100,,,percent of total billed charges,100% of total billed charges,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2006,100,,,percent of total billed charges,100% of total billed charges,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240.71,61.85,,,percent of total billed charges,61.85% of total billed charges,678.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,691.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,881.79,130,,,Fee Schedule,130% of WA Medicaid ,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,756.26,37.7,,,percent of total billed charges,37.70% of total billed charges,756.26,37.7,,,percent of total billed charges,37.70% of total billed charges,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,68003.4,33.9,,,percent of total billed charges,33.9% of total billed charges,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1564.68,78,,,percent of total billed charges,78% of total billed charges,2006,100,,,percent of total billed charges,100% of total billed charges,1656.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1656.96,82.6,,,percent of total billed charges,82.6% of total billed charges,678.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,184.15,68003.4,
LUMBAR LAMINECTOMY,96063017,CDM,960,RC,63017,HCPCS,Outpatient,,,2269,1474.85,,1996.72,88,,,percent of total billed charges,88% of total Billed charges,209.11,100,,,Fee Schedule,100% of Medicare rate,718.77,100,,,Fee Schedule,100% of WA Medicaid,2269,100,,,percent of total billed charges,100% of total billed charges,740.33,103,,,Fee Schedule,103% of WA Medicaid,209.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,365.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,718.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1565.61,69,,,percent of total billed charges,69% of total billed charges,2269,100,,,percent of total billed charges,100% of total billed charges,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2269,100,,,percent of total billed charges,100% of total billed charges,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2269,100,,,percent of total billed charges,100% of total billed charges,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1403.38,61.85,,,percent of total billed charges,61.85% of total billed charges,718.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,718.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,733.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,934.4,130,,,Fee Schedule,130% of WA Medicaid ,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,855.41,37.7,,,percent of total billed charges,37.70% of total billed charges,855.41,37.7,,,percent of total billed charges,37.70% of total billed charges,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,76919.1,33.9,,,percent of total billed charges,33.9% of total billed charges,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1769.82,78,,,percent of total billed charges,78% of total billed charges,2269,100,,,percent of total billed charges,100% of total billed charges,1874.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1874.19,82.6,,,percent of total billed charges,82.6% of total billed charges,718.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,718.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,209.11,76919.1,
LAMINOTOMY W/DECOMPRES NERVROT,96063020,CDM,960,RC,63020,HCPCS,Outpatient,,,2131,1385.15,,1875.28,88,,,percent of total billed charges,88% of total Billed charges,159.87,100,,,Fee Schedule,100% of Medicare rate,626.64,100,,,Fee Schedule,100% of WA Medicaid,2131,100,,,percent of total billed charges,100% of total billed charges,645.44,103,,,Fee Schedule,103% of WA Medicaid,159.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,279.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,626.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1470.39,69,,,percent of total billed charges,69% of total billed charges,2131,100,,,percent of total billed charges,100% of total billed charges,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2131,100,,,percent of total billed charges,100% of total billed charges,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2131,100,,,percent of total billed charges,100% of total billed charges,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1318.02,61.85,,,percent of total billed charges,61.85% of total billed charges,626.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,626.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,814.63,130,,,Fee Schedule,130% of WA Medicaid ,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,803.39,37.7,,,percent of total billed charges,37.70% of total billed charges,803.39,37.7,,,percent of total billed charges,37.70% of total billed charges,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,72240.9,33.9,,,percent of total billed charges,33.9% of total billed charges,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1662.18,78,,,percent of total billed charges,78% of total billed charges,2131,100,,,percent of total billed charges,100% of total billed charges,1760.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1760.21,82.6,,,percent of total billed charges,82.6% of total billed charges,626.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,626.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,159.87,72240.9,
LOW BACK DISC SURGERY,96063030,CDM,960,RC,63030,HCPCS,Outpatient,,,2030,1319.50,,1786.4,88,,,percent of total billed charges,88% of total Billed charges,128.76,100,,,Fee Schedule,100% of Medicare rate,524.07,100,,,Fee Schedule,100% of WA Medicaid,2030,100,,,percent of total billed charges,100% of total billed charges,539.79,103,,,Fee Schedule,103% of WA Medicaid,128.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,225.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,524.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1400.7,69,,,percent of total billed charges,69% of total billed charges,2030,100,,,percent of total billed charges,100% of total billed charges,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2030,100,,,percent of total billed charges,100% of total billed charges,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2030,100,,,percent of total billed charges,100% of total billed charges,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1255.56,61.85,,,percent of total billed charges,61.85% of total billed charges,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,681.29,130,,,Fee Schedule,130% of WA Medicaid ,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.31,37.7,,,percent of total billed charges,37.70% of total billed charges,765.31,37.7,,,percent of total billed charges,37.70% of total billed charges,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,68817,33.9,,,percent of total billed charges,33.9% of total billed charges,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1583.4,78,,,percent of total billed charges,78% of total billed charges,2030,100,,,percent of total billed charges,100% of total billed charges,1676.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1676.78,82.6,,,percent of total billed charges,82.6% of total billed charges,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.76,68817,
LAMINOTOMY SINGLE INTERSPACE,96063042,CDM,960,RC,63042,HCPCS,Outpatient,,,2663,1730.95,,2343.44,88,,,percent of total billed charges,88% of total Billed charges,184.88,100,,,Fee Schedule,100% of Medicare rate,736.49,100,,,Fee Schedule,100% of WA Medicaid,2663,100,,,percent of total billed charges,100% of total billed charges,758.58,103,,,Fee Schedule,103% of WA Medicaid,184.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,323.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,736.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1837.47,69,,,percent of total billed charges,69% of total billed charges,2663,100,,,percent of total billed charges,100% of total billed charges,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2663,100,,,percent of total billed charges,100% of total billed charges,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2663,100,,,percent of total billed charges,100% of total billed charges,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1647.07,61.85,,,percent of total billed charges,61.85% of total billed charges,736.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,957.44,130,,,Fee Schedule,130% of WA Medicaid ,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1003.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1003.95,37.7,,,percent of total billed charges,37.70% of total billed charges,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,90275.7,33.9,,,percent of total billed charges,33.9% of total billed charges,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2077.14,78,,,percent of total billed charges,78% of total billed charges,2663,100,,,percent of total billed charges,100% of total billed charges,2199.64,82.6,,,percent of total billed charges,82.6% of total billed charges,2199.64,82.6,,,percent of total billed charges,82.6% of total billed charges,736.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,184.88,90275.7,
LAMINOTOMY EA ADD'L INTERSPACE,96063044,CDM,960,RC,63044,HCPCS,Outpatient,,,1332,865.80,,1172.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,368.15,100,,,Fee Schedule,100% of WA Medicaid,1332,100,,,percent of total billed charges,100% of total billed charges,379.19,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,368.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,919.08,69,,,percent of total billed charges,69% of total billed charges,1332,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1332,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1332,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,823.84,61.85,,,percent of total billed charges,61.85% of total billed charges,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,368.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,375.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,478.6,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,502.16,37.7,,,percent of total billed charges,37.70% of total billed charges,502.16,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,45154.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1038.96,78,,,percent of total billed charges,78% of total billed charges,1332,100,,,percent of total billed charges,100% of total billed charges,1100.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1100.23,82.6,,,percent of total billed charges,82.6% of total billed charges,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,368.15,45154.8,
REMOVE SPINE LAMINA 1 CRVL,96063045,CDM,960,RC,63045,HCPCS,Outpatient,,,2726,1771.90,,2398.88,88,,,percent of total billed charges,88% of total Billed charges,205.1,100,,,Fee Schedule,100% of Medicare rate,731.27,100,,,Fee Schedule,100% of WA Medicaid,2726,100,,,percent of total billed charges,100% of total billed charges,753.21,103,,,Fee Schedule,103% of WA Medicaid,205.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,358.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,731.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1880.94,69,,,percent of total billed charges,69% of total billed charges,2726,100,,,percent of total billed charges,100% of total billed charges,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2726,100,,,percent of total billed charges,100% of total billed charges,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2726,100,,,percent of total billed charges,100% of total billed charges,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1686.03,61.85,,,percent of total billed charges,61.85% of total billed charges,731.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,950.65,130,,,Fee Schedule,130% of WA Medicaid ,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1027.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1027.7,37.7,,,percent of total billed charges,37.70% of total billed charges,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,92411.4,33.9,,,percent of total billed charges,33.9% of total billed charges,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2126.28,78,,,percent of total billed charges,78% of total billed charges,2726,100,,,percent of total billed charges,100% of total billed charges,2251.68,82.6,,,percent of total billed charges,82.6% of total billed charges,2251.68,82.6,,,percent of total billed charges,82.6% of total billed charges,731.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,205.1,92411.4,
REMOVE SPINE LAMINA 1 THRC,96063046,CDM,960,RC,63046,HCPCS,Outpatient,,,2525,1641.25,,2222,88,,,percent of total billed charges,88% of total Billed charges,187.33,100,,,Fee Schedule,100% of Medicare rate,699.38,100,,,Fee Schedule,100% of WA Medicaid,2525,100,,,percent of total billed charges,100% of total billed charges,720.36,103,,,Fee Schedule,103% of WA Medicaid,187.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,327.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,699.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1742.25,69,,,percent of total billed charges,69% of total billed charges,2525,100,,,percent of total billed charges,100% of total billed charges,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2525,100,,,percent of total billed charges,100% of total billed charges,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2525,100,,,percent of total billed charges,100% of total billed charges,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1561.71,61.85,,,percent of total billed charges,61.85% of total billed charges,699.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,713.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,909.19,130,,,Fee Schedule,130% of WA Medicaid ,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,951.93,37.7,,,percent of total billed charges,37.70% of total billed charges,951.93,37.7,,,percent of total billed charges,37.70% of total billed charges,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,85597.5,33.9,,,percent of total billed charges,33.9% of total billed charges,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1969.5,78,,,percent of total billed charges,78% of total billed charges,2525,100,,,percent of total billed charges,100% of total billed charges,2085.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2085.65,82.6,,,percent of total billed charges,82.6% of total billed charges,699.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.33,85597.5,
LAMINECTOMY W/DEC SPINE;LUMBAR,96063047,CDM,960,RC,63047,HCPCS,Outpatient,,,2078,1350.70,,1828.64,88,,,percent of total billed charges,88% of total Billed charges,160.84,100,,,Fee Schedule,100% of Medicare rate,630.18,100,,,Fee Schedule,100% of WA Medicaid,2078,100,,,percent of total billed charges,100% of total billed charges,649.09,103,,,Fee Schedule,103% of WA Medicaid,160.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,281.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,630.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1433.82,69,,,percent of total billed charges,69% of total billed charges,2078,100,,,percent of total billed charges,100% of total billed charges,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2078,100,,,percent of total billed charges,100% of total billed charges,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2078,100,,,percent of total billed charges,100% of total billed charges,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1285.24,61.85,,,percent of total billed charges,61.85% of total billed charges,630.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,630.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,819.23,130,,,Fee Schedule,130% of WA Medicaid ,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,783.41,37.7,,,percent of total billed charges,37.70% of total billed charges,783.41,37.7,,,percent of total billed charges,37.70% of total billed charges,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,70444.2,33.9,,,percent of total billed charges,33.9% of total billed charges,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1620.84,78,,,percent of total billed charges,78% of total billed charges,2078,100,,,percent of total billed charges,100% of total billed charges,1716.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1716.43,82.6,,,percent of total billed charges,82.6% of total billed charges,630.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,630.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,160.84,70444.2,
REMOVE SPINE LAMINA ADD-ON,96063048,CDM,960,RC,63048,HCPCS,Outpatient,,,462,300.30,,406.56,88,,,percent of total billed charges,88% of total Billed charges,34.95,100,,,Fee Schedule,100% of Medicare rate,116.38,100,,,Fee Schedule,100% of WA Medicaid,462,100,,,percent of total billed charges,100% of total billed charges,119.87,103,,,Fee Schedule,103% of WA Medicaid,34.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,116.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,318.78,69,,,percent of total billed charges,69% of total billed charges,462,100,,,percent of total billed charges,100% of total billed charges,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,462,100,,,percent of total billed charges,100% of total billed charges,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,462,100,,,percent of total billed charges,100% of total billed charges,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.75,61.85,,,percent of total billed charges,61.85% of total billed charges,116.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,151.29,130,,,Fee Schedule,130% of WA Medicaid ,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.17,37.7,,,percent of total billed charges,37.70% of total billed charges,174.17,37.7,,,percent of total billed charges,37.70% of total billed charges,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,15661.8,33.9,,,percent of total billed charges,33.9% of total billed charges,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.36,78,,,percent of total billed charges,78% of total billed charges,462,100,,,percent of total billed charges,100% of total billed charges,381.61,82.6,,,percent of total billed charges,82.6% of total billed charges,381.61,82.6,,,percent of total billed charges,82.6% of total billed charges,116.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.95,15661.8,
63056 TRANSPEDICULAR APPROACH WITH DECOMPRESSION OF SPINAL C,97563056,CDM,975,RC,63056,HCPCS,Outpatient,,,7183,4668.95,,6321.04,88,,,percent of total billed charges,88% of total Billed charges,233.03,100,,,Fee Schedule,100% of Medicare rate,842.05,100,,,Fee Schedule,100% of WA Medicaid,7183,100,,,percent of total billed charges,100% of total billed charges,867.31,103,,,Fee Schedule,103% of WA Medicaid,233.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,407.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,842.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4956.27,69,,,percent of total billed charges,69% of total billed charges,7183,100,,,percent of total billed charges,100% of total billed charges,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,7183,100,,,percent of total billed charges,100% of total billed charges,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,7183,100,,,percent of total billed charges,100% of total billed charges,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4442.69,61.85,,,percent of total billed charges,61.85% of total billed charges,842.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,858.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1094.67,130,,,Fee Schedule,130% of WA Medicaid ,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2707.99,37.7,,,percent of total billed charges,37.70% of total billed charges,2707.99,37.7,,,percent of total billed charges,37.70% of total billed charges,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,243503.7,33.9,,,percent of total billed charges,33.9% of total billed charges,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,5602.74,78,,,percent of total billed charges,78% of total billed charges,7183,100,,,percent of total billed charges,100% of total billed charges,5933.16,82.6,,,percent of total billed charges,82.6% of total billed charges,5933.16,82.6,,,percent of total billed charges,82.6% of total billed charges,842.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,233.03,243503.7,
63052 LAM FACETC/FRMT ARTHRD LUM 1,96063052,CDM,975,RC,63052,HCPCS,Outpatient,,,886,575.90,,779.68,88,,,percent of total billed charges,88% of total Billed charges,42.83,100,,,Fee Schedule,100% of Medicare rate,142.67,100,,,Fee Schedule,100% of WA Medicaid,886,100,,,percent of total billed charges,100% of total billed charges,146.95,103,,,Fee Schedule,103% of WA Medicaid,42.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,142.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,611.34,69,,,percent of total billed charges,69% of total billed charges,886,100,,,percent of total billed charges,100% of total billed charges,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,886,100,,,percent of total billed charges,100% of total billed charges,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,886,100,,,percent of total billed charges,100% of total billed charges,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.99,61.85,,,percent of total billed charges,61.85% of total billed charges,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,185.47,130,,,Fee Schedule,130% of WA Medicaid ,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.02,37.7,,,percent of total billed charges,37.70% of total billed charges,334.02,37.7,,,percent of total billed charges,37.70% of total billed charges,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,30035.4,33.9,,,percent of total billed charges,33.9% of total billed charges,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,691.08,78,,,percent of total billed charges,78% of total billed charges,886,100,,,percent of total billed charges,100% of total billed charges,731.84,82.6,,,percent of total billed charges,82.6% of total billed charges,731.84,82.6,,,percent of total billed charges,82.6% of total billed charges,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.83,30035.4,
63053 LAM FACTC/FRMT ARTHRD LUM EA,96063053,CDM,975,RC,63053,HCPCS,Outpatient,,,664,431.60,,584.32,88,,,percent of total billed charges,88% of total Billed charges,38.09,100,,,Fee Schedule,100% of Medicare rate,126.63,100,,,Fee Schedule,100% of WA Medicaid,664,100,,,percent of total billed charges,100% of total billed charges,130.43,103,,,Fee Schedule,103% of WA Medicaid,38.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,126.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,458.16,69,,,percent of total billed charges,69% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,664,100,,,percent of total billed charges,100% of total billed charges,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,664,100,,,percent of total billed charges,100% of total billed charges,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.68,61.85,,,percent of total billed charges,61.85% of total billed charges,126.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,164.62,130,,,Fee Schedule,130% of WA Medicaid ,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.33,37.7,,,percent of total billed charges,37.70% of total billed charges,250.33,37.7,,,percent of total billed charges,37.70% of total billed charges,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,22509.6,33.9,,,percent of total billed charges,33.9% of total billed charges,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.92,78,,,percent of total billed charges,78% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,126.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.09,22509.6,
DISECTOMY DECOMPRESS CERVICAL,96063075,CDM,960,RC,63075,HCPCS,Outpatient,,,3011,1957.15,,2649.68,88,,,percent of total billed charges,88% of total Billed charges,205.17,100,,,Fee Schedule,100% of Medicare rate,766.7,100,,,Fee Schedule,100% of WA Medicaid,3011,100,,,percent of total billed charges,100% of total billed charges,789.7,103,,,Fee Schedule,103% of WA Medicaid,205.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,359.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,766.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2077.59,69,,,percent of total billed charges,69% of total billed charges,3011,100,,,percent of total billed charges,100% of total billed charges,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3011,100,,,percent of total billed charges,100% of total billed charges,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3011,100,,,percent of total billed charges,100% of total billed charges,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1862.3,61.85,,,percent of total billed charges,61.85% of total billed charges,766.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,782.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,996.71,130,,,Fee Schedule,130% of WA Medicaid ,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1135.15,37.7,,,percent of total billed charges,37.70% of total billed charges,1135.15,37.7,,,percent of total billed charges,37.70% of total billed charges,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,102072.9,33.9,,,percent of total billed charges,33.9% of total billed charges,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2348.58,78,,,percent of total billed charges,78% of total billed charges,3011,100,,,percent of total billed charges,100% of total billed charges,2487.09,82.6,,,percent of total billed charges,82.6% of total billed charges,2487.09,82.6,,,percent of total billed charges,82.6% of total billed charges,766.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,205.17,102072.9,
VERTEBRAL CORPECTOMY,96063081,CDM,960,RC,63081,HCPCS,Outpatient,,,3223,2094.95,,2836.24,88,,,percent of total billed charges,88% of total Billed charges,279.47,100,,,Fee Schedule,100% of Medicare rate,994.42,100,,,Fee Schedule,100% of WA Medicaid,3223,100,,,percent of total billed charges,100% of total billed charges,1024.25,103,,,Fee Schedule,103% of WA Medicaid,279.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,489.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,994.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2223.87,69,,,percent of total billed charges,69% of total billed charges,3223,100,,,percent of total billed charges,100% of total billed charges,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,3223,100,,,percent of total billed charges,100% of total billed charges,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,3223,100,,,percent of total billed charges,100% of total billed charges,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1993.43,61.85,,,percent of total billed charges,61.85% of total billed charges,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,994.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1292.75,130,,,Fee Schedule,130% of WA Medicaid ,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1215.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1215.07,37.7,,,percent of total billed charges,37.70% of total billed charges,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,109259.7,33.9,,,percent of total billed charges,33.9% of total billed charges,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,2513.94,78,,,percent of total billed charges,78% of total billed charges,3223,100,,,percent of total billed charges,100% of total billed charges,2662.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2662.2,82.6,,,percent of total billed charges,82.6% of total billed charges,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,279.47,109259.7,
"63082 VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTI",97563082,CDM,975,RC,63082,HCPCS,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,45.13,100,,,Fee Schedule,100% of Medicare rate,146.96,100,,,Fee Schedule,100% of WA Medicaid,1800,100,,,percent of total billed charges,100% of total billed charges,151.37,103,,,Fee Schedule,103% of WA Medicaid,45.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,146.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1800,100,,,percent of total billed charges,100% of total billed charges,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1800,100,,,percent of total billed charges,100% of total billed charges,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.05,130,,,Fee Schedule,130% of WA Medicaid ,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,61020,33.9,,,percent of total billed charges,33.9% of total billed charges,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.13,61020,
"63102 VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTI",97563102,CDM,975,RC,63102,HCPCS,Outpatient,,,7340,4771.00,,6459.2,88,,,percent of total billed charges,88% of total Billed charges,358.02,100,,,Fee Schedule,100% of Medicare rate,1288.16,100,,,Fee Schedule,100% of WA Medicaid,7340,100,,,percent of total billed charges,100% of total billed charges,1326.8,103,,,Fee Schedule,103% of WA Medicaid,358.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,626.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1288.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5064.6,69,,,percent of total billed charges,69% of total billed charges,7340,100,,,percent of total billed charges,100% of total billed charges,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7340,100,,,percent of total billed charges,100% of total billed charges,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7340,100,,,percent of total billed charges,100% of total billed charges,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4539.79,61.85,,,percent of total billed charges,61.85% of total billed charges,1288.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1288.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1313.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1674.61,130,,,Fee Schedule,130% of WA Medicaid ,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2767.18,37.7,,,percent of total billed charges,37.70% of total billed charges,2767.18,37.7,,,percent of total billed charges,37.70% of total billed charges,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,248826,33.9,,,percent of total billed charges,33.9% of total billed charges,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,5725.2,78,,,percent of total billed charges,78% of total billed charges,7340,100,,,percent of total billed charges,100% of total billed charges,6062.84,82.6,,,percent of total billed charges,82.6% of total billed charges,6062.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1288.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1288.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,358.02,248826,
LAMINECTOMY FOR EXCISION/EVAC,96063267,CDM,960,RC,63267,HCPCS,Outpatient,,,2306,1498.90,,2029.28,88,,,percent of total billed charges,88% of total Billed charges,216.69,100,,,Fee Schedule,100% of Medicare rate,778.64,100,,,Fee Schedule,100% of WA Medicaid,2306,100,,,percent of total billed charges,100% of total billed charges,802,103,,,Fee Schedule,103% of WA Medicaid,216.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,379.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,778.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1591.14,69,,,percent of total billed charges,69% of total billed charges,2306,100,,,percent of total billed charges,100% of total billed charges,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2306,100,,,percent of total billed charges,100% of total billed charges,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2306,100,,,percent of total billed charges,100% of total billed charges,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1426.26,61.85,,,percent of total billed charges,61.85% of total billed charges,778.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,794.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1012.23,130,,,Fee Schedule,130% of WA Medicaid ,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,869.36,37.7,,,percent of total billed charges,37.70% of total billed charges,869.36,37.7,,,percent of total billed charges,37.70% of total billed charges,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,78173.4,33.9,,,percent of total billed charges,33.9% of total billed charges,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1798.68,78,,,percent of total billed charges,78% of total billed charges,2306,100,,,percent of total billed charges,100% of total billed charges,1904.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1904.76,82.6,,,percent of total billed charges,82.6% of total billed charges,778.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,216.69,78173.4,
63277 LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLAS,97563277,CDM,975,RC,63277,HCPCS,Outpatient,,,9464,6151.60,,8328.32,88,,,percent of total billed charges,88% of total Billed charges,255.44,100,,,Fee Schedule,100% of Medicare rate,883.45,100,,,Fee Schedule,100% of WA Medicaid,9464,100,,,percent of total billed charges,100% of total billed charges,909.95,103,,,Fee Schedule,103% of WA Medicaid,255.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,447.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,883.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6530.16,69,,,percent of total billed charges,69% of total billed charges,9464,100,,,percent of total billed charges,100% of total billed charges,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,9464,100,,,percent of total billed charges,100% of total billed charges,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,9464,100,,,percent of total billed charges,100% of total billed charges,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5853.48,61.85,,,percent of total billed charges,61.85% of total billed charges,883.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,883.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,901.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1148.49,130,,,Fee Schedule,130% of WA Medicaid ,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,3567.93,37.7,,,percent of total billed charges,37.70% of total billed charges,3567.93,37.7,,,percent of total billed charges,37.70% of total billed charges,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,320829.6,33.9,,,percent of total billed charges,33.9% of total billed charges,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,7381.92,78,,,percent of total billed charges,78% of total billed charges,9464,100,,,percent of total billed charges,100% of total billed charges,7817.26,82.6,,,percent of total billed charges,82.6% of total billed charges,7817.26,82.6,,,percent of total billed charges,82.6% of total billed charges,883.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,883.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,255.44,320829.6,
63650 PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODE,97563650,CDM,975,RC,63650,HCPCS,Outpatient,,,3047,1980.55,,2681.36,88,,,percent of total billed charges,88% of total Billed charges,33.75,100,,,Fee Schedule,100% of Medicare rate,236.48,100,,,Fee Schedule,100% of WA Medicaid,3047,100,,,percent of total billed charges,100% of total billed charges,243.57,103,,,Fee Schedule,103% of WA Medicaid,33.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,236.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2102.43,69,,,percent of total billed charges,69% of total billed charges,3047,100,,,percent of total billed charges,100% of total billed charges,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3047,100,,,percent of total billed charges,100% of total billed charges,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3047,100,,,percent of total billed charges,100% of total billed charges,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1884.57,61.85,,,percent of total billed charges,61.85% of total billed charges,236.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,307.42,130,,,Fee Schedule,130% of WA Medicaid ,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1148.72,37.7,,,percent of total billed charges,37.70% of total billed charges,1148.72,37.7,,,percent of total billed charges,37.70% of total billed charges,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,103293.3,33.9,,,percent of total billed charges,33.9% of total billed charges,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2376.66,78,,,percent of total billed charges,78% of total billed charges,3047,100,,,percent of total billed charges,100% of total billed charges,2516.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2516.82,82.6,,,percent of total billed charges,82.6% of total billed charges,236.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.75,103293.3,
63661 REMOVAL OF SPINAL NEUROSTIMULATOR ELECTRODE PERCUTANEO,63661,CDM,960,RC,63661,HCPCS,Outpatient,,,696,452.40,,612.48,88,,,percent of total billed charges,88% of total Billed charges,36.38,100,,,Fee Schedule,100% of Medicare rate,188.37,100,,,Fee Schedule,100% of WA Medicaid,696,100,,,percent of total billed charges,100% of total billed charges,194.02,103,,,Fee Schedule,103% of WA Medicaid,36.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,188.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,480.24,69,,,percent of total billed charges,69% of total billed charges,696,100,,,percent of total billed charges,100% of total billed charges,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,696,100,,,percent of total billed charges,100% of total billed charges,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,696,100,,,percent of total billed charges,100% of total billed charges,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.48,61.85,,,percent of total billed charges,61.85% of total billed charges,188.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,244.88,130,,,Fee Schedule,130% of WA Medicaid ,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.39,37.7,,,percent of total billed charges,37.70% of total billed charges,262.39,37.7,,,percent of total billed charges,37.70% of total billed charges,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,23594.4,33.9,,,percent of total billed charges,33.9% of total billed charges,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,542.88,78,,,percent of total billed charges,78% of total billed charges,696,100,,,percent of total billed charges,100% of total billed charges,574.9,82.6,,,percent of total billed charges,82.6% of total billed charges,574.9,82.6,,,percent of total billed charges,82.6% of total billed charges,188.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.38,23594.4,
"63663 REVISION INCLUDING REPLACEMENT, WHEN PERFORMED, OF SPI",97563663,CDM,975,RC,63663,HCPCS,Outpatient,,,1581,1027.65,,1391.28,88,,,percent of total billed charges,88% of total Billed charges,43.13,100,,,Fee Schedule,100% of Medicare rate,257,100,,,Fee Schedule,100% of WA Medicaid,1581,100,,,percent of total billed charges,100% of total billed charges,264.71,103,,,Fee Schedule,103% of WA Medicaid,43.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,257,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1090.89,69,,,percent of total billed charges,69% of total billed charges,1581,100,,,percent of total billed charges,100% of total billed charges,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1581,100,,,percent of total billed charges,100% of total billed charges,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1581,100,,,percent of total billed charges,100% of total billed charges,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,977.85,61.85,,,percent of total billed charges,61.85% of total billed charges,257,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,257,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,334.1,130,,,Fee Schedule,130% of WA Medicaid ,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.04,37.7,,,percent of total billed charges,37.70% of total billed charges,596.04,37.7,,,percent of total billed charges,37.70% of total billed charges,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,53595.9,33.9,,,percent of total billed charges,33.9% of total billed charges,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1233.18,78,,,percent of total billed charges,78% of total billed charges,1581,100,,,percent of total billed charges,100% of total billed charges,1305.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1305.91,82.6,,,percent of total billed charges,82.6% of total billed charges,257,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,257,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.13,53595.9,
"63664 REVISION INCLUDING REPLACEMENT, WHEN PERFORMED, OF SPI",9603664,CDM,960,RC,63664,HCPCS,Outpatient,,,696,452.40,,612.48,88,,,percent of total billed charges,88% of total Billed charges,133.85,100,,,Fee Schedule,100% of Medicare rate,507.28,100,,,Fee Schedule,100% of WA Medicaid,696,100,,,percent of total billed charges,100% of total billed charges,522.5,103,,,Fee Schedule,103% of WA Medicaid,133.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,234.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,507.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,480.24,69,,,percent of total billed charges,69% of total billed charges,696,100,,,percent of total billed charges,100% of total billed charges,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,696,100,,,percent of total billed charges,100% of total billed charges,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,696,100,,,percent of total billed charges,100% of total billed charges,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.48,61.85,,,percent of total billed charges,61.85% of total billed charges,507.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,659.46,130,,,Fee Schedule,130% of WA Medicaid ,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.39,37.7,,,percent of total billed charges,37.70% of total billed charges,262.39,37.7,,,percent of total billed charges,37.70% of total billed charges,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,23594.4,33.9,,,percent of total billed charges,33.9% of total billed charges,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,542.88,78,,,percent of total billed charges,78% of total billed charges,696,100,,,percent of total billed charges,100% of total billed charges,574.9,82.6,,,percent of total billed charges,82.6% of total billed charges,574.9,82.6,,,percent of total billed charges,82.6% of total billed charges,507.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,133.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,133.85,23594.4,
REVISE/REMOVE NEUOR RECEIVER,96063688,CDM,960,RC,63688,HCPCS,Outpatient,,,777,505.05,,683.76,88,,,percent of total billed charges,88% of total Billed charges,35.26,100,,,Fee Schedule,100% of Medicare rate,171.95,100,,,Fee Schedule,100% of WA Medicaid,777,100,,,percent of total billed charges,100% of total billed charges,177.11,103,,,Fee Schedule,103% of WA Medicaid,35.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,171.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,536.13,69,,,percent of total billed charges,69% of total billed charges,777,100,,,percent of total billed charges,100% of total billed charges,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,777,100,,,percent of total billed charges,100% of total billed charges,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,777,100,,,percent of total billed charges,100% of total billed charges,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.57,61.85,,,percent of total billed charges,61.85% of total billed charges,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,223.54,130,,,Fee Schedule,130% of WA Medicaid ,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.93,37.7,,,percent of total billed charges,37.70% of total billed charges,292.93,37.7,,,percent of total billed charges,37.70% of total billed charges,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,26340.3,33.9,,,percent of total billed charges,33.9% of total billed charges,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.06,78,,,percent of total billed charges,78% of total billed charges,777,100,,,percent of total billed charges,100% of total billed charges,641.8,82.6,,,percent of total billed charges,82.6% of total billed charges,641.8,82.6,,,percent of total billed charges,82.6% of total billed charges,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.26,26340.3,
REP OF DURAL/CEREBRO FLUIDLEAK,96063707,CDM,960,RC,63707,HCPCS,Outpatient,,,1898,1233.70,,1670.24,88,,,percent of total billed charges,88% of total Billed charges,139.78,100,,,Fee Schedule,100% of Medicare rate,536,100,,,Fee Schedule,100% of WA Medicaid,1898,100,,,percent of total billed charges,100% of total billed charges,552.08,103,,,Fee Schedule,103% of WA Medicaid,139.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,244.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,536,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1309.62,69,,,percent of total billed charges,69% of total billed charges,1898,100,,,percent of total billed charges,100% of total billed charges,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1898,100,,,percent of total billed charges,100% of total billed charges,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1898,100,,,percent of total billed charges,100% of total billed charges,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1173.91,61.85,,,percent of total billed charges,61.85% of total billed charges,536,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,536,100,,,Fee Schedule,100% of WA Medicare OPPS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,696.8,130,,,Fee Schedule,130% of WA Medicaid ,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,715.55,37.7,,,percent of total billed charges,37.70% of total billed charges,715.55,37.7,,,percent of total billed charges,37.70% of total billed charges,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,64342.2,33.9,,,percent of total billed charges,33.9% of total billed charges,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1480.44,78,,,percent of total billed charges,78% of total billed charges,1898,100,,,percent of total billed charges,100% of total billed charges,1567.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1567.75,82.6,,,percent of total billed charges,82.6% of total billed charges,536,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,536,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,139.78,64342.2,
REPAIR OF DURAL GRAFT SPINAL,96063710,CDM,960,RC,63710,HCPCS,Outpatient,,,2067,1343.55,,1818.96,88,,,percent of total billed charges,88% of total Billed charges,150.86,100,,,Fee Schedule,100% of Medicare rate,618.06,100,,,Fee Schedule,100% of WA Medicaid,2067,100,,,percent of total billed charges,100% of total billed charges,636.6,103,,,Fee Schedule,103% of WA Medicaid,150.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,264.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,618.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1426.23,69,,,percent of total billed charges,69% of total billed charges,2067,100,,,percent of total billed charges,100% of total billed charges,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2067,100,,,percent of total billed charges,100% of total billed charges,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2067,100,,,percent of total billed charges,100% of total billed charges,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1278.44,61.85,,,percent of total billed charges,61.85% of total billed charges,618.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,630.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,803.48,130,,,Fee Schedule,130% of WA Medicaid ,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,779.26,37.7,,,percent of total billed charges,37.70% of total billed charges,779.26,37.7,,,percent of total billed charges,37.70% of total billed charges,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,70071.3,33.9,,,percent of total billed charges,33.9% of total billed charges,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1612.26,78,,,percent of total billed charges,78% of total billed charges,2067,100,,,percent of total billed charges,100% of total billed charges,1707.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1707.34,82.6,,,percent of total billed charges,82.6% of total billed charges,618.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,150.86,70071.3,
64405 Injection anesthetic agent or steroid greater occipita,97564405,CDM,975,RC,64405,HCPCS,Outpatient,,,807,524.55,,710.16,88,,,percent of total billed charges,88% of total Billed charges,7.26,100,,,Fee Schedule,100% of Medicare rate,29.47,100,,,Fee Schedule,100% of WA Medicaid,807,100,,,percent of total billed charges,100% of total billed charges,30.35,103,,,Fee Schedule,103% of WA Medicaid,7.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,556.83,69,,,percent of total billed charges,69% of total billed charges,807,100,,,percent of total billed charges,100% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,807,100,,,percent of total billed charges,100% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,807,100,,,percent of total billed charges,100% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.13,61.85,,,percent of total billed charges,61.85% of total billed charges,29.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,38.31,130,,,Fee Schedule,130% of WA Medicaid ,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.24,37.7,,,percent of total billed charges,37.70% of total billed charges,304.24,37.7,,,percent of total billed charges,37.70% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,27357.3,33.9,,,percent of total billed charges,33.9% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.46,78,,,percent of total billed charges,78% of total billed charges,807,100,,,percent of total billed charges,100% of total billed charges,666.58,82.6,,,percent of total billed charges,82.6% of total billed charges,666.58,82.6,,,percent of total billed charges,82.6% of total billed charges,29.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.26,27357.3,
"64420 INJECTION, ANESTHETIC AGENT; INTERCOSTAL NERVE, SINGLE",97564420,CDM,975,RC,64420,HCPCS,Outpatient,,,382,248.30,,336.16,88,,,percent of total billed charges,88% of total Billed charges,4.33,100,,,Fee Schedule,100% of Medicare rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,382,100,,,percent of total billed charges,100% of total billed charges,34,103,,,Fee Schedule,103% of WA Medicaid,4.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,263.58,69,,,percent of total billed charges,69% of total billed charges,382,100,,,percent of total billed charges,100% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,382,100,,,percent of total billed charges,100% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,382,100,,,percent of total billed charges,100% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.27,61.85,,,percent of total billed charges,61.85% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.91,130,,,Fee Schedule,130% of WA Medicaid ,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.01,37.7,,,percent of total billed charges,37.70% of total billed charges,144.01,37.7,,,percent of total billed charges,37.70% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,12949.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.96,78,,,percent of total billed charges,78% of total billed charges,382,100,,,percent of total billed charges,100% of total billed charges,315.53,82.6,,,percent of total billed charges,82.6% of total billed charges,315.53,82.6,,,percent of total billed charges,82.6% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.33,12949.8,
64454 Genicular Nerve Block Profee,97564454,CDM,975,RC,64454,HCPCS,Outpatient,,,797,518.05,,701.36,88,,,percent of total billed charges,88% of total Billed charges,6.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,797,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,549.93,69,,,percent of total billed charges,69% of total billed charges,797,100,,,percent of total billed charges,100% of total billed charges,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,797,100,,,percent of total billed charges,100% of total billed charges,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,797,100,,,percent of total billed charges,100% of total billed charges,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.94,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.47,37.7,,,percent of total billed charges,37.70% of total billed charges,300.47,37.7,,,percent of total billed charges,37.70% of total billed charges,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,27018.3,33.9,,,percent of total billed charges,33.9% of total billed charges,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.66,78,,,percent of total billed charges,78% of total billed charges,797,100,,,percent of total billed charges,100% of total billed charges,658.32,82.6,,,percent of total billed charges,82.6% of total billed charges,658.32,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",6.09,27018.3,
"64494 INJECTION(S), DIAGNOSTIC OR THERAPEUTIC AGENT, PARAVER",97564494,CDM,975,RC,64494,HCPCS,Outpatient,,,233,151.45,,205.04,88,,,percent of total billed charges,88% of total Billed charges,4.11,100,,,Fee Schedule,100% of Medicare rate,28.53,100,,,Fee Schedule,100% of WA Medicaid,233,100,,,percent of total billed charges,100% of total billed charges,29.39,103,,,Fee Schedule,103% of WA Medicaid,4.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,160.77,69,,,percent of total billed charges,69% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,233,100,,,percent of total billed charges,100% of total billed charges,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,233,100,,,percent of total billed charges,100% of total billed charges,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.11,61.85,,,percent of total billed charges,61.85% of total billed charges,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.09,130,,,Fee Schedule,130% of WA Medicaid ,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.84,37.7,,,percent of total billed charges,37.70% of total billed charges,87.84,37.7,,,percent of total billed charges,37.70% of total billed charges,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,7898.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.74,78,,,percent of total billed charges,78% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.11,7898.7,
"64495 INJECTION(S), DIAGNOSTIC OR THERAPEUTIC AGENT, PARAVER",97564495,CDM,975,RC,64495,HCPCS,Outpatient,,,236,153.40,,207.68,88,,,percent of total billed charges,88% of total Billed charges,4.14,100,,,Fee Schedule,100% of Medicare rate,29.28,100,,,Fee Schedule,100% of WA Medicaid,236,100,,,percent of total billed charges,100% of total billed charges,30.16,103,,,Fee Schedule,103% of WA Medicaid,4.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,162.84,69,,,percent of total billed charges,69% of total billed charges,236,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,236,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,236,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.97,61.85,,,percent of total billed charges,61.85% of total billed charges,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,38.06,130,,,Fee Schedule,130% of WA Medicaid ,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.97,37.7,,,percent of total billed charges,37.70% of total billed charges,88.97,37.7,,,percent of total billed charges,37.70% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,8000.4,33.9,,,percent of total billed charges,33.9% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.08,78,,,percent of total billed charges,78% of total billed charges,236,100,,,percent of total billed charges,100% of total billed charges,194.94,82.6,,,percent of total billed charges,82.6% of total billed charges,194.94,82.6,,,percent of total billed charges,82.6% of total billed charges,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.14,8000.4,
INJ ANE SPENOPALATINE GANGLION,96064505,CDM,960,RC,64505,HCPCS,Outpatient,,,197,128.05,,173.36,88,,,percent of total billed charges,88% of total Billed charges,12.76,100,,,Fee Schedule,100% of Medicare rate,60.05,100,,,Fee Schedule,100% of WA Medicaid,197,100,,,percent of total billed charges,100% of total billed charges,61.85,103,,,Fee Schedule,103% of WA Medicaid,12.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,135.93,69,,,percent of total billed charges,69% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,197,100,,,percent of total billed charges,100% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,197,100,,,percent of total billed charges,100% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.84,61.85,,,percent of total billed charges,61.85% of total billed charges,60.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,78.07,130,,,Fee Schedule,130% of WA Medicaid ,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.27,37.7,,,percent of total billed charges,37.70% of total billed charges,74.27,37.7,,,percent of total billed charges,37.70% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,6678.3,33.9,,,percent of total billed charges,33.9% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.66,78,,,percent of total billed charges,78% of total billed charges,197,100,,,percent of total billed charges,100% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,162.72,82.6,,,percent of total billed charges,82.6% of total billed charges,60.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.76,6678.3,
INCISION FOR IMPL NEUROSTIMULA,96064581,CDM,960,RC,64581,HCPCS,Outpatient,,,1050,682.50,,924,88,,,percent of total billed charges,88% of total Billed charges,63.16,100,,,Fee Schedule,100% of Medicare rate,370.58,100,,,Fee Schedule,100% of WA Medicaid,1050,100,,,percent of total billed charges,100% of total billed charges,381.7,103,,,Fee Schedule,103% of WA Medicaid,63.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,110.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,370.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,724.5,69,,,percent of total billed charges,69% of total billed charges,1050,100,,,percent of total billed charges,100% of total billed charges,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1050,100,,,percent of total billed charges,100% of total billed charges,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1050,100,,,percent of total billed charges,100% of total billed charges,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,649.43,61.85,,,percent of total billed charges,61.85% of total billed charges,370.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,481.75,130,,,Fee Schedule,130% of WA Medicaid ,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.85,37.7,,,percent of total billed charges,37.70% of total billed charges,395.85,37.7,,,percent of total billed charges,37.70% of total billed charges,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,35595,33.9,,,percent of total billed charges,33.9% of total billed charges,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,819,78,,,percent of total billed charges,78% of total billed charges,1050,100,,,percent of total billed charges,100% of total billed charges,867.3,82.6,,,percent of total billed charges,82.6% of total billed charges,867.3,82.6,,,percent of total billed charges,82.6% of total billed charges,370.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.16,35595,
DESTROY NERVE FACE MUSCLE,96064612,CDM,960,RC,64612,HCPCS,Outpatient,,,1882,1223.30,,1656.16,88,,,percent of total billed charges,88% of total Billed charges,11.4,100,,,Fee Schedule,100% of Medicare rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,1882,100,,,percent of total billed charges,100% of total billed charges,71.08,103,,,Fee Schedule,103% of WA Medicaid,11.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1298.58,69,,,percent of total billed charges,69% of total billed charges,1882,100,,,percent of total billed charges,100% of total billed charges,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1882,100,,,percent of total billed charges,100% of total billed charges,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1882,100,,,percent of total billed charges,100% of total billed charges,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1164.02,61.85,,,percent of total billed charges,61.85% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.71,130,,,Fee Schedule,130% of WA Medicaid ,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.51,37.7,,,percent of total billed charges,37.70% of total billed charges,709.51,37.7,,,percent of total billed charges,37.70% of total billed charges,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,63799.8,33.9,,,percent of total billed charges,33.9% of total billed charges,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1467.96,78,,,percent of total billed charges,78% of total billed charges,1882,100,,,percent of total billed charges,100% of total billed charges,1554.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1554.53,82.6,,,percent of total billed charges,82.6% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.4,63799.8,
ADMINSTRATION CHEMODENERVATION,96064615,CDM,960,RC,64615,HCPCS,Outpatient,,,205,133.25,,180.4,88,,,percent of total billed charges,88% of total Billed charges,19.97,100,,,Fee Schedule,100% of Medicare rate,68.63,100,,,Fee Schedule,100% of WA Medicaid,205,100,,,percent of total billed charges,100% of total billed charges,70.69,103,,,Fee Schedule,103% of WA Medicaid,19.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,141.45,69,,,percent of total billed charges,69% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,205,100,,,percent of total billed charges,100% of total billed charges,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,205,100,,,percent of total billed charges,100% of total billed charges,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.79,61.85,,,percent of total billed charges,61.85% of total billed charges,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.22,130,,,Fee Schedule,130% of WA Medicaid ,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.29,37.7,,,percent of total billed charges,37.70% of total billed charges,77.29,37.7,,,percent of total billed charges,37.70% of total billed charges,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,6949.5,33.9,,,percent of total billed charges,33.9% of total billed charges,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.9,78,,,percent of total billed charges,78% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.97,6949.5,
64624 DESTRUCTION GENICULAR NERVE BRANCHES,97564624,CDM,975,RC,64624,HCPCS,Outpatient,,,511,332.15,,449.68,88,,,percent of total billed charges,88% of total Billed charges,10.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,511,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,10.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,352.59,69,,,percent of total billed charges,69% of total billed charges,511,100,,,percent of total billed charges,100% of total billed charges,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,511,100,,,percent of total billed charges,100% of total billed charges,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,511,100,,,percent of total billed charges,100% of total billed charges,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.05,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.65,37.7,,,percent of total billed charges,37.70% of total billed charges,192.65,37.7,,,percent of total billed charges,37.70% of total billed charges,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,17322.9,33.9,,,percent of total billed charges,33.9% of total billed charges,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.58,78,,,percent of total billed charges,78% of total billed charges,511,100,,,percent of total billed charges,100% of total billed charges,422.09,82.6,,,percent of total billed charges,82.6% of total billed charges,422.09,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",10.36,17322.9,
"64625 Radiofrequency ablation, nerves innervating the sacroi",97564625,CDM,975,RC,64625,HCPCS,Outpatient,,,682,443.30,,600.16,88,,,percent of total billed charges,88% of total Billed charges,14.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,682,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,14.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,470.58,69,,,percent of total billed charges,69% of total billed charges,682,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,682,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,682,100,,,percent of total billed charges,100% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.82,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.11,37.7,,,percent of total billed charges,37.70% of total billed charges,257.11,37.7,,,percent of total billed charges,37.70% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,23119.8,33.9,,,percent of total billed charges,33.9% of total billed charges,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,531.96,78,,,percent of total billed charges,78% of total billed charges,682,100,,,percent of total billed charges,100% of total billed charges,563.33,82.6,,,percent of total billed charges,82.6% of total billed charges,563.33,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",14.18,23119.8,
"64635 DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBR",97564635,CDM,975,RC,64635,HCPCS,Outpatient,,,1124,730.60,,989.12,88,,,percent of total billed charges,88% of total Billed charges,14.09,100,,,Fee Schedule,100% of Medicare rate,109.85,100,,,Fee Schedule,100% of WA Medicaid,1124,100,,,percent of total billed charges,100% of total billed charges,113.15,103,,,Fee Schedule,103% of WA Medicaid,14.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,109.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,775.56,69,,,percent of total billed charges,69% of total billed charges,1124,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1124,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1124,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,695.19,61.85,,,percent of total billed charges,61.85% of total billed charges,109.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,142.81,130,,,Fee Schedule,130% of WA Medicaid ,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.75,37.7,,,percent of total billed charges,37.70% of total billed charges,423.75,37.7,,,percent of total billed charges,37.70% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,38103.6,33.9,,,percent of total billed charges,33.9% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.72,78,,,percent of total billed charges,78% of total billed charges,1124,100,,,percent of total billed charges,100% of total billed charges,928.42,82.6,,,percent of total billed charges,82.6% of total billed charges,928.42,82.6,,,percent of total billed charges,82.6% of total billed charges,109.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.09,38103.6,
"64636 DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBR",97564636,CDM,975,RC,64636,HCPCS,Outpatient,,,472,306.80,,415.36,88,,,percent of total billed charges,88% of total Billed charges,4.6,100,,,Fee Schedule,100% of Medicare rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,472,100,,,percent of total billed charges,100% of total billed charges,34,103,,,Fee Schedule,103% of WA Medicaid,4.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,325.68,69,,,percent of total billed charges,69% of total billed charges,472,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,472,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,472,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.93,61.85,,,percent of total billed charges,61.85% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.91,130,,,Fee Schedule,130% of WA Medicaid ,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.94,37.7,,,percent of total billed charges,37.70% of total billed charges,177.94,37.7,,,percent of total billed charges,37.70% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,16000.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.16,78,,,percent of total billed charges,78% of total billed charges,472,100,,,percent of total billed charges,100% of total billed charges,389.87,82.6,,,percent of total billed charges,82.6% of total billed charges,389.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.6,16000.8,
NEUROPLASTY AND/OR TRANSPOSIT,96064718,CDM,960,RC,64718,HCPCS,Outpatient,,,1084,704.60,,953.92,88,,,percent of total billed charges,88% of total Billed charges,56.93,100,,,Fee Schedule,100% of Medicare rate,353.23,100,,,Fee Schedule,100% of WA Medicaid,1084,100,,,percent of total billed charges,100% of total billed charges,363.83,103,,,Fee Schedule,103% of WA Medicaid,56.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,353.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,747.96,69,,,percent of total billed charges,69% of total billed charges,1084,100,,,percent of total billed charges,100% of total billed charges,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1084,100,,,percent of total billed charges,100% of total billed charges,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1084,100,,,percent of total billed charges,100% of total billed charges,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,670.45,61.85,,,percent of total billed charges,61.85% of total billed charges,353.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,459.2,130,,,Fee Schedule,130% of WA Medicaid ,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.67,37.7,,,percent of total billed charges,37.70% of total billed charges,408.67,37.7,,,percent of total billed charges,37.70% of total billed charges,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,36747.6,33.9,,,percent of total billed charges,33.9% of total billed charges,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,845.52,78,,,percent of total billed charges,78% of total billed charges,1084,100,,,percent of total billed charges,100% of total billed charges,895.38,82.6,,,percent of total billed charges,82.6% of total billed charges,895.38,82.6,,,percent of total billed charges,82.6% of total billed charges,353.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.93,36747.6,
CARPAL TUNNEL RELEASE,96064721,CDM,960,RC,64721,HCPCS,Outpatient,,,795,516.75,,699.6,88,,,percent of total billed charges,88% of total Billed charges,39.69,100,,,Fee Schedule,100% of Medicare rate,257.18,100,,,Fee Schedule,100% of WA Medicaid,795,100,,,percent of total billed charges,100% of total billed charges,264.9,103,,,Fee Schedule,103% of WA Medicaid,39.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,257.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,548.55,69,,,percent of total billed charges,69% of total billed charges,795,100,,,percent of total billed charges,100% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,795,100,,,percent of total billed charges,100% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,795,100,,,percent of total billed charges,100% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.71,61.85,,,percent of total billed charges,61.85% of total billed charges,257.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,334.33,130,,,Fee Schedule,130% of WA Medicaid ,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.72,37.7,,,percent of total billed charges,37.70% of total billed charges,299.72,37.7,,,percent of total billed charges,37.70% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,26950.5,33.9,,,percent of total billed charges,33.9% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,620.1,78,,,percent of total billed charges,78% of total billed charges,795,100,,,percent of total billed charges,100% of total billed charges,656.67,82.6,,,percent of total billed charges,82.6% of total billed charges,656.67,82.6,,,percent of total billed charges,82.6% of total billed charges,257.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.69,26950.5,
"64831 SUTURE OF DIGITAL NERVE, HAND OR FOOT; 1 NERVE ProFee",97564831,CDM,975,RC,64831,HCPCS,Outpatient,,,2032,1320.80,,1788.16,88,,,percent of total billed charges,88% of total Billed charges,65.52,100,,,Fee Schedule,100% of Medicare rate,402.84,100,,,Fee Schedule,100% of WA Medicaid,2032,100,,,percent of total billed charges,100% of total billed charges,414.93,103,,,Fee Schedule,103% of WA Medicaid,65.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,402.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1402.08,69,,,percent of total billed charges,69% of total billed charges,2032,100,,,percent of total billed charges,100% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2032,100,,,percent of total billed charges,100% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2032,100,,,percent of total billed charges,100% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1256.79,61.85,,,percent of total billed charges,61.85% of total billed charges,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,523.69,130,,,Fee Schedule,130% of WA Medicaid ,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.06,37.7,,,percent of total billed charges,37.70% of total billed charges,766.06,37.7,,,percent of total billed charges,37.70% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,68884.8,33.9,,,percent of total billed charges,33.9% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1584.96,78,,,percent of total billed charges,78% of total billed charges,2032,100,,,percent of total billed charges,100% of total billed charges,1678.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1678.43,82.6,,,percent of total billed charges,82.6% of total billed charges,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.52,68884.8,
UNLISTED NERVOUS SYSTEM SURG,96064999,CDM,960,RC,64999,HCPCS,Outpatient,,,577,375.05,,507.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,577,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,398.13,69,,,percent of total billed charges,69% of total billed charges,577,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,577,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,577,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,356.87,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,217.53,37.7,,,percent of total billed charges,37.70% of total billed charges,217.53,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,19560.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,450.06,78,,,percent of total billed charges,78% of total billed charges,577,100,,,percent of total billed charges,100% of total billed charges,476.6,82.6,,,percent of total billed charges,82.6% of total billed charges,476.6,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",217.53,19560.3,
67808 EXCISION OF CHALAZION; UNDER GENERAL ANESTHESIA AND/OR,97567808,CDM,975,RC,67808,HCPCS,Outpatient,,,1295,841.75,,1139.6,88,,,percent of total billed charges,88% of total Billed charges,21.01,100,,,Fee Schedule,100% of Medicare rate,212.61,100,,,Fee Schedule,100% of WA Medicaid,1295,100,,,percent of total billed charges,100% of total billed charges,218.99,103,,,Fee Schedule,103% of WA Medicaid,21.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,212.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,893.55,69,,,percent of total billed charges,69% of total billed charges,1295,100,,,percent of total billed charges,100% of total billed charges,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1295,100,,,percent of total billed charges,100% of total billed charges,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1295,100,,,percent of total billed charges,100% of total billed charges,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,800.96,61.85,,,percent of total billed charges,61.85% of total billed charges,212.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,276.39,130,,,Fee Schedule,130% of WA Medicaid ,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.22,37.7,,,percent of total billed charges,37.70% of total billed charges,488.22,37.7,,,percent of total billed charges,37.70% of total billed charges,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,43900.5,33.9,,,percent of total billed charges,33.9% of total billed charges,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1010.1,78,,,percent of total billed charges,78% of total billed charges,1295,100,,,percent of total billed charges,100% of total billed charges,1069.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1069.67,82.6,,,percent of total billed charges,82.6% of total billed charges,212.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.01,43900.5,
67904 REPAIR OF BLEPHAROPTOSIS; (TARSO) LEVATOR RESECTION OR,97567904,CDM,975,RC,67904,HCPCS,Outpatient,,,1259,818.35,,1107.92,88,,,percent of total billed charges,88% of total Billed charges,35.6,100,,,Fee Schedule,100% of Medicare rate,342.23,100,,,Fee Schedule,100% of WA Medicaid,1259,100,,,percent of total billed charges,100% of total billed charges,352.5,103,,,Fee Schedule,103% of WA Medicaid,35.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,62.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,342.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,868.71,69,,,percent of total billed charges,69% of total billed charges,1259,100,,,percent of total billed charges,100% of total billed charges,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259,100,,,percent of total billed charges,100% of total billed charges,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259,100,,,percent of total billed charges,100% of total billed charges,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.69,61.85,,,percent of total billed charges,61.85% of total billed charges,342.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,444.9,130,,,Fee Schedule,130% of WA Medicaid ,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.64,37.7,,,percent of total billed charges,37.70% of total billed charges,474.64,37.7,,,percent of total billed charges,37.70% of total billed charges,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,42680.1,33.9,,,percent of total billed charges,33.9% of total billed charges,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,982.02,78,,,percent of total billed charges,78% of total billed charges,1259,100,,,percent of total billed charges,100% of total billed charges,1039.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1039.93,82.6,,,percent of total billed charges,82.6% of total billed charges,342.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.6,42680.1,
"69000 DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA;",97569000,CDM,975,RC,69000,HCPCS,Outpatient,,,546,354.90,,480.48,88,,,percent of total billed charges,88% of total Billed charges,9.81,100,,,Fee Schedule,100% of Medicare rate,73.29,100,,,Fee Schedule,100% of WA Medicaid,546,100,,,percent of total billed charges,100% of total billed charges,75.49,103,,,Fee Schedule,103% of WA Medicaid,9.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,73.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,376.74,69,,,percent of total billed charges,69% of total billed charges,546,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,546,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,546,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.7,61.85,,,percent of total billed charges,61.85% of total billed charges,73.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.28,130,,,Fee Schedule,130% of WA Medicaid ,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.84,37.7,,,percent of total billed charges,37.70% of total billed charges,205.84,37.7,,,percent of total billed charges,37.70% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,18509.4,33.9,,,percent of total billed charges,33.9% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.88,78,,,percent of total billed charges,78% of total billed charges,546,100,,,percent of total billed charges,100% of total billed charges,451,82.6,,,percent of total billed charges,82.6% of total billed charges,451,82.6,,,percent of total billed charges,82.6% of total billed charges,73.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.81,18509.4,
"69110 EXCISION EXTERNAL EAR; PARTIAL, SIMPLE REPAIR ProFee",97569110,CDM,975,RC,69110,HCPCS,Outpatient,,,928,603.20,,816.64,88,,,percent of total billed charges,88% of total Billed charges,23.55,100,,,Fee Schedule,100% of Medicare rate,192.1,100,,,Fee Schedule,100% of WA Medicaid,928,100,,,percent of total billed charges,100% of total billed charges,197.86,103,,,Fee Schedule,103% of WA Medicaid,23.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,192.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,640.32,69,,,percent of total billed charges,69% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,928,100,,,percent of total billed charges,100% of total billed charges,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,928,100,,,percent of total billed charges,100% of total billed charges,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,573.97,61.85,,,percent of total billed charges,61.85% of total billed charges,192.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,249.73,130,,,Fee Schedule,130% of WA Medicaid ,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.86,37.7,,,percent of total billed charges,37.70% of total billed charges,349.86,37.7,,,percent of total billed charges,37.70% of total billed charges,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,31459.2,33.9,,,percent of total billed charges,33.9% of total billed charges,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.84,78,,,percent of total billed charges,78% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,192.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.55,31459.2,
"69145 EXCISION SOFT TISSUE LESION, EXTERNAL AUDITORY CANAL P",97569145,CDM,975,RC,69145,HCPCS,Outpatient,,,535,347.75,,470.8,88,,,percent of total billed charges,88% of total Billed charges,18.31,100,,,Fee Schedule,100% of Medicare rate,151.62,100,,,Fee Schedule,100% of WA Medicaid,535,100,,,percent of total billed charges,100% of total billed charges,156.17,103,,,Fee Schedule,103% of WA Medicaid,18.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,151.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,369.15,69,,,percent of total billed charges,69% of total billed charges,535,100,,,percent of total billed charges,100% of total billed charges,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,535,100,,,percent of total billed charges,100% of total billed charges,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,535,100,,,percent of total billed charges,100% of total billed charges,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.9,61.85,,,percent of total billed charges,61.85% of total billed charges,151.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,197.11,130,,,Fee Schedule,130% of WA Medicaid ,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.7,37.7,,,percent of total billed charges,37.70% of total billed charges,201.7,37.7,,,percent of total billed charges,37.70% of total billed charges,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,18136.5,33.9,,,percent of total billed charges,33.9% of total billed charges,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.3,78,,,percent of total billed charges,78% of total billed charges,535,100,,,percent of total billed charges,100% of total billed charges,441.91,82.6,,,percent of total billed charges,82.6% of total billed charges,441.91,82.6,,,percent of total billed charges,82.6% of total billed charges,151.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.31,18136.5,
RADICAL EXCISION EXTERNAL AUDITORY CANAL LES,97569150,CDM,975,RC,69150,HCPCS,Outpatient,,,3633,2361.45,,3197.04,88,,,percent of total billed charges,88% of total Billed charges,84,100,,,Fee Schedule,100% of Medicare rate,581.88,100,,,Fee Schedule,100% of WA Medicaid,3633,100,,,percent of total billed charges,100% of total billed charges,599.34,103,,,Fee Schedule,103% of WA Medicaid,84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,147.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,581.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2506.77,69,,,percent of total billed charges,69% of total billed charges,3633,100,,,percent of total billed charges,100% of total billed charges,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3633,100,,,percent of total billed charges,100% of total billed charges,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3633,100,,,percent of total billed charges,100% of total billed charges,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2247.01,61.85,,,percent of total billed charges,61.85% of total billed charges,581.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,581.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,593.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,756.44,130,,,Fee Schedule,130% of WA Medicaid ,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1369.64,37.7,,,percent of total billed charges,37.70% of total billed charges,1369.64,37.7,,,percent of total billed charges,37.70% of total billed charges,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,123158.7,33.9,,,percent of total billed charges,33.9% of total billed charges,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2833.74,78,,,percent of total billed charges,78% of total billed charges,3633,100,,,percent of total billed charges,100% of total billed charges,3000.86,82.6,,,percent of total billed charges,82.6% of total billed charges,3000.86,82.6,,,percent of total billed charges,82.6% of total billed charges,581.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,84,100,,,Fee Schedule,100% of Medicare RBRVS rate,581.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84,123158.7,
REM IMPACT CERUMEN REQ IRRIGAT,96069209,CDM,960,RC,69209,HCPCS,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,0.76,100,,,Fee Schedule,100% of Medicare rate,9.51,100,,,Fee Schedule,100% of WA Medicaid,58,100,,,percent of total billed charges,100% of total billed charges,9.8,103,,,Fee Schedule,103% of WA Medicaid,0.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,58,100,,,percent of total billed charges,100% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,58,100,,,percent of total billed charges,100% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.36,130,,,Fee Schedule,130% of WA Medicaid ,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1966.2,33.9,,,percent of total billed charges,33.9% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.76,1966.2,
"69300 OTOPLASTY, PROTRUDING EAR, WITH OR WITHOUT SIZE REDUCT",97569300,CDM,975,RC,69300,HCPCS,Outpatient,,,980,637.00,,862.4,88,,,percent of total billed charges,88% of total Billed charges,38.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,980,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,38.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,676.2,69,,,percent of total billed charges,69% of total billed charges,980,100,,,percent of total billed charges,100% of total billed charges,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,980,100,,,percent of total billed charges,100% of total billed charges,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,980,100,,,percent of total billed charges,100% of total billed charges,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.13,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.46,37.7,,,percent of total billed charges,37.70% of total billed charges,369.46,37.7,,,percent of total billed charges,37.70% of total billed charges,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,33222,33.9,,,percent of total billed charges,33.9% of total billed charges,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,764.4,78,,,percent of total billed charges,78% of total billed charges,980,100,,,percent of total billed charges,100% of total billed charges,809.48,82.6,,,percent of total billed charges,82.6% of total billed charges,809.48,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",38.72,33222,
"UNLISTED PROCEDURE, EXTERNAL EAR ProFee",69399,CDM,983,RC,69399,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,8475,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",94.25,8475,
69505 MASTOIDECTOMY; MODIFIED RADICAL ProFee,97569505,CDM,975,RC,69505,HCPCS,Outpatient,,,1924,1250.60,,1693.12,88,,,percent of total billed charges,88% of total Billed charges,87.1,100,,,Fee Schedule,100% of Medicare rate,717.28,100,,,Fee Schedule,100% of WA Medicaid,1924,100,,,percent of total billed charges,100% of total billed charges,738.8,103,,,Fee Schedule,103% of WA Medicaid,87.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,152.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,717.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1327.56,69,,,percent of total billed charges,69% of total billed charges,1924,100,,,percent of total billed charges,100% of total billed charges,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1924,100,,,percent of total billed charges,100% of total billed charges,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1924,100,,,percent of total billed charges,100% of total billed charges,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1189.99,61.85,,,percent of total billed charges,61.85% of total billed charges,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,932.46,130,,,Fee Schedule,130% of WA Medicaid ,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,725.35,37.7,,,percent of total billed charges,37.70% of total billed charges,725.35,37.7,,,percent of total billed charges,37.70% of total billed charges,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,65223.6,33.9,,,percent of total billed charges,33.9% of total billed charges,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1500.72,78,,,percent of total billed charges,78% of total billed charges,1924,100,,,percent of total billed charges,100% of total billed charges,1589.22,82.6,,,percent of total billed charges,82.6% of total billed charges,1589.22,82.6,,,percent of total billed charges,82.6% of total billed charges,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.1,65223.6,
"69610 TYMPANIC MEMBRANE REPAIR, WITH OR WITHOUT SITE PREPARA",97569610,CDM,975,RC,69610,HCPCS,Outpatient,,,758,492.70,,667.04,88,,,percent of total billed charges,88% of total Billed charges,25.82,100,,,Fee Schedule,100% of Medicare rate,165.24,100,,,Fee Schedule,100% of WA Medicaid,758,100,,,percent of total billed charges,100% of total billed charges,170.2,103,,,Fee Schedule,103% of WA Medicaid,25.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,165.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,523.02,69,,,percent of total billed charges,69% of total billed charges,758,100,,,percent of total billed charges,100% of total billed charges,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,758,100,,,percent of total billed charges,100% of total billed charges,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,758,100,,,percent of total billed charges,100% of total billed charges,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.82,61.85,,,percent of total billed charges,61.85% of total billed charges,165.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,214.81,130,,,Fee Schedule,130% of WA Medicaid ,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.77,37.7,,,percent of total billed charges,37.70% of total billed charges,285.77,37.7,,,percent of total billed charges,37.70% of total billed charges,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,25696.2,33.9,,,percent of total billed charges,33.9% of total billed charges,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.24,78,,,percent of total billed charges,78% of total billed charges,758,100,,,percent of total billed charges,100% of total billed charges,626.11,82.6,,,percent of total billed charges,82.6% of total billed charges,626.11,82.6,,,percent of total billed charges,82.6% of total billed charges,165.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.82,25696.2,
69620 MYRINGOPLASTY (SURGERY CONFINED TO DRUMHEAD AND DONOR,97569620,CDM,975,RC,69620,HCPCS,Outpatient,,,956,621.40,,841.28,88,,,percent of total billed charges,88% of total Billed charges,38.23,100,,,Fee Schedule,100% of Medicare rate,288.7,100,,,Fee Schedule,100% of WA Medicaid,956,100,,,percent of total billed charges,100% of total billed charges,297.36,103,,,Fee Schedule,103% of WA Medicaid,38.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,288.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,659.64,69,,,percent of total billed charges,69% of total billed charges,956,100,,,percent of total billed charges,100% of total billed charges,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,956,100,,,percent of total billed charges,100% of total billed charges,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,956,100,,,percent of total billed charges,100% of total billed charges,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.29,61.85,,,percent of total billed charges,61.85% of total billed charges,288.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,294.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,375.31,130,,,Fee Schedule,130% of WA Medicaid ,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.41,37.7,,,percent of total billed charges,37.70% of total billed charges,360.41,37.7,,,percent of total billed charges,37.70% of total billed charges,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,32408.4,33.9,,,percent of total billed charges,33.9% of total billed charges,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.68,78,,,percent of total billed charges,78% of total billed charges,956,100,,,percent of total billed charges,100% of total billed charges,789.66,82.6,,,percent of total billed charges,82.6% of total billed charges,789.66,82.6,,,percent of total billed charges,82.6% of total billed charges,288.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.23,32408.4,
69631 TYMPANOPLASTY WITHOUT MASTOIDECTOMY (INCLUDING CANALPL,97569631,CDM,975,RC,69631,HCPCS,Outpatient,,,1903,1236.95,,1674.64,88,,,percent of total billed charges,88% of total Billed charges,65.91,100,,,Fee Schedule,100% of Medicare rate,520.34,100,,,Fee Schedule,100% of WA Medicaid,1903,100,,,percent of total billed charges,100% of total billed charges,535.95,103,,,Fee Schedule,103% of WA Medicaid,65.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,115.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,520.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1313.07,69,,,percent of total billed charges,69% of total billed charges,1903,100,,,percent of total billed charges,100% of total billed charges,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1903,100,,,percent of total billed charges,100% of total billed charges,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1903,100,,,percent of total billed charges,100% of total billed charges,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1177.01,61.85,,,percent of total billed charges,61.85% of total billed charges,520.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,676.44,130,,,Fee Schedule,130% of WA Medicaid ,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.43,37.7,,,percent of total billed charges,37.70% of total billed charges,717.43,37.7,,,percent of total billed charges,37.70% of total billed charges,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,64511.7,33.9,,,percent of total billed charges,33.9% of total billed charges,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1484.34,78,,,percent of total billed charges,78% of total billed charges,1903,100,,,percent of total billed charges,100% of total billed charges,1571.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1571.88,82.6,,,percent of total billed charges,82.6% of total billed charges,520.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.91,64511.7,
69633 TYMPANOPLASTY WITHOUT MASTOIDECTOMY (INCLUDING CANALPL,97569633,CDM,975,RC,69633,HCPCS,Outpatient,,,2164,1406.60,,1904.32,88,,,percent of total billed charges,88% of total Billed charges,80.67,100,,,Fee Schedule,100% of Medicare rate,613.59,100,,,Fee Schedule,100% of WA Medicaid,2164,100,,,percent of total billed charges,100% of total billed charges,632,103,,,Fee Schedule,103% of WA Medicaid,80.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,141.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,613.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1493.16,69,,,percent of total billed charges,69% of total billed charges,2164,100,,,percent of total billed charges,100% of total billed charges,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2164,100,,,percent of total billed charges,100% of total billed charges,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2164,100,,,percent of total billed charges,100% of total billed charges,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1338.43,61.85,,,percent of total billed charges,61.85% of total billed charges,613.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,613.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,797.67,130,,,Fee Schedule,130% of WA Medicaid ,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.83,37.7,,,percent of total billed charges,37.70% of total billed charges,815.83,37.7,,,percent of total billed charges,37.70% of total billed charges,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,73359.6,33.9,,,percent of total billed charges,33.9% of total billed charges,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1687.92,78,,,percent of total billed charges,78% of total billed charges,2164,100,,,percent of total billed charges,100% of total billed charges,1787.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1787.46,82.6,,,percent of total billed charges,82.6% of total billed charges,613.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,613.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.67,73359.6,
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING,97569641,CDM,975,RC,69641,HCPCS,Outpatient,,,2262,1470.30,,1990.56,88,,,percent of total billed charges,88% of total Billed charges,80.3,100,,,Fee Schedule,100% of Medicare rate,606.13,100,,,Fee Schedule,100% of WA Medicaid,2262,100,,,percent of total billed charges,100% of total billed charges,624.31,103,,,Fee Schedule,103% of WA Medicaid,80.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,606.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1560.78,69,,,percent of total billed charges,69% of total billed charges,2262,100,,,percent of total billed charges,100% of total billed charges,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2262,100,,,percent of total billed charges,100% of total billed charges,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2262,100,,,percent of total billed charges,100% of total billed charges,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1399.05,61.85,,,percent of total billed charges,61.85% of total billed charges,606.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.97,130,,,Fee Schedule,130% of WA Medicaid ,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,852.77,37.7,,,percent of total billed charges,37.70% of total billed charges,852.77,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,76681.8,33.9,,,percent of total billed charges,33.9% of total billed charges,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1764.36,78,,,percent of total billed charges,78% of total billed charges,2262,100,,,percent of total billed charges,100% of total billed charges,1868.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1868.41,82.6,,,percent of total billed charges,82.6% of total billed charges,606.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.3,76681.8,
69643 TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLAST,97569643,CDM,975,RC,69643,HCPCS,Outpatient,,,2576,1674.40,,2266.88,88,,,percent of total billed charges,88% of total Billed charges,95.88,100,,,Fee Schedule,100% of Medicare rate,709.82,100,,,Fee Schedule,100% of WA Medicaid,2576,100,,,percent of total billed charges,100% of total billed charges,731.11,103,,,Fee Schedule,103% of WA Medicaid,95.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,167.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,709.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1777.44,69,,,percent of total billed charges,69% of total billed charges,2576,100,,,percent of total billed charges,100% of total billed charges,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2576,100,,,percent of total billed charges,100% of total billed charges,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2576,100,,,percent of total billed charges,100% of total billed charges,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1593.26,61.85,,,percent of total billed charges,61.85% of total billed charges,709.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,922.77,130,,,Fee Schedule,130% of WA Medicaid ,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,971.15,37.7,,,percent of total billed charges,37.70% of total billed charges,971.15,37.7,,,percent of total billed charges,37.70% of total billed charges,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,87326.4,33.9,,,percent of total billed charges,33.9% of total billed charges,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2009.28,78,,,percent of total billed charges,78% of total billed charges,2576,100,,,percent of total billed charges,100% of total billed charges,2127.78,82.6,,,percent of total billed charges,82.6% of total billed charges,2127.78,82.6,,,percent of total billed charges,82.6% of total billed charges,709.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.88,87326.4,
69644 TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLAST,97569644,CDM,975,RC,69644,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,110.77,100,,,Fee Schedule,100% of Medicare rate,876.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,902.47,103,,,Fee Schedule,103% of WA Medicaid,110.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,876.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,876.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,893.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1139.03,130,,,Fee Schedule,130% of WA Medicaid ,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,876.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.77,1139.03,
69646 TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLAST,97569646,CDM,975,RC,69646,HCPCS,Outpatient,,,3200,2080.00,,2816,88,,,percent of total billed charges,88% of total Billed charges,119.48,100,,,Fee Schedule,100% of Medicare rate,913.48,100,,,Fee Schedule,100% of WA Medicaid,3200,100,,,percent of total billed charges,100% of total billed charges,940.88,103,,,Fee Schedule,103% of WA Medicaid,119.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,209.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,913.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2208,69,,,percent of total billed charges,69% of total billed charges,3200,100,,,percent of total billed charges,100% of total billed charges,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3200,100,,,percent of total billed charges,100% of total billed charges,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3200,100,,,percent of total billed charges,100% of total billed charges,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1979.2,61.85,,,percent of total billed charges,61.85% of total billed charges,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1187.52,130,,,Fee Schedule,130% of WA Medicaid ,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1206.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1206.4,37.7,,,percent of total billed charges,37.70% of total billed charges,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,108480,33.9,,,percent of total billed charges,33.9% of total billed charges,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2496,78,,,percent of total billed charges,78% of total billed charges,3200,100,,,percent of total billed charges,100% of total billed charges,2643.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2643.2,82.6,,,percent of total billed charges,82.6% of total billed charges,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.48,108480,
FLUOROSCOPY UP TO 1 HR PROFEE,76000,CDM,960,RC,76000,HCPCS,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,2.35,100,,,Fee Schedule,100% of Medicare rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,42,100,,,percent of total billed charges,100% of total billed charges,8.64,103,,,Fee Schedule,103% of WA Medicaid,2.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,42,100,,,percent of total billed charges,100% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,42,100,,,percent of total billed charges,100% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.91,130,,,Fee Schedule,130% of WA Medicaid ,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.35,1423.8,
76942 US GUIDED NEEDLE PLACMENT ProFee,97276942,CDM,972,RC,76942,HCPCS,Outpatient,,,107,69.55,,94.16,88,,,percent of total billed charges,88% of total Billed charges,2.82,100,,,Fee Schedule,100% of Medicare rate,16.97,100,,,Fee Schedule,100% of WA Medicaid,107,100,,,percent of total billed charges,100% of total billed charges,17.48,103,,,Fee Schedule,103% of WA Medicaid,2.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,73.83,69,,,percent of total billed charges,69% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,107,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,107,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.18,61.85,,,percent of total billed charges,61.85% of total billed charges,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.06,130,,,Fee Schedule,130% of WA Medicaid ,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,3627.3,33.9,,,percent of total billed charges,33.9% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.46,78,,,percent of total billed charges,78% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.82,3627.3,
77003 FLUORO NEEDLE PLACEMENT SPINE PRO FEE,97577003,CDM,975,RC,77003,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,4.55,100,,,Fee Schedule,100% of Medicare rate,16.23,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,16.72,103,,,Fee Schedule,103% of WA Medicaid,4.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,100,100,,,percent of total billed charges,100% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,100,100,,,percent of total billed charges,100% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.1,130,,,Fee Schedule,130% of WA Medicaid ,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3390,33.9,,,percent of total billed charges,33.9% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.55,3390,
90847 FAMILY PSYCHOTHERAPY WITH PT ProFee,97590847,CDM,975,RC,90847,HCPCS,Outpatient,,,384,249.60,,337.92,88,,,percent of total billed charges,88% of total Billed charges,4.88,100,,,Fee Schedule,100% of Medicare rate,71.15,100,,,Fee Schedule,100% of WA Medicaid,384,100,,,percent of total billed charges,100% of total billed charges,73.28,103,,,Fee Schedule,103% of WA Medicaid,4.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,71.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,264.96,69,,,percent of total billed charges,69% of total billed charges,384,100,,,percent of total billed charges,100% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,384,100,,,percent of total billed charges,100% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,384,100,,,percent of total billed charges,100% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.5,61.85,,,percent of total billed charges,61.85% of total billed charges,71.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,92.5,130,,,Fee Schedule,130% of WA Medicaid ,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.77,37.7,,,percent of total billed charges,37.70% of total billed charges,144.77,37.7,,,percent of total billed charges,37.70% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,13017.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.52,78,,,percent of total billed charges,78% of total billed charges,384,100,,,percent of total billed charges,100% of total billed charges,317.18,82.6,,,percent of total billed charges,82.6% of total billed charges,317.18,82.6,,,percent of total billed charges,82.6% of total billed charges,71.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.88,13017.6,
EKG INTERPRETATION,98593010,CDM,985,RC,93010,HCPCS,Outpatient,,,16.85,10.95,,14.83,88,,,percent of total billed charges,88% of total Billed charges,0.5,100,,,Fee Schedule,100% of Medicare rate,4.48,100,,,Fee Schedule,100% of WA Medicaid,16.85,100,,,percent of total billed charges,100% of total billed charges,4.61,103,,,Fee Schedule,103% of WA Medicaid,0.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,4.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,11.63,69,,,percent of total billed charges,69% of total billed charges,16.85,100,,,percent of total billed charges,100% of total billed charges,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.85,100,,,percent of total billed charges,100% of total billed charges,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.85,100,,,percent of total billed charges,100% of total billed charges,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.42,61.85,,,percent of total billed charges,61.85% of total billed charges,4.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.82,130,,,Fee Schedule,130% of WA Medicaid ,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.35,37.7,,,percent of total billed charges,37.70% of total billed charges,6.35,37.7,,,percent of total billed charges,37.70% of total billed charges,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.22,33.9,,,percent of total billed charges,33.9% of total billed charges,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.14,78,,,percent of total billed charges,78% of total billed charges,16.85,100,,,percent of total billed charges,100% of total billed charges,13.92,82.6,,,percent of total billed charges,82.6% of total billed charges,13.92,82.6,,,percent of total billed charges,82.6% of total billed charges,4.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.5,571.22,
95811 PSS W 4/> P W CPAP/BIPAP W/TEC ProFee,97595811,CDM,983,RC,95811,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,26.95,100,,,Fee Schedule,100% of Medicare rate,68.82,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,70.88,103,,,Fee Schedule,103% of WA Medicaid,26.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,239,100,,,percent of total billed charges,100% of total billed charges,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,239,100,,,percent of total billed charges,100% of total billed charges,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.82,61.85,,,percent of total billed charges,61.85% of total billed charges,68.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.47,130,,,Fee Schedule,130% of WA Medicaid ,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,8102.1,33.9,,,percent of total billed charges,33.9% of total billed charges,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,68.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.95,8102.1,
DEBRIDEMENT,PRO84097597,CDM,960,RC,97597,HCPCS,Outpatient,,,164,106.60,,144.32,88,,,percent of total billed charges,88% of total Billed charges,2.61,100,,,Fee Schedule,100% of Medicare rate,19.77,100,,,Fee Schedule,100% of WA Medicaid,164,100,,,percent of total billed charges,100% of total billed charges,20.36,103,,,Fee Schedule,103% of WA Medicaid,2.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,113.16,69,,,percent of total billed charges,69% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,164,100,,,percent of total billed charges,100% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,164,100,,,percent of total billed charges,100% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.43,61.85,,,percent of total billed charges,61.85% of total billed charges,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.7,130,,,Fee Schedule,130% of WA Medicaid ,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.83,37.7,,,percent of total billed charges,37.70% of total billed charges,61.83,37.7,,,percent of total billed charges,37.70% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,5559.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.92,78,,,percent of total billed charges,78% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.61,5559.6,
97802 DIETARY TEACHING EACH 15 MIN CHARGE,97802,CDM,975,RC,97802,HCPCS,Outpatient,,,142,92.30,,124.96,88,,,percent of total billed charges,88% of total Billed charges,1.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,142,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,142,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,142,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.83,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,4813.8,33.9,,,percent of total billed charges,33.9% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",1.23,4813.8,
97803 Nutrition Consult Profee,97597803,CDM,975,RC,97803,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,1.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.34,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2813.7,33.9,,,percent of total billed charges,33.9% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",1.08,2813.7,
OP VISIT LEVEL 2 NEW PT DR,96099202,CDM,960,RC,99202,HCPCS,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,3.49,100,,,Fee Schedule,100% of Medicare rate,21.38,100,,,Fee Schedule,100% of WA Medicaid,167,100,,,percent of total billed charges,100% of total billed charges,22.02,103,,,Fee Schedule,103% of WA Medicaid,3.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,167,100,,,percent of total billed charges,100% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,167,100,,,percent of total billed charges,100% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.29,61.85,,,percent of total billed charges,61.85% of total billed charges,21.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.79,130,,,Fee Schedule,130% of WA Medicaid ,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,5661.3,33.9,,,percent of total billed charges,33.9% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,21.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.49,5661.3,
OP VISIT LEVEL 3 NEW PT DR,96099203,CDM,960,RC,99203,HCPCS,Outpatient,,,242,157.30,,212.96,88,,,percent of total billed charges,88% of total Billed charges,6.6,100,,,Fee Schedule,100% of Medicare rate,36.82,100,,,Fee Schedule,100% of WA Medicaid,242,100,,,percent of total billed charges,100% of total billed charges,37.92,103,,,Fee Schedule,103% of WA Medicaid,6.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,36.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,166.98,69,,,percent of total billed charges,69% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,242,100,,,percent of total billed charges,100% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,242,100,,,percent of total billed charges,100% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.68,61.85,,,percent of total billed charges,61.85% of total billed charges,36.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.87,130,,,Fee Schedule,130% of WA Medicaid ,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,8203.8,33.9,,,percent of total billed charges,33.9% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.76,78,,,percent of total billed charges,78% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,36.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.6,8203.8,
OP VISIT LEVEL 4 NEW PT DR,96099204,CDM,960,RC,99204,HCPCS,Outpatient,,,370,240.50,,325.6,88,,,percent of total billed charges,88% of total Billed charges,10.21,100,,,Fee Schedule,100% of Medicare rate,59.97,100,,,Fee Schedule,100% of WA Medicaid,370,100,,,percent of total billed charges,100% of total billed charges,61.77,103,,,Fee Schedule,103% of WA Medicaid,10.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,255.3,69,,,percent of total billed charges,69% of total billed charges,370,100,,,percent of total billed charges,100% of total billed charges,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,370,100,,,percent of total billed charges,100% of total billed charges,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,370,100,,,percent of total billed charges,100% of total billed charges,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.85,61.85,,,percent of total billed charges,61.85% of total billed charges,59.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,77.96,130,,,Fee Schedule,130% of WA Medicaid ,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.49,37.7,,,percent of total billed charges,37.70% of total billed charges,139.49,37.7,,,percent of total billed charges,37.70% of total billed charges,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,12543,33.9,,,percent of total billed charges,33.9% of total billed charges,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.6,78,,,percent of total billed charges,78% of total billed charges,370,100,,,percent of total billed charges,100% of total billed charges,305.62,82.6,,,percent of total billed charges,82.6% of total billed charges,305.62,82.6,,,percent of total billed charges,82.6% of total billed charges,59.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.21,12543,
OP VISIT LEVEL 5 NEW PT DR,96099205,CDM,983,RC,99205,HCPCS,Outpatient,,,462,300.30,,406.56,88,,,percent of total billed charges,88% of total Billed charges,13.98,100,,,Fee Schedule,100% of Medicare rate,81.65,100,,,Fee Schedule,100% of WA Medicaid,462,100,,,percent of total billed charges,100% of total billed charges,84.1,103,,,Fee Schedule,103% of WA Medicaid,13.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,81.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,318.78,69,,,percent of total billed charges,69% of total billed charges,462,100,,,percent of total billed charges,100% of total billed charges,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,462,100,,,percent of total billed charges,100% of total billed charges,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,462,100,,,percent of total billed charges,100% of total billed charges,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.75,61.85,,,percent of total billed charges,61.85% of total billed charges,81.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,106.15,130,,,Fee Schedule,130% of WA Medicaid ,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.17,37.7,,,percent of total billed charges,37.70% of total billed charges,174.17,37.7,,,percent of total billed charges,37.70% of total billed charges,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,15661.8,33.9,,,percent of total billed charges,33.9% of total billed charges,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.36,78,,,percent of total billed charges,78% of total billed charges,462,100,,,percent of total billed charges,100% of total billed charges,381.61,82.6,,,percent of total billed charges,82.6% of total billed charges,381.61,82.6,,,percent of total billed charges,82.6% of total billed charges,81.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.98,15661.8,
HOSPITAL ADMIT LEVEL 2,96099222,CDM,960,RC,99222,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,9.86,100,,,Fee Schedule,100% of Medicare rate,73.67,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,75.88,103,,,Fee Schedule,103% of WA Medicaid,9.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,73.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,308,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,308,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.5,61.85,,,percent of total billed charges,61.85% of total billed charges,73.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.77,130,,,Fee Schedule,130% of WA Medicaid ,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,10441.2,33.9,,,percent of total billed charges,33.9% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,73.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.86,10441.2,
HOSPITAL ADMIT LEVEL 3,96099223,CDM,960,RC,99223,HCPCS,Outpatient,,,454,295.10,,399.52,88,,,percent of total billed charges,88% of total Billed charges,11.91,100,,,Fee Schedule,100% of Medicare rate,97.73,100,,,Fee Schedule,100% of WA Medicaid,454,100,,,percent of total billed charges,100% of total billed charges,100.66,103,,,Fee Schedule,103% of WA Medicaid,11.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,97.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,313.26,69,,,percent of total billed charges,69% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,454,100,,,percent of total billed charges,100% of total billed charges,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,454,100,,,percent of total billed charges,100% of total billed charges,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.8,61.85,,,percent of total billed charges,61.85% of total billed charges,97.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,127.05,130,,,Fee Schedule,130% of WA Medicaid ,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,15390.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.12,78,,,percent of total billed charges,78% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,97.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.91,15390.6,
99221 ADMISSION EVAL<30 MIN PROFEE,99221,CDM,960,RC,99221,HCPCS,Outpatient,,,281,182.65,,247.28,88,,,percent of total billed charges,88% of total Billed charges,7.13,100,,,Fee Schedule,100% of Medicare rate,46.44,100,,,Fee Schedule,100% of WA Medicaid,281,100,,,percent of total billed charges,100% of total billed charges,47.83,103,,,Fee Schedule,103% of WA Medicaid,7.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,193.89,69,,,percent of total billed charges,69% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,281,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,281,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.8,61.85,,,percent of total billed charges,61.85% of total billed charges,46.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.37,130,,,Fee Schedule,130% of WA Medicaid ,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.94,37.7,,,percent of total billed charges,37.70% of total billed charges,105.94,37.7,,,percent of total billed charges,37.70% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,9525.9,33.9,,,percent of total billed charges,33.9% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.18,78,,,percent of total billed charges,78% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,46.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.13,9525.9,
INPATIENT VISIT LEVEL 1,98799231,CDM,987,RC,99231,HCPCS,Outpatient,,,111.5,72.48,,98.12,88,,,percent of total billed charges,88% of total Billed charges,3.81,100,,,Fee Schedule,100% of Medicare rate,27.79,100,,,Fee Schedule,100% of WA Medicaid,111.5,100,,,percent of total billed charges,100% of total billed charges,28.62,103,,,Fee Schedule,103% of WA Medicaid,3.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,76.94,69,,,percent of total billed charges,69% of total billed charges,111.5,100,,,percent of total billed charges,100% of total billed charges,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.5,100,,,percent of total billed charges,100% of total billed charges,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.5,100,,,percent of total billed charges,100% of total billed charges,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.96,61.85,,,percent of total billed charges,61.85% of total billed charges,27.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,36.13,130,,,Fee Schedule,130% of WA Medicaid ,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.04,37.7,,,percent of total billed charges,37.70% of total billed charges,42.04,37.7,,,percent of total billed charges,37.70% of total billed charges,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,3779.85,33.9,,,percent of total billed charges,33.9% of total billed charges,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.97,78,,,percent of total billed charges,78% of total billed charges,111.5,100,,,percent of total billed charges,100% of total billed charges,92.1,82.6,,,percent of total billed charges,82.6% of total billed charges,92.1,82.6,,,percent of total billed charges,82.6% of total billed charges,27.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.81,3779.85,
INPATIENT VISIT LEVEL 2,98799232,CDM,987,RC,99232,HCPCS,Outpatient,,,186.5,121.23,,164.12,88,,,percent of total billed charges,88% of total Billed charges,5.46,100,,,Fee Schedule,100% of Medicare rate,44.39,100,,,Fee Schedule,100% of WA Medicaid,186.5,100,,,percent of total billed charges,100% of total billed charges,45.72,103,,,Fee Schedule,103% of WA Medicaid,5.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,44.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,128.69,69,,,percent of total billed charges,69% of total billed charges,186.5,100,,,percent of total billed charges,100% of total billed charges,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.5,100,,,percent of total billed charges,100% of total billed charges,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.5,100,,,percent of total billed charges,100% of total billed charges,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.35,61.85,,,percent of total billed charges,61.85% of total billed charges,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,57.71,130,,,Fee Schedule,130% of WA Medicaid ,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.31,37.7,,,percent of total billed charges,37.70% of total billed charges,70.31,37.7,,,percent of total billed charges,37.70% of total billed charges,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,6322.35,33.9,,,percent of total billed charges,33.9% of total billed charges,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.47,78,,,percent of total billed charges,78% of total billed charges,186.5,100,,,percent of total billed charges,100% of total billed charges,154.05,82.6,,,percent of total billed charges,82.6% of total billed charges,154.05,82.6,,,percent of total billed charges,82.6% of total billed charges,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.46,6322.35,
INPATIENT VISIT LEVEL 3,98799233,CDM,987,RC,99233,HCPCS,Outpatient,,,260.25,169.16,,229.02,88,,,percent of total billed charges,88% of total Billed charges,8.21,100,,,Fee Schedule,100% of Medicare rate,66.95,100,,,Fee Schedule,100% of WA Medicaid,260.25,100,,,percent of total billed charges,100% of total billed charges,68.96,103,,,Fee Schedule,103% of WA Medicaid,8.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,179.57,69,,,percent of total billed charges,69% of total billed charges,260.25,100,,,percent of total billed charges,100% of total billed charges,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.25,100,,,percent of total billed charges,100% of total billed charges,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.25,100,,,percent of total billed charges,100% of total billed charges,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.96,61.85,,,percent of total billed charges,61.85% of total billed charges,66.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,87.04,130,,,Fee Schedule,130% of WA Medicaid ,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.11,37.7,,,percent of total billed charges,37.70% of total billed charges,98.11,37.7,,,percent of total billed charges,37.70% of total billed charges,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,8822.48,33.9,,,percent of total billed charges,33.9% of total billed charges,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,203,78,,,percent of total billed charges,78% of total billed charges,260.25,100,,,percent of total billed charges,100% of total billed charges,214.97,82.6,,,percent of total billed charges,82.6% of total billed charges,214.97,82.6,,,percent of total billed charges,82.6% of total billed charges,66.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.21,8822.48,
E/M ADMIT  DISCH SAME DAY-DET,96099234,CDM,960,RC,99234,HCPCS,Outpatient,,,303,196.95,,266.64,88,,,percent of total billed charges,88% of total Billed charges,7.32,100,,,Fee Schedule,100% of Medicare rate,55.02,100,,,Fee Schedule,100% of WA Medicaid,303,100,,,percent of total billed charges,100% of total billed charges,56.67,103,,,Fee Schedule,103% of WA Medicaid,7.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,55.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,209.07,69,,,percent of total billed charges,69% of total billed charges,303,100,,,percent of total billed charges,100% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,303,100,,,percent of total billed charges,100% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,303,100,,,percent of total billed charges,100% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.41,61.85,,,percent of total billed charges,61.85% of total billed charges,55.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,71.53,130,,,Fee Schedule,130% of WA Medicaid ,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.23,37.7,,,percent of total billed charges,37.70% of total billed charges,114.23,37.7,,,percent of total billed charges,37.70% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,10271.7,33.9,,,percent of total billed charges,33.9% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.34,78,,,percent of total billed charges,78% of total billed charges,303,100,,,percent of total billed charges,100% of total billed charges,250.28,82.6,,,percent of total billed charges,82.6% of total billed charges,250.28,82.6,,,percent of total billed charges,82.6% of total billed charges,55.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,10271.7,
E/M ADMIT  DISCH SAME DAY-COM,96099235,CDM,960,RC,99235,HCPCS,Outpatient,,,379,246.35,,333.52,88,,,percent of total billed charges,88% of total Billed charges,10.98,100,,,Fee Schedule,100% of Medicare rate,89.89,100,,,Fee Schedule,100% of WA Medicaid,379,100,,,percent of total billed charges,100% of total billed charges,92.59,103,,,Fee Schedule,103% of WA Medicaid,10.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,89.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,261.51,69,,,percent of total billed charges,69% of total billed charges,379,100,,,percent of total billed charges,100% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,379,100,,,percent of total billed charges,100% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,379,100,,,percent of total billed charges,100% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.41,61.85,,,percent of total billed charges,61.85% of total billed charges,89.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,116.86,130,,,Fee Schedule,130% of WA Medicaid ,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.88,37.7,,,percent of total billed charges,37.70% of total billed charges,142.88,37.7,,,percent of total billed charges,37.70% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,12848.1,33.9,,,percent of total billed charges,33.9% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.62,78,,,percent of total billed charges,78% of total billed charges,379,100,,,percent of total billed charges,100% of total billed charges,313.05,82.6,,,percent of total billed charges,82.6% of total billed charges,313.05,82.6,,,percent of total billed charges,82.6% of total billed charges,89.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.98,12848.1,
E/M ADMIT  DISCH SAME DAY-HIG,96099236,CDM,960,RC,99236,HCPCS,Outpatient,,,487,316.55,,428.56,88,,,percent of total billed charges,88% of total Billed charges,14.51,100,,,Fee Schedule,100% of Medicare rate,117.31,100,,,Fee Schedule,100% of WA Medicaid,487,100,,,percent of total billed charges,100% of total billed charges,120.83,103,,,Fee Schedule,103% of WA Medicaid,14.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,117.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,336.03,69,,,percent of total billed charges,69% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,487,100,,,percent of total billed charges,100% of total billed charges,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,487,100,,,percent of total billed charges,100% of total billed charges,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.21,61.85,,,percent of total billed charges,61.85% of total billed charges,117.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,152.5,130,,,Fee Schedule,130% of WA Medicaid ,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,16509.3,33.9,,,percent of total billed charges,33.9% of total billed charges,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.86,78,,,percent of total billed charges,78% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,117.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.51,16509.3,
HOSPITAL DISCHARGE DAY,96099239,CDM,960,RC,99239,HCPCS,Outpatient,,,240,156.00,,211.2,88,,,percent of total billed charges,88% of total Billed charges,7.32,100,,,Fee Schedule,100% of Medicare rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,240,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,7.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,240,100,,,percent of total billed charges,100% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,240,100,,,percent of total billed charges,100% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.44,61.85,,,percent of total billed charges,61.85% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,8136,33.9,,,percent of total billed charges,33.9% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,8136,
99238 DISCHARGE 30 MIN OR LESS,97599238,CDM,975,RC,99238,HCPCS,Outpatient,,,193,125.45,,169.84,88,,,percent of total billed charges,88% of total Billed charges,5.28,100,,,Fee Schedule,100% of Medicare rate,46.07,100,,,Fee Schedule,100% of WA Medicaid,193,100,,,percent of total billed charges,100% of total billed charges,47.45,103,,,Fee Schedule,103% of WA Medicaid,5.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,133.17,69,,,percent of total billed charges,69% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,193,100,,,percent of total billed charges,100% of total billed charges,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,193,100,,,percent of total billed charges,100% of total billed charges,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.37,61.85,,,percent of total billed charges,61.85% of total billed charges,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.89,130,,,Fee Schedule,130% of WA Medicaid ,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,6542.7,33.9,,,percent of total billed charges,33.9% of total billed charges,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.54,78,,,percent of total billed charges,78% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.28,6542.7,
OUTPT CONSULT LEVEL 2,98799242,CDM,987,RC,99242,HCPCS,Outpatient,,,194.25,126.26,,170.94,88,,,percent of total billed charges,88% of total Billed charges,3.49,100,,,Fee Schedule,100% of Medicare rate,31.71,100,,,Fee Schedule,100% of WA Medicaid,194.25,100,,,percent of total billed charges,100% of total billed charges,32.66,103,,,Fee Schedule,103% of WA Medicaid,3.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,31.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,134.03,69,,,percent of total billed charges,69% of total billed charges,194.25,100,,,percent of total billed charges,100% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.25,100,,,percent of total billed charges,100% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.25,100,,,percent of total billed charges,100% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.14,61.85,,,percent of total billed charges,61.85% of total billed charges,31.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.22,130,,,Fee Schedule,130% of WA Medicaid ,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.23,37.7,,,percent of total billed charges,37.70% of total billed charges,73.23,37.7,,,percent of total billed charges,37.70% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,6585.08,33.9,,,percent of total billed charges,33.9% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.52,78,,,percent of total billed charges,78% of total billed charges,194.25,100,,,percent of total billed charges,100% of total billed charges,160.45,82.6,,,percent of total billed charges,82.6% of total billed charges,160.45,82.6,,,percent of total billed charges,82.6% of total billed charges,31.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.49,6585.08,
OUTPT CONSULT LEVEL 3,98799243,CDM,987,RC,99243,HCPCS,Outpatient,,,247,160.55,,217.36,88,,,percent of total billed charges,88% of total Billed charges,5.49,100,,,Fee Schedule,100% of Medicare rate,49.98,100,,,Fee Schedule,100% of WA Medicaid,247,100,,,percent of total billed charges,100% of total billed charges,51.48,103,,,Fee Schedule,103% of WA Medicaid,5.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,170.43,69,,,percent of total billed charges,69% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,247,100,,,percent of total billed charges,100% of total billed charges,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,247,100,,,percent of total billed charges,100% of total billed charges,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.77,61.85,,,percent of total billed charges,61.85% of total billed charges,49.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.97,130,,,Fee Schedule,130% of WA Medicaid ,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,8373.3,33.9,,,percent of total billed charges,33.9% of total billed charges,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.66,78,,,percent of total billed charges,78% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,49.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.49,8373.3,
OUTPT CONSULT LEVEL 4,98799244,CDM,987,RC,99244,HCPCS,Outpatient,,,286.75,186.39,,252.34,88,,,percent of total billed charges,88% of total Billed charges,8.17,100,,,Fee Schedule,100% of Medicare rate,76.09,100,,,Fee Schedule,100% of WA Medicaid,286.75,100,,,percent of total billed charges,100% of total billed charges,78.37,103,,,Fee Schedule,103% of WA Medicaid,8.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,76.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,197.86,69,,,percent of total billed charges,69% of total billed charges,286.75,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.75,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.75,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.35,61.85,,,percent of total billed charges,61.85% of total billed charges,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,98.92,130,,,Fee Schedule,130% of WA Medicaid ,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.1,37.7,,,percent of total billed charges,37.70% of total billed charges,108.1,37.7,,,percent of total billed charges,37.70% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,9720.83,33.9,,,percent of total billed charges,33.9% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.67,78,,,percent of total billed charges,78% of total billed charges,286.75,100,,,percent of total billed charges,100% of total billed charges,236.86,82.6,,,percent of total billed charges,82.6% of total billed charges,236.86,82.6,,,percent of total billed charges,82.6% of total billed charges,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.17,9720.83,
OUTPT CONSULT LEVEL 5,98799245,CDM,987,RC,99245,HCPCS,Outpatient,,,343.25,223.11,,302.06,88,,,percent of total billed charges,88% of total Billed charges,11.36,100,,,Fee Schedule,100% of Medicare rate,102.02,100,,,Fee Schedule,100% of WA Medicaid,343.25,100,,,percent of total billed charges,100% of total billed charges,105.08,103,,,Fee Schedule,103% of WA Medicaid,11.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,236.84,69,,,percent of total billed charges,69% of total billed charges,343.25,100,,,percent of total billed charges,100% of total billed charges,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.25,100,,,percent of total billed charges,100% of total billed charges,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.25,100,,,percent of total billed charges,100% of total billed charges,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.3,61.85,,,percent of total billed charges,61.85% of total billed charges,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.63,130,,,Fee Schedule,130% of WA Medicaid ,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.41,37.7,,,percent of total billed charges,37.70% of total billed charges,129.41,37.7,,,percent of total billed charges,37.70% of total billed charges,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,11636.18,33.9,,,percent of total billed charges,33.9% of total billed charges,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.74,78,,,percent of total billed charges,78% of total billed charges,343.25,100,,,percent of total billed charges,100% of total billed charges,283.52,82.6,,,percent of total billed charges,82.6% of total billed charges,283.52,82.6,,,percent of total billed charges,82.6% of total billed charges,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.36,11636.18,
INITIAL IP CONSULT LEVEL 2,98799252,CDM,987,RC,99252,HCPCS,Outpatient,,,194.25,126.26,,170.94,88,,,percent of total billed charges,88% of total Billed charges,4.46,100,,,Fee Schedule,100% of Medicare rate,40.1,100,,,Fee Schedule,100% of WA Medicaid,194.25,100,,,percent of total billed charges,100% of total billed charges,41.3,103,,,Fee Schedule,103% of WA Medicaid,4.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,134.03,69,,,percent of total billed charges,69% of total billed charges,194.25,100,,,percent of total billed charges,100% of total billed charges,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.25,100,,,percent of total billed charges,100% of total billed charges,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.25,100,,,percent of total billed charges,100% of total billed charges,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.14,61.85,,,percent of total billed charges,61.85% of total billed charges,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,52.13,130,,,Fee Schedule,130% of WA Medicaid ,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.23,37.7,,,percent of total billed charges,37.70% of total billed charges,73.23,37.7,,,percent of total billed charges,37.70% of total billed charges,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,6585.08,33.9,,,percent of total billed charges,33.9% of total billed charges,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.52,78,,,percent of total billed charges,78% of total billed charges,194.25,100,,,percent of total billed charges,100% of total billed charges,160.45,82.6,,,percent of total billed charges,82.6% of total billed charges,160.45,82.6,,,percent of total billed charges,82.6% of total billed charges,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.46,6585.08,
IP CONSULTATION,96099253,CDM,960,RC,99253,HCPCS,Outpatient,,,259,168.35,,227.92,88,,,percent of total billed charges,88% of total Billed charges,6.1,100,,,Fee Schedule,100% of Medicare rate,56.51,100,,,Fee Schedule,100% of WA Medicaid,259,100,,,percent of total billed charges,100% of total billed charges,58.21,103,,,Fee Schedule,103% of WA Medicaid,6.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,178.71,69,,,percent of total billed charges,69% of total billed charges,259,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,259,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,259,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.19,61.85,,,percent of total billed charges,61.85% of total billed charges,56.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,73.46,130,,,Fee Schedule,130% of WA Medicaid ,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.64,37.7,,,percent of total billed charges,37.70% of total billed charges,97.64,37.7,,,percent of total billed charges,37.70% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,8780.1,33.9,,,percent of total billed charges,33.9% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.02,78,,,percent of total billed charges,78% of total billed charges,259,100,,,percent of total billed charges,100% of total billed charges,213.93,82.6,,,percent of total billed charges,82.6% of total billed charges,213.93,82.6,,,percent of total billed charges,82.6% of total billed charges,56.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.1,8780.1,
IP CONSULT LEVEL 4,96099254,CDM,960,RC,99254,HCPCS,Outpatient,,,375,243.75,,330,88,,,percent of total billed charges,88% of total Billed charges,8.3,100,,,Fee Schedule,100% of Medicare rate,78.52,100,,,Fee Schedule,100% of WA Medicaid,375,100,,,percent of total billed charges,100% of total billed charges,80.88,103,,,Fee Schedule,103% of WA Medicaid,8.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,78.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,258.75,69,,,percent of total billed charges,69% of total billed charges,375,100,,,percent of total billed charges,100% of total billed charges,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,375,100,,,percent of total billed charges,100% of total billed charges,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,375,100,,,percent of total billed charges,100% of total billed charges,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.94,61.85,,,percent of total billed charges,61.85% of total billed charges,78.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,102.08,130,,,Fee Schedule,130% of WA Medicaid ,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.38,37.7,,,percent of total billed charges,37.70% of total billed charges,141.38,37.7,,,percent of total billed charges,37.70% of total billed charges,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,12712.5,33.9,,,percent of total billed charges,33.9% of total billed charges,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.5,78,,,percent of total billed charges,78% of total billed charges,375,100,,,percent of total billed charges,100% of total billed charges,309.75,82.6,,,percent of total billed charges,82.6% of total billed charges,309.75,82.6,,,percent of total billed charges,82.6% of total billed charges,78.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.3,12712.5,
IP CONSULT LEVEL 5,96099255,CDM,960,RC,99255,HCPCS,Outpatient,,,453,294.45,,398.64,88,,,percent of total billed charges,88% of total Billed charges,11.53,100,,,Fee Schedule,100% of Medicare rate,105.19,100,,,Fee Schedule,100% of WA Medicaid,453,100,,,percent of total billed charges,100% of total billed charges,108.35,103,,,Fee Schedule,103% of WA Medicaid,11.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,105.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,312.57,69,,,percent of total billed charges,69% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,453,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,453,100,,,percent of total billed charges,100% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.18,61.85,,,percent of total billed charges,61.85% of total billed charges,105.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.75,130,,,Fee Schedule,130% of WA Medicaid ,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,15356.7,33.9,,,percent of total billed charges,33.9% of total billed charges,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.34,78,,,percent of total billed charges,78% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,105.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.53,15356.7,
ER profee Level 3,98199283,CDM,981,RC,99283,HCPCS,Outpatient,,,141,91.65,,124.08,88,,,percent of total billed charges,88% of total Billed charges,6.51,100,,,Fee Schedule,100% of Medicare rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,141,100,,,percent of total billed charges,100% of total billed charges,40.73,103,,,Fee Schedule,103% of WA Medicaid,6.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,97.29,69,,,percent of total billed charges,69% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,141,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,141,100,,,percent of total billed charges,100% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.21,61.85,,,percent of total billed charges,61.85% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.4,130,,,Fee Schedule,130% of WA Medicaid ,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.16,37.7,,,percent of total billed charges,37.70% of total billed charges,53.16,37.7,,,percent of total billed charges,37.70% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4779.9,33.9,,,percent of total billed charges,33.9% of total billed charges,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.98,78,,,percent of total billed charges,78% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.51,4779.9,
CRITICAL CARE 30-74 MIN,99291,CDM,975,RC,99291,HCPCS,Outpatient,,,736,478.40,25,647.68,88,,,percent of total billed charges,88% of total Billed charges,17.2,100,,,Fee Schedule,100% of Medicare rate,119.17,100,,,Fee Schedule,100% of WA Medicaid,736,100,,,percent of total billed charges,100% of total billed charges,122.75,103,,,Fee Schedule,103% of WA Medicaid,17.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,119.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,507.84,69,,,percent of total billed charges,69% of total billed charges,736,100,,,percent of total billed charges,100% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,736,100,,,percent of total billed charges,100% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,736,100,,,percent of total billed charges,100% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.22,61.85,,,percent of total billed charges,61.85% of total billed charges,119.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,154.92,130,,,Fee Schedule,130% of WA Medicaid ,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.47,37.7,,,percent of total billed charges,37.70% of total billed charges,277.47,37.7,,,percent of total billed charges,37.70% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,24950.4,33.9,,,percent of total billed charges,33.9% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.08,78,,,percent of total billed charges,78% of total billed charges,736,100,,,percent of total billed charges,100% of total billed charges,607.94,82.6,,,percent of total billed charges,82.6% of total billed charges,607.94,82.6,,,percent of total billed charges,82.6% of total billed charges,119.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.2,24950.4,
"99460 Initial Hospital Care, Per Day, Normal Newborn",99460,CDM,975,RC,99460,HCPCS,Outpatient,,,257,167.05,,226.16,88,,,percent of total billed charges,88% of total Billed charges,6.14,100,,,Fee Schedule,100% of Medicare rate,63.76,100,,,Fee Schedule,100% of WA Medicaid,257,100,,,percent of total billed charges,100% of total billed charges,65.67,103,,,Fee Schedule,103% of WA Medicaid,6.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,177.33,69,,,percent of total billed charges,69% of total billed charges,257,100,,,percent of total billed charges,100% of total billed charges,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,257,100,,,percent of total billed charges,100% of total billed charges,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,257,100,,,percent of total billed charges,100% of total billed charges,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.95,61.85,,,percent of total billed charges,61.85% of total billed charges,63.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.89,130,,,Fee Schedule,130% of WA Medicaid ,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.89,37.7,,,percent of total billed charges,37.70% of total billed charges,96.89,37.7,,,percent of total billed charges,37.70% of total billed charges,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,8712.3,33.9,,,percent of total billed charges,33.9% of total billed charges,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.46,78,,,percent of total billed charges,78% of total billed charges,257,100,,,percent of total billed charges,100% of total billed charges,212.28,82.6,,,percent of total billed charges,82.6% of total billed charges,212.28,82.6,,,percent of total billed charges,82.6% of total billed charges,63.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.14,8712.3,
SUBSEQ HOS CARE EM PER DAY PROFEE,96099462,CDM,960,RC,99462,HCPCS,Outpatient,,,68,44.20,,59.84,88,,,percent of total billed charges,88% of total Billed charges,2.77,100,,,Fee Schedule,100% of Medicare rate,28.01,100,,,Fee Schedule,100% of WA Medicaid,68,100,,,percent of total billed charges,100% of total billed charges,28.85,103,,,Fee Schedule,103% of WA Medicaid,2.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,46.92,69,,,percent of total billed charges,69% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,68,100,,,percent of total billed charges,100% of total billed charges,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,68,100,,,percent of total billed charges,100% of total billed charges,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.06,61.85,,,percent of total billed charges,61.85% of total billed charges,28.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,36.41,130,,,Fee Schedule,130% of WA Medicaid ,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2305.2,33.9,,,percent of total billed charges,33.9% of total billed charges,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.04,78,,,percent of total billed charges,78% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,28.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.77,2305.2,
INI CARE ADM/DS SAME DAY PROFEE,96099463,CDM,960,RC,99463,HCPCS,Outpatient,,,154,100.10,,135.52,88,,,percent of total billed charges,88% of total Billed charges,7.12,100,,,Fee Schedule,100% of Medicare rate,74.69,100,,,Fee Schedule,100% of WA Medicaid,154,100,,,percent of total billed charges,100% of total billed charges,76.93,103,,,Fee Schedule,103% of WA Medicaid,7.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,106.26,69,,,percent of total billed charges,69% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,154,100,,,percent of total billed charges,100% of total billed charges,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,154,100,,,percent of total billed charges,100% of total billed charges,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.25,61.85,,,percent of total billed charges,61.85% of total billed charges,74.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,97.1,130,,,Fee Schedule,130% of WA Medicaid ,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,5220.6,33.9,,,percent of total billed charges,33.9% of total billed charges,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.12,78,,,percent of total billed charges,78% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,74.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.12,5220.6,
99471 CRITICAL CARE PEDIATRIC INITIAL,96099471,CDM,960,RC,99471,HCPCS,Outpatient,,,2706,1758.90,,2381.28,88,,,percent of total billed charges,88% of total Billed charges,51.85,100,,,Fee Schedule,100% of Medicare rate,435.85,100,,,Fee Schedule,100% of WA Medicaid,2706,100,,,percent of total billed charges,100% of total billed charges,448.93,103,,,Fee Schedule,103% of WA Medicaid,51.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,435.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1867.14,69,,,percent of total billed charges,69% of total billed charges,2706,100,,,percent of total billed charges,100% of total billed charges,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2706,100,,,percent of total billed charges,100% of total billed charges,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2706,100,,,percent of total billed charges,100% of total billed charges,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1673.66,61.85,,,percent of total billed charges,61.85% of total billed charges,435.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,566.61,130,,,Fee Schedule,130% of WA Medicaid ,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1020.16,37.7,,,percent of total billed charges,37.70% of total billed charges,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,91733.4,33.9,,,percent of total billed charges,33.9% of total billed charges,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2110.68,78,,,percent of total billed charges,78% of total billed charges,2706,100,,,percent of total billed charges,100% of total billed charges,2235.16,82.6,,,percent of total billed charges,82.6% of total billed charges,2235.16,82.6,,,percent of total billed charges,82.6% of total billed charges,435.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.85,91733.4,
OP VISIT LEVEL 1,96099201,CDM,960,RC,99211,HCPCS,Outpatient,,,98,63.70,,86.24,88,,,percent of total billed charges,88% of total Billed charges,0.52,100,,,Fee Schedule,100% of Medicare rate,4.01,100,,,Fee Schedule,100% of WA Medicaid,98,100,,,percent of total billed charges,100% of total billed charges,4.13,103,,,Fee Schedule,103% of WA Medicaid,0.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,4.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,67.62,69,,,percent of total billed charges,69% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,98,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,98,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,61.85,,,percent of total billed charges,61.85% of total billed charges,4.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.21,130,,,Fee Schedule,130% of WA Medicaid ,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,3322.2,33.9,,,percent of total billed charges,33.9% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.44,78,,,percent of total billed charges,78% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.52,3322.2,
G0104 SIGMOIDOSCOPY FLEX SCREEN ProFee,975G0104,CDM,975,RC,,,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,400,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,400,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,400,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150.8,37.7,,,percent of total billed charges,37.70% of total billed charges,150.8,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,13560,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",150.8,13560,
"COLONOSCOPY SCREEN, HIGH RISK PROFEE",G0105,CDM,982,RC,,,Outpatient,,,574,373.10,,505.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,574,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,396.06,69,,,percent of total billed charges,69% of total billed charges,574,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,574,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,574,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,355.02,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,216.4,37.7,,,percent of total billed charges,37.70% of total billed charges,216.4,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,19458.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,447.72,78,,,percent of total billed charges,78% of total billed charges,574,100,,,percent of total billed charges,100% of total billed charges,474.12,82.6,,,percent of total billed charges,82.6% of total billed charges,474.12,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",216.4,19458.6,
SCRN COLONOSCOPY PT NOT H PROFEE,G0121,CDM,960,RC,G0121,HCPCS,Outpatient,,,865,562.25,,761.2,88,,,percent of total billed charges,88% of total Billed charges,16.62,100,,,Fee Schedule,100% of Medicare rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,865,100,,,percent of total billed charges,100% of total billed charges,53.41,103,,,Fee Schedule,103% of WA Medicaid,16.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,596.85,69,,,percent of total billed charges,69% of total billed charges,865,100,,,percent of total billed charges,100% of total billed charges,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,865,100,,,percent of total billed charges,100% of total billed charges,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,865,100,,,percent of total billed charges,100% of total billed charges,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,535,61.85,,,percent of total billed charges,61.85% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.41,130,,,Fee Schedule,130% of WA Medicaid ,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.11,37.7,,,percent of total billed charges,37.70% of total billed charges,326.11,37.7,,,percent of total billed charges,37.70% of total billed charges,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,29323.5,33.9,,,percent of total billed charges,33.9% of total billed charges,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.7,78,,,percent of total billed charges,78% of total billed charges,865,100,,,percent of total billed charges,100% of total billed charges,714.49,82.6,,,percent of total billed charges,82.6% of total billed charges,714.49,82.6,,,percent of total billed charges,82.6% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.62,29323.5,
G0406 INPT/TELE FOLLOW UP 15,G0406PROFEE,CDM,960,RC,,,Outpatient,,,79,51.35,,69.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,79,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,54.51,69,,,percent of total billed charges,69% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,79,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,79,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,48.86,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.78,37.7,,,percent of total billed charges,37.70% of total billed charges,29.78,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2678.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,61.62,78,,,percent of total billed charges,78% of total billed charges,79,100,,,percent of total billed charges,100% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,65.25,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",29.78,2678.1,
G0427 ER/INIT IP TELEHEALTH CONS 70 MIN,G0427PROFEE,CDM,960,RC,,,Outpatient,,,408,265.20,,359.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,408,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,281.52,69,,,percent of total billed charges,69% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,408,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,408,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,252.35,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,13831.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,318.24,78,,,percent of total billed charges,78% of total billed charges,408,100,,,percent of total billed charges,100% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",153.82,13831.2,
G0426 ER/INIT IP TELEHEALTH CONS 50 MIN,G0426PROFEE,CDM,960,RC,,,Outpatient,,,275,178.75,,242,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,275,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,189.75,69,,,percent of total billed charges,69% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,275,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,275,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,170.09,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,9322.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,214.5,78,,,percent of total billed charges,78% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",103.68,9322.5,
G0425 ER/INIT IP TELEHEALTH CONS 30 MIN,G0425PROFEE,CDM,960,RC,,,Outpatient,,,203,131.95,,178.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,203,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,140.07,69,,,percent of total billed charges,69% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,203,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,203,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,125.56,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,6881.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,158.34,78,,,percent of total billed charges,78% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",76.53,6881.7,
INTRO NDLE A/O CATH ARTE SHUNT,96036147,CDM,960,RC,36147,HCPCS,Outpatient,,,1731,1125.15,,1523.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1731,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1194.39,69,,,percent of total billed charges,69% of total billed charges,1731,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1731,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1731,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1070.62,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,652.59,37.7,,,percent of total billed charges,37.70% of total billed charges,652.59,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,58680.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1350.18,78,,,percent of total billed charges,78% of total billed charges,1731,100,,,percent of total billed charges,100% of total billed charges,1429.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1429.81,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",652.59,58680.9,
Report,97274350,CDM,972,RC,74350,HCPCS,Outpatient,,,55,35.75,26,48.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,55,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,55,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,55,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1864.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",20.74,1864.5,
Report,97274340,CDM,972,RC,74340,HCPCS,Outpatient,,,55,35.75,26,48.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,14.17,100,,,Fee Schedule,100% of WA Medicaid,55,100,,,percent of total billed charges,100% of total billed charges,14.6,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,55,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,55,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.42,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1864.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.17,1864.5,
Report,97270390,CDM,972,RC,70390,HCPCS,Outpatient,,,97,63.05,26,85.36,88,,,percent of total billed charges,88% of total Billed charges,4.37,100,,,Fee Schedule,100% of Medicare rate,10.07,100,,,Fee Schedule,100% of WA Medicaid,97,100,,,percent of total billed charges,100% of total billed charges,10.37,103,,,Fee Schedule,103% of WA Medicaid,4.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,10.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,66.93,69,,,percent of total billed charges,69% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,97,100,,,percent of total billed charges,100% of total billed charges,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,97,100,,,percent of total billed charges,100% of total billed charges,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.99,61.85,,,percent of total billed charges,61.85% of total billed charges,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.09,130,,,Fee Schedule,130% of WA Medicaid ,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,3288.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.66,78,,,percent of total billed charges,78% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.37,3288.3,
MG Mammo Diagnostic Bilateral w/ Tomo. ProFee,97277066,CDM,972,RC,77066,HCPCS,Outpatient,,,51,33.15,26,44.88,88,,,percent of total billed charges,88% of total Billed charges,6.72,100,,,Fee Schedule,100% of Medicare rate,26.67,100,,,Fee Schedule,100% of WA Medicaid,51,100,,,percent of total billed charges,100% of total billed charges,27.47,103,,,Fee Schedule,103% of WA Medicaid,6.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,26.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,35.19,69,,,percent of total billed charges,69% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,51,100,,,percent of total billed charges,100% of total billed charges,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,51,100,,,percent of total billed charges,100% of total billed charges,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.54,61.85,,,percent of total billed charges,61.85% of total billed charges,26.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,34.67,130,,,Fee Schedule,130% of WA Medicaid ,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1728.9,33.9,,,percent of total billed charges,33.9% of total billed charges,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.78,78,,,percent of total billed charges,78% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,26.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.72,1728.9,
MG Mammo Diagnostic Left w/ Tomo. ProFee,97277065,CDM,972,RC,77065,HCPCS,Outpatient,,,51,33.15,26|LT,44.88,88,,,percent of total billed charges,88% of total Billed charges,5.17,100,,,Fee Schedule,100% of Medicare rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,51,100,,,percent of total billed charges,100% of total billed charges,22.28,103,,,Fee Schedule,103% of WA Medicaid,5.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,35.19,69,,,percent of total billed charges,69% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,51,100,,,percent of total billed charges,100% of total billed charges,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,51,100,,,percent of total billed charges,100% of total billed charges,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.54,61.85,,,percent of total billed charges,61.85% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.12,130,,,Fee Schedule,130% of WA Medicaid ,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1728.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.78,78,,,percent of total billed charges,78% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.17,1728.9,
MRA Brain/Head w/ + w/o Contrast ProFee,97270546,CDM,972,RC,70546,HCPCS,Outpatient,,,317,206.05,26,278.96,88,,,percent of total billed charges,88% of total Billed charges,13.62,100,,,Fee Schedule,100% of Medicare rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,317,100,,,percent of total billed charges,100% of total billed charges,40.73,103,,,Fee Schedule,103% of WA Medicaid,13.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,218.73,69,,,percent of total billed charges,69% of total billed charges,317,100,,,percent of total billed charges,100% of total billed charges,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,317,100,,,percent of total billed charges,100% of total billed charges,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,317,100,,,percent of total billed charges,100% of total billed charges,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.06,61.85,,,percent of total billed charges,61.85% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.4,130,,,Fee Schedule,130% of WA Medicaid ,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.51,37.7,,,percent of total billed charges,37.70% of total billed charges,119.51,37.7,,,percent of total billed charges,37.70% of total billed charges,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,10746.3,33.9,,,percent of total billed charges,33.9% of total billed charges,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.26,78,,,percent of total billed charges,78% of total billed charges,317,100,,,percent of total billed charges,100% of total billed charges,261.84,82.6,,,percent of total billed charges,82.6% of total billed charges,261.84,82.6,,,percent of total billed charges,82.6% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.62,10746.3,
MRA Abdomen w/ Contrast ProFee,97274185,CDM,972,RC,74185,HCPCS,Outpatient,,,302,196.30,26,265.76,88,,,percent of total billed charges,88% of total Billed charges,14.09,100,,,Fee Schedule,100% of Medicare rate,47.56,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,48.99,103,,,Fee Schedule,103% of WA Medicaid,14.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.79,61.85,,,percent of total billed charges,61.85% of total billed charges,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.83,130,,,Fee Schedule,130% of WA Medicaid ,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,10237.8,33.9,,,percent of total billed charges,33.9% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.09,10237.8,
MRA Lower Extremity w/ + w/o Cnt Left ProFee,97273725,CDM,972,RC,73725,HCPCS,Outpatient,,,302,196.30,26|LT,265.76,88,,,percent of total billed charges,88% of total Billed charges,14.31,100,,,Fee Schedule,100% of Medicare rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,49.37,103,,,Fee Schedule,103% of WA Medicaid,14.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.79,61.85,,,percent of total billed charges,61.85% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.31,130,,,Fee Schedule,130% of WA Medicaid ,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,10237.8,33.9,,,percent of total billed charges,33.9% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.31,10237.8,
MRA Lower Extremity w/ Contrast Left ProFee,97273725,CDM,972,RC,73725,HCPCS,Outpatient,,,302,196.30,26|LT,265.76,88,,,percent of total billed charges,88% of total Billed charges,14.31,100,,,Fee Schedule,100% of Medicare rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,49.37,103,,,Fee Schedule,103% of WA Medicaid,14.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.79,61.85,,,percent of total billed charges,61.85% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.31,130,,,Fee Schedule,130% of WA Medicaid ,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,10237.8,33.9,,,percent of total billed charges,33.9% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.31,10237.8,
MRA Lower Extremity w/ + w/o Cnt Right ProFee,97273725,CDM,972,RC,73725,HCPCS,Outpatient,,,211,137.15,26|RT,185.68,88,,,percent of total billed charges,88% of total Billed charges,14.31,100,,,Fee Schedule,100% of Medicare rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,211,100,,,percent of total billed charges,100% of total billed charges,49.37,103,,,Fee Schedule,103% of WA Medicaid,14.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,145.59,69,,,percent of total billed charges,69% of total billed charges,211,100,,,percent of total billed charges,100% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,211,100,,,percent of total billed charges,100% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,211,100,,,percent of total billed charges,100% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.5,61.85,,,percent of total billed charges,61.85% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.31,130,,,Fee Schedule,130% of WA Medicaid ,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.55,37.7,,,percent of total billed charges,37.70% of total billed charges,79.55,37.7,,,percent of total billed charges,37.70% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7152.9,33.9,,,percent of total billed charges,33.9% of total billed charges,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.58,78,,,percent of total billed charges,78% of total billed charges,211,100,,,percent of total billed charges,100% of total billed charges,174.29,82.6,,,percent of total billed charges,82.6% of total billed charges,174.29,82.6,,,percent of total billed charges,82.6% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.31,7152.9,
MRA Pelvis w/ + w/o Contrast ProFee,97272198,CDM,972,RC,72198,HCPCS,Outpatient,,,302,196.30,26,265.76,88,,,percent of total billed charges,88% of total Billed charges,14.13,100,,,Fee Schedule,100% of Medicare rate,47.56,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,48.99,103,,,Fee Schedule,103% of WA Medicaid,14.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.79,61.85,,,percent of total billed charges,61.85% of total billed charges,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.83,130,,,Fee Schedule,130% of WA Medicaid ,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,10237.8,33.9,,,percent of total billed charges,33.9% of total billed charges,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.13,10237.8,
MRA Upper Extremity w/ + w/o Cnt Left ProFee,97273225,CDM,972,RC,73225,HCPCS,Outpatient,,,216,140.40,26|LT,190.08,88,,,percent of total billed charges,88% of total Billed charges,14.26,100,,,Fee Schedule,100% of Medicare rate,46.25,100,,,Fee Schedule,100% of WA Medicaid,216,100,,,percent of total billed charges,100% of total billed charges,47.64,103,,,Fee Schedule,103% of WA Medicaid,14.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,149.04,69,,,percent of total billed charges,69% of total billed charges,216,100,,,percent of total billed charges,100% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,216,100,,,percent of total billed charges,100% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,216,100,,,percent of total billed charges,100% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.6,61.85,,,percent of total billed charges,61.85% of total billed charges,46.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.13,130,,,Fee Schedule,130% of WA Medicaid ,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.43,37.7,,,percent of total billed charges,37.70% of total billed charges,81.43,37.7,,,percent of total billed charges,37.70% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,7322.4,33.9,,,percent of total billed charges,33.9% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.48,78,,,percent of total billed charges,78% of total billed charges,216,100,,,percent of total billed charges,100% of total billed charges,178.42,82.6,,,percent of total billed charges,82.6% of total billed charges,178.42,82.6,,,percent of total billed charges,82.6% of total billed charges,46.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.26,7322.4,
MRI Abdomen w/ Contrast ProFee,97274182,CDM,972,RC,74182,HCPCS,Outpatient,,,369,239.85,26,324.72,88,,,percent of total billed charges,88% of total Billed charges,12.73,100,,,Fee Schedule,100% of Medicare rate,46.07,100,,,Fee Schedule,100% of WA Medicaid,369,100,,,percent of total billed charges,100% of total billed charges,47.45,103,,,Fee Schedule,103% of WA Medicaid,12.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,254.61,69,,,percent of total billed charges,69% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,369,100,,,percent of total billed charges,100% of total billed charges,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,369,100,,,percent of total billed charges,100% of total billed charges,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.23,61.85,,,percent of total billed charges,61.85% of total billed charges,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.89,130,,,Fee Schedule,130% of WA Medicaid ,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,139.11,37.7,,,percent of total billed charges,37.70% of total billed charges,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,12509.1,33.9,,,percent of total billed charges,33.9% of total billed charges,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.82,78,,,percent of total billed charges,78% of total billed charges,369,100,,,percent of total billed charges,100% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,304.79,82.6,,,percent of total billed charges,82.6% of total billed charges,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.73,12509.1,
MRI Breast w/o Contrast Bilateral ProFee,97277047,CDM,972,RC,77047,HCPCS,Outpatient,,,579,376.35,26|50,509.52,88,,,percent of total billed charges,88% of total Billed charges,9.54,100,,,Fee Schedule,100% of Medicare rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,579,100,,,percent of total billed charges,100% of total billed charges,43.99,103,,,Fee Schedule,103% of WA Medicaid,9.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,399.51,69,,,percent of total billed charges,69% of total billed charges,579,100,,,percent of total billed charges,100% of total billed charges,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,579,100,,,percent of total billed charges,100% of total billed charges,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,579,100,,,percent of total billed charges,100% of total billed charges,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.11,61.85,,,percent of total billed charges,61.85% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.52,130,,,Fee Schedule,130% of WA Medicaid ,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.28,37.7,,,percent of total billed charges,37.70% of total billed charges,218.28,37.7,,,percent of total billed charges,37.70% of total billed charges,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,19628.1,33.9,,,percent of total billed charges,33.9% of total billed charges,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.62,78,,,percent of total billed charges,78% of total billed charges,579,100,,,percent of total billed charges,100% of total billed charges,478.25,82.6,,,percent of total billed charges,82.6% of total billed charges,478.25,82.6,,,percent of total billed charges,82.6% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.54,19628.1,
MRI Face Neck Orbit w/ Contrast ProFee,97270542,CDM,972,RC,70542,HCPCS,Outpatient,,,357,232.05,26,314.16,88,,,percent of total billed charges,88% of total Billed charges,11.38,100,,,Fee Schedule,100% of Medicare rate,43.27,100,,,Fee Schedule,100% of WA Medicaid,357,100,,,percent of total billed charges,100% of total billed charges,44.57,103,,,Fee Schedule,103% of WA Medicaid,11.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,43.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,246.33,69,,,percent of total billed charges,69% of total billed charges,357,100,,,percent of total billed charges,100% of total billed charges,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,357,100,,,percent of total billed charges,100% of total billed charges,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,357,100,,,percent of total billed charges,100% of total billed charges,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.8,61.85,,,percent of total billed charges,61.85% of total billed charges,43.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,56.25,130,,,Fee Schedule,130% of WA Medicaid ,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.59,37.7,,,percent of total billed charges,37.70% of total billed charges,134.59,37.7,,,percent of total billed charges,37.70% of total billed charges,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,12102.3,33.9,,,percent of total billed charges,33.9% of total billed charges,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.46,78,,,percent of total billed charges,78% of total billed charges,357,100,,,percent of total billed charges,100% of total billed charges,294.88,82.6,,,percent of total billed charges,82.6% of total billed charges,294.88,82.6,,,percent of total billed charges,82.6% of total billed charges,43.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.38,12102.3,
MRI Pelvis w/ Contrast ProFee,97272196,CDM,972,RC,72196,HCPCS,Outpatient,,,364,236.60,26,320.32,88,,,percent of total billed charges,88% of total Billed charges,11.64,100,,,Fee Schedule,100% of Medicare rate,46.07,100,,,Fee Schedule,100% of WA Medicaid,364,100,,,percent of total billed charges,100% of total billed charges,47.45,103,,,Fee Schedule,103% of WA Medicaid,11.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,364,100,,,percent of total billed charges,100% of total billed charges,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,364,100,,,percent of total billed charges,100% of total billed charges,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.13,61.85,,,percent of total billed charges,61.85% of total billed charges,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.89,130,,,Fee Schedule,130% of WA Medicaid ,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,12339.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.64,12339.6,
NM Bone Imaging Limited Injection ProFee,97278300,CDM,972,RC,78300,HCPCS,Outpatient,,,1551.4,1008.41,26,1365.23,88,,,percent of total billed charges,88% of total Billed charges,7.97,100,,,Fee Schedule,100% of Medicare rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,1551.4,100,,,percent of total billed charges,100% of total billed charges,16.9,103,,,Fee Schedule,103% of WA Medicaid,7.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1070.47,69,,,percent of total billed charges,69% of total billed charges,1551.4,100,,,percent of total billed charges,100% of total billed charges,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1551.4,100,,,percent of total billed charges,100% of total billed charges,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1551.4,100,,,percent of total billed charges,100% of total billed charges,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,959.54,61.85,,,percent of total billed charges,61.85% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.33,130,,,Fee Schedule,130% of WA Medicaid ,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,584.88,37.7,,,percent of total billed charges,37.70% of total billed charges,584.88,37.7,,,percent of total billed charges,37.70% of total billed charges,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,52592.46,33.9,,,percent of total billed charges,33.9% of total billed charges,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1210.09,78,,,percent of total billed charges,78% of total billed charges,1551.4,100,,,percent of total billed charges,100% of total billed charges,1281.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1281.46,82.6,,,percent of total billed charges,82.6% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.97,52592.46,
NM Bone Imaging Multiple Areas ProFee,97278305,CDM,972,RC,78305,HCPCS,Outpatient,,,2200.91,1430.59,26,1936.8,88,,,percent of total billed charges,88% of total Billed charges,9.81,100,,,Fee Schedule,100% of Medicare rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,2200.91,100,,,percent of total billed charges,100% of total billed charges,22.28,103,,,Fee Schedule,103% of WA Medicaid,9.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1518.63,69,,,percent of total billed charges,69% of total billed charges,2200.91,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2200.91,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2200.91,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1361.26,61.85,,,percent of total billed charges,61.85% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.12,130,,,Fee Schedule,130% of WA Medicaid ,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.74,37.7,,,percent of total billed charges,37.70% of total billed charges,829.74,37.7,,,percent of total billed charges,37.70% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,74610.85,33.9,,,percent of total billed charges,33.9% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1716.71,78,,,percent of total billed charges,78% of total billed charges,2200.91,100,,,percent of total billed charges,100% of total billed charges,1817.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1817.95,82.6,,,percent of total billed charges,82.6% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.81,74610.85,
NM Bone Imaging Whole Body ProFee,97278306,CDM,972,RC,78306,HCPCS,Outpatient,,,2559.78,1663.86,26,2252.61,88,,,percent of total billed charges,88% of total Billed charges,10.43,100,,,Fee Schedule,100% of Medicare rate,22.38,100,,,Fee Schedule,100% of WA Medicaid,2559.78,100,,,percent of total billed charges,100% of total billed charges,23.05,103,,,Fee Schedule,103% of WA Medicaid,10.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1766.25,69,,,percent of total billed charges,69% of total billed charges,2559.78,100,,,percent of total billed charges,100% of total billed charges,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2559.78,100,,,percent of total billed charges,100% of total billed charges,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2559.78,100,,,percent of total billed charges,100% of total billed charges,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1583.22,61.85,,,percent of total billed charges,61.85% of total billed charges,22.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.09,130,,,Fee Schedule,130% of WA Medicaid ,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,965.04,37.7,,,percent of total billed charges,37.70% of total billed charges,965.04,37.7,,,percent of total billed charges,37.70% of total billed charges,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,86776.54,33.9,,,percent of total billed charges,33.9% of total billed charges,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1996.63,78,,,percent of total billed charges,78% of total billed charges,2559.78,100,,,percent of total billed charges,100% of total billed charges,2114.38,82.6,,,percent of total billed charges,82.6% of total billed charges,2114.38,82.6,,,percent of total billed charges,82.6% of total billed charges,22.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.43,86776.54,
NM Bone Spect ProFee,97278803,CDM,972,RC,78803,HCPCS,Outpatient,,,2554.63,1660.51,26,2248.07,88,,,percent of total billed charges,88% of total Billed charges,13.37,100,,,Fee Schedule,100% of Medicare rate,28.16,100,,,Fee Schedule,100% of WA Medicaid,2554.63,100,,,percent of total billed charges,100% of total billed charges,29,103,,,Fee Schedule,103% of WA Medicaid,13.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1762.69,69,,,percent of total billed charges,69% of total billed charges,2554.63,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2554.63,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2554.63,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1580.04,61.85,,,percent of total billed charges,61.85% of total billed charges,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,36.61,130,,,Fee Schedule,130% of WA Medicaid ,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,963.1,37.7,,,percent of total billed charges,37.70% of total billed charges,963.1,37.7,,,percent of total billed charges,37.70% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,86601.96,33.9,,,percent of total billed charges,33.9% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1992.61,78,,,percent of total billed charges,78% of total billed charges,2554.63,100,,,percent of total billed charges,100% of total billed charges,2110.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2110.12,82.6,,,percent of total billed charges,82.6% of total billed charges,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.37,86601.96,
NM Bone Three Phase Study ProFee,97278315,CDM,972,RC,78315,HCPCS,Outpatient,,,2438.99,1585.34,26,2146.31,88,,,percent of total billed charges,88% of total Billed charges,12.67,100,,,Fee Schedule,100% of Medicare rate,26.86,100,,,Fee Schedule,100% of WA Medicaid,2438.99,100,,,percent of total billed charges,100% of total billed charges,27.67,103,,,Fee Schedule,103% of WA Medicaid,12.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,26.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1682.9,69,,,percent of total billed charges,69% of total billed charges,2438.99,100,,,percent of total billed charges,100% of total billed charges,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2438.99,100,,,percent of total billed charges,100% of total billed charges,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2438.99,100,,,percent of total billed charges,100% of total billed charges,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1508.52,61.85,,,percent of total billed charges,61.85% of total billed charges,26.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,34.92,130,,,Fee Schedule,130% of WA Medicaid ,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,919.5,37.7,,,percent of total billed charges,37.70% of total billed charges,919.5,37.7,,,percent of total billed charges,37.70% of total billed charges,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,82681.76,33.9,,,percent of total billed charges,33.9% of total billed charges,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1902.41,78,,,percent of total billed charges,78% of total billed charges,2438.99,100,,,percent of total billed charges,100% of total billed charges,2014.61,82.6,,,percent of total billed charges,82.6% of total billed charges,2014.61,82.6,,,percent of total billed charges,82.6% of total billed charges,26.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.67,82681.76,
NM Gastric Emptying Study ProFee,97278264,CDM,972,RC,78264,HCPCS,Outpatient,,,2365.21,1537.39,26,2081.38,88,,,percent of total billed charges,88% of total Billed charges,11.97,100,,,Fee Schedule,100% of Medicare rate,20.7,100,,,Fee Schedule,100% of WA Medicaid,2365.21,100,,,percent of total billed charges,100% of total billed charges,21.32,103,,,Fee Schedule,103% of WA Medicaid,11.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1631.99,69,,,percent of total billed charges,69% of total billed charges,2365.21,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2365.21,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2365.21,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1462.88,61.85,,,percent of total billed charges,61.85% of total billed charges,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.91,130,,,Fee Schedule,130% of WA Medicaid ,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,891.68,37.7,,,percent of total billed charges,37.70% of total billed charges,891.68,37.7,,,percent of total billed charges,37.70% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,80180.62,33.9,,,percent of total billed charges,33.9% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1844.86,78,,,percent of total billed charges,78% of total billed charges,2365.21,100,,,percent of total billed charges,100% of total billed charges,1953.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1953.66,82.6,,,percent of total billed charges,82.6% of total billed charges,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.97,80180.62,
NM Gastrointestinal Blood Loss Imaging ProFee,97278278,CDM,972,RC,78278,HCPCS,Outpatient,,,2505.4,1628.51,26,2204.75,88,,,percent of total billed charges,88% of total Billed charges,12.74,100,,,Fee Schedule,100% of Medicare rate,26.11,100,,,Fee Schedule,100% of WA Medicaid,2505.4,100,,,percent of total billed charges,100% of total billed charges,26.89,103,,,Fee Schedule,103% of WA Medicaid,12.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,26.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1728.73,69,,,percent of total billed charges,69% of total billed charges,2505.4,100,,,percent of total billed charges,100% of total billed charges,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2505.4,100,,,percent of total billed charges,100% of total billed charges,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2505.4,100,,,percent of total billed charges,100% of total billed charges,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1549.59,61.85,,,percent of total billed charges,61.85% of total billed charges,26.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.94,130,,,Fee Schedule,130% of WA Medicaid ,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,944.54,37.7,,,percent of total billed charges,37.70% of total billed charges,944.54,37.7,,,percent of total billed charges,37.70% of total billed charges,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,84933.06,33.9,,,percent of total billed charges,33.9% of total billed charges,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1954.21,78,,,percent of total billed charges,78% of total billed charges,2505.4,100,,,percent of total billed charges,100% of total billed charges,2069.46,82.6,,,percent of total billed charges,82.6% of total billed charges,2069.46,82.6,,,percent of total billed charges,82.6% of total billed charges,26.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.74,84933.06,
NM Intestine Imaging Meckels ProFee,97278290,CDM,972,RC,78290,HCPCS,Outpatient,,,2298.33,1493.91,26,2022.53,88,,,percent of total billed charges,88% of total Billed charges,11.66,100,,,Fee Schedule,100% of Medicare rate,17.72,100,,,Fee Schedule,100% of WA Medicaid,2298.33,100,,,percent of total billed charges,100% of total billed charges,18.25,103,,,Fee Schedule,103% of WA Medicaid,11.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,17.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1585.85,69,,,percent of total billed charges,69% of total billed charges,2298.33,100,,,percent of total billed charges,100% of total billed charges,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2298.33,100,,,percent of total billed charges,100% of total billed charges,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2298.33,100,,,percent of total billed charges,100% of total billed charges,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1421.52,61.85,,,percent of total billed charges,61.85% of total billed charges,17.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.04,130,,,Fee Schedule,130% of WA Medicaid ,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,866.47,37.7,,,percent of total billed charges,37.70% of total billed charges,866.47,37.7,,,percent of total billed charges,37.70% of total billed charges,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,77913.39,33.9,,,percent of total billed charges,33.9% of total billed charges,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1792.7,78,,,percent of total billed charges,78% of total billed charges,2298.33,100,,,percent of total billed charges,100% of total billed charges,1898.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1898.42,82.6,,,percent of total billed charges,82.6% of total billed charges,17.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.66,77913.39,
NM Liver Imaging Spect ProFee,97278803,CDM,972,RC,78803,HCPCS,Outpatient,,,2982.72,1938.77,26,2624.79,88,,,percent of total billed charges,88% of total Billed charges,13.37,100,,,Fee Schedule,100% of Medicare rate,28.16,100,,,Fee Schedule,100% of WA Medicaid,2982.72,100,,,percent of total billed charges,100% of total billed charges,29,103,,,Fee Schedule,103% of WA Medicaid,13.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2058.08,69,,,percent of total billed charges,69% of total billed charges,2982.72,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2982.72,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2982.72,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1844.81,61.85,,,percent of total billed charges,61.85% of total billed charges,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,36.61,130,,,Fee Schedule,130% of WA Medicaid ,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1124.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1124.49,37.7,,,percent of total billed charges,37.70% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,101114.21,33.9,,,percent of total billed charges,33.9% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2326.52,78,,,percent of total billed charges,78% of total billed charges,2982.72,100,,,percent of total billed charges,100% of total billed charges,2463.73,82.6,,,percent of total billed charges,82.6% of total billed charges,2463.73,82.6,,,percent of total billed charges,82.6% of total billed charges,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.37,101114.21,
NM Myocardial SPECT Rest and Stress ProFee,34178452,CDM,972,RC,78452,HCPCS,Outpatient,,,4746.56,3085.26,26,4176.97,88,,,percent of total billed charges,88% of total Billed charges,17.05,100,,,Fee Schedule,100% of Medicare rate,42.52,100,,,Fee Schedule,100% of WA Medicaid,4746.56,100,,,percent of total billed charges,100% of total billed charges,43.8,103,,,Fee Schedule,103% of WA Medicaid,17.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3275.13,69,,,percent of total billed charges,69% of total billed charges,4746.56,100,,,percent of total billed charges,100% of total billed charges,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,4746.56,100,,,percent of total billed charges,100% of total billed charges,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,4746.56,100,,,percent of total billed charges,100% of total billed charges,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2935.75,61.85,,,percent of total billed charges,61.85% of total billed charges,42.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.28,130,,,Fee Schedule,130% of WA Medicaid ,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1789.45,37.7,,,percent of total billed charges,37.70% of total billed charges,1789.45,37.7,,,percent of total billed charges,37.70% of total billed charges,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,160908.38,33.9,,,percent of total billed charges,33.9% of total billed charges,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3702.32,78,,,percent of total billed charges,78% of total billed charges,4746.56,100,,,percent of total billed charges,100% of total billed charges,3920.66,82.6,,,percent of total billed charges,82.6% of total billed charges,3920.66,82.6,,,percent of total billed charges,82.6% of total billed charges,42.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.05,160908.38,
NM Parathyroid Imaging ProFee,97278071,CDM,972,RC,78070,HCPCS,Outpatient,,,2113.17,1373.56,26,1859.59,88,,,percent of total billed charges,88% of total Billed charges,10.69,100,,,Fee Schedule,100% of Medicare rate,21.07,100,,,Fee Schedule,100% of WA Medicaid,2113.17,100,,,percent of total billed charges,100% of total billed charges,21.7,103,,,Fee Schedule,103% of WA Medicaid,10.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1458.09,69,,,percent of total billed charges,69% of total billed charges,2113.17,100,,,percent of total billed charges,100% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2113.17,100,,,percent of total billed charges,100% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2113.17,100,,,percent of total billed charges,100% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1307,61.85,,,percent of total billed charges,61.85% of total billed charges,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.39,130,,,Fee Schedule,130% of WA Medicaid ,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,796.67,37.7,,,percent of total billed charges,37.70% of total billed charges,796.67,37.7,,,percent of total billed charges,37.70% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,71636.46,33.9,,,percent of total billed charges,33.9% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1648.27,78,,,percent of total billed charges,78% of total billed charges,2113.17,100,,,percent of total billed charges,100% of total billed charges,1745.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1745.48,82.6,,,percent of total billed charges,82.6% of total billed charges,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.69,71636.46,
NM Parathyroid Imaging w/ Spect ProFee,97278071,CDM,972,RC,78071,HCPCS,Outpatient,,,92,59.80,26,80.96,88,,,percent of total billed charges,88% of total Billed charges,12.78,100,,,Fee Schedule,100% of Medicare rate,31.33,100,,,Fee Schedule,100% of WA Medicaid,92,100,,,percent of total billed charges,100% of total billed charges,32.27,103,,,Fee Schedule,103% of WA Medicaid,12.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,31.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,63.48,69,,,percent of total billed charges,69% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,92,100,,,percent of total billed charges,100% of total billed charges,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,92,100,,,percent of total billed charges,100% of total billed charges,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.9,61.85,,,percent of total billed charges,61.85% of total billed charges,31.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.73,130,,,Fee Schedule,130% of WA Medicaid ,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,3118.8,33.9,,,percent of total billed charges,33.9% of total billed charges,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.76,78,,,percent of total billed charges,78% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,31.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.78,3118.8,
NM Radiopharm Therapy Oral Admin ProFee,97279005,CDM,972,RC,79005,HCPCS,Outpatient,,,1457.5,947.38,26,1282.6,88,,,percent of total billed charges,88% of total Billed charges,6.42,100,,,Fee Schedule,100% of Medicare rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,1457.5,100,,,percent of total billed charges,100% of total billed charges,48.6,103,,,Fee Schedule,103% of WA Medicaid,6.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1005.68,69,,,percent of total billed charges,69% of total billed charges,1457.5,100,,,percent of total billed charges,100% of total billed charges,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.5,100,,,percent of total billed charges,100% of total billed charges,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.5,100,,,percent of total billed charges,100% of total billed charges,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,901.46,61.85,,,percent of total billed charges,61.85% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.33,130,,,Fee Schedule,130% of WA Medicaid ,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.48,37.7,,,percent of total billed charges,37.70% of total billed charges,549.48,37.7,,,percent of total billed charges,37.70% of total billed charges,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,49409.25,33.9,,,percent of total billed charges,33.9% of total billed charges,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1136.85,78,,,percent of total billed charges,78% of total billed charges,1457.5,100,,,percent of total billed charges,100% of total billed charges,1203.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1203.9,82.6,,,percent of total billed charges,82.6% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.42,49409.25,
NM Radiopharm Therapy Oral Admin ProFee EO,97279005,CDM,972,RC,79005,HCPCS,Outpatient,,,1457.5,947.38,26,1282.6,88,,,percent of total billed charges,88% of total Billed charges,6.42,100,,,Fee Schedule,100% of Medicare rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,1457.5,100,,,percent of total billed charges,100% of total billed charges,48.6,103,,,Fee Schedule,103% of WA Medicaid,6.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1005.68,69,,,percent of total billed charges,69% of total billed charges,1457.5,100,,,percent of total billed charges,100% of total billed charges,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.5,100,,,percent of total billed charges,100% of total billed charges,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.5,100,,,percent of total billed charges,100% of total billed charges,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,901.46,61.85,,,percent of total billed charges,61.85% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.33,130,,,Fee Schedule,130% of WA Medicaid ,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.48,37.7,,,percent of total billed charges,37.70% of total billed charges,549.48,37.7,,,percent of total billed charges,37.70% of total billed charges,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,49409.25,33.9,,,percent of total billed charges,33.9% of total billed charges,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1136.85,78,,,percent of total billed charges,78% of total billed charges,1457.5,100,,,percent of total billed charges,100% of total billed charges,1203.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1203.9,82.6,,,percent of total billed charges,82.6% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.42,49409.25,
NM Tumor Loc Limited ProFee,97278800,CDM,972,RC,78800,HCPCS,Outpatient,,,3211.35,2087.38,26,2825.99,88,,,percent of total billed charges,88% of total Billed charges,9.8,100,,,Fee Schedule,100% of Medicare rate,17.16,100,,,Fee Schedule,100% of WA Medicaid,3211.35,100,,,percent of total billed charges,100% of total billed charges,17.67,103,,,Fee Schedule,103% of WA Medicaid,9.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,17.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2215.83,69,,,percent of total billed charges,69% of total billed charges,3211.35,100,,,percent of total billed charges,100% of total billed charges,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3211.35,100,,,percent of total billed charges,100% of total billed charges,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3211.35,100,,,percent of total billed charges,100% of total billed charges,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1986.22,61.85,,,percent of total billed charges,61.85% of total billed charges,17.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.31,130,,,Fee Schedule,130% of WA Medicaid ,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1210.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1210.68,37.7,,,percent of total billed charges,37.70% of total billed charges,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,108864.77,33.9,,,percent of total billed charges,33.9% of total billed charges,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2504.85,78,,,percent of total billed charges,78% of total billed charges,3211.35,100,,,percent of total billed charges,100% of total billed charges,2652.58,82.6,,,percent of total billed charges,82.6% of total billed charges,2652.58,82.6,,,percent of total billed charges,82.6% of total billed charges,17.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.8,108864.77,
NM Tumor Loc Multiple Areas ProFee,97278801,CDM,972,RC,78801,HCPCS,Outpatient,,,3719.28,2417.53,26,3272.97,88,,,percent of total billed charges,88% of total Billed charges,9.8,100,,,Fee Schedule,100% of Medicare rate,19.02,100,,,Fee Schedule,100% of WA Medicaid,3719.28,100,,,percent of total billed charges,100% of total billed charges,19.59,103,,,Fee Schedule,103% of WA Medicaid,9.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2566.3,69,,,percent of total billed charges,69% of total billed charges,3719.28,100,,,percent of total billed charges,100% of total billed charges,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3719.28,100,,,percent of total billed charges,100% of total billed charges,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3719.28,100,,,percent of total billed charges,100% of total billed charges,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2300.37,61.85,,,percent of total billed charges,61.85% of total billed charges,19.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.73,130,,,Fee Schedule,130% of WA Medicaid ,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1402.17,37.7,,,percent of total billed charges,37.70% of total billed charges,1402.17,37.7,,,percent of total billed charges,37.70% of total billed charges,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,126083.59,33.9,,,percent of total billed charges,33.9% of total billed charges,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2901.04,78,,,percent of total billed charges,78% of total billed charges,3719.28,100,,,percent of total billed charges,100% of total billed charges,3072.13,82.6,,,percent of total billed charges,82.6% of total billed charges,3072.13,82.6,,,percent of total billed charges,82.6% of total billed charges,19.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.8,126083.59,
NM Thyroid Image w/Uptk Sng/Mlt Scan ProFee,97278014,CDM,972,RC,78014,HCPCS,Outpatient,,,3878.67,2521.14,26,3413.23,88,,,percent of total billed charges,88% of total Billed charges,8.32,100,,,Fee Schedule,100% of Medicare rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,3878.67,100,,,percent of total billed charges,100% of total billed charges,13.26,103,,,Fee Schedule,103% of WA Medicaid,8.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2676.28,69,,,percent of total billed charges,69% of total billed charges,3878.67,100,,,percent of total billed charges,100% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,3878.67,100,,,percent of total billed charges,100% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,3878.67,100,,,percent of total billed charges,100% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2398.96,61.85,,,percent of total billed charges,61.85% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16.73,130,,,Fee Schedule,130% of WA Medicaid ,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1462.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1462.26,37.7,,,percent of total billed charges,37.70% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,131486.91,33.9,,,percent of total billed charges,33.9% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,3025.36,78,,,percent of total billed charges,78% of total billed charges,3878.67,100,,,percent of total billed charges,100% of total billed charges,3203.78,82.6,,,percent of total billed charges,82.6% of total billed charges,3203.78,82.6,,,percent of total billed charges,82.6% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.32,131486.91,
NM Thyroid Imaging ProFee,97278013,CDM,972,RC,78013,HCPCS,Outpatient,,,3501.63,2276.06,26,3081.43,88,,,percent of total billed charges,88% of total Billed charges,6.87,100,,,Fee Schedule,100% of Medicare rate,9.7,100,,,Fee Schedule,100% of WA Medicaid,3501.63,100,,,percent of total billed charges,100% of total billed charges,9.99,103,,,Fee Schedule,103% of WA Medicaid,6.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2416.12,69,,,percent of total billed charges,69% of total billed charges,3501.63,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3501.63,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3501.63,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2165.76,61.85,,,percent of total billed charges,61.85% of total billed charges,9.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.61,130,,,Fee Schedule,130% of WA Medicaid ,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1320.11,37.7,,,percent of total billed charges,37.70% of total billed charges,1320.11,37.7,,,percent of total billed charges,37.70% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,118705.26,33.9,,,percent of total billed charges,33.9% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2731.27,78,,,percent of total billed charges,78% of total billed charges,3501.63,100,,,percent of total billed charges,100% of total billed charges,2892.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2892.35,82.6,,,percent of total billed charges,82.6% of total billed charges,9.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.87,118705.26,
PET CT Limited Area ProFee,97278814,CDM,972,RC,78814,HCPCS,Outpatient,,,260,169.00,26,228.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,56.88,100,,,Fee Schedule,100% of WA Medicaid,260,100,,,percent of total billed charges,100% of total billed charges,58.59,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,260,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,260,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,58.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,73.94,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,8814,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.88,8814,
PET CT Skull Base to Midthigh ProFee,97278815,CDM,972,RC,78815,HCPCS,Outpatient,,,6822.33,4434.51,26,6003.65,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,63.41,100,,,Fee Schedule,100% of WA Medicaid,6822.33,100,,,percent of total billed charges,100% of total billed charges,65.31,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4707.41,69,,,percent of total billed charges,69% of total billed charges,6822.33,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6822.33,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6822.33,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4219.61,61.85,,,percent of total billed charges,61.85% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.43,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,2572.02,37.7,,,percent of total billed charges,37.70% of total billed charges,2572.02,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,231276.99,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,5321.42,78,,,percent of total billed charges,78% of total billed charges,6822.33,100,,,percent of total billed charges,100% of total billed charges,5635.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5635.24,82.6,,,percent of total billed charges,82.6% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.41,231276.99,
PET CT Whole Body ProFee,97278816,CDM,972,RC,78816,HCPCS,Outpatient,,,8777.92,5705.65,26,7724.57,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,63.97,100,,,Fee Schedule,100% of WA Medicaid,8777.92,100,,,percent of total billed charges,100% of total billed charges,65.89,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6056.76,69,,,percent of total billed charges,69% of total billed charges,8777.92,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,8777.92,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,8777.92,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5429.14,61.85,,,percent of total billed charges,61.85% of total billed charges,63.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,83.16,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,3309.28,37.7,,,percent of total billed charges,37.70% of total billed charges,3309.28,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,297571.49,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,6846.78,78,,,percent of total billed charges,78% of total billed charges,8777.92,100,,,percent of total billed charges,100% of total billed charges,7250.56,82.6,,,percent of total billed charges,82.6% of total billed charges,7250.56,82.6,,,percent of total billed charges,82.6% of total billed charges,63.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.97,297571.49,
US Biopsy Renal Right ProFee,97250200,CDM,972,RC,50200,HCPCS,Outpatient,,,686,445.90,26|RT,603.68,88,,,percent of total billed charges,88% of total Billed charges,9.96,100,,,Fee Schedule,100% of Medicare rate,70.68,100,,,Fee Schedule,100% of WA Medicaid,686,100,,,percent of total billed charges,100% of total billed charges,72.8,103,,,Fee Schedule,103% of WA Medicaid,9.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,473.34,69,,,percent of total billed charges,69% of total billed charges,686,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,686,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,686,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.29,61.85,,,percent of total billed charges,61.85% of total billed charges,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,91.88,130,,,Fee Schedule,130% of WA Medicaid ,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.62,37.7,,,percent of total billed charges,37.70% of total billed charges,258.62,37.7,,,percent of total billed charges,37.70% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,23255.4,33.9,,,percent of total billed charges,33.9% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.08,78,,,percent of total billed charges,78% of total billed charges,686,100,,,percent of total billed charges,100% of total billed charges,566.64,82.6,,,percent of total billed charges,82.6% of total billed charges,566.64,82.6,,,percent of total billed charges,82.6% of total billed charges,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.96,23255.4,
US Biopsy Renal Left ProFee,97250200,CDM,972,RC,50200,HCPCS,Outpatient,,,686,445.90,26|LT,603.68,88,,,percent of total billed charges,88% of total Billed charges,9.96,100,,,Fee Schedule,100% of Medicare rate,70.68,100,,,Fee Schedule,100% of WA Medicaid,686,100,,,percent of total billed charges,100% of total billed charges,72.8,103,,,Fee Schedule,103% of WA Medicaid,9.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,473.34,69,,,percent of total billed charges,69% of total billed charges,686,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,686,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,686,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.29,61.85,,,percent of total billed charges,61.85% of total billed charges,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,91.88,130,,,Fee Schedule,130% of WA Medicaid ,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.62,37.7,,,percent of total billed charges,37.70% of total billed charges,258.62,37.7,,,percent of total billed charges,37.70% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,23255.4,33.9,,,percent of total billed charges,33.9% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.08,78,,,percent of total billed charges,78% of total billed charges,686,100,,,percent of total billed charges,100% of total billed charges,566.64,82.6,,,percent of total billed charges,82.6% of total billed charges,566.64,82.6,,,percent of total billed charges,82.6% of total billed charges,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.96,23255.4,
US Encephalogram ProFee,97276506,CDM,972,RC,76506,HCPCS,Outpatient,,,56,36.40,26,49.28,88,,,percent of total billed charges,88% of total Billed charges,5.3,100,,,Fee Schedule,100% of Medicare rate,17.34,100,,,Fee Schedule,100% of WA Medicaid,56,100,,,percent of total billed charges,100% of total billed charges,17.86,103,,,Fee Schedule,103% of WA Medicaid,5.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,17.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,56,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,56,100,,,percent of total billed charges,100% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.54,130,,,Fee Schedule,130% of WA Medicaid ,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1898.4,33.9,,,percent of total billed charges,33.9% of total billed charges,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.3,1898.4,
Report,96093306,CDM,960,RC,93306,HCPCS,Outpatient,,,250,162.50,26,220,88,,,percent of total billed charges,88% of total Billed charges,8.13,100,,,Fee Schedule,100% of Medicare rate,38.61,100,,,Fee Schedule,100% of WA Medicaid,250,100,,,percent of total billed charges,100% of total billed charges,39.77,103,,,Fee Schedule,103% of WA Medicaid,8.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,250,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,250,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.19,130,,,Fee Schedule,130% of WA Medicaid ,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8475,33.9,,,percent of total billed charges,33.9% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.13,8475,
Report,960C8924,CDM,960,RC,93308,HCPCS,Outpatient,,,87,56.55,26,76.56,88,,,percent of total billed charges,88% of total Billed charges,4.09,100,,,Fee Schedule,100% of Medicare rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,87,100,,,percent of total billed charges,100% of total billed charges,14.41,103,,,Fee Schedule,103% of WA Medicaid,4.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,87,100,,,percent of total billed charges,100% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,87,100,,,percent of total billed charges,100% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.19,130,,,Fee Schedule,130% of WA Medicaid ,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2949.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.09,2949.3,
Rreport,96093320,CDM,960,RC,93320,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,2.08,100,,,Fee Schedule,100% of Medicare rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,2.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,120,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,120,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.84,130,,,Fee Schedule,130% of WA Medicaid ,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,4068,33.9,,,percent of total billed charges,33.9% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.08,4068,
Report,96093306,CDM,960,RC,93306,HCPCS,Outpatient,,,240,156.00,26,211.2,88,,,percent of total billed charges,88% of total Billed charges,8.13,100,,,Fee Schedule,100% of Medicare rate,38.61,100,,,Fee Schedule,100% of WA Medicaid,240,100,,,percent of total billed charges,100% of total billed charges,39.77,103,,,Fee Schedule,103% of WA Medicaid,8.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,240,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,240,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.44,61.85,,,percent of total billed charges,61.85% of total billed charges,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.19,130,,,Fee Schedule,130% of WA Medicaid ,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8136,33.9,,,percent of total billed charges,33.9% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.13,8136,
Report,96093308,CDM,960,RC,93308,HCPCS,Outpatient,,,87,56.55,26,76.56,88,,,percent of total billed charges,88% of total Billed charges,4.09,100,,,Fee Schedule,100% of Medicare rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,87,100,,,percent of total billed charges,100% of total billed charges,14.41,103,,,Fee Schedule,103% of WA Medicaid,4.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,87,100,,,percent of total billed charges,100% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,87,100,,,percent of total billed charges,100% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.19,130,,,Fee Schedule,130% of WA Medicaid ,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2949.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.09,2949.3,
US Echo Congenital Complete ProFee,97293303,CDM,972,RC,93303,HCPCS,Outpatient,,,214,139.10,,188.32,88,,,percent of total billed charges,88% of total Billed charges,8.6,100,,,Fee Schedule,100% of Medicare rate,34.32,100,,,Fee Schedule,100% of WA Medicaid,214,100,,,percent of total billed charges,100% of total billed charges,35.35,103,,,Fee Schedule,103% of WA Medicaid,8.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,34.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,147.66,69,,,percent of total billed charges,69% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,214,100,,,percent of total billed charges,100% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,214,100,,,percent of total billed charges,100% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.36,61.85,,,percent of total billed charges,61.85% of total billed charges,34.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,44.62,130,,,Fee Schedule,130% of WA Medicaid ,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,80.68,37.7,,,percent of total billed charges,37.70% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,7254.6,33.9,,,percent of total billed charges,33.9% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.92,78,,,percent of total billed charges,78% of total billed charges,214,100,,,percent of total billed charges,100% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,176.76,82.6,,,percent of total billed charges,82.6% of total billed charges,34.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.6,7254.6,
Report,96093321,CDM,960,RC,93321,HCPCS,Outpatient,,,25,16.25,26,22,88,,,percent of total billed charges,88% of total Billed charges,1.03,100,,,Fee Schedule,100% of Medicare rate,3.92,100,,,Fee Schedule,100% of WA Medicaid,25,100,,,percent of total billed charges,100% of total billed charges,4.04,103,,,Fee Schedule,103% of WA Medicaid,1.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,3.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,25,100,,,percent of total billed charges,100% of total billed charges,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,25,100,,,percent of total billed charges,100% of total billed charges,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,3.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.1,130,,,Fee Schedule,130% of WA Medicaid ,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.5,33.9,,,percent of total billed charges,33.9% of total billed charges,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,3.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.03,847.5,
Report,960C8929,CDM,960,RC,93306,HCPCS,Outpatient,,,250,162.50,26,220,88,,,percent of total billed charges,88% of total Billed charges,8.13,100,,,Fee Schedule,100% of Medicare rate,38.61,100,,,Fee Schedule,100% of WA Medicaid,250,100,,,percent of total billed charges,100% of total billed charges,39.77,103,,,Fee Schedule,103% of WA Medicaid,8.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,250,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,250,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.19,130,,,Fee Schedule,130% of WA Medicaid ,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8475,33.9,,,percent of total billed charges,33.9% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.13,8475,
US Hips Infant Dynamic ProFee,97276885,CDM,972,RC,76885,HCPCS,Outpatient,,,58,37.70,26,51.04,88,,,percent of total billed charges,88% of total Billed charges,5.75,100,,,Fee Schedule,100% of Medicare rate,19.77,100,,,Fee Schedule,100% of WA Medicaid,58,100,,,percent of total billed charges,100% of total billed charges,20.36,103,,,Fee Schedule,103% of WA Medicaid,5.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,58,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,58,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.7,130,,,Fee Schedule,130% of WA Medicaid ,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1966.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.75,1966.2,
US OB Follow Up ProFee,97276816,CDM,972,RC,76816,HCPCS,Outpatient,,,67,43.55,26,58.96,88,,,percent of total billed charges,88% of total Billed charges,4.17,100,,,Fee Schedule,100% of Medicare rate,22.94,100,,,Fee Schedule,100% of WA Medicaid,67,100,,,percent of total billed charges,100% of total billed charges,23.63,103,,,Fee Schedule,103% of WA Medicaid,4.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,46.23,69,,,percent of total billed charges,69% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,67,100,,,percent of total billed charges,100% of total billed charges,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,67,100,,,percent of total billed charges,100% of total billed charges,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.44,61.85,,,percent of total billed charges,61.85% of total billed charges,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.82,130,,,Fee Schedule,130% of WA Medicaid ,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.26,37.7,,,percent of total billed charges,37.70% of total billed charges,25.26,37.7,,,percent of total billed charges,37.70% of total billed charges,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2271.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.26,78,,,percent of total billed charges,78% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.17,2271.3,
US OB Nuchal Measure 1st Trimester ProFee,97276813,CDM,972,RC,76813,HCPCS,Outpatient,,,64,41.60,26,56.32,88,,,percent of total billed charges,88% of total Billed charges,4.6,100,,,Fee Schedule,100% of Medicare rate,31.71,100,,,Fee Schedule,100% of WA Medicaid,64,100,,,percent of total billed charges,100% of total billed charges,32.66,103,,,Fee Schedule,103% of WA Medicaid,4.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,31.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,44.16,69,,,percent of total billed charges,69% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,64,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,64,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.58,61.85,,,percent of total billed charges,61.85% of total billed charges,31.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.22,130,,,Fee Schedule,130% of WA Medicaid ,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.13,37.7,,,percent of total billed charges,37.70% of total billed charges,24.13,37.7,,,percent of total billed charges,37.70% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,2169.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.92,78,,,percent of total billed charges,78% of total billed charges,64,100,,,percent of total billed charges,100% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,52.86,82.6,,,percent of total billed charges,82.6% of total billed charges,31.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.6,2169.6,
US Vessel Mapping for Dialysis ProFee,97293985,CDM,972,RC,93985,HCPCS,Outpatient,,,22,14.30,26,19.36,88,,,percent of total billed charges,88% of total Billed charges,11.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,11.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,22,100,,,percent of total billed charges,100% of total billed charges,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,22,100,,,percent of total billed charges,100% of total billed charges,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.29,37.7,,,percent of total billed charges,37.70% of total billed charges,8.29,37.7,,,percent of total billed charges,37.70% of total billed charges,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.8,33.9,,,percent of total billed charges,33.9% of total billed charges,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",8.29,745.8,
XR Chest 2 Views w/ Apical Lordotic ProFee,97271047,CDM,972,RC,71047,HCPCS,Outpatient,,,66,42.90,26,58.08,88,,,percent of total billed charges,88% of total Billed charges,1.83,100,,,Fee Schedule,100% of Medicare rate,7.46,100,,,Fee Schedule,100% of WA Medicaid,66,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,1.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,7.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,66,100,,,percent of total billed charges,100% of total billed charges,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,66,100,,,percent of total billed charges,100% of total billed charges,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.82,61.85,,,percent of total billed charges,61.85% of total billed charges,7.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.7,130,,,Fee Schedule,130% of WA Medicaid ,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2237.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,2237.4,
XR Chest 2 Views w/ Fluoroscopy ProFee,97271023,CDM,972,RC,71023,HCPCS,Outpatient,,,63,40.95,26,55.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,63,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,63,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,38.97,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2135.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",23.75,2135.7,
XR Elbow 2 Views Left ProFee,97273070,CDM,972,RC,73070,HCPCS,Outpatient,,,34,22.10,26|LT,29.92,88,,,percent of total billed charges,88% of total Billed charges,1.42,100,,,Fee Schedule,100% of Medicare rate,4.66,100,,,Fee Schedule,100% of WA Medicaid,34,100,,,percent of total billed charges,100% of total billed charges,4.8,103,,,Fee Schedule,103% of WA Medicaid,1.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,4.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,34,100,,,percent of total billed charges,100% of total billed charges,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,34,100,,,percent of total billed charges,100% of total billed charges,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,4.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.06,130,,,Fee Schedule,130% of WA Medicaid ,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152.6,33.9,,,percent of total billed charges,33.9% of total billed charges,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,4.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.42,1152.6,
Report,97227096,CDM,972,RC,27096,HCPCS,Outpatient,,,85,55.25,26,74.8,88,,,percent of total billed charges,88% of total Billed charges,6.12,100,,,Fee Schedule,100% of Medicare rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,48.6,103,,,Fee Schedule,103% of WA Medicaid,6.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,85,100,,,percent of total billed charges,100% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,85,100,,,percent of total billed charges,100% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.57,61.85,,,percent of total billed charges,61.85% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.33,130,,,Fee Schedule,130% of WA Medicaid ,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2881.5,33.9,,,percent of total billed charges,33.9% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.12,2881.5,
XR Upper GI w/ Small Bowel ProFee,97274240,CDM,972,RC,74240,HCPCS,Outpatient,,,115,74.75,26,101.2,88,,,percent of total billed charges,88% of total Billed charges,5.09,100,,,Fee Schedule,100% of Medicare rate,21.45,100,,,Fee Schedule,100% of WA Medicaid,115,100,,,percent of total billed charges,100% of total billed charges,22.09,103,,,Fee Schedule,103% of WA Medicaid,5.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,79.35,69,,,percent of total billed charges,69% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,115,100,,,percent of total billed charges,100% of total billed charges,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,115,100,,,percent of total billed charges,100% of total billed charges,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.13,61.85,,,percent of total billed charges,61.85% of total billed charges,21.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.89,130,,,Fee Schedule,130% of WA Medicaid ,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.36,37.7,,,percent of total billed charges,37.70% of total billed charges,43.36,37.7,,,percent of total billed charges,37.70% of total billed charges,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3898.5,33.9,,,percent of total billed charges,33.9% of total billed charges,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.7,78,,,percent of total billed charges,78% of total billed charges,115,100,,,percent of total billed charges,100% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,94.99,82.6,,,percent of total billed charges,82.6% of total billed charges,21.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.09,3898.5,
43202 ESOPHAGOSCOPY FLEX BIOPSYY CHARGE,75043202,CDM,975,RC,43202,HCPCS,Outpatient,,,1017,661.05,,894.96,88,,,percent of total billed charges,88% of total Billed charges,9.03,100,,,Fee Schedule,100% of Medicare rate,58.19,100,,,Fee Schedule,100% of WA Medicaid,1017,100,,,percent of total billed charges,100% of total billed charges,59.94,103,,,Fee Schedule,103% of WA Medicaid,9.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,701.73,69,,,percent of total billed charges,69% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.01,61.85,,,percent of total billed charges,61.85% of total billed charges,58.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,75.65,130,,,Fee Schedule,130% of WA Medicaid ,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,34476.3,33.9,,,percent of total billed charges,33.9% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,793.26,78,,,percent of total billed charges,78% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,58.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.03,34476.3,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH BAND LIGATION OF E",76143205,CDM,975,RC,43205,HCPCS,Outpatient,,,421,273.65,,370.48,88,,,percent of total billed charges,88% of total Billed charges,11.71,100,,,Fee Schedule,100% of Medicare rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,421,100,,,percent of total billed charges,100% of total billed charges,81.64,103,,,Fee Schedule,103% of WA Medicaid,11.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,290.49,69,,,percent of total billed charges,69% of total billed charges,421,100,,,percent of total billed charges,100% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,421,100,,,percent of total billed charges,100% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,421,100,,,percent of total billed charges,100% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.39,61.85,,,percent of total billed charges,61.85% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.04,130,,,Fee Schedule,130% of WA Medicaid ,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.72,37.7,,,percent of total billed charges,37.70% of total billed charges,158.72,37.7,,,percent of total billed charges,37.70% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,14271.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.38,78,,,percent of total billed charges,78% of total billed charges,421,100,,,percent of total billed charges,100% of total billed charges,347.75,82.6,,,percent of total billed charges,82.6% of total billed charges,347.75,82.6,,,percent of total billed charges,82.6% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.71,14271.9,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF FOREIGN",76143215,CDM,975,RC,43215,HCPCS,Outpatient,,,1140,741.00,,1003.2,88,,,percent of total billed charges,88% of total Billed charges,14.04,100,,,Fee Schedule,100% of Medicare rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,1140,100,,,percent of total billed charges,100% of total billed charges,81.64,103,,,Fee Schedule,103% of WA Medicaid,14.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,786.6,69,,,percent of total billed charges,69% of total billed charges,1140,100,,,percent of total billed charges,100% of total billed charges,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1140,100,,,percent of total billed charges,100% of total billed charges,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1140,100,,,percent of total billed charges,100% of total billed charges,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,705.09,61.85,,,percent of total billed charges,61.85% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.04,130,,,Fee Schedule,130% of WA Medicaid ,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.78,37.7,,,percent of total billed charges,37.70% of total billed charges,429.78,37.7,,,percent of total billed charges,37.70% of total billed charges,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,38646,33.9,,,percent of total billed charges,33.9% of total billed charges,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,889.2,78,,,percent of total billed charges,78% of total billed charges,1140,100,,,percent of total billed charges,100% of total billed charges,941.64,82.6,,,percent of total billed charges,82.6% of total billed charges,941.64,82.6,,,percent of total billed charges,82.6% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.04,38646,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH DILATION OF ESOPHAG",76143213,CDM,975,RC,43213,HCPCS,Outpatient,,,3472,2256.80,,3055.36,88,,,percent of total billed charges,88% of total Billed charges,26.84,100,,,Fee Schedule,100% of Medicare rate,144.72,100,,,Fee Schedule,100% of WA Medicaid,3472,100,,,percent of total billed charges,100% of total billed charges,149.06,103,,,Fee Schedule,103% of WA Medicaid,26.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,46.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,144.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2395.68,69,,,percent of total billed charges,69% of total billed charges,3472,100,,,percent of total billed charges,100% of total billed charges,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3472,100,,,percent of total billed charges,100% of total billed charges,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3472,100,,,percent of total billed charges,100% of total billed charges,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2147.43,61.85,,,percent of total billed charges,61.85% of total billed charges,144.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,188.14,130,,,Fee Schedule,130% of WA Medicaid ,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1308.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1308.94,37.7,,,percent of total billed charges,37.70% of total billed charges,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,117700.8,33.9,,,percent of total billed charges,33.9% of total billed charges,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2708.16,78,,,percent of total billed charges,78% of total billed charges,3472,100,,,percent of total billed charges,100% of total billed charges,2867.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2867.87,82.6,,,percent of total billed charges,82.6% of total billed charges,144.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.84,117700.8,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH INSERTION OF GUIDE",76143226,CDM,975,RC,43226,HCPCS,Outpatient,,,823,534.95,,724.24,88,,,percent of total billed charges,88% of total Billed charges,13.2,100,,,Fee Schedule,100% of Medicare rate,73.11,100,,,Fee Schedule,100% of WA Medicaid,823,100,,,percent of total billed charges,100% of total billed charges,75.3,103,,,Fee Schedule,103% of WA Medicaid,13.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,73.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,567.87,69,,,percent of total billed charges,69% of total billed charges,823,100,,,percent of total billed charges,100% of total billed charges,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,823,100,,,percent of total billed charges,100% of total billed charges,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,823,100,,,percent of total billed charges,100% of total billed charges,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.03,61.85,,,percent of total billed charges,61.85% of total billed charges,73.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.04,130,,,Fee Schedule,130% of WA Medicaid ,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.27,37.7,,,percent of total billed charges,37.70% of total billed charges,310.27,37.7,,,percent of total billed charges,37.70% of total billed charges,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,27899.7,33.9,,,percent of total billed charges,33.9% of total billed charges,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,641.94,78,,,percent of total billed charges,78% of total billed charges,823,100,,,percent of total billed charges,100% of total billed charges,679.8,82.6,,,percent of total billed charges,82.6% of total billed charges,679.8,82.6,,,percent of total billed charges,82.6% of total billed charges,73.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.2,27899.7,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH TRANSENDOSCOPIC BAL",76143220,CDM,975,RC,43220,HCPCS,Outpatient,,,2184,1419.60,,1921.92,88,,,percent of total billed charges,88% of total Billed charges,10.51,100,,,Fee Schedule,100% of Medicare rate,66.39,100,,,Fee Schedule,100% of WA Medicaid,2184,100,,,percent of total billed charges,100% of total billed charges,68.38,103,,,Fee Schedule,103% of WA Medicaid,10.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1506.96,69,,,percent of total billed charges,69% of total billed charges,2184,100,,,percent of total billed charges,100% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2184,100,,,percent of total billed charges,100% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2184,100,,,percent of total billed charges,100% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1350.8,61.85,,,percent of total billed charges,61.85% of total billed charges,66.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,86.31,130,,,Fee Schedule,130% of WA Medicaid ,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,823.37,37.7,,,percent of total billed charges,37.70% of total billed charges,823.37,37.7,,,percent of total billed charges,37.70% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,74037.6,33.9,,,percent of total billed charges,33.9% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1703.52,78,,,percent of total billed charges,78% of total billed charges,2184,100,,,percent of total billed charges,100% of total billed charges,1803.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1803.98,82.6,,,percent of total billed charges,82.6% of total billed charges,66.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.51,74037.6,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH CONTROL OF BLEEDIN",76143227,CDM,975,RC,43227,HCPCS,Outpatient,,,570,370.50,,501.6,88,,,percent of total billed charges,88% of total Billed charges,14.49,100,,,Fee Schedule,100% of Medicare rate,92.5,100,,,Fee Schedule,100% of WA Medicaid,570,100,,,percent of total billed charges,100% of total billed charges,95.28,103,,,Fee Schedule,103% of WA Medicaid,14.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,92.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,393.3,69,,,percent of total billed charges,69% of total billed charges,570,100,,,percent of total billed charges,100% of total billed charges,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,570,100,,,percent of total billed charges,100% of total billed charges,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,570,100,,,percent of total billed charges,100% of total billed charges,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.55,61.85,,,percent of total billed charges,61.85% of total billed charges,92.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,120.25,130,,,Fee Schedule,130% of WA Medicaid ,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.89,37.7,,,percent of total billed charges,37.70% of total billed charges,214.89,37.7,,,percent of total billed charges,37.70% of total billed charges,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,19323,33.9,,,percent of total billed charges,33.9% of total billed charges,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.6,78,,,percent of total billed charges,78% of total billed charges,570,100,,,percent of total billed charges,100% of total billed charges,470.82,82.6,,,percent of total billed charges,82.6% of total billed charges,470.82,82.6,,,percent of total billed charges,82.6% of total billed charges,92.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.49,19323,
GASTROSCOPY DIAGNOSTIC W/WO BRUSHING SURG,76143235,CDM,975,RC,43235,HCPCS,Outpatient,,,673,437.45,,592.24,88,,,percent of total billed charges,88% of total Billed charges,10.39,100,,,Fee Schedule,100% of Medicare rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,673,100,,,percent of total billed charges,100% of total billed charges,71.08,103,,,Fee Schedule,103% of WA Medicaid,10.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,464.37,69,,,percent of total billed charges,69% of total billed charges,673,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,673,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,673,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.25,61.85,,,percent of total billed charges,61.85% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.71,130,,,Fee Schedule,130% of WA Medicaid ,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.72,37.7,,,percent of total billed charges,37.70% of total billed charges,253.72,37.7,,,percent of total billed charges,37.70% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,22814.7,33.9,,,percent of total billed charges,33.9% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.94,78,,,percent of total billed charges,78% of total billed charges,673,100,,,percent of total billed charges,100% of total billed charges,555.9,82.6,,,percent of total billed charges,82.6% of total billed charges,555.9,82.6,,,percent of total billed charges,82.6% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.39,22814.7,
GASTROSCOPY W/BX,76143239,CDM,975,RC,43239,HCPCS,Outpatient,,,1125,731.25,,990,88,,,percent of total billed charges,88% of total Billed charges,11.89,100,,,Fee Schedule,100% of Medicare rate,77.96,100,,,Fee Schedule,100% of WA Medicaid,1125,100,,,percent of total billed charges,100% of total billed charges,80.3,103,,,Fee Schedule,103% of WA Medicaid,11.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,776.25,69,,,percent of total billed charges,69% of total billed charges,1125,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1125,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1125,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,695.81,61.85,,,percent of total billed charges,61.85% of total billed charges,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.35,130,,,Fee Schedule,130% of WA Medicaid ,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.13,37.7,,,percent of total billed charges,37.70% of total billed charges,424.13,37.7,,,percent of total billed charges,37.70% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,38137.5,33.9,,,percent of total billed charges,33.9% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,877.5,78,,,percent of total billed charges,78% of total billed charges,1125,100,,,percent of total billed charges,100% of total billed charges,929.25,82.6,,,percent of total billed charges,82.6% of total billed charges,929.25,82.6,,,percent of total billed charges,82.6% of total billed charges,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.89,38137.5,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; W/ DIRECTED",76143236,CDM,975,RC,43236,HCPCS,Outpatient,,,841,546.65,,740.08,88,,,percent of total billed charges,88% of total Billed charges,11.89,100,,,Fee Schedule,100% of Medicare rate,77.96,100,,,Fee Schedule,100% of WA Medicaid,841,100,,,percent of total billed charges,100% of total billed charges,80.3,103,,,Fee Schedule,103% of WA Medicaid,11.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,580.29,69,,,percent of total billed charges,69% of total billed charges,841,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,841,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,841,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.16,61.85,,,percent of total billed charges,61.85% of total billed charges,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.35,130,,,Fee Schedule,130% of WA Medicaid ,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.06,37.7,,,percent of total billed charges,37.70% of total billed charges,317.06,37.7,,,percent of total billed charges,37.70% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,28509.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,655.98,78,,,percent of total billed charges,78% of total billed charges,841,100,,,percent of total billed charges,100% of total billed charges,694.67,82.6,,,percent of total billed charges,82.6% of total billed charges,694.67,82.6,,,percent of total billed charges,82.6% of total billed charges,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.89,28509.9,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH DILATI",76143233,CDM,975,RC,43233,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,23.09,100,,,Fee Schedule,100% of Medicare rate,127.75,100,,,Fee Schedule,100% of WA Medicaid,650,100,,,percent of total billed charges,100% of total billed charges,131.58,103,,,Fee Schedule,103% of WA Medicaid,23.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,127.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,127.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,166.08,130,,,Fee Schedule,130% of WA Medicaid ,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,22035,33.9,,,percent of total billed charges,33.9% of total billed charges,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,127.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,22035,
GASTROSCOPY DIAGNOSTIC W/WO BRUSHING SURG SU,76143235,CDM,975,RC,43235,HCPCS,Outpatient,,,673,437.45,,592.24,88,,,percent of total billed charges,88% of total Billed charges,10.39,100,,,Fee Schedule,100% of Medicare rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,673,100,,,percent of total billed charges,100% of total billed charges,71.08,103,,,Fee Schedule,103% of WA Medicaid,10.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,464.37,69,,,percent of total billed charges,69% of total billed charges,673,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,673,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,673,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.25,61.85,,,percent of total billed charges,61.85% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.71,130,,,Fee Schedule,130% of WA Medicaid ,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.72,37.7,,,percent of total billed charges,37.70% of total billed charges,253.72,37.7,,,percent of total billed charges,37.70% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,22814.7,33.9,,,percent of total billed charges,33.9% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.94,78,,,percent of total billed charges,78% of total billed charges,673,100,,,percent of total billed charges,100% of total billed charges,555.9,82.6,,,percent of total billed charges,82.6% of total billed charges,555.9,82.6,,,percent of total billed charges,82.6% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.39,22814.7,
GASTROSCOPY WITH PEG TUBE PLACEMENT SURG,76143246,CDM,975,RC,43246,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,20.17,100,,,Fee Schedule,100% of Medicare rate,111.71,100,,,Fee Schedule,100% of WA Medicaid,455,100,,,percent of total billed charges,100% of total billed charges,115.06,103,,,Fee Schedule,103% of WA Medicaid,20.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,111.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,455,100,,,percent of total billed charges,100% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,455,100,,,percent of total billed charges,100% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,111.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.22,130,,,Fee Schedule,130% of WA Medicaid ,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,15424.5,33.9,,,percent of total billed charges,33.9% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,111.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.17,15424.5,
GASTROSCOPY W REMOVAL FOREIGN BODY SURG,76143247,CDM,975,RC,43247,HCPCS,Outpatient,,,875,568.75,,770,88,,,percent of total billed charges,88% of total Billed charges,15.6,100,,,Fee Schedule,100% of Medicare rate,99.03,100,,,Fee Schedule,100% of WA Medicaid,875,100,,,percent of total billed charges,100% of total billed charges,102,103,,,Fee Schedule,103% of WA Medicaid,15.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,99.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,603.75,69,,,percent of total billed charges,69% of total billed charges,875,100,,,percent of total billed charges,100% of total billed charges,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,875,100,,,percent of total billed charges,100% of total billed charges,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,875,100,,,percent of total billed charges,100% of total billed charges,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.19,61.85,,,percent of total billed charges,61.85% of total billed charges,99.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.74,130,,,Fee Schedule,130% of WA Medicaid ,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.88,37.7,,,percent of total billed charges,37.70% of total billed charges,329.88,37.7,,,percent of total billed charges,37.70% of total billed charges,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,29662.5,33.9,,,percent of total billed charges,33.9% of total billed charges,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.5,78,,,percent of total billed charges,78% of total billed charges,875,100,,,percent of total billed charges,100% of total billed charges,722.75,82.6,,,percent of total billed charges,82.6% of total billed charges,722.75,82.6,,,percent of total billed charges,82.6% of total billed charges,99.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.6,29662.5,
GASTROSCOPY W DILATION GASTRIC/DUODENUM SURG,76143245,CDM,975,RC,43245,HCPCS,Outpatient,,,1731,1125.15,,1523.28,88,,,percent of total billed charges,88% of total Billed charges,16.6,100,,,Fee Schedule,100% of Medicare rate,98.29,100,,,Fee Schedule,100% of WA Medicaid,1731,100,,,percent of total billed charges,100% of total billed charges,101.24,103,,,Fee Schedule,103% of WA Medicaid,16.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,98.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1194.39,69,,,percent of total billed charges,69% of total billed charges,1731,100,,,percent of total billed charges,100% of total billed charges,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1731,100,,,percent of total billed charges,100% of total billed charges,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1731,100,,,percent of total billed charges,100% of total billed charges,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1070.62,61.85,,,percent of total billed charges,61.85% of total billed charges,98.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,127.78,130,,,Fee Schedule,130% of WA Medicaid ,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,652.59,37.7,,,percent of total billed charges,37.70% of total billed charges,652.59,37.7,,,percent of total billed charges,37.70% of total billed charges,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,58680.9,33.9,,,percent of total billed charges,33.9% of total billed charges,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1350.18,78,,,percent of total billed charges,78% of total billed charges,1731,100,,,percent of total billed charges,100% of total billed charges,1429.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1429.81,82.6,,,percent of total billed charges,82.6% of total billed charges,98.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.6,58680.9,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSO",76143248,CDM,975,RC,43248,HCPCS,Outpatient,,,1155,750.75,,1016.4,88,,,percent of total billed charges,88% of total Billed charges,14.26,100,,,Fee Schedule,100% of Medicare rate,93.25,100,,,Fee Schedule,100% of WA Medicaid,1155,100,,,percent of total billed charges,100% of total billed charges,96.05,103,,,Fee Schedule,103% of WA Medicaid,14.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,93.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,796.95,69,,,percent of total billed charges,69% of total billed charges,1155,100,,,percent of total billed charges,100% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1155,100,,,percent of total billed charges,100% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1155,100,,,percent of total billed charges,100% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.37,61.85,,,percent of total billed charges,61.85% of total billed charges,93.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,121.23,130,,,Fee Schedule,130% of WA Medicaid ,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.44,37.7,,,percent of total billed charges,37.70% of total billed charges,435.44,37.7,,,percent of total billed charges,37.70% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,39154.5,33.9,,,percent of total billed charges,33.9% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,900.9,78,,,percent of total billed charges,78% of total billed charges,1155,100,,,percent of total billed charges,100% of total billed charges,954.03,82.6,,,percent of total billed charges,82.6% of total billed charges,954.03,82.6,,,percent of total billed charges,82.6% of total billed charges,93.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.26,39154.5,
EGD W/DILATION (ANY METHOD) SURG,76143249,CDM,975,RC,43249,HCPCS,Outpatient,,,2281,1482.65,,2007.28,88,,,percent of total billed charges,88% of total Billed charges,13.37,100,,,Fee Schedule,100% of Medicare rate,86.16,100,,,Fee Schedule,100% of WA Medicaid,2281,100,,,percent of total billed charges,100% of total billed charges,88.74,103,,,Fee Schedule,103% of WA Medicaid,13.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,86.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1573.89,69,,,percent of total billed charges,69% of total billed charges,2281,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2281,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2281,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1410.8,61.85,,,percent of total billed charges,61.85% of total billed charges,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,112.01,130,,,Fee Schedule,130% of WA Medicaid ,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.94,37.7,,,percent of total billed charges,37.70% of total billed charges,859.94,37.7,,,percent of total billed charges,37.70% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,77325.9,33.9,,,percent of total billed charges,33.9% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1779.18,78,,,percent of total billed charges,78% of total billed charges,2281,100,,,percent of total billed charges,100% of total billed charges,1884.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1884.11,82.6,,,percent of total billed charges,82.6% of total billed charges,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.37,77325.9,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; W/ BAND LIG",76143244,CDM,975,RC,43244,HCPCS,Outpatient,,,725,471.25,,638,88,,,percent of total billed charges,88% of total Billed charges,20.47,100,,,Fee Schedule,100% of Medicare rate,137.08,100,,,Fee Schedule,100% of WA Medicaid,725,100,,,percent of total billed charges,100% of total billed charges,141.19,103,,,Fee Schedule,103% of WA Medicaid,20.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,137.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,500.25,69,,,percent of total billed charges,69% of total billed charges,725,100,,,percent of total billed charges,100% of total billed charges,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,725,100,,,percent of total billed charges,100% of total billed charges,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,725,100,,,percent of total billed charges,100% of total billed charges,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,448.41,61.85,,,percent of total billed charges,61.85% of total billed charges,137.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,178.2,130,,,Fee Schedule,130% of WA Medicaid ,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.33,37.7,,,percent of total billed charges,37.70% of total billed charges,273.33,37.7,,,percent of total billed charges,37.70% of total billed charges,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,24577.5,33.9,,,percent of total billed charges,33.9% of total billed charges,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.5,78,,,percent of total billed charges,78% of total billed charges,725,100,,,percent of total billed charges,100% of total billed charges,598.85,82.6,,,percent of total billed charges,82.6% of total billed charges,598.85,82.6,,,percent of total billed charges,82.6% of total billed charges,137.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.47,24577.5,
GASTROSCOPY W/CONTROLL OF BLEED SURG,76143255,CDM,975,RC,43255,HCPCS,Outpatient,,,931,605.15,,819.28,88,,,percent of total billed charges,88% of total Billed charges,16.55,100,,,Fee Schedule,100% of Medicare rate,112.09,100,,,Fee Schedule,100% of WA Medicaid,931,100,,,percent of total billed charges,100% of total billed charges,115.45,103,,,Fee Schedule,103% of WA Medicaid,16.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,642.39,69,,,percent of total billed charges,69% of total billed charges,931,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,931,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,931,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.82,61.85,,,percent of total billed charges,61.85% of total billed charges,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.72,130,,,Fee Schedule,130% of WA Medicaid ,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.99,37.7,,,percent of total billed charges,37.70% of total billed charges,350.99,37.7,,,percent of total billed charges,37.70% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,31560.9,33.9,,,percent of total billed charges,33.9% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.18,78,,,percent of total billed charges,78% of total billed charges,931,100,,,percent of total billed charges,100% of total billed charges,769.01,82.6,,,percent of total billed charges,82.6% of total billed charges,769.01,82.6,,,percent of total billed charges,82.6% of total billed charges,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.55,31560.9,
Esophagogastroduodenoscopy removal of tumor(s) w/ snare tec,75043251,CDM,975,RC,43251,HCPCS,Outpatient,,,685,445.25,,602.8,88,,,percent of total billed charges,88% of total Billed charges,16.69,100,,,Fee Schedule,100% of Medicare rate,109.66,100,,,Fee Schedule,100% of WA Medicaid,685,100,,,percent of total billed charges,100% of total billed charges,112.95,103,,,Fee Schedule,103% of WA Medicaid,16.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,109.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,472.65,69,,,percent of total billed charges,69% of total billed charges,685,100,,,percent of total billed charges,100% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,685,100,,,percent of total billed charges,100% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,685,100,,,percent of total billed charges,100% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.67,61.85,,,percent of total billed charges,61.85% of total billed charges,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,142.56,130,,,Fee Schedule,130% of WA Medicaid ,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.25,37.7,,,percent of total billed charges,37.70% of total billed charges,258.25,37.7,,,percent of total billed charges,37.70% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,23221.5,33.9,,,percent of total billed charges,33.9% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.3,78,,,percent of total billed charges,78% of total billed charges,685,100,,,percent of total billed charges,100% of total billed charges,565.81,82.6,,,percent of total billed charges,82.6% of total billed charges,565.81,82.6,,,percent of total billed charges,82.6% of total billed charges,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.69,23221.5,
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAP,76143262,CDM,975,RC,43262,HCPCS,Outpatient,,,1026,666.90,,902.88,88,,,percent of total billed charges,88% of total Billed charges,30.23,100,,,Fee Schedule,100% of Medicare rate,199,100,,,Fee Schedule,100% of WA Medicaid,1026,100,,,percent of total billed charges,100% of total billed charges,204.97,103,,,Fee Schedule,103% of WA Medicaid,30.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,199,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,707.94,69,,,percent of total billed charges,69% of total billed charges,1026,100,,,percent of total billed charges,100% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1026,100,,,percent of total billed charges,100% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1026,100,,,percent of total billed charges,100% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.58,61.85,,,percent of total billed charges,61.85% of total billed charges,199,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,199,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,258.7,130,,,Fee Schedule,130% of WA Medicaid ,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.8,37.7,,,percent of total billed charges,37.70% of total billed charges,386.8,37.7,,,percent of total billed charges,37.70% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,34781.4,33.9,,,percent of total billed charges,33.9% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,800.28,78,,,percent of total billed charges,78% of total billed charges,1026,100,,,percent of total billed charges,100% of total billed charges,847.48,82.6,,,percent of total billed charges,82.6% of total billed charges,847.48,82.6,,,percent of total billed charges,82.6% of total billed charges,199,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,199,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.23,34781.4,
43264 ERCP; WITH REMVOAL OF CALCULI/DEBRIS FROM BI,76143264,CDM,975,RC,43264,HCPCS,Outpatient,,,1046,679.90,,920.48,88,,,percent of total billed charges,88% of total Billed charges,30.96,100,,,Fee Schedule,100% of Medicare rate,203.1,100,,,Fee Schedule,100% of WA Medicaid,1046,100,,,percent of total billed charges,100% of total billed charges,209.19,103,,,Fee Schedule,103% of WA Medicaid,30.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,203.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,721.74,69,,,percent of total billed charges,69% of total billed charges,1046,100,,,percent of total billed charges,100% of total billed charges,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046,100,,,percent of total billed charges,100% of total billed charges,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046,100,,,percent of total billed charges,100% of total billed charges,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.95,61.85,,,percent of total billed charges,61.85% of total billed charges,203.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,264.03,130,,,Fee Schedule,130% of WA Medicaid ,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.34,37.7,,,percent of total billed charges,37.70% of total billed charges,394.34,37.7,,,percent of total billed charges,37.70% of total billed charges,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,35459.4,33.9,,,percent of total billed charges,33.9% of total billed charges,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.88,78,,,percent of total billed charges,78% of total billed charges,1046,100,,,percent of total billed charges,100% of total billed charges,864,82.6,,,percent of total billed charges,82.6% of total billed charges,864,82.6,,,percent of total billed charges,82.6% of total billed charges,203.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.96,35459.4,
(ERCP); with removal of foreign body(s) or stent(s) SURG,76143275,CDM,975,RC,43275,HCPCS,Outpatient,,,1080,702.00,,950.4,88,,,percent of total billed charges,88% of total Billed charges,32.1,100,,,Fee Schedule,100% of Medicare rate,209.81,100,,,Fee Schedule,100% of WA Medicaid,1080,100,,,percent of total billed charges,100% of total billed charges,216.1,103,,,Fee Schedule,103% of WA Medicaid,32.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,209.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,745.2,69,,,percent of total billed charges,69% of total billed charges,1080,100,,,percent of total billed charges,100% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080,100,,,percent of total billed charges,100% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080,100,,,percent of total billed charges,100% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.98,61.85,,,percent of total billed charges,61.85% of total billed charges,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,272.75,130,,,Fee Schedule,130% of WA Medicaid ,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.16,37.7,,,percent of total billed charges,37.70% of total billed charges,407.16,37.7,,,percent of total billed charges,37.70% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,36612,33.9,,,percent of total billed charges,33.9% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.4,78,,,percent of total billed charges,78% of total billed charges,1080,100,,,percent of total billed charges,100% of total billed charges,892.08,82.6,,,percent of total billed charges,82.6% of total billed charges,892.08,82.6,,,percent of total billed charges,82.6% of total billed charges,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.1,36612,
(ERCP); with placement of endoscopic stent into biliary SUR,76143274,CDM,975,RC,43274,HCPCS,Outpatient,,,1323,859.95,,1164.24,88,,,percent of total billed charges,88% of total Billed charges,40.08,100,,,Fee Schedule,100% of Medicare rate,257.74,100,,,Fee Schedule,100% of WA Medicaid,1323,100,,,percent of total billed charges,100% of total billed charges,265.47,103,,,Fee Schedule,103% of WA Medicaid,40.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,257.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,912.87,69,,,percent of total billed charges,69% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323,100,,,percent of total billed charges,100% of total billed charges,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323,100,,,percent of total billed charges,100% of total billed charges,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,818.28,61.85,,,percent of total billed charges,61.85% of total billed charges,257.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,335.06,130,,,Fee Schedule,130% of WA Medicaid ,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,44849.7,33.9,,,percent of total billed charges,33.9% of total billed charges,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031.94,78,,,percent of total billed charges,78% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,257.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.08,44849.7,
(ERCP); with trans-endoscopic balloon dilation of SURG,76143277,CDM,975,RC,43277,HCPCS,Outpatient,,,1085,705.25,,954.8,88,,,percent of total billed charges,88% of total Billed charges,32.16,100,,,Fee Schedule,100% of Medicare rate,210.93,100,,,Fee Schedule,100% of WA Medicaid,1085,100,,,percent of total billed charges,100% of total billed charges,217.26,103,,,Fee Schedule,103% of WA Medicaid,32.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,210.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,748.65,69,,,percent of total billed charges,69% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085,100,,,percent of total billed charges,100% of total billed charges,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085,100,,,percent of total billed charges,100% of total billed charges,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.07,61.85,,,percent of total billed charges,61.85% of total billed charges,210.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,274.21,130,,,Fee Schedule,130% of WA Medicaid ,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,36781.5,33.9,,,percent of total billed charges,33.9% of total billed charges,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.3,78,,,percent of total billed charges,78% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,210.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.16,36781.5,
GASTROSCOPY W ABLATION ANY KIND SURG,76143270,CDM,975,RC,43270,HCPCS,Outpatient,,,1368,889.20,,1203.84,88,,,percent of total billed charges,88% of total Billed charges,18.82,100,,,Fee Schedule,100% of Medicare rate,125.51,100,,,Fee Schedule,100% of WA Medicaid,1368,100,,,percent of total billed charges,100% of total billed charges,129.28,103,,,Fee Schedule,103% of WA Medicaid,18.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,125.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,943.92,69,,,percent of total billed charges,69% of total billed charges,1368,100,,,percent of total billed charges,100% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368,100,,,percent of total billed charges,100% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368,100,,,percent of total billed charges,100% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.11,61.85,,,percent of total billed charges,61.85% of total billed charges,125.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,163.16,130,,,Fee Schedule,130% of WA Medicaid ,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.74,37.7,,,percent of total billed charges,37.70% of total billed charges,515.74,37.7,,,percent of total billed charges,37.70% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,46375.2,33.9,,,percent of total billed charges,33.9% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067.04,78,,,percent of total billed charges,78% of total billed charges,1368,100,,,percent of total billed charges,100% of total billed charges,1129.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1129.97,82.6,,,percent of total billed charges,82.6% of total billed charges,125.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.82,46375.2,
ERCP with removal/exchange of stent(s) of pancreatic duct SU,76143276,CDM,975,RC,43276,HCPCS,Outpatient,,,1377,895.05,,1211.76,88,,,percent of total billed charges,88% of total Billed charges,41.68,100,,,Fee Schedule,100% of Medicare rate,268.37,100,,,Fee Schedule,100% of WA Medicaid,1377,100,,,percent of total billed charges,100% of total billed charges,276.42,103,,,Fee Schedule,103% of WA Medicaid,41.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,268.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,950.13,69,,,percent of total billed charges,69% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377,100,,,percent of total billed charges,100% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377,100,,,percent of total billed charges,100% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.67,61.85,,,percent of total billed charges,61.85% of total billed charges,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,348.88,130,,,Fee Schedule,130% of WA Medicaid ,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,46680.3,33.9,,,percent of total billed charges,33.9% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.06,78,,,percent of total billed charges,78% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.68,46680.3,
"Replacement of gastrostomy tube, percutaneous, includes rem",76143763,CDM,975,RC,43763,HCPCS,Outpatient,,,296,192.40,,260.48,88,,,percent of total billed charges,88% of total Billed charges,9.6,100,,,Fee Schedule,100% of Medicare rate,49.24,100,,,Fee Schedule,100% of WA Medicaid,296,100,,,percent of total billed charges,100% of total billed charges,50.72,103,,,Fee Schedule,103% of WA Medicaid,9.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,204.24,69,,,percent of total billed charges,69% of total billed charges,296,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,296,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,296,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.08,61.85,,,percent of total billed charges,61.85% of total billed charges,49.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.01,130,,,Fee Schedule,130% of WA Medicaid ,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.59,37.7,,,percent of total billed charges,37.70% of total billed charges,111.59,37.7,,,percent of total billed charges,37.70% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,10034.4,33.9,,,percent of total billed charges,33.9% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.88,78,,,percent of total billed charges,78% of total billed charges,296,100,,,percent of total billed charges,100% of total billed charges,244.5,82.6,,,percent of total billed charges,82.6% of total billed charges,244.5,82.6,,,percent of total billed charges,82.6% of total billed charges,49.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.6,10034.4,
Replace Gastrostomy Tube SURG,76143762,CDM,975,RC,43762,HCPCS,Outpatient,,,107,69.55,,94.16,88,,,percent of total billed charges,88% of total Billed charges,4.73,100,,,Fee Schedule,100% of Medicare rate,20.7,100,,,Fee Schedule,100% of WA Medicaid,107,100,,,percent of total billed charges,100% of total billed charges,21.32,103,,,Fee Schedule,103% of WA Medicaid,4.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,73.83,69,,,percent of total billed charges,69% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,107,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,107,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.18,61.85,,,percent of total billed charges,61.85% of total billed charges,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.91,130,,,Fee Schedule,130% of WA Medicaid ,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,40.34,37.7,,,percent of total billed charges,37.70% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3627.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.46,78,,,percent of total billed charges,78% of total billed charges,107,100,,,percent of total billed charges,100% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,88.38,82.6,,,percent of total billed charges,82.6% of total billed charges,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.73,3627.3,
"Smll Intestinal Endscpy, Entrscpy Bynd Scnd Port Of Duodenu",76144361,CDM,975,RC,44361,HCPCS,Outpatient,,,555,360.75,,488.4,88,,,percent of total billed charges,88% of total Billed charges,13.25,100,,,Fee Schedule,100% of Medicare rate,88.96,100,,,Fee Schedule,100% of WA Medicaid,555,100,,,percent of total billed charges,100% of total billed charges,91.63,103,,,Fee Schedule,103% of WA Medicaid,13.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,88.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,382.95,69,,,percent of total billed charges,69% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,555,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,555,100,,,percent of total billed charges,100% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.27,61.85,,,percent of total billed charges,61.85% of total billed charges,88.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,115.65,130,,,Fee Schedule,130% of WA Medicaid ,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,18814.5,33.9,,,percent of total billed charges,33.9% of total billed charges,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.9,78,,,percent of total billed charges,78% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,88.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.25,18814.5,
"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTI",76144366,CDM,975,RC,44366,HCPCS,Outpatient,,,837,544.05,,736.56,88,,,percent of total billed charges,88% of total Billed charges,19.79,100,,,Fee Schedule,100% of Medicare rate,134.09,100,,,Fee Schedule,100% of WA Medicaid,837,100,,,percent of total billed charges,100% of total billed charges,138.11,103,,,Fee Schedule,103% of WA Medicaid,19.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,134.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,577.53,69,,,percent of total billed charges,69% of total billed charges,837,100,,,percent of total billed charges,100% of total billed charges,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,837,100,,,percent of total billed charges,100% of total billed charges,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,837,100,,,percent of total billed charges,100% of total billed charges,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.68,61.85,,,percent of total billed charges,61.85% of total billed charges,134.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.32,130,,,Fee Schedule,130% of WA Medicaid ,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.55,37.7,,,percent of total billed charges,37.70% of total billed charges,315.55,37.7,,,percent of total billed charges,37.70% of total billed charges,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,28374.3,33.9,,,percent of total billed charges,33.9% of total billed charges,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,652.86,78,,,percent of total billed charges,78% of total billed charges,837,100,,,percent of total billed charges,100% of total billed charges,691.36,82.6,,,percent of total billed charges,82.6% of total billed charges,691.36,82.6,,,percent of total billed charges,82.6% of total billed charges,134.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.79,28374.3,
"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTIO",76144369,CDM,975,RC,44369,HCPCS,Outpatient,,,858,557.70,,755.04,88,,,percent of total billed charges,88% of total Billed charges,20.48,100,,,Fee Schedule,100% of Medicare rate,137.26,100,,,Fee Schedule,100% of WA Medicaid,858,100,,,percent of total billed charges,100% of total billed charges,141.38,103,,,Fee Schedule,103% of WA Medicaid,20.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,137.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,592.02,69,,,percent of total billed charges,69% of total billed charges,858,100,,,percent of total billed charges,100% of total billed charges,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,858,100,,,percent of total billed charges,100% of total billed charges,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,858,100,,,percent of total billed charges,100% of total billed charges,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.67,61.85,,,percent of total billed charges,61.85% of total billed charges,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,178.44,130,,,Fee Schedule,130% of WA Medicaid ,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.47,37.7,,,percent of total billed charges,37.70% of total billed charges,323.47,37.7,,,percent of total billed charges,37.70% of total billed charges,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,29086.2,33.9,,,percent of total billed charges,33.9% of total billed charges,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,669.24,78,,,percent of total billed charges,78% of total billed charges,858,100,,,percent of total billed charges,100% of total billed charges,708.71,82.6,,,percent of total billed charges,82.6% of total billed charges,708.71,82.6,,,percent of total billed charges,82.6% of total billed charges,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.48,29086.2,
"SMALL BOWEL ENDOSCOPY, DIAG NOT INCLUDING",76144360,CDM,975,RC,44360,HCPCS,Outpatient,,,502,326.30,,441.76,88,,,percent of total billed charges,88% of total Billed charges,12.04,100,,,Fee Schedule,100% of Medicare rate,80.75,100,,,Fee Schedule,100% of WA Medicaid,502,100,,,percent of total billed charges,100% of total billed charges,83.17,103,,,Fee Schedule,103% of WA Medicaid,12.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,80.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,346.38,69,,,percent of total billed charges,69% of total billed charges,502,100,,,percent of total billed charges,100% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,502,100,,,percent of total billed charges,100% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,502,100,,,percent of total billed charges,100% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.49,61.85,,,percent of total billed charges,61.85% of total billed charges,80.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,104.98,130,,,Fee Schedule,130% of WA Medicaid ,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.25,37.7,,,percent of total billed charges,37.70% of total billed charges,189.25,37.7,,,percent of total billed charges,37.70% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,17017.8,33.9,,,percent of total billed charges,33.9% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.56,78,,,percent of total billed charges,78% of total billed charges,502,100,,,percent of total billed charges,100% of total billed charges,414.65,82.6,,,percent of total billed charges,82.6% of total billed charges,414.65,82.6,,,percent of total billed charges,82.6% of total billed charges,80.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.04,17017.8,
"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTI",76144364,CDM,975,RC,44364,HCPCS,Outpatient,,,714,464.10,,628.32,88,,,percent of total billed charges,88% of total Billed charges,16.93,100,,,Fee Schedule,100% of Medicare rate,114.32,100,,,Fee Schedule,100% of WA Medicaid,714,100,,,percent of total billed charges,100% of total billed charges,117.75,103,,,Fee Schedule,103% of WA Medicaid,16.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,114.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,492.66,69,,,percent of total billed charges,69% of total billed charges,714,100,,,percent of total billed charges,100% of total billed charges,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,714,100,,,percent of total billed charges,100% of total billed charges,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,714,100,,,percent of total billed charges,100% of total billed charges,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.61,61.85,,,percent of total billed charges,61.85% of total billed charges,114.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,148.62,130,,,Fee Schedule,130% of WA Medicaid ,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.18,37.7,,,percent of total billed charges,37.70% of total billed charges,269.18,37.7,,,percent of total billed charges,37.70% of total billed charges,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,24204.6,33.9,,,percent of total billed charges,33.9% of total billed charges,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.92,78,,,percent of total billed charges,78% of total billed charges,714,100,,,percent of total billed charges,100% of total billed charges,589.76,82.6,,,percent of total billed charges,82.6% of total billed charges,589.76,82.6,,,percent of total billed charges,82.6% of total billed charges,114.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.93,24204.6,
"Small intestinal endoscopy, enteroscopy beyond second portio",76144373,CDM,975,RC,44373,HCPCS,Outpatient,,,1096,712.40,,964.48,88,,,percent of total billed charges,88% of total Billed charges,16.8,100,,,Fee Schedule,100% of Medicare rate,106.86,100,,,Fee Schedule,100% of WA Medicaid,1096,100,,,percent of total billed charges,100% of total billed charges,110.07,103,,,Fee Schedule,103% of WA Medicaid,16.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,106.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,756.24,69,,,percent of total billed charges,69% of total billed charges,1096,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1096,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1096,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.88,61.85,,,percent of total billed charges,61.85% of total billed charges,106.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,109,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,138.92,130,,,Fee Schedule,130% of WA Medicaid ,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.19,37.7,,,percent of total billed charges,37.70% of total billed charges,413.19,37.7,,,percent of total billed charges,37.70% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,37154.4,33.9,,,percent of total billed charges,33.9% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,854.88,78,,,percent of total billed charges,78% of total billed charges,1096,100,,,percent of total billed charges,100% of total billed charges,905.3,82.6,,,percent of total billed charges,82.6% of total billed charges,905.3,82.6,,,percent of total billed charges,82.6% of total billed charges,106.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.8,37154.4,
"SMALL BOWEL ENDOSCOPY, BEYOND SECOND PORTION W BIOPSY,",76144377,CDM,975,RC,44377,HCPCS,Outpatient,,,1045,679.25,,919.6,88,,,percent of total billed charges,88% of total Billed charges,25.94,100,,,Fee Schedule,100% of Medicare rate,166.92,100,,,Fee Schedule,100% of WA Medicaid,1045,100,,,percent of total billed charges,100% of total billed charges,171.93,103,,,Fee Schedule,103% of WA Medicaid,25.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,166.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,721.05,69,,,percent of total billed charges,69% of total billed charges,1045,100,,,percent of total billed charges,100% of total billed charges,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045,100,,,percent of total billed charges,100% of total billed charges,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045,100,,,percent of total billed charges,100% of total billed charges,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.33,61.85,,,percent of total billed charges,61.85% of total billed charges,166.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,217,130,,,Fee Schedule,130% of WA Medicaid ,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.97,37.7,,,percent of total billed charges,37.70% of total billed charges,393.97,37.7,,,percent of total billed charges,37.70% of total billed charges,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,35425.5,33.9,,,percent of total billed charges,33.9% of total billed charges,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.1,78,,,percent of total billed charges,78% of total billed charges,1045,100,,,percent of total billed charges,100% of total billed charges,863.17,82.6,,,percent of total billed charges,82.6% of total billed charges,863.17,82.6,,,percent of total billed charges,82.6% of total billed charges,166.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.94,35425.5,
"Smll Intstnl Endscpy, Entrscpy Bynd Scnd Portion Of Duodenum",76144378,CDM,975,RC,44378,HCPCS,Outpatient,,,1345,874.25,,1183.6,88,,,percent of total billed charges,88% of total Billed charges,32.6,100,,,Fee Schedule,100% of Medicare rate,214.48,100,,,Fee Schedule,100% of WA Medicaid,1345,100,,,percent of total billed charges,100% of total billed charges,220.91,103,,,Fee Schedule,103% of WA Medicaid,32.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,214.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,928.05,69,,,percent of total billed charges,69% of total billed charges,1345,100,,,percent of total billed charges,100% of total billed charges,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1345,100,,,percent of total billed charges,100% of total billed charges,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1345,100,,,percent of total billed charges,100% of total billed charges,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,831.88,61.85,,,percent of total billed charges,61.85% of total billed charges,214.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,278.82,130,,,Fee Schedule,130% of WA Medicaid ,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.07,37.7,,,percent of total billed charges,37.70% of total billed charges,507.07,37.7,,,percent of total billed charges,37.70% of total billed charges,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,45595.5,33.9,,,percent of total billed charges,33.9% of total billed charges,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1049.1,78,,,percent of total billed charges,78% of total billed charges,1345,100,,,percent of total billed charges,100% of total billed charges,1110.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1110.97,82.6,,,percent of total billed charges,82.6% of total billed charges,214.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.6,45595.5,
"Ileoscopy, Through Stoma; With Biopsy, Single Or Multiple",76144382,CDM,975,RC,44382,HCPCS,Outpatient,,,255.71,166.21,,225.02,88,,,percent of total billed charges,88% of total Billed charges,6.1,100,,,Fee Schedule,100% of Medicare rate,41.96,100,,,Fee Schedule,100% of WA Medicaid,255.71,100,,,percent of total billed charges,100% of total billed charges,43.22,103,,,Fee Schedule,103% of WA Medicaid,6.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,41.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,176.44,69,,,percent of total billed charges,69% of total billed charges,255.71,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.71,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.71,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.16,61.85,,,percent of total billed charges,61.85% of total billed charges,41.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,54.55,130,,,Fee Schedule,130% of WA Medicaid ,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.4,37.7,,,percent of total billed charges,37.70% of total billed charges,96.4,37.7,,,percent of total billed charges,37.70% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,8668.57,33.9,,,percent of total billed charges,33.9% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.45,78,,,percent of total billed charges,78% of total billed charges,255.71,100,,,percent of total billed charges,100% of total billed charges,211.22,82.6,,,percent of total billed charges,82.6% of total billed charges,211.22,82.6,,,percent of total billed charges,82.6% of total billed charges,41.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.1,8668.57,
COLONOSCOPY THRU STOMA,76144388,CDM,975,RC,44388,HCPCS,Outpatient,,,754,490.10,,663.52,88,,,percent of total billed charges,88% of total Billed charges,15.25,100,,,Fee Schedule,100% of Medicare rate,87.28,100,,,Fee Schedule,100% of WA Medicaid,754,100,,,percent of total billed charges,100% of total billed charges,89.9,103,,,Fee Schedule,103% of WA Medicaid,15.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,87.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,520.26,69,,,percent of total billed charges,69% of total billed charges,754,100,,,percent of total billed charges,100% of total billed charges,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,754,100,,,percent of total billed charges,100% of total billed charges,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,754,100,,,percent of total billed charges,100% of total billed charges,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.35,61.85,,,percent of total billed charges,61.85% of total billed charges,87.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,113.46,130,,,Fee Schedule,130% of WA Medicaid ,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.26,37.7,,,percent of total billed charges,37.70% of total billed charges,284.26,37.7,,,percent of total billed charges,37.70% of total billed charges,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,25560.6,33.9,,,percent of total billed charges,33.9% of total billed charges,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.12,78,,,percent of total billed charges,78% of total billed charges,754,100,,,percent of total billed charges,100% of total billed charges,622.8,82.6,,,percent of total billed charges,82.6% of total billed charges,622.8,82.6,,,percent of total billed charges,82.6% of total billed charges,87.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.25,25560.6,
"ILEOSCOPY, THROUGH STOMA; WITH TRANSENDOSCOPIC BALLOON DILA",76144381,CDM,975,RC,44381,HCPCS,Outpatient,,,2463,1600.95,,2167.44,88,,,percent of total billed charges,88% of total Billed charges,7.2,100,,,Fee Schedule,100% of Medicare rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,2463,100,,,percent of total billed charges,100% of total billed charges,49.37,103,,,Fee Schedule,103% of WA Medicaid,7.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1699.47,69,,,percent of total billed charges,69% of total billed charges,2463,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2463,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2463,100,,,percent of total billed charges,100% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1523.37,61.85,,,percent of total billed charges,61.85% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.31,130,,,Fee Schedule,130% of WA Medicaid ,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,928.55,37.7,,,percent of total billed charges,37.70% of total billed charges,928.55,37.7,,,percent of total billed charges,37.70% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,83495.7,33.9,,,percent of total billed charges,33.9% of total billed charges,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1921.14,78,,,percent of total billed charges,78% of total billed charges,2463,100,,,percent of total billed charges,100% of total billed charges,2034.44,82.6,,,percent of total billed charges,82.6% of total billed charges,2034.44,82.6,,,percent of total billed charges,82.6% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.2,83495.7,
Ileoxopy thru Stoma,76144380,CDM,975,RC,44380,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,4.58,100,,,Fee Schedule,100% of Medicare rate,32.64,100,,,Fee Schedule,100% of WA Medicaid,195,100,,,percent of total billed charges,100% of total billed charges,33.62,103,,,Fee Schedule,103% of WA Medicaid,4.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,195,100,,,percent of total billed charges,100% of total billed charges,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,195,100,,,percent of total billed charges,100% of total billed charges,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,32.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.43,130,,,Fee Schedule,130% of WA Medicaid ,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,6610.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.58,6610.5,
"COLONOSCOPY THROUGH STOMA; WITH CONTROL OF BLEEDING, ANY ME",76144391,CDM,975,RC,44391,HCPCS,Outpatient,,,806,523.90,,709.28,88,,,percent of total billed charges,88% of total Billed charges,20.04,100,,,Fee Schedule,100% of Medicare rate,128.87,100,,,Fee Schedule,100% of WA Medicaid,806,100,,,percent of total billed charges,100% of total billed charges,132.74,103,,,Fee Schedule,103% of WA Medicaid,20.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,128.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,556.14,69,,,percent of total billed charges,69% of total billed charges,806,100,,,percent of total billed charges,100% of total billed charges,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,806,100,,,percent of total billed charges,100% of total billed charges,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,806,100,,,percent of total billed charges,100% of total billed charges,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,498.51,61.85,,,percent of total billed charges,61.85% of total billed charges,128.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,167.53,130,,,Fee Schedule,130% of WA Medicaid ,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.86,37.7,,,percent of total billed charges,37.70% of total billed charges,303.86,37.7,,,percent of total billed charges,37.70% of total billed charges,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,27323.4,33.9,,,percent of total billed charges,33.9% of total billed charges,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,628.68,78,,,percent of total billed charges,78% of total billed charges,806,100,,,percent of total billed charges,100% of total billed charges,665.76,82.6,,,percent of total billed charges,82.6% of total billed charges,665.76,82.6,,,percent of total billed charges,82.6% of total billed charges,128.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.04,27323.4,
"COLONOSCOPY THROUGH STOMA; REMOVAL OF TUMOR/POLYP, SNARE TE",76144394,CDM,975,RC,44394,HCPCS,Outpatient,,,1062,690.30,,934.56,88,,,percent of total billed charges,88% of total Billed charges,20.66,100,,,Fee Schedule,100% of Medicare rate,125.89,100,,,Fee Schedule,100% of WA Medicaid,1062,100,,,percent of total billed charges,100% of total billed charges,129.67,103,,,Fee Schedule,103% of WA Medicaid,20.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,125.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,732.78,69,,,percent of total billed charges,69% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1062,100,,,percent of total billed charges,100% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1062,100,,,percent of total billed charges,100% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,656.85,61.85,,,percent of total billed charges,61.85% of total billed charges,125.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,163.66,130,,,Fee Schedule,130% of WA Medicaid ,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.37,37.7,,,percent of total billed charges,37.70% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,36001.8,33.9,,,percent of total billed charges,33.9% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,828.36,78,,,percent of total billed charges,78% of total billed charges,1062,100,,,percent of total billed charges,100% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,877.21,82.6,,,percent of total billed charges,82.6% of total billed charges,125.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.66,36001.8,
"COLONOSCOPY THROUGH STOMA; WITH ABLATION OF TUMOR(S), POLYP",76144401,CDM,975,RC,44401,HCPCS,Outpatient,,,846,549.90,,744.48,88,,,percent of total billed charges,88% of total Billed charges,20.38,100,,,Fee Schedule,100% of Medicare rate,135.59,100,,,Fee Schedule,100% of WA Medicaid,846,100,,,percent of total billed charges,100% of total billed charges,139.66,103,,,Fee Schedule,103% of WA Medicaid,20.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,135.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,583.74,69,,,percent of total billed charges,69% of total billed charges,846,100,,,percent of total billed charges,100% of total billed charges,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,846,100,,,percent of total billed charges,100% of total billed charges,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,846,100,,,percent of total billed charges,100% of total billed charges,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,523.25,61.85,,,percent of total billed charges,61.85% of total billed charges,135.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,176.27,130,,,Fee Schedule,130% of WA Medicaid ,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.94,37.7,,,percent of total billed charges,37.70% of total billed charges,318.94,37.7,,,percent of total billed charges,37.70% of total billed charges,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,28679.4,33.9,,,percent of total billed charges,33.9% of total billed charges,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.88,78,,,percent of total billed charges,78% of total billed charges,846,100,,,percent of total billed charges,100% of total billed charges,698.8,82.6,,,percent of total billed charges,82.6% of total billed charges,698.8,82.6,,,percent of total billed charges,82.6% of total billed charges,135.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.38,28679.4,
COLONOSCOPY THROUGH STOMA; WITH DIRECTED SUBMUCOSAL INJECTIO,76144404,CDM,975,RC,44404,HCPCS,Outpatient,,,761,494.65,,669.68,88,,,percent of total billed charges,88% of total Billed charges,15.45,100,,,Fee Schedule,100% of Medicare rate,96.05,100,,,Fee Schedule,100% of WA Medicaid,761,100,,,percent of total billed charges,100% of total billed charges,98.93,103,,,Fee Schedule,103% of WA Medicaid,15.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,96.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,525.09,69,,,percent of total billed charges,69% of total billed charges,761,100,,,percent of total billed charges,100% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,761,100,,,percent of total billed charges,100% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,761,100,,,percent of total billed charges,100% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.68,61.85,,,percent of total billed charges,61.85% of total billed charges,96.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,124.87,130,,,Fee Schedule,130% of WA Medicaid ,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.9,37.7,,,percent of total billed charges,37.70% of total billed charges,286.9,37.7,,,percent of total billed charges,37.70% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,25797.9,33.9,,,percent of total billed charges,33.9% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,593.58,78,,,percent of total billed charges,78% of total billed charges,761,100,,,percent of total billed charges,100% of total billed charges,628.59,82.6,,,percent of total billed charges,82.6% of total billed charges,628.59,82.6,,,percent of total billed charges,82.6% of total billed charges,96.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.45,25797.9,
COLONOSCOPY THROUGH STOMA; WITH TRANSENDOSCOPIC BALLOON DIL,76144405,CDM,975,RC,44405,HCPCS,Outpatient,,,640.15,416.10,,563.33,88,,,percent of total billed charges,88% of total Billed charges,15.54,100,,,Fee Schedule,100% of Medicare rate,102.76,100,,,Fee Schedule,100% of WA Medicaid,640.15,100,,,percent of total billed charges,100% of total billed charges,105.84,103,,,Fee Schedule,103% of WA Medicaid,15.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,441.7,69,,,percent of total billed charges,69% of total billed charges,640.15,100,,,percent of total billed charges,100% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.15,100,,,percent of total billed charges,100% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.15,100,,,percent of total billed charges,100% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.93,61.85,,,percent of total billed charges,61.85% of total billed charges,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,133.59,130,,,Fee Schedule,130% of WA Medicaid ,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.34,37.7,,,percent of total billed charges,37.70% of total billed charges,241.34,37.7,,,percent of total billed charges,37.70% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,21701.09,33.9,,,percent of total billed charges,33.9% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.32,78,,,percent of total billed charges,78% of total billed charges,640.15,100,,,percent of total billed charges,100% of total billed charges,528.76,82.6,,,percent of total billed charges,82.6% of total billed charges,528.76,82.6,,,percent of total billed charges,82.6% of total billed charges,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.54,21701.09,
FLEX SIG SURG,76145330,CDM,975,RC,45330,HCPCS,Outpatient,,,293,190.45,,257.84,88,,,percent of total billed charges,88% of total Billed charges,4.81,100,,,Fee Schedule,100% of Medicare rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,293,100,,,percent of total billed charges,100% of total billed charges,33.23,103,,,Fee Schedule,103% of WA Medicaid,4.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,202.17,69,,,percent of total billed charges,69% of total billed charges,293,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,293,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,293,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.22,61.85,,,percent of total billed charges,61.85% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.94,130,,,Fee Schedule,130% of WA Medicaid ,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.46,37.7,,,percent of total billed charges,37.70% of total billed charges,110.46,37.7,,,percent of total billed charges,37.70% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9932.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.54,78,,,percent of total billed charges,78% of total billed charges,293,100,,,percent of total billed charges,100% of total billed charges,242.02,82.6,,,percent of total billed charges,82.6% of total billed charges,242.02,82.6,,,percent of total billed charges,82.6% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,9932.7,
FLEX SIG W/BX,76145331,CDM,975,RC,45331,HCPCS,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,6.05,100,,,Fee Schedule,100% of Medicare rate,41.03,100,,,Fee Schedule,100% of WA Medicaid,350,100,,,percent of total billed charges,100% of total billed charges,42.26,103,,,Fee Schedule,103% of WA Medicaid,6.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,41.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,350,100,,,percent of total billed charges,100% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,350,100,,,percent of total billed charges,100% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,41.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.34,130,,,Fee Schedule,130% of WA Medicaid ,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,11865,33.9,,,percent of total billed charges,33.9% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,41.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.05,11865,
FLEX SIG W/REMOVAL POLYP/SNARE,76145338,CDM,975,RC,45338,HCPCS,Outpatient,,,684,444.60,,601.92,88,,,percent of total billed charges,88% of total Billed charges,10.31,100,,,Fee Schedule,100% of Medicare rate,67.7,100,,,Fee Schedule,100% of WA Medicaid,684,100,,,percent of total billed charges,100% of total billed charges,69.73,103,,,Fee Schedule,103% of WA Medicaid,10.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,67.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,471.96,69,,,percent of total billed charges,69% of total billed charges,684,100,,,percent of total billed charges,100% of total billed charges,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,684,100,,,percent of total billed charges,100% of total billed charges,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,684,100,,,percent of total billed charges,100% of total billed charges,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.05,61.85,,,percent of total billed charges,61.85% of total billed charges,67.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,88.01,130,,,Fee Schedule,130% of WA Medicaid ,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.87,37.7,,,percent of total billed charges,37.70% of total billed charges,257.87,37.7,,,percent of total billed charges,37.70% of total billed charges,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,23187.6,33.9,,,percent of total billed charges,33.9% of total billed charges,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,533.52,78,,,percent of total billed charges,78% of total billed charges,684,100,,,percent of total billed charges,100% of total billed charges,564.98,82.6,,,percent of total billed charges,82.6% of total billed charges,564.98,82.6,,,percent of total billed charges,82.6% of total billed charges,67.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.31,23187.6,
"IGMOIDOSCOPY, FLEXIBLE",76145335,CDM,975,RC,45335,HCPCS,Outpatient,,,928,603.20,,816.64,88,,,percent of total billed charges,88% of total Billed charges,5.63,100,,,Fee Schedule,100% of Medicare rate,38.05,100,,,Fee Schedule,100% of WA Medicaid,928,100,,,percent of total billed charges,100% of total billed charges,39.19,103,,,Fee Schedule,103% of WA Medicaid,5.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,640.32,69,,,percent of total billed charges,69% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,928,100,,,percent of total billed charges,100% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,928,100,,,percent of total billed charges,100% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,573.97,61.85,,,percent of total billed charges,61.85% of total billed charges,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.47,130,,,Fee Schedule,130% of WA Medicaid ,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.86,37.7,,,percent of total billed charges,37.70% of total billed charges,349.86,37.7,,,percent of total billed charges,37.70% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,31459.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.84,78,,,percent of total billed charges,78% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.63,31459.2,
"Sigmoidoscopy,flexible w/ctrl bleeding",76145334,CDM,975,RC,45334,HCPCS,Outpatient,,,340,221.00,,299.2,88,,,percent of total billed charges,88% of total Billed charges,9.72,100,,,Fee Schedule,100% of Medicare rate,66.21,100,,,Fee Schedule,100% of WA Medicaid,340,100,,,percent of total billed charges,100% of total billed charges,68.2,103,,,Fee Schedule,103% of WA Medicaid,9.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,234.6,69,,,percent of total billed charges,69% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.29,61.85,,,percent of total billed charges,61.85% of total billed charges,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,86.07,130,,,Fee Schedule,130% of WA Medicaid ,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,11526,33.9,,,percent of total billed charges,33.9% of total billed charges,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.2,78,,,percent of total billed charges,78% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.72,11526,
"SIGMOIDOSCOPY, FLEXIBLE",76145340,CDM,975,RC,45340,HCPCS,Outpatient,,,275,178.75,,242,88,,,percent of total billed charges,88% of total Billed charges,7.01,100,,,Fee Schedule,100% of Medicare rate,44.39,100,,,Fee Schedule,100% of WA Medicaid,275,100,,,percent of total billed charges,100% of total billed charges,45.72,103,,,Fee Schedule,103% of WA Medicaid,7.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,44.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,189.75,69,,,percent of total billed charges,69% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,275,100,,,percent of total billed charges,100% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,275,100,,,percent of total billed charges,100% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.09,61.85,,,percent of total billed charges,61.85% of total billed charges,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,57.71,130,,,Fee Schedule,130% of WA Medicaid ,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,9322.5,33.9,,,percent of total billed charges,33.9% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.5,78,,,percent of total billed charges,78% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.01,9322.5,
"Sigmoidoscopy, flexible w/ablation of tumors SURG",76145346,CDM,975,RC,45346,HCPCS,Outpatient,,,560,364.00,,492.8,88,,,percent of total billed charges,88% of total Billed charges,13.83,100,,,Fee Schedule,100% of Medicare rate,89.89,100,,,Fee Schedule,100% of WA Medicaid,560,100,,,percent of total billed charges,100% of total billed charges,92.59,103,,,Fee Schedule,103% of WA Medicaid,13.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,89.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,386.4,69,,,percent of total billed charges,69% of total billed charges,560,100,,,percent of total billed charges,100% of total billed charges,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,560,100,,,percent of total billed charges,100% of total billed charges,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,560,100,,,percent of total billed charges,100% of total billed charges,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.36,61.85,,,percent of total billed charges,61.85% of total billed charges,89.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,116.86,130,,,Fee Schedule,130% of WA Medicaid ,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.12,37.7,,,percent of total billed charges,37.70% of total billed charges,211.12,37.7,,,percent of total billed charges,37.70% of total billed charges,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,18984,33.9,,,percent of total billed charges,33.9% of total billed charges,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.8,78,,,percent of total billed charges,78% of total billed charges,560,100,,,percent of total billed charges,100% of total billed charges,462.56,82.6,,,percent of total billed charges,82.6% of total billed charges,462.56,82.6,,,percent of total billed charges,82.6% of total billed charges,89.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.83,18984,
DIAGNOSTIC COLONOSCOPY SURG,76145378,CDM,975,RC,45378,HCPCS,Outpatient,,,832,540.80,,732.16,88,,,percent of total billed charges,88% of total Billed charges,16.35,100,,,Fee Schedule,100% of Medicare rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,832,100,,,percent of total billed charges,100% of total billed charges,53.41,103,,,Fee Schedule,103% of WA Medicaid,16.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,574.08,69,,,percent of total billed charges,69% of total billed charges,832,100,,,percent of total billed charges,100% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,832,100,,,percent of total billed charges,100% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,832,100,,,percent of total billed charges,100% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,514.59,61.85,,,percent of total billed charges,61.85% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.41,130,,,Fee Schedule,130% of WA Medicaid ,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.66,37.7,,,percent of total billed charges,37.70% of total billed charges,313.66,37.7,,,percent of total billed charges,37.70% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,28204.8,33.9,,,percent of total billed charges,33.9% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,648.96,78,,,percent of total billed charges,78% of total billed charges,832,100,,,percent of total billed charges,100% of total billed charges,687.23,82.6,,,percent of total billed charges,82.6% of total billed charges,687.23,82.6,,,percent of total billed charges,82.6% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.35,28204.8,
COLONOSCOPY W/CONTROL BLEED SURG,76145382,CDM,975,RC,45382,HCPCS,Outpatient,,,1287,836.55,,1132.56,88,,,percent of total billed charges,88% of total Billed charges,21.9,100,,,Fee Schedule,100% of Medicare rate,144.54,100,,,Fee Schedule,100% of WA Medicaid,1287,100,,,percent of total billed charges,100% of total billed charges,148.88,103,,,Fee Schedule,103% of WA Medicaid,21.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,144.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,888.03,69,,,percent of total billed charges,69% of total billed charges,1287,100,,,percent of total billed charges,100% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1287,100,,,percent of total billed charges,100% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1287,100,,,percent of total billed charges,100% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,796.01,61.85,,,percent of total billed charges,61.85% of total billed charges,144.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,187.9,130,,,Fee Schedule,130% of WA Medicaid ,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.2,37.7,,,percent of total billed charges,37.70% of total billed charges,485.2,37.7,,,percent of total billed charges,37.70% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,43629.3,33.9,,,percent of total billed charges,33.9% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1003.86,78,,,percent of total billed charges,78% of total billed charges,1287,100,,,percent of total billed charges,100% of total billed charges,1063.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1063.06,82.6,,,percent of total billed charges,82.6% of total billed charges,144.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.9,43629.3,
COLONOSCOPY W/POLYPECTOMY SURG,76145385,CDM,975,RC,45385,HCPCS,Outpatient,,,828,538.20,,728.64,88,,,percent of total billed charges,88% of total Billed charges,22.03,100,,,Fee Schedule,100% of Medicare rate,141.93,100,,,Fee Schedule,100% of WA Medicaid,828,100,,,percent of total billed charges,100% of total billed charges,146.19,103,,,Fee Schedule,103% of WA Medicaid,22.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,141.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,571.32,69,,,percent of total billed charges,69% of total billed charges,828,100,,,percent of total billed charges,100% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,828,100,,,percent of total billed charges,100% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,828,100,,,percent of total billed charges,100% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.12,61.85,,,percent of total billed charges,61.85% of total billed charges,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,184.51,130,,,Fee Schedule,130% of WA Medicaid ,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.16,37.7,,,percent of total billed charges,37.70% of total billed charges,312.16,37.7,,,percent of total billed charges,37.70% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,28069.2,33.9,,,percent of total billed charges,33.9% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.84,78,,,percent of total billed charges,78% of total billed charges,828,100,,,percent of total billed charges,100% of total billed charges,683.93,82.6,,,percent of total billed charges,82.6% of total billed charges,683.93,82.6,,,percent of total billed charges,82.6% of total billed charges,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.03,28069.2,
COLONOSCOPY ABLATION TUMOR POLYP LESION,76145388,CDM,975,RC,45388,HCPCS,Outpatient,,,1200,780.00,,1056,88,,,percent of total billed charges,88% of total Billed charges,24.31,100,,,Fee Schedule,100% of Medicare rate,150.88,100,,,Fee Schedule,100% of WA Medicaid,1200,100,,,percent of total billed charges,100% of total billed charges,155.41,103,,,Fee Schedule,103% of WA Medicaid,24.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,150.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,828,69,,,percent of total billed charges,69% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,742.2,61.85,,,percent of total billed charges,61.85% of total billed charges,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.14,130,,,Fee Schedule,130% of WA Medicaid ,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,40680,33.9,,,percent of total billed charges,33.9% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,936,78,,,percent of total billed charges,78% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.31,40680,
COLONOSCOPY SUB INJ SURG,76145381,CDM,975,RC,45381,HCPCS,Outpatient,,,1035,672.75,,910.8,88,,,percent of total billed charges,88% of total Billed charges,17.33,100,,,Fee Schedule,100% of Medicare rate,112.09,100,,,Fee Schedule,100% of WA Medicaid,1035,100,,,percent of total billed charges,100% of total billed charges,115.45,103,,,Fee Schedule,103% of WA Medicaid,17.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,714.15,69,,,percent of total billed charges,69% of total billed charges,1035,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.15,61.85,,,percent of total billed charges,61.85% of total billed charges,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.72,130,,,Fee Schedule,130% of WA Medicaid ,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.2,37.7,,,percent of total billed charges,37.70% of total billed charges,390.2,37.7,,,percent of total billed charges,37.70% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,35086.5,33.9,,,percent of total billed charges,33.9% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,807.3,78,,,percent of total billed charges,78% of total billed charges,1035,100,,,percent of total billed charges,100% of total billed charges,854.91,82.6,,,percent of total billed charges,82.6% of total billed charges,854.91,82.6,,,percent of total billed charges,82.6% of total billed charges,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.33,35086.5,
"COLONOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC BALLOON DILATIO",76145386,CDM,975,RC,45386,HCPCS,Outpatient,,,717,466.05,,630.96,88,,,percent of total billed charges,88% of total Billed charges,18.71,100,,,Fee Schedule,100% of Medicare rate,118.43,100,,,Fee Schedule,100% of WA Medicaid,717,100,,,percent of total billed charges,100% of total billed charges,121.98,103,,,Fee Schedule,103% of WA Medicaid,18.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,118.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,494.73,69,,,percent of total billed charges,69% of total billed charges,717,100,,,percent of total billed charges,100% of total billed charges,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,717,100,,,percent of total billed charges,100% of total billed charges,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,717,100,,,percent of total billed charges,100% of total billed charges,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.46,61.85,,,percent of total billed charges,61.85% of total billed charges,118.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,153.96,130,,,Fee Schedule,130% of WA Medicaid ,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.31,37.7,,,percent of total billed charges,37.70% of total billed charges,270.31,37.7,,,percent of total billed charges,37.70% of total billed charges,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,24306.3,33.9,,,percent of total billed charges,33.9% of total billed charges,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,559.26,78,,,percent of total billed charges,78% of total billed charges,717,100,,,percent of total billed charges,100% of total billed charges,592.24,82.6,,,percent of total billed charges,82.6% of total billed charges,592.24,82.6,,,percent of total billed charges,82.6% of total billed charges,118.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.71,24306.3,
COLONOSCOPY W/BX SURG,76145380,CDM,975,RC,45380,HCPCS,Outpatient,,,991,644.15,,872.08,88,,,percent of total billed charges,88% of total Billed charges,17.34,100,,,Fee Schedule,100% of Medicare rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,991,100,,,percent of total billed charges,100% of total billed charges,115.64,103,,,Fee Schedule,103% of WA Medicaid,17.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,683.79,69,,,percent of total billed charges,69% of total billed charges,991,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,991,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,991,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.93,61.85,,,percent of total billed charges,61.85% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.95,130,,,Fee Schedule,130% of WA Medicaid ,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.61,37.7,,,percent of total billed charges,37.70% of total billed charges,373.61,37.7,,,percent of total billed charges,37.70% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,33594.9,33.9,,,percent of total billed charges,33.9% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,772.98,78,,,percent of total billed charges,78% of total billed charges,991,100,,,percent of total billed charges,100% of total billed charges,818.57,82.6,,,percent of total billed charges,82.6% of total billed charges,818.57,82.6,,,percent of total billed charges,82.6% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.34,33594.9,
"45389 Colonoscopy, flexible; with endoscopic stent placement",75045389,CDM,975,RC,45389,HCPCS,Outpatient,,,1002,651.30,,881.76,88,,,percent of total billed charges,88% of total Billed charges,24.88,100,,,Fee Schedule,100% of Medicare rate,161.7,100,,,Fee Schedule,100% of WA Medicaid,1002,100,,,percent of total billed charges,100% of total billed charges,166.55,103,,,Fee Schedule,103% of WA Medicaid,24.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,161.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,691.38,69,,,percent of total billed charges,69% of total billed charges,1002,100,,,percent of total billed charges,100% of total billed charges,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1002,100,,,percent of total billed charges,100% of total billed charges,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1002,100,,,percent of total billed charges,100% of total billed charges,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,619.74,61.85,,,percent of total billed charges,61.85% of total billed charges,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.21,130,,,Fee Schedule,130% of WA Medicaid ,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.75,37.7,,,percent of total billed charges,37.70% of total billed charges,377.75,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,33967.8,33.9,,,percent of total billed charges,33.9% of total billed charges,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,781.56,78,,,percent of total billed charges,78% of total billed charges,1002,100,,,percent of total billed charges,100% of total billed charges,827.65,82.6,,,percent of total billed charges,82.6% of total billed charges,827.65,82.6,,,percent of total billed charges,82.6% of total billed charges,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.88,33967.8,
"45398 Colonoscopy, flexible; with band ligation(s) (eg, hemo",75045398,CDM,975,RC,45398,HCPCS,Outpatient,,,813,528.45,,715.44,88,,,percent of total billed charges,88% of total Billed charges,23.27,100,,,Fee Schedule,100% of Medicare rate,131.11,100,,,Fee Schedule,100% of WA Medicaid,813,100,,,percent of total billed charges,100% of total billed charges,135.04,103,,,Fee Schedule,103% of WA Medicaid,23.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,131.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,560.97,69,,,percent of total billed charges,69% of total billed charges,813,100,,,percent of total billed charges,100% of total billed charges,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,813,100,,,percent of total billed charges,100% of total billed charges,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,813,100,,,percent of total billed charges,100% of total billed charges,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.84,61.85,,,percent of total billed charges,61.85% of total billed charges,131.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,170.44,130,,,Fee Schedule,130% of WA Medicaid ,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.5,37.7,,,percent of total billed charges,37.70% of total billed charges,306.5,37.7,,,percent of total billed charges,37.70% of total billed charges,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,27560.7,33.9,,,percent of total billed charges,33.9% of total billed charges,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.14,78,,,percent of total billed charges,78% of total billed charges,813,100,,,percent of total billed charges,100% of total billed charges,671.54,82.6,,,percent of total billed charges,82.6% of total billed charges,671.54,82.6,,,percent of total billed charges,82.6% of total billed charges,131.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.27,27560.7,
Abdominal Paracentesis Diagnostic/Therapeutic W/Imaging,76149083,CDM,975,RC,49083,HCPCS,Outpatient,,,773,502.45,,680.24,88,,,percent of total billed charges,88% of total Billed charges,8.32,100,,,Fee Schedule,100% of Medicare rate,59.12,100,,,Fee Schedule,100% of WA Medicaid,773,100,,,percent of total billed charges,100% of total billed charges,60.89,103,,,Fee Schedule,103% of WA Medicaid,8.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,533.37,69,,,percent of total billed charges,69% of total billed charges,773,100,,,percent of total billed charges,100% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,773,100,,,percent of total billed charges,100% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,773,100,,,percent of total billed charges,100% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.1,61.85,,,percent of total billed charges,61.85% of total billed charges,59.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.86,130,,,Fee Schedule,130% of WA Medicaid ,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.42,37.7,,,percent of total billed charges,37.70% of total billed charges,291.42,37.7,,,percent of total billed charges,37.70% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,26204.7,33.9,,,percent of total billed charges,33.9% of total billed charges,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.94,78,,,percent of total billed charges,78% of total billed charges,773,100,,,percent of total billed charges,100% of total billed charges,638.5,82.6,,,percent of total billed charges,82.6% of total billed charges,638.5,82.6,,,percent of total billed charges,82.6% of total billed charges,59.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.32,26204.7,
"Peritoneal lavage, including imaging guidance, when performe",76149084,CDM,975,RC,49084,HCPCS,Outpatient,,,191,124.15,,168.08,88,,,percent of total billed charges,88% of total Billed charges,14.79,100,,,Fee Schedule,100% of Medicare rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,191,100,,,percent of total billed charges,100% of total billed charges,60.7,103,,,Fee Schedule,103% of WA Medicaid,14.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,131.79,69,,,percent of total billed charges,69% of total billed charges,191,100,,,percent of total billed charges,100% of total billed charges,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,191,100,,,percent of total billed charges,100% of total billed charges,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,191,100,,,percent of total billed charges,100% of total billed charges,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.13,61.85,,,percent of total billed charges,61.85% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.61,130,,,Fee Schedule,130% of WA Medicaid ,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.01,37.7,,,percent of total billed charges,37.70% of total billed charges,72.01,37.7,,,percent of total billed charges,37.70% of total billed charges,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,6474.9,33.9,,,percent of total billed charges,33.9% of total billed charges,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.98,78,,,percent of total billed charges,78% of total billed charges,191,100,,,percent of total billed charges,100% of total billed charges,157.77,82.6,,,percent of total billed charges,82.6% of total billed charges,157.77,82.6,,,percent of total billed charges,82.6% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.79,6474.9,
ABD PARACENTESIS W/O IMAGING CHARGE,76149082,CDM,975,RC,49082,HCPCS,Outpatient,,,152,98.80,,133.76,88,,,percent of total billed charges,88% of total Billed charges,7.11,100,,,Fee Schedule,100% of Medicare rate,41.22,100,,,Fee Schedule,100% of WA Medicaid,152,100,,,percent of total billed charges,100% of total billed charges,42.46,103,,,Fee Schedule,103% of WA Medicaid,7.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,41.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,104.88,69,,,percent of total billed charges,69% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,152,100,,,percent of total billed charges,100% of total billed charges,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,152,100,,,percent of total billed charges,100% of total billed charges,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.01,61.85,,,percent of total billed charges,61.85% of total billed charges,41.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.59,130,,,Fee Schedule,130% of WA Medicaid ,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.3,37.7,,,percent of total billed charges,37.70% of total billed charges,57.3,37.7,,,percent of total billed charges,37.70% of total billed charges,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,5152.8,33.9,,,percent of total billed charges,33.9% of total billed charges,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.56,78,,,percent of total billed charges,78% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,41.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.11,5152.8,
COLONOSCOPY-DX HIGH RISK,750G0105,CDM,975,RC,,,Outpatient,,,555,360.75,,488.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,382.95,69,,,percent of total billed charges,69% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,343.27,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,18814.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,432.9,78,,,percent of total billed charges,78% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",209.24,18814.5,
750G0121,750G0121,CDM,975,RC,,,Outpatient,,,552,358.80,,485.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,380.88,69,,,percent of total billed charges,69% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,341.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,18712.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,430.56,78,,,percent of total billed charges,78% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",208.1,18712.8,
0001A- Pfizer-Biontech Covid-19 Vaccine - 1st Dose,0001A,CDM,510,RC,0001A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,162.5,
0011A- Moderna Covid-19 Vaccine - 1st Dose,0011A,CDM,771,RC,0011A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,162.5,
Moderna Covid-19 Vaccine - 2nd Dose,0012A,CDM,771,RC,0012A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,162.5,
0031A Janssen Covid-19 Vaccine Administration Charge,0031A,CDM,510,RC,0031A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,162.5,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,162.5,
0064A- Moderna Covid-19 Vaccine - Booster Dose,0064A,CDM,771,RC,0064A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,37.7,,,percent of total billed charges,37.70% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,40.68,33.9,,,percent of total billed charges,33.9% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,120,
0071A- Pfizer-Biontech Covid-19 Pediatric Vaccine - 1st Dose,0071A,CDM,510,RC,0071A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,120,
0072A- Pfizer-Biontech Covid-19 Pediatric Vaccine - 2nd Dose,0072A,CDM,510,RC,0072A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,120,
0074A- Pfizer-Biontech Covid-19 Pediatric Vaccine - Booster,0074A,CDM,510,RC,0074A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,120,
0081A- Pfizer-Biontech Covid-19 Pediatric (6m-4y) Vaccine Ad,0081A,CDM,510,RC,0081A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,120,
0082A- Pfizer-Biontech Covid-19 Pediatric (6m-4y) Vaccine Ad,0082A,CDM,510,RC,0082A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,120,
0124A - Pfizer-Biontech Covid-19 Bivalent Booster Administra,0124A,CDM,510,RC,0124A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,120,
0134A - Moderna Covid-19 Bivalent Booster Administration Cha,0134A,CDM,510,RC,0134A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,120,
0154A -  Pfizer-Biontech Covid-19 Pediatric Vaccine- Bivalen,0154A,CDM,510,RC,0154A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,120,
0173A - Pfizer-Biontech Covid-19 Pediatric Vaccine- Bivalent,0173A,CDM,510,RC,0173A,HCPCS,Outpatient,,,120,78.00,,105.6,88,,,percent of total billed charges,88% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,120,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,60,50,,,percent of total billed charges,50% of total Billed charges,75.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,18.36,15.3,,,percent of total billed charges,15.3% of total billed charges,82.8,69,,,percent of total billed charges,69% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,120,100,,,percent of total billed charges,100% of total billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,74.22,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,60,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,93.6,78,,,percent of total billed charges,78% of total billed charges,120,100,,,percent of total billed charges,100% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,99.12,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,60,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.36,120,
RSV MAB IM 50MG,90378,CDM,510,RC,90378,HCPCS,Outpatient,,,1099,714.35,,967.12,88,,,percent of total billed charges,88% of total Billed charges,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1011.48,100,,,Fee Schedule,100% of WA Medicaid,1099,100,,,percent of total billed charges,100% of total billed charges,1041.83,103,,,Fee Schedule,103% of WA Medicaid,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,692.37,63,,,percent of total billed charges,63% of total billed charges,594.44,175,,,Fee Schedule,175% of Medicare OPPS Rate,1011.48,100,,,Fee Schedule,100% of WA Medicaid,168.15,15.3,,,percent of total billed charges,15.3% of total billed charges,758.31,69,,,percent of total billed charges,69% of total billed charges,1099,100,,,percent of total billed charges,100% of total billed charges,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1099,100,,,percent of total billed charges,100% of total billed charges,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1099,100,,,percent of total billed charges,100% of total billed charges,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,4535.18,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,1011.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1092.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1031.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1314.93,130,,,Fee Schedule,130% of WA Medicaid ,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,857.22,78,,,percent of total billed charges,78% of total billed charges,1099,100,,,percent of total billed charges,100% of total billed charges,907.77,82.6,,,percent of total billed charges,82.6% of total billed charges,907.77,82.6,,,percent of total billed charges,82.6% of total billed charges,1011.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,343.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,339.68,100,,,Fee Schedule,100% of Medicare OPPS rate,1011.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,168.15,4535.18,
IMMUNIZATION ADMIN,90471,CDM,510,RC,90471,HCPCS,Outpatient,,,42.76,27.79,,37.63,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,42.76,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,26.94,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,6.54,15.3,,,percent of total billed charges,15.3% of total billed charges,29.5,69,,,percent of total billed charges,69% of total billed charges,42.76,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,42.76,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,42.76,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,78,,,percent of total billed charges,78% of total billed charges,42.76,100,,,percent of total billed charges,100% of total billed charges,35.32,82.6,,,percent of total billed charges,82.6% of total billed charges,35.32,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.54,251.75,
IMMUNE ADMIN ORAL/NASAL ADDL,90474,CDM,510,RC,90474,HCPCS,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,19,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.97,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,2.91,15.3,,,percent of total billed charges,15.3% of total billed charges,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,19,100,,,percent of total billed charges,100% of total billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.5,50,,,percent of total billed charges,50% of total Billed charges,9.5,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.5,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.91,45.03,
IMMUNIZATION ADMIN EACH ADD,90472,CDM,510,RC,90472,HCPCS,Outpatient,,,21.09,13.71,,18.56,88,,,percent of total billed charges,88% of total Billed charges,10.55,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid,21.09,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,10.55,50,,,percent of total billed charges,50% of total Billed charges,13.29,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,100,,,Fee Schedule,100% of WA Medicaid,3.23,15.3,,,percent of total billed charges,15.3% of total billed charges,14.55,69,,,percent of total billed charges,69% of total billed charges,21.09,100,,,percent of total billed charges,100% of total billed charges,10.55,50,,,percent of total billed charges,50% of total Billed charges,21.09,100,,,percent of total billed charges,100% of total billed charges,10.55,50,,,percent of total billed charges,50% of total Billed charges,21.09,100,,,percent of total billed charges,100% of total billed charges,10.55,50,,,percent of total billed charges,50% of total Billed charges,13.04,61.85,,,percent of total billed charges,61.85% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.55,50,,,percent of total billed charges,50% of total Billed charges,10.55,50,,,percent of total billed charges,50% of total Billed charges,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.55,50,,,percent of total billed charges,50% of total Billed charges,10.55,50,,,percent of total billed charges,50% of total Billed charges,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,10.55,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.55,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.55,50,,,percent of total billed charges,50% of total Billed charges,16.45,78,,,percent of total billed charges,78% of total billed charges,21.09,100,,,percent of total billed charges,100% of total billed charges,17.42,82.6,,,percent of total billed charges,82.6% of total billed charges,17.42,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.55,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.55,50,,,percent of total billed charges,50% of total Billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.23,45.03,
IMMUNE ADMIN ORAL/NASAL,90473,CDM,510,RC,90473,HCPCS,Outpatient,,,67,43.55,,58.96,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,67,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,42.21,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,10.25,15.3,,,percent of total billed charges,15.3% of total billed charges,46.23,69,,,percent of total billed charges,69% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,67,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,67,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,52.26,78,,,percent of total billed charges,78% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.25,251.75,
90471 Administration flu vaccine,90471,CDM,510,RC,90471,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,45,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,28.35,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,45,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,45,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.89,251.75,
90471 Administration pneumococcal vaccine,90471,CDM,510,RC,90471,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,45,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,28.35,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,45,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,45,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.89,251.75,
HEP A VACCINE ADULT IM,90632,CDM,510,RC,90632,HCPCS,Outpatient,,,67.34,43.77,,59.26,88,,,percent of total billed charges,88% of total Billed charges,33.67,50,,,percent of total billed charges,50% of total Billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid,67.34,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,33.67,50,,,percent of total billed charges,50% of total Billed charges,42.42,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,10.3,15.3,,,percent of total billed charges,15.3% of total billed charges,46.46,69,,,percent of total billed charges,69% of total billed charges,67.34,100,,,percent of total billed charges,100% of total billed charges,33.67,50,,,percent of total billed charges,50% of total Billed charges,67.34,100,,,percent of total billed charges,100% of total billed charges,33.67,50,,,percent of total billed charges,50% of total Billed charges,67.34,100,,,percent of total billed charges,100% of total billed charges,33.67,50,,,percent of total billed charges,50% of total Billed charges,41.65,61.85,,,percent of total billed charges,61.85% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.67,50,,,percent of total billed charges,50% of total Billed charges,33.67,50,,,percent of total billed charges,50% of total Billed charges,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.67,50,,,percent of total billed charges,50% of total Billed charges,33.67,50,,,percent of total billed charges,50% of total Billed charges,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,33.67,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.67,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,33.67,50,,,percent of total billed charges,50% of total Billed charges,52.53,78,,,percent of total billed charges,78% of total billed charges,67.34,100,,,percent of total billed charges,100% of total billed charges,55.62,82.6,,,percent of total billed charges,82.6% of total billed charges,55.62,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.67,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,33.67,50,,,percent of total billed charges,50% of total Billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.3,67.34,
HEP A VACC PED/ADOL 2 DOSE,90633,CDM,510,RC,90633,HCPCS,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid,35,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,17.5,50,,,percent of total billed charges,50% of total Billed charges,22.05,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,5.36,15.3,,,percent of total billed charges,15.3% of total billed charges,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,35,100,,,percent of total billed charges,100% of total billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.5,50,,,percent of total billed charges,50% of total Billed charges,17.5,50,,,percent of total billed charges,50% of total Billed charges,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,17.5,50,,,percent of total billed charges,50% of total Billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.36,35,
HEP A/HEP B VACC ADULT IM,90636,CDM,510,RC,90636,HCPCS,Outpatient,,,142,92.30,,124.96,88,,,percent of total billed charges,88% of total Billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,101.83,103,,,Fee Schedule,103% of WA Medicaid,71,50,,,percent of total billed charges,50% of total Billed charges,89.46,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,21.73,15.3,,,percent of total billed charges,15.3% of total billed charges,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,142,100,,,percent of total billed charges,100% of total billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,142,100,,,percent of total billed charges,100% of total billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,87.83,61.85,,,percent of total billed charges,61.85% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71,50,,,percent of total billed charges,50% of total Billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,73.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71,50,,,percent of total billed charges,50% of total Billed charges,71,50,,,percent of total billed charges,50% of total Billed charges,100.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.53,130,,,Fee Schedule,130% of WA Medicaid ,71,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,71,50,,,percent of total billed charges,50% of total Billed charges,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,71,50,,,percent of total billed charges,50% of total Billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.73,142,
HIB VACCINE PRP-OMP IM,90647,CDM,510,RC,90647,HCPCS,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid,22,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.37,31.69,
HIB VACCINE PRP-T IM,90648,CDM,510,RC,90648,HCPCS,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.59,31.69,
90651 Human Papilloma virus (HPV) vaccine,90651,CDM,510,RC,90651,HCPCS,Outpatient,,,373,242.45,,328.24,88,,,percent of total billed charges,88% of total Billed charges,186.5,50,,,percent of total billed charges,50% of total Billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid,373,100,,,percent of total billed charges,100% of total billed charges,101.83,103,,,Fee Schedule,103% of WA Medicaid,186.5,50,,,percent of total billed charges,50% of total Billed charges,234.99,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,57.07,15.3,,,percent of total billed charges,15.3% of total billed charges,257.37,69,,,percent of total billed charges,69% of total billed charges,373,100,,,percent of total billed charges,100% of total billed charges,186.5,50,,,percent of total billed charges,50% of total Billed charges,373,100,,,percent of total billed charges,100% of total billed charges,186.5,50,,,percent of total billed charges,50% of total Billed charges,373,100,,,percent of total billed charges,100% of total billed charges,186.5,50,,,percent of total billed charges,50% of total Billed charges,230.7,61.85,,,percent of total billed charges,61.85% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.5,50,,,percent of total billed charges,50% of total Billed charges,186.5,50,,,percent of total billed charges,50% of total Billed charges,73.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,186.5,50,,,percent of total billed charges,50% of total Billed charges,186.5,50,,,percent of total billed charges,50% of total Billed charges,100.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.53,130,,,Fee Schedule,130% of WA Medicaid ,186.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,186.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,186.5,50,,,percent of total billed charges,50% of total Billed charges,290.94,78,,,percent of total billed charges,78% of total billed charges,373,100,,,percent of total billed charges,100% of total billed charges,308.1,82.6,,,percent of total billed charges,82.6% of total billed charges,308.1,82.6,,,percent of total billed charges,82.6% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,186.5,50,,,percent of total billed charges,50% of total Billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.07,373,
FLU VAC NO PRSV 3 VAL 6-35 M,90655,CDM,983,RC,90655,HCPCS,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,20,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,20,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.54,37.7,,,percent of total billed charges,37.70% of total billed charges,7.54,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,678,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",7.54,678,
"GLOVE, EXAM MEDIUM NITRILE",90658,CDM,510,RC,90658,HCPCS,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid,18,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,9,50,,,percent of total billed charges,50% of total Billed charges,11.34,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18,100,,,percent of total billed charges,100% of total billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9,50,,,percent of total billed charges,50% of total Billed charges,9,50,,,percent of total billed charges,50% of total Billed charges,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9,50,,,percent of total billed charges,50% of total Billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.75,31.69,
PNEUMOCOCCAL VACC 13 VAL IM,90670,CDM,510,RC,90670,HCPCS,Outpatient,,,170,110.50,,149.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,170,100,,,percent of total billed charges,100% of total billed charges,101.83,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,107.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,26.01,15.3,,,percent of total billed charges,15.3% of total billed charges,117.3,69,,,percent of total billed charges,69% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,170,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,132.6,78,,,percent of total billed charges,78% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.01,170,
RABIES VACCINE IM,90675,CDM,510,RC,90675,HCPCS,Outpatient,,,268.78,174.71,,236.53,88,,,percent of total billed charges,88% of total Billed charges,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,98.87,100,,,Fee Schedule,100% of WA Medicaid,268.78,100,,,percent of total billed charges,100% of total billed charges,101.83,103,,,Fee Schedule,103% of WA Medicaid,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,169.33,63,,,percent of total billed charges,63% of total billed charges,564.84,175,,,Fee Schedule,175% of Medicare OPPS Rate,98.87,100,,,Fee Schedule,100% of WA Medicaid,41.12,15.3,,,percent of total billed charges,15.3% of total billed charges,185.46,69,,,percent of total billed charges,69% of total billed charges,268.78,100,,,percent of total billed charges,100% of total billed charges,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,268.78,100,,,percent of total billed charges,100% of total billed charges,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,268.78,100,,,percent of total billed charges,100% of total billed charges,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,1249.28,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,73.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,100.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.53,130,,,Fee Schedule,130% of WA Medicaid ,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,209.65,78,,,percent of total billed charges,78% of total billed charges,268.78,100,,,percent of total billed charges,100% of total billed charges,222.01,82.6,,,percent of total billed charges,82.6% of total billed charges,222.01,82.6,,,percent of total billed charges,82.6% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,325.99,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,322.77,100,,,Fee Schedule,100% of Medicare OPPS rate,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.12,1249.28,
PNEUMOCOCCAL VACC 20 VALENT (PCV20),90677,CDM,510,RC,90677,HCPCS,Outpatient,,,770,500.50,,677.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,770,100,,,percent of total billed charges,100% of total billed charges,101.83,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,485.1,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,117.81,15.3,,,percent of total billed charges,15.3% of total billed charges,531.3,69,,,percent of total billed charges,69% of total billed charges,770,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,770,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,770,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,600.6,78,,,percent of total billed charges,78% of total billed charges,770,100,,,percent of total billed charges,100% of total billed charges,636.02,82.6,,,percent of total billed charges,82.6% of total billed charges,636.02,82.6,,,percent of total billed charges,82.6% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.23,770,
ROTOVIRUS VACC 3 DOSE ORAL,90680,CDM,510,RC,90680,HCPCS,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,101.83,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,60.48,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,96,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,96,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.69,128.53,
FLU VACC 4 VAL 3 YRS PLUS IM,90688,CDM,510,RC,90688,HCPCS,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,24.38,100,,,Fee Schedule,100% of WA Medicaid,25,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,15.75,63,,,percent of total billed charges,63% of total billed charges,36.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.38,100,,,Fee Schedule,100% of WA Medicaid,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,25,100,,,percent of total billed charges,100% of total billed charges,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,25,100,,,percent of total billed charges,100% of total billed charges,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,73.33,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,21.09,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,20.88,100,,,Fee Schedule,100% of Medicare OPPS rate,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.83,73.33,
DTAP-IPV VACC 4-6 YR IM,90696,CDM,510,RC,90696,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,94,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,59.22,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,14.38,15.3,,,percent of total billed charges,15.3% of total billed charges,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,94,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,94,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.38,94,
DTAP-HIB-IP VACCINE IM,90698,CDM,510,RC,90698,HCPCS,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,60.48,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,96,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,96,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.69,96,
TYPHOID VACCINE IM,90691,CDM,510,RC,90691,HCPCS,Outpatient,,,60,39.00,,52.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,60,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,37.8,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,9.18,15.3,,,percent of total billed charges,15.3% of total billed charges,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,60,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,60,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.18,60,
DTAP VACCINE < 7 YRS IM,90700,CDM,510,RC,90700,HCPCS,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,33,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,20.79,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,33,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,33,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.05,33,
MMR VACCINE SC,90707,CDM,510,RC,90707,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,15.3,15.3,,,percent of total billed charges,15.3% of total billed charges,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,100,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,100,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.3,100,
MMRV VACCINE SC,90710,CDM,510,RC,90710,HCPCS,Outpatient,,,160,104.00,,140.8,88,,,percent of total billed charges,88% of total Billed charges,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,24.38,100,,,Fee Schedule,100% of WA Medicaid,160,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,100.8,63,,,percent of total billed charges,63% of total billed charges,248.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.38,100,,,Fee Schedule,100% of WA Medicaid,24.48,15.3,,,percent of total billed charges,15.3% of total billed charges,110.4,69,,,percent of total billed charges,69% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,160,100,,,percent of total billed charges,100% of total billed charges,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,124.8,78,,,percent of total billed charges,78% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,143.44,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,142.04,100,,,Fee Schedule,100% of Medicare OPPS rate,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.06,248.57,
POLIOVIRUS IPV SC/IM,90713,CDM,510,RC,90713,HCPCS,Outpatient,,,38,24.70,,33.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,38,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,23.94,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,5.81,15.3,,,percent of total billed charges,15.3% of total billed charges,26.22,69,,,percent of total billed charges,69% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,38,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,38,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.64,78,,,percent of total billed charges,78% of total billed charges,38,100,,,percent of total billed charges,100% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,31.39,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.81,38,
TD VACCINE NO PRSRV 7/> IM,90714,CDM,510,RC,90714,HCPCS,Outpatient,,,21.22,13.79,,18.67,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,21.22,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,13.37,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,3.25,15.3,,,percent of total billed charges,15.3% of total billed charges,14.64,69,,,percent of total billed charges,69% of total billed charges,21.22,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,21.22,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,21.22,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.55,78,,,percent of total billed charges,78% of total billed charges,21.22,100,,,percent of total billed charges,100% of total billed charges,17.53,82.6,,,percent of total billed charges,82.6% of total billed charges,17.53,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,31.69,
TDAP VACCINE 7 YRS/> IM,90715,CDM,510,RC,90715,HCPCS,Outpatient,,,41.91,27.24,,36.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,41.91,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,26.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,6.41,15.3,,,percent of total billed charges,15.3% of total billed charges,28.92,69,,,percent of total billed charges,69% of total billed charges,41.91,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,41.91,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,41.91,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.69,78,,,percent of total billed charges,78% of total billed charges,41.91,100,,,percent of total billed charges,100% of total billed charges,34.62,82.6,,,percent of total billed charges,82.6% of total billed charges,34.62,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.41,41.91,
CHICKEN POX VACCINE SC,90716,CDM,510,RC,90716,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,101.83,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,113.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,27.54,15.3,,,percent of total billed charges,15.3% of total billed charges,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,180,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,180,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.54,180,
YELLOW FEVER VACCINE SC,90717,CDM,510,RC,90717,HCPCS,Outpatient,,,117,76.05,,102.96,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,117,100,,,percent of total billed charges,100% of total billed charges,101.83,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,73.71,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,17.9,15.3,,,percent of total billed charges,15.3% of total billed charges,80.73,69,,,percent of total billed charges,69% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,117,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,117,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,91.26,78,,,percent of total billed charges,78% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.9,128.53,
DTAP-HEP B-IPV VACCINE IM,90723,CDM,510,RC,90723,HCPCS,Outpatient,,,95,61.75,,83.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,95,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,59.85,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,14.54,15.3,,,percent of total billed charges,15.3% of total billed charges,65.55,69,,,percent of total billed charges,69% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,95,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,95,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,74.1,78,,,percent of total billed charges,78% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.54,95,
MENINGOCOCCAL VACCINE IM,90734,CDM,510,RC,90734,HCPCS,Outpatient,,,136,88.40,,119.68,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,136,100,,,percent of total billed charges,100% of total billed charges,101.83,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,85.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,20.81,15.3,,,percent of total billed charges,15.3% of total billed charges,93.84,69,,,percent of total billed charges,69% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,136,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,136,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,106.08,78,,,percent of total billed charges,78% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.81,136,
PNEUMOCOCCAL VACC 23 VAL IM,90732,CDM,510,RC,90732,HCPCS,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,200,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,126,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,30.6,15.3,,,percent of total billed charges,15.3% of total billed charges,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.06,200,
ZOSTER VACC SC,90736,CDM,510,RC,90736,HCPCS,Outpatient,,,276,179.40,,242.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,276,100,,,percent of total billed charges,100% of total billed charges,101.83,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,173.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,42.23,15.3,,,percent of total billed charges,15.3% of total billed charges,190.44,69,,,percent of total billed charges,69% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,276,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,276,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,215.28,78,,,percent of total billed charges,78% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.23,276,
HEP B VACC ADULT 3 DOSE IM,90746,CDM,510,RC,90746,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,52.29,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,12.7,15.3,,,percent of total billed charges,15.3% of total billed charges,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,83,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,83,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,44.61,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.7,83,
HEPB VACC PED/ADOL 3 DOSE IM,90744,CDM,510,RC,90744,HCPCS,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,30,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,30,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,16.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.59,31.69,
Zoster (Shingrix) vaccine,90750,CDM,510,RC,90750,HCPCS,Outpatient,,,288,187.20,,253.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,288,100,,,percent of total billed charges,100% of total billed charges,101.83,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,181.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid,44.06,15.3,,,percent of total billed charges,15.3% of total billed charges,198.72,69,,,percent of total billed charges,69% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,288,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,288,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,100.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,224.64,78,,,percent of total billed charges,78% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,98.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.06,288,
ADMIN INFLUENZA VIRUS VAC,G0008,CDM,510,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
ADMIN PNEUMOCOCCAL VACCINE,G0009,CDM,510,RC,,,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,7.79,17.304,,,percent of total billed charges,17.304% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,28.35,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,15.3,,,percent of total billed charges,15.3% of total billed charges,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,45,100,,,percent of total billed charges,100% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.71,17.136,,,percent of total billed charges,17.136% of total billed charges,9.83,21.84,,,percent of total billed charges,21.84% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,22.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,22.5,50,,,percent of total billed charges,50% of total Billed charges,7.56,16.8,,,percent of total billed charges,16.8% of total billed charges,6.89,45,
G0010 Administration of hepatitis b vaccine,G0010,CDM,771,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,8.48,33.9,,,percent of total billed charges,33.9% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
FLU VACCINE 4 VALENT NASAL,90672,CDM,510,RC,90672,HCPCS,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,24.38,100,,,Fee Schedule,100% of WA Medicaid,62,100,,,percent of total billed charges,100% of total billed charges,25.11,103,,,Fee Schedule,103% of WA Medicaid,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,39.06,63,,,percent of total billed charges,63% of total billed charges,48.63,175,,,Fee Schedule,175% of Medicare OPPS Rate,24.38,100,,,Fee Schedule,100% of WA Medicaid,9.49,15.3,,,percent of total billed charges,15.3% of total billed charges,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,62,100,,,percent of total billed charges,100% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,62,100,,,percent of total billed charges,100% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,102.82,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,18.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,24.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.69,130,,,Fee Schedule,130% of WA Medicaid ,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,28.07,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,27.79,100,,,Fee Schedule,100% of Medicare OPPS rate,24.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.49,102.82,
LUMBAR SPINE PROCES DISTRACT,22867,CDM,983,RC,22867,HCPCS,Outpatient,,,3716,2415.40,,3270.08,88,,,percent of total billed charges,88% of total Billed charges,154.27,100,,,Fee Schedule,100% of Medicare rate,608.92,100,,,Fee Schedule,100% of WA Medicaid,3716,100,,,percent of total billed charges,100% of total billed charges,627.19,103,,,Fee Schedule,103% of WA Medicaid,154.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,269.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,608.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2564.04,69,,,percent of total billed charges,69% of total billed charges,3716,100,,,percent of total billed charges,100% of total billed charges,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3716,100,,,percent of total billed charges,100% of total billed charges,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3716,100,,,percent of total billed charges,100% of total billed charges,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2298.35,61.85,,,percent of total billed charges,61.85% of total billed charges,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,791.6,130,,,Fee Schedule,130% of WA Medicaid ,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1400.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1400.93,37.7,,,percent of total billed charges,37.70% of total billed charges,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,125972.4,33.9,,,percent of total billed charges,33.9% of total billed charges,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2898.48,78,,,percent of total billed charges,78% of total billed charges,3716,100,,,percent of total billed charges,100% of total billed charges,3069.42,82.6,,,percent of total billed charges,82.6% of total billed charges,3069.42,82.6,,,percent of total billed charges,82.6% of total billed charges,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,154.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,154.27,125972.4,
LUMBAR SPINE PROCESS ADDL,22868,CDM,983,RC,22868,HCPCS,Outpatient,,,760,494.00,,668.8,88,,,percent of total billed charges,88% of total Billed charges,40.55,100,,,Fee Schedule,100% of Medicare rate,133.91,100,,,Fee Schedule,100% of WA Medicaid,760,100,,,percent of total billed charges,100% of total billed charges,137.93,103,,,Fee Schedule,103% of WA Medicaid,40.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,133.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,524.4,69,,,percent of total billed charges,69% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,760,100,,,percent of total billed charges,100% of total billed charges,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,760,100,,,percent of total billed charges,100% of total billed charges,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.06,61.85,,,percent of total billed charges,61.85% of total billed charges,133.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.08,130,,,Fee Schedule,130% of WA Medicaid ,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,25764,33.9,,,percent of total billed charges,33.9% of total billed charges,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,592.8,78,,,percent of total billed charges,78% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,133.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.55,25764,
PERQ SACRAL AUGMT BILAT INJ,0201T,CDM,983,RC,0201T,HCPCS,Outpatient,,,1651,1073.15,,1452.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1651,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1139.19,69,,,percent of total billed charges,69% of total billed charges,1651,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1651,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1651,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1021.14,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,622.43,37.7,,,percent of total billed charges,37.70% of total billed charges,622.43,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,55968.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1287.78,78,,,percent of total billed charges,78% of total billed charges,1651,100,,,percent of total billed charges,100% of total billed charges,1363.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1363.73,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",622.43,55968.9,
FNA W/O IMAGE,10021,CDM,983,RC,10021,HCPCS,Outpatient,,,310,201.50,,272.8,88,,,percent of total billed charges,88% of total Billed charges,5.26,100,,,Fee Schedule,100% of Medicare rate,30.77,100,,,Fee Schedule,100% of WA Medicaid,310,100,,,percent of total billed charges,100% of total billed charges,31.69,103,,,Fee Schedule,103% of WA Medicaid,5.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,213.9,69,,,percent of total billed charges,69% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,310,100,,,percent of total billed charges,100% of total billed charges,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,310,100,,,percent of total billed charges,100% of total billed charges,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.74,61.85,,,percent of total billed charges,61.85% of total billed charges,30.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40,130,,,Fee Schedule,130% of WA Medicaid ,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,116.87,37.7,,,percent of total billed charges,37.70% of total billed charges,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,10509,33.9,,,percent of total billed charges,33.9% of total billed charges,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.8,78,,,percent of total billed charges,78% of total billed charges,310,100,,,percent of total billed charges,100% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,256.06,82.6,,,percent of total billed charges,82.6% of total billed charges,30.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.26,10509,
ACNE SURGERY,10040,CDM,983,RC,10040,HCPCS,Outpatient,,,159,103.35,,139.92,88,,,percent of total billed charges,88% of total Billed charges,4.15,100,,,Fee Schedule,100% of Medicare rate,29.47,100,,,Fee Schedule,100% of WA Medicaid,159,100,,,percent of total billed charges,100% of total billed charges,30.35,103,,,Fee Schedule,103% of WA Medicaid,4.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,109.71,69,,,percent of total billed charges,69% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,159,100,,,percent of total billed charges,100% of total billed charges,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,159,100,,,percent of total billed charges,100% of total billed charges,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.34,61.85,,,percent of total billed charges,61.85% of total billed charges,29.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,38.31,130,,,Fee Schedule,130% of WA Medicaid ,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,5390.1,33.9,,,percent of total billed charges,33.9% of total billed charges,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.02,78,,,percent of total billed charges,78% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,29.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.15,5390.1,
DRAINAGE OF SKIN ABSCESS,10060,CDM,983,RC,10060,HCPCS,Outpatient,,,330,214.50,,290.4,88,,,percent of total billed charges,88% of total Billed charges,6.65,100,,,Fee Schedule,100% of Medicare rate,62.48,100,,,Fee Schedule,100% of WA Medicaid,330,100,,,percent of total billed charges,100% of total billed charges,64.35,103,,,Fee Schedule,103% of WA Medicaid,6.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,62.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,227.7,69,,,percent of total billed charges,69% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,330,100,,,percent of total billed charges,100% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,330,100,,,percent of total billed charges,100% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.11,61.85,,,percent of total billed charges,61.85% of total billed charges,62.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,81.22,130,,,Fee Schedule,130% of WA Medicaid ,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,11187,33.9,,,percent of total billed charges,33.9% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.4,78,,,percent of total billed charges,78% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,62.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.65,11187,
DRAINAGE OF SKIN ABSCESS,10061,CDM,983,RC,10061,HCPCS,Outpatient,,,516,335.40,,454.08,88,,,percent of total billed charges,88% of total Billed charges,13.92,100,,,Fee Schedule,100% of Medicare rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,516,100,,,percent of total billed charges,100% of total billed charges,110.26,103,,,Fee Schedule,103% of WA Medicaid,13.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,356.04,69,,,percent of total billed charges,69% of total billed charges,516,100,,,percent of total billed charges,100% of total billed charges,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,516,100,,,percent of total billed charges,100% of total billed charges,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,516,100,,,percent of total billed charges,100% of total billed charges,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.15,61.85,,,percent of total billed charges,61.85% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.17,130,,,Fee Schedule,130% of WA Medicaid ,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.53,37.7,,,percent of total billed charges,37.70% of total billed charges,194.53,37.7,,,percent of total billed charges,37.70% of total billed charges,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,17492.4,33.9,,,percent of total billed charges,33.9% of total billed charges,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.48,78,,,percent of total billed charges,78% of total billed charges,516,100,,,percent of total billed charges,100% of total billed charges,426.22,82.6,,,percent of total billed charges,82.6% of total billed charges,426.22,82.6,,,percent of total billed charges,82.6% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.92,17492.4,
DRAINAGE OF PILONIDAL CYST,10080,CDM,983,RC,10080,HCPCS,Outpatient,,,286,185.90,,251.68,88,,,percent of total billed charges,88% of total Billed charges,8.4,100,,,Fee Schedule,100% of Medicare rate,61.36,100,,,Fee Schedule,100% of WA Medicaid,286,100,,,percent of total billed charges,100% of total billed charges,63.2,103,,,Fee Schedule,103% of WA Medicaid,8.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,61.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,197.34,69,,,percent of total billed charges,69% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,286,100,,,percent of total billed charges,100% of total billed charges,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,286,100,,,percent of total billed charges,100% of total billed charges,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.89,61.85,,,percent of total billed charges,61.85% of total billed charges,61.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.77,130,,,Fee Schedule,130% of WA Medicaid ,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.82,37.7,,,percent of total billed charges,37.70% of total billed charges,107.82,37.7,,,percent of total billed charges,37.70% of total billed charges,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,9695.4,33.9,,,percent of total billed charges,33.9% of total billed charges,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.08,78,,,percent of total billed charges,78% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,61.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.4,9695.4,
DRAINAGE OF PILONIDAL CYST,10081,CDM,983,RC,10081,HCPCS,Outpatient,,,594,386.10,,522.72,88,,,percent of total billed charges,88% of total Billed charges,17.35,100,,,Fee Schedule,100% of Medicare rate,97.91,100,,,Fee Schedule,100% of WA Medicaid,594,100,,,percent of total billed charges,100% of total billed charges,100.85,103,,,Fee Schedule,103% of WA Medicaid,17.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,97.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,409.86,69,,,percent of total billed charges,69% of total billed charges,594,100,,,percent of total billed charges,100% of total billed charges,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,594,100,,,percent of total billed charges,100% of total billed charges,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,594,100,,,percent of total billed charges,100% of total billed charges,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.39,61.85,,,percent of total billed charges,61.85% of total billed charges,97.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,127.28,130,,,Fee Schedule,130% of WA Medicaid ,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.94,37.7,,,percent of total billed charges,37.70% of total billed charges,223.94,37.7,,,percent of total billed charges,37.70% of total billed charges,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,20136.6,33.9,,,percent of total billed charges,33.9% of total billed charges,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.32,78,,,percent of total billed charges,78% of total billed charges,594,100,,,percent of total billed charges,100% of total billed charges,490.64,82.6,,,percent of total billed charges,82.6% of total billed charges,490.64,82.6,,,percent of total billed charges,82.6% of total billed charges,97.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.35,20136.6,
REMOVE FOREIGN BODY,10120,CDM,983,RC,10120,HCPCS,Outpatient,,,265.11,172.32,,233.3,88,,,percent of total billed charges,88% of total Billed charges,7.13,100,,,Fee Schedule,100% of Medicare rate,61.92,100,,,Fee Schedule,100% of WA Medicaid,265.11,100,,,percent of total billed charges,100% of total billed charges,63.78,103,,,Fee Schedule,103% of WA Medicaid,7.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,61.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,182.93,69,,,percent of total billed charges,69% of total billed charges,265.11,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.11,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.11,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.97,61.85,,,percent of total billed charges,61.85% of total billed charges,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,80.5,130,,,Fee Schedule,130% of WA Medicaid ,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.95,37.7,,,percent of total billed charges,37.70% of total billed charges,99.95,37.7,,,percent of total billed charges,37.70% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8987.23,33.9,,,percent of total billed charges,33.9% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.79,78,,,percent of total billed charges,78% of total billed charges,265.11,100,,,percent of total billed charges,100% of total billed charges,218.98,82.6,,,percent of total billed charges,82.6% of total billed charges,218.98,82.6,,,percent of total billed charges,82.6% of total billed charges,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.13,8987.23,
REMOVE FOREIGN BODY,10121,CDM,983,RC,10121,HCPCS,Outpatient,,,461.02,299.66,,405.7,88,,,percent of total billed charges,88% of total Billed charges,15.93,100,,,Fee Schedule,100% of Medicare rate,105.56,100,,,Fee Schedule,100% of WA Medicaid,461.02,100,,,percent of total billed charges,100% of total billed charges,108.73,103,,,Fee Schedule,103% of WA Medicaid,15.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,105.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,318.1,69,,,percent of total billed charges,69% of total billed charges,461.02,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.02,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.02,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.14,61.85,,,percent of total billed charges,61.85% of total billed charges,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,137.23,130,,,Fee Schedule,130% of WA Medicaid ,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.8,37.7,,,percent of total billed charges,37.70% of total billed charges,173.8,37.7,,,percent of total billed charges,37.70% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15628.58,33.9,,,percent of total billed charges,33.9% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.6,78,,,percent of total billed charges,78% of total billed charges,461.02,100,,,percent of total billed charges,100% of total billed charges,380.8,82.6,,,percent of total billed charges,82.6% of total billed charges,380.8,82.6,,,percent of total billed charges,82.6% of total billed charges,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.93,15628.58,
DRAINAGE OF HEMATOMA/FLUID,10140,CDM,983,RC,10140,HCPCS,Outpatient,,,281.91,183.24,,248.08,88,,,percent of total billed charges,88% of total Billed charges,9.06,100,,,Fee Schedule,100% of Medicare rate,68.63,100,,,Fee Schedule,100% of WA Medicaid,281.91,100,,,percent of total billed charges,100% of total billed charges,70.69,103,,,Fee Schedule,103% of WA Medicaid,9.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,194.52,69,,,percent of total billed charges,69% of total billed charges,281.91,100,,,percent of total billed charges,100% of total billed charges,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.91,100,,,percent of total billed charges,100% of total billed charges,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.91,100,,,percent of total billed charges,100% of total billed charges,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.36,61.85,,,percent of total billed charges,61.85% of total billed charges,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.22,130,,,Fee Schedule,130% of WA Medicaid ,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.28,37.7,,,percent of total billed charges,37.70% of total billed charges,106.28,37.7,,,percent of total billed charges,37.70% of total billed charges,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,9556.75,33.9,,,percent of total billed charges,33.9% of total billed charges,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.89,78,,,percent of total billed charges,78% of total billed charges,281.91,100,,,percent of total billed charges,100% of total billed charges,232.86,82.6,,,percent of total billed charges,82.6% of total billed charges,232.86,82.6,,,percent of total billed charges,82.6% of total billed charges,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.06,9556.75,
PUNCTURE DRAINAGE OF LESION,10160,CDM,983,RC,10160,HCPCS,Outpatient,,,203,131.95,,178.64,88,,,percent of total billed charges,88% of total Billed charges,7.1,100,,,Fee Schedule,100% of Medicare rate,56.14,100,,,Fee Schedule,100% of WA Medicaid,203,100,,,percent of total billed charges,100% of total billed charges,57.82,103,,,Fee Schedule,103% of WA Medicaid,7.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,140.07,69,,,percent of total billed charges,69% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,203,100,,,percent of total billed charges,100% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,203,100,,,percent of total billed charges,100% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.56,61.85,,,percent of total billed charges,61.85% of total billed charges,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,72.98,130,,,Fee Schedule,130% of WA Medicaid ,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6881.7,33.9,,,percent of total billed charges,33.9% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.34,78,,,percent of total billed charges,78% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.1,6881.7,
COMPLEX DRAINAGE WOUND,10180,CDM,983,RC,10180,HCPCS,Outpatient,,,570,370.50,,501.6,88,,,percent of total billed charges,88% of total Billed charges,18.63,100,,,Fee Schedule,100% of Medicare rate,102.76,100,,,Fee Schedule,100% of WA Medicaid,570,100,,,percent of total billed charges,100% of total billed charges,105.84,103,,,Fee Schedule,103% of WA Medicaid,18.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,393.3,69,,,percent of total billed charges,69% of total billed charges,570,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,570,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,570,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.55,61.85,,,percent of total billed charges,61.85% of total billed charges,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,133.59,130,,,Fee Schedule,130% of WA Medicaid ,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.89,37.7,,,percent of total billed charges,37.70% of total billed charges,214.89,37.7,,,percent of total billed charges,37.70% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,19323,33.9,,,percent of total billed charges,33.9% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.6,78,,,percent of total billed charges,78% of total billed charges,570,100,,,percent of total billed charges,100% of total billed charges,470.82,82.6,,,percent of total billed charges,82.6% of total billed charges,470.82,82.6,,,percent of total billed charges,82.6% of total billed charges,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.63,19323,
DEBRIDE INFECTED SKIN,11000,CDM,983,RC,11000,HCPCS,Outpatient,,,94.17,61.21,,82.87,88,,,percent of total billed charges,88% of total Billed charges,2.12,100,,,Fee Schedule,100% of Medicare rate,15.48,100,,,Fee Schedule,100% of WA Medicaid,94.17,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,2.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,15.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,64.98,69,,,percent of total billed charges,69% of total billed charges,94.17,100,,,percent of total billed charges,100% of total billed charges,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.17,100,,,percent of total billed charges,100% of total billed charges,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.17,100,,,percent of total billed charges,100% of total billed charges,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.24,61.85,,,percent of total billed charges,61.85% of total billed charges,15.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.12,130,,,Fee Schedule,130% of WA Medicaid ,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.5,37.7,,,percent of total billed charges,37.70% of total billed charges,35.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,3192.36,33.9,,,percent of total billed charges,33.9% of total billed charges,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.45,78,,,percent of total billed charges,78% of total billed charges,94.17,100,,,percent of total billed charges,100% of total billed charges,77.78,82.6,,,percent of total billed charges,82.6% of total billed charges,77.78,82.6,,,percent of total billed charges,82.6% of total billed charges,15.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.12,3192.36,
DEBRIDE INFECTED SKIN ADD-ON,11001,CDM,983,RC,11001,HCPCS,Outpatient,,,60,39.00,,52.8,88,,,percent of total billed charges,88% of total Billed charges,1.22,100,,,Fee Schedule,100% of Medicare rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,60,100,,,percent of total billed charges,100% of total billed charges,8.64,103,,,Fee Schedule,103% of WA Medicaid,1.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,60,100,,,percent of total billed charges,100% of total billed charges,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,60,100,,,percent of total billed charges,100% of total billed charges,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.11,61.85,,,percent of total billed charges,61.85% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.91,130,,,Fee Schedule,130% of WA Medicaid ,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2034,33.9,,,percent of total billed charges,33.9% of total billed charges,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.22,2034,
DEBRIDE GENIT/PER/ABDOM WALL,11006,CDM,983,RC,11006,HCPCS,Outpatient,,,1876,1219.40,,1650.88,88,,,percent of total billed charges,88% of total Billed charges,93.6,100,,,Fee Schedule,100% of Medicare rate,386.06,100,,,Fee Schedule,100% of WA Medicaid,1876,100,,,percent of total billed charges,100% of total billed charges,397.64,103,,,Fee Schedule,103% of WA Medicaid,93.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,163.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,386.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1294.44,69,,,percent of total billed charges,69% of total billed charges,1876,100,,,percent of total billed charges,100% of total billed charges,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1876,100,,,percent of total billed charges,100% of total billed charges,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1876,100,,,percent of total billed charges,100% of total billed charges,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1160.31,61.85,,,percent of total billed charges,61.85% of total billed charges,386.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,501.88,130,,,Fee Schedule,130% of WA Medicaid ,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,707.25,37.7,,,percent of total billed charges,37.70% of total billed charges,707.25,37.7,,,percent of total billed charges,37.70% of total billed charges,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,63596.4,33.9,,,percent of total billed charges,33.9% of total billed charges,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1463.28,78,,,percent of total billed charges,78% of total billed charges,1876,100,,,percent of total billed charges,100% of total billed charges,1549.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1549.58,82.6,,,percent of total billed charges,82.6% of total billed charges,386.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,93.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,93.6,63596.4,
DEBRIDE ABDOM WALL,11005,CDM,983,RC,11005,HCPCS,Outpatient,,,2071,1346.15,,1822.48,88,,,percent of total billed charges,88% of total Billed charges,111.26,100,,,Fee Schedule,100% of Medicare rate,425.41,100,,,Fee Schedule,100% of WA Medicaid,2071,100,,,percent of total billed charges,100% of total billed charges,438.17,103,,,Fee Schedule,103% of WA Medicaid,111.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,194.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,425.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1428.99,69,,,percent of total billed charges,69% of total billed charges,2071,100,,,percent of total billed charges,100% of total billed charges,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2071,100,,,percent of total billed charges,100% of total billed charges,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2071,100,,,percent of total billed charges,100% of total billed charges,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1280.91,61.85,,,percent of total billed charges,61.85% of total billed charges,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,553.03,130,,,Fee Schedule,130% of WA Medicaid ,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.77,37.7,,,percent of total billed charges,37.70% of total billed charges,780.77,37.7,,,percent of total billed charges,37.70% of total billed charges,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,70206.9,33.9,,,percent of total billed charges,33.9% of total billed charges,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1615.38,78,,,percent of total billed charges,78% of total billed charges,2071,100,,,percent of total billed charges,100% of total billed charges,1710.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1710.65,82.6,,,percent of total billed charges,82.6% of total billed charges,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,111.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.26,70206.9,
DEBRIDE GENITALIA  PERINEUM,11004,CDM,983,RC,11004,HCPCS,Outpatient,,,1551,1008.15,,1364.88,88,,,percent of total billed charges,88% of total Billed charges,70.59,100,,,Fee Schedule,100% of Medicare rate,314.07,100,,,Fee Schedule,100% of WA Medicaid,1551,100,,,percent of total billed charges,100% of total billed charges,323.49,103,,,Fee Schedule,103% of WA Medicaid,70.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,123.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,314.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1070.19,69,,,percent of total billed charges,69% of total billed charges,1551,100,,,percent of total billed charges,100% of total billed charges,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1551,100,,,percent of total billed charges,100% of total billed charges,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1551,100,,,percent of total billed charges,100% of total billed charges,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,959.29,61.85,,,percent of total billed charges,61.85% of total billed charges,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,408.29,130,,,Fee Schedule,130% of WA Medicaid ,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,584.73,37.7,,,percent of total billed charges,37.70% of total billed charges,584.73,37.7,,,percent of total billed charges,37.70% of total billed charges,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,52578.9,33.9,,,percent of total billed charges,33.9% of total billed charges,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1209.78,78,,,percent of total billed charges,78% of total billed charges,1551,100,,,percent of total billed charges,100% of total billed charges,1281.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1281.13,82.6,,,percent of total billed charges,82.6% of total billed charges,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.59,52578.9,
REMOVE MESH FROM ABD WALL,11008,CDM,983,RC,11008,HCPCS,Outpatient,,,744,483.60,,654.72,88,,,percent of total billed charges,88% of total Billed charges,39.84,100,,,Fee Schedule,100% of Medicare rate,149.57,100,,,Fee Schedule,100% of WA Medicaid,744,100,,,percent of total billed charges,100% of total billed charges,154.06,103,,,Fee Schedule,103% of WA Medicaid,39.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,149.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,513.36,69,,,percent of total billed charges,69% of total billed charges,744,100,,,percent of total billed charges,100% of total billed charges,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,744,100,,,percent of total billed charges,100% of total billed charges,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,744,100,,,percent of total billed charges,100% of total billed charges,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.16,61.85,,,percent of total billed charges,61.85% of total billed charges,149.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,194.44,130,,,Fee Schedule,130% of WA Medicaid ,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.49,37.7,,,percent of total billed charges,37.70% of total billed charges,280.49,37.7,,,percent of total billed charges,37.70% of total billed charges,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,25221.6,33.9,,,percent of total billed charges,33.9% of total billed charges,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,580.32,78,,,percent of total billed charges,78% of total billed charges,744,100,,,percent of total billed charges,100% of total billed charges,614.54,82.6,,,percent of total billed charges,82.6% of total billed charges,614.54,82.6,,,percent of total billed charges,82.6% of total billed charges,149.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.84,25221.6,
DEBRIDE SKIN AT FX SITE,11010,CDM,983,RC,11010,HCPCS,Outpatient,,,869,564.85,,764.72,88,,,percent of total billed charges,88% of total Billed charges,27.46,100,,,Fee Schedule,100% of Medicare rate,157.03,100,,,Fee Schedule,100% of WA Medicaid,869,100,,,percent of total billed charges,100% of total billed charges,161.74,103,,,Fee Schedule,103% of WA Medicaid,27.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,157.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,599.61,69,,,percent of total billed charges,69% of total billed charges,869,100,,,percent of total billed charges,100% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,869,100,,,percent of total billed charges,100% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,869,100,,,percent of total billed charges,100% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.48,61.85,,,percent of total billed charges,61.85% of total billed charges,157.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,204.14,130,,,Fee Schedule,130% of WA Medicaid ,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.61,37.7,,,percent of total billed charges,37.70% of total billed charges,327.61,37.7,,,percent of total billed charges,37.70% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,29459.1,33.9,,,percent of total billed charges,33.9% of total billed charges,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.82,78,,,percent of total billed charges,78% of total billed charges,869,100,,,percent of total billed charges,100% of total billed charges,717.79,82.6,,,percent of total billed charges,82.6% of total billed charges,717.79,82.6,,,percent of total billed charges,82.6% of total billed charges,157.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.46,29459.1,
DEBRIDE SKIN MUSC AT FX SITE,11011,CDM,983,RC,11011,HCPCS,Outpatient,,,1459,948.35,,1283.92,88,,,percent of total billed charges,88% of total Billed charges,33.99,100,,,Fee Schedule,100% of Medicare rate,167.29,100,,,Fee Schedule,100% of WA Medicaid,1459,100,,,percent of total billed charges,100% of total billed charges,172.31,103,,,Fee Schedule,103% of WA Medicaid,33.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,167.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1006.71,69,,,percent of total billed charges,69% of total billed charges,1459,100,,,percent of total billed charges,100% of total billed charges,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1459,100,,,percent of total billed charges,100% of total billed charges,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1459,100,,,percent of total billed charges,100% of total billed charges,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.39,61.85,,,percent of total billed charges,61.85% of total billed charges,167.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,217.48,130,,,Fee Schedule,130% of WA Medicaid ,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.04,37.7,,,percent of total billed charges,37.70% of total billed charges,550.04,37.7,,,percent of total billed charges,37.70% of total billed charges,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,49460.1,33.9,,,percent of total billed charges,33.9% of total billed charges,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1138.02,78,,,percent of total billed charges,78% of total billed charges,1459,100,,,percent of total billed charges,100% of total billed charges,1205.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1205.13,82.6,,,percent of total billed charges,82.6% of total billed charges,167.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.99,49460.1,
DEB SKIN BONE AT FX SITE,11012,CDM,983,RC,11012,HCPCS,Outpatient,,,2126,1381.90,,1870.88,88,,,percent of total billed charges,88% of total Billed charges,47.09,100,,,Fee Schedule,100% of Medicare rate,233.68,100,,,Fee Schedule,100% of WA Medicaid,2126,100,,,percent of total billed charges,100% of total billed charges,240.69,103,,,Fee Schedule,103% of WA Medicaid,47.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,82.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,233.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1466.94,69,,,percent of total billed charges,69% of total billed charges,2126,100,,,percent of total billed charges,100% of total billed charges,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2126,100,,,percent of total billed charges,100% of total billed charges,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2126,100,,,percent of total billed charges,100% of total billed charges,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1314.93,61.85,,,percent of total billed charges,61.85% of total billed charges,233.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,303.78,130,,,Fee Schedule,130% of WA Medicaid ,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,801.5,37.7,,,percent of total billed charges,37.70% of total billed charges,801.5,37.7,,,percent of total billed charges,37.70% of total billed charges,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,72071.4,33.9,,,percent of total billed charges,33.9% of total billed charges,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1658.28,78,,,percent of total billed charges,78% of total billed charges,2126,100,,,percent of total billed charges,100% of total billed charges,1756.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1756.08,82.6,,,percent of total billed charges,82.6% of total billed charges,233.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.09,72071.4,
DEB SUBQ TISSUE 20 SQ CM/<,11042,CDM,983,RC,11042,HCPCS,Outpatient,,,297,193.05,,261.36,88,,,percent of total billed charges,88% of total Billed charges,5.19,100,,,Fee Schedule,100% of Medicare rate,34.5,100,,,Fee Schedule,100% of WA Medicaid,297,100,,,percent of total billed charges,100% of total billed charges,35.54,103,,,Fee Schedule,103% of WA Medicaid,5.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,34.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,204.93,69,,,percent of total billed charges,69% of total billed charges,297,100,,,percent of total billed charges,100% of total billed charges,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,297,100,,,percent of total billed charges,100% of total billed charges,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,297,100,,,percent of total billed charges,100% of total billed charges,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.69,61.85,,,percent of total billed charges,61.85% of total billed charges,34.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,44.85,130,,,Fee Schedule,130% of WA Medicaid ,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.97,37.7,,,percent of total billed charges,37.70% of total billed charges,111.97,37.7,,,percent of total billed charges,37.70% of total billed charges,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,10068.3,33.9,,,percent of total billed charges,33.9% of total billed charges,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.66,78,,,percent of total billed charges,78% of total billed charges,297,100,,,percent of total billed charges,100% of total billed charges,245.32,82.6,,,percent of total billed charges,82.6% of total billed charges,245.32,82.6,,,percent of total billed charges,82.6% of total billed charges,34.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.19,10068.3,
DEB MUSC/FASCIA 20 SQ CM/<,11043,CDM,983,RC,11043,HCPCS,Outpatient,,,583,378.95,,513.04,88,,,percent of total billed charges,88% of total Billed charges,14.95,100,,,Fee Schedule,100% of Medicare rate,86.54,100,,,Fee Schedule,100% of WA Medicaid,583,100,,,percent of total billed charges,100% of total billed charges,89.14,103,,,Fee Schedule,103% of WA Medicaid,14.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,86.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,402.27,69,,,percent of total billed charges,69% of total billed charges,583,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,583,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,583,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.59,61.85,,,percent of total billed charges,61.85% of total billed charges,86.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,112.5,130,,,Fee Schedule,130% of WA Medicaid ,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.79,37.7,,,percent of total billed charges,37.70% of total billed charges,219.79,37.7,,,percent of total billed charges,37.70% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,19763.7,33.9,,,percent of total billed charges,33.9% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.74,78,,,percent of total billed charges,78% of total billed charges,583,100,,,percent of total billed charges,100% of total billed charges,481.56,82.6,,,percent of total billed charges,82.6% of total billed charges,481.56,82.6,,,percent of total billed charges,82.6% of total billed charges,86.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.95,19763.7,
DEB BONE 20 SQ CM/<,11044,CDM,983,RC,11044,HCPCS,Outpatient,,,813,528.45,,715.44,88,,,percent of total billed charges,88% of total Billed charges,23.81,100,,,Fee Schedule,100% of Medicare rate,126.45,100,,,Fee Schedule,100% of WA Medicaid,813,100,,,percent of total billed charges,100% of total billed charges,130.24,103,,,Fee Schedule,103% of WA Medicaid,23.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,126.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,560.97,69,,,percent of total billed charges,69% of total billed charges,813,100,,,percent of total billed charges,100% of total billed charges,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,813,100,,,percent of total billed charges,100% of total billed charges,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,813,100,,,percent of total billed charges,100% of total billed charges,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.84,61.85,,,percent of total billed charges,61.85% of total billed charges,126.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,164.39,130,,,Fee Schedule,130% of WA Medicaid ,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.5,37.7,,,percent of total billed charges,37.70% of total billed charges,306.5,37.7,,,percent of total billed charges,37.70% of total billed charges,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,27560.7,33.9,,,percent of total billed charges,33.9% of total billed charges,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.14,78,,,percent of total billed charges,78% of total billed charges,813,100,,,percent of total billed charges,100% of total billed charges,671.54,82.6,,,percent of total billed charges,82.6% of total billed charges,671.54,82.6,,,percent of total billed charges,82.6% of total billed charges,126.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.81,27560.7,
DEB SUBQ TISSUE ADD-ON,11045,CDM,983,RC,11045,HCPCS,Outpatient,,,137,89.05,,120.56,88,,,percent of total billed charges,88% of total Billed charges,2.82,100,,,Fee Schedule,100% of Medicare rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,137,100,,,percent of total billed charges,100% of total billed charges,14.41,103,,,Fee Schedule,103% of WA Medicaid,2.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,94.53,69,,,percent of total billed charges,69% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,137,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,137,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.73,61.85,,,percent of total billed charges,61.85% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.19,130,,,Fee Schedule,130% of WA Medicaid ,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4644.3,33.9,,,percent of total billed charges,33.9% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.86,78,,,percent of total billed charges,78% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.82,4644.3,
DEB MUSC/FASCIA ADD-ON,11046,CDM,983,RC,11046,HCPCS,Outpatient,,,242,157.30,,212.96,88,,,percent of total billed charges,88% of total Billed charges,6.54,100,,,Fee Schedule,100% of Medicare rate,30.4,100,,,Fee Schedule,100% of WA Medicaid,242,100,,,percent of total billed charges,100% of total billed charges,31.31,103,,,Fee Schedule,103% of WA Medicaid,6.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,166.98,69,,,percent of total billed charges,69% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,242,100,,,percent of total billed charges,100% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,242,100,,,percent of total billed charges,100% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.68,61.85,,,percent of total billed charges,61.85% of total billed charges,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,39.52,130,,,Fee Schedule,130% of WA Medicaid ,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,8203.8,33.9,,,percent of total billed charges,33.9% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.76,78,,,percent of total billed charges,78% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.54,8203.8,
DEB BONE ADD-ON,11047,CDM,983,RC,11047,HCPCS,Outpatient,,,407,264.55,,358.16,88,,,percent of total billed charges,88% of total Billed charges,11.93,100,,,Fee Schedule,100% of Medicare rate,53.9,100,,,Fee Schedule,100% of WA Medicaid,407,100,,,percent of total billed charges,100% of total billed charges,55.52,103,,,Fee Schedule,103% of WA Medicaid,11.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,53.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,280.83,69,,,percent of total billed charges,69% of total billed charges,407,100,,,percent of total billed charges,100% of total billed charges,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,407,100,,,percent of total billed charges,100% of total billed charges,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,407,100,,,percent of total billed charges,100% of total billed charges,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.73,61.85,,,percent of total billed charges,61.85% of total billed charges,53.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,70.07,130,,,Fee Schedule,130% of WA Medicaid ,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.44,37.7,,,percent of total billed charges,37.70% of total billed charges,153.44,37.7,,,percent of total billed charges,37.70% of total billed charges,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,13797.3,33.9,,,percent of total billed charges,33.9% of total billed charges,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.46,78,,,percent of total billed charges,78% of total billed charges,407,100,,,percent of total billed charges,100% of total billed charges,336.18,82.6,,,percent of total billed charges,82.6% of total billed charges,336.18,82.6,,,percent of total billed charges,82.6% of total billed charges,53.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.93,13797.3,
"DEBRIDE SKIN, PARTIAL",11040,CDM,983,RC,11040,HCPCS,Outpatient,,,71.72,46.62,,63.11,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71.72,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,49.49,69,,,percent of total billed charges,69% of total billed charges,71.72,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,71.72,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,71.72,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,44.36,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.04,37.7,,,percent of total billed charges,37.70% of total billed charges,27.04,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2431.31,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,55.94,78,,,percent of total billed charges,78% of total billed charges,71.72,100,,,percent of total billed charges,100% of total billed charges,59.24,82.6,,,percent of total billed charges,82.6% of total billed charges,59.24,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",27.04,2431.31,
TRIM SKIN LESION,11055,CDM,983,RC,11055,HCPCS,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,1.24,100,,,Fee Schedule,100% of Medicare rate,8.58,100,,,Fee Schedule,100% of WA Medicaid,72,100,,,percent of total billed charges,100% of total billed charges,8.84,103,,,Fee Schedule,103% of WA Medicaid,1.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,72,100,,,percent of total billed charges,100% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,72,100,,,percent of total billed charges,100% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.53,61.85,,,percent of total billed charges,61.85% of total billed charges,8.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.15,130,,,Fee Schedule,130% of WA Medicaid ,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2440.8,33.9,,,percent of total billed charges,33.9% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.24,2440.8,
TRIM SKIN LESIONS 2 TO 4,11056,CDM,983,RC,11056,HCPCS,Outpatient,,,78,50.70,,68.64,88,,,percent of total billed charges,88% of total Billed charges,1.69,100,,,Fee Schedule,100% of Medicare rate,12.31,100,,,Fee Schedule,100% of WA Medicaid,78,100,,,percent of total billed charges,100% of total billed charges,12.68,103,,,Fee Schedule,103% of WA Medicaid,1.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,12.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,53.82,69,,,percent of total billed charges,69% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,78,100,,,percent of total billed charges,100% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,78,100,,,percent of total billed charges,100% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.24,61.85,,,percent of total billed charges,61.85% of total billed charges,12.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16,130,,,Fee Schedule,130% of WA Medicaid ,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.41,37.7,,,percent of total billed charges,37.70% of total billed charges,29.41,37.7,,,percent of total billed charges,37.70% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2644.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.84,78,,,percent of total billed charges,78% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,12.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.69,2644.2,
TRIM SKIN LESIONS OVER 4,11057,CDM,983,RC,11057,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,2.15,100,,,Fee Schedule,100% of Medicare rate,16.04,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,16.52,103,,,Fee Schedule,103% of WA Medicaid,2.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,90,100,,,percent of total billed charges,100% of total billed charges,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,90,100,,,percent of total billed charges,100% of total billed charges,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.67,61.85,,,percent of total billed charges,61.85% of total billed charges,16.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.85,130,,,Fee Schedule,130% of WA Medicaid ,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3051,33.9,,,percent of total billed charges,33.9% of total billed charges,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,16.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.15,3051,
REMOVAL OF SKIN TAGS <W/15,11200,CDM,983,RC,11200,HCPCS,Outpatient,,,163,105.95,,143.44,88,,,percent of total billed charges,88% of total Billed charges,4.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,163,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,112.47,69,,,percent of total billed charges,69% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,163,100,,,percent of total billed charges,100% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,163,100,,,percent of total billed charges,100% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.82,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,5525.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.14,78,,,percent of total billed charges,78% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",4.69,5525.7,
REMOVE SKIN TAGS ADD-ON,11201,CDM,983,RC,11201,HCPCS,Outpatient,,,81,52.65,,71.28,88,,,percent of total billed charges,88% of total Billed charges,1.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,81,100,,,percent of total billed charges,100% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,81,100,,,percent of total billed charges,100% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2745.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",1.26,2745.9,
SHAVE SKIN LESION 0.5 CM/<,11300,CDM,983,RC,11300,HCPCS,Outpatient,,,171,111.15,,150.48,88,,,percent of total billed charges,88% of total Billed charges,2.83,100,,,Fee Schedule,100% of Medicare rate,19.21,100,,,Fee Schedule,100% of WA Medicaid,171,100,,,percent of total billed charges,100% of total billed charges,19.79,103,,,Fee Schedule,103% of WA Medicaid,2.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,117.99,69,,,percent of total billed charges,69% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,171,100,,,percent of total billed charges,100% of total billed charges,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,171,100,,,percent of total billed charges,100% of total billed charges,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.76,61.85,,,percent of total billed charges,61.85% of total billed charges,19.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.97,130,,,Fee Schedule,130% of WA Medicaid ,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,5796.9,33.9,,,percent of total billed charges,33.9% of total billed charges,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.38,78,,,percent of total billed charges,78% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,19.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.83,5796.9,
SHAVE SKIN LESION 0.6-1.0 CM,11301,CDM,983,RC,11301,HCPCS,Outpatient,,,215,139.75,,189.2,88,,,percent of total billed charges,88% of total Billed charges,4.12,100,,,Fee Schedule,100% of Medicare rate,28.91,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,29.78,103,,,Fee Schedule,103% of WA Medicaid,4.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.98,61.85,,,percent of total billed charges,61.85% of total billed charges,28.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.58,130,,,Fee Schedule,130% of WA Medicaid ,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,7288.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.12,7288.5,
SHAVE SKIN LESION 1.1-2.0 CM,11302,CDM,983,RC,11302,HCPCS,Outpatient,,,259,168.35,,227.92,88,,,percent of total billed charges,88% of total Billed charges,4.63,100,,,Fee Schedule,100% of Medicare rate,33.76,100,,,Fee Schedule,100% of WA Medicaid,259,100,,,percent of total billed charges,100% of total billed charges,34.77,103,,,Fee Schedule,103% of WA Medicaid,4.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,178.71,69,,,percent of total billed charges,69% of total billed charges,259,100,,,percent of total billed charges,100% of total billed charges,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,259,100,,,percent of total billed charges,100% of total billed charges,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,259,100,,,percent of total billed charges,100% of total billed charges,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.19,61.85,,,percent of total billed charges,61.85% of total billed charges,33.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.89,130,,,Fee Schedule,130% of WA Medicaid ,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.64,37.7,,,percent of total billed charges,37.70% of total billed charges,97.64,37.7,,,percent of total billed charges,37.70% of total billed charges,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,8780.1,33.9,,,percent of total billed charges,33.9% of total billed charges,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.02,78,,,percent of total billed charges,78% of total billed charges,259,100,,,percent of total billed charges,100% of total billed charges,213.93,82.6,,,percent of total billed charges,82.6% of total billed charges,213.93,82.6,,,percent of total billed charges,82.6% of total billed charges,33.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.63,8780.1,
SHAVE SKIN LESION >2.0 CM,11303,CDM,983,RC,11303,HCPCS,Outpatient,,,372,241.80,,327.36,88,,,percent of total billed charges,88% of total Billed charges,5.75,100,,,Fee Schedule,100% of Medicare rate,40.1,100,,,Fee Schedule,100% of WA Medicaid,372,100,,,percent of total billed charges,100% of total billed charges,41.3,103,,,Fee Schedule,103% of WA Medicaid,5.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,256.68,69,,,percent of total billed charges,69% of total billed charges,372,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,372,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,372,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.08,61.85,,,percent of total billed charges,61.85% of total billed charges,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,52.13,130,,,Fee Schedule,130% of WA Medicaid ,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.24,37.7,,,percent of total billed charges,37.70% of total billed charges,140.24,37.7,,,percent of total billed charges,37.70% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,12610.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.16,78,,,percent of total billed charges,78% of total billed charges,372,100,,,percent of total billed charges,100% of total billed charges,307.27,82.6,,,percent of total billed charges,82.6% of total billed charges,307.27,82.6,,,percent of total billed charges,82.6% of total billed charges,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.75,12610.8,
SHAVE SKIN LESION 0.5 CM/<,11305,CDM,983,RC,11305,HCPCS,Outpatient,,,173,112.45,,152.24,88,,,percent of total billed charges,88% of total Billed charges,2.93,100,,,Fee Schedule,100% of Medicare rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,173,100,,,percent of total billed charges,100% of total billed charges,21.52,103,,,Fee Schedule,103% of WA Medicaid,2.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,119.37,69,,,percent of total billed charges,69% of total billed charges,173,100,,,percent of total billed charges,100% of total billed charges,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,173,100,,,percent of total billed charges,100% of total billed charges,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,173,100,,,percent of total billed charges,100% of total billed charges,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,107,61.85,,,percent of total billed charges,61.85% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.16,130,,,Fee Schedule,130% of WA Medicaid ,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.22,37.7,,,percent of total billed charges,37.70% of total billed charges,65.22,37.7,,,percent of total billed charges,37.70% of total billed charges,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5864.7,33.9,,,percent of total billed charges,33.9% of total billed charges,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.94,78,,,percent of total billed charges,78% of total billed charges,173,100,,,percent of total billed charges,100% of total billed charges,142.9,82.6,,,percent of total billed charges,82.6% of total billed charges,142.9,82.6,,,percent of total billed charges,82.6% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.93,5864.7,
SHAVE SKIN LESION 0.6-1.0 CM,11306,CDM,983,RC,11306,HCPCS,Outpatient,,,231,150.15,,203.28,88,,,percent of total billed charges,88% of total Billed charges,3.79,100,,,Fee Schedule,100% of Medicare rate,27.42,100,,,Fee Schedule,100% of WA Medicaid,231,100,,,percent of total billed charges,100% of total billed charges,28.24,103,,,Fee Schedule,103% of WA Medicaid,3.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,159.39,69,,,percent of total billed charges,69% of total billed charges,231,100,,,percent of total billed charges,100% of total billed charges,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,231,100,,,percent of total billed charges,100% of total billed charges,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,231,100,,,percent of total billed charges,100% of total billed charges,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.87,61.85,,,percent of total billed charges,61.85% of total billed charges,27.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.65,130,,,Fee Schedule,130% of WA Medicaid ,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.09,37.7,,,percent of total billed charges,37.70% of total billed charges,87.09,37.7,,,percent of total billed charges,37.70% of total billed charges,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,7830.9,33.9,,,percent of total billed charges,33.9% of total billed charges,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.18,78,,,percent of total billed charges,78% of total billed charges,231,100,,,percent of total billed charges,100% of total billed charges,190.81,82.6,,,percent of total billed charges,82.6% of total billed charges,190.81,82.6,,,percent of total billed charges,82.6% of total billed charges,27.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.79,7830.9,
SHAVE SKIN LESION 1.1-2.0 CM,11307,CDM,983,RC,11307,HCPCS,Outpatient,,,281,182.65,,247.28,88,,,percent of total billed charges,88% of total Billed charges,4.97,100,,,Fee Schedule,100% of Medicare rate,35.06,100,,,Fee Schedule,100% of WA Medicaid,281,100,,,percent of total billed charges,100% of total billed charges,36.11,103,,,Fee Schedule,103% of WA Medicaid,4.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,193.89,69,,,percent of total billed charges,69% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,281,100,,,percent of total billed charges,100% of total billed charges,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,281,100,,,percent of total billed charges,100% of total billed charges,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.8,61.85,,,percent of total billed charges,61.85% of total billed charges,35.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.58,130,,,Fee Schedule,130% of WA Medicaid ,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.94,37.7,,,percent of total billed charges,37.70% of total billed charges,105.94,37.7,,,percent of total billed charges,37.70% of total billed charges,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,9525.9,33.9,,,percent of total billed charges,33.9% of total billed charges,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.18,78,,,percent of total billed charges,78% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,35.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.97,9525.9,
SHAVE SKIN LESION >2.0 CM,11308,CDM,983,RC,11308,HCPCS,Outpatient,,,372,241.80,,327.36,88,,,percent of total billed charges,88% of total Billed charges,5.44,100,,,Fee Schedule,100% of Medicare rate,39.17,100,,,Fee Schedule,100% of WA Medicaid,372,100,,,percent of total billed charges,100% of total billed charges,40.35,103,,,Fee Schedule,103% of WA Medicaid,5.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,256.68,69,,,percent of total billed charges,69% of total billed charges,372,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,372,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,372,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.08,61.85,,,percent of total billed charges,61.85% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.92,130,,,Fee Schedule,130% of WA Medicaid ,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.24,37.7,,,percent of total billed charges,37.70% of total billed charges,140.24,37.7,,,percent of total billed charges,37.70% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,12610.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.16,78,,,percent of total billed charges,78% of total billed charges,372,100,,,percent of total billed charges,100% of total billed charges,307.27,82.6,,,percent of total billed charges,82.6% of total billed charges,307.27,82.6,,,percent of total billed charges,82.6% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.44,12610.8,
SHAVE SKIN LESION 0.5 CM/<,11310,CDM,983,RC,11310,HCPCS,Outpatient,,,207,134.55,,182.16,88,,,percent of total billed charges,88% of total Billed charges,3.69,100,,,Fee Schedule,100% of Medicare rate,25.74,100,,,Fee Schedule,100% of WA Medicaid,207,100,,,percent of total billed charges,100% of total billed charges,26.51,103,,,Fee Schedule,103% of WA Medicaid,3.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,142.83,69,,,percent of total billed charges,69% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,207,100,,,percent of total billed charges,100% of total billed charges,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,207,100,,,percent of total billed charges,100% of total billed charges,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.03,61.85,,,percent of total billed charges,61.85% of total billed charges,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.46,130,,,Fee Schedule,130% of WA Medicaid ,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,78.04,37.7,,,percent of total billed charges,37.70% of total billed charges,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,7017.3,33.9,,,percent of total billed charges,33.9% of total billed charges,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.46,78,,,percent of total billed charges,78% of total billed charges,207,100,,,percent of total billed charges,100% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,170.98,82.6,,,percent of total billed charges,82.6% of total billed charges,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.69,7017.3,
SHAVE SKIN LESION 0.6-1.0 CM,11311,CDM,983,RC,11311,HCPCS,Outpatient,,,254,165.10,,223.52,88,,,percent of total billed charges,88% of total Billed charges,4.98,100,,,Fee Schedule,100% of Medicare rate,35.44,100,,,Fee Schedule,100% of WA Medicaid,254,100,,,percent of total billed charges,100% of total billed charges,36.5,103,,,Fee Schedule,103% of WA Medicaid,4.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,175.26,69,,,percent of total billed charges,69% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.1,61.85,,,percent of total billed charges,61.85% of total billed charges,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.07,130,,,Fee Schedule,130% of WA Medicaid ,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,8610.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.12,78,,,percent of total billed charges,78% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.98,8610.6,
SHAVE SKIN LESION 1.1-2.0 CM,11312,CDM,983,RC,11312,HCPCS,Outpatient,,,302,196.30,,265.76,88,,,percent of total billed charges,88% of total Billed charges,5.84,100,,,Fee Schedule,100% of Medicare rate,41.96,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,43.22,103,,,Fee Schedule,103% of WA Medicaid,5.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,41.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.79,61.85,,,percent of total billed charges,61.85% of total billed charges,41.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,54.55,130,,,Fee Schedule,130% of WA Medicaid ,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,10237.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,41.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.84,10237.8,
SHAVE SKIN LESION >2.0 CM,11313,CDM,983,RC,11313,HCPCS,Outpatient,,,394,256.10,,346.72,88,,,percent of total billed charges,88% of total Billed charges,7.79,100,,,Fee Schedule,100% of Medicare rate,54.27,100,,,Fee Schedule,100% of WA Medicaid,394,100,,,percent of total billed charges,100% of total billed charges,55.9,103,,,Fee Schedule,103% of WA Medicaid,7.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,54.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,271.86,69,,,percent of total billed charges,69% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,394,100,,,percent of total billed charges,100% of total billed charges,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,394,100,,,percent of total billed charges,100% of total billed charges,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.69,61.85,,,percent of total billed charges,61.85% of total billed charges,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,70.55,130,,,Fee Schedule,130% of WA Medicaid ,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,13356.6,33.9,,,percent of total billed charges,33.9% of total billed charges,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.32,78,,,percent of total billed charges,78% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.79,13356.6,
EXC TR-EXT B9+MARG 0.5 CM<,11400,CDM,983,RC,11400,HCPCS,Outpatient,,,255,165.75,,224.4,88,,,percent of total billed charges,88% of total Billed charges,5.71,100,,,Fee Schedule,100% of Medicare rate,49.61,100,,,Fee Schedule,100% of WA Medicaid,255,100,,,percent of total billed charges,100% of total billed charges,51.1,103,,,Fee Schedule,103% of WA Medicaid,5.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,175.95,69,,,percent of total billed charges,69% of total billed charges,255,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,255,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,255,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.72,61.85,,,percent of total billed charges,61.85% of total billed charges,49.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.49,130,,,Fee Schedule,130% of WA Medicaid ,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.14,37.7,,,percent of total billed charges,37.70% of total billed charges,96.14,37.7,,,percent of total billed charges,37.70% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,8644.5,33.9,,,percent of total billed charges,33.9% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.9,78,,,percent of total billed charges,78% of total billed charges,255,100,,,percent of total billed charges,100% of total billed charges,210.63,82.6,,,percent of total billed charges,82.6% of total billed charges,210.63,82.6,,,percent of total billed charges,82.6% of total billed charges,49.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.71,8644.5,
EXC TR-EXT B9+MARG 0.6-1 CM,11401,CDM,983,RC,11401,HCPCS,Outpatient,,,311,202.15,,273.68,88,,,percent of total billed charges,88% of total Billed charges,7.39,100,,,Fee Schedule,100% of Medicare rate,61.73,100,,,Fee Schedule,100% of WA Medicaid,311,100,,,percent of total billed charges,100% of total billed charges,63.58,103,,,Fee Schedule,103% of WA Medicaid,7.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,61.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,214.59,69,,,percent of total billed charges,69% of total billed charges,311,100,,,percent of total billed charges,100% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,311,100,,,percent of total billed charges,100% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,311,100,,,percent of total billed charges,100% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.35,61.85,,,percent of total billed charges,61.85% of total billed charges,61.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,80.25,130,,,Fee Schedule,130% of WA Medicaid ,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.25,37.7,,,percent of total billed charges,37.70% of total billed charges,117.25,37.7,,,percent of total billed charges,37.70% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10542.9,33.9,,,percent of total billed charges,33.9% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.58,78,,,percent of total billed charges,78% of total billed charges,311,100,,,percent of total billed charges,100% of total billed charges,256.89,82.6,,,percent of total billed charges,82.6% of total billed charges,256.89,82.6,,,percent of total billed charges,82.6% of total billed charges,61.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.39,10542.9,
EXC TR-EXT B9+MARG 1.1-2 CM,11402,CDM,983,RC,11402,HCPCS,Outpatient,,,384,249.60,,337.92,88,,,percent of total billed charges,88% of total Billed charges,8.46,100,,,Fee Schedule,100% of Medicare rate,67.33,100,,,Fee Schedule,100% of WA Medicaid,384,100,,,percent of total billed charges,100% of total billed charges,69.35,103,,,Fee Schedule,103% of WA Medicaid,8.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,67.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,264.96,69,,,percent of total billed charges,69% of total billed charges,384,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,384,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,384,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.5,61.85,,,percent of total billed charges,61.85% of total billed charges,67.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,87.53,130,,,Fee Schedule,130% of WA Medicaid ,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.77,37.7,,,percent of total billed charges,37.70% of total billed charges,144.77,37.7,,,percent of total billed charges,37.70% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,13017.6,33.9,,,percent of total billed charges,33.9% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.52,78,,,percent of total billed charges,78% of total billed charges,384,100,,,percent of total billed charges,100% of total billed charges,317.18,82.6,,,percent of total billed charges,82.6% of total billed charges,317.18,82.6,,,percent of total billed charges,82.6% of total billed charges,67.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.46,13017.6,
EXC TR-EXT B9+MARG 2.1-3CM/<,11403,CDM,983,RC,11403,HCPCS,Outpatient,,,493,320.45,,433.84,88,,,percent of total billed charges,88% of total Billed charges,11.58,100,,,Fee Schedule,100% of Medicare rate,87.1,100,,,Fee Schedule,100% of WA Medicaid,493,100,,,percent of total billed charges,100% of total billed charges,89.71,103,,,Fee Schedule,103% of WA Medicaid,11.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,87.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,340.17,69,,,percent of total billed charges,69% of total billed charges,493,100,,,percent of total billed charges,100% of total billed charges,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,493,100,,,percent of total billed charges,100% of total billed charges,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,493,100,,,percent of total billed charges,100% of total billed charges,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.92,61.85,,,percent of total billed charges,61.85% of total billed charges,87.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,113.23,130,,,Fee Schedule,130% of WA Medicaid ,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.86,37.7,,,percent of total billed charges,37.70% of total billed charges,185.86,37.7,,,percent of total billed charges,37.70% of total billed charges,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,16712.7,33.9,,,percent of total billed charges,33.9% of total billed charges,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.54,78,,,percent of total billed charges,78% of total billed charges,493,100,,,percent of total billed charges,100% of total billed charges,407.22,82.6,,,percent of total billed charges,82.6% of total billed charges,407.22,82.6,,,percent of total billed charges,82.6% of total billed charges,87.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.58,16712.7,
EXC TR-EXT B9+MARG 3.1-4 CM,11404,CDM,983,RC,11404,HCPCS,Outpatient,,,609,395.85,,535.92,88,,,percent of total billed charges,88% of total Billed charges,14.09,100,,,Fee Schedule,100% of Medicare rate,95.49,100,,,Fee Schedule,100% of WA Medicaid,609,100,,,percent of total billed charges,100% of total billed charges,98.35,103,,,Fee Schedule,103% of WA Medicaid,14.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,95.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,420.21,69,,,percent of total billed charges,69% of total billed charges,609,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,609,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,609,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.67,61.85,,,percent of total billed charges,61.85% of total billed charges,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,124.14,130,,,Fee Schedule,130% of WA Medicaid ,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.59,37.7,,,percent of total billed charges,37.70% of total billed charges,229.59,37.7,,,percent of total billed charges,37.70% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,20645.1,33.9,,,percent of total billed charges,33.9% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.02,78,,,percent of total billed charges,78% of total billed charges,609,100,,,percent of total billed charges,100% of total billed charges,503.03,82.6,,,percent of total billed charges,82.6% of total billed charges,503.03,82.6,,,percent of total billed charges,82.6% of total billed charges,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.09,20645.1,
EXC TR-EXT B9+MARG >4.0 CM,11406,CDM,983,RC,11406,HCPCS,Outpatient,,,869,564.85,,764.72,88,,,percent of total billed charges,88% of total Billed charges,24.63,100,,,Fee Schedule,100% of Medicare rate,142.67,100,,,Fee Schedule,100% of WA Medicaid,869,100,,,percent of total billed charges,100% of total billed charges,146.95,103,,,Fee Schedule,103% of WA Medicaid,24.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,142.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,599.61,69,,,percent of total billed charges,69% of total billed charges,869,100,,,percent of total billed charges,100% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,869,100,,,percent of total billed charges,100% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,869,100,,,percent of total billed charges,100% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.48,61.85,,,percent of total billed charges,61.85% of total billed charges,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,185.47,130,,,Fee Schedule,130% of WA Medicaid ,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.61,37.7,,,percent of total billed charges,37.70% of total billed charges,327.61,37.7,,,percent of total billed charges,37.70% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,29459.1,33.9,,,percent of total billed charges,33.9% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.82,78,,,percent of total billed charges,78% of total billed charges,869,100,,,percent of total billed charges,100% of total billed charges,717.79,82.6,,,percent of total billed charges,82.6% of total billed charges,717.79,82.6,,,percent of total billed charges,82.6% of total billed charges,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.63,29459.1,
EXC H-F-NK-SP B9+MARG 0.5/<,11420,CDM,983,RC,11420,HCPCS,Outpatient,,,178,115.70,,156.64,88,,,percent of total billed charges,88% of total Billed charges,5.11,100,,,Fee Schedule,100% of Medicare rate,48.12,100,,,Fee Schedule,100% of WA Medicaid,178,100,,,percent of total billed charges,100% of total billed charges,49.56,103,,,Fee Schedule,103% of WA Medicaid,5.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,122.82,69,,,percent of total billed charges,69% of total billed charges,178,100,,,percent of total billed charges,100% of total billed charges,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,178,100,,,percent of total billed charges,100% of total billed charges,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,178,100,,,percent of total billed charges,100% of total billed charges,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.09,61.85,,,percent of total billed charges,61.85% of total billed charges,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.56,130,,,Fee Schedule,130% of WA Medicaid ,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.11,37.7,,,percent of total billed charges,37.70% of total billed charges,67.11,37.7,,,percent of total billed charges,37.70% of total billed charges,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,6034.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.84,78,,,percent of total billed charges,78% of total billed charges,178,100,,,percent of total billed charges,100% of total billed charges,147.03,82.6,,,percent of total billed charges,82.6% of total billed charges,147.03,82.6,,,percent of total billed charges,82.6% of total billed charges,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.11,6034.2,
EXC H-F-NK-SP B9+MARG 0.6-1,11421,CDM,983,RC,11421,HCPCS,Outpatient,,,349,226.85,,307.12,88,,,percent of total billed charges,88% of total Billed charges,7.74,100,,,Fee Schedule,100% of Medicare rate,63.41,100,,,Fee Schedule,100% of WA Medicaid,349,100,,,percent of total billed charges,100% of total billed charges,65.31,103,,,Fee Schedule,103% of WA Medicaid,7.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,240.81,69,,,percent of total billed charges,69% of total billed charges,349,100,,,percent of total billed charges,100% of total billed charges,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,349,100,,,percent of total billed charges,100% of total billed charges,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,349,100,,,percent of total billed charges,100% of total billed charges,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.86,61.85,,,percent of total billed charges,61.85% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.43,130,,,Fee Schedule,130% of WA Medicaid ,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.57,37.7,,,percent of total billed charges,37.70% of total billed charges,131.57,37.7,,,percent of total billed charges,37.70% of total billed charges,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,11831.1,33.9,,,percent of total billed charges,33.9% of total billed charges,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.22,78,,,percent of total billed charges,78% of total billed charges,349,100,,,percent of total billed charges,100% of total billed charges,288.27,82.6,,,percent of total billed charges,82.6% of total billed charges,288.27,82.6,,,percent of total billed charges,82.6% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.74,11831.1,
EXC H-F-NK-SP B9+MARG 1.1-2,11422,CDM,983,RC,11422,HCPCS,Outpatient,,,431,280.15,,379.28,88,,,percent of total billed charges,88% of total Billed charges,9.6,100,,,Fee Schedule,100% of Medicare rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,431,100,,,percent of total billed charges,100% of total billed charges,81.64,103,,,Fee Schedule,103% of WA Medicaid,9.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,297.39,69,,,percent of total billed charges,69% of total billed charges,431,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,431,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,431,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.57,61.85,,,percent of total billed charges,61.85% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.04,130,,,Fee Schedule,130% of WA Medicaid ,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.49,37.7,,,percent of total billed charges,37.70% of total billed charges,162.49,37.7,,,percent of total billed charges,37.70% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,14610.9,33.9,,,percent of total billed charges,33.9% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.18,78,,,percent of total billed charges,78% of total billed charges,431,100,,,percent of total billed charges,100% of total billed charges,356.01,82.6,,,percent of total billed charges,82.6% of total billed charges,356.01,82.6,,,percent of total billed charges,82.6% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.6,14610.9,
EXC H-F-NK-SP B9+MARG 2.1-3,11423,CDM,983,RC,11423,HCPCS,Outpatient,,,566,367.90,,498.08,88,,,percent of total billed charges,88% of total Billed charges,11.8,100,,,Fee Schedule,100% of Medicare rate,91.39,100,,,Fee Schedule,100% of WA Medicaid,566,100,,,percent of total billed charges,100% of total billed charges,94.13,103,,,Fee Schedule,103% of WA Medicaid,11.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,91.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,390.54,69,,,percent of total billed charges,69% of total billed charges,566,100,,,percent of total billed charges,100% of total billed charges,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,566,100,,,percent of total billed charges,100% of total billed charges,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,566,100,,,percent of total billed charges,100% of total billed charges,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.07,61.85,,,percent of total billed charges,61.85% of total billed charges,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,118.81,130,,,Fee Schedule,130% of WA Medicaid ,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.38,37.7,,,percent of total billed charges,37.70% of total billed charges,213.38,37.7,,,percent of total billed charges,37.70% of total billed charges,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,19187.4,33.9,,,percent of total billed charges,33.9% of total billed charges,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.48,78,,,percent of total billed charges,78% of total billed charges,566,100,,,percent of total billed charges,100% of total billed charges,467.52,82.6,,,percent of total billed charges,82.6% of total billed charges,467.52,82.6,,,percent of total billed charges,82.6% of total billed charges,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.8,19187.4,
EXC H-F-NK-SP B9+MARG 3.1-4,11424,CDM,983,RC,11424,HCPCS,Outpatient,,,692,449.80,,608.96,88,,,percent of total billed charges,88% of total Billed charges,15.1,100,,,Fee Schedule,100% of Medicare rate,104.81,100,,,Fee Schedule,100% of WA Medicaid,692,100,,,percent of total billed charges,100% of total billed charges,107.95,103,,,Fee Schedule,103% of WA Medicaid,15.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,104.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,477.48,69,,,percent of total billed charges,69% of total billed charges,692,100,,,percent of total billed charges,100% of total billed charges,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,692,100,,,percent of total billed charges,100% of total billed charges,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,692,100,,,percent of total billed charges,100% of total billed charges,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,428,61.85,,,percent of total billed charges,61.85% of total billed charges,104.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.25,130,,,Fee Schedule,130% of WA Medicaid ,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.88,37.7,,,percent of total billed charges,37.70% of total billed charges,260.88,37.7,,,percent of total billed charges,37.70% of total billed charges,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,23458.8,33.9,,,percent of total billed charges,33.9% of total billed charges,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.76,78,,,percent of total billed charges,78% of total billed charges,692,100,,,percent of total billed charges,100% of total billed charges,571.59,82.6,,,percent of total billed charges,82.6% of total billed charges,571.59,82.6,,,percent of total billed charges,82.6% of total billed charges,104.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.1,23458.8,
EXC H-F-NK-SP B9+MARG >4 CM,11426,CDM,983,RC,11426,HCPCS,Outpatient,,,978,635.70,,860.64,88,,,percent of total billed charges,88% of total Billed charges,24.43,100,,,Fee Schedule,100% of Medicare rate,153.68,100,,,Fee Schedule,100% of WA Medicaid,978,100,,,percent of total billed charges,100% of total billed charges,158.29,103,,,Fee Schedule,103% of WA Medicaid,24.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,153.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,674.82,69,,,percent of total billed charges,69% of total billed charges,978,100,,,percent of total billed charges,100% of total billed charges,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,978,100,,,percent of total billed charges,100% of total billed charges,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,978,100,,,percent of total billed charges,100% of total billed charges,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,604.89,61.85,,,percent of total billed charges,61.85% of total billed charges,153.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,199.78,130,,,Fee Schedule,130% of WA Medicaid ,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.71,37.7,,,percent of total billed charges,37.70% of total billed charges,368.71,37.7,,,percent of total billed charges,37.70% of total billed charges,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33154.2,33.9,,,percent of total billed charges,33.9% of total billed charges,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,762.84,78,,,percent of total billed charges,78% of total billed charges,978,100,,,percent of total billed charges,100% of total billed charges,807.83,82.6,,,percent of total billed charges,82.6% of total billed charges,807.83,82.6,,,percent of total billed charges,82.6% of total billed charges,153.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.43,33154.2,
EXC FACE-MM B9+MARG 0.5 CM/<,11440,CDM,983,RC,11440,HCPCS,Outpatient,,,323,209.95,,284.24,88,,,percent of total billed charges,88% of total Billed charges,6.16,100,,,Fee Schedule,100% of Medicare rate,63.22,100,,,Fee Schedule,100% of WA Medicaid,323,100,,,percent of total billed charges,100% of total billed charges,65.12,103,,,Fee Schedule,103% of WA Medicaid,6.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,222.87,69,,,percent of total billed charges,69% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,323,100,,,percent of total billed charges,100% of total billed charges,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,323,100,,,percent of total billed charges,100% of total billed charges,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.78,61.85,,,percent of total billed charges,61.85% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.19,130,,,Fee Schedule,130% of WA Medicaid ,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,10949.7,33.9,,,percent of total billed charges,33.9% of total billed charges,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.94,78,,,percent of total billed charges,78% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.16,10949.7,
EXC FACE-MM B9+MARG 0.6-1 CM,11441,CDM,983,RC,11441,HCPCS,Outpatient,,,405,263.25,,356.4,88,,,percent of total billed charges,88% of total Billed charges,9.28,100,,,Fee Schedule,100% of Medicare rate,78.14,100,,,Fee Schedule,100% of WA Medicaid,405,100,,,percent of total billed charges,100% of total billed charges,80.48,103,,,Fee Schedule,103% of WA Medicaid,9.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,78.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,279.45,69,,,percent of total billed charges,69% of total billed charges,405,100,,,percent of total billed charges,100% of total billed charges,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,405,100,,,percent of total billed charges,100% of total billed charges,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,405,100,,,percent of total billed charges,100% of total billed charges,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.49,61.85,,,percent of total billed charges,61.85% of total billed charges,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.58,130,,,Fee Schedule,130% of WA Medicaid ,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.69,37.7,,,percent of total billed charges,37.70% of total billed charges,152.69,37.7,,,percent of total billed charges,37.70% of total billed charges,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,13729.5,33.9,,,percent of total billed charges,33.9% of total billed charges,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.9,78,,,percent of total billed charges,78% of total billed charges,405,100,,,percent of total billed charges,100% of total billed charges,334.53,82.6,,,percent of total billed charges,82.6% of total billed charges,334.53,82.6,,,percent of total billed charges,82.6% of total billed charges,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.28,13729.5,
EXC FACE-MM B9+MARG 1.1-2 CM,11442,CDM,983,RC,11442,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,10.72,100,,,Fee Schedule,100% of Medicare rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,88.36,103,,,Fee Schedule,103% of WA Medicaid,10.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.72,61.85,,,percent of total billed charges,61.85% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.53,130,,,Fee Schedule,130% of WA Medicaid ,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,17085.6,33.9,,,percent of total billed charges,33.9% of total billed charges,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.72,17085.6,
EXC FACE-MM B9+MARG 2.1-3 CM,11443,CDM,983,RC,11443,HCPCS,Outpatient,,,655,425.75,,576.4,88,,,percent of total billed charges,88% of total Billed charges,13.76,100,,,Fee Schedule,100% of Medicare rate,104.07,100,,,Fee Schedule,100% of WA Medicaid,655,100,,,percent of total billed charges,100% of total billed charges,107.19,103,,,Fee Schedule,103% of WA Medicaid,13.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,104.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,451.95,69,,,percent of total billed charges,69% of total billed charges,655,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,655,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,655,100,,,percent of total billed charges,100% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.12,61.85,,,percent of total billed charges,61.85% of total billed charges,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,135.29,130,,,Fee Schedule,130% of WA Medicaid ,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.94,37.7,,,percent of total billed charges,37.70% of total billed charges,246.94,37.7,,,percent of total billed charges,37.70% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,22204.5,33.9,,,percent of total billed charges,33.9% of total billed charges,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.9,78,,,percent of total billed charges,78% of total billed charges,655,100,,,percent of total billed charges,100% of total billed charges,541.03,82.6,,,percent of total billed charges,82.6% of total billed charges,541.03,82.6,,,percent of total billed charges,82.6% of total billed charges,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.76,22204.5,
EXC FACE-MM B9+MARG 3.1-4 CM,11444,CDM,983,RC,11444,HCPCS,Outpatient,,,856,556.40,,753.28,88,,,percent of total billed charges,88% of total Billed charges,18.26,100,,,Fee Schedule,100% of Medicare rate,130.18,100,,,Fee Schedule,100% of WA Medicaid,856,100,,,percent of total billed charges,100% of total billed charges,134.09,103,,,Fee Schedule,103% of WA Medicaid,18.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,130.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,590.64,69,,,percent of total billed charges,69% of total billed charges,856,100,,,percent of total billed charges,100% of total billed charges,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,856,100,,,percent of total billed charges,100% of total billed charges,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,856,100,,,percent of total billed charges,100% of total billed charges,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,529.44,61.85,,,percent of total billed charges,61.85% of total billed charges,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,169.23,130,,,Fee Schedule,130% of WA Medicaid ,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.71,37.7,,,percent of total billed charges,37.70% of total billed charges,322.71,37.7,,,percent of total billed charges,37.70% of total billed charges,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,29018.4,33.9,,,percent of total billed charges,33.9% of total billed charges,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.68,78,,,percent of total billed charges,78% of total billed charges,856,100,,,percent of total billed charges,100% of total billed charges,707.06,82.6,,,percent of total billed charges,82.6% of total billed charges,707.06,82.6,,,percent of total billed charges,82.6% of total billed charges,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.26,29018.4,
EXC FACE-MM B9+MARG >4 CM,11446,CDM,983,RC,11446,HCPCS,Outpatient,,,1064,691.60,,936.32,88,,,percent of total billed charges,88% of total Billed charges,27.22,100,,,Fee Schedule,100% of Medicare rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,1064,100,,,percent of total billed charges,100% of total billed charges,187.48,103,,,Fee Schedule,103% of WA Medicaid,27.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,734.16,69,,,percent of total billed charges,69% of total billed charges,1064,100,,,percent of total billed charges,100% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064,100,,,percent of total billed charges,100% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064,100,,,percent of total billed charges,100% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.08,61.85,,,percent of total billed charges,61.85% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,236.63,130,,,Fee Schedule,130% of WA Medicaid ,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.13,37.7,,,percent of total billed charges,37.70% of total billed charges,401.13,37.7,,,percent of total billed charges,37.70% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,36069.6,33.9,,,percent of total billed charges,33.9% of total billed charges,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.92,78,,,percent of total billed charges,78% of total billed charges,1064,100,,,percent of total billed charges,100% of total billed charges,878.86,82.6,,,percent of total billed charges,82.6% of total billed charges,878.86,82.6,,,percent of total billed charges,82.6% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.22,36069.6,
REMOVAL SWEAT GLAND LESION,11450,CDM,983,RC,11450,HCPCS,Outpatient,,,551,358.15,,484.88,88,,,percent of total billed charges,88% of total Billed charges,27.16,100,,,Fee Schedule,100% of Medicare rate,151.62,100,,,Fee Schedule,100% of WA Medicaid,551,100,,,percent of total billed charges,100% of total billed charges,156.17,103,,,Fee Schedule,103% of WA Medicaid,27.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,151.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,380.19,69,,,percent of total billed charges,69% of total billed charges,551,100,,,percent of total billed charges,100% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,551,100,,,percent of total billed charges,100% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,551,100,,,percent of total billed charges,100% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.79,61.85,,,percent of total billed charges,61.85% of total billed charges,151.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,197.11,130,,,Fee Schedule,130% of WA Medicaid ,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.73,37.7,,,percent of total billed charges,37.70% of total billed charges,207.73,37.7,,,percent of total billed charges,37.70% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,18678.9,33.9,,,percent of total billed charges,33.9% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.78,78,,,percent of total billed charges,78% of total billed charges,551,100,,,percent of total billed charges,100% of total billed charges,455.13,82.6,,,percent of total billed charges,82.6% of total billed charges,455.13,82.6,,,percent of total billed charges,82.6% of total billed charges,151.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.16,18678.9,
REMOVAL SWEAT GLAND LESION,11451,CDM,983,RC,11451,HCPCS,Outpatient,,,851,553.15,,748.88,88,,,percent of total billed charges,88% of total Billed charges,34.68,100,,,Fee Schedule,100% of Medicare rate,190.98,100,,,Fee Schedule,100% of WA Medicaid,851,100,,,percent of total billed charges,100% of total billed charges,196.71,103,,,Fee Schedule,103% of WA Medicaid,34.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,190.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,587.19,69,,,percent of total billed charges,69% of total billed charges,851,100,,,percent of total billed charges,100% of total billed charges,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,851,100,,,percent of total billed charges,100% of total billed charges,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,851,100,,,percent of total billed charges,100% of total billed charges,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,526.34,61.85,,,percent of total billed charges,61.85% of total billed charges,190.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,248.27,130,,,Fee Schedule,130% of WA Medicaid ,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.83,37.7,,,percent of total billed charges,37.70% of total billed charges,320.83,37.7,,,percent of total billed charges,37.70% of total billed charges,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,28848.9,33.9,,,percent of total billed charges,33.9% of total billed charges,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.78,78,,,percent of total billed charges,78% of total billed charges,851,100,,,percent of total billed charges,100% of total billed charges,702.93,82.6,,,percent of total billed charges,82.6% of total billed charges,702.93,82.6,,,percent of total billed charges,82.6% of total billed charges,190.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.68,28848.9,
REMOVAL SWEAT GLAND LESION,11462,CDM,983,RC,11462,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,25.23,100,,,Fee Schedule,100% of Medicare rate,144.72,100,,,Fee Schedule,100% of WA Medicaid,650,100,,,percent of total billed charges,100% of total billed charges,149.06,103,,,Fee Schedule,103% of WA Medicaid,25.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,144.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,144.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,188.14,130,,,Fee Schedule,130% of WA Medicaid ,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,22035,33.9,,,percent of total billed charges,33.9% of total billed charges,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,144.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.23,22035,
REMOVAL SWEAT GLAND LESION,11463,CDM,983,RC,11463,HCPCS,Outpatient,,,880,572.00,,774.4,88,,,percent of total billed charges,88% of total Billed charges,33.7,100,,,Fee Schedule,100% of Medicare rate,192.1,100,,,Fee Schedule,100% of WA Medicaid,880,100,,,percent of total billed charges,100% of total billed charges,197.86,103,,,Fee Schedule,103% of WA Medicaid,33.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,192.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,607.2,69,,,percent of total billed charges,69% of total billed charges,880,100,,,percent of total billed charges,100% of total billed charges,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,880,100,,,percent of total billed charges,100% of total billed charges,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,880,100,,,percent of total billed charges,100% of total billed charges,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.28,61.85,,,percent of total billed charges,61.85% of total billed charges,192.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,249.73,130,,,Fee Schedule,130% of WA Medicaid ,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.76,37.7,,,percent of total billed charges,37.70% of total billed charges,331.76,37.7,,,percent of total billed charges,37.70% of total billed charges,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,29832,33.9,,,percent of total billed charges,33.9% of total billed charges,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.4,78,,,percent of total billed charges,78% of total billed charges,880,100,,,percent of total billed charges,100% of total billed charges,726.88,82.6,,,percent of total billed charges,82.6% of total billed charges,726.88,82.6,,,percent of total billed charges,82.6% of total billed charges,192.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.7,29832,
REMOVAL SWEAT GLAND LESION,11470,CDM,983,RC,11470,HCPCS,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,28.94,100,,,Fee Schedule,100% of Medicare rate,165.8,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,170.77,103,,,Fee Schedule,103% of WA Medicaid,28.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,50.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,165.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,165.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,215.54,130,,,Fee Schedule,130% of WA Medicaid ,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,30510,33.9,,,percent of total billed charges,33.9% of total billed charges,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,165.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.94,30510,
EXC TR-EXT MAL+MARG 0.5 CM/<,11600,CDM,983,RC,11600,HCPCS,Outpatient,,,319,207.35,,280.72,88,,,percent of total billed charges,88% of total Billed charges,9.43,100,,,Fee Schedule,100% of Medicare rate,70.87,100,,,Fee Schedule,100% of WA Medicaid,319,100,,,percent of total billed charges,100% of total billed charges,73,103,,,Fee Schedule,103% of WA Medicaid,9.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,220.11,69,,,percent of total billed charges,69% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,319,100,,,percent of total billed charges,100% of total billed charges,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,319,100,,,percent of total billed charges,100% of total billed charges,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.3,61.85,,,percent of total billed charges,61.85% of total billed charges,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,92.13,130,,,Fee Schedule,130% of WA Medicaid ,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,10814.1,33.9,,,percent of total billed charges,33.9% of total billed charges,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.82,78,,,percent of total billed charges,78% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.43,10814.1,
EXC TR-EXT MAL+MARG 0.6-1 CM,11601,CDM,983,RC,11601,HCPCS,Outpatient,,,305,198.25,,268.4,88,,,percent of total billed charges,88% of total Billed charges,10.98,100,,,Fee Schedule,100% of Medicare rate,85.6,100,,,Fee Schedule,100% of WA Medicaid,305,100,,,percent of total billed charges,100% of total billed charges,88.17,103,,,Fee Schedule,103% of WA Medicaid,10.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,210.45,69,,,percent of total billed charges,69% of total billed charges,305,100,,,percent of total billed charges,100% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,305,100,,,percent of total billed charges,100% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,305,100,,,percent of total billed charges,100% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.64,61.85,,,percent of total billed charges,61.85% of total billed charges,85.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.28,130,,,Fee Schedule,130% of WA Medicaid ,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.99,37.7,,,percent of total billed charges,37.70% of total billed charges,114.99,37.7,,,percent of total billed charges,37.70% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10339.5,33.9,,,percent of total billed charges,33.9% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.9,78,,,percent of total billed charges,78% of total billed charges,305,100,,,percent of total billed charges,100% of total billed charges,251.93,82.6,,,percent of total billed charges,82.6% of total billed charges,251.93,82.6,,,percent of total billed charges,82.6% of total billed charges,85.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.98,10339.5,
EXC TR-EXT MAL+MARG 1.1-2 CM,11602,CDM,983,RC,11602,HCPCS,Outpatient,,,460,299.00,,404.8,88,,,percent of total billed charges,88% of total Billed charges,11.37,100,,,Fee Schedule,100% of Medicare rate,93.06,100,,,Fee Schedule,100% of WA Medicaid,460,100,,,percent of total billed charges,100% of total billed charges,95.85,103,,,Fee Schedule,103% of WA Medicaid,11.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,93.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,317.4,69,,,percent of total billed charges,69% of total billed charges,460,100,,,percent of total billed charges,100% of total billed charges,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,460,100,,,percent of total billed charges,100% of total billed charges,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,460,100,,,percent of total billed charges,100% of total billed charges,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.51,61.85,,,percent of total billed charges,61.85% of total billed charges,93.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,120.98,130,,,Fee Schedule,130% of WA Medicaid ,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.42,37.7,,,percent of total billed charges,37.70% of total billed charges,173.42,37.7,,,percent of total billed charges,37.70% of total billed charges,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,15594,33.9,,,percent of total billed charges,33.9% of total billed charges,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.8,78,,,percent of total billed charges,78% of total billed charges,460,100,,,percent of total billed charges,100% of total billed charges,379.96,82.6,,,percent of total billed charges,82.6% of total billed charges,379.96,82.6,,,percent of total billed charges,82.6% of total billed charges,93.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.37,15594,
EXC TR-EXT MAL+MARG 2.1-3 CM,11603,CDM,983,RC,11603,HCPCS,Outpatient,,,550,357.50,,484,88,,,percent of total billed charges,88% of total Billed charges,14.64,100,,,Fee Schedule,100% of Medicare rate,110.78,100,,,Fee Schedule,100% of WA Medicaid,550,100,,,percent of total billed charges,100% of total billed charges,114.1,103,,,Fee Schedule,103% of WA Medicaid,14.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,110.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,379.5,69,,,percent of total billed charges,69% of total billed charges,550,100,,,percent of total billed charges,100% of total billed charges,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,550,100,,,percent of total billed charges,100% of total billed charges,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,550,100,,,percent of total billed charges,100% of total billed charges,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.18,61.85,,,percent of total billed charges,61.85% of total billed charges,110.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,113,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,144.01,130,,,Fee Schedule,130% of WA Medicaid ,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.35,37.7,,,percent of total billed charges,37.70% of total billed charges,207.35,37.7,,,percent of total billed charges,37.70% of total billed charges,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,18645,33.9,,,percent of total billed charges,33.9% of total billed charges,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,429,78,,,percent of total billed charges,78% of total billed charges,550,100,,,percent of total billed charges,100% of total billed charges,454.3,82.6,,,percent of total billed charges,82.6% of total billed charges,454.3,82.6,,,percent of total billed charges,82.6% of total billed charges,110.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.64,18645,
EXC TR-EXT MAL+MARG 3.1-4 CM,11604,CDM,983,RC,11604,HCPCS,Outpatient,,,658,427.70,,579.04,88,,,percent of total billed charges,88% of total Billed charges,17.29,100,,,Fee Schedule,100% of Medicare rate,121.6,100,,,Fee Schedule,100% of WA Medicaid,658,100,,,percent of total billed charges,100% of total billed charges,125.25,103,,,Fee Schedule,103% of WA Medicaid,17.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,121.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,454.02,69,,,percent of total billed charges,69% of total billed charges,658,100,,,percent of total billed charges,100% of total billed charges,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,658,100,,,percent of total billed charges,100% of total billed charges,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,658,100,,,percent of total billed charges,100% of total billed charges,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.97,61.85,,,percent of total billed charges,61.85% of total billed charges,121.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,158.08,130,,,Fee Schedule,130% of WA Medicaid ,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.07,37.7,,,percent of total billed charges,37.70% of total billed charges,248.07,37.7,,,percent of total billed charges,37.70% of total billed charges,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,22306.2,33.9,,,percent of total billed charges,33.9% of total billed charges,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.24,78,,,percent of total billed charges,78% of total billed charges,658,100,,,percent of total billed charges,100% of total billed charges,543.51,82.6,,,percent of total billed charges,82.6% of total billed charges,543.51,82.6,,,percent of total billed charges,82.6% of total billed charges,121.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.29,22306.2,
EXC TR-EXT MAL+MARG >4 CM,11606,CDM,983,RC,11606,HCPCS,Outpatient,,,902,586.30,,793.76,88,,,percent of total billed charges,88% of total Billed charges,32.02,100,,,Fee Schedule,100% of Medicare rate,179.41,100,,,Fee Schedule,100% of WA Medicaid,902,100,,,percent of total billed charges,100% of total billed charges,184.79,103,,,Fee Schedule,103% of WA Medicaid,32.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,179.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,622.38,69,,,percent of total billed charges,69% of total billed charges,902,100,,,percent of total billed charges,100% of total billed charges,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,902,100,,,percent of total billed charges,100% of total billed charges,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,902,100,,,percent of total billed charges,100% of total billed charges,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.89,61.85,,,percent of total billed charges,61.85% of total billed charges,179.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,183,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,233.23,130,,,Fee Schedule,130% of WA Medicaid ,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.05,37.7,,,percent of total billed charges,37.70% of total billed charges,340.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,30577.8,33.9,,,percent of total billed charges,33.9% of total billed charges,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,703.56,78,,,percent of total billed charges,78% of total billed charges,902,100,,,percent of total billed charges,100% of total billed charges,745.05,82.6,,,percent of total billed charges,82.6% of total billed charges,745.05,82.6,,,percent of total billed charges,82.6% of total billed charges,179.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.02,30577.8,
EXC H-F-NK-SP MAL+MARG 0.5/<,11620,CDM,983,RC,11620,HCPCS,Outpatient,,,357,232.05,,314.16,88,,,percent of total billed charges,88% of total Billed charges,9.71,100,,,Fee Schedule,100% of Medicare rate,71.43,100,,,Fee Schedule,100% of WA Medicaid,357,100,,,percent of total billed charges,100% of total billed charges,73.57,103,,,Fee Schedule,103% of WA Medicaid,9.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,71.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,246.33,69,,,percent of total billed charges,69% of total billed charges,357,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,357,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,357,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.8,61.85,,,percent of total billed charges,61.85% of total billed charges,71.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,92.86,130,,,Fee Schedule,130% of WA Medicaid ,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.59,37.7,,,percent of total billed charges,37.70% of total billed charges,134.59,37.7,,,percent of total billed charges,37.70% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,12102.3,33.9,,,percent of total billed charges,33.9% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.46,78,,,percent of total billed charges,78% of total billed charges,357,100,,,percent of total billed charges,100% of total billed charges,294.88,82.6,,,percent of total billed charges,82.6% of total billed charges,294.88,82.6,,,percent of total billed charges,82.6% of total billed charges,71.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.71,12102.3,
EXC S/N/H/F/G MAL+MRG 0.6-1,11621,CDM,983,RC,11621,HCPCS,Outpatient,,,453,294.45,,398.64,88,,,percent of total billed charges,88% of total Billed charges,11.26,100,,,Fee Schedule,100% of Medicare rate,85.98,100,,,Fee Schedule,100% of WA Medicaid,453,100,,,percent of total billed charges,100% of total billed charges,88.56,103,,,Fee Schedule,103% of WA Medicaid,11.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,312.57,69,,,percent of total billed charges,69% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,453,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,453,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.18,61.85,,,percent of total billed charges,61.85% of total billed charges,85.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.77,130,,,Fee Schedule,130% of WA Medicaid ,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,15356.7,33.9,,,percent of total billed charges,33.9% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.34,78,,,percent of total billed charges,78% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,85.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.26,15356.7,
EXC S/N/H/F/G MAL+MRG 1.1-2,11622,CDM,983,RC,11622,HCPCS,Outpatient,,,537,349.05,,472.56,88,,,percent of total billed charges,88% of total Billed charges,12.64,100,,,Fee Schedule,100% of Medicare rate,97.35,100,,,Fee Schedule,100% of WA Medicaid,537,100,,,percent of total billed charges,100% of total billed charges,100.27,103,,,Fee Schedule,103% of WA Medicaid,12.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,97.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,370.53,69,,,percent of total billed charges,69% of total billed charges,537,100,,,percent of total billed charges,100% of total billed charges,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,537,100,,,percent of total billed charges,100% of total billed charges,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,537,100,,,percent of total billed charges,100% of total billed charges,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.13,61.85,,,percent of total billed charges,61.85% of total billed charges,97.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.56,130,,,Fee Schedule,130% of WA Medicaid ,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.45,37.7,,,percent of total billed charges,37.70% of total billed charges,202.45,37.7,,,percent of total billed charges,37.70% of total billed charges,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,18204.3,33.9,,,percent of total billed charges,33.9% of total billed charges,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.86,78,,,percent of total billed charges,78% of total billed charges,537,100,,,percent of total billed charges,100% of total billed charges,443.56,82.6,,,percent of total billed charges,82.6% of total billed charges,443.56,82.6,,,percent of total billed charges,82.6% of total billed charges,97.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.64,18204.3,
EXC S/N/H/F/G MAL+MRG 2.1-3,11623,CDM,983,RC,11623,HCPCS,Outpatient,,,656,426.40,,577.28,88,,,percent of total billed charges,88% of total Billed charges,16.67,100,,,Fee Schedule,100% of Medicare rate,119.73,100,,,Fee Schedule,100% of WA Medicaid,656,100,,,percent of total billed charges,100% of total billed charges,123.32,103,,,Fee Schedule,103% of WA Medicaid,16.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,119.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,452.64,69,,,percent of total billed charges,69% of total billed charges,656,100,,,percent of total billed charges,100% of total billed charges,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,656,100,,,percent of total billed charges,100% of total billed charges,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,656,100,,,percent of total billed charges,100% of total billed charges,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.74,61.85,,,percent of total billed charges,61.85% of total billed charges,119.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,155.65,130,,,Fee Schedule,130% of WA Medicaid ,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.31,37.7,,,percent of total billed charges,37.70% of total billed charges,247.31,37.7,,,percent of total billed charges,37.70% of total billed charges,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,22238.4,33.9,,,percent of total billed charges,33.9% of total billed charges,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,511.68,78,,,percent of total billed charges,78% of total billed charges,656,100,,,percent of total billed charges,100% of total billed charges,541.86,82.6,,,percent of total billed charges,82.6% of total billed charges,541.86,82.6,,,percent of total billed charges,82.6% of total billed charges,119.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.67,22238.4,
EXC S/N/H/F/G MAL+MRG 3.1-4,11624,CDM,983,RC,11624,HCPCS,Outpatient,,,753,489.45,,662.64,88,,,percent of total billed charges,88% of total Billed charges,20.63,100,,,Fee Schedule,100% of Medicare rate,135.77,100,,,Fee Schedule,100% of WA Medicaid,753,100,,,percent of total billed charges,100% of total billed charges,139.84,103,,,Fee Schedule,103% of WA Medicaid,20.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,135.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,519.57,69,,,percent of total billed charges,69% of total billed charges,753,100,,,percent of total billed charges,100% of total billed charges,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,753,100,,,percent of total billed charges,100% of total billed charges,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,753,100,,,percent of total billed charges,100% of total billed charges,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.73,61.85,,,percent of total billed charges,61.85% of total billed charges,135.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,176.5,130,,,Fee Schedule,130% of WA Medicaid ,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.88,37.7,,,percent of total billed charges,37.70% of total billed charges,283.88,37.7,,,percent of total billed charges,37.70% of total billed charges,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,25526.7,33.9,,,percent of total billed charges,33.9% of total billed charges,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,587.34,78,,,percent of total billed charges,78% of total billed charges,753,100,,,percent of total billed charges,100% of total billed charges,621.98,82.6,,,percent of total billed charges,82.6% of total billed charges,621.98,82.6,,,percent of total billed charges,82.6% of total billed charges,135.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.63,25526.7,
EXC S/N/H/F/G MAL+MRG >4 CM,11626,CDM,983,RC,11626,HCPCS,Outpatient,,,1071,696.15,,942.48,88,,,percent of total billed charges,88% of total Billed charges,28.67,100,,,Fee Schedule,100% of Medicare rate,164.87,100,,,Fee Schedule,100% of WA Medicaid,1071,100,,,percent of total billed charges,100% of total billed charges,169.82,103,,,Fee Schedule,103% of WA Medicaid,28.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,50.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,164.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,738.99,69,,,percent of total billed charges,69% of total billed charges,1071,100,,,percent of total billed charges,100% of total billed charges,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1071,100,,,percent of total billed charges,100% of total billed charges,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1071,100,,,percent of total billed charges,100% of total billed charges,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,662.41,61.85,,,percent of total billed charges,61.85% of total billed charges,164.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,214.33,130,,,Fee Schedule,130% of WA Medicaid ,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.77,37.7,,,percent of total billed charges,37.70% of total billed charges,403.77,37.7,,,percent of total billed charges,37.70% of total billed charges,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,36306.9,33.9,,,percent of total billed charges,33.9% of total billed charges,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.38,78,,,percent of total billed charges,78% of total billed charges,1071,100,,,percent of total billed charges,100% of total billed charges,884.65,82.6,,,percent of total billed charges,82.6% of total billed charges,884.65,82.6,,,percent of total billed charges,82.6% of total billed charges,164.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.67,36306.9,
EXC F/E/E/N/L MAL+MRG 0.5CM<,11640,CDM,983,RC,11640,HCPCS,Outpatient,,,449,291.85,,395.12,88,,,percent of total billed charges,88% of total Billed charges,9.3,100,,,Fee Schedule,100% of Medicare rate,73.48,100,,,Fee Schedule,100% of WA Medicaid,449,100,,,percent of total billed charges,100% of total billed charges,75.68,103,,,Fee Schedule,103% of WA Medicaid,9.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,73.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,309.81,69,,,percent of total billed charges,69% of total billed charges,449,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,449,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,449,100,,,percent of total billed charges,100% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.71,61.85,,,percent of total billed charges,61.85% of total billed charges,73.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.52,130,,,Fee Schedule,130% of WA Medicaid ,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.27,37.7,,,percent of total billed charges,37.70% of total billed charges,169.27,37.7,,,percent of total billed charges,37.70% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,15221.1,33.9,,,percent of total billed charges,33.9% of total billed charges,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.22,78,,,percent of total billed charges,78% of total billed charges,449,100,,,percent of total billed charges,100% of total billed charges,370.87,82.6,,,percent of total billed charges,82.6% of total billed charges,370.87,82.6,,,percent of total billed charges,82.6% of total billed charges,73.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.3,15221.1,
EXC F/E/E/N/L MAL+MRG 0.6-1,11641,CDM,983,RC,11641,HCPCS,Outpatient,,,569,369.85,,500.72,88,,,percent of total billed charges,88% of total Billed charges,11.71,100,,,Fee Schedule,100% of Medicare rate,89.52,100,,,Fee Schedule,100% of WA Medicaid,569,100,,,percent of total billed charges,100% of total billed charges,92.21,103,,,Fee Schedule,103% of WA Medicaid,11.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,89.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,392.61,69,,,percent of total billed charges,69% of total billed charges,569,100,,,percent of total billed charges,100% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,569,100,,,percent of total billed charges,100% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,569,100,,,percent of total billed charges,100% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.93,61.85,,,percent of total billed charges,61.85% of total billed charges,89.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,116.38,130,,,Fee Schedule,130% of WA Medicaid ,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.51,37.7,,,percent of total billed charges,37.70% of total billed charges,214.51,37.7,,,percent of total billed charges,37.70% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,19289.1,33.9,,,percent of total billed charges,33.9% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.82,78,,,percent of total billed charges,78% of total billed charges,569,100,,,percent of total billed charges,100% of total billed charges,469.99,82.6,,,percent of total billed charges,82.6% of total billed charges,469.99,82.6,,,percent of total billed charges,82.6% of total billed charges,89.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.71,19289.1,
EXC F/E/E/N/L MAL+MRG 1.1-2,11642,CDM,983,RC,11642,HCPCS,Outpatient,,,663,430.95,,583.44,88,,,percent of total billed charges,88% of total Billed charges,14.32,100,,,Fee Schedule,100% of Medicare rate,104.63,100,,,Fee Schedule,100% of WA Medicaid,663,100,,,percent of total billed charges,100% of total billed charges,107.77,103,,,Fee Schedule,103% of WA Medicaid,14.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,104.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,457.47,69,,,percent of total billed charges,69% of total billed charges,663,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,663,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,663,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.07,61.85,,,percent of total billed charges,61.85% of total billed charges,104.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.02,130,,,Fee Schedule,130% of WA Medicaid ,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.95,37.7,,,percent of total billed charges,37.70% of total billed charges,249.95,37.7,,,percent of total billed charges,37.70% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,22475.7,33.9,,,percent of total billed charges,33.9% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.14,78,,,percent of total billed charges,78% of total billed charges,663,100,,,percent of total billed charges,100% of total billed charges,547.64,82.6,,,percent of total billed charges,82.6% of total billed charges,547.64,82.6,,,percent of total billed charges,82.6% of total billed charges,104.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.32,22475.7,
EXC F/E/E/N/L MAL+MRG 2.1-3,11643,CDM,983,RC,11643,HCPCS,Outpatient,,,790,513.50,,695.2,88,,,percent of total billed charges,88% of total Billed charges,18.77,100,,,Fee Schedule,100% of Medicare rate,129.8,100,,,Fee Schedule,100% of WA Medicaid,790,100,,,percent of total billed charges,100% of total billed charges,133.69,103,,,Fee Schedule,103% of WA Medicaid,18.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,129.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,545.1,69,,,percent of total billed charges,69% of total billed charges,790,100,,,percent of total billed charges,100% of total billed charges,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,790,100,,,percent of total billed charges,100% of total billed charges,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,790,100,,,percent of total billed charges,100% of total billed charges,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.62,61.85,,,percent of total billed charges,61.85% of total billed charges,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,168.74,130,,,Fee Schedule,130% of WA Medicaid ,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.83,37.7,,,percent of total billed charges,37.70% of total billed charges,297.83,37.7,,,percent of total billed charges,37.70% of total billed charges,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,26781,33.9,,,percent of total billed charges,33.9% of total billed charges,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,616.2,78,,,percent of total billed charges,78% of total billed charges,790,100,,,percent of total billed charges,100% of total billed charges,652.54,82.6,,,percent of total billed charges,82.6% of total billed charges,652.54,82.6,,,percent of total billed charges,82.6% of total billed charges,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.77,26781,
EXC F/E/E/N/L MAL+MRG 3.1-4,11644,CDM,983,RC,11644,HCPCS,Outpatient,,,722,469.30,,635.36,88,,,percent of total billed charges,88% of total Billed charges,24.53,100,,,Fee Schedule,100% of Medicare rate,160.39,100,,,Fee Schedule,100% of WA Medicaid,722,100,,,percent of total billed charges,100% of total billed charges,165.2,103,,,Fee Schedule,103% of WA Medicaid,24.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,160.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,498.18,69,,,percent of total billed charges,69% of total billed charges,722,100,,,percent of total billed charges,100% of total billed charges,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,722,100,,,percent of total billed charges,100% of total billed charges,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,722,100,,,percent of total billed charges,100% of total billed charges,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.56,61.85,,,percent of total billed charges,61.85% of total billed charges,160.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,208.51,130,,,Fee Schedule,130% of WA Medicaid ,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.19,37.7,,,percent of total billed charges,37.70% of total billed charges,272.19,37.7,,,percent of total billed charges,37.70% of total billed charges,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,24475.8,33.9,,,percent of total billed charges,33.9% of total billed charges,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,563.16,78,,,percent of total billed charges,78% of total billed charges,722,100,,,percent of total billed charges,100% of total billed charges,596.37,82.6,,,percent of total billed charges,82.6% of total billed charges,596.37,82.6,,,percent of total billed charges,82.6% of total billed charges,160.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.53,24475.8,
"REMOVE MALIG LESION,FACE/OVER 4 CM",11646,CDM,983,RC,11646,HCPCS,Outpatient,,,1048,681.20,,922.24,88,,,percent of total billed charges,88% of total Billed charges,37.3,100,,,Fee Schedule,100% of Medicare rate,220.44,100,,,Fee Schedule,100% of WA Medicaid,1048,100,,,percent of total billed charges,100% of total billed charges,227.05,103,,,Fee Schedule,103% of WA Medicaid,37.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,220.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,723.12,69,,,percent of total billed charges,69% of total billed charges,1048,100,,,percent of total billed charges,100% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1048,100,,,percent of total billed charges,100% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1048,100,,,percent of total billed charges,100% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,648.19,61.85,,,percent of total billed charges,61.85% of total billed charges,220.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,286.57,130,,,Fee Schedule,130% of WA Medicaid ,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.1,37.7,,,percent of total billed charges,37.70% of total billed charges,395.1,37.7,,,percent of total billed charges,37.70% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,35527.2,33.9,,,percent of total billed charges,33.9% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,817.44,78,,,percent of total billed charges,78% of total billed charges,1048,100,,,percent of total billed charges,100% of total billed charges,865.65,82.6,,,percent of total billed charges,82.6% of total billed charges,865.65,82.6,,,percent of total billed charges,82.6% of total billed charges,220.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.3,35527.2,
TRIM NAIL(S) ANY NUMBER,11719,CDM,983,RC,11719,HCPCS,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,0.48,100,,,Fee Schedule,100% of Medicare rate,4.1,100,,,Fee Schedule,100% of WA Medicaid,43,100,,,percent of total billed charges,100% of total billed charges,4.22,103,,,Fee Schedule,103% of WA Medicaid,0.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,4.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,43,100,,,percent of total billed charges,100% of total billed charges,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,43,100,,,percent of total billed charges,100% of total billed charges,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,4.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.33,130,,,Fee Schedule,130% of WA Medicaid ,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.7,33.9,,,percent of total billed charges,33.9% of total billed charges,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,4.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.48,1457.7,
DEBRIDE NAIL 1-5,11720,CDM,983,RC,11720,HCPCS,Outpatient,,,58,37.70,,51.04,88,,,percent of total billed charges,88% of total Billed charges,1.2,100,,,Fee Schedule,100% of Medicare rate,7.83,100,,,Fee Schedule,100% of WA Medicaid,58,100,,,percent of total billed charges,100% of total billed charges,8.06,103,,,Fee Schedule,103% of WA Medicaid,1.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,7.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,40.02,69,,,percent of total billed charges,69% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,58,100,,,percent of total billed charges,100% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,58,100,,,percent of total billed charges,100% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.87,61.85,,,percent of total billed charges,61.85% of total billed charges,7.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.18,130,,,Fee Schedule,130% of WA Medicaid ,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,21.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1966.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.24,78,,,percent of total billed charges,78% of total billed charges,58,100,,,percent of total billed charges,100% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,47.91,82.6,,,percent of total billed charges,82.6% of total billed charges,7.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.2,1966.2,
DEBRIDE NAIL 6 OR MORE,11721,CDM,983,RC,11721,HCPCS,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,1.74,100,,,Fee Schedule,100% of Medicare rate,13.24,100,,,Fee Schedule,100% of WA Medicaid,91,100,,,percent of total billed charges,100% of total billed charges,13.64,103,,,Fee Schedule,103% of WA Medicaid,1.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,91,100,,,percent of total billed charges,100% of total billed charges,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,91,100,,,percent of total billed charges,100% of total billed charges,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.28,61.85,,,percent of total billed charges,61.85% of total billed charges,13.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,17.21,130,,,Fee Schedule,130% of WA Medicaid ,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3084.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,13.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.74,3084.9,
REMOVAL OF NAIL PLATE,11730,CDM,983,RC,11730,HCPCS,Outpatient,,,166.95,108.52,,146.92,88,,,percent of total billed charges,88% of total Billed charges,3.94,100,,,Fee Schedule,100% of Medicare rate,30.4,100,,,Fee Schedule,100% of WA Medicaid,166.95,100,,,percent of total billed charges,100% of total billed charges,31.31,103,,,Fee Schedule,103% of WA Medicaid,3.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,115.2,69,,,percent of total billed charges,69% of total billed charges,166.95,100,,,percent of total billed charges,100% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.95,100,,,percent of total billed charges,100% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.95,100,,,percent of total billed charges,100% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.26,61.85,,,percent of total billed charges,61.85% of total billed charges,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,39.52,130,,,Fee Schedule,130% of WA Medicaid ,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.94,37.7,,,percent of total billed charges,37.70% of total billed charges,62.94,37.7,,,percent of total billed charges,37.70% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,5659.61,33.9,,,percent of total billed charges,33.9% of total billed charges,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.22,78,,,percent of total billed charges,78% of total billed charges,166.95,100,,,percent of total billed charges,100% of total billed charges,137.9,82.6,,,percent of total billed charges,82.6% of total billed charges,137.9,82.6,,,percent of total billed charges,82.6% of total billed charges,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.94,5659.61,
REMOVE NAIL PLATE ADD-ON,11732,CDM,983,RC,11732,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,1.28,100,,,Fee Schedule,100% of Medicare rate,9.51,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,9.8,103,,,Fee Schedule,103% of WA Medicaid,1.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,90,100,,,percent of total billed charges,100% of total billed charges,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,90,100,,,percent of total billed charges,100% of total billed charges,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.67,61.85,,,percent of total billed charges,61.85% of total billed charges,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.36,130,,,Fee Schedule,130% of WA Medicaid ,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,3051,33.9,,,percent of total billed charges,33.9% of total billed charges,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.28,3051,
DRAIN BLOOD FROM UNDER NAIL,11740,CDM,983,RC,11740,HCPCS,Outpatient,,,84.36,54.83,,74.24,88,,,percent of total billed charges,88% of total Billed charges,1.77,100,,,Fee Schedule,100% of Medicare rate,18.84,100,,,Fee Schedule,100% of WA Medicaid,84.36,100,,,percent of total billed charges,100% of total billed charges,19.41,103,,,Fee Schedule,103% of WA Medicaid,1.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,18.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,58.21,69,,,percent of total billed charges,69% of total billed charges,84.36,100,,,percent of total billed charges,100% of total billed charges,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.36,100,,,percent of total billed charges,100% of total billed charges,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.36,100,,,percent of total billed charges,100% of total billed charges,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.18,61.85,,,percent of total billed charges,61.85% of total billed charges,18.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.49,130,,,Fee Schedule,130% of WA Medicaid ,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.8,37.7,,,percent of total billed charges,37.70% of total billed charges,31.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2859.8,33.9,,,percent of total billed charges,33.9% of total billed charges,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.8,78,,,percent of total billed charges,78% of total billed charges,84.36,100,,,percent of total billed charges,100% of total billed charges,69.68,82.6,,,percent of total billed charges,82.6% of total billed charges,69.68,82.6,,,percent of total billed charges,82.6% of total billed charges,18.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.77,2859.8,
REMOVAL OF NAIL BED,11750,CDM,983,RC,11750,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,60.7,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.72,61.85,,,percent of total billed charges,61.85% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.61,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,17085.6,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.47,17085.6,
REMOVE NAIL BED/FINGER TIP,11752,CDM,983,RC,,,Outpatient,,,714,464.10,,628.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,714,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,492.66,69,,,percent of total billed charges,69% of total billed charges,714,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,714,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,714,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,441.61,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,269.18,37.7,,,percent of total billed charges,37.70% of total billed charges,269.18,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,24204.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,556.92,78,,,percent of total billed charges,78% of total billed charges,714,100,,,percent of total billed charges,100% of total billed charges,589.76,82.6,,,percent of total billed charges,82.6% of total billed charges,589.76,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",269.18,24204.6,
REPAIR OF NAIL BED,11760,CDM,983,RC,11760,HCPCS,Outpatient,,,397.67,258.49,,349.95,88,,,percent of total billed charges,88% of total Billed charges,8.25,100,,,Fee Schedule,100% of Medicare rate,63.22,100,,,Fee Schedule,100% of WA Medicaid,397.67,100,,,percent of total billed charges,100% of total billed charges,65.12,103,,,Fee Schedule,103% of WA Medicaid,8.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,274.39,69,,,percent of total billed charges,69% of total billed charges,397.67,100,,,percent of total billed charges,100% of total billed charges,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.67,100,,,percent of total billed charges,100% of total billed charges,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.67,100,,,percent of total billed charges,100% of total billed charges,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.96,61.85,,,percent of total billed charges,61.85% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.19,130,,,Fee Schedule,130% of WA Medicaid ,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.92,37.7,,,percent of total billed charges,37.70% of total billed charges,149.92,37.7,,,percent of total billed charges,37.70% of total billed charges,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,13481.01,33.9,,,percent of total billed charges,33.9% of total billed charges,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.18,78,,,percent of total billed charges,78% of total billed charges,397.67,100,,,percent of total billed charges,100% of total billed charges,328.48,82.6,,,percent of total billed charges,82.6% of total billed charges,328.48,82.6,,,percent of total billed charges,82.6% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.25,13481.01,
EXCISION OF NAIL FOLD TOE,11765,CDM,983,RC,11765,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,5.44,100,,,Fee Schedule,100% of Medicare rate,54.27,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,55.9,103,,,Fee Schedule,103% of WA Medicaid,5.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,54.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,180,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,180,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.33,61.85,,,percent of total billed charges,61.85% of total billed charges,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,70.55,130,,,Fee Schedule,130% of WA Medicaid ,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,6102,33.9,,,percent of total billed charges,33.9% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.44,6102,
REMOVE PILONIDAL CYST SIMPLE,11770,CDM,983,RC,11770,HCPCS,Outpatient,,,767,498.55,,674.96,88,,,percent of total billed charges,88% of total Billed charges,21.15,100,,,Fee Schedule,100% of Medicare rate,106.12,100,,,Fee Schedule,100% of WA Medicaid,767,100,,,percent of total billed charges,100% of total billed charges,109.3,103,,,Fee Schedule,103% of WA Medicaid,21.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,106.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,529.23,69,,,percent of total billed charges,69% of total billed charges,767,100,,,percent of total billed charges,100% of total billed charges,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,767,100,,,percent of total billed charges,100% of total billed charges,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,767,100,,,percent of total billed charges,100% of total billed charges,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.39,61.85,,,percent of total billed charges,61.85% of total billed charges,106.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,137.96,130,,,Fee Schedule,130% of WA Medicaid ,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.16,37.7,,,percent of total billed charges,37.70% of total billed charges,289.16,37.7,,,percent of total billed charges,37.70% of total billed charges,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,26001.3,33.9,,,percent of total billed charges,33.9% of total billed charges,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.26,78,,,percent of total billed charges,78% of total billed charges,767,100,,,percent of total billed charges,100% of total billed charges,633.54,82.6,,,percent of total billed charges,82.6% of total billed charges,633.54,82.6,,,percent of total billed charges,82.6% of total billed charges,106.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.15,26001.3,
REMOVE PILONIDAL CYST EXTEN,11771,CDM,983,RC,11771,HCPCS,Outpatient,,,1298,843.70,,1142.24,88,,,percent of total billed charges,88% of total Billed charges,49.93,100,,,Fee Schedule,100% of Medicare rate,258.86,100,,,Fee Schedule,100% of WA Medicaid,1298,100,,,percent of total billed charges,100% of total billed charges,266.63,103,,,Fee Schedule,103% of WA Medicaid,49.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,258.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,895.62,69,,,percent of total billed charges,69% of total billed charges,1298,100,,,percent of total billed charges,100% of total billed charges,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1298,100,,,percent of total billed charges,100% of total billed charges,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1298,100,,,percent of total billed charges,100% of total billed charges,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,802.81,61.85,,,percent of total billed charges,61.85% of total billed charges,258.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,336.52,130,,,Fee Schedule,130% of WA Medicaid ,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.35,37.7,,,percent of total billed charges,37.70% of total billed charges,489.35,37.7,,,percent of total billed charges,37.70% of total billed charges,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,44002.2,33.9,,,percent of total billed charges,33.9% of total billed charges,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1012.44,78,,,percent of total billed charges,78% of total billed charges,1298,100,,,percent of total billed charges,100% of total billed charges,1072.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1072.15,82.6,,,percent of total billed charges,82.6% of total billed charges,258.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.93,44002.2,
REMOVE PILONIDAL CYST COMPL,11772,CDM,983,RC,11772,HCPCS,Outpatient,,,2484,1614.60,,2185.92,88,,,percent of total billed charges,88% of total Billed charges,60.61,100,,,Fee Schedule,100% of Medicare rate,334.02,100,,,Fee Schedule,100% of WA Medicaid,2484,100,,,percent of total billed charges,100% of total billed charges,344.04,103,,,Fee Schedule,103% of WA Medicaid,60.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,106.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,334.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1713.96,69,,,percent of total billed charges,69% of total billed charges,2484,100,,,percent of total billed charges,100% of total billed charges,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2484,100,,,percent of total billed charges,100% of total billed charges,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2484,100,,,percent of total billed charges,100% of total billed charges,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1536.35,61.85,,,percent of total billed charges,61.85% of total billed charges,334.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,434.23,130,,,Fee Schedule,130% of WA Medicaid ,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,936.47,37.7,,,percent of total billed charges,37.70% of total billed charges,936.47,37.7,,,percent of total billed charges,37.70% of total billed charges,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,84207.6,33.9,,,percent of total billed charges,33.9% of total billed charges,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1937.52,78,,,percent of total billed charges,78% of total billed charges,2484,100,,,percent of total billed charges,100% of total billed charges,2051.78,82.6,,,percent of total billed charges,82.6% of total billed charges,2051.78,82.6,,,percent of total billed charges,82.6% of total billed charges,334.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.61,84207.6,
INJECT SKIN LESIONS </W 7,11900,CDM,983,RC,11900,HCPCS,Outpatient,,,127,82.55,,111.76,88,,,percent of total billed charges,88% of total Billed charges,2.45,100,,,Fee Schedule,100% of Medicare rate,16.97,100,,,Fee Schedule,100% of WA Medicaid,127,100,,,percent of total billed charges,100% of total billed charges,17.48,103,,,Fee Schedule,103% of WA Medicaid,2.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,87.63,69,,,percent of total billed charges,69% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,127,100,,,percent of total billed charges,100% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,127,100,,,percent of total billed charges,100% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.55,61.85,,,percent of total billed charges,61.85% of total billed charges,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.06,130,,,Fee Schedule,130% of WA Medicaid ,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.88,37.7,,,percent of total billed charges,37.70% of total billed charges,47.88,37.7,,,percent of total billed charges,37.70% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,4305.3,33.9,,,percent of total billed charges,33.9% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.06,78,,,percent of total billed charges,78% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.45,4305.3,
TX CONTOUR DEFECTS 1 CC/<,11950,CDM,983,RC,11950,HCPCS,Outpatient,,,97,63.05,,85.36,88,,,percent of total billed charges,88% of total Billed charges,5.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,66.93,69,,,percent of total billed charges,69% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,97,100,,,percent of total billed charges,100% of total billed charges,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,97,100,,,percent of total billed charges,100% of total billed charges,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.99,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,36.57,37.7,,,percent of total billed charges,37.70% of total billed charges,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3288.3,33.9,,,percent of total billed charges,33.9% of total billed charges,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.66,78,,,percent of total billed charges,78% of total billed charges,97,100,,,percent of total billed charges,100% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,80.12,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",5.69,3288.3,
REMOVE CONTRACEPTIVE CAPSULE,11976,CDM,983,RC,11976,HCPCS,Outpatient,,,389,252.85,,342.32,88,,,percent of total billed charges,88% of total Billed charges,10.53,100,,,Fee Schedule,100% of Medicare rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,389,100,,,percent of total billed charges,100% of total billed charges,53.41,103,,,Fee Schedule,103% of WA Medicaid,10.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,268.41,69,,,percent of total billed charges,69% of total billed charges,389,100,,,percent of total billed charges,100% of total billed charges,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,389,100,,,percent of total billed charges,100% of total billed charges,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,389,100,,,percent of total billed charges,100% of total billed charges,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.6,61.85,,,percent of total billed charges,61.85% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.41,130,,,Fee Schedule,130% of WA Medicaid ,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.65,37.7,,,percent of total billed charges,37.70% of total billed charges,146.65,37.7,,,percent of total billed charges,37.70% of total billed charges,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,13187.1,33.9,,,percent of total billed charges,33.9% of total billed charges,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.42,78,,,percent of total billed charges,78% of total billed charges,389,100,,,percent of total billed charges,100% of total billed charges,321.31,82.6,,,percent of total billed charges,82.6% of total billed charges,321.31,82.6,,,percent of total billed charges,82.6% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.53,13187.1,
REMOVAL TISSUE EXPDR W/O INS PROSTHESIS,11971,CDM,983,RC,11971,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,50.52,100,,,Fee Schedule,100% of Medicare rate,319.85,100,,,Fee Schedule,100% of WA Medicaid,650,100,,,percent of total billed charges,100% of total billed charges,329.45,103,,,Fee Schedule,103% of WA Medicaid,50.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,88.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,319.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,319.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,415.81,130,,,Fee Schedule,130% of WA Medicaid ,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,22035,33.9,,,percent of total billed charges,33.9% of total billed charges,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,319.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.52,22035,
11970 Replacement of tissue expander with permanent prosthes,11970,CDM,983,RC,11970,HCPCS,Outpatient,,,1250,812.50,,1100,88,,,percent of total billed charges,88% of total Billed charges,53.09,100,,,Fee Schedule,100% of Medicare rate,324.14,100,,,Fee Schedule,100% of WA Medicaid,1250,100,,,percent of total billed charges,100% of total billed charges,333.86,103,,,Fee Schedule,103% of WA Medicaid,53.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,324.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,862.5,69,,,percent of total billed charges,69% of total billed charges,1250,100,,,percent of total billed charges,100% of total billed charges,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1250,100,,,percent of total billed charges,100% of total billed charges,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1250,100,,,percent of total billed charges,100% of total billed charges,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,773.13,61.85,,,percent of total billed charges,61.85% of total billed charges,324.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,421.38,130,,,Fee Schedule,130% of WA Medicaid ,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.25,37.7,,,percent of total billed charges,37.70% of total billed charges,471.25,37.7,,,percent of total billed charges,37.70% of total billed charges,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,42375,33.9,,,percent of total billed charges,33.9% of total billed charges,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,975,78,,,percent of total billed charges,78% of total billed charges,1250,100,,,percent of total billed charges,100% of total billed charges,1032.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1032.5,82.6,,,percent of total billed charges,82.6% of total billed charges,324.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.09,42375,
INSERT DRUG IMPLANT DEVICE,11981,CDM,983,RC,11981,HCPCS,Outpatient,,,422,274.30,,371.36,88,,,percent of total billed charges,88% of total Billed charges,7.3,100,,,Fee Schedule,100% of Medicare rate,334.06,100,,,Fee Schedule,100% of WA Medicaid,422,100,,,percent of total billed charges,100% of total billed charges,344.08,103,,,Fee Schedule,103% of WA Medicaid,7.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,334.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,291.18,69,,,percent of total billed charges,69% of total billed charges,422,100,,,percent of total billed charges,100% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,422,100,,,percent of total billed charges,100% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,422,100,,,percent of total billed charges,100% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.01,61.85,,,percent of total billed charges,61.85% of total billed charges,334.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,434.28,130,,,Fee Schedule,130% of WA Medicaid ,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.09,37.7,,,percent of total billed charges,37.70% of total billed charges,159.09,37.7,,,percent of total billed charges,37.70% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,14305.8,33.9,,,percent of total billed charges,33.9% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.16,78,,,percent of total billed charges,78% of total billed charges,422,100,,,percent of total billed charges,100% of total billed charges,348.57,82.6,,,percent of total billed charges,82.6% of total billed charges,348.57,82.6,,,percent of total billed charges,82.6% of total billed charges,334.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.3,14305.8,
REMOVE DRUG IMPLANT DEVICE,11982,CDM,983,RC,11982,HCPCS,Outpatient,,,465,302.25,,409.2,88,,,percent of total billed charges,88% of total Billed charges,8.39,100,,,Fee Schedule,100% of Medicare rate,40.84,100,,,Fee Schedule,100% of WA Medicaid,465,100,,,percent of total billed charges,100% of total billed charges,42.07,103,,,Fee Schedule,103% of WA Medicaid,8.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,320.85,69,,,percent of total billed charges,69% of total billed charges,465,100,,,percent of total billed charges,100% of total billed charges,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,465,100,,,percent of total billed charges,100% of total billed charges,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,465,100,,,percent of total billed charges,100% of total billed charges,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.6,61.85,,,percent of total billed charges,61.85% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.09,130,,,Fee Schedule,130% of WA Medicaid ,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.31,37.7,,,percent of total billed charges,37.70% of total billed charges,175.31,37.7,,,percent of total billed charges,37.70% of total billed charges,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,15763.5,33.9,,,percent of total billed charges,33.9% of total billed charges,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.7,78,,,percent of total billed charges,78% of total billed charges,465,100,,,percent of total billed charges,100% of total billed charges,384.09,82.6,,,percent of total billed charges,82.6% of total billed charges,384.09,82.6,,,percent of total billed charges,82.6% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.39,15763.5,
REMOVE/INSERT DRUG IMPLANT,11983,CDM,983,RC,11983,HCPCS,Outpatient,,,730,474.50,,642.4,88,,,percent of total billed charges,88% of total Billed charges,11.87,100,,,Fee Schedule,100% of Medicare rate,356.82,100,,,Fee Schedule,100% of WA Medicaid,730,100,,,percent of total billed charges,100% of total billed charges,367.52,103,,,Fee Schedule,103% of WA Medicaid,11.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,356.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,503.7,69,,,percent of total billed charges,69% of total billed charges,730,100,,,percent of total billed charges,100% of total billed charges,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,730,100,,,percent of total billed charges,100% of total billed charges,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,730,100,,,percent of total billed charges,100% of total billed charges,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.51,61.85,,,percent of total billed charges,61.85% of total billed charges,356.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,463.87,130,,,Fee Schedule,130% of WA Medicaid ,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.21,37.7,,,percent of total billed charges,37.70% of total billed charges,275.21,37.7,,,percent of total billed charges,37.70% of total billed charges,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,24747,33.9,,,percent of total billed charges,33.9% of total billed charges,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,569.4,78,,,percent of total billed charges,78% of total billed charges,730,100,,,percent of total billed charges,100% of total billed charges,602.98,82.6,,,percent of total billed charges,82.6% of total billed charges,602.98,82.6,,,percent of total billed charges,82.6% of total billed charges,356.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.87,24747,
IMPLANT HORMONE PELLET(S),11980,CDM,983,RC,11980,HCPCS,Outpatient,,,283,183.95,,249.04,88,,,percent of total billed charges,88% of total Billed charges,5.53,100,,,Fee Schedule,100% of Medicare rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,283,100,,,percent of total billed charges,100% of total billed charges,31.89,103,,,Fee Schedule,103% of WA Medicaid,5.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,195.27,69,,,percent of total billed charges,69% of total billed charges,283,100,,,percent of total billed charges,100% of total billed charges,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,283,100,,,percent of total billed charges,100% of total billed charges,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,283,100,,,percent of total billed charges,100% of total billed charges,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.04,61.85,,,percent of total billed charges,61.85% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.25,130,,,Fee Schedule,130% of WA Medicaid ,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.69,37.7,,,percent of total billed charges,37.70% of total billed charges,106.69,37.7,,,percent of total billed charges,37.70% of total billed charges,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,9593.7,33.9,,,percent of total billed charges,33.9% of total billed charges,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.74,78,,,percent of total billed charges,78% of total billed charges,283,100,,,percent of total billed charges,100% of total billed charges,233.76,82.6,,,percent of total billed charges,82.6% of total billed charges,233.76,82.6,,,percent of total billed charges,82.6% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.53,9593.7,
RPR S/N/AX/GEN/TRNK 2.5CM/<,12001,CDM,983,RC,12001,HCPCS,Outpatient,,,154.15,100.20,,135.65,88,,,percent of total billed charges,88% of total Billed charges,5.48,100,,,Fee Schedule,100% of Medicare rate,24.99,100,,,Fee Schedule,100% of WA Medicaid,154.15,100,,,percent of total billed charges,100% of total billed charges,25.74,103,,,Fee Schedule,103% of WA Medicaid,5.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,24.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,106.36,69,,,percent of total billed charges,69% of total billed charges,154.15,100,,,percent of total billed charges,100% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.15,100,,,percent of total billed charges,100% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.15,100,,,percent of total billed charges,100% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.34,61.85,,,percent of total billed charges,61.85% of total billed charges,24.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.49,130,,,Fee Schedule,130% of WA Medicaid ,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.11,37.7,,,percent of total billed charges,37.70% of total billed charges,58.11,37.7,,,percent of total billed charges,37.70% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5225.69,33.9,,,percent of total billed charges,33.9% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.24,78,,,percent of total billed charges,78% of total billed charges,154.15,100,,,percent of total billed charges,100% of total billed charges,127.33,82.6,,,percent of total billed charges,82.6% of total billed charges,127.33,82.6,,,percent of total billed charges,82.6% of total billed charges,24.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.48,5225.69,
RPR S/N/AX/GEN/TRNK2.6-7.5CM,12002,CDM,983,RC,12002,HCPCS,Outpatient,,,187.14,121.64,,164.68,88,,,percent of total billed charges,88% of total Billed charges,7.44,100,,,Fee Schedule,100% of Medicare rate,32.82,100,,,Fee Schedule,100% of WA Medicaid,187.14,100,,,percent of total billed charges,100% of total billed charges,33.8,103,,,Fee Schedule,103% of WA Medicaid,7.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,129.13,69,,,percent of total billed charges,69% of total billed charges,187.14,100,,,percent of total billed charges,100% of total billed charges,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.14,100,,,percent of total billed charges,100% of total billed charges,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.14,100,,,percent of total billed charges,100% of total billed charges,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.75,61.85,,,percent of total billed charges,61.85% of total billed charges,32.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.67,130,,,Fee Schedule,130% of WA Medicaid ,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.55,37.7,,,percent of total billed charges,37.70% of total billed charges,70.55,37.7,,,percent of total billed charges,37.70% of total billed charges,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,6344.05,33.9,,,percent of total billed charges,33.9% of total billed charges,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.97,78,,,percent of total billed charges,78% of total billed charges,187.14,100,,,percent of total billed charges,100% of total billed charges,154.58,82.6,,,percent of total billed charges,82.6% of total billed charges,154.58,82.6,,,percent of total billed charges,82.6% of total billed charges,32.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.44,6344.05,
RPR S/N/AX/GEN/TRK7.6-12.5CM,12004,CDM,983,RC,12004,HCPCS,Outpatient,,,213.82,138.98,,188.16,88,,,percent of total billed charges,88% of total Billed charges,9.69,100,,,Fee Schedule,100% of Medicare rate,40.84,100,,,Fee Schedule,100% of WA Medicaid,213.82,100,,,percent of total billed charges,100% of total billed charges,42.07,103,,,Fee Schedule,103% of WA Medicaid,9.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,147.54,69,,,percent of total billed charges,69% of total billed charges,213.82,100,,,percent of total billed charges,100% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.82,100,,,percent of total billed charges,100% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.82,100,,,percent of total billed charges,100% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.25,61.85,,,percent of total billed charges,61.85% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.09,130,,,Fee Schedule,130% of WA Medicaid ,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.61,37.7,,,percent of total billed charges,37.70% of total billed charges,80.61,37.7,,,percent of total billed charges,37.70% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,7248.5,33.9,,,percent of total billed charges,33.9% of total billed charges,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.78,78,,,percent of total billed charges,78% of total billed charges,213.82,100,,,percent of total billed charges,100% of total billed charges,176.62,82.6,,,percent of total billed charges,82.6% of total billed charges,176.62,82.6,,,percent of total billed charges,82.6% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.69,7248.5,
RPR S/N/A/GEN/TRK12.6-20.0CM,12005,CDM,983,RC,12005,HCPCS,Outpatient,,,434,282.10,,381.92,88,,,percent of total billed charges,88% of total Billed charges,13.15,100,,,Fee Schedule,100% of Medicare rate,52.41,100,,,Fee Schedule,100% of WA Medicaid,434,100,,,percent of total billed charges,100% of total billed charges,53.98,103,,,Fee Schedule,103% of WA Medicaid,13.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,52.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,299.46,69,,,percent of total billed charges,69% of total billed charges,434,100,,,percent of total billed charges,100% of total billed charges,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,434,100,,,percent of total billed charges,100% of total billed charges,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,434,100,,,percent of total billed charges,100% of total billed charges,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.43,61.85,,,percent of total billed charges,61.85% of total billed charges,52.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,68.13,130,,,Fee Schedule,130% of WA Medicaid ,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.62,37.7,,,percent of total billed charges,37.70% of total billed charges,163.62,37.7,,,percent of total billed charges,37.70% of total billed charges,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,14712.6,33.9,,,percent of total billed charges,33.9% of total billed charges,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.52,78,,,percent of total billed charges,78% of total billed charges,434,100,,,percent of total billed charges,100% of total billed charges,358.48,82.6,,,percent of total billed charges,82.6% of total billed charges,358.48,82.6,,,percent of total billed charges,82.6% of total billed charges,52.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.15,14712.6,
RPR S/N/A/GEN/TRK20.1-30.0CM,12006,CDM,983,RC,12006,HCPCS,Outpatient,,,473,307.45,,416.24,88,,,percent of total billed charges,88% of total Billed charges,15.59,100,,,Fee Schedule,100% of Medicare rate,64.16,100,,,Fee Schedule,100% of WA Medicaid,473,100,,,percent of total billed charges,100% of total billed charges,66.08,103,,,Fee Schedule,103% of WA Medicaid,15.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,64.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,326.37,69,,,percent of total billed charges,69% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,473,100,,,percent of total billed charges,100% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,473,100,,,percent of total billed charges,100% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.55,61.85,,,percent of total billed charges,61.85% of total billed charges,64.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,83.41,130,,,Fee Schedule,130% of WA Medicaid ,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,178.32,37.7,,,percent of total billed charges,37.70% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,16034.7,33.9,,,percent of total billed charges,33.9% of total billed charges,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.94,78,,,percent of total billed charges,78% of total billed charges,473,100,,,percent of total billed charges,100% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,390.7,82.6,,,percent of total billed charges,82.6% of total billed charges,64.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.59,16034.7,
RPR S/N/AX/GEN/TRNK >30.0 CM,12007,CDM,983,RC,12007,HCPCS,Outpatient,,,533,346.45,,469.04,88,,,percent of total billed charges,88% of total Billed charges,19.28,100,,,Fee Schedule,100% of Medicare rate,79.82,100,,,Fee Schedule,100% of WA Medicaid,533,100,,,percent of total billed charges,100% of total billed charges,82.21,103,,,Fee Schedule,103% of WA Medicaid,19.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,367.77,69,,,percent of total billed charges,69% of total billed charges,533,100,,,percent of total billed charges,100% of total billed charges,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,533,100,,,percent of total billed charges,100% of total billed charges,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,533,100,,,percent of total billed charges,100% of total billed charges,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.66,61.85,,,percent of total billed charges,61.85% of total billed charges,79.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.77,130,,,Fee Schedule,130% of WA Medicaid ,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.94,37.7,,,percent of total billed charges,37.70% of total billed charges,200.94,37.7,,,percent of total billed charges,37.70% of total billed charges,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,18068.7,33.9,,,percent of total billed charges,33.9% of total billed charges,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.74,78,,,percent of total billed charges,78% of total billed charges,533,100,,,percent of total billed charges,100% of total billed charges,440.26,82.6,,,percent of total billed charges,82.6% of total billed charges,440.26,82.6,,,percent of total billed charges,82.6% of total billed charges,79.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.28,18068.7,
RPR F/E/E/N/L/M 2.5 CM/<,12011,CDM,983,RC,12011,HCPCS,Outpatient,,,183.36,119.18,,161.36,88,,,percent of total billed charges,88% of total Billed charges,7.09,100,,,Fee Schedule,100% of Medicare rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,183.36,100,,,percent of total billed charges,100% of total billed charges,31.89,103,,,Fee Schedule,103% of WA Medicaid,7.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,126.52,69,,,percent of total billed charges,69% of total billed charges,183.36,100,,,percent of total billed charges,100% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.36,100,,,percent of total billed charges,100% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.36,100,,,percent of total billed charges,100% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.41,61.85,,,percent of total billed charges,61.85% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.25,130,,,Fee Schedule,130% of WA Medicaid ,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.13,37.7,,,percent of total billed charges,37.70% of total billed charges,69.13,37.7,,,percent of total billed charges,37.70% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,6215.9,33.9,,,percent of total billed charges,33.9% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.02,78,,,percent of total billed charges,78% of total billed charges,183.36,100,,,percent of total billed charges,100% of total billed charges,151.46,82.6,,,percent of total billed charges,82.6% of total billed charges,151.46,82.6,,,percent of total billed charges,82.6% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.09,6215.9,
RPR F/E/E/N/L/M 2.6-5.0 CM,12013,CDM,983,RC,12013,HCPCS,Outpatient,,,206.33,134.11,,181.57,88,,,percent of total billed charges,88% of total Billed charges,7.92,100,,,Fee Schedule,100% of Medicare rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,206.33,100,,,percent of total billed charges,100% of total billed charges,33.04,103,,,Fee Schedule,103% of WA Medicaid,7.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,142.37,69,,,percent of total billed charges,69% of total billed charges,206.33,100,,,percent of total billed charges,100% of total billed charges,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.33,100,,,percent of total billed charges,100% of total billed charges,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.33,100,,,percent of total billed charges,100% of total billed charges,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.62,61.85,,,percent of total billed charges,61.85% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.7,130,,,Fee Schedule,130% of WA Medicaid ,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.79,37.7,,,percent of total billed charges,37.70% of total billed charges,77.79,37.7,,,percent of total billed charges,37.70% of total billed charges,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,6994.59,33.9,,,percent of total billed charges,33.9% of total billed charges,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.94,78,,,percent of total billed charges,78% of total billed charges,206.33,100,,,percent of total billed charges,100% of total billed charges,170.43,82.6,,,percent of total billed charges,82.6% of total billed charges,170.43,82.6,,,percent of total billed charges,82.6% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,8,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.92,6994.59,
RPR F/E/E/N/L/M 5.1-7.5 CM,12014,CDM,983,RC,12014,HCPCS,Outpatient,,,236.08,153.45,,207.75,88,,,percent of total billed charges,88% of total Billed charges,10.5,100,,,Fee Schedule,100% of Medicare rate,41.4,100,,,Fee Schedule,100% of WA Medicaid,236.08,100,,,percent of total billed charges,100% of total billed charges,42.64,103,,,Fee Schedule,103% of WA Medicaid,10.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,41.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,162.9,69,,,percent of total billed charges,69% of total billed charges,236.08,100,,,percent of total billed charges,100% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.08,100,,,percent of total billed charges,100% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.08,100,,,percent of total billed charges,100% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.02,61.85,,,percent of total billed charges,61.85% of total billed charges,41.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.82,130,,,Fee Schedule,130% of WA Medicaid ,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,89,37.7,,,percent of total billed charges,37.70% of total billed charges,89,37.7,,,percent of total billed charges,37.70% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,8003.11,33.9,,,percent of total billed charges,33.9% of total billed charges,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.14,78,,,percent of total billed charges,78% of total billed charges,236.08,100,,,percent of total billed charges,100% of total billed charges,195,82.6,,,percent of total billed charges,82.6% of total billed charges,195,82.6,,,percent of total billed charges,82.6% of total billed charges,41.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.5,8003.11,
RPR F/E/E/N/L/M 7.6-12.5 CM,12015,CDM,983,RC,12015,HCPCS,Outpatient,,,501,325.65,,440.88,88,,,percent of total billed charges,88% of total Billed charges,13.13,100,,,Fee Schedule,100% of Medicare rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,501,100,,,percent of total billed charges,100% of total billed charges,53.41,103,,,Fee Schedule,103% of WA Medicaid,13.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,345.69,69,,,percent of total billed charges,69% of total billed charges,501,100,,,percent of total billed charges,100% of total billed charges,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,501,100,,,percent of total billed charges,100% of total billed charges,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,501,100,,,percent of total billed charges,100% of total billed charges,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.87,61.85,,,percent of total billed charges,61.85% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.41,130,,,Fee Schedule,130% of WA Medicaid ,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.88,37.7,,,percent of total billed charges,37.70% of total billed charges,188.88,37.7,,,percent of total billed charges,37.70% of total billed charges,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,16983.9,33.9,,,percent of total billed charges,33.9% of total billed charges,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.78,78,,,percent of total billed charges,78% of total billed charges,501,100,,,percent of total billed charges,100% of total billed charges,413.83,82.6,,,percent of total billed charges,82.6% of total billed charges,413.83,82.6,,,percent of total billed charges,82.6% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.13,16983.9,
RPR FE/E/EN/L/M 12.6-20.0 CM,12016,CDM,983,RC,12016,HCPCS,Outpatient,,,501,325.65,,440.88,88,,,percent of total billed charges,88% of total Billed charges,17.75,100,,,Fee Schedule,100% of Medicare rate,70.31,100,,,Fee Schedule,100% of WA Medicaid,501,100,,,percent of total billed charges,100% of total billed charges,72.42,103,,,Fee Schedule,103% of WA Medicaid,17.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,345.69,69,,,percent of total billed charges,69% of total billed charges,501,100,,,percent of total billed charges,100% of total billed charges,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,501,100,,,percent of total billed charges,100% of total billed charges,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,501,100,,,percent of total billed charges,100% of total billed charges,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.87,61.85,,,percent of total billed charges,61.85% of total billed charges,70.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,91.4,130,,,Fee Schedule,130% of WA Medicaid ,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.88,37.7,,,percent of total billed charges,37.70% of total billed charges,188.88,37.7,,,percent of total billed charges,37.70% of total billed charges,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,16983.9,33.9,,,percent of total billed charges,33.9% of total billed charges,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.78,78,,,percent of total billed charges,78% of total billed charges,501,100,,,percent of total billed charges,100% of total billed charges,413.83,82.6,,,percent of total billed charges,82.6% of total billed charges,413.83,82.6,,,percent of total billed charges,82.6% of total billed charges,70.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.75,16983.9,
RPR FE/E/EN/L/M 20.1-30.0 CM,12017,CDM,983,RC,12017,HCPCS,Outpatient,,,830,539.50,,730.4,88,,,percent of total billed charges,88% of total Billed charges,22.41,100,,,Fee Schedule,100% of Medicare rate,84.86,100,,,Fee Schedule,100% of WA Medicaid,830,100,,,percent of total billed charges,100% of total billed charges,87.41,103,,,Fee Schedule,103% of WA Medicaid,22.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,84.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,572.7,69,,,percent of total billed charges,69% of total billed charges,830,100,,,percent of total billed charges,100% of total billed charges,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,830,100,,,percent of total billed charges,100% of total billed charges,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,830,100,,,percent of total billed charges,100% of total billed charges,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.36,61.85,,,percent of total billed charges,61.85% of total billed charges,84.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,110.32,130,,,Fee Schedule,130% of WA Medicaid ,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.91,37.7,,,percent of total billed charges,37.70% of total billed charges,312.91,37.7,,,percent of total billed charges,37.70% of total billed charges,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,28137,33.9,,,percent of total billed charges,33.9% of total billed charges,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.4,78,,,percent of total billed charges,78% of total billed charges,830,100,,,percent of total billed charges,100% of total billed charges,685.58,82.6,,,percent of total billed charges,82.6% of total billed charges,685.58,82.6,,,percent of total billed charges,82.6% of total billed charges,84.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.41,28137,
RPR F/E/E/N/L/M >30.0 CM,12018,CDM,983,RC,12018,HCPCS,Outpatient,,,746,484.90,,656.48,88,,,percent of total billed charges,88% of total Billed charges,25.05,100,,,Fee Schedule,100% of Medicare rate,95.49,100,,,Fee Schedule,100% of WA Medicaid,746,100,,,percent of total billed charges,100% of total billed charges,98.35,103,,,Fee Schedule,103% of WA Medicaid,25.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,95.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,514.74,69,,,percent of total billed charges,69% of total billed charges,746,100,,,percent of total billed charges,100% of total billed charges,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,746,100,,,percent of total billed charges,100% of total billed charges,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,746,100,,,percent of total billed charges,100% of total billed charges,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.4,61.85,,,percent of total billed charges,61.85% of total billed charges,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,124.14,130,,,Fee Schedule,130% of WA Medicaid ,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.24,37.7,,,percent of total billed charges,37.70% of total billed charges,281.24,37.7,,,percent of total billed charges,37.70% of total billed charges,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,25289.4,33.9,,,percent of total billed charges,33.9% of total billed charges,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,581.88,78,,,percent of total billed charges,78% of total billed charges,746,100,,,percent of total billed charges,100% of total billed charges,616.2,82.6,,,percent of total billed charges,82.6% of total billed charges,616.2,82.6,,,percent of total billed charges,82.6% of total billed charges,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.05,25289.4,
CLOSURE OF SPLIT WOUND,12020,CDM,983,RC,12020,HCPCS,Outpatient,,,356,231.40,,313.28,88,,,percent of total billed charges,88% of total Billed charges,16.59,100,,,Fee Schedule,100% of Medicare rate,108.17,100,,,Fee Schedule,100% of WA Medicaid,356,100,,,percent of total billed charges,100% of total billed charges,111.42,103,,,Fee Schedule,103% of WA Medicaid,16.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,108.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,245.64,69,,,percent of total billed charges,69% of total billed charges,356,100,,,percent of total billed charges,100% of total billed charges,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,356,100,,,percent of total billed charges,100% of total billed charges,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,356,100,,,percent of total billed charges,100% of total billed charges,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.19,61.85,,,percent of total billed charges,61.85% of total billed charges,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,140.62,130,,,Fee Schedule,130% of WA Medicaid ,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.21,37.7,,,percent of total billed charges,37.70% of total billed charges,134.21,37.7,,,percent of total billed charges,37.70% of total billed charges,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,12068.4,33.9,,,percent of total billed charges,33.9% of total billed charges,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.68,78,,,percent of total billed charges,78% of total billed charges,356,100,,,percent of total billed charges,100% of total billed charges,294.06,82.6,,,percent of total billed charges,82.6% of total billed charges,294.06,82.6,,,percent of total billed charges,82.6% of total billed charges,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.59,12068.4,
CLOSURE OF SPLIT WOUND,12021,CDM,983,RC,12021,HCPCS,Outpatient,,,314,204.10,,276.32,88,,,percent of total billed charges,88% of total Billed charges,12.32,100,,,Fee Schedule,100% of Medicare rate,81.5,100,,,Fee Schedule,100% of WA Medicaid,314,100,,,percent of total billed charges,100% of total billed charges,83.95,103,,,Fee Schedule,103% of WA Medicaid,12.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,81.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,216.66,69,,,percent of total billed charges,69% of total billed charges,314,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,314,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,314,100,,,percent of total billed charges,100% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.21,61.85,,,percent of total billed charges,61.85% of total billed charges,81.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,105.95,130,,,Fee Schedule,130% of WA Medicaid ,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.38,37.7,,,percent of total billed charges,37.70% of total billed charges,118.38,37.7,,,percent of total billed charges,37.70% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,10644.6,33.9,,,percent of total billed charges,33.9% of total billed charges,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.92,78,,,percent of total billed charges,78% of total billed charges,314,100,,,percent of total billed charges,100% of total billed charges,259.36,82.6,,,percent of total billed charges,82.6% of total billed charges,259.36,82.6,,,percent of total billed charges,82.6% of total billed charges,81.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.32,10644.6,
INTMD RPR S/A/T/EXT 2.5 CM/<,12031,CDM,983,RC,12031,HCPCS,Outpatient,,,648,421.20,,570.24,88,,,percent of total billed charges,88% of total Billed charges,11.08,100,,,Fee Schedule,100% of Medicare rate,87.47,100,,,Fee Schedule,100% of WA Medicaid,648,100,,,percent of total billed charges,100% of total billed charges,90.09,103,,,Fee Schedule,103% of WA Medicaid,11.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,87.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,447.12,69,,,percent of total billed charges,69% of total billed charges,648,100,,,percent of total billed charges,100% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,648,100,,,percent of total billed charges,100% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,648,100,,,percent of total billed charges,100% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.79,61.85,,,percent of total billed charges,61.85% of total billed charges,87.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,113.71,130,,,Fee Schedule,130% of WA Medicaid ,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.3,37.7,,,percent of total billed charges,37.70% of total billed charges,244.3,37.7,,,percent of total billed charges,37.70% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,21967.2,33.9,,,percent of total billed charges,33.9% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.44,78,,,percent of total billed charges,78% of total billed charges,648,100,,,percent of total billed charges,100% of total billed charges,535.25,82.6,,,percent of total billed charges,82.6% of total billed charges,535.25,82.6,,,percent of total billed charges,82.6% of total billed charges,87.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.08,21967.2,
INTMD RPR S/A/T/EXT 2.6-7.5,12032,CDM,983,RC,12032,HCPCS,Outpatient,,,504.96,328.22,,444.36,88,,,percent of total billed charges,88% of total Billed charges,13.29,100,,,Fee Schedule,100% of Medicare rate,110.04,100,,,Fee Schedule,100% of WA Medicaid,504.96,100,,,percent of total billed charges,100% of total billed charges,113.34,103,,,Fee Schedule,103% of WA Medicaid,13.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,110.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,348.42,69,,,percent of total billed charges,69% of total billed charges,504.96,100,,,percent of total billed charges,100% of total billed charges,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.96,100,,,percent of total billed charges,100% of total billed charges,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.96,100,,,percent of total billed charges,100% of total billed charges,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.32,61.85,,,percent of total billed charges,61.85% of total billed charges,110.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,143.05,130,,,Fee Schedule,130% of WA Medicaid ,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.37,37.7,,,percent of total billed charges,37.70% of total billed charges,190.37,37.7,,,percent of total billed charges,37.70% of total billed charges,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,17118.14,33.9,,,percent of total billed charges,33.9% of total billed charges,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.87,78,,,percent of total billed charges,78% of total billed charges,504.96,100,,,percent of total billed charges,100% of total billed charges,417.1,82.6,,,percent of total billed charges,82.6% of total billed charges,417.1,82.6,,,percent of total billed charges,82.6% of total billed charges,110.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.29,17118.14,
INTMD RPR S/TR/EXT 7.6-12.5,12034,CDM,983,RC,12034,HCPCS,Outpatient,,,519.02,337.36,,456.74,88,,,percent of total billed charges,88% of total Billed charges,16.57,100,,,Fee Schedule,100% of Medicare rate,117.87,100,,,Fee Schedule,100% of WA Medicaid,519.02,100,,,percent of total billed charges,100% of total billed charges,121.41,103,,,Fee Schedule,103% of WA Medicaid,16.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,117.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,358.12,69,,,percent of total billed charges,69% of total billed charges,519.02,100,,,percent of total billed charges,100% of total billed charges,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.02,100,,,percent of total billed charges,100% of total billed charges,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.02,100,,,percent of total billed charges,100% of total billed charges,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.01,61.85,,,percent of total billed charges,61.85% of total billed charges,117.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,153.23,130,,,Fee Schedule,130% of WA Medicaid ,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.67,37.7,,,percent of total billed charges,37.70% of total billed charges,195.67,37.7,,,percent of total billed charges,37.70% of total billed charges,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,17594.78,33.9,,,percent of total billed charges,33.9% of total billed charges,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.84,78,,,percent of total billed charges,78% of total billed charges,519.02,100,,,percent of total billed charges,100% of total billed charges,428.71,82.6,,,percent of total billed charges,82.6% of total billed charges,428.71,82.6,,,percent of total billed charges,82.6% of total billed charges,117.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.57,17594.78,
INTMD RPR S/A/T/EXT 12.6-20,12035,CDM,983,RC,12035,HCPCS,Outpatient,,,762,495.30,,670.56,88,,,percent of total billed charges,88% of total Billed charges,23.6,100,,,Fee Schedule,100% of Medicare rate,137.82,100,,,Fee Schedule,100% of WA Medicaid,762,100,,,percent of total billed charges,100% of total billed charges,141.95,103,,,Fee Schedule,103% of WA Medicaid,23.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,137.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,525.78,69,,,percent of total billed charges,69% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,762,100,,,percent of total billed charges,100% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,762,100,,,percent of total billed charges,100% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.3,61.85,,,percent of total billed charges,61.85% of total billed charges,137.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,179.17,130,,,Fee Schedule,130% of WA Medicaid ,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,25831.8,33.9,,,percent of total billed charges,33.9% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.36,78,,,percent of total billed charges,78% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,137.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.6,25831.8,
INTMD RPR S/A/T/EXT 20.1-30,12036,CDM,983,RC,12036,HCPCS,Outpatient,,,750,487.50,,660,88,,,percent of total billed charges,88% of total Billed charges,31.28,100,,,Fee Schedule,100% of Medicare rate,160.39,100,,,Fee Schedule,100% of WA Medicaid,750,100,,,percent of total billed charges,100% of total billed charges,165.2,103,,,Fee Schedule,103% of WA Medicaid,31.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,160.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,517.5,69,,,percent of total billed charges,69% of total billed charges,750,100,,,percent of total billed charges,100% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,750,100,,,percent of total billed charges,100% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,750,100,,,percent of total billed charges,100% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.88,61.85,,,percent of total billed charges,61.85% of total billed charges,160.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,208.51,130,,,Fee Schedule,130% of WA Medicaid ,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.75,37.7,,,percent of total billed charges,37.70% of total billed charges,282.75,37.7,,,percent of total billed charges,37.70% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,25425,33.9,,,percent of total billed charges,33.9% of total billed charges,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,585,78,,,percent of total billed charges,78% of total billed charges,750,100,,,percent of total billed charges,100% of total billed charges,619.5,82.6,,,percent of total billed charges,82.6% of total billed charges,619.5,82.6,,,percent of total billed charges,82.6% of total billed charges,160.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.28,25425,
INTMD RPR S/TR/EXT >30.0 CM,12037,CDM,983,RC,12037,HCPCS,Outpatient,,,884,574.60,,777.92,88,,,percent of total billed charges,88% of total Billed charges,37.3,100,,,Fee Schedule,100% of Medicare rate,185.94,100,,,Fee Schedule,100% of WA Medicaid,884,100,,,percent of total billed charges,100% of total billed charges,191.52,103,,,Fee Schedule,103% of WA Medicaid,37.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,185.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,609.96,69,,,percent of total billed charges,69% of total billed charges,884,100,,,percent of total billed charges,100% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,884,100,,,percent of total billed charges,100% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,884,100,,,percent of total billed charges,100% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.75,61.85,,,percent of total billed charges,61.85% of total billed charges,185.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,241.72,130,,,Fee Schedule,130% of WA Medicaid ,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.27,37.7,,,percent of total billed charges,37.70% of total billed charges,333.27,37.7,,,percent of total billed charges,37.70% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,29967.6,33.9,,,percent of total billed charges,33.9% of total billed charges,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,689.52,78,,,percent of total billed charges,78% of total billed charges,884,100,,,percent of total billed charges,100% of total billed charges,730.18,82.6,,,percent of total billed charges,82.6% of total billed charges,730.18,82.6,,,percent of total billed charges,82.6% of total billed charges,185.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.3,29967.6,
INTMD RPR N-HF/GENIT 2.5CM/<,12041,CDM,983,RC,12041,HCPCS,Outpatient,,,403.03,261.97,,354.67,88,,,percent of total billed charges,88% of total Billed charges,11.13,100,,,Fee Schedule,100% of Medicare rate,83.55,100,,,Fee Schedule,100% of WA Medicaid,403.03,100,,,percent of total billed charges,100% of total billed charges,86.06,103,,,Fee Schedule,103% of WA Medicaid,11.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,83.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,278.09,69,,,percent of total billed charges,69% of total billed charges,403.03,100,,,percent of total billed charges,100% of total billed charges,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.03,100,,,percent of total billed charges,100% of total billed charges,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.03,100,,,percent of total billed charges,100% of total billed charges,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.27,61.85,,,percent of total billed charges,61.85% of total billed charges,83.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,108.62,130,,,Fee Schedule,130% of WA Medicaid ,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.94,37.7,,,percent of total billed charges,37.70% of total billed charges,151.94,37.7,,,percent of total billed charges,37.70% of total billed charges,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,13662.72,33.9,,,percent of total billed charges,33.9% of total billed charges,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.36,78,,,percent of total billed charges,78% of total billed charges,403.03,100,,,percent of total billed charges,100% of total billed charges,332.9,82.6,,,percent of total billed charges,82.6% of total billed charges,332.9,82.6,,,percent of total billed charges,82.6% of total billed charges,83.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.13,13662.72,
INTMD RPR N-HF/GENIT2.6-7.5,12042,CDM,983,RC,12042,HCPCS,Outpatient,,,479.77,311.85,,422.2,88,,,percent of total billed charges,88% of total Billed charges,14.48,100,,,Fee Schedule,100% of Medicare rate,112.65,100,,,Fee Schedule,100% of WA Medicaid,479.77,100,,,percent of total billed charges,100% of total billed charges,116.03,103,,,Fee Schedule,103% of WA Medicaid,14.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,331.04,69,,,percent of total billed charges,69% of total billed charges,479.77,100,,,percent of total billed charges,100% of total billed charges,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.77,100,,,percent of total billed charges,100% of total billed charges,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.77,100,,,percent of total billed charges,100% of total billed charges,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.74,61.85,,,percent of total billed charges,61.85% of total billed charges,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,146.45,130,,,Fee Schedule,130% of WA Medicaid ,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.87,37.7,,,percent of total billed charges,37.70% of total billed charges,180.87,37.7,,,percent of total billed charges,37.70% of total billed charges,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,16264.2,33.9,,,percent of total billed charges,33.9% of total billed charges,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.22,78,,,percent of total billed charges,78% of total billed charges,479.77,100,,,percent of total billed charges,100% of total billed charges,396.29,82.6,,,percent of total billed charges,82.6% of total billed charges,396.29,82.6,,,percent of total billed charges,82.6% of total billed charges,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.48,16264.2,
INTMD RPR N-HF/GENIT7.6-12.5,12044,CDM,983,RC,12044,HCPCS,Outpatient,,,600.45,390.29,,528.4,88,,,percent of total billed charges,88% of total Billed charges,18.13,100,,,Fee Schedule,100% of Medicare rate,122.72,100,,,Fee Schedule,100% of WA Medicaid,600.45,100,,,percent of total billed charges,100% of total billed charges,126.4,103,,,Fee Schedule,103% of WA Medicaid,18.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,122.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,414.31,69,,,percent of total billed charges,69% of total billed charges,600.45,100,,,percent of total billed charges,100% of total billed charges,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,600.45,100,,,percent of total billed charges,100% of total billed charges,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,600.45,100,,,percent of total billed charges,100% of total billed charges,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.38,61.85,,,percent of total billed charges,61.85% of total billed charges,122.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,159.54,130,,,Fee Schedule,130% of WA Medicaid ,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.37,37.7,,,percent of total billed charges,37.70% of total billed charges,226.37,37.7,,,percent of total billed charges,37.70% of total billed charges,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,20355.26,33.9,,,percent of total billed charges,33.9% of total billed charges,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.35,78,,,percent of total billed charges,78% of total billed charges,600.45,100,,,percent of total billed charges,100% of total billed charges,495.97,82.6,,,percent of total billed charges,82.6% of total billed charges,495.97,82.6,,,percent of total billed charges,82.6% of total billed charges,122.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.13,20355.26,
INTMD RPR N-HF/GENIT12.6-20,12045,CDM,983,RC,12045,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,26.15,100,,,Fee Schedule,100% of Medicare rate,157.03,100,,,Fee Schedule,100% of WA Medicaid,585,100,,,percent of total billed charges,100% of total billed charges,161.74,103,,,Fee Schedule,103% of WA Medicaid,26.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,157.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,585,100,,,percent of total billed charges,100% of total billed charges,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,585,100,,,percent of total billed charges,100% of total billed charges,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,157.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,204.14,130,,,Fee Schedule,130% of WA Medicaid ,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,19831.5,33.9,,,percent of total billed charges,33.9% of total billed charges,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,157.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.15,19831.5,
INTMD RPR N-HF/GENIT20.1-30,12046,CDM,983,RC,12046,HCPCS,Outpatient,,,856,556.40,,753.28,88,,,percent of total billed charges,88% of total Billed charges,38.59,100,,,Fee Schedule,100% of Medicare rate,181.28,100,,,Fee Schedule,100% of WA Medicaid,856,100,,,percent of total billed charges,100% of total billed charges,186.72,103,,,Fee Schedule,103% of WA Medicaid,38.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,181.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,590.64,69,,,percent of total billed charges,69% of total billed charges,856,100,,,percent of total billed charges,100% of total billed charges,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,856,100,,,percent of total billed charges,100% of total billed charges,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,856,100,,,percent of total billed charges,100% of total billed charges,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,529.44,61.85,,,percent of total billed charges,61.85% of total billed charges,181.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,235.66,130,,,Fee Schedule,130% of WA Medicaid ,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.71,37.7,,,percent of total billed charges,37.70% of total billed charges,322.71,37.7,,,percent of total billed charges,37.70% of total billed charges,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,29018.4,33.9,,,percent of total billed charges,33.9% of total billed charges,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.68,78,,,percent of total billed charges,78% of total billed charges,856,100,,,percent of total billed charges,100% of total billed charges,707.06,82.6,,,percent of total billed charges,82.6% of total billed charges,707.06,82.6,,,percent of total billed charges,82.6% of total billed charges,181.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.59,29018.4,
INTMD RPR N-HF/GENIT >30.0CM,12047,CDM,983,RC,12047,HCPCS,Outpatient,,,876,569.40,,770.88,88,,,percent of total billed charges,88% of total Billed charges,43.51,100,,,Fee Schedule,100% of Medicare rate,200.49,100,,,Fee Schedule,100% of WA Medicaid,876,100,,,percent of total billed charges,100% of total billed charges,206.5,103,,,Fee Schedule,103% of WA Medicaid,43.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,604.44,69,,,percent of total billed charges,69% of total billed charges,876,100,,,percent of total billed charges,100% of total billed charges,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,876,100,,,percent of total billed charges,100% of total billed charges,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,876,100,,,percent of total billed charges,100% of total billed charges,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.81,61.85,,,percent of total billed charges,61.85% of total billed charges,200.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,260.64,130,,,Fee Schedule,130% of WA Medicaid ,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.25,37.7,,,percent of total billed charges,37.70% of total billed charges,330.25,37.7,,,percent of total billed charges,37.70% of total billed charges,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,29696.4,33.9,,,percent of total billed charges,33.9% of total billed charges,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.28,78,,,percent of total billed charges,78% of total billed charges,876,100,,,percent of total billed charges,100% of total billed charges,723.58,82.6,,,percent of total billed charges,82.6% of total billed charges,723.58,82.6,,,percent of total billed charges,82.6% of total billed charges,200.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.51,29696.4,
INTMD RPR FACE/MM 2.6-5.0 CM,12052,CDM,983,RC,12052,HCPCS,Outpatient,,,489.14,317.94,,430.44,88,,,percent of total billed charges,88% of total Billed charges,15.11,100,,,Fee Schedule,100% of Medicare rate,114.7,100,,,Fee Schedule,100% of WA Medicaid,489.14,100,,,percent of total billed charges,100% of total billed charges,118.14,103,,,Fee Schedule,103% of WA Medicaid,15.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,114.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,337.51,69,,,percent of total billed charges,69% of total billed charges,489.14,100,,,percent of total billed charges,100% of total billed charges,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.14,100,,,percent of total billed charges,100% of total billed charges,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.14,100,,,percent of total billed charges,100% of total billed charges,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.53,61.85,,,percent of total billed charges,61.85% of total billed charges,114.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,149.11,130,,,Fee Schedule,130% of WA Medicaid ,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.41,37.7,,,percent of total billed charges,37.70% of total billed charges,184.41,37.7,,,percent of total billed charges,37.70% of total billed charges,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,16581.85,33.9,,,percent of total billed charges,33.9% of total billed charges,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.53,78,,,percent of total billed charges,78% of total billed charges,489.14,100,,,percent of total billed charges,100% of total billed charges,404.03,82.6,,,percent of total billed charges,82.6% of total billed charges,404.03,82.6,,,percent of total billed charges,82.6% of total billed charges,114.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.11,16581.85,
INTMD RPR FACE/MM 2.5 CM/<,12051,CDM,983,RC,12051,HCPCS,Outpatient,,,472,306.80,,415.36,88,,,percent of total billed charges,88% of total Billed charges,13.17,100,,,Fee Schedule,100% of Medicare rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,472,100,,,percent of total billed charges,100% of total billed charges,100.47,103,,,Fee Schedule,103% of WA Medicaid,13.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,325.68,69,,,percent of total billed charges,69% of total billed charges,472,100,,,percent of total billed charges,100% of total billed charges,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,472,100,,,percent of total billed charges,100% of total billed charges,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,472,100,,,percent of total billed charges,100% of total billed charges,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.93,61.85,,,percent of total billed charges,61.85% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.8,130,,,Fee Schedule,130% of WA Medicaid ,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.94,37.7,,,percent of total billed charges,37.70% of total billed charges,177.94,37.7,,,percent of total billed charges,37.70% of total billed charges,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,16000.8,33.9,,,percent of total billed charges,33.9% of total billed charges,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.16,78,,,percent of total billed charges,78% of total billed charges,472,100,,,percent of total billed charges,100% of total billed charges,389.87,82.6,,,percent of total billed charges,82.6% of total billed charges,389.87,82.6,,,percent of total billed charges,82.6% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.17,16000.8,
INTMD RPR FACE/MM 5.1-7.5 CM,12053,CDM,983,RC,12053,HCPCS,Outpatient,,,678,440.70,,596.64,88,,,percent of total billed charges,88% of total Billed charges,16.87,100,,,Fee Schedule,100% of Medicare rate,123.46,100,,,Fee Schedule,100% of WA Medicaid,678,100,,,percent of total billed charges,100% of total billed charges,127.16,103,,,Fee Schedule,103% of WA Medicaid,16.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,123.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,467.82,69,,,percent of total billed charges,69% of total billed charges,678,100,,,percent of total billed charges,100% of total billed charges,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,678,100,,,percent of total billed charges,100% of total billed charges,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,678,100,,,percent of total billed charges,100% of total billed charges,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.34,61.85,,,percent of total billed charges,61.85% of total billed charges,123.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,160.5,130,,,Fee Schedule,130% of WA Medicaid ,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.61,37.7,,,percent of total billed charges,37.70% of total billed charges,255.61,37.7,,,percent of total billed charges,37.70% of total billed charges,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,22984.2,33.9,,,percent of total billed charges,33.9% of total billed charges,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.84,78,,,percent of total billed charges,78% of total billed charges,678,100,,,percent of total billed charges,100% of total billed charges,560.03,82.6,,,percent of total billed charges,82.6% of total billed charges,560.03,82.6,,,percent of total billed charges,82.6% of total billed charges,123.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.87,22984.2,
INTMD RPR FACE/MM 7.6-12.5CM,12054,CDM,983,RC,12054,HCPCS,Outpatient,,,614.5,399.43,,540.76,88,,,percent of total billed charges,88% of total Billed charges,20.1,100,,,Fee Schedule,100% of Medicare rate,125.33,100,,,Fee Schedule,100% of WA Medicaid,614.5,100,,,percent of total billed charges,100% of total billed charges,129.09,103,,,Fee Schedule,103% of WA Medicaid,20.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,125.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,424.01,69,,,percent of total billed charges,69% of total billed charges,614.5,100,,,percent of total billed charges,100% of total billed charges,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.5,100,,,percent of total billed charges,100% of total billed charges,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.5,100,,,percent of total billed charges,100% of total billed charges,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.07,61.85,,,percent of total billed charges,61.85% of total billed charges,125.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,162.93,130,,,Fee Schedule,130% of WA Medicaid ,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.67,37.7,,,percent of total billed charges,37.70% of total billed charges,231.67,37.7,,,percent of total billed charges,37.70% of total billed charges,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,20831.55,33.9,,,percent of total billed charges,33.9% of total billed charges,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.31,78,,,percent of total billed charges,78% of total billed charges,614.5,100,,,percent of total billed charges,100% of total billed charges,507.58,82.6,,,percent of total billed charges,82.6% of total billed charges,507.58,82.6,,,percent of total billed charges,82.6% of total billed charges,125.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.1,20831.55,
LAYER CLOSURE OF WOUND/FACE/12.6-20CM,12055,CDM,983,RC,12055,HCPCS,Outpatient,,,619,402.35,,544.72,88,,,percent of total billed charges,88% of total Billed charges,30.07,100,,,Fee Schedule,100% of Medicare rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,619,100,,,percent of total billed charges,100% of total billed charges,177.3,103,,,Fee Schedule,103% of WA Medicaid,30.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,427.11,69,,,percent of total billed charges,69% of total billed charges,619,100,,,percent of total billed charges,100% of total billed charges,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,619,100,,,percent of total billed charges,100% of total billed charges,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,619,100,,,percent of total billed charges,100% of total billed charges,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.85,61.85,,,percent of total billed charges,61.85% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,223.78,130,,,Fee Schedule,130% of WA Medicaid ,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.36,37.7,,,percent of total billed charges,37.70% of total billed charges,233.36,37.7,,,percent of total billed charges,37.70% of total billed charges,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,20984.1,33.9,,,percent of total billed charges,33.9% of total billed charges,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.82,78,,,percent of total billed charges,78% of total billed charges,619,100,,,percent of total billed charges,100% of total billed charges,511.29,82.6,,,percent of total billed charges,82.6% of total billed charges,511.29,82.6,,,percent of total billed charges,82.6% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.07,20984.1,
INTMD RPR FACE/MM 20.1-30.0,12056,CDM,983,RC,12056,HCPCS,Outpatient,,,1079,701.35,,949.52,88,,,percent of total billed charges,88% of total Billed charges,36.98,100,,,Fee Schedule,100% of Medicare rate,219.88,100,,,Fee Schedule,100% of WA Medicaid,1079,100,,,percent of total billed charges,100% of total billed charges,226.48,103,,,Fee Schedule,103% of WA Medicaid,36.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,219.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,744.51,69,,,percent of total billed charges,69% of total billed charges,1079,100,,,percent of total billed charges,100% of total billed charges,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079,100,,,percent of total billed charges,100% of total billed charges,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079,100,,,percent of total billed charges,100% of total billed charges,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.36,61.85,,,percent of total billed charges,61.85% of total billed charges,219.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,285.84,130,,,Fee Schedule,130% of WA Medicaid ,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.78,37.7,,,percent of total billed charges,37.70% of total billed charges,406.78,37.7,,,percent of total billed charges,37.70% of total billed charges,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,36578.1,33.9,,,percent of total billed charges,33.9% of total billed charges,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.62,78,,,percent of total billed charges,78% of total billed charges,1079,100,,,percent of total billed charges,100% of total billed charges,891.25,82.6,,,percent of total billed charges,82.6% of total billed charges,891.25,82.6,,,percent of total billed charges,82.6% of total billed charges,219.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.98,36578.1,
INTMD RPR FACE/MM >30.0 CM,12057,CDM,983,RC,12057,HCPCS,Outpatient,,,995,646.75,,875.6,88,,,percent of total billed charges,88% of total Billed charges,41.65,100,,,Fee Schedule,100% of Medicare rate,239.28,100,,,Fee Schedule,100% of WA Medicaid,995,100,,,percent of total billed charges,100% of total billed charges,246.46,103,,,Fee Schedule,103% of WA Medicaid,41.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,239.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,686.55,69,,,percent of total billed charges,69% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,995,100,,,percent of total billed charges,100% of total billed charges,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,995,100,,,percent of total billed charges,100% of total billed charges,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.41,61.85,,,percent of total billed charges,61.85% of total billed charges,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,311.06,130,,,Fee Schedule,130% of WA Medicaid ,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,33730.5,33.9,,,percent of total billed charges,33.9% of total billed charges,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,776.1,78,,,percent of total billed charges,78% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.65,33730.5,
CMPLX RPR TRUNK 2.6-7.5 CM,13101,CDM,983,RC,13101,HCPCS,Outpatient,,,680,442.00,,598.4,88,,,percent of total billed charges,88% of total Billed charges,18.33,100,,,Fee Schedule,100% of Medicare rate,141.37,100,,,Fee Schedule,100% of WA Medicaid,680,100,,,percent of total billed charges,100% of total billed charges,145.61,103,,,Fee Schedule,103% of WA Medicaid,18.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,141.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,469.2,69,,,percent of total billed charges,69% of total billed charges,680,100,,,percent of total billed charges,100% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,680,100,,,percent of total billed charges,100% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,680,100,,,percent of total billed charges,100% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.58,61.85,,,percent of total billed charges,61.85% of total billed charges,141.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,183.78,130,,,Fee Schedule,130% of WA Medicaid ,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.36,37.7,,,percent of total billed charges,37.70% of total billed charges,256.36,37.7,,,percent of total billed charges,37.70% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,23052,33.9,,,percent of total billed charges,33.9% of total billed charges,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.4,78,,,percent of total billed charges,78% of total billed charges,680,100,,,percent of total billed charges,100% of total billed charges,561.68,82.6,,,percent of total billed charges,82.6% of total billed charges,561.68,82.6,,,percent of total billed charges,82.6% of total billed charges,141.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.33,23052,
CMPLX RPR TRUNK ADDL 5CM/<,13102,CDM,983,RC,13102,HCPCS,Outpatient,,,206.64,134.32,,181.84,88,,,percent of total billed charges,88% of total Billed charges,7.31,100,,,Fee Schedule,100% of Medicare rate,40.28,100,,,Fee Schedule,100% of WA Medicaid,206.64,100,,,percent of total billed charges,100% of total billed charges,41.49,103,,,Fee Schedule,103% of WA Medicaid,7.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,142.58,69,,,percent of total billed charges,69% of total billed charges,206.64,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.64,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.64,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.81,61.85,,,percent of total billed charges,61.85% of total billed charges,40.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,52.36,130,,,Fee Schedule,130% of WA Medicaid ,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.9,37.7,,,percent of total billed charges,37.70% of total billed charges,77.9,37.7,,,percent of total billed charges,37.70% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7005.1,33.9,,,percent of total billed charges,33.9% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.18,78,,,percent of total billed charges,78% of total billed charges,206.64,100,,,percent of total billed charges,100% of total billed charges,170.68,82.6,,,percent of total billed charges,82.6% of total billed charges,170.68,82.6,,,percent of total billed charges,82.6% of total billed charges,40.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.31,7005.1,
CMPLX RPR TRUNK 1.1-2.5 CM,13100,CDM,983,RC,13100,HCPCS,Outpatient,,,500,325.00,,440,88,,,percent of total billed charges,88% of total Billed charges,15.88,100,,,Fee Schedule,100% of Medicare rate,114.51,100,,,Fee Schedule,100% of WA Medicaid,500,100,,,percent of total billed charges,100% of total billed charges,117.95,103,,,Fee Schedule,103% of WA Medicaid,15.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,114.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,345,69,,,percent of total billed charges,69% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,500,100,,,percent of total billed charges,100% of total billed charges,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,500,100,,,percent of total billed charges,100% of total billed charges,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.25,61.85,,,percent of total billed charges,61.85% of total billed charges,114.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,148.86,130,,,Fee Schedule,130% of WA Medicaid ,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.5,37.7,,,percent of total billed charges,37.70% of total billed charges,188.5,37.7,,,percent of total billed charges,37.70% of total billed charges,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,16950,33.9,,,percent of total billed charges,33.9% of total billed charges,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,390,78,,,percent of total billed charges,78% of total billed charges,500,100,,,percent of total billed charges,100% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,413,82.6,,,percent of total billed charges,82.6% of total billed charges,114.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.88,16950,
CMPLX RPR S/A/L 1.1-2.5 CM,13120,CDM,983,RC,13120,HCPCS,Outpatient,,,598,388.70,,526.24,88,,,percent of total billed charges,88% of total Billed charges,17.36,100,,,Fee Schedule,100% of Medicare rate,132.79,100,,,Fee Schedule,100% of WA Medicaid,598,100,,,percent of total billed charges,100% of total billed charges,136.77,103,,,Fee Schedule,103% of WA Medicaid,17.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,132.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,412.62,69,,,percent of total billed charges,69% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,598,100,,,percent of total billed charges,100% of total billed charges,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,598,100,,,percent of total billed charges,100% of total billed charges,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.86,61.85,,,percent of total billed charges,61.85% of total billed charges,132.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,172.63,130,,,Fee Schedule,130% of WA Medicaid ,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,20272.2,33.9,,,percent of total billed charges,33.9% of total billed charges,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.44,78,,,percent of total billed charges,78% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,132.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.36,20272.2,
CMPLX RPR S/A/L ADDL 5 CM/>,13122,CDM,983,RC,13122,HCPCS,Outpatient,,,307,199.55,,270.16,88,,,percent of total billed charges,88% of total Billed charges,8.15,100,,,Fee Schedule,100% of Medicare rate,46.25,100,,,Fee Schedule,100% of WA Medicaid,307,100,,,percent of total billed charges,100% of total billed charges,47.64,103,,,Fee Schedule,103% of WA Medicaid,8.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,211.83,69,,,percent of total billed charges,69% of total billed charges,307,100,,,percent of total billed charges,100% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,307,100,,,percent of total billed charges,100% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,307,100,,,percent of total billed charges,100% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.88,61.85,,,percent of total billed charges,61.85% of total billed charges,46.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.13,130,,,Fee Schedule,130% of WA Medicaid ,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.74,37.7,,,percent of total billed charges,37.70% of total billed charges,115.74,37.7,,,percent of total billed charges,37.70% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,10407.3,33.9,,,percent of total billed charges,33.9% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.46,78,,,percent of total billed charges,78% of total billed charges,307,100,,,percent of total billed charges,100% of total billed charges,253.58,82.6,,,percent of total billed charges,82.6% of total billed charges,253.58,82.6,,,percent of total billed charges,82.6% of total billed charges,46.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.15,10407.3,
CMPLX RPR S/A/L 2.6-7.5 CM,13121,CDM,983,RC,13121,HCPCS,Outpatient,,,817,531.05,,718.96,88,,,percent of total billed charges,88% of total Billed charges,19.93,100,,,Fee Schedule,100% of Medicare rate,146.96,100,,,Fee Schedule,100% of WA Medicaid,817,100,,,percent of total billed charges,100% of total billed charges,151.37,103,,,Fee Schedule,103% of WA Medicaid,19.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,146.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,563.73,69,,,percent of total billed charges,69% of total billed charges,817,100,,,percent of total billed charges,100% of total billed charges,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,817,100,,,percent of total billed charges,100% of total billed charges,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,817,100,,,percent of total billed charges,100% of total billed charges,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.31,61.85,,,percent of total billed charges,61.85% of total billed charges,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.05,130,,,Fee Schedule,130% of WA Medicaid ,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.01,37.7,,,percent of total billed charges,37.70% of total billed charges,308.01,37.7,,,percent of total billed charges,37.70% of total billed charges,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,27696.3,33.9,,,percent of total billed charges,33.9% of total billed charges,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.26,78,,,percent of total billed charges,78% of total billed charges,817,100,,,percent of total billed charges,100% of total billed charges,674.84,82.6,,,percent of total billed charges,82.6% of total billed charges,674.84,82.6,,,percent of total billed charges,82.6% of total billed charges,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.93,27696.3,
CMPLX RPR F/C/C/M/N/AX/G/H/F,13131,CDM,983,RC,13131,HCPCS,Outpatient,,,746,484.90,,656.48,88,,,percent of total billed charges,88% of total Billed charges,19.19,100,,,Fee Schedule,100% of Medicare rate,138.01,100,,,Fee Schedule,100% of WA Medicaid,746,100,,,percent of total billed charges,100% of total billed charges,142.15,103,,,Fee Schedule,103% of WA Medicaid,19.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,138.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,514.74,69,,,percent of total billed charges,69% of total billed charges,746,100,,,percent of total billed charges,100% of total billed charges,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,746,100,,,percent of total billed charges,100% of total billed charges,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,746,100,,,percent of total billed charges,100% of total billed charges,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.4,61.85,,,percent of total billed charges,61.85% of total billed charges,138.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,179.41,130,,,Fee Schedule,130% of WA Medicaid ,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.24,37.7,,,percent of total billed charges,37.70% of total billed charges,281.24,37.7,,,percent of total billed charges,37.70% of total billed charges,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,25289.4,33.9,,,percent of total billed charges,33.9% of total billed charges,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,581.88,78,,,percent of total billed charges,78% of total billed charges,746,100,,,percent of total billed charges,100% of total billed charges,616.2,82.6,,,percent of total billed charges,82.6% of total billed charges,616.2,82.6,,,percent of total billed charges,82.6% of total billed charges,138.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.19,25289.4,
CMPLX RPR F/C/C/M/N/AX/G/H/F,13132,CDM,983,RC,13132,HCPCS,Outpatient,,,792,514.80,,696.96,88,,,percent of total billed charges,88% of total Billed charges,23.33,100,,,Fee Schedule,100% of Medicare rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,792,100,,,percent of total billed charges,100% of total billed charges,177.3,103,,,Fee Schedule,103% of WA Medicaid,23.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,546.48,69,,,percent of total billed charges,69% of total billed charges,792,100,,,percent of total billed charges,100% of total billed charges,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,792,100,,,percent of total billed charges,100% of total billed charges,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,792,100,,,percent of total billed charges,100% of total billed charges,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.85,61.85,,,percent of total billed charges,61.85% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,223.78,130,,,Fee Schedule,130% of WA Medicaid ,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.58,37.7,,,percent of total billed charges,37.70% of total billed charges,298.58,37.7,,,percent of total billed charges,37.70% of total billed charges,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,26848.8,33.9,,,percent of total billed charges,33.9% of total billed charges,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.76,78,,,percent of total billed charges,78% of total billed charges,792,100,,,percent of total billed charges,100% of total billed charges,654.19,82.6,,,percent of total billed charges,82.6% of total billed charges,654.19,82.6,,,percent of total billed charges,82.6% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.33,26848.8,
CMPLX RPR F/C/C/M/N/AX/G/H/F,13133,CDM,983,RC,13133,HCPCS,Outpatient,,,488,317.20,,429.44,88,,,percent of total billed charges,88% of total Billed charges,11.25,100,,,Fee Schedule,100% of Medicare rate,70.5,100,,,Fee Schedule,100% of WA Medicaid,488,100,,,percent of total billed charges,100% of total billed charges,72.62,103,,,Fee Schedule,103% of WA Medicaid,11.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,336.72,69,,,percent of total billed charges,69% of total billed charges,488,100,,,percent of total billed charges,100% of total billed charges,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,488,100,,,percent of total billed charges,100% of total billed charges,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,488,100,,,percent of total billed charges,100% of total billed charges,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.83,61.85,,,percent of total billed charges,61.85% of total billed charges,70.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,91.65,130,,,Fee Schedule,130% of WA Medicaid ,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.98,37.7,,,percent of total billed charges,37.70% of total billed charges,183.98,37.7,,,percent of total billed charges,37.70% of total billed charges,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,16543.2,33.9,,,percent of total billed charges,33.9% of total billed charges,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.64,78,,,percent of total billed charges,78% of total billed charges,488,100,,,percent of total billed charges,100% of total billed charges,403.09,82.6,,,percent of total billed charges,82.6% of total billed charges,403.09,82.6,,,percent of total billed charges,82.6% of total billed charges,70.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.25,16543.2,
CMPLX RPR E/N/E/L ADDL 5CM/<,13153,CDM,983,RC,13153,HCPCS,Outpatient,,,522,339.30,,459.36,88,,,percent of total billed charges,88% of total Billed charges,13.64,100,,,Fee Schedule,100% of Medicare rate,76.47,100,,,Fee Schedule,100% of WA Medicaid,522,100,,,percent of total billed charges,100% of total billed charges,78.76,103,,,Fee Schedule,103% of WA Medicaid,13.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,76.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,360.18,69,,,percent of total billed charges,69% of total billed charges,522,100,,,percent of total billed charges,100% of total billed charges,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,522,100,,,percent of total billed charges,100% of total billed charges,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,522,100,,,percent of total billed charges,100% of total billed charges,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.86,61.85,,,percent of total billed charges,61.85% of total billed charges,76.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,99.41,130,,,Fee Schedule,130% of WA Medicaid ,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.79,37.7,,,percent of total billed charges,37.70% of total billed charges,196.79,37.7,,,percent of total billed charges,37.70% of total billed charges,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,17695.8,33.9,,,percent of total billed charges,33.9% of total billed charges,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.16,78,,,percent of total billed charges,78% of total billed charges,522,100,,,percent of total billed charges,100% of total billed charges,431.17,82.6,,,percent of total billed charges,82.6% of total billed charges,431.17,82.6,,,percent of total billed charges,82.6% of total billed charges,76.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.64,17695.8,
CMPLX RPR E/N/E/L 1.1-2.5 CM,13151,CDM,983,RC,13151,HCPCS,Outpatient,,,875,568.75,,770,88,,,percent of total billed charges,88% of total Billed charges,22.34,100,,,Fee Schedule,100% of Medicare rate,158.34,100,,,Fee Schedule,100% of WA Medicaid,875,100,,,percent of total billed charges,100% of total billed charges,163.09,103,,,Fee Schedule,103% of WA Medicaid,22.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,158.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,603.75,69,,,percent of total billed charges,69% of total billed charges,875,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,875,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,875,100,,,percent of total billed charges,100% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.19,61.85,,,percent of total billed charges,61.85% of total billed charges,158.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,205.84,130,,,Fee Schedule,130% of WA Medicaid ,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.88,37.7,,,percent of total billed charges,37.70% of total billed charges,329.88,37.7,,,percent of total billed charges,37.70% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,29662.5,33.9,,,percent of total billed charges,33.9% of total billed charges,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.5,78,,,percent of total billed charges,78% of total billed charges,875,100,,,percent of total billed charges,100% of total billed charges,722.75,82.6,,,percent of total billed charges,82.6% of total billed charges,722.75,82.6,,,percent of total billed charges,82.6% of total billed charges,158.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.34,29662.5,
CMPLX RPR E/N/E/L 2.6-7.5 CM,13152,CDM,983,RC,13152,HCPCS,Outpatient,,,1309,850.85,,1151.92,88,,,percent of total billed charges,88% of total Billed charges,27.16,100,,,Fee Schedule,100% of Medicare rate,190.6,100,,,Fee Schedule,100% of WA Medicaid,1309,100,,,percent of total billed charges,100% of total billed charges,196.32,103,,,Fee Schedule,103% of WA Medicaid,27.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,190.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,903.21,69,,,percent of total billed charges,69% of total billed charges,1309,100,,,percent of total billed charges,100% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1309,100,,,percent of total billed charges,100% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1309,100,,,percent of total billed charges,100% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,809.62,61.85,,,percent of total billed charges,61.85% of total billed charges,190.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,247.78,130,,,Fee Schedule,130% of WA Medicaid ,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,493.49,37.7,,,percent of total billed charges,37.70% of total billed charges,493.49,37.7,,,percent of total billed charges,37.70% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,44375.1,33.9,,,percent of total billed charges,33.9% of total billed charges,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1021.02,78,,,percent of total billed charges,78% of total billed charges,1309,100,,,percent of total billed charges,100% of total billed charges,1081.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1081.23,82.6,,,percent of total billed charges,82.6% of total billed charges,190.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.16,44375.1,
REPAIR OF WOUND OR LESION,13150,CDM,983,RC,13150,HCPCS,Outpatient,,,719,467.35,,632.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,719,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,496.11,69,,,percent of total billed charges,69% of total billed charges,719,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,719,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,719,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,444.7,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,271.06,37.7,,,percent of total billed charges,37.70% of total billed charges,271.06,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,24374.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,560.82,78,,,percent of total billed charges,78% of total billed charges,719,100,,,percent of total billed charges,100% of total billed charges,593.89,82.6,,,percent of total billed charges,82.6% of total billed charges,593.89,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",271.06,24374.1,
LATE CLOSURE OF WOUND,13160,CDM,983,RC,13160,HCPCS,Outpatient,,,1604,1042.60,,1411.52,88,,,percent of total billed charges,88% of total Billed charges,77.63,100,,,Fee Schedule,100% of Medicare rate,454.31,100,,,Fee Schedule,100% of WA Medicaid,1604,100,,,percent of total billed charges,100% of total billed charges,467.94,103,,,Fee Schedule,103% of WA Medicaid,77.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,454.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1106.76,69,,,percent of total billed charges,69% of total billed charges,1604,100,,,percent of total billed charges,100% of total billed charges,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1604,100,,,percent of total billed charges,100% of total billed charges,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1604,100,,,percent of total billed charges,100% of total billed charges,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,992.07,61.85,,,percent of total billed charges,61.85% of total billed charges,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,590.6,130,,,Fee Schedule,130% of WA Medicaid ,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,604.71,37.7,,,percent of total billed charges,37.70% of total billed charges,604.71,37.7,,,percent of total billed charges,37.70% of total billed charges,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,54375.6,33.9,,,percent of total billed charges,33.9% of total billed charges,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1251.12,78,,,percent of total billed charges,78% of total billed charges,1604,100,,,percent of total billed charges,100% of total billed charges,1324.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1324.9,82.6,,,percent of total billed charges,82.6% of total billed charges,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.63,54375.6,
TIS TRNFR TRUNK 10 SQ CM/<,14000,CDM,983,RC,14000,HCPCS,Outpatient,,,1705,1108.25,,1500.4,88,,,percent of total billed charges,88% of total Billed charges,44.88,100,,,Fee Schedule,100% of Medicare rate,291.69,100,,,Fee Schedule,100% of WA Medicaid,1705,100,,,percent of total billed charges,100% of total billed charges,300.44,103,,,Fee Schedule,103% of WA Medicaid,44.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,291.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1176.45,69,,,percent of total billed charges,69% of total billed charges,1705,100,,,percent of total billed charges,100% of total billed charges,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1705,100,,,percent of total billed charges,100% of total billed charges,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1705,100,,,percent of total billed charges,100% of total billed charges,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1054.54,61.85,,,percent of total billed charges,61.85% of total billed charges,291.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,379.2,130,,,Fee Schedule,130% of WA Medicaid ,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.79,37.7,,,percent of total billed charges,37.70% of total billed charges,642.79,37.7,,,percent of total billed charges,37.70% of total billed charges,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,57799.5,33.9,,,percent of total billed charges,33.9% of total billed charges,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329.9,78,,,percent of total billed charges,78% of total billed charges,1705,100,,,percent of total billed charges,100% of total billed charges,1408.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1408.33,82.6,,,percent of total billed charges,82.6% of total billed charges,291.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.88,57799.5,
TIS TRNFR TRUNK 10.1-30SQCM,14001,CDM,983,RC,14001,HCPCS,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,62.54,100,,,Fee Schedule,100% of Medicare rate,375.61,100,,,Fee Schedule,100% of WA Medicaid,1800,100,,,percent of total billed charges,100% of total billed charges,386.88,103,,,Fee Schedule,103% of WA Medicaid,62.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,375.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1800,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1800,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,488.29,130,,,Fee Schedule,130% of WA Medicaid ,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,61020,33.9,,,percent of total billed charges,33.9% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.54,61020,
TIS TRNFR S/A/L 10.1-30 SQCM,14021,CDM,983,RC,14021,HCPCS,Outpatient,,,1984,1289.60,,1745.92,88,,,percent of total billed charges,88% of total Billed charges,56.74,100,,,Fee Schedule,100% of Medicare rate,408.44,100,,,Fee Schedule,100% of WA Medicaid,1984,100,,,percent of total billed charges,100% of total billed charges,420.69,103,,,Fee Schedule,103% of WA Medicaid,56.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,408.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1368.96,69,,,percent of total billed charges,69% of total billed charges,1984,100,,,percent of total billed charges,100% of total billed charges,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1984,100,,,percent of total billed charges,100% of total billed charges,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1984,100,,,percent of total billed charges,100% of total billed charges,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1227.1,61.85,,,percent of total billed charges,61.85% of total billed charges,408.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,530.97,130,,,Fee Schedule,130% of WA Medicaid ,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,747.97,37.7,,,percent of total billed charges,37.70% of total billed charges,747.97,37.7,,,percent of total billed charges,37.70% of total billed charges,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,67257.6,33.9,,,percent of total billed charges,33.9% of total billed charges,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1547.52,78,,,percent of total billed charges,78% of total billed charges,1984,100,,,percent of total billed charges,100% of total billed charges,1638.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1638.78,82.6,,,percent of total billed charges,82.6% of total billed charges,408.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.74,67257.6,
TIS TRNFR S/A/L 10 SQ CM/<,14020,CDM,983,RC,14020,HCPCS,Outpatient,,,1966,1277.90,,1730.08,88,,,percent of total billed charges,88% of total Billed charges,44.48,100,,,Fee Schedule,100% of Medicare rate,328.43,100,,,Fee Schedule,100% of WA Medicaid,1966,100,,,percent of total billed charges,100% of total billed charges,338.28,103,,,Fee Schedule,103% of WA Medicaid,44.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,328.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1356.54,69,,,percent of total billed charges,69% of total billed charges,1966,100,,,percent of total billed charges,100% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1966,100,,,percent of total billed charges,100% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1966,100,,,percent of total billed charges,100% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1215.97,61.85,,,percent of total billed charges,61.85% of total billed charges,328.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,335,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,426.96,130,,,Fee Schedule,130% of WA Medicaid ,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,741.18,37.7,,,percent of total billed charges,37.70% of total billed charges,741.18,37.7,,,percent of total billed charges,37.70% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,66647.4,33.9,,,percent of total billed charges,33.9% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1533.48,78,,,percent of total billed charges,78% of total billed charges,1966,100,,,percent of total billed charges,100% of total billed charges,1623.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1623.92,82.6,,,percent of total billed charges,82.6% of total billed charges,328.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.48,66647.4,
TIS TRNFR F/C/C/M/N/A/G/H/F,14040,CDM,983,RC,14040,HCPCS,Outpatient,,,1752,1138.80,,1541.76,88,,,percent of total billed charges,88% of total Billed charges,47.97,100,,,Fee Schedule,100% of Medicare rate,359.95,100,,,Fee Schedule,100% of WA Medicaid,1752,100,,,percent of total billed charges,100% of total billed charges,370.75,103,,,Fee Schedule,103% of WA Medicaid,47.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,359.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1208.88,69,,,percent of total billed charges,69% of total billed charges,1752,100,,,percent of total billed charges,100% of total billed charges,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1752,100,,,percent of total billed charges,100% of total billed charges,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1752,100,,,percent of total billed charges,100% of total billed charges,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1083.61,61.85,,,percent of total billed charges,61.85% of total billed charges,359.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,467.94,130,,,Fee Schedule,130% of WA Medicaid ,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,660.5,37.7,,,percent of total billed charges,37.70% of total billed charges,660.5,37.7,,,percent of total billed charges,37.70% of total billed charges,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,59392.8,33.9,,,percent of total billed charges,33.9% of total billed charges,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1366.56,78,,,percent of total billed charges,78% of total billed charges,1752,100,,,percent of total billed charges,100% of total billed charges,1447.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1447.15,82.6,,,percent of total billed charges,82.6% of total billed charges,359.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.97,59392.8,
TIS TRNFR F/C/C/M/N/A/G/H/F,14041,CDM,983,RC,14041,HCPCS,Outpatient,,,2147,1395.55,,1889.36,88,,,percent of total billed charges,88% of total Billed charges,57.82,100,,,Fee Schedule,100% of Medicare rate,438.65,100,,,Fee Schedule,100% of WA Medicaid,2147,100,,,percent of total billed charges,100% of total billed charges,451.81,103,,,Fee Schedule,103% of WA Medicaid,57.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,438.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1481.43,69,,,percent of total billed charges,69% of total billed charges,2147,100,,,percent of total billed charges,100% of total billed charges,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2147,100,,,percent of total billed charges,100% of total billed charges,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2147,100,,,percent of total billed charges,100% of total billed charges,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1327.92,61.85,,,percent of total billed charges,61.85% of total billed charges,438.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,570.25,130,,,Fee Schedule,130% of WA Medicaid ,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,809.42,37.7,,,percent of total billed charges,37.70% of total billed charges,809.42,37.7,,,percent of total billed charges,37.70% of total billed charges,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,72783.3,33.9,,,percent of total billed charges,33.9% of total billed charges,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1674.66,78,,,percent of total billed charges,78% of total billed charges,2147,100,,,percent of total billed charges,100% of total billed charges,1773.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1773.42,82.6,,,percent of total billed charges,82.6% of total billed charges,438.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.82,72783.3,
TIS TRNFR E/N/E/L 10 SQ CM/<,14060,CDM,983,RC,14060,HCPCS,Outpatient,,,1865,1212.25,,1641.2,88,,,percent of total billed charges,88% of total Billed charges,49.73,100,,,Fee Schedule,100% of Medicare rate,383.63,100,,,Fee Schedule,100% of WA Medicaid,1865,100,,,percent of total billed charges,100% of total billed charges,395.14,103,,,Fee Schedule,103% of WA Medicaid,49.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,383.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1286.85,69,,,percent of total billed charges,69% of total billed charges,1865,100,,,percent of total billed charges,100% of total billed charges,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1865,100,,,percent of total billed charges,100% of total billed charges,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1865,100,,,percent of total billed charges,100% of total billed charges,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1153.5,61.85,,,percent of total billed charges,61.85% of total billed charges,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,498.72,130,,,Fee Schedule,130% of WA Medicaid ,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,703.11,37.7,,,percent of total billed charges,37.70% of total billed charges,703.11,37.7,,,percent of total billed charges,37.70% of total billed charges,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,63223.5,33.9,,,percent of total billed charges,33.9% of total billed charges,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1454.7,78,,,percent of total billed charges,78% of total billed charges,1865,100,,,percent of total billed charges,100% of total billed charges,1540.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1540.49,82.6,,,percent of total billed charges,82.6% of total billed charges,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.73,63223.5,
TIS TRNFR E/N/E/L10.1-30SQCM,14061,CDM,983,RC,14061,HCPCS,Outpatient,,,2297,1493.05,,2021.36,88,,,percent of total billed charges,88% of total Billed charges,62.13,100,,,Fee Schedule,100% of Medicare rate,471.47,100,,,Fee Schedule,100% of WA Medicaid,2297,100,,,percent of total billed charges,100% of total billed charges,485.61,103,,,Fee Schedule,103% of WA Medicaid,62.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,471.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1584.93,69,,,percent of total billed charges,69% of total billed charges,2297,100,,,percent of total billed charges,100% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2297,100,,,percent of total billed charges,100% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2297,100,,,percent of total billed charges,100% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1420.69,61.85,,,percent of total billed charges,61.85% of total billed charges,471.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,612.91,130,,,Fee Schedule,130% of WA Medicaid ,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,865.97,37.7,,,percent of total billed charges,37.70% of total billed charges,865.97,37.7,,,percent of total billed charges,37.70% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,77868.3,33.9,,,percent of total billed charges,33.9% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1791.66,78,,,percent of total billed charges,78% of total billed charges,2297,100,,,percent of total billed charges,100% of total billed charges,1897.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1897.32,82.6,,,percent of total billed charges,82.6% of total billed charges,471.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.13,77868.3,
TIS TRNFR ANY 30.1-60 SQ CM,14301,CDM,983,RC,14301,HCPCS,Outpatient,,,2432,1580.80,,2140.16,88,,,percent of total billed charges,88% of total Billed charges,79.34,100,,,Fee Schedule,100% of Medicare rate,497.21,100,,,Fee Schedule,100% of WA Medicaid,2432,100,,,percent of total billed charges,100% of total billed charges,512.13,103,,,Fee Schedule,103% of WA Medicaid,79.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,497.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1678.08,69,,,percent of total billed charges,69% of total billed charges,2432,100,,,percent of total billed charges,100% of total billed charges,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2432,100,,,percent of total billed charges,100% of total billed charges,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2432,100,,,percent of total billed charges,100% of total billed charges,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1504.19,61.85,,,percent of total billed charges,61.85% of total billed charges,497.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,646.37,130,,,Fee Schedule,130% of WA Medicaid ,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.86,37.7,,,percent of total billed charges,37.70% of total billed charges,916.86,37.7,,,percent of total billed charges,37.70% of total billed charges,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,82444.8,33.9,,,percent of total billed charges,33.9% of total billed charges,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1896.96,78,,,percent of total billed charges,78% of total billed charges,2432,100,,,percent of total billed charges,100% of total billed charges,2008.83,82.6,,,percent of total billed charges,82.6% of total billed charges,2008.83,82.6,,,percent of total billed charges,82.6% of total billed charges,497.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.34,82444.8,
FILLETED FINGER/TOE FLAP,14350,CDM,983,RC,14350,HCPCS,Outpatient,,,1966,1277.90,,1730.08,88,,,percent of total billed charges,88% of total Billed charges,50.02,100,,,Fee Schedule,100% of Medicare rate,388.29,100,,,Fee Schedule,100% of WA Medicaid,1966,100,,,percent of total billed charges,100% of total billed charges,399.94,103,,,Fee Schedule,103% of WA Medicaid,50.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,388.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1356.54,69,,,percent of total billed charges,69% of total billed charges,1966,100,,,percent of total billed charges,100% of total billed charges,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1966,100,,,percent of total billed charges,100% of total billed charges,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1966,100,,,percent of total billed charges,100% of total billed charges,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1215.97,61.85,,,percent of total billed charges,61.85% of total billed charges,388.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,504.78,130,,,Fee Schedule,130% of WA Medicaid ,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,741.18,37.7,,,percent of total billed charges,37.70% of total billed charges,741.18,37.7,,,percent of total billed charges,37.70% of total billed charges,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,66647.4,33.9,,,percent of total billed charges,33.9% of total billed charges,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1533.48,78,,,percent of total billed charges,78% of total billed charges,1966,100,,,percent of total billed charges,100% of total billed charges,1623.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1623.92,82.6,,,percent of total billed charges,82.6% of total billed charges,388.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.02,66647.4,
WOUND PREP TRK/ARM/LEG,15002,CDM,983,RC,15002,HCPCS,Outpatient,,,1036,673.40,,911.68,88,,,percent of total billed charges,88% of total Billed charges,23.63,100,,,Fee Schedule,100% of Medicare rate,123.28,100,,,Fee Schedule,100% of WA Medicaid,1036,100,,,percent of total billed charges,100% of total billed charges,126.98,103,,,Fee Schedule,103% of WA Medicaid,23.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,123.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,714.84,69,,,percent of total billed charges,69% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1036,100,,,percent of total billed charges,100% of total billed charges,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1036,100,,,percent of total billed charges,100% of total billed charges,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.77,61.85,,,percent of total billed charges,61.85% of total billed charges,123.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,160.26,130,,,Fee Schedule,130% of WA Medicaid ,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,35120.4,33.9,,,percent of total billed charges,33.9% of total billed charges,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,808.08,78,,,percent of total billed charges,78% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,123.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.63,35120.4,
WOUND PREP F/N/HF/G,15004,CDM,983,RC,15004,HCPCS,Outpatient,,,751.8,488.67,,661.58,88,,,percent of total billed charges,88% of total Billed charges,23.79,100,,,Fee Schedule,100% of Medicare rate,146.03,100,,,Fee Schedule,100% of WA Medicaid,751.8,100,,,percent of total billed charges,100% of total billed charges,150.41,103,,,Fee Schedule,103% of WA Medicaid,23.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,146.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,518.74,69,,,percent of total billed charges,69% of total billed charges,751.8,100,,,percent of total billed charges,100% of total billed charges,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.8,100,,,percent of total billed charges,100% of total billed charges,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.8,100,,,percent of total billed charges,100% of total billed charges,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.99,61.85,,,percent of total billed charges,61.85% of total billed charges,146.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,189.84,130,,,Fee Schedule,130% of WA Medicaid ,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.43,37.7,,,percent of total billed charges,37.70% of total billed charges,283.43,37.7,,,percent of total billed charges,37.70% of total billed charges,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,25486.02,33.9,,,percent of total billed charges,33.9% of total billed charges,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,586.4,78,,,percent of total billed charges,78% of total billed charges,751.8,100,,,percent of total billed charges,100% of total billed charges,620.99,82.6,,,percent of total billed charges,82.6% of total billed charges,620.99,82.6,,,percent of total billed charges,82.6% of total billed charges,146.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.79,25486.02,
15005 Wnd Prep F/N/HF/G Addl CM,15005,CDM,983,RC,15005,HCPCS,Outpatient,,,551,358.15,,484.88,88,,,percent of total billed charges,88% of total Billed charges,11.19,100,,,Fee Schedule,100% of Medicare rate,49.8,100,,,Fee Schedule,100% of WA Medicaid,551,100,,,percent of total billed charges,100% of total billed charges,51.29,103,,,Fee Schedule,103% of WA Medicaid,11.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,380.19,69,,,percent of total billed charges,69% of total billed charges,551,100,,,percent of total billed charges,100% of total billed charges,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,551,100,,,percent of total billed charges,100% of total billed charges,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,551,100,,,percent of total billed charges,100% of total billed charges,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.79,61.85,,,percent of total billed charges,61.85% of total billed charges,49.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.74,130,,,Fee Schedule,130% of WA Medicaid ,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.73,37.7,,,percent of total billed charges,37.70% of total billed charges,207.73,37.7,,,percent of total billed charges,37.70% of total billed charges,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,18678.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.78,78,,,percent of total billed charges,78% of total billed charges,551,100,,,percent of total billed charges,100% of total billed charges,455.13,82.6,,,percent of total billed charges,82.6% of total billed charges,455.13,82.6,,,percent of total billed charges,82.6% of total billed charges,49.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.19,18678.9,
PINCH GRAFT SINGLE OR MULT TO COV ULCER,15050,CDM,983,RC,15050,HCPCS,Outpatient,,,672,436.80,,591.36,88,,,percent of total billed charges,88% of total Billed charges,40.09,100,,,Fee Schedule,100% of Medicare rate,264.83,100,,,Fee Schedule,100% of WA Medicaid,672,100,,,percent of total billed charges,100% of total billed charges,272.77,103,,,Fee Schedule,103% of WA Medicaid,40.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,463.68,69,,,percent of total billed charges,69% of total billed charges,672,100,,,percent of total billed charges,100% of total billed charges,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,672,100,,,percent of total billed charges,100% of total billed charges,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,672,100,,,percent of total billed charges,100% of total billed charges,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.63,61.85,,,percent of total billed charges,61.85% of total billed charges,264.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,344.28,130,,,Fee Schedule,130% of WA Medicaid ,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.34,37.7,,,percent of total billed charges,37.70% of total billed charges,253.34,37.7,,,percent of total billed charges,37.70% of total billed charges,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,22780.8,33.9,,,percent of total billed charges,33.9% of total billed charges,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.16,78,,,percent of total billed charges,78% of total billed charges,672,100,,,percent of total billed charges,100% of total billed charges,555.07,82.6,,,percent of total billed charges,82.6% of total billed charges,555.07,82.6,,,percent of total billed charges,82.6% of total billed charges,264.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.09,22780.8,
SKIN SPLT GRFT T/A/L ADD-ON,15101,CDM,983,RC,15101,HCPCS,Outpatient,,,307.2,199.68,,270.34,88,,,percent of total billed charges,88% of total Billed charges,13.14,100,,,Fee Schedule,100% of Medicare rate,62.1,100,,,Fee Schedule,100% of WA Medicaid,307.2,100,,,percent of total billed charges,100% of total billed charges,63.96,103,,,Fee Schedule,103% of WA Medicaid,13.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,62.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,211.97,69,,,percent of total billed charges,69% of total billed charges,307.2,100,,,percent of total billed charges,100% of total billed charges,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.2,100,,,percent of total billed charges,100% of total billed charges,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.2,100,,,percent of total billed charges,100% of total billed charges,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,61.85,,,percent of total billed charges,61.85% of total billed charges,62.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,80.73,130,,,Fee Schedule,130% of WA Medicaid ,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.81,37.7,,,percent of total billed charges,37.70% of total billed charges,115.81,37.7,,,percent of total billed charges,37.70% of total billed charges,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,10414.08,33.9,,,percent of total billed charges,33.9% of total billed charges,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.62,78,,,percent of total billed charges,78% of total billed charges,307.2,100,,,percent of total billed charges,100% of total billed charges,253.75,82.6,,,percent of total billed charges,82.6% of total billed charges,253.75,82.6,,,percent of total billed charges,82.6% of total billed charges,62.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.14,10414.08,
SKIN SPLT GRFT TRNK/ARM/LEG,15100,CDM,983,RC,15100,HCPCS,Outpatient,,,2025,1316.25,,1782,88,,,percent of total billed charges,88% of total Billed charges,71.63,100,,,Fee Schedule,100% of Medicare rate,409.93,100,,,Fee Schedule,100% of WA Medicaid,2025,100,,,percent of total billed charges,100% of total billed charges,422.23,103,,,Fee Schedule,103% of WA Medicaid,71.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,125.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,409.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1397.25,69,,,percent of total billed charges,69% of total billed charges,2025,100,,,percent of total billed charges,100% of total billed charges,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2025,100,,,percent of total billed charges,100% of total billed charges,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2025,100,,,percent of total billed charges,100% of total billed charges,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1252.46,61.85,,,percent of total billed charges,61.85% of total billed charges,409.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,532.91,130,,,Fee Schedule,130% of WA Medicaid ,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.43,37.7,,,percent of total billed charges,37.70% of total billed charges,763.43,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,68647.5,33.9,,,percent of total billed charges,33.9% of total billed charges,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1579.5,78,,,percent of total billed charges,78% of total billed charges,2025,100,,,percent of total billed charges,100% of total billed charges,1672.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1672.65,82.6,,,percent of total billed charges,82.6% of total billed charges,409.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.63,68647.5,
SKN SPLT A-GRFT FAC/NCK/HF/G,15120,CDM,983,RC,15120,HCPCS,Outpatient,,,3190,2073.50,,2807.2,88,,,percent of total billed charges,88% of total Billed charges,64.13,100,,,Fee Schedule,100% of Medicare rate,395.38,100,,,Fee Schedule,100% of WA Medicaid,3190,100,,,percent of total billed charges,100% of total billed charges,407.24,103,,,Fee Schedule,103% of WA Medicaid,64.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,395.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2201.1,69,,,percent of total billed charges,69% of total billed charges,3190,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,3190,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,3190,100,,,percent of total billed charges,100% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1973.02,61.85,,,percent of total billed charges,61.85% of total billed charges,395.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,513.99,130,,,Fee Schedule,130% of WA Medicaid ,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1202.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1202.63,37.7,,,percent of total billed charges,37.70% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,108141,33.9,,,percent of total billed charges,33.9% of total billed charges,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2488.2,78,,,percent of total billed charges,78% of total billed charges,3190,100,,,percent of total billed charges,100% of total billed charges,2634.94,82.6,,,percent of total billed charges,82.6% of total billed charges,2634.94,82.6,,,percent of total billed charges,82.6% of total billed charges,395.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.13,108141,
SKN SPLT A-GRFT F/N/HF/G ADD,15121,CDM,983,RC,15121,HCPCS,Outpatient,,,369.87,240.42,,325.49,88,,,percent of total billed charges,88% of total Billed charges,14.29,100,,,Fee Schedule,100% of Medicare rate,74.23,100,,,Fee Schedule,100% of WA Medicaid,369.87,100,,,percent of total billed charges,100% of total billed charges,76.46,103,,,Fee Schedule,103% of WA Medicaid,14.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,255.21,69,,,percent of total billed charges,69% of total billed charges,369.87,100,,,percent of total billed charges,100% of total billed charges,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.87,100,,,percent of total billed charges,100% of total billed charges,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.87,100,,,percent of total billed charges,100% of total billed charges,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.76,61.85,,,percent of total billed charges,61.85% of total billed charges,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,96.5,130,,,Fee Schedule,130% of WA Medicaid ,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.44,37.7,,,percent of total billed charges,37.70% of total billed charges,139.44,37.7,,,percent of total billed charges,37.70% of total billed charges,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,12538.59,33.9,,,percent of total billed charges,33.9% of total billed charges,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.5,78,,,percent of total billed charges,78% of total billed charges,369.87,100,,,percent of total billed charges,100% of total billed charges,305.51,82.6,,,percent of total billed charges,82.6% of total billed charges,305.51,82.6,,,percent of total billed charges,82.6% of total billed charges,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.29,12538.59,
SKIN FULL GRAFT SCLP/ARM/LEG,15220,CDM,983,RC,15220,HCPCS,Outpatient,,,1719,1117.35,,1512.72,88,,,percent of total billed charges,88% of total Billed charges,49.38,100,,,Fee Schedule,100% of Medicare rate,352.49,100,,,Fee Schedule,100% of WA Medicaid,1719,100,,,percent of total billed charges,100% of total billed charges,363.06,103,,,Fee Schedule,103% of WA Medicaid,49.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,352.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1186.11,69,,,percent of total billed charges,69% of total billed charges,1719,100,,,percent of total billed charges,100% of total billed charges,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1719,100,,,percent of total billed charges,100% of total billed charges,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1719,100,,,percent of total billed charges,100% of total billed charges,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.2,61.85,,,percent of total billed charges,61.85% of total billed charges,352.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,458.24,130,,,Fee Schedule,130% of WA Medicaid ,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,648.06,37.7,,,percent of total billed charges,37.70% of total billed charges,648.06,37.7,,,percent of total billed charges,37.70% of total billed charges,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,58274.1,33.9,,,percent of total billed charges,33.9% of total billed charges,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340.82,78,,,percent of total billed charges,78% of total billed charges,1719,100,,,percent of total billed charges,100% of total billed charges,1419.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1419.89,82.6,,,percent of total billed charges,82.6% of total billed charges,352.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.38,58274.1,
SKIN FULL GRFT FACE/GENIT/HF,15240,CDM,983,RC,15240,HCPCS,Outpatient,,,2525,1641.25,,2222,88,,,percent of total billed charges,88% of total Billed charges,61.53,100,,,Fee Schedule,100% of Medicare rate,460.47,100,,,Fee Schedule,100% of WA Medicaid,2525,100,,,percent of total billed charges,100% of total billed charges,474.28,103,,,Fee Schedule,103% of WA Medicaid,61.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,107.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,460.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1742.25,69,,,percent of total billed charges,69% of total billed charges,2525,100,,,percent of total billed charges,100% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2525,100,,,percent of total billed charges,100% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2525,100,,,percent of total billed charges,100% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1561.71,61.85,,,percent of total billed charges,61.85% of total billed charges,460.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,598.61,130,,,Fee Schedule,130% of WA Medicaid ,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,951.93,37.7,,,percent of total billed charges,37.70% of total billed charges,951.93,37.7,,,percent of total billed charges,37.70% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,85597.5,33.9,,,percent of total billed charges,33.9% of total billed charges,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1969.5,78,,,percent of total billed charges,78% of total billed charges,2525,100,,,percent of total billed charges,100% of total billed charges,2085.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2085.65,82.6,,,percent of total billed charges,82.6% of total billed charges,460.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.53,85597.5,
FULL THICK GRAFT INC CLOSURE OF DONER SI,15260,CDM,983,RC,15260,HCPCS,Outpatient,,,1245,809.25,,1095.6,88,,,percent of total billed charges,88% of total Billed charges,61.69,100,,,Fee Schedule,100% of Medicare rate,487.88,100,,,Fee Schedule,100% of WA Medicaid,1245,100,,,percent of total billed charges,100% of total billed charges,502.52,103,,,Fee Schedule,103% of WA Medicaid,61.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,107.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,487.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,859.05,69,,,percent of total billed charges,69% of total billed charges,1245,100,,,percent of total billed charges,100% of total billed charges,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1245,100,,,percent of total billed charges,100% of total billed charges,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1245,100,,,percent of total billed charges,100% of total billed charges,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,770.03,61.85,,,percent of total billed charges,61.85% of total billed charges,487.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,634.24,130,,,Fee Schedule,130% of WA Medicaid ,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.37,37.7,,,percent of total billed charges,37.70% of total billed charges,469.37,37.7,,,percent of total billed charges,37.70% of total billed charges,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,42205.5,33.9,,,percent of total billed charges,33.9% of total billed charges,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,971.1,78,,,percent of total billed charges,78% of total billed charges,1245,100,,,percent of total billed charges,100% of total billed charges,1028.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1028.37,82.6,,,percent of total billed charges,82.6% of total billed charges,487.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.69,42205.5,
SKN SUB GRFT T/A/L CHILD ADD,15274,CDM,983,RC,15274,HCPCS,Outpatient,,,126.5,82.23,,111.32,88,,,percent of total billed charges,88% of total Billed charges,5.71,100,,,Fee Schedule,100% of Medicare rate,24.62,100,,,Fee Schedule,100% of WA Medicaid,126.5,100,,,percent of total billed charges,100% of total billed charges,25.36,103,,,Fee Schedule,103% of WA Medicaid,5.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,24.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,87.29,69,,,percent of total billed charges,69% of total billed charges,126.5,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.5,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.5,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.24,61.85,,,percent of total billed charges,61.85% of total billed charges,24.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.01,130,,,Fee Schedule,130% of WA Medicaid ,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.69,37.7,,,percent of total billed charges,37.70% of total billed charges,47.69,37.7,,,percent of total billed charges,37.70% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,4288.35,33.9,,,percent of total billed charges,33.9% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.67,78,,,percent of total billed charges,78% of total billed charges,126.5,100,,,percent of total billed charges,100% of total billed charges,104.49,82.6,,,percent of total billed charges,82.6% of total billed charges,104.49,82.6,,,percent of total billed charges,82.6% of total billed charges,24.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.71,4288.35,
SKIN SUB GRFT T/ARM/LG CHILD,15273,CDM,983,RC,15273,HCPCS,Outpatient,,,561.58,365.03,,494.19,88,,,percent of total billed charges,88% of total Billed charges,22.36,100,,,Fee Schedule,100% of Medicare rate,108.92,100,,,Fee Schedule,100% of WA Medicaid,561.58,100,,,percent of total billed charges,100% of total billed charges,112.19,103,,,Fee Schedule,103% of WA Medicaid,22.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,108.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,387.49,69,,,percent of total billed charges,69% of total billed charges,561.58,100,,,percent of total billed charges,100% of total billed charges,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.58,100,,,percent of total billed charges,100% of total billed charges,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.58,100,,,percent of total billed charges,100% of total billed charges,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,347.34,61.85,,,percent of total billed charges,61.85% of total billed charges,108.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.6,130,,,Fee Schedule,130% of WA Medicaid ,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.72,37.7,,,percent of total billed charges,37.70% of total billed charges,211.72,37.7,,,percent of total billed charges,37.70% of total billed charges,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,19037.56,33.9,,,percent of total billed charges,33.9% of total billed charges,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.03,78,,,percent of total billed charges,78% of total billed charges,561.58,100,,,percent of total billed charges,100% of total billed charges,463.87,82.6,,,percent of total billed charges,82.6% of total billed charges,463.87,82.6,,,percent of total billed charges,82.6% of total billed charges,108.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.36,19037.56,
15277 Skin Sub Grft F/N/HF/G Child,15277,CDM,983,RC,15277,HCPCS,Outpatient,,,1377,895.05,,1211.76,88,,,percent of total billed charges,88% of total Billed charges,25.24,100,,,Fee Schedule,100% of Medicare rate,124.02,100,,,Fee Schedule,100% of WA Medicaid,1377,100,,,percent of total billed charges,100% of total billed charges,127.74,103,,,Fee Schedule,103% of WA Medicaid,25.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,124.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,950.13,69,,,percent of total billed charges,69% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377,100,,,percent of total billed charges,100% of total billed charges,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377,100,,,percent of total billed charges,100% of total billed charges,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.67,61.85,,,percent of total billed charges,61.85% of total billed charges,124.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,161.23,130,,,Fee Schedule,130% of WA Medicaid ,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,46680.3,33.9,,,percent of total billed charges,33.9% of total billed charges,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.06,78,,,percent of total billed charges,78% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,124.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.24,46680.3,
15278 Skin Sub Grft F/N/HF/G Child Add,15278,CDM,983,RC,15278,HCPCS,Outpatient,,,348,226.20,,306.24,88,,,percent of total billed charges,88% of total Billed charges,6.82,100,,,Fee Schedule,100% of Medicare rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,348,100,,,percent of total billed charges,100% of total billed charges,31.89,103,,,Fee Schedule,103% of WA Medicaid,6.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,240.12,69,,,percent of total billed charges,69% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,348,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,348,100,,,percent of total billed charges,100% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.24,61.85,,,percent of total billed charges,61.85% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.25,130,,,Fee Schedule,130% of WA Medicaid ,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,131.2,37.7,,,percent of total billed charges,37.70% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,11797.2,33.9,,,percent of total billed charges,33.9% of total billed charges,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.44,78,,,percent of total billed charges,78% of total billed charges,348,100,,,percent of total billed charges,100% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,287.45,82.6,,,percent of total billed charges,82.6% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.82,11797.2,
MUSCLE-SKIN GRAFT LEG,15738,CDM,983,RC,15738,HCPCS,Outpatient,,,3322,2159.30,,2923.36,88,,,percent of total billed charges,88% of total Billed charges,133.42,100,,,Fee Schedule,100% of Medicare rate,720.64,100,,,Fee Schedule,100% of WA Medicaid,3322,100,,,percent of total billed charges,100% of total billed charges,742.26,103,,,Fee Schedule,103% of WA Medicaid,133.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,233.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,720.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2292.18,69,,,percent of total billed charges,69% of total billed charges,3322,100,,,percent of total billed charges,100% of total billed charges,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,3322,100,,,percent of total billed charges,100% of total billed charges,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,3322,100,,,percent of total billed charges,100% of total billed charges,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2054.66,61.85,,,percent of total billed charges,61.85% of total billed charges,720.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,720.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,735.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,936.83,130,,,Fee Schedule,130% of WA Medicaid ,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1252.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1252.39,37.7,,,percent of total billed charges,37.70% of total billed charges,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,112615.8,33.9,,,percent of total billed charges,33.9% of total billed charges,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2591.16,78,,,percent of total billed charges,78% of total billed charges,3322,100,,,percent of total billed charges,100% of total billed charges,2743.97,82.6,,,percent of total billed charges,82.6% of total billed charges,2743.97,82.6,,,percent of total billed charges,82.6% of total billed charges,720.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,133.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,720.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,133.42,112615.8,
MUSCLE-SKIN GRAFT TRUNK,15734,CDM,983,RC,15734,HCPCS,Outpatient,,,3635,2362.75,,3198.8,88,,,percent of total billed charges,88% of total Billed charges,173.99,100,,,Fee Schedule,100% of Medicare rate,849.88,100,,,Fee Schedule,100% of WA Medicaid,3635,100,,,percent of total billed charges,100% of total billed charges,875.38,103,,,Fee Schedule,103% of WA Medicaid,173.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,304.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,849.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2508.15,69,,,percent of total billed charges,69% of total billed charges,3635,100,,,percent of total billed charges,100% of total billed charges,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3635,100,,,percent of total billed charges,100% of total billed charges,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3635,100,,,percent of total billed charges,100% of total billed charges,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2248.25,61.85,,,percent of total billed charges,61.85% of total billed charges,849.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,849.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,866.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1104.84,130,,,Fee Schedule,130% of WA Medicaid ,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1370.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1370.4,37.7,,,percent of total billed charges,37.70% of total billed charges,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,123226.5,33.9,,,percent of total billed charges,33.9% of total billed charges,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2835.3,78,,,percent of total billed charges,78% of total billed charges,3635,100,,,percent of total billed charges,100% of total billed charges,3002.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3002.51,82.6,,,percent of total billed charges,82.6% of total billed charges,849.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,173.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,849.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,173.99,123226.5,
ACELLULAR DERM MARTRIX IMPLANT,15777,CDM,983,RC,15777,HCPCS,Outpatient,,,486,315.90,,427.68,88,,,percent of total billed charges,88% of total Billed charges,24.74,100,,,Fee Schedule,100% of Medicare rate,119.73,100,,,Fee Schedule,100% of WA Medicaid,486,100,,,percent of total billed charges,100% of total billed charges,123.32,103,,,Fee Schedule,103% of WA Medicaid,24.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,119.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,335.34,69,,,percent of total billed charges,69% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.59,61.85,,,percent of total billed charges,61.85% of total billed charges,119.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,155.65,130,,,Fee Schedule,130% of WA Medicaid ,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,16475.4,33.9,,,percent of total billed charges,33.9% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.08,78,,,percent of total billed charges,78% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,119.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.74,16475.4,
DERMA-FAT-FASCIA GRAFT,15770,CDM,983,RC,15770,HCPCS,Outpatient,,,2234,1452.10,,1965.92,88,,,percent of total billed charges,88% of total Billed charges,58.08,100,,,Fee Schedule,100% of Medicare rate,389.6,100,,,Fee Schedule,100% of WA Medicaid,2234,100,,,percent of total billed charges,100% of total billed charges,401.29,103,,,Fee Schedule,103% of WA Medicaid,58.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,389.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1541.46,69,,,percent of total billed charges,69% of total billed charges,2234,100,,,percent of total billed charges,100% of total billed charges,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2234,100,,,percent of total billed charges,100% of total billed charges,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2234,100,,,percent of total billed charges,100% of total billed charges,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1381.73,61.85,,,percent of total billed charges,61.85% of total billed charges,389.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,506.48,130,,,Fee Schedule,130% of WA Medicaid ,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.22,37.7,,,percent of total billed charges,37.70% of total billed charges,842.22,37.7,,,percent of total billed charges,37.70% of total billed charges,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,75732.6,33.9,,,percent of total billed charges,33.9% of total billed charges,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1742.52,78,,,percent of total billed charges,78% of total billed charges,2234,100,,,percent of total billed charges,100% of total billed charges,1845.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1845.28,82.6,,,percent of total billed charges,82.6% of total billed charges,389.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.08,75732.6,
REV. UPPER EYELID W/EXCE SKIN WEIGH DWN,15823,CDM,983,RC,15823,HCPCS,Outpatient,,,1250,812.50,,1100,88,,,percent of total billed charges,88% of total Billed charges,32.11,100,,,Fee Schedule,100% of Medicare rate,320.59,100,,,Fee Schedule,100% of WA Medicaid,1250,100,,,percent of total billed charges,100% of total billed charges,330.21,103,,,Fee Schedule,103% of WA Medicaid,32.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,320.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,862.5,69,,,percent of total billed charges,69% of total billed charges,1250,100,,,percent of total billed charges,100% of total billed charges,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1250,100,,,percent of total billed charges,100% of total billed charges,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1250,100,,,percent of total billed charges,100% of total billed charges,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,773.13,61.85,,,percent of total billed charges,61.85% of total billed charges,320.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,327,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,416.77,130,,,Fee Schedule,130% of WA Medicaid ,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.25,37.7,,,percent of total billed charges,37.70% of total billed charges,471.25,37.7,,,percent of total billed charges,37.70% of total billed charges,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,42375,33.9,,,percent of total billed charges,33.9% of total billed charges,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,975,78,,,percent of total billed charges,78% of total billed charges,1250,100,,,percent of total billed charges,100% of total billed charges,1032.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1032.5,82.6,,,percent of total billed charges,82.6% of total billed charges,320.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.11,42375,
REVISION OF LOWER EYELID,15821,CDM,983,RC,15821,HCPCS,Outpatient,,,1250,812.50,,1100,88,,,percent of total billed charges,88% of total Billed charges,33.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,862.5,69,,,percent of total billed charges,69% of total billed charges,1250,100,,,percent of total billed charges,100% of total billed charges,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1250,100,,,percent of total billed charges,100% of total billed charges,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1250,100,,,percent of total billed charges,100% of total billed charges,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,773.13,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.25,37.7,,,percent of total billed charges,37.70% of total billed charges,471.25,37.7,,,percent of total billed charges,37.70% of total billed charges,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,42375,33.9,,,percent of total billed charges,33.9% of total billed charges,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,975,78,,,percent of total billed charges,78% of total billed charges,1250,100,,,percent of total billed charges,100% of total billed charges,1032.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1032.5,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",33.39,42375,
REVISION OF UPPER EYELID,15822,CDM,983,RC,15822,HCPCS,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,25.68,100,,,Fee Schedule,100% of Medicare rate,232.57,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,239.55,103,,,Fee Schedule,103% of WA Medicaid,25.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,232.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,232.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,302.34,130,,,Fee Schedule,130% of WA Medicaid ,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,30510,33.9,,,percent of total billed charges,33.9% of total billed charges,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,232.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.68,30510,
EXC SKIN ABD,15830,CDM,983,RC,15830,HCPCS,Outpatient,,,2306,1498.90,,2029.28,88,,,percent of total billed charges,88% of total Billed charges,122.86,100,,,Fee Schedule,100% of Medicare rate,668.23,100,,,Fee Schedule,100% of WA Medicaid,2306,100,,,percent of total billed charges,100% of total billed charges,688.28,103,,,Fee Schedule,103% of WA Medicaid,122.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,215.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,668.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1591.14,69,,,percent of total billed charges,69% of total billed charges,2306,100,,,percent of total billed charges,100% of total billed charges,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2306,100,,,percent of total billed charges,100% of total billed charges,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2306,100,,,percent of total billed charges,100% of total billed charges,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1426.26,61.85,,,percent of total billed charges,61.85% of total billed charges,668.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,681.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,868.7,130,,,Fee Schedule,130% of WA Medicaid ,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,869.36,37.7,,,percent of total billed charges,37.70% of total billed charges,869.36,37.7,,,percent of total billed charges,37.70% of total billed charges,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,78173.4,33.9,,,percent of total billed charges,33.9% of total billed charges,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1798.68,78,,,percent of total billed charges,78% of total billed charges,2306,100,,,percent of total billed charges,100% of total billed charges,1904.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1904.76,82.6,,,percent of total billed charges,82.6% of total billed charges,668.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,122.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,122.86,78173.4,
EXCISE EXCESS SKIN AND TISSUE,15839,CDM,983,RC,15839,HCPCS,Outpatient,,,1560,1014.00,,1372.8,88,,,percent of total billed charges,88% of total Billed charges,72.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1560,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1076.4,69,,,percent of total billed charges,69% of total billed charges,1560,100,,,percent of total billed charges,100% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1560,100,,,percent of total billed charges,100% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1560,100,,,percent of total billed charges,100% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,964.86,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.12,37.7,,,percent of total billed charges,37.70% of total billed charges,588.12,37.7,,,percent of total billed charges,37.70% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,52884,33.9,,,percent of total billed charges,33.9% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1216.8,78,,,percent of total billed charges,78% of total billed charges,1560,100,,,percent of total billed charges,100% of total billed charges,1288.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1288.56,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",72.39,52884,
EXC SKIN ABD ADD-ON,15847,CDM,983,RC,15847,HCPCS,Outpatient,,,540,351.00,,475.2,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,540,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,372.6,69,,,percent of total billed charges,69% of total billed charges,540,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,540,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,540,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,333.99,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,203.58,37.7,,,percent of total billed charges,37.70% of total billed charges,203.58,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,18306,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,421.2,78,,,percent of total billed charges,78% of total billed charges,540,100,,,percent of total billed charges,100% of total billed charges,446.04,82.6,,,percent of total billed charges,82.6% of total billed charges,446.04,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",203.58,18306,
NERVE PALSY MICROSURG GRAFT,15842,CDM,983,RC,15842,HCPCS,Outpatient,,,7869,5114.85,,6924.72,88,,,percent of total billed charges,88% of total Billed charges,277.98,100,,,Fee Schedule,100% of Medicare rate,1529.3,100,,,Fee Schedule,100% of WA Medicaid,7869,100,,,percent of total billed charges,100% of total billed charges,1575.18,103,,,Fee Schedule,103% of WA Medicaid,277.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,486.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1529.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5429.61,69,,,percent of total billed charges,69% of total billed charges,7869,100,,,percent of total billed charges,100% of total billed charges,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,7869,100,,,percent of total billed charges,100% of total billed charges,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,7869,100,,,percent of total billed charges,100% of total billed charges,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4866.98,61.85,,,percent of total billed charges,61.85% of total billed charges,1529.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1529.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1988.09,130,,,Fee Schedule,130% of WA Medicaid ,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2966.61,37.7,,,percent of total billed charges,37.70% of total billed charges,2966.61,37.7,,,percent of total billed charges,37.70% of total billed charges,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,266759.1,33.9,,,percent of total billed charges,33.9% of total billed charges,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,6137.82,78,,,percent of total billed charges,78% of total billed charges,7869,100,,,percent of total billed charges,100% of total billed charges,6499.79,82.6,,,percent of total billed charges,82.6% of total billed charges,6499.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1529.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,277.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1529.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,277.98,266759.1,
DRESSING CHANGE NOT FOR BURN,15852,CDM,983,RC,15852,HCPCS,Outpatient,,,272,176.80,,239.36,88,,,percent of total billed charges,88% of total Billed charges,4.95,100,,,Fee Schedule,100% of Medicare rate,24.99,100,,,Fee Schedule,100% of WA Medicaid,272,100,,,percent of total billed charges,100% of total billed charges,25.74,103,,,Fee Schedule,103% of WA Medicaid,4.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,24.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,187.68,69,,,percent of total billed charges,69% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,272,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,272,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.23,61.85,,,percent of total billed charges,61.85% of total billed charges,24.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.49,130,,,Fee Schedule,130% of WA Medicaid ,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,9220.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.16,78,,,percent of total billed charges,78% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,24.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,5,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.95,9220.8,
SUCTION LIPECTOMY UPPER EXTREMITY,15878,CDM,983,RC,15878,HCPCS,Outpatient,,,775,503.75,,682,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,775,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,534.75,69,,,percent of total billed charges,69% of total billed charges,775,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,775,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,775,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,479.34,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,292.18,37.7,,,percent of total billed charges,37.70% of total billed charges,292.18,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,26272.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,604.5,78,,,percent of total billed charges,78% of total billed charges,775,100,,,percent of total billed charges,100% of total billed charges,640.15,82.6,,,percent of total billed charges,82.6% of total billed charges,640.15,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",292.18,26272.5,
SUCTION LIPECTOMY HEAD  NECK,15876,CDM,983,RC,15876,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15255,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",169.65,15255,
SUCITON LIPECTOMY TURNK,15877,CDM,983,RC,15877,HCPCS,Outpatient,,,2995,1946.75,,2635.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2066.55,69,,,percent of total billed charges,69% of total billed charges,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1852.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1129.12,37.7,,,percent of total billed charges,37.70% of total billed charges,1129.12,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,101530.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2336.1,78,,,percent of total billed charges,78% of total billed charges,2995,100,,,percent of total billed charges,100% of total billed charges,2473.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2473.87,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1129.12,101530.5,
REMOVE SACRUM PRESSURE SORE,15937,CDM,983,RC,15937,HCPCS,Outpatient,,,2125,1381.25,,1870,88,,,percent of total billed charges,88% of total Billed charges,110.76,100,,,Fee Schedule,100% of Medicare rate,591.21,100,,,Fee Schedule,100% of WA Medicaid,2125,100,,,percent of total billed charges,100% of total billed charges,608.95,103,,,Fee Schedule,103% of WA Medicaid,110.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,591.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1466.25,69,,,percent of total billed charges,69% of total billed charges,2125,100,,,percent of total billed charges,100% of total billed charges,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2125,100,,,percent of total billed charges,100% of total billed charges,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2125,100,,,percent of total billed charges,100% of total billed charges,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1314.31,61.85,,,percent of total billed charges,61.85% of total billed charges,591.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,603.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,768.57,130,,,Fee Schedule,130% of WA Medicaid ,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,801.13,37.7,,,percent of total billed charges,37.70% of total billed charges,801.13,37.7,,,percent of total billed charges,37.70% of total billed charges,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,72037.5,33.9,,,percent of total billed charges,33.9% of total billed charges,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1657.5,78,,,percent of total billed charges,78% of total billed charges,2125,100,,,percent of total billed charges,100% of total billed charges,1755.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1755.25,82.6,,,percent of total billed charges,82.6% of total billed charges,591.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.76,72037.5,
REMOVE HIP PRESSURE SORE,15946,CDM,983,RC,15946,HCPCS,Outpatient,,,3292,2139.80,,2896.96,88,,,percent of total billed charges,88% of total Billed charges,173.3,100,,,Fee Schedule,100% of Medicare rate,916.27,100,,,Fee Schedule,100% of WA Medicaid,3292,100,,,percent of total billed charges,100% of total billed charges,943.76,103,,,Fee Schedule,103% of WA Medicaid,173.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,303.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,916.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2271.48,69,,,percent of total billed charges,69% of total billed charges,3292,100,,,percent of total billed charges,100% of total billed charges,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3292,100,,,percent of total billed charges,100% of total billed charges,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3292,100,,,percent of total billed charges,100% of total billed charges,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2036.1,61.85,,,percent of total billed charges,61.85% of total billed charges,916.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,934.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1191.15,130,,,Fee Schedule,130% of WA Medicaid ,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1241.08,37.7,,,percent of total billed charges,37.70% of total billed charges,1241.08,37.7,,,percent of total billed charges,37.70% of total billed charges,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,111598.8,33.9,,,percent of total billed charges,33.9% of total billed charges,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2567.76,78,,,percent of total billed charges,78% of total billed charges,3292,100,,,percent of total billed charges,100% of total billed charges,2719.19,82.6,,,percent of total billed charges,82.6% of total billed charges,2719.19,82.6,,,percent of total billed charges,82.6% of total billed charges,916.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,173.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,173.3,111598.8,
INITIAL TREATMENT OF BURN(S),16000,CDM,983,RC,16000,HCPCS,Outpatient,,,115.4,75.01,,101.55,88,,,percent of total billed charges,88% of total Billed charges,4.98,100,,,Fee Schedule,100% of Medicare rate,25.55,100,,,Fee Schedule,100% of WA Medicaid,115.4,100,,,percent of total billed charges,100% of total billed charges,26.32,103,,,Fee Schedule,103% of WA Medicaid,4.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,79.63,69,,,percent of total billed charges,69% of total billed charges,115.4,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.4,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.4,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.37,61.85,,,percent of total billed charges,61.85% of total billed charges,25.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.22,130,,,Fee Schedule,130% of WA Medicaid ,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.51,37.7,,,percent of total billed charges,37.70% of total billed charges,43.51,37.7,,,percent of total billed charges,37.70% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3912.06,33.9,,,percent of total billed charges,33.9% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.01,78,,,percent of total billed charges,78% of total billed charges,115.4,100,,,percent of total billed charges,100% of total billed charges,95.32,82.6,,,percent of total billed charges,82.6% of total billed charges,95.32,82.6,,,percent of total billed charges,82.6% of total billed charges,25.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.98,3912.06,
DRESS/DEBRID P-THICK BURN M,16025,CDM,983,RC,16025,HCPCS,Outpatient,,,246.62,160.30,,217.03,88,,,percent of total billed charges,88% of total Billed charges,10.87,100,,,Fee Schedule,100% of Medicare rate,63.41,100,,,Fee Schedule,100% of WA Medicaid,246.62,100,,,percent of total billed charges,100% of total billed charges,65.31,103,,,Fee Schedule,103% of WA Medicaid,10.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,170.17,69,,,percent of total billed charges,69% of total billed charges,246.62,100,,,percent of total billed charges,100% of total billed charges,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.62,100,,,percent of total billed charges,100% of total billed charges,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.62,100,,,percent of total billed charges,100% of total billed charges,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.53,61.85,,,percent of total billed charges,61.85% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.43,130,,,Fee Schedule,130% of WA Medicaid ,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.98,37.7,,,percent of total billed charges,37.70% of total billed charges,92.98,37.7,,,percent of total billed charges,37.70% of total billed charges,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,8360.42,33.9,,,percent of total billed charges,33.9% of total billed charges,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.36,78,,,percent of total billed charges,78% of total billed charges,246.62,100,,,percent of total billed charges,100% of total billed charges,203.71,82.6,,,percent of total billed charges,82.6% of total billed charges,203.71,82.6,,,percent of total billed charges,82.6% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.87,8360.42,
DRESS/DEBRID P-THICK BURN S,16020,CDM,983,RC,16020,HCPCS,Outpatient,,,142.15,92.40,,125.09,88,,,percent of total billed charges,88% of total Billed charges,4.81,100,,,Fee Schedule,100% of Medicare rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,142.15,100,,,percent of total billed charges,100% of total billed charges,33.23,103,,,Fee Schedule,103% of WA Medicaid,4.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,98.08,69,,,percent of total billed charges,69% of total billed charges,142.15,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.15,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.15,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.92,61.85,,,percent of total billed charges,61.85% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.94,130,,,Fee Schedule,130% of WA Medicaid ,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.59,37.7,,,percent of total billed charges,37.70% of total billed charges,53.59,37.7,,,percent of total billed charges,37.70% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4818.89,33.9,,,percent of total billed charges,33.9% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.88,78,,,percent of total billed charges,78% of total billed charges,142.15,100,,,percent of total billed charges,100% of total billed charges,117.42,82.6,,,percent of total billed charges,82.6% of total billed charges,117.42,82.6,,,percent of total billed charges,82.6% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,4818.89,
DRESS AND/OR DEBRIDE W/O ANES; LARGE,16030,CDM,983,RC,16030,HCPCS,Outpatient,,,436,283.40,,383.68,88,,,percent of total billed charges,88% of total Billed charges,14.83,100,,,Fee Schedule,100% of Medicare rate,74.6,100,,,Fee Schedule,100% of WA Medicaid,436,100,,,percent of total billed charges,100% of total billed charges,76.84,103,,,Fee Schedule,103% of WA Medicaid,14.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,300.84,69,,,percent of total billed charges,69% of total billed charges,436,100,,,percent of total billed charges,100% of total billed charges,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,436,100,,,percent of total billed charges,100% of total billed charges,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,436,100,,,percent of total billed charges,100% of total billed charges,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.67,61.85,,,percent of total billed charges,61.85% of total billed charges,74.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,96.98,130,,,Fee Schedule,130% of WA Medicaid ,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.37,37.7,,,percent of total billed charges,37.70% of total billed charges,164.37,37.7,,,percent of total billed charges,37.70% of total billed charges,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,14780.4,33.9,,,percent of total billed charges,33.9% of total billed charges,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.08,78,,,percent of total billed charges,78% of total billed charges,436,100,,,percent of total billed charges,100% of total billed charges,360.14,82.6,,,percent of total billed charges,82.6% of total billed charges,360.14,82.6,,,percent of total billed charges,82.6% of total billed charges,74.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.83,14780.4,
DESTRUCT PREMALG LESION,17000,CDM,983,RC,17000,HCPCS,Outpatient,,,181,117.65,,159.28,88,,,percent of total billed charges,88% of total Billed charges,3.25,100,,,Fee Schedule,100% of Medicare rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,181,100,,,percent of total billed charges,100% of total billed charges,33.23,103,,,Fee Schedule,103% of WA Medicaid,3.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,124.89,69,,,percent of total billed charges,69% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,181,100,,,percent of total billed charges,100% of total billed charges,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,181,100,,,percent of total billed charges,100% of total billed charges,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.95,61.85,,,percent of total billed charges,61.85% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.94,130,,,Fee Schedule,130% of WA Medicaid ,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,68.24,37.7,,,percent of total billed charges,37.70% of total billed charges,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,6135.9,33.9,,,percent of total billed charges,33.9% of total billed charges,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.18,78,,,percent of total billed charges,78% of total billed charges,181,100,,,percent of total billed charges,100% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,149.51,82.6,,,percent of total billed charges,82.6% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,6135.9,
DESTRUCT PREMALG LES 2-14,17003,CDM,983,RC,17003,HCPCS,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,0.06,100,,,Fee Schedule,100% of Medicare rate,1.12,100,,,Fee Schedule,100% of WA Medicaid,43,100,,,percent of total billed charges,100% of total billed charges,1.15,103,,,Fee Schedule,103% of WA Medicaid,0.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,43,100,,,percent of total billed charges,100% of total billed charges,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,43,100,,,percent of total billed charges,100% of total billed charges,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1.46,130,,,Fee Schedule,130% of WA Medicaid ,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.7,33.9,,,percent of total billed charges,33.9% of total billed charges,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.06,1457.7,
DESTROY PREMAL LESIONS 15/>,17004,CDM,983,RC,17004,HCPCS,Outpatient,,,511,332.15,,449.68,88,,,percent of total billed charges,88% of total Billed charges,6.88,100,,,Fee Schedule,100% of Medicare rate,56.88,100,,,Fee Schedule,100% of WA Medicaid,511,100,,,percent of total billed charges,100% of total billed charges,58.59,103,,,Fee Schedule,103% of WA Medicaid,6.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,352.59,69,,,percent of total billed charges,69% of total billed charges,511,100,,,percent of total billed charges,100% of total billed charges,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,511,100,,,percent of total billed charges,100% of total billed charges,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,511,100,,,percent of total billed charges,100% of total billed charges,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.05,61.85,,,percent of total billed charges,61.85% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,73.94,130,,,Fee Schedule,130% of WA Medicaid ,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.65,37.7,,,percent of total billed charges,37.70% of total billed charges,192.65,37.7,,,percent of total billed charges,37.70% of total billed charges,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,17322.9,33.9,,,percent of total billed charges,33.9% of total billed charges,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.58,78,,,percent of total billed charges,78% of total billed charges,511,100,,,percent of total billed charges,100% of total billed charges,422.09,82.6,,,percent of total billed charges,82.6% of total billed charges,422.09,82.6,,,percent of total billed charges,82.6% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.88,17322.9,
DESTRUCTION OF SKIN LESIONS,17106,CDM,983,RC,17106,HCPCS,Outpatient,,,663,430.95,,583.44,88,,,percent of total billed charges,88% of total Billed charges,19.57,100,,,Fee Schedule,100% of Medicare rate,160.2,100,,,Fee Schedule,100% of WA Medicaid,663,100,,,percent of total billed charges,100% of total billed charges,165.01,103,,,Fee Schedule,103% of WA Medicaid,19.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,160.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,457.47,69,,,percent of total billed charges,69% of total billed charges,663,100,,,percent of total billed charges,100% of total billed charges,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,663,100,,,percent of total billed charges,100% of total billed charges,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,663,100,,,percent of total billed charges,100% of total billed charges,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.07,61.85,,,percent of total billed charges,61.85% of total billed charges,160.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,208.26,130,,,Fee Schedule,130% of WA Medicaid ,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.95,37.7,,,percent of total billed charges,37.70% of total billed charges,249.95,37.7,,,percent of total billed charges,37.70% of total billed charges,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,22475.7,33.9,,,percent of total billed charges,33.9% of total billed charges,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.14,78,,,percent of total billed charges,78% of total billed charges,663,100,,,percent of total billed charges,100% of total billed charges,547.64,82.6,,,percent of total billed charges,82.6% of total billed charges,547.64,82.6,,,percent of total billed charges,82.6% of total billed charges,160.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.57,22475.7,
DESTRUCT B9 LESION 1-14,17110,CDM,983,RC,17110,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,3.93,100,,,Fee Schedule,100% of Medicare rate,40.47,100,,,Fee Schedule,100% of WA Medicaid,450,100,,,percent of total billed charges,100% of total billed charges,41.68,103,,,Fee Schedule,103% of WA Medicaid,3.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,450,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,450,100,,,percent of total billed charges,100% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,40.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,52.61,130,,,Fee Schedule,130% of WA Medicaid ,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15255,33.9,,,percent of total billed charges,33.9% of total billed charges,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.93,15255,
DESTRUCT LESION 15 OR MORE,17111,CDM,983,RC,17111,HCPCS,Outpatient,,,274,178.10,,241.12,88,,,percent of total billed charges,88% of total Billed charges,5.15,100,,,Fee Schedule,100% of Medicare rate,48.68,100,,,Fee Schedule,100% of WA Medicaid,274,100,,,percent of total billed charges,100% of total billed charges,50.14,103,,,Fee Schedule,103% of WA Medicaid,5.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,189.06,69,,,percent of total billed charges,69% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,274,100,,,percent of total billed charges,100% of total billed charges,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,274,100,,,percent of total billed charges,100% of total billed charges,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.47,61.85,,,percent of total billed charges,61.85% of total billed charges,48.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.28,130,,,Fee Schedule,130% of WA Medicaid ,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.3,37.7,,,percent of total billed charges,37.70% of total billed charges,103.3,37.7,,,percent of total billed charges,37.70% of total billed charges,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,9288.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.72,78,,,percent of total billed charges,78% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,48.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.15,9288.6,
CHEMICAL CAUTERY TISSUE,17250,CDM,983,RC,17250,HCPCS,Outpatient,,,112,72.80,,98.56,88,,,percent of total billed charges,88% of total Billed charges,3.21,100,,,Fee Schedule,100% of Medicare rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,112,100,,,percent of total billed charges,100% of total billed charges,22.28,103,,,Fee Schedule,103% of WA Medicaid,3.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,77.28,69,,,percent of total billed charges,69% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,112,100,,,percent of total billed charges,100% of total billed charges,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,112,100,,,percent of total billed charges,100% of total billed charges,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.27,61.85,,,percent of total billed charges,61.85% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.12,130,,,Fee Schedule,130% of WA Medicaid ,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.22,37.7,,,percent of total billed charges,37.70% of total billed charges,42.22,37.7,,,percent of total billed charges,37.70% of total billed charges,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3796.8,33.9,,,percent of total billed charges,33.9% of total billed charges,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.36,78,,,percent of total billed charges,78% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.21,3796.8,
DESTRUCTION OF SKIN LESIONS,17260,CDM,983,RC,17260,HCPCS,Outpatient,,,245,159.25,,215.6,88,,,percent of total billed charges,88% of total Billed charges,4.74,100,,,Fee Schedule,100% of Medicare rate,40.84,100,,,Fee Schedule,100% of WA Medicaid,245,100,,,percent of total billed charges,100% of total billed charges,42.07,103,,,Fee Schedule,103% of WA Medicaid,4.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,169.05,69,,,percent of total billed charges,69% of total billed charges,245,100,,,percent of total billed charges,100% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,245,100,,,percent of total billed charges,100% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,245,100,,,percent of total billed charges,100% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.53,61.85,,,percent of total billed charges,61.85% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.09,130,,,Fee Schedule,130% of WA Medicaid ,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.37,37.7,,,percent of total billed charges,37.70% of total billed charges,92.37,37.7,,,percent of total billed charges,37.70% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,8305.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.1,78,,,percent of total billed charges,78% of total billed charges,245,100,,,percent of total billed charges,100% of total billed charges,202.37,82.6,,,percent of total billed charges,82.6% of total billed charges,202.37,82.6,,,percent of total billed charges,82.6% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.74,8305.5,
DESTRUCTION OF SKIN LESIONS,17261,CDM,983,RC,17261,HCPCS,Outpatient,,,336,218.40,,295.68,88,,,percent of total billed charges,88% of total Billed charges,6.02,100,,,Fee Schedule,100% of Medicare rate,50.54,100,,,Fee Schedule,100% of WA Medicaid,336,100,,,percent of total billed charges,100% of total billed charges,52.06,103,,,Fee Schedule,103% of WA Medicaid,6.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,50.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,231.84,69,,,percent of total billed charges,69% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.82,61.85,,,percent of total billed charges,61.85% of total billed charges,50.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,65.7,130,,,Fee Schedule,130% of WA Medicaid ,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,11390.4,33.9,,,percent of total billed charges,33.9% of total billed charges,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.08,78,,,percent of total billed charges,78% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,50.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.02,11390.4,
DESTRUCTION OF SKIN LESIONS,17262,CDM,983,RC,17262,HCPCS,Outpatient,,,428,278.20,,376.64,88,,,percent of total billed charges,88% of total Billed charges,7.76,100,,,Fee Schedule,100% of Medicare rate,63.6,100,,,Fee Schedule,100% of WA Medicaid,428,100,,,percent of total billed charges,100% of total billed charges,65.51,103,,,Fee Schedule,103% of WA Medicaid,7.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,295.32,69,,,percent of total billed charges,69% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,428,100,,,percent of total billed charges,100% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,428,100,,,percent of total billed charges,100% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.72,61.85,,,percent of total billed charges,61.85% of total billed charges,63.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.68,130,,,Fee Schedule,130% of WA Medicaid ,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,14509.2,33.9,,,percent of total billed charges,33.9% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.84,78,,,percent of total billed charges,78% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,63.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.76,14509.2,
DESTRUCTION OF SKIN LESIONS,17270,CDM,983,RC,17270,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,6.79,100,,,Fee Schedule,100% of Medicare rate,55.2,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,56.86,103,,,Fee Schedule,103% of WA Medicaid,6.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,55.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,269,100,,,percent of total billed charges,100% of total billed charges,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,269,100,,,percent of total billed charges,100% of total billed charges,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.38,61.85,,,percent of total billed charges,61.85% of total billed charges,55.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,71.76,130,,,Fee Schedule,130% of WA Medicaid ,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,9119.1,33.9,,,percent of total billed charges,33.9% of total billed charges,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,55.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.79,9119.1,
DESTRUCTION OF SKIN LESIONS,17271,CDM,983,RC,17271,HCPCS,Outpatient,,,387,251.55,,340.56,88,,,percent of total billed charges,88% of total Billed charges,7.34,100,,,Fee Schedule,100% of Medicare rate,60.61,100,,,Fee Schedule,100% of WA Medicaid,387,100,,,percent of total billed charges,100% of total billed charges,62.43,103,,,Fee Schedule,103% of WA Medicaid,7.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,267.03,69,,,percent of total billed charges,69% of total billed charges,387,100,,,percent of total billed charges,100% of total billed charges,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,387,100,,,percent of total billed charges,100% of total billed charges,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,387,100,,,percent of total billed charges,100% of total billed charges,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.36,61.85,,,percent of total billed charges,61.85% of total billed charges,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,78.79,130,,,Fee Schedule,130% of WA Medicaid ,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.9,37.7,,,percent of total billed charges,37.70% of total billed charges,145.9,37.7,,,percent of total billed charges,37.70% of total billed charges,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,13119.3,33.9,,,percent of total billed charges,33.9% of total billed charges,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.86,78,,,percent of total billed charges,78% of total billed charges,387,100,,,percent of total billed charges,100% of total billed charges,319.66,82.6,,,percent of total billed charges,82.6% of total billed charges,319.66,82.6,,,percent of total billed charges,82.6% of total billed charges,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.34,13119.3,
DESTRUCTION OF SKIN LESIONS,17272,CDM,983,RC,17272,HCPCS,Outpatient,,,357,232.05,,314.16,88,,,percent of total billed charges,88% of total Billed charges,8.6,100,,,Fee Schedule,100% of Medicare rate,69.75,100,,,Fee Schedule,100% of WA Medicaid,357,100,,,percent of total billed charges,100% of total billed charges,71.84,103,,,Fee Schedule,103% of WA Medicaid,8.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,246.33,69,,,percent of total billed charges,69% of total billed charges,357,100,,,percent of total billed charges,100% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,357,100,,,percent of total billed charges,100% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,357,100,,,percent of total billed charges,100% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.8,61.85,,,percent of total billed charges,61.85% of total billed charges,69.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,90.68,130,,,Fee Schedule,130% of WA Medicaid ,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.59,37.7,,,percent of total billed charges,37.70% of total billed charges,134.59,37.7,,,percent of total billed charges,37.70% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,12102.3,33.9,,,percent of total billed charges,33.9% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.46,78,,,percent of total billed charges,78% of total billed charges,357,100,,,percent of total billed charges,100% of total billed charges,294.88,82.6,,,percent of total billed charges,82.6% of total billed charges,294.88,82.6,,,percent of total billed charges,82.6% of total billed charges,69.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.6,12102.3,
DESTRUCTION OF SKIN LESIONS,17274,CDM,983,RC,17274,HCPCS,Outpatient,,,407.13,264.63,,358.27,88,,,percent of total billed charges,88% of total Billed charges,12.05,100,,,Fee Schedule,100% of Medicare rate,95.86,100,,,Fee Schedule,100% of WA Medicaid,407.13,100,,,percent of total billed charges,100% of total billed charges,98.74,103,,,Fee Schedule,103% of WA Medicaid,12.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,95.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,280.92,69,,,percent of total billed charges,69% of total billed charges,407.13,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.13,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.13,100,,,percent of total billed charges,100% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.81,61.85,,,percent of total billed charges,61.85% of total billed charges,95.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,124.62,130,,,Fee Schedule,130% of WA Medicaid ,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.49,37.7,,,percent of total billed charges,37.70% of total billed charges,153.49,37.7,,,percent of total billed charges,37.70% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,13801.71,33.9,,,percent of total billed charges,33.9% of total billed charges,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.56,78,,,percent of total billed charges,78% of total billed charges,407.13,100,,,percent of total billed charges,100% of total billed charges,336.29,82.6,,,percent of total billed charges,82.6% of total billed charges,336.29,82.6,,,percent of total billed charges,82.6% of total billed charges,95.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.05,13801.71,
DESTRUCTION OF SKIN LESIONS,17280,CDM,983,RC,17280,HCPCS,Outpatient,,,288,187.20,,253.44,88,,,percent of total billed charges,88% of total Billed charges,6.01,100,,,Fee Schedule,100% of Medicare rate,50.36,100,,,Fee Schedule,100% of WA Medicaid,288,100,,,percent of total billed charges,100% of total billed charges,51.87,103,,,Fee Schedule,103% of WA Medicaid,6.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,50.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,198.72,69,,,percent of total billed charges,69% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,288,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,288,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.13,61.85,,,percent of total billed charges,61.85% of total billed charges,50.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,65.47,130,,,Fee Schedule,130% of WA Medicaid ,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,9763.2,33.9,,,percent of total billed charges,33.9% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.64,78,,,percent of total billed charges,78% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,50.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.01,9763.2,
DESTRUCTION OF SKIN LESIONS,17281,CDM,983,RC,17281,HCPCS,Outpatient,,,330,214.50,,290.4,88,,,percent of total billed charges,88% of total Billed charges,8.5,100,,,Fee Schedule,100% of Medicare rate,68.07,100,,,Fee Schedule,100% of WA Medicaid,330,100,,,percent of total billed charges,100% of total billed charges,70.11,103,,,Fee Schedule,103% of WA Medicaid,8.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,227.7,69,,,percent of total billed charges,69% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,330,100,,,percent of total billed charges,100% of total billed charges,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,330,100,,,percent of total billed charges,100% of total billed charges,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.11,61.85,,,percent of total billed charges,61.85% of total billed charges,68.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,88.49,130,,,Fee Schedule,130% of WA Medicaid ,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,11187,33.9,,,percent of total billed charges,33.9% of total billed charges,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.4,78,,,percent of total billed charges,78% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,68.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.5,11187,
DESTRUCTION OF SKIN LESIONS,17282,CDM,983,RC,17282,HCPCS,Outpatient,,,409,265.85,,359.92,88,,,percent of total billed charges,88% of total Billed charges,9.83,100,,,Fee Schedule,100% of Medicare rate,78.33,100,,,Fee Schedule,100% of WA Medicaid,409,100,,,percent of total billed charges,100% of total billed charges,80.68,103,,,Fee Schedule,103% of WA Medicaid,9.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,78.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,282.21,69,,,percent of total billed charges,69% of total billed charges,409,100,,,percent of total billed charges,100% of total billed charges,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,409,100,,,percent of total billed charges,100% of total billed charges,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,409,100,,,percent of total billed charges,100% of total billed charges,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.97,61.85,,,percent of total billed charges,61.85% of total billed charges,78.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.83,130,,,Fee Schedule,130% of WA Medicaid ,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.19,37.7,,,percent of total billed charges,37.70% of total billed charges,154.19,37.7,,,percent of total billed charges,37.70% of total billed charges,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,13865.1,33.9,,,percent of total billed charges,33.9% of total billed charges,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.02,78,,,percent of total billed charges,78% of total billed charges,409,100,,,percent of total billed charges,100% of total billed charges,337.83,82.6,,,percent of total billed charges,82.6% of total billed charges,337.83,82.6,,,percent of total billed charges,82.6% of total billed charges,78.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.83,13865.1,
CRYOTHERAPY OF SKIN,17340,CDM,983,RC,17340,HCPCS,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,3.82,100,,,Fee Schedule,100% of Medicare rate,28.16,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,29,103,,,Fee Schedule,103% of WA Medicaid,3.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,135,100,,,percent of total billed charges,100% of total billed charges,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,135,100,,,percent of total billed charges,100% of total billed charges,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.5,61.85,,,percent of total billed charges,61.85% of total billed charges,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,36.61,130,,,Fee Schedule,130% of WA Medicaid ,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4576.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.82,4576.5,
SKIN PEEL THERAPY,17360,CDM,983,RC,17360,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,6.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,100,100,,,percent of total billed charges,100% of total billed charges,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,100,100,,,percent of total billed charges,100% of total billed charges,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3390,33.9,,,percent of total billed charges,33.9% of total billed charges,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",6.96,3390,
SKIN TISSUE PROCEDURE,17999,CDM,983,RC,17999,HCPCS,Outpatient,,,187,121.55,,164.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,187,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,129.03,69,,,percent of total billed charges,69% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,187,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,187,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,115.66,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,70.5,37.7,,,percent of total billed charges,37.70% of total billed charges,70.5,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,6339.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,145.86,78,,,percent of total billed charges,78% of total billed charges,187,100,,,percent of total billed charges,100% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,154.46,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",70.5,6339.3,
DRAINAGE OF BREAST LESION,19000,CDM,983,RC,19000,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,4.1,100,,,Fee Schedule,100% of Medicare rate,23.5,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,24.21,103,,,Fee Schedule,103% of WA Medicaid,4.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,194,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,194,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.99,61.85,,,percent of total billed charges,61.85% of total billed charges,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.55,130,,,Fee Schedule,130% of WA Medicaid ,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6576.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.1,6576.6,
DRAIN BREAST LESION ADD-ON,19001,CDM,983,RC,19001,HCPCS,Outpatient,,,112,72.80,,98.56,88,,,percent of total billed charges,88% of total Billed charges,1.92,100,,,Fee Schedule,100% of Medicare rate,11.75,100,,,Fee Schedule,100% of WA Medicaid,112,100,,,percent of total billed charges,100% of total billed charges,12.1,103,,,Fee Schedule,103% of WA Medicaid,1.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,77.28,69,,,percent of total billed charges,69% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,112,100,,,percent of total billed charges,100% of total billed charges,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,112,100,,,percent of total billed charges,100% of total billed charges,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.27,61.85,,,percent of total billed charges,61.85% of total billed charges,11.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.28,130,,,Fee Schedule,130% of WA Medicaid ,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.22,37.7,,,percent of total billed charges,37.70% of total billed charges,42.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,3796.8,33.9,,,percent of total billed charges,33.9% of total billed charges,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.36,78,,,percent of total billed charges,78% of total billed charges,112,100,,,percent of total billed charges,100% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,92.51,82.6,,,percent of total billed charges,82.6% of total billed charges,11.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.92,3796.8,
INCISION OF BREAST LESION,19020,CDM,983,RC,19020,HCPCS,Outpatient,,,751,488.15,,660.88,88,,,percent of total billed charges,88% of total Billed charges,33.67,100,,,Fee Schedule,100% of Medicare rate,181.65,100,,,Fee Schedule,100% of WA Medicaid,751,100,,,percent of total billed charges,100% of total billed charges,187.1,103,,,Fee Schedule,103% of WA Medicaid,33.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,181.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,518.19,69,,,percent of total billed charges,69% of total billed charges,751,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,751,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,751,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.49,61.85,,,percent of total billed charges,61.85% of total billed charges,181.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,236.15,130,,,Fee Schedule,130% of WA Medicaid ,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.13,37.7,,,percent of total billed charges,37.70% of total billed charges,283.13,37.7,,,percent of total billed charges,37.70% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,25458.9,33.9,,,percent of total billed charges,33.9% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.78,78,,,percent of total billed charges,78% of total billed charges,751,100,,,percent of total billed charges,100% of total billed charges,620.33,82.6,,,percent of total billed charges,82.6% of total billed charges,620.33,82.6,,,percent of total billed charges,82.6% of total billed charges,181.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.67,25458.9,
BX BREAST ADD LESION US IMAG,19084,CDM,983,RC,19084,HCPCS,Outpatient,,,225,146.25,,198,88,,,percent of total billed charges,88% of total Billed charges,6.41,100,,,Fee Schedule,100% of Medicare rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,225,100,,,percent of total billed charges,100% of total billed charges,43.99,103,,,Fee Schedule,103% of WA Medicaid,6.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,155.25,69,,,percent of total billed charges,69% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,225,100,,,percent of total billed charges,100% of total billed charges,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,225,100,,,percent of total billed charges,100% of total billed charges,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.16,61.85,,,percent of total billed charges,61.85% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.52,130,,,Fee Schedule,130% of WA Medicaid ,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7627.5,33.9,,,percent of total billed charges,33.9% of total billed charges,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.5,78,,,percent of total billed charges,78% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.41,7627.5,
BX BREAST ADD LESION STRTCTC,19082,CDM,983,RC,19082,HCPCS,Outpatient,,,240,156.00,,211.2,88,,,percent of total billed charges,88% of total Billed charges,6.81,100,,,Fee Schedule,100% of Medicare rate,45.32,100,,,Fee Schedule,100% of WA Medicaid,240,100,,,percent of total billed charges,100% of total billed charges,46.68,103,,,Fee Schedule,103% of WA Medicaid,6.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,45.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,240,100,,,percent of total billed charges,100% of total billed charges,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,240,100,,,percent of total billed charges,100% of total billed charges,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.44,61.85,,,percent of total billed charges,61.85% of total billed charges,45.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.92,130,,,Fee Schedule,130% of WA Medicaid ,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,8136,33.9,,,percent of total billed charges,33.9% of total billed charges,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,45.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.81,8136,
BX BREAST 1ST LESION STRTCTC,19081,CDM,983,RC,19081,HCPCS,Outpatient,,,494,321.10,,434.72,88,,,percent of total billed charges,88% of total Billed charges,13.35,100,,,Fee Schedule,100% of Medicare rate,90.45,100,,,Fee Schedule,100% of WA Medicaid,494,100,,,percent of total billed charges,100% of total billed charges,93.16,103,,,Fee Schedule,103% of WA Medicaid,13.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,90.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,340.86,69,,,percent of total billed charges,69% of total billed charges,494,100,,,percent of total billed charges,100% of total billed charges,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,494,100,,,percent of total billed charges,100% of total billed charges,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,494,100,,,percent of total billed charges,100% of total billed charges,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.54,61.85,,,percent of total billed charges,61.85% of total billed charges,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,117.59,130,,,Fee Schedule,130% of WA Medicaid ,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.24,37.7,,,percent of total billed charges,37.70% of total billed charges,186.24,37.7,,,percent of total billed charges,37.70% of total billed charges,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,16746.6,33.9,,,percent of total billed charges,33.9% of total billed charges,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.32,78,,,percent of total billed charges,78% of total billed charges,494,100,,,percent of total billed charges,100% of total billed charges,408.04,82.6,,,percent of total billed charges,82.6% of total billed charges,408.04,82.6,,,percent of total billed charges,82.6% of total billed charges,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.35,16746.6,
BX BREAST 1ST LESION US IMAG,19083,CDM,983,RC,19083,HCPCS,Outpatient,,,464,301.60,,408.32,88,,,percent of total billed charges,88% of total Billed charges,13.09,100,,,Fee Schedule,100% of Medicare rate,85.6,100,,,Fee Schedule,100% of WA Medicaid,464,100,,,percent of total billed charges,100% of total billed charges,88.17,103,,,Fee Schedule,103% of WA Medicaid,13.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,320.16,69,,,percent of total billed charges,69% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,464,100,,,percent of total billed charges,100% of total billed charges,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,464,100,,,percent of total billed charges,100% of total billed charges,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.98,61.85,,,percent of total billed charges,61.85% of total billed charges,85.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.28,130,,,Fee Schedule,130% of WA Medicaid ,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,15729.6,33.9,,,percent of total billed charges,33.9% of total billed charges,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.92,78,,,percent of total billed charges,78% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,85.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.09,15729.6,
BIOPSY OF BREAST OPEN,19101,CDM,983,RC,19101,HCPCS,Outpatient,,,1095,711.75,,963.6,88,,,percent of total billed charges,88% of total Billed charges,27.2,100,,,Fee Schedule,100% of Medicare rate,127.19,100,,,Fee Schedule,100% of WA Medicaid,1095,100,,,percent of total billed charges,100% of total billed charges,131.01,103,,,Fee Schedule,103% of WA Medicaid,27.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,127.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,755.55,69,,,percent of total billed charges,69% of total billed charges,1095,100,,,percent of total billed charges,100% of total billed charges,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1095,100,,,percent of total billed charges,100% of total billed charges,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1095,100,,,percent of total billed charges,100% of total billed charges,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.26,61.85,,,percent of total billed charges,61.85% of total billed charges,127.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,165.35,130,,,Fee Schedule,130% of WA Medicaid ,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.82,37.7,,,percent of total billed charges,37.70% of total billed charges,412.82,37.7,,,percent of total billed charges,37.70% of total billed charges,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,37120.5,33.9,,,percent of total billed charges,33.9% of total billed charges,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,854.1,78,,,percent of total billed charges,78% of total billed charges,1095,100,,,percent of total billed charges,100% of total billed charges,904.47,82.6,,,percent of total billed charges,82.6% of total billed charges,904.47,82.6,,,percent of total billed charges,82.6% of total billed charges,127.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.2,37120.5,
BREAST BIOPSY ASPIRATION W/OUT IMAGING,19100,CDM,983,RC,19100,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,10.06,100,,,Fee Schedule,100% of Medicare rate,38.23,100,,,Fee Schedule,100% of WA Medicaid,269,100,,,percent of total billed charges,100% of total billed charges,39.38,103,,,Fee Schedule,103% of WA Medicaid,10.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,269,100,,,percent of total billed charges,100% of total billed charges,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,269,100,,,percent of total billed charges,100% of total billed charges,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.38,61.85,,,percent of total billed charges,61.85% of total billed charges,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.7,130,,,Fee Schedule,130% of WA Medicaid ,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,9119.1,33.9,,,percent of total billed charges,33.9% of total billed charges,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.06,9119.1,
REMOVAL OF BREAST LESION,19120,CDM,983,RC,19120,HCPCS,Outpatient,,,1460,949.00,,1284.8,88,,,percent of total billed charges,88% of total Billed charges,50.74,100,,,Fee Schedule,100% of Medicare rate,239.28,100,,,Fee Schedule,100% of WA Medicaid,1460,100,,,percent of total billed charges,100% of total billed charges,246.46,103,,,Fee Schedule,103% of WA Medicaid,50.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,88.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,239.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1007.4,69,,,percent of total billed charges,69% of total billed charges,1460,100,,,percent of total billed charges,100% of total billed charges,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1460,100,,,percent of total billed charges,100% of total billed charges,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1460,100,,,percent of total billed charges,100% of total billed charges,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,903.01,61.85,,,percent of total billed charges,61.85% of total billed charges,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,311.06,130,,,Fee Schedule,130% of WA Medicaid ,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.42,37.7,,,percent of total billed charges,37.70% of total billed charges,550.42,37.7,,,percent of total billed charges,37.70% of total billed charges,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,49494,33.9,,,percent of total billed charges,33.9% of total billed charges,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1138.8,78,,,percent of total billed charges,78% of total billed charges,1460,100,,,percent of total billed charges,100% of total billed charges,1205.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1205.96,82.6,,,percent of total billed charges,82.6% of total billed charges,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.74,49494,
EXCISION ADDL BREAST LESION,19126,CDM,983,RC,19126,HCPCS,Outpatient,,,871,566.15,,766.48,88,,,percent of total billed charges,88% of total Billed charges,23.87,100,,,Fee Schedule,100% of Medicare rate,88.21,100,,,Fee Schedule,100% of WA Medicaid,871,100,,,percent of total billed charges,100% of total billed charges,90.86,103,,,Fee Schedule,103% of WA Medicaid,23.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,88.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,600.99,69,,,percent of total billed charges,69% of total billed charges,871,100,,,percent of total billed charges,100% of total billed charges,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,871,100,,,percent of total billed charges,100% of total billed charges,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,871,100,,,percent of total billed charges,100% of total billed charges,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,538.71,61.85,,,percent of total billed charges,61.85% of total billed charges,88.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,114.67,130,,,Fee Schedule,130% of WA Medicaid ,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.37,37.7,,,percent of total billed charges,37.70% of total billed charges,328.37,37.7,,,percent of total billed charges,37.70% of total billed charges,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,29526.9,33.9,,,percent of total billed charges,33.9% of total billed charges,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,679.38,78,,,percent of total billed charges,78% of total billed charges,871,100,,,percent of total billed charges,100% of total billed charges,719.45,82.6,,,percent of total billed charges,82.6% of total billed charges,719.45,82.6,,,percent of total billed charges,82.6% of total billed charges,88.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.87,29526.9,
EXCISION BREAST LESION,19125,CDM,983,RC,19125,HCPCS,Outpatient,,,1641,1066.65,,1444.08,88,,,percent of total billed charges,88% of total Billed charges,57.76,100,,,Fee Schedule,100% of Medicare rate,264.08,100,,,Fee Schedule,100% of WA Medicaid,1641,100,,,percent of total billed charges,100% of total billed charges,272,103,,,Fee Schedule,103% of WA Medicaid,57.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1132.29,69,,,percent of total billed charges,69% of total billed charges,1641,100,,,percent of total billed charges,100% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1641,100,,,percent of total billed charges,100% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1641,100,,,percent of total billed charges,100% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014.96,61.85,,,percent of total billed charges,61.85% of total billed charges,264.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,343.3,130,,,Fee Schedule,130% of WA Medicaid ,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.66,37.7,,,percent of total billed charges,37.70% of total billed charges,618.66,37.7,,,percent of total billed charges,37.70% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,55629.9,33.9,,,percent of total billed charges,33.9% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1279.98,78,,,percent of total billed charges,78% of total billed charges,1641,100,,,percent of total billed charges,100% of total billed charges,1355.47,82.6,,,percent of total billed charges,82.6% of total billed charges,1355.47,82.6,,,percent of total billed charges,82.6% of total billed charges,264.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.76,55629.9,
Excision of chest wall tumor including ribs,21601,CDM,983,RC,,,Outpatient,,,3206,2083.90,,2821.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3206,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2212.14,69,,,percent of total billed charges,69% of total billed charges,3206,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3206,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3206,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1982.91,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1208.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1208.66,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,108683.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2500.68,78,,,percent of total billed charges,78% of total billed charges,3206,100,,,percent of total billed charges,100% of total billed charges,2648.16,82.6,,,percent of total billed charges,82.6% of total billed charges,2648.16,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1208.66,108683.4,
"Exc of chest wall tumor, incl ribs, plastic",21602,CDM,983,RC,21602,HCPCS,Outpatient,,,4554,2960.10,,4007.52,88,,,percent of total billed charges,88% of total Billed charges,185.46,100,,,Fee Schedule,100% of Medicare rate,866.29,100,,,Fee Schedule,100% of WA Medicaid,4554,100,,,percent of total billed charges,100% of total billed charges,892.28,103,,,Fee Schedule,103% of WA Medicaid,185.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,324.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,866.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3142.26,69,,,percent of total billed charges,69% of total billed charges,4554,100,,,percent of total billed charges,100% of total billed charges,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,4554,100,,,percent of total billed charges,100% of total billed charges,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,4554,100,,,percent of total billed charges,100% of total billed charges,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2816.65,61.85,,,percent of total billed charges,61.85% of total billed charges,866.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,866.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,883.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1126.18,130,,,Fee Schedule,130% of WA Medicaid ,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1716.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1716.86,37.7,,,percent of total billed charges,37.70% of total billed charges,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,154380.6,33.9,,,percent of total billed charges,33.9% of total billed charges,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3552.12,78,,,percent of total billed charges,78% of total billed charges,4554,100,,,percent of total billed charges,100% of total billed charges,3761.6,82.6,,,percent of total billed charges,82.6% of total billed charges,3761.6,82.6,,,percent of total billed charges,82.6% of total billed charges,866.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,866.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,185.46,154380.6,
PERQ DEVICE BREAST EA IMAG,19282,CDM,983,RC,19282,HCPCS,Outpatient,,,138,89.70,,121.44,88,,,percent of total billed charges,88% of total Billed charges,3.79,100,,,Fee Schedule,100% of Medicare rate,27.42,100,,,Fee Schedule,100% of WA Medicaid,138,100,,,percent of total billed charges,100% of total billed charges,28.24,103,,,Fee Schedule,103% of WA Medicaid,3.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,138,100,,,percent of total billed charges,100% of total billed charges,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,138,100,,,percent of total billed charges,100% of total billed charges,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.35,61.85,,,percent of total billed charges,61.85% of total billed charges,27.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.65,130,,,Fee Schedule,130% of WA Medicaid ,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,4678.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,27.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.79,4678.2,
PERQ DEV BREAST ADD STRTCTC,19284,CDM,983,RC,19284,HCPCS,Outpatient,,,139,90.35,,122.32,88,,,percent of total billed charges,88% of total Billed charges,4.31,100,,,Fee Schedule,100% of Medicare rate,27.6,100,,,Fee Schedule,100% of WA Medicaid,139,100,,,percent of total billed charges,100% of total billed charges,28.43,103,,,Fee Schedule,103% of WA Medicaid,4.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,95.91,69,,,percent of total billed charges,69% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,139,100,,,percent of total billed charges,100% of total billed charges,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,139,100,,,percent of total billed charges,100% of total billed charges,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.97,61.85,,,percent of total billed charges,61.85% of total billed charges,27.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.88,130,,,Fee Schedule,130% of WA Medicaid ,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.4,37.7,,,percent of total billed charges,37.70% of total billed charges,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,4712.1,33.9,,,percent of total billed charges,33.9% of total billed charges,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.42,78,,,percent of total billed charges,78% of total billed charges,139,100,,,percent of total billed charges,100% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,114.81,82.6,,,percent of total billed charges,82.6% of total billed charges,27.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.31,4712.1,
PERQ DEV BREAST ADD US IMAG,19286,CDM,983,RC,19286,HCPCS,Outpatient,,,119,77.35,,104.72,88,,,percent of total billed charges,88% of total Billed charges,3.57,100,,,Fee Schedule,100% of Medicare rate,23.5,100,,,Fee Schedule,100% of WA Medicaid,119,100,,,percent of total billed charges,100% of total billed charges,24.21,103,,,Fee Schedule,103% of WA Medicaid,3.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,82.11,69,,,percent of total billed charges,69% of total billed charges,119,100,,,percent of total billed charges,100% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,119,100,,,percent of total billed charges,100% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,119,100,,,percent of total billed charges,100% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.6,61.85,,,percent of total billed charges,61.85% of total billed charges,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.55,130,,,Fee Schedule,130% of WA Medicaid ,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.86,37.7,,,percent of total billed charges,37.70% of total billed charges,44.86,37.7,,,percent of total billed charges,37.70% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,4034.1,33.9,,,percent of total billed charges,33.9% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.82,78,,,percent of total billed charges,78% of total billed charges,119,100,,,percent of total billed charges,100% of total billed charges,98.29,82.6,,,percent of total billed charges,82.6% of total billed charges,98.29,82.6,,,percent of total billed charges,82.6% of total billed charges,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.57,4034.1,
PERQ DEVICE BREAST 1ST IMAG,19281,CDM,983,RC,19281,HCPCS,Outpatient,,,284,184.60,,249.92,88,,,percent of total billed charges,88% of total Billed charges,7.56,100,,,Fee Schedule,100% of Medicare rate,54.64,100,,,Fee Schedule,100% of WA Medicaid,284,100,,,percent of total billed charges,100% of total billed charges,56.28,103,,,Fee Schedule,103% of WA Medicaid,7.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,54.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,195.96,69,,,percent of total billed charges,69% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,284,100,,,percent of total billed charges,100% of total billed charges,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,284,100,,,percent of total billed charges,100% of total billed charges,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.65,61.85,,,percent of total billed charges,61.85% of total billed charges,54.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,71.03,130,,,Fee Schedule,130% of WA Medicaid ,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,9627.6,33.9,,,percent of total billed charges,33.9% of total billed charges,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.52,78,,,percent of total billed charges,78% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,54.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.56,9627.6,
PERQ DEV BREAST 1ST STRTCTC,19283,CDM,983,RC,19283,HCPCS,Outpatient,,,288,187.20,,253.44,88,,,percent of total billed charges,88% of total Billed charges,8.37,100,,,Fee Schedule,100% of Medicare rate,55.2,100,,,Fee Schedule,100% of WA Medicaid,288,100,,,percent of total billed charges,100% of total billed charges,56.86,103,,,Fee Schedule,103% of WA Medicaid,8.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,55.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,198.72,69,,,percent of total billed charges,69% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,288,100,,,percent of total billed charges,100% of total billed charges,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,288,100,,,percent of total billed charges,100% of total billed charges,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.13,61.85,,,percent of total billed charges,61.85% of total billed charges,55.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,71.76,130,,,Fee Schedule,130% of WA Medicaid ,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,108.58,37.7,,,percent of total billed charges,37.70% of total billed charges,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,9763.2,33.9,,,percent of total billed charges,33.9% of total billed charges,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.64,78,,,percent of total billed charges,78% of total billed charges,288,100,,,percent of total billed charges,100% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,237.89,82.6,,,percent of total billed charges,82.6% of total billed charges,55.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.37,9763.2,
PERQ DEV BREAST 1ST US IMAG,19285,CDM,983,RC,19285,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,6.88,100,,,Fee Schedule,100% of Medicare rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,244,100,,,percent of total billed charges,100% of total billed charges,48.03,103,,,Fee Schedule,103% of WA Medicaid,6.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,244,100,,,percent of total billed charges,100% of total billed charges,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,244,100,,,percent of total billed charges,100% of total billed charges,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.91,61.85,,,percent of total billed charges,61.85% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.62,130,,,Fee Schedule,130% of WA Medicaid ,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,8271.6,33.9,,,percent of total billed charges,33.9% of total billed charges,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.88,8271.6,
MAST MOD RAD,19307,CDM,983,RC,19307,HCPCS,Outpatient,,,3055,1985.75,,2688.4,88,,,percent of total billed charges,88% of total Billed charges,153.27,100,,,Fee Schedule,100% of Medicare rate,668.04,100,,,Fee Schedule,100% of WA Medicaid,3055,100,,,percent of total billed charges,100% of total billed charges,688.08,103,,,Fee Schedule,103% of WA Medicaid,153.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,268.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,668.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2107.95,69,,,percent of total billed charges,69% of total billed charges,3055,100,,,percent of total billed charges,100% of total billed charges,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3055,100,,,percent of total billed charges,100% of total billed charges,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3055,100,,,percent of total billed charges,100% of total billed charges,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1889.52,61.85,,,percent of total billed charges,61.85% of total billed charges,668.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,681.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,868.45,130,,,Fee Schedule,130% of WA Medicaid ,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1151.74,37.7,,,percent of total billed charges,37.70% of total billed charges,1151.74,37.7,,,percent of total billed charges,37.70% of total billed charges,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,103564.5,33.9,,,percent of total billed charges,33.9% of total billed charges,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2382.9,78,,,percent of total billed charges,78% of total billed charges,3055,100,,,percent of total billed charges,100% of total billed charges,2523.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2523.43,82.6,,,percent of total billed charges,82.6% of total billed charges,668.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,153.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,153.27,103564.5,
MAST RADICAL,19305,CDM,983,RC,19305,HCPCS,Outpatient,,,3099.03,2014.37,,2727.15,88,,,percent of total billed charges,88% of total Billed charges,148.47,100,,,Fee Schedule,100% of Medicare rate,651.07,100,,,Fee Schedule,100% of WA Medicaid,3099.03,100,,,percent of total billed charges,100% of total billed charges,670.6,103,,,Fee Schedule,103% of WA Medicaid,148.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,259.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,651.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2138.33,69,,,percent of total billed charges,69% of total billed charges,3099.03,100,,,percent of total billed charges,100% of total billed charges,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,3099.03,100,,,percent of total billed charges,100% of total billed charges,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,3099.03,100,,,percent of total billed charges,100% of total billed charges,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1916.75,61.85,,,percent of total billed charges,61.85% of total billed charges,651.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,651.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,846.39,130,,,Fee Schedule,130% of WA Medicaid ,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1168.33,37.7,,,percent of total billed charges,37.70% of total billed charges,1168.33,37.7,,,percent of total billed charges,37.70% of total billed charges,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,105057.12,33.9,,,percent of total billed charges,33.9% of total billed charges,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,2417.24,78,,,percent of total billed charges,78% of total billed charges,3099.03,100,,,percent of total billed charges,100% of total billed charges,2559.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2559.8,82.6,,,percent of total billed charges,82.6% of total billed charges,651.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,148.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,651.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,148.47,105057.12,
P-MASTECTOMY W/LN REMOVAL,19302,CDM,983,RC,19302,HCPCS,Outpatient,,,3206,2083.90,,2821.28,88,,,percent of total billed charges,88% of total Billed charges,118.93,100,,,Fee Schedule,100% of Medicare rate,513.81,100,,,Fee Schedule,100% of WA Medicaid,3206,100,,,percent of total billed charges,100% of total billed charges,529.22,103,,,Fee Schedule,103% of WA Medicaid,118.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,208.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,513.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2212.14,69,,,percent of total billed charges,69% of total billed charges,3206,100,,,percent of total billed charges,100% of total billed charges,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3206,100,,,percent of total billed charges,100% of total billed charges,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3206,100,,,percent of total billed charges,100% of total billed charges,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1982.91,61.85,,,percent of total billed charges,61.85% of total billed charges,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,667.95,130,,,Fee Schedule,130% of WA Medicaid ,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1208.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1208.66,37.7,,,percent of total billed charges,37.70% of total billed charges,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,108683.4,33.9,,,percent of total billed charges,33.9% of total billed charges,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2500.68,78,,,percent of total billed charges,78% of total billed charges,3206,100,,,percent of total billed charges,100% of total billed charges,2648.16,82.6,,,percent of total billed charges,82.6% of total billed charges,2648.16,82.6,,,percent of total billed charges,82.6% of total billed charges,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,118.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,118.93,108683.4,
MAST SIMPLE COMPLETE,19303,CDM,983,RC,19303,HCPCS,Outpatient,,,2960,1924.00,,2604.8,88,,,percent of total billed charges,88% of total Billed charges,126.39,100,,,Fee Schedule,100% of Medicare rate,541.78,100,,,Fee Schedule,100% of WA Medicaid,2960,100,,,percent of total billed charges,100% of total billed charges,558.03,103,,,Fee Schedule,103% of WA Medicaid,126.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,221.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,541.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2042.4,69,,,percent of total billed charges,69% of total billed charges,2960,100,,,percent of total billed charges,100% of total billed charges,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2960,100,,,percent of total billed charges,100% of total billed charges,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2960,100,,,percent of total billed charges,100% of total billed charges,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1830.76,61.85,,,percent of total billed charges,61.85% of total billed charges,541.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,704.31,130,,,Fee Schedule,130% of WA Medicaid ,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1115.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1115.92,37.7,,,percent of total billed charges,37.70% of total billed charges,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,100344,33.9,,,percent of total billed charges,33.9% of total billed charges,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2308.8,78,,,percent of total billed charges,78% of total billed charges,2960,100,,,percent of total billed charges,100% of total billed charges,2444.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2444.96,82.6,,,percent of total billed charges,82.6% of total billed charges,541.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,126.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.39,100344,
REMOVAL OF BREAST TISSUE,19300,CDM,983,RC,19300,HCPCS,Outpatient,,,586,380.90,,515.68,88,,,percent of total billed charges,88% of total Billed charges,45.27,100,,,Fee Schedule,100% of Medicare rate,249.54,100,,,Fee Schedule,100% of WA Medicaid,586,100,,,percent of total billed charges,100% of total billed charges,257.03,103,,,Fee Schedule,103% of WA Medicaid,45.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,249.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,404.34,69,,,percent of total billed charges,69% of total billed charges,586,100,,,percent of total billed charges,100% of total billed charges,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,586,100,,,percent of total billed charges,100% of total billed charges,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,586,100,,,percent of total billed charges,100% of total billed charges,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.44,61.85,,,percent of total billed charges,61.85% of total billed charges,249.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,324.4,130,,,Fee Schedule,130% of WA Medicaid ,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.92,37.7,,,percent of total billed charges,37.70% of total billed charges,220.92,37.7,,,percent of total billed charges,37.70% of total billed charges,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,19865.4,33.9,,,percent of total billed charges,33.9% of total billed charges,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.08,78,,,percent of total billed charges,78% of total billed charges,586,100,,,percent of total billed charges,100% of total billed charges,484.04,82.6,,,percent of total billed charges,82.6% of total billed charges,484.04,82.6,,,percent of total billed charges,82.6% of total billed charges,249.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.27,19865.4,
PARTIAL MASTECTOMY,19301,CDM,983,RC,19301,HCPCS,Outpatient,,,1335,867.75,,1174.8,88,,,percent of total billed charges,88% of total Billed charges,86.16,100,,,Fee Schedule,100% of Medicare rate,374.49,100,,,Fee Schedule,100% of WA Medicaid,1335,100,,,percent of total billed charges,100% of total billed charges,385.72,103,,,Fee Schedule,103% of WA Medicaid,86.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,150.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,374.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,921.15,69,,,percent of total billed charges,69% of total billed charges,1335,100,,,percent of total billed charges,100% of total billed charges,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1335,100,,,percent of total billed charges,100% of total billed charges,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1335,100,,,percent of total billed charges,100% of total billed charges,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,825.7,61.85,,,percent of total billed charges,61.85% of total billed charges,374.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,486.84,130,,,Fee Schedule,130% of WA Medicaid ,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,503.3,37.7,,,percent of total billed charges,37.70% of total billed charges,503.3,37.7,,,percent of total billed charges,37.70% of total billed charges,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,45256.5,33.9,,,percent of total billed charges,33.9% of total billed charges,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1041.3,78,,,percent of total billed charges,78% of total billed charges,1335,100,,,percent of total billed charges,100% of total billed charges,1102.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1102.71,82.6,,,percent of total billed charges,82.6% of total billed charges,374.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.16,45256.5,
REDUCTION OF LARGE BREAST,19318,CDM,983,RC,19318,HCPCS,Outpatient,,,7995,5196.75,,7035.6,88,,,percent of total billed charges,88% of total Billed charges,110.68,100,,,Fee Schedule,100% of Medicare rate,624.22,100,,,Fee Schedule,100% of WA Medicaid,7995,100,,,percent of total billed charges,100% of total billed charges,642.95,103,,,Fee Schedule,103% of WA Medicaid,110.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,624.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5516.55,69,,,percent of total billed charges,69% of total billed charges,7995,100,,,percent of total billed charges,100% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,7995,100,,,percent of total billed charges,100% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,7995,100,,,percent of total billed charges,100% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,4944.91,61.85,,,percent of total billed charges,61.85% of total billed charges,624.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,636.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,811.49,130,,,Fee Schedule,130% of WA Medicaid ,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,3014.12,37.7,,,percent of total billed charges,37.70% of total billed charges,3014.12,37.7,,,percent of total billed charges,37.70% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,271030.5,33.9,,,percent of total billed charges,33.9% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,6236.1,78,,,percent of total billed charges,78% of total billed charges,7995,100,,,percent of total billed charges,100% of total billed charges,6603.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6603.87,82.6,,,percent of total billed charges,82.6% of total billed charges,624.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.68,271030.5,
SUSPENSION OF BREAST,19316,CDM,983,RC,19316,HCPCS,Outpatient,,,1590,1033.50,,1399.2,88,,,percent of total billed charges,88% of total Billed charges,80.45,100,,,Fee Schedule,100% of Medicare rate,454.31,100,,,Fee Schedule,100% of WA Medicaid,1590,100,,,percent of total billed charges,100% of total billed charges,467.94,103,,,Fee Schedule,103% of WA Medicaid,80.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,454.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1097.1,69,,,percent of total billed charges,69% of total billed charges,1590,100,,,percent of total billed charges,100% of total billed charges,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1590,100,,,percent of total billed charges,100% of total billed charges,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1590,100,,,percent of total billed charges,100% of total billed charges,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,983.42,61.85,,,percent of total billed charges,61.85% of total billed charges,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,590.6,130,,,Fee Schedule,130% of WA Medicaid ,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.43,37.7,,,percent of total billed charges,37.70% of total billed charges,599.43,37.7,,,percent of total billed charges,37.70% of total billed charges,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,53901,33.9,,,percent of total billed charges,33.9% of total billed charges,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240.2,78,,,percent of total billed charges,78% of total billed charges,1590,100,,,percent of total billed charges,100% of total billed charges,1313.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1313.34,82.6,,,percent of total billed charges,82.6% of total billed charges,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.45,53901,
ENLGE BREAST W/IMPLANT,19325,CDM,983,RC,19325,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,57.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1300,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,57.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,44070,33.9,,,percent of total billed charges,33.9% of total billed charges,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",57.83,44070,
REMOVAL OF BREAST IMPLANT,19328,CDM,983,RC,19328,HCPCS,Outpatient,,,1020,663.00,,897.6,88,,,percent of total billed charges,88% of total Billed charges,53.61,100,,,Fee Schedule,100% of Medicare rate,319.1,100,,,Fee Schedule,100% of WA Medicaid,1020,100,,,percent of total billed charges,100% of total billed charges,328.67,103,,,Fee Schedule,103% of WA Medicaid,53.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,319.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,703.8,69,,,percent of total billed charges,69% of total billed charges,1020,100,,,percent of total billed charges,100% of total billed charges,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020,100,,,percent of total billed charges,100% of total billed charges,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020,100,,,percent of total billed charges,100% of total billed charges,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,630.87,61.85,,,percent of total billed charges,61.85% of total billed charges,319.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,414.83,130,,,Fee Schedule,130% of WA Medicaid ,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.54,37.7,,,percent of total billed charges,37.70% of total billed charges,384.54,37.7,,,percent of total billed charges,37.70% of total billed charges,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,34578,33.9,,,percent of total billed charges,33.9% of total billed charges,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,795.6,78,,,percent of total billed charges,78% of total billed charges,1020,100,,,percent of total billed charges,100% of total billed charges,842.52,82.6,,,percent of total billed charges,82.6% of total billed charges,842.52,82.6,,,percent of total billed charges,82.6% of total billed charges,319.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.61,34578,
REMOVAL OF IMPLANT MATERIAL BREAST,19330,CDM,983,RC,19330,HCPCS,Outpatient,,,1281,832.65,,1127.28,88,,,percent of total billed charges,88% of total Billed charges,63.87,100,,,Fee Schedule,100% of Medicare rate,370.95,100,,,Fee Schedule,100% of WA Medicaid,1281,100,,,percent of total billed charges,100% of total billed charges,382.08,103,,,Fee Schedule,103% of WA Medicaid,63.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,111.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,370.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,883.89,69,,,percent of total billed charges,69% of total billed charges,1281,100,,,percent of total billed charges,100% of total billed charges,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1281,100,,,percent of total billed charges,100% of total billed charges,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1281,100,,,percent of total billed charges,100% of total billed charges,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,792.3,61.85,,,percent of total billed charges,61.85% of total billed charges,370.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,482.24,130,,,Fee Schedule,130% of WA Medicaid ,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.94,37.7,,,percent of total billed charges,37.70% of total billed charges,482.94,37.7,,,percent of total billed charges,37.70% of total billed charges,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,43425.9,33.9,,,percent of total billed charges,33.9% of total billed charges,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,999.18,78,,,percent of total billed charges,78% of total billed charges,1281,100,,,percent of total billed charges,100% of total billed charges,1058.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1058.11,82.6,,,percent of total billed charges,82.6% of total billed charges,370.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.87,43425.9,
IMMEDIATE BREAST PROSTHESIS,19340,CDM,983,RC,19340,HCPCS,Outpatient,,,2070,1345.50,,1821.6,88,,,percent of total billed charges,88% of total Billed charges,76.36,100,,,Fee Schedule,100% of Medicare rate,435.85,100,,,Fee Schedule,100% of WA Medicaid,2070,100,,,percent of total billed charges,100% of total billed charges,448.93,103,,,Fee Schedule,103% of WA Medicaid,76.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,133.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,435.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1428.3,69,,,percent of total billed charges,69% of total billed charges,2070,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2070,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2070,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1280.3,61.85,,,percent of total billed charges,61.85% of total billed charges,435.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,566.61,130,,,Fee Schedule,130% of WA Medicaid ,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.39,37.7,,,percent of total billed charges,37.70% of total billed charges,780.39,37.7,,,percent of total billed charges,37.70% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,70173,33.9,,,percent of total billed charges,33.9% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1614.6,78,,,percent of total billed charges,78% of total billed charges,2070,100,,,percent of total billed charges,100% of total billed charges,1709.82,82.6,,,percent of total billed charges,82.6% of total billed charges,1709.82,82.6,,,percent of total billed charges,82.6% of total billed charges,435.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.36,70173,
BREAST RECONSTRUCITON,19357,CDM,983,RC,19357,HCPCS,Outpatient,,,3100,2015.00,,2728,88,,,percent of total billed charges,88% of total Billed charges,107.49,100,,,Fee Schedule,100% of Medicare rate,668.6,100,,,Fee Schedule,100% of WA Medicaid,3100,100,,,percent of total billed charges,100% of total billed charges,688.66,103,,,Fee Schedule,103% of WA Medicaid,107.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,188.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,668.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2139,69,,,percent of total billed charges,69% of total billed charges,3100,100,,,percent of total billed charges,100% of total billed charges,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3100,100,,,percent of total billed charges,100% of total billed charges,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3100,100,,,percent of total billed charges,100% of total billed charges,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1917.35,61.85,,,percent of total billed charges,61.85% of total billed charges,668.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,681.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,869.18,130,,,Fee Schedule,130% of WA Medicaid ,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1168.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1168.7,37.7,,,percent of total billed charges,37.70% of total billed charges,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,105090,33.9,,,percent of total billed charges,33.9% of total billed charges,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2418,78,,,percent of total billed charges,78% of total billed charges,3100,100,,,percent of total billed charges,100% of total billed charges,2560.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2560.6,82.6,,,percent of total billed charges,82.6% of total billed charges,668.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.49,105090,
BREAST RECONSTRUCTION-NIPPLE AREOLA RECO,19350,CDM,983,RC,19350,HCPCS,Outpatient,,,1363,885.95,,1199.44,88,,,percent of total billed charges,88% of total Billed charges,64.47,100,,,Fee Schedule,100% of Medicare rate,387.55,100,,,Fee Schedule,100% of WA Medicaid,1363,100,,,percent of total billed charges,100% of total billed charges,399.18,103,,,Fee Schedule,103% of WA Medicaid,64.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,387.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,940.47,69,,,percent of total billed charges,69% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1363,100,,,percent of total billed charges,100% of total billed charges,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1363,100,,,percent of total billed charges,100% of total billed charges,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,843.02,61.85,,,percent of total billed charges,61.85% of total billed charges,387.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,503.82,130,,,Fee Schedule,130% of WA Medicaid ,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,46205.7,33.9,,,percent of total billed charges,33.9% of total billed charges,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.14,78,,,percent of total billed charges,78% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,387.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.47,46205.7,
CORRECT INVERTED NIPPLES,19355,CDM,983,RC,19355,HCPCS,Outpatient,,,1140,741.00,,1003.2,88,,,percent of total billed charges,88% of total Billed charges,59.39,100,,,Fee Schedule,100% of Medicare rate,354.91,100,,,Fee Schedule,100% of WA Medicaid,1140,100,,,percent of total billed charges,100% of total billed charges,365.56,103,,,Fee Schedule,103% of WA Medicaid,59.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,354.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,786.6,69,,,percent of total billed charges,69% of total billed charges,1140,100,,,percent of total billed charges,100% of total billed charges,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1140,100,,,percent of total billed charges,100% of total billed charges,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1140,100,,,percent of total billed charges,100% of total billed charges,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,705.09,61.85,,,percent of total billed charges,61.85% of total billed charges,354.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,461.38,130,,,Fee Schedule,130% of WA Medicaid ,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.78,37.7,,,percent of total billed charges,37.70% of total billed charges,429.78,37.7,,,percent of total billed charges,37.70% of total billed charges,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,38646,33.9,,,percent of total billed charges,33.9% of total billed charges,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,889.2,78,,,percent of total billed charges,78% of total billed charges,1140,100,,,percent of total billed charges,100% of total billed charges,941.64,82.6,,,percent of total billed charges,82.6% of total billed charges,941.64,82.6,,,percent of total billed charges,82.6% of total billed charges,354.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.39,38646,
BREAST RECONSTR W/LAT FLAP,19361,CDM,983,RC,19361,HCPCS,Outpatient,,,3200,2080.00,,2816,88,,,percent of total billed charges,88% of total Billed charges,159.78,100,,,Fee Schedule,100% of Medicare rate,886.43,100,,,Fee Schedule,100% of WA Medicaid,3200,100,,,percent of total billed charges,100% of total billed charges,913.02,103,,,Fee Schedule,103% of WA Medicaid,159.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,279.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,886.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2208,69,,,percent of total billed charges,69% of total billed charges,3200,100,,,percent of total billed charges,100% of total billed charges,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,3200,100,,,percent of total billed charges,100% of total billed charges,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,3200,100,,,percent of total billed charges,100% of total billed charges,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1979.2,61.85,,,percent of total billed charges,61.85% of total billed charges,886.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,886.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1152.36,130,,,Fee Schedule,130% of WA Medicaid ,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1206.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1206.4,37.7,,,percent of total billed charges,37.70% of total billed charges,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,108480,33.9,,,percent of total billed charges,33.9% of total billed charges,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2496,78,,,percent of total billed charges,78% of total billed charges,3200,100,,,percent of total billed charges,100% of total billed charges,2643.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2643.2,82.6,,,percent of total billed charges,82.6% of total billed charges,886.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,159.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,886.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,159.78,108480,
SURGERY OF BREAST CAPSULE-OPEN,19370,CDM,983,RC,19370,HCPCS,Outpatient,,,1410,916.50,,1240.8,88,,,percent of total billed charges,88% of total Billed charges,64.69,100,,,Fee Schedule,100% of Medicare rate,386.61,100,,,Fee Schedule,100% of WA Medicaid,1410,100,,,percent of total billed charges,100% of total billed charges,398.21,103,,,Fee Schedule,103% of WA Medicaid,64.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,113.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,386.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,972.9,69,,,percent of total billed charges,69% of total billed charges,1410,100,,,percent of total billed charges,100% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1410,100,,,percent of total billed charges,100% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1410,100,,,percent of total billed charges,100% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,872.09,61.85,,,percent of total billed charges,61.85% of total billed charges,386.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,502.59,130,,,Fee Schedule,130% of WA Medicaid ,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,531.57,37.7,,,percent of total billed charges,37.70% of total billed charges,531.57,37.7,,,percent of total billed charges,37.70% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,47799,33.9,,,percent of total billed charges,33.9% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1099.8,78,,,percent of total billed charges,78% of total billed charges,1410,100,,,percent of total billed charges,100% of total billed charges,1164.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1164.66,82.6,,,percent of total billed charges,82.6% of total billed charges,386.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.69,47799,
REMOVAL OF BREAST CAPSULE,19371,CDM,983,RC,19371,HCPCS,Outpatient,,,1610,1046.50,,1416.8,88,,,percent of total billed charges,88% of total Billed charges,69.74,100,,,Fee Schedule,100% of Medicare rate,408.62,100,,,Fee Schedule,100% of WA Medicaid,1610,100,,,percent of total billed charges,100% of total billed charges,420.88,103,,,Fee Schedule,103% of WA Medicaid,69.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,122.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,408.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1110.9,69,,,percent of total billed charges,69% of total billed charges,1610,100,,,percent of total billed charges,100% of total billed charges,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1610,100,,,percent of total billed charges,100% of total billed charges,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1610,100,,,percent of total billed charges,100% of total billed charges,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,995.79,61.85,,,percent of total billed charges,61.85% of total billed charges,408.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,531.21,130,,,Fee Schedule,130% of WA Medicaid ,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.97,37.7,,,percent of total billed charges,37.70% of total billed charges,606.97,37.7,,,percent of total billed charges,37.70% of total billed charges,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,54579,33.9,,,percent of total billed charges,33.9% of total billed charges,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1255.8,78,,,percent of total billed charges,78% of total billed charges,1610,100,,,percent of total billed charges,100% of total billed charges,1329.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1329.86,82.6,,,percent of total billed charges,82.6% of total billed charges,408.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.74,54579,
REVISE BREAST RECONSTRUCTION,19380,CDM,983,RC,19380,HCPCS,Outpatient,,,1590,1033.50,,1399.2,88,,,percent of total billed charges,88% of total Billed charges,78.35,100,,,Fee Schedule,100% of Medicare rate,463.83,100,,,Fee Schedule,100% of WA Medicaid,1590,100,,,percent of total billed charges,100% of total billed charges,477.74,103,,,Fee Schedule,103% of WA Medicaid,78.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,463.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1097.1,69,,,percent of total billed charges,69% of total billed charges,1590,100,,,percent of total billed charges,100% of total billed charges,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1590,100,,,percent of total billed charges,100% of total billed charges,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1590,100,,,percent of total billed charges,100% of total billed charges,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,983.42,61.85,,,percent of total billed charges,61.85% of total billed charges,463.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,602.98,130,,,Fee Schedule,130% of WA Medicaid ,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.43,37.7,,,percent of total billed charges,37.70% of total billed charges,599.43,37.7,,,percent of total billed charges,37.70% of total billed charges,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,53901,33.9,,,percent of total billed charges,33.9% of total billed charges,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240.2,78,,,percent of total billed charges,78% of total billed charges,1590,100,,,percent of total billed charges,100% of total billed charges,1313.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1313.34,82.6,,,percent of total billed charges,82.6% of total billed charges,463.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.35,53901,
EXPLORE WOUND ABDOMEN,20102,CDM,983,RC,20102,HCPCS,Outpatient,,,1622,1054.30,,1427.36,88,,,percent of total billed charges,88% of total Billed charges,32.81,100,,,Fee Schedule,100% of Medicare rate,144.91,100,,,Fee Schedule,100% of WA Medicaid,1622,100,,,percent of total billed charges,100% of total billed charges,149.26,103,,,Fee Schedule,103% of WA Medicaid,32.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,144.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1119.18,69,,,percent of total billed charges,69% of total billed charges,1622,100,,,percent of total billed charges,100% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1622,100,,,percent of total billed charges,100% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1622,100,,,percent of total billed charges,100% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1003.21,61.85,,,percent of total billed charges,61.85% of total billed charges,144.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,188.38,130,,,Fee Schedule,130% of WA Medicaid ,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,611.49,37.7,,,percent of total billed charges,37.70% of total billed charges,611.49,37.7,,,percent of total billed charges,37.70% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,54985.8,33.9,,,percent of total billed charges,33.9% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1265.16,78,,,percent of total billed charges,78% of total billed charges,1622,100,,,percent of total billed charges,100% of total billed charges,1339.77,82.6,,,percent of total billed charges,82.6% of total billed charges,1339.77,82.6,,,percent of total billed charges,82.6% of total billed charges,144.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.81,54985.8,
EXPLORE WOUND EXTREMITY,20103,CDM,983,RC,20103,HCPCS,Outpatient,,,1362,885.30,,1198.56,88,,,percent of total billed charges,88% of total Billed charges,37.08,100,,,Fee Schedule,100% of Medicare rate,196.57,100,,,Fee Schedule,100% of WA Medicaid,1362,100,,,percent of total billed charges,100% of total billed charges,202.47,103,,,Fee Schedule,103% of WA Medicaid,37.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,196.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,939.78,69,,,percent of total billed charges,69% of total billed charges,1362,100,,,percent of total billed charges,100% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1362,100,,,percent of total billed charges,100% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1362,100,,,percent of total billed charges,100% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.4,61.85,,,percent of total billed charges,61.85% of total billed charges,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,255.54,130,,,Fee Schedule,130% of WA Medicaid ,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.47,37.7,,,percent of total billed charges,37.70% of total billed charges,513.47,37.7,,,percent of total billed charges,37.70% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,46171.8,33.9,,,percent of total billed charges,33.9% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1062.36,78,,,percent of total billed charges,78% of total billed charges,1362,100,,,percent of total billed charges,100% of total billed charges,1125.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1125.01,82.6,,,percent of total billed charges,82.6% of total billed charges,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.08,46171.8,
EXPLORE WOUND CHEST,20101,CDM,983,RC,20101,HCPCS,Outpatient,,,1976,1284.40,,1738.88,88,,,percent of total billed charges,88% of total Billed charges,27.77,100,,,Fee Schedule,100% of Medicare rate,118.24,100,,,Fee Schedule,100% of WA Medicaid,1976,100,,,percent of total billed charges,100% of total billed charges,121.79,103,,,Fee Schedule,103% of WA Medicaid,27.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,118.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1363.44,69,,,percent of total billed charges,69% of total billed charges,1976,100,,,percent of total billed charges,100% of total billed charges,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1976,100,,,percent of total billed charges,100% of total billed charges,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1976,100,,,percent of total billed charges,100% of total billed charges,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1222.16,61.85,,,percent of total billed charges,61.85% of total billed charges,118.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,153.71,130,,,Fee Schedule,130% of WA Medicaid ,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,744.95,37.7,,,percent of total billed charges,37.70% of total billed charges,744.95,37.7,,,percent of total billed charges,37.70% of total billed charges,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,66986.4,33.9,,,percent of total billed charges,33.9% of total billed charges,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1541.28,78,,,percent of total billed charges,78% of total billed charges,1976,100,,,percent of total billed charges,100% of total billed charges,1632.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1632.18,82.6,,,percent of total billed charges,82.6% of total billed charges,118.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.77,66986.4,
EXPLORE WOUND NECK,20100,CDM,983,RC,20100,HCPCS,Outpatient,,,1864,1211.60,,1640.32,88,,,percent of total billed charges,88% of total Billed charges,75.14,100,,,Fee Schedule,100% of Medicare rate,337.01,100,,,Fee Schedule,100% of WA Medicaid,1864,100,,,percent of total billed charges,100% of total billed charges,347.12,103,,,Fee Schedule,103% of WA Medicaid,75.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,131.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,337.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1286.16,69,,,percent of total billed charges,69% of total billed charges,1864,100,,,percent of total billed charges,100% of total billed charges,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1864,100,,,percent of total billed charges,100% of total billed charges,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1864,100,,,percent of total billed charges,100% of total billed charges,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152.88,61.85,,,percent of total billed charges,61.85% of total billed charges,337.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,438.11,130,,,Fee Schedule,130% of WA Medicaid ,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,702.73,37.7,,,percent of total billed charges,37.70% of total billed charges,702.73,37.7,,,percent of total billed charges,37.70% of total billed charges,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,63189.6,33.9,,,percent of total billed charges,33.9% of total billed charges,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1453.92,78,,,percent of total billed charges,78% of total billed charges,1864,100,,,percent of total billed charges,100% of total billed charges,1539.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1539.66,82.6,,,percent of total billed charges,82.6% of total billed charges,337.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.14,63189.6,
NEEDLE BIOPSY MUSCLE,20206,CDM,983,RC,20206,HCPCS,Outpatient,,,356,231.40,,313.28,88,,,percent of total billed charges,88% of total Billed charges,4.29,100,,,Fee Schedule,100% of Medicare rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,356,100,,,percent of total billed charges,100% of total billed charges,33.23,103,,,Fee Schedule,103% of WA Medicaid,4.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,245.64,69,,,percent of total billed charges,69% of total billed charges,356,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,356,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,356,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.19,61.85,,,percent of total billed charges,61.85% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.94,130,,,Fee Schedule,130% of WA Medicaid ,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.21,37.7,,,percent of total billed charges,37.70% of total billed charges,134.21,37.7,,,percent of total billed charges,37.70% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,12068.4,33.9,,,percent of total billed charges,33.9% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.68,78,,,percent of total billed charges,78% of total billed charges,356,100,,,percent of total billed charges,100% of total billed charges,294.06,82.6,,,percent of total billed charges,82.6% of total billed charges,294.06,82.6,,,percent of total billed charges,82.6% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.29,12068.4,
MUSCLE BIOPSY,20200,CDM,983,RC,20200,HCPCS,Outpatient,,,454,295.10,,399.52,88,,,percent of total billed charges,88% of total Billed charges,12.43,100,,,Fee Schedule,100% of Medicare rate,53.71,100,,,Fee Schedule,100% of WA Medicaid,454,100,,,percent of total billed charges,100% of total billed charges,55.32,103,,,Fee Schedule,103% of WA Medicaid,12.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,53.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,313.26,69,,,percent of total billed charges,69% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,454,100,,,percent of total billed charges,100% of total billed charges,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,454,100,,,percent of total billed charges,100% of total billed charges,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.8,61.85,,,percent of total billed charges,61.85% of total billed charges,53.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,69.82,130,,,Fee Schedule,130% of WA Medicaid ,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,15390.6,33.9,,,percent of total billed charges,33.9% of total billed charges,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.12,78,,,percent of total billed charges,78% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,53.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.43,15390.6,
DEEP MUSCLE BIOPSY,20205,CDM,983,RC,20205,HCPCS,Outpatient,,,765,497.25,,673.2,88,,,percent of total billed charges,88% of total Billed charges,21.72,100,,,Fee Schedule,100% of Medicare rate,87.28,100,,,Fee Schedule,100% of WA Medicaid,765,100,,,percent of total billed charges,100% of total billed charges,89.9,103,,,Fee Schedule,103% of WA Medicaid,21.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,87.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,527.85,69,,,percent of total billed charges,69% of total billed charges,765,100,,,percent of total billed charges,100% of total billed charges,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,765,100,,,percent of total billed charges,100% of total billed charges,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,765,100,,,percent of total billed charges,100% of total billed charges,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.15,61.85,,,percent of total billed charges,61.85% of total billed charges,87.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,113.46,130,,,Fee Schedule,130% of WA Medicaid ,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.41,37.7,,,percent of total billed charges,37.70% of total billed charges,288.41,37.7,,,percent of total billed charges,37.70% of total billed charges,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,25933.5,33.9,,,percent of total billed charges,33.9% of total billed charges,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.7,78,,,percent of total billed charges,78% of total billed charges,765,100,,,percent of total billed charges,100% of total billed charges,631.89,82.6,,,percent of total billed charges,82.6% of total billed charges,631.89,82.6,,,percent of total billed charges,82.6% of total billed charges,87.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.72,25933.5,
BONE BIOPSY TROCAR/NEEDLE,20220,CDM,960,RC,20220,HCPCS,Outpatient,,,425,276.25,,374,88,,,percent of total billed charges,88% of total Billed charges,6.73,100,,,Fee Schedule,100% of Medicare rate,48.86,100,,,Fee Schedule,100% of WA Medicaid,425,100,,,percent of total billed charges,100% of total billed charges,50.33,103,,,Fee Schedule,103% of WA Medicaid,6.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,293.25,69,,,percent of total billed charges,69% of total billed charges,425,100,,,percent of total billed charges,100% of total billed charges,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,425,100,,,percent of total billed charges,100% of total billed charges,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,425,100,,,percent of total billed charges,100% of total billed charges,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.86,61.85,,,percent of total billed charges,61.85% of total billed charges,48.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.52,130,,,Fee Schedule,130% of WA Medicaid ,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.23,37.7,,,percent of total billed charges,37.70% of total billed charges,160.23,37.7,,,percent of total billed charges,37.70% of total billed charges,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,14407.5,33.9,,,percent of total billed charges,33.9% of total billed charges,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.5,78,,,percent of total billed charges,78% of total billed charges,425,100,,,percent of total billed charges,100% of total billed charges,351.05,82.6,,,percent of total billed charges,82.6% of total billed charges,351.05,82.6,,,percent of total billed charges,82.6% of total billed charges,48.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.73,14407.5,
BONE BIOPSY TROCAR/NEEDLE,20225,CDM,983,RC,20225,HCPCS,Outpatient,,,430,279.50,,378.4,88,,,percent of total billed charges,88% of total Billed charges,10.3,100,,,Fee Schedule,100% of Medicare rate,72.18,100,,,Fee Schedule,100% of WA Medicaid,430,100,,,percent of total billed charges,100% of total billed charges,74.35,103,,,Fee Schedule,103% of WA Medicaid,10.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,72.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,296.7,69,,,percent of total billed charges,69% of total billed charges,430,100,,,percent of total billed charges,100% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,430,100,,,percent of total billed charges,100% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,430,100,,,percent of total billed charges,100% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.96,61.85,,,percent of total billed charges,61.85% of total billed charges,72.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,93.83,130,,,Fee Schedule,130% of WA Medicaid ,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.11,37.7,,,percent of total billed charges,37.70% of total billed charges,162.11,37.7,,,percent of total billed charges,37.70% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,14577,33.9,,,percent of total billed charges,33.9% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.4,78,,,percent of total billed charges,78% of total billed charges,430,100,,,percent of total billed charges,100% of total billed charges,355.18,82.6,,,percent of total billed charges,82.6% of total billed charges,355.18,82.6,,,percent of total billed charges,82.6% of total billed charges,72.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.3,14577,
BONE BIOPSY EXCISIONAL,20245,CDM,983,RC,20245,HCPCS,Outpatient,,,1426,926.90,,1254.88,88,,,percent of total billed charges,88% of total Billed charges,37.44,100,,,Fee Schedule,100% of Medicare rate,193.03,100,,,Fee Schedule,100% of WA Medicaid,1426,100,,,percent of total billed charges,100% of total billed charges,198.82,103,,,Fee Schedule,103% of WA Medicaid,37.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,193.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,983.94,69,,,percent of total billed charges,69% of total billed charges,1426,100,,,percent of total billed charges,100% of total billed charges,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1426,100,,,percent of total billed charges,100% of total billed charges,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1426,100,,,percent of total billed charges,100% of total billed charges,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,881.98,61.85,,,percent of total billed charges,61.85% of total billed charges,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,250.94,130,,,Fee Schedule,130% of WA Medicaid ,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.6,37.7,,,percent of total billed charges,37.70% of total billed charges,537.6,37.7,,,percent of total billed charges,37.70% of total billed charges,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,48341.4,33.9,,,percent of total billed charges,33.9% of total billed charges,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1112.28,78,,,percent of total billed charges,78% of total billed charges,1426,100,,,percent of total billed charges,100% of total billed charges,1177.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1177.88,82.6,,,percent of total billed charges,82.6% of total billed charges,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.44,48341.4,
BONE BIOPSY EXCISIONAL,20240,CDM,983,RC,20240,HCPCS,Outpatient,,,794,516.10,,698.72,88,,,percent of total billed charges,88% of total Billed charges,11.97,100,,,Fee Schedule,100% of Medicare rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,794,100,,,percent of total billed charges,100% of total billed charges,81.64,103,,,Fee Schedule,103% of WA Medicaid,11.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,547.86,69,,,percent of total billed charges,69% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,794,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,794,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.09,61.85,,,percent of total billed charges,61.85% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.04,130,,,Fee Schedule,130% of WA Medicaid ,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,299.34,37.7,,,percent of total billed charges,37.70% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,26916.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,619.32,78,,,percent of total billed charges,78% of total billed charges,794,100,,,percent of total billed charges,100% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,655.84,82.6,,,percent of total billed charges,82.6% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.97,26916.6,
OPEN BONE BIOPSY,20251,CDM,983,RC,20251,HCPCS,Outpatient,,,1937,1259.05,,1704.56,88,,,percent of total billed charges,88% of total Billed charges,52.03,100,,,Fee Schedule,100% of Medicare rate,239.28,100,,,Fee Schedule,100% of WA Medicaid,1937,100,,,percent of total billed charges,100% of total billed charges,246.46,103,,,Fee Schedule,103% of WA Medicaid,52.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,91.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,239.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1336.53,69,,,percent of total billed charges,69% of total billed charges,1937,100,,,percent of total billed charges,100% of total billed charges,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1937,100,,,percent of total billed charges,100% of total billed charges,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1937,100,,,percent of total billed charges,100% of total billed charges,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198.03,61.85,,,percent of total billed charges,61.85% of total billed charges,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,311.06,130,,,Fee Schedule,130% of WA Medicaid ,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.25,37.7,,,percent of total billed charges,37.70% of total billed charges,730.25,37.7,,,percent of total billed charges,37.70% of total billed charges,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,65664.3,33.9,,,percent of total billed charges,33.9% of total billed charges,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1510.86,78,,,percent of total billed charges,78% of total billed charges,1937,100,,,percent of total billed charges,100% of total billed charges,1599.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1599.96,82.6,,,percent of total billed charges,82.6% of total billed charges,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.03,65664.3,
OPEN BONE BIOPSY,20250,CDM,983,RC,20250,HCPCS,Outpatient,,,1862,1210.30,,1638.56,88,,,percent of total billed charges,88% of total Billed charges,49.91,100,,,Fee Schedule,100% of Medicare rate,223.8,100,,,Fee Schedule,100% of WA Medicaid,1862,100,,,percent of total billed charges,100% of total billed charges,230.51,103,,,Fee Schedule,103% of WA Medicaid,49.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,223.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1284.78,69,,,percent of total billed charges,69% of total billed charges,1862,100,,,percent of total billed charges,100% of total billed charges,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1862,100,,,percent of total billed charges,100% of total billed charges,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1862,100,,,percent of total billed charges,100% of total billed charges,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1151.65,61.85,,,percent of total billed charges,61.85% of total billed charges,223.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,290.94,130,,,Fee Schedule,130% of WA Medicaid ,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.97,37.7,,,percent of total billed charges,37.70% of total billed charges,701.97,37.7,,,percent of total billed charges,37.70% of total billed charges,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,63121.8,33.9,,,percent of total billed charges,33.9% of total billed charges,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1452.36,78,,,percent of total billed charges,78% of total billed charges,1862,100,,,percent of total billed charges,100% of total billed charges,1538.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1538.01,82.6,,,percent of total billed charges,82.6% of total billed charges,223.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.91,63121.8,
INJECTION OF SINUS TRACT,20500,CDM,983,RC,20500,HCPCS,Outpatient,,,791,514.15,,696.08,88,,,percent of total billed charges,88% of total Billed charges,6.61,100,,,Fee Schedule,100% of Medicare rate,51.66,100,,,Fee Schedule,100% of WA Medicaid,791,100,,,percent of total billed charges,100% of total billed charges,53.21,103,,,Fee Schedule,103% of WA Medicaid,6.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,51.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,545.79,69,,,percent of total billed charges,69% of total billed charges,791,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,791,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,791,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.23,61.85,,,percent of total billed charges,61.85% of total billed charges,51.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.16,130,,,Fee Schedule,130% of WA Medicaid ,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.21,37.7,,,percent of total billed charges,37.70% of total billed charges,298.21,37.7,,,percent of total billed charges,37.70% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,26814.9,33.9,,,percent of total billed charges,33.9% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,616.98,78,,,percent of total billed charges,78% of total billed charges,791,100,,,percent of total billed charges,100% of total billed charges,653.37,82.6,,,percent of total billed charges,82.6% of total billed charges,653.37,82.6,,,percent of total billed charges,82.6% of total billed charges,51.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.61,26814.9,
REMOVAL OF FOREIGN BODY,20520,CDM,983,RC,20520,HCPCS,Outpatient,,,343.86,223.51,,302.6,88,,,percent of total billed charges,88% of total Billed charges,12.04,100,,,Fee Schedule,100% of Medicare rate,85.98,100,,,Fee Schedule,100% of WA Medicaid,343.86,100,,,percent of total billed charges,100% of total billed charges,88.56,103,,,Fee Schedule,103% of WA Medicaid,12.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,237.26,69,,,percent of total billed charges,69% of total billed charges,343.86,100,,,percent of total billed charges,100% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.86,100,,,percent of total billed charges,100% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.86,100,,,percent of total billed charges,100% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.68,61.85,,,percent of total billed charges,61.85% of total billed charges,85.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.77,130,,,Fee Schedule,130% of WA Medicaid ,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.64,37.7,,,percent of total billed charges,37.70% of total billed charges,129.64,37.7,,,percent of total billed charges,37.70% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,11656.85,33.9,,,percent of total billed charges,33.9% of total billed charges,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.21,78,,,percent of total billed charges,78% of total billed charges,343.86,100,,,percent of total billed charges,100% of total billed charges,284.03,82.6,,,percent of total billed charges,82.6% of total billed charges,284.03,82.6,,,percent of total billed charges,82.6% of total billed charges,85.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.04,11656.85,
THER INJECTION CARP TUNNEL,20526,CDM,983,RC,20526,HCPCS,Outpatient,,,190,123.50,,167.2,88,,,percent of total billed charges,88% of total Billed charges,6.1,100,,,Fee Schedule,100% of Medicare rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,33.04,103,,,Fee Schedule,103% of WA Medicaid,6.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.52,61.85,,,percent of total billed charges,61.85% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.7,130,,,Fee Schedule,130% of WA Medicaid ,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6441,33.9,,,percent of total billed charges,33.9% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.1,6441,
REMOVAL OF FOREIGN BODY,20525,CDM,983,RC,20525,HCPCS,Outpatient,,,1031,670.15,,907.28,88,,,percent of total billed charges,88% of total Billed charges,24.59,100,,,Fee Schedule,100% of Medicare rate,141.93,100,,,Fee Schedule,100% of WA Medicaid,1031,100,,,percent of total billed charges,100% of total billed charges,146.19,103,,,Fee Schedule,103% of WA Medicaid,24.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,141.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,711.39,69,,,percent of total billed charges,69% of total billed charges,1031,100,,,percent of total billed charges,100% of total billed charges,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031,100,,,percent of total billed charges,100% of total billed charges,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031,100,,,percent of total billed charges,100% of total billed charges,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.67,61.85,,,percent of total billed charges,61.85% of total billed charges,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,184.51,130,,,Fee Schedule,130% of WA Medicaid ,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.69,37.7,,,percent of total billed charges,37.70% of total billed charges,388.69,37.7,,,percent of total billed charges,37.70% of total billed charges,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,34950.9,33.9,,,percent of total billed charges,33.9% of total billed charges,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.18,78,,,percent of total billed charges,78% of total billed charges,1031,100,,,percent of total billed charges,100% of total billed charges,851.61,82.6,,,percent of total billed charges,82.6% of total billed charges,851.61,82.6,,,percent of total billed charges,82.6% of total billed charges,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.59,34950.9,
INJ TENDON SHEATH/LIGAMENT,20550,CDM,983,RC,20550,HCPCS,Outpatient,,,164,106.60,,144.32,88,,,percent of total billed charges,88% of total Billed charges,3.75,100,,,Fee Schedule,100% of Medicare rate,21.82,100,,,Fee Schedule,100% of WA Medicaid,164,100,,,percent of total billed charges,100% of total billed charges,22.47,103,,,Fee Schedule,103% of WA Medicaid,3.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,113.16,69,,,percent of total billed charges,69% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,164,100,,,percent of total billed charges,100% of total billed charges,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,164,100,,,percent of total billed charges,100% of total billed charges,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.43,61.85,,,percent of total billed charges,61.85% of total billed charges,21.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.37,130,,,Fee Schedule,130% of WA Medicaid ,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.83,37.7,,,percent of total billed charges,37.70% of total billed charges,61.83,37.7,,,percent of total billed charges,37.70% of total billed charges,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5559.6,33.9,,,percent of total billed charges,33.9% of total billed charges,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.92,78,,,percent of total billed charges,78% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,21.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.75,5559.6,
INJECT TRIGGER POINTS 3/>,20553,CDM,983,RC,20553,HCPCS,Outpatient,,,107.79,70.06,,94.86,88,,,percent of total billed charges,88% of total Billed charges,3.59,100,,,Fee Schedule,100% of Medicare rate,23.69,100,,,Fee Schedule,100% of WA Medicaid,107.79,100,,,percent of total billed charges,100% of total billed charges,24.4,103,,,Fee Schedule,103% of WA Medicaid,3.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,74.38,69,,,percent of total billed charges,69% of total billed charges,107.79,100,,,percent of total billed charges,100% of total billed charges,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.79,100,,,percent of total billed charges,100% of total billed charges,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.79,100,,,percent of total billed charges,100% of total billed charges,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.67,61.85,,,percent of total billed charges,61.85% of total billed charges,23.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.8,130,,,Fee Schedule,130% of WA Medicaid ,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.64,37.7,,,percent of total billed charges,37.70% of total billed charges,40.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3654.08,33.9,,,percent of total billed charges,33.9% of total billed charges,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.08,78,,,percent of total billed charges,78% of total billed charges,107.79,100,,,percent of total billed charges,100% of total billed charges,89.03,82.6,,,percent of total billed charges,82.6% of total billed charges,89.03,82.6,,,percent of total billed charges,82.6% of total billed charges,23.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.59,3654.08,
INJ TRIGGER POINT 1/2 MUSCL,20552,CDM,983,RC,20552,HCPCS,Outpatient,,,93.14,60.54,,81.96,88,,,percent of total billed charges,88% of total Billed charges,3.18,100,,,Fee Schedule,100% of Medicare rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,93.14,100,,,percent of total billed charges,100% of total billed charges,21.52,103,,,Fee Schedule,103% of WA Medicaid,3.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,64.27,69,,,percent of total billed charges,69% of total billed charges,93.14,100,,,percent of total billed charges,100% of total billed charges,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.14,100,,,percent of total billed charges,100% of total billed charges,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.14,100,,,percent of total billed charges,100% of total billed charges,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.61,61.85,,,percent of total billed charges,61.85% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.16,130,,,Fee Schedule,130% of WA Medicaid ,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.11,37.7,,,percent of total billed charges,37.70% of total billed charges,35.11,37.7,,,percent of total billed charges,37.70% of total billed charges,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3157.45,33.9,,,percent of total billed charges,33.9% of total billed charges,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.65,78,,,percent of total billed charges,78% of total billed charges,93.14,100,,,percent of total billed charges,100% of total billed charges,76.93,82.6,,,percent of total billed charges,82.6% of total billed charges,76.93,82.6,,,percent of total billed charges,82.6% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.18,3157.45,
"20551 Injection(s), single tendon origin/insertion",20551,CDM,983,RC,20551,HCPCS,Outpatient,,,175,113.75,,154,88,,,percent of total billed charges,88% of total Billed charges,3.48,100,,,Fee Schedule,100% of Medicare rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,175,100,,,percent of total billed charges,100% of total billed charges,22.28,103,,,Fee Schedule,103% of WA Medicaid,3.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,120.75,69,,,percent of total billed charges,69% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,175,100,,,percent of total billed charges,100% of total billed charges,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,175,100,,,percent of total billed charges,100% of total billed charges,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.24,61.85,,,percent of total billed charges,61.85% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.12,130,,,Fee Schedule,130% of WA Medicaid ,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5932.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.5,78,,,percent of total billed charges,78% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.48,5932.5,
DRAIN/INJECT JOINT/BURSA,20600,CDM,983,RC,20600,HCPCS,Outpatient,,,80.97,52.63,,71.25,88,,,percent of total billed charges,88% of total Billed charges,3.4,100,,,Fee Schedule,100% of Medicare rate,20.14,100,,,Fee Schedule,100% of WA Medicaid,80.97,100,,,percent of total billed charges,100% of total billed charges,20.74,103,,,Fee Schedule,103% of WA Medicaid,3.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,55.87,69,,,percent of total billed charges,69% of total billed charges,80.97,100,,,percent of total billed charges,100% of total billed charges,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.97,100,,,percent of total billed charges,100% of total billed charges,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.97,100,,,percent of total billed charges,100% of total billed charges,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.08,61.85,,,percent of total billed charges,61.85% of total billed charges,20.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.18,130,,,Fee Schedule,130% of WA Medicaid ,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.53,37.7,,,percent of total billed charges,37.70% of total billed charges,30.53,37.7,,,percent of total billed charges,37.70% of total billed charges,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2744.88,33.9,,,percent of total billed charges,33.9% of total billed charges,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.16,78,,,percent of total billed charges,78% of total billed charges,80.97,100,,,percent of total billed charges,100% of total billed charges,66.88,82.6,,,percent of total billed charges,82.6% of total billed charges,66.88,82.6,,,percent of total billed charges,82.6% of total billed charges,20.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.4,2744.88,
DRAIN/INJ JOINT/BURSA W/US,20606,CDM,983,RC,20606,HCPCS,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,4.92,100,,,Fee Schedule,100% of Medicare rate,29.28,100,,,Fee Schedule,100% of WA Medicaid,220,100,,,percent of total billed charges,100% of total billed charges,30.16,103,,,Fee Schedule,103% of WA Medicaid,4.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,220,100,,,percent of total billed charges,100% of total billed charges,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,220,100,,,percent of total billed charges,100% of total billed charges,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.07,61.85,,,percent of total billed charges,61.85% of total billed charges,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,38.06,130,,,Fee Schedule,130% of WA Medicaid ,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,7458,33.9,,,percent of total billed charges,33.9% of total billed charges,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.92,7458,
DRAIN/INJ JOINT/BURSA W/US,20604,CDM,983,RC,20604,HCPCS,Outpatient,,,199,129.35,,175.12,88,,,percent of total billed charges,88% of total Billed charges,3.95,100,,,Fee Schedule,100% of Medicare rate,25.74,100,,,Fee Schedule,100% of WA Medicaid,199,100,,,percent of total billed charges,100% of total billed charges,26.51,103,,,Fee Schedule,103% of WA Medicaid,3.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,137.31,69,,,percent of total billed charges,69% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,199,100,,,percent of total billed charges,100% of total billed charges,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,199,100,,,percent of total billed charges,100% of total billed charges,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.08,61.85,,,percent of total billed charges,61.85% of total billed charges,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.46,130,,,Fee Schedule,130% of WA Medicaid ,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.02,37.7,,,percent of total billed charges,37.70% of total billed charges,75.02,37.7,,,percent of total billed charges,37.70% of total billed charges,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,6746.1,33.9,,,percent of total billed charges,33.9% of total billed charges,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.22,78,,,percent of total billed charges,78% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.95,6746.1,
DRAIN/INJECT JOINT/BURSA,20605,CDM,983,RC,20605,HCPCS,Outpatient,,,83.77,54.45,,73.72,88,,,percent of total billed charges,88% of total Billed charges,3.43,100,,,Fee Schedule,100% of Medicare rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,83.77,100,,,percent of total billed charges,100% of total billed charges,21.52,103,,,Fee Schedule,103% of WA Medicaid,3.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,57.8,69,,,percent of total billed charges,69% of total billed charges,83.77,100,,,percent of total billed charges,100% of total billed charges,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.77,100,,,percent of total billed charges,100% of total billed charges,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.77,100,,,percent of total billed charges,100% of total billed charges,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.81,61.85,,,percent of total billed charges,61.85% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.16,130,,,Fee Schedule,130% of WA Medicaid ,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.58,37.7,,,percent of total billed charges,37.70% of total billed charges,31.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2839.8,33.9,,,percent of total billed charges,33.9% of total billed charges,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.34,78,,,percent of total billed charges,78% of total billed charges,83.77,100,,,percent of total billed charges,100% of total billed charges,69.19,82.6,,,percent of total billed charges,82.6% of total billed charges,69.19,82.6,,,percent of total billed charges,82.6% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.43,2839.8,
ASPIRATE/INJ GANGLION CYST,20612,CDM,983,RC,20612,HCPCS,Outpatient,,,161,104.65,,141.68,88,,,percent of total billed charges,88% of total Billed charges,3.83,100,,,Fee Schedule,100% of Medicare rate,23.31,100,,,Fee Schedule,100% of WA Medicaid,161,100,,,percent of total billed charges,100% of total billed charges,24.01,103,,,Fee Schedule,103% of WA Medicaid,3.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,111.09,69,,,percent of total billed charges,69% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,161,100,,,percent of total billed charges,100% of total billed charges,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,161,100,,,percent of total billed charges,100% of total billed charges,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.58,61.85,,,percent of total billed charges,61.85% of total billed charges,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.3,130,,,Fee Schedule,130% of WA Medicaid ,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.7,37.7,,,percent of total billed charges,37.70% of total billed charges,60.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,5457.9,33.9,,,percent of total billed charges,33.9% of total billed charges,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.58,78,,,percent of total billed charges,78% of total billed charges,161,100,,,percent of total billed charges,100% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,132.99,82.6,,,percent of total billed charges,82.6% of total billed charges,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.83,5457.9,
DRAIN/INJECT JOINT/BURSA,20610,CDM,983,RC,20610,HCPCS,Outpatient,,,100.17,65.11,,88.15,88,,,percent of total billed charges,88% of total Billed charges,4.73,100,,,Fee Schedule,100% of Medicare rate,25.74,100,,,Fee Schedule,100% of WA Medicaid,100.17,100,,,percent of total billed charges,100% of total billed charges,26.51,103,,,Fee Schedule,103% of WA Medicaid,4.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,69.12,69,,,percent of total billed charges,69% of total billed charges,100.17,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.17,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.17,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.96,61.85,,,percent of total billed charges,61.85% of total billed charges,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.46,130,,,Fee Schedule,130% of WA Medicaid ,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.76,37.7,,,percent of total billed charges,37.70% of total billed charges,37.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3395.76,33.9,,,percent of total billed charges,33.9% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.13,78,,,percent of total billed charges,78% of total billed charges,100.17,100,,,percent of total billed charges,100% of total billed charges,82.74,82.6,,,percent of total billed charges,82.6% of total billed charges,82.74,82.6,,,percent of total billed charges,82.6% of total billed charges,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.73,3395.76,
DRAIN/INJ JOINT/BURSA W/US,20611,CDM,983,RC,20611,HCPCS,Outpatient,,,252,163.80,,221.76,88,,,percent of total billed charges,88% of total Billed charges,5.65,100,,,Fee Schedule,100% of Medicare rate,33.2,100,,,Fee Schedule,100% of WA Medicaid,252,100,,,percent of total billed charges,100% of total billed charges,34.2,103,,,Fee Schedule,103% of WA Medicaid,5.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,173.88,69,,,percent of total billed charges,69% of total billed charges,252,100,,,percent of total billed charges,100% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,252,100,,,percent of total billed charges,100% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,252,100,,,percent of total billed charges,100% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.86,61.85,,,percent of total billed charges,61.85% of total billed charges,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.16,130,,,Fee Schedule,130% of WA Medicaid ,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,95,37.7,,,percent of total billed charges,37.70% of total billed charges,95,37.7,,,percent of total billed charges,37.70% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,8542.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.56,78,,,percent of total billed charges,78% of total billed charges,252,100,,,percent of total billed charges,100% of total billed charges,208.15,82.6,,,percent of total billed charges,82.6% of total billed charges,208.15,82.6,,,percent of total billed charges,82.6% of total billed charges,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.65,8542.8,
TREATMENT OF BONE CYST,20615,CDM,983,RC,20615,HCPCS,Outpatient,,,526,341.90,,462.88,88,,,percent of total billed charges,88% of total Billed charges,13.24,100,,,Fee Schedule,100% of Medicare rate,94,100,,,Fee Schedule,100% of WA Medicaid,526,100,,,percent of total billed charges,100% of total billed charges,96.82,103,,,Fee Schedule,103% of WA Medicaid,13.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,362.94,69,,,percent of total billed charges,69% of total billed charges,526,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,526,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,526,100,,,percent of total billed charges,100% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.33,61.85,,,percent of total billed charges,61.85% of total billed charges,94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,122.2,130,,,Fee Schedule,130% of WA Medicaid ,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.3,37.7,,,percent of total billed charges,37.70% of total billed charges,198.3,37.7,,,percent of total billed charges,37.70% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,17831.4,33.9,,,percent of total billed charges,33.9% of total billed charges,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.28,78,,,percent of total billed charges,78% of total billed charges,526,100,,,percent of total billed charges,100% of total billed charges,434.48,82.6,,,percent of total billed charges,82.6% of total billed charges,434.48,82.6,,,percent of total billed charges,82.6% of total billed charges,94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.24,17831.4,
APPLY REM FIXATION DEVICE,20660,CDM,983,RC,20660,HCPCS,Outpatient,,,1672,1086.80,,1471.36,88,,,percent of total billed charges,88% of total Billed charges,40.24,100,,,Fee Schedule,100% of Medicare rate,132.97,100,,,Fee Schedule,100% of WA Medicaid,1672,100,,,percent of total billed charges,100% of total billed charges,136.96,103,,,Fee Schedule,103% of WA Medicaid,40.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,132.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1153.68,69,,,percent of total billed charges,69% of total billed charges,1672,100,,,percent of total billed charges,100% of total billed charges,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1672,100,,,percent of total billed charges,100% of total billed charges,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1672,100,,,percent of total billed charges,100% of total billed charges,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034.13,61.85,,,percent of total billed charges,61.85% of total billed charges,132.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,172.86,130,,,Fee Schedule,130% of WA Medicaid ,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,630.34,37.7,,,percent of total billed charges,37.70% of total billed charges,630.34,37.7,,,percent of total billed charges,37.70% of total billed charges,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,56680.8,33.9,,,percent of total billed charges,33.9% of total billed charges,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1304.16,78,,,percent of total billed charges,78% of total billed charges,1672,100,,,percent of total billed charges,100% of total billed charges,1381.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1381.07,82.6,,,percent of total billed charges,82.6% of total billed charges,132.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.24,56680.8,
REMOVAL OF FIXATION DEVICE,20665,CDM,983,RC,20665,HCPCS,Outpatient,,,392,254.80,,344.96,88,,,percent of total billed charges,88% of total Billed charges,5.84,100,,,Fee Schedule,100% of Medicare rate,56.88,100,,,Fee Schedule,100% of WA Medicaid,392,100,,,percent of total billed charges,100% of total billed charges,58.59,103,,,Fee Schedule,103% of WA Medicaid,5.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,270.48,69,,,percent of total billed charges,69% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,392,100,,,percent of total billed charges,100% of total billed charges,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,392,100,,,percent of total billed charges,100% of total billed charges,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.45,61.85,,,percent of total billed charges,61.85% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,73.94,130,,,Fee Schedule,130% of WA Medicaid ,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.78,37.7,,,percent of total billed charges,37.70% of total billed charges,147.78,37.7,,,percent of total billed charges,37.70% of total billed charges,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,13288.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.76,78,,,percent of total billed charges,78% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.84,13288.8,
APPLICATION OF HEAD BRACE,20661,CDM,983,RC,20661,HCPCS,Outpatient,,,1557,1012.05,,1370.16,88,,,percent of total billed charges,88% of total Billed charges,64.31,100,,,Fee Schedule,100% of Medicare rate,306.42,100,,,Fee Schedule,100% of WA Medicaid,1557,100,,,percent of total billed charges,100% of total billed charges,315.61,103,,,Fee Schedule,103% of WA Medicaid,64.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,306.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1074.33,69,,,percent of total billed charges,69% of total billed charges,1557,100,,,percent of total billed charges,100% of total billed charges,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1557,100,,,percent of total billed charges,100% of total billed charges,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1557,100,,,percent of total billed charges,100% of total billed charges,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,963,61.85,,,percent of total billed charges,61.85% of total billed charges,306.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,398.35,130,,,Fee Schedule,130% of WA Medicaid ,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,586.99,37.7,,,percent of total billed charges,37.70% of total billed charges,586.99,37.7,,,percent of total billed charges,37.70% of total billed charges,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,52782.3,33.9,,,percent of total billed charges,33.9% of total billed charges,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1214.46,78,,,percent of total billed charges,78% of total billed charges,1557,100,,,percent of total billed charges,100% of total billed charges,1286.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1286.08,82.6,,,percent of total billed charges,82.6% of total billed charges,306.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.31,52782.3,
REMOVAL OF SUPPORT IMPLANT,20670,CDM,983,RC,20670,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,11.43,100,,,Fee Schedule,100% of Medicare rate,84.48,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,87.01,103,,,Fee Schedule,103% of WA Medicaid,11.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,84.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.72,61.85,,,percent of total billed charges,61.85% of total billed charges,84.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,109.82,130,,,Fee Schedule,130% of WA Medicaid ,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,17085.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,84.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.43,17085.6,
REMOVAL OF SUPPORT IMPLANT,20680,CDM,983,RC,20680,HCPCS,Outpatient,,,1232,800.80,,1084.16,88,,,percent of total billed charges,88% of total Billed charges,40.25,100,,,Fee Schedule,100% of Medicare rate,242.45,100,,,Fee Schedule,100% of WA Medicaid,1232,100,,,percent of total billed charges,100% of total billed charges,249.72,103,,,Fee Schedule,103% of WA Medicaid,40.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,242.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,850.08,69,,,percent of total billed charges,69% of total billed charges,1232,100,,,percent of total billed charges,100% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1232,100,,,percent of total billed charges,100% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1232,100,,,percent of total billed charges,100% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,761.99,61.85,,,percent of total billed charges,61.85% of total billed charges,242.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,315.19,130,,,Fee Schedule,130% of WA Medicaid ,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.46,37.7,,,percent of total billed charges,37.70% of total billed charges,464.46,37.7,,,percent of total billed charges,37.70% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,41764.8,33.9,,,percent of total billed charges,33.9% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,960.96,78,,,percent of total billed charges,78% of total billed charges,1232,100,,,percent of total billed charges,100% of total billed charges,1017.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1017.63,82.6,,,percent of total billed charges,82.6% of total billed charges,242.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.25,41764.8,
APPLY BONE FIXATION DEVICE,20692,CDM,983,RC,20692,HCPCS,Outpatient,,,3086,2005.90,,2715.68,88,,,percent of total billed charges,88% of total Billed charges,108.9,100,,,Fee Schedule,100% of Medicare rate,649.95,100,,,Fee Schedule,100% of WA Medicaid,3086,100,,,percent of total billed charges,100% of total billed charges,669.45,103,,,Fee Schedule,103% of WA Medicaid,108.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,190.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,649.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2129.34,69,,,percent of total billed charges,69% of total billed charges,3086,100,,,percent of total billed charges,100% of total billed charges,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,3086,100,,,percent of total billed charges,100% of total billed charges,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,3086,100,,,percent of total billed charges,100% of total billed charges,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1908.69,61.85,,,percent of total billed charges,61.85% of total billed charges,649.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,649.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,662.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,844.94,130,,,Fee Schedule,130% of WA Medicaid ,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163.42,37.7,,,percent of total billed charges,37.70% of total billed charges,1163.42,37.7,,,percent of total billed charges,37.70% of total billed charges,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,104615.4,33.9,,,percent of total billed charges,33.9% of total billed charges,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2407.08,78,,,percent of total billed charges,78% of total billed charges,3086,100,,,percent of total billed charges,100% of total billed charges,2549.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2549.04,82.6,,,percent of total billed charges,82.6% of total billed charges,649.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,108.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,649.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.9,104615.4,
APPLY BONE FIXATION DEVICE,20690,CDM,983,RC,20690,HCPCS,Outpatient,,,1436,933.40,,1263.68,88,,,percent of total billed charges,88% of total Billed charges,62.66,100,,,Fee Schedule,100% of Medicare rate,342.6,100,,,Fee Schedule,100% of WA Medicaid,1436,100,,,percent of total billed charges,100% of total billed charges,352.88,103,,,Fee Schedule,103% of WA Medicaid,62.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,342.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,990.84,69,,,percent of total billed charges,69% of total billed charges,1436,100,,,percent of total billed charges,100% of total billed charges,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1436,100,,,percent of total billed charges,100% of total billed charges,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1436,100,,,percent of total billed charges,100% of total billed charges,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,888.17,61.85,,,percent of total billed charges,61.85% of total billed charges,342.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,445.38,130,,,Fee Schedule,130% of WA Medicaid ,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.37,37.7,,,percent of total billed charges,37.70% of total billed charges,541.37,37.7,,,percent of total billed charges,37.70% of total billed charges,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,48680.4,33.9,,,percent of total billed charges,33.9% of total billed charges,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1120.08,78,,,percent of total billed charges,78% of total billed charges,1436,100,,,percent of total billed charges,100% of total billed charges,1186.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.14,82.6,,,percent of total billed charges,82.6% of total billed charges,342.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.66,48680.4,
ADJUST BONE FIXATION DEVICE,20693,CDM,983,RC,20693,HCPCS,Outpatient,,,1567,1018.55,,1378.96,88,,,percent of total billed charges,88% of total Billed charges,40.13,100,,,Fee Schedule,100% of Medicare rate,260.17,100,,,Fee Schedule,100% of WA Medicaid,1567,100,,,percent of total billed charges,100% of total billed charges,267.98,103,,,Fee Schedule,103% of WA Medicaid,40.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,260.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1081.23,69,,,percent of total billed charges,69% of total billed charges,1567,100,,,percent of total billed charges,100% of total billed charges,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1567,100,,,percent of total billed charges,100% of total billed charges,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1567,100,,,percent of total billed charges,100% of total billed charges,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,969.19,61.85,,,percent of total billed charges,61.85% of total billed charges,260.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,338.22,130,,,Fee Schedule,130% of WA Medicaid ,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.76,37.7,,,percent of total billed charges,37.70% of total billed charges,590.76,37.7,,,percent of total billed charges,37.70% of total billed charges,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,53121.3,33.9,,,percent of total billed charges,33.9% of total billed charges,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1222.26,78,,,percent of total billed charges,78% of total billed charges,1567,100,,,percent of total billed charges,100% of total billed charges,1294.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1294.34,82.6,,,percent of total billed charges,82.6% of total billed charges,260.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.13,53121.3,
REMOVE BONE FIXATION DEVICE,20694,CDM,983,RC,20694,HCPCS,Outpatient,,,1201,780.65,,1056.88,88,,,percent of total billed charges,88% of total Billed charges,30.73,100,,,Fee Schedule,100% of Medicare rate,200.11,100,,,Fee Schedule,100% of WA Medicaid,1201,100,,,percent of total billed charges,100% of total billed charges,206.11,103,,,Fee Schedule,103% of WA Medicaid,30.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,828.69,69,,,percent of total billed charges,69% of total billed charges,1201,100,,,percent of total billed charges,100% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1201,100,,,percent of total billed charges,100% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1201,100,,,percent of total billed charges,100% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,742.82,61.85,,,percent of total billed charges,61.85% of total billed charges,200.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,260.14,130,,,Fee Schedule,130% of WA Medicaid ,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.78,37.7,,,percent of total billed charges,37.70% of total billed charges,452.78,37.7,,,percent of total billed charges,37.70% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,40713.9,33.9,,,percent of total billed charges,33.9% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,936.78,78,,,percent of total billed charges,78% of total billed charges,1201,100,,,percent of total billed charges,100% of total billed charges,992.03,82.6,,,percent of total billed charges,82.6% of total billed charges,992.03,82.6,,,percent of total billed charges,82.6% of total billed charges,200.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.73,40713.9,
REPLANTATION THUMB COMPLETE,20827,CDM,983,RC,20827,HCPCS,Outpatient,,,7590,4933.50,,6679.2,88,,,percent of total billed charges,88% of total Billed charges,201.85,100,,,Fee Schedule,100% of Medicare rate,1034.33,100,,,Fee Schedule,100% of WA Medicaid,7590,100,,,percent of total billed charges,100% of total billed charges,1065.36,103,,,Fee Schedule,103% of WA Medicaid,201.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,353.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1034.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5237.1,69,,,percent of total billed charges,69% of total billed charges,7590,100,,,percent of total billed charges,100% of total billed charges,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,7590,100,,,percent of total billed charges,100% of total billed charges,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,7590,100,,,percent of total billed charges,100% of total billed charges,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,4694.42,61.85,,,percent of total billed charges,61.85% of total billed charges,1034.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1055.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1344.63,130,,,Fee Schedule,130% of WA Medicaid ,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2861.43,37.7,,,percent of total billed charges,37.70% of total billed charges,2861.43,37.7,,,percent of total billed charges,37.70% of total billed charges,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,257301,33.9,,,percent of total billed charges,33.9% of total billed charges,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,5920.2,78,,,percent of total billed charges,78% of total billed charges,7590,100,,,percent of total billed charges,100% of total billed charges,6269.34,82.6,,,percent of total billed charges,82.6% of total billed charges,6269.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1034.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,201.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,201.85,257301,
REMOVAL OF BONE FOR GRAFT,20900,CDM,983,RC,20900,HCPCS,Outpatient,,,1272,826.80,,1119.36,88,,,percent of total billed charges,88% of total Billed charges,18.35,100,,,Fee Schedule,100% of Medicare rate,102.02,100,,,Fee Schedule,100% of WA Medicaid,1272,100,,,percent of total billed charges,100% of total billed charges,105.08,103,,,Fee Schedule,103% of WA Medicaid,18.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,877.68,69,,,percent of total billed charges,69% of total billed charges,1272,100,,,percent of total billed charges,100% of total billed charges,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272,100,,,percent of total billed charges,100% of total billed charges,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272,100,,,percent of total billed charges,100% of total billed charges,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.73,61.85,,,percent of total billed charges,61.85% of total billed charges,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.63,130,,,Fee Schedule,130% of WA Medicaid ,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.54,37.7,,,percent of total billed charges,37.70% of total billed charges,479.54,37.7,,,percent of total billed charges,37.70% of total billed charges,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,43120.8,33.9,,,percent of total billed charges,33.9% of total billed charges,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,992.16,78,,,percent of total billed charges,78% of total billed charges,1272,100,,,percent of total billed charges,100% of total billed charges,1050.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1050.67,82.6,,,percent of total billed charges,82.6% of total billed charges,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.35,43120.8,
REMOVAL OF BONE FOR GRAFT,20902,CDM,983,RC,20902,HCPCS,Outpatient,,,1910,1241.50,,1680.8,88,,,percent of total billed charges,88% of total Billed charges,30.23,100,,,Fee Schedule,100% of Medicare rate,154.98,100,,,Fee Schedule,100% of WA Medicaid,1910,100,,,percent of total billed charges,100% of total billed charges,159.63,103,,,Fee Schedule,103% of WA Medicaid,30.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,154.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1317.9,69,,,percent of total billed charges,69% of total billed charges,1910,100,,,percent of total billed charges,100% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1910,100,,,percent of total billed charges,100% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1910,100,,,percent of total billed charges,100% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1181.34,61.85,,,percent of total billed charges,61.85% of total billed charges,154.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,201.47,130,,,Fee Schedule,130% of WA Medicaid ,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,720.07,37.7,,,percent of total billed charges,37.70% of total billed charges,720.07,37.7,,,percent of total billed charges,37.70% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,64749,33.9,,,percent of total billed charges,33.9% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1489.8,78,,,percent of total billed charges,78% of total billed charges,1910,100,,,percent of total billed charges,100% of total billed charges,1577.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1577.66,82.6,,,percent of total billed charges,82.6% of total billed charges,154.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.23,64749,
REMOVAL OF FASCIA FOR GRAFT,20922,CDM,983,RC,20922,HCPCS,Outpatient,,,1529,993.85,,1345.52,88,,,percent of total billed charges,88% of total Billed charges,55.82,100,,,Fee Schedule,100% of Medicare rate,286.84,100,,,Fee Schedule,100% of WA Medicaid,1529,100,,,percent of total billed charges,100% of total billed charges,295.45,103,,,Fee Schedule,103% of WA Medicaid,55.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,286.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1055.01,69,,,percent of total billed charges,69% of total billed charges,1529,100,,,percent of total billed charges,100% of total billed charges,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1529,100,,,percent of total billed charges,100% of total billed charges,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1529,100,,,percent of total billed charges,100% of total billed charges,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,945.69,61.85,,,percent of total billed charges,61.85% of total billed charges,286.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,372.89,130,,,Fee Schedule,130% of WA Medicaid ,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,576.43,37.7,,,percent of total billed charges,37.70% of total billed charges,576.43,37.7,,,percent of total billed charges,37.70% of total billed charges,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,51833.1,33.9,,,percent of total billed charges,33.9% of total billed charges,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1192.62,78,,,percent of total billed charges,78% of total billed charges,1529,100,,,percent of total billed charges,100% of total billed charges,1262.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1262.95,82.6,,,percent of total billed charges,82.6% of total billed charges,286.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.82,51833.1,
SP BONE ALGRFT MORSEL ADD-ON,20930,CDM,983,RC,20930,HCPCS,Outpatient,,,598,388.70,,526.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,598,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,412.62,69,,,percent of total billed charges,69% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,598,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,598,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,369.86,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,20272.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,466.44,78,,,percent of total billed charges,78% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",225.45,20272.2,
SP BONE AGRFT STRUCT ADD-ON,20938,CDM,983,RC,20938,HCPCS,Outpatient,,,1181,767.65,,1039.28,88,,,percent of total billed charges,88% of total Billed charges,30.79,100,,,Fee Schedule,100% of Medicare rate,101.27,100,,,Fee Schedule,100% of WA Medicaid,1181,100,,,percent of total billed charges,100% of total billed charges,104.31,103,,,Fee Schedule,103% of WA Medicaid,30.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,101.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,814.89,69,,,percent of total billed charges,69% of total billed charges,1181,100,,,percent of total billed charges,100% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1181,100,,,percent of total billed charges,100% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1181,100,,,percent of total billed charges,100% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.45,61.85,,,percent of total billed charges,61.85% of total billed charges,101.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,131.65,130,,,Fee Schedule,130% of WA Medicaid ,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.24,37.7,,,percent of total billed charges,37.70% of total billed charges,445.24,37.7,,,percent of total billed charges,37.70% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,40035.9,33.9,,,percent of total billed charges,33.9% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,921.18,78,,,percent of total billed charges,78% of total billed charges,1181,100,,,percent of total billed charges,100% of total billed charges,975.51,82.6,,,percent of total billed charges,82.6% of total billed charges,975.51,82.6,,,percent of total billed charges,82.6% of total billed charges,101.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.79,40035.9,
SP BONE AGRFT LOCAL ADD-ON,20936,CDM,983,RC,20936,HCPCS,Outpatient,,,823,534.95,,724.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,823,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,567.87,69,,,percent of total billed charges,69% of total billed charges,823,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,823,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,823,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,509.03,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,310.27,37.7,,,percent of total billed charges,37.70% of total billed charges,310.27,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,27899.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,641.94,78,,,percent of total billed charges,78% of total billed charges,823,100,,,percent of total billed charges,100% of total billed charges,679.8,82.6,,,percent of total billed charges,82.6% of total billed charges,679.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",310.27,27899.7,
SP BONE ALGRFT STRUCT ADD-ON,20931,CDM,983,RC,20931,HCPCS,Outpatient,,,699,454.35,,615.12,88,,,percent of total billed charges,88% of total Billed charges,18.53,100,,,Fee Schedule,100% of Medicare rate,60.99,100,,,Fee Schedule,100% of WA Medicaid,699,100,,,percent of total billed charges,100% of total billed charges,62.82,103,,,Fee Schedule,103% of WA Medicaid,18.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,482.31,69,,,percent of total billed charges,69% of total billed charges,699,100,,,percent of total billed charges,100% of total billed charges,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,699,100,,,percent of total billed charges,100% of total billed charges,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,699,100,,,percent of total billed charges,100% of total billed charges,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.33,61.85,,,percent of total billed charges,61.85% of total billed charges,60.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.29,130,,,Fee Schedule,130% of WA Medicaid ,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.52,37.7,,,percent of total billed charges,37.70% of total billed charges,263.52,37.7,,,percent of total billed charges,37.70% of total billed charges,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,23696.1,33.9,,,percent of total billed charges,33.9% of total billed charges,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.22,78,,,percent of total billed charges,78% of total billed charges,699,100,,,percent of total billed charges,100% of total billed charges,577.37,82.6,,,percent of total billed charges,82.6% of total billed charges,577.37,82.6,,,percent of total billed charges,82.6% of total billed charges,60.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.53,23696.1,
SP BONE AGRFT MORSEL ADD-ON,20937,CDM,983,RC,20937,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,25.64,100,,,Fee Schedule,100% of Medicare rate,92.32,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,95.09,103,,,Fee Schedule,103% of WA Medicaid,25.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,92.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.72,61.85,,,percent of total billed charges,61.85% of total billed charges,92.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,120.02,130,,,Fee Schedule,130% of WA Medicaid ,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,17085.6,33.9,,,percent of total billed charges,33.9% of total billed charges,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,92.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.64,17085.6,
20939 Bone Marrow Aspir Bone Grfg,20939,CDM,983,RC,20939,HCPCS,Outpatient,,,416,270.40,,366.08,88,,,percent of total billed charges,88% of total Billed charges,10.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,416,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,10.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,287.04,69,,,percent of total billed charges,69% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,416,100,,,percent of total billed charges,100% of total billed charges,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,416,100,,,percent of total billed charges,100% of total billed charges,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.3,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,14102.4,33.9,,,percent of total billed charges,33.9% of total billed charges,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.48,78,,,percent of total billed charges,78% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",10.86,14102.4,
FLUID PRESSURE MUSCLE,20950,CDM,983,RC,20950,HCPCS,Outpatient,,,404,262.60,,355.52,88,,,percent of total billed charges,88% of total Billed charges,8.38,100,,,Fee Schedule,100% of Medicare rate,50.73,100,,,Fee Schedule,100% of WA Medicaid,404,100,,,percent of total billed charges,100% of total billed charges,52.25,103,,,Fee Schedule,103% of WA Medicaid,8.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,50.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,278.76,69,,,percent of total billed charges,69% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,404,100,,,percent of total billed charges,100% of total billed charges,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,404,100,,,percent of total billed charges,100% of total billed charges,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.87,61.85,,,percent of total billed charges,61.85% of total billed charges,50.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,65.95,130,,,Fee Schedule,130% of WA Medicaid ,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,13695.6,33.9,,,percent of total billed charges,33.9% of total billed charges,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.12,78,,,percent of total billed charges,78% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,50.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.38,13695.6,
ILIAC BONE GRAFT MICROVASC,20956,CDM,983,RC,20956,HCPCS,Outpatient,,,7632,4960.80,,6716.16,88,,,percent of total billed charges,88% of total Billed charges,299.45,100,,,Fee Schedule,100% of Medicare rate,1492.37,100,,,Fee Schedule,100% of WA Medicaid,7632,100,,,percent of total billed charges,100% of total billed charges,1537.14,103,,,Fee Schedule,103% of WA Medicaid,299.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,524.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1492.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5266.08,69,,,percent of total billed charges,69% of total billed charges,7632,100,,,percent of total billed charges,100% of total billed charges,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,7632,100,,,percent of total billed charges,100% of total billed charges,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,7632,100,,,percent of total billed charges,100% of total billed charges,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,4720.39,61.85,,,percent of total billed charges,61.85% of total billed charges,1492.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1492.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1522.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1940.08,130,,,Fee Schedule,130% of WA Medicaid ,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2877.26,37.7,,,percent of total billed charges,37.70% of total billed charges,2877.26,37.7,,,percent of total billed charges,37.70% of total billed charges,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,258724.8,33.9,,,percent of total billed charges,33.9% of total billed charges,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,5952.96,78,,,percent of total billed charges,78% of total billed charges,7632,100,,,percent of total billed charges,100% of total billed charges,6304.03,82.6,,,percent of total billed charges,82.6% of total billed charges,6304.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1492.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,299.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1492.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,299.45,258724.8,
CPTR-ASST DIR MS PX,20985,CDM,983,RC,20985,HCPCS,Outpatient,,,468,304.20,,411.84,88,,,percent of total billed charges,88% of total Billed charges,17.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,468,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,17.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,322.92,69,,,percent of total billed charges,69% of total billed charges,468,100,,,percent of total billed charges,100% of total billed charges,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,468,100,,,percent of total billed charges,100% of total billed charges,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,468,100,,,percent of total billed charges,100% of total billed charges,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.46,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.44,37.7,,,percent of total billed charges,37.70% of total billed charges,176.44,37.7,,,percent of total billed charges,37.70% of total billed charges,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,15865.2,33.9,,,percent of total billed charges,33.9% of total billed charges,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,365.04,78,,,percent of total billed charges,78% of total billed charges,468,100,,,percent of total billed charges,100% of total billed charges,386.57,82.6,,,percent of total billed charges,82.6% of total billed charges,386.57,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",17.49,15865.2,
RESECT FACE/SCALP TUM 2 CM/>,21016,CDM,983,RC,21016,HCPCS,Outpatient,,,2771,1801.15,,2438.48,88,,,percent of total billed charges,88% of total Billed charges,105.25,100,,,Fee Schedule,100% of Medicare rate,574.79,100,,,Fee Schedule,100% of WA Medicaid,2771,100,,,percent of total billed charges,100% of total billed charges,592.03,103,,,Fee Schedule,103% of WA Medicaid,105.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,184.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,574.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1911.99,69,,,percent of total billed charges,69% of total billed charges,2771,100,,,percent of total billed charges,100% of total billed charges,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2771,100,,,percent of total billed charges,100% of total billed charges,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2771,100,,,percent of total billed charges,100% of total billed charges,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1713.86,61.85,,,percent of total billed charges,61.85% of total billed charges,574.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,586.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,747.23,130,,,Fee Schedule,130% of WA Medicaid ,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1044.67,37.7,,,percent of total billed charges,37.70% of total billed charges,1044.67,37.7,,,percent of total billed charges,37.70% of total billed charges,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,93936.9,33.9,,,percent of total billed charges,33.9% of total billed charges,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2161.38,78,,,percent of total billed charges,78% of total billed charges,2771,100,,,percent of total billed charges,100% of total billed charges,2288.85,82.6,,,percent of total billed charges,82.6% of total billed charges,2288.85,82.6,,,percent of total billed charges,82.6% of total billed charges,574.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,105.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105.25,93936.9,
RESECT FACE/SCALP TUM < 2 CM,21015,CDM,983,RC,21015,HCPCS,Outpatient,,,1848,1201.20,,1626.24,88,,,percent of total billed charges,88% of total Billed charges,63.94,100,,,Fee Schedule,100% of Medicare rate,401.91,100,,,Fee Schedule,100% of WA Medicaid,1848,100,,,percent of total billed charges,100% of total billed charges,413.97,103,,,Fee Schedule,103% of WA Medicaid,63.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,111.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,401.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1275.12,69,,,percent of total billed charges,69% of total billed charges,1848,100,,,percent of total billed charges,100% of total billed charges,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1848,100,,,percent of total billed charges,100% of total billed charges,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1848,100,,,percent of total billed charges,100% of total billed charges,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1142.99,61.85,,,percent of total billed charges,61.85% of total billed charges,401.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.48,130,,,Fee Schedule,130% of WA Medicaid ,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.7,37.7,,,percent of total billed charges,37.70% of total billed charges,696.7,37.7,,,percent of total billed charges,37.70% of total billed charges,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,62647.2,33.9,,,percent of total billed charges,33.9% of total billed charges,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1441.44,78,,,percent of total billed charges,78% of total billed charges,1848,100,,,percent of total billed charges,100% of total billed charges,1526.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1526.45,82.6,,,percent of total billed charges,82.6% of total billed charges,401.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.94,62647.2,
EXC FACE LES SBQ 2 CM/<,21012,CDM,983,RC,21012,HCPCS,Outpatient,,,918,596.70,,807.84,88,,,percent of total billed charges,88% of total Billed charges,33.93,100,,,Fee Schedule,100% of Medicare rate,196.57,100,,,Fee Schedule,100% of WA Medicaid,918,100,,,percent of total billed charges,100% of total billed charges,202.47,103,,,Fee Schedule,103% of WA Medicaid,33.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,196.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,633.42,69,,,percent of total billed charges,69% of total billed charges,918,100,,,percent of total billed charges,100% of total billed charges,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,918,100,,,percent of total billed charges,100% of total billed charges,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,918,100,,,percent of total billed charges,100% of total billed charges,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.78,61.85,,,percent of total billed charges,61.85% of total billed charges,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,255.54,130,,,Fee Schedule,130% of WA Medicaid ,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.09,37.7,,,percent of total billed charges,37.70% of total billed charges,346.09,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,31120.2,33.9,,,percent of total billed charges,33.9% of total billed charges,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,716.04,78,,,percent of total billed charges,78% of total billed charges,918,100,,,percent of total billed charges,100% of total billed charges,758.27,82.6,,,percent of total billed charges,82.6% of total billed charges,758.27,82.6,,,percent of total billed charges,82.6% of total billed charges,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.93,31120.2,
EXC FACE LES SC <2 CM,21011,CDM,983,RC,21011,HCPCS,Outpatient,,,710,461.50,,624.8,88,,,percent of total billed charges,88% of total Billed charges,21.23,100,,,Fee Schedule,100% of Medicare rate,152.56,100,,,Fee Schedule,100% of WA Medicaid,710,100,,,percent of total billed charges,100% of total billed charges,157.14,103,,,Fee Schedule,103% of WA Medicaid,21.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,152.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,489.9,69,,,percent of total billed charges,69% of total billed charges,710,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,710,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,710,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.14,61.85,,,percent of total billed charges,61.85% of total billed charges,152.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,198.33,130,,,Fee Schedule,130% of WA Medicaid ,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.67,37.7,,,percent of total billed charges,37.70% of total billed charges,267.67,37.7,,,percent of total billed charges,37.70% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,24069,33.9,,,percent of total billed charges,33.9% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.8,78,,,percent of total billed charges,78% of total billed charges,710,100,,,percent of total billed charges,100% of total billed charges,586.46,82.6,,,percent of total billed charges,82.6% of total billed charges,586.46,82.6,,,percent of total billed charges,82.6% of total billed charges,152.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.23,24069,
EXC FACE TUM DEEP 2 CM/>,21014,CDM,983,RC,21014,HCPCS,Outpatient,,,1414,919.10,,1244.32,88,,,percent of total billed charges,88% of total Billed charges,50.86,100,,,Fee Schedule,100% of Medicare rate,301.2,100,,,Fee Schedule,100% of WA Medicaid,1414,100,,,percent of total billed charges,100% of total billed charges,310.24,103,,,Fee Schedule,103% of WA Medicaid,50.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,301.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,975.66,69,,,percent of total billed charges,69% of total billed charges,1414,100,,,percent of total billed charges,100% of total billed charges,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1414,100,,,percent of total billed charges,100% of total billed charges,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1414,100,,,percent of total billed charges,100% of total billed charges,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,874.56,61.85,,,percent of total billed charges,61.85% of total billed charges,301.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,391.56,130,,,Fee Schedule,130% of WA Medicaid ,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,533.08,37.7,,,percent of total billed charges,37.70% of total billed charges,533.08,37.7,,,percent of total billed charges,37.70% of total billed charges,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,47934.6,33.9,,,percent of total billed charges,33.9% of total billed charges,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1102.92,78,,,percent of total billed charges,78% of total billed charges,1414,100,,,percent of total billed charges,100% of total billed charges,1167.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1167.96,82.6,,,percent of total billed charges,82.6% of total billed charges,301.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.86,47934.6,
EXC FACE TUM DEEP < 2 CM,21013,CDM,983,RC,21013,HCPCS,Outpatient,,,1095,711.75,,963.6,88,,,percent of total billed charges,88% of total Billed charges,37.14,100,,,Fee Schedule,100% of Medicare rate,232.94,100,,,Fee Schedule,100% of WA Medicaid,1095,100,,,percent of total billed charges,100% of total billed charges,239.93,103,,,Fee Schedule,103% of WA Medicaid,37.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,232.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,755.55,69,,,percent of total billed charges,69% of total billed charges,1095,100,,,percent of total billed charges,100% of total billed charges,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1095,100,,,percent of total billed charges,100% of total billed charges,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1095,100,,,percent of total billed charges,100% of total billed charges,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.26,61.85,,,percent of total billed charges,61.85% of total billed charges,232.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,302.82,130,,,Fee Schedule,130% of WA Medicaid ,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.82,37.7,,,percent of total billed charges,37.70% of total billed charges,412.82,37.7,,,percent of total billed charges,37.70% of total billed charges,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,37120.5,33.9,,,percent of total billed charges,33.9% of total billed charges,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,854.1,78,,,percent of total billed charges,78% of total billed charges,1095,100,,,percent of total billed charges,100% of total billed charges,904.47,82.6,,,percent of total billed charges,82.6% of total billed charges,904.47,82.6,,,percent of total billed charges,82.6% of total billed charges,232.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.14,37120.5,
REMOVAL OF BENIGN TUMOR; FACIAL BONE,21029,CDM,983,RC,21029,HCPCS,Outpatient,,,1558,1012.70,,1371.04,88,,,percent of total billed charges,88% of total Billed charges,54.29,100,,,Fee Schedule,100% of Medicare rate,361.81,100,,,Fee Schedule,100% of WA Medicaid,1558,100,,,percent of total billed charges,100% of total billed charges,372.66,103,,,Fee Schedule,103% of WA Medicaid,54.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,361.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1075.02,69,,,percent of total billed charges,69% of total billed charges,1558,100,,,percent of total billed charges,100% of total billed charges,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1558,100,,,percent of total billed charges,100% of total billed charges,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1558,100,,,percent of total billed charges,100% of total billed charges,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,963.62,61.85,,,percent of total billed charges,61.85% of total billed charges,361.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,470.35,130,,,Fee Schedule,130% of WA Medicaid ,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,587.37,37.7,,,percent of total billed charges,37.70% of total billed charges,587.37,37.7,,,percent of total billed charges,37.70% of total billed charges,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,52816.2,33.9,,,percent of total billed charges,33.9% of total billed charges,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1215.24,78,,,percent of total billed charges,78% of total billed charges,1558,100,,,percent of total billed charges,100% of total billed charges,1286.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1286.91,82.6,,,percent of total billed charges,82.6% of total billed charges,361.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.29,52816.2,
EXCISE MAX/ZYGOMA B9 TUMOR,21030,CDM,983,RC,21030,HCPCS,Outpatient,,,1458,947.70,,1283.04,88,,,percent of total billed charges,88% of total Billed charges,23.44,100,,,Fee Schedule,100% of Medicare rate,209.44,100,,,Fee Schedule,100% of WA Medicaid,1458,100,,,percent of total billed charges,100% of total billed charges,215.72,103,,,Fee Schedule,103% of WA Medicaid,23.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,209.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1006.02,69,,,percent of total billed charges,69% of total billed charges,1458,100,,,percent of total billed charges,100% of total billed charges,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1458,100,,,percent of total billed charges,100% of total billed charges,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1458,100,,,percent of total billed charges,100% of total billed charges,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,901.77,61.85,,,percent of total billed charges,61.85% of total billed charges,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,272.27,130,,,Fee Schedule,130% of WA Medicaid ,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.67,37.7,,,percent of total billed charges,37.70% of total billed charges,549.67,37.7,,,percent of total billed charges,37.70% of total billed charges,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,49426.2,33.9,,,percent of total billed charges,33.9% of total billed charges,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1137.24,78,,,percent of total billed charges,78% of total billed charges,1458,100,,,percent of total billed charges,100% of total billed charges,1204.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1204.31,82.6,,,percent of total billed charges,82.6% of total billed charges,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.44,49426.2,
EXCISE MANDIBLE LESION,21040,CDM,983,RC,21040,HCPCS,Outpatient,,,1131,735.15,,995.28,88,,,percent of total billed charges,88% of total Billed charges,23.48,100,,,Fee Schedule,100% of Medicare rate,210.19,100,,,Fee Schedule,100% of WA Medicaid,1131,100,,,percent of total billed charges,100% of total billed charges,216.5,103,,,Fee Schedule,103% of WA Medicaid,23.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,210.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,780.39,69,,,percent of total billed charges,69% of total billed charges,1131,100,,,percent of total billed charges,100% of total billed charges,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131,100,,,percent of total billed charges,100% of total billed charges,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131,100,,,percent of total billed charges,100% of total billed charges,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.52,61.85,,,percent of total billed charges,61.85% of total billed charges,210.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,273.25,130,,,Fee Schedule,130% of WA Medicaid ,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.39,37.7,,,percent of total billed charges,37.70% of total billed charges,426.39,37.7,,,percent of total billed charges,37.70% of total billed charges,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,38340.9,33.9,,,percent of total billed charges,33.9% of total billed charges,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,882.18,78,,,percent of total billed charges,78% of total billed charges,1131,100,,,percent of total billed charges,100% of total billed charges,934.21,82.6,,,percent of total billed charges,82.6% of total billed charges,934.21,82.6,,,percent of total billed charges,82.6% of total billed charges,210.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.48,38340.9,
RECONSTRUCT ORBIT/FOREHEAD,21172,CDM,983,RC,21172,HCPCS,Outpatient,,,5335,3467.75,,4694.8,88,,,percent of total billed charges,88% of total Billed charges,367.85,100,,,Fee Schedule,100% of Medicare rate,1195.28,100,,,Fee Schedule,100% of WA Medicaid,5335,100,,,percent of total billed charges,100% of total billed charges,1231.14,103,,,Fee Schedule,103% of WA Medicaid,367.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,643.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1195.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3681.15,69,,,percent of total billed charges,69% of total billed charges,5335,100,,,percent of total billed charges,100% of total billed charges,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,5335,100,,,percent of total billed charges,100% of total billed charges,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,5335,100,,,percent of total billed charges,100% of total billed charges,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,3299.7,61.85,,,percent of total billed charges,61.85% of total billed charges,1195.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1195.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1219.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1553.86,130,,,Fee Schedule,130% of WA Medicaid ,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2011.3,37.7,,,percent of total billed charges,37.70% of total billed charges,2011.3,37.7,,,percent of total billed charges,37.70% of total billed charges,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,180856.5,33.9,,,percent of total billed charges,33.9% of total billed charges,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,4161.3,78,,,percent of total billed charges,78% of total billed charges,5335,100,,,percent of total billed charges,100% of total billed charges,4406.71,82.6,,,percent of total billed charges,82.6% of total billed charges,4406.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1195.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,367.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1195.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,367.85,180856.5,
RECONSTRUCTION OF ORBIT,21256,CDM,983,RC,21256,HCPCS,Outpatient,,,6496,4222.40,,5716.48,88,,,percent of total billed charges,88% of total Billed charges,122.15,100,,,Fee Schedule,100% of Medicare rate,709.45,100,,,Fee Schedule,100% of WA Medicaid,6496,100,,,percent of total billed charges,100% of total billed charges,730.73,103,,,Fee Schedule,103% of WA Medicaid,122.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,213.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,709.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4482.24,69,,,percent of total billed charges,69% of total billed charges,6496,100,,,percent of total billed charges,100% of total billed charges,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,6496,100,,,percent of total billed charges,100% of total billed charges,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,6496,100,,,percent of total billed charges,100% of total billed charges,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,4017.78,61.85,,,percent of total billed charges,61.85% of total billed charges,709.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,922.29,130,,,Fee Schedule,130% of WA Medicaid ,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2448.99,37.7,,,percent of total billed charges,37.70% of total billed charges,2448.99,37.7,,,percent of total billed charges,37.70% of total billed charges,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,220214.4,33.9,,,percent of total billed charges,33.9% of total billed charges,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,5066.88,78,,,percent of total billed charges,78% of total billed charges,6496,100,,,percent of total billed charges,100% of total billed charges,5365.7,82.6,,,percent of total billed charges,82.6% of total billed charges,5365.7,82.6,,,percent of total billed charges,82.6% of total billed charges,709.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,122.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,122.15,220214.4,
CLOSED TX NOSE FX W/O STABLJ,21315,CDM,983,RC,21315,HCPCS,Outpatient,,,548,356.20,,482.24,88,,,percent of total billed charges,88% of total Billed charges,5.94,100,,,Fee Schedule,100% of Medicare rate,33.94,100,,,Fee Schedule,100% of WA Medicaid,548,100,,,percent of total billed charges,100% of total billed charges,34.96,103,,,Fee Schedule,103% of WA Medicaid,5.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,378.12,69,,,percent of total billed charges,69% of total billed charges,548,100,,,percent of total billed charges,100% of total billed charges,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,548,100,,,percent of total billed charges,100% of total billed charges,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,548,100,,,percent of total billed charges,100% of total billed charges,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.94,61.85,,,percent of total billed charges,61.85% of total billed charges,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,44.12,130,,,Fee Schedule,130% of WA Medicaid ,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.6,37.7,,,percent of total billed charges,37.70% of total billed charges,206.6,37.7,,,percent of total billed charges,37.70% of total billed charges,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,18577.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.44,78,,,percent of total billed charges,78% of total billed charges,548,100,,,percent of total billed charges,100% of total billed charges,452.65,82.6,,,percent of total billed charges,82.6% of total billed charges,452.65,82.6,,,percent of total billed charges,82.6% of total billed charges,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,6,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.94,18577.2,
OPEN TX OF NASAL FX;W CONCOMITANT FX SEP,21335,CDM,983,RC,21335,HCPCS,Outpatient,,,1521,988.65,,1338.48,88,,,percent of total billed charges,88% of total Billed charges,57.15,100,,,Fee Schedule,100% of Medicare rate,416.64,100,,,Fee Schedule,100% of WA Medicaid,1521,100,,,percent of total billed charges,100% of total billed charges,429.14,103,,,Fee Schedule,103% of WA Medicaid,57.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,416.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1049.49,69,,,percent of total billed charges,69% of total billed charges,1521,100,,,percent of total billed charges,100% of total billed charges,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1521,100,,,percent of total billed charges,100% of total billed charges,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1521,100,,,percent of total billed charges,100% of total billed charges,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,940.74,61.85,,,percent of total billed charges,61.85% of total billed charges,416.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,541.63,130,,,Fee Schedule,130% of WA Medicaid ,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,573.42,37.7,,,percent of total billed charges,37.70% of total billed charges,573.42,37.7,,,percent of total billed charges,37.70% of total billed charges,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,51561.9,33.9,,,percent of total billed charges,33.9% of total billed charges,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1186.38,78,,,percent of total billed charges,78% of total billed charges,1521,100,,,percent of total billed charges,100% of total billed charges,1256.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1256.35,82.6,,,percent of total billed charges,82.6% of total billed charges,416.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.15,51561.9,
CLOSED TREATMENT OF NASAL SEPTAL FX,21337,CDM,983,RC,21337,HCPCS,Outpatient,,,549,356.85,,483.12,88,,,percent of total billed charges,88% of total Billed charges,22.75,100,,,Fee Schedule,100% of Medicare rate,176.8,100,,,Fee Schedule,100% of WA Medicaid,549,100,,,percent of total billed charges,100% of total billed charges,182.1,103,,,Fee Schedule,103% of WA Medicaid,22.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,176.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,378.81,69,,,percent of total billed charges,69% of total billed charges,549,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,549,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,549,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.56,61.85,,,percent of total billed charges,61.85% of total billed charges,176.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,229.84,130,,,Fee Schedule,130% of WA Medicaid ,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.97,37.7,,,percent of total billed charges,37.70% of total billed charges,206.97,37.7,,,percent of total billed charges,37.70% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,18611.1,33.9,,,percent of total billed charges,33.9% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.22,78,,,percent of total billed charges,78% of total billed charges,549,100,,,percent of total billed charges,100% of total billed charges,453.47,82.6,,,percent of total billed charges,82.6% of total billed charges,453.47,82.6,,,percent of total billed charges,82.6% of total billed charges,176.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.75,18611.1,
OPEN TX COMPL FRONT SINUS FX,21344,CDM,983,RC,21344,HCPCS,Outpatient,,,5670,3685.50,,4989.6,88,,,percent of total billed charges,88% of total Billed charges,123.72,100,,,Fee Schedule,100% of Medicare rate,797.85,100,,,Fee Schedule,100% of WA Medicaid,5670,100,,,percent of total billed charges,100% of total billed charges,821.79,103,,,Fee Schedule,103% of WA Medicaid,123.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,216.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,797.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3912.3,69,,,percent of total billed charges,69% of total billed charges,5670,100,,,percent of total billed charges,100% of total billed charges,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5670,100,,,percent of total billed charges,100% of total billed charges,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5670,100,,,percent of total billed charges,100% of total billed charges,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3506.9,61.85,,,percent of total billed charges,61.85% of total billed charges,797.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,797.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1037.21,130,,,Fee Schedule,130% of WA Medicaid ,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2137.59,37.7,,,percent of total billed charges,37.70% of total billed charges,2137.59,37.7,,,percent of total billed charges,37.70% of total billed charges,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,192213,33.9,,,percent of total billed charges,33.9% of total billed charges,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,4422.6,78,,,percent of total billed charges,78% of total billed charges,5670,100,,,percent of total billed charges,100% of total billed charges,4683.42,82.6,,,percent of total billed charges,82.6% of total billed charges,4683.42,82.6,,,percent of total billed charges,82.6% of total billed charges,797.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,123.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,797.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,123.72,192213,
OPEN TX DPRSD FRONT SINUS FX,21343,CDM,983,RC,21343,HCPCS,Outpatient,,,3893,2530.45,,3425.84,88,,,percent of total billed charges,88% of total Billed charges,87.29,100,,,Fee Schedule,100% of Medicare rate,629.81,100,,,Fee Schedule,100% of WA Medicaid,3893,100,,,percent of total billed charges,100% of total billed charges,648.7,103,,,Fee Schedule,103% of WA Medicaid,87.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,152.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,629.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2686.17,69,,,percent of total billed charges,69% of total billed charges,3893,100,,,percent of total billed charges,100% of total billed charges,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,3893,100,,,percent of total billed charges,100% of total billed charges,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,3893,100,,,percent of total billed charges,100% of total billed charges,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2407.82,61.85,,,percent of total billed charges,61.85% of total billed charges,629.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,818.75,130,,,Fee Schedule,130% of WA Medicaid ,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1467.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1467.66,37.7,,,percent of total billed charges,37.70% of total billed charges,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,131972.7,33.9,,,percent of total billed charges,33.9% of total billed charges,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,3036.54,78,,,percent of total billed charges,78% of total billed charges,3893,100,,,percent of total billed charges,100% of total billed charges,3215.62,82.6,,,percent of total billed charges,82.6% of total billed charges,3215.62,82.6,,,percent of total billed charges,82.6% of total billed charges,629.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.29,131972.7,
OPN TX COMPLEX MALAR FX,21365,CDM,983,RC,21365,HCPCS,Outpatient,,,1604,1042.60,,1411.52,88,,,percent of total billed charges,88% of total Billed charges,96.85,100,,,Fee Schedule,100% of Medicare rate,617.5,100,,,Fee Schedule,100% of WA Medicaid,1604,100,,,percent of total billed charges,100% of total billed charges,636.03,103,,,Fee Schedule,103% of WA Medicaid,96.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,169.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,617.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1106.76,69,,,percent of total billed charges,69% of total billed charges,1604,100,,,percent of total billed charges,100% of total billed charges,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1604,100,,,percent of total billed charges,100% of total billed charges,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1604,100,,,percent of total billed charges,100% of total billed charges,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,992.07,61.85,,,percent of total billed charges,61.85% of total billed charges,617.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,802.75,130,,,Fee Schedule,130% of WA Medicaid ,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,604.71,37.7,,,percent of total billed charges,37.70% of total billed charges,604.71,37.7,,,percent of total billed charges,37.70% of total billed charges,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,54375.6,33.9,,,percent of total billed charges,33.9% of total billed charges,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1251.12,78,,,percent of total billed charges,78% of total billed charges,1604,100,,,percent of total billed charges,100% of total billed charges,1324.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1324.9,82.6,,,percent of total billed charges,82.6% of total billed charges,617.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.85,54375.6,
OPEN TRMT OF DEPRESSED MALAR FX,21360,CDM,983,RC,21360,HCPCS,Outpatient,,,984,639.60,,865.92,88,,,percent of total billed charges,88% of total Billed charges,43.56,100,,,Fee Schedule,100% of Medicare rate,305.67,100,,,Fee Schedule,100% of WA Medicaid,984,100,,,percent of total billed charges,100% of total billed charges,314.84,103,,,Fee Schedule,103% of WA Medicaid,43.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,305.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,678.96,69,,,percent of total billed charges,69% of total billed charges,984,100,,,percent of total billed charges,100% of total billed charges,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,984,100,,,percent of total billed charges,100% of total billed charges,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,984,100,,,percent of total billed charges,100% of total billed charges,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.6,61.85,,,percent of total billed charges,61.85% of total billed charges,305.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,397.37,130,,,Fee Schedule,130% of WA Medicaid ,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.97,37.7,,,percent of total billed charges,37.70% of total billed charges,370.97,37.7,,,percent of total billed charges,37.70% of total billed charges,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,33357.6,33.9,,,percent of total billed charges,33.9% of total billed charges,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,767.52,78,,,percent of total billed charges,78% of total billed charges,984,100,,,percent of total billed charges,100% of total billed charges,812.78,82.6,,,percent of total billed charges,82.6% of total billed charges,812.78,82.6,,,percent of total billed charges,82.6% of total billed charges,305.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,44,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.56,33357.6,
OPN TX COMPLX MALAR W/GRFT,21366,CDM,983,RC,21366,HCPCS,Outpatient,,,2400,1560.00,,2112,88,,,percent of total billed charges,88% of total Billed charges,127.57,100,,,Fee Schedule,100% of Medicare rate,728.28,100,,,Fee Schedule,100% of WA Medicaid,2400,100,,,percent of total billed charges,100% of total billed charges,750.13,103,,,Fee Schedule,103% of WA Medicaid,127.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,223.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,728.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1656,69,,,percent of total billed charges,69% of total billed charges,2400,100,,,percent of total billed charges,100% of total billed charges,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2400,100,,,percent of total billed charges,100% of total billed charges,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2400,100,,,percent of total billed charges,100% of total billed charges,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1484.4,61.85,,,percent of total billed charges,61.85% of total billed charges,728.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,728.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,742.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,946.76,130,,,Fee Schedule,130% of WA Medicaid ,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.8,37.7,,,percent of total billed charges,37.70% of total billed charges,904.8,37.7,,,percent of total billed charges,37.70% of total billed charges,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,81360,33.9,,,percent of total billed charges,33.9% of total billed charges,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1872,78,,,percent of total billed charges,78% of total billed charges,2400,100,,,percent of total billed charges,100% of total billed charges,1982.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1982.4,82.6,,,percent of total billed charges,82.6% of total billed charges,728.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,127.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,728.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,127.57,81360,
OPN TX ORBIT PERIORBT W/GRFT,21395,CDM,983,RC,21395,HCPCS,Outpatient,,,3724,2420.60,,3277.12,88,,,percent of total billed charges,88% of total Billed charges,100.57,100,,,Fee Schedule,100% of Medicare rate,575.17,100,,,Fee Schedule,100% of WA Medicaid,3724,100,,,percent of total billed charges,100% of total billed charges,592.43,103,,,Fee Schedule,103% of WA Medicaid,100.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,176,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,575.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2569.56,69,,,percent of total billed charges,69% of total billed charges,3724,100,,,percent of total billed charges,100% of total billed charges,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3724,100,,,percent of total billed charges,100% of total billed charges,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3724,100,,,percent of total billed charges,100% of total billed charges,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2303.29,61.85,,,percent of total billed charges,61.85% of total billed charges,575.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,586.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,747.72,130,,,Fee Schedule,130% of WA Medicaid ,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1403.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1403.95,37.7,,,percent of total billed charges,37.70% of total billed charges,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,126243.6,33.9,,,percent of total billed charges,33.9% of total billed charges,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2904.72,78,,,percent of total billed charges,78% of total billed charges,3724,100,,,percent of total billed charges,100% of total billed charges,3076.02,82.6,,,percent of total billed charges,82.6% of total billed charges,3076.02,82.6,,,percent of total billed charges,82.6% of total billed charges,575.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,100.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,100.57,126243.6,
OPN TX ORBIT PERIORBTL IMPLT,21390,CDM,983,RC,21390,HCPCS,Outpatient,,,1650,1072.50,,1452,88,,,percent of total billed charges,88% of total Billed charges,63.78,100,,,Fee Schedule,100% of Medicare rate,463.45,100,,,Fee Schedule,100% of WA Medicaid,1650,100,,,percent of total billed charges,100% of total billed charges,477.35,103,,,Fee Schedule,103% of WA Medicaid,63.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,111.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,463.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1138.5,69,,,percent of total billed charges,69% of total billed charges,1650,100,,,percent of total billed charges,100% of total billed charges,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650,100,,,percent of total billed charges,100% of total billed charges,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650,100,,,percent of total billed charges,100% of total billed charges,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.53,61.85,,,percent of total billed charges,61.85% of total billed charges,463.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,472.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,602.49,130,,,Fee Schedule,130% of WA Medicaid ,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.05,37.7,,,percent of total billed charges,37.70% of total billed charges,622.05,37.7,,,percent of total billed charges,37.70% of total billed charges,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,55935,33.9,,,percent of total billed charges,33.9% of total billed charges,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1287,78,,,percent of total billed charges,78% of total billed charges,1650,100,,,percent of total billed charges,100% of total billed charges,1362.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1362.9,82.6,,,percent of total billed charges,82.6% of total billed charges,463.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.78,55935,
OPN TX ORBIT FX W/O IMPLANT,21406,CDM,983,RC,21406,HCPCS,Outpatient,,,2247,1460.55,,1977.36,88,,,percent of total billed charges,88% of total Billed charges,53.29,100,,,Fee Schedule,100% of Medicare rate,337.94,100,,,Fee Schedule,100% of WA Medicaid,2247,100,,,percent of total billed charges,100% of total billed charges,348.08,103,,,Fee Schedule,103% of WA Medicaid,53.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,337.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1550.43,69,,,percent of total billed charges,69% of total billed charges,2247,100,,,percent of total billed charges,100% of total billed charges,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2247,100,,,percent of total billed charges,100% of total billed charges,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2247,100,,,percent of total billed charges,100% of total billed charges,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1389.77,61.85,,,percent of total billed charges,61.85% of total billed charges,337.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,439.32,130,,,Fee Schedule,130% of WA Medicaid ,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.12,37.7,,,percent of total billed charges,37.70% of total billed charges,847.12,37.7,,,percent of total billed charges,37.70% of total billed charges,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,76173.3,33.9,,,percent of total billed charges,33.9% of total billed charges,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1752.66,78,,,percent of total billed charges,78% of total billed charges,2247,100,,,percent of total billed charges,100% of total billed charges,1856.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1856.02,82.6,,,percent of total billed charges,82.6% of total billed charges,337.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.29,76173.3,
OPN TX ORBIT FX W/IMPLANT,21407,CDM,983,RC,21407,HCPCS,Outpatient,,,1350,877.50,,1188,88,,,percent of total billed charges,88% of total Billed charges,49.6,100,,,Fee Schedule,100% of Medicare rate,371.14,100,,,Fee Schedule,100% of WA Medicaid,1350,100,,,percent of total billed charges,100% of total billed charges,382.27,103,,,Fee Schedule,103% of WA Medicaid,49.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,371.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,931.5,69,,,percent of total billed charges,69% of total billed charges,1350,100,,,percent of total billed charges,100% of total billed charges,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1350,100,,,percent of total billed charges,100% of total billed charges,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1350,100,,,percent of total billed charges,100% of total billed charges,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,834.98,61.85,,,percent of total billed charges,61.85% of total billed charges,371.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,482.48,130,,,Fee Schedule,130% of WA Medicaid ,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,508.95,37.7,,,percent of total billed charges,37.70% of total billed charges,508.95,37.7,,,percent of total billed charges,37.70% of total billed charges,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,45765,33.9,,,percent of total billed charges,33.9% of total billed charges,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1053,78,,,percent of total billed charges,78% of total billed charges,1350,100,,,percent of total billed charges,100% of total billed charges,1115.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1115.1,82.6,,,percent of total billed charges,82.6% of total billed charges,371.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.6,45765,
CLOSED TRTMT OF MANDIBULAR FX W/MANIPULA,21451,CDM,983,RC,21451,HCPCS,Outpatient,,,1132,735.80,,996.16,88,,,percent of total billed charges,88% of total Billed charges,33.67,100,,,Fee Schedule,100% of Medicare rate,376.54,100,,,Fee Schedule,100% of WA Medicaid,1132,100,,,percent of total billed charges,100% of total billed charges,387.84,103,,,Fee Schedule,103% of WA Medicaid,33.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,376.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,781.08,69,,,percent of total billed charges,69% of total billed charges,1132,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1132,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1132,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.14,61.85,,,percent of total billed charges,61.85% of total billed charges,376.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,489.5,130,,,Fee Schedule,130% of WA Medicaid ,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.76,37.7,,,percent of total billed charges,37.70% of total billed charges,426.76,37.7,,,percent of total billed charges,37.70% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,38374.8,33.9,,,percent of total billed charges,33.9% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,882.96,78,,,percent of total billed charges,78% of total billed charges,1132,100,,,percent of total billed charges,100% of total billed charges,935.03,82.6,,,percent of total billed charges,82.6% of total billed charges,935.03,82.6,,,percent of total billed charges,82.6% of total billed charges,376.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.67,38374.8,
DRAIN NECK/CHEST LESION,21501,CDM,983,RC,21501,HCPCS,Outpatient,,,896,582.40,,788.48,88,,,percent of total billed charges,88% of total Billed charges,31.59,100,,,Fee Schedule,100% of Medicare rate,196.76,100,,,Fee Schedule,100% of WA Medicaid,896,100,,,percent of total billed charges,100% of total billed charges,202.66,103,,,Fee Schedule,103% of WA Medicaid,31.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,55.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,196.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,618.24,69,,,percent of total billed charges,69% of total billed charges,896,100,,,percent of total billed charges,100% of total billed charges,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,896,100,,,percent of total billed charges,100% of total billed charges,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,896,100,,,percent of total billed charges,100% of total billed charges,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.18,61.85,,,percent of total billed charges,61.85% of total billed charges,196.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,255.79,130,,,Fee Schedule,130% of WA Medicaid ,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.79,37.7,,,percent of total billed charges,37.70% of total billed charges,337.79,37.7,,,percent of total billed charges,37.70% of total billed charges,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,30374.4,33.9,,,percent of total billed charges,33.9% of total billed charges,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.88,78,,,percent of total billed charges,78% of total billed charges,896,100,,,percent of total billed charges,100% of total billed charges,740.1,82.6,,,percent of total billed charges,82.6% of total billed charges,740.1,82.6,,,percent of total billed charges,82.6% of total billed charges,196.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.59,30374.4,
BIOPSY OF NECK/CHEST,21550,CDM,983,RC,21550,HCPCS,Outpatient,,,394,256.10,,346.72,88,,,percent of total billed charges,88% of total Billed charges,12.78,100,,,Fee Schedule,100% of Medicare rate,90.27,100,,,Fee Schedule,100% of WA Medicaid,394,100,,,percent of total billed charges,100% of total billed charges,92.98,103,,,Fee Schedule,103% of WA Medicaid,12.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,90.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,271.86,69,,,percent of total billed charges,69% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,394,100,,,percent of total billed charges,100% of total billed charges,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,394,100,,,percent of total billed charges,100% of total billed charges,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.69,61.85,,,percent of total billed charges,61.85% of total billed charges,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,117.35,130,,,Fee Schedule,130% of WA Medicaid ,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,13356.6,33.9,,,percent of total billed charges,33.9% of total billed charges,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.32,78,,,percent of total billed charges,78% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.78,13356.6,
EXC NECK LES SC 3 CM/>,21552,CDM,983,RC,21552,HCPCS,Outpatient,,,1342,872.30,,1180.96,88,,,percent of total billed charges,88% of total Billed charges,52.68,100,,,Fee Schedule,100% of Medicare rate,256.44,100,,,Fee Schedule,100% of WA Medicaid,1342,100,,,percent of total billed charges,100% of total billed charges,264.13,103,,,Fee Schedule,103% of WA Medicaid,52.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,256.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,925.98,69,,,percent of total billed charges,69% of total billed charges,1342,100,,,percent of total billed charges,100% of total billed charges,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1342,100,,,percent of total billed charges,100% of total billed charges,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1342,100,,,percent of total billed charges,100% of total billed charges,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,830.03,61.85,,,percent of total billed charges,61.85% of total billed charges,256.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,333.37,130,,,Fee Schedule,130% of WA Medicaid ,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.93,37.7,,,percent of total billed charges,37.70% of total billed charges,505.93,37.7,,,percent of total billed charges,37.70% of total billed charges,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,45493.8,33.9,,,percent of total billed charges,33.9% of total billed charges,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046.76,78,,,percent of total billed charges,78% of total billed charges,1342,100,,,percent of total billed charges,100% of total billed charges,1108.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1108.49,82.6,,,percent of total billed charges,82.6% of total billed charges,256.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.68,45493.8,
EXC NECK LES SC < 3 CM,21555,CDM,983,RC,21555,HCPCS,Outpatient,,,816,530.40,,718.08,88,,,percent of total billed charges,88% of total Billed charges,30.39,100,,,Fee Schedule,100% of Medicare rate,178.48,100,,,Fee Schedule,100% of WA Medicaid,816,100,,,percent of total billed charges,100% of total billed charges,183.83,103,,,Fee Schedule,103% of WA Medicaid,30.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,178.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,563.04,69,,,percent of total billed charges,69% of total billed charges,816,100,,,percent of total billed charges,100% of total billed charges,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,816,100,,,percent of total billed charges,100% of total billed charges,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,816,100,,,percent of total billed charges,100% of total billed charges,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.7,61.85,,,percent of total billed charges,61.85% of total billed charges,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,232.02,130,,,Fee Schedule,130% of WA Medicaid ,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.63,37.7,,,percent of total billed charges,37.70% of total billed charges,307.63,37.7,,,percent of total billed charges,37.70% of total billed charges,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,27662.4,33.9,,,percent of total billed charges,33.9% of total billed charges,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,636.48,78,,,percent of total billed charges,78% of total billed charges,816,100,,,percent of total billed charges,100% of total billed charges,674.02,82.6,,,percent of total billed charges,82.6% of total billed charges,674.02,82.6,,,percent of total billed charges,82.6% of total billed charges,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.39,27662.4,
EXC NECK TUM DEEP 5 CM/>,21554,CDM,983,RC,21554,HCPCS,Outpatient,,,1937,1259.05,,1704.56,88,,,percent of total billed charges,88% of total Billed charges,84.02,100,,,Fee Schedule,100% of Medicare rate,417.76,100,,,Fee Schedule,100% of WA Medicaid,1937,100,,,percent of total billed charges,100% of total billed charges,430.29,103,,,Fee Schedule,103% of WA Medicaid,84.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,147.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,417.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1336.53,69,,,percent of total billed charges,69% of total billed charges,1937,100,,,percent of total billed charges,100% of total billed charges,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1937,100,,,percent of total billed charges,100% of total billed charges,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1937,100,,,percent of total billed charges,100% of total billed charges,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198.03,61.85,,,percent of total billed charges,61.85% of total billed charges,417.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.09,130,,,Fee Schedule,130% of WA Medicaid ,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.25,37.7,,,percent of total billed charges,37.70% of total billed charges,730.25,37.7,,,percent of total billed charges,37.70% of total billed charges,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,65664.3,33.9,,,percent of total billed charges,33.9% of total billed charges,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1510.86,78,,,percent of total billed charges,78% of total billed charges,1937,100,,,percent of total billed charges,100% of total billed charges,1599.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1599.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,84.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84.02,65664.3,
EXC NECK TUM DEEP < 5 CM,21556,CDM,983,RC,21556,HCPCS,Outpatient,,,1389,902.85,,1222.32,88,,,percent of total billed charges,88% of total Billed charges,54.96,100,,,Fee Schedule,100% of Medicare rate,304.93,100,,,Fee Schedule,100% of WA Medicaid,1389,100,,,percent of total billed charges,100% of total billed charges,314.08,103,,,Fee Schedule,103% of WA Medicaid,54.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,96.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,304.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,958.41,69,,,percent of total billed charges,69% of total billed charges,1389,100,,,percent of total billed charges,100% of total billed charges,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1389,100,,,percent of total billed charges,100% of total billed charges,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1389,100,,,percent of total billed charges,100% of total billed charges,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.1,61.85,,,percent of total billed charges,61.85% of total billed charges,304.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,396.41,130,,,Fee Schedule,130% of WA Medicaid ,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,523.65,37.7,,,percent of total billed charges,37.70% of total billed charges,523.65,37.7,,,percent of total billed charges,37.70% of total billed charges,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,47087.1,33.9,,,percent of total billed charges,33.9% of total billed charges,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1083.42,78,,,percent of total billed charges,78% of total billed charges,1389,100,,,percent of total billed charges,100% of total billed charges,1147.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1147.31,82.6,,,percent of total billed charges,82.6% of total billed charges,304.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.96,47087.1,
RESECT NECK TUMOR 5 CM/>,21558,CDM,983,RC,21558,HCPCS,Outpatient,,,4255,2765.75,,3744.4,88,,,percent of total billed charges,88% of total Billed charges,160.35,100,,,Fee Schedule,100% of Medicare rate,757.75,100,,,Fee Schedule,100% of WA Medicaid,4255,100,,,percent of total billed charges,100% of total billed charges,780.48,103,,,Fee Schedule,103% of WA Medicaid,160.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,280.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,757.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2935.95,69,,,percent of total billed charges,69% of total billed charges,4255,100,,,percent of total billed charges,100% of total billed charges,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,4255,100,,,percent of total billed charges,100% of total billed charges,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,4255,100,,,percent of total billed charges,100% of total billed charges,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2631.72,61.85,,,percent of total billed charges,61.85% of total billed charges,757.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,757.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,772.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,985.08,130,,,Fee Schedule,130% of WA Medicaid ,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1604.14,37.7,,,percent of total billed charges,37.70% of total billed charges,1604.14,37.7,,,percent of total billed charges,37.70% of total billed charges,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,144244.5,33.9,,,percent of total billed charges,33.9% of total billed charges,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3318.9,78,,,percent of total billed charges,78% of total billed charges,4255,100,,,percent of total billed charges,100% of total billed charges,3514.63,82.6,,,percent of total billed charges,82.6% of total billed charges,3514.63,82.6,,,percent of total billed charges,82.6% of total billed charges,757.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,160.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,757.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,160.35,144244.5,
RESECT NECK THORAX TUMOR<5CM,21557,CDM,983,RC,21557,HCPCS,Outpatient,,,3506,2278.90,,3085.28,88,,,percent of total billed charges,88% of total Billed charges,110.99,100,,,Fee Schedule,100% of Medicare rate,545.51,100,,,Fee Schedule,100% of WA Medicaid,3506,100,,,percent of total billed charges,100% of total billed charges,561.88,103,,,Fee Schedule,103% of WA Medicaid,110.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,194.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,545.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2419.14,69,,,percent of total billed charges,69% of total billed charges,3506,100,,,percent of total billed charges,100% of total billed charges,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3506,100,,,percent of total billed charges,100% of total billed charges,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3506,100,,,percent of total billed charges,100% of total billed charges,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2168.46,61.85,,,percent of total billed charges,61.85% of total billed charges,545.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,709.16,130,,,Fee Schedule,130% of WA Medicaid ,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1321.76,37.7,,,percent of total billed charges,37.70% of total billed charges,1321.76,37.7,,,percent of total billed charges,37.70% of total billed charges,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,118853.4,33.9,,,percent of total billed charges,33.9% of total billed charges,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2734.68,78,,,percent of total billed charges,78% of total billed charges,3506,100,,,percent of total billed charges,100% of total billed charges,2895.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2895.96,82.6,,,percent of total billed charges,82.6% of total billed charges,545.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.99,118853.4,
EXCISION OF CHEST WALL TUMOR INCLUDING RIBS,21603,CDM,983,RC,21603,HCPCS,Outpatient,,,4982,3238.30,,4384.16,88,,,percent of total billed charges,88% of total Billed charges,211.02,100,,,Fee Schedule,100% of Medicare rate,946.86,100,,,Fee Schedule,100% of WA Medicaid,4982,100,,,percent of total billed charges,100% of total billed charges,975.27,103,,,Fee Schedule,103% of WA Medicaid,211.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,369.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,946.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3437.58,69,,,percent of total billed charges,69% of total billed charges,4982,100,,,percent of total billed charges,100% of total billed charges,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4982,100,,,percent of total billed charges,100% of total billed charges,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4982,100,,,percent of total billed charges,100% of total billed charges,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3081.37,61.85,,,percent of total billed charges,61.85% of total billed charges,946.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,946.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,965.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1230.92,130,,,Fee Schedule,130% of WA Medicaid ,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1878.21,37.7,,,percent of total billed charges,37.70% of total billed charges,1878.21,37.7,,,percent of total billed charges,37.70% of total billed charges,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,168889.8,33.9,,,percent of total billed charges,33.9% of total billed charges,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3885.96,78,,,percent of total billed charges,78% of total billed charges,4982,100,,,percent of total billed charges,100% of total billed charges,4115.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4115.13,82.6,,,percent of total billed charges,82.6% of total billed charges,946.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,211.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,946.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,211.02,168889.8,
"19272 Excision of chest wall tumor involving ribs, with plas",21602,CDM,983,RC,21602,HCPCS,Outpatient,,,4554,2960.10,,4007.52,88,,,percent of total billed charges,88% of total Billed charges,185.46,100,,,Fee Schedule,100% of Medicare rate,866.29,100,,,Fee Schedule,100% of WA Medicaid,4554,100,,,percent of total billed charges,100% of total billed charges,892.28,103,,,Fee Schedule,103% of WA Medicaid,185.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,324.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,866.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3142.26,69,,,percent of total billed charges,69% of total billed charges,4554,100,,,percent of total billed charges,100% of total billed charges,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,4554,100,,,percent of total billed charges,100% of total billed charges,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,4554,100,,,percent of total billed charges,100% of total billed charges,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2816.65,61.85,,,percent of total billed charges,61.85% of total billed charges,866.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,866.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,883.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1126.18,130,,,Fee Schedule,130% of WA Medicaid ,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1716.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1716.86,37.7,,,percent of total billed charges,37.70% of total billed charges,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,154380.6,33.9,,,percent of total billed charges,33.9% of total billed charges,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3552.12,78,,,percent of total billed charges,78% of total billed charges,4554,100,,,percent of total billed charges,100% of total billed charges,3761.6,82.6,,,percent of total billed charges,82.6% of total billed charges,3761.6,82.6,,,percent of total billed charges,82.6% of total billed charges,866.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,185.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,866.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,185.46,154380.6,
21601 Excision of chest wall tumor including rib(s),21601,CDM,983,RC,21601,HCPCS,Outpatient,,,3206,2083.90,,2821.28,88,,,percent of total billed charges,88% of total Billed charges,150.09,100,,,Fee Schedule,100% of Medicare rate,646.78,100,,,Fee Schedule,100% of WA Medicaid,3206,100,,,percent of total billed charges,100% of total billed charges,666.18,103,,,Fee Schedule,103% of WA Medicaid,150.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,262.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,646.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2212.14,69,,,percent of total billed charges,69% of total billed charges,3206,100,,,percent of total billed charges,100% of total billed charges,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3206,100,,,percent of total billed charges,100% of total billed charges,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3206,100,,,percent of total billed charges,100% of total billed charges,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1982.91,61.85,,,percent of total billed charges,61.85% of total billed charges,646.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,840.81,130,,,Fee Schedule,130% of WA Medicaid ,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1208.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1208.66,37.7,,,percent of total billed charges,37.70% of total billed charges,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,108683.4,33.9,,,percent of total billed charges,33.9% of total billed charges,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2500.68,78,,,percent of total billed charges,78% of total billed charges,3206,100,,,percent of total billed charges,100% of total billed charges,2648.16,82.6,,,percent of total billed charges,82.6% of total billed charges,2648.16,82.6,,,percent of total billed charges,82.6% of total billed charges,646.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,150.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,150.09,108683.4,
PARTIAL REMOVAL OF RIB,21610,CDM,983,RC,21610,HCPCS,Outpatient,,,2797,1818.05,,2461.36,88,,,percent of total billed charges,88% of total Billed charges,207.89,100,,,Fee Schedule,100% of Medicare rate,685.76,100,,,Fee Schedule,100% of WA Medicaid,2797,100,,,percent of total billed charges,100% of total billed charges,706.33,103,,,Fee Schedule,103% of WA Medicaid,207.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,363.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,685.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1929.93,69,,,percent of total billed charges,69% of total billed charges,2797,100,,,percent of total billed charges,100% of total billed charges,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2797,100,,,percent of total billed charges,100% of total billed charges,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2797,100,,,percent of total billed charges,100% of total billed charges,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1729.94,61.85,,,percent of total billed charges,61.85% of total billed charges,685.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,891.49,130,,,Fee Schedule,130% of WA Medicaid ,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1054.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1054.47,37.7,,,percent of total billed charges,37.70% of total billed charges,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,94818.3,33.9,,,percent of total billed charges,33.9% of total billed charges,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2181.66,78,,,percent of total billed charges,78% of total billed charges,2797,100,,,percent of total billed charges,100% of total billed charges,2310.32,82.6,,,percent of total billed charges,82.6% of total billed charges,2310.32,82.6,,,percent of total billed charges,82.6% of total billed charges,685.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,207.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,207.89,94818.3,
REMOVAL OF RIB,21615,CDM,983,RC,21615,HCPCS,Outpatient,,,1668,1084.20,,1467.84,88,,,percent of total billed charges,88% of total Billed charges,85.6,100,,,Fee Schedule,100% of Medicare rate,348.38,100,,,Fee Schedule,100% of WA Medicaid,1668,100,,,percent of total billed charges,100% of total billed charges,358.83,103,,,Fee Schedule,103% of WA Medicaid,85.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,149.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,348.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1150.92,69,,,percent of total billed charges,69% of total billed charges,1668,100,,,percent of total billed charges,100% of total billed charges,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1668,100,,,percent of total billed charges,100% of total billed charges,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1668,100,,,percent of total billed charges,100% of total billed charges,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031.66,61.85,,,percent of total billed charges,61.85% of total billed charges,348.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,452.89,130,,,Fee Schedule,130% of WA Medicaid ,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,628.84,37.7,,,percent of total billed charges,37.70% of total billed charges,628.84,37.7,,,percent of total billed charges,37.70% of total billed charges,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,56545.2,33.9,,,percent of total billed charges,33.9% of total billed charges,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1301.04,78,,,percent of total billed charges,78% of total billed charges,1668,100,,,percent of total billed charges,100% of total billed charges,1377.77,82.6,,,percent of total billed charges,82.6% of total billed charges,1377.77,82.6,,,percent of total billed charges,82.6% of total billed charges,348.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,85.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.6,56545.2,
STERNAL DEBRIDEMENT,21627,CDM,983,RC,21627,HCPCS,Outpatient,,,1492,969.80,,1312.96,88,,,percent of total billed charges,88% of total Billed charges,60.38,100,,,Fee Schedule,100% of Medicare rate,314.44,100,,,Fee Schedule,100% of WA Medicaid,1492,100,,,percent of total billed charges,100% of total billed charges,323.87,103,,,Fee Schedule,103% of WA Medicaid,60.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,314.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1029.48,69,,,percent of total billed charges,69% of total billed charges,1492,100,,,percent of total billed charges,100% of total billed charges,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1492,100,,,percent of total billed charges,100% of total billed charges,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1492,100,,,percent of total billed charges,100% of total billed charges,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,922.8,61.85,,,percent of total billed charges,61.85% of total billed charges,314.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,408.77,130,,,Fee Schedule,130% of WA Medicaid ,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.48,37.7,,,percent of total billed charges,37.70% of total billed charges,562.48,37.7,,,percent of total billed charges,37.70% of total billed charges,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,50578.8,33.9,,,percent of total billed charges,33.9% of total billed charges,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163.76,78,,,percent of total billed charges,78% of total billed charges,1492,100,,,percent of total billed charges,100% of total billed charges,1232.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1232.39,82.6,,,percent of total billed charges,82.6% of total billed charges,314.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.38,50578.8,
REVISION OF NECK MUSCLE,21700,CDM,983,RC,21700,HCPCS,Outpatient,,,999,649.35,,879.12,88,,,percent of total billed charges,88% of total Billed charges,51.18,100,,,Fee Schedule,100% of Medicare rate,197.5,100,,,Fee Schedule,100% of WA Medicaid,999,100,,,percent of total billed charges,100% of total billed charges,203.43,103,,,Fee Schedule,103% of WA Medicaid,51.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,197.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,689.31,69,,,percent of total billed charges,69% of total billed charges,999,100,,,percent of total billed charges,100% of total billed charges,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,999,100,,,percent of total billed charges,100% of total billed charges,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,999,100,,,percent of total billed charges,100% of total billed charges,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.88,61.85,,,percent of total billed charges,61.85% of total billed charges,197.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,256.75,130,,,Fee Schedule,130% of WA Medicaid ,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.62,37.7,,,percent of total billed charges,37.70% of total billed charges,376.62,37.7,,,percent of total billed charges,37.70% of total billed charges,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,33866.1,33.9,,,percent of total billed charges,33.9% of total billed charges,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,779.22,78,,,percent of total billed charges,78% of total billed charges,999,100,,,percent of total billed charges,100% of total billed charges,825.17,82.6,,,percent of total billed charges,82.6% of total billed charges,825.17,82.6,,,percent of total billed charges,82.6% of total billed charges,197.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.18,33866.1,
TREATMENT OF RIB FRACTURE,21800,CDM,983,RC,21800,HCPCS,Outpatient,,,249,161.85,,219.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,249,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,171.81,69,,,percent of total billed charges,69% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,249,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,249,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,154.01,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,8441.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,194.22,78,,,percent of total billed charges,78% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",93.87,8441.1,
BIOPSY SOFT TISSUE OF BACK,21920,CDM,983,RC,21920,HCPCS,Outpatient,,,302,196.30,,265.76,88,,,percent of total billed charges,88% of total Billed charges,13.26,100,,,Fee Schedule,100% of Medicare rate,89.52,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,92.21,103,,,Fee Schedule,103% of WA Medicaid,13.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,89.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.79,61.85,,,percent of total billed charges,61.85% of total billed charges,89.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,116.38,130,,,Fee Schedule,130% of WA Medicaid ,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,10237.8,33.9,,,percent of total billed charges,33.9% of total billed charges,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,89.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.26,10237.8,
BIOPSY SOFT TISSUE OF BACK,21925,CDM,983,RC,21925,HCPCS,Outpatient,,,1109,720.85,,975.92,88,,,percent of total billed charges,88% of total Billed charges,38.81,100,,,Fee Schedule,100% of Medicare rate,220.44,100,,,Fee Schedule,100% of WA Medicaid,1109,100,,,percent of total billed charges,100% of total billed charges,227.05,103,,,Fee Schedule,103% of WA Medicaid,38.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,220.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,765.21,69,,,percent of total billed charges,69% of total billed charges,1109,100,,,percent of total billed charges,100% of total billed charges,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1109,100,,,percent of total billed charges,100% of total billed charges,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1109,100,,,percent of total billed charges,100% of total billed charges,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.92,61.85,,,percent of total billed charges,61.85% of total billed charges,220.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,286.57,130,,,Fee Schedule,130% of WA Medicaid ,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.09,37.7,,,percent of total billed charges,37.70% of total billed charges,418.09,37.7,,,percent of total billed charges,37.70% of total billed charges,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,37595.1,33.9,,,percent of total billed charges,33.9% of total billed charges,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,865.02,78,,,percent of total billed charges,78% of total billed charges,1109,100,,,percent of total billed charges,100% of total billed charges,916.03,82.6,,,percent of total billed charges,82.6% of total billed charges,916.03,82.6,,,percent of total billed charges,82.6% of total billed charges,220.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.81,37595.1,
EXC BACK TUM DEEP 5 CM/>,21933,CDM,983,RC,21933,HCPCS,Outpatient,,,1982,1288.30,,1744.16,88,,,percent of total billed charges,88% of total Billed charges,90.12,100,,,Fee Schedule,100% of Medicare rate,420.37,100,,,Fee Schedule,100% of WA Medicaid,1982,100,,,percent of total billed charges,100% of total billed charges,432.98,103,,,Fee Schedule,103% of WA Medicaid,90.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,420.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1367.58,69,,,percent of total billed charges,69% of total billed charges,1982,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1982,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1982,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1225.87,61.85,,,percent of total billed charges,61.85% of total billed charges,420.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,546.48,130,,,Fee Schedule,130% of WA Medicaid ,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,747.21,37.7,,,percent of total billed charges,37.70% of total billed charges,747.21,37.7,,,percent of total billed charges,37.70% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,67189.8,33.9,,,percent of total billed charges,33.9% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1545.96,78,,,percent of total billed charges,78% of total billed charges,1982,100,,,percent of total billed charges,100% of total billed charges,1637.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1637.13,82.6,,,percent of total billed charges,82.6% of total billed charges,420.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.12,67189.8,
EXC BACK TUM DEEP < 5 CM,21932,CDM,983,RC,21932,HCPCS,Outpatient,,,1775,1153.75,,1562,88,,,percent of total billed charges,88% of total Billed charges,77.55,100,,,Fee Schedule,100% of Medicare rate,378.78,100,,,Fee Schedule,100% of WA Medicaid,1775,100,,,percent of total billed charges,100% of total billed charges,390.14,103,,,Fee Schedule,103% of WA Medicaid,77.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,378.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1224.75,69,,,percent of total billed charges,69% of total billed charges,1775,100,,,percent of total billed charges,100% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1775,100,,,percent of total billed charges,100% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1775,100,,,percent of total billed charges,100% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1097.84,61.85,,,percent of total billed charges,61.85% of total billed charges,378.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,492.41,130,,,Fee Schedule,130% of WA Medicaid ,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,669.18,37.7,,,percent of total billed charges,37.70% of total billed charges,669.18,37.7,,,percent of total billed charges,37.70% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,60172.5,33.9,,,percent of total billed charges,33.9% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1384.5,78,,,percent of total billed charges,78% of total billed charges,1775,100,,,percent of total billed charges,100% of total billed charges,1466.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1466.15,82.6,,,percent of total billed charges,82.6% of total billed charges,378.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.55,60172.5,
RESECT BACK TUM < 5 CM,21935,CDM,983,RC,21935,HCPCS,Outpatient,,,3705,2408.25,,3260.4,88,,,percent of total billed charges,88% of total Billed charges,127.06,100,,,Fee Schedule,100% of Medicare rate,579.46,100,,,Fee Schedule,100% of WA Medicaid,3705,100,,,percent of total billed charges,100% of total billed charges,596.84,103,,,Fee Schedule,103% of WA Medicaid,127.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,222.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,579.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2556.45,69,,,percent of total billed charges,69% of total billed charges,3705,100,,,percent of total billed charges,100% of total billed charges,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,3705,100,,,percent of total billed charges,100% of total billed charges,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,3705,100,,,percent of total billed charges,100% of total billed charges,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2291.54,61.85,,,percent of total billed charges,61.85% of total billed charges,579.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,579.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,753.3,130,,,Fee Schedule,130% of WA Medicaid ,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1396.79,37.7,,,percent of total billed charges,37.70% of total billed charges,1396.79,37.7,,,percent of total billed charges,37.70% of total billed charges,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,125599.5,33.9,,,percent of total billed charges,33.9% of total billed charges,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2889.9,78,,,percent of total billed charges,78% of total billed charges,3705,100,,,percent of total billed charges,100% of total billed charges,3060.33,82.6,,,percent of total billed charges,82.6% of total billed charges,3060.33,82.6,,,percent of total billed charges,82.6% of total billed charges,579.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,127.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,579.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,127.06,125599.5,
EXC BACK LES SC 3 CM/>,21931,CDM,983,RC,21931,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,56.71,100,,,Fee Schedule,100% of Medicare rate,268.93,100,,,Fee Schedule,100% of WA Medicaid,1300,100,,,percent of total billed charges,100% of total billed charges,277,103,,,Fee Schedule,103% of WA Medicaid,56.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,268.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,268.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,349.61,130,,,Fee Schedule,130% of WA Medicaid ,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,44070,33.9,,,percent of total billed charges,33.9% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,268.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.71,44070,
EXC BACK LES SC < 3 CM,21930,CDM,983,RC,21930,HCPCS,Outpatient,,,1132,735.80,,996.16,88,,,percent of total billed charges,88% of total Billed charges,39.13,100,,,Fee Schedule,100% of Medicare rate,211.3,100,,,Fee Schedule,100% of WA Medicaid,1132,100,,,percent of total billed charges,100% of total billed charges,217.64,103,,,Fee Schedule,103% of WA Medicaid,39.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,211.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,781.08,69,,,percent of total billed charges,69% of total billed charges,1132,100,,,percent of total billed charges,100% of total billed charges,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1132,100,,,percent of total billed charges,100% of total billed charges,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1132,100,,,percent of total billed charges,100% of total billed charges,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.14,61.85,,,percent of total billed charges,61.85% of total billed charges,211.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,274.69,130,,,Fee Schedule,130% of WA Medicaid ,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.76,37.7,,,percent of total billed charges,37.70% of total billed charges,426.76,37.7,,,percent of total billed charges,37.70% of total billed charges,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38374.8,33.9,,,percent of total billed charges,33.9% of total billed charges,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,882.96,78,,,percent of total billed charges,78% of total billed charges,1132,100,,,percent of total billed charges,100% of total billed charges,935.03,82.6,,,percent of total billed charges,82.6% of total billed charges,935.03,82.6,,,percent of total billed charges,82.6% of total billed charges,211.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.13,38374.8,
ID P-SPINE C/T/CERV-THOR,22010,CDM,983,RC,22010,HCPCS,Outpatient,,,2956,1921.40,,2601.28,88,,,percent of total billed charges,88% of total Billed charges,132.56,100,,,Fee Schedule,100% of Medicare rate,556.89,100,,,Fee Schedule,100% of WA Medicaid,2956,100,,,percent of total billed charges,100% of total billed charges,573.6,103,,,Fee Schedule,103% of WA Medicaid,132.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,231.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,556.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2039.64,69,,,percent of total billed charges,69% of total billed charges,2956,100,,,percent of total billed charges,100% of total billed charges,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2956,100,,,percent of total billed charges,100% of total billed charges,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2956,100,,,percent of total billed charges,100% of total billed charges,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1828.29,61.85,,,percent of total billed charges,61.85% of total billed charges,556.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,568.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,723.96,130,,,Fee Schedule,130% of WA Medicaid ,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1114.41,37.7,,,percent of total billed charges,37.70% of total billed charges,1114.41,37.7,,,percent of total billed charges,37.70% of total billed charges,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,100208.4,33.9,,,percent of total billed charges,33.9% of total billed charges,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2305.68,78,,,percent of total billed charges,78% of total billed charges,2956,100,,,percent of total billed charges,100% of total billed charges,2441.66,82.6,,,percent of total billed charges,82.6% of total billed charges,2441.66,82.6,,,percent of total billed charges,82.6% of total billed charges,556.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,132.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,132.56,100208.4,
ID ABSCESS P-SPINE L/S/LS,22015,CDM,983,RC,22015,HCPCS,Outpatient,,,2929,1903.85,,2577.52,88,,,percent of total billed charges,88% of total Billed charges,121.54,100,,,Fee Schedule,100% of Medicare rate,544.77,100,,,Fee Schedule,100% of WA Medicaid,2929,100,,,percent of total billed charges,100% of total billed charges,561.11,103,,,Fee Schedule,103% of WA Medicaid,121.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,212.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,544.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2021.01,69,,,percent of total billed charges,69% of total billed charges,2929,100,,,percent of total billed charges,100% of total billed charges,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2929,100,,,percent of total billed charges,100% of total billed charges,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2929,100,,,percent of total billed charges,100% of total billed charges,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1811.59,61.85,,,percent of total billed charges,61.85% of total billed charges,544.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,555.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,708.2,130,,,Fee Schedule,130% of WA Medicaid ,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1104.23,37.7,,,percent of total billed charges,37.70% of total billed charges,1104.23,37.7,,,percent of total billed charges,37.70% of total billed charges,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,99293.1,33.9,,,percent of total billed charges,33.9% of total billed charges,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2284.62,78,,,percent of total billed charges,78% of total billed charges,2929,100,,,percent of total billed charges,100% of total billed charges,2419.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2419.35,82.6,,,percent of total billed charges,82.6% of total billed charges,544.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.54,99293.1,
REMOVE PART OF NECK VERTEBRA,22100,CDM,983,RC,22100,HCPCS,Outpatient,,,2051,1333.15,,1804.88,88,,,percent of total billed charges,88% of total Billed charges,146.91,100,,,Fee Schedule,100% of Medicare rate,544.21,100,,,Fee Schedule,100% of WA Medicaid,2051,100,,,percent of total billed charges,100% of total billed charges,560.54,103,,,Fee Schedule,103% of WA Medicaid,146.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,257.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,544.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1415.19,69,,,percent of total billed charges,69% of total billed charges,2051,100,,,percent of total billed charges,100% of total billed charges,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2051,100,,,percent of total billed charges,100% of total billed charges,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2051,100,,,percent of total billed charges,100% of total billed charges,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1268.54,61.85,,,percent of total billed charges,61.85% of total billed charges,544.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,555.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,707.47,130,,,Fee Schedule,130% of WA Medicaid ,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,773.23,37.7,,,percent of total billed charges,37.70% of total billed charges,773.23,37.7,,,percent of total billed charges,37.70% of total billed charges,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,69528.9,33.9,,,percent of total billed charges,33.9% of total billed charges,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1599.78,78,,,percent of total billed charges,78% of total billed charges,2051,100,,,percent of total billed charges,100% of total billed charges,1694.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1694.13,82.6,,,percent of total billed charges,82.6% of total billed charges,544.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,146.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,146.91,69528.9,
REMOVE PART THORAX VERTEBRA,22101,CDM,983,RC,22101,HCPCS,Outpatient,,,2079,1351.35,,1829.52,88,,,percent of total billed charges,88% of total Billed charges,114.77,100,,,Fee Schedule,100% of Medicare rate,505.23,100,,,Fee Schedule,100% of WA Medicaid,2079,100,,,percent of total billed charges,100% of total billed charges,520.39,103,,,Fee Schedule,103% of WA Medicaid,114.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,200.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,505.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1434.51,69,,,percent of total billed charges,69% of total billed charges,2079,100,,,percent of total billed charges,100% of total billed charges,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2079,100,,,percent of total billed charges,100% of total billed charges,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2079,100,,,percent of total billed charges,100% of total billed charges,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1285.86,61.85,,,percent of total billed charges,61.85% of total billed charges,505.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,656.8,130,,,Fee Schedule,130% of WA Medicaid ,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,783.78,37.7,,,percent of total billed charges,37.70% of total billed charges,783.78,37.7,,,percent of total billed charges,37.70% of total billed charges,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,70478.1,33.9,,,percent of total billed charges,33.9% of total billed charges,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1621.62,78,,,percent of total billed charges,78% of total billed charges,2079,100,,,percent of total billed charges,100% of total billed charges,1717.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1717.25,82.6,,,percent of total billed charges,82.6% of total billed charges,505.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,114.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.77,70478.1,
REMOVE EXTRA SPINE SEGMENT,22103,CDM,983,RC,22103,HCPCS,Outpatient,,,427,277.55,,375.76,88,,,percent of total billed charges,88% of total Billed charges,18.99,100,,,Fee Schedule,100% of Medicare rate,74.6,100,,,Fee Schedule,100% of WA Medicaid,427,100,,,percent of total billed charges,100% of total billed charges,76.84,103,,,Fee Schedule,103% of WA Medicaid,18.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,294.63,69,,,percent of total billed charges,69% of total billed charges,427,100,,,percent of total billed charges,100% of total billed charges,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,427,100,,,percent of total billed charges,100% of total billed charges,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,427,100,,,percent of total billed charges,100% of total billed charges,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.1,61.85,,,percent of total billed charges,61.85% of total billed charges,74.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,96.98,130,,,Fee Schedule,130% of WA Medicaid ,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.98,37.7,,,percent of total billed charges,37.70% of total billed charges,160.98,37.7,,,percent of total billed charges,37.70% of total billed charges,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,14475.3,33.9,,,percent of total billed charges,33.9% of total billed charges,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.06,78,,,percent of total billed charges,78% of total billed charges,427,100,,,percent of total billed charges,100% of total billed charges,352.7,82.6,,,percent of total billed charges,82.6% of total billed charges,352.7,82.6,,,percent of total billed charges,82.6% of total billed charges,74.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.99,14475.3,
REMOVE PART LUMBAR VERTEBRA,22102,CDM,983,RC,22102,HCPCS,Outpatient,,,2048,1331.20,,1802.24,88,,,percent of total billed charges,88% of total Billed charges,80.96,100,,,Fee Schedule,100% of Medicare rate,444.06,100,,,Fee Schedule,100% of WA Medicaid,2048,100,,,percent of total billed charges,100% of total billed charges,457.38,103,,,Fee Schedule,103% of WA Medicaid,80.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,141.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,444.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1413.12,69,,,percent of total billed charges,69% of total billed charges,2048,100,,,percent of total billed charges,100% of total billed charges,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2048,100,,,percent of total billed charges,100% of total billed charges,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2048,100,,,percent of total billed charges,100% of total billed charges,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1266.69,61.85,,,percent of total billed charges,61.85% of total billed charges,444.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,577.28,130,,,Fee Schedule,130% of WA Medicaid ,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,772.1,37.7,,,percent of total billed charges,37.70% of total billed charges,772.1,37.7,,,percent of total billed charges,37.70% of total billed charges,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,69427.2,33.9,,,percent of total billed charges,33.9% of total billed charges,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1597.44,78,,,percent of total billed charges,78% of total billed charges,2048,100,,,percent of total billed charges,100% of total billed charges,1691.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1691.65,82.6,,,percent of total billed charges,82.6% of total billed charges,444.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.96,69427.2,
REMOVE EXTRA SPINE SEGMENT,22116,CDM,983,RC,22116,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,23.57,100,,,Fee Schedule,100% of Medicare rate,77.77,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,80.1,103,,,Fee Schedule,103% of WA Medicaid,23.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,480,100,,,percent of total billed charges,100% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,480,100,,,percent of total billed charges,100% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.88,61.85,,,percent of total billed charges,61.85% of total billed charges,77.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.1,130,,,Fee Schedule,130% of WA Medicaid ,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,16272,33.9,,,percent of total billed charges,33.9% of total billed charges,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,77.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.57,16272,
REMOVE PART OF NECK VERTEBRA,22110,CDM,983,RC,22110,HCPCS,Outpatient,,,2629,1708.85,,2313.52,88,,,percent of total billed charges,88% of total Billed charges,151.27,100,,,Fee Schedule,100% of Medicare rate,606.68,100,,,Fee Schedule,100% of WA Medicaid,2629,100,,,percent of total billed charges,100% of total billed charges,624.88,103,,,Fee Schedule,103% of WA Medicaid,151.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,264.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,606.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1814.01,69,,,percent of total billed charges,69% of total billed charges,2629,100,,,percent of total billed charges,100% of total billed charges,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2629,100,,,percent of total billed charges,100% of total billed charges,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2629,100,,,percent of total billed charges,100% of total billed charges,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1626.04,61.85,,,percent of total billed charges,61.85% of total billed charges,606.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,788.68,130,,,Fee Schedule,130% of WA Medicaid ,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,991.13,37.7,,,percent of total billed charges,37.70% of total billed charges,991.13,37.7,,,percent of total billed charges,37.70% of total billed charges,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,89123.1,33.9,,,percent of total billed charges,33.9% of total billed charges,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2050.62,78,,,percent of total billed charges,78% of total billed charges,2629,100,,,percent of total billed charges,100% of total billed charges,2171.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2171.55,82.6,,,percent of total billed charges,82.6% of total billed charges,606.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,151.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,151.27,89123.1,
REMOVE PART THORAX VERTEBRA,22112,CDM,983,RC,22112,HCPCS,Outpatient,,,2613,1698.45,,2299.44,88,,,percent of total billed charges,88% of total Billed charges,186.02,100,,,Fee Schedule,100% of Medicare rate,650.89,100,,,Fee Schedule,100% of WA Medicaid,2613,100,,,percent of total billed charges,100% of total billed charges,670.42,103,,,Fee Schedule,103% of WA Medicaid,186.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,325.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,650.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1802.97,69,,,percent of total billed charges,69% of total billed charges,2613,100,,,percent of total billed charges,100% of total billed charges,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2613,100,,,percent of total billed charges,100% of total billed charges,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2613,100,,,percent of total billed charges,100% of total billed charges,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1616.14,61.85,,,percent of total billed charges,61.85% of total billed charges,650.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,650.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,846.16,130,,,Fee Schedule,130% of WA Medicaid ,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,985.1,37.7,,,percent of total billed charges,37.70% of total billed charges,985.1,37.7,,,percent of total billed charges,37.70% of total billed charges,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,88580.7,33.9,,,percent of total billed charges,33.9% of total billed charges,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2038.14,78,,,percent of total billed charges,78% of total billed charges,2613,100,,,percent of total billed charges,100% of total billed charges,2158.34,82.6,,,percent of total billed charges,82.6% of total billed charges,2158.34,82.6,,,percent of total billed charges,82.6% of total billed charges,650.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,650.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,186.02,88580.7,
REMOVE PART LUMBAR VERTEBRA,22114,CDM,983,RC,22114,HCPCS,Outpatient,,,2643,1717.95,,2325.84,88,,,percent of total billed charges,88% of total Billed charges,186.02,100,,,Fee Schedule,100% of Medicare rate,650.89,100,,,Fee Schedule,100% of WA Medicaid,2643,100,,,percent of total billed charges,100% of total billed charges,670.42,103,,,Fee Schedule,103% of WA Medicaid,186.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,325.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,650.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1823.67,69,,,percent of total billed charges,69% of total billed charges,2643,100,,,percent of total billed charges,100% of total billed charges,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2643,100,,,percent of total billed charges,100% of total billed charges,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2643,100,,,percent of total billed charges,100% of total billed charges,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1634.7,61.85,,,percent of total billed charges,61.85% of total billed charges,650.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,650.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,846.16,130,,,Fee Schedule,130% of WA Medicaid ,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,996.41,37.7,,,percent of total billed charges,37.70% of total billed charges,996.41,37.7,,,percent of total billed charges,37.70% of total billed charges,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,89597.7,33.9,,,percent of total billed charges,33.9% of total billed charges,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2061.54,78,,,percent of total billed charges,78% of total billed charges,2643,100,,,percent of total billed charges,100% of total billed charges,2183.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2183.12,82.6,,,percent of total billed charges,82.6% of total billed charges,650.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,186.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,650.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,186.02,89597.7,
INCIS 1 VERTEBRAL SEG LUMBAR,22214,CDM,983,RC,22214,HCPCS,Outpatient,,,4646,3019.90,,4088.48,88,,,percent of total billed charges,88% of total Billed charges,207.62,100,,,Fee Schedule,100% of Medicare rate,863.5,100,,,Fee Schedule,100% of WA Medicaid,4646,100,,,percent of total billed charges,100% of total billed charges,889.41,103,,,Fee Schedule,103% of WA Medicaid,207.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,363.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,863.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3205.74,69,,,percent of total billed charges,69% of total billed charges,4646,100,,,percent of total billed charges,100% of total billed charges,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,4646,100,,,percent of total billed charges,100% of total billed charges,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,4646,100,,,percent of total billed charges,100% of total billed charges,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2873.55,61.85,,,percent of total billed charges,61.85% of total billed charges,863.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,880.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1122.55,130,,,Fee Schedule,130% of WA Medicaid ,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1751.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1751.54,37.7,,,percent of total billed charges,37.70% of total billed charges,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,157499.4,33.9,,,percent of total billed charges,33.9% of total billed charges,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,3623.88,78,,,percent of total billed charges,78% of total billed charges,4646,100,,,percent of total billed charges,100% of total billed charges,3837.6,82.6,,,percent of total billed charges,82.6% of total billed charges,3837.6,82.6,,,percent of total billed charges,82.6% of total billed charges,863.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,207.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,207.62,157499.4,
CLOSED TX SPINE PROCESS FX,22305,CDM,983,RC,,,Outpatient,,,658,427.70,,579.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,658,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,454.02,69,,,percent of total billed charges,69% of total billed charges,658,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,658,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,658,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,406.97,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,248.07,37.7,,,percent of total billed charges,37.70% of total billed charges,248.07,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,22306.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,513.24,78,,,percent of total billed charges,78% of total billed charges,658,100,,,percent of total billed charges,100% of total billed charges,543.51,82.6,,,percent of total billed charges,82.6% of total billed charges,543.51,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",248.07,22306.2,
CLOSED TX VERT FX W/O MANJ,22310,CDM,983,RC,22310,HCPCS,Outpatient,,,999,649.35,,879.12,88,,,percent of total billed charges,88% of total Billed charges,29.13,100,,,Fee Schedule,100% of Medicare rate,174.56,100,,,Fee Schedule,100% of WA Medicaid,999,100,,,percent of total billed charges,100% of total billed charges,179.8,103,,,Fee Schedule,103% of WA Medicaid,29.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,50.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,174.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,689.31,69,,,percent of total billed charges,69% of total billed charges,999,100,,,percent of total billed charges,100% of total billed charges,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,999,100,,,percent of total billed charges,100% of total billed charges,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,999,100,,,percent of total billed charges,100% of total billed charges,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.88,61.85,,,percent of total billed charges,61.85% of total billed charges,174.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,226.93,130,,,Fee Schedule,130% of WA Medicaid ,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.62,37.7,,,percent of total billed charges,37.70% of total billed charges,376.62,37.7,,,percent of total billed charges,37.70% of total billed charges,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,33866.1,33.9,,,percent of total billed charges,33.9% of total billed charges,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,779.22,78,,,percent of total billed charges,78% of total billed charges,999,100,,,percent of total billed charges,100% of total billed charges,825.17,82.6,,,percent of total billed charges,82.6% of total billed charges,825.17,82.6,,,percent of total billed charges,82.6% of total billed charges,174.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.13,33866.1,
CLOSED TX VERT FX W/MANJ,22315,CDM,983,RC,22315,HCPCS,Outpatient,,,1980,1287.00,,1742.4,88,,,percent of total billed charges,88% of total Billed charges,87.25,100,,,Fee Schedule,100% of Medicare rate,450.77,100,,,Fee Schedule,100% of WA Medicaid,1980,100,,,percent of total billed charges,100% of total billed charges,464.29,103,,,Fee Schedule,103% of WA Medicaid,87.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,152.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,450.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1366.2,69,,,percent of total billed charges,69% of total billed charges,1980,100,,,percent of total billed charges,100% of total billed charges,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1980,100,,,percent of total billed charges,100% of total billed charges,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1980,100,,,percent of total billed charges,100% of total billed charges,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1224.63,61.85,,,percent of total billed charges,61.85% of total billed charges,450.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,586,130,,,Fee Schedule,130% of WA Medicaid ,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.46,37.7,,,percent of total billed charges,37.70% of total billed charges,746.46,37.7,,,percent of total billed charges,37.70% of total billed charges,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,67122,33.9,,,percent of total billed charges,33.9% of total billed charges,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1544.4,78,,,percent of total billed charges,78% of total billed charges,1980,100,,,percent of total billed charges,100% of total billed charges,1635.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1635.48,82.6,,,percent of total billed charges,82.6% of total billed charges,450.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.25,67122,
TREAT ODONTOID FX W/O GRAFT,22318,CDM,983,RC,22318,HCPCS,Outpatient,,,4281,2782.65,,3767.28,88,,,percent of total billed charges,88% of total Billed charges,285.46,100,,,Fee Schedule,100% of Medicare rate,936.42,100,,,Fee Schedule,100% of WA Medicaid,4281,100,,,percent of total billed charges,100% of total billed charges,964.51,103,,,Fee Schedule,103% of WA Medicaid,285.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,499.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,936.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2953.89,69,,,percent of total billed charges,69% of total billed charges,4281,100,,,percent of total billed charges,100% of total billed charges,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,4281,100,,,percent of total billed charges,100% of total billed charges,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,4281,100,,,percent of total billed charges,100% of total billed charges,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2647.8,61.85,,,percent of total billed charges,61.85% of total billed charges,936.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,936.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,955.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1217.35,130,,,Fee Schedule,130% of WA Medicaid ,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1613.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1613.94,37.7,,,percent of total billed charges,37.70% of total billed charges,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,145125.9,33.9,,,percent of total billed charges,33.9% of total billed charges,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3339.18,78,,,percent of total billed charges,78% of total billed charges,4281,100,,,percent of total billed charges,100% of total billed charges,3536.11,82.6,,,percent of total billed charges,82.6% of total billed charges,3536.11,82.6,,,percent of total billed charges,82.6% of total billed charges,936.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,285.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,936.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,285.46,145125.9,
TREAT ODONTOID FX W/GRAFT,22319,CDM,983,RC,22319,HCPCS,Outpatient,,,4809,3125.85,,4231.92,88,,,percent of total billed charges,88% of total Billed charges,328.84,100,,,Fee Schedule,100% of Medicare rate,1035.45,100,,,Fee Schedule,100% of WA Medicaid,4809,100,,,percent of total billed charges,100% of total billed charges,1066.51,103,,,Fee Schedule,103% of WA Medicaid,328.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,575.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1035.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3318.21,69,,,percent of total billed charges,69% of total billed charges,4809,100,,,percent of total billed charges,100% of total billed charges,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,4809,100,,,percent of total billed charges,100% of total billed charges,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,4809,100,,,percent of total billed charges,100% of total billed charges,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2974.37,61.85,,,percent of total billed charges,61.85% of total billed charges,1035.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1056.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1346.09,130,,,Fee Schedule,130% of WA Medicaid ,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1812.99,37.7,,,percent of total billed charges,37.70% of total billed charges,1812.99,37.7,,,percent of total billed charges,37.70% of total billed charges,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,163025.1,33.9,,,percent of total billed charges,33.9% of total billed charges,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3751.02,78,,,percent of total billed charges,78% of total billed charges,4809,100,,,percent of total billed charges,100% of total billed charges,3972.23,82.6,,,percent of total billed charges,82.6% of total billed charges,3972.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1035.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,328.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,328.84,163025.1,
TREAT EACH ADD SPINE FX,22328,CDM,983,RC,22328,HCPCS,Outpatient,,,931,605.15,,819.28,88,,,percent of total billed charges,88% of total Billed charges,48.68,100,,,Fee Schedule,100% of Medicare rate,155.17,100,,,Fee Schedule,100% of WA Medicaid,931,100,,,percent of total billed charges,100% of total billed charges,159.83,103,,,Fee Schedule,103% of WA Medicaid,48.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,155.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,642.39,69,,,percent of total billed charges,69% of total billed charges,931,100,,,percent of total billed charges,100% of total billed charges,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,931,100,,,percent of total billed charges,100% of total billed charges,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,931,100,,,percent of total billed charges,100% of total billed charges,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.82,61.85,,,percent of total billed charges,61.85% of total billed charges,155.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,201.72,130,,,Fee Schedule,130% of WA Medicaid ,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.99,37.7,,,percent of total billed charges,37.70% of total billed charges,350.99,37.7,,,percent of total billed charges,37.70% of total billed charges,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,31560.9,33.9,,,percent of total billed charges,33.9% of total billed charges,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.18,78,,,percent of total billed charges,78% of total billed charges,931,100,,,percent of total billed charges,100% of total billed charges,769.01,82.6,,,percent of total billed charges,82.6% of total billed charges,769.01,82.6,,,percent of total billed charges,82.6% of total billed charges,155.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.68,31560.9,
TREAT NECK SPINE FRACTURE,22326,CDM,983,RC,22326,HCPCS,Outpatient,,,3996,2597.40,,3516.48,88,,,percent of total billed charges,88% of total Billed charges,239.05,100,,,Fee Schedule,100% of Medicare rate,858.46,100,,,Fee Schedule,100% of WA Medicaid,3996,100,,,percent of total billed charges,100% of total billed charges,884.21,103,,,Fee Schedule,103% of WA Medicaid,239.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,418.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,858.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2757.24,69,,,percent of total billed charges,69% of total billed charges,3996,100,,,percent of total billed charges,100% of total billed charges,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3996,100,,,percent of total billed charges,100% of total billed charges,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3996,100,,,percent of total billed charges,100% of total billed charges,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2471.53,61.85,,,percent of total billed charges,61.85% of total billed charges,858.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,858.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,875.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1116,130,,,Fee Schedule,130% of WA Medicaid ,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1506.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1506.49,37.7,,,percent of total billed charges,37.70% of total billed charges,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,135464.4,33.9,,,percent of total billed charges,33.9% of total billed charges,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3116.88,78,,,percent of total billed charges,78% of total billed charges,3996,100,,,percent of total billed charges,100% of total billed charges,3300.7,82.6,,,percent of total billed charges,82.6% of total billed charges,3300.7,82.6,,,percent of total billed charges,82.6% of total billed charges,858.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,239.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,858.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,239.05,135464.4,
TREAT THORAX SPINE FRACTURE,22327,CDM,983,RC,22327,HCPCS,Outpatient,,,3791,2464.15,,3336.08,88,,,percent of total billed charges,88% of total Billed charges,235.05,100,,,Fee Schedule,100% of Medicare rate,876.74,100,,,Fee Schedule,100% of WA Medicaid,3791,100,,,percent of total billed charges,100% of total billed charges,903.04,103,,,Fee Schedule,103% of WA Medicaid,235.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,411.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,876.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2615.79,69,,,percent of total billed charges,69% of total billed charges,3791,100,,,percent of total billed charges,100% of total billed charges,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3791,100,,,percent of total billed charges,100% of total billed charges,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3791,100,,,percent of total billed charges,100% of total billed charges,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2344.73,61.85,,,percent of total billed charges,61.85% of total billed charges,876.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1139.76,130,,,Fee Schedule,130% of WA Medicaid ,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1429.21,37.7,,,percent of total billed charges,37.70% of total billed charges,1429.21,37.7,,,percent of total billed charges,37.70% of total billed charges,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,128514.9,33.9,,,percent of total billed charges,33.9% of total billed charges,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2956.98,78,,,percent of total billed charges,78% of total billed charges,3791,100,,,percent of total billed charges,100% of total billed charges,3131.37,82.6,,,percent of total billed charges,82.6% of total billed charges,3131.37,82.6,,,percent of total billed charges,82.6% of total billed charges,876.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,235.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,235.05,128514.9,
TREAT SPINE FRACTURE,22325,CDM,983,RC,22325,HCPCS,Outpatient,,,4266,2772.90,,3754.08,88,,,percent of total billed charges,88% of total Billed charges,221.04,100,,,Fee Schedule,100% of Medicare rate,842.42,100,,,Fee Schedule,100% of WA Medicaid,4266,100,,,percent of total billed charges,100% of total billed charges,867.69,103,,,Fee Schedule,103% of WA Medicaid,221.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,386.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,842.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2943.54,69,,,percent of total billed charges,69% of total billed charges,4266,100,,,percent of total billed charges,100% of total billed charges,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,4266,100,,,percent of total billed charges,100% of total billed charges,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,4266,100,,,percent of total billed charges,100% of total billed charges,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2638.52,61.85,,,percent of total billed charges,61.85% of total billed charges,842.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1095.15,130,,,Fee Schedule,130% of WA Medicaid ,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1608.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1608.28,37.7,,,percent of total billed charges,37.70% of total billed charges,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,144617.4,33.9,,,percent of total billed charges,33.9% of total billed charges,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3327.48,78,,,percent of total billed charges,78% of total billed charges,4266,100,,,percent of total billed charges,100% of total billed charges,3523.72,82.6,,,percent of total billed charges,82.6% of total billed charges,3523.72,82.6,,,percent of total billed charges,82.6% of total billed charges,842.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,221.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,221.04,144617.4,
MANIPULATION OF SPINE,22505,CDM,983,RC,22505,HCPCS,Outpatient,,,465,302.25,,409.2,88,,,percent of total billed charges,88% of total Billed charges,15.33,100,,,Fee Schedule,100% of Medicare rate,74.41,100,,,Fee Schedule,100% of WA Medicaid,465,100,,,percent of total billed charges,100% of total billed charges,76.64,103,,,Fee Schedule,103% of WA Medicaid,15.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,320.85,69,,,percent of total billed charges,69% of total billed charges,465,100,,,percent of total billed charges,100% of total billed charges,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,465,100,,,percent of total billed charges,100% of total billed charges,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,465,100,,,percent of total billed charges,100% of total billed charges,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.6,61.85,,,percent of total billed charges,61.85% of total billed charges,74.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,96.73,130,,,Fee Schedule,130% of WA Medicaid ,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.31,37.7,,,percent of total billed charges,37.70% of total billed charges,175.31,37.7,,,percent of total billed charges,37.70% of total billed charges,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,15763.5,33.9,,,percent of total billed charges,33.9% of total billed charges,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.7,78,,,percent of total billed charges,78% of total billed charges,465,100,,,percent of total billed charges,100% of total billed charges,384.09,82.6,,,percent of total billed charges,82.6% of total billed charges,384.09,82.6,,,percent of total billed charges,82.6% of total billed charges,74.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.33,15763.5,
PERCUT VERTEBROPLASTY THOR,22520,CDM,983,RC,22520,HCPCS,Outpatient,,,1760,1144.00,,1548.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1760,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1214.4,69,,,percent of total billed charges,69% of total billed charges,1760,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1760,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1760,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1088.56,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,663.52,37.7,,,percent of total billed charges,37.70% of total billed charges,663.52,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,59664,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1372.8,78,,,percent of total billed charges,78% of total billed charges,1760,100,,,percent of total billed charges,100% of total billed charges,1453.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1453.76,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",663.52,59664,
PERCUT VERTEBROPLASTY LUMB,22521,CDM,983,RC,22521,HCPCS,Outpatient,,,1651,1073.15,,1452.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1651,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1139.19,69,,,percent of total billed charges,69% of total billed charges,1651,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1651,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1651,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1021.14,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,622.43,37.7,,,percent of total billed charges,37.70% of total billed charges,622.43,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,55968.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1287.78,78,,,percent of total billed charges,78% of total billed charges,1651,100,,,percent of total billed charges,100% of total billed charges,1363.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1363.73,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",622.43,55968.9,
PERCUT VERTEBROPLASTY ADDL,22522,CDM,983,RC,22522,HCPCS,Outpatient,,,577,375.05,,507.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,577,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,398.13,69,,,percent of total billed charges,69% of total billed charges,577,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,577,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,577,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,356.87,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,217.53,37.7,,,percent of total billed charges,37.70% of total billed charges,217.53,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,19560.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,450.06,78,,,percent of total billed charges,78% of total billed charges,577,100,,,percent of total billed charges,100% of total billed charges,476.6,82.6,,,percent of total billed charges,82.6% of total billed charges,476.6,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",217.53,19560.3,
PERCUT KYPHOPLASTY LUMBAR,22524,CDM,983,RC,22524,HCPCS,Outpatient,,,2724,1770.60,,2397.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2724,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1879.56,69,,,percent of total billed charges,69% of total billed charges,2724,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2724,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2724,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1684.79,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1026.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1026.95,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,92343.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2124.72,78,,,percent of total billed charges,78% of total billed charges,2724,100,,,percent of total billed charges,100% of total billed charges,2250.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2250.02,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1026.95,92343.6,
PERCUT KYPHOPLASTY ADD-ON,22525,CDM,983,RC,22525,HCPCS,Outpatient,,,862,560.30,,758.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,862,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,594.78,69,,,percent of total billed charges,69% of total billed charges,862,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,862,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,862,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,533.15,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,324.97,37.7,,,percent of total billed charges,37.70% of total billed charges,324.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,29221.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,672.36,78,,,percent of total billed charges,78% of total billed charges,862,100,,,percent of total billed charges,100% of total billed charges,712.01,82.6,,,percent of total billed charges,82.6% of total billed charges,712.01,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",324.97,29221.8,
PERCUT KYPHOPLASTY THOR,22523,CDM,983,RC,22523,HCPCS,Outpatient,,,1779,1156.35,,1565.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1779,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1227.51,69,,,percent of total billed charges,69% of total billed charges,1779,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1779,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1779,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1100.31,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,670.68,37.7,,,percent of total billed charges,37.70% of total billed charges,670.68,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,60308.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1387.62,78,,,percent of total billed charges,78% of total billed charges,1779,100,,,percent of total billed charges,100% of total billed charges,1469.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1469.45,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",670.68,60308.1,
LAT THOR/LUMB ADDL SEG,22534,CDM,983,RC,22534,HCPCS,Outpatient,,,1472,956.80,,1295.36,88,,,percent of total billed charges,88% of total Billed charges,57.24,100,,,Fee Schedule,100% of Medicare rate,199.37,100,,,Fee Schedule,100% of WA Medicaid,1472,100,,,percent of total billed charges,100% of total billed charges,205.35,103,,,Fee Schedule,103% of WA Medicaid,57.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,199.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1015.68,69,,,percent of total billed charges,69% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1472,100,,,percent of total billed charges,100% of total billed charges,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1472,100,,,percent of total billed charges,100% of total billed charges,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,910.43,61.85,,,percent of total billed charges,61.85% of total billed charges,199.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,259.18,130,,,Fee Schedule,130% of WA Medicaid ,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,49900.8,33.9,,,percent of total billed charges,33.9% of total billed charges,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1148.16,78,,,percent of total billed charges,78% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,199.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.24,49900.8,
LAT THORAX SPINE FUSION,22532,CDM,983,RC,22532,HCPCS,Outpatient,,,5828,3788.20,,5128.64,88,,,percent of total billed charges,88% of total Billed charges,273.75,100,,,Fee Schedule,100% of Medicare rate,1014.37,100,,,Fee Schedule,100% of WA Medicaid,5828,100,,,percent of total billed charges,100% of total billed charges,1044.8,103,,,Fee Schedule,103% of WA Medicaid,273.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,479.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1014.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4021.32,69,,,percent of total billed charges,69% of total billed charges,5828,100,,,percent of total billed charges,100% of total billed charges,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5828,100,,,percent of total billed charges,100% of total billed charges,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5828,100,,,percent of total billed charges,100% of total billed charges,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3604.62,61.85,,,percent of total billed charges,61.85% of total billed charges,1014.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1318.68,130,,,Fee Schedule,130% of WA Medicaid ,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2197.16,37.7,,,percent of total billed charges,37.70% of total billed charges,2197.16,37.7,,,percent of total billed charges,37.70% of total billed charges,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,197569.2,33.9,,,percent of total billed charges,33.9% of total billed charges,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,4545.84,78,,,percent of total billed charges,78% of total billed charges,5828,100,,,percent of total billed charges,100% of total billed charges,4813.93,82.6,,,percent of total billed charges,82.6% of total billed charges,4813.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1014.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,273.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.75,197569.2,
LAT LUMBAR SPINE FUSION,22533,CDM,983,RC,22533,HCPCS,Outpatient,,,5714,3714.10,,5028.32,88,,,percent of total billed charges,88% of total Billed charges,218.34,100,,,Fee Schedule,100% of Medicare rate,943.13,100,,,Fee Schedule,100% of WA Medicaid,5714,100,,,percent of total billed charges,100% of total billed charges,971.42,103,,,Fee Schedule,103% of WA Medicaid,218.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,382.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,943.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3942.66,69,,,percent of total billed charges,69% of total billed charges,5714,100,,,percent of total billed charges,100% of total billed charges,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,5714,100,,,percent of total billed charges,100% of total billed charges,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,5714,100,,,percent of total billed charges,100% of total billed charges,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,3534.11,61.85,,,percent of total billed charges,61.85% of total billed charges,943.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,943.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,961.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1226.07,130,,,Fee Schedule,130% of WA Medicaid ,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2154.18,37.7,,,percent of total billed charges,37.70% of total billed charges,2154.18,37.7,,,percent of total billed charges,37.70% of total billed charges,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,193704.6,33.9,,,percent of total billed charges,33.9% of total billed charges,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,4456.92,78,,,percent of total billed charges,78% of total billed charges,5714,100,,,percent of total billed charges,100% of total billed charges,4719.76,82.6,,,percent of total billed charges,82.6% of total billed charges,4719.76,82.6,,,percent of total billed charges,82.6% of total billed charges,943.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,218.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,943.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,218.34,193704.6,
NECK SPINE FUSION,22548,CDM,983,RC,22548,HCPCS,Outpatient,,,8702,5656.30,,7657.76,88,,,percent of total billed charges,88% of total Billed charges,351.22,100,,,Fee Schedule,100% of Medicare rate,1110.42,100,,,Fee Schedule,100% of WA Medicaid,8702,100,,,percent of total billed charges,100% of total billed charges,1143.73,103,,,Fee Schedule,103% of WA Medicaid,351.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,614.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1110.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6004.38,69,,,percent of total billed charges,69% of total billed charges,8702,100,,,percent of total billed charges,100% of total billed charges,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,8702,100,,,percent of total billed charges,100% of total billed charges,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,8702,100,,,percent of total billed charges,100% of total billed charges,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,5382.19,61.85,,,percent of total billed charges,61.85% of total billed charges,1110.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1110.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1132.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1443.55,130,,,Fee Schedule,130% of WA Medicaid ,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,3280.65,37.7,,,percent of total billed charges,37.70% of total billed charges,3280.65,37.7,,,percent of total billed charges,37.70% of total billed charges,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,294997.8,33.9,,,percent of total billed charges,33.9% of total billed charges,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,6787.56,78,,,percent of total billed charges,78% of total billed charges,8702,100,,,percent of total billed charges,100% of total billed charges,7187.85,82.6,,,percent of total billed charges,82.6% of total billed charges,7187.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1110.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,351.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1110.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,351.22,294997.8,
NECK SPINE FUSION,22554,CDM,983,RC,22554,HCPCS,Outpatient,,,6294,4091.10,,5538.72,88,,,percent of total billed charges,88% of total Billed charges,190.09,100,,,Fee Schedule,100% of Medicare rate,717.28,100,,,Fee Schedule,100% of WA Medicaid,6294,100,,,percent of total billed charges,100% of total billed charges,738.8,103,,,Fee Schedule,103% of WA Medicaid,190.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,332.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,717.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4342.86,69,,,percent of total billed charges,69% of total billed charges,6294,100,,,percent of total billed charges,100% of total billed charges,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,6294,100,,,percent of total billed charges,100% of total billed charges,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,6294,100,,,percent of total billed charges,100% of total billed charges,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3892.84,61.85,,,percent of total billed charges,61.85% of total billed charges,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,932.46,130,,,Fee Schedule,130% of WA Medicaid ,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2372.84,37.7,,,percent of total billed charges,37.70% of total billed charges,2372.84,37.7,,,percent of total billed charges,37.70% of total billed charges,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,213366.6,33.9,,,percent of total billed charges,33.9% of total billed charges,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4909.32,78,,,percent of total billed charges,78% of total billed charges,6294,100,,,percent of total billed charges,100% of total billed charges,5198.84,82.6,,,percent of total billed charges,82.6% of total billed charges,5198.84,82.6,,,percent of total billed charges,82.6% of total billed charges,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,190.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,190.09,213366.6,
THORAX SPINE FUSION,22556,CDM,983,RC,22556,HCPCS,Outpatient,,,8106,5268.90,,7133.28,88,,,percent of total billed charges,88% of total Billed charges,253.43,100,,,Fee Schedule,100% of Medicare rate,953.57,100,,,Fee Schedule,100% of WA Medicaid,8106,100,,,percent of total billed charges,100% of total billed charges,982.18,103,,,Fee Schedule,103% of WA Medicaid,253.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,443.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,953.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5593.14,69,,,percent of total billed charges,69% of total billed charges,8106,100,,,percent of total billed charges,100% of total billed charges,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,8106,100,,,percent of total billed charges,100% of total billed charges,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,8106,100,,,percent of total billed charges,100% of total billed charges,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,5013.56,61.85,,,percent of total billed charges,61.85% of total billed charges,953.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,953.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,972.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1239.64,130,,,Fee Schedule,130% of WA Medicaid ,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3055.96,37.7,,,percent of total billed charges,37.70% of total billed charges,3055.96,37.7,,,percent of total billed charges,37.70% of total billed charges,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,274793.4,33.9,,,percent of total billed charges,33.9% of total billed charges,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6322.68,78,,,percent of total billed charges,78% of total billed charges,8106,100,,,percent of total billed charges,100% of total billed charges,6695.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6695.56,82.6,,,percent of total billed charges,82.6% of total billed charges,953.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,253.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,953.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,253.43,274793.4,
LUMBAR SPINE FUSION,22558,CDM,983,RC,22558,HCPCS,Outpatient,,,6763,4395.95,,5951.44,88,,,percent of total billed charges,88% of total Billed charges,214.61,100,,,Fee Schedule,100% of Medicare rate,861.63,100,,,Fee Schedule,100% of WA Medicaid,6763,100,,,percent of total billed charges,100% of total billed charges,887.48,103,,,Fee Schedule,103% of WA Medicaid,214.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,375.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,861.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4666.47,69,,,percent of total billed charges,69% of total billed charges,6763,100,,,percent of total billed charges,100% of total billed charges,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6763,100,,,percent of total billed charges,100% of total billed charges,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6763,100,,,percent of total billed charges,100% of total billed charges,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4182.92,61.85,,,percent of total billed charges,61.85% of total billed charges,861.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,878.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.12,130,,,Fee Schedule,130% of WA Medicaid ,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2549.65,37.7,,,percent of total billed charges,37.70% of total billed charges,2549.65,37.7,,,percent of total billed charges,37.70% of total billed charges,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,229265.7,33.9,,,percent of total billed charges,33.9% of total billed charges,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,5275.14,78,,,percent of total billed charges,78% of total billed charges,6763,100,,,percent of total billed charges,100% of total billed charges,5586.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5586.24,82.6,,,percent of total billed charges,82.6% of total billed charges,861.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,214.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,214.61,229265.7,
ADDITIONAL SPINAL FUSION,22585,CDM,983,RC,22585,HCPCS,Outpatient,,,1700,1105.00,,1496,88,,,percent of total billed charges,88% of total Billed charges,51.51,100,,,Fee Schedule,100% of Medicare rate,179.23,100,,,Fee Schedule,100% of WA Medicaid,1700,100,,,percent of total billed charges,100% of total billed charges,184.61,103,,,Fee Schedule,103% of WA Medicaid,51.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,179.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1173,69,,,percent of total billed charges,69% of total billed charges,1700,100,,,percent of total billed charges,100% of total billed charges,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1700,100,,,percent of total billed charges,100% of total billed charges,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1700,100,,,percent of total billed charges,100% of total billed charges,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1051.45,61.85,,,percent of total billed charges,61.85% of total billed charges,179.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,233,130,,,Fee Schedule,130% of WA Medicaid ,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.9,37.7,,,percent of total billed charges,37.70% of total billed charges,640.9,37.7,,,percent of total billed charges,37.70% of total billed charges,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,57630,33.9,,,percent of total billed charges,33.9% of total billed charges,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1326,78,,,percent of total billed charges,78% of total billed charges,1700,100,,,percent of total billed charges,100% of total billed charges,1404.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1404.2,82.6,,,percent of total billed charges,82.6% of total billed charges,179.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.51,57630,
SPINE  SKULL SPINAL FUSION,22590,CDM,983,RC,22590,HCPCS,Outpatient,,,7300,4745.00,,6424,88,,,percent of total billed charges,88% of total Billed charges,258.76,100,,,Fee Schedule,100% of Medicare rate,902.85,100,,,Fee Schedule,100% of WA Medicaid,7300,100,,,percent of total billed charges,100% of total billed charges,929.94,103,,,Fee Schedule,103% of WA Medicaid,258.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,452.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,902.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5037,69,,,percent of total billed charges,69% of total billed charges,7300,100,,,percent of total billed charges,100% of total billed charges,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7300,100,,,percent of total billed charges,100% of total billed charges,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7300,100,,,percent of total billed charges,100% of total billed charges,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,4515.05,61.85,,,percent of total billed charges,61.85% of total billed charges,902.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,920.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1173.71,130,,,Fee Schedule,130% of WA Medicaid ,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2752.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2752.1,37.7,,,percent of total billed charges,37.70% of total billed charges,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,247470,33.9,,,percent of total billed charges,33.9% of total billed charges,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,5694,78,,,percent of total billed charges,78% of total billed charges,7300,100,,,percent of total billed charges,100% of total billed charges,6029.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6029.8,82.6,,,percent of total billed charges,82.6% of total billed charges,902.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,258.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,258.76,247470,
NECK SPINAL FUSION,22595,CDM,983,RC,22595,HCPCS,Outpatient,,,6953,4519.45,,6118.64,88,,,percent of total billed charges,88% of total Billed charges,245.03,100,,,Fee Schedule,100% of Medicare rate,863.87,100,,,Fee Schedule,100% of WA Medicaid,6953,100,,,percent of total billed charges,100% of total billed charges,889.79,103,,,Fee Schedule,103% of WA Medicaid,245.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,428.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,863.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4797.57,69,,,percent of total billed charges,69% of total billed charges,6953,100,,,percent of total billed charges,100% of total billed charges,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6953,100,,,percent of total billed charges,100% of total billed charges,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6953,100,,,percent of total billed charges,100% of total billed charges,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4300.43,61.85,,,percent of total billed charges,61.85% of total billed charges,863.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,881.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1123.03,130,,,Fee Schedule,130% of WA Medicaid ,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2621.28,37.7,,,percent of total billed charges,37.70% of total billed charges,2621.28,37.7,,,percent of total billed charges,37.70% of total billed charges,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,235706.7,33.9,,,percent of total billed charges,33.9% of total billed charges,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,5423.34,78,,,percent of total billed charges,78% of total billed charges,6953,100,,,percent of total billed charges,100% of total billed charges,5743.18,82.6,,,percent of total billed charges,82.6% of total billed charges,5743.18,82.6,,,percent of total billed charges,82.6% of total billed charges,863.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,245.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,245.03,235706.7,
NECK SPINE FUSION,22600,CDM,983,RC,22600,HCPCS,Outpatient,,,5967,3878.55,,5250.96,88,,,percent of total billed charges,88% of total Billed charges,197.94,100,,,Fee Schedule,100% of Medicare rate,743.58,100,,,Fee Schedule,100% of WA Medicaid,5967,100,,,percent of total billed charges,100% of total billed charges,765.89,103,,,Fee Schedule,103% of WA Medicaid,197.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,346.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,743.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4117.23,69,,,percent of total billed charges,69% of total billed charges,5967,100,,,percent of total billed charges,100% of total billed charges,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,5967,100,,,percent of total billed charges,100% of total billed charges,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,5967,100,,,percent of total billed charges,100% of total billed charges,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3690.59,61.85,,,percent of total billed charges,61.85% of total billed charges,743.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,743.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,758.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,966.65,130,,,Fee Schedule,130% of WA Medicaid ,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2249.56,37.7,,,percent of total billed charges,37.70% of total billed charges,2249.56,37.7,,,percent of total billed charges,37.70% of total billed charges,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,202281.3,33.9,,,percent of total billed charges,33.9% of total billed charges,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,4654.26,78,,,percent of total billed charges,78% of total billed charges,5967,100,,,percent of total billed charges,100% of total billed charges,4928.74,82.6,,,percent of total billed charges,82.6% of total billed charges,4928.74,82.6,,,percent of total billed charges,82.6% of total billed charges,743.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,197.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,743.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,197.94,202281.3,
SPINE FUSION EXTRA SEGMENT,22614,CDM,983,RC,22614,HCPCS,Outpatient,,,1799,1169.35,,1583.12,88,,,percent of total billed charges,88% of total Billed charges,65.39,100,,,Fee Schedule,100% of Medicare rate,216.15,100,,,Fee Schedule,100% of WA Medicaid,1799,100,,,percent of total billed charges,100% of total billed charges,222.63,103,,,Fee Schedule,103% of WA Medicaid,65.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,216.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1241.31,69,,,percent of total billed charges,69% of total billed charges,1799,100,,,percent of total billed charges,100% of total billed charges,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1799,100,,,percent of total billed charges,100% of total billed charges,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1799,100,,,percent of total billed charges,100% of total billed charges,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1112.68,61.85,,,percent of total billed charges,61.85% of total billed charges,216.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281,130,,,Fee Schedule,130% of WA Medicaid ,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.22,37.7,,,percent of total billed charges,37.70% of total billed charges,678.22,37.7,,,percent of total billed charges,37.70% of total billed charges,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,60986.1,33.9,,,percent of total billed charges,33.9% of total billed charges,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1403.22,78,,,percent of total billed charges,78% of total billed charges,1799,100,,,percent of total billed charges,100% of total billed charges,1485.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.97,82.6,,,percent of total billed charges,82.6% of total billed charges,216.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.39,60986.1,
THORAX SPINE FUSION,22610,CDM,983,RC,22610,HCPCS,Outpatient,,,5340,3471.00,,4699.2,88,,,percent of total billed charges,88% of total Billed charges,187.96,100,,,Fee Schedule,100% of Medicare rate,731.64,100,,,Fee Schedule,100% of WA Medicaid,5340,100,,,percent of total billed charges,100% of total billed charges,753.59,103,,,Fee Schedule,103% of WA Medicaid,187.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,328.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,731.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3684.6,69,,,percent of total billed charges,69% of total billed charges,5340,100,,,percent of total billed charges,100% of total billed charges,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,5340,100,,,percent of total billed charges,100% of total billed charges,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,5340,100,,,percent of total billed charges,100% of total billed charges,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3302.79,61.85,,,percent of total billed charges,61.85% of total billed charges,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,951.13,130,,,Fee Schedule,130% of WA Medicaid ,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2013.18,37.7,,,percent of total billed charges,37.70% of total billed charges,2013.18,37.7,,,percent of total billed charges,37.70% of total billed charges,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,181026,33.9,,,percent of total billed charges,33.9% of total billed charges,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4165.2,78,,,percent of total billed charges,78% of total billed charges,5340,100,,,percent of total billed charges,100% of total billed charges,4410.84,82.6,,,percent of total billed charges,82.6% of total billed charges,4410.84,82.6,,,percent of total billed charges,82.6% of total billed charges,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,187.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.96,181026,
LUMBAR SPINE FUSION,22612,CDM,983,RC,22612,HCPCS,Outpatient,,,6157,4002.05,,5418.16,88,,,percent of total billed charges,88% of total Billed charges,222.07,100,,,Fee Schedule,100% of Medicare rate,895.39,100,,,Fee Schedule,100% of WA Medicaid,6157,100,,,percent of total billed charges,100% of total billed charges,922.25,103,,,Fee Schedule,103% of WA Medicaid,222.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,388.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,895.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4248.33,69,,,percent of total billed charges,69% of total billed charges,6157,100,,,percent of total billed charges,100% of total billed charges,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,6157,100,,,percent of total billed charges,100% of total billed charges,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,6157,100,,,percent of total billed charges,100% of total billed charges,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3808.1,61.85,,,percent of total billed charges,61.85% of total billed charges,895.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,895.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1164.01,130,,,Fee Schedule,130% of WA Medicaid ,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2321.19,37.7,,,percent of total billed charges,37.70% of total billed charges,2321.19,37.7,,,percent of total billed charges,37.70% of total billed charges,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,208722.3,33.9,,,percent of total billed charges,33.9% of total billed charges,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,4802.46,78,,,percent of total billed charges,78% of total billed charges,6157,100,,,percent of total billed charges,100% of total billed charges,5085.68,82.6,,,percent of total billed charges,82.6% of total billed charges,5085.68,82.6,,,percent of total billed charges,82.6% of total billed charges,895.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,222.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,895.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,222.07,208722.3,
SPINE FUSION EXTRA SEGMENT,22632,CDM,983,RC,22632,HCPCS,Outpatient,,,1533,996.45,,1349.04,88,,,percent of total billed charges,88% of total Billed charges,57.1,100,,,Fee Schedule,100% of Medicare rate,176.99,100,,,Fee Schedule,100% of WA Medicaid,1533,100,,,percent of total billed charges,100% of total billed charges,182.3,103,,,Fee Schedule,103% of WA Medicaid,57.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,176.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1057.77,69,,,percent of total billed charges,69% of total billed charges,1533,100,,,percent of total billed charges,100% of total billed charges,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1533,100,,,percent of total billed charges,100% of total billed charges,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1533,100,,,percent of total billed charges,100% of total billed charges,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,948.16,61.85,,,percent of total billed charges,61.85% of total billed charges,176.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,230.09,130,,,Fee Schedule,130% of WA Medicaid ,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.94,37.7,,,percent of total billed charges,37.70% of total billed charges,577.94,37.7,,,percent of total billed charges,37.70% of total billed charges,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,51968.7,33.9,,,percent of total billed charges,33.9% of total billed charges,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1195.74,78,,,percent of total billed charges,78% of total billed charges,1533,100,,,percent of total billed charges,100% of total billed charges,1266.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.26,82.6,,,percent of total billed charges,82.6% of total billed charges,176.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.1,51968.7,
LUMBAR SPINE FUSION,22630,CDM,983,RC,22630,HCPCS,Outpatient,,,6080,3952.00,,5350.4,88,,,percent of total billed charges,88% of total Billed charges,251.76,100,,,Fee Schedule,100% of Medicare rate,882.7,100,,,Fee Schedule,100% of WA Medicaid,6080,100,,,percent of total billed charges,100% of total billed charges,909.18,103,,,Fee Schedule,103% of WA Medicaid,251.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,440.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,882.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4195.2,69,,,percent of total billed charges,69% of total billed charges,6080,100,,,percent of total billed charges,100% of total billed charges,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,6080,100,,,percent of total billed charges,100% of total billed charges,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,6080,100,,,percent of total billed charges,100% of total billed charges,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,3760.48,61.85,,,percent of total billed charges,61.85% of total billed charges,882.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,882.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,900.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1147.51,130,,,Fee Schedule,130% of WA Medicaid ,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2292.16,37.7,,,percent of total billed charges,37.70% of total billed charges,2292.16,37.7,,,percent of total billed charges,37.70% of total billed charges,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,206112,33.9,,,percent of total billed charges,33.9% of total billed charges,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,4742.4,78,,,percent of total billed charges,78% of total billed charges,6080,100,,,percent of total billed charges,100% of total billed charges,5022.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5022.08,82.6,,,percent of total billed charges,82.6% of total billed charges,882.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,251.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,882.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,251.76,206112,
POST FUSION 7-12 VERT SEG,22802,CDM,983,RC,22802,HCPCS,Outpatient,,,6202,4031.30,,5457.76,88,,,percent of total billed charges,88% of total Billed charges,300.22,100,,,Fee Schedule,100% of Medicare rate,1196.21,100,,,Fee Schedule,100% of WA Medicaid,6202,100,,,percent of total billed charges,100% of total billed charges,1232.1,103,,,Fee Schedule,103% of WA Medicaid,300.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,525.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1196.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4279.38,69,,,percent of total billed charges,69% of total billed charges,6202,100,,,percent of total billed charges,100% of total billed charges,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,6202,100,,,percent of total billed charges,100% of total billed charges,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,6202,100,,,percent of total billed charges,100% of total billed charges,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,3835.94,61.85,,,percent of total billed charges,61.85% of total billed charges,1196.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1196.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1220.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1555.07,130,,,Fee Schedule,130% of WA Medicaid ,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2338.15,37.7,,,percent of total billed charges,37.70% of total billed charges,2338.15,37.7,,,percent of total billed charges,37.70% of total billed charges,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,210247.8,33.9,,,percent of total billed charges,33.9% of total billed charges,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,4837.56,78,,,percent of total billed charges,78% of total billed charges,6202,100,,,percent of total billed charges,100% of total billed charges,5122.85,82.6,,,percent of total billed charges,82.6% of total billed charges,5122.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1196.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,300.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1196.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,300.22,210247.8,
ANT FUSION 2-3 VERT SEG,22808,CDM,983,RC,22808,HCPCS,Outpatient,,,8881,5772.65,,7815.28,88,,,percent of total billed charges,88% of total Billed charges,272.38,100,,,Fee Schedule,100% of Medicare rate,1032.09,100,,,Fee Schedule,100% of WA Medicaid,8881,100,,,percent of total billed charges,100% of total billed charges,1063.05,103,,,Fee Schedule,103% of WA Medicaid,272.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,476.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1032.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6127.89,69,,,percent of total billed charges,69% of total billed charges,8881,100,,,percent of total billed charges,100% of total billed charges,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,8881,100,,,percent of total billed charges,100% of total billed charges,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,8881,100,,,percent of total billed charges,100% of total billed charges,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,5492.9,61.85,,,percent of total billed charges,61.85% of total billed charges,1032.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1052.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1341.72,130,,,Fee Schedule,130% of WA Medicaid ,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3348.14,37.7,,,percent of total billed charges,37.70% of total billed charges,3348.14,37.7,,,percent of total billed charges,37.70% of total billed charges,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,301065.9,33.9,,,percent of total billed charges,33.9% of total billed charges,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,6927.18,78,,,percent of total billed charges,78% of total billed charges,8881,100,,,percent of total billed charges,100% of total billed charges,7335.71,82.6,,,percent of total billed charges,82.6% of total billed charges,7335.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1032.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,272.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,272.38,301065.9,
ANT FUSION 4-7 VERT SEG,22810,CDM,983,RC,22810,HCPCS,Outpatient,,,10296,6692.40,,9060.48,88,,,percent of total billed charges,88% of total Billed charges,228.84,100,,,Fee Schedule,100% of Medicare rate,1137.09,100,,,Fee Schedule,100% of WA Medicaid,10296,100,,,percent of total billed charges,100% of total billed charges,1171.2,103,,,Fee Schedule,103% of WA Medicaid,228.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,400.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1137.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7104.24,69,,,percent of total billed charges,69% of total billed charges,10296,100,,,percent of total billed charges,100% of total billed charges,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,10296,100,,,percent of total billed charges,100% of total billed charges,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,10296,100,,,percent of total billed charges,100% of total billed charges,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,6368.08,61.85,,,percent of total billed charges,61.85% of total billed charges,1137.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1137.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1159.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1478.22,130,,,Fee Schedule,130% of WA Medicaid ,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3881.59,37.7,,,percent of total billed charges,37.70% of total billed charges,3881.59,37.7,,,percent of total billed charges,37.70% of total billed charges,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,349034.4,33.9,,,percent of total billed charges,33.9% of total billed charges,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,8030.88,78,,,percent of total billed charges,78% of total billed charges,10296,100,,,percent of total billed charges,100% of total billed charges,8504.5,82.6,,,percent of total billed charges,82.6% of total billed charges,8504.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,228.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1137.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,228.84,349034.4,
EXPLORATION OF SPINAL FUSION,22830,CDM,983,RC,22830,HCPCS,Outpatient,,,4515,2934.75,,3973.2,88,,,percent of total billed charges,88% of total Billed charges,112.48,100,,,Fee Schedule,100% of Medicare rate,470.91,100,,,Fee Schedule,100% of WA Medicaid,4515,100,,,percent of total billed charges,100% of total billed charges,485.04,103,,,Fee Schedule,103% of WA Medicaid,112.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,196.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,470.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3115.35,69,,,percent of total billed charges,69% of total billed charges,4515,100,,,percent of total billed charges,100% of total billed charges,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4515,100,,,percent of total billed charges,100% of total billed charges,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4515,100,,,percent of total billed charges,100% of total billed charges,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2792.53,61.85,,,percent of total billed charges,61.85% of total billed charges,470.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,612.18,130,,,Fee Schedule,130% of WA Medicaid ,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1702.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1702.16,37.7,,,percent of total billed charges,37.70% of total billed charges,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,153058.5,33.9,,,percent of total billed charges,33.9% of total billed charges,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3521.7,78,,,percent of total billed charges,78% of total billed charges,4515,100,,,percent of total billed charges,100% of total billed charges,3729.39,82.6,,,percent of total billed charges,82.6% of total billed charges,3729.39,82.6,,,percent of total billed charges,82.6% of total billed charges,470.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,112.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.48,153058.5,
INSERT SPINE FIXATION DEVICE,22844,CDM,983,RC,22844,HCPCS,Outpatient,,,5359,3483.35,,4715.92,88,,,percent of total billed charges,88% of total Billed charges,150.47,100,,,Fee Schedule,100% of Medicare rate,544.58,100,,,Fee Schedule,100% of WA Medicaid,5359,100,,,percent of total billed charges,100% of total billed charges,560.92,103,,,Fee Schedule,103% of WA Medicaid,150.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,263.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,544.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3697.71,69,,,percent of total billed charges,69% of total billed charges,5359,100,,,percent of total billed charges,100% of total billed charges,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,5359,100,,,percent of total billed charges,100% of total billed charges,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,5359,100,,,percent of total billed charges,100% of total billed charges,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,3314.54,61.85,,,percent of total billed charges,61.85% of total billed charges,544.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,555.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,707.95,130,,,Fee Schedule,130% of WA Medicaid ,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,2020.34,37.7,,,percent of total billed charges,37.70% of total billed charges,2020.34,37.7,,,percent of total billed charges,37.70% of total billed charges,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,181670.1,33.9,,,percent of total billed charges,33.9% of total billed charges,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,4180.02,78,,,percent of total billed charges,78% of total billed charges,5359,100,,,percent of total billed charges,100% of total billed charges,4426.53,82.6,,,percent of total billed charges,82.6% of total billed charges,4426.53,82.6,,,percent of total billed charges,82.6% of total billed charges,544.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,150.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,150.47,181670.1,
INSERT SPINE FIXATION DEVICE,22843,CDM,983,RC,22843,HCPCS,Outpatient,,,4825,3136.25,,4246,88,,,percent of total billed charges,88% of total Billed charges,135.69,100,,,Fee Schedule,100% of Medicare rate,451.33,100,,,Fee Schedule,100% of WA Medicaid,4825,100,,,percent of total billed charges,100% of total billed charges,464.87,103,,,Fee Schedule,103% of WA Medicaid,135.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,237.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,451.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3329.25,69,,,percent of total billed charges,69% of total billed charges,4825,100,,,percent of total billed charges,100% of total billed charges,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4825,100,,,percent of total billed charges,100% of total billed charges,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4825,100,,,percent of total billed charges,100% of total billed charges,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2984.26,61.85,,,percent of total billed charges,61.85% of total billed charges,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,586.73,130,,,Fee Schedule,130% of WA Medicaid ,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1819.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1819.03,37.7,,,percent of total billed charges,37.70% of total billed charges,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,163567.5,33.9,,,percent of total billed charges,33.9% of total billed charges,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3763.5,78,,,percent of total billed charges,78% of total billed charges,4825,100,,,percent of total billed charges,100% of total billed charges,3985.45,82.6,,,percent of total billed charges,82.6% of total billed charges,3985.45,82.6,,,percent of total billed charges,82.6% of total billed charges,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,135.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,135.69,163567.5,
INSERT SPINE FIXATION DEVICE,22842,CDM,983,RC,22842,HCPCS,Outpatient,,,4408,2865.20,,3879.04,88,,,percent of total billed charges,88% of total Billed charges,126.32,100,,,Fee Schedule,100% of Medicare rate,421.49,100,,,Fee Schedule,100% of WA Medicaid,4408,100,,,percent of total billed charges,100% of total billed charges,434.13,103,,,Fee Schedule,103% of WA Medicaid,126.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,221.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,421.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3041.52,69,,,percent of total billed charges,69% of total billed charges,4408,100,,,percent of total billed charges,100% of total billed charges,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,4408,100,,,percent of total billed charges,100% of total billed charges,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,4408,100,,,percent of total billed charges,100% of total billed charges,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2726.35,61.85,,,percent of total billed charges,61.85% of total billed charges,421.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,547.94,130,,,Fee Schedule,130% of WA Medicaid ,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1661.82,37.7,,,percent of total billed charges,37.70% of total billed charges,1661.82,37.7,,,percent of total billed charges,37.70% of total billed charges,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,149431.2,33.9,,,percent of total billed charges,33.9% of total billed charges,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,3438.24,78,,,percent of total billed charges,78% of total billed charges,4408,100,,,percent of total billed charges,100% of total billed charges,3641.01,82.6,,,percent of total billed charges,82.6% of total billed charges,3641.01,82.6,,,percent of total billed charges,82.6% of total billed charges,421.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,126.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.32,149431.2,
INSERT SPINE FIXATION DEVICE,22841,CDM,983,RC,22841,HCPCS,Outpatient,,,1503,976.95,,1322.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1503,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1037.07,69,,,percent of total billed charges,69% of total billed charges,1503,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1503,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1503,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,929.61,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,566.63,37.7,,,percent of total billed charges,37.70% of total billed charges,566.63,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,50951.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1172.34,78,,,percent of total billed charges,78% of total billed charges,1503,100,,,percent of total billed charges,100% of total billed charges,1241.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1241.48,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",566.63,50951.7,
INSERT SPINE FIXATION DEVICE,22845,CDM,983,RC,22845,HCPCS,Outpatient,,,4633,3011.45,,4077.04,88,,,percent of total billed charges,88% of total Billed charges,121.87,100,,,Fee Schedule,100% of Medicare rate,400.98,100,,,Fee Schedule,100% of WA Medicaid,4633,100,,,percent of total billed charges,100% of total billed charges,413.01,103,,,Fee Schedule,103% of WA Medicaid,121.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,213.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,400.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3196.77,69,,,percent of total billed charges,69% of total billed charges,4633,100,,,percent of total billed charges,100% of total billed charges,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,4633,100,,,percent of total billed charges,100% of total billed charges,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,4633,100,,,percent of total billed charges,100% of total billed charges,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2865.51,61.85,,,percent of total billed charges,61.85% of total billed charges,400.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,409,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.27,130,,,Fee Schedule,130% of WA Medicaid ,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1746.64,37.7,,,percent of total billed charges,37.70% of total billed charges,1746.64,37.7,,,percent of total billed charges,37.70% of total billed charges,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,157058.7,33.9,,,percent of total billed charges,33.9% of total billed charges,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3613.74,78,,,percent of total billed charges,78% of total billed charges,4633,100,,,percent of total billed charges,100% of total billed charges,3826.86,82.6,,,percent of total billed charges,82.6% of total billed charges,3826.86,82.6,,,percent of total billed charges,82.6% of total billed charges,400.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.87,157058.7,
INSERT SPINE FIXATION DEVICE,22846,CDM,983,RC,22846,HCPCS,Outpatient,,,4224,2745.60,,3717.12,88,,,percent of total billed charges,88% of total Billed charges,127.66,100,,,Fee Schedule,100% of Medicare rate,417.39,100,,,Fee Schedule,100% of WA Medicaid,4224,100,,,percent of total billed charges,100% of total billed charges,429.91,103,,,Fee Schedule,103% of WA Medicaid,127.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,223.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,417.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2914.56,69,,,percent of total billed charges,69% of total billed charges,4224,100,,,percent of total billed charges,100% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,4224,100,,,percent of total billed charges,100% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,4224,100,,,percent of total billed charges,100% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2612.54,61.85,,,percent of total billed charges,61.85% of total billed charges,417.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,542.61,130,,,Fee Schedule,130% of WA Medicaid ,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1592.45,37.7,,,percent of total billed charges,37.70% of total billed charges,1592.45,37.7,,,percent of total billed charges,37.70% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,143193.6,33.9,,,percent of total billed charges,33.9% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,3294.72,78,,,percent of total billed charges,78% of total billed charges,4224,100,,,percent of total billed charges,100% of total billed charges,3489.02,82.6,,,percent of total billed charges,82.6% of total billed charges,3489.02,82.6,,,percent of total billed charges,82.6% of total billed charges,417.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,127.66,143193.6,
INSERT SPINE FIXATION DEVICE,22840,CDM,983,RC,22840,HCPCS,Outpatient,,,3634,2362.10,,3197.92,88,,,percent of total billed charges,88% of total Billed charges,122,100,,,Fee Schedule,100% of Medicare rate,418.13,100,,,Fee Schedule,100% of WA Medicaid,3634,100,,,percent of total billed charges,100% of total billed charges,430.67,103,,,Fee Schedule,103% of WA Medicaid,122,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,213.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,418.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2507.46,69,,,percent of total billed charges,69% of total billed charges,3634,100,,,percent of total billed charges,100% of total billed charges,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,3634,100,,,percent of total billed charges,100% of total billed charges,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,3634,100,,,percent of total billed charges,100% of total billed charges,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,2247.63,61.85,,,percent of total billed charges,61.85% of total billed charges,418.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,543.57,130,,,Fee Schedule,130% of WA Medicaid ,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,1370.02,37.7,,,percent of total billed charges,37.70% of total billed charges,1370.02,37.7,,,percent of total billed charges,37.70% of total billed charges,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,123192.6,33.9,,,percent of total billed charges,33.9% of total billed charges,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,2834.52,78,,,percent of total billed charges,78% of total billed charges,3634,100,,,percent of total billed charges,100% of total billed charges,3001.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3001.68,82.6,,,percent of total billed charges,82.6% of total billed charges,418.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,122,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,122,123192.6,
REINSERT SPINAL FIXATION,22849,CDM,983,RC,22849,HCPCS,Outpatient,,,6039,3925.35,,5314.32,88,,,percent of total billed charges,88% of total Billed charges,188.97,100,,,Fee Schedule,100% of Medicare rate,739.85,100,,,Fee Schedule,100% of WA Medicaid,6039,100,,,percent of total billed charges,100% of total billed charges,762.05,103,,,Fee Schedule,103% of WA Medicaid,188.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,330.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,739.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4166.91,69,,,percent of total billed charges,69% of total billed charges,6039,100,,,percent of total billed charges,100% of total billed charges,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,6039,100,,,percent of total billed charges,100% of total billed charges,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,6039,100,,,percent of total billed charges,100% of total billed charges,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,3735.12,61.85,,,percent of total billed charges,61.85% of total billed charges,739.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,739.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,754.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,961.81,130,,,Fee Schedule,130% of WA Medicaid ,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2276.7,37.7,,,percent of total billed charges,37.70% of total billed charges,2276.7,37.7,,,percent of total billed charges,37.70% of total billed charges,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,204722.1,33.9,,,percent of total billed charges,33.9% of total billed charges,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,4710.42,78,,,percent of total billed charges,78% of total billed charges,6039,100,,,percent of total billed charges,100% of total billed charges,4988.21,82.6,,,percent of total billed charges,82.6% of total billed charges,4988.21,82.6,,,percent of total billed charges,82.6% of total billed charges,739.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,188.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,739.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,188.97,204722.1,
APPLY SPINE PROSTH DEVICE,22851,CDM,983,RC,,,Outpatient,,,2111,1372.15,,1857.68,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2111,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1456.59,69,,,percent of total billed charges,69% of total billed charges,2111,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2111,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2111,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1305.65,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,795.85,37.7,,,percent of total billed charges,37.70% of total billed charges,795.85,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,71562.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1646.58,78,,,percent of total billed charges,78% of total billed charges,2111,100,,,percent of total billed charges,100% of total billed charges,1743.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1743.69,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",795.85,71562.9,
CERV ARTIFIC DISKECTOMY,22856,CDM,975,RC,22856,HCPCS,Outpatient,,,19818,12881.70,,17439.84,88,,,percent of total billed charges,88% of total Billed charges,243.48,100,,,Fee Schedule,100% of Medicare rate,917.21,100,,,Fee Schedule,100% of WA Medicaid,19818,100,,,percent of total billed charges,100% of total billed charges,944.73,103,,,Fee Schedule,103% of WA Medicaid,243.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,426.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,917.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,13674.42,69,,,percent of total billed charges,69% of total billed charges,19818,100,,,percent of total billed charges,100% of total billed charges,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,19818,100,,,percent of total billed charges,100% of total billed charges,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,19818,100,,,percent of total billed charges,100% of total billed charges,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,12257.43,61.85,,,percent of total billed charges,61.85% of total billed charges,917.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,917.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,935.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1192.37,130,,,Fee Schedule,130% of WA Medicaid ,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,7471.39,37.7,,,percent of total billed charges,37.70% of total billed charges,7471.39,37.7,,,percent of total billed charges,37.70% of total billed charges,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,671830.2,33.9,,,percent of total billed charges,33.9% of total billed charges,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,15458.04,78,,,percent of total billed charges,78% of total billed charges,19818,100,,,percent of total billed charges,100% of total billed charges,16369.67,82.6,,,percent of total billed charges,82.6% of total billed charges,16369.67,82.6,,,percent of total billed charges,82.6% of total billed charges,917.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,243.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,917.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,243.48,671830.2,
REMOVE SPINE FIXATION DEVICE,22850,CDM,983,RC,22850,HCPCS,Outpatient,,,3570,2320.50,,3141.6,88,,,percent of total billed charges,88% of total Billed charges,99.25,100,,,Fee Schedule,100% of Medicare rate,421.86,100,,,Fee Schedule,100% of WA Medicaid,3570,100,,,percent of total billed charges,100% of total billed charges,434.52,103,,,Fee Schedule,103% of WA Medicaid,99.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,421.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2463.3,69,,,percent of total billed charges,69% of total billed charges,3570,100,,,percent of total billed charges,100% of total billed charges,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3570,100,,,percent of total billed charges,100% of total billed charges,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3570,100,,,percent of total billed charges,100% of total billed charges,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2208.05,61.85,,,percent of total billed charges,61.85% of total billed charges,421.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,548.42,130,,,Fee Schedule,130% of WA Medicaid ,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1345.89,37.7,,,percent of total billed charges,37.70% of total billed charges,1345.89,37.7,,,percent of total billed charges,37.70% of total billed charges,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,121023,33.9,,,percent of total billed charges,33.9% of total billed charges,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2784.6,78,,,percent of total billed charges,78% of total billed charges,3570,100,,,percent of total billed charges,100% of total billed charges,2948.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2948.82,82.6,,,percent of total billed charges,82.6% of total billed charges,421.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.25,121023,
LUMBAR ARTIF DISKECTOMY,22857,CDM,983,RC,22857,HCPCS,Outpatient,,,20326,13211.90,,17886.88,88,,,percent of total billed charges,88% of total Billed charges,197.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20326,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,197.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,346.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,14024.94,69,,,percent of total billed charges,69% of total billed charges,20326,100,,,percent of total billed charges,100% of total billed charges,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,20326,100,,,percent of total billed charges,100% of total billed charges,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,20326,100,,,percent of total billed charges,100% of total billed charges,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,12571.63,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,7662.9,37.7,,,percent of total billed charges,37.70% of total billed charges,7662.9,37.7,,,percent of total billed charges,37.70% of total billed charges,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,689051.4,33.9,,,percent of total billed charges,33.9% of total billed charges,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,15854.28,78,,,percent of total billed charges,78% of total billed charges,20326,100,,,percent of total billed charges,100% of total billed charges,16789.28,82.6,,,percent of total billed charges,82.6% of total billed charges,16789.28,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,197.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",197.74,689051.4,
REMOVE SPINE FIXATION DEVICE,22852,CDM,983,RC,22852,HCPCS,Outpatient,,,2875,1868.75,,2530,88,,,percent of total billed charges,88% of total Billed charges,95.09,100,,,Fee Schedule,100% of Medicare rate,406.94,100,,,Fee Schedule,100% of WA Medicaid,2875,100,,,percent of total billed charges,100% of total billed charges,419.15,103,,,Fee Schedule,103% of WA Medicaid,95.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,166.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,406.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1983.75,69,,,percent of total billed charges,69% of total billed charges,2875,100,,,percent of total billed charges,100% of total billed charges,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2875,100,,,percent of total billed charges,100% of total billed charges,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2875,100,,,percent of total billed charges,100% of total billed charges,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1778.19,61.85,,,percent of total billed charges,61.85% of total billed charges,406.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,529.02,130,,,Fee Schedule,130% of WA Medicaid ,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1083.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1083.88,37.7,,,percent of total billed charges,37.70% of total billed charges,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,97462.5,33.9,,,percent of total billed charges,33.9% of total billed charges,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2242.5,78,,,percent of total billed charges,78% of total billed charges,2875,100,,,percent of total billed charges,100% of total billed charges,2374.75,82.6,,,percent of total billed charges,82.6% of total billed charges,2374.75,82.6,,,percent of total billed charges,82.6% of total billed charges,406.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,95.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.09,97462.5,
REMOVE SPINE FIXATION DEVICE,22855,CDM,983,RC,22855,HCPCS,Outpatient,,,3789,2462.85,,3334.32,88,,,percent of total billed charges,88% of total Billed charges,161.86,100,,,Fee Schedule,100% of Medicare rate,629.62,100,,,Fee Schedule,100% of WA Medicaid,3789,100,,,percent of total billed charges,100% of total billed charges,648.51,103,,,Fee Schedule,103% of WA Medicaid,161.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,283.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,629.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2614.41,69,,,percent of total billed charges,69% of total billed charges,3789,100,,,percent of total billed charges,100% of total billed charges,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,3789,100,,,percent of total billed charges,100% of total billed charges,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,3789,100,,,percent of total billed charges,100% of total billed charges,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2343.5,61.85,,,percent of total billed charges,61.85% of total billed charges,629.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,818.51,130,,,Fee Schedule,130% of WA Medicaid ,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1428.45,37.7,,,percent of total billed charges,37.70% of total billed charges,1428.45,37.7,,,percent of total billed charges,37.70% of total billed charges,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,128447.1,33.9,,,percent of total billed charges,33.9% of total billed charges,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2955.42,78,,,percent of total billed charges,78% of total billed charges,3789,100,,,percent of total billed charges,100% of total billed charges,3129.71,82.6,,,percent of total billed charges,82.6% of total billed charges,3129.71,82.6,,,percent of total billed charges,82.6% of total billed charges,629.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,161.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,161.86,128447.1,
SPINE SURGERY PROCEDURE,22899,CDM,983,RC,22899,HCPCS,Outpatient,,,3716,2415.40,,3270.08,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3716,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2564.04,69,,,percent of total billed charges,69% of total billed charges,3716,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3716,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3716,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2298.35,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1400.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1400.93,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,125972.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2898.48,78,,,percent of total billed charges,78% of total billed charges,3716,100,,,percent of total billed charges,100% of total billed charges,3069.42,82.6,,,percent of total billed charges,82.6% of total billed charges,3069.42,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1400.93,125972.4,
EXC ABDL TUM DEEP < 5 CM,22900,CDM,983,RC,22900,HCPCS,Outpatient,,,1533,996.45,,1349.04,88,,,percent of total billed charges,88% of total Billed charges,67.66,100,,,Fee Schedule,100% of Medicare rate,324.14,100,,,Fee Schedule,100% of WA Medicaid,1533,100,,,percent of total billed charges,100% of total billed charges,333.86,103,,,Fee Schedule,103% of WA Medicaid,67.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,118.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,324.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1057.77,69,,,percent of total billed charges,69% of total billed charges,1533,100,,,percent of total billed charges,100% of total billed charges,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1533,100,,,percent of total billed charges,100% of total billed charges,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1533,100,,,percent of total billed charges,100% of total billed charges,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,948.16,61.85,,,percent of total billed charges,61.85% of total billed charges,324.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,421.38,130,,,Fee Schedule,130% of WA Medicaid ,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.94,37.7,,,percent of total billed charges,37.70% of total billed charges,577.94,37.7,,,percent of total billed charges,37.70% of total billed charges,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,51968.7,33.9,,,percent of total billed charges,33.9% of total billed charges,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1195.74,78,,,percent of total billed charges,78% of total billed charges,1533,100,,,percent of total billed charges,100% of total billed charges,1266.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1266.26,82.6,,,percent of total billed charges,82.6% of total billed charges,324.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.66,51968.7,
EXC ABDL TUM DEEP 5 CM/>,22901,CDM,983,RC,22901,HCPCS,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,82.53,100,,,Fee Schedule,100% of Medicare rate,379.71,100,,,Fee Schedule,100% of WA Medicaid,1800,100,,,percent of total billed charges,100% of total billed charges,391.1,103,,,Fee Schedule,103% of WA Medicaid,82.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,144.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,379.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1800,100,,,percent of total billed charges,100% of total billed charges,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1800,100,,,percent of total billed charges,100% of total billed charges,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,379.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,493.62,130,,,Fee Schedule,130% of WA Medicaid ,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,61020,33.9,,,percent of total billed charges,33.9% of total billed charges,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,379.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.53,61020,
EXC ABD LES SC 3 CM/>,22903,CDM,983,RC,22903,HCPCS,Outpatient,,,1182,768.30,,1040.16,88,,,percent of total billed charges,88% of total Billed charges,53.75,100,,,Fee Schedule,100% of Medicare rate,252.15,100,,,Fee Schedule,100% of WA Medicaid,1182,100,,,percent of total billed charges,100% of total billed charges,259.71,103,,,Fee Schedule,103% of WA Medicaid,53.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,252.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,815.58,69,,,percent of total billed charges,69% of total billed charges,1182,100,,,percent of total billed charges,100% of total billed charges,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1182,100,,,percent of total billed charges,100% of total billed charges,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1182,100,,,percent of total billed charges,100% of total billed charges,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.07,61.85,,,percent of total billed charges,61.85% of total billed charges,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,327.8,130,,,Fee Schedule,130% of WA Medicaid ,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.61,37.7,,,percent of total billed charges,37.70% of total billed charges,445.61,37.7,,,percent of total billed charges,37.70% of total billed charges,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,40069.8,33.9,,,percent of total billed charges,33.9% of total billed charges,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,921.96,78,,,percent of total billed charges,78% of total billed charges,1182,100,,,percent of total billed charges,100% of total billed charges,976.33,82.6,,,percent of total billed charges,82.6% of total billed charges,976.33,82.6,,,percent of total billed charges,82.6% of total billed charges,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.75,40069.8,
EXC ABD LES SC < 3 CM,22902,CDM,983,RC,22902,HCPCS,Outpatient,,,891,579.15,,784.08,88,,,percent of total billed charges,88% of total Billed charges,37.65,100,,,Fee Schedule,100% of Medicare rate,193.03,100,,,Fee Schedule,100% of WA Medicaid,891,100,,,percent of total billed charges,100% of total billed charges,198.82,103,,,Fee Schedule,103% of WA Medicaid,37.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,193.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,614.79,69,,,percent of total billed charges,69% of total billed charges,891,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,891,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,891,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.08,61.85,,,percent of total billed charges,61.85% of total billed charges,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,250.94,130,,,Fee Schedule,130% of WA Medicaid ,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.91,37.7,,,percent of total billed charges,37.70% of total billed charges,335.91,37.7,,,percent of total billed charges,37.70% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,30204.9,33.9,,,percent of total billed charges,33.9% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,694.98,78,,,percent of total billed charges,78% of total billed charges,891,100,,,percent of total billed charges,100% of total billed charges,735.97,82.6,,,percent of total billed charges,82.6% of total billed charges,735.97,82.6,,,percent of total billed charges,82.6% of total billed charges,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.65,30204.9,
REMOVAL OF CALCIUM DEPOSITS,23000,CDM,983,RC,23000,HCPCS,Outpatient,,,1554,1010.10,,1367.52,88,,,percent of total billed charges,88% of total Billed charges,32.04,100,,,Fee Schedule,100% of Medicare rate,210,100,,,Fee Schedule,100% of WA Medicaid,1554,100,,,percent of total billed charges,100% of total billed charges,216.3,103,,,Fee Schedule,103% of WA Medicaid,32.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,210,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1072.26,69,,,percent of total billed charges,69% of total billed charges,1554,100,,,percent of total billed charges,100% of total billed charges,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1554,100,,,percent of total billed charges,100% of total billed charges,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1554,100,,,percent of total billed charges,100% of total billed charges,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,961.15,61.85,,,percent of total billed charges,61.85% of total billed charges,210,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,210,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,273,130,,,Fee Schedule,130% of WA Medicaid ,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.86,37.7,,,percent of total billed charges,37.70% of total billed charges,585.86,37.7,,,percent of total billed charges,37.70% of total billed charges,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,52680.6,33.9,,,percent of total billed charges,33.9% of total billed charges,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1212.12,78,,,percent of total billed charges,78% of total billed charges,1554,100,,,percent of total billed charges,100% of total billed charges,1283.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1283.6,82.6,,,percent of total billed charges,82.6% of total billed charges,210,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,210,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.04,52680.6,
DRAIN SHOULDER LESION,23030,CDM,983,RC,23030,HCPCS,Outpatient,,,957,622.05,,842.16,88,,,percent of total billed charges,88% of total Billed charges,25.91,100,,,Fee Schedule,100% of Medicare rate,147.34,100,,,Fee Schedule,100% of WA Medicaid,957,100,,,percent of total billed charges,100% of total billed charges,151.76,103,,,Fee Schedule,103% of WA Medicaid,25.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,147.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,660.33,69,,,percent of total billed charges,69% of total billed charges,957,100,,,percent of total billed charges,100% of total billed charges,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,957,100,,,percent of total billed charges,100% of total billed charges,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,957,100,,,percent of total billed charges,100% of total billed charges,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.9,61.85,,,percent of total billed charges,61.85% of total billed charges,147.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.54,130,,,Fee Schedule,130% of WA Medicaid ,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.79,37.7,,,percent of total billed charges,37.70% of total billed charges,360.79,37.7,,,percent of total billed charges,37.70% of total billed charges,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,32442.3,33.9,,,percent of total billed charges,33.9% of total billed charges,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.46,78,,,percent of total billed charges,78% of total billed charges,957,100,,,percent of total billed charges,100% of total billed charges,790.48,82.6,,,percent of total billed charges,82.6% of total billed charges,790.48,82.6,,,percent of total billed charges,82.6% of total billed charges,147.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.91,32442.3,
DRAIN SHOULDER BURSA,23031,CDM,983,RC,23031,HCPCS,Outpatient,,,844,548.60,,742.72,88,,,percent of total billed charges,88% of total Billed charges,21.59,100,,,Fee Schedule,100% of Medicare rate,129.62,100,,,Fee Schedule,100% of WA Medicaid,844,100,,,percent of total billed charges,100% of total billed charges,133.51,103,,,Fee Schedule,103% of WA Medicaid,21.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,129.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,582.36,69,,,percent of total billed charges,69% of total billed charges,844,100,,,percent of total billed charges,100% of total billed charges,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,844,100,,,percent of total billed charges,100% of total billed charges,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,844,100,,,percent of total billed charges,100% of total billed charges,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.01,61.85,,,percent of total billed charges,61.85% of total billed charges,129.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,168.51,130,,,Fee Schedule,130% of WA Medicaid ,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.19,37.7,,,percent of total billed charges,37.70% of total billed charges,318.19,37.7,,,percent of total billed charges,37.70% of total billed charges,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,28611.6,33.9,,,percent of total billed charges,33.9% of total billed charges,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.32,78,,,percent of total billed charges,78% of total billed charges,844,100,,,percent of total billed charges,100% of total billed charges,697.14,82.6,,,percent of total billed charges,82.6% of total billed charges,697.14,82.6,,,percent of total billed charges,82.6% of total billed charges,129.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.59,28611.6,
EXPLORATORY SHOULDER SURGERY,23040,CDM,983,RC,23040,HCPCS,Outpatient,,,2746,1784.90,,2416.48,88,,,percent of total billed charges,88% of total Billed charges,72.46,100,,,Fee Schedule,100% of Medicare rate,416.08,100,,,Fee Schedule,100% of WA Medicaid,2746,100,,,percent of total billed charges,100% of total billed charges,428.56,103,,,Fee Schedule,103% of WA Medicaid,72.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,416.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1894.74,69,,,percent of total billed charges,69% of total billed charges,2746,100,,,percent of total billed charges,100% of total billed charges,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2746,100,,,percent of total billed charges,100% of total billed charges,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2746,100,,,percent of total billed charges,100% of total billed charges,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1698.4,61.85,,,percent of total billed charges,61.85% of total billed charges,416.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,540.9,130,,,Fee Schedule,130% of WA Medicaid ,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1035.24,37.7,,,percent of total billed charges,37.70% of total billed charges,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,93089.4,33.9,,,percent of total billed charges,33.9% of total billed charges,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2141.88,78,,,percent of total billed charges,78% of total billed charges,2746,100,,,percent of total billed charges,100% of total billed charges,2268.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2268.2,82.6,,,percent of total billed charges,82.6% of total billed charges,416.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.46,93089.4,
EXPLORATORY SHOULDER SURGERY,23044,CDM,983,RC,23044,HCPCS,Outpatient,,,1825,1186.25,,1606,88,,,percent of total billed charges,88% of total Billed charges,58.77,100,,,Fee Schedule,100% of Medicare rate,328.43,100,,,Fee Schedule,100% of WA Medicaid,1825,100,,,percent of total billed charges,100% of total billed charges,338.28,103,,,Fee Schedule,103% of WA Medicaid,58.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,328.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1259.25,69,,,percent of total billed charges,69% of total billed charges,1825,100,,,percent of total billed charges,100% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825,100,,,percent of total billed charges,100% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825,100,,,percent of total billed charges,100% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128.76,61.85,,,percent of total billed charges,61.85% of total billed charges,328.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,335,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,426.96,130,,,Fee Schedule,130% of WA Medicaid ,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,688.03,37.7,,,percent of total billed charges,37.70% of total billed charges,688.03,37.7,,,percent of total billed charges,37.70% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,61867.5,33.9,,,percent of total billed charges,33.9% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.5,78,,,percent of total billed charges,78% of total billed charges,1825,100,,,percent of total billed charges,100% of total billed charges,1507.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1507.45,82.6,,,percent of total billed charges,82.6% of total billed charges,328.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.77,61867.5,
BIOPSY SHOULDER TISSUES,23065,CDM,983,RC,23065,HCPCS,Outpatient,,,525,341.25,,462,88,,,percent of total billed charges,88% of total Billed charges,13.94,100,,,Fee Schedule,100% of Medicare rate,92.32,100,,,Fee Schedule,100% of WA Medicaid,525,100,,,percent of total billed charges,100% of total billed charges,95.09,103,,,Fee Schedule,103% of WA Medicaid,13.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,92.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,362.25,69,,,percent of total billed charges,69% of total billed charges,525,100,,,percent of total billed charges,100% of total billed charges,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,525,100,,,percent of total billed charges,100% of total billed charges,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,525,100,,,percent of total billed charges,100% of total billed charges,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.71,61.85,,,percent of total billed charges,61.85% of total billed charges,92.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,120.02,130,,,Fee Schedule,130% of WA Medicaid ,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.93,37.7,,,percent of total billed charges,37.70% of total billed charges,197.93,37.7,,,percent of total billed charges,37.70% of total billed charges,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,17797.5,33.9,,,percent of total billed charges,33.9% of total billed charges,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.5,78,,,percent of total billed charges,78% of total billed charges,525,100,,,percent of total billed charges,100% of total billed charges,433.65,82.6,,,percent of total billed charges,82.6% of total billed charges,433.65,82.6,,,percent of total billed charges,82.6% of total billed charges,92.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.94,17797.5,
BIOPSY SHOULDER TISSUES,23066,CDM,983,RC,23066,HCPCS,Outpatient,,,1669,1084.85,,1468.72,88,,,percent of total billed charges,88% of total Billed charges,34.97,100,,,Fee Schedule,100% of Medicare rate,216.53,100,,,Fee Schedule,100% of WA Medicaid,1669,100,,,percent of total billed charges,100% of total billed charges,223.03,103,,,Fee Schedule,103% of WA Medicaid,34.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,216.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1151.61,69,,,percent of total billed charges,69% of total billed charges,1669,100,,,percent of total billed charges,100% of total billed charges,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1669,100,,,percent of total billed charges,100% of total billed charges,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1669,100,,,percent of total billed charges,100% of total billed charges,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032.28,61.85,,,percent of total billed charges,61.85% of total billed charges,216.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,281.49,130,,,Fee Schedule,130% of WA Medicaid ,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.21,37.7,,,percent of total billed charges,37.70% of total billed charges,629.21,37.7,,,percent of total billed charges,37.70% of total billed charges,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,56579.1,33.9,,,percent of total billed charges,33.9% of total billed charges,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1301.82,78,,,percent of total billed charges,78% of total billed charges,1669,100,,,percent of total billed charges,100% of total billed charges,1378.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1378.59,82.6,,,percent of total billed charges,82.6% of total billed charges,216.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.97,56579.1,
EXC SHOULDER TUM DEEP 5 CM/>,23073,CDM,983,RC,23073,HCPCS,Outpatient,,,2192,1424.80,,1928.96,88,,,percent of total billed charges,88% of total Billed charges,79.93,100,,,Fee Schedule,100% of Medicare rate,399.48,100,,,Fee Schedule,100% of WA Medicaid,2192,100,,,percent of total billed charges,100% of total billed charges,411.46,103,,,Fee Schedule,103% of WA Medicaid,79.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,139.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,399.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1512.48,69,,,percent of total billed charges,69% of total billed charges,2192,100,,,percent of total billed charges,100% of total billed charges,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2192,100,,,percent of total billed charges,100% of total billed charges,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2192,100,,,percent of total billed charges,100% of total billed charges,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1355.75,61.85,,,percent of total billed charges,61.85% of total billed charges,399.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,519.32,130,,,Fee Schedule,130% of WA Medicaid ,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,826.38,37.7,,,percent of total billed charges,37.70% of total billed charges,826.38,37.7,,,percent of total billed charges,37.70% of total billed charges,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,74308.8,33.9,,,percent of total billed charges,33.9% of total billed charges,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1709.76,78,,,percent of total billed charges,78% of total billed charges,2192,100,,,percent of total billed charges,100% of total billed charges,1810.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1810.59,82.6,,,percent of total billed charges,82.6% of total billed charges,399.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.93,74308.8,
EXC SHOULDER TUM DEEP < 5 CM,23076,CDM,983,RC,23076,HCPCS,Outpatient,,,1714,1114.10,,1508.32,88,,,percent of total billed charges,88% of total Billed charges,59.06,100,,,Fee Schedule,100% of Medicare rate,314.07,100,,,Fee Schedule,100% of WA Medicaid,1714,100,,,percent of total billed charges,100% of total billed charges,323.49,103,,,Fee Schedule,103% of WA Medicaid,59.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,314.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1182.66,69,,,percent of total billed charges,69% of total billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1714,100,,,percent of total billed charges,100% of total billed charges,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1714,100,,,percent of total billed charges,100% of total billed charges,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1060.11,61.85,,,percent of total billed charges,61.85% of total billed charges,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,408.29,130,,,Fee Schedule,130% of WA Medicaid ,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.18,37.7,,,percent of total billed charges,37.70% of total billed charges,646.18,37.7,,,percent of total billed charges,37.70% of total billed charges,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,58104.6,33.9,,,percent of total billed charges,33.9% of total billed charges,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1336.92,78,,,percent of total billed charges,78% of total billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,1415.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1415.76,82.6,,,percent of total billed charges,82.6% of total billed charges,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.06,58104.6,
EXC SHOULDER LES SC 3 CM/>,23071,CDM,983,RC,23071,HCPCS,Outpatient,,,977,635.05,,859.76,88,,,percent of total billed charges,88% of total Billed charges,48.53,100,,,Fee Schedule,100% of Medicare rate,241.89,100,,,Fee Schedule,100% of WA Medicaid,977,100,,,percent of total billed charges,100% of total billed charges,249.15,103,,,Fee Schedule,103% of WA Medicaid,48.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,84.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,241.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,674.13,69,,,percent of total billed charges,69% of total billed charges,977,100,,,percent of total billed charges,100% of total billed charges,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,977,100,,,percent of total billed charges,100% of total billed charges,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,977,100,,,percent of total billed charges,100% of total billed charges,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,604.27,61.85,,,percent of total billed charges,61.85% of total billed charges,241.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,314.46,130,,,Fee Schedule,130% of WA Medicaid ,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.33,37.7,,,percent of total billed charges,37.70% of total billed charges,368.33,37.7,,,percent of total billed charges,37.70% of total billed charges,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,33120.3,33.9,,,percent of total billed charges,33.9% of total billed charges,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,762.06,78,,,percent of total billed charges,78% of total billed charges,977,100,,,percent of total billed charges,100% of total billed charges,807,82.6,,,percent of total billed charges,82.6% of total billed charges,807,82.6,,,percent of total billed charges,82.6% of total billed charges,241.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.53,33120.3,
EXC SHOULDER LES SC < 3 CM,23075,CDM,983,RC,23075,HCPCS,Outpatient,,,1105,718.25,,972.4,88,,,percent of total billed charges,88% of total Billed charges,33.68,100,,,Fee Schedule,100% of Medicare rate,191.72,100,,,Fee Schedule,100% of WA Medicaid,1105,100,,,percent of total billed charges,100% of total billed charges,197.47,103,,,Fee Schedule,103% of WA Medicaid,33.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,191.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,762.45,69,,,percent of total billed charges,69% of total billed charges,1105,100,,,percent of total billed charges,100% of total billed charges,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105,100,,,percent of total billed charges,100% of total billed charges,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105,100,,,percent of total billed charges,100% of total billed charges,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.44,61.85,,,percent of total billed charges,61.85% of total billed charges,191.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,249.24,130,,,Fee Schedule,130% of WA Medicaid ,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.59,37.7,,,percent of total billed charges,37.70% of total billed charges,416.59,37.7,,,percent of total billed charges,37.70% of total billed charges,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,37459.5,33.9,,,percent of total billed charges,33.9% of total billed charges,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.9,78,,,percent of total billed charges,78% of total billed charges,1105,100,,,percent of total billed charges,100% of total billed charges,912.73,82.6,,,percent of total billed charges,82.6% of total billed charges,912.73,82.6,,,percent of total billed charges,82.6% of total billed charges,191.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.68,37459.5,
SHOULDER JOINT SURGERY,23101,CDM,983,RC,23101,HCPCS,Outpatient,,,1382,898.30,,1216.16,88,,,percent of total billed charges,88% of total Billed charges,45.25,100,,,Fee Schedule,100% of Medicare rate,268.93,100,,,Fee Schedule,100% of WA Medicaid,1382,100,,,percent of total billed charges,100% of total billed charges,277,103,,,Fee Schedule,103% of WA Medicaid,45.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,268.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,953.58,69,,,percent of total billed charges,69% of total billed charges,1382,100,,,percent of total billed charges,100% of total billed charges,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1382,100,,,percent of total billed charges,100% of total billed charges,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1382,100,,,percent of total billed charges,100% of total billed charges,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,854.77,61.85,,,percent of total billed charges,61.85% of total billed charges,268.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,349.61,130,,,Fee Schedule,130% of WA Medicaid ,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,521.01,37.7,,,percent of total billed charges,37.70% of total billed charges,521.01,37.7,,,percent of total billed charges,37.70% of total billed charges,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,46849.8,33.9,,,percent of total billed charges,33.9% of total billed charges,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1077.96,78,,,percent of total billed charges,78% of total billed charges,1382,100,,,percent of total billed charges,100% of total billed charges,1141.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1141.53,82.6,,,percent of total billed charges,82.6% of total billed charges,268.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.25,46849.8,
EXPLORE TREAT SHOULDER JOINT,23107,CDM,983,RC,23107,HCPCS,Outpatient,,,2063,1340.95,,1815.44,88,,,percent of total billed charges,88% of total Billed charges,67.03,100,,,Fee Schedule,100% of Medicare rate,386.99,100,,,Fee Schedule,100% of WA Medicaid,2063,100,,,percent of total billed charges,100% of total billed charges,398.6,103,,,Fee Schedule,103% of WA Medicaid,67.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,117.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,386.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1423.47,69,,,percent of total billed charges,69% of total billed charges,2063,100,,,percent of total billed charges,100% of total billed charges,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2063,100,,,percent of total billed charges,100% of total billed charges,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2063,100,,,percent of total billed charges,100% of total billed charges,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1275.97,61.85,,,percent of total billed charges,61.85% of total billed charges,386.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,503.09,130,,,Fee Schedule,130% of WA Medicaid ,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,777.75,37.7,,,percent of total billed charges,37.70% of total billed charges,777.75,37.7,,,percent of total billed charges,37.70% of total billed charges,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,69935.7,33.9,,,percent of total billed charges,33.9% of total billed charges,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1609.14,78,,,percent of total billed charges,78% of total billed charges,2063,100,,,percent of total billed charges,100% of total billed charges,1704.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1704.04,82.6,,,percent of total billed charges,82.6% of total billed charges,386.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.03,69935.7,
PARTIAL REMOVAL COLLAR BONE,23120,CDM,983,RC,23120,HCPCS,Outpatient,,,1923,1249.95,,1692.24,88,,,percent of total billed charges,88% of total Billed charges,57.27,100,,,Fee Schedule,100% of Medicare rate,344.65,100,,,Fee Schedule,100% of WA Medicaid,1923,100,,,percent of total billed charges,100% of total billed charges,354.99,103,,,Fee Schedule,103% of WA Medicaid,57.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,344.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1326.87,69,,,percent of total billed charges,69% of total billed charges,1923,100,,,percent of total billed charges,100% of total billed charges,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1923,100,,,percent of total billed charges,100% of total billed charges,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1923,100,,,percent of total billed charges,100% of total billed charges,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1189.38,61.85,,,percent of total billed charges,61.85% of total billed charges,344.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,448.05,130,,,Fee Schedule,130% of WA Medicaid ,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.97,37.7,,,percent of total billed charges,37.70% of total billed charges,724.97,37.7,,,percent of total billed charges,37.70% of total billed charges,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,65189.7,33.9,,,percent of total billed charges,33.9% of total billed charges,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1499.94,78,,,percent of total billed charges,78% of total billed charges,1923,100,,,percent of total billed charges,100% of total billed charges,1588.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1588.4,82.6,,,percent of total billed charges,82.6% of total billed charges,344.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.27,65189.7,
REMOVE SHOULDER BONE PART,23130,CDM,983,RC,23130,HCPCS,Outpatient,,,2233,1451.45,,1965.04,88,,,percent of total billed charges,88% of total Billed charges,60.24,100,,,Fee Schedule,100% of Medicare rate,361.62,100,,,Fee Schedule,100% of WA Medicaid,2233,100,,,percent of total billed charges,100% of total billed charges,372.47,103,,,Fee Schedule,103% of WA Medicaid,60.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,361.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1540.77,69,,,percent of total billed charges,69% of total billed charges,2233,100,,,percent of total billed charges,100% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2233,100,,,percent of total billed charges,100% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2233,100,,,percent of total billed charges,100% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1381.11,61.85,,,percent of total billed charges,61.85% of total billed charges,361.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,470.11,130,,,Fee Schedule,130% of WA Medicaid ,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.84,37.7,,,percent of total billed charges,37.70% of total billed charges,841.84,37.7,,,percent of total billed charges,37.70% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,75698.7,33.9,,,percent of total billed charges,33.9% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1741.74,78,,,percent of total billed charges,78% of total billed charges,2233,100,,,percent of total billed charges,100% of total billed charges,1844.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1844.46,82.6,,,percent of total billed charges,82.6% of total billed charges,361.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.24,75698.7,
REMOVAL OF BONE LESION,23140,CDM,983,RC,23140,HCPCS,Outpatient,,,1789,1162.85,,1574.32,88,,,percent of total billed charges,88% of total Billed charges,55.47,100,,,Fee Schedule,100% of Medicare rate,325.07,100,,,Fee Schedule,100% of WA Medicaid,1789,100,,,percent of total billed charges,100% of total billed charges,334.82,103,,,Fee Schedule,103% of WA Medicaid,55.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,325.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1234.41,69,,,percent of total billed charges,69% of total billed charges,1789,100,,,percent of total billed charges,100% of total billed charges,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1789,100,,,percent of total billed charges,100% of total billed charges,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1789,100,,,percent of total billed charges,100% of total billed charges,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1106.5,61.85,,,percent of total billed charges,61.85% of total billed charges,325.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,422.59,130,,,Fee Schedule,130% of WA Medicaid ,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.45,37.7,,,percent of total billed charges,37.70% of total billed charges,674.45,37.7,,,percent of total billed charges,37.70% of total billed charges,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,60647.1,33.9,,,percent of total billed charges,33.9% of total billed charges,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1395.42,78,,,percent of total billed charges,78% of total billed charges,1789,100,,,percent of total billed charges,100% of total billed charges,1477.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1477.71,82.6,,,percent of total billed charges,82.6% of total billed charges,325.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.47,60647.1,
REMOVAL OF HUMERUS LESION,23156,CDM,983,RC,23156,HCPCS,Outpatient,,,1067,693.55,,938.96,88,,,percent of total billed charges,88% of total Billed charges,69.27,100,,,Fee Schedule,100% of Medicare rate,394.82,100,,,Fee Schedule,100% of WA Medicaid,1067,100,,,percent of total billed charges,100% of total billed charges,406.66,103,,,Fee Schedule,103% of WA Medicaid,69.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,121.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,394.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,736.23,69,,,percent of total billed charges,69% of total billed charges,1067,100,,,percent of total billed charges,100% of total billed charges,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067,100,,,percent of total billed charges,100% of total billed charges,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067,100,,,percent of total billed charges,100% of total billed charges,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.94,61.85,,,percent of total billed charges,61.85% of total billed charges,394.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,513.27,130,,,Fee Schedule,130% of WA Medicaid ,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.26,37.7,,,percent of total billed charges,37.70% of total billed charges,402.26,37.7,,,percent of total billed charges,37.70% of total billed charges,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,36171.3,33.9,,,percent of total billed charges,33.9% of total billed charges,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,832.26,78,,,percent of total billed charges,78% of total billed charges,1067,100,,,percent of total billed charges,100% of total billed charges,881.34,82.6,,,percent of total billed charges,82.6% of total billed charges,881.34,82.6,,,percent of total billed charges,82.6% of total billed charges,394.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.27,36171.3,
REMOVE SHOULDER FOREIGN BODY,23331,CDM,983,RC,23331,HCPCS,Outpatient,,,1926,1251.90,,1694.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1926,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1328.94,69,,,percent of total billed charges,69% of total billed charges,1926,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1926,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1926,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1191.23,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,726.1,37.7,,,percent of total billed charges,37.70% of total billed charges,726.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,65291.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1502.28,78,,,percent of total billed charges,78% of total billed charges,1926,100,,,percent of total billed charges,100% of total billed charges,1590.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1590.88,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",726.1,65291.4,
REMOVE SHOULDER FOREIGN BODY,23332,CDM,983,RC,23332,HCPCS,Outpatient,,,3025,1966.25,,2662,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3025,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2087.25,69,,,percent of total billed charges,69% of total billed charges,3025,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3025,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3025,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1870.96,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1140.43,37.7,,,percent of total billed charges,37.70% of total billed charges,1140.43,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,102547.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2359.5,78,,,percent of total billed charges,78% of total billed charges,3025,100,,,percent of total billed charges,100% of total billed charges,2498.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2498.65,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1140.43,102547.5,
MUSCLE TRANSFERS,23397,CDM,983,RC,23397,HCPCS,Outpatient,,,3422,2224.30,,3011.36,88,,,percent of total billed charges,88% of total Billed charges,124.42,100,,,Fee Schedule,100% of Medicare rate,653.31,100,,,Fee Schedule,100% of WA Medicaid,3422,100,,,percent of total billed charges,100% of total billed charges,672.91,103,,,Fee Schedule,103% of WA Medicaid,124.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,217.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,653.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2361.18,69,,,percent of total billed charges,69% of total billed charges,3422,100,,,percent of total billed charges,100% of total billed charges,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,3422,100,,,percent of total billed charges,100% of total billed charges,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,3422,100,,,percent of total billed charges,100% of total billed charges,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2116.51,61.85,,,percent of total billed charges,61.85% of total billed charges,653.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,653.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,666.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,849.3,130,,,Fee Schedule,130% of WA Medicaid ,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1290.09,37.7,,,percent of total billed charges,37.70% of total billed charges,1290.09,37.7,,,percent of total billed charges,37.70% of total billed charges,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,116005.8,33.9,,,percent of total billed charges,33.9% of total billed charges,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2669.16,78,,,percent of total billed charges,78% of total billed charges,3422,100,,,percent of total billed charges,100% of total billed charges,2826.57,82.6,,,percent of total billed charges,82.6% of total billed charges,2826.57,82.6,,,percent of total billed charges,82.6% of total billed charges,653.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,124.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,653.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.42,116005.8,
INCISION OF TENDON  MUSCLE,23405,CDM,983,RC,23405,HCPCS,Outpatient,,,1882,1223.30,,1656.16,88,,,percent of total billed charges,88% of total Billed charges,59,100,,,Fee Schedule,100% of Medicare rate,357.33,100,,,Fee Schedule,100% of WA Medicaid,1882,100,,,percent of total billed charges,100% of total billed charges,368.05,103,,,Fee Schedule,103% of WA Medicaid,59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,357.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1298.58,69,,,percent of total billed charges,69% of total billed charges,1882,100,,,percent of total billed charges,100% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1882,100,,,percent of total billed charges,100% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1882,100,,,percent of total billed charges,100% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1164.02,61.85,,,percent of total billed charges,61.85% of total billed charges,357.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,464.53,130,,,Fee Schedule,130% of WA Medicaid ,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.51,37.7,,,percent of total billed charges,37.70% of total billed charges,709.51,37.7,,,percent of total billed charges,37.70% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,63799.8,33.9,,,percent of total billed charges,33.9% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1467.96,78,,,percent of total billed charges,78% of total billed charges,1882,100,,,percent of total billed charges,100% of total billed charges,1554.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1554.53,82.6,,,percent of total billed charges,82.6% of total billed charges,357.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59,63799.8,
REPAIR ROTATOR CUFF CHRONIC,23412,CDM,983,RC,23412,HCPCS,Outpatient,,,2970,1930.50,,2613.6,88,,,percent of total billed charges,88% of total Billed charges,88.14,100,,,Fee Schedule,100% of Medicare rate,491.99,100,,,Fee Schedule,100% of WA Medicaid,2970,100,,,percent of total billed charges,100% of total billed charges,506.75,103,,,Fee Schedule,103% of WA Medicaid,88.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,154.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,491.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2049.3,69,,,percent of total billed charges,69% of total billed charges,2970,100,,,percent of total billed charges,100% of total billed charges,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2970,100,,,percent of total billed charges,100% of total billed charges,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2970,100,,,percent of total billed charges,100% of total billed charges,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836.95,61.85,,,percent of total billed charges,61.85% of total billed charges,491.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,501.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,639.59,130,,,Fee Schedule,130% of WA Medicaid ,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1119.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1119.69,37.7,,,percent of total billed charges,37.70% of total billed charges,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,100683,33.9,,,percent of total billed charges,33.9% of total billed charges,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2316.6,78,,,percent of total billed charges,78% of total billed charges,2970,100,,,percent of total billed charges,100% of total billed charges,2453.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2453.22,82.6,,,percent of total billed charges,82.6% of total billed charges,491.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.14,100683,
REPAIR ROTATOR CUFF ACUTE,23410,CDM,983,RC,23410,HCPCS,Outpatient,,,3152,2048.80,,2773.76,88,,,percent of total billed charges,88% of total Billed charges,84.05,100,,,Fee Schedule,100% of Medicare rate,473.52,100,,,Fee Schedule,100% of WA Medicaid,3152,100,,,percent of total billed charges,100% of total billed charges,487.73,103,,,Fee Schedule,103% of WA Medicaid,84.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,147.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,473.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2174.88,69,,,percent of total billed charges,69% of total billed charges,3152,100,,,percent of total billed charges,100% of total billed charges,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3152,100,,,percent of total billed charges,100% of total billed charges,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3152,100,,,percent of total billed charges,100% of total billed charges,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1949.51,61.85,,,percent of total billed charges,61.85% of total billed charges,473.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,615.58,130,,,Fee Schedule,130% of WA Medicaid ,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1188.3,37.7,,,percent of total billed charges,37.70% of total billed charges,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,106852.8,33.9,,,percent of total billed charges,33.9% of total billed charges,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2458.56,78,,,percent of total billed charges,78% of total billed charges,3152,100,,,percent of total billed charges,100% of total billed charges,2603.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2603.55,82.6,,,percent of total billed charges,82.6% of total billed charges,473.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,84.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84.05,106852.8,
RELEASE OF SHOULDER LIGAMENT,23415,CDM,983,RC,23415,HCPCS,Outpatient,,,2082,1353.30,,1832.16,88,,,percent of total billed charges,88% of total Billed charges,69.85,100,,,Fee Schedule,100% of Medicare rate,406.01,100,,,Fee Schedule,100% of WA Medicaid,2082,100,,,percent of total billed charges,100% of total billed charges,418.19,103,,,Fee Schedule,103% of WA Medicaid,69.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,122.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,406.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1436.58,69,,,percent of total billed charges,69% of total billed charges,2082,100,,,percent of total billed charges,100% of total billed charges,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2082,100,,,percent of total billed charges,100% of total billed charges,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2082,100,,,percent of total billed charges,100% of total billed charges,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1287.72,61.85,,,percent of total billed charges,61.85% of total billed charges,406.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,527.81,130,,,Fee Schedule,130% of WA Medicaid ,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,784.91,37.7,,,percent of total billed charges,37.70% of total billed charges,784.91,37.7,,,percent of total billed charges,37.70% of total billed charges,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,70579.8,33.9,,,percent of total billed charges,33.9% of total billed charges,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1623.96,78,,,percent of total billed charges,78% of total billed charges,2082,100,,,percent of total billed charges,100% of total billed charges,1719.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1719.73,82.6,,,percent of total billed charges,82.6% of total billed charges,406.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.85,70579.8,
REPAIR OF SHOULDER,23420,CDM,983,RC,23420,HCPCS,Outpatient,,,3960,2574.00,,3484.8,88,,,percent of total billed charges,88% of total Billed charges,101.17,100,,,Fee Schedule,100% of Medicare rate,562.11,100,,,Fee Schedule,100% of WA Medicaid,3960,100,,,percent of total billed charges,100% of total billed charges,578.97,103,,,Fee Schedule,103% of WA Medicaid,101.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,177.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,562.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2732.4,69,,,percent of total billed charges,69% of total billed charges,3960,100,,,percent of total billed charges,100% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3960,100,,,percent of total billed charges,100% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3960,100,,,percent of total billed charges,100% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2449.26,61.85,,,percent of total billed charges,61.85% of total billed charges,562.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,573.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,730.74,130,,,Fee Schedule,130% of WA Medicaid ,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1492.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1492.92,37.7,,,percent of total billed charges,37.70% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,134244,33.9,,,percent of total billed charges,33.9% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3088.8,78,,,percent of total billed charges,78% of total billed charges,3960,100,,,percent of total billed charges,100% of total billed charges,3270.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3270.96,82.6,,,percent of total billed charges,82.6% of total billed charges,562.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.17,134244,
REPAIR BICEPS TENDON,23430,CDM,983,RC,23430,HCPCS,Outpatient,,,2410,1566.50,,2120.8,88,,,percent of total billed charges,88% of total Billed charges,74.84,100,,,Fee Schedule,100% of Medicare rate,431.75,100,,,Fee Schedule,100% of WA Medicaid,2410,100,,,percent of total billed charges,100% of total billed charges,444.7,103,,,Fee Schedule,103% of WA Medicaid,74.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,130.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,431.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1662.9,69,,,percent of total billed charges,69% of total billed charges,2410,100,,,percent of total billed charges,100% of total billed charges,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2410,100,,,percent of total billed charges,100% of total billed charges,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2410,100,,,percent of total billed charges,100% of total billed charges,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1490.59,61.85,,,percent of total billed charges,61.85% of total billed charges,431.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,431.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,561.28,130,,,Fee Schedule,130% of WA Medicaid ,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,908.57,37.7,,,percent of total billed charges,37.70% of total billed charges,908.57,37.7,,,percent of total billed charges,37.70% of total billed charges,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,81699,33.9,,,percent of total billed charges,33.9% of total billed charges,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1879.8,78,,,percent of total billed charges,78% of total billed charges,2410,100,,,percent of total billed charges,100% of total billed charges,1990.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1990.66,82.6,,,percent of total billed charges,82.6% of total billed charges,431.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,74.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,431.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.84,81699,
REMOVE/TRANSPLANT TENDON,23440,CDM,983,RC,23440,HCPCS,Outpatient,,,2123,1379.95,,1868.24,88,,,percent of total billed charges,88% of total Billed charges,79.58,100,,,Fee Schedule,100% of Medicare rate,437.72,100,,,Fee Schedule,100% of WA Medicaid,2123,100,,,percent of total billed charges,100% of total billed charges,450.85,103,,,Fee Schedule,103% of WA Medicaid,79.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,139.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,437.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1464.87,69,,,percent of total billed charges,69% of total billed charges,2123,100,,,percent of total billed charges,100% of total billed charges,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2123,100,,,percent of total billed charges,100% of total billed charges,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2123,100,,,percent of total billed charges,100% of total billed charges,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1313.08,61.85,,,percent of total billed charges,61.85% of total billed charges,437.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,437.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,569.04,130,,,Fee Schedule,130% of WA Medicaid ,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,800.37,37.7,,,percent of total billed charges,37.70% of total billed charges,800.37,37.7,,,percent of total billed charges,37.70% of total billed charges,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,71969.7,33.9,,,percent of total billed charges,33.9% of total billed charges,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.94,78,,,percent of total billed charges,78% of total billed charges,2123,100,,,percent of total billed charges,100% of total billed charges,1753.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1753.6,82.6,,,percent of total billed charges,82.6% of total billed charges,437.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,437.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.58,71969.7,
REPAIR SHOULDER CAPSULE,23450,CDM,983,RC,23450,HCPCS,Outpatient,,,3302,2146.30,,2905.76,88,,,percent of total billed charges,88% of total Billed charges,101.49,100,,,Fee Schedule,100% of Medicare rate,543.27,100,,,Fee Schedule,100% of WA Medicaid,3302,100,,,percent of total billed charges,100% of total billed charges,559.57,103,,,Fee Schedule,103% of WA Medicaid,101.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,177.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,543.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2278.38,69,,,percent of total billed charges,69% of total billed charges,3302,100,,,percent of total billed charges,100% of total billed charges,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3302,100,,,percent of total billed charges,100% of total billed charges,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3302,100,,,percent of total billed charges,100% of total billed charges,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2042.29,61.85,,,percent of total billed charges,61.85% of total billed charges,543.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,543.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,706.25,130,,,Fee Schedule,130% of WA Medicaid ,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1244.85,37.7,,,percent of total billed charges,37.70% of total billed charges,1244.85,37.7,,,percent of total billed charges,37.70% of total billed charges,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,111937.8,33.9,,,percent of total billed charges,33.9% of total billed charges,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2575.56,78,,,percent of total billed charges,78% of total billed charges,3302,100,,,percent of total billed charges,100% of total billed charges,2727.45,82.6,,,percent of total billed charges,82.6% of total billed charges,2727.45,82.6,,,percent of total billed charges,82.6% of total billed charges,543.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,101.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,543.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.49,111937.8,
REPAIR SHOULDER CAPSULE,23455,CDM,983,RC,23455,HCPCS,Outpatient,,,3862,2510.30,,3398.56,88,,,percent of total billed charges,88% of total Billed charges,104.75,100,,,Fee Schedule,100% of Medicare rate,565.47,100,,,Fee Schedule,100% of WA Medicaid,3862,100,,,percent of total billed charges,100% of total billed charges,582.43,103,,,Fee Schedule,103% of WA Medicaid,104.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,183.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,565.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2664.78,69,,,percent of total billed charges,69% of total billed charges,3862,100,,,percent of total billed charges,100% of total billed charges,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3862,100,,,percent of total billed charges,100% of total billed charges,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3862,100,,,percent of total billed charges,100% of total billed charges,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2388.65,61.85,,,percent of total billed charges,61.85% of total billed charges,565.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,576.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,735.11,130,,,Fee Schedule,130% of WA Medicaid ,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1455.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1455.97,37.7,,,percent of total billed charges,37.70% of total billed charges,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,130921.8,33.9,,,percent of total billed charges,33.9% of total billed charges,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3012.36,78,,,percent of total billed charges,78% of total billed charges,3862,100,,,percent of total billed charges,100% of total billed charges,3190.01,82.6,,,percent of total billed charges,82.6% of total billed charges,3190.01,82.6,,,percent of total billed charges,82.6% of total billed charges,565.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,104.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,104.75,130921.8,
REPAIR SHOULDER CAPSULE,23466,CDM,983,RC,23466,HCPCS,Outpatient,,,3909,2540.85,,3439.92,88,,,percent of total billed charges,88% of total Billed charges,117.27,100,,,Fee Schedule,100% of Medicare rate,646.22,100,,,Fee Schedule,100% of WA Medicaid,3909,100,,,percent of total billed charges,100% of total billed charges,665.61,103,,,Fee Schedule,103% of WA Medicaid,117.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,205.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,646.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2697.21,69,,,percent of total billed charges,69% of total billed charges,3909,100,,,percent of total billed charges,100% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3909,100,,,percent of total billed charges,100% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3909,100,,,percent of total billed charges,100% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2417.72,61.85,,,percent of total billed charges,61.85% of total billed charges,646.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,840.09,130,,,Fee Schedule,130% of WA Medicaid ,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1473.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1473.69,37.7,,,percent of total billed charges,37.70% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,132515.1,33.9,,,percent of total billed charges,33.9% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3049.02,78,,,percent of total billed charges,78% of total billed charges,3909,100,,,percent of total billed charges,100% of total billed charges,3228.83,82.6,,,percent of total billed charges,82.6% of total billed charges,3228.83,82.6,,,percent of total billed charges,82.6% of total billed charges,646.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.27,132515.1,
REPAIR SHOULDER CAPSULE,23462,CDM,983,RC,23462,HCPCS,Outpatient,,,3232,2100.80,,2844.16,88,,,percent of total billed charges,88% of total Billed charges,116.5,100,,,Fee Schedule,100% of Medicare rate,611.35,100,,,Fee Schedule,100% of WA Medicaid,3232,100,,,percent of total billed charges,100% of total billed charges,629.69,103,,,Fee Schedule,103% of WA Medicaid,116.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,203.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,611.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2230.08,69,,,percent of total billed charges,69% of total billed charges,3232,100,,,percent of total billed charges,100% of total billed charges,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,3232,100,,,percent of total billed charges,100% of total billed charges,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,3232,100,,,percent of total billed charges,100% of total billed charges,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1998.99,61.85,,,percent of total billed charges,61.85% of total billed charges,611.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,611.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,623.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,794.76,130,,,Fee Schedule,130% of WA Medicaid ,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1218.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1218.46,37.7,,,percent of total billed charges,37.70% of total billed charges,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,109564.8,33.9,,,percent of total billed charges,33.9% of total billed charges,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2520.96,78,,,percent of total billed charges,78% of total billed charges,3232,100,,,percent of total billed charges,100% of total billed charges,2669.63,82.6,,,percent of total billed charges,82.6% of total billed charges,2669.63,82.6,,,percent of total billed charges,82.6% of total billed charges,611.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,116.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,611.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,116.5,109564.8,
REPAIR SHOULDER CAPSULE,23460,CDM,983,RC,23460,HCPCS,Outpatient,,,3635,2362.75,,3198.8,88,,,percent of total billed charges,88% of total Billed charges,117.75,100,,,Fee Schedule,100% of Medicare rate,625.33,100,,,Fee Schedule,100% of WA Medicaid,3635,100,,,percent of total billed charges,100% of total billed charges,644.09,103,,,Fee Schedule,103% of WA Medicaid,117.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,206.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,625.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2508.15,69,,,percent of total billed charges,69% of total billed charges,3635,100,,,percent of total billed charges,100% of total billed charges,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3635,100,,,percent of total billed charges,100% of total billed charges,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3635,100,,,percent of total billed charges,100% of total billed charges,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2248.25,61.85,,,percent of total billed charges,61.85% of total billed charges,625.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,812.93,130,,,Fee Schedule,130% of WA Medicaid ,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1370.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1370.4,37.7,,,percent of total billed charges,37.70% of total billed charges,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,123226.5,33.9,,,percent of total billed charges,33.9% of total billed charges,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2835.3,78,,,percent of total billed charges,78% of total billed charges,3635,100,,,percent of total billed charges,100% of total billed charges,3002.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3002.51,82.6,,,percent of total billed charges,82.6% of total billed charges,625.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.75,123226.5,
REVIS RECONST SHOULDER JOINT,23474,CDM,983,RC,23474,HCPCS,Outpatient,,,6567,4268.55,,5778.96,88,,,percent of total billed charges,88% of total Billed charges,191.52,100,,,Fee Schedule,100% of Medicare rate,985.47,100,,,Fee Schedule,100% of WA Medicaid,6567,100,,,percent of total billed charges,100% of total billed charges,1015.03,103,,,Fee Schedule,103% of WA Medicaid,191.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,335.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,985.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4531.23,69,,,percent of total billed charges,69% of total billed charges,6567,100,,,percent of total billed charges,100% of total billed charges,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,6567,100,,,percent of total billed charges,100% of total billed charges,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,6567,100,,,percent of total billed charges,100% of total billed charges,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4061.69,61.85,,,percent of total billed charges,61.85% of total billed charges,985.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,985.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1005.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1281.11,130,,,Fee Schedule,130% of WA Medicaid ,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2475.76,37.7,,,percent of total billed charges,37.70% of total billed charges,2475.76,37.7,,,percent of total billed charges,37.70% of total billed charges,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,222621.3,33.9,,,percent of total billed charges,33.9% of total billed charges,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5122.26,78,,,percent of total billed charges,78% of total billed charges,6567,100,,,percent of total billed charges,100% of total billed charges,5424.34,82.6,,,percent of total billed charges,82.6% of total billed charges,5424.34,82.6,,,percent of total billed charges,82.6% of total billed charges,985.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,191.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,985.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,191.52,222621.3,
REVIS RECONST SHOULDER JOINT,23473,CDM,983,RC,23473,HCPCS,Outpatient,,,6078,3950.70,,5348.64,88,,,percent of total billed charges,88% of total Billed charges,175.79,100,,,Fee Schedule,100% of Medicare rate,913.66,100,,,Fee Schedule,100% of WA Medicaid,6078,100,,,percent of total billed charges,100% of total billed charges,941.07,103,,,Fee Schedule,103% of WA Medicaid,175.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,307.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,913.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4193.82,69,,,percent of total billed charges,69% of total billed charges,6078,100,,,percent of total billed charges,100% of total billed charges,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,6078,100,,,percent of total billed charges,100% of total billed charges,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,6078,100,,,percent of total billed charges,100% of total billed charges,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3759.24,61.85,,,percent of total billed charges,61.85% of total billed charges,913.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1187.76,130,,,Fee Schedule,130% of WA Medicaid ,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2291.41,37.7,,,percent of total billed charges,37.70% of total billed charges,2291.41,37.7,,,percent of total billed charges,37.70% of total billed charges,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,206044.2,33.9,,,percent of total billed charges,33.9% of total billed charges,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,4740.84,78,,,percent of total billed charges,78% of total billed charges,6078,100,,,percent of total billed charges,100% of total billed charges,5020.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5020.43,82.6,,,percent of total billed charges,82.6% of total billed charges,913.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,175.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,175.79,206044.2,
RECONSTRUCT SHOULDER JOINT,23470,CDM,983,RC,23470,HCPCS,Outpatient,,,3894,2531.10,,3426.72,88,,,percent of total billed charges,88% of total Billed charges,128.15,100,,,Fee Schedule,100% of Medicare rate,684.64,100,,,Fee Schedule,100% of WA Medicaid,3894,100,,,percent of total billed charges,100% of total billed charges,705.18,103,,,Fee Schedule,103% of WA Medicaid,128.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,224.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,684.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2686.86,69,,,percent of total billed charges,69% of total billed charges,3894,100,,,percent of total billed charges,100% of total billed charges,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3894,100,,,percent of total billed charges,100% of total billed charges,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3894,100,,,percent of total billed charges,100% of total billed charges,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2408.44,61.85,,,percent of total billed charges,61.85% of total billed charges,684.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,684.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,890.03,130,,,Fee Schedule,130% of WA Medicaid ,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1468.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1468.04,37.7,,,percent of total billed charges,37.70% of total billed charges,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,132006.6,33.9,,,percent of total billed charges,33.9% of total billed charges,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3037.32,78,,,percent of total billed charges,78% of total billed charges,3894,100,,,percent of total billed charges,100% of total billed charges,3216.44,82.6,,,percent of total billed charges,82.6% of total billed charges,3216.44,82.6,,,percent of total billed charges,82.6% of total billed charges,684.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,128.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,684.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.15,132006.6,
RECONSTRUCT SHOULDER JOINT,23472,CDM,983,RC,23472,HCPCS,Outpatient,,,5457,3547.05,,4802.16,88,,,percent of total billed charges,88% of total Billed charges,156.96,100,,,Fee Schedule,100% of Medicare rate,822.47,100,,,Fee Schedule,100% of WA Medicaid,5457,100,,,percent of total billed charges,100% of total billed charges,847.14,103,,,Fee Schedule,103% of WA Medicaid,156.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,274.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,822.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3765.33,69,,,percent of total billed charges,69% of total billed charges,5457,100,,,percent of total billed charges,100% of total billed charges,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,5457,100,,,percent of total billed charges,100% of total billed charges,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,5457,100,,,percent of total billed charges,100% of total billed charges,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3375.15,61.85,,,percent of total billed charges,61.85% of total billed charges,822.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,822.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,838.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1069.21,130,,,Fee Schedule,130% of WA Medicaid ,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2057.29,37.7,,,percent of total billed charges,37.70% of total billed charges,2057.29,37.7,,,percent of total billed charges,37.70% of total billed charges,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,184992.3,33.9,,,percent of total billed charges,33.9% of total billed charges,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4256.46,78,,,percent of total billed charges,78% of total billed charges,5457,100,,,percent of total billed charges,100% of total billed charges,4507.48,82.6,,,percent of total billed charges,82.6% of total billed charges,4507.48,82.6,,,percent of total billed charges,82.6% of total billed charges,822.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,156.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,822.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,156.96,184992.3,
REVISION OF COLLAR BONE,23485,CDM,983,RC,23485,HCPCS,Outpatient,,,2622,1704.30,,2307.36,88,,,percent of total billed charges,88% of total Billed charges,101.73,100,,,Fee Schedule,100% of Medicare rate,547.75,100,,,Fee Schedule,100% of WA Medicaid,2622,100,,,percent of total billed charges,100% of total billed charges,564.18,103,,,Fee Schedule,103% of WA Medicaid,101.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,178.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,547.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1809.18,69,,,percent of total billed charges,69% of total billed charges,2622,100,,,percent of total billed charges,100% of total billed charges,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2622,100,,,percent of total billed charges,100% of total billed charges,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2622,100,,,percent of total billed charges,100% of total billed charges,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1621.71,61.85,,,percent of total billed charges,61.85% of total billed charges,547.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,712.08,130,,,Fee Schedule,130% of WA Medicaid ,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,988.49,37.7,,,percent of total billed charges,37.70% of total billed charges,988.49,37.7,,,percent of total billed charges,37.70% of total billed charges,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,88885.8,33.9,,,percent of total billed charges,33.9% of total billed charges,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2045.16,78,,,percent of total billed charges,78% of total billed charges,2622,100,,,percent of total billed charges,100% of total billed charges,2165.77,82.6,,,percent of total billed charges,82.6% of total billed charges,2165.77,82.6,,,percent of total billed charges,82.6% of total billed charges,547.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,101.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.73,88885.8,
TREAT CLAVICLE FRACTURE,23500,CDM,983,RC,23500,HCPCS,Outpatient,,,543,352.95,,477.84,88,,,percent of total billed charges,88% of total Billed charges,18.7,100,,,Fee Schedule,100% of Medicare rate,139.32,100,,,Fee Schedule,100% of WA Medicaid,543,100,,,percent of total billed charges,100% of total billed charges,143.5,103,,,Fee Schedule,103% of WA Medicaid,18.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,139.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,374.67,69,,,percent of total billed charges,69% of total billed charges,543,100,,,percent of total billed charges,100% of total billed charges,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,543,100,,,percent of total billed charges,100% of total billed charges,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,543,100,,,percent of total billed charges,100% of total billed charges,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.85,61.85,,,percent of total billed charges,61.85% of total billed charges,139.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,181.12,130,,,Fee Schedule,130% of WA Medicaid ,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.71,37.7,,,percent of total billed charges,37.70% of total billed charges,204.71,37.7,,,percent of total billed charges,37.70% of total billed charges,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,18407.7,33.9,,,percent of total billed charges,33.9% of total billed charges,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.54,78,,,percent of total billed charges,78% of total billed charges,543,100,,,percent of total billed charges,100% of total billed charges,448.52,82.6,,,percent of total billed charges,82.6% of total billed charges,448.52,82.6,,,percent of total billed charges,82.6% of total billed charges,139.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.7,18407.7,
TREAT CLAVICLE FRACTURE,23505,CDM,983,RC,23505,HCPCS,Outpatient,,,785,510.25,,690.8,88,,,percent of total billed charges,88% of total Billed charges,30.5,100,,,Fee Schedule,100% of Medicare rate,200.86,100,,,Fee Schedule,100% of WA Medicaid,785,100,,,percent of total billed charges,100% of total billed charges,206.89,103,,,Fee Schedule,103% of WA Medicaid,30.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,541.65,69,,,percent of total billed charges,69% of total billed charges,785,100,,,percent of total billed charges,100% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,785,100,,,percent of total billed charges,100% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,785,100,,,percent of total billed charges,100% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.52,61.85,,,percent of total billed charges,61.85% of total billed charges,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,261.12,130,,,Fee Schedule,130% of WA Medicaid ,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.95,37.7,,,percent of total billed charges,37.70% of total billed charges,295.95,37.7,,,percent of total billed charges,37.70% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,26611.5,33.9,,,percent of total billed charges,33.9% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.3,78,,,percent of total billed charges,78% of total billed charges,785,100,,,percent of total billed charges,100% of total billed charges,648.41,82.6,,,percent of total billed charges,82.6% of total billed charges,648.41,82.6,,,percent of total billed charges,82.6% of total billed charges,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.5,26611.5,
TREAT CLAVICLE FRACTURE,23515,CDM,983,RC,23515,HCPCS,Outpatient,,,2213,1438.45,,1947.44,88,,,percent of total billed charges,88% of total Billed charges,72.07,100,,,Fee Schedule,100% of Medicare rate,418.69,100,,,Fee Schedule,100% of WA Medicaid,2213,100,,,percent of total billed charges,100% of total billed charges,431.25,103,,,Fee Schedule,103% of WA Medicaid,72.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,418.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1526.97,69,,,percent of total billed charges,69% of total billed charges,2213,100,,,percent of total billed charges,100% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2213,100,,,percent of total billed charges,100% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2213,100,,,percent of total billed charges,100% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368.74,61.85,,,percent of total billed charges,61.85% of total billed charges,418.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,544.3,130,,,Fee Schedule,130% of WA Medicaid ,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,834.3,37.7,,,percent of total billed charges,37.70% of total billed charges,834.3,37.7,,,percent of total billed charges,37.70% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,75020.7,33.9,,,percent of total billed charges,33.9% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1726.14,78,,,percent of total billed charges,78% of total billed charges,2213,100,,,percent of total billed charges,100% of total billed charges,1827.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1827.94,82.6,,,percent of total billed charges,82.6% of total billed charges,418.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.07,75020.7,
TREAT CLAVICLE DISLOCATION,23530,CDM,983,RC,23530,HCPCS,Outpatient,,,1759,1143.35,,1547.92,88,,,percent of total billed charges,88% of total Billed charges,57.62,100,,,Fee Schedule,100% of Medicare rate,336.45,100,,,Fee Schedule,100% of WA Medicaid,1759,100,,,percent of total billed charges,100% of total billed charges,346.54,103,,,Fee Schedule,103% of WA Medicaid,57.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,336.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1213.71,69,,,percent of total billed charges,69% of total billed charges,1759,100,,,percent of total billed charges,100% of total billed charges,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1759,100,,,percent of total billed charges,100% of total billed charges,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1759,100,,,percent of total billed charges,100% of total billed charges,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1087.94,61.85,,,percent of total billed charges,61.85% of total billed charges,336.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.39,130,,,Fee Schedule,130% of WA Medicaid ,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.14,37.7,,,percent of total billed charges,37.70% of total billed charges,663.14,37.7,,,percent of total billed charges,37.70% of total billed charges,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,59630.1,33.9,,,percent of total billed charges,33.9% of total billed charges,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1372.02,78,,,percent of total billed charges,78% of total billed charges,1759,100,,,percent of total billed charges,100% of total billed charges,1452.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1452.93,82.6,,,percent of total billed charges,82.6% of total billed charges,336.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.62,59630.1,
TREAT CLAVICLE DISLOCATION,23552,CDM,983,RC,23552,HCPCS,Outpatient,,,1774,1153.10,,1561.12,88,,,percent of total billed charges,88% of total Billed charges,64.22,100,,,Fee Schedule,100% of Medicare rate,377.85,100,,,Fee Schedule,100% of WA Medicaid,1774,100,,,percent of total billed charges,100% of total billed charges,389.19,103,,,Fee Schedule,103% of WA Medicaid,64.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,377.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1224.06,69,,,percent of total billed charges,69% of total billed charges,1774,100,,,percent of total billed charges,100% of total billed charges,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1774,100,,,percent of total billed charges,100% of total billed charges,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1774,100,,,percent of total billed charges,100% of total billed charges,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1097.22,61.85,,,percent of total billed charges,61.85% of total billed charges,377.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,491.21,130,,,Fee Schedule,130% of WA Medicaid ,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.8,37.7,,,percent of total billed charges,37.70% of total billed charges,668.8,37.7,,,percent of total billed charges,37.70% of total billed charges,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,60138.6,33.9,,,percent of total billed charges,33.9% of total billed charges,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1383.72,78,,,percent of total billed charges,78% of total billed charges,1774,100,,,percent of total billed charges,100% of total billed charges,1465.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1465.32,82.6,,,percent of total billed charges,82.6% of total billed charges,377.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.22,60138.6,
TREAT CLAVICLE DISLOCATION,23550,CDM,983,RC,23550,HCPCS,Outpatient,,,1541,1001.65,,1356.08,88,,,percent of total billed charges,88% of total Billed charges,56.71,100,,,Fee Schedule,100% of Medicare rate,333.84,100,,,Fee Schedule,100% of WA Medicaid,1541,100,,,percent of total billed charges,100% of total billed charges,343.86,103,,,Fee Schedule,103% of WA Medicaid,56.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,333.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1063.29,69,,,percent of total billed charges,69% of total billed charges,1541,100,,,percent of total billed charges,100% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1541,100,,,percent of total billed charges,100% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1541,100,,,percent of total billed charges,100% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,953.11,61.85,,,percent of total billed charges,61.85% of total billed charges,333.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,433.99,130,,,Fee Schedule,130% of WA Medicaid ,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,580.96,37.7,,,percent of total billed charges,37.70% of total billed charges,580.96,37.7,,,percent of total billed charges,37.70% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,52239.9,33.9,,,percent of total billed charges,33.9% of total billed charges,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1201.98,78,,,percent of total billed charges,78% of total billed charges,1541,100,,,percent of total billed charges,100% of total billed charges,1272.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1272.87,82.6,,,percent of total billed charges,82.6% of total billed charges,333.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.71,52239.9,
TREAT SCAPULA FRACTURE,23585,CDM,983,RC,23585,HCPCS,Outpatient,,,2713,1763.45,,2387.44,88,,,percent of total billed charges,88% of total Billed charges,102.14,100,,,Fee Schedule,100% of Medicare rate,560.62,100,,,Fee Schedule,100% of WA Medicaid,2713,100,,,percent of total billed charges,100% of total billed charges,577.44,103,,,Fee Schedule,103% of WA Medicaid,102.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,178.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,560.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1871.97,69,,,percent of total billed charges,69% of total billed charges,2713,100,,,percent of total billed charges,100% of total billed charges,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2713,100,,,percent of total billed charges,100% of total billed charges,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2713,100,,,percent of total billed charges,100% of total billed charges,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1677.99,61.85,,,percent of total billed charges,61.85% of total billed charges,560.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,560.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,728.81,130,,,Fee Schedule,130% of WA Medicaid ,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1022.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1022.8,37.7,,,percent of total billed charges,37.70% of total billed charges,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,91970.7,33.9,,,percent of total billed charges,33.9% of total billed charges,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2116.14,78,,,percent of total billed charges,78% of total billed charges,2713,100,,,percent of total billed charges,100% of total billed charges,2240.94,82.6,,,percent of total billed charges,82.6% of total billed charges,2240.94,82.6,,,percent of total billed charges,82.6% of total billed charges,560.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,102.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,560.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,102.14,91970.7,
TREAT FX PROX HUMERUS NECK,23600,CDM,983,RC,23600,HCPCS,Outpatient,,,874,568.10,,769.12,88,,,percent of total billed charges,88% of total Billed charges,25.36,100,,,Fee Schedule,100% of Medicare rate,192.47,100,,,Fee Schedule,100% of WA Medicaid,874,100,,,percent of total billed charges,100% of total billed charges,198.24,103,,,Fee Schedule,103% of WA Medicaid,25.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,192.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,603.06,69,,,percent of total billed charges,69% of total billed charges,874,100,,,percent of total billed charges,100% of total billed charges,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,874,100,,,percent of total billed charges,100% of total billed charges,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,874,100,,,percent of total billed charges,100% of total billed charges,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,540.57,61.85,,,percent of total billed charges,61.85% of total billed charges,192.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,250.21,130,,,Fee Schedule,130% of WA Medicaid ,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.5,37.7,,,percent of total billed charges,37.70% of total billed charges,329.5,37.7,,,percent of total billed charges,37.70% of total billed charges,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,29628.6,33.9,,,percent of total billed charges,33.9% of total billed charges,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,681.72,78,,,percent of total billed charges,78% of total billed charges,874,100,,,percent of total billed charges,100% of total billed charges,721.92,82.6,,,percent of total billed charges,82.6% of total billed charges,721.92,82.6,,,percent of total billed charges,82.6% of total billed charges,192.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.36,29628.6,
TREAT HUMERUS FRACTURE,23605,CDM,983,RC,23605,HCPCS,Outpatient,,,1326,861.90,,1166.88,88,,,percent of total billed charges,88% of total Billed charges,40.6,100,,,Fee Schedule,100% of Medicare rate,254.76,100,,,Fee Schedule,100% of WA Medicaid,1326,100,,,percent of total billed charges,100% of total billed charges,262.4,103,,,Fee Schedule,103% of WA Medicaid,40.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,71.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,254.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,914.94,69,,,percent of total billed charges,69% of total billed charges,1326,100,,,percent of total billed charges,100% of total billed charges,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1326,100,,,percent of total billed charges,100% of total billed charges,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1326,100,,,percent of total billed charges,100% of total billed charges,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,820.13,61.85,,,percent of total billed charges,61.85% of total billed charges,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,331.19,130,,,Fee Schedule,130% of WA Medicaid ,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.9,37.7,,,percent of total billed charges,37.70% of total billed charges,499.9,37.7,,,percent of total billed charges,37.70% of total billed charges,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,44951.4,33.9,,,percent of total billed charges,33.9% of total billed charges,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034.28,78,,,percent of total billed charges,78% of total billed charges,1326,100,,,percent of total billed charges,100% of total billed charges,1095.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1095.28,82.6,,,percent of total billed charges,82.6% of total billed charges,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.6,44951.4,
TREAT HUMERUS FRACTURE,23616,CDM,983,RC,23616,HCPCS,Outpatient,,,5518,3586.70,,4855.84,88,,,percent of total billed charges,88% of total Billed charges,134.26,100,,,Fee Schedule,100% of Medicare rate,707.02,100,,,Fee Schedule,100% of WA Medicaid,5518,100,,,percent of total billed charges,100% of total billed charges,728.23,103,,,Fee Schedule,103% of WA Medicaid,134.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,234.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,707.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3807.42,69,,,percent of total billed charges,69% of total billed charges,5518,100,,,percent of total billed charges,100% of total billed charges,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,5518,100,,,percent of total billed charges,100% of total billed charges,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,5518,100,,,percent of total billed charges,100% of total billed charges,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,3412.88,61.85,,,percent of total billed charges,61.85% of total billed charges,707.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,707.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,721.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,919.13,130,,,Fee Schedule,130% of WA Medicaid ,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2080.29,37.7,,,percent of total billed charges,37.70% of total billed charges,2080.29,37.7,,,percent of total billed charges,37.70% of total billed charges,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,187060.2,33.9,,,percent of total billed charges,33.9% of total billed charges,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,4304.04,78,,,percent of total billed charges,78% of total billed charges,5518,100,,,percent of total billed charges,100% of total billed charges,4557.87,82.6,,,percent of total billed charges,82.6% of total billed charges,4557.87,82.6,,,percent of total billed charges,82.6% of total billed charges,707.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,134.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,707.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,134.26,187060.2,
TREAT HUMERUS FRACTURE,23615,CDM,983,RC,23615,HCPCS,Outpatient,,,3135,2037.75,,2758.8,88,,,percent of total billed charges,88% of total Billed charges,90.91,100,,,Fee Schedule,100% of Medicare rate,510.26,100,,,Fee Schedule,100% of WA Medicaid,3135,100,,,percent of total billed charges,100% of total billed charges,525.57,103,,,Fee Schedule,103% of WA Medicaid,90.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,159.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,510.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2163.15,69,,,percent of total billed charges,69% of total billed charges,3135,100,,,percent of total billed charges,100% of total billed charges,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3135,100,,,percent of total billed charges,100% of total billed charges,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3135,100,,,percent of total billed charges,100% of total billed charges,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1939,61.85,,,percent of total billed charges,61.85% of total billed charges,510.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,663.34,130,,,Fee Schedule,130% of WA Medicaid ,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1181.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1181.9,37.7,,,percent of total billed charges,37.70% of total billed charges,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,106276.5,33.9,,,percent of total billed charges,33.9% of total billed charges,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2445.3,78,,,percent of total billed charges,78% of total billed charges,3135,100,,,percent of total billed charges,100% of total billed charges,2589.51,82.6,,,percent of total billed charges,82.6% of total billed charges,2589.51,82.6,,,percent of total billed charges,82.6% of total billed charges,510.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.91,106276.5,
TREAT HUMERUS FRACTURE,23630,CDM,983,RC,23630,HCPCS,Outpatient,,,2296,1492.40,,2020.48,88,,,percent of total billed charges,88% of total Billed charges,78.82,100,,,Fee Schedule,100% of Medicare rate,453.38,100,,,Fee Schedule,100% of WA Medicaid,2296,100,,,percent of total billed charges,100% of total billed charges,466.98,103,,,Fee Schedule,103% of WA Medicaid,78.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,453.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1584.24,69,,,percent of total billed charges,69% of total billed charges,2296,100,,,percent of total billed charges,100% of total billed charges,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2296,100,,,percent of total billed charges,100% of total billed charges,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2296,100,,,percent of total billed charges,100% of total billed charges,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1420.08,61.85,,,percent of total billed charges,61.85% of total billed charges,453.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,462.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,589.39,130,,,Fee Schedule,130% of WA Medicaid ,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,865.59,37.7,,,percent of total billed charges,37.70% of total billed charges,865.59,37.7,,,percent of total billed charges,37.70% of total billed charges,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,77834.4,33.9,,,percent of total billed charges,33.9% of total billed charges,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1790.88,78,,,percent of total billed charges,78% of total billed charges,2296,100,,,percent of total billed charges,100% of total billed charges,1896.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1896.5,82.6,,,percent of total billed charges,82.6% of total billed charges,453.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.82,77834.4,
TREAT SHOULDER DISLOCATION,23650,CDM,983,RC,23650,HCPCS,Outpatient,,,624,405.60,,549.12,88,,,percent of total billed charges,88% of total Billed charges,28.41,100,,,Fee Schedule,100% of Medicare rate,180.72,100,,,Fee Schedule,100% of WA Medicaid,624,100,,,percent of total billed charges,100% of total billed charges,186.14,103,,,Fee Schedule,103% of WA Medicaid,28.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,180.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,430.56,69,,,percent of total billed charges,69% of total billed charges,624,100,,,percent of total billed charges,100% of total billed charges,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,624,100,,,percent of total billed charges,100% of total billed charges,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,624,100,,,percent of total billed charges,100% of total billed charges,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.94,61.85,,,percent of total billed charges,61.85% of total billed charges,180.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,234.94,130,,,Fee Schedule,130% of WA Medicaid ,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.25,37.7,,,percent of total billed charges,37.70% of total billed charges,235.25,37.7,,,percent of total billed charges,37.70% of total billed charges,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,21153.6,33.9,,,percent of total billed charges,33.9% of total billed charges,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.72,78,,,percent of total billed charges,78% of total billed charges,624,100,,,percent of total billed charges,100% of total billed charges,515.42,82.6,,,percent of total billed charges,82.6% of total billed charges,515.42,82.6,,,percent of total billed charges,82.6% of total billed charges,180.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.41,21153.6,
TREAT SHOULDER DISLOCATION,23655,CDM,983,RC,23655,HCPCS,Outpatient,,,1113,723.45,,979.44,88,,,percent of total billed charges,88% of total Billed charges,37.87,100,,,Fee Schedule,100% of Medicare rate,242.26,100,,,Fee Schedule,100% of WA Medicaid,1113,100,,,percent of total billed charges,100% of total billed charges,249.53,103,,,Fee Schedule,103% of WA Medicaid,37.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,242.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,767.97,69,,,percent of total billed charges,69% of total billed charges,1113,100,,,percent of total billed charges,100% of total billed charges,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1113,100,,,percent of total billed charges,100% of total billed charges,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1113,100,,,percent of total billed charges,100% of total billed charges,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,688.39,61.85,,,percent of total billed charges,61.85% of total billed charges,242.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,314.94,130,,,Fee Schedule,130% of WA Medicaid ,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.6,37.7,,,percent of total billed charges,37.70% of total billed charges,419.6,37.7,,,percent of total billed charges,37.70% of total billed charges,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,37730.7,33.9,,,percent of total billed charges,33.9% of total billed charges,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,868.14,78,,,percent of total billed charges,78% of total billed charges,1113,100,,,percent of total billed charges,100% of total billed charges,919.34,82.6,,,percent of total billed charges,82.6% of total billed charges,919.34,82.6,,,percent of total billed charges,82.6% of total billed charges,242.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.87,37730.7,
TREAT DISLOCATION/FRACTURE,23670,CDM,983,RC,23670,HCPCS,Outpatient,,,2065,1342.25,,1817.2,88,,,percent of total billed charges,88% of total Billed charges,91.09,100,,,Fee Schedule,100% of Medicare rate,503.74,100,,,Fee Schedule,100% of WA Medicaid,2065,100,,,percent of total billed charges,100% of total billed charges,518.85,103,,,Fee Schedule,103% of WA Medicaid,91.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,159.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,503.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1424.85,69,,,percent of total billed charges,69% of total billed charges,2065,100,,,percent of total billed charges,100% of total billed charges,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2065,100,,,percent of total billed charges,100% of total billed charges,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2065,100,,,percent of total billed charges,100% of total billed charges,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1277.2,61.85,,,percent of total billed charges,61.85% of total billed charges,503.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,503.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,654.86,130,,,Fee Schedule,130% of WA Medicaid ,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.51,37.7,,,percent of total billed charges,37.70% of total billed charges,778.51,37.7,,,percent of total billed charges,37.70% of total billed charges,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,70003.5,33.9,,,percent of total billed charges,33.9% of total billed charges,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1610.7,78,,,percent of total billed charges,78% of total billed charges,2065,100,,,percent of total billed charges,100% of total billed charges,1705.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1705.69,82.6,,,percent of total billed charges,82.6% of total billed charges,503.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,92,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,503.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.09,70003.5,
TREAT DISLOCATION/FRACTURE,23680,CDM,983,RC,23680,HCPCS,Outpatient,,,2420,1573.00,,2129.6,88,,,percent of total billed charges,88% of total Billed charges,94.35,100,,,Fee Schedule,100% of Medicare rate,530.97,100,,,Fee Schedule,100% of WA Medicaid,2420,100,,,percent of total billed charges,100% of total billed charges,546.9,103,,,Fee Schedule,103% of WA Medicaid,94.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,165.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,530.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1669.8,69,,,percent of total billed charges,69% of total billed charges,2420,100,,,percent of total billed charges,100% of total billed charges,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2420,100,,,percent of total billed charges,100% of total billed charges,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2420,100,,,percent of total billed charges,100% of total billed charges,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1496.77,61.85,,,percent of total billed charges,61.85% of total billed charges,530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,690.26,130,,,Fee Schedule,130% of WA Medicaid ,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,912.34,37.7,,,percent of total billed charges,37.70% of total billed charges,912.34,37.7,,,percent of total billed charges,37.70% of total billed charges,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,82038,33.9,,,percent of total billed charges,33.9% of total billed charges,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1887.6,78,,,percent of total billed charges,78% of total billed charges,2420,100,,,percent of total billed charges,100% of total billed charges,1998.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1998.92,82.6,,,percent of total billed charges,82.6% of total billed charges,530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,94.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.35,82038,
FIXATION OF SHOULDER,23700,CDM,983,RC,23700,HCPCS,Outpatient,,,713,463.45,,627.44,88,,,percent of total billed charges,88% of total Billed charges,18.96,100,,,Fee Schedule,100% of Medicare rate,113.95,100,,,Fee Schedule,100% of WA Medicaid,713,100,,,percent of total billed charges,100% of total billed charges,117.37,103,,,Fee Schedule,103% of WA Medicaid,18.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,113.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,491.97,69,,,percent of total billed charges,69% of total billed charges,713,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,713,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,713,100,,,percent of total billed charges,100% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.99,61.85,,,percent of total billed charges,61.85% of total billed charges,113.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,148.14,130,,,Fee Schedule,130% of WA Medicaid ,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.8,37.7,,,percent of total billed charges,37.70% of total billed charges,268.8,37.7,,,percent of total billed charges,37.70% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,24170.7,33.9,,,percent of total billed charges,33.9% of total billed charges,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.14,78,,,percent of total billed charges,78% of total billed charges,713,100,,,percent of total billed charges,100% of total billed charges,588.94,82.6,,,percent of total billed charges,82.6% of total billed charges,588.94,82.6,,,percent of total billed charges,82.6% of total billed charges,113.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.96,24170.7,
SHOULDER SURGERY PROCEDURE,23929,CDM,983,RC,23929,HCPCS,Outpatient,,,3816,2480.40,,3358.08,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3816,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2633.04,69,,,percent of total billed charges,69% of total billed charges,3816,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3816,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3816,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2360.2,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1438.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1438.63,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,129362.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2976.48,78,,,percent of total billed charges,78% of total billed charges,3816,100,,,percent of total billed charges,100% of total billed charges,3152.02,82.6,,,percent of total billed charges,82.6% of total billed charges,3152.02,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1438.63,129362.4,
DRAINAGE OF ARM LESION,23930,CDM,983,RC,23930,HCPCS,Outpatient,,,740,481.00,,651.2,88,,,percent of total billed charges,88% of total Billed charges,22.88,100,,,Fee Schedule,100% of Medicare rate,124.21,100,,,Fee Schedule,100% of WA Medicaid,740,100,,,percent of total billed charges,100% of total billed charges,127.94,103,,,Fee Schedule,103% of WA Medicaid,22.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,124.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,510.6,69,,,percent of total billed charges,69% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,740,100,,,percent of total billed charges,100% of total billed charges,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,740,100,,,percent of total billed charges,100% of total billed charges,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.69,61.85,,,percent of total billed charges,61.85% of total billed charges,124.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,161.47,130,,,Fee Schedule,130% of WA Medicaid ,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,25086,33.9,,,percent of total billed charges,33.9% of total billed charges,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.2,78,,,percent of total billed charges,78% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,124.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.88,25086,
DRAIN ARM/ELBOW BONE LESION,23935,CDM,983,RC,23935,HCPCS,Outpatient,,,1747,1135.55,,1537.36,88,,,percent of total billed charges,88% of total Billed charges,48.79,100,,,Fee Schedule,100% of Medicare rate,301.76,100,,,Fee Schedule,100% of WA Medicaid,1747,100,,,percent of total billed charges,100% of total billed charges,310.81,103,,,Fee Schedule,103% of WA Medicaid,48.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,301.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1205.43,69,,,percent of total billed charges,69% of total billed charges,1747,100,,,percent of total billed charges,100% of total billed charges,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1747,100,,,percent of total billed charges,100% of total billed charges,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1747,100,,,percent of total billed charges,100% of total billed charges,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080.52,61.85,,,percent of total billed charges,61.85% of total billed charges,301.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,392.29,130,,,Fee Schedule,130% of WA Medicaid ,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.62,37.7,,,percent of total billed charges,37.70% of total billed charges,658.62,37.7,,,percent of total billed charges,37.70% of total billed charges,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,59223.3,33.9,,,percent of total billed charges,33.9% of total billed charges,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1362.66,78,,,percent of total billed charges,78% of total billed charges,1747,100,,,percent of total billed charges,100% of total billed charges,1443.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1443.02,82.6,,,percent of total billed charges,82.6% of total billed charges,301.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.79,59223.3,
DRAINAGE OF ARM BURSA,23931,CDM,983,RC,23931,HCPCS,Outpatient,,,523,339.95,,460.24,88,,,percent of total billed charges,88% of total Billed charges,14.05,100,,,Fee Schedule,100% of Medicare rate,94.74,100,,,Fee Schedule,100% of WA Medicaid,523,100,,,percent of total billed charges,100% of total billed charges,97.58,103,,,Fee Schedule,103% of WA Medicaid,14.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,94.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,360.87,69,,,percent of total billed charges,69% of total billed charges,523,100,,,percent of total billed charges,100% of total billed charges,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,523,100,,,percent of total billed charges,100% of total billed charges,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,523,100,,,percent of total billed charges,100% of total billed charges,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.48,61.85,,,percent of total billed charges,61.85% of total billed charges,94.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,123.16,130,,,Fee Schedule,130% of WA Medicaid ,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.17,37.7,,,percent of total billed charges,37.70% of total billed charges,197.17,37.7,,,percent of total billed charges,37.70% of total billed charges,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,17729.7,33.9,,,percent of total billed charges,33.9% of total billed charges,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.94,78,,,percent of total billed charges,78% of total billed charges,523,100,,,percent of total billed charges,100% of total billed charges,432,82.6,,,percent of total billed charges,82.6% of total billed charges,432,82.6,,,percent of total billed charges,82.6% of total billed charges,94.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.05,17729.7,
RELEASE ELBOW JOINT,24006,CDM,983,RC,24006,HCPCS,Outpatient,,,2733,1776.45,,2405.04,88,,,percent of total billed charges,88% of total Billed charges,71.1,100,,,Fee Schedule,100% of Medicare rate,414.96,100,,,Fee Schedule,100% of WA Medicaid,2733,100,,,percent of total billed charges,100% of total billed charges,427.41,103,,,Fee Schedule,103% of WA Medicaid,71.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,414.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1885.77,69,,,percent of total billed charges,69% of total billed charges,2733,100,,,percent of total billed charges,100% of total billed charges,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2733,100,,,percent of total billed charges,100% of total billed charges,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2733,100,,,percent of total billed charges,100% of total billed charges,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1690.36,61.85,,,percent of total billed charges,61.85% of total billed charges,414.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,539.45,130,,,Fee Schedule,130% of WA Medicaid ,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1030.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1030.34,37.7,,,percent of total billed charges,37.70% of total billed charges,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,92648.7,33.9,,,percent of total billed charges,33.9% of total billed charges,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2131.74,78,,,percent of total billed charges,78% of total billed charges,2733,100,,,percent of total billed charges,100% of total billed charges,2257.46,82.6,,,percent of total billed charges,82.6% of total billed charges,2257.46,82.6,,,percent of total billed charges,82.6% of total billed charges,414.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.1,92648.7,
EXPLORATORY ELBOW SURGERY,24000,CDM,983,RC,24000,HCPCS,Outpatient,,,1312,852.80,,1154.56,88,,,percent of total billed charges,88% of total Billed charges,46.4,100,,,Fee Schedule,100% of Medicare rate,280.87,100,,,Fee Schedule,100% of WA Medicaid,1312,100,,,percent of total billed charges,100% of total billed charges,289.3,103,,,Fee Schedule,103% of WA Medicaid,46.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,280.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,905.28,69,,,percent of total billed charges,69% of total billed charges,1312,100,,,percent of total billed charges,100% of total billed charges,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1312,100,,,percent of total billed charges,100% of total billed charges,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1312,100,,,percent of total billed charges,100% of total billed charges,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.47,61.85,,,percent of total billed charges,61.85% of total billed charges,280.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,365.13,130,,,Fee Schedule,130% of WA Medicaid ,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.62,37.7,,,percent of total billed charges,37.70% of total billed charges,494.62,37.7,,,percent of total billed charges,37.70% of total billed charges,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,44476.8,33.9,,,percent of total billed charges,33.9% of total billed charges,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1023.36,78,,,percent of total billed charges,78% of total billed charges,1312,100,,,percent of total billed charges,100% of total billed charges,1083.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1083.71,82.6,,,percent of total billed charges,82.6% of total billed charges,280.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.4,44476.8,
BIOPSY ARM/ELBOW SOFT TISSUE,24066,CDM,983,RC,24066,HCPCS,Outpatient,,,1129,733.85,,993.52,88,,,percent of total billed charges,88% of total Billed charges,42.79,100,,,Fee Schedule,100% of Medicare rate,246.74,100,,,Fee Schedule,100% of WA Medicaid,1129,100,,,percent of total billed charges,100% of total billed charges,254.14,103,,,Fee Schedule,103% of WA Medicaid,42.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,246.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,779.01,69,,,percent of total billed charges,69% of total billed charges,1129,100,,,percent of total billed charges,100% of total billed charges,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1129,100,,,percent of total billed charges,100% of total billed charges,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1129,100,,,percent of total billed charges,100% of total billed charges,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.29,61.85,,,percent of total billed charges,61.85% of total billed charges,246.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,320.76,130,,,Fee Schedule,130% of WA Medicaid ,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.63,37.7,,,percent of total billed charges,37.70% of total billed charges,425.63,37.7,,,percent of total billed charges,37.70% of total billed charges,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,38273.1,33.9,,,percent of total billed charges,33.9% of total billed charges,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,880.62,78,,,percent of total billed charges,78% of total billed charges,1129,100,,,percent of total billed charges,100% of total billed charges,932.55,82.6,,,percent of total billed charges,82.6% of total billed charges,932.55,82.6,,,percent of total billed charges,82.6% of total billed charges,246.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.79,38273.1,
BIOPSY ARM/ELBOW SOFT TISSUE,24065,CDM,983,RC,24065,HCPCS,Outpatient,,,463,300.95,,407.44,88,,,percent of total billed charges,88% of total Billed charges,13.28,100,,,Fee Schedule,100% of Medicare rate,94.74,100,,,Fee Schedule,100% of WA Medicaid,463,100,,,percent of total billed charges,100% of total billed charges,97.58,103,,,Fee Schedule,103% of WA Medicaid,13.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,94.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,319.47,69,,,percent of total billed charges,69% of total billed charges,463,100,,,percent of total billed charges,100% of total billed charges,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,463,100,,,percent of total billed charges,100% of total billed charges,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,463,100,,,percent of total billed charges,100% of total billed charges,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.37,61.85,,,percent of total billed charges,61.85% of total billed charges,94.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,123.16,130,,,Fee Schedule,130% of WA Medicaid ,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.55,37.7,,,percent of total billed charges,37.70% of total billed charges,174.55,37.7,,,percent of total billed charges,37.70% of total billed charges,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,15695.7,33.9,,,percent of total billed charges,33.9% of total billed charges,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.14,78,,,percent of total billed charges,78% of total billed charges,463,100,,,percent of total billed charges,100% of total billed charges,382.44,82.6,,,percent of total billed charges,82.6% of total billed charges,382.44,82.6,,,percent of total billed charges,82.6% of total billed charges,94.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.28,15695.7,
EXC ARM/ELBOW LES SC 3 CM/>,24071,CDM,983,RC,24071,HCPCS,Outpatient,,,1090,708.50,,959.2,88,,,percent of total billed charges,88% of total Billed charges,45.76,100,,,Fee Schedule,100% of Medicare rate,233.68,100,,,Fee Schedule,100% of WA Medicaid,1090,100,,,percent of total billed charges,100% of total billed charges,240.69,103,,,Fee Schedule,103% of WA Medicaid,45.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,233.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,752.1,69,,,percent of total billed charges,69% of total billed charges,1090,100,,,percent of total billed charges,100% of total billed charges,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1090,100,,,percent of total billed charges,100% of total billed charges,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1090,100,,,percent of total billed charges,100% of total billed charges,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.17,61.85,,,percent of total billed charges,61.85% of total billed charges,233.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,303.78,130,,,Fee Schedule,130% of WA Medicaid ,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.93,37.7,,,percent of total billed charges,37.70% of total billed charges,410.93,37.7,,,percent of total billed charges,37.70% of total billed charges,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,36951,33.9,,,percent of total billed charges,33.9% of total billed charges,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,850.2,78,,,percent of total billed charges,78% of total billed charges,1090,100,,,percent of total billed charges,100% of total billed charges,900.34,82.6,,,percent of total billed charges,82.6% of total billed charges,900.34,82.6,,,percent of total billed charges,82.6% of total billed charges,233.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.76,36951,
EXC ARM/ELBOW LES SC < 3 CM,24075,CDM,983,RC,24075,HCPCS,Outpatient,,,1031,670.15,,907.28,88,,,percent of total billed charges,88% of total Billed charges,33.43,100,,,Fee Schedule,100% of Medicare rate,191.91,100,,,Fee Schedule,100% of WA Medicaid,1031,100,,,percent of total billed charges,100% of total billed charges,197.67,103,,,Fee Schedule,103% of WA Medicaid,33.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,191.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,711.39,69,,,percent of total billed charges,69% of total billed charges,1031,100,,,percent of total billed charges,100% of total billed charges,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031,100,,,percent of total billed charges,100% of total billed charges,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031,100,,,percent of total billed charges,100% of total billed charges,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.67,61.85,,,percent of total billed charges,61.85% of total billed charges,191.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,249.48,130,,,Fee Schedule,130% of WA Medicaid ,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.69,37.7,,,percent of total billed charges,37.70% of total billed charges,388.69,37.7,,,percent of total billed charges,37.70% of total billed charges,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,34950.9,33.9,,,percent of total billed charges,33.9% of total billed charges,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.18,78,,,percent of total billed charges,78% of total billed charges,1031,100,,,percent of total billed charges,100% of total billed charges,851.61,82.6,,,percent of total billed charges,82.6% of total billed charges,851.61,82.6,,,percent of total billed charges,82.6% of total billed charges,191.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.43,34950.9,
EX ARM/ELBOW TUM DEEP 5 CM/>,24073,CDM,983,RC,24073,HCPCS,Outpatient,,,1902,1236.30,,1673.76,88,,,percent of total billed charges,88% of total Billed charges,79.03,100,,,Fee Schedule,100% of Medicare rate,397.25,100,,,Fee Schedule,100% of WA Medicaid,1902,100,,,percent of total billed charges,100% of total billed charges,409.17,103,,,Fee Schedule,103% of WA Medicaid,79.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,397.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1312.38,69,,,percent of total billed charges,69% of total billed charges,1902,100,,,percent of total billed charges,100% of total billed charges,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1902,100,,,percent of total billed charges,100% of total billed charges,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1902,100,,,percent of total billed charges,100% of total billed charges,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1176.39,61.85,,,percent of total billed charges,61.85% of total billed charges,397.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,516.43,130,,,Fee Schedule,130% of WA Medicaid ,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.05,37.7,,,percent of total billed charges,37.70% of total billed charges,717.05,37.7,,,percent of total billed charges,37.70% of total billed charges,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,64477.8,33.9,,,percent of total billed charges,33.9% of total billed charges,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1483.56,78,,,percent of total billed charges,78% of total billed charges,1902,100,,,percent of total billed charges,100% of total billed charges,1571.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1571.05,82.6,,,percent of total billed charges,82.6% of total billed charges,397.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.03,64477.8,
EX ARM/ELBOW TUM DEEP < 5 CM,24076,CDM,983,RC,24076,HCPCS,Outpatient,,,1504,977.60,,1323.52,88,,,percent of total billed charges,88% of total Billed charges,56.88,100,,,Fee Schedule,100% of Medicare rate,317.05,100,,,Fee Schedule,100% of WA Medicaid,1504,100,,,percent of total billed charges,100% of total billed charges,326.56,103,,,Fee Schedule,103% of WA Medicaid,56.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,317.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1037.76,69,,,percent of total billed charges,69% of total billed charges,1504,100,,,percent of total billed charges,100% of total billed charges,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1504,100,,,percent of total billed charges,100% of total billed charges,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1504,100,,,percent of total billed charges,100% of total billed charges,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,930.22,61.85,,,percent of total billed charges,61.85% of total billed charges,317.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,412.17,130,,,Fee Schedule,130% of WA Medicaid ,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.01,37.7,,,percent of total billed charges,37.70% of total billed charges,567.01,37.7,,,percent of total billed charges,37.70% of total billed charges,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,50985.6,33.9,,,percent of total billed charges,33.9% of total billed charges,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1173.12,78,,,percent of total billed charges,78% of total billed charges,1504,100,,,percent of total billed charges,100% of total billed charges,1242.3,82.6,,,percent of total billed charges,82.6% of total billed charges,1242.3,82.6,,,percent of total billed charges,82.6% of total billed charges,317.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.88,50985.6,
EXPLORE/TREAT ELBOW JOINT,24101,CDM,983,RC,24101,HCPCS,Outpatient,,,2485,1615.25,,2186.8,88,,,percent of total billed charges,88% of total Billed charges,47.43,100,,,Fee Schedule,100% of Medicare rate,295.6,100,,,Fee Schedule,100% of WA Medicaid,2485,100,,,percent of total billed charges,100% of total billed charges,304.47,103,,,Fee Schedule,103% of WA Medicaid,47.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,295.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1714.65,69,,,percent of total billed charges,69% of total billed charges,2485,100,,,percent of total billed charges,100% of total billed charges,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2485,100,,,percent of total billed charges,100% of total billed charges,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2485,100,,,percent of total billed charges,100% of total billed charges,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1536.97,61.85,,,percent of total billed charges,61.85% of total billed charges,295.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,384.28,130,,,Fee Schedule,130% of WA Medicaid ,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,936.85,37.7,,,percent of total billed charges,37.70% of total billed charges,936.85,37.7,,,percent of total billed charges,37.70% of total billed charges,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,84241.5,33.9,,,percent of total billed charges,33.9% of total billed charges,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1938.3,78,,,percent of total billed charges,78% of total billed charges,2485,100,,,percent of total billed charges,100% of total billed charges,2052.61,82.6,,,percent of total billed charges,82.6% of total billed charges,2052.61,82.6,,,percent of total billed charges,82.6% of total billed charges,295.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.43,84241.5,
REMOVE ELBOW JOINT LINING,24102,CDM,983,RC,24102,HCPCS,Outpatient,,,2980,1937.00,,2622.4,88,,,percent of total billed charges,88% of total Billed charges,60.42,100,,,Fee Schedule,100% of Medicare rate,359.95,100,,,Fee Schedule,100% of WA Medicaid,2980,100,,,percent of total billed charges,100% of total billed charges,370.75,103,,,Fee Schedule,103% of WA Medicaid,60.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,359.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2056.2,69,,,percent of total billed charges,69% of total billed charges,2980,100,,,percent of total billed charges,100% of total billed charges,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2980,100,,,percent of total billed charges,100% of total billed charges,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2980,100,,,percent of total billed charges,100% of total billed charges,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1843.13,61.85,,,percent of total billed charges,61.85% of total billed charges,359.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,467.94,130,,,Fee Schedule,130% of WA Medicaid ,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1123.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1123.46,37.7,,,percent of total billed charges,37.70% of total billed charges,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,101022,33.9,,,percent of total billed charges,33.9% of total billed charges,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2324.4,78,,,percent of total billed charges,78% of total billed charges,2980,100,,,percent of total billed charges,100% of total billed charges,2461.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2461.48,82.6,,,percent of total billed charges,82.6% of total billed charges,359.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.42,101022,
REMOVAL OF ELBOW BURSA,24105,CDM,983,RC,24105,HCPCS,Outpatient,,,1325,861.25,,1166,88,,,percent of total billed charges,88% of total Billed charges,30.71,100,,,Fee Schedule,100% of Medicare rate,214.85,100,,,Fee Schedule,100% of WA Medicaid,1325,100,,,percent of total billed charges,100% of total billed charges,221.3,103,,,Fee Schedule,103% of WA Medicaid,30.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,214.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,914.25,69,,,percent of total billed charges,69% of total billed charges,1325,100,,,percent of total billed charges,100% of total billed charges,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1325,100,,,percent of total billed charges,100% of total billed charges,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1325,100,,,percent of total billed charges,100% of total billed charges,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,819.51,61.85,,,percent of total billed charges,61.85% of total billed charges,214.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,279.31,130,,,Fee Schedule,130% of WA Medicaid ,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.53,37.7,,,percent of total billed charges,37.70% of total billed charges,499.53,37.7,,,percent of total billed charges,37.70% of total billed charges,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,44917.5,33.9,,,percent of total billed charges,33.9% of total billed charges,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1033.5,78,,,percent of total billed charges,78% of total billed charges,1325,100,,,percent of total billed charges,100% of total billed charges,1094.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1094.45,82.6,,,percent of total billed charges,82.6% of total billed charges,214.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.71,44917.5,
REMOVE/GRAFT BONE LESION,24116,CDM,983,RC,24116,HCPCS,Outpatient,,,2025,1316.25,,1782,88,,,percent of total billed charges,88% of total Billed charges,91.73,100,,,Fee Schedule,100% of Medicare rate,495.9,100,,,Fee Schedule,100% of WA Medicaid,2025,100,,,percent of total billed charges,100% of total billed charges,510.78,103,,,Fee Schedule,103% of WA Medicaid,91.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,160.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,495.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1397.25,69,,,percent of total billed charges,69% of total billed charges,2025,100,,,percent of total billed charges,100% of total billed charges,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2025,100,,,percent of total billed charges,100% of total billed charges,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2025,100,,,percent of total billed charges,100% of total billed charges,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1252.46,61.85,,,percent of total billed charges,61.85% of total billed charges,495.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,644.67,130,,,Fee Schedule,130% of WA Medicaid ,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.43,37.7,,,percent of total billed charges,37.70% of total billed charges,763.43,37.7,,,percent of total billed charges,37.70% of total billed charges,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,68647.5,33.9,,,percent of total billed charges,33.9% of total billed charges,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1579.5,78,,,percent of total billed charges,78% of total billed charges,2025,100,,,percent of total billed charges,100% of total billed charges,1672.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1672.65,82.6,,,percent of total billed charges,82.6% of total billed charges,495.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.73,68647.5,
REMOVE HUMERUS LESION,24110,CDM,983,RC,24110,HCPCS,Outpatient,,,2144,1393.60,,1886.72,88,,,percent of total billed charges,88% of total Billed charges,58.62,100,,,Fee Schedule,100% of Medicare rate,345.58,100,,,Fee Schedule,100% of WA Medicaid,2144,100,,,percent of total billed charges,100% of total billed charges,355.95,103,,,Fee Schedule,103% of WA Medicaid,58.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,345.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1479.36,69,,,percent of total billed charges,69% of total billed charges,2144,100,,,percent of total billed charges,100% of total billed charges,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2144,100,,,percent of total billed charges,100% of total billed charges,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2144,100,,,percent of total billed charges,100% of total billed charges,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1326.06,61.85,,,percent of total billed charges,61.85% of total billed charges,345.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.25,130,,,Fee Schedule,130% of WA Medicaid ,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,808.29,37.7,,,percent of total billed charges,37.70% of total billed charges,808.29,37.7,,,percent of total billed charges,37.70% of total billed charges,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,72681.6,33.9,,,percent of total billed charges,33.9% of total billed charges,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1672.32,78,,,percent of total billed charges,78% of total billed charges,2144,100,,,percent of total billed charges,100% of total billed charges,1770.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1770.94,82.6,,,percent of total billed charges,82.6% of total billed charges,345.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.62,72681.6,
REMOVE ELBOW LESION,24120,CDM,983,RC,24120,HCPCS,Outpatient,,,1735,1127.75,,1526.8,88,,,percent of total billed charges,88% of total Billed charges,51.42,100,,,Fee Schedule,100% of Medicare rate,312.2,100,,,Fee Schedule,100% of WA Medicaid,1735,100,,,percent of total billed charges,100% of total billed charges,321.57,103,,,Fee Schedule,103% of WA Medicaid,51.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,312.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1197.15,69,,,percent of total billed charges,69% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1735,100,,,percent of total billed charges,100% of total billed charges,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1735,100,,,percent of total billed charges,100% of total billed charges,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1073.1,61.85,,,percent of total billed charges,61.85% of total billed charges,312.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,405.86,130,,,Fee Schedule,130% of WA Medicaid ,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,654.1,37.7,,,percent of total billed charges,37.70% of total billed charges,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,58816.5,33.9,,,percent of total billed charges,33.9% of total billed charges,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1353.3,78,,,percent of total billed charges,78% of total billed charges,1735,100,,,percent of total billed charges,100% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1433.11,82.6,,,percent of total billed charges,82.6% of total billed charges,312.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.42,58816.5,
PARTIAL REMOVAL OF ELBOW,24147,CDM,983,RC,24147,HCPCS,Outpatient,,,2249,1461.85,,1979.12,88,,,percent of total billed charges,88% of total Billed charges,59,100,,,Fee Schedule,100% of Medicare rate,367.96,100,,,Fee Schedule,100% of WA Medicaid,2249,100,,,percent of total billed charges,100% of total billed charges,379,103,,,Fee Schedule,103% of WA Medicaid,59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,367.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1551.81,69,,,percent of total billed charges,69% of total billed charges,2249,100,,,percent of total billed charges,100% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2249,100,,,percent of total billed charges,100% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2249,100,,,percent of total billed charges,100% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1391.01,61.85,,,percent of total billed charges,61.85% of total billed charges,367.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,478.35,130,,,Fee Schedule,130% of WA Medicaid ,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.87,37.7,,,percent of total billed charges,37.70% of total billed charges,847.87,37.7,,,percent of total billed charges,37.70% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,76241.1,33.9,,,percent of total billed charges,33.9% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1754.22,78,,,percent of total billed charges,78% of total billed charges,2249,100,,,percent of total billed charges,100% of total billed charges,1857.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1857.67,82.6,,,percent of total billed charges,82.6% of total billed charges,367.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59,76241.1,
REMOVE RADIUS HEAD IMPLANT,24164,CDM,983,RC,24164,HCPCS,Outpatient,,,1919,1247.35,,1688.72,88,,,percent of total billed charges,88% of total Billed charges,75.52,100,,,Fee Schedule,100% of Medicare rate,420,100,,,Fee Schedule,100% of WA Medicaid,1919,100,,,percent of total billed charges,100% of total billed charges,432.6,103,,,Fee Schedule,103% of WA Medicaid,75.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,132.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,420,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1324.11,69,,,percent of total billed charges,69% of total billed charges,1919,100,,,percent of total billed charges,100% of total billed charges,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1919,100,,,percent of total billed charges,100% of total billed charges,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1919,100,,,percent of total billed charges,100% of total billed charges,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1186.9,61.85,,,percent of total billed charges,61.85% of total billed charges,420,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,420,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,546,130,,,Fee Schedule,130% of WA Medicaid ,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.46,37.7,,,percent of total billed charges,37.70% of total billed charges,723.46,37.7,,,percent of total billed charges,37.70% of total billed charges,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,65054.1,33.9,,,percent of total billed charges,33.9% of total billed charges,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1496.82,78,,,percent of total billed charges,78% of total billed charges,1919,100,,,percent of total billed charges,100% of total billed charges,1585.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1585.09,82.6,,,percent of total billed charges,82.6% of total billed charges,420,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,420,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.52,65054.1,
REMOVAL OF ARM FOREIGN BODY,24200,CDM,983,RC,24200,HCPCS,Outpatient,,,803,521.95,,706.64,88,,,percent of total billed charges,88% of total Billed charges,12.89,100,,,Fee Schedule,100% of Medicare rate,82.43,100,,,Fee Schedule,100% of WA Medicaid,803,100,,,percent of total billed charges,100% of total billed charges,84.9,103,,,Fee Schedule,103% of WA Medicaid,12.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,82.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,554.07,69,,,percent of total billed charges,69% of total billed charges,803,100,,,percent of total billed charges,100% of total billed charges,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,803,100,,,percent of total billed charges,100% of total billed charges,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,803,100,,,percent of total billed charges,100% of total billed charges,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.66,61.85,,,percent of total billed charges,61.85% of total billed charges,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.16,130,,,Fee Schedule,130% of WA Medicaid ,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.73,37.7,,,percent of total billed charges,37.70% of total billed charges,302.73,37.7,,,percent of total billed charges,37.70% of total billed charges,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,27221.7,33.9,,,percent of total billed charges,33.9% of total billed charges,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,626.34,78,,,percent of total billed charges,78% of total billed charges,803,100,,,percent of total billed charges,100% of total billed charges,663.28,82.6,,,percent of total billed charges,82.6% of total billed charges,663.28,82.6,,,percent of total billed charges,82.6% of total billed charges,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.89,27221.7,
REMOVAL OF ARM FOREIGN BODY,24201,CDM,983,RC,24201,HCPCS,Outpatient,,,1588,1032.20,,1397.44,88,,,percent of total billed charges,88% of total Billed charges,37.52,100,,,Fee Schedule,100% of Medicare rate,235.74,100,,,Fee Schedule,100% of WA Medicaid,1588,100,,,percent of total billed charges,100% of total billed charges,242.81,103,,,Fee Schedule,103% of WA Medicaid,37.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,235.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1095.72,69,,,percent of total billed charges,69% of total billed charges,1588,100,,,percent of total billed charges,100% of total billed charges,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1588,100,,,percent of total billed charges,100% of total billed charges,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1588,100,,,percent of total billed charges,100% of total billed charges,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,982.18,61.85,,,percent of total billed charges,61.85% of total billed charges,235.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,306.46,130,,,Fee Schedule,130% of WA Medicaid ,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.68,37.7,,,percent of total billed charges,37.70% of total billed charges,598.68,37.7,,,percent of total billed charges,37.70% of total billed charges,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,53833.2,33.9,,,percent of total billed charges,33.9% of total billed charges,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1238.64,78,,,percent of total billed charges,78% of total billed charges,1588,100,,,percent of total billed charges,100% of total billed charges,1311.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1311.69,82.6,,,percent of total billed charges,82.6% of total billed charges,235.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.52,53833.2,
MUSCLE/TENDON TRANSFER,24301,CDM,983,RC,24301,HCPCS,Outpatient,,,2674,1738.10,,2353.12,88,,,percent of total billed charges,88% of total Billed charges,77.34,100,,,Fee Schedule,100% of Medicare rate,434.73,100,,,Fee Schedule,100% of WA Medicaid,2674,100,,,percent of total billed charges,100% of total billed charges,447.77,103,,,Fee Schedule,103% of WA Medicaid,77.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,434.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1845.06,69,,,percent of total billed charges,69% of total billed charges,2674,100,,,percent of total billed charges,100% of total billed charges,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2674,100,,,percent of total billed charges,100% of total billed charges,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2674,100,,,percent of total billed charges,100% of total billed charges,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1653.87,61.85,,,percent of total billed charges,61.85% of total billed charges,434.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,565.15,130,,,Fee Schedule,130% of WA Medicaid ,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1008.1,37.7,,,percent of total billed charges,37.70% of total billed charges,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,90648.6,33.9,,,percent of total billed charges,33.9% of total billed charges,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2085.72,78,,,percent of total billed charges,78% of total billed charges,2674,100,,,percent of total billed charges,100% of total billed charges,2208.72,82.6,,,percent of total billed charges,82.6% of total billed charges,2208.72,82.6,,,percent of total billed charges,82.6% of total billed charges,434.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.34,90648.6,
MANIPULATE ELBOW W/ANESTH,24300,CDM,983,RC,24300,HCPCS,Outpatient,,,1201,780.65,,1056.88,88,,,percent of total billed charges,88% of total Billed charges,33.27,100,,,Fee Schedule,100% of Medicare rate,264.27,100,,,Fee Schedule,100% of WA Medicaid,1201,100,,,percent of total billed charges,100% of total billed charges,272.2,103,,,Fee Schedule,103% of WA Medicaid,33.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,828.69,69,,,percent of total billed charges,69% of total billed charges,1201,100,,,percent of total billed charges,100% of total billed charges,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1201,100,,,percent of total billed charges,100% of total billed charges,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1201,100,,,percent of total billed charges,100% of total billed charges,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,742.82,61.85,,,percent of total billed charges,61.85% of total billed charges,264.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,343.55,130,,,Fee Schedule,130% of WA Medicaid ,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.78,37.7,,,percent of total billed charges,37.70% of total billed charges,452.78,37.7,,,percent of total billed charges,37.70% of total billed charges,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,40713.9,33.9,,,percent of total billed charges,33.9% of total billed charges,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,936.78,78,,,percent of total billed charges,78% of total billed charges,1201,100,,,percent of total billed charges,100% of total billed charges,992.03,82.6,,,percent of total billed charges,82.6% of total billed charges,992.03,82.6,,,percent of total billed charges,82.6% of total billed charges,264.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.27,40713.9,
REVISION OF ARM TENDON,24310,CDM,983,RC,24310,HCPCS,Outpatient,,,1842,1197.30,,1620.96,88,,,percent of total billed charges,88% of total Billed charges,45.48,100,,,Fee Schedule,100% of Medicare rate,278.26,100,,,Fee Schedule,100% of WA Medicaid,1842,100,,,percent of total billed charges,100% of total billed charges,286.61,103,,,Fee Schedule,103% of WA Medicaid,45.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,278.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1270.98,69,,,percent of total billed charges,69% of total billed charges,1842,100,,,percent of total billed charges,100% of total billed charges,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1842,100,,,percent of total billed charges,100% of total billed charges,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1842,100,,,percent of total billed charges,100% of total billed charges,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1139.28,61.85,,,percent of total billed charges,61.85% of total billed charges,278.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,361.74,130,,,Fee Schedule,130% of WA Medicaid ,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,694.43,37.7,,,percent of total billed charges,37.70% of total billed charges,694.43,37.7,,,percent of total billed charges,37.70% of total billed charges,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,62443.8,33.9,,,percent of total billed charges,33.9% of total billed charges,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1436.76,78,,,percent of total billed charges,78% of total billed charges,1842,100,,,percent of total billed charges,100% of total billed charges,1521.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1521.49,82.6,,,percent of total billed charges,82.6% of total billed charges,278.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.48,62443.8,
REPAIR ARM TENDON/MUSCLE,24341,CDM,983,RC,24341,HCPCS,Outpatient,,,2335,1517.75,,2054.8,88,,,percent of total billed charges,88% of total Billed charges,71.01,100,,,Fee Schedule,100% of Medicare rate,438.46,100,,,Fee Schedule,100% of WA Medicaid,2335,100,,,percent of total billed charges,100% of total billed charges,451.61,103,,,Fee Schedule,103% of WA Medicaid,71.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,438.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1611.15,69,,,percent of total billed charges,69% of total billed charges,2335,100,,,percent of total billed charges,100% of total billed charges,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2335,100,,,percent of total billed charges,100% of total billed charges,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2335,100,,,percent of total billed charges,100% of total billed charges,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1444.2,61.85,,,percent of total billed charges,61.85% of total billed charges,438.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,570,130,,,Fee Schedule,130% of WA Medicaid ,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,880.3,37.7,,,percent of total billed charges,37.70% of total billed charges,880.3,37.7,,,percent of total billed charges,37.70% of total billed charges,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,79156.5,33.9,,,percent of total billed charges,33.9% of total billed charges,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1821.3,78,,,percent of total billed charges,78% of total billed charges,2335,100,,,percent of total billed charges,100% of total billed charges,1928.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1928.71,82.6,,,percent of total billed charges,82.6% of total billed charges,438.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.01,79156.5,
REPAIR OF RUPTURED TENDON,24342,CDM,983,RC,24342,HCPCS,Outpatient,,,3029,1968.85,,2665.52,88,,,percent of total billed charges,88% of total Billed charges,78.55,100,,,Fee Schedule,100% of Medicare rate,447.97,100,,,Fee Schedule,100% of WA Medicaid,3029,100,,,percent of total billed charges,100% of total billed charges,461.41,103,,,Fee Schedule,103% of WA Medicaid,78.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,447.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2090.01,69,,,percent of total billed charges,69% of total billed charges,3029,100,,,percent of total billed charges,100% of total billed charges,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3029,100,,,percent of total billed charges,100% of total billed charges,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3029,100,,,percent of total billed charges,100% of total billed charges,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1873.44,61.85,,,percent of total billed charges,61.85% of total billed charges,447.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,582.36,130,,,Fee Schedule,130% of WA Medicaid ,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1141.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1141.93,37.7,,,percent of total billed charges,37.70% of total billed charges,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,102683.1,33.9,,,percent of total billed charges,33.9% of total billed charges,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2362.62,78,,,percent of total billed charges,78% of total billed charges,3029,100,,,percent of total billed charges,100% of total billed charges,2501.95,82.6,,,percent of total billed charges,82.6% of total billed charges,2501.95,82.6,,,percent of total billed charges,82.6% of total billed charges,447.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.55,102683.1,
REPAIR ELBOW DEB/ATTCH OPEN,24359,CDM,983,RC,24359,HCPCS,Outpatient,,,2041,1326.65,,1796.08,88,,,percent of total billed charges,88% of total Billed charges,65.71,100,,,Fee Schedule,100% of Medicare rate,386.43,100,,,Fee Schedule,100% of WA Medicaid,2041,100,,,percent of total billed charges,100% of total billed charges,398.02,103,,,Fee Schedule,103% of WA Medicaid,65.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,386.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1408.29,69,,,percent of total billed charges,69% of total billed charges,2041,100,,,percent of total billed charges,100% of total billed charges,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2041,100,,,percent of total billed charges,100% of total billed charges,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2041,100,,,percent of total billed charges,100% of total billed charges,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262.36,61.85,,,percent of total billed charges,61.85% of total billed charges,386.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,502.36,130,,,Fee Schedule,130% of WA Medicaid ,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,769.46,37.7,,,percent of total billed charges,37.70% of total billed charges,769.46,37.7,,,percent of total billed charges,37.70% of total billed charges,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,69189.9,33.9,,,percent of total billed charges,33.9% of total billed charges,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1591.98,78,,,percent of total billed charges,78% of total billed charges,2041,100,,,percent of total billed charges,100% of total billed charges,1685.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1685.87,82.6,,,percent of total billed charges,82.6% of total billed charges,386.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.71,69189.9,
REPAIR ELBOW W/DEB OPEN,24358,CDM,983,RC,24358,HCPCS,Outpatient,,,1597,1038.05,,1405.36,88,,,percent of total billed charges,88% of total Billed charges,49.8,100,,,Fee Schedule,100% of Medicare rate,311.27,100,,,Fee Schedule,100% of WA Medicaid,1597,100,,,percent of total billed charges,100% of total billed charges,320.61,103,,,Fee Schedule,103% of WA Medicaid,49.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,311.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1101.93,69,,,percent of total billed charges,69% of total billed charges,1597,100,,,percent of total billed charges,100% of total billed charges,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1597,100,,,percent of total billed charges,100% of total billed charges,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1597,100,,,percent of total billed charges,100% of total billed charges,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,987.74,61.85,,,percent of total billed charges,61.85% of total billed charges,311.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,404.65,130,,,Fee Schedule,130% of WA Medicaid ,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.07,37.7,,,percent of total billed charges,37.70% of total billed charges,602.07,37.7,,,percent of total billed charges,37.70% of total billed charges,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,54138.3,33.9,,,percent of total billed charges,33.9% of total billed charges,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1245.66,78,,,percent of total billed charges,78% of total billed charges,1597,100,,,percent of total billed charges,100% of total billed charges,1319.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1319.12,82.6,,,percent of total billed charges,82.6% of total billed charges,311.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.8,54138.3,
REPLACE ELBOW JOINT,24363,CDM,983,RC,24363,HCPCS,Outpatient,,,6424,4175.60,,5653.12,88,,,percent of total billed charges,88% of total Billed charges,156.38,100,,,Fee Schedule,100% of Medicare rate,826.38,100,,,Fee Schedule,100% of WA Medicaid,6424,100,,,percent of total billed charges,100% of total billed charges,851.17,103,,,Fee Schedule,103% of WA Medicaid,156.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,273.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,826.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4432.56,69,,,percent of total billed charges,69% of total billed charges,6424,100,,,percent of total billed charges,100% of total billed charges,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,6424,100,,,percent of total billed charges,100% of total billed charges,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,6424,100,,,percent of total billed charges,100% of total billed charges,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3973.24,61.85,,,percent of total billed charges,61.85% of total billed charges,826.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,826.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1074.29,130,,,Fee Schedule,130% of WA Medicaid ,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2421.85,37.7,,,percent of total billed charges,37.70% of total billed charges,2421.85,37.7,,,percent of total billed charges,37.70% of total billed charges,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,217773.6,33.9,,,percent of total billed charges,33.9% of total billed charges,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,5010.72,78,,,percent of total billed charges,78% of total billed charges,6424,100,,,percent of total billed charges,100% of total billed charges,5306.22,82.6,,,percent of total billed charges,82.6% of total billed charges,5306.22,82.6,,,percent of total billed charges,82.6% of total billed charges,826.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,156.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,826.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,156.38,217773.6,
RECONSTRUCT ELBOW JOINT,24361,CDM,983,RC,24361,HCPCS,Outpatient,,,3392,2204.80,,2984.96,88,,,percent of total billed charges,88% of total Billed charges,107.27,100,,,Fee Schedule,100% of Medicare rate,579.08,100,,,Fee Schedule,100% of WA Medicaid,3392,100,,,percent of total billed charges,100% of total billed charges,596.45,103,,,Fee Schedule,103% of WA Medicaid,107.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,187.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,579.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2340.48,69,,,percent of total billed charges,69% of total billed charges,3392,100,,,percent of total billed charges,100% of total billed charges,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3392,100,,,percent of total billed charges,100% of total billed charges,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3392,100,,,percent of total billed charges,100% of total billed charges,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2097.95,61.85,,,percent of total billed charges,61.85% of total billed charges,579.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,579.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,752.8,130,,,Fee Schedule,130% of WA Medicaid ,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1278.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1278.78,37.7,,,percent of total billed charges,37.70% of total billed charges,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,114988.8,33.9,,,percent of total billed charges,33.9% of total billed charges,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2645.76,78,,,percent of total billed charges,78% of total billed charges,3392,100,,,percent of total billed charges,100% of total billed charges,2801.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2801.79,82.6,,,percent of total billed charges,82.6% of total billed charges,579.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,579.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.27,114988.8,
RECONSTRUCT HEAD OF RADIUS,24366,CDM,983,RC,24366,HCPCS,Outpatient,,,2756,1791.40,,2425.28,88,,,percent of total billed charges,88% of total Billed charges,67.72,100,,,Fee Schedule,100% of Medicare rate,395.01,100,,,Fee Schedule,100% of WA Medicaid,2756,100,,,percent of total billed charges,100% of total billed charges,406.86,103,,,Fee Schedule,103% of WA Medicaid,67.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,118.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,395.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1901.64,69,,,percent of total billed charges,69% of total billed charges,2756,100,,,percent of total billed charges,100% of total billed charges,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2756,100,,,percent of total billed charges,100% of total billed charges,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2756,100,,,percent of total billed charges,100% of total billed charges,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1704.59,61.85,,,percent of total billed charges,61.85% of total billed charges,395.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,513.51,130,,,Fee Schedule,130% of WA Medicaid ,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1039.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1039.01,37.7,,,percent of total billed charges,37.70% of total billed charges,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,93428.4,33.9,,,percent of total billed charges,33.9% of total billed charges,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2149.68,78,,,percent of total billed charges,78% of total billed charges,2756,100,,,percent of total billed charges,100% of total billed charges,2276.46,82.6,,,percent of total billed charges,82.6% of total billed charges,2276.46,82.6,,,percent of total billed charges,82.6% of total billed charges,395.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.72,93428.4,
RECONSTRUCT HEAD OF RADIUS,24365,CDM,983,RC,24365,HCPCS,Outpatient,,,2290,1488.50,,2015.2,88,,,percent of total billed charges,88% of total Billed charges,65.52,100,,,Fee Schedule,100% of Medicare rate,373,100,,,Fee Schedule,100% of WA Medicaid,2290,100,,,percent of total billed charges,100% of total billed charges,384.19,103,,,Fee Schedule,103% of WA Medicaid,65.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,373,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1580.1,69,,,percent of total billed charges,69% of total billed charges,2290,100,,,percent of total billed charges,100% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2290,100,,,percent of total billed charges,100% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2290,100,,,percent of total billed charges,100% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1416.37,61.85,,,percent of total billed charges,61.85% of total billed charges,373,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,373,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,484.9,130,,,Fee Schedule,130% of WA Medicaid ,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.33,37.7,,,percent of total billed charges,37.70% of total billed charges,863.33,37.7,,,percent of total billed charges,37.70% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,77631,33.9,,,percent of total billed charges,33.9% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786.2,78,,,percent of total billed charges,78% of total billed charges,2290,100,,,percent of total billed charges,100% of total billed charges,1891.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1891.54,82.6,,,percent of total billed charges,82.6% of total billed charges,373,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,373,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.52,77631,
REPAIR OF HUMERUS,24430,CDM,983,RC,24430,HCPCS,Outpatient,,,3924,2550.60,,3453.12,88,,,percent of total billed charges,88% of total Billed charges,111.29,100,,,Fee Schedule,100% of Medicare rate,606.31,100,,,Fee Schedule,100% of WA Medicaid,3924,100,,,percent of total billed charges,100% of total billed charges,624.5,103,,,Fee Schedule,103% of WA Medicaid,111.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,194.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,606.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2707.56,69,,,percent of total billed charges,69% of total billed charges,3924,100,,,percent of total billed charges,100% of total billed charges,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,3924,100,,,percent of total billed charges,100% of total billed charges,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,3924,100,,,percent of total billed charges,100% of total billed charges,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2426.99,61.85,,,percent of total billed charges,61.85% of total billed charges,606.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,788.2,130,,,Fee Schedule,130% of WA Medicaid ,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1479.35,37.7,,,percent of total billed charges,37.70% of total billed charges,1479.35,37.7,,,percent of total billed charges,37.70% of total billed charges,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,133023.6,33.9,,,percent of total billed charges,33.9% of total billed charges,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,3060.72,78,,,percent of total billed charges,78% of total billed charges,3924,100,,,percent of total billed charges,100% of total billed charges,3241.22,82.6,,,percent of total billed charges,82.6% of total billed charges,3241.22,82.6,,,percent of total billed charges,82.6% of total billed charges,606.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,111.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.29,133023.6,
REPAIR HUMERUS WITH GRAFT,24435,CDM,983,RC,24435,HCPCS,Outpatient,,,3301,2145.65,,2904.88,88,,,percent of total billed charges,88% of total Billed charges,111.65,100,,,Fee Schedule,100% of Medicare rate,623.47,100,,,Fee Schedule,100% of WA Medicaid,3301,100,,,percent of total billed charges,100% of total billed charges,642.17,103,,,Fee Schedule,103% of WA Medicaid,111.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,195.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,623.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2277.69,69,,,percent of total billed charges,69% of total billed charges,3301,100,,,percent of total billed charges,100% of total billed charges,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3301,100,,,percent of total billed charges,100% of total billed charges,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3301,100,,,percent of total billed charges,100% of total billed charges,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2041.67,61.85,,,percent of total billed charges,61.85% of total billed charges,623.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,623.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,635.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,810.51,130,,,Fee Schedule,130% of WA Medicaid ,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1244.48,37.7,,,percent of total billed charges,37.70% of total billed charges,1244.48,37.7,,,percent of total billed charges,37.70% of total billed charges,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,111903.9,33.9,,,percent of total billed charges,33.9% of total billed charges,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2574.78,78,,,percent of total billed charges,78% of total billed charges,3301,100,,,percent of total billed charges,100% of total billed charges,2726.63,82.6,,,percent of total billed charges,82.6% of total billed charges,2726.63,82.6,,,percent of total billed charges,82.6% of total billed charges,623.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,111.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,623.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.65,111903.9,
DECOMPRESSION OF FOREARM,24495,CDM,983,RC,24495,HCPCS,Outpatient,,,2264,1471.60,,1992.32,88,,,percent of total billed charges,88% of total Billed charges,72.91,100,,,Fee Schedule,100% of Medicare rate,541.04,100,,,Fee Schedule,100% of WA Medicaid,2264,100,,,percent of total billed charges,100% of total billed charges,557.27,103,,,Fee Schedule,103% of WA Medicaid,72.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,127.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,541.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1562.16,69,,,percent of total billed charges,69% of total billed charges,2264,100,,,percent of total billed charges,100% of total billed charges,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2264,100,,,percent of total billed charges,100% of total billed charges,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2264,100,,,percent of total billed charges,100% of total billed charges,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1400.28,61.85,,,percent of total billed charges,61.85% of total billed charges,541.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,703.35,130,,,Fee Schedule,130% of WA Medicaid ,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,853.53,37.7,,,percent of total billed charges,37.70% of total billed charges,853.53,37.7,,,percent of total billed charges,37.70% of total billed charges,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,76749.6,33.9,,,percent of total billed charges,33.9% of total billed charges,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1765.92,78,,,percent of total billed charges,78% of total billed charges,2264,100,,,percent of total billed charges,100% of total billed charges,1870.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1870.06,82.6,,,percent of total billed charges,82.6% of total billed charges,541.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.91,76749.6,
TREAT FX HUMERUS SHAFT,24500,CDM,983,RC,24500,HCPCS,Outpatient,,,760,494.00,,668.8,88,,,percent of total billed charges,88% of total Billed charges,28.51,100,,,Fee Schedule,100% of Medicare rate,202.73,100,,,Fee Schedule,100% of WA Medicaid,760,100,,,percent of total billed charges,100% of total billed charges,208.81,103,,,Fee Schedule,103% of WA Medicaid,28.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,202.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,524.4,69,,,percent of total billed charges,69% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,760,100,,,percent of total billed charges,100% of total billed charges,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,760,100,,,percent of total billed charges,100% of total billed charges,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.06,61.85,,,percent of total billed charges,61.85% of total billed charges,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,263.55,130,,,Fee Schedule,130% of WA Medicaid ,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,25764,33.9,,,percent of total billed charges,33.9% of total billed charges,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,592.8,78,,,percent of total billed charges,78% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.51,25764,
TREAT HUMERUS FRACTURE,24516,CDM,983,RC,24516,HCPCS,Outpatient,,,2972,1931.80,,2615.36,88,,,percent of total billed charges,88% of total Billed charges,90.12,100,,,Fee Schedule,100% of Medicare rate,494.97,100,,,Fee Schedule,100% of WA Medicaid,2972,100,,,percent of total billed charges,100% of total billed charges,509.82,103,,,Fee Schedule,103% of WA Medicaid,90.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,494.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2050.68,69,,,percent of total billed charges,69% of total billed charges,2972,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2972,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2972,100,,,percent of total billed charges,100% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1838.18,61.85,,,percent of total billed charges,61.85% of total billed charges,494.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,643.46,130,,,Fee Schedule,130% of WA Medicaid ,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1120.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1120.44,37.7,,,percent of total billed charges,37.70% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,100750.8,33.9,,,percent of total billed charges,33.9% of total billed charges,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2318.16,78,,,percent of total billed charges,78% of total billed charges,2972,100,,,percent of total billed charges,100% of total billed charges,2454.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2454.87,82.6,,,percent of total billed charges,82.6% of total billed charges,494.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.12,100750.8,
TREAT HUMERUS FRACTURE,24515,CDM,983,RC,24515,HCPCS,Outpatient,,,2511,1632.15,,2209.68,88,,,percent of total billed charges,88% of total Billed charges,90.07,100,,,Fee Schedule,100% of Medicare rate,509.15,100,,,Fee Schedule,100% of WA Medicaid,2511,100,,,percent of total billed charges,100% of total billed charges,524.42,103,,,Fee Schedule,103% of WA Medicaid,90.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,509.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1732.59,69,,,percent of total billed charges,69% of total billed charges,2511,100,,,percent of total billed charges,100% of total billed charges,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2511,100,,,percent of total billed charges,100% of total billed charges,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2511,100,,,percent of total billed charges,100% of total billed charges,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1553.05,61.85,,,percent of total billed charges,61.85% of total billed charges,509.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,661.9,130,,,Fee Schedule,130% of WA Medicaid ,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,946.65,37.7,,,percent of total billed charges,37.70% of total billed charges,946.65,37.7,,,percent of total billed charges,37.70% of total billed charges,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,85122.9,33.9,,,percent of total billed charges,33.9% of total billed charges,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1958.58,78,,,percent of total billed charges,78% of total billed charges,2511,100,,,percent of total billed charges,100% of total billed charges,2074.09,82.6,,,percent of total billed charges,82.6% of total billed charges,2074.09,82.6,,,percent of total billed charges,82.6% of total billed charges,509.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.07,85122.9,
TREAT HUMERUS FRACTURE,24538,CDM,983,RC,24538,HCPCS,Outpatient,,,2890,1878.50,,2543.2,88,,,percent of total billed charges,88% of total Billed charges,76.58,100,,,Fee Schedule,100% of Medicare rate,460.66,100,,,Fee Schedule,100% of WA Medicaid,2890,100,,,percent of total billed charges,100% of total billed charges,474.48,103,,,Fee Schedule,103% of WA Medicaid,76.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,134.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,460.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1994.1,69,,,percent of total billed charges,69% of total billed charges,2890,100,,,percent of total billed charges,100% of total billed charges,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2890,100,,,percent of total billed charges,100% of total billed charges,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2890,100,,,percent of total billed charges,100% of total billed charges,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1787.47,61.85,,,percent of total billed charges,61.85% of total billed charges,460.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,598.86,130,,,Fee Schedule,130% of WA Medicaid ,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1089.53,37.7,,,percent of total billed charges,37.70% of total billed charges,1089.53,37.7,,,percent of total billed charges,37.70% of total billed charges,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,97971,33.9,,,percent of total billed charges,33.9% of total billed charges,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2254.2,78,,,percent of total billed charges,78% of total billed charges,2890,100,,,percent of total billed charges,100% of total billed charges,2387.14,82.6,,,percent of total billed charges,82.6% of total billed charges,2387.14,82.6,,,percent of total billed charges,82.6% of total billed charges,460.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.58,97971,
TREAT HUMERUS FRACTURE,24530,CDM,983,RC,24530,HCPCS,Outpatient,,,843,547.95,,741.84,88,,,percent of total billed charges,88% of total Billed charges,30.32,100,,,Fee Schedule,100% of Medicare rate,212.42,100,,,Fee Schedule,100% of WA Medicaid,843,100,,,percent of total billed charges,100% of total billed charges,218.79,103,,,Fee Schedule,103% of WA Medicaid,30.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,212.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,581.67,69,,,percent of total billed charges,69% of total billed charges,843,100,,,percent of total billed charges,100% of total billed charges,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,843,100,,,percent of total billed charges,100% of total billed charges,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,843,100,,,percent of total billed charges,100% of total billed charges,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,521.4,61.85,,,percent of total billed charges,61.85% of total billed charges,212.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,276.15,130,,,Fee Schedule,130% of WA Medicaid ,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.81,37.7,,,percent of total billed charges,37.70% of total billed charges,317.81,37.7,,,percent of total billed charges,37.70% of total billed charges,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,28577.7,33.9,,,percent of total billed charges,33.9% of total billed charges,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,657.54,78,,,percent of total billed charges,78% of total billed charges,843,100,,,percent of total billed charges,100% of total billed charges,696.32,82.6,,,percent of total billed charges,82.6% of total billed charges,696.32,82.6,,,percent of total billed charges,82.6% of total billed charges,212.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.32,28577.7,
TREAT HUMERUS FRACTURE,24535,CDM,983,RC,24535,HCPCS,Outpatient,,,1841,1196.65,,1620.08,88,,,percent of total billed charges,88% of total Billed charges,55.66,100,,,Fee Schedule,100% of Medicare rate,338.87,100,,,Fee Schedule,100% of WA Medicaid,1841,100,,,percent of total billed charges,100% of total billed charges,349.04,103,,,Fee Schedule,103% of WA Medicaid,55.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,338.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1270.29,69,,,percent of total billed charges,69% of total billed charges,1841,100,,,percent of total billed charges,100% of total billed charges,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1841,100,,,percent of total billed charges,100% of total billed charges,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1841,100,,,percent of total billed charges,100% of total billed charges,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1138.66,61.85,,,percent of total billed charges,61.85% of total billed charges,338.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.53,130,,,Fee Schedule,130% of WA Medicaid ,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,694.06,37.7,,,percent of total billed charges,37.70% of total billed charges,694.06,37.7,,,percent of total billed charges,37.70% of total billed charges,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,62409.9,33.9,,,percent of total billed charges,33.9% of total billed charges,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1435.98,78,,,percent of total billed charges,78% of total billed charges,1841,100,,,percent of total billed charges,100% of total billed charges,1520.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1520.67,82.6,,,percent of total billed charges,82.6% of total billed charges,338.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.66,62409.9,
TREAT HUMERUS FRACTURE,24546,CDM,983,RC,24546,HCPCS,Outpatient,,,4376,2844.40,,3850.88,88,,,percent of total billed charges,88% of total Billed charges,108.69,100,,,Fee Schedule,100% of Medicare rate,596.24,100,,,Fee Schedule,100% of WA Medicaid,4376,100,,,percent of total billed charges,100% of total billed charges,614.13,103,,,Fee Schedule,103% of WA Medicaid,108.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,190.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,596.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3019.44,69,,,percent of total billed charges,69% of total billed charges,4376,100,,,percent of total billed charges,100% of total billed charges,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4376,100,,,percent of total billed charges,100% of total billed charges,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4376,100,,,percent of total billed charges,100% of total billed charges,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2706.56,61.85,,,percent of total billed charges,61.85% of total billed charges,596.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,775.11,130,,,Fee Schedule,130% of WA Medicaid ,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1649.75,37.7,,,percent of total billed charges,37.70% of total billed charges,1649.75,37.7,,,percent of total billed charges,37.70% of total billed charges,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,148346.4,33.9,,,percent of total billed charges,33.9% of total billed charges,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3413.28,78,,,percent of total billed charges,78% of total billed charges,4376,100,,,percent of total billed charges,100% of total billed charges,3614.58,82.6,,,percent of total billed charges,82.6% of total billed charges,3614.58,82.6,,,percent of total billed charges,82.6% of total billed charges,596.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,108.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.69,148346.4,
TREAT HUMERUS FRACTURE,24545,CDM,983,RC,24545,HCPCS,Outpatient,,,3210,2086.50,,2824.8,88,,,percent of total billed charges,88% of total Billed charges,96.91,100,,,Fee Schedule,100% of Medicare rate,535.26,100,,,Fee Schedule,100% of WA Medicaid,3210,100,,,percent of total billed charges,100% of total billed charges,551.32,103,,,Fee Schedule,103% of WA Medicaid,96.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,169.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,535.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2214.9,69,,,percent of total billed charges,69% of total billed charges,3210,100,,,percent of total billed charges,100% of total billed charges,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3210,100,,,percent of total billed charges,100% of total billed charges,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3210,100,,,percent of total billed charges,100% of total billed charges,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1985.39,61.85,,,percent of total billed charges,61.85% of total billed charges,535.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,695.84,130,,,Fee Schedule,130% of WA Medicaid ,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1210.17,37.7,,,percent of total billed charges,37.70% of total billed charges,1210.17,37.7,,,percent of total billed charges,37.70% of total billed charges,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,108819,33.9,,,percent of total billed charges,33.9% of total billed charges,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2503.8,78,,,percent of total billed charges,78% of total billed charges,3210,100,,,percent of total billed charges,100% of total billed charges,2651.46,82.6,,,percent of total billed charges,82.6% of total billed charges,2651.46,82.6,,,percent of total billed charges,82.6% of total billed charges,535.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.91,108819,
TREAT HUMERUS FRACTURE,24566,CDM,983,RC,24566,HCPCS,Outpatient,,,1928,1253.20,,1696.64,88,,,percent of total billed charges,88% of total Billed charges,70.38,100,,,Fee Schedule,100% of Medicare rate,421.49,100,,,Fee Schedule,100% of WA Medicaid,1928,100,,,percent of total billed charges,100% of total billed charges,434.13,103,,,Fee Schedule,103% of WA Medicaid,70.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,123.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,421.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1330.32,69,,,percent of total billed charges,69% of total billed charges,1928,100,,,percent of total billed charges,100% of total billed charges,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1928,100,,,percent of total billed charges,100% of total billed charges,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1928,100,,,percent of total billed charges,100% of total billed charges,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1192.47,61.85,,,percent of total billed charges,61.85% of total billed charges,421.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,547.94,130,,,Fee Schedule,130% of WA Medicaid ,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.86,37.7,,,percent of total billed charges,37.70% of total billed charges,726.86,37.7,,,percent of total billed charges,37.70% of total billed charges,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,65359.2,33.9,,,percent of total billed charges,33.9% of total billed charges,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1503.84,78,,,percent of total billed charges,78% of total billed charges,1928,100,,,percent of total billed charges,100% of total billed charges,1592.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1592.53,82.6,,,percent of total billed charges,82.6% of total billed charges,421.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.38,65359.2,
TREAT HUMERUS FRACTURE,24576,CDM,983,RC,24576,HCPCS,Outpatient,,,777,505.05,,683.76,88,,,percent of total billed charges,88% of total Billed charges,25.81,100,,,Fee Schedule,100% of Medicare rate,190.98,100,,,Fee Schedule,100% of WA Medicaid,777,100,,,percent of total billed charges,100% of total billed charges,196.71,103,,,Fee Schedule,103% of WA Medicaid,25.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,190.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,536.13,69,,,percent of total billed charges,69% of total billed charges,777,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,777,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,777,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.57,61.85,,,percent of total billed charges,61.85% of total billed charges,190.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,248.27,130,,,Fee Schedule,130% of WA Medicaid ,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.93,37.7,,,percent of total billed charges,37.70% of total billed charges,292.93,37.7,,,percent of total billed charges,37.70% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,26340.3,33.9,,,percent of total billed charges,33.9% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.06,78,,,percent of total billed charges,78% of total billed charges,777,100,,,percent of total billed charges,100% of total billed charges,641.8,82.6,,,percent of total billed charges,82.6% of total billed charges,641.8,82.6,,,percent of total billed charges,82.6% of total billed charges,190.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.81,26340.3,
TREAT HUMERUS FRACTURE,24575,CDM,983,RC,24575,HCPCS,Outpatient,,,2526,1641.90,,2222.88,88,,,percent of total billed charges,88% of total Billed charges,72.49,100,,,Fee Schedule,100% of Medicare rate,426.9,100,,,Fee Schedule,100% of WA Medicaid,2526,100,,,percent of total billed charges,100% of total billed charges,439.71,103,,,Fee Schedule,103% of WA Medicaid,72.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,426.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1742.94,69,,,percent of total billed charges,69% of total billed charges,2526,100,,,percent of total billed charges,100% of total billed charges,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2526,100,,,percent of total billed charges,100% of total billed charges,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2526,100,,,percent of total billed charges,100% of total billed charges,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1562.33,61.85,,,percent of total billed charges,61.85% of total billed charges,426.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,554.97,130,,,Fee Schedule,130% of WA Medicaid ,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,952.3,37.7,,,percent of total billed charges,37.70% of total billed charges,952.3,37.7,,,percent of total billed charges,37.70% of total billed charges,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,85631.4,33.9,,,percent of total billed charges,33.9% of total billed charges,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1970.28,78,,,percent of total billed charges,78% of total billed charges,2526,100,,,percent of total billed charges,100% of total billed charges,2086.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2086.48,82.6,,,percent of total billed charges,82.6% of total billed charges,426.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.49,85631.4,
TREAT HUMERUS FRACTURE,24579,CDM,983,RC,24579,HCPCS,Outpatient,,,2463,1600.95,,2167.44,88,,,percent of total billed charges,88% of total Billed charges,84.32,100,,,Fee Schedule,100% of Medicare rate,483.78,100,,,Fee Schedule,100% of WA Medicaid,2463,100,,,percent of total billed charges,100% of total billed charges,498.29,103,,,Fee Schedule,103% of WA Medicaid,84.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,147.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,483.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1699.47,69,,,percent of total billed charges,69% of total billed charges,2463,100,,,percent of total billed charges,100% of total billed charges,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2463,100,,,percent of total billed charges,100% of total billed charges,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2463,100,,,percent of total billed charges,100% of total billed charges,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1523.37,61.85,,,percent of total billed charges,61.85% of total billed charges,483.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,483.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,493.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,628.91,130,,,Fee Schedule,130% of WA Medicaid ,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,928.55,37.7,,,percent of total billed charges,37.70% of total billed charges,928.55,37.7,,,percent of total billed charges,37.70% of total billed charges,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,83495.7,33.9,,,percent of total billed charges,33.9% of total billed charges,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1921.14,78,,,percent of total billed charges,78% of total billed charges,2463,100,,,percent of total billed charges,100% of total billed charges,2034.44,82.6,,,percent of total billed charges,82.6% of total billed charges,2034.44,82.6,,,percent of total billed charges,82.6% of total billed charges,483.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,84.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,483.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84.32,83495.7,
TREAT HUMERUS FRACTURE,24582,CDM,983,RC,24582,HCPCS,Outpatient,,,1276,829.40,,1122.88,88,,,percent of total billed charges,88% of total Billed charges,79.28,100,,,Fee Schedule,100% of Medicare rate,477.44,100,,,Fee Schedule,100% of WA Medicaid,1276,100,,,percent of total billed charges,100% of total billed charges,491.76,103,,,Fee Schedule,103% of WA Medicaid,79.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,477.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,880.44,69,,,percent of total billed charges,69% of total billed charges,1276,100,,,percent of total billed charges,100% of total billed charges,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1276,100,,,percent of total billed charges,100% of total billed charges,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1276,100,,,percent of total billed charges,100% of total billed charges,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,789.21,61.85,,,percent of total billed charges,61.85% of total billed charges,477.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,477.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,620.67,130,,,Fee Schedule,130% of WA Medicaid ,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.05,37.7,,,percent of total billed charges,37.70% of total billed charges,481.05,37.7,,,percent of total billed charges,37.70% of total billed charges,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,43256.4,33.9,,,percent of total billed charges,33.9% of total billed charges,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,995.28,78,,,percent of total billed charges,78% of total billed charges,1276,100,,,percent of total billed charges,100% of total billed charges,1053.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1053.98,82.6,,,percent of total billed charges,82.6% of total billed charges,477.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,477.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.28,43256.4,
TREAT ELBOW FRACTURE,24587,CDM,983,RC,24587,HCPCS,Outpatient,,,2943,1912.95,,2589.84,88,,,percent of total billed charges,88% of total Billed charges,117.7,100,,,Fee Schedule,100% of Medicare rate,624.4,100,,,Fee Schedule,100% of WA Medicaid,2943,100,,,percent of total billed charges,100% of total billed charges,643.13,103,,,Fee Schedule,103% of WA Medicaid,117.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,205.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,624.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2030.67,69,,,percent of total billed charges,69% of total billed charges,2943,100,,,percent of total billed charges,100% of total billed charges,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2943,100,,,percent of total billed charges,100% of total billed charges,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2943,100,,,percent of total billed charges,100% of total billed charges,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1820.25,61.85,,,percent of total billed charges,61.85% of total billed charges,624.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,636.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,811.72,130,,,Fee Schedule,130% of WA Medicaid ,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1109.51,37.7,,,percent of total billed charges,37.70% of total billed charges,1109.51,37.7,,,percent of total billed charges,37.70% of total billed charges,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,99767.7,33.9,,,percent of total billed charges,33.9% of total billed charges,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2295.54,78,,,percent of total billed charges,78% of total billed charges,2943,100,,,percent of total billed charges,100% of total billed charges,2430.92,82.6,,,percent of total billed charges,82.6% of total billed charges,2430.92,82.6,,,percent of total billed charges,82.6% of total billed charges,624.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.7,99767.7,
TREAT ELBOW FRACTURE,24586,CDM,983,RC,24586,HCPCS,Outpatient,,,3819,2482.35,,3360.72,88,,,percent of total billed charges,88% of total Billed charges,114.8,100,,,Fee Schedule,100% of Medicare rate,623.66,100,,,Fee Schedule,100% of WA Medicaid,3819,100,,,percent of total billed charges,100% of total billed charges,642.37,103,,,Fee Schedule,103% of WA Medicaid,114.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,200.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,623.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2635.11,69,,,percent of total billed charges,69% of total billed charges,3819,100,,,percent of total billed charges,100% of total billed charges,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3819,100,,,percent of total billed charges,100% of total billed charges,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3819,100,,,percent of total billed charges,100% of total billed charges,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2362.05,61.85,,,percent of total billed charges,61.85% of total billed charges,623.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,623.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,636.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,810.76,130,,,Fee Schedule,130% of WA Medicaid ,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1439.76,37.7,,,percent of total billed charges,37.70% of total billed charges,1439.76,37.7,,,percent of total billed charges,37.70% of total billed charges,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,129464.1,33.9,,,percent of total billed charges,33.9% of total billed charges,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2978.82,78,,,percent of total billed charges,78% of total billed charges,3819,100,,,percent of total billed charges,100% of total billed charges,3154.49,82.6,,,percent of total billed charges,82.6% of total billed charges,3154.49,82.6,,,percent of total billed charges,82.6% of total billed charges,623.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,114.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,623.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.8,129464.1,
TREAT ELBOW DISLOCATION,24605,CDM,983,RC,24605,HCPCS,Outpatient,,,1174,763.10,,1033.12,88,,,percent of total billed charges,88% of total Billed charges,44.94,100,,,Fee Schedule,100% of Medicare rate,283.11,100,,,Fee Schedule,100% of WA Medicaid,1174,100,,,percent of total billed charges,100% of total billed charges,291.6,103,,,Fee Schedule,103% of WA Medicaid,44.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,283.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,810.06,69,,,percent of total billed charges,69% of total billed charges,1174,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1174,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1174,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.12,61.85,,,percent of total billed charges,61.85% of total billed charges,283.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,368.04,130,,,Fee Schedule,130% of WA Medicaid ,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.6,37.7,,,percent of total billed charges,37.70% of total billed charges,442.6,37.7,,,percent of total billed charges,37.70% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,39798.6,33.9,,,percent of total billed charges,33.9% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,915.72,78,,,percent of total billed charges,78% of total billed charges,1174,100,,,percent of total billed charges,100% of total billed charges,969.72,82.6,,,percent of total billed charges,82.6% of total billed charges,969.72,82.6,,,percent of total billed charges,82.6% of total billed charges,283.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.94,39798.6,
TREAT ELBOW DISLOCATION,24600,CDM,983,RC,24600,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,34.32,100,,,Fee Schedule,100% of Medicare rate,204.03,100,,,Fee Schedule,100% of WA Medicaid,650,100,,,percent of total billed charges,100% of total billed charges,210.15,103,,,Fee Schedule,103% of WA Medicaid,34.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,204.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,204.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,265.24,130,,,Fee Schedule,130% of WA Medicaid ,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,22035,33.9,,,percent of total billed charges,33.9% of total billed charges,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,204.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.32,22035,
TREAT ELBOW FRACTURE,24620,CDM,983,RC,24620,HCPCS,Outpatient,,,1617,1051.05,,1422.96,88,,,percent of total billed charges,88% of total Billed charges,57.11,100,,,Fee Schedule,100% of Medicare rate,346.7,100,,,Fee Schedule,100% of WA Medicaid,1617,100,,,percent of total billed charges,100% of total billed charges,357.1,103,,,Fee Schedule,103% of WA Medicaid,57.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,346.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1115.73,69,,,percent of total billed charges,69% of total billed charges,1617,100,,,percent of total billed charges,100% of total billed charges,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1617,100,,,percent of total billed charges,100% of total billed charges,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1617,100,,,percent of total billed charges,100% of total billed charges,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1000.11,61.85,,,percent of total billed charges,61.85% of total billed charges,346.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,450.71,130,,,Fee Schedule,130% of WA Medicaid ,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,609.61,37.7,,,percent of total billed charges,37.70% of total billed charges,609.61,37.7,,,percent of total billed charges,37.70% of total billed charges,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,54816.3,33.9,,,percent of total billed charges,33.9% of total billed charges,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1261.26,78,,,percent of total billed charges,78% of total billed charges,1617,100,,,percent of total billed charges,100% of total billed charges,1335.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1335.64,82.6,,,percent of total billed charges,82.6% of total billed charges,346.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.11,54816.3,
TREAT ELBOW FRACTURE,24635,CDM,983,RC,24635,HCPCS,Outpatient,,,3837,2494.05,,3376.56,88,,,percent of total billed charges,88% of total Billed charges,65.84,100,,,Fee Schedule,100% of Medicare rate,394.26,100,,,Fee Schedule,100% of WA Medicaid,3837,100,,,percent of total billed charges,100% of total billed charges,406.09,103,,,Fee Schedule,103% of WA Medicaid,65.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,115.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,394.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2647.53,69,,,percent of total billed charges,69% of total billed charges,3837,100,,,percent of total billed charges,100% of total billed charges,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3837,100,,,percent of total billed charges,100% of total billed charges,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3837,100,,,percent of total billed charges,100% of total billed charges,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2373.18,61.85,,,percent of total billed charges,61.85% of total billed charges,394.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,512.54,130,,,Fee Schedule,130% of WA Medicaid ,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1446.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1446.55,37.7,,,percent of total billed charges,37.70% of total billed charges,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,130074.3,33.9,,,percent of total billed charges,33.9% of total billed charges,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2992.86,78,,,percent of total billed charges,78% of total billed charges,3837,100,,,percent of total billed charges,100% of total billed charges,3169.36,82.6,,,percent of total billed charges,82.6% of total billed charges,3169.36,82.6,,,percent of total billed charges,82.6% of total billed charges,394.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.84,130074.3,
TREAT ELBOW DISLOCATION,24640,CDM,983,RC,24640,HCPCS,Outpatient,,,272,176.80,,239.36,88,,,percent of total billed charges,88% of total Billed charges,4.79,100,,,Fee Schedule,100% of Medicare rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,272,100,,,percent of total billed charges,100% of total billed charges,48.03,103,,,Fee Schedule,103% of WA Medicaid,4.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,187.68,69,,,percent of total billed charges,69% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,272,100,,,percent of total billed charges,100% of total billed charges,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,272,100,,,percent of total billed charges,100% of total billed charges,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.23,61.85,,,percent of total billed charges,61.85% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.62,130,,,Fee Schedule,130% of WA Medicaid ,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,9220.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.16,78,,,percent of total billed charges,78% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.79,9220.8,
TREAT FX RADIAL HEAD/NECK,24650,CDM,983,RC,24650,HCPCS,Outpatient,,,635,412.75,,558.8,88,,,percent of total billed charges,88% of total Billed charges,19.53,100,,,Fee Schedule,100% of Medicare rate,150.32,100,,,Fee Schedule,100% of WA Medicaid,635,100,,,percent of total billed charges,100% of total billed charges,154.83,103,,,Fee Schedule,103% of WA Medicaid,19.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,150.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,438.15,69,,,percent of total billed charges,69% of total billed charges,635,100,,,percent of total billed charges,100% of total billed charges,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,635,100,,,percent of total billed charges,100% of total billed charges,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,635,100,,,percent of total billed charges,100% of total billed charges,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.75,61.85,,,percent of total billed charges,61.85% of total billed charges,150.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,195.42,130,,,Fee Schedule,130% of WA Medicaid ,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.4,37.7,,,percent of total billed charges,37.70% of total billed charges,239.4,37.7,,,percent of total billed charges,37.70% of total billed charges,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,21526.5,33.9,,,percent of total billed charges,33.9% of total billed charges,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.3,78,,,percent of total billed charges,78% of total billed charges,635,100,,,percent of total billed charges,100% of total billed charges,524.51,82.6,,,percent of total billed charges,82.6% of total billed charges,524.51,82.6,,,percent of total billed charges,82.6% of total billed charges,150.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.53,21526.5,
TREAT RADIUS FRACTURE,24655,CDM,983,RC,24655,HCPCS,Outpatient,,,1105,718.25,,972.4,88,,,percent of total billed charges,88% of total Billed charges,37.42,100,,,Fee Schedule,100% of Medicare rate,243.76,100,,,Fee Schedule,100% of WA Medicaid,1105,100,,,percent of total billed charges,100% of total billed charges,251.07,103,,,Fee Schedule,103% of WA Medicaid,37.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,243.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,762.45,69,,,percent of total billed charges,69% of total billed charges,1105,100,,,percent of total billed charges,100% of total billed charges,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105,100,,,percent of total billed charges,100% of total billed charges,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105,100,,,percent of total billed charges,100% of total billed charges,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.44,61.85,,,percent of total billed charges,61.85% of total billed charges,243.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,316.89,130,,,Fee Schedule,130% of WA Medicaid ,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.59,37.7,,,percent of total billed charges,37.70% of total billed charges,416.59,37.7,,,percent of total billed charges,37.70% of total billed charges,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,37459.5,33.9,,,percent of total billed charges,33.9% of total billed charges,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.9,78,,,percent of total billed charges,78% of total billed charges,1105,100,,,percent of total billed charges,100% of total billed charges,912.73,82.6,,,percent of total billed charges,82.6% of total billed charges,912.73,82.6,,,percent of total billed charges,82.6% of total billed charges,243.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.42,37459.5,
TREAT RADIUS FRACTURE,24666,CDM,983,RC,24666,HCPCS,Outpatient,,,2655,1725.75,,2336.4,88,,,percent of total billed charges,88% of total Billed charges,73.21,100,,,Fee Schedule,100% of Medicare rate,425.41,100,,,Fee Schedule,100% of WA Medicaid,2655,100,,,percent of total billed charges,100% of total billed charges,438.17,103,,,Fee Schedule,103% of WA Medicaid,73.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,128.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,425.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1831.95,69,,,percent of total billed charges,69% of total billed charges,2655,100,,,percent of total billed charges,100% of total billed charges,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2655,100,,,percent of total billed charges,100% of total billed charges,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2655,100,,,percent of total billed charges,100% of total billed charges,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1642.12,61.85,,,percent of total billed charges,61.85% of total billed charges,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,553.03,130,,,Fee Schedule,130% of WA Medicaid ,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1000.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1000.94,37.7,,,percent of total billed charges,37.70% of total billed charges,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,90004.5,33.9,,,percent of total billed charges,33.9% of total billed charges,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2070.9,78,,,percent of total billed charges,78% of total billed charges,2655,100,,,percent of total billed charges,100% of total billed charges,2193.03,82.6,,,percent of total billed charges,82.6% of total billed charges,2193.03,82.6,,,percent of total billed charges,82.6% of total billed charges,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.21,90004.5,
TREAT RADIUS FRACTURE,24665,CDM,983,RC,24665,HCPCS,Outpatient,,,2076,1349.40,,1826.88,88,,,percent of total billed charges,88% of total Billed charges,62.74,100,,,Fee Schedule,100% of Medicare rate,384.56,100,,,Fee Schedule,100% of WA Medicaid,2076,100,,,percent of total billed charges,100% of total billed charges,396.1,103,,,Fee Schedule,103% of WA Medicaid,62.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,384.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1432.44,69,,,percent of total billed charges,69% of total billed charges,2076,100,,,percent of total billed charges,100% of total billed charges,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2076,100,,,percent of total billed charges,100% of total billed charges,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2076,100,,,percent of total billed charges,100% of total billed charges,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1284.01,61.85,,,percent of total billed charges,61.85% of total billed charges,384.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,499.93,130,,,Fee Schedule,130% of WA Medicaid ,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,782.65,37.7,,,percent of total billed charges,37.70% of total billed charges,782.65,37.7,,,percent of total billed charges,37.70% of total billed charges,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,70376.4,33.9,,,percent of total billed charges,33.9% of total billed charges,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1619.28,78,,,percent of total billed charges,78% of total billed charges,2076,100,,,percent of total billed charges,100% of total billed charges,1714.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1714.78,82.6,,,percent of total billed charges,82.6% of total billed charges,384.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.74,70376.4,
"CLOSED TX ULNAR FX,PROX END;W/O MANIP",24670,CDM,983,RC,24670,HCPCS,Outpatient,,,697,453.05,,613.36,88,,,percent of total billed charges,88% of total Billed charges,22.26,100,,,Fee Schedule,100% of Medicare rate,162.81,100,,,Fee Schedule,100% of WA Medicaid,697,100,,,percent of total billed charges,100% of total billed charges,167.69,103,,,Fee Schedule,103% of WA Medicaid,22.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,162.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,480.93,69,,,percent of total billed charges,69% of total billed charges,697,100,,,percent of total billed charges,100% of total billed charges,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,697,100,,,percent of total billed charges,100% of total billed charges,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,697,100,,,percent of total billed charges,100% of total billed charges,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,431.09,61.85,,,percent of total billed charges,61.85% of total billed charges,162.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,211.65,130,,,Fee Schedule,130% of WA Medicaid ,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.77,37.7,,,percent of total billed charges,37.70% of total billed charges,262.77,37.7,,,percent of total billed charges,37.70% of total billed charges,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,23628.3,33.9,,,percent of total billed charges,33.9% of total billed charges,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,543.66,78,,,percent of total billed charges,78% of total billed charges,697,100,,,percent of total billed charges,100% of total billed charges,575.72,82.6,,,percent of total billed charges,82.6% of total billed charges,575.72,82.6,,,percent of total billed charges,82.6% of total billed charges,162.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.26,23628.3,
TREAT ULNAR FRACTURE,24685,CDM,983,RC,24685,HCPCS,Outpatient,,,2291,1489.15,,2016.08,88,,,percent of total billed charges,88% of total Billed charges,63.39,100,,,Fee Schedule,100% of Medicare rate,382.14,100,,,Fee Schedule,100% of WA Medicaid,2291,100,,,percent of total billed charges,100% of total billed charges,393.6,103,,,Fee Schedule,103% of WA Medicaid,63.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,110.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,382.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1580.79,69,,,percent of total billed charges,69% of total billed charges,2291,100,,,percent of total billed charges,100% of total billed charges,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2291,100,,,percent of total billed charges,100% of total billed charges,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2291,100,,,percent of total billed charges,100% of total billed charges,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1416.98,61.85,,,percent of total billed charges,61.85% of total billed charges,382.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,496.78,130,,,Fee Schedule,130% of WA Medicaid ,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.71,37.7,,,percent of total billed charges,37.70% of total billed charges,863.71,37.7,,,percent of total billed charges,37.70% of total billed charges,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,77664.9,33.9,,,percent of total billed charges,33.9% of total billed charges,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786.98,78,,,percent of total billed charges,78% of total billed charges,2291,100,,,percent of total billed charges,100% of total billed charges,1892.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1892.37,82.6,,,percent of total billed charges,82.6% of total billed charges,382.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.39,77664.9,
INCISION OF TENDON SHEATH,25000,CDM,983,RC,25000,HCPCS,Outpatient,,,1433,931.45,,1261.04,88,,,percent of total billed charges,88% of total Billed charges,28.46,100,,,Fee Schedule,100% of Medicare rate,206.64,100,,,Fee Schedule,100% of WA Medicaid,1433,100,,,percent of total billed charges,100% of total billed charges,212.84,103,,,Fee Schedule,103% of WA Medicaid,28.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,206.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,988.77,69,,,percent of total billed charges,69% of total billed charges,1433,100,,,percent of total billed charges,100% of total billed charges,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1433,100,,,percent of total billed charges,100% of total billed charges,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1433,100,,,percent of total billed charges,100% of total billed charges,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,886.31,61.85,,,percent of total billed charges,61.85% of total billed charges,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,268.63,130,,,Fee Schedule,130% of WA Medicaid ,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,540.24,37.7,,,percent of total billed charges,37.70% of total billed charges,540.24,37.7,,,percent of total billed charges,37.70% of total billed charges,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,48578.7,33.9,,,percent of total billed charges,33.9% of total billed charges,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117.74,78,,,percent of total billed charges,78% of total billed charges,1433,100,,,percent of total billed charges,100% of total billed charges,1183.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1183.66,82.6,,,percent of total billed charges,82.6% of total billed charges,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.46,48578.7,
DECOMPRESS FOREARM 1 SPACE,25020,CDM,983,RC,25020,HCPCS,Outpatient,,,2616,1700.40,,2302.08,88,,,percent of total billed charges,88% of total Billed charges,53.42,100,,,Fee Schedule,100% of Medicare rate,436.78,100,,,Fee Schedule,100% of WA Medicaid,2616,100,,,percent of total billed charges,100% of total billed charges,449.88,103,,,Fee Schedule,103% of WA Medicaid,53.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,436.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1805.04,69,,,percent of total billed charges,69% of total billed charges,2616,100,,,percent of total billed charges,100% of total billed charges,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2616,100,,,percent of total billed charges,100% of total billed charges,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2616,100,,,percent of total billed charges,100% of total billed charges,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1618,61.85,,,percent of total billed charges,61.85% of total billed charges,436.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,567.81,130,,,Fee Schedule,130% of WA Medicaid ,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,986.23,37.7,,,percent of total billed charges,37.70% of total billed charges,986.23,37.7,,,percent of total billed charges,37.70% of total billed charges,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,88682.4,33.9,,,percent of total billed charges,33.9% of total billed charges,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2040.48,78,,,percent of total billed charges,78% of total billed charges,2616,100,,,percent of total billed charges,100% of total billed charges,2160.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2160.82,82.6,,,percent of total billed charges,82.6% of total billed charges,436.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.42,88682.4,
DECOMPRESS FOREARM 1 SPACE,25023,CDM,983,RC,25023,HCPCS,Outpatient,,,3031,1970.15,,2667.28,88,,,percent of total billed charges,88% of total Billed charges,112.87,100,,,Fee Schedule,100% of Medicare rate,763.16,100,,,Fee Schedule,100% of WA Medicaid,3031,100,,,percent of total billed charges,100% of total billed charges,786.05,103,,,Fee Schedule,103% of WA Medicaid,112.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,197.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,763.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2091.39,69,,,percent of total billed charges,69% of total billed charges,3031,100,,,percent of total billed charges,100% of total billed charges,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3031,100,,,percent of total billed charges,100% of total billed charges,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3031,100,,,percent of total billed charges,100% of total billed charges,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1874.67,61.85,,,percent of total billed charges,61.85% of total billed charges,763.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,992.11,130,,,Fee Schedule,130% of WA Medicaid ,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1142.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1142.69,37.7,,,percent of total billed charges,37.70% of total billed charges,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,102750.9,33.9,,,percent of total billed charges,33.9% of total billed charges,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2364.18,78,,,percent of total billed charges,78% of total billed charges,3031,100,,,percent of total billed charges,100% of total billed charges,2503.61,82.6,,,percent of total billed charges,82.6% of total billed charges,2503.61,82.6,,,percent of total billed charges,82.6% of total billed charges,763.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,114,101,,,Fee Schedule,101% of Medicare RBRVS rate,112.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.87,102750.9,
DECOMPRESS FOREARM 2 SPACES,25025,CDM,983,RC,25025,HCPCS,Outpatient,,,3326,2161.90,,2926.88,88,,,percent of total billed charges,88% of total Billed charges,132.98,100,,,Fee Schedule,100% of Medicare rate,702.73,100,,,Fee Schedule,100% of WA Medicaid,3326,100,,,percent of total billed charges,100% of total billed charges,723.81,103,,,Fee Schedule,103% of WA Medicaid,132.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,232.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,702.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2294.94,69,,,percent of total billed charges,69% of total billed charges,3326,100,,,percent of total billed charges,100% of total billed charges,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3326,100,,,percent of total billed charges,100% of total billed charges,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3326,100,,,percent of total billed charges,100% of total billed charges,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2057.13,61.85,,,percent of total billed charges,61.85% of total billed charges,702.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,702.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,716.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,913.55,130,,,Fee Schedule,130% of WA Medicaid ,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1253.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1253.9,37.7,,,percent of total billed charges,37.70% of total billed charges,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,112751.4,33.9,,,percent of total billed charges,33.9% of total billed charges,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2594.28,78,,,percent of total billed charges,78% of total billed charges,3326,100,,,percent of total billed charges,100% of total billed charges,2747.28,82.6,,,percent of total billed charges,82.6% of total billed charges,2747.28,82.6,,,percent of total billed charges,82.6% of total billed charges,702.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,132.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,702.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,132.98,112751.4,
DECOMPRESS FOREARM 2 SPACES,25024,CDM,983,RC,25024,HCPCS,Outpatient,,,2129,1383.85,,1873.52,88,,,percent of total billed charges,88% of total Billed charges,80.03,100,,,Fee Schedule,100% of Medicare rate,451.33,100,,,Fee Schedule,100% of WA Medicaid,2129,100,,,percent of total billed charges,100% of total billed charges,464.87,103,,,Fee Schedule,103% of WA Medicaid,80.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,451.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1469.01,69,,,percent of total billed charges,69% of total billed charges,2129,100,,,percent of total billed charges,100% of total billed charges,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2129,100,,,percent of total billed charges,100% of total billed charges,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2129,100,,,percent of total billed charges,100% of total billed charges,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1316.79,61.85,,,percent of total billed charges,61.85% of total billed charges,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,586.73,130,,,Fee Schedule,130% of WA Medicaid ,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,802.63,37.7,,,percent of total billed charges,37.70% of total billed charges,802.63,37.7,,,percent of total billed charges,37.70% of total billed charges,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,72173.1,33.9,,,percent of total billed charges,33.9% of total billed charges,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1660.62,78,,,percent of total billed charges,78% of total billed charges,2129,100,,,percent of total billed charges,100% of total billed charges,1758.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1758.55,82.6,,,percent of total billed charges,82.6% of total billed charges,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.03,72173.1,
DRAINAGE OF FOREARM LESION,25028,CDM,983,RC,25028,HCPCS,Outpatient,,,1118,726.70,,983.84,88,,,percent of total billed charges,88% of total Billed charges,49.66,100,,,Fee Schedule,100% of Medicare rate,409.74,100,,,Fee Schedule,100% of WA Medicaid,1118,100,,,percent of total billed charges,100% of total billed charges,422.03,103,,,Fee Schedule,103% of WA Medicaid,49.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,409.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,771.42,69,,,percent of total billed charges,69% of total billed charges,1118,100,,,percent of total billed charges,100% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1118,100,,,percent of total billed charges,100% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1118,100,,,percent of total billed charges,100% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,691.48,61.85,,,percent of total billed charges,61.85% of total billed charges,409.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,532.66,130,,,Fee Schedule,130% of WA Medicaid ,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.49,37.7,,,percent of total billed charges,37.70% of total billed charges,421.49,37.7,,,percent of total billed charges,37.70% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,37900.2,33.9,,,percent of total billed charges,33.9% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,872.04,78,,,percent of total billed charges,78% of total billed charges,1118,100,,,percent of total billed charges,100% of total billed charges,923.47,82.6,,,percent of total billed charges,82.6% of total billed charges,923.47,82.6,,,percent of total billed charges,82.6% of total billed charges,409.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.66,37900.2,
EXPLORE/TREAT WRIST JOINT,25040,CDM,983,RC,25040,HCPCS,Outpatient,,,2245,1459.25,,1975.6,88,,,percent of total billed charges,88% of total Billed charges,55,100,,,Fee Schedule,100% of Medicare rate,326,100,,,Fee Schedule,100% of WA Medicaid,2245,100,,,percent of total billed charges,100% of total billed charges,335.78,103,,,Fee Schedule,103% of WA Medicaid,55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,96.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,326,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1549.05,69,,,percent of total billed charges,69% of total billed charges,2245,100,,,percent of total billed charges,100% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2245,100,,,percent of total billed charges,100% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2245,100,,,percent of total billed charges,100% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1388.53,61.85,,,percent of total billed charges,61.85% of total billed charges,326,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,326,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,423.8,130,,,Fee Schedule,130% of WA Medicaid ,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.37,37.7,,,percent of total billed charges,37.70% of total billed charges,846.37,37.7,,,percent of total billed charges,37.70% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,76105.5,33.9,,,percent of total billed charges,33.9% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1751.1,78,,,percent of total billed charges,78% of total billed charges,2245,100,,,percent of total billed charges,100% of total billed charges,1854.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1854.37,82.6,,,percent of total billed charges,82.6% of total billed charges,326,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,326,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55,76105.5,
BIOPSY FOREARM/WRIST SOFT TISSUES,25066,CDM,983,RC,25066,HCPCS,Outpatient,,,740,481.00,,651.2,88,,,percent of total billed charges,88% of total Billed charges,32.66,100,,,Fee Schedule,100% of Medicare rate,217.09,100,,,Fee Schedule,100% of WA Medicaid,740,100,,,percent of total billed charges,100% of total billed charges,223.6,103,,,Fee Schedule,103% of WA Medicaid,32.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,217.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,510.6,69,,,percent of total billed charges,69% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,740,100,,,percent of total billed charges,100% of total billed charges,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,740,100,,,percent of total billed charges,100% of total billed charges,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.69,61.85,,,percent of total billed charges,61.85% of total billed charges,217.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,282.22,130,,,Fee Schedule,130% of WA Medicaid ,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,25086,33.9,,,percent of total billed charges,33.9% of total billed charges,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.2,78,,,percent of total billed charges,78% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,217.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.66,25086,
BIOPSY FOREARM SOFT TISSUES,25065,CDM,983,RC,25065,HCPCS,Outpatient,,,427.05,277.58,,375.8,88,,,percent of total billed charges,88% of total Billed charges,12.61,100,,,Fee Schedule,100% of Medicare rate,91.94,100,,,Fee Schedule,100% of WA Medicaid,427.05,100,,,percent of total billed charges,100% of total billed charges,94.7,103,,,Fee Schedule,103% of WA Medicaid,12.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,91.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,294.66,69,,,percent of total billed charges,69% of total billed charges,427.05,100,,,percent of total billed charges,100% of total billed charges,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.05,100,,,percent of total billed charges,100% of total billed charges,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.05,100,,,percent of total billed charges,100% of total billed charges,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.13,61.85,,,percent of total billed charges,61.85% of total billed charges,91.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.52,130,,,Fee Schedule,130% of WA Medicaid ,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,161,37.7,,,percent of total billed charges,37.70% of total billed charges,161,37.7,,,percent of total billed charges,37.70% of total billed charges,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,14477,33.9,,,percent of total billed charges,33.9% of total billed charges,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.1,78,,,percent of total billed charges,78% of total billed charges,427.05,100,,,percent of total billed charges,100% of total billed charges,352.74,82.6,,,percent of total billed charges,82.6% of total billed charges,352.74,82.6,,,percent of total billed charges,82.6% of total billed charges,91.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.61,14477,
EXC FOREARM LES SC 3 CM/>,25071,CDM,983,RC,25071,HCPCS,Outpatient,,,1162,755.30,,1022.56,88,,,percent of total billed charges,88% of total Billed charges,45.86,100,,,Fee Schedule,100% of Medicare rate,245.43,100,,,Fee Schedule,100% of WA Medicaid,1162,100,,,percent of total billed charges,100% of total billed charges,252.79,103,,,Fee Schedule,103% of WA Medicaid,45.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,245.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,801.78,69,,,percent of total billed charges,69% of total billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162,100,,,percent of total billed charges,100% of total billed charges,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162,100,,,percent of total billed charges,100% of total billed charges,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,718.7,61.85,,,percent of total billed charges,61.85% of total billed charges,245.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,319.06,130,,,Fee Schedule,130% of WA Medicaid ,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.07,37.7,,,percent of total billed charges,37.70% of total billed charges,438.07,37.7,,,percent of total billed charges,37.70% of total billed charges,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,39391.8,33.9,,,percent of total billed charges,33.9% of total billed charges,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,906.36,78,,,percent of total billed charges,78% of total billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,959.81,82.6,,,percent of total billed charges,82.6% of total billed charges,959.81,82.6,,,percent of total billed charges,82.6% of total billed charges,245.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.86,39391.8,
EXC FOREARM LES SC < 3 CM,25075,CDM,983,RC,25075,HCPCS,Outpatient,,,978,635.70,,860.64,88,,,percent of total billed charges,88% of total Billed charges,30.2,100,,,Fee Schedule,100% of Medicare rate,184.82,100,,,Fee Schedule,100% of WA Medicaid,978,100,,,percent of total billed charges,100% of total billed charges,190.36,103,,,Fee Schedule,103% of WA Medicaid,30.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,184.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,674.82,69,,,percent of total billed charges,69% of total billed charges,978,100,,,percent of total billed charges,100% of total billed charges,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,978,100,,,percent of total billed charges,100% of total billed charges,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,978,100,,,percent of total billed charges,100% of total billed charges,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,604.89,61.85,,,percent of total billed charges,61.85% of total billed charges,184.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,240.27,130,,,Fee Schedule,130% of WA Medicaid ,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.71,37.7,,,percent of total billed charges,37.70% of total billed charges,368.71,37.7,,,percent of total billed charges,37.70% of total billed charges,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,33154.2,33.9,,,percent of total billed charges,33.9% of total billed charges,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,762.84,78,,,percent of total billed charges,78% of total billed charges,978,100,,,percent of total billed charges,100% of total billed charges,807.83,82.6,,,percent of total billed charges,82.6% of total billed charges,807.83,82.6,,,percent of total billed charges,82.6% of total billed charges,184.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.2,33154.2,
EXC FOREARM TUM DEEP < 3 CM,25076,CDM,983,RC,25076,HCPCS,Outpatient,,,1692,1099.80,,1488.96,88,,,percent of total billed charges,88% of total Billed charges,49.9,100,,,Fee Schedule,100% of Medicare rate,303.06,100,,,Fee Schedule,100% of WA Medicaid,1692,100,,,percent of total billed charges,100% of total billed charges,312.15,103,,,Fee Schedule,103% of WA Medicaid,49.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,303.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1167.48,69,,,percent of total billed charges,69% of total billed charges,1692,100,,,percent of total billed charges,100% of total billed charges,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1692,100,,,percent of total billed charges,100% of total billed charges,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1692,100,,,percent of total billed charges,100% of total billed charges,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046.5,61.85,,,percent of total billed charges,61.85% of total billed charges,303.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,393.98,130,,,Fee Schedule,130% of WA Medicaid ,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.88,37.7,,,percent of total billed charges,37.70% of total billed charges,637.88,37.7,,,percent of total billed charges,37.70% of total billed charges,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,57358.8,33.9,,,percent of total billed charges,33.9% of total billed charges,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319.76,78,,,percent of total billed charges,78% of total billed charges,1692,100,,,percent of total billed charges,100% of total billed charges,1397.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.59,82.6,,,percent of total billed charges,82.6% of total billed charges,303.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.9,57358.8,
EXPLORE/TREAT WRIST JOINT,25101,CDM,983,RC,25101,HCPCS,Outpatient,,,1110,721.50,,976.8,88,,,percent of total billed charges,88% of total Billed charges,37.25,100,,,Fee Schedule,100% of Medicare rate,240.21,100,,,Fee Schedule,100% of WA Medicaid,1110,100,,,percent of total billed charges,100% of total billed charges,247.42,103,,,Fee Schedule,103% of WA Medicaid,37.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,240.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,765.9,69,,,percent of total billed charges,69% of total billed charges,1110,100,,,percent of total billed charges,100% of total billed charges,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1110,100,,,percent of total billed charges,100% of total billed charges,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1110,100,,,percent of total billed charges,100% of total billed charges,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.54,61.85,,,percent of total billed charges,61.85% of total billed charges,240.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,312.27,130,,,Fee Schedule,130% of WA Medicaid ,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.47,37.7,,,percent of total billed charges,37.70% of total billed charges,418.47,37.7,,,percent of total billed charges,37.70% of total billed charges,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,37629,33.9,,,percent of total billed charges,33.9% of total billed charges,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,865.8,78,,,percent of total billed charges,78% of total billed charges,1110,100,,,percent of total billed charges,100% of total billed charges,916.86,82.6,,,percent of total billed charges,82.6% of total billed charges,916.86,82.6,,,percent of total billed charges,82.6% of total billed charges,240.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.25,37629,
REMOVE WRIST JOINT CARTILAGE,25107,CDM,983,RC,25107,HCPCS,Outpatient,,,2299,1494.35,,2023.12,88,,,percent of total billed charges,88% of total Billed charges,56.42,100,,,Fee Schedule,100% of Medicare rate,363.12,100,,,Fee Schedule,100% of WA Medicaid,2299,100,,,percent of total billed charges,100% of total billed charges,374.01,103,,,Fee Schedule,103% of WA Medicaid,56.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,98.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,363.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1586.31,69,,,percent of total billed charges,69% of total billed charges,2299,100,,,percent of total billed charges,100% of total billed charges,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2299,100,,,percent of total billed charges,100% of total billed charges,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2299,100,,,percent of total billed charges,100% of total billed charges,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1421.93,61.85,,,percent of total billed charges,61.85% of total billed charges,363.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,472.06,130,,,Fee Schedule,130% of WA Medicaid ,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,866.72,37.7,,,percent of total billed charges,37.70% of total billed charges,866.72,37.7,,,percent of total billed charges,37.70% of total billed charges,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,77936.1,33.9,,,percent of total billed charges,33.9% of total billed charges,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1793.22,78,,,percent of total billed charges,78% of total billed charges,2299,100,,,percent of total billed charges,100% of total billed charges,1898.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1898.97,82.6,,,percent of total billed charges,82.6% of total billed charges,363.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.42,77936.1,
EXCISE TENDON FOREARM/WRIST,25109,CDM,983,RC,25109,HCPCS,Outpatient,,,1464,951.60,,1288.32,88,,,percent of total billed charges,88% of total Billed charges,50.23,100,,,Fee Schedule,100% of Medicare rate,314.44,100,,,Fee Schedule,100% of WA Medicaid,1464,100,,,percent of total billed charges,100% of total billed charges,323.87,103,,,Fee Schedule,103% of WA Medicaid,50.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,314.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1010.16,69,,,percent of total billed charges,69% of total billed charges,1464,100,,,percent of total billed charges,100% of total billed charges,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1464,100,,,percent of total billed charges,100% of total billed charges,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1464,100,,,percent of total billed charges,100% of total billed charges,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,905.48,61.85,,,percent of total billed charges,61.85% of total billed charges,314.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,408.77,130,,,Fee Schedule,130% of WA Medicaid ,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.93,37.7,,,percent of total billed charges,37.70% of total billed charges,551.93,37.7,,,percent of total billed charges,37.70% of total billed charges,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,49629.6,33.9,,,percent of total billed charges,33.9% of total billed charges,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1141.92,78,,,percent of total billed charges,78% of total billed charges,1464,100,,,percent of total billed charges,100% of total billed charges,1209.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1209.26,82.6,,,percent of total billed charges,82.6% of total billed charges,314.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.23,49629.6,
REMOVE WRIST JOINT LINING,25105,CDM,983,RC,25105,HCPCS,Outpatient,,,1311,852.15,,1153.68,88,,,percent of total billed charges,88% of total Billed charges,45.15,100,,,Fee Schedule,100% of Medicare rate,286.84,100,,,Fee Schedule,100% of WA Medicaid,1311,100,,,percent of total billed charges,100% of total billed charges,295.45,103,,,Fee Schedule,103% of WA Medicaid,45.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,286.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,904.59,69,,,percent of total billed charges,69% of total billed charges,1311,100,,,percent of total billed charges,100% of total billed charges,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1311,100,,,percent of total billed charges,100% of total billed charges,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1311,100,,,percent of total billed charges,100% of total billed charges,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,810.85,61.85,,,percent of total billed charges,61.85% of total billed charges,286.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,372.89,130,,,Fee Schedule,130% of WA Medicaid ,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.25,37.7,,,percent of total billed charges,37.70% of total billed charges,494.25,37.7,,,percent of total billed charges,37.70% of total billed charges,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,44442.9,33.9,,,percent of total billed charges,33.9% of total billed charges,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1022.58,78,,,percent of total billed charges,78% of total billed charges,1311,100,,,percent of total billed charges,100% of total billed charges,1082.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1082.89,82.6,,,percent of total billed charges,82.6% of total billed charges,286.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.15,44442.9,
BIOPSY OF WRIST JOINT,25100,CDM,983,RC,25100,HCPCS,Outpatient,,,950,617.50,,836,88,,,percent of total billed charges,88% of total Billed charges,32.15,100,,,Fee Schedule,100% of Medicare rate,207.57,100,,,Fee Schedule,100% of WA Medicaid,950,100,,,percent of total billed charges,100% of total billed charges,213.8,103,,,Fee Schedule,103% of WA Medicaid,32.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,207.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,655.5,69,,,percent of total billed charges,69% of total billed charges,950,100,,,percent of total billed charges,100% of total billed charges,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,950,100,,,percent of total billed charges,100% of total billed charges,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,950,100,,,percent of total billed charges,100% of total billed charges,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,587.58,61.85,,,percent of total billed charges,61.85% of total billed charges,207.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,269.84,130,,,Fee Schedule,130% of WA Medicaid ,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.15,37.7,,,percent of total billed charges,37.70% of total billed charges,358.15,37.7,,,percent of total billed charges,37.70% of total billed charges,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,32205,33.9,,,percent of total billed charges,33.9% of total billed charges,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,741,78,,,percent of total billed charges,78% of total billed charges,950,100,,,percent of total billed charges,100% of total billed charges,784.7,82.6,,,percent of total billed charges,82.6% of total billed charges,784.7,82.6,,,percent of total billed charges,82.6% of total billed charges,207.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.15,32205,
REMOVE WRIST/FOREARM LESION,25116,CDM,983,RC,25116,HCPCS,Outpatient,,,1349,876.85,,1187.12,88,,,percent of total billed charges,88% of total Billed charges,55.74,100,,,Fee Schedule,100% of Medicare rate,355.1,100,,,Fee Schedule,100% of WA Medicaid,1349,100,,,percent of total billed charges,100% of total billed charges,365.75,103,,,Fee Schedule,103% of WA Medicaid,55.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,355.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,930.81,69,,,percent of total billed charges,69% of total billed charges,1349,100,,,percent of total billed charges,100% of total billed charges,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1349,100,,,percent of total billed charges,100% of total billed charges,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1349,100,,,percent of total billed charges,100% of total billed charges,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,834.36,61.85,,,percent of total billed charges,61.85% of total billed charges,355.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,461.63,130,,,Fee Schedule,130% of WA Medicaid ,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,508.57,37.7,,,percent of total billed charges,37.70% of total billed charges,508.57,37.7,,,percent of total billed charges,37.70% of total billed charges,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,45731.1,33.9,,,percent of total billed charges,33.9% of total billed charges,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1052.22,78,,,percent of total billed charges,78% of total billed charges,1349,100,,,percent of total billed charges,100% of total billed charges,1114.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1114.27,82.6,,,percent of total billed charges,82.6% of total billed charges,355.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.74,45731.1,
EXCISE WRIST TENDON SHEATH,25118,CDM,983,RC,25118,HCPCS,Outpatient,,,864,561.60,,760.32,88,,,percent of total billed charges,88% of total Billed charges,33.96,100,,,Fee Schedule,100% of Medicare rate,227.16,100,,,Fee Schedule,100% of WA Medicaid,864,100,,,percent of total billed charges,100% of total billed charges,233.97,103,,,Fee Schedule,103% of WA Medicaid,33.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,227.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,596.16,69,,,percent of total billed charges,69% of total billed charges,864,100,,,percent of total billed charges,100% of total billed charges,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,864,100,,,percent of total billed charges,100% of total billed charges,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,864,100,,,percent of total billed charges,100% of total billed charges,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.38,61.85,,,percent of total billed charges,61.85% of total billed charges,227.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,295.31,130,,,Fee Schedule,130% of WA Medicaid ,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.73,37.7,,,percent of total billed charges,37.70% of total billed charges,325.73,37.7,,,percent of total billed charges,37.70% of total billed charges,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,29289.6,33.9,,,percent of total billed charges,33.9% of total billed charges,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,673.92,78,,,percent of total billed charges,78% of total billed charges,864,100,,,percent of total billed charges,100% of total billed charges,713.66,82.6,,,percent of total billed charges,82.6% of total billed charges,713.66,82.6,,,percent of total billed charges,82.6% of total billed charges,227.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.96,29289.6,
REREMOVE WRIST TENDON LESION,25112,CDM,983,RC,25112,HCPCS,Outpatient,,,1402,911.30,,1233.76,88,,,percent of total billed charges,88% of total Billed charges,35.49,100,,,Fee Schedule,100% of Medicare rate,231.45,100,,,Fee Schedule,100% of WA Medicaid,1402,100,,,percent of total billed charges,100% of total billed charges,238.39,103,,,Fee Schedule,103% of WA Medicaid,35.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,62.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,231.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,967.38,69,,,percent of total billed charges,69% of total billed charges,1402,100,,,percent of total billed charges,100% of total billed charges,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1402,100,,,percent of total billed charges,100% of total billed charges,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1402,100,,,percent of total billed charges,100% of total billed charges,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,867.14,61.85,,,percent of total billed charges,61.85% of total billed charges,231.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,300.89,130,,,Fee Schedule,130% of WA Medicaid ,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.55,37.7,,,percent of total billed charges,37.70% of total billed charges,528.55,37.7,,,percent of total billed charges,37.70% of total billed charges,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,47527.8,33.9,,,percent of total billed charges,33.9% of total billed charges,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1093.56,78,,,percent of total billed charges,78% of total billed charges,1402,100,,,percent of total billed charges,100% of total billed charges,1158.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1158.05,82.6,,,percent of total billed charges,82.6% of total billed charges,231.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.49,47527.8,
REMOVE WRIST TENDON LESION,25110,CDM,983,RC,25110,HCPCS,Outpatient,,,928,603.20,,816.64,88,,,percent of total billed charges,88% of total Billed charges,30.73,100,,,Fee Schedule,100% of Medicare rate,205.15,100,,,Fee Schedule,100% of WA Medicaid,928,100,,,percent of total billed charges,100% of total billed charges,211.3,103,,,Fee Schedule,103% of WA Medicaid,30.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,205.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,640.32,69,,,percent of total billed charges,69% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,928,100,,,percent of total billed charges,100% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,928,100,,,percent of total billed charges,100% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,573.97,61.85,,,percent of total billed charges,61.85% of total billed charges,205.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,266.7,130,,,Fee Schedule,130% of WA Medicaid ,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.86,37.7,,,percent of total billed charges,37.70% of total billed charges,349.86,37.7,,,percent of total billed charges,37.70% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,31459.2,33.9,,,percent of total billed charges,33.9% of total billed charges,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.84,78,,,percent of total billed charges,78% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,205.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.73,31459.2,
REMOVE WRIST TENDON LESION,25111,CDM,983,RC,25111,HCPCS,Outpatient,,,1162,755.30,,1022.56,88,,,percent of total billed charges,88% of total Billed charges,27.79,100,,,Fee Schedule,100% of Medicare rate,193.77,100,,,Fee Schedule,100% of WA Medicaid,1162,100,,,percent of total billed charges,100% of total billed charges,199.58,103,,,Fee Schedule,103% of WA Medicaid,27.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,193.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,801.78,69,,,percent of total billed charges,69% of total billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162,100,,,percent of total billed charges,100% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162,100,,,percent of total billed charges,100% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,718.7,61.85,,,percent of total billed charges,61.85% of total billed charges,193.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,251.9,130,,,Fee Schedule,130% of WA Medicaid ,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.07,37.7,,,percent of total billed charges,37.70% of total billed charges,438.07,37.7,,,percent of total billed charges,37.70% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,39391.8,33.9,,,percent of total billed charges,33.9% of total billed charges,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,906.36,78,,,percent of total billed charges,78% of total billed charges,1162,100,,,percent of total billed charges,100% of total billed charges,959.81,82.6,,,percent of total billed charges,82.6% of total billed charges,959.81,82.6,,,percent of total billed charges,82.6% of total billed charges,193.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.79,39391.8,
REMOVE  GRAFT WRIST LESION,25135,CDM,983,RC,25135,HCPCS,Outpatient,,,2090,1358.50,,1839.2,88,,,percent of total billed charges,88% of total Billed charges,55.43,100,,,Fee Schedule,100% of Medicare rate,329.36,100,,,Fee Schedule,100% of WA Medicaid,2090,100,,,percent of total billed charges,100% of total billed charges,339.24,103,,,Fee Schedule,103% of WA Medicaid,55.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,329.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1442.1,69,,,percent of total billed charges,69% of total billed charges,2090,100,,,percent of total billed charges,100% of total billed charges,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2090,100,,,percent of total billed charges,100% of total billed charges,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2090,100,,,percent of total billed charges,100% of total billed charges,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1292.67,61.85,,,percent of total billed charges,61.85% of total billed charges,329.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,428.17,130,,,Fee Schedule,130% of WA Medicaid ,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,787.93,37.7,,,percent of total billed charges,37.70% of total billed charges,787.93,37.7,,,percent of total billed charges,37.70% of total billed charges,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,70851,33.9,,,percent of total billed charges,33.9% of total billed charges,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1630.2,78,,,percent of total billed charges,78% of total billed charges,2090,100,,,percent of total billed charges,100% of total billed charges,1726.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1726.34,82.6,,,percent of total billed charges,82.6% of total billed charges,329.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.43,70851,
PARTIAL REMOVAL OF ULNA,25240,CDM,983,RC,25240,HCPCS,Outpatient,,,1843,1197.95,,1621.84,88,,,percent of total billed charges,88% of total Billed charges,39.79,100,,,Fee Schedule,100% of Medicare rate,254.01,100,,,Fee Schedule,100% of WA Medicaid,1843,100,,,percent of total billed charges,100% of total billed charges,261.63,103,,,Fee Schedule,103% of WA Medicaid,39.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,254.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1271.67,69,,,percent of total billed charges,69% of total billed charges,1843,100,,,percent of total billed charges,100% of total billed charges,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1843,100,,,percent of total billed charges,100% of total billed charges,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1843,100,,,percent of total billed charges,100% of total billed charges,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1139.9,61.85,,,percent of total billed charges,61.85% of total billed charges,254.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,330.21,130,,,Fee Schedule,130% of WA Medicaid ,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,694.81,37.7,,,percent of total billed charges,37.70% of total billed charges,694.81,37.7,,,percent of total billed charges,37.70% of total billed charges,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,62477.7,33.9,,,percent of total billed charges,33.9% of total billed charges,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1437.54,78,,,percent of total billed charges,78% of total billed charges,1843,100,,,percent of total billed charges,100% of total billed charges,1522.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1522.32,82.6,,,percent of total billed charges,82.6% of total billed charges,254.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.79,62477.7,
REMOVE FOREARM FOREIGN BODY,25248,CDM,983,RC,25248,HCPCS,Outpatient,,,1360,884.00,,1196.8,88,,,percent of total billed charges,88% of total Billed charges,42.65,100,,,Fee Schedule,100% of Medicare rate,249.16,100,,,Fee Schedule,100% of WA Medicaid,1360,100,,,percent of total billed charges,100% of total billed charges,256.63,103,,,Fee Schedule,103% of WA Medicaid,42.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,249.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,938.4,69,,,percent of total billed charges,69% of total billed charges,1360,100,,,percent of total billed charges,100% of total billed charges,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1360,100,,,percent of total billed charges,100% of total billed charges,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1360,100,,,percent of total billed charges,100% of total billed charges,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.16,61.85,,,percent of total billed charges,61.85% of total billed charges,249.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,323.91,130,,,Fee Schedule,130% of WA Medicaid ,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.72,37.7,,,percent of total billed charges,37.70% of total billed charges,512.72,37.7,,,percent of total billed charges,37.70% of total billed charges,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,46104,33.9,,,percent of total billed charges,33.9% of total billed charges,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1060.8,78,,,percent of total billed charges,78% of total billed charges,1360,100,,,percent of total billed charges,100% of total billed charges,1123.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1123.36,82.6,,,percent of total billed charges,82.6% of total billed charges,249.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.65,46104,
MANIPULATE WRIST W/ANESTHES,25259,CDM,983,RC,25259,HCPCS,Outpatient,,,1147,745.55,,1009.36,88,,,percent of total billed charges,88% of total Billed charges,32.77,100,,,Fee Schedule,100% of Medicare rate,259.61,100,,,Fee Schedule,100% of WA Medicaid,1147,100,,,percent of total billed charges,100% of total billed charges,267.4,103,,,Fee Schedule,103% of WA Medicaid,32.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,259.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,791.43,69,,,percent of total billed charges,69% of total billed charges,1147,100,,,percent of total billed charges,100% of total billed charges,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1147,100,,,percent of total billed charges,100% of total billed charges,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1147,100,,,percent of total billed charges,100% of total billed charges,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.42,61.85,,,percent of total billed charges,61.85% of total billed charges,259.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,337.49,130,,,Fee Schedule,130% of WA Medicaid ,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.42,37.7,,,percent of total billed charges,37.70% of total billed charges,432.42,37.7,,,percent of total billed charges,37.70% of total billed charges,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,38883.3,33.9,,,percent of total billed charges,33.9% of total billed charges,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.66,78,,,percent of total billed charges,78% of total billed charges,1147,100,,,percent of total billed charges,100% of total billed charges,947.42,82.6,,,percent of total billed charges,82.6% of total billed charges,947.42,82.6,,,percent of total billed charges,82.6% of total billed charges,259.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.77,38883.3,
REPAIR FOREARM TENDON/MUSCLE,25260,CDM,983,RC,25260,HCPCS,Outpatient,,,1929,1253.85,,1697.52,88,,,percent of total billed charges,88% of total Billed charges,59.47,100,,,Fee Schedule,100% of Medicare rate,371.88,100,,,Fee Schedule,100% of WA Medicaid,1929,100,,,percent of total billed charges,100% of total billed charges,383.04,103,,,Fee Schedule,103% of WA Medicaid,59.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,104.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,371.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1331.01,69,,,percent of total billed charges,69% of total billed charges,1929,100,,,percent of total billed charges,100% of total billed charges,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1929,100,,,percent of total billed charges,100% of total billed charges,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1929,100,,,percent of total billed charges,100% of total billed charges,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193.09,61.85,,,percent of total billed charges,61.85% of total billed charges,371.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,483.44,130,,,Fee Schedule,130% of WA Medicaid ,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,727.23,37.7,,,percent of total billed charges,37.70% of total billed charges,727.23,37.7,,,percent of total billed charges,37.70% of total billed charges,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,65393.1,33.9,,,percent of total billed charges,33.9% of total billed charges,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1504.62,78,,,percent of total billed charges,78% of total billed charges,1929,100,,,percent of total billed charges,100% of total billed charges,1593.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1593.35,82.6,,,percent of total billed charges,82.6% of total billed charges,371.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.47,65393.1,
REPAIR FOREARM TENDON/MUSCLE,25270,CDM,983,RC,25270,HCPCS,Outpatient,,,1986,1290.90,,1747.68,88,,,percent of total billed charges,88% of total Billed charges,46.39,100,,,Fee Schedule,100% of Medicare rate,290.75,100,,,Fee Schedule,100% of WA Medicaid,1986,100,,,percent of total billed charges,100% of total billed charges,299.47,103,,,Fee Schedule,103% of WA Medicaid,46.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,290.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1370.34,69,,,percent of total billed charges,69% of total billed charges,1986,100,,,percent of total billed charges,100% of total billed charges,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1986,100,,,percent of total billed charges,100% of total billed charges,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1986,100,,,percent of total billed charges,100% of total billed charges,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1228.34,61.85,,,percent of total billed charges,61.85% of total billed charges,290.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,377.98,130,,,Fee Schedule,130% of WA Medicaid ,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,748.72,37.7,,,percent of total billed charges,37.70% of total billed charges,748.72,37.7,,,percent of total billed charges,37.70% of total billed charges,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,67325.4,33.9,,,percent of total billed charges,33.9% of total billed charges,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1549.08,78,,,percent of total billed charges,78% of total billed charges,1986,100,,,percent of total billed charges,100% of total billed charges,1640.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1640.44,82.6,,,percent of total billed charges,82.6% of total billed charges,290.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.39,67325.4,
INCISE WRIST/FOREARM TENDON,25290,CDM,983,RC,25290,HCPCS,Outpatient,,,2195,1426.75,,1931.6,88,,,percent of total billed charges,88% of total Billed charges,40.22,100,,,Fee Schedule,100% of Medicare rate,257.18,100,,,Fee Schedule,100% of WA Medicaid,2195,100,,,percent of total billed charges,100% of total billed charges,264.9,103,,,Fee Schedule,103% of WA Medicaid,40.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,257.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1514.55,69,,,percent of total billed charges,69% of total billed charges,2195,100,,,percent of total billed charges,100% of total billed charges,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2195,100,,,percent of total billed charges,100% of total billed charges,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2195,100,,,percent of total billed charges,100% of total billed charges,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357.61,61.85,,,percent of total billed charges,61.85% of total billed charges,257.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,334.33,130,,,Fee Schedule,130% of WA Medicaid ,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,827.52,37.7,,,percent of total billed charges,37.70% of total billed charges,827.52,37.7,,,percent of total billed charges,37.70% of total billed charges,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,74410.5,33.9,,,percent of total billed charges,33.9% of total billed charges,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1712.1,78,,,percent of total billed charges,78% of total billed charges,2195,100,,,percent of total billed charges,100% of total billed charges,1813.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1813.07,82.6,,,percent of total billed charges,82.6% of total billed charges,257.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.22,74410.5,
RELEASE WRIST/FOREARM TENDON,25295,CDM,983,RC,25295,HCPCS,Outpatient,,,2078,1350.70,,1828.64,88,,,percent of total billed charges,88% of total Billed charges,49.19,100,,,Fee Schedule,100% of Medicare rate,309.4,100,,,Fee Schedule,100% of WA Medicaid,2078,100,,,percent of total billed charges,100% of total billed charges,318.68,103,,,Fee Schedule,103% of WA Medicaid,49.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,309.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1433.82,69,,,percent of total billed charges,69% of total billed charges,2078,100,,,percent of total billed charges,100% of total billed charges,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2078,100,,,percent of total billed charges,100% of total billed charges,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2078,100,,,percent of total billed charges,100% of total billed charges,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1285.24,61.85,,,percent of total billed charges,61.85% of total billed charges,309.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,402.22,130,,,Fee Schedule,130% of WA Medicaid ,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,783.41,37.7,,,percent of total billed charges,37.70% of total billed charges,783.41,37.7,,,percent of total billed charges,37.70% of total billed charges,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,70444.2,33.9,,,percent of total billed charges,33.9% of total billed charges,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1620.84,78,,,percent of total billed charges,78% of total billed charges,2078,100,,,percent of total billed charges,100% of total billed charges,1716.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1716.43,82.6,,,percent of total billed charges,82.6% of total billed charges,309.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.19,70444.2,
FUSION OF TENDONS AT WRIST,25301,CDM,983,RC,25301,HCPCS,Outpatient,,,2241,1456.65,,1972.08,88,,,percent of total billed charges,88% of total Billed charges,62.03,100,,,Fee Schedule,100% of Medicare rate,375.8,100,,,Fee Schedule,100% of WA Medicaid,2241,100,,,percent of total billed charges,100% of total billed charges,387.07,103,,,Fee Schedule,103% of WA Medicaid,62.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,375.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1546.29,69,,,percent of total billed charges,69% of total billed charges,2241,100,,,percent of total billed charges,100% of total billed charges,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2241,100,,,percent of total billed charges,100% of total billed charges,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2241,100,,,percent of total billed charges,100% of total billed charges,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1386.06,61.85,,,percent of total billed charges,61.85% of total billed charges,375.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,488.54,130,,,Fee Schedule,130% of WA Medicaid ,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,844.86,37.7,,,percent of total billed charges,37.70% of total billed charges,844.86,37.7,,,percent of total billed charges,37.70% of total billed charges,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,75969.9,33.9,,,percent of total billed charges,33.9% of total billed charges,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1747.98,78,,,percent of total billed charges,78% of total billed charges,2241,100,,,percent of total billed charges,100% of total billed charges,1851.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1851.07,82.6,,,percent of total billed charges,82.6% of total billed charges,375.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.03,75969.9,
REPAIR/REVISE WRIST JOINT,25320,CDM,983,RC,25320,HCPCS,Outpatient,,,3472,2256.80,,3055.36,88,,,percent of total billed charges,88% of total Billed charges,93.08,100,,,Fee Schedule,100% of Medicare rate,577.03,100,,,Fee Schedule,100% of WA Medicaid,3472,100,,,percent of total billed charges,100% of total billed charges,594.34,103,,,Fee Schedule,103% of WA Medicaid,93.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,162.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,577.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2395.68,69,,,percent of total billed charges,69% of total billed charges,3472,100,,,percent of total billed charges,100% of total billed charges,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,3472,100,,,percent of total billed charges,100% of total billed charges,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,3472,100,,,percent of total billed charges,100% of total billed charges,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2147.43,61.85,,,percent of total billed charges,61.85% of total billed charges,577.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,750.14,130,,,Fee Schedule,130% of WA Medicaid ,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1308.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1308.94,37.7,,,percent of total billed charges,37.70% of total billed charges,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,117700.8,33.9,,,percent of total billed charges,33.9% of total billed charges,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2708.16,78,,,percent of total billed charges,78% of total billed charges,3472,100,,,percent of total billed charges,100% of total billed charges,2867.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2867.87,82.6,,,percent of total billed charges,82.6% of total billed charges,577.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,93.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,93.08,117700.8,
REVISION OF RADIUS,25350,CDM,983,RC,25350,HCPCS,Outpatient,,,2898,1883.70,,2550.24,88,,,percent of total billed charges,88% of total Billed charges,65.27,100,,,Fee Schedule,100% of Medicare rate,392.96,100,,,Fee Schedule,100% of WA Medicaid,2898,100,,,percent of total billed charges,100% of total billed charges,404.75,103,,,Fee Schedule,103% of WA Medicaid,65.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,392.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1999.62,69,,,percent of total billed charges,69% of total billed charges,2898,100,,,percent of total billed charges,100% of total billed charges,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2898,100,,,percent of total billed charges,100% of total billed charges,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2898,100,,,percent of total billed charges,100% of total billed charges,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1792.41,61.85,,,percent of total billed charges,61.85% of total billed charges,392.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,510.85,130,,,Fee Schedule,130% of WA Medicaid ,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1092.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1092.55,37.7,,,percent of total billed charges,37.70% of total billed charges,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,98242.2,33.9,,,percent of total billed charges,33.9% of total billed charges,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2260.44,78,,,percent of total billed charges,78% of total billed charges,2898,100,,,percent of total billed charges,100% of total billed charges,2393.75,82.6,,,percent of total billed charges,82.6% of total billed charges,2393.75,82.6,,,percent of total billed charges,82.6% of total billed charges,392.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.27,98242.2,
REVISION OF ULNA,25360,CDM,983,RC,25360,HCPCS,Outpatient,,,2609,1695.85,,2295.92,88,,,percent of total billed charges,88% of total Billed charges,64.73,100,,,Fee Schedule,100% of Medicare rate,382.7,100,,,Fee Schedule,100% of WA Medicaid,2609,100,,,percent of total billed charges,100% of total billed charges,394.18,103,,,Fee Schedule,103% of WA Medicaid,64.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,113.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,382.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1800.21,69,,,percent of total billed charges,69% of total billed charges,2609,100,,,percent of total billed charges,100% of total billed charges,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2609,100,,,percent of total billed charges,100% of total billed charges,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2609,100,,,percent of total billed charges,100% of total billed charges,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1613.67,61.85,,,percent of total billed charges,61.85% of total billed charges,382.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,497.51,130,,,Fee Schedule,130% of WA Medicaid ,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,983.59,37.7,,,percent of total billed charges,37.70% of total billed charges,983.59,37.7,,,percent of total billed charges,37.70% of total billed charges,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,88445.1,33.9,,,percent of total billed charges,33.9% of total billed charges,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2035.02,78,,,percent of total billed charges,78% of total billed charges,2609,100,,,percent of total billed charges,100% of total billed charges,2155.03,82.6,,,percent of total billed charges,82.6% of total billed charges,2155.03,82.6,,,percent of total billed charges,82.6% of total billed charges,382.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.73,88445.1,
LENGTHEN RADIUS OR ULNA,25391,CDM,983,RC,25391,HCPCS,Outpatient,,,3866,2512.90,,3402.08,88,,,percent of total billed charges,88% of total Billed charges,106.15,100,,,Fee Schedule,100% of Medicare rate,572.56,100,,,Fee Schedule,100% of WA Medicaid,3866,100,,,percent of total billed charges,100% of total billed charges,589.74,103,,,Fee Schedule,103% of WA Medicaid,106.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,185.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,572.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2667.54,69,,,percent of total billed charges,69% of total billed charges,3866,100,,,percent of total billed charges,100% of total billed charges,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3866,100,,,percent of total billed charges,100% of total billed charges,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3866,100,,,percent of total billed charges,100% of total billed charges,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2391.12,61.85,,,percent of total billed charges,61.85% of total billed charges,572.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,572.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,584.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,744.33,130,,,Fee Schedule,130% of WA Medicaid ,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.48,37.7,,,percent of total billed charges,37.70% of total billed charges,1457.48,37.7,,,percent of total billed charges,37.70% of total billed charges,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,131057.4,33.9,,,percent of total billed charges,33.9% of total billed charges,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3015.48,78,,,percent of total billed charges,78% of total billed charges,3866,100,,,percent of total billed charges,100% of total billed charges,3193.32,82.6,,,percent of total billed charges,82.6% of total billed charges,3193.32,82.6,,,percent of total billed charges,82.6% of total billed charges,572.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,572.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.15,131057.4,
SHORTEN RADIUS OR ULNA,25390,CDM,983,RC,25390,HCPCS,Outpatient,,,3466,2252.90,,3050.08,88,,,percent of total billed charges,88% of total Billed charges,76.09,100,,,Fee Schedule,100% of Medicare rate,445.55,100,,,Fee Schedule,100% of WA Medicaid,3466,100,,,percent of total billed charges,100% of total billed charges,458.92,103,,,Fee Schedule,103% of WA Medicaid,76.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,133.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,445.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2391.54,69,,,percent of total billed charges,69% of total billed charges,3466,100,,,percent of total billed charges,100% of total billed charges,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3466,100,,,percent of total billed charges,100% of total billed charges,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3466,100,,,percent of total billed charges,100% of total billed charges,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2143.72,61.85,,,percent of total billed charges,61.85% of total billed charges,445.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,579.22,130,,,Fee Schedule,130% of WA Medicaid ,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1306.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1306.68,37.7,,,percent of total billed charges,37.70% of total billed charges,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,117497.4,33.9,,,percent of total billed charges,33.9% of total billed charges,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2703.48,78,,,percent of total billed charges,78% of total billed charges,3466,100,,,percent of total billed charges,100% of total billed charges,2862.92,82.6,,,percent of total billed charges,82.6% of total billed charges,2862.92,82.6,,,percent of total billed charges,82.6% of total billed charges,445.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.09,117497.4,
REPAIR RADIUS OR ULNA,25400,CDM,983,RC,25400,HCPCS,Outpatient,,,3281,2132.65,,2887.28,88,,,percent of total billed charges,88% of total Billed charges,80.96,100,,,Fee Schedule,100% of Medicare rate,464.01,100,,,Fee Schedule,100% of WA Medicaid,3281,100,,,percent of total billed charges,100% of total billed charges,477.93,103,,,Fee Schedule,103% of WA Medicaid,80.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,141.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,464.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2263.89,69,,,percent of total billed charges,69% of total billed charges,3281,100,,,percent of total billed charges,100% of total billed charges,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3281,100,,,percent of total billed charges,100% of total billed charges,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3281,100,,,percent of total billed charges,100% of total billed charges,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2029.3,61.85,,,percent of total billed charges,61.85% of total billed charges,464.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,603.21,130,,,Fee Schedule,130% of WA Medicaid ,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1236.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1236.94,37.7,,,percent of total billed charges,37.70% of total billed charges,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,111225.9,33.9,,,percent of total billed charges,33.9% of total billed charges,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2559.18,78,,,percent of total billed charges,78% of total billed charges,3281,100,,,percent of total billed charges,100% of total billed charges,2710.11,82.6,,,percent of total billed charges,82.6% of total billed charges,2710.11,82.6,,,percent of total billed charges,82.6% of total billed charges,464.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.96,111225.9,
REPAIR/GRAFT RADIUS OR ULNA,25405,CDM,983,RC,25405,HCPCS,Outpatient,,,4136,2688.40,,3639.68,88,,,percent of total billed charges,88% of total Billed charges,106.34,100,,,Fee Schedule,100% of Medicare rate,596.05,100,,,Fee Schedule,100% of WA Medicaid,4136,100,,,percent of total billed charges,100% of total billed charges,613.93,103,,,Fee Schedule,103% of WA Medicaid,106.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,186.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,596.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2853.84,69,,,percent of total billed charges,69% of total billed charges,4136,100,,,percent of total billed charges,100% of total billed charges,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,4136,100,,,percent of total billed charges,100% of total billed charges,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,4136,100,,,percent of total billed charges,100% of total billed charges,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2558.12,61.85,,,percent of total billed charges,61.85% of total billed charges,596.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,607.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,774.87,130,,,Fee Schedule,130% of WA Medicaid ,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559.27,37.7,,,percent of total billed charges,37.70% of total billed charges,1559.27,37.7,,,percent of total billed charges,37.70% of total billed charges,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,140210.4,33.9,,,percent of total billed charges,33.9% of total billed charges,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,3226.08,78,,,percent of total billed charges,78% of total billed charges,4136,100,,,percent of total billed charges,100% of total billed charges,3416.34,82.6,,,percent of total billed charges,82.6% of total billed charges,3416.34,82.6,,,percent of total billed charges,82.6% of total billed charges,596.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.34,140210.4,
REPAIR RADIUS  ULNA,25415,CDM,983,RC,25415,HCPCS,Outpatient,,,3833,2491.45,,3373.04,88,,,percent of total billed charges,88% of total Billed charges,102.73,100,,,Fee Schedule,100% of Medicare rate,557.08,100,,,Fee Schedule,100% of WA Medicaid,3833,100,,,percent of total billed charges,100% of total billed charges,573.79,103,,,Fee Schedule,103% of WA Medicaid,102.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,179.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,557.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2644.77,69,,,percent of total billed charges,69% of total billed charges,3833,100,,,percent of total billed charges,100% of total billed charges,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3833,100,,,percent of total billed charges,100% of total billed charges,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3833,100,,,percent of total billed charges,100% of total billed charges,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2370.71,61.85,,,percent of total billed charges,61.85% of total billed charges,557.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,568.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,724.2,130,,,Fee Schedule,130% of WA Medicaid ,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1445.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1445.04,37.7,,,percent of total billed charges,37.70% of total billed charges,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,129938.7,33.9,,,percent of total billed charges,33.9% of total billed charges,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2989.74,78,,,percent of total billed charges,78% of total billed charges,3833,100,,,percent of total billed charges,100% of total billed charges,3166.06,82.6,,,percent of total billed charges,82.6% of total billed charges,3166.06,82.6,,,percent of total billed charges,82.6% of total billed charges,557.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,102.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,102.73,129938.7,
REPAIR/GRAFT RADIUS  ULNA,25420,CDM,983,RC,25420,HCPCS,Outpatient,,,4985,3240.25,,4386.8,88,,,percent of total billed charges,88% of total Billed charges,126.49,100,,,Fee Schedule,100% of Medicare rate,668.23,100,,,Fee Schedule,100% of WA Medicaid,4985,100,,,percent of total billed charges,100% of total billed charges,688.28,103,,,Fee Schedule,103% of WA Medicaid,126.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,221.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,668.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3439.65,69,,,percent of total billed charges,69% of total billed charges,4985,100,,,percent of total billed charges,100% of total billed charges,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4985,100,,,percent of total billed charges,100% of total billed charges,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4985,100,,,percent of total billed charges,100% of total billed charges,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3083.22,61.85,,,percent of total billed charges,61.85% of total billed charges,668.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,681.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,868.7,130,,,Fee Schedule,130% of WA Medicaid ,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1879.35,37.7,,,percent of total billed charges,37.70% of total billed charges,1879.35,37.7,,,percent of total billed charges,37.70% of total billed charges,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,168991.5,33.9,,,percent of total billed charges,33.9% of total billed charges,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3888.3,78,,,percent of total billed charges,78% of total billed charges,4985,100,,,percent of total billed charges,100% of total billed charges,4117.61,82.6,,,percent of total billed charges,82.6% of total billed charges,4117.61,82.6,,,percent of total billed charges,82.6% of total billed charges,668.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,126.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.49,168991.5,
REPAIR OF NONUNION OF SCAPHOID CARPAL,25440,CDM,983,RC,25440,HCPCS,Outpatient,,,1803,1171.95,,1586.64,88,,,percent of total billed charges,88% of total Billed charges,76.36,100,,,Fee Schedule,100% of Medicare rate,445.74,100,,,Fee Schedule,100% of WA Medicaid,1803,100,,,percent of total billed charges,100% of total billed charges,459.11,103,,,Fee Schedule,103% of WA Medicaid,76.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,133.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,445.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1244.07,69,,,percent of total billed charges,69% of total billed charges,1803,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1803,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1803,100,,,percent of total billed charges,100% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1115.16,61.85,,,percent of total billed charges,61.85% of total billed charges,445.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,579.46,130,,,Fee Schedule,130% of WA Medicaid ,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,679.73,37.7,,,percent of total billed charges,37.70% of total billed charges,679.73,37.7,,,percent of total billed charges,37.70% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,61121.7,33.9,,,percent of total billed charges,33.9% of total billed charges,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1406.34,78,,,percent of total billed charges,78% of total billed charges,1803,100,,,percent of total billed charges,100% of total billed charges,1489.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1489.28,82.6,,,percent of total billed charges,82.6% of total billed charges,445.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.36,61121.7,
REPAIR WRIST JOINTS,25447,CDM,983,RC,25447,HCPCS,Outpatient,,,2272,1476.80,,1999.36,88,,,percent of total billed charges,88% of total Billed charges,80.17,100,,,Fee Schedule,100% of Medicare rate,483.97,100,,,Fee Schedule,100% of WA Medicaid,2272,100,,,percent of total billed charges,100% of total billed charges,498.49,103,,,Fee Schedule,103% of WA Medicaid,80.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,483.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1567.68,69,,,percent of total billed charges,69% of total billed charges,2272,100,,,percent of total billed charges,100% of total billed charges,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2272,100,,,percent of total billed charges,100% of total billed charges,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2272,100,,,percent of total billed charges,100% of total billed charges,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1405.23,61.85,,,percent of total billed charges,61.85% of total billed charges,483.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,483.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,493.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,629.16,130,,,Fee Schedule,130% of WA Medicaid ,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,856.54,37.7,,,percent of total billed charges,37.70% of total billed charges,856.54,37.7,,,percent of total billed charges,37.70% of total billed charges,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,77020.8,33.9,,,percent of total billed charges,33.9% of total billed charges,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1772.16,78,,,percent of total billed charges,78% of total billed charges,2272,100,,,percent of total billed charges,100% of total billed charges,1876.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1876.67,82.6,,,percent of total billed charges,82.6% of total billed charges,483.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,483.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.17,77020.8,
TREAT FX RADIUS SHAFT,25500,CDM,510,RC,25500,HCPCS,Outpatient,,,591,384.15,,520.08,88,,,percent of total billed charges,88% of total Billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,591,100,,,percent of total billed charges,100% of total billed charges,412.25,103,,,Fee Schedule,103% of WA Medicaid,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,372.33,63,,,percent of total billed charges,63% of total billed charges,420.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid,90.42,15.3,,,percent of total billed charges,15.3% of total billed charges,407.79,69,,,percent of total billed charges,69% of total billed charges,591,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,591,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,591,100,,,percent of total billed charges,100% of total billed charges,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,837.64,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,296.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,408.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.32,130,,,Fee Schedule,130% of WA Medicaid ,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,460.98,78,,,percent of total billed charges,78% of total billed charges,591,100,,,percent of total billed charges,100% of total billed charges,488.17,82.6,,,percent of total billed charges,82.6% of total billed charges,488.17,82.6,,,percent of total billed charges,82.6% of total billed charges,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,242.92,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,240.53,100,,,Fee Schedule,100% of Medicare OPPS rate,400.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.42,837.64,
TREAT FRACTURE OF RADIUS,25505,CDM,983,RC,25505,HCPCS,Outpatient,,,1232,800.80,,1084.16,88,,,percent of total billed charges,88% of total Billed charges,43.75,100,,,Fee Schedule,100% of Medicare rate,275.27,100,,,Fee Schedule,100% of WA Medicaid,1232,100,,,percent of total billed charges,100% of total billed charges,283.53,103,,,Fee Schedule,103% of WA Medicaid,43.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,275.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,850.08,69,,,percent of total billed charges,69% of total billed charges,1232,100,,,percent of total billed charges,100% of total billed charges,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1232,100,,,percent of total billed charges,100% of total billed charges,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1232,100,,,percent of total billed charges,100% of total billed charges,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,761.99,61.85,,,percent of total billed charges,61.85% of total billed charges,275.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,357.85,130,,,Fee Schedule,130% of WA Medicaid ,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.46,37.7,,,percent of total billed charges,37.70% of total billed charges,464.46,37.7,,,percent of total billed charges,37.70% of total billed charges,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,41764.8,33.9,,,percent of total billed charges,33.9% of total billed charges,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,960.96,78,,,percent of total billed charges,78% of total billed charges,1232,100,,,percent of total billed charges,100% of total billed charges,1017.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1017.63,82.6,,,percent of total billed charges,82.6% of total billed charges,275.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.75,41764.8,
TREAT FRACTURE OF RADIUS,25515,CDM,983,RC,25515,HCPCS,Outpatient,,,2355,1530.75,,2072.4,88,,,percent of total billed charges,88% of total Billed charges,65.72,100,,,Fee Schedule,100% of Medicare rate,391.84,100,,,Fee Schedule,100% of WA Medicaid,2355,100,,,percent of total billed charges,100% of total billed charges,403.6,103,,,Fee Schedule,103% of WA Medicaid,65.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,115.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,391.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1624.95,69,,,percent of total billed charges,69% of total billed charges,2355,100,,,percent of total billed charges,100% of total billed charges,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2355,100,,,percent of total billed charges,100% of total billed charges,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2355,100,,,percent of total billed charges,100% of total billed charges,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1456.57,61.85,,,percent of total billed charges,61.85% of total billed charges,391.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.39,130,,,Fee Schedule,130% of WA Medicaid ,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,887.84,37.7,,,percent of total billed charges,37.70% of total billed charges,887.84,37.7,,,percent of total billed charges,37.70% of total billed charges,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,79834.5,33.9,,,percent of total billed charges,33.9% of total billed charges,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836.9,78,,,percent of total billed charges,78% of total billed charges,2355,100,,,percent of total billed charges,100% of total billed charges,1945.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1945.23,82.6,,,percent of total billed charges,82.6% of total billed charges,391.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.72,79834.5,
TREAT FRACTURE OF RADIUS,25526,CDM,983,RC,25526,HCPCS,Outpatient,,,1409,915.85,,1239.92,88,,,percent of total billed charges,88% of total Billed charges,99.4,100,,,Fee Schedule,100% of Medicare rate,553.35,100,,,Fee Schedule,100% of WA Medicaid,1409,100,,,percent of total billed charges,100% of total billed charges,569.95,103,,,Fee Schedule,103% of WA Medicaid,99.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,553.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,972.21,69,,,percent of total billed charges,69% of total billed charges,1409,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1409,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1409,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,871.47,61.85,,,percent of total billed charges,61.85% of total billed charges,553.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,719.36,130,,,Fee Schedule,130% of WA Medicaid ,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,531.19,37.7,,,percent of total billed charges,37.70% of total billed charges,531.19,37.7,,,percent of total billed charges,37.70% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,47765.1,33.9,,,percent of total billed charges,33.9% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1099.02,78,,,percent of total billed charges,78% of total billed charges,1409,100,,,percent of total billed charges,100% of total billed charges,1163.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1163.83,82.6,,,percent of total billed charges,82.6% of total billed charges,553.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.4,47765.1,
TREAT FRACTURE OF RADIUS,25525,CDM,983,RC,25525,HCPCS,Outpatient,,,3057,1987.05,,2690.16,88,,,percent of total billed charges,88% of total Billed charges,78.64,100,,,Fee Schedule,100% of Medicare rate,459.91,100,,,Fee Schedule,100% of WA Medicaid,3057,100,,,percent of total billed charges,100% of total billed charges,473.71,103,,,Fee Schedule,103% of WA Medicaid,78.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,459.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2109.33,69,,,percent of total billed charges,69% of total billed charges,3057,100,,,percent of total billed charges,100% of total billed charges,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,3057,100,,,percent of total billed charges,100% of total billed charges,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,3057,100,,,percent of total billed charges,100% of total billed charges,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1890.75,61.85,,,percent of total billed charges,61.85% of total billed charges,459.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,597.88,130,,,Fee Schedule,130% of WA Medicaid ,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1152.49,37.7,,,percent of total billed charges,37.70% of total billed charges,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,103632.3,33.9,,,percent of total billed charges,33.9% of total billed charges,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2384.46,78,,,percent of total billed charges,78% of total billed charges,3057,100,,,percent of total billed charges,100% of total billed charges,2525.08,82.6,,,percent of total billed charges,82.6% of total billed charges,2525.08,82.6,,,percent of total billed charges,82.6% of total billed charges,459.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.64,103632.3,
TREAT FX ULNA SHAFT,25530,CDM,983,RC,25530,HCPCS,Outpatient,,,746,484.90,,656.48,88,,,percent of total billed charges,88% of total Billed charges,18.93,100,,,Fee Schedule,100% of Medicare rate,148.83,100,,,Fee Schedule,100% of WA Medicaid,746,100,,,percent of total billed charges,100% of total billed charges,153.29,103,,,Fee Schedule,103% of WA Medicaid,18.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,148.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,514.74,69,,,percent of total billed charges,69% of total billed charges,746,100,,,percent of total billed charges,100% of total billed charges,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,746,100,,,percent of total billed charges,100% of total billed charges,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,746,100,,,percent of total billed charges,100% of total billed charges,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.4,61.85,,,percent of total billed charges,61.85% of total billed charges,148.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,193.48,130,,,Fee Schedule,130% of WA Medicaid ,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.24,37.7,,,percent of total billed charges,37.70% of total billed charges,281.24,37.7,,,percent of total billed charges,37.70% of total billed charges,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,25289.4,33.9,,,percent of total billed charges,33.9% of total billed charges,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,581.88,78,,,percent of total billed charges,78% of total billed charges,746,100,,,percent of total billed charges,100% of total billed charges,616.2,82.6,,,percent of total billed charges,82.6% of total billed charges,616.2,82.6,,,percent of total billed charges,82.6% of total billed charges,148.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.93,25289.4,
CLOSED TX OF ULNAR SHAFT FX;W/ MANIP,25535,CDM,983,RC,25535,HCPCS,Outpatient,,,715,464.75,,629.2,88,,,percent of total billed charges,88% of total Billed charges,42.08,100,,,Fee Schedule,100% of Medicare rate,273.22,100,,,Fee Schedule,100% of WA Medicaid,715,100,,,percent of total billed charges,100% of total billed charges,281.42,103,,,Fee Schedule,103% of WA Medicaid,42.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,273.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,493.35,69,,,percent of total billed charges,69% of total billed charges,715,100,,,percent of total billed charges,100% of total billed charges,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,715,100,,,percent of total billed charges,100% of total billed charges,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,715,100,,,percent of total billed charges,100% of total billed charges,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.23,61.85,,,percent of total billed charges,61.85% of total billed charges,273.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,355.19,130,,,Fee Schedule,130% of WA Medicaid ,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.56,37.7,,,percent of total billed charges,37.70% of total billed charges,269.56,37.7,,,percent of total billed charges,37.70% of total billed charges,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,24238.5,33.9,,,percent of total billed charges,33.9% of total billed charges,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.7,78,,,percent of total billed charges,78% of total billed charges,715,100,,,percent of total billed charges,100% of total billed charges,590.59,82.6,,,percent of total billed charges,82.6% of total billed charges,590.59,82.6,,,percent of total billed charges,82.6% of total billed charges,273.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.08,24238.5,
TREAT FRACTURE OF ULNA,25545,CDM,983,RC,25545,HCPCS,Outpatient,,,2151,1398.15,,1892.88,88,,,percent of total billed charges,88% of total Billed charges,59.7,100,,,Fee Schedule,100% of Medicare rate,366.29,100,,,Fee Schedule,100% of WA Medicaid,2151,100,,,percent of total billed charges,100% of total billed charges,377.28,103,,,Fee Schedule,103% of WA Medicaid,59.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,104.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,366.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1484.19,69,,,percent of total billed charges,69% of total billed charges,2151,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2151,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2151,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1330.39,61.85,,,percent of total billed charges,61.85% of total billed charges,366.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,476.18,130,,,Fee Schedule,130% of WA Medicaid ,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,810.93,37.7,,,percent of total billed charges,37.70% of total billed charges,810.93,37.7,,,percent of total billed charges,37.70% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,72918.9,33.9,,,percent of total billed charges,33.9% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1677.78,78,,,percent of total billed charges,78% of total billed charges,2151,100,,,percent of total billed charges,100% of total billed charges,1776.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1776.73,82.6,,,percent of total billed charges,82.6% of total billed charges,366.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.7,72918.9,
TREAT FX RAD/ULN SHAFT,25560,CDM,983,RC,25560,HCPCS,Outpatient,,,716,465.40,,630.08,88,,,percent of total billed charges,88% of total Billed charges,21.49,100,,,Fee Schedule,100% of Medicare rate,157.97,100,,,Fee Schedule,100% of WA Medicaid,716,100,,,percent of total billed charges,100% of total billed charges,162.71,103,,,Fee Schedule,103% of WA Medicaid,21.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,157.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,494.04,69,,,percent of total billed charges,69% of total billed charges,716,100,,,percent of total billed charges,100% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,716,100,,,percent of total billed charges,100% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,716,100,,,percent of total billed charges,100% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.85,61.85,,,percent of total billed charges,61.85% of total billed charges,157.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,205.36,130,,,Fee Schedule,130% of WA Medicaid ,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.93,37.7,,,percent of total billed charges,37.70% of total billed charges,269.93,37.7,,,percent of total billed charges,37.70% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,24272.4,33.9,,,percent of total billed charges,33.9% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.48,78,,,percent of total billed charges,78% of total billed charges,716,100,,,percent of total billed charges,100% of total billed charges,591.42,82.6,,,percent of total billed charges,82.6% of total billed charges,591.42,82.6,,,percent of total billed charges,82.6% of total billed charges,157.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.49,24272.4,
TREAT FX RAD/ULN SHAFT W/ MANIP.,25565,CDM,983,RC,25565,HCPCS,Outpatient,,,1678,1090.70,,1476.64,88,,,percent of total billed charges,88% of total Billed charges,45.88,100,,,Fee Schedule,100% of Medicare rate,276.02,100,,,Fee Schedule,100% of WA Medicaid,1678,100,,,percent of total billed charges,100% of total billed charges,284.3,103,,,Fee Schedule,103% of WA Medicaid,45.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,276.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1157.82,69,,,percent of total billed charges,69% of total billed charges,1678,100,,,percent of total billed charges,100% of total billed charges,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1678,100,,,percent of total billed charges,100% of total billed charges,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1678,100,,,percent of total billed charges,100% of total billed charges,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1037.84,61.85,,,percent of total billed charges,61.85% of total billed charges,276.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,358.83,130,,,Fee Schedule,130% of WA Medicaid ,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,632.61,37.7,,,percent of total billed charges,37.70% of total billed charges,632.61,37.7,,,percent of total billed charges,37.70% of total billed charges,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,56884.2,33.9,,,percent of total billed charges,33.9% of total billed charges,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1308.84,78,,,percent of total billed charges,78% of total billed charges,1678,100,,,percent of total billed charges,100% of total billed charges,1386.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1386.03,82.6,,,percent of total billed charges,82.6% of total billed charges,276.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.88,56884.2,
TREAT FRACTURE RADIUS/ULNA,25575,CDM,983,RC,25575,HCPCS,Outpatient,,,3002,1951.30,,2641.76,88,,,percent of total billed charges,88% of total Billed charges,91.37,100,,,Fee Schedule,100% of Medicare rate,524.07,100,,,Fee Schedule,100% of WA Medicaid,3002,100,,,percent of total billed charges,100% of total billed charges,539.79,103,,,Fee Schedule,103% of WA Medicaid,91.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,159.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,524.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2071.38,69,,,percent of total billed charges,69% of total billed charges,3002,100,,,percent of total billed charges,100% of total billed charges,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,3002,100,,,percent of total billed charges,100% of total billed charges,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,3002,100,,,percent of total billed charges,100% of total billed charges,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1856.74,61.85,,,percent of total billed charges,61.85% of total billed charges,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,681.29,130,,,Fee Schedule,130% of WA Medicaid ,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131.75,37.7,,,percent of total billed charges,37.70% of total billed charges,1131.75,37.7,,,percent of total billed charges,37.70% of total billed charges,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,101767.8,33.9,,,percent of total billed charges,33.9% of total billed charges,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2341.56,78,,,percent of total billed charges,78% of total billed charges,3002,100,,,percent of total billed charges,100% of total billed charges,2479.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2479.65,82.6,,,percent of total billed charges,82.6% of total billed charges,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.37,101767.8,
TREAT FRACTURE RADIUS  ULNA,25574,CDM,983,RC,25574,HCPCS,Outpatient,,,2395,1556.75,,2107.6,88,,,percent of total billed charges,88% of total Billed charges,66.37,100,,,Fee Schedule,100% of Medicare rate,394.26,100,,,Fee Schedule,100% of WA Medicaid,2395,100,,,percent of total billed charges,100% of total billed charges,406.09,103,,,Fee Schedule,103% of WA Medicaid,66.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,116.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,394.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1652.55,69,,,percent of total billed charges,69% of total billed charges,2395,100,,,percent of total billed charges,100% of total billed charges,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2395,100,,,percent of total billed charges,100% of total billed charges,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2395,100,,,percent of total billed charges,100% of total billed charges,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1481.31,61.85,,,percent of total billed charges,61.85% of total billed charges,394.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,512.54,130,,,Fee Schedule,130% of WA Medicaid ,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.92,37.7,,,percent of total billed charges,37.70% of total billed charges,902.92,37.7,,,percent of total billed charges,37.70% of total billed charges,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,81190.5,33.9,,,percent of total billed charges,33.9% of total billed charges,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1868.1,78,,,percent of total billed charges,78% of total billed charges,2395,100,,,percent of total billed charges,100% of total billed charges,1978.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1978.27,82.6,,,percent of total billed charges,82.6% of total billed charges,394.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,66.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.37,81190.5,
TREAT FX DIST RAD,25600,CDM,983,RC,25600,HCPCS,Outpatient,,,732,475.80,,644.16,88,,,percent of total billed charges,88% of total Billed charges,24.37,100,,,Fee Schedule,100% of Medicare rate,198.44,100,,,Fee Schedule,100% of WA Medicaid,732,100,,,percent of total billed charges,100% of total billed charges,204.39,103,,,Fee Schedule,103% of WA Medicaid,24.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,198.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,505.08,69,,,percent of total billed charges,69% of total billed charges,732,100,,,percent of total billed charges,100% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,732,100,,,percent of total billed charges,100% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,732,100,,,percent of total billed charges,100% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.74,61.85,,,percent of total billed charges,61.85% of total billed charges,198.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,257.97,130,,,Fee Schedule,130% of WA Medicaid ,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.96,37.7,,,percent of total billed charges,37.70% of total billed charges,275.96,37.7,,,percent of total billed charges,37.70% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,24814.8,33.9,,,percent of total billed charges,33.9% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,570.96,78,,,percent of total billed charges,78% of total billed charges,732,100,,,percent of total billed charges,100% of total billed charges,604.63,82.6,,,percent of total billed charges,82.6% of total billed charges,604.63,82.6,,,percent of total billed charges,82.6% of total billed charges,198.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.37,24814.8,
TREAT FX DIST RAD W/ MANIP.,25605,CDM,983,RC,25605,HCPCS,Outpatient,,,1211,787.15,,1065.68,88,,,percent of total billed charges,88% of total Billed charges,49.13,100,,,Fee Schedule,100% of Medicare rate,303.44,100,,,Fee Schedule,100% of WA Medicaid,1211,100,,,percent of total billed charges,100% of total billed charges,312.54,103,,,Fee Schedule,103% of WA Medicaid,49.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,303.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,835.59,69,,,percent of total billed charges,69% of total billed charges,1211,100,,,percent of total billed charges,100% of total billed charges,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1211,100,,,percent of total billed charges,100% of total billed charges,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1211,100,,,percent of total billed charges,100% of total billed charges,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,749,61.85,,,percent of total billed charges,61.85% of total billed charges,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,394.47,130,,,Fee Schedule,130% of WA Medicaid ,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.55,37.7,,,percent of total billed charges,37.70% of total billed charges,456.55,37.7,,,percent of total billed charges,37.70% of total billed charges,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,41052.9,33.9,,,percent of total billed charges,33.9% of total billed charges,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,944.58,78,,,percent of total billed charges,78% of total billed charges,1211,100,,,percent of total billed charges,100% of total billed charges,1000.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1000.29,82.6,,,percent of total billed charges,82.6% of total billed charges,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.13,41052.9,
TREAT FX RAD INTRA-ARTICUL,25608,CDM,983,RC,25608,HCPCS,Outpatient,,,2602,1691.30,,2289.76,88,,,percent of total billed charges,88% of total Billed charges,81.88,100,,,Fee Schedule,100% of Medicare rate,481.92,100,,,Fee Schedule,100% of WA Medicaid,2602,100,,,percent of total billed charges,100% of total billed charges,496.38,103,,,Fee Schedule,103% of WA Medicaid,81.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,143.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,481.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1795.38,69,,,percent of total billed charges,69% of total billed charges,2602,100,,,percent of total billed charges,100% of total billed charges,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2602,100,,,percent of total billed charges,100% of total billed charges,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2602,100,,,percent of total billed charges,100% of total billed charges,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1609.34,61.85,,,percent of total billed charges,61.85% of total billed charges,481.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,626.5,130,,,Fee Schedule,130% of WA Medicaid ,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,980.95,37.7,,,percent of total billed charges,37.70% of total billed charges,980.95,37.7,,,percent of total billed charges,37.70% of total billed charges,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,88207.8,33.9,,,percent of total billed charges,33.9% of total billed charges,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2029.56,78,,,percent of total billed charges,78% of total billed charges,2602,100,,,percent of total billed charges,100% of total billed charges,2149.25,82.6,,,percent of total billed charges,82.6% of total billed charges,2149.25,82.6,,,percent of total billed charges,82.6% of total billed charges,481.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.88,88207.8,
TREAT FX RADIAL 3+ FRAG,25609,CDM,983,RC,25609,HCPCS,Outpatient,,,1996,1297.40,,1756.48,88,,,percent of total billed charges,88% of total Billed charges,104.16,100,,,Fee Schedule,100% of Medicare rate,609.48,100,,,Fee Schedule,100% of WA Medicaid,1996,100,,,percent of total billed charges,100% of total billed charges,627.76,103,,,Fee Schedule,103% of WA Medicaid,104.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,182.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,609.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1377.24,69,,,percent of total billed charges,69% of total billed charges,1996,100,,,percent of total billed charges,100% of total billed charges,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1996,100,,,percent of total billed charges,100% of total billed charges,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1996,100,,,percent of total billed charges,100% of total billed charges,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1234.53,61.85,,,percent of total billed charges,61.85% of total billed charges,609.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,609.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,792.32,130,,,Fee Schedule,130% of WA Medicaid ,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,752.49,37.7,,,percent of total billed charges,37.70% of total billed charges,752.49,37.7,,,percent of total billed charges,37.70% of total billed charges,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,67664.4,33.9,,,percent of total billed charges,33.9% of total billed charges,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1556.88,78,,,percent of total billed charges,78% of total billed charges,1996,100,,,percent of total billed charges,100% of total billed charges,1648.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1648.7,82.6,,,percent of total billed charges,82.6% of total billed charges,609.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,104.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,609.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,104.16,67664.4,
TREAT FX RAD EXTRA-ARTICUL,25607,CDM,983,RC,25607,HCPCS,Outpatient,,,1952,1268.80,,1717.76,88,,,percent of total billed charges,88% of total Billed charges,71.23,100,,,Fee Schedule,100% of Medicare rate,432.49,100,,,Fee Schedule,100% of WA Medicaid,1952,100,,,percent of total billed charges,100% of total billed charges,445.46,103,,,Fee Schedule,103% of WA Medicaid,71.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,432.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1346.88,69,,,percent of total billed charges,69% of total billed charges,1952,100,,,percent of total billed charges,100% of total billed charges,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1952,100,,,percent of total billed charges,100% of total billed charges,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1952,100,,,percent of total billed charges,100% of total billed charges,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1207.31,61.85,,,percent of total billed charges,61.85% of total billed charges,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562.24,130,,,Fee Schedule,130% of WA Medicaid ,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,735.9,37.7,,,percent of total billed charges,37.70% of total billed charges,735.9,37.7,,,percent of total billed charges,37.70% of total billed charges,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,66172.8,33.9,,,percent of total billed charges,33.9% of total billed charges,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1522.56,78,,,percent of total billed charges,78% of total billed charges,1952,100,,,percent of total billed charges,100% of total billed charges,1612.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1612.35,82.6,,,percent of total billed charges,82.6% of total billed charges,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.23,66172.8,
TREAT FX DISTAL RADIAL,25606,CDM,983,RC,25606,HCPCS,Outpatient,,,1996,1297.40,,1756.48,88,,,percent of total billed charges,88% of total Billed charges,64.18,100,,,Fee Schedule,100% of Medicare rate,392.58,100,,,Fee Schedule,100% of WA Medicaid,1996,100,,,percent of total billed charges,100% of total billed charges,404.36,103,,,Fee Schedule,103% of WA Medicaid,64.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,392.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1377.24,69,,,percent of total billed charges,69% of total billed charges,1996,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1996,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1996,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1234.53,61.85,,,percent of total billed charges,61.85% of total billed charges,392.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,510.35,130,,,Fee Schedule,130% of WA Medicaid ,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,752.49,37.7,,,percent of total billed charges,37.70% of total billed charges,752.49,37.7,,,percent of total billed charges,37.70% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,67664.4,33.9,,,percent of total billed charges,33.9% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1556.88,78,,,percent of total billed charges,78% of total billed charges,1996,100,,,percent of total billed charges,100% of total billed charges,1648.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1648.7,82.6,,,percent of total billed charges,82.6% of total billed charges,392.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.18,67664.4,
TREAT FX SCAPHOID,25622,CDM,983,RC,25622,HCPCS,Outpatient,,,732,475.80,,644.16,88,,,percent of total billed charges,88% of total Billed charges,22.8,100,,,Fee Schedule,100% of Medicare rate,173.07,100,,,Fee Schedule,100% of WA Medicaid,732,100,,,percent of total billed charges,100% of total billed charges,178.26,103,,,Fee Schedule,103% of WA Medicaid,22.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,173.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,505.08,69,,,percent of total billed charges,69% of total billed charges,732,100,,,percent of total billed charges,100% of total billed charges,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,732,100,,,percent of total billed charges,100% of total billed charges,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,732,100,,,percent of total billed charges,100% of total billed charges,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.74,61.85,,,percent of total billed charges,61.85% of total billed charges,173.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,224.99,130,,,Fee Schedule,130% of WA Medicaid ,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.96,37.7,,,percent of total billed charges,37.70% of total billed charges,275.96,37.7,,,percent of total billed charges,37.70% of total billed charges,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,24814.8,33.9,,,percent of total billed charges,33.9% of total billed charges,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,570.96,78,,,percent of total billed charges,78% of total billed charges,732,100,,,percent of total billed charges,100% of total billed charges,604.63,82.6,,,percent of total billed charges,82.6% of total billed charges,604.63,82.6,,,percent of total billed charges,82.6% of total billed charges,173.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.8,24814.8,
TREAT WRIST BONE FRACTURE,25624,CDM,983,RC,25624,HCPCS,Outpatient,,,993,645.45,,873.84,88,,,percent of total billed charges,88% of total Billed charges,39.69,100,,,Fee Schedule,100% of Medicare rate,267.44,100,,,Fee Schedule,100% of WA Medicaid,993,100,,,percent of total billed charges,100% of total billed charges,275.46,103,,,Fee Schedule,103% of WA Medicaid,39.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,267.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,685.17,69,,,percent of total billed charges,69% of total billed charges,993,100,,,percent of total billed charges,100% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,993,100,,,percent of total billed charges,100% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,993,100,,,percent of total billed charges,100% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.17,61.85,,,percent of total billed charges,61.85% of total billed charges,267.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,347.67,130,,,Fee Schedule,130% of WA Medicaid ,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.36,37.7,,,percent of total billed charges,37.70% of total billed charges,374.36,37.7,,,percent of total billed charges,37.70% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,33662.7,33.9,,,percent of total billed charges,33.9% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,774.54,78,,,percent of total billed charges,78% of total billed charges,993,100,,,percent of total billed charges,100% of total billed charges,820.22,82.6,,,percent of total billed charges,82.6% of total billed charges,820.22,82.6,,,percent of total billed charges,82.6% of total billed charges,267.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.69,33662.7,
TREAT WRIST BONE FRACTURE OPEN,25628,CDM,983,RC,25628,HCPCS,Outpatient,,,1624,1055.60,,1429.12,88,,,percent of total billed charges,88% of total Billed charges,68.97,100,,,Fee Schedule,100% of Medicare rate,418.88,100,,,Fee Schedule,100% of WA Medicaid,1624,100,,,percent of total billed charges,100% of total billed charges,431.45,103,,,Fee Schedule,103% of WA Medicaid,68.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,120.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,418.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1120.56,69,,,percent of total billed charges,69% of total billed charges,1624,100,,,percent of total billed charges,100% of total billed charges,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1624,100,,,percent of total billed charges,100% of total billed charges,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1624,100,,,percent of total billed charges,100% of total billed charges,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1004.44,61.85,,,percent of total billed charges,61.85% of total billed charges,418.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,544.54,130,,,Fee Schedule,130% of WA Medicaid ,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.25,37.7,,,percent of total billed charges,37.70% of total billed charges,612.25,37.7,,,percent of total billed charges,37.70% of total billed charges,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,55053.6,33.9,,,percent of total billed charges,33.9% of total billed charges,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1266.72,78,,,percent of total billed charges,78% of total billed charges,1624,100,,,percent of total billed charges,100% of total billed charges,1341.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1341.42,82.6,,,percent of total billed charges,82.6% of total billed charges,418.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.97,55053.6,
TREAT WRIST BONE FRACTURE,25635,CDM,983,RC,25635,HCPCS,Outpatient,,,956,621.40,,841.28,88,,,percent of total billed charges,88% of total Billed charges,38.22,100,,,Fee Schedule,100% of Medicare rate,254.2,100,,,Fee Schedule,100% of WA Medicaid,956,100,,,percent of total billed charges,100% of total billed charges,261.83,103,,,Fee Schedule,103% of WA Medicaid,38.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,254.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,659.64,69,,,percent of total billed charges,69% of total billed charges,956,100,,,percent of total billed charges,100% of total billed charges,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,956,100,,,percent of total billed charges,100% of total billed charges,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,956,100,,,percent of total billed charges,100% of total billed charges,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.29,61.85,,,percent of total billed charges,61.85% of total billed charges,254.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,330.46,130,,,Fee Schedule,130% of WA Medicaid ,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.41,37.7,,,percent of total billed charges,37.70% of total billed charges,360.41,37.7,,,percent of total billed charges,37.70% of total billed charges,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,32408.4,33.9,,,percent of total billed charges,33.9% of total billed charges,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.68,78,,,percent of total billed charges,78% of total billed charges,956,100,,,percent of total billed charges,100% of total billed charges,789.66,82.6,,,percent of total billed charges,82.6% of total billed charges,789.66,82.6,,,percent of total billed charges,82.6% of total billed charges,254.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.22,32408.4,
TREAT FX CARPAL BONE,25630,CDM,983,RC,25630,HCPCS,Outpatient,,,683,443.95,,601.04,88,,,percent of total billed charges,88% of total Billed charges,24.07,100,,,Fee Schedule,100% of Medicare rate,172.33,100,,,Fee Schedule,100% of WA Medicaid,683,100,,,percent of total billed charges,100% of total billed charges,177.5,103,,,Fee Schedule,103% of WA Medicaid,24.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,172.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,471.27,69,,,percent of total billed charges,69% of total billed charges,683,100,,,percent of total billed charges,100% of total billed charges,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,683,100,,,percent of total billed charges,100% of total billed charges,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,683,100,,,percent of total billed charges,100% of total billed charges,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.44,61.85,,,percent of total billed charges,61.85% of total billed charges,172.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,224.03,130,,,Fee Schedule,130% of WA Medicaid ,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.49,37.7,,,percent of total billed charges,37.70% of total billed charges,257.49,37.7,,,percent of total billed charges,37.70% of total billed charges,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,23153.7,33.9,,,percent of total billed charges,33.9% of total billed charges,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,532.74,78,,,percent of total billed charges,78% of total billed charges,683,100,,,percent of total billed charges,100% of total billed charges,564.16,82.6,,,percent of total billed charges,82.6% of total billed charges,564.16,82.6,,,percent of total billed charges,82.6% of total billed charges,172.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.07,23153.7,
TREAT WRIST BONE FRACTURE,25645,CDM,983,RC,25645,HCPCS,Outpatient,,,1903,1236.95,,1674.64,88,,,percent of total billed charges,88% of total Billed charges,57.25,100,,,Fee Schedule,100% of Medicare rate,334.21,100,,,Fee Schedule,100% of WA Medicaid,1903,100,,,percent of total billed charges,100% of total billed charges,344.24,103,,,Fee Schedule,103% of WA Medicaid,57.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,334.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1313.07,69,,,percent of total billed charges,69% of total billed charges,1903,100,,,percent of total billed charges,100% of total billed charges,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1903,100,,,percent of total billed charges,100% of total billed charges,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1903,100,,,percent of total billed charges,100% of total billed charges,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1177.01,61.85,,,percent of total billed charges,61.85% of total billed charges,334.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,434.47,130,,,Fee Schedule,130% of WA Medicaid ,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.43,37.7,,,percent of total billed charges,37.70% of total billed charges,717.43,37.7,,,percent of total billed charges,37.70% of total billed charges,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,64511.7,33.9,,,percent of total billed charges,33.9% of total billed charges,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1484.34,78,,,percent of total billed charges,78% of total billed charges,1903,100,,,percent of total billed charges,100% of total billed charges,1571.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1571.88,82.6,,,percent of total billed charges,82.6% of total billed charges,334.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.25,64511.7,
PIN ULNAR STYLOID FRACTURE,25651,CDM,983,RC,25651,HCPCS,Outpatient,,,1247,810.55,,1097.36,88,,,percent of total billed charges,88% of total Billed charges,44.81,100,,,Fee Schedule,100% of Medicare rate,290.57,100,,,Fee Schedule,100% of WA Medicaid,1247,100,,,percent of total billed charges,100% of total billed charges,299.29,103,,,Fee Schedule,103% of WA Medicaid,44.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,290.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,860.43,69,,,percent of total billed charges,69% of total billed charges,1247,100,,,percent of total billed charges,100% of total billed charges,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1247,100,,,percent of total billed charges,100% of total billed charges,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1247,100,,,percent of total billed charges,100% of total billed charges,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,771.27,61.85,,,percent of total billed charges,61.85% of total billed charges,290.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,377.74,130,,,Fee Schedule,130% of WA Medicaid ,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.12,37.7,,,percent of total billed charges,37.70% of total billed charges,470.12,37.7,,,percent of total billed charges,37.70% of total billed charges,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,42273.3,33.9,,,percent of total billed charges,33.9% of total billed charges,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,972.66,78,,,percent of total billed charges,78% of total billed charges,1247,100,,,percent of total billed charges,100% of total billed charges,1030.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1030.02,82.6,,,percent of total billed charges,82.6% of total billed charges,290.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.81,42273.3,
TREAT FRACTURE ULNAR STYLOID,25652,CDM,983,RC,25652,HCPCS,Outpatient,,,1529,993.85,,1345.52,88,,,percent of total billed charges,88% of total Billed charges,60.4,100,,,Fee Schedule,100% of Medicare rate,364.79,100,,,Fee Schedule,100% of WA Medicaid,1529,100,,,percent of total billed charges,100% of total billed charges,375.73,103,,,Fee Schedule,103% of WA Medicaid,60.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,364.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1055.01,69,,,percent of total billed charges,69% of total billed charges,1529,100,,,percent of total billed charges,100% of total billed charges,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1529,100,,,percent of total billed charges,100% of total billed charges,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1529,100,,,percent of total billed charges,100% of total billed charges,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,945.69,61.85,,,percent of total billed charges,61.85% of total billed charges,364.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,474.23,130,,,Fee Schedule,130% of WA Medicaid ,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,576.43,37.7,,,percent of total billed charges,37.70% of total billed charges,576.43,37.7,,,percent of total billed charges,37.70% of total billed charges,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,51833.1,33.9,,,percent of total billed charges,33.9% of total billed charges,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1192.62,78,,,percent of total billed charges,78% of total billed charges,1529,100,,,percent of total billed charges,100% of total billed charges,1262.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1262.95,82.6,,,percent of total billed charges,82.6% of total billed charges,364.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,61,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.4,51833.1,
TREAT WRIST DISLOCATION,25670,CDM,983,RC,25670,HCPCS,Outpatient,,,1751,1138.15,,1540.88,88,,,percent of total billed charges,88% of total Billed charges,59.88,100,,,Fee Schedule,100% of Medicare rate,354.72,100,,,Fee Schedule,100% of WA Medicaid,1751,100,,,percent of total billed charges,100% of total billed charges,365.36,103,,,Fee Schedule,103% of WA Medicaid,59.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,104.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,354.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1208.19,69,,,percent of total billed charges,69% of total billed charges,1751,100,,,percent of total billed charges,100% of total billed charges,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1751,100,,,percent of total billed charges,100% of total billed charges,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1751,100,,,percent of total billed charges,100% of total billed charges,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1082.99,61.85,,,percent of total billed charges,61.85% of total billed charges,354.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,461.14,130,,,Fee Schedule,130% of WA Medicaid ,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,660.13,37.7,,,percent of total billed charges,37.70% of total billed charges,660.13,37.7,,,percent of total billed charges,37.70% of total billed charges,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,59358.9,33.9,,,percent of total billed charges,33.9% of total billed charges,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1365.78,78,,,percent of total billed charges,78% of total billed charges,1751,100,,,percent of total billed charges,100% of total billed charges,1446.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1446.33,82.6,,,percent of total billed charges,82.6% of total billed charges,354.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.88,59358.9,
TREATMENT WRIST DISLOCATION,25676,CDM,983,RC,25676,HCPCS,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,60.37,100,,,Fee Schedule,100% of Medicare rate,368.9,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,379.97,103,,,Fee Schedule,103% of WA Medicaid,60.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,368.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,368.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,479.57,130,,,Fee Schedule,130% of WA Medicaid ,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,30510,33.9,,,percent of total billed charges,33.9% of total billed charges,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,368.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.37,30510,
PERCUTANEOUS SKELETAL FIXATION ULNAR FX,25671,CDM,983,RC,25671,HCPCS,Outpatient,,,915,594.75,,805.2,88,,,percent of total billed charges,88% of total Billed charges,51.07,100,,,Fee Schedule,100% of Medicare rate,315.74,100,,,Fee Schedule,100% of WA Medicaid,915,100,,,percent of total billed charges,100% of total billed charges,325.21,103,,,Fee Schedule,103% of WA Medicaid,51.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,315.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,631.35,69,,,percent of total billed charges,69% of total billed charges,915,100,,,percent of total billed charges,100% of total billed charges,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,915,100,,,percent of total billed charges,100% of total billed charges,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,915,100,,,percent of total billed charges,100% of total billed charges,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.93,61.85,,,percent of total billed charges,61.85% of total billed charges,315.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,410.46,130,,,Fee Schedule,130% of WA Medicaid ,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.96,37.7,,,percent of total billed charges,37.70% of total billed charges,344.96,37.7,,,percent of total billed charges,37.70% of total billed charges,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,31018.5,33.9,,,percent of total billed charges,33.9% of total billed charges,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,713.7,78,,,percent of total billed charges,78% of total billed charges,915,100,,,percent of total billed charges,100% of total billed charges,755.79,82.6,,,percent of total billed charges,82.6% of total billed charges,755.79,82.6,,,percent of total billed charges,82.6% of total billed charges,315.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.07,31018.5,
TREAT WRIST FRACTURE,25685,CDM,983,RC,25685,HCPCS,Outpatient,,,2136,1388.40,,1879.68,88,,,percent of total billed charges,88% of total Billed charges,76.39,100,,,Fee Schedule,100% of Medicare rate,426.53,100,,,Fee Schedule,100% of WA Medicaid,2136,100,,,percent of total billed charges,100% of total billed charges,439.33,103,,,Fee Schedule,103% of WA Medicaid,76.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,133.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,426.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1473.84,69,,,percent of total billed charges,69% of total billed charges,2136,100,,,percent of total billed charges,100% of total billed charges,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2136,100,,,percent of total billed charges,100% of total billed charges,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2136,100,,,percent of total billed charges,100% of total billed charges,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1321.12,61.85,,,percent of total billed charges,61.85% of total billed charges,426.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,554.49,130,,,Fee Schedule,130% of WA Medicaid ,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,805.27,37.7,,,percent of total billed charges,37.70% of total billed charges,805.27,37.7,,,percent of total billed charges,37.70% of total billed charges,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,72410.4,33.9,,,percent of total billed charges,33.9% of total billed charges,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1666.08,78,,,percent of total billed charges,78% of total billed charges,2136,100,,,percent of total billed charges,100% of total billed charges,1764.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1764.34,82.6,,,percent of total billed charges,82.6% of total billed charges,426.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.39,72410.4,
TREAT WRIST DISLOCATION,25690,CDM,983,RC,25690,HCPCS,Outpatient,,,1323,859.95,,1164.24,88,,,percent of total billed charges,88% of total Billed charges,46.47,100,,,Fee Schedule,100% of Medicare rate,292.43,100,,,Fee Schedule,100% of WA Medicaid,1323,100,,,percent of total billed charges,100% of total billed charges,301.2,103,,,Fee Schedule,103% of WA Medicaid,46.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,292.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,912.87,69,,,percent of total billed charges,69% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323,100,,,percent of total billed charges,100% of total billed charges,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323,100,,,percent of total billed charges,100% of total billed charges,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,818.28,61.85,,,percent of total billed charges,61.85% of total billed charges,292.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,380.16,130,,,Fee Schedule,130% of WA Medicaid ,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,44849.7,33.9,,,percent of total billed charges,33.9% of total billed charges,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031.94,78,,,percent of total billed charges,78% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,292.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.47,44849.7,
FUSION OF WRIST JOINT,25800,CDM,983,RC,25800,HCPCS,Outpatient,,,1952,1268.80,,1717.76,88,,,percent of total billed charges,88% of total Billed charges,71.6,100,,,Fee Schedule,100% of Medicare rate,424.29,100,,,Fee Schedule,100% of WA Medicaid,1952,100,,,percent of total billed charges,100% of total billed charges,437.02,103,,,Fee Schedule,103% of WA Medicaid,71.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,125.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,424.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1346.88,69,,,percent of total billed charges,69% of total billed charges,1952,100,,,percent of total billed charges,100% of total billed charges,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1952,100,,,percent of total billed charges,100% of total billed charges,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1952,100,,,percent of total billed charges,100% of total billed charges,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1207.31,61.85,,,percent of total billed charges,61.85% of total billed charges,424.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,551.58,130,,,Fee Schedule,130% of WA Medicaid ,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,735.9,37.7,,,percent of total billed charges,37.70% of total billed charges,735.9,37.7,,,percent of total billed charges,37.70% of total billed charges,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,66172.8,33.9,,,percent of total billed charges,33.9% of total billed charges,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1522.56,78,,,percent of total billed charges,78% of total billed charges,1952,100,,,percent of total billed charges,100% of total billed charges,1612.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1612.35,82.6,,,percent of total billed charges,82.6% of total billed charges,424.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.6,66172.8,
FUSION/GRAFT OF WRIST JOINT,25805,CDM,983,RC,25805,HCPCS,Outpatient,,,2255,1465.75,,1984.4,88,,,percent of total billed charges,88% of total Billed charges,88.31,100,,,Fee Schedule,100% of Medicare rate,490.31,100,,,Fee Schedule,100% of WA Medicaid,2255,100,,,percent of total billed charges,100% of total billed charges,505.02,103,,,Fee Schedule,103% of WA Medicaid,88.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,154.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,490.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1555.95,69,,,percent of total billed charges,69% of total billed charges,2255,100,,,percent of total billed charges,100% of total billed charges,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2255,100,,,percent of total billed charges,100% of total billed charges,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2255,100,,,percent of total billed charges,100% of total billed charges,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1394.72,61.85,,,percent of total billed charges,61.85% of total billed charges,490.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,637.4,130,,,Fee Schedule,130% of WA Medicaid ,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,850.14,37.7,,,percent of total billed charges,37.70% of total billed charges,850.14,37.7,,,percent of total billed charges,37.70% of total billed charges,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,76444.5,33.9,,,percent of total billed charges,33.9% of total billed charges,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1758.9,78,,,percent of total billed charges,78% of total billed charges,2255,100,,,percent of total billed charges,100% of total billed charges,1862.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1862.63,82.6,,,percent of total billed charges,82.6% of total billed charges,490.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.31,76444.5,
FUSION/GRAFT OF WRIST JOINT,25810,CDM,983,RC,25810,HCPCS,Outpatient,,,3047,1980.55,,2681.36,88,,,percent of total billed charges,88% of total Billed charges,85.06,100,,,Fee Schedule,100% of Medicare rate,502.8,100,,,Fee Schedule,100% of WA Medicaid,3047,100,,,percent of total billed charges,100% of total billed charges,517.88,103,,,Fee Schedule,103% of WA Medicaid,85.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,148.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,502.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2102.43,69,,,percent of total billed charges,69% of total billed charges,3047,100,,,percent of total billed charges,100% of total billed charges,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,3047,100,,,percent of total billed charges,100% of total billed charges,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,3047,100,,,percent of total billed charges,100% of total billed charges,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1884.57,61.85,,,percent of total billed charges,61.85% of total billed charges,502.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,653.64,130,,,Fee Schedule,130% of WA Medicaid ,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1148.72,37.7,,,percent of total billed charges,37.70% of total billed charges,1148.72,37.7,,,percent of total billed charges,37.70% of total billed charges,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,103293.3,33.9,,,percent of total billed charges,33.9% of total billed charges,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2376.66,78,,,percent of total billed charges,78% of total billed charges,3047,100,,,percent of total billed charges,100% of total billed charges,2516.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2516.82,82.6,,,percent of total billed charges,82.6% of total billed charges,502.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,85.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.06,103293.3,
FUSE HAND BONES WITH GRAFT,25825,CDM,983,RC,25825,HCPCS,Outpatient,,,3009,1955.85,,2647.92,88,,,percent of total billed charges,88% of total Billed charges,71.54,100,,,Fee Schedule,100% of Medicare rate,463.64,100,,,Fee Schedule,100% of WA Medicaid,3009,100,,,percent of total billed charges,100% of total billed charges,477.55,103,,,Fee Schedule,103% of WA Medicaid,71.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,125.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,463.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2076.21,69,,,percent of total billed charges,69% of total billed charges,3009,100,,,percent of total billed charges,100% of total billed charges,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,3009,100,,,percent of total billed charges,100% of total billed charges,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,3009,100,,,percent of total billed charges,100% of total billed charges,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1861.07,61.85,,,percent of total billed charges,61.85% of total billed charges,463.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,472.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,602.73,130,,,Fee Schedule,130% of WA Medicaid ,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1134.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1134.39,37.7,,,percent of total billed charges,37.70% of total billed charges,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,102005.1,33.9,,,percent of total billed charges,33.9% of total billed charges,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2347.02,78,,,percent of total billed charges,78% of total billed charges,3009,100,,,percent of total billed charges,100% of total billed charges,2485.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2485.43,82.6,,,percent of total billed charges,82.6% of total billed charges,463.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.54,102005.1,
AMPUTATION OF FOREARM,25900,CDM,983,RC,25900,HCPCS,Outpatient,,,2069,1344.85,,1820.72,88,,,percent of total billed charges,88% of total Billed charges,71.2,100,,,Fee Schedule,100% of Medicare rate,416.83,100,,,Fee Schedule,100% of WA Medicaid,2069,100,,,percent of total billed charges,100% of total billed charges,429.33,103,,,Fee Schedule,103% of WA Medicaid,71.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,416.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1427.61,69,,,percent of total billed charges,69% of total billed charges,2069,100,,,percent of total billed charges,100% of total billed charges,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2069,100,,,percent of total billed charges,100% of total billed charges,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2069,100,,,percent of total billed charges,100% of total billed charges,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1279.68,61.85,,,percent of total billed charges,61.85% of total billed charges,416.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,541.88,130,,,Fee Schedule,130% of WA Medicaid ,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.01,37.7,,,percent of total billed charges,37.70% of total billed charges,780.01,37.7,,,percent of total billed charges,37.70% of total billed charges,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,70139.1,33.9,,,percent of total billed charges,33.9% of total billed charges,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1613.82,78,,,percent of total billed charges,78% of total billed charges,2069,100,,,percent of total billed charges,100% of total billed charges,1708.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1708.99,82.6,,,percent of total billed charges,82.6% of total billed charges,416.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.2,70139.1,
AMPUTATION FOLLOW UP SURGERY,25931,CDM,983,RC,25931,HCPCS,Outpatient,,,1365,887.25,,1201.2,88,,,percent of total billed charges,88% of total Billed charges,67.6,100,,,Fee Schedule,100% of Medicare rate,468.67,100,,,Fee Schedule,100% of WA Medicaid,1365,100,,,percent of total billed charges,100% of total billed charges,482.73,103,,,Fee Schedule,103% of WA Medicaid,67.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,118.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,468.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,941.85,69,,,percent of total billed charges,69% of total billed charges,1365,100,,,percent of total billed charges,100% of total billed charges,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1365,100,,,percent of total billed charges,100% of total billed charges,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1365,100,,,percent of total billed charges,100% of total billed charges,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,844.25,61.85,,,percent of total billed charges,61.85% of total billed charges,468.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,609.27,130,,,Fee Schedule,130% of WA Medicaid ,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,514.61,37.7,,,percent of total billed charges,37.70% of total billed charges,514.61,37.7,,,percent of total billed charges,37.70% of total billed charges,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,46273.5,33.9,,,percent of total billed charges,33.9% of total billed charges,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064.7,78,,,percent of total billed charges,78% of total billed charges,1365,100,,,percent of total billed charges,100% of total billed charges,1127.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1127.49,82.6,,,percent of total billed charges,82.6% of total billed charges,468.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.6,46273.5,
DRAINAGE OF FINGER ABSCESS,26011,CDM,983,RC,26011,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,16.31,100,,,Fee Schedule,100% of Medicare rate,108.17,100,,,Fee Schedule,100% of WA Medicaid,650,100,,,percent of total billed charges,100% of total billed charges,111.42,103,,,Fee Schedule,103% of WA Medicaid,16.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,108.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,140.62,130,,,Fee Schedule,130% of WA Medicaid ,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,22035,33.9,,,percent of total billed charges,33.9% of total billed charges,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.31,22035,
DRAINAGE OF FINGER ABSCESS,26010,CDM,983,RC,26010,HCPCS,Outpatient,,,447.55,290.91,,393.84,88,,,percent of total billed charges,88% of total Billed charges,11.36,100,,,Fee Schedule,100% of Medicare rate,82.99,100,,,Fee Schedule,100% of WA Medicaid,447.55,100,,,percent of total billed charges,100% of total billed charges,85.48,103,,,Fee Schedule,103% of WA Medicaid,11.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,82.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,308.81,69,,,percent of total billed charges,69% of total billed charges,447.55,100,,,percent of total billed charges,100% of total billed charges,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.55,100,,,percent of total billed charges,100% of total billed charges,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.55,100,,,percent of total billed charges,100% of total billed charges,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.81,61.85,,,percent of total billed charges,61.85% of total billed charges,82.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.89,130,,,Fee Schedule,130% of WA Medicaid ,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.73,37.7,,,percent of total billed charges,37.70% of total billed charges,168.73,37.7,,,percent of total billed charges,37.70% of total billed charges,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,15171.95,33.9,,,percent of total billed charges,33.9% of total billed charges,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.09,78,,,percent of total billed charges,78% of total billed charges,447.55,100,,,percent of total billed charges,100% of total billed charges,369.68,82.6,,,percent of total billed charges,82.6% of total billed charges,369.68,82.6,,,percent of total billed charges,82.6% of total billed charges,82.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.36,15171.95,
DRAIN HAND TENDON SHEATH,26020,CDM,983,RC,26020,HCPCS,Outpatient,,,1667,1083.55,,1466.96,88,,,percent of total billed charges,88% of total Billed charges,51.12,100,,,Fee Schedule,100% of Medicare rate,326.56,100,,,Fee Schedule,100% of WA Medicaid,1667,100,,,percent of total billed charges,100% of total billed charges,336.36,103,,,Fee Schedule,103% of WA Medicaid,51.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,326.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1150.23,69,,,percent of total billed charges,69% of total billed charges,1667,100,,,percent of total billed charges,100% of total billed charges,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1667,100,,,percent of total billed charges,100% of total billed charges,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1667,100,,,percent of total billed charges,100% of total billed charges,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031.04,61.85,,,percent of total billed charges,61.85% of total billed charges,326.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,424.53,130,,,Fee Schedule,130% of WA Medicaid ,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,628.46,37.7,,,percent of total billed charges,37.70% of total billed charges,628.46,37.7,,,percent of total billed charges,37.70% of total billed charges,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,56511.3,33.9,,,percent of total billed charges,33.9% of total billed charges,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300.26,78,,,percent of total billed charges,78% of total billed charges,1667,100,,,percent of total billed charges,100% of total billed charges,1376.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1376.94,82.6,,,percent of total billed charges,82.6% of total billed charges,326.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.12,56511.3,
TREAT HAND BONE LESION,26034,CDM,983,RC,26034,HCPCS,Outpatient,,,2140,1391.00,,1883.2,88,,,percent of total billed charges,88% of total Billed charges,49.71,100,,,Fee Schedule,100% of Medicare rate,324.51,100,,,Fee Schedule,100% of WA Medicaid,2140,100,,,percent of total billed charges,100% of total billed charges,334.25,103,,,Fee Schedule,103% of WA Medicaid,49.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,324.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1476.6,69,,,percent of total billed charges,69% of total billed charges,2140,100,,,percent of total billed charges,100% of total billed charges,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2140,100,,,percent of total billed charges,100% of total billed charges,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2140,100,,,percent of total billed charges,100% of total billed charges,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323.59,61.85,,,percent of total billed charges,61.85% of total billed charges,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,331,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,421.86,130,,,Fee Schedule,130% of WA Medicaid ,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.78,37.7,,,percent of total billed charges,37.70% of total billed charges,806.78,37.7,,,percent of total billed charges,37.70% of total billed charges,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,72546,33.9,,,percent of total billed charges,33.9% of total billed charges,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1669.2,78,,,percent of total billed charges,78% of total billed charges,2140,100,,,percent of total billed charges,100% of total billed charges,1767.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1767.64,82.6,,,percent of total billed charges,82.6% of total billed charges,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.71,72546,
DECOMPRESS FINGERS/HAND,26037,CDM,983,RC,26037,HCPCS,Outpatient,,,1279,831.35,,1125.52,88,,,percent of total billed charges,88% of total Billed charges,55.33,100,,,Fee Schedule,100% of Medicare rate,327.12,100,,,Fee Schedule,100% of WA Medicaid,1279,100,,,percent of total billed charges,100% of total billed charges,336.93,103,,,Fee Schedule,103% of WA Medicaid,55.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,96.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,327.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,882.51,69,,,percent of total billed charges,69% of total billed charges,1279,100,,,percent of total billed charges,100% of total billed charges,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1279,100,,,percent of total billed charges,100% of total billed charges,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1279,100,,,percent of total billed charges,100% of total billed charges,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,791.06,61.85,,,percent of total billed charges,61.85% of total billed charges,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,425.26,130,,,Fee Schedule,130% of WA Medicaid ,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.18,37.7,,,percent of total billed charges,37.70% of total billed charges,482.18,37.7,,,percent of total billed charges,37.70% of total billed charges,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,43358.1,33.9,,,percent of total billed charges,33.9% of total billed charges,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,997.62,78,,,percent of total billed charges,78% of total billed charges,1279,100,,,percent of total billed charges,100% of total billed charges,1056.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1056.45,82.6,,,percent of total billed charges,82.6% of total billed charges,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.33,43358.1,
RELEASE PALM CONTRACTURE,26045,CDM,983,RC,26045,HCPCS,Outpatient,,,2111,1372.15,,1857.68,88,,,percent of total billed charges,88% of total Billed charges,43.93,100,,,Fee Schedule,100% of Medicare rate,278.63,100,,,Fee Schedule,100% of WA Medicaid,2111,100,,,percent of total billed charges,100% of total billed charges,286.99,103,,,Fee Schedule,103% of WA Medicaid,43.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,278.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1456.59,69,,,percent of total billed charges,69% of total billed charges,2111,100,,,percent of total billed charges,100% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2111,100,,,percent of total billed charges,100% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2111,100,,,percent of total billed charges,100% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1305.65,61.85,,,percent of total billed charges,61.85% of total billed charges,278.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,362.22,130,,,Fee Schedule,130% of WA Medicaid ,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,795.85,37.7,,,percent of total billed charges,37.70% of total billed charges,795.85,37.7,,,percent of total billed charges,37.70% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,71562.9,33.9,,,percent of total billed charges,33.9% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1646.58,78,,,percent of total billed charges,78% of total billed charges,2111,100,,,percent of total billed charges,100% of total billed charges,1743.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1743.69,82.6,,,percent of total billed charges,82.6% of total billed charges,278.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.93,71562.9,
INCISE FINGER TENDON SHEATH,26055,CDM,983,RC,26055,HCPCS,Outpatient,,,1545,1004.25,,1359.6,88,,,percent of total billed charges,88% of total Billed charges,24.39,100,,,Fee Schedule,100% of Medicare rate,173.63,100,,,Fee Schedule,100% of WA Medicaid,1545,100,,,percent of total billed charges,100% of total billed charges,178.84,103,,,Fee Schedule,103% of WA Medicaid,24.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,173.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1066.05,69,,,percent of total billed charges,69% of total billed charges,1545,100,,,percent of total billed charges,100% of total billed charges,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1545,100,,,percent of total billed charges,100% of total billed charges,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1545,100,,,percent of total billed charges,100% of total billed charges,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,955.58,61.85,,,percent of total billed charges,61.85% of total billed charges,173.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,225.72,130,,,Fee Schedule,130% of WA Medicaid ,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,582.47,37.7,,,percent of total billed charges,37.70% of total billed charges,582.47,37.7,,,percent of total billed charges,37.70% of total billed charges,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,52375.5,33.9,,,percent of total billed charges,33.9% of total billed charges,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1205.1,78,,,percent of total billed charges,78% of total billed charges,1545,100,,,percent of total billed charges,100% of total billed charges,1276.17,82.6,,,percent of total billed charges,82.6% of total billed charges,1276.17,82.6,,,percent of total billed charges,82.6% of total billed charges,173.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.39,52375.5,
EXPLORE/TREAT HAND JOINT,26070,CDM,983,RC,26070,HCPCS,Outpatient,,,1006,653.90,,885.28,88,,,percent of total billed charges,88% of total Billed charges,28.22,100,,,Fee Schedule,100% of Medicare rate,191.72,100,,,Fee Schedule,100% of WA Medicaid,1006,100,,,percent of total billed charges,100% of total billed charges,197.47,103,,,Fee Schedule,103% of WA Medicaid,28.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,191.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,694.14,69,,,percent of total billed charges,69% of total billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1006,100,,,percent of total billed charges,100% of total billed charges,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1006,100,,,percent of total billed charges,100% of total billed charges,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.21,61.85,,,percent of total billed charges,61.85% of total billed charges,191.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,249.24,130,,,Fee Schedule,130% of WA Medicaid ,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.26,37.7,,,percent of total billed charges,37.70% of total billed charges,379.26,37.7,,,percent of total billed charges,37.70% of total billed charges,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,34103.4,33.9,,,percent of total billed charges,33.9% of total billed charges,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,784.68,78,,,percent of total billed charges,78% of total billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,830.96,82.6,,,percent of total billed charges,82.6% of total billed charges,830.96,82.6,,,percent of total billed charges,82.6% of total billed charges,191.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.22,34103.4,
EXPLORE/TREAT FINGER JOINT,26075,CDM,983,RC,26075,HCPCS,Outpatient,,,1183,768.95,,1041.04,88,,,percent of total billed charges,88% of total Billed charges,29.73,100,,,Fee Schedule,100% of Medicare rate,200.86,100,,,Fee Schedule,100% of WA Medicaid,1183,100,,,percent of total billed charges,100% of total billed charges,206.89,103,,,Fee Schedule,103% of WA Medicaid,29.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,816.27,69,,,percent of total billed charges,69% of total billed charges,1183,100,,,percent of total billed charges,100% of total billed charges,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1183,100,,,percent of total billed charges,100% of total billed charges,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1183,100,,,percent of total billed charges,100% of total billed charges,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.69,61.85,,,percent of total billed charges,61.85% of total billed charges,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,261.12,130,,,Fee Schedule,130% of WA Medicaid ,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.99,37.7,,,percent of total billed charges,37.70% of total billed charges,445.99,37.7,,,percent of total billed charges,37.70% of total billed charges,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,40103.7,33.9,,,percent of total billed charges,33.9% of total billed charges,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,922.74,78,,,percent of total billed charges,78% of total billed charges,1183,100,,,percent of total billed charges,100% of total billed charges,977.16,82.6,,,percent of total billed charges,82.6% of total billed charges,977.16,82.6,,,percent of total billed charges,82.6% of total billed charges,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.73,40103.7,
EXPLORE/TREAT FINGER JOINT,26080,CDM,983,RC,26080,HCPCS,Outpatient,,,721,468.65,,634.48,88,,,percent of total billed charges,88% of total Billed charges,34.47,100,,,Fee Schedule,100% of Medicare rate,237.04,100,,,Fee Schedule,100% of WA Medicaid,721,100,,,percent of total billed charges,100% of total billed charges,244.15,103,,,Fee Schedule,103% of WA Medicaid,34.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,237.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,497.49,69,,,percent of total billed charges,69% of total billed charges,721,100,,,percent of total billed charges,100% of total billed charges,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,721,100,,,percent of total billed charges,100% of total billed charges,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,721,100,,,percent of total billed charges,100% of total billed charges,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.94,61.85,,,percent of total billed charges,61.85% of total billed charges,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,308.15,130,,,Fee Schedule,130% of WA Medicaid ,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.82,37.7,,,percent of total billed charges,37.70% of total billed charges,271.82,37.7,,,percent of total billed charges,37.70% of total billed charges,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,24441.9,33.9,,,percent of total billed charges,33.9% of total billed charges,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.38,78,,,percent of total billed charges,78% of total billed charges,721,100,,,percent of total billed charges,100% of total billed charges,595.55,82.6,,,percent of total billed charges,82.6% of total billed charges,595.55,82.6,,,percent of total billed charges,82.6% of total billed charges,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.47,24441.9,
EXC HAND LES SC 1.5 CM/>,26111,CDM,983,RC,26111,HCPCS,Outpatient,,,1241,806.65,,1092.08,88,,,percent of total billed charges,88% of total Billed charges,40.01,100,,,Fee Schedule,100% of Medicare rate,243.2,100,,,Fee Schedule,100% of WA Medicaid,1241,100,,,percent of total billed charges,100% of total billed charges,250.5,103,,,Fee Schedule,103% of WA Medicaid,40.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,243.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,856.29,69,,,percent of total billed charges,69% of total billed charges,1241,100,,,percent of total billed charges,100% of total billed charges,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1241,100,,,percent of total billed charges,100% of total billed charges,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1241,100,,,percent of total billed charges,100% of total billed charges,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,767.56,61.85,,,percent of total billed charges,61.85% of total billed charges,243.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,316.16,130,,,Fee Schedule,130% of WA Medicaid ,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,467.86,37.7,,,percent of total billed charges,37.70% of total billed charges,467.86,37.7,,,percent of total billed charges,37.70% of total billed charges,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,42069.9,33.9,,,percent of total billed charges,33.9% of total billed charges,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,967.98,78,,,percent of total billed charges,78% of total billed charges,1241,100,,,percent of total billed charges,100% of total billed charges,1025.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1025.07,82.6,,,percent of total billed charges,82.6% of total billed charges,243.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.01,42069.9,
EXC HAND TUM DEEP 1.5 CM/>,26113,CDM,983,RC,26113,HCPCS,Outpatient,,,1618,1051.70,,1423.84,88,,,percent of total billed charges,88% of total Billed charges,51.57,100,,,Fee Schedule,100% of Medicare rate,320.03,100,,,Fee Schedule,100% of WA Medicaid,1618,100,,,percent of total billed charges,100% of total billed charges,329.63,103,,,Fee Schedule,103% of WA Medicaid,51.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,320.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1116.42,69,,,percent of total billed charges,69% of total billed charges,1618,100,,,percent of total billed charges,100% of total billed charges,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1618,100,,,percent of total billed charges,100% of total billed charges,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1618,100,,,percent of total billed charges,100% of total billed charges,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1000.73,61.85,,,percent of total billed charges,61.85% of total billed charges,320.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,416.04,130,,,Fee Schedule,130% of WA Medicaid ,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,609.99,37.7,,,percent of total billed charges,37.70% of total billed charges,609.99,37.7,,,percent of total billed charges,37.70% of total billed charges,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,54850.2,33.9,,,percent of total billed charges,33.9% of total billed charges,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262.04,78,,,percent of total billed charges,78% of total billed charges,1618,100,,,percent of total billed charges,100% of total billed charges,1336.47,82.6,,,percent of total billed charges,82.6% of total billed charges,1336.47,82.6,,,percent of total billed charges,82.6% of total billed charges,320.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.57,54850.2,
EXC HAND LES SC < 1.5 CM,26115,CDM,983,RC,26115,HCPCS,Outpatient,,,1498,973.70,,1318.24,88,,,percent of total billed charges,88% of total Billed charges,29.74,100,,,Fee Schedule,100% of Medicare rate,196.2,100,,,Fee Schedule,100% of WA Medicaid,1498,100,,,percent of total billed charges,100% of total billed charges,202.09,103,,,Fee Schedule,103% of WA Medicaid,29.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,196.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1033.62,69,,,percent of total billed charges,69% of total billed charges,1498,100,,,percent of total billed charges,100% of total billed charges,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1498,100,,,percent of total billed charges,100% of total billed charges,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1498,100,,,percent of total billed charges,100% of total billed charges,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,926.51,61.85,,,percent of total billed charges,61.85% of total billed charges,196.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,255.06,130,,,Fee Schedule,130% of WA Medicaid ,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.75,37.7,,,percent of total billed charges,37.70% of total billed charges,564.75,37.7,,,percent of total billed charges,37.70% of total billed charges,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,50782.2,33.9,,,percent of total billed charges,33.9% of total billed charges,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1168.44,78,,,percent of total billed charges,78% of total billed charges,1498,100,,,percent of total billed charges,100% of total billed charges,1237.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1237.35,82.6,,,percent of total billed charges,82.6% of total billed charges,196.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.74,50782.2,
EXC HAND TUM DEEP < 1.5 CM,26116,CDM,983,RC,26116,HCPCS,Outpatient,,,2065,1342.25,,1817.2,88,,,percent of total billed charges,88% of total Billed charges,48.84,100,,,Fee Schedule,100% of Medicare rate,307.54,100,,,Fee Schedule,100% of WA Medicaid,2065,100,,,percent of total billed charges,100% of total billed charges,316.77,103,,,Fee Schedule,103% of WA Medicaid,48.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,307.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1424.85,69,,,percent of total billed charges,69% of total billed charges,2065,100,,,percent of total billed charges,100% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2065,100,,,percent of total billed charges,100% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2065,100,,,percent of total billed charges,100% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1277.2,61.85,,,percent of total billed charges,61.85% of total billed charges,307.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,399.8,130,,,Fee Schedule,130% of WA Medicaid ,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.51,37.7,,,percent of total billed charges,37.70% of total billed charges,778.51,37.7,,,percent of total billed charges,37.70% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,70003.5,33.9,,,percent of total billed charges,33.9% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1610.7,78,,,percent of total billed charges,78% of total billed charges,2065,100,,,percent of total billed charges,100% of total billed charges,1705.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1705.69,82.6,,,percent of total billed charges,82.6% of total billed charges,307.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.84,70003.5,
RELEASE PALM CONTRACTURE,26123,CDM,983,RC,26123,HCPCS,Outpatient,,,3870,2515.50,,3405.6,88,,,percent of total billed charges,88% of total Billed charges,78.87,100,,,Fee Schedule,100% of Medicare rate,489,100,,,Fee Schedule,100% of WA Medicaid,3870,100,,,percent of total billed charges,100% of total billed charges,503.67,103,,,Fee Schedule,103% of WA Medicaid,78.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,489,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2670.3,69,,,percent of total billed charges,69% of total billed charges,3870,100,,,percent of total billed charges,100% of total billed charges,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3870,100,,,percent of total billed charges,100% of total billed charges,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3870,100,,,percent of total billed charges,100% of total billed charges,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2393.6,61.85,,,percent of total billed charges,61.85% of total billed charges,489,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,489,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,498.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,635.7,130,,,Fee Schedule,130% of WA Medicaid ,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1458.99,37.7,,,percent of total billed charges,37.70% of total billed charges,1458.99,37.7,,,percent of total billed charges,37.70% of total billed charges,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,131193,33.9,,,percent of total billed charges,33.9% of total billed charges,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3018.6,78,,,percent of total billed charges,78% of total billed charges,3870,100,,,percent of total billed charges,100% of total billed charges,3196.62,82.6,,,percent of total billed charges,82.6% of total billed charges,3196.62,82.6,,,percent of total billed charges,82.6% of total billed charges,489,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,489,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.87,131193,
RELEASE PALM CONTRACTURE,26125,CDM,983,RC,26125,HCPCS,Outpatient,,,1504,977.60,,1323.52,88,,,percent of total billed charges,88% of total Billed charges,30.52,100,,,Fee Schedule,100% of Medicare rate,150.51,100,,,Fee Schedule,100% of WA Medicaid,1504,100,,,percent of total billed charges,100% of total billed charges,155.03,103,,,Fee Schedule,103% of WA Medicaid,30.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,150.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1037.76,69,,,percent of total billed charges,69% of total billed charges,1504,100,,,percent of total billed charges,100% of total billed charges,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1504,100,,,percent of total billed charges,100% of total billed charges,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1504,100,,,percent of total billed charges,100% of total billed charges,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,930.22,61.85,,,percent of total billed charges,61.85% of total billed charges,150.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,195.66,130,,,Fee Schedule,130% of WA Medicaid ,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.01,37.7,,,percent of total billed charges,37.70% of total billed charges,567.01,37.7,,,percent of total billed charges,37.70% of total billed charges,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,50985.6,33.9,,,percent of total billed charges,33.9% of total billed charges,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1173.12,78,,,percent of total billed charges,78% of total billed charges,1504,100,,,percent of total billed charges,100% of total billed charges,1242.3,82.6,,,percent of total billed charges,82.6% of total billed charges,1242.3,82.6,,,percent of total billed charges,82.6% of total billed charges,150.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.52,50985.6,
RELEASE PALM CONTRACTURE,26121,CDM,983,RC,26121,HCPCS,Outpatient,,,1650,1072.50,,1452,88,,,percent of total billed charges,88% of total Billed charges,56.83,100,,,Fee Schedule,100% of Medicare rate,350.99,100,,,Fee Schedule,100% of WA Medicaid,1650,100,,,percent of total billed charges,100% of total billed charges,361.52,103,,,Fee Schedule,103% of WA Medicaid,56.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,350.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1138.5,69,,,percent of total billed charges,69% of total billed charges,1650,100,,,percent of total billed charges,100% of total billed charges,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650,100,,,percent of total billed charges,100% of total billed charges,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650,100,,,percent of total billed charges,100% of total billed charges,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.53,61.85,,,percent of total billed charges,61.85% of total billed charges,350.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,456.29,130,,,Fee Schedule,130% of WA Medicaid ,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.05,37.7,,,percent of total billed charges,37.70% of total billed charges,622.05,37.7,,,percent of total billed charges,37.70% of total billed charges,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,55935,33.9,,,percent of total billed charges,33.9% of total billed charges,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1287,78,,,percent of total billed charges,78% of total billed charges,1650,100,,,percent of total billed charges,100% of total billed charges,1362.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1362.9,82.6,,,percent of total billed charges,82.6% of total billed charges,350.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.83,55935,
REVISE FINGER JOINT/EACH,26140,CDM,983,RC,26140,HCPCS,Outpatient,,,721,468.65,,634.48,88,,,percent of total billed charges,88% of total Billed charges,46.58,100,,,Fee Schedule,100% of Medicare rate,299.33,100,,,Fee Schedule,100% of WA Medicaid,721,100,,,percent of total billed charges,100% of total billed charges,308.31,103,,,Fee Schedule,103% of WA Medicaid,46.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,299.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,497.49,69,,,percent of total billed charges,69% of total billed charges,721,100,,,percent of total billed charges,100% of total billed charges,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,721,100,,,percent of total billed charges,100% of total billed charges,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,721,100,,,percent of total billed charges,100% of total billed charges,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.94,61.85,,,percent of total billed charges,61.85% of total billed charges,299.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,389.13,130,,,Fee Schedule,130% of WA Medicaid ,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.82,37.7,,,percent of total billed charges,37.70% of total billed charges,271.82,37.7,,,percent of total billed charges,37.70% of total billed charges,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,24441.9,33.9,,,percent of total billed charges,33.9% of total billed charges,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.38,78,,,percent of total billed charges,78% of total billed charges,721,100,,,percent of total billed charges,100% of total billed charges,595.55,82.6,,,percent of total billed charges,82.6% of total billed charges,595.55,82.6,,,percent of total billed charges,82.6% of total billed charges,299.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.58,24441.9,
TENDON EXCISION PALM/FINGER,26145,CDM,983,RC,26145,HCPCS,Outpatient,,,1163,755.95,,1023.44,88,,,percent of total billed charges,88% of total Billed charges,47.84,100,,,Fee Schedule,100% of Medicare rate,303.44,100,,,Fee Schedule,100% of WA Medicaid,1163,100,,,percent of total billed charges,100% of total billed charges,312.54,103,,,Fee Schedule,103% of WA Medicaid,47.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,303.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,802.47,69,,,percent of total billed charges,69% of total billed charges,1163,100,,,percent of total billed charges,100% of total billed charges,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163,100,,,percent of total billed charges,100% of total billed charges,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163,100,,,percent of total billed charges,100% of total billed charges,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,719.32,61.85,,,percent of total billed charges,61.85% of total billed charges,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,394.47,130,,,Fee Schedule,130% of WA Medicaid ,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.45,37.7,,,percent of total billed charges,37.70% of total billed charges,438.45,37.7,,,percent of total billed charges,37.70% of total billed charges,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,39425.7,33.9,,,percent of total billed charges,33.9% of total billed charges,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,907.14,78,,,percent of total billed charges,78% of total billed charges,1163,100,,,percent of total billed charges,100% of total billed charges,960.64,82.6,,,percent of total billed charges,82.6% of total billed charges,960.64,82.6,,,percent of total billed charges,82.6% of total billed charges,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.84,39425.7,
REMOVE TENDON SHEATH LESION,26160,CDM,983,RC,26160,HCPCS,Outpatient,,,1450,942.50,,1276,88,,,percent of total billed charges,88% of total Billed charges,27.48,100,,,Fee Schedule,100% of Medicare rate,187.81,100,,,Fee Schedule,100% of WA Medicaid,1450,100,,,percent of total billed charges,100% of total billed charges,193.44,103,,,Fee Schedule,103% of WA Medicaid,27.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,187.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1000.5,69,,,percent of total billed charges,69% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1450,100,,,percent of total billed charges,100% of total billed charges,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1450,100,,,percent of total billed charges,100% of total billed charges,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,896.83,61.85,,,percent of total billed charges,61.85% of total billed charges,187.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,244.15,130,,,Fee Schedule,130% of WA Medicaid ,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.65,37.7,,,percent of total billed charges,37.70% of total billed charges,546.65,37.7,,,percent of total billed charges,37.70% of total billed charges,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,49155,33.9,,,percent of total billed charges,33.9% of total billed charges,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131,78,,,percent of total billed charges,78% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,187.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.48,49155,
REMOVE HAND BONE LESION,26200,CDM,983,RC,26200,HCPCS,Outpatient,,,1891,1229.15,,1664.08,88,,,percent of total billed charges,88% of total Billed charges,41.95,100,,,Fee Schedule,100% of Medicare rate,265.58,100,,,Fee Schedule,100% of WA Medicaid,1891,100,,,percent of total billed charges,100% of total billed charges,273.55,103,,,Fee Schedule,103% of WA Medicaid,41.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,265.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1304.79,69,,,percent of total billed charges,69% of total billed charges,1891,100,,,percent of total billed charges,100% of total billed charges,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1891,100,,,percent of total billed charges,100% of total billed charges,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1891,100,,,percent of total billed charges,100% of total billed charges,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1169.58,61.85,,,percent of total billed charges,61.85% of total billed charges,265.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,345.25,130,,,Fee Schedule,130% of WA Medicaid ,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.91,37.7,,,percent of total billed charges,37.70% of total billed charges,712.91,37.7,,,percent of total billed charges,37.70% of total billed charges,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,64104.9,33.9,,,percent of total billed charges,33.9% of total billed charges,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1474.98,78,,,percent of total billed charges,78% of total billed charges,1891,100,,,percent of total billed charges,100% of total billed charges,1561.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1561.97,82.6,,,percent of total billed charges,82.6% of total billed charges,265.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.95,64104.9,
PARTIAL REMOVAL FINGER BONE,26235,CDM,983,RC,26235,HCPCS,Outpatient,,,1394,906.10,,1226.72,88,,,percent of total billed charges,88% of total Billed charges,46.33,100,,,Fee Schedule,100% of Medicare rate,289.63,100,,,Fee Schedule,100% of WA Medicaid,1394,100,,,percent of total billed charges,100% of total billed charges,298.32,103,,,Fee Schedule,103% of WA Medicaid,46.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,289.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,961.86,69,,,percent of total billed charges,69% of total billed charges,1394,100,,,percent of total billed charges,100% of total billed charges,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1394,100,,,percent of total billed charges,100% of total billed charges,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1394,100,,,percent of total billed charges,100% of total billed charges,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,862.19,61.85,,,percent of total billed charges,61.85% of total billed charges,289.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,376.52,130,,,Fee Schedule,130% of WA Medicaid ,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.54,37.7,,,percent of total billed charges,37.70% of total billed charges,525.54,37.7,,,percent of total billed charges,37.70% of total billed charges,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,47256.6,33.9,,,percent of total billed charges,33.9% of total billed charges,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1087.32,78,,,percent of total billed charges,78% of total billed charges,1394,100,,,percent of total billed charges,100% of total billed charges,1151.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1151.44,82.6,,,percent of total billed charges,82.6% of total billed charges,289.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.33,47256.6,
PARTIAL REMOVAL FINGER BONE,26236,CDM,983,RC,26236,HCPCS,Outpatient,,,981,637.65,,863.28,88,,,percent of total billed charges,88% of total Billed charges,41.16,100,,,Fee Schedule,100% of Medicare rate,260.35,100,,,Fee Schedule,100% of WA Medicaid,981,100,,,percent of total billed charges,100% of total billed charges,268.16,103,,,Fee Schedule,103% of WA Medicaid,41.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,260.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,676.89,69,,,percent of total billed charges,69% of total billed charges,981,100,,,percent of total billed charges,100% of total billed charges,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,981,100,,,percent of total billed charges,100% of total billed charges,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,981,100,,,percent of total billed charges,100% of total billed charges,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.75,61.85,,,percent of total billed charges,61.85% of total billed charges,260.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,338.46,130,,,Fee Schedule,130% of WA Medicaid ,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.84,37.7,,,percent of total billed charges,37.70% of total billed charges,369.84,37.7,,,percent of total billed charges,37.70% of total billed charges,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,33255.9,33.9,,,percent of total billed charges,33.9% of total billed charges,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.18,78,,,percent of total billed charges,78% of total billed charges,981,100,,,percent of total billed charges,100% of total billed charges,810.31,82.6,,,percent of total billed charges,82.6% of total billed charges,810.31,82.6,,,percent of total billed charges,82.6% of total billed charges,260.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.16,33255.9,
REPAIR FINGER/HAND TENDON,26357,CDM,983,RC,26357,HCPCS,Outpatient,,,1931,1255.15,,1699.28,88,,,percent of total billed charges,88% of total Billed charges,85.93,100,,,Fee Schedule,100% of Medicare rate,520.15,100,,,Fee Schedule,100% of WA Medicaid,1931,100,,,percent of total billed charges,100% of total billed charges,535.75,103,,,Fee Schedule,103% of WA Medicaid,85.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,150.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,520.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1332.39,69,,,percent of total billed charges,69% of total billed charges,1931,100,,,percent of total billed charges,100% of total billed charges,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1931,100,,,percent of total billed charges,100% of total billed charges,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1931,100,,,percent of total billed charges,100% of total billed charges,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1194.32,61.85,,,percent of total billed charges,61.85% of total billed charges,520.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,676.2,130,,,Fee Schedule,130% of WA Medicaid ,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,727.99,37.7,,,percent of total billed charges,37.70% of total billed charges,727.99,37.7,,,percent of total billed charges,37.70% of total billed charges,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,65460.9,33.9,,,percent of total billed charges,33.9% of total billed charges,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1506.18,78,,,percent of total billed charges,78% of total billed charges,1931,100,,,percent of total billed charges,100% of total billed charges,1595.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1595.01,82.6,,,percent of total billed charges,82.6% of total billed charges,520.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,85.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.93,65460.9,
REPAIR FINGER/HAND TENDON,26350,CDM,983,RC,26350,HCPCS,Outpatient,,,2843,1847.95,,2501.84,88,,,percent of total billed charges,88% of total Billed charges,54.25,100,,,Fee Schedule,100% of Medicare rate,442.75,100,,,Fee Schedule,100% of WA Medicaid,2843,100,,,percent of total billed charges,100% of total billed charges,456.03,103,,,Fee Schedule,103% of WA Medicaid,54.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,442.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1961.67,69,,,percent of total billed charges,69% of total billed charges,2843,100,,,percent of total billed charges,100% of total billed charges,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2843,100,,,percent of total billed charges,100% of total billed charges,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2843,100,,,percent of total billed charges,100% of total billed charges,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1758.4,61.85,,,percent of total billed charges,61.85% of total billed charges,442.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,575.58,130,,,Fee Schedule,130% of WA Medicaid ,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1071.81,37.7,,,percent of total billed charges,37.70% of total billed charges,1071.81,37.7,,,percent of total billed charges,37.70% of total billed charges,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,96377.7,33.9,,,percent of total billed charges,33.9% of total billed charges,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2217.54,78,,,percent of total billed charges,78% of total billed charges,2843,100,,,percent of total billed charges,100% of total billed charges,2348.32,82.6,,,percent of total billed charges,82.6% of total billed charges,2348.32,82.6,,,percent of total billed charges,82.6% of total billed charges,442.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.25,96377.7,
REPAIR FINGER/HAND TENDON,26356,CDM,983,RC,26356,HCPCS,Outpatient,,,3655,2375.75,,3216.4,88,,,percent of total billed charges,88% of total Billed charges,70.89,100,,,Fee Schedule,100% of Medicare rate,466.25,100,,,Fee Schedule,100% of WA Medicaid,3655,100,,,percent of total billed charges,100% of total billed charges,480.24,103,,,Fee Schedule,103% of WA Medicaid,70.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,466.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2521.95,69,,,percent of total billed charges,69% of total billed charges,3655,100,,,percent of total billed charges,100% of total billed charges,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,3655,100,,,percent of total billed charges,100% of total billed charges,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,3655,100,,,percent of total billed charges,100% of total billed charges,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2260.62,61.85,,,percent of total billed charges,61.85% of total billed charges,466.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,606.13,130,,,Fee Schedule,130% of WA Medicaid ,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1377.94,37.7,,,percent of total billed charges,37.70% of total billed charges,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,123904.5,33.9,,,percent of total billed charges,33.9% of total billed charges,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2850.9,78,,,percent of total billed charges,78% of total billed charges,3655,100,,,percent of total billed charges,100% of total billed charges,3019.03,82.6,,,percent of total billed charges,82.6% of total billed charges,3019.03,82.6,,,percent of total billed charges,82.6% of total billed charges,466.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.89,123904.5,
REPAIR FINGER/HAND TENDON,26373,CDM,983,RC,26373,HCPCS,Outpatient,,,1234,802.10,,1085.92,88,,,percent of total billed charges,88% of total Billed charges,71.71,100,,,Fee Schedule,100% of Medicare rate,517.72,100,,,Fee Schedule,100% of WA Medicaid,1234,100,,,percent of total billed charges,100% of total billed charges,533.25,103,,,Fee Schedule,103% of WA Medicaid,71.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,125.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,517.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,851.46,69,,,percent of total billed charges,69% of total billed charges,1234,100,,,percent of total billed charges,100% of total billed charges,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1234,100,,,percent of total billed charges,100% of total billed charges,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1234,100,,,percent of total billed charges,100% of total billed charges,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.23,61.85,,,percent of total billed charges,61.85% of total billed charges,517.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,673.04,130,,,Fee Schedule,130% of WA Medicaid ,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.22,37.7,,,percent of total billed charges,37.70% of total billed charges,465.22,37.7,,,percent of total billed charges,37.70% of total billed charges,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,41832.6,33.9,,,percent of total billed charges,33.9% of total billed charges,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,962.52,78,,,percent of total billed charges,78% of total billed charges,1234,100,,,percent of total billed charges,100% of total billed charges,1019.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1019.28,82.6,,,percent of total billed charges,82.6% of total billed charges,517.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.71,41832.6,
REPAIR OF PROFUNDUS TENDON;EACH,26370,CDM,983,RC,26370,HCPCS,Outpatient,,,1785,1160.25,,1570.8,88,,,percent of total billed charges,88% of total Billed charges,59.7,100,,,Fee Schedule,100% of Medicare rate,461.96,100,,,Fee Schedule,100% of WA Medicaid,1785,100,,,percent of total billed charges,100% of total billed charges,475.82,103,,,Fee Schedule,103% of WA Medicaid,59.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,104.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,461.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1231.65,69,,,percent of total billed charges,69% of total billed charges,1785,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1785,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1785,100,,,percent of total billed charges,100% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1104.02,61.85,,,percent of total billed charges,61.85% of total billed charges,461.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,600.55,130,,,Fee Schedule,130% of WA Medicaid ,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,672.95,37.7,,,percent of total billed charges,37.70% of total billed charges,672.95,37.7,,,percent of total billed charges,37.70% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,60511.5,33.9,,,percent of total billed charges,33.9% of total billed charges,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1392.3,78,,,percent of total billed charges,78% of total billed charges,1785,100,,,percent of total billed charges,100% of total billed charges,1474.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1474.41,82.6,,,percent of total billed charges,82.6% of total billed charges,461.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.7,60511.5,
REPAIR FINGER TENDON,26418,CDM,983,RC,26418,HCPCS,Outpatient,,,2238,1454.70,,1969.44,88,,,percent of total billed charges,88% of total Billed charges,41.75,100,,,Fee Schedule,100% of Medicare rate,372.63,100,,,Fee Schedule,100% of WA Medicaid,2238,100,,,percent of total billed charges,100% of total billed charges,383.81,103,,,Fee Schedule,103% of WA Medicaid,41.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,372.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1544.22,69,,,percent of total billed charges,69% of total billed charges,2238,100,,,percent of total billed charges,100% of total billed charges,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2238,100,,,percent of total billed charges,100% of total billed charges,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2238,100,,,percent of total billed charges,100% of total billed charges,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1384.2,61.85,,,percent of total billed charges,61.85% of total billed charges,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,484.42,130,,,Fee Schedule,130% of WA Medicaid ,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,843.73,37.7,,,percent of total billed charges,37.70% of total billed charges,843.73,37.7,,,percent of total billed charges,37.70% of total billed charges,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,75868.2,33.9,,,percent of total billed charges,33.9% of total billed charges,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1745.64,78,,,percent of total billed charges,78% of total billed charges,2238,100,,,percent of total billed charges,100% of total billed charges,1848.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1848.59,82.6,,,percent of total billed charges,82.6% of total billed charges,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.75,75868.2,
REPAIR HAND TENDON,26410,CDM,983,RC,26410,HCPCS,Outpatient,,,1954,1270.10,,1719.52,88,,,percent of total billed charges,88% of total Billed charges,42.52,100,,,Fee Schedule,100% of Medicare rate,357.33,100,,,Fee Schedule,100% of WA Medicaid,1954,100,,,percent of total billed charges,100% of total billed charges,368.05,103,,,Fee Schedule,103% of WA Medicaid,42.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,357.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1348.26,69,,,percent of total billed charges,69% of total billed charges,1954,100,,,percent of total billed charges,100% of total billed charges,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1954,100,,,percent of total billed charges,100% of total billed charges,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1954,100,,,percent of total billed charges,100% of total billed charges,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1208.55,61.85,,,percent of total billed charges,61.85% of total billed charges,357.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,464.53,130,,,Fee Schedule,130% of WA Medicaid ,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.66,37.7,,,percent of total billed charges,37.70% of total billed charges,736.66,37.7,,,percent of total billed charges,37.70% of total billed charges,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,66240.6,33.9,,,percent of total billed charges,33.9% of total billed charges,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1524.12,78,,,percent of total billed charges,78% of total billed charges,1954,100,,,percent of total billed charges,100% of total billed charges,1614,82.6,,,percent of total billed charges,82.6% of total billed charges,1614,82.6,,,percent of total billed charges,82.6% of total billed charges,357.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.52,66240.6,
REPAIR OF EXTENSOR TENDON W/O GRAFT,26433,CDM,983,RC,26433,HCPCS,Outpatient,,,1253,814.45,,1102.64,88,,,percent of total billed charges,88% of total Billed charges,40.82,100,,,Fee Schedule,100% of Medicare rate,339.43,100,,,Fee Schedule,100% of WA Medicaid,1253,100,,,percent of total billed charges,100% of total billed charges,349.61,103,,,Fee Schedule,103% of WA Medicaid,40.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,71.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,339.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,864.57,69,,,percent of total billed charges,69% of total billed charges,1253,100,,,percent of total billed charges,100% of total billed charges,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1253,100,,,percent of total billed charges,100% of total billed charges,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1253,100,,,percent of total billed charges,100% of total billed charges,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,774.98,61.85,,,percent of total billed charges,61.85% of total billed charges,339.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,441.26,130,,,Fee Schedule,130% of WA Medicaid ,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,472.38,37.7,,,percent of total billed charges,37.70% of total billed charges,472.38,37.7,,,percent of total billed charges,37.70% of total billed charges,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,42476.7,33.9,,,percent of total billed charges,33.9% of total billed charges,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,977.34,78,,,percent of total billed charges,78% of total billed charges,1253,100,,,percent of total billed charges,100% of total billed charges,1034.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1034.98,82.6,,,percent of total billed charges,82.6% of total billed charges,339.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.82,42476.7,
RELEASE HAND/FINGER TENDON,26445,CDM,983,RC,26445,HCPCS,Outpatient,,,1888,1227.20,,1661.44,88,,,percent of total billed charges,88% of total Billed charges,40.29,100,,,Fee Schedule,100% of Medicare rate,359.57,100,,,Fee Schedule,100% of WA Medicaid,1888,100,,,percent of total billed charges,100% of total billed charges,370.36,103,,,Fee Schedule,103% of WA Medicaid,40.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,359.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1302.72,69,,,percent of total billed charges,69% of total billed charges,1888,100,,,percent of total billed charges,100% of total billed charges,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1888,100,,,percent of total billed charges,100% of total billed charges,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1888,100,,,percent of total billed charges,100% of total billed charges,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1167.73,61.85,,,percent of total billed charges,61.85% of total billed charges,359.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,467.44,130,,,Fee Schedule,130% of WA Medicaid ,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.78,37.7,,,percent of total billed charges,37.70% of total billed charges,711.78,37.7,,,percent of total billed charges,37.70% of total billed charges,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,64003.2,33.9,,,percent of total billed charges,33.9% of total billed charges,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1472.64,78,,,percent of total billed charges,78% of total billed charges,1888,100,,,percent of total billed charges,100% of total billed charges,1559.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1559.49,82.6,,,percent of total billed charges,82.6% of total billed charges,359.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.29,64003.2,
INCISION OF FINGER TENDON,26455,CDM,983,RC,26455,HCPCS,Outpatient,,,1309,850.85,,1151.92,88,,,percent of total billed charges,88% of total Billed charges,33.02,100,,,Fee Schedule,100% of Medicare rate,274.53,100,,,Fee Schedule,100% of WA Medicaid,1309,100,,,percent of total billed charges,100% of total billed charges,282.77,103,,,Fee Schedule,103% of WA Medicaid,33.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,274.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,903.21,69,,,percent of total billed charges,69% of total billed charges,1309,100,,,percent of total billed charges,100% of total billed charges,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1309,100,,,percent of total billed charges,100% of total billed charges,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1309,100,,,percent of total billed charges,100% of total billed charges,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,809.62,61.85,,,percent of total billed charges,61.85% of total billed charges,274.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,356.89,130,,,Fee Schedule,130% of WA Medicaid ,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,493.49,37.7,,,percent of total billed charges,37.70% of total billed charges,493.49,37.7,,,percent of total billed charges,37.70% of total billed charges,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,44375.1,33.9,,,percent of total billed charges,33.9% of total billed charges,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1021.02,78,,,percent of total billed charges,78% of total billed charges,1309,100,,,percent of total billed charges,100% of total billed charges,1081.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1081.23,82.6,,,percent of total billed charges,82.6% of total billed charges,274.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.02,44375.1,
INCISE HAND/FINGER TENDON,26460,CDM,983,RC,26460,HCPCS,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,31.44,100,,,Fee Schedule,100% of Medicare rate,269.31,100,,,Fee Schedule,100% of WA Medicaid,800,100,,,percent of total billed charges,100% of total billed charges,277.39,103,,,Fee Schedule,103% of WA Medicaid,31.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,55.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,269.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,800,100,,,percent of total billed charges,100% of total billed charges,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,800,100,,,percent of total billed charges,100% of total billed charges,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,269.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,350.1,130,,,Fee Schedule,130% of WA Medicaid ,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,27120,33.9,,,percent of total billed charges,33.9% of total billed charges,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,269.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.44,27120,
TENDON LENGTHENING,26476,CDM,983,RC,26476,HCPCS,Outpatient,,,1291,839.15,,1136.08,88,,,percent of total billed charges,88% of total Billed charges,49.01,100,,,Fee Schedule,100% of Medicare rate,382.14,100,,,Fee Schedule,100% of WA Medicaid,1291,100,,,percent of total billed charges,100% of total billed charges,393.6,103,,,Fee Schedule,103% of WA Medicaid,49.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,382.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,890.79,69,,,percent of total billed charges,69% of total billed charges,1291,100,,,percent of total billed charges,100% of total billed charges,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1291,100,,,percent of total billed charges,100% of total billed charges,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1291,100,,,percent of total billed charges,100% of total billed charges,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,798.48,61.85,,,percent of total billed charges,61.85% of total billed charges,382.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,496.78,130,,,Fee Schedule,130% of WA Medicaid ,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.71,37.7,,,percent of total billed charges,37.70% of total billed charges,486.71,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,43764.9,33.9,,,percent of total billed charges,33.9% of total billed charges,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1006.98,78,,,percent of total billed charges,78% of total billed charges,1291,100,,,percent of total billed charges,100% of total billed charges,1066.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1066.37,82.6,,,percent of total billed charges,82.6% of total billed charges,382.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.01,43764.9,
LENGTHENING OF HAND TENDON,26478,CDM,983,RC,26478,HCPCS,Outpatient,,,1374,893.10,,1209.12,88,,,percent of total billed charges,88% of total Billed charges,49.66,100,,,Fee Schedule,100% of Medicare rate,389.23,100,,,Fee Schedule,100% of WA Medicaid,1374,100,,,percent of total billed charges,100% of total billed charges,400.91,103,,,Fee Schedule,103% of WA Medicaid,49.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,389.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,948.06,69,,,percent of total billed charges,69% of total billed charges,1374,100,,,percent of total billed charges,100% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1374,100,,,percent of total billed charges,100% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1374,100,,,percent of total billed charges,100% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,849.82,61.85,,,percent of total billed charges,61.85% of total billed charges,389.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,506,130,,,Fee Schedule,130% of WA Medicaid ,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,518,37.7,,,percent of total billed charges,37.70% of total billed charges,518,37.7,,,percent of total billed charges,37.70% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,46578.6,33.9,,,percent of total billed charges,33.9% of total billed charges,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1071.72,78,,,percent of total billed charges,78% of total billed charges,1374,100,,,percent of total billed charges,100% of total billed charges,1134.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1134.92,82.6,,,percent of total billed charges,82.6% of total billed charges,389.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.66,46578.6,
TRANSPLANT HAND TENDON,26480,CDM,983,RC,26480,HCPCS,Outpatient,,,3162,2055.30,,2782.56,88,,,percent of total billed charges,88% of total Billed charges,57.74,100,,,Fee Schedule,100% of Medicare rate,464.57,100,,,Fee Schedule,100% of WA Medicaid,3162,100,,,percent of total billed charges,100% of total billed charges,478.51,103,,,Fee Schedule,103% of WA Medicaid,57.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,464.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2181.78,69,,,percent of total billed charges,69% of total billed charges,3162,100,,,percent of total billed charges,100% of total billed charges,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3162,100,,,percent of total billed charges,100% of total billed charges,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3162,100,,,percent of total billed charges,100% of total billed charges,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1955.7,61.85,,,percent of total billed charges,61.85% of total billed charges,464.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,603.94,130,,,Fee Schedule,130% of WA Medicaid ,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1192.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1192.07,37.7,,,percent of total billed charges,37.70% of total billed charges,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,107191.8,33.9,,,percent of total billed charges,33.9% of total billed charges,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2466.36,78,,,percent of total billed charges,78% of total billed charges,3162,100,,,percent of total billed charges,100% of total billed charges,2611.81,82.6,,,percent of total billed charges,82.6% of total billed charges,2611.81,82.6,,,percent of total billed charges,82.6% of total billed charges,464.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.74,107191.8,
TRANSPLANT PALM TENDON,26485,CDM,983,RC,26485,HCPCS,Outpatient,,,2190,1423.50,,1927.2,88,,,percent of total billed charges,88% of total Billed charges,64.69,100,,,Fee Schedule,100% of Medicare rate,492.92,100,,,Fee Schedule,100% of WA Medicaid,2190,100,,,percent of total billed charges,100% of total billed charges,507.71,103,,,Fee Schedule,103% of WA Medicaid,64.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,113.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,492.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1511.1,69,,,percent of total billed charges,69% of total billed charges,2190,100,,,percent of total billed charges,100% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2190,100,,,percent of total billed charges,100% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2190,100,,,percent of total billed charges,100% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1354.52,61.85,,,percent of total billed charges,61.85% of total billed charges,492.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,640.8,130,,,Fee Schedule,130% of WA Medicaid ,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,825.63,37.7,,,percent of total billed charges,37.70% of total billed charges,825.63,37.7,,,percent of total billed charges,37.70% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,74241,33.9,,,percent of total billed charges,33.9% of total billed charges,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1708.2,78,,,percent of total billed charges,78% of total billed charges,2190,100,,,percent of total billed charges,100% of total billed charges,1808.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1808.94,82.6,,,percent of total billed charges,82.6% of total billed charges,492.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.69,74241,
RELEASE KNUCKLE CONTRACTURE,26520,CDM,983,RC,26520,HCPCS,Outpatient,,,2389,1552.85,,2102.32,88,,,percent of total billed charges,88% of total Billed charges,48.1,100,,,Fee Schedule,100% of Medicare rate,404.52,100,,,Fee Schedule,100% of WA Medicaid,2389,100,,,percent of total billed charges,100% of total billed charges,416.66,103,,,Fee Schedule,103% of WA Medicaid,48.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,84.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,404.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1648.41,69,,,percent of total billed charges,69% of total billed charges,2389,100,,,percent of total billed charges,100% of total billed charges,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2389,100,,,percent of total billed charges,100% of total billed charges,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2389,100,,,percent of total billed charges,100% of total billed charges,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1477.6,61.85,,,percent of total billed charges,61.85% of total billed charges,404.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,525.88,130,,,Fee Schedule,130% of WA Medicaid ,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,900.65,37.7,,,percent of total billed charges,37.70% of total billed charges,900.65,37.7,,,percent of total billed charges,37.70% of total billed charges,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,80987.1,33.9,,,percent of total billed charges,33.9% of total billed charges,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1863.42,78,,,percent of total billed charges,78% of total billed charges,2389,100,,,percent of total billed charges,100% of total billed charges,1973.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1973.31,82.6,,,percent of total billed charges,82.6% of total billed charges,404.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.1,80987.1,
"ARTHROPLASTY, INTERPHALANG JOINT;EA",26535,CDM,983,RC,26535,HCPCS,Outpatient,,,983,638.95,,865.04,88,,,percent of total billed charges,88% of total Billed charges,39,100,,,Fee Schedule,100% of Medicare rate,258.68,100,,,Fee Schedule,100% of WA Medicaid,983,100,,,percent of total billed charges,100% of total billed charges,266.44,103,,,Fee Schedule,103% of WA Medicaid,39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,258.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,678.27,69,,,percent of total billed charges,69% of total billed charges,983,100,,,percent of total billed charges,100% of total billed charges,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,983,100,,,percent of total billed charges,100% of total billed charges,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,983,100,,,percent of total billed charges,100% of total billed charges,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,607.99,61.85,,,percent of total billed charges,61.85% of total billed charges,258.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,336.28,130,,,Fee Schedule,130% of WA Medicaid ,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.59,37.7,,,percent of total billed charges,37.70% of total billed charges,370.59,37.7,,,percent of total billed charges,37.70% of total billed charges,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,33323.7,33.9,,,percent of total billed charges,33.9% of total billed charges,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.74,78,,,percent of total billed charges,78% of total billed charges,983,100,,,percent of total billed charges,100% of total billed charges,811.96,82.6,,,percent of total billed charges,82.6% of total billed charges,811.96,82.6,,,percent of total billed charges,82.6% of total billed charges,258.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,39,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39,33323.7,
REPAIR HAND JOINT,26540,CDM,983,RC,26540,HCPCS,Outpatient,,,3341,2171.65,,2940.08,88,,,percent of total billed charges,88% of total Billed charges,54.03,100,,,Fee Schedule,100% of Medicare rate,412.91,100,,,Fee Schedule,100% of WA Medicaid,3341,100,,,percent of total billed charges,100% of total billed charges,425.3,103,,,Fee Schedule,103% of WA Medicaid,54.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,412.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2305.29,69,,,percent of total billed charges,69% of total billed charges,3341,100,,,percent of total billed charges,100% of total billed charges,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3341,100,,,percent of total billed charges,100% of total billed charges,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3341,100,,,percent of total billed charges,100% of total billed charges,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2066.41,61.85,,,percent of total billed charges,61.85% of total billed charges,412.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,536.78,130,,,Fee Schedule,130% of WA Medicaid ,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259.56,37.7,,,percent of total billed charges,37.70% of total billed charges,1259.56,37.7,,,percent of total billed charges,37.70% of total billed charges,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,113259.9,33.9,,,percent of total billed charges,33.9% of total billed charges,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2605.98,78,,,percent of total billed charges,78% of total billed charges,3341,100,,,percent of total billed charges,100% of total billed charges,2759.67,82.6,,,percent of total billed charges,82.6% of total billed charges,2759.67,82.6,,,percent of total billed charges,82.6% of total billed charges,412.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.03,113259.9,
CORRECT FINGER DEFORMITY,26567,CDM,983,RC,26567,HCPCS,Outpatient,,,2091,1359.15,,1840.08,88,,,percent of total billed charges,88% of total Billed charges,56.44,100,,,Fee Schedule,100% of Medicare rate,424.29,100,,,Fee Schedule,100% of WA Medicaid,2091,100,,,percent of total billed charges,100% of total billed charges,437.02,103,,,Fee Schedule,103% of WA Medicaid,56.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,98.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,424.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1442.79,69,,,percent of total billed charges,69% of total billed charges,2091,100,,,percent of total billed charges,100% of total billed charges,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2091,100,,,percent of total billed charges,100% of total billed charges,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2091,100,,,percent of total billed charges,100% of total billed charges,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1293.28,61.85,,,percent of total billed charges,61.85% of total billed charges,424.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,551.58,130,,,Fee Schedule,130% of WA Medicaid ,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,788.31,37.7,,,percent of total billed charges,37.70% of total billed charges,788.31,37.7,,,percent of total billed charges,37.70% of total billed charges,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,70884.9,33.9,,,percent of total billed charges,33.9% of total billed charges,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1630.98,78,,,percent of total billed charges,78% of total billed charges,2091,100,,,percent of total billed charges,100% of total billed charges,1727.17,82.6,,,percent of total billed charges,82.6% of total billed charges,1727.17,82.6,,,percent of total billed charges,82.6% of total billed charges,424.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,57,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.44,70884.9,
CORRECT METACARPAL FLAW,26565,CDM,983,RC,26565,HCPCS,Outpatient,,,2734,1777.10,,2405.92,88,,,percent of total billed charges,88% of total Billed charges,55.65,100,,,Fee Schedule,100% of Medicare rate,419.25,100,,,Fee Schedule,100% of WA Medicaid,2734,100,,,percent of total billed charges,100% of total billed charges,431.83,103,,,Fee Schedule,103% of WA Medicaid,55.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,419.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1886.46,69,,,percent of total billed charges,69% of total billed charges,2734,100,,,percent of total billed charges,100% of total billed charges,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2734,100,,,percent of total billed charges,100% of total billed charges,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2734,100,,,percent of total billed charges,100% of total billed charges,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1690.98,61.85,,,percent of total billed charges,61.85% of total billed charges,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,545.03,130,,,Fee Schedule,130% of WA Medicaid ,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1030.72,37.7,,,percent of total billed charges,37.70% of total billed charges,1030.72,37.7,,,percent of total billed charges,37.70% of total billed charges,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,92682.6,33.9,,,percent of total billed charges,33.9% of total billed charges,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2132.52,78,,,percent of total billed charges,78% of total billed charges,2734,100,,,percent of total billed charges,100% of total billed charges,2258.28,82.6,,,percent of total billed charges,82.6% of total billed charges,2258.28,82.6,,,percent of total billed charges,82.6% of total billed charges,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.65,92682.6,
TREAT FX METACARPAL,26600,CDM,983,RC,26600,HCPCS,Outpatient,,,517,336.05,,454.96,88,,,percent of total billed charges,88% of total Billed charges,22.14,100,,,Fee Schedule,100% of Medicare rate,175.5,100,,,Fee Schedule,100% of WA Medicaid,517,100,,,percent of total billed charges,100% of total billed charges,180.77,103,,,Fee Schedule,103% of WA Medicaid,22.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,175.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,356.73,69,,,percent of total billed charges,69% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,517,100,,,percent of total billed charges,100% of total billed charges,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,517,100,,,percent of total billed charges,100% of total billed charges,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.76,61.85,,,percent of total billed charges,61.85% of total billed charges,175.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,228.15,130,,,Fee Schedule,130% of WA Medicaid ,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,17526.3,33.9,,,percent of total billed charges,33.9% of total billed charges,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.26,78,,,percent of total billed charges,78% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,175.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.14,17526.3,
TREAT METACARPAL FRACTURE,26605,CDM,983,RC,26605,HCPCS,Outpatient,,,778,505.70,,684.64,88,,,percent of total billed charges,88% of total Billed charges,24.74,100,,,Fee Schedule,100% of Medicare rate,180.35,100,,,Fee Schedule,100% of WA Medicaid,778,100,,,percent of total billed charges,100% of total billed charges,185.76,103,,,Fee Schedule,103% of WA Medicaid,24.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,180.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,536.82,69,,,percent of total billed charges,69% of total billed charges,778,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,778,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,778,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.19,61.85,,,percent of total billed charges,61.85% of total billed charges,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,234.46,130,,,Fee Schedule,130% of WA Medicaid ,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.31,37.7,,,percent of total billed charges,37.70% of total billed charges,293.31,37.7,,,percent of total billed charges,37.70% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,26374.2,33.9,,,percent of total billed charges,33.9% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.84,78,,,percent of total billed charges,78% of total billed charges,778,100,,,percent of total billed charges,100% of total billed charges,642.63,82.6,,,percent of total billed charges,82.6% of total billed charges,642.63,82.6,,,percent of total billed charges,82.6% of total billed charges,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.74,26374.2,
TREAT METACARPAL FRACTURE,26607,CDM,983,RC,26607,HCPCS,Outpatient,,,1297,843.05,,1141.36,88,,,percent of total billed charges,88% of total Billed charges,45.57,100,,,Fee Schedule,100% of Medicare rate,300.27,100,,,Fee Schedule,100% of WA Medicaid,1297,100,,,percent of total billed charges,100% of total billed charges,309.28,103,,,Fee Schedule,103% of WA Medicaid,45.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,300.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,894.93,69,,,percent of total billed charges,69% of total billed charges,1297,100,,,percent of total billed charges,100% of total billed charges,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1297,100,,,percent of total billed charges,100% of total billed charges,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1297,100,,,percent of total billed charges,100% of total billed charges,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,802.19,61.85,,,percent of total billed charges,61.85% of total billed charges,300.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,390.35,130,,,Fee Schedule,130% of WA Medicaid ,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.97,37.7,,,percent of total billed charges,37.70% of total billed charges,488.97,37.7,,,percent of total billed charges,37.70% of total billed charges,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,43968.3,33.9,,,percent of total billed charges,33.9% of total billed charges,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1011.66,78,,,percent of total billed charges,78% of total billed charges,1297,100,,,percent of total billed charges,100% of total billed charges,1071.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1071.32,82.6,,,percent of total billed charges,82.6% of total billed charges,300.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.57,43968.3,
TREAT METACARPAL FRACTURE,26608,CDM,983,RC,26608,HCPCS,Outpatient,,,1458,947.70,,1283.04,88,,,percent of total billed charges,88% of total Billed charges,43.25,100,,,Fee Schedule,100% of Medicare rate,285.72,100,,,Fee Schedule,100% of WA Medicaid,1458,100,,,percent of total billed charges,100% of total billed charges,294.29,103,,,Fee Schedule,103% of WA Medicaid,43.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,285.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1006.02,69,,,percent of total billed charges,69% of total billed charges,1458,100,,,percent of total billed charges,100% of total billed charges,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1458,100,,,percent of total billed charges,100% of total billed charges,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1458,100,,,percent of total billed charges,100% of total billed charges,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,901.77,61.85,,,percent of total billed charges,61.85% of total billed charges,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,371.44,130,,,Fee Schedule,130% of WA Medicaid ,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.67,37.7,,,percent of total billed charges,37.70% of total billed charges,549.67,37.7,,,percent of total billed charges,37.70% of total billed charges,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,49426.2,33.9,,,percent of total billed charges,33.9% of total billed charges,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1137.24,78,,,percent of total billed charges,78% of total billed charges,1458,100,,,percent of total billed charges,100% of total billed charges,1204.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1204.31,82.6,,,percent of total billed charges,82.6% of total billed charges,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.25,49426.2,
TREAT METACARPAL FRACTURE,26615,CDM,983,RC,26615,HCPCS,Outpatient,,,1589,1032.85,,1398.32,88,,,percent of total billed charges,88% of total Billed charges,52.78,100,,,Fee Schedule,100% of Medicare rate,338.5,100,,,Fee Schedule,100% of WA Medicaid,1589,100,,,percent of total billed charges,100% of total billed charges,348.66,103,,,Fee Schedule,103% of WA Medicaid,52.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,338.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1096.41,69,,,percent of total billed charges,69% of total billed charges,1589,100,,,percent of total billed charges,100% of total billed charges,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1589,100,,,percent of total billed charges,100% of total billed charges,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1589,100,,,percent of total billed charges,100% of total billed charges,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,982.8,61.85,,,percent of total billed charges,61.85% of total billed charges,338.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.05,130,,,Fee Schedule,130% of WA Medicaid ,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.05,37.7,,,percent of total billed charges,37.70% of total billed charges,599.05,37.7,,,percent of total billed charges,37.70% of total billed charges,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,53867.1,33.9,,,percent of total billed charges,33.9% of total billed charges,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1239.42,78,,,percent of total billed charges,78% of total billed charges,1589,100,,,percent of total billed charges,100% of total billed charges,1312.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1312.51,82.6,,,percent of total billed charges,82.6% of total billed charges,338.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.78,53867.1,
TREAT THUMB FRACTURE,26645,CDM,983,RC,26645,HCPCS,Outpatient,,,1091,709.15,,960.08,88,,,percent of total billed charges,88% of total Billed charges,37.04,100,,,Fee Schedule,100% of Medicare rate,236.3,100,,,Fee Schedule,100% of WA Medicaid,1091,100,,,percent of total billed charges,100% of total billed charges,243.39,103,,,Fee Schedule,103% of WA Medicaid,37.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,236.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,752.79,69,,,percent of total billed charges,69% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1091,100,,,percent of total billed charges,100% of total billed charges,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1091,100,,,percent of total billed charges,100% of total billed charges,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.78,61.85,,,percent of total billed charges,61.85% of total billed charges,236.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,307.19,130,,,Fee Schedule,130% of WA Medicaid ,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,36984.9,33.9,,,percent of total billed charges,33.9% of total billed charges,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,850.98,78,,,percent of total billed charges,78% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,236.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.04,36984.9,
TREAT THUMB DISLOCATION,26641,CDM,983,RC,26641,HCPCS,Outpatient,,,830,539.50,,730.4,88,,,percent of total billed charges,88% of total Billed charges,34.35,100,,,Fee Schedule,100% of Medicare rate,229.95,100,,,Fee Schedule,100% of WA Medicaid,830,100,,,percent of total billed charges,100% of total billed charges,236.85,103,,,Fee Schedule,103% of WA Medicaid,34.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,229.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,572.7,69,,,percent of total billed charges,69% of total billed charges,830,100,,,percent of total billed charges,100% of total billed charges,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,830,100,,,percent of total billed charges,100% of total billed charges,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,830,100,,,percent of total billed charges,100% of total billed charges,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.36,61.85,,,percent of total billed charges,61.85% of total billed charges,229.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.94,130,,,Fee Schedule,130% of WA Medicaid ,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.91,37.7,,,percent of total billed charges,37.70% of total billed charges,312.91,37.7,,,percent of total billed charges,37.70% of total billed charges,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,28137,33.9,,,percent of total billed charges,33.9% of total billed charges,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.4,78,,,percent of total billed charges,78% of total billed charges,830,100,,,percent of total billed charges,100% of total billed charges,685.58,82.6,,,percent of total billed charges,82.6% of total billed charges,685.58,82.6,,,percent of total billed charges,82.6% of total billed charges,229.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.35,28137,
TREAT THUMB FRACTURE,26665,CDM,983,RC,26665,HCPCS,Outpatient,,,2327,1512.55,,2047.76,88,,,percent of total billed charges,88% of total Billed charges,54.6,100,,,Fee Schedule,100% of Medicare rate,368.15,100,,,Fee Schedule,100% of WA Medicaid,2327,100,,,percent of total billed charges,100% of total billed charges,379.19,103,,,Fee Schedule,103% of WA Medicaid,54.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,368.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1605.63,69,,,percent of total billed charges,69% of total billed charges,2327,100,,,percent of total billed charges,100% of total billed charges,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,2327,100,,,percent of total billed charges,100% of total billed charges,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,2327,100,,,percent of total billed charges,100% of total billed charges,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1439.25,61.85,,,percent of total billed charges,61.85% of total billed charges,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,478.6,130,,,Fee Schedule,130% of WA Medicaid ,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,877.28,37.7,,,percent of total billed charges,37.70% of total billed charges,877.28,37.7,,,percent of total billed charges,37.70% of total billed charges,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,78885.3,33.9,,,percent of total billed charges,33.9% of total billed charges,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1815.06,78,,,percent of total billed charges,78% of total billed charges,2327,100,,,percent of total billed charges,100% of total billed charges,1922.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1922.1,82.6,,,percent of total billed charges,82.6% of total billed charges,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.6,78885.3,
TREAT HAND DISLOCATION,26675,CDM,983,RC,26675,HCPCS,Outpatient,,,1358,882.70,,1195.04,88,,,percent of total billed charges,88% of total Billed charges,39.44,100,,,Fee Schedule,100% of Medicare rate,252.52,100,,,Fee Schedule,100% of WA Medicaid,1358,100,,,percent of total billed charges,100% of total billed charges,260.1,103,,,Fee Schedule,103% of WA Medicaid,39.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,252.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,937.02,69,,,percent of total billed charges,69% of total billed charges,1358,100,,,percent of total billed charges,100% of total billed charges,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1358,100,,,percent of total billed charges,100% of total billed charges,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1358,100,,,percent of total billed charges,100% of total billed charges,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,839.92,61.85,,,percent of total billed charges,61.85% of total billed charges,252.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,328.28,130,,,Fee Schedule,130% of WA Medicaid ,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,511.97,37.7,,,percent of total billed charges,37.70% of total billed charges,511.97,37.7,,,percent of total billed charges,37.70% of total billed charges,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,46036.2,33.9,,,percent of total billed charges,33.9% of total billed charges,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1059.24,78,,,percent of total billed charges,78% of total billed charges,1358,100,,,percent of total billed charges,100% of total billed charges,1121.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1121.71,82.6,,,percent of total billed charges,82.6% of total billed charges,252.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.44,46036.2,
TREATMENT OF HAND DISLOCATION,26686,CDM,983,RC,26686,HCPCS,Outpatient,,,895,581.75,,787.6,88,,,percent of total billed charges,88% of total Billed charges,62.67,100,,,Fee Schedule,100% of Medicare rate,363.3,100,,,Fee Schedule,100% of WA Medicaid,895,100,,,percent of total billed charges,100% of total billed charges,374.2,103,,,Fee Schedule,103% of WA Medicaid,62.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,363.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,617.55,69,,,percent of total billed charges,69% of total billed charges,895,100,,,percent of total billed charges,100% of total billed charges,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,895,100,,,percent of total billed charges,100% of total billed charges,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,895,100,,,percent of total billed charges,100% of total billed charges,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.56,61.85,,,percent of total billed charges,61.85% of total billed charges,363.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,472.29,130,,,Fee Schedule,130% of WA Medicaid ,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.42,37.7,,,percent of total billed charges,37.70% of total billed charges,337.42,37.7,,,percent of total billed charges,37.70% of total billed charges,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,30340.5,33.9,,,percent of total billed charges,33.9% of total billed charges,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.1,78,,,percent of total billed charges,78% of total billed charges,895,100,,,percent of total billed charges,100% of total billed charges,739.27,82.6,,,percent of total billed charges,82.6% of total billed charges,739.27,82.6,,,percent of total billed charges,82.6% of total billed charges,363.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.67,30340.5,
TREAT HAND DISLOCATION,26685,CDM,983,RC,26685,HCPCS,Outpatient,,,1764,1146.60,,1552.32,88,,,percent of total billed charges,88% of total Billed charges,49.46,100,,,Fee Schedule,100% of Medicare rate,339.62,100,,,Fee Schedule,100% of WA Medicaid,1764,100,,,percent of total billed charges,100% of total billed charges,349.81,103,,,Fee Schedule,103% of WA Medicaid,49.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,339.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1217.16,69,,,percent of total billed charges,69% of total billed charges,1764,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1764,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1764,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1091.03,61.85,,,percent of total billed charges,61.85% of total billed charges,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,441.51,130,,,Fee Schedule,130% of WA Medicaid ,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,665.03,37.7,,,percent of total billed charges,37.70% of total billed charges,665.03,37.7,,,percent of total billed charges,37.70% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,59799.6,33.9,,,percent of total billed charges,33.9% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1375.92,78,,,percent of total billed charges,78% of total billed charges,1764,100,,,percent of total billed charges,100% of total billed charges,1457.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1457.06,82.6,,,percent of total billed charges,82.6% of total billed charges,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.46,59799.6,
TREAT KNUCKLE DISLOCATION,26700,CDM,983,RC,26700,HCPCS,Outpatient,,,522,339.30,,459.36,88,,,percent of total billed charges,88% of total Billed charges,29.59,100,,,Fee Schedule,100% of Medicare rate,188.18,100,,,Fee Schedule,100% of WA Medicaid,522,100,,,percent of total billed charges,100% of total billed charges,193.83,103,,,Fee Schedule,103% of WA Medicaid,29.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,188.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,360.18,69,,,percent of total billed charges,69% of total billed charges,522,100,,,percent of total billed charges,100% of total billed charges,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,522,100,,,percent of total billed charges,100% of total billed charges,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,522,100,,,percent of total billed charges,100% of total billed charges,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.86,61.85,,,percent of total billed charges,61.85% of total billed charges,188.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,244.63,130,,,Fee Schedule,130% of WA Medicaid ,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.79,37.7,,,percent of total billed charges,37.70% of total billed charges,196.79,37.7,,,percent of total billed charges,37.70% of total billed charges,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,17695.8,33.9,,,percent of total billed charges,33.9% of total billed charges,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.16,78,,,percent of total billed charges,78% of total billed charges,522,100,,,percent of total billed charges,100% of total billed charges,431.17,82.6,,,percent of total billed charges,82.6% of total billed charges,431.17,82.6,,,percent of total billed charges,82.6% of total billed charges,188.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.59,17695.8,
TREAT KNUCKLE DISLOCATION,26705,CDM,983,RC,26705,HCPCS,Outpatient,,,913,593.45,,803.44,88,,,percent of total billed charges,88% of total Billed charges,36.08,100,,,Fee Schedule,100% of Medicare rate,237.97,100,,,Fee Schedule,100% of WA Medicaid,913,100,,,percent of total billed charges,100% of total billed charges,245.11,103,,,Fee Schedule,103% of WA Medicaid,36.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,237.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,629.97,69,,,percent of total billed charges,69% of total billed charges,913,100,,,percent of total billed charges,100% of total billed charges,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,913,100,,,percent of total billed charges,100% of total billed charges,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,913,100,,,percent of total billed charges,100% of total billed charges,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.69,61.85,,,percent of total billed charges,61.85% of total billed charges,237.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,309.36,130,,,Fee Schedule,130% of WA Medicaid ,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.2,37.7,,,percent of total billed charges,37.70% of total billed charges,344.2,37.7,,,percent of total billed charges,37.70% of total billed charges,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,30950.7,33.9,,,percent of total billed charges,33.9% of total billed charges,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.14,78,,,percent of total billed charges,78% of total billed charges,913,100,,,percent of total billed charges,100% of total billed charges,754.14,82.6,,,percent of total billed charges,82.6% of total billed charges,754.14,82.6,,,percent of total billed charges,82.6% of total billed charges,237.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.08,30950.7,
TREAT KNUCKLE DISLOCATION,26715,CDM,983,RC,26715,HCPCS,Outpatient,,,1299,844.35,,1143.12,88,,,percent of total billed charges,88% of total Billed charges,52.72,100,,,Fee Schedule,100% of Medicare rate,337.38,100,,,Fee Schedule,100% of WA Medicaid,1299,100,,,percent of total billed charges,100% of total billed charges,347.5,103,,,Fee Schedule,103% of WA Medicaid,52.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,337.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,896.31,69,,,percent of total billed charges,69% of total billed charges,1299,100,,,percent of total billed charges,100% of total billed charges,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1299,100,,,percent of total billed charges,100% of total billed charges,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1299,100,,,percent of total billed charges,100% of total billed charges,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,803.43,61.85,,,percent of total billed charges,61.85% of total billed charges,337.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,438.59,130,,,Fee Schedule,130% of WA Medicaid ,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.72,37.7,,,percent of total billed charges,37.70% of total billed charges,489.72,37.7,,,percent of total billed charges,37.70% of total billed charges,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,44036.1,33.9,,,percent of total billed charges,33.9% of total billed charges,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1013.22,78,,,percent of total billed charges,78% of total billed charges,1299,100,,,percent of total billed charges,100% of total billed charges,1072.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1072.97,82.6,,,percent of total billed charges,82.6% of total billed charges,337.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.72,44036.1,
TREAT FINGER FRACTURE EACH,26725,CDM,983,RC,26725,HCPCS,Outpatient,,,662,430.30,,582.56,88,,,percent of total billed charges,88% of total Billed charges,27.52,100,,,Fee Schedule,100% of Medicare rate,183.52,100,,,Fee Schedule,100% of WA Medicaid,662,100,,,percent of total billed charges,100% of total billed charges,189.03,103,,,Fee Schedule,103% of WA Medicaid,27.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,183.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,456.78,69,,,percent of total billed charges,69% of total billed charges,662,100,,,percent of total billed charges,100% of total billed charges,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,662,100,,,percent of total billed charges,100% of total billed charges,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,662,100,,,percent of total billed charges,100% of total billed charges,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.45,61.85,,,percent of total billed charges,61.85% of total billed charges,183.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,238.58,130,,,Fee Schedule,130% of WA Medicaid ,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.57,37.7,,,percent of total billed charges,37.70% of total billed charges,249.57,37.7,,,percent of total billed charges,37.70% of total billed charges,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,22441.8,33.9,,,percent of total billed charges,33.9% of total billed charges,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.36,78,,,percent of total billed charges,78% of total billed charges,662,100,,,percent of total billed charges,100% of total billed charges,546.81,82.6,,,percent of total billed charges,82.6% of total billed charges,546.81,82.6,,,percent of total billed charges,82.6% of total billed charges,183.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.52,22441.8,
TREAT FINGER FRACTURE EACH,26727,CDM,983,RC,26727,HCPCS,Outpatient,,,1595,1036.75,,1403.6,88,,,percent of total billed charges,88% of total Billed charges,42.01,100,,,Fee Schedule,100% of Medicare rate,281.8,100,,,Fee Schedule,100% of WA Medicaid,1595,100,,,percent of total billed charges,100% of total billed charges,290.25,103,,,Fee Schedule,103% of WA Medicaid,42.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,281.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1100.55,69,,,percent of total billed charges,69% of total billed charges,1595,100,,,percent of total billed charges,100% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1595,100,,,percent of total billed charges,100% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1595,100,,,percent of total billed charges,100% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,986.51,61.85,,,percent of total billed charges,61.85% of total billed charges,281.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,366.34,130,,,Fee Schedule,130% of WA Medicaid ,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,601.32,37.7,,,percent of total billed charges,37.70% of total billed charges,601.32,37.7,,,percent of total billed charges,37.70% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,54070.5,33.9,,,percent of total billed charges,33.9% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1244.1,78,,,percent of total billed charges,78% of total billed charges,1595,100,,,percent of total billed charges,100% of total billed charges,1317.47,82.6,,,percent of total billed charges,82.6% of total billed charges,1317.47,82.6,,,percent of total billed charges,82.6% of total billed charges,281.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.01,54070.5,
TREAT FX P1 OR P2 NONOP,26720,CDM,983,RC,26720,HCPCS,Outpatient,,,510,331.50,,448.8,88,,,percent of total billed charges,88% of total Billed charges,15.14,100,,,Fee Schedule,100% of Medicare rate,116,100,,,Fee Schedule,100% of WA Medicaid,510,100,,,percent of total billed charges,100% of total billed charges,119.48,103,,,Fee Schedule,103% of WA Medicaid,15.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,116,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,351.9,69,,,percent of total billed charges,69% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,510,100,,,percent of total billed charges,100% of total billed charges,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,510,100,,,percent of total billed charges,100% of total billed charges,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.44,61.85,,,percent of total billed charges,61.85% of total billed charges,116,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,116,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,150.8,130,,,Fee Schedule,130% of WA Medicaid ,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,17289,33.9,,,percent of total billed charges,33.9% of total billed charges,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.8,78,,,percent of total billed charges,78% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,116,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,116,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.14,17289,
TREAT FINGER FRACTURE EACH,26735,CDM,983,RC,26735,HCPCS,Outpatient,,,1988,1292.20,,1749.44,88,,,percent of total billed charges,88% of total Billed charges,55.44,100,,,Fee Schedule,100% of Medicare rate,349.5,100,,,Fee Schedule,100% of WA Medicaid,1988,100,,,percent of total billed charges,100% of total billed charges,359.99,103,,,Fee Schedule,103% of WA Medicaid,55.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,349.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1371.72,69,,,percent of total billed charges,69% of total billed charges,1988,100,,,percent of total billed charges,100% of total billed charges,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1988,100,,,percent of total billed charges,100% of total billed charges,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1988,100,,,percent of total billed charges,100% of total billed charges,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1229.58,61.85,,,percent of total billed charges,61.85% of total billed charges,349.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,454.35,130,,,Fee Schedule,130% of WA Medicaid ,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,749.48,37.7,,,percent of total billed charges,37.70% of total billed charges,749.48,37.7,,,percent of total billed charges,37.70% of total billed charges,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,67393.2,33.9,,,percent of total billed charges,33.9% of total billed charges,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1550.64,78,,,percent of total billed charges,78% of total billed charges,1988,100,,,percent of total billed charges,100% of total billed charges,1642.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1642.09,82.6,,,percent of total billed charges,82.6% of total billed charges,349.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.44,67393.2,
FX TX MC OR INTERPHALANGEAL JT NO MANIPU,26740,CDM,983,RC,26740,HCPCS,Outpatient,,,546,354.90,,480.48,88,,,percent of total billed charges,88% of total Billed charges,17.17,100,,,Fee Schedule,100% of Medicare rate,134.84,100,,,Fee Schedule,100% of WA Medicaid,546,100,,,percent of total billed charges,100% of total billed charges,138.89,103,,,Fee Schedule,103% of WA Medicaid,17.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,134.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,376.74,69,,,percent of total billed charges,69% of total billed charges,546,100,,,percent of total billed charges,100% of total billed charges,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,546,100,,,percent of total billed charges,100% of total billed charges,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,546,100,,,percent of total billed charges,100% of total billed charges,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.7,61.85,,,percent of total billed charges,61.85% of total billed charges,134.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,175.29,130,,,Fee Schedule,130% of WA Medicaid ,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.84,37.7,,,percent of total billed charges,37.70% of total billed charges,205.84,37.7,,,percent of total billed charges,37.70% of total billed charges,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,18509.4,33.9,,,percent of total billed charges,33.9% of total billed charges,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.88,78,,,percent of total billed charges,78% of total billed charges,546,100,,,percent of total billed charges,100% of total billed charges,451,82.6,,,percent of total billed charges,82.6% of total billed charges,451,82.6,,,percent of total billed charges,82.6% of total billed charges,134.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.17,18509.4,
TREAT FINGER FRACTURE EACH,26742,CDM,983,RC,26742,HCPCS,Outpatient,,,1159,753.35,,1019.92,88,,,percent of total billed charges,88% of total Billed charges,30.76,100,,,Fee Schedule,100% of Medicare rate,200.86,100,,,Fee Schedule,100% of WA Medicaid,1159,100,,,percent of total billed charges,100% of total billed charges,206.89,103,,,Fee Schedule,103% of WA Medicaid,30.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,799.71,69,,,percent of total billed charges,69% of total billed charges,1159,100,,,percent of total billed charges,100% of total billed charges,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1159,100,,,percent of total billed charges,100% of total billed charges,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1159,100,,,percent of total billed charges,100% of total billed charges,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,716.84,61.85,,,percent of total billed charges,61.85% of total billed charges,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,261.12,130,,,Fee Schedule,130% of WA Medicaid ,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.94,37.7,,,percent of total billed charges,37.70% of total billed charges,436.94,37.7,,,percent of total billed charges,37.70% of total billed charges,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,39290.1,33.9,,,percent of total billed charges,33.9% of total billed charges,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.02,78,,,percent of total billed charges,78% of total billed charges,1159,100,,,percent of total billed charges,100% of total billed charges,957.33,82.6,,,percent of total billed charges,82.6% of total billed charges,957.33,82.6,,,percent of total billed charges,82.6% of total billed charges,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.76,39290.1,
TREAT FINGER FRACTURE EACH,26746,CDM,983,RC,26746,HCPCS,Outpatient,,,2231,1450.15,,1963.28,88,,,percent of total billed charges,88% of total Billed charges,70.44,100,,,Fee Schedule,100% of Medicare rate,432.31,100,,,Fee Schedule,100% of WA Medicaid,2231,100,,,percent of total billed charges,100% of total billed charges,445.28,103,,,Fee Schedule,103% of WA Medicaid,70.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,123.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,432.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1539.39,69,,,percent of total billed charges,69% of total billed charges,2231,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2231,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2231,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1379.87,61.85,,,percent of total billed charges,61.85% of total billed charges,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562,130,,,Fee Schedule,130% of WA Medicaid ,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.09,37.7,,,percent of total billed charges,37.70% of total billed charges,841.09,37.7,,,percent of total billed charges,37.70% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,75630.9,33.9,,,percent of total billed charges,33.9% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1740.18,78,,,percent of total billed charges,78% of total billed charges,2231,100,,,percent of total billed charges,100% of total billed charges,1842.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1842.81,82.6,,,percent of total billed charges,82.6% of total billed charges,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.44,75630.9,
TREAT FINGER FRACTURE EACH,26755,CDM,983,RC,26755,HCPCS,Outpatient,,,519,337.35,,456.72,88,,,percent of total billed charges,88% of total Billed charges,25.25,100,,,Fee Schedule,100% of Medicare rate,164.87,100,,,Fee Schedule,100% of WA Medicaid,519,100,,,percent of total billed charges,100% of total billed charges,169.82,103,,,Fee Schedule,103% of WA Medicaid,25.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,164.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,358.11,69,,,percent of total billed charges,69% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,519,100,,,percent of total billed charges,100% of total billed charges,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,519,100,,,percent of total billed charges,100% of total billed charges,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,321,61.85,,,percent of total billed charges,61.85% of total billed charges,164.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,214.33,130,,,Fee Schedule,130% of WA Medicaid ,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,195.66,37.7,,,percent of total billed charges,37.70% of total billed charges,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,17594.1,33.9,,,percent of total billed charges,33.9% of total billed charges,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.82,78,,,percent of total billed charges,78% of total billed charges,519,100,,,percent of total billed charges,100% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,428.69,82.6,,,percent of total billed charges,82.6% of total billed charges,164.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.25,17594.1,
PIN FINGER FRACTURE EACH,26756,CDM,983,RC,26756,HCPCS,Outpatient,,,1385,900.25,,1218.8,88,,,percent of total billed charges,88% of total Billed charges,36.08,100,,,Fee Schedule,100% of Medicare rate,253.08,100,,,Fee Schedule,100% of WA Medicaid,1385,100,,,percent of total billed charges,100% of total billed charges,260.67,103,,,Fee Schedule,103% of WA Medicaid,36.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,253.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,955.65,69,,,percent of total billed charges,69% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385,100,,,percent of total billed charges,100% of total billed charges,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385,100,,,percent of total billed charges,100% of total billed charges,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,856.62,61.85,,,percent of total billed charges,61.85% of total billed charges,253.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,329,130,,,Fee Schedule,130% of WA Medicaid ,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,46951.5,33.9,,,percent of total billed charges,33.9% of total billed charges,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080.3,78,,,percent of total billed charges,78% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,253.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.08,46951.5,
TREAT FINGER FRACTURE EACH,26765,CDM,983,RC,26765,HCPCS,Outpatient,,,1052,683.80,,925.76,88,,,percent of total billed charges,88% of total Billed charges,44.94,100,,,Fee Schedule,100% of Medicare rate,298.03,100,,,Fee Schedule,100% of WA Medicaid,1052,100,,,percent of total billed charges,100% of total billed charges,306.97,103,,,Fee Schedule,103% of WA Medicaid,44.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,298.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,725.88,69,,,percent of total billed charges,69% of total billed charges,1052,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1052,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1052,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,650.66,61.85,,,percent of total billed charges,61.85% of total billed charges,298.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,387.44,130,,,Fee Schedule,130% of WA Medicaid ,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.6,37.7,,,percent of total billed charges,37.70% of total billed charges,396.6,37.7,,,percent of total billed charges,37.70% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,35662.8,33.9,,,percent of total billed charges,33.9% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,820.56,78,,,percent of total billed charges,78% of total billed charges,1052,100,,,percent of total billed charges,100% of total billed charges,868.95,82.6,,,percent of total billed charges,82.6% of total billed charges,868.95,82.6,,,percent of total billed charges,82.6% of total billed charges,298.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.94,35662.8,
TREAT FINGER DISLOCATION,26775,CDM,983,RC,26775,HCPCS,Outpatient,,,850,552.50,,748,88,,,percent of total billed charges,88% of total Billed charges,30.42,100,,,Fee Schedule,100% of Medicare rate,214.1,100,,,Fee Schedule,100% of WA Medicaid,850,100,,,percent of total billed charges,100% of total billed charges,220.52,103,,,Fee Schedule,103% of WA Medicaid,30.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,214.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,586.5,69,,,percent of total billed charges,69% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,850,100,,,percent of total billed charges,100% of total billed charges,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,850,100,,,percent of total billed charges,100% of total billed charges,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.73,61.85,,,percent of total billed charges,61.85% of total billed charges,214.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,278.33,130,,,Fee Schedule,130% of WA Medicaid ,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,28815,33.9,,,percent of total billed charges,33.9% of total billed charges,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,663,78,,,percent of total billed charges,78% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,214.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.42,28815,
PIN FINGER DISLOCATION,26776,CDM,983,RC,26776,HCPCS,Outpatient,,,1328,863.20,,1168.64,88,,,percent of total billed charges,88% of total Billed charges,38.92,100,,,Fee Schedule,100% of Medicare rate,267.63,100,,,Fee Schedule,100% of WA Medicaid,1328,100,,,percent of total billed charges,100% of total billed charges,275.66,103,,,Fee Schedule,103% of WA Medicaid,38.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,267.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,916.32,69,,,percent of total billed charges,69% of total billed charges,1328,100,,,percent of total billed charges,100% of total billed charges,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1328,100,,,percent of total billed charges,100% of total billed charges,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1328,100,,,percent of total billed charges,100% of total billed charges,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,821.37,61.85,,,percent of total billed charges,61.85% of total billed charges,267.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,347.92,130,,,Fee Schedule,130% of WA Medicaid ,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.66,37.7,,,percent of total billed charges,37.70% of total billed charges,500.66,37.7,,,percent of total billed charges,37.70% of total billed charges,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,45019.2,33.9,,,percent of total billed charges,33.9% of total billed charges,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035.84,78,,,percent of total billed charges,78% of total billed charges,1328,100,,,percent of total billed charges,100% of total billed charges,1096.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1096.93,82.6,,,percent of total billed charges,82.6% of total billed charges,267.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.92,45019.2,
TREAT FINGER DISLOCATION,26770,CDM,983,RC,26770,HCPCS,Outpatient,,,398,258.70,,350.24,88,,,percent of total billed charges,88% of total Billed charges,24.4,100,,,Fee Schedule,100% of Medicare rate,158.71,100,,,Fee Schedule,100% of WA Medicaid,398,100,,,percent of total billed charges,100% of total billed charges,163.47,103,,,Fee Schedule,103% of WA Medicaid,24.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,158.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,274.62,69,,,percent of total billed charges,69% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,398,100,,,percent of total billed charges,100% of total billed charges,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,398,100,,,percent of total billed charges,100% of total billed charges,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.16,61.85,,,percent of total billed charges,61.85% of total billed charges,158.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,206.32,130,,,Fee Schedule,130% of WA Medicaid ,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,13492.2,33.9,,,percent of total billed charges,33.9% of total billed charges,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.44,78,,,percent of total billed charges,78% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,158.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.4,13492.2,
"ARTHRODESIS,CARPOMETA JOINT, THUMB",26841,CDM,983,RC,26841,HCPCS,Outpatient,,,1714,1114.10,,1508.32,88,,,percent of total billed charges,88% of total Billed charges,61.28,100,,,Fee Schedule,100% of Medicare rate,457.48,100,,,Fee Schedule,100% of WA Medicaid,1714,100,,,percent of total billed charges,100% of total billed charges,471.2,103,,,Fee Schedule,103% of WA Medicaid,61.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,107.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,457.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1182.66,69,,,percent of total billed charges,69% of total billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1714,100,,,percent of total billed charges,100% of total billed charges,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1714,100,,,percent of total billed charges,100% of total billed charges,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1060.11,61.85,,,percent of total billed charges,61.85% of total billed charges,457.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,594.72,130,,,Fee Schedule,130% of WA Medicaid ,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.18,37.7,,,percent of total billed charges,37.70% of total billed charges,646.18,37.7,,,percent of total billed charges,37.70% of total billed charges,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,58104.6,33.9,,,percent of total billed charges,33.9% of total billed charges,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1336.92,78,,,percent of total billed charges,78% of total billed charges,1714,100,,,percent of total billed charges,100% of total billed charges,1415.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1415.76,82.6,,,percent of total billed charges,82.6% of total billed charges,457.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.28,58104.6,
FUSION OF KNUCKLE,26850,CDM,983,RC,26850,HCPCS,Outpatient,,,2582,1678.30,,2272.16,88,,,percent of total billed charges,88% of total Billed charges,57.42,100,,,Fee Schedule,100% of Medicare rate,433.24,100,,,Fee Schedule,100% of WA Medicaid,2582,100,,,percent of total billed charges,100% of total billed charges,446.24,103,,,Fee Schedule,103% of WA Medicaid,57.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,433.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1781.58,69,,,percent of total billed charges,69% of total billed charges,2582,100,,,percent of total billed charges,100% of total billed charges,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2582,100,,,percent of total billed charges,100% of total billed charges,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2582,100,,,percent of total billed charges,100% of total billed charges,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1596.97,61.85,,,percent of total billed charges,61.85% of total billed charges,433.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,563.21,130,,,Fee Schedule,130% of WA Medicaid ,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,973.41,37.7,,,percent of total billed charges,37.70% of total billed charges,973.41,37.7,,,percent of total billed charges,37.70% of total billed charges,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,87529.8,33.9,,,percent of total billed charges,33.9% of total billed charges,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2013.96,78,,,percent of total billed charges,78% of total billed charges,2582,100,,,percent of total billed charges,100% of total billed charges,2132.73,82.6,,,percent of total billed charges,82.6% of total billed charges,2132.73,82.6,,,percent of total billed charges,82.6% of total billed charges,433.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.42,87529.8,
FUSION OF FINGER JOINT,26860,CDM,983,RC,26860,HCPCS,Outpatient,,,2110,1371.50,,1856.8,88,,,percent of total billed charges,88% of total Billed charges,43.15,100,,,Fee Schedule,100% of Medicare rate,364.42,100,,,Fee Schedule,100% of WA Medicaid,2110,100,,,percent of total billed charges,100% of total billed charges,375.35,103,,,Fee Schedule,103% of WA Medicaid,43.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,364.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1455.9,69,,,percent of total billed charges,69% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2110,100,,,percent of total billed charges,100% of total billed charges,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2110,100,,,percent of total billed charges,100% of total billed charges,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1305.04,61.85,,,percent of total billed charges,61.85% of total billed charges,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,473.75,130,,,Fee Schedule,130% of WA Medicaid ,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,795.47,37.7,,,percent of total billed charges,37.70% of total billed charges,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,71529,33.9,,,percent of total billed charges,33.9% of total billed charges,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1645.8,78,,,percent of total billed charges,78% of total billed charges,2110,100,,,percent of total billed charges,100% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1742.86,82.6,,,percent of total billed charges,82.6% of total billed charges,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.15,71529,
AMPUTATE METACARPAL BONE,26910,CDM,983,RC,26910,HCPCS,Outpatient,,,1455,945.75,,1280.4,88,,,percent of total billed charges,88% of total Billed charges,62.87,100,,,Fee Schedule,100% of Medicare rate,447.6,100,,,Fee Schedule,100% of WA Medicaid,1455,100,,,percent of total billed charges,100% of total billed charges,461.03,103,,,Fee Schedule,103% of WA Medicaid,62.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,110.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,447.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1003.95,69,,,percent of total billed charges,69% of total billed charges,1455,100,,,percent of total billed charges,100% of total billed charges,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1455,100,,,percent of total billed charges,100% of total billed charges,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1455,100,,,percent of total billed charges,100% of total billed charges,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,899.92,61.85,,,percent of total billed charges,61.85% of total billed charges,447.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,581.88,130,,,Fee Schedule,130% of WA Medicaid ,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.54,37.7,,,percent of total billed charges,37.70% of total billed charges,548.54,37.7,,,percent of total billed charges,37.70% of total billed charges,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,49324.5,33.9,,,percent of total billed charges,33.9% of total billed charges,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1134.9,78,,,percent of total billed charges,78% of total billed charges,1455,100,,,percent of total billed charges,100% of total billed charges,1201.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1201.83,82.6,,,percent of total billed charges,82.6% of total billed charges,447.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.87,49324.5,
AMPUTATION OF FINGER/THUMB,26952,CDM,983,RC,26952,HCPCS,Outpatient,,,2273,1477.45,,2000.24,88,,,percent of total billed charges,88% of total Billed charges,53.02,100,,,Fee Schedule,100% of Medicare rate,403.59,100,,,Fee Schedule,100% of WA Medicaid,2273,100,,,percent of total billed charges,100% of total billed charges,415.7,103,,,Fee Schedule,103% of WA Medicaid,53.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,403.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1568.37,69,,,percent of total billed charges,69% of total billed charges,2273,100,,,percent of total billed charges,100% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2273,100,,,percent of total billed charges,100% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2273,100,,,percent of total billed charges,100% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1405.85,61.85,,,percent of total billed charges,61.85% of total billed charges,403.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,524.67,130,,,Fee Schedule,130% of WA Medicaid ,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,856.92,37.7,,,percent of total billed charges,37.70% of total billed charges,856.92,37.7,,,percent of total billed charges,37.70% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,77054.7,33.9,,,percent of total billed charges,33.9% of total billed charges,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1772.94,78,,,percent of total billed charges,78% of total billed charges,2273,100,,,percent of total billed charges,100% of total billed charges,1877.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1877.5,82.6,,,percent of total billed charges,82.6% of total billed charges,403.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.02,77054.7,
AMPUTATION OF FINGER/THUMB,26951,CDM,983,RC,26951,HCPCS,Outpatient,,,1303,846.95,,1146.64,88,,,percent of total billed charges,88% of total Billed charges,52.88,100,,,Fee Schedule,100% of Medicare rate,416.45,100,,,Fee Schedule,100% of WA Medicaid,1303,100,,,percent of total billed charges,100% of total billed charges,428.94,103,,,Fee Schedule,103% of WA Medicaid,52.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,416.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,899.07,69,,,percent of total billed charges,69% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1303,100,,,percent of total billed charges,100% of total billed charges,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1303,100,,,percent of total billed charges,100% of total billed charges,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,805.91,61.85,,,percent of total billed charges,61.85% of total billed charges,416.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,541.39,130,,,Fee Schedule,130% of WA Medicaid ,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,491.23,37.7,,,percent of total billed charges,37.70% of total billed charges,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,44171.7,33.9,,,percent of total billed charges,33.9% of total billed charges,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1016.34,78,,,percent of total billed charges,78% of total billed charges,1303,100,,,percent of total billed charges,100% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1076.28,82.6,,,percent of total billed charges,82.6% of total billed charges,416.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.88,44171.7,
DRAINAGE OF PELVIS LESION,26990,CDM,983,RC,26990,HCPCS,Outpatient,,,1926,1251.90,,1694.88,88,,,percent of total billed charges,88% of total Billed charges,64.66,100,,,Fee Schedule,100% of Medicare rate,396.87,100,,,Fee Schedule,100% of WA Medicaid,1926,100,,,percent of total billed charges,100% of total billed charges,408.78,103,,,Fee Schedule,103% of WA Medicaid,64.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,113.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,396.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1328.94,69,,,percent of total billed charges,69% of total billed charges,1926,100,,,percent of total billed charges,100% of total billed charges,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1926,100,,,percent of total billed charges,100% of total billed charges,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1926,100,,,percent of total billed charges,100% of total billed charges,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191.23,61.85,,,percent of total billed charges,61.85% of total billed charges,396.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,515.93,130,,,Fee Schedule,130% of WA Medicaid ,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.1,37.7,,,percent of total billed charges,37.70% of total billed charges,726.1,37.7,,,percent of total billed charges,37.70% of total billed charges,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,65291.4,33.9,,,percent of total billed charges,33.9% of total billed charges,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1502.28,78,,,percent of total billed charges,78% of total billed charges,1926,100,,,percent of total billed charges,100% of total billed charges,1590.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1590.88,82.6,,,percent of total billed charges,82.6% of total billed charges,396.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.66,65291.4,
DRAINAGE OF PELVIS BURSA,26991,CDM,983,RC,26991,HCPCS,Outpatient,,,1611,1047.15,,1417.68,88,,,percent of total billed charges,88% of total Billed charges,55,100,,,Fee Schedule,100% of Medicare rate,306.05,100,,,Fee Schedule,100% of WA Medicaid,1611,100,,,percent of total billed charges,100% of total billed charges,315.23,103,,,Fee Schedule,103% of WA Medicaid,55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,96.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,306.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1111.59,69,,,percent of total billed charges,69% of total billed charges,1611,100,,,percent of total billed charges,100% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1611,100,,,percent of total billed charges,100% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1611,100,,,percent of total billed charges,100% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,996.4,61.85,,,percent of total billed charges,61.85% of total billed charges,306.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,397.87,130,,,Fee Schedule,130% of WA Medicaid ,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,607.35,37.7,,,percent of total billed charges,37.70% of total billed charges,607.35,37.7,,,percent of total billed charges,37.70% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,54612.9,33.9,,,percent of total billed charges,33.9% of total billed charges,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1256.58,78,,,percent of total billed charges,78% of total billed charges,1611,100,,,percent of total billed charges,100% of total billed charges,1330.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1330.69,82.6,,,percent of total billed charges,82.6% of total billed charges,306.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,55,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55,54612.9,
DRAINAGE OF BONE LESION,26992,CDM,983,RC,26992,HCPCS,Outpatient,,,1813,1178.45,,1595.44,88,,,percent of total billed charges,88% of total Billed charges,102.53,100,,,Fee Schedule,100% of Medicare rate,583.56,100,,,Fee Schedule,100% of WA Medicaid,1813,100,,,percent of total billed charges,100% of total billed charges,601.07,103,,,Fee Schedule,103% of WA Medicaid,102.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,179.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,583.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1250.97,69,,,percent of total billed charges,69% of total billed charges,1813,100,,,percent of total billed charges,100% of total billed charges,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1813,100,,,percent of total billed charges,100% of total billed charges,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1813,100,,,percent of total billed charges,100% of total billed charges,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1121.34,61.85,,,percent of total billed charges,61.85% of total billed charges,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,595.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,758.63,130,,,Fee Schedule,130% of WA Medicaid ,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.5,37.7,,,percent of total billed charges,37.70% of total billed charges,683.5,37.7,,,percent of total billed charges,37.70% of total billed charges,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,61460.7,33.9,,,percent of total billed charges,33.9% of total billed charges,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1414.14,78,,,percent of total billed charges,78% of total billed charges,1813,100,,,percent of total billed charges,100% of total billed charges,1497.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1497.54,82.6,,,percent of total billed charges,82.6% of total billed charges,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,102.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,102.53,61460.7,
INCISION OF HIP TENDON,27001,CDM,983,RC,27001,HCPCS,Outpatient,,,987,641.55,,868.56,88,,,percent of total billed charges,88% of total Billed charges,54.66,100,,,Fee Schedule,100% of Medicare rate,314.44,100,,,Fee Schedule,100% of WA Medicaid,987,100,,,percent of total billed charges,100% of total billed charges,323.87,103,,,Fee Schedule,103% of WA Medicaid,54.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,314.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,681.03,69,,,percent of total billed charges,69% of total billed charges,987,100,,,percent of total billed charges,100% of total billed charges,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,987,100,,,percent of total billed charges,100% of total billed charges,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,987,100,,,percent of total billed charges,100% of total billed charges,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.46,61.85,,,percent of total billed charges,61.85% of total billed charges,314.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,408.77,130,,,Fee Schedule,130% of WA Medicaid ,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.1,37.7,,,percent of total billed charges,37.70% of total billed charges,372.1,37.7,,,percent of total billed charges,37.70% of total billed charges,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,33459.3,33.9,,,percent of total billed charges,33.9% of total billed charges,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,769.86,78,,,percent of total billed charges,78% of total billed charges,987,100,,,percent of total billed charges,100% of total billed charges,815.26,82.6,,,percent of total billed charges,82.6% of total billed charges,815.26,82.6,,,percent of total billed charges,82.6% of total billed charges,314.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.66,33459.3,
INCISION OF HIP/THIGH FASCIA,27025,CDM,983,RC,27025,HCPCS,Outpatient,,,2866,1862.90,,2522.08,88,,,percent of total billed charges,88% of total Billed charges,96.38,100,,,Fee Schedule,100% of Medicare rate,535.26,100,,,Fee Schedule,100% of WA Medicaid,2866,100,,,percent of total billed charges,100% of total billed charges,551.32,103,,,Fee Schedule,103% of WA Medicaid,96.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,168.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,535.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1977.54,69,,,percent of total billed charges,69% of total billed charges,2866,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2866,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2866,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1772.62,61.85,,,percent of total billed charges,61.85% of total billed charges,535.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,695.84,130,,,Fee Schedule,130% of WA Medicaid ,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080.48,37.7,,,percent of total billed charges,37.70% of total billed charges,1080.48,37.7,,,percent of total billed charges,37.70% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,97157.4,33.9,,,percent of total billed charges,33.9% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2235.48,78,,,percent of total billed charges,78% of total billed charges,2866,100,,,percent of total billed charges,100% of total billed charges,2367.32,82.6,,,percent of total billed charges,82.6% of total billed charges,2367.32,82.6,,,percent of total billed charges,82.6% of total billed charges,535.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.38,97157.4,
DRAINAGE OF HIP JOINT,27030,CDM,983,RC,27030,HCPCS,Outpatient,,,1472,956.80,,1295.36,88,,,percent of total billed charges,88% of total Billed charges,100.66,100,,,Fee Schedule,100% of Medicare rate,537.12,100,,,Fee Schedule,100% of WA Medicaid,1472,100,,,percent of total billed charges,100% of total billed charges,553.23,103,,,Fee Schedule,103% of WA Medicaid,100.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,176.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,537.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1015.68,69,,,percent of total billed charges,69% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1472,100,,,percent of total billed charges,100% of total billed charges,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1472,100,,,percent of total billed charges,100% of total billed charges,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,910.43,61.85,,,percent of total billed charges,61.85% of total billed charges,537.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,698.26,130,,,Fee Schedule,130% of WA Medicaid ,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,554.94,37.7,,,percent of total billed charges,37.70% of total billed charges,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,49900.8,33.9,,,percent of total billed charges,33.9% of total billed charges,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1148.16,78,,,percent of total billed charges,78% of total billed charges,1472,100,,,percent of total billed charges,100% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1215.87,82.6,,,percent of total billed charges,82.6% of total billed charges,537.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,100.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,100.66,49900.8,
BIOPSY OF SOFT TISSUES,27041,CDM,983,RC,27041,HCPCS,Outpatient,,,2749,1786.85,,2419.12,88,,,percent of total billed charges,88% of total Billed charges,73.62,100,,,Fee Schedule,100% of Medicare rate,408.06,100,,,Fee Schedule,100% of WA Medicaid,2749,100,,,percent of total billed charges,100% of total billed charges,420.3,103,,,Fee Schedule,103% of WA Medicaid,73.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,128.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,408.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1896.81,69,,,percent of total billed charges,69% of total billed charges,2749,100,,,percent of total billed charges,100% of total billed charges,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2749,100,,,percent of total billed charges,100% of total billed charges,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2749,100,,,percent of total billed charges,100% of total billed charges,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1700.26,61.85,,,percent of total billed charges,61.85% of total billed charges,408.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,530.48,130,,,Fee Schedule,130% of WA Medicaid ,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1036.37,37.7,,,percent of total billed charges,37.70% of total billed charges,1036.37,37.7,,,percent of total billed charges,37.70% of total billed charges,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,93191.1,33.9,,,percent of total billed charges,33.9% of total billed charges,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2144.22,78,,,percent of total billed charges,78% of total billed charges,2749,100,,,percent of total billed charges,100% of total billed charges,2270.67,82.6,,,percent of total billed charges,82.6% of total billed charges,2270.67,82.6,,,percent of total billed charges,82.6% of total billed charges,408.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.62,93191.1,
BIOPSY OF SACROILIAC JOINT,27050,CDM,983,RC,27050,HCPCS,Outpatient,,,1079,701.35,,949.52,88,,,percent of total billed charges,88% of total Billed charges,38,100,,,Fee Schedule,100% of Medicare rate,239.84,100,,,Fee Schedule,100% of WA Medicaid,1079,100,,,percent of total billed charges,100% of total billed charges,247.04,103,,,Fee Schedule,103% of WA Medicaid,38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,239.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,744.51,69,,,percent of total billed charges,69% of total billed charges,1079,100,,,percent of total billed charges,100% of total billed charges,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079,100,,,percent of total billed charges,100% of total billed charges,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079,100,,,percent of total billed charges,100% of total billed charges,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.36,61.85,,,percent of total billed charges,61.85% of total billed charges,239.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,311.79,130,,,Fee Schedule,130% of WA Medicaid ,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.78,37.7,,,percent of total billed charges,37.70% of total billed charges,406.78,37.7,,,percent of total billed charges,37.70% of total billed charges,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,36578.1,33.9,,,percent of total billed charges,33.9% of total billed charges,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.62,78,,,percent of total billed charges,78% of total billed charges,1079,100,,,percent of total billed charges,100% of total billed charges,891.25,82.6,,,percent of total billed charges,82.6% of total billed charges,891.25,82.6,,,percent of total billed charges,82.6% of total billed charges,239.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,38,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38,36578.1,
BIOPSY OF HIP JOINT,27052,CDM,983,RC,27052,HCPCS,Outpatient,,,1782,1158.30,,1568.16,88,,,percent of total billed charges,88% of total Billed charges,57.48,100,,,Fee Schedule,100% of Medicare rate,338.68,100,,,Fee Schedule,100% of WA Medicaid,1782,100,,,percent of total billed charges,100% of total billed charges,348.84,103,,,Fee Schedule,103% of WA Medicaid,57.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,338.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1229.58,69,,,percent of total billed charges,69% of total billed charges,1782,100,,,percent of total billed charges,100% of total billed charges,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1782,100,,,percent of total billed charges,100% of total billed charges,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1782,100,,,percent of total billed charges,100% of total billed charges,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1102.17,61.85,,,percent of total billed charges,61.85% of total billed charges,338.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.28,130,,,Fee Schedule,130% of WA Medicaid ,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.81,37.7,,,percent of total billed charges,37.70% of total billed charges,671.81,37.7,,,percent of total billed charges,37.70% of total billed charges,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,60409.8,33.9,,,percent of total billed charges,33.9% of total billed charges,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1389.96,78,,,percent of total billed charges,78% of total billed charges,1782,100,,,percent of total billed charges,100% of total billed charges,1471.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1471.93,82.6,,,percent of total billed charges,82.6% of total billed charges,338.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.48,60409.8,
REMOVE HIP BONE LES SUPER,27065,CDM,983,RC,27065,HCPCS,Outpatient,,,1588,1032.20,,1397.44,88,,,percent of total billed charges,88% of total Billed charges,50.07,100,,,Fee Schedule,100% of Medicare rate,306.42,100,,,Fee Schedule,100% of WA Medicaid,1588,100,,,percent of total billed charges,100% of total billed charges,315.61,103,,,Fee Schedule,103% of WA Medicaid,50.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,306.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1095.72,69,,,percent of total billed charges,69% of total billed charges,1588,100,,,percent of total billed charges,100% of total billed charges,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1588,100,,,percent of total billed charges,100% of total billed charges,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1588,100,,,percent of total billed charges,100% of total billed charges,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,982.18,61.85,,,percent of total billed charges,61.85% of total billed charges,306.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,398.35,130,,,Fee Schedule,130% of WA Medicaid ,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.68,37.7,,,percent of total billed charges,37.70% of total billed charges,598.68,37.7,,,percent of total billed charges,37.70% of total billed charges,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,53833.2,33.9,,,percent of total billed charges,33.9% of total billed charges,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1238.64,78,,,percent of total billed charges,78% of total billed charges,1588,100,,,percent of total billed charges,100% of total billed charges,1311.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1311.69,82.6,,,percent of total billed charges,82.6% of total billed charges,306.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.07,53833.2,
REMOVE HIP BONE LES DEEP,27066,CDM,983,RC,27066,HCPCS,Outpatient,,,1839,1195.35,,1618.32,88,,,percent of total billed charges,88% of total Billed charges,83.44,100,,,Fee Schedule,100% of Medicare rate,471.85,100,,,Fee Schedule,100% of WA Medicaid,1839,100,,,percent of total billed charges,100% of total billed charges,486.01,103,,,Fee Schedule,103% of WA Medicaid,83.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,146.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,471.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1268.91,69,,,percent of total billed charges,69% of total billed charges,1839,100,,,percent of total billed charges,100% of total billed charges,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1839,100,,,percent of total billed charges,100% of total billed charges,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1839,100,,,percent of total billed charges,100% of total billed charges,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1137.42,61.85,,,percent of total billed charges,61.85% of total billed charges,471.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,613.41,130,,,Fee Schedule,130% of WA Medicaid ,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,693.3,37.7,,,percent of total billed charges,37.70% of total billed charges,693.3,37.7,,,percent of total billed charges,37.70% of total billed charges,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,62342.1,33.9,,,percent of total billed charges,33.9% of total billed charges,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1434.42,78,,,percent of total billed charges,78% of total billed charges,1839,100,,,percent of total billed charges,100% of total billed charges,1519.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1519.01,82.6,,,percent of total billed charges,82.6% of total billed charges,471.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.44,62342.1,
REMOVE FEMUR LESION/BURSA,27062,CDM,983,RC,27062,HCPCS,Outpatient,,,1413,918.45,,1243.44,88,,,percent of total billed charges,88% of total Billed charges,44.07,100,,,Fee Schedule,100% of Medicare rate,266.14,100,,,Fee Schedule,100% of WA Medicaid,1413,100,,,percent of total billed charges,100% of total billed charges,274.12,103,,,Fee Schedule,103% of WA Medicaid,44.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,266.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,974.97,69,,,percent of total billed charges,69% of total billed charges,1413,100,,,percent of total billed charges,100% of total billed charges,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1413,100,,,percent of total billed charges,100% of total billed charges,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1413,100,,,percent of total billed charges,100% of total billed charges,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,873.94,61.85,,,percent of total billed charges,61.85% of total billed charges,266.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,345.98,130,,,Fee Schedule,130% of WA Medicaid ,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,532.7,37.7,,,percent of total billed charges,37.70% of total billed charges,532.7,37.7,,,percent of total billed charges,37.70% of total billed charges,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,47900.7,33.9,,,percent of total billed charges,33.9% of total billed charges,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1102.14,78,,,percent of total billed charges,78% of total billed charges,1413,100,,,percent of total billed charges,100% of total billed charges,1167.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1167.14,82.6,,,percent of total billed charges,82.6% of total billed charges,266.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.07,47900.7,
PART REMOVE HIP BONE SUPER,27070,CDM,983,RC,27070,HCPCS,Outpatient,,,2676,1739.40,,2354.88,88,,,percent of total billed charges,88% of total Billed charges,85.78,100,,,Fee Schedule,100% of Medicare rate,511.76,100,,,Fee Schedule,100% of WA Medicaid,2676,100,,,percent of total billed charges,100% of total billed charges,527.11,103,,,Fee Schedule,103% of WA Medicaid,85.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,150.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,511.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1846.44,69,,,percent of total billed charges,69% of total billed charges,2676,100,,,percent of total billed charges,100% of total billed charges,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2676,100,,,percent of total billed charges,100% of total billed charges,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2676,100,,,percent of total billed charges,100% of total billed charges,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.11,61.85,,,percent of total billed charges,61.85% of total billed charges,511.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,511.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,522,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,665.29,130,,,Fee Schedule,130% of WA Medicaid ,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008.85,37.7,,,percent of total billed charges,37.70% of total billed charges,1008.85,37.7,,,percent of total billed charges,37.70% of total billed charges,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,90716.4,33.9,,,percent of total billed charges,33.9% of total billed charges,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2087.28,78,,,percent of total billed charges,78% of total billed charges,2676,100,,,percent of total billed charges,100% of total billed charges,2210.38,82.6,,,percent of total billed charges,82.6% of total billed charges,2210.38,82.6,,,percent of total billed charges,82.6% of total billed charges,511.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,85.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,511.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.78,90716.4,
REMOVE HIP FOREIGN BODY,27087,CDM,983,RC,27087,HCPCS,Outpatient,,,1194,776.10,,1050.72,88,,,percent of total billed charges,88% of total Billed charges,71.54,100,,,Fee Schedule,100% of Medicare rate,353.79,100,,,Fee Schedule,100% of WA Medicaid,1194,100,,,percent of total billed charges,100% of total billed charges,364.4,103,,,Fee Schedule,103% of WA Medicaid,71.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,125.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,353.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,823.86,69,,,percent of total billed charges,69% of total billed charges,1194,100,,,percent of total billed charges,100% of total billed charges,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1194,100,,,percent of total billed charges,100% of total billed charges,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1194,100,,,percent of total billed charges,100% of total billed charges,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,738.49,61.85,,,percent of total billed charges,61.85% of total billed charges,353.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,459.93,130,,,Fee Schedule,130% of WA Medicaid ,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.14,37.7,,,percent of total billed charges,37.70% of total billed charges,450.14,37.7,,,percent of total billed charges,37.70% of total billed charges,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,40476.6,33.9,,,percent of total billed charges,33.9% of total billed charges,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.32,78,,,percent of total billed charges,78% of total billed charges,1194,100,,,percent of total billed charges,100% of total billed charges,986.24,82.6,,,percent of total billed charges,82.6% of total billed charges,986.24,82.6,,,percent of total billed charges,82.6% of total billed charges,353.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.54,40476.6,
REMOVE HIP FOREIGN BODY,27086,CDM,983,RC,27086,HCPCS,Outpatient,,,714,464.10,,628.32,88,,,percent of total billed charges,88% of total Billed charges,15.57,100,,,Fee Schedule,100% of Medicare rate,99.03,100,,,Fee Schedule,100% of WA Medicaid,714,100,,,percent of total billed charges,100% of total billed charges,102,103,,,Fee Schedule,103% of WA Medicaid,15.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,99.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,492.66,69,,,percent of total billed charges,69% of total billed charges,714,100,,,percent of total billed charges,100% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,714,100,,,percent of total billed charges,100% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,714,100,,,percent of total billed charges,100% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.61,61.85,,,percent of total billed charges,61.85% of total billed charges,99.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.74,130,,,Fee Schedule,130% of WA Medicaid ,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.18,37.7,,,percent of total billed charges,37.70% of total billed charges,269.18,37.7,,,percent of total billed charges,37.70% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,24204.6,33.9,,,percent of total billed charges,33.9% of total billed charges,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.92,78,,,percent of total billed charges,78% of total billed charges,714,100,,,percent of total billed charges,100% of total billed charges,589.76,82.6,,,percent of total billed charges,82.6% of total billed charges,589.76,82.6,,,percent of total billed charges,82.6% of total billed charges,99.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.57,24204.6,
REMOVAL OF TAIL BONE,27080,CDM,983,RC,27080,HCPCS,Outpatient,,,1744,1133.60,,1534.72,88,,,percent of total billed charges,88% of total Billed charges,58.77,100,,,Fee Schedule,100% of Medicare rate,293.74,100,,,Fee Schedule,100% of WA Medicaid,1744,100,,,percent of total billed charges,100% of total billed charges,302.55,103,,,Fee Schedule,103% of WA Medicaid,58.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,293.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1203.36,69,,,percent of total billed charges,69% of total billed charges,1744,100,,,percent of total billed charges,100% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1744,100,,,percent of total billed charges,100% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1744,100,,,percent of total billed charges,100% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1078.66,61.85,,,percent of total billed charges,61.85% of total billed charges,293.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,381.86,130,,,Fee Schedule,130% of WA Medicaid ,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,657.49,37.7,,,percent of total billed charges,37.70% of total billed charges,657.49,37.7,,,percent of total billed charges,37.70% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,59121.6,33.9,,,percent of total billed charges,33.9% of total billed charges,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1360.32,78,,,percent of total billed charges,78% of total billed charges,1744,100,,,percent of total billed charges,100% of total billed charges,1440.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1440.54,82.6,,,percent of total billed charges,82.6% of total billed charges,293.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.77,59121.6,
INJECT SACROILIAC JOINT,27096,CDM,983,RC,27096,HCPCS,Outpatient,,,249,161.85,,219.12,88,,,percent of total billed charges,88% of total Billed charges,6.12,100,,,Fee Schedule,100% of Medicare rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,249,100,,,percent of total billed charges,100% of total billed charges,48.6,103,,,Fee Schedule,103% of WA Medicaid,6.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,171.81,69,,,percent of total billed charges,69% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,249,100,,,percent of total billed charges,100% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,249,100,,,percent of total billed charges,100% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.01,61.85,,,percent of total billed charges,61.85% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.33,130,,,Fee Schedule,130% of WA Medicaid ,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,8441.1,33.9,,,percent of total billed charges,33.9% of total billed charges,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.22,78,,,percent of total billed charges,78% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.12,8441.1,
REMOVAL OF HIP PROSTHESIS,27091,CDM,983,RC,27091,HCPCS,Outpatient,,,3984,2589.60,,3505.92,88,,,percent of total billed charges,88% of total Billed charges,177.66,100,,,Fee Schedule,100% of Medicare rate,904.9,100,,,Fee Schedule,100% of WA Medicaid,3984,100,,,percent of total billed charges,100% of total billed charges,932.05,103,,,Fee Schedule,103% of WA Medicaid,177.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,310.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,904.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2748.96,69,,,percent of total billed charges,69% of total billed charges,3984,100,,,percent of total billed charges,100% of total billed charges,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,3984,100,,,percent of total billed charges,100% of total billed charges,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,3984,100,,,percent of total billed charges,100% of total billed charges,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2464.1,61.85,,,percent of total billed charges,61.85% of total billed charges,904.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,923,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1176.37,130,,,Fee Schedule,130% of WA Medicaid ,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1501.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1501.97,37.7,,,percent of total billed charges,37.70% of total billed charges,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,135057.6,33.9,,,percent of total billed charges,33.9% of total billed charges,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,3107.52,78,,,percent of total billed charges,78% of total billed charges,3984,100,,,percent of total billed charges,100% of total billed charges,3290.78,82.6,,,percent of total billed charges,82.6% of total billed charges,3290.78,82.6,,,percent of total billed charges,82.6% of total billed charges,904.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,177.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,177.66,135057.6,
REMOVAL OF HIP PROSTHESIS,27090,CDM,983,RC,27090,HCPCS,Outpatient,,,1825,1186.25,,1606,88,,,percent of total billed charges,88% of total Billed charges,86.63,100,,,Fee Schedule,100% of Medicare rate,478.19,100,,,Fee Schedule,100% of WA Medicaid,1825,100,,,percent of total billed charges,100% of total billed charges,492.54,103,,,Fee Schedule,103% of WA Medicaid,86.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,151.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,478.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1259.25,69,,,percent of total billed charges,69% of total billed charges,1825,100,,,percent of total billed charges,100% of total billed charges,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825,100,,,percent of total billed charges,100% of total billed charges,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825,100,,,percent of total billed charges,100% of total billed charges,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128.76,61.85,,,percent of total billed charges,61.85% of total billed charges,478.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,621.65,130,,,Fee Schedule,130% of WA Medicaid ,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,688.03,37.7,,,percent of total billed charges,37.70% of total billed charges,688.03,37.7,,,percent of total billed charges,37.70% of total billed charges,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,61867.5,33.9,,,percent of total billed charges,33.9% of total billed charges,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.5,78,,,percent of total billed charges,78% of total billed charges,1825,100,,,percent of total billed charges,100% of total billed charges,1507.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1507.45,82.6,,,percent of total billed charges,82.6% of total billed charges,478.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.63,61867.5,
PARTIAL HIP REPLACEMENT,27125,CDM,983,RC,27125,HCPCS,Outpatient,,,3361,2184.65,,2957.68,88,,,percent of total billed charges,88% of total Billed charges,122.55,100,,,Fee Schedule,100% of Medicare rate,647.34,100,,,Fee Schedule,100% of WA Medicaid,3361,100,,,percent of total billed charges,100% of total billed charges,666.76,103,,,Fee Schedule,103% of WA Medicaid,122.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,214.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,647.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2319.09,69,,,percent of total billed charges,69% of total billed charges,3361,100,,,percent of total billed charges,100% of total billed charges,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3361,100,,,percent of total billed charges,100% of total billed charges,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3361,100,,,percent of total billed charges,100% of total billed charges,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2078.78,61.85,,,percent of total billed charges,61.85% of total billed charges,647.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,660.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,841.54,130,,,Fee Schedule,130% of WA Medicaid ,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1267.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1267.1,37.7,,,percent of total billed charges,37.70% of total billed charges,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,113937.9,33.9,,,percent of total billed charges,33.9% of total billed charges,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2621.58,78,,,percent of total billed charges,78% of total billed charges,3361,100,,,percent of total billed charges,100% of total billed charges,2776.19,82.6,,,percent of total billed charges,82.6% of total billed charges,2776.19,82.6,,,percent of total billed charges,82.6% of total billed charges,647.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,122.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,122.55,113937.9,
RECONSTRUCTION OF HIP SOCKET,27122,CDM,983,RC,27122,HCPCS,Outpatient,,,4113,2673.45,,3619.44,88,,,percent of total billed charges,88% of total Billed charges,119.4,100,,,Fee Schedule,100% of Medicare rate,632.05,100,,,Fee Schedule,100% of WA Medicaid,4113,100,,,percent of total billed charges,100% of total billed charges,651.01,103,,,Fee Schedule,103% of WA Medicaid,119.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,208.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,632.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2837.97,69,,,percent of total billed charges,69% of total billed charges,4113,100,,,percent of total billed charges,100% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,4113,100,,,percent of total billed charges,100% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,4113,100,,,percent of total billed charges,100% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2543.89,61.85,,,percent of total billed charges,61.85% of total billed charges,632.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,632.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,644.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,821.67,130,,,Fee Schedule,130% of WA Medicaid ,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1550.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1550.6,37.7,,,percent of total billed charges,37.70% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,139430.7,33.9,,,percent of total billed charges,33.9% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,3208.14,78,,,percent of total billed charges,78% of total billed charges,4113,100,,,percent of total billed charges,100% of total billed charges,3397.34,82.6,,,percent of total billed charges,82.6% of total billed charges,3397.34,82.6,,,percent of total billed charges,82.6% of total billed charges,632.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,632.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.4,139430.7,
REVISE HIP JOINT REPLACEMENT,27134,CDM,983,RC,27134,HCPCS,Outpatient,,,6211,4037.15,,5465.68,88,,,percent of total billed charges,88% of total Billed charges,218.63,100,,,Fee Schedule,100% of Medicare rate,1075.92,100,,,Fee Schedule,100% of WA Medicaid,6211,100,,,percent of total billed charges,100% of total billed charges,1108.2,103,,,Fee Schedule,103% of WA Medicaid,218.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,382.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1075.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4285.59,69,,,percent of total billed charges,69% of total billed charges,6211,100,,,percent of total billed charges,100% of total billed charges,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,6211,100,,,percent of total billed charges,100% of total billed charges,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,6211,100,,,percent of total billed charges,100% of total billed charges,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,3841.5,61.85,,,percent of total billed charges,61.85% of total billed charges,1075.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1075.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1097.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1398.7,130,,,Fee Schedule,130% of WA Medicaid ,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2341.55,37.7,,,percent of total billed charges,37.70% of total billed charges,2341.55,37.7,,,percent of total billed charges,37.70% of total billed charges,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,210552.9,33.9,,,percent of total billed charges,33.9% of total billed charges,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,4844.58,78,,,percent of total billed charges,78% of total billed charges,6211,100,,,percent of total billed charges,100% of total billed charges,5130.29,82.6,,,percent of total billed charges,82.6% of total billed charges,5130.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1075.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,218.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1075.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,218.63,210552.9,
REVISE HIP JOINT REPLACEMENT,27138,CDM,983,RC,27138,HCPCS,Outpatient,,,4572,2971.80,,4023.36,88,,,percent of total billed charges,88% of total Billed charges,171.83,100,,,Fee Schedule,100% of Medicare rate,863.12,100,,,Fee Schedule,100% of WA Medicaid,4572,100,,,percent of total billed charges,100% of total billed charges,889.01,103,,,Fee Schedule,103% of WA Medicaid,171.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,300.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,863.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3154.68,69,,,percent of total billed charges,69% of total billed charges,4572,100,,,percent of total billed charges,100% of total billed charges,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,4572,100,,,percent of total billed charges,100% of total billed charges,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,4572,100,,,percent of total billed charges,100% of total billed charges,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2827.78,61.85,,,percent of total billed charges,61.85% of total billed charges,863.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,880.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1122.06,130,,,Fee Schedule,130% of WA Medicaid ,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1723.64,37.7,,,percent of total billed charges,37.70% of total billed charges,1723.64,37.7,,,percent of total billed charges,37.70% of total billed charges,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,154990.8,33.9,,,percent of total billed charges,33.9% of total billed charges,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3566.16,78,,,percent of total billed charges,78% of total billed charges,4572,100,,,percent of total billed charges,100% of total billed charges,3776.47,82.6,,,percent of total billed charges,82.6% of total billed charges,3776.47,82.6,,,percent of total billed charges,82.6% of total billed charges,863.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,171.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,171.83,154990.8,
TOTAL HIP ARTHROPLASTY,27130,CDM,983,RC,27130,HCPCS,Outpatient,,,6589,4282.85,,5798.32,88,,,percent of total billed charges,88% of total Billed charges,143.06,100,,,Fee Schedule,100% of Medicare rate,730.89,100,,,Fee Schedule,100% of WA Medicaid,6589,100,,,percent of total billed charges,100% of total billed charges,752.82,103,,,Fee Schedule,103% of WA Medicaid,143.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,250.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,730.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4546.41,69,,,percent of total billed charges,69% of total billed charges,6589,100,,,percent of total billed charges,100% of total billed charges,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,6589,100,,,percent of total billed charges,100% of total billed charges,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,6589,100,,,percent of total billed charges,100% of total billed charges,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4075.3,61.85,,,percent of total billed charges,61.85% of total billed charges,730.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,950.16,130,,,Fee Schedule,130% of WA Medicaid ,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2484.05,37.7,,,percent of total billed charges,37.70% of total billed charges,2484.05,37.7,,,percent of total billed charges,37.70% of total billed charges,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,223367.1,33.9,,,percent of total billed charges,33.9% of total billed charges,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,5139.42,78,,,percent of total billed charges,78% of total billed charges,6589,100,,,percent of total billed charges,100% of total billed charges,5442.51,82.6,,,percent of total billed charges,82.6% of total billed charges,5442.51,82.6,,,percent of total billed charges,82.6% of total billed charges,730.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,143.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,143.06,223367.1,
REVISE HIP JOINT REPLACEMENT,27137,CDM,983,RC,27137,HCPCS,Outpatient,,,4280,2782.00,,3766.4,88,,,percent of total billed charges,88% of total Billed charges,164.97,100,,,Fee Schedule,100% of Medicare rate,831.42,100,,,Fee Schedule,100% of WA Medicaid,4280,100,,,percent of total billed charges,100% of total billed charges,856.36,103,,,Fee Schedule,103% of WA Medicaid,164.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,288.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,831.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2953.2,69,,,percent of total billed charges,69% of total billed charges,4280,100,,,percent of total billed charges,100% of total billed charges,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,4280,100,,,percent of total billed charges,100% of total billed charges,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,4280,100,,,percent of total billed charges,100% of total billed charges,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2647.18,61.85,,,percent of total billed charges,61.85% of total billed charges,831.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,831.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,848.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1080.85,130,,,Fee Schedule,130% of WA Medicaid ,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1613.56,37.7,,,percent of total billed charges,37.70% of total billed charges,1613.56,37.7,,,percent of total billed charges,37.70% of total billed charges,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,145092,33.9,,,percent of total billed charges,33.9% of total billed charges,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,3338.4,78,,,percent of total billed charges,78% of total billed charges,4280,100,,,percent of total billed charges,100% of total billed charges,3535.28,82.6,,,percent of total billed charges,82.6% of total billed charges,3535.28,82.6,,,percent of total billed charges,82.6% of total billed charges,831.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,164.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,831.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,164.97,145092,
TOTAL HIP ARTHROPLASTY,27132,CDM,983,RC,27132,HCPCS,Outpatient,,,5302,3446.30,,4665.76,88,,,percent of total billed charges,88% of total Billed charges,186.96,100,,,Fee Schedule,100% of Medicare rate,948.54,100,,,Fee Schedule,100% of WA Medicaid,5302,100,,,percent of total billed charges,100% of total billed charges,977,103,,,Fee Schedule,103% of WA Medicaid,186.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,327.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,948.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3658.38,69,,,percent of total billed charges,69% of total billed charges,5302,100,,,percent of total billed charges,100% of total billed charges,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,5302,100,,,percent of total billed charges,100% of total billed charges,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,5302,100,,,percent of total billed charges,100% of total billed charges,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3279.29,61.85,,,percent of total billed charges,61.85% of total billed charges,948.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,948.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,967.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1233.1,130,,,Fee Schedule,130% of WA Medicaid ,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1998.85,37.7,,,percent of total billed charges,37.70% of total billed charges,1998.85,37.7,,,percent of total billed charges,37.70% of total billed charges,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,179737.8,33.9,,,percent of total billed charges,33.9% of total billed charges,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4135.56,78,,,percent of total billed charges,78% of total billed charges,5302,100,,,percent of total billed charges,100% of total billed charges,4379.45,82.6,,,percent of total billed charges,82.6% of total billed charges,4379.45,82.6,,,percent of total billed charges,82.6% of total billed charges,948.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,186.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,948.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,186.96,179737.8,
TREAT HIP WALL FRACTURE,27226,CDM,983,RC,27226,HCPCS,Outpatient,,,3575,2323.75,,3146,88,,,percent of total billed charges,88% of total Billed charges,115.17,100,,,Fee Schedule,100% of Medicare rate,605.75,100,,,Fee Schedule,100% of WA Medicaid,3575,100,,,percent of total billed charges,100% of total billed charges,623.92,103,,,Fee Schedule,103% of WA Medicaid,115.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,201.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,605.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2466.75,69,,,percent of total billed charges,69% of total billed charges,3575,100,,,percent of total billed charges,100% of total billed charges,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3575,100,,,percent of total billed charges,100% of total billed charges,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3575,100,,,percent of total billed charges,100% of total billed charges,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2211.14,61.85,,,percent of total billed charges,61.85% of total billed charges,605.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,605.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.48,130,,,Fee Schedule,130% of WA Medicaid ,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1347.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1347.78,37.7,,,percent of total billed charges,37.70% of total billed charges,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,121192.5,33.9,,,percent of total billed charges,33.9% of total billed charges,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2788.5,78,,,percent of total billed charges,78% of total billed charges,3575,100,,,percent of total billed charges,100% of total billed charges,2952.95,82.6,,,percent of total billed charges,82.6% of total billed charges,2952.95,82.6,,,percent of total billed charges,82.6% of total billed charges,605.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,115.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,605.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,115.17,121192.5,
TREAT FX FEMORAL IT/PT/ST,27238,CDM,983,RC,27238,HCPCS,Outpatient,,,1188,772.20,,1045.44,88,,,percent of total billed charges,88% of total Billed charges,45.35,100,,,Fee Schedule,100% of Medicare rate,275.83,100,,,Fee Schedule,100% of WA Medicaid,1188,100,,,percent of total billed charges,100% of total billed charges,284.1,103,,,Fee Schedule,103% of WA Medicaid,45.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,275.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,819.72,69,,,percent of total billed charges,69% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188,100,,,percent of total billed charges,100% of total billed charges,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188,100,,,percent of total billed charges,100% of total billed charges,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.78,61.85,,,percent of total billed charges,61.85% of total billed charges,275.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,358.58,130,,,Fee Schedule,130% of WA Medicaid ,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.88,37.7,,,percent of total billed charges,37.70% of total billed charges,447.88,37.7,,,percent of total billed charges,37.70% of total billed charges,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,40273.2,33.9,,,percent of total billed charges,33.9% of total billed charges,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,926.64,78,,,percent of total billed charges,78% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,275.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.35,40273.2,
TREAT THIGH FRACTURE,27236,CDM,983,RC,27236,HCPCS,Outpatient,,,4391,2854.15,,3864.08,88,,,percent of total billed charges,88% of total Billed charges,129.33,100,,,Fee Schedule,100% of Medicare rate,682.59,100,,,Fee Schedule,100% of WA Medicaid,4391,100,,,percent of total billed charges,100% of total billed charges,703.07,103,,,Fee Schedule,103% of WA Medicaid,129.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,226.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,682.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3029.79,69,,,percent of total billed charges,69% of total billed charges,4391,100,,,percent of total billed charges,100% of total billed charges,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4391,100,,,percent of total billed charges,100% of total billed charges,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4391,100,,,percent of total billed charges,100% of total billed charges,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2715.83,61.85,,,percent of total billed charges,61.85% of total billed charges,682.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,887.37,130,,,Fee Schedule,130% of WA Medicaid ,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.41,37.7,,,percent of total billed charges,37.70% of total billed charges,1655.41,37.7,,,percent of total billed charges,37.70% of total billed charges,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,148854.9,33.9,,,percent of total billed charges,33.9% of total billed charges,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3424.98,78,,,percent of total billed charges,78% of total billed charges,4391,100,,,percent of total billed charges,100% of total billed charges,3626.97,82.6,,,percent of total billed charges,82.6% of total billed charges,3626.97,82.6,,,percent of total billed charges,82.6% of total billed charges,682.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,129.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,129.33,148854.9,
TREAT THIGH FRACTURE,27235,CDM,983,RC,27235,HCPCS,Outpatient,,,3681,2392.65,,3239.28,88,,,percent of total billed charges,88% of total Billed charges,95.92,100,,,Fee Schedule,100% of Medicare rate,521.27,100,,,Fee Schedule,100% of WA Medicaid,3681,100,,,percent of total billed charges,100% of total billed charges,536.91,103,,,Fee Schedule,103% of WA Medicaid,95.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,167.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,521.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2539.89,69,,,percent of total billed charges,69% of total billed charges,3681,100,,,percent of total billed charges,100% of total billed charges,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,3681,100,,,percent of total billed charges,100% of total billed charges,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,3681,100,,,percent of total billed charges,100% of total billed charges,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2276.7,61.85,,,percent of total billed charges,61.85% of total billed charges,521.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,521.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,531.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,677.65,130,,,Fee Schedule,130% of WA Medicaid ,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1387.74,37.7,,,percent of total billed charges,37.70% of total billed charges,1387.74,37.7,,,percent of total billed charges,37.70% of total billed charges,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,124785.9,33.9,,,percent of total billed charges,33.9% of total billed charges,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2871.18,78,,,percent of total billed charges,78% of total billed charges,3681,100,,,percent of total billed charges,100% of total billed charges,3040.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3040.51,82.6,,,percent of total billed charges,82.6% of total billed charges,521.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,95.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,521.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.92,124785.9,
TREAT THIGH FRACTURE,27244,CDM,983,RC,27244,HCPCS,Outpatient,,,4269,2774.85,,3756.72,88,,,percent of total billed charges,88% of total Billed charges,133.45,100,,,Fee Schedule,100% of Medicare rate,701.43,100,,,Fee Schedule,100% of WA Medicaid,4269,100,,,percent of total billed charges,100% of total billed charges,722.47,103,,,Fee Schedule,103% of WA Medicaid,133.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,233.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,701.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2945.61,69,,,percent of total billed charges,69% of total billed charges,4269,100,,,percent of total billed charges,100% of total billed charges,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,4269,100,,,percent of total billed charges,100% of total billed charges,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,4269,100,,,percent of total billed charges,100% of total billed charges,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2640.38,61.85,,,percent of total billed charges,61.85% of total billed charges,701.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,715.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,911.86,130,,,Fee Schedule,130% of WA Medicaid ,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1609.41,37.7,,,percent of total billed charges,37.70% of total billed charges,1609.41,37.7,,,percent of total billed charges,37.70% of total billed charges,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,144719.1,33.9,,,percent of total billed charges,33.9% of total billed charges,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,3329.82,78,,,percent of total billed charges,78% of total billed charges,4269,100,,,percent of total billed charges,100% of total billed charges,3526.19,82.6,,,percent of total billed charges,82.6% of total billed charges,3526.19,82.6,,,percent of total billed charges,82.6% of total billed charges,701.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,133.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,133.45,144719.1,
TREAT THIGH FRACTURE,27245,CDM,983,RC,27245,HCPCS,Outpatient,,,4900,3185.00,,4312,88,,,percent of total billed charges,88% of total Billed charges,132.88,100,,,Fee Schedule,100% of Medicare rate,700.68,100,,,Fee Schedule,100% of WA Medicaid,4900,100,,,percent of total billed charges,100% of total billed charges,721.7,103,,,Fee Schedule,103% of WA Medicaid,132.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,232.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,700.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3381,69,,,percent of total billed charges,69% of total billed charges,4900,100,,,percent of total billed charges,100% of total billed charges,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,4900,100,,,percent of total billed charges,100% of total billed charges,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,4900,100,,,percent of total billed charges,100% of total billed charges,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,3030.65,61.85,,,percent of total billed charges,61.85% of total billed charges,700.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,910.88,130,,,Fee Schedule,130% of WA Medicaid ,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1847.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1847.3,37.7,,,percent of total billed charges,37.70% of total billed charges,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,166110,33.9,,,percent of total billed charges,33.9% of total billed charges,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,3822,78,,,percent of total billed charges,78% of total billed charges,4900,100,,,percent of total billed charges,100% of total billed charges,4047.4,82.6,,,percent of total billed charges,82.6% of total billed charges,4047.4,82.6,,,percent of total billed charges,82.6% of total billed charges,700.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,132.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,132.88,166110,
TREAT THIGH FRACTURE,27248,CDM,983,RC,27248,HCPCS,Outpatient,,,1948,1266.20,,1714.24,88,,,percent of total billed charges,88% of total Billed charges,79.86,100,,,Fee Schedule,100% of Medicare rate,428.02,100,,,Fee Schedule,100% of WA Medicaid,1948,100,,,percent of total billed charges,100% of total billed charges,440.86,103,,,Fee Schedule,103% of WA Medicaid,79.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,139.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,428.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1344.12,69,,,percent of total billed charges,69% of total billed charges,1948,100,,,percent of total billed charges,100% of total billed charges,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1948,100,,,percent of total billed charges,100% of total billed charges,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1948,100,,,percent of total billed charges,100% of total billed charges,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1204.84,61.85,,,percent of total billed charges,61.85% of total billed charges,428.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,556.43,130,,,Fee Schedule,130% of WA Medicaid ,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.4,37.7,,,percent of total billed charges,37.70% of total billed charges,734.4,37.7,,,percent of total billed charges,37.70% of total billed charges,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,66037.2,33.9,,,percent of total billed charges,33.9% of total billed charges,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1519.44,78,,,percent of total billed charges,78% of total billed charges,1948,100,,,percent of total billed charges,100% of total billed charges,1609.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1609.05,82.6,,,percent of total billed charges,82.6% of total billed charges,428.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.86,66037.2,
TREAT HIP DISLOCATION,27257,CDM,983,RC,27257,HCPCS,Outpatient,,,1039,675.35,,914.32,88,,,percent of total billed charges,88% of total Billed charges,40.21,100,,,Fee Schedule,100% of Medicare rate,206.83,100,,,Fee Schedule,100% of WA Medicaid,1039,100,,,percent of total billed charges,100% of total billed charges,213.03,103,,,Fee Schedule,103% of WA Medicaid,40.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,206.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,716.91,69,,,percent of total billed charges,69% of total billed charges,1039,100,,,percent of total billed charges,100% of total billed charges,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1039,100,,,percent of total billed charges,100% of total billed charges,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1039,100,,,percent of total billed charges,100% of total billed charges,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.62,61.85,,,percent of total billed charges,61.85% of total billed charges,206.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,268.88,130,,,Fee Schedule,130% of WA Medicaid ,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.7,37.7,,,percent of total billed charges,37.70% of total billed charges,391.7,37.7,,,percent of total billed charges,37.70% of total billed charges,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,35222.1,33.9,,,percent of total billed charges,33.9% of total billed charges,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,810.42,78,,,percent of total billed charges,78% of total billed charges,1039,100,,,percent of total billed charges,100% of total billed charges,858.21,82.6,,,percent of total billed charges,82.6% of total billed charges,858.21,82.6,,,percent of total billed charges,82.6% of total billed charges,206.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.21,35222.1,
CLOSED TX OF HIP DISLOCATION W/ ANES,27252,CDM,983,RC,27252,HCPCS,Outpatient,,,1720,1118.00,,1513.6,88,,,percent of total billed charges,88% of total Billed charges,81.3,100,,,Fee Schedule,100% of Medicare rate,430.63,100,,,Fee Schedule,100% of WA Medicaid,1720,100,,,percent of total billed charges,100% of total billed charges,443.55,103,,,Fee Schedule,103% of WA Medicaid,81.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,142.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,430.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1186.8,69,,,percent of total billed charges,69% of total billed charges,1720,100,,,percent of total billed charges,100% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1720,100,,,percent of total billed charges,100% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1720,100,,,percent of total billed charges,100% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.82,61.85,,,percent of total billed charges,61.85% of total billed charges,430.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,559.82,130,,,Fee Schedule,130% of WA Medicaid ,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,648.44,37.7,,,percent of total billed charges,37.70% of total billed charges,648.44,37.7,,,percent of total billed charges,37.70% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,58308,33.9,,,percent of total billed charges,33.9% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1341.6,78,,,percent of total billed charges,78% of total billed charges,1720,100,,,percent of total billed charges,100% of total billed charges,1420.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1420.72,82.6,,,percent of total billed charges,82.6% of total billed charges,430.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.3,58308,
TREAT HIP DISLOCATION,27266,CDM,983,RC,27266,HCPCS,Outpatient,,,1343,872.95,,1181.84,88,,,percent of total billed charges,88% of total Billed charges,59.09,100,,,Fee Schedule,100% of Medicare rate,339.62,100,,,Fee Schedule,100% of WA Medicaid,1343,100,,,percent of total billed charges,100% of total billed charges,349.81,103,,,Fee Schedule,103% of WA Medicaid,59.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,339.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,926.67,69,,,percent of total billed charges,69% of total billed charges,1343,100,,,percent of total billed charges,100% of total billed charges,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1343,100,,,percent of total billed charges,100% of total billed charges,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1343,100,,,percent of total billed charges,100% of total billed charges,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,830.65,61.85,,,percent of total billed charges,61.85% of total billed charges,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,441.51,130,,,Fee Schedule,130% of WA Medicaid ,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,506.31,37.7,,,percent of total billed charges,37.70% of total billed charges,506.31,37.7,,,percent of total billed charges,37.70% of total billed charges,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,45527.7,33.9,,,percent of total billed charges,33.9% of total billed charges,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1047.54,78,,,percent of total billed charges,78% of total billed charges,1343,100,,,percent of total billed charges,100% of total billed charges,1109.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1109.32,82.6,,,percent of total billed charges,82.6% of total billed charges,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.09,45527.7,
TREAT HIP DISLOCATION,27265,CDM,983,RC,27265,HCPCS,Outpatient,,,882,573.30,,776.16,88,,,percent of total billed charges,88% of total Billed charges,41.76,100,,,Fee Schedule,100% of Medicare rate,246.93,100,,,Fee Schedule,100% of WA Medicaid,882,100,,,percent of total billed charges,100% of total billed charges,254.34,103,,,Fee Schedule,103% of WA Medicaid,41.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,246.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,608.58,69,,,percent of total billed charges,69% of total billed charges,882,100,,,percent of total billed charges,100% of total billed charges,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,882,100,,,percent of total billed charges,100% of total billed charges,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,882,100,,,percent of total billed charges,100% of total billed charges,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.52,61.85,,,percent of total billed charges,61.85% of total billed charges,246.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,321.01,130,,,Fee Schedule,130% of WA Medicaid ,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.51,37.7,,,percent of total billed charges,37.70% of total billed charges,332.51,37.7,,,percent of total billed charges,37.70% of total billed charges,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,29899.8,33.9,,,percent of total billed charges,33.9% of total billed charges,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,687.96,78,,,percent of total billed charges,78% of total billed charges,882,100,,,percent of total billed charges,100% of total billed charges,728.53,82.6,,,percent of total billed charges,82.6% of total billed charges,728.53,82.6,,,percent of total billed charges,82.6% of total billed charges,246.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.76,29899.8,
INCISION OF THIGH TENDON,27306,CDM,983,RC,27306,HCPCS,Outpatient,,,1180,767.00,,1038.4,88,,,percent of total billed charges,88% of total Billed charges,23.33,100,,,Fee Schedule,100% of Medicare rate,202.35,100,,,Fee Schedule,100% of WA Medicaid,1180,100,,,percent of total billed charges,100% of total billed charges,208.42,103,,,Fee Schedule,103% of WA Medicaid,23.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,202.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,814.2,69,,,percent of total billed charges,69% of total billed charges,1180,100,,,percent of total billed charges,100% of total billed charges,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1180,100,,,percent of total billed charges,100% of total billed charges,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1180,100,,,percent of total billed charges,100% of total billed charges,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.83,61.85,,,percent of total billed charges,61.85% of total billed charges,202.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,263.06,130,,,Fee Schedule,130% of WA Medicaid ,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.86,37.7,,,percent of total billed charges,37.70% of total billed charges,444.86,37.7,,,percent of total billed charges,37.70% of total billed charges,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,40002,33.9,,,percent of total billed charges,33.9% of total billed charges,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,920.4,78,,,percent of total billed charges,78% of total billed charges,1180,100,,,percent of total billed charges,100% of total billed charges,974.68,82.6,,,percent of total billed charges,82.6% of total billed charges,974.68,82.6,,,percent of total billed charges,82.6% of total billed charges,202.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.33,40002,
DRAIN THIGH/KNEE LESION,27301,CDM,983,RC,27301,HCPCS,Outpatient,,,908,590.20,,799.04,88,,,percent of total billed charges,88% of total Billed charges,53.14,100,,,Fee Schedule,100% of Medicare rate,295.23,100,,,Fee Schedule,100% of WA Medicaid,908,100,,,percent of total billed charges,100% of total billed charges,304.09,103,,,Fee Schedule,103% of WA Medicaid,53.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,295.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,626.52,69,,,percent of total billed charges,69% of total billed charges,908,100,,,percent of total billed charges,100% of total billed charges,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,908,100,,,percent of total billed charges,100% of total billed charges,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,908,100,,,percent of total billed charges,100% of total billed charges,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.6,61.85,,,percent of total billed charges,61.85% of total billed charges,295.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,383.8,130,,,Fee Schedule,130% of WA Medicaid ,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.32,37.7,,,percent of total billed charges,37.70% of total billed charges,342.32,37.7,,,percent of total billed charges,37.70% of total billed charges,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,30781.2,33.9,,,percent of total billed charges,33.9% of total billed charges,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,708.24,78,,,percent of total billed charges,78% of total billed charges,908,100,,,percent of total billed charges,100% of total billed charges,750.01,82.6,,,percent of total billed charges,82.6% of total billed charges,750.01,82.6,,,percent of total billed charges,82.6% of total billed charges,295.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.14,30781.2,
INCISE THIGH TENDON  FASCIA,27305,CDM,983,RC,27305,HCPCS,Outpatient,,,1316,855.40,,1158.08,88,,,percent of total billed charges,88% of total Billed charges,47.02,100,,,Fee Schedule,100% of Medicare rate,282.92,100,,,Fee Schedule,100% of WA Medicaid,1316,100,,,percent of total billed charges,100% of total billed charges,291.41,103,,,Fee Schedule,103% of WA Medicaid,47.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,82.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,908.04,69,,,percent of total billed charges,69% of total billed charges,1316,100,,,percent of total billed charges,100% of total billed charges,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1316,100,,,percent of total billed charges,100% of total billed charges,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1316,100,,,percent of total billed charges,100% of total billed charges,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.95,61.85,,,percent of total billed charges,61.85% of total billed charges,282.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.8,130,,,Fee Schedule,130% of WA Medicaid ,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.13,37.7,,,percent of total billed charges,37.70% of total billed charges,496.13,37.7,,,percent of total billed charges,37.70% of total billed charges,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,44612.4,33.9,,,percent of total billed charges,33.9% of total billed charges,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1026.48,78,,,percent of total billed charges,78% of total billed charges,1316,100,,,percent of total billed charges,100% of total billed charges,1087.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1087.02,82.6,,,percent of total billed charges,82.6% of total billed charges,282.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.02,44612.4,
EXPLORATION OF KNEE JOINT,27310,CDM,983,RC,27310,HCPCS,Outpatient,,,1788,1162.20,,1573.44,88,,,percent of total billed charges,88% of total Billed charges,75.26,100,,,Fee Schedule,100% of Medicare rate,424.85,100,,,Fee Schedule,100% of WA Medicaid,1788,100,,,percent of total billed charges,100% of total billed charges,437.6,103,,,Fee Schedule,103% of WA Medicaid,75.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,131.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,424.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1233.72,69,,,percent of total billed charges,69% of total billed charges,1788,100,,,percent of total billed charges,100% of total billed charges,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1788,100,,,percent of total billed charges,100% of total billed charges,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1788,100,,,percent of total billed charges,100% of total billed charges,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105.88,61.85,,,percent of total billed charges,61.85% of total billed charges,424.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,552.31,130,,,Fee Schedule,130% of WA Medicaid ,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.08,37.7,,,percent of total billed charges,37.70% of total billed charges,674.08,37.7,,,percent of total billed charges,37.70% of total billed charges,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,60613.2,33.9,,,percent of total billed charges,33.9% of total billed charges,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1394.64,78,,,percent of total billed charges,78% of total billed charges,1788,100,,,percent of total billed charges,100% of total billed charges,1476.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1476.89,82.6,,,percent of total billed charges,82.6% of total billed charges,424.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.26,60613.2,
EXC THIGH/KNEE LES SC < 3 CM,27327,CDM,983,RC,27327,HCPCS,Outpatient,,,692,449.80,,608.96,88,,,percent of total billed charges,88% of total Billed charges,32.22,100,,,Fee Schedule,100% of Medicare rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,692,100,,,percent of total billed charges,100% of total billed charges,189.41,103,,,Fee Schedule,103% of WA Medicaid,32.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,477.48,69,,,percent of total billed charges,69% of total billed charges,692,100,,,percent of total billed charges,100% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,692,100,,,percent of total billed charges,100% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,692,100,,,percent of total billed charges,100% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,428,61.85,,,percent of total billed charges,61.85% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,239.06,130,,,Fee Schedule,130% of WA Medicaid ,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.88,37.7,,,percent of total billed charges,37.70% of total billed charges,260.88,37.7,,,percent of total billed charges,37.70% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,23458.8,33.9,,,percent of total billed charges,33.9% of total billed charges,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.76,78,,,percent of total billed charges,78% of total billed charges,692,100,,,percent of total billed charges,100% of total billed charges,571.59,82.6,,,percent of total billed charges,82.6% of total billed charges,571.59,82.6,,,percent of total billed charges,82.6% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.22,23458.8,
EXC THIGH/KNEE TUM DEEP <5CM,27328,CDM,983,RC,27328,HCPCS,Outpatient,,,1340,871.00,,1179.2,88,,,percent of total billed charges,88% of total Billed charges,70.27,100,,,Fee Schedule,100% of Medicare rate,359.2,100,,,Fee Schedule,100% of WA Medicaid,1340,100,,,percent of total billed charges,100% of total billed charges,369.98,103,,,Fee Schedule,103% of WA Medicaid,70.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,122.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,359.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,924.6,69,,,percent of total billed charges,69% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340,100,,,percent of total billed charges,100% of total billed charges,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340,100,,,percent of total billed charges,100% of total billed charges,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,828.79,61.85,,,percent of total billed charges,61.85% of total billed charges,359.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,466.96,130,,,Fee Schedule,130% of WA Medicaid ,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,505.18,37.7,,,percent of total billed charges,37.70% of total billed charges,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,45426,33.9,,,percent of total billed charges,33.9% of total billed charges,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045.2,78,,,percent of total billed charges,78% of total billed charges,1340,100,,,percent of total billed charges,100% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1106.84,82.6,,,percent of total billed charges,82.6% of total billed charges,359.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.27,45426,
NEURECTOMY POPLITEAL,27326,CDM,983,RC,27326,HCPCS,Outpatient,,,1443,937.95,,1269.84,88,,,percent of total billed charges,88% of total Billed charges,50.6,100,,,Fee Schedule,100% of Medicare rate,306.79,100,,,Fee Schedule,100% of WA Medicaid,1443,100,,,percent of total billed charges,100% of total billed charges,315.99,103,,,Fee Schedule,103% of WA Medicaid,50.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,88.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,306.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,995.67,69,,,percent of total billed charges,69% of total billed charges,1443,100,,,percent of total billed charges,100% of total billed charges,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1443,100,,,percent of total billed charges,100% of total billed charges,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1443,100,,,percent of total billed charges,100% of total billed charges,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,892.5,61.85,,,percent of total billed charges,61.85% of total billed charges,306.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,398.83,130,,,Fee Schedule,130% of WA Medicaid ,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.01,37.7,,,percent of total billed charges,37.70% of total billed charges,544.01,37.7,,,percent of total billed charges,37.70% of total billed charges,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,48917.7,33.9,,,percent of total billed charges,33.9% of total billed charges,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1125.54,78,,,percent of total billed charges,78% of total billed charges,1443,100,,,percent of total billed charges,100% of total billed charges,1191.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1191.92,82.6,,,percent of total billed charges,82.6% of total billed charges,306.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.6,48917.7,
EXPLORE/TREAT KNEE JOINT,27331,CDM,983,RC,27331,HCPCS,Outpatient,,,1597,1038.05,,1405.36,88,,,percent of total billed charges,88% of total Billed charges,46.59,100,,,Fee Schedule,100% of Medicare rate,279.75,100,,,Fee Schedule,100% of WA Medicaid,1597,100,,,percent of total billed charges,100% of total billed charges,288.14,103,,,Fee Schedule,103% of WA Medicaid,46.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,279.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1101.93,69,,,percent of total billed charges,69% of total billed charges,1597,100,,,percent of total billed charges,100% of total billed charges,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1597,100,,,percent of total billed charges,100% of total billed charges,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1597,100,,,percent of total billed charges,100% of total billed charges,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,987.74,61.85,,,percent of total billed charges,61.85% of total billed charges,279.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,363.68,130,,,Fee Schedule,130% of WA Medicaid ,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.07,37.7,,,percent of total billed charges,37.70% of total billed charges,602.07,37.7,,,percent of total billed charges,37.70% of total billed charges,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,54138.3,33.9,,,percent of total billed charges,33.9% of total billed charges,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1245.66,78,,,percent of total billed charges,78% of total billed charges,1597,100,,,percent of total billed charges,100% of total billed charges,1319.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1319.12,82.6,,,percent of total billed charges,82.6% of total billed charges,279.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.59,54138.3,
EXC THIGH/KNEE LES SC 3 CM/>,27337,CDM,983,RC,27337,HCPCS,Outpatient,,,869,564.85,,764.72,88,,,percent of total billed charges,88% of total Billed charges,48.51,100,,,Fee Schedule,100% of Medicare rate,241.52,100,,,Fee Schedule,100% of WA Medicaid,869,100,,,percent of total billed charges,100% of total billed charges,248.77,103,,,Fee Schedule,103% of WA Medicaid,48.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,84.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,241.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,599.61,69,,,percent of total billed charges,69% of total billed charges,869,100,,,percent of total billed charges,100% of total billed charges,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,869,100,,,percent of total billed charges,100% of total billed charges,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,869,100,,,percent of total billed charges,100% of total billed charges,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.48,61.85,,,percent of total billed charges,61.85% of total billed charges,241.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,313.98,130,,,Fee Schedule,130% of WA Medicaid ,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.61,37.7,,,percent of total billed charges,37.70% of total billed charges,327.61,37.7,,,percent of total billed charges,37.70% of total billed charges,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,29459.1,33.9,,,percent of total billed charges,33.9% of total billed charges,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.82,78,,,percent of total billed charges,78% of total billed charges,869,100,,,percent of total billed charges,100% of total billed charges,717.79,82.6,,,percent of total billed charges,82.6% of total billed charges,717.79,82.6,,,percent of total billed charges,82.6% of total billed charges,241.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,49,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.51,29459.1,
EXC THIGH/KNEE TUM DEP 5CM/>,27339,CDM,983,RC,27339,HCPCS,Outpatient,,,1686,1095.90,,1483.68,88,,,percent of total billed charges,88% of total Billed charges,87.9,100,,,Fee Schedule,100% of Medicare rate,432.49,100,,,Fee Schedule,100% of WA Medicaid,1686,100,,,percent of total billed charges,100% of total billed charges,445.46,103,,,Fee Schedule,103% of WA Medicaid,87.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,153.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,432.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1163.34,69,,,percent of total billed charges,69% of total billed charges,1686,100,,,percent of total billed charges,100% of total billed charges,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1686,100,,,percent of total billed charges,100% of total billed charges,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1686,100,,,percent of total billed charges,100% of total billed charges,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1042.79,61.85,,,percent of total billed charges,61.85% of total billed charges,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562.24,130,,,Fee Schedule,130% of WA Medicaid ,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,635.62,37.7,,,percent of total billed charges,37.70% of total billed charges,635.62,37.7,,,percent of total billed charges,37.70% of total billed charges,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,57155.4,33.9,,,percent of total billed charges,33.9% of total billed charges,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1315.08,78,,,percent of total billed charges,78% of total billed charges,1686,100,,,percent of total billed charges,100% of total billed charges,1392.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1392.64,82.6,,,percent of total billed charges,82.6% of total billed charges,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.9,57155.4,
REMOVE KNEE JOINT LINING,27334,CDM,983,RC,27334,HCPCS,Outpatient,,,2370,1540.50,,2085.6,88,,,percent of total billed charges,88% of total Billed charges,69.48,100,,,Fee Schedule,100% of Medicare rate,399.11,100,,,Fee Schedule,100% of WA Medicaid,2370,100,,,percent of total billed charges,100% of total billed charges,411.08,103,,,Fee Schedule,103% of WA Medicaid,69.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,121.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,399.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1635.3,69,,,percent of total billed charges,69% of total billed charges,2370,100,,,percent of total billed charges,100% of total billed charges,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2370,100,,,percent of total billed charges,100% of total billed charges,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2370,100,,,percent of total billed charges,100% of total billed charges,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1465.85,61.85,,,percent of total billed charges,61.85% of total billed charges,399.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,518.84,130,,,Fee Schedule,130% of WA Medicaid ,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,893.49,37.7,,,percent of total billed charges,37.70% of total billed charges,893.49,37.7,,,percent of total billed charges,37.70% of total billed charges,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,80343,33.9,,,percent of total billed charges,33.9% of total billed charges,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1848.6,78,,,percent of total billed charges,78% of total billed charges,2370,100,,,percent of total billed charges,100% of total billed charges,1957.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1957.62,82.6,,,percent of total billed charges,82.6% of total billed charges,399.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.48,80343,
REMOVE KNEE CYST,27347,CDM,983,RC,27347,HCPCS,Outpatient,,,1069,694.85,,940.72,88,,,percent of total billed charges,88% of total Billed charges,50.99,100,,,Fee Schedule,100% of Medicare rate,309.03,100,,,Fee Schedule,100% of WA Medicaid,1069,100,,,percent of total billed charges,100% of total billed charges,318.3,103,,,Fee Schedule,103% of WA Medicaid,50.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,309.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,737.61,69,,,percent of total billed charges,69% of total billed charges,1069,100,,,percent of total billed charges,100% of total billed charges,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1069,100,,,percent of total billed charges,100% of total billed charges,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1069,100,,,percent of total billed charges,100% of total billed charges,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,661.18,61.85,,,percent of total billed charges,61.85% of total billed charges,309.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,401.74,130,,,Fee Schedule,130% of WA Medicaid ,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.01,37.7,,,percent of total billed charges,37.70% of total billed charges,403.01,37.7,,,percent of total billed charges,37.70% of total billed charges,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,36239.1,33.9,,,percent of total billed charges,33.9% of total billed charges,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,833.82,78,,,percent of total billed charges,78% of total billed charges,1069,100,,,percent of total billed charges,100% of total billed charges,882.99,82.6,,,percent of total billed charges,82.6% of total billed charges,882.99,82.6,,,percent of total billed charges,82.6% of total billed charges,309.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.99,36239.1,
REMOVAL OF KNEECAP BURSA,27340,CDM,983,RC,27340,HCPCS,Outpatient,,,960,624.00,,844.8,88,,,percent of total billed charges,88% of total Billed charges,34.48,100,,,Fee Schedule,100% of Medicare rate,222.12,100,,,Fee Schedule,100% of WA Medicaid,960,100,,,percent of total billed charges,100% of total billed charges,228.78,103,,,Fee Schedule,103% of WA Medicaid,34.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,222.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,662.4,69,,,percent of total billed charges,69% of total billed charges,960,100,,,percent of total billed charges,100% of total billed charges,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,960,100,,,percent of total billed charges,100% of total billed charges,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,960,100,,,percent of total billed charges,100% of total billed charges,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,593.76,61.85,,,percent of total billed charges,61.85% of total billed charges,222.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,288.76,130,,,Fee Schedule,130% of WA Medicaid ,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.92,37.7,,,percent of total billed charges,37.70% of total billed charges,361.92,37.7,,,percent of total billed charges,37.70% of total billed charges,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,32544,33.9,,,percent of total billed charges,33.9% of total billed charges,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,748.8,78,,,percent of total billed charges,78% of total billed charges,960,100,,,percent of total billed charges,100% of total billed charges,792.96,82.6,,,percent of total billed charges,82.6% of total billed charges,792.96,82.6,,,percent of total billed charges,82.6% of total billed charges,222.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.48,32544,
REMOVE FEMUR LESION/FIXATION,27358,CDM,983,RC,27358,HCPCS,Outpatient,,,908,590.20,,799.04,88,,,percent of total billed charges,88% of total Billed charges,33.5,100,,,Fee Schedule,100% of Medicare rate,152.74,100,,,Fee Schedule,100% of WA Medicaid,908,100,,,percent of total billed charges,100% of total billed charges,157.32,103,,,Fee Schedule,103% of WA Medicaid,33.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,152.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,626.52,69,,,percent of total billed charges,69% of total billed charges,908,100,,,percent of total billed charges,100% of total billed charges,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,908,100,,,percent of total billed charges,100% of total billed charges,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,908,100,,,percent of total billed charges,100% of total billed charges,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.6,61.85,,,percent of total billed charges,61.85% of total billed charges,152.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,198.56,130,,,Fee Schedule,130% of WA Medicaid ,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.32,37.7,,,percent of total billed charges,37.70% of total billed charges,342.32,37.7,,,percent of total billed charges,37.70% of total billed charges,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,30781.2,33.9,,,percent of total billed charges,33.9% of total billed charges,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,708.24,78,,,percent of total billed charges,78% of total billed charges,908,100,,,percent of total billed charges,100% of total billed charges,750.01,82.6,,,percent of total billed charges,82.6% of total billed charges,750.01,82.6,,,percent of total billed charges,82.6% of total billed charges,152.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.5,30781.2,
REMOVE FEMUR LESION,27355,CDM,983,RC,27355,HCPCS,Outpatient,,,1711,1112.15,,1505.68,88,,,percent of total billed charges,88% of total Billed charges,61.16,100,,,Fee Schedule,100% of Medicare rate,354.35,100,,,Fee Schedule,100% of WA Medicaid,1711,100,,,percent of total billed charges,100% of total billed charges,364.98,103,,,Fee Schedule,103% of WA Medicaid,61.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,107.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,354.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1180.59,69,,,percent of total billed charges,69% of total billed charges,1711,100,,,percent of total billed charges,100% of total billed charges,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1711,100,,,percent of total billed charges,100% of total billed charges,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1711,100,,,percent of total billed charges,100% of total billed charges,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1058.25,61.85,,,percent of total billed charges,61.85% of total billed charges,354.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,460.66,130,,,Fee Schedule,130% of WA Medicaid ,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.05,37.7,,,percent of total billed charges,37.70% of total billed charges,645.05,37.7,,,percent of total billed charges,37.70% of total billed charges,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,58002.9,33.9,,,percent of total billed charges,33.9% of total billed charges,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1334.58,78,,,percent of total billed charges,78% of total billed charges,1711,100,,,percent of total billed charges,100% of total billed charges,1413.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1413.29,82.6,,,percent of total billed charges,82.6% of total billed charges,354.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.16,58002.9,
REMOVAL OF KNEECAP,27350,CDM,983,RC,27350,HCPCS,Outpatient,,,1606,1043.90,,1413.28,88,,,percent of total billed charges,88% of total Billed charges,65.17,100,,,Fee Schedule,100% of Medicare rate,381.21,100,,,Fee Schedule,100% of WA Medicaid,1606,100,,,percent of total billed charges,100% of total billed charges,392.65,103,,,Fee Schedule,103% of WA Medicaid,65.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,381.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1108.14,69,,,percent of total billed charges,69% of total billed charges,1606,100,,,percent of total billed charges,100% of total billed charges,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1606,100,,,percent of total billed charges,100% of total billed charges,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1606,100,,,percent of total billed charges,100% of total billed charges,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,993.31,61.85,,,percent of total billed charges,61.85% of total billed charges,381.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,495.57,130,,,Fee Schedule,130% of WA Medicaid ,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,605.46,37.7,,,percent of total billed charges,37.70% of total billed charges,605.46,37.7,,,percent of total billed charges,37.70% of total billed charges,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,54443.4,33.9,,,percent of total billed charges,33.9% of total billed charges,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1252.68,78,,,percent of total billed charges,78% of total billed charges,1606,100,,,percent of total billed charges,100% of total billed charges,1326.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1326.56,82.6,,,percent of total billed charges,82.6% of total billed charges,381.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.17,54443.4,
PARTIAL REMOVAL LEG BONE(S),27360,CDM,983,RC,27360,HCPCS,Outpatient,,,2135,1387.75,,1878.8,88,,,percent of total billed charges,88% of total Billed charges,87.95,100,,,Fee Schedule,100% of Medicare rate,523.88,100,,,Fee Schedule,100% of WA Medicaid,2135,100,,,percent of total billed charges,100% of total billed charges,539.6,103,,,Fee Schedule,103% of WA Medicaid,87.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,153.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,523.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1473.15,69,,,percent of total billed charges,69% of total billed charges,2135,100,,,percent of total billed charges,100% of total billed charges,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2135,100,,,percent of total billed charges,100% of total billed charges,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2135,100,,,percent of total billed charges,100% of total billed charges,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1320.5,61.85,,,percent of total billed charges,61.85% of total billed charges,523.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,523.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,681.04,130,,,Fee Schedule,130% of WA Medicaid ,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.9,37.7,,,percent of total billed charges,37.70% of total billed charges,804.9,37.7,,,percent of total billed charges,37.70% of total billed charges,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,72376.5,33.9,,,percent of total billed charges,33.9% of total billed charges,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1665.3,78,,,percent of total billed charges,78% of total billed charges,2135,100,,,percent of total billed charges,100% of total billed charges,1763.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1763.51,82.6,,,percent of total billed charges,82.6% of total billed charges,523.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,523.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.95,72376.5,
REMOVAL OF FOREIGN BODY,27372,CDM,983,RC,27372,HCPCS,Outpatient,,,1026.32,667.11,,903.16,88,,,percent of total billed charges,88% of total Billed charges,41.02,100,,,Fee Schedule,100% of Medicare rate,232.75,100,,,Fee Schedule,100% of WA Medicaid,1026.32,100,,,percent of total billed charges,100% of total billed charges,239.73,103,,,Fee Schedule,103% of WA Medicaid,41.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,71.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,232.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,708.16,69,,,percent of total billed charges,69% of total billed charges,1026.32,100,,,percent of total billed charges,100% of total billed charges,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1026.32,100,,,percent of total billed charges,100% of total billed charges,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1026.32,100,,,percent of total billed charges,100% of total billed charges,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.78,61.85,,,percent of total billed charges,61.85% of total billed charges,232.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,302.58,130,,,Fee Schedule,130% of WA Medicaid ,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.92,37.7,,,percent of total billed charges,37.70% of total billed charges,386.92,37.7,,,percent of total billed charges,37.70% of total billed charges,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,34792.25,33.9,,,percent of total billed charges,33.9% of total billed charges,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,800.53,78,,,percent of total billed charges,78% of total billed charges,1026.32,100,,,percent of total billed charges,100% of total billed charges,847.74,82.6,,,percent of total billed charges,82.6% of total billed charges,847.74,82.6,,,percent of total billed charges,82.6% of total billed charges,232.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.02,34792.25,
REPAIR/GRAFT KNEECAP TENDON,27381,CDM,983,RC,27381,HCPCS,Outpatient,,,2070,1345.50,,1821.6,88,,,percent of total billed charges,88% of total Billed charges,81.3,100,,,Fee Schedule,100% of Medicare rate,475.95,100,,,Fee Schedule,100% of WA Medicaid,2070,100,,,percent of total billed charges,100% of total billed charges,490.23,103,,,Fee Schedule,103% of WA Medicaid,81.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,142.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,475.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1428.3,69,,,percent of total billed charges,69% of total billed charges,2070,100,,,percent of total billed charges,100% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2070,100,,,percent of total billed charges,100% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2070,100,,,percent of total billed charges,100% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1280.3,61.85,,,percent of total billed charges,61.85% of total billed charges,475.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,618.74,130,,,Fee Schedule,130% of WA Medicaid ,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.39,37.7,,,percent of total billed charges,37.70% of total billed charges,780.39,37.7,,,percent of total billed charges,37.70% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,70173,33.9,,,percent of total billed charges,33.9% of total billed charges,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1614.6,78,,,percent of total billed charges,78% of total billed charges,2070,100,,,percent of total billed charges,100% of total billed charges,1709.82,82.6,,,percent of total billed charges,82.6% of total billed charges,1709.82,82.6,,,percent of total billed charges,82.6% of total billed charges,475.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.3,70173,
REPAIR/GRAFT OF THIGH MUSCLE,27386,CDM,983,RC,27386,HCPCS,Outpatient,,,2283,1483.95,,2009.04,88,,,percent of total billed charges,88% of total Billed charges,83.96,100,,,Fee Schedule,100% of Medicare rate,497.02,100,,,Fee Schedule,100% of WA Medicaid,2283,100,,,percent of total billed charges,100% of total billed charges,511.93,103,,,Fee Schedule,103% of WA Medicaid,83.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,146.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,497.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1575.27,69,,,percent of total billed charges,69% of total billed charges,2283,100,,,percent of total billed charges,100% of total billed charges,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2283,100,,,percent of total billed charges,100% of total billed charges,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2283,100,,,percent of total billed charges,100% of total billed charges,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1412.04,61.85,,,percent of total billed charges,61.85% of total billed charges,497.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,506.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,646.13,130,,,Fee Schedule,130% of WA Medicaid ,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,860.69,37.7,,,percent of total billed charges,37.70% of total billed charges,860.69,37.7,,,percent of total billed charges,37.70% of total billed charges,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,77393.7,33.9,,,percent of total billed charges,33.9% of total billed charges,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1780.74,78,,,percent of total billed charges,78% of total billed charges,2283,100,,,percent of total billed charges,100% of total billed charges,1885.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1885.76,82.6,,,percent of total billed charges,82.6% of total billed charges,497.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.96,77393.7,
REPAIR OF THIGH MUSCLE,27385,CDM,983,RC,27385,HCPCS,Outpatient,,,1584,1029.60,,1393.92,88,,,percent of total billed charges,88% of total Billed charges,54.49,100,,,Fee Schedule,100% of Medicare rate,356.59,100,,,Fee Schedule,100% of WA Medicaid,1584,100,,,percent of total billed charges,100% of total billed charges,367.29,103,,,Fee Schedule,103% of WA Medicaid,54.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,356.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1092.96,69,,,percent of total billed charges,69% of total billed charges,1584,100,,,percent of total billed charges,100% of total billed charges,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1584,100,,,percent of total billed charges,100% of total billed charges,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1584,100,,,percent of total billed charges,100% of total billed charges,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,979.7,61.85,,,percent of total billed charges,61.85% of total billed charges,356.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,463.57,130,,,Fee Schedule,130% of WA Medicaid ,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.17,37.7,,,percent of total billed charges,37.70% of total billed charges,597.17,37.7,,,percent of total billed charges,37.70% of total billed charges,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,53697.6,33.9,,,percent of total billed charges,33.9% of total billed charges,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1235.52,78,,,percent of total billed charges,78% of total billed charges,1584,100,,,percent of total billed charges,100% of total billed charges,1308.38,82.6,,,percent of total billed charges,82.6% of total billed charges,1308.38,82.6,,,percent of total billed charges,82.6% of total billed charges,356.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.49,53697.6,
REPAIR OF KNEECAP TENDON,27380,CDM,983,RC,27380,HCPCS,Outpatient,,,1588,1032.20,,1397.44,88,,,percent of total billed charges,88% of total Billed charges,58.3,100,,,Fee Schedule,100% of Medicare rate,364.42,100,,,Fee Schedule,100% of WA Medicaid,1588,100,,,percent of total billed charges,100% of total billed charges,375.35,103,,,Fee Schedule,103% of WA Medicaid,58.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,364.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1095.72,69,,,percent of total billed charges,69% of total billed charges,1588,100,,,percent of total billed charges,100% of total billed charges,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1588,100,,,percent of total billed charges,100% of total billed charges,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1588,100,,,percent of total billed charges,100% of total billed charges,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,982.18,61.85,,,percent of total billed charges,61.85% of total billed charges,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,473.75,130,,,Fee Schedule,130% of WA Medicaid ,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.68,37.7,,,percent of total billed charges,37.70% of total billed charges,598.68,37.7,,,percent of total billed charges,37.70% of total billed charges,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,53833.2,33.9,,,percent of total billed charges,33.9% of total billed charges,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1238.64,78,,,percent of total billed charges,78% of total billed charges,1588,100,,,percent of total billed charges,100% of total billed charges,1311.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1311.69,82.6,,,percent of total billed charges,82.6% of total billed charges,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.3,53833.2,
INCISION OF THIGH TENDON,27390,CDM,983,RC,27390,HCPCS,Outpatient,,,1304,847.60,,1147.52,88,,,percent of total billed charges,88% of total Billed charges,44.01,100,,,Fee Schedule,100% of Medicare rate,265.2,100,,,Fee Schedule,100% of WA Medicaid,1304,100,,,percent of total billed charges,100% of total billed charges,273.16,103,,,Fee Schedule,103% of WA Medicaid,44.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,265.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,899.76,69,,,percent of total billed charges,69% of total billed charges,1304,100,,,percent of total billed charges,100% of total billed charges,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1304,100,,,percent of total billed charges,100% of total billed charges,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1304,100,,,percent of total billed charges,100% of total billed charges,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.52,61.85,,,percent of total billed charges,61.85% of total billed charges,265.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,344.76,130,,,Fee Schedule,130% of WA Medicaid ,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.61,37.7,,,percent of total billed charges,37.70% of total billed charges,491.61,37.7,,,percent of total billed charges,37.70% of total billed charges,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,44205.6,33.9,,,percent of total billed charges,33.9% of total billed charges,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017.12,78,,,percent of total billed charges,78% of total billed charges,1304,100,,,percent of total billed charges,100% of total billed charges,1077.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1077.1,82.6,,,percent of total billed charges,82.6% of total billed charges,265.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.01,44205.6,
REPAIR OF KNEE LIGAMENTS,27409,CDM,983,RC,27409,HCPCS,Outpatient,,,2647,1720.55,,2329.36,88,,,percent of total billed charges,88% of total Billed charges,102.19,100,,,Fee Schedule,100% of Medicare rate,556.7,100,,,Fee Schedule,100% of WA Medicaid,2647,100,,,percent of total billed charges,100% of total billed charges,573.4,103,,,Fee Schedule,103% of WA Medicaid,102.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,178.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,556.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1826.43,69,,,percent of total billed charges,69% of total billed charges,2647,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2647,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2647,100,,,percent of total billed charges,100% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1637.17,61.85,,,percent of total billed charges,61.85% of total billed charges,556.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,723.71,130,,,Fee Schedule,130% of WA Medicaid ,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,997.92,37.7,,,percent of total billed charges,37.70% of total billed charges,997.92,37.7,,,percent of total billed charges,37.70% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,89733.3,33.9,,,percent of total billed charges,33.9% of total billed charges,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2064.66,78,,,percent of total billed charges,78% of total billed charges,2647,100,,,percent of total billed charges,100% of total billed charges,2186.42,82.6,,,percent of total billed charges,82.6% of total billed charges,2186.42,82.6,,,percent of total billed charges,82.6% of total billed charges,556.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,102.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,102.19,89733.3,
REPAIR OF KNEE LIGAMENT,27405,CDM,983,RC,27405,HCPCS,Outpatient,,,2291,1489.15,,2016.08,88,,,percent of total billed charges,88% of total Billed charges,67.89,100,,,Fee Schedule,100% of Medicare rate,393.33,100,,,Fee Schedule,100% of WA Medicaid,2291,100,,,percent of total billed charges,100% of total billed charges,405.13,103,,,Fee Schedule,103% of WA Medicaid,67.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,118.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,393.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1580.79,69,,,percent of total billed charges,69% of total billed charges,2291,100,,,percent of total billed charges,100% of total billed charges,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2291,100,,,percent of total billed charges,100% of total billed charges,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2291,100,,,percent of total billed charges,100% of total billed charges,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1416.98,61.85,,,percent of total billed charges,61.85% of total billed charges,393.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,511.33,130,,,Fee Schedule,130% of WA Medicaid ,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.71,37.7,,,percent of total billed charges,37.70% of total billed charges,863.71,37.7,,,percent of total billed charges,37.70% of total billed charges,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77664.9,33.9,,,percent of total billed charges,33.9% of total billed charges,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786.98,78,,,percent of total billed charges,78% of total billed charges,2291,100,,,percent of total billed charges,100% of total billed charges,1892.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1892.37,82.6,,,percent of total billed charges,82.6% of total billed charges,393.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.89,77664.9,
REPAIR DEGENERATED KNEECAP,27418,CDM,983,RC,27418,HCPCS,Outpatient,,,1881,1222.65,,1655.28,88,,,percent of total billed charges,88% of total Billed charges,81.55,100,,,Fee Schedule,100% of Medicare rate,475.2,100,,,Fee Schedule,100% of WA Medicaid,1881,100,,,percent of total billed charges,100% of total billed charges,489.46,103,,,Fee Schedule,103% of WA Medicaid,81.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,142.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,475.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1297.89,69,,,percent of total billed charges,69% of total billed charges,1881,100,,,percent of total billed charges,100% of total billed charges,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1881,100,,,percent of total billed charges,100% of total billed charges,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1881,100,,,percent of total billed charges,100% of total billed charges,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163.4,61.85,,,percent of total billed charges,61.85% of total billed charges,475.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,484.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,617.76,130,,,Fee Schedule,130% of WA Medicaid ,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.14,37.7,,,percent of total billed charges,37.70% of total billed charges,709.14,37.7,,,percent of total billed charges,37.70% of total billed charges,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,63765.9,33.9,,,percent of total billed charges,33.9% of total billed charges,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1467.18,78,,,percent of total billed charges,78% of total billed charges,1881,100,,,percent of total billed charges,100% of total billed charges,1553.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1553.71,82.6,,,percent of total billed charges,82.6% of total billed charges,475.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.55,63765.9,
OSTEOCHONDRAL KNEE ALLOGRAFT,27415,CDM,983,RC,27415,HCPCS,Outpatient,,,3785,2460.25,,3330.8,88,,,percent of total billed charges,88% of total Billed charges,148.5,100,,,Fee Schedule,100% of Medicare rate,785.54,100,,,Fee Schedule,100% of WA Medicaid,3785,100,,,percent of total billed charges,100% of total billed charges,809.11,103,,,Fee Schedule,103% of WA Medicaid,148.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,259.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,785.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2611.65,69,,,percent of total billed charges,69% of total billed charges,3785,100,,,percent of total billed charges,100% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,3785,100,,,percent of total billed charges,100% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,3785,100,,,percent of total billed charges,100% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2341.02,61.85,,,percent of total billed charges,61.85% of total billed charges,785.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,785.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,801.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1021.2,130,,,Fee Schedule,130% of WA Medicaid ,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1426.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1426.95,37.7,,,percent of total billed charges,37.70% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,128311.5,33.9,,,percent of total billed charges,33.9% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2952.3,78,,,percent of total billed charges,78% of total billed charges,3785,100,,,percent of total billed charges,100% of total billed charges,3126.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3126.41,82.6,,,percent of total billed charges,82.6% of total billed charges,785.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,785.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,148.5,128311.5,
RECONSTRUCTION KNEE,27429,CDM,983,RC,27429,HCPCS,Outpatient,,,3440,2236.00,,3027.2,88,,,percent of total billed charges,88% of total Billed charges,132.08,100,,,Fee Schedule,100% of Medicare rate,725.67,100,,,Fee Schedule,100% of WA Medicaid,3440,100,,,percent of total billed charges,100% of total billed charges,747.44,103,,,Fee Schedule,103% of WA Medicaid,132.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,231.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,725.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2373.6,69,,,percent of total billed charges,69% of total billed charges,3440,100,,,percent of total billed charges,100% of total billed charges,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,3440,100,,,percent of total billed charges,100% of total billed charges,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,3440,100,,,percent of total billed charges,100% of total billed charges,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2127.64,61.85,,,percent of total billed charges,61.85% of total billed charges,725.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,725.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,740.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,943.37,130,,,Fee Schedule,130% of WA Medicaid ,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1296.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1296.88,37.7,,,percent of total billed charges,37.70% of total billed charges,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,116616,33.9,,,percent of total billed charges,33.9% of total billed charges,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2683.2,78,,,percent of total billed charges,78% of total billed charges,3440,100,,,percent of total billed charges,100% of total billed charges,2841.44,82.6,,,percent of total billed charges,82.6% of total billed charges,2841.44,82.6,,,percent of total billed charges,82.6% of total billed charges,725.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,132.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,725.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,132.08,116616,
REVISION OF UNSTABLE KNEECAP,27422,CDM,983,RC,27422,HCPCS,Outpatient,,,2295,1491.75,,2019.6,88,,,percent of total billed charges,88% of total Billed charges,76.05,100,,,Fee Schedule,100% of Medicare rate,429.88,100,,,Fee Schedule,100% of WA Medicaid,2295,100,,,percent of total billed charges,100% of total billed charges,442.78,103,,,Fee Schedule,103% of WA Medicaid,76.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,133.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,429.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1583.55,69,,,percent of total billed charges,69% of total billed charges,2295,100,,,percent of total billed charges,100% of total billed charges,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2295,100,,,percent of total billed charges,100% of total billed charges,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2295,100,,,percent of total billed charges,100% of total billed charges,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1419.46,61.85,,,percent of total billed charges,61.85% of total billed charges,429.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,558.84,130,,,Fee Schedule,130% of WA Medicaid ,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,865.22,37.7,,,percent of total billed charges,37.70% of total billed charges,865.22,37.7,,,percent of total billed charges,37.70% of total billed charges,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,77800.5,33.9,,,percent of total billed charges,33.9% of total billed charges,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1790.1,78,,,percent of total billed charges,78% of total billed charges,2295,100,,,percent of total billed charges,100% of total billed charges,1895.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1895.67,82.6,,,percent of total billed charges,82.6% of total billed charges,429.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.05,77800.5,
RECONSTRUCTION KNEE,27428,CDM,983,RC,27428,HCPCS,Outpatient,,,3518,2286.70,,3095.84,88,,,percent of total billed charges,88% of total Billed charges,117.14,100,,,Fee Schedule,100% of Medicare rate,643.98,100,,,Fee Schedule,100% of WA Medicaid,3518,100,,,percent of total billed charges,100% of total billed charges,663.3,103,,,Fee Schedule,103% of WA Medicaid,117.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,205,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,643.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2427.42,69,,,percent of total billed charges,69% of total billed charges,3518,100,,,percent of total billed charges,100% of total billed charges,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,3518,100,,,percent of total billed charges,100% of total billed charges,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,3518,100,,,percent of total billed charges,100% of total billed charges,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2175.88,61.85,,,percent of total billed charges,61.85% of total billed charges,643.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,643.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,656.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,837.17,130,,,Fee Schedule,130% of WA Medicaid ,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1326.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1326.29,37.7,,,percent of total billed charges,37.70% of total billed charges,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,119260.2,33.9,,,percent of total billed charges,33.9% of total billed charges,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2744.04,78,,,percent of total billed charges,78% of total billed charges,3518,100,,,percent of total billed charges,100% of total billed charges,2905.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2905.87,82.6,,,percent of total billed charges,82.6% of total billed charges,643.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,643.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.14,119260.2,
REVISION OF UNSTABLE KNEECAP,27420,CDM,983,RC,27420,HCPCS,Outpatient,,,2131,1385.15,,1875.28,88,,,percent of total billed charges,88% of total Billed charges,77.86,100,,,Fee Schedule,100% of Medicare rate,434.73,100,,,Fee Schedule,100% of WA Medicaid,2131,100,,,percent of total billed charges,100% of total billed charges,447.77,103,,,Fee Schedule,103% of WA Medicaid,77.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,136.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,434.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1470.39,69,,,percent of total billed charges,69% of total billed charges,2131,100,,,percent of total billed charges,100% of total billed charges,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2131,100,,,percent of total billed charges,100% of total billed charges,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2131,100,,,percent of total billed charges,100% of total billed charges,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1318.02,61.85,,,percent of total billed charges,61.85% of total billed charges,434.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,565.15,130,,,Fee Schedule,130% of WA Medicaid ,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,803.39,37.7,,,percent of total billed charges,37.70% of total billed charges,803.39,37.7,,,percent of total billed charges,37.70% of total billed charges,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,72240.9,33.9,,,percent of total billed charges,33.9% of total billed charges,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1662.18,78,,,percent of total billed charges,78% of total billed charges,2131,100,,,percent of total billed charges,100% of total billed charges,1760.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1760.21,82.6,,,percent of total billed charges,82.6% of total billed charges,434.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.86,72240.9,
RECONSTRUCTION KNEE,27427,CDM,983,RC,27427,HCPCS,Outpatient,,,2469,1604.85,,2172.72,88,,,percent of total billed charges,88% of total Billed charges,71.16,100,,,Fee Schedule,100% of Medicare rate,410.86,100,,,Fee Schedule,100% of WA Medicaid,2469,100,,,percent of total billed charges,100% of total billed charges,423.19,103,,,Fee Schedule,103% of WA Medicaid,71.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,410.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1703.61,69,,,percent of total billed charges,69% of total billed charges,2469,100,,,percent of total billed charges,100% of total billed charges,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2469,100,,,percent of total billed charges,100% of total billed charges,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2469,100,,,percent of total billed charges,100% of total billed charges,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1527.08,61.85,,,percent of total billed charges,61.85% of total billed charges,410.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,534.12,130,,,Fee Schedule,130% of WA Medicaid ,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,930.81,37.7,,,percent of total billed charges,37.70% of total billed charges,930.81,37.7,,,percent of total billed charges,37.70% of total billed charges,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,83699.1,33.9,,,percent of total billed charges,33.9% of total billed charges,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1925.82,78,,,percent of total billed charges,78% of total billed charges,2469,100,,,percent of total billed charges,100% of total billed charges,2039.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2039.39,82.6,,,percent of total billed charges,82.6% of total billed charges,410.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.16,83699.1,
LAT RETINACULAR RELEASE OPEN,27425,CDM,983,RC,27425,HCPCS,Outpatient,,,1008,655.20,,887.04,88,,,percent of total billed charges,88% of total Billed charges,42.86,100,,,Fee Schedule,100% of Medicare rate,268,100,,,Fee Schedule,100% of WA Medicaid,1008,100,,,percent of total billed charges,100% of total billed charges,276.04,103,,,Fee Schedule,103% of WA Medicaid,42.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,268,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,695.52,69,,,percent of total billed charges,69% of total billed charges,1008,100,,,percent of total billed charges,100% of total billed charges,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008,100,,,percent of total billed charges,100% of total billed charges,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008,100,,,percent of total billed charges,100% of total billed charges,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,623.45,61.85,,,percent of total billed charges,61.85% of total billed charges,268,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,268,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,348.4,130,,,Fee Schedule,130% of WA Medicaid ,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.02,37.7,,,percent of total billed charges,37.70% of total billed charges,380.02,37.7,,,percent of total billed charges,37.70% of total billed charges,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,34171.2,33.9,,,percent of total billed charges,33.9% of total billed charges,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.24,78,,,percent of total billed charges,78% of total billed charges,1008,100,,,percent of total billed charges,100% of total billed charges,832.61,82.6,,,percent of total billed charges,82.6% of total billed charges,832.61,82.6,,,percent of total billed charges,82.6% of total billed charges,268,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,268,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.86,34171.2,
REVISION OF THIGH MUSCLES,27430,CDM,983,RC,27430,HCPCS,Outpatient,,,1823,1184.95,,1604.24,88,,,percent of total billed charges,88% of total Billed charges,76.59,100,,,Fee Schedule,100% of Medicare rate,430.44,100,,,Fee Schedule,100% of WA Medicaid,1823,100,,,percent of total billed charges,100% of total billed charges,443.35,103,,,Fee Schedule,103% of WA Medicaid,76.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,134.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,430.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1257.87,69,,,percent of total billed charges,69% of total billed charges,1823,100,,,percent of total billed charges,100% of total billed charges,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1823,100,,,percent of total billed charges,100% of total billed charges,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1823,100,,,percent of total billed charges,100% of total billed charges,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1127.53,61.85,,,percent of total billed charges,61.85% of total billed charges,430.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,559.57,130,,,Fee Schedule,130% of WA Medicaid ,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,687.27,37.7,,,percent of total billed charges,37.70% of total billed charges,687.27,37.7,,,percent of total billed charges,37.70% of total billed charges,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,61799.7,33.9,,,percent of total billed charges,33.9% of total billed charges,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1421.94,78,,,percent of total billed charges,78% of total billed charges,1823,100,,,percent of total billed charges,100% of total billed charges,1505.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1505.8,82.6,,,percent of total billed charges,82.6% of total billed charges,430.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.59,61799.7,
INCISION OF KNEE JOINT,27435,CDM,983,RC,27435,HCPCS,Outpatient,,,1850,1202.50,,1628,88,,,percent of total billed charges,88% of total Billed charges,81.94,100,,,Fee Schedule,100% of Medicare rate,468.12,100,,,Fee Schedule,100% of WA Medicaid,1850,100,,,percent of total billed charges,100% of total billed charges,482.16,103,,,Fee Schedule,103% of WA Medicaid,81.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,143.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,468.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1276.5,69,,,percent of total billed charges,69% of total billed charges,1850,100,,,percent of total billed charges,100% of total billed charges,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1850,100,,,percent of total billed charges,100% of total billed charges,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1850,100,,,percent of total billed charges,100% of total billed charges,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1144.23,61.85,,,percent of total billed charges,61.85% of total billed charges,468.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,477.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,608.56,130,,,Fee Schedule,130% of WA Medicaid ,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.45,37.7,,,percent of total billed charges,37.70% of total billed charges,697.45,37.7,,,percent of total billed charges,37.70% of total billed charges,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,62715,33.9,,,percent of total billed charges,33.9% of total billed charges,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1443,78,,,percent of total billed charges,78% of total billed charges,1850,100,,,percent of total billed charges,100% of total billed charges,1528.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1528.1,82.6,,,percent of total billed charges,82.6% of total billed charges,468.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.94,62715,
REVISE KNEECAP WITH IMPLANT,27438,CDM,983,RC,27438,HCPCS,Outpatient,,,2121,1378.65,,1866.48,88,,,percent of total billed charges,88% of total Billed charges,88.04,100,,,Fee Schedule,100% of Medicare rate,485.09,100,,,Fee Schedule,100% of WA Medicaid,2121,100,,,percent of total billed charges,100% of total billed charges,499.64,103,,,Fee Schedule,103% of WA Medicaid,88.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,154.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,485.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1463.49,69,,,percent of total billed charges,69% of total billed charges,2121,100,,,percent of total billed charges,100% of total billed charges,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2121,100,,,percent of total billed charges,100% of total billed charges,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2121,100,,,percent of total billed charges,100% of total billed charges,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1311.84,61.85,,,percent of total billed charges,61.85% of total billed charges,485.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,630.62,130,,,Fee Schedule,130% of WA Medicaid ,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.62,37.7,,,percent of total billed charges,37.70% of total billed charges,799.62,37.7,,,percent of total billed charges,37.70% of total billed charges,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,71901.9,33.9,,,percent of total billed charges,33.9% of total billed charges,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1654.38,78,,,percent of total billed charges,78% of total billed charges,2121,100,,,percent of total billed charges,100% of total billed charges,1751.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1751.95,82.6,,,percent of total billed charges,82.6% of total billed charges,485.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.04,71901.9,
TOTAL KNEE ARTHROPLASTY,27447,CDM,983,RC,27447,HCPCS,Outpatient,,,4772,3101.80,,4199.36,88,,,percent of total billed charges,88% of total Billed charges,142.48,100,,,Fee Schedule,100% of Medicare rate,729.77,100,,,Fee Schedule,100% of WA Medicaid,4772,100,,,percent of total billed charges,100% of total billed charges,751.66,103,,,Fee Schedule,103% of WA Medicaid,142.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,249.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,729.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3292.68,69,,,percent of total billed charges,69% of total billed charges,4772,100,,,percent of total billed charges,100% of total billed charges,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4772,100,,,percent of total billed charges,100% of total billed charges,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4772,100,,,percent of total billed charges,100% of total billed charges,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2951.48,61.85,,,percent of total billed charges,61.85% of total billed charges,729.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,744.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,948.7,130,,,Fee Schedule,130% of WA Medicaid ,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1799.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1799.04,37.7,,,percent of total billed charges,37.70% of total billed charges,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,161770.8,33.9,,,percent of total billed charges,33.9% of total billed charges,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3722.16,78,,,percent of total billed charges,78% of total billed charges,4772,100,,,percent of total billed charges,100% of total billed charges,3941.67,82.6,,,percent of total billed charges,82.6% of total billed charges,3941.67,82.6,,,percent of total billed charges,82.6% of total billed charges,729.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,142.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,142.48,161770.8,
REVISION OF KNEE JOINT,27446,CDM,983,RC,27446,HCPCS,Outpatient,,,3639,2365.35,,3202.32,88,,,percent of total billed charges,88% of total Billed charges,125.58,100,,,Fee Schedule,100% of Medicare rate,655.55,100,,,Fee Schedule,100% of WA Medicaid,3639,100,,,percent of total billed charges,100% of total billed charges,675.22,103,,,Fee Schedule,103% of WA Medicaid,125.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,219.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,655.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2510.91,69,,,percent of total billed charges,69% of total billed charges,3639,100,,,percent of total billed charges,100% of total billed charges,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3639,100,,,percent of total billed charges,100% of total billed charges,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3639,100,,,percent of total billed charges,100% of total billed charges,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2250.72,61.85,,,percent of total billed charges,61.85% of total billed charges,655.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,655.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,852.22,130,,,Fee Schedule,130% of WA Medicaid ,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1371.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1371.9,37.7,,,percent of total billed charges,37.70% of total billed charges,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,123362.1,33.9,,,percent of total billed charges,33.9% of total billed charges,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2838.42,78,,,percent of total billed charges,78% of total billed charges,3639,100,,,percent of total billed charges,100% of total billed charges,3005.81,82.6,,,percent of total billed charges,82.6% of total billed charges,3005.81,82.6,,,percent of total billed charges,82.6% of total billed charges,655.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,125.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,655.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,125.58,123362.1,
REVISION OF KNEE JOINT,27442,CDM,983,RC,27442,HCPCS,Outpatient,,,2548,1656.20,,2242.24,88,,,percent of total billed charges,88% of total Billed charges,91.19,100,,,Fee Schedule,100% of Medicare rate,500.57,100,,,Fee Schedule,100% of WA Medicaid,2548,100,,,percent of total billed charges,100% of total billed charges,515.59,103,,,Fee Schedule,103% of WA Medicaid,91.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,159.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,500.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1758.12,69,,,percent of total billed charges,69% of total billed charges,2548,100,,,percent of total billed charges,100% of total billed charges,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2548,100,,,percent of total billed charges,100% of total billed charges,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2548,100,,,percent of total billed charges,100% of total billed charges,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1575.94,61.85,,,percent of total billed charges,61.85% of total billed charges,500.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,650.74,130,,,Fee Schedule,130% of WA Medicaid ,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,960.6,37.7,,,percent of total billed charges,37.70% of total billed charges,960.6,37.7,,,percent of total billed charges,37.70% of total billed charges,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,86377.2,33.9,,,percent of total billed charges,33.9% of total billed charges,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1987.44,78,,,percent of total billed charges,78% of total billed charges,2548,100,,,percent of total billed charges,100% of total billed charges,2104.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2104.65,82.6,,,percent of total billed charges,82.6% of total billed charges,500.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.19,86377.2,
REVISION OF KNEE JOINT,27445,CDM,983,RC,27445,HCPCS,Outpatient,,,3885,2525.25,,3418.8,88,,,percent of total billed charges,88% of total Billed charges,137.33,100,,,Fee Schedule,100% of Medicare rate,716.16,100,,,Fee Schedule,100% of WA Medicaid,3885,100,,,percent of total billed charges,100% of total billed charges,737.64,103,,,Fee Schedule,103% of WA Medicaid,137.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,240.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,716.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2680.65,69,,,percent of total billed charges,69% of total billed charges,3885,100,,,percent of total billed charges,100% of total billed charges,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3885,100,,,percent of total billed charges,100% of total billed charges,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3885,100,,,percent of total billed charges,100% of total billed charges,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2402.87,61.85,,,percent of total billed charges,61.85% of total billed charges,716.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,716.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,931.01,130,,,Fee Schedule,130% of WA Medicaid ,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1464.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1464.65,37.7,,,percent of total billed charges,37.70% of total billed charges,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,131701.5,33.9,,,percent of total billed charges,33.9% of total billed charges,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3030.3,78,,,percent of total billed charges,78% of total billed charges,3885,100,,,percent of total billed charges,100% of total billed charges,3209.01,82.6,,,percent of total billed charges,82.6% of total billed charges,3209.01,82.6,,,percent of total billed charges,82.6% of total billed charges,716.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,137.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,716.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,137.33,131701.5,
REALIGNMENT OF KNEE,27455,CDM,983,RC,27455,HCPCS,Outpatient,,,2626,1706.90,,2310.88,88,,,percent of total billed charges,88% of total Billed charges,100.45,100,,,Fee Schedule,100% of Medicare rate,553.35,100,,,Fee Schedule,100% of WA Medicaid,2626,100,,,percent of total billed charges,100% of total billed charges,569.95,103,,,Fee Schedule,103% of WA Medicaid,100.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,175.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,553.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1811.94,69,,,percent of total billed charges,69% of total billed charges,2626,100,,,percent of total billed charges,100% of total billed charges,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2626,100,,,percent of total billed charges,100% of total billed charges,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2626,100,,,percent of total billed charges,100% of total billed charges,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1624.18,61.85,,,percent of total billed charges,61.85% of total billed charges,553.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,719.36,130,,,Fee Schedule,130% of WA Medicaid ,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,990,37.7,,,percent of total billed charges,37.70% of total billed charges,990,37.7,,,percent of total billed charges,37.70% of total billed charges,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,89021.4,33.9,,,percent of total billed charges,33.9% of total billed charges,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2048.28,78,,,percent of total billed charges,78% of total billed charges,2626,100,,,percent of total billed charges,100% of total billed charges,2169.08,82.6,,,percent of total billed charges,82.6% of total billed charges,2169.08,82.6,,,percent of total billed charges,82.6% of total billed charges,553.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,100.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,100.45,89021.4,
REPAIR/GRAFT OF THIGH,27472,CDM,983,RC,27472,HCPCS,Outpatient,,,3766,2447.90,,3314.08,88,,,percent of total billed charges,88% of total Billed charges,137.94,100,,,Fee Schedule,100% of Medicare rate,722.87,100,,,Fee Schedule,100% of WA Medicaid,3766,100,,,percent of total billed charges,100% of total billed charges,744.56,103,,,Fee Schedule,103% of WA Medicaid,137.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,241.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,722.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2598.54,69,,,percent of total billed charges,69% of total billed charges,3766,100,,,percent of total billed charges,100% of total billed charges,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3766,100,,,percent of total billed charges,100% of total billed charges,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3766,100,,,percent of total billed charges,100% of total billed charges,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2329.27,61.85,,,percent of total billed charges,61.85% of total billed charges,722.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,722.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,737.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,939.73,130,,,Fee Schedule,130% of WA Medicaid ,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1419.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1419.78,37.7,,,percent of total billed charges,37.70% of total billed charges,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,127667.4,33.9,,,percent of total billed charges,33.9% of total billed charges,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2937.48,78,,,percent of total billed charges,78% of total billed charges,3766,100,,,percent of total billed charges,100% of total billed charges,3110.72,82.6,,,percent of total billed charges,82.6% of total billed charges,3110.72,82.6,,,percent of total billed charges,82.6% of total billed charges,722.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,137.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,722.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,137.94,127667.4,
REPAIR OF THIGH,27470,CDM,983,RC,27470,HCPCS,Outpatient,,,2908,1890.20,,2559.04,88,,,percent of total billed charges,88% of total Billed charges,127.21,100,,,Fee Schedule,100% of Medicare rate,676.81,100,,,Fee Schedule,100% of WA Medicaid,2908,100,,,percent of total billed charges,100% of total billed charges,697.11,103,,,Fee Schedule,103% of WA Medicaid,127.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,222.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,676.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2006.52,69,,,percent of total billed charges,69% of total billed charges,2908,100,,,percent of total billed charges,100% of total billed charges,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2908,100,,,percent of total billed charges,100% of total billed charges,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2908,100,,,percent of total billed charges,100% of total billed charges,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1798.6,61.85,,,percent of total billed charges,61.85% of total billed charges,676.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,676.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,690.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,879.85,130,,,Fee Schedule,130% of WA Medicaid ,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1096.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1096.32,37.7,,,percent of total billed charges,37.70% of total billed charges,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,98581.2,33.9,,,percent of total billed charges,33.9% of total billed charges,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2268.24,78,,,percent of total billed charges,78% of total billed charges,2908,100,,,percent of total billed charges,100% of total billed charges,2402.01,82.6,,,percent of total billed charges,82.6% of total billed charges,2402.01,82.6,,,percent of total billed charges,82.6% of total billed charges,676.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,127.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,676.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,127.21,98581.2,
REMOVAL OF KNEE PROSTHESIS,27488,CDM,983,RC,27488,HCPCS,Outpatient,,,2742,1782.30,,2412.96,88,,,percent of total billed charges,88% of total Billed charges,129.82,100,,,Fee Schedule,100% of Medicare rate,686.88,100,,,Fee Schedule,100% of WA Medicaid,2742,100,,,percent of total billed charges,100% of total billed charges,707.49,103,,,Fee Schedule,103% of WA Medicaid,129.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,227.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,686.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1891.98,69,,,percent of total billed charges,69% of total billed charges,2742,100,,,percent of total billed charges,100% of total billed charges,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2742,100,,,percent of total billed charges,100% of total billed charges,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2742,100,,,percent of total billed charges,100% of total billed charges,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1695.93,61.85,,,percent of total billed charges,61.85% of total billed charges,686.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,892.94,130,,,Fee Schedule,130% of WA Medicaid ,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1033.73,37.7,,,percent of total billed charges,37.70% of total billed charges,1033.73,37.7,,,percent of total billed charges,37.70% of total billed charges,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,92953.8,33.9,,,percent of total billed charges,33.9% of total billed charges,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2138.76,78,,,percent of total billed charges,78% of total billed charges,2742,100,,,percent of total billed charges,100% of total billed charges,2264.89,82.6,,,percent of total billed charges,82.6% of total billed charges,2264.89,82.6,,,percent of total billed charges,82.6% of total billed charges,686.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,129.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,129.82,92953.8,
REVISE/REPLACE KNEE JOINT,27486,CDM,983,RC,27486,HCPCS,Outpatient,,,4064,2641.60,,3576.32,88,,,percent of total billed charges,88% of total Billed charges,154.47,100,,,Fee Schedule,100% of Medicare rate,799.9,100,,,Fee Schedule,100% of WA Medicaid,4064,100,,,percent of total billed charges,100% of total billed charges,823.9,103,,,Fee Schedule,103% of WA Medicaid,154.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,270.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,799.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2804.16,69,,,percent of total billed charges,69% of total billed charges,4064,100,,,percent of total billed charges,100% of total billed charges,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,4064,100,,,percent of total billed charges,100% of total billed charges,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,4064,100,,,percent of total billed charges,100% of total billed charges,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,2513.58,61.85,,,percent of total billed charges,61.85% of total billed charges,799.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1039.87,130,,,Fee Schedule,130% of WA Medicaid ,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1532.13,37.7,,,percent of total billed charges,37.70% of total billed charges,1532.13,37.7,,,percent of total billed charges,37.70% of total billed charges,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,137769.6,33.9,,,percent of total billed charges,33.9% of total billed charges,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,3169.92,78,,,percent of total billed charges,78% of total billed charges,4064,100,,,percent of total billed charges,100% of total billed charges,3356.86,82.6,,,percent of total billed charges,82.6% of total billed charges,3356.86,82.6,,,percent of total billed charges,82.6% of total billed charges,799.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,154.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,154.47,137769.6,
REVISE/REPLACE KNEE JOINT,27487,CDM,983,RC,27487,HCPCS,Outpatient,,,5569,3619.85,,4900.72,88,,,percent of total billed charges,88% of total Billed charges,197.17,100,,,Fee Schedule,100% of Medicare rate,994.42,100,,,Fee Schedule,100% of WA Medicaid,5569,100,,,percent of total billed charges,100% of total billed charges,1024.25,103,,,Fee Schedule,103% of WA Medicaid,197.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,345.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,994.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3842.61,69,,,percent of total billed charges,69% of total billed charges,5569,100,,,percent of total billed charges,100% of total billed charges,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,5569,100,,,percent of total billed charges,100% of total billed charges,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,5569,100,,,percent of total billed charges,100% of total billed charges,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3444.43,61.85,,,percent of total billed charges,61.85% of total billed charges,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,994.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1292.75,130,,,Fee Schedule,130% of WA Medicaid ,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2099.51,37.7,,,percent of total billed charges,37.70% of total billed charges,2099.51,37.7,,,percent of total billed charges,37.70% of total billed charges,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,188789.1,33.9,,,percent of total billed charges,33.9% of total billed charges,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4343.82,78,,,percent of total billed charges,78% of total billed charges,5569,100,,,percent of total billed charges,100% of total billed charges,4599.99,82.6,,,percent of total billed charges,82.6% of total billed charges,4599.99,82.6,,,percent of total billed charges,82.6% of total billed charges,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,197.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,197.17,188789.1,
DECOMPRESSION OF THIGH/KNEE,27496,CDM,983,RC,27496,HCPCS,Outpatient,,,1466,952.90,,1290.08,88,,,percent of total billed charges,88% of total Billed charges,53.23,100,,,Fee Schedule,100% of Medicare rate,322.27,100,,,Fee Schedule,100% of WA Medicaid,1466,100,,,percent of total billed charges,100% of total billed charges,331.94,103,,,Fee Schedule,103% of WA Medicaid,53.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,322.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1011.54,69,,,percent of total billed charges,69% of total billed charges,1466,100,,,percent of total billed charges,100% of total billed charges,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1466,100,,,percent of total billed charges,100% of total billed charges,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1466,100,,,percent of total billed charges,100% of total billed charges,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,906.72,61.85,,,percent of total billed charges,61.85% of total billed charges,322.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,418.95,130,,,Fee Schedule,130% of WA Medicaid ,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.68,37.7,,,percent of total billed charges,37.70% of total billed charges,552.68,37.7,,,percent of total billed charges,37.70% of total billed charges,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,49697.4,33.9,,,percent of total billed charges,33.9% of total billed charges,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1143.48,78,,,percent of total billed charges,78% of total billed charges,1466,100,,,percent of total billed charges,100% of total billed charges,1210.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1210.92,82.6,,,percent of total billed charges,82.6% of total billed charges,322.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.23,49697.4,
CLOSE TX OF FEMORAL FX DIST END;W/O MAN,27508,CDM,983,RC,27508,HCPCS,Outpatient,,,1185,770.25,,1042.8,88,,,percent of total billed charges,88% of total Billed charges,47.85,100,,,Fee Schedule,100% of Medicare rate,293.92,100,,,Fee Schedule,100% of WA Medicaid,1185,100,,,percent of total billed charges,100% of total billed charges,302.74,103,,,Fee Schedule,103% of WA Medicaid,47.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,293.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,817.65,69,,,percent of total billed charges,69% of total billed charges,1185,100,,,percent of total billed charges,100% of total billed charges,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1185,100,,,percent of total billed charges,100% of total billed charges,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1185,100,,,percent of total billed charges,100% of total billed charges,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,732.92,61.85,,,percent of total billed charges,61.85% of total billed charges,293.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,382.1,130,,,Fee Schedule,130% of WA Medicaid ,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.75,37.7,,,percent of total billed charges,37.70% of total billed charges,446.75,37.7,,,percent of total billed charges,37.70% of total billed charges,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,40171.5,33.9,,,percent of total billed charges,33.9% of total billed charges,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,924.3,78,,,percent of total billed charges,78% of total billed charges,1185,100,,,percent of total billed charges,100% of total billed charges,978.81,82.6,,,percent of total billed charges,82.6% of total billed charges,978.81,82.6,,,percent of total billed charges,82.6% of total billed charges,293.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.85,40171.5,
TREATMENT OF THIGH FRACTURE,27509,CDM,983,RC,27509,HCPCS,Outpatient,,,2085,1355.25,,1834.8,88,,,percent of total billed charges,88% of total Billed charges,63.26,100,,,Fee Schedule,100% of Medicare rate,394.63,100,,,Fee Schedule,100% of WA Medicaid,2085,100,,,percent of total billed charges,100% of total billed charges,406.47,103,,,Fee Schedule,103% of WA Medicaid,63.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,110.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,394.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1438.65,69,,,percent of total billed charges,69% of total billed charges,2085,100,,,percent of total billed charges,100% of total billed charges,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2085,100,,,percent of total billed charges,100% of total billed charges,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2085,100,,,percent of total billed charges,100% of total billed charges,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1289.57,61.85,,,percent of total billed charges,61.85% of total billed charges,394.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,513.02,130,,,Fee Schedule,130% of WA Medicaid ,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.05,37.7,,,percent of total billed charges,37.70% of total billed charges,786.05,37.7,,,percent of total billed charges,37.70% of total billed charges,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,70681.5,33.9,,,percent of total billed charges,33.9% of total billed charges,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1626.3,78,,,percent of total billed charges,78% of total billed charges,2085,100,,,percent of total billed charges,100% of total billed charges,1722.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1722.21,82.6,,,percent of total billed charges,82.6% of total billed charges,394.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.26,70681.5,
TREATMENT OF THIGH FRACTURE,27507,CDM,983,RC,27507,HCPCS,Outpatient,,,3935,2557.75,,3462.8,88,,,percent of total billed charges,88% of total Billed charges,105.63,100,,,Fee Schedule,100% of Medicare rate,552.6,100,,,Fee Schedule,100% of WA Medicaid,3935,100,,,percent of total billed charges,100% of total billed charges,569.18,103,,,Fee Schedule,103% of WA Medicaid,105.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,184.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,552.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2715.15,69,,,percent of total billed charges,69% of total billed charges,3935,100,,,percent of total billed charges,100% of total billed charges,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,3935,100,,,percent of total billed charges,100% of total billed charges,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,3935,100,,,percent of total billed charges,100% of total billed charges,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2433.8,61.85,,,percent of total billed charges,61.85% of total billed charges,552.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,563.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,718.38,130,,,Fee Schedule,130% of WA Medicaid ,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1483.5,37.7,,,percent of total billed charges,37.70% of total billed charges,1483.5,37.7,,,percent of total billed charges,37.70% of total billed charges,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,133396.5,33.9,,,percent of total billed charges,33.9% of total billed charges,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,3069.3,78,,,percent of total billed charges,78% of total billed charges,3935,100,,,percent of total billed charges,100% of total billed charges,3250.31,82.6,,,percent of total billed charges,82.6% of total billed charges,3250.31,82.6,,,percent of total billed charges,82.6% of total billed charges,552.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,105.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105.63,133396.5,
TREATMENT OF THIGH FRACTURE,27506,CDM,983,RC,27506,HCPCS,Outpatient,,,5298,3443.70,,4662.24,88,,,percent of total billed charges,88% of total Billed charges,144.58,100,,,Fee Schedule,100% of Medicare rate,765.21,100,,,Fee Schedule,100% of WA Medicaid,5298,100,,,percent of total billed charges,100% of total billed charges,788.17,103,,,Fee Schedule,103% of WA Medicaid,144.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,253.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,765.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3655.62,69,,,percent of total billed charges,69% of total billed charges,5298,100,,,percent of total billed charges,100% of total billed charges,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,5298,100,,,percent of total billed charges,100% of total billed charges,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,5298,100,,,percent of total billed charges,100% of total billed charges,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3276.81,61.85,,,percent of total billed charges,61.85% of total billed charges,765.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,994.77,130,,,Fee Schedule,130% of WA Medicaid ,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1997.35,37.7,,,percent of total billed charges,37.70% of total billed charges,1997.35,37.7,,,percent of total billed charges,37.70% of total billed charges,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,179602.2,33.9,,,percent of total billed charges,33.9% of total billed charges,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4132.44,78,,,percent of total billed charges,78% of total billed charges,5298,100,,,percent of total billed charges,100% of total billed charges,4376.15,82.6,,,percent of total billed charges,82.6% of total billed charges,4376.15,82.6,,,percent of total billed charges,82.6% of total billed charges,765.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,144.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,144.58,179602.2,
TREATMENT OF THIGH FRACTURE,27502,CDM,983,RC,27502,HCPCS,Outpatient,,,2431,1580.15,,2139.28,88,,,percent of total billed charges,88% of total Billed charges,83.5,100,,,Fee Schedule,100% of Medicare rate,432.87,100,,,Fee Schedule,100% of WA Medicaid,2431,100,,,percent of total billed charges,100% of total billed charges,445.86,103,,,Fee Schedule,103% of WA Medicaid,83.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,146.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,432.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1677.39,69,,,percent of total billed charges,69% of total billed charges,2431,100,,,percent of total billed charges,100% of total billed charges,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2431,100,,,percent of total billed charges,100% of total billed charges,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2431,100,,,percent of total billed charges,100% of total billed charges,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1503.57,61.85,,,percent of total billed charges,61.85% of total billed charges,432.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562.73,130,,,Fee Schedule,130% of WA Medicaid ,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.49,37.7,,,percent of total billed charges,37.70% of total billed charges,916.49,37.7,,,percent of total billed charges,37.70% of total billed charges,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,82410.9,33.9,,,percent of total billed charges,33.9% of total billed charges,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1896.18,78,,,percent of total billed charges,78% of total billed charges,2431,100,,,percent of total billed charges,100% of total billed charges,2008.01,82.6,,,percent of total billed charges,82.6% of total billed charges,2008.01,82.6,,,percent of total billed charges,82.6% of total billed charges,432.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.5,82410.9,
TREATMENT OF THIGH FRACTURE,27513,CDM,983,RC,27513,HCPCS,Outpatient,,,4392,2854.80,,3864.96,88,,,percent of total billed charges,88% of total Billed charges,139.16,100,,,Fee Schedule,100% of Medicare rate,700.87,100,,,Fee Schedule,100% of WA Medicaid,4392,100,,,percent of total billed charges,100% of total billed charges,721.9,103,,,Fee Schedule,103% of WA Medicaid,139.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,243.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,700.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3030.48,69,,,percent of total billed charges,69% of total billed charges,4392,100,,,percent of total billed charges,100% of total billed charges,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,4392,100,,,percent of total billed charges,100% of total billed charges,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,4392,100,,,percent of total billed charges,100% of total billed charges,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2716.45,61.85,,,percent of total billed charges,61.85% of total billed charges,700.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,911.13,130,,,Fee Schedule,130% of WA Medicaid ,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1655.78,37.7,,,percent of total billed charges,37.70% of total billed charges,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,148888.8,33.9,,,percent of total billed charges,33.9% of total billed charges,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,3425.76,78,,,percent of total billed charges,78% of total billed charges,4392,100,,,percent of total billed charges,100% of total billed charges,3627.79,82.6,,,percent of total billed charges,82.6% of total billed charges,3627.79,82.6,,,percent of total billed charges,82.6% of total billed charges,700.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,139.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,139.16,148888.8,
TREATMENT OF THIGH FRACTURE,27511,CDM,983,RC,27511,HCPCS,Outpatient,,,3736,2428.40,,3287.68,88,,,percent of total billed charges,88% of total Billed charges,110.33,100,,,Fee Schedule,100% of Medicare rate,567.71,100,,,Fee Schedule,100% of WA Medicaid,3736,100,,,percent of total billed charges,100% of total billed charges,584.74,103,,,Fee Schedule,103% of WA Medicaid,110.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,567.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2577.84,69,,,percent of total billed charges,69% of total billed charges,3736,100,,,percent of total billed charges,100% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3736,100,,,percent of total billed charges,100% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3736,100,,,percent of total billed charges,100% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2310.72,61.85,,,percent of total billed charges,61.85% of total billed charges,567.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,579.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,738.02,130,,,Fee Schedule,130% of WA Medicaid ,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1408.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1408.47,37.7,,,percent of total billed charges,37.70% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,126650.4,33.9,,,percent of total billed charges,33.9% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2914.08,78,,,percent of total billed charges,78% of total billed charges,3736,100,,,percent of total billed charges,100% of total billed charges,3085.94,82.6,,,percent of total billed charges,82.6% of total billed charges,3085.94,82.6,,,percent of total billed charges,82.6% of total billed charges,567.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.33,126650.4,
TREAT THIGH FX GROWTH PLATE,27517,CDM,983,RC,27517,HCPCS,Outpatient,,,2114,1374.10,,1860.32,88,,,percent of total billed charges,88% of total Billed charges,69.64,100,,,Fee Schedule,100% of Medicare rate,402.09,100,,,Fee Schedule,100% of WA Medicaid,2114,100,,,percent of total billed charges,100% of total billed charges,414.15,103,,,Fee Schedule,103% of WA Medicaid,69.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,121.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,402.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1458.66,69,,,percent of total billed charges,69% of total billed charges,2114,100,,,percent of total billed charges,100% of total billed charges,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2114,100,,,percent of total billed charges,100% of total billed charges,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2114,100,,,percent of total billed charges,100% of total billed charges,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1307.51,61.85,,,percent of total billed charges,61.85% of total billed charges,402.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,522.72,130,,,Fee Schedule,130% of WA Medicaid ,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,796.98,37.7,,,percent of total billed charges,37.70% of total billed charges,796.98,37.7,,,percent of total billed charges,37.70% of total billed charges,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,71664.6,33.9,,,percent of total billed charges,33.9% of total billed charges,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1648.92,78,,,percent of total billed charges,78% of total billed charges,2114,100,,,percent of total billed charges,100% of total billed charges,1746.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1746.16,82.6,,,percent of total billed charges,82.6% of total billed charges,402.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.64,71664.6,
TREATMENT OF THIGH FRACTURE,27514,CDM,983,RC,27514,HCPCS,Outpatient,,,4155,2700.75,,3656.4,88,,,percent of total billed charges,88% of total Billed charges,106.06,100,,,Fee Schedule,100% of Medicare rate,550.73,100,,,Fee Schedule,100% of WA Medicaid,4155,100,,,percent of total billed charges,100% of total billed charges,567.25,103,,,Fee Schedule,103% of WA Medicaid,106.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,185.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,550.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2866.95,69,,,percent of total billed charges,69% of total billed charges,4155,100,,,percent of total billed charges,100% of total billed charges,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4155,100,,,percent of total billed charges,100% of total billed charges,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4155,100,,,percent of total billed charges,100% of total billed charges,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2569.87,61.85,,,percent of total billed charges,61.85% of total billed charges,550.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,715.95,130,,,Fee Schedule,130% of WA Medicaid ,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1566.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1566.44,37.7,,,percent of total billed charges,37.70% of total billed charges,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,140854.5,33.9,,,percent of total billed charges,33.9% of total billed charges,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,3240.9,78,,,percent of total billed charges,78% of total billed charges,4155,100,,,percent of total billed charges,100% of total billed charges,3432.03,82.6,,,percent of total billed charges,82.6% of total billed charges,3432.03,82.6,,,percent of total billed charges,82.6% of total billed charges,550.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.06,140854.5,
TREAT KNEECAP FRACTURE,27524,CDM,983,RC,27524,HCPCS,Outpatient,,,3029,1968.85,,2665.52,88,,,percent of total billed charges,88% of total Billed charges,77.67,100,,,Fee Schedule,100% of Medicare rate,436.04,100,,,Fee Schedule,100% of WA Medicaid,3029,100,,,percent of total billed charges,100% of total billed charges,449.12,103,,,Fee Schedule,103% of WA Medicaid,77.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,436.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2090.01,69,,,percent of total billed charges,69% of total billed charges,3029,100,,,percent of total billed charges,100% of total billed charges,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,3029,100,,,percent of total billed charges,100% of total billed charges,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,3029,100,,,percent of total billed charges,100% of total billed charges,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1873.44,61.85,,,percent of total billed charges,61.85% of total billed charges,436.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,566.85,130,,,Fee Schedule,130% of WA Medicaid ,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1141.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1141.93,37.7,,,percent of total billed charges,37.70% of total billed charges,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,102683.1,33.9,,,percent of total billed charges,33.9% of total billed charges,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2362.62,78,,,percent of total billed charges,78% of total billed charges,3029,100,,,percent of total billed charges,100% of total billed charges,2501.95,82.6,,,percent of total billed charges,82.6% of total billed charges,2501.95,82.6,,,percent of total billed charges,82.6% of total billed charges,436.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.67,102683.1,
TREAT KNEE FRACTURE,27536,CDM,983,RC,27536,HCPCS,Outpatient,,,3622,2354.30,,3187.36,88,,,percent of total billed charges,88% of total Billed charges,128.41,100,,,Fee Schedule,100% of Medicare rate,679.98,100,,,Fee Schedule,100% of WA Medicaid,3622,100,,,percent of total billed charges,100% of total billed charges,700.38,103,,,Fee Schedule,103% of WA Medicaid,128.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,224.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,679.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2499.18,69,,,percent of total billed charges,69% of total billed charges,3622,100,,,percent of total billed charges,100% of total billed charges,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,3622,100,,,percent of total billed charges,100% of total billed charges,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,3622,100,,,percent of total billed charges,100% of total billed charges,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2240.21,61.85,,,percent of total billed charges,61.85% of total billed charges,679.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,679.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,693.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,883.97,130,,,Fee Schedule,130% of WA Medicaid ,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1365.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1365.49,37.7,,,percent of total billed charges,37.70% of total billed charges,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,122785.8,33.9,,,percent of total billed charges,33.9% of total billed charges,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2825.16,78,,,percent of total billed charges,78% of total billed charges,3622,100,,,percent of total billed charges,100% of total billed charges,2991.77,82.6,,,percent of total billed charges,82.6% of total billed charges,2991.77,82.6,,,percent of total billed charges,82.6% of total billed charges,679.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,128.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,679.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.41,122785.8,
TREAT KNEE FRACTURE,27535,CDM,983,RC,27535,HCPCS,Outpatient,,,3541,2301.65,,3116.08,88,,,percent of total billed charges,88% of total Billed charges,98.07,100,,,Fee Schedule,100% of Medicare rate,512.32,100,,,Fee Schedule,100% of WA Medicaid,3541,100,,,percent of total billed charges,100% of total billed charges,527.69,103,,,Fee Schedule,103% of WA Medicaid,98.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,171.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,512.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2443.29,69,,,percent of total billed charges,69% of total billed charges,3541,100,,,percent of total billed charges,100% of total billed charges,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3541,100,,,percent of total billed charges,100% of total billed charges,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3541,100,,,percent of total billed charges,100% of total billed charges,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2190.11,61.85,,,percent of total billed charges,61.85% of total billed charges,512.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,666.02,130,,,Fee Schedule,130% of WA Medicaid ,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1334.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1334.96,37.7,,,percent of total billed charges,37.70% of total billed charges,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,120039.9,33.9,,,percent of total billed charges,33.9% of total billed charges,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2761.98,78,,,percent of total billed charges,78% of total billed charges,3541,100,,,percent of total billed charges,100% of total billed charges,2924.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2924.87,82.6,,,percent of total billed charges,82.6% of total billed charges,512.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.07,120039.9,
TREAT FX PROX TIB PLATEAU,27530,CDM,983,RC,27530,HCPCS,Outpatient,,,984,639.60,,865.92,88,,,percent of total billed charges,88% of total Billed charges,22.69,100,,,Fee Schedule,100% of Medicare rate,176.06,100,,,Fee Schedule,100% of WA Medicaid,984,100,,,percent of total billed charges,100% of total billed charges,181.34,103,,,Fee Schedule,103% of WA Medicaid,22.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,176.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,678.96,69,,,percent of total billed charges,69% of total billed charges,984,100,,,percent of total billed charges,100% of total billed charges,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,984,100,,,percent of total billed charges,100% of total billed charges,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,984,100,,,percent of total billed charges,100% of total billed charges,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.6,61.85,,,percent of total billed charges,61.85% of total billed charges,176.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,228.88,130,,,Fee Schedule,130% of WA Medicaid ,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.97,37.7,,,percent of total billed charges,37.70% of total billed charges,370.97,37.7,,,percent of total billed charges,37.70% of total billed charges,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,33357.6,33.9,,,percent of total billed charges,33.9% of total billed charges,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,767.52,78,,,percent of total billed charges,78% of total billed charges,984,100,,,percent of total billed charges,100% of total billed charges,812.78,82.6,,,percent of total billed charges,82.6% of total billed charges,812.78,82.6,,,percent of total billed charges,82.6% of total billed charges,176.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.69,33357.6,
TREAT KNEE FRACTURE,27540,CDM,983,RC,27540,HCPCS,Outpatient,,,3217,2091.05,,2830.96,88,,,percent of total billed charges,88% of total Billed charges,84.39,100,,,Fee Schedule,100% of Medicare rate,470.17,100,,,Fee Schedule,100% of WA Medicaid,3217,100,,,percent of total billed charges,100% of total billed charges,484.28,103,,,Fee Schedule,103% of WA Medicaid,84.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,147.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,470.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2219.73,69,,,percent of total billed charges,69% of total billed charges,3217,100,,,percent of total billed charges,100% of total billed charges,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,3217,100,,,percent of total billed charges,100% of total billed charges,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,3217,100,,,percent of total billed charges,100% of total billed charges,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1989.71,61.85,,,percent of total billed charges,61.85% of total billed charges,470.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,611.22,130,,,Fee Schedule,130% of WA Medicaid ,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1212.81,37.7,,,percent of total billed charges,37.70% of total billed charges,1212.81,37.7,,,percent of total billed charges,37.70% of total billed charges,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,109056.3,33.9,,,percent of total billed charges,33.9% of total billed charges,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2509.26,78,,,percent of total billed charges,78% of total billed charges,3217,100,,,percent of total billed charges,100% of total billed charges,2657.24,82.6,,,percent of total billed charges,82.6% of total billed charges,2657.24,82.6,,,percent of total billed charges,82.6% of total billed charges,470.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,84.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84.39,109056.3,
TREAT KNEE DISLOCATION,27558,CDM,983,RC,27558,HCPCS,Outpatient,,,3923,2549.95,,3452.24,88,,,percent of total billed charges,88% of total Billed charges,133.9,100,,,Fee Schedule,100% of Medicare rate,674.94,100,,,Fee Schedule,100% of WA Medicaid,3923,100,,,percent of total billed charges,100% of total billed charges,695.19,103,,,Fee Schedule,103% of WA Medicaid,133.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,234.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,674.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2706.87,69,,,percent of total billed charges,69% of total billed charges,3923,100,,,percent of total billed charges,100% of total billed charges,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,3923,100,,,percent of total billed charges,100% of total billed charges,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,3923,100,,,percent of total billed charges,100% of total billed charges,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2426.38,61.85,,,percent of total billed charges,61.85% of total billed charges,674.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,688.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,877.42,130,,,Fee Schedule,130% of WA Medicaid ,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1478.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1478.97,37.7,,,percent of total billed charges,37.70% of total billed charges,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,132989.7,33.9,,,percent of total billed charges,33.9% of total billed charges,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,3059.94,78,,,percent of total billed charges,78% of total billed charges,3923,100,,,percent of total billed charges,100% of total billed charges,3240.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3240.4,82.6,,,percent of total billed charges,82.6% of total billed charges,674.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,133.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,133.9,132989.7,
TX KNEE DISLOCATION WITH ANESTH,27552,CDM,983,RC,27552,HCPCS,Outpatient,,,1413,918.45,,1243.44,88,,,percent of total billed charges,88% of total Billed charges,62.82,100,,,Fee Schedule,100% of Medicare rate,371.14,100,,,Fee Schedule,100% of WA Medicaid,1413,100,,,percent of total billed charges,100% of total billed charges,382.27,103,,,Fee Schedule,103% of WA Medicaid,62.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,371.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,974.97,69,,,percent of total billed charges,69% of total billed charges,1413,100,,,percent of total billed charges,100% of total billed charges,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1413,100,,,percent of total billed charges,100% of total billed charges,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1413,100,,,percent of total billed charges,100% of total billed charges,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,873.94,61.85,,,percent of total billed charges,61.85% of total billed charges,371.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,482.48,130,,,Fee Schedule,130% of WA Medicaid ,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,532.7,37.7,,,percent of total billed charges,37.70% of total billed charges,532.7,37.7,,,percent of total billed charges,37.70% of total billed charges,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,47900.7,33.9,,,percent of total billed charges,33.9% of total billed charges,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1102.14,78,,,percent of total billed charges,78% of total billed charges,1413,100,,,percent of total billed charges,100% of total billed charges,1167.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1167.14,82.6,,,percent of total billed charges,82.6% of total billed charges,371.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.82,47900.7,
TREAT KNEECAP DISLOCATION,27560,CDM,983,RC,27560,HCPCS,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,32,100,,,Fee Schedule,100% of Medicare rate,204.59,100,,,Fee Schedule,100% of WA Medicaid,800,100,,,percent of total billed charges,100% of total billed charges,210.73,103,,,Fee Schedule,103% of WA Medicaid,32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,204.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,800,100,,,percent of total billed charges,100% of total billed charges,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,800,100,,,percent of total billed charges,100% of total billed charges,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,204.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,265.97,130,,,Fee Schedule,130% of WA Medicaid ,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,27120,33.9,,,percent of total billed charges,33.9% of total billed charges,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,204.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,32,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32,27120,
FIXATION OF KNEE JOINT,27570,CDM,983,RC,27570,HCPCS,Outpatient,,,738,479.70,,649.44,88,,,percent of total billed charges,88% of total Billed charges,14.33,100,,,Fee Schedule,100% of Medicare rate,90.27,100,,,Fee Schedule,100% of WA Medicaid,738,100,,,percent of total billed charges,100% of total billed charges,92.98,103,,,Fee Schedule,103% of WA Medicaid,14.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,90.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,509.22,69,,,percent of total billed charges,69% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,738,100,,,percent of total billed charges,100% of total billed charges,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,738,100,,,percent of total billed charges,100% of total billed charges,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.45,61.85,,,percent of total billed charges,61.85% of total billed charges,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,117.35,130,,,Fee Schedule,130% of WA Medicaid ,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.23,37.7,,,percent of total billed charges,37.70% of total billed charges,278.23,37.7,,,percent of total billed charges,37.70% of total billed charges,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,25018.2,33.9,,,percent of total billed charges,33.9% of total billed charges,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.64,78,,,percent of total billed charges,78% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.33,25018.2,
FUSION OF KNEE,27580,CDM,983,RC,27580,HCPCS,Outpatient,,,2467,1603.55,,2170.96,88,,,percent of total billed charges,88% of total Billed charges,157.59,100,,,Fee Schedule,100% of Medicare rate,845.22,100,,,Fee Schedule,100% of WA Medicaid,2467,100,,,percent of total billed charges,100% of total billed charges,870.58,103,,,Fee Schedule,103% of WA Medicaid,157.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,275.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,845.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1702.23,69,,,percent of total billed charges,69% of total billed charges,2467,100,,,percent of total billed charges,100% of total billed charges,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2467,100,,,percent of total billed charges,100% of total billed charges,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2467,100,,,percent of total billed charges,100% of total billed charges,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1525.84,61.85,,,percent of total billed charges,61.85% of total billed charges,845.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,845.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,862.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1098.79,130,,,Fee Schedule,130% of WA Medicaid ,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,930.06,37.7,,,percent of total billed charges,37.70% of total billed charges,930.06,37.7,,,percent of total billed charges,37.70% of total billed charges,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,83631.3,33.9,,,percent of total billed charges,33.9% of total billed charges,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1924.26,78,,,percent of total billed charges,78% of total billed charges,2467,100,,,percent of total billed charges,100% of total billed charges,2037.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2037.74,82.6,,,percent of total billed charges,82.6% of total billed charges,845.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,157.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,845.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,157.59,83631.3,
AMPUTATION FOLLOW-UP SURGERY,27594,CDM,983,RC,27594,HCPCS,Outpatient,,,1331,865.15,,1171.28,88,,,percent of total billed charges,88% of total Billed charges,59,100,,,Fee Schedule,100% of Medicare rate,287.96,100,,,Fee Schedule,100% of WA Medicaid,1331,100,,,percent of total billed charges,100% of total billed charges,296.6,103,,,Fee Schedule,103% of WA Medicaid,59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,287.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,918.39,69,,,percent of total billed charges,69% of total billed charges,1331,100,,,percent of total billed charges,100% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1331,100,,,percent of total billed charges,100% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1331,100,,,percent of total billed charges,100% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,823.22,61.85,,,percent of total billed charges,61.85% of total billed charges,287.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,374.35,130,,,Fee Schedule,130% of WA Medicaid ,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,501.79,37.7,,,percent of total billed charges,37.70% of total billed charges,501.79,37.7,,,percent of total billed charges,37.70% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,45120.9,33.9,,,percent of total billed charges,33.9% of total billed charges,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1038.18,78,,,percent of total billed charges,78% of total billed charges,1331,100,,,percent of total billed charges,100% of total billed charges,1099.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1099.41,82.6,,,percent of total billed charges,82.6% of total billed charges,287.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,59,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59,45120.9,
AMPUTATION FOLLOW-UP SURGERY,27596,CDM,983,RC,27596,HCPCS,Outpatient,,,1831,1190.15,,1611.28,88,,,percent of total billed charges,88% of total Billed charges,89.89,100,,,Fee Schedule,100% of Medicare rate,400.6,100,,,Fee Schedule,100% of WA Medicaid,1831,100,,,percent of total billed charges,100% of total billed charges,412.62,103,,,Fee Schedule,103% of WA Medicaid,89.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,400.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1263.39,69,,,percent of total billed charges,69% of total billed charges,1831,100,,,percent of total billed charges,100% of total billed charges,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1831,100,,,percent of total billed charges,100% of total billed charges,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1831,100,,,percent of total billed charges,100% of total billed charges,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1132.47,61.85,,,percent of total billed charges,61.85% of total billed charges,400.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.78,130,,,Fee Schedule,130% of WA Medicaid ,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,690.29,37.7,,,percent of total billed charges,37.70% of total billed charges,690.29,37.7,,,percent of total billed charges,37.70% of total billed charges,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,62070.9,33.9,,,percent of total billed charges,33.9% of total billed charges,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1428.18,78,,,percent of total billed charges,78% of total billed charges,1831,100,,,percent of total billed charges,100% of total billed charges,1512.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1512.41,82.6,,,percent of total billed charges,82.6% of total billed charges,400.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,89.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,89.89,62070.9,
AMPUTATE LEG AT THIGH,27590,CDM,983,RC,27590,HCPCS,Outpatient,,,2712,1762.80,,2386.56,88,,,percent of total billed charges,88% of total Billed charges,107.94,100,,,Fee Schedule,100% of Medicare rate,436.97,100,,,Fee Schedule,100% of WA Medicaid,2712,100,,,percent of total billed charges,100% of total billed charges,450.08,103,,,Fee Schedule,103% of WA Medicaid,107.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,188.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,436.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1871.28,69,,,percent of total billed charges,69% of total billed charges,2712,100,,,percent of total billed charges,100% of total billed charges,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2712,100,,,percent of total billed charges,100% of total billed charges,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2712,100,,,percent of total billed charges,100% of total billed charges,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1677.37,61.85,,,percent of total billed charges,61.85% of total billed charges,436.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,568.06,130,,,Fee Schedule,130% of WA Medicaid ,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1022.42,37.7,,,percent of total billed charges,37.70% of total billed charges,1022.42,37.7,,,percent of total billed charges,37.70% of total billed charges,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,91936.8,33.9,,,percent of total billed charges,33.9% of total billed charges,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2115.36,78,,,percent of total billed charges,78% of total billed charges,2712,100,,,percent of total billed charges,100% of total billed charges,2240.11,82.6,,,percent of total billed charges,82.6% of total billed charges,2240.11,82.6,,,percent of total billed charges,82.6% of total billed charges,436.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.94,91936.8,
AMPUTATE LOWER LEG AT KNEE,27598,CDM,983,RC,27598,HCPCS,Outpatient,,,2693,1750.45,,2369.84,88,,,percent of total billed charges,88% of total Billed charges,89.33,100,,,Fee Schedule,100% of Medicare rate,389.97,100,,,Fee Schedule,100% of WA Medicaid,2693,100,,,percent of total billed charges,100% of total billed charges,401.67,103,,,Fee Schedule,103% of WA Medicaid,89.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,156.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,389.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1858.17,69,,,percent of total billed charges,69% of total billed charges,2693,100,,,percent of total billed charges,100% of total billed charges,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2693,100,,,percent of total billed charges,100% of total billed charges,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2693,100,,,percent of total billed charges,100% of total billed charges,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1665.62,61.85,,,percent of total billed charges,61.85% of total billed charges,389.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,506.96,130,,,Fee Schedule,130% of WA Medicaid ,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1015.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1015.26,37.7,,,percent of total billed charges,37.70% of total billed charges,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,91292.7,33.9,,,percent of total billed charges,33.9% of total billed charges,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2100.54,78,,,percent of total billed charges,78% of total billed charges,2693,100,,,percent of total billed charges,100% of total billed charges,2224.42,82.6,,,percent of total billed charges,82.6% of total billed charges,2224.42,82.6,,,percent of total billed charges,82.6% of total billed charges,389.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,89.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,89.33,91292.7,
DECOMPRESSION OF LOWER LEG,27602,CDM,983,RC,27602,HCPCS,Outpatient,,,1781,1157.65,,1567.28,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare rate,267.44,100,,,Fee Schedule,100% of WA Medicaid,1781,100,,,percent of total billed charges,100% of total billed charges,275.46,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,267.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1228.89,69,,,percent of total billed charges,69% of total billed charges,1781,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1781,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1781,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1101.55,61.85,,,percent of total billed charges,61.85% of total billed charges,267.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,347.67,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.44,37.7,,,percent of total billed charges,37.70% of total billed charges,671.44,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,60375.9,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1389.18,78,,,percent of total billed charges,78% of total billed charges,1781,100,,,percent of total billed charges,100% of total billed charges,1471.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1471.11,82.6,,,percent of total billed charges,82.6% of total billed charges,267.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,63,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.38,60375.9,
DECOMPRESSION OF LOWER LEG,27600,CDM,983,RC,27600,HCPCS,Outpatient,,,1446,939.90,,1272.48,88,,,percent of total billed charges,88% of total Billed charges,44.2,100,,,Fee Schedule,100% of Medicare rate,228.46,100,,,Fee Schedule,100% of WA Medicaid,1446,100,,,percent of total billed charges,100% of total billed charges,235.31,103,,,Fee Schedule,103% of WA Medicaid,44.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,228.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,997.74,69,,,percent of total billed charges,69% of total billed charges,1446,100,,,percent of total billed charges,100% of total billed charges,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1446,100,,,percent of total billed charges,100% of total billed charges,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1446,100,,,percent of total billed charges,100% of total billed charges,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.35,61.85,,,percent of total billed charges,61.85% of total billed charges,228.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,297,130,,,Fee Schedule,130% of WA Medicaid ,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.14,37.7,,,percent of total billed charges,37.70% of total billed charges,545.14,37.7,,,percent of total billed charges,37.70% of total billed charges,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,49019.4,33.9,,,percent of total billed charges,33.9% of total billed charges,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1127.88,78,,,percent of total billed charges,78% of total billed charges,1446,100,,,percent of total billed charges,100% of total billed charges,1194.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1194.4,82.6,,,percent of total billed charges,82.6% of total billed charges,228.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.2,49019.4,
DRAIN LOWER LEG LESION,27603,CDM,983,RC,27603,HCPCS,Outpatient,,,889.24,578.01,,782.53,88,,,percent of total billed charges,88% of total Billed charges,36.53,100,,,Fee Schedule,100% of Medicare rate,226.04,100,,,Fee Schedule,100% of WA Medicaid,889.24,100,,,percent of total billed charges,100% of total billed charges,232.82,103,,,Fee Schedule,103% of WA Medicaid,36.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,226.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,613.58,69,,,percent of total billed charges,69% of total billed charges,889.24,100,,,percent of total billed charges,100% of total billed charges,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,889.24,100,,,percent of total billed charges,100% of total billed charges,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,889.24,100,,,percent of total billed charges,100% of total billed charges,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.99,61.85,,,percent of total billed charges,61.85% of total billed charges,226.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,293.85,130,,,Fee Schedule,130% of WA Medicaid ,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.24,37.7,,,percent of total billed charges,37.70% of total billed charges,335.24,37.7,,,percent of total billed charges,37.70% of total billed charges,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,30145.24,33.9,,,percent of total billed charges,33.9% of total billed charges,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,693.61,78,,,percent of total billed charges,78% of total billed charges,889.24,100,,,percent of total billed charges,100% of total billed charges,734.51,82.6,,,percent of total billed charges,82.6% of total billed charges,734.51,82.6,,,percent of total billed charges,82.6% of total billed charges,226.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.53,30145.24,
DECOMPRESSION OF LOWER LEG,27601,CDM,983,RC,27601,HCPCS,Outpatient,,,1407,914.55,,1238.16,88,,,percent of total billed charges,88% of total Billed charges,44.57,100,,,Fee Schedule,100% of Medicare rate,255.69,100,,,Fee Schedule,100% of WA Medicaid,1407,100,,,percent of total billed charges,100% of total billed charges,263.36,103,,,Fee Schedule,103% of WA Medicaid,44.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,255.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,970.83,69,,,percent of total billed charges,69% of total billed charges,1407,100,,,percent of total billed charges,100% of total billed charges,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1407,100,,,percent of total billed charges,100% of total billed charges,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1407,100,,,percent of total billed charges,100% of total billed charges,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,870.23,61.85,,,percent of total billed charges,61.85% of total billed charges,255.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,332.4,130,,,Fee Schedule,130% of WA Medicaid ,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.44,37.7,,,percent of total billed charges,37.70% of total billed charges,530.44,37.7,,,percent of total billed charges,37.70% of total billed charges,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,47697.3,33.9,,,percent of total billed charges,33.9% of total billed charges,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1097.46,78,,,percent of total billed charges,78% of total billed charges,1407,100,,,percent of total billed charges,100% of total billed charges,1162.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1162.18,82.6,,,percent of total billed charges,82.6% of total billed charges,255.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.57,47697.3,
TREAT LOWER LEG BONE LESION,27607,CDM,983,RC,27607,HCPCS,Outpatient,,,1850,1202.50,,1628,88,,,percent of total billed charges,88% of total Billed charges,58.16,100,,,Fee Schedule,100% of Medicare rate,346.14,100,,,Fee Schedule,100% of WA Medicaid,1850,100,,,percent of total billed charges,100% of total billed charges,356.52,103,,,Fee Schedule,103% of WA Medicaid,58.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,346.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1276.5,69,,,percent of total billed charges,69% of total billed charges,1850,100,,,percent of total billed charges,100% of total billed charges,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1850,100,,,percent of total billed charges,100% of total billed charges,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1850,100,,,percent of total billed charges,100% of total billed charges,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1144.23,61.85,,,percent of total billed charges,61.85% of total billed charges,346.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,449.98,130,,,Fee Schedule,130% of WA Medicaid ,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.45,37.7,,,percent of total billed charges,37.70% of total billed charges,697.45,37.7,,,percent of total billed charges,37.70% of total billed charges,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,62715,33.9,,,percent of total billed charges,33.9% of total billed charges,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1443,78,,,percent of total billed charges,78% of total billed charges,1850,100,,,percent of total billed charges,100% of total billed charges,1528.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1528.1,82.6,,,percent of total billed charges,82.6% of total billed charges,346.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.16,62715,
EXPLORATION OF ANKLE JOINT,27612,CDM,983,RC,27612,HCPCS,Outpatient,,,1992,1294.80,,1752.96,88,,,percent of total billed charges,88% of total Billed charges,49.91,100,,,Fee Schedule,100% of Medicare rate,332.53,100,,,Fee Schedule,100% of WA Medicaid,1992,100,,,percent of total billed charges,100% of total billed charges,342.51,103,,,Fee Schedule,103% of WA Medicaid,49.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,332.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1374.48,69,,,percent of total billed charges,69% of total billed charges,1992,100,,,percent of total billed charges,100% of total billed charges,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1992,100,,,percent of total billed charges,100% of total billed charges,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1992,100,,,percent of total billed charges,100% of total billed charges,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1232.05,61.85,,,percent of total billed charges,61.85% of total billed charges,332.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,432.29,130,,,Fee Schedule,130% of WA Medicaid ,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,750.98,37.7,,,percent of total billed charges,37.70% of total billed charges,750.98,37.7,,,percent of total billed charges,37.70% of total billed charges,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,67528.8,33.9,,,percent of total billed charges,33.9% of total billed charges,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1553.76,78,,,percent of total billed charges,78% of total billed charges,1992,100,,,percent of total billed charges,100% of total billed charges,1645.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.39,82.6,,,percent of total billed charges,82.6% of total billed charges,332.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.91,67528.8,
EXC LEG/ANKLE TUM < 3 CM,27618,CDM,983,RC,27618,HCPCS,Outpatient,,,1072,696.80,,943.36,88,,,percent of total billed charges,88% of total Billed charges,29.09,100,,,Fee Schedule,100% of Medicare rate,178.48,100,,,Fee Schedule,100% of WA Medicaid,1072,100,,,percent of total billed charges,100% of total billed charges,183.83,103,,,Fee Schedule,103% of WA Medicaid,29.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,50.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,178.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,739.68,69,,,percent of total billed charges,69% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1072,100,,,percent of total billed charges,100% of total billed charges,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1072,100,,,percent of total billed charges,100% of total billed charges,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.03,61.85,,,percent of total billed charges,61.85% of total billed charges,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,232.02,130,,,Fee Schedule,130% of WA Medicaid ,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,36340.8,33.9,,,percent of total billed charges,33.9% of total billed charges,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,836.16,78,,,percent of total billed charges,78% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.09,36340.8,
EXPLORE/TREAT ANKLE JOINT,27610,CDM,983,RC,27610,HCPCS,Outpatient,,,2064,1341.60,,1816.32,88,,,percent of total billed charges,88% of total Billed charges,61.94,100,,,Fee Schedule,100% of Medicare rate,373.75,100,,,Fee Schedule,100% of WA Medicaid,2064,100,,,percent of total billed charges,100% of total billed charges,384.96,103,,,Fee Schedule,103% of WA Medicaid,61.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,373.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1424.16,69,,,percent of total billed charges,69% of total billed charges,2064,100,,,percent of total billed charges,100% of total billed charges,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2064,100,,,percent of total billed charges,100% of total billed charges,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2064,100,,,percent of total billed charges,100% of total billed charges,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1276.58,61.85,,,percent of total billed charges,61.85% of total billed charges,373.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,485.88,130,,,Fee Schedule,130% of WA Medicaid ,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.13,37.7,,,percent of total billed charges,37.70% of total billed charges,778.13,37.7,,,percent of total billed charges,37.70% of total billed charges,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,69969.6,33.9,,,percent of total billed charges,33.9% of total billed charges,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1609.92,78,,,percent of total billed charges,78% of total billed charges,2064,100,,,percent of total billed charges,100% of total billed charges,1704.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1704.86,82.6,,,percent of total billed charges,82.6% of total billed charges,373.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.94,69969.6,
EXC LEG/ANKLE TUM DEEP <5 CM,27619,CDM,983,RC,27619,HCPCS,Outpatient,,,1713,1113.45,,1507.44,88,,,percent of total billed charges,88% of total Billed charges,45.2,100,,,Fee Schedule,100% of Medicare rate,272.48,100,,,Fee Schedule,100% of WA Medicaid,1713,100,,,percent of total billed charges,100% of total billed charges,280.65,103,,,Fee Schedule,103% of WA Medicaid,45.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,272.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1181.97,69,,,percent of total billed charges,69% of total billed charges,1713,100,,,percent of total billed charges,100% of total billed charges,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1713,100,,,percent of total billed charges,100% of total billed charges,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1713,100,,,percent of total billed charges,100% of total billed charges,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1059.49,61.85,,,percent of total billed charges,61.85% of total billed charges,272.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.22,130,,,Fee Schedule,130% of WA Medicaid ,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.8,37.7,,,percent of total billed charges,37.70% of total billed charges,645.8,37.7,,,percent of total billed charges,37.70% of total billed charges,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,58070.7,33.9,,,percent of total billed charges,33.9% of total billed charges,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1336.14,78,,,percent of total billed charges,78% of total billed charges,1713,100,,,percent of total billed charges,100% of total billed charges,1414.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1414.94,82.6,,,percent of total billed charges,82.6% of total billed charges,272.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.2,58070.7,
BIOPSY LOWER LEG SOFT TISSUE,27614,CDM,983,RC,27614,HCPCS,Outpatient,,,999,649.35,,879.12,88,,,percent of total billed charges,88% of total Billed charges,37.35,100,,,Fee Schedule,100% of Medicare rate,241.7,100,,,Fee Schedule,100% of WA Medicaid,999,100,,,percent of total billed charges,100% of total billed charges,248.95,103,,,Fee Schedule,103% of WA Medicaid,37.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,241.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,689.31,69,,,percent of total billed charges,69% of total billed charges,999,100,,,percent of total billed charges,100% of total billed charges,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,999,100,,,percent of total billed charges,100% of total billed charges,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,999,100,,,percent of total billed charges,100% of total billed charges,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.88,61.85,,,percent of total billed charges,61.85% of total billed charges,241.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,314.21,130,,,Fee Schedule,130% of WA Medicaid ,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.62,37.7,,,percent of total billed charges,37.70% of total billed charges,376.62,37.7,,,percent of total billed charges,37.70% of total billed charges,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,33866.1,33.9,,,percent of total billed charges,33.9% of total billed charges,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,779.22,78,,,percent of total billed charges,78% of total billed charges,999,100,,,percent of total billed charges,100% of total billed charges,825.17,82.6,,,percent of total billed charges,82.6% of total billed charges,825.17,82.6,,,percent of total billed charges,82.6% of total billed charges,241.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.35,33866.1,
REMOVAL OF TENDON LESION,27630,CDM,983,RC,27630,HCPCS,Outpatient,,,1264,821.60,,1112.32,88,,,percent of total billed charges,88% of total Billed charges,29.39,100,,,Fee Schedule,100% of Medicare rate,208.88,100,,,Fee Schedule,100% of WA Medicaid,1264,100,,,percent of total billed charges,100% of total billed charges,215.15,103,,,Fee Schedule,103% of WA Medicaid,29.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,208.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,872.16,69,,,percent of total billed charges,69% of total billed charges,1264,100,,,percent of total billed charges,100% of total billed charges,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1264,100,,,percent of total billed charges,100% of total billed charges,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1264,100,,,percent of total billed charges,100% of total billed charges,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,781.78,61.85,,,percent of total billed charges,61.85% of total billed charges,208.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,271.54,130,,,Fee Schedule,130% of WA Medicaid ,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,476.53,37.7,,,percent of total billed charges,37.70% of total billed charges,476.53,37.7,,,percent of total billed charges,37.70% of total billed charges,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,42849.6,33.9,,,percent of total billed charges,33.9% of total billed charges,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,985.92,78,,,percent of total billed charges,78% of total billed charges,1264,100,,,percent of total billed charges,100% of total billed charges,1044.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1044.06,82.6,,,percent of total billed charges,82.6% of total billed charges,208.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.39,42849.6,
"EXCISION,TUMOR,SOFT TISSUE OF LEG/ANKLE",27634,CDM,983,RC,27634,HCPCS,Outpatient,,,1609,1045.85,,1415.92,88,,,percent of total billed charges,88% of total Billed charges,71.69,100,,,Fee Schedule,100% of Medicare rate,385.87,100,,,Fee Schedule,100% of WA Medicaid,1609,100,,,percent of total billed charges,100% of total billed charges,397.45,103,,,Fee Schedule,103% of WA Medicaid,71.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,125.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,385.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1110.21,69,,,percent of total billed charges,69% of total billed charges,1609,100,,,percent of total billed charges,100% of total billed charges,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1609,100,,,percent of total billed charges,100% of total billed charges,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1609,100,,,percent of total billed charges,100% of total billed charges,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,995.17,61.85,,,percent of total billed charges,61.85% of total billed charges,385.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,501.63,130,,,Fee Schedule,130% of WA Medicaid ,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.59,37.7,,,percent of total billed charges,37.70% of total billed charges,606.59,37.7,,,percent of total billed charges,37.70% of total billed charges,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,54545.1,33.9,,,percent of total billed charges,33.9% of total billed charges,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1255.02,78,,,percent of total billed charges,78% of total billed charges,1609,100,,,percent of total billed charges,100% of total billed charges,1329.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1329.03,82.6,,,percent of total billed charges,82.6% of total billed charges,385.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.69,54545.1,
REMOVE LOWER LEG BONE LESION,27635,CDM,983,RC,27635,HCPCS,Outpatient,,,2241,1456.65,,1972.08,88,,,percent of total billed charges,88% of total Billed charges,54.53,100,,,Fee Schedule,100% of Medicare rate,336.63,100,,,Fee Schedule,100% of WA Medicaid,2241,100,,,percent of total billed charges,100% of total billed charges,346.73,103,,,Fee Schedule,103% of WA Medicaid,54.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,336.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1546.29,69,,,percent of total billed charges,69% of total billed charges,2241,100,,,percent of total billed charges,100% of total billed charges,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2241,100,,,percent of total billed charges,100% of total billed charges,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2241,100,,,percent of total billed charges,100% of total billed charges,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1386.06,61.85,,,percent of total billed charges,61.85% of total billed charges,336.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.62,130,,,Fee Schedule,130% of WA Medicaid ,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,844.86,37.7,,,percent of total billed charges,37.70% of total billed charges,844.86,37.7,,,percent of total billed charges,37.70% of total billed charges,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,75969.9,33.9,,,percent of total billed charges,33.9% of total billed charges,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1747.98,78,,,percent of total billed charges,78% of total billed charges,2241,100,,,percent of total billed charges,100% of total billed charges,1851.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1851.07,82.6,,,percent of total billed charges,82.6% of total billed charges,336.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.53,75969.9,
RESECT TALUS/CALCANEUS TUM,27647,CDM,983,RC,27647,HCPCS,Outpatient,,,2370,1540.50,,2085.6,88,,,percent of total billed charges,88% of total Billed charges,71.41,100,,,Fee Schedule,100% of Medicare rate,565.47,100,,,Fee Schedule,100% of WA Medicaid,2370,100,,,percent of total billed charges,100% of total billed charges,582.43,103,,,Fee Schedule,103% of WA Medicaid,71.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,565.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1635.3,69,,,percent of total billed charges,69% of total billed charges,2370,100,,,percent of total billed charges,100% of total billed charges,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2370,100,,,percent of total billed charges,100% of total billed charges,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2370,100,,,percent of total billed charges,100% of total billed charges,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1465.85,61.85,,,percent of total billed charges,61.85% of total billed charges,565.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,576.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,735.11,130,,,Fee Schedule,130% of WA Medicaid ,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,893.49,37.7,,,percent of total billed charges,37.70% of total billed charges,893.49,37.7,,,percent of total billed charges,37.70% of total billed charges,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,80343,33.9,,,percent of total billed charges,33.9% of total billed charges,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1848.6,78,,,percent of total billed charges,78% of total billed charges,2370,100,,,percent of total billed charges,100% of total billed charges,1957.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1957.62,82.6,,,percent of total billed charges,82.6% of total billed charges,565.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.41,80343,
PARTIAL REMOVAL OF FIBULA,27641,CDM,983,RC,27641,HCPCS,Outpatient,,,1822,1184.30,,1603.36,88,,,percent of total billed charges,88% of total Billed charges,61.07,100,,,Fee Schedule,100% of Medicare rate,376.73,100,,,Fee Schedule,100% of WA Medicaid,1822,100,,,percent of total billed charges,100% of total billed charges,388.03,103,,,Fee Schedule,103% of WA Medicaid,61.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,106.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,376.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1257.18,69,,,percent of total billed charges,69% of total billed charges,1822,100,,,percent of total billed charges,100% of total billed charges,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1822,100,,,percent of total billed charges,100% of total billed charges,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1822,100,,,percent of total billed charges,100% of total billed charges,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1126.91,61.85,,,percent of total billed charges,61.85% of total billed charges,376.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,489.75,130,,,Fee Schedule,130% of WA Medicaid ,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.89,37.7,,,percent of total billed charges,37.70% of total billed charges,686.89,37.7,,,percent of total billed charges,37.70% of total billed charges,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,61765.8,33.9,,,percent of total billed charges,33.9% of total billed charges,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1421.16,78,,,percent of total billed charges,78% of total billed charges,1822,100,,,percent of total billed charges,100% of total billed charges,1504.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1504.97,82.6,,,percent of total billed charges,82.6% of total billed charges,376.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.07,61765.8,
PARTIAL REMOVAL OF TIBIA,27640,CDM,983,RC,27640,HCPCS,Outpatient,,,2908,1890.20,,2559.04,88,,,percent of total billed charges,88% of total Billed charges,82.79,100,,,Fee Schedule,100% of Medicare rate,478.93,100,,,Fee Schedule,100% of WA Medicaid,2908,100,,,percent of total billed charges,100% of total billed charges,493.3,103,,,Fee Schedule,103% of WA Medicaid,82.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,144.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,478.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2006.52,69,,,percent of total billed charges,69% of total billed charges,2908,100,,,percent of total billed charges,100% of total billed charges,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2908,100,,,percent of total billed charges,100% of total billed charges,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2908,100,,,percent of total billed charges,100% of total billed charges,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1798.6,61.85,,,percent of total billed charges,61.85% of total billed charges,478.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,622.61,130,,,Fee Schedule,130% of WA Medicaid ,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1096.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1096.32,37.7,,,percent of total billed charges,37.70% of total billed charges,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,98581.2,33.9,,,percent of total billed charges,33.9% of total billed charges,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2268.24,78,,,percent of total billed charges,78% of total billed charges,2908,100,,,percent of total billed charges,100% of total billed charges,2402.01,82.6,,,percent of total billed charges,82.6% of total billed charges,2402.01,82.6,,,percent of total billed charges,82.6% of total billed charges,478.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.79,98581.2,
REPAIR OF LEG TENDON EACH,27659,CDM,983,RC,27659,HCPCS,Outpatient,,,2043,1327.95,,1797.84,88,,,percent of total billed charges,88% of total Billed charges,39.35,100,,,Fee Schedule,100% of Medicare rate,274.71,100,,,Fee Schedule,100% of WA Medicaid,2043,100,,,percent of total billed charges,100% of total billed charges,282.95,103,,,Fee Schedule,103% of WA Medicaid,39.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,274.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1409.67,69,,,percent of total billed charges,69% of total billed charges,2043,100,,,percent of total billed charges,100% of total billed charges,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2043,100,,,percent of total billed charges,100% of total billed charges,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2043,100,,,percent of total billed charges,100% of total billed charges,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1263.6,61.85,,,percent of total billed charges,61.85% of total billed charges,274.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,357.12,130,,,Fee Schedule,130% of WA Medicaid ,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,770.21,37.7,,,percent of total billed charges,37.70% of total billed charges,770.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,69257.7,33.9,,,percent of total billed charges,33.9% of total billed charges,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1593.54,78,,,percent of total billed charges,78% of total billed charges,2043,100,,,percent of total billed charges,100% of total billed charges,1687.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1687.52,82.6,,,percent of total billed charges,82.6% of total billed charges,274.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.35,69257.7,
REPAIR ACHILLES TENDON,27650,CDM,983,RC,27650,HCPCS,Outpatient,,,2538,1649.70,,2233.44,88,,,percent of total billed charges,88% of total Billed charges,57.17,100,,,Fee Schedule,100% of Medicare rate,381.95,100,,,Fee Schedule,100% of WA Medicaid,2538,100,,,percent of total billed charges,100% of total billed charges,393.41,103,,,Fee Schedule,103% of WA Medicaid,57.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,381.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1751.22,69,,,percent of total billed charges,69% of total billed charges,2538,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2538,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2538,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1569.75,61.85,,,percent of total billed charges,61.85% of total billed charges,381.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,496.54,130,,,Fee Schedule,130% of WA Medicaid ,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,956.83,37.7,,,percent of total billed charges,37.70% of total billed charges,956.83,37.7,,,percent of total billed charges,37.70% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,86038.2,33.9,,,percent of total billed charges,33.9% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1979.64,78,,,percent of total billed charges,78% of total billed charges,2538,100,,,percent of total billed charges,100% of total billed charges,2096.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2096.39,82.6,,,percent of total billed charges,82.6% of total billed charges,381.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.17,86038.2,
REPAIR OF LEG TENDON EACH,27658,CDM,983,RC,27658,HCPCS,Outpatient,,,1510,981.50,,1328.8,88,,,percent of total billed charges,88% of total Billed charges,30.27,100,,,Fee Schedule,100% of Medicare rate,215.78,100,,,Fee Schedule,100% of WA Medicaid,1510,100,,,percent of total billed charges,100% of total billed charges,222.25,103,,,Fee Schedule,103% of WA Medicaid,30.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,215.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1041.9,69,,,percent of total billed charges,69% of total billed charges,1510,100,,,percent of total billed charges,100% of total billed charges,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1510,100,,,percent of total billed charges,100% of total billed charges,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1510,100,,,percent of total billed charges,100% of total billed charges,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,933.94,61.85,,,percent of total billed charges,61.85% of total billed charges,215.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,280.51,130,,,Fee Schedule,130% of WA Medicaid ,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,569.27,37.7,,,percent of total billed charges,37.70% of total billed charges,569.27,37.7,,,percent of total billed charges,37.70% of total billed charges,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,51189,33.9,,,percent of total billed charges,33.9% of total billed charges,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1177.8,78,,,percent of total billed charges,78% of total billed charges,1510,100,,,percent of total billed charges,100% of total billed charges,1247.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1247.26,82.6,,,percent of total billed charges,82.6% of total billed charges,215.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.27,51189,
REPAIR OF ACHILLES TENDON,27654,CDM,983,RC,27654,HCPCS,Outpatient,,,3062,1990.30,,2694.56,88,,,percent of total billed charges,88% of total Billed charges,62.54,100,,,Fee Schedule,100% of Medicare rate,414.78,100,,,Fee Schedule,100% of WA Medicaid,3062,100,,,percent of total billed charges,100% of total billed charges,427.22,103,,,Fee Schedule,103% of WA Medicaid,62.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,414.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2112.78,69,,,percent of total billed charges,69% of total billed charges,3062,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,3062,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,3062,100,,,percent of total billed charges,100% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1893.85,61.85,,,percent of total billed charges,61.85% of total billed charges,414.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,539.21,130,,,Fee Schedule,130% of WA Medicaid ,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1154.37,37.7,,,percent of total billed charges,37.70% of total billed charges,1154.37,37.7,,,percent of total billed charges,37.70% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,103801.8,33.9,,,percent of total billed charges,33.9% of total billed charges,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2388.36,78,,,percent of total billed charges,78% of total billed charges,3062,100,,,percent of total billed charges,100% of total billed charges,2529.21,82.6,,,percent of total billed charges,82.6% of total billed charges,2529.21,82.6,,,percent of total billed charges,82.6% of total billed charges,414.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.54,103801.8,
REPAIR OF LEG TENDON EACH,27665,CDM,983,RC,27665,HCPCS,Outpatient,,,1336,868.40,,1175.68,88,,,percent of total billed charges,88% of total Billed charges,36.37,100,,,Fee Schedule,100% of Medicare rate,248.05,100,,,Fee Schedule,100% of WA Medicaid,1336,100,,,percent of total billed charges,100% of total billed charges,255.49,103,,,Fee Schedule,103% of WA Medicaid,36.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,248.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,921.84,69,,,percent of total billed charges,69% of total billed charges,1336,100,,,percent of total billed charges,100% of total billed charges,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1336,100,,,percent of total billed charges,100% of total billed charges,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1336,100,,,percent of total billed charges,100% of total billed charges,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,826.32,61.85,,,percent of total billed charges,61.85% of total billed charges,248.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,322.47,130,,,Fee Schedule,130% of WA Medicaid ,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,503.67,37.7,,,percent of total billed charges,37.70% of total billed charges,503.67,37.7,,,percent of total billed charges,37.70% of total billed charges,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,45290.4,33.9,,,percent of total billed charges,33.9% of total billed charges,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1042.08,78,,,percent of total billed charges,78% of total billed charges,1336,100,,,percent of total billed charges,100% of total billed charges,1103.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1103.54,82.6,,,percent of total billed charges,82.6% of total billed charges,248.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.37,45290.4,
REPAIR OF LEG TENDON EACH,27664,CDM,983,RC,27664,HCPCS,Outpatient,,,1432,930.80,,1260.16,88,,,percent of total billed charges,88% of total Billed charges,30.34,100,,,Fee Schedule,100% of Medicare rate,212.24,100,,,Fee Schedule,100% of WA Medicaid,1432,100,,,percent of total billed charges,100% of total billed charges,218.61,103,,,Fee Schedule,103% of WA Medicaid,30.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,212.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,988.08,69,,,percent of total billed charges,69% of total billed charges,1432,100,,,percent of total billed charges,100% of total billed charges,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1432,100,,,percent of total billed charges,100% of total billed charges,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1432,100,,,percent of total billed charges,100% of total billed charges,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.69,61.85,,,percent of total billed charges,61.85% of total billed charges,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,275.91,130,,,Fee Schedule,130% of WA Medicaid ,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.86,37.7,,,percent of total billed charges,37.70% of total billed charges,539.86,37.7,,,percent of total billed charges,37.70% of total billed charges,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,48544.8,33.9,,,percent of total billed charges,33.9% of total billed charges,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116.96,78,,,percent of total billed charges,78% of total billed charges,1432,100,,,percent of total billed charges,100% of total billed charges,1182.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1182.83,82.6,,,percent of total billed charges,82.6% of total billed charges,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.34,48544.8,
REPAIR LOWER LEG TENDONS,27676,CDM,983,RC,27676,HCPCS,Outpatient,,,2098,1363.70,,1846.24,88,,,percent of total billed charges,88% of total Billed charges,56.46,100,,,Fee Schedule,100% of Medicare rate,353.42,100,,,Fee Schedule,100% of WA Medicaid,2098,100,,,percent of total billed charges,100% of total billed charges,364.02,103,,,Fee Schedule,103% of WA Medicaid,56.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,98.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,353.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1447.62,69,,,percent of total billed charges,69% of total billed charges,2098,100,,,percent of total billed charges,100% of total billed charges,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2098,100,,,percent of total billed charges,100% of total billed charges,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2098,100,,,percent of total billed charges,100% of total billed charges,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1297.61,61.85,,,percent of total billed charges,61.85% of total billed charges,353.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,459.45,130,,,Fee Schedule,130% of WA Medicaid ,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,790.95,37.7,,,percent of total billed charges,37.70% of total billed charges,790.95,37.7,,,percent of total billed charges,37.70% of total billed charges,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,71122.2,33.9,,,percent of total billed charges,33.9% of total billed charges,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1636.44,78,,,percent of total billed charges,78% of total billed charges,2098,100,,,percent of total billed charges,100% of total billed charges,1732.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1732.95,82.6,,,percent of total billed charges,82.6% of total billed charges,353.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.46,71122.2,
REVISE LOWER LEG TENDONS,27686,CDM,983,RC,27686,HCPCS,Outpatient,,,1980,1287.00,,1742.4,88,,,percent of total billed charges,88% of total Billed charges,47.38,100,,,Fee Schedule,100% of Medicare rate,309.03,100,,,Fee Schedule,100% of WA Medicaid,1980,100,,,percent of total billed charges,100% of total billed charges,318.3,103,,,Fee Schedule,103% of WA Medicaid,47.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,82.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,309.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1366.2,69,,,percent of total billed charges,69% of total billed charges,1980,100,,,percent of total billed charges,100% of total billed charges,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1980,100,,,percent of total billed charges,100% of total billed charges,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1980,100,,,percent of total billed charges,100% of total billed charges,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1224.63,61.85,,,percent of total billed charges,61.85% of total billed charges,309.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,401.74,130,,,Fee Schedule,130% of WA Medicaid ,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.46,37.7,,,percent of total billed charges,37.70% of total billed charges,746.46,37.7,,,percent of total billed charges,37.70% of total billed charges,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,67122,33.9,,,percent of total billed charges,33.9% of total billed charges,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1544.4,78,,,percent of total billed charges,78% of total billed charges,1980,100,,,percent of total billed charges,100% of total billed charges,1635.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1635.48,82.6,,,percent of total billed charges,82.6% of total billed charges,309.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.38,67122,
REVISION OF LOWER LEG TENDON,27685,CDM,983,RC,27685,HCPCS,Outpatient,,,1818,1181.70,,1599.84,88,,,percent of total billed charges,88% of total Billed charges,38.41,100,,,Fee Schedule,100% of Medicare rate,271.73,100,,,Fee Schedule,100% of WA Medicaid,1818,100,,,percent of total billed charges,100% of total billed charges,279.88,103,,,Fee Schedule,103% of WA Medicaid,38.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,271.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1254.42,69,,,percent of total billed charges,69% of total billed charges,1818,100,,,percent of total billed charges,100% of total billed charges,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1818,100,,,percent of total billed charges,100% of total billed charges,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1818,100,,,percent of total billed charges,100% of total billed charges,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1124.43,61.85,,,percent of total billed charges,61.85% of total billed charges,271.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,353.25,130,,,Fee Schedule,130% of WA Medicaid ,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.39,37.7,,,percent of total billed charges,37.70% of total billed charges,685.39,37.7,,,percent of total billed charges,37.70% of total billed charges,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,61630.2,33.9,,,percent of total billed charges,33.9% of total billed charges,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1418.04,78,,,percent of total billed charges,78% of total billed charges,1818,100,,,percent of total billed charges,100% of total billed charges,1501.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1501.67,82.6,,,percent of total billed charges,82.6% of total billed charges,271.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.41,61630.2,
REVISION OF CALF TENDON,27687,CDM,983,RC,27687,HCPCS,Outpatient,,,1670,1085.50,,1469.6,88,,,percent of total billed charges,88% of total Billed charges,38.56,100,,,Fee Schedule,100% of Medicare rate,264.64,100,,,Fee Schedule,100% of WA Medicaid,1670,100,,,percent of total billed charges,100% of total billed charges,272.58,103,,,Fee Schedule,103% of WA Medicaid,38.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1152.3,69,,,percent of total billed charges,69% of total billed charges,1670,100,,,percent of total billed charges,100% of total billed charges,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1670,100,,,percent of total billed charges,100% of total billed charges,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1670,100,,,percent of total billed charges,100% of total billed charges,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032.9,61.85,,,percent of total billed charges,61.85% of total billed charges,264.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,344.03,130,,,Fee Schedule,130% of WA Medicaid ,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.59,37.7,,,percent of total billed charges,37.70% of total billed charges,629.59,37.7,,,percent of total billed charges,37.70% of total billed charges,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,56613,33.9,,,percent of total billed charges,33.9% of total billed charges,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1302.6,78,,,percent of total billed charges,78% of total billed charges,1670,100,,,percent of total billed charges,100% of total billed charges,1379.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1379.42,82.6,,,percent of total billed charges,82.6% of total billed charges,264.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.56,56613,
REPAIR OF ANKLE LIGAMENT,27698,CDM,983,RC,27698,HCPCS,Outpatient,,,3051,1983.15,,2684.88,88,,,percent of total billed charges,88% of total Billed charges,58.04,100,,,Fee Schedule,100% of Medicare rate,368.34,100,,,Fee Schedule,100% of WA Medicaid,3051,100,,,percent of total billed charges,100% of total billed charges,379.39,103,,,Fee Schedule,103% of WA Medicaid,58.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,368.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2105.19,69,,,percent of total billed charges,69% of total billed charges,3051,100,,,percent of total billed charges,100% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3051,100,,,percent of total billed charges,100% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3051,100,,,percent of total billed charges,100% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1887.04,61.85,,,percent of total billed charges,61.85% of total billed charges,368.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,478.84,130,,,Fee Schedule,130% of WA Medicaid ,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1150.23,37.7,,,percent of total billed charges,37.70% of total billed charges,1150.23,37.7,,,percent of total billed charges,37.70% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,103428.9,33.9,,,percent of total billed charges,33.9% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2379.78,78,,,percent of total billed charges,78% of total billed charges,3051,100,,,percent of total billed charges,100% of total billed charges,2520.13,82.6,,,percent of total billed charges,82.6% of total billed charges,2520.13,82.6,,,percent of total billed charges,82.6% of total billed charges,368.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.04,103428.9,
REVISE ADDITIONAL LEG TENDON,27692,CDM,983,RC,27692,HCPCS,Outpatient,,,434,282.10,,381.92,88,,,percent of total billed charges,88% of total Billed charges,11.57,100,,,Fee Schedule,100% of Medicare rate,56.88,100,,,Fee Schedule,100% of WA Medicaid,434,100,,,percent of total billed charges,100% of total billed charges,58.59,103,,,Fee Schedule,103% of WA Medicaid,11.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,299.46,69,,,percent of total billed charges,69% of total billed charges,434,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,434,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,434,100,,,percent of total billed charges,100% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.43,61.85,,,percent of total billed charges,61.85% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,73.94,130,,,Fee Schedule,130% of WA Medicaid ,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.62,37.7,,,percent of total billed charges,37.70% of total billed charges,163.62,37.7,,,percent of total billed charges,37.70% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,14712.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.52,78,,,percent of total billed charges,78% of total billed charges,434,100,,,percent of total billed charges,100% of total billed charges,358.48,82.6,,,percent of total billed charges,82.6% of total billed charges,358.48,82.6,,,percent of total billed charges,82.6% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.57,14712.6,
REPAIR OF ANKLE LIGAMENT,27695,CDM,983,RC,27695,HCPCS,Outpatient,,,2085,1355.25,,1834.8,88,,,percent of total billed charges,88% of total Billed charges,42.39,100,,,Fee Schedule,100% of Medicare rate,283.48,100,,,Fee Schedule,100% of WA Medicaid,2085,100,,,percent of total billed charges,100% of total billed charges,291.98,103,,,Fee Schedule,103% of WA Medicaid,42.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,283.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1438.65,69,,,percent of total billed charges,69% of total billed charges,2085,100,,,percent of total billed charges,100% of total billed charges,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2085,100,,,percent of total billed charges,100% of total billed charges,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2085,100,,,percent of total billed charges,100% of total billed charges,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1289.57,61.85,,,percent of total billed charges,61.85% of total billed charges,283.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,368.52,130,,,Fee Schedule,130% of WA Medicaid ,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.05,37.7,,,percent of total billed charges,37.70% of total billed charges,786.05,37.7,,,percent of total billed charges,37.70% of total billed charges,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,70681.5,33.9,,,percent of total billed charges,33.9% of total billed charges,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1626.3,78,,,percent of total billed charges,78% of total billed charges,2085,100,,,percent of total billed charges,100% of total billed charges,1722.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1722.21,82.6,,,percent of total billed charges,82.6% of total billed charges,283.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.39,70681.5,
REVISE LOWER LEG TENDON,27690,CDM,983,RC,27690,HCPCS,Outpatient,,,2005,1303.25,,1764.4,88,,,percent of total billed charges,88% of total Billed charges,53.72,100,,,Fee Schedule,100% of Medicare rate,370.58,100,,,Fee Schedule,100% of WA Medicaid,2005,100,,,percent of total billed charges,100% of total billed charges,381.7,103,,,Fee Schedule,103% of WA Medicaid,53.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,370.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1383.45,69,,,percent of total billed charges,69% of total billed charges,2005,100,,,percent of total billed charges,100% of total billed charges,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2005,100,,,percent of total billed charges,100% of total billed charges,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2005,100,,,percent of total billed charges,100% of total billed charges,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240.09,61.85,,,percent of total billed charges,61.85% of total billed charges,370.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,481.75,130,,,Fee Schedule,130% of WA Medicaid ,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,755.89,37.7,,,percent of total billed charges,37.70% of total billed charges,755.89,37.7,,,percent of total billed charges,37.70% of total billed charges,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,67969.5,33.9,,,percent of total billed charges,33.9% of total billed charges,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1563.9,78,,,percent of total billed charges,78% of total billed charges,2005,100,,,percent of total billed charges,100% of total billed charges,1656.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1656.13,82.6,,,percent of total billed charges,82.6% of total billed charges,370.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.72,67969.5,
REVISE LOWER LEG TENDON,27691,CDM,983,RC,27691,HCPCS,Outpatient,,,2513,1633.45,,2211.44,88,,,percent of total billed charges,88% of total Billed charges,68.03,100,,,Fee Schedule,100% of Medicare rate,430.44,100,,,Fee Schedule,100% of WA Medicaid,2513,100,,,percent of total billed charges,100% of total billed charges,443.35,103,,,Fee Schedule,103% of WA Medicaid,68.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,119.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,430.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1733.97,69,,,percent of total billed charges,69% of total billed charges,2513,100,,,percent of total billed charges,100% of total billed charges,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2513,100,,,percent of total billed charges,100% of total billed charges,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2513,100,,,percent of total billed charges,100% of total billed charges,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1554.29,61.85,,,percent of total billed charges,61.85% of total billed charges,430.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,559.57,130,,,Fee Schedule,130% of WA Medicaid ,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,947.4,37.7,,,percent of total billed charges,37.70% of total billed charges,947.4,37.7,,,percent of total billed charges,37.70% of total billed charges,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,85190.7,33.9,,,percent of total billed charges,33.9% of total billed charges,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1960.14,78,,,percent of total billed charges,78% of total billed charges,2513,100,,,percent of total billed charges,100% of total billed charges,2075.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2075.74,82.6,,,percent of total billed charges,82.6% of total billed charges,430.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.03,85190.7,
REMOVAL OF ANKLE IMPLANT,27704,CDM,983,RC,27704,HCPCS,Outpatient,,,1200,780.00,,1056,88,,,percent of total billed charges,88% of total Billed charges,52.59,100,,,Fee Schedule,100% of Medicare rate,329.36,100,,,Fee Schedule,100% of WA Medicaid,1200,100,,,percent of total billed charges,100% of total billed charges,339.24,103,,,Fee Schedule,103% of WA Medicaid,52.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,329.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,828,69,,,percent of total billed charges,69% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,742.2,61.85,,,percent of total billed charges,61.85% of total billed charges,329.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,428.17,130,,,Fee Schedule,130% of WA Medicaid ,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,40680,33.9,,,percent of total billed charges,33.9% of total billed charges,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,936,78,,,percent of total billed charges,78% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,329.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.59,40680,
INCISION OF FIBULA,27707,CDM,983,RC,27707,HCPCS,Outpatient,,,1526,991.90,,1342.88,88,,,percent of total billed charges,88% of total Billed charges,35.35,100,,,Fee Schedule,100% of Medicare rate,238.72,100,,,Fee Schedule,100% of WA Medicaid,1526,100,,,percent of total billed charges,100% of total billed charges,245.88,103,,,Fee Schedule,103% of WA Medicaid,35.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,238.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1052.94,69,,,percent of total billed charges,69% of total billed charges,1526,100,,,percent of total billed charges,100% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1526,100,,,percent of total billed charges,100% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1526,100,,,percent of total billed charges,100% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,943.83,61.85,,,percent of total billed charges,61.85% of total billed charges,238.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,310.34,130,,,Fee Schedule,130% of WA Medicaid ,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.3,37.7,,,percent of total billed charges,37.70% of total billed charges,575.3,37.7,,,percent of total billed charges,37.70% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,51731.4,33.9,,,percent of total billed charges,33.9% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1190.28,78,,,percent of total billed charges,78% of total billed charges,1526,100,,,percent of total billed charges,100% of total billed charges,1260.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1260.48,82.6,,,percent of total billed charges,82.6% of total billed charges,238.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.35,51731.4,
INCISION OF TIBIA,27705,CDM,983,RC,27705,HCPCS,Outpatient,,,3175,2063.75,,2794,88,,,percent of total billed charges,88% of total Billed charges,74.12,100,,,Fee Schedule,100% of Medicare rate,432.31,100,,,Fee Schedule,100% of WA Medicaid,3175,100,,,percent of total billed charges,100% of total billed charges,445.28,103,,,Fee Schedule,103% of WA Medicaid,74.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,129.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,432.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2190.75,69,,,percent of total billed charges,69% of total billed charges,3175,100,,,percent of total billed charges,100% of total billed charges,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,3175,100,,,percent of total billed charges,100% of total billed charges,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,3175,100,,,percent of total billed charges,100% of total billed charges,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1963.74,61.85,,,percent of total billed charges,61.85% of total billed charges,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562,130,,,Fee Schedule,130% of WA Medicaid ,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1196.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1196.98,37.7,,,percent of total billed charges,37.70% of total billed charges,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,107632.5,33.9,,,percent of total billed charges,33.9% of total billed charges,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2476.5,78,,,percent of total billed charges,78% of total billed charges,3175,100,,,percent of total billed charges,100% of total billed charges,2622.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2622.55,82.6,,,percent of total billed charges,82.6% of total billed charges,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,74.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.12,107632.5,
REPAIR OF TIBIA,27720,CDM,983,RC,27720,HCPCS,Outpatient,,,3368,2189.20,,2963.84,88,,,percent of total billed charges,88% of total Billed charges,88.72,100,,,Fee Schedule,100% of Medicare rate,502.99,100,,,Fee Schedule,100% of WA Medicaid,3368,100,,,percent of total billed charges,100% of total billed charges,518.08,103,,,Fee Schedule,103% of WA Medicaid,88.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,155.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,502.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2323.92,69,,,percent of total billed charges,69% of total billed charges,3368,100,,,percent of total billed charges,100% of total billed charges,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3368,100,,,percent of total billed charges,100% of total billed charges,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3368,100,,,percent of total billed charges,100% of total billed charges,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2083.11,61.85,,,percent of total billed charges,61.85% of total billed charges,502.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,653.89,130,,,Fee Schedule,130% of WA Medicaid ,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1269.74,37.7,,,percent of total billed charges,37.70% of total billed charges,1269.74,37.7,,,percent of total billed charges,37.70% of total billed charges,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,114175.2,33.9,,,percent of total billed charges,33.9% of total billed charges,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2627.04,78,,,percent of total billed charges,78% of total billed charges,3368,100,,,percent of total billed charges,100% of total billed charges,2781.97,82.6,,,percent of total billed charges,82.6% of total billed charges,2781.97,82.6,,,percent of total billed charges,82.6% of total billed charges,502.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.72,114175.2,
REPAIR/GRAFT OF TIBIA,27724,CDM,983,RC,27724,HCPCS,Outpatient,,,4923,3199.95,,4332.24,88,,,percent of total billed charges,88% of total Billed charges,139.83,100,,,Fee Schedule,100% of Medicare rate,713.74,100,,,Fee Schedule,100% of WA Medicaid,4923,100,,,percent of total billed charges,100% of total billed charges,735.15,103,,,Fee Schedule,103% of WA Medicaid,139.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,244.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,713.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3396.87,69,,,percent of total billed charges,69% of total billed charges,4923,100,,,percent of total billed charges,100% of total billed charges,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,4923,100,,,percent of total billed charges,100% of total billed charges,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,4923,100,,,percent of total billed charges,100% of total billed charges,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3044.88,61.85,,,percent of total billed charges,61.85% of total billed charges,713.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,713.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,728.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,927.86,130,,,Fee Schedule,130% of WA Medicaid ,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1855.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1855.97,37.7,,,percent of total billed charges,37.70% of total billed charges,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,166889.7,33.9,,,percent of total billed charges,33.9% of total billed charges,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3839.94,78,,,percent of total billed charges,78% of total billed charges,4923,100,,,percent of total billed charges,100% of total billed charges,4066.4,82.6,,,percent of total billed charges,82.6% of total billed charges,4066.4,82.6,,,percent of total billed charges,82.6% of total billed charges,713.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,139.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,713.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,139.83,166889.7,
REPAIR FIBULA NONUNION,27726,CDM,983,RC,27726,HCPCS,Outpatient,,,2888,1877.20,,2541.44,88,,,percent of total billed charges,88% of total Billed charges,99.92,100,,,Fee Schedule,100% of Medicare rate,547.75,100,,,Fee Schedule,100% of WA Medicaid,2888,100,,,percent of total billed charges,100% of total billed charges,564.18,103,,,Fee Schedule,103% of WA Medicaid,99.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,174.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,547.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1992.72,69,,,percent of total billed charges,69% of total billed charges,2888,100,,,percent of total billed charges,100% of total billed charges,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2888,100,,,percent of total billed charges,100% of total billed charges,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2888,100,,,percent of total billed charges,100% of total billed charges,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786.23,61.85,,,percent of total billed charges,61.85% of total billed charges,547.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,712.08,130,,,Fee Schedule,130% of WA Medicaid ,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1088.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1088.78,37.7,,,percent of total billed charges,37.70% of total billed charges,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,97903.2,33.9,,,percent of total billed charges,33.9% of total billed charges,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2252.64,78,,,percent of total billed charges,78% of total billed charges,2888,100,,,percent of total billed charges,100% of total billed charges,2385.49,82.6,,,percent of total billed charges,82.6% of total billed charges,2385.49,82.6,,,percent of total billed charges,82.6% of total billed charges,547.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.92,97903.2,
TREATMENT OF TIBIA FRACTURE,27758,CDM,983,RC,27758,HCPCS,Outpatient,,,3790,2463.50,,3335.2,88,,,percent of total billed charges,88% of total Billed charges,93.61,100,,,Fee Schedule,100% of Medicare rate,516.98,100,,,Fee Schedule,100% of WA Medicaid,3790,100,,,percent of total billed charges,100% of total billed charges,532.49,103,,,Fee Schedule,103% of WA Medicaid,93.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,163.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,516.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2615.1,69,,,percent of total billed charges,69% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,3790,100,,,percent of total billed charges,100% of total billed charges,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,3790,100,,,percent of total billed charges,100% of total billed charges,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2344.12,61.85,,,percent of total billed charges,61.85% of total billed charges,516.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,672.07,130,,,Fee Schedule,130% of WA Medicaid ,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1428.83,37.7,,,percent of total billed charges,37.70% of total billed charges,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,128481,33.9,,,percent of total billed charges,33.9% of total billed charges,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2956.2,78,,,percent of total billed charges,78% of total billed charges,3790,100,,,percent of total billed charges,100% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,3130.54,82.6,,,percent of total billed charges,82.6% of total billed charges,516.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,93.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,93.61,128481,
TREATMENT OF TIBIA FRACTURE,27752,CDM,983,RC,27752,HCPCS,Outpatient,,,1605,1043.25,,1412.4,88,,,percent of total billed charges,88% of total Billed charges,48.64,100,,,Fee Schedule,100% of Medicare rate,288.89,100,,,Fee Schedule,100% of WA Medicaid,1605,100,,,percent of total billed charges,100% of total billed charges,297.56,103,,,Fee Schedule,103% of WA Medicaid,48.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,288.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1107.45,69,,,percent of total billed charges,69% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1605,100,,,percent of total billed charges,100% of total billed charges,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1605,100,,,percent of total billed charges,100% of total billed charges,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,992.69,61.85,,,percent of total billed charges,61.85% of total billed charges,288.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,294.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,375.56,130,,,Fee Schedule,130% of WA Medicaid ,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,605.09,37.7,,,percent of total billed charges,37.70% of total billed charges,605.09,37.7,,,percent of total billed charges,37.70% of total billed charges,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,54409.5,33.9,,,percent of total billed charges,33.9% of total billed charges,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1251.9,78,,,percent of total billed charges,78% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,288.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.64,54409.5,
TREATMENT OF TIBIA FRACTURE,27759,CDM,983,RC,27759,HCPCS,Outpatient,,,3352,2178.80,,2949.76,88,,,percent of total billed charges,88% of total Billed charges,106.39,100,,,Fee Schedule,100% of Medicare rate,572.18,100,,,Fee Schedule,100% of WA Medicaid,3352,100,,,percent of total billed charges,100% of total billed charges,589.35,103,,,Fee Schedule,103% of WA Medicaid,106.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,186.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,572.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2312.88,69,,,percent of total billed charges,69% of total billed charges,3352,100,,,percent of total billed charges,100% of total billed charges,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,3352,100,,,percent of total billed charges,100% of total billed charges,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,3352,100,,,percent of total billed charges,100% of total billed charges,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2073.21,61.85,,,percent of total billed charges,61.85% of total billed charges,572.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,572.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,743.83,130,,,Fee Schedule,130% of WA Medicaid ,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1263.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1263.7,37.7,,,percent of total billed charges,37.70% of total billed charges,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,113632.8,33.9,,,percent of total billed charges,33.9% of total billed charges,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2614.56,78,,,percent of total billed charges,78% of total billed charges,3352,100,,,percent of total billed charges,100% of total billed charges,2768.75,82.6,,,percent of total billed charges,82.6% of total billed charges,2768.75,82.6,,,percent of total billed charges,82.6% of total billed charges,572.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,572.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.39,113632.8,
TREAT FX MEDIAL MALLEOLUS,27760,CDM,983,RC,27760,HCPCS,Outpatient,,,802,521.30,,705.76,88,,,percent of total billed charges,88% of total Billed charges,24.54,100,,,Fee Schedule,100% of Medicare rate,186.31,100,,,Fee Schedule,100% of WA Medicaid,802,100,,,percent of total billed charges,100% of total billed charges,191.9,103,,,Fee Schedule,103% of WA Medicaid,24.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,186.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,553.38,69,,,percent of total billed charges,69% of total billed charges,802,100,,,percent of total billed charges,100% of total billed charges,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,802,100,,,percent of total billed charges,100% of total billed charges,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,802,100,,,percent of total billed charges,100% of total billed charges,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.04,61.85,,,percent of total billed charges,61.85% of total billed charges,186.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,242.2,130,,,Fee Schedule,130% of WA Medicaid ,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.35,37.7,,,percent of total billed charges,37.70% of total billed charges,302.35,37.7,,,percent of total billed charges,37.70% of total billed charges,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,27187.8,33.9,,,percent of total billed charges,33.9% of total billed charges,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.56,78,,,percent of total billed charges,78% of total billed charges,802,100,,,percent of total billed charges,100% of total billed charges,662.45,82.6,,,percent of total billed charges,82.6% of total billed charges,662.45,82.6,,,percent of total billed charges,82.6% of total billed charges,186.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.54,27187.8,
OPEN TREATMENT POST ANKLE FX,27769,CDM,983,RC,27769,HCPCS,Outpatient,,,1660,1079.00,,1460.8,88,,,percent of total billed charges,88% of total Billed charges,73.46,100,,,Fee Schedule,100% of Medicare rate,420.18,100,,,Fee Schedule,100% of WA Medicaid,1660,100,,,percent of total billed charges,100% of total billed charges,432.79,103,,,Fee Schedule,103% of WA Medicaid,73.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,128.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,420.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1145.4,69,,,percent of total billed charges,69% of total billed charges,1660,100,,,percent of total billed charges,100% of total billed charges,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1660,100,,,percent of total billed charges,100% of total billed charges,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1660,100,,,percent of total billed charges,100% of total billed charges,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1026.71,61.85,,,percent of total billed charges,61.85% of total billed charges,420.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,546.23,130,,,Fee Schedule,130% of WA Medicaid ,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.82,37.7,,,percent of total billed charges,37.70% of total billed charges,625.82,37.7,,,percent of total billed charges,37.70% of total billed charges,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,56274,33.9,,,percent of total billed charges,33.9% of total billed charges,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1294.8,78,,,percent of total billed charges,78% of total billed charges,1660,100,,,percent of total billed charges,100% of total billed charges,1371.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1371.16,82.6,,,percent of total billed charges,82.6% of total billed charges,420.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.46,56274,
OPTX MEDIAL ANKLE FX,27766,CDM,983,RC,27766,HCPCS,Outpatient,,,2417,1571.05,,2126.96,88,,,percent of total billed charges,88% of total Billed charges,57.17,100,,,Fee Schedule,100% of Medicare rate,352.67,100,,,Fee Schedule,100% of WA Medicaid,2417,100,,,percent of total billed charges,100% of total billed charges,363.25,103,,,Fee Schedule,103% of WA Medicaid,57.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,352.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1667.73,69,,,percent of total billed charges,69% of total billed charges,2417,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2417,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2417,100,,,percent of total billed charges,100% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1494.91,61.85,,,percent of total billed charges,61.85% of total billed charges,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,458.47,130,,,Fee Schedule,130% of WA Medicaid ,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,911.21,37.7,,,percent of total billed charges,37.70% of total billed charges,911.21,37.7,,,percent of total billed charges,37.70% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,81936.3,33.9,,,percent of total billed charges,33.9% of total billed charges,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1885.26,78,,,percent of total billed charges,78% of total billed charges,2417,100,,,percent of total billed charges,100% of total billed charges,1996.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1996.44,82.6,,,percent of total billed charges,82.6% of total billed charges,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.17,81936.3,
CLTX POST ANKLE FX W/MNPJ,27768,CDM,983,RC,27768,HCPCS,Outpatient,,,635,412.75,,558.8,88,,,percent of total billed charges,88% of total Billed charges,42.01,100,,,Fee Schedule,100% of Medicare rate,266.88,100,,,Fee Schedule,100% of WA Medicaid,635,100,,,percent of total billed charges,100% of total billed charges,274.89,103,,,Fee Schedule,103% of WA Medicaid,42.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,266.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,438.15,69,,,percent of total billed charges,69% of total billed charges,635,100,,,percent of total billed charges,100% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,635,100,,,percent of total billed charges,100% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,635,100,,,percent of total billed charges,100% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.75,61.85,,,percent of total billed charges,61.85% of total billed charges,266.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,346.94,130,,,Fee Schedule,130% of WA Medicaid ,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.4,37.7,,,percent of total billed charges,37.70% of total billed charges,239.4,37.7,,,percent of total billed charges,37.70% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,21526.5,33.9,,,percent of total billed charges,33.9% of total billed charges,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.3,78,,,percent of total billed charges,78% of total billed charges,635,100,,,percent of total billed charges,100% of total billed charges,524.51,82.6,,,percent of total billed charges,82.6% of total billed charges,524.51,82.6,,,percent of total billed charges,82.6% of total billed charges,266.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.01,21526.5,
CLTX MED ANKLE FX W/MNPJ,27762,CDM,983,RC,27762,HCPCS,Outpatient,,,1181,767.65,,1039.28,88,,,percent of total billed charges,88% of total Billed charges,43.06,100,,,Fee Schedule,100% of Medicare rate,261.85,100,,,Fee Schedule,100% of WA Medicaid,1181,100,,,percent of total billed charges,100% of total billed charges,269.71,103,,,Fee Schedule,103% of WA Medicaid,43.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,261.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,814.89,69,,,percent of total billed charges,69% of total billed charges,1181,100,,,percent of total billed charges,100% of total billed charges,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1181,100,,,percent of total billed charges,100% of total billed charges,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1181,100,,,percent of total billed charges,100% of total billed charges,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,730.45,61.85,,,percent of total billed charges,61.85% of total billed charges,261.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,340.41,130,,,Fee Schedule,130% of WA Medicaid ,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.24,37.7,,,percent of total billed charges,37.70% of total billed charges,445.24,37.7,,,percent of total billed charges,37.70% of total billed charges,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,40035.9,33.9,,,percent of total billed charges,33.9% of total billed charges,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,921.18,78,,,percent of total billed charges,78% of total billed charges,1181,100,,,percent of total billed charges,100% of total billed charges,975.51,82.6,,,percent of total billed charges,82.6% of total billed charges,975.51,82.6,,,percent of total billed charges,82.6% of total billed charges,261.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.06,40035.9,
TREAT FX LATERAL MALLEOLUS,27786,CDM,983,RC,27786,HCPCS,Outpatient,,,791,514.15,,696.08,88,,,percent of total billed charges,88% of total Billed charges,23.1,100,,,Fee Schedule,100% of Medicare rate,173.82,100,,,Fee Schedule,100% of WA Medicaid,791,100,,,percent of total billed charges,100% of total billed charges,179.03,103,,,Fee Schedule,103% of WA Medicaid,23.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,173.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,545.79,69,,,percent of total billed charges,69% of total billed charges,791,100,,,percent of total billed charges,100% of total billed charges,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,791,100,,,percent of total billed charges,100% of total billed charges,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,791,100,,,percent of total billed charges,100% of total billed charges,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.23,61.85,,,percent of total billed charges,61.85% of total billed charges,173.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,225.97,130,,,Fee Schedule,130% of WA Medicaid ,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.21,37.7,,,percent of total billed charges,37.70% of total billed charges,298.21,37.7,,,percent of total billed charges,37.70% of total billed charges,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,26814.9,33.9,,,percent of total billed charges,33.9% of total billed charges,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,616.98,78,,,percent of total billed charges,78% of total billed charges,791,100,,,percent of total billed charges,100% of total billed charges,653.37,82.6,,,percent of total billed charges,82.6% of total billed charges,653.37,82.6,,,percent of total billed charges,82.6% of total billed charges,173.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.1,26814.9,
TREATMENT OF ANKLE FRACTURE,27788,CDM,983,RC,27788,HCPCS,Outpatient,,,1029,668.85,,905.52,88,,,percent of total billed charges,88% of total Billed charges,35.65,100,,,Fee Schedule,100% of Medicare rate,229.58,100,,,Fee Schedule,100% of WA Medicaid,1029,100,,,percent of total billed charges,100% of total billed charges,236.47,103,,,Fee Schedule,103% of WA Medicaid,35.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,62.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,229.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,710.01,69,,,percent of total billed charges,69% of total billed charges,1029,100,,,percent of total billed charges,100% of total billed charges,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1029,100,,,percent of total billed charges,100% of total billed charges,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1029,100,,,percent of total billed charges,100% of total billed charges,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,636.44,61.85,,,percent of total billed charges,61.85% of total billed charges,229.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,298.45,130,,,Fee Schedule,130% of WA Medicaid ,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.93,37.7,,,percent of total billed charges,37.70% of total billed charges,387.93,37.7,,,percent of total billed charges,37.70% of total billed charges,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,34883.1,33.9,,,percent of total billed charges,33.9% of total billed charges,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,802.62,78,,,percent of total billed charges,78% of total billed charges,1029,100,,,percent of total billed charges,100% of total billed charges,849.95,82.6,,,percent of total billed charges,82.6% of total billed charges,849.95,82.6,,,percent of total billed charges,82.6% of total billed charges,229.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.65,34883.1,
TREATMENT OF FIBULA FRACTURE,27784,CDM,983,RC,27784,HCPCS,Outpatient,,,2195,1426.75,,1931.6,88,,,percent of total billed charges,88% of total Billed charges,70.87,100,,,Fee Schedule,100% of Medicare rate,415.34,100,,,Fee Schedule,100% of WA Medicaid,2195,100,,,percent of total billed charges,100% of total billed charges,427.8,103,,,Fee Schedule,103% of WA Medicaid,70.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,415.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1514.55,69,,,percent of total billed charges,69% of total billed charges,2195,100,,,percent of total billed charges,100% of total billed charges,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2195,100,,,percent of total billed charges,100% of total billed charges,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2195,100,,,percent of total billed charges,100% of total billed charges,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357.61,61.85,,,percent of total billed charges,61.85% of total billed charges,415.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,539.94,130,,,Fee Schedule,130% of WA Medicaid ,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,827.52,37.7,,,percent of total billed charges,37.70% of total billed charges,827.52,37.7,,,percent of total billed charges,37.70% of total billed charges,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,74410.5,33.9,,,percent of total billed charges,33.9% of total billed charges,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1712.1,78,,,percent of total billed charges,78% of total billed charges,2195,100,,,percent of total billed charges,100% of total billed charges,1813.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1813.07,82.6,,,percent of total billed charges,82.6% of total billed charges,415.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.87,74410.5,
TREATMENT OF ANKLE FRACTURE,27792,CDM,983,RC,27792,HCPCS,Outpatient,,,2251,1463.15,,1980.88,88,,,percent of total billed charges,88% of total Billed charges,61.73,100,,,Fee Schedule,100% of Medicare rate,375.05,100,,,Fee Schedule,100% of WA Medicaid,2251,100,,,percent of total billed charges,100% of total billed charges,386.3,103,,,Fee Schedule,103% of WA Medicaid,61.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,375.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1553.19,69,,,percent of total billed charges,69% of total billed charges,2251,100,,,percent of total billed charges,100% of total billed charges,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2251,100,,,percent of total billed charges,100% of total billed charges,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2251,100,,,percent of total billed charges,100% of total billed charges,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1392.24,61.85,,,percent of total billed charges,61.85% of total billed charges,375.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,487.57,130,,,Fee Schedule,130% of WA Medicaid ,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,848.63,37.7,,,percent of total billed charges,37.70% of total billed charges,848.63,37.7,,,percent of total billed charges,37.70% of total billed charges,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,76308.9,33.9,,,percent of total billed charges,33.9% of total billed charges,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1755.78,78,,,percent of total billed charges,78% of total billed charges,2251,100,,,percent of total billed charges,100% of total billed charges,1859.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1859.33,82.6,,,percent of total billed charges,82.6% of total billed charges,375.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.73,76308.9,
TREATMENT OF ANKLE FRACTURE,27814,CDM,983,RC,27814,HCPCS,Outpatient,,,3006,1953.90,,2645.28,88,,,percent of total billed charges,88% of total Billed charges,76.17,100,,,Fee Schedule,100% of Medicare rate,442.19,100,,,Fee Schedule,100% of WA Medicaid,3006,100,,,percent of total billed charges,100% of total billed charges,455.46,103,,,Fee Schedule,103% of WA Medicaid,76.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,133.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,442.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2074.14,69,,,percent of total billed charges,69% of total billed charges,3006,100,,,percent of total billed charges,100% of total billed charges,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3006,100,,,percent of total billed charges,100% of total billed charges,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3006,100,,,percent of total billed charges,100% of total billed charges,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1859.21,61.85,,,percent of total billed charges,61.85% of total billed charges,442.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,574.85,130,,,Fee Schedule,130% of WA Medicaid ,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1133.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1133.26,37.7,,,percent of total billed charges,37.70% of total billed charges,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,101903.4,33.9,,,percent of total billed charges,33.9% of total billed charges,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2344.68,78,,,percent of total billed charges,78% of total billed charges,3006,100,,,percent of total billed charges,100% of total billed charges,2482.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2482.96,82.6,,,percent of total billed charges,82.6% of total billed charges,442.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.17,101903.4,
TREAT FX TRI-MALLEOLUS,27816,CDM,983,RC,27816,HCPCS,Outpatient,,,917,596.05,,806.96,88,,,percent of total billed charges,88% of total Billed charges,24.63,100,,,Fee Schedule,100% of Medicare rate,178.29,100,,,Fee Schedule,100% of WA Medicaid,917,100,,,percent of total billed charges,100% of total billed charges,183.64,103,,,Fee Schedule,103% of WA Medicaid,24.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,178.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,632.73,69,,,percent of total billed charges,69% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,917,100,,,percent of total billed charges,100% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,917,100,,,percent of total billed charges,100% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.16,61.85,,,percent of total billed charges,61.85% of total billed charges,178.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,231.78,130,,,Fee Schedule,130% of WA Medicaid ,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,31086.3,33.9,,,percent of total billed charges,33.9% of total billed charges,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,715.26,78,,,percent of total billed charges,78% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,178.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.63,31086.3,
TREATMENT OF ANKLE FRACTURE,27818,CDM,983,RC,27818,HCPCS,Outpatient,,,1536,998.40,,1351.68,88,,,percent of total billed charges,88% of total Billed charges,44.04,100,,,Fee Schedule,100% of Medicare rate,260.73,100,,,Fee Schedule,100% of WA Medicaid,1536,100,,,percent of total billed charges,100% of total billed charges,268.55,103,,,Fee Schedule,103% of WA Medicaid,44.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,260.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1059.84,69,,,percent of total billed charges,69% of total billed charges,1536,100,,,percent of total billed charges,100% of total billed charges,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1536,100,,,percent of total billed charges,100% of total billed charges,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1536,100,,,percent of total billed charges,100% of total billed charges,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,950.02,61.85,,,percent of total billed charges,61.85% of total billed charges,260.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,338.95,130,,,Fee Schedule,130% of WA Medicaid ,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,579.07,37.7,,,percent of total billed charges,37.70% of total billed charges,579.07,37.7,,,percent of total billed charges,37.70% of total billed charges,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,52070.4,33.9,,,percent of total billed charges,33.9% of total billed charges,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198.08,78,,,percent of total billed charges,78% of total billed charges,1536,100,,,percent of total billed charges,100% of total billed charges,1268.74,82.6,,,percent of total billed charges,82.6% of total billed charges,1268.74,82.6,,,percent of total billed charges,82.6% of total billed charges,260.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.04,52070.4,
TREATMENT OF ANKLE FRACTURE,27810,CDM,983,RC,27810,HCPCS,Outpatient,,,1447,940.55,,1273.36,88,,,percent of total billed charges,88% of total Billed charges,41.88,100,,,Fee Schedule,100% of Medicare rate,254.39,100,,,Fee Schedule,100% of WA Medicaid,1447,100,,,percent of total billed charges,100% of total billed charges,262.02,103,,,Fee Schedule,103% of WA Medicaid,41.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,254.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,998.43,69,,,percent of total billed charges,69% of total billed charges,1447,100,,,percent of total billed charges,100% of total billed charges,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1447,100,,,percent of total billed charges,100% of total billed charges,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1447,100,,,percent of total billed charges,100% of total billed charges,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.97,61.85,,,percent of total billed charges,61.85% of total billed charges,254.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,330.71,130,,,Fee Schedule,130% of WA Medicaid ,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.52,37.7,,,percent of total billed charges,37.70% of total billed charges,545.52,37.7,,,percent of total billed charges,37.70% of total billed charges,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,49053.3,33.9,,,percent of total billed charges,33.9% of total billed charges,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128.66,78,,,percent of total billed charges,78% of total billed charges,1447,100,,,percent of total billed charges,100% of total billed charges,1195.22,82.6,,,percent of total billed charges,82.6% of total billed charges,1195.22,82.6,,,percent of total billed charges,82.6% of total billed charges,254.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.88,49053.3,
TREAT LOWER LEG FRACTURE,27825,CDM,983,RC,27825,HCPCS,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,49.43,100,,,Fee Schedule,100% of Medicare rate,288.89,100,,,Fee Schedule,100% of WA Medicaid,1800,100,,,percent of total billed charges,100% of total billed charges,297.56,103,,,Fee Schedule,103% of WA Medicaid,49.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,288.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1800,100,,,percent of total billed charges,100% of total billed charges,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1800,100,,,percent of total billed charges,100% of total billed charges,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,288.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,294.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,375.56,130,,,Fee Schedule,130% of WA Medicaid ,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,61020,33.9,,,percent of total billed charges,33.9% of total billed charges,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,288.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.43,61020,
TREAT LOWER LEG FRACTURE,27826,CDM,983,RC,27826,HCPCS,Outpatient,,,2446,1589.90,,2152.48,88,,,percent of total billed charges,88% of total Billed charges,77.93,100,,,Fee Schedule,100% of Medicare rate,495.9,100,,,Fee Schedule,100% of WA Medicaid,2446,100,,,percent of total billed charges,100% of total billed charges,510.78,103,,,Fee Schedule,103% of WA Medicaid,77.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,136.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,495.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1687.74,69,,,percent of total billed charges,69% of total billed charges,2446,100,,,percent of total billed charges,100% of total billed charges,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2446,100,,,percent of total billed charges,100% of total billed charges,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2446,100,,,percent of total billed charges,100% of total billed charges,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1512.85,61.85,,,percent of total billed charges,61.85% of total billed charges,495.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,644.67,130,,,Fee Schedule,130% of WA Medicaid ,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,922.14,37.7,,,percent of total billed charges,37.70% of total billed charges,922.14,37.7,,,percent of total billed charges,37.70% of total billed charges,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,82919.4,33.9,,,percent of total billed charges,33.9% of total billed charges,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1907.88,78,,,percent of total billed charges,78% of total billed charges,2446,100,,,percent of total billed charges,100% of total billed charges,2020.4,82.6,,,percent of total billed charges,82.6% of total billed charges,2020.4,82.6,,,percent of total billed charges,82.6% of total billed charges,495.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.93,82919.4,
TREAT LOWER LEG FRACTURE,27828,CDM,983,RC,27828,HCPCS,Outpatient,,,4270,2775.50,,3757.6,88,,,percent of total billed charges,88% of total Billed charges,134.04,100,,,Fee Schedule,100% of Medicare rate,763.16,100,,,Fee Schedule,100% of WA Medicaid,4270,100,,,percent of total billed charges,100% of total billed charges,786.05,103,,,Fee Schedule,103% of WA Medicaid,134.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,234.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,763.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2946.3,69,,,percent of total billed charges,69% of total billed charges,4270,100,,,percent of total billed charges,100% of total billed charges,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,4270,100,,,percent of total billed charges,100% of total billed charges,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,4270,100,,,percent of total billed charges,100% of total billed charges,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2641,61.85,,,percent of total billed charges,61.85% of total billed charges,763.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,992.11,130,,,Fee Schedule,130% of WA Medicaid ,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1609.79,37.7,,,percent of total billed charges,37.70% of total billed charges,1609.79,37.7,,,percent of total billed charges,37.70% of total billed charges,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,144753,33.9,,,percent of total billed charges,33.9% of total billed charges,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3330.6,78,,,percent of total billed charges,78% of total billed charges,4270,100,,,percent of total billed charges,100% of total billed charges,3527.02,82.6,,,percent of total billed charges,82.6% of total billed charges,3527.02,82.6,,,percent of total billed charges,82.6% of total billed charges,763.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,134.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,134.04,144753,
TREAT LOWER LEG FRACTURE,27827,CDM,983,RC,27827,HCPCS,Outpatient,,,4273,2777.45,,3760.24,88,,,percent of total billed charges,88% of total Billed charges,109.26,100,,,Fee Schedule,100% of Medicare rate,647.53,100,,,Fee Schedule,100% of WA Medicaid,4273,100,,,percent of total billed charges,100% of total billed charges,666.96,103,,,Fee Schedule,103% of WA Medicaid,109.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,191.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,647.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2948.37,69,,,percent of total billed charges,69% of total billed charges,4273,100,,,percent of total billed charges,100% of total billed charges,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,4273,100,,,percent of total billed charges,100% of total billed charges,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,4273,100,,,percent of total billed charges,100% of total billed charges,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2642.85,61.85,,,percent of total billed charges,61.85% of total billed charges,647.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,660.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,841.79,130,,,Fee Schedule,130% of WA Medicaid ,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1610.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1610.92,37.7,,,percent of total billed charges,37.70% of total billed charges,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,144854.7,33.9,,,percent of total billed charges,33.9% of total billed charges,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,3332.94,78,,,percent of total billed charges,78% of total billed charges,4273,100,,,percent of total billed charges,100% of total billed charges,3529.5,82.6,,,percent of total billed charges,82.6% of total billed charges,3529.5,82.6,,,percent of total billed charges,82.6% of total billed charges,647.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,109.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,109.26,144854.7,
TREAT LOWER LEG JOINT,27829,CDM,983,RC,27829,HCPCS,Outpatient,,,2275,1478.75,,2002,88,,,percent of total billed charges,88% of total Billed charges,64.18,100,,,Fee Schedule,100% of Medicare rate,412.17,100,,,Fee Schedule,100% of WA Medicaid,2275,100,,,percent of total billed charges,100% of total billed charges,424.54,103,,,Fee Schedule,103% of WA Medicaid,64.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,412.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1569.75,69,,,percent of total billed charges,69% of total billed charges,2275,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2275,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2275,100,,,percent of total billed charges,100% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1407.09,61.85,,,percent of total billed charges,61.85% of total billed charges,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,535.82,130,,,Fee Schedule,130% of WA Medicaid ,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,857.68,37.7,,,percent of total billed charges,37.70% of total billed charges,857.68,37.7,,,percent of total billed charges,37.70% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,77122.5,33.9,,,percent of total billed charges,33.9% of total billed charges,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1774.5,78,,,percent of total billed charges,78% of total billed charges,2275,100,,,percent of total billed charges,100% of total billed charges,1879.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1879.15,82.6,,,percent of total billed charges,82.6% of total billed charges,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.18,77122.5,
TREAT FX TIBIAL PLAFOND/PILON,27824,CDM,983,RC,27824,HCPCS,Outpatient,,,1017,661.05,,894.96,88,,,percent of total billed charges,88% of total Billed charges,25.45,100,,,Fee Schedule,100% of Medicare rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,1017,100,,,percent of total billed charges,100% of total billed charges,189.41,103,,,Fee Schedule,103% of WA Medicaid,25.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,701.73,69,,,percent of total billed charges,69% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,100,,,percent of total billed charges,100% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.01,61.85,,,percent of total billed charges,61.85% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,239.06,130,,,Fee Schedule,130% of WA Medicaid ,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,34476.3,33.9,,,percent of total billed charges,33.9% of total billed charges,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,793.26,78,,,percent of total billed charges,78% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.45,34476.3,
TREATMENT OF ANKLE FRACTURE,27822,CDM,983,RC,27822,HCPCS,Outpatient,,,3117,2026.05,,2742.96,88,,,percent of total billed charges,88% of total Billed charges,82.15,100,,,Fee Schedule,100% of Medicare rate,507.09,100,,,Fee Schedule,100% of WA Medicaid,3117,100,,,percent of total billed charges,100% of total billed charges,522.3,103,,,Fee Schedule,103% of WA Medicaid,82.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,143.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,507.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2150.73,69,,,percent of total billed charges,69% of total billed charges,3117,100,,,percent of total billed charges,100% of total billed charges,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3117,100,,,percent of total billed charges,100% of total billed charges,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3117,100,,,percent of total billed charges,100% of total billed charges,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1927.86,61.85,,,percent of total billed charges,61.85% of total billed charges,507.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,659.22,130,,,Fee Schedule,130% of WA Medicaid ,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1175.11,37.7,,,percent of total billed charges,37.70% of total billed charges,1175.11,37.7,,,percent of total billed charges,37.70% of total billed charges,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,105666.3,33.9,,,percent of total billed charges,33.9% of total billed charges,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2431.26,78,,,percent of total billed charges,78% of total billed charges,3117,100,,,percent of total billed charges,100% of total billed charges,2574.64,82.6,,,percent of total billed charges,82.6% of total billed charges,2574.64,82.6,,,percent of total billed charges,82.6% of total billed charges,507.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.15,105666.3,
OPEN TRT TRIMALLEOLAR ANKLE FX,27823,CDM,983,RC,27823,HCPCS,Outpatient,,,2257,1467.05,,1986.16,88,,,percent of total billed charges,88% of total Billed charges,95.82,100,,,Fee Schedule,100% of Medicare rate,569.57,100,,,Fee Schedule,100% of WA Medicaid,2257,100,,,percent of total billed charges,100% of total billed charges,586.66,103,,,Fee Schedule,103% of WA Medicaid,95.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,167.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,569.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1557.33,69,,,percent of total billed charges,69% of total billed charges,2257,100,,,percent of total billed charges,100% of total billed charges,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2257,100,,,percent of total billed charges,100% of total billed charges,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2257,100,,,percent of total billed charges,100% of total billed charges,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1395.95,61.85,,,percent of total billed charges,61.85% of total billed charges,569.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,569.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,580.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,740.44,130,,,Fee Schedule,130% of WA Medicaid ,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,850.89,37.7,,,percent of total billed charges,37.70% of total billed charges,850.89,37.7,,,percent of total billed charges,37.70% of total billed charges,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,76512.3,33.9,,,percent of total billed charges,33.9% of total billed charges,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1760.46,78,,,percent of total billed charges,78% of total billed charges,2257,100,,,percent of total billed charges,100% of total billed charges,1864.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1864.28,82.6,,,percent of total billed charges,82.6% of total billed charges,569.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,95.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,569.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.82,76512.3,
TREAT ANKLE DISLOCATION,27848,CDM,983,RC,27848,HCPCS,Outpatient,,,2248,1461.20,,1978.24,88,,,percent of total billed charges,88% of total Billed charges,77.91,100,,,Fee Schedule,100% of Medicare rate,455.06,100,,,Fee Schedule,100% of WA Medicaid,2248,100,,,percent of total billed charges,100% of total billed charges,468.71,103,,,Fee Schedule,103% of WA Medicaid,77.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,136.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,455.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1551.12,69,,,percent of total billed charges,69% of total billed charges,2248,100,,,percent of total billed charges,100% of total billed charges,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2248,100,,,percent of total billed charges,100% of total billed charges,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2248,100,,,percent of total billed charges,100% of total billed charges,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1390.39,61.85,,,percent of total billed charges,61.85% of total billed charges,455.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,591.58,130,,,Fee Schedule,130% of WA Medicaid ,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.5,37.7,,,percent of total billed charges,37.70% of total billed charges,847.5,37.7,,,percent of total billed charges,37.70% of total billed charges,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,76207.2,33.9,,,percent of total billed charges,33.9% of total billed charges,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1753.44,78,,,percent of total billed charges,78% of total billed charges,2248,100,,,percent of total billed charges,100% of total billed charges,1856.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1856.85,82.6,,,percent of total billed charges,82.6% of total billed charges,455.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.91,76207.2,
TREAT ANKLE DISLOCATION,27846,CDM,983,RC,27846,HCPCS,Outpatient,,,2017,1311.05,,1774.96,88,,,percent of total billed charges,88% of total Billed charges,73.75,100,,,Fee Schedule,100% of Medicare rate,420.56,100,,,Fee Schedule,100% of WA Medicaid,2017,100,,,percent of total billed charges,100% of total billed charges,433.18,103,,,Fee Schedule,103% of WA Medicaid,73.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,129.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,420.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1391.73,69,,,percent of total billed charges,69% of total billed charges,2017,100,,,percent of total billed charges,100% of total billed charges,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2017,100,,,percent of total billed charges,100% of total billed charges,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2017,100,,,percent of total billed charges,100% of total billed charges,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1247.51,61.85,,,percent of total billed charges,61.85% of total billed charges,420.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,546.73,130,,,Fee Schedule,130% of WA Medicaid ,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,760.41,37.7,,,percent of total billed charges,37.70% of total billed charges,760.41,37.7,,,percent of total billed charges,37.70% of total billed charges,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,68376.3,33.9,,,percent of total billed charges,33.9% of total billed charges,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1573.26,78,,,percent of total billed charges,78% of total billed charges,2017,100,,,percent of total billed charges,100% of total billed charges,1666.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1666.04,82.6,,,percent of total billed charges,82.6% of total billed charges,420.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.75,68376.3,
TREAT ANKLE DISLOCATION,27842,CDM,983,RC,27842,HCPCS,Outpatient,,,1362,885.30,,1198.56,88,,,percent of total billed charges,88% of total Billed charges,47.36,100,,,Fee Schedule,100% of Medicare rate,289.26,100,,,Fee Schedule,100% of WA Medicaid,1362,100,,,percent of total billed charges,100% of total billed charges,297.94,103,,,Fee Schedule,103% of WA Medicaid,47.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,82.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,289.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,939.78,69,,,percent of total billed charges,69% of total billed charges,1362,100,,,percent of total billed charges,100% of total billed charges,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1362,100,,,percent of total billed charges,100% of total billed charges,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1362,100,,,percent of total billed charges,100% of total billed charges,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.4,61.85,,,percent of total billed charges,61.85% of total billed charges,289.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,376.04,130,,,Fee Schedule,130% of WA Medicaid ,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.47,37.7,,,percent of total billed charges,37.70% of total billed charges,513.47,37.7,,,percent of total billed charges,37.70% of total billed charges,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,46171.8,33.9,,,percent of total billed charges,33.9% of total billed charges,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1062.36,78,,,percent of total billed charges,78% of total billed charges,1362,100,,,percent of total billed charges,100% of total billed charges,1125.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1125.01,82.6,,,percent of total billed charges,82.6% of total billed charges,289.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.36,46171.8,
TREAT ANKLE DISLOCATION,27840,CDM,983,RC,27840,HCPCS,Outpatient,,,1200,780.00,,1056,88,,,percent of total billed charges,88% of total Billed charges,37.24,100,,,Fee Schedule,100% of Medicare rate,230.14,100,,,Fee Schedule,100% of WA Medicaid,1200,100,,,percent of total billed charges,100% of total billed charges,237.04,103,,,Fee Schedule,103% of WA Medicaid,37.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,230.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,828,69,,,percent of total billed charges,69% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1200,100,,,percent of total billed charges,100% of total billed charges,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,742.2,61.85,,,percent of total billed charges,61.85% of total billed charges,230.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,299.18,130,,,Fee Schedule,130% of WA Medicaid ,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,452.4,37.7,,,percent of total billed charges,37.70% of total billed charges,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,40680,33.9,,,percent of total billed charges,33.9% of total billed charges,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,936,78,,,percent of total billed charges,78% of total billed charges,1200,100,,,percent of total billed charges,100% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,991.2,82.6,,,percent of total billed charges,82.6% of total billed charges,230.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.24,40680,
FUSION OF TIBIOFIBULAR JOINT,27871,CDM,983,RC,27871,HCPCS,Outpatient,,,3037,1974.05,,2672.56,88,,,percent of total billed charges,88% of total Billed charges,68.52,100,,,Fee Schedule,100% of Medicare rate,400.23,100,,,Fee Schedule,100% of WA Medicaid,3037,100,,,percent of total billed charges,100% of total billed charges,412.24,103,,,Fee Schedule,103% of WA Medicaid,68.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,119.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,400.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2095.53,69,,,percent of total billed charges,69% of total billed charges,3037,100,,,percent of total billed charges,100% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,3037,100,,,percent of total billed charges,100% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,3037,100,,,percent of total billed charges,100% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1878.38,61.85,,,percent of total billed charges,61.85% of total billed charges,400.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.3,130,,,Fee Schedule,130% of WA Medicaid ,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1144.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1144.95,37.7,,,percent of total billed charges,37.70% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,102954.3,33.9,,,percent of total billed charges,33.9% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2368.86,78,,,percent of total billed charges,78% of total billed charges,3037,100,,,percent of total billed charges,100% of total billed charges,2508.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2508.56,82.6,,,percent of total billed charges,82.6% of total billed charges,400.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.52,102954.3,
FUSION OF ANKLE JOINT OPEN,27870,CDM,983,RC,27870,HCPCS,Outpatient,,,3841,2496.65,,3380.08,88,,,percent of total billed charges,88% of total Billed charges,99.99,100,,,Fee Schedule,100% of Medicare rate,578.52,100,,,Fee Schedule,100% of WA Medicaid,3841,100,,,percent of total billed charges,100% of total billed charges,595.88,103,,,Fee Schedule,103% of WA Medicaid,99.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,174.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,578.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2650.29,69,,,percent of total billed charges,69% of total billed charges,3841,100,,,percent of total billed charges,100% of total billed charges,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3841,100,,,percent of total billed charges,100% of total billed charges,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3841,100,,,percent of total billed charges,100% of total billed charges,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2375.66,61.85,,,percent of total billed charges,61.85% of total billed charges,578.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,578.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,752.08,130,,,Fee Schedule,130% of WA Medicaid ,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1448.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1448.06,37.7,,,percent of total billed charges,37.70% of total billed charges,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,130209.9,33.9,,,percent of total billed charges,33.9% of total billed charges,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2995.98,78,,,percent of total billed charges,78% of total billed charges,3841,100,,,percent of total billed charges,100% of total billed charges,3172.67,82.6,,,percent of total billed charges,82.6% of total billed charges,3172.67,82.6,,,percent of total billed charges,82.6% of total billed charges,578.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,578.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.99,130209.9,
AMPUTATION OF FOOT AT ANKLE,27888,CDM,983,RC,27888,HCPCS,Outpatient,,,1886,1225.90,,1659.68,88,,,percent of total billed charges,88% of total Billed charges,83.74,100,,,Fee Schedule,100% of Medicare rate,317.61,100,,,Fee Schedule,100% of WA Medicaid,1886,100,,,percent of total billed charges,100% of total billed charges,327.14,103,,,Fee Schedule,103% of WA Medicaid,83.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,146.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,317.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1301.34,69,,,percent of total billed charges,69% of total billed charges,1886,100,,,percent of total billed charges,100% of total billed charges,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1886,100,,,percent of total billed charges,100% of total billed charges,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1886,100,,,percent of total billed charges,100% of total billed charges,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1166.49,61.85,,,percent of total billed charges,61.85% of total billed charges,317.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,412.89,130,,,Fee Schedule,130% of WA Medicaid ,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.02,37.7,,,percent of total billed charges,37.70% of total billed charges,711.02,37.7,,,percent of total billed charges,37.70% of total billed charges,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,63935.4,33.9,,,percent of total billed charges,33.9% of total billed charges,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1471.08,78,,,percent of total billed charges,78% of total billed charges,1886,100,,,percent of total billed charges,100% of total billed charges,1557.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.84,82.6,,,percent of total billed charges,82.6% of total billed charges,317.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.74,63935.4,
AMPUTATION FOLLOW-UP SURGERY,27884,CDM,983,RC,27884,HCPCS,Outpatient,,,1512,982.80,,1330.56,88,,,percent of total billed charges,88% of total Billed charges,70.2,100,,,Fee Schedule,100% of Medicare rate,327.87,100,,,Fee Schedule,100% of WA Medicaid,1512,100,,,percent of total billed charges,100% of total billed charges,337.71,103,,,Fee Schedule,103% of WA Medicaid,70.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,122.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,327.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1043.28,69,,,percent of total billed charges,69% of total billed charges,1512,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1512,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1512,100,,,percent of total billed charges,100% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,935.17,61.85,,,percent of total billed charges,61.85% of total billed charges,327.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,426.23,130,,,Fee Schedule,130% of WA Medicaid ,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,570.02,37.7,,,percent of total billed charges,37.70% of total billed charges,570.02,37.7,,,percent of total billed charges,37.70% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,51256.8,33.9,,,percent of total billed charges,33.9% of total billed charges,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1179.36,78,,,percent of total billed charges,78% of total billed charges,1512,100,,,percent of total billed charges,100% of total billed charges,1248.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1248.91,82.6,,,percent of total billed charges,82.6% of total billed charges,327.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.2,51256.8,
AMPUTATION OF LOWER LEG,27882,CDM,983,RC,27882,HCPCS,Outpatient,,,1705,1108.25,,1500.4,88,,,percent of total billed charges,88% of total Billed charges,78.96,100,,,Fee Schedule,100% of Medicare rate,330.85,100,,,Fee Schedule,100% of WA Medicaid,1705,100,,,percent of total billed charges,100% of total billed charges,340.78,103,,,Fee Schedule,103% of WA Medicaid,78.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,330.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1176.45,69,,,percent of total billed charges,69% of total billed charges,1705,100,,,percent of total billed charges,100% of total billed charges,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1705,100,,,percent of total billed charges,100% of total billed charges,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1705,100,,,percent of total billed charges,100% of total billed charges,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1054.54,61.85,,,percent of total billed charges,61.85% of total billed charges,330.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,430.11,130,,,Fee Schedule,130% of WA Medicaid ,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.79,37.7,,,percent of total billed charges,37.70% of total billed charges,642.79,37.7,,,percent of total billed charges,37.70% of total billed charges,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,57799.5,33.9,,,percent of total billed charges,33.9% of total billed charges,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329.9,78,,,percent of total billed charges,78% of total billed charges,1705,100,,,percent of total billed charges,100% of total billed charges,1408.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1408.33,82.6,,,percent of total billed charges,82.6% of total billed charges,330.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.96,57799.5,
AMPUTATION FOLLOW-UP SURGERY,27886,CDM,983,RC,27886,HCPCS,Outpatient,,,2269,1474.85,,1996.72,88,,,percent of total billed charges,88% of total Billed charges,79.78,100,,,Fee Schedule,100% of Medicare rate,366.47,100,,,Fee Schedule,100% of WA Medicaid,2269,100,,,percent of total billed charges,100% of total billed charges,377.46,103,,,Fee Schedule,103% of WA Medicaid,79.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,139.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,366.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1565.61,69,,,percent of total billed charges,69% of total billed charges,2269,100,,,percent of total billed charges,100% of total billed charges,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2269,100,,,percent of total billed charges,100% of total billed charges,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2269,100,,,percent of total billed charges,100% of total billed charges,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1403.38,61.85,,,percent of total billed charges,61.85% of total billed charges,366.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,476.41,130,,,Fee Schedule,130% of WA Medicaid ,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,855.41,37.7,,,percent of total billed charges,37.70% of total billed charges,855.41,37.7,,,percent of total billed charges,37.70% of total billed charges,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,76919.1,33.9,,,percent of total billed charges,33.9% of total billed charges,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1769.82,78,,,percent of total billed charges,78% of total billed charges,2269,100,,,percent of total billed charges,100% of total billed charges,1874.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1874.19,82.6,,,percent of total billed charges,82.6% of total billed charges,366.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.78,76919.1,
AMPUTATION OF LOWER LEG,27880,CDM,983,RC,27880,HCPCS,Outpatient,,,2703,1756.95,,2378.64,88,,,percent of total billed charges,88% of total Billed charges,121.43,100,,,Fee Schedule,100% of Medicare rate,500.94,100,,,Fee Schedule,100% of WA Medicaid,2703,100,,,percent of total billed charges,100% of total billed charges,515.97,103,,,Fee Schedule,103% of WA Medicaid,121.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,212.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,500.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1865.07,69,,,percent of total billed charges,69% of total billed charges,2703,100,,,percent of total billed charges,100% of total billed charges,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2703,100,,,percent of total billed charges,100% of total billed charges,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2703,100,,,percent of total billed charges,100% of total billed charges,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1671.81,61.85,,,percent of total billed charges,61.85% of total billed charges,500.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,651.22,130,,,Fee Schedule,130% of WA Medicaid ,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1019.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1019.03,37.7,,,percent of total billed charges,37.70% of total billed charges,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,91631.7,33.9,,,percent of total billed charges,33.9% of total billed charges,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2108.34,78,,,percent of total billed charges,78% of total billed charges,2703,100,,,percent of total billed charges,100% of total billed charges,2232.68,82.6,,,percent of total billed charges,82.6% of total billed charges,2232.68,82.6,,,percent of total billed charges,82.6% of total billed charges,500.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.43,91631.7,
AMPUTATION OF FOOT AT ANKLE,27889,CDM,983,RC,27889,HCPCS,Outpatient,,,1814,1179.10,,1596.32,88,,,percent of total billed charges,88% of total Billed charges,79.19,100,,,Fee Schedule,100% of Medicare rate,359.76,100,,,Fee Schedule,100% of WA Medicaid,1814,100,,,percent of total billed charges,100% of total billed charges,370.55,103,,,Fee Schedule,103% of WA Medicaid,79.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,359.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1251.66,69,,,percent of total billed charges,69% of total billed charges,1814,100,,,percent of total billed charges,100% of total billed charges,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1814,100,,,percent of total billed charges,100% of total billed charges,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1814,100,,,percent of total billed charges,100% of total billed charges,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1121.96,61.85,,,percent of total billed charges,61.85% of total billed charges,359.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,467.69,130,,,Fee Schedule,130% of WA Medicaid ,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.88,37.7,,,percent of total billed charges,37.70% of total billed charges,683.88,37.7,,,percent of total billed charges,37.70% of total billed charges,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,61494.6,33.9,,,percent of total billed charges,33.9% of total billed charges,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1414.92,78,,,percent of total billed charges,78% of total billed charges,1814,100,,,percent of total billed charges,100% of total billed charges,1498.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1498.36,82.6,,,percent of total billed charges,82.6% of total billed charges,359.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.19,61494.6,
"ID BELOW FASCIA,FOOT, SINGLE BURSA SPAC",28002,CDM,983,RC,28002,HCPCS,Outpatient,,,1014,659.10,,892.32,88,,,percent of total billed charges,88% of total Billed charges,10.69,100,,,Fee Schedule,100% of Medicare rate,79.45,100,,,Fee Schedule,100% of WA Medicaid,1014,100,,,percent of total billed charges,100% of total billed charges,81.83,103,,,Fee Schedule,103% of WA Medicaid,10.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,699.66,69,,,percent of total billed charges,69% of total billed charges,1014,100,,,percent of total billed charges,100% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,100,,,percent of total billed charges,100% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,100,,,percent of total billed charges,100% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,627.16,61.85,,,percent of total billed charges,61.85% of total billed charges,79.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.29,130,,,Fee Schedule,130% of WA Medicaid ,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.28,37.7,,,percent of total billed charges,37.70% of total billed charges,382.28,37.7,,,percent of total billed charges,37.70% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,34374.6,33.9,,,percent of total billed charges,33.9% of total billed charges,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,790.92,78,,,percent of total billed charges,78% of total billed charges,1014,100,,,percent of total billed charges,100% of total billed charges,837.56,82.6,,,percent of total billed charges,82.6% of total billed charges,837.56,82.6,,,percent of total billed charges,82.6% of total billed charges,79.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.69,34374.6,
I  D BELOW FASCIA W OR W/O TEND SHEATH,28003,CDM,983,RC,28003,HCPCS,Outpatient,,,1747,1135.55,,1537.36,88,,,percent of total billed charges,88% of total Billed charges,22.49,100,,,Fee Schedule,100% of Medicare rate,145.47,100,,,Fee Schedule,100% of WA Medicaid,1747,100,,,percent of total billed charges,100% of total billed charges,149.83,103,,,Fee Schedule,103% of WA Medicaid,22.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,145.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1205.43,69,,,percent of total billed charges,69% of total billed charges,1747,100,,,percent of total billed charges,100% of total billed charges,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1747,100,,,percent of total billed charges,100% of total billed charges,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1747,100,,,percent of total billed charges,100% of total billed charges,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080.52,61.85,,,percent of total billed charges,61.85% of total billed charges,145.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,189.11,130,,,Fee Schedule,130% of WA Medicaid ,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.62,37.7,,,percent of total billed charges,37.70% of total billed charges,658.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,59223.3,33.9,,,percent of total billed charges,33.9% of total billed charges,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1362.66,78,,,percent of total billed charges,78% of total billed charges,1747,100,,,percent of total billed charges,100% of total billed charges,1443.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1443.02,82.6,,,percent of total billed charges,82.6% of total billed charges,145.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.49,59223.3,
TREAT FOOT BONE LESION,28005,CDM,983,RC,28005,HCPCS,Outpatient,,,1677,1090.05,,1475.76,88,,,percent of total billed charges,88% of total Billed charges,40.99,100,,,Fee Schedule,100% of Medicare rate,329.92,100,,,Fee Schedule,100% of WA Medicaid,1677,100,,,percent of total billed charges,100% of total billed charges,339.82,103,,,Fee Schedule,103% of WA Medicaid,40.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,71.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,329.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1157.13,69,,,percent of total billed charges,69% of total billed charges,1677,100,,,percent of total billed charges,100% of total billed charges,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1677,100,,,percent of total billed charges,100% of total billed charges,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1677,100,,,percent of total billed charges,100% of total billed charges,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1037.22,61.85,,,percent of total billed charges,61.85% of total billed charges,329.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,428.9,130,,,Fee Schedule,130% of WA Medicaid ,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,632.23,37.7,,,percent of total billed charges,37.70% of total billed charges,632.23,37.7,,,percent of total billed charges,37.70% of total billed charges,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,56850.3,33.9,,,percent of total billed charges,33.9% of total billed charges,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1308.06,78,,,percent of total billed charges,78% of total billed charges,1677,100,,,percent of total billed charges,100% of total billed charges,1385.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1385.2,82.6,,,percent of total billed charges,82.6% of total billed charges,329.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.99,56850.3,
INCISION OF FOOT FASCIA,28008,CDM,983,RC,28008,HCPCS,Outpatient,,,1252,813.80,,1101.76,88,,,percent of total billed charges,88% of total Billed charges,19.65,100,,,Fee Schedule,100% of Medicare rate,171.39,100,,,Fee Schedule,100% of WA Medicaid,1252,100,,,percent of total billed charges,100% of total billed charges,176.53,103,,,Fee Schedule,103% of WA Medicaid,19.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,171.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,863.88,69,,,percent of total billed charges,69% of total billed charges,1252,100,,,percent of total billed charges,100% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1252,100,,,percent of total billed charges,100% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1252,100,,,percent of total billed charges,100% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,774.36,61.85,,,percent of total billed charges,61.85% of total billed charges,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,222.81,130,,,Fee Schedule,130% of WA Medicaid ,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,472,37.7,,,percent of total billed charges,37.70% of total billed charges,472,37.7,,,percent of total billed charges,37.70% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,42442.8,33.9,,,percent of total billed charges,33.9% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,976.56,78,,,percent of total billed charges,78% of total billed charges,1252,100,,,percent of total billed charges,100% of total billed charges,1034.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1034.15,82.6,,,percent of total billed charges,82.6% of total billed charges,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.65,42442.8,
EXPLORATION OF FOOT JOINT,28022,CDM,983,RC,28022,HCPCS,Outpatient,,,656,426.40,,577.28,88,,,percent of total billed charges,88% of total Billed charges,24.04,100,,,Fee Schedule,100% of Medicare rate,190.79,100,,,Fee Schedule,100% of WA Medicaid,656,100,,,percent of total billed charges,100% of total billed charges,196.51,103,,,Fee Schedule,103% of WA Medicaid,24.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,190.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,452.64,69,,,percent of total billed charges,69% of total billed charges,656,100,,,percent of total billed charges,100% of total billed charges,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,656,100,,,percent of total billed charges,100% of total billed charges,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,656,100,,,percent of total billed charges,100% of total billed charges,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.74,61.85,,,percent of total billed charges,61.85% of total billed charges,190.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,248.03,130,,,Fee Schedule,130% of WA Medicaid ,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.31,37.7,,,percent of total billed charges,37.70% of total billed charges,247.31,37.7,,,percent of total billed charges,37.70% of total billed charges,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,22238.4,33.9,,,percent of total billed charges,33.9% of total billed charges,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,511.68,78,,,percent of total billed charges,78% of total billed charges,656,100,,,percent of total billed charges,100% of total billed charges,541.86,82.6,,,percent of total billed charges,82.6% of total billed charges,541.86,82.6,,,percent of total billed charges,82.6% of total billed charges,190.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.04,22238.4,
28024 Exploration of toe joint,28024,CDM,983,RC,28024,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,21.39,100,,,Fee Schedule,100% of Medicare rate,179.97,100,,,Fee Schedule,100% of WA Medicaid,1885,100,,,percent of total billed charges,100% of total billed charges,185.37,103,,,Fee Schedule,103% of WA Medicaid,21.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,179.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1885,100,,,percent of total billed charges,100% of total billed charges,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1885,100,,,percent of total billed charges,100% of total billed charges,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,179.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,233.96,130,,,Fee Schedule,130% of WA Medicaid ,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,63901.5,33.9,,,percent of total billed charges,33.9% of total billed charges,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,179.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.39,63901.5,
EXC FOOT/TOE TUM SC 1.5 CM/>,28039,CDM,983,RC,28039,HCPCS,Outpatient,,,510,331.50,,448.8,88,,,percent of total billed charges,88% of total Billed charges,26.13,100,,,Fee Schedule,100% of Medicare rate,195.83,100,,,Fee Schedule,100% of WA Medicaid,510,100,,,percent of total billed charges,100% of total billed charges,201.7,103,,,Fee Schedule,103% of WA Medicaid,26.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,195.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,351.9,69,,,percent of total billed charges,69% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,510,100,,,percent of total billed charges,100% of total billed charges,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,510,100,,,percent of total billed charges,100% of total billed charges,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.44,61.85,,,percent of total billed charges,61.85% of total billed charges,195.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,254.58,130,,,Fee Schedule,130% of WA Medicaid ,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,17289,33.9,,,percent of total billed charges,33.9% of total billed charges,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.8,78,,,percent of total billed charges,78% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,195.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.13,17289,
DECOMPRESSION OF TIBIA NERVE,28035,CDM,983,RC,28035,HCPCS,Outpatient,,,1206,783.90,,1061.28,88,,,percent of total billed charges,88% of total Billed charges,27.57,100,,,Fee Schedule,100% of Medicare rate,208.69,100,,,Fee Schedule,100% of WA Medicaid,1206,100,,,percent of total billed charges,100% of total billed charges,214.95,103,,,Fee Schedule,103% of WA Medicaid,27.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,208.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,832.14,69,,,percent of total billed charges,69% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1206,100,,,percent of total billed charges,100% of total billed charges,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1206,100,,,percent of total billed charges,100% of total billed charges,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.91,61.85,,,percent of total billed charges,61.85% of total billed charges,208.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,271.3,130,,,Fee Schedule,130% of WA Medicaid ,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,454.66,37.7,,,percent of total billed charges,37.70% of total billed charges,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,40883.4,33.9,,,percent of total billed charges,33.9% of total billed charges,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,940.68,78,,,percent of total billed charges,78% of total billed charges,1206,100,,,percent of total billed charges,100% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,996.16,82.6,,,percent of total billed charges,82.6% of total billed charges,208.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.57,40883.4,
EX FOOT/TOE TUMOR DEEP LESS THAN 1.5,28045,CDM,983,RC,28045,HCPCS,Outpatient,,,1130,734.50,,994.4,88,,,percent of total billed charges,88% of total Billed charges,24.1,100,,,Fee Schedule,100% of Medicare rate,201.61,100,,,Fee Schedule,100% of WA Medicaid,1130,100,,,percent of total billed charges,100% of total billed charges,207.66,103,,,Fee Schedule,103% of WA Medicaid,24.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,201.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,779.7,69,,,percent of total billed charges,69% of total billed charges,1130,100,,,percent of total billed charges,100% of total billed charges,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1130,100,,,percent of total billed charges,100% of total billed charges,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1130,100,,,percent of total billed charges,100% of total billed charges,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.91,61.85,,,percent of total billed charges,61.85% of total billed charges,201.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,262.09,130,,,Fee Schedule,130% of WA Medicaid ,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.01,37.7,,,percent of total billed charges,37.70% of total billed charges,426.01,37.7,,,percent of total billed charges,37.70% of total billed charges,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,38307,33.9,,,percent of total billed charges,33.9% of total billed charges,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,881.4,78,,,percent of total billed charges,78% of total billed charges,1130,100,,,percent of total billed charges,100% of total billed charges,933.38,82.6,,,percent of total billed charges,82.6% of total billed charges,933.38,82.6,,,percent of total billed charges,82.6% of total billed charges,201.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.1,38307,
EXC FOOT/TOE TUM SC < 1.5 CM,28043,CDM,983,RC,28043,HCPCS,Outpatient,,,901,585.65,,792.88,88,,,percent of total billed charges,88% of total Billed charges,18.11,100,,,Fee Schedule,100% of Medicare rate,152.18,100,,,Fee Schedule,100% of WA Medicaid,901,100,,,percent of total billed charges,100% of total billed charges,156.75,103,,,Fee Schedule,103% of WA Medicaid,18.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,152.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,621.69,69,,,percent of total billed charges,69% of total billed charges,901,100,,,percent of total billed charges,100% of total billed charges,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,901,100,,,percent of total billed charges,100% of total billed charges,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,901,100,,,percent of total billed charges,100% of total billed charges,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.27,61.85,,,percent of total billed charges,61.85% of total billed charges,152.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,197.83,130,,,Fee Schedule,130% of WA Medicaid ,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.68,37.7,,,percent of total billed charges,37.70% of total billed charges,339.68,37.7,,,percent of total billed charges,37.70% of total billed charges,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,30543.9,33.9,,,percent of total billed charges,33.9% of total billed charges,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,702.78,78,,,percent of total billed charges,78% of total billed charges,901,100,,,percent of total billed charges,100% of total billed charges,744.23,82.6,,,percent of total billed charges,82.6% of total billed charges,744.23,82.6,,,percent of total billed charges,82.6% of total billed charges,152.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.11,30543.9,
PARTIAL REMOVAL FOOT FASCIA,28060,CDM,983,RC,28060,HCPCS,Outpatient,,,1175,763.75,,1034,88,,,percent of total billed charges,88% of total Billed charges,26.08,100,,,Fee Schedule,100% of Medicare rate,209.81,100,,,Fee Schedule,100% of WA Medicaid,1175,100,,,percent of total billed charges,100% of total billed charges,216.1,103,,,Fee Schedule,103% of WA Medicaid,26.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,209.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,810.75,69,,,percent of total billed charges,69% of total billed charges,1175,100,,,percent of total billed charges,100% of total billed charges,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1175,100,,,percent of total billed charges,100% of total billed charges,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1175,100,,,percent of total billed charges,100% of total billed charges,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.74,61.85,,,percent of total billed charges,61.85% of total billed charges,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,272.75,130,,,Fee Schedule,130% of WA Medicaid ,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.98,37.7,,,percent of total billed charges,37.70% of total billed charges,442.98,37.7,,,percent of total billed charges,37.70% of total billed charges,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,39832.5,33.9,,,percent of total billed charges,33.9% of total billed charges,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.5,78,,,percent of total billed charges,78% of total billed charges,1175,100,,,percent of total billed charges,100% of total billed charges,970.55,82.6,,,percent of total billed charges,82.6% of total billed charges,970.55,82.6,,,percent of total billed charges,82.6% of total billed charges,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.08,39832.5,
REMOVAL OF FOOT LESION,28080,CDM,983,RC,28080,HCPCS,Outpatient,,,1341,871.65,,1180.08,88,,,percent of total billed charges,88% of total Billed charges,24.89,100,,,Fee Schedule,100% of Medicare rate,222.31,100,,,Fee Schedule,100% of WA Medicaid,1341,100,,,percent of total billed charges,100% of total billed charges,228.98,103,,,Fee Schedule,103% of WA Medicaid,24.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,222.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,925.29,69,,,percent of total billed charges,69% of total billed charges,1341,100,,,percent of total billed charges,100% of total billed charges,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1341,100,,,percent of total billed charges,100% of total billed charges,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1341,100,,,percent of total billed charges,100% of total billed charges,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.41,61.85,,,percent of total billed charges,61.85% of total billed charges,222.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,289,130,,,Fee Schedule,130% of WA Medicaid ,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.56,37.7,,,percent of total billed charges,37.70% of total billed charges,505.56,37.7,,,percent of total billed charges,37.70% of total billed charges,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,45459.9,33.9,,,percent of total billed charges,33.9% of total billed charges,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045.98,78,,,percent of total billed charges,78% of total billed charges,1341,100,,,percent of total billed charges,100% of total billed charges,1107.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1107.67,82.6,,,percent of total billed charges,82.6% of total billed charges,222.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.89,45459.9,
EXCISE FOOT TENDON SHEATH,28088,CDM,983,RC,28088,HCPCS,Outpatient,,,1293,840.45,,1137.84,88,,,percent of total billed charges,88% of total Billed charges,21.49,100,,,Fee Schedule,100% of Medicare rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,1293,100,,,percent of total billed charges,100% of total billed charges,177.3,103,,,Fee Schedule,103% of WA Medicaid,21.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,892.17,69,,,percent of total billed charges,69% of total billed charges,1293,100,,,percent of total billed charges,100% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1293,100,,,percent of total billed charges,100% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1293,100,,,percent of total billed charges,100% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.72,61.85,,,percent of total billed charges,61.85% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,223.78,130,,,Fee Schedule,130% of WA Medicaid ,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.46,37.7,,,percent of total billed charges,37.70% of total billed charges,487.46,37.7,,,percent of total billed charges,37.70% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,43832.7,33.9,,,percent of total billed charges,33.9% of total billed charges,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008.54,78,,,percent of total billed charges,78% of total billed charges,1293,100,,,percent of total billed charges,100% of total billed charges,1068.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1068.02,82.6,,,percent of total billed charges,82.6% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.49,43832.7,
"EXCISION, TOE",28092,CDM,983,RC,28092,HCPCS,Outpatient,,,559,363.35,,491.92,88,,,percent of total billed charges,88% of total Billed charges,18.51,100,,,Fee Schedule,100% of Medicare rate,159.83,100,,,Fee Schedule,100% of WA Medicaid,559,100,,,percent of total billed charges,100% of total billed charges,164.62,103,,,Fee Schedule,103% of WA Medicaid,18.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,159.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,385.71,69,,,percent of total billed charges,69% of total billed charges,559,100,,,percent of total billed charges,100% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,559,100,,,percent of total billed charges,100% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,559,100,,,percent of total billed charges,100% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.74,61.85,,,percent of total billed charges,61.85% of total billed charges,159.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,207.78,130,,,Fee Schedule,130% of WA Medicaid ,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.74,37.7,,,percent of total billed charges,37.70% of total billed charges,210.74,37.7,,,percent of total billed charges,37.70% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18950.1,33.9,,,percent of total billed charges,33.9% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.02,78,,,percent of total billed charges,78% of total billed charges,559,100,,,percent of total billed charges,100% of total billed charges,461.73,82.6,,,percent of total billed charges,82.6% of total billed charges,461.73,82.6,,,percent of total billed charges,82.6% of total billed charges,159.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.51,18950.1,
REMOVAL OF FOOT LESION,28090,CDM,983,RC,28090,HCPCS,Outpatient,,,1427,927.55,,1255.76,88,,,percent of total billed charges,88% of total Billed charges,21.66,100,,,Fee Schedule,100% of Medicare rate,180.16,100,,,Fee Schedule,100% of WA Medicaid,1427,100,,,percent of total billed charges,100% of total billed charges,185.56,103,,,Fee Schedule,103% of WA Medicaid,21.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,180.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,984.63,69,,,percent of total billed charges,69% of total billed charges,1427,100,,,percent of total billed charges,100% of total billed charges,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1427,100,,,percent of total billed charges,100% of total billed charges,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1427,100,,,percent of total billed charges,100% of total billed charges,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,882.6,61.85,,,percent of total billed charges,61.85% of total billed charges,180.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,234.21,130,,,Fee Schedule,130% of WA Medicaid ,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.98,37.7,,,percent of total billed charges,37.70% of total billed charges,537.98,37.7,,,percent of total billed charges,37.70% of total billed charges,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,48375.3,33.9,,,percent of total billed charges,33.9% of total billed charges,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1113.06,78,,,percent of total billed charges,78% of total billed charges,1427,100,,,percent of total billed charges,100% of total billed charges,1178.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1178.7,82.6,,,percent of total billed charges,82.6% of total billed charges,180.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.66,48375.3,
REMOVAL OF FOOT LESION,28104,CDM,983,RC,28104,HCPCS,Outpatient,,,1554,1010.10,,1367.52,88,,,percent of total billed charges,88% of total Billed charges,26.93,100,,,Fee Schedule,100% of Medicare rate,206.27,100,,,Fee Schedule,100% of WA Medicaid,1554,100,,,percent of total billed charges,100% of total billed charges,212.46,103,,,Fee Schedule,103% of WA Medicaid,26.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,206.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1072.26,69,,,percent of total billed charges,69% of total billed charges,1554,100,,,percent of total billed charges,100% of total billed charges,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1554,100,,,percent of total billed charges,100% of total billed charges,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1554,100,,,percent of total billed charges,100% of total billed charges,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,961.15,61.85,,,percent of total billed charges,61.85% of total billed charges,206.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,268.15,130,,,Fee Schedule,130% of WA Medicaid ,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.86,37.7,,,percent of total billed charges,37.70% of total billed charges,585.86,37.7,,,percent of total billed charges,37.70% of total billed charges,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,52680.6,33.9,,,percent of total billed charges,33.9% of total billed charges,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1212.12,78,,,percent of total billed charges,78% of total billed charges,1554,100,,,percent of total billed charges,100% of total billed charges,1283.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1283.6,82.6,,,percent of total billed charges,82.6% of total billed charges,206.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.93,52680.6,
REMOVE/GRAFT FOOT LESION,28103,CDM,983,RC,28103,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,25.3,100,,,Fee Schedule,100% of Medicare rate,224.17,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,230.9,103,,,Fee Schedule,103% of WA Medicaid,25.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,224.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,632,100,,,percent of total billed charges,100% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,632,100,,,percent of total billed charges,100% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.89,61.85,,,percent of total billed charges,61.85% of total billed charges,224.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,291.42,130,,,Fee Schedule,130% of WA Medicaid ,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,21424.8,33.9,,,percent of total billed charges,33.9% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,224.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.3,21424.8,
REMOVAL OF ANKLE/HEEL LESION,28100,CDM,983,RC,28100,HCPCS,Outpatient,,,2136,1388.40,,1879.68,88,,,percent of total billed charges,88% of total Billed charges,34.05,100,,,Fee Schedule,100% of Medicare rate,243.2,100,,,Fee Schedule,100% of WA Medicaid,2136,100,,,percent of total billed charges,100% of total billed charges,250.5,103,,,Fee Schedule,103% of WA Medicaid,34.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,243.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1473.84,69,,,percent of total billed charges,69% of total billed charges,2136,100,,,percent of total billed charges,100% of total billed charges,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2136,100,,,percent of total billed charges,100% of total billed charges,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2136,100,,,percent of total billed charges,100% of total billed charges,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1321.12,61.85,,,percent of total billed charges,61.85% of total billed charges,243.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,316.16,130,,,Fee Schedule,130% of WA Medicaid ,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,805.27,37.7,,,percent of total billed charges,37.70% of total billed charges,805.27,37.7,,,percent of total billed charges,37.70% of total billed charges,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,72410.4,33.9,,,percent of total billed charges,33.9% of total billed charges,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1666.08,78,,,percent of total billed charges,78% of total billed charges,2136,100,,,percent of total billed charges,100% of total billed charges,1764.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1764.34,82.6,,,percent of total billed charges,82.6% of total billed charges,243.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.05,72410.4,
REMOVAL OF TOE LESIONS,28108,CDM,983,RC,28108,HCPCS,Outpatient,,,1211,787.15,,1065.68,88,,,percent of total billed charges,88% of total Billed charges,19.23,100,,,Fee Schedule,100% of Medicare rate,168.6,100,,,Fee Schedule,100% of WA Medicaid,1211,100,,,percent of total billed charges,100% of total billed charges,173.66,103,,,Fee Schedule,103% of WA Medicaid,19.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,168.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,835.59,69,,,percent of total billed charges,69% of total billed charges,1211,100,,,percent of total billed charges,100% of total billed charges,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1211,100,,,percent of total billed charges,100% of total billed charges,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1211,100,,,percent of total billed charges,100% of total billed charges,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,749,61.85,,,percent of total billed charges,61.85% of total billed charges,168.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,219.18,130,,,Fee Schedule,130% of WA Medicaid ,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.55,37.7,,,percent of total billed charges,37.70% of total billed charges,456.55,37.7,,,percent of total billed charges,37.70% of total billed charges,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,41052.9,33.9,,,percent of total billed charges,33.9% of total billed charges,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,944.58,78,,,percent of total billed charges,78% of total billed charges,1211,100,,,percent of total billed charges,100% of total billed charges,1000.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1000.29,82.6,,,percent of total billed charges,82.6% of total billed charges,168.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.23,41052.9,
PART REMOVAL OF METATARSAL,28112,CDM,983,RC,28112,HCPCS,Outpatient,,,1500,975.00,,1320,88,,,percent of total billed charges,88% of total Billed charges,22.56,100,,,Fee Schedule,100% of Medicare rate,182.4,100,,,Fee Schedule,100% of WA Medicaid,1500,100,,,percent of total billed charges,100% of total billed charges,187.87,103,,,Fee Schedule,103% of WA Medicaid,22.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,182.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1035,69,,,percent of total billed charges,69% of total billed charges,1500,100,,,percent of total billed charges,100% of total billed charges,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1500,100,,,percent of total billed charges,100% of total billed charges,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1500,100,,,percent of total billed charges,100% of total billed charges,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,927.75,61.85,,,percent of total billed charges,61.85% of total billed charges,182.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,237.12,130,,,Fee Schedule,130% of WA Medicaid ,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.5,37.7,,,percent of total billed charges,37.70% of total billed charges,565.5,37.7,,,percent of total billed charges,37.70% of total billed charges,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,50850,33.9,,,percent of total billed charges,33.9% of total billed charges,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1170,78,,,percent of total billed charges,78% of total billed charges,1500,100,,,percent of total billed charges,100% of total billed charges,1239,82.6,,,percent of total billed charges,82.6% of total billed charges,1239,82.6,,,percent of total billed charges,82.6% of total billed charges,182.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.56,50850,
REMOVAL OF HEEL SPUR,28119,CDM,983,RC,28119,HCPCS,Outpatient,,,1740,1131.00,,1531.2,88,,,percent of total billed charges,88% of total Billed charges,25.95,100,,,Fee Schedule,100% of Medicare rate,212.24,100,,,Fee Schedule,100% of WA Medicaid,1740,100,,,percent of total billed charges,100% of total billed charges,218.61,103,,,Fee Schedule,103% of WA Medicaid,25.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,212.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1200.6,69,,,percent of total billed charges,69% of total billed charges,1740,100,,,percent of total billed charges,100% of total billed charges,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1740,100,,,percent of total billed charges,100% of total billed charges,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1740,100,,,percent of total billed charges,100% of total billed charges,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1076.19,61.85,,,percent of total billed charges,61.85% of total billed charges,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,275.91,130,,,Fee Schedule,130% of WA Medicaid ,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,655.98,37.7,,,percent of total billed charges,37.70% of total billed charges,655.98,37.7,,,percent of total billed charges,37.70% of total billed charges,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,58986,33.9,,,percent of total billed charges,33.9% of total billed charges,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357.2,78,,,percent of total billed charges,78% of total billed charges,1740,100,,,percent of total billed charges,100% of total billed charges,1437.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1437.24,82.6,,,percent of total billed charges,82.6% of total billed charges,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.95,58986,
PART REMOVAL OF METATARSAL,28111,CDM,983,RC,28111,HCPCS,Outpatient,,,1512,982.80,,1330.56,88,,,percent of total billed charges,88% of total Billed charges,23.21,100,,,Fee Schedule,100% of Medicare rate,184.64,100,,,Fee Schedule,100% of WA Medicaid,1512,100,,,percent of total billed charges,100% of total billed charges,190.18,103,,,Fee Schedule,103% of WA Medicaid,23.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,184.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1043.28,69,,,percent of total billed charges,69% of total billed charges,1512,100,,,percent of total billed charges,100% of total billed charges,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1512,100,,,percent of total billed charges,100% of total billed charges,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1512,100,,,percent of total billed charges,100% of total billed charges,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,935.17,61.85,,,percent of total billed charges,61.85% of total billed charges,184.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,240.03,130,,,Fee Schedule,130% of WA Medicaid ,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,570.02,37.7,,,percent of total billed charges,37.70% of total billed charges,570.02,37.7,,,percent of total billed charges,37.70% of total billed charges,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,51256.8,33.9,,,percent of total billed charges,33.9% of total billed charges,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1179.36,78,,,percent of total billed charges,78% of total billed charges,1512,100,,,percent of total billed charges,100% of total billed charges,1248.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1248.91,82.6,,,percent of total billed charges,82.6% of total billed charges,184.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.21,51256.8,
PART REMOVAL OF METATARSAL,28113,CDM,983,RC,28113,HCPCS,Outpatient,,,1505,978.25,,1324.4,88,,,percent of total billed charges,88% of total Billed charges,28.4,100,,,Fee Schedule,100% of Medicare rate,249.35,100,,,Fee Schedule,100% of WA Medicaid,1505,100,,,percent of total billed charges,100% of total billed charges,256.83,103,,,Fee Schedule,103% of WA Medicaid,28.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,249.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1038.45,69,,,percent of total billed charges,69% of total billed charges,1505,100,,,percent of total billed charges,100% of total billed charges,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1505,100,,,percent of total billed charges,100% of total billed charges,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1505,100,,,percent of total billed charges,100% of total billed charges,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,930.84,61.85,,,percent of total billed charges,61.85% of total billed charges,249.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,324.16,130,,,Fee Schedule,130% of WA Medicaid ,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.39,37.7,,,percent of total billed charges,37.70% of total billed charges,567.39,37.7,,,percent of total billed charges,37.70% of total billed charges,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,51019.5,33.9,,,percent of total billed charges,33.9% of total billed charges,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1173.9,78,,,percent of total billed charges,78% of total billed charges,1505,100,,,percent of total billed charges,100% of total billed charges,1243.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1243.13,82.6,,,percent of total billed charges,82.6% of total billed charges,249.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.4,51019.5,
PARTIAL REMOVAL OF FOOT BONE,28122,CDM,983,RC,28122,HCPCS,Outpatient,,,1680,1092.00,,1478.4,88,,,percent of total billed charges,88% of total Billed charges,32.36,100,,,Fee Schedule,100% of Medicare rate,255.13,100,,,Fee Schedule,100% of WA Medicaid,1680,100,,,percent of total billed charges,100% of total billed charges,262.78,103,,,Fee Schedule,103% of WA Medicaid,32.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,255.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1159.2,69,,,percent of total billed charges,69% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1680,100,,,percent of total billed charges,100% of total billed charges,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1680,100,,,percent of total billed charges,100% of total billed charges,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1039.08,61.85,,,percent of total billed charges,61.85% of total billed charges,255.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,331.67,130,,,Fee Schedule,130% of WA Medicaid ,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,56952,33.9,,,percent of total billed charges,33.9% of total billed charges,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1310.4,78,,,percent of total billed charges,78% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,255.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.36,56952,
PART REMOVAL OF ANKLE/HEEL,28120,CDM,983,RC,28120,HCPCS,Outpatient,,,1999,1299.35,,1759.12,88,,,percent of total billed charges,88% of total Billed charges,40.03,100,,,Fee Schedule,100% of Medicare rate,287.58,100,,,Fee Schedule,100% of WA Medicaid,1999,100,,,percent of total billed charges,100% of total billed charges,296.21,103,,,Fee Schedule,103% of WA Medicaid,40.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,287.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1379.31,69,,,percent of total billed charges,69% of total billed charges,1999,100,,,percent of total billed charges,100% of total billed charges,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1999,100,,,percent of total billed charges,100% of total billed charges,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1999,100,,,percent of total billed charges,100% of total billed charges,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1236.38,61.85,,,percent of total billed charges,61.85% of total billed charges,287.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,373.85,130,,,Fee Schedule,130% of WA Medicaid ,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,753.62,37.7,,,percent of total billed charges,37.70% of total billed charges,753.62,37.7,,,percent of total billed charges,37.70% of total billed charges,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,67766.1,33.9,,,percent of total billed charges,33.9% of total billed charges,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559.22,78,,,percent of total billed charges,78% of total billed charges,1999,100,,,percent of total billed charges,100% of total billed charges,1651.17,82.6,,,percent of total billed charges,82.6% of total billed charges,1651.17,82.6,,,percent of total billed charges,82.6% of total billed charges,287.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.03,67766.1,
PARTIAL REMOVAL OF TOE,28124,CDM,983,RC,28124,HCPCS,Outpatient,,,1155,750.75,,1016.4,88,,,percent of total billed charges,88% of total Billed charges,21.94,100,,,Fee Schedule,100% of Medicare rate,195.27,100,,,Fee Schedule,100% of WA Medicaid,1155,100,,,percent of total billed charges,100% of total billed charges,201.13,103,,,Fee Schedule,103% of WA Medicaid,21.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,195.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,796.95,69,,,percent of total billed charges,69% of total billed charges,1155,100,,,percent of total billed charges,100% of total billed charges,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1155,100,,,percent of total billed charges,100% of total billed charges,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1155,100,,,percent of total billed charges,100% of total billed charges,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.37,61.85,,,percent of total billed charges,61.85% of total billed charges,195.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,253.85,130,,,Fee Schedule,130% of WA Medicaid ,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.44,37.7,,,percent of total billed charges,37.70% of total billed charges,435.44,37.7,,,percent of total billed charges,37.70% of total billed charges,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,39154.5,33.9,,,percent of total billed charges,33.9% of total billed charges,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,900.9,78,,,percent of total billed charges,78% of total billed charges,1155,100,,,percent of total billed charges,100% of total billed charges,954.03,82.6,,,percent of total billed charges,82.6% of total billed charges,954.03,82.6,,,percent of total billed charges,82.6% of total billed charges,195.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.94,39154.5,
REMOVAL OF METATARSAL,28140,CDM,983,RC,28140,HCPCS,Outpatient,,,1694,1101.10,,1490.72,88,,,percent of total billed charges,88% of total Billed charges,37.01,100,,,Fee Schedule,100% of Medicare rate,244.32,100,,,Fee Schedule,100% of WA Medicaid,1694,100,,,percent of total billed charges,100% of total billed charges,251.65,103,,,Fee Schedule,103% of WA Medicaid,37.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,244.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1168.86,69,,,percent of total billed charges,69% of total billed charges,1694,100,,,percent of total billed charges,100% of total billed charges,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1694,100,,,percent of total billed charges,100% of total billed charges,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1694,100,,,percent of total billed charges,100% of total billed charges,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1047.74,61.85,,,percent of total billed charges,61.85% of total billed charges,244.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,317.62,130,,,Fee Schedule,130% of WA Medicaid ,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,638.64,37.7,,,percent of total billed charges,37.70% of total billed charges,638.64,37.7,,,percent of total billed charges,37.70% of total billed charges,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,57426.6,33.9,,,percent of total billed charges,33.9% of total billed charges,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1321.32,78,,,percent of total billed charges,78% of total billed charges,1694,100,,,percent of total billed charges,100% of total billed charges,1399.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1399.24,82.6,,,percent of total billed charges,82.6% of total billed charges,244.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.01,57426.6,
PARTIAL REMOVAL OF TOE,28153,CDM,983,RC,28153,HCPCS,Outpatient,,,1158,752.70,,1019.04,88,,,percent of total billed charges,88% of total Billed charges,17.2,100,,,Fee Schedule,100% of Medicare rate,154.61,100,,,Fee Schedule,100% of WA Medicaid,1158,100,,,percent of total billed charges,100% of total billed charges,159.25,103,,,Fee Schedule,103% of WA Medicaid,17.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,154.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,799.02,69,,,percent of total billed charges,69% of total billed charges,1158,100,,,percent of total billed charges,100% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1158,100,,,percent of total billed charges,100% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1158,100,,,percent of total billed charges,100% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,716.22,61.85,,,percent of total billed charges,61.85% of total billed charges,154.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,200.99,130,,,Fee Schedule,130% of WA Medicaid ,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.57,37.7,,,percent of total billed charges,37.70% of total billed charges,436.57,37.7,,,percent of total billed charges,37.70% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39256.2,33.9,,,percent of total billed charges,33.9% of total billed charges,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,903.24,78,,,percent of total billed charges,78% of total billed charges,1158,100,,,percent of total billed charges,100% of total billed charges,956.51,82.6,,,percent of total billed charges,82.6% of total billed charges,956.51,82.6,,,percent of total billed charges,82.6% of total billed charges,154.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.2,39256.2,
REMOVAL OF TOE,28150,CDM,983,RC,28150,HCPCS,Outpatient,,,788,512.20,,693.44,88,,,percent of total billed charges,88% of total Billed charges,19.46,100,,,Fee Schedule,100% of Medicare rate,162.81,100,,,Fee Schedule,100% of WA Medicaid,788,100,,,percent of total billed charges,100% of total billed charges,167.69,103,,,Fee Schedule,103% of WA Medicaid,19.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,162.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,543.72,69,,,percent of total billed charges,69% of total billed charges,788,100,,,percent of total billed charges,100% of total billed charges,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,788,100,,,percent of total billed charges,100% of total billed charges,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,788,100,,,percent of total billed charges,100% of total billed charges,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.38,61.85,,,percent of total billed charges,61.85% of total billed charges,162.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,211.65,130,,,Fee Schedule,130% of WA Medicaid ,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.08,37.7,,,percent of total billed charges,37.70% of total billed charges,297.08,37.7,,,percent of total billed charges,37.70% of total billed charges,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,26713.2,33.9,,,percent of total billed charges,33.9% of total billed charges,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.64,78,,,percent of total billed charges,78% of total billed charges,788,100,,,percent of total billed charges,100% of total billed charges,650.89,82.6,,,percent of total billed charges,82.6% of total billed charges,650.89,82.6,,,percent of total billed charges,82.6% of total billed charges,162.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.46,26713.2,
PARTIAL REMOVAL OF TOE,28160,CDM,983,RC,28160,HCPCS,Outpatient,,,1317,856.05,,1158.96,88,,,percent of total billed charges,88% of total Billed charges,17.8,100,,,Fee Schedule,100% of Medicare rate,156.1,100,,,Fee Schedule,100% of WA Medicaid,1317,100,,,percent of total billed charges,100% of total billed charges,160.78,103,,,Fee Schedule,103% of WA Medicaid,17.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,156.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,908.73,69,,,percent of total billed charges,69% of total billed charges,1317,100,,,percent of total billed charges,100% of total billed charges,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1317,100,,,percent of total billed charges,100% of total billed charges,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1317,100,,,percent of total billed charges,100% of total billed charges,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,814.56,61.85,,,percent of total billed charges,61.85% of total billed charges,156.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,202.93,130,,,Fee Schedule,130% of WA Medicaid ,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.51,37.7,,,percent of total billed charges,37.70% of total billed charges,496.51,37.7,,,percent of total billed charges,37.70% of total billed charges,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,44646.3,33.9,,,percent of total billed charges,33.9% of total billed charges,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1027.26,78,,,percent of total billed charges,78% of total billed charges,1317,100,,,percent of total billed charges,100% of total billed charges,1087.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1087.84,82.6,,,percent of total billed charges,82.6% of total billed charges,156.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.8,44646.3,
REMOVAL OF FOOT FOREIGN BODY,28190,CDM,983,RC,28190,HCPCS,Outpatient,,,440,286.00,,387.2,88,,,percent of total billed charges,88% of total Billed charges,9.23,100,,,Fee Schedule,100% of Medicare rate,76.84,100,,,Fee Schedule,100% of WA Medicaid,440,100,,,percent of total billed charges,100% of total billed charges,79.15,103,,,Fee Schedule,103% of WA Medicaid,9.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,76.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,303.6,69,,,percent of total billed charges,69% of total billed charges,440,100,,,percent of total billed charges,100% of total billed charges,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,440,100,,,percent of total billed charges,100% of total billed charges,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,440,100,,,percent of total billed charges,100% of total billed charges,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.14,61.85,,,percent of total billed charges,61.85% of total billed charges,76.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,99.89,130,,,Fee Schedule,130% of WA Medicaid ,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.88,37.7,,,percent of total billed charges,37.70% of total billed charges,165.88,37.7,,,percent of total billed charges,37.70% of total billed charges,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,14916,33.9,,,percent of total billed charges,33.9% of total billed charges,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.2,78,,,percent of total billed charges,78% of total billed charges,440,100,,,percent of total billed charges,100% of total billed charges,363.44,82.6,,,percent of total billed charges,82.6% of total billed charges,363.44,82.6,,,percent of total billed charges,82.6% of total billed charges,76.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.23,14916,
REMOVAL OF FOOT FOREIGN BODY,28192,CDM,983,RC,28192,HCPCS,Outpatient,,,765,497.25,,673.2,88,,,percent of total billed charges,88% of total Billed charges,21.16,100,,,Fee Schedule,100% of Medicare rate,180.35,100,,,Fee Schedule,100% of WA Medicaid,765,100,,,percent of total billed charges,100% of total billed charges,185.76,103,,,Fee Schedule,103% of WA Medicaid,21.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,180.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,527.85,69,,,percent of total billed charges,69% of total billed charges,765,100,,,percent of total billed charges,100% of total billed charges,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,765,100,,,percent of total billed charges,100% of total billed charges,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,765,100,,,percent of total billed charges,100% of total billed charges,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.15,61.85,,,percent of total billed charges,61.85% of total billed charges,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,234.46,130,,,Fee Schedule,130% of WA Medicaid ,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.41,37.7,,,percent of total billed charges,37.70% of total billed charges,288.41,37.7,,,percent of total billed charges,37.70% of total billed charges,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,25933.5,33.9,,,percent of total billed charges,33.9% of total billed charges,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.7,78,,,percent of total billed charges,78% of total billed charges,765,100,,,percent of total billed charges,100% of total billed charges,631.89,82.6,,,percent of total billed charges,82.6% of total billed charges,631.89,82.6,,,percent of total billed charges,82.6% of total billed charges,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.16,25933.5,
REMOVAL OF FOOT FOREIGN BODY,28193,CDM,983,RC,28193,HCPCS,Outpatient,,,1212,787.80,,1066.56,88,,,percent of total billed charges,88% of total Billed charges,24.65,100,,,Fee Schedule,100% of Medicare rate,212.05,100,,,Fee Schedule,100% of WA Medicaid,1212,100,,,percent of total billed charges,100% of total billed charges,218.41,103,,,Fee Schedule,103% of WA Medicaid,24.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,212.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,836.28,69,,,percent of total billed charges,69% of total billed charges,1212,100,,,percent of total billed charges,100% of total billed charges,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1212,100,,,percent of total billed charges,100% of total billed charges,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1212,100,,,percent of total billed charges,100% of total billed charges,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,749.62,61.85,,,percent of total billed charges,61.85% of total billed charges,212.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,275.67,130,,,Fee Schedule,130% of WA Medicaid ,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.92,37.7,,,percent of total billed charges,37.70% of total billed charges,456.92,37.7,,,percent of total billed charges,37.70% of total billed charges,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,41086.8,33.9,,,percent of total billed charges,33.9% of total billed charges,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,945.36,78,,,percent of total billed charges,78% of total billed charges,1212,100,,,percent of total billed charges,100% of total billed charges,1001.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1001.11,82.6,,,percent of total billed charges,82.6% of total billed charges,212.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.65,41086.8,
REPAIR OF FOOT TENDON,28208,CDM,983,RC,28208,HCPCS,Outpatient,,,1116,725.40,,982.08,88,,,percent of total billed charges,88% of total Billed charges,23.86,100,,,Fee Schedule,100% of Medicare rate,187.62,100,,,Fee Schedule,100% of WA Medicaid,1116,100,,,percent of total billed charges,100% of total billed charges,193.25,103,,,Fee Schedule,103% of WA Medicaid,23.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,187.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,770.04,69,,,percent of total billed charges,69% of total billed charges,1116,100,,,percent of total billed charges,100% of total billed charges,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116,100,,,percent of total billed charges,100% of total billed charges,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116,100,,,percent of total billed charges,100% of total billed charges,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,690.25,61.85,,,percent of total billed charges,61.85% of total billed charges,187.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,243.91,130,,,Fee Schedule,130% of WA Medicaid ,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.73,37.7,,,percent of total billed charges,37.70% of total billed charges,420.73,37.7,,,percent of total billed charges,37.70% of total billed charges,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,37832.4,33.9,,,percent of total billed charges,33.9% of total billed charges,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,870.48,78,,,percent of total billed charges,78% of total billed charges,1116,100,,,percent of total billed charges,100% of total billed charges,921.82,82.6,,,percent of total billed charges,82.6% of total billed charges,921.82,82.6,,,percent of total billed charges,82.6% of total billed charges,187.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.86,37832.4,
RELEASE OF FOOT TENDON,28225,CDM,983,RC,28225,HCPCS,Outpatient,,,1101,715.65,,968.88,88,,,percent of total billed charges,88% of total Billed charges,18.51,100,,,Fee Schedule,100% of Medicare rate,154.8,100,,,Fee Schedule,100% of WA Medicaid,1101,100,,,percent of total billed charges,100% of total billed charges,159.44,103,,,Fee Schedule,103% of WA Medicaid,18.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,154.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,759.69,69,,,percent of total billed charges,69% of total billed charges,1101,100,,,percent of total billed charges,100% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1101,100,,,percent of total billed charges,100% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1101,100,,,percent of total billed charges,100% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,680.97,61.85,,,percent of total billed charges,61.85% of total billed charges,154.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,201.24,130,,,Fee Schedule,130% of WA Medicaid ,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.08,37.7,,,percent of total billed charges,37.70% of total billed charges,415.08,37.7,,,percent of total billed charges,37.70% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,37323.9,33.9,,,percent of total billed charges,33.9% of total billed charges,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,858.78,78,,,percent of total billed charges,78% of total billed charges,1101,100,,,percent of total billed charges,100% of total billed charges,909.43,82.6,,,percent of total billed charges,82.6% of total billed charges,909.43,82.6,,,percent of total billed charges,82.6% of total billed charges,154.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.51,37323.9,
RELEASE OF FOOT TENDON,28220,CDM,983,RC,28220,HCPCS,Outpatient,,,1120,728.00,,985.6,88,,,percent of total billed charges,88% of total Billed charges,21.04,100,,,Fee Schedule,100% of Medicare rate,178.11,100,,,Fee Schedule,100% of WA Medicaid,1120,100,,,percent of total billed charges,100% of total billed charges,183.45,103,,,Fee Schedule,103% of WA Medicaid,21.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,178.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,772.8,69,,,percent of total billed charges,69% of total billed charges,1120,100,,,percent of total billed charges,100% of total billed charges,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1120,100,,,percent of total billed charges,100% of total billed charges,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1120,100,,,percent of total billed charges,100% of total billed charges,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.72,61.85,,,percent of total billed charges,61.85% of total billed charges,178.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,231.54,130,,,Fee Schedule,130% of WA Medicaid ,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.24,37.7,,,percent of total billed charges,37.70% of total billed charges,422.24,37.7,,,percent of total billed charges,37.70% of total billed charges,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,37968,33.9,,,percent of total billed charges,33.9% of total billed charges,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,873.6,78,,,percent of total billed charges,78% of total billed charges,1120,100,,,percent of total billed charges,100% of total billed charges,925.12,82.6,,,percent of total billed charges,82.6% of total billed charges,925.12,82.6,,,percent of total billed charges,82.6% of total billed charges,178.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.04,37968,
REVISION OF FOOT TENDON,28238,CDM,983,RC,28238,HCPCS,Outpatient,,,2168,1409.20,,1907.84,88,,,percent of total billed charges,88% of total Billed charges,38.5,100,,,Fee Schedule,100% of Medicare rate,282.73,100,,,Fee Schedule,100% of WA Medicaid,2168,100,,,percent of total billed charges,100% of total billed charges,291.21,103,,,Fee Schedule,103% of WA Medicaid,38.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1495.92,69,,,percent of total billed charges,69% of total billed charges,2168,100,,,percent of total billed charges,100% of total billed charges,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2168,100,,,percent of total billed charges,100% of total billed charges,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2168,100,,,percent of total billed charges,100% of total billed charges,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340.91,61.85,,,percent of total billed charges,61.85% of total billed charges,282.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.55,130,,,Fee Schedule,130% of WA Medicaid ,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,817.34,37.7,,,percent of total billed charges,37.70% of total billed charges,817.34,37.7,,,percent of total billed charges,37.70% of total billed charges,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,73495.2,33.9,,,percent of total billed charges,33.9% of total billed charges,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1691.04,78,,,percent of total billed charges,78% of total billed charges,2168,100,,,percent of total billed charges,100% of total billed charges,1790.77,82.6,,,percent of total billed charges,82.6% of total billed charges,1790.77,82.6,,,percent of total billed charges,82.6% of total billed charges,282.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.5,73495.2,
REVISION OF FOOT FASCIA,28250,CDM,983,RC,28250,HCPCS,Outpatient,,,1523,989.95,,1340.24,88,,,percent of total billed charges,88% of total Billed charges,34.12,100,,,Fee Schedule,100% of Medicare rate,239.47,100,,,Fee Schedule,100% of WA Medicaid,1523,100,,,percent of total billed charges,100% of total billed charges,246.65,103,,,Fee Schedule,103% of WA Medicaid,34.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,239.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1050.87,69,,,percent of total billed charges,69% of total billed charges,1523,100,,,percent of total billed charges,100% of total billed charges,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1523,100,,,percent of total billed charges,100% of total billed charges,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1523,100,,,percent of total billed charges,100% of total billed charges,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,941.98,61.85,,,percent of total billed charges,61.85% of total billed charges,239.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,311.31,130,,,Fee Schedule,130% of WA Medicaid ,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.17,37.7,,,percent of total billed charges,37.70% of total billed charges,574.17,37.7,,,percent of total billed charges,37.70% of total billed charges,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,51629.7,33.9,,,percent of total billed charges,33.9% of total billed charges,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1187.94,78,,,percent of total billed charges,78% of total billed charges,1523,100,,,percent of total billed charges,100% of total billed charges,1258,82.6,,,percent of total billed charges,82.6% of total billed charges,1258,82.6,,,percent of total billed charges,82.6% of total billed charges,239.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.12,51629.7,
RELEASE OF TOE JOINT EACH,28272,CDM,983,RC,28272,HCPCS,Outpatient,,,716,465.40,,630.08,88,,,percent of total billed charges,88% of total Billed charges,16.01,100,,,Fee Schedule,100% of Medicare rate,146.59,100,,,Fee Schedule,100% of WA Medicaid,716,100,,,percent of total billed charges,100% of total billed charges,150.99,103,,,Fee Schedule,103% of WA Medicaid,16.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,146.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,494.04,69,,,percent of total billed charges,69% of total billed charges,716,100,,,percent of total billed charges,100% of total billed charges,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,716,100,,,percent of total billed charges,100% of total billed charges,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,716,100,,,percent of total billed charges,100% of total billed charges,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.85,61.85,,,percent of total billed charges,61.85% of total billed charges,146.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,190.57,130,,,Fee Schedule,130% of WA Medicaid ,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.93,37.7,,,percent of total billed charges,37.70% of total billed charges,269.93,37.7,,,percent of total billed charges,37.70% of total billed charges,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,24272.4,33.9,,,percent of total billed charges,33.9% of total billed charges,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.48,78,,,percent of total billed charges,78% of total billed charges,716,100,,,percent of total billed charges,100% of total billed charges,591.42,82.6,,,percent of total billed charges,82.6% of total billed charges,591.42,82.6,,,percent of total billed charges,82.6% of total billed charges,146.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.01,24272.4,
REPAIR OF HAMMERTOE,28286,CDM,983,RC,28286,HCPCS,Outpatient,,,1273,827.45,,1120.24,88,,,percent of total billed charges,88% of total Billed charges,19.5,100,,,Fee Schedule,100% of Medicare rate,173.45,100,,,Fee Schedule,100% of WA Medicaid,1273,100,,,percent of total billed charges,100% of total billed charges,178.65,103,,,Fee Schedule,103% of WA Medicaid,19.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,173.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,878.37,69,,,percent of total billed charges,69% of total billed charges,1273,100,,,percent of total billed charges,100% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1273,100,,,percent of total billed charges,100% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1273,100,,,percent of total billed charges,100% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,787.35,61.85,,,percent of total billed charges,61.85% of total billed charges,173.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,225.49,130,,,Fee Schedule,130% of WA Medicaid ,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.92,37.7,,,percent of total billed charges,37.70% of total billed charges,479.92,37.7,,,percent of total billed charges,37.70% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,43154.7,33.9,,,percent of total billed charges,33.9% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,992.94,78,,,percent of total billed charges,78% of total billed charges,1273,100,,,percent of total billed charges,100% of total billed charges,1051.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1051.5,82.6,,,percent of total billed charges,82.6% of total billed charges,173.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.5,43154.7,
PARTIAL REMOVAL OF FOOT BONE,28288,CDM,983,RC,28288,HCPCS,Outpatient,,,1429,928.85,,1257.52,88,,,percent of total billed charges,88% of total Billed charges,30.5,100,,,Fee Schedule,100% of Medicare rate,254.76,100,,,Fee Schedule,100% of WA Medicaid,1429,100,,,percent of total billed charges,100% of total billed charges,262.4,103,,,Fee Schedule,103% of WA Medicaid,30.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,254.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,986.01,69,,,percent of total billed charges,69% of total billed charges,1429,100,,,percent of total billed charges,100% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1429,100,,,percent of total billed charges,100% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1429,100,,,percent of total billed charges,100% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,883.84,61.85,,,percent of total billed charges,61.85% of total billed charges,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,331.19,130,,,Fee Schedule,130% of WA Medicaid ,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,538.73,37.7,,,percent of total billed charges,37.70% of total billed charges,538.73,37.7,,,percent of total billed charges,37.70% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,48443.1,33.9,,,percent of total billed charges,33.9% of total billed charges,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1114.62,78,,,percent of total billed charges,78% of total billed charges,1429,100,,,percent of total billed charges,100% of total billed charges,1180.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1180.35,82.6,,,percent of total billed charges,82.6% of total billed charges,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.5,48443.1,
REPAIR HALLUX RIGIDUS,28289,CDM,983,RC,28289,HCPCS,Outpatient,,,1837,1194.05,,1616.56,88,,,percent of total billed charges,88% of total Billed charges,34.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1837,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,34.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1267.53,69,,,percent of total billed charges,69% of total billed charges,1837,100,,,percent of total billed charges,100% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1837,100,,,percent of total billed charges,100% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1837,100,,,percent of total billed charges,100% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1136.18,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.55,37.7,,,percent of total billed charges,37.70% of total billed charges,692.55,37.7,,,percent of total billed charges,37.70% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,62274.3,33.9,,,percent of total billed charges,33.9% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1432.86,78,,,percent of total billed charges,78% of total billed charges,1837,100,,,percent of total billed charges,100% of total billed charges,1517.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1517.36,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",34.86,62274.3,
REPAIR OF HAMMERTOE,28285,CDM,983,RC,28285,HCPCS,Outpatient,,,1377,895.05,,1211.76,88,,,percent of total billed charges,88% of total Billed charges,27.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1377,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,27.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,950.13,69,,,percent of total billed charges,69% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377,100,,,percent of total billed charges,100% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377,100,,,percent of total billed charges,100% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.67,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,46680.3,33.9,,,percent of total billed charges,33.9% of total billed charges,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.06,78,,,percent of total billed charges,78% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",27.17,46680.3,
CORRECTION OF BUNION,28296,CDM,983,RC,28296,HCPCS,Outpatient,,,2830,1839.50,,2490.4,88,,,percent of total billed charges,88% of total Billed charges,35.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2830,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,35.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,62.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1952.7,69,,,percent of total billed charges,69% of total billed charges,2830,100,,,percent of total billed charges,100% of total billed charges,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2830,100,,,percent of total billed charges,100% of total billed charges,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2830,100,,,percent of total billed charges,100% of total billed charges,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1750.36,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1066.91,37.7,,,percent of total billed charges,37.70% of total billed charges,1066.91,37.7,,,percent of total billed charges,37.70% of total billed charges,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,95937,33.9,,,percent of total billed charges,33.9% of total billed charges,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2207.4,78,,,percent of total billed charges,78% of total billed charges,2830,100,,,percent of total billed charges,100% of total billed charges,2337.58,82.6,,,percent of total billed charges,82.6% of total billed charges,2337.58,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",35.66,95937,
CORRECTION OF BUNION,28899,CDM,983,RC,28899,HCPCS,Outpatient,,,2239,1455.35,,1970.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2239,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1544.91,69,,,percent of total billed charges,69% of total billed charges,2239,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2239,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2239,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1384.82,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,844.1,37.7,,,percent of total billed charges,37.70% of total billed charges,844.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,75902.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1746.42,78,,,percent of total billed charges,78% of total billed charges,2239,100,,,percent of total billed charges,100% of total billed charges,1849.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1849.41,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",844.1,75902.1,
CORRECTION OF BUNION,28297,CDM,983,RC,28297,HCPCS,Outpatient,,,2608,1695.20,,2295.04,88,,,percent of total billed charges,88% of total Billed charges,47.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2608,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,47.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1799.52,69,,,percent of total billed charges,69% of total billed charges,2608,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2608,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2608,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1613.05,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,983.22,37.7,,,percent of total billed charges,37.70% of total billed charges,983.22,37.7,,,percent of total billed charges,37.70% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,88411.2,33.9,,,percent of total billed charges,33.9% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2034.24,78,,,percent of total billed charges,78% of total billed charges,2608,100,,,percent of total billed charges,100% of total billed charges,2154.21,82.6,,,percent of total billed charges,82.6% of total billed charges,2154.21,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",47.64,88411.2,
CORRECTION OF BUNION,28292,CDM,983,RC,28292,HCPCS,Outpatient,,,2134,1387.10,,1877.92,88,,,percent of total billed charges,88% of total Billed charges,34.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2134,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1472.46,69,,,percent of total billed charges,69% of total billed charges,2134,100,,,percent of total billed charges,100% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2134,100,,,percent of total billed charges,100% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2134,100,,,percent of total billed charges,100% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319.88,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.52,37.7,,,percent of total billed charges,37.70% of total billed charges,804.52,37.7,,,percent of total billed charges,37.70% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72342.6,33.9,,,percent of total billed charges,33.9% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1664.52,78,,,percent of total billed charges,78% of total billed charges,2134,100,,,percent of total billed charges,100% of total billed charges,1762.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1762.68,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",34.07,72342.6,
CORRECTION OF BUNION,28298,CDM,983,RC,28298,HCPCS,Outpatient,,,2091,1359.15,,1840.08,88,,,percent of total billed charges,88% of total Billed charges,39.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2091,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,39.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1442.79,69,,,percent of total billed charges,69% of total billed charges,2091,100,,,percent of total billed charges,100% of total billed charges,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2091,100,,,percent of total billed charges,100% of total billed charges,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2091,100,,,percent of total billed charges,100% of total billed charges,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1293.28,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,788.31,37.7,,,percent of total billed charges,37.70% of total billed charges,788.31,37.7,,,percent of total billed charges,37.70% of total billed charges,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,70884.9,33.9,,,percent of total billed charges,33.9% of total billed charges,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1630.98,78,,,percent of total billed charges,78% of total billed charges,2091,100,,,percent of total billed charges,100% of total billed charges,1727.17,82.6,,,percent of total billed charges,82.6% of total billed charges,1727.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",39.89,70884.9,
CORRECTION OF BUNION,28299,CDM,983,RC,28299,HCPCS,Outpatient,,,2648,1721.20,,2330.24,88,,,percent of total billed charges,88% of total Billed charges,46.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2648,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,46.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1827.12,69,,,percent of total billed charges,69% of total billed charges,2648,100,,,percent of total billed charges,100% of total billed charges,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2648,100,,,percent of total billed charges,100% of total billed charges,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2648,100,,,percent of total billed charges,100% of total billed charges,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1637.79,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,998.3,37.7,,,percent of total billed charges,37.70% of total billed charges,998.3,37.7,,,percent of total billed charges,37.70% of total billed charges,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,89767.2,33.9,,,percent of total billed charges,33.9% of total billed charges,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2065.44,78,,,percent of total billed charges,78% of total billed charges,2648,100,,,percent of total billed charges,100% of total billed charges,2187.25,82.6,,,percent of total billed charges,82.6% of total billed charges,2187.25,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",46.17,89767.2,
CORRECTION OF BUNION,28291,CDM,983,RC,28291,HCPCS,Outpatient,,,2492,1619.80,,2192.96,88,,,percent of total billed charges,88% of total Billed charges,33.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2492,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,33.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1719.48,69,,,percent of total billed charges,69% of total billed charges,2492,100,,,percent of total billed charges,100% of total billed charges,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2492,100,,,percent of total billed charges,100% of total billed charges,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2492,100,,,percent of total billed charges,100% of total billed charges,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1541.3,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,939.48,37.7,,,percent of total billed charges,37.70% of total billed charges,939.48,37.7,,,percent of total billed charges,37.70% of total billed charges,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,84478.8,33.9,,,percent of total billed charges,33.9% of total billed charges,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1943.76,78,,,percent of total billed charges,78% of total billed charges,2492,100,,,percent of total billed charges,100% of total billed charges,2058.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2058.39,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",33.85,84478.8,
CORRECTION OF BUNION,28290,CDM,983,RC,28292,HCPCS,Outpatient,,,1758,1142.70,,1547.04,88,,,percent of total billed charges,88% of total Billed charges,34.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1758,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1213.02,69,,,percent of total billed charges,69% of total billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1758,100,,,percent of total billed charges,100% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1758,100,,,percent of total billed charges,100% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1087.32,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,662.77,37.7,,,percent of total billed charges,37.70% of total billed charges,662.77,37.7,,,percent of total billed charges,37.70% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,59596.2,33.9,,,percent of total billed charges,33.9% of total billed charges,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1371.24,78,,,percent of total billed charges,78% of total billed charges,1758,100,,,percent of total billed charges,100% of total billed charges,1452.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1452.11,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",34.07,59596.2,
INCISION OF HEEL BONE,28300,CDM,983,RC,28300,HCPCS,Outpatient,,,2482,1613.30,,2184.16,88,,,percent of total billed charges,88% of total Billed charges,60.24,100,,,Fee Schedule,100% of Medicare rate,375.8,100,,,Fee Schedule,100% of WA Medicaid,2482,100,,,percent of total billed charges,100% of total billed charges,387.07,103,,,Fee Schedule,103% of WA Medicaid,60.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,375.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1712.58,69,,,percent of total billed charges,69% of total billed charges,2482,100,,,percent of total billed charges,100% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2482,100,,,percent of total billed charges,100% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2482,100,,,percent of total billed charges,100% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1535.12,61.85,,,percent of total billed charges,61.85% of total billed charges,375.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,488.54,130,,,Fee Schedule,130% of WA Medicaid ,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,935.71,37.7,,,percent of total billed charges,37.70% of total billed charges,935.71,37.7,,,percent of total billed charges,37.70% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,84139.8,33.9,,,percent of total billed charges,33.9% of total billed charges,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1935.96,78,,,percent of total billed charges,78% of total billed charges,2482,100,,,percent of total billed charges,100% of total billed charges,2050.13,82.6,,,percent of total billed charges,82.6% of total billed charges,2050.13,82.6,,,percent of total billed charges,82.6% of total billed charges,375.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.24,84139.8,
INCISION OF METATARSAL,28308,CDM,983,RC,28308,HCPCS,Outpatient,,,2583,1678.95,,2273.04,88,,,percent of total billed charges,88% of total Billed charges,29.28,100,,,Fee Schedule,100% of Medicare rate,226.6,100,,,Fee Schedule,100% of WA Medicaid,2583,100,,,percent of total billed charges,100% of total billed charges,233.4,103,,,Fee Schedule,103% of WA Medicaid,29.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,226.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1782.27,69,,,percent of total billed charges,69% of total billed charges,2583,100,,,percent of total billed charges,100% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2583,100,,,percent of total billed charges,100% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2583,100,,,percent of total billed charges,100% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1597.59,61.85,,,percent of total billed charges,61.85% of total billed charges,226.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,294.58,130,,,Fee Schedule,130% of WA Medicaid ,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,973.79,37.7,,,percent of total billed charges,37.70% of total billed charges,973.79,37.7,,,percent of total billed charges,37.70% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,87563.7,33.9,,,percent of total billed charges,33.9% of total billed charges,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2014.74,78,,,percent of total billed charges,78% of total billed charges,2583,100,,,percent of total billed charges,100% of total billed charges,2133.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2133.56,82.6,,,percent of total billed charges,82.6% of total billed charges,226.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.28,87563.7,
INCISE/GRAFT MIDFOOT BONES,28305,CDM,983,RC,28305,HCPCS,Outpatient,,,2583,1678.95,,2273.04,88,,,percent of total billed charges,88% of total Billed charges,58.88,100,,,Fee Schedule,100% of Medicare rate,389.04,100,,,Fee Schedule,100% of WA Medicaid,2583,100,,,percent of total billed charges,100% of total billed charges,400.71,103,,,Fee Schedule,103% of WA Medicaid,58.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,389.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1782.27,69,,,percent of total billed charges,69% of total billed charges,2583,100,,,percent of total billed charges,100% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2583,100,,,percent of total billed charges,100% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2583,100,,,percent of total billed charges,100% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1597.59,61.85,,,percent of total billed charges,61.85% of total billed charges,389.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,505.75,130,,,Fee Schedule,130% of WA Medicaid ,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,973.79,37.7,,,percent of total billed charges,37.70% of total billed charges,973.79,37.7,,,percent of total billed charges,37.70% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,87563.7,33.9,,,percent of total billed charges,33.9% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2014.74,78,,,percent of total billed charges,78% of total billed charges,2583,100,,,percent of total billed charges,100% of total billed charges,2133.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2133.56,82.6,,,percent of total billed charges,82.6% of total billed charges,389.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.88,87563.7,
INCISION OF ANKLE BONE,28302,CDM,983,RC,28302,HCPCS,Outpatient,,,2340,1521.00,,2059.2,88,,,percent of total billed charges,88% of total Billed charges,73.97,100,,,Fee Schedule,100% of Medicare rate,415.15,100,,,Fee Schedule,100% of WA Medicaid,2340,100,,,percent of total billed charges,100% of total billed charges,427.6,103,,,Fee Schedule,103% of WA Medicaid,73.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,129.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,415.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1614.6,69,,,percent of total billed charges,69% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2340,100,,,percent of total billed charges,100% of total billed charges,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2340,100,,,percent of total billed charges,100% of total billed charges,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1447.29,61.85,,,percent of total billed charges,61.85% of total billed charges,415.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,539.7,130,,,Fee Schedule,130% of WA Medicaid ,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,882.18,37.7,,,percent of total billed charges,37.70% of total billed charges,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,79326,33.9,,,percent of total billed charges,33.9% of total billed charges,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825.2,78,,,percent of total billed charges,78% of total billed charges,2340,100,,,percent of total billed charges,100% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1932.84,82.6,,,percent of total billed charges,82.6% of total billed charges,415.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.97,79326,
REVISION OF BIG TOE,28310,CDM,983,RC,28310,HCPCS,Outpatient,,,1232,800.80,,1084.16,88,,,percent of total billed charges,88% of total Billed charges,27.47,100,,,Fee Schedule,100% of Medicare rate,211.49,100,,,Fee Schedule,100% of WA Medicaid,1232,100,,,percent of total billed charges,100% of total billed charges,217.83,103,,,Fee Schedule,103% of WA Medicaid,27.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,211.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,850.08,69,,,percent of total billed charges,69% of total billed charges,1232,100,,,percent of total billed charges,100% of total billed charges,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1232,100,,,percent of total billed charges,100% of total billed charges,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1232,100,,,percent of total billed charges,100% of total billed charges,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,761.99,61.85,,,percent of total billed charges,61.85% of total billed charges,211.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,274.94,130,,,Fee Schedule,130% of WA Medicaid ,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.46,37.7,,,percent of total billed charges,37.70% of total billed charges,464.46,37.7,,,percent of total billed charges,37.70% of total billed charges,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,41764.8,33.9,,,percent of total billed charges,33.9% of total billed charges,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,960.96,78,,,percent of total billed charges,78% of total billed charges,1232,100,,,percent of total billed charges,100% of total billed charges,1017.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1017.63,82.6,,,percent of total billed charges,82.6% of total billed charges,211.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.47,41764.8,
REPAIR DEFORMITY OF TOE,28313,CDM,983,RC,28313,HCPCS,Outpatient,,,1258,817.70,,1107.04,88,,,percent of total billed charges,88% of total Billed charges,29.23,100,,,Fee Schedule,100% of Medicare rate,210.75,100,,,Fee Schedule,100% of WA Medicaid,1258,100,,,percent of total billed charges,100% of total billed charges,217.07,103,,,Fee Schedule,103% of WA Medicaid,29.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,210.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,868.02,69,,,percent of total billed charges,69% of total billed charges,1258,100,,,percent of total billed charges,100% of total billed charges,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1258,100,,,percent of total billed charges,100% of total billed charges,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1258,100,,,percent of total billed charges,100% of total billed charges,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.07,61.85,,,percent of total billed charges,61.85% of total billed charges,210.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,273.98,130,,,Fee Schedule,130% of WA Medicaid ,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.27,37.7,,,percent of total billed charges,37.70% of total billed charges,474.27,37.7,,,percent of total billed charges,37.70% of total billed charges,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,42646.2,33.9,,,percent of total billed charges,33.9% of total billed charges,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,981.24,78,,,percent of total billed charges,78% of total billed charges,1258,100,,,percent of total billed charges,100% of total billed charges,1039.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1039.11,82.6,,,percent of total billed charges,82.6% of total billed charges,210.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.23,42646.2,
REMOVAL OF SESAMOID BONE,28315,CDM,983,RC,28315,HCPCS,Outpatient,,,1361,884.65,,1197.68,88,,,percent of total billed charges,88% of total Billed charges,23.2,100,,,Fee Schedule,100% of Medicare rate,189.67,100,,,Fee Schedule,100% of WA Medicaid,1361,100,,,percent of total billed charges,100% of total billed charges,195.36,103,,,Fee Schedule,103% of WA Medicaid,23.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,189.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,939.09,69,,,percent of total billed charges,69% of total billed charges,1361,100,,,percent of total billed charges,100% of total billed charges,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1361,100,,,percent of total billed charges,100% of total billed charges,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1361,100,,,percent of total billed charges,100% of total billed charges,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.78,61.85,,,percent of total billed charges,61.85% of total billed charges,189.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,246.57,130,,,Fee Schedule,130% of WA Medicaid ,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.1,37.7,,,percent of total billed charges,37.70% of total billed charges,513.1,37.7,,,percent of total billed charges,37.70% of total billed charges,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,46137.9,33.9,,,percent of total billed charges,33.9% of total billed charges,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1061.58,78,,,percent of total billed charges,78% of total billed charges,1361,100,,,percent of total billed charges,100% of total billed charges,1124.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1124.19,82.6,,,percent of total billed charges,82.6% of total billed charges,189.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.2,46137.9,
REPAIR OF EXTRA TOES,28344,CDM,983,RC,28344,HCPCS,Outpatient,,,986,640.90,,867.68,88,,,percent of total billed charges,88% of total Billed charges,17.64,100,,,Fee Schedule,100% of Medicare rate,162.81,100,,,Fee Schedule,100% of WA Medicaid,986,100,,,percent of total billed charges,100% of total billed charges,167.69,103,,,Fee Schedule,103% of WA Medicaid,17.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,162.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,680.34,69,,,percent of total billed charges,69% of total billed charges,986,100,,,percent of total billed charges,100% of total billed charges,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,986,100,,,percent of total billed charges,100% of total billed charges,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,986,100,,,percent of total billed charges,100% of total billed charges,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,609.84,61.85,,,percent of total billed charges,61.85% of total billed charges,162.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,211.65,130,,,Fee Schedule,130% of WA Medicaid ,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.72,37.7,,,percent of total billed charges,37.70% of total billed charges,371.72,37.7,,,percent of total billed charges,37.70% of total billed charges,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,33425.4,33.9,,,percent of total billed charges,33.9% of total billed charges,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,769.08,78,,,percent of total billed charges,78% of total billed charges,986,100,,,percent of total billed charges,100% of total billed charges,814.44,82.6,,,percent of total billed charges,82.6% of total billed charges,814.44,82.6,,,percent of total billed charges,82.6% of total billed charges,162.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.64,33425.4,
TREATMENT OF HEEL FRACTURE,28406,CDM,983,RC,28406,HCPCS,Outpatient,,,1203,781.95,,1058.64,88,,,percent of total billed charges,88% of total Billed charges,53.26,100,,,Fee Schedule,100% of Medicare rate,348.01,100,,,Fee Schedule,100% of WA Medicaid,1203,100,,,percent of total billed charges,100% of total billed charges,358.45,103,,,Fee Schedule,103% of WA Medicaid,53.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,348.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,830.07,69,,,percent of total billed charges,69% of total billed charges,1203,100,,,percent of total billed charges,100% of total billed charges,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1203,100,,,percent of total billed charges,100% of total billed charges,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1203,100,,,percent of total billed charges,100% of total billed charges,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,744.06,61.85,,,percent of total billed charges,61.85% of total billed charges,348.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,452.41,130,,,Fee Schedule,130% of WA Medicaid ,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.53,37.7,,,percent of total billed charges,37.70% of total billed charges,453.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,40781.7,33.9,,,percent of total billed charges,33.9% of total billed charges,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,938.34,78,,,percent of total billed charges,78% of total billed charges,1203,100,,,percent of total billed charges,100% of total billed charges,993.68,82.6,,,percent of total billed charges,82.6% of total billed charges,993.68,82.6,,,percent of total billed charges,82.6% of total billed charges,348.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.26,40781.7,
TREAT HEEL FRACTURE,28415,CDM,983,RC,28415,HCPCS,Outpatient,,,3917,2546.05,,3446.96,88,,,percent of total billed charges,88% of total Billed charges,103.54,100,,,Fee Schedule,100% of Medicare rate,646.6,100,,,Fee Schedule,100% of WA Medicaid,3917,100,,,percent of total billed charges,100% of total billed charges,666,103,,,Fee Schedule,103% of WA Medicaid,103.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,181.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,646.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2702.73,69,,,percent of total billed charges,69% of total billed charges,3917,100,,,percent of total billed charges,100% of total billed charges,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,3917,100,,,percent of total billed charges,100% of total billed charges,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,3917,100,,,percent of total billed charges,100% of total billed charges,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2422.66,61.85,,,percent of total billed charges,61.85% of total billed charges,646.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,840.58,130,,,Fee Schedule,130% of WA Medicaid ,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1476.71,37.7,,,percent of total billed charges,37.70% of total billed charges,1476.71,37.7,,,percent of total billed charges,37.70% of total billed charges,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,132786.3,33.9,,,percent of total billed charges,33.9% of total billed charges,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,3055.26,78,,,percent of total billed charges,78% of total billed charges,3917,100,,,percent of total billed charges,100% of total billed charges,3235.44,82.6,,,percent of total billed charges,82.6% of total billed charges,3235.44,82.6,,,percent of total billed charges,82.6% of total billed charges,646.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,103.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,103.54,132786.3,
TREAT/GRAFT HEEL FRACTURE,28420,CDM,983,RC,28420,HCPCS,Outpatient,,,4114,2674.10,,3620.32,88,,,percent of total billed charges,88% of total Billed charges,132.93,100,,,Fee Schedule,100% of Medicare rate,747.12,100,,,Fee Schedule,100% of WA Medicaid,4114,100,,,percent of total billed charges,100% of total billed charges,769.53,103,,,Fee Schedule,103% of WA Medicaid,132.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,232.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,747.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2838.66,69,,,percent of total billed charges,69% of total billed charges,4114,100,,,percent of total billed charges,100% of total billed charges,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4114,100,,,percent of total billed charges,100% of total billed charges,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4114,100,,,percent of total billed charges,100% of total billed charges,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2544.51,61.85,,,percent of total billed charges,61.85% of total billed charges,747.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,747.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,762.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,971.26,130,,,Fee Schedule,130% of WA Medicaid ,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1550.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1550.98,37.7,,,percent of total billed charges,37.70% of total billed charges,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,139464.6,33.9,,,percent of total billed charges,33.9% of total billed charges,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3208.92,78,,,percent of total billed charges,78% of total billed charges,4114,100,,,percent of total billed charges,100% of total billed charges,3398.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3398.16,82.6,,,percent of total billed charges,82.6% of total billed charges,747.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,132.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,747.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,132.93,139464.6,
TREAT FX TALUS,28430,CDM,983,RC,28430,HCPCS,Outpatient,,,695,451.75,,611.6,88,,,percent of total billed charges,88% of total Billed charges,15.99,100,,,Fee Schedule,100% of Medicare rate,127.01,100,,,Fee Schedule,100% of WA Medicaid,695,100,,,percent of total billed charges,100% of total billed charges,130.82,103,,,Fee Schedule,103% of WA Medicaid,15.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,127.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,479.55,69,,,percent of total billed charges,69% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,695,100,,,percent of total billed charges,100% of total billed charges,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,695,100,,,percent of total billed charges,100% of total billed charges,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.86,61.85,,,percent of total billed charges,61.85% of total billed charges,127.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,165.11,130,,,Fee Schedule,130% of WA Medicaid ,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,262.02,37.7,,,percent of total billed charges,37.70% of total billed charges,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,23560.5,33.9,,,percent of total billed charges,33.9% of total billed charges,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,542.1,78,,,percent of total billed charges,78% of total billed charges,695,100,,,percent of total billed charges,100% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,574.07,82.6,,,percent of total billed charges,82.6% of total billed charges,127.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.99,23560.5,
TREAT MIDFOOT FRACTURE EACH,28465,CDM,983,RC,28465,HCPCS,Outpatient,,,2071,1346.15,,1822.48,88,,,percent of total billed charges,88% of total Billed charges,53.37,100,,,Fee Schedule,100% of Medicare rate,373.93,100,,,Fee Schedule,100% of WA Medicaid,2071,100,,,percent of total billed charges,100% of total billed charges,385.15,103,,,Fee Schedule,103% of WA Medicaid,53.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,373.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1428.99,69,,,percent of total billed charges,69% of total billed charges,2071,100,,,percent of total billed charges,100% of total billed charges,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2071,100,,,percent of total billed charges,100% of total billed charges,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2071,100,,,percent of total billed charges,100% of total billed charges,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1280.91,61.85,,,percent of total billed charges,61.85% of total billed charges,373.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,486.11,130,,,Fee Schedule,130% of WA Medicaid ,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.77,37.7,,,percent of total billed charges,37.70% of total billed charges,780.77,37.7,,,percent of total billed charges,37.70% of total billed charges,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,70206.9,33.9,,,percent of total billed charges,33.9% of total billed charges,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1615.38,78,,,percent of total billed charges,78% of total billed charges,2071,100,,,percent of total billed charges,100% of total billed charges,1710.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1710.65,82.6,,,percent of total billed charges,82.6% of total billed charges,373.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.37,70206.9,
TREAT FX SINGLE METATARSAL,28470,CDM,983,RC,28470,HCPCS,Outpatient,,,563,365.95,,495.44,88,,,percent of total billed charges,88% of total Billed charges,14.02,100,,,Fee Schedule,100% of Medicare rate,124.21,100,,,Fee Schedule,100% of WA Medicaid,563,100,,,percent of total billed charges,100% of total billed charges,127.94,103,,,Fee Schedule,103% of WA Medicaid,14.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,124.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,388.47,69,,,percent of total billed charges,69% of total billed charges,563,100,,,percent of total billed charges,100% of total billed charges,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,563,100,,,percent of total billed charges,100% of total billed charges,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,563,100,,,percent of total billed charges,100% of total billed charges,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.22,61.85,,,percent of total billed charges,61.85% of total billed charges,124.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,161.47,130,,,Fee Schedule,130% of WA Medicaid ,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.25,37.7,,,percent of total billed charges,37.70% of total billed charges,212.25,37.7,,,percent of total billed charges,37.70% of total billed charges,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,19085.7,33.9,,,percent of total billed charges,33.9% of total billed charges,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.14,78,,,percent of total billed charges,78% of total billed charges,563,100,,,percent of total billed charges,100% of total billed charges,465.04,82.6,,,percent of total billed charges,82.6% of total billed charges,465.04,82.6,,,percent of total billed charges,82.6% of total billed charges,124.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.02,19085.7,
"TREAT METATARSAL FX W MANIPULATION, EACH",28476,CDM,983,RC,28476,HCPCS,Outpatient,,,828,538.20,,728.64,88,,,percent of total billed charges,88% of total Billed charges,26.33,100,,,Fee Schedule,100% of Medicare rate,230.89,100,,,Fee Schedule,100% of WA Medicaid,828,100,,,percent of total billed charges,100% of total billed charges,237.82,103,,,Fee Schedule,103% of WA Medicaid,26.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,46.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,230.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,571.32,69,,,percent of total billed charges,69% of total billed charges,828,100,,,percent of total billed charges,100% of total billed charges,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,828,100,,,percent of total billed charges,100% of total billed charges,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,828,100,,,percent of total billed charges,100% of total billed charges,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.12,61.85,,,percent of total billed charges,61.85% of total billed charges,230.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,300.16,130,,,Fee Schedule,130% of WA Medicaid ,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.16,37.7,,,percent of total billed charges,37.70% of total billed charges,312.16,37.7,,,percent of total billed charges,37.70% of total billed charges,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,28069.2,33.9,,,percent of total billed charges,33.9% of total billed charges,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.84,78,,,percent of total billed charges,78% of total billed charges,828,100,,,percent of total billed charges,100% of total billed charges,683.93,82.6,,,percent of total billed charges,82.6% of total billed charges,683.93,82.6,,,percent of total billed charges,82.6% of total billed charges,230.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.33,28069.2,
TREAT METATARSAL FRACTURE,28475,CDM,983,RC,28475,HCPCS,Outpatient,,,812,527.80,,714.56,88,,,percent of total billed charges,88% of total Billed charges,16.77,100,,,Fee Schedule,100% of Medicare rate,136.7,100,,,Fee Schedule,100% of WA Medicaid,812,100,,,percent of total billed charges,100% of total billed charges,140.8,103,,,Fee Schedule,103% of WA Medicaid,16.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,136.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,560.28,69,,,percent of total billed charges,69% of total billed charges,812,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,812,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,812,100,,,percent of total billed charges,100% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.22,61.85,,,percent of total billed charges,61.85% of total billed charges,136.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,177.71,130,,,Fee Schedule,130% of WA Medicaid ,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.12,37.7,,,percent of total billed charges,37.70% of total billed charges,306.12,37.7,,,percent of total billed charges,37.70% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,27526.8,33.9,,,percent of total billed charges,33.9% of total billed charges,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.36,78,,,percent of total billed charges,78% of total billed charges,812,100,,,percent of total billed charges,100% of total billed charges,670.71,82.6,,,percent of total billed charges,82.6% of total billed charges,670.71,82.6,,,percent of total billed charges,82.6% of total billed charges,136.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.77,27526.8,
TREAT METATARSAL FRACTURE,28485,CDM,983,RC,28485,HCPCS,Outpatient,,,1880,1222.00,,1654.4,88,,,percent of total billed charges,88% of total Billed charges,42.76,100,,,Fee Schedule,100% of Medicare rate,330.29,100,,,Fee Schedule,100% of WA Medicaid,1880,100,,,percent of total billed charges,100% of total billed charges,340.2,103,,,Fee Schedule,103% of WA Medicaid,42.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,330.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1297.2,69,,,percent of total billed charges,69% of total billed charges,1880,100,,,percent of total billed charges,100% of total billed charges,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1880,100,,,percent of total billed charges,100% of total billed charges,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1880,100,,,percent of total billed charges,100% of total billed charges,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162.78,61.85,,,percent of total billed charges,61.85% of total billed charges,330.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,429.38,130,,,Fee Schedule,130% of WA Medicaid ,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,708.76,37.7,,,percent of total billed charges,37.70% of total billed charges,708.76,37.7,,,percent of total billed charges,37.70% of total billed charges,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,63732,33.9,,,percent of total billed charges,33.9% of total billed charges,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1466.4,78,,,percent of total billed charges,78% of total billed charges,1880,100,,,percent of total billed charges,100% of total billed charges,1552.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1552.88,82.6,,,percent of total billed charges,82.6% of total billed charges,330.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.76,63732,
TREAT FX GREAT TOE,28490,CDM,983,RC,28490,HCPCS,Outpatient,,,377,245.05,,331.76,88,,,percent of total billed charges,88% of total Billed charges,8.1,100,,,Fee Schedule,100% of Medicare rate,75.53,100,,,Fee Schedule,100% of WA Medicaid,377,100,,,percent of total billed charges,100% of total billed charges,77.8,103,,,Fee Schedule,103% of WA Medicaid,8.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,75.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,260.13,69,,,percent of total billed charges,69% of total billed charges,377,100,,,percent of total billed charges,100% of total billed charges,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,377,100,,,percent of total billed charges,100% of total billed charges,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,377,100,,,percent of total billed charges,100% of total billed charges,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.17,61.85,,,percent of total billed charges,61.85% of total billed charges,75.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,98.19,130,,,Fee Schedule,130% of WA Medicaid ,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.13,37.7,,,percent of total billed charges,37.70% of total billed charges,142.13,37.7,,,percent of total billed charges,37.70% of total billed charges,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,12780.3,33.9,,,percent of total billed charges,33.9% of total billed charges,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,294.06,78,,,percent of total billed charges,78% of total billed charges,377,100,,,percent of total billed charges,100% of total billed charges,311.4,82.6,,,percent of total billed charges,82.6% of total billed charges,311.4,82.6,,,percent of total billed charges,82.6% of total billed charges,75.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.1,12780.3,
28496 Treat Big toe Fracture,28496,CDM,983,RC,28496,HCPCS,Outpatient,,,1512,982.80,,1330.56,88,,,percent of total billed charges,88% of total Billed charges,21.53,100,,,Fee Schedule,100% of Medicare rate,163.75,100,,,Fee Schedule,100% of WA Medicaid,1512,100,,,percent of total billed charges,100% of total billed charges,168.66,103,,,Fee Schedule,103% of WA Medicaid,21.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,163.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1043.28,69,,,percent of total billed charges,69% of total billed charges,1512,100,,,percent of total billed charges,100% of total billed charges,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1512,100,,,percent of total billed charges,100% of total billed charges,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1512,100,,,percent of total billed charges,100% of total billed charges,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,935.17,61.85,,,percent of total billed charges,61.85% of total billed charges,163.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,212.88,130,,,Fee Schedule,130% of WA Medicaid ,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,570.02,37.7,,,percent of total billed charges,37.70% of total billed charges,570.02,37.7,,,percent of total billed charges,37.70% of total billed charges,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,51256.8,33.9,,,percent of total billed charges,33.9% of total billed charges,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1179.36,78,,,percent of total billed charges,78% of total billed charges,1512,100,,,percent of total billed charges,100% of total billed charges,1248.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1248.91,82.6,,,percent of total billed charges,82.6% of total billed charges,163.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.53,51256.8,
TREAT BIG TOE FRACTURE,28505,CDM,983,RC,28505,HCPCS,Outpatient,,,1344,873.60,,1182.72,88,,,percent of total billed charges,88% of total Billed charges,39.04,100,,,Fee Schedule,100% of Medicare rate,288.52,100,,,Fee Schedule,100% of WA Medicaid,1344,100,,,percent of total billed charges,100% of total billed charges,297.18,103,,,Fee Schedule,103% of WA Medicaid,39.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,288.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,927.36,69,,,percent of total billed charges,69% of total billed charges,1344,100,,,percent of total billed charges,100% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1344,100,,,percent of total billed charges,100% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1344,100,,,percent of total billed charges,100% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,831.26,61.85,,,percent of total billed charges,61.85% of total billed charges,288.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,294.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,375.08,130,,,Fee Schedule,130% of WA Medicaid ,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,506.69,37.7,,,percent of total billed charges,37.70% of total billed charges,506.69,37.7,,,percent of total billed charges,37.70% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,45561.6,33.9,,,percent of total billed charges,33.9% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1048.32,78,,,percent of total billed charges,78% of total billed charges,1344,100,,,percent of total billed charges,100% of total billed charges,1110.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1110.14,82.6,,,percent of total billed charges,82.6% of total billed charges,288.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.04,45561.6,
TREAT FX LESSER TOE,28510,CDM,983,RC,28510,HCPCS,Outpatient,,,306,198.90,,269.28,88,,,percent of total billed charges,88% of total Billed charges,7.46,100,,,Fee Schedule,100% of Medicare rate,73.29,100,,,Fee Schedule,100% of WA Medicaid,306,100,,,percent of total billed charges,100% of total billed charges,75.49,103,,,Fee Schedule,103% of WA Medicaid,7.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,73.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,211.14,69,,,percent of total billed charges,69% of total billed charges,306,100,,,percent of total billed charges,100% of total billed charges,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,306,100,,,percent of total billed charges,100% of total billed charges,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,306,100,,,percent of total billed charges,100% of total billed charges,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.26,61.85,,,percent of total billed charges,61.85% of total billed charges,73.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.28,130,,,Fee Schedule,130% of WA Medicaid ,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.36,37.7,,,percent of total billed charges,37.70% of total billed charges,115.36,37.7,,,percent of total billed charges,37.70% of total billed charges,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,10373.4,33.9,,,percent of total billed charges,33.9% of total billed charges,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.68,78,,,percent of total billed charges,78% of total billed charges,306,100,,,percent of total billed charges,100% of total billed charges,252.76,82.6,,,percent of total billed charges,82.6% of total billed charges,252.76,82.6,,,percent of total billed charges,82.6% of total billed charges,73.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.46,10373.4,
TREATMENT OF TOE FRACTURE,28515,CDM,983,RC,28515,HCPCS,Outpatient,,,461,299.65,,405.68,88,,,percent of total billed charges,88% of total Billed charges,8.94,100,,,Fee Schedule,100% of Medicare rate,86.72,100,,,Fee Schedule,100% of WA Medicaid,461,100,,,percent of total billed charges,100% of total billed charges,89.32,103,,,Fee Schedule,103% of WA Medicaid,8.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,86.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,318.09,69,,,percent of total billed charges,69% of total billed charges,461,100,,,percent of total billed charges,100% of total billed charges,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,461,100,,,percent of total billed charges,100% of total billed charges,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,461,100,,,percent of total billed charges,100% of total billed charges,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.13,61.85,,,percent of total billed charges,61.85% of total billed charges,86.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,112.74,130,,,Fee Schedule,130% of WA Medicaid ,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.8,37.7,,,percent of total billed charges,37.70% of total billed charges,173.8,37.7,,,percent of total billed charges,37.70% of total billed charges,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,15627.9,33.9,,,percent of total billed charges,33.9% of total billed charges,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.58,78,,,percent of total billed charges,78% of total billed charges,461,100,,,percent of total billed charges,100% of total billed charges,380.79,82.6,,,percent of total billed charges,82.6% of total billed charges,380.79,82.6,,,percent of total billed charges,82.6% of total billed charges,86.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.94,15627.9,
TREAT TOE FRACTURE,28525,CDM,983,RC,28525,HCPCS,Outpatient,,,1374,893.10,,1209.12,88,,,percent of total billed charges,88% of total Billed charges,30.43,100,,,Fee Schedule,100% of Medicare rate,238.53,100,,,Fee Schedule,100% of WA Medicaid,1374,100,,,percent of total billed charges,100% of total billed charges,245.69,103,,,Fee Schedule,103% of WA Medicaid,30.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,238.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,948.06,69,,,percent of total billed charges,69% of total billed charges,1374,100,,,percent of total billed charges,100% of total billed charges,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1374,100,,,percent of total billed charges,100% of total billed charges,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1374,100,,,percent of total billed charges,100% of total billed charges,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,849.82,61.85,,,percent of total billed charges,61.85% of total billed charges,238.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,310.09,130,,,Fee Schedule,130% of WA Medicaid ,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,518,37.7,,,percent of total billed charges,37.70% of total billed charges,518,37.7,,,percent of total billed charges,37.70% of total billed charges,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,46578.6,33.9,,,percent of total billed charges,33.9% of total billed charges,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1071.72,78,,,percent of total billed charges,78% of total billed charges,1374,100,,,percent of total billed charges,100% of total billed charges,1134.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1134.92,82.6,,,percent of total billed charges,82.6% of total billed charges,238.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.43,46578.6,
TREAT FOOT DISLOCATION,28575,CDM,983,RC,28575,HCPCS,Outpatient,,,1035,672.75,,910.8,88,,,percent of total billed charges,88% of total Billed charges,29.34,100,,,Fee Schedule,100% of Medicare rate,203.66,100,,,Fee Schedule,100% of WA Medicaid,1035,100,,,percent of total billed charges,100% of total billed charges,209.77,103,,,Fee Schedule,103% of WA Medicaid,29.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,203.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,714.15,69,,,percent of total billed charges,69% of total billed charges,1035,100,,,percent of total billed charges,100% of total billed charges,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035,100,,,percent of total billed charges,100% of total billed charges,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035,100,,,percent of total billed charges,100% of total billed charges,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.15,61.85,,,percent of total billed charges,61.85% of total billed charges,203.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,264.76,130,,,Fee Schedule,130% of WA Medicaid ,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.2,37.7,,,percent of total billed charges,37.70% of total billed charges,390.2,37.7,,,percent of total billed charges,37.70% of total billed charges,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,35086.5,33.9,,,percent of total billed charges,33.9% of total billed charges,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,807.3,78,,,percent of total billed charges,78% of total billed charges,1035,100,,,percent of total billed charges,100% of total billed charges,854.91,82.6,,,percent of total billed charges,82.6% of total billed charges,854.91,82.6,,,percent of total billed charges,82.6% of total billed charges,203.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.34,35086.5,
TREAT FOOT DISLOCATION,28606,CDM,983,RC,28606,HCPCS,Outpatient,,,1692,1099.80,,1488.96,88,,,percent of total billed charges,88% of total Billed charges,35.18,100,,,Fee Schedule,100% of Medicare rate,230.14,100,,,Fee Schedule,100% of WA Medicaid,1692,100,,,percent of total billed charges,100% of total billed charges,237.04,103,,,Fee Schedule,103% of WA Medicaid,35.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,230.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1167.48,69,,,percent of total billed charges,69% of total billed charges,1692,100,,,percent of total billed charges,100% of total billed charges,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1692,100,,,percent of total billed charges,100% of total billed charges,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1692,100,,,percent of total billed charges,100% of total billed charges,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046.5,61.85,,,percent of total billed charges,61.85% of total billed charges,230.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,299.18,130,,,Fee Schedule,130% of WA Medicaid ,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.88,37.7,,,percent of total billed charges,37.70% of total billed charges,637.88,37.7,,,percent of total billed charges,37.70% of total billed charges,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,57358.8,33.9,,,percent of total billed charges,33.9% of total billed charges,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319.76,78,,,percent of total billed charges,78% of total billed charges,1692,100,,,percent of total billed charges,100% of total billed charges,1397.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1397.59,82.6,,,percent of total billed charges,82.6% of total billed charges,230.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.18,57358.8,
REPAIR FOOT DISLOCATION,28615,CDM,983,RC,28615,HCPCS,Outpatient,,,2279,1481.35,,2005.52,88,,,percent of total billed charges,88% of total Billed charges,71.26,100,,,Fee Schedule,100% of Medicare rate,482.85,100,,,Fee Schedule,100% of WA Medicaid,2279,100,,,percent of total billed charges,100% of total billed charges,497.34,103,,,Fee Schedule,103% of WA Medicaid,71.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,482.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1572.51,69,,,percent of total billed charges,69% of total billed charges,2279,100,,,percent of total billed charges,100% of total billed charges,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2279,100,,,percent of total billed charges,100% of total billed charges,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2279,100,,,percent of total billed charges,100% of total billed charges,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1409.56,61.85,,,percent of total billed charges,61.85% of total billed charges,482.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,627.71,130,,,Fee Schedule,130% of WA Medicaid ,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.18,37.7,,,percent of total billed charges,37.70% of total billed charges,859.18,37.7,,,percent of total billed charges,37.70% of total billed charges,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,77258.1,33.9,,,percent of total billed charges,33.9% of total billed charges,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1777.62,78,,,percent of total billed charges,78% of total billed charges,2279,100,,,percent of total billed charges,100% of total billed charges,1882.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1882.45,82.6,,,percent of total billed charges,82.6% of total billed charges,482.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.26,77258.1,
REPAIR TOE DISLOCATION,28645,CDM,983,RC,28645,HCPCS,Outpatient,,,1490,968.50,,1311.2,88,,,percent of total billed charges,88% of total Billed charges,37.21,100,,,Fee Schedule,100% of Medicare rate,283.29,100,,,Fee Schedule,100% of WA Medicaid,1490,100,,,percent of total billed charges,100% of total billed charges,291.79,103,,,Fee Schedule,103% of WA Medicaid,37.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,283.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1028.1,69,,,percent of total billed charges,69% of total billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1490,100,,,percent of total billed charges,100% of total billed charges,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1490,100,,,percent of total billed charges,100% of total billed charges,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,921.57,61.85,,,percent of total billed charges,61.85% of total billed charges,283.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,368.28,130,,,Fee Schedule,130% of WA Medicaid ,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.73,37.7,,,percent of total billed charges,37.70% of total billed charges,561.73,37.7,,,percent of total billed charges,37.70% of total billed charges,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,50511,33.9,,,percent of total billed charges,33.9% of total billed charges,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162.2,78,,,percent of total billed charges,78% of total billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,1230.74,82.6,,,percent of total billed charges,82.6% of total billed charges,1230.74,82.6,,,percent of total billed charges,82.6% of total billed charges,283.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.21,50511,
PERCUTANEOUSSKELETAL FIXATION,28666,CDM,983,RC,28666,HCPCS,Outpatient,,,459,298.35,,403.92,88,,,percent of total billed charges,88% of total Billed charges,10.82,100,,,Fee Schedule,100% of Medicare rate,102.2,100,,,Fee Schedule,100% of WA Medicaid,459,100,,,percent of total billed charges,100% of total billed charges,105.27,103,,,Fee Schedule,103% of WA Medicaid,10.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,316.71,69,,,percent of total billed charges,69% of total billed charges,459,100,,,percent of total billed charges,100% of total billed charges,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,459,100,,,percent of total billed charges,100% of total billed charges,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,459,100,,,percent of total billed charges,100% of total billed charges,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.89,61.85,,,percent of total billed charges,61.85% of total billed charges,102.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.86,130,,,Fee Schedule,130% of WA Medicaid ,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.04,37.7,,,percent of total billed charges,37.70% of total billed charges,173.04,37.7,,,percent of total billed charges,37.70% of total billed charges,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,15560.1,33.9,,,percent of total billed charges,33.9% of total billed charges,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.02,78,,,percent of total billed charges,78% of total billed charges,459,100,,,percent of total billed charges,100% of total billed charges,379.13,82.6,,,percent of total billed charges,82.6% of total billed charges,379.13,82.6,,,percent of total billed charges,82.6% of total billed charges,102.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.82,15560.1,
FUSION OF FOOT BONES,28705,CDM,983,RC,28705,HCPCS,Outpatient,,,2879,1871.35,,2533.52,88,,,percent of total billed charges,88% of total Billed charges,117.16,100,,,Fee Schedule,100% of Medicare rate,696.58,100,,,Fee Schedule,100% of WA Medicaid,2879,100,,,percent of total billed charges,100% of total billed charges,717.48,103,,,Fee Schedule,103% of WA Medicaid,117.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,205.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,696.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1986.51,69,,,percent of total billed charges,69% of total billed charges,2879,100,,,percent of total billed charges,100% of total billed charges,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2879,100,,,percent of total billed charges,100% of total billed charges,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2879,100,,,percent of total billed charges,100% of total billed charges,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1780.66,61.85,,,percent of total billed charges,61.85% of total billed charges,696.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,710.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,905.55,130,,,Fee Schedule,130% of WA Medicaid ,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1085.38,37.7,,,percent of total billed charges,37.70% of total billed charges,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,97598.1,33.9,,,percent of total billed charges,33.9% of total billed charges,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2245.62,78,,,percent of total billed charges,78% of total billed charges,2879,100,,,percent of total billed charges,100% of total billed charges,2378.05,82.6,,,percent of total billed charges,82.6% of total billed charges,2378.05,82.6,,,percent of total billed charges,82.6% of total billed charges,696.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.16,97598.1,
FUSION OF FOOT BONES,28715,CDM,983,RC,28715,HCPCS,Outpatient,,,4399,2859.35,,3871.12,88,,,percent of total billed charges,88% of total Billed charges,88.17,100,,,Fee Schedule,100% of Medicare rate,541.97,100,,,Fee Schedule,100% of WA Medicaid,4399,100,,,percent of total billed charges,100% of total billed charges,558.23,103,,,Fee Schedule,103% of WA Medicaid,88.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,154.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,541.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3035.31,69,,,percent of total billed charges,69% of total billed charges,4399,100,,,percent of total billed charges,100% of total billed charges,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4399,100,,,percent of total billed charges,100% of total billed charges,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4399,100,,,percent of total billed charges,100% of total billed charges,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2720.78,61.85,,,percent of total billed charges,61.85% of total billed charges,541.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,704.56,130,,,Fee Schedule,130% of WA Medicaid ,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1658.42,37.7,,,percent of total billed charges,37.70% of total billed charges,1658.42,37.7,,,percent of total billed charges,37.70% of total billed charges,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,149126.1,33.9,,,percent of total billed charges,33.9% of total billed charges,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3431.22,78,,,percent of total billed charges,78% of total billed charges,4399,100,,,percent of total billed charges,100% of total billed charges,3633.57,82.6,,,percent of total billed charges,82.6% of total billed charges,3633.57,82.6,,,percent of total billed charges,82.6% of total billed charges,541.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.17,149126.1,
FUSION OF FOOT BONES,28725,CDM,983,RC,28725,HCPCS,Outpatient,,,3023,1964.95,,2660.24,88,,,percent of total billed charges,88% of total Billed charges,71.4,100,,,Fee Schedule,100% of Medicare rate,450.02,100,,,Fee Schedule,100% of WA Medicaid,3023,100,,,percent of total billed charges,100% of total billed charges,463.52,103,,,Fee Schedule,103% of WA Medicaid,71.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,450.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2085.87,69,,,percent of total billed charges,69% of total billed charges,3023,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,3023,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,3023,100,,,percent of total billed charges,100% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1869.73,61.85,,,percent of total billed charges,61.85% of total billed charges,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,585.03,130,,,Fee Schedule,130% of WA Medicaid ,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1139.67,37.7,,,percent of total billed charges,37.70% of total billed charges,1139.67,37.7,,,percent of total billed charges,37.70% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,102479.7,33.9,,,percent of total billed charges,33.9% of total billed charges,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2357.94,78,,,percent of total billed charges,78% of total billed charges,3023,100,,,percent of total billed charges,100% of total billed charges,2497,82.6,,,percent of total billed charges,82.6% of total billed charges,2497,82.6,,,percent of total billed charges,82.6% of total billed charges,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.4,102479.7,
FUSION OF FOOT BONES,28730,CDM,983,RC,28730,HCPCS,Outpatient,,,2917,1896.05,,2566.96,88,,,percent of total billed charges,88% of total Billed charges,63.56,100,,,Fee Schedule,100% of Medicare rate,419.25,100,,,Fee Schedule,100% of WA Medicaid,2917,100,,,percent of total billed charges,100% of total billed charges,431.83,103,,,Fee Schedule,103% of WA Medicaid,63.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,111.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,419.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2012.73,69,,,percent of total billed charges,69% of total billed charges,2917,100,,,percent of total billed charges,100% of total billed charges,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2917,100,,,percent of total billed charges,100% of total billed charges,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2917,100,,,percent of total billed charges,100% of total billed charges,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1804.16,61.85,,,percent of total billed charges,61.85% of total billed charges,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,545.03,130,,,Fee Schedule,130% of WA Medicaid ,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1099.71,37.7,,,percent of total billed charges,37.70% of total billed charges,1099.71,37.7,,,percent of total billed charges,37.70% of total billed charges,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,98886.3,33.9,,,percent of total billed charges,33.9% of total billed charges,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2275.26,78,,,percent of total billed charges,78% of total billed charges,2917,100,,,percent of total billed charges,100% of total billed charges,2409.44,82.6,,,percent of total billed charges,82.6% of total billed charges,2409.44,82.6,,,percent of total billed charges,82.6% of total billed charges,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.56,98886.3,
FUSION OF FOOT BONES,28740,CDM,983,RC,28740,HCPCS,Outpatient,,,2258,1467.70,,1987.04,88,,,percent of total billed charges,88% of total Billed charges,51.72,100,,,Fee Schedule,100% of Medicare rate,356.77,100,,,Fee Schedule,100% of WA Medicaid,2258,100,,,percent of total billed charges,100% of total billed charges,367.47,103,,,Fee Schedule,103% of WA Medicaid,51.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,356.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1558.02,69,,,percent of total billed charges,69% of total billed charges,2258,100,,,percent of total billed charges,100% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2258,100,,,percent of total billed charges,100% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2258,100,,,percent of total billed charges,100% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1396.57,61.85,,,percent of total billed charges,61.85% of total billed charges,356.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,463.8,130,,,Fee Schedule,130% of WA Medicaid ,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.27,37.7,,,percent of total billed charges,37.70% of total billed charges,851.27,37.7,,,percent of total billed charges,37.70% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,76546.2,33.9,,,percent of total billed charges,33.9% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1761.24,78,,,percent of total billed charges,78% of total billed charges,2258,100,,,percent of total billed charges,100% of total billed charges,1865.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1865.11,82.6,,,percent of total billed charges,82.6% of total billed charges,356.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.72,76546.2,
FUSION OF BIG TOE JOINT,28750,CDM,983,RC,28750,HCPCS,Outpatient,,,2402,1561.30,,2113.76,88,,,percent of total billed charges,88% of total Billed charges,47.64,100,,,Fee Schedule,100% of Medicare rate,333.65,100,,,Fee Schedule,100% of WA Medicaid,2402,100,,,percent of total billed charges,100% of total billed charges,343.66,103,,,Fee Schedule,103% of WA Medicaid,47.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,333.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1657.38,69,,,percent of total billed charges,69% of total billed charges,2402,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2402,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2402,100,,,percent of total billed charges,100% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1485.64,61.85,,,percent of total billed charges,61.85% of total billed charges,333.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,433.75,130,,,Fee Schedule,130% of WA Medicaid ,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,905.55,37.7,,,percent of total billed charges,37.70% of total billed charges,905.55,37.7,,,percent of total billed charges,37.70% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,81427.8,33.9,,,percent of total billed charges,33.9% of total billed charges,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1873.56,78,,,percent of total billed charges,78% of total billed charges,2402,100,,,percent of total billed charges,100% of total billed charges,1984.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1984.05,82.6,,,percent of total billed charges,82.6% of total billed charges,333.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.64,81427.8,
FUSION OF BIG TOE JOINT,28755,CDM,983,RC,28755,HCPCS,Outpatient,,,1415,919.75,,1245.2,88,,,percent of total billed charges,88% of total Billed charges,25.04,100,,,Fee Schedule,100% of Medicare rate,195.08,100,,,Fee Schedule,100% of WA Medicaid,1415,100,,,percent of total billed charges,100% of total billed charges,200.93,103,,,Fee Schedule,103% of WA Medicaid,25.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,195.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,976.35,69,,,percent of total billed charges,69% of total billed charges,1415,100,,,percent of total billed charges,100% of total billed charges,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1415,100,,,percent of total billed charges,100% of total billed charges,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1415,100,,,percent of total billed charges,100% of total billed charges,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,875.18,61.85,,,percent of total billed charges,61.85% of total billed charges,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,253.6,130,,,Fee Schedule,130% of WA Medicaid ,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,533.46,37.7,,,percent of total billed charges,37.70% of total billed charges,533.46,37.7,,,percent of total billed charges,37.70% of total billed charges,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,47968.5,33.9,,,percent of total billed charges,33.9% of total billed charges,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1103.7,78,,,percent of total billed charges,78% of total billed charges,1415,100,,,percent of total billed charges,100% of total billed charges,1168.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1168.79,82.6,,,percent of total billed charges,82.6% of total billed charges,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.04,47968.5,
AMPUTATION OF MIDFOOT,28800,CDM,983,RC,28800,HCPCS,Outpatient,,,2251,1463.15,,1980.88,88,,,percent of total billed charges,88% of total Billed charges,41.66,100,,,Fee Schedule,100% of Medicare rate,303.25,100,,,Fee Schedule,100% of WA Medicaid,2251,100,,,percent of total billed charges,100% of total billed charges,312.35,103,,,Fee Schedule,103% of WA Medicaid,41.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,303.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1553.19,69,,,percent of total billed charges,69% of total billed charges,2251,100,,,percent of total billed charges,100% of total billed charges,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2251,100,,,percent of total billed charges,100% of total billed charges,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2251,100,,,percent of total billed charges,100% of total billed charges,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1392.24,61.85,,,percent of total billed charges,61.85% of total billed charges,303.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,394.23,130,,,Fee Schedule,130% of WA Medicaid ,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,848.63,37.7,,,percent of total billed charges,37.70% of total billed charges,848.63,37.7,,,percent of total billed charges,37.70% of total billed charges,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,76308.9,33.9,,,percent of total billed charges,33.9% of total billed charges,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1755.78,78,,,percent of total billed charges,78% of total billed charges,2251,100,,,percent of total billed charges,100% of total billed charges,1859.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1859.33,82.6,,,percent of total billed charges,82.6% of total billed charges,303.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.66,76308.9,
AMPUTATION THRU METATARSAL,28805,CDM,983,RC,28805,HCPCS,Outpatient,,,2285,1485.25,,2010.8,88,,,percent of total billed charges,88% of total Billed charges,62.44,100,,,Fee Schedule,100% of Medicare rate,401.53,100,,,Fee Schedule,100% of WA Medicaid,2285,100,,,percent of total billed charges,100% of total billed charges,413.58,103,,,Fee Schedule,103% of WA Medicaid,62.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,401.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1576.65,69,,,percent of total billed charges,69% of total billed charges,2285,100,,,percent of total billed charges,100% of total billed charges,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2285,100,,,percent of total billed charges,100% of total billed charges,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2285,100,,,percent of total billed charges,100% of total billed charges,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1413.27,61.85,,,percent of total billed charges,61.85% of total billed charges,401.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,521.99,130,,,Fee Schedule,130% of WA Medicaid ,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.45,37.7,,,percent of total billed charges,37.70% of total billed charges,861.45,37.7,,,percent of total billed charges,37.70% of total billed charges,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,77461.5,33.9,,,percent of total billed charges,33.9% of total billed charges,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1782.3,78,,,percent of total billed charges,78% of total billed charges,2285,100,,,percent of total billed charges,100% of total billed charges,1887.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1887.41,82.6,,,percent of total billed charges,82.6% of total billed charges,401.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.44,77461.5,
AMPUTATION TOE  METATARSAL,28810,CDM,983,RC,28810,HCPCS,Outpatient,,,1546,1004.90,,1360.48,88,,,percent of total billed charges,88% of total Billed charges,38.46,100,,,Fee Schedule,100% of Medicare rate,242.64,100,,,Fee Schedule,100% of WA Medicaid,1546,100,,,percent of total billed charges,100% of total billed charges,249.92,103,,,Fee Schedule,103% of WA Medicaid,38.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,242.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1066.74,69,,,percent of total billed charges,69% of total billed charges,1546,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1546,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1546,100,,,percent of total billed charges,100% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,956.2,61.85,,,percent of total billed charges,61.85% of total billed charges,242.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,315.43,130,,,Fee Schedule,130% of WA Medicaid ,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,582.84,37.7,,,percent of total billed charges,37.70% of total billed charges,582.84,37.7,,,percent of total billed charges,37.70% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,52409.4,33.9,,,percent of total billed charges,33.9% of total billed charges,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1205.88,78,,,percent of total billed charges,78% of total billed charges,1546,100,,,percent of total billed charges,100% of total billed charges,1277,82.6,,,percent of total billed charges,82.6% of total billed charges,1277,82.6,,,percent of total billed charges,82.6% of total billed charges,242.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.46,52409.4,
AMPUTATION OF TOE,28820,CDM,983,RC,28820,HCPCS,Outpatient,,,1335,867.75,,1174.8,88,,,percent of total billed charges,88% of total Billed charges,15.93,100,,,Fee Schedule,100% of Medicare rate,100.15,100,,,Fee Schedule,100% of WA Medicaid,1335,100,,,percent of total billed charges,100% of total billed charges,103.15,103,,,Fee Schedule,103% of WA Medicaid,15.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,100.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,921.15,69,,,percent of total billed charges,69% of total billed charges,1335,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1335,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1335,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,825.7,61.85,,,percent of total billed charges,61.85% of total billed charges,100.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.2,130,,,Fee Schedule,130% of WA Medicaid ,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,503.3,37.7,,,percent of total billed charges,37.70% of total billed charges,503.3,37.7,,,percent of total billed charges,37.70% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,45256.5,33.9,,,percent of total billed charges,33.9% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1041.3,78,,,percent of total billed charges,78% of total billed charges,1335,100,,,percent of total billed charges,100% of total billed charges,1102.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1102.71,82.6,,,percent of total billed charges,82.6% of total billed charges,100.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.93,45256.5,
PARTIAL AMPUTATION OF TOE,28825,CDM,983,RC,28825,HCPCS,Outpatient,,,1255,815.75,,1104.4,88,,,percent of total billed charges,88% of total Billed charges,15.54,100,,,Fee Schedule,100% of Medicare rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,1255,100,,,percent of total billed charges,100% of total billed charges,100.47,103,,,Fee Schedule,103% of WA Medicaid,15.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,865.95,69,,,percent of total billed charges,69% of total billed charges,1255,100,,,percent of total billed charges,100% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1255,100,,,percent of total billed charges,100% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1255,100,,,percent of total billed charges,100% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,776.22,61.85,,,percent of total billed charges,61.85% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.8,130,,,Fee Schedule,130% of WA Medicaid ,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.14,37.7,,,percent of total billed charges,37.70% of total billed charges,473.14,37.7,,,percent of total billed charges,37.70% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,42544.5,33.9,,,percent of total billed charges,33.9% of total billed charges,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,978.9,78,,,percent of total billed charges,78% of total billed charges,1255,100,,,percent of total billed charges,100% of total billed charges,1036.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1036.63,82.6,,,percent of total billed charges,82.6% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.54,42544.5,
APPLICATION OF LONG ARM CAST,29065,CDM,983,RC,29065,HCPCS,Outpatient,,,234,152.10,,205.92,88,,,percent of total billed charges,88% of total Billed charges,6.48,100,,,Fee Schedule,100% of Medicare rate,39.35,100,,,Fee Schedule,100% of WA Medicaid,234,100,,,percent of total billed charges,100% of total billed charges,40.53,103,,,Fee Schedule,103% of WA Medicaid,6.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,161.46,69,,,percent of total billed charges,69% of total billed charges,234,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,234,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,234,100,,,percent of total billed charges,100% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.73,61.85,,,percent of total billed charges,61.85% of total billed charges,39.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.16,130,,,Fee Schedule,130% of WA Medicaid ,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.22,37.7,,,percent of total billed charges,37.70% of total billed charges,88.22,37.7,,,percent of total billed charges,37.70% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,7932.6,33.9,,,percent of total billed charges,33.9% of total billed charges,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.52,78,,,percent of total billed charges,78% of total billed charges,234,100,,,percent of total billed charges,100% of total billed charges,193.28,82.6,,,percent of total billed charges,82.6% of total billed charges,193.28,82.6,,,percent of total billed charges,82.6% of total billed charges,39.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.48,7932.6,
APPLICATION OF FOREARM CAST,29075,CDM,983,RC,29075,HCPCS,Outpatient,,,199,129.35,,175.12,88,,,percent of total billed charges,88% of total Billed charges,5.79,100,,,Fee Schedule,100% of Medicare rate,36.18,100,,,Fee Schedule,100% of WA Medicaid,199,100,,,percent of total billed charges,100% of total billed charges,37.27,103,,,Fee Schedule,103% of WA Medicaid,5.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,36.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,137.31,69,,,percent of total billed charges,69% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,199,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,199,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.08,61.85,,,percent of total billed charges,61.85% of total billed charges,36.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.03,130,,,Fee Schedule,130% of WA Medicaid ,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.02,37.7,,,percent of total billed charges,37.70% of total billed charges,75.02,37.7,,,percent of total billed charges,37.70% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,6746.1,33.9,,,percent of total billed charges,33.9% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.22,78,,,percent of total billed charges,78% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,36.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.79,6746.1,
APPLY HAND/WRIST CAST,29085,CDM,983,RC,29085,HCPCS,Outpatient,,,196,127.40,,172.48,88,,,percent of total billed charges,88% of total Billed charges,6.2,100,,,Fee Schedule,100% of Medicare rate,39.17,100,,,Fee Schedule,100% of WA Medicaid,196,100,,,percent of total billed charges,100% of total billed charges,40.35,103,,,Fee Schedule,103% of WA Medicaid,6.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,135.24,69,,,percent of total billed charges,69% of total billed charges,196,100,,,percent of total billed charges,100% of total billed charges,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,196,100,,,percent of total billed charges,100% of total billed charges,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,196,100,,,percent of total billed charges,100% of total billed charges,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.23,61.85,,,percent of total billed charges,61.85% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.92,130,,,Fee Schedule,130% of WA Medicaid ,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.89,37.7,,,percent of total billed charges,37.70% of total billed charges,73.89,37.7,,,percent of total billed charges,37.70% of total billed charges,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,6644.4,33.9,,,percent of total billed charges,33.9% of total billed charges,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.88,78,,,percent of total billed charges,78% of total billed charges,196,100,,,percent of total billed charges,100% of total billed charges,161.9,82.6,,,percent of total billed charges,82.6% of total billed charges,161.9,82.6,,,percent of total billed charges,82.6% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.2,6644.4,
APPLY FOREARM SPLINT,29125,CDM,983,RC,29125,HCPCS,Outpatient,,,112.76,73.29,,99.23,88,,,percent of total billed charges,88% of total Billed charges,3.56,100,,,Fee Schedule,100% of Medicare rate,23.5,100,,,Fee Schedule,100% of WA Medicaid,112.76,100,,,percent of total billed charges,100% of total billed charges,24.21,103,,,Fee Schedule,103% of WA Medicaid,3.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,77.8,69,,,percent of total billed charges,69% of total billed charges,112.76,100,,,percent of total billed charges,100% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.76,100,,,percent of total billed charges,100% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.76,100,,,percent of total billed charges,100% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.74,61.85,,,percent of total billed charges,61.85% of total billed charges,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.55,130,,,Fee Schedule,130% of WA Medicaid ,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.51,37.7,,,percent of total billed charges,37.70% of total billed charges,42.51,37.7,,,percent of total billed charges,37.70% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3822.56,33.9,,,percent of total billed charges,33.9% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.95,78,,,percent of total billed charges,78% of total billed charges,112.76,100,,,percent of total billed charges,100% of total billed charges,93.14,82.6,,,percent of total billed charges,82.6% of total billed charges,93.14,82.6,,,percent of total billed charges,82.6% of total billed charges,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.56,3822.56,
APPLICATION OF FINGER SPLINT,29130,CDM,983,RC,29130,HCPCS,Outpatient,,,69.12,44.93,,60.83,88,,,percent of total billed charges,88% of total Billed charges,3.2,100,,,Fee Schedule,100% of Medicare rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,69.12,100,,,percent of total billed charges,100% of total billed charges,16.9,103,,,Fee Schedule,103% of WA Medicaid,3.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,47.69,69,,,percent of total billed charges,69% of total billed charges,69.12,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.12,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.12,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.75,61.85,,,percent of total billed charges,61.85% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.33,130,,,Fee Schedule,130% of WA Medicaid ,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.06,37.7,,,percent of total billed charges,37.70% of total billed charges,26.06,37.7,,,percent of total billed charges,37.70% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2343.17,33.9,,,percent of total billed charges,33.9% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.91,78,,,percent of total billed charges,78% of total billed charges,69.12,100,,,percent of total billed charges,100% of total billed charges,57.09,82.6,,,percent of total billed charges,82.6% of total billed charges,57.09,82.6,,,percent of total billed charges,82.6% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.2,2343.17,
APPLICATION OF FINGER SPLINT,29131,CDM,983,RC,29131,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,3.38,100,,,Fee Schedule,100% of Medicare rate,19.77,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,20.36,103,,,Fee Schedule,103% of WA Medicaid,3.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,100,,,percent of total billed charges,100% of total billed charges,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,100,,,percent of total billed charges,100% of total billed charges,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.7,130,,,Fee Schedule,130% of WA Medicaid ,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2373,33.9,,,percent of total billed charges,33.9% of total billed charges,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.38,2373,
STRAPPING OF SHOULDER,29240,CDM,983,RC,29240,HCPCS,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,1.05,100,,,Fee Schedule,100% of Medicare rate,10.07,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,10.37,103,,,Fee Schedule,103% of WA Medicaid,1.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,10.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,96,100,,,percent of total billed charges,100% of total billed charges,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,96,100,,,percent of total billed charges,100% of total billed charges,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.38,61.85,,,percent of total billed charges,61.85% of total billed charges,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.09,130,,,Fee Schedule,130% of WA Medicaid ,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3254.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.05,3254.4,
STRAPPING OF ELBOW OR WRIST,29260,CDM,983,RC,29260,HCPCS,Outpatient,,,86.11,55.97,,75.78,88,,,percent of total billed charges,88% of total Billed charges,1.34,100,,,Fee Schedule,100% of Medicare rate,10.63,100,,,Fee Schedule,100% of WA Medicaid,86.11,100,,,percent of total billed charges,100% of total billed charges,10.95,103,,,Fee Schedule,103% of WA Medicaid,1.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,10.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,59.42,69,,,percent of total billed charges,69% of total billed charges,86.11,100,,,percent of total billed charges,100% of total billed charges,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.11,100,,,percent of total billed charges,100% of total billed charges,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.11,100,,,percent of total billed charges,100% of total billed charges,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.26,61.85,,,percent of total billed charges,61.85% of total billed charges,10.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.82,130,,,Fee Schedule,130% of WA Medicaid ,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.46,37.7,,,percent of total billed charges,37.70% of total billed charges,32.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2919.13,33.9,,,percent of total billed charges,33.9% of total billed charges,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.17,78,,,percent of total billed charges,78% of total billed charges,86.11,100,,,percent of total billed charges,100% of total billed charges,71.13,82.6,,,percent of total billed charges,82.6% of total billed charges,71.13,82.6,,,percent of total billed charges,82.6% of total billed charges,10.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.34,2919.13,
STRAPPING OF HAND OR FINGER,29280,CDM,983,RC,29280,HCPCS,Outpatient,,,81,52.65,,71.28,88,,,percent of total billed charges,88% of total Billed charges,1.9,100,,,Fee Schedule,100% of Medicare rate,11.38,100,,,Fee Schedule,100% of WA Medicaid,81,100,,,percent of total billed charges,100% of total billed charges,11.72,103,,,Fee Schedule,103% of WA Medicaid,1.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,81,100,,,percent of total billed charges,100% of total billed charges,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,81,100,,,percent of total billed charges,100% of total billed charges,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.1,61.85,,,percent of total billed charges,61.85% of total billed charges,11.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.79,130,,,Fee Schedule,130% of WA Medicaid ,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2745.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,11.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.9,2745.9,
29305 Application of Hip Cast,29305,CDM,983,RC,29305,HCPCS,Outpatient,,,980,637.00,,862.4,88,,,percent of total billed charges,88% of total Billed charges,15.44,100,,,Fee Schedule,100% of Medicare rate,91.39,100,,,Fee Schedule,100% of WA Medicaid,980,100,,,percent of total billed charges,100% of total billed charges,94.13,103,,,Fee Schedule,103% of WA Medicaid,15.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,91.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,676.2,69,,,percent of total billed charges,69% of total billed charges,980,100,,,percent of total billed charges,100% of total billed charges,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,980,100,,,percent of total billed charges,100% of total billed charges,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,980,100,,,percent of total billed charges,100% of total billed charges,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.13,61.85,,,percent of total billed charges,61.85% of total billed charges,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,118.81,130,,,Fee Schedule,130% of WA Medicaid ,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.46,37.7,,,percent of total billed charges,37.70% of total billed charges,369.46,37.7,,,percent of total billed charges,37.70% of total billed charges,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,33222,33.9,,,percent of total billed charges,33.9% of total billed charges,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,764.4,78,,,percent of total billed charges,78% of total billed charges,980,100,,,percent of total billed charges,100% of total billed charges,809.48,82.6,,,percent of total billed charges,82.6% of total billed charges,809.48,82.6,,,percent of total billed charges,82.6% of total billed charges,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.44,33222,
APPLICATION OF HIP CASTS,29325,CDM,983,RC,29325,HCPCS,Outpatient,,,758,492.70,,667.04,88,,,percent of total billed charges,88% of total Billed charges,17.56,100,,,Fee Schedule,100% of Medicare rate,102.2,100,,,Fee Schedule,100% of WA Medicaid,758,100,,,percent of total billed charges,100% of total billed charges,105.27,103,,,Fee Schedule,103% of WA Medicaid,17.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,523.02,69,,,percent of total billed charges,69% of total billed charges,758,100,,,percent of total billed charges,100% of total billed charges,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,758,100,,,percent of total billed charges,100% of total billed charges,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,758,100,,,percent of total billed charges,100% of total billed charges,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.82,61.85,,,percent of total billed charges,61.85% of total billed charges,102.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.86,130,,,Fee Schedule,130% of WA Medicaid ,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.77,37.7,,,percent of total billed charges,37.70% of total billed charges,285.77,37.7,,,percent of total billed charges,37.70% of total billed charges,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,25696.2,33.9,,,percent of total billed charges,33.9% of total billed charges,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.24,78,,,percent of total billed charges,78% of total billed charges,758,100,,,percent of total billed charges,100% of total billed charges,626.11,82.6,,,percent of total billed charges,82.6% of total billed charges,626.11,82.6,,,percent of total billed charges,82.6% of total billed charges,102.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.56,25696.2,
APPLICATION OF LONG LEG CAST,29345,CDM,983,RC,29345,HCPCS,Outpatient,,,301,195.65,,264.88,88,,,percent of total billed charges,88% of total Billed charges,9.73,100,,,Fee Schedule,100% of Medicare rate,56.88,100,,,Fee Schedule,100% of WA Medicaid,301,100,,,percent of total billed charges,100% of total billed charges,58.59,103,,,Fee Schedule,103% of WA Medicaid,9.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,207.69,69,,,percent of total billed charges,69% of total billed charges,301,100,,,percent of total billed charges,100% of total billed charges,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,301,100,,,percent of total billed charges,100% of total billed charges,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,301,100,,,percent of total billed charges,100% of total billed charges,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.17,61.85,,,percent of total billed charges,61.85% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,73.94,130,,,Fee Schedule,130% of WA Medicaid ,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.48,37.7,,,percent of total billed charges,37.70% of total billed charges,113.48,37.7,,,percent of total billed charges,37.70% of total billed charges,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,10203.9,33.9,,,percent of total billed charges,33.9% of total billed charges,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.78,78,,,percent of total billed charges,78% of total billed charges,301,100,,,percent of total billed charges,100% of total billed charges,248.63,82.6,,,percent of total billed charges,82.6% of total billed charges,248.63,82.6,,,percent of total billed charges,82.6% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.73,10203.9,
APPLICATION OF LONG LEG CAST,29365,CDM,983,RC,29365,HCPCS,Outpatient,,,332,215.80,,292.16,88,,,percent of total billed charges,88% of total Billed charges,8.88,100,,,Fee Schedule,100% of Medicare rate,50.54,100,,,Fee Schedule,100% of WA Medicaid,332,100,,,percent of total billed charges,100% of total billed charges,52.06,103,,,Fee Schedule,103% of WA Medicaid,8.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,50.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,229.08,69,,,percent of total billed charges,69% of total billed charges,332,100,,,percent of total billed charges,100% of total billed charges,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,332,100,,,percent of total billed charges,100% of total billed charges,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,332,100,,,percent of total billed charges,100% of total billed charges,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.34,61.85,,,percent of total billed charges,61.85% of total billed charges,50.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,65.7,130,,,Fee Schedule,130% of WA Medicaid ,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.16,37.7,,,percent of total billed charges,37.70% of total billed charges,125.16,37.7,,,percent of total billed charges,37.70% of total billed charges,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,11254.8,33.9,,,percent of total billed charges,33.9% of total billed charges,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.96,78,,,percent of total billed charges,78% of total billed charges,332,100,,,percent of total billed charges,100% of total billed charges,274.23,82.6,,,percent of total billed charges,82.6% of total billed charges,274.23,82.6,,,percent of total billed charges,82.6% of total billed charges,50.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.88,11254.8,
APPLY SHORT LEG CAST,29405,CDM,983,RC,29405,HCPCS,Outpatient,,,222,144.30,,195.36,88,,,percent of total billed charges,88% of total Billed charges,5.15,100,,,Fee Schedule,100% of Medicare rate,33.94,100,,,Fee Schedule,100% of WA Medicaid,222,100,,,percent of total billed charges,100% of total billed charges,34.96,103,,,Fee Schedule,103% of WA Medicaid,5.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,153.18,69,,,percent of total billed charges,69% of total billed charges,222,100,,,percent of total billed charges,100% of total billed charges,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,222,100,,,percent of total billed charges,100% of total billed charges,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,222,100,,,percent of total billed charges,100% of total billed charges,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.31,61.85,,,percent of total billed charges,61.85% of total billed charges,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,44.12,130,,,Fee Schedule,130% of WA Medicaid ,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.69,37.7,,,percent of total billed charges,37.70% of total billed charges,83.69,37.7,,,percent of total billed charges,37.70% of total billed charges,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,7525.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.16,78,,,percent of total billed charges,78% of total billed charges,222,100,,,percent of total billed charges,100% of total billed charges,183.37,82.6,,,percent of total billed charges,82.6% of total billed charges,183.37,82.6,,,percent of total billed charges,82.6% of total billed charges,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.15,7525.8,
APPLICATION OF LEG CAST,29450,CDM,983,RC,29450,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,9.34,100,,,Fee Schedule,100% of Medicare rate,63.97,100,,,Fee Schedule,100% of WA Medicaid,195,100,,,percent of total billed charges,100% of total billed charges,65.89,103,,,Fee Schedule,103% of WA Medicaid,9.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,195,100,,,percent of total billed charges,100% of total billed charges,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,195,100,,,percent of total billed charges,100% of total billed charges,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,63.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,83.16,130,,,Fee Schedule,130% of WA Medicaid ,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,6610.5,33.9,,,percent of total billed charges,33.9% of total billed charges,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,63.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.34,6610.5,
APPLICATION LONG LEG SPLINT,29505,CDM,983,RC,29505,HCPCS,Outpatient,,,145.15,94.35,,127.73,88,,,percent of total billed charges,88% of total Billed charges,4.7,100,,,Fee Schedule,100% of Medicare rate,30.21,100,,,Fee Schedule,100% of WA Medicaid,145.15,100,,,percent of total billed charges,100% of total billed charges,31.12,103,,,Fee Schedule,103% of WA Medicaid,4.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,100.15,69,,,percent of total billed charges,69% of total billed charges,145.15,100,,,percent of total billed charges,100% of total billed charges,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.15,100,,,percent of total billed charges,100% of total billed charges,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.15,100,,,percent of total billed charges,100% of total billed charges,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.78,61.85,,,percent of total billed charges,61.85% of total billed charges,30.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,39.27,130,,,Fee Schedule,130% of WA Medicaid ,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.72,37.7,,,percent of total billed charges,37.70% of total billed charges,54.72,37.7,,,percent of total billed charges,37.70% of total billed charges,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,4920.59,33.9,,,percent of total billed charges,33.9% of total billed charges,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.22,78,,,percent of total billed charges,78% of total billed charges,145.15,100,,,percent of total billed charges,100% of total billed charges,119.89,82.6,,,percent of total billed charges,82.6% of total billed charges,119.89,82.6,,,percent of total billed charges,82.6% of total billed charges,30.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.7,4920.59,
APPLICATION LOWER LEG SPLINT,29515,CDM,983,RC,29515,HCPCS,Outpatient,,,124.76,81.09,,109.79,88,,,percent of total billed charges,88% of total Billed charges,4.36,100,,,Fee Schedule,100% of Medicare rate,28.72,100,,,Fee Schedule,100% of WA Medicaid,124.76,100,,,percent of total billed charges,100% of total billed charges,29.58,103,,,Fee Schedule,103% of WA Medicaid,4.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,86.08,69,,,percent of total billed charges,69% of total billed charges,124.76,100,,,percent of total billed charges,100% of total billed charges,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.76,100,,,percent of total billed charges,100% of total billed charges,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.76,100,,,percent of total billed charges,100% of total billed charges,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.16,61.85,,,percent of total billed charges,61.85% of total billed charges,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.34,130,,,Fee Schedule,130% of WA Medicaid ,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.03,37.7,,,percent of total billed charges,37.70% of total billed charges,47.03,37.7,,,percent of total billed charges,37.70% of total billed charges,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4229.36,33.9,,,percent of total billed charges,33.9% of total billed charges,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.31,78,,,percent of total billed charges,78% of total billed charges,124.76,100,,,percent of total billed charges,100% of total billed charges,103.05,82.6,,,percent of total billed charges,82.6% of total billed charges,103.05,82.6,,,percent of total billed charges,82.6% of total billed charges,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.36,4229.36,
STRAPPING OF ANKLE AND/OR FT,29540,CDM,983,RC,29540,HCPCS,Outpatient,,,66,42.90,,58.08,88,,,percent of total billed charges,88% of total Billed charges,1.29,100,,,Fee Schedule,100% of Medicare rate,9.7,100,,,Fee Schedule,100% of WA Medicaid,66,100,,,percent of total billed charges,100% of total billed charges,9.99,103,,,Fee Schedule,103% of WA Medicaid,1.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,45.54,69,,,percent of total billed charges,69% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,66,100,,,percent of total billed charges,100% of total billed charges,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,66,100,,,percent of total billed charges,100% of total billed charges,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.82,61.85,,,percent of total billed charges,61.85% of total billed charges,9.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.61,130,,,Fee Schedule,130% of WA Medicaid ,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,24.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2237.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.48,78,,,percent of total billed charges,78% of total billed charges,66,100,,,percent of total billed charges,100% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,54.52,82.6,,,percent of total billed charges,82.6% of total billed charges,9.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.29,2237.4,
STRAPPING OF TOES,29550,CDM,983,RC,29550,HCPCS,Outpatient,,,76,49.40,,66.88,88,,,percent of total billed charges,88% of total Billed charges,0.85,100,,,Fee Schedule,100% of Medicare rate,6.15,100,,,Fee Schedule,100% of WA Medicaid,76,100,,,percent of total billed charges,100% of total billed charges,6.33,103,,,Fee Schedule,103% of WA Medicaid,0.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,6.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,52.44,69,,,percent of total billed charges,69% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,76,100,,,percent of total billed charges,100% of total billed charges,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,76,100,,,percent of total billed charges,100% of total billed charges,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.01,61.85,,,percent of total billed charges,61.85% of total billed charges,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8,130,,,Fee Schedule,130% of WA Medicaid ,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.65,37.7,,,percent of total billed charges,37.70% of total billed charges,28.65,37.7,,,percent of total billed charges,37.70% of total billed charges,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.28,78,,,percent of total billed charges,78% of total billed charges,76,100,,,percent of total billed charges,100% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,62.78,82.6,,,percent of total billed charges,82.6% of total billed charges,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.85,2576.4,
APPLICATION OF PASTE BOOT,29580,CDM,983,RC,29580,HCPCS,Outpatient,,,109,70.85,,95.92,88,,,percent of total billed charges,88% of total Billed charges,2.59,100,,,Fee Schedule,100% of Medicare rate,14.55,100,,,Fee Schedule,100% of WA Medicaid,109,100,,,percent of total billed charges,100% of total billed charges,14.99,103,,,Fee Schedule,103% of WA Medicaid,2.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,14.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,75.21,69,,,percent of total billed charges,69% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,109,100,,,percent of total billed charges,100% of total billed charges,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,109,100,,,percent of total billed charges,100% of total billed charges,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.42,61.85,,,percent of total billed charges,61.85% of total billed charges,14.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.92,130,,,Fee Schedule,130% of WA Medicaid ,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3695.1,33.9,,,percent of total billed charges,33.9% of total billed charges,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.02,78,,,percent of total billed charges,78% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,14.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.59,3695.1,
APPLY MULTLAY COMPRS LWR LEG,29581,CDM,983,RC,29581,HCPCS,Outpatient,,,98,63.70,,86.24,88,,,percent of total billed charges,88% of total Billed charges,1.06,100,,,Fee Schedule,100% of Medicare rate,15.11,100,,,Fee Schedule,100% of WA Medicaid,98,100,,,percent of total billed charges,100% of total billed charges,15.56,103,,,Fee Schedule,103% of WA Medicaid,1.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,15.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,67.62,69,,,percent of total billed charges,69% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,98,100,,,percent of total billed charges,100% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,98,100,,,percent of total billed charges,100% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,61.85,,,percent of total billed charges,61.85% of total billed charges,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19.64,130,,,Fee Schedule,130% of WA Medicaid ,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,3322.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.44,78,,,percent of total billed charges,78% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.06,3322.2,
REMOVAL/REVISION OF CAST,29700,CDM,983,RC,29700,HCPCS,Outpatient,,,98,63.70,,86.24,88,,,percent of total billed charges,88% of total Billed charges,3.58,100,,,Fee Schedule,100% of Medicare rate,18.65,100,,,Fee Schedule,100% of WA Medicaid,98,100,,,percent of total billed charges,100% of total billed charges,19.21,103,,,Fee Schedule,103% of WA Medicaid,3.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,18.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,67.62,69,,,percent of total billed charges,69% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,98,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,98,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,61.85,,,percent of total billed charges,61.85% of total billed charges,18.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.25,130,,,Fee Schedule,130% of WA Medicaid ,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3322.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.44,78,,,percent of total billed charges,78% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,18.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.58,3322.2,
SHOULDER ARTHROSCOPY DX,29805,CDM,983,RC,29805,HCPCS,Outpatient,,,940,611.00,,827.2,88,,,percent of total billed charges,88% of total Billed charges,44.95,100,,,Fee Schedule,100% of Medicare rate,272.85,100,,,Fee Schedule,100% of WA Medicaid,940,100,,,percent of total billed charges,100% of total billed charges,281.04,103,,,Fee Schedule,103% of WA Medicaid,44.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,272.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,648.6,69,,,percent of total billed charges,69% of total billed charges,940,100,,,percent of total billed charges,100% of total billed charges,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,940,100,,,percent of total billed charges,100% of total billed charges,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,940,100,,,percent of total billed charges,100% of total billed charges,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,581.39,61.85,,,percent of total billed charges,61.85% of total billed charges,272.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,354.71,130,,,Fee Schedule,130% of WA Medicaid ,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.38,37.7,,,percent of total billed charges,37.70% of total billed charges,354.38,37.7,,,percent of total billed charges,37.70% of total billed charges,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,31866,33.9,,,percent of total billed charges,33.9% of total billed charges,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,733.2,78,,,percent of total billed charges,78% of total billed charges,940,100,,,percent of total billed charges,100% of total billed charges,776.44,82.6,,,percent of total billed charges,82.6% of total billed charges,776.44,82.6,,,percent of total billed charges,82.6% of total billed charges,272.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.95,31866,
SHOULDER ARTHROSCOPY/SURGERY,29807,CDM,983,RC,29807,HCPCS,Outpatient,,,2633,1711.45,,2317.04,88,,,percent of total billed charges,88% of total Billed charges,107.31,100,,,Fee Schedule,100% of Medicare rate,594.94,100,,,Fee Schedule,100% of WA Medicaid,2633,100,,,percent of total billed charges,100% of total billed charges,612.79,103,,,Fee Schedule,103% of WA Medicaid,107.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,187.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,594.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1816.77,69,,,percent of total billed charges,69% of total billed charges,2633,100,,,percent of total billed charges,100% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2633,100,,,percent of total billed charges,100% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2633,100,,,percent of total billed charges,100% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1628.51,61.85,,,percent of total billed charges,61.85% of total billed charges,594.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,773.42,130,,,Fee Schedule,130% of WA Medicaid ,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,992.64,37.7,,,percent of total billed charges,37.70% of total billed charges,992.64,37.7,,,percent of total billed charges,37.70% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,89258.7,33.9,,,percent of total billed charges,33.9% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2053.74,78,,,percent of total billed charges,78% of total billed charges,2633,100,,,percent of total billed charges,100% of total billed charges,2174.86,82.6,,,percent of total billed charges,82.6% of total billed charges,2174.86,82.6,,,percent of total billed charges,82.6% of total billed charges,594.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.31,89258.7,
SHOULDER ARTHROSCOPY/SURGERY,29806,CDM,983,RC,29806,HCPCS,Outpatient,,,2843,1847.95,,2501.84,88,,,percent of total billed charges,88% of total Billed charges,110.38,100,,,Fee Schedule,100% of Medicare rate,608.92,100,,,Fee Schedule,100% of WA Medicaid,2843,100,,,percent of total billed charges,100% of total billed charges,627.19,103,,,Fee Schedule,103% of WA Medicaid,110.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,608.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1961.67,69,,,percent of total billed charges,69% of total billed charges,2843,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2843,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2843,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1758.4,61.85,,,percent of total billed charges,61.85% of total billed charges,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,791.6,130,,,Fee Schedule,130% of WA Medicaid ,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1071.81,37.7,,,percent of total billed charges,37.70% of total billed charges,1071.81,37.7,,,percent of total billed charges,37.70% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,96377.7,33.9,,,percent of total billed charges,33.9% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2217.54,78,,,percent of total billed charges,78% of total billed charges,2843,100,,,percent of total billed charges,100% of total billed charges,2348.32,82.6,,,percent of total billed charges,82.6% of total billed charges,2348.32,82.6,,,percent of total billed charges,82.6% of total billed charges,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.38,96377.7,
SHOULDER ARTHROSCOPY/SURGERY,29819,CDM,983,RC,29819,HCPCS,Outpatient,,,2140,1391.00,,1883.2,88,,,percent of total billed charges,88% of total Billed charges,57.89,100,,,Fee Schedule,100% of Medicare rate,341.48,100,,,Fee Schedule,100% of WA Medicaid,2140,100,,,percent of total billed charges,100% of total billed charges,351.72,103,,,Fee Schedule,103% of WA Medicaid,57.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,341.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1476.6,69,,,percent of total billed charges,69% of total billed charges,2140,100,,,percent of total billed charges,100% of total billed charges,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2140,100,,,percent of total billed charges,100% of total billed charges,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2140,100,,,percent of total billed charges,100% of total billed charges,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323.59,61.85,,,percent of total billed charges,61.85% of total billed charges,341.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,443.92,130,,,Fee Schedule,130% of WA Medicaid ,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.78,37.7,,,percent of total billed charges,37.70% of total billed charges,806.78,37.7,,,percent of total billed charges,37.70% of total billed charges,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,72546,33.9,,,percent of total billed charges,33.9% of total billed charges,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1669.2,78,,,percent of total billed charges,78% of total billed charges,2140,100,,,percent of total billed charges,100% of total billed charges,1767.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1767.64,82.6,,,percent of total billed charges,82.6% of total billed charges,341.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.89,72546,
SHOULDER ARTHROSCOPY/SURGERY,29826,CDM,983,RC,29826,HCPCS,Outpatient,,,694,451.10,,610.72,88,,,percent of total billed charges,88% of total Billed charges,20.11,100,,,Fee Schedule,100% of Medicare rate,95.67,100,,,Fee Schedule,100% of WA Medicaid,694,100,,,percent of total billed charges,100% of total billed charges,98.54,103,,,Fee Schedule,103% of WA Medicaid,20.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,95.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,478.86,69,,,percent of total billed charges,69% of total billed charges,694,100,,,percent of total billed charges,100% of total billed charges,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,694,100,,,percent of total billed charges,100% of total billed charges,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,694,100,,,percent of total billed charges,100% of total billed charges,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.24,61.85,,,percent of total billed charges,61.85% of total billed charges,95.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,124.37,130,,,Fee Schedule,130% of WA Medicaid ,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.64,37.7,,,percent of total billed charges,37.70% of total billed charges,261.64,37.7,,,percent of total billed charges,37.70% of total billed charges,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,23526.6,33.9,,,percent of total billed charges,33.9% of total billed charges,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.32,78,,,percent of total billed charges,78% of total billed charges,694,100,,,percent of total billed charges,100% of total billed charges,573.24,82.6,,,percent of total billed charges,82.6% of total billed charges,573.24,82.6,,,percent of total billed charges,82.6% of total billed charges,95.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.11,23526.6,
SHOULDER ARTHROSCOPY/SURGERY,29824,CDM,983,RC,29824,HCPCS,Outpatient,,,1495,971.75,,1315.6,88,,,percent of total billed charges,88% of total Billed charges,66.59,100,,,Fee Schedule,100% of Medicare rate,393.33,100,,,Fee Schedule,100% of WA Medicaid,1495,100,,,percent of total billed charges,100% of total billed charges,405.13,103,,,Fee Schedule,103% of WA Medicaid,66.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,116.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,393.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1031.55,69,,,percent of total billed charges,69% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1495,100,,,percent of total billed charges,100% of total billed charges,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1495,100,,,percent of total billed charges,100% of total billed charges,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,924.66,61.85,,,percent of total billed charges,61.85% of total billed charges,393.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,511.33,130,,,Fee Schedule,130% of WA Medicaid ,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,563.62,37.7,,,percent of total billed charges,37.70% of total billed charges,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,50680.5,33.9,,,percent of total billed charges,33.9% of total billed charges,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1166.1,78,,,percent of total billed charges,78% of total billed charges,1495,100,,,percent of total billed charges,100% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1234.87,82.6,,,percent of total billed charges,82.6% of total billed charges,393.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,66.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.59,50680.5,
SHOULDER ARTHROSCOPY/SURGERY,29825,CDM,983,RC,29825,HCPCS,Outpatient,,,2232,1450.80,,1964.16,88,,,percent of total billed charges,88% of total Billed charges,57.33,100,,,Fee Schedule,100% of Medicare rate,340.74,100,,,Fee Schedule,100% of WA Medicaid,2232,100,,,percent of total billed charges,100% of total billed charges,350.96,103,,,Fee Schedule,103% of WA Medicaid,57.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,340.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1540.08,69,,,percent of total billed charges,69% of total billed charges,2232,100,,,percent of total billed charges,100% of total billed charges,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2232,100,,,percent of total billed charges,100% of total billed charges,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2232,100,,,percent of total billed charges,100% of total billed charges,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1380.49,61.85,,,percent of total billed charges,61.85% of total billed charges,340.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,347.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,442.96,130,,,Fee Schedule,130% of WA Medicaid ,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.46,37.7,,,percent of total billed charges,37.70% of total billed charges,841.46,37.7,,,percent of total billed charges,37.70% of total billed charges,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,75664.8,33.9,,,percent of total billed charges,33.9% of total billed charges,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1740.96,78,,,percent of total billed charges,78% of total billed charges,2232,100,,,percent of total billed charges,100% of total billed charges,1843.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1843.63,82.6,,,percent of total billed charges,82.6% of total billed charges,340.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.33,75664.8,
ARTHROSCOP ROTATOR CUFF REPR,29827,CDM,983,RC,29827,HCPCS,Outpatient,,,2652,1723.80,,2333.76,88,,,percent of total billed charges,88% of total Billed charges,111.9,100,,,Fee Schedule,100% of Medicare rate,612.84,100,,,Fee Schedule,100% of WA Medicaid,2652,100,,,percent of total billed charges,100% of total billed charges,631.23,103,,,Fee Schedule,103% of WA Medicaid,111.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,195.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,612.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1829.88,69,,,percent of total billed charges,69% of total billed charges,2652,100,,,percent of total billed charges,100% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2652,100,,,percent of total billed charges,100% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2652,100,,,percent of total billed charges,100% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1640.26,61.85,,,percent of total billed charges,61.85% of total billed charges,612.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,796.69,130,,,Fee Schedule,130% of WA Medicaid ,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,999.8,37.7,,,percent of total billed charges,37.70% of total billed charges,999.8,37.7,,,percent of total billed charges,37.70% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,89902.8,33.9,,,percent of total billed charges,33.9% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2068.56,78,,,percent of total billed charges,78% of total billed charges,2652,100,,,percent of total billed charges,100% of total billed charges,2190.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2190.55,82.6,,,percent of total billed charges,82.6% of total billed charges,612.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.9,89902.8,
SHOULDER ARTHROSCOPY/SURGERY,29823,CDM,983,RC,29823,HCPCS,Outpatient,,,1368,889.20,,1203.84,88,,,percent of total billed charges,88% of total Billed charges,58.83,100,,,Fee Schedule,100% of Medicare rate,344.47,100,,,Fee Schedule,100% of WA Medicaid,1368,100,,,percent of total billed charges,100% of total billed charges,354.8,103,,,Fee Schedule,103% of WA Medicaid,58.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,344.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,943.92,69,,,percent of total billed charges,69% of total billed charges,1368,100,,,percent of total billed charges,100% of total billed charges,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368,100,,,percent of total billed charges,100% of total billed charges,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368,100,,,percent of total billed charges,100% of total billed charges,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.11,61.85,,,percent of total billed charges,61.85% of total billed charges,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,447.81,130,,,Fee Schedule,130% of WA Medicaid ,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.74,37.7,,,percent of total billed charges,37.70% of total billed charges,515.74,37.7,,,percent of total billed charges,37.70% of total billed charges,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,46375.2,33.9,,,percent of total billed charges,33.9% of total billed charges,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067.04,78,,,percent of total billed charges,78% of total billed charges,1368,100,,,percent of total billed charges,100% of total billed charges,1129.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1129.97,82.6,,,percent of total billed charges,82.6% of total billed charges,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.83,46375.2,
SHOULDER ARTHROSCOPY/SURGERY,29820,CDM,983,RC,29820,HCPCS,Outpatient,,,1913,1243.45,,1683.44,88,,,percent of total billed charges,88% of total Billed charges,52.35,100,,,Fee Schedule,100% of Medicare rate,309.96,100,,,Fee Schedule,100% of WA Medicaid,1913,100,,,percent of total billed charges,100% of total billed charges,319.26,103,,,Fee Schedule,103% of WA Medicaid,52.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,91.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,309.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1319.97,69,,,percent of total billed charges,69% of total billed charges,1913,100,,,percent of total billed charges,100% of total billed charges,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1913,100,,,percent of total billed charges,100% of total billed charges,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1913,100,,,percent of total billed charges,100% of total billed charges,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1183.19,61.85,,,percent of total billed charges,61.85% of total billed charges,309.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,402.95,130,,,Fee Schedule,130% of WA Medicaid ,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,721.2,37.7,,,percent of total billed charges,37.70% of total billed charges,721.2,37.7,,,percent of total billed charges,37.70% of total billed charges,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,64850.7,33.9,,,percent of total billed charges,33.9% of total billed charges,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1492.14,78,,,percent of total billed charges,78% of total billed charges,1913,100,,,percent of total billed charges,100% of total billed charges,1580.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1580.14,82.6,,,percent of total billed charges,82.6% of total billed charges,309.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.35,64850.7,
SHOULDER ARTHROSCOPY/SURGERY,29822,CDM,983,RC,29822,HCPCS,Outpatient,,,2140,1391.00,,1883.2,88,,,percent of total billed charges,88% of total Billed charges,52.89,100,,,Fee Schedule,100% of Medicare rate,315.56,100,,,Fee Schedule,100% of WA Medicaid,2140,100,,,percent of total billed charges,100% of total billed charges,325.03,103,,,Fee Schedule,103% of WA Medicaid,52.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,315.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1476.6,69,,,percent of total billed charges,69% of total billed charges,2140,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2140,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2140,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323.59,61.85,,,percent of total billed charges,61.85% of total billed charges,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,410.23,130,,,Fee Schedule,130% of WA Medicaid ,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.78,37.7,,,percent of total billed charges,37.70% of total billed charges,806.78,37.7,,,percent of total billed charges,37.70% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,72546,33.9,,,percent of total billed charges,33.9% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1669.2,78,,,percent of total billed charges,78% of total billed charges,2140,100,,,percent of total billed charges,100% of total billed charges,1767.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1767.64,82.6,,,percent of total billed charges,82.6% of total billed charges,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.89,72546,
ARTHROSCOPY BICEPS TENODESIS,29828,CDM,983,RC,29828,HCPCS,Outpatient,,,2893,1880.45,,2545.84,88,,,percent of total billed charges,88% of total Billed charges,94.92,100,,,Fee Schedule,100% of Medicare rate,527.05,100,,,Fee Schedule,100% of WA Medicaid,2893,100,,,percent of total billed charges,100% of total billed charges,542.86,103,,,Fee Schedule,103% of WA Medicaid,94.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,166.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,527.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1996.17,69,,,percent of total billed charges,69% of total billed charges,2893,100,,,percent of total billed charges,100% of total billed charges,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2893,100,,,percent of total billed charges,100% of total billed charges,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2893,100,,,percent of total billed charges,100% of total billed charges,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1789.32,61.85,,,percent of total billed charges,61.85% of total billed charges,527.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,685.17,130,,,Fee Schedule,130% of WA Medicaid ,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1090.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1090.66,37.7,,,percent of total billed charges,37.70% of total billed charges,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,98072.7,33.9,,,percent of total billed charges,33.9% of total billed charges,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2256.54,78,,,percent of total billed charges,78% of total billed charges,2893,100,,,percent of total billed charges,100% of total billed charges,2389.62,82.6,,,percent of total billed charges,82.6% of total billed charges,2389.62,82.6,,,percent of total billed charges,82.6% of total billed charges,527.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,94.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.92,98072.7,
WRIST ENDOSCOPY/SURGERY,29848,CDM,983,RC,29848,HCPCS,Outpatient,,,1371,891.15,,1206.48,88,,,percent of total billed charges,88% of total Billed charges,47.69,100,,,Fee Schedule,100% of Medicare rate,300.82,100,,,Fee Schedule,100% of WA Medicaid,1371,100,,,percent of total billed charges,100% of total billed charges,309.84,103,,,Fee Schedule,103% of WA Medicaid,47.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,300.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,945.99,69,,,percent of total billed charges,69% of total billed charges,1371,100,,,percent of total billed charges,100% of total billed charges,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1371,100,,,percent of total billed charges,100% of total billed charges,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1371,100,,,percent of total billed charges,100% of total billed charges,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.96,61.85,,,percent of total billed charges,61.85% of total billed charges,300.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,391.07,130,,,Fee Schedule,130% of WA Medicaid ,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.87,37.7,,,percent of total billed charges,37.70% of total billed charges,516.87,37.7,,,percent of total billed charges,37.70% of total billed charges,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,46476.9,33.9,,,percent of total billed charges,33.9% of total billed charges,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1069.38,78,,,percent of total billed charges,78% of total billed charges,1371,100,,,percent of total billed charges,100% of total billed charges,1132.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1132.45,82.6,,,percent of total billed charges,82.6% of total billed charges,300.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.69,46476.9,
KNEE ARTHROSCOPY/SURGERY,29851,CDM,983,RC,29851,HCPCS,Outpatient,,,2686,1745.90,,2363.68,88,,,percent of total billed charges,88% of total Billed charges,98.96,100,,,Fee Schedule,100% of Medicare rate,534.7,100,,,Fee Schedule,100% of WA Medicaid,2686,100,,,percent of total billed charges,100% of total billed charges,550.74,103,,,Fee Schedule,103% of WA Medicaid,98.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,534.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1853.34,69,,,percent of total billed charges,69% of total billed charges,2686,100,,,percent of total billed charges,100% of total billed charges,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2686,100,,,percent of total billed charges,100% of total billed charges,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2686,100,,,percent of total billed charges,100% of total billed charges,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1661.29,61.85,,,percent of total billed charges,61.85% of total billed charges,534.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,695.11,130,,,Fee Schedule,130% of WA Medicaid ,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1012.62,37.7,,,percent of total billed charges,37.70% of total billed charges,1012.62,37.7,,,percent of total billed charges,37.70% of total billed charges,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,91055.4,33.9,,,percent of total billed charges,33.9% of total billed charges,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2095.08,78,,,percent of total billed charges,78% of total billed charges,2686,100,,,percent of total billed charges,100% of total billed charges,2218.64,82.6,,,percent of total billed charges,82.6% of total billed charges,2218.64,82.6,,,percent of total billed charges,82.6% of total billed charges,534.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.96,91055.4,
HIP ARTHR0 W/DEBRIDEMENT,29862,CDM,983,RC,29862,HCPCS,Outpatient,,,1989,1292.85,,1750.32,88,,,percent of total billed charges,88% of total Billed charges,82.38,100,,,Fee Schedule,100% of Medicare rate,471.47,100,,,Fee Schedule,100% of WA Medicaid,1989,100,,,percent of total billed charges,100% of total billed charges,485.61,103,,,Fee Schedule,103% of WA Medicaid,82.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,144.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,471.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1372.41,69,,,percent of total billed charges,69% of total billed charges,1989,100,,,percent of total billed charges,100% of total billed charges,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1989,100,,,percent of total billed charges,100% of total billed charges,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1989,100,,,percent of total billed charges,100% of total billed charges,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1230.2,61.85,,,percent of total billed charges,61.85% of total billed charges,471.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,612.91,130,,,Fee Schedule,130% of WA Medicaid ,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,749.85,37.7,,,percent of total billed charges,37.70% of total billed charges,749.85,37.7,,,percent of total billed charges,37.70% of total billed charges,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,67427.1,33.9,,,percent of total billed charges,33.9% of total billed charges,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1551.42,78,,,percent of total billed charges,78% of total billed charges,1989,100,,,percent of total billed charges,100% of total billed charges,1642.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1642.91,82.6,,,percent of total billed charges,82.6% of total billed charges,471.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.38,67427.1,
AUTGRFT IMPLNT KNEE W/SCOPE,29866,CDM,983,RC,29866,HCPCS,Outpatient,,,2544,1653.60,,2238.72,88,,,percent of total billed charges,88% of total Billed charges,110.24,100,,,Fee Schedule,100% of Medicare rate,606.5,100,,,Fee Schedule,100% of WA Medicaid,2544,100,,,percent of total billed charges,100% of total billed charges,624.7,103,,,Fee Schedule,103% of WA Medicaid,110.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,192.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,606.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1755.36,69,,,percent of total billed charges,69% of total billed charges,2544,100,,,percent of total billed charges,100% of total billed charges,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2544,100,,,percent of total billed charges,100% of total billed charges,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2544,100,,,percent of total billed charges,100% of total billed charges,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1573.46,61.85,,,percent of total billed charges,61.85% of total billed charges,606.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,788.45,130,,,Fee Schedule,130% of WA Medicaid ,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,959.09,37.7,,,percent of total billed charges,37.70% of total billed charges,959.09,37.7,,,percent of total billed charges,37.70% of total billed charges,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,86241.6,33.9,,,percent of total billed charges,33.9% of total billed charges,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1984.32,78,,,percent of total billed charges,78% of total billed charges,2544,100,,,percent of total billed charges,100% of total billed charges,2101.34,82.6,,,percent of total billed charges,82.6% of total billed charges,2101.34,82.6,,,percent of total billed charges,82.6% of total billed charges,606.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.24,86241.6,
KNEE ARTHROSCOPY/SURGERY,29879,CDM,983,RC,29879,HCPCS,Outpatient,,,2613,1698.45,,2299.44,88,,,percent of total billed charges,88% of total Billed charges,67.13,100,,,Fee Schedule,100% of Medicare rate,383.63,100,,,Fee Schedule,100% of WA Medicaid,2613,100,,,percent of total billed charges,100% of total billed charges,395.14,103,,,Fee Schedule,103% of WA Medicaid,67.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,117.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,383.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1802.97,69,,,percent of total billed charges,69% of total billed charges,2613,100,,,percent of total billed charges,100% of total billed charges,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2613,100,,,percent of total billed charges,100% of total billed charges,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2613,100,,,percent of total billed charges,100% of total billed charges,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1616.14,61.85,,,percent of total billed charges,61.85% of total billed charges,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,498.72,130,,,Fee Schedule,130% of WA Medicaid ,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,985.1,37.7,,,percent of total billed charges,37.70% of total billed charges,985.1,37.7,,,percent of total billed charges,37.70% of total billed charges,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,88580.7,33.9,,,percent of total billed charges,33.9% of total billed charges,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2038.14,78,,,percent of total billed charges,78% of total billed charges,2613,100,,,percent of total billed charges,100% of total billed charges,2158.34,82.6,,,percent of total billed charges,82.6% of total billed charges,2158.34,82.6,,,percent of total billed charges,82.6% of total billed charges,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.13,88580.7,
KNEE ARTHROSCOPY/SURGERY,29877,CDM,983,RC,29877,HCPCS,Outpatient,,,2347,1525.55,,2065.36,88,,,percent of total billed charges,88% of total Billed charges,62.02,100,,,Fee Schedule,100% of Medicare rate,360.69,100,,,Fee Schedule,100% of WA Medicaid,2347,100,,,percent of total billed charges,100% of total billed charges,371.51,103,,,Fee Schedule,103% of WA Medicaid,62.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,360.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1619.43,69,,,percent of total billed charges,69% of total billed charges,2347,100,,,percent of total billed charges,100% of total billed charges,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2347,100,,,percent of total billed charges,100% of total billed charges,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2347,100,,,percent of total billed charges,100% of total billed charges,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1451.62,61.85,,,percent of total billed charges,61.85% of total billed charges,360.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,468.9,130,,,Fee Schedule,130% of WA Medicaid ,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,884.82,37.7,,,percent of total billed charges,37.70% of total billed charges,884.82,37.7,,,percent of total billed charges,37.70% of total billed charges,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,79563.3,33.9,,,percent of total billed charges,33.9% of total billed charges,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1830.66,78,,,percent of total billed charges,78% of total billed charges,2347,100,,,percent of total billed charges,100% of total billed charges,1938.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1938.62,82.6,,,percent of total billed charges,82.6% of total billed charges,360.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.02,79563.3,
KNEE ARTHROSCOPY DX,29870,CDM,983,RC,29870,HCPCS,Outpatient,,,1072,696.80,,943.36,88,,,percent of total billed charges,88% of total Billed charges,39.33,100,,,Fee Schedule,100% of Medicare rate,240.21,100,,,Fee Schedule,100% of WA Medicaid,1072,100,,,percent of total billed charges,100% of total billed charges,247.42,103,,,Fee Schedule,103% of WA Medicaid,39.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,240.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,739.68,69,,,percent of total billed charges,69% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1072,100,,,percent of total billed charges,100% of total billed charges,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1072,100,,,percent of total billed charges,100% of total billed charges,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.03,61.85,,,percent of total billed charges,61.85% of total billed charges,240.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,312.27,130,,,Fee Schedule,130% of WA Medicaid ,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,404.14,37.7,,,percent of total billed charges,37.70% of total billed charges,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,36340.8,33.9,,,percent of total billed charges,33.9% of total billed charges,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,836.16,78,,,percent of total billed charges,78% of total billed charges,1072,100,,,percent of total billed charges,100% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,885.47,82.6,,,percent of total billed charges,82.6% of total billed charges,240.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.33,36340.8,
KNEE ARTHROSCOPY/SURGERY,29875,CDM,983,RC,29875,HCPCS,Outpatient,,,2140,1391.00,,1883.2,88,,,percent of total billed charges,88% of total Billed charges,48.94,100,,,Fee Schedule,100% of Medicare rate,289.63,100,,,Fee Schedule,100% of WA Medicaid,2140,100,,,percent of total billed charges,100% of total billed charges,298.32,103,,,Fee Schedule,103% of WA Medicaid,48.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,289.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1476.6,69,,,percent of total billed charges,69% of total billed charges,2140,100,,,percent of total billed charges,100% of total billed charges,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2140,100,,,percent of total billed charges,100% of total billed charges,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2140,100,,,percent of total billed charges,100% of total billed charges,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323.59,61.85,,,percent of total billed charges,61.85% of total billed charges,289.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,376.52,130,,,Fee Schedule,130% of WA Medicaid ,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.78,37.7,,,percent of total billed charges,37.70% of total billed charges,806.78,37.7,,,percent of total billed charges,37.70% of total billed charges,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,72546,33.9,,,percent of total billed charges,33.9% of total billed charges,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1669.2,78,,,percent of total billed charges,78% of total billed charges,2140,100,,,percent of total billed charges,100% of total billed charges,1767.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1767.64,82.6,,,percent of total billed charges,82.6% of total billed charges,289.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.94,72546,
KNEE ARTHROSCOPY/SURGERY,29876,CDM,983,RC,29876,HCPCS,Outpatient,,,2608,1695.20,,2295.04,88,,,percent of total billed charges,88% of total Billed charges,65.82,100,,,Fee Schedule,100% of Medicare rate,378.6,100,,,Fee Schedule,100% of WA Medicaid,2608,100,,,percent of total billed charges,100% of total billed charges,389.96,103,,,Fee Schedule,103% of WA Medicaid,65.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,115.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,378.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1799.52,69,,,percent of total billed charges,69% of total billed charges,2608,100,,,percent of total billed charges,100% of total billed charges,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2608,100,,,percent of total billed charges,100% of total billed charges,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2608,100,,,percent of total billed charges,100% of total billed charges,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1613.05,61.85,,,percent of total billed charges,61.85% of total billed charges,378.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,492.18,130,,,Fee Schedule,130% of WA Medicaid ,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,983.22,37.7,,,percent of total billed charges,37.70% of total billed charges,983.22,37.7,,,percent of total billed charges,37.70% of total billed charges,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,88411.2,33.9,,,percent of total billed charges,33.9% of total billed charges,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2034.24,78,,,percent of total billed charges,78% of total billed charges,2608,100,,,percent of total billed charges,100% of total billed charges,2154.21,82.6,,,percent of total billed charges,82.6% of total billed charges,2154.21,82.6,,,percent of total billed charges,82.6% of total billed charges,378.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.82,88411.2,
KNEE ARTHROSCOPY/SURGERY,29874,CDM,983,RC,29874,HCPCS,Outpatient,,,1950,1267.50,,1716,88,,,percent of total billed charges,88% of total Billed charges,54.07,100,,,Fee Schedule,100% of Medicare rate,313.13,100,,,Fee Schedule,100% of WA Medicaid,1950,100,,,percent of total billed charges,100% of total billed charges,322.52,103,,,Fee Schedule,103% of WA Medicaid,54.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,313.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1345.5,69,,,percent of total billed charges,69% of total billed charges,1950,100,,,percent of total billed charges,100% of total billed charges,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1950,100,,,percent of total billed charges,100% of total billed charges,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1950,100,,,percent of total billed charges,100% of total billed charges,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1206.08,61.85,,,percent of total billed charges,61.85% of total billed charges,313.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,407.07,130,,,Fee Schedule,130% of WA Medicaid ,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,735.15,37.7,,,percent of total billed charges,37.70% of total billed charges,735.15,37.7,,,percent of total billed charges,37.70% of total billed charges,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,66105,33.9,,,percent of total billed charges,33.9% of total billed charges,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1521,78,,,percent of total billed charges,78% of total billed charges,1950,100,,,percent of total billed charges,100% of total billed charges,1610.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1610.7,82.6,,,percent of total billed charges,82.6% of total billed charges,313.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.07,66105,
KNEE ARTHROSCOPY/DRAINAGE,29871,CDM,983,RC,29871,HCPCS,Outpatient,,,1559,1013.35,,1371.92,88,,,percent of total billed charges,88% of total Billed charges,50.81,100,,,Fee Schedule,100% of Medicare rate,300.64,100,,,Fee Schedule,100% of WA Medicaid,1559,100,,,percent of total billed charges,100% of total billed charges,309.66,103,,,Fee Schedule,103% of WA Medicaid,50.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,88.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,300.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1075.71,69,,,percent of total billed charges,69% of total billed charges,1559,100,,,percent of total billed charges,100% of total billed charges,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559,100,,,percent of total billed charges,100% of total billed charges,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559,100,,,percent of total billed charges,100% of total billed charges,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,964.24,61.85,,,percent of total billed charges,61.85% of total billed charges,300.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,390.83,130,,,Fee Schedule,130% of WA Medicaid ,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,587.74,37.7,,,percent of total billed charges,37.70% of total billed charges,587.74,37.7,,,percent of total billed charges,37.70% of total billed charges,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,52850.1,33.9,,,percent of total billed charges,33.9% of total billed charges,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1216.02,78,,,percent of total billed charges,78% of total billed charges,1559,100,,,percent of total billed charges,100% of total billed charges,1287.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1287.73,82.6,,,percent of total billed charges,82.6% of total billed charges,300.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.81,52850.1,
KNEE ARTHROSCOPY/SURGERY,29873,CDM,983,RC,29873,HCPCS,Outpatient,,,1293,840.45,,1137.84,88,,,percent of total billed charges,88% of total Billed charges,49.26,100,,,Fee Schedule,100% of Medicare rate,316.12,100,,,Fee Schedule,100% of WA Medicaid,1293,100,,,percent of total billed charges,100% of total billed charges,325.6,103,,,Fee Schedule,103% of WA Medicaid,49.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,316.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,892.17,69,,,percent of total billed charges,69% of total billed charges,1293,100,,,percent of total billed charges,100% of total billed charges,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1293,100,,,percent of total billed charges,100% of total billed charges,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1293,100,,,percent of total billed charges,100% of total billed charges,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.72,61.85,,,percent of total billed charges,61.85% of total billed charges,316.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,410.96,130,,,Fee Schedule,130% of WA Medicaid ,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.46,37.7,,,percent of total billed charges,37.70% of total billed charges,487.46,37.7,,,percent of total billed charges,37.70% of total billed charges,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,43832.7,33.9,,,percent of total billed charges,33.9% of total billed charges,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008.54,78,,,percent of total billed charges,78% of total billed charges,1293,100,,,percent of total billed charges,100% of total billed charges,1068.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1068.02,82.6,,,percent of total billed charges,82.6% of total billed charges,316.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.26,43832.7,
KNEE ARTHROSCOPY/SURGERY,29880,CDM,983,RC,29880,HCPCS,Outpatient,,,2362,1535.30,,2078.56,88,,,percent of total billed charges,88% of total Billed charges,55.58,100,,,Fee Schedule,100% of Medicare rate,327.12,100,,,Fee Schedule,100% of WA Medicaid,2362,100,,,percent of total billed charges,100% of total billed charges,336.93,103,,,Fee Schedule,103% of WA Medicaid,55.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,327.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1629.78,69,,,percent of total billed charges,69% of total billed charges,2362,100,,,percent of total billed charges,100% of total billed charges,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2362,100,,,percent of total billed charges,100% of total billed charges,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2362,100,,,percent of total billed charges,100% of total billed charges,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1460.9,61.85,,,percent of total billed charges,61.85% of total billed charges,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,425.26,130,,,Fee Schedule,130% of WA Medicaid ,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,890.47,37.7,,,percent of total billed charges,37.70% of total billed charges,890.47,37.7,,,percent of total billed charges,37.70% of total billed charges,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,80071.8,33.9,,,percent of total billed charges,33.9% of total billed charges,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1842.36,78,,,percent of total billed charges,78% of total billed charges,2362,100,,,percent of total billed charges,100% of total billed charges,1951.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1951.01,82.6,,,percent of total billed charges,82.6% of total billed charges,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.58,80071.8,
KNEE ARTHROSCOPY/SURGERY,29881,CDM,983,RC,29881,HCPCS,Outpatient,,,2458,1597.70,,2163.04,88,,,percent of total billed charges,88% of total Billed charges,52.89,100,,,Fee Schedule,100% of Medicare rate,315.56,100,,,Fee Schedule,100% of WA Medicaid,2458,100,,,percent of total billed charges,100% of total billed charges,325.03,103,,,Fee Schedule,103% of WA Medicaid,52.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,315.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1696.02,69,,,percent of total billed charges,69% of total billed charges,2458,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2458,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2458,100,,,percent of total billed charges,100% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1520.27,61.85,,,percent of total billed charges,61.85% of total billed charges,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,410.23,130,,,Fee Schedule,130% of WA Medicaid ,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,926.67,37.7,,,percent of total billed charges,37.70% of total billed charges,926.67,37.7,,,percent of total billed charges,37.70% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,83326.2,33.9,,,percent of total billed charges,33.9% of total billed charges,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1917.24,78,,,percent of total billed charges,78% of total billed charges,2458,100,,,percent of total billed charges,100% of total billed charges,2030.31,82.6,,,percent of total billed charges,82.6% of total billed charges,2030.31,82.6,,,percent of total billed charges,82.6% of total billed charges,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.89,83326.2,
KNEE ARTHROSCOPY/SURGERY,29889,CDM,983,RC,29889,HCPCS,Outpatient,,,3965,2577.25,,3489.2,88,,,percent of total billed charges,88% of total Billed charges,130.43,100,,,Fee Schedule,100% of Medicare rate,703.85,100,,,Fee Schedule,100% of WA Medicaid,3965,100,,,percent of total billed charges,100% of total billed charges,724.97,103,,,Fee Schedule,103% of WA Medicaid,130.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,228.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,703.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2735.85,69,,,percent of total billed charges,69% of total billed charges,3965,100,,,percent of total billed charges,100% of total billed charges,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3965,100,,,percent of total billed charges,100% of total billed charges,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3965,100,,,percent of total billed charges,100% of total billed charges,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2452.35,61.85,,,percent of total billed charges,61.85% of total billed charges,703.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,703.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,915.01,130,,,Fee Schedule,130% of WA Medicaid ,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1494.81,37.7,,,percent of total billed charges,37.70% of total billed charges,1494.81,37.7,,,percent of total billed charges,37.70% of total billed charges,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,134413.5,33.9,,,percent of total billed charges,33.9% of total billed charges,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3092.7,78,,,percent of total billed charges,78% of total billed charges,3965,100,,,percent of total billed charges,100% of total billed charges,3275.09,82.6,,,percent of total billed charges,82.6% of total billed charges,3275.09,82.6,,,percent of total billed charges,82.6% of total billed charges,703.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,130.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,703.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,130.43,134413.5,
KNEE ARTHROSCOPY/SURGERY,29888,CDM,983,RC,29888,HCPCS,Outpatient,,,4502,2926.30,,3961.76,88,,,percent of total billed charges,88% of total Billed charges,101.29,100,,,Fee Schedule,100% of Medicare rate,558.94,100,,,Fee Schedule,100% of WA Medicaid,4502,100,,,percent of total billed charges,100% of total billed charges,575.71,103,,,Fee Schedule,103% of WA Medicaid,101.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,177.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,558.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3106.38,69,,,percent of total billed charges,69% of total billed charges,4502,100,,,percent of total billed charges,100% of total billed charges,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,4502,100,,,percent of total billed charges,100% of total billed charges,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,4502,100,,,percent of total billed charges,100% of total billed charges,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2784.49,61.85,,,percent of total billed charges,61.85% of total billed charges,558.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,570.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,726.62,130,,,Fee Schedule,130% of WA Medicaid ,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1697.25,37.7,,,percent of total billed charges,37.70% of total billed charges,1697.25,37.7,,,percent of total billed charges,37.70% of total billed charges,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,152617.8,33.9,,,percent of total billed charges,33.9% of total billed charges,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,3511.56,78,,,percent of total billed charges,78% of total billed charges,4502,100,,,percent of total billed charges,100% of total billed charges,3718.65,82.6,,,percent of total billed charges,82.6% of total billed charges,3718.65,82.6,,,percent of total billed charges,82.6% of total billed charges,558.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,101.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.29,152617.8,
KNEE ARTHROSCOPY/SURGERY,29884,CDM,983,RC,29884,HCPCS,Outpatient,,,1971,1281.15,,1734.48,88,,,percent of total billed charges,88% of total Billed charges,61.99,100,,,Fee Schedule,100% of Medicare rate,360.13,100,,,Fee Schedule,100% of WA Medicaid,1971,100,,,percent of total billed charges,100% of total billed charges,370.93,103,,,Fee Schedule,103% of WA Medicaid,61.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,360.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1359.99,69,,,percent of total billed charges,69% of total billed charges,1971,100,,,percent of total billed charges,100% of total billed charges,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1971,100,,,percent of total billed charges,100% of total billed charges,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1971,100,,,percent of total billed charges,100% of total billed charges,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1219.06,61.85,,,percent of total billed charges,61.85% of total billed charges,360.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,468.17,130,,,Fee Schedule,130% of WA Medicaid ,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,743.07,37.7,,,percent of total billed charges,37.70% of total billed charges,743.07,37.7,,,percent of total billed charges,37.70% of total billed charges,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,66816.9,33.9,,,percent of total billed charges,33.9% of total billed charges,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1537.38,78,,,percent of total billed charges,78% of total billed charges,1971,100,,,percent of total billed charges,100% of total billed charges,1628.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1628.05,82.6,,,percent of total billed charges,82.6% of total billed charges,360.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,61.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,61.99,66816.9,
KNEE ARTHROSCOPY/SURGERY,29883,CDM,983,RC,29883,HCPCS,Outpatient,,,3161,2054.65,,2781.68,88,,,percent of total billed charges,88% of total Billed charges,88.11,100,,,Fee Schedule,100% of Medicare rate,486.39,100,,,Fee Schedule,100% of WA Medicaid,3161,100,,,percent of total billed charges,100% of total billed charges,500.98,103,,,Fee Schedule,103% of WA Medicaid,88.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,154.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,486.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2181.09,69,,,percent of total billed charges,69% of total billed charges,3161,100,,,percent of total billed charges,100% of total billed charges,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,3161,100,,,percent of total billed charges,100% of total billed charges,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,3161,100,,,percent of total billed charges,100% of total billed charges,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1955.08,61.85,,,percent of total billed charges,61.85% of total billed charges,486.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,632.31,130,,,Fee Schedule,130% of WA Medicaid ,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1191.7,37.7,,,percent of total billed charges,37.70% of total billed charges,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,107157.9,33.9,,,percent of total billed charges,33.9% of total billed charges,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2465.58,78,,,percent of total billed charges,78% of total billed charges,3161,100,,,percent of total billed charges,100% of total billed charges,2610.99,82.6,,,percent of total billed charges,82.6% of total billed charges,2610.99,82.6,,,percent of total billed charges,82.6% of total billed charges,486.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.11,107157.9,
KNEE ARTHROSCOPY/SURGERY,29882,CDM,983,RC,29882,HCPCS,Outpatient,,,2524,1640.60,,2221.12,88,,,percent of total billed charges,88% of total Billed charges,69.2,100,,,Fee Schedule,100% of Medicare rate,398.36,100,,,Fee Schedule,100% of WA Medicaid,2524,100,,,percent of total billed charges,100% of total billed charges,410.31,103,,,Fee Schedule,103% of WA Medicaid,69.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,121.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,398.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1741.56,69,,,percent of total billed charges,69% of total billed charges,2524,100,,,percent of total billed charges,100% of total billed charges,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2524,100,,,percent of total billed charges,100% of total billed charges,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2524,100,,,percent of total billed charges,100% of total billed charges,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1561.09,61.85,,,percent of total billed charges,61.85% of total billed charges,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,517.87,130,,,Fee Schedule,130% of WA Medicaid ,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,951.55,37.7,,,percent of total billed charges,37.70% of total billed charges,951.55,37.7,,,percent of total billed charges,37.70% of total billed charges,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,85563.6,33.9,,,percent of total billed charges,33.9% of total billed charges,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1968.72,78,,,percent of total billed charges,78% of total billed charges,2524,100,,,percent of total billed charges,100% of total billed charges,2084.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2084.82,82.6,,,percent of total billed charges,82.6% of total billed charges,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.2,85563.6,
ANKLE ARTHROSCOPY/SURGERY,29898,CDM,983,RC,29898,HCPCS,Outpatient,,,2240,1456.00,,1971.2,88,,,percent of total billed charges,88% of total Billed charges,49.21,100,,,Fee Schedule,100% of Medicare rate,323.95,100,,,Fee Schedule,100% of WA Medicaid,2240,100,,,percent of total billed charges,100% of total billed charges,333.67,103,,,Fee Schedule,103% of WA Medicaid,49.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,323.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1545.6,69,,,percent of total billed charges,69% of total billed charges,2240,100,,,percent of total billed charges,100% of total billed charges,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2240,100,,,percent of total billed charges,100% of total billed charges,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2240,100,,,percent of total billed charges,100% of total billed charges,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385.44,61.85,,,percent of total billed charges,61.85% of total billed charges,323.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,421.14,130,,,Fee Schedule,130% of WA Medicaid ,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,844.48,37.7,,,percent of total billed charges,37.70% of total billed charges,844.48,37.7,,,percent of total billed charges,37.70% of total billed charges,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,75936,33.9,,,percent of total billed charges,33.9% of total billed charges,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1747.2,78,,,percent of total billed charges,78% of total billed charges,2240,100,,,percent of total billed charges,100% of total billed charges,1850.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1850.24,82.6,,,percent of total billed charges,82.6% of total billed charges,323.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.21,75936,
ANKLE ARTHROSCOPY/SURGERY,29895,CDM,983,RC,29895,HCPCS,Outpatient,,,1419,922.35,,1248.72,88,,,percent of total billed charges,88% of total Billed charges,40.56,100,,,Fee Schedule,100% of Medicare rate,267.81,100,,,Fee Schedule,100% of WA Medicaid,1419,100,,,percent of total billed charges,100% of total billed charges,275.84,103,,,Fee Schedule,103% of WA Medicaid,40.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,267.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,979.11,69,,,percent of total billed charges,69% of total billed charges,1419,100,,,percent of total billed charges,100% of total billed charges,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1419,100,,,percent of total billed charges,100% of total billed charges,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1419,100,,,percent of total billed charges,100% of total billed charges,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,877.65,61.85,,,percent of total billed charges,61.85% of total billed charges,267.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,348.15,130,,,Fee Schedule,130% of WA Medicaid ,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.96,37.7,,,percent of total billed charges,37.70% of total billed charges,534.96,37.7,,,percent of total billed charges,37.70% of total billed charges,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,48104.1,33.9,,,percent of total billed charges,33.9% of total billed charges,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1106.82,78,,,percent of total billed charges,78% of total billed charges,1419,100,,,percent of total billed charges,100% of total billed charges,1172.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1172.09,82.6,,,percent of total billed charges,82.6% of total billed charges,267.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.56,48104.1,
ANKLE ARTHROSCOPY/SURGERY,29897,CDM,983,RC,29897,HCPCS,Outpatient,,,2022,1314.30,,1779.36,88,,,percent of total billed charges,88% of total Billed charges,45.44,100,,,Fee Schedule,100% of Medicare rate,286.65,100,,,Fee Schedule,100% of WA Medicaid,2022,100,,,percent of total billed charges,100% of total billed charges,295.25,103,,,Fee Schedule,103% of WA Medicaid,45.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,286.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1395.18,69,,,percent of total billed charges,69% of total billed charges,2022,100,,,percent of total billed charges,100% of total billed charges,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2022,100,,,percent of total billed charges,100% of total billed charges,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2022,100,,,percent of total billed charges,100% of total billed charges,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1250.61,61.85,,,percent of total billed charges,61.85% of total billed charges,286.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,372.65,130,,,Fee Schedule,130% of WA Medicaid ,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,762.29,37.7,,,percent of total billed charges,37.70% of total billed charges,762.29,37.7,,,percent of total billed charges,37.70% of total billed charges,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,68545.8,33.9,,,percent of total billed charges,33.9% of total billed charges,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1577.16,78,,,percent of total billed charges,78% of total billed charges,2022,100,,,percent of total billed charges,100% of total billed charges,1670.17,82.6,,,percent of total billed charges,82.6% of total billed charges,1670.17,82.6,,,percent of total billed charges,82.6% of total billed charges,286.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.44,68545.8,
ARTHROSCOPY OF JOINT,29999,CDM,983,RC,29999,HCPCS,Outpatient,,,1601,1040.65,,1408.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1601,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1104.69,69,,,percent of total billed charges,69% of total billed charges,1601,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1601,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1601,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,990.22,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,603.58,37.7,,,percent of total billed charges,37.70% of total billed charges,603.58,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,54273.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1248.78,78,,,percent of total billed charges,78% of total billed charges,1601,100,,,percent of total billed charges,100% of total billed charges,1322.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1322.43,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",603.58,54273.9,
DRAINAGE OF NOSE LESION,30000,CDM,983,RC,30000,HCPCS,Outpatient,,,326.32,212.11,,287.16,88,,,percent of total billed charges,88% of total Billed charges,9.42,100,,,Fee Schedule,100% of Medicare rate,70.87,100,,,Fee Schedule,100% of WA Medicaid,326.32,100,,,percent of total billed charges,100% of total billed charges,73,103,,,Fee Schedule,103% of WA Medicaid,9.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,225.16,69,,,percent of total billed charges,69% of total billed charges,326.32,100,,,percent of total billed charges,100% of total billed charges,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.32,100,,,percent of total billed charges,100% of total billed charges,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.32,100,,,percent of total billed charges,100% of total billed charges,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.83,61.85,,,percent of total billed charges,61.85% of total billed charges,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,92.13,130,,,Fee Schedule,130% of WA Medicaid ,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.02,37.7,,,percent of total billed charges,37.70% of total billed charges,123.02,37.7,,,percent of total billed charges,37.70% of total billed charges,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,11062.25,33.9,,,percent of total billed charges,33.9% of total billed charges,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.53,78,,,percent of total billed charges,78% of total billed charges,326.32,100,,,percent of total billed charges,100% of total billed charges,269.54,82.6,,,percent of total billed charges,82.6% of total billed charges,269.54,82.6,,,percent of total billed charges,82.6% of total billed charges,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.42,11062.25,
REMOVAL OF NOSE POLYP(S),30110,CDM,983,RC,30110,HCPCS,Outpatient,,,441,286.65,,388.08,88,,,percent of total billed charges,88% of total Billed charges,10.3,100,,,Fee Schedule,100% of Medicare rate,77.58,100,,,Fee Schedule,100% of WA Medicaid,441,100,,,percent of total billed charges,100% of total billed charges,79.91,103,,,Fee Schedule,103% of WA Medicaid,10.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,304.29,69,,,percent of total billed charges,69% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,441,100,,,percent of total billed charges,100% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,441,100,,,percent of total billed charges,100% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.76,61.85,,,percent of total billed charges,61.85% of total billed charges,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,100.85,130,,,Fee Schedule,130% of WA Medicaid ,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.26,37.7,,,percent of total billed charges,37.70% of total billed charges,166.26,37.7,,,percent of total billed charges,37.70% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,14949.9,33.9,,,percent of total billed charges,33.9% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.98,78,,,percent of total billed charges,78% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.3,14949.9,
"EXCISION OR DEST,INTRANASAL LESION;EXT",30118,CDM,983,RC,30118,HCPCS,Outpatient,,,1819,1182.35,,1600.72,88,,,percent of total billed charges,88% of total Billed charges,51.59,100,,,Fee Schedule,100% of Medicare rate,415.34,100,,,Fee Schedule,100% of WA Medicaid,1819,100,,,percent of total billed charges,100% of total billed charges,427.8,103,,,Fee Schedule,103% of WA Medicaid,51.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,415.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1255.11,69,,,percent of total billed charges,69% of total billed charges,1819,100,,,percent of total billed charges,100% of total billed charges,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1819,100,,,percent of total billed charges,100% of total billed charges,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1819,100,,,percent of total billed charges,100% of total billed charges,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1125.05,61.85,,,percent of total billed charges,61.85% of total billed charges,415.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,539.94,130,,,Fee Schedule,130% of WA Medicaid ,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.76,37.7,,,percent of total billed charges,37.70% of total billed charges,685.76,37.7,,,percent of total billed charges,37.70% of total billed charges,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,61664.1,33.9,,,percent of total billed charges,33.9% of total billed charges,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1418.82,78,,,percent of total billed charges,78% of total billed charges,1819,100,,,percent of total billed charges,100% of total billed charges,1502.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1502.49,82.6,,,percent of total billed charges,82.6% of total billed charges,415.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.59,61664.1,
"EXCISIONOR DESTRUCTION,INTRANASAL LESION",30117,CDM,983,RC,30117,HCPCS,Outpatient,,,2178,1415.70,,1916.64,88,,,percent of total billed charges,88% of total Billed charges,27.26,100,,,Fee Schedule,100% of Medicare rate,243.57,100,,,Fee Schedule,100% of WA Medicaid,2178,100,,,percent of total billed charges,100% of total billed charges,250.88,103,,,Fee Schedule,103% of WA Medicaid,27.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,243.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1502.82,69,,,percent of total billed charges,69% of total billed charges,2178,100,,,percent of total billed charges,100% of total billed charges,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2178,100,,,percent of total billed charges,100% of total billed charges,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2178,100,,,percent of total billed charges,100% of total billed charges,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1347.09,61.85,,,percent of total billed charges,61.85% of total billed charges,243.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,316.64,130,,,Fee Schedule,130% of WA Medicaid ,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,821.11,37.7,,,percent of total billed charges,37.70% of total billed charges,821.11,37.7,,,percent of total billed charges,37.70% of total billed charges,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,73834.2,33.9,,,percent of total billed charges,33.9% of total billed charges,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1698.84,78,,,percent of total billed charges,78% of total billed charges,2178,100,,,percent of total billed charges,100% of total billed charges,1799.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1799.03,82.6,,,percent of total billed charges,82.6% of total billed charges,243.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.26,73834.2,
EXCISION NASAL POLYP(S) EXTENSIVE,30115,CDM,983,RC,30115,HCPCS,Outpatient,,,879,571.35,,773.52,88,,,percent of total billed charges,88% of total Billed charges,30.97,100,,,Fee Schedule,100% of Medicare rate,274.71,100,,,Fee Schedule,100% of WA Medicaid,879,100,,,percent of total billed charges,100% of total billed charges,282.95,103,,,Fee Schedule,103% of WA Medicaid,30.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,274.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,606.51,69,,,percent of total billed charges,69% of total billed charges,879,100,,,percent of total billed charges,100% of total billed charges,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,879,100,,,percent of total billed charges,100% of total billed charges,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,879,100,,,percent of total billed charges,100% of total billed charges,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,543.66,61.85,,,percent of total billed charges,61.85% of total billed charges,274.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,357.12,130,,,Fee Schedule,130% of WA Medicaid ,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.38,37.7,,,percent of total billed charges,37.70% of total billed charges,331.38,37.7,,,percent of total billed charges,37.70% of total billed charges,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,29798.1,33.9,,,percent of total billed charges,33.9% of total billed charges,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.62,78,,,percent of total billed charges,78% of total billed charges,879,100,,,percent of total billed charges,100% of total billed charges,726.05,82.6,,,percent of total billed charges,82.6% of total billed charges,726.05,82.6,,,percent of total billed charges,82.6% of total billed charges,274.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.97,29798.1,
"EXC INFERIOR TURBINATE,PART OR COMPLETE",30130,CDM,983,RC,30130,HCPCS,Outpatient,,,720,468.00,,633.6,88,,,percent of total billed charges,88% of total Billed charges,25.58,100,,,Fee Schedule,100% of Medicare rate,246.37,100,,,Fee Schedule,100% of WA Medicaid,720,100,,,percent of total billed charges,100% of total billed charges,253.76,103,,,Fee Schedule,103% of WA Medicaid,25.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,246.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,496.8,69,,,percent of total billed charges,69% of total billed charges,720,100,,,percent of total billed charges,100% of total billed charges,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,720,100,,,percent of total billed charges,100% of total billed charges,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,720,100,,,percent of total billed charges,100% of total billed charges,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.32,61.85,,,percent of total billed charges,61.85% of total billed charges,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,320.28,130,,,Fee Schedule,130% of WA Medicaid ,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.44,37.7,,,percent of total billed charges,37.70% of total billed charges,271.44,37.7,,,percent of total billed charges,37.70% of total billed charges,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,24408,33.9,,,percent of total billed charges,33.9% of total billed charges,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.6,78,,,percent of total billed charges,78% of total billed charges,720,100,,,percent of total billed charges,100% of total billed charges,594.72,82.6,,,percent of total billed charges,82.6% of total billed charges,594.72,82.6,,,percent of total billed charges,82.6% of total billed charges,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.58,24408,
"SUBMUCOUS RESECTION INFERIOR,TURBINATE",30140,CDM,983,RC,30140,HCPCS,Outpatient,,,785,510.25,,690.8,88,,,percent of total billed charges,88% of total Billed charges,16.49,100,,,Fee Schedule,100% of Medicare rate,101.08,100,,,Fee Schedule,100% of WA Medicaid,785,100,,,percent of total billed charges,100% of total billed charges,104.11,103,,,Fee Schedule,103% of WA Medicaid,16.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,101.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,541.65,69,,,percent of total billed charges,69% of total billed charges,785,100,,,percent of total billed charges,100% of total billed charges,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,785,100,,,percent of total billed charges,100% of total billed charges,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,785,100,,,percent of total billed charges,100% of total billed charges,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.52,61.85,,,percent of total billed charges,61.85% of total billed charges,101.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,131.4,130,,,Fee Schedule,130% of WA Medicaid ,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.95,37.7,,,percent of total billed charges,37.70% of total billed charges,295.95,37.7,,,percent of total billed charges,37.70% of total billed charges,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,26611.5,33.9,,,percent of total billed charges,33.9% of total billed charges,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.3,78,,,percent of total billed charges,78% of total billed charges,785,100,,,percent of total billed charges,100% of total billed charges,648.41,82.6,,,percent of total billed charges,82.6% of total billed charges,648.41,82.6,,,percent of total billed charges,82.6% of total billed charges,101.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.49,26611.5,
INJECTION TREATMENT OF NOSE,30200,CDM,983,RC,30200,HCPCS,Outpatient,,,257,167.05,,226.16,88,,,percent of total billed charges,88% of total Billed charges,4.67,100,,,Fee Schedule,100% of Medicare rate,34.69,100,,,Fee Schedule,100% of WA Medicaid,257,100,,,percent of total billed charges,100% of total billed charges,35.73,103,,,Fee Schedule,103% of WA Medicaid,4.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,34.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,177.33,69,,,percent of total billed charges,69% of total billed charges,257,100,,,percent of total billed charges,100% of total billed charges,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,257,100,,,percent of total billed charges,100% of total billed charges,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,257,100,,,percent of total billed charges,100% of total billed charges,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.95,61.85,,,percent of total billed charges,61.85% of total billed charges,34.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.1,130,,,Fee Schedule,130% of WA Medicaid ,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.89,37.7,,,percent of total billed charges,37.70% of total billed charges,96.89,37.7,,,percent of total billed charges,37.70% of total billed charges,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,8712.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.46,78,,,percent of total billed charges,78% of total billed charges,257,100,,,percent of total billed charges,100% of total billed charges,212.28,82.6,,,percent of total billed charges,82.6% of total billed charges,212.28,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.67,8712.3,
REMOVE NASAL FOREIGN BODY,30300,CDM,983,RC,30300,HCPCS,Outpatient,,,336,218.40,,295.68,88,,,percent of total billed charges,88% of total Billed charges,7.94,100,,,Fee Schedule,100% of Medicare rate,72.55,100,,,Fee Schedule,100% of WA Medicaid,336,100,,,percent of total billed charges,100% of total billed charges,74.73,103,,,Fee Schedule,103% of WA Medicaid,7.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,72.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,231.84,69,,,percent of total billed charges,69% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.82,61.85,,,percent of total billed charges,61.85% of total billed charges,72.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,94.32,130,,,Fee Schedule,130% of WA Medicaid ,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,11390.4,33.9,,,percent of total billed charges,33.9% of total billed charges,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.08,78,,,percent of total billed charges,78% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,72.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.94,11390.4,
RECONSTRUCTION OF NOSE,30400,CDM,983,RC,30400,HCPCS,Outpatient,,,2075,1348.75,,1826,88,,,percent of total billed charges,88% of total Billed charges,89.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2075,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,89.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1431.75,69,,,percent of total billed charges,69% of total billed charges,2075,100,,,percent of total billed charges,100% of total billed charges,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2075,100,,,percent of total billed charges,100% of total billed charges,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2075,100,,,percent of total billed charges,100% of total billed charges,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1283.39,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,782.28,37.7,,,percent of total billed charges,37.70% of total billed charges,782.28,37.7,,,percent of total billed charges,37.70% of total billed charges,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,70342.5,33.9,,,percent of total billed charges,33.9% of total billed charges,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1618.5,78,,,percent of total billed charges,78% of total billed charges,2075,100,,,percent of total billed charges,100% of total billed charges,1713.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1713.95,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,89.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",89.8,70342.5,
"RHINOPLASTY,PRIMARY;COMPLETE",30410,CDM,983,RC,30410,HCPCS,Outpatient,,,3042,1977.30,,2676.96,88,,,percent of total billed charges,88% of total Billed charges,110.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3042,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,110.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2098.98,69,,,percent of total billed charges,69% of total billed charges,3042,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3042,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3042,100,,,percent of total billed charges,100% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1881.48,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1146.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1146.83,37.7,,,percent of total billed charges,37.70% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,103123.8,33.9,,,percent of total billed charges,33.9% of total billed charges,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2372.76,78,,,percent of total billed charges,78% of total billed charges,3042,100,,,percent of total billed charges,100% of total billed charges,2512.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2512.69,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",110.38,103123.8,
"RHINOPLASTY, PRIMARY, MAJOR SEPTAL REPR",30420,CDM,983,RC,30420,HCPCS,Outpatient,,,2740,1781.00,,2411.2,88,,,percent of total billed charges,88% of total Billed charges,109.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2740,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,109.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,191.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1890.6,69,,,percent of total billed charges,69% of total billed charges,2740,100,,,percent of total billed charges,100% of total billed charges,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2740,100,,,percent of total billed charges,100% of total billed charges,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2740,100,,,percent of total billed charges,100% of total billed charges,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1694.69,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1032.98,37.7,,,percent of total billed charges,37.70% of total billed charges,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,92886,33.9,,,percent of total billed charges,33.9% of total billed charges,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2137.2,78,,,percent of total billed charges,78% of total billed charges,2740,100,,,percent of total billed charges,100% of total billed charges,2263.24,82.6,,,percent of total billed charges,82.6% of total billed charges,2263.24,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,109.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",109.22,92886,
REVISION OF NOSE,30450,CDM,983,RC,30450,HCPCS,Outpatient,,,2996,1947.40,,2636.48,88,,,percent of total billed charges,88% of total Billed charges,147.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2996,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,147.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,257.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2067.24,69,,,percent of total billed charges,69% of total billed charges,2996,100,,,percent of total billed charges,100% of total billed charges,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2996,100,,,percent of total billed charges,100% of total billed charges,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2996,100,,,percent of total billed charges,100% of total billed charges,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1853.03,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1129.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1129.49,37.7,,,percent of total billed charges,37.70% of total billed charges,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,101564.4,33.9,,,percent of total billed charges,33.9% of total billed charges,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2336.88,78,,,percent of total billed charges,78% of total billed charges,2996,100,,,percent of total billed charges,100% of total billed charges,2474.7,82.6,,,percent of total billed charges,82.6% of total billed charges,2474.7,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,147.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",147.33,101564.4,
REVISION OF NOSE,30462,CDM,983,RC,30462,HCPCS,Outpatient,,,2824,1835.60,,2485.12,88,,,percent of total billed charges,88% of total Billed charges,145.49,100,,,Fee Schedule,100% of Medicare rate,918.14,100,,,Fee Schedule,100% of WA Medicaid,2824,100,,,percent of total billed charges,100% of total billed charges,945.68,103,,,Fee Schedule,103% of WA Medicaid,145.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,254.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,918.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1948.56,69,,,percent of total billed charges,69% of total billed charges,2824,100,,,percent of total billed charges,100% of total billed charges,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2824,100,,,percent of total billed charges,100% of total billed charges,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2824,100,,,percent of total billed charges,100% of total billed charges,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1746.64,61.85,,,percent of total billed charges,61.85% of total billed charges,918.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,918.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,936.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1193.58,130,,,Fee Schedule,130% of WA Medicaid ,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1064.65,37.7,,,percent of total billed charges,37.70% of total billed charges,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,95733.6,33.9,,,percent of total billed charges,33.9% of total billed charges,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2202.72,78,,,percent of total billed charges,78% of total billed charges,2824,100,,,percent of total billed charges,100% of total billed charges,2332.62,82.6,,,percent of total billed charges,82.6% of total billed charges,2332.62,82.6,,,percent of total billed charges,82.6% of total billed charges,918.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,145.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,918.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,145.49,95733.6,
REVISION OF NOSE,30460,CDM,983,RC,30460,HCPCS,Outpatient,,,1636,1063.40,,1439.68,88,,,percent of total billed charges,88% of total Billed charges,74.42,100,,,Fee Schedule,100% of Medicare rate,478.75,100,,,Fee Schedule,100% of WA Medicaid,1636,100,,,percent of total billed charges,100% of total billed charges,493.11,103,,,Fee Schedule,103% of WA Medicaid,74.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,130.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,478.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1128.84,69,,,percent of total billed charges,69% of total billed charges,1636,100,,,percent of total billed charges,100% of total billed charges,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1636,100,,,percent of total billed charges,100% of total billed charges,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1636,100,,,percent of total billed charges,100% of total billed charges,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1011.87,61.85,,,percent of total billed charges,61.85% of total billed charges,478.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,622.38,130,,,Fee Schedule,130% of WA Medicaid ,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,616.77,37.7,,,percent of total billed charges,37.70% of total billed charges,616.77,37.7,,,percent of total billed charges,37.70% of total billed charges,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,55460.4,33.9,,,percent of total billed charges,33.9% of total billed charges,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1276.08,78,,,percent of total billed charges,78% of total billed charges,1636,100,,,percent of total billed charges,100% of total billed charges,1351.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1351.34,82.6,,,percent of total billed charges,82.6% of total billed charges,478.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,74.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.42,55460.4,
REPAIR NASAL STENOSIS,30465,CDM,983,RC,30465,HCPCS,Outpatient,,,2025,1316.25,,1782,88,,,percent of total billed charges,88% of total Billed charges,78.59,100,,,Fee Schedule,100% of Medicare rate,598.29,100,,,Fee Schedule,100% of WA Medicaid,2025,100,,,percent of total billed charges,100% of total billed charges,616.24,103,,,Fee Schedule,103% of WA Medicaid,78.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,598.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1397.25,69,,,percent of total billed charges,69% of total billed charges,2025,100,,,percent of total billed charges,100% of total billed charges,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2025,100,,,percent of total billed charges,100% of total billed charges,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2025,100,,,percent of total billed charges,100% of total billed charges,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1252.46,61.85,,,percent of total billed charges,61.85% of total billed charges,598.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,777.78,130,,,Fee Schedule,130% of WA Medicaid ,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.43,37.7,,,percent of total billed charges,37.70% of total billed charges,763.43,37.7,,,percent of total billed charges,37.70% of total billed charges,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,68647.5,33.9,,,percent of total billed charges,33.9% of total billed charges,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1579.5,78,,,percent of total billed charges,78% of total billed charges,2025,100,,,percent of total billed charges,100% of total billed charges,1672.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1672.65,82.6,,,percent of total billed charges,82.6% of total billed charges,598.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.59,68647.5,
SEPTOPLASTY OR SUBMUCOUS RESECTION,30520,CDM,983,RC,30520,HCPCS,Outpatient,,,1259,818.35,,1107.92,88,,,percent of total billed charges,88% of total Billed charges,47.73,100,,,Fee Schedule,100% of Medicare rate,396.5,100,,,Fee Schedule,100% of WA Medicaid,1259,100,,,percent of total billed charges,100% of total billed charges,408.4,103,,,Fee Schedule,103% of WA Medicaid,47.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,396.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,868.71,69,,,percent of total billed charges,69% of total billed charges,1259,100,,,percent of total billed charges,100% of total billed charges,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259,100,,,percent of total billed charges,100% of total billed charges,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259,100,,,percent of total billed charges,100% of total billed charges,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.69,61.85,,,percent of total billed charges,61.85% of total billed charges,396.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,515.45,130,,,Fee Schedule,130% of WA Medicaid ,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.64,37.7,,,percent of total billed charges,37.70% of total billed charges,474.64,37.7,,,percent of total billed charges,37.70% of total billed charges,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,42680.1,33.9,,,percent of total billed charges,33.9% of total billed charges,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,982.02,78,,,percent of total billed charges,78% of total billed charges,1259,100,,,percent of total billed charges,100% of total billed charges,1039.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1039.93,82.6,,,percent of total billed charges,82.6% of total billed charges,396.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.73,42680.1,
CAUTERY/ABLATION;MUCOSA OF TURBINATE,30801,CDM,983,RC,30801,HCPCS,Outpatient,,,449,291.85,,395.12,88,,,percent of total billed charges,88% of total Billed charges,9.11,100,,,Fee Schedule,100% of Medicare rate,90.08,100,,,Fee Schedule,100% of WA Medicaid,449,100,,,percent of total billed charges,100% of total billed charges,92.78,103,,,Fee Schedule,103% of WA Medicaid,9.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,90.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,309.81,69,,,percent of total billed charges,69% of total billed charges,449,100,,,percent of total billed charges,100% of total billed charges,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,449,100,,,percent of total billed charges,100% of total billed charges,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,449,100,,,percent of total billed charges,100% of total billed charges,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.71,61.85,,,percent of total billed charges,61.85% of total billed charges,90.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,117.1,130,,,Fee Schedule,130% of WA Medicaid ,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.27,37.7,,,percent of total billed charges,37.70% of total billed charges,169.27,37.7,,,percent of total billed charges,37.70% of total billed charges,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,15221.1,33.9,,,percent of total billed charges,33.9% of total billed charges,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.22,78,,,percent of total billed charges,78% of total billed charges,449,100,,,percent of total billed charges,100% of total billed charges,370.87,82.6,,,percent of total billed charges,82.6% of total billed charges,370.87,82.6,,,percent of total billed charges,82.6% of total billed charges,90.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.11,15221.1,
"ABLATION,SOFT TISSUE OF INF TURBINATES",30802,CDM,983,RC,30802,HCPCS,Outpatient,,,581,377.65,,511.28,88,,,percent of total billed charges,88% of total Billed charges,14,100,,,Fee Schedule,100% of Medicare rate,118.8,100,,,Fee Schedule,100% of WA Medicaid,581,100,,,percent of total billed charges,100% of total billed charges,122.36,103,,,Fee Schedule,103% of WA Medicaid,14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,118.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,400.89,69,,,percent of total billed charges,69% of total billed charges,581,100,,,percent of total billed charges,100% of total billed charges,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,581,100,,,percent of total billed charges,100% of total billed charges,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,581,100,,,percent of total billed charges,100% of total billed charges,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.35,61.85,,,percent of total billed charges,61.85% of total billed charges,118.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,154.44,130,,,Fee Schedule,130% of WA Medicaid ,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.04,37.7,,,percent of total billed charges,37.70% of total billed charges,219.04,37.7,,,percent of total billed charges,37.70% of total billed charges,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,19695.9,33.9,,,percent of total billed charges,33.9% of total billed charges,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.18,78,,,percent of total billed charges,78% of total billed charges,581,100,,,percent of total billed charges,100% of total billed charges,479.91,82.6,,,percent of total billed charges,82.6% of total billed charges,479.91,82.6,,,percent of total billed charges,82.6% of total billed charges,118.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14,19695.9,
CONTROL OF NOSEBLEED,30903,CDM,983,RC,30903,HCPCS,Outpatient,,,336,218.40,,295.68,88,,,percent of total billed charges,88% of total Billed charges,9.02,100,,,Fee Schedule,100% of Medicare rate,42.9,100,,,Fee Schedule,100% of WA Medicaid,336,100,,,percent of total billed charges,100% of total billed charges,44.19,103,,,Fee Schedule,103% of WA Medicaid,9.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,231.84,69,,,percent of total billed charges,69% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.82,61.85,,,percent of total billed charges,61.85% of total billed charges,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.77,130,,,Fee Schedule,130% of WA Medicaid ,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,11390.4,33.9,,,percent of total billed charges,33.9% of total billed charges,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.08,78,,,percent of total billed charges,78% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.02,11390.4,
CONTROL OF NOSEBLEED,30901,CDM,983,RC,30901,HCPCS,Outpatient,,,226,146.90,,198.88,88,,,percent of total billed charges,88% of total Billed charges,6.6,100,,,Fee Schedule,100% of Medicare rate,31.52,100,,,Fee Schedule,100% of WA Medicaid,226,100,,,percent of total billed charges,100% of total billed charges,32.47,103,,,Fee Schedule,103% of WA Medicaid,6.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,31.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,155.94,69,,,percent of total billed charges,69% of total billed charges,226,100,,,percent of total billed charges,100% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,226,100,,,percent of total billed charges,100% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,226,100,,,percent of total billed charges,100% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.78,61.85,,,percent of total billed charges,61.85% of total billed charges,31.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.98,130,,,Fee Schedule,130% of WA Medicaid ,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.2,37.7,,,percent of total billed charges,37.70% of total billed charges,85.2,37.7,,,percent of total billed charges,37.70% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,7661.4,33.9,,,percent of total billed charges,33.9% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.28,78,,,percent of total billed charges,78% of total billed charges,226,100,,,percent of total billed charges,100% of total billed charges,186.68,82.6,,,percent of total billed charges,82.6% of total billed charges,186.68,82.6,,,percent of total billed charges,82.6% of total billed charges,31.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.6,7661.4,
THER FX NASAL INF TURBINATE,30930,CDM,983,RC,30930,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,8.57,100,,,Fee Schedule,100% of Medicare rate,69.56,100,,,Fee Schedule,100% of WA Medicaid,260,100,,,percent of total billed charges,100% of total billed charges,71.65,103,,,Fee Schedule,103% of WA Medicaid,8.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,260,100,,,percent of total billed charges,100% of total billed charges,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,260,100,,,percent of total billed charges,100% of total billed charges,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,69.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,90.43,130,,,Fee Schedule,130% of WA Medicaid ,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,8814,33.9,,,percent of total billed charges,33.9% of total billed charges,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,69.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.57,8814,
NASAL SURGERY PROCEDURE,30999,CDM,983,RC,30999,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,450,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15255,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",169.65,15255,
LAVAGE BY CANNULATION;MAXILLARY SINUS,31000,CDM,983,RC,31000,HCPCS,Outpatient,,,320,208.00,,281.6,88,,,percent of total billed charges,88% of total Billed charges,7.81,100,,,Fee Schedule,100% of Medicare rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,320,100,,,percent of total billed charges,100% of total billed charges,66.85,103,,,Fee Schedule,103% of WA Medicaid,7.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,64.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,220.8,69,,,percent of total billed charges,69% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,320,100,,,percent of total billed charges,100% of total billed charges,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,320,100,,,percent of total billed charges,100% of total billed charges,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.92,61.85,,,percent of total billed charges,61.85% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.37,130,,,Fee Schedule,130% of WA Medicaid ,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,10848,33.9,,,percent of total billed charges,33.9% of total billed charges,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.6,78,,,percent of total billed charges,78% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.81,10848,
EXPLORE SINUS REMOVE POLYPS,31032,CDM,983,RC,31032,HCPCS,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,41.84,100,,,Fee Schedule,100% of Medicare rate,348.01,100,,,Fee Schedule,100% of WA Medicaid,1150,100,,,percent of total billed charges,100% of total billed charges,358.45,103,,,Fee Schedule,103% of WA Medicaid,41.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,348.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1150,100,,,percent of total billed charges,100% of total billed charges,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1150,100,,,percent of total billed charges,100% of total billed charges,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.28,61.85,,,percent of total billed charges,61.85% of total billed charges,348.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,452.41,130,,,Fee Schedule,130% of WA Medicaid ,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,38985,33.9,,,percent of total billed charges,33.9% of total billed charges,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,348.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.84,38985,
SINUSOTOMY,31070,CDM,983,RC,31070,HCPCS,Outpatient,,,797,518.05,,701.36,88,,,percent of total billed charges,88% of total Billed charges,31.02,100,,,Fee Schedule,100% of Medicare rate,280.68,100,,,Fee Schedule,100% of WA Medicaid,797,100,,,percent of total billed charges,100% of total billed charges,289.1,103,,,Fee Schedule,103% of WA Medicaid,31.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,280.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,549.93,69,,,percent of total billed charges,69% of total billed charges,797,100,,,percent of total billed charges,100% of total billed charges,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,797,100,,,percent of total billed charges,100% of total billed charges,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,797,100,,,percent of total billed charges,100% of total billed charges,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.94,61.85,,,percent of total billed charges,61.85% of total billed charges,280.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,364.88,130,,,Fee Schedule,130% of WA Medicaid ,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.47,37.7,,,percent of total billed charges,37.70% of total billed charges,300.47,37.7,,,percent of total billed charges,37.70% of total billed charges,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,27018.3,33.9,,,percent of total billed charges,33.9% of total billed charges,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.66,78,,,percent of total billed charges,78% of total billed charges,797,100,,,percent of total billed charges,100% of total billed charges,658.32,82.6,,,percent of total billed charges,82.6% of total billed charges,658.32,82.6,,,percent of total billed charges,82.6% of total billed charges,280.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.02,27018.3,
NASAL ENDOSCOPY W CONTROL OF NASAL HEMM,31238,CDM,983,RC,31238,HCPCS,Outpatient,,,403,261.95,,354.64,88,,,percent of total billed charges,88% of total Billed charges,15.4,100,,,Fee Schedule,100% of Medicare rate,95.3,100,,,Fee Schedule,100% of WA Medicaid,403,100,,,percent of total billed charges,100% of total billed charges,98.16,103,,,Fee Schedule,103% of WA Medicaid,15.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,95.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,278.07,69,,,percent of total billed charges,69% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,403,100,,,percent of total billed charges,100% of total billed charges,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,403,100,,,percent of total billed charges,100% of total billed charges,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.26,61.85,,,percent of total billed charges,61.85% of total billed charges,95.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,123.89,130,,,Fee Schedule,130% of WA Medicaid ,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,13661.7,33.9,,,percent of total billed charges,33.9% of total billed charges,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.34,78,,,percent of total billed charges,78% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,95.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.4,13661.7,
NASAL ENDOSCOPY;DIAGNOSIT UNI OR BILAT,31231,CDM,983,RC,31231,HCPCS,Outpatient,,,383,248.95,,337.04,88,,,percent of total billed charges,88% of total Billed charges,6.08,100,,,Fee Schedule,100% of Medicare rate,36.55,100,,,Fee Schedule,100% of WA Medicaid,383,100,,,percent of total billed charges,100% of total billed charges,37.65,103,,,Fee Schedule,103% of WA Medicaid,6.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,36.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,264.27,69,,,percent of total billed charges,69% of total billed charges,383,100,,,percent of total billed charges,100% of total billed charges,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,383,100,,,percent of total billed charges,100% of total billed charges,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,383,100,,,percent of total billed charges,100% of total billed charges,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.89,61.85,,,percent of total billed charges,61.85% of total billed charges,36.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.52,130,,,Fee Schedule,130% of WA Medicaid ,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.39,37.7,,,percent of total billed charges,37.70% of total billed charges,144.39,37.7,,,percent of total billed charges,37.70% of total billed charges,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,12983.7,33.9,,,percent of total billed charges,33.9% of total billed charges,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.74,78,,,percent of total billed charges,78% of total billed charges,383,100,,,percent of total billed charges,100% of total billed charges,316.36,82.6,,,percent of total billed charges,82.6% of total billed charges,316.36,82.6,,,percent of total billed charges,82.6% of total billed charges,36.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.08,12983.7,
"NASAL/SINUS ENDOSCOPY,SURGICAL W CONCHA",31240,CDM,983,RC,31240,HCPCS,Outpatient,,,380,247.00,,334.4,88,,,percent of total billed charges,88% of total Billed charges,14.63,100,,,Fee Schedule,100% of Medicare rate,90.45,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,93.16,103,,,Fee Schedule,103% of WA Medicaid,14.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,90.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,380,100,,,percent of total billed charges,100% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,380,100,,,percent of total billed charges,100% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.03,61.85,,,percent of total billed charges,61.85% of total billed charges,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,117.59,130,,,Fee Schedule,130% of WA Medicaid ,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,12882,33.9,,,percent of total billed charges,33.9% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.63,12882,
NASAL/SINUS ENDOSCOPY W/ETHMOIDECTOMY,31255,CDM,983,RC,31255,HCPCS,Outpatient,,,871,566.15,,766.48,88,,,percent of total billed charges,88% of total Billed charges,31.15,100,,,Fee Schedule,100% of Medicare rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,871,100,,,percent of total billed charges,100% of total billed charges,187.48,103,,,Fee Schedule,103% of WA Medicaid,31.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,600.99,69,,,percent of total billed charges,69% of total billed charges,871,100,,,percent of total billed charges,100% of total billed charges,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,871,100,,,percent of total billed charges,100% of total billed charges,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,871,100,,,percent of total billed charges,100% of total billed charges,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,538.71,61.85,,,percent of total billed charges,61.85% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,236.63,130,,,Fee Schedule,130% of WA Medicaid ,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.37,37.7,,,percent of total billed charges,37.70% of total billed charges,328.37,37.7,,,percent of total billed charges,37.70% of total billed charges,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,29526.9,33.9,,,percent of total billed charges,33.9% of total billed charges,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,679.38,78,,,percent of total billed charges,78% of total billed charges,871,100,,,percent of total billed charges,100% of total billed charges,719.45,82.6,,,percent of total billed charges,82.6% of total billed charges,719.45,82.6,,,percent of total billed charges,82.6% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.15,29526.9,
NASAL/SINUS ENCOSCOPYWW/ETHMOIDECTOMY,31254,CDM,983,RC,31254,HCPCS,Outpatient,,,592,384.80,,520.96,88,,,percent of total billed charges,88% of total Billed charges,23.07,100,,,Fee Schedule,100% of Medicare rate,137.26,100,,,Fee Schedule,100% of WA Medicaid,592,100,,,percent of total billed charges,100% of total billed charges,141.38,103,,,Fee Schedule,103% of WA Medicaid,23.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,137.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,408.48,69,,,percent of total billed charges,69% of total billed charges,592,100,,,percent of total billed charges,100% of total billed charges,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,592,100,,,percent of total billed charges,100% of total billed charges,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,592,100,,,percent of total billed charges,100% of total billed charges,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.15,61.85,,,percent of total billed charges,61.85% of total billed charges,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,178.44,130,,,Fee Schedule,130% of WA Medicaid ,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.18,37.7,,,percent of total billed charges,37.70% of total billed charges,223.18,37.7,,,percent of total billed charges,37.70% of total billed charges,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,20068.8,33.9,,,percent of total billed charges,33.9% of total billed charges,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.76,78,,,percent of total billed charges,78% of total billed charges,592,100,,,percent of total billed charges,100% of total billed charges,488.99,82.6,,,percent of total billed charges,82.6% of total billed charges,488.99,82.6,,,percent of total billed charges,82.6% of total billed charges,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.07,20068.8,
NASAL/SINUS ENDOSCOPY W MAXI ANTROSTOMY,31256,CDM,983,RC,31256,HCPCS,Outpatient,,,428,278.20,,376.64,88,,,percent of total billed charges,88% of total Billed charges,16.79,100,,,Fee Schedule,100% of Medicare rate,101.83,100,,,Fee Schedule,100% of WA Medicaid,428,100,,,percent of total billed charges,100% of total billed charges,104.88,103,,,Fee Schedule,103% of WA Medicaid,16.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,101.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,295.32,69,,,percent of total billed charges,69% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,428,100,,,percent of total billed charges,100% of total billed charges,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,428,100,,,percent of total billed charges,100% of total billed charges,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.72,61.85,,,percent of total billed charges,61.85% of total billed charges,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.38,130,,,Fee Schedule,130% of WA Medicaid ,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,161.36,37.7,,,percent of total billed charges,37.70% of total billed charges,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14509.2,33.9,,,percent of total billed charges,33.9% of total billed charges,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.84,78,,,percent of total billed charges,78% of total billed charges,428,100,,,percent of total billed charges,100% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,353.53,82.6,,,percent of total billed charges,82.6% of total billed charges,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.79,14509.2,
NASAL ENDOSCOPY W REMOVAL OF TISSUE,31267,CDM,983,RC,31267,HCPCS,Outpatient,,,690,448.50,,607.2,88,,,percent of total billed charges,88% of total Billed charges,25.81,100,,,Fee Schedule,100% of Medicare rate,149.76,100,,,Fee Schedule,100% of WA Medicaid,690,100,,,percent of total billed charges,100% of total billed charges,154.25,103,,,Fee Schedule,103% of WA Medicaid,25.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,149.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,476.1,69,,,percent of total billed charges,69% of total billed charges,690,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,690,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,690,100,,,percent of total billed charges,100% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.77,61.85,,,percent of total billed charges,61.85% of total billed charges,149.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,194.69,130,,,Fee Schedule,130% of WA Medicaid ,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.13,37.7,,,percent of total billed charges,37.70% of total billed charges,260.13,37.7,,,percent of total billed charges,37.70% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,23391,33.9,,,percent of total billed charges,33.9% of total billed charges,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,538.2,78,,,percent of total billed charges,78% of total billed charges,690,100,,,percent of total billed charges,100% of total billed charges,569.94,82.6,,,percent of total billed charges,82.6% of total billed charges,569.94,82.6,,,percent of total billed charges,82.6% of total billed charges,149.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.81,23391,
NASAL/SINUS ENDOSCOPY,31276,CDM,983,RC,31276,HCPCS,Outpatient,,,1647,1070.55,,1449.36,88,,,percent of total billed charges,88% of total Billed charges,36.93,100,,,Fee Schedule,100% of Medicare rate,212.98,100,,,Fee Schedule,100% of WA Medicaid,1647,100,,,percent of total billed charges,100% of total billed charges,219.37,103,,,Fee Schedule,103% of WA Medicaid,36.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,212.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1136.43,69,,,percent of total billed charges,69% of total billed charges,1647,100,,,percent of total billed charges,100% of total billed charges,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1647,100,,,percent of total billed charges,100% of total billed charges,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1647,100,,,percent of total billed charges,100% of total billed charges,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1018.67,61.85,,,percent of total billed charges,61.85% of total billed charges,212.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,276.87,130,,,Fee Schedule,130% of WA Medicaid ,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,620.92,37.7,,,percent of total billed charges,37.70% of total billed charges,620.92,37.7,,,percent of total billed charges,37.70% of total billed charges,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,55833.3,33.9,,,percent of total billed charges,33.9% of total billed charges,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1284.66,78,,,percent of total billed charges,78% of total billed charges,1647,100,,,percent of total billed charges,100% of total billed charges,1360.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1360.42,82.6,,,percent of total billed charges,82.6% of total billed charges,212.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.93,55833.3,
NASAL/SINUS ENDOSCOPY SURG,31288,CDM,983,RC,31288,HCPCS,Outpatient,,,2116,1375.40,,1862.08,88,,,percent of total billed charges,88% of total Billed charges,22.54,100,,,Fee Schedule,100% of Medicare rate,132.04,100,,,Fee Schedule,100% of WA Medicaid,2116,100,,,percent of total billed charges,100% of total billed charges,136,103,,,Fee Schedule,103% of WA Medicaid,22.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,132.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1460.04,69,,,percent of total billed charges,69% of total billed charges,2116,100,,,percent of total billed charges,100% of total billed charges,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2116,100,,,percent of total billed charges,100% of total billed charges,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2116,100,,,percent of total billed charges,100% of total billed charges,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1308.75,61.85,,,percent of total billed charges,61.85% of total billed charges,132.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,171.65,130,,,Fee Schedule,130% of WA Medicaid ,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,797.73,37.7,,,percent of total billed charges,37.70% of total billed charges,797.73,37.7,,,percent of total billed charges,37.70% of total billed charges,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,71732.4,33.9,,,percent of total billed charges,33.9% of total billed charges,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650.48,78,,,percent of total billed charges,78% of total billed charges,2116,100,,,percent of total billed charges,100% of total billed charges,1747.82,82.6,,,percent of total billed charges,82.6% of total billed charges,1747.82,82.6,,,percent of total billed charges,82.6% of total billed charges,132.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.54,71732.4,
NASAL/SINUS ENDOS SURGICAL W/SPHENOIDOTO,31287,CDM,983,RC,31287,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,18.97,100,,,Fee Schedule,100% of Medicare rate,113.58,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,116.99,103,,,Fee Schedule,103% of WA Medicaid,18.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,113.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.72,61.85,,,percent of total billed charges,61.85% of total billed charges,113.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,147.65,130,,,Fee Schedule,130% of WA Medicaid ,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,17085.6,33.9,,,percent of total billed charges,33.9% of total billed charges,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,113.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.97,17085.6,
UNLISTED PROC: ACCESSORY SINUS,31299,CDM,983,RC,31299,HCPCS,Outpatient,,,1489,967.85,,1310.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1489,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1027.41,69,,,percent of total billed charges,69% of total billed charges,1489,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1489,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1489,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,920.95,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,561.35,37.7,,,percent of total billed charges,37.70% of total billed charges,561.35,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,50477.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1161.42,78,,,percent of total billed charges,78% of total billed charges,1489,100,,,percent of total billed charges,100% of total billed charges,1229.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1229.91,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",561.35,50477.1,
LARYNGOTOMY W/ REM OF TUMOR/LARYNGOCELE,31300,CDM,983,RC,31300,HCPCS,Outpatient,,,2650,1722.50,,2332,88,,,percent of total billed charges,88% of total Billed charges,97.94,100,,,Fee Schedule,100% of Medicare rate,724.37,100,,,Fee Schedule,100% of WA Medicaid,2650,100,,,percent of total billed charges,100% of total billed charges,746.1,103,,,Fee Schedule,103% of WA Medicaid,97.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,171.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,724.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1828.5,69,,,percent of total billed charges,69% of total billed charges,2650,100,,,percent of total billed charges,100% of total billed charges,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2650,100,,,percent of total billed charges,100% of total billed charges,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2650,100,,,percent of total billed charges,100% of total billed charges,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1639.03,61.85,,,percent of total billed charges,61.85% of total billed charges,724.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,738.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,941.68,130,,,Fee Schedule,130% of WA Medicaid ,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,999.05,37.7,,,percent of total billed charges,37.70% of total billed charges,999.05,37.7,,,percent of total billed charges,37.70% of total billed charges,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,89835,33.9,,,percent of total billed charges,33.9% of total billed charges,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2067,78,,,percent of total billed charges,78% of total billed charges,2650,100,,,percent of total billed charges,100% of total billed charges,2188.9,82.6,,,percent of total billed charges,82.6% of total billed charges,2188.9,82.6,,,percent of total billed charges,82.6% of total billed charges,724.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,97.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.94,89835,
INSERT EMERGENCY AIRWAY,31500,CDM,983,RC,31500,HCPCS,Outpatient,,,407,264.55,,358.16,88,,,percent of total billed charges,88% of total Billed charges,15.28,100,,,Fee Schedule,100% of Medicare rate,77.77,100,,,Fee Schedule,100% of WA Medicaid,407,100,,,percent of total billed charges,100% of total billed charges,80.1,103,,,Fee Schedule,103% of WA Medicaid,15.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,280.83,69,,,percent of total billed charges,69% of total billed charges,407,100,,,percent of total billed charges,100% of total billed charges,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,407,100,,,percent of total billed charges,100% of total billed charges,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,407,100,,,percent of total billed charges,100% of total billed charges,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.73,61.85,,,percent of total billed charges,61.85% of total billed charges,77.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.1,130,,,Fee Schedule,130% of WA Medicaid ,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.44,37.7,,,percent of total billed charges,37.70% of total billed charges,153.44,37.7,,,percent of total billed charges,37.70% of total billed charges,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,13797.3,33.9,,,percent of total billed charges,33.9% of total billed charges,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.46,78,,,percent of total billed charges,78% of total billed charges,407,100,,,percent of total billed charges,100% of total billed charges,336.18,82.6,,,percent of total billed charges,82.6% of total billed charges,336.18,82.6,,,percent of total billed charges,82.6% of total billed charges,77.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.28,13797.3,
"LARYNGOSCOPY,INDIRECT;DIAGNOSTIC",31505,CDM,983,RC,31505,HCPCS,Outpatient,,,188,122.20,,165.44,88,,,percent of total billed charges,88% of total Billed charges,3.58,100,,,Fee Schedule,100% of Medicare rate,28.72,100,,,Fee Schedule,100% of WA Medicaid,188,100,,,percent of total billed charges,100% of total billed charges,29.58,103,,,Fee Schedule,103% of WA Medicaid,3.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,129.72,69,,,percent of total billed charges,69% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,188,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,188,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.28,61.85,,,percent of total billed charges,61.85% of total billed charges,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.34,130,,,Fee Schedule,130% of WA Medicaid ,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,6373.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.64,78,,,percent of total billed charges,78% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.58,6373.2,
LARYNGOSCOPY FOR ASPIRATION,31515,CDM,983,RC,31515,HCPCS,Outpatient,,,539,350.35,,474.32,88,,,percent of total billed charges,88% of total Billed charges,9.56,100,,,Fee Schedule,100% of Medicare rate,63.22,100,,,Fee Schedule,100% of WA Medicaid,539,100,,,percent of total billed charges,100% of total billed charges,65.12,103,,,Fee Schedule,103% of WA Medicaid,9.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,371.91,69,,,percent of total billed charges,69% of total billed charges,539,100,,,percent of total billed charges,100% of total billed charges,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,539,100,,,percent of total billed charges,100% of total billed charges,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,539,100,,,percent of total billed charges,100% of total billed charges,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.37,61.85,,,percent of total billed charges,61.85% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.19,130,,,Fee Schedule,130% of WA Medicaid ,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.2,37.7,,,percent of total billed charges,37.70% of total billed charges,203.2,37.7,,,percent of total billed charges,37.70% of total billed charges,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,18272.1,33.9,,,percent of total billed charges,33.9% of total billed charges,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.42,78,,,percent of total billed charges,78% of total billed charges,539,100,,,percent of total billed charges,100% of total billed charges,445.21,82.6,,,percent of total billed charges,82.6% of total billed charges,445.21,82.6,,,percent of total billed charges,82.6% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.56,18272.1,
DX LARYNGOSCOPY W/OPERSCOPE,31526,CDM,983,RC,31526,HCPCS,Outpatient,,,330,214.50,,290.4,88,,,percent of total billed charges,88% of total Billed charges,14.55,100,,,Fee Schedule,100% of Medicare rate,89.15,100,,,Fee Schedule,100% of WA Medicaid,330,100,,,percent of total billed charges,100% of total billed charges,91.82,103,,,Fee Schedule,103% of WA Medicaid,14.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,89.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,227.7,69,,,percent of total billed charges,69% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,330,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,330,100,,,percent of total billed charges,100% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.11,61.85,,,percent of total billed charges,61.85% of total billed charges,89.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,115.9,130,,,Fee Schedule,130% of WA Medicaid ,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,124.41,37.7,,,percent of total billed charges,37.70% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,11187,33.9,,,percent of total billed charges,33.9% of total billed charges,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.4,78,,,percent of total billed charges,78% of total billed charges,330,100,,,percent of total billed charges,100% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,272.58,82.6,,,percent of total billed charges,82.6% of total billed charges,89.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.55,11187,
LARYNGOSCOPY DIRECT W OR W/O TRACHEOSCOP,31525,CDM,983,RC,31525,HCPCS,Outpatient,,,301,195.65,,264.88,88,,,percent of total billed charges,88% of total Billed charges,14.91,100,,,Fee Schedule,100% of Medicare rate,91.01,100,,,Fee Schedule,100% of WA Medicaid,301,100,,,percent of total billed charges,100% of total billed charges,93.74,103,,,Fee Schedule,103% of WA Medicaid,14.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,91.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,207.69,69,,,percent of total billed charges,69% of total billed charges,301,100,,,percent of total billed charges,100% of total billed charges,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,301,100,,,percent of total billed charges,100% of total billed charges,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,301,100,,,percent of total billed charges,100% of total billed charges,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.17,61.85,,,percent of total billed charges,61.85% of total billed charges,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,118.31,130,,,Fee Schedule,130% of WA Medicaid ,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.48,37.7,,,percent of total billed charges,37.70% of total billed charges,113.48,37.7,,,percent of total billed charges,37.70% of total billed charges,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,10203.9,33.9,,,percent of total billed charges,33.9% of total billed charges,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.78,78,,,percent of total billed charges,78% of total billed charges,301,100,,,percent of total billed charges,100% of total billed charges,248.63,82.6,,,percent of total billed charges,82.6% of total billed charges,248.63,82.6,,,percent of total billed charges,82.6% of total billed charges,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.91,10203.9,
"LARYNGOSCOPY,DIRECT,OPERATIVE W/BIOPSY",31536,CDM,983,RC,31536,HCPCS,Outpatient,,,415,269.75,,365.2,88,,,percent of total billed charges,88% of total Billed charges,19.5,100,,,Fee Schedule,100% of Medicare rate,118.8,100,,,Fee Schedule,100% of WA Medicaid,415,100,,,percent of total billed charges,100% of total billed charges,122.36,103,,,Fee Schedule,103% of WA Medicaid,19.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,118.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,286.35,69,,,percent of total billed charges,69% of total billed charges,415,100,,,percent of total billed charges,100% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,415,100,,,percent of total billed charges,100% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,415,100,,,percent of total billed charges,100% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.68,61.85,,,percent of total billed charges,61.85% of total billed charges,118.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,154.44,130,,,Fee Schedule,130% of WA Medicaid ,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.46,37.7,,,percent of total billed charges,37.70% of total billed charges,156.46,37.7,,,percent of total billed charges,37.70% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,14068.5,33.9,,,percent of total billed charges,33.9% of total billed charges,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.7,78,,,percent of total billed charges,78% of total billed charges,415,100,,,percent of total billed charges,100% of total billed charges,342.79,82.6,,,percent of total billed charges,82.6% of total billed charges,342.79,82.6,,,percent of total billed charges,82.6% of total billed charges,118.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.5,14068.5,
LARYNGOSCOPY W/ BIOPSY,31535,CDM,983,RC,31535,HCPCS,Outpatient,,,412,267.80,,362.56,88,,,percent of total billed charges,88% of total Billed charges,17.58,100,,,Fee Schedule,100% of Medicare rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,412,100,,,percent of total billed charges,100% of total billed charges,110.26,103,,,Fee Schedule,103% of WA Medicaid,17.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,284.28,69,,,percent of total billed charges,69% of total billed charges,412,100,,,percent of total billed charges,100% of total billed charges,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,412,100,,,percent of total billed charges,100% of total billed charges,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,412,100,,,percent of total billed charges,100% of total billed charges,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.82,61.85,,,percent of total billed charges,61.85% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.17,130,,,Fee Schedule,130% of WA Medicaid ,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.32,37.7,,,percent of total billed charges,37.70% of total billed charges,155.32,37.7,,,percent of total billed charges,37.70% of total billed charges,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,13966.8,33.9,,,percent of total billed charges,33.9% of total billed charges,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.36,78,,,percent of total billed charges,78% of total billed charges,412,100,,,percent of total billed charges,100% of total billed charges,340.31,82.6,,,percent of total billed charges,82.6% of total billed charges,340.31,82.6,,,percent of total billed charges,82.6% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.58,13966.8,
LARYNGOSCOPY W/ REMOVAL OF POLYP,31540,CDM,983,RC,31540,HCPCS,Outpatient,,,529,343.85,,465.52,88,,,percent of total billed charges,88% of total Billed charges,22.75,100,,,Fee Schedule,100% of Medicare rate,136.15,100,,,Fee Schedule,100% of WA Medicaid,529,100,,,percent of total billed charges,100% of total billed charges,140.23,103,,,Fee Schedule,103% of WA Medicaid,22.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,136.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,365.01,69,,,percent of total billed charges,69% of total billed charges,529,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,529,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,529,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.19,61.85,,,percent of total billed charges,61.85% of total billed charges,136.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,177,130,,,Fee Schedule,130% of WA Medicaid ,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.43,37.7,,,percent of total billed charges,37.70% of total billed charges,199.43,37.7,,,percent of total billed charges,37.70% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,17933.1,33.9,,,percent of total billed charges,33.9% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.62,78,,,percent of total billed charges,78% of total billed charges,529,100,,,percent of total billed charges,100% of total billed charges,436.95,82.6,,,percent of total billed charges,82.6% of total billed charges,436.95,82.6,,,percent of total billed charges,82.6% of total billed charges,136.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.75,17933.1,
LARYNGOSCOPY;WITH OPERATING MICROSCOPE,31541,CDM,983,RC,31541,HCPCS,Outpatient,,,577,375.05,,507.76,88,,,percent of total billed charges,88% of total Billed charges,24.95,100,,,Fee Schedule,100% of Medicare rate,148.27,100,,,Fee Schedule,100% of WA Medicaid,577,100,,,percent of total billed charges,100% of total billed charges,152.72,103,,,Fee Schedule,103% of WA Medicaid,24.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,148.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,398.13,69,,,percent of total billed charges,69% of total billed charges,577,100,,,percent of total billed charges,100% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,577,100,,,percent of total billed charges,100% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,577,100,,,percent of total billed charges,100% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.87,61.85,,,percent of total billed charges,61.85% of total billed charges,148.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,192.75,130,,,Fee Schedule,130% of WA Medicaid ,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.53,37.7,,,percent of total billed charges,37.70% of total billed charges,217.53,37.7,,,percent of total billed charges,37.70% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,19560.3,33.9,,,percent of total billed charges,33.9% of total billed charges,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.06,78,,,percent of total billed charges,78% of total billed charges,577,100,,,percent of total billed charges,100% of total billed charges,476.6,82.6,,,percent of total billed charges,82.6% of total billed charges,476.6,82.6,,,percent of total billed charges,82.6% of total billed charges,148.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.95,19560.3,
LARYNGOSCOPY FLEXILE FIBEROPTIC DIAGNOTI,31575,CDM,983,RC,31575,HCPCS,Outpatient,,,238,154.70,,209.44,88,,,percent of total billed charges,88% of total Billed charges,5.71,100,,,Fee Schedule,100% of Medicare rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,238,100,,,percent of total billed charges,100% of total billed charges,40.73,103,,,Fee Schedule,103% of WA Medicaid,5.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,164.22,69,,,percent of total billed charges,69% of total billed charges,238,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,238,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,238,100,,,percent of total billed charges,100% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.2,61.85,,,percent of total billed charges,61.85% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.4,130,,,Fee Schedule,130% of WA Medicaid ,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.73,37.7,,,percent of total billed charges,37.70% of total billed charges,89.73,37.7,,,percent of total billed charges,37.70% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,8068.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.64,78,,,percent of total billed charges,78% of total billed charges,238,100,,,percent of total billed charges,100% of total billed charges,196.59,82.6,,,percent of total billed charges,82.6% of total billed charges,196.59,82.6,,,percent of total billed charges,82.6% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.71,8068.2,
INCISION OF WINDPIPE,31605,CDM,983,RC,31605,HCPCS,Outpatient,,,917,596.05,,806.96,88,,,percent of total billed charges,88% of total Billed charges,42.34,100,,,Fee Schedule,100% of Medicare rate,182.21,100,,,Fee Schedule,100% of WA Medicaid,917,100,,,percent of total billed charges,100% of total billed charges,187.68,103,,,Fee Schedule,103% of WA Medicaid,42.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,182.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,632.73,69,,,percent of total billed charges,69% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,917,100,,,percent of total billed charges,100% of total billed charges,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,917,100,,,percent of total billed charges,100% of total billed charges,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.16,61.85,,,percent of total billed charges,61.85% of total billed charges,182.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,236.87,130,,,Fee Schedule,130% of WA Medicaid ,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,31086.3,33.9,,,percent of total billed charges,33.9% of total billed charges,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,715.26,78,,,percent of total billed charges,78% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,182.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.34,31086.3,
INCISION OF WINDPIPE,31603,CDM,983,RC,31603,HCPCS,Outpatient,,,1433,931.45,,1261.04,88,,,percent of total billed charges,88% of total Billed charges,38.47,100,,,Fee Schedule,100% of Medicare rate,177.73,100,,,Fee Schedule,100% of WA Medicaid,1433,100,,,percent of total billed charges,100% of total billed charges,183.06,103,,,Fee Schedule,103% of WA Medicaid,38.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,177.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,988.77,69,,,percent of total billed charges,69% of total billed charges,1433,100,,,percent of total billed charges,100% of total billed charges,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1433,100,,,percent of total billed charges,100% of total billed charges,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1433,100,,,percent of total billed charges,100% of total billed charges,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,886.31,61.85,,,percent of total billed charges,61.85% of total billed charges,177.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,231.05,130,,,Fee Schedule,130% of WA Medicaid ,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,540.24,37.7,,,percent of total billed charges,37.70% of total billed charges,540.24,37.7,,,percent of total billed charges,37.70% of total billed charges,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,48578.7,33.9,,,percent of total billed charges,33.9% of total billed charges,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117.74,78,,,percent of total billed charges,78% of total billed charges,1433,100,,,percent of total billed charges,100% of total billed charges,1183.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1183.66,82.6,,,percent of total billed charges,82.6% of total billed charges,177.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.47,48578.7,
INCISION OF WINDPIPE,31600,CDM,983,RC,31600,HCPCS,Outpatient,,,1385,900.25,,1218.8,88,,,percent of total billed charges,88% of total Billed charges,36.99,100,,,Fee Schedule,100% of Medicare rate,169.72,100,,,Fee Schedule,100% of WA Medicaid,1385,100,,,percent of total billed charges,100% of total billed charges,174.81,103,,,Fee Schedule,103% of WA Medicaid,36.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,169.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,955.65,69,,,percent of total billed charges,69% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385,100,,,percent of total billed charges,100% of total billed charges,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385,100,,,percent of total billed charges,100% of total billed charges,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,856.62,61.85,,,percent of total billed charges,61.85% of total billed charges,169.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.64,130,,,Fee Schedule,130% of WA Medicaid ,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,46951.5,33.9,,,percent of total billed charges,33.9% of total billed charges,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080.3,78,,,percent of total billed charges,78% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,169.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.99,46951.5,
DX BRONCHOSCOPE/WASH,31622,CDM,983,RC,31622,HCPCS,Outpatient,,,953,619.45,,838.64,88,,,percent of total billed charges,88% of total Billed charges,11.94,100,,,Fee Schedule,100% of Medicare rate,73.67,100,,,Fee Schedule,100% of WA Medicaid,953,100,,,percent of total billed charges,100% of total billed charges,75.88,103,,,Fee Schedule,103% of WA Medicaid,11.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,73.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,657.57,69,,,percent of total billed charges,69% of total billed charges,953,100,,,percent of total billed charges,100% of total billed charges,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,953,100,,,percent of total billed charges,100% of total billed charges,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,953,100,,,percent of total billed charges,100% of total billed charges,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,589.43,61.85,,,percent of total billed charges,61.85% of total billed charges,73.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.77,130,,,Fee Schedule,130% of WA Medicaid ,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,32306.7,33.9,,,percent of total billed charges,33.9% of total billed charges,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,743.34,78,,,percent of total billed charges,78% of total billed charges,953,100,,,percent of total billed charges,100% of total billed charges,787.18,82.6,,,percent of total billed charges,82.6% of total billed charges,787.18,82.6,,,percent of total billed charges,82.6% of total billed charges,73.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.94,32306.7,
CLEARANCE OF AIRWAYS,31720,CDM,983,RC,31720,HCPCS,Outpatient,,,476,309.40,,418.88,88,,,percent of total billed charges,88% of total Billed charges,3.51,100,,,Fee Schedule,100% of Medicare rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,476,100,,,percent of total billed charges,100% of total billed charges,27.85,103,,,Fee Schedule,103% of WA Medicaid,3.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,328.44,69,,,percent of total billed charges,69% of total billed charges,476,100,,,percent of total billed charges,100% of total billed charges,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,476,100,,,percent of total billed charges,100% of total billed charges,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,476,100,,,percent of total billed charges,100% of total billed charges,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,294.41,61.85,,,percent of total billed charges,61.85% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.15,130,,,Fee Schedule,130% of WA Medicaid ,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.45,37.7,,,percent of total billed charges,37.70% of total billed charges,179.45,37.7,,,percent of total billed charges,37.70% of total billed charges,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,16136.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.28,78,,,percent of total billed charges,78% of total billed charges,476,100,,,percent of total billed charges,100% of total billed charges,393.18,82.6,,,percent of total billed charges,82.6% of total billed charges,393.18,82.6,,,percent of total billed charges,82.6% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.51,16136.4,
REPAIR OF WINDPIPE,31750,CDM,983,RC,31750,HCPCS,Outpatient,,,4087,2656.55,,3596.56,88,,,percent of total billed charges,88% of total Billed charges,99.24,100,,,Fee Schedule,100% of Medicare rate,784.98,100,,,Fee Schedule,100% of WA Medicaid,4087,100,,,percent of total billed charges,100% of total billed charges,808.53,103,,,Fee Schedule,103% of WA Medicaid,99.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,784.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2820.03,69,,,percent of total billed charges,69% of total billed charges,4087,100,,,percent of total billed charges,100% of total billed charges,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,4087,100,,,percent of total billed charges,100% of total billed charges,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,4087,100,,,percent of total billed charges,100% of total billed charges,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2527.81,61.85,,,percent of total billed charges,61.85% of total billed charges,784.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,784.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,800.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1020.47,130,,,Fee Schedule,130% of WA Medicaid ,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1540.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1540.8,37.7,,,percent of total billed charges,37.70% of total billed charges,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,138549.3,33.9,,,percent of total billed charges,33.9% of total billed charges,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,3187.86,78,,,percent of total billed charges,78% of total billed charges,4087,100,,,percent of total billed charges,100% of total billed charges,3375.86,82.6,,,percent of total billed charges,82.6% of total billed charges,3375.86,82.6,,,percent of total billed charges,82.6% of total billed charges,784.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,784.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.24,138549.3,
REPAIR OF WINDPIPE INJURY,31800,CDM,983,RC,31800,HCPCS,Outpatient,,,2050.98,1333.14,,1804.86,88,,,percent of total billed charges,88% of total Billed charges,52.96,100,,,Fee Schedule,100% of Medicare rate,411.42,100,,,Fee Schedule,100% of WA Medicaid,2050.98,100,,,percent of total billed charges,100% of total billed charges,423.76,103,,,Fee Schedule,103% of WA Medicaid,52.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,411.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1415.18,69,,,percent of total billed charges,69% of total billed charges,2050.98,100,,,percent of total billed charges,100% of total billed charges,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2050.98,100,,,percent of total billed charges,100% of total billed charges,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2050.98,100,,,percent of total billed charges,100% of total billed charges,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1268.53,61.85,,,percent of total billed charges,61.85% of total billed charges,411.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,534.85,130,,,Fee Schedule,130% of WA Medicaid ,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,773.22,37.7,,,percent of total billed charges,37.70% of total billed charges,773.22,37.7,,,percent of total billed charges,37.70% of total billed charges,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,69528.22,33.9,,,percent of total billed charges,33.9% of total billed charges,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1599.76,78,,,percent of total billed charges,78% of total billed charges,2050.98,100,,,percent of total billed charges,100% of total billed charges,1694.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1694.11,82.6,,,percent of total billed charges,82.6% of total billed charges,411.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.96,69528.22,
THORACOSTOMY W/RIB RESECTION,32035,CDM,983,RC,32035,HCPCS,Outpatient,,,2958,1922.70,,2603.04,88,,,percent of total billed charges,88% of total Billed charges,93.84,100,,,Fee Schedule,100% of Medicare rate,411.79,100,,,Fee Schedule,100% of WA Medicaid,2958,100,,,percent of total billed charges,100% of total billed charges,424.14,103,,,Fee Schedule,103% of WA Medicaid,93.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,164.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,411.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2041.02,69,,,percent of total billed charges,69% of total billed charges,2958,100,,,percent of total billed charges,100% of total billed charges,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2958,100,,,percent of total billed charges,100% of total billed charges,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2958,100,,,percent of total billed charges,100% of total billed charges,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1829.52,61.85,,,percent of total billed charges,61.85% of total billed charges,411.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,535.33,130,,,Fee Schedule,130% of WA Medicaid ,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1115.17,37.7,,,percent of total billed charges,37.70% of total billed charges,1115.17,37.7,,,percent of total billed charges,37.70% of total billed charges,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,100276.2,33.9,,,percent of total billed charges,33.9% of total billed charges,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2307.24,78,,,percent of total billed charges,78% of total billed charges,2958,100,,,percent of total billed charges,100% of total billed charges,2443.31,82.6,,,percent of total billed charges,82.6% of total billed charges,2443.31,82.6,,,percent of total billed charges,82.6% of total billed charges,411.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,93.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,93.84,100276.2,
OPEN WEDGE/BX LUNG INFILTR,32096,CDM,983,RC,32096,HCPCS,Outpatient,,,2006,1303.90,,1765.28,88,,,percent of total billed charges,88% of total Billed charges,109.76,100,,,Fee Schedule,100% of Medicare rate,442.01,100,,,Fee Schedule,100% of WA Medicaid,2006,100,,,percent of total billed charges,100% of total billed charges,455.27,103,,,Fee Schedule,103% of WA Medicaid,109.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,192.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,442.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1384.14,69,,,percent of total billed charges,69% of total billed charges,2006,100,,,percent of total billed charges,100% of total billed charges,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2006,100,,,percent of total billed charges,100% of total billed charges,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2006,100,,,percent of total billed charges,100% of total billed charges,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240.71,61.85,,,percent of total billed charges,61.85% of total billed charges,442.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,574.61,130,,,Fee Schedule,130% of WA Medicaid ,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,756.26,37.7,,,percent of total billed charges,37.70% of total billed charges,756.26,37.7,,,percent of total billed charges,37.70% of total billed charges,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,68003.4,33.9,,,percent of total billed charges,33.9% of total billed charges,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1564.68,78,,,percent of total billed charges,78% of total billed charges,2006,100,,,percent of total billed charges,100% of total billed charges,1656.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1656.96,82.6,,,percent of total billed charges,82.6% of total billed charges,442.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,109.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,109.76,68003.4,
OPEN WEDGE/BX LUNG NODULE,32097,CDM,983,RC,32097,HCPCS,Outpatient,,,2006,1303.90,,1765.28,88,,,percent of total billed charges,88% of total Billed charges,109.8,100,,,Fee Schedule,100% of Medicare rate,442.75,100,,,Fee Schedule,100% of WA Medicaid,2006,100,,,percent of total billed charges,100% of total billed charges,456.03,103,,,Fee Schedule,103% of WA Medicaid,109.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,192.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,442.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1384.14,69,,,percent of total billed charges,69% of total billed charges,2006,100,,,percent of total billed charges,100% of total billed charges,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2006,100,,,percent of total billed charges,100% of total billed charges,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2006,100,,,percent of total billed charges,100% of total billed charges,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240.71,61.85,,,percent of total billed charges,61.85% of total billed charges,442.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,575.58,130,,,Fee Schedule,130% of WA Medicaid ,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,756.26,37.7,,,percent of total billed charges,37.70% of total billed charges,756.26,37.7,,,percent of total billed charges,37.70% of total billed charges,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,68003.4,33.9,,,percent of total billed charges,33.9% of total billed charges,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1564.68,78,,,percent of total billed charges,78% of total billed charges,2006,100,,,percent of total billed charges,100% of total billed charges,1656.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1656.96,82.6,,,percent of total billed charges,82.6% of total billed charges,442.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,109.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,109.8,68003.4,
OPEN BIOPSY OF LUNG PLEURA,32098,CDM,983,RC,32098,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,102.32,100,,,Fee Schedule,100% of Medicare rate,419.25,100,,,Fee Schedule,100% of WA Medicaid,1885,100,,,percent of total billed charges,100% of total billed charges,431.83,103,,,Fee Schedule,103% of WA Medicaid,102.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,179.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,419.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1885,100,,,percent of total billed charges,100% of total billed charges,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1885,100,,,percent of total billed charges,100% of total billed charges,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,545.03,130,,,Fee Schedule,130% of WA Medicaid ,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,63901.5,33.9,,,percent of total billed charges,33.9% of total billed charges,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,102.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,102.32,63901.5,
EXPLORATION OF CHEST,32100,CDM,983,RC,32100,HCPCS,Outpatient,,,4583,2978.95,,4033.04,88,,,percent of total billed charges,88% of total Billed charges,108.58,100,,,Fee Schedule,100% of Medicare rate,449.47,100,,,Fee Schedule,100% of WA Medicaid,4583,100,,,percent of total billed charges,100% of total billed charges,462.95,103,,,Fee Schedule,103% of WA Medicaid,108.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,190.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,449.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3162.27,69,,,percent of total billed charges,69% of total billed charges,4583,100,,,percent of total billed charges,100% of total billed charges,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4583,100,,,percent of total billed charges,100% of total billed charges,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4583,100,,,percent of total billed charges,100% of total billed charges,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2834.59,61.85,,,percent of total billed charges,61.85% of total billed charges,449.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,458.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,584.31,130,,,Fee Schedule,130% of WA Medicaid ,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1727.79,37.7,,,percent of total billed charges,37.70% of total billed charges,1727.79,37.7,,,percent of total billed charges,37.70% of total billed charges,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,155363.7,33.9,,,percent of total billed charges,33.9% of total billed charges,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3574.74,78,,,percent of total billed charges,78% of total billed charges,4583,100,,,percent of total billed charges,100% of total billed charges,3785.56,82.6,,,percent of total billed charges,82.6% of total billed charges,3785.56,82.6,,,percent of total billed charges,82.6% of total billed charges,449.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,108.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.58,155363.7,
EXPLORE/REPAIR CHEST,32110,CDM,983,RC,32110,HCPCS,Outpatient,,,4017.72,2611.52,,3535.59,88,,,percent of total billed charges,88% of total Billed charges,199.89,100,,,Fee Schedule,100% of Medicare rate,817.06,100,,,Fee Schedule,100% of WA Medicaid,4017.72,100,,,percent of total billed charges,100% of total billed charges,841.57,103,,,Fee Schedule,103% of WA Medicaid,199.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,349.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,817.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2772.23,69,,,percent of total billed charges,69% of total billed charges,4017.72,100,,,percent of total billed charges,100% of total billed charges,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,4017.72,100,,,percent of total billed charges,100% of total billed charges,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,4017.72,100,,,percent of total billed charges,100% of total billed charges,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2484.96,61.85,,,percent of total billed charges,61.85% of total billed charges,817.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,817.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,833.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1062.18,130,,,Fee Schedule,130% of WA Medicaid ,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1514.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1514.68,37.7,,,percent of total billed charges,37.70% of total billed charges,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,136200.71,33.9,,,percent of total billed charges,33.9% of total billed charges,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,3133.82,78,,,percent of total billed charges,78% of total billed charges,4017.72,100,,,percent of total billed charges,100% of total billed charges,3318.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3318.64,82.6,,,percent of total billed charges,82.6% of total billed charges,817.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,199.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,817.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,199.89,136200.71,
REMOVE/TREAT LUNG LESIONS,32141,CDM,983,RC,32141,HCPCS,Outpatient,,,5030,3269.50,,4426.4,88,,,percent of total billed charges,88% of total Billed charges,213.57,100,,,Fee Schedule,100% of Medicare rate,834.4,100,,,Fee Schedule,100% of WA Medicaid,5030,100,,,percent of total billed charges,100% of total billed charges,859.43,103,,,Fee Schedule,103% of WA Medicaid,213.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,373.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,834.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3470.7,69,,,percent of total billed charges,69% of total billed charges,5030,100,,,percent of total billed charges,100% of total billed charges,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,5030,100,,,percent of total billed charges,100% of total billed charges,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,5030,100,,,percent of total billed charges,100% of total billed charges,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3111.06,61.85,,,percent of total billed charges,61.85% of total billed charges,834.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,834.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1084.72,130,,,Fee Schedule,130% of WA Medicaid ,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1896.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1896.31,37.7,,,percent of total billed charges,37.70% of total billed charges,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,170517,33.9,,,percent of total billed charges,33.9% of total billed charges,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3923.4,78,,,percent of total billed charges,78% of total billed charges,5030,100,,,percent of total billed charges,100% of total billed charges,4154.78,82.6,,,percent of total billed charges,82.6% of total billed charges,4154.78,82.6,,,percent of total billed charges,82.6% of total billed charges,834.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,213.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,834.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,213.57,170517,
REMOVAL OF LUNG LESION(S),32140,CDM,983,RC,32140,HCPCS,Outpatient,,,2717,1766.05,,2390.96,88,,,percent of total billed charges,88% of total Billed charges,135.62,100,,,Fee Schedule,100% of Medicare rate,548.68,100,,,Fee Schedule,100% of WA Medicaid,2717,100,,,percent of total billed charges,100% of total billed charges,565.14,103,,,Fee Schedule,103% of WA Medicaid,135.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,237.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,548.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1874.73,69,,,percent of total billed charges,69% of total billed charges,2717,100,,,percent of total billed charges,100% of total billed charges,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2717,100,,,percent of total billed charges,100% of total billed charges,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2717,100,,,percent of total billed charges,100% of total billed charges,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1680.46,61.85,,,percent of total billed charges,61.85% of total billed charges,548.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,559.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,713.28,130,,,Fee Schedule,130% of WA Medicaid ,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1024.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1024.31,37.7,,,percent of total billed charges,37.70% of total billed charges,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,92106.3,33.9,,,percent of total billed charges,33.9% of total billed charges,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2119.26,78,,,percent of total billed charges,78% of total billed charges,2717,100,,,percent of total billed charges,100% of total billed charges,2244.24,82.6,,,percent of total billed charges,82.6% of total billed charges,2244.24,82.6,,,percent of total billed charges,82.6% of total billed charges,548.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,135.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,135.62,92106.3,
OPEN CHEST HEART MASSAGE,32160,CDM,983,RC,32160,HCPCS,Outpatient,,,2176.63,1414.81,,1915.43,88,,,percent of total billed charges,88% of total Billed charges,102.34,100,,,Fee Schedule,100% of Medicare rate,444.62,100,,,Fee Schedule,100% of WA Medicaid,2176.63,100,,,percent of total billed charges,100% of total billed charges,457.96,103,,,Fee Schedule,103% of WA Medicaid,102.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,179.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,444.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1501.87,69,,,percent of total billed charges,69% of total billed charges,2176.63,100,,,percent of total billed charges,100% of total billed charges,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2176.63,100,,,percent of total billed charges,100% of total billed charges,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2176.63,100,,,percent of total billed charges,100% of total billed charges,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1346.25,61.85,,,percent of total billed charges,61.85% of total billed charges,444.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,578.01,130,,,Fee Schedule,130% of WA Medicaid ,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,820.59,37.7,,,percent of total billed charges,37.70% of total billed charges,820.59,37.7,,,percent of total billed charges,37.70% of total billed charges,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,73787.76,33.9,,,percent of total billed charges,33.9% of total billed charges,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1697.77,78,,,percent of total billed charges,78% of total billed charges,2176.63,100,,,percent of total billed charges,100% of total billed charges,1797.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1797.9,82.6,,,percent of total billed charges,82.6% of total billed charges,444.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,102.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,102.34,73787.76,
DRAIN OPEN LUNG LESION,32200,CDM,983,RC,32200,HCPCS,Outpatient,,,5194,3376.10,,4570.72,88,,,percent of total billed charges,88% of total Billed charges,152.8,100,,,Fee Schedule,100% of Medicare rate,633.54,100,,,Fee Schedule,100% of WA Medicaid,5194,100,,,percent of total billed charges,100% of total billed charges,652.55,103,,,Fee Schedule,103% of WA Medicaid,152.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,267.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,633.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3583.86,69,,,percent of total billed charges,69% of total billed charges,5194,100,,,percent of total billed charges,100% of total billed charges,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,5194,100,,,percent of total billed charges,100% of total billed charges,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,5194,100,,,percent of total billed charges,100% of total billed charges,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3212.49,61.85,,,percent of total billed charges,61.85% of total billed charges,633.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,823.6,130,,,Fee Schedule,130% of WA Medicaid ,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1958.14,37.7,,,percent of total billed charges,37.70% of total billed charges,1958.14,37.7,,,percent of total billed charges,37.70% of total billed charges,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,176076.6,33.9,,,percent of total billed charges,33.9% of total billed charges,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,4051.32,78,,,percent of total billed charges,78% of total billed charges,5194,100,,,percent of total billed charges,100% of total billed charges,4290.24,82.6,,,percent of total billed charges,82.6% of total billed charges,4290.24,82.6,,,percent of total billed charges,82.6% of total billed charges,633.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,152.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,152.8,176076.6,
PARTIAL RELEASE OF LUNG,32225,CDM,983,RC,32225,HCPCS,Outpatient,,,3733,2426.45,,3285.04,88,,,percent of total billed charges,88% of total Billed charges,133.94,100,,,Fee Schedule,100% of Medicare rate,551.11,100,,,Fee Schedule,100% of WA Medicaid,3733,100,,,percent of total billed charges,100% of total billed charges,567.64,103,,,Fee Schedule,103% of WA Medicaid,133.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,234.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,551.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2575.77,69,,,percent of total billed charges,69% of total billed charges,3733,100,,,percent of total billed charges,100% of total billed charges,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3733,100,,,percent of total billed charges,100% of total billed charges,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3733,100,,,percent of total billed charges,100% of total billed charges,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2308.86,61.85,,,percent of total billed charges,61.85% of total billed charges,551.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,716.44,130,,,Fee Schedule,130% of WA Medicaid ,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1407.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1407.34,37.7,,,percent of total billed charges,37.70% of total billed charges,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,126548.7,33.9,,,percent of total billed charges,33.9% of total billed charges,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2911.74,78,,,percent of total billed charges,78% of total billed charges,3733,100,,,percent of total billed charges,100% of total billed charges,3083.46,82.6,,,percent of total billed charges,82.6% of total billed charges,3083.46,82.6,,,percent of total billed charges,82.6% of total billed charges,551.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,133.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,133.94,126548.7,
RELEASE OF LUNG,32220,CDM,983,RC,32220,HCPCS,Outpatient,,,6223,4044.95,,5476.24,88,,,percent of total billed charges,88% of total Billed charges,214.91,100,,,Fee Schedule,100% of Medicare rate,885.69,100,,,Fee Schedule,100% of WA Medicaid,6223,100,,,percent of total billed charges,100% of total billed charges,912.26,103,,,Fee Schedule,103% of WA Medicaid,214.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,376.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,885.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4293.87,69,,,percent of total billed charges,69% of total billed charges,6223,100,,,percent of total billed charges,100% of total billed charges,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,6223,100,,,percent of total billed charges,100% of total billed charges,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,6223,100,,,percent of total billed charges,100% of total billed charges,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3848.93,61.85,,,percent of total billed charges,61.85% of total billed charges,885.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,903.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1151.4,130,,,Fee Schedule,130% of WA Medicaid ,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2346.07,37.7,,,percent of total billed charges,37.70% of total billed charges,2346.07,37.7,,,percent of total billed charges,37.70% of total billed charges,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,210959.7,33.9,,,percent of total billed charges,33.9% of total billed charges,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,4853.94,78,,,percent of total billed charges,78% of total billed charges,6223,100,,,percent of total billed charges,100% of total billed charges,5140.2,82.6,,,percent of total billed charges,82.6% of total billed charges,5140.2,82.6,,,percent of total billed charges,82.6% of total billed charges,885.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,214.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,214.91,210959.7,
REMOVAL OF CHEST LINING,32310,CDM,983,RC,32310,HCPCS,Outpatient,,,4226,2746.90,,3718.88,88,,,percent of total billed charges,88% of total Billed charges,124.73,100,,,Fee Schedule,100% of Medicare rate,509.52,100,,,Fee Schedule,100% of WA Medicaid,4226,100,,,percent of total billed charges,100% of total billed charges,524.81,103,,,Fee Schedule,103% of WA Medicaid,124.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,218.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,509.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2915.94,69,,,percent of total billed charges,69% of total billed charges,4226,100,,,percent of total billed charges,100% of total billed charges,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4226,100,,,percent of total billed charges,100% of total billed charges,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4226,100,,,percent of total billed charges,100% of total billed charges,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2613.78,61.85,,,percent of total billed charges,61.85% of total billed charges,509.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,662.38,130,,,Fee Schedule,130% of WA Medicaid ,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1593.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1593.2,37.7,,,percent of total billed charges,37.70% of total billed charges,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,143261.4,33.9,,,percent of total billed charges,33.9% of total billed charges,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3296.28,78,,,percent of total billed charges,78% of total billed charges,4226,100,,,percent of total billed charges,100% of total billed charges,3490.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3490.68,82.6,,,percent of total billed charges,82.6% of total billed charges,509.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,124.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.73,143261.4,
FREE/REMOVE CHEST LINING,32320,CDM,983,RC,32320,HCPCS,Outpatient,,,6565,4267.25,,5777.2,88,,,percent of total billed charges,88% of total Billed charges,218.37,100,,,Fee Schedule,100% of Medicare rate,886.99,100,,,Fee Schedule,100% of WA Medicaid,6565,100,,,percent of total billed charges,100% of total billed charges,913.6,103,,,Fee Schedule,103% of WA Medicaid,218.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,382.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,886.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4529.85,69,,,percent of total billed charges,69% of total billed charges,6565,100,,,percent of total billed charges,100% of total billed charges,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,6565,100,,,percent of total billed charges,100% of total billed charges,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,6565,100,,,percent of total billed charges,100% of total billed charges,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,4060.45,61.85,,,percent of total billed charges,61.85% of total billed charges,886.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,886.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1153.09,130,,,Fee Schedule,130% of WA Medicaid ,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2475.01,37.7,,,percent of total billed charges,37.70% of total billed charges,2475.01,37.7,,,percent of total billed charges,37.70% of total billed charges,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,222553.5,33.9,,,percent of total billed charges,33.9% of total billed charges,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,5120.7,78,,,percent of total billed charges,78% of total billed charges,6565,100,,,percent of total billed charges,100% of total billed charges,5422.69,82.6,,,percent of total billed charges,82.6% of total billed charges,5422.69,82.6,,,percent of total billed charges,82.6% of total billed charges,886.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,218.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,886.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,218.37,222553.5,
REMOVE LUNG PNEUMONECTOMY,32440,CDM,983,RC,32440,HCPCS,Outpatient,,,4429,2878.85,,3897.52,88,,,percent of total billed charges,88% of total Billed charges,219.48,100,,,Fee Schedule,100% of Medicare rate,863.12,100,,,Fee Schedule,100% of WA Medicaid,4429,100,,,percent of total billed charges,100% of total billed charges,889.01,103,,,Fee Schedule,103% of WA Medicaid,219.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,384.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,863.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3056.01,69,,,percent of total billed charges,69% of total billed charges,4429,100,,,percent of total billed charges,100% of total billed charges,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4429,100,,,percent of total billed charges,100% of total billed charges,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4429,100,,,percent of total billed charges,100% of total billed charges,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2739.34,61.85,,,percent of total billed charges,61.85% of total billed charges,863.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,880.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1122.06,130,,,Fee Schedule,130% of WA Medicaid ,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1669.73,37.7,,,percent of total billed charges,37.70% of total billed charges,1669.73,37.7,,,percent of total billed charges,37.70% of total billed charges,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,150143.1,33.9,,,percent of total billed charges,33.9% of total billed charges,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3454.62,78,,,percent of total billed charges,78% of total billed charges,4429,100,,,percent of total billed charges,100% of total billed charges,3658.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3658.35,82.6,,,percent of total billed charges,82.6% of total billed charges,863.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,219.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,219.48,150143.1,
SEGMENTECTOMY,32484,CDM,983,RC,32484,HCPCS,Outpatient,,,6824,4435.60,,6005.12,88,,,percent of total billed charges,88% of total Billed charges,201.96,100,,,Fee Schedule,100% of Medicare rate,786.66,100,,,Fee Schedule,100% of WA Medicaid,6824,100,,,percent of total billed charges,100% of total billed charges,810.26,103,,,Fee Schedule,103% of WA Medicaid,201.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,353.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,786.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4708.56,69,,,percent of total billed charges,69% of total billed charges,6824,100,,,percent of total billed charges,100% of total billed charges,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,6824,100,,,percent of total billed charges,100% of total billed charges,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,6824,100,,,percent of total billed charges,100% of total billed charges,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4220.64,61.85,,,percent of total billed charges,61.85% of total billed charges,786.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,802.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1022.66,130,,,Fee Schedule,130% of WA Medicaid ,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2572.65,37.7,,,percent of total billed charges,37.70% of total billed charges,2572.65,37.7,,,percent of total billed charges,37.70% of total billed charges,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,231333.6,33.9,,,percent of total billed charges,33.9% of total billed charges,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,5322.72,78,,,percent of total billed charges,78% of total billed charges,6824,100,,,percent of total billed charges,100% of total billed charges,5636.62,82.6,,,percent of total billed charges,82.6% of total billed charges,5636.62,82.6,,,percent of total billed charges,82.6% of total billed charges,786.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,201.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,201.96,231333.6,
PARTIAL REMOVAL OF LUNG,32480,CDM,983,RC,32480,HCPCS,Outpatient,,,6760,4394.00,,5948.8,88,,,percent of total billed charges,88% of total Billed charges,205.71,100,,,Fee Schedule,100% of Medicare rate,813.89,100,,,Fee Schedule,100% of WA Medicaid,6760,100,,,percent of total billed charges,100% of total billed charges,838.31,103,,,Fee Schedule,103% of WA Medicaid,205.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,360,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,813.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4664.4,69,,,percent of total billed charges,69% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,6760,100,,,percent of total billed charges,100% of total billed charges,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,6760,100,,,percent of total billed charges,100% of total billed charges,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,4181.06,61.85,,,percent of total billed charges,61.85% of total billed charges,813.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,830.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1058.06,130,,,Fee Schedule,130% of WA Medicaid ,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2548.52,37.7,,,percent of total billed charges,37.70% of total billed charges,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,229164,33.9,,,percent of total billed charges,33.9% of total billed charges,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5272.8,78,,,percent of total billed charges,78% of total billed charges,6760,100,,,percent of total billed charges,100% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,5583.76,82.6,,,percent of total billed charges,82.6% of total billed charges,813.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,205.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,205.71,229164,
BILOBECTOMY,32482,CDM,983,RC,32482,HCPCS,Outpatient,,,5447,3540.55,,4793.36,88,,,percent of total billed charges,88% of total Billed charges,219.58,100,,,Fee Schedule,100% of Medicare rate,870.02,100,,,Fee Schedule,100% of WA Medicaid,5447,100,,,percent of total billed charges,100% of total billed charges,896.12,103,,,Fee Schedule,103% of WA Medicaid,219.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,384.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,870.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3758.43,69,,,percent of total billed charges,69% of total billed charges,5447,100,,,percent of total billed charges,100% of total billed charges,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,5447,100,,,percent of total billed charges,100% of total billed charges,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,5447,100,,,percent of total billed charges,100% of total billed charges,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3368.97,61.85,,,percent of total billed charges,61.85% of total billed charges,870.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,870.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,887.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1131.03,130,,,Fee Schedule,130% of WA Medicaid ,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2053.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2053.52,37.7,,,percent of total billed charges,37.70% of total billed charges,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,184653.3,33.9,,,percent of total billed charges,33.9% of total billed charges,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4248.66,78,,,percent of total billed charges,78% of total billed charges,5447,100,,,percent of total billed charges,100% of total billed charges,4499.22,82.6,,,percent of total billed charges,82.6% of total billed charges,4499.22,82.6,,,percent of total billed charges,82.6% of total billed charges,870.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,219.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,870.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,219.58,184653.3,
COMPLETION PNEUMONECTOMY,32488,CDM,983,RC,32488,HCPCS,Outpatient,,,9841,6396.65,,8660.08,88,,,percent of total billed charges,88% of total Billed charges,345.52,100,,,Fee Schedule,100% of Medicare rate,1307.55,100,,,Fee Schedule,100% of WA Medicaid,9841,100,,,percent of total billed charges,100% of total billed charges,1346.78,103,,,Fee Schedule,103% of WA Medicaid,345.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,604.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1307.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6790.29,69,,,percent of total billed charges,69% of total billed charges,9841,100,,,percent of total billed charges,100% of total billed charges,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,9841,100,,,percent of total billed charges,100% of total billed charges,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,9841,100,,,percent of total billed charges,100% of total billed charges,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,6086.66,61.85,,,percent of total billed charges,61.85% of total billed charges,1307.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1307.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1333.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1699.82,130,,,Fee Schedule,130% of WA Medicaid ,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,3710.06,37.7,,,percent of total billed charges,37.70% of total billed charges,3710.06,37.7,,,percent of total billed charges,37.70% of total billed charges,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,333609.9,33.9,,,percent of total billed charges,33.9% of total billed charges,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,7675.98,78,,,percent of total billed charges,78% of total billed charges,9841,100,,,percent of total billed charges,100% of total billed charges,8128.67,82.6,,,percent of total billed charges,82.6% of total billed charges,8128.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1307.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,345.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1307.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,345.52,333609.9,
LUNG VOLUME REDUCTION,32491,CDM,983,RC,32491,HCPCS,Outpatient,,,4060,2639.00,,3572.8,88,,,percent of total billed charges,88% of total Billed charges,204.59,100,,,Fee Schedule,100% of Medicare rate,812.58,100,,,Fee Schedule,100% of WA Medicaid,4060,100,,,percent of total billed charges,100% of total billed charges,836.96,103,,,Fee Schedule,103% of WA Medicaid,204.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,358.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,812.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2801.4,69,,,percent of total billed charges,69% of total billed charges,4060,100,,,percent of total billed charges,100% of total billed charges,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,4060,100,,,percent of total billed charges,100% of total billed charges,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,4060,100,,,percent of total billed charges,100% of total billed charges,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2511.11,61.85,,,percent of total billed charges,61.85% of total billed charges,812.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,812.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,828.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1056.35,130,,,Fee Schedule,130% of WA Medicaid ,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1530.62,37.7,,,percent of total billed charges,37.70% of total billed charges,1530.62,37.7,,,percent of total billed charges,37.70% of total billed charges,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,137634,33.9,,,percent of total billed charges,33.9% of total billed charges,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3166.8,78,,,percent of total billed charges,78% of total billed charges,4060,100,,,percent of total billed charges,100% of total billed charges,3353.56,82.6,,,percent of total billed charges,82.6% of total billed charges,3353.56,82.6,,,percent of total billed charges,82.6% of total billed charges,812.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,204.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,812.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,204.59,137634,
WEDGE RESECT OF LUNG DIAG,98332507,CDM,983,RC,32507,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,23.41,100,,,Fee Schedule,100% of Medicare rate,84.3,100,,,Fee Schedule,100% of WA Medicaid,390,100,,,percent of total billed charges,100% of total billed charges,86.83,103,,,Fee Schedule,103% of WA Medicaid,23.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,84.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,390,100,,,percent of total billed charges,100% of total billed charges,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,390,100,,,percent of total billed charges,100% of total billed charges,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,84.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,109.59,130,,,Fee Schedule,130% of WA Medicaid ,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,13221,33.9,,,percent of total billed charges,33.9% of total billed charges,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,84.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.41,13221,
WEDGE RESECT OF LUNG ADD-ON,32506,CDM,983,RC,32506,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,23.42,100,,,Fee Schedule,100% of Medicare rate,84.48,100,,,Fee Schedule,100% of WA Medicaid,390,100,,,percent of total billed charges,100% of total billed charges,87.01,103,,,Fee Schedule,103% of WA Medicaid,23.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,84.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,390,100,,,percent of total billed charges,100% of total billed charges,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,390,100,,,percent of total billed charges,100% of total billed charges,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,84.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,109.82,130,,,Fee Schedule,130% of WA Medicaid ,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,13221,33.9,,,percent of total billed charges,33.9% of total billed charges,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,84.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.42,13221,
WEDGE RESECT OF LUNG INITIAL,32505,CDM,983,RC,32505,HCPCS,Outpatient,,,2312,1502.80,,2034.56,88,,,percent of total billed charges,88% of total Billed charges,126.59,100,,,Fee Schedule,100% of Medicare rate,515.11,100,,,Fee Schedule,100% of WA Medicaid,2312,100,,,percent of total billed charges,100% of total billed charges,530.56,103,,,Fee Schedule,103% of WA Medicaid,126.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,221.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,515.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1595.28,69,,,percent of total billed charges,69% of total billed charges,2312,100,,,percent of total billed charges,100% of total billed charges,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2312,100,,,percent of total billed charges,100% of total billed charges,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2312,100,,,percent of total billed charges,100% of total billed charges,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1429.97,61.85,,,percent of total billed charges,61.85% of total billed charges,515.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,669.64,130,,,Fee Schedule,130% of WA Medicaid ,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,871.62,37.7,,,percent of total billed charges,37.70% of total billed charges,871.62,37.7,,,percent of total billed charges,37.70% of total billed charges,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,78376.8,33.9,,,percent of total billed charges,33.9% of total billed charges,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1803.36,78,,,percent of total billed charges,78% of total billed charges,2312,100,,,percent of total billed charges,100% of total billed charges,1909.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1909.71,82.6,,,percent of total billed charges,82.6% of total billed charges,515.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,126.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.59,78376.8,
REMOVAL OF LUNG LESION,32540,CDM,983,RC,32540,HCPCS,Outpatient,,,5991,3894.15,,5272.08,88,,,percent of total billed charges,88% of total Billed charges,245.31,100,,,Fee Schedule,100% of Medicare rate,949.1,100,,,Fee Schedule,100% of WA Medicaid,5991,100,,,percent of total billed charges,100% of total billed charges,977.57,103,,,Fee Schedule,103% of WA Medicaid,245.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,429.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,949.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4133.79,69,,,percent of total billed charges,69% of total billed charges,5991,100,,,percent of total billed charges,100% of total billed charges,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,5991,100,,,percent of total billed charges,100% of total billed charges,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,5991,100,,,percent of total billed charges,100% of total billed charges,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,3705.43,61.85,,,percent of total billed charges,61.85% of total billed charges,949.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,949.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,968.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1233.83,130,,,Fee Schedule,130% of WA Medicaid ,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2258.61,37.7,,,percent of total billed charges,37.70% of total billed charges,2258.61,37.7,,,percent of total billed charges,37.70% of total billed charges,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,203094.9,33.9,,,percent of total billed charges,33.9% of total billed charges,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,4672.98,78,,,percent of total billed charges,78% of total billed charges,5991,100,,,percent of total billed charges,100% of total billed charges,4948.57,82.6,,,percent of total billed charges,82.6% of total billed charges,4948.57,82.6,,,percent of total billed charges,82.6% of total billed charges,949.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,245.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,949.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,245.31,203094.9,
ASPIRATE PLEURA W/O IMAGING,32554,CDM,983,RC,32554,HCPCS,Outpatient,,,247,160.55,,217.36,88,,,percent of total billed charges,88% of total Billed charges,8.05,100,,,Fee Schedule,100% of Medicare rate,49.05,100,,,Fee Schedule,100% of WA Medicaid,247,100,,,percent of total billed charges,100% of total billed charges,50.52,103,,,Fee Schedule,103% of WA Medicaid,8.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,170.43,69,,,percent of total billed charges,69% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,247,100,,,percent of total billed charges,100% of total billed charges,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,247,100,,,percent of total billed charges,100% of total billed charges,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.77,61.85,,,percent of total billed charges,61.85% of total billed charges,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.77,130,,,Fee Schedule,130% of WA Medicaid ,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,8373.3,33.9,,,percent of total billed charges,33.9% of total billed charges,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.66,78,,,percent of total billed charges,78% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.05,8373.3,
INSERT CATH PLEURA W/ IMAGE,32557,CDM,983,RC,32557,HCPCS,Outpatient,,,451,293.15,,396.88,88,,,percent of total billed charges,88% of total Billed charges,12.41,100,,,Fee Schedule,100% of Medicare rate,82.43,100,,,Fee Schedule,100% of WA Medicaid,451,100,,,percent of total billed charges,100% of total billed charges,84.9,103,,,Fee Schedule,103% of WA Medicaid,12.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,82.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,311.19,69,,,percent of total billed charges,69% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,451,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,451,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.94,61.85,,,percent of total billed charges,61.85% of total billed charges,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.16,130,,,Fee Schedule,130% of WA Medicaid ,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,15288.9,33.9,,,percent of total billed charges,33.9% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.78,78,,,percent of total billed charges,78% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.41,15288.9,
ASPIRATE PLEURA W/ IMAGING,32555,CDM,983,RC,32555,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,8.9,100,,,Fee Schedule,100% of Medicare rate,60.43,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,62.24,103,,,Fee Schedule,103% of WA Medicaid,8.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,308,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,308,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.5,61.85,,,percent of total billed charges,61.85% of total billed charges,60.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,78.56,130,,,Fee Schedule,130% of WA Medicaid ,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,10441.2,33.9,,,percent of total billed charges,33.9% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,60.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.9,10441.2,
INSERT CATH PLEURA W/O IMAGE,32556,CDM,983,RC,32556,HCPCS,Outpatient,,,337,219.05,,296.56,88,,,percent of total billed charges,88% of total Billed charges,13.23,100,,,Fee Schedule,100% of Medicare rate,68.45,100,,,Fee Schedule,100% of WA Medicaid,337,100,,,percent of total billed charges,100% of total billed charges,70.5,103,,,Fee Schedule,103% of WA Medicaid,13.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,232.53,69,,,percent of total billed charges,69% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,337,100,,,percent of total billed charges,100% of total billed charges,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,337,100,,,percent of total billed charges,100% of total billed charges,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.43,61.85,,,percent of total billed charges,61.85% of total billed charges,68.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,88.99,130,,,Fee Schedule,130% of WA Medicaid ,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.05,37.7,,,percent of total billed charges,37.70% of total billed charges,127.05,37.7,,,percent of total billed charges,37.70% of total billed charges,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,11424.3,33.9,,,percent of total billed charges,33.9% of total billed charges,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.86,78,,,percent of total billed charges,78% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,68.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.23,11424.3,
INSERTION OF CHEST TUBE,32551,CDM,983,RC,32551,HCPCS,Outpatient,,,865,562.25,,761.2,88,,,percent of total billed charges,88% of total Billed charges,18.29,100,,,Fee Schedule,100% of Medicare rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,865,100,,,percent of total billed charges,100% of total billed charges,88.36,103,,,Fee Schedule,103% of WA Medicaid,18.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,596.85,69,,,percent of total billed charges,69% of total billed charges,865,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,865,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,865,100,,,percent of total billed charges,100% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,535,61.85,,,percent of total billed charges,61.85% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.53,130,,,Fee Schedule,130% of WA Medicaid ,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.11,37.7,,,percent of total billed charges,37.70% of total billed charges,326.11,37.7,,,percent of total billed charges,37.70% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,29323.5,33.9,,,percent of total billed charges,33.9% of total billed charges,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.7,78,,,percent of total billed charges,78% of total billed charges,865,100,,,percent of total billed charges,100% of total billed charges,714.49,82.6,,,percent of total billed charges,82.6% of total billed charges,714.49,82.6,,,percent of total billed charges,82.6% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.29,29323.5,
INSERT PLEURAL CATH,32550,CDM,983,RC,32550,HCPCS,Outpatient,,,615,399.75,,541.2,88,,,percent of total billed charges,88% of total Billed charges,19.98,100,,,Fee Schedule,100% of Medicare rate,112.83,100,,,Fee Schedule,100% of WA Medicaid,615,100,,,percent of total billed charges,100% of total billed charges,116.21,103,,,Fee Schedule,103% of WA Medicaid,19.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,424.35,69,,,percent of total billed charges,69% of total billed charges,615,100,,,percent of total billed charges,100% of total billed charges,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,615,100,,,percent of total billed charges,100% of total billed charges,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,615,100,,,percent of total billed charges,100% of total billed charges,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.38,61.85,,,percent of total billed charges,61.85% of total billed charges,112.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,146.68,130,,,Fee Schedule,130% of WA Medicaid ,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.86,37.7,,,percent of total billed charges,37.70% of total billed charges,231.86,37.7,,,percent of total billed charges,37.70% of total billed charges,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,20848.5,33.9,,,percent of total billed charges,33.9% of total billed charges,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.7,78,,,percent of total billed charges,78% of total billed charges,615,100,,,percent of total billed charges,100% of total billed charges,507.99,82.6,,,percent of total billed charges,82.6% of total billed charges,507.99,82.6,,,percent of total billed charges,82.6% of total billed charges,112.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.98,20848.5,
TREAT PLEURODESIS W/AGENT,32560,CDM,983,RC,32560,HCPCS,Outpatient,,,610,396.50,,536.8,88,,,percent of total billed charges,88% of total Billed charges,8.44,100,,,Fee Schedule,100% of Medicare rate,41.78,100,,,Fee Schedule,100% of WA Medicaid,610,100,,,percent of total billed charges,100% of total billed charges,43.03,103,,,Fee Schedule,103% of WA Medicaid,8.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,41.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,420.9,69,,,percent of total billed charges,69% of total billed charges,610,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,610,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,610,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.29,61.85,,,percent of total billed charges,61.85% of total billed charges,41.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,54.31,130,,,Fee Schedule,130% of WA Medicaid ,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.97,37.7,,,percent of total billed charges,37.70% of total billed charges,229.97,37.7,,,percent of total billed charges,37.70% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,20679,33.9,,,percent of total billed charges,33.9% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.8,78,,,percent of total billed charges,78% of total billed charges,610,100,,,percent of total billed charges,100% of total billed charges,503.86,82.6,,,percent of total billed charges,82.6% of total billed charges,503.86,82.6,,,percent of total billed charges,82.6% of total billed charges,41.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.44,20679,
THORACOSCOPY DIAGNOSTIC,32601,CDM,983,RC,32601,HCPCS,Outpatient,,,1576,1024.40,,1386.88,88,,,percent of total billed charges,88% of total Billed charges,43.18,100,,,Fee Schedule,100% of Medicare rate,168.78,100,,,Fee Schedule,100% of WA Medicaid,1576,100,,,percent of total billed charges,100% of total billed charges,173.84,103,,,Fee Schedule,103% of WA Medicaid,43.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,168.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1087.44,69,,,percent of total billed charges,69% of total billed charges,1576,100,,,percent of total billed charges,100% of total billed charges,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1576,100,,,percent of total billed charges,100% of total billed charges,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1576,100,,,percent of total billed charges,100% of total billed charges,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,974.76,61.85,,,percent of total billed charges,61.85% of total billed charges,168.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,219.41,130,,,Fee Schedule,130% of WA Medicaid ,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.15,37.7,,,percent of total billed charges,37.70% of total billed charges,594.15,37.7,,,percent of total billed charges,37.70% of total billed charges,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,53426.4,33.9,,,percent of total billed charges,33.9% of total billed charges,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1229.28,78,,,percent of total billed charges,78% of total billed charges,1576,100,,,percent of total billed charges,100% of total billed charges,1301.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1301.78,82.6,,,percent of total billed charges,82.6% of total billed charges,168.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.18,53426.4,
THORACOSCOPY W/BX INFILTRATE,32607,CDM,983,RC,32607,HCPCS,Outpatient,,,769,499.85,,676.72,88,,,percent of total billed charges,88% of total Billed charges,43.16,100,,,Fee Schedule,100% of Medicare rate,168.41,100,,,Fee Schedule,100% of WA Medicaid,769,100,,,percent of total billed charges,100% of total billed charges,173.46,103,,,Fee Schedule,103% of WA Medicaid,43.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,168.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,530.61,69,,,percent of total billed charges,69% of total billed charges,769,100,,,percent of total billed charges,100% of total billed charges,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,769,100,,,percent of total billed charges,100% of total billed charges,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,769,100,,,percent of total billed charges,100% of total billed charges,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.63,61.85,,,percent of total billed charges,61.85% of total billed charges,168.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,218.93,130,,,Fee Schedule,130% of WA Medicaid ,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.91,37.7,,,percent of total billed charges,37.70% of total billed charges,289.91,37.7,,,percent of total billed charges,37.70% of total billed charges,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,26069.1,33.9,,,percent of total billed charges,33.9% of total billed charges,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.82,78,,,percent of total billed charges,78% of total billed charges,769,100,,,percent of total billed charges,100% of total billed charges,635.19,82.6,,,percent of total billed charges,82.6% of total billed charges,635.19,82.6,,,percent of total billed charges,82.6% of total billed charges,168.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.16,26069.1,
THORACOSCOPY W/BX NODULE,32608,CDM,983,RC,32608,HCPCS,Outpatient,,,944,613.60,,830.72,88,,,percent of total billed charges,88% of total Billed charges,54.53,100,,,Fee Schedule,100% of Medicare rate,206.64,100,,,Fee Schedule,100% of WA Medicaid,944,100,,,percent of total billed charges,100% of total billed charges,212.84,103,,,Fee Schedule,103% of WA Medicaid,54.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,206.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,651.36,69,,,percent of total billed charges,69% of total billed charges,944,100,,,percent of total billed charges,100% of total billed charges,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,944,100,,,percent of total billed charges,100% of total billed charges,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,944,100,,,percent of total billed charges,100% of total billed charges,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.86,61.85,,,percent of total billed charges,61.85% of total billed charges,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,268.63,130,,,Fee Schedule,130% of WA Medicaid ,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.89,37.7,,,percent of total billed charges,37.70% of total billed charges,355.89,37.7,,,percent of total billed charges,37.70% of total billed charges,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,32001.6,33.9,,,percent of total billed charges,33.9% of total billed charges,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.32,78,,,percent of total billed charges,78% of total billed charges,944,100,,,percent of total billed charges,100% of total billed charges,779.74,82.6,,,percent of total billed charges,82.6% of total billed charges,779.74,82.6,,,percent of total billed charges,82.6% of total billed charges,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.53,32001.6,
THORACOSCOPY W/BX MED SPACE,32606,CDM,983,RC,32606,HCPCS,Outpatient,,,2097,1363.05,,1845.36,88,,,percent of total billed charges,88% of total Billed charges,66.78,100,,,Fee Schedule,100% of Medicare rate,251.78,100,,,Fee Schedule,100% of WA Medicaid,2097,100,,,percent of total billed charges,100% of total billed charges,259.33,103,,,Fee Schedule,103% of WA Medicaid,66.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,116.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,251.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1446.93,69,,,percent of total billed charges,69% of total billed charges,2097,100,,,percent of total billed charges,100% of total billed charges,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2097,100,,,percent of total billed charges,100% of total billed charges,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2097,100,,,percent of total billed charges,100% of total billed charges,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1296.99,61.85,,,percent of total billed charges,61.85% of total billed charges,251.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,327.31,130,,,Fee Schedule,130% of WA Medicaid ,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,790.57,37.7,,,percent of total billed charges,37.70% of total billed charges,790.57,37.7,,,percent of total billed charges,37.70% of total billed charges,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,71088.3,33.9,,,percent of total billed charges,33.9% of total billed charges,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1635.66,78,,,percent of total billed charges,78% of total billed charges,2097,100,,,percent of total billed charges,100% of total billed charges,1732.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1732.12,82.6,,,percent of total billed charges,82.6% of total billed charges,251.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,66.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.78,71088.3,
THORACOSCOPY WBX SAC,32604,CDM,983,RC,32604,HCPCS,Outpatient,,,2178,1415.70,,1916.64,88,,,percent of total billed charges,88% of total Billed charges,70.13,100,,,Fee Schedule,100% of Medicare rate,261.1,100,,,Fee Schedule,100% of WA Medicaid,2178,100,,,percent of total billed charges,100% of total billed charges,268.93,103,,,Fee Schedule,103% of WA Medicaid,70.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,122.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,261.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1502.82,69,,,percent of total billed charges,69% of total billed charges,2178,100,,,percent of total billed charges,100% of total billed charges,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2178,100,,,percent of total billed charges,100% of total billed charges,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2178,100,,,percent of total billed charges,100% of total billed charges,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1347.09,61.85,,,percent of total billed charges,61.85% of total billed charges,261.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,339.43,130,,,Fee Schedule,130% of WA Medicaid ,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,821.11,37.7,,,percent of total billed charges,37.70% of total billed charges,821.11,37.7,,,percent of total billed charges,37.70% of total billed charges,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,73834.2,33.9,,,percent of total billed charges,33.9% of total billed charges,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1698.84,78,,,percent of total billed charges,78% of total billed charges,2178,100,,,percent of total billed charges,100% of total billed charges,1799.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1799.03,82.6,,,percent of total billed charges,82.6% of total billed charges,261.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.13,73834.2,
THORACOSCOPY W/BX PLEURA,32609,CDM,983,RC,32609,HCPCS,Outpatient,,,654,425.10,,575.52,88,,,percent of total billed charges,88% of total Billed charges,33.13,100,,,Fee Schedule,100% of Medicare rate,140.81,100,,,Fee Schedule,100% of WA Medicaid,654,100,,,percent of total billed charges,100% of total billed charges,145.03,103,,,Fee Schedule,103% of WA Medicaid,33.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,140.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,451.26,69,,,percent of total billed charges,69% of total billed charges,654,100,,,percent of total billed charges,100% of total billed charges,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,654,100,,,percent of total billed charges,100% of total billed charges,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,654,100,,,percent of total billed charges,100% of total billed charges,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.5,61.85,,,percent of total billed charges,61.85% of total billed charges,140.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,183.05,130,,,Fee Schedule,130% of WA Medicaid ,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.56,37.7,,,percent of total billed charges,37.70% of total billed charges,246.56,37.7,,,percent of total billed charges,37.70% of total billed charges,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,22170.6,33.9,,,percent of total billed charges,33.9% of total billed charges,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.12,78,,,percent of total billed charges,78% of total billed charges,654,100,,,percent of total billed charges,100% of total billed charges,540.2,82.6,,,percent of total billed charges,82.6% of total billed charges,540.2,82.6,,,percent of total billed charges,82.6% of total billed charges,140.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.13,22170.6,
THORACOSCOPY RESECT BULLAE,32655,CDM,983,RC,32655,HCPCS,Outpatient,,,4800,3120.00,,4224,88,,,percent of total billed charges,88% of total Billed charges,130.45,100,,,Fee Schedule,100% of Medicare rate,529.1,100,,,Fee Schedule,100% of WA Medicaid,4800,100,,,percent of total billed charges,100% of total billed charges,544.97,103,,,Fee Schedule,103% of WA Medicaid,130.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,228.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,529.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3312,69,,,percent of total billed charges,69% of total billed charges,4800,100,,,percent of total billed charges,100% of total billed charges,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,4800,100,,,percent of total billed charges,100% of total billed charges,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,4800,100,,,percent of total billed charges,100% of total billed charges,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2968.8,61.85,,,percent of total billed charges,61.85% of total billed charges,529.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,529.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,687.83,130,,,Fee Schedule,130% of WA Medicaid ,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1809.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1809.6,37.7,,,percent of total billed charges,37.70% of total billed charges,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,162720,33.9,,,percent of total billed charges,33.9% of total billed charges,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,3744,78,,,percent of total billed charges,78% of total billed charges,4800,100,,,percent of total billed charges,100% of total billed charges,3964.8,82.6,,,percent of total billed charges,82.6% of total billed charges,3964.8,82.6,,,percent of total billed charges,82.6% of total billed charges,529.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,130.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,529.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,130.45,162720,
THORACOSCOPY REM TOTL CORTEX,32652,CDM,983,RC,32652,HCPCS,Outpatient,,,6147,3995.55,,5409.36,88,,,percent of total billed charges,88% of total Billed charges,233.56,100,,,Fee Schedule,100% of Medicare rate,913.48,100,,,Fee Schedule,100% of WA Medicaid,6147,100,,,percent of total billed charges,100% of total billed charges,940.88,103,,,Fee Schedule,103% of WA Medicaid,233.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,408.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,913.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4241.43,69,,,percent of total billed charges,69% of total billed charges,6147,100,,,percent of total billed charges,100% of total billed charges,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,6147,100,,,percent of total billed charges,100% of total billed charges,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,6147,100,,,percent of total billed charges,100% of total billed charges,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3801.92,61.85,,,percent of total billed charges,61.85% of total billed charges,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1187.52,130,,,Fee Schedule,130% of WA Medicaid ,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2317.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2317.42,37.7,,,percent of total billed charges,37.70% of total billed charges,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,208383.3,33.9,,,percent of total billed charges,33.9% of total billed charges,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4794.66,78,,,percent of total billed charges,78% of total billed charges,6147,100,,,percent of total billed charges,100% of total billed charges,5077.42,82.6,,,percent of total billed charges,82.6% of total billed charges,5077.42,82.6,,,percent of total billed charges,82.6% of total billed charges,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,233.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,233.56,208383.3,
THORACOSCOPY REMOV FB/FIBRIN,32653,CDM,983,RC,32653,HCPCS,Outpatient,,,4882,3173.30,,4296.16,88,,,percent of total billed charges,88% of total Billed charges,140.92,100,,,Fee Schedule,100% of Medicare rate,584.86,100,,,Fee Schedule,100% of WA Medicaid,4882,100,,,percent of total billed charges,100% of total billed charges,602.41,103,,,Fee Schedule,103% of WA Medicaid,140.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,246.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,584.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3368.58,69,,,percent of total billed charges,69% of total billed charges,4882,100,,,percent of total billed charges,100% of total billed charges,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,4882,100,,,percent of total billed charges,100% of total billed charges,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,4882,100,,,percent of total billed charges,100% of total billed charges,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,3019.52,61.85,,,percent of total billed charges,61.85% of total billed charges,584.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,584.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,760.32,130,,,Fee Schedule,130% of WA Medicaid ,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1840.51,37.7,,,percent of total billed charges,37.70% of total billed charges,1840.51,37.7,,,percent of total billed charges,37.70% of total billed charges,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,165499.8,33.9,,,percent of total billed charges,33.9% of total billed charges,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,3807.96,78,,,percent of total billed charges,78% of total billed charges,4882,100,,,percent of total billed charges,100% of total billed charges,4032.53,82.6,,,percent of total billed charges,82.6% of total billed charges,4032.53,82.6,,,percent of total billed charges,82.6% of total billed charges,584.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,140.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,584.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.92,165499.8,
THORACOSCOPY W/SAC FB REMOVE,32658,CDM,983,RC,32658,HCPCS,Outpatient,,,3406,2213.90,,2997.28,88,,,percent of total billed charges,88% of total Billed charges,95.7,100,,,Fee Schedule,100% of Medicare rate,397.25,100,,,Fee Schedule,100% of WA Medicaid,3406,100,,,percent of total billed charges,100% of total billed charges,409.17,103,,,Fee Schedule,103% of WA Medicaid,95.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,167.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,397.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2350.14,69,,,percent of total billed charges,69% of total billed charges,3406,100,,,percent of total billed charges,100% of total billed charges,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,3406,100,,,percent of total billed charges,100% of total billed charges,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,3406,100,,,percent of total billed charges,100% of total billed charges,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2106.61,61.85,,,percent of total billed charges,61.85% of total billed charges,397.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,516.43,130,,,Fee Schedule,130% of WA Medicaid ,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1284.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1284.06,37.7,,,percent of total billed charges,37.70% of total billed charges,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,115463.4,33.9,,,percent of total billed charges,33.9% of total billed charges,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2656.68,78,,,percent of total billed charges,78% of total billed charges,3406,100,,,percent of total billed charges,100% of total billed charges,2813.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2813.36,82.6,,,percent of total billed charges,82.6% of total billed charges,397.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,95.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.7,115463.4,
THORACOSCOPY W/PLEURODESIS,32650,CDM,983,RC,32650,HCPCS,Outpatient,,,3635,2362.75,,3198.8,88,,,percent of total billed charges,88% of total Billed charges,86.61,100,,,Fee Schedule,100% of Medicare rate,372.63,100,,,Fee Schedule,100% of WA Medicaid,3635,100,,,percent of total billed charges,100% of total billed charges,383.81,103,,,Fee Schedule,103% of WA Medicaid,86.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,151.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,372.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2508.15,69,,,percent of total billed charges,69% of total billed charges,3635,100,,,percent of total billed charges,100% of total billed charges,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,3635,100,,,percent of total billed charges,100% of total billed charges,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,3635,100,,,percent of total billed charges,100% of total billed charges,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2248.25,61.85,,,percent of total billed charges,61.85% of total billed charges,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,484.42,130,,,Fee Schedule,130% of WA Medicaid ,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1370.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1370.4,37.7,,,percent of total billed charges,37.70% of total billed charges,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,123226.5,33.9,,,percent of total billed charges,33.9% of total billed charges,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2835.3,78,,,percent of total billed charges,78% of total billed charges,3635,100,,,percent of total billed charges,100% of total billed charges,3002.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3002.51,82.6,,,percent of total billed charges,82.6% of total billed charges,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,86.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.61,123226.5,
THORACOSCOPY REMOVE CORTEX,32651,CDM,983,RC,32651,HCPCS,Outpatient,,,4415,2869.75,,3885.2,88,,,percent of total billed charges,88% of total Billed charges,150.51,100,,,Fee Schedule,100% of Medicare rate,604.26,100,,,Fee Schedule,100% of WA Medicaid,4415,100,,,percent of total billed charges,100% of total billed charges,622.39,103,,,Fee Schedule,103% of WA Medicaid,150.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,263.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,604.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3046.35,69,,,percent of total billed charges,69% of total billed charges,4415,100,,,percent of total billed charges,100% of total billed charges,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4415,100,,,percent of total billed charges,100% of total billed charges,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4415,100,,,percent of total billed charges,100% of total billed charges,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2730.68,61.85,,,percent of total billed charges,61.85% of total billed charges,604.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,604.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,616.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,785.54,130,,,Fee Schedule,130% of WA Medicaid ,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1664.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1664.46,37.7,,,percent of total billed charges,37.70% of total billed charges,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,149668.5,33.9,,,percent of total billed charges,33.9% of total billed charges,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,3443.7,78,,,percent of total billed charges,78% of total billed charges,4415,100,,,percent of total billed charges,100% of total billed charges,3646.79,82.6,,,percent of total billed charges,82.6% of total billed charges,3646.79,82.6,,,percent of total billed charges,82.6% of total billed charges,604.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,150.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,604.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,150.51,149668.5,
THORACOSCOPY CONTRL BLEEDING,32654,CDM,983,RC,32654,HCPCS,Outpatient,,,4910,3191.50,,4320.8,88,,,percent of total billed charges,88% of total Billed charges,157.25,100,,,Fee Schedule,100% of Medicare rate,653.12,100,,,Fee Schedule,100% of WA Medicaid,4910,100,,,percent of total billed charges,100% of total billed charges,672.71,103,,,Fee Schedule,103% of WA Medicaid,157.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,275.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,653.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3387.9,69,,,percent of total billed charges,69% of total billed charges,4910,100,,,percent of total billed charges,100% of total billed charges,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,4910,100,,,percent of total billed charges,100% of total billed charges,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,4910,100,,,percent of total billed charges,100% of total billed charges,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3036.84,61.85,,,percent of total billed charges,61.85% of total billed charges,653.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,653.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,666.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,849.06,130,,,Fee Schedule,130% of WA Medicaid ,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1851.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1851.07,37.7,,,percent of total billed charges,37.70% of total billed charges,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,166449,33.9,,,percent of total billed charges,33.9% of total billed charges,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3829.8,78,,,percent of total billed charges,78% of total billed charges,4910,100,,,percent of total billed charges,100% of total billed charges,4055.66,82.6,,,percent of total billed charges,82.6% of total billed charges,4055.66,82.6,,,percent of total billed charges,82.6% of total billed charges,653.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,157.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,653.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,157.25,166449,
THORACOSCOPY W/SAC DRAINAGE,32659,CDM,983,RC,32659,HCPCS,Outpatient,,,4610,2996.50,,4056.8,88,,,percent of total billed charges,88% of total Billed charges,96.82,100,,,Fee Schedule,100% of Medicare rate,408.81,100,,,Fee Schedule,100% of WA Medicaid,4610,100,,,percent of total billed charges,100% of total billed charges,421.07,103,,,Fee Schedule,103% of WA Medicaid,96.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,169.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,408.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3180.9,69,,,percent of total billed charges,69% of total billed charges,4610,100,,,percent of total billed charges,100% of total billed charges,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4610,100,,,percent of total billed charges,100% of total billed charges,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4610,100,,,percent of total billed charges,100% of total billed charges,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2851.29,61.85,,,percent of total billed charges,61.85% of total billed charges,408.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,531.45,130,,,Fee Schedule,130% of WA Medicaid ,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1737.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1737.97,37.7,,,percent of total billed charges,37.70% of total billed charges,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,156279,33.9,,,percent of total billed charges,33.9% of total billed charges,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,3595.8,78,,,percent of total billed charges,78% of total billed charges,4610,100,,,percent of total billed charges,100% of total billed charges,3807.86,82.6,,,percent of total billed charges,82.6% of total billed charges,3807.86,82.6,,,percent of total billed charges,82.6% of total billed charges,408.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.82,156279,
THORACOSCOPY W/PLEURECTOMY,32656,CDM,983,RC,32656,HCPCS,Outpatient,,,5793,3765.45,,5097.84,88,,,percent of total billed charges,88% of total Billed charges,107.36,100,,,Fee Schedule,100% of Medicare rate,445.92,100,,,Fee Schedule,100% of WA Medicaid,5793,100,,,percent of total billed charges,100% of total billed charges,459.3,103,,,Fee Schedule,103% of WA Medicaid,107.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,187.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,445.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3997.17,69,,,percent of total billed charges,69% of total billed charges,5793,100,,,percent of total billed charges,100% of total billed charges,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,5793,100,,,percent of total billed charges,100% of total billed charges,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,5793,100,,,percent of total billed charges,100% of total billed charges,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3582.97,61.85,,,percent of total billed charges,61.85% of total billed charges,445.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,579.7,130,,,Fee Schedule,130% of WA Medicaid ,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2183.96,37.7,,,percent of total billed charges,37.70% of total billed charges,2183.96,37.7,,,percent of total billed charges,37.70% of total billed charges,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,196382.7,33.9,,,percent of total billed charges,33.9% of total billed charges,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4518.54,78,,,percent of total billed charges,78% of total billed charges,5793,100,,,percent of total billed charges,100% of total billed charges,4785.02,82.6,,,percent of total billed charges,82.6% of total billed charges,4785.02,82.6,,,percent of total billed charges,82.6% of total billed charges,445.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.36,196382.7,
THORACOSCOPY W/W RESECT DIAG,32668,CDM,983,RC,32668,HCPCS,Outpatient,,,393,255.45,,345.84,88,,,percent of total billed charges,88% of total Billed charges,23.69,100,,,Fee Schedule,100% of Medicare rate,84.67,100,,,Fee Schedule,100% of WA Medicaid,393,100,,,percent of total billed charges,100% of total billed charges,87.21,103,,,Fee Schedule,103% of WA Medicaid,23.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,84.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,271.17,69,,,percent of total billed charges,69% of total billed charges,393,100,,,percent of total billed charges,100% of total billed charges,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,393,100,,,percent of total billed charges,100% of total billed charges,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,393,100,,,percent of total billed charges,100% of total billed charges,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.07,61.85,,,percent of total billed charges,61.85% of total billed charges,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,110.07,130,,,Fee Schedule,130% of WA Medicaid ,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.16,37.7,,,percent of total billed charges,37.70% of total billed charges,148.16,37.7,,,percent of total billed charges,37.70% of total billed charges,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,13322.7,33.9,,,percent of total billed charges,33.9% of total billed charges,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.54,78,,,percent of total billed charges,78% of total billed charges,393,100,,,percent of total billed charges,100% of total billed charges,324.62,82.6,,,percent of total billed charges,82.6% of total billed charges,324.62,82.6,,,percent of total billed charges,82.6% of total billed charges,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.69,13322.7,
THORACOSCOPY W/W RESECT ADDL,32667,CDM,983,RC,32667,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,23.69,100,,,Fee Schedule,100% of Medicare rate,84.67,100,,,Fee Schedule,100% of WA Medicaid,390,100,,,percent of total billed charges,100% of total billed charges,87.21,103,,,Fee Schedule,103% of WA Medicaid,23.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,84.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,390,100,,,percent of total billed charges,100% of total billed charges,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,390,100,,,percent of total billed charges,100% of total billed charges,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,110.07,130,,,Fee Schedule,130% of WA Medicaid ,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,13221,33.9,,,percent of total billed charges,33.9% of total billed charges,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.69,13221,
THORACOSCOPY REMOVE SEGMENT,32669,CDM,983,RC,32669,HCPCS,Outpatient,,,3333,2166.45,,2933.04,88,,,percent of total billed charges,88% of total Billed charges,189.2,100,,,Fee Schedule,100% of Medicare rate,737.05,100,,,Fee Schedule,100% of WA Medicaid,3333,100,,,percent of total billed charges,100% of total billed charges,759.16,103,,,Fee Schedule,103% of WA Medicaid,189.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,331.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,737.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2299.77,69,,,percent of total billed charges,69% of total billed charges,3333,100,,,percent of total billed charges,100% of total billed charges,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3333,100,,,percent of total billed charges,100% of total billed charges,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3333,100,,,percent of total billed charges,100% of total billed charges,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2061.46,61.85,,,percent of total billed charges,61.85% of total billed charges,737.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,737.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,958.17,130,,,Fee Schedule,130% of WA Medicaid ,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1256.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1256.54,37.7,,,percent of total billed charges,37.70% of total billed charges,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,112988.7,33.9,,,percent of total billed charges,33.9% of total billed charges,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2599.74,78,,,percent of total billed charges,78% of total billed charges,3333,100,,,percent of total billed charges,100% of total billed charges,2753.06,82.6,,,percent of total billed charges,82.6% of total billed charges,2753.06,82.6,,,percent of total billed charges,82.6% of total billed charges,737.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,189.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,737.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,189.2,112988.7,
THORACOSCOPY W/WEDGE RESECT,32666,CDM,983,RC,32666,HCPCS,Outpatient,,,2164,1406.60,,1904.32,88,,,percent of total billed charges,88% of total Billed charges,117.83,100,,,Fee Schedule,100% of Medicare rate,482.1,100,,,Fee Schedule,100% of WA Medicaid,2164,100,,,percent of total billed charges,100% of total billed charges,496.56,103,,,Fee Schedule,103% of WA Medicaid,117.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,206.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,482.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1493.16,69,,,percent of total billed charges,69% of total billed charges,2164,100,,,percent of total billed charges,100% of total billed charges,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2164,100,,,percent of total billed charges,100% of total billed charges,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2164,100,,,percent of total billed charges,100% of total billed charges,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1338.43,61.85,,,percent of total billed charges,61.85% of total billed charges,482.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,491.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,626.73,130,,,Fee Schedule,130% of WA Medicaid ,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.83,37.7,,,percent of total billed charges,37.70% of total billed charges,815.83,37.7,,,percent of total billed charges,37.70% of total billed charges,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,73359.6,33.9,,,percent of total billed charges,33.9% of total billed charges,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1687.92,78,,,percent of total billed charges,78% of total billed charges,2164,100,,,percent of total billed charges,100% of total billed charges,1787.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1787.46,82.6,,,percent of total billed charges,82.6% of total billed charges,482.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.83,73359.6,
THORACOSCOPY W/MEDIAST EXC,32662,CDM,983,RC,32662,HCPCS,Outpatient,,,5376,3494.40,,4730.88,88,,,percent of total billed charges,88% of total Billed charges,121.89,100,,,Fee Schedule,100% of Medicare rate,494.97,100,,,Fee Schedule,100% of WA Medicaid,5376,100,,,percent of total billed charges,100% of total billed charges,509.82,103,,,Fee Schedule,103% of WA Medicaid,121.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,213.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,494.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3709.44,69,,,percent of total billed charges,69% of total billed charges,5376,100,,,percent of total billed charges,100% of total billed charges,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,5376,100,,,percent of total billed charges,100% of total billed charges,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,5376,100,,,percent of total billed charges,100% of total billed charges,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,3325.06,61.85,,,percent of total billed charges,61.85% of total billed charges,494.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,643.46,130,,,Fee Schedule,130% of WA Medicaid ,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2026.75,37.7,,,percent of total billed charges,37.70% of total billed charges,2026.75,37.7,,,percent of total billed charges,37.70% of total billed charges,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,182246.4,33.9,,,percent of total billed charges,33.9% of total billed charges,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,4193.28,78,,,percent of total billed charges,78% of total billed charges,5376,100,,,percent of total billed charges,100% of total billed charges,4440.58,82.6,,,percent of total billed charges,82.6% of total billed charges,4440.58,82.6,,,percent of total billed charges,82.6% of total billed charges,494.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.89,182246.4,
THORACOSCOPY W/PERICARD EXC,32661,CDM,983,RC,32661,HCPCS,Outpatient,,,3791,2464.15,,3336.08,88,,,percent of total billed charges,88% of total Billed charges,109.01,100,,,Fee Schedule,100% of Medicare rate,442.75,100,,,Fee Schedule,100% of WA Medicaid,3791,100,,,percent of total billed charges,100% of total billed charges,456.03,103,,,Fee Schedule,103% of WA Medicaid,109.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,190.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,442.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2615.79,69,,,percent of total billed charges,69% of total billed charges,3791,100,,,percent of total billed charges,100% of total billed charges,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,3791,100,,,percent of total billed charges,100% of total billed charges,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,3791,100,,,percent of total billed charges,100% of total billed charges,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2344.73,61.85,,,percent of total billed charges,61.85% of total billed charges,442.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,575.58,130,,,Fee Schedule,130% of WA Medicaid ,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1429.21,37.7,,,percent of total billed charges,37.70% of total billed charges,1429.21,37.7,,,percent of total billed charges,37.70% of total billed charges,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,128514.9,33.9,,,percent of total billed charges,33.9% of total billed charges,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2956.98,78,,,percent of total billed charges,78% of total billed charges,3791,100,,,percent of total billed charges,100% of total billed charges,3131.37,82.6,,,percent of total billed charges,82.6% of total billed charges,3131.37,82.6,,,percent of total billed charges,82.6% of total billed charges,442.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,109.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,109.01,128514.9,
THORACOSCOPY W/LOBECTOMY,32663,CDM,983,RC,32663,HCPCS,Outpatient,,,6754,4390.10,,5943.52,88,,,percent of total billed charges,88% of total Billed charges,197.55,100,,,Fee Schedule,100% of Medicare rate,767.26,100,,,Fee Schedule,100% of WA Medicaid,6754,100,,,percent of total billed charges,100% of total billed charges,790.28,103,,,Fee Schedule,103% of WA Medicaid,197.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,345.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,767.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4660.26,69,,,percent of total billed charges,69% of total billed charges,6754,100,,,percent of total billed charges,100% of total billed charges,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,6754,100,,,percent of total billed charges,100% of total billed charges,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,6754,100,,,percent of total billed charges,100% of total billed charges,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4177.35,61.85,,,percent of total billed charges,61.85% of total billed charges,767.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,767.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,782.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,997.44,130,,,Fee Schedule,130% of WA Medicaid ,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2546.26,37.7,,,percent of total billed charges,37.70% of total billed charges,2546.26,37.7,,,percent of total billed charges,37.70% of total billed charges,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,228960.6,33.9,,,percent of total billed charges,33.9% of total billed charges,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,5268.12,78,,,percent of total billed charges,78% of total billed charges,6754,100,,,percent of total billed charges,100% of total billed charges,5578.8,82.6,,,percent of total billed charges,82.6% of total billed charges,5578.8,82.6,,,percent of total billed charges,82.6% of total billed charges,767.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,197.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,767.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,197.55,228960.6,
THORACOSCOPY W/ TH NRV EXC,32664,CDM,983,RC,32664,HCPCS,Outpatient,,,3613,2348.45,,3179.44,88,,,percent of total billed charges,88% of total Billed charges,116.39,100,,,Fee Schedule,100% of Medicare rate,469.42,100,,,Fee Schedule,100% of WA Medicaid,3613,100,,,percent of total billed charges,100% of total billed charges,483.5,103,,,Fee Schedule,103% of WA Medicaid,116.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,203.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,469.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2492.97,69,,,percent of total billed charges,69% of total billed charges,3613,100,,,percent of total billed charges,100% of total billed charges,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,3613,100,,,percent of total billed charges,100% of total billed charges,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,3613,100,,,percent of total billed charges,100% of total billed charges,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2234.64,61.85,,,percent of total billed charges,61.85% of total billed charges,469.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,610.25,130,,,Fee Schedule,130% of WA Medicaid ,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1362.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1362.1,37.7,,,percent of total billed charges,37.70% of total billed charges,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,122480.7,33.9,,,percent of total billed charges,33.9% of total billed charges,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2818.14,78,,,percent of total billed charges,78% of total billed charges,3613,100,,,percent of total billed charges,100% of total billed charges,2984.34,82.6,,,percent of total billed charges,82.6% of total billed charges,2984.34,82.6,,,percent of total billed charges,82.6% of total billed charges,469.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,116.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,116.39,122480.7,
THORACOSCOPY LYMPH NODE EXC,32674,CDM,983,RC,32674,HCPCS,Outpatient,,,535,347.75,,470.8,88,,,percent of total billed charges,88% of total Billed charges,32.89,100,,,Fee Schedule,100% of Medicare rate,116.19,100,,,Fee Schedule,100% of WA Medicaid,535,100,,,percent of total billed charges,100% of total billed charges,119.68,103,,,Fee Schedule,103% of WA Medicaid,32.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,116.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,369.15,69,,,percent of total billed charges,69% of total billed charges,535,100,,,percent of total billed charges,100% of total billed charges,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,535,100,,,percent of total billed charges,100% of total billed charges,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,535,100,,,percent of total billed charges,100% of total billed charges,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.9,61.85,,,percent of total billed charges,61.85% of total billed charges,116.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,151.05,130,,,Fee Schedule,130% of WA Medicaid ,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.7,37.7,,,percent of total billed charges,37.70% of total billed charges,201.7,37.7,,,percent of total billed charges,37.70% of total billed charges,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,18136.5,33.9,,,percent of total billed charges,33.9% of total billed charges,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.3,78,,,percent of total billed charges,78% of total billed charges,535,100,,,percent of total billed charges,100% of total billed charges,441.91,82.6,,,percent of total billed charges,82.6% of total billed charges,441.91,82.6,,,percent of total billed charges,82.6% of total billed charges,116.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.89,18136.5,
"Pericardiocentesis, including imaging guidance, when perform",33016,CDM,983,RC,33016,HCPCS,Outpatient,,,327,212.55,,287.76,88,,,percent of total billed charges,88% of total Billed charges,31.92,100,,,Fee Schedule,100% of Medicare rate,127.57,100,,,Fee Schedule,100% of WA Medicaid,327,100,,,percent of total billed charges,100% of total billed charges,131.4,103,,,Fee Schedule,103% of WA Medicaid,31.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,55.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,127.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,225.63,69,,,percent of total billed charges,69% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,327,100,,,percent of total billed charges,100% of total billed charges,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,327,100,,,percent of total billed charges,100% of total billed charges,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.25,61.85,,,percent of total billed charges,61.85% of total billed charges,127.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,165.84,130,,,Fee Schedule,130% of WA Medicaid ,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,11085.3,33.9,,,percent of total billed charges,33.9% of total billed charges,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.06,78,,,percent of total billed charges,78% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,127.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.92,11085.3,
"Pericardial drainage with insertion of indwelling catheter,",33017,CDM,983,RC,33017,HCPCS,Outpatient,,,1086,705.90,,955.68,88,,,percent of total billed charges,88% of total Billed charges,34.1,100,,,Fee Schedule,100% of Medicare rate,134.47,100,,,Fee Schedule,100% of WA Medicaid,1086,100,,,percent of total billed charges,100% of total billed charges,138.5,103,,,Fee Schedule,103% of WA Medicaid,34.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,134.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,749.34,69,,,percent of total billed charges,69% of total billed charges,1086,100,,,percent of total billed charges,100% of total billed charges,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1086,100,,,percent of total billed charges,100% of total billed charges,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1086,100,,,percent of total billed charges,100% of total billed charges,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.69,61.85,,,percent of total billed charges,61.85% of total billed charges,134.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.81,130,,,Fee Schedule,130% of WA Medicaid ,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.42,37.7,,,percent of total billed charges,37.70% of total billed charges,409.42,37.7,,,percent of total billed charges,37.70% of total billed charges,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,36815.4,33.9,,,percent of total billed charges,33.9% of total billed charges,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.08,78,,,percent of total billed charges,78% of total billed charges,1086,100,,,percent of total billed charges,100% of total billed charges,897.04,82.6,,,percent of total billed charges,82.6% of total billed charges,897.04,82.6,,,percent of total billed charges,82.6% of total billed charges,134.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.1,36815.4,
33016 - Pericardiocentesis w/imaging,33016,CDM,983,RC,33016,HCPCS,Outpatient,,,327,212.55,,287.76,88,,,percent of total billed charges,88% of total Billed charges,31.92,100,,,Fee Schedule,100% of Medicare rate,127.57,100,,,Fee Schedule,100% of WA Medicaid,327,100,,,percent of total billed charges,100% of total billed charges,131.4,103,,,Fee Schedule,103% of WA Medicaid,31.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,55.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,127.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,225.63,69,,,percent of total billed charges,69% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,327,100,,,percent of total billed charges,100% of total billed charges,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,327,100,,,percent of total billed charges,100% of total billed charges,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.25,61.85,,,percent of total billed charges,61.85% of total billed charges,127.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,165.84,130,,,Fee Schedule,130% of WA Medicaid ,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,11085.3,33.9,,,percent of total billed charges,33.9% of total billed charges,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.06,78,,,percent of total billed charges,78% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,127.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.92,11085.3,
INCISION OF HEART SAC,33020,CDM,983,RC,33020,HCPCS,Outpatient,,,2421.46,1573.95,,2130.88,88,,,percent of total billed charges,88% of total Billed charges,111.19,100,,,Fee Schedule,100% of Medicare rate,454.31,100,,,Fee Schedule,100% of WA Medicaid,2421.46,100,,,percent of total billed charges,100% of total billed charges,467.94,103,,,Fee Schedule,103% of WA Medicaid,111.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,194.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,454.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1670.81,69,,,percent of total billed charges,69% of total billed charges,2421.46,100,,,percent of total billed charges,100% of total billed charges,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2421.46,100,,,percent of total billed charges,100% of total billed charges,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2421.46,100,,,percent of total billed charges,100% of total billed charges,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1497.67,61.85,,,percent of total billed charges,61.85% of total billed charges,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,590.6,130,,,Fee Schedule,130% of WA Medicaid ,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,912.89,37.7,,,percent of total billed charges,37.70% of total billed charges,912.89,37.7,,,percent of total billed charges,37.70% of total billed charges,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,82087.49,33.9,,,percent of total billed charges,33.9% of total billed charges,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1888.74,78,,,percent of total billed charges,78% of total billed charges,2421.46,100,,,percent of total billed charges,100% of total billed charges,2000.13,82.6,,,percent of total billed charges,82.6% of total billed charges,2000.13,82.6,,,percent of total billed charges,82.6% of total billed charges,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,111.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.19,82087.49,
INCISION OF HEART SAC,33025,CDM,983,RC,33025,HCPCS,Outpatient,,,2732,1775.80,,2404.16,88,,,percent of total billed charges,88% of total Billed charges,104.72,100,,,Fee Schedule,100% of Medicare rate,425.22,100,,,Fee Schedule,100% of WA Medicaid,2732,100,,,percent of total billed charges,100% of total billed charges,437.98,103,,,Fee Schedule,103% of WA Medicaid,104.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,183.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,425.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1885.08,69,,,percent of total billed charges,69% of total billed charges,2732,100,,,percent of total billed charges,100% of total billed charges,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2732,100,,,percent of total billed charges,100% of total billed charges,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2732,100,,,percent of total billed charges,100% of total billed charges,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1689.74,61.85,,,percent of total billed charges,61.85% of total billed charges,425.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,552.79,130,,,Fee Schedule,130% of WA Medicaid ,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1029.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1029.96,37.7,,,percent of total billed charges,37.70% of total billed charges,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,92614.8,33.9,,,percent of total billed charges,33.9% of total billed charges,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2130.96,78,,,percent of total billed charges,78% of total billed charges,2732,100,,,percent of total billed charges,100% of total billed charges,2256.63,82.6,,,percent of total billed charges,82.6% of total billed charges,2256.63,82.6,,,percent of total billed charges,82.6% of total billed charges,425.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,104.72,92614.8,
REMOVAL OF HEART LESION,33120,CDM,983,RC,33120,HCPCS,Outpatient,,,5771,3751.15,,5078.48,88,,,percent of total billed charges,88% of total Billed charges,299.51,100,,,Fee Schedule,100% of Medicare rate,1138.58,100,,,Fee Schedule,100% of WA Medicaid,5771,100,,,percent of total billed charges,100% of total billed charges,1172.74,103,,,Fee Schedule,103% of WA Medicaid,299.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,524.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1138.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3981.99,69,,,percent of total billed charges,69% of total billed charges,5771,100,,,percent of total billed charges,100% of total billed charges,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,5771,100,,,percent of total billed charges,100% of total billed charges,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,5771,100,,,percent of total billed charges,100% of total billed charges,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,3569.36,61.85,,,percent of total billed charges,61.85% of total billed charges,1138.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1138.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1161.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1480.15,130,,,Fee Schedule,130% of WA Medicaid ,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2175.67,37.7,,,percent of total billed charges,37.70% of total billed charges,2175.67,37.7,,,percent of total billed charges,37.70% of total billed charges,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,195636.9,33.9,,,percent of total billed charges,33.9% of total billed charges,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4501.38,78,,,percent of total billed charges,78% of total billed charges,5771,100,,,percent of total billed charges,100% of total billed charges,4766.85,82.6,,,percent of total billed charges,82.6% of total billed charges,4766.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1138.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,299.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1138.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,299.51,195636.9,
HEART REVASCULARIZE (TMR),33140,CDM,983,RC,33140,HCPCS,Outpatient,,,4355,2830.75,,3832.4,88,,,percent of total billed charges,88% of total Billed charges,215.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4355,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,215.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,376.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,3004.95,69,,,percent of total billed charges,69% of total billed charges,4355,100,,,percent of total billed charges,100% of total billed charges,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4355,100,,,percent of total billed charges,100% of total billed charges,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4355,100,,,percent of total billed charges,100% of total billed charges,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2693.57,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1641.84,37.7,,,percent of total billed charges,37.70% of total billed charges,1641.84,37.7,,,percent of total billed charges,37.70% of total billed charges,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,147634.5,33.9,,,percent of total billed charges,33.9% of total billed charges,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,3396.9,78,,,percent of total billed charges,78% of total billed charges,4355,100,,,percent of total billed charges,100% of total billed charges,3597.23,82.6,,,percent of total billed charges,82.6% of total billed charges,3597.23,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,215.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",215.06,147634.5,
INSERT EPICARD ELTRD ENDO,33203,CDM,983,RC,33203,HCPCS,Outpatient,,,2319,1507.35,,2040.72,88,,,percent of total billed charges,88% of total Billed charges,113.35,100,,,Fee Schedule,100% of Medicare rate,446.11,100,,,Fee Schedule,100% of WA Medicaid,2319,100,,,percent of total billed charges,100% of total billed charges,459.49,103,,,Fee Schedule,103% of WA Medicaid,113.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,198.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,446.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1600.11,69,,,percent of total billed charges,69% of total billed charges,2319,100,,,percent of total billed charges,100% of total billed charges,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2319,100,,,percent of total billed charges,100% of total billed charges,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2319,100,,,percent of total billed charges,100% of total billed charges,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1434.3,61.85,,,percent of total billed charges,61.85% of total billed charges,446.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,579.94,130,,,Fee Schedule,130% of WA Medicaid ,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,874.26,37.7,,,percent of total billed charges,37.70% of total billed charges,874.26,37.7,,,percent of total billed charges,37.70% of total billed charges,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,78614.1,33.9,,,percent of total billed charges,33.9% of total billed charges,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1808.82,78,,,percent of total billed charges,78% of total billed charges,2319,100,,,percent of total billed charges,100% of total billed charges,1915.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1915.49,82.6,,,percent of total billed charges,82.6% of total billed charges,446.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,113.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.35,78614.1,
INSERT HEART PM ATRIAL,33206,CDM,983,RC,33206,HCPCS,Outpatient,,,1746,1134.90,,1536.48,88,,,percent of total billed charges,88% of total Billed charges,55.07,100,,,Fee Schedule,100% of Medicare rate,252.15,100,,,Fee Schedule,100% of WA Medicaid,1746,100,,,percent of total billed charges,100% of total billed charges,259.71,103,,,Fee Schedule,103% of WA Medicaid,55.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,96.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,252.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1204.74,69,,,percent of total billed charges,69% of total billed charges,1746,100,,,percent of total billed charges,100% of total billed charges,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1746,100,,,percent of total billed charges,100% of total billed charges,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1746,100,,,percent of total billed charges,100% of total billed charges,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079.9,61.85,,,percent of total billed charges,61.85% of total billed charges,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,327.8,130,,,Fee Schedule,130% of WA Medicaid ,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,658.24,37.7,,,percent of total billed charges,37.70% of total billed charges,658.24,37.7,,,percent of total billed charges,37.70% of total billed charges,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,59189.4,33.9,,,percent of total billed charges,33.9% of total billed charges,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1361.88,78,,,percent of total billed charges,78% of total billed charges,1746,100,,,percent of total billed charges,100% of total billed charges,1442.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1442.2,82.6,,,percent of total billed charges,82.6% of total billed charges,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.07,59189.4,
INSERT HEART PM VENTRICULAR,33207,CDM,983,RC,33207,HCPCS,Outpatient,,,1843,1197.95,,1621.84,88,,,percent of total billed charges,88% of total Billed charges,59.87,100,,,Fee Schedule,100% of Medicare rate,264.08,100,,,Fee Schedule,100% of WA Medicaid,1843,100,,,percent of total billed charges,100% of total billed charges,272,103,,,Fee Schedule,103% of WA Medicaid,59.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,104.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1271.67,69,,,percent of total billed charges,69% of total billed charges,1843,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1843,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1843,100,,,percent of total billed charges,100% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1139.9,61.85,,,percent of total billed charges,61.85% of total billed charges,264.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,343.3,130,,,Fee Schedule,130% of WA Medicaid ,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,694.81,37.7,,,percent of total billed charges,37.70% of total billed charges,694.81,37.7,,,percent of total billed charges,37.70% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,62477.7,33.9,,,percent of total billed charges,33.9% of total billed charges,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1437.54,78,,,percent of total billed charges,78% of total billed charges,1843,100,,,percent of total billed charges,100% of total billed charges,1522.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1522.32,82.6,,,percent of total billed charges,82.6% of total billed charges,264.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.87,62477.7,
INSERT EPICARD ELTRD OPEN,33202,CDM,983,RC,33202,HCPCS,Outpatient,,,2077,1350.05,,1827.76,88,,,percent of total billed charges,88% of total Billed charges,104.72,100,,,Fee Schedule,100% of Medicare rate,425.22,100,,,Fee Schedule,100% of WA Medicaid,2077,100,,,percent of total billed charges,100% of total billed charges,437.98,103,,,Fee Schedule,103% of WA Medicaid,104.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,183.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,425.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1433.13,69,,,percent of total billed charges,69% of total billed charges,2077,100,,,percent of total billed charges,100% of total billed charges,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2077,100,,,percent of total billed charges,100% of total billed charges,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2077,100,,,percent of total billed charges,100% of total billed charges,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1284.62,61.85,,,percent of total billed charges,61.85% of total billed charges,425.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,552.79,130,,,Fee Schedule,130% of WA Medicaid ,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,783.03,37.7,,,percent of total billed charges,37.70% of total billed charges,783.03,37.7,,,percent of total billed charges,37.70% of total billed charges,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,70410.3,33.9,,,percent of total billed charges,33.9% of total billed charges,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1620.06,78,,,percent of total billed charges,78% of total billed charges,2077,100,,,percent of total billed charges,100% of total billed charges,1715.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1715.6,82.6,,,percent of total billed charges,82.6% of total billed charges,425.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,104.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,104.72,70410.3,
INSRT HEART PM ATRIAL  VENT,33208,CDM,983,RC,33208,HCPCS,Outpatient,,,2154,1400.10,,1895.52,88,,,percent of total billed charges,88% of total Billed charges,65.16,100,,,Fee Schedule,100% of Medicare rate,285.72,100,,,Fee Schedule,100% of WA Medicaid,2154,100,,,percent of total billed charges,100% of total billed charges,294.29,103,,,Fee Schedule,103% of WA Medicaid,65.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,285.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1486.26,69,,,percent of total billed charges,69% of total billed charges,2154,100,,,percent of total billed charges,100% of total billed charges,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2154,100,,,percent of total billed charges,100% of total billed charges,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2154,100,,,percent of total billed charges,100% of total billed charges,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1332.25,61.85,,,percent of total billed charges,61.85% of total billed charges,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,371.44,130,,,Fee Schedule,130% of WA Medicaid ,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,812.06,37.7,,,percent of total billed charges,37.70% of total billed charges,812.06,37.7,,,percent of total billed charges,37.70% of total billed charges,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,73020.6,33.9,,,percent of total billed charges,33.9% of total billed charges,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1680.12,78,,,percent of total billed charges,78% of total billed charges,2154,100,,,percent of total billed charges,100% of total billed charges,1779.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1779.2,82.6,,,percent of total billed charges,82.6% of total billed charges,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.16,73020.6,
INSERT ELECTRD/PM CATH SNGL,33210,CDM,983,RC,33210,HCPCS,Outpatient,,,658,427.70,,579.04,88,,,percent of total billed charges,88% of total Billed charges,20.99,100,,,Fee Schedule,100% of Medicare rate,87.84,100,,,Fee Schedule,100% of WA Medicaid,658,100,,,percent of total billed charges,100% of total billed charges,90.48,103,,,Fee Schedule,103% of WA Medicaid,20.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,87.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,454.02,69,,,percent of total billed charges,69% of total billed charges,658,100,,,percent of total billed charges,100% of total billed charges,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,658,100,,,percent of total billed charges,100% of total billed charges,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,658,100,,,percent of total billed charges,100% of total billed charges,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.97,61.85,,,percent of total billed charges,61.85% of total billed charges,87.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,114.19,130,,,Fee Schedule,130% of WA Medicaid ,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.07,37.7,,,percent of total billed charges,37.70% of total billed charges,248.07,37.7,,,percent of total billed charges,37.70% of total billed charges,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,22306.2,33.9,,,percent of total billed charges,33.9% of total billed charges,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.24,78,,,percent of total billed charges,78% of total billed charges,658,100,,,percent of total billed charges,100% of total billed charges,543.51,82.6,,,percent of total billed charges,82.6% of total billed charges,543.51,82.6,,,percent of total billed charges,82.6% of total billed charges,87.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.99,22306.2,
INSERT 1 ELECTRODE PM-DEFIB,33216,CDM,983,RC,33216,HCPCS,Outpatient,,,1158,752.70,,1019.04,88,,,percent of total billed charges,88% of total Billed charges,43.86,100,,,Fee Schedule,100% of Medicare rate,207.02,100,,,Fee Schedule,100% of WA Medicaid,1158,100,,,percent of total billed charges,100% of total billed charges,213.23,103,,,Fee Schedule,103% of WA Medicaid,43.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,207.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,799.02,69,,,percent of total billed charges,69% of total billed charges,1158,100,,,percent of total billed charges,100% of total billed charges,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1158,100,,,percent of total billed charges,100% of total billed charges,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1158,100,,,percent of total billed charges,100% of total billed charges,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,716.22,61.85,,,percent of total billed charges,61.85% of total billed charges,207.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,269.13,130,,,Fee Schedule,130% of WA Medicaid ,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,436.57,37.7,,,percent of total billed charges,37.70% of total billed charges,436.57,37.7,,,percent of total billed charges,37.70% of total billed charges,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,39256.2,33.9,,,percent of total billed charges,33.9% of total billed charges,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,903.24,78,,,percent of total billed charges,78% of total billed charges,1158,100,,,percent of total billed charges,100% of total billed charges,956.51,82.6,,,percent of total billed charges,82.6% of total billed charges,956.51,82.6,,,percent of total billed charges,82.6% of total billed charges,207.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.86,39256.2,
REPOSITION PACING-DEFIB LEAD,33215,CDM,983,RC,33215,HCPCS,Outpatient,,,752,488.80,,661.76,88,,,percent of total billed charges,88% of total Billed charges,38.4,100,,,Fee Schedule,100% of Medicare rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,752,100,,,percent of total billed charges,100% of total billed charges,177.3,103,,,Fee Schedule,103% of WA Medicaid,38.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,518.88,69,,,percent of total billed charges,69% of total billed charges,752,100,,,percent of total billed charges,100% of total billed charges,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,752,100,,,percent of total billed charges,100% of total billed charges,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,752,100,,,percent of total billed charges,100% of total billed charges,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.11,61.85,,,percent of total billed charges,61.85% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,223.78,130,,,Fee Schedule,130% of WA Medicaid ,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.5,37.7,,,percent of total billed charges,37.70% of total billed charges,283.5,37.7,,,percent of total billed charges,37.70% of total billed charges,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,25492.8,33.9,,,percent of total billed charges,33.9% of total billed charges,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,586.56,78,,,percent of total billed charges,78% of total billed charges,752,100,,,percent of total billed charges,100% of total billed charges,621.15,82.6,,,percent of total billed charges,82.6% of total billed charges,621.15,82.6,,,percent of total billed charges,82.6% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.4,25492.8,
REPAIR LEAD PACE-DEFIB ONE,33218,CDM,983,RC,33218,HCPCS,Outpatient,,,1011,657.15,,889.68,88,,,percent of total billed charges,88% of total Billed charges,45.7,100,,,Fee Schedule,100% of Medicare rate,217.27,100,,,Fee Schedule,100% of WA Medicaid,1011,100,,,percent of total billed charges,100% of total billed charges,223.79,103,,,Fee Schedule,103% of WA Medicaid,45.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,217.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,697.59,69,,,percent of total billed charges,69% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1011,100,,,percent of total billed charges,100% of total billed charges,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1011,100,,,percent of total billed charges,100% of total billed charges,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.3,61.85,,,percent of total billed charges,61.85% of total billed charges,217.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,282.45,130,,,Fee Schedule,130% of WA Medicaid ,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,34272.9,33.9,,,percent of total billed charges,33.9% of total billed charges,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,788.58,78,,,percent of total billed charges,78% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,217.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.7,34272.9,
INSERT 2 ELECTRODE PM-DEFIB,33217,CDM,983,RC,33217,HCPCS,Outpatient,,,1151,748.15,,1012.88,88,,,percent of total billed charges,88% of total Billed charges,43.78,100,,,Fee Schedule,100% of Medicare rate,205.34,100,,,Fee Schedule,100% of WA Medicaid,1151,100,,,percent of total billed charges,100% of total billed charges,211.5,103,,,Fee Schedule,103% of WA Medicaid,43.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,205.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,794.19,69,,,percent of total billed charges,69% of total billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1151,100,,,percent of total billed charges,100% of total billed charges,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1151,100,,,percent of total billed charges,100% of total billed charges,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.89,61.85,,,percent of total billed charges,61.85% of total billed charges,205.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,266.94,130,,,Fee Schedule,130% of WA Medicaid ,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.93,37.7,,,percent of total billed charges,37.70% of total billed charges,433.93,37.7,,,percent of total billed charges,37.70% of total billed charges,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,39018.9,33.9,,,percent of total billed charges,33.9% of total billed charges,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,897.78,78,,,percent of total billed charges,78% of total billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,950.73,82.6,,,percent of total billed charges,82.6% of total billed charges,950.73,82.6,,,percent of total billed charges,82.6% of total billed charges,205.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.78,39018.9,
INSERT CARD ELECTRODES DUAL,33211,CDM,983,RC,33211,HCPCS,Outpatient,,,514,334.10,,452.32,88,,,percent of total billed charges,88% of total Billed charges,22.25,100,,,Fee Schedule,100% of Medicare rate,91.76,100,,,Fee Schedule,100% of WA Medicaid,514,100,,,percent of total billed charges,100% of total billed charges,94.51,103,,,Fee Schedule,103% of WA Medicaid,22.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,91.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,354.66,69,,,percent of total billed charges,69% of total billed charges,514,100,,,percent of total billed charges,100% of total billed charges,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,514,100,,,percent of total billed charges,100% of total billed charges,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,514,100,,,percent of total billed charges,100% of total billed charges,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.91,61.85,,,percent of total billed charges,61.85% of total billed charges,91.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.29,130,,,Fee Schedule,130% of WA Medicaid ,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.78,37.7,,,percent of total billed charges,37.70% of total billed charges,193.78,37.7,,,percent of total billed charges,37.70% of total billed charges,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,17424.6,33.9,,,percent of total billed charges,33.9% of total billed charges,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.92,78,,,percent of total billed charges,78% of total billed charges,514,100,,,percent of total billed charges,100% of total billed charges,424.56,82.6,,,percent of total billed charges,82.6% of total billed charges,424.56,82.6,,,percent of total billed charges,82.6% of total billed charges,91.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.25,17424.6,
INSERT PULSE GEN SNGL LEAD,33212,CDM,983,RC,33212,HCPCS,Outpatient,,,1078,700.70,,948.64,88,,,percent of total billed charges,88% of total Billed charges,39.31,100,,,Fee Schedule,100% of Medicare rate,179.6,100,,,Fee Schedule,100% of WA Medicaid,1078,100,,,percent of total billed charges,100% of total billed charges,184.99,103,,,Fee Schedule,103% of WA Medicaid,39.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,179.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,743.82,69,,,percent of total billed charges,69% of total billed charges,1078,100,,,percent of total billed charges,100% of total billed charges,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1078,100,,,percent of total billed charges,100% of total billed charges,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1078,100,,,percent of total billed charges,100% of total billed charges,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,666.74,61.85,,,percent of total billed charges,61.85% of total billed charges,179.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,233.48,130,,,Fee Schedule,130% of WA Medicaid ,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.41,37.7,,,percent of total billed charges,37.70% of total billed charges,406.41,37.7,,,percent of total billed charges,37.70% of total billed charges,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,36544.2,33.9,,,percent of total billed charges,33.9% of total billed charges,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,840.84,78,,,percent of total billed charges,78% of total billed charges,1078,100,,,percent of total billed charges,100% of total billed charges,890.43,82.6,,,percent of total billed charges,82.6% of total billed charges,890.43,82.6,,,percent of total billed charges,82.6% of total billed charges,179.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.31,36544.2,
INSERT PULSE GEN DUAL LEADS,33213,CDM,983,RC,33213,HCPCS,Outpatient,,,1144,743.60,,1006.72,88,,,percent of total billed charges,88% of total Billed charges,41.31,100,,,Fee Schedule,100% of Medicare rate,187.99,100,,,Fee Schedule,100% of WA Medicaid,1144,100,,,percent of total billed charges,100% of total billed charges,193.63,103,,,Fee Schedule,103% of WA Medicaid,41.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,187.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,789.36,69,,,percent of total billed charges,69% of total billed charges,1144,100,,,percent of total billed charges,100% of total billed charges,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1144,100,,,percent of total billed charges,100% of total billed charges,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1144,100,,,percent of total billed charges,100% of total billed charges,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,707.56,61.85,,,percent of total billed charges,61.85% of total billed charges,187.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,244.39,130,,,Fee Schedule,130% of WA Medicaid ,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,431.29,37.7,,,percent of total billed charges,37.70% of total billed charges,431.29,37.7,,,percent of total billed charges,37.70% of total billed charges,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,38781.6,33.9,,,percent of total billed charges,33.9% of total billed charges,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,892.32,78,,,percent of total billed charges,78% of total billed charges,1144,100,,,percent of total billed charges,100% of total billed charges,944.94,82.6,,,percent of total billed charges,82.6% of total billed charges,944.94,82.6,,,percent of total billed charges,82.6% of total billed charges,187.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.31,38781.6,
UPGRADE OF PACEMAKER SYSTEM,33214,CDM,983,RC,33214,HCPCS,Outpatient,,,1400,910.00,,1232,88,,,percent of total billed charges,88% of total Billed charges,58.12,100,,,Fee Schedule,100% of Medicare rate,265.58,100,,,Fee Schedule,100% of WA Medicaid,1400,100,,,percent of total billed charges,100% of total billed charges,273.55,103,,,Fee Schedule,103% of WA Medicaid,58.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,265.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,966,69,,,percent of total billed charges,69% of total billed charges,1400,100,,,percent of total billed charges,100% of total billed charges,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1400,100,,,percent of total billed charges,100% of total billed charges,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1400,100,,,percent of total billed charges,100% of total billed charges,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,865.9,61.85,,,percent of total billed charges,61.85% of total billed charges,265.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,345.25,130,,,Fee Schedule,130% of WA Medicaid ,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.8,37.7,,,percent of total billed charges,37.70% of total billed charges,527.8,37.7,,,percent of total billed charges,37.70% of total billed charges,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,47460,33.9,,,percent of total billed charges,33.9% of total billed charges,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1092,78,,,percent of total billed charges,78% of total billed charges,1400,100,,,percent of total billed charges,100% of total billed charges,1156.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1156.4,82.6,,,percent of total billed charges,82.6% of total billed charges,265.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.12,47460,
L VENTRIC PACING LEAD ADD-ON,33225,CDM,983,RC,33225,HCPCS,Outpatient,,,1046,679.90,,920.48,88,,,percent of total billed charges,88% of total Billed charges,62.33,100,,,Fee Schedule,100% of Medicare rate,251.22,100,,,Fee Schedule,100% of WA Medicaid,1046,100,,,percent of total billed charges,100% of total billed charges,258.76,103,,,Fee Schedule,103% of WA Medicaid,62.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,251.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,721.74,69,,,percent of total billed charges,69% of total billed charges,1046,100,,,percent of total billed charges,100% of total billed charges,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046,100,,,percent of total billed charges,100% of total billed charges,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046,100,,,percent of total billed charges,100% of total billed charges,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.95,61.85,,,percent of total billed charges,61.85% of total billed charges,251.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,326.59,130,,,Fee Schedule,130% of WA Medicaid ,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.34,37.7,,,percent of total billed charges,37.70% of total billed charges,394.34,37.7,,,percent of total billed charges,37.70% of total billed charges,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,35459.4,33.9,,,percent of total billed charges,33.9% of total billed charges,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.88,78,,,percent of total billed charges,78% of total billed charges,1046,100,,,percent of total billed charges,100% of total billed charges,864,82.6,,,percent of total billed charges,82.6% of total billed charges,864,82.6,,,percent of total billed charges,82.6% of total billed charges,251.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.33,35459.4,
REPAIR LEAD PACE-DEFIB DUAL,33220,CDM,983,RC,33220,HCPCS,Outpatient,,,1361,884.65,,1197.68,88,,,percent of total billed charges,88% of total Billed charges,46.45,100,,,Fee Schedule,100% of Medicare rate,211.86,100,,,Fee Schedule,100% of WA Medicaid,1361,100,,,percent of total billed charges,100% of total billed charges,218.22,103,,,Fee Schedule,103% of WA Medicaid,46.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,211.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,939.09,69,,,percent of total billed charges,69% of total billed charges,1361,100,,,percent of total billed charges,100% of total billed charges,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1361,100,,,percent of total billed charges,100% of total billed charges,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1361,100,,,percent of total billed charges,100% of total billed charges,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.78,61.85,,,percent of total billed charges,61.85% of total billed charges,211.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,275.42,130,,,Fee Schedule,130% of WA Medicaid ,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.1,37.7,,,percent of total billed charges,37.70% of total billed charges,513.1,37.7,,,percent of total billed charges,37.70% of total billed charges,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,46137.9,33.9,,,percent of total billed charges,33.9% of total billed charges,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1061.58,78,,,percent of total billed charges,78% of total billed charges,1361,100,,,percent of total billed charges,100% of total billed charges,1124.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1124.19,82.6,,,percent of total billed charges,82.6% of total billed charges,211.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.45,46137.9,
INSERT PACING LEAD  CONNECT,33224,CDM,983,RC,33224,HCPCS,Outpatient,,,1207,784.55,,1062.16,88,,,percent of total billed charges,88% of total Billed charges,67.96,100,,,Fee Schedule,100% of Medicare rate,279.19,100,,,Fee Schedule,100% of WA Medicaid,1207,100,,,percent of total billed charges,100% of total billed charges,287.57,103,,,Fee Schedule,103% of WA Medicaid,67.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,118.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,279.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,832.83,69,,,percent of total billed charges,69% of total billed charges,1207,100,,,percent of total billed charges,100% of total billed charges,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1207,100,,,percent of total billed charges,100% of total billed charges,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1207,100,,,percent of total billed charges,100% of total billed charges,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.53,61.85,,,percent of total billed charges,61.85% of total billed charges,279.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,362.95,130,,,Fee Schedule,130% of WA Medicaid ,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.04,37.7,,,percent of total billed charges,37.70% of total billed charges,455.04,37.7,,,percent of total billed charges,37.70% of total billed charges,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,40917.3,33.9,,,percent of total billed charges,33.9% of total billed charges,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,941.46,78,,,percent of total billed charges,78% of total billed charges,1207,100,,,percent of total billed charges,100% of total billed charges,996.98,82.6,,,percent of total billed charges,82.6% of total billed charges,996.98,82.6,,,percent of total billed charges,82.6% of total billed charges,279.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.96,40917.3,
INSERT PULSE GEN MULT LEADS,33221,CDM,983,RC,33221,HCPCS,Outpatient,,,1114,724.10,,980.32,88,,,percent of total billed charges,88% of total Billed charges,42.91,100,,,Fee Schedule,100% of Medicare rate,198.81,100,,,Fee Schedule,100% of WA Medicaid,1114,100,,,percent of total billed charges,100% of total billed charges,204.77,103,,,Fee Schedule,103% of WA Medicaid,42.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,198.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,768.66,69,,,percent of total billed charges,69% of total billed charges,1114,100,,,percent of total billed charges,100% of total billed charges,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1114,100,,,percent of total billed charges,100% of total billed charges,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1114,100,,,percent of total billed charges,100% of total billed charges,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,689.01,61.85,,,percent of total billed charges,61.85% of total billed charges,198.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,258.45,130,,,Fee Schedule,130% of WA Medicaid ,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.98,37.7,,,percent of total billed charges,37.70% of total billed charges,419.98,37.7,,,percent of total billed charges,37.70% of total billed charges,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,37764.6,33.9,,,percent of total billed charges,33.9% of total billed charges,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,868.92,78,,,percent of total billed charges,78% of total billed charges,1114,100,,,percent of total billed charges,100% of total billed charges,920.16,82.6,,,percent of total billed charges,82.6% of total billed charges,920.16,82.6,,,percent of total billed charges,82.6% of total billed charges,198.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.91,37764.6,
REMOVEREPLACE PM GEN SINGL,33227,CDM,983,RC,33227,HCPCS,Outpatient,,,820,533.00,,721.6,88,,,percent of total billed charges,88% of total Billed charges,41.34,100,,,Fee Schedule,100% of Medicare rate,188.74,100,,,Fee Schedule,100% of WA Medicaid,820,100,,,percent of total billed charges,100% of total billed charges,194.4,103,,,Fee Schedule,103% of WA Medicaid,41.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,188.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,565.8,69,,,percent of total billed charges,69% of total billed charges,820,100,,,percent of total billed charges,100% of total billed charges,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,820,100,,,percent of total billed charges,100% of total billed charges,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,820,100,,,percent of total billed charges,100% of total billed charges,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.17,61.85,,,percent of total billed charges,61.85% of total billed charges,188.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,245.36,130,,,Fee Schedule,130% of WA Medicaid ,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.14,37.7,,,percent of total billed charges,37.70% of total billed charges,309.14,37.7,,,percent of total billed charges,37.70% of total billed charges,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,27798,33.9,,,percent of total billed charges,33.9% of total billed charges,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.6,78,,,percent of total billed charges,78% of total billed charges,820,100,,,percent of total billed charges,100% of total billed charges,677.32,82.6,,,percent of total billed charges,82.6% of total billed charges,677.32,82.6,,,percent of total billed charges,82.6% of total billed charges,188.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.34,27798,
REMVREPLC PM GEN DUAL LEAD,33228,CDM,983,RC,33228,HCPCS,Outpatient,,,855,555.75,,752.4,88,,,percent of total billed charges,88% of total Billed charges,43.08,100,,,Fee Schedule,100% of Medicare rate,196.94,100,,,Fee Schedule,100% of WA Medicaid,855,100,,,percent of total billed charges,100% of total billed charges,202.85,103,,,Fee Schedule,103% of WA Medicaid,43.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,196.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,589.95,69,,,percent of total billed charges,69% of total billed charges,855,100,,,percent of total billed charges,100% of total billed charges,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,855,100,,,percent of total billed charges,100% of total billed charges,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,855,100,,,percent of total billed charges,100% of total billed charges,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.82,61.85,,,percent of total billed charges,61.85% of total billed charges,196.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,256.02,130,,,Fee Schedule,130% of WA Medicaid ,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.34,37.7,,,percent of total billed charges,37.70% of total billed charges,322.34,37.7,,,percent of total billed charges,37.70% of total billed charges,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,28984.5,33.9,,,percent of total billed charges,33.9% of total billed charges,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,666.9,78,,,percent of total billed charges,78% of total billed charges,855,100,,,percent of total billed charges,100% of total billed charges,706.23,82.6,,,percent of total billed charges,82.6% of total billed charges,706.23,82.6,,,percent of total billed charges,82.6% of total billed charges,196.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.08,28984.5,
REPOSITION L VENTRIC LEAD,33226,CDM,983,RC,33226,HCPCS,Outpatient,,,1117,726.05,,982.96,88,,,percent of total billed charges,88% of total Billed charges,66.02,100,,,Fee Schedule,100% of Medicare rate,267.07,100,,,Fee Schedule,100% of WA Medicaid,1117,100,,,percent of total billed charges,100% of total billed charges,275.08,103,,,Fee Schedule,103% of WA Medicaid,66.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,115.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,267.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,770.73,69,,,percent of total billed charges,69% of total billed charges,1117,100,,,percent of total billed charges,100% of total billed charges,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117,100,,,percent of total billed charges,100% of total billed charges,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117,100,,,percent of total billed charges,100% of total billed charges,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,690.86,61.85,,,percent of total billed charges,61.85% of total billed charges,267.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,347.19,130,,,Fee Schedule,130% of WA Medicaid ,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.11,37.7,,,percent of total billed charges,37.70% of total billed charges,421.11,37.7,,,percent of total billed charges,37.70% of total billed charges,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,37866.3,33.9,,,percent of total billed charges,33.9% of total billed charges,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,871.26,78,,,percent of total billed charges,78% of total billed charges,1117,100,,,percent of total billed charges,100% of total billed charges,922.64,82.6,,,percent of total billed charges,82.6% of total billed charges,922.64,82.6,,,percent of total billed charges,82.6% of total billed charges,267.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,66.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.02,37866.3,
RELOCATE POCKET FOR DEFIB,33223,CDM,983,RC,33223,HCPCS,Outpatient,,,1226,796.90,,1078.88,88,,,percent of total billed charges,88% of total Billed charges,49.62,100,,,Fee Schedule,100% of Medicare rate,227.53,100,,,Fee Schedule,100% of WA Medicaid,1226,100,,,percent of total billed charges,100% of total billed charges,234.36,103,,,Fee Schedule,103% of WA Medicaid,49.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,227.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,845.94,69,,,percent of total billed charges,69% of total billed charges,1226,100,,,percent of total billed charges,100% of total billed charges,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1226,100,,,percent of total billed charges,100% of total billed charges,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1226,100,,,percent of total billed charges,100% of total billed charges,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,758.28,61.85,,,percent of total billed charges,61.85% of total billed charges,227.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,295.79,130,,,Fee Schedule,130% of WA Medicaid ,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,462.2,37.7,,,percent of total billed charges,37.70% of total billed charges,462.2,37.7,,,percent of total billed charges,37.70% of total billed charges,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,41561.4,33.9,,,percent of total billed charges,33.9% of total billed charges,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,956.28,78,,,percent of total billed charges,78% of total billed charges,1226,100,,,percent of total billed charges,100% of total billed charges,1012.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1012.68,82.6,,,percent of total billed charges,82.6% of total billed charges,227.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.62,41561.4,
RELOCATION POCKET PACEMAKER,33222,CDM,983,RC,33222,HCPCS,Outpatient,,,958,622.70,,843.04,88,,,percent of total billed charges,88% of total Billed charges,39.2,100,,,Fee Schedule,100% of Medicare rate,192.65,100,,,Fee Schedule,100% of WA Medicaid,958,100,,,percent of total billed charges,100% of total billed charges,198.43,103,,,Fee Schedule,103% of WA Medicaid,39.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,192.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,661.02,69,,,percent of total billed charges,69% of total billed charges,958,100,,,percent of total billed charges,100% of total billed charges,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,958,100,,,percent of total billed charges,100% of total billed charges,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,958,100,,,percent of total billed charges,100% of total billed charges,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,592.52,61.85,,,percent of total billed charges,61.85% of total billed charges,192.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,250.45,130,,,Fee Schedule,130% of WA Medicaid ,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.17,37.7,,,percent of total billed charges,37.70% of total billed charges,361.17,37.7,,,percent of total billed charges,37.70% of total billed charges,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,32476.2,33.9,,,percent of total billed charges,33.9% of total billed charges,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,747.24,78,,,percent of total billed charges,78% of total billed charges,958,100,,,percent of total billed charges,100% of total billed charges,791.31,82.6,,,percent of total billed charges,82.6% of total billed charges,791.31,82.6,,,percent of total billed charges,82.6% of total billed charges,192.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.2,32476.2,
INSRT PULSE GEN W/MULT LEADS,33231,CDM,983,RC,33231,HCPCS,Outpatient,,,1438,934.70,,1265.44,88,,,percent of total billed charges,88% of total Billed charges,48.84,100,,,Fee Schedule,100% of Medicare rate,222.49,100,,,Fee Schedule,100% of WA Medicaid,1438,100,,,percent of total billed charges,100% of total billed charges,229.16,103,,,Fee Schedule,103% of WA Medicaid,48.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,222.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,992.22,69,,,percent of total billed charges,69% of total billed charges,1438,100,,,percent of total billed charges,100% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1438,100,,,percent of total billed charges,100% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1438,100,,,percent of total billed charges,100% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,889.4,61.85,,,percent of total billed charges,61.85% of total billed charges,222.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,289.24,130,,,Fee Schedule,130% of WA Medicaid ,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,542.13,37.7,,,percent of total billed charges,37.70% of total billed charges,542.13,37.7,,,percent of total billed charges,37.70% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,48748.2,33.9,,,percent of total billed charges,33.9% of total billed charges,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1121.64,78,,,percent of total billed charges,78% of total billed charges,1438,100,,,percent of total billed charges,100% of total billed charges,1187.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1187.79,82.6,,,percent of total billed charges,82.6% of total billed charges,222.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.84,48748.2,
REMOVE ELECTRODE/THORACOTOMY,33237,CDM,983,RC,33237,HCPCS,Outpatient,,,2629,1708.85,,2313.52,88,,,percent of total billed charges,88% of total Billed charges,107.64,100,,,Fee Schedule,100% of Medicare rate,466.06,100,,,Fee Schedule,100% of WA Medicaid,2629,100,,,percent of total billed charges,100% of total billed charges,480.04,103,,,Fee Schedule,103% of WA Medicaid,107.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,188.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,466.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1814.01,69,,,percent of total billed charges,69% of total billed charges,2629,100,,,percent of total billed charges,100% of total billed charges,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2629,100,,,percent of total billed charges,100% of total billed charges,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2629,100,,,percent of total billed charges,100% of total billed charges,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1626.04,61.85,,,percent of total billed charges,61.85% of total billed charges,466.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,605.88,130,,,Fee Schedule,130% of WA Medicaid ,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,991.13,37.7,,,percent of total billed charges,37.70% of total billed charges,991.13,37.7,,,percent of total billed charges,37.70% of total billed charges,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,89123.1,33.9,,,percent of total billed charges,33.9% of total billed charges,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2050.62,78,,,percent of total billed charges,78% of total billed charges,2629,100,,,percent of total billed charges,100% of total billed charges,2171.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2171.55,82.6,,,percent of total billed charges,82.6% of total billed charges,466.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.64,89123.1,
REMOVAL OF PACEMAKER SYSTEM,33234,CDM,983,RC,33234,HCPCS,Outpatient,,,1193,775.45,,1049.84,88,,,percent of total billed charges,88% of total Billed charges,59.04,100,,,Fee Schedule,100% of Medicare rate,268.37,100,,,Fee Schedule,100% of WA Medicaid,1193,100,,,percent of total billed charges,100% of total billed charges,276.42,103,,,Fee Schedule,103% of WA Medicaid,59.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,268.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,823.17,69,,,percent of total billed charges,69% of total billed charges,1193,100,,,percent of total billed charges,100% of total billed charges,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193,100,,,percent of total billed charges,100% of total billed charges,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193,100,,,percent of total billed charges,100% of total billed charges,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,737.87,61.85,,,percent of total billed charges,61.85% of total billed charges,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,348.88,130,,,Fee Schedule,130% of WA Medicaid ,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.76,37.7,,,percent of total billed charges,37.70% of total billed charges,449.76,37.7,,,percent of total billed charges,37.70% of total billed charges,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,40442.7,33.9,,,percent of total billed charges,33.9% of total billed charges,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,930.54,78,,,percent of total billed charges,78% of total billed charges,1193,100,,,percent of total billed charges,100% of total billed charges,985.42,82.6,,,percent of total billed charges,82.6% of total billed charges,985.42,82.6,,,percent of total billed charges,82.6% of total billed charges,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.04,40442.7,
REMOVE ELECTRODE/THORACOTOMY,33236,CDM,983,RC,33236,HCPCS,Outpatient,,,2297,1493.05,,2021.36,88,,,percent of total billed charges,88% of total Billed charges,98.72,100,,,Fee Schedule,100% of Medicare rate,435.1,100,,,Fee Schedule,100% of WA Medicaid,2297,100,,,percent of total billed charges,100% of total billed charges,448.15,103,,,Fee Schedule,103% of WA Medicaid,98.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,172.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,435.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1584.93,69,,,percent of total billed charges,69% of total billed charges,2297,100,,,percent of total billed charges,100% of total billed charges,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2297,100,,,percent of total billed charges,100% of total billed charges,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2297,100,,,percent of total billed charges,100% of total billed charges,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1420.69,61.85,,,percent of total billed charges,61.85% of total billed charges,435.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,565.63,130,,,Fee Schedule,130% of WA Medicaid ,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,865.97,37.7,,,percent of total billed charges,37.70% of total billed charges,865.97,37.7,,,percent of total billed charges,37.70% of total billed charges,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,77868.3,33.9,,,percent of total billed charges,33.9% of total billed charges,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1791.66,78,,,percent of total billed charges,78% of total billed charges,2297,100,,,percent of total billed charges,100% of total billed charges,1897.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1897.32,82.6,,,percent of total billed charges,82.6% of total billed charges,435.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.72,77868.3,
INSRT PULSE GEN W/DUAL LEADS,33230,CDM,983,RC,33230,HCPCS,Outpatient,,,1386,900.90,,1219.68,88,,,percent of total billed charges,88% of total Billed charges,47.26,100,,,Fee Schedule,100% of Medicare rate,207.2,100,,,Fee Schedule,100% of WA Medicaid,1386,100,,,percent of total billed charges,100% of total billed charges,213.42,103,,,Fee Schedule,103% of WA Medicaid,47.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,82.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,207.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,956.34,69,,,percent of total billed charges,69% of total billed charges,1386,100,,,percent of total billed charges,100% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1386,100,,,percent of total billed charges,100% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1386,100,,,percent of total billed charges,100% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,857.24,61.85,,,percent of total billed charges,61.85% of total billed charges,207.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,269.36,130,,,Fee Schedule,130% of WA Medicaid ,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.52,37.7,,,percent of total billed charges,37.70% of total billed charges,522.52,37.7,,,percent of total billed charges,37.70% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,46985.4,33.9,,,percent of total billed charges,33.9% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1081.08,78,,,percent of total billed charges,78% of total billed charges,1386,100,,,percent of total billed charges,100% of total billed charges,1144.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1144.84,82.6,,,percent of total billed charges,82.6% of total billed charges,207.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.26,46985.4,
REMOVAL PACEMAKER ELECTRODE,33235,CDM,983,RC,33235,HCPCS,Outpatient,,,1442,937.30,,1268.96,88,,,percent of total billed charges,88% of total Billed charges,77.25,100,,,Fee Schedule,100% of Medicare rate,353.04,100,,,Fee Schedule,100% of WA Medicaid,1442,100,,,percent of total billed charges,100% of total billed charges,363.63,103,,,Fee Schedule,103% of WA Medicaid,77.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,353.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,994.98,69,,,percent of total billed charges,69% of total billed charges,1442,100,,,percent of total billed charges,100% of total billed charges,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1442,100,,,percent of total billed charges,100% of total billed charges,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1442,100,,,percent of total billed charges,100% of total billed charges,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,891.88,61.85,,,percent of total billed charges,61.85% of total billed charges,353.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,458.95,130,,,Fee Schedule,130% of WA Medicaid ,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,543.63,37.7,,,percent of total billed charges,37.70% of total billed charges,543.63,37.7,,,percent of total billed charges,37.70% of total billed charges,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,48883.8,33.9,,,percent of total billed charges,33.9% of total billed charges,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1124.76,78,,,percent of total billed charges,78% of total billed charges,1442,100,,,percent of total billed charges,100% of total billed charges,1191.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1191.09,82.6,,,percent of total billed charges,82.6% of total billed charges,353.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.25,48883.8,
REMOVE ELECTRODE/THORACOTOMY,33238,CDM,983,RC,33238,HCPCS,Outpatient,,,2787,1811.55,,2452.56,88,,,percent of total billed charges,88% of total Billed charges,121.52,100,,,Fee Schedule,100% of Medicare rate,527.8,100,,,Fee Schedule,100% of WA Medicaid,2787,100,,,percent of total billed charges,100% of total billed charges,543.63,103,,,Fee Schedule,103% of WA Medicaid,121.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,212.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,527.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1923.03,69,,,percent of total billed charges,69% of total billed charges,2787,100,,,percent of total billed charges,100% of total billed charges,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2787,100,,,percent of total billed charges,100% of total billed charges,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2787,100,,,percent of total billed charges,100% of total billed charges,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1723.76,61.85,,,percent of total billed charges,61.85% of total billed charges,527.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,538.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,686.14,130,,,Fee Schedule,130% of WA Medicaid ,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1050.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1050.7,37.7,,,percent of total billed charges,37.70% of total billed charges,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,94479.3,33.9,,,percent of total billed charges,33.9% of total billed charges,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2173.86,78,,,percent of total billed charges,78% of total billed charges,2787,100,,,percent of total billed charges,100% of total billed charges,2302.06,82.6,,,percent of total billed charges,82.6% of total billed charges,2302.06,82.6,,,percent of total billed charges,82.6% of total billed charges,527.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.52,94479.3,
REMOVE ELTRD TRANSVEN,33244,CDM,983,RC,33244,HCPCS,Outpatient,,,2183,1418.95,,1921.04,88,,,percent of total billed charges,88% of total Billed charges,107.18,100,,,Fee Schedule,100% of Medicare rate,477.63,100,,,Fee Schedule,100% of WA Medicaid,2183,100,,,percent of total billed charges,100% of total billed charges,491.96,103,,,Fee Schedule,103% of WA Medicaid,107.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,187.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,477.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1506.27,69,,,percent of total billed charges,69% of total billed charges,2183,100,,,percent of total billed charges,100% of total billed charges,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2183,100,,,percent of total billed charges,100% of total billed charges,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2183,100,,,percent of total billed charges,100% of total billed charges,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1350.19,61.85,,,percent of total billed charges,61.85% of total billed charges,477.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,477.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,620.92,130,,,Fee Schedule,130% of WA Medicaid ,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,822.99,37.7,,,percent of total billed charges,37.70% of total billed charges,822.99,37.7,,,percent of total billed charges,37.70% of total billed charges,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,74003.7,33.9,,,percent of total billed charges,33.9% of total billed charges,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1702.74,78,,,percent of total billed charges,78% of total billed charges,2183,100,,,percent of total billed charges,100% of total billed charges,1803.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1803.16,82.6,,,percent of total billed charges,82.6% of total billed charges,477.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,477.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.18,74003.7,
NSERT PACE-DEFIB W/LEAD,33249,CDM,983,RC,33249,HCPCS,Outpatient,,,2993,1945.45,,2633.84,88,,,percent of total billed charges,88% of total Billed charges,114.78,100,,,Fee Schedule,100% of Medicare rate,503.18,100,,,Fee Schedule,100% of WA Medicaid,2993,100,,,percent of total billed charges,100% of total billed charges,518.28,103,,,Fee Schedule,103% of WA Medicaid,114.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,200.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,503.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2065.17,69,,,percent of total billed charges,69% of total billed charges,2993,100,,,percent of total billed charges,100% of total billed charges,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2993,100,,,percent of total billed charges,100% of total billed charges,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2993,100,,,percent of total billed charges,100% of total billed charges,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1851.17,61.85,,,percent of total billed charges,61.85% of total billed charges,503.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,503.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,654.13,130,,,Fee Schedule,130% of WA Medicaid ,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1128.36,37.7,,,percent of total billed charges,37.70% of total billed charges,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,101462.7,33.9,,,percent of total billed charges,33.9% of total billed charges,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2334.54,78,,,percent of total billed charges,78% of total billed charges,2993,100,,,percent of total billed charges,100% of total billed charges,2472.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2472.22,82.6,,,percent of total billed charges,82.6% of total billed charges,503.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,114.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,503.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.78,101462.7,
REMOVE ELTRD/THORACOTOMY,33243,CDM,983,RC,33243,HCPCS,Outpatient,,,4036,2623.40,,3551.68,88,,,percent of total billed charges,88% of total Billed charges,187.16,100,,,Fee Schedule,100% of Medicare rate,757.75,100,,,Fee Schedule,100% of WA Medicaid,4036,100,,,percent of total billed charges,100% of total billed charges,780.48,103,,,Fee Schedule,103% of WA Medicaid,187.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,327.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,757.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2784.84,69,,,percent of total billed charges,69% of total billed charges,4036,100,,,percent of total billed charges,100% of total billed charges,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,4036,100,,,percent of total billed charges,100% of total billed charges,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,4036,100,,,percent of total billed charges,100% of total billed charges,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2496.27,61.85,,,percent of total billed charges,61.85% of total billed charges,757.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,757.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,772.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,985.08,130,,,Fee Schedule,130% of WA Medicaid ,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1521.57,37.7,,,percent of total billed charges,37.70% of total billed charges,1521.57,37.7,,,percent of total billed charges,37.70% of total billed charges,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,136820.4,33.9,,,percent of total billed charges,33.9% of total billed charges,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,3148.08,78,,,percent of total billed charges,78% of total billed charges,4036,100,,,percent of total billed charges,100% of total billed charges,3333.74,82.6,,,percent of total billed charges,82.6% of total billed charges,3333.74,82.6,,,percent of total billed charges,82.6% of total billed charges,757.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,187.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,757.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.16,136820.4,
INSRT PULSE GEN W/SINGL LEAD,33240,CDM,983,RC,33240,HCPCS,Outpatient,,,1339,870.35,,1178.32,88,,,percent of total billed charges,88% of total Billed charges,45.29,100,,,Fee Schedule,100% of Medicare rate,204.4,100,,,Fee Schedule,100% of WA Medicaid,1339,100,,,percent of total billed charges,100% of total billed charges,210.53,103,,,Fee Schedule,103% of WA Medicaid,45.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,204.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,923.91,69,,,percent of total billed charges,69% of total billed charges,1339,100,,,percent of total billed charges,100% of total billed charges,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1339,100,,,percent of total billed charges,100% of total billed charges,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1339,100,,,percent of total billed charges,100% of total billed charges,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,828.17,61.85,,,percent of total billed charges,61.85% of total billed charges,204.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,265.72,130,,,Fee Schedule,130% of WA Medicaid ,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.8,37.7,,,percent of total billed charges,37.70% of total billed charges,504.8,37.7,,,percent of total billed charges,37.70% of total billed charges,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,45392.1,33.9,,,percent of total billed charges,33.9% of total billed charges,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1044.42,78,,,percent of total billed charges,78% of total billed charges,1339,100,,,percent of total billed charges,100% of total billed charges,1106.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1106.01,82.6,,,percent of total billed charges,82.6% of total billed charges,204.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.29,45392.1,
REMOVE PULSE GENERATOR,33241,CDM,983,RC,33241,HCPCS,Outpatient,,,675,438.75,,594,88,,,percent of total billed charges,88% of total Billed charges,24.51,100,,,Fee Schedule,100% of Medicare rate,120.48,100,,,Fee Schedule,100% of WA Medicaid,675,100,,,percent of total billed charges,100% of total billed charges,124.09,103,,,Fee Schedule,103% of WA Medicaid,24.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,120.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,465.75,69,,,percent of total billed charges,69% of total billed charges,675,100,,,percent of total billed charges,100% of total billed charges,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,675,100,,,percent of total billed charges,100% of total billed charges,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,675,100,,,percent of total billed charges,100% of total billed charges,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.49,61.85,,,percent of total billed charges,61.85% of total billed charges,120.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,156.62,130,,,Fee Schedule,130% of WA Medicaid ,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.48,37.7,,,percent of total billed charges,37.70% of total billed charges,254.48,37.7,,,percent of total billed charges,37.70% of total billed charges,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,22882.5,33.9,,,percent of total billed charges,33.9% of total billed charges,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,526.5,78,,,percent of total billed charges,78% of total billed charges,675,100,,,percent of total billed charges,100% of total billed charges,557.55,82.6,,,percent of total billed charges,82.6% of total billed charges,557.55,82.6,,,percent of total billed charges,82.6% of total billed charges,120.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.51,22882.5,
ABLATE HEART DYSRHYTHM FOCUS,33250,CDM,983,RC,33250,HCPCS,Outpatient,,,4219,2742.35,,3712.72,88,,,percent of total billed charges,88% of total Billed charges,197.78,100,,,Fee Schedule,100% of Medicare rate,795.98,100,,,Fee Schedule,100% of WA Medicaid,4219,100,,,percent of total billed charges,100% of total billed charges,819.86,103,,,Fee Schedule,103% of WA Medicaid,197.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,346.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,795.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2911.11,69,,,percent of total billed charges,69% of total billed charges,4219,100,,,percent of total billed charges,100% of total billed charges,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,4219,100,,,percent of total billed charges,100% of total billed charges,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,4219,100,,,percent of total billed charges,100% of total billed charges,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2609.45,61.85,,,percent of total billed charges,61.85% of total billed charges,795.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,795.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1034.77,130,,,Fee Schedule,130% of WA Medicaid ,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1590.56,37.7,,,percent of total billed charges,37.70% of total billed charges,1590.56,37.7,,,percent of total billed charges,37.70% of total billed charges,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,143024.1,33.9,,,percent of total billed charges,33.9% of total billed charges,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,3290.82,78,,,percent of total billed charges,78% of total billed charges,4219,100,,,percent of total billed charges,100% of total billed charges,3484.89,82.6,,,percent of total billed charges,82.6% of total billed charges,3484.89,82.6,,,percent of total billed charges,82.6% of total billed charges,795.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,197.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,795.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,197.78,143024.1,
ABLATE HEART DYSRHYTHM FOCUS,33251,CDM,983,RC,33251,HCPCS,Outpatient,,,4526,2941.90,,3982.88,88,,,percent of total billed charges,88% of total Billed charges,232.98,100,,,Fee Schedule,100% of Medicare rate,892.22,100,,,Fee Schedule,100% of WA Medicaid,4526,100,,,percent of total billed charges,100% of total billed charges,918.99,103,,,Fee Schedule,103% of WA Medicaid,232.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,407.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,892.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3122.94,69,,,percent of total billed charges,69% of total billed charges,4526,100,,,percent of total billed charges,100% of total billed charges,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4526,100,,,percent of total billed charges,100% of total billed charges,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4526,100,,,percent of total billed charges,100% of total billed charges,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2799.33,61.85,,,percent of total billed charges,61.85% of total billed charges,892.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,892.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,910.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1159.89,130,,,Fee Schedule,130% of WA Medicaid ,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1706.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1706.3,37.7,,,percent of total billed charges,37.70% of total billed charges,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,153431.4,33.9,,,percent of total billed charges,33.9% of total billed charges,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3530.28,78,,,percent of total billed charges,78% of total billed charges,4526,100,,,percent of total billed charges,100% of total billed charges,3738.48,82.6,,,percent of total billed charges,82.6% of total billed charges,3738.48,82.6,,,percent of total billed charges,82.6% of total billed charges,892.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,232.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,892.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,232.98,153431.4,
REMVREPLC CVD GEN MULT LEAD,33264,CDM,983,RC,33264,HCPCS,Outpatient,,,1233,801.45,,1085.04,88,,,percent of total billed charges,88% of total Billed charges,49.68,100,,,Fee Schedule,100% of Medicare rate,223.8,100,,,Fee Schedule,100% of WA Medicaid,1233,100,,,percent of total billed charges,100% of total billed charges,230.51,103,,,Fee Schedule,103% of WA Medicaid,49.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,223.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,850.77,69,,,percent of total billed charges,69% of total billed charges,1233,100,,,percent of total billed charges,100% of total billed charges,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1233,100,,,percent of total billed charges,100% of total billed charges,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1233,100,,,percent of total billed charges,100% of total billed charges,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,762.61,61.85,,,percent of total billed charges,61.85% of total billed charges,223.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,290.94,130,,,Fee Schedule,130% of WA Medicaid ,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.84,37.7,,,percent of total billed charges,37.70% of total billed charges,464.84,37.7,,,percent of total billed charges,37.70% of total billed charges,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,41798.7,33.9,,,percent of total billed charges,33.9% of total billed charges,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,961.74,78,,,percent of total billed charges,78% of total billed charges,1233,100,,,percent of total billed charges,100% of total billed charges,1018.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1018.46,82.6,,,percent of total billed charges,82.6% of total billed charges,223.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.68,41798.7,
REMVREPLC CVD GEN SING LEAD,33262,CDM,983,RC,33262,HCPCS,Outpatient,,,1142,742.30,,1004.96,88,,,percent of total billed charges,88% of total Billed charges,45.15,100,,,Fee Schedule,100% of Medicare rate,206.64,100,,,Fee Schedule,100% of WA Medicaid,1142,100,,,percent of total billed charges,100% of total billed charges,212.84,103,,,Fee Schedule,103% of WA Medicaid,45.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,206.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,787.98,69,,,percent of total billed charges,69% of total billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1142,100,,,percent of total billed charges,100% of total billed charges,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1142,100,,,percent of total billed charges,100% of total billed charges,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,706.33,61.85,,,percent of total billed charges,61.85% of total billed charges,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,268.63,130,,,Fee Schedule,130% of WA Medicaid ,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.53,37.7,,,percent of total billed charges,37.70% of total billed charges,430.53,37.7,,,percent of total billed charges,37.70% of total billed charges,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,38713.8,33.9,,,percent of total billed charges,33.9% of total billed charges,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,890.76,78,,,percent of total billed charges,78% of total billed charges,1142,100,,,percent of total billed charges,100% of total billed charges,943.29,82.6,,,percent of total billed charges,82.6% of total billed charges,943.29,82.6,,,percent of total billed charges,82.6% of total billed charges,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.15,38713.8,
REMVREPLC CVD GEN DUAL LEAD,33263,CDM,983,RC,33263,HCPCS,Outpatient,,,1188,772.20,,1045.44,88,,,percent of total billed charges,88% of total Billed charges,47.39,100,,,Fee Schedule,100% of Medicare rate,214.66,100,,,Fee Schedule,100% of WA Medicaid,1188,100,,,percent of total billed charges,100% of total billed charges,221.1,103,,,Fee Schedule,103% of WA Medicaid,47.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,82.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,214.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,819.72,69,,,percent of total billed charges,69% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188,100,,,percent of total billed charges,100% of total billed charges,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188,100,,,percent of total billed charges,100% of total billed charges,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.78,61.85,,,percent of total billed charges,61.85% of total billed charges,214.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,279.06,130,,,Fee Schedule,130% of WA Medicaid ,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.88,37.7,,,percent of total billed charges,37.70% of total billed charges,447.88,37.7,,,percent of total billed charges,37.70% of total billed charges,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,40273.2,33.9,,,percent of total billed charges,33.9% of total billed charges,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,926.64,78,,,percent of total billed charges,78% of total billed charges,1188,100,,,percent of total billed charges,100% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,981.29,82.6,,,percent of total billed charges,82.6% of total billed charges,214.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.39,40273.2,
REMOVE PAT-ACTIVE HT RECORD,33286,CDM,983,RC,33286,HCPCS,Outpatient,,,598,388.70,,526.24,88,,,percent of total billed charges,88% of total Billed charges,11.31,100,,,Fee Schedule,100% of Medicare rate,47,100,,,Fee Schedule,100% of WA Medicaid,598,100,,,percent of total billed charges,100% of total billed charges,48.41,103,,,Fee Schedule,103% of WA Medicaid,11.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,412.62,69,,,percent of total billed charges,69% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,598,100,,,percent of total billed charges,100% of total billed charges,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,598,100,,,percent of total billed charges,100% of total billed charges,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.86,61.85,,,percent of total billed charges,61.85% of total billed charges,47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.1,130,,,Fee Schedule,130% of WA Medicaid ,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,20272.2,33.9,,,percent of total billed charges,33.9% of total billed charges,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.44,78,,,percent of total billed charges,78% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.31,20272.2,
IMPLANT PAT-ACTIVE HT RECORD,33285,CDM,983,RC,33285,HCPCS,Outpatient,,,847,550.55,,745.36,88,,,percent of total billed charges,88% of total Billed charges,11.61,100,,,Fee Schedule,100% of Medicare rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,847,100,,,percent of total billed charges,100% of total billed charges,49.37,103,,,Fee Schedule,103% of WA Medicaid,11.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,584.43,69,,,percent of total billed charges,69% of total billed charges,847,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,847,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,847,100,,,percent of total billed charges,100% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,523.87,61.85,,,percent of total billed charges,61.85% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.31,130,,,Fee Schedule,130% of WA Medicaid ,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.32,37.7,,,percent of total billed charges,37.70% of total billed charges,319.32,37.7,,,percent of total billed charges,37.70% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,28713.3,33.9,,,percent of total billed charges,33.9% of total billed charges,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,660.66,78,,,percent of total billed charges,78% of total billed charges,847,100,,,percent of total billed charges,100% of total billed charges,699.62,82.6,,,percent of total billed charges,82.6% of total billed charges,699.62,82.6,,,percent of total billed charges,82.6% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.61,28713.3,
REPAIR OF HEART WOUND,33300,CDM,983,RC,33300,HCPCS,Outpatient,,,5505,3578.25,,4844.4,88,,,percent of total billed charges,88% of total Billed charges,352.44,100,,,Fee Schedule,100% of Medicare rate,1329.56,100,,,Fee Schedule,100% of WA Medicaid,5505,100,,,percent of total billed charges,100% of total billed charges,1369.45,103,,,Fee Schedule,103% of WA Medicaid,352.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,616.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1329.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3798.45,69,,,percent of total billed charges,69% of total billed charges,5505,100,,,percent of total billed charges,100% of total billed charges,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5505,100,,,percent of total billed charges,100% of total billed charges,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5505,100,,,percent of total billed charges,100% of total billed charges,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,3404.84,61.85,,,percent of total billed charges,61.85% of total billed charges,1329.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1356.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1728.43,130,,,Fee Schedule,130% of WA Medicaid ,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2075.39,37.7,,,percent of total billed charges,37.70% of total billed charges,2075.39,37.7,,,percent of total billed charges,37.70% of total billed charges,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,186619.5,33.9,,,percent of total billed charges,33.9% of total billed charges,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,4293.9,78,,,percent of total billed charges,78% of total billed charges,5505,100,,,percent of total billed charges,100% of total billed charges,4547.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4547.13,82.6,,,percent of total billed charges,82.6% of total billed charges,1329.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,352.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,352.44,186619.5,
REPAIR MAJOR BLOOD VESSEL(S),33320,CDM,983,RC,33320,HCPCS,Outpatient,,,3063,1990.95,,2695.44,88,,,percent of total billed charges,88% of total Billed charges,149.69,100,,,Fee Schedule,100% of Medicare rate,588.41,100,,,Fee Schedule,100% of WA Medicaid,3063,100,,,percent of total billed charges,100% of total billed charges,606.06,103,,,Fee Schedule,103% of WA Medicaid,149.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,261.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,588.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2113.47,69,,,percent of total billed charges,69% of total billed charges,3063,100,,,percent of total billed charges,100% of total billed charges,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3063,100,,,percent of total billed charges,100% of total billed charges,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,3063,100,,,percent of total billed charges,100% of total billed charges,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1894.47,61.85,,,percent of total billed charges,61.85% of total billed charges,588.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,600.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,764.93,130,,,Fee Schedule,130% of WA Medicaid ,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1154.75,37.7,,,percent of total billed charges,37.70% of total billed charges,1154.75,37.7,,,percent of total billed charges,37.70% of total billed charges,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,103835.7,33.9,,,percent of total billed charges,33.9% of total billed charges,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2389.14,78,,,percent of total billed charges,78% of total billed charges,3063,100,,,percent of total billed charges,100% of total billed charges,2530.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2530.04,82.6,,,percent of total billed charges,82.6% of total billed charges,588.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,149.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,149.69,103835.7,
REPLACEMENT OF AORTIC VALVE,33406,CDM,983,RC,33406,HCPCS,Outpatient,,,8726,5671.90,,7678.88,88,,,percent of total billed charges,88% of total Billed charges,421.72,100,,,Fee Schedule,100% of Medicare rate,1569.96,100,,,Fee Schedule,100% of WA Medicaid,8726,100,,,percent of total billed charges,100% of total billed charges,1617.06,103,,,Fee Schedule,103% of WA Medicaid,421.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,738,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1569.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6020.94,69,,,percent of total billed charges,69% of total billed charges,8726,100,,,percent of total billed charges,100% of total billed charges,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,8726,100,,,percent of total billed charges,100% of total billed charges,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,8726,100,,,percent of total billed charges,100% of total billed charges,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5397.03,61.85,,,percent of total billed charges,61.85% of total billed charges,1569.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1569.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1601.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2040.95,130,,,Fee Schedule,130% of WA Medicaid ,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3289.7,37.7,,,percent of total billed charges,37.70% of total billed charges,3289.7,37.7,,,percent of total billed charges,37.70% of total billed charges,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,295811.4,33.9,,,percent of total billed charges,33.9% of total billed charges,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6806.28,78,,,percent of total billed charges,78% of total billed charges,8726,100,,,percent of total billed charges,100% of total billed charges,7207.68,82.6,,,percent of total billed charges,82.6% of total billed charges,7207.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1569.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,421.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1569.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,421.72,295811.4,
REPLACEMENT OF AORTIC VALVE,33405,CDM,983,RC,33405,HCPCS,Outpatient,,,7100,4615.00,,6248,88,,,percent of total billed charges,88% of total Billed charges,322.91,100,,,Fee Schedule,100% of Medicare rate,1237.8,100,,,Fee Schedule,100% of WA Medicaid,7100,100,,,percent of total billed charges,100% of total billed charges,1274.93,103,,,Fee Schedule,103% of WA Medicaid,322.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,565.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1237.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4899,69,,,percent of total billed charges,69% of total billed charges,7100,100,,,percent of total billed charges,100% of total billed charges,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,7100,100,,,percent of total billed charges,100% of total billed charges,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,7100,100,,,percent of total billed charges,100% of total billed charges,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,4391.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1237.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1237.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1609.14,130,,,Fee Schedule,130% of WA Medicaid ,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2676.7,37.7,,,percent of total billed charges,37.70% of total billed charges,2676.7,37.7,,,percent of total billed charges,37.70% of total billed charges,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,240690,33.9,,,percent of total billed charges,33.9% of total billed charges,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,5538,78,,,percent of total billed charges,78% of total billed charges,7100,100,,,percent of total billed charges,100% of total billed charges,5864.6,82.6,,,percent of total billed charges,82.6% of total billed charges,5864.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1237.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,322.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1237.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,322.91,240690,
REPLACEMENT OF AORTIC VALVE,33410,CDM,983,RC,33410,HCPCS,Outpatient,,,6175,4013.75,,5434,88,,,percent of total billed charges,88% of total Billed charges,364.63,100,,,Fee Schedule,100% of Medicare rate,1383.83,100,,,Fee Schedule,100% of WA Medicaid,6175,100,,,percent of total billed charges,100% of total billed charges,1425.34,103,,,Fee Schedule,103% of WA Medicaid,364.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,638.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1383.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4260.75,69,,,percent of total billed charges,69% of total billed charges,6175,100,,,percent of total billed charges,100% of total billed charges,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,6175,100,,,percent of total billed charges,100% of total billed charges,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,6175,100,,,percent of total billed charges,100% of total billed charges,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,3819.24,61.85,,,percent of total billed charges,61.85% of total billed charges,1383.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1383.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1411.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1798.98,130,,,Fee Schedule,130% of WA Medicaid ,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2327.98,37.7,,,percent of total billed charges,37.70% of total billed charges,2327.98,37.7,,,percent of total billed charges,37.70% of total billed charges,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,209332.5,33.9,,,percent of total billed charges,33.9% of total billed charges,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,4816.5,78,,,percent of total billed charges,78% of total billed charges,6175,100,,,percent of total billed charges,100% of total billed charges,5100.55,82.6,,,percent of total billed charges,82.6% of total billed charges,5100.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1383.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,364.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1383.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,364.63,209332.5,
REVISE VENTRICLE MUSCLE,33416,CDM,983,RC,33416,HCPCS,Outpatient,,,5858,3807.70,,5155.04,88,,,percent of total billed charges,88% of total Billed charges,285.51,100,,,Fee Schedule,100% of Medicare rate,1105.01,100,,,Fee Schedule,100% of WA Medicaid,5858,100,,,percent of total billed charges,100% of total billed charges,1138.16,103,,,Fee Schedule,103% of WA Medicaid,285.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,499.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1105.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4042.02,69,,,percent of total billed charges,69% of total billed charges,5858,100,,,percent of total billed charges,100% of total billed charges,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,5858,100,,,percent of total billed charges,100% of total billed charges,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,5858,100,,,percent of total billed charges,100% of total billed charges,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,3623.17,61.85,,,percent of total billed charges,61.85% of total billed charges,1105.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1127.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1436.51,130,,,Fee Schedule,130% of WA Medicaid ,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2208.47,37.7,,,percent of total billed charges,37.70% of total billed charges,2208.47,37.7,,,percent of total billed charges,37.70% of total billed charges,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,198586.2,33.9,,,percent of total billed charges,33.9% of total billed charges,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4569.24,78,,,percent of total billed charges,78% of total billed charges,5858,100,,,percent of total billed charges,100% of total billed charges,4838.71,82.6,,,percent of total billed charges,82.6% of total billed charges,4838.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1105.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,285.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,285.51,198586.2,
REPLACEMENT OF AORTIC VALVE,33413,CDM,983,RC,33413,HCPCS,Outpatient,,,9798,6368.70,,8622.24,88,,,percent of total billed charges,88% of total Billed charges,452.61,100,,,Fee Schedule,100% of Medicare rate,1746.2,100,,,Fee Schedule,100% of WA Medicaid,9798,100,,,percent of total billed charges,100% of total billed charges,1798.59,103,,,Fee Schedule,103% of WA Medicaid,452.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,792.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1746.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6760.62,69,,,percent of total billed charges,69% of total billed charges,9798,100,,,percent of total billed charges,100% of total billed charges,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,9798,100,,,percent of total billed charges,100% of total billed charges,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,9798,100,,,percent of total billed charges,100% of total billed charges,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6060.06,61.85,,,percent of total billed charges,61.85% of total billed charges,1746.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1746.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1781.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2270.06,130,,,Fee Schedule,130% of WA Medicaid ,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,3693.85,37.7,,,percent of total billed charges,37.70% of total billed charges,3693.85,37.7,,,percent of total billed charges,37.70% of total billed charges,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,332152.2,33.9,,,percent of total billed charges,33.9% of total billed charges,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,7642.44,78,,,percent of total billed charges,78% of total billed charges,9798,100,,,percent of total billed charges,100% of total billed charges,8093.15,82.6,,,percent of total billed charges,82.6% of total billed charges,8093.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1746.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,452.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1746.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,452.61,332152.2,
REPLACEMENT OF AORTIC VALVE,33411,CDM,983,RC,33411,HCPCS,Outpatient,,,8576,5574.40,,7546.88,88,,,percent of total billed charges,88% of total Billed charges,481.27,100,,,Fee Schedule,100% of Medicare rate,1822.11,100,,,Fee Schedule,100% of WA Medicaid,8576,100,,,percent of total billed charges,100% of total billed charges,1876.77,103,,,Fee Schedule,103% of WA Medicaid,481.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,842.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1822.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5917.44,69,,,percent of total billed charges,69% of total billed charges,8576,100,,,percent of total billed charges,100% of total billed charges,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,8576,100,,,percent of total billed charges,100% of total billed charges,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,8576,100,,,percent of total billed charges,100% of total billed charges,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,5304.26,61.85,,,percent of total billed charges,61.85% of total billed charges,1822.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1822.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1858.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2368.74,130,,,Fee Schedule,130% of WA Medicaid ,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3233.15,37.7,,,percent of total billed charges,37.70% of total billed charges,3233.15,37.7,,,percent of total billed charges,37.70% of total billed charges,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,290726.4,33.9,,,percent of total billed charges,33.9% of total billed charges,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,6689.28,78,,,percent of total billed charges,78% of total billed charges,8576,100,,,percent of total billed charges,100% of total billed charges,7083.78,82.6,,,percent of total billed charges,82.6% of total billed charges,7083.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1822.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,481.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1822.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,481.27,290726.4,
REPAIR OF MITRAL VALVE,33427,CDM,983,RC,33427,HCPCS,Outpatient,,,7826,5086.90,,6886.88,88,,,percent of total billed charges,88% of total Billed charges,341.76,100,,,Fee Schedule,100% of Medicare rate,1329.19,100,,,Fee Schedule,100% of WA Medicaid,7826,100,,,percent of total billed charges,100% of total billed charges,1369.07,103,,,Fee Schedule,103% of WA Medicaid,341.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,598.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1329.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5399.94,69,,,percent of total billed charges,69% of total billed charges,7826,100,,,percent of total billed charges,100% of total billed charges,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7826,100,,,percent of total billed charges,100% of total billed charges,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7826,100,,,percent of total billed charges,100% of total billed charges,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,4840.38,61.85,,,percent of total billed charges,61.85% of total billed charges,1329.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1355.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1727.95,130,,,Fee Schedule,130% of WA Medicaid ,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2950.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2950.4,37.7,,,percent of total billed charges,37.70% of total billed charges,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,265301.4,33.9,,,percent of total billed charges,33.9% of total billed charges,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,6104.28,78,,,percent of total billed charges,78% of total billed charges,7826,100,,,percent of total billed charges,100% of total billed charges,6464.28,82.6,,,percent of total billed charges,82.6% of total billed charges,6464.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1329.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,341.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,341.76,265301.4,
REPAIR OF MITRAL VALVE,33426,CDM,983,RC,33426,HCPCS,Outpatient,,,7140,4641.00,,6283.2,88,,,percent of total billed charges,88% of total Billed charges,338.89,100,,,Fee Schedule,100% of Medicare rate,1299.53,100,,,Fee Schedule,100% of WA Medicaid,7140,100,,,percent of total billed charges,100% of total billed charges,1338.52,103,,,Fee Schedule,103% of WA Medicaid,338.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,593.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1299.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4926.6,69,,,percent of total billed charges,69% of total billed charges,7140,100,,,percent of total billed charges,100% of total billed charges,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,7140,100,,,percent of total billed charges,100% of total billed charges,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,7140,100,,,percent of total billed charges,100% of total billed charges,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,4416.09,61.85,,,percent of total billed charges,61.85% of total billed charges,1299.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1299.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1325.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1689.39,130,,,Fee Schedule,130% of WA Medicaid ,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2691.78,37.7,,,percent of total billed charges,37.70% of total billed charges,2691.78,37.7,,,percent of total billed charges,37.70% of total billed charges,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,242046,33.9,,,percent of total billed charges,33.9% of total billed charges,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,5569.2,78,,,percent of total billed charges,78% of total billed charges,7140,100,,,percent of total billed charges,100% of total billed charges,5897.64,82.6,,,percent of total billed charges,82.6% of total billed charges,5897.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1299.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,338.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1299.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,338.89,242046,
REVISION OF MITRAL VALVE,33422,CDM,983,RC,33422,HCPCS,Outpatient,,,4590.68,2983.94,,4039.8,88,,,percent of total billed charges,88% of total Billed charges,226.06,100,,,Fee Schedule,100% of Medicare rate,908.63,100,,,Fee Schedule,100% of WA Medicaid,4590.68,100,,,percent of total billed charges,100% of total billed charges,935.89,103,,,Fee Schedule,103% of WA Medicaid,226.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,395.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,908.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3167.57,69,,,percent of total billed charges,69% of total billed charges,4590.68,100,,,percent of total billed charges,100% of total billed charges,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4590.68,100,,,percent of total billed charges,100% of total billed charges,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4590.68,100,,,percent of total billed charges,100% of total billed charges,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2839.34,61.85,,,percent of total billed charges,61.85% of total billed charges,908.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,908.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,926.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1181.22,130,,,Fee Schedule,130% of WA Medicaid ,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1730.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1730.69,37.7,,,percent of total billed charges,37.70% of total billed charges,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,155624.05,33.9,,,percent of total billed charges,33.9% of total billed charges,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,3580.73,78,,,percent of total billed charges,78% of total billed charges,4590.68,100,,,percent of total billed charges,100% of total billed charges,3791.9,82.6,,,percent of total billed charges,82.6% of total billed charges,3791.9,82.6,,,percent of total billed charges,82.6% of total billed charges,908.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,226.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,908.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,226.06,155624.05,
REPLACEMENT OF MITRAL VALVE,33430,CDM,983,RC,33430,HCPCS,Outpatient,,,7283,4733.95,,6409.04,88,,,percent of total billed charges,88% of total Billed charges,397.4,100,,,Fee Schedule,100% of Medicare rate,1527.62,100,,,Fee Schedule,100% of WA Medicaid,7283,100,,,percent of total billed charges,100% of total billed charges,1573.45,103,,,Fee Schedule,103% of WA Medicaid,397.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,695.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1527.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5025.27,69,,,percent of total billed charges,69% of total billed charges,7283,100,,,percent of total billed charges,100% of total billed charges,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,7283,100,,,percent of total billed charges,100% of total billed charges,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,7283,100,,,percent of total billed charges,100% of total billed charges,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,4504.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1527.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1527.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1558.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1985.91,130,,,Fee Schedule,130% of WA Medicaid ,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2745.69,37.7,,,percent of total billed charges,37.70% of total billed charges,2745.69,37.7,,,percent of total billed charges,37.70% of total billed charges,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,246893.7,33.9,,,percent of total billed charges,33.9% of total billed charges,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,5680.74,78,,,percent of total billed charges,78% of total billed charges,7283,100,,,percent of total billed charges,100% of total billed charges,6015.76,82.6,,,percent of total billed charges,82.6% of total billed charges,6015.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1527.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,397.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1527.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,397.4,246893.7,
REPLACE TRICUSPID VALVE,33465,CDM,983,RC,33465,HCPCS,Outpatient,,,7761,5044.65,,6829.68,88,,,percent of total billed charges,88% of total Billed charges,392.79,100,,,Fee Schedule,100% of Medicare rate,1498.71,100,,,Fee Schedule,100% of WA Medicaid,7761,100,,,percent of total billed charges,100% of total billed charges,1543.67,103,,,Fee Schedule,103% of WA Medicaid,392.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,687.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1498.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5355.09,69,,,percent of total billed charges,69% of total billed charges,7761,100,,,percent of total billed charges,100% of total billed charges,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,7761,100,,,percent of total billed charges,100% of total billed charges,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,7761,100,,,percent of total billed charges,100% of total billed charges,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,4800.18,61.85,,,percent of total billed charges,61.85% of total billed charges,1498.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1498.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1528.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1948.32,130,,,Fee Schedule,130% of WA Medicaid ,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2925.9,37.7,,,percent of total billed charges,37.70% of total billed charges,2925.9,37.7,,,percent of total billed charges,37.70% of total billed charges,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,263097.9,33.9,,,percent of total billed charges,33.9% of total billed charges,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,6053.58,78,,,percent of total billed charges,78% of total billed charges,7761,100,,,percent of total billed charges,100% of total billed charges,6410.59,82.6,,,percent of total billed charges,82.6% of total billed charges,6410.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1498.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,392.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1498.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,392.79,263097.9,
REVISION OF TRICUSPID VALVE,33460,CDM,983,RC,33460,HCPCS,Outpatient,,,6721,4368.65,,5914.48,88,,,percent of total billed charges,88% of total Billed charges,337.91,100,,,Fee Schedule,100% of Medicare rate,1299.91,100,,,Fee Schedule,100% of WA Medicaid,6721,100,,,percent of total billed charges,100% of total billed charges,1338.91,103,,,Fee Schedule,103% of WA Medicaid,337.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,591.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1299.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4637.49,69,,,percent of total billed charges,69% of total billed charges,6721,100,,,percent of total billed charges,100% of total billed charges,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,6721,100,,,percent of total billed charges,100% of total billed charges,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,6721,100,,,percent of total billed charges,100% of total billed charges,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,4156.94,61.85,,,percent of total billed charges,61.85% of total billed charges,1299.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1299.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1325.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1689.88,130,,,Fee Schedule,130% of WA Medicaid ,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2533.82,37.7,,,percent of total billed charges,37.70% of total billed charges,2533.82,37.7,,,percent of total billed charges,37.70% of total billed charges,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,227841.9,33.9,,,percent of total billed charges,33.9% of total billed charges,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,5242.38,78,,,percent of total billed charges,78% of total billed charges,6721,100,,,percent of total billed charges,100% of total billed charges,5551.55,82.6,,,percent of total billed charges,82.6% of total billed charges,5551.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1299.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,337.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1299.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,337.91,227841.9,
VALVULOPLASTY TRICUSPID,33463,CDM,983,RC,33463,HCPCS,Outpatient,,,5312,3452.80,,4674.56,88,,,percent of total billed charges,88% of total Billed charges,429.84,100,,,Fee Schedule,100% of Medicare rate,1674.21,100,,,Fee Schedule,100% of WA Medicaid,5312,100,,,percent of total billed charges,100% of total billed charges,1724.44,103,,,Fee Schedule,103% of WA Medicaid,429.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,752.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1674.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3665.28,69,,,percent of total billed charges,69% of total billed charges,5312,100,,,percent of total billed charges,100% of total billed charges,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5312,100,,,percent of total billed charges,100% of total billed charges,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5312,100,,,percent of total billed charges,100% of total billed charges,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3285.47,61.85,,,percent of total billed charges,61.85% of total billed charges,1674.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1674.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1707.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2176.47,130,,,Fee Schedule,130% of WA Medicaid ,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2002.62,37.7,,,percent of total billed charges,37.70% of total billed charges,2002.62,37.7,,,percent of total billed charges,37.70% of total billed charges,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,180076.8,33.9,,,percent of total billed charges,33.9% of total billed charges,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,4143.36,78,,,percent of total billed charges,78% of total billed charges,5312,100,,,percent of total billed charges,100% of total billed charges,4387.71,82.6,,,percent of total billed charges,82.6% of total billed charges,4387.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1674.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,429.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1674.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,429.84,180076.8,
VALVULOPLASTY TRICUSPID,33464,CDM,983,RC,33464,HCPCS,Outpatient,,,5918,3846.70,,5207.84,88,,,percent of total billed charges,88% of total Billed charges,340.71,100,,,Fee Schedule,100% of Medicare rate,1329,100,,,Fee Schedule,100% of WA Medicaid,5918,100,,,percent of total billed charges,100% of total billed charges,1368.87,103,,,Fee Schedule,103% of WA Medicaid,340.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,596.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1329,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4083.42,69,,,percent of total billed charges,69% of total billed charges,5918,100,,,percent of total billed charges,100% of total billed charges,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5918,100,,,percent of total billed charges,100% of total billed charges,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,5918,100,,,percent of total billed charges,100% of total billed charges,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,3660.28,61.85,,,percent of total billed charges,61.85% of total billed charges,1329,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329,100,,,Fee Schedule,100% of WA Medicare OPPS rate,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1355.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1727.7,130,,,Fee Schedule,130% of WA Medicaid ,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2231.09,37.7,,,percent of total billed charges,37.70% of total billed charges,2231.09,37.7,,,percent of total billed charges,37.70% of total billed charges,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,200620.2,33.9,,,percent of total billed charges,33.9% of total billed charges,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,4616.04,78,,,percent of total billed charges,78% of total billed charges,5918,100,,,percent of total billed charges,100% of total billed charges,4888.27,82.6,,,percent of total billed charges,82.6% of total billed charges,4888.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1329,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,340.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,340.71,200620.2,
ENDOSCOPIC VEIN HARVEST,33508,CDM,983,RC,33508,HCPCS,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,2.28,100,,,Fee Schedule,100% of Medicare rate,8.77,100,,,Fee Schedule,100% of WA Medicaid,52,100,,,percent of total billed charges,100% of total billed charges,9.03,103,,,Fee Schedule,103% of WA Medicaid,2.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,52,100,,,percent of total billed charges,100% of total billed charges,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,52,100,,,percent of total billed charges,100% of total billed charges,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,8.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.4,130,,,Fee Schedule,130% of WA Medicaid ,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,8.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.28,1762.8,
CABG ARTERY-VEIN SINGLE,33517,CDM,983,RC,33517,HCPCS,Outpatient,,,6399,4159.35,,5631.12,88,,,percent of total billed charges,88% of total Billed charges,27.93,100,,,Fee Schedule,100% of Medicare rate,101.08,100,,,Fee Schedule,100% of WA Medicaid,6399,100,,,percent of total billed charges,100% of total billed charges,104.11,103,,,Fee Schedule,103% of WA Medicaid,27.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,101.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4415.31,69,,,percent of total billed charges,69% of total billed charges,6399,100,,,percent of total billed charges,100% of total billed charges,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,6399,100,,,percent of total billed charges,100% of total billed charges,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,6399,100,,,percent of total billed charges,100% of total billed charges,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3957.78,61.85,,,percent of total billed charges,61.85% of total billed charges,101.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,131.4,130,,,Fee Schedule,130% of WA Medicaid ,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2412.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2412.42,37.7,,,percent of total billed charges,37.70% of total billed charges,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,216926.1,33.9,,,percent of total billed charges,33.9% of total billed charges,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4991.22,78,,,percent of total billed charges,78% of total billed charges,6399,100,,,percent of total billed charges,100% of total billed charges,5285.57,82.6,,,percent of total billed charges,82.6% of total billed charges,5285.57,82.6,,,percent of total billed charges,82.6% of total billed charges,101.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.93,216926.1,
CABG ARTERY-VEIN TWO,33518,CDM,983,RC,33518,HCPCS,Outpatient,,,1076,699.40,,946.88,88,,,percent of total billed charges,88% of total Billed charges,60.77,100,,,Fee Schedule,100% of Medicare rate,221.38,100,,,Fee Schedule,100% of WA Medicaid,1076,100,,,percent of total billed charges,100% of total billed charges,228.02,103,,,Fee Schedule,103% of WA Medicaid,60.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,106.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,221.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,742.44,69,,,percent of total billed charges,69% of total billed charges,1076,100,,,percent of total billed charges,100% of total billed charges,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1076,100,,,percent of total billed charges,100% of total billed charges,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1076,100,,,percent of total billed charges,100% of total billed charges,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,665.51,61.85,,,percent of total billed charges,61.85% of total billed charges,221.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,287.79,130,,,Fee Schedule,130% of WA Medicaid ,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.65,37.7,,,percent of total billed charges,37.70% of total billed charges,405.65,37.7,,,percent of total billed charges,37.70% of total billed charges,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,36476.4,33.9,,,percent of total billed charges,33.9% of total billed charges,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,839.28,78,,,percent of total billed charges,78% of total billed charges,1076,100,,,percent of total billed charges,100% of total billed charges,888.78,82.6,,,percent of total billed charges,82.6% of total billed charges,888.78,82.6,,,percent of total billed charges,82.6% of total billed charges,221.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.77,36476.4,
CABG ARTERY-VEIN THREE,33519,CDM,983,RC,33519,HCPCS,Outpatient,,,1515,984.75,,1333.2,88,,,percent of total billed charges,88% of total Billed charges,80.65,100,,,Fee Schedule,100% of Medicare rate,292.81,100,,,Fee Schedule,100% of WA Medicaid,1515,100,,,percent of total billed charges,100% of total billed charges,301.59,103,,,Fee Schedule,103% of WA Medicaid,80.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,141.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,292.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1045.35,69,,,percent of total billed charges,69% of total billed charges,1515,100,,,percent of total billed charges,100% of total billed charges,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1515,100,,,percent of total billed charges,100% of total billed charges,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1515,100,,,percent of total billed charges,100% of total billed charges,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,937.03,61.85,,,percent of total billed charges,61.85% of total billed charges,292.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,380.65,130,,,Fee Schedule,130% of WA Medicaid ,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.16,37.7,,,percent of total billed charges,37.70% of total billed charges,571.16,37.7,,,percent of total billed charges,37.70% of total billed charges,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,51358.5,33.9,,,percent of total billed charges,33.9% of total billed charges,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1181.7,78,,,percent of total billed charges,78% of total billed charges,1515,100,,,percent of total billed charges,100% of total billed charges,1251.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1251.39,82.6,,,percent of total billed charges,82.6% of total billed charges,292.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.65,51358.5,
CABG VEIN SINGLE,33510,CDM,983,RC,33510,HCPCS,Outpatient,,,5087,3306.55,,4476.56,88,,,percent of total billed charges,88% of total Billed charges,272.25,100,,,Fee Schedule,100% of Medicare rate,1055.59,100,,,Fee Schedule,100% of WA Medicaid,5087,100,,,percent of total billed charges,100% of total billed charges,1087.26,103,,,Fee Schedule,103% of WA Medicaid,272.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,476.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1055.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3510.03,69,,,percent of total billed charges,69% of total billed charges,5087,100,,,percent of total billed charges,100% of total billed charges,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,5087,100,,,percent of total billed charges,100% of total billed charges,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,5087,100,,,percent of total billed charges,100% of total billed charges,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3146.31,61.85,,,percent of total billed charges,61.85% of total billed charges,1055.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1055.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1076.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1372.27,130,,,Fee Schedule,130% of WA Medicaid ,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1917.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1917.8,37.7,,,percent of total billed charges,37.70% of total billed charges,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,172449.3,33.9,,,percent of total billed charges,33.9% of total billed charges,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3967.86,78,,,percent of total billed charges,78% of total billed charges,5087,100,,,percent of total billed charges,100% of total billed charges,4201.86,82.6,,,percent of total billed charges,82.6% of total billed charges,4201.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1055.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,272.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1055.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,272.25,172449.3,
CABG VEIN TWO,33511,CDM,983,RC,33511,HCPCS,Outpatient,,,5606,3643.90,,4933.28,88,,,percent of total billed charges,88% of total Billed charges,299.78,100,,,Fee Schedule,100% of Medicare rate,1158.91,100,,,Fee Schedule,100% of WA Medicaid,5606,100,,,percent of total billed charges,100% of total billed charges,1193.68,103,,,Fee Schedule,103% of WA Medicaid,299.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,524.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1158.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3868.14,69,,,percent of total billed charges,69% of total billed charges,5606,100,,,percent of total billed charges,100% of total billed charges,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,5606,100,,,percent of total billed charges,100% of total billed charges,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,5606,100,,,percent of total billed charges,100% of total billed charges,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,3467.31,61.85,,,percent of total billed charges,61.85% of total billed charges,1158.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1158.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1182.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1506.58,130,,,Fee Schedule,130% of WA Medicaid ,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2113.46,37.7,,,percent of total billed charges,37.70% of total billed charges,2113.46,37.7,,,percent of total billed charges,37.70% of total billed charges,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,190043.4,33.9,,,percent of total billed charges,33.9% of total billed charges,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,4372.68,78,,,percent of total billed charges,78% of total billed charges,5606,100,,,percent of total billed charges,100% of total billed charges,4630.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4630.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1158.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,299.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1158.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,299.78,190043.4,
CABG VEIN THREE,33512,CDM,983,RC,33512,HCPCS,Outpatient,,,6221,4043.65,,5474.48,88,,,percent of total billed charges,88% of total Billed charges,344.09,100,,,Fee Schedule,100% of Medicare rate,1319.3,100,,,Fee Schedule,100% of WA Medicaid,6221,100,,,percent of total billed charges,100% of total billed charges,1358.88,103,,,Fee Schedule,103% of WA Medicaid,344.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,602.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1319.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4292.49,69,,,percent of total billed charges,69% of total billed charges,6221,100,,,percent of total billed charges,100% of total billed charges,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,6221,100,,,percent of total billed charges,100% of total billed charges,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,6221,100,,,percent of total billed charges,100% of total billed charges,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3847.69,61.85,,,percent of total billed charges,61.85% of total billed charges,1319.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1345.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1715.09,130,,,Fee Schedule,130% of WA Medicaid ,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2345.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2345.32,37.7,,,percent of total billed charges,37.70% of total billed charges,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,210891.9,33.9,,,percent of total billed charges,33.9% of total billed charges,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4852.38,78,,,percent of total billed charges,78% of total billed charges,6221,100,,,percent of total billed charges,100% of total billed charges,5138.55,82.6,,,percent of total billed charges,82.6% of total billed charges,5138.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1319.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,347.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,344.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,344.09,210891.9,
CABG VEIN FOUR,33513,CDM,983,RC,33513,HCPCS,Outpatient,,,6824.32,4435.81,,6005.4,88,,,percent of total billed charges,88% of total Billed charges,353.05,100,,,Fee Schedule,100% of Medicare rate,1346.34,100,,,Fee Schedule,100% of WA Medicaid,6824.32,100,,,percent of total billed charges,100% of total billed charges,1386.73,103,,,Fee Schedule,103% of WA Medicaid,353.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,617.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1346.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4708.78,69,,,percent of total billed charges,69% of total billed charges,6824.32,100,,,percent of total billed charges,100% of total billed charges,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6824.32,100,,,percent of total billed charges,100% of total billed charges,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6824.32,100,,,percent of total billed charges,100% of total billed charges,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,4220.84,61.85,,,percent of total billed charges,61.85% of total billed charges,1346.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1346.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1373.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1750.24,130,,,Fee Schedule,130% of WA Medicaid ,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2572.77,37.7,,,percent of total billed charges,37.70% of total billed charges,2572.77,37.7,,,percent of total billed charges,37.70% of total billed charges,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,231344.45,33.9,,,percent of total billed charges,33.9% of total billed charges,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,5322.97,78,,,percent of total billed charges,78% of total billed charges,6824.32,100,,,percent of total billed charges,100% of total billed charges,5636.89,82.6,,,percent of total billed charges,82.6% of total billed charges,5636.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1346.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,353.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1346.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,353.05,231344.45,
CABG VEIN FIVE,33514,CDM,983,RC,33514,HCPCS,Outpatient,,,7204.92,4683.20,,6340.33,88,,,percent of total billed charges,88% of total Billed charges,364.29,100,,,Fee Schedule,100% of Medicare rate,1416.47,100,,,Fee Schedule,100% of WA Medicaid,7204.92,100,,,percent of total billed charges,100% of total billed charges,1458.96,103,,,Fee Schedule,103% of WA Medicaid,364.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,637.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1416.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4971.39,69,,,percent of total billed charges,69% of total billed charges,7204.92,100,,,percent of total billed charges,100% of total billed charges,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,7204.92,100,,,percent of total billed charges,100% of total billed charges,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,7204.92,100,,,percent of total billed charges,100% of total billed charges,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,4456.24,61.85,,,percent of total billed charges,61.85% of total billed charges,1416.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1416.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1444.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1841.41,130,,,Fee Schedule,130% of WA Medicaid ,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2716.25,37.7,,,percent of total billed charges,37.70% of total billed charges,2716.25,37.7,,,percent of total billed charges,37.70% of total billed charges,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,244246.79,33.9,,,percent of total billed charges,33.9% of total billed charges,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,5619.84,78,,,percent of total billed charges,78% of total billed charges,7204.92,100,,,percent of total billed charges,100% of total billed charges,5951.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5951.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1416.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,364.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1416.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,364.29,244246.79,
CABG ART-VEIN SIX OR MORE,33523,CDM,983,RC,33523,HCPCS,Outpatient,,,3063,1990.95,,2695.44,88,,,percent of total billed charges,88% of total Billed charges,119.81,100,,,Fee Schedule,100% of Medicare rate,444.24,100,,,Fee Schedule,100% of WA Medicaid,3063,100,,,percent of total billed charges,100% of total billed charges,457.57,103,,,Fee Schedule,103% of WA Medicaid,119.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,209.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,444.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2113.47,69,,,percent of total billed charges,69% of total billed charges,3063,100,,,percent of total billed charges,100% of total billed charges,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,3063,100,,,percent of total billed charges,100% of total billed charges,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,3063,100,,,percent of total billed charges,100% of total billed charges,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1894.47,61.85,,,percent of total billed charges,61.85% of total billed charges,444.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,577.51,130,,,Fee Schedule,130% of WA Medicaid ,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1154.75,37.7,,,percent of total billed charges,37.70% of total billed charges,1154.75,37.7,,,percent of total billed charges,37.70% of total billed charges,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,103835.7,33.9,,,percent of total billed charges,33.9% of total billed charges,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2389.14,78,,,percent of total billed charges,78% of total billed charges,3063,100,,,percent of total billed charges,100% of total billed charges,2530.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2530.04,82.6,,,percent of total billed charges,82.6% of total billed charges,444.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,119.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.81,103835.7,
CABG ARTERY-VEIN FOUR,33521,CDM,983,RC,33521,HCPCS,Outpatient,,,1981,1287.65,,1743.28,88,,,percent of total billed charges,88% of total Billed charges,96.45,100,,,Fee Schedule,100% of Medicare rate,350.99,100,,,Fee Schedule,100% of WA Medicaid,1981,100,,,percent of total billed charges,100% of total billed charges,361.52,103,,,Fee Schedule,103% of WA Medicaid,96.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,168.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,350.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1366.89,69,,,percent of total billed charges,69% of total billed charges,1981,100,,,percent of total billed charges,100% of total billed charges,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1981,100,,,percent of total billed charges,100% of total billed charges,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1981,100,,,percent of total billed charges,100% of total billed charges,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1225.25,61.85,,,percent of total billed charges,61.85% of total billed charges,350.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,456.29,130,,,Fee Schedule,130% of WA Medicaid ,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.84,37.7,,,percent of total billed charges,37.70% of total billed charges,746.84,37.7,,,percent of total billed charges,37.70% of total billed charges,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,67155.9,33.9,,,percent of total billed charges,33.9% of total billed charges,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1545.18,78,,,percent of total billed charges,78% of total billed charges,1981,100,,,percent of total billed charges,100% of total billed charges,1636.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1636.31,82.6,,,percent of total billed charges,82.6% of total billed charges,350.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.45,67155.9,
CABG ARTERY-VEIN FIVE,33522,CDM,983,RC,33522,HCPCS,Outpatient,,,2516,1635.40,,2214.08,88,,,percent of total billed charges,88% of total Billed charges,108.87,100,,,Fee Schedule,100% of Medicare rate,394.45,100,,,Fee Schedule,100% of WA Medicaid,2516,100,,,percent of total billed charges,100% of total billed charges,406.28,103,,,Fee Schedule,103% of WA Medicaid,108.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,190.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,394.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1736.04,69,,,percent of total billed charges,69% of total billed charges,2516,100,,,percent of total billed charges,100% of total billed charges,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2516,100,,,percent of total billed charges,100% of total billed charges,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2516,100,,,percent of total billed charges,100% of total billed charges,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1556.15,61.85,,,percent of total billed charges,61.85% of total billed charges,394.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,512.79,130,,,Fee Schedule,130% of WA Medicaid ,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,948.53,37.7,,,percent of total billed charges,37.70% of total billed charges,948.53,37.7,,,percent of total billed charges,37.70% of total billed charges,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,85292.4,33.9,,,percent of total billed charges,33.9% of total billed charges,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1962.48,78,,,percent of total billed charges,78% of total billed charges,2516,100,,,percent of total billed charges,100% of total billed charges,2078.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2078.22,82.6,,,percent of total billed charges,82.6% of total billed charges,394.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,108.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.87,85292.4,
CORONARY ARTERY BYPASS/REOP,33530,CDM,983,RC,33530,HCPCS,Outpatient,,,1329,863.85,,1169.52,88,,,percent of total billed charges,88% of total Billed charges,77.51,100,,,Fee Schedule,100% of Medicare rate,282.55,100,,,Fee Schedule,100% of WA Medicaid,1329,100,,,percent of total billed charges,100% of total billed charges,291.03,103,,,Fee Schedule,103% of WA Medicaid,77.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,917.01,69,,,percent of total billed charges,69% of total billed charges,1329,100,,,percent of total billed charges,100% of total billed charges,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329,100,,,percent of total billed charges,100% of total billed charges,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329,100,,,percent of total billed charges,100% of total billed charges,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,821.99,61.85,,,percent of total billed charges,61.85% of total billed charges,282.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.32,130,,,Fee Schedule,130% of WA Medicaid ,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,501.03,37.7,,,percent of total billed charges,37.70% of total billed charges,501.03,37.7,,,percent of total billed charges,37.70% of total billed charges,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,45053.1,33.9,,,percent of total billed charges,33.9% of total billed charges,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1036.62,78,,,percent of total billed charges,78% of total billed charges,1329,100,,,percent of total billed charges,100% of total billed charges,1097.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1097.75,82.6,,,percent of total billed charges,82.6% of total billed charges,282.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.51,45053.1,
CABG ARTERIAL TWO,33534,CDM,983,RC,33534,HCPCS,Outpatient,,,6562,4265.30,,5774.56,88,,,percent of total billed charges,88% of total Billed charges,311.81,100,,,Fee Schedule,100% of Medicare rate,1199.94,100,,,Fee Schedule,100% of WA Medicaid,6562,100,,,percent of total billed charges,100% of total billed charges,1235.94,103,,,Fee Schedule,103% of WA Medicaid,311.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,545.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1199.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4527.78,69,,,percent of total billed charges,69% of total billed charges,6562,100,,,percent of total billed charges,100% of total billed charges,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,6562,100,,,percent of total billed charges,100% of total billed charges,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,6562,100,,,percent of total billed charges,100% of total billed charges,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4058.6,61.85,,,percent of total billed charges,61.85% of total billed charges,1199.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1199.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1223.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1559.92,130,,,Fee Schedule,130% of WA Medicaid ,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2473.87,37.7,,,percent of total billed charges,37.70% of total billed charges,2473.87,37.7,,,percent of total billed charges,37.70% of total billed charges,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,222451.8,33.9,,,percent of total billed charges,33.9% of total billed charges,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,5118.36,78,,,percent of total billed charges,78% of total billed charges,6562,100,,,percent of total billed charges,100% of total billed charges,5420.21,82.6,,,percent of total billed charges,82.6% of total billed charges,5420.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1199.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,311.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1199.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,311.81,222451.8,
CABG ARTERIAL THREE,33535,CDM,983,RC,33535,HCPCS,Outpatient,,,6386,4150.90,,5619.68,88,,,percent of total billed charges,88% of total Billed charges,346.61,100,,,Fee Schedule,100% of Medicare rate,1332.54,100,,,Fee Schedule,100% of WA Medicaid,6386,100,,,percent of total billed charges,100% of total billed charges,1372.52,103,,,Fee Schedule,103% of WA Medicaid,346.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,606.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1332.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4406.34,69,,,percent of total billed charges,69% of total billed charges,6386,100,,,percent of total billed charges,100% of total billed charges,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6386,100,,,percent of total billed charges,100% of total billed charges,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6386,100,,,percent of total billed charges,100% of total billed charges,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,3949.74,61.85,,,percent of total billed charges,61.85% of total billed charges,1332.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1332.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1359.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1732.3,130,,,Fee Schedule,130% of WA Medicaid ,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2407.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2407.52,37.7,,,percent of total billed charges,37.70% of total billed charges,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,216485.4,33.9,,,percent of total billed charges,33.9% of total billed charges,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4981.08,78,,,percent of total billed charges,78% of total billed charges,6386,100,,,percent of total billed charges,100% of total billed charges,5274.84,82.6,,,percent of total billed charges,82.6% of total billed charges,5274.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1332.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,346.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1332.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,346.61,216485.4,
CABG ARTERIAL SINGLE,33533,CDM,983,RC,33533,HCPCS,Outpatient,,,5936,3858.40,,5223.68,88,,,percent of total billed charges,88% of total Billed charges,264.27,100,,,Fee Schedule,100% of Medicare rate,1022.39,100,,,Fee Schedule,100% of WA Medicaid,5936,100,,,percent of total billed charges,100% of total billed charges,1053.06,103,,,Fee Schedule,103% of WA Medicaid,264.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,462.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1022.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4095.84,69,,,percent of total billed charges,69% of total billed charges,5936,100,,,percent of total billed charges,100% of total billed charges,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,5936,100,,,percent of total billed charges,100% of total billed charges,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,5936,100,,,percent of total billed charges,100% of total billed charges,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3671.42,61.85,,,percent of total billed charges,61.85% of total billed charges,1022.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1022.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1042.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1329.11,130,,,Fee Schedule,130% of WA Medicaid ,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2237.87,37.7,,,percent of total billed charges,37.70% of total billed charges,2237.87,37.7,,,percent of total billed charges,37.70% of total billed charges,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,201230.4,33.9,,,percent of total billed charges,33.9% of total billed charges,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,4630.08,78,,,percent of total billed charges,78% of total billed charges,5936,100,,,percent of total billed charges,100% of total billed charges,4903.14,82.6,,,percent of total billed charges,82.6% of total billed charges,4903.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1022.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,264.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1022.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,264.27,201230.4,
OPEN CORONARY ENDARTERECTOMY,33572,CDM,983,RC,33572,HCPCS,Outpatient,,,981,637.65,,863.28,88,,,percent of total billed charges,88% of total Billed charges,34.62,100,,,Fee Schedule,100% of Medicare rate,124.4,100,,,Fee Schedule,100% of WA Medicaid,981,100,,,percent of total billed charges,100% of total billed charges,128.13,103,,,Fee Schedule,103% of WA Medicaid,34.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,124.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,676.89,69,,,percent of total billed charges,69% of total billed charges,981,100,,,percent of total billed charges,100% of total billed charges,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,981,100,,,percent of total billed charges,100% of total billed charges,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,981,100,,,percent of total billed charges,100% of total billed charges,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.75,61.85,,,percent of total billed charges,61.85% of total billed charges,124.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,161.72,130,,,Fee Schedule,130% of WA Medicaid ,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.84,37.7,,,percent of total billed charges,37.70% of total billed charges,369.84,37.7,,,percent of total billed charges,37.70% of total billed charges,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,33255.9,33.9,,,percent of total billed charges,33.9% of total billed charges,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.18,78,,,percent of total billed charges,78% of total billed charges,981,100,,,percent of total billed charges,100% of total billed charges,810.31,82.6,,,percent of total billed charges,82.6% of total billed charges,810.31,82.6,,,percent of total billed charges,82.6% of total billed charges,124.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.62,33255.9,
REPAIR HEART SEPTUM DEFECT,33641,CDM,983,RC,33641,HCPCS,Outpatient,,,4767,3098.55,,4194.96,88,,,percent of total billed charges,88% of total Billed charges,237.56,100,,,Fee Schedule,100% of Medicare rate,895.2,100,,,Fee Schedule,100% of WA Medicaid,4767,100,,,percent of total billed charges,100% of total billed charges,922.06,103,,,Fee Schedule,103% of WA Medicaid,237.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,415.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,895.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3289.23,69,,,percent of total billed charges,69% of total billed charges,4767,100,,,percent of total billed charges,100% of total billed charges,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4767,100,,,percent of total billed charges,100% of total billed charges,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4767,100,,,percent of total billed charges,100% of total billed charges,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2948.39,61.85,,,percent of total billed charges,61.85% of total billed charges,895.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,895.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1163.76,130,,,Fee Schedule,130% of WA Medicaid ,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1797.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1797.16,37.7,,,percent of total billed charges,37.70% of total billed charges,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,161601.3,33.9,,,percent of total billed charges,33.9% of total billed charges,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3718.26,78,,,percent of total billed charges,78% of total billed charges,4767,100,,,percent of total billed charges,100% of total billed charges,3937.54,82.6,,,percent of total billed charges,82.6% of total billed charges,3937.54,82.6,,,percent of total billed charges,82.6% of total billed charges,895.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,237.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,895.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,237.56,161601.3,
REVISION OF HEART VEINS,33645,CDM,983,RC,33645,HCPCS,Outpatient,,,4758,3092.70,,4187.04,88,,,percent of total billed charges,88% of total Billed charges,250.85,100,,,Fee Schedule,100% of Medicare rate,945.18,100,,,Fee Schedule,100% of WA Medicaid,4758,100,,,percent of total billed charges,100% of total billed charges,973.54,103,,,Fee Schedule,103% of WA Medicaid,250.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,438.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,945.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3283.02,69,,,percent of total billed charges,69% of total billed charges,4758,100,,,percent of total billed charges,100% of total billed charges,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,4758,100,,,percent of total billed charges,100% of total billed charges,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,4758,100,,,percent of total billed charges,100% of total billed charges,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2942.82,61.85,,,percent of total billed charges,61.85% of total billed charges,945.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,945.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,964.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1228.73,130,,,Fee Schedule,130% of WA Medicaid ,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1793.77,37.7,,,percent of total billed charges,37.70% of total billed charges,1793.77,37.7,,,percent of total billed charges,37.70% of total billed charges,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,161296.2,33.9,,,percent of total billed charges,33.9% of total billed charges,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,3711.24,78,,,percent of total billed charges,78% of total billed charges,4758,100,,,percent of total billed charges,100% of total billed charges,3930.11,82.6,,,percent of total billed charges,82.6% of total billed charges,3930.11,82.6,,,percent of total billed charges,82.6% of total billed charges,945.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,250.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,945.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,250.85,161296.2,
REPAIR HEART SEPTUM DEFECTS,33647,CDM,983,RC,33647,HCPCS,Outpatient,,,5277,3430.05,,4643.76,88,,,percent of total billed charges,88% of total Billed charges,264.16,100,,,Fee Schedule,100% of Medicare rate,990.69,100,,,Fee Schedule,100% of WA Medicaid,5277,100,,,percent of total billed charges,100% of total billed charges,1020.41,103,,,Fee Schedule,103% of WA Medicaid,264.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,462.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,990.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3641.13,69,,,percent of total billed charges,69% of total billed charges,5277,100,,,percent of total billed charges,100% of total billed charges,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,5277,100,,,percent of total billed charges,100% of total billed charges,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,5277,100,,,percent of total billed charges,100% of total billed charges,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,3263.82,61.85,,,percent of total billed charges,61.85% of total billed charges,990.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,990.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1010.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1287.9,130,,,Fee Schedule,130% of WA Medicaid ,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1989.43,37.7,,,percent of total billed charges,37.70% of total billed charges,1989.43,37.7,,,percent of total billed charges,37.70% of total billed charges,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,178890.3,33.9,,,percent of total billed charges,33.9% of total billed charges,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,4116.06,78,,,percent of total billed charges,78% of total billed charges,5277,100,,,percent of total billed charges,100% of total billed charges,4358.8,82.6,,,percent of total billed charges,82.6% of total billed charges,4358.8,82.6,,,percent of total billed charges,82.6% of total billed charges,990.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,264.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,990.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,264.16,178890.3,
"Ascending aorta graft, with cardiopulmonary bypass, includes",33858,CDM,983,RC,33858,HCPCS,Outpatient,,,6758,4392.70,,5947.04,88,,,percent of total billed charges,88% of total Billed charges,492.08,100,,,Fee Schedule,100% of Medicare rate,1839.45,100,,,Fee Schedule,100% of WA Medicaid,6758,100,,,percent of total billed charges,100% of total billed charges,1894.63,103,,,Fee Schedule,103% of WA Medicaid,492.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,861.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1839.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4663.02,69,,,percent of total billed charges,69% of total billed charges,6758,100,,,percent of total billed charges,100% of total billed charges,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,6758,100,,,percent of total billed charges,100% of total billed charges,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,6758,100,,,percent of total billed charges,100% of total billed charges,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,4179.82,61.85,,,percent of total billed charges,61.85% of total billed charges,1839.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1839.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1876.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2391.29,130,,,Fee Schedule,130% of WA Medicaid ,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2547.77,37.7,,,percent of total billed charges,37.70% of total billed charges,2547.77,37.7,,,percent of total billed charges,37.70% of total billed charges,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,229096.2,33.9,,,percent of total billed charges,33.9% of total billed charges,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,5271.24,78,,,percent of total billed charges,78% of total billed charges,6758,100,,,percent of total billed charges,100% of total billed charges,5582.11,82.6,,,percent of total billed charges,82.6% of total billed charges,5582.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1839.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,497,101,,,Fee Schedule,101% of Medicare RBRVS rate,492.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1839.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,492.08,229096.2,
ASCENDING AORTIC GRAFT,33864,CDM,983,RC,33864,HCPCS,Outpatient,,,9558,6212.70,,8411.04,88,,,percent of total billed charges,88% of total Billed charges,467.91,100,,,Fee Schedule,100% of Medicare rate,1740.79,100,,,Fee Schedule,100% of WA Medicaid,9558,100,,,percent of total billed charges,100% of total billed charges,1793.01,103,,,Fee Schedule,103% of WA Medicaid,467.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,818.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1740.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6595.02,69,,,percent of total billed charges,69% of total billed charges,9558,100,,,percent of total billed charges,100% of total billed charges,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,9558,100,,,percent of total billed charges,100% of total billed charges,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,9558,100,,,percent of total billed charges,100% of total billed charges,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,5911.62,61.85,,,percent of total billed charges,61.85% of total billed charges,1740.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1740.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1775.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2263.03,130,,,Fee Schedule,130% of WA Medicaid ,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3603.37,37.7,,,percent of total billed charges,37.70% of total billed charges,3603.37,37.7,,,percent of total billed charges,37.70% of total billed charges,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,324016.2,33.9,,,percent of total billed charges,33.9% of total billed charges,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,7455.24,78,,,percent of total billed charges,78% of total billed charges,9558,100,,,percent of total billed charges,100% of total billed charges,7894.91,82.6,,,percent of total billed charges,82.6% of total billed charges,7894.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1740.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,472.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,467.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1740.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,467.91,324016.2,
ASCENDING AORTIC GRAFT,33863,CDM,983,RC,33863,HCPCS,Outpatient,,,7993,5195.45,,7033.84,88,,,percent of total billed charges,88% of total Billed charges,455.38,100,,,Fee Schedule,100% of Medicare rate,1705.17,100,,,Fee Schedule,100% of WA Medicaid,7993,100,,,percent of total billed charges,100% of total billed charges,1756.33,103,,,Fee Schedule,103% of WA Medicaid,455.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,796.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1705.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5515.17,69,,,percent of total billed charges,69% of total billed charges,7993,100,,,percent of total billed charges,100% of total billed charges,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,7993,100,,,percent of total billed charges,100% of total billed charges,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,7993,100,,,percent of total billed charges,100% of total billed charges,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,4943.67,61.85,,,percent of total billed charges,61.85% of total billed charges,1705.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1705.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1739.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2216.72,130,,,Fee Schedule,130% of WA Medicaid ,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3013.36,37.7,,,percent of total billed charges,37.70% of total billed charges,3013.36,37.7,,,percent of total billed charges,37.70% of total billed charges,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,270962.7,33.9,,,percent of total billed charges,33.9% of total billed charges,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,6234.54,78,,,percent of total billed charges,78% of total billed charges,7993,100,,,percent of total billed charges,100% of total billed charges,6602.22,82.6,,,percent of total billed charges,82.6% of total billed charges,6602.22,82.6,,,percent of total billed charges,82.6% of total billed charges,1705.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,455.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1705.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,455.38,270962.7,
THORACOABDOMINAL GRAFT,33877,CDM,983,RC,33877,HCPCS,Outpatient,,,10353,6729.45,,9110.64,88,,,percent of total billed charges,88% of total Billed charges,539.42,100,,,Fee Schedule,100% of Medicare rate,1948.18,100,,,Fee Schedule,100% of WA Medicaid,10353,100,,,percent of total billed charges,100% of total billed charges,2006.63,103,,,Fee Schedule,103% of WA Medicaid,539.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,943.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1948.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7143.57,69,,,percent of total billed charges,69% of total billed charges,10353,100,,,percent of total billed charges,100% of total billed charges,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,10353,100,,,percent of total billed charges,100% of total billed charges,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,10353,100,,,percent of total billed charges,100% of total billed charges,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,6403.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1948.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1948.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1987.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2532.63,130,,,Fee Schedule,130% of WA Medicaid ,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,3903.08,37.7,,,percent of total billed charges,37.70% of total billed charges,3903.08,37.7,,,percent of total billed charges,37.70% of total billed charges,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,350966.7,33.9,,,percent of total billed charges,33.9% of total billed charges,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,8075.34,78,,,percent of total billed charges,78% of total billed charges,10353,100,,,percent of total billed charges,100% of total billed charges,8551.58,82.6,,,percent of total billed charges,82.6% of total billed charges,8551.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1948.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,544.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,539.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1948.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,539.42,350966.7,
THORACIC AORTIC GRAFT,33875,CDM,983,RC,33875,HCPCS,Outpatient,,,6468,4204.20,,5691.84,88,,,percent of total billed charges,88% of total Billed charges,396.79,100,,,Fee Schedule,100% of Medicare rate,1490.88,100,,,Fee Schedule,100% of WA Medicaid,6468,100,,,percent of total billed charges,100% of total billed charges,1535.61,103,,,Fee Schedule,103% of WA Medicaid,396.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,694.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1490.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4462.92,69,,,percent of total billed charges,69% of total billed charges,6468,100,,,percent of total billed charges,100% of total billed charges,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,6468,100,,,percent of total billed charges,100% of total billed charges,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,6468,100,,,percent of total billed charges,100% of total billed charges,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,4000.46,61.85,,,percent of total billed charges,61.85% of total billed charges,1490.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1490.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1520.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1938.14,130,,,Fee Schedule,130% of WA Medicaid ,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2438.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2438.44,37.7,,,percent of total billed charges,37.70% of total billed charges,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,219265.2,33.9,,,percent of total billed charges,33.9% of total billed charges,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5045.04,78,,,percent of total billed charges,78% of total billed charges,6468,100,,,percent of total billed charges,100% of total billed charges,5342.57,82.6,,,percent of total billed charges,82.6% of total billed charges,5342.57,82.6,,,percent of total billed charges,82.6% of total billed charges,1490.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,396.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1490.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,396.79,219265.2,
"Transverse aortic arch graft, with cardiopulmonary bypass, w",33871,CDM,983,RC,33871,HCPCS,Outpatient,,,7474,4858.10,,6577.12,88,,,percent of total billed charges,88% of total Billed charges,472.81,100,,,Fee Schedule,100% of Medicare rate,1764.66,100,,,Fee Schedule,100% of WA Medicaid,7474,100,,,percent of total billed charges,100% of total billed charges,1817.6,103,,,Fee Schedule,103% of WA Medicaid,472.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,827.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1764.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5157.06,69,,,percent of total billed charges,69% of total billed charges,7474,100,,,percent of total billed charges,100% of total billed charges,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,7474,100,,,percent of total billed charges,100% of total billed charges,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,7474,100,,,percent of total billed charges,100% of total billed charges,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4622.67,61.85,,,percent of total billed charges,61.85% of total billed charges,1764.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1764.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1799.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2294.06,130,,,Fee Schedule,130% of WA Medicaid ,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2817.7,37.7,,,percent of total billed charges,37.70% of total billed charges,2817.7,37.7,,,percent of total billed charges,37.70% of total billed charges,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,253368.6,33.9,,,percent of total billed charges,33.9% of total billed charges,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,5829.72,78,,,percent of total billed charges,78% of total billed charges,7474,100,,,percent of total billed charges,100% of total billed charges,6173.52,82.6,,,percent of total billed charges,82.6% of total billed charges,6173.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1764.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,477.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,472.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1764.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,472.81,253368.6,
INSERT IA PERCUT DEVICE,33967,CDM,983,RC,33967,HCPCS,Outpatient,,,796,517.40,,700.48,88,,,percent of total billed charges,88% of total Billed charges,36.23,100,,,Fee Schedule,100% of Medicare rate,140.25,100,,,Fee Schedule,100% of WA Medicaid,796,100,,,percent of total billed charges,100% of total billed charges,144.46,103,,,Fee Schedule,103% of WA Medicaid,36.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,140.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,549.24,69,,,percent of total billed charges,69% of total billed charges,796,100,,,percent of total billed charges,100% of total billed charges,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,796,100,,,percent of total billed charges,100% of total billed charges,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,796,100,,,percent of total billed charges,100% of total billed charges,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.33,61.85,,,percent of total billed charges,61.85% of total billed charges,140.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,182.33,130,,,Fee Schedule,130% of WA Medicaid ,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.09,37.7,,,percent of total billed charges,37.70% of total billed charges,300.09,37.7,,,percent of total billed charges,37.70% of total billed charges,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,26984.4,33.9,,,percent of total billed charges,33.9% of total billed charges,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,620.88,78,,,percent of total billed charges,78% of total billed charges,796,100,,,percent of total billed charges,100% of total billed charges,657.5,82.6,,,percent of total billed charges,82.6% of total billed charges,657.5,82.6,,,percent of total billed charges,82.6% of total billed charges,140.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.23,26984.4,
REMOVE AORTIC ASSIST DEVICE,33968,CDM,983,RC,33968,HCPCS,Outpatient,,,93,60.45,,81.84,88,,,percent of total billed charges,88% of total Billed charges,4.61,100,,,Fee Schedule,100% of Medicare rate,18.28,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,18.83,103,,,Fee Schedule,103% of WA Medicaid,4.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,18.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,93,100,,,percent of total billed charges,100% of total billed charges,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,93,100,,,percent of total billed charges,100% of total billed charges,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.52,61.85,,,percent of total billed charges,61.85% of total billed charges,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.76,130,,,Fee Schedule,130% of WA Medicaid ,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,3152.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.61,3152.7,
AORTIC CIRCULATION ASSIST,33970,CDM,983,RC,33970,HCPCS,Outpatient,,,1001,650.65,,880.88,88,,,percent of total billed charges,88% of total Billed charges,49.82,100,,,Fee Schedule,100% of Medicare rate,190.98,100,,,Fee Schedule,100% of WA Medicaid,1001,100,,,percent of total billed charges,100% of total billed charges,196.71,103,,,Fee Schedule,103% of WA Medicaid,49.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,190.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,690.69,69,,,percent of total billed charges,69% of total billed charges,1001,100,,,percent of total billed charges,100% of total billed charges,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1001,100,,,percent of total billed charges,100% of total billed charges,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1001,100,,,percent of total billed charges,100% of total billed charges,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,619.12,61.85,,,percent of total billed charges,61.85% of total billed charges,190.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,248.27,130,,,Fee Schedule,130% of WA Medicaid ,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.38,37.7,,,percent of total billed charges,37.70% of total billed charges,377.38,37.7,,,percent of total billed charges,37.70% of total billed charges,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,33933.9,33.9,,,percent of total billed charges,33.9% of total billed charges,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.78,78,,,percent of total billed charges,78% of total billed charges,1001,100,,,percent of total billed charges,100% of total billed charges,826.83,82.6,,,percent of total billed charges,82.6% of total billed charges,826.83,82.6,,,percent of total billed charges,82.6% of total billed charges,190.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.82,33933.9,
REPOSITION VAD DIFF SESSION,33993,CDM,983,RC,33993,HCPCS,Outpatient,,,512,332.80,,450.56,88,,,percent of total billed charges,88% of total Billed charges,21.91,100,,,Fee Schedule,100% of Medicare rate,90.27,100,,,Fee Schedule,100% of WA Medicaid,512,100,,,percent of total billed charges,100% of total billed charges,92.98,103,,,Fee Schedule,103% of WA Medicaid,21.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,90.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,353.28,69,,,percent of total billed charges,69% of total billed charges,512,100,,,percent of total billed charges,100% of total billed charges,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,512,100,,,percent of total billed charges,100% of total billed charges,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,512,100,,,percent of total billed charges,100% of total billed charges,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.67,61.85,,,percent of total billed charges,61.85% of total billed charges,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,117.35,130,,,Fee Schedule,130% of WA Medicaid ,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.02,37.7,,,percent of total billed charges,37.70% of total billed charges,193.02,37.7,,,percent of total billed charges,37.70% of total billed charges,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,17356.8,33.9,,,percent of total billed charges,33.9% of total billed charges,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.36,78,,,percent of total billed charges,78% of total billed charges,512,100,,,percent of total billed charges,100% of total billed charges,422.91,82.6,,,percent of total billed charges,82.6% of total billed charges,422.91,82.6,,,percent of total billed charges,82.6% of total billed charges,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.91,17356.8,
INSERT VAD ARTVEIN ACCESS,33991,CDM,983,RC,33991,HCPCS,Outpatient,,,1784,1159.60,,1569.92,88,,,percent of total billed charges,88% of total Billed charges,65.89,100,,,Fee Schedule,100% of Medicare rate,244.32,100,,,Fee Schedule,100% of WA Medicaid,1784,100,,,percent of total billed charges,100% of total billed charges,251.65,103,,,Fee Schedule,103% of WA Medicaid,65.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,115.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,244.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1230.96,69,,,percent of total billed charges,69% of total billed charges,1784,100,,,percent of total billed charges,100% of total billed charges,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1784,100,,,percent of total billed charges,100% of total billed charges,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1784,100,,,percent of total billed charges,100% of total billed charges,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1103.4,61.85,,,percent of total billed charges,61.85% of total billed charges,244.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,317.62,130,,,Fee Schedule,130% of WA Medicaid ,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,672.57,37.7,,,percent of total billed charges,37.70% of total billed charges,672.57,37.7,,,percent of total billed charges,37.70% of total billed charges,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,60477.6,33.9,,,percent of total billed charges,33.9% of total billed charges,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1391.52,78,,,percent of total billed charges,78% of total billed charges,1784,100,,,percent of total billed charges,100% of total billed charges,1473.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1473.58,82.6,,,percent of total billed charges,82.6% of total billed charges,244.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.89,60477.6,
REMOVE VAD DIFFERENT SESSION,33992,CDM,983,RC,33992,HCPCS,Outpatient,,,583,378.95,,513.04,88,,,percent of total billed charges,88% of total Billed charges,26.41,100,,,Fee Schedule,100% of Medicare rate,101.83,100,,,Fee Schedule,100% of WA Medicaid,583,100,,,percent of total billed charges,100% of total billed charges,104.88,103,,,Fee Schedule,103% of WA Medicaid,26.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,46.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,101.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,402.27,69,,,percent of total billed charges,69% of total billed charges,583,100,,,percent of total billed charges,100% of total billed charges,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,583,100,,,percent of total billed charges,100% of total billed charges,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,583,100,,,percent of total billed charges,100% of total billed charges,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.59,61.85,,,percent of total billed charges,61.85% of total billed charges,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.38,130,,,Fee Schedule,130% of WA Medicaid ,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.79,37.7,,,percent of total billed charges,37.70% of total billed charges,219.79,37.7,,,percent of total billed charges,37.70% of total billed charges,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,19763.7,33.9,,,percent of total billed charges,33.9% of total billed charges,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.74,78,,,percent of total billed charges,78% of total billed charges,583,100,,,percent of total billed charges,100% of total billed charges,481.56,82.6,,,percent of total billed charges,82.6% of total billed charges,481.56,82.6,,,percent of total billed charges,82.6% of total billed charges,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.41,19763.7,
INSERT VAD ARTERY ACCESS,33990,CDM,983,RC,33990,HCPCS,Outpatient,,,1225,796.25,,1078,88,,,percent of total billed charges,88% of total Billed charges,50.31,100,,,Fee Schedule,100% of Medicare rate,195.45,100,,,Fee Schedule,100% of WA Medicaid,1225,100,,,percent of total billed charges,100% of total billed charges,201.31,103,,,Fee Schedule,103% of WA Medicaid,50.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,88.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,195.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,845.25,69,,,percent of total billed charges,69% of total billed charges,1225,100,,,percent of total billed charges,100% of total billed charges,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1225,100,,,percent of total billed charges,100% of total billed charges,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1225,100,,,percent of total billed charges,100% of total billed charges,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,757.66,61.85,,,percent of total billed charges,61.85% of total billed charges,195.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,254.09,130,,,Fee Schedule,130% of WA Medicaid ,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.83,37.7,,,percent of total billed charges,37.70% of total billed charges,461.83,37.7,,,percent of total billed charges,37.70% of total billed charges,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,41527.5,33.9,,,percent of total billed charges,33.9% of total billed charges,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,955.5,78,,,percent of total billed charges,78% of total billed charges,1225,100,,,percent of total billed charges,100% of total billed charges,1011.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1011.85,82.6,,,percent of total billed charges,82.6% of total billed charges,195.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.31,41527.5,
REMOVAL OF ARTERY CLOT,34101,CDM,983,RC,34101,HCPCS,Outpatient,,,1697,1103.05,,1493.36,88,,,percent of total billed charges,88% of total Billed charges,87.46,100,,,Fee Schedule,100% of Medicare rate,323.76,100,,,Fee Schedule,100% of WA Medicaid,1697,100,,,percent of total billed charges,100% of total billed charges,333.47,103,,,Fee Schedule,103% of WA Medicaid,87.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,153.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,323.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1170.93,69,,,percent of total billed charges,69% of total billed charges,1697,100,,,percent of total billed charges,100% of total billed charges,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1697,100,,,percent of total billed charges,100% of total billed charges,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1697,100,,,percent of total billed charges,100% of total billed charges,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1049.59,61.85,,,percent of total billed charges,61.85% of total billed charges,323.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,420.89,130,,,Fee Schedule,130% of WA Medicaid ,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.77,37.7,,,percent of total billed charges,37.70% of total billed charges,639.77,37.7,,,percent of total billed charges,37.70% of total billed charges,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,57528.3,33.9,,,percent of total billed charges,33.9% of total billed charges,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323.66,78,,,percent of total billed charges,78% of total billed charges,1697,100,,,percent of total billed charges,100% of total billed charges,1401.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1401.72,82.6,,,percent of total billed charges,82.6% of total billed charges,323.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.46,57528.3,
REMOVAL OF ARM ARTERY CLOT,34111,CDM,983,RC,34111,HCPCS,Outpatient,,,1797,1168.05,,1581.36,88,,,percent of total billed charges,88% of total Billed charges,87.44,100,,,Fee Schedule,100% of Medicare rate,323.39,100,,,Fee Schedule,100% of WA Medicaid,1797,100,,,percent of total billed charges,100% of total billed charges,333.09,103,,,Fee Schedule,103% of WA Medicaid,87.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,153.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,323.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1239.93,69,,,percent of total billed charges,69% of total billed charges,1797,100,,,percent of total billed charges,100% of total billed charges,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1797,100,,,percent of total billed charges,100% of total billed charges,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1797,100,,,percent of total billed charges,100% of total billed charges,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1111.44,61.85,,,percent of total billed charges,61.85% of total billed charges,323.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,420.41,130,,,Fee Schedule,130% of WA Medicaid ,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.47,37.7,,,percent of total billed charges,37.70% of total billed charges,677.47,37.7,,,percent of total billed charges,37.70% of total billed charges,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,60918.3,33.9,,,percent of total billed charges,33.9% of total billed charges,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1401.66,78,,,percent of total billed charges,78% of total billed charges,1797,100,,,percent of total billed charges,100% of total billed charges,1484.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1484.32,82.6,,,percent of total billed charges,82.6% of total billed charges,323.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.44,60918.3,
REMOVAL OF ARTERY CLOT,34151,CDM,983,RC,34151,HCPCS,Outpatient,,,4099,2664.35,,3607.12,88,,,percent of total billed charges,88% of total Billed charges,209.54,100,,,Fee Schedule,100% of Medicare rate,751.78,100,,,Fee Schedule,100% of WA Medicaid,4099,100,,,percent of total billed charges,100% of total billed charges,774.33,103,,,Fee Schedule,103% of WA Medicaid,209.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,366.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,751.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2828.31,69,,,percent of total billed charges,69% of total billed charges,4099,100,,,percent of total billed charges,100% of total billed charges,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,4099,100,,,percent of total billed charges,100% of total billed charges,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,4099,100,,,percent of total billed charges,100% of total billed charges,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2535.23,61.85,,,percent of total billed charges,61.85% of total billed charges,751.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,977.31,130,,,Fee Schedule,130% of WA Medicaid ,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1545.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1545.32,37.7,,,percent of total billed charges,37.70% of total billed charges,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,138956.1,33.9,,,percent of total billed charges,33.9% of total billed charges,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,3197.22,78,,,percent of total billed charges,78% of total billed charges,4099,100,,,percent of total billed charges,100% of total billed charges,3385.77,82.6,,,percent of total billed charges,82.6% of total billed charges,3385.77,82.6,,,percent of total billed charges,82.6% of total billed charges,751.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,209.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,209.54,138956.1,
REMOVAL OF ARTERY CLOT,34201,CDM,983,RC,34201,HCPCS,Outpatient,,,2883,1873.95,,2537.04,88,,,percent of total billed charges,88% of total Billed charges,154.57,100,,,Fee Schedule,100% of Medicare rate,551.67,100,,,Fee Schedule,100% of WA Medicaid,2883,100,,,percent of total billed charges,100% of total billed charges,568.22,103,,,Fee Schedule,103% of WA Medicaid,154.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,270.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,551.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1989.27,69,,,percent of total billed charges,69% of total billed charges,2883,100,,,percent of total billed charges,100% of total billed charges,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2883,100,,,percent of total billed charges,100% of total billed charges,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2883,100,,,percent of total billed charges,100% of total billed charges,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1783.14,61.85,,,percent of total billed charges,61.85% of total billed charges,551.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,717.17,130,,,Fee Schedule,130% of WA Medicaid ,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1086.89,37.7,,,percent of total billed charges,37.70% of total billed charges,1086.89,37.7,,,percent of total billed charges,37.70% of total billed charges,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,97733.7,33.9,,,percent of total billed charges,33.9% of total billed charges,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2248.74,78,,,percent of total billed charges,78% of total billed charges,2883,100,,,percent of total billed charges,100% of total billed charges,2381.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2381.36,82.6,,,percent of total billed charges,82.6% of total billed charges,551.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,154.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,154.57,97733.7,
REMOVAL OF LEG ARTERY CLOT,34203,CDM,983,RC,34203,HCPCS,Outpatient,,,2677,1740.05,,2355.76,88,,,percent of total billed charges,88% of total Billed charges,141.88,100,,,Fee Schedule,100% of Medicare rate,513.25,100,,,Fee Schedule,100% of WA Medicaid,2677,100,,,percent of total billed charges,100% of total billed charges,528.65,103,,,Fee Schedule,103% of WA Medicaid,141.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,248.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,513.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1847.13,69,,,percent of total billed charges,69% of total billed charges,2677,100,,,percent of total billed charges,100% of total billed charges,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2677,100,,,percent of total billed charges,100% of total billed charges,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2677,100,,,percent of total billed charges,100% of total billed charges,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.72,61.85,,,percent of total billed charges,61.85% of total billed charges,513.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,523.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,667.23,130,,,Fee Schedule,130% of WA Medicaid ,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1009.23,37.7,,,percent of total billed charges,37.70% of total billed charges,1009.23,37.7,,,percent of total billed charges,37.70% of total billed charges,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,90750.3,33.9,,,percent of total billed charges,33.9% of total billed charges,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2088.06,78,,,percent of total billed charges,78% of total billed charges,2677,100,,,percent of total billed charges,100% of total billed charges,2211.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2211.2,82.6,,,percent of total billed charges,82.6% of total billed charges,513.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,141.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,141.88,90750.3,
REMOVAL OF VEIN CLOT,34421,CDM,983,RC,34421,HCPCS,Outpatient,,,2333,1516.45,,2053.04,88,,,percent of total billed charges,88% of total Billed charges,106.34,100,,,Fee Schedule,100% of Medicare rate,376.17,100,,,Fee Schedule,100% of WA Medicaid,2333,100,,,percent of total billed charges,100% of total billed charges,387.46,103,,,Fee Schedule,103% of WA Medicaid,106.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,186.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,376.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1609.77,69,,,percent of total billed charges,69% of total billed charges,2333,100,,,percent of total billed charges,100% of total billed charges,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2333,100,,,percent of total billed charges,100% of total billed charges,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2333,100,,,percent of total billed charges,100% of total billed charges,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1442.96,61.85,,,percent of total billed charges,61.85% of total billed charges,376.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,489.02,130,,,Fee Schedule,130% of WA Medicaid ,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,879.54,37.7,,,percent of total billed charges,37.70% of total billed charges,879.54,37.7,,,percent of total billed charges,37.70% of total billed charges,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,79088.7,33.9,,,percent of total billed charges,33.9% of total billed charges,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1819.74,78,,,percent of total billed charges,78% of total billed charges,2333,100,,,percent of total billed charges,100% of total billed charges,1927.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1927.06,82.6,,,percent of total billed charges,82.6% of total billed charges,376.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.34,79088.7,
REMOVAL OF VEIN CLOT,34471,CDM,983,RC,34471,HCPCS,Outpatient,,,2902,1886.30,,2553.76,88,,,percent of total billed charges,88% of total Billed charges,167.1,100,,,Fee Schedule,100% of Medicare rate,582.25,100,,,Fee Schedule,100% of WA Medicaid,2902,100,,,percent of total billed charges,100% of total billed charges,599.72,103,,,Fee Schedule,103% of WA Medicaid,167.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,292.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,582.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2002.38,69,,,percent of total billed charges,69% of total billed charges,2902,100,,,percent of total billed charges,100% of total billed charges,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2902,100,,,percent of total billed charges,100% of total billed charges,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2902,100,,,percent of total billed charges,100% of total billed charges,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1794.89,61.85,,,percent of total billed charges,61.85% of total billed charges,582.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,582.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,593.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,756.93,130,,,Fee Schedule,130% of WA Medicaid ,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1094.05,37.7,,,percent of total billed charges,37.70% of total billed charges,1094.05,37.7,,,percent of total billed charges,37.70% of total billed charges,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,98377.8,33.9,,,percent of total billed charges,33.9% of total billed charges,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2263.56,78,,,percent of total billed charges,78% of total billed charges,2902,100,,,percent of total billed charges,100% of total billed charges,2397.05,82.6,,,percent of total billed charges,82.6% of total billed charges,2397.05,82.6,,,percent of total billed charges,82.6% of total billed charges,582.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,167.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,582.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,167.1,98377.8,
ENDOVAS AAA REPR W/2-P PART,34802,CDM,983,RC,,,Outpatient,,,3310,2151.50,,2912.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2283.9,69,,,percent of total billed charges,69% of total billed charges,3310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2047.24,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1247.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1247.87,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,112209,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2581.8,78,,,percent of total billed charges,78% of total billed charges,3310,100,,,percent of total billed charges,100% of total billed charges,2734.06,82.6,,,percent of total billed charges,82.6% of total billed charges,2734.06,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1247.87,112209,
ENDOVAS AAA REPR W/3-P PART,34803,CDM,983,RC,,,Outpatient,,,3891,2529.15,,3424.08,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3891,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2684.79,69,,,percent of total billed charges,69% of total billed charges,3891,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3891,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3891,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2406.58,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1466.91,37.7,,,percent of total billed charges,37.70% of total billed charges,1466.91,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,131904.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,3034.98,78,,,percent of total billed charges,78% of total billed charges,3891,100,,,percent of total billed charges,100% of total billed charges,3213.97,82.6,,,percent of total billed charges,82.6% of total billed charges,3213.97,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1466.91,131904.9,
ENDOVAS AAA REPR W/LONG TUBE,34805,CDM,983,RC,,,Outpatient,,,3045,1979.25,,2679.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3045,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2101.05,69,,,percent of total billed charges,69% of total billed charges,3045,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3045,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3045,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1883.33,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1147.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1147.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,103225.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2375.1,78,,,percent of total billed charges,78% of total billed charges,3045,100,,,percent of total billed charges,100% of total billed charges,2515.17,82.6,,,percent of total billed charges,82.6% of total billed charges,2515.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1147.97,103225.5,
ENDOVAS AAA REPR W/SM TUBE,34800,CDM,983,RC,,,Outpatient,,,3207,2084.55,,2822.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3207,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2212.83,69,,,percent of total billed charges,69% of total billed charges,3207,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3207,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3207,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1983.53,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1209.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1209.04,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,108717.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2501.46,78,,,percent of total billed charges,78% of total billed charges,3207,100,,,percent of total billed charges,100% of total billed charges,2648.98,82.6,,,percent of total billed charges,82.6% of total billed charges,2648.98,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1209.04,108717.3,
ENDOVAS ILIAC A DEVICE ADDON,34808,CDM,983,RC,34808,HCPCS,Outpatient,,,614,399.10,,540.32,88,,,percent of total billed charges,88% of total Billed charges,32.47,100,,,Fee Schedule,100% of Medicare rate,108.17,100,,,Fee Schedule,100% of WA Medicaid,614,100,,,percent of total billed charges,100% of total billed charges,111.42,103,,,Fee Schedule,103% of WA Medicaid,32.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,108.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,423.66,69,,,percent of total billed charges,69% of total billed charges,614,100,,,percent of total billed charges,100% of total billed charges,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,614,100,,,percent of total billed charges,100% of total billed charges,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,614,100,,,percent of total billed charges,100% of total billed charges,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.76,61.85,,,percent of total billed charges,61.85% of total billed charges,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,140.62,130,,,Fee Schedule,130% of WA Medicaid ,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.48,37.7,,,percent of total billed charges,37.70% of total billed charges,231.48,37.7,,,percent of total billed charges,37.70% of total billed charges,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,20814.6,33.9,,,percent of total billed charges,33.9% of total billed charges,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.92,78,,,percent of total billed charges,78% of total billed charges,614,100,,,percent of total billed charges,100% of total billed charges,507.16,82.6,,,percent of total billed charges,82.6% of total billed charges,507.16,82.6,,,percent of total billed charges,82.6% of total billed charges,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.47,20814.6,
XPOSE FOR ENDOPROSTH FEMORL,34812,CDM,983,RC,34812,HCPCS,Outpatient,,,910,591.50,,800.8,88,,,percent of total billed charges,88% of total Billed charges,32.57,100,,,Fee Schedule,100% of Medicare rate,110.22,100,,,Fee Schedule,100% of WA Medicaid,910,100,,,percent of total billed charges,100% of total billed charges,113.53,103,,,Fee Schedule,103% of WA Medicaid,32.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,110.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,627.9,69,,,percent of total billed charges,69% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,910,100,,,percent of total billed charges,100% of total billed charges,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,910,100,,,percent of total billed charges,100% of total billed charges,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.84,61.85,,,percent of total billed charges,61.85% of total billed charges,110.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,143.29,130,,,Fee Schedule,130% of WA Medicaid ,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,343.07,37.7,,,percent of total billed charges,37.70% of total billed charges,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,30849,33.9,,,percent of total billed charges,33.9% of total billed charges,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.8,78,,,percent of total billed charges,78% of total billed charges,910,100,,,percent of total billed charges,100% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,751.66,82.6,,,percent of total billed charges,82.6% of total billed charges,110.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.57,30849,
ENDOVASC EXTEN PROSTH ADDL,34826,CDM,983,RC,,,Outpatient,,,567,368.55,,498.96,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,567,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,391.23,69,,,percent of total billed charges,69% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,567,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,567,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,350.69,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,19221.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,442.26,78,,,percent of total billed charges,78% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",213.76,19221.3,
ENDOVASC EXTEND PROSTH INIT,34825,CDM,983,RC,,,Outpatient,,,1555,1010.75,,1368.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1072.95,69,,,percent of total billed charges,69% of total billed charges,1555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,961.77,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,586.24,37.7,,,percent of total billed charges,37.70% of total billed charges,586.24,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,52714.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1212.9,78,,,percent of total billed charges,78% of total billed charges,1555,100,,,percent of total billed charges,100% of total billed charges,1284.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1284.43,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",586.24,52714.5,
XPOSE FOR ENDOPROSTH ILIAC,34833,CDM,983,RC,34833,HCPCS,Outpatient,,,1761,1144.65,,1549.68,88,,,percent of total billed charges,88% of total Billed charges,63.8,100,,,Fee Schedule,100% of Medicare rate,209.44,100,,,Fee Schedule,100% of WA Medicaid,1761,100,,,percent of total billed charges,100% of total billed charges,215.72,103,,,Fee Schedule,103% of WA Medicaid,63.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,111.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,209.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1215.09,69,,,percent of total billed charges,69% of total billed charges,1761,100,,,percent of total billed charges,100% of total billed charges,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1761,100,,,percent of total billed charges,100% of total billed charges,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1761,100,,,percent of total billed charges,100% of total billed charges,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1089.18,61.85,,,percent of total billed charges,61.85% of total billed charges,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,272.27,130,,,Fee Schedule,130% of WA Medicaid ,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.9,37.7,,,percent of total billed charges,37.70% of total billed charges,663.9,37.7,,,percent of total billed charges,37.70% of total billed charges,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,59697.9,33.9,,,percent of total billed charges,33.9% of total billed charges,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1373.58,78,,,percent of total billed charges,78% of total billed charges,1761,100,,,percent of total billed charges,100% of total billed charges,1454.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1454.59,82.6,,,percent of total billed charges,82.6% of total billed charges,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,63.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.8,59697.9,
ENDOVASC ILIAC REPR W/GRAFT,34900,CDM,983,RC,,,Outpatient,,,2853,1854.45,,2510.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2853,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1968.57,69,,,percent of total billed charges,69% of total billed charges,2853,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2853,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2853,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1764.58,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1075.58,37.7,,,percent of total billed charges,37.70% of total billed charges,1075.58,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,96716.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2225.34,78,,,percent of total billed charges,78% of total billed charges,2853,100,,,percent of total billed charges,100% of total billed charges,2356.58,82.6,,,percent of total billed charges,82.6% of total billed charges,2356.58,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1075.58,96716.7,
REPAIR DEFECT OF ARTERY,35011,CDM,983,RC,35011,HCPCS,Outpatient,,,2482,1613.30,,2184.16,88,,,percent of total billed charges,88% of total Billed charges,149.71,100,,,Fee Schedule,100% of Medicare rate,548.68,100,,,Fee Schedule,100% of WA Medicaid,2482,100,,,percent of total billed charges,100% of total billed charges,565.14,103,,,Fee Schedule,103% of WA Medicaid,149.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,262,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,548.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1712.58,69,,,percent of total billed charges,69% of total billed charges,2482,100,,,percent of total billed charges,100% of total billed charges,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2482,100,,,percent of total billed charges,100% of total billed charges,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2482,100,,,percent of total billed charges,100% of total billed charges,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1535.12,61.85,,,percent of total billed charges,61.85% of total billed charges,548.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,559.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,713.28,130,,,Fee Schedule,130% of WA Medicaid ,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,935.71,37.7,,,percent of total billed charges,37.70% of total billed charges,935.71,37.7,,,percent of total billed charges,37.70% of total billed charges,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,84139.8,33.9,,,percent of total billed charges,33.9% of total billed charges,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1935.96,78,,,percent of total billed charges,78% of total billed charges,2482,100,,,percent of total billed charges,100% of total billed charges,2050.13,82.6,,,percent of total billed charges,82.6% of total billed charges,2050.13,82.6,,,percent of total billed charges,82.6% of total billed charges,548.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,149.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,149.71,84139.8,
REPAIR DEFECT OF ARM ARTERY,35045,CDM,983,RC,35045,HCPCS,Outpatient,,,2740.68,1781.44,,2411.8,88,,,percent of total billed charges,88% of total Billed charges,141.3,100,,,Fee Schedule,100% of Medicare rate,527.05,100,,,Fee Schedule,100% of WA Medicaid,2740.68,100,,,percent of total billed charges,100% of total billed charges,542.86,103,,,Fee Schedule,103% of WA Medicaid,141.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,247.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,527.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1891.07,69,,,percent of total billed charges,69% of total billed charges,2740.68,100,,,percent of total billed charges,100% of total billed charges,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2740.68,100,,,percent of total billed charges,100% of total billed charges,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2740.68,100,,,percent of total billed charges,100% of total billed charges,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1695.11,61.85,,,percent of total billed charges,61.85% of total billed charges,527.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,685.17,130,,,Fee Schedule,130% of WA Medicaid ,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1033.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1033.24,37.7,,,percent of total billed charges,37.70% of total billed charges,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,92909.05,33.9,,,percent of total billed charges,33.9% of total billed charges,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2137.73,78,,,percent of total billed charges,78% of total billed charges,2740.68,100,,,percent of total billed charges,100% of total billed charges,2263.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2263.8,82.6,,,percent of total billed charges,82.6% of total billed charges,527.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,141.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,141.3,92909.05,
REPAIR DEFECT OF ARTERY,35081,CDM,983,RC,35081,HCPCS,Outpatient,,,4683,3043.95,,4121.04,88,,,percent of total billed charges,88% of total Billed charges,265.59,100,,,Fee Schedule,100% of Medicare rate,932.5,100,,,Fee Schedule,100% of WA Medicaid,4683,100,,,percent of total billed charges,100% of total billed charges,960.48,103,,,Fee Schedule,103% of WA Medicaid,265.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,464.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,932.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3231.27,69,,,percent of total billed charges,69% of total billed charges,4683,100,,,percent of total billed charges,100% of total billed charges,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,4683,100,,,percent of total billed charges,100% of total billed charges,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,4683,100,,,percent of total billed charges,100% of total billed charges,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2896.44,61.85,,,percent of total billed charges,61.85% of total billed charges,932.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,932.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,951.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1212.25,130,,,Fee Schedule,130% of WA Medicaid ,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1765.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1765.49,37.7,,,percent of total billed charges,37.70% of total billed charges,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,158753.7,33.9,,,percent of total billed charges,33.9% of total billed charges,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3652.74,78,,,percent of total billed charges,78% of total billed charges,4683,100,,,percent of total billed charges,100% of total billed charges,3868.16,82.6,,,percent of total billed charges,82.6% of total billed charges,3868.16,82.6,,,percent of total billed charges,82.6% of total billed charges,932.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,265.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,932.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,265.59,158753.7,
REPAIR ARTERY RUPTURE AORTA,35082,CDM,983,RC,35082,HCPCS,Outpatient,,,5462,3550.30,,4806.56,88,,,percent of total billed charges,88% of total Billed charges,332.59,100,,,Fee Schedule,100% of Medicare rate,1163.57,100,,,Fee Schedule,100% of WA Medicaid,5462,100,,,percent of total billed charges,100% of total billed charges,1198.48,103,,,Fee Schedule,103% of WA Medicaid,332.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,582.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1163.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3768.78,69,,,percent of total billed charges,69% of total billed charges,5462,100,,,percent of total billed charges,100% of total billed charges,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,5462,100,,,percent of total billed charges,100% of total billed charges,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,5462,100,,,percent of total billed charges,100% of total billed charges,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3378.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1163.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1186.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1512.64,130,,,Fee Schedule,130% of WA Medicaid ,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2059.17,37.7,,,percent of total billed charges,37.70% of total billed charges,2059.17,37.7,,,percent of total billed charges,37.70% of total billed charges,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,185161.8,33.9,,,percent of total billed charges,33.9% of total billed charges,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,4260.36,78,,,percent of total billed charges,78% of total billed charges,5462,100,,,percent of total billed charges,100% of total billed charges,4511.61,82.6,,,percent of total billed charges,82.6% of total billed charges,4511.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1163.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,332.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,332.59,185161.8,
REPAIR DEFECT OF ARTERY,35102,CDM,983,RC,35102,HCPCS,Outpatient,,,5343,3472.95,,4701.84,88,,,percent of total billed charges,88% of total Billed charges,289.35,100,,,Fee Schedule,100% of Medicare rate,1013.63,100,,,Fee Schedule,100% of WA Medicaid,5343,100,,,percent of total billed charges,100% of total billed charges,1044.04,103,,,Fee Schedule,103% of WA Medicaid,289.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,506.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1013.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3686.67,69,,,percent of total billed charges,69% of total billed charges,5343,100,,,percent of total billed charges,100% of total billed charges,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,5343,100,,,percent of total billed charges,100% of total billed charges,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,5343,100,,,percent of total billed charges,100% of total billed charges,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3304.65,61.85,,,percent of total billed charges,61.85% of total billed charges,1013.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1013.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1033.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1317.72,130,,,Fee Schedule,130% of WA Medicaid ,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2014.31,37.7,,,percent of total billed charges,37.70% of total billed charges,2014.31,37.7,,,percent of total billed charges,37.70% of total billed charges,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,181127.7,33.9,,,percent of total billed charges,33.9% of total billed charges,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,4167.54,78,,,percent of total billed charges,78% of total billed charges,5343,100,,,percent of total billed charges,100% of total billed charges,4413.32,82.6,,,percent of total billed charges,82.6% of total billed charges,4413.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1013.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,289.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1013.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,289.35,181127.7,
REPAIR ARTERY RUPTURE AORTA,35103,CDM,983,RC,35103,HCPCS,Outpatient,,,5729,3723.85,,5041.52,88,,,percent of total billed charges,88% of total Billed charges,346.02,100,,,Fee Schedule,100% of Medicare rate,1191.36,100,,,Fee Schedule,100% of WA Medicaid,5729,100,,,percent of total billed charges,100% of total billed charges,1227.1,103,,,Fee Schedule,103% of WA Medicaid,346.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,605.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1191.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3953.01,69,,,percent of total billed charges,69% of total billed charges,5729,100,,,percent of total billed charges,100% of total billed charges,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,5729,100,,,percent of total billed charges,100% of total billed charges,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,5729,100,,,percent of total billed charges,100% of total billed charges,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3543.39,61.85,,,percent of total billed charges,61.85% of total billed charges,1191.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1215.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1548.77,130,,,Fee Schedule,130% of WA Medicaid ,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2159.83,37.7,,,percent of total billed charges,37.70% of total billed charges,2159.83,37.7,,,percent of total billed charges,37.70% of total billed charges,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,194213.1,33.9,,,percent of total billed charges,33.9% of total billed charges,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4468.62,78,,,percent of total billed charges,78% of total billed charges,5729,100,,,percent of total billed charges,100% of total billed charges,4732.15,82.6,,,percent of total billed charges,82.6% of total billed charges,4732.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1191.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,346.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,346.02,194213.1,
REPAIR DEFECT OF ARTERY,35121,CDM,983,RC,35121,HCPCS,Outpatient,,,5059,3288.35,,4451.92,88,,,percent of total billed charges,88% of total Billed charges,248.76,100,,,Fee Schedule,100% of Medicare rate,849.32,100,,,Fee Schedule,100% of WA Medicaid,5059,100,,,percent of total billed charges,100% of total billed charges,874.8,103,,,Fee Schedule,103% of WA Medicaid,248.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,435.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,849.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3490.71,69,,,percent of total billed charges,69% of total billed charges,5059,100,,,percent of total billed charges,100% of total billed charges,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,5059,100,,,percent of total billed charges,100% of total billed charges,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,5059,100,,,percent of total billed charges,100% of total billed charges,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,3128.99,61.85,,,percent of total billed charges,61.85% of total billed charges,849.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,849.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,866.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1104.12,130,,,Fee Schedule,130% of WA Medicaid ,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1907.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1907.24,37.7,,,percent of total billed charges,37.70% of total billed charges,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,171500.1,33.9,,,percent of total billed charges,33.9% of total billed charges,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,3946.02,78,,,percent of total billed charges,78% of total billed charges,5059,100,,,percent of total billed charges,100% of total billed charges,4178.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4178.73,82.6,,,percent of total billed charges,82.6% of total billed charges,849.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,248.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,849.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,248.76,171500.1,
REPAIR DEFECT OF ARTERY,35131,CDM,983,RC,35131,HCPCS,Outpatient,,,3821,2483.65,,3362.48,88,,,percent of total billed charges,88% of total Billed charges,209.75,100,,,Fee Schedule,100% of Medicare rate,746,100,,,Fee Schedule,100% of WA Medicaid,3821,100,,,percent of total billed charges,100% of total billed charges,768.38,103,,,Fee Schedule,103% of WA Medicaid,209.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,367.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,746,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2636.49,69,,,percent of total billed charges,69% of total billed charges,3821,100,,,percent of total billed charges,100% of total billed charges,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3821,100,,,percent of total billed charges,100% of total billed charges,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3821,100,,,percent of total billed charges,100% of total billed charges,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2363.29,61.85,,,percent of total billed charges,61.85% of total billed charges,746,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,746,100,,,Fee Schedule,100% of WA Medicare OPPS rate,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,760.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,969.8,130,,,Fee Schedule,130% of WA Medicaid ,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1440.52,37.7,,,percent of total billed charges,37.70% of total billed charges,1440.52,37.7,,,percent of total billed charges,37.70% of total billed charges,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,129531.9,33.9,,,percent of total billed charges,33.9% of total billed charges,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2980.38,78,,,percent of total billed charges,78% of total billed charges,3821,100,,,percent of total billed charges,100% of total billed charges,3156.15,82.6,,,percent of total billed charges,82.6% of total billed charges,3156.15,82.6,,,percent of total billed charges,82.6% of total billed charges,746,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,209.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,746,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,209.75,129531.9,
REPAIR DEFECT OF ARTERY,35141,CDM,983,RC,35141,HCPCS,Outpatient,,,1333,866.45,,1173.04,88,,,percent of total billed charges,88% of total Billed charges,165.92,100,,,Fee Schedule,100% of Medicare rate,589.71,100,,,Fee Schedule,100% of WA Medicaid,1333,100,,,percent of total billed charges,100% of total billed charges,607.4,103,,,Fee Schedule,103% of WA Medicaid,165.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,290.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,589.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,919.77,69,,,percent of total billed charges,69% of total billed charges,1333,100,,,percent of total billed charges,100% of total billed charges,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1333,100,,,percent of total billed charges,100% of total billed charges,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1333,100,,,percent of total billed charges,100% of total billed charges,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,824.46,61.85,,,percent of total billed charges,61.85% of total billed charges,589.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,589.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,601.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,766.62,130,,,Fee Schedule,130% of WA Medicaid ,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.54,37.7,,,percent of total billed charges,37.70% of total billed charges,502.54,37.7,,,percent of total billed charges,37.70% of total billed charges,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,45188.7,33.9,,,percent of total billed charges,33.9% of total billed charges,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1039.74,78,,,percent of total billed charges,78% of total billed charges,1333,100,,,percent of total billed charges,100% of total billed charges,1101.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1101.06,82.6,,,percent of total billed charges,82.6% of total billed charges,589.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,165.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,589.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,165.92,45188.7,
REPAIR DEFECT OF ARTERY,35151,CDM,983,RC,35151,HCPCS,Outpatient,,,3273,2127.45,,2880.24,88,,,percent of total billed charges,88% of total Billed charges,189.14,100,,,Fee Schedule,100% of Medicare rate,670.28,100,,,Fee Schedule,100% of WA Medicaid,3273,100,,,percent of total billed charges,100% of total billed charges,690.39,103,,,Fee Schedule,103% of WA Medicaid,189.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,330.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,670.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2258.37,69,,,percent of total billed charges,69% of total billed charges,3273,100,,,percent of total billed charges,100% of total billed charges,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,3273,100,,,percent of total billed charges,100% of total billed charges,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,3273,100,,,percent of total billed charges,100% of total billed charges,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2024.35,61.85,,,percent of total billed charges,61.85% of total billed charges,670.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,670.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,871.36,130,,,Fee Schedule,130% of WA Medicaid ,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1233.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1233.92,37.7,,,percent of total billed charges,37.70% of total billed charges,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,110954.7,33.9,,,percent of total billed charges,33.9% of total billed charges,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2552.94,78,,,percent of total billed charges,78% of total billed charges,3273,100,,,percent of total billed charges,100% of total billed charges,2703.5,82.6,,,percent of total billed charges,82.6% of total billed charges,2703.5,82.6,,,percent of total billed charges,82.6% of total billed charges,670.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,189.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,670.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,189.14,110954.7,
REPAIR BLOOD VESSEL LESION,35190,CDM,983,RC,35190,HCPCS,Outpatient,,,2587,1681.55,,2276.56,88,,,percent of total billed charges,88% of total Billed charges,108.29,100,,,Fee Schedule,100% of Medicare rate,413.66,100,,,Fee Schedule,100% of WA Medicaid,2587,100,,,percent of total billed charges,100% of total billed charges,426.07,103,,,Fee Schedule,103% of WA Medicaid,108.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,189.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,413.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1785.03,69,,,percent of total billed charges,69% of total billed charges,2587,100,,,percent of total billed charges,100% of total billed charges,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2587,100,,,percent of total billed charges,100% of total billed charges,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2587,100,,,percent of total billed charges,100% of total billed charges,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1600.06,61.85,,,percent of total billed charges,61.85% of total billed charges,413.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,537.76,130,,,Fee Schedule,130% of WA Medicaid ,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,975.3,37.7,,,percent of total billed charges,37.70% of total billed charges,975.3,37.7,,,percent of total billed charges,37.70% of total billed charges,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,87699.3,33.9,,,percent of total billed charges,33.9% of total billed charges,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2017.86,78,,,percent of total billed charges,78% of total billed charges,2587,100,,,percent of total billed charges,100% of total billed charges,2136.86,82.6,,,percent of total billed charges,82.6% of total billed charges,2136.86,82.6,,,percent of total billed charges,82.6% of total billed charges,413.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,108.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.29,87699.3,
REPAIR BLOOD VESSEL LESION,35206,CDM,983,RC,35206,HCPCS,Outpatient,,,3382,2198.30,,2976.16,88,,,percent of total billed charges,88% of total Billed charges,106.58,100,,,Fee Schedule,100% of Medicare rate,435.66,100,,,Fee Schedule,100% of WA Medicaid,3382,100,,,percent of total billed charges,100% of total billed charges,448.73,103,,,Fee Schedule,103% of WA Medicaid,106.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,186.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,435.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2333.58,69,,,percent of total billed charges,69% of total billed charges,3382,100,,,percent of total billed charges,100% of total billed charges,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3382,100,,,percent of total billed charges,100% of total billed charges,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3382,100,,,percent of total billed charges,100% of total billed charges,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2091.77,61.85,,,percent of total billed charges,61.85% of total billed charges,435.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,566.36,130,,,Fee Schedule,130% of WA Medicaid ,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1275.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1275.01,37.7,,,percent of total billed charges,37.70% of total billed charges,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,114649.8,33.9,,,percent of total billed charges,33.9% of total billed charges,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2637.96,78,,,percent of total billed charges,78% of total billed charges,3382,100,,,percent of total billed charges,100% of total billed charges,2793.53,82.6,,,percent of total billed charges,82.6% of total billed charges,2793.53,82.6,,,percent of total billed charges,82.6% of total billed charges,435.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.58,114649.8,
REPAIR BLOOD VESSEL LESION,35201,CDM,983,RC,35201,HCPCS,Outpatient,,,2589,1682.85,,2278.32,88,,,percent of total billed charges,88% of total Billed charges,130.82,100,,,Fee Schedule,100% of Medicare rate,510.82,100,,,Fee Schedule,100% of WA Medicaid,2589,100,,,percent of total billed charges,100% of total billed charges,526.14,103,,,Fee Schedule,103% of WA Medicaid,130.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,228.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,510.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1786.41,69,,,percent of total billed charges,69% of total billed charges,2589,100,,,percent of total billed charges,100% of total billed charges,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2589,100,,,percent of total billed charges,100% of total billed charges,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2589,100,,,percent of total billed charges,100% of total billed charges,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1601.3,61.85,,,percent of total billed charges,61.85% of total billed charges,510.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,521.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,664.07,130,,,Fee Schedule,130% of WA Medicaid ,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,976.05,37.7,,,percent of total billed charges,37.70% of total billed charges,976.05,37.7,,,percent of total billed charges,37.70% of total billed charges,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,87767.1,33.9,,,percent of total billed charges,33.9% of total billed charges,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2019.42,78,,,percent of total billed charges,78% of total billed charges,2589,100,,,percent of total billed charges,100% of total billed charges,2138.51,82.6,,,percent of total billed charges,82.6% of total billed charges,2138.51,82.6,,,percent of total billed charges,82.6% of total billed charges,510.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,130.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,130.82,87767.1,
REPAIR BLOOD VESSEL LESION,35221,CDM,983,RC,35221,HCPCS,Outpatient,,,4008,2605.20,,3527.04,88,,,percent of total billed charges,88% of total Billed charges,211.87,100,,,Fee Schedule,100% of Medicare rate,806.8,100,,,Fee Schedule,100% of WA Medicaid,4008,100,,,percent of total billed charges,100% of total billed charges,831,103,,,Fee Schedule,103% of WA Medicaid,211.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,370.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,806.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2765.52,69,,,percent of total billed charges,69% of total billed charges,4008,100,,,percent of total billed charges,100% of total billed charges,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,4008,100,,,percent of total billed charges,100% of total billed charges,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,4008,100,,,percent of total billed charges,100% of total billed charges,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2478.95,61.85,,,percent of total billed charges,61.85% of total billed charges,806.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,822.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1048.84,130,,,Fee Schedule,130% of WA Medicaid ,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1511.02,37.7,,,percent of total billed charges,37.70% of total billed charges,1511.02,37.7,,,percent of total billed charges,37.70% of total billed charges,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,135871.2,33.9,,,percent of total billed charges,33.9% of total billed charges,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3126.24,78,,,percent of total billed charges,78% of total billed charges,4008,100,,,percent of total billed charges,100% of total billed charges,3310.61,82.6,,,percent of total billed charges,82.6% of total billed charges,3310.61,82.6,,,percent of total billed charges,82.6% of total billed charges,806.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,211.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,211.87,135871.2,
REPAIR BLOOD VESSEL LESION,35226,CDM,983,RC,35226,HCPCS,Outpatient,,,2329,1513.85,,2049.52,88,,,percent of total billed charges,88% of total Billed charges,120.39,100,,,Fee Schedule,100% of Medicare rate,450.58,100,,,Fee Schedule,100% of WA Medicaid,2329,100,,,percent of total billed charges,100% of total billed charges,464.1,103,,,Fee Schedule,103% of WA Medicaid,120.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,210.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,450.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1607.01,69,,,percent of total billed charges,69% of total billed charges,2329,100,,,percent of total billed charges,100% of total billed charges,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2329,100,,,percent of total billed charges,100% of total billed charges,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2329,100,,,percent of total billed charges,100% of total billed charges,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1440.49,61.85,,,percent of total billed charges,61.85% of total billed charges,450.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,585.75,130,,,Fee Schedule,130% of WA Medicaid ,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,878.03,37.7,,,percent of total billed charges,37.70% of total billed charges,878.03,37.7,,,percent of total billed charges,37.70% of total billed charges,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,78953.1,33.9,,,percent of total billed charges,33.9% of total billed charges,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1816.62,78,,,percent of total billed charges,78% of total billed charges,2329,100,,,percent of total billed charges,100% of total billed charges,1923.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1923.75,82.6,,,percent of total billed charges,82.6% of total billed charges,450.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,120.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,120.39,78953.1,
REPAIR BLOOD VESSEL LESION,35236,CDM,983,RC,35236,HCPCS,Outpatient,,,2927,1902.55,,2575.76,88,,,percent of total billed charges,88% of total Billed charges,139.2,100,,,Fee Schedule,100% of Medicare rate,546.82,100,,,Fee Schedule,100% of WA Medicaid,2927,100,,,percent of total billed charges,100% of total billed charges,563.22,103,,,Fee Schedule,103% of WA Medicaid,139.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,243.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,546.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2019.63,69,,,percent of total billed charges,69% of total billed charges,2927,100,,,percent of total billed charges,100% of total billed charges,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2927,100,,,percent of total billed charges,100% of total billed charges,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2927,100,,,percent of total billed charges,100% of total billed charges,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1810.35,61.85,,,percent of total billed charges,61.85% of total billed charges,546.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,710.87,130,,,Fee Schedule,130% of WA Medicaid ,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1103.48,37.7,,,percent of total billed charges,37.70% of total billed charges,1103.48,37.7,,,percent of total billed charges,37.70% of total billed charges,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,99225.3,33.9,,,percent of total billed charges,33.9% of total billed charges,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2283.06,78,,,percent of total billed charges,78% of total billed charges,2927,100,,,percent of total billed charges,100% of total billed charges,2417.7,82.6,,,percent of total billed charges,82.6% of total billed charges,2417.7,82.6,,,percent of total billed charges,82.6% of total billed charges,546.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,139.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,139.2,99225.3,
REPAIR BLOOD VESSEL LESION,35231,CDM,983,RC,35231,HCPCS,Outpatient,,,3350,2177.50,,2948,88,,,percent of total billed charges,88% of total Billed charges,137.5,100,,,Fee Schedule,100% of Medicare rate,697.88,100,,,Fee Schedule,100% of WA Medicaid,3350,100,,,percent of total billed charges,100% of total billed charges,718.82,103,,,Fee Schedule,103% of WA Medicaid,137.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,240.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,697.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2311.5,69,,,percent of total billed charges,69% of total billed charges,3350,100,,,percent of total billed charges,100% of total billed charges,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,3350,100,,,percent of total billed charges,100% of total billed charges,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,3350,100,,,percent of total billed charges,100% of total billed charges,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2071.98,61.85,,,percent of total billed charges,61.85% of total billed charges,697.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,907.24,130,,,Fee Schedule,130% of WA Medicaid ,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1262.95,37.7,,,percent of total billed charges,37.70% of total billed charges,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,113565,33.9,,,percent of total billed charges,33.9% of total billed charges,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2613,78,,,percent of total billed charges,78% of total billed charges,3350,100,,,percent of total billed charges,100% of total billed charges,2767.1,82.6,,,percent of total billed charges,82.6% of total billed charges,2767.1,82.6,,,percent of total billed charges,82.6% of total billed charges,697.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,137.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,137.5,113565,
REPAIR BLOOD VESSEL LESION,35241,CDM,983,RC,35241,HCPCS,Outpatient,,,3957,2572.05,,3482.16,88,,,percent of total billed charges,88% of total Billed charges,195.37,100,,,Fee Schedule,100% of Medicare rate,784.79,100,,,Fee Schedule,100% of WA Medicaid,3957,100,,,percent of total billed charges,100% of total billed charges,808.33,103,,,Fee Schedule,103% of WA Medicaid,195.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,341.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,784.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2730.33,69,,,percent of total billed charges,69% of total billed charges,3957,100,,,percent of total billed charges,100% of total billed charges,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,3957,100,,,percent of total billed charges,100% of total billed charges,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,3957,100,,,percent of total billed charges,100% of total billed charges,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2447.4,61.85,,,percent of total billed charges,61.85% of total billed charges,784.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,784.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,800.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1020.23,130,,,Fee Schedule,130% of WA Medicaid ,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1491.79,37.7,,,percent of total billed charges,37.70% of total billed charges,1491.79,37.7,,,percent of total billed charges,37.70% of total billed charges,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,134142.3,33.9,,,percent of total billed charges,33.9% of total billed charges,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,3086.46,78,,,percent of total billed charges,78% of total billed charges,3957,100,,,percent of total billed charges,100% of total billed charges,3268.48,82.6,,,percent of total billed charges,82.6% of total billed charges,3268.48,82.6,,,percent of total billed charges,82.6% of total billed charges,784.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,195.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,784.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.37,134142.3,
REPAIR BLOOD VESSEL LESION,35256,CDM,983,RC,35256,HCPCS,Outpatient,,,2963,1925.95,,2607.44,88,,,percent of total billed charges,88% of total Billed charges,148.68,100,,,Fee Schedule,100% of Medicare rate,548.68,100,,,Fee Schedule,100% of WA Medicaid,2963,100,,,percent of total billed charges,100% of total billed charges,565.14,103,,,Fee Schedule,103% of WA Medicaid,148.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,260.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,548.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2044.47,69,,,percent of total billed charges,69% of total billed charges,2963,100,,,percent of total billed charges,100% of total billed charges,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2963,100,,,percent of total billed charges,100% of total billed charges,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2963,100,,,percent of total billed charges,100% of total billed charges,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1832.62,61.85,,,percent of total billed charges,61.85% of total billed charges,548.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,559.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,713.28,130,,,Fee Schedule,130% of WA Medicaid ,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117.05,37.7,,,percent of total billed charges,37.70% of total billed charges,1117.05,37.7,,,percent of total billed charges,37.70% of total billed charges,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,100445.7,33.9,,,percent of total billed charges,33.9% of total billed charges,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2311.14,78,,,percent of total billed charges,78% of total billed charges,2963,100,,,percent of total billed charges,100% of total billed charges,2447.44,82.6,,,percent of total billed charges,82.6% of total billed charges,2447.44,82.6,,,percent of total billed charges,82.6% of total billed charges,548.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,148.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,148.68,100445.7,
REPAIR BLOOD VESSEL LESION,35266,CDM,983,RC,35266,HCPCS,Outpatient,,,2643,1717.95,,2325.84,88,,,percent of total billed charges,88% of total Billed charges,124.61,100,,,Fee Schedule,100% of Medicare rate,471.66,100,,,Fee Schedule,100% of WA Medicaid,2643,100,,,percent of total billed charges,100% of total billed charges,485.81,103,,,Fee Schedule,103% of WA Medicaid,124.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,218.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,471.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1823.67,69,,,percent of total billed charges,69% of total billed charges,2643,100,,,percent of total billed charges,100% of total billed charges,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2643,100,,,percent of total billed charges,100% of total billed charges,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2643,100,,,percent of total billed charges,100% of total billed charges,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1634.7,61.85,,,percent of total billed charges,61.85% of total billed charges,471.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,613.16,130,,,Fee Schedule,130% of WA Medicaid ,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,996.41,37.7,,,percent of total billed charges,37.70% of total billed charges,996.41,37.7,,,percent of total billed charges,37.70% of total billed charges,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,89597.7,33.9,,,percent of total billed charges,33.9% of total billed charges,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2061.54,78,,,percent of total billed charges,78% of total billed charges,2643,100,,,percent of total billed charges,100% of total billed charges,2183.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2183.12,82.6,,,percent of total billed charges,82.6% of total billed charges,471.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,124.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.61,89597.7,
REPAIR BLOOD VESSEL LESION,35281,CDM,983,RC,35281,HCPCS,Outpatient,,,4786,3110.90,,4211.68,88,,,percent of total billed charges,88% of total Billed charges,242.22,100,,,Fee Schedule,100% of Medicare rate,879.53,100,,,Fee Schedule,100% of WA Medicaid,4786,100,,,percent of total billed charges,100% of total billed charges,905.92,103,,,Fee Schedule,103% of WA Medicaid,242.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,423.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,879.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3302.34,69,,,percent of total billed charges,69% of total billed charges,4786,100,,,percent of total billed charges,100% of total billed charges,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,4786,100,,,percent of total billed charges,100% of total billed charges,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,4786,100,,,percent of total billed charges,100% of total billed charges,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2960.14,61.85,,,percent of total billed charges,61.85% of total billed charges,879.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,879.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,897.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1143.39,130,,,Fee Schedule,130% of WA Medicaid ,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1804.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1804.32,37.7,,,percent of total billed charges,37.70% of total billed charges,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,162245.4,33.9,,,percent of total billed charges,33.9% of total billed charges,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,3733.08,78,,,percent of total billed charges,78% of total billed charges,4786,100,,,percent of total billed charges,100% of total billed charges,3953.24,82.6,,,percent of total billed charges,82.6% of total billed charges,3953.24,82.6,,,percent of total billed charges,82.6% of total billed charges,879.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,242.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,879.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,242.22,162245.4,
REPAIR BLOOD VESSEL LESION,35286,CDM,983,RC,35286,HCPCS,Outpatient,,,2612,1697.80,,2298.56,88,,,percent of total billed charges,88% of total Billed charges,136.9,100,,,Fee Schedule,100% of Medicare rate,502.8,100,,,Fee Schedule,100% of WA Medicaid,2612,100,,,percent of total billed charges,100% of total billed charges,517.88,103,,,Fee Schedule,103% of WA Medicaid,136.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,239.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,502.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1802.28,69,,,percent of total billed charges,69% of total billed charges,2612,100,,,percent of total billed charges,100% of total billed charges,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2612,100,,,percent of total billed charges,100% of total billed charges,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2612,100,,,percent of total billed charges,100% of total billed charges,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1615.52,61.85,,,percent of total billed charges,61.85% of total billed charges,502.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,653.64,130,,,Fee Schedule,130% of WA Medicaid ,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,984.72,37.7,,,percent of total billed charges,37.70% of total billed charges,984.72,37.7,,,percent of total billed charges,37.70% of total billed charges,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,88546.8,33.9,,,percent of total billed charges,33.9% of total billed charges,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2037.36,78,,,percent of total billed charges,78% of total billed charges,2612,100,,,percent of total billed charges,100% of total billed charges,2157.51,82.6,,,percent of total billed charges,82.6% of total billed charges,2157.51,82.6,,,percent of total billed charges,82.6% of total billed charges,502.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,136.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,136.9,88546.8,
RECHANNELING OF ARTERY,35304,CDM,983,RC,35304,HCPCS,Outpatient,,,3844,2498.60,,3382.72,88,,,percent of total billed charges,88% of total Billed charges,195.51,100,,,Fee Schedule,100% of Medicare rate,687.63,100,,,Fee Schedule,100% of WA Medicaid,3844,100,,,percent of total billed charges,100% of total billed charges,708.26,103,,,Fee Schedule,103% of WA Medicaid,195.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,342.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,687.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2652.36,69,,,percent of total billed charges,69% of total billed charges,3844,100,,,percent of total billed charges,100% of total billed charges,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,3844,100,,,percent of total billed charges,100% of total billed charges,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,3844,100,,,percent of total billed charges,100% of total billed charges,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2377.51,61.85,,,percent of total billed charges,61.85% of total billed charges,687.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,687.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,893.92,130,,,Fee Schedule,130% of WA Medicaid ,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1449.19,37.7,,,percent of total billed charges,37.70% of total billed charges,1449.19,37.7,,,percent of total billed charges,37.70% of total billed charges,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,130311.6,33.9,,,percent of total billed charges,33.9% of total billed charges,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2998.32,78,,,percent of total billed charges,78% of total billed charges,3844,100,,,percent of total billed charges,100% of total billed charges,3175.14,82.6,,,percent of total billed charges,82.6% of total billed charges,3175.14,82.6,,,percent of total billed charges,82.6% of total billed charges,687.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,195.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,687.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.51,130311.6,
RECHANNELING OF ARTERY,35305,CDM,983,RC,35305,HCPCS,Outpatient,,,3700,2405.00,,3256,88,,,percent of total billed charges,88% of total Billed charges,187.64,100,,,Fee Schedule,100% of Medicare rate,661.7,100,,,Fee Schedule,100% of WA Medicaid,3700,100,,,percent of total billed charges,100% of total billed charges,681.55,103,,,Fee Schedule,103% of WA Medicaid,187.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,328.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,661.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2553,69,,,percent of total billed charges,69% of total billed charges,3700,100,,,percent of total billed charges,100% of total billed charges,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,3700,100,,,percent of total billed charges,100% of total billed charges,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,3700,100,,,percent of total billed charges,100% of total billed charges,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2288.45,61.85,,,percent of total billed charges,61.85% of total billed charges,661.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,661.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,860.21,130,,,Fee Schedule,130% of WA Medicaid ,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1394.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1394.9,37.7,,,percent of total billed charges,37.70% of total billed charges,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,125430,33.9,,,percent of total billed charges,33.9% of total billed charges,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2886,78,,,percent of total billed charges,78% of total billed charges,3700,100,,,percent of total billed charges,100% of total billed charges,3056.2,82.6,,,percent of total billed charges,82.6% of total billed charges,3056.2,82.6,,,percent of total billed charges,82.6% of total billed charges,661.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,187.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,661.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.64,125430,
RECHANNELING OF ARTERY,35306,CDM,983,RC,35306,HCPCS,Outpatient,,,1330,864.50,,1170.4,88,,,percent of total billed charges,88% of total Billed charges,72.01,100,,,Fee Schedule,100% of Medicare rate,237.04,100,,,Fee Schedule,100% of WA Medicaid,1330,100,,,percent of total billed charges,100% of total billed charges,244.15,103,,,Fee Schedule,103% of WA Medicaid,72.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,237.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,917.7,69,,,percent of total billed charges,69% of total billed charges,1330,100,,,percent of total billed charges,100% of total billed charges,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1330,100,,,percent of total billed charges,100% of total billed charges,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1330,100,,,percent of total billed charges,100% of total billed charges,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,822.61,61.85,,,percent of total billed charges,61.85% of total billed charges,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,308.15,130,,,Fee Schedule,130% of WA Medicaid ,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,501.41,37.7,,,percent of total billed charges,37.70% of total billed charges,501.41,37.7,,,percent of total billed charges,37.70% of total billed charges,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,45087,33.9,,,percent of total billed charges,33.9% of total billed charges,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1037.4,78,,,percent of total billed charges,78% of total billed charges,1330,100,,,percent of total billed charges,100% of total billed charges,1098.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1098.58,82.6,,,percent of total billed charges,82.6% of total billed charges,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.01,45087,
RECHANNELING OF ARTERY,35303,CDM,983,RC,35303,HCPCS,Outpatient,,,3700,2405.00,,3256,88,,,percent of total billed charges,88% of total Billed charges,187.08,100,,,Fee Schedule,100% of Medicare rate,660.77,100,,,Fee Schedule,100% of WA Medicaid,3700,100,,,percent of total billed charges,100% of total billed charges,680.59,103,,,Fee Schedule,103% of WA Medicaid,187.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,327.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,660.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2553,69,,,percent of total billed charges,69% of total billed charges,3700,100,,,percent of total billed charges,100% of total billed charges,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,3700,100,,,percent of total billed charges,100% of total billed charges,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,3700,100,,,percent of total billed charges,100% of total billed charges,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2288.45,61.85,,,percent of total billed charges,61.85% of total billed charges,660.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,660.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,673.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,859,130,,,Fee Schedule,130% of WA Medicaid ,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1394.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1394.9,37.7,,,percent of total billed charges,37.70% of total billed charges,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,125430,33.9,,,percent of total billed charges,33.9% of total billed charges,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2886,78,,,percent of total billed charges,78% of total billed charges,3700,100,,,percent of total billed charges,100% of total billed charges,3056.2,82.6,,,percent of total billed charges,82.6% of total billed charges,3056.2,82.6,,,percent of total billed charges,82.6% of total billed charges,660.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,187.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,660.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.08,125430,
RECHANNELING OF ARTERY,35301,CDM,983,RC,35301,HCPCS,Outpatient,,,4580,2977.00,,4030.4,88,,,percent of total billed charges,88% of total Billed charges,171.17,100,,,Fee Schedule,100% of Medicare rate,610.6,100,,,Fee Schedule,100% of WA Medicaid,4580,100,,,percent of total billed charges,100% of total billed charges,628.92,103,,,Fee Schedule,103% of WA Medicaid,171.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,299.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,610.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3160.2,69,,,percent of total billed charges,69% of total billed charges,4580,100,,,percent of total billed charges,100% of total billed charges,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4580,100,,,percent of total billed charges,100% of total billed charges,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4580,100,,,percent of total billed charges,100% of total billed charges,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2832.73,61.85,,,percent of total billed charges,61.85% of total billed charges,610.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,793.78,130,,,Fee Schedule,130% of WA Medicaid ,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1726.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1726.66,37.7,,,percent of total billed charges,37.70% of total billed charges,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,155262,33.9,,,percent of total billed charges,33.9% of total billed charges,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3572.4,78,,,percent of total billed charges,78% of total billed charges,4580,100,,,percent of total billed charges,100% of total billed charges,3783.08,82.6,,,percent of total billed charges,82.6% of total billed charges,3783.08,82.6,,,percent of total billed charges,82.6% of total billed charges,610.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,171.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,171.17,155262,
RECHANNELING OF ARTERY,35302,CDM,983,RC,35302,HCPCS,Outpatient,,,3042,1977.30,,2676.96,88,,,percent of total billed charges,88% of total Billed charges,168.98,100,,,Fee Schedule,100% of Medicare rate,603.33,100,,,Fee Schedule,100% of WA Medicaid,3042,100,,,percent of total billed charges,100% of total billed charges,621.43,103,,,Fee Schedule,103% of WA Medicaid,168.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,295.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,603.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2098.98,69,,,percent of total billed charges,69% of total billed charges,3042,100,,,percent of total billed charges,100% of total billed charges,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3042,100,,,percent of total billed charges,100% of total billed charges,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3042,100,,,percent of total billed charges,100% of total billed charges,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1881.48,61.85,,,percent of total billed charges,61.85% of total billed charges,603.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,603.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,784.33,130,,,Fee Schedule,130% of WA Medicaid ,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1146.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1146.83,37.7,,,percent of total billed charges,37.70% of total billed charges,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,103123.8,33.9,,,percent of total billed charges,33.9% of total billed charges,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2372.76,78,,,percent of total billed charges,78% of total billed charges,3042,100,,,percent of total billed charges,100% of total billed charges,2512.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2512.69,82.6,,,percent of total billed charges,82.6% of total billed charges,603.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,168.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,603.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,168.98,103123.8,
RECHANNELING OF ARTERY,35321,CDM,983,RC,35321,HCPCS,Outpatient,,,2409,1565.85,,2119.92,88,,,percent of total billed charges,88% of total Billed charges,132.73,100,,,Fee Schedule,100% of Medicare rate,487.7,100,,,Fee Schedule,100% of WA Medicaid,2409,100,,,percent of total billed charges,100% of total billed charges,502.33,103,,,Fee Schedule,103% of WA Medicaid,132.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,232.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,487.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1662.21,69,,,percent of total billed charges,69% of total billed charges,2409,100,,,percent of total billed charges,100% of total billed charges,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2409,100,,,percent of total billed charges,100% of total billed charges,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2409,100,,,percent of total billed charges,100% of total billed charges,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1489.97,61.85,,,percent of total billed charges,61.85% of total billed charges,487.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,634.01,130,,,Fee Schedule,130% of WA Medicaid ,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,908.19,37.7,,,percent of total billed charges,37.70% of total billed charges,908.19,37.7,,,percent of total billed charges,37.70% of total billed charges,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,81665.1,33.9,,,percent of total billed charges,33.9% of total billed charges,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1879.02,78,,,percent of total billed charges,78% of total billed charges,2409,100,,,percent of total billed charges,100% of total billed charges,1989.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1989.83,82.6,,,percent of total billed charges,82.6% of total billed charges,487.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,132.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,132.73,81665.1,
RECHANNELING OF ARTERY,35341,CDM,983,RC,35341,HCPCS,Outpatient,,,4072,2646.80,,3583.36,88,,,percent of total billed charges,88% of total Billed charges,208.12,100,,,Fee Schedule,100% of Medicare rate,749.54,100,,,Fee Schedule,100% of WA Medicaid,4072,100,,,percent of total billed charges,100% of total billed charges,772.03,103,,,Fee Schedule,103% of WA Medicaid,208.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,364.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,749.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2809.68,69,,,percent of total billed charges,69% of total billed charges,4072,100,,,percent of total billed charges,100% of total billed charges,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,4072,100,,,percent of total billed charges,100% of total billed charges,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,4072,100,,,percent of total billed charges,100% of total billed charges,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2518.53,61.85,,,percent of total billed charges,61.85% of total billed charges,749.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,749.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,764.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,974.4,130,,,Fee Schedule,130% of WA Medicaid ,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1535.14,37.7,,,percent of total billed charges,37.70% of total billed charges,1535.14,37.7,,,percent of total billed charges,37.70% of total billed charges,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,138040.8,33.9,,,percent of total billed charges,33.9% of total billed charges,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,3176.16,78,,,percent of total billed charges,78% of total billed charges,4072,100,,,percent of total billed charges,100% of total billed charges,3363.47,82.6,,,percent of total billed charges,82.6% of total billed charges,3363.47,82.6,,,percent of total billed charges,82.6% of total billed charges,749.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,208.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,749.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,208.12,138040.8,
RECHANNELING OF ARTERY,35355,CDM,983,RC,35355,HCPCS,Outpatient,,,2792,1814.80,,2456.96,88,,,percent of total billed charges,88% of total Billed charges,156.8,100,,,Fee Schedule,100% of Medicare rate,554.46,100,,,Fee Schedule,100% of WA Medicaid,2792,100,,,percent of total billed charges,100% of total billed charges,571.09,103,,,Fee Schedule,103% of WA Medicaid,156.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,274.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,554.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1926.48,69,,,percent of total billed charges,69% of total billed charges,2792,100,,,percent of total billed charges,100% of total billed charges,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2792,100,,,percent of total billed charges,100% of total billed charges,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2792,100,,,percent of total billed charges,100% of total billed charges,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1726.85,61.85,,,percent of total billed charges,61.85% of total billed charges,554.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,720.8,130,,,Fee Schedule,130% of WA Medicaid ,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1052.58,37.7,,,percent of total billed charges,37.70% of total billed charges,1052.58,37.7,,,percent of total billed charges,37.70% of total billed charges,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,94648.8,33.9,,,percent of total billed charges,33.9% of total billed charges,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2177.76,78,,,percent of total billed charges,78% of total billed charges,2792,100,,,percent of total billed charges,100% of total billed charges,2306.19,82.6,,,percent of total billed charges,82.6% of total billed charges,2306.19,82.6,,,percent of total billed charges,82.6% of total billed charges,554.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,156.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,156.8,94648.8,
RECHANNELING OF ARTERY,35351,CDM,983,RC,35351,HCPCS,Outpatient,,,3521,2288.65,,3098.48,88,,,percent of total billed charges,88% of total Billed charges,195.56,100,,,Fee Schedule,100% of Medicare rate,693.41,100,,,Fee Schedule,100% of WA Medicaid,3521,100,,,percent of total billed charges,100% of total billed charges,714.21,103,,,Fee Schedule,103% of WA Medicaid,195.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,342.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,693.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2429.49,69,,,percent of total billed charges,69% of total billed charges,3521,100,,,percent of total billed charges,100% of total billed charges,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3521,100,,,percent of total billed charges,100% of total billed charges,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3521,100,,,percent of total billed charges,100% of total billed charges,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2177.74,61.85,,,percent of total billed charges,61.85% of total billed charges,693.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,693.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,707.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,901.43,130,,,Fee Schedule,130% of WA Medicaid ,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1327.42,37.7,,,percent of total billed charges,37.70% of total billed charges,1327.42,37.7,,,percent of total billed charges,37.70% of total billed charges,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,119361.9,33.9,,,percent of total billed charges,33.9% of total billed charges,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2746.38,78,,,percent of total billed charges,78% of total billed charges,3521,100,,,percent of total billed charges,100% of total billed charges,2908.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2908.35,82.6,,,percent of total billed charges,82.6% of total billed charges,693.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,195.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,693.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.56,119361.9,
RECHANNELING OF ARTERY,35361,CDM,983,RC,35361,HCPCS,Outpatient,,,4623,3004.95,,4068.24,88,,,percent of total billed charges,88% of total Billed charges,239.34,100,,,Fee Schedule,100% of Medicare rate,818.74,100,,,Fee Schedule,100% of WA Medicaid,4623,100,,,percent of total billed charges,100% of total billed charges,843.3,103,,,Fee Schedule,103% of WA Medicaid,239.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,418.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,818.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3189.87,69,,,percent of total billed charges,69% of total billed charges,4623,100,,,percent of total billed charges,100% of total billed charges,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,4623,100,,,percent of total billed charges,100% of total billed charges,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,4623,100,,,percent of total billed charges,100% of total billed charges,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2859.33,61.85,,,percent of total billed charges,61.85% of total billed charges,818.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,818.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1064.36,130,,,Fee Schedule,130% of WA Medicaid ,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1742.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1742.87,37.7,,,percent of total billed charges,37.70% of total billed charges,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,156719.7,33.9,,,percent of total billed charges,33.9% of total billed charges,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,3605.94,78,,,percent of total billed charges,78% of total billed charges,4623,100,,,percent of total billed charges,100% of total billed charges,3818.6,82.6,,,percent of total billed charges,82.6% of total billed charges,3818.6,82.6,,,percent of total billed charges,82.6% of total billed charges,818.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,239.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,818.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,239.34,156719.7,
RECHANNELING OF ARTERY,35372,CDM,983,RC,35372,HCPCS,Outpatient,,,2650,1722.50,,2332,88,,,percent of total billed charges,88% of total Billed charges,147.3,100,,,Fee Schedule,100% of Medicare rate,527.42,100,,,Fee Schedule,100% of WA Medicaid,2650,100,,,percent of total billed charges,100% of total billed charges,543.24,103,,,Fee Schedule,103% of WA Medicaid,147.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,257.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,527.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1828.5,69,,,percent of total billed charges,69% of total billed charges,2650,100,,,percent of total billed charges,100% of total billed charges,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2650,100,,,percent of total billed charges,100% of total billed charges,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2650,100,,,percent of total billed charges,100% of total billed charges,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1639.03,61.85,,,percent of total billed charges,61.85% of total billed charges,527.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,685.65,130,,,Fee Schedule,130% of WA Medicaid ,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,999.05,37.7,,,percent of total billed charges,37.70% of total billed charges,999.05,37.7,,,percent of total billed charges,37.70% of total billed charges,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,89835,33.9,,,percent of total billed charges,33.9% of total billed charges,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2067,78,,,percent of total billed charges,78% of total billed charges,2650,100,,,percent of total billed charges,100% of total billed charges,2188.9,82.6,,,percent of total billed charges,82.6% of total billed charges,2188.9,82.6,,,percent of total billed charges,82.6% of total billed charges,527.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,147.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,147.3,89835,
RECHANNELING OF ARTERY,35371,CDM,983,RC,35371,HCPCS,Outpatient,,,2216,1440.40,,1950.08,88,,,percent of total billed charges,88% of total Billed charges,121.68,100,,,Fee Schedule,100% of Medicare rate,440.7,100,,,Fee Schedule,100% of WA Medicaid,2216,100,,,percent of total billed charges,100% of total billed charges,453.92,103,,,Fee Schedule,103% of WA Medicaid,121.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,212.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,440.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1529.04,69,,,percent of total billed charges,69% of total billed charges,2216,100,,,percent of total billed charges,100% of total billed charges,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2216,100,,,percent of total billed charges,100% of total billed charges,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2216,100,,,percent of total billed charges,100% of total billed charges,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1370.6,61.85,,,percent of total billed charges,61.85% of total billed charges,440.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,572.91,130,,,Fee Schedule,130% of WA Medicaid ,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.43,37.7,,,percent of total billed charges,37.70% of total billed charges,835.43,37.7,,,percent of total billed charges,37.70% of total billed charges,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,75122.4,33.9,,,percent of total billed charges,33.9% of total billed charges,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1728.48,78,,,percent of total billed charges,78% of total billed charges,2216,100,,,percent of total billed charges,100% of total billed charges,1830.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1830.42,82.6,,,percent of total billed charges,82.6% of total billed charges,440.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.68,75122.4,
REPAIR VENOUS BLOCKAGE,35460,CDM,983,RC,,,Outpatient,,,867,563.55,,762.96,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,867,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,598.23,69,,,percent of total billed charges,69% of total billed charges,867,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,867,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,867,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,536.24,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,326.86,37.7,,,percent of total billed charges,37.70% of total billed charges,326.86,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,29391.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,676.26,78,,,percent of total billed charges,78% of total billed charges,867,100,,,percent of total billed charges,100% of total billed charges,716.14,82.6,,,percent of total billed charges,82.6% of total billed charges,716.14,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",326.86,29391.3,
REPAIR ARTERIAL BLOCKAGE,35475,CDM,983,RC,,,Outpatient,,,917,596.05,,806.96,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,917,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,632.73,69,,,percent of total billed charges,69% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,917,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,917,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,567.16,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,345.71,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,31086.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,715.26,78,,,percent of total billed charges,78% of total billed charges,917,100,,,percent of total billed charges,100% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,757.44,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",345.71,31086.3,
REPAIR ARTERIAL BLOCKAGE,35471,CDM,983,RC,,,Outpatient,,,1542,1002.30,,1356.96,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1542,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1063.98,69,,,percent of total billed charges,69% of total billed charges,1542,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1542,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1542,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,953.73,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,581.33,37.7,,,percent of total billed charges,37.70% of total billed charges,581.33,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,52273.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1202.76,78,,,percent of total billed charges,78% of total billed charges,1542,100,,,percent of total billed charges,100% of total billed charges,1273.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1273.69,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",581.33,52273.8,
REPAIR VENOUS BLOCKAGE,35476,CDM,983,RC,,,Outpatient,,,762,495.30,,670.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,762,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,525.78,69,,,percent of total billed charges,69% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,762,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,762,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,471.3,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,25831.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,594.36,78,,,percent of total billed charges,78% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",287.27,25831.8,
REPAIR ARTERIAL BLOCKAGE,35472,CDM,983,RC,,,Outpatient,,,934,607.10,,821.92,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,934,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,644.46,69,,,percent of total billed charges,69% of total billed charges,934,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,934,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,934,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,577.68,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,352.12,37.7,,,percent of total billed charges,37.70% of total billed charges,352.12,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,31662.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,728.52,78,,,percent of total billed charges,78% of total billed charges,934,100,,,percent of total billed charges,100% of total billed charges,771.48,82.6,,,percent of total billed charges,82.6% of total billed charges,771.48,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",352.12,31662.6,
HARVEST VEIN FOR BYPASS,35500,CDM,983,RC,35500,HCPCS,Outpatient,,,1177,765.05,,1035.76,88,,,percent of total billed charges,88% of total Billed charges,50.03,100,,,Fee Schedule,100% of Medicare rate,170.09,100,,,Fee Schedule,100% of WA Medicaid,1177,100,,,percent of total billed charges,100% of total billed charges,175.19,103,,,Fee Schedule,103% of WA Medicaid,50.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,170.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,812.13,69,,,percent of total billed charges,69% of total billed charges,1177,100,,,percent of total billed charges,100% of total billed charges,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1177,100,,,percent of total billed charges,100% of total billed charges,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1177,100,,,percent of total billed charges,100% of total billed charges,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,727.97,61.85,,,percent of total billed charges,61.85% of total billed charges,170.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,221.12,130,,,Fee Schedule,130% of WA Medicaid ,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.73,37.7,,,percent of total billed charges,37.70% of total billed charges,443.73,37.7,,,percent of total billed charges,37.70% of total billed charges,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,39900.3,33.9,,,percent of total billed charges,33.9% of total billed charges,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,918.06,78,,,percent of total billed charges,78% of total billed charges,1177,100,,,percent of total billed charges,100% of total billed charges,972.2,82.6,,,percent of total billed charges,82.6% of total billed charges,972.2,82.6,,,percent of total billed charges,82.6% of total billed charges,170.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.03,39900.3,
ART BYP GRFT SUBCLAV-CAROTID,35506,CDM,983,RC,35506,HCPCS,Outpatient,,,3427,2227.55,,3015.76,88,,,percent of total billed charges,88% of total Billed charges,199.8,100,,,Fee Schedule,100% of Medicare rate,684.83,100,,,Fee Schedule,100% of WA Medicaid,3427,100,,,percent of total billed charges,100% of total billed charges,705.37,103,,,Fee Schedule,103% of WA Medicaid,199.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,349.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,684.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2364.63,69,,,percent of total billed charges,69% of total billed charges,3427,100,,,percent of total billed charges,100% of total billed charges,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3427,100,,,percent of total billed charges,100% of total billed charges,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3427,100,,,percent of total billed charges,100% of total billed charges,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2119.6,61.85,,,percent of total billed charges,61.85% of total billed charges,684.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,684.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,890.28,130,,,Fee Schedule,130% of WA Medicaid ,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1291.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1291.98,37.7,,,percent of total billed charges,37.70% of total billed charges,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,116175.3,33.9,,,percent of total billed charges,33.9% of total billed charges,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2673.06,78,,,percent of total billed charges,78% of total billed charges,3427,100,,,percent of total billed charges,100% of total billed charges,2830.7,82.6,,,percent of total billed charges,82.6% of total billed charges,2830.7,82.6,,,percent of total billed charges,82.6% of total billed charges,684.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,199.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,684.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,199.8,116175.3,
ART BYP GRFT BRCHL-ULNR-RDL,35523,CDM,983,RC,35523,HCPCS,Outpatient,,,5854,3805.10,,5151.52,88,,,percent of total billed charges,88% of total Billed charges,191.09,100,,,Fee Schedule,100% of Medicare rate,662.63,100,,,Fee Schedule,100% of WA Medicaid,5854,100,,,percent of total billed charges,100% of total billed charges,682.51,103,,,Fee Schedule,103% of WA Medicaid,191.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,334.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,662.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4039.26,69,,,percent of total billed charges,69% of total billed charges,5854,100,,,percent of total billed charges,100% of total billed charges,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,5854,100,,,percent of total billed charges,100% of total billed charges,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,5854,100,,,percent of total billed charges,100% of total billed charges,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3620.7,61.85,,,percent of total billed charges,61.85% of total billed charges,662.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,662.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,675.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,861.42,130,,,Fee Schedule,130% of WA Medicaid ,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2206.96,37.7,,,percent of total billed charges,37.70% of total billed charges,2206.96,37.7,,,percent of total billed charges,37.70% of total billed charges,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,198450.6,33.9,,,percent of total billed charges,33.9% of total billed charges,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4566.12,78,,,percent of total billed charges,78% of total billed charges,5854,100,,,percent of total billed charges,100% of total billed charges,4835.4,82.6,,,percent of total billed charges,82.6% of total billed charges,4835.4,82.6,,,percent of total billed charges,82.6% of total billed charges,662.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,193,101,,,Fee Schedule,101% of Medicare RBRVS rate,191.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,662.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,191.09,198450.6,
ART BYP GRFT AXILL-BRACHIAL,35522,CDM,983,RC,35522,HCPCS,Outpatient,,,5382,3498.30,,4736.16,88,,,percent of total billed charges,88% of total Billed charges,182.84,100,,,Fee Schedule,100% of Medicare rate,629.25,100,,,Fee Schedule,100% of WA Medicaid,5382,100,,,percent of total billed charges,100% of total billed charges,648.13,103,,,Fee Schedule,103% of WA Medicaid,182.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,319.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,629.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3713.58,69,,,percent of total billed charges,69% of total billed charges,5382,100,,,percent of total billed charges,100% of total billed charges,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5382,100,,,percent of total billed charges,100% of total billed charges,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5382,100,,,percent of total billed charges,100% of total billed charges,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3328.77,61.85,,,percent of total billed charges,61.85% of total billed charges,629.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,641.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,818.03,130,,,Fee Schedule,130% of WA Medicaid ,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2029.01,37.7,,,percent of total billed charges,37.70% of total billed charges,2029.01,37.7,,,percent of total billed charges,37.70% of total billed charges,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,182449.8,33.9,,,percent of total billed charges,33.9% of total billed charges,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,4197.96,78,,,percent of total billed charges,78% of total billed charges,5382,100,,,percent of total billed charges,100% of total billed charges,4445.53,82.6,,,percent of total billed charges,82.6% of total billed charges,4445.53,82.6,,,percent of total billed charges,82.6% of total billed charges,629.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,182.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,182.84,182449.8,
ART BYP GRFT BRACHIAL-BRCHL,35525,CDM,983,RC,35525,HCPCS,Outpatient,,,2927,1902.55,,2575.76,88,,,percent of total billed charges,88% of total Billed charges,171.75,100,,,Fee Schedule,100% of Medicare rate,611.35,100,,,Fee Schedule,100% of WA Medicaid,2927,100,,,percent of total billed charges,100% of total billed charges,629.69,103,,,Fee Schedule,103% of WA Medicaid,171.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,300.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,611.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2019.63,69,,,percent of total billed charges,69% of total billed charges,2927,100,,,percent of total billed charges,100% of total billed charges,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2927,100,,,percent of total billed charges,100% of total billed charges,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2927,100,,,percent of total billed charges,100% of total billed charges,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1810.35,61.85,,,percent of total billed charges,61.85% of total billed charges,611.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,611.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,623.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,794.76,130,,,Fee Schedule,130% of WA Medicaid ,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1103.48,37.7,,,percent of total billed charges,37.70% of total billed charges,1103.48,37.7,,,percent of total billed charges,37.70% of total billed charges,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,99225.3,33.9,,,percent of total billed charges,33.9% of total billed charges,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2283.06,78,,,percent of total billed charges,78% of total billed charges,2927,100,,,percent of total billed charges,100% of total billed charges,2417.7,82.6,,,percent of total billed charges,82.6% of total billed charges,2417.7,82.6,,,percent of total billed charges,82.6% of total billed charges,611.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,171.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,611.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,171.75,99225.3,
ART BYP GRFT AORCEL/AORMESEN,35531,CDM,983,RC,35531,HCPCS,Outpatient,,,8224,5345.60,,7237.12,88,,,percent of total billed charges,88% of total Billed charges,309.05,100,,,Fee Schedule,100% of Medicare rate,1046.64,100,,,Fee Schedule,100% of WA Medicaid,8224,100,,,percent of total billed charges,100% of total billed charges,1078.04,103,,,Fee Schedule,103% of WA Medicaid,309.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,540.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1046.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5674.56,69,,,percent of total billed charges,69% of total billed charges,8224,100,,,percent of total billed charges,100% of total billed charges,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,8224,100,,,percent of total billed charges,100% of total billed charges,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,8224,100,,,percent of total billed charges,100% of total billed charges,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,5086.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1046.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1360.63,130,,,Fee Schedule,130% of WA Medicaid ,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3100.45,37.7,,,percent of total billed charges,37.70% of total billed charges,3100.45,37.7,,,percent of total billed charges,37.70% of total billed charges,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,278793.6,33.9,,,percent of total billed charges,33.9% of total billed charges,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6414.72,78,,,percent of total billed charges,78% of total billed charges,8224,100,,,percent of total billed charges,100% of total billed charges,6793.02,82.6,,,percent of total billed charges,82.6% of total billed charges,6793.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1046.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,309.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,309.05,278793.6,
ART BYP GRFT FEM-POPLITEAL,35556,CDM,983,RC,35556,HCPCS,Outpatient,,,5703,3706.95,,5018.64,88,,,percent of total billed charges,88% of total Billed charges,211.83,100,,,Fee Schedule,100% of Medicare rate,750.85,100,,,Fee Schedule,100% of WA Medicaid,5703,100,,,percent of total billed charges,100% of total billed charges,773.38,103,,,Fee Schedule,103% of WA Medicaid,211.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,370.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,750.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3935.07,69,,,percent of total billed charges,69% of total billed charges,5703,100,,,percent of total billed charges,100% of total billed charges,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,5703,100,,,percent of total billed charges,100% of total billed charges,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,5703,100,,,percent of total billed charges,100% of total billed charges,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3527.31,61.85,,,percent of total billed charges,61.85% of total billed charges,750.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,750.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,976.11,130,,,Fee Schedule,130% of WA Medicaid ,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2150.03,37.7,,,percent of total billed charges,37.70% of total billed charges,2150.03,37.7,,,percent of total billed charges,37.70% of total billed charges,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,193331.7,33.9,,,percent of total billed charges,33.9% of total billed charges,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,4448.34,78,,,percent of total billed charges,78% of total billed charges,5703,100,,,percent of total billed charges,100% of total billed charges,4710.68,82.6,,,percent of total billed charges,82.6% of total billed charges,4710.68,82.6,,,percent of total billed charges,82.6% of total billed charges,750.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,211.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,750.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,211.83,193331.7,
ART BYP GRFT FEM-FEMORAL,35558,CDM,983,RC,35558,HCPCS,Outpatient,,,4985,3240.25,,4386.8,88,,,percent of total billed charges,88% of total Billed charges,184.19,100,,,Fee Schedule,100% of Medicare rate,670.47,100,,,Fee Schedule,100% of WA Medicaid,4985,100,,,percent of total billed charges,100% of total billed charges,690.58,103,,,Fee Schedule,103% of WA Medicaid,184.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,322.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,670.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3439.65,69,,,percent of total billed charges,69% of total billed charges,4985,100,,,percent of total billed charges,100% of total billed charges,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,4985,100,,,percent of total billed charges,100% of total billed charges,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,4985,100,,,percent of total billed charges,100% of total billed charges,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,3083.22,61.85,,,percent of total billed charges,61.85% of total billed charges,670.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,670.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,871.61,130,,,Fee Schedule,130% of WA Medicaid ,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1879.35,37.7,,,percent of total billed charges,37.70% of total billed charges,1879.35,37.7,,,percent of total billed charges,37.70% of total billed charges,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,168991.5,33.9,,,percent of total billed charges,33.9% of total billed charges,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,3888.3,78,,,percent of total billed charges,78% of total billed charges,4985,100,,,percent of total billed charges,100% of total billed charges,4117.61,82.6,,,percent of total billed charges,82.6% of total billed charges,4117.61,82.6,,,percent of total billed charges,82.6% of total billed charges,670.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,184.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,670.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,184.19,168991.5,
ART BYP FEM-ANT-POST TIB/PRL,35566,CDM,983,RC,35566,HCPCS,Outpatient,,,6453,4194.45,,5678.64,88,,,percent of total billed charges,88% of total Billed charges,256.02,100,,,Fee Schedule,100% of Medicare rate,893.89,100,,,Fee Schedule,100% of WA Medicaid,6453,100,,,percent of total billed charges,100% of total billed charges,920.71,103,,,Fee Schedule,103% of WA Medicaid,256.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,448.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,893.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4452.57,69,,,percent of total billed charges,69% of total billed charges,6453,100,,,percent of total billed charges,100% of total billed charges,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,6453,100,,,percent of total billed charges,100% of total billed charges,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,6453,100,,,percent of total billed charges,100% of total billed charges,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3991.18,61.85,,,percent of total billed charges,61.85% of total billed charges,893.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,893.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,911.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1162.06,130,,,Fee Schedule,130% of WA Medicaid ,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2432.78,37.7,,,percent of total billed charges,37.70% of total billed charges,2432.78,37.7,,,percent of total billed charges,37.70% of total billed charges,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,218756.7,33.9,,,percent of total billed charges,33.9% of total billed charges,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,5033.34,78,,,percent of total billed charges,78% of total billed charges,6453,100,,,percent of total billed charges,100% of total billed charges,5330.18,82.6,,,percent of total billed charges,82.6% of total billed charges,5330.18,82.6,,,percent of total billed charges,82.6% of total billed charges,893.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,256.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,893.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.02,218756.7,
ART BYP GRFT ILIOFEMORAL,35565,CDM,983,RC,35565,HCPCS,Outpatient,,,3692,2399.80,,3248.96,88,,,percent of total billed charges,88% of total Billed charges,198.15,100,,,Fee Schedule,100% of Medicare rate,708.14,100,,,Fee Schedule,100% of WA Medicaid,3692,100,,,percent of total billed charges,100% of total billed charges,729.38,103,,,Fee Schedule,103% of WA Medicaid,198.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,346.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,708.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2547.48,69,,,percent of total billed charges,69% of total billed charges,3692,100,,,percent of total billed charges,100% of total billed charges,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3692,100,,,percent of total billed charges,100% of total billed charges,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3692,100,,,percent of total billed charges,100% of total billed charges,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2283.5,61.85,,,percent of total billed charges,61.85% of total billed charges,708.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,708.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,722.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,920.58,130,,,Fee Schedule,130% of WA Medicaid ,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1391.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1391.88,37.7,,,percent of total billed charges,37.70% of total billed charges,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,125158.8,33.9,,,percent of total billed charges,33.9% of total billed charges,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2879.76,78,,,percent of total billed charges,78% of total billed charges,3692,100,,,percent of total billed charges,100% of total billed charges,3049.59,82.6,,,percent of total billed charges,82.6% of total billed charges,3049.59,82.6,,,percent of total billed charges,82.6% of total billed charges,708.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,198.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,708.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,198.15,125158.8,
ART BYP TIBIAL-TIB/PERONEAL,35570,CDM,983,RC,35570,HCPCS,Outpatient,,,6270,4075.50,,5517.6,88,,,percent of total billed charges,88% of total Billed charges,230.97,100,,,Fee Schedule,100% of Medicare rate,793,100,,,Fee Schedule,100% of WA Medicaid,6270,100,,,percent of total billed charges,100% of total billed charges,816.79,103,,,Fee Schedule,103% of WA Medicaid,230.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,404.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,793,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4326.3,69,,,percent of total billed charges,69% of total billed charges,6270,100,,,percent of total billed charges,100% of total billed charges,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,6270,100,,,percent of total billed charges,100% of total billed charges,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,6270,100,,,percent of total billed charges,100% of total billed charges,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,3878,61.85,,,percent of total billed charges,61.85% of total billed charges,793,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,793,100,,,Fee Schedule,100% of WA Medicare OPPS rate,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,808.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1030.9,130,,,Fee Schedule,130% of WA Medicaid ,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2363.79,37.7,,,percent of total billed charges,37.70% of total billed charges,2363.79,37.7,,,percent of total billed charges,37.70% of total billed charges,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,212553,33.9,,,percent of total billed charges,33.9% of total billed charges,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,4890.6,78,,,percent of total billed charges,78% of total billed charges,6270,100,,,percent of total billed charges,100% of total billed charges,5179.02,82.6,,,percent of total billed charges,82.6% of total billed charges,5179.02,82.6,,,percent of total billed charges,82.6% of total billed charges,793,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,230.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,793,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,230.97,212553,
ART BYP POP-TIBL-PRL-OTHER,35571,CDM,983,RC,35571,HCPCS,Outpatient,,,6086,3955.90,,5355.68,88,,,percent of total billed charges,88% of total Billed charges,202.31,100,,,Fee Schedule,100% of Medicare rate,712.99,100,,,Fee Schedule,100% of WA Medicaid,6086,100,,,percent of total billed charges,100% of total billed charges,734.38,103,,,Fee Schedule,103% of WA Medicaid,202.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,354.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,712.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4199.34,69,,,percent of total billed charges,69% of total billed charges,6086,100,,,percent of total billed charges,100% of total billed charges,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,6086,100,,,percent of total billed charges,100% of total billed charges,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,6086,100,,,percent of total billed charges,100% of total billed charges,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,3764.19,61.85,,,percent of total billed charges,61.85% of total billed charges,712.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,727.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,926.89,130,,,Fee Schedule,130% of WA Medicaid ,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2294.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2294.42,37.7,,,percent of total billed charges,37.70% of total billed charges,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,206315.4,33.9,,,percent of total billed charges,33.9% of total billed charges,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,4747.08,78,,,percent of total billed charges,78% of total billed charges,6086,100,,,percent of total billed charges,100% of total billed charges,5027.04,82.6,,,percent of total billed charges,82.6% of total billed charges,5027.04,82.6,,,percent of total billed charges,82.6% of total billed charges,712.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,202.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,202.31,206315.4,
HARVEST ART FOR CABG ADD-ON,35600,CDM,983,RC,35600,HCPCS,Outpatient,,,801,520.65,,704.88,88,,,percent of total billed charges,88% of total Billed charges,27.63,100,,,Fee Schedule,100% of Medicare rate,100.34,100,,,Fee Schedule,100% of WA Medicaid,801,100,,,percent of total billed charges,100% of total billed charges,103.35,103,,,Fee Schedule,103% of WA Medicaid,27.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,100.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,552.69,69,,,percent of total billed charges,69% of total billed charges,801,100,,,percent of total billed charges,100% of total billed charges,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,801,100,,,percent of total billed charges,100% of total billed charges,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,801,100,,,percent of total billed charges,100% of total billed charges,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.42,61.85,,,percent of total billed charges,61.85% of total billed charges,100.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,130.44,130,,,Fee Schedule,130% of WA Medicaid ,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.98,37.7,,,percent of total billed charges,37.70% of total billed charges,301.98,37.7,,,percent of total billed charges,37.70% of total billed charges,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,27153.9,33.9,,,percent of total billed charges,33.9% of total billed charges,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.78,78,,,percent of total billed charges,78% of total billed charges,801,100,,,percent of total billed charges,100% of total billed charges,661.63,82.6,,,percent of total billed charges,82.6% of total billed charges,661.63,82.6,,,percent of total billed charges,82.6% of total billed charges,100.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.63,27153.9,
ART BYP CAROTID-SUBCLAVIAN,35606,CDM,983,RC,35606,HCPCS,Outpatient,,,5211,3387.15,,4585.68,88,,,percent of total billed charges,88% of total Billed charges,178.18,100,,,Fee Schedule,100% of Medicare rate,635.03,100,,,Fee Schedule,100% of WA Medicaid,5211,100,,,percent of total billed charges,100% of total billed charges,654.08,103,,,Fee Schedule,103% of WA Medicaid,178.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,311.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,635.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3595.59,69,,,percent of total billed charges,69% of total billed charges,5211,100,,,percent of total billed charges,100% of total billed charges,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,5211,100,,,percent of total billed charges,100% of total billed charges,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,5211,100,,,percent of total billed charges,100% of total billed charges,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3223,61.85,,,percent of total billed charges,61.85% of total billed charges,635.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,635.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,825.54,130,,,Fee Schedule,130% of WA Medicaid ,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1964.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1964.55,37.7,,,percent of total billed charges,37.70% of total billed charges,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,176652.9,33.9,,,percent of total billed charges,33.9% of total billed charges,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,4064.58,78,,,percent of total billed charges,78% of total billed charges,5211,100,,,percent of total billed charges,100% of total billed charges,4304.29,82.6,,,percent of total billed charges,82.6% of total billed charges,4304.29,82.6,,,percent of total billed charges,82.6% of total billed charges,635.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,178.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,635.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,178.18,176652.9,
ART BYP AOR-CELIAC-MSN-RENAL,35631,CDM,983,RC,35631,HCPCS,Outpatient,,,6427,4177.55,,5655.76,88,,,percent of total billed charges,88% of total Billed charges,283.33,100,,,Fee Schedule,100% of Medicare rate,997.96,100,,,Fee Schedule,100% of WA Medicaid,6427,100,,,percent of total billed charges,100% of total billed charges,1027.9,103,,,Fee Schedule,103% of WA Medicaid,283.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,495.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,997.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4434.63,69,,,percent of total billed charges,69% of total billed charges,6427,100,,,percent of total billed charges,100% of total billed charges,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,6427,100,,,percent of total billed charges,100% of total billed charges,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,6427,100,,,percent of total billed charges,100% of total billed charges,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3975.1,61.85,,,percent of total billed charges,61.85% of total billed charges,997.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,997.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1297.35,130,,,Fee Schedule,130% of WA Medicaid ,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2422.98,37.7,,,percent of total billed charges,37.70% of total billed charges,2422.98,37.7,,,percent of total billed charges,37.70% of total billed charges,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,217875.3,33.9,,,percent of total billed charges,33.9% of total billed charges,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,5013.06,78,,,percent of total billed charges,78% of total billed charges,6427,100,,,percent of total billed charges,100% of total billed charges,5308.7,82.6,,,percent of total billed charges,82.6% of total billed charges,5308.7,82.6,,,percent of total billed charges,82.6% of total billed charges,997.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,283.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,997.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,283.33,217875.3,
ART BYP AORTOILIAC,35637,CDM,983,RC,35637,HCPCS,Outpatient,,,4853,3154.45,,4270.64,88,,,percent of total billed charges,88% of total Billed charges,260.83,100,,,Fee Schedule,100% of Medicare rate,891.1,100,,,Fee Schedule,100% of WA Medicaid,4853,100,,,percent of total billed charges,100% of total billed charges,917.83,103,,,Fee Schedule,103% of WA Medicaid,260.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,456.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,891.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3348.57,69,,,percent of total billed charges,69% of total billed charges,4853,100,,,percent of total billed charges,100% of total billed charges,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,4853,100,,,percent of total billed charges,100% of total billed charges,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,4853,100,,,percent of total billed charges,100% of total billed charges,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3001.58,61.85,,,percent of total billed charges,61.85% of total billed charges,891.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,891.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,908.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1158.43,130,,,Fee Schedule,130% of WA Medicaid ,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1829.58,37.7,,,percent of total billed charges,37.70% of total billed charges,1829.58,37.7,,,percent of total billed charges,37.70% of total billed charges,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,164516.7,33.9,,,percent of total billed charges,33.9% of total billed charges,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3785.34,78,,,percent of total billed charges,78% of total billed charges,4853,100,,,percent of total billed charges,100% of total billed charges,4008.58,82.6,,,percent of total billed charges,82.6% of total billed charges,4008.58,82.6,,,percent of total billed charges,82.6% of total billed charges,891.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,260.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,891.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,260.83,164516.7,
ART BYP ILIORENAL,35634,CDM,983,RC,35634,HCPCS,Outpatient,,,5637,3664.05,,4960.56,88,,,percent of total billed charges,88% of total Billed charges,278.98,100,,,Fee Schedule,100% of Medicare rate,949.47,100,,,Fee Schedule,100% of WA Medicaid,5637,100,,,percent of total billed charges,100% of total billed charges,977.95,103,,,Fee Schedule,103% of WA Medicaid,278.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,488.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,949.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3889.53,69,,,percent of total billed charges,69% of total billed charges,5637,100,,,percent of total billed charges,100% of total billed charges,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,5637,100,,,percent of total billed charges,100% of total billed charges,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,5637,100,,,percent of total billed charges,100% of total billed charges,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3486.48,61.85,,,percent of total billed charges,61.85% of total billed charges,949.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,949.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,968.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1234.31,130,,,Fee Schedule,130% of WA Medicaid ,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2125.15,37.7,,,percent of total billed charges,37.70% of total billed charges,2125.15,37.7,,,percent of total billed charges,37.70% of total billed charges,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,191094.3,33.9,,,percent of total billed charges,33.9% of total billed charges,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4396.86,78,,,percent of total billed charges,78% of total billed charges,5637,100,,,percent of total billed charges,100% of total billed charges,4656.16,82.6,,,percent of total billed charges,82.6% of total billed charges,4656.16,82.6,,,percent of total billed charges,82.6% of total billed charges,949.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,278.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,949.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,278.98,191094.3,
ART BYP AORTOBIFEMORAL,35646,CDM,983,RC,35646,HCPCS,Outpatient,,,7308,4750.20,,6431.04,88,,,percent of total billed charges,88% of total Billed charges,260.67,100,,,Fee Schedule,100% of Medicare rate,918.14,100,,,Fee Schedule,100% of WA Medicaid,7308,100,,,percent of total billed charges,100% of total billed charges,945.68,103,,,Fee Schedule,103% of WA Medicaid,260.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,456.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,918.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5042.52,69,,,percent of total billed charges,69% of total billed charges,7308,100,,,percent of total billed charges,100% of total billed charges,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,7308,100,,,percent of total billed charges,100% of total billed charges,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,7308,100,,,percent of total billed charges,100% of total billed charges,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,4520,61.85,,,percent of total billed charges,61.85% of total billed charges,918.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,918.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,936.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1193.58,130,,,Fee Schedule,130% of WA Medicaid ,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2755.12,37.7,,,percent of total billed charges,37.70% of total billed charges,2755.12,37.7,,,percent of total billed charges,37.70% of total billed charges,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,247741.2,33.9,,,percent of total billed charges,33.9% of total billed charges,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,5700.24,78,,,percent of total billed charges,78% of total billed charges,7308,100,,,percent of total billed charges,100% of total billed charges,6036.41,82.6,,,percent of total billed charges,82.6% of total billed charges,6036.41,82.6,,,percent of total billed charges,82.6% of total billed charges,918.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,260.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,918.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,260.67,247741.2,
ART BYP AORTOFEMORAL,35647,CDM,983,RC,35647,HCPCS,Outpatient,,,6456,4196.40,,5681.28,88,,,percent of total billed charges,88% of total Billed charges,236.05,100,,,Fee Schedule,100% of Medicare rate,835.71,100,,,Fee Schedule,100% of WA Medicaid,6456,100,,,percent of total billed charges,100% of total billed charges,860.78,103,,,Fee Schedule,103% of WA Medicaid,236.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,413.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,835.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4454.64,69,,,percent of total billed charges,69% of total billed charges,6456,100,,,percent of total billed charges,100% of total billed charges,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6456,100,,,percent of total billed charges,100% of total billed charges,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6456,100,,,percent of total billed charges,100% of total billed charges,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3993.04,61.85,,,percent of total billed charges,61.85% of total billed charges,835.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,852.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1086.42,130,,,Fee Schedule,130% of WA Medicaid ,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2433.91,37.7,,,percent of total billed charges,37.70% of total billed charges,2433.91,37.7,,,percent of total billed charges,37.70% of total billed charges,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,218858.4,33.9,,,percent of total billed charges,33.9% of total billed charges,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,5035.68,78,,,percent of total billed charges,78% of total billed charges,6456,100,,,percent of total billed charges,100% of total billed charges,5332.66,82.6,,,percent of total billed charges,82.6% of total billed charges,5332.66,82.6,,,percent of total billed charges,82.6% of total billed charges,835.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,236.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,236.05,218858.4,
ART BYP AXILL-FEM-FEMORAL,35654,CDM,983,RC,35654,HCPCS,Outpatient,,,5835,3792.75,,5134.8,88,,,percent of total billed charges,88% of total Billed charges,208.14,100,,,Fee Schedule,100% of Medicare rate,734.81,100,,,Fee Schedule,100% of WA Medicaid,5835,100,,,percent of total billed charges,100% of total billed charges,756.85,103,,,Fee Schedule,103% of WA Medicaid,208.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,364.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,734.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4026.15,69,,,percent of total billed charges,69% of total billed charges,5835,100,,,percent of total billed charges,100% of total billed charges,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,5835,100,,,percent of total billed charges,100% of total billed charges,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,5835,100,,,percent of total billed charges,100% of total billed charges,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,3608.95,61.85,,,percent of total billed charges,61.85% of total billed charges,734.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,749.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,955.25,130,,,Fee Schedule,130% of WA Medicaid ,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2199.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2199.8,37.7,,,percent of total billed charges,37.70% of total billed charges,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,197806.5,33.9,,,percent of total billed charges,33.9% of total billed charges,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4551.3,78,,,percent of total billed charges,78% of total billed charges,5835,100,,,percent of total billed charges,100% of total billed charges,4819.71,82.6,,,percent of total billed charges,82.6% of total billed charges,4819.71,82.6,,,percent of total billed charges,82.6% of total billed charges,734.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,208.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,208.14,197806.5,
ART BYP AXILLARY-AXILLARY,35650,CDM,983,RC,35650,HCPCS,Outpatient,,,4725,3071.25,,4158,88,,,percent of total billed charges,88% of total Billed charges,159.18,100,,,Fee Schedule,100% of Medicare rate,550.18,100,,,Fee Schedule,100% of WA Medicaid,4725,100,,,percent of total billed charges,100% of total billed charges,566.69,103,,,Fee Schedule,103% of WA Medicaid,159.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,278.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,550.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3260.25,69,,,percent of total billed charges,69% of total billed charges,4725,100,,,percent of total billed charges,100% of total billed charges,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,4725,100,,,percent of total billed charges,100% of total billed charges,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,4725,100,,,percent of total billed charges,100% of total billed charges,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2922.41,61.85,,,percent of total billed charges,61.85% of total billed charges,550.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,715.23,130,,,Fee Schedule,130% of WA Medicaid ,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1781.33,37.7,,,percent of total billed charges,37.70% of total billed charges,1781.33,37.7,,,percent of total billed charges,37.70% of total billed charges,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,160177.5,33.9,,,percent of total billed charges,33.9% of total billed charges,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3685.5,78,,,percent of total billed charges,78% of total billed charges,4725,100,,,percent of total billed charges,100% of total billed charges,3902.85,82.6,,,percent of total billed charges,82.6% of total billed charges,3902.85,82.6,,,percent of total billed charges,82.6% of total billed charges,550.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,159.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,159.18,160177.5,
ART BYP FEMORAL-POPLITEAL,35656,CDM,983,RC,35656,HCPCS,Outpatient,,,5176,3364.40,,4554.88,88,,,percent of total billed charges,88% of total Billed charges,162.48,100,,,Fee Schedule,100% of Medicare rate,578.71,100,,,Fee Schedule,100% of WA Medicaid,5176,100,,,percent of total billed charges,100% of total billed charges,596.07,103,,,Fee Schedule,103% of WA Medicaid,162.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,284.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,578.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3571.44,69,,,percent of total billed charges,69% of total billed charges,5176,100,,,percent of total billed charges,100% of total billed charges,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5176,100,,,percent of total billed charges,100% of total billed charges,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5176,100,,,percent of total billed charges,100% of total billed charges,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3201.36,61.85,,,percent of total billed charges,61.85% of total billed charges,578.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,578.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,752.32,130,,,Fee Schedule,130% of WA Medicaid ,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1951.35,37.7,,,percent of total billed charges,37.70% of total billed charges,1951.35,37.7,,,percent of total billed charges,37.70% of total billed charges,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,175466.4,33.9,,,percent of total billed charges,33.9% of total billed charges,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4037.28,78,,,percent of total billed charges,78% of total billed charges,5176,100,,,percent of total billed charges,100% of total billed charges,4275.38,82.6,,,percent of total billed charges,82.6% of total billed charges,4275.38,82.6,,,percent of total billed charges,82.6% of total billed charges,578.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,162.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,578.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,162.48,175466.4,
ART BYP FEM-ANT-POST TIB/PRL,35666,CDM,983,RC,35666,HCPCS,Outpatient,,,5775,3753.75,,5082,88,,,percent of total billed charges,88% of total Billed charges,189.49,100,,,Fee Schedule,100% of Medicare rate,697.32,100,,,Fee Schedule,100% of WA Medicaid,5775,100,,,percent of total billed charges,100% of total billed charges,718.24,103,,,Fee Schedule,103% of WA Medicaid,189.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,331.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,697.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3984.75,69,,,percent of total billed charges,69% of total billed charges,5775,100,,,percent of total billed charges,100% of total billed charges,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,5775,100,,,percent of total billed charges,100% of total billed charges,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,5775,100,,,percent of total billed charges,100% of total billed charges,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3571.84,61.85,,,percent of total billed charges,61.85% of total billed charges,697.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,906.52,130,,,Fee Schedule,130% of WA Medicaid ,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2177.18,37.7,,,percent of total billed charges,37.70% of total billed charges,2177.18,37.7,,,percent of total billed charges,37.70% of total billed charges,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,195772.5,33.9,,,percent of total billed charges,33.9% of total billed charges,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4504.5,78,,,percent of total billed charges,78% of total billed charges,5775,100,,,percent of total billed charges,100% of total billed charges,4770.15,82.6,,,percent of total billed charges,82.6% of total billed charges,4770.15,82.6,,,percent of total billed charges,82.6% of total billed charges,697.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,189.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,189.49,195772.5,
ART BYP FEMORAL-FEMORAL,35661,CDM,983,RC,35661,HCPCS,Outpatient,,,4584,2979.60,,4033.92,88,,,percent of total billed charges,88% of total Billed charges,161.78,100,,,Fee Schedule,100% of Medicare rate,585.24,100,,,Fee Schedule,100% of WA Medicaid,4584,100,,,percent of total billed charges,100% of total billed charges,602.8,103,,,Fee Schedule,103% of WA Medicaid,161.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,283.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,585.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3162.96,69,,,percent of total billed charges,69% of total billed charges,4584,100,,,percent of total billed charges,100% of total billed charges,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,4584,100,,,percent of total billed charges,100% of total billed charges,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,4584,100,,,percent of total billed charges,100% of total billed charges,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2835.2,61.85,,,percent of total billed charges,61.85% of total billed charges,585.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,760.81,130,,,Fee Schedule,130% of WA Medicaid ,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1728.17,37.7,,,percent of total billed charges,37.70% of total billed charges,1728.17,37.7,,,percent of total billed charges,37.70% of total billed charges,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,155397.6,33.9,,,percent of total billed charges,33.9% of total billed charges,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,3575.52,78,,,percent of total billed charges,78% of total billed charges,4584,100,,,percent of total billed charges,100% of total billed charges,3786.38,82.6,,,percent of total billed charges,82.6% of total billed charges,3786.38,82.6,,,percent of total billed charges,82.6% of total billed charges,585.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,161.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,161.78,155397.6,
ART BYP ILIOFEMORAL,35665,CDM,983,RC,35665,HCPCS,Outpatient,,,5315,3454.75,,4677.2,88,,,percent of total billed charges,88% of total Billed charges,175.8,100,,,Fee Schedule,100% of Medicare rate,634.1,100,,,Fee Schedule,100% of WA Medicaid,5315,100,,,percent of total billed charges,100% of total billed charges,653.12,103,,,Fee Schedule,103% of WA Medicaid,175.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,307.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,634.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3667.35,69,,,percent of total billed charges,69% of total billed charges,5315,100,,,percent of total billed charges,100% of total billed charges,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,5315,100,,,percent of total billed charges,100% of total billed charges,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,5315,100,,,percent of total billed charges,100% of total billed charges,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3287.33,61.85,,,percent of total billed charges,61.85% of total billed charges,634.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,824.33,130,,,Fee Schedule,130% of WA Medicaid ,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2003.76,37.7,,,percent of total billed charges,37.70% of total billed charges,2003.76,37.7,,,percent of total billed charges,37.70% of total billed charges,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,180178.5,33.9,,,percent of total billed charges,33.9% of total billed charges,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,4145.7,78,,,percent of total billed charges,78% of total billed charges,5315,100,,,percent of total billed charges,100% of total billed charges,4390.19,82.6,,,percent of total billed charges,82.6% of total billed charges,4390.19,82.6,,,percent of total billed charges,82.6% of total billed charges,634.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,175.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,175.8,180178.5,
BYPASS GRAFT PATENCY/PATCH,35685,CDM,983,RC,35685,HCPCS,Outpatient,,,548.27,356.38,,482.48,88,,,percent of total billed charges,88% of total Billed charges,32.07,100,,,Fee Schedule,100% of Medicare rate,105.56,100,,,Fee Schedule,100% of WA Medicaid,548.27,100,,,percent of total billed charges,100% of total billed charges,108.73,103,,,Fee Schedule,103% of WA Medicaid,32.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,105.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,378.31,69,,,percent of total billed charges,69% of total billed charges,548.27,100,,,percent of total billed charges,100% of total billed charges,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.27,100,,,percent of total billed charges,100% of total billed charges,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.27,100,,,percent of total billed charges,100% of total billed charges,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.1,61.85,,,percent of total billed charges,61.85% of total billed charges,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,137.23,130,,,Fee Schedule,130% of WA Medicaid ,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.7,37.7,,,percent of total billed charges,37.70% of total billed charges,206.7,37.7,,,percent of total billed charges,37.70% of total billed charges,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,18586.35,33.9,,,percent of total billed charges,33.9% of total billed charges,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.65,78,,,percent of total billed charges,78% of total billed charges,548.27,100,,,percent of total billed charges,100% of total billed charges,452.87,82.6,,,percent of total billed charges,82.6% of total billed charges,452.87,82.6,,,percent of total billed charges,82.6% of total billed charges,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.07,18586.35,
COMPOSITE BYP GRFT 3/> SEGMT,35683,CDM,983,RC,35683,HCPCS,Outpatient,,,1725,1121.25,,1518,88,,,percent of total billed charges,88% of total Billed charges,66.32,100,,,Fee Schedule,100% of Medicare rate,217.83,100,,,Fee Schedule,100% of WA Medicaid,1725,100,,,percent of total billed charges,100% of total billed charges,224.36,103,,,Fee Schedule,103% of WA Medicaid,66.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,116.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,217.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1190.25,69,,,percent of total billed charges,69% of total billed charges,1725,100,,,percent of total billed charges,100% of total billed charges,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1725,100,,,percent of total billed charges,100% of total billed charges,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1725,100,,,percent of total billed charges,100% of total billed charges,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1066.91,61.85,,,percent of total billed charges,61.85% of total billed charges,217.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,283.18,130,,,Fee Schedule,130% of WA Medicaid ,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,650.33,37.7,,,percent of total billed charges,37.70% of total billed charges,650.33,37.7,,,percent of total billed charges,37.70% of total billed charges,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,58477.5,33.9,,,percent of total billed charges,33.9% of total billed charges,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1345.5,78,,,percent of total billed charges,78% of total billed charges,1725,100,,,percent of total billed charges,100% of total billed charges,1424.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1424.85,82.6,,,percent of total billed charges,82.6% of total billed charges,217.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,66.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.32,58477.5,
COMPOSITE BYP GRFT 2 VEINS,35682,CDM,983,RC,35682,HCPCS,Outpatient,,,1741,1131.65,,1532.08,88,,,percent of total billed charges,88% of total Billed charges,56.19,100,,,Fee Schedule,100% of Medicare rate,188.37,100,,,Fee Schedule,100% of WA Medicaid,1741,100,,,percent of total billed charges,100% of total billed charges,194.02,103,,,Fee Schedule,103% of WA Medicaid,56.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,98.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,188.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1201.29,69,,,percent of total billed charges,69% of total billed charges,1741,100,,,percent of total billed charges,100% of total billed charges,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1741,100,,,percent of total billed charges,100% of total billed charges,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1741,100,,,percent of total billed charges,100% of total billed charges,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1076.81,61.85,,,percent of total billed charges,61.85% of total billed charges,188.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,244.88,130,,,Fee Schedule,130% of WA Medicaid ,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,656.36,37.7,,,percent of total billed charges,37.70% of total billed charges,656.36,37.7,,,percent of total billed charges,37.70% of total billed charges,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,59019.9,33.9,,,percent of total billed charges,33.9% of total billed charges,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357.98,78,,,percent of total billed charges,78% of total billed charges,1741,100,,,percent of total billed charges,100% of total billed charges,1438.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1438.07,82.6,,,percent of total billed charges,82.6% of total billed charges,188.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.19,59019.9,
REIMPLANT ARTERY EACH,35697,CDM,983,RC,35697,HCPCS,Outpatient,,,629,408.85,,553.52,88,,,percent of total billed charges,88% of total Billed charges,23.35,100,,,Fee Schedule,100% of Medicare rate,78.14,100,,,Fee Schedule,100% of WA Medicaid,629,100,,,percent of total billed charges,100% of total billed charges,80.48,103,,,Fee Schedule,103% of WA Medicaid,23.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,78.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,434.01,69,,,percent of total billed charges,69% of total billed charges,629,100,,,percent of total billed charges,100% of total billed charges,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,629,100,,,percent of total billed charges,100% of total billed charges,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,629,100,,,percent of total billed charges,100% of total billed charges,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.04,61.85,,,percent of total billed charges,61.85% of total billed charges,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.58,130,,,Fee Schedule,130% of WA Medicaid ,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.13,37.7,,,percent of total billed charges,37.70% of total billed charges,237.13,37.7,,,percent of total billed charges,37.70% of total billed charges,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,21323.1,33.9,,,percent of total billed charges,33.9% of total billed charges,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.62,78,,,percent of total billed charges,78% of total billed charges,629,100,,,percent of total billed charges,100% of total billed charges,519.55,82.6,,,percent of total billed charges,82.6% of total billed charges,519.55,82.6,,,percent of total billed charges,82.6% of total billed charges,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.35,21323.1,
REOPERATION BYPASS GRAFT,35700,CDM,983,RC,35700,HCPCS,Outpatient,,,825,536.25,,726,88,,,percent of total billed charges,88% of total Billed charges,24.02,100,,,Fee Schedule,100% of Medicare rate,80.94,100,,,Fee Schedule,100% of WA Medicaid,825,100,,,percent of total billed charges,100% of total billed charges,83.37,103,,,Fee Schedule,103% of WA Medicaid,24.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,80.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,569.25,69,,,percent of total billed charges,69% of total billed charges,825,100,,,percent of total billed charges,100% of total billed charges,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,825,100,,,percent of total billed charges,100% of total billed charges,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,825,100,,,percent of total billed charges,100% of total billed charges,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.26,61.85,,,percent of total billed charges,61.85% of total billed charges,80.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,105.22,130,,,Fee Schedule,130% of WA Medicaid ,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.03,37.7,,,percent of total billed charges,37.70% of total billed charges,311.03,37.7,,,percent of total billed charges,37.70% of total billed charges,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,27967.5,33.9,,,percent of total billed charges,33.9% of total billed charges,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,643.5,78,,,percent of total billed charges,78% of total billed charges,825,100,,,percent of total billed charges,100% of total billed charges,681.45,82.6,,,percent of total billed charges,82.6% of total billed charges,681.45,82.6,,,percent of total billed charges,82.6% of total billed charges,80.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.02,27967.5,
EXPLORATION CAROTID ARTERY,35701,CDM,983,RC,35701,HCPCS,Outpatient,,,2149,1396.85,,1891.12,88,,,percent of total billed charges,88% of total Billed charges,46.42,100,,,Fee Schedule,100% of Medicare rate,245.43,100,,,Fee Schedule,100% of WA Medicaid,2149,100,,,percent of total billed charges,100% of total billed charges,252.79,103,,,Fee Schedule,103% of WA Medicaid,46.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,245.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1482.81,69,,,percent of total billed charges,69% of total billed charges,2149,100,,,percent of total billed charges,100% of total billed charges,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2149,100,,,percent of total billed charges,100% of total billed charges,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2149,100,,,percent of total billed charges,100% of total billed charges,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1329.16,61.85,,,percent of total billed charges,61.85% of total billed charges,245.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,319.06,130,,,Fee Schedule,130% of WA Medicaid ,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,810.17,37.7,,,percent of total billed charges,37.70% of total billed charges,810.17,37.7,,,percent of total billed charges,37.70% of total billed charges,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,72851.1,33.9,,,percent of total billed charges,33.9% of total billed charges,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1676.22,78,,,percent of total billed charges,78% of total billed charges,2149,100,,,percent of total billed charges,100% of total billed charges,1775.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1775.07,82.6,,,percent of total billed charges,82.6% of total billed charges,245.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.42,72851.1,
"Exploration not followed by surgical repair, artery; upper e",35702,CDM,983,RC,35702,HCPCS,Outpatient,,,1897,1233.05,,1669.36,88,,,percent of total billed charges,88% of total Billed charges,55.25,100,,,Fee Schedule,100% of Medicare rate,225.48,100,,,Fee Schedule,100% of WA Medicaid,1897,100,,,percent of total billed charges,100% of total billed charges,232.24,103,,,Fee Schedule,103% of WA Medicaid,55.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,96.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,225.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1308.93,69,,,percent of total billed charges,69% of total billed charges,1897,100,,,percent of total billed charges,100% of total billed charges,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1897,100,,,percent of total billed charges,100% of total billed charges,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1897,100,,,percent of total billed charges,100% of total billed charges,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1173.29,61.85,,,percent of total billed charges,61.85% of total billed charges,225.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,293.12,130,,,Fee Schedule,130% of WA Medicaid ,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,715.17,37.7,,,percent of total billed charges,37.70% of total billed charges,715.17,37.7,,,percent of total billed charges,37.70% of total billed charges,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,64308.3,33.9,,,percent of total billed charges,33.9% of total billed charges,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1479.66,78,,,percent of total billed charges,78% of total billed charges,1897,100,,,percent of total billed charges,100% of total billed charges,1566.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1566.92,82.6,,,percent of total billed charges,82.6% of total billed charges,225.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.25,64308.3,
"Exploration not followed by surgical repair, artery; lower e",35703,CDM,983,RC,35703,HCPCS,Outpatient,,,1577,1025.05,,1387.76,88,,,percent of total billed charges,88% of total Billed charges,58.47,100,,,Fee Schedule,100% of Medicare rate,227.16,100,,,Fee Schedule,100% of WA Medicaid,1577,100,,,percent of total billed charges,100% of total billed charges,233.97,103,,,Fee Schedule,103% of WA Medicaid,58.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,227.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1088.13,69,,,percent of total billed charges,69% of total billed charges,1577,100,,,percent of total billed charges,100% of total billed charges,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1577,100,,,percent of total billed charges,100% of total billed charges,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1577,100,,,percent of total billed charges,100% of total billed charges,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,975.37,61.85,,,percent of total billed charges,61.85% of total billed charges,227.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,295.31,130,,,Fee Schedule,130% of WA Medicaid ,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.53,37.7,,,percent of total billed charges,37.70% of total billed charges,594.53,37.7,,,percent of total billed charges,37.70% of total billed charges,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,53460.3,33.9,,,percent of total billed charges,33.9% of total billed charges,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1230.06,78,,,percent of total billed charges,78% of total billed charges,1577,100,,,percent of total billed charges,100% of total billed charges,1302.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1302.6,82.6,,,percent of total billed charges,82.6% of total billed charges,227.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.47,53460.3,
EXPLORE NECK VESSELS,35800,CDM,983,RC,35800,HCPCS,Outpatient,,,1875,1218.75,,1650,88,,,percent of total billed charges,88% of total Billed charges,82.45,100,,,Fee Schedule,100% of Medicare rate,412.17,100,,,Fee Schedule,100% of WA Medicaid,1875,100,,,percent of total billed charges,100% of total billed charges,424.54,103,,,Fee Schedule,103% of WA Medicaid,82.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,144.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,412.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1293.75,69,,,percent of total billed charges,69% of total billed charges,1875,100,,,percent of total billed charges,100% of total billed charges,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1875,100,,,percent of total billed charges,100% of total billed charges,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1875,100,,,percent of total billed charges,100% of total billed charges,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1159.69,61.85,,,percent of total billed charges,61.85% of total billed charges,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,535.82,130,,,Fee Schedule,130% of WA Medicaid ,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,706.88,37.7,,,percent of total billed charges,37.70% of total billed charges,706.88,37.7,,,percent of total billed charges,37.70% of total billed charges,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,63562.5,33.9,,,percent of total billed charges,33.9% of total billed charges,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1462.5,78,,,percent of total billed charges,78% of total billed charges,1875,100,,,percent of total billed charges,100% of total billed charges,1548.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1548.75,82.6,,,percent of total billed charges,82.6% of total billed charges,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.45,63562.5,
EXPLORE ABDOMINAL VESSELS,35840,CDM,983,RC,35840,HCPCS,Outpatient,,,2619,1702.35,,2304.72,88,,,percent of total billed charges,88% of total Billed charges,166.44,100,,,Fee Schedule,100% of Medicare rate,675.13,100,,,Fee Schedule,100% of WA Medicaid,2619,100,,,percent of total billed charges,100% of total billed charges,695.38,103,,,Fee Schedule,103% of WA Medicaid,166.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,291.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,675.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1807.11,69,,,percent of total billed charges,69% of total billed charges,2619,100,,,percent of total billed charges,100% of total billed charges,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2619,100,,,percent of total billed charges,100% of total billed charges,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2619,100,,,percent of total billed charges,100% of total billed charges,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1619.85,61.85,,,percent of total billed charges,61.85% of total billed charges,675.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,675.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,688.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,877.67,130,,,Fee Schedule,130% of WA Medicaid ,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,987.36,37.7,,,percent of total billed charges,37.70% of total billed charges,987.36,37.7,,,percent of total billed charges,37.70% of total billed charges,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,88784.1,33.9,,,percent of total billed charges,33.9% of total billed charges,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2042.82,78,,,percent of total billed charges,78% of total billed charges,2619,100,,,percent of total billed charges,100% of total billed charges,2163.29,82.6,,,percent of total billed charges,82.6% of total billed charges,2163.29,82.6,,,percent of total billed charges,82.6% of total billed charges,675.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,166.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,675.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,166.44,88784.1,
EXPLORE LIMB VESSELS,35860,CDM,983,RC,35860,HCPCS,Outpatient,,,2036,1323.40,,1791.68,88,,,percent of total billed charges,88% of total Billed charges,120.86,100,,,Fee Schedule,100% of Medicare rate,459.72,100,,,Fee Schedule,100% of WA Medicaid,2036,100,,,percent of total billed charges,100% of total billed charges,473.51,103,,,Fee Schedule,103% of WA Medicaid,120.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,211.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,459.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1404.84,69,,,percent of total billed charges,69% of total billed charges,2036,100,,,percent of total billed charges,100% of total billed charges,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2036,100,,,percent of total billed charges,100% of total billed charges,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2036,100,,,percent of total billed charges,100% of total billed charges,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259.27,61.85,,,percent of total billed charges,61.85% of total billed charges,459.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,597.64,130,,,Fee Schedule,130% of WA Medicaid ,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,767.57,37.7,,,percent of total billed charges,37.70% of total billed charges,767.57,37.7,,,percent of total billed charges,37.70% of total billed charges,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,69020.4,33.9,,,percent of total billed charges,33.9% of total billed charges,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1588.08,78,,,percent of total billed charges,78% of total billed charges,2036,100,,,percent of total billed charges,100% of total billed charges,1681.74,82.6,,,percent of total billed charges,82.6% of total billed charges,1681.74,82.6,,,percent of total billed charges,82.6% of total billed charges,459.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,120.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,120.86,69020.4,
REVISE GRAFT W/VEIN,35879,CDM,983,RC,35879,HCPCS,Outpatient,,,3699,2404.35,,3255.12,88,,,percent of total billed charges,88% of total Billed charges,138.99,100,,,Fee Schedule,100% of Medicare rate,497.77,100,,,Fee Schedule,100% of WA Medicaid,3699,100,,,percent of total billed charges,100% of total billed charges,512.7,103,,,Fee Schedule,103% of WA Medicaid,138.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,243.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,497.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2552.31,69,,,percent of total billed charges,69% of total billed charges,3699,100,,,percent of total billed charges,100% of total billed charges,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3699,100,,,percent of total billed charges,100% of total billed charges,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3699,100,,,percent of total billed charges,100% of total billed charges,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2287.83,61.85,,,percent of total billed charges,61.85% of total billed charges,497.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,647.1,130,,,Fee Schedule,130% of WA Medicaid ,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1394.52,37.7,,,percent of total billed charges,37.70% of total billed charges,1394.52,37.7,,,percent of total billed charges,37.70% of total billed charges,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,125396.1,33.9,,,percent of total billed charges,33.9% of total billed charges,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2885.22,78,,,percent of total billed charges,78% of total billed charges,3699,100,,,percent of total billed charges,100% of total billed charges,3055.37,82.6,,,percent of total billed charges,82.6% of total billed charges,3055.37,82.6,,,percent of total billed charges,82.6% of total billed charges,497.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,138.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,138.99,125396.1,
REMOVAL OF CLOT IN GRAFT,35876,CDM,983,RC,35876,HCPCS,Outpatient,,,3720,2418.00,,3273.6,88,,,percent of total billed charges,88% of total Billed charges,140.65,100,,,Fee Schedule,100% of Medicare rate,509.52,100,,,Fee Schedule,100% of WA Medicaid,3720,100,,,percent of total billed charges,100% of total billed charges,524.81,103,,,Fee Schedule,103% of WA Medicaid,140.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,246.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,509.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2566.8,69,,,percent of total billed charges,69% of total billed charges,3720,100,,,percent of total billed charges,100% of total billed charges,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3720,100,,,percent of total billed charges,100% of total billed charges,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3720,100,,,percent of total billed charges,100% of total billed charges,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2300.82,61.85,,,percent of total billed charges,61.85% of total billed charges,509.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,662.38,130,,,Fee Schedule,130% of WA Medicaid ,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1402.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1402.44,37.7,,,percent of total billed charges,37.70% of total billed charges,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,126108,33.9,,,percent of total billed charges,33.9% of total billed charges,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2901.6,78,,,percent of total billed charges,78% of total billed charges,3720,100,,,percent of total billed charges,100% of total billed charges,3072.72,82.6,,,percent of total billed charges,82.6% of total billed charges,3072.72,82.6,,,percent of total billed charges,82.6% of total billed charges,509.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,140.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.65,126108,
REMOVAL OF CLOT IN GRAFT,35875,CDM,983,RC,35875,HCPCS,Outpatient,,,2780,1807.00,,2446.4,88,,,percent of total billed charges,88% of total Billed charges,85.79,100,,,Fee Schedule,100% of Medicare rate,321.71,100,,,Fee Schedule,100% of WA Medicaid,2780,100,,,percent of total billed charges,100% of total billed charges,331.36,103,,,Fee Schedule,103% of WA Medicaid,85.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,150.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,321.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1918.2,69,,,percent of total billed charges,69% of total billed charges,2780,100,,,percent of total billed charges,100% of total billed charges,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2780,100,,,percent of total billed charges,100% of total billed charges,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2780,100,,,percent of total billed charges,100% of total billed charges,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1719.43,61.85,,,percent of total billed charges,61.85% of total billed charges,321.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,418.22,130,,,Fee Schedule,130% of WA Medicaid ,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1048.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1048.06,37.7,,,percent of total billed charges,37.70% of total billed charges,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,94242,33.9,,,percent of total billed charges,33.9% of total billed charges,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2168.4,78,,,percent of total billed charges,78% of total billed charges,2780,100,,,percent of total billed charges,100% of total billed charges,2296.28,82.6,,,percent of total billed charges,82.6% of total billed charges,2296.28,82.6,,,percent of total billed charges,82.6% of total billed charges,321.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.79,94242,
REVISE GRAFT W/NONAUTO GRAFT,35883,CDM,983,RC,35883,HCPCS,Outpatient,,,5150,3347.50,,4532,88,,,percent of total billed charges,88% of total Billed charges,183.1,100,,,Fee Schedule,100% of Medicare rate,644.17,100,,,Fee Schedule,100% of WA Medicaid,5150,100,,,percent of total billed charges,100% of total billed charges,663.5,103,,,Fee Schedule,103% of WA Medicaid,183.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,320.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,644.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3553.5,69,,,percent of total billed charges,69% of total billed charges,5150,100,,,percent of total billed charges,100% of total billed charges,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,5150,100,,,percent of total billed charges,100% of total billed charges,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,5150,100,,,percent of total billed charges,100% of total billed charges,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,3185.28,61.85,,,percent of total billed charges,61.85% of total billed charges,644.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,644.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,657.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,837.42,130,,,Fee Schedule,130% of WA Medicaid ,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1941.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1941.55,37.7,,,percent of total billed charges,37.70% of total billed charges,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,174585,33.9,,,percent of total billed charges,33.9% of total billed charges,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4017,78,,,percent of total billed charges,78% of total billed charges,5150,100,,,percent of total billed charges,100% of total billed charges,4253.9,82.6,,,percent of total billed charges,82.6% of total billed charges,4253.9,82.6,,,percent of total billed charges,82.6% of total billed charges,644.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,183.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,644.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,183.1,174585,
REVISE GRAFT W/VEIN,35881,CDM,983,RC,35881,HCPCS,Outpatient,,,4358,2832.70,,3835.04,88,,,percent of total billed charges,88% of total Billed charges,153.79,100,,,Fee Schedule,100% of Medicare rate,556.89,100,,,Fee Schedule,100% of WA Medicaid,4358,100,,,percent of total billed charges,100% of total billed charges,573.6,103,,,Fee Schedule,103% of WA Medicaid,153.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,269.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,556.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3007.02,69,,,percent of total billed charges,69% of total billed charges,4358,100,,,percent of total billed charges,100% of total billed charges,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,4358,100,,,percent of total billed charges,100% of total billed charges,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,4358,100,,,percent of total billed charges,100% of total billed charges,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2695.42,61.85,,,percent of total billed charges,61.85% of total billed charges,556.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,568.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,723.96,130,,,Fee Schedule,130% of WA Medicaid ,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1642.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1642.97,37.7,,,percent of total billed charges,37.70% of total billed charges,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,147736.2,33.9,,,percent of total billed charges,33.9% of total billed charges,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3399.24,78,,,percent of total billed charges,78% of total billed charges,4358,100,,,percent of total billed charges,100% of total billed charges,3599.71,82.6,,,percent of total billed charges,82.6% of total billed charges,3599.71,82.6,,,percent of total billed charges,82.6% of total billed charges,556.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,153.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,153.79,147736.2,
REVISE GRAFT W/VEIN,35884,CDM,983,RC,35884,HCPCS,Outpatient,,,5282,3433.30,,4648.16,88,,,percent of total billed charges,88% of total Billed charges,194.66,100,,,Fee Schedule,100% of Medicare rate,666.18,100,,,Fee Schedule,100% of WA Medicaid,5282,100,,,percent of total billed charges,100% of total billed charges,686.17,103,,,Fee Schedule,103% of WA Medicaid,194.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,340.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,666.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3644.58,69,,,percent of total billed charges,69% of total billed charges,5282,100,,,percent of total billed charges,100% of total billed charges,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,5282,100,,,percent of total billed charges,100% of total billed charges,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,5282,100,,,percent of total billed charges,100% of total billed charges,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,3266.92,61.85,,,percent of total billed charges,61.85% of total billed charges,666.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,666.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,679.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,866.03,130,,,Fee Schedule,130% of WA Medicaid ,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1991.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1991.31,37.7,,,percent of total billed charges,37.70% of total billed charges,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,179059.8,33.9,,,percent of total billed charges,33.9% of total billed charges,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,4119.96,78,,,percent of total billed charges,78% of total billed charges,5282,100,,,percent of total billed charges,100% of total billed charges,4362.93,82.6,,,percent of total billed charges,82.6% of total billed charges,4362.93,82.6,,,percent of total billed charges,82.6% of total billed charges,666.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,194.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,666.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,194.66,179059.8,
EXCISION GRAFT EXTREMITY,35903,CDM,983,RC,35903,HCPCS,Outpatient,,,2687,1746.55,,2364.56,88,,,percent of total billed charges,88% of total Billed charges,77.62,100,,,Fee Schedule,100% of Medicare rate,310.15,100,,,Fee Schedule,100% of WA Medicaid,2687,100,,,percent of total billed charges,100% of total billed charges,319.45,103,,,Fee Schedule,103% of WA Medicaid,77.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,310.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1854.03,69,,,percent of total billed charges,69% of total billed charges,2687,100,,,percent of total billed charges,100% of total billed charges,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2687,100,,,percent of total billed charges,100% of total billed charges,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2687,100,,,percent of total billed charges,100% of total billed charges,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1661.91,61.85,,,percent of total billed charges,61.85% of total billed charges,310.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,403.2,130,,,Fee Schedule,130% of WA Medicaid ,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1013,37.7,,,percent of total billed charges,37.70% of total billed charges,1013,37.7,,,percent of total billed charges,37.70% of total billed charges,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,91089.3,33.9,,,percent of total billed charges,33.9% of total billed charges,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2095.86,78,,,percent of total billed charges,78% of total billed charges,2687,100,,,percent of total billed charges,100% of total billed charges,2219.46,82.6,,,percent of total billed charges,82.6% of total billed charges,2219.46,82.6,,,percent of total billed charges,82.6% of total billed charges,310.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.62,91089.3,
EXCISION GRAFT ABDOMEN,35907,CDM,983,RC,35907,HCPCS,Outpatient,,,7887,5126.55,,6940.56,88,,,percent of total billed charges,88% of total Billed charges,295.54,100,,,Fee Schedule,100% of Medicare rate,1027.43,100,,,Fee Schedule,100% of WA Medicaid,7887,100,,,percent of total billed charges,100% of total billed charges,1058.25,103,,,Fee Schedule,103% of WA Medicaid,295.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,517.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1027.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5442.03,69,,,percent of total billed charges,69% of total billed charges,7887,100,,,percent of total billed charges,100% of total billed charges,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,7887,100,,,percent of total billed charges,100% of total billed charges,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,7887,100,,,percent of total billed charges,100% of total billed charges,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,4878.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1027.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1027.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1047.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1335.66,130,,,Fee Schedule,130% of WA Medicaid ,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2973.4,37.7,,,percent of total billed charges,37.70% of total billed charges,2973.4,37.7,,,percent of total billed charges,37.70% of total billed charges,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,267369.3,33.9,,,percent of total billed charges,33.9% of total billed charges,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,6151.86,78,,,percent of total billed charges,78% of total billed charges,7887,100,,,percent of total billed charges,100% of total billed charges,6514.66,82.6,,,percent of total billed charges,82.6% of total billed charges,6514.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1027.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,295.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1027.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,295.54,267369.3,
EXCISION GRAFT THORAX,35905,CDM,983,RC,35905,HCPCS,Outpatient,,,6939,4510.35,,6106.32,88,,,percent of total billed charges,88% of total Billed charges,264.56,100,,,Fee Schedule,100% of Medicare rate,902.66,100,,,Fee Schedule,100% of WA Medicaid,6939,100,,,percent of total billed charges,100% of total billed charges,929.74,103,,,Fee Schedule,103% of WA Medicaid,264.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,462.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,902.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4787.91,69,,,percent of total billed charges,69% of total billed charges,6939,100,,,percent of total billed charges,100% of total billed charges,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,6939,100,,,percent of total billed charges,100% of total billed charges,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,6939,100,,,percent of total billed charges,100% of total billed charges,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4291.77,61.85,,,percent of total billed charges,61.85% of total billed charges,902.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,920.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1173.46,130,,,Fee Schedule,130% of WA Medicaid ,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2616,37.7,,,percent of total billed charges,37.70% of total billed charges,2616,37.7,,,percent of total billed charges,37.70% of total billed charges,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,235232.1,33.9,,,percent of total billed charges,33.9% of total billed charges,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,5412.42,78,,,percent of total billed charges,78% of total billed charges,6939,100,,,percent of total billed charges,100% of total billed charges,5731.61,82.6,,,percent of total billed charges,82.6% of total billed charges,5731.61,82.6,,,percent of total billed charges,82.6% of total billed charges,902.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,264.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,264.56,235232.1,
PLACE NEEDLE IN VEIN,36000,CDM,983,RC,36000,HCPCS,Outpatient,,,95,61.75,,83.6,88,,,percent of total billed charges,88% of total Billed charges,0.79,100,,,Fee Schedule,100% of Medicare rate,5.04,100,,,Fee Schedule,100% of WA Medicaid,95,100,,,percent of total billed charges,100% of total billed charges,5.19,103,,,Fee Schedule,103% of WA Medicaid,0.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,5.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,65.55,69,,,percent of total billed charges,69% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,95,100,,,percent of total billed charges,100% of total billed charges,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,95,100,,,percent of total billed charges,100% of total billed charges,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.76,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.55,130,,,Fee Schedule,130% of WA Medicaid ,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.82,37.7,,,percent of total billed charges,37.70% of total billed charges,35.82,37.7,,,percent of total billed charges,37.70% of total billed charges,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3220.5,33.9,,,percent of total billed charges,33.9% of total billed charges,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.1,78,,,percent of total billed charges,78% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.79,3220.5,
PSEUDOANEURYSM INJECTION TRT,36002,CDM,983,RC,36002,HCPCS,Outpatient,,,448,291.20,,394.24,88,,,percent of total billed charges,88% of total Billed charges,11.08,100,,,Fee Schedule,100% of Medicare rate,57.44,100,,,Fee Schedule,100% of WA Medicaid,448,100,,,percent of total billed charges,100% of total billed charges,59.16,103,,,Fee Schedule,103% of WA Medicaid,11.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,57.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,309.12,69,,,percent of total billed charges,69% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,448,100,,,percent of total billed charges,100% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,448,100,,,percent of total billed charges,100% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.09,61.85,,,percent of total billed charges,61.85% of total billed charges,57.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,74.67,130,,,Fee Schedule,130% of WA Medicaid ,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,168.9,37.7,,,percent of total billed charges,37.70% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,15187.2,33.9,,,percent of total billed charges,33.9% of total billed charges,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.44,78,,,percent of total billed charges,78% of total billed charges,448,100,,,percent of total billed charges,100% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,370.05,82.6,,,percent of total billed charges,82.6% of total billed charges,57.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.08,15187.2,
INJECTION EXT VENOGRAPHY,36005,CDM,983,RC,36005,HCPCS,Outpatient,,,459,298.35,,403.92,88,,,percent of total billed charges,88% of total Billed charges,5.52,100,,,Fee Schedule,100% of Medicare rate,25.92,100,,,Fee Schedule,100% of WA Medicaid,459,100,,,percent of total billed charges,100% of total billed charges,26.7,103,,,Fee Schedule,103% of WA Medicaid,5.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,316.71,69,,,percent of total billed charges,69% of total billed charges,459,100,,,percent of total billed charges,100% of total billed charges,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,459,100,,,percent of total billed charges,100% of total billed charges,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,459,100,,,percent of total billed charges,100% of total billed charges,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.89,61.85,,,percent of total billed charges,61.85% of total billed charges,25.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.7,130,,,Fee Schedule,130% of WA Medicaid ,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.04,37.7,,,percent of total billed charges,37.70% of total billed charges,173.04,37.7,,,percent of total billed charges,37.70% of total billed charges,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,15560.1,33.9,,,percent of total billed charges,33.9% of total billed charges,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.02,78,,,percent of total billed charges,78% of total billed charges,459,100,,,percent of total billed charges,100% of total billed charges,379.13,82.6,,,percent of total billed charges,82.6% of total billed charges,379.13,82.6,,,percent of total billed charges,82.6% of total billed charges,25.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.52,15560.1,
PLACE CATHETER IN VEIN,36011,CDM,983,RC,36011,HCPCS,Outpatient,,,1384,899.60,,1217.92,88,,,percent of total billed charges,88% of total Billed charges,17.99,100,,,Fee Schedule,100% of Medicare rate,84.86,100,,,Fee Schedule,100% of WA Medicaid,1384,100,,,percent of total billed charges,100% of total billed charges,87.41,103,,,Fee Schedule,103% of WA Medicaid,17.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,84.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,954.96,69,,,percent of total billed charges,69% of total billed charges,1384,100,,,percent of total billed charges,100% of total billed charges,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1384,100,,,percent of total billed charges,100% of total billed charges,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1384,100,,,percent of total billed charges,100% of total billed charges,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,856,61.85,,,percent of total billed charges,61.85% of total billed charges,84.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,110.32,130,,,Fee Schedule,130% of WA Medicaid ,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,521.77,37.7,,,percent of total billed charges,37.70% of total billed charges,521.77,37.7,,,percent of total billed charges,37.70% of total billed charges,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,46917.6,33.9,,,percent of total billed charges,33.9% of total billed charges,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079.52,78,,,percent of total billed charges,78% of total billed charges,1384,100,,,percent of total billed charges,100% of total billed charges,1143.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1143.18,82.6,,,percent of total billed charges,82.6% of total billed charges,84.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.99,46917.6,
PLACE CATHETER IN VEIN,36012,CDM,983,RC,36012,HCPCS,Outpatient,,,1106,718.90,,973.28,88,,,percent of total billed charges,88% of total Billed charges,19.8,100,,,Fee Schedule,100% of Medicare rate,94.56,100,,,Fee Schedule,100% of WA Medicaid,1106,100,,,percent of total billed charges,100% of total billed charges,97.4,103,,,Fee Schedule,103% of WA Medicaid,19.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,94.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,763.14,69,,,percent of total billed charges,69% of total billed charges,1106,100,,,percent of total billed charges,100% of total billed charges,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1106,100,,,percent of total billed charges,100% of total billed charges,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1106,100,,,percent of total billed charges,100% of total billed charges,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,684.06,61.85,,,percent of total billed charges,61.85% of total billed charges,94.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,122.93,130,,,Fee Schedule,130% of WA Medicaid ,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.96,37.7,,,percent of total billed charges,37.70% of total billed charges,416.96,37.7,,,percent of total billed charges,37.70% of total billed charges,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,37493.4,33.9,,,percent of total billed charges,33.9% of total billed charges,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,862.68,78,,,percent of total billed charges,78% of total billed charges,1106,100,,,percent of total billed charges,100% of total billed charges,913.56,82.6,,,percent of total billed charges,82.6% of total billed charges,913.56,82.6,,,percent of total billed charges,82.6% of total billed charges,94.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,20,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.8,37493.4,
PLACE CATHETER IN ARTERY,36015,CDM,983,RC,36015,HCPCS,Outpatient,,,449,291.85,,395.12,88,,,percent of total billed charges,88% of total Billed charges,16.38,100,,,Fee Schedule,100% of Medicare rate,93.62,100,,,Fee Schedule,100% of WA Medicaid,449,100,,,percent of total billed charges,100% of total billed charges,96.43,103,,,Fee Schedule,103% of WA Medicaid,16.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,93.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,309.81,69,,,percent of total billed charges,69% of total billed charges,449,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,449,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,449,100,,,percent of total billed charges,100% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.71,61.85,,,percent of total billed charges,61.85% of total billed charges,93.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,121.71,130,,,Fee Schedule,130% of WA Medicaid ,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.27,37.7,,,percent of total billed charges,37.70% of total billed charges,169.27,37.7,,,percent of total billed charges,37.70% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,15221.1,33.9,,,percent of total billed charges,33.9% of total billed charges,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.22,78,,,percent of total billed charges,78% of total billed charges,449,100,,,percent of total billed charges,100% of total billed charges,370.87,82.6,,,percent of total billed charges,82.6% of total billed charges,370.87,82.6,,,percent of total billed charges,82.6% of total billed charges,93.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.38,15221.1,
PLACE CATHETER IN ARTERY,36014,CDM,983,RC,36014,HCPCS,Outpatient,,,402,261.30,,353.76,88,,,percent of total billed charges,88% of total Billed charges,16.82,100,,,Fee Schedule,100% of Medicare rate,82.43,100,,,Fee Schedule,100% of WA Medicaid,402,100,,,percent of total billed charges,100% of total billed charges,84.9,103,,,Fee Schedule,103% of WA Medicaid,16.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,82.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,277.38,69,,,percent of total billed charges,69% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,402,100,,,percent of total billed charges,100% of total billed charges,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,402,100,,,percent of total billed charges,100% of total billed charges,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.64,61.85,,,percent of total billed charges,61.85% of total billed charges,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.16,130,,,Fee Schedule,130% of WA Medicaid ,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,151.55,37.7,,,percent of total billed charges,37.70% of total billed charges,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,13627.8,33.9,,,percent of total billed charges,33.9% of total billed charges,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.56,78,,,percent of total billed charges,78% of total billed charges,402,100,,,percent of total billed charges,100% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,332.05,82.6,,,percent of total billed charges,82.6% of total billed charges,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.82,13627.8,
PLACE CATHETER IN VEIN,36010,CDM,983,RC,36010,HCPCS,Outpatient,,,477,310.05,,419.76,88,,,percent of total billed charges,88% of total Billed charges,13.5,100,,,Fee Schedule,100% of Medicare rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,477,100,,,percent of total billed charges,100% of total billed charges,60.7,103,,,Fee Schedule,103% of WA Medicaid,13.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,329.13,69,,,percent of total billed charges,69% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,477,100,,,percent of total billed charges,100% of total billed charges,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,477,100,,,percent of total billed charges,100% of total billed charges,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.02,61.85,,,percent of total billed charges,61.85% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.61,130,,,Fee Schedule,130% of WA Medicaid ,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,16170.3,33.9,,,percent of total billed charges,33.9% of total billed charges,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.06,78,,,percent of total billed charges,78% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.5,16170.3,
ESTABLISH ACCESS TO ARTERY,36100,CDM,983,RC,36100,HCPCS,Outpatient,,,618,401.70,,543.84,88,,,percent of total billed charges,88% of total Billed charges,23.28,100,,,Fee Schedule,100% of Medicare rate,81.87,100,,,Fee Schedule,100% of WA Medicaid,618,100,,,percent of total billed charges,100% of total billed charges,84.33,103,,,Fee Schedule,103% of WA Medicaid,23.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,81.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,426.42,69,,,percent of total billed charges,69% of total billed charges,618,100,,,percent of total billed charges,100% of total billed charges,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,618,100,,,percent of total billed charges,100% of total billed charges,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,618,100,,,percent of total billed charges,100% of total billed charges,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.23,61.85,,,percent of total billed charges,61.85% of total billed charges,81.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,106.43,130,,,Fee Schedule,130% of WA Medicaid ,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.99,37.7,,,percent of total billed charges,37.70% of total billed charges,232.99,37.7,,,percent of total billed charges,37.70% of total billed charges,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,20950.2,33.9,,,percent of total billed charges,33.9% of total billed charges,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.04,78,,,percent of total billed charges,78% of total billed charges,618,100,,,percent of total billed charges,100% of total billed charges,510.47,82.6,,,percent of total billed charges,82.6% of total billed charges,510.47,82.6,,,percent of total billed charges,82.6% of total billed charges,81.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.28,20950.2,
ESTABLISH ACCESS TO ARTERY,36120,CDM,983,RC,,,Outpatient,,,273,177.45,,240.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,273,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,188.37,69,,,percent of total billed charges,69% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,273,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,273,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,168.85,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,102.92,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,9254.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,212.94,78,,,percent of total billed charges,78% of total billed charges,273,100,,,percent of total billed charges,100% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,225.5,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",102.92,9254.7,
ACCESS AV DIAL GRFT FOR EVAL,36147,CDM,983,RC,,,Outpatient,,,1338,869.70,,1177.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1338,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,923.22,69,,,percent of total billed charges,69% of total billed charges,1338,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1338,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1338,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,827.55,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,504.43,37.7,,,percent of total billed charges,37.70% of total billed charges,504.43,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,45358.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1043.64,78,,,percent of total billed charges,78% of total billed charges,1338,100,,,percent of total billed charges,100% of total billed charges,1105.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1105.19,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",504.43,45358.2,
ESTABLISH ACCESS TO ARTERY,36140,CDM,983,RC,36140,HCPCS,Outpatient,,,693,450.45,,609.84,88,,,percent of total billed charges,88% of total Billed charges,11.89,100,,,Fee Schedule,100% of Medicare rate,48.12,100,,,Fee Schedule,100% of WA Medicaid,693,100,,,percent of total billed charges,100% of total billed charges,49.56,103,,,Fee Schedule,103% of WA Medicaid,11.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,478.17,69,,,percent of total billed charges,69% of total billed charges,693,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,693,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,693,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.62,61.85,,,percent of total billed charges,61.85% of total billed charges,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.56,130,,,Fee Schedule,130% of WA Medicaid ,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.26,37.7,,,percent of total billed charges,37.70% of total billed charges,261.26,37.7,,,percent of total billed charges,37.70% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,23492.7,33.9,,,percent of total billed charges,33.9% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,540.54,78,,,percent of total billed charges,78% of total billed charges,693,100,,,percent of total billed charges,100% of total billed charges,572.42,82.6,,,percent of total billed charges,82.6% of total billed charges,572.42,82.6,,,percent of total billed charges,82.6% of total billed charges,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.89,23492.7,
ACCESS AV DIAL GRFT FOR PROC,36148,CDM,983,RC,,,Outpatient,,,422,274.30,,371.36,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,422,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,291.18,69,,,percent of total billed charges,69% of total billed charges,422,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,422,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,422,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,261.01,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,159.09,37.7,,,percent of total billed charges,37.70% of total billed charges,159.09,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,14305.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,329.16,78,,,percent of total billed charges,78% of total billed charges,422,100,,,percent of total billed charges,100% of total billed charges,348.57,82.6,,,percent of total billed charges,82.6% of total billed charges,348.57,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",159.09,14305.8,
PLACE CATHETER IN AORTA,36200,CDM,983,RC,36200,HCPCS,Outpatient,,,918,596.70,,807.84,88,,,percent of total billed charges,88% of total Billed charges,19.81,100,,,Fee Schedule,100% of Medicare rate,75.16,100,,,Fee Schedule,100% of WA Medicaid,918,100,,,percent of total billed charges,100% of total billed charges,77.41,103,,,Fee Schedule,103% of WA Medicaid,19.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,75.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,633.42,69,,,percent of total billed charges,69% of total billed charges,918,100,,,percent of total billed charges,100% of total billed charges,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,918,100,,,percent of total billed charges,100% of total billed charges,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,918,100,,,percent of total billed charges,100% of total billed charges,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,567.78,61.85,,,percent of total billed charges,61.85% of total billed charges,75.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,97.71,130,,,Fee Schedule,130% of WA Medicaid ,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.09,37.7,,,percent of total billed charges,37.70% of total billed charges,346.09,37.7,,,percent of total billed charges,37.70% of total billed charges,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,31120.2,33.9,,,percent of total billed charges,33.9% of total billed charges,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,716.04,78,,,percent of total billed charges,78% of total billed charges,918,100,,,percent of total billed charges,100% of total billed charges,758.27,82.6,,,percent of total billed charges,82.6% of total billed charges,758.27,82.6,,,percent of total billed charges,82.6% of total billed charges,75.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.81,31120.2,
PLACE CATHETER IN ARTERY,36218,CDM,983,RC,36218,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,6.96,100,,,Fee Schedule,100% of Medicare rate,28.53,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,29.39,103,,,Fee Schedule,103% of WA Medicaid,6.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,194,100,,,percent of total billed charges,100% of total billed charges,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,194,100,,,percent of total billed charges,100% of total billed charges,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.99,61.85,,,percent of total billed charges,61.85% of total billed charges,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.09,130,,,Fee Schedule,130% of WA Medicaid ,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,6576.6,33.9,,,percent of total billed charges,33.9% of total billed charges,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.96,6576.6,
PLACE CATHETER IN ARTERY,36216,CDM,983,RC,36216,HCPCS,Outpatient,,,1006,653.90,,885.28,88,,,percent of total billed charges,88% of total Billed charges,36.12,100,,,Fee Schedule,100% of Medicare rate,147.89,100,,,Fee Schedule,100% of WA Medicaid,1006,100,,,percent of total billed charges,100% of total billed charges,152.33,103,,,Fee Schedule,103% of WA Medicaid,36.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,147.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,694.14,69,,,percent of total billed charges,69% of total billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1006,100,,,percent of total billed charges,100% of total billed charges,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1006,100,,,percent of total billed charges,100% of total billed charges,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.21,61.85,,,percent of total billed charges,61.85% of total billed charges,147.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,192.26,130,,,Fee Schedule,130% of WA Medicaid ,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.26,37.7,,,percent of total billed charges,37.70% of total billed charges,379.26,37.7,,,percent of total billed charges,37.70% of total billed charges,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,34103.4,33.9,,,percent of total billed charges,33.9% of total billed charges,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,784.68,78,,,percent of total billed charges,78% of total billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,830.96,82.6,,,percent of total billed charges,82.6% of total billed charges,830.96,82.6,,,percent of total billed charges,82.6% of total billed charges,147.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.12,34103.4,
PLACE CATHETER IN ARTERY,36215,CDM,983,RC,36215,HCPCS,Outpatient,,,894,581.10,,786.72,88,,,percent of total billed charges,88% of total Billed charges,21.73,100,,,Fee Schedule,100% of Medicare rate,116.56,100,,,Fee Schedule,100% of WA Medicaid,894,100,,,percent of total billed charges,100% of total billed charges,120.06,103,,,Fee Schedule,103% of WA Medicaid,21.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,116.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,616.86,69,,,percent of total billed charges,69% of total billed charges,894,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,894,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,894,100,,,percent of total billed charges,100% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.94,61.85,,,percent of total billed charges,61.85% of total billed charges,116.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,151.53,130,,,Fee Schedule,130% of WA Medicaid ,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.04,37.7,,,percent of total billed charges,37.70% of total billed charges,337.04,37.7,,,percent of total billed charges,37.70% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,30306.6,33.9,,,percent of total billed charges,33.9% of total billed charges,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.32,78,,,percent of total billed charges,78% of total billed charges,894,100,,,percent of total billed charges,100% of total billed charges,738.44,82.6,,,percent of total billed charges,82.6% of total billed charges,738.44,82.6,,,percent of total billed charges,82.6% of total billed charges,116.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.73,30306.6,
PLACE CATHETER IN ARTERY,36217,CDM,983,RC,36217,HCPCS,Outpatient,,,1214,789.10,,1068.32,88,,,percent of total billed charges,88% of total Billed charges,47.47,100,,,Fee Schedule,100% of Medicare rate,181.09,100,,,Fee Schedule,100% of WA Medicaid,1214,100,,,percent of total billed charges,100% of total billed charges,186.52,103,,,Fee Schedule,103% of WA Medicaid,47.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,181.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,837.66,69,,,percent of total billed charges,69% of total billed charges,1214,100,,,percent of total billed charges,100% of total billed charges,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1214,100,,,percent of total billed charges,100% of total billed charges,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1214,100,,,percent of total billed charges,100% of total billed charges,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,750.86,61.85,,,percent of total billed charges,61.85% of total billed charges,181.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,235.42,130,,,Fee Schedule,130% of WA Medicaid ,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.68,37.7,,,percent of total billed charges,37.70% of total billed charges,457.68,37.7,,,percent of total billed charges,37.70% of total billed charges,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,41154.6,33.9,,,percent of total billed charges,33.9% of total billed charges,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,946.92,78,,,percent of total billed charges,78% of total billed charges,1214,100,,,percent of total billed charges,100% of total billed charges,1002.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1002.76,82.6,,,percent of total billed charges,82.6% of total billed charges,181.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.47,41154.6,
PLACE CATH CAROTID/INOM ART,36222,CDM,983,RC,36222,HCPCS,Outpatient,,,1070,695.50,,941.6,88,,,percent of total billed charges,88% of total Billed charges,41.98,100,,,Fee Schedule,100% of Medicare rate,155.73,100,,,Fee Schedule,100% of WA Medicaid,1070,100,,,percent of total billed charges,100% of total billed charges,160.4,103,,,Fee Schedule,103% of WA Medicaid,41.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,155.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,738.3,69,,,percent of total billed charges,69% of total billed charges,1070,100,,,percent of total billed charges,100% of total billed charges,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1070,100,,,percent of total billed charges,100% of total billed charges,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1070,100,,,percent of total billed charges,100% of total billed charges,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,661.8,61.85,,,percent of total billed charges,61.85% of total billed charges,155.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,202.45,130,,,Fee Schedule,130% of WA Medicaid ,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.39,37.7,,,percent of total billed charges,37.70% of total billed charges,403.39,37.7,,,percent of total billed charges,37.70% of total billed charges,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,36273,33.9,,,percent of total billed charges,33.9% of total billed charges,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,834.6,78,,,percent of total billed charges,78% of total billed charges,1070,100,,,percent of total billed charges,100% of total billed charges,883.82,82.6,,,percent of total billed charges,82.6% of total billed charges,883.82,82.6,,,percent of total billed charges,82.6% of total billed charges,155.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.98,36273,
PLACE CATH CAROTID/INOM ART,36223,CDM,983,RC,36223,HCPCS,Outpatient,,,1156,751.40,,1017.28,88,,,percent of total billed charges,88% of total Billed charges,52.06,100,,,Fee Schedule,100% of Medicare rate,179.6,100,,,Fee Schedule,100% of WA Medicaid,1156,100,,,percent of total billed charges,100% of total billed charges,184.99,103,,,Fee Schedule,103% of WA Medicaid,52.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,91.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,179.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,797.64,69,,,percent of total billed charges,69% of total billed charges,1156,100,,,percent of total billed charges,100% of total billed charges,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1156,100,,,percent of total billed charges,100% of total billed charges,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1156,100,,,percent of total billed charges,100% of total billed charges,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.99,61.85,,,percent of total billed charges,61.85% of total billed charges,179.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,233.48,130,,,Fee Schedule,130% of WA Medicaid ,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.81,37.7,,,percent of total billed charges,37.70% of total billed charges,435.81,37.7,,,percent of total billed charges,37.70% of total billed charges,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,39188.4,33.9,,,percent of total billed charges,33.9% of total billed charges,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,901.68,78,,,percent of total billed charges,78% of total billed charges,1156,100,,,percent of total billed charges,100% of total billed charges,954.86,82.6,,,percent of total billed charges,82.6% of total billed charges,954.86,82.6,,,percent of total billed charges,82.6% of total billed charges,179.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.06,39188.4,
PLACE CATH SUBCLAVIAN ART,36225,CDM,983,RC,36225,HCPCS,Outpatient,,,1152,748.80,,1013.76,88,,,percent of total billed charges,88% of total Billed charges,51.72,100,,,Fee Schedule,100% of Medicare rate,178.11,100,,,Fee Schedule,100% of WA Medicaid,1152,100,,,percent of total billed charges,100% of total billed charges,183.45,103,,,Fee Schedule,103% of WA Medicaid,51.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,178.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,794.88,69,,,percent of total billed charges,69% of total billed charges,1152,100,,,percent of total billed charges,100% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152,100,,,percent of total billed charges,100% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152,100,,,percent of total billed charges,100% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.51,61.85,,,percent of total billed charges,61.85% of total billed charges,178.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,231.54,130,,,Fee Schedule,130% of WA Medicaid ,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.3,37.7,,,percent of total billed charges,37.70% of total billed charges,434.3,37.7,,,percent of total billed charges,37.70% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,39052.8,33.9,,,percent of total billed charges,33.9% of total billed charges,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,898.56,78,,,percent of total billed charges,78% of total billed charges,1152,100,,,percent of total billed charges,100% of total billed charges,951.55,82.6,,,percent of total billed charges,82.6% of total billed charges,951.55,82.6,,,percent of total billed charges,82.6% of total billed charges,178.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.72,39052.8,
PLACE CATH THORACIC AORTA,36221,CDM,983,RC,36221,HCPCS,Outpatient,,,791,514.15,,696.08,88,,,percent of total billed charges,88% of total Billed charges,28.56,100,,,Fee Schedule,100% of Medicare rate,107.98,100,,,Fee Schedule,100% of WA Medicaid,791,100,,,percent of total billed charges,100% of total billed charges,111.22,103,,,Fee Schedule,103% of WA Medicaid,28.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,107.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,545.79,69,,,percent of total billed charges,69% of total billed charges,791,100,,,percent of total billed charges,100% of total billed charges,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,791,100,,,percent of total billed charges,100% of total billed charges,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,791,100,,,percent of total billed charges,100% of total billed charges,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.23,61.85,,,percent of total billed charges,61.85% of total billed charges,107.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,140.37,130,,,Fee Schedule,130% of WA Medicaid ,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.21,37.7,,,percent of total billed charges,37.70% of total billed charges,298.21,37.7,,,percent of total billed charges,37.70% of total billed charges,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,26814.9,33.9,,,percent of total billed charges,33.9% of total billed charges,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,616.98,78,,,percent of total billed charges,78% of total billed charges,791,100,,,percent of total billed charges,100% of total billed charges,653.37,82.6,,,percent of total billed charges,82.6% of total billed charges,653.37,82.6,,,percent of total billed charges,82.6% of total billed charges,107.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.56,26814.9,
PLACE CATH INTRACRANIAL ART,36228,CDM,983,RC,36228,HCPCS,Outpatient,,,813,528.45,,715.44,88,,,percent of total billed charges,88% of total Billed charges,42.47,100,,,Fee Schedule,100% of Medicare rate,135.77,100,,,Fee Schedule,100% of WA Medicaid,813,100,,,percent of total billed charges,100% of total billed charges,139.84,103,,,Fee Schedule,103% of WA Medicaid,42.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,135.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,560.97,69,,,percent of total billed charges,69% of total billed charges,813,100,,,percent of total billed charges,100% of total billed charges,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,813,100,,,percent of total billed charges,100% of total billed charges,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,813,100,,,percent of total billed charges,100% of total billed charges,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.84,61.85,,,percent of total billed charges,61.85% of total billed charges,135.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,176.5,130,,,Fee Schedule,130% of WA Medicaid ,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.5,37.7,,,percent of total billed charges,37.70% of total billed charges,306.5,37.7,,,percent of total billed charges,37.70% of total billed charges,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,27560.7,33.9,,,percent of total billed charges,33.9% of total billed charges,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.14,78,,,percent of total billed charges,78% of total billed charges,813,100,,,percent of total billed charges,100% of total billed charges,671.54,82.6,,,percent of total billed charges,82.6% of total billed charges,671.54,82.6,,,percent of total billed charges,82.6% of total billed charges,135.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.47,27560.7,
PLACE CATH XTRNL CAROTID,36227,CDM,983,RC,36227,HCPCS,Outpatient,,,399,259.35,,351.12,88,,,percent of total billed charges,88% of total Billed charges,19.84,100,,,Fee Schedule,100% of Medicare rate,66.02,100,,,Fee Schedule,100% of WA Medicaid,399,100,,,percent of total billed charges,100% of total billed charges,68,103,,,Fee Schedule,103% of WA Medicaid,19.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,275.31,69,,,percent of total billed charges,69% of total billed charges,399,100,,,percent of total billed charges,100% of total billed charges,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,399,100,,,percent of total billed charges,100% of total billed charges,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,399,100,,,percent of total billed charges,100% of total billed charges,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.78,61.85,,,percent of total billed charges,61.85% of total billed charges,66.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.83,130,,,Fee Schedule,130% of WA Medicaid ,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.42,37.7,,,percent of total billed charges,37.70% of total billed charges,150.42,37.7,,,percent of total billed charges,37.70% of total billed charges,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,13526.1,33.9,,,percent of total billed charges,33.9% of total billed charges,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.22,78,,,percent of total billed charges,78% of total billed charges,399,100,,,percent of total billed charges,100% of total billed charges,329.57,82.6,,,percent of total billed charges,82.6% of total billed charges,329.57,82.6,,,percent of total billed charges,82.6% of total billed charges,66.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.84,13526.1,
PLACE CATH VERTEBRAL ART,36226,CDM,983,RC,36226,HCPCS,Outpatient,,,1261,819.65,,1109.68,88,,,percent of total billed charges,88% of total Billed charges,59.39,100,,,Fee Schedule,100% of Medicare rate,200.49,100,,,Fee Schedule,100% of WA Medicaid,1261,100,,,percent of total billed charges,100% of total billed charges,206.5,103,,,Fee Schedule,103% of WA Medicaid,59.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,870.09,69,,,percent of total billed charges,69% of total billed charges,1261,100,,,percent of total billed charges,100% of total billed charges,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1261,100,,,percent of total billed charges,100% of total billed charges,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1261,100,,,percent of total billed charges,100% of total billed charges,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,779.93,61.85,,,percent of total billed charges,61.85% of total billed charges,200.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,260.64,130,,,Fee Schedule,130% of WA Medicaid ,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.4,37.7,,,percent of total billed charges,37.70% of total billed charges,475.4,37.7,,,percent of total billed charges,37.70% of total billed charges,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,42747.9,33.9,,,percent of total billed charges,33.9% of total billed charges,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,983.58,78,,,percent of total billed charges,78% of total billed charges,1261,100,,,percent of total billed charges,100% of total billed charges,1041.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1041.59,82.6,,,percent of total billed charges,82.6% of total billed charges,200.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.39,42747.9,
PLACE CATH CAROTD ART,36224,CDM,983,RC,36224,HCPCS,Outpatient,,,1259,818.35,,1107.92,88,,,percent of total billed charges,88% of total Billed charges,60.23,100,,,Fee Schedule,100% of Medicare rate,201.79,100,,,Fee Schedule,100% of WA Medicaid,1259,100,,,percent of total billed charges,100% of total billed charges,207.84,103,,,Fee Schedule,103% of WA Medicaid,60.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,201.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,868.71,69,,,percent of total billed charges,69% of total billed charges,1259,100,,,percent of total billed charges,100% of total billed charges,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259,100,,,percent of total billed charges,100% of total billed charges,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1259,100,,,percent of total billed charges,100% of total billed charges,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.69,61.85,,,percent of total billed charges,61.85% of total billed charges,201.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,262.33,130,,,Fee Schedule,130% of WA Medicaid ,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.64,37.7,,,percent of total billed charges,37.70% of total billed charges,474.64,37.7,,,percent of total billed charges,37.70% of total billed charges,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,42680.1,33.9,,,percent of total billed charges,33.9% of total billed charges,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,982.02,78,,,percent of total billed charges,78% of total billed charges,1259,100,,,percent of total billed charges,100% of total billed charges,1039.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1039.93,82.6,,,percent of total billed charges,82.6% of total billed charges,201.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.23,42680.1,
INS CATH ABD/L-EXT ART 2ND,36246,CDM,983,RC,36246,HCPCS,Outpatient,,,725,471.25,,638,88,,,percent of total billed charges,88% of total Billed charges,34.23,100,,,Fee Schedule,100% of Medicare rate,136.52,100,,,Fee Schedule,100% of WA Medicaid,725,100,,,percent of total billed charges,100% of total billed charges,140.62,103,,,Fee Schedule,103% of WA Medicaid,34.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,136.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,500.25,69,,,percent of total billed charges,69% of total billed charges,725,100,,,percent of total billed charges,100% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,725,100,,,percent of total billed charges,100% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,725,100,,,percent of total billed charges,100% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,448.41,61.85,,,percent of total billed charges,61.85% of total billed charges,136.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,177.48,130,,,Fee Schedule,130% of WA Medicaid ,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.33,37.7,,,percent of total billed charges,37.70% of total billed charges,273.33,37.7,,,percent of total billed charges,37.70% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,24577.5,33.9,,,percent of total billed charges,33.9% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.5,78,,,percent of total billed charges,78% of total billed charges,725,100,,,percent of total billed charges,100% of total billed charges,598.85,82.6,,,percent of total billed charges,82.6% of total billed charges,598.85,82.6,,,percent of total billed charges,82.6% of total billed charges,136.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.23,24577.5,
INS CATH ABD/L-EXT ART 3RD,36247,CDM,983,RC,36247,HCPCS,Outpatient,,,863,560.95,,759.44,88,,,percent of total billed charges,88% of total Billed charges,35.3,100,,,Fee Schedule,100% of Medicare rate,161.7,100,,,Fee Schedule,100% of WA Medicaid,863,100,,,percent of total billed charges,100% of total billed charges,166.55,103,,,Fee Schedule,103% of WA Medicaid,35.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,161.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,595.47,69,,,percent of total billed charges,69% of total billed charges,863,100,,,percent of total billed charges,100% of total billed charges,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,863,100,,,percent of total billed charges,100% of total billed charges,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,863,100,,,percent of total billed charges,100% of total billed charges,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,533.77,61.85,,,percent of total billed charges,61.85% of total billed charges,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.21,130,,,Fee Schedule,130% of WA Medicaid ,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.35,37.7,,,percent of total billed charges,37.70% of total billed charges,325.35,37.7,,,percent of total billed charges,37.70% of total billed charges,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,29255.7,33.9,,,percent of total billed charges,33.9% of total billed charges,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,673.14,78,,,percent of total billed charges,78% of total billed charges,863,100,,,percent of total billed charges,100% of total billed charges,712.84,82.6,,,percent of total billed charges,82.6% of total billed charges,712.84,82.6,,,percent of total billed charges,82.6% of total billed charges,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.3,29255.7,
INS CATH ABD/L-EXT ART ADDL,36248,CDM,983,RC,36248,HCPCS,Outpatient,,,137,89.05,,120.56,88,,,percent of total billed charges,88% of total Billed charges,4.51,100,,,Fee Schedule,100% of Medicare rate,26.3,100,,,Fee Schedule,100% of WA Medicaid,137,100,,,percent of total billed charges,100% of total billed charges,27.09,103,,,Fee Schedule,103% of WA Medicaid,4.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,26.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,94.53,69,,,percent of total billed charges,69% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,137,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,137,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.73,61.85,,,percent of total billed charges,61.85% of total billed charges,26.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,34.19,130,,,Fee Schedule,130% of WA Medicaid ,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4644.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.86,78,,,percent of total billed charges,78% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,26.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.51,4644.3,
INS CATH ABD/L-EXT ART 1ST,36245,CDM,983,RC,36245,HCPCS,Outpatient,,,686,445.90,,603.68,88,,,percent of total billed charges,88% of total Billed charges,28.32,100,,,Fee Schedule,100% of Medicare rate,128.13,100,,,Fee Schedule,100% of WA Medicaid,686,100,,,percent of total billed charges,100% of total billed charges,131.97,103,,,Fee Schedule,103% of WA Medicaid,28.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,128.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,473.34,69,,,percent of total billed charges,69% of total billed charges,686,100,,,percent of total billed charges,100% of total billed charges,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,686,100,,,percent of total billed charges,100% of total billed charges,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,686,100,,,percent of total billed charges,100% of total billed charges,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.29,61.85,,,percent of total billed charges,61.85% of total billed charges,128.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,166.57,130,,,Fee Schedule,130% of WA Medicaid ,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.62,37.7,,,percent of total billed charges,37.70% of total billed charges,258.62,37.7,,,percent of total billed charges,37.70% of total billed charges,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,23255.4,33.9,,,percent of total billed charges,33.9% of total billed charges,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.08,78,,,percent of total billed charges,78% of total billed charges,686,100,,,percent of total billed charges,100% of total billed charges,566.64,82.6,,,percent of total billed charges,82.6% of total billed charges,566.64,82.6,,,percent of total billed charges,82.6% of total billed charges,128.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.32,23255.4,
INS CATH REN ART 1ST BILAT,36252,CDM,983,RC,36252,HCPCS,Outpatient,,,1191,774.15,,1048.08,88,,,percent of total billed charges,88% of total Billed charges,48.9,100,,,Fee Schedule,100% of Medicare rate,193.4,100,,,Fee Schedule,100% of WA Medicaid,1191,100,,,percent of total billed charges,100% of total billed charges,199.2,103,,,Fee Schedule,103% of WA Medicaid,48.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,193.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,821.79,69,,,percent of total billed charges,69% of total billed charges,1191,100,,,percent of total billed charges,100% of total billed charges,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191,100,,,percent of total billed charges,100% of total billed charges,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191,100,,,percent of total billed charges,100% of total billed charges,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.63,61.85,,,percent of total billed charges,61.85% of total billed charges,193.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,251.42,130,,,Fee Schedule,130% of WA Medicaid ,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.01,37.7,,,percent of total billed charges,37.70% of total billed charges,449.01,37.7,,,percent of total billed charges,37.70% of total billed charges,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,40374.9,33.9,,,percent of total billed charges,33.9% of total billed charges,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,928.98,78,,,percent of total billed charges,78% of total billed charges,1191,100,,,percent of total billed charges,100% of total billed charges,983.77,82.6,,,percent of total billed charges,82.6% of total billed charges,983.77,82.6,,,percent of total billed charges,82.6% of total billed charges,193.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.9,40374.9,
INS CATH REN ART 1ST UNILAT,36251,CDM,983,RC,36251,HCPCS,Outpatient,,,916,595.40,,806.08,88,,,percent of total billed charges,88% of total Billed charges,31.22,100,,,Fee Schedule,100% of Medicare rate,138.76,100,,,Fee Schedule,100% of WA Medicaid,916,100,,,percent of total billed charges,100% of total billed charges,142.92,103,,,Fee Schedule,103% of WA Medicaid,31.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,138.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,632.04,69,,,percent of total billed charges,69% of total billed charges,916,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,916,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,916,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,566.55,61.85,,,percent of total billed charges,61.85% of total billed charges,138.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,180.39,130,,,Fee Schedule,130% of WA Medicaid ,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.33,37.7,,,percent of total billed charges,37.70% of total billed charges,345.33,37.7,,,percent of total billed charges,37.70% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31052.4,33.9,,,percent of total billed charges,33.9% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.48,78,,,percent of total billed charges,78% of total billed charges,916,100,,,percent of total billed charges,100% of total billed charges,756.62,82.6,,,percent of total billed charges,82.6% of total billed charges,756.62,82.6,,,percent of total billed charges,82.6% of total billed charges,138.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.22,31052.4,
BL DRAW < 3 YRS FEM/JUGULAR,36400,CDM,983,RC,36400,HCPCS,Outpatient,,,78,50.70,,68.64,88,,,percent of total billed charges,88% of total Billed charges,1.33,100,,,Fee Schedule,100% of Medicare rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,78,100,,,percent of total billed charges,100% of total billed charges,10.75,103,,,Fee Schedule,103% of WA Medicaid,1.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,53.82,69,,,percent of total billed charges,69% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,78,100,,,percent of total billed charges,100% of total billed charges,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,78,100,,,percent of total billed charges,100% of total billed charges,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.24,61.85,,,percent of total billed charges,61.85% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.57,130,,,Fee Schedule,130% of WA Medicaid ,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.41,37.7,,,percent of total billed charges,37.70% of total billed charges,29.41,37.7,,,percent of total billed charges,37.70% of total billed charges,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2644.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.84,78,,,percent of total billed charges,78% of total billed charges,78,100,,,percent of total billed charges,100% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,64.43,82.6,,,percent of total billed charges,82.6% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.33,2644.2,
BL DRAW <3 YRS OTHER VEIN,36406,CDM,983,RC,36406,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,0.52,100,,,Fee Schedule,100% of Medicare rate,5.04,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,5.19,103,,,Fee Schedule,103% of WA Medicaid,0.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,5.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,48,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,48,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.69,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.55,130,,,Fee Schedule,130% of WA Medicaid ,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1627.2,33.9,,,percent of total billed charges,33.9% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.52,1627.2,
NON-ROUTINE BL DRAW 3/> YRS,36410,CDM,983,RC,36410,HCPCS,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,0.79,100,,,Fee Schedule,100% of Medicare rate,5.04,100,,,Fee Schedule,100% of WA Medicaid,49,100,,,percent of total billed charges,100% of total billed charges,5.19,103,,,Fee Schedule,103% of WA Medicaid,0.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,5.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,49,100,,,percent of total billed charges,100% of total billed charges,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,49,100,,,percent of total billed charges,100% of total billed charges,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.55,130,,,Fee Schedule,130% of WA Medicaid ,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1661.1,33.9,,,percent of total billed charges,33.9% of total billed charges,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.79,1661.1,
CAPILLARY BLOOD DRAW,36416,CDM,983,RC,36416,HCPCS,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,7.63,100,,,Fee Schedule,100% of WA Medicaid,15,100,,,percent of total billed charges,100% of total billed charges,7.86,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,15,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,15,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,7.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.92,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,5.66,37.7,,,percent of total billed charges,37.70% of total billed charges,5.66,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,508.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,7.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.66,508.5,
VEIN ACCESS CUTDOWN > 1 YR,36425,CDM,983,RC,36425,HCPCS,Outpatient,,,110,71.50,,96.8,88,,,percent of total billed charges,88% of total Billed charges,4.02,100,,,Fee Schedule,100% of Medicare rate,22.01,100,,,Fee Schedule,100% of WA Medicaid,110,100,,,percent of total billed charges,100% of total billed charges,22.67,103,,,Fee Schedule,103% of WA Medicaid,4.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,75.9,69,,,percent of total billed charges,69% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,110,100,,,percent of total billed charges,100% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,110,100,,,percent of total billed charges,100% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.04,61.85,,,percent of total billed charges,61.85% of total billed charges,22.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.61,130,,,Fee Schedule,130% of WA Medicaid ,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3729,33.9,,,percent of total billed charges,33.9% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.8,78,,,percent of total billed charges,78% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,22.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.02,3729,
INJECTION(S) SPIDER VEINS,36468,CDM,983,RC,36468,HCPCS,Outpatient,,,244,158.60,,214.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,244,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,168.36,69,,,percent of total billed charges,69% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,244,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,244,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,150.91,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.99,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,8271.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,190.32,78,,,percent of total billed charges,78% of total billed charges,244,100,,,percent of total billed charges,100% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,201.54,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",91.99,8271.6,
ENDOVENOUS RF VEIN ADD-ON,36476,CDM,983,RC,36476,HCPCS,Outpatient,,,1120,728.00,,985.6,88,,,percent of total billed charges,88% of total Billed charges,18.35,100,,,Fee Schedule,100% of Medicare rate,72.18,100,,,Fee Schedule,100% of WA Medicaid,1120,100,,,percent of total billed charges,100% of total billed charges,74.35,103,,,Fee Schedule,103% of WA Medicaid,18.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,72.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,772.8,69,,,percent of total billed charges,69% of total billed charges,1120,100,,,percent of total billed charges,100% of total billed charges,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1120,100,,,percent of total billed charges,100% of total billed charges,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1120,100,,,percent of total billed charges,100% of total billed charges,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.72,61.85,,,percent of total billed charges,61.85% of total billed charges,72.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,93.83,130,,,Fee Schedule,130% of WA Medicaid ,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.24,37.7,,,percent of total billed charges,37.70% of total billed charges,422.24,37.7,,,percent of total billed charges,37.70% of total billed charges,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,37968,33.9,,,percent of total billed charges,33.9% of total billed charges,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,873.6,78,,,percent of total billed charges,78% of total billed charges,1120,100,,,percent of total billed charges,100% of total billed charges,925.12,82.6,,,percent of total billed charges,82.6% of total billed charges,925.12,82.6,,,percent of total billed charges,82.6% of total billed charges,72.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.35,37968,
ENDOVENOUS LASER 1ST VEIN,36478,CDM,983,RC,36478,HCPCS,Outpatient,,,4016,2610.40,,3534.08,88,,,percent of total billed charges,88% of total Billed charges,36.3,100,,,Fee Schedule,100% of Medicare rate,151.44,100,,,Fee Schedule,100% of WA Medicaid,4016,100,,,percent of total billed charges,100% of total billed charges,155.98,103,,,Fee Schedule,103% of WA Medicaid,36.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,151.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2771.04,69,,,percent of total billed charges,69% of total billed charges,4016,100,,,percent of total billed charges,100% of total billed charges,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,4016,100,,,percent of total billed charges,100% of total billed charges,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,4016,100,,,percent of total billed charges,100% of total billed charges,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2483.9,61.85,,,percent of total billed charges,61.85% of total billed charges,151.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.87,130,,,Fee Schedule,130% of WA Medicaid ,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1514.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1514.03,37.7,,,percent of total billed charges,37.70% of total billed charges,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,136142.4,33.9,,,percent of total billed charges,33.9% of total billed charges,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3132.48,78,,,percent of total billed charges,78% of total billed charges,4016,100,,,percent of total billed charges,100% of total billed charges,3317.22,82.6,,,percent of total billed charges,82.6% of total billed charges,3317.22,82.6,,,percent of total billed charges,82.6% of total billed charges,151.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.3,136142.4,
ENDOVENOUS LASER VEIN ADDON,36479,CDM,983,RC,36479,HCPCS,Outpatient,,,1166,757.90,,1026.08,88,,,percent of total billed charges,88% of total Billed charges,18.18,100,,,Fee Schedule,100% of Medicare rate,73.85,100,,,Fee Schedule,100% of WA Medicaid,1166,100,,,percent of total billed charges,100% of total billed charges,76.07,103,,,Fee Schedule,103% of WA Medicaid,18.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,73.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,804.54,69,,,percent of total billed charges,69% of total billed charges,1166,100,,,percent of total billed charges,100% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1166,100,,,percent of total billed charges,100% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1166,100,,,percent of total billed charges,100% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,721.17,61.85,,,percent of total billed charges,61.85% of total billed charges,73.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,96.01,130,,,Fee Schedule,130% of WA Medicaid ,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.58,37.7,,,percent of total billed charges,37.70% of total billed charges,439.58,37.7,,,percent of total billed charges,37.70% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,39527.4,33.9,,,percent of total billed charges,33.9% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,909.48,78,,,percent of total billed charges,78% of total billed charges,1166,100,,,percent of total billed charges,100% of total billed charges,963.12,82.6,,,percent of total billed charges,82.6% of total billed charges,963.12,82.6,,,percent of total billed charges,82.6% of total billed charges,73.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.18,39527.4,
ENDOVENOUS RF 1ST VEIN,36475,CDM,960,RC,36475,HCPCS,Outpatient,,,714,464.10,,628.32,88,,,percent of total billed charges,88% of total Billed charges,37.84,100,,,Fee Schedule,100% of Medicare rate,151.07,100,,,Fee Schedule,100% of WA Medicaid,714,100,,,percent of total billed charges,100% of total billed charges,155.6,103,,,Fee Schedule,103% of WA Medicaid,37.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,151.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,492.66,69,,,percent of total billed charges,69% of total billed charges,714,100,,,percent of total billed charges,100% of total billed charges,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,714,100,,,percent of total billed charges,100% of total billed charges,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,714,100,,,percent of total billed charges,100% of total billed charges,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.61,61.85,,,percent of total billed charges,61.85% of total billed charges,151.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.39,130,,,Fee Schedule,130% of WA Medicaid ,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.18,37.7,,,percent of total billed charges,37.70% of total billed charges,269.18,37.7,,,percent of total billed charges,37.70% of total billed charges,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,24204.6,33.9,,,percent of total billed charges,33.9% of total billed charges,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.92,78,,,percent of total billed charges,78% of total billed charges,714,100,,,percent of total billed charges,100% of total billed charges,589.76,82.6,,,percent of total billed charges,82.6% of total billed charges,589.76,82.6,,,percent of total billed charges,82.6% of total billed charges,151.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.84,24204.6,
INJECTION THERAPY OF VEINS,36471,CDM,983,RC,36471,HCPCS,Outpatient,,,492,319.80,,432.96,88,,,percent of total billed charges,88% of total Billed charges,9.98,100,,,Fee Schedule,100% of Medicare rate,41.4,100,,,Fee Schedule,100% of WA Medicaid,492,100,,,percent of total billed charges,100% of total billed charges,42.64,103,,,Fee Schedule,103% of WA Medicaid,9.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,41.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,339.48,69,,,percent of total billed charges,69% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,492,100,,,percent of total billed charges,100% of total billed charges,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,492,100,,,percent of total billed charges,100% of total billed charges,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.3,61.85,,,percent of total billed charges,61.85% of total billed charges,41.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.82,130,,,Fee Schedule,130% of WA Medicaid ,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,185.48,37.7,,,percent of total billed charges,37.70% of total billed charges,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,16678.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.76,78,,,percent of total billed charges,78% of total billed charges,492,100,,,percent of total billed charges,100% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,406.39,82.6,,,percent of total billed charges,82.6% of total billed charges,41.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.98,16678.8,
INJECTION THERAPY OF VEIN,36470,CDM,983,RC,36470,HCPCS,Outpatient,,,421,273.65,,370.48,88,,,percent of total billed charges,88% of total Billed charges,4.99,100,,,Fee Schedule,100% of Medicare rate,20.7,100,,,Fee Schedule,100% of WA Medicaid,421,100,,,percent of total billed charges,100% of total billed charges,21.32,103,,,Fee Schedule,103% of WA Medicaid,4.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,290.49,69,,,percent of total billed charges,69% of total billed charges,421,100,,,percent of total billed charges,100% of total billed charges,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,421,100,,,percent of total billed charges,100% of total billed charges,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,421,100,,,percent of total billed charges,100% of total billed charges,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.39,61.85,,,percent of total billed charges,61.85% of total billed charges,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.91,130,,,Fee Schedule,130% of WA Medicaid ,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.72,37.7,,,percent of total billed charges,37.70% of total billed charges,158.72,37.7,,,percent of total billed charges,37.70% of total billed charges,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,14271.9,33.9,,,percent of total billed charges,33.9% of total billed charges,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.38,78,,,percent of total billed charges,78% of total billed charges,421,100,,,percent of total billed charges,100% of total billed charges,347.75,82.6,,,percent of total billed charges,82.6% of total billed charges,347.75,82.6,,,percent of total billed charges,82.6% of total billed charges,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.99,14271.9,
36482 Endoven therm chem ad 1st vein,36482,CDM,983,RC,36482,HCPCS,Outpatient,,,365,237.25,,321.2,88,,,percent of total billed charges,88% of total Billed charges,23.85,100,,,Fee Schedule,100% of Medicare rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,365,100,,,percent of total billed charges,100% of total billed charges,100.47,103,,,Fee Schedule,103% of WA Medicaid,23.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,97.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,251.85,69,,,percent of total billed charges,69% of total billed charges,365,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,365,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,365,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.75,61.85,,,percent of total billed charges,61.85% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.8,130,,,Fee Schedule,130% of WA Medicaid ,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.61,37.7,,,percent of total billed charges,37.70% of total billed charges,137.61,37.7,,,percent of total billed charges,37.70% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,12373.5,33.9,,,percent of total billed charges,33.9% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.7,78,,,percent of total billed charges,78% of total billed charges,365,100,,,percent of total billed charges,100% of total billed charges,301.49,82.6,,,percent of total billed charges,82.6% of total billed charges,301.49,82.6,,,percent of total billed charges,82.6% of total billed charges,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.85,12373.5,
36483 Endoven therm chem ad sub vein,36483,CDM,983,RC,36483,HCPCS,Outpatient,,,878,570.70,,772.64,88,,,percent of total billed charges,88% of total Billed charges,12.65,100,,,Fee Schedule,100% of Medicare rate,47.74,100,,,Fee Schedule,100% of WA Medicaid,878,100,,,percent of total billed charges,100% of total billed charges,49.17,103,,,Fee Schedule,103% of WA Medicaid,12.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,605.82,69,,,percent of total billed charges,69% of total billed charges,878,100,,,percent of total billed charges,100% of total billed charges,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,878,100,,,percent of total billed charges,100% of total billed charges,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,878,100,,,percent of total billed charges,100% of total billed charges,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,543.04,61.85,,,percent of total billed charges,61.85% of total billed charges,47.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.06,130,,,Fee Schedule,130% of WA Medicaid ,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.01,37.7,,,percent of total billed charges,37.70% of total billed charges,331.01,37.7,,,percent of total billed charges,37.70% of total billed charges,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,29764.2,33.9,,,percent of total billed charges,33.9% of total billed charges,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,684.84,78,,,percent of total billed charges,78% of total billed charges,878,100,,,percent of total billed charges,100% of total billed charges,725.23,82.6,,,percent of total billed charges,82.6% of total billed charges,725.23,82.6,,,percent of total billed charges,82.6% of total billed charges,47.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.65,29764.2,
CATHETER OF UMBILICAL VEIN/DIAG NEWBORN,36510,CDM,983,RC,36510,HCPCS,Outpatient,,,270,175.50,,237.6,88,,,percent of total billed charges,88% of total Billed charges,3.65,100,,,Fee Schedule,100% of Medicare rate,29.84,100,,,Fee Schedule,100% of WA Medicaid,270,100,,,percent of total billed charges,100% of total billed charges,30.74,103,,,Fee Schedule,103% of WA Medicaid,3.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,186.3,69,,,percent of total billed charges,69% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,270,100,,,percent of total billed charges,100% of total billed charges,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,270,100,,,percent of total billed charges,100% of total billed charges,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,167,61.85,,,percent of total billed charges,61.85% of total billed charges,29.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,38.79,130,,,Fee Schedule,130% of WA Medicaid ,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,9153,33.9,,,percent of total billed charges,33.9% of total billed charges,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.6,78,,,percent of total billed charges,78% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,29.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.65,9153,
INSERT TUNNELED CV CATH,36558,CDM,983,RC,36558,HCPCS,Outpatient,,,1079,701.35,,949.52,88,,,percent of total billed charges,88% of total Billed charges,24.23,100,,,Fee Schedule,100% of Medicare rate,144.35,100,,,Fee Schedule,100% of WA Medicaid,1079,100,,,percent of total billed charges,100% of total billed charges,148.68,103,,,Fee Schedule,103% of WA Medicaid,24.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,144.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,744.51,69,,,percent of total billed charges,69% of total billed charges,1079,100,,,percent of total billed charges,100% of total billed charges,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079,100,,,percent of total billed charges,100% of total billed charges,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079,100,,,percent of total billed charges,100% of total billed charges,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.36,61.85,,,percent of total billed charges,61.85% of total billed charges,144.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,187.66,130,,,Fee Schedule,130% of WA Medicaid ,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.78,37.7,,,percent of total billed charges,37.70% of total billed charges,406.78,37.7,,,percent of total billed charges,37.70% of total billed charges,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,36578.1,33.9,,,percent of total billed charges,33.9% of total billed charges,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.62,78,,,percent of total billed charges,78% of total billed charges,1079,100,,,percent of total billed charges,100% of total billed charges,891.25,82.6,,,percent of total billed charges,82.6% of total billed charges,891.25,82.6,,,percent of total billed charges,82.6% of total billed charges,144.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.23,36578.1,
INSERT NON-TUNNEL CV CATH,36556,CDM,983,RC,36556,HCPCS,Outpatient,,,517,336.05,,454.96,88,,,percent of total billed charges,88% of total Billed charges,8.44,100,,,Fee Schedule,100% of Medicare rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,517,100,,,percent of total billed charges,100% of total billed charges,48.03,103,,,Fee Schedule,103% of WA Medicaid,8.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,356.73,69,,,percent of total billed charges,69% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,517,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,517,100,,,percent of total billed charges,100% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.76,61.85,,,percent of total billed charges,61.85% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.62,130,,,Fee Schedule,130% of WA Medicaid ,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,17526.3,33.9,,,percent of total billed charges,33.9% of total billed charges,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.26,78,,,percent of total billed charges,78% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.44,17526.3,
INSERT TUNNELED CV CATH,36561,CDM,983,RC,36561,HCPCS,Outpatient,,,1269,824.85,,1116.72,88,,,percent of total billed charges,88% of total Billed charges,34.67,100,,,Fee Schedule,100% of Medicare rate,185.01,100,,,Fee Schedule,100% of WA Medicaid,1269,100,,,percent of total billed charges,100% of total billed charges,190.56,103,,,Fee Schedule,103% of WA Medicaid,34.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,185.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,875.61,69,,,percent of total billed charges,69% of total billed charges,1269,100,,,percent of total billed charges,100% of total billed charges,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1269,100,,,percent of total billed charges,100% of total billed charges,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1269,100,,,percent of total billed charges,100% of total billed charges,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,784.88,61.85,,,percent of total billed charges,61.85% of total billed charges,185.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,240.51,130,,,Fee Schedule,130% of WA Medicaid ,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.41,37.7,,,percent of total billed charges,37.70% of total billed charges,478.41,37.7,,,percent of total billed charges,37.70% of total billed charges,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,43019.1,33.9,,,percent of total billed charges,33.9% of total billed charges,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,989.82,78,,,percent of total billed charges,78% of total billed charges,1269,100,,,percent of total billed charges,100% of total billed charges,1048.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1048.19,82.6,,,percent of total billed charges,82.6% of total billed charges,185.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.67,43019.1,
INSERT PICC CATH,36569,CDM,983,RC,36569,HCPCS,Outpatient,,,486,315.90,,427.68,88,,,percent of total billed charges,88% of total Billed charges,10.29,100,,,Fee Schedule,100% of Medicare rate,52.22,100,,,Fee Schedule,100% of WA Medicaid,486,100,,,percent of total billed charges,100% of total billed charges,53.79,103,,,Fee Schedule,103% of WA Medicaid,10.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,52.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,335.34,69,,,percent of total billed charges,69% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.59,61.85,,,percent of total billed charges,61.85% of total billed charges,52.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.89,130,,,Fee Schedule,130% of WA Medicaid ,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,16475.4,33.9,,,percent of total billed charges,33.9% of total billed charges,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.08,78,,,percent of total billed charges,78% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,52.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.29,16475.4,
INSERT PICVAD CATH,36571,CDM,983,RC,36571,HCPCS,Outpatient,,,1169,759.85,,1028.72,88,,,percent of total billed charges,88% of total Billed charges,36.72,100,,,Fee Schedule,100% of Medicare rate,174.75,100,,,Fee Schedule,100% of WA Medicaid,1169,100,,,percent of total billed charges,100% of total billed charges,179.99,103,,,Fee Schedule,103% of WA Medicaid,36.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,174.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,806.61,69,,,percent of total billed charges,69% of total billed charges,1169,100,,,percent of total billed charges,100% of total billed charges,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1169,100,,,percent of total billed charges,100% of total billed charges,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1169,100,,,percent of total billed charges,100% of total billed charges,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.03,61.85,,,percent of total billed charges,61.85% of total billed charges,174.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,227.18,130,,,Fee Schedule,130% of WA Medicaid ,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.71,37.7,,,percent of total billed charges,37.70% of total billed charges,440.71,37.7,,,percent of total billed charges,37.70% of total billed charges,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,39629.1,33.9,,,percent of total billed charges,33.9% of total billed charges,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,911.82,78,,,percent of total billed charges,78% of total billed charges,1169,100,,,percent of total billed charges,100% of total billed charges,965.59,82.6,,,percent of total billed charges,82.6% of total billed charges,965.59,82.6,,,percent of total billed charges,82.6% of total billed charges,174.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.72,39629.1,
REMOVAL TUNNELED CV CATH,36589,CDM,983,RC,36589,HCPCS,Outpatient,,,336,218.40,,295.68,88,,,percent of total billed charges,88% of total Billed charges,12.85,100,,,Fee Schedule,100% of Medicare rate,76.47,100,,,Fee Schedule,100% of WA Medicaid,336,100,,,percent of total billed charges,100% of total billed charges,78.76,103,,,Fee Schedule,103% of WA Medicaid,12.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,76.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,231.84,69,,,percent of total billed charges,69% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.82,61.85,,,percent of total billed charges,61.85% of total billed charges,76.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,99.41,130,,,Fee Schedule,130% of WA Medicaid ,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,11390.4,33.9,,,percent of total billed charges,33.9% of total billed charges,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.08,78,,,percent of total billed charges,78% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,76.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.85,11390.4,
REPLACE TUNNELED CV CATH,36581,CDM,983,RC,36581,HCPCS,Outpatient,,,2787,1811.55,,2452.56,88,,,percent of total billed charges,88% of total Billed charges,16.28,100,,,Fee Schedule,100% of Medicare rate,102.02,100,,,Fee Schedule,100% of WA Medicaid,2787,100,,,percent of total billed charges,100% of total billed charges,105.08,103,,,Fee Schedule,103% of WA Medicaid,16.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1923.03,69,,,percent of total billed charges,69% of total billed charges,2787,100,,,percent of total billed charges,100% of total billed charges,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2787,100,,,percent of total billed charges,100% of total billed charges,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2787,100,,,percent of total billed charges,100% of total billed charges,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1723.76,61.85,,,percent of total billed charges,61.85% of total billed charges,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.63,130,,,Fee Schedule,130% of WA Medicaid ,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1050.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1050.7,37.7,,,percent of total billed charges,37.70% of total billed charges,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,94479.3,33.9,,,percent of total billed charges,33.9% of total billed charges,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2173.86,78,,,percent of total billed charges,78% of total billed charges,2787,100,,,percent of total billed charges,100% of total billed charges,2302.06,82.6,,,percent of total billed charges,82.6% of total billed charges,2302.06,82.6,,,percent of total billed charges,82.6% of total billed charges,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.28,94479.3,
REPLACE PICVAD CATH,36585,CDM,983,RC,36585,HCPCS,Outpatient,,,968,629.20,,851.84,88,,,percent of total billed charges,88% of total Billed charges,26.15,100,,,Fee Schedule,100% of Medicare rate,156.47,100,,,Fee Schedule,100% of WA Medicaid,968,100,,,percent of total billed charges,100% of total billed charges,161.16,103,,,Fee Schedule,103% of WA Medicaid,26.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,156.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,667.92,69,,,percent of total billed charges,69% of total billed charges,968,100,,,percent of total billed charges,100% of total billed charges,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,968,100,,,percent of total billed charges,100% of total billed charges,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,968,100,,,percent of total billed charges,100% of total billed charges,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.71,61.85,,,percent of total billed charges,61.85% of total billed charges,156.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,203.41,130,,,Fee Schedule,130% of WA Medicaid ,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.94,37.7,,,percent of total billed charges,37.70% of total billed charges,364.94,37.7,,,percent of total billed charges,37.70% of total billed charges,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,32815.2,33.9,,,percent of total billed charges,33.9% of total billed charges,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,755.04,78,,,percent of total billed charges,78% of total billed charges,968,100,,,percent of total billed charges,100% of total billed charges,799.57,82.6,,,percent of total billed charges,82.6% of total billed charges,799.57,82.6,,,percent of total billed charges,82.6% of total billed charges,156.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.15,32815.2,
REPLACE CVAD CATH,36580,CDM,983,RC,36580,HCPCS,Outpatient,,,237,154.05,,208.56,88,,,percent of total billed charges,88% of total Billed charges,6.31,100,,,Fee Schedule,100% of Medicare rate,35.81,100,,,Fee Schedule,100% of WA Medicaid,237,100,,,percent of total billed charges,100% of total billed charges,36.88,103,,,Fee Schedule,103% of WA Medicaid,6.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,163.53,69,,,percent of total billed charges,69% of total billed charges,237,100,,,percent of total billed charges,100% of total billed charges,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,237,100,,,percent of total billed charges,100% of total billed charges,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,237,100,,,percent of total billed charges,100% of total billed charges,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.58,61.85,,,percent of total billed charges,61.85% of total billed charges,35.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.55,130,,,Fee Schedule,130% of WA Medicaid ,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.35,37.7,,,percent of total billed charges,37.70% of total billed charges,89.35,37.7,,,percent of total billed charges,37.70% of total billed charges,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,8034.3,33.9,,,percent of total billed charges,33.9% of total billed charges,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.86,78,,,percent of total billed charges,78% of total billed charges,237,100,,,percent of total billed charges,100% of total billed charges,195.76,82.6,,,percent of total billed charges,82.6% of total billed charges,195.76,82.6,,,percent of total billed charges,82.6% of total billed charges,35.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.31,8034.3,
REPLACE TUNNELED CV CATH,36582,CDM,983,RC,36582,HCPCS,Outpatient,,,1662,1080.30,,1462.56,88,,,percent of total billed charges,88% of total Billed charges,30.75,100,,,Fee Schedule,100% of Medicare rate,159.83,100,,,Fee Schedule,100% of WA Medicaid,1662,100,,,percent of total billed charges,100% of total billed charges,164.62,103,,,Fee Schedule,103% of WA Medicaid,30.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,159.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1146.78,69,,,percent of total billed charges,69% of total billed charges,1662,100,,,percent of total billed charges,100% of total billed charges,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1662,100,,,percent of total billed charges,100% of total billed charges,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1662,100,,,percent of total billed charges,100% of total billed charges,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1027.95,61.85,,,percent of total billed charges,61.85% of total billed charges,159.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,207.78,130,,,Fee Schedule,130% of WA Medicaid ,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,626.57,37.7,,,percent of total billed charges,37.70% of total billed charges,626.57,37.7,,,percent of total billed charges,37.70% of total billed charges,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,56341.8,33.9,,,percent of total billed charges,33.9% of total billed charges,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1296.36,78,,,percent of total billed charges,78% of total billed charges,1662,100,,,percent of total billed charges,100% of total billed charges,1372.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1372.81,82.6,,,percent of total billed charges,82.6% of total billed charges,159.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.75,56341.8,
REMOVAL TUNNELED CV CATH,36590,CDM,983,RC,36590,HCPCS,Outpatient,,,720,468.00,,633.6,88,,,percent of total billed charges,88% of total Billed charges,19.62,100,,,Fee Schedule,100% of Medicare rate,106.31,100,,,Fee Schedule,100% of WA Medicaid,720,100,,,percent of total billed charges,100% of total billed charges,109.5,103,,,Fee Schedule,103% of WA Medicaid,19.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,106.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,496.8,69,,,percent of total billed charges,69% of total billed charges,720,100,,,percent of total billed charges,100% of total billed charges,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,720,100,,,percent of total billed charges,100% of total billed charges,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,720,100,,,percent of total billed charges,100% of total billed charges,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.32,61.85,,,percent of total billed charges,61.85% of total billed charges,106.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,138.2,130,,,Fee Schedule,130% of WA Medicaid ,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.44,37.7,,,percent of total billed charges,37.70% of total billed charges,271.44,37.7,,,percent of total billed charges,37.70% of total billed charges,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,24408,33.9,,,percent of total billed charges,33.9% of total billed charges,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.6,78,,,percent of total billed charges,78% of total billed charges,720,100,,,percent of total billed charges,100% of total billed charges,594.72,82.6,,,percent of total billed charges,82.6% of total billed charges,594.72,82.6,,,percent of total billed charges,82.6% of total billed charges,106.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.62,24408,
INJ W/FLUOR EVAL CV DEVICE,36598,CDM,983,RC,36598,HCPCS,Outpatient,,,355,230.75,,312.4,88,,,percent of total billed charges,88% of total Billed charges,2.86,100,,,Fee Schedule,100% of Medicare rate,19.58,100,,,Fee Schedule,100% of WA Medicaid,355,100,,,percent of total billed charges,100% of total billed charges,20.17,103,,,Fee Schedule,103% of WA Medicaid,2.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,244.95,69,,,percent of total billed charges,69% of total billed charges,355,100,,,percent of total billed charges,100% of total billed charges,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,355,100,,,percent of total billed charges,100% of total billed charges,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,355,100,,,percent of total billed charges,100% of total billed charges,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.57,61.85,,,percent of total billed charges,61.85% of total billed charges,19.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.45,130,,,Fee Schedule,130% of WA Medicaid ,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.84,37.7,,,percent of total billed charges,37.70% of total billed charges,133.84,37.7,,,percent of total billed charges,37.70% of total billed charges,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,12034.5,33.9,,,percent of total billed charges,33.9% of total billed charges,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.9,78,,,percent of total billed charges,78% of total billed charges,355,100,,,percent of total billed charges,100% of total billed charges,293.23,82.6,,,percent of total billed charges,82.6% of total billed charges,293.23,82.6,,,percent of total billed charges,82.6% of total billed charges,19.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.86,12034.5,
REPOSITION VENOUS CATHETER,36597,CDM,983,RC,36597,HCPCS,Outpatient,,,262,170.30,,230.56,88,,,percent of total billed charges,88% of total Billed charges,5.64,100,,,Fee Schedule,100% of Medicare rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,262,100,,,percent of total billed charges,100% of total billed charges,34,103,,,Fee Schedule,103% of WA Medicaid,5.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,180.78,69,,,percent of total billed charges,69% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,262,100,,,percent of total billed charges,100% of total billed charges,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,262,100,,,percent of total billed charges,100% of total billed charges,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.05,61.85,,,percent of total billed charges,61.85% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.91,130,,,Fee Schedule,130% of WA Medicaid ,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,8881.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.36,78,,,percent of total billed charges,78% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.64,8881.8,
DECLOT VASCULAR DEVICE,36593,CDM,983,RC,36593,HCPCS,Outpatient,,,134,87.10,,117.92,88,,,percent of total billed charges,88% of total Billed charges,1.6,100,,,Fee Schedule,100% of Medicare rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,134,100,,,percent of total billed charges,100% of total billed charges,21.52,103,,,Fee Schedule,103% of WA Medicaid,1.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,92.46,69,,,percent of total billed charges,69% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,134,100,,,percent of total billed charges,100% of total billed charges,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,134,100,,,percent of total billed charges,100% of total billed charges,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.88,61.85,,,percent of total billed charges,61.85% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.16,130,,,Fee Schedule,130% of WA Medicaid ,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,50.52,37.7,,,percent of total billed charges,37.70% of total billed charges,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4542.6,33.9,,,percent of total billed charges,33.9% of total billed charges,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.52,78,,,percent of total billed charges,78% of total billed charges,134,100,,,percent of total billed charges,100% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,110.68,82.6,,,percent of total billed charges,82.6% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.6,4542.6,
36592 Collect spec central/peripheral cath,36592,CDM,983,RC,36592,HCPCS,Outpatient,,,249,161.85,,219.12,88,,,percent of total billed charges,88% of total Billed charges,1.19,100,,,Fee Schedule,100% of Medicare rate,18.09,100,,,Fee Schedule,100% of WA Medicaid,249,100,,,percent of total billed charges,100% of total billed charges,18.63,103,,,Fee Schedule,103% of WA Medicaid,1.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,18.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,171.81,69,,,percent of total billed charges,69% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,249,100,,,percent of total billed charges,100% of total billed charges,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,249,100,,,percent of total billed charges,100% of total billed charges,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.01,61.85,,,percent of total billed charges,61.85% of total billed charges,18.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.52,130,,,Fee Schedule,130% of WA Medicaid ,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,8441.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.22,78,,,percent of total billed charges,78% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,18.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.19,8441.1,
INSERTION CATHETER ARTERY,36620,CDM,983,RC,36620,HCPCS,Outpatient,,,309,200.85,,271.92,88,,,percent of total billed charges,88% of total Billed charges,3.63,100,,,Fee Schedule,100% of Medicare rate,24.43,100,,,Fee Schedule,100% of WA Medicaid,309,100,,,percent of total billed charges,100% of total billed charges,25.16,103,,,Fee Schedule,103% of WA Medicaid,3.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,24.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,213.21,69,,,percent of total billed charges,69% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,309,100,,,percent of total billed charges,100% of total billed charges,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,309,100,,,percent of total billed charges,100% of total billed charges,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.12,61.85,,,percent of total billed charges,61.85% of total billed charges,24.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.76,130,,,Fee Schedule,130% of WA Medicaid ,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,10475.1,33.9,,,percent of total billed charges,33.9% of total billed charges,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.02,78,,,percent of total billed charges,78% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,24.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.63,10475.1,
INSERTION CATHETER ARTERY,36625,CDM,983,RC,36625,HCPCS,Outpatient,,,392,254.80,,344.96,88,,,percent of total billed charges,88% of total Billed charges,11.63,100,,,Fee Schedule,100% of Medicare rate,58,100,,,Fee Schedule,100% of WA Medicaid,392,100,,,percent of total billed charges,100% of total billed charges,59.74,103,,,Fee Schedule,103% of WA Medicaid,11.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,270.48,69,,,percent of total billed charges,69% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,392,100,,,percent of total billed charges,100% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,392,100,,,percent of total billed charges,100% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.45,61.85,,,percent of total billed charges,61.85% of total billed charges,58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,75.4,130,,,Fee Schedule,130% of WA Medicaid ,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.78,37.7,,,percent of total billed charges,37.70% of total billed charges,147.78,37.7,,,percent of total billed charges,37.70% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,13288.8,33.9,,,percent of total billed charges,33.9% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.76,78,,,percent of total billed charges,78% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.63,13288.8,
INSERTION CATHETER ARTERY,36660,CDM,983,RC,36660,HCPCS,Outpatient,,,389,252.85,,342.32,88,,,percent of total billed charges,88% of total Billed charges,4.61,100,,,Fee Schedule,100% of Medicare rate,38.23,100,,,Fee Schedule,100% of WA Medicaid,389,100,,,percent of total billed charges,100% of total billed charges,39.38,103,,,Fee Schedule,103% of WA Medicaid,4.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,268.41,69,,,percent of total billed charges,69% of total billed charges,389,100,,,percent of total billed charges,100% of total billed charges,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,389,100,,,percent of total billed charges,100% of total billed charges,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,389,100,,,percent of total billed charges,100% of total billed charges,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.6,61.85,,,percent of total billed charges,61.85% of total billed charges,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.7,130,,,Fee Schedule,130% of WA Medicaid ,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.65,37.7,,,percent of total billed charges,37.70% of total billed charges,146.65,37.7,,,percent of total billed charges,37.70% of total billed charges,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,13187.1,33.9,,,percent of total billed charges,33.9% of total billed charges,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.42,78,,,percent of total billed charges,78% of total billed charges,389,100,,,percent of total billed charges,100% of total billed charges,321.31,82.6,,,percent of total billed charges,82.6% of total billed charges,321.31,82.6,,,percent of total billed charges,82.6% of total billed charges,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.61,13187.1,
INSERTION OF CANNULA,36800,CDM,983,RC,36800,HCPCS,Outpatient,,,484,314.60,,425.92,88,,,percent of total billed charges,88% of total Billed charges,11.07,100,,,Fee Schedule,100% of Medicare rate,66.95,100,,,Fee Schedule,100% of WA Medicaid,484,100,,,percent of total billed charges,100% of total billed charges,68.96,103,,,Fee Schedule,103% of WA Medicaid,11.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,333.96,69,,,percent of total billed charges,69% of total billed charges,484,100,,,percent of total billed charges,100% of total billed charges,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,484,100,,,percent of total billed charges,100% of total billed charges,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,484,100,,,percent of total billed charges,100% of total billed charges,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.35,61.85,,,percent of total billed charges,61.85% of total billed charges,66.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,87.04,130,,,Fee Schedule,130% of WA Medicaid ,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.47,37.7,,,percent of total billed charges,37.70% of total billed charges,182.47,37.7,,,percent of total billed charges,37.70% of total billed charges,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,16407.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.52,78,,,percent of total billed charges,78% of total billed charges,484,100,,,percent of total billed charges,100% of total billed charges,399.78,82.6,,,percent of total billed charges,82.6% of total billed charges,399.78,82.6,,,percent of total billed charges,82.6% of total billed charges,66.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.07,16407.6,
INSERTION OF CANNULA,36815,CDM,983,RC,36815,HCPCS,Outpatient,,,517,336.05,,454.96,88,,,percent of total billed charges,88% of total Billed charges,20.48,100,,,Fee Schedule,100% of Medicare rate,73.11,100,,,Fee Schedule,100% of WA Medicaid,517,100,,,percent of total billed charges,100% of total billed charges,75.3,103,,,Fee Schedule,103% of WA Medicaid,20.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,73.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,356.73,69,,,percent of total billed charges,69% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,517,100,,,percent of total billed charges,100% of total billed charges,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,517,100,,,percent of total billed charges,100% of total billed charges,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.76,61.85,,,percent of total billed charges,61.85% of total billed charges,73.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.04,130,,,Fee Schedule,130% of WA Medicaid ,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,17526.3,33.9,,,percent of total billed charges,33.9% of total billed charges,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.26,78,,,percent of total billed charges,78% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,73.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.48,17526.3,
AV FUSE UPPR ARM CEPHALIC,36818,CDM,983,RC,36818,HCPCS,Outpatient,,,2087,1356.55,,1836.56,88,,,percent of total billed charges,88% of total Billed charges,99.02,100,,,Fee Schedule,100% of Medicare rate,375.61,100,,,Fee Schedule,100% of WA Medicaid,2087,100,,,percent of total billed charges,100% of total billed charges,386.88,103,,,Fee Schedule,103% of WA Medicaid,99.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,375.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1440.03,69,,,percent of total billed charges,69% of total billed charges,2087,100,,,percent of total billed charges,100% of total billed charges,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2087,100,,,percent of total billed charges,100% of total billed charges,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2087,100,,,percent of total billed charges,100% of total billed charges,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1290.81,61.85,,,percent of total billed charges,61.85% of total billed charges,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,488.29,130,,,Fee Schedule,130% of WA Medicaid ,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.8,37.7,,,percent of total billed charges,37.70% of total billed charges,786.8,37.7,,,percent of total billed charges,37.70% of total billed charges,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,70749.3,33.9,,,percent of total billed charges,33.9% of total billed charges,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1627.86,78,,,percent of total billed charges,78% of total billed charges,2087,100,,,percent of total billed charges,100% of total billed charges,1723.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1723.86,82.6,,,percent of total billed charges,82.6% of total billed charges,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.02,70749.3,
AV FUSE UPPR ARM BASILIC,36819,CDM,983,RC,36819,HCPCS,Outpatient,,,2358,1532.70,,2075.04,88,,,percent of total billed charges,88% of total Billed charges,106.9,100,,,Fee Schedule,100% of Medicare rate,397.06,100,,,Fee Schedule,100% of WA Medicaid,2358,100,,,percent of total billed charges,100% of total billed charges,408.97,103,,,Fee Schedule,103% of WA Medicaid,106.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,187.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,397.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1627.02,69,,,percent of total billed charges,69% of total billed charges,2358,100,,,percent of total billed charges,100% of total billed charges,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2358,100,,,percent of total billed charges,100% of total billed charges,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2358,100,,,percent of total billed charges,100% of total billed charges,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1458.42,61.85,,,percent of total billed charges,61.85% of total billed charges,397.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,405,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,516.18,130,,,Fee Schedule,130% of WA Medicaid ,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,888.97,37.7,,,percent of total billed charges,37.70% of total billed charges,888.97,37.7,,,percent of total billed charges,37.70% of total billed charges,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,79936.2,33.9,,,percent of total billed charges,33.9% of total billed charges,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1839.24,78,,,percent of total billed charges,78% of total billed charges,2358,100,,,percent of total billed charges,100% of total billed charges,1947.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1947.71,82.6,,,percent of total billed charges,82.6% of total billed charges,397.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.9,79936.2,
ARTERY-VEIN AUTOGRAFT,36825,CDM,983,RC,36825,HCPCS,Outpatient,,,2546,1654.90,,2240.48,88,,,percent of total billed charges,88% of total Billed charges,114.47,100,,,Fee Schedule,100% of Medicare rate,432.31,100,,,Fee Schedule,100% of WA Medicaid,2546,100,,,percent of total billed charges,100% of total billed charges,445.28,103,,,Fee Schedule,103% of WA Medicaid,114.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,200.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,432.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1756.74,69,,,percent of total billed charges,69% of total billed charges,2546,100,,,percent of total billed charges,100% of total billed charges,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,2546,100,,,percent of total billed charges,100% of total billed charges,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,2546,100,,,percent of total billed charges,100% of total billed charges,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1574.7,61.85,,,percent of total billed charges,61.85% of total billed charges,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562,130,,,Fee Schedule,130% of WA Medicaid ,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,959.84,37.7,,,percent of total billed charges,37.70% of total billed charges,959.84,37.7,,,percent of total billed charges,37.70% of total billed charges,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,86309.4,33.9,,,percent of total billed charges,33.9% of total billed charges,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1985.88,78,,,percent of total billed charges,78% of total billed charges,2546,100,,,percent of total billed charges,100% of total billed charges,2103,82.6,,,percent of total billed charges,82.6% of total billed charges,2103,82.6,,,percent of total billed charges,82.6% of total billed charges,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,114.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.47,86309.4,
AV FUSION/FOREARM VEIN,36820,CDM,983,RC,36820,HCPCS,Outpatient,,,2212,1437.80,,1946.56,88,,,percent of total billed charges,88% of total Billed charges,104.74,100,,,Fee Schedule,100% of Medicare rate,395.57,100,,,Fee Schedule,100% of WA Medicaid,2212,100,,,percent of total billed charges,100% of total billed charges,407.44,103,,,Fee Schedule,103% of WA Medicaid,104.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,183.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,395.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1526.28,69,,,percent of total billed charges,69% of total billed charges,2212,100,,,percent of total billed charges,100% of total billed charges,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2212,100,,,percent of total billed charges,100% of total billed charges,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2212,100,,,percent of total billed charges,100% of total billed charges,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1368.12,61.85,,,percent of total billed charges,61.85% of total billed charges,395.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,514.24,130,,,Fee Schedule,130% of WA Medicaid ,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,833.92,37.7,,,percent of total billed charges,37.70% of total billed charges,833.92,37.7,,,percent of total billed charges,37.70% of total billed charges,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,74986.8,33.9,,,percent of total billed charges,33.9% of total billed charges,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1725.36,78,,,percent of total billed charges,78% of total billed charges,2212,100,,,percent of total billed charges,100% of total billed charges,1827.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1827.11,82.6,,,percent of total billed charges,82.6% of total billed charges,395.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,104.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,104.74,74986.8,
AV FUSION DIRECT ANY SITE,36821,CDM,983,RC,36821,HCPCS,Outpatient,,,1886,1225.90,,1659.68,88,,,percent of total billed charges,88% of total Billed charges,95.04,100,,,Fee Schedule,100% of Medicare rate,359.39,100,,,Fee Schedule,100% of WA Medicaid,1886,100,,,percent of total billed charges,100% of total billed charges,370.17,103,,,Fee Schedule,103% of WA Medicaid,95.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,166.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,359.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1301.34,69,,,percent of total billed charges,69% of total billed charges,1886,100,,,percent of total billed charges,100% of total billed charges,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1886,100,,,percent of total billed charges,100% of total billed charges,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1886,100,,,percent of total billed charges,100% of total billed charges,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1166.49,61.85,,,percent of total billed charges,61.85% of total billed charges,359.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,467.21,130,,,Fee Schedule,130% of WA Medicaid ,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.02,37.7,,,percent of total billed charges,37.70% of total billed charges,711.02,37.7,,,percent of total billed charges,37.70% of total billed charges,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,63935.4,33.9,,,percent of total billed charges,33.9% of total billed charges,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1471.08,78,,,percent of total billed charges,78% of total billed charges,1886,100,,,percent of total billed charges,100% of total billed charges,1557.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.84,82.6,,,percent of total billed charges,82.6% of total billed charges,359.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,95.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.04,63935.4,
ARTERY-VEIN NONAUTOGRAFT,36830,CDM,983,RC,36830,HCPCS,Outpatient,,,2470,1605.50,,2173.6,88,,,percent of total billed charges,88% of total Billed charges,96.27,100,,,Fee Schedule,100% of Medicare rate,362.93,100,,,Fee Schedule,100% of WA Medicaid,2470,100,,,percent of total billed charges,100% of total billed charges,373.82,103,,,Fee Schedule,103% of WA Medicaid,96.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,168.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,362.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1704.3,69,,,percent of total billed charges,69% of total billed charges,2470,100,,,percent of total billed charges,100% of total billed charges,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2470,100,,,percent of total billed charges,100% of total billed charges,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2470,100,,,percent of total billed charges,100% of total billed charges,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1527.7,61.85,,,percent of total billed charges,61.85% of total billed charges,362.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,471.81,130,,,Fee Schedule,130% of WA Medicaid ,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.19,37.7,,,percent of total billed charges,37.70% of total billed charges,931.19,37.7,,,percent of total billed charges,37.70% of total billed charges,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,83733,33.9,,,percent of total billed charges,33.9% of total billed charges,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1926.6,78,,,percent of total billed charges,78% of total billed charges,2470,100,,,percent of total billed charges,100% of total billed charges,2040.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2040.22,82.6,,,percent of total billed charges,82.6% of total billed charges,362.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.27,83733,
DIST REVAS LIGATION HEMO,36838,CDM,983,RC,36838,HCPCS,Outpatient,,,3490,2268.50,,3071.2,88,,,percent of total billed charges,88% of total Billed charges,172.75,100,,,Fee Schedule,100% of Medicare rate,615.64,100,,,Fee Schedule,100% of WA Medicaid,3490,100,,,percent of total billed charges,100% of total billed charges,634.11,103,,,Fee Schedule,103% of WA Medicaid,172.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,302.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,615.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2408.1,69,,,percent of total billed charges,69% of total billed charges,3490,100,,,percent of total billed charges,100% of total billed charges,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3490,100,,,percent of total billed charges,100% of total billed charges,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3490,100,,,percent of total billed charges,100% of total billed charges,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2158.57,61.85,,,percent of total billed charges,61.85% of total billed charges,615.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,627.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,800.33,130,,,Fee Schedule,130% of WA Medicaid ,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1315.73,37.7,,,percent of total billed charges,37.70% of total billed charges,1315.73,37.7,,,percent of total billed charges,37.70% of total billed charges,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,118311,33.9,,,percent of total billed charges,33.9% of total billed charges,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2722.2,78,,,percent of total billed charges,78% of total billed charges,3490,100,,,percent of total billed charges,100% of total billed charges,2882.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2882.74,82.6,,,percent of total billed charges,82.6% of total billed charges,615.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,172.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,172.75,118311,
AV FISTULA REVISION,36833,CDM,983,RC,36833,HCPCS,Outpatient,,,2117,1376.05,,1862.96,88,,,percent of total billed charges,88% of total Billed charges,116.66,100,,,Fee Schedule,100% of Medicare rate,439.39,100,,,Fee Schedule,100% of WA Medicaid,2117,100,,,percent of total billed charges,100% of total billed charges,452.57,103,,,Fee Schedule,103% of WA Medicaid,116.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,204.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,439.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1460.73,69,,,percent of total billed charges,69% of total billed charges,2117,100,,,percent of total billed charges,100% of total billed charges,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2117,100,,,percent of total billed charges,100% of total billed charges,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2117,100,,,percent of total billed charges,100% of total billed charges,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1309.36,61.85,,,percent of total billed charges,61.85% of total billed charges,439.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,448.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,571.21,130,,,Fee Schedule,130% of WA Medicaid ,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,798.11,37.7,,,percent of total billed charges,37.70% of total billed charges,798.11,37.7,,,percent of total billed charges,37.70% of total billed charges,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,71766.3,33.9,,,percent of total billed charges,33.9% of total billed charges,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1651.26,78,,,percent of total billed charges,78% of total billed charges,2117,100,,,percent of total billed charges,100% of total billed charges,1748.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1748.64,82.6,,,percent of total billed charges,82.6% of total billed charges,439.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,116.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,116.66,71766.3,
AV FISTULA REVISION OPEN,36832,CDM,983,RC,36832,HCPCS,Outpatient,,,2113,1373.45,,1859.44,88,,,percent of total billed charges,88% of total Billed charges,108.48,100,,,Fee Schedule,100% of Medicare rate,412.35,100,,,Fee Schedule,100% of WA Medicaid,2113,100,,,percent of total billed charges,100% of total billed charges,424.72,103,,,Fee Schedule,103% of WA Medicaid,108.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,189.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,412.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1457.97,69,,,percent of total billed charges,69% of total billed charges,2113,100,,,percent of total billed charges,100% of total billed charges,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2113,100,,,percent of total billed charges,100% of total billed charges,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2113,100,,,percent of total billed charges,100% of total billed charges,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1306.89,61.85,,,percent of total billed charges,61.85% of total billed charges,412.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,536.06,130,,,Fee Schedule,130% of WA Medicaid ,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,796.6,37.7,,,percent of total billed charges,37.70% of total billed charges,796.6,37.7,,,percent of total billed charges,37.70% of total billed charges,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,71630.7,33.9,,,percent of total billed charges,33.9% of total billed charges,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1648.14,78,,,percent of total billed charges,78% of total billed charges,2113,100,,,percent of total billed charges,100% of total billed charges,1745.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1745.34,82.6,,,percent of total billed charges,82.6% of total billed charges,412.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,108.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.48,71630.7,
OPEN THROMBECT AV FISTULA,36831,CDM,983,RC,36831,HCPCS,Outpatient,,,1583,1028.95,,1393.04,88,,,percent of total billed charges,88% of total Billed charges,88.64,100,,,Fee Schedule,100% of Medicare rate,336.45,100,,,Fee Schedule,100% of WA Medicaid,1583,100,,,percent of total billed charges,100% of total billed charges,346.54,103,,,Fee Schedule,103% of WA Medicaid,88.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,155.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,336.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1092.27,69,,,percent of total billed charges,69% of total billed charges,1583,100,,,percent of total billed charges,100% of total billed charges,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1583,100,,,percent of total billed charges,100% of total billed charges,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1583,100,,,percent of total billed charges,100% of total billed charges,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,979.09,61.85,,,percent of total billed charges,61.85% of total billed charges,336.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,437.39,130,,,Fee Schedule,130% of WA Medicaid ,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.79,37.7,,,percent of total billed charges,37.70% of total billed charges,596.79,37.7,,,percent of total billed charges,37.70% of total billed charges,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,53663.7,33.9,,,percent of total billed charges,33.9% of total billed charges,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1234.74,78,,,percent of total billed charges,78% of total billed charges,1583,100,,,percent of total billed charges,100% of total billed charges,1307.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1307.56,82.6,,,percent of total billed charges,82.6% of total billed charges,336.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.64,53663.7,
CANNULA DECLOTTING,36861,CDM,983,RC,36861,HCPCS,Outpatient,,,724,470.60,,637.12,88,,,percent of total billed charges,88% of total Billed charges,20.61,100,,,Fee Schedule,100% of Medicare rate,75.72,100,,,Fee Schedule,100% of WA Medicaid,724,100,,,percent of total billed charges,100% of total billed charges,77.99,103,,,Fee Schedule,103% of WA Medicaid,20.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,75.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,499.56,69,,,percent of total billed charges,69% of total billed charges,724,100,,,percent of total billed charges,100% of total billed charges,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,724,100,,,percent of total billed charges,100% of total billed charges,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,724,100,,,percent of total billed charges,100% of total billed charges,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.79,61.85,,,percent of total billed charges,61.85% of total billed charges,75.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,98.44,130,,,Fee Schedule,130% of WA Medicaid ,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.95,37.7,,,percent of total billed charges,37.70% of total billed charges,272.95,37.7,,,percent of total billed charges,37.70% of total billed charges,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,24543.6,33.9,,,percent of total billed charges,33.9% of total billed charges,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.72,78,,,percent of total billed charges,78% of total billed charges,724,100,,,percent of total billed charges,100% of total billed charges,598.02,82.6,,,percent of total billed charges,82.6% of total billed charges,598.02,82.6,,,percent of total billed charges,82.6% of total billed charges,75.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.61,24543.6,
PERCUT THROMBECT AV FISTULA,36870,CDM,983,RC,,,Outpatient,,,7187,4671.55,,6324.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7187,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,4959.03,69,,,percent of total billed charges,69% of total billed charges,7187,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,7187,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,7187,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4445.16,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2709.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2709.5,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,243639.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,5605.86,78,,,percent of total billed charges,78% of total billed charges,7187,100,,,percent of total billed charges,100% of total billed charges,5936.46,82.6,,,percent of total billed charges,82.6% of total billed charges,5936.46,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",2709.5,243639.3,
INTRO CATH DIALYSIS CIRCUIT,36902,CDM,983,RC,36902,HCPCS,Outpatient,,,599.03,389.37,,527.15,88,,,percent of total billed charges,88% of total Billed charges,25.61,100,,,Fee Schedule,100% of Medicare rate,130.74,100,,,Fee Schedule,100% of WA Medicaid,599.03,100,,,percent of total billed charges,100% of total billed charges,134.66,103,,,Fee Schedule,103% of WA Medicaid,25.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,130.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,413.33,69,,,percent of total billed charges,69% of total billed charges,599.03,100,,,percent of total billed charges,100% of total billed charges,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.03,100,,,percent of total billed charges,100% of total billed charges,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.03,100,,,percent of total billed charges,100% of total billed charges,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.5,61.85,,,percent of total billed charges,61.85% of total billed charges,130.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,169.96,130,,,Fee Schedule,130% of WA Medicaid ,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.83,37.7,,,percent of total billed charges,37.70% of total billed charges,225.83,37.7,,,percent of total billed charges,37.70% of total billed charges,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,20307.12,33.9,,,percent of total billed charges,33.9% of total billed charges,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,467.24,78,,,percent of total billed charges,78% of total billed charges,599.03,100,,,percent of total billed charges,100% of total billed charges,494.8,82.6,,,percent of total billed charges,82.6% of total billed charges,494.8,82.6,,,percent of total billed charges,82.6% of total billed charges,130.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.61,20307.12,
BALO ANGIOP CTR DIALYSIS SEG,36907,CDM,983,RC,36907,HCPCS,Outpatient,,,344.63,224.01,,303.27,88,,,percent of total billed charges,88% of total Billed charges,15.88,100,,,Fee Schedule,100% of Medicare rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,344.63,100,,,percent of total billed charges,100% of total billed charges,81.64,103,,,Fee Schedule,103% of WA Medicaid,15.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,237.79,69,,,percent of total billed charges,69% of total billed charges,344.63,100,,,percent of total billed charges,100% of total billed charges,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.63,100,,,percent of total billed charges,100% of total billed charges,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.63,100,,,percent of total billed charges,100% of total billed charges,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.15,61.85,,,percent of total billed charges,61.85% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.04,130,,,Fee Schedule,130% of WA Medicaid ,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.93,37.7,,,percent of total billed charges,37.70% of total billed charges,129.93,37.7,,,percent of total billed charges,37.70% of total billed charges,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,11682.96,33.9,,,percent of total billed charges,33.9% of total billed charges,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.81,78,,,percent of total billed charges,78% of total billed charges,344.63,100,,,percent of total billed charges,100% of total billed charges,284.66,82.6,,,percent of total billed charges,82.6% of total billed charges,284.66,82.6,,,percent of total billed charges,82.6% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.88,11682.96,
STENT PLMT CTR DIALYSIS SEG,36908,CDM,983,RC,36908,HCPCS,Outpatient,,,516.26,335.57,,454.31,88,,,percent of total billed charges,88% of total Billed charges,24.37,100,,,Fee Schedule,100% of Medicare rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,516.26,100,,,percent of total billed charges,100% of total billed charges,115.64,103,,,Fee Schedule,103% of WA Medicaid,24.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,356.22,69,,,percent of total billed charges,69% of total billed charges,516.26,100,,,percent of total billed charges,100% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.26,100,,,percent of total billed charges,100% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.26,100,,,percent of total billed charges,100% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.31,61.85,,,percent of total billed charges,61.85% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.95,130,,,Fee Schedule,130% of WA Medicaid ,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.63,37.7,,,percent of total billed charges,37.70% of total billed charges,194.63,37.7,,,percent of total billed charges,37.70% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,17501.21,33.9,,,percent of total billed charges,33.9% of total billed charges,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.68,78,,,percent of total billed charges,78% of total billed charges,516.26,100,,,percent of total billed charges,100% of total billed charges,426.43,82.6,,,percent of total billed charges,82.6% of total billed charges,426.43,82.6,,,percent of total billed charges,82.6% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.37,17501.21,
INTRO CATH DIALYSIS CIRCUIT,36903,CDM,983,RC,36903,HCPCS,Outpatient,,,819.61,532.75,,721.26,88,,,percent of total billed charges,88% of total Billed charges,35.81,100,,,Fee Schedule,100% of Medicare rate,171.39,100,,,Fee Schedule,100% of WA Medicaid,819.61,100,,,percent of total billed charges,100% of total billed charges,176.53,103,,,Fee Schedule,103% of WA Medicaid,35.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,62.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,171.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,565.53,69,,,percent of total billed charges,69% of total billed charges,819.61,100,,,percent of total billed charges,100% of total billed charges,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,819.61,100,,,percent of total billed charges,100% of total billed charges,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,819.61,100,,,percent of total billed charges,100% of total billed charges,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,506.93,61.85,,,percent of total billed charges,61.85% of total billed charges,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,222.81,130,,,Fee Schedule,130% of WA Medicaid ,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.99,37.7,,,percent of total billed charges,37.70% of total billed charges,308.99,37.7,,,percent of total billed charges,37.70% of total billed charges,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,27784.78,33.9,,,percent of total billed charges,33.9% of total billed charges,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.3,78,,,percent of total billed charges,78% of total billed charges,819.61,100,,,percent of total billed charges,100% of total billed charges,677,82.6,,,percent of total billed charges,82.6% of total billed charges,677,82.6,,,percent of total billed charges,82.6% of total billed charges,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.81,27784.78,
THRMBC/NFS DIALYSIS CIRCUIT,36904,CDM,983,RC,36904,HCPCS,Outpatient,,,943.66,613.38,,830.42,88,,,percent of total billed charges,88% of total Billed charges,39.67,100,,,Fee Schedule,100% of Medicare rate,200.3,100,,,Fee Schedule,100% of WA Medicaid,943.66,100,,,percent of total billed charges,100% of total billed charges,206.31,103,,,Fee Schedule,103% of WA Medicaid,39.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,651.13,69,,,percent of total billed charges,69% of total billed charges,943.66,100,,,percent of total billed charges,100% of total billed charges,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,943.66,100,,,percent of total billed charges,100% of total billed charges,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,943.66,100,,,percent of total billed charges,100% of total billed charges,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.65,61.85,,,percent of total billed charges,61.85% of total billed charges,200.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,260.39,130,,,Fee Schedule,130% of WA Medicaid ,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.76,37.7,,,percent of total billed charges,37.70% of total billed charges,355.76,37.7,,,percent of total billed charges,37.70% of total billed charges,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,31990.07,33.9,,,percent of total billed charges,33.9% of total billed charges,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.05,78,,,percent of total billed charges,78% of total billed charges,943.66,100,,,percent of total billed charges,100% of total billed charges,779.46,82.6,,,percent of total billed charges,82.6% of total billed charges,779.46,82.6,,,percent of total billed charges,82.6% of total billed charges,200.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.67,31990.07,
THRMBC/NFS DIALYSIS CIRCUIT,36905,CDM,983,RC,36905,HCPCS,Outpatient,,,1184.1,769.67,,1042.01,88,,,percent of total billed charges,88% of total Billed charges,44.94,100,,,Fee Schedule,100% of Medicare rate,241.14,100,,,Fee Schedule,100% of WA Medicaid,1184.1,100,,,percent of total billed charges,100% of total billed charges,248.37,103,,,Fee Schedule,103% of WA Medicaid,44.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,241.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,817.03,69,,,percent of total billed charges,69% of total billed charges,1184.1,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1184.1,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1184.1,100,,,percent of total billed charges,100% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,732.37,61.85,,,percent of total billed charges,61.85% of total billed charges,241.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,313.48,130,,,Fee Schedule,130% of WA Medicaid ,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.41,37.7,,,percent of total billed charges,37.70% of total billed charges,446.41,37.7,,,percent of total billed charges,37.70% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,40140.99,33.9,,,percent of total billed charges,33.9% of total billed charges,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,923.6,78,,,percent of total billed charges,78% of total billed charges,1184.1,100,,,percent of total billed charges,100% of total billed charges,978.07,82.6,,,percent of total billed charges,82.6% of total billed charges,978.07,82.6,,,percent of total billed charges,82.6% of total billed charges,241.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.94,40140.99,
THRMBC/NFS DIALYSIS CIRCUIT,36906,CDM,983,RC,36906,HCPCS,Outpatient,,,1381.55,898.01,,1215.76,88,,,percent of total billed charges,88% of total Billed charges,53.9,100,,,Fee Schedule,100% of Medicare rate,277.89,100,,,Fee Schedule,100% of WA Medicaid,1381.55,100,,,percent of total billed charges,100% of total billed charges,286.23,103,,,Fee Schedule,103% of WA Medicaid,53.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,277.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,953.27,69,,,percent of total billed charges,69% of total billed charges,1381.55,100,,,percent of total billed charges,100% of total billed charges,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1381.55,100,,,percent of total billed charges,100% of total billed charges,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1381.55,100,,,percent of total billed charges,100% of total billed charges,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,854.49,61.85,,,percent of total billed charges,61.85% of total billed charges,277.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,361.26,130,,,Fee Schedule,130% of WA Medicaid ,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.84,37.7,,,percent of total billed charges,37.70% of total billed charges,520.84,37.7,,,percent of total billed charges,37.70% of total billed charges,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,46834.55,33.9,,,percent of total billed charges,33.9% of total billed charges,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1077.61,78,,,percent of total billed charges,78% of total billed charges,1381.55,100,,,percent of total billed charges,100% of total billed charges,1141.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1141.16,82.6,,,percent of total billed charges,82.6% of total billed charges,277.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.9,46834.55,
DIALYSIS CIRCUIT EMBOLJ,36909,CDM,983,RC,36909,HCPCS,Outpatient,,,490.87,319.07,,431.97,88,,,percent of total billed charges,88% of total Billed charges,23.16,100,,,Fee Schedule,100% of Medicare rate,108.92,100,,,Fee Schedule,100% of WA Medicaid,490.87,100,,,percent of total billed charges,100% of total billed charges,112.19,103,,,Fee Schedule,103% of WA Medicaid,23.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,108.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,338.7,69,,,percent of total billed charges,69% of total billed charges,490.87,100,,,percent of total billed charges,100% of total billed charges,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.87,100,,,percent of total billed charges,100% of total billed charges,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.87,100,,,percent of total billed charges,100% of total billed charges,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.6,61.85,,,percent of total billed charges,61.85% of total billed charges,108.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.6,130,,,Fee Schedule,130% of WA Medicaid ,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.06,37.7,,,percent of total billed charges,37.70% of total billed charges,185.06,37.7,,,percent of total billed charges,37.70% of total billed charges,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,16640.49,33.9,,,percent of total billed charges,33.9% of total billed charges,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.88,78,,,percent of total billed charges,78% of total billed charges,490.87,100,,,percent of total billed charges,100% of total billed charges,405.46,82.6,,,percent of total billed charges,82.6% of total billed charges,405.46,82.6,,,percent of total billed charges,82.6% of total billed charges,108.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.16,16640.49,
INTRO CATH DIALYSIS CIRCUIT,36901,CDM,983,RC,36901,HCPCS,Outpatient,,,402.24,261.46,,353.97,88,,,percent of total billed charges,88% of total Billed charges,18.09,100,,,Fee Schedule,100% of Medicare rate,91.57,100,,,Fee Schedule,100% of WA Medicaid,402.24,100,,,percent of total billed charges,100% of total billed charges,94.32,103,,,Fee Schedule,103% of WA Medicaid,18.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,91.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,277.55,69,,,percent of total billed charges,69% of total billed charges,402.24,100,,,percent of total billed charges,100% of total billed charges,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.24,100,,,percent of total billed charges,100% of total billed charges,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.24,100,,,percent of total billed charges,100% of total billed charges,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.79,61.85,,,percent of total billed charges,61.85% of total billed charges,91.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.04,130,,,Fee Schedule,130% of WA Medicaid ,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.64,37.7,,,percent of total billed charges,37.70% of total billed charges,151.64,37.7,,,percent of total billed charges,37.70% of total billed charges,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,13635.94,33.9,,,percent of total billed charges,33.9% of total billed charges,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.75,78,,,percent of total billed charges,78% of total billed charges,402.24,100,,,percent of total billed charges,100% of total billed charges,332.25,82.6,,,percent of total billed charges,82.6% of total billed charges,332.25,82.6,,,percent of total billed charges,82.6% of total billed charges,91.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.09,13635.94,
VENOUS MECH THROMBECTOMY,37187,CDM,983,RC,37187,HCPCS,Outpatient,,,1213,788.45,,1067.44,88,,,percent of total billed charges,88% of total Billed charges,44.28,100,,,Fee Schedule,100% of Medicare rate,213.92,100,,,Fee Schedule,100% of WA Medicaid,1213,100,,,percent of total billed charges,100% of total billed charges,220.34,103,,,Fee Schedule,103% of WA Medicaid,44.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,213.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,836.97,69,,,percent of total billed charges,69% of total billed charges,1213,100,,,percent of total billed charges,100% of total billed charges,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1213,100,,,percent of total billed charges,100% of total billed charges,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1213,100,,,percent of total billed charges,100% of total billed charges,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,750.24,61.85,,,percent of total billed charges,61.85% of total billed charges,213.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,278.1,130,,,Fee Schedule,130% of WA Medicaid ,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.3,37.7,,,percent of total billed charges,37.70% of total billed charges,457.3,37.7,,,percent of total billed charges,37.70% of total billed charges,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,41120.7,33.9,,,percent of total billed charges,33.9% of total billed charges,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,946.14,78,,,percent of total billed charges,78% of total billed charges,1213,100,,,percent of total billed charges,100% of total billed charges,1001.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1001.94,82.6,,,percent of total billed charges,82.6% of total billed charges,213.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.28,41120.7,
PRIM ART M-THROMBECT ADD-ON,37185,CDM,983,RC,37185,HCPCS,Outpatient,,,2613,1698.45,,2299.44,88,,,percent of total billed charges,88% of total Billed charges,21.01,100,,,Fee Schedule,100% of Medicare rate,87.84,100,,,Fee Schedule,100% of WA Medicaid,2613,100,,,percent of total billed charges,100% of total billed charges,90.48,103,,,Fee Schedule,103% of WA Medicaid,21.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,87.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1802.97,69,,,percent of total billed charges,69% of total billed charges,2613,100,,,percent of total billed charges,100% of total billed charges,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2613,100,,,percent of total billed charges,100% of total billed charges,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2613,100,,,percent of total billed charges,100% of total billed charges,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1616.14,61.85,,,percent of total billed charges,61.85% of total billed charges,87.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,114.19,130,,,Fee Schedule,130% of WA Medicaid ,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,985.1,37.7,,,percent of total billed charges,37.70% of total billed charges,985.1,37.7,,,percent of total billed charges,37.70% of total billed charges,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,88580.7,33.9,,,percent of total billed charges,33.9% of total billed charges,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2038.14,78,,,percent of total billed charges,78% of total billed charges,2613,100,,,percent of total billed charges,100% of total billed charges,2158.34,82.6,,,percent of total billed charges,82.6% of total billed charges,2158.34,82.6,,,percent of total billed charges,82.6% of total billed charges,87.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.01,88580.7,
PRIM ART MECH THROMBECTOMY,37184,CDM,983,RC,37184,HCPCS,Outpatient,,,7991,5194.15,,7032.08,88,,,percent of total billed charges,88% of total Billed charges,53.11,100,,,Fee Schedule,100% of Medicare rate,233.5,100,,,Fee Schedule,100% of WA Medicaid,7991,100,,,percent of total billed charges,100% of total billed charges,240.51,103,,,Fee Schedule,103% of WA Medicaid,53.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,233.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5513.79,69,,,percent of total billed charges,69% of total billed charges,7991,100,,,percent of total billed charges,100% of total billed charges,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,7991,100,,,percent of total billed charges,100% of total billed charges,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,7991,100,,,percent of total billed charges,100% of total billed charges,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,4942.43,61.85,,,percent of total billed charges,61.85% of total billed charges,233.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,303.55,130,,,Fee Schedule,130% of WA Medicaid ,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,3012.61,37.7,,,percent of total billed charges,37.70% of total billed charges,3012.61,37.7,,,percent of total billed charges,37.70% of total billed charges,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,270894.9,33.9,,,percent of total billed charges,33.9% of total billed charges,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,6232.98,78,,,percent of total billed charges,78% of total billed charges,7991,100,,,percent of total billed charges,100% of total billed charges,6600.57,82.6,,,percent of total billed charges,82.6% of total billed charges,6600.57,82.6,,,percent of total billed charges,82.6% of total billed charges,233.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.11,270894.9,
SEC ART M-THROMBECT ADD-ON,37186,CDM,983,RC,37186,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,33.17,100,,,Fee Schedule,100% of Medicare rate,131.3,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,135.24,103,,,Fee Schedule,103% of WA Medicaid,33.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,131.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,632,100,,,percent of total billed charges,100% of total billed charges,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,632,100,,,percent of total billed charges,100% of total billed charges,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.89,61.85,,,percent of total billed charges,61.85% of total billed charges,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,170.69,130,,,Fee Schedule,130% of WA Medicaid ,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,21424.8,33.9,,,percent of total billed charges,33.9% of total billed charges,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.17,21424.8,
REM ENDOVAS VENA CAVA FILTER,37193,CDM,983,RC,37193,HCPCS,Outpatient,,,1436,933.40,,1263.68,88,,,percent of total billed charges,88% of total Billed charges,37.49,100,,,Fee Schedule,100% of Medicare rate,188.37,100,,,Fee Schedule,100% of WA Medicaid,1436,100,,,percent of total billed charges,100% of total billed charges,194.02,103,,,Fee Schedule,103% of WA Medicaid,37.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,188.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,990.84,69,,,percent of total billed charges,69% of total billed charges,1436,100,,,percent of total billed charges,100% of total billed charges,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1436,100,,,percent of total billed charges,100% of total billed charges,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1436,100,,,percent of total billed charges,100% of total billed charges,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,888.17,61.85,,,percent of total billed charges,61.85% of total billed charges,188.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,244.88,130,,,Fee Schedule,130% of WA Medicaid ,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.37,37.7,,,percent of total billed charges,37.70% of total billed charges,541.37,37.7,,,percent of total billed charges,37.70% of total billed charges,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,48680.4,33.9,,,percent of total billed charges,33.9% of total billed charges,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1120.08,78,,,percent of total billed charges,78% of total billed charges,1436,100,,,percent of total billed charges,100% of total billed charges,1186.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.14,82.6,,,percent of total billed charges,82.6% of total billed charges,188.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.49,48680.4,
REDO ENDOVAS VENA CAVA FILTR,37192,CDM,983,RC,37192,HCPCS,Outpatient,,,1436,933.40,,1263.68,88,,,percent of total billed charges,88% of total Billed charges,55.17,100,,,Fee Schedule,100% of Medicare rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,1436,100,,,percent of total billed charges,100% of total billed charges,189.41,103,,,Fee Schedule,103% of WA Medicaid,55.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,96.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,990.84,69,,,percent of total billed charges,69% of total billed charges,1436,100,,,percent of total billed charges,100% of total billed charges,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1436,100,,,percent of total billed charges,100% of total billed charges,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1436,100,,,percent of total billed charges,100% of total billed charges,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,888.17,61.85,,,percent of total billed charges,61.85% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,239.06,130,,,Fee Schedule,130% of WA Medicaid ,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.37,37.7,,,percent of total billed charges,37.70% of total billed charges,541.37,37.7,,,percent of total billed charges,37.70% of total billed charges,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,48680.4,33.9,,,percent of total billed charges,33.9% of total billed charges,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1120.08,78,,,percent of total billed charges,78% of total billed charges,1436,100,,,percent of total billed charges,100% of total billed charges,1186.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1186.14,82.6,,,percent of total billed charges,82.6% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.17,48680.4,
REMOVE INTRVAS FOREIGN BODY,37197,CDM,983,RC,37197,HCPCS,Outpatient,,,932,605.80,,820.16,88,,,percent of total billed charges,88% of total Billed charges,34.86,100,,,Fee Schedule,100% of Medicare rate,163.19,100,,,Fee Schedule,100% of WA Medicaid,932,100,,,percent of total billed charges,100% of total billed charges,168.09,103,,,Fee Schedule,103% of WA Medicaid,34.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,163.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,643.08,69,,,percent of total billed charges,69% of total billed charges,932,100,,,percent of total billed charges,100% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,932,100,,,percent of total billed charges,100% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,932,100,,,percent of total billed charges,100% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,576.44,61.85,,,percent of total billed charges,61.85% of total billed charges,163.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,212.15,130,,,Fee Schedule,130% of WA Medicaid ,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.36,37.7,,,percent of total billed charges,37.70% of total billed charges,351.36,37.7,,,percent of total billed charges,37.70% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,31594.8,33.9,,,percent of total billed charges,33.9% of total billed charges,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.96,78,,,percent of total billed charges,78% of total billed charges,932,100,,,percent of total billed charges,100% of total billed charges,769.83,82.6,,,percent of total billed charges,82.6% of total billed charges,769.83,82.6,,,percent of total billed charges,82.6% of total billed charges,163.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.86,31594.8,
INS ENDOVAS VENA CAVA FILTR,37191,CDM,983,RC,37191,HCPCS,Outpatient,,,961,624.65,,845.68,88,,,percent of total billed charges,88% of total Billed charges,22.71,100,,,Fee Schedule,100% of Medicare rate,120.29,100,,,Fee Schedule,100% of WA Medicaid,961,100,,,percent of total billed charges,100% of total billed charges,123.9,103,,,Fee Schedule,103% of WA Medicaid,22.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,120.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,663.09,69,,,percent of total billed charges,69% of total billed charges,961,100,,,percent of total billed charges,100% of total billed charges,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,961,100,,,percent of total billed charges,100% of total billed charges,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,961,100,,,percent of total billed charges,100% of total billed charges,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.38,61.85,,,percent of total billed charges,61.85% of total billed charges,120.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,156.38,130,,,Fee Schedule,130% of WA Medicaid ,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.3,37.7,,,percent of total billed charges,37.70% of total billed charges,362.3,37.7,,,percent of total billed charges,37.70% of total billed charges,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,32577.9,33.9,,,percent of total billed charges,33.9% of total billed charges,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,749.58,78,,,percent of total billed charges,78% of total billed charges,961,100,,,percent of total billed charges,100% of total billed charges,793.79,82.6,,,percent of total billed charges,82.6% of total billed charges,793.79,82.6,,,percent of total billed charges,82.6% of total billed charges,120.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.71,32577.9,
TRANSCATHETER THERAPY INFUSE,37201,CDM,983,RC,37201,HCPCS,Outpatient,,,838,544.70,,737.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,838,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,578.22,69,,,percent of total billed charges,69% of total billed charges,838,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,838,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,838,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,518.3,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,315.93,37.7,,,percent of total billed charges,37.70% of total billed charges,315.93,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,28408.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,653.64,78,,,percent of total billed charges,78% of total billed charges,838,100,,,percent of total billed charges,100% of total billed charges,692.19,82.6,,,percent of total billed charges,82.6% of total billed charges,692.19,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",315.93,28408.2,
TRANSCATHETER THERAPY INFUSE,37202,CDM,983,RC,37202,HCPCS,Outpatient,,,895,581.75,,787.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,895,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,617.55,69,,,percent of total billed charges,69% of total billed charges,895,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,895,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,895,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,553.56,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,337.42,37.7,,,percent of total billed charges,37.70% of total billed charges,337.42,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,30340.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,698.1,78,,,percent of total billed charges,78% of total billed charges,895,100,,,percent of total billed charges,100% of total billed charges,739.27,82.6,,,percent of total billed charges,82.6% of total billed charges,739.27,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",337.42,30340.5,
TRANSCATH IV STENT/PERC ADDL,37206,CDM,983,RC,37206,HCPCS,Outpatient,,,694,451.10,,610.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,694,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,478.86,69,,,percent of total billed charges,69% of total billed charges,694,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,694,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,694,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,429.24,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,261.64,37.7,,,percent of total billed charges,37.70% of total billed charges,261.64,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,23526.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,541.32,78,,,percent of total billed charges,78% of total billed charges,694,100,,,percent of total billed charges,100% of total billed charges,573.24,82.6,,,percent of total billed charges,82.6% of total billed charges,573.24,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",261.64,23526.6,
TRANSCATH IV STENT/OPEN ADDL,37208,CDM,983,RC,37208,HCPCS,Outpatient,,,880,572.00,,774.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,880,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,607.2,69,,,percent of total billed charges,69% of total billed charges,880,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,880,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,880,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,544.28,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,331.76,37.7,,,percent of total billed charges,37.70% of total billed charges,331.76,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,29832,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,686.4,78,,,percent of total billed charges,78% of total billed charges,880,100,,,percent of total billed charges,100% of total billed charges,726.88,82.6,,,percent of total billed charges,82.6% of total billed charges,726.88,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",331.76,29832,
"TRANSCATH IV STENT, PERCUT",37205,CDM,983,RC,37205,HCPCS,Outpatient,,,6148,3996.20,,5410.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,4242.12,69,,,percent of total billed charges,69% of total billed charges,6148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3802.54,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2317.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2317.8,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,208417.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,4795.44,78,,,percent of total billed charges,78% of total billed charges,6148,100,,,percent of total billed charges,100% of total billed charges,5078.25,82.6,,,percent of total billed charges,82.6% of total billed charges,5078.25,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",2317.8,208417.2,
"TRANSCATH IV STENT, OPEN",37207,CDM,983,RC,37207,HCPCS,Outpatient,,,1797,1168.05,,1581.36,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1797,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1239.93,69,,,percent of total billed charges,69% of total billed charges,1797,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1797,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1797,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1111.44,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,677.47,37.7,,,percent of total billed charges,37.70% of total billed charges,677.47,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,60918.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1401.66,78,,,percent of total billed charges,78% of total billed charges,1797,100,,,percent of total billed charges,100% of total billed charges,1484.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1484.32,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",677.47,60918.3,
TRANSCATHETER OCCLUSION,37204,CDM,983,RC,37204,HCPCS,Outpatient,,,3375,2193.75,,2970,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3375,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2328.75,69,,,percent of total billed charges,69% of total billed charges,3375,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3375,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3375,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2087.44,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1272.38,37.7,,,percent of total billed charges,37.70% of total billed charges,1272.38,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,114412.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2632.5,78,,,percent of total billed charges,78% of total billed charges,3375,100,,,percent of total billed charges,100% of total billed charges,2787.75,82.6,,,percent of total billed charges,82.6% of total billed charges,2787.75,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1272.38,114412.5,
THROMBLYTIC ART/VEN THERAPY,37213,CDM,983,RC,37213,HCPCS,Outpatient,,,761,494.65,,669.68,88,,,percent of total billed charges,88% of total Billed charges,27.64,100,,,Fee Schedule,100% of Medicare rate,124.96,100,,,Fee Schedule,100% of WA Medicaid,761,100,,,percent of total billed charges,100% of total billed charges,128.71,103,,,Fee Schedule,103% of WA Medicaid,27.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,124.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,525.09,69,,,percent of total billed charges,69% of total billed charges,761,100,,,percent of total billed charges,100% of total billed charges,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,761,100,,,percent of total billed charges,100% of total billed charges,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,761,100,,,percent of total billed charges,100% of total billed charges,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.68,61.85,,,percent of total billed charges,61.85% of total billed charges,124.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,162.45,130,,,Fee Schedule,130% of WA Medicaid ,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.9,37.7,,,percent of total billed charges,37.70% of total billed charges,286.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,25797.9,33.9,,,percent of total billed charges,33.9% of total billed charges,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,593.58,78,,,percent of total billed charges,78% of total billed charges,761,100,,,percent of total billed charges,100% of total billed charges,628.59,82.6,,,percent of total billed charges,82.6% of total billed charges,628.59,82.6,,,percent of total billed charges,82.6% of total billed charges,124.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.64,25797.9,
CESSJ THERAPY CATH REMOVAL,37214,CDM,983,RC,37214,HCPCS,Outpatient,,,447,290.55,,393.36,88,,,percent of total billed charges,88% of total Billed charges,15.17,100,,,Fee Schedule,100% of Medicare rate,65.83,100,,,Fee Schedule,100% of WA Medicaid,447,100,,,percent of total billed charges,100% of total billed charges,67.8,103,,,Fee Schedule,103% of WA Medicaid,15.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,65.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,308.43,69,,,percent of total billed charges,69% of total billed charges,447,100,,,percent of total billed charges,100% of total billed charges,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,447,100,,,percent of total billed charges,100% of total billed charges,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,447,100,,,percent of total billed charges,100% of total billed charges,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.47,61.85,,,percent of total billed charges,61.85% of total billed charges,65.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.58,130,,,Fee Schedule,130% of WA Medicaid ,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.52,37.7,,,percent of total billed charges,37.70% of total billed charges,168.52,37.7,,,percent of total billed charges,37.70% of total billed charges,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,15153.3,33.9,,,percent of total billed charges,33.9% of total billed charges,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.66,78,,,percent of total billed charges,78% of total billed charges,447,100,,,percent of total billed charges,100% of total billed charges,369.22,82.6,,,percent of total billed charges,82.6% of total billed charges,369.22,82.6,,,percent of total billed charges,82.6% of total billed charges,65.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.17,15153.3,
THROMBOLYTIC ART THERAPY,37211,CDM,983,RC,37211,HCPCS,Outpatient,,,1234,802.10,,1085.92,88,,,percent of total billed charges,88% of total Billed charges,49.24,100,,,Fee Schedule,100% of Medicare rate,209.44,100,,,Fee Schedule,100% of WA Medicaid,1234,100,,,percent of total billed charges,100% of total billed charges,215.72,103,,,Fee Schedule,103% of WA Medicaid,49.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,209.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,851.46,69,,,percent of total billed charges,69% of total billed charges,1234,100,,,percent of total billed charges,100% of total billed charges,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1234,100,,,percent of total billed charges,100% of total billed charges,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1234,100,,,percent of total billed charges,100% of total billed charges,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.23,61.85,,,percent of total billed charges,61.85% of total billed charges,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,272.27,130,,,Fee Schedule,130% of WA Medicaid ,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.22,37.7,,,percent of total billed charges,37.70% of total billed charges,465.22,37.7,,,percent of total billed charges,37.70% of total billed charges,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,41832.6,33.9,,,percent of total billed charges,33.9% of total billed charges,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,962.52,78,,,percent of total billed charges,78% of total billed charges,1234,100,,,percent of total billed charges,100% of total billed charges,1019.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1019.28,82.6,,,percent of total billed charges,82.6% of total billed charges,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.24,41832.6,
THROMBOLYTIC VENOUS THERAPY,37212,CDM,983,RC,37212,HCPCS,Outpatient,,,1089,707.85,,958.32,88,,,percent of total billed charges,88% of total Billed charges,40.31,100,,,Fee Schedule,100% of Medicare rate,182.96,100,,,Fee Schedule,100% of WA Medicaid,1089,100,,,percent of total billed charges,100% of total billed charges,188.45,103,,,Fee Schedule,103% of WA Medicaid,40.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,182.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,751.41,69,,,percent of total billed charges,69% of total billed charges,1089,100,,,percent of total billed charges,100% of total billed charges,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1089,100,,,percent of total billed charges,100% of total billed charges,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1089,100,,,percent of total billed charges,100% of total billed charges,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,673.55,61.85,,,percent of total billed charges,61.85% of total billed charges,182.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,237.85,130,,,Fee Schedule,130% of WA Medicaid ,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.55,37.7,,,percent of total billed charges,37.70% of total billed charges,410.55,37.7,,,percent of total billed charges,37.70% of total billed charges,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,36917.1,33.9,,,percent of total billed charges,33.9% of total billed charges,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,849.42,78,,,percent of total billed charges,78% of total billed charges,1089,100,,,percent of total billed charges,100% of total billed charges,899.51,82.6,,,percent of total billed charges,82.6% of total billed charges,899.51,82.6,,,percent of total billed charges,82.6% of total billed charges,182.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.31,36917.1,
STENT PLACEMT RETRO CAROTID,37217,CDM,983,RC,37217,HCPCS,Outpatient,,,3005,1953.25,,2644.4,88,,,percent of total billed charges,88% of total Billed charges,160.11,100,,,Fee Schedule,100% of Medicare rate,583,100,,,Fee Schedule,100% of WA Medicaid,3005,100,,,percent of total billed charges,100% of total billed charges,600.49,103,,,Fee Schedule,103% of WA Medicaid,160.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,280.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,583,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2073.45,69,,,percent of total billed charges,69% of total billed charges,3005,100,,,percent of total billed charges,100% of total billed charges,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,3005,100,,,percent of total billed charges,100% of total billed charges,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,3005,100,,,percent of total billed charges,100% of total billed charges,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1858.59,61.85,,,percent of total billed charges,61.85% of total billed charges,583,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,583,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,757.9,130,,,Fee Schedule,130% of WA Medicaid ,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1132.89,37.7,,,percent of total billed charges,37.70% of total billed charges,1132.89,37.7,,,percent of total billed charges,37.70% of total billed charges,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,101869.5,33.9,,,percent of total billed charges,33.9% of total billed charges,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2343.9,78,,,percent of total billed charges,78% of total billed charges,3005,100,,,percent of total billed charges,100% of total billed charges,2482.13,82.6,,,percent of total billed charges,82.6% of total billed charges,2482.13,82.6,,,percent of total billed charges,82.6% of total billed charges,583,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,160.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,583,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,160.11,101869.5,
TRANSCATH STENT CCA W/O EPS,37216,CDM,983,RC,37216,HCPCS,Outpatient,,,3694,2401.10,,3250.72,88,,,percent of total billed charges,88% of total Billed charges,76.77,100,,,Fee Schedule,100% of Medicare rate,554.84,100,,,Fee Schedule,100% of WA Medicaid,3694,100,,,percent of total billed charges,100% of total billed charges,571.49,103,,,Fee Schedule,103% of WA Medicaid,76.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,134.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,554.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2548.86,69,,,percent of total billed charges,69% of total billed charges,3694,100,,,percent of total billed charges,100% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,3694,100,,,percent of total billed charges,100% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,3694,100,,,percent of total billed charges,100% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2284.74,61.85,,,percent of total billed charges,61.85% of total billed charges,554.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,721.29,130,,,Fee Schedule,130% of WA Medicaid ,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1392.64,37.7,,,percent of total billed charges,37.70% of total billed charges,1392.64,37.7,,,percent of total billed charges,37.70% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,125226.6,33.9,,,percent of total billed charges,33.9% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2881.32,78,,,percent of total billed charges,78% of total billed charges,3694,100,,,percent of total billed charges,100% of total billed charges,3051.24,82.6,,,percent of total billed charges,82.6% of total billed charges,3051.24,82.6,,,percent of total billed charges,82.6% of total billed charges,554.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.77,125226.6,
TRANSCATH STENT CCA W/EPS,37215,CDM,983,RC,37215,HCPCS,Outpatient,,,2768,1799.20,,2435.84,88,,,percent of total billed charges,88% of total Billed charges,147.28,100,,,Fee Schedule,100% of Medicare rate,537.31,100,,,Fee Schedule,100% of WA Medicaid,2768,100,,,percent of total billed charges,100% of total billed charges,553.43,103,,,Fee Schedule,103% of WA Medicaid,147.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,257.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,537.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1909.92,69,,,percent of total billed charges,69% of total billed charges,2768,100,,,percent of total billed charges,100% of total billed charges,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2768,100,,,percent of total billed charges,100% of total billed charges,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2768,100,,,percent of total billed charges,100% of total billed charges,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1712.01,61.85,,,percent of total billed charges,61.85% of total billed charges,537.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,698.5,130,,,Fee Schedule,130% of WA Medicaid ,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1043.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1043.54,37.7,,,percent of total billed charges,37.70% of total billed charges,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,93835.2,33.9,,,percent of total billed charges,33.9% of total billed charges,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2159.04,78,,,percent of total billed charges,78% of total billed charges,2768,100,,,percent of total billed charges,100% of total billed charges,2286.37,82.6,,,percent of total billed charges,82.6% of total billed charges,2286.37,82.6,,,percent of total billed charges,82.6% of total billed charges,537.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,147.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,147.28,93835.2,
FEM/POPL REVASC STNT  ATHER,37227,CDM,983,RC,37227,HCPCS,Outpatient,,,2284,1484.60,,2009.92,88,,,percent of total billed charges,88% of total Billed charges,100.06,100,,,Fee Schedule,100% of Medicare rate,384.75,100,,,Fee Schedule,100% of WA Medicaid,2284,100,,,percent of total billed charges,100% of total billed charges,396.29,103,,,Fee Schedule,103% of WA Medicaid,100.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,175.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,384.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1575.96,69,,,percent of total billed charges,69% of total billed charges,2284,100,,,percent of total billed charges,100% of total billed charges,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2284,100,,,percent of total billed charges,100% of total billed charges,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2284,100,,,percent of total billed charges,100% of total billed charges,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1412.65,61.85,,,percent of total billed charges,61.85% of total billed charges,384.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,500.18,130,,,Fee Schedule,130% of WA Medicaid ,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.07,37.7,,,percent of total billed charges,37.70% of total billed charges,861.07,37.7,,,percent of total billed charges,37.70% of total billed charges,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,77427.6,33.9,,,percent of total billed charges,33.9% of total billed charges,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1781.52,78,,,percent of total billed charges,78% of total billed charges,2284,100,,,percent of total billed charges,100% of total billed charges,1886.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1886.58,82.6,,,percent of total billed charges,82.6% of total billed charges,384.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,100.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,100.06,77427.6,
ILIAC REVASC ADD-ON,37222,CDM,983,RC,37222,HCPCS,Outpatient,,,580,377.00,,510.4,88,,,percent of total billed charges,88% of total Billed charges,26.28,100,,,Fee Schedule,100% of Medicare rate,99.22,100,,,Fee Schedule,100% of WA Medicaid,580,100,,,percent of total billed charges,100% of total billed charges,102.2,103,,,Fee Schedule,103% of WA Medicaid,26.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,99.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,400.2,69,,,percent of total billed charges,69% of total billed charges,580,100,,,percent of total billed charges,100% of total billed charges,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,580,100,,,percent of total billed charges,100% of total billed charges,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,580,100,,,percent of total billed charges,100% of total billed charges,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.73,61.85,,,percent of total billed charges,61.85% of total billed charges,99.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.99,130,,,Fee Schedule,130% of WA Medicaid ,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.66,37.7,,,percent of total billed charges,37.70% of total billed charges,218.66,37.7,,,percent of total billed charges,37.70% of total billed charges,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,19662,33.9,,,percent of total billed charges,33.9% of total billed charges,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.4,78,,,percent of total billed charges,78% of total billed charges,580,100,,,percent of total billed charges,100% of total billed charges,479.08,82.6,,,percent of total billed charges,82.6% of total billed charges,479.08,82.6,,,percent of total billed charges,82.6% of total billed charges,99.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.28,19662,
ILIAC REVASC W/STENT ADD-ON,37223,CDM,983,RC,37223,HCPCS,Outpatient,,,658,427.70,,579.04,88,,,percent of total billed charges,88% of total Billed charges,31.44,100,,,Fee Schedule,100% of Medicare rate,113.39,100,,,Fee Schedule,100% of WA Medicaid,658,100,,,percent of total billed charges,100% of total billed charges,116.79,103,,,Fee Schedule,103% of WA Medicaid,31.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,55.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,113.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,454.02,69,,,percent of total billed charges,69% of total billed charges,658,100,,,percent of total billed charges,100% of total billed charges,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,658,100,,,percent of total billed charges,100% of total billed charges,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,658,100,,,percent of total billed charges,100% of total billed charges,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.97,61.85,,,percent of total billed charges,61.85% of total billed charges,113.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,147.41,130,,,Fee Schedule,130% of WA Medicaid ,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.07,37.7,,,percent of total billed charges,37.70% of total billed charges,248.07,37.7,,,percent of total billed charges,37.70% of total billed charges,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,22306.2,33.9,,,percent of total billed charges,33.9% of total billed charges,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.24,78,,,percent of total billed charges,78% of total billed charges,658,100,,,percent of total billed charges,100% of total billed charges,543.51,82.6,,,percent of total billed charges,82.6% of total billed charges,543.51,82.6,,,percent of total billed charges,82.6% of total billed charges,113.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.44,22306.2,
ILIAC REVASC,37220,CDM,983,RC,37220,HCPCS,Outpatient,,,1274,828.10,,1121.12,88,,,percent of total billed charges,88% of total Billed charges,56.55,100,,,Fee Schedule,100% of Medicare rate,214.85,100,,,Fee Schedule,100% of WA Medicaid,1274,100,,,percent of total billed charges,100% of total billed charges,221.3,103,,,Fee Schedule,103% of WA Medicaid,56.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,98.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,214.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,879.06,69,,,percent of total billed charges,69% of total billed charges,1274,100,,,percent of total billed charges,100% of total billed charges,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1274,100,,,percent of total billed charges,100% of total billed charges,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1274,100,,,percent of total billed charges,100% of total billed charges,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,787.97,61.85,,,percent of total billed charges,61.85% of total billed charges,214.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,279.31,130,,,Fee Schedule,130% of WA Medicaid ,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.3,37.7,,,percent of total billed charges,37.70% of total billed charges,480.3,37.7,,,percent of total billed charges,37.70% of total billed charges,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,43188.6,33.9,,,percent of total billed charges,33.9% of total billed charges,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,993.72,78,,,percent of total billed charges,78% of total billed charges,1274,100,,,percent of total billed charges,100% of total billed charges,1052.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1052.32,82.6,,,percent of total billed charges,82.6% of total billed charges,214.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.55,43188.6,
FEM/POPL REVAS W/ATHER,37225,CDM,983,RC,37225,HCPCS,Outpatient,,,1891,1229.15,,1664.08,88,,,percent of total billed charges,88% of total Billed charges,82.97,100,,,Fee Schedule,100% of Medicare rate,321.9,100,,,Fee Schedule,100% of WA Medicaid,1891,100,,,percent of total billed charges,100% of total billed charges,331.56,103,,,Fee Schedule,103% of WA Medicaid,82.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,145.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,321.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1304.79,69,,,percent of total billed charges,69% of total billed charges,1891,100,,,percent of total billed charges,100% of total billed charges,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1891,100,,,percent of total billed charges,100% of total billed charges,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1891,100,,,percent of total billed charges,100% of total billed charges,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1169.58,61.85,,,percent of total billed charges,61.85% of total billed charges,321.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,418.47,130,,,Fee Schedule,130% of WA Medicaid ,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.91,37.7,,,percent of total billed charges,37.70% of total billed charges,712.91,37.7,,,percent of total billed charges,37.70% of total billed charges,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,64104.9,33.9,,,percent of total billed charges,33.9% of total billed charges,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1474.98,78,,,percent of total billed charges,78% of total billed charges,1891,100,,,percent of total billed charges,100% of total billed charges,1561.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1561.97,82.6,,,percent of total billed charges,82.6% of total billed charges,321.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.97,64104.9,
FEM/POPL REVASC W/STENT,37226,CDM,983,RC,37226,HCPCS,Outpatient,,,1559,1013.35,,1371.92,88,,,percent of total billed charges,88% of total Billed charges,75.21,100,,,Fee Schedule,100% of Medicare rate,278.26,100,,,Fee Schedule,100% of WA Medicaid,1559,100,,,percent of total billed charges,100% of total billed charges,286.61,103,,,Fee Schedule,103% of WA Medicaid,75.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,131.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,278.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1075.71,69,,,percent of total billed charges,69% of total billed charges,1559,100,,,percent of total billed charges,100% of total billed charges,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559,100,,,percent of total billed charges,100% of total billed charges,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559,100,,,percent of total billed charges,100% of total billed charges,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,964.24,61.85,,,percent of total billed charges,61.85% of total billed charges,278.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,361.74,130,,,Fee Schedule,130% of WA Medicaid ,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,587.74,37.7,,,percent of total billed charges,37.70% of total billed charges,587.74,37.7,,,percent of total billed charges,37.70% of total billed charges,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,52850.1,33.9,,,percent of total billed charges,33.9% of total billed charges,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1216.02,78,,,percent of total billed charges,78% of total billed charges,1559,100,,,percent of total billed charges,100% of total billed charges,1287.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1287.73,82.6,,,percent of total billed charges,82.6% of total billed charges,278.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.21,52850.1,
ILIAC REVASC W/STENT,37221,CDM,983,RC,37221,HCPCS,Outpatient,,,1552,1008.80,,1365.76,88,,,percent of total billed charges,88% of total Billed charges,71.37,100,,,Fee Schedule,100% of Medicare rate,264.46,100,,,Fee Schedule,100% of WA Medicaid,1552,100,,,percent of total billed charges,100% of total billed charges,272.39,103,,,Fee Schedule,103% of WA Medicaid,71.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1070.88,69,,,percent of total billed charges,69% of total billed charges,1552,100,,,percent of total billed charges,100% of total billed charges,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1552,100,,,percent of total billed charges,100% of total billed charges,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1552,100,,,percent of total billed charges,100% of total billed charges,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,959.91,61.85,,,percent of total billed charges,61.85% of total billed charges,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,343.8,130,,,Fee Schedule,130% of WA Medicaid ,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.1,37.7,,,percent of total billed charges,37.70% of total billed charges,585.1,37.7,,,percent of total billed charges,37.70% of total billed charges,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,52612.8,33.9,,,percent of total billed charges,33.9% of total billed charges,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1210.56,78,,,percent of total billed charges,78% of total billed charges,1552,100,,,percent of total billed charges,100% of total billed charges,1281.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1281.95,82.6,,,percent of total billed charges,82.6% of total billed charges,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.37,52612.8,
FEM/POPL REVAS W/TLA,37224,CDM,983,RC,37224,HCPCS,Outpatient,,,1403,911.95,,1234.64,88,,,percent of total billed charges,88% of total Billed charges,64.29,100,,,Fee Schedule,100% of Medicare rate,238.72,100,,,Fee Schedule,100% of WA Medicaid,1403,100,,,percent of total billed charges,100% of total billed charges,245.88,103,,,Fee Schedule,103% of WA Medicaid,64.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,238.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,968.07,69,,,percent of total billed charges,69% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1403,100,,,percent of total billed charges,100% of total billed charges,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1403,100,,,percent of total billed charges,100% of total billed charges,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,867.76,61.85,,,percent of total billed charges,61.85% of total billed charges,238.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,310.34,130,,,Fee Schedule,130% of WA Medicaid ,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,528.93,37.7,,,percent of total billed charges,37.70% of total billed charges,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,47561.7,33.9,,,percent of total billed charges,33.9% of total billed charges,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1094.34,78,,,percent of total billed charges,78% of total billed charges,1403,100,,,percent of total billed charges,100% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1158.88,82.6,,,percent of total billed charges,82.6% of total billed charges,238.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.29,47561.7,
TIB/PER REVASC W/ATHER,37229,CDM,983,RC,37229,HCPCS,Outpatient,,,2216,1440.40,,1950.08,88,,,percent of total billed charges,88% of total Billed charges,92.18,100,,,Fee Schedule,100% of Medicare rate,373.19,100,,,Fee Schedule,100% of WA Medicaid,2216,100,,,percent of total billed charges,100% of total billed charges,384.39,103,,,Fee Schedule,103% of WA Medicaid,92.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,161.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,373.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1529.04,69,,,percent of total billed charges,69% of total billed charges,2216,100,,,percent of total billed charges,100% of total billed charges,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2216,100,,,percent of total billed charges,100% of total billed charges,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2216,100,,,percent of total billed charges,100% of total billed charges,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1370.6,61.85,,,percent of total billed charges,61.85% of total billed charges,373.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,485.15,130,,,Fee Schedule,130% of WA Medicaid ,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.43,37.7,,,percent of total billed charges,37.70% of total billed charges,835.43,37.7,,,percent of total billed charges,37.70% of total billed charges,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,75122.4,33.9,,,percent of total billed charges,33.9% of total billed charges,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1728.48,78,,,percent of total billed charges,78% of total billed charges,2216,100,,,percent of total billed charges,100% of total billed charges,1830.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1830.42,82.6,,,percent of total billed charges,82.6% of total billed charges,373.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,92.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,92.18,75122.4,
TIB/PER REVASC W/TLA,37228,CDM,983,RC,37228,HCPCS,Outpatient,,,1715,1114.75,,1509.2,88,,,percent of total billed charges,88% of total Billed charges,77.15,100,,,Fee Schedule,100% of Medicare rate,290.19,100,,,Fee Schedule,100% of WA Medicaid,1715,100,,,percent of total billed charges,100% of total billed charges,298.9,103,,,Fee Schedule,103% of WA Medicaid,77.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,290.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1183.35,69,,,percent of total billed charges,69% of total billed charges,1715,100,,,percent of total billed charges,100% of total billed charges,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1715,100,,,percent of total billed charges,100% of total billed charges,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1715,100,,,percent of total billed charges,100% of total billed charges,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1060.73,61.85,,,percent of total billed charges,61.85% of total billed charges,290.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,377.25,130,,,Fee Schedule,130% of WA Medicaid ,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.56,37.7,,,percent of total billed charges,37.70% of total billed charges,646.56,37.7,,,percent of total billed charges,37.70% of total billed charges,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,58138.5,33.9,,,percent of total billed charges,33.9% of total billed charges,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1337.7,78,,,percent of total billed charges,78% of total billed charges,1715,100,,,percent of total billed charges,100% of total billed charges,1416.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1416.59,82.6,,,percent of total billed charges,82.6% of total billed charges,290.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.15,58138.5,
TIB/PER REVASC STENT  ATHER,37231,CDM,983,RC,37231,HCPCS,Outpatient,,,2323,1509.95,,2044.24,88,,,percent of total billed charges,88% of total Billed charges,90.57,100,,,Fee Schedule,100% of Medicare rate,396.69,100,,,Fee Schedule,100% of WA Medicaid,2323,100,,,percent of total billed charges,100% of total billed charges,408.59,103,,,Fee Schedule,103% of WA Medicaid,90.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,158.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,396.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1602.87,69,,,percent of total billed charges,69% of total billed charges,2323,100,,,percent of total billed charges,100% of total billed charges,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2323,100,,,percent of total billed charges,100% of total billed charges,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2323,100,,,percent of total billed charges,100% of total billed charges,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1436.78,61.85,,,percent of total billed charges,61.85% of total billed charges,396.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,515.7,130,,,Fee Schedule,130% of WA Medicaid ,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,875.77,37.7,,,percent of total billed charges,37.70% of total billed charges,875.77,37.7,,,percent of total billed charges,37.70% of total billed charges,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,78749.7,33.9,,,percent of total billed charges,33.9% of total billed charges,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1811.94,78,,,percent of total billed charges,78% of total billed charges,2323,100,,,percent of total billed charges,100% of total billed charges,1918.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1918.8,82.6,,,percent of total billed charges,82.6% of total billed charges,396.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.57,78749.7,
TIB/PER REVASC STNT  ATHER,37235,CDM,983,RC,37235,HCPCS,Outpatient,,,1207,784.55,,1062.16,88,,,percent of total billed charges,88% of total Billed charges,39.12,100,,,Fee Schedule,100% of Medicare rate,199.37,100,,,Fee Schedule,100% of WA Medicaid,1207,100,,,percent of total billed charges,100% of total billed charges,205.35,103,,,Fee Schedule,103% of WA Medicaid,39.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,199.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,832.83,69,,,percent of total billed charges,69% of total billed charges,1207,100,,,percent of total billed charges,100% of total billed charges,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1207,100,,,percent of total billed charges,100% of total billed charges,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1207,100,,,percent of total billed charges,100% of total billed charges,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.53,61.85,,,percent of total billed charges,61.85% of total billed charges,199.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,259.18,130,,,Fee Schedule,130% of WA Medicaid ,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.04,37.7,,,percent of total billed charges,37.70% of total billed charges,455.04,37.7,,,percent of total billed charges,37.70% of total billed charges,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,40917.3,33.9,,,percent of total billed charges,33.9% of total billed charges,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,941.46,78,,,percent of total billed charges,78% of total billed charges,1207,100,,,percent of total billed charges,100% of total billed charges,996.98,82.6,,,percent of total billed charges,82.6% of total billed charges,996.98,82.6,,,percent of total billed charges,82.6% of total billed charges,199.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.12,40917.3,
TIBPER REVASC W/ATHER ADD-ON,37233,CDM,983,RC,37233,HCPCS,Outpatient,,,1021,663.65,,898.48,88,,,percent of total billed charges,88% of total Billed charges,41.63,100,,,Fee Schedule,100% of Medicare rate,173.45,100,,,Fee Schedule,100% of WA Medicaid,1021,100,,,percent of total billed charges,100% of total billed charges,178.65,103,,,Fee Schedule,103% of WA Medicaid,41.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,173.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,704.49,69,,,percent of total billed charges,69% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1021,100,,,percent of total billed charges,100% of total billed charges,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1021,100,,,percent of total billed charges,100% of total billed charges,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,631.49,61.85,,,percent of total billed charges,61.85% of total billed charges,173.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,225.49,130,,,Fee Schedule,130% of WA Medicaid ,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,34611.9,33.9,,,percent of total billed charges,33.9% of total billed charges,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,796.38,78,,,percent of total billed charges,78% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,173.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.63,34611.9,
OPEN/PERQ PLACE STENT SAME,37238,CDM,983,RC,37238,HCPCS,Outpatient,,,897,583.05,,789.36,88,,,percent of total billed charges,88% of total Billed charges,39.93,100,,,Fee Schedule,100% of Medicare rate,165.8,100,,,Fee Schedule,100% of WA Medicaid,897,100,,,percent of total billed charges,100% of total billed charges,170.77,103,,,Fee Schedule,103% of WA Medicaid,39.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,165.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,618.93,69,,,percent of total billed charges,69% of total billed charges,897,100,,,percent of total billed charges,100% of total billed charges,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,897,100,,,percent of total billed charges,100% of total billed charges,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,897,100,,,percent of total billed charges,100% of total billed charges,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,554.79,61.85,,,percent of total billed charges,61.85% of total billed charges,165.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,215.54,130,,,Fee Schedule,130% of WA Medicaid ,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.17,37.7,,,percent of total billed charges,37.70% of total billed charges,338.17,37.7,,,percent of total billed charges,37.70% of total billed charges,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,30408.3,33.9,,,percent of total billed charges,33.9% of total billed charges,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.66,78,,,percent of total billed charges,78% of total billed charges,897,100,,,percent of total billed charges,100% of total billed charges,740.92,82.6,,,percent of total billed charges,82.6% of total billed charges,740.92,82.6,,,percent of total billed charges,82.6% of total billed charges,165.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.93,30408.3,
OPEN/PERQ PLACE STENT EA ADD,37239,CDM,983,RC,37239,HCPCS,Outpatient,,,416,270.40,,366.08,88,,,percent of total billed charges,88% of total Billed charges,19.61,100,,,Fee Schedule,100% of Medicare rate,81.31,100,,,Fee Schedule,100% of WA Medicaid,416,100,,,percent of total billed charges,100% of total billed charges,83.75,103,,,Fee Schedule,103% of WA Medicaid,19.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,81.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,287.04,69,,,percent of total billed charges,69% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,416,100,,,percent of total billed charges,100% of total billed charges,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,416,100,,,percent of total billed charges,100% of total billed charges,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.3,61.85,,,percent of total billed charges,61.85% of total billed charges,81.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,105.7,130,,,Fee Schedule,130% of WA Medicaid ,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,14102.4,33.9,,,percent of total billed charges,33.9% of total billed charges,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.48,78,,,percent of total billed charges,78% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,81.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.61,14102.4,
TIB/PER REVASC ADD-ON,37232,CDM,983,RC,37232,HCPCS,Outpatient,,,620,403.00,,545.6,88,,,percent of total billed charges,88% of total Billed charges,26.96,100,,,Fee Schedule,100% of Medicare rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,620,100,,,percent of total billed charges,100% of total billed charges,110.26,103,,,Fee Schedule,103% of WA Medicaid,26.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,107.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,427.8,69,,,percent of total billed charges,69% of total billed charges,620,100,,,percent of total billed charges,100% of total billed charges,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,620,100,,,percent of total billed charges,100% of total billed charges,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,620,100,,,percent of total billed charges,100% of total billed charges,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.47,61.85,,,percent of total billed charges,61.85% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.17,130,,,Fee Schedule,130% of WA Medicaid ,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.74,37.7,,,percent of total billed charges,37.70% of total billed charges,233.74,37.7,,,percent of total billed charges,37.70% of total billed charges,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,21018,33.9,,,percent of total billed charges,33.9% of total billed charges,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,483.6,78,,,percent of total billed charges,78% of total billed charges,620,100,,,percent of total billed charges,100% of total billed charges,512.12,82.6,,,percent of total billed charges,82.6% of total billed charges,512.12,82.6,,,percent of total billed charges,82.6% of total billed charges,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.96,21018,
TIB/PER REVASC W/STENT,37230,CDM,983,RC,37230,HCPCS,Outpatient,,,2138,1389.70,,1881.44,88,,,percent of total billed charges,88% of total Billed charges,96.56,100,,,Fee Schedule,100% of Medicare rate,372.63,100,,,Fee Schedule,100% of WA Medicaid,2138,100,,,percent of total billed charges,100% of total billed charges,383.81,103,,,Fee Schedule,103% of WA Medicaid,96.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,168.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,372.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1475.22,69,,,percent of total billed charges,69% of total billed charges,2138,100,,,percent of total billed charges,100% of total billed charges,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2138,100,,,percent of total billed charges,100% of total billed charges,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2138,100,,,percent of total billed charges,100% of total billed charges,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1322.35,61.85,,,percent of total billed charges,61.85% of total billed charges,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,484.42,130,,,Fee Schedule,130% of WA Medicaid ,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.03,37.7,,,percent of total billed charges,37.70% of total billed charges,806.03,37.7,,,percent of total billed charges,37.70% of total billed charges,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,72478.2,33.9,,,percent of total billed charges,33.9% of total billed charges,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1667.64,78,,,percent of total billed charges,78% of total billed charges,2138,100,,,percent of total billed charges,100% of total billed charges,1765.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1765.99,82.6,,,percent of total billed charges,82.6% of total billed charges,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.56,72478.2,
OPEN/PERQ PLACE STENT 1ST,37236,CDM,983,RC,37236,HCPCS,Outpatient,,,1280,832.00,,1126.4,88,,,percent of total billed charges,88% of total Billed charges,62.13,100,,,Fee Schedule,100% of Medicare rate,237.04,100,,,Fee Schedule,100% of WA Medicaid,1280,100,,,percent of total billed charges,100% of total billed charges,244.15,103,,,Fee Schedule,103% of WA Medicaid,62.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,237.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,883.2,69,,,percent of total billed charges,69% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1280,100,,,percent of total billed charges,100% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1280,100,,,percent of total billed charges,100% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,791.68,61.85,,,percent of total billed charges,61.85% of total billed charges,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,308.15,130,,,Fee Schedule,130% of WA Medicaid ,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,482.56,37.7,,,percent of total billed charges,37.70% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,43392,33.9,,,percent of total billed charges,33.9% of total billed charges,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,998.4,78,,,percent of total billed charges,78% of total billed charges,1280,100,,,percent of total billed charges,100% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1057.28,82.6,,,percent of total billed charges,82.6% of total billed charges,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.13,43392,
OPEN/PERQ PLACE STENT EA ADD,37237,CDM,983,RC,37237,HCPCS,Outpatient,,,597,388.05,,525.36,88,,,percent of total billed charges,88% of total Billed charges,30.92,100,,,Fee Schedule,100% of Medicare rate,113.21,100,,,Fee Schedule,100% of WA Medicaid,597,100,,,percent of total billed charges,100% of total billed charges,116.61,103,,,Fee Schedule,103% of WA Medicaid,30.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,113.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,411.93,69,,,percent of total billed charges,69% of total billed charges,597,100,,,percent of total billed charges,100% of total billed charges,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,597,100,,,percent of total billed charges,100% of total billed charges,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,597,100,,,percent of total billed charges,100% of total billed charges,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.24,61.85,,,percent of total billed charges,61.85% of total billed charges,113.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,147.17,130,,,Fee Schedule,130% of WA Medicaid ,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.07,37.7,,,percent of total billed charges,37.70% of total billed charges,225.07,37.7,,,percent of total billed charges,37.70% of total billed charges,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,20238.3,33.9,,,percent of total billed charges,33.9% of total billed charges,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.66,78,,,percent of total billed charges,78% of total billed charges,597,100,,,percent of total billed charges,100% of total billed charges,493.12,82.6,,,percent of total billed charges,82.6% of total billed charges,493.12,82.6,,,percent of total billed charges,82.6% of total billed charges,113.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.92,20238.3,
REVSC OPN/PRQ TIB/PERO STENT,37234,CDM,983,RC,37234,HCPCS,Outpatient,,,850,552.50,,748,88,,,percent of total billed charges,88% of total Billed charges,38.64,100,,,Fee Schedule,100% of Medicare rate,151.25,100,,,Fee Schedule,100% of WA Medicaid,850,100,,,percent of total billed charges,100% of total billed charges,155.79,103,,,Fee Schedule,103% of WA Medicaid,38.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,151.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,586.5,69,,,percent of total billed charges,69% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,850,100,,,percent of total billed charges,100% of total billed charges,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,850,100,,,percent of total billed charges,100% of total billed charges,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.73,61.85,,,percent of total billed charges,61.85% of total billed charges,151.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.63,130,,,Fee Schedule,130% of WA Medicaid ,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,28815,33.9,,,percent of total billed charges,33.9% of total billed charges,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,663,78,,,percent of total billed charges,78% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,151.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.64,28815,
VASC EMBOLIZE/OCCLUDE BLEED,37244,CDM,983,RC,37244,HCPCS,Outpatient,,,1896,1232.40,,1668.48,88,,,percent of total billed charges,88% of total Billed charges,58.02,100,,,Fee Schedule,100% of Medicare rate,360.5,100,,,Fee Schedule,100% of WA Medicaid,1896,100,,,percent of total billed charges,100% of total billed charges,371.32,103,,,Fee Schedule,103% of WA Medicaid,58.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,360.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1308.24,69,,,percent of total billed charges,69% of total billed charges,1896,100,,,percent of total billed charges,100% of total billed charges,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1896,100,,,percent of total billed charges,100% of total billed charges,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1896,100,,,percent of total billed charges,100% of total billed charges,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1172.68,61.85,,,percent of total billed charges,61.85% of total billed charges,360.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,468.65,130,,,Fee Schedule,130% of WA Medicaid ,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.79,37.7,,,percent of total billed charges,37.70% of total billed charges,714.79,37.7,,,percent of total billed charges,37.70% of total billed charges,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,64274.4,33.9,,,percent of total billed charges,33.9% of total billed charges,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1478.88,78,,,percent of total billed charges,78% of total billed charges,1896,100,,,percent of total billed charges,100% of total billed charges,1566.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1566.1,82.6,,,percent of total billed charges,82.6% of total billed charges,360.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.02,64274.4,
TRLUML BALO ANGIOP ADDL ART,37247,CDM,983,RC,37247,HCPCS,Outpatient,,,487,316.55,,428.56,88,,,percent of total billed charges,88% of total Billed charges,22.61,100,,,Fee Schedule,100% of Medicare rate,93.62,100,,,Fee Schedule,100% of WA Medicaid,487,100,,,percent of total billed charges,100% of total billed charges,96.43,103,,,Fee Schedule,103% of WA Medicaid,22.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,93.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,336.03,69,,,percent of total billed charges,69% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,487,100,,,percent of total billed charges,100% of total billed charges,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,487,100,,,percent of total billed charges,100% of total billed charges,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.21,61.85,,,percent of total billed charges,61.85% of total billed charges,93.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,121.71,130,,,Fee Schedule,130% of WA Medicaid ,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,16509.3,33.9,,,percent of total billed charges,33.9% of total billed charges,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.86,78,,,percent of total billed charges,78% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,93.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.61,16509.3,
TRLUML BALO ANGIOP ADDL VEIN,37249,CDM,983,RC,37249,HCPCS,Outpatient,,,415,269.75,,365.2,88,,,percent of total billed charges,88% of total Billed charges,17.93,100,,,Fee Schedule,100% of Medicare rate,78.7,100,,,Fee Schedule,100% of WA Medicaid,415,100,,,percent of total billed charges,100% of total billed charges,81.06,103,,,Fee Schedule,103% of WA Medicaid,17.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,78.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,286.35,69,,,percent of total billed charges,69% of total billed charges,415,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,415,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,415,100,,,percent of total billed charges,100% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.68,61.85,,,percent of total billed charges,61.85% of total billed charges,78.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,102.31,130,,,Fee Schedule,130% of WA Medicaid ,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.46,37.7,,,percent of total billed charges,37.70% of total billed charges,156.46,37.7,,,percent of total billed charges,37.70% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,14068.5,33.9,,,percent of total billed charges,33.9% of total billed charges,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.7,78,,,percent of total billed charges,78% of total billed charges,415,100,,,percent of total billed charges,100% of total billed charges,342.79,82.6,,,percent of total billed charges,82.6% of total billed charges,342.79,82.6,,,percent of total billed charges,82.6% of total billed charges,78.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.93,14068.5,
TRLUML BALO ANGIOP 1ST VEIN,37248,CDM,983,RC,37248,HCPCS,Outpatient,,,845,549.25,,743.6,88,,,percent of total billed charges,88% of total Billed charges,32.18,100,,,Fee Schedule,100% of Medicare rate,161.7,100,,,Fee Schedule,100% of WA Medicaid,845,100,,,percent of total billed charges,100% of total billed charges,166.55,103,,,Fee Schedule,103% of WA Medicaid,32.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,161.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,583.05,69,,,percent of total billed charges,69% of total billed charges,845,100,,,percent of total billed charges,100% of total billed charges,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,845,100,,,percent of total billed charges,100% of total billed charges,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,845,100,,,percent of total billed charges,100% of total billed charges,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.63,61.85,,,percent of total billed charges,61.85% of total billed charges,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.21,130,,,Fee Schedule,130% of WA Medicaid ,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.57,37.7,,,percent of total billed charges,37.70% of total billed charges,318.57,37.7,,,percent of total billed charges,37.70% of total billed charges,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,28645.5,33.9,,,percent of total billed charges,33.9% of total billed charges,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.1,78,,,percent of total billed charges,78% of total billed charges,845,100,,,percent of total billed charges,100% of total billed charges,697.97,82.6,,,percent of total billed charges,82.6% of total billed charges,697.97,82.6,,,percent of total billed charges,82.6% of total billed charges,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.18,28645.5,
VASC EMBOLIZE/OCCLUDE ORGAN,37243,CDM,983,RC,37243,HCPCS,Outpatient,,,1626,1056.90,,1430.88,88,,,percent of total billed charges,88% of total Billed charges,48.12,100,,,Fee Schedule,100% of Medicare rate,305.86,100,,,Fee Schedule,100% of WA Medicaid,1626,100,,,percent of total billed charges,100% of total billed charges,315.04,103,,,Fee Schedule,103% of WA Medicaid,48.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,84.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,305.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1121.94,69,,,percent of total billed charges,69% of total billed charges,1626,100,,,percent of total billed charges,100% of total billed charges,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1626,100,,,percent of total billed charges,100% of total billed charges,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1626,100,,,percent of total billed charges,100% of total billed charges,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1005.68,61.85,,,percent of total billed charges,61.85% of total billed charges,305.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,397.62,130,,,Fee Schedule,130% of WA Medicaid ,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,613,37.7,,,percent of total billed charges,37.70% of total billed charges,613,37.7,,,percent of total billed charges,37.70% of total billed charges,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,55121.4,33.9,,,percent of total billed charges,33.9% of total billed charges,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1268.28,78,,,percent of total billed charges,78% of total billed charges,1626,100,,,percent of total billed charges,100% of total billed charges,1343.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1343.08,82.6,,,percent of total billed charges,82.6% of total billed charges,305.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.12,55121.4,
VASC EMBOLIZE/OCCLUDE ARTERY,37242,CDM,983,RC,37242,HCPCS,Outpatient,,,1396,907.40,,1228.48,88,,,percent of total billed charges,88% of total Billed charges,53.63,100,,,Fee Schedule,100% of Medicare rate,257.93,100,,,Fee Schedule,100% of WA Medicaid,1396,100,,,percent of total billed charges,100% of total billed charges,265.67,103,,,Fee Schedule,103% of WA Medicaid,53.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,257.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,963.24,69,,,percent of total billed charges,69% of total billed charges,1396,100,,,percent of total billed charges,100% of total billed charges,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1396,100,,,percent of total billed charges,100% of total billed charges,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1396,100,,,percent of total billed charges,100% of total billed charges,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.43,61.85,,,percent of total billed charges,61.85% of total billed charges,257.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,335.31,130,,,Fee Schedule,130% of WA Medicaid ,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,526.29,37.7,,,percent of total billed charges,37.70% of total billed charges,526.29,37.7,,,percent of total billed charges,37.70% of total billed charges,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,47324.4,33.9,,,percent of total billed charges,33.9% of total billed charges,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1088.88,78,,,percent of total billed charges,78% of total billed charges,1396,100,,,percent of total billed charges,100% of total billed charges,1153.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1153.1,82.6,,,percent of total billed charges,82.6% of total billed charges,257.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.63,47324.4,
TRLUML BALO ANGIOP 1ST ART,37246,CDM,983,RC,37246,HCPCS,Outpatient,,,982,638.30,,864.16,88,,,percent of total billed charges,88% of total Billed charges,43.97,100,,,Fee Schedule,100% of Medicare rate,188.18,100,,,Fee Schedule,100% of WA Medicaid,982,100,,,percent of total billed charges,100% of total billed charges,193.83,103,,,Fee Schedule,103% of WA Medicaid,43.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,188.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,677.58,69,,,percent of total billed charges,69% of total billed charges,982,100,,,percent of total billed charges,100% of total billed charges,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,982,100,,,percent of total billed charges,100% of total billed charges,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,982,100,,,percent of total billed charges,100% of total billed charges,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,607.37,61.85,,,percent of total billed charges,61.85% of total billed charges,188.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,244.63,130,,,Fee Schedule,130% of WA Medicaid ,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.21,37.7,,,percent of total billed charges,37.70% of total billed charges,370.21,37.7,,,percent of total billed charges,37.70% of total billed charges,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,33289.8,33.9,,,percent of total billed charges,33.9% of total billed charges,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.96,78,,,percent of total billed charges,78% of total billed charges,982,100,,,percent of total billed charges,100% of total billed charges,811.13,82.6,,,percent of total billed charges,82.6% of total billed charges,811.13,82.6,,,percent of total billed charges,82.6% of total billed charges,188.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.97,33289.8,
VASC EMBOLIZE/OCCLUDE VENOUS,37241,CDM,983,RC,37241,HCPCS,Outpatient,,,1248,811.20,,1098.24,88,,,percent of total billed charges,88% of total Billed charges,45.78,100,,,Fee Schedule,100% of Medicare rate,232.19,100,,,Fee Schedule,100% of WA Medicaid,1248,100,,,percent of total billed charges,100% of total billed charges,239.16,103,,,Fee Schedule,103% of WA Medicaid,45.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,232.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,861.12,69,,,percent of total billed charges,69% of total billed charges,1248,100,,,percent of total billed charges,100% of total billed charges,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1248,100,,,percent of total billed charges,100% of total billed charges,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1248,100,,,percent of total billed charges,100% of total billed charges,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,771.89,61.85,,,percent of total billed charges,61.85% of total billed charges,232.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,301.85,130,,,Fee Schedule,130% of WA Medicaid ,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.5,37.7,,,percent of total billed charges,37.70% of total billed charges,470.5,37.7,,,percent of total billed charges,37.70% of total billed charges,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,42307.2,33.9,,,percent of total billed charges,33.9% of total billed charges,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,973.44,78,,,percent of total billed charges,78% of total billed charges,1248,100,,,percent of total billed charges,100% of total billed charges,1030.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1030.85,82.6,,,percent of total billed charges,82.6% of total billed charges,232.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.78,42307.2,
INTRAVASCULAR ULTRASOUND (NONCORONARY VESSEL) DURING DIAGNOSTIC EVALUATION AND/O,37253,CDM,983,RC,37253,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,9.03,100,,,Fee Schedule,100% of Medicare rate,38.23,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,39.38,103,,,Fee Schedule,103% of WA Medicaid,9.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,186,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,186,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.04,61.85,,,percent of total billed charges,61.85% of total billed charges,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.7,130,,,Fee Schedule,130% of WA Medicaid ,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6305.4,33.9,,,percent of total billed charges,33.9% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.03,6305.4,
INTRAVASCULAR ULTRASOUND (NONCORONARY VESSEL) DURING DIAGNOSTIC EVALUATION AND/O,37252,CDM,983,RC,37252,HCPCS,Outpatient,,,233,151.45,,205.04,88,,,percent of total billed charges,88% of total Billed charges,11.63,100,,,Fee Schedule,100% of Medicare rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,233,100,,,percent of total billed charges,100% of total billed charges,49.37,103,,,Fee Schedule,103% of WA Medicaid,11.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,160.77,69,,,percent of total billed charges,69% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,233,100,,,percent of total billed charges,100% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,233,100,,,percent of total billed charges,100% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.11,61.85,,,percent of total billed charges,61.85% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.31,130,,,Fee Schedule,130% of WA Medicaid ,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.84,37.7,,,percent of total billed charges,37.70% of total billed charges,87.84,37.7,,,percent of total billed charges,37.70% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,7898.7,33.9,,,percent of total billed charges,33.9% of total billed charges,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.74,78,,,percent of total billed charges,78% of total billed charges,233,100,,,percent of total billed charges,100% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,192.46,82.6,,,percent of total billed charges,82.6% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.63,7898.7,
IV US EACH ADD VESSEL ADD-ON,37251,CDM,983,RC,37251,HCPCS,Outpatient,,,269,174.85,,236.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,269,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,185.61,69,,,percent of total billed charges,69% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,269,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,269,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,166.38,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,101.41,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,9119.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,209.82,78,,,percent of total billed charges,78% of total billed charges,269,100,,,percent of total billed charges,100% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,222.19,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",101.41,9119.1,
IV US FIRST VESSEL ADD-ON,37250,CDM,983,RC,37250,HCPCS,Outpatient,,,355,230.75,,312.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,355,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,244.95,69,,,percent of total billed charges,69% of total billed charges,355,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,355,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,355,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,219.57,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,133.84,37.7,,,percent of total billed charges,37.70% of total billed charges,133.84,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12034.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,276.9,78,,,percent of total billed charges,78% of total billed charges,355,100,,,percent of total billed charges,100% of total billed charges,293.23,82.6,,,percent of total billed charges,82.6% of total billed charges,293.23,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",133.84,12034.5,
LIGATION OF NECK ARTERY,37606,CDM,983,RC,37606,HCPCS,Outpatient,,,1584,1029.60,,1393.92,88,,,percent of total billed charges,88% of total Billed charges,117.27,100,,,Fee Schedule,100% of Medicare rate,419.25,100,,,Fee Schedule,100% of WA Medicaid,1584,100,,,percent of total billed charges,100% of total billed charges,431.83,103,,,Fee Schedule,103% of WA Medicaid,117.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,205.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,419.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1092.96,69,,,percent of total billed charges,69% of total billed charges,1584,100,,,percent of total billed charges,100% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1584,100,,,percent of total billed charges,100% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1584,100,,,percent of total billed charges,100% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,979.7,61.85,,,percent of total billed charges,61.85% of total billed charges,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,427.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,545.03,130,,,Fee Schedule,130% of WA Medicaid ,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.17,37.7,,,percent of total billed charges,37.70% of total billed charges,597.17,37.7,,,percent of total billed charges,37.70% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,53697.6,33.9,,,percent of total billed charges,33.9% of total billed charges,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1235.52,78,,,percent of total billed charges,78% of total billed charges,1584,100,,,percent of total billed charges,100% of total billed charges,1308.38,82.6,,,percent of total billed charges,82.6% of total billed charges,1308.38,82.6,,,percent of total billed charges,82.6% of total billed charges,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.27,53697.6,
LIGATION OF A-V FISTULA,37607,CDM,983,RC,37607,HCPCS,Outpatient,,,1300,845.00,,1144,88,,,percent of total billed charges,88% of total Billed charges,49.84,100,,,Fee Schedule,100% of Medicare rate,206.83,100,,,Fee Schedule,100% of WA Medicaid,1300,100,,,percent of total billed charges,100% of total billed charges,213.03,103,,,Fee Schedule,103% of WA Medicaid,49.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,206.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,897,69,,,percent of total billed charges,69% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300,100,,,percent of total billed charges,100% of total billed charges,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.05,61.85,,,percent of total billed charges,61.85% of total billed charges,206.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,268.88,130,,,Fee Schedule,130% of WA Medicaid ,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,490.1,37.7,,,percent of total billed charges,37.70% of total billed charges,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,44070,33.9,,,percent of total billed charges,33.9% of total billed charges,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,78,,,percent of total billed charges,78% of total billed charges,1300,100,,,percent of total billed charges,100% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1073.8,82.6,,,percent of total billed charges,82.6% of total billed charges,206.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.84,44070,
LIGATION OF NECK ARTERY,37605,CDM,983,RC,37605,HCPCS,Outpatient,,,2216,1440.40,,1950.08,88,,,percent of total billed charges,88% of total Billed charges,113.56,100,,,Fee Schedule,100% of Medicare rate,399.67,100,,,Fee Schedule,100% of WA Medicaid,2216,100,,,percent of total billed charges,100% of total billed charges,411.66,103,,,Fee Schedule,103% of WA Medicaid,113.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,198.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,399.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1529.04,69,,,percent of total billed charges,69% of total billed charges,2216,100,,,percent of total billed charges,100% of total billed charges,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2216,100,,,percent of total billed charges,100% of total billed charges,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2216,100,,,percent of total billed charges,100% of total billed charges,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1370.6,61.85,,,percent of total billed charges,61.85% of total billed charges,399.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,519.57,130,,,Fee Schedule,130% of WA Medicaid ,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.43,37.7,,,percent of total billed charges,37.70% of total billed charges,835.43,37.7,,,percent of total billed charges,37.70% of total billed charges,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,75122.4,33.9,,,percent of total billed charges,33.9% of total billed charges,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1728.48,78,,,percent of total billed charges,78% of total billed charges,2216,100,,,percent of total billed charges,100% of total billed charges,1830.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1830.42,82.6,,,percent of total billed charges,82.6% of total billed charges,399.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,113.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.56,75122.4,
TEMPORAL ARTERY PROCEDURE,37609,CDM,983,RC,37609,HCPCS,Outpatient,,,736,478.40,,647.68,88,,,percent of total billed charges,88% of total Billed charges,22.7,100,,,Fee Schedule,100% of Medicare rate,115.63,100,,,Fee Schedule,100% of WA Medicaid,736,100,,,percent of total billed charges,100% of total billed charges,119.1,103,,,Fee Schedule,103% of WA Medicaid,22.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,115.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,507.84,69,,,percent of total billed charges,69% of total billed charges,736,100,,,percent of total billed charges,100% of total billed charges,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,736,100,,,percent of total billed charges,100% of total billed charges,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,736,100,,,percent of total billed charges,100% of total billed charges,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.22,61.85,,,percent of total billed charges,61.85% of total billed charges,115.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,150.32,130,,,Fee Schedule,130% of WA Medicaid ,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.47,37.7,,,percent of total billed charges,37.70% of total billed charges,277.47,37.7,,,percent of total billed charges,37.70% of total billed charges,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,24950.4,33.9,,,percent of total billed charges,33.9% of total billed charges,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.08,78,,,percent of total billed charges,78% of total billed charges,736,100,,,percent of total billed charges,100% of total billed charges,607.94,82.6,,,percent of total billed charges,82.6% of total billed charges,607.94,82.6,,,percent of total billed charges,82.6% of total billed charges,115.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.7,24950.4,
LIGATION OF NECK ARTERY,37600,CDM,983,RC,37600,HCPCS,Outpatient,,,1978,1285.70,,1740.64,88,,,percent of total billed charges,88% of total Billed charges,77.55,100,,,Fee Schedule,100% of Medicare rate,422.61,100,,,Fee Schedule,100% of WA Medicaid,1978,100,,,percent of total billed charges,100% of total billed charges,435.29,103,,,Fee Schedule,103% of WA Medicaid,77.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,422.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1364.82,69,,,percent of total billed charges,69% of total billed charges,1978,100,,,percent of total billed charges,100% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1978,100,,,percent of total billed charges,100% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1978,100,,,percent of total billed charges,100% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1223.39,61.85,,,percent of total billed charges,61.85% of total billed charges,422.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,431.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,549.39,130,,,Fee Schedule,130% of WA Medicaid ,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.71,37.7,,,percent of total billed charges,37.70% of total billed charges,745.71,37.7,,,percent of total billed charges,37.70% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,67054.2,33.9,,,percent of total billed charges,33.9% of total billed charges,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1542.84,78,,,percent of total billed charges,78% of total billed charges,1978,100,,,percent of total billed charges,100% of total billed charges,1633.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1633.83,82.6,,,percent of total billed charges,82.6% of total billed charges,422.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.55,67054.2,
LIGATION OF EXTREMITY ARTERY,37618,CDM,983,RC,37618,HCPCS,Outpatient,,,1408,915.20,,1239.04,88,,,percent of total billed charges,88% of total Billed charges,48.99,100,,,Fee Schedule,100% of Medicare rate,220.63,100,,,Fee Schedule,100% of WA Medicaid,1408,100,,,percent of total billed charges,100% of total billed charges,227.25,103,,,Fee Schedule,103% of WA Medicaid,48.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,220.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,971.52,69,,,percent of total billed charges,69% of total billed charges,1408,100,,,percent of total billed charges,100% of total billed charges,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1408,100,,,percent of total billed charges,100% of total billed charges,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1408,100,,,percent of total billed charges,100% of total billed charges,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,870.85,61.85,,,percent of total billed charges,61.85% of total billed charges,220.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,286.82,130,,,Fee Schedule,130% of WA Medicaid ,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.82,37.7,,,percent of total billed charges,37.70% of total billed charges,530.82,37.7,,,percent of total billed charges,37.70% of total billed charges,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,47731.2,33.9,,,percent of total billed charges,33.9% of total billed charges,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1098.24,78,,,percent of total billed charges,78% of total billed charges,1408,100,,,percent of total billed charges,100% of total billed charges,1163.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1163.01,82.6,,,percent of total billed charges,82.6% of total billed charges,220.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.99,47731.2,
LIGATION OF ABDOMEN ARTERY,37617,CDM,983,RC,37617,HCPCS,Outpatient,,,3676,2389.40,,3234.88,88,,,percent of total billed charges,88% of total Billed charges,180.62,100,,,Fee Schedule,100% of Medicare rate,731.64,100,,,Fee Schedule,100% of WA Medicaid,3676,100,,,percent of total billed charges,100% of total billed charges,753.59,103,,,Fee Schedule,103% of WA Medicaid,180.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,316.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,731.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2536.44,69,,,percent of total billed charges,69% of total billed charges,3676,100,,,percent of total billed charges,100% of total billed charges,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,3676,100,,,percent of total billed charges,100% of total billed charges,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,3676,100,,,percent of total billed charges,100% of total billed charges,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2273.61,61.85,,,percent of total billed charges,61.85% of total billed charges,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,951.13,130,,,Fee Schedule,130% of WA Medicaid ,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385.85,37.7,,,percent of total billed charges,37.70% of total billed charges,1385.85,37.7,,,percent of total billed charges,37.70% of total billed charges,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,124616.4,33.9,,,percent of total billed charges,33.9% of total billed charges,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2867.28,78,,,percent of total billed charges,78% of total billed charges,3676,100,,,percent of total billed charges,100% of total billed charges,3036.38,82.6,,,percent of total billed charges,82.6% of total billed charges,3036.38,82.6,,,percent of total billed charges,82.6% of total billed charges,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,180.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,180.62,124616.4,
REVISE LEG VEIN,37700,CDM,983,RC,37700,HCPCS,Outpatient,,,1099,714.35,,967.12,88,,,percent of total billed charges,88% of total Billed charges,31.83,100,,,Fee Schedule,100% of Medicare rate,136.15,100,,,Fee Schedule,100% of WA Medicaid,1099,100,,,percent of total billed charges,100% of total billed charges,140.23,103,,,Fee Schedule,103% of WA Medicaid,31.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,55.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,136.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,758.31,69,,,percent of total billed charges,69% of total billed charges,1099,100,,,percent of total billed charges,100% of total billed charges,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1099,100,,,percent of total billed charges,100% of total billed charges,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1099,100,,,percent of total billed charges,100% of total billed charges,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,679.73,61.85,,,percent of total billed charges,61.85% of total billed charges,136.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,177,130,,,Fee Schedule,130% of WA Medicaid ,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.32,37.7,,,percent of total billed charges,37.70% of total billed charges,414.32,37.7,,,percent of total billed charges,37.70% of total billed charges,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,37256.1,33.9,,,percent of total billed charges,33.9% of total billed charges,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,857.22,78,,,percent of total billed charges,78% of total billed charges,1099,100,,,percent of total billed charges,100% of total billed charges,907.77,82.6,,,percent of total billed charges,82.6% of total billed charges,907.77,82.6,,,percent of total billed charges,82.6% of total billed charges,136.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.83,37256.1,
LIGATE/STRIP LONG LEG VEIN,37722,CDM,983,RC,37722,HCPCS,Outpatient,,,1605,1043.25,,1412.4,88,,,percent of total billed charges,88% of total Billed charges,66.06,100,,,Fee Schedule,100% of Medicare rate,253.08,100,,,Fee Schedule,100% of WA Medicaid,1605,100,,,percent of total billed charges,100% of total billed charges,260.67,103,,,Fee Schedule,103% of WA Medicaid,66.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,115.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,253.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1107.45,69,,,percent of total billed charges,69% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1605,100,,,percent of total billed charges,100% of total billed charges,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1605,100,,,percent of total billed charges,100% of total billed charges,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,992.69,61.85,,,percent of total billed charges,61.85% of total billed charges,253.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,329,130,,,Fee Schedule,130% of WA Medicaid ,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,605.09,37.7,,,percent of total billed charges,37.70% of total billed charges,605.09,37.7,,,percent of total billed charges,37.70% of total billed charges,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,54409.5,33.9,,,percent of total billed charges,33.9% of total billed charges,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1251.9,78,,,percent of total billed charges,78% of total billed charges,1605,100,,,percent of total billed charges,100% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1325.73,82.6,,,percent of total billed charges,82.6% of total billed charges,253.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,66.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.06,54409.5,
LIGATE LEG VEINS OPEN,37761,CDM,983,RC,37761,HCPCS,Outpatient,,,1764,1146.60,,1552.32,88,,,percent of total billed charges,88% of total Billed charges,73.27,100,,,Fee Schedule,100% of Medicare rate,296.54,100,,,Fee Schedule,100% of WA Medicaid,1764,100,,,percent of total billed charges,100% of total billed charges,305.44,103,,,Fee Schedule,103% of WA Medicaid,73.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,128.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,296.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1217.16,69,,,percent of total billed charges,69% of total billed charges,1764,100,,,percent of total billed charges,100% of total billed charges,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1764,100,,,percent of total billed charges,100% of total billed charges,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1764,100,,,percent of total billed charges,100% of total billed charges,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1091.03,61.85,,,percent of total billed charges,61.85% of total billed charges,296.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,385.5,130,,,Fee Schedule,130% of WA Medicaid ,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,665.03,37.7,,,percent of total billed charges,37.70% of total billed charges,665.03,37.7,,,percent of total billed charges,37.70% of total billed charges,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,59799.6,33.9,,,percent of total billed charges,33.9% of total billed charges,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1375.92,78,,,percent of total billed charges,78% of total billed charges,1764,100,,,percent of total billed charges,100% of total billed charges,1457.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1457.06,82.6,,,percent of total billed charges,82.6% of total billed charges,296.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,74,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.27,59799.6,
LIGATE LEG VEINS RADICAL,37760,CDM,983,RC,37760,HCPCS,Outpatient,,,2516,1635.40,,2214.08,88,,,percent of total billed charges,88% of total Billed charges,86.17,100,,,Fee Schedule,100% of Medicare rate,314.07,100,,,Fee Schedule,100% of WA Medicaid,2516,100,,,percent of total billed charges,100% of total billed charges,323.49,103,,,Fee Schedule,103% of WA Medicaid,86.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,150.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,314.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1736.04,69,,,percent of total billed charges,69% of total billed charges,2516,100,,,percent of total billed charges,100% of total billed charges,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2516,100,,,percent of total billed charges,100% of total billed charges,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2516,100,,,percent of total billed charges,100% of total billed charges,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1556.15,61.85,,,percent of total billed charges,61.85% of total billed charges,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,408.29,130,,,Fee Schedule,130% of WA Medicaid ,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,948.53,37.7,,,percent of total billed charges,37.70% of total billed charges,948.53,37.7,,,percent of total billed charges,37.70% of total billed charges,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,85292.4,33.9,,,percent of total billed charges,33.9% of total billed charges,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1962.48,78,,,percent of total billed charges,78% of total billed charges,2516,100,,,percent of total billed charges,100% of total billed charges,2078.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2078.22,82.6,,,percent of total billed charges,82.6% of total billed charges,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,86.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.17,85292.4,
PHLEB VEINS - EXTREM 20+,37766,CDM,983,RC,37766,HCPCS,Outpatient,,,1574,1023.10,,1385.12,88,,,percent of total billed charges,88% of total Billed charges,44.65,100,,,Fee Schedule,100% of Medicare rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,1574,100,,,percent of total billed charges,100% of total billed charges,187.48,103,,,Fee Schedule,103% of WA Medicaid,44.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,182.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1086.06,69,,,percent of total billed charges,69% of total billed charges,1574,100,,,percent of total billed charges,100% of total billed charges,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1574,100,,,percent of total billed charges,100% of total billed charges,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1574,100,,,percent of total billed charges,100% of total billed charges,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,973.52,61.85,,,percent of total billed charges,61.85% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,236.63,130,,,Fee Schedule,130% of WA Medicaid ,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,593.4,37.7,,,percent of total billed charges,37.70% of total billed charges,593.4,37.7,,,percent of total billed charges,37.70% of total billed charges,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,53358.6,33.9,,,percent of total billed charges,33.9% of total billed charges,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1227.72,78,,,percent of total billed charges,78% of total billed charges,1574,100,,,percent of total billed charges,100% of total billed charges,1300.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1300.12,82.6,,,percent of total billed charges,82.6% of total billed charges,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.65,53358.6,
STAB PHLEB VEINS XTR 10-20,37765,CDM,983,RC,37765,HCPCS,Outpatient,,,1231,800.15,,1083.28,88,,,percent of total billed charges,88% of total Billed charges,36.14,100,,,Fee Schedule,100% of Medicare rate,148.64,100,,,Fee Schedule,100% of WA Medicaid,1231,100,,,percent of total billed charges,100% of total billed charges,153.1,103,,,Fee Schedule,103% of WA Medicaid,36.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,148.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,849.39,69,,,percent of total billed charges,69% of total billed charges,1231,100,,,percent of total billed charges,100% of total billed charges,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1231,100,,,percent of total billed charges,100% of total billed charges,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1231,100,,,percent of total billed charges,100% of total billed charges,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,761.37,61.85,,,percent of total billed charges,61.85% of total billed charges,148.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,193.23,130,,,Fee Schedule,130% of WA Medicaid ,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.09,37.7,,,percent of total billed charges,37.70% of total billed charges,464.09,37.7,,,percent of total billed charges,37.70% of total billed charges,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,41730.9,33.9,,,percent of total billed charges,33.9% of total billed charges,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,960.18,78,,,percent of total billed charges,78% of total billed charges,1231,100,,,percent of total billed charges,100% of total billed charges,1016.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1016.81,82.6,,,percent of total billed charges,82.6% of total billed charges,148.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.14,41730.9,
REVISION OF LEG VEIN,37780,CDM,983,RC,37780,HCPCS,Outpatient,,,894,581.10,,786.72,88,,,percent of total billed charges,88% of total Billed charges,32.34,100,,,Fee Schedule,100% of Medicare rate,130.74,100,,,Fee Schedule,100% of WA Medicaid,894,100,,,percent of total billed charges,100% of total billed charges,134.66,103,,,Fee Schedule,103% of WA Medicaid,32.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,130.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,616.86,69,,,percent of total billed charges,69% of total billed charges,894,100,,,percent of total billed charges,100% of total billed charges,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,894,100,,,percent of total billed charges,100% of total billed charges,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,894,100,,,percent of total billed charges,100% of total billed charges,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.94,61.85,,,percent of total billed charges,61.85% of total billed charges,130.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,169.96,130,,,Fee Schedule,130% of WA Medicaid ,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.04,37.7,,,percent of total billed charges,37.70% of total billed charges,337.04,37.7,,,percent of total billed charges,37.70% of total billed charges,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,30306.6,33.9,,,percent of total billed charges,33.9% of total billed charges,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.32,78,,,percent of total billed charges,78% of total billed charges,894,100,,,percent of total billed charges,100% of total billed charges,738.44,82.6,,,percent of total billed charges,82.6% of total billed charges,738.44,82.6,,,percent of total billed charges,82.6% of total billed charges,130.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.34,30306.6,
LIGATE/DIVIDE/EXCISE VEIN,37785,CDM,983,RC,37785,HCPCS,Outpatient,,,879,571.35,,773.52,88,,,percent of total billed charges,88% of total Billed charges,32.67,100,,,Fee Schedule,100% of Medicare rate,142.3,100,,,Fee Schedule,100% of WA Medicaid,879,100,,,percent of total billed charges,100% of total billed charges,146.57,103,,,Fee Schedule,103% of WA Medicaid,32.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,142.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,606.51,69,,,percent of total billed charges,69% of total billed charges,879,100,,,percent of total billed charges,100% of total billed charges,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,879,100,,,percent of total billed charges,100% of total billed charges,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,879,100,,,percent of total billed charges,100% of total billed charges,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,543.66,61.85,,,percent of total billed charges,61.85% of total billed charges,142.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,184.99,130,,,Fee Schedule,130% of WA Medicaid ,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.38,37.7,,,percent of total billed charges,37.70% of total billed charges,331.38,37.7,,,percent of total billed charges,37.70% of total billed charges,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,29798.1,33.9,,,percent of total billed charges,33.9% of total billed charges,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.62,78,,,percent of total billed charges,78% of total billed charges,879,100,,,percent of total billed charges,100% of total billed charges,726.05,82.6,,,percent of total billed charges,82.6% of total billed charges,726.05,82.6,,,percent of total billed charges,82.6% of total billed charges,142.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,33,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.67,29798.1,
REMOVAL OF SPLEEN PARTIAL,38101,CDM,983,RC,38101,HCPCS,Outpatient,,,3152,2048.80,,2773.76,88,,,percent of total billed charges,88% of total Billed charges,164.86,100,,,Fee Schedule,100% of Medicare rate,650.33,100,,,Fee Schedule,100% of WA Medicaid,3152,100,,,percent of total billed charges,100% of total billed charges,669.84,103,,,Fee Schedule,103% of WA Medicaid,164.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,288.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,650.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2174.88,69,,,percent of total billed charges,69% of total billed charges,3152,100,,,percent of total billed charges,100% of total billed charges,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,3152,100,,,percent of total billed charges,100% of total billed charges,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,3152,100,,,percent of total billed charges,100% of total billed charges,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1949.51,61.85,,,percent of total billed charges,61.85% of total billed charges,650.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,650.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,845.43,130,,,Fee Schedule,130% of WA Medicaid ,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1188.3,37.7,,,percent of total billed charges,37.70% of total billed charges,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,106852.8,33.9,,,percent of total billed charges,33.9% of total billed charges,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2458.56,78,,,percent of total billed charges,78% of total billed charges,3152,100,,,percent of total billed charges,100% of total billed charges,2603.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2603.55,82.6,,,percent of total billed charges,82.6% of total billed charges,650.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,164.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,650.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,164.86,106852.8,
REMOVAL OF SPLEEN TOTAL,38100,CDM,983,RC,38100,HCPCS,Outpatient,,,4796,3117.40,,4220.48,88,,,percent of total billed charges,88% of total Billed charges,155.93,100,,,Fee Schedule,100% of Medicare rate,643.24,100,,,Fee Schedule,100% of WA Medicaid,4796,100,,,percent of total billed charges,100% of total billed charges,662.54,103,,,Fee Schedule,103% of WA Medicaid,155.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,272.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,643.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3309.24,69,,,percent of total billed charges,69% of total billed charges,4796,100,,,percent of total billed charges,100% of total billed charges,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4796,100,,,percent of total billed charges,100% of total billed charges,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4796,100,,,percent of total billed charges,100% of total billed charges,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2966.33,61.85,,,percent of total billed charges,61.85% of total billed charges,643.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,643.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,656.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,836.21,130,,,Fee Schedule,130% of WA Medicaid ,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1808.09,37.7,,,percent of total billed charges,37.70% of total billed charges,1808.09,37.7,,,percent of total billed charges,37.70% of total billed charges,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,162584.4,33.9,,,percent of total billed charges,33.9% of total billed charges,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3740.88,78,,,percent of total billed charges,78% of total billed charges,4796,100,,,percent of total billed charges,100% of total billed charges,3961.5,82.6,,,percent of total billed charges,82.6% of total billed charges,3961.5,82.6,,,percent of total billed charges,82.6% of total billed charges,643.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,155.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,643.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,155.93,162584.4,
REPAIR OF RUPTURED SPLEEN,38115,CDM,983,RC,38115,HCPCS,Outpatient,,,4886,3175.90,,4299.68,88,,,percent of total billed charges,88% of total Billed charges,184.41,100,,,Fee Schedule,100% of Medicare rate,720.45,100,,,Fee Schedule,100% of WA Medicaid,4886,100,,,percent of total billed charges,100% of total billed charges,742.06,103,,,Fee Schedule,103% of WA Medicaid,184.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,322.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,720.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3371.34,69,,,percent of total billed charges,69% of total billed charges,4886,100,,,percent of total billed charges,100% of total billed charges,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,4886,100,,,percent of total billed charges,100% of total billed charges,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,4886,100,,,percent of total billed charges,100% of total billed charges,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,3021.99,61.85,,,percent of total billed charges,61.85% of total billed charges,720.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,720.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,734.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,936.59,130,,,Fee Schedule,130% of WA Medicaid ,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1842.02,37.7,,,percent of total billed charges,37.70% of total billed charges,1842.02,37.7,,,percent of total billed charges,37.70% of total billed charges,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,165635.4,33.9,,,percent of total billed charges,33.9% of total billed charges,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,3811.08,78,,,percent of total billed charges,78% of total billed charges,4886,100,,,percent of total billed charges,100% of total billed charges,4035.84,82.6,,,percent of total billed charges,82.6% of total billed charges,4035.84,82.6,,,percent of total billed charges,82.6% of total billed charges,720.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,184.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,720.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,184.41,165635.4,
LAPAROSCOPY SPLENECTOMY,38120,CDM,983,RC,38120,HCPCS,Outpatient,,,2860,1859.00,,2516.8,88,,,percent of total billed charges,88% of total Billed charges,142.76,100,,,Fee Schedule,100% of Medicare rate,596.05,100,,,Fee Schedule,100% of WA Medicaid,2860,100,,,percent of total billed charges,100% of total billed charges,613.93,103,,,Fee Schedule,103% of WA Medicaid,142.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,249.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,596.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1973.4,69,,,percent of total billed charges,69% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2860,100,,,percent of total billed charges,100% of total billed charges,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2860,100,,,percent of total billed charges,100% of total billed charges,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1768.91,61.85,,,percent of total billed charges,61.85% of total billed charges,596.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,607.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,774.87,130,,,Fee Schedule,130% of WA Medicaid ,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1078.22,37.7,,,percent of total billed charges,37.70% of total billed charges,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,96954,33.9,,,percent of total billed charges,33.9% of total billed charges,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2230.8,78,,,percent of total billed charges,78% of total billed charges,2860,100,,,percent of total billed charges,100% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2362.36,82.6,,,percent of total billed charges,82.6% of total billed charges,596.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,142.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,142.76,96954,
BONE MARROW BIOPSY,38221,CDM,983,RC,38221,HCPCS,Outpatient,,,635,412.75,,558.8,88,,,percent of total billed charges,88% of total Billed charges,4.69,100,,,Fee Schedule,100% of Medicare rate,39.72,100,,,Fee Schedule,100% of WA Medicaid,635,100,,,percent of total billed charges,100% of total billed charges,40.91,103,,,Fee Schedule,103% of WA Medicaid,4.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,438.15,69,,,percent of total billed charges,69% of total billed charges,635,100,,,percent of total billed charges,100% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,635,100,,,percent of total billed charges,100% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,635,100,,,percent of total billed charges,100% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.75,61.85,,,percent of total billed charges,61.85% of total billed charges,39.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.64,130,,,Fee Schedule,130% of WA Medicaid ,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.4,37.7,,,percent of total billed charges,37.70% of total billed charges,239.4,37.7,,,percent of total billed charges,37.70% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,21526.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.3,78,,,percent of total billed charges,78% of total billed charges,635,100,,,percent of total billed charges,100% of total billed charges,524.51,82.6,,,percent of total billed charges,82.6% of total billed charges,524.51,82.6,,,percent of total billed charges,82.6% of total billed charges,39.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.69,21526.5,
BONE MARROW ASPIRATION,38220,CDM,983,RC,38220,HCPCS,Outpatient,,,226,146.90,,198.88,88,,,percent of total billed charges,88% of total Billed charges,4.6,100,,,Fee Schedule,100% of Medicare rate,38.05,100,,,Fee Schedule,100% of WA Medicaid,226,100,,,percent of total billed charges,100% of total billed charges,39.19,103,,,Fee Schedule,103% of WA Medicaid,4.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,155.94,69,,,percent of total billed charges,69% of total billed charges,226,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,226,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,226,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.78,61.85,,,percent of total billed charges,61.85% of total billed charges,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.47,130,,,Fee Schedule,130% of WA Medicaid ,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.2,37.7,,,percent of total billed charges,37.70% of total billed charges,85.2,37.7,,,percent of total billed charges,37.70% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,7661.4,33.9,,,percent of total billed charges,33.9% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.28,78,,,percent of total billed charges,78% of total billed charges,226,100,,,percent of total billed charges,100% of total billed charges,186.68,82.6,,,percent of total billed charges,82.6% of total billed charges,186.68,82.6,,,percent of total billed charges,82.6% of total billed charges,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.6,7661.4,
NEEDLE BIOPSY LYMPH NODES,38505,CDM,983,RC,38505,HCPCS,Outpatient,,,545,354.25,,479.6,88,,,percent of total billed charges,88% of total Billed charges,6.69,100,,,Fee Schedule,100% of Medicare rate,48.12,100,,,Fee Schedule,100% of WA Medicaid,545,100,,,percent of total billed charges,100% of total billed charges,49.56,103,,,Fee Schedule,103% of WA Medicaid,6.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,376.05,69,,,percent of total billed charges,69% of total billed charges,545,100,,,percent of total billed charges,100% of total billed charges,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,545,100,,,percent of total billed charges,100% of total billed charges,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,545,100,,,percent of total billed charges,100% of total billed charges,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.08,61.85,,,percent of total billed charges,61.85% of total billed charges,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.56,130,,,Fee Schedule,130% of WA Medicaid ,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.47,37.7,,,percent of total billed charges,37.70% of total billed charges,205.47,37.7,,,percent of total billed charges,37.70% of total billed charges,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,18475.5,33.9,,,percent of total billed charges,33.9% of total billed charges,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.1,78,,,percent of total billed charges,78% of total billed charges,545,100,,,percent of total billed charges,100% of total billed charges,450.17,82.6,,,percent of total billed charges,82.6% of total billed charges,450.17,82.6,,,percent of total billed charges,82.6% of total billed charges,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.69,18475.5,
BIOPSY/REMOVAL LYMPH NODES,38500,CDM,983,RC,38500,HCPCS,Outpatient,,,1027,667.55,,903.76,88,,,percent of total billed charges,88% of total Billed charges,31,100,,,Fee Schedule,100% of Medicare rate,145.28,100,,,Fee Schedule,100% of WA Medicaid,1027,100,,,percent of total billed charges,100% of total billed charges,149.64,103,,,Fee Schedule,103% of WA Medicaid,31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,145.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,708.63,69,,,percent of total billed charges,69% of total billed charges,1027,100,,,percent of total billed charges,100% of total billed charges,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1027,100,,,percent of total billed charges,100% of total billed charges,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1027,100,,,percent of total billed charges,100% of total billed charges,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,635.2,61.85,,,percent of total billed charges,61.85% of total billed charges,145.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,188.86,130,,,Fee Schedule,130% of WA Medicaid ,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.18,37.7,,,percent of total billed charges,37.70% of total billed charges,387.18,37.7,,,percent of total billed charges,37.70% of total billed charges,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,34815.3,33.9,,,percent of total billed charges,33.9% of total billed charges,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,801.06,78,,,percent of total billed charges,78% of total billed charges,1027,100,,,percent of total billed charges,100% of total billed charges,848.3,82.6,,,percent of total billed charges,82.6% of total billed charges,848.3,82.6,,,percent of total billed charges,82.6% of total billed charges,145.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,31,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31,34815.3,
BIOPSY/REMOVAL LYMPH NODES,38510,CDM,983,RC,38510,HCPCS,Outpatient,,,1525,991.25,,1342,88,,,percent of total billed charges,88% of total Billed charges,46,100,,,Fee Schedule,100% of Medicare rate,237.79,100,,,Fee Schedule,100% of WA Medicaid,1525,100,,,percent of total billed charges,100% of total billed charges,244.92,103,,,Fee Schedule,103% of WA Medicaid,46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,237.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1052.25,69,,,percent of total billed charges,69% of total billed charges,1525,100,,,percent of total billed charges,100% of total billed charges,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1525,100,,,percent of total billed charges,100% of total billed charges,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1525,100,,,percent of total billed charges,100% of total billed charges,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,943.21,61.85,,,percent of total billed charges,61.85% of total billed charges,237.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,309.13,130,,,Fee Schedule,130% of WA Medicaid ,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.93,37.7,,,percent of total billed charges,37.70% of total billed charges,574.93,37.7,,,percent of total billed charges,37.70% of total billed charges,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,51697.5,33.9,,,percent of total billed charges,33.9% of total billed charges,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1189.5,78,,,percent of total billed charges,78% of total billed charges,1525,100,,,percent of total billed charges,100% of total billed charges,1259.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1259.65,82.6,,,percent of total billed charges,82.6% of total billed charges,237.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,46,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46,51697.5,
BIOPSY/REMOVAL LYMPH NODES,38520,CDM,983,RC,38520,HCPCS,Outpatient,,,1294,841.10,,1138.72,88,,,percent of total billed charges,88% of total Billed charges,52.46,100,,,Fee Schedule,100% of Medicare rate,267.07,100,,,Fee Schedule,100% of WA Medicaid,1294,100,,,percent of total billed charges,100% of total billed charges,275.08,103,,,Fee Schedule,103% of WA Medicaid,52.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,91.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,267.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,892.86,69,,,percent of total billed charges,69% of total billed charges,1294,100,,,percent of total billed charges,100% of total billed charges,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1294,100,,,percent of total billed charges,100% of total billed charges,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1294,100,,,percent of total billed charges,100% of total billed charges,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,800.34,61.85,,,percent of total billed charges,61.85% of total billed charges,267.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,347.19,130,,,Fee Schedule,130% of WA Medicaid ,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.84,37.7,,,percent of total billed charges,37.70% of total billed charges,487.84,37.7,,,percent of total billed charges,37.70% of total billed charges,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,43866.6,33.9,,,percent of total billed charges,33.9% of total billed charges,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1009.32,78,,,percent of total billed charges,78% of total billed charges,1294,100,,,percent of total billed charges,100% of total billed charges,1068.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1068.84,82.6,,,percent of total billed charges,82.6% of total billed charges,267.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.46,43866.6,
BIOPSY/REMOVAL LYMPH NODES,38525,CDM,983,RC,38525,HCPCS,Outpatient,,,1023,664.95,,900.24,88,,,percent of total billed charges,88% of total Billed charges,55.02,100,,,Fee Schedule,100% of Medicare rate,251.59,100,,,Fee Schedule,100% of WA Medicaid,1023,100,,,percent of total billed charges,100% of total billed charges,259.14,103,,,Fee Schedule,103% of WA Medicaid,55.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,96.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,251.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,705.87,69,,,percent of total billed charges,69% of total billed charges,1023,100,,,percent of total billed charges,100% of total billed charges,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1023,100,,,percent of total billed charges,100% of total billed charges,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1023,100,,,percent of total billed charges,100% of total billed charges,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,632.73,61.85,,,percent of total billed charges,61.85% of total billed charges,251.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,327.07,130,,,Fee Schedule,130% of WA Medicaid ,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.67,37.7,,,percent of total billed charges,37.70% of total billed charges,385.67,37.7,,,percent of total billed charges,37.70% of total billed charges,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,34679.7,33.9,,,percent of total billed charges,33.9% of total billed charges,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,797.94,78,,,percent of total billed charges,78% of total billed charges,1023,100,,,percent of total billed charges,100% of total billed charges,845,82.6,,,percent of total billed charges,82.6% of total billed charges,845,82.6,,,percent of total billed charges,82.6% of total billed charges,251.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.02,34679.7,
EXPLORE DEEP NODE(S) NECK,38542,CDM,983,RC,38542,HCPCS,Outpatient,,,1425,926.25,,1254,88,,,percent of total billed charges,88% of total Billed charges,51.89,100,,,Fee Schedule,100% of Medicare rate,300.64,100,,,Fee Schedule,100% of WA Medicaid,1425,100,,,percent of total billed charges,100% of total billed charges,309.66,103,,,Fee Schedule,103% of WA Medicaid,51.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,300.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,983.25,69,,,percent of total billed charges,69% of total billed charges,1425,100,,,percent of total billed charges,100% of total billed charges,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1425,100,,,percent of total billed charges,100% of total billed charges,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1425,100,,,percent of total billed charges,100% of total billed charges,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,881.36,61.85,,,percent of total billed charges,61.85% of total billed charges,300.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,390.83,130,,,Fee Schedule,130% of WA Medicaid ,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.23,37.7,,,percent of total billed charges,37.70% of total billed charges,537.23,37.7,,,percent of total billed charges,37.70% of total billed charges,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,48307.5,33.9,,,percent of total billed charges,33.9% of total billed charges,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1111.5,78,,,percent of total billed charges,78% of total billed charges,1425,100,,,percent of total billed charges,100% of total billed charges,1177.05,82.6,,,percent of total billed charges,82.6% of total billed charges,1177.05,82.6,,,percent of total billed charges,82.6% of total billed charges,300.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.89,48307.5,
LAPAROSCOPY LYMPH NODE BIOP,38570,CDM,983,RC,38570,HCPCS,Outpatient,,,1378,895.70,,1212.64,88,,,percent of total billed charges,88% of total Billed charges,54.15,100,,,Fee Schedule,100% of Medicare rate,293.74,100,,,Fee Schedule,100% of WA Medicaid,1378,100,,,percent of total billed charges,100% of total billed charges,302.55,103,,,Fee Schedule,103% of WA Medicaid,54.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,293.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,950.82,69,,,percent of total billed charges,69% of total billed charges,1378,100,,,percent of total billed charges,100% of total billed charges,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1378,100,,,percent of total billed charges,100% of total billed charges,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1378,100,,,percent of total billed charges,100% of total billed charges,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,852.29,61.85,,,percent of total billed charges,61.85% of total billed charges,293.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,381.86,130,,,Fee Schedule,130% of WA Medicaid ,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.51,37.7,,,percent of total billed charges,37.70% of total billed charges,519.51,37.7,,,percent of total billed charges,37.70% of total billed charges,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,46714.2,33.9,,,percent of total billed charges,33.9% of total billed charges,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.84,78,,,percent of total billed charges,78% of total billed charges,1378,100,,,percent of total billed charges,100% of total billed charges,1138.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1138.23,82.6,,,percent of total billed charges,82.6% of total billed charges,293.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.15,46714.2,
CERVICAL LYMPHADENECTOMY,38724,CDM,983,RC,38724,HCPCS,Outpatient,,,3051,1983.15,,2684.88,88,,,percent of total billed charges,88% of total Billed charges,140.38,100,,,Fee Schedule,100% of Medicare rate,827.13,100,,,Fee Schedule,100% of WA Medicaid,3051,100,,,percent of total billed charges,100% of total billed charges,851.94,103,,,Fee Schedule,103% of WA Medicaid,140.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,245.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,827.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2105.19,69,,,percent of total billed charges,69% of total billed charges,3051,100,,,percent of total billed charges,100% of total billed charges,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3051,100,,,percent of total billed charges,100% of total billed charges,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3051,100,,,percent of total billed charges,100% of total billed charges,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1887.04,61.85,,,percent of total billed charges,61.85% of total billed charges,827.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,827.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,843.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1075.27,130,,,Fee Schedule,130% of WA Medicaid ,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1150.23,37.7,,,percent of total billed charges,37.70% of total billed charges,1150.23,37.7,,,percent of total billed charges,37.70% of total billed charges,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,103428.9,33.9,,,percent of total billed charges,33.9% of total billed charges,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2379.78,78,,,percent of total billed charges,78% of total billed charges,3051,100,,,percent of total billed charges,100% of total billed charges,2520.13,82.6,,,percent of total billed charges,82.6% of total billed charges,2520.13,82.6,,,percent of total billed charges,82.6% of total billed charges,827.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,140.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,827.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.38,103428.9,
CERVICAL LYMPHADENECTOMY,38720,CDM,983,RC,38720,HCPCS,Outpatient,,,2831,1840.15,,2491.28,88,,,percent of total billed charges,88% of total Billed charges,139.17,100,,,Fee Schedule,100% of Medicare rate,764.84,100,,,Fee Schedule,100% of WA Medicaid,2831,100,,,percent of total billed charges,100% of total billed charges,787.79,103,,,Fee Schedule,103% of WA Medicaid,139.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,243.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,764.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1953.39,69,,,percent of total billed charges,69% of total billed charges,2831,100,,,percent of total billed charges,100% of total billed charges,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2831,100,,,percent of total billed charges,100% of total billed charges,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2831,100,,,percent of total billed charges,100% of total billed charges,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1750.97,61.85,,,percent of total billed charges,61.85% of total billed charges,764.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,764.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,994.29,130,,,Fee Schedule,130% of WA Medicaid ,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1067.29,37.7,,,percent of total billed charges,37.70% of total billed charges,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,95970.9,33.9,,,percent of total billed charges,33.9% of total billed charges,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2208.18,78,,,percent of total billed charges,78% of total billed charges,2831,100,,,percent of total billed charges,100% of total billed charges,2338.41,82.6,,,percent of total billed charges,82.6% of total billed charges,2338.41,82.6,,,percent of total billed charges,82.6% of total billed charges,764.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,139.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,764.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,139.17,95970.9,
REMOVE THORACIC LYMPH NODES,38746,CDM,983,RC,38746,HCPCS,Outpatient,,,1077,700.05,,947.76,88,,,percent of total billed charges,88% of total Billed charges,32.35,100,,,Fee Schedule,100% of Medicare rate,116,100,,,Fee Schedule,100% of WA Medicaid,1077,100,,,percent of total billed charges,100% of total billed charges,119.48,103,,,Fee Schedule,103% of WA Medicaid,32.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,116,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,743.13,69,,,percent of total billed charges,69% of total billed charges,1077,100,,,percent of total billed charges,100% of total billed charges,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1077,100,,,percent of total billed charges,100% of total billed charges,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1077,100,,,percent of total billed charges,100% of total billed charges,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,666.12,61.85,,,percent of total billed charges,61.85% of total billed charges,116,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,116,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,150.8,130,,,Fee Schedule,130% of WA Medicaid ,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.03,37.7,,,percent of total billed charges,37.70% of total billed charges,406.03,37.7,,,percent of total billed charges,37.70% of total billed charges,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,36510.3,33.9,,,percent of total billed charges,33.9% of total billed charges,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,840.06,78,,,percent of total billed charges,78% of total billed charges,1077,100,,,percent of total billed charges,100% of total billed charges,889.6,82.6,,,percent of total billed charges,82.6% of total billed charges,889.6,82.6,,,percent of total billed charges,82.6% of total billed charges,116,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,116,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.35,36510.3,
REMOVE ARMPIT LYMPH NODES,38740,CDM,983,RC,38740,HCPCS,Outpatient,,,1911.58,1242.53,,1682.19,88,,,percent of total billed charges,88% of total Billed charges,90.54,100,,,Fee Schedule,100% of Medicare rate,398.55,100,,,Fee Schedule,100% of WA Medicaid,1911.58,100,,,percent of total billed charges,100% of total billed charges,410.51,103,,,Fee Schedule,103% of WA Medicaid,90.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,158.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,398.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1318.99,69,,,percent of total billed charges,69% of total billed charges,1911.58,100,,,percent of total billed charges,100% of total billed charges,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1911.58,100,,,percent of total billed charges,100% of total billed charges,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1911.58,100,,,percent of total billed charges,100% of total billed charges,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1182.31,61.85,,,percent of total billed charges,61.85% of total billed charges,398.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,518.12,130,,,Fee Schedule,130% of WA Medicaid ,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,720.67,37.7,,,percent of total billed charges,37.70% of total billed charges,720.67,37.7,,,percent of total billed charges,37.70% of total billed charges,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,64802.56,33.9,,,percent of total billed charges,33.9% of total billed charges,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1491.03,78,,,percent of total billed charges,78% of total billed charges,1911.58,100,,,percent of total billed charges,100% of total billed charges,1578.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1578.97,82.6,,,percent of total billed charges,82.6% of total billed charges,398.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.54,64802.56,
REMOVE ARMPIT LYMPH NODES,38745,CDM,983,RC,38745,HCPCS,Outpatient,,,4215,2739.75,,3709.2,88,,,percent of total billed charges,88% of total Billed charges,116.63,100,,,Fee Schedule,100% of Medicare rate,499.45,100,,,Fee Schedule,100% of WA Medicaid,4215,100,,,percent of total billed charges,100% of total billed charges,514.43,103,,,Fee Schedule,103% of WA Medicaid,116.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,204.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,499.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2908.35,69,,,percent of total billed charges,69% of total billed charges,4215,100,,,percent of total billed charges,100% of total billed charges,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,4215,100,,,percent of total billed charges,100% of total billed charges,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,4215,100,,,percent of total billed charges,100% of total billed charges,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2606.98,61.85,,,percent of total billed charges,61.85% of total billed charges,499.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,649.29,130,,,Fee Schedule,130% of WA Medicaid ,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1589.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1589.06,37.7,,,percent of total billed charges,37.70% of total billed charges,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,142888.5,33.9,,,percent of total billed charges,33.9% of total billed charges,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,3287.7,78,,,percent of total billed charges,78% of total billed charges,4215,100,,,percent of total billed charges,100% of total billed charges,3481.59,82.6,,,percent of total billed charges,82.6% of total billed charges,3481.59,82.6,,,percent of total billed charges,82.6% of total billed charges,499.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,116.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,116.63,142888.5,
RA TRACER ID OF SENTINL NODE,38792,CDM,983,RC,38792,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,3.02,100,,,Fee Schedule,100% of Medicare rate,17.9,100,,,Fee Schedule,100% of WA Medicaid,271,100,,,percent of total billed charges,100% of total billed charges,18.44,103,,,Fee Schedule,103% of WA Medicaid,3.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,17.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,271,100,,,percent of total billed charges,100% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,271,100,,,percent of total billed charges,100% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.61,61.85,,,percent of total billed charges,61.85% of total billed charges,17.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.27,130,,,Fee Schedule,130% of WA Medicaid ,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,9186.9,33.9,,,percent of total billed charges,33.9% of total billed charges,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,17.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.02,9186.9,
IO MAP OF SENT LYMPH NODE,38900,CDM,983,RC,38900,HCPCS,Outpatient,,,367,238.55,,322.96,88,,,percent of total billed charges,88% of total Billed charges,19.33,100,,,Fee Schedule,100% of Medicare rate,75.91,100,,,Fee Schedule,100% of WA Medicaid,367,100,,,percent of total billed charges,100% of total billed charges,78.19,103,,,Fee Schedule,103% of WA Medicaid,19.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,75.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,253.23,69,,,percent of total billed charges,69% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,367,100,,,percent of total billed charges,100% of total billed charges,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,367,100,,,percent of total billed charges,100% of total billed charges,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.99,61.85,,,percent of total billed charges,61.85% of total billed charges,75.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,98.68,130,,,Fee Schedule,130% of WA Medicaid ,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,12441.3,33.9,,,percent of total billed charges,33.9% of total billed charges,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.26,78,,,percent of total billed charges,78% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,75.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.33,12441.3,
BLOOD/LYMPH SYSTEM PROCEDURE,38999,CDM,983,RC,38999,HCPCS,Outpatient,,,1161.49,754.97,,1022.11,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1161.49,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,801.43,69,,,percent of total billed charges,69% of total billed charges,1161.49,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1161.49,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1161.49,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,718.38,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,437.88,37.7,,,percent of total billed charges,37.70% of total billed charges,437.88,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,39374.51,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,905.96,78,,,percent of total billed charges,78% of total billed charges,1161.49,100,,,percent of total billed charges,100% of total billed charges,959.39,82.6,,,percent of total billed charges,82.6% of total billed charges,959.39,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",437.88,39374.51,
EXPLORATION OF CHEST,39000,CDM,983,RC,39000,HCPCS,Outpatient,,,362,235.30,,318.56,88,,,percent of total billed charges,88% of total Billed charges,59.18,100,,,Fee Schedule,100% of Medicare rate,286.09,100,,,Fee Schedule,100% of WA Medicaid,362,100,,,percent of total billed charges,100% of total billed charges,294.67,103,,,Fee Schedule,103% of WA Medicaid,59.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,286.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,249.78,69,,,percent of total billed charges,69% of total billed charges,362,100,,,percent of total billed charges,100% of total billed charges,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,362,100,,,percent of total billed charges,100% of total billed charges,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,362,100,,,percent of total billed charges,100% of total billed charges,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.9,61.85,,,percent of total billed charges,61.85% of total billed charges,286.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,371.92,130,,,Fee Schedule,130% of WA Medicaid ,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.47,37.7,,,percent of total billed charges,37.70% of total billed charges,136.47,37.7,,,percent of total billed charges,37.70% of total billed charges,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,12271.8,33.9,,,percent of total billed charges,33.9% of total billed charges,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.36,78,,,percent of total billed charges,78% of total billed charges,362,100,,,percent of total billed charges,100% of total billed charges,299.01,82.6,,,percent of total billed charges,82.6% of total billed charges,299.01,82.6,,,percent of total billed charges,82.6% of total billed charges,286.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.18,12271.8,
EXPLORATION OF CHEST,39010,CDM,983,RC,39010,HCPCS,Outpatient,,,3183,2068.95,,2801.04,88,,,percent of total billed charges,88% of total Billed charges,105.67,100,,,Fee Schedule,100% of Medicare rate,438.46,100,,,Fee Schedule,100% of WA Medicaid,3183,100,,,percent of total billed charges,100% of total billed charges,451.61,103,,,Fee Schedule,103% of WA Medicaid,105.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,184.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,438.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2196.27,69,,,percent of total billed charges,69% of total billed charges,3183,100,,,percent of total billed charges,100% of total billed charges,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,3183,100,,,percent of total billed charges,100% of total billed charges,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,3183,100,,,percent of total billed charges,100% of total billed charges,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1968.69,61.85,,,percent of total billed charges,61.85% of total billed charges,438.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,447.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,570,130,,,Fee Schedule,130% of WA Medicaid ,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1199.99,37.7,,,percent of total billed charges,37.70% of total billed charges,1199.99,37.7,,,percent of total billed charges,37.70% of total billed charges,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,107903.7,33.9,,,percent of total billed charges,33.9% of total billed charges,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2482.74,78,,,percent of total billed charges,78% of total billed charges,3183,100,,,percent of total billed charges,100% of total billed charges,2629.16,82.6,,,percent of total billed charges,82.6% of total billed charges,2629.16,82.6,,,percent of total billed charges,82.6% of total billed charges,438.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,105.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105.67,107903.7,
RESECT MEDIASTINAL TUMOR,39220,CDM,983,RC,39220,HCPCS,Outpatient,,,5121,3328.65,,4506.48,88,,,percent of total billed charges,88% of total Billed charges,149.25,100,,,Fee Schedule,100% of Medicare rate,629.62,100,,,Fee Schedule,100% of WA Medicaid,5121,100,,,percent of total billed charges,100% of total billed charges,648.51,103,,,Fee Schedule,103% of WA Medicaid,149.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,261.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,629.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3533.49,69,,,percent of total billed charges,69% of total billed charges,5121,100,,,percent of total billed charges,100% of total billed charges,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,5121,100,,,percent of total billed charges,100% of total billed charges,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,5121,100,,,percent of total billed charges,100% of total billed charges,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3167.34,61.85,,,percent of total billed charges,61.85% of total billed charges,629.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,818.51,130,,,Fee Schedule,130% of WA Medicaid ,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1930.62,37.7,,,percent of total billed charges,37.70% of total billed charges,1930.62,37.7,,,percent of total billed charges,37.70% of total billed charges,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,173601.9,33.9,,,percent of total billed charges,33.9% of total billed charges,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3994.38,78,,,percent of total billed charges,78% of total billed charges,5121,100,,,percent of total billed charges,100% of total billed charges,4229.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4229.95,82.6,,,percent of total billed charges,82.6% of total billed charges,629.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,149.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,149.25,173601.9,
MEDIASTINOSCOPY INCL BIOPSY,39400,CDM,983,RC,39400,HCPCS,Outpatient,,,1801,1170.65,,1584.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1801,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1242.69,69,,,percent of total billed charges,69% of total billed charges,1801,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1801,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1801,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1113.92,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,678.98,37.7,,,percent of total billed charges,37.70% of total billed charges,678.98,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,61053.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1404.78,78,,,percent of total billed charges,78% of total billed charges,1801,100,,,percent of total billed charges,100% of total billed charges,1487.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1487.63,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",678.98,61053.9,
REPAIR DIAPHRAGM LACERATION,39501,CDM,983,RC,39501,HCPCS,Outpatient,,,2322,1509.30,,2043.36,88,,,percent of total billed charges,88% of total Billed charges,112.17,100,,,Fee Schedule,100% of Medicare rate,478.37,100,,,Fee Schedule,100% of WA Medicaid,2322,100,,,percent of total billed charges,100% of total billed charges,492.72,103,,,Fee Schedule,103% of WA Medicaid,112.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,196.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,478.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1602.18,69,,,percent of total billed charges,69% of total billed charges,2322,100,,,percent of total billed charges,100% of total billed charges,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2322,100,,,percent of total billed charges,100% of total billed charges,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2322,100,,,percent of total billed charges,100% of total billed charges,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1436.16,61.85,,,percent of total billed charges,61.85% of total billed charges,478.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,621.88,130,,,Fee Schedule,130% of WA Medicaid ,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,875.39,37.7,,,percent of total billed charges,37.70% of total billed charges,875.39,37.7,,,percent of total billed charges,37.70% of total billed charges,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,78715.8,33.9,,,percent of total billed charges,33.9% of total billed charges,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1811.16,78,,,percent of total billed charges,78% of total billed charges,2322,100,,,percent of total billed charges,100% of total billed charges,1917.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1917.97,82.6,,,percent of total billed charges,82.6% of total billed charges,478.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,112.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.17,78715.8,
REPAIR OF DIAPHRAGM HERNIA,39541,CDM,983,RC,39541,HCPCS,Outpatient,,,2567,1668.55,,2258.96,88,,,percent of total billed charges,88% of total Billed charges,127.9,100,,,Fee Schedule,100% of Medicare rate,520.34,100,,,Fee Schedule,100% of WA Medicaid,2567,100,,,percent of total billed charges,100% of total billed charges,535.95,103,,,Fee Schedule,103% of WA Medicaid,127.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,223.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,520.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1771.23,69,,,percent of total billed charges,69% of total billed charges,2567,100,,,percent of total billed charges,100% of total billed charges,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2567,100,,,percent of total billed charges,100% of total billed charges,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2567,100,,,percent of total billed charges,100% of total billed charges,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1587.69,61.85,,,percent of total billed charges,61.85% of total billed charges,520.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,676.44,130,,,Fee Schedule,130% of WA Medicaid ,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,967.76,37.7,,,percent of total billed charges,37.70% of total billed charges,967.76,37.7,,,percent of total billed charges,37.70% of total billed charges,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,87021.3,33.9,,,percent of total billed charges,33.9% of total billed charges,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2002.26,78,,,percent of total billed charges,78% of total billed charges,2567,100,,,percent of total billed charges,100% of total billed charges,2120.34,82.6,,,percent of total billed charges,82.6% of total billed charges,2120.34,82.6,,,percent of total billed charges,82.6% of total billed charges,520.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,127.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,127.9,87021.3,
RESECT DIAPHRAGM COMPLEX,39561,CDM,983,RC,39561,HCPCS,Outpatient,,,3400,2210.00,,2992,88,,,percent of total billed charges,88% of total Billed charges,163.74,100,,,Fee Schedule,100% of Medicare rate,703.66,100,,,Fee Schedule,100% of WA Medicaid,3400,100,,,percent of total billed charges,100% of total billed charges,724.77,103,,,Fee Schedule,103% of WA Medicaid,163.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,286.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,703.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2346,69,,,percent of total billed charges,69% of total billed charges,3400,100,,,percent of total billed charges,100% of total billed charges,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3400,100,,,percent of total billed charges,100% of total billed charges,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3400,100,,,percent of total billed charges,100% of total billed charges,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2102.9,61.85,,,percent of total billed charges,61.85% of total billed charges,703.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,703.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,914.76,130,,,Fee Schedule,130% of WA Medicaid ,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1281.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1281.8,37.7,,,percent of total billed charges,37.70% of total billed charges,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,115260,33.9,,,percent of total billed charges,33.9% of total billed charges,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2652,78,,,percent of total billed charges,78% of total billed charges,3400,100,,,percent of total billed charges,100% of total billed charges,2808.4,82.6,,,percent of total billed charges,82.6% of total billed charges,2808.4,82.6,,,percent of total billed charges,82.6% of total billed charges,703.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,163.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,703.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,163.74,115260,
RESECT DIAPHRAGM SIMPLE,39560,CDM,983,RC,39560,HCPCS,Outpatient,,,2180,1417.00,,1918.4,88,,,percent of total billed charges,88% of total Billed charges,99.34,100,,,Fee Schedule,100% of Medicare rate,451.7,100,,,Fee Schedule,100% of WA Medicaid,2180,100,,,percent of total billed charges,100% of total billed charges,465.25,103,,,Fee Schedule,103% of WA Medicaid,99.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,451.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1504.2,69,,,percent of total billed charges,69% of total billed charges,2180,100,,,percent of total billed charges,100% of total billed charges,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2180,100,,,percent of total billed charges,100% of total billed charges,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2180,100,,,percent of total billed charges,100% of total billed charges,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1348.33,61.85,,,percent of total billed charges,61.85% of total billed charges,451.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,587.21,130,,,Fee Schedule,130% of WA Medicaid ,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,821.86,37.7,,,percent of total billed charges,37.70% of total billed charges,821.86,37.7,,,percent of total billed charges,37.70% of total billed charges,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,73902,33.9,,,percent of total billed charges,33.9% of total billed charges,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1700.4,78,,,percent of total billed charges,78% of total billed charges,2180,100,,,percent of total billed charges,100% of total billed charges,1800.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1800.68,82.6,,,percent of total billed charges,82.6% of total billed charges,451.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.34,73902,
BIOPSY OF LIP,40490,CDM,983,RC,40490,HCPCS,Outpatient,,,302,196.30,,265.76,88,,,percent of total billed charges,88% of total Billed charges,5.44,100,,,Fee Schedule,100% of Medicare rate,39.17,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,40.35,103,,,Fee Schedule,103% of WA Medicaid,5.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.79,61.85,,,percent of total billed charges,61.85% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.92,130,,,Fee Schedule,130% of WA Medicaid ,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,10237.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.44,10237.8,
PARTIAL EXCISION OF LIP,40500,CDM,983,RC,40500,HCPCS,Outpatient,,,740,481.00,,651.2,88,,,percent of total billed charges,88% of total Billed charges,26.69,100,,,Fee Schedule,100% of Medicare rate,217.09,100,,,Fee Schedule,100% of WA Medicaid,740,100,,,percent of total billed charges,100% of total billed charges,223.6,103,,,Fee Schedule,103% of WA Medicaid,26.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,46.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,217.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,510.6,69,,,percent of total billed charges,69% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,740,100,,,percent of total billed charges,100% of total billed charges,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,740,100,,,percent of total billed charges,100% of total billed charges,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.69,61.85,,,percent of total billed charges,61.85% of total billed charges,217.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,282.22,130,,,Fee Schedule,130% of WA Medicaid ,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,25086,33.9,,,percent of total billed charges,33.9% of total billed charges,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.2,78,,,percent of total billed charges,78% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,217.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.69,25086,
EXCISION LIP,40520,CDM,983,RC,40520,HCPCS,Outpatient,,,1147,745.55,,1009.36,88,,,percent of total billed charges,88% of total Billed charges,29.57,100,,,Fee Schedule,100% of Medicare rate,207.39,100,,,Fee Schedule,100% of WA Medicaid,1147,100,,,percent of total billed charges,100% of total billed charges,213.61,103,,,Fee Schedule,103% of WA Medicaid,29.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,207.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,791.43,69,,,percent of total billed charges,69% of total billed charges,1147,100,,,percent of total billed charges,100% of total billed charges,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1147,100,,,percent of total billed charges,100% of total billed charges,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1147,100,,,percent of total billed charges,100% of total billed charges,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.42,61.85,,,percent of total billed charges,61.85% of total billed charges,207.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,269.61,130,,,Fee Schedule,130% of WA Medicaid ,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.42,37.7,,,percent of total billed charges,37.70% of total billed charges,432.42,37.7,,,percent of total billed charges,37.70% of total billed charges,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,38883.3,33.9,,,percent of total billed charges,33.9% of total billed charges,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.66,78,,,percent of total billed charges,78% of total billed charges,1147,100,,,percent of total billed charges,100% of total billed charges,947.42,82.6,,,percent of total billed charges,82.6% of total billed charges,947.42,82.6,,,percent of total billed charges,82.6% of total billed charges,207.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.57,38883.3,
"EXCISION, FULL THICKNESS LIP",40527,CDM,983,RC,40527,HCPCS,Outpatient,,,1293,840.45,,1137.84,88,,,percent of total billed charges,88% of total Billed charges,54.39,100,,,Fee Schedule,100% of Medicare rate,363.3,100,,,Fee Schedule,100% of WA Medicaid,1293,100,,,percent of total billed charges,100% of total billed charges,374.2,103,,,Fee Schedule,103% of WA Medicaid,54.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,363.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,892.17,69,,,percent of total billed charges,69% of total billed charges,1293,100,,,percent of total billed charges,100% of total billed charges,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1293,100,,,percent of total billed charges,100% of total billed charges,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1293,100,,,percent of total billed charges,100% of total billed charges,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.72,61.85,,,percent of total billed charges,61.85% of total billed charges,363.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,472.29,130,,,Fee Schedule,130% of WA Medicaid ,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.46,37.7,,,percent of total billed charges,37.70% of total billed charges,487.46,37.7,,,percent of total billed charges,37.70% of total billed charges,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,43832.7,33.9,,,percent of total billed charges,33.9% of total billed charges,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008.54,78,,,percent of total billed charges,78% of total billed charges,1293,100,,,percent of total billed charges,100% of total billed charges,1068.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1068.02,82.6,,,percent of total billed charges,82.6% of total billed charges,363.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.39,43832.7,
REPAIR LIP,40654,CDM,983,RC,40654,HCPCS,Outpatient,,,1128,733.20,,992.64,88,,,percent of total billed charges,88% of total Billed charges,35.35,100,,,Fee Schedule,100% of Medicare rate,248.42,100,,,Fee Schedule,100% of WA Medicaid,1128,100,,,percent of total billed charges,100% of total billed charges,255.87,103,,,Fee Schedule,103% of WA Medicaid,35.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,248.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,778.32,69,,,percent of total billed charges,69% of total billed charges,1128,100,,,percent of total billed charges,100% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128,100,,,percent of total billed charges,100% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128,100,,,percent of total billed charges,100% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.67,61.85,,,percent of total billed charges,61.85% of total billed charges,248.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,322.95,130,,,Fee Schedule,130% of WA Medicaid ,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.26,37.7,,,percent of total billed charges,37.70% of total billed charges,425.26,37.7,,,percent of total billed charges,37.70% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,38239.2,33.9,,,percent of total billed charges,33.9% of total billed charges,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,879.84,78,,,percent of total billed charges,78% of total billed charges,1128,100,,,percent of total billed charges,100% of total billed charges,931.73,82.6,,,percent of total billed charges,82.6% of total billed charges,931.73,82.6,,,percent of total billed charges,82.6% of total billed charges,248.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.35,38239.2,
REPAIR CLEFT LIP/NASAL,40700,CDM,983,RC,40700,HCPCS,Outpatient,,,2100,1365.00,,1848,88,,,percent of total billed charges,88% of total Billed charges,98.34,100,,,Fee Schedule,100% of Medicare rate,577.4,100,,,Fee Schedule,100% of WA Medicaid,2100,100,,,percent of total billed charges,100% of total billed charges,594.72,103,,,Fee Schedule,103% of WA Medicaid,98.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,172.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,577.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1449,69,,,percent of total billed charges,69% of total billed charges,2100,100,,,percent of total billed charges,100% of total billed charges,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2100,100,,,percent of total billed charges,100% of total billed charges,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2100,100,,,percent of total billed charges,100% of total billed charges,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1298.85,61.85,,,percent of total billed charges,61.85% of total billed charges,577.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,750.62,130,,,Fee Schedule,130% of WA Medicaid ,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,791.7,37.7,,,percent of total billed charges,37.70% of total billed charges,791.7,37.7,,,percent of total billed charges,37.70% of total billed charges,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,71190,33.9,,,percent of total billed charges,33.9% of total billed charges,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1638,78,,,percent of total billed charges,78% of total billed charges,2100,100,,,percent of total billed charges,100% of total billed charges,1734.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1734.6,82.6,,,percent of total billed charges,82.6% of total billed charges,577.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.34,71190,
REPAIR CLEFT LIP/NASAL-SECONDARY,40720,CDM,983,RC,40720,HCPCS,Outpatient,,,2070,1345.50,,1821.6,88,,,percent of total billed charges,88% of total Billed charges,101.17,100,,,Fee Schedule,100% of Medicare rate,586.54,100,,,Fee Schedule,100% of WA Medicaid,2070,100,,,percent of total billed charges,100% of total billed charges,604.14,103,,,Fee Schedule,103% of WA Medicaid,101.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,177.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,586.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1428.3,69,,,percent of total billed charges,69% of total billed charges,2070,100,,,percent of total billed charges,100% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2070,100,,,percent of total billed charges,100% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2070,100,,,percent of total billed charges,100% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1280.3,61.85,,,percent of total billed charges,61.85% of total billed charges,586.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,586.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,762.5,130,,,Fee Schedule,130% of WA Medicaid ,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.39,37.7,,,percent of total billed charges,37.70% of total billed charges,780.39,37.7,,,percent of total billed charges,37.70% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,70173,33.9,,,percent of total billed charges,33.9% of total billed charges,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1614.6,78,,,percent of total billed charges,78% of total billed charges,2070,100,,,percent of total billed charges,100% of total billed charges,1709.82,82.6,,,percent of total billed charges,82.6% of total billed charges,1709.82,82.6,,,percent of total billed charges,82.6% of total billed charges,586.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,101.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,586.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.17,70173,
DRAINAGE OF MOUTH LESION,40800,CDM,983,RC,40800,HCPCS,Outpatient,,,286,185.90,,251.68,88,,,percent of total billed charges,88% of total Billed charges,7.02,100,,,Fee Schedule,100% of Medicare rate,69.75,100,,,Fee Schedule,100% of WA Medicaid,286,100,,,percent of total billed charges,100% of total billed charges,71.84,103,,,Fee Schedule,103% of WA Medicaid,7.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,197.34,69,,,percent of total billed charges,69% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,286,100,,,percent of total billed charges,100% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,286,100,,,percent of total billed charges,100% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.89,61.85,,,percent of total billed charges,61.85% of total billed charges,69.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,90.68,130,,,Fee Schedule,130% of WA Medicaid ,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.82,37.7,,,percent of total billed charges,37.70% of total billed charges,107.82,37.7,,,percent of total billed charges,37.70% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,9695.4,33.9,,,percent of total billed charges,33.9% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.08,78,,,percent of total billed charges,78% of total billed charges,286,100,,,percent of total billed charges,100% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,236.24,82.6,,,percent of total billed charges,82.6% of total billed charges,69.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.02,9695.4,
REMOVAL OF FORIEGN BODY/MOUTH,40804,CDM,983,RC,40804,HCPCS,Outpatient,,,321,208.65,,282.48,88,,,percent of total billed charges,88% of total Billed charges,7.39,100,,,Fee Schedule,100% of Medicare rate,66.77,100,,,Fee Schedule,100% of WA Medicaid,321,100,,,percent of total billed charges,100% of total billed charges,68.77,103,,,Fee Schedule,103% of WA Medicaid,7.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,221.49,69,,,percent of total billed charges,69% of total billed charges,321,100,,,percent of total billed charges,100% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,321,100,,,percent of total billed charges,100% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,321,100,,,percent of total billed charges,100% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.54,61.85,,,percent of total billed charges,61.85% of total billed charges,66.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,86.8,130,,,Fee Schedule,130% of WA Medicaid ,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.02,37.7,,,percent of total billed charges,37.70% of total billed charges,121.02,37.7,,,percent of total billed charges,37.70% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10881.9,33.9,,,percent of total billed charges,33.9% of total billed charges,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.38,78,,,percent of total billed charges,78% of total billed charges,321,100,,,percent of total billed charges,100% of total billed charges,265.15,82.6,,,percent of total billed charges,82.6% of total billed charges,265.15,82.6,,,percent of total billed charges,82.6% of total billed charges,66.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.39,10881.9,
BIOPSY OF MOUTH LESION,40808,CDM,983,RC,40808,HCPCS,Outpatient,,,405,263.25,,356.4,88,,,percent of total billed charges,88% of total Billed charges,6.1,100,,,Fee Schedule,100% of Medicare rate,52.03,100,,,Fee Schedule,100% of WA Medicaid,405,100,,,percent of total billed charges,100% of total billed charges,53.59,103,,,Fee Schedule,103% of WA Medicaid,6.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,52.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,279.45,69,,,percent of total billed charges,69% of total billed charges,405,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,405,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,405,100,,,percent of total billed charges,100% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.49,61.85,,,percent of total billed charges,61.85% of total billed charges,52.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.64,130,,,Fee Schedule,130% of WA Medicaid ,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.69,37.7,,,percent of total billed charges,37.70% of total billed charges,152.69,37.7,,,percent of total billed charges,37.70% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,13729.5,33.9,,,percent of total billed charges,33.9% of total billed charges,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.9,78,,,percent of total billed charges,78% of total billed charges,405,100,,,percent of total billed charges,100% of total billed charges,334.53,82.6,,,percent of total billed charges,82.6% of total billed charges,334.53,82.6,,,percent of total billed charges,82.6% of total billed charges,52.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.1,13729.5,
INCISION OF LABIAL FRENUM,40806,CDM,983,RC,40806,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,2.2,100,,,Fee Schedule,100% of Medicare rate,17.16,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,17.67,103,,,Fee Schedule,103% of WA Medicaid,2.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,17.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69,100,,,percent of total billed charges,100% of total billed charges,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69,100,,,percent of total billed charges,100% of total billed charges,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.68,61.85,,,percent of total billed charges,61.85% of total billed charges,17.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.31,130,,,Fee Schedule,130% of WA Medicaid ,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2339.1,33.9,,,percent of total billed charges,33.9% of total billed charges,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,17.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.2,2339.1,
EXCISION OF LESION OF MUCOSA:W/O REPAIR,40810,CDM,983,RC,40810,HCPCS,Outpatient,,,380,247.00,,334.4,88,,,percent of total billed charges,88% of total Billed charges,8.17,100,,,Fee Schedule,100% of Medicare rate,71.8,100,,,Fee Schedule,100% of WA Medicaid,380,100,,,percent of total billed charges,100% of total billed charges,73.95,103,,,Fee Schedule,103% of WA Medicaid,8.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,71.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,262.2,69,,,percent of total billed charges,69% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,380,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,380,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.03,61.85,,,percent of total billed charges,61.85% of total billed charges,71.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,93.34,130,,,Fee Schedule,130% of WA Medicaid ,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,143.26,37.7,,,percent of total billed charges,37.70% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,12882,33.9,,,percent of total billed charges,33.9% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.4,78,,,percent of total billed charges,78% of total billed charges,380,100,,,percent of total billed charges,100% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,313.88,82.6,,,percent of total billed charges,82.6% of total billed charges,71.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.17,12882,
EXCISE/REPAIR MOUTH LESION,40812,CDM,983,RC,40812,HCPCS,Outpatient,,,489,317.85,,430.32,88,,,percent of total billed charges,88% of total Billed charges,12.3,100,,,Fee Schedule,100% of Medicare rate,105.93,100,,,Fee Schedule,100% of WA Medicaid,489,100,,,percent of total billed charges,100% of total billed charges,109.11,103,,,Fee Schedule,103% of WA Medicaid,12.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,105.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,337.41,69,,,percent of total billed charges,69% of total billed charges,489,100,,,percent of total billed charges,100% of total billed charges,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,489,100,,,percent of total billed charges,100% of total billed charges,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,489,100,,,percent of total billed charges,100% of total billed charges,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.45,61.85,,,percent of total billed charges,61.85% of total billed charges,105.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,137.71,130,,,Fee Schedule,130% of WA Medicaid ,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.35,37.7,,,percent of total billed charges,37.70% of total billed charges,184.35,37.7,,,percent of total billed charges,37.70% of total billed charges,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,16577.1,33.9,,,percent of total billed charges,33.9% of total billed charges,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.42,78,,,percent of total billed charges,78% of total billed charges,489,100,,,percent of total billed charges,100% of total billed charges,403.91,82.6,,,percent of total billed charges,82.6% of total billed charges,403.91,82.6,,,percent of total billed charges,82.6% of total billed charges,105.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.3,16577.1,
DRAINAGE OF MOUTH LESION,41000,CDM,983,RC,41000,HCPCS,Outpatient,,,319,207.35,,280.72,88,,,percent of total billed charges,88% of total Billed charges,7.07,100,,,Fee Schedule,100% of Medicare rate,60.61,100,,,Fee Schedule,100% of WA Medicaid,319,100,,,percent of total billed charges,100% of total billed charges,62.43,103,,,Fee Schedule,103% of WA Medicaid,7.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,220.11,69,,,percent of total billed charges,69% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,319,100,,,percent of total billed charges,100% of total billed charges,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,319,100,,,percent of total billed charges,100% of total billed charges,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.3,61.85,,,percent of total billed charges,61.85% of total billed charges,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,78.79,130,,,Fee Schedule,130% of WA Medicaid ,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,10814.1,33.9,,,percent of total billed charges,33.9% of total billed charges,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.82,78,,,percent of total billed charges,78% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.07,10814.1,
INCISION OF TONGUE FOLD,41010,CDM,983,RC,41010,HCPCS,Outpatient,,,336,218.40,,295.68,88,,,percent of total billed charges,88% of total Billed charges,7.54,100,,,Fee Schedule,100% of Medicare rate,64.72,100,,,Fee Schedule,100% of WA Medicaid,336,100,,,percent of total billed charges,100% of total billed charges,66.66,103,,,Fee Schedule,103% of WA Medicaid,7.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,64.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,231.84,69,,,percent of total billed charges,69% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.82,61.85,,,percent of total billed charges,61.85% of total billed charges,64.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.14,130,,,Fee Schedule,130% of WA Medicaid ,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,11390.4,33.9,,,percent of total billed charges,33.9% of total billed charges,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.08,78,,,percent of total billed charges,78% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,64.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.54,11390.4,
BIOPSY OF TONGUE;ANTERIOR TWO THIRDS,41100,CDM,983,RC,41100,HCPCS,Outpatient,,,339,220.35,,298.32,88,,,percent of total billed charges,88% of total Billed charges,8.2,100,,,Fee Schedule,100% of Medicare rate,62.29,100,,,Fee Schedule,100% of WA Medicaid,339,100,,,percent of total billed charges,100% of total billed charges,64.16,103,,,Fee Schedule,103% of WA Medicaid,8.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,62.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,233.91,69,,,percent of total billed charges,69% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,339,100,,,percent of total billed charges,100% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,339,100,,,percent of total billed charges,100% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.67,61.85,,,percent of total billed charges,61.85% of total billed charges,62.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,80.98,130,,,Fee Schedule,130% of WA Medicaid ,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,11492.1,33.9,,,percent of total billed charges,33.9% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.42,78,,,percent of total billed charges,78% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,62.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.2,11492.1,
EXCISION OF LESION POSTERIOR 1/3 TONGUE,41113,CDM,983,RC,41113,HCPCS,Outpatient,,,516,335.40,,454.08,88,,,percent of total billed charges,88% of total Billed charges,18.18,100,,,Fee Schedule,100% of Medicare rate,153.68,100,,,Fee Schedule,100% of WA Medicaid,516,100,,,percent of total billed charges,100% of total billed charges,158.29,103,,,Fee Schedule,103% of WA Medicaid,18.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,153.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,356.04,69,,,percent of total billed charges,69% of total billed charges,516,100,,,percent of total billed charges,100% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,516,100,,,percent of total billed charges,100% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,516,100,,,percent of total billed charges,100% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.15,61.85,,,percent of total billed charges,61.85% of total billed charges,153.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,199.78,130,,,Fee Schedule,130% of WA Medicaid ,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.53,37.7,,,percent of total billed charges,37.70% of total billed charges,194.53,37.7,,,percent of total billed charges,37.70% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,17492.4,33.9,,,percent of total billed charges,33.9% of total billed charges,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.48,78,,,percent of total billed charges,78% of total billed charges,516,100,,,percent of total billed charges,100% of total billed charges,426.22,82.6,,,percent of total billed charges,82.6% of total billed charges,426.22,82.6,,,percent of total billed charges,82.6% of total billed charges,153.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.18,17492.4,
EXCISE LESION OF TONGUE W/ CLOSURE,41112,CDM,983,RC,41112,HCPCS,Outpatient,,,596,387.40,,524.48,88,,,percent of total billed charges,88% of total Billed charges,16.78,100,,,Fee Schedule,100% of Medicare rate,141.93,100,,,Fee Schedule,100% of WA Medicaid,596,100,,,percent of total billed charges,100% of total billed charges,146.19,103,,,Fee Schedule,103% of WA Medicaid,16.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,141.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,411.24,69,,,percent of total billed charges,69% of total billed charges,596,100,,,percent of total billed charges,100% of total billed charges,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,596,100,,,percent of total billed charges,100% of total billed charges,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,596,100,,,percent of total billed charges,100% of total billed charges,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.63,61.85,,,percent of total billed charges,61.85% of total billed charges,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,184.51,130,,,Fee Schedule,130% of WA Medicaid ,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.69,37.7,,,percent of total billed charges,37.70% of total billed charges,224.69,37.7,,,percent of total billed charges,37.70% of total billed charges,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,20204.4,33.9,,,percent of total billed charges,33.9% of total billed charges,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.88,78,,,percent of total billed charges,78% of total billed charges,596,100,,,percent of total billed charges,100% of total billed charges,492.3,82.6,,,percent of total billed charges,82.6% of total billed charges,492.3,82.6,,,percent of total billed charges,82.6% of total billed charges,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.78,20204.4,
EXCISION OF LINGUAL FRENUM (FRENECTOMY),41115,CDM,983,RC,41115,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,10.96,100,,,Fee Schedule,100% of Medicare rate,85.42,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,87.98,103,,,Fee Schedule,103% of WA Medicaid,10.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,308,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,308,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.5,61.85,,,percent of total billed charges,61.85% of total billed charges,85.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.05,130,,,Fee Schedule,130% of WA Medicaid ,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10441.2,33.9,,,percent of total billed charges,33.9% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,85.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.96,10441.2,
PARTIAL REMOVAL OF TONGUE,41120,CDM,983,RC,41120,HCPCS,Outpatient,,,2255,1465.75,,1984.4,88,,,percent of total billed charges,88% of total Billed charges,74.47,100,,,Fee Schedule,100% of Medicare rate,614.89,100,,,Fee Schedule,100% of WA Medicaid,2255,100,,,percent of total billed charges,100% of total billed charges,633.34,103,,,Fee Schedule,103% of WA Medicaid,74.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,130.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,614.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1555.95,69,,,percent of total billed charges,69% of total billed charges,2255,100,,,percent of total billed charges,100% of total billed charges,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,2255,100,,,percent of total billed charges,100% of total billed charges,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,2255,100,,,percent of total billed charges,100% of total billed charges,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1394.72,61.85,,,percent of total billed charges,61.85% of total billed charges,614.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,627.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,799.36,130,,,Fee Schedule,130% of WA Medicaid ,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,850.14,37.7,,,percent of total billed charges,37.70% of total billed charges,850.14,37.7,,,percent of total billed charges,37.70% of total billed charges,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,76444.5,33.9,,,percent of total billed charges,33.9% of total billed charges,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1758.9,78,,,percent of total billed charges,78% of total billed charges,2255,100,,,percent of total billed charges,100% of total billed charges,1862.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1862.63,82.6,,,percent of total billed charges,82.6% of total billed charges,614.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,74.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.47,76444.5,
REPAIR TONGUE LACERATION;2.5CM OR LESS,41250,CDM,983,RC,41250,HCPCS,Outpatient,,,411,267.15,,361.68,88,,,percent of total billed charges,88% of total Billed charges,14.52,100,,,Fee Schedule,100% of Medicare rate,88.77,100,,,Fee Schedule,100% of WA Medicaid,411,100,,,percent of total billed charges,100% of total billed charges,91.43,103,,,Fee Schedule,103% of WA Medicaid,14.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,88.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,283.59,69,,,percent of total billed charges,69% of total billed charges,411,100,,,percent of total billed charges,100% of total billed charges,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,411,100,,,percent of total billed charges,100% of total billed charges,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,411,100,,,percent of total billed charges,100% of total billed charges,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.2,61.85,,,percent of total billed charges,61.85% of total billed charges,88.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,115.4,130,,,Fee Schedule,130% of WA Medicaid ,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.95,37.7,,,percent of total billed charges,37.70% of total billed charges,154.95,37.7,,,percent of total billed charges,37.70% of total billed charges,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,13932.9,33.9,,,percent of total billed charges,33.9% of total billed charges,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.58,78,,,percent of total billed charges,78% of total billed charges,411,100,,,percent of total billed charges,100% of total billed charges,339.49,82.6,,,percent of total billed charges,82.6% of total billed charges,339.49,82.6,,,percent of total billed charges,82.6% of total billed charges,88.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.52,13932.9,
EXCISION OF GUM LESION,41827,CDM,983,RC,41827,HCPCS,Outpatient,,,639,415.35,,562.32,88,,,percent of total billed charges,88% of total Billed charges,19.69,100,,,Fee Schedule,100% of Medicare rate,167.66,100,,,Fee Schedule,100% of WA Medicaid,639,100,,,percent of total billed charges,100% of total billed charges,172.69,103,,,Fee Schedule,103% of WA Medicaid,19.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,167.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,440.91,69,,,percent of total billed charges,69% of total billed charges,639,100,,,percent of total billed charges,100% of total billed charges,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,639,100,,,percent of total billed charges,100% of total billed charges,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,639,100,,,percent of total billed charges,100% of total billed charges,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.22,61.85,,,percent of total billed charges,61.85% of total billed charges,167.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,217.96,130,,,Fee Schedule,130% of WA Medicaid ,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.9,37.7,,,percent of total billed charges,37.70% of total billed charges,240.9,37.7,,,percent of total billed charges,37.70% of total billed charges,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,21662.1,33.9,,,percent of total billed charges,33.9% of total billed charges,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,498.42,78,,,percent of total billed charges,78% of total billed charges,639,100,,,percent of total billed charges,100% of total billed charges,527.81,82.6,,,percent of total billed charges,82.6% of total billed charges,527.81,82.6,,,percent of total billed charges,82.6% of total billed charges,167.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.69,21662.1,
CONTROL ORAL BLEEDING,41899,CDM,983,RC,41899,HCPCS,Outpatient,,,175,113.75,,154,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,120.75,69,,,percent of total billed charges,69% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,175,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,175,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,108.24,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,5932.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,136.5,78,,,percent of total billed charges,78% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",65.98,5932.5,
"EXCISE LESION OF PALATE,UVULA, W/O CLOS",42104,CDM,983,RC,42104,HCPCS,Outpatient,,,377,245.05,,331.76,88,,,percent of total billed charges,88% of total Billed charges,10.1,100,,,Fee Schedule,100% of Medicare rate,78.7,100,,,Fee Schedule,100% of WA Medicaid,377,100,,,percent of total billed charges,100% of total billed charges,81.06,103,,,Fee Schedule,103% of WA Medicaid,10.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,78.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,260.13,69,,,percent of total billed charges,69% of total billed charges,377,100,,,percent of total billed charges,100% of total billed charges,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,377,100,,,percent of total billed charges,100% of total billed charges,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,377,100,,,percent of total billed charges,100% of total billed charges,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.17,61.85,,,percent of total billed charges,61.85% of total billed charges,78.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,102.31,130,,,Fee Schedule,130% of WA Medicaid ,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.13,37.7,,,percent of total billed charges,37.70% of total billed charges,142.13,37.7,,,percent of total billed charges,37.70% of total billed charges,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,12780.3,33.9,,,percent of total billed charges,33.9% of total billed charges,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,294.06,78,,,percent of total billed charges,78% of total billed charges,377,100,,,percent of total billed charges,100% of total billed charges,311.4,82.6,,,percent of total billed charges,82.6% of total billed charges,311.4,82.6,,,percent of total billed charges,82.6% of total billed charges,78.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.1,12780.3,
UVULECTOMY,42140,CDM,983,RC,42140,HCPCS,Outpatient,,,614,399.10,,540.32,88,,,percent of total billed charges,88% of total Billed charges,11.26,100,,,Fee Schedule,100% of Medicare rate,96.23,100,,,Fee Schedule,100% of WA Medicaid,614,100,,,percent of total billed charges,100% of total billed charges,99.12,103,,,Fee Schedule,103% of WA Medicaid,11.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,96.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,423.66,69,,,percent of total billed charges,69% of total billed charges,614,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,614,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,614,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.76,61.85,,,percent of total billed charges,61.85% of total billed charges,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,125.1,130,,,Fee Schedule,130% of WA Medicaid ,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.48,37.7,,,percent of total billed charges,37.70% of total billed charges,231.48,37.7,,,percent of total billed charges,37.70% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,20814.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.92,78,,,percent of total billed charges,78% of total billed charges,614,100,,,percent of total billed charges,100% of total billed charges,507.16,82.6,,,percent of total billed charges,82.6% of total billed charges,507.16,82.6,,,percent of total billed charges,82.6% of total billed charges,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.26,20814.6,
PALATOPHARYNGOPLASTY,42145,CDM,983,RC,42145,HCPCS,Outpatient,,,1486,965.90,,1307.68,88,,,percent of total billed charges,88% of total Billed charges,58.29,100,,,Fee Schedule,100% of Medicare rate,398.18,100,,,Fee Schedule,100% of WA Medicaid,1486,100,,,percent of total billed charges,100% of total billed charges,410.13,103,,,Fee Schedule,103% of WA Medicaid,58.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,398.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1025.34,69,,,percent of total billed charges,69% of total billed charges,1486,100,,,percent of total billed charges,100% of total billed charges,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1486,100,,,percent of total billed charges,100% of total billed charges,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1486,100,,,percent of total billed charges,100% of total billed charges,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,919.09,61.85,,,percent of total billed charges,61.85% of total billed charges,398.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,517.63,130,,,Fee Schedule,130% of WA Medicaid ,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,560.22,37.7,,,percent of total billed charges,37.70% of total billed charges,560.22,37.7,,,percent of total billed charges,37.70% of total billed charges,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,50375.4,33.9,,,percent of total billed charges,33.9% of total billed charges,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1159.08,78,,,percent of total billed charges,78% of total billed charges,1486,100,,,percent of total billed charges,100% of total billed charges,1227.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1227.44,82.6,,,percent of total billed charges,82.6% of total billed charges,398.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.29,50375.4,
"DRAINAGE OF ABSCESS;PAROTID,COMPLICATED",42305,CDM,983,RC,42305,HCPCS,Outpatient,,,1020,663.00,,897.6,88,,,percent of total billed charges,88% of total Billed charges,37.08,100,,,Fee Schedule,100% of Medicare rate,251.22,100,,,Fee Schedule,100% of WA Medicaid,1020,100,,,percent of total billed charges,100% of total billed charges,258.76,103,,,Fee Schedule,103% of WA Medicaid,37.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,251.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,703.8,69,,,percent of total billed charges,69% of total billed charges,1020,100,,,percent of total billed charges,100% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020,100,,,percent of total billed charges,100% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020,100,,,percent of total billed charges,100% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,630.87,61.85,,,percent of total billed charges,61.85% of total billed charges,251.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,326.59,130,,,Fee Schedule,130% of WA Medicaid ,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.54,37.7,,,percent of total billed charges,37.70% of total billed charges,384.54,37.7,,,percent of total billed charges,37.70% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,34578,33.9,,,percent of total billed charges,33.9% of total billed charges,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,795.6,78,,,percent of total billed charges,78% of total billed charges,1020,100,,,percent of total billed charges,100% of total billed charges,842.52,82.6,,,percent of total billed charges,82.6% of total billed charges,842.52,82.6,,,percent of total billed charges,82.6% of total billed charges,251.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.08,34578,
SIALOLITHOTOMY,42330,CDM,983,RC,42330,HCPCS,Outpatient,,,557,362.05,,490.16,88,,,percent of total billed charges,88% of total Billed charges,13.36,100,,,Fee Schedule,100% of Medicare rate,96.23,100,,,Fee Schedule,100% of WA Medicaid,557,100,,,percent of total billed charges,100% of total billed charges,99.12,103,,,Fee Schedule,103% of WA Medicaid,13.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,96.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,384.33,69,,,percent of total billed charges,69% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,557,100,,,percent of total billed charges,100% of total billed charges,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,557,100,,,percent of total billed charges,100% of total billed charges,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.5,61.85,,,percent of total billed charges,61.85% of total billed charges,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,125.1,130,,,Fee Schedule,130% of WA Medicaid ,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,209.99,37.7,,,percent of total billed charges,37.70% of total billed charges,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,18882.3,33.9,,,percent of total billed charges,33.9% of total billed charges,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.46,78,,,percent of total billed charges,78% of total billed charges,557,100,,,percent of total billed charges,100% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,460.08,82.6,,,percent of total billed charges,82.6% of total billed charges,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.36,18882.3,
EXCISE SUBLINGUAL SALIVARY CYST,42408,CDM,983,RC,42408,HCPCS,Outpatient,,,929,603.85,,817.52,88,,,percent of total billed charges,88% of total Billed charges,22.83,100,,,Fee Schedule,100% of Medicare rate,202.73,100,,,Fee Schedule,100% of WA Medicaid,929,100,,,percent of total billed charges,100% of total billed charges,208.81,103,,,Fee Schedule,103% of WA Medicaid,22.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,202.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,641.01,69,,,percent of total billed charges,69% of total billed charges,929,100,,,percent of total billed charges,100% of total billed charges,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,929,100,,,percent of total billed charges,100% of total billed charges,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,929,100,,,percent of total billed charges,100% of total billed charges,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.59,61.85,,,percent of total billed charges,61.85% of total billed charges,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,263.55,130,,,Fee Schedule,130% of WA Medicaid ,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.23,37.7,,,percent of total billed charges,37.70% of total billed charges,350.23,37.7,,,percent of total billed charges,37.70% of total billed charges,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,31493.1,33.9,,,percent of total billed charges,33.9% of total billed charges,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.62,78,,,percent of total billed charges,78% of total billed charges,929,100,,,percent of total billed charges,100% of total billed charges,767.35,82.6,,,percent of total billed charges,82.6% of total billed charges,767.35,82.6,,,percent of total billed charges,82.6% of total billed charges,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.83,31493.1,
EXCISE PAROTID TUMOR OF LATERAL LOBE,42415,CDM,983,RC,42415,HCPCS,Outpatient,,,2381,1547.65,,2095.28,88,,,percent of total billed charges,88% of total Billed charges,98.63,100,,,Fee Schedule,100% of Medicare rate,606.5,100,,,Fee Schedule,100% of WA Medicaid,2381,100,,,percent of total billed charges,100% of total billed charges,624.7,103,,,Fee Schedule,103% of WA Medicaid,98.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,172.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,606.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1642.89,69,,,percent of total billed charges,69% of total billed charges,2381,100,,,percent of total billed charges,100% of total billed charges,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2381,100,,,percent of total billed charges,100% of total billed charges,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2381,100,,,percent of total billed charges,100% of total billed charges,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1472.65,61.85,,,percent of total billed charges,61.85% of total billed charges,606.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,788.45,130,,,Fee Schedule,130% of WA Medicaid ,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,897.64,37.7,,,percent of total billed charges,37.70% of total billed charges,897.64,37.7,,,percent of total billed charges,37.70% of total billed charges,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,80715.9,33.9,,,percent of total billed charges,33.9% of total billed charges,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1857.18,78,,,percent of total billed charges,78% of total billed charges,2381,100,,,percent of total billed charges,100% of total billed charges,1966.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1966.71,82.6,,,percent of total billed charges,82.6% of total billed charges,606.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.63,80715.9,
EXCISION OF PAROTID TUMOR,42410,CDM,983,RC,42410,HCPCS,Outpatient,,,1323,859.95,,1164.24,88,,,percent of total billed charges,88% of total Billed charges,58.54,100,,,Fee Schedule,100% of Medicare rate,363.12,100,,,Fee Schedule,100% of WA Medicaid,1323,100,,,percent of total billed charges,100% of total billed charges,374.01,103,,,Fee Schedule,103% of WA Medicaid,58.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,102.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,363.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,912.87,69,,,percent of total billed charges,69% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323,100,,,percent of total billed charges,100% of total billed charges,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323,100,,,percent of total billed charges,100% of total billed charges,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,818.28,61.85,,,percent of total billed charges,61.85% of total billed charges,363.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,472.06,130,,,Fee Schedule,130% of WA Medicaid ,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,44849.7,33.9,,,percent of total billed charges,33.9% of total billed charges,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031.94,78,,,percent of total billed charges,78% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,363.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.54,44849.7,
"EXCISION OF PAROTID TUMOR,TOTAL W/DISEC",42420,CDM,983,RC,42420,HCPCS,Outpatient,,,2728,1773.20,,2400.64,88,,,percent of total billed charges,88% of total Billed charges,110.7,100,,,Fee Schedule,100% of Medicare rate,677.74,100,,,Fee Schedule,100% of WA Medicaid,2728,100,,,percent of total billed charges,100% of total billed charges,698.07,103,,,Fee Schedule,103% of WA Medicaid,110.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,677.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1882.32,69,,,percent of total billed charges,69% of total billed charges,2728,100,,,percent of total billed charges,100% of total billed charges,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2728,100,,,percent of total billed charges,100% of total billed charges,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2728,100,,,percent of total billed charges,100% of total billed charges,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1687.27,61.85,,,percent of total billed charges,61.85% of total billed charges,677.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,691.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,881.06,130,,,Fee Schedule,130% of WA Medicaid ,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1028.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1028.46,37.7,,,percent of total billed charges,37.70% of total billed charges,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,92479.2,33.9,,,percent of total billed charges,33.9% of total billed charges,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,2127.84,78,,,percent of total billed charges,78% of total billed charges,2728,100,,,percent of total billed charges,100% of total billed charges,2253.33,82.6,,,percent of total billed charges,82.6% of total billed charges,2253.33,82.6,,,percent of total billed charges,82.6% of total billed charges,677.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.7,92479.2,
EXCISION SUBMANDIBULAR GLAND,42440,CDM,983,RC,42440,HCPCS,Outpatient,,,888,577.20,,781.44,88,,,percent of total billed charges,88% of total Billed charges,36.55,100,,,Fee Schedule,100% of Medicare rate,240.96,100,,,Fee Schedule,100% of WA Medicaid,888,100,,,percent of total billed charges,100% of total billed charges,248.19,103,,,Fee Schedule,103% of WA Medicaid,36.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,63.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,240.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,612.72,69,,,percent of total billed charges,69% of total billed charges,888,100,,,percent of total billed charges,100% of total billed charges,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,888,100,,,percent of total billed charges,100% of total billed charges,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,888,100,,,percent of total billed charges,100% of total billed charges,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.23,61.85,,,percent of total billed charges,61.85% of total billed charges,240.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,313.25,130,,,Fee Schedule,130% of WA Medicaid ,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.78,37.7,,,percent of total billed charges,37.70% of total billed charges,334.78,37.7,,,percent of total billed charges,37.70% of total billed charges,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,30103.2,33.9,,,percent of total billed charges,33.9% of total billed charges,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.64,78,,,percent of total billed charges,78% of total billed charges,888,100,,,percent of total billed charges,100% of total billed charges,733.49,82.6,,,percent of total billed charges,82.6% of total billed charges,733.49,82.6,,,percent of total billed charges,82.6% of total billed charges,240.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.55,30103.2,
EXCISION SUBLINGUAL GLAND,42450,CDM,983,RC,42450,HCPCS,Outpatient,,,932,605.80,,820.16,88,,,percent of total billed charges,88% of total Billed charges,29.58,100,,,Fee Schedule,100% of Medicare rate,212.61,100,,,Fee Schedule,100% of WA Medicaid,932,100,,,percent of total billed charges,100% of total billed charges,218.99,103,,,Fee Schedule,103% of WA Medicaid,29.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,212.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,643.08,69,,,percent of total billed charges,69% of total billed charges,932,100,,,percent of total billed charges,100% of total billed charges,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,932,100,,,percent of total billed charges,100% of total billed charges,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,932,100,,,percent of total billed charges,100% of total billed charges,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,576.44,61.85,,,percent of total billed charges,61.85% of total billed charges,212.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,276.39,130,,,Fee Schedule,130% of WA Medicaid ,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.36,37.7,,,percent of total billed charges,37.70% of total billed charges,351.36,37.7,,,percent of total billed charges,37.70% of total billed charges,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,31594.8,33.9,,,percent of total billed charges,33.9% of total billed charges,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.96,78,,,percent of total billed charges,78% of total billed charges,932,100,,,percent of total billed charges,100% of total billed charges,769.83,82.6,,,percent of total billed charges,82.6% of total billed charges,769.83,82.6,,,percent of total billed charges,82.6% of total billed charges,212.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.58,31594.8,
DRAINAGE OF TONSIL ABSCESS,42700,CDM,983,RC,42700,HCPCS,Outpatient,,,392,254.80,,344.96,88,,,percent of total billed charges,88% of total Billed charges,10.65,100,,,Fee Schedule,100% of Medicare rate,79.45,100,,,Fee Schedule,100% of WA Medicaid,392,100,,,percent of total billed charges,100% of total billed charges,81.83,103,,,Fee Schedule,103% of WA Medicaid,10.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,270.48,69,,,percent of total billed charges,69% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,392,100,,,percent of total billed charges,100% of total billed charges,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,392,100,,,percent of total billed charges,100% of total billed charges,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.45,61.85,,,percent of total billed charges,61.85% of total billed charges,79.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.29,130,,,Fee Schedule,130% of WA Medicaid ,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.78,37.7,,,percent of total billed charges,37.70% of total billed charges,147.78,37.7,,,percent of total billed charges,37.70% of total billed charges,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,13288.8,33.9,,,percent of total billed charges,33.9% of total billed charges,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.76,78,,,percent of total billed charges,78% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,79.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.65,13288.8,
BIOPSY;OROPHARYNX,42800,CDM,983,RC,42800,HCPCS,Outpatient,,,323,209.95,,284.24,88,,,percent of total billed charges,88% of total Billed charges,9.04,100,,,Fee Schedule,100% of Medicare rate,68.45,100,,,Fee Schedule,100% of WA Medicaid,323,100,,,percent of total billed charges,100% of total billed charges,70.5,103,,,Fee Schedule,103% of WA Medicaid,9.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,222.87,69,,,percent of total billed charges,69% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,323,100,,,percent of total billed charges,100% of total billed charges,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,323,100,,,percent of total billed charges,100% of total billed charges,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.78,61.85,,,percent of total billed charges,61.85% of total billed charges,68.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,88.99,130,,,Fee Schedule,130% of WA Medicaid ,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,121.77,37.7,,,percent of total billed charges,37.70% of total billed charges,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,10949.7,33.9,,,percent of total billed charges,33.9% of total billed charges,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.94,78,,,percent of total billed charges,78% of total billed charges,323,100,,,percent of total billed charges,100% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,266.8,82.6,,,percent of total billed charges,82.6% of total billed charges,68.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.04,10949.7,
EXCISION BRANCHIAL CLEFT CYST,42815,CDM,983,RC,42815,HCPCS,Outpatient,,,1045,679.25,,919.6,88,,,percent of total billed charges,88% of total Billed charges,45.22,100,,,Fee Schedule,100% of Medicare rate,312.57,100,,,Fee Schedule,100% of WA Medicaid,1045,100,,,percent of total billed charges,100% of total billed charges,321.95,103,,,Fee Schedule,103% of WA Medicaid,45.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,312.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,721.05,69,,,percent of total billed charges,69% of total billed charges,1045,100,,,percent of total billed charges,100% of total billed charges,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045,100,,,percent of total billed charges,100% of total billed charges,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045,100,,,percent of total billed charges,100% of total billed charges,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.33,61.85,,,percent of total billed charges,61.85% of total billed charges,312.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,406.34,130,,,Fee Schedule,130% of WA Medicaid ,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.97,37.7,,,percent of total billed charges,37.70% of total billed charges,393.97,37.7,,,percent of total billed charges,37.70% of total billed charges,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,35425.5,33.9,,,percent of total billed charges,33.9% of total billed charges,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.1,78,,,percent of total billed charges,78% of total billed charges,1045,100,,,percent of total billed charges,100% of total billed charges,863.17,82.6,,,percent of total billed charges,82.6% of total billed charges,863.17,82.6,,,percent of total billed charges,82.6% of total billed charges,312.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.22,35425.5,
TONSILLECTOMY,42825,CDM,983,RC,42825,HCPCS,Outpatient,,,554,360.10,,487.52,88,,,percent of total billed charges,88% of total Billed charges,21.23,100,,,Fee Schedule,100% of Medicare rate,157.22,100,,,Fee Schedule,100% of WA Medicaid,554,100,,,percent of total billed charges,100% of total billed charges,161.94,103,,,Fee Schedule,103% of WA Medicaid,21.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,157.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,382.26,69,,,percent of total billed charges,69% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,554,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,554,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.65,61.85,,,percent of total billed charges,61.85% of total billed charges,157.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,204.39,130,,,Fee Schedule,130% of WA Medicaid ,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,208.86,37.7,,,percent of total billed charges,37.70% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,18780.6,33.9,,,percent of total billed charges,33.9% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.12,78,,,percent of total billed charges,78% of total billed charges,554,100,,,percent of total billed charges,100% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,457.6,82.6,,,percent of total billed charges,82.6% of total billed charges,157.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.23,18780.6,
TONSILLECTOMY/ADNOID YOUNGER THAN 12 YRS,42820,CDM,983,RC,42820,HCPCS,Outpatient,,,619,402.35,,544.72,88,,,percent of total billed charges,88% of total Billed charges,24.74,100,,,Fee Schedule,100% of Medicare rate,169.53,100,,,Fee Schedule,100% of WA Medicaid,619,100,,,percent of total billed charges,100% of total billed charges,174.62,103,,,Fee Schedule,103% of WA Medicaid,24.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,169.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,427.11,69,,,percent of total billed charges,69% of total billed charges,619,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,619,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,619,100,,,percent of total billed charges,100% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.85,61.85,,,percent of total billed charges,61.85% of total billed charges,169.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,220.39,130,,,Fee Schedule,130% of WA Medicaid ,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.36,37.7,,,percent of total billed charges,37.70% of total billed charges,233.36,37.7,,,percent of total billed charges,37.70% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,20984.1,33.9,,,percent of total billed charges,33.9% of total billed charges,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.82,78,,,percent of total billed charges,78% of total billed charges,619,100,,,percent of total billed charges,100% of total billed charges,511.29,82.6,,,percent of total billed charges,82.6% of total billed charges,511.29,82.6,,,percent of total billed charges,82.6% of total billed charges,169.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.74,20984.1,
"TONSILLECTOMY,PRIM OR SEC, AGE 12/OVER",42826,CDM,983,RC,42826,HCPCS,Outpatient,,,534,347.10,,469.92,88,,,percent of total billed charges,88% of total Billed charges,20.82,100,,,Fee Schedule,100% of Medicare rate,149.57,100,,,Fee Schedule,100% of WA Medicaid,534,100,,,percent of total billed charges,100% of total billed charges,154.06,103,,,Fee Schedule,103% of WA Medicaid,20.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,149.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,368.46,69,,,percent of total billed charges,69% of total billed charges,534,100,,,percent of total billed charges,100% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,534,100,,,percent of total billed charges,100% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,534,100,,,percent of total billed charges,100% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.28,61.85,,,percent of total billed charges,61.85% of total billed charges,149.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,194.44,130,,,Fee Schedule,130% of WA Medicaid ,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.32,37.7,,,percent of total billed charges,37.70% of total billed charges,201.32,37.7,,,percent of total billed charges,37.70% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,18102.6,33.9,,,percent of total billed charges,33.9% of total billed charges,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.52,78,,,percent of total billed charges,78% of total billed charges,534,100,,,percent of total billed charges,100% of total billed charges,441.08,82.6,,,percent of total billed charges,82.6% of total billed charges,441.08,82.6,,,percent of total billed charges,82.6% of total billed charges,149.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.82,18102.6,
TONSILLECTOMY  ADENOIDECTOMY 12YRS/OVER,42821,CDM,983,RC,42821,HCPCS,Outpatient,,,644,418.60,,566.72,88,,,percent of total billed charges,88% of total Billed charges,25.65,100,,,Fee Schedule,100% of Medicare rate,176.99,100,,,Fee Schedule,100% of WA Medicaid,644,100,,,percent of total billed charges,100% of total billed charges,182.3,103,,,Fee Schedule,103% of WA Medicaid,25.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,176.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,444.36,69,,,percent of total billed charges,69% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,644,100,,,percent of total billed charges,100% of total billed charges,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,644,100,,,percent of total billed charges,100% of total billed charges,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.31,61.85,,,percent of total billed charges,61.85% of total billed charges,176.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,230.09,130,,,Fee Schedule,130% of WA Medicaid ,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,242.79,37.7,,,percent of total billed charges,37.70% of total billed charges,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,21831.6,33.9,,,percent of total billed charges,33.9% of total billed charges,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.32,78,,,percent of total billed charges,78% of total billed charges,644,100,,,percent of total billed charges,100% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,531.94,82.6,,,percent of total billed charges,82.6% of total billed charges,176.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.65,21831.6,
ADENOIDECTOMY PRIMARY;YOUNGER THAN 12 YR,42830,CDM,983,RC,42830,HCPCS,Outpatient,,,437,284.05,,384.56,88,,,percent of total billed charges,88% of total Billed charges,16.68,100,,,Fee Schedule,100% of Medicare rate,125.14,100,,,Fee Schedule,100% of WA Medicaid,437,100,,,percent of total billed charges,100% of total billed charges,128.89,103,,,Fee Schedule,103% of WA Medicaid,16.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,125.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,301.53,69,,,percent of total billed charges,69% of total billed charges,437,100,,,percent of total billed charges,100% of total billed charges,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,437,100,,,percent of total billed charges,100% of total billed charges,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,437,100,,,percent of total billed charges,100% of total billed charges,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.28,61.85,,,percent of total billed charges,61.85% of total billed charges,125.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,162.68,130,,,Fee Schedule,130% of WA Medicaid ,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.75,37.7,,,percent of total billed charges,37.70% of total billed charges,164.75,37.7,,,percent of total billed charges,37.70% of total billed charges,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,14814.3,33.9,,,percent of total billed charges,33.9% of total billed charges,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.86,78,,,percent of total billed charges,78% of total billed charges,437,100,,,percent of total billed charges,100% of total billed charges,360.96,82.6,,,percent of total billed charges,82.6% of total billed charges,360.96,82.6,,,percent of total billed charges,82.6% of total billed charges,125.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.68,14814.3,
"ADENOIDECTOMY,PRIMARY;12 YRS OR OLDER",42831,CDM,983,RC,42831,HCPCS,Outpatient,,,543,352.95,,477.84,88,,,percent of total billed charges,88% of total Billed charges,17.52,100,,,Fee Schedule,100% of Medicare rate,136.15,100,,,Fee Schedule,100% of WA Medicaid,543,100,,,percent of total billed charges,100% of total billed charges,140.23,103,,,Fee Schedule,103% of WA Medicaid,17.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,136.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,374.67,69,,,percent of total billed charges,69% of total billed charges,543,100,,,percent of total billed charges,100% of total billed charges,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,543,100,,,percent of total billed charges,100% of total billed charges,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,543,100,,,percent of total billed charges,100% of total billed charges,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.85,61.85,,,percent of total billed charges,61.85% of total billed charges,136.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,177,130,,,Fee Schedule,130% of WA Medicaid ,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.71,37.7,,,percent of total billed charges,37.70% of total billed charges,204.71,37.7,,,percent of total billed charges,37.70% of total billed charges,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,18407.7,33.9,,,percent of total billed charges,33.9% of total billed charges,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.54,78,,,percent of total billed charges,78% of total billed charges,543,100,,,percent of total billed charges,100% of total billed charges,448.52,82.6,,,percent of total billed charges,82.6% of total billed charges,448.52,82.6,,,percent of total billed charges,82.6% of total billed charges,136.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.52,18407.7,
RADICAL TONSILLECTOMY,42842,CDM,983,RC,42842,HCPCS,Outpatient,,,2061,1339.65,,1813.68,88,,,percent of total billed charges,88% of total Billed charges,77.92,100,,,Fee Schedule,100% of Medicare rate,585.42,100,,,Fee Schedule,100% of WA Medicaid,2061,100,,,percent of total billed charges,100% of total billed charges,602.98,103,,,Fee Schedule,103% of WA Medicaid,77.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,136.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,585.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1422.09,69,,,percent of total billed charges,69% of total billed charges,2061,100,,,percent of total billed charges,100% of total billed charges,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2061,100,,,percent of total billed charges,100% of total billed charges,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2061,100,,,percent of total billed charges,100% of total billed charges,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1274.73,61.85,,,percent of total billed charges,61.85% of total billed charges,585.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,761.05,130,,,Fee Schedule,130% of WA Medicaid ,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,777,37.7,,,percent of total billed charges,37.70% of total billed charges,777,37.7,,,percent of total billed charges,37.70% of total billed charges,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,69867.9,33.9,,,percent of total billed charges,33.9% of total billed charges,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1607.58,78,,,percent of total billed charges,78% of total billed charges,2061,100,,,percent of total billed charges,100% of total billed charges,1702.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1702.39,82.6,,,percent of total billed charges,82.6% of total billed charges,585.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.92,69867.9,
EXCISION OF TONSIL TAGS,42860,CDM,983,RC,42860,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,14.83,100,,,Fee Schedule,100% of Medicare rate,114.51,100,,,Fee Schedule,100% of WA Medicaid,455,100,,,percent of total billed charges,100% of total billed charges,117.95,103,,,Fee Schedule,103% of WA Medicaid,14.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,114.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,455,100,,,percent of total billed charges,100% of total billed charges,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,455,100,,,percent of total billed charges,100% of total billed charges,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,114.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,148.86,130,,,Fee Schedule,130% of WA Medicaid ,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,15424.5,33.9,,,percent of total billed charges,33.9% of total billed charges,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,114.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.83,15424.5,
RECONSTRUCTION OF THROAT,42950,CDM,983,RC,42950,HCPCS,Outpatient,,,1639,1065.35,,1442.32,88,,,percent of total billed charges,88% of total Billed charges,55.99,100,,,Fee Schedule,100% of Medicare rate,464.94,100,,,Fee Schedule,100% of WA Medicaid,1639,100,,,percent of total billed charges,100% of total billed charges,478.89,103,,,Fee Schedule,103% of WA Medicaid,55.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,464.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1130.91,69,,,percent of total billed charges,69% of total billed charges,1639,100,,,percent of total billed charges,100% of total billed charges,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1639,100,,,percent of total billed charges,100% of total billed charges,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1639,100,,,percent of total billed charges,100% of total billed charges,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1013.72,61.85,,,percent of total billed charges,61.85% of total billed charges,464.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,604.42,130,,,Fee Schedule,130% of WA Medicaid ,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.9,37.7,,,percent of total billed charges,37.70% of total billed charges,617.9,37.7,,,percent of total billed charges,37.70% of total billed charges,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,55562.1,33.9,,,percent of total billed charges,33.9% of total billed charges,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1278.42,78,,,percent of total billed charges,78% of total billed charges,1639,100,,,percent of total billed charges,100% of total billed charges,1353.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1353.81,82.6,,,percent of total billed charges,82.6% of total billed charges,464.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.99,55562.1,
CONTROL OROPHARYNGEAL HEMORRHAGE,42962,CDM,983,RC,42962,HCPCS,Outpatient,,,1102,716.30,,969.76,88,,,percent of total billed charges,88% of total Billed charges,44.04,100,,,Fee Schedule,100% of Medicare rate,299.89,100,,,Fee Schedule,100% of WA Medicaid,1102,100,,,percent of total billed charges,100% of total billed charges,308.89,103,,,Fee Schedule,103% of WA Medicaid,44.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,299.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,760.38,69,,,percent of total billed charges,69% of total billed charges,1102,100,,,percent of total billed charges,100% of total billed charges,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1102,100,,,percent of total billed charges,100% of total billed charges,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1102,100,,,percent of total billed charges,100% of total billed charges,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,681.59,61.85,,,percent of total billed charges,61.85% of total billed charges,299.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,389.86,130,,,Fee Schedule,130% of WA Medicaid ,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.45,37.7,,,percent of total billed charges,37.70% of total billed charges,415.45,37.7,,,percent of total billed charges,37.70% of total billed charges,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,37357.8,33.9,,,percent of total billed charges,33.9% of total billed charges,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.56,78,,,percent of total billed charges,78% of total billed charges,1102,100,,,percent of total billed charges,100% of total billed charges,910.25,82.6,,,percent of total billed charges,82.6% of total billed charges,910.25,82.6,,,percent of total billed charges,82.6% of total billed charges,299.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.04,37357.8,
INCISION OF ESOPHAGUS,43020,CDM,983,RC,43020,HCPCS,Outpatient,,,1386,900.90,,1219.68,88,,,percent of total billed charges,88% of total Billed charges,71.99,100,,,Fee Schedule,100% of Medicare rate,322.46,100,,,Fee Schedule,100% of WA Medicaid,1386,100,,,percent of total billed charges,100% of total billed charges,332.13,103,,,Fee Schedule,103% of WA Medicaid,71.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,125.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,322.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,956.34,69,,,percent of total billed charges,69% of total billed charges,1386,100,,,percent of total billed charges,100% of total billed charges,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1386,100,,,percent of total billed charges,100% of total billed charges,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1386,100,,,percent of total billed charges,100% of total billed charges,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,857.24,61.85,,,percent of total billed charges,61.85% of total billed charges,322.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,419.2,130,,,Fee Schedule,130% of WA Medicaid ,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.52,37.7,,,percent of total billed charges,37.70% of total billed charges,522.52,37.7,,,percent of total billed charges,37.70% of total billed charges,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,46985.4,33.9,,,percent of total billed charges,33.9% of total billed charges,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1081.08,78,,,percent of total billed charges,78% of total billed charges,1386,100,,,percent of total billed charges,100% of total billed charges,1144.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1144.84,82.6,,,percent of total billed charges,82.6% of total billed charges,322.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.99,46985.4,
THROAT MUSCLE SURGERY,43030,CDM,983,RC,43030,HCPCS,Outpatient,,,1456,946.40,,1281.28,88,,,percent of total billed charges,88% of total Billed charges,48.08,100,,,Fee Schedule,100% of Medicare rate,302.13,100,,,Fee Schedule,100% of WA Medicaid,1456,100,,,percent of total billed charges,100% of total billed charges,311.19,103,,,Fee Schedule,103% of WA Medicaid,48.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,84.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,302.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1004.64,69,,,percent of total billed charges,69% of total billed charges,1456,100,,,percent of total billed charges,100% of total billed charges,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1456,100,,,percent of total billed charges,100% of total billed charges,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1456,100,,,percent of total billed charges,100% of total billed charges,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,900.54,61.85,,,percent of total billed charges,61.85% of total billed charges,302.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,392.77,130,,,Fee Schedule,130% of WA Medicaid ,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,548.91,37.7,,,percent of total billed charges,37.70% of total billed charges,548.91,37.7,,,percent of total billed charges,37.70% of total billed charges,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,49358.4,33.9,,,percent of total billed charges,33.9% of total billed charges,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1135.68,78,,,percent of total billed charges,78% of total billed charges,1456,100,,,percent of total billed charges,100% of total billed charges,1202.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1202.66,82.6,,,percent of total billed charges,82.6% of total billed charges,302.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.08,49358.4,
INCISION OF ESOPHAGUS,43045,CDM,983,RC,43045,HCPCS,Outpatient,,,3572,2321.80,,3143.36,88,,,percent of total billed charges,88% of total Billed charges,178.61,100,,,Fee Schedule,100% of Medicare rate,723.99,100,,,Fee Schedule,100% of WA Medicaid,3572,100,,,percent of total billed charges,100% of total billed charges,745.71,103,,,Fee Schedule,103% of WA Medicaid,178.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,312.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,723.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2464.68,69,,,percent of total billed charges,69% of total billed charges,3572,100,,,percent of total billed charges,100% of total billed charges,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,3572,100,,,percent of total billed charges,100% of total billed charges,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,3572,100,,,percent of total billed charges,100% of total billed charges,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2209.28,61.85,,,percent of total billed charges,61.85% of total billed charges,723.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,738.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,941.19,130,,,Fee Schedule,130% of WA Medicaid ,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1346.64,37.7,,,percent of total billed charges,37.70% of total billed charges,1346.64,37.7,,,percent of total billed charges,37.70% of total billed charges,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,121090.8,33.9,,,percent of total billed charges,33.9% of total billed charges,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2786.16,78,,,percent of total billed charges,78% of total billed charges,3572,100,,,percent of total billed charges,100% of total billed charges,2950.47,82.6,,,percent of total billed charges,82.6% of total billed charges,2950.47,82.6,,,percent of total billed charges,82.6% of total billed charges,723.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,178.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,178.61,121090.8,
REMOVAL OF ESOPHAGUS,43108,CDM,983,RC,43108,HCPCS,Outpatient,,,12704,8257.60,,11179.52,88,,,percent of total billed charges,88% of total Billed charges,659.89,100,,,Fee Schedule,100% of Medicare rate,2416.29,100,,,Fee Schedule,100% of WA Medicaid,12704,100,,,percent of total billed charges,100% of total billed charges,2488.78,103,,,Fee Schedule,103% of WA Medicaid,659.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1154.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2416.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8765.76,69,,,percent of total billed charges,69% of total billed charges,12704,100,,,percent of total billed charges,100% of total billed charges,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12704,100,,,percent of total billed charges,100% of total billed charges,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12704,100,,,percent of total billed charges,100% of total billed charges,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,7857.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2416.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2416.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2464.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3141.18,130,,,Fee Schedule,130% of WA Medicaid ,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,4789.41,37.7,,,percent of total billed charges,37.70% of total billed charges,4789.41,37.7,,,percent of total billed charges,37.70% of total billed charges,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,430665.6,33.9,,,percent of total billed charges,33.9% of total billed charges,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,9909.12,78,,,percent of total billed charges,78% of total billed charges,12704,100,,,percent of total billed charges,100% of total billed charges,10493.5,82.6,,,percent of total billed charges,82.6% of total billed charges,10493.5,82.6,,,percent of total billed charges,82.6% of total billed charges,2416.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,666.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,659.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2416.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,659.89,430665.6,
EXCISION OF ESOPHAGUS LESION,43101,CDM,983,RC,43101,HCPCS,Outpatient,,,2763,1795.95,,2431.44,88,,,percent of total billed charges,88% of total Billed charges,138.45,100,,,Fee Schedule,100% of Medicare rate,557.82,100,,,Fee Schedule,100% of WA Medicaid,2763,100,,,percent of total billed charges,100% of total billed charges,574.55,103,,,Fee Schedule,103% of WA Medicaid,138.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,242.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,557.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1906.47,69,,,percent of total billed charges,69% of total billed charges,2763,100,,,percent of total billed charges,100% of total billed charges,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2763,100,,,percent of total billed charges,100% of total billed charges,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2763,100,,,percent of total billed charges,100% of total billed charges,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1708.92,61.85,,,percent of total billed charges,61.85% of total billed charges,557.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,568.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,725.17,130,,,Fee Schedule,130% of WA Medicaid ,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1041.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1041.65,37.7,,,percent of total billed charges,37.70% of total billed charges,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,93665.7,33.9,,,percent of total billed charges,33.9% of total billed charges,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2155.14,78,,,percent of total billed charges,78% of total billed charges,2763,100,,,percent of total billed charges,100% of total billed charges,2282.24,82.6,,,percent of total billed charges,82.6% of total billed charges,2282.24,82.6,,,percent of total billed charges,82.6% of total billed charges,557.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,138.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,138.45,93665.7,
EXCISION OF ESOPHAGUS LESION,43100,CDM,983,RC,43100,HCPCS,Outpatient,,,1766,1147.90,,1554.08,88,,,percent of total billed charges,88% of total Billed charges,56.18,100,,,Fee Schedule,100% of Medicare rate,367.59,100,,,Fee Schedule,100% of WA Medicaid,1766,100,,,percent of total billed charges,100% of total billed charges,378.62,103,,,Fee Schedule,103% of WA Medicaid,56.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,98.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,367.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1218.54,69,,,percent of total billed charges,69% of total billed charges,1766,100,,,percent of total billed charges,100% of total billed charges,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1766,100,,,percent of total billed charges,100% of total billed charges,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1766,100,,,percent of total billed charges,100% of total billed charges,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1092.27,61.85,,,percent of total billed charges,61.85% of total billed charges,367.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,477.87,130,,,Fee Schedule,130% of WA Medicaid ,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,665.78,37.7,,,percent of total billed charges,37.70% of total billed charges,665.78,37.7,,,percent of total billed charges,37.70% of total billed charges,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,59867.4,33.9,,,percent of total billed charges,33.9% of total billed charges,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377.48,78,,,percent of total billed charges,78% of total billed charges,1766,100,,,percent of total billed charges,100% of total billed charges,1458.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1458.72,82.6,,,percent of total billed charges,82.6% of total billed charges,367.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.18,59867.4,
REMOVAL OF ESOPHAGUS,43107,CDM,983,RC,43107,HCPCS,Outpatient,,,6954,4520.10,,6119.52,88,,,percent of total billed charges,88% of total Billed charges,420.61,100,,,Fee Schedule,100% of Medicare rate,1639.15,100,,,Fee Schedule,100% of WA Medicaid,6954,100,,,percent of total billed charges,100% of total billed charges,1688.32,103,,,Fee Schedule,103% of WA Medicaid,420.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,736.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1639.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4798.26,69,,,percent of total billed charges,69% of total billed charges,6954,100,,,percent of total billed charges,100% of total billed charges,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6954,100,,,percent of total billed charges,100% of total billed charges,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6954,100,,,percent of total billed charges,100% of total billed charges,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4301.05,61.85,,,percent of total billed charges,61.85% of total billed charges,1639.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1639.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1671.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2130.9,130,,,Fee Schedule,130% of WA Medicaid ,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2621.66,37.7,,,percent of total billed charges,37.70% of total billed charges,2621.66,37.7,,,percent of total billed charges,37.70% of total billed charges,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,235740.6,33.9,,,percent of total billed charges,33.9% of total billed charges,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,5424.12,78,,,percent of total billed charges,78% of total billed charges,6954,100,,,percent of total billed charges,100% of total billed charges,5744,82.6,,,percent of total billed charges,82.6% of total billed charges,5744,82.6,,,percent of total billed charges,82.6% of total billed charges,1639.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,420.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1639.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,420.61,235740.6,
PARTIAL REMOVAL OF ESOPHAGUS,43118,CDM,983,RC,43118,HCPCS,Outpatient,,,9859,6408.35,,8675.92,88,,,percent of total billed charges,88% of total Billed charges,535.23,100,,,Fee Schedule,100% of Medicare rate,1973.54,100,,,Fee Schedule,100% of WA Medicaid,9859,100,,,percent of total billed charges,100% of total billed charges,2032.75,103,,,Fee Schedule,103% of WA Medicaid,535.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,936.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1973.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6802.71,69,,,percent of total billed charges,69% of total billed charges,9859,100,,,percent of total billed charges,100% of total billed charges,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,9859,100,,,percent of total billed charges,100% of total billed charges,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,9859,100,,,percent of total billed charges,100% of total billed charges,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,6097.79,61.85,,,percent of total billed charges,61.85% of total billed charges,1973.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1973.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,2013.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2565.6,130,,,Fee Schedule,130% of WA Medicaid ,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,3716.84,37.7,,,percent of total billed charges,37.70% of total billed charges,3716.84,37.7,,,percent of total billed charges,37.70% of total billed charges,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,334220.1,33.9,,,percent of total billed charges,33.9% of total billed charges,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,7690.02,78,,,percent of total billed charges,78% of total billed charges,9859,100,,,percent of total billed charges,100% of total billed charges,8143.53,82.6,,,percent of total billed charges,82.6% of total billed charges,8143.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1973.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,540.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,535.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1973.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,535.23,334220.1,
REMOVAL OF ESOPHAGUS,43113,CDM,983,RC,43113,HCPCS,Outpatient,,,12426,8076.90,,10934.88,88,,,percent of total billed charges,88% of total Billed charges,639.1,100,,,Fee Schedule,100% of Medicare rate,2367.43,100,,,Fee Schedule,100% of WA Medicaid,12426,100,,,percent of total billed charges,100% of total billed charges,2438.45,103,,,Fee Schedule,103% of WA Medicaid,639.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1118.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2367.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8573.94,69,,,percent of total billed charges,69% of total billed charges,12426,100,,,percent of total billed charges,100% of total billed charges,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,12426,100,,,percent of total billed charges,100% of total billed charges,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,12426,100,,,percent of total billed charges,100% of total billed charges,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7685.48,61.85,,,percent of total billed charges,61.85% of total billed charges,2367.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2367.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2414.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3077.66,130,,,Fee Schedule,130% of WA Medicaid ,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4684.6,37.7,,,percent of total billed charges,37.70% of total billed charges,4684.6,37.7,,,percent of total billed charges,37.70% of total billed charges,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,421241.4,33.9,,,percent of total billed charges,33.9% of total billed charges,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,9692.28,78,,,percent of total billed charges,78% of total billed charges,12426,100,,,percent of total billed charges,100% of total billed charges,10263.88,82.6,,,percent of total billed charges,82.6% of total billed charges,10263.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2367.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,639.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2367.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,639.1,421241.4,
PARTIAL REMOVAL OF ESOPHAGUS,43116,CDM,983,RC,43116,HCPCS,Outpatient,,,14635,9512.75,,12878.8,88,,,percent of total billed charges,88% of total Billed charges,739.79,100,,,Fee Schedule,100% of Medicare rate,2699.96,100,,,Fee Schedule,100% of WA Medicaid,14635,100,,,percent of total billed charges,100% of total billed charges,2780.96,103,,,Fee Schedule,103% of WA Medicaid,739.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1294.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2699.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,10098.15,69,,,percent of total billed charges,69% of total billed charges,14635,100,,,percent of total billed charges,100% of total billed charges,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14635,100,,,percent of total billed charges,100% of total billed charges,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14635,100,,,percent of total billed charges,100% of total billed charges,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,9051.75,61.85,,,percent of total billed charges,61.85% of total billed charges,2699.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2699.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2753.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3509.95,130,,,Fee Schedule,130% of WA Medicaid ,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5517.4,37.7,,,percent of total billed charges,37.70% of total billed charges,5517.4,37.7,,,percent of total billed charges,37.70% of total billed charges,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,496126.5,33.9,,,percent of total billed charges,33.9% of total billed charges,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,11415.3,78,,,percent of total billed charges,78% of total billed charges,14635,100,,,percent of total billed charges,100% of total billed charges,12088.51,82.6,,,percent of total billed charges,82.6% of total billed charges,12088.51,82.6,,,percent of total billed charges,82.6% of total billed charges,2699.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,747.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,739.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2699.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,739.79,496126.5,
PARTIAL REMOVAL OF ESOPHAGUS,43117,CDM,983,RC,43117,HCPCS,Outpatient,,,6741,4381.65,,5932.08,88,,,percent of total billed charges,88% of total Billed charges,463.85,100,,,Fee Schedule,100% of Medicare rate,1789.28,100,,,Fee Schedule,100% of WA Medicaid,6741,100,,,percent of total billed charges,100% of total billed charges,1842.96,103,,,Fee Schedule,103% of WA Medicaid,463.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,811.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1789.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4651.29,69,,,percent of total billed charges,69% of total billed charges,6741,100,,,percent of total billed charges,100% of total billed charges,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6741,100,,,percent of total billed charges,100% of total billed charges,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6741,100,,,percent of total billed charges,100% of total billed charges,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,4169.31,61.85,,,percent of total billed charges,61.85% of total billed charges,1789.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1789.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2326.06,130,,,Fee Schedule,130% of WA Medicaid ,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2541.36,37.7,,,percent of total billed charges,37.70% of total billed charges,2541.36,37.7,,,percent of total billed charges,37.70% of total billed charges,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,228519.9,33.9,,,percent of total billed charges,33.9% of total billed charges,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,5257.98,78,,,percent of total billed charges,78% of total billed charges,6741,100,,,percent of total billed charges,100% of total billed charges,5568.07,82.6,,,percent of total billed charges,82.6% of total billed charges,5568.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1789.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,463.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1789.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,463.85,228519.9,
REMOVAL OF ESOPHAGUS,43112,CDM,983,RC,43112,HCPCS,Outpatient,,,7346,4774.90,,6464.48,88,,,percent of total billed charges,88% of total Billed charges,488.78,100,,,Fee Schedule,100% of Medicare rate,1896.89,100,,,Fee Schedule,100% of WA Medicaid,7346,100,,,percent of total billed charges,100% of total billed charges,1953.8,103,,,Fee Schedule,103% of WA Medicaid,488.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,855.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1896.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5068.74,69,,,percent of total billed charges,69% of total billed charges,7346,100,,,percent of total billed charges,100% of total billed charges,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,7346,100,,,percent of total billed charges,100% of total billed charges,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,7346,100,,,percent of total billed charges,100% of total billed charges,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,4543.5,61.85,,,percent of total billed charges,61.85% of total billed charges,1896.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1896.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1934.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2465.96,130,,,Fee Schedule,130% of WA Medicaid ,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2769.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2769.44,37.7,,,percent of total billed charges,37.70% of total billed charges,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,249029.4,33.9,,,percent of total billed charges,33.9% of total billed charges,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,5729.88,78,,,percent of total billed charges,78% of total billed charges,7346,100,,,percent of total billed charges,100% of total billed charges,6067.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6067.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1896.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,493.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,488.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1896.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,488.78,249029.4,
REMOVAL OF ESOPHAGUS,43124,CDM,983,RC,43124,HCPCS,Outpatient,,,10438,6784.70,,9185.44,88,,,percent of total billed charges,88% of total Billed charges,553.8,100,,,Fee Schedule,100% of Medicare rate,2080.41,100,,,Fee Schedule,100% of WA Medicaid,10438,100,,,percent of total billed charges,100% of total billed charges,2142.82,103,,,Fee Schedule,103% of WA Medicaid,553.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,969.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2080.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7202.22,69,,,percent of total billed charges,69% of total billed charges,10438,100,,,percent of total billed charges,100% of total billed charges,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,10438,100,,,percent of total billed charges,100% of total billed charges,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,10438,100,,,percent of total billed charges,100% of total billed charges,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,6455.9,61.85,,,percent of total billed charges,61.85% of total billed charges,2080.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2080.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2122.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2704.53,130,,,Fee Schedule,130% of WA Medicaid ,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3935.13,37.7,,,percent of total billed charges,37.70% of total billed charges,3935.13,37.7,,,percent of total billed charges,37.70% of total billed charges,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,353848.2,33.9,,,percent of total billed charges,33.9% of total billed charges,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,8141.64,78,,,percent of total billed charges,78% of total billed charges,10438,100,,,percent of total billed charges,100% of total billed charges,8621.79,82.6,,,percent of total billed charges,82.6% of total billed charges,8621.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2080.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,559.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,553.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,2080.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,553.8,353848.2,
PARTIAL REMOVAL OF ESOPHAGUS,43123,CDM,983,RC,43123,HCPCS,Outpatient,,,12880,8372.00,,11334.4,88,,,percent of total billed charges,88% of total Billed charges,663.36,100,,,Fee Schedule,100% of Medicare rate,2453.03,100,,,Fee Schedule,100% of WA Medicaid,12880,100,,,percent of total billed charges,100% of total billed charges,2526.62,103,,,Fee Schedule,103% of WA Medicaid,663.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1160.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2453.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8887.2,69,,,percent of total billed charges,69% of total billed charges,12880,100,,,percent of total billed charges,100% of total billed charges,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,12880,100,,,percent of total billed charges,100% of total billed charges,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,12880,100,,,percent of total billed charges,100% of total billed charges,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,7966.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2453.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2453.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2502.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3188.94,130,,,Fee Schedule,130% of WA Medicaid ,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4855.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4855.76,37.7,,,percent of total billed charges,37.70% of total billed charges,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,436632,33.9,,,percent of total billed charges,33.9% of total billed charges,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,10046.4,78,,,percent of total billed charges,78% of total billed charges,12880,100,,,percent of total billed charges,100% of total billed charges,10638.88,82.6,,,percent of total billed charges,82.6% of total billed charges,10638.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2453.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,669.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,663.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2453.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,663.36,436632,
PARTIAL REMOVAL OF ESOPHAGUS,43121,CDM,983,RC,43121,HCPCS,Outpatient,,,7835,5092.75,,6894.8,88,,,percent of total billed charges,88% of total Billed charges,413.36,100,,,Fee Schedule,100% of Medicare rate,1564.74,100,,,Fee Schedule,100% of WA Medicaid,7835,100,,,percent of total billed charges,100% of total billed charges,1611.68,103,,,Fee Schedule,103% of WA Medicaid,413.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,723.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1564.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5406.15,69,,,percent of total billed charges,69% of total billed charges,7835,100,,,percent of total billed charges,100% of total billed charges,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,7835,100,,,percent of total billed charges,100% of total billed charges,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,7835,100,,,percent of total billed charges,100% of total billed charges,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4845.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1564.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1564.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1596.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2034.16,130,,,Fee Schedule,130% of WA Medicaid ,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2953.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2953.8,37.7,,,percent of total billed charges,37.70% of total billed charges,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,265606.5,33.9,,,percent of total billed charges,33.9% of total billed charges,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6111.3,78,,,percent of total billed charges,78% of total billed charges,7835,100,,,percent of total billed charges,100% of total billed charges,6471.71,82.6,,,percent of total billed charges,82.6% of total billed charges,6471.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1564.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,413.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1564.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,413.36,265606.5,
PARTIAL REMOVAL OF ESOPHAGUS,43122,CDM,983,RC,43122,HCPCS,Outpatient,,,6998,4548.70,,6158.24,88,,,percent of total billed charges,88% of total Billed charges,358.05,100,,,Fee Schedule,100% of Medicare rate,1423.55,100,,,Fee Schedule,100% of WA Medicaid,6998,100,,,percent of total billed charges,100% of total billed charges,1466.26,103,,,Fee Schedule,103% of WA Medicaid,358.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,626.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1423.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4828.62,69,,,percent of total billed charges,69% of total billed charges,6998,100,,,percent of total billed charges,100% of total billed charges,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6998,100,,,percent of total billed charges,100% of total billed charges,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6998,100,,,percent of total billed charges,100% of total billed charges,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,4328.26,61.85,,,percent of total billed charges,61.85% of total billed charges,1423.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1452.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1850.62,130,,,Fee Schedule,130% of WA Medicaid ,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2638.25,37.7,,,percent of total billed charges,37.70% of total billed charges,2638.25,37.7,,,percent of total billed charges,37.70% of total billed charges,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,237232.2,33.9,,,percent of total billed charges,33.9% of total billed charges,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,5458.44,78,,,percent of total billed charges,78% of total billed charges,6998,100,,,percent of total billed charges,100% of total billed charges,5780.35,82.6,,,percent of total billed charges,82.6% of total billed charges,5780.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1423.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,358.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,358.05,237232.2,
REMOVAL OF ESOPHAGUS POUCH,43130,CDM,983,RC,43130,HCPCS,Outpatient,,,2205,1433.25,,1940.4,88,,,percent of total billed charges,88% of total Billed charges,82.77,100,,,Fee Schedule,100% of Medicare rate,453.2,100,,,Fee Schedule,100% of WA Medicaid,2205,100,,,percent of total billed charges,100% of total billed charges,466.8,103,,,Fee Schedule,103% of WA Medicaid,82.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,144.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,453.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1521.45,69,,,percent of total billed charges,69% of total billed charges,2205,100,,,percent of total billed charges,100% of total billed charges,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2205,100,,,percent of total billed charges,100% of total billed charges,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2205,100,,,percent of total billed charges,100% of total billed charges,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1363.79,61.85,,,percent of total billed charges,61.85% of total billed charges,453.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,462.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,589.16,130,,,Fee Schedule,130% of WA Medicaid ,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,831.29,37.7,,,percent of total billed charges,37.70% of total billed charges,831.29,37.7,,,percent of total billed charges,37.70% of total billed charges,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,74749.5,33.9,,,percent of total billed charges,33.9% of total billed charges,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1719.9,78,,,percent of total billed charges,78% of total billed charges,2205,100,,,percent of total billed charges,100% of total billed charges,1821.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1821.33,82.6,,,percent of total billed charges,82.6% of total billed charges,453.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.77,74749.5,
ESOPHAGOSCP RIG TRNSO BIOPSY,43193,CDM,983,RC,43193,HCPCS,Outpatient,,,355,230.75,,312.4,88,,,percent of total billed charges,88% of total Billed charges,15.71,100,,,Fee Schedule,100% of Medicare rate,96.23,100,,,Fee Schedule,100% of WA Medicaid,355,100,,,percent of total billed charges,100% of total billed charges,99.12,103,,,Fee Schedule,103% of WA Medicaid,15.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,96.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,244.95,69,,,percent of total billed charges,69% of total billed charges,355,100,,,percent of total billed charges,100% of total billed charges,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,355,100,,,percent of total billed charges,100% of total billed charges,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,355,100,,,percent of total billed charges,100% of total billed charges,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.57,61.85,,,percent of total billed charges,61.85% of total billed charges,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,125.1,130,,,Fee Schedule,130% of WA Medicaid ,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.84,37.7,,,percent of total billed charges,37.70% of total billed charges,133.84,37.7,,,percent of total billed charges,37.70% of total billed charges,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,12034.5,33.9,,,percent of total billed charges,33.9% of total billed charges,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.9,78,,,percent of total billed charges,78% of total billed charges,355,100,,,percent of total billed charges,100% of total billed charges,293.23,82.6,,,percent of total billed charges,82.6% of total billed charges,293.23,82.6,,,percent of total billed charges,82.6% of total billed charges,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.71,12034.5,
ESOPHAGOSCOPY RIGID TRNSO DX,43191,CDM,983,RC,43191,HCPCS,Outpatient,,,314,204.10,,276.32,88,,,percent of total billed charges,88% of total Billed charges,14.53,100,,,Fee Schedule,100% of Medicare rate,88.59,100,,,Fee Schedule,100% of WA Medicaid,314,100,,,percent of total billed charges,100% of total billed charges,91.25,103,,,Fee Schedule,103% of WA Medicaid,14.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,88.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,216.66,69,,,percent of total billed charges,69% of total billed charges,314,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,314,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,314,100,,,percent of total billed charges,100% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.21,61.85,,,percent of total billed charges,61.85% of total billed charges,88.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,115.17,130,,,Fee Schedule,130% of WA Medicaid ,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.38,37.7,,,percent of total billed charges,37.70% of total billed charges,118.38,37.7,,,percent of total billed charges,37.70% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,10644.6,33.9,,,percent of total billed charges,33.9% of total billed charges,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.92,78,,,percent of total billed charges,78% of total billed charges,314,100,,,percent of total billed charges,100% of total billed charges,259.36,82.6,,,percent of total billed charges,82.6% of total billed charges,259.36,82.6,,,percent of total billed charges,82.6% of total billed charges,88.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.53,10644.6,
ESOPH SCOPE W/SUBMUCOUS INJ,43201,CDM,983,RC,43201,HCPCS,Outpatient,,,773,502.45,,680.24,88,,,percent of total billed charges,88% of total Billed charges,9.31,100,,,Fee Schedule,100% of Medicare rate,58.56,100,,,Fee Schedule,100% of WA Medicaid,773,100,,,percent of total billed charges,100% of total billed charges,60.32,103,,,Fee Schedule,103% of WA Medicaid,9.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,533.37,69,,,percent of total billed charges,69% of total billed charges,773,100,,,percent of total billed charges,100% of total billed charges,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,773,100,,,percent of total billed charges,100% of total billed charges,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,773,100,,,percent of total billed charges,100% of total billed charges,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.1,61.85,,,percent of total billed charges,61.85% of total billed charges,58.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.13,130,,,Fee Schedule,130% of WA Medicaid ,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.42,37.7,,,percent of total billed charges,37.70% of total billed charges,291.42,37.7,,,percent of total billed charges,37.70% of total billed charges,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,26204.7,33.9,,,percent of total billed charges,33.9% of total billed charges,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.94,78,,,percent of total billed charges,78% of total billed charges,773,100,,,percent of total billed charges,100% of total billed charges,638.5,82.6,,,percent of total billed charges,82.6% of total billed charges,638.5,82.6,,,percent of total billed charges,82.6% of total billed charges,58.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.31,26204.7,
ESOPH SCOPE W/SCLEROSIS INJ,43204,CDM,983,RC,43204,HCPCS,Outpatient,,,406,263.90,,357.28,88,,,percent of total billed charges,88% of total Billed charges,11.01,100,,,Fee Schedule,100% of Medicare rate,75.91,100,,,Fee Schedule,100% of WA Medicaid,406,100,,,percent of total billed charges,100% of total billed charges,78.19,103,,,Fee Schedule,103% of WA Medicaid,11.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,75.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,280.14,69,,,percent of total billed charges,69% of total billed charges,406,100,,,percent of total billed charges,100% of total billed charges,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,406,100,,,percent of total billed charges,100% of total billed charges,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,406,100,,,percent of total billed charges,100% of total billed charges,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.11,61.85,,,percent of total billed charges,61.85% of total billed charges,75.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,98.68,130,,,Fee Schedule,130% of WA Medicaid ,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.06,37.7,,,percent of total billed charges,37.70% of total billed charges,153.06,37.7,,,percent of total billed charges,37.70% of total billed charges,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,13763.4,33.9,,,percent of total billed charges,33.9% of total billed charges,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.68,78,,,percent of total billed charges,78% of total billed charges,406,100,,,percent of total billed charges,100% of total billed charges,335.36,82.6,,,percent of total billed charges,82.6% of total billed charges,335.36,82.6,,,percent of total billed charges,82.6% of total billed charges,75.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.01,13763.4,
ESOPHAGUS ENDOSCOPY/LIGATION,43205,CDM,983,RC,43205,HCPCS,Outpatient,,,421,273.65,,370.48,88,,,percent of total billed charges,88% of total Billed charges,11.71,100,,,Fee Schedule,100% of Medicare rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,421,100,,,percent of total billed charges,100% of total billed charges,81.64,103,,,Fee Schedule,103% of WA Medicaid,11.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,290.49,69,,,percent of total billed charges,69% of total billed charges,421,100,,,percent of total billed charges,100% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,421,100,,,percent of total billed charges,100% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,421,100,,,percent of total billed charges,100% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.39,61.85,,,percent of total billed charges,61.85% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.04,130,,,Fee Schedule,130% of WA Medicaid ,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.72,37.7,,,percent of total billed charges,37.70% of total billed charges,158.72,37.7,,,percent of total billed charges,37.70% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,14271.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.38,78,,,percent of total billed charges,78% of total billed charges,421,100,,,percent of total billed charges,100% of total billed charges,347.75,82.6,,,percent of total billed charges,82.6% of total billed charges,347.75,82.6,,,percent of total billed charges,82.6% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.71,14271.9,
ESOPHAGOSCOPY FLEX BIOPSY,43202,CDM,983,RC,43202,HCPCS,Outpatient,,,1017,661.05,,894.96,88,,,percent of total billed charges,88% of total Billed charges,9.03,100,,,Fee Schedule,100% of Medicare rate,58.19,100,,,Fee Schedule,100% of WA Medicaid,1017,100,,,percent of total billed charges,100% of total billed charges,59.94,103,,,Fee Schedule,103% of WA Medicaid,9.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,701.73,69,,,percent of total billed charges,69% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.01,61.85,,,percent of total billed charges,61.85% of total billed charges,58.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,75.65,130,,,Fee Schedule,130% of WA Medicaid ,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,383.41,37.7,,,percent of total billed charges,37.70% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,34476.3,33.9,,,percent of total billed charges,33.9% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,793.26,78,,,percent of total billed charges,78% of total billed charges,1017,100,,,percent of total billed charges,100% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,840.04,82.6,,,percent of total billed charges,82.6% of total billed charges,58.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.03,34476.3,
ESOPH OPTICAL ENDOMICROSCOPY,43206,CDM,983,RC,43206,HCPCS,Outpatient,,,929,603.85,,817.52,88,,,percent of total billed charges,88% of total Billed charges,10.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,929,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,10.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,641.01,69,,,percent of total billed charges,69% of total billed charges,929,100,,,percent of total billed charges,100% of total billed charges,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,929,100,,,percent of total billed charges,100% of total billed charges,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,929,100,,,percent of total billed charges,100% of total billed charges,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.59,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.23,37.7,,,percent of total billed charges,37.70% of total billed charges,350.23,37.7,,,percent of total billed charges,37.70% of total billed charges,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,31493.1,33.9,,,percent of total billed charges,33.9% of total billed charges,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.62,78,,,percent of total billed charges,78% of total billed charges,929,100,,,percent of total billed charges,100% of total billed charges,767.35,82.6,,,percent of total billed charges,82.6% of total billed charges,767.35,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",10.68,31493.1,
ESOPHAGOSCOPY FLEXIBLE BRUSH,43200,CDM,983,RC,43200,HCPCS,Outpatient,,,760,494.00,,668.8,88,,,percent of total billed charges,88% of total Billed charges,8.33,100,,,Fee Schedule,100% of Medicare rate,49.8,100,,,Fee Schedule,100% of WA Medicaid,760,100,,,percent of total billed charges,100% of total billed charges,51.29,103,,,Fee Schedule,103% of WA Medicaid,8.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,524.4,69,,,percent of total billed charges,69% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,760,100,,,percent of total billed charges,100% of total billed charges,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,760,100,,,percent of total billed charges,100% of total billed charges,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.06,61.85,,,percent of total billed charges,61.85% of total billed charges,49.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.74,130,,,Fee Schedule,130% of WA Medicaid ,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,286.52,37.7,,,percent of total billed charges,37.70% of total billed charges,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,25764,33.9,,,percent of total billed charges,33.9% of total billed charges,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,592.8,78,,,percent of total billed charges,78% of total billed charges,760,100,,,percent of total billed charges,100% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,627.76,82.6,,,percent of total billed charges,82.6% of total billed charges,49.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.33,25764,
ESOPHAGOSCOPY RETRO BALLOON,43213,CDM,983,RC,43213,HCPCS,Outpatient,,,3472,2256.80,,3055.36,88,,,percent of total billed charges,88% of total Billed charges,26.84,100,,,Fee Schedule,100% of Medicare rate,144.72,100,,,Fee Schedule,100% of WA Medicaid,3472,100,,,percent of total billed charges,100% of total billed charges,149.06,103,,,Fee Schedule,103% of WA Medicaid,26.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,46.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,144.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2395.68,69,,,percent of total billed charges,69% of total billed charges,3472,100,,,percent of total billed charges,100% of total billed charges,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3472,100,,,percent of total billed charges,100% of total billed charges,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3472,100,,,percent of total billed charges,100% of total billed charges,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2147.43,61.85,,,percent of total billed charges,61.85% of total billed charges,144.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,188.14,130,,,Fee Schedule,130% of WA Medicaid ,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1308.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1308.94,37.7,,,percent of total billed charges,37.70% of total billed charges,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,117700.8,33.9,,,percent of total billed charges,33.9% of total billed charges,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2708.16,78,,,percent of total billed charges,78% of total billed charges,3472,100,,,percent of total billed charges,100% of total billed charges,2867.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2867.87,82.6,,,percent of total billed charges,82.6% of total billed charges,144.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.84,117700.8,
ESOPHAGOSC DILATE BALLOON 30,43214,CDM,983,RC,43214,HCPCS,Outpatient,,,549,356.85,,483.12,88,,,percent of total billed charges,88% of total Billed charges,19.23,100,,,Fee Schedule,100% of Medicare rate,108.73,100,,,Fee Schedule,100% of WA Medicaid,549,100,,,percent of total billed charges,100% of total billed charges,111.99,103,,,Fee Schedule,103% of WA Medicaid,19.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,108.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,378.81,69,,,percent of total billed charges,69% of total billed charges,549,100,,,percent of total billed charges,100% of total billed charges,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,549,100,,,percent of total billed charges,100% of total billed charges,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,549,100,,,percent of total billed charges,100% of total billed charges,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.56,61.85,,,percent of total billed charges,61.85% of total billed charges,108.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.35,130,,,Fee Schedule,130% of WA Medicaid ,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.97,37.7,,,percent of total billed charges,37.70% of total billed charges,206.97,37.7,,,percent of total billed charges,37.70% of total billed charges,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,18611.1,33.9,,,percent of total billed charges,33.9% of total billed charges,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.22,78,,,percent of total billed charges,78% of total billed charges,549,100,,,percent of total billed charges,100% of total billed charges,453.47,82.6,,,percent of total billed charges,82.6% of total billed charges,453.47,82.6,,,percent of total billed charges,82.6% of total billed charges,108.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.23,18611.1,
ESOPHAGOSCOPY LESION REMOVAL,43216,CDM,983,RC,43216,HCPCS,Outpatient,,,1179,766.35,,1037.52,88,,,percent of total billed charges,88% of total Billed charges,10.97,100,,,Fee Schedule,100% of Medicare rate,75.16,100,,,Fee Schedule,100% of WA Medicaid,1179,100,,,percent of total billed charges,100% of total billed charges,77.41,103,,,Fee Schedule,103% of WA Medicaid,10.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,75.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,813.51,69,,,percent of total billed charges,69% of total billed charges,1179,100,,,percent of total billed charges,100% of total billed charges,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1179,100,,,percent of total billed charges,100% of total billed charges,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1179,100,,,percent of total billed charges,100% of total billed charges,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.21,61.85,,,percent of total billed charges,61.85% of total billed charges,75.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,97.71,130,,,Fee Schedule,130% of WA Medicaid ,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.48,37.7,,,percent of total billed charges,37.70% of total billed charges,444.48,37.7,,,percent of total billed charges,37.70% of total billed charges,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,39968.1,33.9,,,percent of total billed charges,33.9% of total billed charges,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,919.62,78,,,percent of total billed charges,78% of total billed charges,1179,100,,,percent of total billed charges,100% of total billed charges,973.85,82.6,,,percent of total billed charges,82.6% of total billed charges,973.85,82.6,,,percent of total billed charges,82.6% of total billed charges,75.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.97,39968.1,
ESOPHAGOSCOP STENT PLACEMENT,43212,CDM,983,RC,43212,HCPCS,Outpatient,,,535,347.75,,470.8,88,,,percent of total billed charges,88% of total Billed charges,19.82,100,,,Fee Schedule,100% of Medicare rate,105,100,,,Fee Schedule,100% of WA Medicaid,535,100,,,percent of total billed charges,100% of total billed charges,108.15,103,,,Fee Schedule,103% of WA Medicaid,19.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,105,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,369.15,69,,,percent of total billed charges,69% of total billed charges,535,100,,,percent of total billed charges,100% of total billed charges,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,535,100,,,percent of total billed charges,100% of total billed charges,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,535,100,,,percent of total billed charges,100% of total billed charges,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.9,61.85,,,percent of total billed charges,61.85% of total billed charges,105,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,105,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.5,130,,,Fee Schedule,130% of WA Medicaid ,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.7,37.7,,,percent of total billed charges,37.70% of total billed charges,201.7,37.7,,,percent of total billed charges,37.70% of total billed charges,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,18136.5,33.9,,,percent of total billed charges,33.9% of total billed charges,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.3,78,,,percent of total billed charges,78% of total billed charges,535,100,,,percent of total billed charges,100% of total billed charges,441.91,82.6,,,percent of total billed charges,82.6% of total billed charges,441.91,82.6,,,percent of total billed charges,82.6% of total billed charges,105,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,105,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.82,18136.5,
ESOPHAGOSCOP MUCOSAL RESECT,43211,CDM,983,RC,43211,HCPCS,Outpatient,,,683,443.95,,601.04,88,,,percent of total billed charges,88% of total Billed charges,19.65,100,,,Fee Schedule,100% of Medicare rate,131.3,100,,,Fee Schedule,100% of WA Medicaid,683,100,,,percent of total billed charges,100% of total billed charges,135.24,103,,,Fee Schedule,103% of WA Medicaid,19.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,131.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,471.27,69,,,percent of total billed charges,69% of total billed charges,683,100,,,percent of total billed charges,100% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,683,100,,,percent of total billed charges,100% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,683,100,,,percent of total billed charges,100% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.44,61.85,,,percent of total billed charges,61.85% of total billed charges,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,170.69,130,,,Fee Schedule,130% of WA Medicaid ,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.49,37.7,,,percent of total billed charges,37.70% of total billed charges,257.49,37.7,,,percent of total billed charges,37.70% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,23153.7,33.9,,,percent of total billed charges,33.9% of total billed charges,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,532.74,78,,,percent of total billed charges,78% of total billed charges,683,100,,,percent of total billed charges,100% of total billed charges,564.16,82.6,,,percent of total billed charges,82.6% of total billed charges,564.16,82.6,,,percent of total billed charges,82.6% of total billed charges,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.65,23153.7,
ESOPHAGOSCOPY SNARE LES REMV,43217,CDM,983,RC,43217,HCPCS,Outpatient,,,1255,815.75,,1104.4,88,,,percent of total billed charges,88% of total Billed charges,13.3,100,,,Fee Schedule,100% of Medicare rate,89.89,100,,,Fee Schedule,100% of WA Medicaid,1255,100,,,percent of total billed charges,100% of total billed charges,92.59,103,,,Fee Schedule,103% of WA Medicaid,13.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,89.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,865.95,69,,,percent of total billed charges,69% of total billed charges,1255,100,,,percent of total billed charges,100% of total billed charges,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1255,100,,,percent of total billed charges,100% of total billed charges,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1255,100,,,percent of total billed charges,100% of total billed charges,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,776.22,61.85,,,percent of total billed charges,61.85% of total billed charges,89.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,116.86,130,,,Fee Schedule,130% of WA Medicaid ,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.14,37.7,,,percent of total billed charges,37.70% of total billed charges,473.14,37.7,,,percent of total billed charges,37.70% of total billed charges,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,42544.5,33.9,,,percent of total billed charges,33.9% of total billed charges,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,978.9,78,,,percent of total billed charges,78% of total billed charges,1255,100,,,percent of total billed charges,100% of total billed charges,1036.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1036.63,82.6,,,percent of total billed charges,82.6% of total billed charges,89.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.3,42544.5,
ESOPHAGOSCOPY FLEX REMOVE FB,43215,CDM,983,RC,43215,HCPCS,Outpatient,,,1140,741.00,,1003.2,88,,,percent of total billed charges,88% of total Billed charges,14.04,100,,,Fee Schedule,100% of Medicare rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,1140,100,,,percent of total billed charges,100% of total billed charges,81.64,103,,,Fee Schedule,103% of WA Medicaid,14.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,786.6,69,,,percent of total billed charges,69% of total billed charges,1140,100,,,percent of total billed charges,100% of total billed charges,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1140,100,,,percent of total billed charges,100% of total billed charges,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1140,100,,,percent of total billed charges,100% of total billed charges,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,705.09,61.85,,,percent of total billed charges,61.85% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.04,130,,,Fee Schedule,130% of WA Medicaid ,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.78,37.7,,,percent of total billed charges,37.70% of total billed charges,429.78,37.7,,,percent of total billed charges,37.70% of total billed charges,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,38646,33.9,,,percent of total billed charges,33.9% of total billed charges,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,889.2,78,,,percent of total billed charges,78% of total billed charges,1140,100,,,percent of total billed charges,100% of total billed charges,941.64,82.6,,,percent of total billed charges,82.6% of total billed charges,941.64,82.6,,,percent of total billed charges,82.6% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.04,38646,
ESOPH ENDOSCOPY DILATION,43226,CDM,983,RC,43226,HCPCS,Outpatient,,,1071,696.15,,942.48,88,,,percent of total billed charges,88% of total Billed charges,13.2,100,,,Fee Schedule,100% of Medicare rate,73.11,100,,,Fee Schedule,100% of WA Medicaid,1071,100,,,percent of total billed charges,100% of total billed charges,75.3,103,,,Fee Schedule,103% of WA Medicaid,13.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,73.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,738.99,69,,,percent of total billed charges,69% of total billed charges,1071,100,,,percent of total billed charges,100% of total billed charges,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1071,100,,,percent of total billed charges,100% of total billed charges,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1071,100,,,percent of total billed charges,100% of total billed charges,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,662.41,61.85,,,percent of total billed charges,61.85% of total billed charges,73.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.04,130,,,Fee Schedule,130% of WA Medicaid ,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.77,37.7,,,percent of total billed charges,37.70% of total billed charges,403.77,37.7,,,percent of total billed charges,37.70% of total billed charges,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,36306.9,33.9,,,percent of total billed charges,33.9% of total billed charges,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,835.38,78,,,percent of total billed charges,78% of total billed charges,1071,100,,,percent of total billed charges,100% of total billed charges,884.65,82.6,,,percent of total billed charges,82.6% of total billed charges,884.65,82.6,,,percent of total billed charges,82.6% of total billed charges,73.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.2,36306.9,
ESOPHAGOSCOPY BALLOON <30MM,43220,CDM,983,RC,43220,HCPCS,Outpatient,,,2841,1846.65,,2500.08,88,,,percent of total billed charges,88% of total Billed charges,10.51,100,,,Fee Schedule,100% of Medicare rate,66.39,100,,,Fee Schedule,100% of WA Medicaid,2841,100,,,percent of total billed charges,100% of total billed charges,68.38,103,,,Fee Schedule,103% of WA Medicaid,10.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1960.29,69,,,percent of total billed charges,69% of total billed charges,2841,100,,,percent of total billed charges,100% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2841,100,,,percent of total billed charges,100% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2841,100,,,percent of total billed charges,100% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1757.16,61.85,,,percent of total billed charges,61.85% of total billed charges,66.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,86.31,130,,,Fee Schedule,130% of WA Medicaid ,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1071.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1071.06,37.7,,,percent of total billed charges,37.70% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,96309.9,33.9,,,percent of total billed charges,33.9% of total billed charges,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2215.98,78,,,percent of total billed charges,78% of total billed charges,2841,100,,,percent of total billed charges,100% of total billed charges,2346.67,82.6,,,percent of total billed charges,82.6% of total billed charges,2346.67,82.6,,,percent of total billed charges,82.6% of total billed charges,66.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.51,96309.9,
ESOPHAGOSCOPY CONTROL BLEED,43227,CDM,983,RC,43227,HCPCS,Outpatient,,,1107,719.55,,974.16,88,,,percent of total billed charges,88% of total Billed charges,14.49,100,,,Fee Schedule,100% of Medicare rate,92.5,100,,,Fee Schedule,100% of WA Medicaid,1107,100,,,percent of total billed charges,100% of total billed charges,95.28,103,,,Fee Schedule,103% of WA Medicaid,14.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,92.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,763.83,69,,,percent of total billed charges,69% of total billed charges,1107,100,,,percent of total billed charges,100% of total billed charges,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1107,100,,,percent of total billed charges,100% of total billed charges,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1107,100,,,percent of total billed charges,100% of total billed charges,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,684.68,61.85,,,percent of total billed charges,61.85% of total billed charges,92.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,120.25,130,,,Fee Schedule,130% of WA Medicaid ,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.34,37.7,,,percent of total billed charges,37.70% of total billed charges,417.34,37.7,,,percent of total billed charges,37.70% of total billed charges,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,37527.3,33.9,,,percent of total billed charges,33.9% of total billed charges,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.46,78,,,percent of total billed charges,78% of total billed charges,1107,100,,,percent of total billed charges,100% of total billed charges,914.38,82.6,,,percent of total billed charges,82.6% of total billed charges,914.38,82.6,,,percent of total billed charges,82.6% of total billed charges,92.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.49,37527.3,
ESOPHAGOSCOPY LESION ABLATE,43229,CDM,983,RC,43229,HCPCS,Outpatient,,,2042,1327.30,,1796.96,88,,,percent of total billed charges,88% of total Billed charges,17.23,100,,,Fee Schedule,100% of Medicare rate,110.22,100,,,Fee Schedule,100% of WA Medicaid,2042,100,,,percent of total billed charges,100% of total billed charges,113.53,103,,,Fee Schedule,103% of WA Medicaid,17.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,110.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1408.98,69,,,percent of total billed charges,69% of total billed charges,2042,100,,,percent of total billed charges,100% of total billed charges,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,2042,100,,,percent of total billed charges,100% of total billed charges,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,2042,100,,,percent of total billed charges,100% of total billed charges,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262.98,61.85,,,percent of total billed charges,61.85% of total billed charges,110.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,143.29,130,,,Fee Schedule,130% of WA Medicaid ,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,769.83,37.7,,,percent of total billed charges,37.70% of total billed charges,769.83,37.7,,,percent of total billed charges,37.70% of total billed charges,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,69223.8,33.9,,,percent of total billed charges,33.9% of total billed charges,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1592.76,78,,,percent of total billed charges,78% of total billed charges,2042,100,,,percent of total billed charges,100% of total billed charges,1686.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1686.69,82.6,,,percent of total billed charges,82.6% of total billed charges,110.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.23,69223.8,
EGD DIAGNOSTIC BRUSH WASH,43235,CDM,983,RC,43235,HCPCS,Outpatient,,,368,239.20,,323.84,88,,,percent of total billed charges,88% of total Billed charges,10.39,100,,,Fee Schedule,100% of Medicare rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,368,100,,,percent of total billed charges,100% of total billed charges,71.08,103,,,Fee Schedule,103% of WA Medicaid,10.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,253.92,69,,,percent of total billed charges,69% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,368,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,368,100,,,percent of total billed charges,100% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.61,61.85,,,percent of total billed charges,61.85% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.71,130,,,Fee Schedule,130% of WA Medicaid ,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,12475.2,33.9,,,percent of total billed charges,33.9% of total billed charges,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.04,78,,,percent of total billed charges,78% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.39,12475.2,
UPPR GI SCOPE W/SUBMUC INJ,43236,CDM,983,RC,43236,HCPCS,Outpatient,,,414,269.10,,364.32,88,,,percent of total billed charges,88% of total Billed charges,11.89,100,,,Fee Schedule,100% of Medicare rate,77.96,100,,,Fee Schedule,100% of WA Medicaid,414,100,,,percent of total billed charges,100% of total billed charges,80.3,103,,,Fee Schedule,103% of WA Medicaid,11.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,285.66,69,,,percent of total billed charges,69% of total billed charges,414,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,414,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,414,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.06,61.85,,,percent of total billed charges,61.85% of total billed charges,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.35,130,,,Fee Schedule,130% of WA Medicaid ,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.08,37.7,,,percent of total billed charges,37.70% of total billed charges,156.08,37.7,,,percent of total billed charges,37.70% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,14034.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.92,78,,,percent of total billed charges,78% of total billed charges,414,100,,,percent of total billed charges,100% of total billed charges,341.96,82.6,,,percent of total billed charges,82.6% of total billed charges,341.96,82.6,,,percent of total billed charges,82.6% of total billed charges,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.89,14034.6,
EGD BALLOON DIL ESOPH30 MM/>,43233,CDM,983,RC,43233,HCPCS,Outpatient,,,650,422.50,,572,88,,,percent of total billed charges,88% of total Billed charges,23.09,100,,,Fee Schedule,100% of Medicare rate,127.75,100,,,Fee Schedule,100% of WA Medicaid,650,100,,,percent of total billed charges,100% of total billed charges,131.58,103,,,Fee Schedule,103% of WA Medicaid,23.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,127.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,448.5,69,,,percent of total billed charges,69% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,650,100,,,percent of total billed charges,100% of total billed charges,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.03,61.85,,,percent of total billed charges,61.85% of total billed charges,127.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,166.08,130,,,Fee Schedule,130% of WA Medicaid ,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,245.05,37.7,,,percent of total billed charges,37.70% of total billed charges,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,22035,33.9,,,percent of total billed charges,33.9% of total billed charges,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,78,,,percent of total billed charges,78% of total billed charges,650,100,,,percent of total billed charges,100% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,536.9,82.6,,,percent of total billed charges,82.6% of total billed charges,127.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.09,22035,
EGD US FINE NEEDLE BX/ASPIR,43238,CDM,983,RC,43238,HCPCS,Outpatient,,,662,430.30,,582.56,88,,,percent of total billed charges,88% of total Billed charges,19.31,100,,,Fee Schedule,100% of Medicare rate,129.8,100,,,Fee Schedule,100% of WA Medicaid,662,100,,,percent of total billed charges,100% of total billed charges,133.69,103,,,Fee Schedule,103% of WA Medicaid,19.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,129.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,456.78,69,,,percent of total billed charges,69% of total billed charges,662,100,,,percent of total billed charges,100% of total billed charges,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,662,100,,,percent of total billed charges,100% of total billed charges,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,662,100,,,percent of total billed charges,100% of total billed charges,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.45,61.85,,,percent of total billed charges,61.85% of total billed charges,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,168.74,130,,,Fee Schedule,130% of WA Medicaid ,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.57,37.7,,,percent of total billed charges,37.70% of total billed charges,249.57,37.7,,,percent of total billed charges,37.70% of total billed charges,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,22441.8,33.9,,,percent of total billed charges,33.9% of total billed charges,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.36,78,,,percent of total billed charges,78% of total billed charges,662,100,,,percent of total billed charges,100% of total billed charges,546.81,82.6,,,percent of total billed charges,82.6% of total billed charges,546.81,82.6,,,percent of total billed charges,82.6% of total billed charges,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.31,22441.8,
ENDOSCOPIC US EXAM ESOPH,43237,CDM,983,RC,43237,HCPCS,Outpatient,,,581,377.65,,511.28,88,,,percent of total billed charges,88% of total Billed charges,16.16,100,,,Fee Schedule,100% of Medicare rate,109.66,100,,,Fee Schedule,100% of WA Medicaid,581,100,,,percent of total billed charges,100% of total billed charges,112.95,103,,,Fee Schedule,103% of WA Medicaid,16.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,109.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,400.89,69,,,percent of total billed charges,69% of total billed charges,581,100,,,percent of total billed charges,100% of total billed charges,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,581,100,,,percent of total billed charges,100% of total billed charges,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,581,100,,,percent of total billed charges,100% of total billed charges,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.35,61.85,,,percent of total billed charges,61.85% of total billed charges,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,142.56,130,,,Fee Schedule,130% of WA Medicaid ,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.04,37.7,,,percent of total billed charges,37.70% of total billed charges,219.04,37.7,,,percent of total billed charges,37.70% of total billed charges,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,19695.9,33.9,,,percent of total billed charges,33.9% of total billed charges,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.18,78,,,percent of total billed charges,78% of total billed charges,581,100,,,percent of total billed charges,100% of total billed charges,479.91,82.6,,,percent of total billed charges,82.6% of total billed charges,479.91,82.6,,,percent of total billed charges,82.6% of total billed charges,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.16,19695.9,
ESOPHAGOSCOPY W/US NEEDLE BX,43232,CDM,983,RC,43232,HCPCS,Outpatient,,,570,370.50,,501.6,88,,,percent of total billed charges,88% of total Billed charges,16.52,100,,,Fee Schedule,100% of Medicare rate,111.34,100,,,Fee Schedule,100% of WA Medicaid,570,100,,,percent of total billed charges,100% of total billed charges,114.68,103,,,Fee Schedule,103% of WA Medicaid,16.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,111.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,393.3,69,,,percent of total billed charges,69% of total billed charges,570,100,,,percent of total billed charges,100% of total billed charges,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,570,100,,,percent of total billed charges,100% of total billed charges,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,570,100,,,percent of total billed charges,100% of total billed charges,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.55,61.85,,,percent of total billed charges,61.85% of total billed charges,111.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,144.74,130,,,Fee Schedule,130% of WA Medicaid ,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.89,37.7,,,percent of total billed charges,37.70% of total billed charges,214.89,37.7,,,percent of total billed charges,37.70% of total billed charges,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,19323,33.9,,,percent of total billed charges,33.9% of total billed charges,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.6,78,,,percent of total billed charges,78% of total billed charges,570,100,,,percent of total billed charges,100% of total billed charges,470.82,82.6,,,percent of total billed charges,82.6% of total billed charges,470.82,82.6,,,percent of total billed charges,82.6% of total billed charges,111.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.52,19323,
EGD BIOPSY SINGLE/MULTIPLE,43239,CDM,983,RC,43239,HCPCS,Outpatient,,,1125,731.25,,990,88,,,percent of total billed charges,88% of total Billed charges,11.89,100,,,Fee Schedule,100% of Medicare rate,77.96,100,,,Fee Schedule,100% of WA Medicaid,1125,100,,,percent of total billed charges,100% of total billed charges,80.3,103,,,Fee Schedule,103% of WA Medicaid,11.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,776.25,69,,,percent of total billed charges,69% of total billed charges,1125,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1125,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1125,100,,,percent of total billed charges,100% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,695.81,61.85,,,percent of total billed charges,61.85% of total billed charges,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.35,130,,,Fee Schedule,130% of WA Medicaid ,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.13,37.7,,,percent of total billed charges,37.70% of total billed charges,424.13,37.7,,,percent of total billed charges,37.70% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,38137.5,33.9,,,percent of total billed charges,33.9% of total billed charges,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,877.5,78,,,percent of total billed charges,78% of total billed charges,1125,100,,,percent of total billed charges,100% of total billed charges,929.25,82.6,,,percent of total billed charges,82.6% of total billed charges,929.25,82.6,,,percent of total billed charges,82.6% of total billed charges,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.89,38137.5,
ESOPHAGOSCOP ULTRASOUND EXAM,43231,CDM,983,RC,43231,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,12.7,100,,,Fee Schedule,100% of Medicare rate,88.21,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,90.86,103,,,Fee Schedule,103% of WA Medicaid,12.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,88.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,480,100,,,percent of total billed charges,100% of total billed charges,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,480,100,,,percent of total billed charges,100% of total billed charges,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.88,61.85,,,percent of total billed charges,61.85% of total billed charges,88.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,114.67,130,,,Fee Schedule,130% of WA Medicaid ,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,16272,33.9,,,percent of total billed charges,33.9% of total billed charges,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,88.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.7,16272,
EGD TUBE/CATH INSERTION,43241,CDM,983,RC,43241,HCPCS,Outpatient,,,425,276.25,,374,88,,,percent of total billed charges,88% of total Billed charges,12.77,100,,,Fee Schedule,100% of Medicare rate,79.82,100,,,Fee Schedule,100% of WA Medicaid,425,100,,,percent of total billed charges,100% of total billed charges,82.21,103,,,Fee Schedule,103% of WA Medicaid,12.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,293.25,69,,,percent of total billed charges,69% of total billed charges,425,100,,,percent of total billed charges,100% of total billed charges,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,425,100,,,percent of total billed charges,100% of total billed charges,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,425,100,,,percent of total billed charges,100% of total billed charges,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.86,61.85,,,percent of total billed charges,61.85% of total billed charges,79.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.77,130,,,Fee Schedule,130% of WA Medicaid ,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.23,37.7,,,percent of total billed charges,37.70% of total billed charges,160.23,37.7,,,percent of total billed charges,37.70% of total billed charges,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,14407.5,33.9,,,percent of total billed charges,33.9% of total billed charges,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.5,78,,,percent of total billed charges,78% of total billed charges,425,100,,,percent of total billed charges,100% of total billed charges,351.05,82.6,,,percent of total billed charges,82.6% of total billed charges,351.05,82.6,,,percent of total billed charges,82.6% of total billed charges,79.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.77,14407.5,
EGD DILATE STRICTURE,43245,CDM,983,RC,43245,HCPCS,Outpatient,,,1731,1125.15,,1523.28,88,,,percent of total billed charges,88% of total Billed charges,16.6,100,,,Fee Schedule,100% of Medicare rate,98.29,100,,,Fee Schedule,100% of WA Medicaid,1731,100,,,percent of total billed charges,100% of total billed charges,101.24,103,,,Fee Schedule,103% of WA Medicaid,16.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,98.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1194.39,69,,,percent of total billed charges,69% of total billed charges,1731,100,,,percent of total billed charges,100% of total billed charges,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1731,100,,,percent of total billed charges,100% of total billed charges,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1731,100,,,percent of total billed charges,100% of total billed charges,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1070.62,61.85,,,percent of total billed charges,61.85% of total billed charges,98.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,127.78,130,,,Fee Schedule,130% of WA Medicaid ,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,652.59,37.7,,,percent of total billed charges,37.70% of total billed charges,652.59,37.7,,,percent of total billed charges,37.70% of total billed charges,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,58680.9,33.9,,,percent of total billed charges,33.9% of total billed charges,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1350.18,78,,,percent of total billed charges,78% of total billed charges,1731,100,,,percent of total billed charges,100% of total billed charges,1429.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1429.81,82.6,,,percent of total billed charges,82.6% of total billed charges,98.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.6,58680.9,
EGD PLACE GASTROSTOMY TUBE,43246,CDM,983,RC,43246,HCPCS,Outpatient,,,591,384.15,,520.08,88,,,percent of total billed charges,88% of total Billed charges,20.17,100,,,Fee Schedule,100% of Medicare rate,111.71,100,,,Fee Schedule,100% of WA Medicaid,591,100,,,percent of total billed charges,100% of total billed charges,115.06,103,,,Fee Schedule,103% of WA Medicaid,20.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,111.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,407.79,69,,,percent of total billed charges,69% of total billed charges,591,100,,,percent of total billed charges,100% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,591,100,,,percent of total billed charges,100% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,591,100,,,percent of total billed charges,100% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,365.53,61.85,,,percent of total billed charges,61.85% of total billed charges,111.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.22,130,,,Fee Schedule,130% of WA Medicaid ,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.81,37.7,,,percent of total billed charges,37.70% of total billed charges,222.81,37.7,,,percent of total billed charges,37.70% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,20034.9,33.9,,,percent of total billed charges,33.9% of total billed charges,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.98,78,,,percent of total billed charges,78% of total billed charges,591,100,,,percent of total billed charges,100% of total billed charges,488.17,82.6,,,percent of total billed charges,82.6% of total billed charges,488.17,82.6,,,percent of total billed charges,82.6% of total billed charges,111.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.17,20034.9,
EGD INJECTION VARICES,43243,CDM,983,RC,43243,HCPCS,Outpatient,,,699,454.35,,615.12,88,,,percent of total billed charges,88% of total Billed charges,21.79,100,,,Fee Schedule,100% of Medicare rate,132.6,100,,,Fee Schedule,100% of WA Medicaid,699,100,,,percent of total billed charges,100% of total billed charges,136.58,103,,,Fee Schedule,103% of WA Medicaid,21.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,132.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,482.31,69,,,percent of total billed charges,69% of total billed charges,699,100,,,percent of total billed charges,100% of total billed charges,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,699,100,,,percent of total billed charges,100% of total billed charges,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,699,100,,,percent of total billed charges,100% of total billed charges,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.33,61.85,,,percent of total billed charges,61.85% of total billed charges,132.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,172.38,130,,,Fee Schedule,130% of WA Medicaid ,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.52,37.7,,,percent of total billed charges,37.70% of total billed charges,263.52,37.7,,,percent of total billed charges,37.70% of total billed charges,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,23696.1,33.9,,,percent of total billed charges,33.9% of total billed charges,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.22,78,,,percent of total billed charges,78% of total billed charges,699,100,,,percent of total billed charges,100% of total billed charges,577.37,82.6,,,percent of total billed charges,82.6% of total billed charges,577.37,82.6,,,percent of total billed charges,82.6% of total billed charges,132.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.79,23696.1,
EGD GUIDE WIRE INSERTION,43248,CDM,983,RC,43248,HCPCS,Outpatient,,,1155,750.75,,1016.4,88,,,percent of total billed charges,88% of total Billed charges,14.26,100,,,Fee Schedule,100% of Medicare rate,93.25,100,,,Fee Schedule,100% of WA Medicaid,1155,100,,,percent of total billed charges,100% of total billed charges,96.05,103,,,Fee Schedule,103% of WA Medicaid,14.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,93.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,796.95,69,,,percent of total billed charges,69% of total billed charges,1155,100,,,percent of total billed charges,100% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1155,100,,,percent of total billed charges,100% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1155,100,,,percent of total billed charges,100% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.37,61.85,,,percent of total billed charges,61.85% of total billed charges,93.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,121.23,130,,,Fee Schedule,130% of WA Medicaid ,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.44,37.7,,,percent of total billed charges,37.70% of total billed charges,435.44,37.7,,,percent of total billed charges,37.70% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,39154.5,33.9,,,percent of total billed charges,33.9% of total billed charges,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,900.9,78,,,percent of total billed charges,78% of total billed charges,1155,100,,,percent of total billed charges,100% of total billed charges,954.03,82.6,,,percent of total billed charges,82.6% of total billed charges,954.03,82.6,,,percent of total billed charges,82.6% of total billed charges,93.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.26,39154.5,
EGD VARICES LIGATION,43244,CDM,983,RC,43244,HCPCS,Outpatient,,,725,471.25,,638,88,,,percent of total billed charges,88% of total Billed charges,20.47,100,,,Fee Schedule,100% of Medicare rate,137.08,100,,,Fee Schedule,100% of WA Medicaid,725,100,,,percent of total billed charges,100% of total billed charges,141.19,103,,,Fee Schedule,103% of WA Medicaid,20.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,137.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,500.25,69,,,percent of total billed charges,69% of total billed charges,725,100,,,percent of total billed charges,100% of total billed charges,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,725,100,,,percent of total billed charges,100% of total billed charges,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,725,100,,,percent of total billed charges,100% of total billed charges,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,448.41,61.85,,,percent of total billed charges,61.85% of total billed charges,137.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,178.2,130,,,Fee Schedule,130% of WA Medicaid ,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.33,37.7,,,percent of total billed charges,37.70% of total billed charges,273.33,37.7,,,percent of total billed charges,37.70% of total billed charges,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,24577.5,33.9,,,percent of total billed charges,33.9% of total billed charges,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.5,78,,,percent of total billed charges,78% of total billed charges,725,100,,,percent of total billed charges,100% of total billed charges,598.85,82.6,,,percent of total billed charges,82.6% of total billed charges,598.85,82.6,,,percent of total billed charges,82.6% of total billed charges,137.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.47,24577.5,
EGD US FINE NEEDLE BX/ASPIR,43242,CDM,983,RC,43242,HCPCS,Outpatient,,,754,490.10,,663.52,88,,,percent of total billed charges,88% of total Billed charges,22.02,100,,,Fee Schedule,100% of Medicare rate,146.96,100,,,Fee Schedule,100% of WA Medicaid,754,100,,,percent of total billed charges,100% of total billed charges,151.37,103,,,Fee Schedule,103% of WA Medicaid,22.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,146.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,520.26,69,,,percent of total billed charges,69% of total billed charges,754,100,,,percent of total billed charges,100% of total billed charges,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,754,100,,,percent of total billed charges,100% of total billed charges,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,754,100,,,percent of total billed charges,100% of total billed charges,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.35,61.85,,,percent of total billed charges,61.85% of total billed charges,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.05,130,,,Fee Schedule,130% of WA Medicaid ,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.26,37.7,,,percent of total billed charges,37.70% of total billed charges,284.26,37.7,,,percent of total billed charges,37.70% of total billed charges,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,25560.6,33.9,,,percent of total billed charges,33.9% of total billed charges,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.12,78,,,percent of total billed charges,78% of total billed charges,754,100,,,percent of total billed charges,100% of total billed charges,622.8,82.6,,,percent of total billed charges,82.6% of total billed charges,622.8,82.6,,,percent of total billed charges,82.6% of total billed charges,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.02,25560.6,
EGD W/TRANSMURAL DRAIN CYST,43240,CDM,983,RC,43240,HCPCS,Outpatient,,,1151,748.15,,1012.88,88,,,percent of total billed charges,88% of total Billed charges,33.6,100,,,Fee Schedule,100% of Medicare rate,218.76,100,,,Fee Schedule,100% of WA Medicaid,1151,100,,,percent of total billed charges,100% of total billed charges,225.32,103,,,Fee Schedule,103% of WA Medicaid,33.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,218.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,794.19,69,,,percent of total billed charges,69% of total billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1151,100,,,percent of total billed charges,100% of total billed charges,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1151,100,,,percent of total billed charges,100% of total billed charges,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.89,61.85,,,percent of total billed charges,61.85% of total billed charges,218.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,284.39,130,,,Fee Schedule,130% of WA Medicaid ,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.93,37.7,,,percent of total billed charges,37.70% of total billed charges,433.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,39018.9,33.9,,,percent of total billed charges,33.9% of total billed charges,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,897.78,78,,,percent of total billed charges,78% of total billed charges,1151,100,,,percent of total billed charges,100% of total billed charges,950.73,82.6,,,percent of total billed charges,82.6% of total billed charges,950.73,82.6,,,percent of total billed charges,82.6% of total billed charges,218.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.6,39018.9,
EGD REMOVE FOREIGN BODY,43247,CDM,983,RC,43247,HCPCS,Outpatient,,,1138,739.70,,1001.44,88,,,percent of total billed charges,88% of total Billed charges,15.6,100,,,Fee Schedule,100% of Medicare rate,99.03,100,,,Fee Schedule,100% of WA Medicaid,1138,100,,,percent of total billed charges,100% of total billed charges,102,103,,,Fee Schedule,103% of WA Medicaid,15.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,99.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,785.22,69,,,percent of total billed charges,69% of total billed charges,1138,100,,,percent of total billed charges,100% of total billed charges,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1138,100,,,percent of total billed charges,100% of total billed charges,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1138,100,,,percent of total billed charges,100% of total billed charges,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,703.85,61.85,,,percent of total billed charges,61.85% of total billed charges,99.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,128.74,130,,,Fee Schedule,130% of WA Medicaid ,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.03,37.7,,,percent of total billed charges,37.70% of total billed charges,429.03,37.7,,,percent of total billed charges,37.70% of total billed charges,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,38578.2,33.9,,,percent of total billed charges,33.9% of total billed charges,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,887.64,78,,,percent of total billed charges,78% of total billed charges,1138,100,,,percent of total billed charges,100% of total billed charges,939.99,82.6,,,percent of total billed charges,82.6% of total billed charges,939.99,82.6,,,percent of total billed charges,82.6% of total billed charges,99.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.6,38578.2,
ESOPH EGD DILATION <30 MM,43249,CDM,983,RC,43249,HCPCS,Outpatient,,,2966,1927.90,,2610.08,88,,,percent of total billed charges,88% of total Billed charges,13.37,100,,,Fee Schedule,100% of Medicare rate,86.16,100,,,Fee Schedule,100% of WA Medicaid,2966,100,,,percent of total billed charges,100% of total billed charges,88.74,103,,,Fee Schedule,103% of WA Medicaid,13.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,86.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2046.54,69,,,percent of total billed charges,69% of total billed charges,2966,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2966,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2966,100,,,percent of total billed charges,100% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1834.47,61.85,,,percent of total billed charges,61.85% of total billed charges,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,112.01,130,,,Fee Schedule,130% of WA Medicaid ,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1118.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1118.18,37.7,,,percent of total billed charges,37.70% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,100547.4,33.9,,,percent of total billed charges,33.9% of total billed charges,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2313.48,78,,,percent of total billed charges,78% of total billed charges,2966,100,,,percent of total billed charges,100% of total billed charges,2449.92,82.6,,,percent of total billed charges,82.6% of total billed charges,2449.92,82.6,,,percent of total billed charges,82.6% of total billed charges,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.37,100547.4,
EGD CAUTERY TUMOR POLYP,43250,CDM,983,RC,43250,HCPCS,Outpatient,,,491,319.15,,432.08,88,,,percent of total billed charges,88% of total Billed charges,16.18,100,,,Fee Schedule,100% of Medicare rate,95.12,100,,,Fee Schedule,100% of WA Medicaid,491,100,,,percent of total billed charges,100% of total billed charges,97.97,103,,,Fee Schedule,103% of WA Medicaid,16.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,95.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,338.79,69,,,percent of total billed charges,69% of total billed charges,491,100,,,percent of total billed charges,100% of total billed charges,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,491,100,,,percent of total billed charges,100% of total billed charges,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,491,100,,,percent of total billed charges,100% of total billed charges,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.68,61.85,,,percent of total billed charges,61.85% of total billed charges,95.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,123.66,130,,,Fee Schedule,130% of WA Medicaid ,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.11,37.7,,,percent of total billed charges,37.70% of total billed charges,185.11,37.7,,,percent of total billed charges,37.70% of total billed charges,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,16644.9,33.9,,,percent of total billed charges,33.9% of total billed charges,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.98,78,,,percent of total billed charges,78% of total billed charges,491,100,,,percent of total billed charges,100% of total billed charges,405.57,82.6,,,percent of total billed charges,82.6% of total billed charges,405.57,82.6,,,percent of total billed charges,82.6% of total billed charges,95.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.18,16644.9,
EGD US TRANSMURAL INJXN/MARK,43253,CDM,983,RC,43253,HCPCS,Outpatient,,,762,495.30,,670.56,88,,,percent of total billed charges,88% of total Billed charges,22.01,100,,,Fee Schedule,100% of Medicare rate,146.59,100,,,Fee Schedule,100% of WA Medicaid,762,100,,,percent of total billed charges,100% of total billed charges,150.99,103,,,Fee Schedule,103% of WA Medicaid,22.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,146.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,525.78,69,,,percent of total billed charges,69% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,762,100,,,percent of total billed charges,100% of total billed charges,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,762,100,,,percent of total billed charges,100% of total billed charges,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.3,61.85,,,percent of total billed charges,61.85% of total billed charges,146.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,190.57,130,,,Fee Schedule,130% of WA Medicaid ,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,25831.8,33.9,,,percent of total billed charges,33.9% of total billed charges,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.36,78,,,percent of total billed charges,78% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,146.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.01,25831.8,
EGD US EXAM DUODENUM/JEJUNUM,43259,CDM,983,RC,43259,HCPCS,Outpatient,,,657,427.05,,578.16,88,,,percent of total billed charges,88% of total Billed charges,18.6,100,,,Fee Schedule,100% of Medicare rate,126.26,100,,,Fee Schedule,100% of WA Medicaid,657,100,,,percent of total billed charges,100% of total billed charges,130.05,103,,,Fee Schedule,103% of WA Medicaid,18.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,126.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,453.33,69,,,percent of total billed charges,69% of total billed charges,657,100,,,percent of total billed charges,100% of total billed charges,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,657,100,,,percent of total billed charges,100% of total billed charges,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,657,100,,,percent of total billed charges,100% of total billed charges,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.35,61.85,,,percent of total billed charges,61.85% of total billed charges,126.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,164.14,130,,,Fee Schedule,130% of WA Medicaid ,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.69,37.7,,,percent of total billed charges,37.70% of total billed charges,247.69,37.7,,,percent of total billed charges,37.70% of total billed charges,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,22272.3,33.9,,,percent of total billed charges,33.9% of total billed charges,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.46,78,,,percent of total billed charges,78% of total billed charges,657,100,,,percent of total billed charges,100% of total billed charges,542.68,82.6,,,percent of total billed charges,82.6% of total billed charges,542.68,82.6,,,percent of total billed charges,82.6% of total billed charges,126.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.6,22272.3,
EGD CONTROL BLEEDING ANY,43255,CDM,983,RC,43255,HCPCS,Outpatient,,,585,380.25,,514.8,88,,,percent of total billed charges,88% of total Billed charges,16.55,100,,,Fee Schedule,100% of Medicare rate,112.09,100,,,Fee Schedule,100% of WA Medicaid,585,100,,,percent of total billed charges,100% of total billed charges,115.45,103,,,Fee Schedule,103% of WA Medicaid,16.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,403.65,69,,,percent of total billed charges,69% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,585,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,585,100,,,percent of total billed charges,100% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.82,61.85,,,percent of total billed charges,61.85% of total billed charges,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.72,130,,,Fee Schedule,130% of WA Medicaid ,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,220.55,37.7,,,percent of total billed charges,37.70% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,19831.5,33.9,,,percent of total billed charges,33.9% of total billed charges,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.3,78,,,percent of total billed charges,78% of total billed charges,585,100,,,percent of total billed charges,100% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,483.21,82.6,,,percent of total billed charges,82.6% of total billed charges,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.55,19831.5,
EGD ENDO MUCOSAL RESECTION,43254,CDM,983,RC,43254,HCPCS,Outpatient,,,779,506.35,,685.52,88,,,percent of total billed charges,88% of total Billed charges,22.75,100,,,Fee Schedule,100% of Medicare rate,150.88,100,,,Fee Schedule,100% of WA Medicaid,779,100,,,percent of total billed charges,100% of total billed charges,155.41,103,,,Fee Schedule,103% of WA Medicaid,22.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,150.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,537.51,69,,,percent of total billed charges,69% of total billed charges,779,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,779,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,779,100,,,percent of total billed charges,100% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.81,61.85,,,percent of total billed charges,61.85% of total billed charges,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.14,130,,,Fee Schedule,130% of WA Medicaid ,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.68,37.7,,,percent of total billed charges,37.70% of total billed charges,293.68,37.7,,,percent of total billed charges,37.70% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,26408.1,33.9,,,percent of total billed charges,33.9% of total billed charges,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,607.62,78,,,percent of total billed charges,78% of total billed charges,779,100,,,percent of total billed charges,100% of total billed charges,643.45,82.6,,,percent of total billed charges,82.6% of total billed charges,643.45,82.6,,,percent of total billed charges,82.6% of total billed charges,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.75,26408.1,
EGD W/THRML TXMNT GERD,43257,CDM,983,RC,43257,HCPCS,Outpatient,,,670,435.50,,589.6,88,,,percent of total billed charges,88% of total Billed charges,22.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,670,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,22.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,462.3,69,,,percent of total billed charges,69% of total billed charges,670,100,,,percent of total billed charges,100% of total billed charges,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,670,100,,,percent of total billed charges,100% of total billed charges,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,670,100,,,percent of total billed charges,100% of total billed charges,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.4,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.59,37.7,,,percent of total billed charges,37.70% of total billed charges,252.59,37.7,,,percent of total billed charges,37.70% of total billed charges,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,22713,33.9,,,percent of total billed charges,33.9% of total billed charges,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.6,78,,,percent of total billed charges,78% of total billed charges,670,100,,,percent of total billed charges,100% of total billed charges,553.42,82.6,,,percent of total billed charges,82.6% of total billed charges,553.42,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",22.72,22713,
EGD OPTICAL ENDOMICROSCOPY,43252,CDM,983,RC,43252,HCPCS,Outpatient,,,491,319.15,,432.08,88,,,percent of total billed charges,88% of total Billed charges,14.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,491,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,14.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,338.79,69,,,percent of total billed charges,69% of total billed charges,491,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,491,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,491,100,,,percent of total billed charges,100% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.68,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.11,37.7,,,percent of total billed charges,37.70% of total billed charges,185.11,37.7,,,percent of total billed charges,37.70% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,16644.9,33.9,,,percent of total billed charges,33.9% of total billed charges,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.98,78,,,percent of total billed charges,78% of total billed charges,491,100,,,percent of total billed charges,100% of total billed charges,405.57,82.6,,,percent of total billed charges,82.6% of total billed charges,405.57,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",14.32,16644.9,
EGD REMOVE LESION SNARE,43251,CDM,983,RC,43251,HCPCS,Outpatient,,,569,369.85,,500.72,88,,,percent of total billed charges,88% of total Billed charges,16.69,100,,,Fee Schedule,100% of Medicare rate,109.66,100,,,Fee Schedule,100% of WA Medicaid,569,100,,,percent of total billed charges,100% of total billed charges,112.95,103,,,Fee Schedule,103% of WA Medicaid,16.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,109.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,392.61,69,,,percent of total billed charges,69% of total billed charges,569,100,,,percent of total billed charges,100% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,569,100,,,percent of total billed charges,100% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,569,100,,,percent of total billed charges,100% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.93,61.85,,,percent of total billed charges,61.85% of total billed charges,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,142.56,130,,,Fee Schedule,130% of WA Medicaid ,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.51,37.7,,,percent of total billed charges,37.70% of total billed charges,214.51,37.7,,,percent of total billed charges,37.70% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,19289.1,33.9,,,percent of total billed charges,33.9% of total billed charges,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.82,78,,,percent of total billed charges,78% of total billed charges,569,100,,,percent of total billed charges,100% of total billed charges,469.99,82.6,,,percent of total billed charges,82.6% of total billed charges,469.99,82.6,,,percent of total billed charges,82.6% of total billed charges,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.69,19289.1,
ERCP LITHOTRIPSY CALCULI,43265,CDM,983,RC,43265,HCPCS,Outpatient,,,1240,806.00,,1091.2,88,,,percent of total billed charges,88% of total Billed charges,37.14,100,,,Fee Schedule,100% of Medicare rate,241.33,100,,,Fee Schedule,100% of WA Medicaid,1240,100,,,percent of total billed charges,100% of total billed charges,248.57,103,,,Fee Schedule,103% of WA Medicaid,37.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,241.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,855.6,69,,,percent of total billed charges,69% of total billed charges,1240,100,,,percent of total billed charges,100% of total billed charges,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240,100,,,percent of total billed charges,100% of total billed charges,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240,100,,,percent of total billed charges,100% of total billed charges,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.94,61.85,,,percent of total billed charges,61.85% of total billed charges,241.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,313.73,130,,,Fee Schedule,130% of WA Medicaid ,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,467.48,37.7,,,percent of total billed charges,37.70% of total billed charges,467.48,37.7,,,percent of total billed charges,37.70% of total billed charges,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,42036,33.9,,,percent of total billed charges,33.9% of total billed charges,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,967.2,78,,,percent of total billed charges,78% of total billed charges,1240,100,,,percent of total billed charges,100% of total billed charges,1024.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1024.24,82.6,,,percent of total billed charges,82.6% of total billed charges,241.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.14,42036,
ERCP W/SPECIMEN COLLECTION,43260,CDM,983,RC,43260,HCPCS,Outpatient,,,929,603.85,,817.52,88,,,percent of total billed charges,88% of total Billed charges,27.67,100,,,Fee Schedule,100% of Medicare rate,180.16,100,,,Fee Schedule,100% of WA Medicaid,929,100,,,percent of total billed charges,100% of total billed charges,185.56,103,,,Fee Schedule,103% of WA Medicaid,27.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,180.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,641.01,69,,,percent of total billed charges,69% of total billed charges,929,100,,,percent of total billed charges,100% of total billed charges,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,929,100,,,percent of total billed charges,100% of total billed charges,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,929,100,,,percent of total billed charges,100% of total billed charges,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.59,61.85,,,percent of total billed charges,61.85% of total billed charges,180.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,234.21,130,,,Fee Schedule,130% of WA Medicaid ,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.23,37.7,,,percent of total billed charges,37.70% of total billed charges,350.23,37.7,,,percent of total billed charges,37.70% of total billed charges,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,31493.1,33.9,,,percent of total billed charges,33.9% of total billed charges,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.62,78,,,percent of total billed charges,78% of total billed charges,929,100,,,percent of total billed charges,100% of total billed charges,767.35,82.6,,,percent of total billed charges,82.6% of total billed charges,767.35,82.6,,,percent of total billed charges,82.6% of total billed charges,180.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.67,31493.1,
ERCP SPHINCTER PRESSURE MEAS,43263,CDM,983,RC,43263,HCPCS,Outpatient,,,1028,668.20,,904.64,88,,,percent of total billed charges,88% of total Billed charges,30.51,100,,,Fee Schedule,100% of Medicare rate,199.37,100,,,Fee Schedule,100% of WA Medicaid,1028,100,,,percent of total billed charges,100% of total billed charges,205.35,103,,,Fee Schedule,103% of WA Medicaid,30.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,199.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,709.32,69,,,percent of total billed charges,69% of total billed charges,1028,100,,,percent of total billed charges,100% of total billed charges,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1028,100,,,percent of total billed charges,100% of total billed charges,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1028,100,,,percent of total billed charges,100% of total billed charges,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,635.82,61.85,,,percent of total billed charges,61.85% of total billed charges,199.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,259.18,130,,,Fee Schedule,130% of WA Medicaid ,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.56,37.7,,,percent of total billed charges,37.70% of total billed charges,387.56,37.7,,,percent of total billed charges,37.70% of total billed charges,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,34849.2,33.9,,,percent of total billed charges,33.9% of total billed charges,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,801.84,78,,,percent of total billed charges,78% of total billed charges,1028,100,,,percent of total billed charges,100% of total billed charges,849.13,82.6,,,percent of total billed charges,82.6% of total billed charges,849.13,82.6,,,percent of total billed charges,82.6% of total billed charges,199.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.51,34849.2,
EGD ENDOSCOPIC STENT PLACE,43266,CDM,983,RC,43266,HCPCS,Outpatient,,,653,424.45,,574.64,88,,,percent of total billed charges,88% of total Billed charges,19.91,100,,,Fee Schedule,100% of Medicare rate,121.41,100,,,Fee Schedule,100% of WA Medicaid,653,100,,,percent of total billed charges,100% of total billed charges,125.05,103,,,Fee Schedule,103% of WA Medicaid,19.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,121.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,450.57,69,,,percent of total billed charges,69% of total billed charges,653,100,,,percent of total billed charges,100% of total billed charges,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,653,100,,,percent of total billed charges,100% of total billed charges,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,653,100,,,percent of total billed charges,100% of total billed charges,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.88,61.85,,,percent of total billed charges,61.85% of total billed charges,121.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,157.83,130,,,Fee Schedule,130% of WA Medicaid ,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.18,37.7,,,percent of total billed charges,37.70% of total billed charges,246.18,37.7,,,percent of total billed charges,37.70% of total billed charges,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,22136.7,33.9,,,percent of total billed charges,33.9% of total billed charges,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.34,78,,,percent of total billed charges,78% of total billed charges,653,100,,,percent of total billed charges,100% of total billed charges,539.38,82.6,,,percent of total billed charges,82.6% of total billed charges,539.38,82.6,,,percent of total billed charges,82.6% of total billed charges,121.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.91,22136.7,
ERCP REMOVE DUCT CALCULI,43264,CDM,983,RC,43264,HCPCS,Outpatient,,,1046,679.90,,920.48,88,,,percent of total billed charges,88% of total Billed charges,30.96,100,,,Fee Schedule,100% of Medicare rate,203.1,100,,,Fee Schedule,100% of WA Medicaid,1046,100,,,percent of total billed charges,100% of total billed charges,209.19,103,,,Fee Schedule,103% of WA Medicaid,30.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,203.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,721.74,69,,,percent of total billed charges,69% of total billed charges,1046,100,,,percent of total billed charges,100% of total billed charges,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046,100,,,percent of total billed charges,100% of total billed charges,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1046,100,,,percent of total billed charges,100% of total billed charges,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.95,61.85,,,percent of total billed charges,61.85% of total billed charges,203.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,264.03,130,,,Fee Schedule,130% of WA Medicaid ,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.34,37.7,,,percent of total billed charges,37.70% of total billed charges,394.34,37.7,,,percent of total billed charges,37.70% of total billed charges,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,35459.4,33.9,,,percent of total billed charges,33.9% of total billed charges,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.88,78,,,percent of total billed charges,78% of total billed charges,1046,100,,,percent of total billed charges,100% of total billed charges,864,82.6,,,percent of total billed charges,82.6% of total billed charges,864,82.6,,,percent of total billed charges,82.6% of total billed charges,203.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.96,35459.4,
ENDO CHOLANGIOPANCREATOGRAPH,43261,CDM,983,RC,43261,HCPCS,Outpatient,,,973,632.45,,856.24,88,,,percent of total billed charges,88% of total Billed charges,29.18,100,,,Fee Schedule,100% of Medicare rate,188.92,100,,,Fee Schedule,100% of WA Medicaid,973,100,,,percent of total billed charges,100% of total billed charges,194.59,103,,,Fee Schedule,103% of WA Medicaid,29.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,188.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,671.37,69,,,percent of total billed charges,69% of total billed charges,973,100,,,percent of total billed charges,100% of total billed charges,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,973,100,,,percent of total billed charges,100% of total billed charges,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,973,100,,,percent of total billed charges,100% of total billed charges,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,601.8,61.85,,,percent of total billed charges,61.85% of total billed charges,188.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,245.6,130,,,Fee Schedule,130% of WA Medicaid ,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.82,37.7,,,percent of total billed charges,37.70% of total billed charges,366.82,37.7,,,percent of total billed charges,37.70% of total billed charges,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,32984.7,33.9,,,percent of total billed charges,33.9% of total billed charges,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,758.94,78,,,percent of total billed charges,78% of total billed charges,973,100,,,percent of total billed charges,100% of total billed charges,803.7,82.6,,,percent of total billed charges,82.6% of total billed charges,803.7,82.6,,,percent of total billed charges,82.6% of total billed charges,188.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.18,32984.7,
ENDO CHOLANGIOPANCREATOGRAPH,43262,CDM,983,RC,43262,HCPCS,Outpatient,,,1026,666.90,,902.88,88,,,percent of total billed charges,88% of total Billed charges,30.23,100,,,Fee Schedule,100% of Medicare rate,199,100,,,Fee Schedule,100% of WA Medicaid,1026,100,,,percent of total billed charges,100% of total billed charges,204.97,103,,,Fee Schedule,103% of WA Medicaid,30.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,199,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,707.94,69,,,percent of total billed charges,69% of total billed charges,1026,100,,,percent of total billed charges,100% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1026,100,,,percent of total billed charges,100% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1026,100,,,percent of total billed charges,100% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.58,61.85,,,percent of total billed charges,61.85% of total billed charges,199,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,199,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,258.7,130,,,Fee Schedule,130% of WA Medicaid ,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.8,37.7,,,percent of total billed charges,37.70% of total billed charges,386.8,37.7,,,percent of total billed charges,37.70% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,34781.4,33.9,,,percent of total billed charges,33.9% of total billed charges,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,800.28,78,,,percent of total billed charges,78% of total billed charges,1026,100,,,percent of total billed charges,100% of total billed charges,847.48,82.6,,,percent of total billed charges,82.6% of total billed charges,847.48,82.6,,,percent of total billed charges,82.6% of total billed charges,199,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,199,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.23,34781.4,
EGD LESION ABLATION,43270,CDM,983,RC,43270,HCPCS,Outpatient,,,674,438.10,,593.12,88,,,percent of total billed charges,88% of total Billed charges,18.82,100,,,Fee Schedule,100% of Medicare rate,125.51,100,,,Fee Schedule,100% of WA Medicaid,674,100,,,percent of total billed charges,100% of total billed charges,129.28,103,,,Fee Schedule,103% of WA Medicaid,18.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,125.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,465.06,69,,,percent of total billed charges,69% of total billed charges,674,100,,,percent of total billed charges,100% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,674,100,,,percent of total billed charges,100% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,674,100,,,percent of total billed charges,100% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.87,61.85,,,percent of total billed charges,61.85% of total billed charges,125.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,163.16,130,,,Fee Schedule,130% of WA Medicaid ,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.1,37.7,,,percent of total billed charges,37.70% of total billed charges,254.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,22848.6,33.9,,,percent of total billed charges,33.9% of total billed charges,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.72,78,,,percent of total billed charges,78% of total billed charges,674,100,,,percent of total billed charges,100% of total billed charges,556.72,82.6,,,percent of total billed charges,82.6% of total billed charges,556.72,82.6,,,percent of total billed charges,82.6% of total billed charges,125.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.82,22848.6,
ERCP STENT EXCHANGE W/DILATE,43276,CDM,983,RC,43276,HCPCS,Outpatient,,,1377,895.05,,1211.76,88,,,percent of total billed charges,88% of total Billed charges,41.68,100,,,Fee Schedule,100% of Medicare rate,268.37,100,,,Fee Schedule,100% of WA Medicaid,1377,100,,,percent of total billed charges,100% of total billed charges,276.42,103,,,Fee Schedule,103% of WA Medicaid,41.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,268.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,950.13,69,,,percent of total billed charges,69% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377,100,,,percent of total billed charges,100% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377,100,,,percent of total billed charges,100% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.67,61.85,,,percent of total billed charges,61.85% of total billed charges,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,348.88,130,,,Fee Schedule,130% of WA Medicaid ,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,46680.3,33.9,,,percent of total billed charges,33.9% of total billed charges,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.06,78,,,percent of total billed charges,78% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.68,46680.3,
ERCP DUCT STENT PLACEMENT,43274,CDM,983,RC,43274,HCPCS,Outpatient,,,1323,859.95,,1164.24,88,,,percent of total billed charges,88% of total Billed charges,40.08,100,,,Fee Schedule,100% of Medicare rate,257.74,100,,,Fee Schedule,100% of WA Medicaid,1323,100,,,percent of total billed charges,100% of total billed charges,265.47,103,,,Fee Schedule,103% of WA Medicaid,40.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,257.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,912.87,69,,,percent of total billed charges,69% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323,100,,,percent of total billed charges,100% of total billed charges,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323,100,,,percent of total billed charges,100% of total billed charges,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,818.28,61.85,,,percent of total billed charges,61.85% of total billed charges,257.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,335.06,130,,,Fee Schedule,130% of WA Medicaid ,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,498.77,37.7,,,percent of total billed charges,37.70% of total billed charges,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,44849.7,33.9,,,percent of total billed charges,33.9% of total billed charges,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031.94,78,,,percent of total billed charges,78% of total billed charges,1323,100,,,percent of total billed charges,100% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1092.8,82.6,,,percent of total billed charges,82.6% of total billed charges,257.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.08,44849.7,
ERCP EA DUCT/AMPULLA DILATE,43277,CDM,983,RC,43277,HCPCS,Outpatient,,,1085,705.25,,954.8,88,,,percent of total billed charges,88% of total Billed charges,32.16,100,,,Fee Schedule,100% of Medicare rate,210.93,100,,,Fee Schedule,100% of WA Medicaid,1085,100,,,percent of total billed charges,100% of total billed charges,217.26,103,,,Fee Schedule,103% of WA Medicaid,32.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,210.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,748.65,69,,,percent of total billed charges,69% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085,100,,,percent of total billed charges,100% of total billed charges,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085,100,,,percent of total billed charges,100% of total billed charges,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.07,61.85,,,percent of total billed charges,61.85% of total billed charges,210.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,274.21,130,,,Fee Schedule,130% of WA Medicaid ,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,409.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,36781.5,33.9,,,percent of total billed charges,33.9% of total billed charges,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.3,78,,,percent of total billed charges,78% of total billed charges,1085,100,,,percent of total billed charges,100% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,896.21,82.6,,,percent of total billed charges,82.6% of total billed charges,210.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.16,36781.5,
ERCP LESION ABLATE W/DILATE,43278,CDM,983,RC,43278,HCPCS,Outpatient,,,1239,805.35,,1090.32,88,,,percent of total billed charges,88% of total Billed charges,37.39,100,,,Fee Schedule,100% of Medicare rate,241.33,100,,,Fee Schedule,100% of WA Medicaid,1239,100,,,percent of total billed charges,100% of total billed charges,248.57,103,,,Fee Schedule,103% of WA Medicaid,37.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,241.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,854.91,69,,,percent of total billed charges,69% of total billed charges,1239,100,,,percent of total billed charges,100% of total billed charges,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1239,100,,,percent of total billed charges,100% of total billed charges,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1239,100,,,percent of total billed charges,100% of total billed charges,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.32,61.85,,,percent of total billed charges,61.85% of total billed charges,241.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,313.73,130,,,Fee Schedule,130% of WA Medicaid ,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,467.1,37.7,,,percent of total billed charges,37.70% of total billed charges,467.1,37.7,,,percent of total billed charges,37.70% of total billed charges,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,42002.1,33.9,,,percent of total billed charges,33.9% of total billed charges,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,966.42,78,,,percent of total billed charges,78% of total billed charges,1239,100,,,percent of total billed charges,100% of total billed charges,1023.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1023.41,82.6,,,percent of total billed charges,82.6% of total billed charges,241.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.39,42002.1,
ERCP REMOVE FORGN BODY DUCT,43275,CDM,983,RC,43275,HCPCS,Outpatient,,,1080,702.00,,950.4,88,,,percent of total billed charges,88% of total Billed charges,32.1,100,,,Fee Schedule,100% of Medicare rate,209.81,100,,,Fee Schedule,100% of WA Medicaid,1080,100,,,percent of total billed charges,100% of total billed charges,216.1,103,,,Fee Schedule,103% of WA Medicaid,32.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,56.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,209.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,745.2,69,,,percent of total billed charges,69% of total billed charges,1080,100,,,percent of total billed charges,100% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080,100,,,percent of total billed charges,100% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080,100,,,percent of total billed charges,100% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.98,61.85,,,percent of total billed charges,61.85% of total billed charges,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,272.75,130,,,Fee Schedule,130% of WA Medicaid ,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.16,37.7,,,percent of total billed charges,37.70% of total billed charges,407.16,37.7,,,percent of total billed charges,37.70% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,36612,33.9,,,percent of total billed charges,33.9% of total billed charges,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.4,78,,,percent of total billed charges,78% of total billed charges,1080,100,,,percent of total billed charges,100% of total billed charges,892.08,82.6,,,percent of total billed charges,82.6% of total billed charges,892.08,82.6,,,percent of total billed charges,82.6% of total billed charges,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.1,36612,
ENDOSCOPIC PANCREATOSCOPY,43273,CDM,983,RC,43273,HCPCS,Outpatient,,,338,219.70,,297.44,88,,,percent of total billed charges,88% of total Billed charges,10.25,100,,,Fee Schedule,100% of Medicare rate,66.21,100,,,Fee Schedule,100% of WA Medicaid,338,100,,,percent of total billed charges,100% of total billed charges,68.2,103,,,Fee Schedule,103% of WA Medicaid,10.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,233.22,69,,,percent of total billed charges,69% of total billed charges,338,100,,,percent of total billed charges,100% of total billed charges,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,338,100,,,percent of total billed charges,100% of total billed charges,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,338,100,,,percent of total billed charges,100% of total billed charges,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.05,61.85,,,percent of total billed charges,61.85% of total billed charges,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,86.07,130,,,Fee Schedule,130% of WA Medicaid ,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.43,37.7,,,percent of total billed charges,37.70% of total billed charges,127.43,37.7,,,percent of total billed charges,37.70% of total billed charges,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,11458.2,33.9,,,percent of total billed charges,33.9% of total billed charges,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.64,78,,,percent of total billed charges,78% of total billed charges,338,100,,,percent of total billed charges,100% of total billed charges,279.19,82.6,,,percent of total billed charges,82.6% of total billed charges,279.19,82.6,,,percent of total billed charges,82.6% of total billed charges,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.25,11458.2,
LAP MYOTOMY HELLER,43279,CDM,983,RC,43279,HCPCS,Outpatient,,,3441,2236.65,,3028.08,88,,,percent of total billed charges,88% of total Billed charges,180.74,100,,,Fee Schedule,100% of Medicare rate,714.67,100,,,Fee Schedule,100% of WA Medicaid,3441,100,,,percent of total billed charges,100% of total billed charges,736.11,103,,,Fee Schedule,103% of WA Medicaid,180.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,316.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,714.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2374.29,69,,,percent of total billed charges,69% of total billed charges,3441,100,,,percent of total billed charges,100% of total billed charges,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3441,100,,,percent of total billed charges,100% of total billed charges,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3441,100,,,percent of total billed charges,100% of total billed charges,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2128.26,61.85,,,percent of total billed charges,61.85% of total billed charges,714.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,728.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,929.07,130,,,Fee Schedule,130% of WA Medicaid ,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1297.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1297.26,37.7,,,percent of total billed charges,37.70% of total billed charges,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,116649.9,33.9,,,percent of total billed charges,33.9% of total billed charges,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2683.98,78,,,percent of total billed charges,78% of total billed charges,3441,100,,,percent of total billed charges,100% of total billed charges,2842.27,82.6,,,percent of total billed charges,82.6% of total billed charges,2842.27,82.6,,,percent of total billed charges,82.6% of total billed charges,714.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,180.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,180.74,116649.9,
LAPAROSCOPY FUNDOPLASTY,43280,CDM,983,RC,43280,HCPCS,Outpatient,,,4158,2702.70,,3659.04,88,,,percent of total billed charges,88% of total Billed charges,149.9,100,,,Fee Schedule,100% of Medicare rate,602.95,100,,,Fee Schedule,100% of WA Medicaid,4158,100,,,percent of total billed charges,100% of total billed charges,621.04,103,,,Fee Schedule,103% of WA Medicaid,149.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,262.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,602.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2869.02,69,,,percent of total billed charges,69% of total billed charges,4158,100,,,percent of total billed charges,100% of total billed charges,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,4158,100,,,percent of total billed charges,100% of total billed charges,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,4158,100,,,percent of total billed charges,100% of total billed charges,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2571.72,61.85,,,percent of total billed charges,61.85% of total billed charges,602.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,783.84,130,,,Fee Schedule,130% of WA Medicaid ,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1567.57,37.7,,,percent of total billed charges,37.70% of total billed charges,1567.57,37.7,,,percent of total billed charges,37.70% of total billed charges,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,140956.2,33.9,,,percent of total billed charges,33.9% of total billed charges,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,3243.24,78,,,percent of total billed charges,78% of total billed charges,4158,100,,,percent of total billed charges,100% of total billed charges,3434.51,82.6,,,percent of total billed charges,82.6% of total billed charges,3434.51,82.6,,,percent of total billed charges,82.6% of total billed charges,602.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,149.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,602.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,149.9,140956.2,
LAP PARAESOPH HER RPR W/MESH,43282,CDM,983,RC,43282,HCPCS,Outpatient,,,4369,2839.85,,3844.72,88,,,percent of total billed charges,88% of total Billed charges,248.57,100,,,Fee Schedule,100% of Medicare rate,962.15,100,,,Fee Schedule,100% of WA Medicaid,4369,100,,,percent of total billed charges,100% of total billed charges,991.01,103,,,Fee Schedule,103% of WA Medicaid,248.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,435,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,962.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3014.61,69,,,percent of total billed charges,69% of total billed charges,4369,100,,,percent of total billed charges,100% of total billed charges,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,4369,100,,,percent of total billed charges,100% of total billed charges,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,4369,100,,,percent of total billed charges,100% of total billed charges,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2702.23,61.85,,,percent of total billed charges,61.85% of total billed charges,962.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,962.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,981.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1250.8,130,,,Fee Schedule,130% of WA Medicaid ,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1647.11,37.7,,,percent of total billed charges,37.70% of total billed charges,1647.11,37.7,,,percent of total billed charges,37.70% of total billed charges,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,148109.1,33.9,,,percent of total billed charges,33.9% of total billed charges,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3407.82,78,,,percent of total billed charges,78% of total billed charges,4369,100,,,percent of total billed charges,100% of total billed charges,3608.79,82.6,,,percent of total billed charges,82.6% of total billed charges,3608.79,82.6,,,percent of total billed charges,82.6% of total billed charges,962.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,248.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,962.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,248.57,148109.1,
ESOPHAGASTRIC FUNDOPLASTY W/ PATCH,43325,CDM,983,RC,43325,HCPCS,Outpatient,,,850,552.50,,748,88,,,percent of total billed charges,88% of total Billed charges,190.9,100,,,Fee Schedule,100% of Medicare rate,760.36,100,,,Fee Schedule,100% of WA Medicaid,850,100,,,percent of total billed charges,100% of total billed charges,783.17,103,,,Fee Schedule,103% of WA Medicaid,190.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,334.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,760.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,586.5,69,,,percent of total billed charges,69% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,850,100,,,percent of total billed charges,100% of total billed charges,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,850,100,,,percent of total billed charges,100% of total billed charges,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.73,61.85,,,percent of total billed charges,61.85% of total billed charges,760.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,760.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,775.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,988.47,130,,,Fee Schedule,130% of WA Medicaid ,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,320.45,37.7,,,percent of total billed charges,37.70% of total billed charges,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,28815,33.9,,,percent of total billed charges,33.9% of total billed charges,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,663,78,,,percent of total billed charges,78% of total billed charges,850,100,,,percent of total billed charges,100% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,702.1,82.6,,,percent of total billed charges,82.6% of total billed charges,760.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,190.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,760.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,190.9,28815,
ESOPH FUNDOPLASTY THOR,43328,CDM,983,RC,43328,HCPCS,Outpatient,,,3822,2484.30,,3363.36,88,,,percent of total billed charges,88% of total Billed charges,160.04,100,,,Fee Schedule,100% of Medicare rate,617.13,100,,,Fee Schedule,100% of WA Medicaid,3822,100,,,percent of total billed charges,100% of total billed charges,635.64,103,,,Fee Schedule,103% of WA Medicaid,160.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,280.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,617.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2637.18,69,,,percent of total billed charges,69% of total billed charges,3822,100,,,percent of total billed charges,100% of total billed charges,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3822,100,,,percent of total billed charges,100% of total billed charges,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3822,100,,,percent of total billed charges,100% of total billed charges,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2363.91,61.85,,,percent of total billed charges,61.85% of total billed charges,617.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,802.27,130,,,Fee Schedule,130% of WA Medicaid ,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1440.89,37.7,,,percent of total billed charges,37.70% of total billed charges,1440.89,37.7,,,percent of total billed charges,37.70% of total billed charges,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,129565.8,33.9,,,percent of total billed charges,33.9% of total billed charges,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2981.16,78,,,percent of total billed charges,78% of total billed charges,3822,100,,,percent of total billed charges,100% of total billed charges,3156.97,82.6,,,percent of total billed charges,82.6% of total billed charges,3156.97,82.6,,,percent of total billed charges,82.6% of total billed charges,617.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,160.04,129565.8,
ESOPH FUNDOPLASTY LAP,43327,CDM,983,RC,43327,HCPCS,Outpatient,,,2612,1697.80,,2298.56,88,,,percent of total billed charges,88% of total Billed charges,110.33,100,,,Fee Schedule,100% of Medicare rate,458.23,100,,,Fee Schedule,100% of WA Medicaid,2612,100,,,percent of total billed charges,100% of total billed charges,471.98,103,,,Fee Schedule,103% of WA Medicaid,110.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,458.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1802.28,69,,,percent of total billed charges,69% of total billed charges,2612,100,,,percent of total billed charges,100% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2612,100,,,percent of total billed charges,100% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2612,100,,,percent of total billed charges,100% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1615.52,61.85,,,percent of total billed charges,61.85% of total billed charges,458.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,458.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,467.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,595.7,130,,,Fee Schedule,130% of WA Medicaid ,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,984.72,37.7,,,percent of total billed charges,37.70% of total billed charges,984.72,37.7,,,percent of total billed charges,37.70% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,88546.8,33.9,,,percent of total billed charges,33.9% of total billed charges,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2037.36,78,,,percent of total billed charges,78% of total billed charges,2612,100,,,percent of total billed charges,100% of total billed charges,2157.51,82.6,,,percent of total billed charges,82.6% of total billed charges,2157.51,82.6,,,percent of total billed charges,82.6% of total billed charges,458.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,458.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.33,88546.8,
TRANSTHOR DIAPHRAG HERN RPR,43335,CDM,983,RC,43335,HCPCS,Outpatient,,,4380,2847.00,,3854.4,88,,,percent of total billed charges,88% of total Billed charges,192.82,100,,,Fee Schedule,100% of Medicare rate,731.45,100,,,Fee Schedule,100% of WA Medicaid,4380,100,,,percent of total billed charges,100% of total billed charges,753.39,103,,,Fee Schedule,103% of WA Medicaid,192.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,337.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,731.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3022.2,69,,,percent of total billed charges,69% of total billed charges,4380,100,,,percent of total billed charges,100% of total billed charges,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4380,100,,,percent of total billed charges,100% of total billed charges,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4380,100,,,percent of total billed charges,100% of total billed charges,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2709.03,61.85,,,percent of total billed charges,61.85% of total billed charges,731.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,746.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,950.89,130,,,Fee Schedule,130% of WA Medicaid ,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1651.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1651.26,37.7,,,percent of total billed charges,37.70% of total billed charges,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,148482,33.9,,,percent of total billed charges,33.9% of total billed charges,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,3416.4,78,,,percent of total billed charges,78% of total billed charges,4380,100,,,percent of total billed charges,100% of total billed charges,3617.88,82.6,,,percent of total billed charges,82.6% of total billed charges,3617.88,82.6,,,percent of total billed charges,82.6% of total billed charges,731.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,192.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,192.82,148482,
TRANSAB ESOPH HIAT HERN RPR,43332,CDM,983,RC,43332,HCPCS,Outpatient,,,3717,2416.05,,3270.96,88,,,percent of total billed charges,88% of total Billed charges,159.95,100,,,Fee Schedule,100% of Medicare rate,640.63,100,,,Fee Schedule,100% of WA Medicaid,3717,100,,,percent of total billed charges,100% of total billed charges,659.85,103,,,Fee Schedule,103% of WA Medicaid,159.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,279.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,640.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2564.73,69,,,percent of total billed charges,69% of total billed charges,3717,100,,,percent of total billed charges,100% of total billed charges,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,3717,100,,,percent of total billed charges,100% of total billed charges,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,3717,100,,,percent of total billed charges,100% of total billed charges,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2298.96,61.85,,,percent of total billed charges,61.85% of total billed charges,640.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,653.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,832.82,130,,,Fee Schedule,130% of WA Medicaid ,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1401.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1401.31,37.7,,,percent of total billed charges,37.70% of total billed charges,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,126006.3,33.9,,,percent of total billed charges,33.9% of total billed charges,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2899.26,78,,,percent of total billed charges,78% of total billed charges,3717,100,,,percent of total billed charges,100% of total billed charges,3070.24,82.6,,,percent of total billed charges,82.6% of total billed charges,3070.24,82.6,,,percent of total billed charges,82.6% of total billed charges,640.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,159.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,159.95,126006.3,
ESOPHAGOMYOTOMY THORACIC,43331,CDM,983,RC,43331,HCPCS,Outpatient,,,3680,2392.00,,3238.4,88,,,percent of total billed charges,88% of total Billed charges,186.78,100,,,Fee Schedule,100% of Medicare rate,740.59,100,,,Fee Schedule,100% of WA Medicaid,3680,100,,,percent of total billed charges,100% of total billed charges,762.81,103,,,Fee Schedule,103% of WA Medicaid,186.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,326.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,740.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2539.2,69,,,percent of total billed charges,69% of total billed charges,3680,100,,,percent of total billed charges,100% of total billed charges,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,3680,100,,,percent of total billed charges,100% of total billed charges,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,3680,100,,,percent of total billed charges,100% of total billed charges,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2276.08,61.85,,,percent of total billed charges,61.85% of total billed charges,740.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,740.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,755.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,962.77,130,,,Fee Schedule,130% of WA Medicaid ,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1387.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1387.36,37.7,,,percent of total billed charges,37.70% of total billed charges,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,124752,33.9,,,percent of total billed charges,33.9% of total billed charges,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2870.4,78,,,percent of total billed charges,78% of total billed charges,3680,100,,,percent of total billed charges,100% of total billed charges,3039.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3039.68,82.6,,,percent of total billed charges,82.6% of total billed charges,740.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,186.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,740.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,186.78,124752,
DILATE ESOPHAGUS 1/MULT PASS,43450,CDM,983,RC,43450,HCPCS,Outpatient,,,237,154.05,,208.56,88,,,percent of total billed charges,88% of total Billed charges,6.53,100,,,Fee Schedule,100% of Medicare rate,45.13,100,,,Fee Schedule,100% of WA Medicaid,237,100,,,percent of total billed charges,100% of total billed charges,46.48,103,,,Fee Schedule,103% of WA Medicaid,6.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,45.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,163.53,69,,,percent of total billed charges,69% of total billed charges,237,100,,,percent of total billed charges,100% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,237,100,,,percent of total billed charges,100% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,237,100,,,percent of total billed charges,100% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.58,61.85,,,percent of total billed charges,61.85% of total billed charges,45.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.67,130,,,Fee Schedule,130% of WA Medicaid ,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.35,37.7,,,percent of total billed charges,37.70% of total billed charges,89.35,37.7,,,percent of total billed charges,37.70% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,8034.3,33.9,,,percent of total billed charges,33.9% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.86,78,,,percent of total billed charges,78% of total billed charges,237,100,,,percent of total billed charges,100% of total billed charges,195.76,82.6,,,percent of total billed charges,82.6% of total billed charges,195.76,82.6,,,percent of total billed charges,82.6% of total billed charges,45.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.53,8034.3,
SURGICAL OPENING OF STOMACH,43500,CDM,983,RC,43500,HCPCS,Outpatient,,,2106,1368.90,,1853.28,88,,,percent of total billed charges,88% of total Billed charges,106.16,100,,,Fee Schedule,100% of Medicare rate,443.12,100,,,Fee Schedule,100% of WA Medicaid,2106,100,,,percent of total billed charges,100% of total billed charges,456.41,103,,,Fee Schedule,103% of WA Medicaid,106.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,185.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,443.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1453.14,69,,,percent of total billed charges,69% of total billed charges,2106,100,,,percent of total billed charges,100% of total billed charges,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2106,100,,,percent of total billed charges,100% of total billed charges,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2106,100,,,percent of total billed charges,100% of total billed charges,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1302.56,61.85,,,percent of total billed charges,61.85% of total billed charges,443.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,576.06,130,,,Fee Schedule,130% of WA Medicaid ,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,793.96,37.7,,,percent of total billed charges,37.70% of total billed charges,793.96,37.7,,,percent of total billed charges,37.70% of total billed charges,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,71393.4,33.9,,,percent of total billed charges,33.9% of total billed charges,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1642.68,78,,,percent of total billed charges,78% of total billed charges,2106,100,,,percent of total billed charges,100% of total billed charges,1739.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1739.56,82.6,,,percent of total billed charges,82.6% of total billed charges,443.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.16,71393.4,
SURGICAL REPAIR OF STOMACH,43501,CDM,983,RC,43501,HCPCS,Outpatient,,,4029,2618.85,,3545.52,88,,,percent of total billed charges,88% of total Billed charges,187.38,100,,,Fee Schedule,100% of Medicare rate,757.38,100,,,Fee Schedule,100% of WA Medicaid,4029,100,,,percent of total billed charges,100% of total billed charges,780.1,103,,,Fee Schedule,103% of WA Medicaid,187.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,327.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,757.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2780.01,69,,,percent of total billed charges,69% of total billed charges,4029,100,,,percent of total billed charges,100% of total billed charges,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,4029,100,,,percent of total billed charges,100% of total billed charges,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,4029,100,,,percent of total billed charges,100% of total billed charges,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2491.94,61.85,,,percent of total billed charges,61.85% of total billed charges,757.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,757.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,772.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,984.59,130,,,Fee Schedule,130% of WA Medicaid ,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1518.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1518.93,37.7,,,percent of total billed charges,37.70% of total billed charges,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,136583.1,33.9,,,percent of total billed charges,33.9% of total billed charges,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3142.62,78,,,percent of total billed charges,78% of total billed charges,4029,100,,,percent of total billed charges,100% of total billed charges,3327.95,82.6,,,percent of total billed charges,82.6% of total billed charges,3327.95,82.6,,,percent of total billed charges,82.6% of total billed charges,757.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,187.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,757.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.38,136583.1,
REMOVAL OF STOMACH PARTIAL,43634,CDM,983,RC,43634,HCPCS,Outpatient,,,5752,3738.80,,5061.76,88,,,percent of total billed charges,88% of total Billed charges,307.93,100,,,Fee Schedule,100% of Medicare rate,1182.04,100,,,Fee Schedule,100% of WA Medicaid,5752,100,,,percent of total billed charges,100% of total billed charges,1217.5,103,,,Fee Schedule,103% of WA Medicaid,307.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,538.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1182.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3968.88,69,,,percent of total billed charges,69% of total billed charges,5752,100,,,percent of total billed charges,100% of total billed charges,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5752,100,,,percent of total billed charges,100% of total billed charges,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5752,100,,,percent of total billed charges,100% of total billed charges,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3557.61,61.85,,,percent of total billed charges,61.85% of total billed charges,1182.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1182.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1205.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1536.65,130,,,Fee Schedule,130% of WA Medicaid ,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2168.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2168.5,37.7,,,percent of total billed charges,37.70% of total billed charges,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,194992.8,33.9,,,percent of total billed charges,33.9% of total billed charges,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4486.56,78,,,percent of total billed charges,78% of total billed charges,5752,100,,,percent of total billed charges,100% of total billed charges,4751.15,82.6,,,percent of total billed charges,82.6% of total billed charges,4751.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1182.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,307.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1182.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,307.93,194992.8,
REMOVAL OF STOMACH PARTIAL,43633,CDM,983,RC,43633,HCPCS,Outpatient,,,5199,3379.35,,4575.12,88,,,percent of total billed charges,88% of total Billed charges,272.31,100,,,Fee Schedule,100% of Medicare rate,1072.93,100,,,Fee Schedule,100% of WA Medicaid,5199,100,,,percent of total billed charges,100% of total billed charges,1105.12,103,,,Fee Schedule,103% of WA Medicaid,272.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,476.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1072.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3587.31,69,,,percent of total billed charges,69% of total billed charges,5199,100,,,percent of total billed charges,100% of total billed charges,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,5199,100,,,percent of total billed charges,100% of total billed charges,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,5199,100,,,percent of total billed charges,100% of total billed charges,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,3215.58,61.85,,,percent of total billed charges,61.85% of total billed charges,1072.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1072.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1094.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1394.81,130,,,Fee Schedule,130% of WA Medicaid ,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1960.02,37.7,,,percent of total billed charges,37.70% of total billed charges,1960.02,37.7,,,percent of total billed charges,37.70% of total billed charges,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,176246.1,33.9,,,percent of total billed charges,33.9% of total billed charges,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,4055.22,78,,,percent of total billed charges,78% of total billed charges,5199,100,,,percent of total billed charges,100% of total billed charges,4294.37,82.6,,,percent of total billed charges,82.6% of total billed charges,4294.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1072.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,272.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1072.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,272.31,176246.1,
REMOVAL OF STOMACH PARTIAL,43631,CDM,983,RC,43631,HCPCS,Outpatient,,,3933,2556.45,,3461.04,88,,,percent of total billed charges,88% of total Billed charges,200.59,100,,,Fee Schedule,100% of Medicare rate,811.09,100,,,Fee Schedule,100% of WA Medicaid,3933,100,,,percent of total billed charges,100% of total billed charges,835.42,103,,,Fee Schedule,103% of WA Medicaid,200.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,351.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,811.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2713.77,69,,,percent of total billed charges,69% of total billed charges,3933,100,,,percent of total billed charges,100% of total billed charges,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3933,100,,,percent of total billed charges,100% of total billed charges,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3933,100,,,percent of total billed charges,100% of total billed charges,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,2432.56,61.85,,,percent of total billed charges,61.85% of total billed charges,811.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,827.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1054.42,130,,,Fee Schedule,130% of WA Medicaid ,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1482.74,37.7,,,percent of total billed charges,37.70% of total billed charges,1482.74,37.7,,,percent of total billed charges,37.70% of total billed charges,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,133328.7,33.9,,,percent of total billed charges,33.9% of total billed charges,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3067.74,78,,,percent of total billed charges,78% of total billed charges,3933,100,,,percent of total billed charges,100% of total billed charges,3248.66,82.6,,,percent of total billed charges,82.6% of total billed charges,3248.66,82.6,,,percent of total billed charges,82.6% of total billed charges,811.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,200.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,200.59,133328.7,
REMOVAL OF STOMACH PARTIAL,43632,CDM,983,RC,43632,HCPCS,Outpatient,,,5501,3575.65,,4840.88,88,,,percent of total billed charges,88% of total Billed charges,289.02,100,,,Fee Schedule,100% of Medicare rate,1133.55,100,,,Fee Schedule,100% of WA Medicaid,5501,100,,,percent of total billed charges,100% of total billed charges,1167.56,103,,,Fee Schedule,103% of WA Medicaid,289.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,505.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1133.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3795.69,69,,,percent of total billed charges,69% of total billed charges,5501,100,,,percent of total billed charges,100% of total billed charges,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,5501,100,,,percent of total billed charges,100% of total billed charges,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,5501,100,,,percent of total billed charges,100% of total billed charges,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3402.37,61.85,,,percent of total billed charges,61.85% of total billed charges,1133.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1133.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1156.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1473.62,130,,,Fee Schedule,130% of WA Medicaid ,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2073.88,37.7,,,percent of total billed charges,37.70% of total billed charges,2073.88,37.7,,,percent of total billed charges,37.70% of total billed charges,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,186483.9,33.9,,,percent of total billed charges,33.9% of total billed charges,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4290.78,78,,,percent of total billed charges,78% of total billed charges,5501,100,,,percent of total billed charges,100% of total billed charges,4543.83,82.6,,,percent of total billed charges,82.6% of total billed charges,4543.83,82.6,,,percent of total billed charges,82.6% of total billed charges,1133.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,289.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1133.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,289.02,186483.9,
VAGOTOMY INCLUDING PYLOROPLASTY,43640,CDM,983,RC,43640,HCPCS,Outpatient,,,2152,1398.80,,1893.76,88,,,percent of total billed charges,88% of total Billed charges,166.07,100,,,Fee Schedule,100% of Medicare rate,668.79,100,,,Fee Schedule,100% of WA Medicaid,2152,100,,,percent of total billed charges,100% of total billed charges,688.85,103,,,Fee Schedule,103% of WA Medicaid,166.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,290.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,668.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1484.88,69,,,percent of total billed charges,69% of total billed charges,2152,100,,,percent of total billed charges,100% of total billed charges,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2152,100,,,percent of total billed charges,100% of total billed charges,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2152,100,,,percent of total billed charges,100% of total billed charges,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1331.01,61.85,,,percent of total billed charges,61.85% of total billed charges,668.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,869.43,130,,,Fee Schedule,130% of WA Medicaid ,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,811.3,37.7,,,percent of total billed charges,37.70% of total billed charges,811.3,37.7,,,percent of total billed charges,37.70% of total billed charges,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72952.8,33.9,,,percent of total billed charges,33.9% of total billed charges,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1678.56,78,,,percent of total billed charges,78% of total billed charges,2152,100,,,percent of total billed charges,100% of total billed charges,1777.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1777.55,82.6,,,percent of total billed charges,82.6% of total billed charges,668.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,166.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,166.07,72952.8,
LAPAROSCOPE PROC STOM,43659,CDM,983,RC,43659,HCPCS,Outpatient,,,3494.61,2271.50,,3075.26,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3494.61,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2411.28,69,,,percent of total billed charges,69% of total billed charges,3494.61,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3494.61,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3494.61,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2161.42,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1317.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1317.47,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,118467.28,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2725.8,78,,,percent of total billed charges,78% of total billed charges,3494.61,100,,,percent of total billed charges,100% of total billed charges,2886.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2886.55,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1317.47,118467.28,
NASAL/OROGASTRIC W/TUBE PLMT,43752,CDM,983,RC,43752,HCPCS,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,3.77,100,,,Fee Schedule,100% of Medicare rate,22.19,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,22.86,103,,,Fee Schedule,103% of WA Medicaid,3.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,135,100,,,percent of total billed charges,100% of total billed charges,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,135,100,,,percent of total billed charges,100% of total billed charges,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.5,61.85,,,percent of total billed charges,61.85% of total billed charges,22.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.85,130,,,Fee Schedule,130% of WA Medicaid ,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,4576.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,22.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.77,4576.5,
REPOSITION GASTROSTOMY TUBE,43761,CDM,983,RC,43761,HCPCS,Outpatient,,,499,324.35,,439.12,88,,,percent of total billed charges,88% of total Billed charges,12.4,100,,,Fee Schedule,100% of Medicare rate,57.63,100,,,Fee Schedule,100% of WA Medicaid,499,100,,,percent of total billed charges,100% of total billed charges,59.36,103,,,Fee Schedule,103% of WA Medicaid,12.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,57.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,344.31,69,,,percent of total billed charges,69% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,499,100,,,percent of total billed charges,100% of total billed charges,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,499,100,,,percent of total billed charges,100% of total billed charges,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.63,61.85,,,percent of total billed charges,61.85% of total billed charges,57.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,74.92,130,,,Fee Schedule,130% of WA Medicaid ,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,16916.1,33.9,,,percent of total billed charges,33.9% of total billed charges,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.22,78,,,percent of total billed charges,78% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,57.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.4,16916.1,
"LAPAROSCOPY, SURGICAL,REMOVAL GASTRIC DE",43774,CDM,983,RC,43774,HCPCS,Outpatient,,,1763,1145.95,,1551.44,88,,,percent of total billed charges,88% of total Billed charges,132.81,100,,,Fee Schedule,100% of Medicare rate,539.92,100,,,Fee Schedule,100% of WA Medicaid,1763,100,,,percent of total billed charges,100% of total billed charges,556.12,103,,,Fee Schedule,103% of WA Medicaid,132.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,232.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,539.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1216.47,69,,,percent of total billed charges,69% of total billed charges,1763,100,,,percent of total billed charges,100% of total billed charges,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1763,100,,,percent of total billed charges,100% of total billed charges,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1763,100,,,percent of total billed charges,100% of total billed charges,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1090.42,61.85,,,percent of total billed charges,61.85% of total billed charges,539.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,701.9,130,,,Fee Schedule,130% of WA Medicaid ,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.65,37.7,,,percent of total billed charges,37.70% of total billed charges,664.65,37.7,,,percent of total billed charges,37.70% of total billed charges,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,59765.7,33.9,,,percent of total billed charges,33.9% of total billed charges,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1375.14,78,,,percent of total billed charges,78% of total billed charges,1763,100,,,percent of total billed charges,100% of total billed charges,1456.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1456.24,82.6,,,percent of total billed charges,82.6% of total billed charges,539.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,132.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,132.81,59765.7,
LAP SLEEVE GASTRECTOMY,43775,CDM,983,RC,43775,HCPCS,Outpatient,,,3110,2021.50,,2736.8,88,,,percent of total billed charges,88% of total Billed charges,167.27,100,,,Fee Schedule,100% of Medicare rate,1157.77,100,,,Fee Schedule,100% of WA Medicaid,3110,100,,,percent of total billed charges,100% of total billed charges,1192.5,103,,,Fee Schedule,103% of WA Medicaid,167.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,292.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1157.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2145.9,69,,,percent of total billed charges,69% of total billed charges,3110,100,,,percent of total billed charges,100% of total billed charges,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3110,100,,,percent of total billed charges,100% of total billed charges,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3110,100,,,percent of total billed charges,100% of total billed charges,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1923.54,61.85,,,percent of total billed charges,61.85% of total billed charges,1157.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1157.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1180.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1505.1,130,,,Fee Schedule,130% of WA Medicaid ,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1172.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1172.47,37.7,,,percent of total billed charges,37.70% of total billed charges,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,105429,33.9,,,percent of total billed charges,33.9% of total billed charges,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,2425.8,78,,,percent of total billed charges,78% of total billed charges,3110,100,,,percent of total billed charges,100% of total billed charges,2568.86,82.6,,,percent of total billed charges,82.6% of total billed charges,2568.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1157.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,167.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1157.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,167.27,105429,
FUSION OF STOMACH AND BOWEL,43820,CDM,983,RC,43820,HCPCS,Outpatient,,,3434,2232.10,,3021.92,88,,,percent of total billed charges,88% of total Billed charges,184.86,100,,,Fee Schedule,100% of Medicare rate,754.02,100,,,Fee Schedule,100% of WA Medicaid,3434,100,,,percent of total billed charges,100% of total billed charges,776.64,103,,,Fee Schedule,103% of WA Medicaid,184.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,323.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,754.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2369.46,69,,,percent of total billed charges,69% of total billed charges,3434,100,,,percent of total billed charges,100% of total billed charges,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,3434,100,,,percent of total billed charges,100% of total billed charges,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,3434,100,,,percent of total billed charges,100% of total billed charges,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2123.93,61.85,,,percent of total billed charges,61.85% of total billed charges,754.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,754.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,769.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,980.23,130,,,Fee Schedule,130% of WA Medicaid ,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1294.62,37.7,,,percent of total billed charges,37.70% of total billed charges,1294.62,37.7,,,percent of total billed charges,37.70% of total billed charges,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,116412.6,33.9,,,percent of total billed charges,33.9% of total billed charges,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2678.52,78,,,percent of total billed charges,78% of total billed charges,3434,100,,,percent of total billed charges,100% of total billed charges,2836.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2836.48,82.6,,,percent of total billed charges,82.6% of total billed charges,754.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,184.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,754.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,184.86,116412.6,
PLACE GASTROSTOMY TUBE,43830,CDM,983,RC,43830,HCPCS,Outpatient,,,1852,1203.80,,1629.76,88,,,percent of total billed charges,88% of total Billed charges,90.27,100,,,Fee Schedule,100% of Medicare rate,398.36,100,,,Fee Schedule,100% of WA Medicaid,1852,100,,,percent of total billed charges,100% of total billed charges,410.31,103,,,Fee Schedule,103% of WA Medicaid,90.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,398.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1277.88,69,,,percent of total billed charges,69% of total billed charges,1852,100,,,percent of total billed charges,100% of total billed charges,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1852,100,,,percent of total billed charges,100% of total billed charges,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1852,100,,,percent of total billed charges,100% of total billed charges,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1145.46,61.85,,,percent of total billed charges,61.85% of total billed charges,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,517.87,130,,,Fee Schedule,130% of WA Medicaid ,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.2,37.7,,,percent of total billed charges,37.70% of total billed charges,698.2,37.7,,,percent of total billed charges,37.70% of total billed charges,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,62782.8,33.9,,,percent of total billed charges,33.9% of total billed charges,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1444.56,78,,,percent of total billed charges,78% of total billed charges,1852,100,,,percent of total billed charges,100% of total billed charges,1529.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1529.75,82.6,,,percent of total billed charges,82.6% of total billed charges,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.27,62782.8,
REPAIR OF STOMACH LESION,43840,CDM,983,RC,43840,HCPCS,Outpatient,,,3713,2413.45,,3267.44,88,,,percent of total billed charges,88% of total Billed charges,187.34,100,,,Fee Schedule,100% of Medicare rate,761.67,100,,,Fee Schedule,100% of WA Medicaid,3713,100,,,percent of total billed charges,100% of total billed charges,784.52,103,,,Fee Schedule,103% of WA Medicaid,187.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,327.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,761.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2561.97,69,,,percent of total billed charges,69% of total billed charges,3713,100,,,percent of total billed charges,100% of total billed charges,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,3713,100,,,percent of total billed charges,100% of total billed charges,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,3713,100,,,percent of total billed charges,100% of total billed charges,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2296.49,61.85,,,percent of total billed charges,61.85% of total billed charges,761.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,761.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,776.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,990.17,130,,,Fee Schedule,130% of WA Medicaid ,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1399.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1399.8,37.7,,,percent of total billed charges,37.70% of total billed charges,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,125870.7,33.9,,,percent of total billed charges,33.9% of total billed charges,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,2896.14,78,,,percent of total billed charges,78% of total billed charges,3713,100,,,percent of total billed charges,100% of total billed charges,3066.94,82.6,,,percent of total billed charges,82.6% of total billed charges,3066.94,82.6,,,percent of total billed charges,82.6% of total billed charges,761.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,187.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,761.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.34,125870.7,
REPAIR STOMACH OPENING,43870,CDM,983,RC,43870,HCPCS,Outpatient,,,1935,1257.75,,1702.8,88,,,percent of total billed charges,88% of total Billed charges,91.95,100,,,Fee Schedule,100% of Medicare rate,400.23,100,,,Fee Schedule,100% of WA Medicaid,1935,100,,,percent of total billed charges,100% of total billed charges,412.24,103,,,Fee Schedule,103% of WA Medicaid,91.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,160.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,400.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1335.15,69,,,percent of total billed charges,69% of total billed charges,1935,100,,,percent of total billed charges,100% of total billed charges,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1935,100,,,percent of total billed charges,100% of total billed charges,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1935,100,,,percent of total billed charges,100% of total billed charges,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1196.8,61.85,,,percent of total billed charges,61.85% of total billed charges,400.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,520.3,130,,,Fee Schedule,130% of WA Medicaid ,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.5,37.7,,,percent of total billed charges,37.70% of total billed charges,729.5,37.7,,,percent of total billed charges,37.70% of total billed charges,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,65596.5,33.9,,,percent of total billed charges,33.9% of total billed charges,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1509.3,78,,,percent of total billed charges,78% of total billed charges,1935,100,,,percent of total billed charges,100% of total billed charges,1598.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1598.31,82.6,,,percent of total billed charges,82.6% of total billed charges,400.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.95,65596.5,
FREEING OF BOWEL ADHESION,44005,CDM,983,RC,44005,HCPCS,Outpatient,,,3189,2072.85,,2806.32,88,,,percent of total billed charges,88% of total Billed charges,148.5,100,,,Fee Schedule,100% of Medicare rate,610.79,100,,,Fee Schedule,100% of WA Medicaid,3189,100,,,percent of total billed charges,100% of total billed charges,629.11,103,,,Fee Schedule,103% of WA Medicaid,148.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,259.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,610.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2200.41,69,,,percent of total billed charges,69% of total billed charges,3189,100,,,percent of total billed charges,100% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,3189,100,,,percent of total billed charges,100% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,3189,100,,,percent of total billed charges,100% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1972.4,61.85,,,percent of total billed charges,61.85% of total billed charges,610.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,623.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,794.03,130,,,Fee Schedule,130% of WA Medicaid ,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1202.25,37.7,,,percent of total billed charges,37.70% of total billed charges,1202.25,37.7,,,percent of total billed charges,37.70% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,108107.1,33.9,,,percent of total billed charges,33.9% of total billed charges,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2487.42,78,,,percent of total billed charges,78% of total billed charges,3189,100,,,percent of total billed charges,100% of total billed charges,2634.11,82.6,,,percent of total billed charges,82.6% of total billed charges,2634.11,82.6,,,percent of total billed charges,82.6% of total billed charges,610.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,148.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,148.5,108107.1,
INSERT NEEDLE CATH BOWEL,44015,CDM,983,RC,44015,HCPCS,Outpatient,,,390.72,253.97,,343.83,88,,,percent of total billed charges,88% of total Billed charges,20.71,100,,,Fee Schedule,100% of Medicare rate,77.58,100,,,Fee Schedule,100% of WA Medicaid,390.72,100,,,percent of total billed charges,100% of total billed charges,79.91,103,,,Fee Schedule,103% of WA Medicaid,20.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,269.6,69,,,percent of total billed charges,69% of total billed charges,390.72,100,,,percent of total billed charges,100% of total billed charges,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.72,100,,,percent of total billed charges,100% of total billed charges,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.72,100,,,percent of total billed charges,100% of total billed charges,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.66,61.85,,,percent of total billed charges,61.85% of total billed charges,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,100.85,130,,,Fee Schedule,130% of WA Medicaid ,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.3,37.7,,,percent of total billed charges,37.70% of total billed charges,147.3,37.7,,,percent of total billed charges,37.70% of total billed charges,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,13245.41,33.9,,,percent of total billed charges,33.9% of total billed charges,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.76,78,,,percent of total billed charges,78% of total billed charges,390.72,100,,,percent of total billed charges,100% of total billed charges,322.73,82.6,,,percent of total billed charges,82.6% of total billed charges,322.73,82.6,,,percent of total billed charges,82.6% of total billed charges,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.71,13245.41,
INCISION OF SMALL BOWEL,44010,CDM,983,RC,44010,HCPCS,Outpatient,,,2371,1541.15,,2086.48,88,,,percent of total billed charges,88% of total Billed charges,91.77,100,,,Fee Schedule,100% of Medicare rate,480.61,100,,,Fee Schedule,100% of WA Medicaid,2371,100,,,percent of total billed charges,100% of total billed charges,495.03,103,,,Fee Schedule,103% of WA Medicaid,91.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,160.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,480.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1635.99,69,,,percent of total billed charges,69% of total billed charges,2371,100,,,percent of total billed charges,100% of total billed charges,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2371,100,,,percent of total billed charges,100% of total billed charges,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2371,100,,,percent of total billed charges,100% of total billed charges,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1466.46,61.85,,,percent of total billed charges,61.85% of total billed charges,480.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,624.79,130,,,Fee Schedule,130% of WA Medicaid ,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,893.87,37.7,,,percent of total billed charges,37.70% of total billed charges,893.87,37.7,,,percent of total billed charges,37.70% of total billed charges,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,80376.9,33.9,,,percent of total billed charges,33.9% of total billed charges,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1849.38,78,,,percent of total billed charges,78% of total billed charges,2371,100,,,percent of total billed charges,100% of total billed charges,1958.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1958.45,82.6,,,percent of total billed charges,82.6% of total billed charges,480.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.77,80376.9,
EXPLORE SMALL INTESTINE,44020,CDM,983,RC,44020,HCPCS,Outpatient,,,2666,1732.90,,2346.08,88,,,percent of total billed charges,88% of total Billed charges,131.82,100,,,Fee Schedule,100% of Medicare rate,545.7,100,,,Fee Schedule,100% of WA Medicaid,2666,100,,,percent of total billed charges,100% of total billed charges,562.07,103,,,Fee Schedule,103% of WA Medicaid,131.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,230.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,545.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1839.54,69,,,percent of total billed charges,69% of total billed charges,2666,100,,,percent of total billed charges,100% of total billed charges,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2666,100,,,percent of total billed charges,100% of total billed charges,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2666,100,,,percent of total billed charges,100% of total billed charges,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1648.92,61.85,,,percent of total billed charges,61.85% of total billed charges,545.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,709.41,130,,,Fee Schedule,130% of WA Medicaid ,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1005.08,37.7,,,percent of total billed charges,37.70% of total billed charges,1005.08,37.7,,,percent of total billed charges,37.70% of total billed charges,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,90377.4,33.9,,,percent of total billed charges,33.9% of total billed charges,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2079.48,78,,,percent of total billed charges,78% of total billed charges,2666,100,,,percent of total billed charges,100% of total billed charges,2202.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2202.12,82.6,,,percent of total billed charges,82.6% of total billed charges,545.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,131.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.82,90377.4,
INCISION OF LARGE BOWEL,44025,CDM,983,RC,44025,HCPCS,Outpatient,,,2691,1749.15,,2368.08,88,,,percent of total billed charges,88% of total Billed charges,131.03,100,,,Fee Schedule,100% of Medicare rate,550.36,100,,,Fee Schedule,100% of WA Medicaid,2691,100,,,percent of total billed charges,100% of total billed charges,566.87,103,,,Fee Schedule,103% of WA Medicaid,131.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,229.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,550.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1856.79,69,,,percent of total billed charges,69% of total billed charges,2691,100,,,percent of total billed charges,100% of total billed charges,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2691,100,,,percent of total billed charges,100% of total billed charges,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2691,100,,,percent of total billed charges,100% of total billed charges,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1664.38,61.85,,,percent of total billed charges,61.85% of total billed charges,550.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,715.47,130,,,Fee Schedule,130% of WA Medicaid ,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014.51,37.7,,,percent of total billed charges,37.70% of total billed charges,1014.51,37.7,,,percent of total billed charges,37.70% of total billed charges,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,91224.9,33.9,,,percent of total billed charges,33.9% of total billed charges,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2098.98,78,,,percent of total billed charges,78% of total billed charges,2691,100,,,percent of total billed charges,100% of total billed charges,2222.77,82.6,,,percent of total billed charges,82.6% of total billed charges,2222.77,82.6,,,percent of total billed charges,82.6% of total billed charges,550.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,131.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,550.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.03,91224.9,
REDUCE BOWEL OBSTRUCTION,44050,CDM,983,RC,44050,HCPCS,Outpatient,,,3035,1972.75,,2670.8,88,,,percent of total billed charges,88% of total Billed charges,126.87,100,,,Fee Schedule,100% of Medicare rate,525.74,100,,,Fee Schedule,100% of WA Medicaid,3035,100,,,percent of total billed charges,100% of total billed charges,541.51,103,,,Fee Schedule,103% of WA Medicaid,126.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,222.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,525.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2094.15,69,,,percent of total billed charges,69% of total billed charges,3035,100,,,percent of total billed charges,100% of total billed charges,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3035,100,,,percent of total billed charges,100% of total billed charges,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3035,100,,,percent of total billed charges,100% of total billed charges,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1877.15,61.85,,,percent of total billed charges,61.85% of total billed charges,525.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,536.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,683.46,130,,,Fee Schedule,130% of WA Medicaid ,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1144.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1144.2,37.7,,,percent of total billed charges,37.70% of total billed charges,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,102886.5,33.9,,,percent of total billed charges,33.9% of total billed charges,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2367.3,78,,,percent of total billed charges,78% of total billed charges,3035,100,,,percent of total billed charges,100% of total billed charges,2506.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2506.91,82.6,,,percent of total billed charges,82.6% of total billed charges,525.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,126.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.87,102886.5,
REMOVAL OF SMALL INTESTINE,44121,CDM,983,RC,44121,HCPCS,Outpatient,,,657,427.05,,578.16,88,,,percent of total billed charges,88% of total Billed charges,34.78,100,,,Fee Schedule,100% of Medicare rate,132.6,100,,,Fee Schedule,100% of WA Medicaid,657,100,,,percent of total billed charges,100% of total billed charges,136.58,103,,,Fee Schedule,103% of WA Medicaid,34.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,132.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,453.33,69,,,percent of total billed charges,69% of total billed charges,657,100,,,percent of total billed charges,100% of total billed charges,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,657,100,,,percent of total billed charges,100% of total billed charges,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,657,100,,,percent of total billed charges,100% of total billed charges,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.35,61.85,,,percent of total billed charges,61.85% of total billed charges,132.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,172.38,130,,,Fee Schedule,130% of WA Medicaid ,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.69,37.7,,,percent of total billed charges,37.70% of total billed charges,247.69,37.7,,,percent of total billed charges,37.70% of total billed charges,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,22272.3,33.9,,,percent of total billed charges,33.9% of total billed charges,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.46,78,,,percent of total billed charges,78% of total billed charges,657,100,,,percent of total billed charges,100% of total billed charges,542.68,82.6,,,percent of total billed charges,82.6% of total billed charges,542.68,82.6,,,percent of total billed charges,82.6% of total billed charges,132.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.78,22272.3,
REMOVAL OF SMALL INTESTINE,44120,CDM,983,RC,44120,HCPCS,Outpatient,,,3775,2453.75,,3322,88,,,percent of total billed charges,88% of total Billed charges,167.36,100,,,Fee Schedule,100% of Medicare rate,682.78,100,,,Fee Schedule,100% of WA Medicaid,3775,100,,,percent of total billed charges,100% of total billed charges,703.26,103,,,Fee Schedule,103% of WA Medicaid,167.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,292.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,682.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2604.75,69,,,percent of total billed charges,69% of total billed charges,3775,100,,,percent of total billed charges,100% of total billed charges,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3775,100,,,percent of total billed charges,100% of total billed charges,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3775,100,,,percent of total billed charges,100% of total billed charges,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2334.84,61.85,,,percent of total billed charges,61.85% of total billed charges,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,887.61,130,,,Fee Schedule,130% of WA Medicaid ,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1423.18,37.7,,,percent of total billed charges,37.70% of total billed charges,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,127972.5,33.9,,,percent of total billed charges,33.9% of total billed charges,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2944.5,78,,,percent of total billed charges,78% of total billed charges,3775,100,,,percent of total billed charges,100% of total billed charges,3118.15,82.6,,,percent of total billed charges,82.6% of total billed charges,3118.15,82.6,,,percent of total billed charges,82.6% of total billed charges,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,167.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,167.36,127972.5,
MOBILIZATION OF COLON,44139,CDM,983,RC,44139,HCPCS,Outpatient,,,532,345.80,,468.16,88,,,percent of total billed charges,88% of total Billed charges,16.47,100,,,Fee Schedule,100% of Medicare rate,66.21,100,,,Fee Schedule,100% of WA Medicaid,532,100,,,percent of total billed charges,100% of total billed charges,68.2,103,,,Fee Schedule,103% of WA Medicaid,16.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,367.08,69,,,percent of total billed charges,69% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,532,100,,,percent of total billed charges,100% of total billed charges,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,532,100,,,percent of total billed charges,100% of total billed charges,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.04,61.85,,,percent of total billed charges,61.85% of total billed charges,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,86.07,130,,,Fee Schedule,130% of WA Medicaid ,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,18034.8,33.9,,,percent of total billed charges,33.9% of total billed charges,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.96,78,,,percent of total billed charges,78% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.47,18034.8,
BOWEL TO BOWEL FUSION,44130,CDM,983,RC,44130,HCPCS,Outpatient,,,3573,2322.45,,3144.24,88,,,percent of total billed charges,88% of total Billed charges,175.65,100,,,Fee Schedule,100% of Medicare rate,736.86,100,,,Fee Schedule,100% of WA Medicaid,3573,100,,,percent of total billed charges,100% of total billed charges,758.97,103,,,Fee Schedule,103% of WA Medicaid,175.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,307.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,736.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2465.37,69,,,percent of total billed charges,69% of total billed charges,3573,100,,,percent of total billed charges,100% of total billed charges,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3573,100,,,percent of total billed charges,100% of total billed charges,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3573,100,,,percent of total billed charges,100% of total billed charges,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2209.9,61.85,,,percent of total billed charges,61.85% of total billed charges,736.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,957.92,130,,,Fee Schedule,130% of WA Medicaid ,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1347.02,37.7,,,percent of total billed charges,37.70% of total billed charges,1347.02,37.7,,,percent of total billed charges,37.70% of total billed charges,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,121124.7,33.9,,,percent of total billed charges,33.9% of total billed charges,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2786.94,78,,,percent of total billed charges,78% of total billed charges,3573,100,,,percent of total billed charges,100% of total billed charges,2951.3,82.6,,,percent of total billed charges,82.6% of total billed charges,2951.3,82.6,,,percent of total billed charges,82.6% of total billed charges,736.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,175.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,175.65,121124.7,
PARTIAL REMOVAL OF COLON,44143,CDM,983,RC,44143,HCPCS,Outpatient,,,4392,2854.80,,3864.96,88,,,percent of total billed charges,88% of total Billed charges,218.67,100,,,Fee Schedule,100% of Medicare rate,922.43,100,,,Fee Schedule,100% of WA Medicaid,4392,100,,,percent of total billed charges,100% of total billed charges,950.1,103,,,Fee Schedule,103% of WA Medicaid,218.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,382.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,922.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3030.48,69,,,percent of total billed charges,69% of total billed charges,4392,100,,,percent of total billed charges,100% of total billed charges,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,4392,100,,,percent of total billed charges,100% of total billed charges,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,4392,100,,,percent of total billed charges,100% of total billed charges,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2716.45,61.85,,,percent of total billed charges,61.85% of total billed charges,922.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,922.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,940.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1199.16,130,,,Fee Schedule,130% of WA Medicaid ,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1655.78,37.7,,,percent of total billed charges,37.70% of total billed charges,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,148888.8,33.9,,,percent of total billed charges,33.9% of total billed charges,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,3425.76,78,,,percent of total billed charges,78% of total billed charges,4392,100,,,percent of total billed charges,100% of total billed charges,3627.79,82.6,,,percent of total billed charges,82.6% of total billed charges,3627.79,82.6,,,percent of total billed charges,82.6% of total billed charges,922.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,218.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,922.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,218.67,148888.8,
"COLECTOMY W/RESECTION,W COLOSTOMY OR ILE",44144,CDM,983,RC,44144,HCPCS,Outpatient,,,3663,2380.95,,3223.44,88,,,percent of total billed charges,88% of total Billed charges,232.07,100,,,Fee Schedule,100% of Medicare rate,984.53,100,,,Fee Schedule,100% of WA Medicaid,3663,100,,,percent of total billed charges,100% of total billed charges,1014.07,103,,,Fee Schedule,103% of WA Medicaid,232.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,406.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,984.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2527.47,69,,,percent of total billed charges,69% of total billed charges,3663,100,,,percent of total billed charges,100% of total billed charges,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3663,100,,,percent of total billed charges,100% of total billed charges,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3663,100,,,percent of total billed charges,100% of total billed charges,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2265.57,61.85,,,percent of total billed charges,61.85% of total billed charges,984.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,984.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1004.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1279.89,130,,,Fee Schedule,130% of WA Medicaid ,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1380.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1380.95,37.7,,,percent of total billed charges,37.70% of total billed charges,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,124175.7,33.9,,,percent of total billed charges,33.9% of total billed charges,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2857.14,78,,,percent of total billed charges,78% of total billed charges,3663,100,,,percent of total billed charges,100% of total billed charges,3025.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3025.64,82.6,,,percent of total billed charges,82.6% of total billed charges,984.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,232.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,984.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,232.07,124175.7,
PARTIAL REMOVAL OF COLON,44145,CDM,983,RC,44145,HCPCS,Outpatient,,,5159,3353.35,,4539.92,88,,,percent of total billed charges,88% of total Billed charges,207.72,100,,,Fee Schedule,100% of Medicare rate,921.5,100,,,Fee Schedule,100% of WA Medicaid,5159,100,,,percent of total billed charges,100% of total billed charges,949.15,103,,,Fee Schedule,103% of WA Medicaid,207.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,363.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,921.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3559.71,69,,,percent of total billed charges,69% of total billed charges,5159,100,,,percent of total billed charges,100% of total billed charges,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5159,100,,,percent of total billed charges,100% of total billed charges,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5159,100,,,percent of total billed charges,100% of total billed charges,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3190.84,61.85,,,percent of total billed charges,61.85% of total billed charges,921.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,921.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,939.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1197.95,130,,,Fee Schedule,130% of WA Medicaid ,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1944.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1944.94,37.7,,,percent of total billed charges,37.70% of total billed charges,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,174890.1,33.9,,,percent of total billed charges,33.9% of total billed charges,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,4024.02,78,,,percent of total billed charges,78% of total billed charges,5159,100,,,percent of total billed charges,100% of total billed charges,4261.33,82.6,,,percent of total billed charges,82.6% of total billed charges,4261.33,82.6,,,percent of total billed charges,82.6% of total billed charges,921.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,207.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,921.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,207.72,174890.1,
PARTIAL REMOVAL OF COLON,44141,CDM,983,RC,44141,HCPCS,Outpatient,,,4891,3179.15,,4304.08,88,,,percent of total billed charges,88% of total Billed charges,237.49,100,,,Fee Schedule,100% of Medicare rate,1014,100,,,Fee Schedule,100% of WA Medicaid,4891,100,,,percent of total billed charges,100% of total billed charges,1044.42,103,,,Fee Schedule,103% of WA Medicaid,237.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,415.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1014,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3374.79,69,,,percent of total billed charges,69% of total billed charges,4891,100,,,percent of total billed charges,100% of total billed charges,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4891,100,,,percent of total billed charges,100% of total billed charges,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4891,100,,,percent of total billed charges,100% of total billed charges,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3025.08,61.85,,,percent of total billed charges,61.85% of total billed charges,1014,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,100,,,Fee Schedule,100% of WA Medicare OPPS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1034.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1318.2,130,,,Fee Schedule,130% of WA Medicaid ,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1843.91,37.7,,,percent of total billed charges,37.70% of total billed charges,1843.91,37.7,,,percent of total billed charges,37.70% of total billed charges,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,165804.9,33.9,,,percent of total billed charges,33.9% of total billed charges,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3814.98,78,,,percent of total billed charges,78% of total billed charges,4891,100,,,percent of total billed charges,100% of total billed charges,4039.97,82.6,,,percent of total billed charges,82.6% of total billed charges,4039.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1014,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,237.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,237.49,165804.9,
PARTIAL REMOVAL OF COLON,44140,CDM,983,RC,44140,HCPCS,Outpatient,,,4250,2762.50,,3740,88,,,percent of total billed charges,88% of total Billed charges,178.48,100,,,Fee Schedule,100% of Medicare rate,751.22,100,,,Fee Schedule,100% of WA Medicaid,4250,100,,,percent of total billed charges,100% of total billed charges,773.76,103,,,Fee Schedule,103% of WA Medicaid,178.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,312.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,751.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2932.5,69,,,percent of total billed charges,69% of total billed charges,4250,100,,,percent of total billed charges,100% of total billed charges,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4250,100,,,percent of total billed charges,100% of total billed charges,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4250,100,,,percent of total billed charges,100% of total billed charges,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2628.63,61.85,,,percent of total billed charges,61.85% of total billed charges,751.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,976.59,130,,,Fee Schedule,130% of WA Medicaid ,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1602.25,37.7,,,percent of total billed charges,37.70% of total billed charges,1602.25,37.7,,,percent of total billed charges,37.70% of total billed charges,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,144075,33.9,,,percent of total billed charges,33.9% of total billed charges,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3315,78,,,percent of total billed charges,78% of total billed charges,4250,100,,,percent of total billed charges,100% of total billed charges,3510.5,82.6,,,percent of total billed charges,82.6% of total billed charges,3510.5,82.6,,,percent of total billed charges,82.6% of total billed charges,751.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,178.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,178.48,144075,
REMOVAL OF COLON,44150,CDM,983,RC,44150,HCPCS,Outpatient,,,5117,3326.05,,4502.96,88,,,percent of total billed charges,88% of total Billed charges,229.39,100,,,Fee Schedule,100% of Medicare rate,1038.06,100,,,Fee Schedule,100% of WA Medicaid,5117,100,,,percent of total billed charges,100% of total billed charges,1069.2,103,,,Fee Schedule,103% of WA Medicaid,229.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,401.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1038.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3530.73,69,,,percent of total billed charges,69% of total billed charges,5117,100,,,percent of total billed charges,100% of total billed charges,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,5117,100,,,percent of total billed charges,100% of total billed charges,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,5117,100,,,percent of total billed charges,100% of total billed charges,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,3164.86,61.85,,,percent of total billed charges,61.85% of total billed charges,1038.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1038.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1058.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1349.48,130,,,Fee Schedule,130% of WA Medicaid ,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1929.11,37.7,,,percent of total billed charges,37.70% of total billed charges,1929.11,37.7,,,percent of total billed charges,37.70% of total billed charges,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,173466.3,33.9,,,percent of total billed charges,33.9% of total billed charges,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,3991.26,78,,,percent of total billed charges,78% of total billed charges,5117,100,,,percent of total billed charges,100% of total billed charges,4226.64,82.6,,,percent of total billed charges,82.6% of total billed charges,4226.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1038.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,229.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1038.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,229.39,173466.3,
REMOVAL OF COLON,44160,CDM,983,RC,44160,HCPCS,Outpatient,,,3382,2198.30,,2976.16,88,,,percent of total billed charges,88% of total Billed charges,162.56,100,,,Fee Schedule,100% of Medicare rate,695.46,100,,,Fee Schedule,100% of WA Medicaid,3382,100,,,percent of total billed charges,100% of total billed charges,716.32,103,,,Fee Schedule,103% of WA Medicaid,162.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,284.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,695.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2333.58,69,,,percent of total billed charges,69% of total billed charges,3382,100,,,percent of total billed charges,100% of total billed charges,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3382,100,,,percent of total billed charges,100% of total billed charges,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3382,100,,,percent of total billed charges,100% of total billed charges,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2091.77,61.85,,,percent of total billed charges,61.85% of total billed charges,695.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,695.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,904.1,130,,,Fee Schedule,130% of WA Medicaid ,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1275.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1275.01,37.7,,,percent of total billed charges,37.70% of total billed charges,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,114649.8,33.9,,,percent of total billed charges,33.9% of total billed charges,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2637.96,78,,,percent of total billed charges,78% of total billed charges,3382,100,,,percent of total billed charges,100% of total billed charges,2793.53,82.6,,,percent of total billed charges,82.6% of total billed charges,2793.53,82.6,,,percent of total billed charges,82.6% of total billed charges,695.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,162.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,695.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,162.56,114649.8,
LAP ENTEROLYSIS,44180,CDM,983,RC,44180,HCPCS,Outpatient,,,1654,1075.10,,1455.52,88,,,percent of total billed charges,88% of total Billed charges,124.3,100,,,Fee Schedule,100% of Medicare rate,516.42,100,,,Fee Schedule,100% of WA Medicaid,1654,100,,,percent of total billed charges,100% of total billed charges,531.91,103,,,Fee Schedule,103% of WA Medicaid,124.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,217.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,516.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1141.26,69,,,percent of total billed charges,69% of total billed charges,1654,100,,,percent of total billed charges,100% of total billed charges,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1654,100,,,percent of total billed charges,100% of total billed charges,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1654,100,,,percent of total billed charges,100% of total billed charges,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1023,61.85,,,percent of total billed charges,61.85% of total billed charges,516.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,526.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,671.35,130,,,Fee Schedule,130% of WA Medicaid ,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,623.56,37.7,,,percent of total billed charges,37.70% of total billed charges,623.56,37.7,,,percent of total billed charges,37.70% of total billed charges,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,56070.6,33.9,,,percent of total billed charges,33.9% of total billed charges,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1290.12,78,,,percent of total billed charges,78% of total billed charges,1654,100,,,percent of total billed charges,100% of total billed charges,1366.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1366.2,82.6,,,percent of total billed charges,82.6% of total billed charges,516.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,124.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.3,56070.6,
LAP JEJUNOSTOMY,44186,CDM,983,RC,44186,HCPCS,Outpatient,,,1164,756.60,,1024.32,88,,,percent of total billed charges,88% of total Billed charges,86.86,100,,,Fee Schedule,100% of Medicare rate,367.59,100,,,Fee Schedule,100% of WA Medicaid,1164,100,,,percent of total billed charges,100% of total billed charges,378.62,103,,,Fee Schedule,103% of WA Medicaid,86.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,152,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,367.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,803.16,69,,,percent of total billed charges,69% of total billed charges,1164,100,,,percent of total billed charges,100% of total billed charges,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1164,100,,,percent of total billed charges,100% of total billed charges,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1164,100,,,percent of total billed charges,100% of total billed charges,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,719.93,61.85,,,percent of total billed charges,61.85% of total billed charges,367.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,477.87,130,,,Fee Schedule,130% of WA Medicaid ,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.83,37.7,,,percent of total billed charges,37.70% of total billed charges,438.83,37.7,,,percent of total billed charges,37.70% of total billed charges,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,39459.6,33.9,,,percent of total billed charges,33.9% of total billed charges,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,907.92,78,,,percent of total billed charges,78% of total billed charges,1164,100,,,percent of total billed charges,100% of total billed charges,961.46,82.6,,,percent of total billed charges,82.6% of total billed charges,961.46,82.6,,,percent of total billed charges,82.6% of total billed charges,367.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,86.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.86,39459.6,
LAP ILEO/JEJUNO-STOMY,44187,CDM,983,RC,44187,HCPCS,Outpatient,,,1927,1252.55,,1695.76,88,,,percent of total billed charges,88% of total Billed charges,119.88,100,,,Fee Schedule,100% of Medicare rate,615.45,100,,,Fee Schedule,100% of WA Medicaid,1927,100,,,percent of total billed charges,100% of total billed charges,633.91,103,,,Fee Schedule,103% of WA Medicaid,119.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,209.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,615.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1329.63,69,,,percent of total billed charges,69% of total billed charges,1927,100,,,percent of total billed charges,100% of total billed charges,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1927,100,,,percent of total billed charges,100% of total billed charges,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1927,100,,,percent of total billed charges,100% of total billed charges,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191.85,61.85,,,percent of total billed charges,61.85% of total billed charges,615.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,627.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,800.09,130,,,Fee Schedule,130% of WA Medicaid ,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.48,37.7,,,percent of total billed charges,37.70% of total billed charges,726.48,37.7,,,percent of total billed charges,37.70% of total billed charges,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,65325.3,33.9,,,percent of total billed charges,33.9% of total billed charges,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1503.06,78,,,percent of total billed charges,78% of total billed charges,1927,100,,,percent of total billed charges,100% of total billed charges,1591.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1591.7,82.6,,,percent of total billed charges,82.6% of total billed charges,615.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,119.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.88,65325.3,
LAP COLOSTOMY,44188,CDM,983,RC,44188,HCPCS,Outpatient,,,3363,2185.95,,2959.44,88,,,percent of total billed charges,88% of total Billed charges,144.73,100,,,Fee Schedule,100% of Medicare rate,682.96,100,,,Fee Schedule,100% of WA Medicaid,3363,100,,,percent of total billed charges,100% of total billed charges,703.45,103,,,Fee Schedule,103% of WA Medicaid,144.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,253.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,682.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2320.47,69,,,percent of total billed charges,69% of total billed charges,3363,100,,,percent of total billed charges,100% of total billed charges,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3363,100,,,percent of total billed charges,100% of total billed charges,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3363,100,,,percent of total billed charges,100% of total billed charges,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2080.02,61.85,,,percent of total billed charges,61.85% of total billed charges,682.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,887.85,130,,,Fee Schedule,130% of WA Medicaid ,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1267.85,37.7,,,percent of total billed charges,37.70% of total billed charges,1267.85,37.7,,,percent of total billed charges,37.70% of total billed charges,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,114005.7,33.9,,,percent of total billed charges,33.9% of total billed charges,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2623.14,78,,,percent of total billed charges,78% of total billed charges,3363,100,,,percent of total billed charges,100% of total billed charges,2777.84,82.6,,,percent of total billed charges,82.6% of total billed charges,2777.84,82.6,,,percent of total billed charges,82.6% of total billed charges,682.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,144.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,144.73,114005.7,
LAP ENTERECTOMY,44202,CDM,983,RC,44202,HCPCS,Outpatient,,,3773,2452.45,,3320.24,88,,,percent of total billed charges,88% of total Billed charges,184.71,100,,,Fee Schedule,100% of Medicare rate,775.65,100,,,Fee Schedule,100% of WA Medicaid,3773,100,,,percent of total billed charges,100% of total billed charges,798.92,103,,,Fee Schedule,103% of WA Medicaid,184.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,323.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,775.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2603.37,69,,,percent of total billed charges,69% of total billed charges,3773,100,,,percent of total billed charges,100% of total billed charges,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,3773,100,,,percent of total billed charges,100% of total billed charges,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,3773,100,,,percent of total billed charges,100% of total billed charges,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2333.6,61.85,,,percent of total billed charges,61.85% of total billed charges,775.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,775.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,791.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1008.35,130,,,Fee Schedule,130% of WA Medicaid ,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1422.42,37.7,,,percent of total billed charges,37.70% of total billed charges,1422.42,37.7,,,percent of total billed charges,37.70% of total billed charges,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,127904.7,33.9,,,percent of total billed charges,33.9% of total billed charges,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2942.94,78,,,percent of total billed charges,78% of total billed charges,3773,100,,,percent of total billed charges,100% of total billed charges,3116.5,82.6,,,percent of total billed charges,82.6% of total billed charges,3116.5,82.6,,,percent of total billed charges,82.6% of total billed charges,775.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,184.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,775.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,184.71,127904.7,
LAP COLECTOMY PART W/ILEUM,44205,CDM,983,RC,44205,HCPCS,Outpatient,,,3663,2380.95,,3223.44,88,,,percent of total billed charges,88% of total Billed charges,163.65,100,,,Fee Schedule,100% of Medicare rate,745.44,100,,,Fee Schedule,100% of WA Medicaid,3663,100,,,percent of total billed charges,100% of total billed charges,767.8,103,,,Fee Schedule,103% of WA Medicaid,163.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,286.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,745.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2527.47,69,,,percent of total billed charges,69% of total billed charges,3663,100,,,percent of total billed charges,100% of total billed charges,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3663,100,,,percent of total billed charges,100% of total billed charges,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3663,100,,,percent of total billed charges,100% of total billed charges,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2265.57,61.85,,,percent of total billed charges,61.85% of total billed charges,745.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,760.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,969.07,130,,,Fee Schedule,130% of WA Medicaid ,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1380.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1380.95,37.7,,,percent of total billed charges,37.70% of total billed charges,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,124175.7,33.9,,,percent of total billed charges,33.9% of total billed charges,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2857.14,78,,,percent of total billed charges,78% of total billed charges,3663,100,,,percent of total billed charges,100% of total billed charges,3025.64,82.6,,,percent of total billed charges,82.6% of total billed charges,3025.64,82.6,,,percent of total billed charges,82.6% of total billed charges,745.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,163.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,163.65,124175.7,
LAP PART COLECTOMY W/STOMA,44206,CDM,983,RC,44206,HCPCS,Outpatient,,,4885,3175.25,,4298.8,88,,,percent of total billed charges,88% of total Billed charges,221.24,100,,,Fee Schedule,100% of Medicare rate,971.11,100,,,Fee Schedule,100% of WA Medicaid,4885,100,,,percent of total billed charges,100% of total billed charges,1000.24,103,,,Fee Schedule,103% of WA Medicaid,221.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,387.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,971.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3370.65,69,,,percent of total billed charges,69% of total billed charges,4885,100,,,percent of total billed charges,100% of total billed charges,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,4885,100,,,percent of total billed charges,100% of total billed charges,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,4885,100,,,percent of total billed charges,100% of total billed charges,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,3021.37,61.85,,,percent of total billed charges,61.85% of total billed charges,971.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,971.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,990.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1262.44,130,,,Fee Schedule,130% of WA Medicaid ,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1841.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1841.65,37.7,,,percent of total billed charges,37.70% of total billed charges,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,165601.5,33.9,,,percent of total billed charges,33.9% of total billed charges,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,3810.3,78,,,percent of total billed charges,78% of total billed charges,4885,100,,,percent of total billed charges,100% of total billed charges,4035.01,82.6,,,percent of total billed charges,82.6% of total billed charges,4035.01,82.6,,,percent of total billed charges,82.6% of total billed charges,971.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,221.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,971.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,221.24,165601.5,
L COLECTOMY/COLOPROCTOSTOMY,44207,CDM,983,RC,44207,HCPCS,Outpatient,,,4716.21,3065.54,,4150.26,88,,,percent of total billed charges,88% of total Billed charges,218.58,100,,,Fee Schedule,100% of Medicare rate,1008.97,100,,,Fee Schedule,100% of WA Medicaid,4716.21,100,,,percent of total billed charges,100% of total billed charges,1039.24,103,,,Fee Schedule,103% of WA Medicaid,218.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,382.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1008.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3254.18,69,,,percent of total billed charges,69% of total billed charges,4716.21,100,,,percent of total billed charges,100% of total billed charges,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4716.21,100,,,percent of total billed charges,100% of total billed charges,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4716.21,100,,,percent of total billed charges,100% of total billed charges,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2916.98,61.85,,,percent of total billed charges,61.85% of total billed charges,1008.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1029.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1311.66,130,,,Fee Schedule,130% of WA Medicaid ,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1778.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1778.01,37.7,,,percent of total billed charges,37.70% of total billed charges,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,159879.52,33.9,,,percent of total billed charges,33.9% of total billed charges,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3678.64,78,,,percent of total billed charges,78% of total billed charges,4716.21,100,,,percent of total billed charges,100% of total billed charges,3895.59,82.6,,,percent of total billed charges,82.6% of total billed charges,3895.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1008.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,218.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,218.58,159879.52,
LAP RESECT S/INTESTINE ADDL,44203,CDM,983,RC,44203,HCPCS,Outpatient,,,657,427.05,,578.16,88,,,percent of total billed charges,88% of total Billed charges,34.23,100,,,Fee Schedule,100% of Medicare rate,132.04,100,,,Fee Schedule,100% of WA Medicaid,657,100,,,percent of total billed charges,100% of total billed charges,136,103,,,Fee Schedule,103% of WA Medicaid,34.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,132.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,453.33,69,,,percent of total billed charges,69% of total billed charges,657,100,,,percent of total billed charges,100% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,657,100,,,percent of total billed charges,100% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,657,100,,,percent of total billed charges,100% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.35,61.85,,,percent of total billed charges,61.85% of total billed charges,132.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,171.65,130,,,Fee Schedule,130% of WA Medicaid ,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.69,37.7,,,percent of total billed charges,37.70% of total billed charges,247.69,37.7,,,percent of total billed charges,37.70% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,22272.3,33.9,,,percent of total billed charges,33.9% of total billed charges,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.46,78,,,percent of total billed charges,78% of total billed charges,657,100,,,percent of total billed charges,100% of total billed charges,542.68,82.6,,,percent of total billed charges,82.6% of total billed charges,542.68,82.6,,,percent of total billed charges,82.6% of total billed charges,132.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.23,22272.3,
LAPARO PARTIAL COLECTOMY,44204,CDM,983,RC,44204,HCPCS,Outpatient,,,4177,2715.05,,3675.76,88,,,percent of total billed charges,88% of total Billed charges,193.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4177,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,193.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,339.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2882.13,69,,,percent of total billed charges,69% of total billed charges,4177,100,,,percent of total billed charges,100% of total billed charges,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4177,100,,,percent of total billed charges,100% of total billed charges,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4177,100,,,percent of total billed charges,100% of total billed charges,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2583.47,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1574.73,37.7,,,percent of total billed charges,37.70% of total billed charges,1574.73,37.7,,,percent of total billed charges,37.70% of total billed charges,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,141600.3,33.9,,,percent of total billed charges,33.9% of total billed charges,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3258.06,78,,,percent of total billed charges,78% of total billed charges,4177,100,,,percent of total billed charges,100% of total billed charges,3450.2,82.6,,,percent of total billed charges,82.6% of total billed charges,3450.2,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,193.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",193.96,141600.3,
LAP MOBIL SPLENIC FL ADD-ON,44213,CDM,983,RC,44213,HCPCS,Outpatient,,,510,331.50,,448.8,88,,,percent of total billed charges,88% of total Billed charges,23.85,100,,,Fee Schedule,100% of Medicare rate,102.58,100,,,Fee Schedule,100% of WA Medicaid,510,100,,,percent of total billed charges,100% of total billed charges,105.66,103,,,Fee Schedule,103% of WA Medicaid,23.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,351.9,69,,,percent of total billed charges,69% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,510,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,510,100,,,percent of total billed charges,100% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.44,61.85,,,percent of total billed charges,61.85% of total billed charges,102.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,133.35,130,,,Fee Schedule,130% of WA Medicaid ,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,17289,33.9,,,percent of total billed charges,33.9% of total billed charges,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.8,78,,,percent of total billed charges,78% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,102.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.85,17289,
LAP CLOSE ENTEROSTOMY,44227,CDM,983,RC,44227,HCPCS,Outpatient,,,4549,2956.85,,4003.12,88,,,percent of total billed charges,88% of total Billed charges,210.96,100,,,Fee Schedule,100% of Medicare rate,923.73,100,,,Fee Schedule,100% of WA Medicaid,4549,100,,,percent of total billed charges,100% of total billed charges,951.44,103,,,Fee Schedule,103% of WA Medicaid,210.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,369.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,923.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3138.81,69,,,percent of total billed charges,69% of total billed charges,4549,100,,,percent of total billed charges,100% of total billed charges,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4549,100,,,percent of total billed charges,100% of total billed charges,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4549,100,,,percent of total billed charges,100% of total billed charges,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2813.56,61.85,,,percent of total billed charges,61.85% of total billed charges,923.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,923.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,942.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1200.85,130,,,Fee Schedule,130% of WA Medicaid ,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1714.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1714.97,37.7,,,percent of total billed charges,37.70% of total billed charges,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,154211.1,33.9,,,percent of total billed charges,33.9% of total billed charges,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3548.22,78,,,percent of total billed charges,78% of total billed charges,4549,100,,,percent of total billed charges,100% of total billed charges,3757.47,82.6,,,percent of total billed charges,82.6% of total billed charges,3757.47,82.6,,,percent of total billed charges,82.6% of total billed charges,923.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,210.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,923.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.96,154211.1,
"UNLISTED LAPAROSCOPY PROCEDURE, INTEST",44238,CDM,983,RC,44238,HCPCS,Outpatient,,,1137,739.05,,1000.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1137,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,784.53,69,,,percent of total billed charges,69% of total billed charges,1137,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1137,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1137,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,703.23,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,428.65,37.7,,,percent of total billed charges,37.70% of total billed charges,428.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,38544.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,886.86,78,,,percent of total billed charges,78% of total billed charges,1137,100,,,percent of total billed charges,100% of total billed charges,939.16,82.6,,,percent of total billed charges,82.6% of total billed charges,939.16,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",428.65,38544.3,
OPEN BOWEL TO SKIN,44300,CDM,983,RC,44300,HCPCS,Outpatient,,,2230,1449.50,,1962.4,88,,,percent of total billed charges,88% of total Billed charges,113.2,100,,,Fee Schedule,100% of Medicare rate,473.34,100,,,Fee Schedule,100% of WA Medicaid,2230,100,,,percent of total billed charges,100% of total billed charges,487.54,103,,,Fee Schedule,103% of WA Medicaid,113.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,198.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,473.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1538.7,69,,,percent of total billed charges,69% of total billed charges,2230,100,,,percent of total billed charges,100% of total billed charges,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2230,100,,,percent of total billed charges,100% of total billed charges,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2230,100,,,percent of total billed charges,100% of total billed charges,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1379.26,61.85,,,percent of total billed charges,61.85% of total billed charges,473.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,615.34,130,,,Fee Schedule,130% of WA Medicaid ,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,840.71,37.7,,,percent of total billed charges,37.70% of total billed charges,840.71,37.7,,,percent of total billed charges,37.70% of total billed charges,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,75597,33.9,,,percent of total billed charges,33.9% of total billed charges,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1739.4,78,,,percent of total billed charges,78% of total billed charges,2230,100,,,percent of total billed charges,100% of total billed charges,1841.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1841.98,82.6,,,percent of total billed charges,82.6% of total billed charges,473.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,113.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,113.2,75597,
REVISION OF ILEOSTOMY,44312,CDM,983,RC,44312,HCPCS,Outpatient,,,1618,1051.70,,1423.84,88,,,percent of total billed charges,88% of total Billed charges,67.97,100,,,Fee Schedule,100% of Medicare rate,339.43,100,,,Fee Schedule,100% of WA Medicaid,1618,100,,,percent of total billed charges,100% of total billed charges,349.61,103,,,Fee Schedule,103% of WA Medicaid,67.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,118.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,339.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1116.42,69,,,percent of total billed charges,69% of total billed charges,1618,100,,,percent of total billed charges,100% of total billed charges,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1618,100,,,percent of total billed charges,100% of total billed charges,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1618,100,,,percent of total billed charges,100% of total billed charges,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1000.73,61.85,,,percent of total billed charges,61.85% of total billed charges,339.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,441.26,130,,,Fee Schedule,130% of WA Medicaid ,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,609.99,37.7,,,percent of total billed charges,37.70% of total billed charges,609.99,37.7,,,percent of total billed charges,37.70% of total billed charges,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,54850.2,33.9,,,percent of total billed charges,33.9% of total billed charges,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262.04,78,,,percent of total billed charges,78% of total billed charges,1618,100,,,percent of total billed charges,100% of total billed charges,1336.47,82.6,,,percent of total billed charges,82.6% of total billed charges,1336.47,82.6,,,percent of total billed charges,82.6% of total billed charges,339.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.97,54850.2,
REVISION OF ILEOSTOMY,44314,CDM,983,RC,44314,HCPCS,Outpatient,,,2762,1795.30,,2430.56,88,,,percent of total billed charges,88% of total Billed charges,115.51,100,,,Fee Schedule,100% of Medicare rate,566.4,100,,,Fee Schedule,100% of WA Medicaid,2762,100,,,percent of total billed charges,100% of total billed charges,583.39,103,,,Fee Schedule,103% of WA Medicaid,115.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,202.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,566.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1905.78,69,,,percent of total billed charges,69% of total billed charges,2762,100,,,percent of total billed charges,100% of total billed charges,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2762,100,,,percent of total billed charges,100% of total billed charges,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2762,100,,,percent of total billed charges,100% of total billed charges,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1708.3,61.85,,,percent of total billed charges,61.85% of total billed charges,566.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,566.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,736.32,130,,,Fee Schedule,130% of WA Medicaid ,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1041.27,37.7,,,percent of total billed charges,37.70% of total billed charges,1041.27,37.7,,,percent of total billed charges,37.70% of total billed charges,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,93631.8,33.9,,,percent of total billed charges,33.9% of total billed charges,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2154.36,78,,,percent of total billed charges,78% of total billed charges,2762,100,,,percent of total billed charges,100% of total billed charges,2281.41,82.6,,,percent of total billed charges,82.6% of total billed charges,2281.41,82.6,,,percent of total billed charges,82.6% of total billed charges,566.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,115.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,566.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,115.51,93631.8,
COLOSTOMY,44320,CDM,983,RC,44320,HCPCS,Outpatient,,,2883,1873.95,,2537.04,88,,,percent of total billed charges,88% of total Billed charges,151.82,100,,,Fee Schedule,100% of Medicare rate,674.2,100,,,Fee Schedule,100% of WA Medicaid,2883,100,,,percent of total billed charges,100% of total billed charges,694.43,103,,,Fee Schedule,103% of WA Medicaid,151.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,265.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,674.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1989.27,69,,,percent of total billed charges,69% of total billed charges,2883,100,,,percent of total billed charges,100% of total billed charges,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2883,100,,,percent of total billed charges,100% of total billed charges,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2883,100,,,percent of total billed charges,100% of total billed charges,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1783.14,61.85,,,percent of total billed charges,61.85% of total billed charges,674.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,687.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,876.46,130,,,Fee Schedule,130% of WA Medicaid ,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1086.89,37.7,,,percent of total billed charges,37.70% of total billed charges,1086.89,37.7,,,percent of total billed charges,37.70% of total billed charges,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,97733.7,33.9,,,percent of total billed charges,33.9% of total billed charges,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2248.74,78,,,percent of total billed charges,78% of total billed charges,2883,100,,,percent of total billed charges,100% of total billed charges,2381.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2381.36,82.6,,,percent of total billed charges,82.6% of total billed charges,674.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,151.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,151.82,97733.7,
REVISION OF COLOSTOMY,44345,CDM,983,RC,44345,HCPCS,Outpatient,,,2824,1835.60,,2485.12,88,,,percent of total billed charges,88% of total Billed charges,127.22,100,,,Fee Schedule,100% of Medicare rate,591.76,100,,,Fee Schedule,100% of WA Medicaid,2824,100,,,percent of total billed charges,100% of total billed charges,609.51,103,,,Fee Schedule,103% of WA Medicaid,127.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,222.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,591.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1948.56,69,,,percent of total billed charges,69% of total billed charges,2824,100,,,percent of total billed charges,100% of total billed charges,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2824,100,,,percent of total billed charges,100% of total billed charges,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2824,100,,,percent of total billed charges,100% of total billed charges,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1746.64,61.85,,,percent of total billed charges,61.85% of total billed charges,591.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,603.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,769.29,130,,,Fee Schedule,130% of WA Medicaid ,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064.65,37.7,,,percent of total billed charges,37.70% of total billed charges,1064.65,37.7,,,percent of total billed charges,37.70% of total billed charges,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,95733.6,33.9,,,percent of total billed charges,33.9% of total billed charges,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2202.72,78,,,percent of total billed charges,78% of total billed charges,2824,100,,,percent of total billed charges,100% of total billed charges,2332.62,82.6,,,percent of total billed charges,82.6% of total billed charges,2332.62,82.6,,,percent of total billed charges,82.6% of total billed charges,591.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,127.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,127.22,95733.6,
REVISION OF COLOSTOMY,44340,CDM,983,RC,44340,HCPCS,Outpatient,,,1684,1094.60,,1481.92,88,,,percent of total billed charges,88% of total Billed charges,73.15,100,,,Fee Schedule,100% of Medicare rate,359.39,100,,,Fee Schedule,100% of WA Medicaid,1684,100,,,percent of total billed charges,100% of total billed charges,370.17,103,,,Fee Schedule,103% of WA Medicaid,73.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,128,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,359.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1161.96,69,,,percent of total billed charges,69% of total billed charges,1684,100,,,percent of total billed charges,100% of total billed charges,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1684,100,,,percent of total billed charges,100% of total billed charges,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1684,100,,,percent of total billed charges,100% of total billed charges,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1041.55,61.85,,,percent of total billed charges,61.85% of total billed charges,359.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,467.21,130,,,Fee Schedule,130% of WA Medicaid ,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.87,37.7,,,percent of total billed charges,37.70% of total billed charges,634.87,37.7,,,percent of total billed charges,37.70% of total billed charges,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,57087.6,33.9,,,percent of total billed charges,33.9% of total billed charges,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1313.52,78,,,percent of total billed charges,78% of total billed charges,1684,100,,,percent of total billed charges,100% of total billed charges,1390.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1390.98,82.6,,,percent of total billed charges,82.6% of total billed charges,359.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.15,57087.6,
REVISION OF COLOSTOMY,44346,CDM,983,RC,44346,HCPCS,Outpatient,,,3175,2063.75,,2794,88,,,percent of total billed charges,88% of total Billed charges,146.38,100,,,Fee Schedule,100% of Medicare rate,664.5,100,,,Fee Schedule,100% of WA Medicaid,3175,100,,,percent of total billed charges,100% of total billed charges,684.44,103,,,Fee Schedule,103% of WA Medicaid,146.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,256.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,664.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2190.75,69,,,percent of total billed charges,69% of total billed charges,3175,100,,,percent of total billed charges,100% of total billed charges,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3175,100,,,percent of total billed charges,100% of total billed charges,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3175,100,,,percent of total billed charges,100% of total billed charges,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1963.74,61.85,,,percent of total billed charges,61.85% of total billed charges,664.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,863.85,130,,,Fee Schedule,130% of WA Medicaid ,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1196.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1196.98,37.7,,,percent of total billed charges,37.70% of total billed charges,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,107632.5,33.9,,,percent of total billed charges,33.9% of total billed charges,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2476.5,78,,,percent of total billed charges,78% of total billed charges,3175,100,,,percent of total billed charges,100% of total billed charges,2622.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2622.55,82.6,,,percent of total billed charges,82.6% of total billed charges,664.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,146.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,146.38,107632.5,
SMALL BOWEL ENDOSCOPY,44373,CDM,983,RC,44373,HCPCS,Outpatient,,,1054,685.10,,927.52,88,,,percent of total billed charges,88% of total Billed charges,16.8,100,,,Fee Schedule,100% of Medicare rate,106.86,100,,,Fee Schedule,100% of WA Medicaid,1054,100,,,percent of total billed charges,100% of total billed charges,110.07,103,,,Fee Schedule,103% of WA Medicaid,16.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,106.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,727.26,69,,,percent of total billed charges,69% of total billed charges,1054,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1054,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1054,100,,,percent of total billed charges,100% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,651.9,61.85,,,percent of total billed charges,61.85% of total billed charges,106.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,109,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,138.92,130,,,Fee Schedule,130% of WA Medicaid ,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.36,37.7,,,percent of total billed charges,37.70% of total billed charges,397.36,37.7,,,percent of total billed charges,37.70% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,35730.6,33.9,,,percent of total billed charges,33.9% of total billed charges,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,822.12,78,,,percent of total billed charges,78% of total billed charges,1054,100,,,percent of total billed charges,100% of total billed charges,870.6,82.6,,,percent of total billed charges,82.6% of total billed charges,870.6,82.6,,,percent of total billed charges,82.6% of total billed charges,106.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.8,35730.6,
COLONOSCOPY,44388,CDM,983,RC,44388,HCPCS,Outpatient,,,948,616.20,,834.24,88,,,percent of total billed charges,88% of total Billed charges,15.25,100,,,Fee Schedule,100% of Medicare rate,87.28,100,,,Fee Schedule,100% of WA Medicaid,948,100,,,percent of total billed charges,100% of total billed charges,89.9,103,,,Fee Schedule,103% of WA Medicaid,15.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,87.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,654.12,69,,,percent of total billed charges,69% of total billed charges,948,100,,,percent of total billed charges,100% of total billed charges,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,948,100,,,percent of total billed charges,100% of total billed charges,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,948,100,,,percent of total billed charges,100% of total billed charges,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,586.34,61.85,,,percent of total billed charges,61.85% of total billed charges,87.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,113.46,130,,,Fee Schedule,130% of WA Medicaid ,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.4,37.7,,,percent of total billed charges,37.70% of total billed charges,357.4,37.7,,,percent of total billed charges,37.70% of total billed charges,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,32137.2,33.9,,,percent of total billed charges,33.9% of total billed charges,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,739.44,78,,,percent of total billed charges,78% of total billed charges,948,100,,,percent of total billed charges,100% of total billed charges,783.05,82.6,,,percent of total billed charges,82.6% of total billed charges,783.05,82.6,,,percent of total billed charges,82.6% of total billed charges,87.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.25,32137.2,
COLONOSCOPY W/BIOPSY THROUGH STOMA,44389,CDM,983,RC,44389,HCPCS,Outpatient,,,625,406.25,,550,88,,,percent of total billed charges,88% of total Billed charges,15.45,100,,,Fee Schedule,100% of Medicare rate,96.05,100,,,Fee Schedule,100% of WA Medicaid,625,100,,,percent of total billed charges,100% of total billed charges,98.93,103,,,Fee Schedule,103% of WA Medicaid,15.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,96.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,431.25,69,,,percent of total billed charges,69% of total billed charges,625,100,,,percent of total billed charges,100% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,625,100,,,percent of total billed charges,100% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,625,100,,,percent of total billed charges,100% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.56,61.85,,,percent of total billed charges,61.85% of total billed charges,96.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,124.87,130,,,Fee Schedule,130% of WA Medicaid ,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.63,37.7,,,percent of total billed charges,37.70% of total billed charges,235.63,37.7,,,percent of total billed charges,37.70% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,21187.5,33.9,,,percent of total billed charges,33.9% of total billed charges,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.5,78,,,percent of total billed charges,78% of total billed charges,625,100,,,percent of total billed charges,100% of total billed charges,516.25,82.6,,,percent of total billed charges,82.6% of total billed charges,516.25,82.6,,,percent of total billed charges,82.6% of total billed charges,96.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.45,21187.5,
COLONOSCOPY W/SNARE THROUGH STOMA,44394,CDM,983,RC,44394,HCPCS,Outpatient,,,470,305.50,,413.6,88,,,percent of total billed charges,88% of total Billed charges,20.66,100,,,Fee Schedule,100% of Medicare rate,125.89,100,,,Fee Schedule,100% of WA Medicaid,470,100,,,percent of total billed charges,100% of total billed charges,129.67,103,,,Fee Schedule,103% of WA Medicaid,20.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,125.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,324.3,69,,,percent of total billed charges,69% of total billed charges,470,100,,,percent of total billed charges,100% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,470,100,,,percent of total billed charges,100% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,470,100,,,percent of total billed charges,100% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.7,61.85,,,percent of total billed charges,61.85% of total billed charges,125.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,163.66,130,,,Fee Schedule,130% of WA Medicaid ,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.19,37.7,,,percent of total billed charges,37.70% of total billed charges,177.19,37.7,,,percent of total billed charges,37.70% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,15933,33.9,,,percent of total billed charges,33.9% of total billed charges,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.6,78,,,percent of total billed charges,78% of total billed charges,470,100,,,percent of total billed charges,100% of total billed charges,388.22,82.6,,,percent of total billed charges,82.6% of total billed charges,388.22,82.6,,,percent of total billed charges,82.6% of total billed charges,125.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.66,15933,
44392 Colonoscopy w/rem Polyp hot bx,44392,CDM,983,RC,44392,HCPCS,Outpatient,,,2522,1639.30,,2219.36,88,,,percent of total billed charges,88% of total Billed charges,21.44,100,,,Fee Schedule,100% of Medicare rate,111.34,100,,,Fee Schedule,100% of WA Medicaid,2522,100,,,percent of total billed charges,100% of total billed charges,114.68,103,,,Fee Schedule,103% of WA Medicaid,21.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,111.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1740.18,69,,,percent of total billed charges,69% of total billed charges,2522,100,,,percent of total billed charges,100% of total billed charges,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2522,100,,,percent of total billed charges,100% of total billed charges,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2522,100,,,percent of total billed charges,100% of total billed charges,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559.86,61.85,,,percent of total billed charges,61.85% of total billed charges,111.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,144.74,130,,,Fee Schedule,130% of WA Medicaid ,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,950.79,37.7,,,percent of total billed charges,37.70% of total billed charges,950.79,37.7,,,percent of total billed charges,37.70% of total billed charges,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,85495.8,33.9,,,percent of total billed charges,33.9% of total billed charges,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1967.16,78,,,percent of total billed charges,78% of total billed charges,2522,100,,,percent of total billed charges,100% of total billed charges,2083.17,82.6,,,percent of total billed charges,82.6% of total billed charges,2083.17,82.6,,,percent of total billed charges,82.6% of total billed charges,111.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.44,85495.8,
SUTURE SMALL INTESTINE,44602,CDM,983,RC,44602,HCPCS,Outpatient,,,2734,1777.10,,2405.92,88,,,percent of total billed charges,88% of total Billed charges,195.99,100,,,Fee Schedule,100% of Medicare rate,781.99,100,,,Fee Schedule,100% of WA Medicaid,2734,100,,,percent of total billed charges,100% of total billed charges,805.45,103,,,Fee Schedule,103% of WA Medicaid,195.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,342.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,781.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1886.46,69,,,percent of total billed charges,69% of total billed charges,2734,100,,,percent of total billed charges,100% of total billed charges,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2734,100,,,percent of total billed charges,100% of total billed charges,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2734,100,,,percent of total billed charges,100% of total billed charges,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1690.98,61.85,,,percent of total billed charges,61.85% of total billed charges,781.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,781.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,797.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1016.59,130,,,Fee Schedule,130% of WA Medicaid ,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1030.72,37.7,,,percent of total billed charges,37.70% of total billed charges,1030.72,37.7,,,percent of total billed charges,37.70% of total billed charges,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,92682.6,33.9,,,percent of total billed charges,33.9% of total billed charges,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2132.52,78,,,percent of total billed charges,78% of total billed charges,2734,100,,,percent of total billed charges,100% of total billed charges,2258.28,82.6,,,percent of total billed charges,82.6% of total billed charges,2258.28,82.6,,,percent of total billed charges,82.6% of total billed charges,781.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,195.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,781.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,195.99,92682.6,
SUTURE LARGE INTESTINE,44604,CDM,983,RC,44604,HCPCS,Outpatient,,,3071,1996.15,,2702.48,88,,,percent of total billed charges,88% of total Billed charges,140.09,100,,,Fee Schedule,100% of Medicare rate,588.97,100,,,Fee Schedule,100% of WA Medicaid,3071,100,,,percent of total billed charges,100% of total billed charges,606.64,103,,,Fee Schedule,103% of WA Medicaid,140.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,245.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,588.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2118.99,69,,,percent of total billed charges,69% of total billed charges,3071,100,,,percent of total billed charges,100% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3071,100,,,percent of total billed charges,100% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3071,100,,,percent of total billed charges,100% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1899.41,61.85,,,percent of total billed charges,61.85% of total billed charges,588.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,600.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,765.66,130,,,Fee Schedule,130% of WA Medicaid ,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1157.77,37.7,,,percent of total billed charges,37.70% of total billed charges,1157.77,37.7,,,percent of total billed charges,37.70% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,104106.9,33.9,,,percent of total billed charges,33.9% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2395.38,78,,,percent of total billed charges,78% of total billed charges,3071,100,,,percent of total billed charges,100% of total billed charges,2536.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2536.65,82.6,,,percent of total billed charges,82.6% of total billed charges,588.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.09,104106.9,
REPAIR BOWEL OPENING,44626,CDM,983,RC,44626,HCPCS,Outpatient,,,4370,2840.50,,3845.6,88,,,percent of total billed charges,88% of total Billed charges,207.91,100,,,Fee Schedule,100% of Medicare rate,885.13,100,,,Fee Schedule,100% of WA Medicaid,4370,100,,,percent of total billed charges,100% of total billed charges,911.68,103,,,Fee Schedule,103% of WA Medicaid,207.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,363.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,885.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3015.3,69,,,percent of total billed charges,69% of total billed charges,4370,100,,,percent of total billed charges,100% of total billed charges,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,4370,100,,,percent of total billed charges,100% of total billed charges,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,4370,100,,,percent of total billed charges,100% of total billed charges,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2702.85,61.85,,,percent of total billed charges,61.85% of total billed charges,885.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1150.67,130,,,Fee Schedule,130% of WA Medicaid ,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1647.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1647.49,37.7,,,percent of total billed charges,37.70% of total billed charges,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,148143,33.9,,,percent of total billed charges,33.9% of total billed charges,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3408.6,78,,,percent of total billed charges,78% of total billed charges,4370,100,,,percent of total billed charges,100% of total billed charges,3609.62,82.6,,,percent of total billed charges,82.6% of total billed charges,3609.62,82.6,,,percent of total billed charges,82.6% of total billed charges,885.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,207.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,207.91,148143,
REPAIR BOWEL OPENING,44625,CDM,983,RC,44625,HCPCS,Outpatient,,,2793,1815.45,,2457.84,88,,,percent of total billed charges,88% of total Billed charges,120.22,100,,,Fee Schedule,100% of Medicare rate,566.77,100,,,Fee Schedule,100% of WA Medicaid,2793,100,,,percent of total billed charges,100% of total billed charges,583.77,103,,,Fee Schedule,103% of WA Medicaid,120.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,210.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,566.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1927.17,69,,,percent of total billed charges,69% of total billed charges,2793,100,,,percent of total billed charges,100% of total billed charges,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2793,100,,,percent of total billed charges,100% of total billed charges,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2793,100,,,percent of total billed charges,100% of total billed charges,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1727.47,61.85,,,percent of total billed charges,61.85% of total billed charges,566.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,566.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,578.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,736.8,130,,,Fee Schedule,130% of WA Medicaid ,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1052.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1052.96,37.7,,,percent of total billed charges,37.70% of total billed charges,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,94682.7,33.9,,,percent of total billed charges,33.9% of total billed charges,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2178.54,78,,,percent of total billed charges,78% of total billed charges,2793,100,,,percent of total billed charges,100% of total billed charges,2307.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2307.02,82.6,,,percent of total billed charges,82.6% of total billed charges,566.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,120.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,566.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,120.22,94682.7,
REPAIR BOWEL OPENING,44620,CDM,983,RC,44620,HCPCS,Outpatient,,,2375,1543.75,,2090,88,,,percent of total billed charges,88% of total Billed charges,105.29,100,,,Fee Schedule,100% of Medicare rate,485.65,100,,,Fee Schedule,100% of WA Medicaid,2375,100,,,percent of total billed charges,100% of total billed charges,500.22,103,,,Fee Schedule,103% of WA Medicaid,105.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,184.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,485.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1638.75,69,,,percent of total billed charges,69% of total billed charges,2375,100,,,percent of total billed charges,100% of total billed charges,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2375,100,,,percent of total billed charges,100% of total billed charges,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,2375,100,,,percent of total billed charges,100% of total billed charges,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1468.94,61.85,,,percent of total billed charges,61.85% of total billed charges,485.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,631.35,130,,,Fee Schedule,130% of WA Medicaid ,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,895.38,37.7,,,percent of total billed charges,37.70% of total billed charges,895.38,37.7,,,percent of total billed charges,37.70% of total billed charges,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,80512.5,33.9,,,percent of total billed charges,33.9% of total billed charges,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1852.5,78,,,percent of total billed charges,78% of total billed charges,2375,100,,,percent of total billed charges,100% of total billed charges,1961.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1961.75,82.6,,,percent of total billed charges,82.6% of total billed charges,485.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,105.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105.29,80512.5,
REPAIR BOWEL-SKIN FISTULA,44640,CDM,983,RC,44640,HCPCS,Outpatient,,,2967,1928.55,,2610.96,88,,,percent of total billed charges,88% of total Billed charges,181.76,100,,,Fee Schedule,100% of Medicare rate,778.45,100,,,Fee Schedule,100% of WA Medicaid,2967,100,,,percent of total billed charges,100% of total billed charges,801.8,103,,,Fee Schedule,103% of WA Medicaid,181.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,318.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,778.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2047.23,69,,,percent of total billed charges,69% of total billed charges,2967,100,,,percent of total billed charges,100% of total billed charges,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2967,100,,,percent of total billed charges,100% of total billed charges,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2967,100,,,percent of total billed charges,100% of total billed charges,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1835.09,61.85,,,percent of total billed charges,61.85% of total billed charges,778.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,794.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1011.99,130,,,Fee Schedule,130% of WA Medicaid ,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1118.56,37.7,,,percent of total billed charges,37.70% of total billed charges,1118.56,37.7,,,percent of total billed charges,37.70% of total billed charges,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,100581.3,33.9,,,percent of total billed charges,33.9% of total billed charges,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2314.26,78,,,percent of total billed charges,78% of total billed charges,2967,100,,,percent of total billed charges,100% of total billed charges,2450.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2450.74,82.6,,,percent of total billed charges,82.6% of total billed charges,778.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,181.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,181.76,100581.3,
REPAIR BOWEL FISTULA,44650,CDM,983,RC,44650,HCPCS,Outpatient,,,3877,2520.05,,3411.76,88,,,percent of total billed charges,88% of total Billed charges,183.58,100,,,Fee Schedule,100% of Medicare rate,803.07,100,,,Fee Schedule,100% of WA Medicaid,3877,100,,,percent of total billed charges,100% of total billed charges,827.16,103,,,Fee Schedule,103% of WA Medicaid,183.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,321.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,803.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2675.13,69,,,percent of total billed charges,69% of total billed charges,3877,100,,,percent of total billed charges,100% of total billed charges,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3877,100,,,percent of total billed charges,100% of total billed charges,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3877,100,,,percent of total billed charges,100% of total billed charges,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2397.92,61.85,,,percent of total billed charges,61.85% of total billed charges,803.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,803.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,819.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1043.99,130,,,Fee Schedule,130% of WA Medicaid ,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1461.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1461.63,37.7,,,percent of total billed charges,37.70% of total billed charges,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,131430.3,33.9,,,percent of total billed charges,33.9% of total billed charges,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3024.06,78,,,percent of total billed charges,78% of total billed charges,3877,100,,,percent of total billed charges,100% of total billed charges,3202.4,82.6,,,percent of total billed charges,82.6% of total billed charges,3202.4,82.6,,,percent of total billed charges,82.6% of total billed charges,803.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,183.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,803.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,183.58,131430.3,
REPAIR BOWEL-BLADDER FISTULA,44660,CDM,983,RC,44660,HCPCS,Outpatient,,,3606,2343.90,,3173.28,88,,,percent of total billed charges,88% of total Billed charges,160.55,100,,,Fee Schedule,100% of Medicare rate,750.1,100,,,Fee Schedule,100% of WA Medicaid,3606,100,,,percent of total billed charges,100% of total billed charges,772.6,103,,,Fee Schedule,103% of WA Medicaid,160.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,280.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,750.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2488.14,69,,,percent of total billed charges,69% of total billed charges,3606,100,,,percent of total billed charges,100% of total billed charges,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3606,100,,,percent of total billed charges,100% of total billed charges,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3606,100,,,percent of total billed charges,100% of total billed charges,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2230.31,61.85,,,percent of total billed charges,61.85% of total billed charges,750.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,750.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,975.13,130,,,Fee Schedule,130% of WA Medicaid ,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1359.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1359.46,37.7,,,percent of total billed charges,37.70% of total billed charges,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,122243.4,33.9,,,percent of total billed charges,33.9% of total billed charges,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2812.68,78,,,percent of total billed charges,78% of total billed charges,3606,100,,,percent of total billed charges,100% of total billed charges,2978.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2978.56,82.6,,,percent of total billed charges,82.6% of total billed charges,750.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,160.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,750.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,160.55,122243.4,
REPAIR BOWEL-BLADDER FISTULA,44661,CDM,983,RC,44661,HCPCS,Outpatient,,,4285,2785.25,,3770.8,88,,,percent of total billed charges,88% of total Billed charges,192.77,100,,,Fee Schedule,100% of Medicare rate,859.02,100,,,Fee Schedule,100% of WA Medicaid,4285,100,,,percent of total billed charges,100% of total billed charges,884.79,103,,,Fee Schedule,103% of WA Medicaid,192.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,337.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,859.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2956.65,69,,,percent of total billed charges,69% of total billed charges,4285,100,,,percent of total billed charges,100% of total billed charges,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,4285,100,,,percent of total billed charges,100% of total billed charges,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,4285,100,,,percent of total billed charges,100% of total billed charges,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2650.27,61.85,,,percent of total billed charges,61.85% of total billed charges,859.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1116.73,130,,,Fee Schedule,130% of WA Medicaid ,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1615.45,37.7,,,percent of total billed charges,37.70% of total billed charges,1615.45,37.7,,,percent of total billed charges,37.70% of total billed charges,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,145261.5,33.9,,,percent of total billed charges,33.9% of total billed charges,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,3342.3,78,,,percent of total billed charges,78% of total billed charges,4285,100,,,percent of total billed charges,100% of total billed charges,3539.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3539.41,82.6,,,percent of total billed charges,82.6% of total billed charges,859.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,192.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,192.77,145261.5,
UNLISTED PROCEDURE INTESTINE,44799,CDM,983,RC,44799,HCPCS,Outpatient,,,3600,2340.00,,3168,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2484,69,,,percent of total billed charges,69% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3600,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2226.6,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1357.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1357.2,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,122040,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2808,78,,,percent of total billed charges,78% of total billed charges,3600,100,,,percent of total billed charges,100% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2973.6,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1357.2,122040,
EXCISION OF BOWEL POUCH,44800,CDM,983,RC,44800,HCPCS,Outpatient,,,3016,1960.40,,2654.08,88,,,percent of total billed charges,88% of total Billed charges,98.46,100,,,Fee Schedule,100% of Medicare rate,440.33,100,,,Fee Schedule,100% of WA Medicaid,3016,100,,,percent of total billed charges,100% of total billed charges,453.54,103,,,Fee Schedule,103% of WA Medicaid,98.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,172.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,440.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2081.04,69,,,percent of total billed charges,69% of total billed charges,3016,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3016,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3016,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1865.4,61.85,,,percent of total billed charges,61.85% of total billed charges,440.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,572.43,130,,,Fee Schedule,130% of WA Medicaid ,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1137.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1137.03,37.7,,,percent of total billed charges,37.70% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,102242.4,33.9,,,percent of total billed charges,33.9% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2352.48,78,,,percent of total billed charges,78% of total billed charges,3016,100,,,percent of total billed charges,100% of total billed charges,2491.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2491.22,82.6,,,percent of total billed charges,82.6% of total billed charges,440.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.46,102242.4,
EXCISION OF MESENTERY LESION,44820,CDM,983,RC,44820,HCPCS,Outpatient,,,2291,1489.15,,2016.08,88,,,percent of total billed charges,88% of total Billed charges,117.15,100,,,Fee Schedule,100% of Medicare rate,479.49,100,,,Fee Schedule,100% of WA Medicaid,2291,100,,,percent of total billed charges,100% of total billed charges,493.87,103,,,Fee Schedule,103% of WA Medicaid,117.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,205.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,479.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1580.79,69,,,percent of total billed charges,69% of total billed charges,2291,100,,,percent of total billed charges,100% of total billed charges,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2291,100,,,percent of total billed charges,100% of total billed charges,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2291,100,,,percent of total billed charges,100% of total billed charges,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1416.98,61.85,,,percent of total billed charges,61.85% of total billed charges,479.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,623.34,130,,,Fee Schedule,130% of WA Medicaid ,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.71,37.7,,,percent of total billed charges,37.70% of total billed charges,863.71,37.7,,,percent of total billed charges,37.70% of total billed charges,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,77664.9,33.9,,,percent of total billed charges,33.9% of total billed charges,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1786.98,78,,,percent of total billed charges,78% of total billed charges,2291,100,,,percent of total billed charges,100% of total billed charges,1892.37,82.6,,,percent of total billed charges,82.6% of total billed charges,1892.37,82.6,,,percent of total billed charges,82.6% of total billed charges,479.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,117.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.15,77664.9,
REPAIR OF MESENTERY,44850,CDM,983,RC,44850,HCPCS,Outpatient,,,2042,1327.30,,1796.96,88,,,percent of total billed charges,88% of total Billed charges,96.48,100,,,Fee Schedule,100% of Medicare rate,422.24,100,,,Fee Schedule,100% of WA Medicaid,2042,100,,,percent of total billed charges,100% of total billed charges,434.91,103,,,Fee Schedule,103% of WA Medicaid,96.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,168.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,422.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1408.98,69,,,percent of total billed charges,69% of total billed charges,2042,100,,,percent of total billed charges,100% of total billed charges,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2042,100,,,percent of total billed charges,100% of total billed charges,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2042,100,,,percent of total billed charges,100% of total billed charges,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262.98,61.85,,,percent of total billed charges,61.85% of total billed charges,422.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,548.91,130,,,Fee Schedule,130% of WA Medicaid ,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,769.83,37.7,,,percent of total billed charges,37.70% of total billed charges,769.83,37.7,,,percent of total billed charges,37.70% of total billed charges,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,69223.8,33.9,,,percent of total billed charges,33.9% of total billed charges,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1592.76,78,,,percent of total billed charges,78% of total billed charges,2042,100,,,percent of total billed charges,100% of total billed charges,1686.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1686.69,82.6,,,percent of total billed charges,82.6% of total billed charges,422.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.48,69223.8,
DRAIN APPENDIX ABSCESS OPEN,44900,CDM,983,RC,44900,HCPCS,Outpatient,,,2105,1368.25,,1852.4,88,,,percent of total billed charges,88% of total Billed charges,107.12,100,,,Fee Schedule,100% of Medicare rate,441.82,100,,,Fee Schedule,100% of WA Medicaid,2105,100,,,percent of total billed charges,100% of total billed charges,455.07,103,,,Fee Schedule,103% of WA Medicaid,107.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,187.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,441.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1452.45,69,,,percent of total billed charges,69% of total billed charges,2105,100,,,percent of total billed charges,100% of total billed charges,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2105,100,,,percent of total billed charges,100% of total billed charges,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2105,100,,,percent of total billed charges,100% of total billed charges,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1301.94,61.85,,,percent of total billed charges,61.85% of total billed charges,441.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,574.37,130,,,Fee Schedule,130% of WA Medicaid ,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,793.59,37.7,,,percent of total billed charges,37.70% of total billed charges,793.59,37.7,,,percent of total billed charges,37.70% of total billed charges,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,71359.5,33.9,,,percent of total billed charges,33.9% of total billed charges,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1641.9,78,,,percent of total billed charges,78% of total billed charges,2105,100,,,percent of total billed charges,100% of total billed charges,1738.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1738.73,82.6,,,percent of total billed charges,82.6% of total billed charges,441.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.12,71359.5,
APPENDECTOMY ADD-ON,44955,CDM,983,RC,44955,HCPCS,Outpatient,,,649,421.85,,571.12,88,,,percent of total billed charges,88% of total Billed charges,11.26,100,,,Fee Schedule,100% of Medicare rate,46.07,100,,,Fee Schedule,100% of WA Medicaid,649,100,,,percent of total billed charges,100% of total billed charges,47.45,103,,,Fee Schedule,103% of WA Medicaid,11.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,447.81,69,,,percent of total billed charges,69% of total billed charges,649,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,649,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,649,100,,,percent of total billed charges,100% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.41,61.85,,,percent of total billed charges,61.85% of total billed charges,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.89,130,,,Fee Schedule,130% of WA Medicaid ,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.67,37.7,,,percent of total billed charges,37.70% of total billed charges,244.67,37.7,,,percent of total billed charges,37.70% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,22001.1,33.9,,,percent of total billed charges,33.9% of total billed charges,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,506.22,78,,,percent of total billed charges,78% of total billed charges,649,100,,,percent of total billed charges,100% of total billed charges,536.07,82.6,,,percent of total billed charges,82.6% of total billed charges,536.07,82.6,,,percent of total billed charges,82.6% of total billed charges,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.26,22001.1,
APPENDECTOMY,44950,CDM,983,RC,44950,HCPCS,Outpatient,,,2041,1326.65,,1796.08,88,,,percent of total billed charges,88% of total Billed charges,86.79,100,,,Fee Schedule,100% of Medicare rate,361.25,100,,,Fee Schedule,100% of WA Medicaid,2041,100,,,percent of total billed charges,100% of total billed charges,372.09,103,,,Fee Schedule,103% of WA Medicaid,86.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,151.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,361.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1408.29,69,,,percent of total billed charges,69% of total billed charges,2041,100,,,percent of total billed charges,100% of total billed charges,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2041,100,,,percent of total billed charges,100% of total billed charges,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,2041,100,,,percent of total billed charges,100% of total billed charges,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262.36,61.85,,,percent of total billed charges,61.85% of total billed charges,361.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,469.63,130,,,Fee Schedule,130% of WA Medicaid ,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,769.46,37.7,,,percent of total billed charges,37.70% of total billed charges,769.46,37.7,,,percent of total billed charges,37.70% of total billed charges,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,69189.9,33.9,,,percent of total billed charges,33.9% of total billed charges,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1591.98,78,,,percent of total billed charges,78% of total billed charges,2041,100,,,percent of total billed charges,100% of total billed charges,1685.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1685.87,82.6,,,percent of total billed charges,82.6% of total billed charges,361.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,86.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.79,69189.9,
APPENDECTOMY,44960,CDM,983,RC,44960,HCPCS,Outpatient,,,2452,1593.80,,2157.76,88,,,percent of total billed charges,88% of total Billed charges,120.18,100,,,Fee Schedule,100% of Medicare rate,492.36,100,,,Fee Schedule,100% of WA Medicaid,2452,100,,,percent of total billed charges,100% of total billed charges,507.13,103,,,Fee Schedule,103% of WA Medicaid,120.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,210.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,492.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1691.88,69,,,percent of total billed charges,69% of total billed charges,2452,100,,,percent of total billed charges,100% of total billed charges,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2452,100,,,percent of total billed charges,100% of total billed charges,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2452,100,,,percent of total billed charges,100% of total billed charges,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1516.56,61.85,,,percent of total billed charges,61.85% of total billed charges,492.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,640.07,130,,,Fee Schedule,130% of WA Medicaid ,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,924.4,37.7,,,percent of total billed charges,37.70% of total billed charges,924.4,37.7,,,percent of total billed charges,37.70% of total billed charges,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,83122.8,33.9,,,percent of total billed charges,33.9% of total billed charges,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1912.56,78,,,percent of total billed charges,78% of total billed charges,2452,100,,,percent of total billed charges,100% of total billed charges,2025.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2025.35,82.6,,,percent of total billed charges,82.6% of total billed charges,492.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,120.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,120.18,83122.8,
LAPAROSCOPY APPENDECTOMY,44970,CDM,983,RC,44970,HCPCS,Outpatient,,,1739,1130.35,,1530.32,88,,,percent of total billed charges,88% of total Billed charges,78.71,100,,,Fee Schedule,100% of Medicare rate,341.3,100,,,Fee Schedule,100% of WA Medicaid,1739,100,,,percent of total billed charges,100% of total billed charges,351.54,103,,,Fee Schedule,103% of WA Medicaid,78.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,341.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1199.91,69,,,percent of total billed charges,69% of total billed charges,1739,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1739,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1739,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1075.57,61.85,,,percent of total billed charges,61.85% of total billed charges,341.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,443.69,130,,,Fee Schedule,130% of WA Medicaid ,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,655.6,37.7,,,percent of total billed charges,37.70% of total billed charges,655.6,37.7,,,percent of total billed charges,37.70% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,58952.1,33.9,,,percent of total billed charges,33.9% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1356.42,78,,,percent of total billed charges,78% of total billed charges,1739,100,,,percent of total billed charges,100% of total billed charges,1436.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1436.41,82.6,,,percent of total billed charges,82.6% of total billed charges,341.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.71,58952.1,
DRAINAGE OF RECTAL ABSCESS,45005,CDM,983,RC,45005,HCPCS,Outpatient,,,658,427.70,,579.04,88,,,percent of total billed charges,88% of total Billed charges,18.24,100,,,Fee Schedule,100% of Medicare rate,95.3,100,,,Fee Schedule,100% of WA Medicaid,658,100,,,percent of total billed charges,100% of total billed charges,98.16,103,,,Fee Schedule,103% of WA Medicaid,18.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,95.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,454.02,69,,,percent of total billed charges,69% of total billed charges,658,100,,,percent of total billed charges,100% of total billed charges,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,658,100,,,percent of total billed charges,100% of total billed charges,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,658,100,,,percent of total billed charges,100% of total billed charges,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.97,61.85,,,percent of total billed charges,61.85% of total billed charges,95.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,123.89,130,,,Fee Schedule,130% of WA Medicaid ,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.07,37.7,,,percent of total billed charges,37.70% of total billed charges,248.07,37.7,,,percent of total billed charges,37.70% of total billed charges,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,22306.2,33.9,,,percent of total billed charges,33.9% of total billed charges,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.24,78,,,percent of total billed charges,78% of total billed charges,658,100,,,percent of total billed charges,100% of total billed charges,543.51,82.6,,,percent of total billed charges,82.6% of total billed charges,543.51,82.6,,,percent of total billed charges,82.6% of total billed charges,95.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.24,22306.2,
DRAINAGE OF PELVIC ABSCESS,45000,CDM,983,RC,45000,HCPCS,Outpatient,,,1177.85,765.60,,1036.51,88,,,percent of total billed charges,88% of total Billed charges,43.32,100,,,Fee Schedule,100% of Medicare rate,246.37,100,,,Fee Schedule,100% of WA Medicaid,1177.85,100,,,percent of total billed charges,100% of total billed charges,253.76,103,,,Fee Schedule,103% of WA Medicaid,43.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,246.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,812.72,69,,,percent of total billed charges,69% of total billed charges,1177.85,100,,,percent of total billed charges,100% of total billed charges,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1177.85,100,,,percent of total billed charges,100% of total billed charges,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1177.85,100,,,percent of total billed charges,100% of total billed charges,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,728.5,61.85,,,percent of total billed charges,61.85% of total billed charges,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,320.28,130,,,Fee Schedule,130% of WA Medicaid ,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.05,37.7,,,percent of total billed charges,37.70% of total billed charges,444.05,37.7,,,percent of total billed charges,37.70% of total billed charges,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,39929.12,33.9,,,percent of total billed charges,33.9% of total billed charges,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,918.72,78,,,percent of total billed charges,78% of total billed charges,1177.85,100,,,percent of total billed charges,100% of total billed charges,972.9,82.6,,,percent of total billed charges,82.6% of total billed charges,972.9,82.6,,,percent of total billed charges,82.6% of total billed charges,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.32,39929.12,
DRAINAGE OF RECTAL ABSCESS,45020,CDM,983,RC,45020,HCPCS,Outpatient,,,1095,711.75,,963.6,88,,,percent of total billed charges,88% of total Billed charges,59.15,100,,,Fee Schedule,100% of Medicare rate,325.26,100,,,Fee Schedule,100% of WA Medicaid,1095,100,,,percent of total billed charges,100% of total billed charges,335.02,103,,,Fee Schedule,103% of WA Medicaid,59.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,325.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,755.55,69,,,percent of total billed charges,69% of total billed charges,1095,100,,,percent of total billed charges,100% of total billed charges,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1095,100,,,percent of total billed charges,100% of total billed charges,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1095,100,,,percent of total billed charges,100% of total billed charges,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,677.26,61.85,,,percent of total billed charges,61.85% of total billed charges,325.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,422.84,130,,,Fee Schedule,130% of WA Medicaid ,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.82,37.7,,,percent of total billed charges,37.70% of total billed charges,412.82,37.7,,,percent of total billed charges,37.70% of total billed charges,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,37120.5,33.9,,,percent of total billed charges,33.9% of total billed charges,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,854.1,78,,,percent of total billed charges,78% of total billed charges,1095,100,,,percent of total billed charges,100% of total billed charges,904.47,82.6,,,percent of total billed charges,82.6% of total billed charges,904.47,82.6,,,percent of total billed charges,82.6% of total billed charges,325.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.15,37120.5,
BIOPSY OF RECTUM,45100,CDM,983,RC,45100,HCPCS,Outpatient,,,829,538.85,,729.52,88,,,percent of total billed charges,88% of total Billed charges,28.68,100,,,Fee Schedule,100% of Medicare rate,175.5,100,,,Fee Schedule,100% of WA Medicaid,829,100,,,percent of total billed charges,100% of total billed charges,180.77,103,,,Fee Schedule,103% of WA Medicaid,28.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,50.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,175.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,572.01,69,,,percent of total billed charges,69% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,829,100,,,percent of total billed charges,100% of total billed charges,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,829,100,,,percent of total billed charges,100% of total billed charges,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.74,61.85,,,percent of total billed charges,61.85% of total billed charges,175.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,228.15,130,,,Fee Schedule,130% of WA Medicaid ,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,312.53,37.7,,,percent of total billed charges,37.70% of total billed charges,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,28103.1,33.9,,,percent of total billed charges,33.9% of total billed charges,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.62,78,,,percent of total billed charges,78% of total billed charges,829,100,,,percent of total billed charges,100% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,684.75,82.6,,,percent of total billed charges,82.6% of total billed charges,175.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.68,28103.1,
REMOVAL OF RECTUM,45112,CDM,983,RC,45112,HCPCS,Outpatient,,,5181,3367.65,,4559.28,88,,,percent of total billed charges,88% of total Billed charges,170.49,100,,,Fee Schedule,100% of Medicare rate,1017.36,100,,,Fee Schedule,100% of WA Medicaid,5181,100,,,percent of total billed charges,100% of total billed charges,1047.88,103,,,Fee Schedule,103% of WA Medicaid,170.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,298.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1017.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3574.89,69,,,percent of total billed charges,69% of total billed charges,5181,100,,,percent of total billed charges,100% of total billed charges,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,5181,100,,,percent of total billed charges,100% of total billed charges,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,5181,100,,,percent of total billed charges,100% of total billed charges,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3204.45,61.85,,,percent of total billed charges,61.85% of total billed charges,1017.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1037.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1322.57,130,,,Fee Schedule,130% of WA Medicaid ,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1953.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1953.24,37.7,,,percent of total billed charges,37.70% of total billed charges,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,175635.9,33.9,,,percent of total billed charges,33.9% of total billed charges,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4041.18,78,,,percent of total billed charges,78% of total billed charges,5181,100,,,percent of total billed charges,100% of total billed charges,4279.51,82.6,,,percent of total billed charges,82.6% of total billed charges,4279.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1017.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,170.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,170.49,175635.9,
REMOVAL OF RECTUM,45110,CDM,983,RC,45110,HCPCS,Outpatient,,,4990,3243.50,,4391.2,88,,,percent of total billed charges,88% of total Billed charges,196.79,100,,,Fee Schedule,100% of Medicare rate,1020.16,100,,,Fee Schedule,100% of WA Medicaid,4990,100,,,percent of total billed charges,100% of total billed charges,1050.76,103,,,Fee Schedule,103% of WA Medicaid,196.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,344.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1020.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3443.1,69,,,percent of total billed charges,69% of total billed charges,4990,100,,,percent of total billed charges,100% of total billed charges,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,4990,100,,,percent of total billed charges,100% of total billed charges,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,4990,100,,,percent of total billed charges,100% of total billed charges,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3086.32,61.85,,,percent of total billed charges,61.85% of total billed charges,1020.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1040.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1326.21,130,,,Fee Schedule,130% of WA Medicaid ,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1881.23,37.7,,,percent of total billed charges,37.70% of total billed charges,1881.23,37.7,,,percent of total billed charges,37.70% of total billed charges,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,169161,33.9,,,percent of total billed charges,33.9% of total billed charges,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3892.2,78,,,percent of total billed charges,78% of total billed charges,4990,100,,,percent of total billed charges,100% of total billed charges,4121.74,82.6,,,percent of total billed charges,82.6% of total billed charges,4121.74,82.6,,,percent of total billed charges,82.6% of total billed charges,1020.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,196.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,196.79,169161,
EXC RECT TUM TRANSANAL PART,45171,CDM,983,RC,45171,HCPCS,Outpatient,,,1565.55,1017.61,,1377.68,88,,,percent of total billed charges,88% of total Billed charges,58.88,100,,,Fee Schedule,100% of Medicare rate,355.47,100,,,Fee Schedule,100% of WA Medicaid,1565.55,100,,,percent of total billed charges,100% of total billed charges,366.13,103,,,Fee Schedule,103% of WA Medicaid,58.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,355.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1080.23,69,,,percent of total billed charges,69% of total billed charges,1565.55,100,,,percent of total billed charges,100% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1565.55,100,,,percent of total billed charges,100% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1565.55,100,,,percent of total billed charges,100% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,968.29,61.85,,,percent of total billed charges,61.85% of total billed charges,355.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,462.11,130,,,Fee Schedule,130% of WA Medicaid ,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.21,37.7,,,percent of total billed charges,37.70% of total billed charges,590.21,37.7,,,percent of total billed charges,37.70% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,53072.15,33.9,,,percent of total billed charges,33.9% of total billed charges,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1221.13,78,,,percent of total billed charges,78% of total billed charges,1565.55,100,,,percent of total billed charges,100% of total billed charges,1293.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1293.14,82.6,,,percent of total billed charges,82.6% of total billed charges,355.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.88,53072.15,
PROCTOSIGMOIDOSCOPY W/BX,45305,CDM,983,RC,45305,HCPCS,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,7.37,100,,,Fee Schedule,100% of Medicare rate,41.4,100,,,Fee Schedule,100% of WA Medicaid,300,100,,,percent of total billed charges,100% of total billed charges,42.64,103,,,Fee Schedule,103% of WA Medicaid,7.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,41.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,300,100,,,percent of total billed charges,100% of total billed charges,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,300,100,,,percent of total billed charges,100% of total billed charges,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,41.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.82,130,,,Fee Schedule,130% of WA Medicaid ,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.1,37.7,,,percent of total billed charges,37.70% of total billed charges,113.1,37.7,,,percent of total billed charges,37.70% of total billed charges,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,10170,33.9,,,percent of total billed charges,33.9% of total billed charges,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,41.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.37,10170,
PROCTOSIGMOIDOSCOPY REMOVAL,45309,CDM,983,RC,45309,HCPCS,Outpatient,,,513,333.45,,451.44,88,,,percent of total billed charges,88% of total Billed charges,12,100,,,Fee Schedule,100% of Medicare rate,50.36,100,,,Fee Schedule,100% of WA Medicaid,513,100,,,percent of total billed charges,100% of total billed charges,51.87,103,,,Fee Schedule,103% of WA Medicaid,12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,50.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,353.97,69,,,percent of total billed charges,69% of total billed charges,513,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,513,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,513,100,,,percent of total billed charges,100% of total billed charges,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.29,61.85,,,percent of total billed charges,61.85% of total billed charges,50.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,65.47,130,,,Fee Schedule,130% of WA Medicaid ,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.4,37.7,,,percent of total billed charges,37.70% of total billed charges,193.4,37.7,,,percent of total billed charges,37.70% of total billed charges,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,17390.7,33.9,,,percent of total billed charges,33.9% of total billed charges,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.14,78,,,percent of total billed charges,78% of total billed charges,513,100,,,percent of total billed charges,100% of total billed charges,423.74,82.6,,,percent of total billed charges,82.6% of total billed charges,423.74,82.6,,,percent of total billed charges,82.6% of total billed charges,50.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,12,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12,17390.7,
PROCTOSIGMOIDOSCOPY DX,45300,CDM,983,RC,45300,HCPCS,Outpatient,,,223,144.95,,196.24,88,,,percent of total billed charges,88% of total Billed charges,4.81,100,,,Fee Schedule,100% of Medicare rate,27.23,100,,,Fee Schedule,100% of WA Medicaid,223,100,,,percent of total billed charges,100% of total billed charges,28.05,103,,,Fee Schedule,103% of WA Medicaid,4.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,153.87,69,,,percent of total billed charges,69% of total billed charges,223,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,223,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,223,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.93,61.85,,,percent of total billed charges,61.85% of total billed charges,27.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.4,130,,,Fee Schedule,130% of WA Medicaid ,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.07,37.7,,,percent of total billed charges,37.70% of total billed charges,84.07,37.7,,,percent of total billed charges,37.70% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,7559.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.94,78,,,percent of total billed charges,78% of total billed charges,223,100,,,percent of total billed charges,100% of total billed charges,184.2,82.6,,,percent of total billed charges,82.6% of total billed charges,184.2,82.6,,,percent of total billed charges,82.6% of total billed charges,27.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,7559.7,
PROCTOSIGMOIDOSCOPY DILATE,45303,CDM,983,RC,45303,HCPCS,Outpatient,,,208,135.20,,183.04,88,,,percent of total billed charges,88% of total Billed charges,8.78,100,,,Fee Schedule,100% of Medicare rate,48.49,100,,,Fee Schedule,100% of WA Medicaid,208,100,,,percent of total billed charges,100% of total billed charges,49.94,103,,,Fee Schedule,103% of WA Medicaid,8.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,143.52,69,,,percent of total billed charges,69% of total billed charges,208,100,,,percent of total billed charges,100% of total billed charges,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,208,100,,,percent of total billed charges,100% of total billed charges,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,208,100,,,percent of total billed charges,100% of total billed charges,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.65,61.85,,,percent of total billed charges,61.85% of total billed charges,48.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.04,130,,,Fee Schedule,130% of WA Medicaid ,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.42,37.7,,,percent of total billed charges,37.70% of total billed charges,78.42,37.7,,,percent of total billed charges,37.70% of total billed charges,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,7051.2,33.9,,,percent of total billed charges,33.9% of total billed charges,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.24,78,,,percent of total billed charges,78% of total billed charges,208,100,,,percent of total billed charges,100% of total billed charges,171.81,82.6,,,percent of total billed charges,82.6% of total billed charges,171.81,82.6,,,percent of total billed charges,82.6% of total billed charges,48.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.78,7051.2,
PROCTOSIGMOIDOSCOPY FB,45307,CDM,983,RC,45307,HCPCS,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,13.35,100,,,Fee Schedule,100% of Medicare rate,56.32,100,,,Fee Schedule,100% of WA Medicaid,167,100,,,percent of total billed charges,100% of total billed charges,58.01,103,,,Fee Schedule,103% of WA Medicaid,13.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,167,100,,,percent of total billed charges,100% of total billed charges,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,167,100,,,percent of total billed charges,100% of total billed charges,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.29,61.85,,,percent of total billed charges,61.85% of total billed charges,56.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,73.22,130,,,Fee Schedule,130% of WA Medicaid ,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,5661.3,33.9,,,percent of total billed charges,33.9% of total billed charges,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,56.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.35,5661.3,
PROCTOSIGMOIDOSCOPY REMOVAL,45315,CDM,983,RC,45315,HCPCS,Outpatient,,,633,411.45,,557.04,88,,,percent of total billed charges,88% of total Billed charges,14.29,100,,,Fee Schedule,100% of Medicare rate,59.31,100,,,Fee Schedule,100% of WA Medicaid,633,100,,,percent of total billed charges,100% of total billed charges,61.09,103,,,Fee Schedule,103% of WA Medicaid,14.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,436.77,69,,,percent of total billed charges,69% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,633,100,,,percent of total billed charges,100% of total billed charges,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,633,100,,,percent of total billed charges,100% of total billed charges,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.51,61.85,,,percent of total billed charges,61.85% of total billed charges,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,77.1,130,,,Fee Schedule,130% of WA Medicaid ,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,21458.7,33.9,,,percent of total billed charges,33.9% of total billed charges,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,493.74,78,,,percent of total billed charges,78% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.29,21458.7,
PROCTOSIGMOIDOSCOPY ABLATE,45320,CDM,983,RC,45320,HCPCS,Outpatient,,,436,283.40,,383.68,88,,,percent of total billed charges,88% of total Billed charges,14,100,,,Fee Schedule,100% of Medicare rate,58.75,100,,,Fee Schedule,100% of WA Medicaid,436,100,,,percent of total billed charges,100% of total billed charges,60.51,103,,,Fee Schedule,103% of WA Medicaid,14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,300.84,69,,,percent of total billed charges,69% of total billed charges,436,100,,,percent of total billed charges,100% of total billed charges,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,436,100,,,percent of total billed charges,100% of total billed charges,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,436,100,,,percent of total billed charges,100% of total billed charges,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.67,61.85,,,percent of total billed charges,61.85% of total billed charges,58.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.38,130,,,Fee Schedule,130% of WA Medicaid ,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.37,37.7,,,percent of total billed charges,37.70% of total billed charges,164.37,37.7,,,percent of total billed charges,37.70% of total billed charges,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,14780.4,33.9,,,percent of total billed charges,33.9% of total billed charges,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.08,78,,,percent of total billed charges,78% of total billed charges,436,100,,,percent of total billed charges,100% of total billed charges,360.14,82.6,,,percent of total billed charges,82.6% of total billed charges,360.14,82.6,,,percent of total billed charges,82.6% of total billed charges,58.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,14,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14,14780.4,
DIAGNOSTIC SIGMOIDOSCOPY,45330,CDM,983,RC,45330,HCPCS,Outpatient,,,307,199.55,,270.16,88,,,percent of total billed charges,88% of total Billed charges,4.81,100,,,Fee Schedule,100% of Medicare rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,307,100,,,percent of total billed charges,100% of total billed charges,33.23,103,,,Fee Schedule,103% of WA Medicaid,4.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,211.83,69,,,percent of total billed charges,69% of total billed charges,307,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,307,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,307,100,,,percent of total billed charges,100% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.88,61.85,,,percent of total billed charges,61.85% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.94,130,,,Fee Schedule,130% of WA Medicaid ,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.74,37.7,,,percent of total billed charges,37.70% of total billed charges,115.74,37.7,,,percent of total billed charges,37.70% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,10407.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.46,78,,,percent of total billed charges,78% of total billed charges,307,100,,,percent of total billed charges,100% of total billed charges,253.58,82.6,,,percent of total billed charges,82.6% of total billed charges,253.58,82.6,,,percent of total billed charges,82.6% of total billed charges,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,10407.3,
SIGMOIDOSCOPY  POLYPECTOMY,45333,CDM,983,RC,45333,HCPCS,Outpatient,,,622,404.30,,547.36,88,,,percent of total billed charges,88% of total Billed charges,9.03,100,,,Fee Schedule,100% of Medicare rate,53.15,100,,,Fee Schedule,100% of WA Medicaid,622,100,,,percent of total billed charges,100% of total billed charges,54.74,103,,,Fee Schedule,103% of WA Medicaid,9.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,53.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,429.18,69,,,percent of total billed charges,69% of total billed charges,622,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,622,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,622,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.71,61.85,,,percent of total billed charges,61.85% of total billed charges,53.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,69.1,130,,,Fee Schedule,130% of WA Medicaid ,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.49,37.7,,,percent of total billed charges,37.70% of total billed charges,234.49,37.7,,,percent of total billed charges,37.70% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,21085.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,485.16,78,,,percent of total billed charges,78% of total billed charges,622,100,,,percent of total billed charges,100% of total billed charges,513.77,82.6,,,percent of total billed charges,82.6% of total billed charges,513.77,82.6,,,percent of total billed charges,82.6% of total billed charges,53.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.03,21085.8,
SIGMOIDOSCOPY AND BIOPSY,45331,CDM,983,RC,45331,HCPCS,Outpatient,,,420,273.00,,369.6,88,,,percent of total billed charges,88% of total Billed charges,6.05,100,,,Fee Schedule,100% of Medicare rate,41.03,100,,,Fee Schedule,100% of WA Medicaid,420,100,,,percent of total billed charges,100% of total billed charges,42.26,103,,,Fee Schedule,103% of WA Medicaid,6.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,41.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,289.8,69,,,percent of total billed charges,69% of total billed charges,420,100,,,percent of total billed charges,100% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,420,100,,,percent of total billed charges,100% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,420,100,,,percent of total billed charges,100% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.77,61.85,,,percent of total billed charges,61.85% of total billed charges,41.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.34,130,,,Fee Schedule,130% of WA Medicaid ,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.34,37.7,,,percent of total billed charges,37.70% of total billed charges,158.34,37.7,,,percent of total billed charges,37.70% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,14238,33.9,,,percent of total billed charges,33.9% of total billed charges,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.6,78,,,percent of total billed charges,78% of total billed charges,420,100,,,percent of total billed charges,100% of total billed charges,346.92,82.6,,,percent of total billed charges,82.6% of total billed charges,346.92,82.6,,,percent of total billed charges,82.6% of total billed charges,41.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.05,14238,
SURGICAL COLONOSCOPY,45355,CDM,983,RC,45355,HCPCS,Outpatient,,,681,442.65,,599.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,681,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,469.89,69,,,percent of total billed charges,69% of total billed charges,681,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,681,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,681,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,421.2,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,256.74,37.7,,,percent of total billed charges,37.70% of total billed charges,256.74,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,23085.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,531.18,78,,,percent of total billed charges,78% of total billed charges,681,100,,,percent of total billed charges,100% of total billed charges,562.51,82.6,,,percent of total billed charges,82.6% of total billed charges,562.51,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",256.74,23085.9,
DIAGNOSTIC COLONOSCOPY,45378,CDM,983,RC,45378,HCPCS,Outpatient,,,1036,673.40,,911.68,88,,,percent of total billed charges,88% of total Billed charges,16.35,100,,,Fee Schedule,100% of Medicare rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,1036,100,,,percent of total billed charges,100% of total billed charges,53.41,103,,,Fee Schedule,103% of WA Medicaid,16.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,714.84,69,,,percent of total billed charges,69% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1036,100,,,percent of total billed charges,100% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1036,100,,,percent of total billed charges,100% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.77,61.85,,,percent of total billed charges,61.85% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.41,130,,,Fee Schedule,130% of WA Medicaid ,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,35120.4,33.9,,,percent of total billed charges,33.9% of total billed charges,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,808.08,78,,,percent of total billed charges,78% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.35,35120.4,
COLONOSCOPY W/FB REMOVAL,45379,CDM,983,RC,45379,HCPCS,Outpatient,,,940,611.00,,827.2,88,,,percent of total billed charges,88% of total Billed charges,20.53,100,,,Fee Schedule,100% of Medicare rate,133.35,100,,,Fee Schedule,100% of WA Medicaid,940,100,,,percent of total billed charges,100% of total billed charges,137.35,103,,,Fee Schedule,103% of WA Medicaid,20.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,133.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,648.6,69,,,percent of total billed charges,69% of total billed charges,940,100,,,percent of total billed charges,100% of total billed charges,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,940,100,,,percent of total billed charges,100% of total billed charges,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,940,100,,,percent of total billed charges,100% of total billed charges,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,581.39,61.85,,,percent of total billed charges,61.85% of total billed charges,133.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,173.36,130,,,Fee Schedule,130% of WA Medicaid ,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.38,37.7,,,percent of total billed charges,37.70% of total billed charges,354.38,37.7,,,percent of total billed charges,37.70% of total billed charges,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,31866,33.9,,,percent of total billed charges,33.9% of total billed charges,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,733.2,78,,,percent of total billed charges,78% of total billed charges,940,100,,,percent of total billed charges,100% of total billed charges,776.44,82.6,,,percent of total billed charges,82.6% of total billed charges,776.44,82.6,,,percent of total billed charges,82.6% of total billed charges,133.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.53,31866,
LESION REMOVE COLONOSCOPY,45384,CDM,983,RC,45384,HCPCS,Outpatient,,,731,475.15,,643.28,88,,,percent of total billed charges,88% of total Billed charges,22.8,100,,,Fee Schedule,100% of Medicare rate,127.19,100,,,Fee Schedule,100% of WA Medicaid,731,100,,,percent of total billed charges,100% of total billed charges,131.01,103,,,Fee Schedule,103% of WA Medicaid,22.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,127.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,504.39,69,,,percent of total billed charges,69% of total billed charges,731,100,,,percent of total billed charges,100% of total billed charges,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,731,100,,,percent of total billed charges,100% of total billed charges,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,731,100,,,percent of total billed charges,100% of total billed charges,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.12,61.85,,,percent of total billed charges,61.85% of total billed charges,127.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,165.35,130,,,Fee Schedule,130% of WA Medicaid ,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.59,37.7,,,percent of total billed charges,37.70% of total billed charges,275.59,37.7,,,percent of total billed charges,37.70% of total billed charges,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,24780.9,33.9,,,percent of total billed charges,33.9% of total billed charges,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,570.18,78,,,percent of total billed charges,78% of total billed charges,731,100,,,percent of total billed charges,100% of total billed charges,603.81,82.6,,,percent of total billed charges,82.6% of total billed charges,603.81,82.6,,,percent of total billed charges,82.6% of total billed charges,127.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.8,24780.9,
LESION REMOVAL COLONOSCOPY,45385,CDM,983,RC,45385,HCPCS,Outpatient,,,828,538.20,,728.64,88,,,percent of total billed charges,88% of total Billed charges,22.03,100,,,Fee Schedule,100% of Medicare rate,141.93,100,,,Fee Schedule,100% of WA Medicaid,828,100,,,percent of total billed charges,100% of total billed charges,146.19,103,,,Fee Schedule,103% of WA Medicaid,22.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,141.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,571.32,69,,,percent of total billed charges,69% of total billed charges,828,100,,,percent of total billed charges,100% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,828,100,,,percent of total billed charges,100% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,828,100,,,percent of total billed charges,100% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.12,61.85,,,percent of total billed charges,61.85% of total billed charges,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,184.51,130,,,Fee Schedule,130% of WA Medicaid ,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.16,37.7,,,percent of total billed charges,37.70% of total billed charges,312.16,37.7,,,percent of total billed charges,37.70% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,28069.2,33.9,,,percent of total billed charges,33.9% of total billed charges,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.84,78,,,percent of total billed charges,78% of total billed charges,828,100,,,percent of total billed charges,100% of total billed charges,683.93,82.6,,,percent of total billed charges,82.6% of total billed charges,683.93,82.6,,,percent of total billed charges,82.6% of total billed charges,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.03,28069.2,
COLONOSCOPY W/ABLATION,45388,CDM,983,RC,45388,HCPCS,Outpatient,,,769,499.85,,676.72,88,,,percent of total billed charges,88% of total Billed charges,24.31,100,,,Fee Schedule,100% of Medicare rate,150.88,100,,,Fee Schedule,100% of WA Medicaid,769,100,,,percent of total billed charges,100% of total billed charges,155.41,103,,,Fee Schedule,103% of WA Medicaid,24.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,150.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,530.61,69,,,percent of total billed charges,69% of total billed charges,769,100,,,percent of total billed charges,100% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,769,100,,,percent of total billed charges,100% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,769,100,,,percent of total billed charges,100% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,475.63,61.85,,,percent of total billed charges,61.85% of total billed charges,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.14,130,,,Fee Schedule,130% of WA Medicaid ,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.91,37.7,,,percent of total billed charges,37.70% of total billed charges,289.91,37.7,,,percent of total billed charges,37.70% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,26069.1,33.9,,,percent of total billed charges,33.9% of total billed charges,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.82,78,,,percent of total billed charges,78% of total billed charges,769,100,,,percent of total billed charges,100% of total billed charges,635.19,82.6,,,percent of total billed charges,82.6% of total billed charges,635.19,82.6,,,percent of total billed charges,82.6% of total billed charges,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.31,26069.1,
COLONOSCOPY SUBMUCOUS INJ,45381,CDM,983,RC,45381,HCPCS,Outpatient,,,1006,653.90,,885.28,88,,,percent of total billed charges,88% of total Billed charges,17.33,100,,,Fee Schedule,100% of Medicare rate,112.09,100,,,Fee Schedule,100% of WA Medicaid,1006,100,,,percent of total billed charges,100% of total billed charges,115.45,103,,,Fee Schedule,103% of WA Medicaid,17.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,694.14,69,,,percent of total billed charges,69% of total billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1006,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1006,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.21,61.85,,,percent of total billed charges,61.85% of total billed charges,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.72,130,,,Fee Schedule,130% of WA Medicaid ,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.26,37.7,,,percent of total billed charges,37.70% of total billed charges,379.26,37.7,,,percent of total billed charges,37.70% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,34103.4,33.9,,,percent of total billed charges,33.9% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,784.68,78,,,percent of total billed charges,78% of total billed charges,1006,100,,,percent of total billed charges,100% of total billed charges,830.96,82.6,,,percent of total billed charges,82.6% of total billed charges,830.96,82.6,,,percent of total billed charges,82.6% of total billed charges,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.33,34103.4,
COLONOSCOPY DILATE STRICTURE,45386,CDM,983,RC,45386,HCPCS,Outpatient,,,717,466.05,,630.96,88,,,percent of total billed charges,88% of total Billed charges,18.71,100,,,Fee Schedule,100% of Medicare rate,118.43,100,,,Fee Schedule,100% of WA Medicaid,717,100,,,percent of total billed charges,100% of total billed charges,121.98,103,,,Fee Schedule,103% of WA Medicaid,18.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,118.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,494.73,69,,,percent of total billed charges,69% of total billed charges,717,100,,,percent of total billed charges,100% of total billed charges,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,717,100,,,percent of total billed charges,100% of total billed charges,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,717,100,,,percent of total billed charges,100% of total billed charges,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.46,61.85,,,percent of total billed charges,61.85% of total billed charges,118.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,153.96,130,,,Fee Schedule,130% of WA Medicaid ,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.31,37.7,,,percent of total billed charges,37.70% of total billed charges,270.31,37.7,,,percent of total billed charges,37.70% of total billed charges,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,24306.3,33.9,,,percent of total billed charges,33.9% of total billed charges,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,559.26,78,,,percent of total billed charges,78% of total billed charges,717,100,,,percent of total billed charges,100% of total billed charges,592.24,82.6,,,percent of total billed charges,82.6% of total billed charges,592.24,82.6,,,percent of total billed charges,82.6% of total billed charges,118.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.71,24306.3,
COLONOSCOPY/CONTROL BLEEDING,45382,CDM,983,RC,45382,HCPCS,Outpatient,,,888,577.20,,781.44,88,,,percent of total billed charges,88% of total Billed charges,21.9,100,,,Fee Schedule,100% of Medicare rate,144.54,100,,,Fee Schedule,100% of WA Medicaid,888,100,,,percent of total billed charges,100% of total billed charges,148.88,103,,,Fee Schedule,103% of WA Medicaid,21.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,144.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,612.72,69,,,percent of total billed charges,69% of total billed charges,888,100,,,percent of total billed charges,100% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,888,100,,,percent of total billed charges,100% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,888,100,,,percent of total billed charges,100% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.23,61.85,,,percent of total billed charges,61.85% of total billed charges,144.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,187.9,130,,,Fee Schedule,130% of WA Medicaid ,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.78,37.7,,,percent of total billed charges,37.70% of total billed charges,334.78,37.7,,,percent of total billed charges,37.70% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,30103.2,33.9,,,percent of total billed charges,33.9% of total billed charges,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.64,78,,,percent of total billed charges,78% of total billed charges,888,100,,,percent of total billed charges,100% of total billed charges,733.49,82.6,,,percent of total billed charges,82.6% of total billed charges,733.49,82.6,,,percent of total billed charges,82.6% of total billed charges,144.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.9,30103.2,
COLONOSCOPY AND BIOPSY,45380,CDM,983,RC,45380,HCPCS,Outpatient,,,1147,745.55,,1009.36,88,,,percent of total billed charges,88% of total Billed charges,17.34,100,,,Fee Schedule,100% of Medicare rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,1147,100,,,percent of total billed charges,100% of total billed charges,115.64,103,,,Fee Schedule,103% of WA Medicaid,17.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,791.43,69,,,percent of total billed charges,69% of total billed charges,1147,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1147,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1147,100,,,percent of total billed charges,100% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.42,61.85,,,percent of total billed charges,61.85% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.95,130,,,Fee Schedule,130% of WA Medicaid ,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.42,37.7,,,percent of total billed charges,37.70% of total billed charges,432.42,37.7,,,percent of total billed charges,37.70% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,38883.3,33.9,,,percent of total billed charges,33.9% of total billed charges,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.66,78,,,percent of total billed charges,78% of total billed charges,1147,100,,,percent of total billed charges,100% of total billed charges,947.42,82.6,,,percent of total billed charges,82.6% of total billed charges,947.42,82.6,,,percent of total billed charges,82.6% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.34,38883.3,
LESION REMOVAL COLONOSCOPY,45383,CDM,983,RC,45383,HCPCS,Outpatient,,,1689,1097.85,,1486.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1689,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1165.41,69,,,percent of total billed charges,69% of total billed charges,1689,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1689,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1689,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1044.65,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,636.75,37.7,,,percent of total billed charges,37.70% of total billed charges,636.75,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,57257.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1317.42,78,,,percent of total billed charges,78% of total billed charges,1689,100,,,percent of total billed charges,100% of total billed charges,1395.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1395.11,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",636.75,57257.1,
COLONOSCOPY W/STENT,45387,CDM,983,RC,45387,HCPCS,Outpatient,,,1007,654.55,,886.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1007,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,694.83,69,,,percent of total billed charges,69% of total billed charges,1007,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1007,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1007,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,622.83,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,379.64,37.7,,,percent of total billed charges,37.70% of total billed charges,379.64,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,34137.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,785.46,78,,,percent of total billed charges,78% of total billed charges,1007,100,,,percent of total billed charges,100% of total billed charges,831.78,82.6,,,percent of total billed charges,82.6% of total billed charges,831.78,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",379.64,34137.3,
LAP REMOVAL OF RECTUM,45395,CDM,983,RC,45395,HCPCS,Outpatient,,,3519,2287.35,,3096.72,88,,,percent of total billed charges,88% of total Billed charges,212.55,100,,,Fee Schedule,100% of Medicare rate,1097.55,100,,,Fee Schedule,100% of WA Medicaid,3519,100,,,percent of total billed charges,100% of total billed charges,1130.48,103,,,Fee Schedule,103% of WA Medicaid,212.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,371.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1097.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2428.11,69,,,percent of total billed charges,69% of total billed charges,3519,100,,,percent of total billed charges,100% of total billed charges,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3519,100,,,percent of total billed charges,100% of total billed charges,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3519,100,,,percent of total billed charges,100% of total billed charges,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2176.5,61.85,,,percent of total billed charges,61.85% of total billed charges,1097.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1097.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1119.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1426.82,130,,,Fee Schedule,130% of WA Medicaid ,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1326.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1326.66,37.7,,,percent of total billed charges,37.70% of total billed charges,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,119294.1,33.9,,,percent of total billed charges,33.9% of total billed charges,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2744.82,78,,,percent of total billed charges,78% of total billed charges,3519,100,,,percent of total billed charges,100% of total billed charges,2906.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2906.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1097.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,212.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1097.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,212.55,119294.1,
COLONOSCOPY W/DECOMPRESSION,45393,CDM,983,RC,45393,HCPCS,Outpatient,,,715.41,465.02,,629.56,88,,,percent of total billed charges,88% of total Billed charges,23.22,100,,,Fee Schedule,100% of Medicare rate,140.06,100,,,Fee Schedule,100% of WA Medicaid,715.41,100,,,percent of total billed charges,100% of total billed charges,144.26,103,,,Fee Schedule,103% of WA Medicaid,23.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,140.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,493.63,69,,,percent of total billed charges,69% of total billed charges,715.41,100,,,percent of total billed charges,100% of total billed charges,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,715.41,100,,,percent of total billed charges,100% of total billed charges,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,715.41,100,,,percent of total billed charges,100% of total billed charges,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.48,61.85,,,percent of total billed charges,61.85% of total billed charges,140.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,182.08,130,,,Fee Schedule,130% of WA Medicaid ,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.71,37.7,,,percent of total billed charges,37.70% of total billed charges,269.71,37.7,,,percent of total billed charges,37.70% of total billed charges,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,24252.4,33.9,,,percent of total billed charges,33.9% of total billed charges,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.02,78,,,percent of total billed charges,78% of total billed charges,715.41,100,,,percent of total billed charges,100% of total billed charges,590.93,82.6,,,percent of total billed charges,82.6% of total billed charges,590.93,82.6,,,percent of total billed charges,82.6% of total billed charges,140.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.22,24252.4,
UNLISTED PROCEDURE COLON,45399,CDM,983,RC,45399,HCPCS,Outpatient,,,2912.88,1893.37,,2563.33,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2912.88,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2009.89,69,,,percent of total billed charges,69% of total billed charges,2912.88,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2912.88,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2912.88,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1801.62,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1098.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1098.16,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,98746.63,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2272.05,78,,,percent of total billed charges,78% of total billed charges,2912.88,100,,,percent of total billed charges,100% of total billed charges,2406.04,82.6,,,percent of total billed charges,82.6% of total billed charges,2406.04,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1098.16,98746.63,
LAPAROSCOPIC PROC,45400,CDM,983,RC,45400,HCPCS,Outpatient,,,2057,1337.05,,1810.16,88,,,percent of total billed charges,88% of total Billed charges,118.74,100,,,Fee Schedule,100% of Medicare rate,637.46,100,,,Fee Schedule,100% of WA Medicaid,2057,100,,,percent of total billed charges,100% of total billed charges,656.58,103,,,Fee Schedule,103% of WA Medicaid,118.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,207.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,637.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1419.33,69,,,percent of total billed charges,69% of total billed charges,2057,100,,,percent of total billed charges,100% of total billed charges,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2057,100,,,percent of total billed charges,100% of total billed charges,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2057,100,,,percent of total billed charges,100% of total billed charges,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272.25,61.85,,,percent of total billed charges,61.85% of total billed charges,637.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,650.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,828.7,130,,,Fee Schedule,130% of WA Medicaid ,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,775.49,37.7,,,percent of total billed charges,37.70% of total billed charges,775.49,37.7,,,percent of total billed charges,37.70% of total billed charges,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,69732.3,33.9,,,percent of total billed charges,33.9% of total billed charges,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1604.46,78,,,percent of total billed charges,78% of total billed charges,2057,100,,,percent of total billed charges,100% of total billed charges,1699.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1699.08,82.6,,,percent of total billed charges,82.6% of total billed charges,637.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,118.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,118.74,69732.3,
EXPLORATION/REPAIR OF RECTUM,45562,CDM,983,RC,45562,HCPCS,Outpatient,,,3108.63,2020.61,,2735.59,88,,,percent of total billed charges,88% of total Billed charges,154.62,100,,,Fee Schedule,100% of Medicare rate,659.09,100,,,Fee Schedule,100% of WA Medicaid,3108.63,100,,,percent of total billed charges,100% of total billed charges,678.86,103,,,Fee Schedule,103% of WA Medicaid,154.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,270.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,659.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2144.95,69,,,percent of total billed charges,69% of total billed charges,3108.63,100,,,percent of total billed charges,100% of total billed charges,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,3108.63,100,,,percent of total billed charges,100% of total billed charges,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,3108.63,100,,,percent of total billed charges,100% of total billed charges,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1922.69,61.85,,,percent of total billed charges,61.85% of total billed charges,659.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,672.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,856.82,130,,,Fee Schedule,130% of WA Medicaid ,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1171.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1171.95,37.7,,,percent of total billed charges,37.70% of total billed charges,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,105382.56,33.9,,,percent of total billed charges,33.9% of total billed charges,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2424.73,78,,,percent of total billed charges,78% of total billed charges,3108.63,100,,,percent of total billed charges,100% of total billed charges,2567.73,82.6,,,percent of total billed charges,82.6% of total billed charges,2567.73,82.6,,,percent of total billed charges,82.6% of total billed charges,659.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,154.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,659.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,154.62,105382.56,
REPAIR OF RECTOCELE,45560,CDM,983,RC,45560,HCPCS,Outpatient,,,1420,923.00,,1249.6,88,,,percent of total billed charges,88% of total Billed charges,68.75,100,,,Fee Schedule,100% of Medicare rate,393.52,100,,,Fee Schedule,100% of WA Medicaid,1420,100,,,percent of total billed charges,100% of total billed charges,405.33,103,,,Fee Schedule,103% of WA Medicaid,68.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,120.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,393.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,979.8,69,,,percent of total billed charges,69% of total billed charges,1420,100,,,percent of total billed charges,100% of total billed charges,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1420,100,,,percent of total billed charges,100% of total billed charges,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1420,100,,,percent of total billed charges,100% of total billed charges,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,878.27,61.85,,,percent of total billed charges,61.85% of total billed charges,393.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,511.58,130,,,Fee Schedule,130% of WA Medicaid ,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.34,37.7,,,percent of total billed charges,37.70% of total billed charges,535.34,37.7,,,percent of total billed charges,37.70% of total billed charges,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,48138,33.9,,,percent of total billed charges,33.9% of total billed charges,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1107.6,78,,,percent of total billed charges,78% of total billed charges,1420,100,,,percent of total billed charges,100% of total billed charges,1172.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1172.92,82.6,,,percent of total billed charges,82.6% of total billed charges,393.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.75,48138,
DILATION OF ANAL SPHINCTER,45905,CDM,983,RC,45905,HCPCS,Outpatient,,,357,232.05,,314.16,88,,,percent of total billed charges,88% of total Billed charges,16.06,100,,,Fee Schedule,100% of Medicare rate,98.29,100,,,Fee Schedule,100% of WA Medicaid,357,100,,,percent of total billed charges,100% of total billed charges,101.24,103,,,Fee Schedule,103% of WA Medicaid,16.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,98.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,246.33,69,,,percent of total billed charges,69% of total billed charges,357,100,,,percent of total billed charges,100% of total billed charges,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,357,100,,,percent of total billed charges,100% of total billed charges,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,357,100,,,percent of total billed charges,100% of total billed charges,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.8,61.85,,,percent of total billed charges,61.85% of total billed charges,98.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,127.78,130,,,Fee Schedule,130% of WA Medicaid ,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.59,37.7,,,percent of total billed charges,37.70% of total billed charges,134.59,37.7,,,percent of total billed charges,37.70% of total billed charges,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,12102.3,33.9,,,percent of total billed charges,33.9% of total billed charges,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.46,78,,,percent of total billed charges,78% of total billed charges,357,100,,,percent of total billed charges,100% of total billed charges,294.88,82.6,,,percent of total billed charges,82.6% of total billed charges,294.88,82.6,,,percent of total billed charges,82.6% of total billed charges,98.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.06,12102.3,
REMOVE RECTAL OBSTRUCTION,45915,CDM,983,RC,45915,HCPCS,Outpatient,,,627,407.55,,551.76,88,,,percent of total billed charges,88% of total Billed charges,22.47,100,,,Fee Schedule,100% of Medicare rate,131.3,100,,,Fee Schedule,100% of WA Medicaid,627,100,,,percent of total billed charges,100% of total billed charges,135.24,103,,,Fee Schedule,103% of WA Medicaid,22.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,131.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,432.63,69,,,percent of total billed charges,69% of total billed charges,627,100,,,percent of total billed charges,100% of total billed charges,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,627,100,,,percent of total billed charges,100% of total billed charges,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,627,100,,,percent of total billed charges,100% of total billed charges,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.8,61.85,,,percent of total billed charges,61.85% of total billed charges,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,170.69,130,,,Fee Schedule,130% of WA Medicaid ,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.38,37.7,,,percent of total billed charges,37.70% of total billed charges,236.38,37.7,,,percent of total billed charges,37.70% of total billed charges,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,21255.3,33.9,,,percent of total billed charges,33.9% of total billed charges,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.06,78,,,percent of total billed charges,78% of total billed charges,627,100,,,percent of total billed charges,100% of total billed charges,517.9,82.6,,,percent of total billed charges,82.6% of total billed charges,517.9,82.6,,,percent of total billed charges,82.6% of total billed charges,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.47,21255.3,
SURG DX EXAM ANORECTAL,45990,CDM,960,RC,45990,HCPCS,Outpatient,,,344,223.60,,302.72,88,,,percent of total billed charges,88% of total Billed charges,11.45,100,,,Fee Schedule,100% of Medicare rate,59.68,100,,,Fee Schedule,100% of WA Medicaid,344,100,,,percent of total billed charges,100% of total billed charges,61.47,103,,,Fee Schedule,103% of WA Medicaid,11.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,237.36,69,,,percent of total billed charges,69% of total billed charges,344,100,,,percent of total billed charges,100% of total billed charges,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,344,100,,,percent of total billed charges,100% of total billed charges,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,344,100,,,percent of total billed charges,100% of total billed charges,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.76,61.85,,,percent of total billed charges,61.85% of total billed charges,59.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,77.58,130,,,Fee Schedule,130% of WA Medicaid ,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.69,37.7,,,percent of total billed charges,37.70% of total billed charges,129.69,37.7,,,percent of total billed charges,37.70% of total billed charges,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,11661.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.32,78,,,percent of total billed charges,78% of total billed charges,344,100,,,percent of total billed charges,100% of total billed charges,284.14,82.6,,,percent of total billed charges,82.6% of total billed charges,284.14,82.6,,,percent of total billed charges,82.6% of total billed charges,59.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.45,11661.6,
REMOVAL OF RECTAL MARKER,46030,CDM,983,RC,46030,HCPCS,Outpatient,,,398,258.70,,350.24,88,,,percent of total billed charges,88% of total Billed charges,8.81,100,,,Fee Schedule,100% of Medicare rate,49.05,100,,,Fee Schedule,100% of WA Medicaid,398,100,,,percent of total billed charges,100% of total billed charges,50.52,103,,,Fee Schedule,103% of WA Medicaid,8.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,274.62,69,,,percent of total billed charges,69% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,398,100,,,percent of total billed charges,100% of total billed charges,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,398,100,,,percent of total billed charges,100% of total billed charges,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.16,61.85,,,percent of total billed charges,61.85% of total billed charges,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.77,130,,,Fee Schedule,130% of WA Medicaid ,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,13492.2,33.9,,,percent of total billed charges,33.9% of total billed charges,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.44,78,,,percent of total billed charges,78% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.81,13492.2,
INCISION OF RECTAL ABSCESS,46040,CDM,983,RC,46040,HCPCS,Outpatient,,,914,594.10,,804.32,88,,,percent of total billed charges,88% of total Billed charges,43.3,100,,,Fee Schedule,100% of Medicare rate,246.37,100,,,Fee Schedule,100% of WA Medicaid,914,100,,,percent of total billed charges,100% of total billed charges,253.76,103,,,Fee Schedule,103% of WA Medicaid,43.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,246.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,630.66,69,,,percent of total billed charges,69% of total billed charges,914,100,,,percent of total billed charges,100% of total billed charges,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,914,100,,,percent of total billed charges,100% of total billed charges,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,914,100,,,percent of total billed charges,100% of total billed charges,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.31,61.85,,,percent of total billed charges,61.85% of total billed charges,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,320.28,130,,,Fee Schedule,130% of WA Medicaid ,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.58,37.7,,,percent of total billed charges,37.70% of total billed charges,344.58,37.7,,,percent of total billed charges,37.70% of total billed charges,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,30984.6,33.9,,,percent of total billed charges,33.9% of total billed charges,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.92,78,,,percent of total billed charges,78% of total billed charges,914,100,,,percent of total billed charges,100% of total billed charges,754.96,82.6,,,percent of total billed charges,82.6% of total billed charges,754.96,82.6,,,percent of total billed charges,82.6% of total billed charges,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.3,30984.6,
INCISION OF RECTAL ABSCESS,46045,CDM,983,RC,46045,HCPCS,Outpatient,,,1490,968.50,,1311.2,88,,,percent of total billed charges,88% of total Billed charges,44.48,100,,,Fee Schedule,100% of Medicare rate,254.01,100,,,Fee Schedule,100% of WA Medicaid,1490,100,,,percent of total billed charges,100% of total billed charges,261.63,103,,,Fee Schedule,103% of WA Medicaid,44.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,254.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1028.1,69,,,percent of total billed charges,69% of total billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1490,100,,,percent of total billed charges,100% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1490,100,,,percent of total billed charges,100% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,921.57,61.85,,,percent of total billed charges,61.85% of total billed charges,254.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,330.21,130,,,Fee Schedule,130% of WA Medicaid ,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.73,37.7,,,percent of total billed charges,37.70% of total billed charges,561.73,37.7,,,percent of total billed charges,37.70% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,50511,33.9,,,percent of total billed charges,33.9% of total billed charges,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1162.2,78,,,percent of total billed charges,78% of total billed charges,1490,100,,,percent of total billed charges,100% of total billed charges,1230.74,82.6,,,percent of total billed charges,82.6% of total billed charges,1230.74,82.6,,,percent of total billed charges,82.6% of total billed charges,254.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.48,50511,
INCISION OF ANAL ABSCESS,46050,CDM,983,RC,46050,HCPCS,Outpatient,,,324,210.60,,285.12,88,,,percent of total billed charges,88% of total Billed charges,9.32,100,,,Fee Schedule,100% of Medicare rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,324,100,,,percent of total billed charges,100% of total billed charges,60.7,103,,,Fee Schedule,103% of WA Medicaid,9.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,223.56,69,,,percent of total billed charges,69% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.39,61.85,,,percent of total billed charges,61.85% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.61,130,,,Fee Schedule,130% of WA Medicaid ,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,10983.6,33.9,,,percent of total billed charges,33.9% of total billed charges,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.72,78,,,percent of total billed charges,78% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.32,10983.6,
INCISION OF RECTAL ABSCESS,46060,CDM,983,RC,46060,HCPCS,Outpatient,,,1891,1229.15,,1664.08,88,,,percent of total billed charges,88% of total Billed charges,45.67,100,,,Fee Schedule,100% of Medicare rate,281.8,100,,,Fee Schedule,100% of WA Medicaid,1891,100,,,percent of total billed charges,100% of total billed charges,290.25,103,,,Fee Schedule,103% of WA Medicaid,45.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,281.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1304.79,69,,,percent of total billed charges,69% of total billed charges,1891,100,,,percent of total billed charges,100% of total billed charges,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1891,100,,,percent of total billed charges,100% of total billed charges,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1891,100,,,percent of total billed charges,100% of total billed charges,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1169.58,61.85,,,percent of total billed charges,61.85% of total billed charges,281.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,366.34,130,,,Fee Schedule,130% of WA Medicaid ,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.91,37.7,,,percent of total billed charges,37.70% of total billed charges,712.91,37.7,,,percent of total billed charges,37.70% of total billed charges,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,64104.9,33.9,,,percent of total billed charges,33.9% of total billed charges,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1474.98,78,,,percent of total billed charges,78% of total billed charges,1891,100,,,percent of total billed charges,100% of total billed charges,1561.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1561.97,82.6,,,percent of total billed charges,82.6% of total billed charges,281.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.67,64104.9,
INCISE EXTERNAL HEMORRHOID,46083,CDM,983,RC,46083,HCPCS,Outpatient,,,304,197.60,,267.52,88,,,percent of total billed charges,88% of total Billed charges,10.35,100,,,Fee Schedule,100% of Medicare rate,63.78,100,,,Fee Schedule,100% of WA Medicaid,304,100,,,percent of total billed charges,100% of total billed charges,65.69,103,,,Fee Schedule,103% of WA Medicaid,10.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,209.76,69,,,percent of total billed charges,69% of total billed charges,304,100,,,percent of total billed charges,100% of total billed charges,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,304,100,,,percent of total billed charges,100% of total billed charges,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,304,100,,,percent of total billed charges,100% of total billed charges,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.02,61.85,,,percent of total billed charges,61.85% of total billed charges,63.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.91,130,,,Fee Schedule,130% of WA Medicaid ,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.61,37.7,,,percent of total billed charges,37.70% of total billed charges,114.61,37.7,,,percent of total billed charges,37.70% of total billed charges,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,10305.6,33.9,,,percent of total billed charges,33.9% of total billed charges,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.12,78,,,percent of total billed charges,78% of total billed charges,304,100,,,percent of total billed charges,100% of total billed charges,251.1,82.6,,,percent of total billed charges,82.6% of total billed charges,251.1,82.6,,,percent of total billed charges,82.6% of total billed charges,63.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.35,10305.6,
REMOVAL OF ANAL FISSURE,46200,CDM,983,RC,46200,HCPCS,Outpatient,,,1219,792.35,,1072.72,88,,,percent of total billed charges,88% of total Billed charges,26.22,100,,,Fee Schedule,100% of Medicare rate,198.62,100,,,Fee Schedule,100% of WA Medicaid,1219,100,,,percent of total billed charges,100% of total billed charges,204.58,103,,,Fee Schedule,103% of WA Medicaid,26.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,198.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,841.11,69,,,percent of total billed charges,69% of total billed charges,1219,100,,,percent of total billed charges,100% of total billed charges,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1219,100,,,percent of total billed charges,100% of total billed charges,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1219,100,,,percent of total billed charges,100% of total billed charges,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,753.95,61.85,,,percent of total billed charges,61.85% of total billed charges,198.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,258.21,130,,,Fee Schedule,130% of WA Medicaid ,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.56,37.7,,,percent of total billed charges,37.70% of total billed charges,459.56,37.7,,,percent of total billed charges,37.70% of total billed charges,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,41324.1,33.9,,,percent of total billed charges,33.9% of total billed charges,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,950.82,78,,,percent of total billed charges,78% of total billed charges,1219,100,,,percent of total billed charges,100% of total billed charges,1006.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1006.89,82.6,,,percent of total billed charges,82.6% of total billed charges,198.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.22,41324.1,
EXCISE ANAL EXT TAG/PAPILLA,46220,CDM,983,RC,46220,HCPCS,Outpatient,,,349,226.85,,307.12,88,,,percent of total billed charges,88% of total Billed charges,11.48,100,,,Fee Schedule,100% of Medicare rate,70.31,100,,,Fee Schedule,100% of WA Medicaid,349,100,,,percent of total billed charges,100% of total billed charges,72.42,103,,,Fee Schedule,103% of WA Medicaid,11.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,240.81,69,,,percent of total billed charges,69% of total billed charges,349,100,,,percent of total billed charges,100% of total billed charges,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,349,100,,,percent of total billed charges,100% of total billed charges,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,349,100,,,percent of total billed charges,100% of total billed charges,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.86,61.85,,,percent of total billed charges,61.85% of total billed charges,70.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,91.4,130,,,Fee Schedule,130% of WA Medicaid ,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.57,37.7,,,percent of total billed charges,37.70% of total billed charges,131.57,37.7,,,percent of total billed charges,37.70% of total billed charges,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,11831.1,33.9,,,percent of total billed charges,33.9% of total billed charges,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.22,78,,,percent of total billed charges,78% of total billed charges,349,100,,,percent of total billed charges,100% of total billed charges,288.27,82.6,,,percent of total billed charges,82.6% of total billed charges,288.27,82.6,,,percent of total billed charges,82.6% of total billed charges,70.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.48,11831.1,
LIGATION OF HEMORRHOID(S),46221,CDM,983,RC,46221,HCPCS,Outpatient,,,337,219.05,,296.56,88,,,percent of total billed charges,88% of total Billed charges,14.95,100,,,Fee Schedule,100% of Medicare rate,111.9,100,,,Fee Schedule,100% of WA Medicaid,337,100,,,percent of total billed charges,100% of total billed charges,115.26,103,,,Fee Schedule,103% of WA Medicaid,14.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,111.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,232.53,69,,,percent of total billed charges,69% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,337,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,337,100,,,percent of total billed charges,100% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.43,61.85,,,percent of total billed charges,61.85% of total billed charges,111.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.47,130,,,Fee Schedule,130% of WA Medicaid ,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.05,37.7,,,percent of total billed charges,37.70% of total billed charges,127.05,37.7,,,percent of total billed charges,37.70% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,11424.3,33.9,,,percent of total billed charges,33.9% of total billed charges,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.86,78,,,percent of total billed charges,78% of total billed charges,337,100,,,percent of total billed charges,100% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,278.36,82.6,,,percent of total billed charges,82.6% of total billed charges,111.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.95,11424.3,
REMOVAL OF ANAL TAGS,46230,CDM,983,RC,46230,HCPCS,Outpatient,,,441,286.65,,388.08,88,,,percent of total billed charges,88% of total Billed charges,17.44,100,,,Fee Schedule,100% of Medicare rate,99.59,100,,,Fee Schedule,100% of WA Medicaid,441,100,,,percent of total billed charges,100% of total billed charges,102.58,103,,,Fee Schedule,103% of WA Medicaid,17.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,99.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,304.29,69,,,percent of total billed charges,69% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,441,100,,,percent of total billed charges,100% of total billed charges,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,441,100,,,percent of total billed charges,100% of total billed charges,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.76,61.85,,,percent of total billed charges,61.85% of total billed charges,99.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.47,130,,,Fee Schedule,130% of WA Medicaid ,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.26,37.7,,,percent of total billed charges,37.70% of total billed charges,166.26,37.7,,,percent of total billed charges,37.70% of total billed charges,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,14949.9,33.9,,,percent of total billed charges,33.9% of total billed charges,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.98,78,,,percent of total billed charges,78% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,99.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.44,14949.9,
REMOVE INT/EXT HEM 1 GROUP,46255,CDM,983,RC,46255,HCPCS,Outpatient,,,1091,709.15,,960.08,88,,,percent of total billed charges,88% of total Billed charges,34.88,100,,,Fee Schedule,100% of Medicare rate,204.4,100,,,Fee Schedule,100% of WA Medicaid,1091,100,,,percent of total billed charges,100% of total billed charges,210.53,103,,,Fee Schedule,103% of WA Medicaid,34.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,204.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,752.79,69,,,percent of total billed charges,69% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1091,100,,,percent of total billed charges,100% of total billed charges,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1091,100,,,percent of total billed charges,100% of total billed charges,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.78,61.85,,,percent of total billed charges,61.85% of total billed charges,204.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,265.72,130,,,Fee Schedule,130% of WA Medicaid ,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,411.31,37.7,,,percent of total billed charges,37.70% of total billed charges,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,36984.9,33.9,,,percent of total billed charges,33.9% of total billed charges,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,850.98,78,,,percent of total billed charges,78% of total billed charges,1091,100,,,percent of total billed charges,100% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,901.17,82.6,,,percent of total billed charges,82.6% of total billed charges,204.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.88,36984.9,
REMOVE EXT HEM GROUPS 2+,46250,CDM,983,RC,46250,HCPCS,Outpatient,,,1883,1223.95,,1657.04,88,,,percent of total billed charges,88% of total Billed charges,30.94,100,,,Fee Schedule,100% of Medicare rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,1883,100,,,percent of total billed charges,100% of total billed charges,189.41,103,,,Fee Schedule,103% of WA Medicaid,30.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1299.27,69,,,percent of total billed charges,69% of total billed charges,1883,100,,,percent of total billed charges,100% of total billed charges,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1883,100,,,percent of total billed charges,100% of total billed charges,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1883,100,,,percent of total billed charges,100% of total billed charges,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1164.64,61.85,,,percent of total billed charges,61.85% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,239.06,130,,,Fee Schedule,130% of WA Medicaid ,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.89,37.7,,,percent of total billed charges,37.70% of total billed charges,709.89,37.7,,,percent of total billed charges,37.70% of total billed charges,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,63833.7,33.9,,,percent of total billed charges,33.9% of total billed charges,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1468.74,78,,,percent of total billed charges,78% of total billed charges,1883,100,,,percent of total billed charges,100% of total billed charges,1555.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1555.36,82.6,,,percent of total billed charges,82.6% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.94,63833.7,
REMOVE IN/EX HEM GRPS  FISS,46261,CDM,983,RC,46261,HCPCS,Outpatient,,,2343,1522.95,,2061.84,88,,,percent of total billed charges,88% of total Billed charges,53.49,100,,,Fee Schedule,100% of Medicare rate,306.61,100,,,Fee Schedule,100% of WA Medicaid,2343,100,,,percent of total billed charges,100% of total billed charges,315.81,103,,,Fee Schedule,103% of WA Medicaid,53.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,306.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1616.67,69,,,percent of total billed charges,69% of total billed charges,2343,100,,,percent of total billed charges,100% of total billed charges,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2343,100,,,percent of total billed charges,100% of total billed charges,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2343,100,,,percent of total billed charges,100% of total billed charges,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1449.15,61.85,,,percent of total billed charges,61.85% of total billed charges,306.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,398.59,130,,,Fee Schedule,130% of WA Medicaid ,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,883.31,37.7,,,percent of total billed charges,37.70% of total billed charges,883.31,37.7,,,percent of total billed charges,37.70% of total billed charges,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,79427.7,33.9,,,percent of total billed charges,33.9% of total billed charges,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1827.54,78,,,percent of total billed charges,78% of total billed charges,2343,100,,,percent of total billed charges,100% of total billed charges,1935.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1935.32,82.6,,,percent of total billed charges,82.6% of total billed charges,306.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.49,79427.7,
REMOVE IN/EX HEM GROUPS 2+,46260,CDM,983,RC,46260,HCPCS,Outpatient,,,2109,1370.85,,1855.92,88,,,percent of total billed charges,88% of total Billed charges,49.09,100,,,Fee Schedule,100% of Medicare rate,277.33,100,,,Fee Schedule,100% of WA Medicaid,2109,100,,,percent of total billed charges,100% of total billed charges,285.65,103,,,Fee Schedule,103% of WA Medicaid,49.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,85.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,277.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1455.21,69,,,percent of total billed charges,69% of total billed charges,2109,100,,,percent of total billed charges,100% of total billed charges,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2109,100,,,percent of total billed charges,100% of total billed charges,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2109,100,,,percent of total billed charges,100% of total billed charges,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1304.42,61.85,,,percent of total billed charges,61.85% of total billed charges,277.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,360.53,130,,,Fee Schedule,130% of WA Medicaid ,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,795.09,37.7,,,percent of total billed charges,37.70% of total billed charges,795.09,37.7,,,percent of total billed charges,37.70% of total billed charges,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,71495.1,33.9,,,percent of total billed charges,33.9% of total billed charges,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1645.02,78,,,percent of total billed charges,78% of total billed charges,2109,100,,,percent of total billed charges,100% of total billed charges,1742.03,82.6,,,percent of total billed charges,82.6% of total billed charges,1742.03,82.6,,,percent of total billed charges,82.6% of total billed charges,277.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.09,71495.1,
REMOVE ANAL FIST SUBQ,46270,CDM,983,RC,46270,HCPCS,Outpatient,,,1079,701.35,,949.52,88,,,percent of total billed charges,88% of total Billed charges,37.65,100,,,Fee Schedule,100% of Medicare rate,232.94,100,,,Fee Schedule,100% of WA Medicaid,1079,100,,,percent of total billed charges,100% of total billed charges,239.93,103,,,Fee Schedule,103% of WA Medicaid,37.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,232.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,744.51,69,,,percent of total billed charges,69% of total billed charges,1079,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079,100,,,percent of total billed charges,100% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.36,61.85,,,percent of total billed charges,61.85% of total billed charges,232.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,302.82,130,,,Fee Schedule,130% of WA Medicaid ,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.78,37.7,,,percent of total billed charges,37.70% of total billed charges,406.78,37.7,,,percent of total billed charges,37.70% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,36578.1,33.9,,,percent of total billed charges,33.9% of total billed charges,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.62,78,,,percent of total billed charges,78% of total billed charges,1079,100,,,percent of total billed charges,100% of total billed charges,891.25,82.6,,,percent of total billed charges,82.6% of total billed charges,891.25,82.6,,,percent of total billed charges,82.6% of total billed charges,232.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.65,36578.1,
REMOVE ANAL FIST COMPLEX,46280,CDM,983,RC,46280,HCPCS,Outpatient,,,1347,875.55,,1185.36,88,,,percent of total billed charges,88% of total Billed charges,43.93,100,,,Fee Schedule,100% of Medicare rate,278.26,100,,,Fee Schedule,100% of WA Medicaid,1347,100,,,percent of total billed charges,100% of total billed charges,286.61,103,,,Fee Schedule,103% of WA Medicaid,43.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,76.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,278.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,929.43,69,,,percent of total billed charges,69% of total billed charges,1347,100,,,percent of total billed charges,100% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1347,100,,,percent of total billed charges,100% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1347,100,,,percent of total billed charges,100% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,833.12,61.85,,,percent of total billed charges,61.85% of total billed charges,278.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,361.74,130,,,Fee Schedule,130% of WA Medicaid ,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.82,37.7,,,percent of total billed charges,37.70% of total billed charges,507.82,37.7,,,percent of total billed charges,37.70% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,45663.3,33.9,,,percent of total billed charges,33.9% of total billed charges,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1050.66,78,,,percent of total billed charges,78% of total billed charges,1347,100,,,percent of total billed charges,100% of total billed charges,1112.62,82.6,,,percent of total billed charges,82.6% of total billed charges,1112.62,82.6,,,percent of total billed charges,82.6% of total billed charges,278.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.93,45663.3,
REMOVAL OF HEMORRHOID CLOT,46320,CDM,983,RC,46320,HCPCS,Outpatient,,,512,332.80,,450.56,88,,,percent of total billed charges,88% of total Billed charges,10.96,100,,,Fee Schedule,100% of Medicare rate,65.46,100,,,Fee Schedule,100% of WA Medicaid,512,100,,,percent of total billed charges,100% of total billed charges,67.42,103,,,Fee Schedule,103% of WA Medicaid,10.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,65.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,353.28,69,,,percent of total billed charges,69% of total billed charges,512,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,512,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,512,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.67,61.85,,,percent of total billed charges,61.85% of total billed charges,65.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.1,130,,,Fee Schedule,130% of WA Medicaid ,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.02,37.7,,,percent of total billed charges,37.70% of total billed charges,193.02,37.7,,,percent of total billed charges,37.70% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,17356.8,33.9,,,percent of total billed charges,33.9% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.36,78,,,percent of total billed charges,78% of total billed charges,512,100,,,percent of total billed charges,100% of total billed charges,422.91,82.6,,,percent of total billed charges,82.6% of total billed charges,422.91,82.6,,,percent of total billed charges,82.6% of total billed charges,65.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.96,17356.8,
INJECTION INTO HEMORRHOID(S),46500,CDM,983,RC,46500,HCPCS,Outpatient,,,275,178.75,,242,88,,,percent of total billed charges,88% of total Billed charges,12.38,100,,,Fee Schedule,100% of Medicare rate,107.8,100,,,Fee Schedule,100% of WA Medicaid,275,100,,,percent of total billed charges,100% of total billed charges,111.03,103,,,Fee Schedule,103% of WA Medicaid,12.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,107.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,189.75,69,,,percent of total billed charges,69% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,275,100,,,percent of total billed charges,100% of total billed charges,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,275,100,,,percent of total billed charges,100% of total billed charges,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.09,61.85,,,percent of total billed charges,61.85% of total billed charges,107.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,140.14,130,,,Fee Schedule,130% of WA Medicaid ,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,103.68,37.7,,,percent of total billed charges,37.70% of total billed charges,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,9322.5,33.9,,,percent of total billed charges,33.9% of total billed charges,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.5,78,,,percent of total billed charges,78% of total billed charges,275,100,,,percent of total billed charges,100% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,227.15,82.6,,,percent of total billed charges,82.6% of total billed charges,107.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.38,9322.5,
DIAGNOSTIC ANOSCOPY,46600,CDM,983,RC,46600,HCPCS,Outpatient,,,138,89.70,,121.44,88,,,percent of total billed charges,88% of total Billed charges,3.58,100,,,Fee Schedule,100% of Medicare rate,23.69,100,,,Fee Schedule,100% of WA Medicaid,138,100,,,percent of total billed charges,100% of total billed charges,24.4,103,,,Fee Schedule,103% of WA Medicaid,3.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,138,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,138,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.35,61.85,,,percent of total billed charges,61.85% of total billed charges,23.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.8,130,,,Fee Schedule,130% of WA Medicaid ,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4678.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,23.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.58,4678.2,
ANOSCOPY AND BIOPSY,46606,CDM,983,RC,46606,HCPCS,Outpatient,,,461,299.65,,405.68,88,,,percent of total billed charges,88% of total Billed charges,7.71,100,,,Fee Schedule,100% of Medicare rate,42.9,100,,,Fee Schedule,100% of WA Medicaid,461,100,,,percent of total billed charges,100% of total billed charges,44.19,103,,,Fee Schedule,103% of WA Medicaid,7.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,318.09,69,,,percent of total billed charges,69% of total billed charges,461,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,461,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,461,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.13,61.85,,,percent of total billed charges,61.85% of total billed charges,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.77,130,,,Fee Schedule,130% of WA Medicaid ,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.8,37.7,,,percent of total billed charges,37.70% of total billed charges,173.8,37.7,,,percent of total billed charges,37.70% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,15627.9,33.9,,,percent of total billed charges,33.9% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.58,78,,,percent of total billed charges,78% of total billed charges,461,100,,,percent of total billed charges,100% of total billed charges,380.79,82.6,,,percent of total billed charges,82.6% of total billed charges,380.79,82.6,,,percent of total billed charges,82.6% of total billed charges,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.71,15627.9,
DIAGNOSTIC ANOSCOPY,46601,CDM,983,RC,46601,HCPCS,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,8.51,100,,,Fee Schedule,100% of Medicare rate,53.15,100,,,Fee Schedule,100% of WA Medicaid,200,100,,,percent of total billed charges,100% of total billed charges,54.74,103,,,Fee Schedule,103% of WA Medicaid,8.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,53.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,200,100,,,percent of total billed charges,100% of total billed charges,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,200,100,,,percent of total billed charges,100% of total billed charges,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,53.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,69.1,130,,,Fee Schedule,130% of WA Medicaid ,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,6780,33.9,,,percent of total billed charges,33.9% of total billed charges,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,53.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.51,6780,
ANOSCOPY AND DILATION,46604,CDM,983,RC,46604,HCPCS,Outpatient,,,202,131.30,,177.76,88,,,percent of total billed charges,88% of total Billed charges,6.65,100,,,Fee Schedule,100% of Medicare rate,37.49,100,,,Fee Schedule,100% of WA Medicaid,202,100,,,percent of total billed charges,100% of total billed charges,38.61,103,,,Fee Schedule,103% of WA Medicaid,6.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,37.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,139.38,69,,,percent of total billed charges,69% of total billed charges,202,100,,,percent of total billed charges,100% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,202,100,,,percent of total billed charges,100% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,202,100,,,percent of total billed charges,100% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.94,61.85,,,percent of total billed charges,61.85% of total billed charges,37.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,48.74,130,,,Fee Schedule,130% of WA Medicaid ,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.15,37.7,,,percent of total billed charges,37.70% of total billed charges,76.15,37.7,,,percent of total billed charges,37.70% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,6847.8,33.9,,,percent of total billed charges,33.9% of total billed charges,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.56,78,,,percent of total billed charges,78% of total billed charges,202,100,,,percent of total billed charges,100% of total billed charges,166.85,82.6,,,percent of total billed charges,82.6% of total billed charges,166.85,82.6,,,percent of total billed charges,82.6% of total billed charges,37.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.65,6847.8,
ANOSCOPY REMOVE FOR BODY,46608,CDM,983,RC,46608,HCPCS,Outpatient,,,372,241.80,,327.36,88,,,percent of total billed charges,88% of total Billed charges,11.33,100,,,Fee Schedule,100% of Medicare rate,47.56,100,,,Fee Schedule,100% of WA Medicaid,372,100,,,percent of total billed charges,100% of total billed charges,48.99,103,,,Fee Schedule,103% of WA Medicaid,11.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,256.68,69,,,percent of total billed charges,69% of total billed charges,372,100,,,percent of total billed charges,100% of total billed charges,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,372,100,,,percent of total billed charges,100% of total billed charges,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,372,100,,,percent of total billed charges,100% of total billed charges,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.08,61.85,,,percent of total billed charges,61.85% of total billed charges,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.83,130,,,Fee Schedule,130% of WA Medicaid ,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.24,37.7,,,percent of total billed charges,37.70% of total billed charges,140.24,37.7,,,percent of total billed charges,37.70% of total billed charges,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,12610.8,33.9,,,percent of total billed charges,33.9% of total billed charges,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.16,78,,,percent of total billed charges,78% of total billed charges,372,100,,,percent of total billed charges,100% of total billed charges,307.27,82.6,,,percent of total billed charges,82.6% of total billed charges,307.27,82.6,,,percent of total billed charges,82.6% of total billed charges,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.33,12610.8,
SURGICAL ENDOSCOPY W/ REMOVAL OF TUMOR,46610,CDM,983,RC,46610,HCPCS,Outpatient,,,403,261.95,,354.64,88,,,percent of total billed charges,88% of total Billed charges,8.62,100,,,Fee Schedule,100% of Medicare rate,45.32,100,,,Fee Schedule,100% of WA Medicaid,403,100,,,percent of total billed charges,100% of total billed charges,46.68,103,,,Fee Schedule,103% of WA Medicaid,8.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,45.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,278.07,69,,,percent of total billed charges,69% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,403,100,,,percent of total billed charges,100% of total billed charges,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,403,100,,,percent of total billed charges,100% of total billed charges,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.26,61.85,,,percent of total billed charges,61.85% of total billed charges,45.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.92,130,,,Fee Schedule,130% of WA Medicaid ,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,151.93,37.7,,,percent of total billed charges,37.70% of total billed charges,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,13661.7,33.9,,,percent of total billed charges,33.9% of total billed charges,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.34,78,,,percent of total billed charges,78% of total billed charges,403,100,,,percent of total billed charges,100% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,332.88,82.6,,,percent of total billed charges,82.6% of total billed charges,45.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.62,13661.7,
REPAIR OF ANAL SPHINCTER,46750,CDM,983,RC,46750,HCPCS,Outpatient,,,1560,1014.00,,1372.8,88,,,percent of total billed charges,88% of total Billed charges,74.37,100,,,Fee Schedule,100% of Medicare rate,426.53,100,,,Fee Schedule,100% of WA Medicaid,1560,100,,,percent of total billed charges,100% of total billed charges,439.33,103,,,Fee Schedule,103% of WA Medicaid,74.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,130.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,426.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1076.4,69,,,percent of total billed charges,69% of total billed charges,1560,100,,,percent of total billed charges,100% of total billed charges,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1560,100,,,percent of total billed charges,100% of total billed charges,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1560,100,,,percent of total billed charges,100% of total billed charges,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,964.86,61.85,,,percent of total billed charges,61.85% of total billed charges,426.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,554.49,130,,,Fee Schedule,130% of WA Medicaid ,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.12,37.7,,,percent of total billed charges,37.70% of total billed charges,588.12,37.7,,,percent of total billed charges,37.70% of total billed charges,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,52884,33.9,,,percent of total billed charges,33.9% of total billed charges,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1216.8,78,,,percent of total billed charges,78% of total billed charges,1560,100,,,percent of total billed charges,100% of total billed charges,1288.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1288.56,82.6,,,percent of total billed charges,82.6% of total billed charges,426.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,74.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.37,52884,
DESTRUCTION ANAL LESION(S),46900,CDM,983,RC,46900,HCPCS,Outpatient,,,342,222.30,,300.96,88,,,percent of total billed charges,88% of total Billed charges,10.93,100,,,Fee Schedule,100% of Medicare rate,79.64,100,,,Fee Schedule,100% of WA Medicaid,342,100,,,percent of total billed charges,100% of total billed charges,82.03,103,,,Fee Schedule,103% of WA Medicaid,10.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,235.98,69,,,percent of total billed charges,69% of total billed charges,342,100,,,percent of total billed charges,100% of total billed charges,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,342,100,,,percent of total billed charges,100% of total billed charges,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,342,100,,,percent of total billed charges,100% of total billed charges,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.53,61.85,,,percent of total billed charges,61.85% of total billed charges,79.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.53,130,,,Fee Schedule,130% of WA Medicaid ,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.93,37.7,,,percent of total billed charges,37.70% of total billed charges,128.93,37.7,,,percent of total billed charges,37.70% of total billed charges,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,11593.8,33.9,,,percent of total billed charges,33.9% of total billed charges,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.76,78,,,percent of total billed charges,78% of total billed charges,342,100,,,percent of total billed charges,100% of total billed charges,282.49,82.6,,,percent of total billed charges,82.6% of total billed charges,282.49,82.6,,,percent of total billed charges,82.6% of total billed charges,79.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.93,11593.8,
DESTRUCTION ANAL LESION(S),46910,CDM,983,RC,46910,HCPCS,Outpatient,,,379,246.35,,333.52,88,,,percent of total billed charges,88% of total Billed charges,12.41,100,,,Fee Schedule,100% of Medicare rate,78.14,100,,,Fee Schedule,100% of WA Medicaid,379,100,,,percent of total billed charges,100% of total billed charges,80.48,103,,,Fee Schedule,103% of WA Medicaid,12.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,78.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,261.51,69,,,percent of total billed charges,69% of total billed charges,379,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,379,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,379,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.41,61.85,,,percent of total billed charges,61.85% of total billed charges,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.58,130,,,Fee Schedule,130% of WA Medicaid ,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.88,37.7,,,percent of total billed charges,37.70% of total billed charges,142.88,37.7,,,percent of total billed charges,37.70% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12848.1,33.9,,,percent of total billed charges,33.9% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.62,78,,,percent of total billed charges,78% of total billed charges,379,100,,,percent of total billed charges,100% of total billed charges,313.05,82.6,,,percent of total billed charges,82.6% of total billed charges,313.05,82.6,,,percent of total billed charges,82.6% of total billed charges,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.41,12848.1,
CRYOSURGERY ANAL LESION(S),46916,CDM,983,RC,46916,HCPCS,Outpatient,,,324,210.60,,285.12,88,,,percent of total billed charges,88% of total Billed charges,10.04,100,,,Fee Schedule,100% of Medicare rate,82.62,100,,,Fee Schedule,100% of WA Medicaid,324,100,,,percent of total billed charges,100% of total billed charges,85.1,103,,,Fee Schedule,103% of WA Medicaid,10.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,82.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,223.56,69,,,percent of total billed charges,69% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.39,61.85,,,percent of total billed charges,61.85% of total billed charges,82.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.41,130,,,Fee Schedule,130% of WA Medicaid ,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,10983.6,33.9,,,percent of total billed charges,33.9% of total billed charges,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.72,78,,,percent of total billed charges,78% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,82.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.04,10983.6,
EXCISION OF ANAL LESION(S),46922,CDM,983,RC,46922,HCPCS,Outpatient,,,539,350.35,,474.32,88,,,percent of total billed charges,88% of total Billed charges,13.52,100,,,Fee Schedule,100% of Medicare rate,79.64,100,,,Fee Schedule,100% of WA Medicaid,539,100,,,percent of total billed charges,100% of total billed charges,82.03,103,,,Fee Schedule,103% of WA Medicaid,13.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,371.91,69,,,percent of total billed charges,69% of total billed charges,539,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,539,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,539,100,,,percent of total billed charges,100% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.37,61.85,,,percent of total billed charges,61.85% of total billed charges,79.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.53,130,,,Fee Schedule,130% of WA Medicaid ,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.2,37.7,,,percent of total billed charges,37.70% of total billed charges,203.2,37.7,,,percent of total billed charges,37.70% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,18272.1,33.9,,,percent of total billed charges,33.9% of total billed charges,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.42,78,,,percent of total billed charges,78% of total billed charges,539,100,,,percent of total billed charges,100% of total billed charges,445.21,82.6,,,percent of total billed charges,82.6% of total billed charges,445.21,82.6,,,percent of total billed charges,82.6% of total billed charges,79.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.52,18272.1,
DESTRUCTION ANAL LESION(S),46924,CDM,983,RC,46924,HCPCS,Outpatient,,,994,646.10,,874.72,88,,,percent of total billed charges,88% of total Billed charges,16.63,100,,,Fee Schedule,100% of Medicare rate,104.07,100,,,Fee Schedule,100% of WA Medicaid,994,100,,,percent of total billed charges,100% of total billed charges,107.19,103,,,Fee Schedule,103% of WA Medicaid,16.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,104.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,685.86,69,,,percent of total billed charges,69% of total billed charges,994,100,,,percent of total billed charges,100% of total billed charges,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,994,100,,,percent of total billed charges,100% of total billed charges,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,994,100,,,percent of total billed charges,100% of total billed charges,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.79,61.85,,,percent of total billed charges,61.85% of total billed charges,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,135.29,130,,,Fee Schedule,130% of WA Medicaid ,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.74,37.7,,,percent of total billed charges,37.70% of total billed charges,374.74,37.7,,,percent of total billed charges,37.70% of total billed charges,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,33696.6,33.9,,,percent of total billed charges,33.9% of total billed charges,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,775.32,78,,,percent of total billed charges,78% of total billed charges,994,100,,,percent of total billed charges,100% of total billed charges,821.04,82.6,,,percent of total billed charges,82.6% of total billed charges,821.04,82.6,,,percent of total billed charges,82.6% of total billed charges,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.63,33696.6,
REMOVE BY LIGAT INT HEM GRPS,46946,CDM,983,RC,46946,HCPCS,Outpatient,,,621,403.65,,546.48,88,,,percent of total billed charges,88% of total Billed charges,30.03,100,,,Fee Schedule,100% of Medicare rate,221.38,100,,,Fee Schedule,100% of WA Medicaid,621,100,,,percent of total billed charges,100% of total billed charges,228.02,103,,,Fee Schedule,103% of WA Medicaid,30.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,221.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,428.49,69,,,percent of total billed charges,69% of total billed charges,621,100,,,percent of total billed charges,100% of total billed charges,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,621,100,,,percent of total billed charges,100% of total billed charges,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,621,100,,,percent of total billed charges,100% of total billed charges,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.09,61.85,,,percent of total billed charges,61.85% of total billed charges,221.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,287.79,130,,,Fee Schedule,130% of WA Medicaid ,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.12,37.7,,,percent of total billed charges,37.70% of total billed charges,234.12,37.7,,,percent of total billed charges,37.70% of total billed charges,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,21051.9,33.9,,,percent of total billed charges,33.9% of total billed charges,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,484.38,78,,,percent of total billed charges,78% of total billed charges,621,100,,,percent of total billed charges,100% of total billed charges,512.95,82.6,,,percent of total billed charges,82.6% of total billed charges,512.95,82.6,,,percent of total billed charges,82.6% of total billed charges,221.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.03,21051.9,
REMOVE BY LIGAT INT HEM GRP,46945,CDM,983,RC,46945,HCPCS,Outpatient,,,621,403.65,,546.48,88,,,percent of total billed charges,88% of total Billed charges,26.5,100,,,Fee Schedule,100% of Medicare rate,198.81,100,,,Fee Schedule,100% of WA Medicaid,621,100,,,percent of total billed charges,100% of total billed charges,204.77,103,,,Fee Schedule,103% of WA Medicaid,26.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,46.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,198.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,428.49,69,,,percent of total billed charges,69% of total billed charges,621,100,,,percent of total billed charges,100% of total billed charges,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,621,100,,,percent of total billed charges,100% of total billed charges,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,621,100,,,percent of total billed charges,100% of total billed charges,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.09,61.85,,,percent of total billed charges,61.85% of total billed charges,198.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,258.45,130,,,Fee Schedule,130% of WA Medicaid ,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,234.12,37.7,,,percent of total billed charges,37.70% of total billed charges,234.12,37.7,,,percent of total billed charges,37.70% of total billed charges,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,21051.9,33.9,,,percent of total billed charges,33.9% of total billed charges,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,484.38,78,,,percent of total billed charges,78% of total billed charges,621,100,,,percent of total billed charges,100% of total billed charges,512.95,82.6,,,percent of total billed charges,82.6% of total billed charges,512.95,82.6,,,percent of total billed charges,82.6% of total billed charges,198.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.5,21051.9,
NEEDLE BIOPSY LIVER ADD-ON,47001,CDM,983,RC,47001,HCPCS,Outpatient,,,427,277.55,,375.76,88,,,percent of total billed charges,88% of total Billed charges,15.2,100,,,Fee Schedule,100% of Medicare rate,56.88,100,,,Fee Schedule,100% of WA Medicaid,427,100,,,percent of total billed charges,100% of total billed charges,58.59,103,,,Fee Schedule,103% of WA Medicaid,15.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,294.63,69,,,percent of total billed charges,69% of total billed charges,427,100,,,percent of total billed charges,100% of total billed charges,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,427,100,,,percent of total billed charges,100% of total billed charges,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,427,100,,,percent of total billed charges,100% of total billed charges,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.1,61.85,,,percent of total billed charges,61.85% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,73.94,130,,,Fee Schedule,130% of WA Medicaid ,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.98,37.7,,,percent of total billed charges,37.70% of total billed charges,160.98,37.7,,,percent of total billed charges,37.70% of total billed charges,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,14475.3,33.9,,,percent of total billed charges,33.9% of total billed charges,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.06,78,,,percent of total billed charges,78% of total billed charges,427,100,,,percent of total billed charges,100% of total billed charges,352.7,82.6,,,percent of total billed charges,82.6% of total billed charges,352.7,82.6,,,percent of total billed charges,82.6% of total billed charges,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.2,14475.3,
WEDGE BIOPSY OF LIVER,47100,CDM,983,RC,47100,HCPCS,Outpatient,,,2032,1320.80,,1788.16,88,,,percent of total billed charges,88% of total Billed charges,108.4,100,,,Fee Schedule,100% of Medicare rate,481.36,100,,,Fee Schedule,100% of WA Medicaid,2032,100,,,percent of total billed charges,100% of total billed charges,495.8,103,,,Fee Schedule,103% of WA Medicaid,108.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,189.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,481.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1402.08,69,,,percent of total billed charges,69% of total billed charges,2032,100,,,percent of total billed charges,100% of total billed charges,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2032,100,,,percent of total billed charges,100% of total billed charges,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2032,100,,,percent of total billed charges,100% of total billed charges,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1256.79,61.85,,,percent of total billed charges,61.85% of total billed charges,481.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,625.77,130,,,Fee Schedule,130% of WA Medicaid ,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.06,37.7,,,percent of total billed charges,37.70% of total billed charges,766.06,37.7,,,percent of total billed charges,37.70% of total billed charges,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,68884.8,33.9,,,percent of total billed charges,33.9% of total billed charges,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1584.96,78,,,percent of total billed charges,78% of total billed charges,2032,100,,,percent of total billed charges,100% of total billed charges,1678.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1678.43,82.6,,,percent of total billed charges,82.6% of total billed charges,481.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,108.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,108.4,68884.8,
REPAIR LIVER WOUND,47350,CDM,983,RC,47350,HCPCS,Outpatient,,,3722,2419.30,,3275.36,88,,,percent of total billed charges,88% of total Billed charges,178.94,100,,,Fee Schedule,100% of Medicare rate,765.02,100,,,Fee Schedule,100% of WA Medicaid,3722,100,,,percent of total billed charges,100% of total billed charges,787.97,103,,,Fee Schedule,103% of WA Medicaid,178.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,313.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,765.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2568.18,69,,,percent of total billed charges,69% of total billed charges,3722,100,,,percent of total billed charges,100% of total billed charges,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3722,100,,,percent of total billed charges,100% of total billed charges,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3722,100,,,percent of total billed charges,100% of total billed charges,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2302.06,61.85,,,percent of total billed charges,61.85% of total billed charges,765.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,994.53,130,,,Fee Schedule,130% of WA Medicaid ,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1403.19,37.7,,,percent of total billed charges,37.70% of total billed charges,1403.19,37.7,,,percent of total billed charges,37.70% of total billed charges,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,126175.8,33.9,,,percent of total billed charges,33.9% of total billed charges,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2903.16,78,,,percent of total billed charges,78% of total billed charges,3722,100,,,percent of total billed charges,100% of total billed charges,3074.37,82.6,,,percent of total billed charges,82.6% of total billed charges,3074.37,82.6,,,percent of total billed charges,82.6% of total billed charges,765.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,178.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,765.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,178.94,126175.8,
REPAIR LIVER WOUND,47361,CDM,983,RC,47361,HCPCS,Outpatient,,,8339.9,5420.94,,7339.11,88,,,percent of total billed charges,88% of total Billed charges,417.31,100,,,Fee Schedule,100% of Medicare rate,1670.48,100,,,Fee Schedule,100% of WA Medicaid,8339.9,100,,,percent of total billed charges,100% of total billed charges,1720.59,103,,,Fee Schedule,103% of WA Medicaid,417.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,730.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1670.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5754.53,69,,,percent of total billed charges,69% of total billed charges,8339.9,100,,,percent of total billed charges,100% of total billed charges,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,8339.9,100,,,percent of total billed charges,100% of total billed charges,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,8339.9,100,,,percent of total billed charges,100% of total billed charges,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,5158.23,61.85,,,percent of total billed charges,61.85% of total billed charges,1670.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1670.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1703.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2171.62,130,,,Fee Schedule,130% of WA Medicaid ,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,3144.14,37.7,,,percent of total billed charges,37.70% of total billed charges,3144.14,37.7,,,percent of total billed charges,37.70% of total billed charges,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,282722.61,33.9,,,percent of total billed charges,33.9% of total billed charges,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,6505.12,78,,,percent of total billed charges,78% of total billed charges,8339.9,100,,,percent of total billed charges,100% of total billed charges,6888.76,82.6,,,percent of total billed charges,82.6% of total billed charges,6888.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1670.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,417.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1670.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,417.31,282722.61,
REPAIR LIVER WOUND,47360,CDM,983,RC,47360,HCPCS,Outpatient,,,5052,3283.80,,4445.76,88,,,percent of total billed charges,88% of total Billed charges,264.37,100,,,Fee Schedule,100% of Medicare rate,1045.89,100,,,Fee Schedule,100% of WA Medicaid,5052,100,,,percent of total billed charges,100% of total billed charges,1077.27,103,,,Fee Schedule,103% of WA Medicaid,264.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,462.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1045.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3485.88,69,,,percent of total billed charges,69% of total billed charges,5052,100,,,percent of total billed charges,100% of total billed charges,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,5052,100,,,percent of total billed charges,100% of total billed charges,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,5052,100,,,percent of total billed charges,100% of total billed charges,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,3124.66,61.85,,,percent of total billed charges,61.85% of total billed charges,1045.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1066.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1359.66,130,,,Fee Schedule,130% of WA Medicaid ,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1904.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1904.6,37.7,,,percent of total billed charges,37.70% of total billed charges,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,171262.8,33.9,,,percent of total billed charges,33.9% of total billed charges,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,3940.56,78,,,percent of total billed charges,78% of total billed charges,5052,100,,,percent of total billed charges,100% of total billed charges,4172.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4172.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1045.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,264.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,264.37,171262.8,
LAPAROSCOPE PROCEDURE LIVER,47379,CDM,983,RC,47379,HCPCS,Outpatient,,,3342,2172.30,,2940.96,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3342,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2305.98,69,,,percent of total billed charges,69% of total billed charges,3342,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3342,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3342,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2067.03,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1259.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1259.93,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,113293.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2606.76,78,,,percent of total billed charges,78% of total billed charges,3342,100,,,percent of total billed charges,100% of total billed charges,2760.49,82.6,,,percent of total billed charges,82.6% of total billed charges,2760.49,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1259.93,113293.8,
LAPARO CHOLECYSTECTOMY/EXPLR,47564,CDM,983,RC,47564,HCPCS,Outpatient,,,4008,2605.20,,3527.04,88,,,percent of total billed charges,88% of total Billed charges,151.55,100,,,Fee Schedule,100% of Medicare rate,629.81,100,,,Fee Schedule,100% of WA Medicaid,4008,100,,,percent of total billed charges,100% of total billed charges,648.7,103,,,Fee Schedule,103% of WA Medicaid,151.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,265.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,629.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2765.52,69,,,percent of total billed charges,69% of total billed charges,4008,100,,,percent of total billed charges,100% of total billed charges,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4008,100,,,percent of total billed charges,100% of total billed charges,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4008,100,,,percent of total billed charges,100% of total billed charges,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2478.95,61.85,,,percent of total billed charges,61.85% of total billed charges,629.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,818.75,130,,,Fee Schedule,130% of WA Medicaid ,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1511.02,37.7,,,percent of total billed charges,37.70% of total billed charges,1511.02,37.7,,,percent of total billed charges,37.70% of total billed charges,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,135871.2,33.9,,,percent of total billed charges,33.9% of total billed charges,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3126.24,78,,,percent of total billed charges,78% of total billed charges,4008,100,,,percent of total billed charges,100% of total billed charges,3310.61,82.6,,,percent of total billed charges,82.6% of total billed charges,3310.61,82.6,,,percent of total billed charges,82.6% of total billed charges,629.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,151.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,151.55,135871.2,
LAPARO CHOLECYSTECTOMY/GRAPH,47563,CDM,983,RC,47563,HCPCS,Outpatient,,,3575,2323.75,,3146,88,,,percent of total billed charges,88% of total Billed charges,96.38,100,,,Fee Schedule,100% of Medicare rate,405.64,100,,,Fee Schedule,100% of WA Medicaid,3575,100,,,percent of total billed charges,100% of total billed charges,417.81,103,,,Fee Schedule,103% of WA Medicaid,96.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,168.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,405.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2466.75,69,,,percent of total billed charges,69% of total billed charges,3575,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3575,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,3575,100,,,percent of total billed charges,100% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2211.14,61.85,,,percent of total billed charges,61.85% of total billed charges,405.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,527.33,130,,,Fee Schedule,130% of WA Medicaid ,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1347.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1347.78,37.7,,,percent of total billed charges,37.70% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,121192.5,33.9,,,percent of total billed charges,33.9% of total billed charges,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2788.5,78,,,percent of total billed charges,78% of total billed charges,3575,100,,,percent of total billed charges,100% of total billed charges,2952.95,82.6,,,percent of total billed charges,82.6% of total billed charges,2952.95,82.6,,,percent of total billed charges,82.6% of total billed charges,405.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.38,121192.5,
LAPAROSCOPIC CHOLECYSTECTOMY,47562,CDM,983,RC,47562,HCPCS,Outpatient,,,3401,2210.65,,2992.88,88,,,percent of total billed charges,88% of total Billed charges,88.19,100,,,Fee Schedule,100% of Medicare rate,373.37,100,,,Fee Schedule,100% of WA Medicaid,3401,100,,,percent of total billed charges,100% of total billed charges,384.57,103,,,Fee Schedule,103% of WA Medicaid,88.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,154.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,373.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2346.69,69,,,percent of total billed charges,69% of total billed charges,3401,100,,,percent of total billed charges,100% of total billed charges,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,3401,100,,,percent of total billed charges,100% of total billed charges,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,3401,100,,,percent of total billed charges,100% of total billed charges,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2103.52,61.85,,,percent of total billed charges,61.85% of total billed charges,373.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,485.38,130,,,Fee Schedule,130% of WA Medicaid ,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1282.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1282.18,37.7,,,percent of total billed charges,37.70% of total billed charges,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,115293.9,33.9,,,percent of total billed charges,33.9% of total billed charges,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2652.78,78,,,percent of total billed charges,78% of total billed charges,3401,100,,,percent of total billed charges,100% of total billed charges,2809.23,82.6,,,percent of total billed charges,82.6% of total billed charges,2809.23,82.6,,,percent of total billed charges,82.6% of total billed charges,373.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.19,115293.9,
REMOVAL OF GALLBLADDER,47605,CDM,983,RC,47605,HCPCS,Outpatient,,,3146,2044.90,,2768.48,88,,,percent of total billed charges,88% of total Billed charges,153.82,100,,,Fee Schedule,100% of Medicare rate,633.17,100,,,Fee Schedule,100% of WA Medicaid,3146,100,,,percent of total billed charges,100% of total billed charges,652.17,103,,,Fee Schedule,103% of WA Medicaid,153.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,269.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,633.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2170.74,69,,,percent of total billed charges,69% of total billed charges,3146,100,,,percent of total billed charges,100% of total billed charges,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,3146,100,,,percent of total billed charges,100% of total billed charges,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,3146,100,,,percent of total billed charges,100% of total billed charges,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1945.8,61.85,,,percent of total billed charges,61.85% of total billed charges,633.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,823.12,130,,,Fee Schedule,130% of WA Medicaid ,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1186.04,37.7,,,percent of total billed charges,37.70% of total billed charges,1186.04,37.7,,,percent of total billed charges,37.70% of total billed charges,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,106649.4,33.9,,,percent of total billed charges,33.9% of total billed charges,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2453.88,78,,,percent of total billed charges,78% of total billed charges,3146,100,,,percent of total billed charges,100% of total billed charges,2598.6,82.6,,,percent of total billed charges,82.6% of total billed charges,2598.6,82.6,,,percent of total billed charges,82.6% of total billed charges,633.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,153.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,153.82,106649.4,
REMOVAL OF GALLBLADDER,47600,CDM,983,RC,47600,HCPCS,Outpatient,,,2982,1938.30,,2624.16,88,,,percent of total billed charges,88% of total Billed charges,144.37,100,,,Fee Schedule,100% of Medicare rate,601.84,100,,,Fee Schedule,100% of WA Medicaid,2982,100,,,percent of total billed charges,100% of total billed charges,619.9,103,,,Fee Schedule,103% of WA Medicaid,144.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,252.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,601.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2057.58,69,,,percent of total billed charges,69% of total billed charges,2982,100,,,percent of total billed charges,100% of total billed charges,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2982,100,,,percent of total billed charges,100% of total billed charges,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2982,100,,,percent of total billed charges,100% of total billed charges,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1844.37,61.85,,,percent of total billed charges,61.85% of total billed charges,601.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,601.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,613.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,782.39,130,,,Fee Schedule,130% of WA Medicaid ,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1124.21,37.7,,,percent of total billed charges,37.70% of total billed charges,1124.21,37.7,,,percent of total billed charges,37.70% of total billed charges,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,101089.8,33.9,,,percent of total billed charges,33.9% of total billed charges,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2325.96,78,,,percent of total billed charges,78% of total billed charges,2982,100,,,percent of total billed charges,100% of total billed charges,2463.13,82.6,,,percent of total billed charges,82.6% of total billed charges,2463.13,82.6,,,percent of total billed charges,82.6% of total billed charges,601.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,144.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,601.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,144.37,101089.8,
REMOVAL OF GALLBLADDER,47610,CDM,983,RC,47610,HCPCS,Outpatient,,,3738,2429.70,,3289.44,88,,,percent of total billed charges,88% of total Billed charges,173.41,100,,,Fee Schedule,100% of Medicare rate,699.19,100,,,Fee Schedule,100% of WA Medicaid,3738,100,,,percent of total billed charges,100% of total billed charges,720.17,103,,,Fee Schedule,103% of WA Medicaid,173.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,303.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,699.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2579.22,69,,,percent of total billed charges,69% of total billed charges,3738,100,,,percent of total billed charges,100% of total billed charges,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,3738,100,,,percent of total billed charges,100% of total billed charges,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,3738,100,,,percent of total billed charges,100% of total billed charges,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2311.95,61.85,,,percent of total billed charges,61.85% of total billed charges,699.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,713.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,908.95,130,,,Fee Schedule,130% of WA Medicaid ,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1409.23,37.7,,,percent of total billed charges,37.70% of total billed charges,1409.23,37.7,,,percent of total billed charges,37.70% of total billed charges,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,126718.2,33.9,,,percent of total billed charges,33.9% of total billed charges,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2915.64,78,,,percent of total billed charges,78% of total billed charges,3738,100,,,percent of total billed charges,100% of total billed charges,3087.59,82.6,,,percent of total billed charges,82.6% of total billed charges,3087.59,82.6,,,percent of total billed charges,82.6% of total billed charges,699.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,173.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,173.41,126718.2,
RESECT/DEBRIDE PANCREAS,48105,CDM,983,RC,48105,HCPCS,Outpatient,,,7715,5014.75,,6789.2,88,,,percent of total billed charges,88% of total Billed charges,362.28,100,,,Fee Schedule,100% of Medicare rate,1572.75,100,,,Fee Schedule,100% of WA Medicaid,7715,100,,,percent of total billed charges,100% of total billed charges,1619.93,103,,,Fee Schedule,103% of WA Medicaid,362.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,633.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1572.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5323.35,69,,,percent of total billed charges,69% of total billed charges,7715,100,,,percent of total billed charges,100% of total billed charges,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,7715,100,,,percent of total billed charges,100% of total billed charges,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,7715,100,,,percent of total billed charges,100% of total billed charges,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4771.73,61.85,,,percent of total billed charges,61.85% of total billed charges,1572.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1572.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1604.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2044.58,130,,,Fee Schedule,130% of WA Medicaid ,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2908.56,37.7,,,percent of total billed charges,37.70% of total billed charges,2908.56,37.7,,,percent of total billed charges,37.70% of total billed charges,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,261538.5,33.9,,,percent of total billed charges,33.9% of total billed charges,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,6017.7,78,,,percent of total billed charges,78% of total billed charges,7715,100,,,percent of total billed charges,100% of total billed charges,6372.59,82.6,,,percent of total billed charges,82.6% of total billed charges,6372.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1572.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,365.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,362.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1572.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,362.28,261538.5,
BIOPSY OF PANCREAS OPEN,48100,CDM,983,RC,48100,HCPCS,Outpatient,,,2410,1566.50,,2120.8,88,,,percent of total billed charges,88% of total Billed charges,119.4,100,,,Fee Schedule,100% of Medicare rate,502.24,100,,,Fee Schedule,100% of WA Medicaid,2410,100,,,percent of total billed charges,100% of total billed charges,517.31,103,,,Fee Schedule,103% of WA Medicaid,119.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,208.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,502.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1662.9,69,,,percent of total billed charges,69% of total billed charges,2410,100,,,percent of total billed charges,100% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2410,100,,,percent of total billed charges,100% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2410,100,,,percent of total billed charges,100% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1490.59,61.85,,,percent of total billed charges,61.85% of total billed charges,502.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,652.91,130,,,Fee Schedule,130% of WA Medicaid ,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,908.57,37.7,,,percent of total billed charges,37.70% of total billed charges,908.57,37.7,,,percent of total billed charges,37.70% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,81699,33.9,,,percent of total billed charges,33.9% of total billed charges,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1879.8,78,,,percent of total billed charges,78% of total billed charges,2410,100,,,percent of total billed charges,100% of total billed charges,1990.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1990.66,82.6,,,percent of total billed charges,82.6% of total billed charges,502.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,119.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.4,81699,
NEEDLE BIOPSY PANCREAS,48102,CDM,983,RC,48102,HCPCS,Outpatient,,,683,443.95,,601.04,88,,,percent of total billed charges,88% of total Billed charges,19.11,100,,,Fee Schedule,100% of Medicare rate,130.74,100,,,Fee Schedule,100% of WA Medicaid,683,100,,,percent of total billed charges,100% of total billed charges,134.66,103,,,Fee Schedule,103% of WA Medicaid,19.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,130.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,471.27,69,,,percent of total billed charges,69% of total billed charges,683,100,,,percent of total billed charges,100% of total billed charges,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,683,100,,,percent of total billed charges,100% of total billed charges,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,683,100,,,percent of total billed charges,100% of total billed charges,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,422.44,61.85,,,percent of total billed charges,61.85% of total billed charges,130.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,169.96,130,,,Fee Schedule,130% of WA Medicaid ,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.49,37.7,,,percent of total billed charges,37.70% of total billed charges,257.49,37.7,,,percent of total billed charges,37.70% of total billed charges,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,23153.7,33.9,,,percent of total billed charges,33.9% of total billed charges,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,532.74,78,,,percent of total billed charges,78% of total billed charges,683,100,,,percent of total billed charges,100% of total billed charges,564.16,82.6,,,percent of total billed charges,82.6% of total billed charges,564.16,82.6,,,percent of total billed charges,82.6% of total billed charges,130.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.11,23153.7,
REMOVAL OF PANCREAS LESION,48120,CDM,983,RC,48120,HCPCS,Outpatient,,,3006,1953.90,,2645.28,88,,,percent of total billed charges,88% of total Billed charges,155.44,100,,,Fee Schedule,100% of Medicare rate,624.4,100,,,Fee Schedule,100% of WA Medicaid,3006,100,,,percent of total billed charges,100% of total billed charges,643.13,103,,,Fee Schedule,103% of WA Medicaid,155.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,272.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,624.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2074.14,69,,,percent of total billed charges,69% of total billed charges,3006,100,,,percent of total billed charges,100% of total billed charges,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,3006,100,,,percent of total billed charges,100% of total billed charges,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,3006,100,,,percent of total billed charges,100% of total billed charges,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1859.21,61.85,,,percent of total billed charges,61.85% of total billed charges,624.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,636.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,811.72,130,,,Fee Schedule,130% of WA Medicaid ,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1133.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1133.26,37.7,,,percent of total billed charges,37.70% of total billed charges,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,101903.4,33.9,,,percent of total billed charges,33.9% of total billed charges,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2344.68,78,,,percent of total billed charges,78% of total billed charges,3006,100,,,percent of total billed charges,100% of total billed charges,2482.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2482.96,82.6,,,percent of total billed charges,82.6% of total billed charges,624.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,155.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,155.44,101903.4,
PARTIAL REMOVAL OF PANCREAS,48140,CDM,983,RC,48140,HCPCS,Outpatient,,,4234,2752.10,,3725.92,88,,,percent of total billed charges,88% of total Billed charges,216,100,,,Fee Schedule,100% of Medicare rate,876.92,100,,,Fee Schedule,100% of WA Medicaid,4234,100,,,percent of total billed charges,100% of total billed charges,903.23,103,,,Fee Schedule,103% of WA Medicaid,216,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,378,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,876.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2921.46,69,,,percent of total billed charges,69% of total billed charges,4234,100,,,percent of total billed charges,100% of total billed charges,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,4234,100,,,percent of total billed charges,100% of total billed charges,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,4234,100,,,percent of total billed charges,100% of total billed charges,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,2618.73,61.85,,,percent of total billed charges,61.85% of total billed charges,876.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1140,130,,,Fee Schedule,130% of WA Medicaid ,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,1596.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1596.22,37.7,,,percent of total billed charges,37.70% of total billed charges,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,143532.6,33.9,,,percent of total billed charges,33.9% of total billed charges,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,3302.52,78,,,percent of total billed charges,78% of total billed charges,4234,100,,,percent of total billed charges,100% of total billed charges,3497.28,82.6,,,percent of total billed charges,82.6% of total billed charges,3497.28,82.6,,,percent of total billed charges,82.6% of total billed charges,876.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,216,100,,,Fee Schedule,100% of Medicare RBRVS rate,876.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,216,143532.6,
PARTIAL REMOVAL OF PANCREAS,48150,CDM,983,RC,48150,HCPCS,Outpatient,,,7525,4891.25,,6622,88,,,percent of total billed charges,88% of total Billed charges,435.32,100,,,Fee Schedule,100% of Medicare rate,1737.43,100,,,Fee Schedule,100% of WA Medicaid,7525,100,,,percent of total billed charges,100% of total billed charges,1789.55,103,,,Fee Schedule,103% of WA Medicaid,435.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,761.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1737.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5192.25,69,,,percent of total billed charges,69% of total billed charges,7525,100,,,percent of total billed charges,100% of total billed charges,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7525,100,,,percent of total billed charges,100% of total billed charges,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7525,100,,,percent of total billed charges,100% of total billed charges,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,4654.21,61.85,,,percent of total billed charges,61.85% of total billed charges,1737.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1737.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1772.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2258.66,130,,,Fee Schedule,130% of WA Medicaid ,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2836.93,37.7,,,percent of total billed charges,37.70% of total billed charges,2836.93,37.7,,,percent of total billed charges,37.70% of total billed charges,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,255097.5,33.9,,,percent of total billed charges,33.9% of total billed charges,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,5869.5,78,,,percent of total billed charges,78% of total billed charges,7525,100,,,percent of total billed charges,100% of total billed charges,6215.65,82.6,,,percent of total billed charges,82.6% of total billed charges,6215.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1737.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,435.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1737.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,435.32,255097.5,
EXPLORATION OF ABDOMEN,49000,CDM,983,RC,49000,HCPCS,Outpatient,,,2386,1550.90,,2099.68,88,,,percent of total billed charges,88% of total Billed charges,99.4,100,,,Fee Schedule,100% of Medicare rate,433.05,100,,,Fee Schedule,100% of WA Medicaid,2386,100,,,percent of total billed charges,100% of total billed charges,446.04,103,,,Fee Schedule,103% of WA Medicaid,99.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,433.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1646.34,69,,,percent of total billed charges,69% of total billed charges,2386,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2386,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2386,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1475.74,61.85,,,percent of total billed charges,61.85% of total billed charges,433.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,562.97,130,,,Fee Schedule,130% of WA Medicaid ,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,899.52,37.7,,,percent of total billed charges,37.70% of total billed charges,899.52,37.7,,,percent of total billed charges,37.70% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,80885.4,33.9,,,percent of total billed charges,33.9% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1861.08,78,,,percent of total billed charges,78% of total billed charges,2386,100,,,percent of total billed charges,100% of total billed charges,1970.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1970.84,82.6,,,percent of total billed charges,82.6% of total billed charges,433.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.4,80885.4,
REOPENING OF ABDOMEN,49002,CDM,983,RC,49002,HCPCS,Outpatient,,,2172,1411.80,,1911.36,88,,,percent of total billed charges,88% of total Billed charges,140.83,100,,,Fee Schedule,100% of Medicare rate,583.56,100,,,Fee Schedule,100% of WA Medicaid,2172,100,,,percent of total billed charges,100% of total billed charges,601.07,103,,,Fee Schedule,103% of WA Medicaid,140.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,246.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,583.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1498.68,69,,,percent of total billed charges,69% of total billed charges,2172,100,,,percent of total billed charges,100% of total billed charges,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2172,100,,,percent of total billed charges,100% of total billed charges,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2172,100,,,percent of total billed charges,100% of total billed charges,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1343.38,61.85,,,percent of total billed charges,61.85% of total billed charges,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,595.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,758.63,130,,,Fee Schedule,130% of WA Medicaid ,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,818.84,37.7,,,percent of total billed charges,37.70% of total billed charges,818.84,37.7,,,percent of total billed charges,37.70% of total billed charges,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,73630.8,33.9,,,percent of total billed charges,33.9% of total billed charges,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1694.16,78,,,percent of total billed charges,78% of total billed charges,2172,100,,,percent of total billed charges,100% of total billed charges,1794.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1794.07,82.6,,,percent of total billed charges,82.6% of total billed charges,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,140.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.83,73630.8,
EXPLORATION BEHIND ABDOMEN,49010,CDM,983,RC,49010,HCPCS,Outpatient,,,2458,1597.70,,2163.04,88,,,percent of total billed charges,88% of total Billed charges,124.52,100,,,Fee Schedule,100% of Medicare rate,515.11,100,,,Fee Schedule,100% of WA Medicaid,2458,100,,,percent of total billed charges,100% of total billed charges,530.56,103,,,Fee Schedule,103% of WA Medicaid,124.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,217.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,515.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1696.02,69,,,percent of total billed charges,69% of total billed charges,2458,100,,,percent of total billed charges,100% of total billed charges,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2458,100,,,percent of total billed charges,100% of total billed charges,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2458,100,,,percent of total billed charges,100% of total billed charges,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1520.27,61.85,,,percent of total billed charges,61.85% of total billed charges,515.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,669.64,130,,,Fee Schedule,130% of WA Medicaid ,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,926.67,37.7,,,percent of total billed charges,37.70% of total billed charges,926.67,37.7,,,percent of total billed charges,37.70% of total billed charges,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,83326.2,33.9,,,percent of total billed charges,33.9% of total billed charges,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1917.24,78,,,percent of total billed charges,78% of total billed charges,2458,100,,,percent of total billed charges,100% of total billed charges,2030.31,82.6,,,percent of total billed charges,82.6% of total billed charges,2030.31,82.6,,,percent of total billed charges,82.6% of total billed charges,515.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,124.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.52,83326.2,
DRAINAGE ABDOM ABSCESS OPEN,49020,CDM,983,RC,49020,HCPCS,Outpatient,,,2316,1505.40,,2038.08,88,,,percent of total billed charges,88% of total Billed charges,210.67,100,,,Fee Schedule,100% of Medicare rate,894.08,100,,,Fee Schedule,100% of WA Medicaid,2316,100,,,percent of total billed charges,100% of total billed charges,920.9,103,,,Fee Schedule,103% of WA Medicaid,210.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,368.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,894.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1598.04,69,,,percent of total billed charges,69% of total billed charges,2316,100,,,percent of total billed charges,100% of total billed charges,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2316,100,,,percent of total billed charges,100% of total billed charges,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2316,100,,,percent of total billed charges,100% of total billed charges,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1432.45,61.85,,,percent of total billed charges,61.85% of total billed charges,894.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,911.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1162.3,130,,,Fee Schedule,130% of WA Medicaid ,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,873.13,37.7,,,percent of total billed charges,37.70% of total billed charges,873.13,37.7,,,percent of total billed charges,37.70% of total billed charges,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,78512.4,33.9,,,percent of total billed charges,33.9% of total billed charges,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1806.48,78,,,percent of total billed charges,78% of total billed charges,2316,100,,,percent of total billed charges,100% of total billed charges,1913.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1913.02,82.6,,,percent of total billed charges,82.6% of total billed charges,894.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,210.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,210.67,78512.4,
DRAIN OPEN ABDOM ABSCESS,49040,CDM,983,RC,49040,HCPCS,Outpatient,,,2026,1316.90,,1782.88,88,,,percent of total billed charges,88% of total Billed charges,132.5,100,,,Fee Schedule,100% of Medicare rate,563.6,100,,,Fee Schedule,100% of WA Medicaid,2026,100,,,percent of total billed charges,100% of total billed charges,580.51,103,,,Fee Schedule,103% of WA Medicaid,132.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,231.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,563.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1397.94,69,,,percent of total billed charges,69% of total billed charges,2026,100,,,percent of total billed charges,100% of total billed charges,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2026,100,,,percent of total billed charges,100% of total billed charges,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2026,100,,,percent of total billed charges,100% of total billed charges,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1253.08,61.85,,,percent of total billed charges,61.85% of total billed charges,563.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,563.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,732.68,130,,,Fee Schedule,130% of WA Medicaid ,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,763.8,37.7,,,percent of total billed charges,37.70% of total billed charges,763.8,37.7,,,percent of total billed charges,37.70% of total billed charges,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,68681.4,33.9,,,percent of total billed charges,33.9% of total billed charges,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1580.28,78,,,percent of total billed charges,78% of total billed charges,2026,100,,,percent of total billed charges,100% of total billed charges,1673.48,82.6,,,percent of total billed charges,82.6% of total billed charges,1673.48,82.6,,,percent of total billed charges,82.6% of total billed charges,563.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,132.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,563.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,132.5,68681.4,
DRAIN OPEN RETROPERI ABSCESS,49060,CDM,983,RC,49060,HCPCS,Outpatient,,,2102,1366.30,,1849.76,88,,,percent of total billed charges,88% of total Billed charges,141.15,100,,,Fee Schedule,100% of Medicare rate,614.33,100,,,Fee Schedule,100% of WA Medicaid,2102,100,,,percent of total billed charges,100% of total billed charges,632.76,103,,,Fee Schedule,103% of WA Medicaid,141.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,247.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,614.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1450.38,69,,,percent of total billed charges,69% of total billed charges,2102,100,,,percent of total billed charges,100% of total billed charges,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2102,100,,,percent of total billed charges,100% of total billed charges,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2102,100,,,percent of total billed charges,100% of total billed charges,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300.09,61.85,,,percent of total billed charges,61.85% of total billed charges,614.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,626.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,798.63,130,,,Fee Schedule,130% of WA Medicaid ,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,792.45,37.7,,,percent of total billed charges,37.70% of total billed charges,792.45,37.7,,,percent of total billed charges,37.70% of total billed charges,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,71257.8,33.9,,,percent of total billed charges,33.9% of total billed charges,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,1639.56,78,,,percent of total billed charges,78% of total billed charges,2102,100,,,percent of total billed charges,100% of total billed charges,1736.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1736.25,82.6,,,percent of total billed charges,82.6% of total billed charges,614.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,141.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,141.15,71257.8,
PERITONEAL LAVAGE,49084,CDM,983,RC,49084,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,14.79,100,,,Fee Schedule,100% of Medicare rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,60.7,103,,,Fee Schedule,103% of WA Medicaid,14.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,58.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,90,100,,,percent of total billed charges,100% of total billed charges,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,90,100,,,percent of total billed charges,100% of total billed charges,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.67,61.85,,,percent of total billed charges,61.85% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.61,130,,,Fee Schedule,130% of WA Medicaid ,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3051,33.9,,,percent of total billed charges,33.9% of total billed charges,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.79,3051,
49081 Paracentesis w/Imaging,49081,CDM,983,RC,49081,HCPCS,Outpatient,,,449,291.85,,395.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,449,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,309.81,69,,,percent of total billed charges,69% of total billed charges,449,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,449,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,449,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,277.71,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,169.27,37.7,,,percent of total billed charges,37.70% of total billed charges,169.27,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15221.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,350.22,78,,,percent of total billed charges,78% of total billed charges,449,100,,,percent of total billed charges,100% of total billed charges,370.87,82.6,,,percent of total billed charges,82.6% of total billed charges,370.87,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",169.27,15221.1,
EXC ABD TUM OVER 10 CM,49205,CDM,983,RC,49205,HCPCS,Outpatient,,,1825,1186.25,,1606,88,,,percent of total billed charges,88% of total Billed charges,224.84,100,,,Fee Schedule,100% of Medicare rate,980.24,100,,,Fee Schedule,100% of WA Medicaid,1825,100,,,percent of total billed charges,100% of total billed charges,1009.65,103,,,Fee Schedule,103% of WA Medicaid,224.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,393.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,980.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1259.25,69,,,percent of total billed charges,69% of total billed charges,1825,100,,,percent of total billed charges,100% of total billed charges,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825,100,,,percent of total billed charges,100% of total billed charges,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1825,100,,,percent of total billed charges,100% of total billed charges,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128.76,61.85,,,percent of total billed charges,61.85% of total billed charges,980.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,980.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,999.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1274.31,130,,,Fee Schedule,130% of WA Medicaid ,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,688.03,37.7,,,percent of total billed charges,37.70% of total billed charges,688.03,37.7,,,percent of total billed charges,37.70% of total billed charges,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,61867.5,33.9,,,percent of total billed charges,33.9% of total billed charges,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.5,78,,,percent of total billed charges,78% of total billed charges,1825,100,,,percent of total billed charges,100% of total billed charges,1507.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1507.45,82.6,,,percent of total billed charges,82.6% of total billed charges,980.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,224.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,980.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,224.84,61867.5,
EXC ABD TUM 5 CM OR LESS,49203,CDM,983,RC,49203,HCPCS,Outpatient,,,376,244.40,,330.88,88,,,percent of total billed charges,88% of total Billed charges,150.94,100,,,Fee Schedule,100% of Medicare rate,671.96,100,,,Fee Schedule,100% of WA Medicaid,376,100,,,percent of total billed charges,100% of total billed charges,692.12,103,,,Fee Schedule,103% of WA Medicaid,150.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,264.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,671.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,259.44,69,,,percent of total billed charges,69% of total billed charges,376,100,,,percent of total billed charges,100% of total billed charges,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,376,100,,,percent of total billed charges,100% of total billed charges,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,376,100,,,percent of total billed charges,100% of total billed charges,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.56,61.85,,,percent of total billed charges,61.85% of total billed charges,671.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,873.55,130,,,Fee Schedule,130% of WA Medicaid ,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.75,37.7,,,percent of total billed charges,37.70% of total billed charges,141.75,37.7,,,percent of total billed charges,37.70% of total billed charges,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,12746.4,33.9,,,percent of total billed charges,33.9% of total billed charges,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.28,78,,,percent of total billed charges,78% of total billed charges,376,100,,,percent of total billed charges,100% of total billed charges,310.58,82.6,,,percent of total billed charges,82.6% of total billed charges,310.58,82.6,,,percent of total billed charges,82.6% of total billed charges,671.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,150.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,141.75,12746.4,
EXC OF PRESACRAL TUMOR,49215,CDM,983,RC,49215,HCPCS,Outpatient,,,4602,2991.30,,4049.76,88,,,percent of total billed charges,88% of total Billed charges,280.81,100,,,Fee Schedule,100% of Medicare rate,1244.33,100,,,Fee Schedule,100% of WA Medicaid,4602,100,,,percent of total billed charges,100% of total billed charges,1281.66,103,,,Fee Schedule,103% of WA Medicaid,280.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,491.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1244.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3175.38,69,,,percent of total billed charges,69% of total billed charges,4602,100,,,percent of total billed charges,100% of total billed charges,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4602,100,,,percent of total billed charges,100% of total billed charges,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4602,100,,,percent of total billed charges,100% of total billed charges,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2846.34,61.85,,,percent of total billed charges,61.85% of total billed charges,1244.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1244.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1269.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1617.63,130,,,Fee Schedule,130% of WA Medicaid ,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1734.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1734.95,37.7,,,percent of total billed charges,37.70% of total billed charges,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,156007.8,33.9,,,percent of total billed charges,33.9% of total billed charges,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,3589.56,78,,,percent of total billed charges,78% of total billed charges,4602,100,,,percent of total billed charges,100% of total billed charges,3801.25,82.6,,,percent of total billed charges,82.6% of total billed charges,3801.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1244.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,280.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1244.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,280.81,156007.8,
EXCISION OF UMBILICUS,49250,CDM,983,RC,49250,HCPCS,Outpatient,,,1680,1092.00,,1478.4,88,,,percent of total billed charges,88% of total Billed charges,72.07,100,,,Fee Schedule,100% of Medicare rate,338.68,100,,,Fee Schedule,100% of WA Medicaid,1680,100,,,percent of total billed charges,100% of total billed charges,348.84,103,,,Fee Schedule,103% of WA Medicaid,72.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,338.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1159.2,69,,,percent of total billed charges,69% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1680,100,,,percent of total billed charges,100% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1680,100,,,percent of total billed charges,100% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1039.08,61.85,,,percent of total billed charges,61.85% of total billed charges,338.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,440.28,130,,,Fee Schedule,130% of WA Medicaid ,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,633.36,37.7,,,percent of total billed charges,37.70% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,56952,33.9,,,percent of total billed charges,33.9% of total billed charges,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1310.4,78,,,percent of total billed charges,78% of total billed charges,1680,100,,,percent of total billed charges,100% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,1387.68,82.6,,,percent of total billed charges,82.6% of total billed charges,338.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.07,56952,
"OMENTECTOMY,EPILOECTOMY",49255,CDM,983,RC,49255,HCPCS,Outpatient,,,1631,1060.15,,1435.28,88,,,percent of total billed charges,88% of total Billed charges,94.55,100,,,Fee Schedule,100% of Medicare rate,450.02,100,,,Fee Schedule,100% of WA Medicaid,1631,100,,,percent of total billed charges,100% of total billed charges,463.52,103,,,Fee Schedule,103% of WA Medicaid,94.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,165.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,450.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1125.39,69,,,percent of total billed charges,69% of total billed charges,1631,100,,,percent of total billed charges,100% of total billed charges,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1631,100,,,percent of total billed charges,100% of total billed charges,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1631,100,,,percent of total billed charges,100% of total billed charges,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1008.77,61.85,,,percent of total billed charges,61.85% of total billed charges,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,585.03,130,,,Fee Schedule,130% of WA Medicaid ,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.89,37.7,,,percent of total billed charges,37.70% of total billed charges,614.89,37.7,,,percent of total billed charges,37.70% of total billed charges,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,55290.9,33.9,,,percent of total billed charges,33.9% of total billed charges,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1272.18,78,,,percent of total billed charges,78% of total billed charges,1631,100,,,percent of total billed charges,100% of total billed charges,1347.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1347.21,82.6,,,percent of total billed charges,82.6% of total billed charges,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,94.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.55,55290.9,
DIAG LAPARO SEPARATE PROC,49320,CDM,983,RC,49320,HCPCS,Outpatient,,,1467,953.55,,1290.96,88,,,percent of total billed charges,88% of total Billed charges,41.51,100,,,Fee Schedule,100% of Medicare rate,186.87,100,,,Fee Schedule,100% of WA Medicaid,1467,100,,,percent of total billed charges,100% of total billed charges,192.48,103,,,Fee Schedule,103% of WA Medicaid,41.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,186.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1012.23,69,,,percent of total billed charges,69% of total billed charges,1467,100,,,percent of total billed charges,100% of total billed charges,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1467,100,,,percent of total billed charges,100% of total billed charges,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1467,100,,,percent of total billed charges,100% of total billed charges,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,907.34,61.85,,,percent of total billed charges,61.85% of total billed charges,186.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,242.93,130,,,Fee Schedule,130% of WA Medicaid ,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.06,37.7,,,percent of total billed charges,37.70% of total billed charges,553.06,37.7,,,percent of total billed charges,37.70% of total billed charges,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,49731.3,33.9,,,percent of total billed charges,33.9% of total billed charges,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1144.26,78,,,percent of total billed charges,78% of total billed charges,1467,100,,,percent of total billed charges,100% of total billed charges,1211.74,82.6,,,percent of total billed charges,82.6% of total billed charges,1211.74,82.6,,,percent of total billed charges,82.6% of total billed charges,186.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.51,49731.3,
LAPAROSCOPY ASPIRATION,49322,CDM,983,RC,49322,HCPCS,Outpatient,,,941,611.65,,828.08,88,,,percent of total billed charges,88% of total Billed charges,47.26,100,,,Fee Schedule,100% of Medicare rate,212.24,100,,,Fee Schedule,100% of WA Medicaid,941,100,,,percent of total billed charges,100% of total billed charges,218.61,103,,,Fee Schedule,103% of WA Medicaid,47.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,82.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,212.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,649.29,69,,,percent of total billed charges,69% of total billed charges,941,100,,,percent of total billed charges,100% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,941,100,,,percent of total billed charges,100% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,941,100,,,percent of total billed charges,100% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,582.01,61.85,,,percent of total billed charges,61.85% of total billed charges,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,275.91,130,,,Fee Schedule,130% of WA Medicaid ,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.76,37.7,,,percent of total billed charges,37.70% of total billed charges,354.76,37.7,,,percent of total billed charges,37.70% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,31899.9,33.9,,,percent of total billed charges,33.9% of total billed charges,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,733.98,78,,,percent of total billed charges,78% of total billed charges,941,100,,,percent of total billed charges,100% of total billed charges,777.27,82.6,,,percent of total billed charges,82.6% of total billed charges,777.27,82.6,,,percent of total billed charges,82.6% of total billed charges,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.26,31899.9,
LAP INSERT TUNNEL IP CATH,49324,CDM,983,RC,49324,HCPCS,Outpatient,,,1083,703.95,,953.04,88,,,percent of total billed charges,88% of total Billed charges,52.73,100,,,Fee Schedule,100% of Medicare rate,217.46,100,,,Fee Schedule,100% of WA Medicaid,1083,100,,,percent of total billed charges,100% of total billed charges,223.98,103,,,Fee Schedule,103% of WA Medicaid,52.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,92.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,217.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,747.27,69,,,percent of total billed charges,69% of total billed charges,1083,100,,,percent of total billed charges,100% of total billed charges,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1083,100,,,percent of total billed charges,100% of total billed charges,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1083,100,,,percent of total billed charges,100% of total billed charges,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,669.84,61.85,,,percent of total billed charges,61.85% of total billed charges,217.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,282.7,130,,,Fee Schedule,130% of WA Medicaid ,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.29,37.7,,,percent of total billed charges,37.70% of total billed charges,408.29,37.7,,,percent of total billed charges,37.70% of total billed charges,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,36713.7,33.9,,,percent of total billed charges,33.9% of total billed charges,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,844.74,78,,,percent of total billed charges,78% of total billed charges,1083,100,,,percent of total billed charges,100% of total billed charges,894.56,82.6,,,percent of total billed charges,82.6% of total billed charges,894.56,82.6,,,percent of total billed charges,82.6% of total billed charges,217.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.73,36713.7,
"UNLISTED LAP PROC ABDOMEN, PERIT  OMEN",49329,CDM,983,RC,49329,HCPCS,Outpatient,,,953.01,619.46,,838.65,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,953.01,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,657.58,69,,,percent of total billed charges,69% of total billed charges,953.01,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,953.01,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,953.01,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,589.44,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,359.28,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,32307.04,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,743.35,78,,,percent of total billed charges,78% of total billed charges,953.01,100,,,percent of total billed charges,100% of total billed charges,787.19,82.6,,,percent of total billed charges,82.6% of total billed charges,787.19,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",359.28,32307.04,
LAPAROSCOPY BIOPSY,49321,CDM,983,RC,49321,HCPCS,Outpatient,,,926,601.90,,814.88,88,,,percent of total billed charges,88% of total Billed charges,41.97,100,,,Fee Schedule,100% of Medicare rate,195.64,100,,,Fee Schedule,100% of WA Medicaid,926,100,,,percent of total billed charges,100% of total billed charges,201.51,103,,,Fee Schedule,103% of WA Medicaid,41.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,195.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,638.94,69,,,percent of total billed charges,69% of total billed charges,926,100,,,percent of total billed charges,100% of total billed charges,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,926,100,,,percent of total billed charges,100% of total billed charges,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,926,100,,,percent of total billed charges,100% of total billed charges,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,572.73,61.85,,,percent of total billed charges,61.85% of total billed charges,195.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,254.33,130,,,Fee Schedule,130% of WA Medicaid ,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.1,37.7,,,percent of total billed charges,37.70% of total billed charges,349.1,37.7,,,percent of total billed charges,37.70% of total billed charges,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,31391.4,33.9,,,percent of total billed charges,33.9% of total billed charges,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,722.28,78,,,percent of total billed charges,78% of total billed charges,926,100,,,percent of total billed charges,100% of total billed charges,764.88,82.6,,,percent of total billed charges,82.6% of total billed charges,764.88,82.6,,,percent of total billed charges,82.6% of total billed charges,195.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.97,31391.4,
REMOVAL OF PERITONEAL FB; PERITONEAL CAV,49402,CDM,983,RC,49402,HCPCS,Outpatient,,,2008,1305.20,,1767.04,88,,,percent of total billed charges,88% of total Billed charges,114.36,100,,,Fee Schedule,100% of Medicare rate,480.42,100,,,Fee Schedule,100% of WA Medicaid,2008,100,,,percent of total billed charges,100% of total billed charges,494.83,103,,,Fee Schedule,103% of WA Medicaid,114.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,200.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,480.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1385.52,69,,,percent of total billed charges,69% of total billed charges,2008,100,,,percent of total billed charges,100% of total billed charges,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2008,100,,,percent of total billed charges,100% of total billed charges,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2008,100,,,percent of total billed charges,100% of total billed charges,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1241.95,61.85,,,percent of total billed charges,61.85% of total billed charges,480.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,624.55,130,,,Fee Schedule,130% of WA Medicaid ,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,757.02,37.7,,,percent of total billed charges,37.70% of total billed charges,757.02,37.7,,,percent of total billed charges,37.70% of total billed charges,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,68071.2,33.9,,,percent of total billed charges,33.9% of total billed charges,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1566.24,78,,,percent of total billed charges,78% of total billed charges,2008,100,,,percent of total billed charges,100% of total billed charges,1658.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1658.61,82.6,,,percent of total billed charges,82.6% of total billed charges,480.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,114.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.36,68071.2,
INS TUN IP CATH FOR DIAL OPN,49421,CDM,983,RC,49421,HCPCS,Outpatient,,,1059,688.35,,931.92,88,,,percent of total billed charges,88% of total Billed charges,32.81,100,,,Fee Schedule,100% of Medicare rate,124.77,100,,,Fee Schedule,100% of WA Medicaid,1059,100,,,percent of total billed charges,100% of total billed charges,128.51,103,,,Fee Schedule,103% of WA Medicaid,32.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,124.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,730.71,69,,,percent of total billed charges,69% of total billed charges,1059,100,,,percent of total billed charges,100% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1059,100,,,percent of total billed charges,100% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1059,100,,,percent of total billed charges,100% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,654.99,61.85,,,percent of total billed charges,61.85% of total billed charges,124.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,162.2,130,,,Fee Schedule,130% of WA Medicaid ,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.24,37.7,,,percent of total billed charges,37.70% of total billed charges,399.24,37.7,,,percent of total billed charges,37.70% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,35900.1,33.9,,,percent of total billed charges,33.9% of total billed charges,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,826.02,78,,,percent of total billed charges,78% of total billed charges,1059,100,,,percent of total billed charges,100% of total billed charges,874.73,82.6,,,percent of total billed charges,82.6% of total billed charges,874.73,82.6,,,percent of total billed charges,82.6% of total billed charges,124.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.81,35900.1,
REMOVE TUNNELED IP CATH,49422,CDM,983,RC,49422,HCPCS,Outpatient,,,1047,680.55,,921.36,88,,,percent of total billed charges,88% of total Billed charges,31.12,100,,,Fee Schedule,100% of Medicare rate,122.16,100,,,Fee Schedule,100% of WA Medicaid,1047,100,,,percent of total billed charges,100% of total billed charges,125.82,103,,,Fee Schedule,103% of WA Medicaid,31.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,122.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,722.43,69,,,percent of total billed charges,69% of total billed charges,1047,100,,,percent of total billed charges,100% of total billed charges,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1047,100,,,percent of total billed charges,100% of total billed charges,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,1047,100,,,percent of total billed charges,100% of total billed charges,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.57,61.85,,,percent of total billed charges,61.85% of total billed charges,122.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,158.81,130,,,Fee Schedule,130% of WA Medicaid ,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.72,37.7,,,percent of total billed charges,37.70% of total billed charges,394.72,37.7,,,percent of total billed charges,37.70% of total billed charges,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,35493.3,33.9,,,percent of total billed charges,33.9% of total billed charges,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,816.66,78,,,percent of total billed charges,78% of total billed charges,1047,100,,,percent of total billed charges,100% of total billed charges,864.82,82.6,,,percent of total billed charges,82.6% of total billed charges,864.82,82.6,,,percent of total billed charges,82.6% of total billed charges,122.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.12,35493.3,
INSERT ABDOMEN-VENOUS DRAIN,49425,CDM,983,RC,49425,HCPCS,Outpatient,,,2529,1643.85,,2225.52,88,,,percent of total billed charges,88% of total Billed charges,105,100,,,Fee Schedule,100% of Medicare rate,441.26,100,,,Fee Schedule,100% of WA Medicaid,2529,100,,,percent of total billed charges,100% of total billed charges,454.5,103,,,Fee Schedule,103% of WA Medicaid,105,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,183.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,441.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1745.01,69,,,percent of total billed charges,69% of total billed charges,2529,100,,,percent of total billed charges,100% of total billed charges,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,2529,100,,,percent of total billed charges,100% of total billed charges,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,2529,100,,,percent of total billed charges,100% of total billed charges,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,1564.19,61.85,,,percent of total billed charges,61.85% of total billed charges,441.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,573.64,130,,,Fee Schedule,130% of WA Medicaid ,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,953.43,37.7,,,percent of total billed charges,37.70% of total billed charges,953.43,37.7,,,percent of total billed charges,37.70% of total billed charges,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,85733.1,33.9,,,percent of total billed charges,33.9% of total billed charges,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,1972.62,78,,,percent of total billed charges,78% of total billed charges,2529,100,,,percent of total billed charges,100% of total billed charges,2088.95,82.6,,,percent of total billed charges,82.6% of total billed charges,2088.95,82.6,,,percent of total billed charges,82.6% of total billed charges,441.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,105,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,105,85733.1,
INSERTION OF GASTROSTOMY TUBE,49440,CDM,983,RC,49440,HCPCS,Outpatient,,,2141,1391.65,,1884.08,88,,,percent of total billed charges,88% of total Billed charges,16.57,100,,,Fee Schedule,100% of Medicare rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,2141,100,,,percent of total billed charges,100% of total billed charges,115.64,103,,,Fee Schedule,103% of WA Medicaid,16.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1477.29,69,,,percent of total billed charges,69% of total billed charges,2141,100,,,percent of total billed charges,100% of total billed charges,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2141,100,,,percent of total billed charges,100% of total billed charges,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2141,100,,,percent of total billed charges,100% of total billed charges,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1324.21,61.85,,,percent of total billed charges,61.85% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,145.95,130,,,Fee Schedule,130% of WA Medicaid ,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,807.16,37.7,,,percent of total billed charges,37.70% of total billed charges,807.16,37.7,,,percent of total billed charges,37.70% of total billed charges,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,72579.9,33.9,,,percent of total billed charges,33.9% of total billed charges,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1669.98,78,,,percent of total billed charges,78% of total billed charges,2141,100,,,percent of total billed charges,100% of total billed charges,1768.47,82.6,,,percent of total billed charges,82.6% of total billed charges,1768.47,82.6,,,percent of total billed charges,82.6% of total billed charges,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.57,72579.9,
REPLACE DUOD/JEJ TUBE PERC,49451,CDM,983,RC,49451,HCPCS,Outpatient,,,2068,1344.20,,1819.84,88,,,percent of total billed charges,88% of total Billed charges,7.76,100,,,Fee Schedule,100% of Medicare rate,48.49,100,,,Fee Schedule,100% of WA Medicaid,2068,100,,,percent of total billed charges,100% of total billed charges,49.94,103,,,Fee Schedule,103% of WA Medicaid,7.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1426.92,69,,,percent of total billed charges,69% of total billed charges,2068,100,,,percent of total billed charges,100% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2068,100,,,percent of total billed charges,100% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2068,100,,,percent of total billed charges,100% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1279.06,61.85,,,percent of total billed charges,61.85% of total billed charges,48.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.04,130,,,Fee Schedule,130% of WA Medicaid ,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,779.64,37.7,,,percent of total billed charges,37.70% of total billed charges,779.64,37.7,,,percent of total billed charges,37.70% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,70105.2,33.9,,,percent of total billed charges,33.9% of total billed charges,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1613.04,78,,,percent of total billed charges,78% of total billed charges,2068,100,,,percent of total billed charges,100% of total billed charges,1708.17,82.6,,,percent of total billed charges,82.6% of total billed charges,1708.17,82.6,,,percent of total billed charges,82.6% of total billed charges,48.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.76,70105.2,
REPLACE G-J TUBE PERC,49452,CDM,983,RC,49452,HCPCS,Outpatient,,,2548,1656.20,,2242.24,88,,,percent of total billed charges,88% of total Billed charges,11.74,100,,,Fee Schedule,100% of Medicare rate,74.79,100,,,Fee Schedule,100% of WA Medicaid,2548,100,,,percent of total billed charges,100% of total billed charges,77.03,103,,,Fee Schedule,103% of WA Medicaid,11.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1758.12,69,,,percent of total billed charges,69% of total billed charges,2548,100,,,percent of total billed charges,100% of total billed charges,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2548,100,,,percent of total billed charges,100% of total billed charges,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2548,100,,,percent of total billed charges,100% of total billed charges,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1575.94,61.85,,,percent of total billed charges,61.85% of total billed charges,74.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,97.23,130,,,Fee Schedule,130% of WA Medicaid ,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,960.6,37.7,,,percent of total billed charges,37.70% of total billed charges,960.6,37.7,,,percent of total billed charges,37.70% of total billed charges,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,86377.2,33.9,,,percent of total billed charges,33.9% of total billed charges,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1987.44,78,,,percent of total billed charges,78% of total billed charges,2548,100,,,percent of total billed charges,100% of total billed charges,2104.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2104.65,82.6,,,percent of total billed charges,82.6% of total billed charges,74.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.74,86377.2,
REPLACE G/C TUBE PERC,49450,CDM,983,RC,49450,HCPCS,Outpatient,,,1889,1227.85,,1662.32,88,,,percent of total billed charges,88% of total Billed charges,5.79,100,,,Fee Schedule,100% of Medicare rate,35.99,100,,,Fee Schedule,100% of WA Medicaid,1889,100,,,percent of total billed charges,100% of total billed charges,37.07,103,,,Fee Schedule,103% of WA Medicaid,5.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1303.41,69,,,percent of total billed charges,69% of total billed charges,1889,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1889,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1889,100,,,percent of total billed charges,100% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1168.35,61.85,,,percent of total billed charges,61.85% of total billed charges,35.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.79,130,,,Fee Schedule,130% of WA Medicaid ,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.15,37.7,,,percent of total billed charges,37.70% of total billed charges,712.15,37.7,,,percent of total billed charges,37.70% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,64037.1,33.9,,,percent of total billed charges,33.9% of total billed charges,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1473.42,78,,,percent of total billed charges,78% of total billed charges,1889,100,,,percent of total billed charges,100% of total billed charges,1560.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1560.31,82.6,,,percent of total billed charges,82.6% of total billed charges,35.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.79,64037.1,
FIX G/COLON TUBE W/DEVICE,49460,CDM,983,RC,49460,HCPCS,Outpatient,,,2089,1357.85,,1838.32,88,,,percent of total billed charges,88% of total Billed charges,4.86,100,,,Fee Schedule,100% of Medicare rate,28.16,100,,,Fee Schedule,100% of WA Medicaid,2089,100,,,percent of total billed charges,100% of total billed charges,29,103,,,Fee Schedule,103% of WA Medicaid,4.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1441.41,69,,,percent of total billed charges,69% of total billed charges,2089,100,,,percent of total billed charges,100% of total billed charges,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2089,100,,,percent of total billed charges,100% of total billed charges,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2089,100,,,percent of total billed charges,100% of total billed charges,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1292.05,61.85,,,percent of total billed charges,61.85% of total billed charges,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,36.61,130,,,Fee Schedule,130% of WA Medicaid ,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,787.55,37.7,,,percent of total billed charges,37.70% of total billed charges,787.55,37.7,,,percent of total billed charges,37.70% of total billed charges,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,70817.1,33.9,,,percent of total billed charges,33.9% of total billed charges,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1629.42,78,,,percent of total billed charges,78% of total billed charges,2089,100,,,percent of total billed charges,100% of total billed charges,1725.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1725.51,82.6,,,percent of total billed charges,82.6% of total billed charges,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.86,70817.1,
FLUORO EXAM OF G/COLON TUBE,49465,CDM,983,RC,49465,HCPCS,Outpatient,,,475,308.75,,418,88,,,percent of total billed charges,88% of total Billed charges,2.45,100,,,Fee Schedule,100% of Medicare rate,16.79,100,,,Fee Schedule,100% of WA Medicaid,475,100,,,percent of total billed charges,100% of total billed charges,17.29,103,,,Fee Schedule,103% of WA Medicaid,2.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,327.75,69,,,percent of total billed charges,69% of total billed charges,475,100,,,percent of total billed charges,100% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,475,100,,,percent of total billed charges,100% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,475,100,,,percent of total billed charges,100% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.79,61.85,,,percent of total billed charges,61.85% of total billed charges,16.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.83,130,,,Fee Schedule,130% of WA Medicaid ,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.08,37.7,,,percent of total billed charges,37.70% of total billed charges,179.08,37.7,,,percent of total billed charges,37.70% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,16102.5,33.9,,,percent of total billed charges,33.9% of total billed charges,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.5,78,,,percent of total billed charges,78% of total billed charges,475,100,,,percent of total billed charges,100% of total billed charges,392.35,82.6,,,percent of total billed charges,82.6% of total billed charges,392.35,82.6,,,percent of total billed charges,82.6% of total billed charges,16.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.45,16102.5,
RPR ING HERNIA BABY BLOCKED,49496,CDM,983,RC,49496,HCPCS,Outpatient,,,1962,1275.30,,1726.56,88,,,percent of total billed charges,88% of total Billed charges,81.23,100,,,Fee Schedule,100% of Medicare rate,349.87,100,,,Fee Schedule,100% of WA Medicaid,1962,100,,,percent of total billed charges,100% of total billed charges,360.37,103,,,Fee Schedule,103% of WA Medicaid,81.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,142.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,349.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1353.78,69,,,percent of total billed charges,69% of total billed charges,1962,100,,,percent of total billed charges,100% of total billed charges,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1962,100,,,percent of total billed charges,100% of total billed charges,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1962,100,,,percent of total billed charges,100% of total billed charges,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1213.5,61.85,,,percent of total billed charges,61.85% of total billed charges,349.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,454.83,130,,,Fee Schedule,130% of WA Medicaid ,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,739.67,37.7,,,percent of total billed charges,37.70% of total billed charges,739.67,37.7,,,percent of total billed charges,37.70% of total billed charges,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,66511.8,33.9,,,percent of total billed charges,33.9% of total billed charges,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1530.36,78,,,percent of total billed charges,78% of total billed charges,1962,100,,,percent of total billed charges,100% of total billed charges,1620.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1620.61,82.6,,,percent of total billed charges,82.6% of total billed charges,349.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.23,66511.8,
RPR HERN PREEMIE REDUC,49491,CDM,983,RC,49491,HCPCS,Outpatient,,,2399,1559.35,,2111.12,88,,,percent of total billed charges,88% of total Billed charges,107.37,100,,,Fee Schedule,100% of Medicare rate,451.7,100,,,Fee Schedule,100% of WA Medicaid,2399,100,,,percent of total billed charges,100% of total billed charges,465.25,103,,,Fee Schedule,103% of WA Medicaid,107.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,187.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,451.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1655.31,69,,,percent of total billed charges,69% of total billed charges,2399,100,,,percent of total billed charges,100% of total billed charges,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2399,100,,,percent of total billed charges,100% of total billed charges,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2399,100,,,percent of total billed charges,100% of total billed charges,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1483.78,61.85,,,percent of total billed charges,61.85% of total billed charges,451.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,460.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,587.21,130,,,Fee Schedule,130% of WA Medicaid ,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,904.42,37.7,,,percent of total billed charges,37.70% of total billed charges,904.42,37.7,,,percent of total billed charges,37.70% of total billed charges,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,81326.1,33.9,,,percent of total billed charges,33.9% of total billed charges,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1871.22,78,,,percent of total billed charges,78% of total billed charges,2399,100,,,percent of total billed charges,100% of total billed charges,1981.57,82.6,,,percent of total billed charges,82.6% of total billed charges,1981.57,82.6,,,percent of total billed charges,82.6% of total billed charges,451.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,451.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.37,81326.1,
RPR ING HERN PREMIE BLOCKED,49492,CDM,983,RC,49492,HCPCS,Outpatient,,,3002,1951.30,,2641.76,88,,,percent of total billed charges,88% of total Billed charges,131.57,100,,,Fee Schedule,100% of Medicare rate,541.22,100,,,Fee Schedule,100% of WA Medicaid,3002,100,,,percent of total billed charges,100% of total billed charges,557.46,103,,,Fee Schedule,103% of WA Medicaid,131.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,230.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,541.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2071.38,69,,,percent of total billed charges,69% of total billed charges,3002,100,,,percent of total billed charges,100% of total billed charges,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3002,100,,,percent of total billed charges,100% of total billed charges,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3002,100,,,percent of total billed charges,100% of total billed charges,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1856.74,61.85,,,percent of total billed charges,61.85% of total billed charges,541.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,703.59,130,,,Fee Schedule,130% of WA Medicaid ,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131.75,37.7,,,percent of total billed charges,37.70% of total billed charges,1131.75,37.7,,,percent of total billed charges,37.70% of total billed charges,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,101767.8,33.9,,,percent of total billed charges,33.9% of total billed charges,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2341.56,78,,,percent of total billed charges,78% of total billed charges,3002,100,,,percent of total billed charges,100% of total billed charges,2479.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2479.65,82.6,,,percent of total billed charges,82.6% of total billed charges,541.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,131.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.57,101767.8,
RPR ING HERNIA BABY REDUC,49495,CDM,983,RC,49495,HCPCS,Outpatient,,,1803,1171.95,,1586.64,88,,,percent of total billed charges,88% of total Billed charges,53.52,100,,,Fee Schedule,100% of Medicare rate,232.75,100,,,Fee Schedule,100% of WA Medicaid,1803,100,,,percent of total billed charges,100% of total billed charges,239.73,103,,,Fee Schedule,103% of WA Medicaid,53.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,93.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,232.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1244.07,69,,,percent of total billed charges,69% of total billed charges,1803,100,,,percent of total billed charges,100% of total billed charges,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1803,100,,,percent of total billed charges,100% of total billed charges,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1803,100,,,percent of total billed charges,100% of total billed charges,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1115.16,61.85,,,percent of total billed charges,61.85% of total billed charges,232.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,302.58,130,,,Fee Schedule,130% of WA Medicaid ,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,679.73,37.7,,,percent of total billed charges,37.70% of total billed charges,679.73,37.7,,,percent of total billed charges,37.70% of total billed charges,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,61121.7,33.9,,,percent of total billed charges,33.9% of total billed charges,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1406.34,78,,,percent of total billed charges,78% of total billed charges,1803,100,,,percent of total billed charges,100% of total billed charges,1489.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1489.28,82.6,,,percent of total billed charges,82.6% of total billed charges,232.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,53.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,53.52,61121.7,
RPR ING HERNIA INIT BLOCKED,49501,CDM,983,RC,49501,HCPCS,Outpatient,,,1921,1248.65,,1690.48,88,,,percent of total billed charges,88% of total Billed charges,80.43,100,,,Fee Schedule,100% of Medicare rate,344.47,100,,,Fee Schedule,100% of WA Medicaid,1921,100,,,percent of total billed charges,100% of total billed charges,354.8,103,,,Fee Schedule,103% of WA Medicaid,80.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,344.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1325.49,69,,,percent of total billed charges,69% of total billed charges,1921,100,,,percent of total billed charges,100% of total billed charges,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1921,100,,,percent of total billed charges,100% of total billed charges,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1921,100,,,percent of total billed charges,100% of total billed charges,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1188.14,61.85,,,percent of total billed charges,61.85% of total billed charges,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,447.81,130,,,Fee Schedule,130% of WA Medicaid ,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.22,37.7,,,percent of total billed charges,37.70% of total billed charges,724.22,37.7,,,percent of total billed charges,37.70% of total billed charges,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,65121.9,33.9,,,percent of total billed charges,33.9% of total billed charges,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1498.38,78,,,percent of total billed charges,78% of total billed charges,1921,100,,,percent of total billed charges,100% of total billed charges,1586.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1586.75,82.6,,,percent of total billed charges,82.6% of total billed charges,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.43,65121.9,
PRP I/HERN INIT BLOCK >5 YR,49507,CDM,983,RC,49507,HCPCS,Outpatient,,,1950,1267.50,,1716,88,,,percent of total billed charges,88% of total Billed charges,76.75,100,,,Fee Schedule,100% of Medicare rate,333.84,100,,,Fee Schedule,100% of WA Medicaid,1950,100,,,percent of total billed charges,100% of total billed charges,343.86,103,,,Fee Schedule,103% of WA Medicaid,76.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,134.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,333.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1345.5,69,,,percent of total billed charges,69% of total billed charges,1950,100,,,percent of total billed charges,100% of total billed charges,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1950,100,,,percent of total billed charges,100% of total billed charges,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1950,100,,,percent of total billed charges,100% of total billed charges,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1206.08,61.85,,,percent of total billed charges,61.85% of total billed charges,333.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,433.99,130,,,Fee Schedule,130% of WA Medicaid ,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,735.15,37.7,,,percent of total billed charges,37.70% of total billed charges,735.15,37.7,,,percent of total billed charges,37.70% of total billed charges,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,66105,33.9,,,percent of total billed charges,33.9% of total billed charges,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1521,78,,,percent of total billed charges,78% of total billed charges,1950,100,,,percent of total billed charges,100% of total billed charges,1610.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1610.7,82.6,,,percent of total billed charges,82.6% of total billed charges,333.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.75,66105,
RPR ING HERNIA INIT REDUCE,49500,CDM,983,RC,49500,HCPCS,Outpatient,,,1647,1070.55,,1449.36,88,,,percent of total billed charges,88% of total Billed charges,51.74,100,,,Fee Schedule,100% of Medicare rate,238.72,100,,,Fee Schedule,100% of WA Medicaid,1647,100,,,percent of total billed charges,100% of total billed charges,245.88,103,,,Fee Schedule,103% of WA Medicaid,51.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,238.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1136.43,69,,,percent of total billed charges,69% of total billed charges,1647,100,,,percent of total billed charges,100% of total billed charges,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1647,100,,,percent of total billed charges,100% of total billed charges,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1647,100,,,percent of total billed charges,100% of total billed charges,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1018.67,61.85,,,percent of total billed charges,61.85% of total billed charges,238.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,310.34,130,,,Fee Schedule,130% of WA Medicaid ,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,620.92,37.7,,,percent of total billed charges,37.70% of total billed charges,620.92,37.7,,,percent of total billed charges,37.70% of total billed charges,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,55833.3,33.9,,,percent of total billed charges,33.9% of total billed charges,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1284.66,78,,,percent of total billed charges,78% of total billed charges,1647,100,,,percent of total billed charges,100% of total billed charges,1360.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1360.42,82.6,,,percent of total billed charges,82.6% of total billed charges,238.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.74,55833.3,
PRP I/HERN INIT REDUC >5 YR,49505,CDM,983,RC,49505,HCPCS,Outpatient,,,1671,1086.15,,1470.48,88,,,percent of total billed charges,88% of total Billed charges,67.83,100,,,Fee Schedule,100% of Medicare rate,297.47,100,,,Fee Schedule,100% of WA Medicaid,1671,100,,,percent of total billed charges,100% of total billed charges,306.39,103,,,Fee Schedule,103% of WA Medicaid,67.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,118.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,297.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1152.99,69,,,percent of total billed charges,69% of total billed charges,1671,100,,,percent of total billed charges,100% of total billed charges,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1671,100,,,percent of total billed charges,100% of total billed charges,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1671,100,,,percent of total billed charges,100% of total billed charges,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1033.51,61.85,,,percent of total billed charges,61.85% of total billed charges,297.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,386.71,130,,,Fee Schedule,130% of WA Medicaid ,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.97,37.7,,,percent of total billed charges,37.70% of total billed charges,629.97,37.7,,,percent of total billed charges,37.70% of total billed charges,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,56646.9,33.9,,,percent of total billed charges,33.9% of total billed charges,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1303.38,78,,,percent of total billed charges,78% of total billed charges,1671,100,,,percent of total billed charges,100% of total billed charges,1380.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1380.25,82.6,,,percent of total billed charges,82.6% of total billed charges,297.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,67.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.83,56646.9,
REREPAIR ING HERNIA BLOCKED,49521,CDM,983,RC,49521,HCPCS,Outpatient,,,2083,1353.95,,1833.04,88,,,percent of total billed charges,88% of total Billed charges,96.09,100,,,Fee Schedule,100% of Medicare rate,405.08,100,,,Fee Schedule,100% of WA Medicaid,2083,100,,,percent of total billed charges,100% of total billed charges,417.23,103,,,Fee Schedule,103% of WA Medicaid,96.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,168.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,405.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1437.27,69,,,percent of total billed charges,69% of total billed charges,2083,100,,,percent of total billed charges,100% of total billed charges,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2083,100,,,percent of total billed charges,100% of total billed charges,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2083,100,,,percent of total billed charges,100% of total billed charges,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1288.34,61.85,,,percent of total billed charges,61.85% of total billed charges,405.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,526.6,130,,,Fee Schedule,130% of WA Medicaid ,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,785.29,37.7,,,percent of total billed charges,37.70% of total billed charges,785.29,37.7,,,percent of total billed charges,37.70% of total billed charges,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,70613.7,33.9,,,percent of total billed charges,33.9% of total billed charges,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1624.74,78,,,percent of total billed charges,78% of total billed charges,2083,100,,,percent of total billed charges,100% of total billed charges,1720.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1720.56,82.6,,,percent of total billed charges,82.6% of total billed charges,405.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.09,70613.7,
REREPAIR ING HERNIA REDUCE,49520,CDM,983,RC,49520,HCPCS,Outpatient,,,1940,1261.00,,1707.2,88,,,percent of total billed charges,88% of total Billed charges,84.57,100,,,Fee Schedule,100% of Medicare rate,358.83,100,,,Fee Schedule,100% of WA Medicaid,1940,100,,,percent of total billed charges,100% of total billed charges,369.59,103,,,Fee Schedule,103% of WA Medicaid,84.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,148,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,358.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1338.6,69,,,percent of total billed charges,69% of total billed charges,1940,100,,,percent of total billed charges,100% of total billed charges,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1940,100,,,percent of total billed charges,100% of total billed charges,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1940,100,,,percent of total billed charges,100% of total billed charges,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1199.89,61.85,,,percent of total billed charges,61.85% of total billed charges,358.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,466.48,130,,,Fee Schedule,130% of WA Medicaid ,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.38,37.7,,,percent of total billed charges,37.70% of total billed charges,731.38,37.7,,,percent of total billed charges,37.70% of total billed charges,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,65766,33.9,,,percent of total billed charges,33.9% of total billed charges,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1513.2,78,,,percent of total billed charges,78% of total billed charges,1940,100,,,percent of total billed charges,100% of total billed charges,1602.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1602.44,82.6,,,percent of total billed charges,82.6% of total billed charges,358.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,84.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84.57,65766,
REPAIR ING HERNIA SLIDING,49525,CDM,983,RC,49525,HCPCS,Outpatient,,,1849,1201.85,,1627.12,88,,,percent of total billed charges,88% of total Billed charges,75.28,100,,,Fee Schedule,100% of Medicare rate,325.63,100,,,Fee Schedule,100% of WA Medicaid,1849,100,,,percent of total billed charges,100% of total billed charges,335.4,103,,,Fee Schedule,103% of WA Medicaid,75.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,131.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,325.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1275.81,69,,,percent of total billed charges,69% of total billed charges,1849,100,,,percent of total billed charges,100% of total billed charges,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1849,100,,,percent of total billed charges,100% of total billed charges,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1849,100,,,percent of total billed charges,100% of total billed charges,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1143.61,61.85,,,percent of total billed charges,61.85% of total billed charges,325.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,423.32,130,,,Fee Schedule,130% of WA Medicaid ,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.07,37.7,,,percent of total billed charges,37.70% of total billed charges,697.07,37.7,,,percent of total billed charges,37.70% of total billed charges,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,62681.1,33.9,,,percent of total billed charges,33.9% of total billed charges,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1442.22,78,,,percent of total billed charges,78% of total billed charges,1849,100,,,percent of total billed charges,100% of total billed charges,1527.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1527.27,82.6,,,percent of total billed charges,82.6% of total billed charges,325.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.28,62681.1,
REPAIR LUMBAR HERNIA,49540,CDM,983,RC,49540,HCPCS,Outpatient,,,2229,1448.85,,1961.52,88,,,percent of total billed charges,88% of total Billed charges,88.02,100,,,Fee Schedule,100% of Medicare rate,379.9,100,,,Fee Schedule,100% of WA Medicaid,2229,100,,,percent of total billed charges,100% of total billed charges,391.3,103,,,Fee Schedule,103% of WA Medicaid,88.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,154.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,379.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1538.01,69,,,percent of total billed charges,69% of total billed charges,2229,100,,,percent of total billed charges,100% of total billed charges,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2229,100,,,percent of total billed charges,100% of total billed charges,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2229,100,,,percent of total billed charges,100% of total billed charges,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1378.64,61.85,,,percent of total billed charges,61.85% of total billed charges,379.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,493.87,130,,,Fee Schedule,130% of WA Medicaid ,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,840.33,37.7,,,percent of total billed charges,37.70% of total billed charges,840.33,37.7,,,percent of total billed charges,37.70% of total billed charges,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,75563.1,33.9,,,percent of total billed charges,33.9% of total billed charges,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1738.62,78,,,percent of total billed charges,78% of total billed charges,2229,100,,,percent of total billed charges,100% of total billed charges,1841.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1841.15,82.6,,,percent of total billed charges,82.6% of total billed charges,379.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,88.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,88.02,75563.1,
RPR FEM HERNIA INIT BLOCKED,49553,CDM,983,RC,49553,HCPCS,Outpatient,,,1822,1184.30,,1603.36,88,,,percent of total billed charges,88% of total Billed charges,83.25,100,,,Fee Schedule,100% of Medicare rate,358.45,100,,,Fee Schedule,100% of WA Medicaid,1822,100,,,percent of total billed charges,100% of total billed charges,369.2,103,,,Fee Schedule,103% of WA Medicaid,83.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,145.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,358.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1257.18,69,,,percent of total billed charges,69% of total billed charges,1822,100,,,percent of total billed charges,100% of total billed charges,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1822,100,,,percent of total billed charges,100% of total billed charges,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1822,100,,,percent of total billed charges,100% of total billed charges,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1126.91,61.85,,,percent of total billed charges,61.85% of total billed charges,358.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,365.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,465.99,130,,,Fee Schedule,130% of WA Medicaid ,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.89,37.7,,,percent of total billed charges,37.70% of total billed charges,686.89,37.7,,,percent of total billed charges,37.70% of total billed charges,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,61765.8,33.9,,,percent of total billed charges,33.9% of total billed charges,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1421.16,78,,,percent of total billed charges,78% of total billed charges,1822,100,,,percent of total billed charges,100% of total billed charges,1504.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1504.97,82.6,,,percent of total billed charges,82.6% of total billed charges,358.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.25,61765.8,
REREPAIR FEM HERNIA BLOCKED,49557,CDM,983,RC,49557,HCPCS,Outpatient,,,2373,1542.45,,2088.24,88,,,percent of total billed charges,88% of total Billed charges,97.05,100,,,Fee Schedule,100% of Medicare rate,408.25,100,,,Fee Schedule,100% of WA Medicaid,2373,100,,,percent of total billed charges,100% of total billed charges,420.5,103,,,Fee Schedule,103% of WA Medicaid,97.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,169.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,408.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1637.37,69,,,percent of total billed charges,69% of total billed charges,2373,100,,,percent of total billed charges,100% of total billed charges,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2373,100,,,percent of total billed charges,100% of total billed charges,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2373,100,,,percent of total billed charges,100% of total billed charges,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1467.7,61.85,,,percent of total billed charges,61.85% of total billed charges,408.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,530.73,130,,,Fee Schedule,130% of WA Medicaid ,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,894.62,37.7,,,percent of total billed charges,37.70% of total billed charges,894.62,37.7,,,percent of total billed charges,37.70% of total billed charges,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,80444.7,33.9,,,percent of total billed charges,33.9% of total billed charges,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1850.94,78,,,percent of total billed charges,78% of total billed charges,2373,100,,,percent of total billed charges,100% of total billed charges,1960.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1960.1,82.6,,,percent of total billed charges,82.6% of total billed charges,408.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,97.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,408.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.05,80444.7,
RPR REM HERNIA INIT REDUCE,49550,CDM,983,RC,49550,HCPCS,Outpatient,,,1683,1093.95,,1481.04,88,,,percent of total billed charges,88% of total Billed charges,75.93,100,,,Fee Schedule,100% of Medicare rate,328.05,100,,,Fee Schedule,100% of WA Medicaid,1683,100,,,percent of total billed charges,100% of total billed charges,337.89,103,,,Fee Schedule,103% of WA Medicaid,75.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,132.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,328.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1161.27,69,,,percent of total billed charges,69% of total billed charges,1683,100,,,percent of total billed charges,100% of total billed charges,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1683,100,,,percent of total billed charges,100% of total billed charges,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1683,100,,,percent of total billed charges,100% of total billed charges,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1040.94,61.85,,,percent of total billed charges,61.85% of total billed charges,328.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,334.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,426.47,130,,,Fee Schedule,130% of WA Medicaid ,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.49,37.7,,,percent of total billed charges,37.70% of total billed charges,634.49,37.7,,,percent of total billed charges,37.70% of total billed charges,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,57053.7,33.9,,,percent of total billed charges,33.9% of total billed charges,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1312.74,78,,,percent of total billed charges,78% of total billed charges,1683,100,,,percent of total billed charges,100% of total billed charges,1390.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1390.16,82.6,,,percent of total billed charges,82.6% of total billed charges,328.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.93,57053.7,
REREPAIR FEM HERNIA REDUCE,49555,CDM,983,RC,49555,HCPCS,Outpatient,,,1958,1272.70,,1723.04,88,,,percent of total billed charges,88% of total Billed charges,80.61,100,,,Fee Schedule,100% of Medicare rate,342.97,100,,,Fee Schedule,100% of WA Medicaid,1958,100,,,percent of total billed charges,100% of total billed charges,353.26,103,,,Fee Schedule,103% of WA Medicaid,80.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,141.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,342.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1351.02,69,,,percent of total billed charges,69% of total billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1958,100,,,percent of total billed charges,100% of total billed charges,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1958,100,,,percent of total billed charges,100% of total billed charges,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1211.02,61.85,,,percent of total billed charges,61.85% of total billed charges,342.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,445.86,130,,,Fee Schedule,130% of WA Medicaid ,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,738.17,37.7,,,percent of total billed charges,37.70% of total billed charges,738.17,37.7,,,percent of total billed charges,37.70% of total billed charges,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,66376.2,33.9,,,percent of total billed charges,33.9% of total billed charges,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1527.24,78,,,percent of total billed charges,78% of total billed charges,1958,100,,,percent of total billed charges,100% of total billed charges,1617.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1617.31,82.6,,,percent of total billed charges,82.6% of total billed charges,342.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.61,66376.2,
983,,,983,RC,,,Outpatient,,,793,515.45,,697.84,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,793,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,547.17,69,,,percent of total billed charges,69% of total billed charges,793,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,793,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,793,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,490.47,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,298.96,37.7,,,percent of total billed charges,37.70% of total billed charges,298.96,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,26882.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,618.54,78,,,percent of total billed charges,78% of total billed charges,793,100,,,percent of total billed charges,100% of total billed charges,655.02,82.6,,,percent of total billed charges,82.6% of total billed charges,655.02,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",298.96,26882.7,
983,,,983,RC,,,Outpatient,,,2383,1548.95,,2097.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2383,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1644.27,69,,,percent of total billed charges,69% of total billed charges,2383,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2383,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2383,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1473.89,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,898.39,37.7,,,percent of total billed charges,37.70% of total billed charges,898.39,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,80783.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1858.74,78,,,percent of total billed charges,78% of total billed charges,2383,100,,,percent of total billed charges,100% of total billed charges,1968.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1968.36,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",898.39,80783.7,
983,,,983,RC,,,Outpatient,,,2310,1501.50,,2032.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1593.9,69,,,percent of total billed charges,69% of total billed charges,2310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2310,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1428.74,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,870.87,37.7,,,percent of total billed charges,37.70% of total billed charges,870.87,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,78309,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1801.8,78,,,percent of total billed charges,78% of total billed charges,2310,100,,,percent of total billed charges,100% of total billed charges,1908.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1908.06,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",870.87,78309,
983,,,983,RC,,,Outpatient,,,2094,1361.10,,1842.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2094,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1444.86,69,,,percent of total billed charges,69% of total billed charges,2094,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2094,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2094,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1295.14,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,789.44,37.7,,,percent of total billed charges,37.70% of total billed charges,789.44,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,70986.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1633.32,78,,,percent of total billed charges,78% of total billed charges,2094,100,,,percent of total billed charges,100% of total billed charges,1729.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1729.64,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",789.44,70986.6,
983,,,983,RC,,,Outpatient,,,1278,830.70,,1124.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1278,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,881.82,69,,,percent of total billed charges,69% of total billed charges,1278,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1278,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1278,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,790.44,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,481.81,37.7,,,percent of total billed charges,37.70% of total billed charges,481.81,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,43324.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,996.84,78,,,percent of total billed charges,78% of total billed charges,1278,100,,,percent of total billed charges,100% of total billed charges,1055.63,82.6,,,percent of total billed charges,82.6% of total billed charges,1055.63,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",481.81,43324.2,
983,,,983,RC,,,Outpatient,,,1499,974.35,,1319.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1499,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1034.31,69,,,percent of total billed charges,69% of total billed charges,1499,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1499,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1499,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,927.13,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,565.12,37.7,,,percent of total billed charges,37.70% of total billed charges,565.12,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,50816.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1169.22,78,,,percent of total billed charges,78% of total billed charges,1499,100,,,percent of total billed charges,100% of total billed charges,1238.17,82.6,,,percent of total billed charges,82.6% of total billed charges,1238.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",565.12,50816.1,
983,,,983,RC,,,Outpatient,,,1715,1114.75,,1509.2,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1715,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1183.35,69,,,percent of total billed charges,69% of total billed charges,1715,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1715,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1715,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1060.73,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,646.56,37.7,,,percent of total billed charges,37.70% of total billed charges,646.56,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,58138.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1337.7,78,,,percent of total billed charges,78% of total billed charges,1715,100,,,percent of total billed charges,100% of total billed charges,1416.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1416.59,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",646.56,58138.5,
983,,,983,RC,,,Outpatient,,,1321,858.65,,1162.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1321,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,911.49,69,,,percent of total billed charges,69% of total billed charges,1321,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1321,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1321,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,817.04,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,498.02,37.7,,,percent of total billed charges,37.70% of total billed charges,498.02,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,44781.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1030.38,78,,,percent of total billed charges,78% of total billed charges,1321,100,,,percent of total billed charges,100% of total billed charges,1091.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1091.15,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",498.02,44781.9,
983,,,983,RC,,,Outpatient,,,1856,1206.40,,1633.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1856,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1280.64,69,,,percent of total billed charges,69% of total billed charges,1856,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1856,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1856,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1147.94,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,699.71,37.7,,,percent of total billed charges,37.70% of total billed charges,699.71,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,62918.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1447.68,78,,,percent of total billed charges,78% of total billed charges,1856,100,,,percent of total billed charges,100% of total billed charges,1533.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1533.06,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",699.71,62918.4,
REPAIR UMBILICAL LESION,49600,CDM,983,RC,49600,HCPCS,Outpatient,,,2423,1574.95,,2132.24,88,,,percent of total billed charges,88% of total Billed charges,98.73,100,,,Fee Schedule,100% of Medicare rate,415.71,100,,,Fee Schedule,100% of WA Medicaid,2423,100,,,percent of total billed charges,100% of total billed charges,428.18,103,,,Fee Schedule,103% of WA Medicaid,98.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,172.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,415.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1671.87,69,,,percent of total billed charges,69% of total billed charges,2423,100,,,percent of total billed charges,100% of total billed charges,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2423,100,,,percent of total billed charges,100% of total billed charges,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2423,100,,,percent of total billed charges,100% of total billed charges,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1498.63,61.85,,,percent of total billed charges,61.85% of total billed charges,415.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,540.42,130,,,Fee Schedule,130% of WA Medicaid ,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.47,37.7,,,percent of total billed charges,37.70% of total billed charges,913.47,37.7,,,percent of total billed charges,37.70% of total billed charges,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,82139.7,33.9,,,percent of total billed charges,33.9% of total billed charges,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1889.94,78,,,percent of total billed charges,78% of total billed charges,2423,100,,,percent of total billed charges,100% of total billed charges,2001.4,82.6,,,percent of total billed charges,82.6% of total billed charges,2001.4,82.6,,,percent of total billed charges,82.6% of total billed charges,415.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.73,82139.7,
983,,,983,RC,,,Outpatient,,,1811,1177.15,,1593.68,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1811,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1249.59,69,,,percent of total billed charges,69% of total billed charges,1811,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1811,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1811,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1120.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,682.75,37.7,,,percent of total billed charges,37.70% of total billed charges,682.75,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,61392.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1412.58,78,,,percent of total billed charges,78% of total billed charges,1811,100,,,percent of total billed charges,100% of total billed charges,1495.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1495.89,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",682.75,61392.9,
983,,,983,RC,,,Outpatient,,,2388,1552.20,,2101.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1647.72,69,,,percent of total billed charges,69% of total billed charges,2388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1476.98,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,900.28,37.7,,,percent of total billed charges,37.70% of total billed charges,900.28,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,80953.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1862.64,78,,,percent of total billed charges,78% of total billed charges,2388,100,,,percent of total billed charges,100% of total billed charges,1972.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1972.49,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",900.28,80953.2,
LAPARO PROC HERNIA REPAIR,49659,CDM,983,RC,49659,HCPCS,Outpatient,,,1044.8,679.12,,919.42,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1044.8,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,720.91,69,,,percent of total billed charges,69% of total billed charges,1044.8,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1044.8,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1044.8,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,646.21,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,393.89,37.7,,,percent of total billed charges,37.70% of total billed charges,393.89,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,35418.72,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,814.94,78,,,percent of total billed charges,78% of total billed charges,1044.8,100,,,percent of total billed charges,100% of total billed charges,863,82.6,,,percent of total billed charges,82.6% of total billed charges,863,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",393.89,35418.72,
983,,,983,RC,,,Outpatient,,,2358,1532.70,,2075.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2358,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1627.02,69,,,percent of total billed charges,69% of total billed charges,2358,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2358,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2358,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1458.42,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,888.97,37.7,,,percent of total billed charges,37.70% of total billed charges,888.97,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,79936.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1839.24,78,,,percent of total billed charges,78% of total billed charges,2358,100,,,percent of total billed charges,100% of total billed charges,1947.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1947.71,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",888.97,79936.2,
983,,,983,RC,,,Outpatient,,,2172,1411.80,,1911.36,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2172,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1498.68,69,,,percent of total billed charges,69% of total billed charges,2172,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2172,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2172,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1343.38,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,818.84,37.7,,,percent of total billed charges,37.70% of total billed charges,818.84,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,73630.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1694.16,78,,,percent of total billed charges,78% of total billed charges,2172,100,,,percent of total billed charges,100% of total billed charges,1794.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1794.07,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",818.84,73630.8,
LAP ING HERNIA REPAIR RECUR,49651,CDM,983,RC,49651,HCPCS,Outpatient,,,1515,984.75,,1333.2,88,,,percent of total billed charges,88% of total Billed charges,72.25,100,,,Fee Schedule,100% of Medicare rate,322.46,100,,,Fee Schedule,100% of WA Medicaid,1515,100,,,percent of total billed charges,100% of total billed charges,332.13,103,,,Fee Schedule,103% of WA Medicaid,72.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,322.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1045.35,69,,,percent of total billed charges,69% of total billed charges,1515,100,,,percent of total billed charges,100% of total billed charges,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1515,100,,,percent of total billed charges,100% of total billed charges,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1515,100,,,percent of total billed charges,100% of total billed charges,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,937.03,61.85,,,percent of total billed charges,61.85% of total billed charges,322.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,419.2,130,,,Fee Schedule,130% of WA Medicaid ,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.16,37.7,,,percent of total billed charges,37.70% of total billed charges,571.16,37.7,,,percent of total billed charges,37.70% of total billed charges,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,51358.5,33.9,,,percent of total billed charges,33.9% of total billed charges,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1181.7,78,,,percent of total billed charges,78% of total billed charges,1515,100,,,percent of total billed charges,100% of total billed charges,1251.39,82.6,,,percent of total billed charges,82.6% of total billed charges,1251.39,82.6,,,percent of total billed charges,82.6% of total billed charges,322.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.25,51358.5,
LAP ING HERNIA REPAIR INIT,49650,CDM,983,RC,49650,HCPCS,Outpatient,,,1183,768.95,,1041.04,88,,,percent of total billed charges,88% of total Billed charges,54.8,100,,,Fee Schedule,100% of Medicare rate,247.3,100,,,Fee Schedule,100% of WA Medicaid,1183,100,,,percent of total billed charges,100% of total billed charges,254.72,103,,,Fee Schedule,103% of WA Medicaid,54.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,95.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,247.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,816.27,69,,,percent of total billed charges,69% of total billed charges,1183,100,,,percent of total billed charges,100% of total billed charges,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1183,100,,,percent of total billed charges,100% of total billed charges,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1183,100,,,percent of total billed charges,100% of total billed charges,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.69,61.85,,,percent of total billed charges,61.85% of total billed charges,247.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,321.49,130,,,Fee Schedule,130% of WA Medicaid ,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,445.99,37.7,,,percent of total billed charges,37.70% of total billed charges,445.99,37.7,,,percent of total billed charges,37.70% of total billed charges,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,40103.7,33.9,,,percent of total billed charges,33.9% of total billed charges,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,922.74,78,,,percent of total billed charges,78% of total billed charges,1183,100,,,percent of total billed charges,100% of total billed charges,977.16,82.6,,,percent of total billed charges,82.6% of total billed charges,977.16,82.6,,,percent of total billed charges,82.6% of total billed charges,247.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,54.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,54.8,40103.7,
REPAIR OF ABDOMINAL WALL,49900,CDM,983,RC,49900,HCPCS,Outpatient,,,2223,1444.95,,1956.24,88,,,percent of total billed charges,88% of total Billed charges,101.22,100,,,Fee Schedule,100% of Medicare rate,468.49,100,,,Fee Schedule,100% of WA Medicaid,2223,100,,,percent of total billed charges,100% of total billed charges,482.54,103,,,Fee Schedule,103% of WA Medicaid,101.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,177.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,468.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1533.87,69,,,percent of total billed charges,69% of total billed charges,2223,100,,,percent of total billed charges,100% of total billed charges,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2223,100,,,percent of total billed charges,100% of total billed charges,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2223,100,,,percent of total billed charges,100% of total billed charges,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1374.93,61.85,,,percent of total billed charges,61.85% of total billed charges,468.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,477.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,609.04,130,,,Fee Schedule,130% of WA Medicaid ,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,838.07,37.7,,,percent of total billed charges,37.70% of total billed charges,838.07,37.7,,,percent of total billed charges,37.70% of total billed charges,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,75359.7,33.9,,,percent of total billed charges,33.9% of total billed charges,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1733.94,78,,,percent of total billed charges,78% of total billed charges,2223,100,,,percent of total billed charges,100% of total billed charges,1836.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1836.2,82.6,,,percent of total billed charges,82.6% of total billed charges,468.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,101.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.22,75359.7,
OMENTAL FLAP INTRA-ABDOM,49905,CDM,983,RC,49905,HCPCS,Outpatient,,,944,613.60,,830.72,88,,,percent of total billed charges,88% of total Billed charges,49.46,100,,,Fee Schedule,100% of Medicare rate,194.33,100,,,Fee Schedule,100% of WA Medicaid,944,100,,,percent of total billed charges,100% of total billed charges,200.16,103,,,Fee Schedule,103% of WA Medicaid,49.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,86.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,194.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,651.36,69,,,percent of total billed charges,69% of total billed charges,944,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,944,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,944,100,,,percent of total billed charges,100% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.86,61.85,,,percent of total billed charges,61.85% of total billed charges,194.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,252.63,130,,,Fee Schedule,130% of WA Medicaid ,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.89,37.7,,,percent of total billed charges,37.70% of total billed charges,355.89,37.7,,,percent of total billed charges,37.70% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,32001.6,33.9,,,percent of total billed charges,33.9% of total billed charges,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.32,78,,,percent of total billed charges,78% of total billed charges,944,100,,,percent of total billed charges,100% of total billed charges,779.74,82.6,,,percent of total billed charges,82.6% of total billed charges,779.74,82.6,,,percent of total billed charges,82.6% of total billed charges,194.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.46,32001.6,
ABDOMEN SURGERY PROCEDURE,49999,CDM,983,RC,49999,HCPCS,Outpatient,,,2083,1353.95,,1833.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2083,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1437.27,69,,,percent of total billed charges,69% of total billed charges,2083,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2083,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2083,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1288.34,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,785.29,37.7,,,percent of total billed charges,37.70% of total billed charges,785.29,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,70613.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1624.74,78,,,percent of total billed charges,78% of total billed charges,2083,100,,,percent of total billed charges,100% of total billed charges,1720.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1720.56,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",785.29,70613.7,
50200 Renal Biopsy Percutaneous,50200,CDM,983,RC,50200,HCPCS,Outpatient,,,3151,2048.15,,2772.88,88,,,percent of total billed charges,88% of total Billed charges,9.96,100,,,Fee Schedule,100% of Medicare rate,70.68,100,,,Fee Schedule,100% of WA Medicaid,3151,100,,,percent of total billed charges,100% of total billed charges,72.8,103,,,Fee Schedule,103% of WA Medicaid,9.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2174.19,69,,,percent of total billed charges,69% of total billed charges,3151,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3151,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3151,100,,,percent of total billed charges,100% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1948.89,61.85,,,percent of total billed charges,61.85% of total billed charges,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,91.88,130,,,Fee Schedule,130% of WA Medicaid ,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1187.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1187.93,37.7,,,percent of total billed charges,37.70% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,106818.9,33.9,,,percent of total billed charges,33.9% of total billed charges,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2457.78,78,,,percent of total billed charges,78% of total billed charges,3151,100,,,percent of total billed charges,100% of total billed charges,2602.73,82.6,,,percent of total billed charges,82.6% of total billed charges,2602.73,82.6,,,percent of total billed charges,82.6% of total billed charges,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.96,106818.9,
REMOVE KIDNEY OPEN,50220,CDM,983,RC,50220,HCPCS,Outpatient,,,2852,1853.80,,2509.76,88,,,percent of total billed charges,88% of total Billed charges,106.55,100,,,Fee Schedule,100% of Medicare rate,593.07,100,,,Fee Schedule,100% of WA Medicaid,2852,100,,,percent of total billed charges,100% of total billed charges,610.86,103,,,Fee Schedule,103% of WA Medicaid,106.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,186.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,593.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1967.88,69,,,percent of total billed charges,69% of total billed charges,2852,100,,,percent of total billed charges,100% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2852,100,,,percent of total billed charges,100% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2852,100,,,percent of total billed charges,100% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1763.96,61.85,,,percent of total billed charges,61.85% of total billed charges,593.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,593.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,604.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,770.99,130,,,Fee Schedule,130% of WA Medicaid ,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1075.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1075.2,37.7,,,percent of total billed charges,37.70% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,96682.8,33.9,,,percent of total billed charges,33.9% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2224.56,78,,,percent of total billed charges,78% of total billed charges,2852,100,,,percent of total billed charges,100% of total billed charges,2355.75,82.6,,,percent of total billed charges,82.6% of total billed charges,2355.75,82.6,,,percent of total billed charges,82.6% of total billed charges,593.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,593.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.55,96682.8,
LAPARO PARTIAL NEPHRECTOMY,50543,CDM,983,RC,50543,HCPCS,Outpatient,,,4509,2930.85,,3967.92,88,,,percent of total billed charges,88% of total Billed charges,131.97,100,,,Fee Schedule,100% of Medicare rate,838.32,100,,,Fee Schedule,100% of WA Medicaid,4509,100,,,percent of total billed charges,100% of total billed charges,863.47,103,,,Fee Schedule,103% of WA Medicaid,131.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,230.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,838.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3111.21,69,,,percent of total billed charges,69% of total billed charges,4509,100,,,percent of total billed charges,100% of total billed charges,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,4509,100,,,percent of total billed charges,100% of total billed charges,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,4509,100,,,percent of total billed charges,100% of total billed charges,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2788.82,61.85,,,percent of total billed charges,61.85% of total billed charges,838.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,838.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,855.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1089.82,130,,,Fee Schedule,130% of WA Medicaid ,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1699.89,37.7,,,percent of total billed charges,37.70% of total billed charges,1699.89,37.7,,,percent of total billed charges,37.70% of total billed charges,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,152855.1,33.9,,,percent of total billed charges,33.9% of total billed charges,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,3517.02,78,,,percent of total billed charges,78% of total billed charges,4509,100,,,percent of total billed charges,100% of total billed charges,3724.43,82.6,,,percent of total billed charges,82.6% of total billed charges,3724.43,82.6,,,percent of total billed charges,82.6% of total billed charges,838.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,131.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,838.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,131.97,152855.1,
INJECTION FOR URETER X-RAY,50690,CDM,983,RC,50690,HCPCS,Outpatient,,,198,128.70,,174.24,88,,,percent of total billed charges,88% of total Billed charges,5.2,100,,,Fee Schedule,100% of Medicare rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,198,100,,,percent of total billed charges,100% of total billed charges,40.73,103,,,Fee Schedule,103% of WA Medicaid,5.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,136.62,69,,,percent of total billed charges,69% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,198,100,,,percent of total billed charges,100% of total billed charges,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,198,100,,,percent of total billed charges,100% of total billed charges,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.46,61.85,,,percent of total billed charges,61.85% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.4,130,,,Fee Schedule,130% of WA Medicaid ,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,74.65,37.7,,,percent of total billed charges,37.70% of total billed charges,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,6712.2,33.9,,,percent of total billed charges,33.9% of total billed charges,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.44,78,,,percent of total billed charges,78% of total billed charges,198,100,,,percent of total billed charges,100% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,163.55,82.6,,,percent of total billed charges,82.6% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.2,6712.2,
CONSTRUCT BOWEL BLADDER,50820,CDM,983,RC,50820,HCPCS,Outpatient,,,2525,1641.25,,2222,88,,,percent of total billed charges,88% of total Billed charges,119.18,100,,,Fee Schedule,100% of Medicare rate,738.54,100,,,Fee Schedule,100% of WA Medicaid,2525,100,,,percent of total billed charges,100% of total billed charges,760.7,103,,,Fee Schedule,103% of WA Medicaid,119.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,208.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,738.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1742.25,69,,,percent of total billed charges,69% of total billed charges,2525,100,,,percent of total billed charges,100% of total billed charges,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2525,100,,,percent of total billed charges,100% of total billed charges,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2525,100,,,percent of total billed charges,100% of total billed charges,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1561.71,61.85,,,percent of total billed charges,61.85% of total billed charges,738.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,738.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,753.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,960.1,130,,,Fee Schedule,130% of WA Medicaid ,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,951.93,37.7,,,percent of total billed charges,37.70% of total billed charges,951.93,37.7,,,percent of total billed charges,37.70% of total billed charges,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,85597.5,33.9,,,percent of total billed charges,33.9% of total billed charges,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1969.5,78,,,percent of total billed charges,78% of total billed charges,2525,100,,,percent of total billed charges,100% of total billed charges,2085.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2085.65,82.6,,,percent of total billed charges,82.6% of total billed charges,738.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,119.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,738.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.18,85597.5,
CYSTOTOMY,51045,CDM,983,RC,51045,HCPCS,Outpatient,,,1079,701.35,,949.52,88,,,percent of total billed charges,88% of total Billed charges,48.46,100,,,Fee Schedule,100% of Medicare rate,284.6,100,,,Fee Schedule,100% of WA Medicaid,1079,100,,,percent of total billed charges,100% of total billed charges,293.14,103,,,Fee Schedule,103% of WA Medicaid,48.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,84.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,284.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,744.51,69,,,percent of total billed charges,69% of total billed charges,1079,100,,,percent of total billed charges,100% of total billed charges,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079,100,,,percent of total billed charges,100% of total billed charges,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1079,100,,,percent of total billed charges,100% of total billed charges,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.36,61.85,,,percent of total billed charges,61.85% of total billed charges,284.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,369.98,130,,,Fee Schedule,130% of WA Medicaid ,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.78,37.7,,,percent of total billed charges,37.70% of total billed charges,406.78,37.7,,,percent of total billed charges,37.70% of total billed charges,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,36578.1,33.9,,,percent of total billed charges,33.9% of total billed charges,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.62,78,,,percent of total billed charges,78% of total billed charges,1079,100,,,percent of total billed charges,100% of total billed charges,891.25,82.6,,,percent of total billed charges,82.6% of total billed charges,891.25,82.6,,,percent of total billed charges,82.6% of total billed charges,284.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,48.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.46,36578.1,
ASPIRATION OF BLADDER,51102,CDM,983,RC,51102,HCPCS,Outpatient,,,516,335.40,,454.08,88,,,percent of total billed charges,88% of total Billed charges,12.26,100,,,Fee Schedule,100% of Medicare rate,79.82,100,,,Fee Schedule,100% of WA Medicaid,516,100,,,percent of total billed charges,100% of total billed charges,82.21,103,,,Fee Schedule,103% of WA Medicaid,12.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,356.04,69,,,percent of total billed charges,69% of total billed charges,516,100,,,percent of total billed charges,100% of total billed charges,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,516,100,,,percent of total billed charges,100% of total billed charges,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,516,100,,,percent of total billed charges,100% of total billed charges,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.15,61.85,,,percent of total billed charges,61.85% of total billed charges,79.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.77,130,,,Fee Schedule,130% of WA Medicaid ,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.53,37.7,,,percent of total billed charges,37.70% of total billed charges,194.53,37.7,,,percent of total billed charges,37.70% of total billed charges,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,17492.4,33.9,,,percent of total billed charges,33.9% of total billed charges,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.48,78,,,percent of total billed charges,78% of total billed charges,516,100,,,percent of total billed charges,100% of total billed charges,426.22,82.6,,,percent of total billed charges,82.6% of total billed charges,426.22,82.6,,,percent of total billed charges,82.6% of total billed charges,79.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.26,17492.4,
IRRIGATION OF BLADDER,51700,CDM,983,RC,51700,HCPCS,Outpatient,,,242,157.30,,212.96,88,,,percent of total billed charges,88% of total Billed charges,2.96,100,,,Fee Schedule,100% of Medicare rate,16.79,100,,,Fee Schedule,100% of WA Medicaid,242,100,,,percent of total billed charges,100% of total billed charges,17.29,103,,,Fee Schedule,103% of WA Medicaid,2.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,166.98,69,,,percent of total billed charges,69% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,242,100,,,percent of total billed charges,100% of total billed charges,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,242,100,,,percent of total billed charges,100% of total billed charges,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.68,61.85,,,percent of total billed charges,61.85% of total billed charges,16.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.83,130,,,Fee Schedule,130% of WA Medicaid ,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8203.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.76,78,,,percent of total billed charges,78% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,16.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.96,8203.8,
INSERT BLADDER CATHETER,51701,CDM,983,RC,51701,HCPCS,Outpatient,,,169,109.85,,148.72,88,,,percent of total billed charges,88% of total Billed charges,2.57,100,,,Fee Schedule,100% of Medicare rate,14.36,100,,,Fee Schedule,100% of WA Medicaid,169,100,,,percent of total billed charges,100% of total billed charges,14.79,103,,,Fee Schedule,103% of WA Medicaid,2.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,14.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,116.61,69,,,percent of total billed charges,69% of total billed charges,169,100,,,percent of total billed charges,100% of total billed charges,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,169,100,,,percent of total billed charges,100% of total billed charges,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,169,100,,,percent of total billed charges,100% of total billed charges,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.53,61.85,,,percent of total billed charges,61.85% of total billed charges,14.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.67,130,,,Fee Schedule,130% of WA Medicaid ,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.71,37.7,,,percent of total billed charges,37.70% of total billed charges,63.71,37.7,,,percent of total billed charges,37.70% of total billed charges,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,5729.1,33.9,,,percent of total billed charges,33.9% of total billed charges,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.82,78,,,percent of total billed charges,78% of total billed charges,169,100,,,percent of total billed charges,100% of total billed charges,139.59,82.6,,,percent of total billed charges,82.6% of total billed charges,139.59,82.6,,,percent of total billed charges,82.6% of total billed charges,14.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.57,5729.1,
INSERT TEMP BLADDER CATH,51702,CDM,983,RC,51702,HCPCS,Outpatient,,,240,156.00,,211.2,88,,,percent of total billed charges,88% of total Billed charges,2.3,100,,,Fee Schedule,100% of Medicare rate,14.17,100,,,Fee Schedule,100% of WA Medicaid,240,100,,,percent of total billed charges,100% of total billed charges,14.6,103,,,Fee Schedule,103% of WA Medicaid,2.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,14.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,240,100,,,percent of total billed charges,100% of total billed charges,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,240,100,,,percent of total billed charges,100% of total billed charges,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.44,61.85,,,percent of total billed charges,61.85% of total billed charges,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.42,130,,,Fee Schedule,130% of WA Medicaid ,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,8136,33.9,,,percent of total billed charges,33.9% of total billed charges,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.3,8136,
INSERT BLADDER CATH COMPLEX,51703,CDM,983,RC,51703,HCPCS,Outpatient,,,356,231.40,,313.28,88,,,percent of total billed charges,88% of total Billed charges,6.93,100,,,Fee Schedule,100% of Medicare rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,356,100,,,percent of total billed charges,100% of total billed charges,43.99,103,,,Fee Schedule,103% of WA Medicaid,6.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,245.64,69,,,percent of total billed charges,69% of total billed charges,356,100,,,percent of total billed charges,100% of total billed charges,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,356,100,,,percent of total billed charges,100% of total billed charges,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,356,100,,,percent of total billed charges,100% of total billed charges,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.19,61.85,,,percent of total billed charges,61.85% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.52,130,,,Fee Schedule,130% of WA Medicaid ,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.21,37.7,,,percent of total billed charges,37.70% of total billed charges,134.21,37.7,,,percent of total billed charges,37.70% of total billed charges,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,12068.4,33.9,,,percent of total billed charges,33.9% of total billed charges,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.68,78,,,percent of total billed charges,78% of total billed charges,356,100,,,percent of total billed charges,100% of total billed charges,294.06,82.6,,,percent of total billed charges,82.6% of total billed charges,294.06,82.6,,,percent of total billed charges,82.6% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,7,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.93,12068.4,
SIMPLE CYSTOMETROGRAM,51725,CDM,983,RC,51725,HCPCS,Outpatient,,,415,269.75,,365.2,88,,,percent of total billed charges,88% of total Billed charges,11.68,100,,,Fee Schedule,100% of Medicare rate,42.34,100,,,Fee Schedule,100% of WA Medicaid,415,100,,,percent of total billed charges,100% of total billed charges,43.61,103,,,Fee Schedule,103% of WA Medicaid,11.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,286.35,69,,,percent of total billed charges,69% of total billed charges,415,100,,,percent of total billed charges,100% of total billed charges,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,415,100,,,percent of total billed charges,100% of total billed charges,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,415,100,,,percent of total billed charges,100% of total billed charges,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.68,61.85,,,percent of total billed charges,61.85% of total billed charges,42.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.04,130,,,Fee Schedule,130% of WA Medicaid ,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.46,37.7,,,percent of total billed charges,37.70% of total billed charges,156.46,37.7,,,percent of total billed charges,37.70% of total billed charges,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,14068.5,33.9,,,percent of total billed charges,33.9% of total billed charges,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.7,78,,,percent of total billed charges,78% of total billed charges,415,100,,,percent of total billed charges,100% of total billed charges,342.79,82.6,,,percent of total billed charges,82.6% of total billed charges,342.79,82.6,,,percent of total billed charges,82.6% of total billed charges,42.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.68,14068.5,
ATTACH BLADDER/URETHRA,51840,CDM,983,RC,51840,HCPCS,Outpatient,,,2828,1838.20,,2488.64,88,,,percent of total billed charges,88% of total Billed charges,60.89,100,,,Fee Schedule,100% of Medicare rate,397.43,100,,,Fee Schedule,100% of WA Medicaid,2828,100,,,percent of total billed charges,100% of total billed charges,409.35,103,,,Fee Schedule,103% of WA Medicaid,60.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,106.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,397.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1951.32,69,,,percent of total billed charges,69% of total billed charges,2828,100,,,percent of total billed charges,100% of total billed charges,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2828,100,,,percent of total billed charges,100% of total billed charges,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2828,100,,,percent of total billed charges,100% of total billed charges,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1749.12,61.85,,,percent of total billed charges,61.85% of total billed charges,397.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,516.66,130,,,Fee Schedule,130% of WA Medicaid ,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1066.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1066.16,37.7,,,percent of total billed charges,37.70% of total billed charges,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,95869.2,33.9,,,percent of total billed charges,33.9% of total billed charges,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2205.84,78,,,percent of total billed charges,78% of total billed charges,2828,100,,,percent of total billed charges,100% of total billed charges,2335.93,82.6,,,percent of total billed charges,82.6% of total billed charges,2335.93,82.6,,,percent of total billed charges,82.6% of total billed charges,397.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.89,95869.2,
REPAIR OF BLADDER WOUND,51865,CDM,983,RC,51865,HCPCS,Outpatient,,,2409.04,1565.88,,2119.96,88,,,percent of total billed charges,88% of total Billed charges,83.05,100,,,Fee Schedule,100% of Medicare rate,506.72,100,,,Fee Schedule,100% of WA Medicaid,2409.04,100,,,percent of total billed charges,100% of total billed charges,521.92,103,,,Fee Schedule,103% of WA Medicaid,83.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,145.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,506.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1662.24,69,,,percent of total billed charges,69% of total billed charges,2409.04,100,,,percent of total billed charges,100% of total billed charges,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2409.04,100,,,percent of total billed charges,100% of total billed charges,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2409.04,100,,,percent of total billed charges,100% of total billed charges,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1489.99,61.85,,,percent of total billed charges,61.85% of total billed charges,506.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,506.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,658.74,130,,,Fee Schedule,130% of WA Medicaid ,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,908.21,37.7,,,percent of total billed charges,37.70% of total billed charges,908.21,37.7,,,percent of total billed charges,37.70% of total billed charges,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,81666.46,33.9,,,percent of total billed charges,33.9% of total billed charges,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1879.05,78,,,percent of total billed charges,78% of total billed charges,2409.04,100,,,percent of total billed charges,100% of total billed charges,1989.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1989.87,82.6,,,percent of total billed charges,82.6% of total billed charges,506.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,506.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.05,81666.46,
REPAIR BLADDER WOUND,51860,CDM,983,RC,51860,HCPCS,Outpatient,,,1070,695.50,,941.6,88,,,percent of total billed charges,88% of total Billed charges,72.14,100,,,Fee Schedule,100% of Medicare rate,423.36,100,,,Fee Schedule,100% of WA Medicaid,1070,100,,,percent of total billed charges,100% of total billed charges,436.06,103,,,Fee Schedule,103% of WA Medicaid,72.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,423.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,738.3,69,,,percent of total billed charges,69% of total billed charges,1070,100,,,percent of total billed charges,100% of total billed charges,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1070,100,,,percent of total billed charges,100% of total billed charges,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1070,100,,,percent of total billed charges,100% of total billed charges,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,661.8,61.85,,,percent of total billed charges,61.85% of total billed charges,423.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,431.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,550.37,130,,,Fee Schedule,130% of WA Medicaid ,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.39,37.7,,,percent of total billed charges,37.70% of total billed charges,403.39,37.7,,,percent of total billed charges,37.70% of total billed charges,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,36273,33.9,,,percent of total billed charges,33.9% of total billed charges,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,834.6,78,,,percent of total billed charges,78% of total billed charges,1070,100,,,percent of total billed charges,100% of total billed charges,883.82,82.6,,,percent of total billed charges,82.6% of total billed charges,883.82,82.6,,,percent of total billed charges,82.6% of total billed charges,423.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.14,36273,
LAP SLING OPERATION,51992,CDM,983,RC,51992,HCPCS,Outpatient,,,1740,1131.00,,1531.2,88,,,percent of total billed charges,88% of total Billed charges,85.69,100,,,Fee Schedule,100% of Medicare rate,472.96,100,,,Fee Schedule,100% of WA Medicaid,1740,100,,,percent of total billed charges,100% of total billed charges,487.15,103,,,Fee Schedule,103% of WA Medicaid,85.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,149.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,472.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1200.6,69,,,percent of total billed charges,69% of total billed charges,1740,100,,,percent of total billed charges,100% of total billed charges,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1740,100,,,percent of total billed charges,100% of total billed charges,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1740,100,,,percent of total billed charges,100% of total billed charges,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1076.19,61.85,,,percent of total billed charges,61.85% of total billed charges,472.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,472.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,614.85,130,,,Fee Schedule,130% of WA Medicaid ,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,655.98,37.7,,,percent of total billed charges,37.70% of total billed charges,655.98,37.7,,,percent of total billed charges,37.70% of total billed charges,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,58986,33.9,,,percent of total billed charges,33.9% of total billed charges,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357.2,78,,,percent of total billed charges,78% of total billed charges,1740,100,,,percent of total billed charges,100% of total billed charges,1437.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1437.24,82.6,,,percent of total billed charges,82.6% of total billed charges,472.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,85.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,472.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.69,58986,
CYSTOURETHOSCOPY,52000,CDM,983,RC,52000,HCPCS,Outpatient,,,499,324.35,,439.12,88,,,percent of total billed charges,88% of total Billed charges,7.31,100,,,Fee Schedule,100% of Medicare rate,44.95,100,,,Fee Schedule,100% of WA Medicaid,499,100,,,percent of total billed charges,100% of total billed charges,46.3,103,,,Fee Schedule,103% of WA Medicaid,7.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,44.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,344.31,69,,,percent of total billed charges,69% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,499,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,499,100,,,percent of total billed charges,100% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.63,61.85,,,percent of total billed charges,61.85% of total billed charges,44.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.44,130,,,Fee Schedule,130% of WA Medicaid ,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,16916.1,33.9,,,percent of total billed charges,33.9% of total billed charges,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.22,78,,,percent of total billed charges,78% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,44.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.31,16916.1,
52204 Cystourethroscopy w/biopsy,52204,CDM,983,RC,52204,HCPCS,Outpatient,,,2269,1474.85,,1996.72,88,,,percent of total billed charges,88% of total Billed charges,12.49,100,,,Fee Schedule,100% of Medicare rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,2269,100,,,percent of total billed charges,100% of total billed charges,81.64,103,,,Fee Schedule,103% of WA Medicaid,12.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1565.61,69,,,percent of total billed charges,69% of total billed charges,2269,100,,,percent of total billed charges,100% of total billed charges,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2269,100,,,percent of total billed charges,100% of total billed charges,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2269,100,,,percent of total billed charges,100% of total billed charges,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1403.38,61.85,,,percent of total billed charges,61.85% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.04,130,,,Fee Schedule,130% of WA Medicaid ,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,855.41,37.7,,,percent of total billed charges,37.70% of total billed charges,855.41,37.7,,,percent of total billed charges,37.70% of total billed charges,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,76919.1,33.9,,,percent of total billed charges,33.9% of total billed charges,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1769.82,78,,,percent of total billed charges,78% of total billed charges,2269,100,,,percent of total billed charges,100% of total billed charges,1874.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1874.19,82.6,,,percent of total billed charges,82.6% of total billed charges,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.49,76919.1,
52214  Cystourethroscopy w/ Fluguratio,52214,CDM,983,RC,52214,HCPCS,Outpatient,,,4174,2713.10,,3673.12,88,,,percent of total billed charges,88% of total Billed charges,16.03,100,,,Fee Schedule,100% of Medicare rate,96.98,100,,,Fee Schedule,100% of WA Medicaid,4174,100,,,percent of total billed charges,100% of total billed charges,99.89,103,,,Fee Schedule,103% of WA Medicaid,16.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,96.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2880.06,69,,,percent of total billed charges,69% of total billed charges,4174,100,,,percent of total billed charges,100% of total billed charges,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4174,100,,,percent of total billed charges,100% of total billed charges,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4174,100,,,percent of total billed charges,100% of total billed charges,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2581.62,61.85,,,percent of total billed charges,61.85% of total billed charges,96.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.07,130,,,Fee Schedule,130% of WA Medicaid ,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1573.6,37.7,,,percent of total billed charges,37.70% of total billed charges,1573.6,37.7,,,percent of total billed charges,37.70% of total billed charges,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,141498.6,33.9,,,percent of total billed charges,33.9% of total billed charges,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3255.72,78,,,percent of total billed charges,78% of total billed charges,4174,100,,,percent of total billed charges,100% of total billed charges,3447.72,82.6,,,percent of total billed charges,82.6% of total billed charges,3447.72,82.6,,,percent of total billed charges,82.6% of total billed charges,96.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.03,141498.6,
52235 Cysto W/fulgurat med bladtumor,52235,CDM,983,RC,52235,HCPCS,Outpatient,,,1829,1188.85,,1609.52,88,,,percent of total billed charges,88% of total Billed charges,25.88,100,,,Fee Schedule,100% of Medicare rate,160.76,100,,,Fee Schedule,100% of WA Medicaid,1829,100,,,percent of total billed charges,100% of total billed charges,165.58,103,,,Fee Schedule,103% of WA Medicaid,25.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,160.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1262.01,69,,,percent of total billed charges,69% of total billed charges,1829,100,,,percent of total billed charges,100% of total billed charges,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1829,100,,,percent of total billed charges,100% of total billed charges,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1829,100,,,percent of total billed charges,100% of total billed charges,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131.24,61.85,,,percent of total billed charges,61.85% of total billed charges,160.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,208.99,130,,,Fee Schedule,130% of WA Medicaid ,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,689.53,37.7,,,percent of total billed charges,37.70% of total billed charges,689.53,37.7,,,percent of total billed charges,37.70% of total billed charges,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,62003.1,33.9,,,percent of total billed charges,33.9% of total billed charges,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1426.62,78,,,percent of total billed charges,78% of total billed charges,1829,100,,,percent of total billed charges,100% of total billed charges,1510.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1510.75,82.6,,,percent of total billed charges,82.6% of total billed charges,160.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.88,62003.1,
52281 Cysto w/dilate urethral,52281,CDM,983,RC,52281,HCPCS,Outpatient,,,1804,1172.60,,1587.52,88,,,percent of total billed charges,88% of total Billed charges,13.32,100,,,Fee Schedule,100% of Medicare rate,85.23,100,,,Fee Schedule,100% of WA Medicaid,1804,100,,,percent of total billed charges,100% of total billed charges,87.79,103,,,Fee Schedule,103% of WA Medicaid,13.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1244.76,69,,,percent of total billed charges,69% of total billed charges,1804,100,,,percent of total billed charges,100% of total billed charges,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1804,100,,,percent of total billed charges,100% of total billed charges,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1804,100,,,percent of total billed charges,100% of total billed charges,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1115.77,61.85,,,percent of total billed charges,61.85% of total billed charges,85.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,110.8,130,,,Fee Schedule,130% of WA Medicaid ,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,680.11,37.7,,,percent of total billed charges,37.70% of total billed charges,680.11,37.7,,,percent of total billed charges,37.70% of total billed charges,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,61155.6,33.9,,,percent of total billed charges,33.9% of total billed charges,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1407.12,78,,,percent of total billed charges,78% of total billed charges,1804,100,,,percent of total billed charges,100% of total billed charges,1490.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1490.1,82.6,,,percent of total billed charges,82.6% of total billed charges,85.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.32,61155.6,
52356 Lithotripsy w/insert stent,52356,CDM,983,RC,52356,HCPCS,Outpatient,,,2505,1628.25,,2204.4,88,,,percent of total billed charges,88% of total Billed charges,37.64,100,,,Fee Schedule,100% of Medicare rate,231.07,100,,,Fee Schedule,100% of WA Medicaid,2505,100,,,percent of total billed charges,100% of total billed charges,238,103,,,Fee Schedule,103% of WA Medicaid,37.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,231.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1728.45,69,,,percent of total billed charges,69% of total billed charges,2505,100,,,percent of total billed charges,100% of total billed charges,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2505,100,,,percent of total billed charges,100% of total billed charges,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2505,100,,,percent of total billed charges,100% of total billed charges,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1549.34,61.85,,,percent of total billed charges,61.85% of total billed charges,231.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,300.39,130,,,Fee Schedule,130% of WA Medicaid ,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,944.39,37.7,,,percent of total billed charges,37.70% of total billed charges,944.39,37.7,,,percent of total billed charges,37.70% of total billed charges,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,84919.5,33.9,,,percent of total billed charges,33.9% of total billed charges,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1953.9,78,,,percent of total billed charges,78% of total billed charges,2505,100,,,percent of total billed charges,100% of total billed charges,2069.13,82.6,,,percent of total billed charges,82.6% of total billed charges,2069.13,82.6,,,percent of total billed charges,82.6% of total billed charges,231.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.64,84919.5,
INCISION OF URETHRA,53000,CDM,983,RC,53000,HCPCS,Outpatient,,,762,495.30,,670.56,88,,,percent of total billed charges,88% of total Billed charges,12.02,100,,,Fee Schedule,100% of Medicare rate,85.42,100,,,Fee Schedule,100% of WA Medicaid,762,100,,,percent of total billed charges,100% of total billed charges,87.98,103,,,Fee Schedule,103% of WA Medicaid,12.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,525.78,69,,,percent of total billed charges,69% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,762,100,,,percent of total billed charges,100% of total billed charges,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,762,100,,,percent of total billed charges,100% of total billed charges,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.3,61.85,,,percent of total billed charges,61.85% of total billed charges,85.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.05,130,,,Fee Schedule,130% of WA Medicaid ,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,287.27,37.7,,,percent of total billed charges,37.70% of total billed charges,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,25831.8,33.9,,,percent of total billed charges,33.9% of total billed charges,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,594.36,78,,,percent of total billed charges,78% of total billed charges,762,100,,,percent of total billed charges,100% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,629.41,82.6,,,percent of total billed charges,82.6% of total billed charges,85.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.02,25831.8,
REMOVAL OF URETHRA GLAND,53270,CDM,983,RC,53270,HCPCS,Outpatient,,,477,310.05,,419.76,88,,,percent of total billed charges,88% of total Billed charges,15.43,100,,,Fee Schedule,100% of Medicare rate,105.75,100,,,Fee Schedule,100% of WA Medicaid,477,100,,,percent of total billed charges,100% of total billed charges,108.92,103,,,Fee Schedule,103% of WA Medicaid,15.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,105.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,329.13,69,,,percent of total billed charges,69% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,477,100,,,percent of total billed charges,100% of total billed charges,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,477,100,,,percent of total billed charges,100% of total billed charges,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.02,61.85,,,percent of total billed charges,61.85% of total billed charges,105.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,137.48,130,,,Fee Schedule,130% of WA Medicaid ,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,16170.3,33.9,,,percent of total billed charges,33.9% of total billed charges,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.06,78,,,percent of total billed charges,78% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,105.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.43,16170.3,
INSERT PORT URETHRAL STENT,53855,CDM,983,RC,53855,HCPCS,Outpatient,,,175,113.75,,154,88,,,percent of total billed charges,88% of total Billed charges,7.6,100,,,Fee Schedule,100% of Medicare rate,45.51,100,,,Fee Schedule,100% of WA Medicaid,175,100,,,percent of total billed charges,100% of total billed charges,46.88,103,,,Fee Schedule,103% of WA Medicaid,7.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,45.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,120.75,69,,,percent of total billed charges,69% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,175,100,,,percent of total billed charges,100% of total billed charges,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,175,100,,,percent of total billed charges,100% of total billed charges,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.24,61.85,,,percent of total billed charges,61.85% of total billed charges,45.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.16,130,,,Fee Schedule,130% of WA Medicaid ,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,5932.5,33.9,,,percent of total billed charges,33.9% of total billed charges,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.5,78,,,percent of total billed charges,78% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,45.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.6,5932.5,
DESTRUCTION PENIS LESION(S),54055,CDM,983,RC,54055,HCPCS,Outpatient,,,332,215.80,,292.16,88,,,percent of total billed charges,88% of total Billed charges,6.83,100,,,Fee Schedule,100% of Medicare rate,55.95,100,,,Fee Schedule,100% of WA Medicaid,332,100,,,percent of total billed charges,100% of total billed charges,57.63,103,,,Fee Schedule,103% of WA Medicaid,6.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,55.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,229.08,69,,,percent of total billed charges,69% of total billed charges,332,100,,,percent of total billed charges,100% of total billed charges,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,332,100,,,percent of total billed charges,100% of total billed charges,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,332,100,,,percent of total billed charges,100% of total billed charges,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.34,61.85,,,percent of total billed charges,61.85% of total billed charges,55.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,72.74,130,,,Fee Schedule,130% of WA Medicaid ,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.16,37.7,,,percent of total billed charges,37.70% of total billed charges,125.16,37.7,,,percent of total billed charges,37.70% of total billed charges,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,11254.8,33.9,,,percent of total billed charges,33.9% of total billed charges,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,258.96,78,,,percent of total billed charges,78% of total billed charges,332,100,,,percent of total billed charges,100% of total billed charges,274.23,82.6,,,percent of total billed charges,82.6% of total billed charges,274.23,82.6,,,percent of total billed charges,82.6% of total billed charges,55.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.83,11254.8,
CRYOSURGERY PENIS LESION(S),54056,CDM,983,RC,54056,HCPCS,Outpatient,,,241,156.65,,212.08,88,,,percent of total billed charges,88% of total Billed charges,7.07,100,,,Fee Schedule,100% of Medicare rate,65.65,100,,,Fee Schedule,100% of WA Medicaid,241,100,,,percent of total billed charges,100% of total billed charges,67.62,103,,,Fee Schedule,103% of WA Medicaid,7.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,65.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,166.29,69,,,percent of total billed charges,69% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,241,100,,,percent of total billed charges,100% of total billed charges,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,241,100,,,percent of total billed charges,100% of total billed charges,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.06,61.85,,,percent of total billed charges,61.85% of total billed charges,65.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.35,130,,,Fee Schedule,130% of WA Medicaid ,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.86,37.7,,,percent of total billed charges,37.70% of total billed charges,90.86,37.7,,,percent of total billed charges,37.70% of total billed charges,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,8169.9,33.9,,,percent of total billed charges,33.9% of total billed charges,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.98,78,,,percent of total billed charges,78% of total billed charges,241,100,,,percent of total billed charges,100% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,199.07,82.6,,,percent of total billed charges,82.6% of total billed charges,65.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.07,8169.9,
DESTRUCTION PENIS LESION(S),54050,CDM,983,RC,54050,HCPCS,Outpatient,,,219,142.35,,192.72,88,,,percent of total billed charges,88% of total Billed charges,7.17,100,,,Fee Schedule,100% of Medicare rate,62.48,100,,,Fee Schedule,100% of WA Medicaid,219,100,,,percent of total billed charges,100% of total billed charges,64.35,103,,,Fee Schedule,103% of WA Medicaid,7.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,62.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,151.11,69,,,percent of total billed charges,69% of total billed charges,219,100,,,percent of total billed charges,100% of total billed charges,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,219,100,,,percent of total billed charges,100% of total billed charges,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,219,100,,,percent of total billed charges,100% of total billed charges,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.45,61.85,,,percent of total billed charges,61.85% of total billed charges,62.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,81.22,130,,,Fee Schedule,130% of WA Medicaid ,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.56,37.7,,,percent of total billed charges,37.70% of total billed charges,82.56,37.7,,,percent of total billed charges,37.70% of total billed charges,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,7424.1,33.9,,,percent of total billed charges,33.9% of total billed charges,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.82,78,,,percent of total billed charges,78% of total billed charges,219,100,,,percent of total billed charges,100% of total billed charges,180.89,82.6,,,percent of total billed charges,82.6% of total billed charges,180.89,82.6,,,percent of total billed charges,82.6% of total billed charges,62.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.17,7424.1,
EXCISION OF PENIS LESION(S),54060,CDM,983,RC,54060,HCPCS,Outpatient,,,507,329.55,,446.16,88,,,percent of total billed charges,88% of total Billed charges,10.23,100,,,Fee Schedule,100% of Medicare rate,76.09,100,,,Fee Schedule,100% of WA Medicaid,507,100,,,percent of total billed charges,100% of total billed charges,78.37,103,,,Fee Schedule,103% of WA Medicaid,10.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,76.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,349.83,69,,,percent of total billed charges,69% of total billed charges,507,100,,,percent of total billed charges,100% of total billed charges,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,100,,,percent of total billed charges,100% of total billed charges,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,100,,,percent of total billed charges,100% of total billed charges,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.58,61.85,,,percent of total billed charges,61.85% of total billed charges,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,98.92,130,,,Fee Schedule,130% of WA Medicaid ,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.14,37.7,,,percent of total billed charges,37.70% of total billed charges,191.14,37.7,,,percent of total billed charges,37.70% of total billed charges,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,17187.3,33.9,,,percent of total billed charges,33.9% of total billed charges,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.46,78,,,percent of total billed charges,78% of total billed charges,507,100,,,percent of total billed charges,100% of total billed charges,418.78,82.6,,,percent of total billed charges,82.6% of total billed charges,418.78,82.6,,,percent of total billed charges,82.6% of total billed charges,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.23,17187.3,
DESTRUCTION PENIS LESION(S),54065,CDM,983,RC,54065,HCPCS,Outpatient,,,741,481.65,,652.08,88,,,percent of total billed charges,88% of total Billed charges,11.97,100,,,Fee Schedule,100% of Medicare rate,99.59,100,,,Fee Schedule,100% of WA Medicaid,741,100,,,percent of total billed charges,100% of total billed charges,102.58,103,,,Fee Schedule,103% of WA Medicaid,11.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,99.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,511.29,69,,,percent of total billed charges,69% of total billed charges,741,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,741,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,741,100,,,percent of total billed charges,100% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,458.31,61.85,,,percent of total billed charges,61.85% of total billed charges,99.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.47,130,,,Fee Schedule,130% of WA Medicaid ,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.36,37.7,,,percent of total billed charges,37.70% of total billed charges,279.36,37.7,,,percent of total billed charges,37.70% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,25119.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.98,78,,,percent of total billed charges,78% of total billed charges,741,100,,,percent of total billed charges,100% of total billed charges,612.07,82.6,,,percent of total billed charges,82.6% of total billed charges,612.07,82.6,,,percent of total billed charges,82.6% of total billed charges,99.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.97,25119.9,
CIRCUMCISION W/REGIONL BLOCK,54150,CDM,983,RC,54150,HCPCS,Outpatient,,,322,209.30,,283.36,88,,,percent of total billed charges,88% of total Billed charges,9.07,100,,,Fee Schedule,100% of Medicare rate,53.71,100,,,Fee Schedule,100% of WA Medicaid,322,100,,,percent of total billed charges,100% of total billed charges,55.32,103,,,Fee Schedule,103% of WA Medicaid,9.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,53.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,222.18,69,,,percent of total billed charges,69% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,322,100,,,percent of total billed charges,100% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,322,100,,,percent of total billed charges,100% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.16,61.85,,,percent of total billed charges,61.85% of total billed charges,53.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,69.82,130,,,Fee Schedule,130% of WA Medicaid ,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.39,37.7,,,percent of total billed charges,37.70% of total billed charges,121.39,37.7,,,percent of total billed charges,37.70% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,10915.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.16,78,,,percent of total billed charges,78% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,53.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.07,10915.8,
CIRCUMCISION NEONATE,54160,CDM,983,RC,54160,HCPCS,Outpatient,,,404,262.60,,355.52,88,,,percent of total billed charges,88% of total Billed charges,12.41,100,,,Fee Schedule,100% of Medicare rate,82.81,100,,,Fee Schedule,100% of WA Medicaid,404,100,,,percent of total billed charges,100% of total billed charges,85.29,103,,,Fee Schedule,103% of WA Medicaid,12.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,82.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,278.76,69,,,percent of total billed charges,69% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,404,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,404,100,,,percent of total billed charges,100% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.87,61.85,,,percent of total billed charges,61.85% of total billed charges,82.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.65,130,,,Fee Schedule,130% of WA Medicaid ,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,13695.6,33.9,,,percent of total billed charges,33.9% of total billed charges,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.12,78,,,percent of total billed charges,78% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,82.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.41,13695.6,
LYSIS PENIL CIRCUMIC LESION,54162,CDM,983,RC,54162,HCPCS,Outpatient,,,584,379.60,,513.92,88,,,percent of total billed charges,88% of total Billed charges,16.43,100,,,Fee Schedule,100% of Medicare rate,114.88,100,,,Fee Schedule,100% of WA Medicaid,584,100,,,percent of total billed charges,100% of total billed charges,118.33,103,,,Fee Schedule,103% of WA Medicaid,16.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,114.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,402.96,69,,,percent of total billed charges,69% of total billed charges,584,100,,,percent of total billed charges,100% of total billed charges,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,584,100,,,percent of total billed charges,100% of total billed charges,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,584,100,,,percent of total billed charges,100% of total billed charges,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.2,61.85,,,percent of total billed charges,61.85% of total billed charges,114.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,149.34,130,,,Fee Schedule,130% of WA Medicaid ,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.17,37.7,,,percent of total billed charges,37.70% of total billed charges,220.17,37.7,,,percent of total billed charges,37.70% of total billed charges,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,19797.6,33.9,,,percent of total billed charges,33.9% of total billed charges,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.52,78,,,percent of total billed charges,78% of total billed charges,584,100,,,percent of total billed charges,100% of total billed charges,482.38,82.6,,,percent of total billed charges,82.6% of total billed charges,482.38,82.6,,,percent of total billed charges,82.6% of total billed charges,114.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.43,19797.6,
REPAIR OF CIRCUMCISION,54163,CDM,983,RC,54163,HCPCS,Outpatient,,,740,481.00,,651.2,88,,,percent of total billed charges,88% of total Billed charges,17.04,100,,,Fee Schedule,100% of Medicare rate,126.63,100,,,Fee Schedule,100% of WA Medicaid,740,100,,,percent of total billed charges,100% of total billed charges,130.43,103,,,Fee Schedule,103% of WA Medicaid,17.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,126.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,510.6,69,,,percent of total billed charges,69% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,740,100,,,percent of total billed charges,100% of total billed charges,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,740,100,,,percent of total billed charges,100% of total billed charges,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.69,61.85,,,percent of total billed charges,61.85% of total billed charges,126.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,164.62,130,,,Fee Schedule,130% of WA Medicaid ,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,278.98,37.7,,,percent of total billed charges,37.70% of total billed charges,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,25086,33.9,,,percent of total billed charges,33.9% of total billed charges,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.2,78,,,percent of total billed charges,78% of total billed charges,740,100,,,percent of total billed charges,100% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,611.24,82.6,,,percent of total billed charges,82.6% of total billed charges,126.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.04,25086,
54161 Circumcision >28 days of age,54161,CDM,983,RC,54161,HCPCS,Outpatient,,,1074,698.10,,945.12,88,,,percent of total billed charges,88% of total Billed charges,16.32,100,,,Fee Schedule,100% of Medicare rate,112.83,100,,,Fee Schedule,100% of WA Medicaid,1074,100,,,percent of total billed charges,100% of total billed charges,116.21,103,,,Fee Schedule,103% of WA Medicaid,16.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,741.06,69,,,percent of total billed charges,69% of total billed charges,1074,100,,,percent of total billed charges,100% of total billed charges,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074,100,,,percent of total billed charges,100% of total billed charges,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074,100,,,percent of total billed charges,100% of total billed charges,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.27,61.85,,,percent of total billed charges,61.85% of total billed charges,112.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,146.68,130,,,Fee Schedule,130% of WA Medicaid ,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.9,37.7,,,percent of total billed charges,37.70% of total billed charges,404.9,37.7,,,percent of total billed charges,37.70% of total billed charges,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,36408.6,33.9,,,percent of total billed charges,33.9% of total billed charges,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,837.72,78,,,percent of total billed charges,78% of total billed charges,1074,100,,,percent of total billed charges,100% of total billed charges,887.12,82.6,,,percent of total billed charges,82.6% of total billed charges,887.12,82.6,,,percent of total billed charges,82.6% of total billed charges,112.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.32,36408.6,
PREPUTIAL STRETCHING,54450,CDM,983,RC,54450,HCPCS,Outpatient,,,190,123.50,,167.2,88,,,percent of total billed charges,88% of total Billed charges,5.32,100,,,Fee Schedule,100% of Medicare rate,31.89,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,32.85,103,,,Fee Schedule,103% of WA Medicaid,5.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,31.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.52,61.85,,,percent of total billed charges,61.85% of total billed charges,31.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.46,130,,,Fee Schedule,130% of WA Medicaid ,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,6441,33.9,,,percent of total billed charges,33.9% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,31.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.32,6441,
REMOVAL OF TESTIS,54530,CDM,983,RC,54530,HCPCS,Outpatient,,,2143,1392.95,,1885.84,88,,,percent of total billed charges,88% of total Billed charges,43.38,100,,,Fee Schedule,100% of Medicare rate,291.5,100,,,Fee Schedule,100% of WA Medicaid,2143,100,,,percent of total billed charges,100% of total billed charges,300.25,103,,,Fee Schedule,103% of WA Medicaid,43.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,291.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1478.67,69,,,percent of total billed charges,69% of total billed charges,2143,100,,,percent of total billed charges,100% of total billed charges,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2143,100,,,percent of total billed charges,100% of total billed charges,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2143,100,,,percent of total billed charges,100% of total billed charges,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1325.45,61.85,,,percent of total billed charges,61.85% of total billed charges,291.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,378.95,130,,,Fee Schedule,130% of WA Medicaid ,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,807.91,37.7,,,percent of total billed charges,37.70% of total billed charges,807.91,37.7,,,percent of total billed charges,37.70% of total billed charges,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,72647.7,33.9,,,percent of total billed charges,33.9% of total billed charges,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1671.54,78,,,percent of total billed charges,78% of total billed charges,2143,100,,,percent of total billed charges,100% of total billed charges,1770.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1770.12,82.6,,,percent of total billed charges,82.6% of total billed charges,291.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.38,72647.7,
SUSPENSION OF TESTIS,54640,CDM,983,RC,54640,HCPCS,Outpatient,,,1340.02,871.01,,1179.22,88,,,percent of total billed charges,88% of total Billed charges,39.39,100,,,Fee Schedule,100% of Medicare rate,244.87,100,,,Fee Schedule,100% of WA Medicaid,1340.02,100,,,percent of total billed charges,100% of total billed charges,252.22,103,,,Fee Schedule,103% of WA Medicaid,39.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,244.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,924.61,69,,,percent of total billed charges,69% of total billed charges,1340.02,100,,,percent of total billed charges,100% of total billed charges,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340.02,100,,,percent of total billed charges,100% of total billed charges,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340.02,100,,,percent of total billed charges,100% of total billed charges,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,828.8,61.85,,,percent of total billed charges,61.85% of total billed charges,244.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,318.33,130,,,Fee Schedule,130% of WA Medicaid ,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.19,37.7,,,percent of total billed charges,37.70% of total billed charges,505.19,37.7,,,percent of total billed charges,37.70% of total billed charges,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,45426.68,33.9,,,percent of total billed charges,33.9% of total billed charges,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1045.22,78,,,percent of total billed charges,78% of total billed charges,1340.02,100,,,percent of total billed charges,100% of total billed charges,1106.86,82.6,,,percent of total billed charges,82.6% of total billed charges,1106.86,82.6,,,percent of total billed charges,82.6% of total billed charges,244.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.39,45426.68,
DRAINAGE OF SCROTUM,54700,CDM,983,RC,54700,HCPCS,Outpatient,,,672,436.80,,591.36,88,,,percent of total billed charges,88% of total Billed charges,18.63,100,,,Fee Schedule,100% of Medicare rate,122.16,100,,,Fee Schedule,100% of WA Medicaid,672,100,,,percent of total billed charges,100% of total billed charges,125.82,103,,,Fee Schedule,103% of WA Medicaid,18.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,122.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,463.68,69,,,percent of total billed charges,69% of total billed charges,672,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,672,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,672,100,,,percent of total billed charges,100% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.63,61.85,,,percent of total billed charges,61.85% of total billed charges,122.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,158.81,130,,,Fee Schedule,130% of WA Medicaid ,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.34,37.7,,,percent of total billed charges,37.70% of total billed charges,253.34,37.7,,,percent of total billed charges,37.70% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,22780.8,33.9,,,percent of total billed charges,33.9% of total billed charges,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.16,78,,,percent of total billed charges,78% of total billed charges,672,100,,,percent of total billed charges,100% of total billed charges,555.07,82.6,,,percent of total billed charges,82.6% of total billed charges,555.07,82.6,,,percent of total billed charges,82.6% of total billed charges,122.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.63,22780.8,
REMOVAL OF HYDROCELE,55040,CDM,983,RC,55040,HCPCS,Outpatient,,,852,553.80,,749.76,88,,,percent of total billed charges,88% of total Billed charges,28.42,100,,,Fee Schedule,100% of Medicare rate,194.89,100,,,Fee Schedule,100% of WA Medicaid,852,100,,,percent of total billed charges,100% of total billed charges,200.74,103,,,Fee Schedule,103% of WA Medicaid,28.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,194.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,587.88,69,,,percent of total billed charges,69% of total billed charges,852,100,,,percent of total billed charges,100% of total billed charges,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,852,100,,,percent of total billed charges,100% of total billed charges,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,852,100,,,percent of total billed charges,100% of total billed charges,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,526.96,61.85,,,percent of total billed charges,61.85% of total billed charges,194.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,253.36,130,,,Fee Schedule,130% of WA Medicaid ,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.2,37.7,,,percent of total billed charges,37.70% of total billed charges,321.2,37.7,,,percent of total billed charges,37.70% of total billed charges,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,28882.8,33.9,,,percent of total billed charges,33.9% of total billed charges,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.56,78,,,percent of total billed charges,78% of total billed charges,852,100,,,percent of total billed charges,100% of total billed charges,703.75,82.6,,,percent of total billed charges,82.6% of total billed charges,703.75,82.6,,,percent of total billed charges,82.6% of total billed charges,194.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.42,28882.8,
REPAIR OF HYDROCELE,55060,CDM,983,RC,55060,HCPCS,Outpatient,,,1047,680.55,,921.36,88,,,percent of total billed charges,88% of total Billed charges,31.22,100,,,Fee Schedule,100% of Medicare rate,218.39,100,,,Fee Schedule,100% of WA Medicaid,1047,100,,,percent of total billed charges,100% of total billed charges,224.94,103,,,Fee Schedule,103% of WA Medicaid,31.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,218.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,722.43,69,,,percent of total billed charges,69% of total billed charges,1047,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1047,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1047,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.57,61.85,,,percent of total billed charges,61.85% of total billed charges,218.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,283.91,130,,,Fee Schedule,130% of WA Medicaid ,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.72,37.7,,,percent of total billed charges,37.70% of total billed charges,394.72,37.7,,,percent of total billed charges,37.70% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,35493.3,33.9,,,percent of total billed charges,33.9% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,816.66,78,,,percent of total billed charges,78% of total billed charges,1047,100,,,percent of total billed charges,100% of total billed charges,864.82,82.6,,,percent of total billed charges,82.6% of total billed charges,864.82,82.6,,,percent of total billed charges,82.6% of total billed charges,218.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.22,35493.3,
REMOVAL OF SPERM DUCT(S),55250,CDM,983,RC,55250,HCPCS,Outpatient,,,852,553.80,,749.76,88,,,percent of total billed charges,88% of total Billed charges,17.37,100,,,Fee Schedule,100% of Medicare rate,132.97,100,,,Fee Schedule,100% of WA Medicaid,852,100,,,percent of total billed charges,100% of total billed charges,136.96,103,,,Fee Schedule,103% of WA Medicaid,17.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,132.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,587.88,69,,,percent of total billed charges,69% of total billed charges,852,100,,,percent of total billed charges,100% of total billed charges,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,852,100,,,percent of total billed charges,100% of total billed charges,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,852,100,,,percent of total billed charges,100% of total billed charges,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,526.96,61.85,,,percent of total billed charges,61.85% of total billed charges,132.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,172.86,130,,,Fee Schedule,130% of WA Medicaid ,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.2,37.7,,,percent of total billed charges,37.70% of total billed charges,321.2,37.7,,,percent of total billed charges,37.70% of total billed charges,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,28882.8,33.9,,,percent of total billed charges,33.9% of total billed charges,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.56,78,,,percent of total billed charges,78% of total billed charges,852,100,,,percent of total billed charges,100% of total billed charges,703.75,82.6,,,percent of total billed charges,82.6% of total billed charges,703.75,82.6,,,percent of total billed charges,82.6% of total billed charges,132.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.37,28882.8,
REMOVAL OF SPERM CORD LESION,55520,CDM,983,RC,55520,HCPCS,Outpatient,,,1217,791.05,,1070.96,88,,,percent of total billed charges,88% of total Billed charges,55.83,100,,,Fee Schedule,100% of Medicare rate,262.22,100,,,Fee Schedule,100% of WA Medicaid,1217,100,,,percent of total billed charges,100% of total billed charges,270.09,103,,,Fee Schedule,103% of WA Medicaid,55.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,262.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,839.73,69,,,percent of total billed charges,69% of total billed charges,1217,100,,,percent of total billed charges,100% of total billed charges,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1217,100,,,percent of total billed charges,100% of total billed charges,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1217,100,,,percent of total billed charges,100% of total billed charges,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,752.71,61.85,,,percent of total billed charges,61.85% of total billed charges,262.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,340.89,130,,,Fee Schedule,130% of WA Medicaid ,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,458.81,37.7,,,percent of total billed charges,37.70% of total billed charges,458.81,37.7,,,percent of total billed charges,37.70% of total billed charges,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,41256.3,33.9,,,percent of total billed charges,33.9% of total billed charges,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,949.26,78,,,percent of total billed charges,78% of total billed charges,1217,100,,,percent of total billed charges,100% of total billed charges,1005.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1005.24,82.6,,,percent of total billed charges,82.6% of total billed charges,262.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.83,41256.3,
REVISE HERNIA  SPERM VEINS,55540,CDM,983,RC,55540,HCPCS,Outpatient,,,1377,895.05,,1211.76,88,,,percent of total billed charges,88% of total Billed charges,72.16,100,,,Fee Schedule,100% of Medicare rate,315.74,100,,,Fee Schedule,100% of WA Medicaid,1377,100,,,percent of total billed charges,100% of total billed charges,325.21,103,,,Fee Schedule,103% of WA Medicaid,72.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,315.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,950.13,69,,,percent of total billed charges,69% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377,100,,,percent of total billed charges,100% of total billed charges,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1377,100,,,percent of total billed charges,100% of total billed charges,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.67,61.85,,,percent of total billed charges,61.85% of total billed charges,315.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,410.46,130,,,Fee Schedule,130% of WA Medicaid ,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,519.13,37.7,,,percent of total billed charges,37.70% of total billed charges,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,46680.3,33.9,,,percent of total billed charges,33.9% of total billed charges,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.06,78,,,percent of total billed charges,78% of total billed charges,1377,100,,,percent of total billed charges,100% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,1137.4,82.6,,,percent of total billed charges,82.6% of total billed charges,315.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.16,46680.3,
55700 Biopsy Prostate,55700,CDM,983,RC,55700,HCPCS,Outpatient,,,891,579.15,,784.08,88,,,percent of total billed charges,88% of total Billed charges,11.9,100,,,Fee Schedule,100% of Medicare rate,72.92,100,,,Fee Schedule,100% of WA Medicaid,891,100,,,percent of total billed charges,100% of total billed charges,75.11,103,,,Fee Schedule,103% of WA Medicaid,11.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,72.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,614.79,69,,,percent of total billed charges,69% of total billed charges,891,100,,,percent of total billed charges,100% of total billed charges,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,891,100,,,percent of total billed charges,100% of total billed charges,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,891,100,,,percent of total billed charges,100% of total billed charges,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.08,61.85,,,percent of total billed charges,61.85% of total billed charges,72.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,94.8,130,,,Fee Schedule,130% of WA Medicaid ,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.91,37.7,,,percent of total billed charges,37.70% of total billed charges,335.91,37.7,,,percent of total billed charges,37.70% of total billed charges,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,30204.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,694.98,78,,,percent of total billed charges,78% of total billed charges,891,100,,,percent of total billed charges,100% of total billed charges,735.97,82.6,,,percent of total billed charges,82.6% of total billed charges,735.97,82.6,,,percent of total billed charges,82.6% of total billed charges,72.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.9,30204.9,
EXTENSIVE PROSTATE SURGERY,55845,CDM,983,RC,55845,HCPCS,Outpatient,,,7040,4576.00,,6195.2,88,,,percent of total billed charges,88% of total Billed charges,121.41,100,,,Fee Schedule,100% of Medicare rate,766.14,100,,,Fee Schedule,100% of WA Medicaid,7040,100,,,percent of total billed charges,100% of total billed charges,789.12,103,,,Fee Schedule,103% of WA Medicaid,121.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,212.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,766.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4857.6,69,,,percent of total billed charges,69% of total billed charges,7040,100,,,percent of total billed charges,100% of total billed charges,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7040,100,,,percent of total billed charges,100% of total billed charges,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7040,100,,,percent of total billed charges,100% of total billed charges,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,4354.24,61.85,,,percent of total billed charges,61.85% of total billed charges,766.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,781.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,995.98,130,,,Fee Schedule,130% of WA Medicaid ,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2654.08,37.7,,,percent of total billed charges,37.70% of total billed charges,2654.08,37.7,,,percent of total billed charges,37.70% of total billed charges,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,238656,33.9,,,percent of total billed charges,33.9% of total billed charges,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,5491.2,78,,,percent of total billed charges,78% of total billed charges,7040,100,,,percent of total billed charges,100% of total billed charges,5815.04,82.6,,,percent of total billed charges,82.6% of total billed charges,5815.04,82.6,,,percent of total billed charges,82.6% of total billed charges,766.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.41,238656,
NP/PA ASSIST RADICAL LAPAROSCOPIC PROSTATECTOMY,55866,CDM,983,RC,55866,HCPCS,Outpatient,,,1179,766.35,,1037.52,88,,,percent of total billed charges,88% of total Billed charges,106.6,100,,,Fee Schedule,100% of Medicare rate,672.15,100,,,Fee Schedule,100% of WA Medicaid,1179,100,,,percent of total billed charges,100% of total billed charges,692.31,103,,,Fee Schedule,103% of WA Medicaid,106.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,186.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,672.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,813.51,69,,,percent of total billed charges,69% of total billed charges,1179,100,,,percent of total billed charges,100% of total billed charges,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1179,100,,,percent of total billed charges,100% of total billed charges,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1179,100,,,percent of total billed charges,100% of total billed charges,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.21,61.85,,,percent of total billed charges,61.85% of total billed charges,672.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,672.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,685.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,873.8,130,,,Fee Schedule,130% of WA Medicaid ,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.48,37.7,,,percent of total billed charges,37.70% of total billed charges,444.48,37.7,,,percent of total billed charges,37.70% of total billed charges,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,39968.1,33.9,,,percent of total billed charges,33.9% of total billed charges,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,919.62,78,,,percent of total billed charges,78% of total billed charges,1179,100,,,percent of total billed charges,100% of total billed charges,973.85,82.6,,,percent of total billed charges,82.6% of total billed charges,973.85,82.6,,,percent of total billed charges,82.6% of total billed charges,672.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,672.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.6,39968.1,
I  D OF VULVA/PERINEUM,56405,CDM,983,RC,56405,HCPCS,Outpatient,,,378,245.70,,332.64,88,,,percent of total billed charges,88% of total Billed charges,10.38,100,,,Fee Schedule,100% of Medicare rate,74.23,100,,,Fee Schedule,100% of WA Medicaid,378,100,,,percent of total billed charges,100% of total billed charges,76.46,103,,,Fee Schedule,103% of WA Medicaid,10.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,260.82,69,,,percent of total billed charges,69% of total billed charges,378,100,,,percent of total billed charges,100% of total billed charges,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,378,100,,,percent of total billed charges,100% of total billed charges,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,378,100,,,percent of total billed charges,100% of total billed charges,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.79,61.85,,,percent of total billed charges,61.85% of total billed charges,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,96.5,130,,,Fee Schedule,130% of WA Medicaid ,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.51,37.7,,,percent of total billed charges,37.70% of total billed charges,142.51,37.7,,,percent of total billed charges,37.70% of total billed charges,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,12814.2,33.9,,,percent of total billed charges,33.9% of total billed charges,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,294.84,78,,,percent of total billed charges,78% of total billed charges,378,100,,,percent of total billed charges,100% of total billed charges,312.23,82.6,,,percent of total billed charges,82.6% of total billed charges,312.23,82.6,,,percent of total billed charges,82.6% of total billed charges,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.38,12814.2,
DRAINAGE OF GLAND ABSCESS,56420,CDM,983,RC,56420,HCPCS,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,9.6,100,,,Fee Schedule,100% of Medicare rate,64.34,100,,,Fee Schedule,100% of WA Medicaid,350,100,,,percent of total billed charges,100% of total billed charges,66.27,103,,,Fee Schedule,103% of WA Medicaid,9.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,64.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,350,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,350,100,,,percent of total billed charges,100% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.48,61.85,,,percent of total billed charges,61.85% of total billed charges,64.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,83.64,130,,,Fee Schedule,130% of WA Medicaid ,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,131.95,37.7,,,percent of total billed charges,37.70% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,11865,33.9,,,percent of total billed charges,33.9% of total billed charges,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,64.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.6,11865,
SURGERY FOR VULVA LESION,56440,CDM,983,RC,56440,HCPCS,Outpatient,,,600,390.00,,528,88,,,percent of total billed charges,88% of total Billed charges,17.95,100,,,Fee Schedule,100% of Medicare rate,104.25,100,,,Fee Schedule,100% of WA Medicaid,600,100,,,percent of total billed charges,100% of total billed charges,107.38,103,,,Fee Schedule,103% of WA Medicaid,17.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,31.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,104.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,414,69,,,percent of total billed charges,69% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,600,100,,,percent of total billed charges,100% of total billed charges,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,600,100,,,percent of total billed charges,100% of total billed charges,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,371.1,61.85,,,percent of total billed charges,61.85% of total billed charges,104.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,135.53,130,,,Fee Schedule,130% of WA Medicaid ,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,226.2,37.7,,,percent of total billed charges,37.70% of total billed charges,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,20340,33.9,,,percent of total billed charges,33.9% of total billed charges,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,468,78,,,percent of total billed charges,78% of total billed charges,600,100,,,percent of total billed charges,100% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,495.6,82.6,,,percent of total billed charges,82.6% of total billed charges,104.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.95,20340,
LYSIS OF LABIAL ADHESIONS,56441,CDM,983,RC,56441,HCPCS,Outpatient,,,340,221.00,,299.2,88,,,percent of total billed charges,88% of total Billed charges,13.05,100,,,Fee Schedule,100% of Medicare rate,90.45,100,,,Fee Schedule,100% of WA Medicaid,340,100,,,percent of total billed charges,100% of total billed charges,93.16,103,,,Fee Schedule,103% of WA Medicaid,13.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,90.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,234.6,69,,,percent of total billed charges,69% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.29,61.85,,,percent of total billed charges,61.85% of total billed charges,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,117.59,130,,,Fee Schedule,130% of WA Medicaid ,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,11526,33.9,,,percent of total billed charges,33.9% of total billed charges,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.2,78,,,percent of total billed charges,78% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.05,11526,
DESTROY VULVA LESIONS SIM,56501,CDM,983,RC,56501,HCPCS,Outpatient,,,289,187.85,,254.32,88,,,percent of total billed charges,88% of total Billed charges,10.33,100,,,Fee Schedule,100% of Medicare rate,78.14,100,,,Fee Schedule,100% of WA Medicaid,289,100,,,percent of total billed charges,100% of total billed charges,80.48,103,,,Fee Schedule,103% of WA Medicaid,10.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,78.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,199.41,69,,,percent of total billed charges,69% of total billed charges,289,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,289,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,289,100,,,percent of total billed charges,100% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.75,61.85,,,percent of total billed charges,61.85% of total billed charges,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,101.58,130,,,Fee Schedule,130% of WA Medicaid ,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.95,37.7,,,percent of total billed charges,37.70% of total billed charges,108.95,37.7,,,percent of total billed charges,37.70% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,9797.1,33.9,,,percent of total billed charges,33.9% of total billed charges,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.42,78,,,percent of total billed charges,78% of total billed charges,289,100,,,percent of total billed charges,100% of total billed charges,238.71,82.6,,,percent of total billed charges,82.6% of total billed charges,238.71,82.6,,,percent of total billed charges,82.6% of total billed charges,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.33,9797.1,
BIOPSY OF VULVA/PERINEUM,56605,CDM,983,RC,56605,HCPCS,Outpatient,,,298,193.70,,262.24,88,,,percent of total billed charges,88% of total Billed charges,6.43,100,,,Fee Schedule,100% of Medicare rate,33.2,100,,,Fee Schedule,100% of WA Medicaid,298,100,,,percent of total billed charges,100% of total billed charges,34.2,103,,,Fee Schedule,103% of WA Medicaid,6.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,205.62,69,,,percent of total billed charges,69% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,298,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,298,100,,,percent of total billed charges,100% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.31,61.85,,,percent of total billed charges,61.85% of total billed charges,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.16,130,,,Fee Schedule,130% of WA Medicaid ,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,10102.2,33.9,,,percent of total billed charges,33.9% of total billed charges,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.44,78,,,percent of total billed charges,78% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.43,10102.2,
BIOPSY OF VULVA OR PERINEUM EA ADDT LES,56606,CDM,983,RC,56606,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,3.2,100,,,Fee Schedule,100% of Medicare rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,16.9,103,,,Fee Schedule,103% of WA Medicaid,3.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,88,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,88,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.43,61.85,,,percent of total billed charges,61.85% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.33,130,,,Fee Schedule,130% of WA Medicaid ,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2983.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.2,2983.2,
PARTIAL REMOVAL OF VULVA,56620,CDM,983,RC,56620,HCPCS,Outpatient,,,2723,1769.95,,2396.24,88,,,percent of total billed charges,88% of total Billed charges,50.9,100,,,Fee Schedule,100% of Medicare rate,342.04,100,,,Fee Schedule,100% of WA Medicaid,2723,100,,,percent of total billed charges,100% of total billed charges,352.3,103,,,Fee Schedule,103% of WA Medicaid,50.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,342.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1878.87,69,,,percent of total billed charges,69% of total billed charges,2723,100,,,percent of total billed charges,100% of total billed charges,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2723,100,,,percent of total billed charges,100% of total billed charges,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2723,100,,,percent of total billed charges,100% of total billed charges,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1684.18,61.85,,,percent of total billed charges,61.85% of total billed charges,342.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,444.65,130,,,Fee Schedule,130% of WA Medicaid ,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1026.57,37.7,,,percent of total billed charges,37.70% of total billed charges,1026.57,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,92309.7,33.9,,,percent of total billed charges,33.9% of total billed charges,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2123.94,78,,,percent of total billed charges,78% of total billed charges,2723,100,,,percent of total billed charges,100% of total billed charges,2249.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2249.2,82.6,,,percent of total billed charges,82.6% of total billed charges,342.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.9,92309.7,
PARTIAL HYMENECTOMY OR REVISE HYMEN RING,56700,CDM,983,RC,56700,HCPCS,Outpatient,,,400,260.00,,352,88,,,percent of total billed charges,88% of total Billed charges,18.38,100,,,Fee Schedule,100% of Medicare rate,117.68,100,,,Fee Schedule,100% of WA Medicaid,400,100,,,percent of total billed charges,100% of total billed charges,121.21,103,,,Fee Schedule,103% of WA Medicaid,18.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,117.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,276,69,,,percent of total billed charges,69% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,400,100,,,percent of total billed charges,100% of total billed charges,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,400,100,,,percent of total billed charges,100% of total billed charges,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.4,61.85,,,percent of total billed charges,61.85% of total billed charges,117.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,152.98,130,,,Fee Schedule,130% of WA Medicaid ,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.8,37.7,,,percent of total billed charges,37.70% of total billed charges,150.8,37.7,,,percent of total billed charges,37.70% of total billed charges,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,13560,33.9,,,percent of total billed charges,33.9% of total billed charges,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,312,78,,,percent of total billed charges,78% of total billed charges,400,100,,,percent of total billed charges,100% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,330.4,82.6,,,percent of total billed charges,82.6% of total billed charges,117.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.38,13560,
EXCISION OF BARTHOLIN'S GLAND/CYST,56740,CDM,983,RC,56740,HCPCS,Outpatient,,,701,455.65,,616.88,88,,,percent of total billed charges,88% of total Billed charges,31.06,100,,,Fee Schedule,100% of Medicare rate,180.91,100,,,Fee Schedule,100% of WA Medicaid,701,100,,,percent of total billed charges,100% of total billed charges,186.34,103,,,Fee Schedule,103% of WA Medicaid,31.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,180.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,483.69,69,,,percent of total billed charges,69% of total billed charges,701,100,,,percent of total billed charges,100% of total billed charges,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,701,100,,,percent of total billed charges,100% of total billed charges,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,701,100,,,percent of total billed charges,100% of total billed charges,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.57,61.85,,,percent of total billed charges,61.85% of total billed charges,180.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,235.18,130,,,Fee Schedule,130% of WA Medicaid ,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.28,37.7,,,percent of total billed charges,37.70% of total billed charges,264.28,37.7,,,percent of total billed charges,37.70% of total billed charges,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,23763.9,33.9,,,percent of total billed charges,33.9% of total billed charges,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.78,78,,,percent of total billed charges,78% of total billed charges,701,100,,,percent of total billed charges,100% of total billed charges,579.03,82.6,,,percent of total billed charges,82.6% of total billed charges,579.03,82.6,,,percent of total billed charges,82.6% of total billed charges,180.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.06,23763.9,
REPAIR OF PERINEUM,56810,CDM,983,RC,56810,HCPCS,Outpatient,,,530,344.50,,466.4,88,,,percent of total billed charges,88% of total Billed charges,26.69,100,,,Fee Schedule,100% of Medicare rate,157.03,100,,,Fee Schedule,100% of WA Medicaid,530,100,,,percent of total billed charges,100% of total billed charges,161.74,103,,,Fee Schedule,103% of WA Medicaid,26.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,46.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,157.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,365.7,69,,,percent of total billed charges,69% of total billed charges,530,100,,,percent of total billed charges,100% of total billed charges,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,530,100,,,percent of total billed charges,100% of total billed charges,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,530,100,,,percent of total billed charges,100% of total billed charges,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.81,61.85,,,percent of total billed charges,61.85% of total billed charges,157.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,204.14,130,,,Fee Schedule,130% of WA Medicaid ,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.81,37.7,,,percent of total billed charges,37.70% of total billed charges,199.81,37.7,,,percent of total billed charges,37.70% of total billed charges,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,17967,33.9,,,percent of total billed charges,33.9% of total billed charges,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.4,78,,,percent of total billed charges,78% of total billed charges,530,100,,,percent of total billed charges,100% of total billed charges,437.78,82.6,,,percent of total billed charges,82.6% of total billed charges,437.78,82.6,,,percent of total billed charges,82.6% of total billed charges,157.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.69,17967,
EXAM OF VULVA W/SCOPE,56820,CDM,983,RC,56820,HCPCS,Outpatient,,,362,235.30,,318.56,88,,,percent of total billed charges,88% of total Billed charges,8.74,100,,,Fee Schedule,100% of Medicare rate,47.56,100,,,Fee Schedule,100% of WA Medicaid,362,100,,,percent of total billed charges,100% of total billed charges,48.99,103,,,Fee Schedule,103% of WA Medicaid,8.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,249.78,69,,,percent of total billed charges,69% of total billed charges,362,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,362,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,362,100,,,percent of total billed charges,100% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.9,61.85,,,percent of total billed charges,61.85% of total billed charges,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,61.83,130,,,Fee Schedule,130% of WA Medicaid ,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.47,37.7,,,percent of total billed charges,37.70% of total billed charges,136.47,37.7,,,percent of total billed charges,37.70% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,12271.8,33.9,,,percent of total billed charges,33.9% of total billed charges,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.36,78,,,percent of total billed charges,78% of total billed charges,362,100,,,percent of total billed charges,100% of total billed charges,299.01,82.6,,,percent of total billed charges,82.6% of total billed charges,299.01,82.6,,,percent of total billed charges,82.6% of total billed charges,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.74,12271.8,
I  D VAGINAL HEMATOMA PP,57022,CDM,983,RC,57022,HCPCS,Outpatient,,,515,334.75,,453.2,88,,,percent of total billed charges,88% of total Billed charges,17.17,100,,,Fee Schedule,100% of Medicare rate,104.44,100,,,Fee Schedule,100% of WA Medicaid,515,100,,,percent of total billed charges,100% of total billed charges,107.57,103,,,Fee Schedule,103% of WA Medicaid,17.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,104.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,355.35,69,,,percent of total billed charges,69% of total billed charges,515,100,,,percent of total billed charges,100% of total billed charges,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,515,100,,,percent of total billed charges,100% of total billed charges,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,515,100,,,percent of total billed charges,100% of total billed charges,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.53,61.85,,,percent of total billed charges,61.85% of total billed charges,104.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,135.77,130,,,Fee Schedule,130% of WA Medicaid ,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.16,37.7,,,percent of total billed charges,37.70% of total billed charges,194.16,37.7,,,percent of total billed charges,37.70% of total billed charges,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,17458.5,33.9,,,percent of total billed charges,33.9% of total billed charges,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.7,78,,,percent of total billed charges,78% of total billed charges,515,100,,,percent of total billed charges,100% of total billed charges,425.39,82.6,,,percent of total billed charges,82.6% of total billed charges,425.39,82.6,,,percent of total billed charges,82.6% of total billed charges,104.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.17,17458.5,
DRAINAGE OF PELVIC FLUID,57020,CDM,983,RC,57020,HCPCS,Outpatient,,,340,221.00,,299.2,88,,,percent of total billed charges,88% of total Billed charges,8.84,100,,,Fee Schedule,100% of Medicare rate,44.39,100,,,Fee Schedule,100% of WA Medicaid,340,100,,,percent of total billed charges,100% of total billed charges,45.72,103,,,Fee Schedule,103% of WA Medicaid,8.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,44.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,234.6,69,,,percent of total billed charges,69% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.29,61.85,,,percent of total billed charges,61.85% of total billed charges,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,57.71,130,,,Fee Schedule,130% of WA Medicaid ,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,11526,33.9,,,percent of total billed charges,33.9% of total billed charges,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.2,78,,,percent of total billed charges,78% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.84,11526,
DESTROY VAG LESIONS SIMPLE,57061,CDM,983,RC,57061,HCPCS,Outpatient,,,371,241.15,,326.48,88,,,percent of total billed charges,88% of total Billed charges,9.25,100,,,Fee Schedule,100% of Medicare rate,67.51,100,,,Fee Schedule,100% of WA Medicaid,371,100,,,percent of total billed charges,100% of total billed charges,69.54,103,,,Fee Schedule,103% of WA Medicaid,9.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,67.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,255.99,69,,,percent of total billed charges,69% of total billed charges,371,100,,,percent of total billed charges,100% of total billed charges,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,371,100,,,percent of total billed charges,100% of total billed charges,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,371,100,,,percent of total billed charges,100% of total billed charges,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.46,61.85,,,percent of total billed charges,61.85% of total billed charges,67.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,87.76,130,,,Fee Schedule,130% of WA Medicaid ,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.87,37.7,,,percent of total billed charges,37.70% of total billed charges,139.87,37.7,,,percent of total billed charges,37.70% of total billed charges,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,12576.9,33.9,,,percent of total billed charges,33.9% of total billed charges,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.38,78,,,percent of total billed charges,78% of total billed charges,371,100,,,percent of total billed charges,100% of total billed charges,306.45,82.6,,,percent of total billed charges,82.6% of total billed charges,306.45,82.6,,,percent of total billed charges,82.6% of total billed charges,67.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.25,12576.9,
DESTROY VAG LESIONS COMPLEX,57065,CDM,983,RC,57065,HCPCS,Outpatient,,,712,462.80,,626.56,88,,,percent of total billed charges,88% of total Billed charges,16.81,100,,,Fee Schedule,100% of Medicare rate,107.61,100,,,Fee Schedule,100% of WA Medicaid,712,100,,,percent of total billed charges,100% of total billed charges,110.84,103,,,Fee Schedule,103% of WA Medicaid,16.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,107.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,491.28,69,,,percent of total billed charges,69% of total billed charges,712,100,,,percent of total billed charges,100% of total billed charges,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,712,100,,,percent of total billed charges,100% of total billed charges,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,712,100,,,percent of total billed charges,100% of total billed charges,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.37,61.85,,,percent of total billed charges,61.85% of total billed charges,107.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,139.89,130,,,Fee Schedule,130% of WA Medicaid ,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.42,37.7,,,percent of total billed charges,37.70% of total billed charges,268.42,37.7,,,percent of total billed charges,37.70% of total billed charges,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,24136.8,33.9,,,percent of total billed charges,33.9% of total billed charges,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,555.36,78,,,percent of total billed charges,78% of total billed charges,712,100,,,percent of total billed charges,100% of total billed charges,588.11,82.6,,,percent of total billed charges,82.6% of total billed charges,588.11,82.6,,,percent of total billed charges,82.6% of total billed charges,107.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.81,24136.8,
BIOPSY OF VAGINA,57100,CDM,983,RC,57100,HCPCS,Outpatient,,,312,202.80,,274.56,88,,,percent of total billed charges,88% of total Billed charges,7.14,100,,,Fee Schedule,100% of Medicare rate,36.93,100,,,Fee Schedule,100% of WA Medicaid,312,100,,,percent of total billed charges,100% of total billed charges,38.04,103,,,Fee Schedule,103% of WA Medicaid,7.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,36.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,215.28,69,,,percent of total billed charges,69% of total billed charges,312,100,,,percent of total billed charges,100% of total billed charges,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,312,100,,,percent of total billed charges,100% of total billed charges,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,312,100,,,percent of total billed charges,100% of total billed charges,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.97,61.85,,,percent of total billed charges,61.85% of total billed charges,36.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,48.01,130,,,Fee Schedule,130% of WA Medicaid ,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.62,37.7,,,percent of total billed charges,37.70% of total billed charges,117.62,37.7,,,percent of total billed charges,37.70% of total billed charges,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,10576.8,33.9,,,percent of total billed charges,33.9% of total billed charges,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.36,78,,,percent of total billed charges,78% of total billed charges,312,100,,,percent of total billed charges,100% of total billed charges,257.71,82.6,,,percent of total billed charges,82.6% of total billed charges,257.71,82.6,,,percent of total billed charges,82.6% of total billed charges,36.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.14,10576.8,
BIOPSY OF VAGINA,57105,CDM,983,RC,57105,HCPCS,Outpatient,,,636,413.40,,559.68,88,,,percent of total billed charges,88% of total Billed charges,12.02,100,,,Fee Schedule,100% of Medicare rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,636,100,,,percent of total billed charges,100% of total billed charges,88.36,103,,,Fee Schedule,103% of WA Medicaid,12.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,438.84,69,,,percent of total billed charges,69% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,636,100,,,percent of total billed charges,100% of total billed charges,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,636,100,,,percent of total billed charges,100% of total billed charges,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.37,61.85,,,percent of total billed charges,61.85% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.53,130,,,Fee Schedule,130% of WA Medicaid ,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,21560.4,33.9,,,percent of total billed charges,33.9% of total billed charges,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.08,78,,,percent of total billed charges,78% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.02,21560.4,
REMOVE VAGINA LESION,57135,CDM,983,RC,57135,HCPCS,Outpatient,,,857,557.05,,754.16,88,,,percent of total billed charges,88% of total Billed charges,17.13,100,,,Fee Schedule,100% of Medicare rate,108.73,100,,,Fee Schedule,100% of WA Medicaid,857,100,,,percent of total billed charges,100% of total billed charges,111.99,103,,,Fee Schedule,103% of WA Medicaid,17.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,108.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,591.33,69,,,percent of total billed charges,69% of total billed charges,857,100,,,percent of total billed charges,100% of total billed charges,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,857,100,,,percent of total billed charges,100% of total billed charges,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,857,100,,,percent of total billed charges,100% of total billed charges,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.05,61.85,,,percent of total billed charges,61.85% of total billed charges,108.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,141.35,130,,,Fee Schedule,130% of WA Medicaid ,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.09,37.7,,,percent of total billed charges,37.70% of total billed charges,323.09,37.7,,,percent of total billed charges,37.70% of total billed charges,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,29052.3,33.9,,,percent of total billed charges,33.9% of total billed charges,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.46,78,,,percent of total billed charges,78% of total billed charges,857,100,,,percent of total billed charges,100% of total billed charges,707.88,82.6,,,percent of total billed charges,82.6% of total billed charges,707.88,82.6,,,percent of total billed charges,82.6% of total billed charges,108.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.13,29052.3,
TREAT VAGINA INFECTION,57150,CDM,983,RC,57150,HCPCS,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,2.84,100,,,Fee Schedule,100% of Medicare rate,14.36,100,,,Fee Schedule,100% of WA Medicaid,104,100,,,percent of total billed charges,100% of total billed charges,14.79,103,,,Fee Schedule,103% of WA Medicaid,2.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,14.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,104,100,,,percent of total billed charges,100% of total billed charges,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,104,100,,,percent of total billed charges,100% of total billed charges,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.32,61.85,,,percent of total billed charges,61.85% of total billed charges,14.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.67,130,,,Fee Schedule,130% of WA Medicaid ,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3525.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,14.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.84,3525.6,
INSERT PESSARY/OTHER DEVICE,57160,CDM,983,RC,57160,HCPCS,Outpatient,,,154,100.10,,135.52,88,,,percent of total billed charges,88% of total Billed charges,4.99,100,,,Fee Schedule,100% of Medicare rate,25.74,100,,,Fee Schedule,100% of WA Medicaid,154,100,,,percent of total billed charges,100% of total billed charges,26.51,103,,,Fee Schedule,103% of WA Medicaid,4.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,106.26,69,,,percent of total billed charges,69% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,154,100,,,percent of total billed charges,100% of total billed charges,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,154,100,,,percent of total billed charges,100% of total billed charges,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.25,61.85,,,percent of total billed charges,61.85% of total billed charges,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.46,130,,,Fee Schedule,130% of WA Medicaid ,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,5220.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.12,78,,,percent of total billed charges,78% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.99,5220.6,
FITTING OF DIAPHRAGM/CAP,57170,CDM,983,RC,57170,HCPCS,Outpatient,,,154,100.10,,135.52,88,,,percent of total billed charges,88% of total Billed charges,5.29,100,,,Fee Schedule,100% of Medicare rate,26.48,100,,,Fee Schedule,100% of WA Medicaid,154,100,,,percent of total billed charges,100% of total billed charges,27.27,103,,,Fee Schedule,103% of WA Medicaid,5.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,26.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,106.26,69,,,percent of total billed charges,69% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,154,100,,,percent of total billed charges,100% of total billed charges,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,154,100,,,percent of total billed charges,100% of total billed charges,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.25,61.85,,,percent of total billed charges,61.85% of total billed charges,26.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,34.42,130,,,Fee Schedule,130% of WA Medicaid ,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,58.06,37.7,,,percent of total billed charges,37.70% of total billed charges,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,5220.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.12,78,,,percent of total billed charges,78% of total billed charges,154,100,,,percent of total billed charges,100% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,127.2,82.6,,,percent of total billed charges,82.6% of total billed charges,26.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.29,5220.6,
TREAT VAGINAL BLEEDING,57180,CDM,983,RC,57180,HCPCS,Outpatient,,,319,207.35,,280.72,88,,,percent of total billed charges,88% of total Billed charges,10.43,100,,,Fee Schedule,100% of Medicare rate,70.12,100,,,Fee Schedule,100% of WA Medicaid,319,100,,,percent of total billed charges,100% of total billed charges,72.22,103,,,Fee Schedule,103% of WA Medicaid,10.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,220.11,69,,,percent of total billed charges,69% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,319,100,,,percent of total billed charges,100% of total billed charges,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,319,100,,,percent of total billed charges,100% of total billed charges,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.3,61.85,,,percent of total billed charges,61.85% of total billed charges,70.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,91.16,130,,,Fee Schedule,130% of WA Medicaid ,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,10814.1,33.9,,,percent of total billed charges,33.9% of total billed charges,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.82,78,,,percent of total billed charges,78% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,70.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.43,10814.1,
REPAIR OF VAGINA,57200,CDM,983,RC,57200,HCPCS,Outpatient,,,835,542.75,,734.8,88,,,percent of total billed charges,88% of total Billed charges,29.36,100,,,Fee Schedule,100% of Medicare rate,193.4,100,,,Fee Schedule,100% of WA Medicaid,835,100,,,percent of total billed charges,100% of total billed charges,199.2,103,,,Fee Schedule,103% of WA Medicaid,29.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,193.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,576.15,69,,,percent of total billed charges,69% of total billed charges,835,100,,,percent of total billed charges,100% of total billed charges,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,835,100,,,percent of total billed charges,100% of total billed charges,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,835,100,,,percent of total billed charges,100% of total billed charges,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.45,61.85,,,percent of total billed charges,61.85% of total billed charges,193.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,251.42,130,,,Fee Schedule,130% of WA Medicaid ,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.8,37.7,,,percent of total billed charges,37.70% of total billed charges,314.8,37.7,,,percent of total billed charges,37.70% of total billed charges,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,28306.5,33.9,,,percent of total billed charges,33.9% of total billed charges,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,651.3,78,,,percent of total billed charges,78% of total billed charges,835,100,,,percent of total billed charges,100% of total billed charges,689.71,82.6,,,percent of total billed charges,82.6% of total billed charges,689.71,82.6,,,percent of total billed charges,82.6% of total billed charges,193.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.36,28306.5,
REPAIR VAGINA/PERINEUM,57210,CDM,983,RC,57210,HCPCS,Outpatient,,,1021,663.65,,898.48,88,,,percent of total billed charges,88% of total Billed charges,36.61,100,,,Fee Schedule,100% of Medicare rate,227.53,100,,,Fee Schedule,100% of WA Medicaid,1021,100,,,percent of total billed charges,100% of total billed charges,234.36,103,,,Fee Schedule,103% of WA Medicaid,36.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,64.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,227.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,704.49,69,,,percent of total billed charges,69% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1021,100,,,percent of total billed charges,100% of total billed charges,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1021,100,,,percent of total billed charges,100% of total billed charges,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,631.49,61.85,,,percent of total billed charges,61.85% of total billed charges,227.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,295.79,130,,,Fee Schedule,130% of WA Medicaid ,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,384.92,37.7,,,percent of total billed charges,37.70% of total billed charges,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,34611.9,33.9,,,percent of total billed charges,33.9% of total billed charges,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,796.38,78,,,percent of total billed charges,78% of total billed charges,1021,100,,,percent of total billed charges,100% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,843.35,82.6,,,percent of total billed charges,82.6% of total billed charges,227.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,36.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,36.61,34611.9,
REVISION OF URETHRA,57220,CDM,983,RC,57220,HCPCS,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,30.79,100,,,Fee Schedule,100% of Medicare rate,200.67,100,,,Fee Schedule,100% of WA Medicaid,632,100,,,percent of total billed charges,100% of total billed charges,206.69,103,,,Fee Schedule,103% of WA Medicaid,30.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,632,100,,,percent of total billed charges,100% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,632,100,,,percent of total billed charges,100% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.89,61.85,,,percent of total billed charges,61.85% of total billed charges,200.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,260.87,130,,,Fee Schedule,130% of WA Medicaid ,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,21424.8,33.9,,,percent of total billed charges,33.9% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,200.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.79,21424.8,
REPAIR BLADDER  VAGINA,57240,CDM,983,RC,57240,HCPCS,Outpatient,,,1859,1208.35,,1635.92,88,,,percent of total billed charges,88% of total Billed charges,59.25,100,,,Fee Schedule,100% of Medicare rate,351.37,100,,,Fee Schedule,100% of WA Medicaid,1859,100,,,percent of total billed charges,100% of total billed charges,361.91,103,,,Fee Schedule,103% of WA Medicaid,59.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,103.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,351.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1282.71,69,,,percent of total billed charges,69% of total billed charges,1859,100,,,percent of total billed charges,100% of total billed charges,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1859,100,,,percent of total billed charges,100% of total billed charges,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1859,100,,,percent of total billed charges,100% of total billed charges,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1149.79,61.85,,,percent of total billed charges,61.85% of total billed charges,351.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,456.78,130,,,Fee Schedule,130% of WA Medicaid ,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.84,37.7,,,percent of total billed charges,37.70% of total billed charges,700.84,37.7,,,percent of total billed charges,37.70% of total billed charges,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,63020.1,33.9,,,percent of total billed charges,33.9% of total billed charges,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1450.02,78,,,percent of total billed charges,78% of total billed charges,1859,100,,,percent of total billed charges,100% of total billed charges,1535.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1535.53,82.6,,,percent of total billed charges,82.6% of total billed charges,351.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,59.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,59.25,63020.1,
REPAIR RECTUM  VAGINA,57250,CDM,983,RC,57250,HCPCS,Outpatient,,,1885,1225.25,,1658.8,88,,,percent of total billed charges,88% of total Billed charges,60.88,100,,,Fee Schedule,100% of Medicare rate,352.67,100,,,Fee Schedule,100% of WA Medicaid,1885,100,,,percent of total billed charges,100% of total billed charges,363.25,103,,,Fee Schedule,103% of WA Medicaid,60.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,106.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,352.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1300.65,69,,,percent of total billed charges,69% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1885,100,,,percent of total billed charges,100% of total billed charges,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1885,100,,,percent of total billed charges,100% of total billed charges,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1165.87,61.85,,,percent of total billed charges,61.85% of total billed charges,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,458.47,130,,,Fee Schedule,130% of WA Medicaid ,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,710.65,37.7,,,percent of total billed charges,37.70% of total billed charges,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,63901.5,33.9,,,percent of total billed charges,33.9% of total billed charges,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1470.3,78,,,percent of total billed charges,78% of total billed charges,1885,100,,,percent of total billed charges,100% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1557.01,82.6,,,percent of total billed charges,82.6% of total billed charges,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.88,63901.5,
INSERT MESH/PELVIC FLR ADDON,57267,CDM,983,RC,57267,HCPCS,Outpatient,,,713,463.45,,627.44,88,,,percent of total billed charges,88% of total Billed charges,26.86,100,,,Fee Schedule,100% of Medicare rate,139.88,100,,,Fee Schedule,100% of WA Medicaid,713,100,,,percent of total billed charges,100% of total billed charges,144.08,103,,,Fee Schedule,103% of WA Medicaid,26.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,139.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,491.97,69,,,percent of total billed charges,69% of total billed charges,713,100,,,percent of total billed charges,100% of total billed charges,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,713,100,,,percent of total billed charges,100% of total billed charges,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,713,100,,,percent of total billed charges,100% of total billed charges,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.99,61.85,,,percent of total billed charges,61.85% of total billed charges,139.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,181.84,130,,,Fee Schedule,130% of WA Medicaid ,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.8,37.7,,,percent of total billed charges,37.70% of total billed charges,268.8,37.7,,,percent of total billed charges,37.70% of total billed charges,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,24170.7,33.9,,,percent of total billed charges,33.9% of total billed charges,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.14,78,,,percent of total billed charges,78% of total billed charges,713,100,,,percent of total billed charges,100% of total billed charges,588.94,82.6,,,percent of total billed charges,82.6% of total billed charges,588.94,82.6,,,percent of total billed charges,82.6% of total billed charges,139.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.86,24170.7,
EXTENSIVE REPAIR OF VAGINA,57265,CDM,983,RC,57265,HCPCS,Outpatient,,,2542,1652.30,,2236.96,88,,,percent of total billed charges,88% of total Billed charges,89.73,100,,,Fee Schedule,100% of Medicare rate,495.9,100,,,Fee Schedule,100% of WA Medicaid,2542,100,,,percent of total billed charges,100% of total billed charges,510.78,103,,,Fee Schedule,103% of WA Medicaid,89.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,157.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,495.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1753.98,69,,,percent of total billed charges,69% of total billed charges,2542,100,,,percent of total billed charges,100% of total billed charges,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2542,100,,,percent of total billed charges,100% of total billed charges,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2542,100,,,percent of total billed charges,100% of total billed charges,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1572.23,61.85,,,percent of total billed charges,61.85% of total billed charges,495.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,644.67,130,,,Fee Schedule,130% of WA Medicaid ,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,958.33,37.7,,,percent of total billed charges,37.70% of total billed charges,958.33,37.7,,,percent of total billed charges,37.70% of total billed charges,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,86173.8,33.9,,,percent of total billed charges,33.9% of total billed charges,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1982.76,78,,,percent of total billed charges,78% of total billed charges,2542,100,,,percent of total billed charges,100% of total billed charges,2099.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2099.69,82.6,,,percent of total billed charges,82.6% of total billed charges,495.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,89.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,89.73,86173.8,
REPAIR OF BOWEL BULGE,57268,CDM,983,RC,57268,HCPCS,Outpatient,,,1344,873.60,,1182.72,88,,,percent of total billed charges,88% of total Billed charges,46.78,100,,,Fee Schedule,100% of Medicare rate,292.43,100,,,Fee Schedule,100% of WA Medicaid,1344,100,,,percent of total billed charges,100% of total billed charges,301.2,103,,,Fee Schedule,103% of WA Medicaid,46.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,292.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,927.36,69,,,percent of total billed charges,69% of total billed charges,1344,100,,,percent of total billed charges,100% of total billed charges,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1344,100,,,percent of total billed charges,100% of total billed charges,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1344,100,,,percent of total billed charges,100% of total billed charges,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,831.26,61.85,,,percent of total billed charges,61.85% of total billed charges,292.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,380.16,130,,,Fee Schedule,130% of WA Medicaid ,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,506.69,37.7,,,percent of total billed charges,37.70% of total billed charges,506.69,37.7,,,percent of total billed charges,37.70% of total billed charges,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,45561.6,33.9,,,percent of total billed charges,33.9% of total billed charges,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,1048.32,78,,,percent of total billed charges,78% of total billed charges,1344,100,,,percent of total billed charges,100% of total billed charges,1110.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1110.14,82.6,,,percent of total billed charges,82.6% of total billed charges,292.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.78,45561.6,
REPAIR OF VAGINA,57260,CDM,983,RC,57260,HCPCS,Outpatient,,,2322,1509.30,,2043.36,88,,,percent of total billed charges,88% of total Billed charges,79.2,100,,,Fee Schedule,100% of Medicare rate,444.06,100,,,Fee Schedule,100% of WA Medicaid,2322,100,,,percent of total billed charges,100% of total billed charges,457.38,103,,,Fee Schedule,103% of WA Medicaid,79.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,444.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1602.18,69,,,percent of total billed charges,69% of total billed charges,2322,100,,,percent of total billed charges,100% of total billed charges,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2322,100,,,percent of total billed charges,100% of total billed charges,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2322,100,,,percent of total billed charges,100% of total billed charges,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1436.16,61.85,,,percent of total billed charges,61.85% of total billed charges,444.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,577.28,130,,,Fee Schedule,130% of WA Medicaid ,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,875.39,37.7,,,percent of total billed charges,37.70% of total billed charges,875.39,37.7,,,percent of total billed charges,37.70% of total billed charges,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,78715.8,33.9,,,percent of total billed charges,33.9% of total billed charges,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1811.16,78,,,percent of total billed charges,78% of total billed charges,2322,100,,,percent of total billed charges,100% of total billed charges,1917.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1917.97,82.6,,,percent of total billed charges,82.6% of total billed charges,444.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,79.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,79.2,78715.8,
REPAIR OF BOWEL POUCH,57270,CDM,983,RC,57270,HCPCS,Outpatient,,,2659,1728.35,,2339.92,88,,,percent of total billed charges,88% of total Billed charges,82.08,100,,,Fee Schedule,100% of Medicare rate,464.2,100,,,Fee Schedule,100% of WA Medicaid,2659,100,,,percent of total billed charges,100% of total billed charges,478.13,103,,,Fee Schedule,103% of WA Medicaid,82.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,143.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,464.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1834.71,69,,,percent of total billed charges,69% of total billed charges,2659,100,,,percent of total billed charges,100% of total billed charges,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2659,100,,,percent of total billed charges,100% of total billed charges,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2659,100,,,percent of total billed charges,100% of total billed charges,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1644.59,61.85,,,percent of total billed charges,61.85% of total billed charges,464.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,603.46,130,,,Fee Schedule,130% of WA Medicaid ,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1002.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1002.44,37.7,,,percent of total billed charges,37.70% of total billed charges,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,90140.1,33.9,,,percent of total billed charges,33.9% of total billed charges,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2074.02,78,,,percent of total billed charges,78% of total billed charges,2659,100,,,percent of total billed charges,100% of total billed charges,2196.33,82.6,,,percent of total billed charges,82.6% of total billed charges,2196.33,82.6,,,percent of total billed charges,82.6% of total billed charges,464.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.08,90140.1,
REPAIR PARAVAG DEFECT OPEN,57284,CDM,983,RC,57284,HCPCS,Outpatient,,,3606,2343.90,,3173.28,88,,,percent of total billed charges,88% of total Billed charges,81.85,100,,,Fee Schedule,100% of Medicare rate,474.46,100,,,Fee Schedule,100% of WA Medicaid,3606,100,,,percent of total billed charges,100% of total billed charges,488.69,103,,,Fee Schedule,103% of WA Medicaid,81.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,143.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,474.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2488.14,69,,,percent of total billed charges,69% of total billed charges,3606,100,,,percent of total billed charges,100% of total billed charges,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,3606,100,,,percent of total billed charges,100% of total billed charges,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,3606,100,,,percent of total billed charges,100% of total billed charges,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2230.31,61.85,,,percent of total billed charges,61.85% of total billed charges,474.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,483.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,616.8,130,,,Fee Schedule,130% of WA Medicaid ,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1359.46,37.7,,,percent of total billed charges,37.70% of total billed charges,1359.46,37.7,,,percent of total billed charges,37.70% of total billed charges,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,122243.4,33.9,,,percent of total billed charges,33.9% of total billed charges,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2812.68,78,,,percent of total billed charges,78% of total billed charges,3606,100,,,percent of total billed charges,100% of total billed charges,2978.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2978.56,82.6,,,percent of total billed charges,82.6% of total billed charges,474.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.85,122243.4,
COLPOPEXY INTRAPERITONEAL,57283,CDM,983,RC,57283,HCPCS,Outpatient,,,1586,1030.90,,1395.68,88,,,percent of total billed charges,88% of total Billed charges,70.34,100,,,Fee Schedule,100% of Medicare rate,399.11,100,,,Fee Schedule,100% of WA Medicaid,1586,100,,,percent of total billed charges,100% of total billed charges,411.08,103,,,Fee Schedule,103% of WA Medicaid,70.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,123.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,399.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1094.34,69,,,percent of total billed charges,69% of total billed charges,1586,100,,,percent of total billed charges,100% of total billed charges,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1586,100,,,percent of total billed charges,100% of total billed charges,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1586,100,,,percent of total billed charges,100% of total billed charges,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,980.94,61.85,,,percent of total billed charges,61.85% of total billed charges,399.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,518.84,130,,,Fee Schedule,130% of WA Medicaid ,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.92,37.7,,,percent of total billed charges,37.70% of total billed charges,597.92,37.7,,,percent of total billed charges,37.70% of total billed charges,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,53765.4,33.9,,,percent of total billed charges,33.9% of total billed charges,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1237.08,78,,,percent of total billed charges,78% of total billed charges,1586,100,,,percent of total billed charges,100% of total billed charges,1310.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1310.04,82.6,,,percent of total billed charges,82.6% of total billed charges,399.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.34,53765.4,
COLPOPEXY EXTRAPERITONEAL,57282,CDM,983,RC,57282,HCPCS,Outpatient,,,815,529.75,,717.2,88,,,percent of total billed charges,88% of total Billed charges,68.39,100,,,Fee Schedule,100% of Medicare rate,396.5,100,,,Fee Schedule,100% of WA Medicaid,815,100,,,percent of total billed charges,100% of total billed charges,408.4,103,,,Fee Schedule,103% of WA Medicaid,68.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,119.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,396.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,562.35,69,,,percent of total billed charges,69% of total billed charges,815,100,,,percent of total billed charges,100% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,815,100,,,percent of total billed charges,100% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,815,100,,,percent of total billed charges,100% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.08,61.85,,,percent of total billed charges,61.85% of total billed charges,396.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,515.45,130,,,Fee Schedule,130% of WA Medicaid ,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.26,37.7,,,percent of total billed charges,37.70% of total billed charges,307.26,37.7,,,percent of total billed charges,37.70% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,27628.5,33.9,,,percent of total billed charges,33.9% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,635.7,78,,,percent of total billed charges,78% of total billed charges,815,100,,,percent of total billed charges,100% of total billed charges,673.19,82.6,,,percent of total billed charges,82.6% of total billed charges,673.19,82.6,,,percent of total billed charges,82.6% of total billed charges,396.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.39,27628.5,
REPAIR BLADDER DEFECT,57288,CDM,983,RC,57288,HCPCS,Outpatient,,,3406,2213.90,,2997.28,88,,,percent of total billed charges,88% of total Billed charges,70.44,100,,,Fee Schedule,100% of Medicare rate,425.97,100,,,Fee Schedule,100% of WA Medicaid,3406,100,,,percent of total billed charges,100% of total billed charges,438.75,103,,,Fee Schedule,103% of WA Medicaid,70.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,123.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,425.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2350.14,69,,,percent of total billed charges,69% of total billed charges,3406,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,3406,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,3406,100,,,percent of total billed charges,100% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2106.61,61.85,,,percent of total billed charges,61.85% of total billed charges,425.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,553.76,130,,,Fee Schedule,130% of WA Medicaid ,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1284.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1284.06,37.7,,,percent of total billed charges,37.70% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,115463.4,33.9,,,percent of total billed charges,33.9% of total billed charges,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2656.68,78,,,percent of total billed charges,78% of total billed charges,3406,100,,,percent of total billed charges,100% of total billed charges,2813.36,82.6,,,percent of total billed charges,82.6% of total billed charges,2813.36,82.6,,,percent of total billed charges,82.6% of total billed charges,425.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.44,115463.4,
REPAIR BLADDER  VAGINA,57289,CDM,983,RC,57289,HCPCS,Outpatient,,,2225,1446.25,,1958,88,,,percent of total billed charges,88% of total Billed charges,80.25,100,,,Fee Schedule,100% of Medicare rate,454.5,100,,,Fee Schedule,100% of WA Medicaid,2225,100,,,percent of total billed charges,100% of total billed charges,468.14,103,,,Fee Schedule,103% of WA Medicaid,80.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,454.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1535.25,69,,,percent of total billed charges,69% of total billed charges,2225,100,,,percent of total billed charges,100% of total billed charges,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2225,100,,,percent of total billed charges,100% of total billed charges,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2225,100,,,percent of total billed charges,100% of total billed charges,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1376.16,61.85,,,percent of total billed charges,61.85% of total billed charges,454.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,590.85,130,,,Fee Schedule,130% of WA Medicaid ,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,838.83,37.7,,,percent of total billed charges,37.70% of total billed charges,838.83,37.7,,,percent of total billed charges,37.70% of total billed charges,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,75427.5,33.9,,,percent of total billed charges,33.9% of total billed charges,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1735.5,78,,,percent of total billed charges,78% of total billed charges,2225,100,,,percent of total billed charges,100% of total billed charges,1837.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1837.85,82.6,,,percent of total billed charges,82.6% of total billed charges,454.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.25,75427.5,
SUSPENSION OF VAGINA,57280,CDM,983,RC,57280,HCPCS,Outpatient,,,3543,2302.95,,3117.84,88,,,percent of total billed charges,88% of total Billed charges,97.21,100,,,Fee Schedule,100% of Medicare rate,549.24,100,,,Fee Schedule,100% of WA Medicaid,3543,100,,,percent of total billed charges,100% of total billed charges,565.72,103,,,Fee Schedule,103% of WA Medicaid,97.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,170.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,549.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2444.67,69,,,percent of total billed charges,69% of total billed charges,3543,100,,,percent of total billed charges,100% of total billed charges,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3543,100,,,percent of total billed charges,100% of total billed charges,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3543,100,,,percent of total billed charges,100% of total billed charges,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2191.35,61.85,,,percent of total billed charges,61.85% of total billed charges,549.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,560.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,714.01,130,,,Fee Schedule,130% of WA Medicaid ,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1335.71,37.7,,,percent of total billed charges,37.70% of total billed charges,1335.71,37.7,,,percent of total billed charges,37.70% of total billed charges,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,120107.7,33.9,,,percent of total billed charges,33.9% of total billed charges,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2763.54,78,,,percent of total billed charges,78% of total billed charges,3543,100,,,percent of total billed charges,100% of total billed charges,2926.52,82.6,,,percent of total billed charges,82.6% of total billed charges,2926.52,82.6,,,percent of total billed charges,82.6% of total billed charges,549.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,97.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.21,120107.7,
REPAIR BLADDER-VAGINA LESION,57320,CDM,983,RC,57320,HCPCS,Outpatient,,,1199,779.35,,1055.12,88,,,percent of total billed charges,88% of total Billed charges,56.27,100,,,Fee Schedule,100% of Medicare rate,324.51,100,,,Fee Schedule,100% of WA Medicaid,1199,100,,,percent of total billed charges,100% of total billed charges,334.25,103,,,Fee Schedule,103% of WA Medicaid,56.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,98.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,324.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,827.31,69,,,percent of total billed charges,69% of total billed charges,1199,100,,,percent of total billed charges,100% of total billed charges,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1199,100,,,percent of total billed charges,100% of total billed charges,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1199,100,,,percent of total billed charges,100% of total billed charges,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,741.58,61.85,,,percent of total billed charges,61.85% of total billed charges,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,331,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,421.86,130,,,Fee Schedule,130% of WA Medicaid ,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.02,37.7,,,percent of total billed charges,37.70% of total billed charges,452.02,37.7,,,percent of total billed charges,37.70% of total billed charges,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,40646.1,33.9,,,percent of total billed charges,33.9% of total billed charges,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,935.22,78,,,percent of total billed charges,78% of total billed charges,1199,100,,,percent of total billed charges,100% of total billed charges,990.37,82.6,,,percent of total billed charges,82.6% of total billed charges,990.37,82.6,,,percent of total billed charges,82.6% of total billed charges,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.27,40646.1,
REMOVAL VAGINAL FOREIGN BODY,57415,CDM,983,RC,57415,HCPCS,Outpatient,,,277,180.05,,243.76,88,,,percent of total billed charges,88% of total Billed charges,15.73,100,,,Fee Schedule,100% of Medicare rate,101.83,100,,,Fee Schedule,100% of WA Medicaid,277,100,,,percent of total billed charges,100% of total billed charges,104.88,103,,,Fee Schedule,103% of WA Medicaid,15.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,101.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,191.13,69,,,percent of total billed charges,69% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,277,100,,,percent of total billed charges,100% of total billed charges,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,277,100,,,percent of total billed charges,100% of total billed charges,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.32,61.85,,,percent of total billed charges,61.85% of total billed charges,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.38,130,,,Fee Schedule,130% of WA Medicaid ,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,9390.3,33.9,,,percent of total billed charges,33.9% of total billed charges,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.06,78,,,percent of total billed charges,78% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.73,9390.3,
PELVIC EXAMINATION,57410,CDM,983,RC,57410,HCPCS,Outpatient,,,397,258.05,,349.36,88,,,percent of total billed charges,88% of total Billed charges,10.71,100,,,Fee Schedule,100% of Medicare rate,60.43,100,,,Fee Schedule,100% of WA Medicaid,397,100,,,percent of total billed charges,100% of total billed charges,62.24,103,,,Fee Schedule,103% of WA Medicaid,10.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,273.93,69,,,percent of total billed charges,69% of total billed charges,397,100,,,percent of total billed charges,100% of total billed charges,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,397,100,,,percent of total billed charges,100% of total billed charges,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,397,100,,,percent of total billed charges,100% of total billed charges,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,245.54,61.85,,,percent of total billed charges,61.85% of total billed charges,60.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,78.56,130,,,Fee Schedule,130% of WA Medicaid ,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.67,37.7,,,percent of total billed charges,37.70% of total billed charges,149.67,37.7,,,percent of total billed charges,37.70% of total billed charges,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,13458.3,33.9,,,percent of total billed charges,33.9% of total billed charges,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.66,78,,,percent of total billed charges,78% of total billed charges,397,100,,,percent of total billed charges,100% of total billed charges,327.92,82.6,,,percent of total billed charges,82.6% of total billed charges,327.92,82.6,,,percent of total billed charges,82.6% of total billed charges,60.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.71,13458.3,
EXAM OF VAGINA W/SCOPE,57420,CDM,983,RC,57420,HCPCS,Outpatient,,,324,210.60,,285.12,88,,,percent of total billed charges,88% of total Billed charges,9.42,100,,,Fee Schedule,100% of Medicare rate,50.73,100,,,Fee Schedule,100% of WA Medicaid,324,100,,,percent of total billed charges,100% of total billed charges,52.25,103,,,Fee Schedule,103% of WA Medicaid,9.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,50.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,223.56,69,,,percent of total billed charges,69% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.39,61.85,,,percent of total billed charges,61.85% of total billed charges,50.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,65.95,130,,,Fee Schedule,130% of WA Medicaid ,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,10983.6,33.9,,,percent of total billed charges,33.9% of total billed charges,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.72,78,,,percent of total billed charges,78% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,50.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.42,10983.6,
EXAM/BIOPSY OF VAG W/SCOPE,57421,CDM,983,RC,57421,HCPCS,Outpatient,,,434,282.10,,381.92,88,,,percent of total billed charges,88% of total Billed charges,13.49,100,,,Fee Schedule,100% of Medicare rate,68.63,100,,,Fee Schedule,100% of WA Medicaid,434,100,,,percent of total billed charges,100% of total billed charges,70.69,103,,,Fee Schedule,103% of WA Medicaid,13.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,299.46,69,,,percent of total billed charges,69% of total billed charges,434,100,,,percent of total billed charges,100% of total billed charges,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,434,100,,,percent of total billed charges,100% of total billed charges,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,434,100,,,percent of total billed charges,100% of total billed charges,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.43,61.85,,,percent of total billed charges,61.85% of total billed charges,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.22,130,,,Fee Schedule,130% of WA Medicaid ,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.62,37.7,,,percent of total billed charges,37.70% of total billed charges,163.62,37.7,,,percent of total billed charges,37.70% of total billed charges,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,14712.6,33.9,,,percent of total billed charges,33.9% of total billed charges,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.52,78,,,percent of total billed charges,78% of total billed charges,434,100,,,percent of total billed charges,100% of total billed charges,358.48,82.6,,,percent of total billed charges,82.6% of total billed charges,358.48,82.6,,,percent of total billed charges,82.6% of total billed charges,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.49,14712.6,
REPAIR PARAVAG DEFECT LAP,57423,CDM,983,RC,57423,HCPCS,Outpatient,,,2555,1660.75,,2248.4,88,,,percent of total billed charges,88% of total Billed charges,95.05,100,,,Fee Schedule,100% of Medicare rate,527.8,100,,,Fee Schedule,100% of WA Medicaid,2555,100,,,percent of total billed charges,100% of total billed charges,543.63,103,,,Fee Schedule,103% of WA Medicaid,95.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,166.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,527.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1762.95,69,,,percent of total billed charges,69% of total billed charges,2555,100,,,percent of total billed charges,100% of total billed charges,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2555,100,,,percent of total billed charges,100% of total billed charges,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2555,100,,,percent of total billed charges,100% of total billed charges,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1580.27,61.85,,,percent of total billed charges,61.85% of total billed charges,527.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,538.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,686.14,130,,,Fee Schedule,130% of WA Medicaid ,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,963.24,37.7,,,percent of total billed charges,37.70% of total billed charges,963.24,37.7,,,percent of total billed charges,37.70% of total billed charges,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,86614.5,33.9,,,percent of total billed charges,33.9% of total billed charges,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1992.9,78,,,percent of total billed charges,78% of total billed charges,2555,100,,,percent of total billed charges,100% of total billed charges,2110.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2110.43,82.6,,,percent of total billed charges,82.6% of total billed charges,527.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,96,101,,,Fee Schedule,101% of Medicare RBRVS rate,95.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,527.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.05,86614.5,
LAPAROSCOPY SURG COLPOPEXY,57425,CDM,983,RC,57425,HCPCS,Outpatient,,,2700,1755.00,,2376,88,,,percent of total billed charges,88% of total Billed charges,98.46,100,,,Fee Schedule,100% of Medicare rate,552.97,100,,,Fee Schedule,100% of WA Medicaid,2700,100,,,percent of total billed charges,100% of total billed charges,569.56,103,,,Fee Schedule,103% of WA Medicaid,98.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,172.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,552.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1863,69,,,percent of total billed charges,69% of total billed charges,2700,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2700,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2700,100,,,percent of total billed charges,100% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1669.95,61.85,,,percent of total billed charges,61.85% of total billed charges,552.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,718.86,130,,,Fee Schedule,130% of WA Medicaid ,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1017.9,37.7,,,percent of total billed charges,37.70% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,91530,33.9,,,percent of total billed charges,33.9% of total billed charges,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2106,78,,,percent of total billed charges,78% of total billed charges,2700,100,,,percent of total billed charges,100% of total billed charges,2230.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2230.2,82.6,,,percent of total billed charges,82.6% of total billed charges,552.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.46,91530,
EXAM OF CERVIX W/SCOPE,57452,CDM,983,RC,57452,HCPCS,Outpatient,,,344,223.60,,302.72,88,,,percent of total billed charges,88% of total Billed charges,8.96,100,,,Fee Schedule,100% of Medicare rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,344,100,,,percent of total billed charges,100% of total billed charges,53.41,103,,,Fee Schedule,103% of WA Medicaid,8.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,51.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,237.36,69,,,percent of total billed charges,69% of total billed charges,344,100,,,percent of total billed charges,100% of total billed charges,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,344,100,,,percent of total billed charges,100% of total billed charges,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,344,100,,,percent of total billed charges,100% of total billed charges,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.76,61.85,,,percent of total billed charges,61.85% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.41,130,,,Fee Schedule,130% of WA Medicaid ,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.69,37.7,,,percent of total billed charges,37.70% of total billed charges,129.69,37.7,,,percent of total billed charges,37.70% of total billed charges,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,11661.6,33.9,,,percent of total billed charges,33.9% of total billed charges,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.32,78,,,percent of total billed charges,78% of total billed charges,344,100,,,percent of total billed charges,100% of total billed charges,284.14,82.6,,,percent of total billed charges,82.6% of total billed charges,284.14,82.6,,,percent of total billed charges,82.6% of total billed charges,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.96,11661.6,
BX/CURETT OF CERVIX W/SCOPE,57454,CDM,983,RC,57454,HCPCS,Outpatient,,,501,325.65,,440.88,88,,,percent of total billed charges,88% of total Billed charges,14.11,100,,,Fee Schedule,100% of Medicare rate,75.72,100,,,Fee Schedule,100% of WA Medicaid,501,100,,,percent of total billed charges,100% of total billed charges,77.99,103,,,Fee Schedule,103% of WA Medicaid,14.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,75.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,345.69,69,,,percent of total billed charges,69% of total billed charges,501,100,,,percent of total billed charges,100% of total billed charges,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,501,100,,,percent of total billed charges,100% of total billed charges,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,501,100,,,percent of total billed charges,100% of total billed charges,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.87,61.85,,,percent of total billed charges,61.85% of total billed charges,75.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,98.44,130,,,Fee Schedule,130% of WA Medicaid ,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.88,37.7,,,percent of total billed charges,37.70% of total billed charges,188.88,37.7,,,percent of total billed charges,37.70% of total billed charges,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,16983.9,33.9,,,percent of total billed charges,33.9% of total billed charges,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.78,78,,,percent of total billed charges,78% of total billed charges,501,100,,,percent of total billed charges,100% of total billed charges,413.83,82.6,,,percent of total billed charges,82.6% of total billed charges,413.83,82.6,,,percent of total billed charges,82.6% of total billed charges,75.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.11,16983.9,
COLOPOSCOPY OF CERVIX WITH BIOPSY,57455,CDM,983,RC,57455,HCPCS,Outpatient,,,304,197.60,,267.52,88,,,percent of total billed charges,88% of total Billed charges,11.79,100,,,Fee Schedule,100% of Medicare rate,61.17,100,,,Fee Schedule,100% of WA Medicaid,304,100,,,percent of total billed charges,100% of total billed charges,63.01,103,,,Fee Schedule,103% of WA Medicaid,11.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,61.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,209.76,69,,,percent of total billed charges,69% of total billed charges,304,100,,,percent of total billed charges,100% of total billed charges,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,304,100,,,percent of total billed charges,100% of total billed charges,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,304,100,,,percent of total billed charges,100% of total billed charges,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.02,61.85,,,percent of total billed charges,61.85% of total billed charges,61.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.52,130,,,Fee Schedule,130% of WA Medicaid ,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.61,37.7,,,percent of total billed charges,37.70% of total billed charges,114.61,37.7,,,percent of total billed charges,37.70% of total billed charges,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,10305.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.12,78,,,percent of total billed charges,78% of total billed charges,304,100,,,percent of total billed charges,100% of total billed charges,251.1,82.6,,,percent of total billed charges,82.6% of total billed charges,251.1,82.6,,,percent of total billed charges,82.6% of total billed charges,61.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.79,10305.6,
COLPOSCOPY CERVIX W/ENDOCERVICAL CURETTA,57456,CDM,983,RC,57456,HCPCS,Outpatient,,,256,166.40,,225.28,88,,,percent of total billed charges,88% of total Billed charges,11.05,100,,,Fee Schedule,100% of Medicare rate,57.07,100,,,Fee Schedule,100% of WA Medicaid,256,100,,,percent of total billed charges,100% of total billed charges,58.78,103,,,Fee Schedule,103% of WA Medicaid,11.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,57.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,176.64,69,,,percent of total billed charges,69% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,256,100,,,percent of total billed charges,100% of total billed charges,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,256,100,,,percent of total billed charges,100% of total billed charges,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.34,61.85,,,percent of total billed charges,61.85% of total billed charges,57.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,74.19,130,,,Fee Schedule,130% of WA Medicaid ,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.51,37.7,,,percent of total billed charges,37.70% of total billed charges,96.51,37.7,,,percent of total billed charges,37.70% of total billed charges,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,8678.4,33.9,,,percent of total billed charges,33.9% of total billed charges,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.68,78,,,percent of total billed charges,78% of total billed charges,256,100,,,percent of total billed charges,100% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,211.46,82.6,,,percent of total billed charges,82.6% of total billed charges,57.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.05,8678.4,
ENDOSCOPY W/ LOOP ELECTRODE CONIZ CERVIX,57461,CDM,983,RC,57461,HCPCS,Outpatient,,,767,498.55,,674.96,88,,,percent of total billed charges,88% of total Billed charges,20.22,100,,,Fee Schedule,100% of Medicare rate,102.76,100,,,Fee Schedule,100% of WA Medicaid,767,100,,,percent of total billed charges,100% of total billed charges,105.84,103,,,Fee Schedule,103% of WA Medicaid,20.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,529.23,69,,,percent of total billed charges,69% of total billed charges,767,100,,,percent of total billed charges,100% of total billed charges,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,767,100,,,percent of total billed charges,100% of total billed charges,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,767,100,,,percent of total billed charges,100% of total billed charges,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.39,61.85,,,percent of total billed charges,61.85% of total billed charges,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,133.59,130,,,Fee Schedule,130% of WA Medicaid ,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.16,37.7,,,percent of total billed charges,37.70% of total billed charges,289.16,37.7,,,percent of total billed charges,37.70% of total billed charges,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,26001.3,33.9,,,percent of total billed charges,33.9% of total billed charges,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.26,78,,,percent of total billed charges,78% of total billed charges,767,100,,,percent of total billed charges,100% of total billed charges,633.54,82.6,,,percent of total billed charges,82.6% of total billed charges,633.54,82.6,,,percent of total billed charges,82.6% of total billed charges,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.22,26001.3,
BX OF CERVIX W/SCOPE LEEP,57460,CDM,983,RC,57460,HCPCS,Outpatient,,,1184,769.60,,1041.92,88,,,percent of total billed charges,88% of total Billed charges,16.95,100,,,Fee Schedule,100% of Medicare rate,90.08,100,,,Fee Schedule,100% of WA Medicaid,1184,100,,,percent of total billed charges,100% of total billed charges,92.78,103,,,Fee Schedule,103% of WA Medicaid,16.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,90.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,816.96,69,,,percent of total billed charges,69% of total billed charges,1184,100,,,percent of total billed charges,100% of total billed charges,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1184,100,,,percent of total billed charges,100% of total billed charges,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1184,100,,,percent of total billed charges,100% of total billed charges,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,732.3,61.85,,,percent of total billed charges,61.85% of total billed charges,90.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,117.1,130,,,Fee Schedule,130% of WA Medicaid ,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.37,37.7,,,percent of total billed charges,37.70% of total billed charges,446.37,37.7,,,percent of total billed charges,37.70% of total billed charges,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,40137.6,33.9,,,percent of total billed charges,33.9% of total billed charges,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,923.52,78,,,percent of total billed charges,78% of total billed charges,1184,100,,,percent of total billed charges,100% of total billed charges,977.98,82.6,,,percent of total billed charges,82.6% of total billed charges,977.98,82.6,,,percent of total billed charges,82.6% of total billed charges,90.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.95,40137.6,
BIOPSY OF CERVIX,57500,CDM,983,RC,57500,HCPCS,Outpatient,,,274,178.10,,241.12,88,,,percent of total billed charges,88% of total Billed charges,7.45,100,,,Fee Schedule,100% of Medicare rate,42.9,100,,,Fee Schedule,100% of WA Medicaid,274,100,,,percent of total billed charges,100% of total billed charges,44.19,103,,,Fee Schedule,103% of WA Medicaid,7.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,189.06,69,,,percent of total billed charges,69% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,274,100,,,percent of total billed charges,100% of total billed charges,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,274,100,,,percent of total billed charges,100% of total billed charges,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.47,61.85,,,percent of total billed charges,61.85% of total billed charges,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.77,130,,,Fee Schedule,130% of WA Medicaid ,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.3,37.7,,,percent of total billed charges,37.70% of total billed charges,103.3,37.7,,,percent of total billed charges,37.70% of total billed charges,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,9288.6,33.9,,,percent of total billed charges,33.9% of total billed charges,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.72,78,,,percent of total billed charges,78% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.45,9288.6,
ENDOCERVICAL CURETTAGE,57505,CDM,983,RC,57505,HCPCS,Outpatient,,,284,184.60,,249.92,88,,,percent of total billed charges,88% of total Billed charges,8.55,100,,,Fee Schedule,100% of Medicare rate,64.16,100,,,Fee Schedule,100% of WA Medicaid,284,100,,,percent of total billed charges,100% of total billed charges,66.08,103,,,Fee Schedule,103% of WA Medicaid,8.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,64.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,195.96,69,,,percent of total billed charges,69% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,284,100,,,percent of total billed charges,100% of total billed charges,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,284,100,,,percent of total billed charges,100% of total billed charges,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.65,61.85,,,percent of total billed charges,61.85% of total billed charges,64.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,83.41,130,,,Fee Schedule,130% of WA Medicaid ,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,9627.6,33.9,,,percent of total billed charges,33.9% of total billed charges,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.52,78,,,percent of total billed charges,78% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,64.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.55,9627.6,
CRYOCAUTERY OF CERVIX,57511,CDM,983,RC,57511,HCPCS,Outpatient,,,370,240.50,,325.6,88,,,percent of total billed charges,88% of total Billed charges,13.06,100,,,Fee Schedule,100% of Medicare rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,370,100,,,percent of total billed charges,100% of total billed charges,88.36,103,,,Fee Schedule,103% of WA Medicaid,13.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,255.3,69,,,percent of total billed charges,69% of total billed charges,370,100,,,percent of total billed charges,100% of total billed charges,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,370,100,,,percent of total billed charges,100% of total billed charges,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,370,100,,,percent of total billed charges,100% of total billed charges,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.85,61.85,,,percent of total billed charges,61.85% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.53,130,,,Fee Schedule,130% of WA Medicaid ,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.49,37.7,,,percent of total billed charges,37.70% of total billed charges,139.49,37.7,,,percent of total billed charges,37.70% of total billed charges,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,12543,33.9,,,percent of total billed charges,33.9% of total billed charges,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.6,78,,,percent of total billed charges,78% of total billed charges,370,100,,,percent of total billed charges,100% of total billed charges,305.62,82.6,,,percent of total billed charges,82.6% of total billed charges,305.62,82.6,,,percent of total billed charges,82.6% of total billed charges,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.06,12543,
CAUTERIZATION OF CERVIX,57510,CDM,983,RC,57510,HCPCS,Outpatient,,,325,211.25,,286,88,,,percent of total billed charges,88% of total Billed charges,11.7,100,,,Fee Schedule,100% of Medicare rate,64.53,100,,,Fee Schedule,100% of WA Medicaid,325,100,,,percent of total billed charges,100% of total billed charges,66.47,103,,,Fee Schedule,103% of WA Medicaid,11.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,64.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,224.25,69,,,percent of total billed charges,69% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,325,100,,,percent of total billed charges,100% of total billed charges,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,325,100,,,percent of total billed charges,100% of total billed charges,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.01,61.85,,,percent of total billed charges,61.85% of total billed charges,64.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,83.89,130,,,Fee Schedule,130% of WA Medicaid ,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,122.53,37.7,,,percent of total billed charges,37.70% of total billed charges,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,11017.5,33.9,,,percent of total billed charges,33.9% of total billed charges,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.5,78,,,percent of total billed charges,78% of total billed charges,325,100,,,percent of total billed charges,100% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,268.45,82.6,,,percent of total billed charges,82.6% of total billed charges,64.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.7,11017.5,
CONIZATION OF CERVIX,57522,CDM,983,RC,57522,HCPCS,Outpatient,,,1319,857.35,,1160.72,88,,,percent of total billed charges,88% of total Billed charges,23.6,100,,,Fee Schedule,100% of Medicare rate,147.89,100,,,Fee Schedule,100% of WA Medicaid,1319,100,,,percent of total billed charges,100% of total billed charges,152.33,103,,,Fee Schedule,103% of WA Medicaid,23.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,147.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,910.11,69,,,percent of total billed charges,69% of total billed charges,1319,100,,,percent of total billed charges,100% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319,100,,,percent of total billed charges,100% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319,100,,,percent of total billed charges,100% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.8,61.85,,,percent of total billed charges,61.85% of total billed charges,147.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,192.26,130,,,Fee Schedule,130% of WA Medicaid ,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.26,37.7,,,percent of total billed charges,37.70% of total billed charges,497.26,37.7,,,percent of total billed charges,37.70% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,44714.1,33.9,,,percent of total billed charges,33.9% of total billed charges,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1028.82,78,,,percent of total billed charges,78% of total billed charges,1319,100,,,percent of total billed charges,100% of total billed charges,1089.49,82.6,,,percent of total billed charges,82.6% of total billed charges,1089.49,82.6,,,percent of total billed charges,82.6% of total billed charges,147.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.6,44714.1,
CONIZATION OF CERVIX,57520,CDM,983,RC,57520,HCPCS,Outpatient,,,1525,991.25,,1342,88,,,percent of total billed charges,88% of total Billed charges,27.21,100,,,Fee Schedule,100% of Medicare rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,1525,100,,,percent of total billed charges,100% of total billed charges,177.3,103,,,Fee Schedule,103% of WA Medicaid,27.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,47.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,172.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1052.25,69,,,percent of total billed charges,69% of total billed charges,1525,100,,,percent of total billed charges,100% of total billed charges,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1525,100,,,percent of total billed charges,100% of total billed charges,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1525,100,,,percent of total billed charges,100% of total billed charges,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,943.21,61.85,,,percent of total billed charges,61.85% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,223.78,130,,,Fee Schedule,130% of WA Medicaid ,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,574.93,37.7,,,percent of total billed charges,37.70% of total billed charges,574.93,37.7,,,percent of total billed charges,37.70% of total billed charges,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,51697.5,33.9,,,percent of total billed charges,33.9% of total billed charges,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1189.5,78,,,percent of total billed charges,78% of total billed charges,1525,100,,,percent of total billed charges,100% of total billed charges,1259.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1259.65,82.6,,,percent of total billed charges,82.6% of total billed charges,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.21,51697.5,
REMOVE CERVIX STUMP/REPAIR,57555,CDM,983,RC,57555,HCPCS,Outpatient,,,1205,783.25,,1060.4,88,,,percent of total billed charges,88% of total Billed charges,62.29,100,,,Fee Schedule,100% of Medicare rate,354.91,100,,,Fee Schedule,100% of WA Medicaid,1205,100,,,percent of total billed charges,100% of total billed charges,365.56,103,,,Fee Schedule,103% of WA Medicaid,62.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,354.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,831.45,69,,,percent of total billed charges,69% of total billed charges,1205,100,,,percent of total billed charges,100% of total billed charges,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1205,100,,,percent of total billed charges,100% of total billed charges,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1205,100,,,percent of total billed charges,100% of total billed charges,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.29,61.85,,,percent of total billed charges,61.85% of total billed charges,354.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,362.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,461.38,130,,,Fee Schedule,130% of WA Medicaid ,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.29,37.7,,,percent of total billed charges,37.70% of total billed charges,454.29,37.7,,,percent of total billed charges,37.70% of total billed charges,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,40849.5,33.9,,,percent of total billed charges,33.9% of total billed charges,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,939.9,78,,,percent of total billed charges,78% of total billed charges,1205,100,,,percent of total billed charges,100% of total billed charges,995.33,82.6,,,percent of total billed charges,82.6% of total billed charges,995.33,82.6,,,percent of total billed charges,82.6% of total billed charges,354.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.29,40849.5,
DILATION  CURRETAGE OF CERVICAL STUMP,57558,CDM,983,RC,57558,HCPCS,Outpatient,,,298,193.70,,262.24,88,,,percent of total billed charges,88% of total Billed charges,11.46,100,,,Fee Schedule,100% of Medicare rate,74.97,100,,,Fee Schedule,100% of WA Medicaid,298,100,,,percent of total billed charges,100% of total billed charges,77.22,103,,,Fee Schedule,103% of WA Medicaid,11.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,205.62,69,,,percent of total billed charges,69% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,298,100,,,percent of total billed charges,100% of total billed charges,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,298,100,,,percent of total billed charges,100% of total billed charges,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.31,61.85,,,percent of total billed charges,61.85% of total billed charges,74.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,97.46,130,,,Fee Schedule,130% of WA Medicaid ,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,10102.2,33.9,,,percent of total billed charges,33.9% of total billed charges,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.44,78,,,percent of total billed charges,78% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,74.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.46,10102.2,
"DILATION OF CERVICAL CANAL,INSTRUMENTAL",57800,CDM,983,RC,57800,HCPCS,Outpatient,,,127,82.55,,111.76,88,,,percent of total billed charges,88% of total Billed charges,4.82,100,,,Fee Schedule,100% of Medicare rate,27.42,100,,,Fee Schedule,100% of WA Medicaid,127,100,,,percent of total billed charges,100% of total billed charges,28.24,103,,,Fee Schedule,103% of WA Medicaid,4.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,87.63,69,,,percent of total billed charges,69% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,127,100,,,percent of total billed charges,100% of total billed charges,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,127,100,,,percent of total billed charges,100% of total billed charges,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.55,61.85,,,percent of total billed charges,61.85% of total billed charges,27.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.65,130,,,Fee Schedule,130% of WA Medicaid ,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.88,37.7,,,percent of total billed charges,37.70% of total billed charges,47.88,37.7,,,percent of total billed charges,37.70% of total billed charges,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4305.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.06,78,,,percent of total billed charges,78% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,27.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.82,4305.3,
BIOPSY OF UTERUS LINING,58100,CDM,983,RC,58100,HCPCS,Outpatient,,,307,199.55,,270.16,88,,,percent of total billed charges,88% of total Billed charges,7.06,100,,,Fee Schedule,100% of Medicare rate,35.44,100,,,Fee Schedule,100% of WA Medicaid,307,100,,,percent of total billed charges,100% of total billed charges,36.5,103,,,Fee Schedule,103% of WA Medicaid,7.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,211.83,69,,,percent of total billed charges,69% of total billed charges,307,100,,,percent of total billed charges,100% of total billed charges,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,307,100,,,percent of total billed charges,100% of total billed charges,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,307,100,,,percent of total billed charges,100% of total billed charges,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.88,61.85,,,percent of total billed charges,61.85% of total billed charges,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.07,130,,,Fee Schedule,130% of WA Medicaid ,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.74,37.7,,,percent of total billed charges,37.70% of total billed charges,115.74,37.7,,,percent of total billed charges,37.70% of total billed charges,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,10407.3,33.9,,,percent of total billed charges,33.9% of total billed charges,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.46,78,,,percent of total billed charges,78% of total billed charges,307,100,,,percent of total billed charges,100% of total billed charges,253.58,82.6,,,percent of total billed charges,82.6% of total billed charges,253.58,82.6,,,percent of total billed charges,82.6% of total billed charges,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.06,10407.3,
ENDO SAMPLE W/ COLPOSCOPY,58110,CDM,983,RC,58110,HCPCS,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,4.56,100,,,Fee Schedule,100% of Medicare rate,22.57,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,23.25,103,,,Fee Schedule,103% of WA Medicaid,4.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,113,100,,,percent of total billed charges,100% of total billed charges,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,113,100,,,percent of total billed charges,100% of total billed charges,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.89,61.85,,,percent of total billed charges,61.85% of total billed charges,22.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.34,130,,,Fee Schedule,130% of WA Medicaid ,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3830.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,22.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.56,3830.7,
DILATION AND CURETTAGE,58120,CDM,983,RC,58120,HCPCS,Outpatient,,,1175,763.75,,1034,88,,,percent of total billed charges,88% of total Billed charges,22.64,100,,,Fee Schedule,100% of Medicare rate,134.28,100,,,Fee Schedule,100% of WA Medicaid,1175,100,,,percent of total billed charges,100% of total billed charges,138.31,103,,,Fee Schedule,103% of WA Medicaid,22.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,39.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,134.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,810.75,69,,,percent of total billed charges,69% of total billed charges,1175,100,,,percent of total billed charges,100% of total billed charges,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1175,100,,,percent of total billed charges,100% of total billed charges,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1175,100,,,percent of total billed charges,100% of total billed charges,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.74,61.85,,,percent of total billed charges,61.85% of total billed charges,134.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.56,130,,,Fee Schedule,130% of WA Medicaid ,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.98,37.7,,,percent of total billed charges,37.70% of total billed charges,442.98,37.7,,,percent of total billed charges,37.70% of total billed charges,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,39832.5,33.9,,,percent of total billed charges,33.9% of total billed charges,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.5,78,,,percent of total billed charges,78% of total billed charges,1175,100,,,percent of total billed charges,100% of total billed charges,970.55,82.6,,,percent of total billed charges,82.6% of total billed charges,970.55,82.6,,,percent of total billed charges,82.6% of total billed charges,134.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.64,39832.5,
MYOMECTOMY ABDOM METHOD,58140,CDM,983,RC,58140,HCPCS,Outpatient,,,3952,2568.80,,3477.76,88,,,percent of total billed charges,88% of total Billed charges,97.22,100,,,Fee Schedule,100% of Medicare rate,524.81,100,,,Fee Schedule,100% of WA Medicaid,3952,100,,,percent of total billed charges,100% of total billed charges,540.55,103,,,Fee Schedule,103% of WA Medicaid,97.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,170.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,524.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2726.88,69,,,percent of total billed charges,69% of total billed charges,3952,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,3952,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,3952,100,,,percent of total billed charges,100% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2444.31,61.85,,,percent of total billed charges,61.85% of total billed charges,524.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,682.25,130,,,Fee Schedule,130% of WA Medicaid ,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1489.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1489.9,37.7,,,percent of total billed charges,37.70% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,133972.8,33.9,,,percent of total billed charges,33.9% of total billed charges,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,3082.56,78,,,percent of total billed charges,78% of total billed charges,3952,100,,,percent of total billed charges,100% of total billed charges,3264.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3264.35,82.6,,,percent of total billed charges,82.6% of total billed charges,524.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,97.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.22,133972.8,
MYOMECTOMY VAG METHOD,58145,CDM,983,RC,58145,HCPCS,Outpatient,,,783,508.95,,689.04,88,,,percent of total billed charges,88% of total Billed charges,56.66,100,,,Fee Schedule,100% of Medicare rate,327.12,100,,,Fee Schedule,100% of WA Medicaid,783,100,,,percent of total billed charges,100% of total billed charges,336.93,103,,,Fee Schedule,103% of WA Medicaid,56.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,327.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,540.27,69,,,percent of total billed charges,69% of total billed charges,783,100,,,percent of total billed charges,100% of total billed charges,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,783,100,,,percent of total billed charges,100% of total billed charges,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,783,100,,,percent of total billed charges,100% of total billed charges,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,484.29,61.85,,,percent of total billed charges,61.85% of total billed charges,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,425.26,130,,,Fee Schedule,130% of WA Medicaid ,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.19,37.7,,,percent of total billed charges,37.70% of total billed charges,295.19,37.7,,,percent of total billed charges,37.70% of total billed charges,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,26543.7,33.9,,,percent of total billed charges,33.9% of total billed charges,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.74,78,,,percent of total billed charges,78% of total billed charges,783,100,,,percent of total billed charges,100% of total billed charges,646.76,82.6,,,percent of total billed charges,82.6% of total billed charges,646.76,82.6,,,percent of total billed charges,82.6% of total billed charges,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.66,26543.7,
TOTAL HYSTERECTOMY,58150,CDM,983,RC,58150,HCPCS,Outpatient,,,4665,3032.25,,4105.2,88,,,percent of total billed charges,88% of total Billed charges,106.03,100,,,Fee Schedule,100% of Medicare rate,578.71,100,,,Fee Schedule,100% of WA Medicaid,4665,100,,,percent of total billed charges,100% of total billed charges,596.07,103,,,Fee Schedule,103% of WA Medicaid,106.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,185.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,578.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3218.85,69,,,percent of total billed charges,69% of total billed charges,4665,100,,,percent of total billed charges,100% of total billed charges,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4665,100,,,percent of total billed charges,100% of total billed charges,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4665,100,,,percent of total billed charges,100% of total billed charges,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2885.3,61.85,,,percent of total billed charges,61.85% of total billed charges,578.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,578.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,752.32,130,,,Fee Schedule,130% of WA Medicaid ,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1758.71,37.7,,,percent of total billed charges,37.70% of total billed charges,1758.71,37.7,,,percent of total billed charges,37.70% of total billed charges,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,158143.5,33.9,,,percent of total billed charges,33.9% of total billed charges,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3638.7,78,,,percent of total billed charges,78% of total billed charges,4665,100,,,percent of total billed charges,100% of total billed charges,3853.29,82.6,,,percent of total billed charges,82.6% of total billed charges,3853.29,82.6,,,percent of total billed charges,82.6% of total billed charges,578.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,578.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.03,158143.5,
TOTAL HYSTERECTOMY,58152,CDM,983,RC,58152,HCPCS,Outpatient,,,5016,3260.40,,4414.08,88,,,percent of total billed charges,88% of total Billed charges,133.06,100,,,Fee Schedule,100% of Medicare rate,701.99,100,,,Fee Schedule,100% of WA Medicaid,5016,100,,,percent of total billed charges,100% of total billed charges,723.05,103,,,Fee Schedule,103% of WA Medicaid,133.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,232.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,701.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3461.04,69,,,percent of total billed charges,69% of total billed charges,5016,100,,,percent of total billed charges,100% of total billed charges,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,5016,100,,,percent of total billed charges,100% of total billed charges,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,5016,100,,,percent of total billed charges,100% of total billed charges,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,3102.4,61.85,,,percent of total billed charges,61.85% of total billed charges,701.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,716.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,912.59,130,,,Fee Schedule,130% of WA Medicaid ,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1891.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1891.03,37.7,,,percent of total billed charges,37.70% of total billed charges,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,170042.4,33.9,,,percent of total billed charges,33.9% of total billed charges,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,3912.48,78,,,percent of total billed charges,78% of total billed charges,5016,100,,,percent of total billed charges,100% of total billed charges,4143.22,82.6,,,percent of total billed charges,82.6% of total billed charges,4143.22,82.6,,,percent of total billed charges,82.6% of total billed charges,701.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,133.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,701.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,133.06,170042.4,
SUB-TOTAL HYSTERECTOMY,58180,CDM,983,RC,58180,HCPCS,Outpatient,,,2252,1463.80,,1981.76,88,,,percent of total billed charges,88% of total Billed charges,102.02,100,,,Fee Schedule,100% of Medicare rate,546.63,100,,,Fee Schedule,100% of WA Medicaid,2252,100,,,percent of total billed charges,100% of total billed charges,563.03,103,,,Fee Schedule,103% of WA Medicaid,102.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,178.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,546.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1553.88,69,,,percent of total billed charges,69% of total billed charges,2252,100,,,percent of total billed charges,100% of total billed charges,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2252,100,,,percent of total billed charges,100% of total billed charges,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2252,100,,,percent of total billed charges,100% of total billed charges,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1392.86,61.85,,,percent of total billed charges,61.85% of total billed charges,546.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,710.62,130,,,Fee Schedule,130% of WA Medicaid ,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,849,37.7,,,percent of total billed charges,37.70% of total billed charges,849,37.7,,,percent of total billed charges,37.70% of total billed charges,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,76342.8,33.9,,,percent of total billed charges,33.9% of total billed charges,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1756.56,78,,,percent of total billed charges,78% of total billed charges,2252,100,,,percent of total billed charges,100% of total billed charges,1860.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1860.15,82.6,,,percent of total billed charges,82.6% of total billed charges,546.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,102.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,102.02,76342.8,
VAG HYST INCLUDING T/O,58262,CDM,983,RC,58262,HCPCS,Outpatient,,,638,414.70,,561.44,88,,,percent of total billed charges,88% of total Billed charges,96.63,100,,,Fee Schedule,100% of Medicare rate,528.35,100,,,Fee Schedule,100% of WA Medicaid,638,100,,,percent of total billed charges,100% of total billed charges,544.2,103,,,Fee Schedule,103% of WA Medicaid,96.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,169.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,528.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,440.22,69,,,percent of total billed charges,69% of total billed charges,638,100,,,percent of total billed charges,100% of total billed charges,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,638,100,,,percent of total billed charges,100% of total billed charges,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,638,100,,,percent of total billed charges,100% of total billed charges,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.6,61.85,,,percent of total billed charges,61.85% of total billed charges,528.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,538.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,686.86,130,,,Fee Schedule,130% of WA Medicaid ,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.53,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,37.7,,,percent of total billed charges,37.70% of total billed charges,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,21628.2,33.9,,,percent of total billed charges,33.9% of total billed charges,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.64,78,,,percent of total billed charges,78% of total billed charges,638,100,,,percent of total billed charges,100% of total billed charges,526.99,82.6,,,percent of total billed charges,82.6% of total billed charges,526.99,82.6,,,percent of total billed charges,82.6% of total billed charges,528.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,96.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,96.63,21628.2,
VAGINAL HYSTERECTOMY,58260,CDM,983,RC,58260,HCPCS,Outpatient,,,1965,1277.25,,1729.2,88,,,percent of total billed charges,88% of total Billed charges,86.74,100,,,Fee Schedule,100% of Medicare rate,478.75,100,,,Fee Schedule,100% of WA Medicaid,1965,100,,,percent of total billed charges,100% of total billed charges,493.11,103,,,Fee Schedule,103% of WA Medicaid,86.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,151.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,478.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1355.85,69,,,percent of total billed charges,69% of total billed charges,1965,100,,,percent of total billed charges,100% of total billed charges,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1965,100,,,percent of total billed charges,100% of total billed charges,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1965,100,,,percent of total billed charges,100% of total billed charges,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1215.35,61.85,,,percent of total billed charges,61.85% of total billed charges,478.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,622.38,130,,,Fee Schedule,130% of WA Medicaid ,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,740.81,37.7,,,percent of total billed charges,37.70% of total billed charges,740.81,37.7,,,percent of total billed charges,37.70% of total billed charges,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,66613.5,33.9,,,percent of total billed charges,33.9% of total billed charges,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1532.7,78,,,percent of total billed charges,78% of total billed charges,1965,100,,,percent of total billed charges,100% of total billed charges,1623.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1623.09,82.6,,,percent of total billed charges,82.6% of total billed charges,478.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,86.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.74,66613.5,
VAG HYST W/ENTEROCELE REPAIR,58270,CDM,983,RC,58270,HCPCS,Outpatient,,,4392,2854.80,,3864.96,88,,,percent of total billed charges,88% of total Billed charges,93.03,100,,,Fee Schedule,100% of Medicare rate,509.33,100,,,Fee Schedule,100% of WA Medicaid,4392,100,,,percent of total billed charges,100% of total billed charges,524.61,103,,,Fee Schedule,103% of WA Medicaid,93.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,162.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,509.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3030.48,69,,,percent of total billed charges,69% of total billed charges,4392,100,,,percent of total billed charges,100% of total billed charges,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4392,100,,,percent of total billed charges,100% of total billed charges,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4392,100,,,percent of total billed charges,100% of total billed charges,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2716.45,61.85,,,percent of total billed charges,61.85% of total billed charges,509.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,662.13,130,,,Fee Schedule,130% of WA Medicaid ,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1655.78,37.7,,,percent of total billed charges,37.70% of total billed charges,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,148888.8,33.9,,,percent of total billed charges,33.9% of total billed charges,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3425.76,78,,,percent of total billed charges,78% of total billed charges,4392,100,,,percent of total billed charges,100% of total billed charges,3627.79,82.6,,,percent of total billed charges,82.6% of total billed charges,3627.79,82.6,,,percent of total billed charges,82.6% of total billed charges,509.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,93.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,93.03,148888.8,
INSERT INTRAUTERINE DEVICE,58300,CDM,983,RC,58300,HCPCS,Outpatient,,,297,193.05,,261.36,88,,,percent of total billed charges,88% of total Billed charges,4.1,100,,,Fee Schedule,100% of Medicare rate,327.35,100,,,Fee Schedule,100% of WA Medicaid,297,100,,,percent of total billed charges,100% of total billed charges,337.17,103,,,Fee Schedule,103% of WA Medicaid,4.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,327.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,204.93,69,,,percent of total billed charges,69% of total billed charges,297,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,297,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,297,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.69,61.85,,,percent of total billed charges,61.85% of total billed charges,327.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,425.56,130,,,Fee Schedule,130% of WA Medicaid ,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.97,37.7,,,percent of total billed charges,37.70% of total billed charges,111.97,37.7,,,percent of total billed charges,37.70% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,10068.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.66,78,,,percent of total billed charges,78% of total billed charges,297,100,,,percent of total billed charges,100% of total billed charges,245.32,82.6,,,percent of total billed charges,82.6% of total billed charges,245.32,82.6,,,percent of total billed charges,82.6% of total billed charges,327.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.1,10068.3,
REMOVE INTRAUTERINE DEVICE,58301,CDM,983,RC,58301,HCPCS,Outpatient,,,191,124.15,,168.08,88,,,percent of total billed charges,88% of total Billed charges,7.41,100,,,Fee Schedule,100% of Medicare rate,37.11,100,,,Fee Schedule,100% of WA Medicaid,191,100,,,percent of total billed charges,100% of total billed charges,38.22,103,,,Fee Schedule,103% of WA Medicaid,7.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,37.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,131.79,69,,,percent of total billed charges,69% of total billed charges,191,100,,,percent of total billed charges,100% of total billed charges,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,191,100,,,percent of total billed charges,100% of total billed charges,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,191,100,,,percent of total billed charges,100% of total billed charges,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.13,61.85,,,percent of total billed charges,61.85% of total billed charges,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,48.24,130,,,Fee Schedule,130% of WA Medicaid ,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.01,37.7,,,percent of total billed charges,37.70% of total billed charges,72.01,37.7,,,percent of total billed charges,37.70% of total billed charges,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,6474.9,33.9,,,percent of total billed charges,33.9% of total billed charges,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.98,78,,,percent of total billed charges,78% of total billed charges,191,100,,,percent of total billed charges,100% of total billed charges,157.77,82.6,,,percent of total billed charges,82.6% of total billed charges,157.77,82.6,,,percent of total billed charges,82.6% of total billed charges,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.41,6474.9,
CATHETER FOR HYSTEROGRAPHY,58340,CDM,983,RC,58340,HCPCS,Outpatient,,,392,254.80,,344.96,88,,,percent of total billed charges,88% of total Billed charges,5.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,392,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,270.48,69,,,percent of total billed charges,69% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,392,100,,,percent of total billed charges,100% of total billed charges,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,392,100,,,percent of total billed charges,100% of total billed charges,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.45,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.78,37.7,,,percent of total billed charges,37.70% of total billed charges,147.78,37.7,,,percent of total billed charges,37.70% of total billed charges,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,13288.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.76,78,,,percent of total billed charges,78% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",5.37,13288.8,
"CHROMOTUBATION OF OVIDUCT,INCLU MATERIAL",58350,CDM,983,RC,58350,HCPCS,Outpatient,,,229,148.85,,201.52,88,,,percent of total billed charges,88% of total Billed charges,7.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,229,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,7.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,158.01,69,,,percent of total billed charges,69% of total billed charges,229,100,,,percent of total billed charges,100% of total billed charges,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,229,100,,,percent of total billed charges,100% of total billed charges,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,229,100,,,percent of total billed charges,100% of total billed charges,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.64,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.33,37.7,,,percent of total billed charges,37.70% of total billed charges,86.33,37.7,,,percent of total billed charges,37.70% of total billed charges,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,7763.1,33.9,,,percent of total billed charges,33.9% of total billed charges,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.62,78,,,percent of total billed charges,78% of total billed charges,229,100,,,percent of total billed charges,100% of total billed charges,189.15,82.6,,,percent of total billed charges,82.6% of total billed charges,189.15,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",7.58,7763.1,
SUSPENSION OF UTERUS,58400,CDM,983,RC,58400,HCPCS,Outpatient,,,900,585.00,,792,88,,,percent of total billed charges,88% of total Billed charges,43.13,100,,,Fee Schedule,100% of Medicare rate,267.25,100,,,Fee Schedule,100% of WA Medicaid,900,100,,,percent of total billed charges,100% of total billed charges,275.27,103,,,Fee Schedule,103% of WA Medicaid,43.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,267.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,621,69,,,percent of total billed charges,69% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,900,100,,,percent of total billed charges,100% of total billed charges,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.65,61.85,,,percent of total billed charges,61.85% of total billed charges,267.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,347.43,130,,,Fee Schedule,130% of WA Medicaid ,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,339.3,37.7,,,percent of total billed charges,37.70% of total billed charges,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,30510,33.9,,,percent of total billed charges,33.9% of total billed charges,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,702,78,,,percent of total billed charges,78% of total billed charges,900,100,,,percent of total billed charges,100% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,743.4,82.6,,,percent of total billed charges,82.6% of total billed charges,267.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.13,30510,
LAPOROSCOPY;SURGICAL,58541,CDM,983,RC,58541,HCPCS,Outpatient,,,2027,1317.55,,1783.76,88,,,percent of total billed charges,88% of total Billed charges,72.87,100,,,Fee Schedule,100% of Medicare rate,417.57,100,,,Fee Schedule,100% of WA Medicaid,2027,100,,,percent of total billed charges,100% of total billed charges,430.1,103,,,Fee Schedule,103% of WA Medicaid,72.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,127.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,417.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1398.63,69,,,percent of total billed charges,69% of total billed charges,2027,100,,,percent of total billed charges,100% of total billed charges,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2027,100,,,percent of total billed charges,100% of total billed charges,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2027,100,,,percent of total billed charges,100% of total billed charges,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1253.7,61.85,,,percent of total billed charges,61.85% of total billed charges,417.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,542.84,130,,,Fee Schedule,130% of WA Medicaid ,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,764.18,37.7,,,percent of total billed charges,37.70% of total billed charges,764.18,37.7,,,percent of total billed charges,37.70% of total billed charges,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,68715.3,33.9,,,percent of total billed charges,33.9% of total billed charges,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1581.06,78,,,percent of total billed charges,78% of total billed charges,2027,100,,,percent of total billed charges,100% of total billed charges,1674.3,82.6,,,percent of total billed charges,82.6% of total billed charges,1674.3,82.6,,,percent of total billed charges,82.6% of total billed charges,417.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.87,68715.3,
LAPAROSCOPY/HYSTEROSCOPY W/ REM OF TUBES,58542,CDM,983,RC,58542,HCPCS,Outpatient,,,2062,1340.30,,1814.56,88,,,percent of total billed charges,88% of total Billed charges,84.9,100,,,Fee Schedule,100% of Medicare rate,473.15,100,,,Fee Schedule,100% of WA Medicaid,2062,100,,,percent of total billed charges,100% of total billed charges,487.34,103,,,Fee Schedule,103% of WA Medicaid,84.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,148.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,473.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1422.78,69,,,percent of total billed charges,69% of total billed charges,2062,100,,,percent of total billed charges,100% of total billed charges,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2062,100,,,percent of total billed charges,100% of total billed charges,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2062,100,,,percent of total billed charges,100% of total billed charges,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1275.35,61.85,,,percent of total billed charges,61.85% of total billed charges,473.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,482.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,615.1,130,,,Fee Schedule,130% of WA Medicaid ,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,777.37,37.7,,,percent of total billed charges,37.70% of total billed charges,777.37,37.7,,,percent of total billed charges,37.70% of total billed charges,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,69901.8,33.9,,,percent of total billed charges,33.9% of total billed charges,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1608.36,78,,,percent of total billed charges,78% of total billed charges,2062,100,,,percent of total billed charges,100% of total billed charges,1703.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1703.21,82.6,,,percent of total billed charges,82.6% of total billed charges,473.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,84.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,84.9,69901.8,
HYSTEROSCOPY BIOPSY,58558,CDM,983,RC,58558,HCPCS,Outpatient,,,743,482.95,,653.84,88,,,percent of total billed charges,88% of total Billed charges,25.3,100,,,Fee Schedule,100% of Medicare rate,130.18,100,,,Fee Schedule,100% of WA Medicaid,743,100,,,percent of total billed charges,100% of total billed charges,134.09,103,,,Fee Schedule,103% of WA Medicaid,25.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,130.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,512.67,69,,,percent of total billed charges,69% of total billed charges,743,100,,,percent of total billed charges,100% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,743,100,,,percent of total billed charges,100% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,743,100,,,percent of total billed charges,100% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.55,61.85,,,percent of total billed charges,61.85% of total billed charges,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,169.23,130,,,Fee Schedule,130% of WA Medicaid ,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.11,37.7,,,percent of total billed charges,37.70% of total billed charges,280.11,37.7,,,percent of total billed charges,37.70% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,25187.7,33.9,,,percent of total billed charges,33.9% of total billed charges,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,579.54,78,,,percent of total billed charges,78% of total billed charges,743,100,,,percent of total billed charges,100% of total billed charges,613.72,82.6,,,percent of total billed charges,82.6% of total billed charges,613.72,82.6,,,percent of total billed charges,82.6% of total billed charges,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.3,25187.7,
LAPARO-VAG HYST COMPLEX,58553,CDM,983,RC,58553,HCPCS,Outpatient,,,3164,2056.60,,2784.32,88,,,percent of total billed charges,88% of total Billed charges,121.72,100,,,Fee Schedule,100% of Medicare rate,634.47,100,,,Fee Schedule,100% of WA Medicaid,3164,100,,,percent of total billed charges,100% of total billed charges,653.5,103,,,Fee Schedule,103% of WA Medicaid,121.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,213.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,634.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2183.16,69,,,percent of total billed charges,69% of total billed charges,3164,100,,,percent of total billed charges,100% of total billed charges,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3164,100,,,percent of total billed charges,100% of total billed charges,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3164,100,,,percent of total billed charges,100% of total billed charges,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1956.93,61.85,,,percent of total billed charges,61.85% of total billed charges,634.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,824.81,130,,,Fee Schedule,130% of WA Medicaid ,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1192.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1192.83,37.7,,,percent of total billed charges,37.70% of total billed charges,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,107259.6,33.9,,,percent of total billed charges,33.9% of total billed charges,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2467.92,78,,,percent of total billed charges,78% of total billed charges,3164,100,,,percent of total billed charges,100% of total billed charges,2613.46,82.6,,,percent of total billed charges,82.6% of total billed charges,2613.46,82.6,,,percent of total billed charges,82.6% of total billed charges,634.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.72,107259.6,
LAPARO-VAG HYST W/T/O COMPL,58554,CDM,983,RC,58554,HCPCS,Outpatient,,,3675,2388.75,,3234,88,,,percent of total billed charges,88% of total Billed charges,140,100,,,Fee Schedule,100% of Medicare rate,740.03,100,,,Fee Schedule,100% of WA Medicaid,3675,100,,,percent of total billed charges,100% of total billed charges,762.23,103,,,Fee Schedule,103% of WA Medicaid,140,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,245,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,740.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2535.75,69,,,percent of total billed charges,69% of total billed charges,3675,100,,,percent of total billed charges,100% of total billed charges,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,3675,100,,,percent of total billed charges,100% of total billed charges,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,3675,100,,,percent of total billed charges,100% of total billed charges,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,2272.99,61.85,,,percent of total billed charges,61.85% of total billed charges,740.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,740.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,754.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,962.04,130,,,Fee Schedule,130% of WA Medicaid ,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385.48,37.7,,,percent of total billed charges,37.70% of total billed charges,1385.48,37.7,,,percent of total billed charges,37.70% of total billed charges,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,124582.5,33.9,,,percent of total billed charges,33.9% of total billed charges,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,2866.5,78,,,percent of total billed charges,78% of total billed charges,3675,100,,,percent of total billed charges,100% of total billed charges,3035.55,82.6,,,percent of total billed charges,82.6% of total billed charges,3035.55,82.6,,,percent of total billed charges,82.6% of total billed charges,740.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,140,100,,,Fee Schedule,100% of Medicare RBRVS rate,740.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140,124582.5,
LAPARO-ASST VAG HYSTERECTOMY,58550,CDM,983,RC,58550,HCPCS,Outpatient,,,2462,1600.30,,2166.56,88,,,percent of total billed charges,88% of total Billed charges,92.42,100,,,Fee Schedule,100% of Medicare rate,502.62,100,,,Fee Schedule,100% of WA Medicaid,2462,100,,,percent of total billed charges,100% of total billed charges,517.7,103,,,Fee Schedule,103% of WA Medicaid,92.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,161.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,502.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1698.78,69,,,percent of total billed charges,69% of total billed charges,2462,100,,,percent of total billed charges,100% of total billed charges,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2462,100,,,percent of total billed charges,100% of total billed charges,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2462,100,,,percent of total billed charges,100% of total billed charges,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1522.75,61.85,,,percent of total billed charges,61.85% of total billed charges,502.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,512.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,653.41,130,,,Fee Schedule,130% of WA Medicaid ,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,928.17,37.7,,,percent of total billed charges,37.70% of total billed charges,928.17,37.7,,,percent of total billed charges,37.70% of total billed charges,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,83461.8,33.9,,,percent of total billed charges,33.9% of total billed charges,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1920.36,78,,,percent of total billed charges,78% of total billed charges,2462,100,,,percent of total billed charges,100% of total billed charges,2033.61,82.6,,,percent of total billed charges,82.6% of total billed charges,2033.61,82.6,,,percent of total billed charges,82.6% of total billed charges,502.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,92.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,92.42,83461.8,
LAPARO-VAG HYST INCL T/O,58552,CDM,983,RC,58552,HCPCS,Outpatient,,,2736,1778.40,,2407.68,88,,,percent of total billed charges,88% of total Billed charges,102.87,100,,,Fee Schedule,100% of Medicare rate,558.01,100,,,Fee Schedule,100% of WA Medicaid,2736,100,,,percent of total billed charges,100% of total billed charges,574.75,103,,,Fee Schedule,103% of WA Medicaid,102.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,180.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,558.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1887.84,69,,,percent of total billed charges,69% of total billed charges,2736,100,,,percent of total billed charges,100% of total billed charges,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2736,100,,,percent of total billed charges,100% of total billed charges,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2736,100,,,percent of total billed charges,100% of total billed charges,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1692.22,61.85,,,percent of total billed charges,61.85% of total billed charges,558.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,569.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,725.41,130,,,Fee Schedule,130% of WA Medicaid ,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1031.47,37.7,,,percent of total billed charges,37.70% of total billed charges,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,92750.4,33.9,,,percent of total billed charges,33.9% of total billed charges,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2134.08,78,,,percent of total billed charges,78% of total billed charges,2736,100,,,percent of total billed charges,100% of total billed charges,2259.94,82.6,,,percent of total billed charges,82.6% of total billed charges,2259.94,82.6,,,percent of total billed charges,82.6% of total billed charges,558.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,102.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,102.87,92750.4,
HYSTEROSCOPY LYSIS,58559,CDM,983,RC,58559,HCPCS,Outpatient,,,954,620.10,,839.52,88,,,percent of total billed charges,88% of total Billed charges,31.27,100,,,Fee Schedule,100% of Medicare rate,159.64,100,,,Fee Schedule,100% of WA Medicaid,954,100,,,percent of total billed charges,100% of total billed charges,164.43,103,,,Fee Schedule,103% of WA Medicaid,31.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,159.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,658.26,69,,,percent of total billed charges,69% of total billed charges,954,100,,,percent of total billed charges,100% of total billed charges,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,954,100,,,percent of total billed charges,100% of total billed charges,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,954,100,,,percent of total billed charges,100% of total billed charges,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.05,61.85,,,percent of total billed charges,61.85% of total billed charges,159.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,207.53,130,,,Fee Schedule,130% of WA Medicaid ,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.66,37.7,,,percent of total billed charges,37.70% of total billed charges,359.66,37.7,,,percent of total billed charges,37.70% of total billed charges,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,32340.6,33.9,,,percent of total billed charges,33.9% of total billed charges,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,744.12,78,,,percent of total billed charges,78% of total billed charges,954,100,,,percent of total billed charges,100% of total billed charges,788,82.6,,,percent of total billed charges,82.6% of total billed charges,788,82.6,,,percent of total billed charges,82.6% of total billed charges,159.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.27,32340.6,
HYSTEROSCOPY DX SEP PROC,58555,CDM,983,RC,58555,HCPCS,Outpatient,,,1152,748.80,,1013.76,88,,,percent of total billed charges,88% of total Billed charges,15.93,100,,,Fee Schedule,100% of Medicare rate,85.42,100,,,Fee Schedule,100% of WA Medicaid,1152,100,,,percent of total billed charges,100% of total billed charges,87.98,103,,,Fee Schedule,103% of WA Medicaid,15.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,85.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,794.88,69,,,percent of total billed charges,69% of total billed charges,1152,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152,100,,,percent of total billed charges,100% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.51,61.85,,,percent of total billed charges,61.85% of total billed charges,85.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,111.05,130,,,Fee Schedule,130% of WA Medicaid ,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.3,37.7,,,percent of total billed charges,37.70% of total billed charges,434.3,37.7,,,percent of total billed charges,37.70% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,39052.8,33.9,,,percent of total billed charges,33.9% of total billed charges,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,898.56,78,,,percent of total billed charges,78% of total billed charges,1152,100,,,percent of total billed charges,100% of total billed charges,951.55,82.6,,,percent of total billed charges,82.6% of total billed charges,951.55,82.6,,,percent of total billed charges,82.6% of total billed charges,85.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.93,39052.8,
HYSTEROSCOPY RESECT SEPTUM,58560,CDM,983,RC,58560,HCPCS,Outpatient,,,1081,702.65,,951.28,88,,,percent of total billed charges,88% of total Billed charges,34.71,100,,,Fee Schedule,100% of Medicare rate,175.68,100,,,Fee Schedule,100% of WA Medicaid,1081,100,,,percent of total billed charges,100% of total billed charges,180.95,103,,,Fee Schedule,103% of WA Medicaid,34.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,175.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,745.89,69,,,percent of total billed charges,69% of total billed charges,1081,100,,,percent of total billed charges,100% of total billed charges,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1081,100,,,percent of total billed charges,100% of total billed charges,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1081,100,,,percent of total billed charges,100% of total billed charges,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.6,61.85,,,percent of total billed charges,61.85% of total billed charges,175.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,228.38,130,,,Fee Schedule,130% of WA Medicaid ,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.54,37.7,,,percent of total billed charges,37.70% of total billed charges,407.54,37.7,,,percent of total billed charges,37.70% of total billed charges,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,36645.9,33.9,,,percent of total billed charges,33.9% of total billed charges,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,843.18,78,,,percent of total billed charges,78% of total billed charges,1081,100,,,percent of total billed charges,100% of total billed charges,892.91,82.6,,,percent of total billed charges,82.6% of total billed charges,892.91,82.6,,,percent of total billed charges,82.6% of total billed charges,175.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.71,36645.9,
HYSTEROSCOPY STERILIZATION,58565,CDM,983,RC,58565,HCPCS,Outpatient,,,1210,786.50,,1064.8,88,,,percent of total billed charges,88% of total Billed charges,45.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1210,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,834.9,69,,,percent of total billed charges,69% of total billed charges,1210,100,,,percent of total billed charges,100% of total billed charges,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1210,100,,,percent of total billed charges,100% of total billed charges,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1210,100,,,percent of total billed charges,100% of total billed charges,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,748.39,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.17,37.7,,,percent of total billed charges,37.70% of total billed charges,456.17,37.7,,,percent of total billed charges,37.70% of total billed charges,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,41019,33.9,,,percent of total billed charges,33.9% of total billed charges,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,943.8,78,,,percent of total billed charges,78% of total billed charges,1210,100,,,percent of total billed charges,100% of total billed charges,999.46,82.6,,,percent of total billed charges,82.6% of total billed charges,999.46,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",45.24,41019,
HYSTEROSCOPY REMOVE FB,58562,CDM,983,RC,58562,HCPCS,Outpatient,,,808,525.20,,711.04,88,,,percent of total billed charges,88% of total Billed charges,24.23,100,,,Fee Schedule,100% of Medicare rate,124.77,100,,,Fee Schedule,100% of WA Medicaid,808,100,,,percent of total billed charges,100% of total billed charges,128.51,103,,,Fee Schedule,103% of WA Medicaid,24.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,124.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,557.52,69,,,percent of total billed charges,69% of total billed charges,808,100,,,percent of total billed charges,100% of total billed charges,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,808,100,,,percent of total billed charges,100% of total billed charges,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,808,100,,,percent of total billed charges,100% of total billed charges,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.75,61.85,,,percent of total billed charges,61.85% of total billed charges,124.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,162.2,130,,,Fee Schedule,130% of WA Medicaid ,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.62,37.7,,,percent of total billed charges,37.70% of total billed charges,304.62,37.7,,,percent of total billed charges,37.70% of total billed charges,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,27391.2,33.9,,,percent of total billed charges,33.9% of total billed charges,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,630.24,78,,,percent of total billed charges,78% of total billed charges,808,100,,,percent of total billed charges,100% of total billed charges,667.41,82.6,,,percent of total billed charges,82.6% of total billed charges,667.41,82.6,,,percent of total billed charges,82.6% of total billed charges,124.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.23,27391.2,
HYSTEROSCOPY REMOVE MYOMA,58561,CDM,983,RC,58561,HCPCS,Outpatient,,,1537,999.05,,1352.56,88,,,percent of total billed charges,88% of total Billed charges,39.94,100,,,Fee Schedule,100% of Medicare rate,200.86,100,,,Fee Schedule,100% of WA Medicaid,1537,100,,,percent of total billed charges,100% of total billed charges,206.89,103,,,Fee Schedule,103% of WA Medicaid,39.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1060.53,69,,,percent of total billed charges,69% of total billed charges,1537,100,,,percent of total billed charges,100% of total billed charges,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1537,100,,,percent of total billed charges,100% of total billed charges,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1537,100,,,percent of total billed charges,100% of total billed charges,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,950.63,61.85,,,percent of total billed charges,61.85% of total billed charges,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,261.12,130,,,Fee Schedule,130% of WA Medicaid ,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,579.45,37.7,,,percent of total billed charges,37.70% of total billed charges,579.45,37.7,,,percent of total billed charges,37.70% of total billed charges,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,52104.3,33.9,,,percent of total billed charges,33.9% of total billed charges,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198.86,78,,,percent of total billed charges,78% of total billed charges,1537,100,,,percent of total billed charges,100% of total billed charges,1269.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1269.56,82.6,,,percent of total billed charges,82.6% of total billed charges,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.94,52104.3,
HYSTEROSCOPY ABLATION,58563,CDM,983,RC,58563,HCPCS,Outpatient,,,955,620.75,,840.4,88,,,percent of total billed charges,88% of total Billed charges,26.76,100,,,Fee Schedule,100% of Medicare rate,138.2,100,,,Fee Schedule,100% of WA Medicaid,955,100,,,percent of total billed charges,100% of total billed charges,142.35,103,,,Fee Schedule,103% of WA Medicaid,26.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,46.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,138.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,658.95,69,,,percent of total billed charges,69% of total billed charges,955,100,,,percent of total billed charges,100% of total billed charges,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,955,100,,,percent of total billed charges,100% of total billed charges,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,955,100,,,percent of total billed charges,100% of total billed charges,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.67,61.85,,,percent of total billed charges,61.85% of total billed charges,138.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,179.66,130,,,Fee Schedule,130% of WA Medicaid ,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.04,37.7,,,percent of total billed charges,37.70% of total billed charges,360.04,37.7,,,percent of total billed charges,37.70% of total billed charges,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,32374.5,33.9,,,percent of total billed charges,33.9% of total billed charges,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,744.9,78,,,percent of total billed charges,78% of total billed charges,955,100,,,percent of total billed charges,100% of total billed charges,788.83,82.6,,,percent of total billed charges,82.6% of total billed charges,788.83,82.6,,,percent of total billed charges,82.6% of total billed charges,138.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.76,32374.5,
TLH W/T/O 250 G OR LESS,58571,CDM,983,RC,58571,HCPCS,Outpatient,,,2901,1885.65,,2552.88,88,,,percent of total billed charges,88% of total Billed charges,93.28,100,,,Fee Schedule,100% of Medicare rate,519.4,100,,,Fee Schedule,100% of WA Medicaid,2901,100,,,percent of total billed charges,100% of total billed charges,534.98,103,,,Fee Schedule,103% of WA Medicaid,93.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,163.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,519.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2001.69,69,,,percent of total billed charges,69% of total billed charges,2901,100,,,percent of total billed charges,100% of total billed charges,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2901,100,,,percent of total billed charges,100% of total billed charges,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2901,100,,,percent of total billed charges,100% of total billed charges,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1794.27,61.85,,,percent of total billed charges,61.85% of total billed charges,519.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,529.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,675.22,130,,,Fee Schedule,130% of WA Medicaid ,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1093.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1093.68,37.7,,,percent of total billed charges,37.70% of total billed charges,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,98343.9,33.9,,,percent of total billed charges,33.9% of total billed charges,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2262.78,78,,,percent of total billed charges,78% of total billed charges,2901,100,,,percent of total billed charges,100% of total billed charges,2396.23,82.6,,,percent of total billed charges,82.6% of total billed charges,2396.23,82.6,,,percent of total billed charges,82.6% of total billed charges,519.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,93.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,93.28,98343.9,
TLH W/T/O UTERUS OVER 250 G,58573,CDM,983,RC,58573,HCPCS,Outpatient,,,3718,2416.70,,3271.84,88,,,percent of total billed charges,88% of total Billed charges,128.19,100,,,Fee Schedule,100% of Medicare rate,693.78,100,,,Fee Schedule,100% of WA Medicaid,3718,100,,,percent of total billed charges,100% of total billed charges,714.59,103,,,Fee Schedule,103% of WA Medicaid,128.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,224.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,693.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2565.42,69,,,percent of total billed charges,69% of total billed charges,3718,100,,,percent of total billed charges,100% of total billed charges,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,3718,100,,,percent of total billed charges,100% of total billed charges,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,3718,100,,,percent of total billed charges,100% of total billed charges,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2299.58,61.85,,,percent of total billed charges,61.85% of total billed charges,693.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,693.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,707.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,901.91,130,,,Fee Schedule,130% of WA Medicaid ,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1401.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1401.69,37.7,,,percent of total billed charges,37.70% of total billed charges,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,126040.2,33.9,,,percent of total billed charges,33.9% of total billed charges,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2900.04,78,,,percent of total billed charges,78% of total billed charges,3718,100,,,percent of total billed charges,100% of total billed charges,3071.07,82.6,,,percent of total billed charges,82.6% of total billed charges,3071.07,82.6,,,percent of total billed charges,82.6% of total billed charges,693.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,128.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,693.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.19,126040.2,
TLH UTERUS OVER 250 G,58572,CDM,983,RC,58572,HCPCS,Outpatient,,,3228,2098.20,,2840.64,88,,,percent of total billed charges,88% of total Billed charges,107.75,100,,,Fee Schedule,100% of Medicare rate,576.66,100,,,Fee Schedule,100% of WA Medicaid,3228,100,,,percent of total billed charges,100% of total billed charges,593.96,103,,,Fee Schedule,103% of WA Medicaid,107.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,188.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,576.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2227.32,69,,,percent of total billed charges,69% of total billed charges,3228,100,,,percent of total billed charges,100% of total billed charges,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3228,100,,,percent of total billed charges,100% of total billed charges,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3228,100,,,percent of total billed charges,100% of total billed charges,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1996.52,61.85,,,percent of total billed charges,61.85% of total billed charges,576.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,576.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,749.66,130,,,Fee Schedule,130% of WA Medicaid ,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1216.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1216.96,37.7,,,percent of total billed charges,37.70% of total billed charges,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,109429.2,33.9,,,percent of total billed charges,33.9% of total billed charges,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2517.84,78,,,percent of total billed charges,78% of total billed charges,3228,100,,,percent of total billed charges,100% of total billed charges,2666.33,82.6,,,percent of total billed charges,82.6% of total billed charges,2666.33,82.6,,,percent of total billed charges,82.6% of total billed charges,576.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,576.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.75,109429.2,
TLH UTERUS 250 G OR LESS,58570,CDM,983,RC,58570,HCPCS,Outpatient,,,2591,1684.15,,2280.08,88,,,percent of total billed charges,88% of total Billed charges,82.44,100,,,Fee Schedule,100% of Medicare rate,461.4,100,,,Fee Schedule,100% of WA Medicaid,2591,100,,,percent of total billed charges,100% of total billed charges,475.24,103,,,Fee Schedule,103% of WA Medicaid,82.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,144.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,461.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1787.79,69,,,percent of total billed charges,69% of total billed charges,2591,100,,,percent of total billed charges,100% of total billed charges,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2591,100,,,percent of total billed charges,100% of total billed charges,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2591,100,,,percent of total billed charges,100% of total billed charges,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1602.53,61.85,,,percent of total billed charges,61.85% of total billed charges,461.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,470.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,599.82,130,,,Fee Schedule,130% of WA Medicaid ,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,976.81,37.7,,,percent of total billed charges,37.70% of total billed charges,976.81,37.7,,,percent of total billed charges,37.70% of total billed charges,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,87834.9,33.9,,,percent of total billed charges,33.9% of total billed charges,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2020.98,78,,,percent of total billed charges,78% of total billed charges,2591,100,,,percent of total billed charges,100% of total billed charges,2140.17,82.6,,,percent of total billed charges,82.6% of total billed charges,2140.17,82.6,,,percent of total billed charges,82.6% of total billed charges,461.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,461.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.44,87834.9,
LAPARO PROC UTERUS,58578,CDM,983,RC,58578,HCPCS,Outpatient,,,2591,1684.15,,2280.08,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2591,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1787.79,69,,,percent of total billed charges,69% of total billed charges,2591,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2591,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2591,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1602.53,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,976.81,37.7,,,percent of total billed charges,37.70% of total billed charges,976.81,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,87834.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2020.98,78,,,percent of total billed charges,78% of total billed charges,2591,100,,,percent of total billed charges,100% of total billed charges,2140.17,82.6,,,percent of total billed charges,82.6% of total billed charges,2140.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",976.81,87834.9,
DIVISION OF FALLOPIAN TUBE,58600,CDM,983,RC,58600,HCPCS,Outpatient,,,1718,1116.70,,1511.84,88,,,percent of total billed charges,88% of total Billed charges,37.43,100,,,Fee Schedule,100% of Medicare rate,213.17,100,,,Fee Schedule,100% of WA Medicaid,1718,100,,,percent of total billed charges,100% of total billed charges,219.57,103,,,Fee Schedule,103% of WA Medicaid,37.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,213.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1185.42,69,,,percent of total billed charges,69% of total billed charges,1718,100,,,percent of total billed charges,100% of total billed charges,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1718,100,,,percent of total billed charges,100% of total billed charges,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1718,100,,,percent of total billed charges,100% of total billed charges,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1062.58,61.85,,,percent of total billed charges,61.85% of total billed charges,213.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,277.12,130,,,Fee Schedule,130% of WA Medicaid ,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.69,37.7,,,percent of total billed charges,37.70% of total billed charges,647.69,37.7,,,percent of total billed charges,37.70% of total billed charges,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,58240.2,33.9,,,percent of total billed charges,33.9% of total billed charges,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340.04,78,,,percent of total billed charges,78% of total billed charges,1718,100,,,percent of total billed charges,100% of total billed charges,1419.07,82.6,,,percent of total billed charges,82.6% of total billed charges,1419.07,82.6,,,percent of total billed charges,82.6% of total billed charges,213.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.43,58240.2,
DIVISION OF FALLOPIAN TUBE,58605,CDM,983,RC,58605,HCPCS,Outpatient,,,1367,888.55,,1202.96,88,,,percent of total billed charges,88% of total Billed charges,33.57,100,,,Fee Schedule,100% of Medicare rate,193.96,100,,,Fee Schedule,100% of WA Medicaid,1367,100,,,percent of total billed charges,100% of total billed charges,199.78,103,,,Fee Schedule,103% of WA Medicaid,33.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,193.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,943.23,69,,,percent of total billed charges,69% of total billed charges,1367,100,,,percent of total billed charges,100% of total billed charges,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1367,100,,,percent of total billed charges,100% of total billed charges,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1367,100,,,percent of total billed charges,100% of total billed charges,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,845.49,61.85,,,percent of total billed charges,61.85% of total billed charges,193.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,252.15,130,,,Fee Schedule,130% of WA Medicaid ,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,515.36,37.7,,,percent of total billed charges,37.70% of total billed charges,515.36,37.7,,,percent of total billed charges,37.70% of total billed charges,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,46341.3,33.9,,,percent of total billed charges,33.9% of total billed charges,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,1066.26,78,,,percent of total billed charges,78% of total billed charges,1367,100,,,percent of total billed charges,100% of total billed charges,1129.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1129.14,82.6,,,percent of total billed charges,82.6% of total billed charges,193.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.57,46341.3,
LIGATE OVIDUCT(S) ADD-ON,58611,CDM,983,RC,58611,HCPCS,Outpatient,,,812,527.80,,714.56,88,,,percent of total billed charges,88% of total Billed charges,8.46,100,,,Fee Schedule,100% of Medicare rate,42.15,100,,,Fee Schedule,100% of WA Medicaid,812,100,,,percent of total billed charges,100% of total billed charges,43.41,103,,,Fee Schedule,103% of WA Medicaid,8.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,560.28,69,,,percent of total billed charges,69% of total billed charges,812,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,812,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,812,100,,,percent of total billed charges,100% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,502.22,61.85,,,percent of total billed charges,61.85% of total billed charges,42.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,54.8,130,,,Fee Schedule,130% of WA Medicaid ,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,306.12,37.7,,,percent of total billed charges,37.70% of total billed charges,306.12,37.7,,,percent of total billed charges,37.70% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,27526.8,33.9,,,percent of total billed charges,33.9% of total billed charges,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.36,78,,,percent of total billed charges,78% of total billed charges,812,100,,,percent of total billed charges,100% of total billed charges,670.71,82.6,,,percent of total billed charges,82.6% of total billed charges,670.71,82.6,,,percent of total billed charges,82.6% of total billed charges,42.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.46,27526.8,
OCCLUDE FALLOPIAN TUBE(S),58615,CDM,983,RC,58615,HCPCS,Outpatient,,,1322,859.30,,1163.36,88,,,percent of total billed charges,88% of total Billed charges,25.06,100,,,Fee Schedule,100% of Medicare rate,145.84,100,,,Fee Schedule,100% of WA Medicaid,1322,100,,,percent of total billed charges,100% of total billed charges,150.22,103,,,Fee Schedule,103% of WA Medicaid,25.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,145.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,912.18,69,,,percent of total billed charges,69% of total billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1322,100,,,percent of total billed charges,100% of total billed charges,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1322,100,,,percent of total billed charges,100% of total billed charges,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,817.66,61.85,,,percent of total billed charges,61.85% of total billed charges,145.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,189.59,130,,,Fee Schedule,130% of WA Medicaid ,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,498.39,37.7,,,percent of total billed charges,37.70% of total billed charges,498.39,37.7,,,percent of total billed charges,37.70% of total billed charges,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,44815.8,33.9,,,percent of total billed charges,33.9% of total billed charges,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031.16,78,,,percent of total billed charges,78% of total billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,1091.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1091.97,82.6,,,percent of total billed charges,82.6% of total billed charges,145.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.06,44815.8,
LAPAROSCOPY EXCISE LESIONS,58662,CDM,983,RC,58662,HCPCS,Outpatient,,,1965,1277.25,,1729.2,88,,,percent of total billed charges,88% of total Billed charges,75.66,100,,,Fee Schedule,100% of Medicare rate,406.38,100,,,Fee Schedule,100% of WA Medicaid,1965,100,,,percent of total billed charges,100% of total billed charges,418.57,103,,,Fee Schedule,103% of WA Medicaid,75.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,132.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,406.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1355.85,69,,,percent of total billed charges,69% of total billed charges,1965,100,,,percent of total billed charges,100% of total billed charges,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1965,100,,,percent of total billed charges,100% of total billed charges,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1965,100,,,percent of total billed charges,100% of total billed charges,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1215.35,61.85,,,percent of total billed charges,61.85% of total billed charges,406.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,528.29,130,,,Fee Schedule,130% of WA Medicaid ,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,740.81,37.7,,,percent of total billed charges,37.70% of total billed charges,740.81,37.7,,,percent of total billed charges,37.70% of total billed charges,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,66613.5,33.9,,,percent of total billed charges,33.9% of total billed charges,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1532.7,78,,,percent of total billed charges,78% of total billed charges,1965,100,,,percent of total billed charges,100% of total billed charges,1623.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1623.09,82.6,,,percent of total billed charges,82.6% of total billed charges,406.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.66,66613.5,
LAPAROSCOPY LYSIS,58660,CDM,983,RC,58660,HCPCS,Outpatient,,,2328,1513.20,,2048.64,88,,,percent of total billed charges,88% of total Billed charges,78.9,100,,,Fee Schedule,100% of Medicare rate,388.85,100,,,Fee Schedule,100% of WA Medicaid,2328,100,,,percent of total billed charges,100% of total billed charges,400.52,103,,,Fee Schedule,103% of WA Medicaid,78.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,138.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,388.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1606.32,69,,,percent of total billed charges,69% of total billed charges,2328,100,,,percent of total billed charges,100% of total billed charges,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2328,100,,,percent of total billed charges,100% of total billed charges,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2328,100,,,percent of total billed charges,100% of total billed charges,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1439.87,61.85,,,percent of total billed charges,61.85% of total billed charges,388.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,505.51,130,,,Fee Schedule,130% of WA Medicaid ,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,877.66,37.7,,,percent of total billed charges,37.70% of total billed charges,877.66,37.7,,,percent of total billed charges,37.70% of total billed charges,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,78919.2,33.9,,,percent of total billed charges,33.9% of total billed charges,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1815.84,78,,,percent of total billed charges,78% of total billed charges,2328,100,,,percent of total billed charges,100% of total billed charges,1922.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1922.93,82.6,,,percent of total billed charges,82.6% of total billed charges,388.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.9,78919.2,
LAPAROSCOPY REMOVE ADNEXA,58661,CDM,983,RC,58661,HCPCS,Outpatient,,,1790,1163.50,,1575.2,88,,,percent of total billed charges,88% of total Billed charges,69.39,100,,,Fee Schedule,100% of Medicare rate,370.76,100,,,Fee Schedule,100% of WA Medicaid,1790,100,,,percent of total billed charges,100% of total billed charges,381.88,103,,,Fee Schedule,103% of WA Medicaid,69.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,121.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,370.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1235.1,69,,,percent of total billed charges,69% of total billed charges,1790,100,,,percent of total billed charges,100% of total billed charges,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1790,100,,,percent of total billed charges,100% of total billed charges,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1790,100,,,percent of total billed charges,100% of total billed charges,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1107.12,61.85,,,percent of total billed charges,61.85% of total billed charges,370.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,481.99,130,,,Fee Schedule,130% of WA Medicaid ,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.83,37.7,,,percent of total billed charges,37.70% of total billed charges,674.83,37.7,,,percent of total billed charges,37.70% of total billed charges,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,60681,33.9,,,percent of total billed charges,33.9% of total billed charges,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1396.2,78,,,percent of total billed charges,78% of total billed charges,1790,100,,,percent of total billed charges,100% of total billed charges,1478.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1478.54,82.6,,,percent of total billed charges,82.6% of total billed charges,370.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,69.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,69.39,60681,
LAPAROSCOPY TUBAL BLOCK,58671,CDM,983,RC,58671,HCPCS,Outpatient,,,841,546.65,,740.08,88,,,percent of total billed charges,88% of total Billed charges,37.45,100,,,Fee Schedule,100% of Medicare rate,213.54,100,,,Fee Schedule,100% of WA Medicaid,841,100,,,percent of total billed charges,100% of total billed charges,219.95,103,,,Fee Schedule,103% of WA Medicaid,37.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,213.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,580.29,69,,,percent of total billed charges,69% of total billed charges,841,100,,,percent of total billed charges,100% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,841,100,,,percent of total billed charges,100% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,841,100,,,percent of total billed charges,100% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.16,61.85,,,percent of total billed charges,61.85% of total billed charges,213.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,277.6,130,,,Fee Schedule,130% of WA Medicaid ,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.06,37.7,,,percent of total billed charges,37.70% of total billed charges,317.06,37.7,,,percent of total billed charges,37.70% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,28509.9,33.9,,,percent of total billed charges,33.9% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,655.98,78,,,percent of total billed charges,78% of total billed charges,841,100,,,percent of total billed charges,100% of total billed charges,694.67,82.6,,,percent of total billed charges,82.6% of total billed charges,694.67,82.6,,,percent of total billed charges,82.6% of total billed charges,213.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.45,28509.9,
LAPAROSCOPY TUBAL CAUTERY,58670,CDM,983,RC,58670,HCPCS,Outpatient,,,1773,1152.45,,1560.24,88,,,percent of total billed charges,88% of total Billed charges,37.45,100,,,Fee Schedule,100% of Medicare rate,213.54,100,,,Fee Schedule,100% of WA Medicaid,1773,100,,,percent of total billed charges,100% of total billed charges,219.95,103,,,Fee Schedule,103% of WA Medicaid,37.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,213.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1223.37,69,,,percent of total billed charges,69% of total billed charges,1773,100,,,percent of total billed charges,100% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1773,100,,,percent of total billed charges,100% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1773,100,,,percent of total billed charges,100% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1096.6,61.85,,,percent of total billed charges,61.85% of total billed charges,213.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,277.6,130,,,Fee Schedule,130% of WA Medicaid ,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.42,37.7,,,percent of total billed charges,37.70% of total billed charges,668.42,37.7,,,percent of total billed charges,37.70% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,60104.7,33.9,,,percent of total billed charges,33.9% of total billed charges,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1382.94,78,,,percent of total billed charges,78% of total billed charges,1773,100,,,percent of total billed charges,100% of total billed charges,1464.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1464.5,82.6,,,percent of total billed charges,82.6% of total billed charges,213.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.45,60104.7,
REMOVAL OF FALLOPIAN TUBE,58700,CDM,983,RC,58700,HCPCS,Outpatient,,,2106,1368.90,,1853.28,88,,,percent of total billed charges,88% of total Billed charges,86.63,100,,,Fee Schedule,100% of Medicare rate,457.3,100,,,Fee Schedule,100% of WA Medicaid,2106,100,,,percent of total billed charges,100% of total billed charges,471.02,103,,,Fee Schedule,103% of WA Medicaid,86.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,151.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,457.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1453.14,69,,,percent of total billed charges,69% of total billed charges,2106,100,,,percent of total billed charges,100% of total billed charges,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2106,100,,,percent of total billed charges,100% of total billed charges,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2106,100,,,percent of total billed charges,100% of total billed charges,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1302.56,61.85,,,percent of total billed charges,61.85% of total billed charges,457.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,594.49,130,,,Fee Schedule,130% of WA Medicaid ,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,793.96,37.7,,,percent of total billed charges,37.70% of total billed charges,793.96,37.7,,,percent of total billed charges,37.70% of total billed charges,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,71393.4,33.9,,,percent of total billed charges,33.9% of total billed charges,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1642.68,78,,,percent of total billed charges,78% of total billed charges,2106,100,,,percent of total billed charges,100% of total billed charges,1739.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1739.56,82.6,,,percent of total billed charges,82.6% of total billed charges,457.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,86.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.63,71393.4,
REMOVAL OF OVARY/TUBE(S),58720,CDM,983,RC,58720,HCPCS,Outpatient,,,2019,1312.35,,1776.72,88,,,percent of total billed charges,88% of total Billed charges,78.71,100,,,Fee Schedule,100% of Medicare rate,435.1,100,,,Fee Schedule,100% of WA Medicaid,2019,100,,,percent of total billed charges,100% of total billed charges,448.15,103,,,Fee Schedule,103% of WA Medicaid,78.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,435.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1393.11,69,,,percent of total billed charges,69% of total billed charges,2019,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2019,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,2019,100,,,percent of total billed charges,100% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1248.75,61.85,,,percent of total billed charges,61.85% of total billed charges,435.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,565.63,130,,,Fee Schedule,130% of WA Medicaid ,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,761.16,37.7,,,percent of total billed charges,37.70% of total billed charges,761.16,37.7,,,percent of total billed charges,37.70% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,68444.1,33.9,,,percent of total billed charges,33.9% of total billed charges,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1574.82,78,,,percent of total billed charges,78% of total billed charges,2019,100,,,percent of total billed charges,100% of total billed charges,1667.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1667.69,82.6,,,percent of total billed charges,82.6% of total billed charges,435.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.71,68444.1,
LYSIS OF ADHESIONS,58740,CDM,983,RC,58740,HCPCS,Outpatient,,,1883,1223.95,,1657.04,88,,,percent of total billed charges,88% of total Billed charges,98.44,100,,,Fee Schedule,100% of Medicare rate,513.81,100,,,Fee Schedule,100% of WA Medicaid,1883,100,,,percent of total billed charges,100% of total billed charges,529.22,103,,,Fee Schedule,103% of WA Medicaid,98.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,172.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,513.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1299.27,69,,,percent of total billed charges,69% of total billed charges,1883,100,,,percent of total billed charges,100% of total billed charges,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1883,100,,,percent of total billed charges,100% of total billed charges,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1883,100,,,percent of total billed charges,100% of total billed charges,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1164.64,61.85,,,percent of total billed charges,61.85% of total billed charges,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,667.95,130,,,Fee Schedule,130% of WA Medicaid ,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.89,37.7,,,percent of total billed charges,37.70% of total billed charges,709.89,37.7,,,percent of total billed charges,37.70% of total billed charges,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,63833.7,33.9,,,percent of total billed charges,33.9% of total billed charges,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1468.74,78,,,percent of total billed charges,78% of total billed charges,1883,100,,,percent of total billed charges,100% of total billed charges,1555.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1555.36,82.6,,,percent of total billed charges,82.6% of total billed charges,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.44,63833.7,
BIOPSY OF OVARY(S),58900,CDM,983,RC,58900,HCPCS,Outpatient,,,1915,1244.75,,1685.2,88,,,percent of total billed charges,88% of total Billed charges,42.59,100,,,Fee Schedule,100% of Medicare rate,252.15,100,,,Fee Schedule,100% of WA Medicaid,1915,100,,,percent of total billed charges,100% of total billed charges,259.71,103,,,Fee Schedule,103% of WA Medicaid,42.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,252.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1321.35,69,,,percent of total billed charges,69% of total billed charges,1915,100,,,percent of total billed charges,100% of total billed charges,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1915,100,,,percent of total billed charges,100% of total billed charges,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1915,100,,,percent of total billed charges,100% of total billed charges,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1184.43,61.85,,,percent of total billed charges,61.85% of total billed charges,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,327.8,130,,,Fee Schedule,130% of WA Medicaid ,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,721.96,37.7,,,percent of total billed charges,37.70% of total billed charges,721.96,37.7,,,percent of total billed charges,37.70% of total billed charges,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,64918.5,33.9,,,percent of total billed charges,33.9% of total billed charges,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1493.7,78,,,percent of total billed charges,78% of total billed charges,1915,100,,,percent of total billed charges,100% of total billed charges,1581.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1581.79,82.6,,,percent of total billed charges,82.6% of total billed charges,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.59,64918.5,
REMOVAL OF OVARIAN CYST(S),58925,CDM,983,RC,58925,HCPCS,Outpatient,,,2506,1628.90,,2205.28,88,,,percent of total billed charges,88% of total Billed charges,83.53,100,,,Fee Schedule,100% of Medicare rate,437.9,100,,,Fee Schedule,100% of WA Medicaid,2506,100,,,percent of total billed charges,100% of total billed charges,451.04,103,,,Fee Schedule,103% of WA Medicaid,83.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,146.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,437.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1729.14,69,,,percent of total billed charges,69% of total billed charges,2506,100,,,percent of total billed charges,100% of total billed charges,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2506,100,,,percent of total billed charges,100% of total billed charges,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2506,100,,,percent of total billed charges,100% of total billed charges,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1549.96,61.85,,,percent of total billed charges,61.85% of total billed charges,437.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,437.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,569.27,130,,,Fee Schedule,130% of WA Medicaid ,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,944.76,37.7,,,percent of total billed charges,37.70% of total billed charges,944.76,37.7,,,percent of total billed charges,37.70% of total billed charges,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,84953.4,33.9,,,percent of total billed charges,33.9% of total billed charges,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1954.68,78,,,percent of total billed charges,78% of total billed charges,2506,100,,,percent of total billed charges,100% of total billed charges,2069.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2069.96,82.6,,,percent of total billed charges,82.6% of total billed charges,437.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,437.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.53,84953.4,
REMOVAL OF OVARY(S),58940,CDM,983,RC,58940,HCPCS,Outpatient,,,2276,1479.40,,2002.88,88,,,percent of total billed charges,88% of total Billed charges,57.28,100,,,Fee Schedule,100% of Medicare rate,319.29,100,,,Fee Schedule,100% of WA Medicaid,2276,100,,,percent of total billed charges,100% of total billed charges,328.87,103,,,Fee Schedule,103% of WA Medicaid,57.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,319.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1570.44,69,,,percent of total billed charges,69% of total billed charges,2276,100,,,percent of total billed charges,100% of total billed charges,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2276,100,,,percent of total billed charges,100% of total billed charges,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2276,100,,,percent of total billed charges,100% of total billed charges,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1407.71,61.85,,,percent of total billed charges,61.85% of total billed charges,319.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,415.08,130,,,Fee Schedule,130% of WA Medicaid ,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,858.05,37.7,,,percent of total billed charges,37.70% of total billed charges,858.05,37.7,,,percent of total billed charges,37.70% of total billed charges,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,77156.4,33.9,,,percent of total billed charges,33.9% of total billed charges,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1775.28,78,,,percent of total billed charges,78% of total billed charges,2276,100,,,percent of total billed charges,100% of total billed charges,1879.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1879.98,82.6,,,percent of total billed charges,82.6% of total billed charges,319.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.28,77156.4,
REMOVAL OF OVARY(S),58943,CDM,983,RC,58943,HCPCS,Outpatient,,,2637,1714.05,,2320.56,88,,,percent of total billed charges,88% of total Billed charges,122.07,100,,,Fee Schedule,100% of Medicare rate,686.69,100,,,Fee Schedule,100% of WA Medicaid,2637,100,,,percent of total billed charges,100% of total billed charges,707.29,103,,,Fee Schedule,103% of WA Medicaid,122.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,213.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,686.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1819.53,69,,,percent of total billed charges,69% of total billed charges,2637,100,,,percent of total billed charges,100% of total billed charges,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2637,100,,,percent of total billed charges,100% of total billed charges,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2637,100,,,percent of total billed charges,100% of total billed charges,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1630.98,61.85,,,percent of total billed charges,61.85% of total billed charges,686.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,892.7,130,,,Fee Schedule,130% of WA Medicaid ,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,994.15,37.7,,,percent of total billed charges,37.70% of total billed charges,994.15,37.7,,,percent of total billed charges,37.70% of total billed charges,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,89394.3,33.9,,,percent of total billed charges,33.9% of total billed charges,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,2056.86,78,,,percent of total billed charges,78% of total billed charges,2637,100,,,percent of total billed charges,100% of total billed charges,2178.16,82.6,,,percent of total billed charges,82.6% of total billed charges,2178.16,82.6,,,percent of total billed charges,82.6% of total billed charges,686.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,122.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,686.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,122.07,89394.3,
EXPLORATION OF ABDOMEN,58960,CDM,983,RC,58960,HCPCS,Outpatient,,,2163,1405.95,,1903.44,88,,,percent of total billed charges,88% of total Billed charges,99.4,100,,,Fee Schedule,100% of Medicare rate,571.81,100,,,Fee Schedule,100% of WA Medicaid,2163,100,,,percent of total billed charges,100% of total billed charges,588.96,103,,,Fee Schedule,103% of WA Medicaid,99.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,571.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1492.47,69,,,percent of total billed charges,69% of total billed charges,2163,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2163,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2163,100,,,percent of total billed charges,100% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1337.82,61.85,,,percent of total billed charges,61.85% of total billed charges,571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,743.35,130,,,Fee Schedule,130% of WA Medicaid ,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.45,37.7,,,percent of total billed charges,37.70% of total billed charges,815.45,37.7,,,percent of total billed charges,37.70% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,73325.7,33.9,,,percent of total billed charges,33.9% of total billed charges,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1687.14,78,,,percent of total billed charges,78% of total billed charges,2163,100,,,percent of total billed charges,100% of total billed charges,1786.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1786.64,82.6,,,percent of total billed charges,82.6% of total billed charges,571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,99.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,99.4,73325.7,
AMNIOCENTESIS THERAPEUTIC,59001,CDM,983,RC,59001,HCPCS,Outpatient,,,375,243.75,,330,88,,,percent of total billed charges,88% of total Billed charges,29.1,100,,,Fee Schedule,100% of Medicare rate,174.66,100,,,Fee Schedule,100% of WA Medicaid,375,100,,,percent of total billed charges,100% of total billed charges,179.9,103,,,Fee Schedule,103% of WA Medicaid,29.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,50.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,174.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,258.75,69,,,percent of total billed charges,69% of total billed charges,375,100,,,percent of total billed charges,100% of total billed charges,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,375,100,,,percent of total billed charges,100% of total billed charges,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,375,100,,,percent of total billed charges,100% of total billed charges,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.94,61.85,,,percent of total billed charges,61.85% of total billed charges,174.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,227.06,130,,,Fee Schedule,130% of WA Medicaid ,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.38,37.7,,,percent of total billed charges,37.70% of total billed charges,141.38,37.7,,,percent of total billed charges,37.70% of total billed charges,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,12712.5,33.9,,,percent of total billed charges,33.9% of total billed charges,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.5,78,,,percent of total billed charges,78% of total billed charges,375,100,,,percent of total billed charges,100% of total billed charges,309.75,82.6,,,percent of total billed charges,82.6% of total billed charges,309.75,82.6,,,percent of total billed charges,82.6% of total billed charges,174.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.1,12712.5,
AMNIOCENTESIS DIAGNOSTIC,59000,CDM,983,RC,59000,HCPCS,Outpatient,,,532,345.80,,468.16,88,,,percent of total billed charges,88% of total Billed charges,12.76,100,,,Fee Schedule,100% of Medicare rate,79.54,100,,,Fee Schedule,100% of WA Medicaid,532,100,,,percent of total billed charges,100% of total billed charges,81.93,103,,,Fee Schedule,103% of WA Medicaid,12.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,79.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,367.08,69,,,percent of total billed charges,69% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,532,100,,,percent of total billed charges,100% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,532,100,,,percent of total billed charges,100% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.04,61.85,,,percent of total billed charges,61.85% of total billed charges,79.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,103.4,130,,,Fee Schedule,130% of WA Medicaid ,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,18034.8,33.9,,,percent of total billed charges,33.9% of total billed charges,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.96,78,,,percent of total billed charges,78% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,79.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.76,18034.8,
FETAL CORD PUNCTURE PRENATAL,59012,CDM,983,RC,59012,HCPCS,Outpatient,,,764,496.60,,672.32,88,,,percent of total billed charges,88% of total Billed charges,33.67,100,,,Fee Schedule,100% of Medicare rate,197.22,100,,,Fee Schedule,100% of WA Medicaid,764,100,,,percent of total billed charges,100% of total billed charges,203.14,103,,,Fee Schedule,103% of WA Medicaid,33.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,197.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,527.16,69,,,percent of total billed charges,69% of total billed charges,764,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,764,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,764,100,,,percent of total billed charges,100% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,472.53,61.85,,,percent of total billed charges,61.85% of total billed charges,197.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,256.39,130,,,Fee Schedule,130% of WA Medicaid ,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.03,37.7,,,percent of total billed charges,37.70% of total billed charges,288.03,37.7,,,percent of total billed charges,37.70% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,25899.6,33.9,,,percent of total billed charges,33.9% of total billed charges,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,595.92,78,,,percent of total billed charges,78% of total billed charges,764,100,,,percent of total billed charges,100% of total billed charges,631.06,82.6,,,percent of total billed charges,82.6% of total billed charges,631.06,82.6,,,percent of total billed charges,82.6% of total billed charges,197.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.67,25899.6,
CHORION BIOPSY,59015,CDM,983,RC,59015,HCPCS,Outpatient,,,678,440.70,,596.64,88,,,percent of total billed charges,88% of total Billed charges,21.5,100,,,Fee Schedule,100% of Medicare rate,128.96,100,,,Fee Schedule,100% of WA Medicaid,678,100,,,percent of total billed charges,100% of total billed charges,132.83,103,,,Fee Schedule,103% of WA Medicaid,21.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,128.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,467.82,69,,,percent of total billed charges,69% of total billed charges,678,100,,,percent of total billed charges,100% of total billed charges,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,678,100,,,percent of total billed charges,100% of total billed charges,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,678,100,,,percent of total billed charges,100% of total billed charges,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.34,61.85,,,percent of total billed charges,61.85% of total billed charges,128.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,167.65,130,,,Fee Schedule,130% of WA Medicaid ,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.61,37.7,,,percent of total billed charges,37.70% of total billed charges,255.61,37.7,,,percent of total billed charges,37.70% of total billed charges,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,22984.2,33.9,,,percent of total billed charges,33.9% of total billed charges,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.84,78,,,percent of total billed charges,78% of total billed charges,678,100,,,percent of total billed charges,100% of total billed charges,560.03,82.6,,,percent of total billed charges,82.6% of total billed charges,560.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.5,22984.2,
FETAL CONTRACT STRESS TEST,59020,CDM,983,RC,59020,HCPCS,Outpatient,,,204,132.60,,179.52,88,,,percent of total billed charges,88% of total Billed charges,7.1,100,,,Fee Schedule,100% of Medicare rate,35.94,100,,,Fee Schedule,100% of WA Medicaid,204,100,,,percent of total billed charges,100% of total billed charges,37.02,103,,,Fee Schedule,103% of WA Medicaid,7.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,140.76,69,,,percent of total billed charges,69% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,204,100,,,percent of total billed charges,100% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,204,100,,,percent of total billed charges,100% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.17,61.85,,,percent of total billed charges,61.85% of total billed charges,35.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.72,130,,,Fee Schedule,130% of WA Medicaid ,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.91,37.7,,,percent of total billed charges,37.70% of total billed charges,76.91,37.7,,,percent of total billed charges,37.70% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,6915.6,33.9,,,percent of total billed charges,33.9% of total billed charges,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.12,78,,,percent of total billed charges,78% of total billed charges,204,100,,,percent of total billed charges,100% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,168.5,82.6,,,percent of total billed charges,82.6% of total billed charges,35.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.1,6915.6,
FETAL NON-STRESS TEST,59025,CDM,983,RC,59025,HCPCS,Outpatient,,,189,122.85,,166.32,88,,,percent of total billed charges,88% of total Billed charges,5.12,100,,,Fee Schedule,100% of Medicare rate,28.51,100,,,Fee Schedule,100% of WA Medicaid,189,100,,,percent of total billed charges,100% of total billed charges,29.37,103,,,Fee Schedule,103% of WA Medicaid,5.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,130.41,69,,,percent of total billed charges,69% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,189,100,,,percent of total billed charges,100% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,189,100,,,percent of total billed charges,100% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.9,61.85,,,percent of total billed charges,61.85% of total billed charges,28.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.06,130,,,Fee Schedule,130% of WA Medicaid ,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,71.25,37.7,,,percent of total billed charges,37.70% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,6407.1,33.9,,,percent of total billed charges,33.9% of total billed charges,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.42,78,,,percent of total billed charges,78% of total billed charges,189,100,,,percent of total billed charges,100% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,156.11,82.6,,,percent of total billed charges,82.6% of total billed charges,28.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.12,6407.1,
FETAL MONITOR W/REPORT,59050,CDM,983,RC,59050,HCPCS,Outpatient,,,202,131.30,,177.76,88,,,percent of total billed charges,88% of total Billed charges,8.2,100,,,Fee Schedule,100% of Medicare rate,48.55,100,,,Fee Schedule,100% of WA Medicaid,202,100,,,percent of total billed charges,100% of total billed charges,50.01,103,,,Fee Schedule,103% of WA Medicaid,8.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,139.38,69,,,percent of total billed charges,69% of total billed charges,202,100,,,percent of total billed charges,100% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,202,100,,,percent of total billed charges,100% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,202,100,,,percent of total billed charges,100% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.94,61.85,,,percent of total billed charges,61.85% of total billed charges,48.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.12,130,,,Fee Schedule,130% of WA Medicaid ,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.15,37.7,,,percent of total billed charges,37.70% of total billed charges,76.15,37.7,,,percent of total billed charges,37.70% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,6847.8,33.9,,,percent of total billed charges,33.9% of total billed charges,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.56,78,,,percent of total billed charges,78% of total billed charges,202,100,,,percent of total billed charges,100% of total billed charges,166.85,82.6,,,percent of total billed charges,82.6% of total billed charges,166.85,82.6,,,percent of total billed charges,82.6% of total billed charges,48.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.2,6847.8,
SURGICAL TRTMT OF ECTOPIC PREGNANCY,59120,CDM,983,RC,59120,HCPCS,Outpatient,,,1889,1227.85,,1662.32,88,,,percent of total billed charges,88% of total Billed charges,125.01,100,,,Fee Schedule,100% of Medicare rate,812.64,100,,,Fee Schedule,100% of WA Medicaid,1889,100,,,percent of total billed charges,100% of total billed charges,837.02,103,,,Fee Schedule,103% of WA Medicaid,125.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,218.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,812.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1303.41,69,,,percent of total billed charges,69% of total billed charges,1889,100,,,percent of total billed charges,100% of total billed charges,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1889,100,,,percent of total billed charges,100% of total billed charges,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1889,100,,,percent of total billed charges,100% of total billed charges,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1168.35,61.85,,,percent of total billed charges,61.85% of total billed charges,812.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,812.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,828.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1056.43,130,,,Fee Schedule,130% of WA Medicaid ,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.15,37.7,,,percent of total billed charges,37.70% of total billed charges,712.15,37.7,,,percent of total billed charges,37.70% of total billed charges,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,64037.1,33.9,,,percent of total billed charges,33.9% of total billed charges,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1473.42,78,,,percent of total billed charges,78% of total billed charges,1889,100,,,percent of total billed charges,100% of total billed charges,1560.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1560.31,82.6,,,percent of total billed charges,82.6% of total billed charges,812.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,125.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,812.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,125.01,64037.1,
LAP TRTMT OF ECTOPIC PREG W/SALPIN OR OO,59151,CDM,983,RC,59151,HCPCS,Outpatient,,,3352,2178.80,,2949.76,88,,,percent of total billed charges,88% of total Billed charges,119.35,100,,,Fee Schedule,100% of Medicare rate,770.98,100,,,Fee Schedule,100% of WA Medicaid,3352,100,,,percent of total billed charges,100% of total billed charges,794.11,103,,,Fee Schedule,103% of WA Medicaid,119.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,208.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,770.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2312.88,69,,,percent of total billed charges,69% of total billed charges,3352,100,,,percent of total billed charges,100% of total billed charges,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3352,100,,,percent of total billed charges,100% of total billed charges,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3352,100,,,percent of total billed charges,100% of total billed charges,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2073.21,61.85,,,percent of total billed charges,61.85% of total billed charges,770.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,770.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,786.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1002.27,130,,,Fee Schedule,130% of WA Medicaid ,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1263.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1263.7,37.7,,,percent of total billed charges,37.70% of total billed charges,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,113632.8,33.9,,,percent of total billed charges,33.9% of total billed charges,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2614.56,78,,,percent of total billed charges,78% of total billed charges,3352,100,,,percent of total billed charges,100% of total billed charges,2768.75,82.6,,,percent of total billed charges,82.6% of total billed charges,2768.75,82.6,,,percent of total billed charges,82.6% of total billed charges,770.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,119.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,770.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.35,113632.8,
TREAT ECTOPIC PREGNANCY,59150,CDM,983,RC,59150,HCPCS,Outpatient,,,3236,2103.40,,2847.68,88,,,percent of total billed charges,88% of total Billed charges,121.17,100,,,Fee Schedule,100% of Medicare rate,788.38,100,,,Fee Schedule,100% of WA Medicaid,3236,100,,,percent of total billed charges,100% of total billed charges,812.03,103,,,Fee Schedule,103% of WA Medicaid,121.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,212.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,788.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2232.84,69,,,percent of total billed charges,69% of total billed charges,3236,100,,,percent of total billed charges,100% of total billed charges,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3236,100,,,percent of total billed charges,100% of total billed charges,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3236,100,,,percent of total billed charges,100% of total billed charges,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2001.47,61.85,,,percent of total billed charges,61.85% of total billed charges,788.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,788.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1024.89,130,,,Fee Schedule,130% of WA Medicaid ,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1219.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1219.97,37.7,,,percent of total billed charges,37.70% of total billed charges,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,109700.4,33.9,,,percent of total billed charges,33.9% of total billed charges,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2524.08,78,,,percent of total billed charges,78% of total billed charges,3236,100,,,percent of total billed charges,100% of total billed charges,2672.94,82.6,,,percent of total billed charges,82.6% of total billed charges,2672.94,82.6,,,percent of total billed charges,82.6% of total billed charges,788.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,788.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.17,109700.4,
D  C AFTER DELIVERY,59160,CDM,983,RC,59160,HCPCS,Outpatient,,,1074,698.10,,945.12,88,,,percent of total billed charges,88% of total Billed charges,27.69,100,,,Fee Schedule,100% of Medicare rate,188.28,100,,,Fee Schedule,100% of WA Medicaid,1074,100,,,percent of total billed charges,100% of total billed charges,193.93,103,,,Fee Schedule,103% of WA Medicaid,27.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,188.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,741.06,69,,,percent of total billed charges,69% of total billed charges,1074,100,,,percent of total billed charges,100% of total billed charges,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074,100,,,percent of total billed charges,100% of total billed charges,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074,100,,,percent of total billed charges,100% of total billed charges,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.27,61.85,,,percent of total billed charges,61.85% of total billed charges,188.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,244.76,130,,,Fee Schedule,130% of WA Medicaid ,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.9,37.7,,,percent of total billed charges,37.70% of total billed charges,404.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,36408.6,33.9,,,percent of total billed charges,33.9% of total billed charges,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,837.72,78,,,percent of total billed charges,78% of total billed charges,1074,100,,,percent of total billed charges,100% of total billed charges,887.12,82.6,,,percent of total billed charges,82.6% of total billed charges,887.12,82.6,,,percent of total billed charges,82.6% of total billed charges,188.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.69,36408.6,
INSERT CERVICAL DILATOR,59200,CDM,983,RC,59200,HCPCS,Outpatient,,,274,178.10,,241.12,88,,,percent of total billed charges,88% of total Billed charges,7.27,100,,,Fee Schedule,100% of Medicare rate,43.36,100,,,Fee Schedule,100% of WA Medicaid,274,100,,,percent of total billed charges,100% of total billed charges,44.66,103,,,Fee Schedule,103% of WA Medicaid,7.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,43.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,189.06,69,,,percent of total billed charges,69% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,274,100,,,percent of total billed charges,100% of total billed charges,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,274,100,,,percent of total billed charges,100% of total billed charges,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.47,61.85,,,percent of total billed charges,61.85% of total billed charges,43.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,56.37,130,,,Fee Schedule,130% of WA Medicaid ,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.3,37.7,,,percent of total billed charges,37.70% of total billed charges,103.3,37.7,,,percent of total billed charges,37.70% of total billed charges,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,9288.6,33.9,,,percent of total billed charges,33.9% of total billed charges,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.72,78,,,percent of total billed charges,78% of total billed charges,274,100,,,percent of total billed charges,100% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,226.32,82.6,,,percent of total billed charges,82.6% of total billed charges,43.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.27,9288.6,
EPISIOTOMY OR VAGINAL REPAIR,59300,CDM,983,RC,59300,HCPCS,Outpatient,,,580,377.00,,510.4,88,,,percent of total billed charges,88% of total Billed charges,23.56,100,,,Fee Schedule,100% of Medicare rate,145.57,100,,,Fee Schedule,100% of WA Medicaid,580,100,,,percent of total billed charges,100% of total billed charges,149.94,103,,,Fee Schedule,103% of WA Medicaid,23.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,145.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,400.2,69,,,percent of total billed charges,69% of total billed charges,580,100,,,percent of total billed charges,100% of total billed charges,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,580,100,,,percent of total billed charges,100% of total billed charges,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,580,100,,,percent of total billed charges,100% of total billed charges,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.73,61.85,,,percent of total billed charges,61.85% of total billed charges,145.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,189.24,130,,,Fee Schedule,130% of WA Medicaid ,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.66,37.7,,,percent of total billed charges,37.70% of total billed charges,218.66,37.7,,,percent of total billed charges,37.70% of total billed charges,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,19662,33.9,,,percent of total billed charges,33.9% of total billed charges,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.4,78,,,percent of total billed charges,78% of total billed charges,580,100,,,percent of total billed charges,100% of total billed charges,479.08,82.6,,,percent of total billed charges,82.6% of total billed charges,479.08,82.6,,,percent of total billed charges,82.6% of total billed charges,145.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.56,19662,
REVISION OF CERVIX,59320,CDM,983,RC,59320,HCPCS,Outpatient,,,1363,885.95,,1199.44,88,,,percent of total billed charges,88% of total Billed charges,23.93,100,,,Fee Schedule,100% of Medicare rate,149.22,100,,,Fee Schedule,100% of WA Medicaid,1363,100,,,percent of total billed charges,100% of total billed charges,153.7,103,,,Fee Schedule,103% of WA Medicaid,23.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,149.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,940.47,69,,,percent of total billed charges,69% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1363,100,,,percent of total billed charges,100% of total billed charges,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1363,100,,,percent of total billed charges,100% of total billed charges,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,843.02,61.85,,,percent of total billed charges,61.85% of total billed charges,149.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,193.99,130,,,Fee Schedule,130% of WA Medicaid ,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,513.85,37.7,,,percent of total billed charges,37.70% of total billed charges,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,46205.7,33.9,,,percent of total billed charges,33.9% of total billed charges,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.14,78,,,percent of total billed charges,78% of total billed charges,1363,100,,,percent of total billed charges,100% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1125.84,82.6,,,percent of total billed charges,82.6% of total billed charges,149.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.93,46205.7,
REPAIR OF UTERUS,59350,CDM,983,RC,59350,HCPCS,Outpatient,,,1481,962.65,,1303.28,88,,,percent of total billed charges,88% of total Billed charges,47.58,100,,,Fee Schedule,100% of Medicare rate,272,100,,,Fee Schedule,100% of WA Medicaid,1481,100,,,percent of total billed charges,100% of total billed charges,280.16,103,,,Fee Schedule,103% of WA Medicaid,47.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,272,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1021.89,69,,,percent of total billed charges,69% of total billed charges,1481,100,,,percent of total billed charges,100% of total billed charges,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1481,100,,,percent of total billed charges,100% of total billed charges,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1481,100,,,percent of total billed charges,100% of total billed charges,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,916,61.85,,,percent of total billed charges,61.85% of total billed charges,272,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,272,100,,,Fee Schedule,100% of WA Medicare OPPS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,353.6,130,,,Fee Schedule,130% of WA Medicaid ,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,558.34,37.7,,,percent of total billed charges,37.70% of total billed charges,558.34,37.7,,,percent of total billed charges,37.70% of total billed charges,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,50205.9,33.9,,,percent of total billed charges,33.9% of total billed charges,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1155.18,78,,,percent of total billed charges,78% of total billed charges,1481,100,,,percent of total billed charges,100% of total billed charges,1223.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1223.31,82.6,,,percent of total billed charges,82.6% of total billed charges,272,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,47.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,272,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,47.58,50205.9,
OBSTETRICAL CARE,59400,CDM,983,RC,59400,HCPCS,Outpatient,,,4166,2707.90,,3666.08,88,,,percent of total billed charges,88% of total Billed charges,336.74,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,4166,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,336.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,589.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2874.54,69,,,percent of total billed charges,69% of total billed charges,4166,100,,,percent of total billed charges,100% of total billed charges,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4166,100,,,percent of total billed charges,100% of total billed charges,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4166,100,,,percent of total billed charges,100% of total billed charges,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2576.67,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,1570.58,37.7,,,percent of total billed charges,37.70% of total billed charges,1570.58,37.7,,,percent of total billed charges,37.70% of total billed charges,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,141227.4,33.9,,,percent of total billed charges,33.9% of total billed charges,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3249.48,78,,,percent of total billed charges,78% of total billed charges,4166,100,,,percent of total billed charges,100% of total billed charges,3441.12,82.6,,,percent of total billed charges,82.6% of total billed charges,3441.12,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,336.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,282.81,141227.4,
OBSTETRICAL CARE,59409,CDM,983,RC,59409,HCPCS,Outpatient,,,2451,1593.15,,2156.88,88,,,percent of total billed charges,88% of total Billed charges,124.94,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,2451,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,124.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,218.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1691.19,69,,,percent of total billed charges,69% of total billed charges,2451,100,,,percent of total billed charges,100% of total billed charges,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2451,100,,,percent of total billed charges,100% of total billed charges,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2451,100,,,percent of total billed charges,100% of total billed charges,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1515.94,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,924.03,37.7,,,percent of total billed charges,37.70% of total billed charges,924.03,37.7,,,percent of total billed charges,37.70% of total billed charges,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,83088.9,33.9,,,percent of total billed charges,33.9% of total billed charges,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1911.78,78,,,percent of total billed charges,78% of total billed charges,2451,100,,,percent of total billed charges,100% of total billed charges,2024.53,82.6,,,percent of total billed charges,82.6% of total billed charges,2024.53,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,124.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.94,83088.9,
ANTEPARTUM MANIPULATION,59412,CDM,983,RC,59412,HCPCS,Outpatient,,,656,426.40,,577.28,88,,,percent of total billed charges,88% of total Billed charges,16.52,100,,,Fee Schedule,100% of Medicare rate,100.99,100,,,Fee Schedule,100% of WA Medicaid,656,100,,,percent of total billed charges,100% of total billed charges,104.02,103,,,Fee Schedule,103% of WA Medicaid,16.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,100.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,452.64,69,,,percent of total billed charges,69% of total billed charges,656,100,,,percent of total billed charges,100% of total billed charges,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,656,100,,,percent of total billed charges,100% of total billed charges,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,656,100,,,percent of total billed charges,100% of total billed charges,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.74,61.85,,,percent of total billed charges,61.85% of total billed charges,100.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,131.29,130,,,Fee Schedule,130% of WA Medicaid ,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.31,37.7,,,percent of total billed charges,37.70% of total billed charges,247.31,37.7,,,percent of total billed charges,37.70% of total billed charges,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,22238.4,33.9,,,percent of total billed charges,33.9% of total billed charges,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,511.68,78,,,percent of total billed charges,78% of total billed charges,656,100,,,percent of total billed charges,100% of total billed charges,541.86,82.6,,,percent of total billed charges,82.6% of total billed charges,541.86,82.6,,,percent of total billed charges,82.6% of total billed charges,100.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.52,22238.4,
OBSTETRICAL CARE,59410,CDM,983,RC,59410,HCPCS,Outpatient,,,2815,1829.75,,2477.2,88,,,percent of total billed charges,88% of total Billed charges,165.49,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,2815,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,165.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,289.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1942.35,69,,,percent of total billed charges,69% of total billed charges,2815,100,,,percent of total billed charges,100% of total billed charges,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2815,100,,,percent of total billed charges,100% of total billed charges,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2815,100,,,percent of total billed charges,100% of total billed charges,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1741.08,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1061.26,37.7,,,percent of total billed charges,37.70% of total billed charges,1061.26,37.7,,,percent of total billed charges,37.70% of total billed charges,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,95428.5,33.9,,,percent of total billed charges,33.9% of total billed charges,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2195.7,78,,,percent of total billed charges,78% of total billed charges,2815,100,,,percent of total billed charges,100% of total billed charges,2325.19,82.6,,,percent of total billed charges,82.6% of total billed charges,2325.19,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,165.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,165.49,95428.5,
DELIVER PLACENTA,59414,CDM,983,RC,59414,HCPCS,Outpatient,,,598,388.70,,526.24,88,,,percent of total billed charges,88% of total Billed charges,15.36,100,,,Fee Schedule,100% of Medicare rate,88.53,100,,,Fee Schedule,100% of WA Medicaid,598,100,,,percent of total billed charges,100% of total billed charges,91.19,103,,,Fee Schedule,103% of WA Medicaid,15.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,88.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,412.62,69,,,percent of total billed charges,69% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,598,100,,,percent of total billed charges,100% of total billed charges,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,598,100,,,percent of total billed charges,100% of total billed charges,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.86,61.85,,,percent of total billed charges,61.85% of total billed charges,88.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,115.09,130,,,Fee Schedule,130% of WA Medicaid ,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,225.45,37.7,,,percent of total billed charges,37.70% of total billed charges,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,20272.2,33.9,,,percent of total billed charges,33.9% of total billed charges,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.44,78,,,percent of total billed charges,78% of total billed charges,598,100,,,percent of total billed charges,100% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,493.95,82.6,,,percent of total billed charges,82.6% of total billed charges,88.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.36,20272.2,
ANTEPARTUM CARE ONLY,59425,CDM,983,RC,59425,HCPCS,Outpatient,,,1263,820.95,,1111.44,88,,,percent of total billed charges,88% of total Billed charges,68.52,100,,,Fee Schedule,100% of Medicare rate,425.21,100,,,Fee Schedule,100% of WA Medicaid,1263,100,,,percent of total billed charges,100% of total billed charges,437.97,103,,,Fee Schedule,103% of WA Medicaid,68.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,119.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,425.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,871.47,69,,,percent of total billed charges,69% of total billed charges,1263,100,,,percent of total billed charges,100% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1263,100,,,percent of total billed charges,100% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1263,100,,,percent of total billed charges,100% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,781.17,61.85,,,percent of total billed charges,61.85% of total billed charges,425.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,552.77,130,,,Fee Schedule,130% of WA Medicaid ,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,476.15,37.7,,,percent of total billed charges,37.70% of total billed charges,476.15,37.7,,,percent of total billed charges,37.70% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,42815.7,33.9,,,percent of total billed charges,33.9% of total billed charges,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,985.14,78,,,percent of total billed charges,78% of total billed charges,1263,100,,,percent of total billed charges,100% of total billed charges,1043.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1043.24,82.6,,,percent of total billed charges,82.6% of total billed charges,425.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.52,42815.7,
ANTEPARTUM CARE ONLY,59426,CDM,983,RC,59426,HCPCS,Outpatient,,,2259,1468.35,,1987.92,88,,,percent of total billed charges,88% of total Billed charges,126.64,100,,,Fee Schedule,100% of Medicare rate,780.63,100,,,Fee Schedule,100% of WA Medicaid,2259,100,,,percent of total billed charges,100% of total billed charges,804.05,103,,,Fee Schedule,103% of WA Medicaid,126.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,221.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,780.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1558.71,69,,,percent of total billed charges,69% of total billed charges,2259,100,,,percent of total billed charges,100% of total billed charges,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2259,100,,,percent of total billed charges,100% of total billed charges,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2259,100,,,percent of total billed charges,100% of total billed charges,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1397.19,61.85,,,percent of total billed charges,61.85% of total billed charges,780.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,796.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1014.82,130,,,Fee Schedule,130% of WA Medicaid ,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.64,37.7,,,percent of total billed charges,37.70% of total billed charges,851.64,37.7,,,percent of total billed charges,37.70% of total billed charges,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,76580.1,33.9,,,percent of total billed charges,33.9% of total billed charges,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1762.02,78,,,percent of total billed charges,78% of total billed charges,2259,100,,,percent of total billed charges,100% of total billed charges,1865.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1865.93,82.6,,,percent of total billed charges,82.6% of total billed charges,780.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,126.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.64,76580.1,
CARE AFTER DELIVERY,59430,CDM,983,RC,59430,HCPCS,Outpatient,,,493,320.45,,433.84,88,,,percent of total billed charges,88% of total Billed charges,28.62,100,,,Fee Schedule,100% of Medicare rate,175.96,100,,,Fee Schedule,100% of WA Medicaid,493,100,,,percent of total billed charges,100% of total billed charges,181.24,103,,,Fee Schedule,103% of WA Medicaid,28.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,50.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,175.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,340.17,69,,,percent of total billed charges,69% of total billed charges,493,100,,,percent of total billed charges,100% of total billed charges,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,493,100,,,percent of total billed charges,100% of total billed charges,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,493,100,,,percent of total billed charges,100% of total billed charges,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.92,61.85,,,percent of total billed charges,61.85% of total billed charges,175.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,228.75,130,,,Fee Schedule,130% of WA Medicaid ,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.86,37.7,,,percent of total billed charges,37.70% of total billed charges,185.86,37.7,,,percent of total billed charges,37.70% of total billed charges,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,16712.7,33.9,,,percent of total billed charges,33.9% of total billed charges,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.54,78,,,percent of total billed charges,78% of total billed charges,493,100,,,percent of total billed charges,100% of total billed charges,407.22,82.6,,,percent of total billed charges,82.6% of total billed charges,407.22,82.6,,,percent of total billed charges,82.6% of total billed charges,175.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.62,16712.7,
ROUTINE OB CARE W/ C-SECT + PP CARE,59510,CDM,983,RC,59510,HCPCS,Outpatient,,,4362,2835.30,,3838.56,88,,,percent of total billed charges,88% of total Billed charges,403.93,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,4362,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,403.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,706.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3009.78,69,,,percent of total billed charges,69% of total billed charges,4362,100,,,percent of total billed charges,100% of total billed charges,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4362,100,,,percent of total billed charges,100% of total billed charges,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4362,100,,,percent of total billed charges,100% of total billed charges,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2697.9,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1644.47,37.7,,,percent of total billed charges,37.70% of total billed charges,1644.47,37.7,,,percent of total billed charges,37.70% of total billed charges,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,147871.8,33.9,,,percent of total billed charges,33.9% of total billed charges,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3402.36,78,,,percent of total billed charges,78% of total billed charges,4362,100,,,percent of total billed charges,100% of total billed charges,3603.01,82.6,,,percent of total billed charges,82.6% of total billed charges,3603.01,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,403.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,282.81,147871.8,
CESAREAN DELIVERY,59515,CDM,983,RC,59515,HCPCS,Outpatient,,,3436,2233.40,,3023.68,88,,,percent of total billed charges,88% of total Billed charges,218.24,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,3436,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,218.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,381.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2370.84,69,,,percent of total billed charges,69% of total billed charges,3436,100,,,percent of total billed charges,100% of total billed charges,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,3436,100,,,percent of total billed charges,100% of total billed charges,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,3436,100,,,percent of total billed charges,100% of total billed charges,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2125.17,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1295.37,37.7,,,percent of total billed charges,37.70% of total billed charges,1295.37,37.7,,,percent of total billed charges,37.70% of total billed charges,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,116480.4,33.9,,,percent of total billed charges,33.9% of total billed charges,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2680.08,78,,,percent of total billed charges,78% of total billed charges,3436,100,,,percent of total billed charges,100% of total billed charges,2838.14,82.6,,,percent of total billed charges,82.6% of total billed charges,2838.14,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,218.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,218.24,116480.4,
REMOVE UTERUS AFTER CESAREAN,59525,CDM,983,RC,59525,HCPCS,Outpatient,,,2240,1456.00,,1971.2,88,,,percent of total billed charges,88% of total Billed charges,82.04,100,,,Fee Schedule,100% of Medicare rate,469.86,100,,,Fee Schedule,100% of WA Medicaid,2240,100,,,percent of total billed charges,100% of total billed charges,483.96,103,,,Fee Schedule,103% of WA Medicaid,82.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,143.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,469.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1545.6,69,,,percent of total billed charges,69% of total billed charges,2240,100,,,percent of total billed charges,100% of total billed charges,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2240,100,,,percent of total billed charges,100% of total billed charges,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2240,100,,,percent of total billed charges,100% of total billed charges,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385.44,61.85,,,percent of total billed charges,61.85% of total billed charges,469.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,610.82,130,,,Fee Schedule,130% of WA Medicaid ,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,844.48,37.7,,,percent of total billed charges,37.70% of total billed charges,844.48,37.7,,,percent of total billed charges,37.70% of total billed charges,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,75936,33.9,,,percent of total billed charges,33.9% of total billed charges,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1747.2,78,,,percent of total billed charges,78% of total billed charges,2240,100,,,percent of total billed charges,100% of total billed charges,1850.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1850.24,82.6,,,percent of total billed charges,82.6% of total billed charges,469.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.04,75936,
VBAC CARE AFTER DELIVERY,59614,CDM,983,RC,59614,HCPCS,Outpatient,,,3335,2167.75,,2934.8,88,,,percent of total billed charges,88% of total Billed charges,196.96,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,3335,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,196.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,344.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2301.15,69,,,percent of total billed charges,69% of total billed charges,3335,100,,,percent of total billed charges,100% of total billed charges,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3335,100,,,percent of total billed charges,100% of total billed charges,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3335,100,,,percent of total billed charges,100% of total billed charges,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2062.7,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1257.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1257.3,37.7,,,percent of total billed charges,37.70% of total billed charges,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,113056.5,33.9,,,percent of total billed charges,33.9% of total billed charges,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2601.3,78,,,percent of total billed charges,78% of total billed charges,3335,100,,,percent of total billed charges,100% of total billed charges,2754.71,82.6,,,percent of total billed charges,82.6% of total billed charges,2754.71,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,196.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,196.96,113056.5,
ATTEMPTED VBAC DELIVERY,59618,CDM,983,RC,59618,HCPCS,Outpatient,,,5223,3394.95,,4596.24,88,,,percent of total billed charges,88% of total Billed charges,412.27,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,5223,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,412.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,721.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3603.87,69,,,percent of total billed charges,69% of total billed charges,5223,100,,,percent of total billed charges,100% of total billed charges,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,5223,100,,,percent of total billed charges,100% of total billed charges,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,5223,100,,,percent of total billed charges,100% of total billed charges,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3230.43,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1969.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1969.07,37.7,,,percent of total billed charges,37.70% of total billed charges,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,177059.7,33.9,,,percent of total billed charges,33.9% of total billed charges,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,4073.94,78,,,percent of total billed charges,78% of total billed charges,5223,100,,,percent of total billed charges,100% of total billed charges,4314.2,82.6,,,percent of total billed charges,82.6% of total billed charges,4314.2,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,412.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,282.81,177059.7,
VBAC DELIVERY,59610,CDM,983,RC,59610,HCPCS,Outpatient,,,4680,3042.00,,4118.4,88,,,percent of total billed charges,88% of total Billed charges,384.02,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,4680,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,384.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,672.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3229.2,69,,,percent of total billed charges,69% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4680,100,,,percent of total billed charges,100% of total billed charges,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4680,100,,,percent of total billed charges,100% of total billed charges,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2894.58,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1764.36,37.7,,,percent of total billed charges,37.70% of total billed charges,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,158652,33.9,,,percent of total billed charges,33.9% of total billed charges,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3650.4,78,,,percent of total billed charges,78% of total billed charges,4680,100,,,percent of total billed charges,100% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,3865.68,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,384.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,282.81,158652,
VBAC DELIVERY ONLY,59612,CDM,983,RC,59612,HCPCS,Outpatient,,,3074,1998.10,,2705.12,88,,,percent of total billed charges,88% of total Billed charges,154.16,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,3074,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,154.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,269.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2121.06,69,,,percent of total billed charges,69% of total billed charges,3074,100,,,percent of total billed charges,100% of total billed charges,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,3074,100,,,percent of total billed charges,100% of total billed charges,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,3074,100,,,percent of total billed charges,100% of total billed charges,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1901.27,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1158.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1158.9,37.7,,,percent of total billed charges,37.70% of total billed charges,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,104208.6,33.9,,,percent of total billed charges,33.9% of total billed charges,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2397.72,78,,,percent of total billed charges,78% of total billed charges,3074,100,,,percent of total billed charges,100% of total billed charges,2539.12,82.6,,,percent of total billed charges,82.6% of total billed charges,2539.12,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,154.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,154.16,104208.6,
ATTEMPTED VBAC DELIVERY ONLY,59620,CDM,983,RC,59620,HCPCS,Outpatient,,,3346,2174.90,,2944.48,88,,,percent of total billed charges,88% of total Billed charges,160.04,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,3346,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,160.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,280.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2308.74,69,,,percent of total billed charges,69% of total billed charges,3346,100,,,percent of total billed charges,100% of total billed charges,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3346,100,,,percent of total billed charges,100% of total billed charges,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3346,100,,,percent of total billed charges,100% of total billed charges,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2069.5,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1261.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1261.44,37.7,,,percent of total billed charges,37.70% of total billed charges,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,113429.4,33.9,,,percent of total billed charges,33.9% of total billed charges,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2609.88,78,,,percent of total billed charges,78% of total billed charges,3346,100,,,percent of total billed charges,100% of total billed charges,2763.8,82.6,,,percent of total billed charges,82.6% of total billed charges,2763.8,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,160.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,160.04,113429.4,
ATTEMPTED VBAC AFTER CARE,59622,CDM,983,RC,59622,HCPCS,Outpatient,,,3731,2425.15,,3283.28,88,,,percent of total billed charges,88% of total Billed charges,226.95,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,3731,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,226.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,397.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2574.39,69,,,percent of total billed charges,69% of total billed charges,3731,100,,,percent of total billed charges,100% of total billed charges,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,3731,100,,,percent of total billed charges,100% of total billed charges,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,3731,100,,,percent of total billed charges,100% of total billed charges,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2307.62,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1406.59,37.7,,,percent of total billed charges,37.70% of total billed charges,1406.59,37.7,,,percent of total billed charges,37.70% of total billed charges,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,126480.9,33.9,,,percent of total billed charges,33.9% of total billed charges,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2910.18,78,,,percent of total billed charges,78% of total billed charges,3731,100,,,percent of total billed charges,100% of total billed charges,3081.81,82.6,,,percent of total billed charges,82.6% of total billed charges,3081.81,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,226.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,226.95,126480.9,
"TREATMENT OF INCOMPLETE AB,ANY TRI/SURG",59812,CDM,983,RC,59812,HCPCS,Outpatient,,,763,495.95,,671.44,88,,,percent of total billed charges,88% of total Billed charges,44.26,100,,,Fee Schedule,100% of Medicare rate,308.16,100,,,Fee Schedule,100% of WA Medicaid,763,100,,,percent of total billed charges,100% of total billed charges,317.4,103,,,Fee Schedule,103% of WA Medicaid,44.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,308.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,526.47,69,,,percent of total billed charges,69% of total billed charges,763,100,,,percent of total billed charges,100% of total billed charges,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,763,100,,,percent of total billed charges,100% of total billed charges,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,763,100,,,percent of total billed charges,100% of total billed charges,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.92,61.85,,,percent of total billed charges,61.85% of total billed charges,308.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,400.61,130,,,Fee Schedule,130% of WA Medicaid ,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.65,37.7,,,percent of total billed charges,37.70% of total billed charges,287.65,37.7,,,percent of total billed charges,37.70% of total billed charges,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,25865.7,33.9,,,percent of total billed charges,33.9% of total billed charges,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,595.14,78,,,percent of total billed charges,78% of total billed charges,763,100,,,percent of total billed charges,100% of total billed charges,630.24,82.6,,,percent of total billed charges,82.6% of total billed charges,630.24,82.6,,,percent of total billed charges,82.6% of total billed charges,308.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.26,25865.7,
TREATMENT OF MISSED ABORTION 2ND TRI,59821,CDM,983,RC,59821,HCPCS,Outpatient,,,520,338.00,,457.6,88,,,percent of total billed charges,88% of total Billed charges,51.87,100,,,Fee Schedule,100% of Medicare rate,380.22,100,,,Fee Schedule,100% of WA Medicaid,520,100,,,percent of total billed charges,100% of total billed charges,391.63,103,,,Fee Schedule,103% of WA Medicaid,51.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,90.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,380.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,358.8,69,,,percent of total billed charges,69% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,520,100,,,percent of total billed charges,100% of total billed charges,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,520,100,,,percent of total billed charges,100% of total billed charges,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.62,61.85,,,percent of total billed charges,61.85% of total billed charges,380.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,494.29,130,,,Fee Schedule,130% of WA Medicaid ,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,196.04,37.7,,,percent of total billed charges,37.70% of total billed charges,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,17628,33.9,,,percent of total billed charges,33.9% of total billed charges,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.6,78,,,percent of total billed charges,78% of total billed charges,520,100,,,percent of total billed charges,100% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,429.52,82.6,,,percent of total billed charges,82.6% of total billed charges,380.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.87,17628,
CARE OF MISCARRIAGE,59820,CDM,983,RC,59820,HCPCS,Outpatient,,,1286,835.90,,1131.68,88,,,percent of total billed charges,88% of total Billed charges,49.85,100,,,Fee Schedule,100% of Medicare rate,390.55,100,,,Fee Schedule,100% of WA Medicaid,1286,100,,,percent of total billed charges,100% of total billed charges,402.27,103,,,Fee Schedule,103% of WA Medicaid,49.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,87.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,390.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,887.34,69,,,percent of total billed charges,69% of total billed charges,1286,100,,,percent of total billed charges,100% of total billed charges,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1286,100,,,percent of total billed charges,100% of total billed charges,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1286,100,,,percent of total billed charges,100% of total billed charges,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,795.39,61.85,,,percent of total billed charges,61.85% of total billed charges,390.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,507.72,130,,,Fee Schedule,130% of WA Medicaid ,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,484.82,37.7,,,percent of total billed charges,37.70% of total billed charges,484.82,37.7,,,percent of total billed charges,37.70% of total billed charges,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,43595.4,33.9,,,percent of total billed charges,33.9% of total billed charges,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1003.08,78,,,percent of total billed charges,78% of total billed charges,1286,100,,,percent of total billed charges,100% of total billed charges,1062.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1062.24,82.6,,,percent of total billed charges,82.6% of total billed charges,390.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,49.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,49.85,43595.4,
TREAT UTERUS INFECTION,59830,CDM,983,RC,59830,HCPCS,Outpatient,,,1518,986.70,,1335.84,88,,,percent of total billed charges,88% of total Billed charges,66.35,100,,,Fee Schedule,100% of Medicare rate,465.3,100,,,Fee Schedule,100% of WA Medicaid,1518,100,,,percent of total billed charges,100% of total billed charges,479.26,103,,,Fee Schedule,103% of WA Medicaid,66.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,116.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,465.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1047.42,69,,,percent of total billed charges,69% of total billed charges,1518,100,,,percent of total billed charges,100% of total billed charges,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1518,100,,,percent of total billed charges,100% of total billed charges,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1518,100,,,percent of total billed charges,100% of total billed charges,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,938.88,61.85,,,percent of total billed charges,61.85% of total billed charges,465.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,604.89,130,,,Fee Schedule,130% of WA Medicaid ,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,572.29,37.7,,,percent of total billed charges,37.70% of total billed charges,572.29,37.7,,,percent of total billed charges,37.70% of total billed charges,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,51460.2,33.9,,,percent of total billed charges,33.9% of total billed charges,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1184.04,78,,,percent of total billed charges,78% of total billed charges,1518,100,,,percent of total billed charges,100% of total billed charges,1253.87,82.6,,,percent of total billed charges,82.6% of total billed charges,1253.87,82.6,,,percent of total billed charges,82.6% of total billed charges,465.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,66.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.35,51460.2,
"INDUCED AB,BY DILATION AND CURETTAGE",59840,CDM,983,RC,59840,HCPCS,Outpatient,,,517,336.05,,454.96,88,,,percent of total billed charges,88% of total Billed charges,30.82,100,,,Fee Schedule,100% of Medicare rate,223.38,100,,,Fee Schedule,100% of WA Medicaid,517,100,,,percent of total billed charges,100% of total billed charges,230.08,103,,,Fee Schedule,103% of WA Medicaid,30.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,223.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,356.73,69,,,percent of total billed charges,69% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,517,100,,,percent of total billed charges,100% of total billed charges,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,517,100,,,percent of total billed charges,100% of total billed charges,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.76,61.85,,,percent of total billed charges,61.85% of total billed charges,223.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,227.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,290.39,130,,,Fee Schedule,130% of WA Medicaid ,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,17526.3,33.9,,,percent of total billed charges,33.9% of total billed charges,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.26,78,,,percent of total billed charges,78% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,223.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.82,17526.3,
ABORTION,59855,CDM,983,RC,59855,HCPCS,Outpatient,,,1779,1156.35,,1565.52,88,,,percent of total billed charges,88% of total Billed charges,64.09,100,,,Fee Schedule,100% of Medicare rate,424.59,100,,,Fee Schedule,100% of WA Medicaid,1779,100,,,percent of total billed charges,100% of total billed charges,437.33,103,,,Fee Schedule,103% of WA Medicaid,64.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,112.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,424.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1227.51,69,,,percent of total billed charges,69% of total billed charges,1779,100,,,percent of total billed charges,100% of total billed charges,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1779,100,,,percent of total billed charges,100% of total billed charges,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1779,100,,,percent of total billed charges,100% of total billed charges,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1100.31,61.85,,,percent of total billed charges,61.85% of total billed charges,424.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,551.97,130,,,Fee Schedule,130% of WA Medicaid ,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,670.68,37.7,,,percent of total billed charges,37.70% of total billed charges,670.68,37.7,,,percent of total billed charges,37.70% of total billed charges,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,60308.1,33.9,,,percent of total billed charges,33.9% of total billed charges,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1387.62,78,,,percent of total billed charges,78% of total billed charges,1779,100,,,percent of total billed charges,100% of total billed charges,1469.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1469.45,82.6,,,percent of total billed charges,82.6% of total billed charges,424.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.09,60308.1,
EVACUATE MOLE OF UTERUS,59870,CDM,983,RC,59870,HCPCS,Outpatient,,,1507,979.55,,1326.16,88,,,percent of total billed charges,88% of total Billed charges,68.39,100,,,Fee Schedule,100% of Medicare rate,541.91,100,,,Fee Schedule,100% of WA Medicaid,1507,100,,,percent of total billed charges,100% of total billed charges,558.17,103,,,Fee Schedule,103% of WA Medicaid,68.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,119.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,541.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1039.83,69,,,percent of total billed charges,69% of total billed charges,1507,100,,,percent of total billed charges,100% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1507,100,,,percent of total billed charges,100% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1507,100,,,percent of total billed charges,100% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,932.08,61.85,,,percent of total billed charges,61.85% of total billed charges,541.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,704.48,130,,,Fee Schedule,130% of WA Medicaid ,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,568.14,37.7,,,percent of total billed charges,37.70% of total billed charges,568.14,37.7,,,percent of total billed charges,37.70% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,51087.3,33.9,,,percent of total billed charges,33.9% of total billed charges,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1175.46,78,,,percent of total billed charges,78% of total billed charges,1507,100,,,percent of total billed charges,100% of total billed charges,1244.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1244.78,82.6,,,percent of total billed charges,82.6% of total billed charges,541.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,68.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,68.39,51087.3,
MATERNITY CARE PROCEDURE/BAKRI BALLOON,59899,CDM,983,RC,59899,HCPCS,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,200,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,6780,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",75.4,6780,
BIOPSY OF THYROID,60100,CDM,983,RC,60100,HCPCS,Outpatient,,,327,212.55,,287.76,88,,,percent of total billed charges,88% of total Billed charges,6.67,100,,,Fee Schedule,100% of Medicare rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,327,100,,,percent of total billed charges,100% of total billed charges,43.99,103,,,Fee Schedule,103% of WA Medicaid,6.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,225.63,69,,,percent of total billed charges,69% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,327,100,,,percent of total billed charges,100% of total billed charges,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,327,100,,,percent of total billed charges,100% of total billed charges,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.25,61.85,,,percent of total billed charges,61.85% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.52,130,,,Fee Schedule,130% of WA Medicaid ,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,11085.3,33.9,,,percent of total billed charges,33.9% of total billed charges,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.06,78,,,percent of total billed charges,78% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.67,11085.3,
PARTIAL THYROID EXCISION,60210,CDM,983,RC,60210,HCPCS,Outpatient,,,2293,1490.45,,2017.84,88,,,percent of total billed charges,88% of total Billed charges,80.39,100,,,Fee Schedule,100% of Medicare rate,402.84,100,,,Fee Schedule,100% of WA Medicaid,2293,100,,,percent of total billed charges,100% of total billed charges,414.93,103,,,Fee Schedule,103% of WA Medicaid,80.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,402.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1582.17,69,,,percent of total billed charges,69% of total billed charges,2293,100,,,percent of total billed charges,100% of total billed charges,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2293,100,,,percent of total billed charges,100% of total billed charges,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2293,100,,,percent of total billed charges,100% of total billed charges,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1418.22,61.85,,,percent of total billed charges,61.85% of total billed charges,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,523.69,130,,,Fee Schedule,130% of WA Medicaid ,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,864.46,37.7,,,percent of total billed charges,37.70% of total billed charges,864.46,37.7,,,percent of total billed charges,37.70% of total billed charges,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,77732.7,33.9,,,percent of total billed charges,33.9% of total billed charges,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1788.54,78,,,percent of total billed charges,78% of total billed charges,2293,100,,,percent of total billed charges,100% of total billed charges,1894.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1894.02,82.6,,,percent of total billed charges,82.6% of total billed charges,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.39,77732.7,
PARTIAL REMOVAL OF THYROID,60225,CDM,983,RC,60225,HCPCS,Outpatient,,,1869,1214.85,,1644.72,88,,,percent of total billed charges,88% of total Billed charges,101.86,100,,,Fee Schedule,100% of Medicare rate,534.7,100,,,Fee Schedule,100% of WA Medicaid,1869,100,,,percent of total billed charges,100% of total billed charges,550.74,103,,,Fee Schedule,103% of WA Medicaid,101.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,178.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,534.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1289.61,69,,,percent of total billed charges,69% of total billed charges,1869,100,,,percent of total billed charges,100% of total billed charges,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1869,100,,,percent of total billed charges,100% of total billed charges,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1869,100,,,percent of total billed charges,100% of total billed charges,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1155.98,61.85,,,percent of total billed charges,61.85% of total billed charges,534.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,545.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,695.11,130,,,Fee Schedule,130% of WA Medicaid ,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,704.61,37.7,,,percent of total billed charges,37.70% of total billed charges,704.61,37.7,,,percent of total billed charges,37.70% of total billed charges,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,63359.1,33.9,,,percent of total billed charges,33.9% of total billed charges,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.82,78,,,percent of total billed charges,78% of total billed charges,1869,100,,,percent of total billed charges,100% of total billed charges,1543.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1543.79,82.6,,,percent of total billed charges,82.6% of total billed charges,534.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,101.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.86,63359.1,
PARTIAL REMOVAL OF THYROID,60220,CDM,983,RC,60220,HCPCS,Outpatient,,,2490,1618.50,,2191.2,88,,,percent of total billed charges,88% of total Billed charges,76.77,100,,,Fee Schedule,100% of Medicare rate,403.21,100,,,Fee Schedule,100% of WA Medicaid,2490,100,,,percent of total billed charges,100% of total billed charges,415.31,103,,,Fee Schedule,103% of WA Medicaid,76.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,134.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,403.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1718.1,69,,,percent of total billed charges,69% of total billed charges,2490,100,,,percent of total billed charges,100% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2490,100,,,percent of total billed charges,100% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2490,100,,,percent of total billed charges,100% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1540.07,61.85,,,percent of total billed charges,61.85% of total billed charges,403.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,524.17,130,,,Fee Schedule,130% of WA Medicaid ,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,938.73,37.7,,,percent of total billed charges,37.70% of total billed charges,938.73,37.7,,,percent of total billed charges,37.70% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,84411,33.9,,,percent of total billed charges,33.9% of total billed charges,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1942.2,78,,,percent of total billed charges,78% of total billed charges,2490,100,,,percent of total billed charges,100% of total billed charges,2056.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2056.74,82.6,,,percent of total billed charges,82.6% of total billed charges,403.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.77,84411,
REMOVAL OF THYROID,60240,CDM,983,RC,60240,HCPCS,Outpatient,,,2475,1608.75,,2178,88,,,percent of total billed charges,88% of total Billed charges,106.55,100,,,Fee Schedule,100% of Medicare rate,519.78,100,,,Fee Schedule,100% of WA Medicaid,2475,100,,,percent of total billed charges,100% of total billed charges,535.37,103,,,Fee Schedule,103% of WA Medicaid,106.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,186.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,519.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1707.75,69,,,percent of total billed charges,69% of total billed charges,2475,100,,,percent of total billed charges,100% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2475,100,,,percent of total billed charges,100% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2475,100,,,percent of total billed charges,100% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1530.79,61.85,,,percent of total billed charges,61.85% of total billed charges,519.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,675.71,130,,,Fee Schedule,130% of WA Medicaid ,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,933.08,37.7,,,percent of total billed charges,37.70% of total billed charges,933.08,37.7,,,percent of total billed charges,37.70% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,83902.5,33.9,,,percent of total billed charges,33.9% of total billed charges,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1930.5,78,,,percent of total billed charges,78% of total billed charges,2475,100,,,percent of total billed charges,100% of total billed charges,2044.35,82.6,,,percent of total billed charges,82.6% of total billed charges,2044.35,82.6,,,percent of total billed charges,82.6% of total billed charges,519.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.55,83902.5,
REM. OF THYROID-SUBSTERNAL THYROID APPRO,60270,CDM,983,RC,60270,HCPCS,Outpatient,,,2746,1784.90,,2416.48,88,,,percent of total billed charges,88% of total Billed charges,161.98,100,,,Fee Schedule,100% of Medicare rate,768.19,100,,,Fee Schedule,100% of WA Medicaid,2746,100,,,percent of total billed charges,100% of total billed charges,791.24,103,,,Fee Schedule,103% of WA Medicaid,161.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,283.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,768.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1894.74,69,,,percent of total billed charges,69% of total billed charges,2746,100,,,percent of total billed charges,100% of total billed charges,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2746,100,,,percent of total billed charges,100% of total billed charges,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2746,100,,,percent of total billed charges,100% of total billed charges,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1698.4,61.85,,,percent of total billed charges,61.85% of total billed charges,768.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,768.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,783.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,998.65,130,,,Fee Schedule,130% of WA Medicaid ,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1035.24,37.7,,,percent of total billed charges,37.70% of total billed charges,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,93089.4,33.9,,,percent of total billed charges,33.9% of total billed charges,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2141.88,78,,,percent of total billed charges,78% of total billed charges,2746,100,,,percent of total billed charges,100% of total billed charges,2268.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2268.2,82.6,,,percent of total billed charges,82.6% of total billed charges,768.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,161.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,768.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,161.98,93089.4,
REMOVAL OF THYROID,60271,CDM,983,RC,60271,HCPCS,Outpatient,,,3334,2167.10,,2933.92,88,,,percent of total billed charges,88% of total Billed charges,121.01,100,,,Fee Schedule,100% of Medicare rate,596.99,100,,,Fee Schedule,100% of WA Medicaid,3334,100,,,percent of total billed charges,100% of total billed charges,614.9,103,,,Fee Schedule,103% of WA Medicaid,121.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,211.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,596.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2300.46,69,,,percent of total billed charges,69% of total billed charges,3334,100,,,percent of total billed charges,100% of total billed charges,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,3334,100,,,percent of total billed charges,100% of total billed charges,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,3334,100,,,percent of total billed charges,100% of total billed charges,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2062.08,61.85,,,percent of total billed charges,61.85% of total billed charges,596.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,608.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,776.09,130,,,Fee Schedule,130% of WA Medicaid ,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1256.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1256.92,37.7,,,percent of total billed charges,37.70% of total billed charges,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,113022.6,33.9,,,percent of total billed charges,33.9% of total billed charges,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2600.52,78,,,percent of total billed charges,78% of total billed charges,3334,100,,,percent of total billed charges,100% of total billed charges,2753.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2753.88,82.6,,,percent of total billed charges,82.6% of total billed charges,596.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,121.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,121.01,113022.6,
REMOVE THYROID DUCT LESION,60281,CDM,983,RC,60281,HCPCS,Outpatient,,,851,553.15,,748.88,88,,,percent of total billed charges,88% of total Billed charges,51.34,100,,,Fee Schedule,100% of Medicare rate,344.84,100,,,Fee Schedule,100% of WA Medicaid,851,100,,,percent of total billed charges,100% of total billed charges,355.19,103,,,Fee Schedule,103% of WA Medicaid,51.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,344.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,587.19,69,,,percent of total billed charges,69% of total billed charges,851,100,,,percent of total billed charges,100% of total billed charges,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,851,100,,,percent of total billed charges,100% of total billed charges,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,851,100,,,percent of total billed charges,100% of total billed charges,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,526.34,61.85,,,percent of total billed charges,61.85% of total billed charges,344.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,448.29,130,,,Fee Schedule,130% of WA Medicaid ,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,320.83,37.7,,,percent of total billed charges,37.70% of total billed charges,320.83,37.7,,,percent of total billed charges,37.70% of total billed charges,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,28848.9,33.9,,,percent of total billed charges,33.9% of total billed charges,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,663.78,78,,,percent of total billed charges,78% of total billed charges,851,100,,,percent of total billed charges,100% of total billed charges,702.93,82.6,,,percent of total billed charges,82.6% of total billed charges,702.93,82.6,,,percent of total billed charges,82.6% of total billed charges,344.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.34,28848.9,
REMOVAL OF THYROGLOSSAL DUCT CYST,60280,CDM,983,RC,60280,HCPCS,Outpatient,,,925,601.25,,814,88,,,percent of total billed charges,88% of total Billed charges,38.53,100,,,Fee Schedule,100% of Medicare rate,264.46,100,,,Fee Schedule,100% of WA Medicaid,925,100,,,percent of total billed charges,100% of total billed charges,272.39,103,,,Fee Schedule,103% of WA Medicaid,38.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,638.25,69,,,percent of total billed charges,69% of total billed charges,925,100,,,percent of total billed charges,100% of total billed charges,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,925,100,,,percent of total billed charges,100% of total billed charges,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,925,100,,,percent of total billed charges,100% of total billed charges,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,572.11,61.85,,,percent of total billed charges,61.85% of total billed charges,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,343.8,130,,,Fee Schedule,130% of WA Medicaid ,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.73,37.7,,,percent of total billed charges,37.70% of total billed charges,348.73,37.7,,,percent of total billed charges,37.70% of total billed charges,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,31357.5,33.9,,,percent of total billed charges,33.9% of total billed charges,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,721.5,78,,,percent of total billed charges,78% of total billed charges,925,100,,,percent of total billed charges,100% of total billed charges,764.05,82.6,,,percent of total billed charges,82.6% of total billed charges,764.05,82.6,,,percent of total billed charges,82.6% of total billed charges,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.53,31357.5,
ASPIR/INJ THYROID CYST,60300,CDM,983,RC,60300,HCPCS,Outpatient,,,229,148.85,,201.52,88,,,percent of total billed charges,88% of total Billed charges,4.02,100,,,Fee Schedule,100% of Medicare rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,229,100,,,percent of total billed charges,100% of total billed charges,27.85,103,,,Fee Schedule,103% of WA Medicaid,4.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,158.01,69,,,percent of total billed charges,69% of total billed charges,229,100,,,percent of total billed charges,100% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,229,100,,,percent of total billed charges,100% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,229,100,,,percent of total billed charges,100% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.64,61.85,,,percent of total billed charges,61.85% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.15,130,,,Fee Schedule,130% of WA Medicaid ,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.33,37.7,,,percent of total billed charges,37.70% of total billed charges,86.33,37.7,,,percent of total billed charges,37.70% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7763.1,33.9,,,percent of total billed charges,33.9% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.62,78,,,percent of total billed charges,78% of total billed charges,229,100,,,percent of total billed charges,100% of total billed charges,189.15,82.6,,,percent of total billed charges,82.6% of total billed charges,189.15,82.6,,,percent of total billed charges,82.6% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.02,7763.1,
RE-EXPLORE PARATHYROIDS,60502,CDM,983,RC,60502,HCPCS,Outpatient,,,2578,1675.70,,2268.64,88,,,percent of total billed charges,88% of total Billed charges,164.41,100,,,Fee Schedule,100% of Medicare rate,735.93,100,,,Fee Schedule,100% of WA Medicaid,2578,100,,,percent of total billed charges,100% of total billed charges,758.01,103,,,Fee Schedule,103% of WA Medicaid,164.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,287.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,735.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1778.82,69,,,percent of total billed charges,69% of total billed charges,2578,100,,,percent of total billed charges,100% of total billed charges,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2578,100,,,percent of total billed charges,100% of total billed charges,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2578,100,,,percent of total billed charges,100% of total billed charges,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1594.49,61.85,,,percent of total billed charges,61.85% of total billed charges,735.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,735.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,750.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,956.71,130,,,Fee Schedule,130% of WA Medicaid ,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,971.91,37.7,,,percent of total billed charges,37.70% of total billed charges,971.91,37.7,,,percent of total billed charges,37.70% of total billed charges,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,87394.2,33.9,,,percent of total billed charges,33.9% of total billed charges,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2010.84,78,,,percent of total billed charges,78% of total billed charges,2578,100,,,percent of total billed charges,100% of total billed charges,2129.43,82.6,,,percent of total billed charges,82.6% of total billed charges,2129.43,82.6,,,percent of total billed charges,82.6% of total billed charges,735.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,164.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,735.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,164.41,87394.2,
AUTOTRANSPLANT PARATHYROID,60512,CDM,983,RC,60512,HCPCS,Outpatient,,,486,315.90,,427.68,88,,,percent of total billed charges,88% of total Billed charges,31.22,100,,,Fee Schedule,100% of Medicare rate,134.09,100,,,Fee Schedule,100% of WA Medicaid,486,100,,,percent of total billed charges,100% of total billed charges,138.11,103,,,Fee Schedule,103% of WA Medicaid,31.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,134.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,335.34,69,,,percent of total billed charges,69% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.59,61.85,,,percent of total billed charges,61.85% of total billed charges,134.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,174.32,130,,,Fee Schedule,130% of WA Medicaid ,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,16475.4,33.9,,,percent of total billed charges,33.9% of total billed charges,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.08,78,,,percent of total billed charges,78% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,134.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.22,16475.4,
LAPAROSCOPIC ADRENALECTOMY,60650,CDM,983,RC,60650,HCPCS,Outpatient,,,1150,747.50,,1012,88,,,percent of total billed charges,88% of total Billed charges,151.26,100,,,Fee Schedule,100% of Medicare rate,667.86,100,,,Fee Schedule,100% of WA Medicaid,1150,100,,,percent of total billed charges,100% of total billed charges,687.9,103,,,Fee Schedule,103% of WA Medicaid,151.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,264.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,667.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,793.5,69,,,percent of total billed charges,69% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1150,100,,,percent of total billed charges,100% of total billed charges,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1150,100,,,percent of total billed charges,100% of total billed charges,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.28,61.85,,,percent of total billed charges,61.85% of total billed charges,667.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,681.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,868.22,130,,,Fee Schedule,130% of WA Medicaid ,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,433.55,37.7,,,percent of total billed charges,37.70% of total billed charges,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,38985,33.9,,,percent of total billed charges,33.9% of total billed charges,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,897,78,,,percent of total billed charges,78% of total billed charges,1150,100,,,percent of total billed charges,100% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,949.9,82.6,,,percent of total billed charges,82.6% of total billed charges,667.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,151.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,151.26,38985,
REMOVE CRANIAL CAVITY FLUID,61001,CDM,983,RC,61001,HCPCS,Outpatient,,,374,243.10,,329.12,88,,,percent of total billed charges,88% of total Billed charges,19.02,100,,,Fee Schedule,100% of Medicare rate,60.61,100,,,Fee Schedule,100% of WA Medicaid,374,100,,,percent of total billed charges,100% of total billed charges,62.43,103,,,Fee Schedule,103% of WA Medicaid,19.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,258.06,69,,,percent of total billed charges,69% of total billed charges,374,100,,,percent of total billed charges,100% of total billed charges,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,374,100,,,percent of total billed charges,100% of total billed charges,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,374,100,,,percent of total billed charges,100% of total billed charges,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.32,61.85,,,percent of total billed charges,61.85% of total billed charges,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,78.79,130,,,Fee Schedule,130% of WA Medicaid ,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,141,37.7,,,percent of total billed charges,37.70% of total billed charges,141,37.7,,,percent of total billed charges,37.70% of total billed charges,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,12678.6,33.9,,,percent of total billed charges,33.9% of total billed charges,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.72,78,,,percent of total billed charges,78% of total billed charges,374,100,,,percent of total billed charges,100% of total billed charges,308.92,82.6,,,percent of total billed charges,82.6% of total billed charges,308.92,82.6,,,percent of total billed charges,82.6% of total billed charges,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.02,12678.6,
REMOVE CRANIAL CAVITY FLUID,61000,CDM,983,RC,61000,HCPCS,Outpatient,,,567,368.55,,498.96,88,,,percent of total billed charges,88% of total Billed charges,20.49,100,,,Fee Schedule,100% of Medicare rate,63.78,100,,,Fee Schedule,100% of WA Medicaid,567,100,,,percent of total billed charges,100% of total billed charges,65.69,103,,,Fee Schedule,103% of WA Medicaid,20.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,35.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,391.23,69,,,percent of total billed charges,69% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,567,100,,,percent of total billed charges,100% of total billed charges,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,567,100,,,percent of total billed charges,100% of total billed charges,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.69,61.85,,,percent of total billed charges,61.85% of total billed charges,63.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.91,130,,,Fee Schedule,130% of WA Medicaid ,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,19221.3,33.9,,,percent of total billed charges,33.9% of total billed charges,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.26,78,,,percent of total billed charges,78% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,63.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,20.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.49,19221.3,
INJECTION INTO BRAIN CANAL,61026,CDM,983,RC,61026,HCPCS,Outpatient,,,628,408.20,,552.64,88,,,percent of total billed charges,88% of total Billed charges,15.2,100,,,Fee Schedule,100% of Medicare rate,61.92,100,,,Fee Schedule,100% of WA Medicaid,628,100,,,percent of total billed charges,100% of total billed charges,63.78,103,,,Fee Schedule,103% of WA Medicaid,15.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,61.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,433.32,69,,,percent of total billed charges,69% of total billed charges,628,100,,,percent of total billed charges,100% of total billed charges,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,628,100,,,percent of total billed charges,100% of total billed charges,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,628,100,,,percent of total billed charges,100% of total billed charges,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.42,61.85,,,percent of total billed charges,61.85% of total billed charges,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,80.5,130,,,Fee Schedule,130% of WA Medicaid ,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.76,37.7,,,percent of total billed charges,37.70% of total billed charges,236.76,37.7,,,percent of total billed charges,37.70% of total billed charges,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,21289.2,33.9,,,percent of total billed charges,33.9% of total billed charges,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.84,78,,,percent of total billed charges,78% of total billed charges,628,100,,,percent of total billed charges,100% of total billed charges,518.73,82.6,,,percent of total billed charges,82.6% of total billed charges,518.73,82.6,,,percent of total billed charges,82.6% of total billed charges,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.2,21289.2,
REMOVE BRAIN CAVITY FLUID,61020,CDM,983,RC,61020,HCPCS,Outpatient,,,485,315.25,,426.8,88,,,percent of total billed charges,88% of total Billed charges,17.71,100,,,Fee Schedule,100% of Medicare rate,60.24,100,,,Fee Schedule,100% of WA Medicaid,485,100,,,percent of total billed charges,100% of total billed charges,62.05,103,,,Fee Schedule,103% of WA Medicaid,17.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,334.65,69,,,percent of total billed charges,69% of total billed charges,485,100,,,percent of total billed charges,100% of total billed charges,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,485,100,,,percent of total billed charges,100% of total billed charges,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,485,100,,,percent of total billed charges,100% of total billed charges,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.97,61.85,,,percent of total billed charges,61.85% of total billed charges,60.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,78.31,130,,,Fee Schedule,130% of WA Medicaid ,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.85,37.7,,,percent of total billed charges,37.70% of total billed charges,182.85,37.7,,,percent of total billed charges,37.70% of total billed charges,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,16441.5,33.9,,,percent of total billed charges,33.9% of total billed charges,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.3,78,,,percent of total billed charges,78% of total billed charges,485,100,,,percent of total billed charges,100% of total billed charges,400.61,82.6,,,percent of total billed charges,82.6% of total billed charges,400.61,82.6,,,percent of total billed charges,82.6% of total billed charges,60.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.71,16441.5,
REMOVE BRAIN CANAL FLUID,61050,CDM,983,RC,61050,HCPCS,Outpatient,,,567,368.55,,498.96,88,,,percent of total billed charges,88% of total Billed charges,5.75,100,,,Fee Schedule,100% of Medicare rate,45.13,100,,,Fee Schedule,100% of WA Medicaid,567,100,,,percent of total billed charges,100% of total billed charges,46.48,103,,,Fee Schedule,103% of WA Medicaid,5.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,45.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,391.23,69,,,percent of total billed charges,69% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,567,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,567,100,,,percent of total billed charges,100% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.69,61.85,,,percent of total billed charges,61.85% of total billed charges,45.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.67,130,,,Fee Schedule,130% of WA Medicaid ,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,213.76,37.7,,,percent of total billed charges,37.70% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,19221.3,33.9,,,percent of total billed charges,33.9% of total billed charges,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,442.26,78,,,percent of total billed charges,78% of total billed charges,567,100,,,percent of total billed charges,100% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,468.34,82.6,,,percent of total billed charges,82.6% of total billed charges,45.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.75,19221.3,
INJECTION INTO BRAIN CANAL,61055,CDM,983,RC,61055,HCPCS,Outpatient,,,665,432.25,,585.2,88,,,percent of total billed charges,88% of total Billed charges,12.55,100,,,Fee Schedule,100% of Medicare rate,65.65,100,,,Fee Schedule,100% of WA Medicaid,665,100,,,percent of total billed charges,100% of total billed charges,67.62,103,,,Fee Schedule,103% of WA Medicaid,12.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,65.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,458.85,69,,,percent of total billed charges,69% of total billed charges,665,100,,,percent of total billed charges,100% of total billed charges,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,665,100,,,percent of total billed charges,100% of total billed charges,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,665,100,,,percent of total billed charges,100% of total billed charges,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.3,61.85,,,percent of total billed charges,61.85% of total billed charges,65.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.35,130,,,Fee Schedule,130% of WA Medicaid ,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.71,37.7,,,percent of total billed charges,37.70% of total billed charges,250.71,37.7,,,percent of total billed charges,37.70% of total billed charges,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,22543.5,33.9,,,percent of total billed charges,33.9% of total billed charges,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,518.7,78,,,percent of total billed charges,78% of total billed charges,665,100,,,percent of total billed charges,100% of total billed charges,549.29,82.6,,,percent of total billed charges,82.6% of total billed charges,549.29,82.6,,,percent of total billed charges,82.6% of total billed charges,65.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.55,22543.5,
BRAIN CANAL SHUNT PROCEDURE,61070,CDM,983,RC,61070,HCPCS,Outpatient,,,399,259.35,,351.12,88,,,percent of total billed charges,88% of total Billed charges,5.83,100,,,Fee Schedule,100% of Medicare rate,31.89,100,,,Fee Schedule,100% of WA Medicaid,399,100,,,percent of total billed charges,100% of total billed charges,32.85,103,,,Fee Schedule,103% of WA Medicaid,5.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,31.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,275.31,69,,,percent of total billed charges,69% of total billed charges,399,100,,,percent of total billed charges,100% of total billed charges,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,399,100,,,percent of total billed charges,100% of total billed charges,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,399,100,,,percent of total billed charges,100% of total billed charges,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.78,61.85,,,percent of total billed charges,61.85% of total billed charges,31.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.46,130,,,Fee Schedule,130% of WA Medicaid ,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.42,37.7,,,percent of total billed charges,37.70% of total billed charges,150.42,37.7,,,percent of total billed charges,37.70% of total billed charges,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,13526.1,33.9,,,percent of total billed charges,33.9% of total billed charges,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.22,78,,,percent of total billed charges,78% of total billed charges,399,100,,,percent of total billed charges,100% of total billed charges,329.57,82.6,,,percent of total billed charges,82.6% of total billed charges,329.57,82.6,,,percent of total billed charges,82.6% of total billed charges,31.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.83,13526.1,
DRILL SKULL FOR IMPLANTATION,61107,CDM,983,RC,61107,HCPCS,Outpatient,,,2557,1662.05,,2250.16,88,,,percent of total billed charges,88% of total Billed charges,62.03,100,,,Fee Schedule,100% of Medicare rate,171.95,100,,,Fee Schedule,100% of WA Medicaid,2557,100,,,percent of total billed charges,100% of total billed charges,177.11,103,,,Fee Schedule,103% of WA Medicaid,62.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,108.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,171.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1764.33,69,,,percent of total billed charges,69% of total billed charges,2557,100,,,percent of total billed charges,100% of total billed charges,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2557,100,,,percent of total billed charges,100% of total billed charges,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2557,100,,,percent of total billed charges,100% of total billed charges,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1581.5,61.85,,,percent of total billed charges,61.85% of total billed charges,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,223.54,130,,,Fee Schedule,130% of WA Medicaid ,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,963.99,37.7,,,percent of total billed charges,37.70% of total billed charges,963.99,37.7,,,percent of total billed charges,37.70% of total billed charges,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,86682.3,33.9,,,percent of total billed charges,33.9% of total billed charges,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1994.46,78,,,percent of total billed charges,78% of total billed charges,2557,100,,,percent of total billed charges,100% of total billed charges,2112.08,82.6,,,percent of total billed charges,82.6% of total billed charges,2112.08,82.6,,,percent of total billed charges,82.6% of total billed charges,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.03,86682.3,
DRILL SKULL FOR DRAINAGE,61108,CDM,983,RC,61108,HCPCS,Outpatient,,,4153,2699.45,,3654.64,88,,,percent of total billed charges,88% of total Billed charges,147.41,100,,,Fee Schedule,100% of Medicare rate,518.28,100,,,Fee Schedule,100% of WA Medicaid,4153,100,,,percent of total billed charges,100% of total billed charges,533.83,103,,,Fee Schedule,103% of WA Medicaid,147.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,257.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,518.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2865.57,69,,,percent of total billed charges,69% of total billed charges,4153,100,,,percent of total billed charges,100% of total billed charges,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,4153,100,,,percent of total billed charges,100% of total billed charges,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,4153,100,,,percent of total billed charges,100% of total billed charges,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2568.63,61.85,,,percent of total billed charges,61.85% of total billed charges,518.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,518.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,673.76,130,,,Fee Schedule,130% of WA Medicaid ,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1565.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1565.68,37.7,,,percent of total billed charges,37.70% of total billed charges,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,140786.7,33.9,,,percent of total billed charges,33.9% of total billed charges,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,3239.34,78,,,percent of total billed charges,78% of total billed charges,4153,100,,,percent of total billed charges,100% of total billed charges,3430.38,82.6,,,percent of total billed charges,82.6% of total billed charges,3430.38,82.6,,,percent of total billed charges,82.6% of total billed charges,518.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,147.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,518.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,147.41,140786.7,
TWIST DRILL HOLE,61105,CDM,983,RC,61105,HCPCS,Outpatient,,,2175,1413.75,,1914,88,,,percent of total billed charges,88% of total Billed charges,72.48,100,,,Fee Schedule,100% of Medicare rate,268.37,100,,,Fee Schedule,100% of WA Medicaid,2175,100,,,percent of total billed charges,100% of total billed charges,276.42,103,,,Fee Schedule,103% of WA Medicaid,72.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,268.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1500.75,69,,,percent of total billed charges,69% of total billed charges,2175,100,,,percent of total billed charges,100% of total billed charges,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2175,100,,,percent of total billed charges,100% of total billed charges,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2175,100,,,percent of total billed charges,100% of total billed charges,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1345.24,61.85,,,percent of total billed charges,61.85% of total billed charges,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,348.88,130,,,Fee Schedule,130% of WA Medicaid ,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,819.98,37.7,,,percent of total billed charges,37.70% of total billed charges,819.98,37.7,,,percent of total billed charges,37.70% of total billed charges,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,73732.5,33.9,,,percent of total billed charges,33.9% of total billed charges,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1696.5,78,,,percent of total billed charges,78% of total billed charges,2175,100,,,percent of total billed charges,100% of total billed charges,1796.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1796.55,82.6,,,percent of total billed charges,82.6% of total billed charges,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.48,73732.5,
BURR HOLE FOR PUNCTURE,61120,CDM,983,RC,61120,HCPCS,Outpatient,,,2995,1946.75,,2635.6,88,,,percent of total billed charges,88% of total Billed charges,126.14,100,,,Fee Schedule,100% of Medicare rate,429.51,100,,,Fee Schedule,100% of WA Medicaid,2995,100,,,percent of total billed charges,100% of total billed charges,442.4,103,,,Fee Schedule,103% of WA Medicaid,126.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,220.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,429.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2066.55,69,,,percent of total billed charges,69% of total billed charges,2995,100,,,percent of total billed charges,100% of total billed charges,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2995,100,,,percent of total billed charges,100% of total billed charges,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2995,100,,,percent of total billed charges,100% of total billed charges,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1852.41,61.85,,,percent of total billed charges,61.85% of total billed charges,429.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,438.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,558.36,130,,,Fee Schedule,130% of WA Medicaid ,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1129.12,37.7,,,percent of total billed charges,37.70% of total billed charges,1129.12,37.7,,,percent of total billed charges,37.70% of total billed charges,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,101530.5,33.9,,,percent of total billed charges,33.9% of total billed charges,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2336.1,78,,,percent of total billed charges,78% of total billed charges,2995,100,,,percent of total billed charges,100% of total billed charges,2473.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2473.87,82.6,,,percent of total billed charges,82.6% of total billed charges,429.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,126.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,126.14,101530.5,
PIERCE SKULL FOR BIOPSY,61140,CDM,983,RC,61140,HCPCS,Outpatient,,,5990,3893.50,,5271.2,88,,,percent of total billed charges,88% of total Billed charges,223.85,100,,,Fee Schedule,100% of Medicare rate,722.5,100,,,Fee Schedule,100% of WA Medicaid,5990,100,,,percent of total billed charges,100% of total billed charges,744.18,103,,,Fee Schedule,103% of WA Medicaid,223.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,391.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,722.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4133.1,69,,,percent of total billed charges,69% of total billed charges,5990,100,,,percent of total billed charges,100% of total billed charges,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,5990,100,,,percent of total billed charges,100% of total billed charges,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,5990,100,,,percent of total billed charges,100% of total billed charges,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,3704.82,61.85,,,percent of total billed charges,61.85% of total billed charges,722.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,722.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,939.25,130,,,Fee Schedule,130% of WA Medicaid ,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2258.23,37.7,,,percent of total billed charges,37.70% of total billed charges,2258.23,37.7,,,percent of total billed charges,37.70% of total billed charges,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,203061,33.9,,,percent of total billed charges,33.9% of total billed charges,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,4672.2,78,,,percent of total billed charges,78% of total billed charges,5990,100,,,percent of total billed charges,100% of total billed charges,4947.74,82.6,,,percent of total billed charges,82.6% of total billed charges,4947.74,82.6,,,percent of total billed charges,82.6% of total billed charges,722.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,223.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,722.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,223.85,203061,
PIERCE SKULL FOR DRAINAGE,61151,CDM,983,RC,61151,HCPCS,Outpatient,,,788,512.20,,693.44,88,,,percent of total billed charges,88% of total Billed charges,175.3,100,,,Fee Schedule,100% of Medicare rate,564.35,100,,,Fee Schedule,100% of WA Medicaid,788,100,,,percent of total billed charges,100% of total billed charges,581.28,103,,,Fee Schedule,103% of WA Medicaid,175.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,306.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,564.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,543.72,69,,,percent of total billed charges,69% of total billed charges,788,100,,,percent of total billed charges,100% of total billed charges,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,788,100,,,percent of total billed charges,100% of total billed charges,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,788,100,,,percent of total billed charges,100% of total billed charges,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,487.38,61.85,,,percent of total billed charges,61.85% of total billed charges,564.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,733.66,130,,,Fee Schedule,130% of WA Medicaid ,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.08,37.7,,,percent of total billed charges,37.70% of total billed charges,297.08,37.7,,,percent of total billed charges,37.70% of total billed charges,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,26713.2,33.9,,,percent of total billed charges,33.9% of total billed charges,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.64,78,,,percent of total billed charges,78% of total billed charges,788,100,,,percent of total billed charges,100% of total billed charges,650.89,82.6,,,percent of total billed charges,82.6% of total billed charges,650.89,82.6,,,percent of total billed charges,82.6% of total billed charges,564.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,175.3,26713.2,
PIERCE SKULL  REMOVE CLOT,61154,CDM,983,RC,61154,HCPCS,Outpatient,,,5333,3466.45,,4693.04,88,,,percent of total billed charges,88% of total Billed charges,221.74,100,,,Fee Schedule,100% of Medicare rate,726.98,100,,,Fee Schedule,100% of WA Medicaid,5333,100,,,percent of total billed charges,100% of total billed charges,748.79,103,,,Fee Schedule,103% of WA Medicaid,221.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,388.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,726.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3679.77,69,,,percent of total billed charges,69% of total billed charges,5333,100,,,percent of total billed charges,100% of total billed charges,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,5333,100,,,percent of total billed charges,100% of total billed charges,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,5333,100,,,percent of total billed charges,100% of total billed charges,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3298.46,61.85,,,percent of total billed charges,61.85% of total billed charges,726.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,741.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,945.07,130,,,Fee Schedule,130% of WA Medicaid ,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2010.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2010.54,37.7,,,percent of total billed charges,37.70% of total billed charges,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,180788.7,33.9,,,percent of total billed charges,33.9% of total billed charges,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4159.74,78,,,percent of total billed charges,78% of total billed charges,5333,100,,,percent of total billed charges,100% of total billed charges,4405.06,82.6,,,percent of total billed charges,82.6% of total billed charges,4405.06,82.6,,,percent of total billed charges,82.6% of total billed charges,726.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,221.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,221.74,180788.7,
PIERCE SKULL FOR DRAINAGE,61150,CDM,983,RC,61150,HCPCS,Outpatient,,,5977,3885.05,,5259.76,88,,,percent of total billed charges,88% of total Billed charges,244.18,100,,,Fee Schedule,100% of Medicare rate,762.97,100,,,Fee Schedule,100% of WA Medicaid,5977,100,,,percent of total billed charges,100% of total billed charges,785.86,103,,,Fee Schedule,103% of WA Medicaid,244.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,427.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,762.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4124.13,69,,,percent of total billed charges,69% of total billed charges,5977,100,,,percent of total billed charges,100% of total billed charges,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,5977,100,,,percent of total billed charges,100% of total billed charges,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,5977,100,,,percent of total billed charges,100% of total billed charges,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3696.77,61.85,,,percent of total billed charges,61.85% of total billed charges,762.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,762.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,991.86,130,,,Fee Schedule,130% of WA Medicaid ,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2253.33,37.7,,,percent of total billed charges,37.70% of total billed charges,2253.33,37.7,,,percent of total billed charges,37.70% of total billed charges,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,202620.3,33.9,,,percent of total billed charges,33.9% of total billed charges,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,4662.06,78,,,percent of total billed charges,78% of total billed charges,5977,100,,,percent of total billed charges,100% of total billed charges,4937,82.6,,,percent of total billed charges,82.6% of total billed charges,4937,82.6,,,percent of total billed charges,82.6% of total billed charges,762.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,244.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,762.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,244.18,202620.3,
PIERCE SKULL FOR DRAINAGE,61156,CDM,983,RC,61156,HCPCS,Outpatient,,,6299,4094.35,,5543.12,88,,,percent of total billed charges,88% of total Billed charges,224.53,100,,,Fee Schedule,100% of Medicare rate,700.31,100,,,Fee Schedule,100% of WA Medicaid,6299,100,,,percent of total billed charges,100% of total billed charges,721.32,103,,,Fee Schedule,103% of WA Medicaid,224.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,392.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,700.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4346.31,69,,,percent of total billed charges,69% of total billed charges,6299,100,,,percent of total billed charges,100% of total billed charges,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6299,100,,,percent of total billed charges,100% of total billed charges,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6299,100,,,percent of total billed charges,100% of total billed charges,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,3895.93,61.85,,,percent of total billed charges,61.85% of total billed charges,700.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,910.4,130,,,Fee Schedule,130% of WA Medicaid ,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2374.72,37.7,,,percent of total billed charges,37.70% of total billed charges,2374.72,37.7,,,percent of total billed charges,37.70% of total billed charges,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,213536.1,33.9,,,percent of total billed charges,33.9% of total billed charges,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,4913.22,78,,,percent of total billed charges,78% of total billed charges,6299,100,,,percent of total billed charges,100% of total billed charges,5202.97,82.6,,,percent of total billed charges,82.6% of total billed charges,5202.97,82.6,,,percent of total billed charges,82.6% of total billed charges,700.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,224.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,224.53,213536.1,
PIERCE SKULL IMPLANT DEVICE,61210,CDM,983,RC,61210,HCPCS,Outpatient,,,2505,1628.25,,2204.4,88,,,percent of total billed charges,88% of total Billed charges,72.93,100,,,Fee Schedule,100% of Medicare rate,201.61,100,,,Fee Schedule,100% of WA Medicaid,2505,100,,,percent of total billed charges,100% of total billed charges,207.66,103,,,Fee Schedule,103% of WA Medicaid,72.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,127.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,201.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1728.45,69,,,percent of total billed charges,69% of total billed charges,2505,100,,,percent of total billed charges,100% of total billed charges,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2505,100,,,percent of total billed charges,100% of total billed charges,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,2505,100,,,percent of total billed charges,100% of total billed charges,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1549.34,61.85,,,percent of total billed charges,61.85% of total billed charges,201.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,262.09,130,,,Fee Schedule,130% of WA Medicaid ,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,944.39,37.7,,,percent of total billed charges,37.70% of total billed charges,944.39,37.7,,,percent of total billed charges,37.70% of total billed charges,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,84919.5,33.9,,,percent of total billed charges,33.9% of total billed charges,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1953.9,78,,,percent of total billed charges,78% of total billed charges,2505,100,,,percent of total billed charges,100% of total billed charges,2069.13,82.6,,,percent of total billed charges,82.6% of total billed charges,2069.13,82.6,,,percent of total billed charges,82.6% of total billed charges,201.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,72.93,84919.5,
INSERT BRAIN-FLUID DEVICE,61215,CDM,983,RC,61215,HCPCS,Outpatient,,,2121,1378.65,,1866.48,88,,,percent of total billed charges,88% of total Billed charges,78.51,100,,,Fee Schedule,100% of Medicare rate,299.33,100,,,Fee Schedule,100% of WA Medicaid,2121,100,,,percent of total billed charges,100% of total billed charges,308.31,103,,,Fee Schedule,103% of WA Medicaid,78.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,137.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,299.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1463.49,69,,,percent of total billed charges,69% of total billed charges,2121,100,,,percent of total billed charges,100% of total billed charges,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2121,100,,,percent of total billed charges,100% of total billed charges,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2121,100,,,percent of total billed charges,100% of total billed charges,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1311.84,61.85,,,percent of total billed charges,61.85% of total billed charges,299.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,389.13,130,,,Fee Schedule,130% of WA Medicaid ,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.62,37.7,,,percent of total billed charges,37.70% of total billed charges,799.62,37.7,,,percent of total billed charges,37.70% of total billed charges,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,71901.9,33.9,,,percent of total billed charges,33.9% of total billed charges,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1654.38,78,,,percent of total billed charges,78% of total billed charges,2121,100,,,percent of total billed charges,100% of total billed charges,1751.95,82.6,,,percent of total billed charges,82.6% of total billed charges,1751.95,82.6,,,percent of total billed charges,82.6% of total billed charges,299.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.51,71901.9,
PIERCE SKULL  EXPLORE,61250,CDM,983,RC,61250,HCPCS,Outpatient,,,3556,2311.40,,3129.28,88,,,percent of total billed charges,88% of total Billed charges,149.83,100,,,Fee Schedule,100% of Medicare rate,494.78,100,,,Fee Schedule,100% of WA Medicaid,3556,100,,,percent of total billed charges,100% of total billed charges,509.62,103,,,Fee Schedule,103% of WA Medicaid,149.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,262.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,494.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2453.64,69,,,percent of total billed charges,69% of total billed charges,3556,100,,,percent of total billed charges,100% of total billed charges,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3556,100,,,percent of total billed charges,100% of total billed charges,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3556,100,,,percent of total billed charges,100% of total billed charges,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2199.39,61.85,,,percent of total billed charges,61.85% of total billed charges,494.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,643.21,130,,,Fee Schedule,130% of WA Medicaid ,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1340.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1340.61,37.7,,,percent of total billed charges,37.70% of total billed charges,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,120548.4,33.9,,,percent of total billed charges,33.9% of total billed charges,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2773.68,78,,,percent of total billed charges,78% of total billed charges,3556,100,,,percent of total billed charges,100% of total billed charges,2937.26,82.6,,,percent of total billed charges,82.6% of total billed charges,2937.26,82.6,,,percent of total billed charges,82.6% of total billed charges,494.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,149.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,149.83,120548.4,
PIERCE SKULL  EXPLORE,61253,CDM,983,RC,61253,HCPCS,Outpatient,,,4794,3116.10,,4218.72,88,,,percent of total billed charges,88% of total Billed charges,175.3,100,,,Fee Schedule,100% of Medicare rate,564.35,100,,,Fee Schedule,100% of WA Medicaid,4794,100,,,percent of total billed charges,100% of total billed charges,581.28,103,,,Fee Schedule,103% of WA Medicaid,175.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,306.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,564.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3307.86,69,,,percent of total billed charges,69% of total billed charges,4794,100,,,percent of total billed charges,100% of total billed charges,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,4794,100,,,percent of total billed charges,100% of total billed charges,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,4794,100,,,percent of total billed charges,100% of total billed charges,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2965.09,61.85,,,percent of total billed charges,61.85% of total billed charges,564.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,733.66,130,,,Fee Schedule,130% of WA Medicaid ,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1807.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1807.34,37.7,,,percent of total billed charges,37.70% of total billed charges,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,162516.6,33.9,,,percent of total billed charges,33.9% of total billed charges,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3739.32,78,,,percent of total billed charges,78% of total billed charges,4794,100,,,percent of total billed charges,100% of total billed charges,3959.84,82.6,,,percent of total billed charges,82.6% of total billed charges,3959.84,82.6,,,percent of total billed charges,82.6% of total billed charges,564.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,175.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,175.3,162516.6,
OPEN SKULL FOR EXPLORATION,61305,CDM,983,RC,61305,HCPCS,Outpatient,,,8306,5398.90,,7309.28,88,,,percent of total billed charges,88% of total Billed charges,369.07,100,,,Fee Schedule,100% of Medicare rate,1128.33,100,,,Fee Schedule,100% of WA Medicaid,8306,100,,,percent of total billed charges,100% of total billed charges,1162.18,103,,,Fee Schedule,103% of WA Medicaid,369.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,645.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1128.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5731.14,69,,,percent of total billed charges,69% of total billed charges,8306,100,,,percent of total billed charges,100% of total billed charges,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,8306,100,,,percent of total billed charges,100% of total billed charges,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,8306,100,,,percent of total billed charges,100% of total billed charges,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,5137.26,61.85,,,percent of total billed charges,61.85% of total billed charges,1128.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1150.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1466.83,130,,,Fee Schedule,130% of WA Medicaid ,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3131.36,37.7,,,percent of total billed charges,37.70% of total billed charges,3131.36,37.7,,,percent of total billed charges,37.70% of total billed charges,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,281573.4,33.9,,,percent of total billed charges,33.9% of total billed charges,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,6478.68,78,,,percent of total billed charges,78% of total billed charges,8306,100,,,percent of total billed charges,100% of total billed charges,6860.76,82.6,,,percent of total billed charges,82.6% of total billed charges,6860.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1128.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,369.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1128.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,369.07,281573.4,
OPEN SKULL FOR EXPLORATION,61304,CDM,983,RC,61304,HCPCS,Outpatient,,,6889,4477.85,,6062.32,88,,,percent of total billed charges,88% of total Billed charges,296.3,100,,,Fee Schedule,100% of Medicare rate,924.48,100,,,Fee Schedule,100% of WA Medicaid,6889,100,,,percent of total billed charges,100% of total billed charges,952.21,103,,,Fee Schedule,103% of WA Medicaid,296.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,518.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,924.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4753.41,69,,,percent of total billed charges,69% of total billed charges,6889,100,,,percent of total billed charges,100% of total billed charges,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,6889,100,,,percent of total billed charges,100% of total billed charges,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,6889,100,,,percent of total billed charges,100% of total billed charges,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,4260.85,61.85,,,percent of total billed charges,61.85% of total billed charges,924.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,924.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,942.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1201.82,130,,,Fee Schedule,130% of WA Medicaid ,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2597.15,37.7,,,percent of total billed charges,37.70% of total billed charges,2597.15,37.7,,,percent of total billed charges,37.70% of total billed charges,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,233537.1,33.9,,,percent of total billed charges,33.9% of total billed charges,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,5373.42,78,,,percent of total billed charges,78% of total billed charges,6889,100,,,percent of total billed charges,100% of total billed charges,5690.31,82.6,,,percent of total billed charges,82.6% of total billed charges,5690.31,82.6,,,percent of total billed charges,82.6% of total billed charges,924.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,296.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,924.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,296.3,233537.1,
OPEN SKULL FOR DRAINAGE,61314,CDM,983,RC,61314,HCPCS,Outpatient,,,7243,4707.95,,6373.84,88,,,percent of total billed charges,88% of total Billed charges,330.6,100,,,Fee Schedule,100% of Medicare rate,1028.92,100,,,Fee Schedule,100% of WA Medicaid,7243,100,,,percent of total billed charges,100% of total billed charges,1059.79,103,,,Fee Schedule,103% of WA Medicaid,330.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,578.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1028.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4997.67,69,,,percent of total billed charges,69% of total billed charges,7243,100,,,percent of total billed charges,100% of total billed charges,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,7243,100,,,percent of total billed charges,100% of total billed charges,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,7243,100,,,percent of total billed charges,100% of total billed charges,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4479.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1028.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1028.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1049.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1337.6,130,,,Fee Schedule,130% of WA Medicaid ,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,2730.61,37.7,,,percent of total billed charges,37.70% of total billed charges,2730.61,37.7,,,percent of total billed charges,37.70% of total billed charges,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,245537.7,33.9,,,percent of total billed charges,33.9% of total billed charges,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,5649.54,78,,,percent of total billed charges,78% of total billed charges,7243,100,,,percent of total billed charges,100% of total billed charges,5982.72,82.6,,,percent of total billed charges,82.6% of total billed charges,5982.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1028.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,330.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1028.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,330.6,245537.7,
OPEN SKULL FOR DRAINAGE,61312,CDM,983,RC,61312,HCPCS,Outpatient,,,7533,4896.45,,6629.04,88,,,percent of total billed charges,88% of total Billed charges,385.38,100,,,Fee Schedule,100% of Medicare rate,1161.52,100,,,Fee Schedule,100% of WA Medicaid,7533,100,,,percent of total billed charges,100% of total billed charges,1196.37,103,,,Fee Schedule,103% of WA Medicaid,385.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,674.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1161.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5197.77,69,,,percent of total billed charges,69% of total billed charges,7533,100,,,percent of total billed charges,100% of total billed charges,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,7533,100,,,percent of total billed charges,100% of total billed charges,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,7533,100,,,percent of total billed charges,100% of total billed charges,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,4659.16,61.85,,,percent of total billed charges,61.85% of total billed charges,1161.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1161.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1184.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1509.98,130,,,Fee Schedule,130% of WA Medicaid ,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2839.94,37.7,,,percent of total billed charges,37.70% of total billed charges,2839.94,37.7,,,percent of total billed charges,37.70% of total billed charges,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,255368.7,33.9,,,percent of total billed charges,33.9% of total billed charges,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,5875.74,78,,,percent of total billed charges,78% of total billed charges,7533,100,,,percent of total billed charges,100% of total billed charges,6222.26,82.6,,,percent of total billed charges,82.6% of total billed charges,6222.26,82.6,,,percent of total billed charges,82.6% of total billed charges,1161.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,385.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1161.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,385.38,255368.7,
IMPLT CRAN BONE FLAP TO ABDO,61316,CDM,983,RC,61316,HCPCS,Outpatient,,,477,310.05,,419.76,88,,,percent of total billed charges,88% of total Billed charges,17.33,100,,,Fee Schedule,100% of Medicare rate,48.12,100,,,Fee Schedule,100% of WA Medicaid,477,100,,,percent of total billed charges,100% of total billed charges,49.56,103,,,Fee Schedule,103% of WA Medicaid,17.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,329.13,69,,,percent of total billed charges,69% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,477,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,477,100,,,percent of total billed charges,100% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.02,61.85,,,percent of total billed charges,61.85% of total billed charges,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.56,130,,,Fee Schedule,130% of WA Medicaid ,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,16170.3,33.9,,,percent of total billed charges,33.9% of total billed charges,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.06,78,,,percent of total billed charges,78% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.33,16170.3,
OPEN SKULL FOR DRAINAGE,61315,CDM,983,RC,61315,HCPCS,Outpatient,,,8689,5647.85,,7646.32,88,,,percent of total billed charges,88% of total Billed charges,382.36,100,,,Fee Schedule,100% of Medicare rate,1163.57,100,,,Fee Schedule,100% of WA Medicaid,8689,100,,,percent of total billed charges,100% of total billed charges,1198.48,103,,,Fee Schedule,103% of WA Medicaid,382.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,669.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1163.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5995.41,69,,,percent of total billed charges,69% of total billed charges,8689,100,,,percent of total billed charges,100% of total billed charges,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,8689,100,,,percent of total billed charges,100% of total billed charges,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,8689,100,,,percent of total billed charges,100% of total billed charges,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,5374.15,61.85,,,percent of total billed charges,61.85% of total billed charges,1163.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1186.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1512.64,130,,,Fee Schedule,130% of WA Medicaid ,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3275.75,37.7,,,percent of total billed charges,37.70% of total billed charges,3275.75,37.7,,,percent of total billed charges,37.70% of total billed charges,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,294557.1,33.9,,,percent of total billed charges,33.9% of total billed charges,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6777.42,78,,,percent of total billed charges,78% of total billed charges,8689,100,,,percent of total billed charges,100% of total billed charges,7177.11,82.6,,,percent of total billed charges,82.6% of total billed charges,7177.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1163.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,382.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,382.36,294557.1,
OPEN SKULL FOR DRAINAGE,61313,CDM,983,RC,61313,HCPCS,Outpatient,,,7770,5050.50,,6837.6,88,,,percent of total billed charges,88% of total Billed charges,361.3,100,,,Fee Schedule,100% of Medicare rate,1119,100,,,Fee Schedule,100% of WA Medicaid,7770,100,,,percent of total billed charges,100% of total billed charges,1152.57,103,,,Fee Schedule,103% of WA Medicaid,361.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,632.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1119,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5361.3,69,,,percent of total billed charges,69% of total billed charges,7770,100,,,percent of total billed charges,100% of total billed charges,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,7770,100,,,percent of total billed charges,100% of total billed charges,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,7770,100,,,percent of total billed charges,100% of total billed charges,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,4805.75,61.85,,,percent of total billed charges,61.85% of total billed charges,1119,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1119,100,,,Fee Schedule,100% of WA Medicare OPPS rate,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1141.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1454.7,130,,,Fee Schedule,130% of WA Medicaid ,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2929.29,37.7,,,percent of total billed charges,37.70% of total billed charges,2929.29,37.7,,,percent of total billed charges,37.70% of total billed charges,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,263403,33.9,,,percent of total billed charges,33.9% of total billed charges,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,6060.6,78,,,percent of total billed charges,78% of total billed charges,7770,100,,,percent of total billed charges,100% of total billed charges,6418.02,82.6,,,percent of total billed charges,82.6% of total billed charges,6418.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1119,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,361.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1119,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,361.3,263403,
DECOMPRESSIVE LOBECTOMY,61323,CDM,983,RC,61323,HCPCS,Outpatient,,,11237,7304.05,,9888.56,88,,,percent of total billed charges,88% of total Billed charges,448.24,100,,,Fee Schedule,100% of Medicare rate,1339.63,100,,,Fee Schedule,100% of WA Medicaid,11237,100,,,percent of total billed charges,100% of total billed charges,1379.82,103,,,Fee Schedule,103% of WA Medicaid,448.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,784.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1339.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7753.53,69,,,percent of total billed charges,69% of total billed charges,11237,100,,,percent of total billed charges,100% of total billed charges,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,11237,100,,,percent of total billed charges,100% of total billed charges,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,11237,100,,,percent of total billed charges,100% of total billed charges,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,6950.08,61.85,,,percent of total billed charges,61.85% of total billed charges,1339.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1339.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1366.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1741.52,130,,,Fee Schedule,130% of WA Medicaid ,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,4236.35,37.7,,,percent of total billed charges,37.70% of total billed charges,4236.35,37.7,,,percent of total billed charges,37.70% of total billed charges,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,380934.3,33.9,,,percent of total billed charges,33.9% of total billed charges,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,8764.86,78,,,percent of total billed charges,78% of total billed charges,11237,100,,,percent of total billed charges,100% of total billed charges,9281.76,82.6,,,percent of total billed charges,82.6% of total billed charges,9281.76,82.6,,,percent of total billed charges,82.6% of total billed charges,1339.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,452.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,448.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1339.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,448.24,380934.3,
OPEN SKULL FOR DRAINAGE,61320,CDM,983,RC,61320,HCPCS,Outpatient,,,8027,5217.55,,7063.76,88,,,percent of total billed charges,88% of total Billed charges,349.08,100,,,Fee Schedule,100% of Medicare rate,1063.98,100,,,Fee Schedule,100% of WA Medicaid,8027,100,,,percent of total billed charges,100% of total billed charges,1095.9,103,,,Fee Schedule,103% of WA Medicaid,349.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,610.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1063.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5538.63,69,,,percent of total billed charges,69% of total billed charges,8027,100,,,percent of total billed charges,100% of total billed charges,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,8027,100,,,percent of total billed charges,100% of total billed charges,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,8027,100,,,percent of total billed charges,100% of total billed charges,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,4964.7,61.85,,,percent of total billed charges,61.85% of total billed charges,1063.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1085.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1383.17,130,,,Fee Schedule,130% of WA Medicaid ,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,3026.18,37.7,,,percent of total billed charges,37.70% of total billed charges,3026.18,37.7,,,percent of total billed charges,37.70% of total billed charges,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,272115.3,33.9,,,percent of total billed charges,33.9% of total billed charges,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,6261.06,78,,,percent of total billed charges,78% of total billed charges,8027,100,,,percent of total billed charges,100% of total billed charges,6630.3,82.6,,,percent of total billed charges,82.6% of total billed charges,6630.3,82.6,,,percent of total billed charges,82.6% of total billed charges,1063.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,349.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1063.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,349.08,272115.3,
OPEN SKULL FOR DRAINAGE,61321,CDM,983,RC,61321,HCPCS,Outpatient,,,8661,5629.65,,7621.68,88,,,percent of total billed charges,88% of total Billed charges,393.03,100,,,Fee Schedule,100% of Medicare rate,1193.79,100,,,Fee Schedule,100% of WA Medicaid,8661,100,,,percent of total billed charges,100% of total billed charges,1229.6,103,,,Fee Schedule,103% of WA Medicaid,393.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,687.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1193.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5976.09,69,,,percent of total billed charges,69% of total billed charges,8661,100,,,percent of total billed charges,100% of total billed charges,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,8661,100,,,percent of total billed charges,100% of total billed charges,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,8661,100,,,percent of total billed charges,100% of total billed charges,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,5356.83,61.85,,,percent of total billed charges,61.85% of total billed charges,1193.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1217.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1551.93,130,,,Fee Schedule,130% of WA Medicaid ,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3265.2,37.7,,,percent of total billed charges,37.70% of total billed charges,3265.2,37.7,,,percent of total billed charges,37.70% of total billed charges,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,293607.9,33.9,,,percent of total billed charges,33.9% of total billed charges,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6755.58,78,,,percent of total billed charges,78% of total billed charges,8661,100,,,percent of total billed charges,100% of total billed charges,7153.99,82.6,,,percent of total billed charges,82.6% of total billed charges,7153.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1193.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,393.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,393.03,293607.9,
EXPLORE ORBIT/REMOVE LESION,61333,CDM,983,RC,61333,HCPCS,Outpatient,,,7962,5175.30,,7006.56,88,,,percent of total billed charges,88% of total Billed charges,376.28,100,,,Fee Schedule,100% of Medicare rate,1131.68,100,,,Fee Schedule,100% of WA Medicaid,7962,100,,,percent of total billed charges,100% of total billed charges,1165.63,103,,,Fee Schedule,103% of WA Medicaid,376.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,658.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1131.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5493.78,69,,,percent of total billed charges,69% of total billed charges,7962,100,,,percent of total billed charges,100% of total billed charges,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,7962,100,,,percent of total billed charges,100% of total billed charges,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,7962,100,,,percent of total billed charges,100% of total billed charges,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4924.5,61.85,,,percent of total billed charges,61.85% of total billed charges,1131.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1471.18,130,,,Fee Schedule,130% of WA Medicaid ,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,3001.67,37.7,,,percent of total billed charges,37.70% of total billed charges,3001.67,37.7,,,percent of total billed charges,37.70% of total billed charges,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,269911.8,33.9,,,percent of total billed charges,33.9% of total billed charges,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,6210.36,78,,,percent of total billed charges,78% of total billed charges,7962,100,,,percent of total billed charges,100% of total billed charges,6576.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6576.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1131.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,376.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,376.28,269911.8,
DECOMPRESS EYE SOCKET,61330,CDM,983,RC,61330,HCPCS,Outpatient,,,8027,5217.55,,7063.76,88,,,percent of total billed charges,88% of total Billed charges,327.36,100,,,Fee Schedule,100% of Medicare rate,1011.76,100,,,Fee Schedule,100% of WA Medicaid,8027,100,,,percent of total billed charges,100% of total billed charges,1042.11,103,,,Fee Schedule,103% of WA Medicaid,327.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,572.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1011.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5538.63,69,,,percent of total billed charges,69% of total billed charges,8027,100,,,percent of total billed charges,100% of total billed charges,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,8027,100,,,percent of total billed charges,100% of total billed charges,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,8027,100,,,percent of total billed charges,100% of total billed charges,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4964.7,61.85,,,percent of total billed charges,61.85% of total billed charges,1011.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1011.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1315.29,130,,,Fee Schedule,130% of WA Medicaid ,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3026.18,37.7,,,percent of total billed charges,37.70% of total billed charges,3026.18,37.7,,,percent of total billed charges,37.70% of total billed charges,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,272115.3,33.9,,,percent of total billed charges,33.9% of total billed charges,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6261.06,78,,,percent of total billed charges,78% of total billed charges,8027,100,,,percent of total billed charges,100% of total billed charges,6630.3,82.6,,,percent of total billed charges,82.6% of total billed charges,6630.3,82.6,,,percent of total billed charges,82.6% of total billed charges,1011.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,327.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1011.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,327.36,272115.3,
EXPLORE ORBIT/REMOVE OBJECT,61334,CDM,983,RC,61334,HCPCS,Outpatient,,,5607,3644.55,,4934.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5607,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,3868.83,69,,,percent of total billed charges,69% of total billed charges,5607,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5607,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5607,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3467.93,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2113.84,37.7,,,percent of total billed charges,37.70% of total billed charges,2113.84,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,190077.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,4373.46,78,,,percent of total billed charges,78% of total billed charges,5607,100,,,percent of total billed charges,100% of total billed charges,4631.38,82.6,,,percent of total billed charges,82.6% of total billed charges,4631.38,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",2113.84,190077.3,
INCISE SKULL (PRESS RELIEF),61343,CDM,983,RC,61343,HCPCS,Outpatient,,,10062,6540.30,,8854.56,88,,,percent of total billed charges,88% of total Billed charges,400.73,100,,,Fee Schedule,100% of Medicare rate,1231.46,100,,,Fee Schedule,100% of WA Medicaid,10062,100,,,percent of total billed charges,100% of total billed charges,1268.4,103,,,Fee Schedule,103% of WA Medicaid,400.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,701.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1231.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6942.78,69,,,percent of total billed charges,69% of total billed charges,10062,100,,,percent of total billed charges,100% of total billed charges,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,10062,100,,,percent of total billed charges,100% of total billed charges,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,10062,100,,,percent of total billed charges,100% of total billed charges,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,6223.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1231.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1231.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1256.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1600.9,130,,,Fee Schedule,130% of WA Medicaid ,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3793.37,37.7,,,percent of total billed charges,37.70% of total billed charges,3793.37,37.7,,,percent of total billed charges,37.70% of total billed charges,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,341101.8,33.9,,,percent of total billed charges,33.9% of total billed charges,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,7848.36,78,,,percent of total billed charges,78% of total billed charges,10062,100,,,percent of total billed charges,100% of total billed charges,8311.21,82.6,,,percent of total billed charges,82.6% of total billed charges,8311.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1231.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,400.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1231.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,400.73,341101.8,
SUBTEMPORAL DECOMPRESSION,61340,CDM,983,RC,61340,HCPCS,Outpatient,,,5121,3328.65,,4506.48,88,,,percent of total billed charges,88% of total Billed charges,259.83,100,,,Fee Schedule,100% of Medicare rate,813.89,100,,,Fee Schedule,100% of WA Medicaid,5121,100,,,percent of total billed charges,100% of total billed charges,838.31,103,,,Fee Schedule,103% of WA Medicaid,259.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,454.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,813.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3533.49,69,,,percent of total billed charges,69% of total billed charges,5121,100,,,percent of total billed charges,100% of total billed charges,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,5121,100,,,percent of total billed charges,100% of total billed charges,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,5121,100,,,percent of total billed charges,100% of total billed charges,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3167.34,61.85,,,percent of total billed charges,61.85% of total billed charges,813.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,830.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1058.06,130,,,Fee Schedule,130% of WA Medicaid ,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1930.62,37.7,,,percent of total billed charges,37.70% of total billed charges,1930.62,37.7,,,percent of total billed charges,37.70% of total billed charges,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,173601.9,33.9,,,percent of total billed charges,33.9% of total billed charges,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,3994.38,78,,,percent of total billed charges,78% of total billed charges,5121,100,,,percent of total billed charges,100% of total billed charges,4229.95,82.6,,,percent of total billed charges,82.6% of total billed charges,4229.95,82.6,,,percent of total billed charges,82.6% of total billed charges,813.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,259.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,259.83,173601.9,
RELIEVE CRANIAL PRESSURE,61345,CDM,983,RC,61345,HCPCS,Outpatient,,,5273,3427.45,,4640.24,88,,,percent of total billed charges,88% of total Billed charges,376.65,100,,,Fee Schedule,100% of Medicare rate,1148.84,100,,,Fee Schedule,100% of WA Medicaid,5273,100,,,percent of total billed charges,100% of total billed charges,1183.31,103,,,Fee Schedule,103% of WA Medicaid,376.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,659.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1148.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3638.37,69,,,percent of total billed charges,69% of total billed charges,5273,100,,,percent of total billed charges,100% of total billed charges,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5273,100,,,percent of total billed charges,100% of total billed charges,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5273,100,,,percent of total billed charges,100% of total billed charges,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3261.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1148.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1148.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1171.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1493.49,130,,,Fee Schedule,130% of WA Medicaid ,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1987.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1987.92,37.7,,,percent of total billed charges,37.70% of total billed charges,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,178754.7,33.9,,,percent of total billed charges,33.9% of total billed charges,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,4112.94,78,,,percent of total billed charges,78% of total billed charges,5273,100,,,percent of total billed charges,100% of total billed charges,4355.5,82.6,,,percent of total billed charges,82.6% of total billed charges,4355.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1148.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,376.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1148.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,376.65,178754.7,
INCISE SKULL FOR SURGERY,61440,CDM,983,RC,61440,HCPCS,Outpatient,,,6172,4011.80,,5431.36,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6172,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,4258.68,69,,,percent of total billed charges,69% of total billed charges,6172,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6172,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6172,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3817.38,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2326.84,37.7,,,percent of total billed charges,37.70% of total billed charges,2326.84,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,209230.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,4814.16,78,,,percent of total billed charges,78% of total billed charges,6172,100,,,percent of total billed charges,100% of total billed charges,5098.07,82.6,,,percent of total billed charges,82.6% of total billed charges,5098.07,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",2326.84,209230.8,
INCISE SKULL FOR SURGERY,61450,CDM,983,RC,61450,HCPCS,Outpatient,,,7988,5192.20,,7029.44,88,,,percent of total billed charges,88% of total Billed charges,356.87,100,,,Fee Schedule,100% of Medicare rate,1078.72,100,,,Fee Schedule,100% of WA Medicaid,7988,100,,,percent of total billed charges,100% of total billed charges,1111.08,103,,,Fee Schedule,103% of WA Medicaid,356.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,624.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1078.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5511.72,69,,,percent of total billed charges,69% of total billed charges,7988,100,,,percent of total billed charges,100% of total billed charges,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,7988,100,,,percent of total billed charges,100% of total billed charges,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,7988,100,,,percent of total billed charges,100% of total billed charges,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,4940.58,61.85,,,percent of total billed charges,61.85% of total billed charges,1078.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1078.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1100.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1402.34,130,,,Fee Schedule,130% of WA Medicaid ,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3011.48,37.7,,,percent of total billed charges,37.70% of total billed charges,3011.48,37.7,,,percent of total billed charges,37.70% of total billed charges,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,270793.2,33.9,,,percent of total billed charges,33.9% of total billed charges,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6230.64,78,,,percent of total billed charges,78% of total billed charges,7988,100,,,percent of total billed charges,100% of total billed charges,6598.09,82.6,,,percent of total billed charges,82.6% of total billed charges,6598.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1078.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,356.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1078.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,356.87,270793.2,
INCISE SKULL FOR BRAIN WOUND,61458,CDM,983,RC,61458,HCPCS,Outpatient,,,8466,5502.90,,7450.08,88,,,percent of total billed charges,88% of total Billed charges,368.96,100,,,Fee Schedule,100% of Medicare rate,1131.12,100,,,Fee Schedule,100% of WA Medicaid,8466,100,,,percent of total billed charges,100% of total billed charges,1165.05,103,,,Fee Schedule,103% of WA Medicaid,368.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,645.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1131.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5841.54,69,,,percent of total billed charges,69% of total billed charges,8466,100,,,percent of total billed charges,100% of total billed charges,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8466,100,,,percent of total billed charges,100% of total billed charges,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8466,100,,,percent of total billed charges,100% of total billed charges,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,5236.22,61.85,,,percent of total billed charges,61.85% of total billed charges,1131.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1153.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1470.46,130,,,Fee Schedule,130% of WA Medicaid ,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3191.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3191.68,37.7,,,percent of total billed charges,37.70% of total billed charges,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,286997.4,33.9,,,percent of total billed charges,33.9% of total billed charges,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,6603.48,78,,,percent of total billed charges,78% of total billed charges,8466,100,,,percent of total billed charges,100% of total billed charges,6992.92,82.6,,,percent of total billed charges,82.6% of total billed charges,6992.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1131.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,368.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,368.96,286997.4,
INCISE SKULL FOR SURGERY,61460,CDM,983,RC,61460,HCPCS,Outpatient,,,8781,5707.65,,7727.28,88,,,percent of total billed charges,88% of total Billed charges,389.4,100,,,Fee Schedule,100% of Medicare rate,1184.09,100,,,Fee Schedule,100% of WA Medicaid,8781,100,,,percent of total billed charges,100% of total billed charges,1219.61,103,,,Fee Schedule,103% of WA Medicaid,389.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,681.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1184.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6058.89,69,,,percent of total billed charges,69% of total billed charges,8781,100,,,percent of total billed charges,100% of total billed charges,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,8781,100,,,percent of total billed charges,100% of total billed charges,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,8781,100,,,percent of total billed charges,100% of total billed charges,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,5431.05,61.85,,,percent of total billed charges,61.85% of total billed charges,1184.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1184.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1207.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1539.32,130,,,Fee Schedule,130% of WA Medicaid ,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,3310.44,37.7,,,percent of total billed charges,37.70% of total billed charges,3310.44,37.7,,,percent of total billed charges,37.70% of total billed charges,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,297675.9,33.9,,,percent of total billed charges,33.9% of total billed charges,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,6849.18,78,,,percent of total billed charges,78% of total billed charges,8781,100,,,percent of total billed charges,100% of total billed charges,7253.11,82.6,,,percent of total billed charges,82.6% of total billed charges,7253.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1184.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,389.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1184.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,389.4,297675.9,
REMOVAL OF SKULL LESION,61500,CDM,983,RC,61500,HCPCS,Outpatient,,,5622,3654.30,,4947.36,88,,,percent of total billed charges,88% of total Billed charges,189.9,100,,,Fee Schedule,100% of Medicare rate,737.79,100,,,Fee Schedule,100% of WA Medicaid,5622,100,,,percent of total billed charges,100% of total billed charges,759.92,103,,,Fee Schedule,103% of WA Medicaid,189.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,332.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,737.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3879.18,69,,,percent of total billed charges,69% of total billed charges,5622,100,,,percent of total billed charges,100% of total billed charges,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,5622,100,,,percent of total billed charges,100% of total billed charges,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,5622,100,,,percent of total billed charges,100% of total billed charges,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,3477.21,61.85,,,percent of total billed charges,61.85% of total billed charges,737.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,737.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,752.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,959.13,130,,,Fee Schedule,130% of WA Medicaid ,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2119.49,37.7,,,percent of total billed charges,37.70% of total billed charges,2119.49,37.7,,,percent of total billed charges,37.70% of total billed charges,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,190585.8,33.9,,,percent of total billed charges,33.9% of total billed charges,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,4385.16,78,,,percent of total billed charges,78% of total billed charges,5622,100,,,percent of total billed charges,100% of total billed charges,4643.77,82.6,,,percent of total billed charges,82.6% of total billed charges,4643.77,82.6,,,percent of total billed charges,82.6% of total billed charges,737.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,189.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,737.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,189.9,190585.8,
REMOVE INFECTED SKULL BONE,61501,CDM,983,RC,61501,HCPCS,Outpatient,,,4687,3046.55,,4124.56,88,,,percent of total billed charges,88% of total Billed charges,156.41,100,,,Fee Schedule,100% of Medicare rate,644.36,100,,,Fee Schedule,100% of WA Medicaid,4687,100,,,percent of total billed charges,100% of total billed charges,663.69,103,,,Fee Schedule,103% of WA Medicaid,156.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,273.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,644.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3234.03,69,,,percent of total billed charges,69% of total billed charges,4687,100,,,percent of total billed charges,100% of total billed charges,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,4687,100,,,percent of total billed charges,100% of total billed charges,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,4687,100,,,percent of total billed charges,100% of total billed charges,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2898.91,61.85,,,percent of total billed charges,61.85% of total billed charges,644.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,644.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,657.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,837.67,130,,,Fee Schedule,130% of WA Medicaid ,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1767,37.7,,,percent of total billed charges,37.70% of total billed charges,1767,37.7,,,percent of total billed charges,37.70% of total billed charges,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,158889.3,33.9,,,percent of total billed charges,33.9% of total billed charges,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,3655.86,78,,,percent of total billed charges,78% of total billed charges,4687,100,,,percent of total billed charges,100% of total billed charges,3871.46,82.6,,,percent of total billed charges,82.6% of total billed charges,3871.46,82.6,,,percent of total billed charges,82.6% of total billed charges,644.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,156.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,644.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,156.41,158889.3,
REMOVE BRAIN LINING LESION,61512,CDM,983,RC,61512,HCPCS,Outpatient,,,9860,6409.00,,8676.8,88,,,percent of total billed charges,88% of total Billed charges,474.07,100,,,Fee Schedule,100% of Medicare rate,1431.2,100,,,Fee Schedule,100% of WA Medicaid,9860,100,,,percent of total billed charges,100% of total billed charges,1474.14,103,,,Fee Schedule,103% of WA Medicaid,474.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,829.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1431.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6803.4,69,,,percent of total billed charges,69% of total billed charges,9860,100,,,percent of total billed charges,100% of total billed charges,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,9860,100,,,percent of total billed charges,100% of total billed charges,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,9860,100,,,percent of total billed charges,100% of total billed charges,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,6098.41,61.85,,,percent of total billed charges,61.85% of total billed charges,1431.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1431.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1459.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1860.56,130,,,Fee Schedule,130% of WA Medicaid ,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,3717.22,37.7,,,percent of total billed charges,37.70% of total billed charges,3717.22,37.7,,,percent of total billed charges,37.70% of total billed charges,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,334254,33.9,,,percent of total billed charges,33.9% of total billed charges,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,7690.8,78,,,percent of total billed charges,78% of total billed charges,9860,100,,,percent of total billed charges,100% of total billed charges,8144.36,82.6,,,percent of total billed charges,82.6% of total billed charges,8144.36,82.6,,,percent of total billed charges,82.6% of total billed charges,1431.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,474.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1431.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,474.07,334254,
REMOVAL OF BRAIN ABSCESS,61514,CDM,983,RC,61514,HCPCS,Outpatient,,,7898,5133.70,,6950.24,88,,,percent of total billed charges,88% of total Billed charges,348.51,100,,,Fee Schedule,100% of Medicare rate,1078.16,100,,,Fee Schedule,100% of WA Medicaid,7898,100,,,percent of total billed charges,100% of total billed charges,1110.5,103,,,Fee Schedule,103% of WA Medicaid,348.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,609.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1078.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5449.62,69,,,percent of total billed charges,69% of total billed charges,7898,100,,,percent of total billed charges,100% of total billed charges,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,7898,100,,,percent of total billed charges,100% of total billed charges,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,7898,100,,,percent of total billed charges,100% of total billed charges,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4884.91,61.85,,,percent of total billed charges,61.85% of total billed charges,1078.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1078.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1099.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1401.61,130,,,Fee Schedule,130% of WA Medicaid ,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2977.55,37.7,,,percent of total billed charges,37.70% of total billed charges,2977.55,37.7,,,percent of total billed charges,37.70% of total billed charges,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,267742.2,33.9,,,percent of total billed charges,33.9% of total billed charges,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,6160.44,78,,,percent of total billed charges,78% of total billed charges,7898,100,,,percent of total billed charges,100% of total billed charges,6523.75,82.6,,,percent of total billed charges,82.6% of total billed charges,6523.75,82.6,,,percent of total billed charges,82.6% of total billed charges,1078.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,352,101,,,Fee Schedule,101% of Medicare RBRVS rate,348.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1078.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,348.51,267742.2,
REMOVAL OF BRAIN LESION,61516,CDM,983,RC,61516,HCPCS,Outpatient,,,7719,5017.35,,6792.72,88,,,percent of total billed charges,88% of total Billed charges,342.16,100,,,Fee Schedule,100% of Medicare rate,1056.15,100,,,Fee Schedule,100% of WA Medicaid,7719,100,,,percent of total billed charges,100% of total billed charges,1087.83,103,,,Fee Schedule,103% of WA Medicaid,342.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,598.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1056.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5326.11,69,,,percent of total billed charges,69% of total billed charges,7719,100,,,percent of total billed charges,100% of total billed charges,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,7719,100,,,percent of total billed charges,100% of total billed charges,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,7719,100,,,percent of total billed charges,100% of total billed charges,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,4774.2,61.85,,,percent of total billed charges,61.85% of total billed charges,1056.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1056.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1077.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1373,130,,,Fee Schedule,130% of WA Medicaid ,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,2910.06,37.7,,,percent of total billed charges,37.70% of total billed charges,2910.06,37.7,,,percent of total billed charges,37.70% of total billed charges,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,261674.1,33.9,,,percent of total billed charges,33.9% of total billed charges,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,6020.82,78,,,percent of total billed charges,78% of total billed charges,7719,100,,,percent of total billed charges,100% of total billed charges,6375.89,82.6,,,percent of total billed charges,82.6% of total billed charges,6375.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1056.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,342.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1056.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,342.16,261674.1,
REMOVAL OF BRAIN LESION,61518,CDM,983,RC,61518,HCPCS,Outpatient,,,10136,6588.40,,8919.68,88,,,percent of total billed charges,88% of total Billed charges,510.98,100,,,Fee Schedule,100% of Medicare rate,1555.6,100,,,Fee Schedule,100% of WA Medicaid,10136,100,,,percent of total billed charges,100% of total billed charges,1602.27,103,,,Fee Schedule,103% of WA Medicaid,510.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,894.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1555.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6993.84,69,,,percent of total billed charges,69% of total billed charges,10136,100,,,percent of total billed charges,100% of total billed charges,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10136,100,,,percent of total billed charges,100% of total billed charges,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10136,100,,,percent of total billed charges,100% of total billed charges,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,6269.12,61.85,,,percent of total billed charges,61.85% of total billed charges,1555.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1555.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1586.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2022.28,130,,,Fee Schedule,130% of WA Medicaid ,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3821.27,37.7,,,percent of total billed charges,37.70% of total billed charges,3821.27,37.7,,,percent of total billed charges,37.70% of total billed charges,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,343610.4,33.9,,,percent of total billed charges,33.9% of total billed charges,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,7906.08,78,,,percent of total billed charges,78% of total billed charges,10136,100,,,percent of total billed charges,100% of total billed charges,8372.34,82.6,,,percent of total billed charges,82.6% of total billed charges,8372.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1555.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,516.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,510.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1555.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,510.98,343610.4,
IMPLT BRAIN CHEMOTX ADD-ON,61517,CDM,983,RC,61517,HCPCS,Outpatient,,,485,315.25,,426.8,88,,,percent of total billed charges,88% of total Billed charges,17.32,100,,,Fee Schedule,100% of Medicare rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,485,100,,,percent of total billed charges,100% of total billed charges,49.37,103,,,Fee Schedule,103% of WA Medicaid,17.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,334.65,69,,,percent of total billed charges,69% of total billed charges,485,100,,,percent of total billed charges,100% of total billed charges,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,485,100,,,percent of total billed charges,100% of total billed charges,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,485,100,,,percent of total billed charges,100% of total billed charges,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.97,61.85,,,percent of total billed charges,61.85% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.31,130,,,Fee Schedule,130% of WA Medicaid ,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.85,37.7,,,percent of total billed charges,37.70% of total billed charges,182.85,37.7,,,percent of total billed charges,37.70% of total billed charges,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,16441.5,33.9,,,percent of total billed charges,33.9% of total billed charges,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.3,78,,,percent of total billed charges,78% of total billed charges,485,100,,,percent of total billed charges,100% of total billed charges,400.61,82.6,,,percent of total billed charges,82.6% of total billed charges,400.61,82.6,,,percent of total billed charges,82.6% of total billed charges,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.32,16441.5,
REMOVAL OF BRAIN LESION,61510,CDM,983,RC,61510,HCPCS,Outpatient,,,9022,5864.30,,7939.36,88,,,percent of total billed charges,88% of total Billed charges,397.35,100,,,Fee Schedule,100% of Medicare rate,1241.9,100,,,Fee Schedule,100% of WA Medicaid,9022,100,,,percent of total billed charges,100% of total billed charges,1279.16,103,,,Fee Schedule,103% of WA Medicaid,397.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,695.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1241.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6225.18,69,,,percent of total billed charges,69% of total billed charges,9022,100,,,percent of total billed charges,100% of total billed charges,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,9022,100,,,percent of total billed charges,100% of total billed charges,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,9022,100,,,percent of total billed charges,100% of total billed charges,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,5580.11,61.85,,,percent of total billed charges,61.85% of total billed charges,1241.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1241.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1266.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1614.47,130,,,Fee Schedule,130% of WA Medicaid ,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3401.29,37.7,,,percent of total billed charges,37.70% of total billed charges,3401.29,37.7,,,percent of total billed charges,37.70% of total billed charges,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,305845.8,33.9,,,percent of total billed charges,33.9% of total billed charges,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,7037.16,78,,,percent of total billed charges,78% of total billed charges,9022,100,,,percent of total billed charges,100% of total billed charges,7452.17,82.6,,,percent of total billed charges,82.6% of total billed charges,7452.17,82.6,,,percent of total billed charges,82.6% of total billed charges,1241.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,401.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,397.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1241.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,397.35,305845.8,
REMOVE BRAIN LINING LESION,61519,CDM,983,RC,61519,HCPCS,Outpatient,,,12717,8266.05,,11190.96,88,,,percent of total billed charges,88% of total Billed charges,549.5,100,,,Fee Schedule,100% of Medicare rate,1645.49,100,,,Fee Schedule,100% of WA Medicaid,12717,100,,,percent of total billed charges,100% of total billed charges,1694.85,103,,,Fee Schedule,103% of WA Medicaid,549.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,961.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1645.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8774.73,69,,,percent of total billed charges,69% of total billed charges,12717,100,,,percent of total billed charges,100% of total billed charges,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,12717,100,,,percent of total billed charges,100% of total billed charges,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,12717,100,,,percent of total billed charges,100% of total billed charges,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,7865.46,61.85,,,percent of total billed charges,61.85% of total billed charges,1645.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1645.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1678.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2139.14,130,,,Fee Schedule,130% of WA Medicaid ,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,4794.31,37.7,,,percent of total billed charges,37.70% of total billed charges,4794.31,37.7,,,percent of total billed charges,37.70% of total billed charges,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,431106.3,33.9,,,percent of total billed charges,33.9% of total billed charges,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,9919.26,78,,,percent of total billed charges,78% of total billed charges,12717,100,,,percent of total billed charges,100% of total billed charges,10504.24,82.6,,,percent of total billed charges,82.6% of total billed charges,10504.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1645.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,555,101,,,Fee Schedule,101% of Medicare RBRVS rate,549.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1645.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,549.5,431106.3,
REMOVAL OF BRAIN LESION,61520,CDM,983,RC,61520,HCPCS,Outpatient,,,13664,8881.60,,12024.32,88,,,percent of total billed charges,88% of total Billed charges,646.9,100,,,Fee Schedule,100% of Medicare rate,2079.48,100,,,Fee Schedule,100% of WA Medicaid,13664,100,,,percent of total billed charges,100% of total billed charges,2141.86,103,,,Fee Schedule,103% of WA Medicaid,646.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1132.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2079.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,9428.16,69,,,percent of total billed charges,69% of total billed charges,13664,100,,,percent of total billed charges,100% of total billed charges,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,13664,100,,,percent of total billed charges,100% of total billed charges,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,13664,100,,,percent of total billed charges,100% of total billed charges,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,8451.18,61.85,,,percent of total billed charges,61.85% of total billed charges,2079.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2079.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2121.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2703.32,130,,,Fee Schedule,130% of WA Medicaid ,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,5151.33,37.7,,,percent of total billed charges,37.70% of total billed charges,5151.33,37.7,,,percent of total billed charges,37.70% of total billed charges,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,463209.6,33.9,,,percent of total billed charges,33.9% of total billed charges,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,10657.92,78,,,percent of total billed charges,78% of total billed charges,13664,100,,,percent of total billed charges,100% of total billed charges,11286.46,82.6,,,percent of total billed charges,82.6% of total billed charges,11286.46,82.6,,,percent of total billed charges,82.6% of total billed charges,2079.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,653.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,646.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2079.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,646.9,463209.6,
REMOVAL OF BRAIN LESION,61526,CDM,983,RC,61526,HCPCS,Outpatient,,,9588,6232.20,,8437.44,88,,,percent of total billed charges,88% of total Billed charges,499.53,100,,,Fee Schedule,100% of Medicare rate,1873.39,100,,,Fee Schedule,100% of WA Medicaid,9588,100,,,percent of total billed charges,100% of total billed charges,1929.59,103,,,Fee Schedule,103% of WA Medicaid,499.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,874.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1873.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6615.72,69,,,percent of total billed charges,69% of total billed charges,9588,100,,,percent of total billed charges,100% of total billed charges,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,9588,100,,,percent of total billed charges,100% of total billed charges,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,9588,100,,,percent of total billed charges,100% of total billed charges,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,5930.18,61.85,,,percent of total billed charges,61.85% of total billed charges,1873.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1873.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1910.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2435.41,130,,,Fee Schedule,130% of WA Medicaid ,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,3614.68,37.7,,,percent of total billed charges,37.70% of total billed charges,3614.68,37.7,,,percent of total billed charges,37.70% of total billed charges,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,325033.2,33.9,,,percent of total billed charges,33.9% of total billed charges,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,7478.64,78,,,percent of total billed charges,78% of total billed charges,9588,100,,,percent of total billed charges,100% of total billed charges,7919.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7919.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1873.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,504.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,499.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1873.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,499.53,325033.2,
REMOVAL OF BRAIN LESION,61521,CDM,983,RC,61521,HCPCS,Outpatient,,,12093,7860.45,,10641.84,88,,,percent of total billed charges,88% of total Billed charges,601.53,100,,,Fee Schedule,100% of Medicare rate,1775.67,100,,,Fee Schedule,100% of WA Medicaid,12093,100,,,percent of total billed charges,100% of total billed charges,1828.94,103,,,Fee Schedule,103% of WA Medicaid,601.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1052.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1775.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8344.17,69,,,percent of total billed charges,69% of total billed charges,12093,100,,,percent of total billed charges,100% of total billed charges,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,12093,100,,,percent of total billed charges,100% of total billed charges,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,12093,100,,,percent of total billed charges,100% of total billed charges,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,7479.52,61.85,,,percent of total billed charges,61.85% of total billed charges,1775.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1775.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1811.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2308.37,130,,,Fee Schedule,130% of WA Medicaid ,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,4559.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4559.06,37.7,,,percent of total billed charges,37.70% of total billed charges,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,409952.7,33.9,,,percent of total billed charges,33.9% of total billed charges,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,9432.54,78,,,percent of total billed charges,78% of total billed charges,12093,100,,,percent of total billed charges,100% of total billed charges,9988.82,82.6,,,percent of total billed charges,82.6% of total billed charges,9988.82,82.6,,,percent of total billed charges,82.6% of total billed charges,1775.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,607.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,601.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1775.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,601.53,409952.7,
REMOVAL OF BRAIN LESION,61524,CDM,983,RC,61524,HCPCS,Outpatient,,,8534,5547.10,,7509.92,88,,,percent of total billed charges,88% of total Billed charges,385.13,100,,,Fee Schedule,100% of Medicare rate,1171.97,100,,,Fee Schedule,100% of WA Medicaid,8534,100,,,percent of total billed charges,100% of total billed charges,1207.13,103,,,Fee Schedule,103% of WA Medicaid,385.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,673.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1171.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5888.46,69,,,percent of total billed charges,69% of total billed charges,8534,100,,,percent of total billed charges,100% of total billed charges,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8534,100,,,percent of total billed charges,100% of total billed charges,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8534,100,,,percent of total billed charges,100% of total billed charges,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,5278.28,61.85,,,percent of total billed charges,61.85% of total billed charges,1171.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1171.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1195.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1523.56,130,,,Fee Schedule,130% of WA Medicaid ,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,3217.32,37.7,,,percent of total billed charges,37.70% of total billed charges,3217.32,37.7,,,percent of total billed charges,37.70% of total billed charges,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,289302.6,33.9,,,percent of total billed charges,33.9% of total billed charges,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,6656.52,78,,,percent of total billed charges,78% of total billed charges,8534,100,,,percent of total billed charges,100% of total billed charges,7049.08,82.6,,,percent of total billed charges,82.6% of total billed charges,7049.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1171.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,385.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1171.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,385.13,289302.6,
REMOVAL OF BRAIN ABSCESS,61522,CDM,983,RC,61522,HCPCS,Outpatient,,,8998,5848.70,,7918.24,88,,,percent of total billed charges,88% of total Billed charges,405.79,100,,,Fee Schedule,100% of Medicare rate,1228.85,100,,,Fee Schedule,100% of WA Medicaid,8998,100,,,percent of total billed charges,100% of total billed charges,1265.72,103,,,Fee Schedule,103% of WA Medicaid,405.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,710.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1228.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6208.62,69,,,percent of total billed charges,69% of total billed charges,8998,100,,,percent of total billed charges,100% of total billed charges,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,8998,100,,,percent of total billed charges,100% of total billed charges,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,8998,100,,,percent of total billed charges,100% of total billed charges,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,5565.26,61.85,,,percent of total billed charges,61.85% of total billed charges,1228.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1228.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1253.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1597.51,130,,,Fee Schedule,130% of WA Medicaid ,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,3392.25,37.7,,,percent of total billed charges,37.70% of total billed charges,3392.25,37.7,,,percent of total billed charges,37.70% of total billed charges,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,305032.2,33.9,,,percent of total billed charges,33.9% of total billed charges,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,7018.44,78,,,percent of total billed charges,78% of total billed charges,8998,100,,,percent of total billed charges,100% of total billed charges,7432.35,82.6,,,percent of total billed charges,82.6% of total billed charges,7432.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1228.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,405.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1228.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,405.79,305032.2,
REMOVAL OF BRAIN LESION,61530,CDM,983,RC,61530,HCPCS,Outpatient,,,11646,7569.90,,10248.48,88,,,percent of total billed charges,88% of total Billed charges,583.02,100,,,Fee Schedule,100% of Medicare rate,1714.87,100,,,Fee Schedule,100% of WA Medicaid,11646,100,,,percent of total billed charges,100% of total billed charges,1766.32,103,,,Fee Schedule,103% of WA Medicaid,583.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1020.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1714.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8035.74,69,,,percent of total billed charges,69% of total billed charges,11646,100,,,percent of total billed charges,100% of total billed charges,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,11646,100,,,percent of total billed charges,100% of total billed charges,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,11646,100,,,percent of total billed charges,100% of total billed charges,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7203.05,61.85,,,percent of total billed charges,61.85% of total billed charges,1714.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1714.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1749.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2229.33,130,,,Fee Schedule,130% of WA Medicaid ,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4390.54,37.7,,,percent of total billed charges,37.70% of total billed charges,4390.54,37.7,,,percent of total billed charges,37.70% of total billed charges,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,394799.4,33.9,,,percent of total billed charges,33.9% of total billed charges,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,9083.88,78,,,percent of total billed charges,78% of total billed charges,11646,100,,,percent of total billed charges,100% of total billed charges,9619.6,82.6,,,percent of total billed charges,82.6% of total billed charges,9619.6,82.6,,,percent of total billed charges,82.6% of total billed charges,1714.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,583.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1714.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,583.02,394799.4,
REMOVAL OF BRAIN TISSUE,61539,CDM,983,RC,61539,HCPCS,Outpatient,,,9956,6471.40,,8761.28,88,,,percent of total billed charges,88% of total Billed charges,440.11,100,,,Fee Schedule,100% of Medicare rate,1323.59,100,,,Fee Schedule,100% of WA Medicaid,9956,100,,,percent of total billed charges,100% of total billed charges,1363.3,103,,,Fee Schedule,103% of WA Medicaid,440.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,770.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1323.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6869.64,69,,,percent of total billed charges,69% of total billed charges,9956,100,,,percent of total billed charges,100% of total billed charges,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,9956,100,,,percent of total billed charges,100% of total billed charges,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,9956,100,,,percent of total billed charges,100% of total billed charges,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,6157.79,61.85,,,percent of total billed charges,61.85% of total billed charges,1323.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1350.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1720.67,130,,,Fee Schedule,130% of WA Medicaid ,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,3753.41,37.7,,,percent of total billed charges,37.70% of total billed charges,3753.41,37.7,,,percent of total billed charges,37.70% of total billed charges,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,337508.4,33.9,,,percent of total billed charges,33.9% of total billed charges,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,7765.68,78,,,percent of total billed charges,78% of total billed charges,9956,100,,,percent of total billed charges,100% of total billed charges,8223.66,82.6,,,percent of total billed charges,82.6% of total billed charges,8223.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1323.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,440.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1323.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,440.11,337508.4,
REMOVAL OF BRAIN TISSUE,61537,CDM,983,RC,61537,HCPCS,Outpatient,,,8777,5705.05,,7723.76,88,,,percent of total billed charges,88% of total Billed charges,466.35,100,,,Fee Schedule,100% of Medicare rate,1372.64,100,,,Fee Schedule,100% of WA Medicaid,8777,100,,,percent of total billed charges,100% of total billed charges,1413.82,103,,,Fee Schedule,103% of WA Medicaid,466.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,816.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1372.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6056.13,69,,,percent of total billed charges,69% of total billed charges,8777,100,,,percent of total billed charges,100% of total billed charges,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,8777,100,,,percent of total billed charges,100% of total billed charges,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,8777,100,,,percent of total billed charges,100% of total billed charges,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,5428.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1372.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1372.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1400.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1784.43,130,,,Fee Schedule,130% of WA Medicaid ,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3308.93,37.7,,,percent of total billed charges,37.70% of total billed charges,3308.93,37.7,,,percent of total billed charges,37.70% of total billed charges,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,297540.3,33.9,,,percent of total billed charges,33.9% of total billed charges,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,6846.06,78,,,percent of total billed charges,78% of total billed charges,8777,100,,,percent of total billed charges,100% of total billed charges,7249.8,82.6,,,percent of total billed charges,82.6% of total billed charges,7249.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1372.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,466.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1372.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,466.35,297540.3,
REMOVAL OF BRAIN TISSUE,61538,CDM,983,RC,61538,HCPCS,Outpatient,,,8369,5439.85,,7364.72,88,,,percent of total billed charges,88% of total Billed charges,505.02,100,,,Fee Schedule,100% of Medicare rate,1485.85,100,,,Fee Schedule,100% of WA Medicaid,8369,100,,,percent of total billed charges,100% of total billed charges,1530.43,103,,,Fee Schedule,103% of WA Medicaid,505.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,883.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1485.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5774.61,69,,,percent of total billed charges,69% of total billed charges,8369,100,,,percent of total billed charges,100% of total billed charges,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,8369,100,,,percent of total billed charges,100% of total billed charges,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,8369,100,,,percent of total billed charges,100% of total billed charges,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,5176.23,61.85,,,percent of total billed charges,61.85% of total billed charges,1485.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1485.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1515.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1931.61,130,,,Fee Schedule,130% of WA Medicaid ,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3155.11,37.7,,,percent of total billed charges,37.70% of total billed charges,3155.11,37.7,,,percent of total billed charges,37.70% of total billed charges,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,283709.1,33.9,,,percent of total billed charges,33.9% of total billed charges,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,6527.82,78,,,percent of total billed charges,78% of total billed charges,8369,100,,,percent of total billed charges,100% of total billed charges,6912.79,82.6,,,percent of total billed charges,82.6% of total billed charges,6912.79,82.6,,,percent of total billed charges,82.6% of total billed charges,1485.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,505.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1485.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,505.02,283709.1,
REMOVAL OF PITUITARY GLAND,61548,CDM,983,RC,61548,HCPCS,Outpatient,,,8777,5705.05,,7723.76,88,,,percent of total billed charges,88% of total Billed charges,259.93,100,,,Fee Schedule,100% of Medicare rate,884.38,100,,,Fee Schedule,100% of WA Medicaid,8777,100,,,percent of total billed charges,100% of total billed charges,910.91,103,,,Fee Schedule,103% of WA Medicaid,259.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,454.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,884.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6056.13,69,,,percent of total billed charges,69% of total billed charges,8777,100,,,percent of total billed charges,100% of total billed charges,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,8777,100,,,percent of total billed charges,100% of total billed charges,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,8777,100,,,percent of total billed charges,100% of total billed charges,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5428.57,61.85,,,percent of total billed charges,61.85% of total billed charges,884.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,884.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1149.69,130,,,Fee Schedule,130% of WA Medicaid ,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3308.93,37.7,,,percent of total billed charges,37.70% of total billed charges,3308.93,37.7,,,percent of total billed charges,37.70% of total billed charges,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,297540.3,33.9,,,percent of total billed charges,33.9% of total billed charges,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,6846.06,78,,,percent of total billed charges,78% of total billed charges,8777,100,,,percent of total billed charges,100% of total billed charges,7249.8,82.6,,,percent of total billed charges,82.6% of total billed charges,7249.8,82.6,,,percent of total billed charges,82.6% of total billed charges,884.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,259.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,884.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,259.93,297540.3,
REMOVE  TREAT BRAIN LESION,61544,CDM,983,RC,61544,HCPCS,Outpatient,,,7792,5064.80,,6856.96,88,,,percent of total billed charges,88% of total Billed charges,352.36,100,,,Fee Schedule,100% of Medicare rate,1067.15,100,,,Fee Schedule,100% of WA Medicaid,7792,100,,,percent of total billed charges,100% of total billed charges,1099.16,103,,,Fee Schedule,103% of WA Medicaid,352.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,616.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1067.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5376.48,69,,,percent of total billed charges,69% of total billed charges,7792,100,,,percent of total billed charges,100% of total billed charges,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,7792,100,,,percent of total billed charges,100% of total billed charges,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,7792,100,,,percent of total billed charges,100% of total billed charges,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4819.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1067.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1088.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1387.3,130,,,Fee Schedule,130% of WA Medicaid ,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2937.58,37.7,,,percent of total billed charges,37.70% of total billed charges,2937.58,37.7,,,percent of total billed charges,37.70% of total billed charges,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,264148.8,33.9,,,percent of total billed charges,33.9% of total billed charges,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6077.76,78,,,percent of total billed charges,78% of total billed charges,7792,100,,,percent of total billed charges,100% of total billed charges,6436.19,82.6,,,percent of total billed charges,82.6% of total billed charges,6436.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1067.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,352.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1067.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,352.36,264148.8,
REMOVAL OF PITUITARY GLAND,61546,CDM,983,RC,61546,HCPCS,Outpatient,,,9660,6279.00,,8500.8,88,,,percent of total billed charges,88% of total Billed charges,430.04,100,,,Fee Schedule,100% of Medicare rate,1295.06,100,,,Fee Schedule,100% of WA Medicaid,9660,100,,,percent of total billed charges,100% of total billed charges,1333.91,103,,,Fee Schedule,103% of WA Medicaid,430.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,752.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1295.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6665.4,69,,,percent of total billed charges,69% of total billed charges,9660,100,,,percent of total billed charges,100% of total billed charges,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,9660,100,,,percent of total billed charges,100% of total billed charges,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,9660,100,,,percent of total billed charges,100% of total billed charges,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,5974.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1295.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1295.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1320.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1683.58,130,,,Fee Schedule,130% of WA Medicaid ,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3641.82,37.7,,,percent of total billed charges,37.70% of total billed charges,3641.82,37.7,,,percent of total billed charges,37.70% of total billed charges,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,327474,33.9,,,percent of total billed charges,33.9% of total billed charges,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,7534.8,78,,,percent of total billed charges,78% of total billed charges,9660,100,,,percent of total billed charges,100% of total billed charges,7979.16,82.6,,,percent of total billed charges,82.6% of total billed charges,7979.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1295.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,434.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,430.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1295.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,430.04,327474,
EXCISION OF BRAIN TUMOR,61545,CDM,983,RC,61545,HCPCS,Outpatient,,,13192,8574.80,,11608.96,88,,,percent of total billed charges,88% of total Billed charges,595.99,100,,,Fee Schedule,100% of Medicare rate,1784.43,100,,,Fee Schedule,100% of WA Medicaid,13192,100,,,percent of total billed charges,100% of total billed charges,1837.96,103,,,Fee Schedule,103% of WA Medicaid,595.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1042.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1784.43,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,9102.48,69,,,percent of total billed charges,69% of total billed charges,13192,100,,,percent of total billed charges,100% of total billed charges,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,13192,100,,,percent of total billed charges,100% of total billed charges,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,13192,100,,,percent of total billed charges,100% of total billed charges,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,8159.25,61.85,,,percent of total billed charges,61.85% of total billed charges,1784.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1784.43,100,,,Fee Schedule,100% of WA Medicare OPPS rate,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1820.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2319.76,130,,,Fee Schedule,130% of WA Medicaid ,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,4973.38,37.7,,,percent of total billed charges,37.70% of total billed charges,4973.38,37.7,,,percent of total billed charges,37.70% of total billed charges,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,447208.8,33.9,,,percent of total billed charges,33.9% of total billed charges,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,10289.76,78,,,percent of total billed charges,78% of total billed charges,13192,100,,,percent of total billed charges,100% of total billed charges,10896.59,82.6,,,percent of total billed charges,82.6% of total billed charges,10896.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1784.43,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,601.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,595.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1784.43,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,595.99,447208.8,
INCISE SKULL/SUTURES,61556,CDM,983,RC,61556,HCPCS,Outpatient,,,7301,4745.65,,6424.88,88,,,percent of total billed charges,88% of total Billed charges,311.35,100,,,Fee Schedule,100% of Medicare rate,964.02,100,,,Fee Schedule,100% of WA Medicaid,7301,100,,,percent of total billed charges,100% of total billed charges,992.94,103,,,Fee Schedule,103% of WA Medicaid,311.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,544.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,964.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5037.69,69,,,percent of total billed charges,69% of total billed charges,7301,100,,,percent of total billed charges,100% of total billed charges,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,7301,100,,,percent of total billed charges,100% of total billed charges,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,7301,100,,,percent of total billed charges,100% of total billed charges,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,4515.67,61.85,,,percent of total billed charges,61.85% of total billed charges,964.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,964.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,983.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1253.23,130,,,Fee Schedule,130% of WA Medicaid ,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2752.48,37.7,,,percent of total billed charges,37.70% of total billed charges,2752.48,37.7,,,percent of total billed charges,37.70% of total billed charges,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,247503.9,33.9,,,percent of total billed charges,33.9% of total billed charges,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,5694.78,78,,,percent of total billed charges,78% of total billed charges,7301,100,,,percent of total billed charges,100% of total billed charges,6030.63,82.6,,,percent of total billed charges,82.6% of total billed charges,6030.63,82.6,,,percent of total billed charges,82.6% of total billed charges,964.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,311.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,964.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,311.35,247503.9,
RELEASE OF SKULL SEAMS,61552,CDM,983,RC,61552,HCPCS,Outpatient,,,5126,3331.90,,4510.88,88,,,percent of total billed charges,88% of total Billed charges,264.44,100,,,Fee Schedule,100% of Medicare rate,842.61,100,,,Fee Schedule,100% of WA Medicaid,5126,100,,,percent of total billed charges,100% of total billed charges,867.89,103,,,Fee Schedule,103% of WA Medicaid,264.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,462.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,842.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3536.94,69,,,percent of total billed charges,69% of total billed charges,5126,100,,,percent of total billed charges,100% of total billed charges,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5126,100,,,percent of total billed charges,100% of total billed charges,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5126,100,,,percent of total billed charges,100% of total billed charges,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,3170.43,61.85,,,percent of total billed charges,61.85% of total billed charges,842.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1095.39,130,,,Fee Schedule,130% of WA Medicaid ,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1932.5,37.7,,,percent of total billed charges,37.70% of total billed charges,1932.5,37.7,,,percent of total billed charges,37.70% of total billed charges,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,173771.4,33.9,,,percent of total billed charges,33.9% of total billed charges,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,3998.28,78,,,percent of total billed charges,78% of total billed charges,5126,100,,,percent of total billed charges,100% of total billed charges,4234.08,82.6,,,percent of total billed charges,82.6% of total billed charges,4234.08,82.6,,,percent of total billed charges,82.6% of total billed charges,842.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,267.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,264.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,264.44,173771.4,
RELEASE OF SKULL SEAMS,61550,CDM,983,RC,61550,HCPCS,Outpatient,,,3960,2574.00,,3484.8,88,,,percent of total billed charges,88% of total Billed charges,204.4,100,,,Fee Schedule,100% of Medicare rate,683.9,100,,,Fee Schedule,100% of WA Medicaid,3960,100,,,percent of total billed charges,100% of total billed charges,704.42,103,,,Fee Schedule,103% of WA Medicaid,204.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,357.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,683.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2732.4,69,,,percent of total billed charges,69% of total billed charges,3960,100,,,percent of total billed charges,100% of total billed charges,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,3960,100,,,percent of total billed charges,100% of total billed charges,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,3960,100,,,percent of total billed charges,100% of total billed charges,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2449.26,61.85,,,percent of total billed charges,61.85% of total billed charges,683.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,889.07,130,,,Fee Schedule,130% of WA Medicaid ,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1492.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1492.92,37.7,,,percent of total billed charges,37.70% of total billed charges,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,134244,33.9,,,percent of total billed charges,33.9% of total billed charges,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,3088.8,78,,,percent of total billed charges,78% of total billed charges,3960,100,,,percent of total billed charges,100% of total billed charges,3270.96,82.6,,,percent of total billed charges,82.6% of total billed charges,3270.96,82.6,,,percent of total billed charges,82.6% of total billed charges,683.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,204.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,204.4,134244,
EXCISION OF SKULL TUMOR,61563,CDM,983,RC,61563,HCPCS,Outpatient,,,8174,5313.10,,7193.12,88,,,percent of total billed charges,88% of total Billed charges,366.29,100,,,Fee Schedule,100% of Medicare rate,1114.9,100,,,Fee Schedule,100% of WA Medicaid,8174,100,,,percent of total billed charges,100% of total billed charges,1148.35,103,,,Fee Schedule,103% of WA Medicaid,366.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,641.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1114.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5640.06,69,,,percent of total billed charges,69% of total billed charges,8174,100,,,percent of total billed charges,100% of total billed charges,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,8174,100,,,percent of total billed charges,100% of total billed charges,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,8174,100,,,percent of total billed charges,100% of total billed charges,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,5055.62,61.85,,,percent of total billed charges,61.85% of total billed charges,1114.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1114.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1137.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1449.37,130,,,Fee Schedule,130% of WA Medicaid ,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,3081.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3081.6,37.7,,,percent of total billed charges,37.70% of total billed charges,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,277098.6,33.9,,,percent of total billed charges,33.9% of total billed charges,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,6375.72,78,,,percent of total billed charges,78% of total billed charges,8174,100,,,percent of total billed charges,100% of total billed charges,6751.72,82.6,,,percent of total billed charges,82.6% of total billed charges,6751.72,82.6,,,percent of total billed charges,82.6% of total billed charges,1114.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,369.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,366.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1114.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,366.29,277098.6,
SKULL BASE/BRAINSTEM SURGERY,61575,CDM,983,RC,61575,HCPCS,Outpatient,,,7918,5146.70,,6967.84,88,,,percent of total billed charges,88% of total Billed charges,469.21,100,,,Fee Schedule,100% of Medicare rate,1402.85,100,,,Fee Schedule,100% of WA Medicaid,7918,100,,,percent of total billed charges,100% of total billed charges,1444.94,103,,,Fee Schedule,103% of WA Medicaid,469.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,821.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1402.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5463.42,69,,,percent of total billed charges,69% of total billed charges,7918,100,,,percent of total billed charges,100% of total billed charges,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,7918,100,,,percent of total billed charges,100% of total billed charges,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,7918,100,,,percent of total billed charges,100% of total billed charges,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,4897.28,61.85,,,percent of total billed charges,61.85% of total billed charges,1402.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1402.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1430.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1823.71,130,,,Fee Schedule,130% of WA Medicaid ,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2985.09,37.7,,,percent of total billed charges,37.70% of total billed charges,2985.09,37.7,,,percent of total billed charges,37.70% of total billed charges,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,268420.2,33.9,,,percent of total billed charges,33.9% of total billed charges,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,6176.04,78,,,percent of total billed charges,78% of total billed charges,7918,100,,,percent of total billed charges,100% of total billed charges,6540.27,82.6,,,percent of total billed charges,82.6% of total billed charges,6540.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1402.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,469.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1402.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,469.21,268420.2,
INCISE SKULL FOR BRAIN WOUND,61571,CDM,983,RC,61571,HCPCS,Outpatient,,,8238,5354.70,,7249.44,88,,,percent of total billed charges,88% of total Billed charges,366.35,100,,,Fee Schedule,100% of Medicare rate,1121.05,100,,,Fee Schedule,100% of WA Medicaid,8238,100,,,percent of total billed charges,100% of total billed charges,1154.68,103,,,Fee Schedule,103% of WA Medicaid,366.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,641.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1121.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5684.22,69,,,percent of total billed charges,69% of total billed charges,8238,100,,,percent of total billed charges,100% of total billed charges,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,8238,100,,,percent of total billed charges,100% of total billed charges,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,8238,100,,,percent of total billed charges,100% of total billed charges,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,5095.2,61.85,,,percent of total billed charges,61.85% of total billed charges,1121.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1121.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1143.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1457.37,130,,,Fee Schedule,130% of WA Medicaid ,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3105.73,37.7,,,percent of total billed charges,37.70% of total billed charges,3105.73,37.7,,,percent of total billed charges,37.70% of total billed charges,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,279268.2,33.9,,,percent of total billed charges,33.9% of total billed charges,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,6425.64,78,,,percent of total billed charges,78% of total billed charges,8238,100,,,percent of total billed charges,100% of total billed charges,6804.59,82.6,,,percent of total billed charges,82.6% of total billed charges,6804.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1121.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,370.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,366.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1121.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,366.35,279268.2,
REMOVE FOREIGN BODY BRAIN,61570,CDM,983,RC,61570,HCPCS,Outpatient,,,7585,4930.25,,6674.8,88,,,percent of total billed charges,88% of total Billed charges,342.62,100,,,Fee Schedule,100% of Medicare rate,1055.03,100,,,Fee Schedule,100% of WA Medicaid,7585,100,,,percent of total billed charges,100% of total billed charges,1086.68,103,,,Fee Schedule,103% of WA Medicaid,342.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,599.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1055.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5233.65,69,,,percent of total billed charges,69% of total billed charges,7585,100,,,percent of total billed charges,100% of total billed charges,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,7585,100,,,percent of total billed charges,100% of total billed charges,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,7585,100,,,percent of total billed charges,100% of total billed charges,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,4691.32,61.85,,,percent of total billed charges,61.85% of total billed charges,1055.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1055.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1076.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1371.54,130,,,Fee Schedule,130% of WA Medicaid ,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2859.55,37.7,,,percent of total billed charges,37.70% of total billed charges,2859.55,37.7,,,percent of total billed charges,37.70% of total billed charges,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,257131.5,33.9,,,percent of total billed charges,33.9% of total billed charges,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,5916.3,78,,,percent of total billed charges,78% of total billed charges,7585,100,,,percent of total billed charges,100% of total billed charges,6265.21,82.6,,,percent of total billed charges,82.6% of total billed charges,6265.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1055.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,342.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1055.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,342.62,257131.5,
CRANIOFACIAL APPROACH SKULL,61581,CDM,983,RC,61581,HCPCS,Outpatient,,,10419,6772.35,,9168.72,88,,,percent of total billed charges,88% of total Billed charges,230.13,100,,,Fee Schedule,100% of Medicare rate,1559.33,100,,,Fee Schedule,100% of WA Medicaid,10419,100,,,percent of total billed charges,100% of total billed charges,1606.11,103,,,Fee Schedule,103% of WA Medicaid,230.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,402.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1559.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7189.11,69,,,percent of total billed charges,69% of total billed charges,10419,100,,,percent of total billed charges,100% of total billed charges,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,10419,100,,,percent of total billed charges,100% of total billed charges,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,10419,100,,,percent of total billed charges,100% of total billed charges,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,6444.15,61.85,,,percent of total billed charges,61.85% of total billed charges,1559.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1590.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2027.13,130,,,Fee Schedule,130% of WA Medicaid ,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,3927.96,37.7,,,percent of total billed charges,37.70% of total billed charges,3927.96,37.7,,,percent of total billed charges,37.70% of total billed charges,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,353204.1,33.9,,,percent of total billed charges,33.9% of total billed charges,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8126.82,78,,,percent of total billed charges,78% of total billed charges,10419,100,,,percent of total billed charges,100% of total billed charges,8606.09,82.6,,,percent of total billed charges,82.6% of total billed charges,8606.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1559.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,230.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,230.13,353204.1,
CRANIOFACIAL APPROACH SKULL,61583,CDM,983,RC,61583,HCPCS,Outpatient,,,9749,6336.85,,8579.12,88,,,percent of total billed charges,88% of total Billed charges,474.8,100,,,Fee Schedule,100% of Medicare rate,1650.34,100,,,Fee Schedule,100% of WA Medicaid,9749,100,,,percent of total billed charges,100% of total billed charges,1699.85,103,,,Fee Schedule,103% of WA Medicaid,474.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,830.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1650.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6726.81,69,,,percent of total billed charges,69% of total billed charges,9749,100,,,percent of total billed charges,100% of total billed charges,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,9749,100,,,percent of total billed charges,100% of total billed charges,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,9749,100,,,percent of total billed charges,100% of total billed charges,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,6029.76,61.85,,,percent of total billed charges,61.85% of total billed charges,1650.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1683.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2145.44,130,,,Fee Schedule,130% of WA Medicaid ,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,3675.37,37.7,,,percent of total billed charges,37.70% of total billed charges,3675.37,37.7,,,percent of total billed charges,37.70% of total billed charges,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,330491.1,33.9,,,percent of total billed charges,33.9% of total billed charges,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,7604.22,78,,,percent of total billed charges,78% of total billed charges,9749,100,,,percent of total billed charges,100% of total billed charges,8052.67,82.6,,,percent of total billed charges,82.6% of total billed charges,8052.67,82.6,,,percent of total billed charges,82.6% of total billed charges,1650.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,479.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,474.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,474.8,330491.1,
CRANIOFACIAL APPROACH SKULL,61582,CDM,983,RC,61582,HCPCS,Outpatient,,,9856,6406.40,,8673.28,88,,,percent of total billed charges,88% of total Billed charges,426.86,100,,,Fee Schedule,100% of Medicare rate,1714.68,100,,,Fee Schedule,100% of WA Medicaid,9856,100,,,percent of total billed charges,100% of total billed charges,1766.12,103,,,Fee Schedule,103% of WA Medicaid,426.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,747.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1714.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6800.64,69,,,percent of total billed charges,69% of total billed charges,9856,100,,,percent of total billed charges,100% of total billed charges,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9856,100,,,percent of total billed charges,100% of total billed charges,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9856,100,,,percent of total billed charges,100% of total billed charges,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,6095.94,61.85,,,percent of total billed charges,61.85% of total billed charges,1714.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1714.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1748.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2229.08,130,,,Fee Schedule,130% of WA Medicaid ,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,3715.71,37.7,,,percent of total billed charges,37.70% of total billed charges,3715.71,37.7,,,percent of total billed charges,37.70% of total billed charges,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,334118.4,33.9,,,percent of total billed charges,33.9% of total billed charges,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,7687.68,78,,,percent of total billed charges,78% of total billed charges,9856,100,,,percent of total billed charges,100% of total billed charges,8141.06,82.6,,,percent of total billed charges,82.6% of total billed charges,8141.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1714.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,431.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,426.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,1714.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,426.86,334118.4,
ORBITOCRANIAL APPROACH/SKULL,61584,CDM,983,RC,61584,HCPCS,Outpatient,,,6690,4348.50,,5887.2,88,,,percent of total billed charges,88% of total Billed charges,465.32,100,,,Fee Schedule,100% of Medicare rate,1628.15,100,,,Fee Schedule,100% of WA Medicaid,6690,100,,,percent of total billed charges,100% of total billed charges,1676.99,103,,,Fee Schedule,103% of WA Medicaid,465.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,814.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1628.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4616.1,69,,,percent of total billed charges,69% of total billed charges,6690,100,,,percent of total billed charges,100% of total billed charges,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,6690,100,,,percent of total billed charges,100% of total billed charges,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,6690,100,,,percent of total billed charges,100% of total billed charges,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,4137.77,61.85,,,percent of total billed charges,61.85% of total billed charges,1628.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1628.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1660.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2116.6,130,,,Fee Schedule,130% of WA Medicaid ,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,2522.13,37.7,,,percent of total billed charges,37.70% of total billed charges,2522.13,37.7,,,percent of total billed charges,37.70% of total billed charges,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,226791,33.9,,,percent of total billed charges,33.9% of total billed charges,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,5218.2,78,,,percent of total billed charges,78% of total billed charges,6690,100,,,percent of total billed charges,100% of total billed charges,5525.94,82.6,,,percent of total billed charges,82.6% of total billed charges,5525.94,82.6,,,percent of total billed charges,82.6% of total billed charges,1628.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,465.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1628.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,465.32,226791,
RESECT NASOPHARYNX SKULL,61586,CDM,983,RC,61586,HCPCS,Outpatient,,,6799,4419.35,,5983.12,88,,,percent of total billed charges,88% of total Billed charges,373.36,100,,,Fee Schedule,100% of Medicare rate,1447.99,100,,,Fee Schedule,100% of WA Medicaid,6799,100,,,percent of total billed charges,100% of total billed charges,1491.43,103,,,Fee Schedule,103% of WA Medicaid,373.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,653.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1447.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4691.31,69,,,percent of total billed charges,69% of total billed charges,6799,100,,,percent of total billed charges,100% of total billed charges,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6799,100,,,percent of total billed charges,100% of total billed charges,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6799,100,,,percent of total billed charges,100% of total billed charges,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4205.18,61.85,,,percent of total billed charges,61.85% of total billed charges,1447.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1447.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1476.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1882.39,130,,,Fee Schedule,130% of WA Medicaid ,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2563.22,37.7,,,percent of total billed charges,37.70% of total billed charges,2563.22,37.7,,,percent of total billed charges,37.70% of total billed charges,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,230486.1,33.9,,,percent of total billed charges,33.9% of total billed charges,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,5303.22,78,,,percent of total billed charges,78% of total billed charges,6799,100,,,percent of total billed charges,100% of total billed charges,5615.97,82.6,,,percent of total billed charges,82.6% of total billed charges,5615.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1447.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,377.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,373.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1447.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,373.36,230486.1,
INFRATEMPORAL APPROACH/SKULL,61591,CDM,983,RC,61591,HCPCS,Outpatient,,,12728,8273.20,,11200.64,88,,,percent of total billed charges,88% of total Billed charges,363.49,100,,,Fee Schedule,100% of Medicare rate,1742.84,100,,,Fee Schedule,100% of WA Medicaid,12728,100,,,percent of total billed charges,100% of total billed charges,1795.13,103,,,Fee Schedule,103% of WA Medicaid,363.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,636.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1742.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8782.32,69,,,percent of total billed charges,69% of total billed charges,12728,100,,,percent of total billed charges,100% of total billed charges,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,12728,100,,,percent of total billed charges,100% of total billed charges,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,12728,100,,,percent of total billed charges,100% of total billed charges,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,7872.27,61.85,,,percent of total billed charges,61.85% of total billed charges,1742.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1742.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1777.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2265.69,130,,,Fee Schedule,130% of WA Medicaid ,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4798.46,37.7,,,percent of total billed charges,37.70% of total billed charges,4798.46,37.7,,,percent of total billed charges,37.70% of total billed charges,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,431479.2,33.9,,,percent of total billed charges,33.9% of total billed charges,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,9927.84,78,,,percent of total billed charges,78% of total billed charges,12728,100,,,percent of total billed charges,100% of total billed charges,10513.33,82.6,,,percent of total billed charges,82.6% of total billed charges,10513.33,82.6,,,percent of total billed charges,82.6% of total billed charges,1742.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,363.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1742.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,363.49,431479.2,
ORBITOCRANIAL APPROACH/SKULL,61592,CDM,983,RC,61592,HCPCS,Outpatient,,,8928,5803.20,,7856.64,88,,,percent of total billed charges,88% of total Billed charges,528.03,100,,,Fee Schedule,100% of Medicare rate,1787.79,100,,,Fee Schedule,100% of WA Medicaid,8928,100,,,percent of total billed charges,100% of total billed charges,1841.42,103,,,Fee Schedule,103% of WA Medicaid,528.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,924.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1787.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6160.32,69,,,percent of total billed charges,69% of total billed charges,8928,100,,,percent of total billed charges,100% of total billed charges,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,8928,100,,,percent of total billed charges,100% of total billed charges,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,8928,100,,,percent of total billed charges,100% of total billed charges,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,5521.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1787.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1787.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1823.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2324.13,130,,,Fee Schedule,130% of WA Medicaid ,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3365.86,37.7,,,percent of total billed charges,37.70% of total billed charges,3365.86,37.7,,,percent of total billed charges,37.70% of total billed charges,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,302659.2,33.9,,,percent of total billed charges,33.9% of total billed charges,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6963.84,78,,,percent of total billed charges,78% of total billed charges,8928,100,,,percent of total billed charges,100% of total billed charges,7374.53,82.6,,,percent of total billed charges,82.6% of total billed charges,7374.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1787.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,533.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,528.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1787.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,528.03,302659.2,
RESECT/EXCISE CRANIAL LESION,61601,CDM,983,RC,61601,HCPCS,Outpatient,,,9428,6128.20,,8296.64,88,,,percent of total billed charges,88% of total Billed charges,387.33,100,,,Fee Schedule,100% of Medicare rate,1379.54,100,,,Fee Schedule,100% of WA Medicaid,9428,100,,,percent of total billed charges,100% of total billed charges,1420.93,103,,,Fee Schedule,103% of WA Medicaid,387.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,677.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1379.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6505.32,69,,,percent of total billed charges,69% of total billed charges,9428,100,,,percent of total billed charges,100% of total billed charges,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,9428,100,,,percent of total billed charges,100% of total billed charges,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,9428,100,,,percent of total billed charges,100% of total billed charges,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,5831.22,61.85,,,percent of total billed charges,61.85% of total billed charges,1379.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1379.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1407.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1793.4,130,,,Fee Schedule,130% of WA Medicaid ,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3554.36,37.7,,,percent of total billed charges,37.70% of total billed charges,3554.36,37.7,,,percent of total billed charges,37.70% of total billed charges,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,319609.2,33.9,,,percent of total billed charges,33.9% of total billed charges,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,7353.84,78,,,percent of total billed charges,78% of total billed charges,9428,100,,,percent of total billed charges,100% of total billed charges,7787.53,82.6,,,percent of total billed charges,82.6% of total billed charges,7787.53,82.6,,,percent of total billed charges,82.6% of total billed charges,1379.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,387.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,1379.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,387.33,319609.2,
RESECT/EXCISE CRANIAL LESION,61606,CDM,983,RC,61606,HCPCS,Outpatient,,,11296,7342.40,,9940.48,88,,,percent of total billed charges,88% of total Billed charges,453.47,100,,,Fee Schedule,100% of Medicare rate,1637.47,100,,,Fee Schedule,100% of WA Medicaid,11296,100,,,percent of total billed charges,100% of total billed charges,1686.59,103,,,Fee Schedule,103% of WA Medicaid,453.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,793.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1637.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7794.24,69,,,percent of total billed charges,69% of total billed charges,11296,100,,,percent of total billed charges,100% of total billed charges,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,11296,100,,,percent of total billed charges,100% of total billed charges,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,11296,100,,,percent of total billed charges,100% of total billed charges,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,6986.58,61.85,,,percent of total billed charges,61.85% of total billed charges,1637.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1637.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1670.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2128.71,130,,,Fee Schedule,130% of WA Medicaid ,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,4258.59,37.7,,,percent of total billed charges,37.70% of total billed charges,4258.59,37.7,,,percent of total billed charges,37.70% of total billed charges,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,382934.4,33.9,,,percent of total billed charges,33.9% of total billed charges,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,8810.88,78,,,percent of total billed charges,78% of total billed charges,11296,100,,,percent of total billed charges,100% of total billed charges,9330.5,82.6,,,percent of total billed charges,82.6% of total billed charges,9330.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1637.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,458,101,,,Fee Schedule,101% of Medicare RBRVS rate,453.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1637.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,453.47,382934.4,
RESECT/EXCISE CRANIAL LESION,61608,CDM,983,RC,61608,HCPCS,Outpatient,,,12315,8004.75,,10837.2,88,,,percent of total billed charges,88% of total Billed charges,575.6,100,,,Fee Schedule,100% of Medicare rate,1842.62,100,,,Fee Schedule,100% of WA Medicaid,12315,100,,,percent of total billed charges,100% of total billed charges,1897.9,103,,,Fee Schedule,103% of WA Medicaid,575.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1007.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1842.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8497.35,69,,,percent of total billed charges,69% of total billed charges,12315,100,,,percent of total billed charges,100% of total billed charges,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,12315,100,,,percent of total billed charges,100% of total billed charges,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,12315,100,,,percent of total billed charges,100% of total billed charges,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,7616.83,61.85,,,percent of total billed charges,61.85% of total billed charges,1842.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1842.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1879.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2395.41,130,,,Fee Schedule,130% of WA Medicaid ,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4642.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4642.76,37.7,,,percent of total billed charges,37.70% of total billed charges,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,417478.5,33.9,,,percent of total billed charges,33.9% of total billed charges,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9605.7,78,,,percent of total billed charges,78% of total billed charges,12315,100,,,percent of total billed charges,100% of total billed charges,10172.19,82.6,,,percent of total billed charges,82.6% of total billed charges,10172.19,82.6,,,percent of total billed charges,82.6% of total billed charges,1842.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,581.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,575.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1842.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,575.6,417478.5,
RESECT/EXCISE CRANIAL LESION,61607,CDM,983,RC,61607,HCPCS,Outpatient,,,11523,7489.95,,10140.24,88,,,percent of total billed charges,88% of total Billed charges,532.22,100,,,Fee Schedule,100% of Medicare rate,1709.46,100,,,Fee Schedule,100% of WA Medicaid,11523,100,,,percent of total billed charges,100% of total billed charges,1760.74,103,,,Fee Schedule,103% of WA Medicaid,532.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,931.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1709.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7950.87,69,,,percent of total billed charges,69% of total billed charges,11523,100,,,percent of total billed charges,100% of total billed charges,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,11523,100,,,percent of total billed charges,100% of total billed charges,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,11523,100,,,percent of total billed charges,100% of total billed charges,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,7126.98,61.85,,,percent of total billed charges,61.85% of total billed charges,1709.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1709.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1743.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2222.3,130,,,Fee Schedule,130% of WA Medicaid ,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,4344.17,37.7,,,percent of total billed charges,37.70% of total billed charges,4344.17,37.7,,,percent of total billed charges,37.70% of total billed charges,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,390629.7,33.9,,,percent of total billed charges,33.9% of total billed charges,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,8987.94,78,,,percent of total billed charges,78% of total billed charges,11523,100,,,percent of total billed charges,100% of total billed charges,9518,82.6,,,percent of total billed charges,82.6% of total billed charges,9518,82.6,,,percent of total billed charges,82.6% of total billed charges,1709.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,537.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,532.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1709.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,532.22,390629.7,
REPAIR DURA,61618,CDM,983,RC,61618,HCPCS,Outpatient,,,5333,3466.45,,4693.04,88,,,percent of total billed charges,88% of total Billed charges,199.04,100,,,Fee Schedule,100% of Medicare rate,729.03,100,,,Fee Schedule,100% of WA Medicaid,5333,100,,,percent of total billed charges,100% of total billed charges,750.9,103,,,Fee Schedule,103% of WA Medicaid,199.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,348.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,729.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3679.77,69,,,percent of total billed charges,69% of total billed charges,5333,100,,,percent of total billed charges,100% of total billed charges,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,5333,100,,,percent of total billed charges,100% of total billed charges,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,5333,100,,,percent of total billed charges,100% of total billed charges,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3298.46,61.85,,,percent of total billed charges,61.85% of total billed charges,729.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,743.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,947.74,130,,,Fee Schedule,130% of WA Medicaid ,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2010.54,37.7,,,percent of total billed charges,37.70% of total billed charges,2010.54,37.7,,,percent of total billed charges,37.70% of total billed charges,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,180788.7,33.9,,,percent of total billed charges,33.9% of total billed charges,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,4159.74,78,,,percent of total billed charges,78% of total billed charges,5333,100,,,percent of total billed charges,100% of total billed charges,4405.06,82.6,,,percent of total billed charges,82.6% of total billed charges,4405.06,82.6,,,percent of total billed charges,82.6% of total billed charges,729.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,199.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,199.04,180788.7,
TRANSCATH OCCLUSION CNS,61624,CDM,983,RC,61624,HCPCS,Outpatient,,,5923,3849.95,,5212.24,88,,,percent of total billed charges,88% of total Billed charges,197.09,100,,,Fee Schedule,100% of Medicare rate,640.25,100,,,Fee Schedule,100% of WA Medicaid,5923,100,,,percent of total billed charges,100% of total billed charges,659.46,103,,,Fee Schedule,103% of WA Medicaid,197.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,344.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,640.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4086.87,69,,,percent of total billed charges,69% of total billed charges,5923,100,,,percent of total billed charges,100% of total billed charges,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,5923,100,,,percent of total billed charges,100% of total billed charges,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,5923,100,,,percent of total billed charges,100% of total billed charges,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3663.38,61.85,,,percent of total billed charges,61.85% of total billed charges,640.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,653.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,832.33,130,,,Fee Schedule,130% of WA Medicaid ,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2232.97,37.7,,,percent of total billed charges,37.70% of total billed charges,2232.97,37.7,,,percent of total billed charges,37.70% of total billed charges,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,200789.7,33.9,,,percent of total billed charges,33.9% of total billed charges,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4619.94,78,,,percent of total billed charges,78% of total billed charges,5923,100,,,percent of total billed charges,100% of total billed charges,4892.4,82.6,,,percent of total billed charges,82.6% of total billed charges,4892.4,82.6,,,percent of total billed charges,82.6% of total billed charges,640.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,197.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,197.09,200789.7,
INTRACRAN ANGIOPLSTY W/STENT,61635,CDM,983,RC,61635,HCPCS,Outpatient,,,8718,5666.70,,7671.84,88,,,percent of total billed charges,88% of total Billed charges,229.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8718,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,229.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,402.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,6015.42,69,,,percent of total billed charges,69% of total billed charges,8718,100,,,percent of total billed charges,100% of total billed charges,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,8718,100,,,percent of total billed charges,100% of total billed charges,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,8718,100,,,percent of total billed charges,100% of total billed charges,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,5392.08,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,3286.69,37.7,,,percent of total billed charges,37.70% of total billed charges,3286.69,37.7,,,percent of total billed charges,37.70% of total billed charges,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,295540.2,33.9,,,percent of total billed charges,33.9% of total billed charges,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,6800.04,78,,,percent of total billed charges,78% of total billed charges,8718,100,,,percent of total billed charges,100% of total billed charges,7201.07,82.6,,,percent of total billed charges,82.6% of total billed charges,7201.07,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,229.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",229.88,295540.2,
INTRACRANIAL VESSEL SURGERY,61686,CDM,983,RC,61686,HCPCS,Outpatient,,,18511,12032.15,,16289.68,88,,,percent of total billed charges,88% of total Billed charges,861.49,100,,,Fee Schedule,100% of Medicare rate,2496.3,100,,,Fee Schedule,100% of WA Medicaid,18511,100,,,percent of total billed charges,100% of total billed charges,2571.19,103,,,Fee Schedule,103% of WA Medicaid,861.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1507.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2496.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,12772.59,69,,,percent of total billed charges,69% of total billed charges,18511,100,,,percent of total billed charges,100% of total billed charges,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,18511,100,,,percent of total billed charges,100% of total billed charges,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,18511,100,,,percent of total billed charges,100% of total billed charges,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,11449.05,61.85,,,percent of total billed charges,61.85% of total billed charges,2496.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2496.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2546.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3245.19,130,,,Fee Schedule,130% of WA Medicaid ,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,6978.65,37.7,,,percent of total billed charges,37.70% of total billed charges,6978.65,37.7,,,percent of total billed charges,37.70% of total billed charges,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,627522.9,33.9,,,percent of total billed charges,33.9% of total billed charges,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,14438.58,78,,,percent of total billed charges,78% of total billed charges,18511,100,,,percent of total billed charges,100% of total billed charges,15290.09,82.6,,,percent of total billed charges,82.6% of total billed charges,15290.09,82.6,,,percent of total billed charges,82.6% of total billed charges,2496.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,870.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,861.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,2496.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,861.49,627522.9,
INTRACRANIAL VESSEL SURGERY,61680,CDM,983,RC,61680,HCPCS,Outpatient,,,7216,4690.40,,6350.08,88,,,percent of total billed charges,88% of total Billed charges,419.38,100,,,Fee Schedule,100% of Medicare rate,1275.29,100,,,Fee Schedule,100% of WA Medicaid,7216,100,,,percent of total billed charges,100% of total billed charges,1313.55,103,,,Fee Schedule,103% of WA Medicaid,419.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,733.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1275.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4979.04,69,,,percent of total billed charges,69% of total billed charges,7216,100,,,percent of total billed charges,100% of total billed charges,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,7216,100,,,percent of total billed charges,100% of total billed charges,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,7216,100,,,percent of total billed charges,100% of total billed charges,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,4463.1,61.85,,,percent of total billed charges,61.85% of total billed charges,1275.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1275.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1657.88,130,,,Fee Schedule,130% of WA Medicaid ,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2720.43,37.7,,,percent of total billed charges,37.70% of total billed charges,2720.43,37.7,,,percent of total billed charges,37.70% of total billed charges,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,244622.4,33.9,,,percent of total billed charges,33.9% of total billed charges,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,5628.48,78,,,percent of total billed charges,78% of total billed charges,7216,100,,,percent of total billed charges,100% of total billed charges,5960.42,82.6,,,percent of total billed charges,82.6% of total billed charges,5960.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1275.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,423.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,419.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1275.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,419.38,244622.4,
INTRACRANIAL VESSEL SURGERY,61684,CDM,983,RC,61684,HCPCS,Outpatient,,,14712,9562.80,,12946.56,88,,,percent of total billed charges,88% of total Billed charges,533.85,100,,,Fee Schedule,100% of Medicare rate,1589.91,100,,,Fee Schedule,100% of WA Medicaid,14712,100,,,percent of total billed charges,100% of total billed charges,1637.61,103,,,Fee Schedule,103% of WA Medicaid,533.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,934.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1589.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,10151.28,69,,,percent of total billed charges,69% of total billed charges,14712,100,,,percent of total billed charges,100% of total billed charges,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,14712,100,,,percent of total billed charges,100% of total billed charges,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,14712,100,,,percent of total billed charges,100% of total billed charges,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,9099.37,61.85,,,percent of total billed charges,61.85% of total billed charges,1589.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1589.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1621.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2066.88,130,,,Fee Schedule,130% of WA Medicaid ,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,5546.42,37.7,,,percent of total billed charges,37.70% of total billed charges,5546.42,37.7,,,percent of total billed charges,37.70% of total billed charges,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,498736.8,33.9,,,percent of total billed charges,33.9% of total billed charges,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,11475.36,78,,,percent of total billed charges,78% of total billed charges,14712,100,,,percent of total billed charges,100% of total billed charges,12152.11,82.6,,,percent of total billed charges,82.6% of total billed charges,12152.11,82.6,,,percent of total billed charges,82.6% of total billed charges,1589.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,533.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1589.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,533.85,498736.8,
INTRACRANIAL VESSEL SURGERY,61682,CDM,983,RC,61682,HCPCS,Outpatient,,,14915,9694.75,,13125.2,88,,,percent of total billed charges,88% of total Billed charges,807.61,100,,,Fee Schedule,100% of Medicare rate,2315.77,100,,,Fee Schedule,100% of WA Medicaid,14915,100,,,percent of total billed charges,100% of total billed charges,2385.24,103,,,Fee Schedule,103% of WA Medicaid,807.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1413.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2315.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,10291.35,69,,,percent of total billed charges,69% of total billed charges,14915,100,,,percent of total billed charges,100% of total billed charges,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,14915,100,,,percent of total billed charges,100% of total billed charges,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,14915,100,,,percent of total billed charges,100% of total billed charges,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,9224.93,61.85,,,percent of total billed charges,61.85% of total billed charges,2315.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2315.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2362.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3010.5,130,,,Fee Schedule,130% of WA Medicaid ,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,5622.96,37.7,,,percent of total billed charges,37.70% of total billed charges,5622.96,37.7,,,percent of total billed charges,37.70% of total billed charges,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,505618.5,33.9,,,percent of total billed charges,33.9% of total billed charges,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,11633.7,78,,,percent of total billed charges,78% of total billed charges,14915,100,,,percent of total billed charges,100% of total billed charges,12319.79,82.6,,,percent of total billed charges,82.6% of total billed charges,12319.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2315.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,807.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2315.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,807.61,505618.5,
BRAIN ANEURYSM REPR COMPLX,61698,CDM,983,RC,61698,HCPCS,Outpatient,,,21657,14077.05,,19058.16,88,,,percent of total billed charges,88% of total Billed charges,887.96,100,,,Fee Schedule,100% of Medicare rate,2569.97,100,,,Fee Schedule,100% of WA Medicaid,21657,100,,,percent of total billed charges,100% of total billed charges,2647.07,103,,,Fee Schedule,103% of WA Medicaid,887.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1553.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2569.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,14943.33,69,,,percent of total billed charges,69% of total billed charges,21657,100,,,percent of total billed charges,100% of total billed charges,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,21657,100,,,percent of total billed charges,100% of total billed charges,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,21657,100,,,percent of total billed charges,100% of total billed charges,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,13394.85,61.85,,,percent of total billed charges,61.85% of total billed charges,2569.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2569.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2621.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3340.96,130,,,Fee Schedule,130% of WA Medicaid ,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8164.69,37.7,,,percent of total billed charges,37.70% of total billed charges,8164.69,37.7,,,percent of total billed charges,37.70% of total billed charges,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,734172.3,33.9,,,percent of total billed charges,33.9% of total billed charges,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,16892.46,78,,,percent of total billed charges,78% of total billed charges,21657,100,,,percent of total billed charges,100% of total billed charges,17888.68,82.6,,,percent of total billed charges,82.6% of total billed charges,17888.68,82.6,,,percent of total billed charges,82.6% of total billed charges,2569.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,896.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,887.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2569.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,887.96,734172.3,
BRAIN ANEURYSM REPR COMPLX,61697,CDM,983,RC,61697,HCPCS,Outpatient,,,12188,7922.20,,10725.44,88,,,percent of total billed charges,88% of total Billed charges,804.98,100,,,Fee Schedule,100% of Medicare rate,2350.27,100,,,Fee Schedule,100% of WA Medicaid,12188,100,,,percent of total billed charges,100% of total billed charges,2420.78,103,,,Fee Schedule,103% of WA Medicaid,804.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1408.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2350.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8409.72,69,,,percent of total billed charges,69% of total billed charges,12188,100,,,percent of total billed charges,100% of total billed charges,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,12188,100,,,percent of total billed charges,100% of total billed charges,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,12188,100,,,percent of total billed charges,100% of total billed charges,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,7538.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2350.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2350.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2397.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3055.35,130,,,Fee Schedule,130% of WA Medicaid ,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4594.88,37.7,,,percent of total billed charges,37.70% of total billed charges,4594.88,37.7,,,percent of total billed charges,37.70% of total billed charges,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,413173.2,33.9,,,percent of total billed charges,33.9% of total billed charges,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,9506.64,78,,,percent of total billed charges,78% of total billed charges,12188,100,,,percent of total billed charges,100% of total billed charges,10067.29,82.6,,,percent of total billed charges,82.6% of total billed charges,10067.29,82.6,,,percent of total billed charges,82.6% of total billed charges,2350.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,804.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2350.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,804.98,413173.2,
INNER SKULL VESSEL SURGERY,61702,CDM,983,RC,61702,HCPCS,Outpatient,,,16461,10699.65,,14485.68,88,,,percent of total billed charges,88% of total Billed charges,766.33,100,,,Fee Schedule,100% of Medicare rate,2237.63,100,,,Fee Schedule,100% of WA Medicaid,16461,100,,,percent of total billed charges,100% of total billed charges,2304.76,103,,,Fee Schedule,103% of WA Medicaid,766.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1341.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2237.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,11358.09,69,,,percent of total billed charges,69% of total billed charges,16461,100,,,percent of total billed charges,100% of total billed charges,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,16461,100,,,percent of total billed charges,100% of total billed charges,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,16461,100,,,percent of total billed charges,100% of total billed charges,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,10181.13,61.85,,,percent of total billed charges,61.85% of total billed charges,2237.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2237.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2282.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2908.92,130,,,Fee Schedule,130% of WA Medicaid ,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,6205.8,37.7,,,percent of total billed charges,37.70% of total billed charges,6205.8,37.7,,,percent of total billed charges,37.70% of total billed charges,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,558027.9,33.9,,,percent of total billed charges,33.9% of total billed charges,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,12839.58,78,,,percent of total billed charges,78% of total billed charges,16461,100,,,percent of total billed charges,100% of total billed charges,13596.79,82.6,,,percent of total billed charges,82.6% of total billed charges,13596.79,82.6,,,percent of total billed charges,82.6% of total billed charges,2237.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,773.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,766.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2237.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,766.33,558027.9,
REVISE CIRCULATION TO HEAD,61705,CDM,983,RC,61705,HCPCS,Outpatient,,,8188,5322.20,,7205.44,88,,,percent of total billed charges,88% of total Billed charges,488.64,100,,,Fee Schedule,100% of Medicare rate,1456.19,100,,,Fee Schedule,100% of WA Medicaid,8188,100,,,percent of total billed charges,100% of total billed charges,1499.88,103,,,Fee Schedule,103% of WA Medicaid,488.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,855.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1456.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5649.72,69,,,percent of total billed charges,69% of total billed charges,8188,100,,,percent of total billed charges,100% of total billed charges,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,8188,100,,,percent of total billed charges,100% of total billed charges,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,8188,100,,,percent of total billed charges,100% of total billed charges,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,5064.28,61.85,,,percent of total billed charges,61.85% of total billed charges,1456.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1456.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1485.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1893.05,130,,,Fee Schedule,130% of WA Medicaid ,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,3086.88,37.7,,,percent of total billed charges,37.70% of total billed charges,3086.88,37.7,,,percent of total billed charges,37.70% of total billed charges,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,277573.2,33.9,,,percent of total billed charges,33.9% of total billed charges,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,6386.64,78,,,percent of total billed charges,78% of total billed charges,8188,100,,,percent of total billed charges,100% of total billed charges,6763.29,82.6,,,percent of total billed charges,82.6% of total billed charges,6763.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1456.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,493.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,488.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1456.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,488.64,277573.2,
BRAIN ANEURYSM REPR SIMPLE,61700,CDM,983,RC,61700,HCPCS,Outpatient,,,12234,7952.10,,10765.92,88,,,percent of total billed charges,88% of total Billed charges,641.8,100,,,Fee Schedule,100% of Medicare rate,1904.35,100,,,Fee Schedule,100% of WA Medicaid,12234,100,,,percent of total billed charges,100% of total billed charges,1961.48,103,,,Fee Schedule,103% of WA Medicaid,641.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1123.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1904.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8441.46,69,,,percent of total billed charges,69% of total billed charges,12234,100,,,percent of total billed charges,100% of total billed charges,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,12234,100,,,percent of total billed charges,100% of total billed charges,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,12234,100,,,percent of total billed charges,100% of total billed charges,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,7566.73,61.85,,,percent of total billed charges,61.85% of total billed charges,1904.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1904.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1942.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2475.66,130,,,Fee Schedule,130% of WA Medicaid ,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,4612.22,37.7,,,percent of total billed charges,37.70% of total billed charges,4612.22,37.7,,,percent of total billed charges,37.70% of total billed charges,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,414732.6,33.9,,,percent of total billed charges,33.9% of total billed charges,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,9542.52,78,,,percent of total billed charges,78% of total billed charges,12234,100,,,percent of total billed charges,100% of total billed charges,10105.28,82.6,,,percent of total billed charges,82.6% of total billed charges,10105.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1904.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,648.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,641.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1904.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,641.8,414732.6,
INCISE SKULL/BRAIN BIOPSY,61750,CDM,983,RC,61750,HCPCS,Outpatient,,,7627,4957.55,,6711.76,88,,,percent of total billed charges,88% of total Billed charges,254.42,100,,,Fee Schedule,100% of Medicare rate,794.86,100,,,Fee Schedule,100% of WA Medicaid,7627,100,,,percent of total billed charges,100% of total billed charges,818.71,103,,,Fee Schedule,103% of WA Medicaid,254.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,445.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,794.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5262.63,69,,,percent of total billed charges,69% of total billed charges,7627,100,,,percent of total billed charges,100% of total billed charges,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,7627,100,,,percent of total billed charges,100% of total billed charges,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,7627,100,,,percent of total billed charges,100% of total billed charges,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,4717.3,61.85,,,percent of total billed charges,61.85% of total billed charges,794.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,794.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,810.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1033.32,130,,,Fee Schedule,130% of WA Medicaid ,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2875.38,37.7,,,percent of total billed charges,37.70% of total billed charges,2875.38,37.7,,,percent of total billed charges,37.70% of total billed charges,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,258555.3,33.9,,,percent of total billed charges,33.9% of total billed charges,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,5949.06,78,,,percent of total billed charges,78% of total billed charges,7627,100,,,percent of total billed charges,100% of total billed charges,6299.9,82.6,,,percent of total billed charges,82.6% of total billed charges,6299.9,82.6,,,percent of total billed charges,82.6% of total billed charges,794.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,254.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,794.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,254.42,258555.3,
BRAIN BIOPSY W/CT/MR GUIDE,61751,CDM,983,RC,61751,HCPCS,Outpatient,,,8093,5260.45,,7121.84,88,,,percent of total billed charges,88% of total Billed charges,243.64,100,,,Fee Schedule,100% of Medicare rate,787.96,100,,,Fee Schedule,100% of WA Medicaid,8093,100,,,percent of total billed charges,100% of total billed charges,811.6,103,,,Fee Schedule,103% of WA Medicaid,243.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,426.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,787.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5584.17,69,,,percent of total billed charges,69% of total billed charges,8093,100,,,percent of total billed charges,100% of total billed charges,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,8093,100,,,percent of total billed charges,100% of total billed charges,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,8093,100,,,percent of total billed charges,100% of total billed charges,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,5005.52,61.85,,,percent of total billed charges,61.85% of total billed charges,787.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,787.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,803.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1024.35,130,,,Fee Schedule,130% of WA Medicaid ,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,3051.06,37.7,,,percent of total billed charges,37.70% of total billed charges,3051.06,37.7,,,percent of total billed charges,37.70% of total billed charges,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,274352.7,33.9,,,percent of total billed charges,33.9% of total billed charges,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,6312.54,78,,,percent of total billed charges,78% of total billed charges,8093,100,,,percent of total billed charges,100% of total billed charges,6684.82,82.6,,,percent of total billed charges,82.6% of total billed charges,6684.82,82.6,,,percent of total billed charges,82.6% of total billed charges,787.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,243.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,787.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,243.64,274352.7,
IMPLANT NEUROELECTRODES,61850,CDM,983,RC,61850,HCPCS,Outpatient,,,4756,3091.40,,4185.28,88,,,percent of total billed charges,88% of total Billed charges,173.56,100,,,Fee Schedule,100% of Medicare rate,560.81,100,,,Fee Schedule,100% of WA Medicaid,4756,100,,,percent of total billed charges,100% of total billed charges,577.63,103,,,Fee Schedule,103% of WA Medicaid,173.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,303.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,560.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3281.64,69,,,percent of total billed charges,69% of total billed charges,4756,100,,,percent of total billed charges,100% of total billed charges,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4756,100,,,percent of total billed charges,100% of total billed charges,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4756,100,,,percent of total billed charges,100% of total billed charges,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,2941.59,61.85,,,percent of total billed charges,61.85% of total billed charges,560.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,560.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,572.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,729.05,130,,,Fee Schedule,130% of WA Medicaid ,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,1793.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1793.01,37.7,,,percent of total billed charges,37.70% of total billed charges,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,161228.4,33.9,,,percent of total billed charges,33.9% of total billed charges,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3709.68,78,,,percent of total billed charges,78% of total billed charges,4756,100,,,percent of total billed charges,100% of total billed charges,3928.46,82.6,,,percent of total billed charges,82.6% of total billed charges,3928.46,82.6,,,percent of total billed charges,82.6% of total billed charges,560.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,173.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,560.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,173.56,161228.4,
IMPLANT NEUROELECTRODES,61860,CDM,983,RC,61860,HCPCS,Outpatient,,,7740,5031.00,,6811.2,88,,,percent of total billed charges,88% of total Billed charges,286.74,100,,,Fee Schedule,100% of Medicare rate,881.03,100,,,Fee Schedule,100% of WA Medicaid,7740,100,,,percent of total billed charges,100% of total billed charges,907.46,103,,,Fee Schedule,103% of WA Medicaid,286.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,501.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,881.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5340.6,69,,,percent of total billed charges,69% of total billed charges,7740,100,,,percent of total billed charges,100% of total billed charges,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,7740,100,,,percent of total billed charges,100% of total billed charges,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,7740,100,,,percent of total billed charges,100% of total billed charges,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4787.19,61.85,,,percent of total billed charges,61.85% of total billed charges,881.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,881.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,898.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1145.34,130,,,Fee Schedule,130% of WA Medicaid ,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,2917.98,37.7,,,percent of total billed charges,37.70% of total billed charges,2917.98,37.7,,,percent of total billed charges,37.70% of total billed charges,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,262386,33.9,,,percent of total billed charges,33.9% of total billed charges,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,6037.2,78,,,percent of total billed charges,78% of total billed charges,7740,100,,,percent of total billed charges,100% of total billed charges,6393.24,82.6,,,percent of total billed charges,82.6% of total billed charges,6393.24,82.6,,,percent of total billed charges,82.6% of total billed charges,881.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,286.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,881.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,286.74,262386,
IMPLANT NEUROELECTRODE,61863,CDM,983,RC,61863,HCPCS,Outpatient,,,7395,4806.75,,6507.6,88,,,percent of total billed charges,88% of total Billed charges,268.61,100,,,Fee Schedule,100% of Medicare rate,852.86,100,,,Fee Schedule,100% of WA Medicaid,7395,100,,,percent of total billed charges,100% of total billed charges,878.45,103,,,Fee Schedule,103% of WA Medicaid,268.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,470.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,852.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5102.55,69,,,percent of total billed charges,69% of total billed charges,7395,100,,,percent of total billed charges,100% of total billed charges,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,7395,100,,,percent of total billed charges,100% of total billed charges,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,7395,100,,,percent of total billed charges,100% of total billed charges,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4573.81,61.85,,,percent of total billed charges,61.85% of total billed charges,852.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,852.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,869.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1108.72,130,,,Fee Schedule,130% of WA Medicaid ,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2787.92,37.7,,,percent of total billed charges,37.70% of total billed charges,2787.92,37.7,,,percent of total billed charges,37.70% of total billed charges,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,250690.5,33.9,,,percent of total billed charges,33.9% of total billed charges,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,5768.1,78,,,percent of total billed charges,78% of total billed charges,7395,100,,,percent of total billed charges,100% of total billed charges,6108.27,82.6,,,percent of total billed charges,82.6% of total billed charges,6108.27,82.6,,,percent of total billed charges,82.6% of total billed charges,852.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,852.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,268.61,250690.5,
INSRT/REDO NEUROSTIM 1 ARRAY,61885,CDM,983,RC,61885,HCPCS,Outpatient,,,2279,1481.35,,2005.52,88,,,percent of total billed charges,88% of total Billed charges,78.05,100,,,Fee Schedule,100% of Medicare rate,305.3,100,,,Fee Schedule,100% of WA Medicaid,2279,100,,,percent of total billed charges,100% of total billed charges,314.46,103,,,Fee Schedule,103% of WA Medicaid,78.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,136.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,305.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1572.51,69,,,percent of total billed charges,69% of total billed charges,2279,100,,,percent of total billed charges,100% of total billed charges,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2279,100,,,percent of total billed charges,100% of total billed charges,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,2279,100,,,percent of total billed charges,100% of total billed charges,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1409.56,61.85,,,percent of total billed charges,61.85% of total billed charges,305.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,396.89,130,,,Fee Schedule,130% of WA Medicaid ,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.18,37.7,,,percent of total billed charges,37.70% of total billed charges,859.18,37.7,,,percent of total billed charges,37.70% of total billed charges,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,77258.1,33.9,,,percent of total billed charges,33.9% of total billed charges,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1777.62,78,,,percent of total billed charges,78% of total billed charges,2279,100,,,percent of total billed charges,100% of total billed charges,1882.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1882.45,82.6,,,percent of total billed charges,82.6% of total billed charges,305.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,78.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,78.05,77258.1,
IMPLANT NEUROSTIM ARRAYS,61886,CDM,983,RC,61886,HCPCS,Outpatient,,,2914,1894.10,,2564.32,88,,,percent of total billed charges,88% of total Billed charges,133.11,100,,,Fee Schedule,100% of Medicare rate,508.96,100,,,Fee Schedule,100% of WA Medicaid,2914,100,,,percent of total billed charges,100% of total billed charges,524.23,103,,,Fee Schedule,103% of WA Medicaid,133.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,232.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,508.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2010.66,69,,,percent of total billed charges,69% of total billed charges,2914,100,,,percent of total billed charges,100% of total billed charges,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2914,100,,,percent of total billed charges,100% of total billed charges,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2914,100,,,percent of total billed charges,100% of total billed charges,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1802.31,61.85,,,percent of total billed charges,61.85% of total billed charges,508.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,508.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,661.65,130,,,Fee Schedule,130% of WA Medicaid ,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1098.58,37.7,,,percent of total billed charges,37.70% of total billed charges,1098.58,37.7,,,percent of total billed charges,37.70% of total billed charges,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,98784.6,33.9,,,percent of total billed charges,33.9% of total billed charges,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2272.92,78,,,percent of total billed charges,78% of total billed charges,2914,100,,,percent of total billed charges,100% of total billed charges,2406.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2406.96,82.6,,,percent of total billed charges,82.6% of total billed charges,508.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,133.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,508.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,133.11,98784.6,
TREAT SKULL FRACTURE,62005,CDM,983,RC,62005,HCPCS,Outpatient,,,6487,4216.55,,5708.56,88,,,percent of total billed charges,88% of total Billed charges,228.72,100,,,Fee Schedule,100% of Medicare rate,721.01,100,,,Fee Schedule,100% of WA Medicaid,6487,100,,,percent of total billed charges,100% of total billed charges,742.64,103,,,Fee Schedule,103% of WA Medicaid,228.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,400.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,721.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4476.03,69,,,percent of total billed charges,69% of total billed charges,6487,100,,,percent of total billed charges,100% of total billed charges,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6487,100,,,percent of total billed charges,100% of total billed charges,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6487,100,,,percent of total billed charges,100% of total billed charges,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,4012.21,61.85,,,percent of total billed charges,61.85% of total billed charges,721.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,721.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,735.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,937.31,130,,,Fee Schedule,130% of WA Medicaid ,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2445.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2445.6,37.7,,,percent of total billed charges,37.70% of total billed charges,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,219909.3,33.9,,,percent of total billed charges,33.9% of total billed charges,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5059.86,78,,,percent of total billed charges,78% of total billed charges,6487,100,,,percent of total billed charges,100% of total billed charges,5358.26,82.6,,,percent of total billed charges,82.6% of total billed charges,5358.26,82.6,,,percent of total billed charges,82.6% of total billed charges,721.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,228.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,721.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,228.72,219909.3,
TREAT SKULL FRACTURE,62000,CDM,983,RC,62000,HCPCS,Outpatient,,,4419,2872.35,,3888.72,88,,,percent of total billed charges,88% of total Billed charges,180.99,100,,,Fee Schedule,100% of Medicare rate,588.59,100,,,Fee Schedule,100% of WA Medicaid,4419,100,,,percent of total billed charges,100% of total billed charges,606.25,103,,,Fee Schedule,103% of WA Medicaid,180.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,316.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,588.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3049.11,69,,,percent of total billed charges,69% of total billed charges,4419,100,,,percent of total billed charges,100% of total billed charges,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,4419,100,,,percent of total billed charges,100% of total billed charges,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,4419,100,,,percent of total billed charges,100% of total billed charges,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,2733.15,61.85,,,percent of total billed charges,61.85% of total billed charges,588.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,600.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,765.17,130,,,Fee Schedule,130% of WA Medicaid ,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1665.96,37.7,,,percent of total billed charges,37.70% of total billed charges,1665.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,149804.1,33.9,,,percent of total billed charges,33.9% of total billed charges,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,3446.82,78,,,percent of total billed charges,78% of total billed charges,4419,100,,,percent of total billed charges,100% of total billed charges,3650.09,82.6,,,percent of total billed charges,82.6% of total billed charges,3650.09,82.6,,,percent of total billed charges,82.6% of total billed charges,588.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,180.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,180.99,149804.1,
TREATMENT OF HEAD INJURY,62010,CDM,983,RC,62010,HCPCS,Outpatient,,,8255,5365.75,,7264.4,88,,,percent of total billed charges,88% of total Billed charges,277.3,100,,,Fee Schedule,100% of Medicare rate,869.65,100,,,Fee Schedule,100% of WA Medicaid,8255,100,,,percent of total billed charges,100% of total billed charges,895.74,103,,,Fee Schedule,103% of WA Medicaid,277.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,485.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,869.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5695.95,69,,,percent of total billed charges,69% of total billed charges,8255,100,,,percent of total billed charges,100% of total billed charges,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,8255,100,,,percent of total billed charges,100% of total billed charges,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,8255,100,,,percent of total billed charges,100% of total billed charges,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,5105.72,61.85,,,percent of total billed charges,61.85% of total billed charges,869.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,869.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,887.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1130.55,130,,,Fee Schedule,130% of WA Medicaid ,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3112.14,37.7,,,percent of total billed charges,37.70% of total billed charges,3112.14,37.7,,,percent of total billed charges,37.70% of total billed charges,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,279844.5,33.9,,,percent of total billed charges,33.9% of total billed charges,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,6438.9,78,,,percent of total billed charges,78% of total billed charges,8255,100,,,percent of total billed charges,100% of total billed charges,6818.63,82.6,,,percent of total billed charges,82.6% of total billed charges,6818.63,82.6,,,percent of total billed charges,82.6% of total billed charges,869.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,277.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,869.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,277.3,279844.5,
REPAIR BRAIN FLUID LEAKAGE,62100,CDM,983,RC,62100,HCPCS,Outpatient,,,9016,5860.40,,7934.08,88,,,percent of total billed charges,88% of total Billed charges,252.92,100,,,Fee Schedule,100% of Medicare rate,889.23,100,,,Fee Schedule,100% of WA Medicaid,9016,100,,,percent of total billed charges,100% of total billed charges,915.91,103,,,Fee Schedule,103% of WA Medicaid,252.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,442.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,889.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6221.04,69,,,percent of total billed charges,69% of total billed charges,9016,100,,,percent of total billed charges,100% of total billed charges,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,9016,100,,,percent of total billed charges,100% of total billed charges,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,9016,100,,,percent of total billed charges,100% of total billed charges,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,5576.4,61.85,,,percent of total billed charges,61.85% of total billed charges,889.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,889.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,907.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1156,130,,,Fee Schedule,130% of WA Medicaid ,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,3399.03,37.7,,,percent of total billed charges,37.70% of total billed charges,3399.03,37.7,,,percent of total billed charges,37.70% of total billed charges,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,305642.4,33.9,,,percent of total billed charges,33.9% of total billed charges,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,7032.48,78,,,percent of total billed charges,78% of total billed charges,9016,100,,,percent of total billed charges,100% of total billed charges,7447.22,82.6,,,percent of total billed charges,82.6% of total billed charges,7447.22,82.6,,,percent of total billed charges,82.6% of total billed charges,889.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,252.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,889.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,252.92,305642.4,
RETR BONE FLAP TO FIX SKULL,62148,CDM,983,RC,62148,HCPCS,Outpatient,,,866,562.90,,762.08,88,,,percent of total billed charges,88% of total Billed charges,24.93,100,,,Fee Schedule,100% of Medicare rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,866,100,,,percent of total billed charges,100% of total billed charges,71.08,103,,,Fee Schedule,103% of WA Medicaid,24.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,43.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,597.54,69,,,percent of total billed charges,69% of total billed charges,866,100,,,percent of total billed charges,100% of total billed charges,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,866,100,,,percent of total billed charges,100% of total billed charges,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,866,100,,,percent of total billed charges,100% of total billed charges,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,535.62,61.85,,,percent of total billed charges,61.85% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.71,130,,,Fee Schedule,130% of WA Medicaid ,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,326.48,37.7,,,percent of total billed charges,37.70% of total billed charges,326.48,37.7,,,percent of total billed charges,37.70% of total billed charges,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,29357.4,33.9,,,percent of total billed charges,33.9% of total billed charges,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,675.48,78,,,percent of total billed charges,78% of total billed charges,866,100,,,percent of total billed charges,100% of total billed charges,715.32,82.6,,,percent of total billed charges,82.6% of total billed charges,715.32,82.6,,,percent of total billed charges,82.6% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.93,29357.4,
REPAIR OF SKULL WITH GRAFT,62147,CDM,983,RC,62147,HCPCS,Outpatient,,,8148,5296.20,,7170.24,88,,,percent of total billed charges,88% of total Billed charges,241.48,100,,,Fee Schedule,100% of Medicare rate,800.27,100,,,Fee Schedule,100% of WA Medicaid,8148,100,,,percent of total billed charges,100% of total billed charges,824.28,103,,,Fee Schedule,103% of WA Medicaid,241.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,422.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,800.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5622.12,69,,,percent of total billed charges,69% of total billed charges,8148,100,,,percent of total billed charges,100% of total billed charges,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,8148,100,,,percent of total billed charges,100% of total billed charges,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,8148,100,,,percent of total billed charges,100% of total billed charges,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5039.54,61.85,,,percent of total billed charges,61.85% of total billed charges,800.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,800.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,816.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1040.35,130,,,Fee Schedule,130% of WA Medicaid ,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3071.8,37.7,,,percent of total billed charges,37.70% of total billed charges,3071.8,37.7,,,percent of total billed charges,37.70% of total billed charges,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,276217.2,33.9,,,percent of total billed charges,33.9% of total billed charges,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,6355.44,78,,,percent of total billed charges,78% of total billed charges,8148,100,,,percent of total billed charges,100% of total billed charges,6730.25,82.6,,,percent of total billed charges,82.6% of total billed charges,6730.25,82.6,,,percent of total billed charges,82.6% of total billed charges,800.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,241.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,800.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,241.48,276217.2,
REPAIR OF SKULL WITH GRAFT,62146,CDM,983,RC,62146,HCPCS,Outpatient,,,6834,4442.10,,6013.92,88,,,percent of total billed charges,88% of total Billed charges,223.91,100,,,Fee Schedule,100% of Medicare rate,708.51,100,,,Fee Schedule,100% of WA Medicaid,6834,100,,,percent of total billed charges,100% of total billed charges,729.77,103,,,Fee Schedule,103% of WA Medicaid,223.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,391.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,708.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4715.46,69,,,percent of total billed charges,69% of total billed charges,6834,100,,,percent of total billed charges,100% of total billed charges,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,6834,100,,,percent of total billed charges,100% of total billed charges,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,6834,100,,,percent of total billed charges,100% of total billed charges,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,4226.83,61.85,,,percent of total billed charges,61.85% of total billed charges,708.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,708.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,722.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,921.06,130,,,Fee Schedule,130% of WA Medicaid ,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2576.42,37.7,,,percent of total billed charges,37.70% of total billed charges,2576.42,37.7,,,percent of total billed charges,37.70% of total billed charges,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,231672.6,33.9,,,percent of total billed charges,33.9% of total billed charges,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,5330.52,78,,,percent of total billed charges,78% of total billed charges,6834,100,,,percent of total billed charges,100% of total billed charges,5644.88,82.6,,,percent of total billed charges,82.6% of total billed charges,5644.88,82.6,,,percent of total billed charges,82.6% of total billed charges,708.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,223.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,708.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,223.91,231672.6,
REPAIR OF SKULL  BRAIN,62145,CDM,983,RC,62145,HCPCS,Outpatient,,,7962,5175.30,,7006.56,88,,,percent of total billed charges,88% of total Billed charges,256.89,100,,,Fee Schedule,100% of Medicare rate,802.14,100,,,Fee Schedule,100% of WA Medicaid,7962,100,,,percent of total billed charges,100% of total billed charges,826.2,103,,,Fee Schedule,103% of WA Medicaid,256.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,449.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,802.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5493.78,69,,,percent of total billed charges,69% of total billed charges,7962,100,,,percent of total billed charges,100% of total billed charges,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,7962,100,,,percent of total billed charges,100% of total billed charges,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,7962,100,,,percent of total billed charges,100% of total billed charges,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,4924.5,61.85,,,percent of total billed charges,61.85% of total billed charges,802.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,802.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,818.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1042.78,130,,,Fee Schedule,130% of WA Medicaid ,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,3001.67,37.7,,,percent of total billed charges,37.70% of total billed charges,3001.67,37.7,,,percent of total billed charges,37.70% of total billed charges,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,269911.8,33.9,,,percent of total billed charges,33.9% of total billed charges,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,6210.36,78,,,percent of total billed charges,78% of total billed charges,7962,100,,,percent of total billed charges,100% of total billed charges,6576.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6576.61,82.6,,,percent of total billed charges,82.6% of total billed charges,802.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,256.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,802.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,256.89,269911.8,
REPAIR OF SKULL DEFECT,62141,CDM,983,RC,62141,HCPCS,Outpatient,,,6389,4152.85,,5622.32,88,,,percent of total billed charges,88% of total Billed charges,191.43,100,,,Fee Schedule,100% of Medicare rate,648.65,100,,,Fee Schedule,100% of WA Medicaid,6389,100,,,percent of total billed charges,100% of total billed charges,668.11,103,,,Fee Schedule,103% of WA Medicaid,191.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,334.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,648.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4408.41,69,,,percent of total billed charges,69% of total billed charges,6389,100,,,percent of total billed charges,100% of total billed charges,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6389,100,,,percent of total billed charges,100% of total billed charges,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6389,100,,,percent of total billed charges,100% of total billed charges,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3951.6,61.85,,,percent of total billed charges,61.85% of total billed charges,648.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,648.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,661.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,843.25,130,,,Fee Schedule,130% of WA Medicaid ,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2408.65,37.7,,,percent of total billed charges,37.70% of total billed charges,2408.65,37.7,,,percent of total billed charges,37.70% of total billed charges,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,216587.1,33.9,,,percent of total billed charges,33.9% of total billed charges,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,4983.42,78,,,percent of total billed charges,78% of total billed charges,6389,100,,,percent of total billed charges,100% of total billed charges,5277.31,82.6,,,percent of total billed charges,82.6% of total billed charges,5277.31,82.6,,,percent of total billed charges,82.6% of total billed charges,648.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,648.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,191.43,216587.1,
REPLACE SKULL PLATE/FLAP,62143,CDM,983,RC,62143,HCPCS,Outpatient,,,5650,3672.50,,4972,88,,,percent of total billed charges,88% of total Billed charges,178.65,100,,,Fee Schedule,100% of Medicare rate,593.63,100,,,Fee Schedule,100% of WA Medicaid,5650,100,,,percent of total billed charges,100% of total billed charges,611.44,103,,,Fee Schedule,103% of WA Medicaid,178.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,312.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,593.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3898.5,69,,,percent of total billed charges,69% of total billed charges,5650,100,,,percent of total billed charges,100% of total billed charges,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5650,100,,,percent of total billed charges,100% of total billed charges,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5650,100,,,percent of total billed charges,100% of total billed charges,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3494.53,61.85,,,percent of total billed charges,61.85% of total billed charges,593.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,593.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,605.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,771.72,130,,,Fee Schedule,130% of WA Medicaid ,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2130.05,37.7,,,percent of total billed charges,37.70% of total billed charges,2130.05,37.7,,,percent of total billed charges,37.70% of total billed charges,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,191535,33.9,,,percent of total billed charges,33.9% of total billed charges,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,4407,78,,,percent of total billed charges,78% of total billed charges,5650,100,,,percent of total billed charges,100% of total billed charges,4666.9,82.6,,,percent of total billed charges,82.6% of total billed charges,4666.9,82.6,,,percent of total billed charges,82.6% of total billed charges,593.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,178.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,593.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,178.65,191535,
REPAIR OF SKULL DEFECT,62140,CDM,983,RC,62140,HCPCS,Outpatient,,,5735,3727.75,,5046.8,88,,,percent of total billed charges,88% of total Billed charges,161.91,100,,,Fee Schedule,100% of Medicare rate,580.95,100,,,Fee Schedule,100% of WA Medicaid,5735,100,,,percent of total billed charges,100% of total billed charges,598.38,103,,,Fee Schedule,103% of WA Medicaid,161.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,283.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,580.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3957.15,69,,,percent of total billed charges,69% of total billed charges,5735,100,,,percent of total billed charges,100% of total billed charges,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,5735,100,,,percent of total billed charges,100% of total billed charges,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,5735,100,,,percent of total billed charges,100% of total billed charges,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3547.1,61.85,,,percent of total billed charges,61.85% of total billed charges,580.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,580.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,592.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,755.24,130,,,Fee Schedule,130% of WA Medicaid ,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2162.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2162.1,37.7,,,percent of total billed charges,37.70% of total billed charges,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,194416.5,33.9,,,percent of total billed charges,33.9% of total billed charges,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,4473.3,78,,,percent of total billed charges,78% of total billed charges,5735,100,,,percent of total billed charges,100% of total billed charges,4737.11,82.6,,,percent of total billed charges,82.6% of total billed charges,4737.11,82.6,,,percent of total billed charges,82.6% of total billed charges,580.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,161.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,580.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,161.91,194416.5,
REMOVE SKULL PLATE/FLAP,62142,CDM,983,RC,62142,HCPCS,Outpatient,,,4609,2995.85,,4055.92,88,,,percent of total billed charges,88% of total Billed charges,146.97,100,,,Fee Schedule,100% of Medicare rate,509.7,100,,,Fee Schedule,100% of WA Medicaid,4609,100,,,percent of total billed charges,100% of total billed charges,524.99,103,,,Fee Schedule,103% of WA Medicaid,146.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,257.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,509.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3180.21,69,,,percent of total billed charges,69% of total billed charges,4609,100,,,percent of total billed charges,100% of total billed charges,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,4609,100,,,percent of total billed charges,100% of total billed charges,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,4609,100,,,percent of total billed charges,100% of total billed charges,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2850.67,61.85,,,percent of total billed charges,61.85% of total billed charges,509.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,662.61,130,,,Fee Schedule,130% of WA Medicaid ,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,1737.59,37.7,,,percent of total billed charges,37.70% of total billed charges,1737.59,37.7,,,percent of total billed charges,37.70% of total billed charges,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,156245.1,33.9,,,percent of total billed charges,33.9% of total billed charges,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,3595.02,78,,,percent of total billed charges,78% of total billed charges,4609,100,,,percent of total billed charges,100% of total billed charges,3807.03,82.6,,,percent of total billed charges,82.6% of total billed charges,3807.03,82.6,,,percent of total billed charges,82.6% of total billed charges,509.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,146.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,146.97,156245.1,
NEUROENDOSCOPY ADD-ON,62160,CDM,983,RC,62160,HCPCS,Outpatient,,,1086,705.90,,955.68,88,,,percent of total billed charges,88% of total Billed charges,37.38,100,,,Fee Schedule,100% of Medicare rate,103.32,100,,,Fee Schedule,100% of WA Medicaid,1086,100,,,percent of total billed charges,100% of total billed charges,106.42,103,,,Fee Schedule,103% of WA Medicaid,37.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,103.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,749.34,69,,,percent of total billed charges,69% of total billed charges,1086,100,,,percent of total billed charges,100% of total billed charges,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1086,100,,,percent of total billed charges,100% of total billed charges,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1086,100,,,percent of total billed charges,100% of total billed charges,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,671.69,61.85,,,percent of total billed charges,61.85% of total billed charges,103.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,134.32,130,,,Fee Schedule,130% of WA Medicaid ,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.42,37.7,,,percent of total billed charges,37.70% of total billed charges,409.42,37.7,,,percent of total billed charges,37.70% of total billed charges,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,36815.4,33.9,,,percent of total billed charges,33.9% of total billed charges,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.08,78,,,percent of total billed charges,78% of total billed charges,1086,100,,,percent of total billed charges,100% of total billed charges,897.04,82.6,,,percent of total billed charges,82.6% of total billed charges,897.04,82.6,,,percent of total billed charges,82.6% of total billed charges,103.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.38,36815.4,
DISSECT BRAIN W/SCOPE,62161,CDM,983,RC,62161,HCPCS,Outpatient,,,7752,5038.80,,6821.76,88,,,percent of total billed charges,88% of total Billed charges,274.85,100,,,Fee Schedule,100% of Medicare rate,862.56,100,,,Fee Schedule,100% of WA Medicaid,7752,100,,,percent of total billed charges,100% of total billed charges,888.44,103,,,Fee Schedule,103% of WA Medicaid,274.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,480.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,862.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5348.88,69,,,percent of total billed charges,69% of total billed charges,7752,100,,,percent of total billed charges,100% of total billed charges,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,7752,100,,,percent of total billed charges,100% of total billed charges,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,7752,100,,,percent of total billed charges,100% of total billed charges,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,4794.61,61.85,,,percent of total billed charges,61.85% of total billed charges,862.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,862.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,879.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1121.33,130,,,Fee Schedule,130% of WA Medicaid ,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,2922.5,37.7,,,percent of total billed charges,37.70% of total billed charges,2922.5,37.7,,,percent of total billed charges,37.70% of total billed charges,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,262792.8,33.9,,,percent of total billed charges,33.9% of total billed charges,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6046.56,78,,,percent of total billed charges,78% of total billed charges,7752,100,,,percent of total billed charges,100% of total billed charges,6403.15,82.6,,,percent of total billed charges,82.6% of total billed charges,6403.15,82.6,,,percent of total billed charges,82.6% of total billed charges,862.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,277.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,274.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,862.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,274.85,262792.8,
REMOVE COLLOID CYST W/SCOPE,62162,CDM,983,RC,62162,HCPCS,Outpatient,,,5059,3288.35,,4451.92,88,,,percent of total billed charges,88% of total Billed charges,346.25,100,,,Fee Schedule,100% of Medicare rate,1064.92,100,,,Fee Schedule,100% of WA Medicaid,5059,100,,,percent of total billed charges,100% of total billed charges,1096.87,103,,,Fee Schedule,103% of WA Medicaid,346.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,605.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1064.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3490.71,69,,,percent of total billed charges,69% of total billed charges,5059,100,,,percent of total billed charges,100% of total billed charges,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,5059,100,,,percent of total billed charges,100% of total billed charges,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,5059,100,,,percent of total billed charges,100% of total billed charges,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3128.99,61.85,,,percent of total billed charges,61.85% of total billed charges,1064.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1086.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1384.4,130,,,Fee Schedule,130% of WA Medicaid ,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1907.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1907.24,37.7,,,percent of total billed charges,37.70% of total billed charges,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,171500.1,33.9,,,percent of total billed charges,33.9% of total billed charges,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3946.02,78,,,percent of total billed charges,78% of total billed charges,5059,100,,,percent of total billed charges,100% of total billed charges,4178.73,82.6,,,percent of total billed charges,82.6% of total billed charges,4178.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1064.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,346.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1064.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,346.25,171500.1,
REMOVE BRAIN TUMOR W/SCOPE,62164,CDM,983,RC,62164,HCPCS,Outpatient,,,10762,6995.30,,9470.56,88,,,percent of total billed charges,88% of total Billed charges,380.42,100,,,Fee Schedule,100% of Medicare rate,1181.66,100,,,Fee Schedule,100% of WA Medicaid,10762,100,,,percent of total billed charges,100% of total billed charges,1217.11,103,,,Fee Schedule,103% of WA Medicaid,380.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,665.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1181.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7425.78,69,,,percent of total billed charges,69% of total billed charges,10762,100,,,percent of total billed charges,100% of total billed charges,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,10762,100,,,percent of total billed charges,100% of total billed charges,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,10762,100,,,percent of total billed charges,100% of total billed charges,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,6656.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1181.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1181.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1205.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1536.16,130,,,Fee Schedule,130% of WA Medicaid ,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,4057.27,37.7,,,percent of total billed charges,37.70% of total billed charges,4057.27,37.7,,,percent of total billed charges,37.70% of total billed charges,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,364831.8,33.9,,,percent of total billed charges,33.9% of total billed charges,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,8394.36,78,,,percent of total billed charges,78% of total billed charges,10762,100,,,percent of total billed charges,100% of total billed charges,8889.41,82.6,,,percent of total billed charges,82.6% of total billed charges,8889.41,82.6,,,percent of total billed charges,82.6% of total billed charges,1181.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,384.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,380.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1181.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,380.42,364831.8,
REMOVE PITUIT TUMOR W/SCOPE,62165,CDM,983,RC,62165,HCPCS,Outpatient,,,9334,6067.10,,8213.92,88,,,percent of total billed charges,88% of total Billed charges,220.94,100,,,Fee Schedule,100% of Medicare rate,858.65,100,,,Fee Schedule,100% of WA Medicaid,9334,100,,,percent of total billed charges,100% of total billed charges,884.41,103,,,Fee Schedule,103% of WA Medicaid,220.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,386.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,858.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6440.46,69,,,percent of total billed charges,69% of total billed charges,9334,100,,,percent of total billed charges,100% of total billed charges,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,9334,100,,,percent of total billed charges,100% of total billed charges,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,9334,100,,,percent of total billed charges,100% of total billed charges,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,5773.08,61.85,,,percent of total billed charges,61.85% of total billed charges,858.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,858.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,875.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1116.25,130,,,Fee Schedule,130% of WA Medicaid ,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,3518.92,37.7,,,percent of total billed charges,37.70% of total billed charges,3518.92,37.7,,,percent of total billed charges,37.70% of total billed charges,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,316422.6,33.9,,,percent of total billed charges,33.9% of total billed charges,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,7280.52,78,,,percent of total billed charges,78% of total billed charges,9334,100,,,percent of total billed charges,100% of total billed charges,7709.88,82.6,,,percent of total billed charges,82.6% of total billed charges,7709.88,82.6,,,percent of total billed charges,82.6% of total billed charges,858.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,220.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,858.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,220.94,316422.6,
ESTABLISH BRAIN CAVITY SHUNT,62192,CDM,983,RC,62192,HCPCS,Outpatient,,,5332,3465.80,,4692.16,88,,,percent of total billed charges,88% of total Billed charges,170.72,100,,,Fee Schedule,100% of Medicare rate,566.4,100,,,Fee Schedule,100% of WA Medicaid,5332,100,,,percent of total billed charges,100% of total billed charges,583.39,103,,,Fee Schedule,103% of WA Medicaid,170.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,298.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,566.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3679.08,69,,,percent of total billed charges,69% of total billed charges,5332,100,,,percent of total billed charges,100% of total billed charges,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5332,100,,,percent of total billed charges,100% of total billed charges,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5332,100,,,percent of total billed charges,100% of total billed charges,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3297.84,61.85,,,percent of total billed charges,61.85% of total billed charges,566.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,566.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,736.32,130,,,Fee Schedule,130% of WA Medicaid ,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,2010.16,37.7,,,percent of total billed charges,37.70% of total billed charges,2010.16,37.7,,,percent of total billed charges,37.70% of total billed charges,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,180754.8,33.9,,,percent of total billed charges,33.9% of total billed charges,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,4158.96,78,,,percent of total billed charges,78% of total billed charges,5332,100,,,percent of total billed charges,100% of total billed charges,4404.23,82.6,,,percent of total billed charges,82.6% of total billed charges,4404.23,82.6,,,percent of total billed charges,82.6% of total billed charges,566.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,170.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,566.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,170.72,180754.8,
ESTABLISH BRAIN CAVITY SHUNT,62190,CDM,983,RC,62190,HCPCS,Outpatient,,,4868,3164.20,,4283.84,88,,,percent of total billed charges,88% of total Billed charges,159.27,100,,,Fee Schedule,100% of Medicare rate,531.34,100,,,Fee Schedule,100% of WA Medicaid,4868,100,,,percent of total billed charges,100% of total billed charges,547.28,103,,,Fee Schedule,103% of WA Medicaid,159.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,278.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,531.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3358.92,69,,,percent of total billed charges,69% of total billed charges,4868,100,,,percent of total billed charges,100% of total billed charges,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,4868,100,,,percent of total billed charges,100% of total billed charges,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,4868,100,,,percent of total billed charges,100% of total billed charges,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3010.86,61.85,,,percent of total billed charges,61.85% of total billed charges,531.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,531.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,541.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,690.74,130,,,Fee Schedule,130% of WA Medicaid ,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,1835.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1835.24,37.7,,,percent of total billed charges,37.70% of total billed charges,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,165025.2,33.9,,,percent of total billed charges,33.9% of total billed charges,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3797.04,78,,,percent of total billed charges,78% of total billed charges,4868,100,,,percent of total billed charges,100% of total billed charges,4020.97,82.6,,,percent of total billed charges,82.6% of total billed charges,4020.97,82.6,,,percent of total billed charges,82.6% of total billed charges,531.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,159.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,531.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,159.27,165025.2,
REPLACE/IRRIGATE CATHETER,62194,CDM,983,RC,62194,HCPCS,Outpatient,,,1926,1251.90,,1694.88,88,,,percent of total billed charges,88% of total Billed charges,77.03,100,,,Fee Schedule,100% of Medicare rate,285.72,100,,,Fee Schedule,100% of WA Medicaid,1926,100,,,percent of total billed charges,100% of total billed charges,294.29,103,,,Fee Schedule,103% of WA Medicaid,77.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,134.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,285.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1328.94,69,,,percent of total billed charges,69% of total billed charges,1926,100,,,percent of total billed charges,100% of total billed charges,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1926,100,,,percent of total billed charges,100% of total billed charges,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1926,100,,,percent of total billed charges,100% of total billed charges,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191.23,61.85,,,percent of total billed charges,61.85% of total billed charges,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,371.44,130,,,Fee Schedule,130% of WA Medicaid ,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.1,37.7,,,percent of total billed charges,37.70% of total billed charges,726.1,37.7,,,percent of total billed charges,37.70% of total billed charges,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,65291.4,33.9,,,percent of total billed charges,33.9% of total billed charges,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1502.28,78,,,percent of total billed charges,78% of total billed charges,1926,100,,,percent of total billed charges,100% of total billed charges,1590.88,82.6,,,percent of total billed charges,82.6% of total billed charges,1590.88,82.6,,,percent of total billed charges,82.6% of total billed charges,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.03,65291.4,
BRAIN CAVITY SHUNT W/SCOPE,62201,CDM,983,RC,62201,HCPCS,Outpatient,,,6299,4094.35,,5543.12,88,,,percent of total billed charges,88% of total Billed charges,208.48,100,,,Fee Schedule,100% of Medicare rate,692.29,100,,,Fee Schedule,100% of WA Medicaid,6299,100,,,percent of total billed charges,100% of total billed charges,713.06,103,,,Fee Schedule,103% of WA Medicaid,208.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,364.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,692.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4346.31,69,,,percent of total billed charges,69% of total billed charges,6299,100,,,percent of total billed charges,100% of total billed charges,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,6299,100,,,percent of total billed charges,100% of total billed charges,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,6299,100,,,percent of total billed charges,100% of total billed charges,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3895.93,61.85,,,percent of total billed charges,61.85% of total billed charges,692.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,706.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,899.98,130,,,Fee Schedule,130% of WA Medicaid ,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2374.72,37.7,,,percent of total billed charges,37.70% of total billed charges,2374.72,37.7,,,percent of total billed charges,37.70% of total billed charges,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,213536.1,33.9,,,percent of total billed charges,33.9% of total billed charges,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,4913.22,78,,,percent of total billed charges,78% of total billed charges,6299,100,,,percent of total billed charges,100% of total billed charges,5202.97,82.6,,,percent of total billed charges,82.6% of total billed charges,5202.97,82.6,,,percent of total billed charges,82.6% of total billed charges,692.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,208.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,208.48,213536.1,
ESTABLISH BRAIN CAVITY SHUNT,62200,CDM,983,RC,62200,HCPCS,Outpatient,,,7797,5068.05,,6861.36,88,,,percent of total billed charges,88% of total Billed charges,249.13,100,,,Fee Schedule,100% of Medicare rate,778.26,100,,,Fee Schedule,100% of WA Medicaid,7797,100,,,percent of total billed charges,100% of total billed charges,801.61,103,,,Fee Schedule,103% of WA Medicaid,249.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,435.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,778.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5379.93,69,,,percent of total billed charges,69% of total billed charges,7797,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7797,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7797,100,,,percent of total billed charges,100% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,4822.44,61.85,,,percent of total billed charges,61.85% of total billed charges,778.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,793.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1011.74,130,,,Fee Schedule,130% of WA Medicaid ,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,2939.47,37.7,,,percent of total billed charges,37.70% of total billed charges,2939.47,37.7,,,percent of total billed charges,37.70% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,264318.3,33.9,,,percent of total billed charges,33.9% of total billed charges,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,6081.66,78,,,percent of total billed charges,78% of total billed charges,7797,100,,,percent of total billed charges,100% of total billed charges,6440.32,82.6,,,percent of total billed charges,82.6% of total billed charges,6440.32,82.6,,,percent of total billed charges,82.6% of total billed charges,778.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,249.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,249.13,264318.3,
ESTABLISH BRAIN CAVITY SHUNT,62223,CDM,983,RC,62223,HCPCS,Outpatient,,,6073,3947.45,,5344.24,88,,,percent of total billed charges,88% of total Billed charges,166.46,100,,,Fee Schedule,100% of Medicare rate,588.97,100,,,Fee Schedule,100% of WA Medicaid,6073,100,,,percent of total billed charges,100% of total billed charges,606.64,103,,,Fee Schedule,103% of WA Medicaid,166.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,291.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,588.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4190.37,69,,,percent of total billed charges,69% of total billed charges,6073,100,,,percent of total billed charges,100% of total billed charges,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,6073,100,,,percent of total billed charges,100% of total billed charges,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,6073,100,,,percent of total billed charges,100% of total billed charges,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3756.15,61.85,,,percent of total billed charges,61.85% of total billed charges,588.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,600.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,765.66,130,,,Fee Schedule,130% of WA Medicaid ,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2289.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2289.52,37.7,,,percent of total billed charges,37.70% of total billed charges,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,205874.7,33.9,,,percent of total billed charges,33.9% of total billed charges,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,4736.94,78,,,percent of total billed charges,78% of total billed charges,6073,100,,,percent of total billed charges,100% of total billed charges,5016.3,82.6,,,percent of total billed charges,82.6% of total billed charges,5016.3,82.6,,,percent of total billed charges,82.6% of total billed charges,588.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,166.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,588.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,166.46,205874.7,
ESTABLISH BRAIN CAVITY SHUNT,62220,CDM,983,RC,62220,HCPCS,Outpatient,,,5610,3646.50,,4936.8,88,,,percent of total billed charges,88% of total Billed charges,166.36,100,,,Fee Schedule,100% of Medicare rate,551.85,100,,,Fee Schedule,100% of WA Medicaid,5610,100,,,percent of total billed charges,100% of total billed charges,568.41,103,,,Fee Schedule,103% of WA Medicaid,166.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,291.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,551.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3870.9,69,,,percent of total billed charges,69% of total billed charges,5610,100,,,percent of total billed charges,100% of total billed charges,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,5610,100,,,percent of total billed charges,100% of total billed charges,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,5610,100,,,percent of total billed charges,100% of total billed charges,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3469.79,61.85,,,percent of total billed charges,61.85% of total billed charges,551.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,717.41,130,,,Fee Schedule,130% of WA Medicaid ,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2114.97,37.7,,,percent of total billed charges,37.70% of total billed charges,2114.97,37.7,,,percent of total billed charges,37.70% of total billed charges,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,190179,33.9,,,percent of total billed charges,33.9% of total billed charges,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4375.8,78,,,percent of total billed charges,78% of total billed charges,5610,100,,,percent of total billed charges,100% of total billed charges,4633.86,82.6,,,percent of total billed charges,82.6% of total billed charges,4633.86,82.6,,,percent of total billed charges,82.6% of total billed charges,551.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,166.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,166.36,190179,
REPLACE/IRRIGATE CATHETER,62225,CDM,983,RC,62225,HCPCS,Outpatient,,,2247,1460.55,,1977.36,88,,,percent of total billed charges,88% of total Billed charges,81.95,100,,,Fee Schedule,100% of Medicare rate,310.34,100,,,Fee Schedule,100% of WA Medicaid,2247,100,,,percent of total billed charges,100% of total billed charges,319.65,103,,,Fee Schedule,103% of WA Medicaid,81.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,143.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,310.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1550.43,69,,,percent of total billed charges,69% of total billed charges,2247,100,,,percent of total billed charges,100% of total billed charges,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2247,100,,,percent of total billed charges,100% of total billed charges,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2247,100,,,percent of total billed charges,100% of total billed charges,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1389.77,61.85,,,percent of total billed charges,61.85% of total billed charges,310.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,403.44,130,,,Fee Schedule,130% of WA Medicaid ,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.12,37.7,,,percent of total billed charges,37.70% of total billed charges,847.12,37.7,,,percent of total billed charges,37.70% of total billed charges,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,76173.3,33.9,,,percent of total billed charges,33.9% of total billed charges,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1752.66,78,,,percent of total billed charges,78% of total billed charges,2247,100,,,percent of total billed charges,100% of total billed charges,1856.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1856.02,82.6,,,percent of total billed charges,82.6% of total billed charges,310.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.95,76173.3,
REPLACE/REVISE BRAIN SHUNT,62230,CDM,983,RC,62230,HCPCS,Outpatient,,,4580,2977.00,,4030.4,88,,,percent of total billed charges,88% of total Billed charges,140.95,100,,,Fee Schedule,100% of Medicare rate,478.93,100,,,Fee Schedule,100% of WA Medicaid,4580,100,,,percent of total billed charges,100% of total billed charges,493.3,103,,,Fee Schedule,103% of WA Medicaid,140.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,246.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,478.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3160.2,69,,,percent of total billed charges,69% of total billed charges,4580,100,,,percent of total billed charges,100% of total billed charges,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,4580,100,,,percent of total billed charges,100% of total billed charges,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,4580,100,,,percent of total billed charges,100% of total billed charges,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2832.73,61.85,,,percent of total billed charges,61.85% of total billed charges,478.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,622.61,130,,,Fee Schedule,130% of WA Medicaid ,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1726.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1726.66,37.7,,,percent of total billed charges,37.70% of total billed charges,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,155262,33.9,,,percent of total billed charges,33.9% of total billed charges,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,3572.4,78,,,percent of total billed charges,78% of total billed charges,4580,100,,,percent of total billed charges,100% of total billed charges,3783.08,82.6,,,percent of total billed charges,82.6% of total billed charges,3783.08,82.6,,,percent of total billed charges,82.6% of total billed charges,478.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,140.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.95,155262,
REPLACE BRAIN CAVITY SHUNT,62258,CDM,983,RC,62258,HCPCS,Outpatient,,,5679,3691.35,,4997.52,88,,,percent of total billed charges,88% of total Billed charges,191.84,100,,,Fee Schedule,100% of Medicare rate,631.86,100,,,Fee Schedule,100% of WA Medicaid,5679,100,,,percent of total billed charges,100% of total billed charges,650.82,103,,,Fee Schedule,103% of WA Medicaid,191.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,335.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,631.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3918.51,69,,,percent of total billed charges,69% of total billed charges,5679,100,,,percent of total billed charges,100% of total billed charges,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5679,100,,,percent of total billed charges,100% of total billed charges,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5679,100,,,percent of total billed charges,100% of total billed charges,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,3512.46,61.85,,,percent of total billed charges,61.85% of total billed charges,631.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,631.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,644.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,821.42,130,,,Fee Schedule,130% of WA Medicaid ,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2140.98,37.7,,,percent of total billed charges,37.70% of total billed charges,2140.98,37.7,,,percent of total billed charges,37.70% of total billed charges,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,192518.1,33.9,,,percent of total billed charges,33.9% of total billed charges,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,4429.62,78,,,percent of total billed charges,78% of total billed charges,5679,100,,,percent of total billed charges,100% of total billed charges,4690.85,82.6,,,percent of total billed charges,82.6% of total billed charges,4690.85,82.6,,,percent of total billed charges,82.6% of total billed charges,631.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,191.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,631.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,191.84,192518.1,
REMOVE BRAIN CAVITY SHUNT,62256,CDM,983,RC,62256,HCPCS,Outpatient,,,2932,1905.80,,2580.16,88,,,percent of total billed charges,88% of total Billed charges,97.17,100,,,Fee Schedule,100% of Medicare rate,352.86,100,,,Fee Schedule,100% of WA Medicaid,2932,100,,,percent of total billed charges,100% of total billed charges,363.45,103,,,Fee Schedule,103% of WA Medicaid,97.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,170.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,352.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2023.08,69,,,percent of total billed charges,69% of total billed charges,2932,100,,,percent of total billed charges,100% of total billed charges,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2932,100,,,percent of total billed charges,100% of total billed charges,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2932,100,,,percent of total billed charges,100% of total billed charges,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1813.44,61.85,,,percent of total billed charges,61.85% of total billed charges,352.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,458.72,130,,,Fee Schedule,130% of WA Medicaid ,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1105.36,37.7,,,percent of total billed charges,37.70% of total billed charges,1105.36,37.7,,,percent of total billed charges,37.70% of total billed charges,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,99394.8,33.9,,,percent of total billed charges,33.9% of total billed charges,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2286.96,78,,,percent of total billed charges,78% of total billed charges,2932,100,,,percent of total billed charges,100% of total billed charges,2421.83,82.6,,,percent of total billed charges,82.6% of total billed charges,2421.83,82.6,,,percent of total billed charges,82.6% of total billed charges,352.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,97.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.17,99394.8,
CSF SHUNT REPROGRAM,62252,CDM,983,RC,62252,HCPCS,Outpatient,,,302,196.30,,265.76,88,,,percent of total billed charges,88% of total Billed charges,9.86,100,,,Fee Schedule,100% of Medicare rate,25.18,100,,,Fee Schedule,100% of WA Medicaid,302,100,,,percent of total billed charges,100% of total billed charges,25.94,103,,,Fee Schedule,103% of WA Medicaid,9.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,208.38,69,,,percent of total billed charges,69% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,302,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.79,61.85,,,percent of total billed charges,61.85% of total billed charges,25.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.73,130,,,Fee Schedule,130% of WA Medicaid ,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,113.85,37.7,,,percent of total billed charges,37.70% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,10237.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.56,78,,,percent of total billed charges,78% of total billed charges,302,100,,,percent of total billed charges,100% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,249.45,82.6,,,percent of total billed charges,82.6% of total billed charges,25.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.86,10237.8,
DRAIN SPINAL CORD CYST,62268,CDM,983,RC,62268,HCPCS,Outpatient,,,2139,1390.35,,1882.32,88,,,percent of total billed charges,88% of total Billed charges,60.55,100,,,Fee Schedule,100% of Medicare rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,2139,100,,,percent of total billed charges,100% of total billed charges,189.41,103,,,Fee Schedule,103% of WA Medicaid,60.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,105.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,183.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1475.91,69,,,percent of total billed charges,69% of total billed charges,2139,100,,,percent of total billed charges,100% of total billed charges,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2139,100,,,percent of total billed charges,100% of total billed charges,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2139,100,,,percent of total billed charges,100% of total billed charges,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1322.97,61.85,,,percent of total billed charges,61.85% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,239.06,130,,,Fee Schedule,130% of WA Medicaid ,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,806.4,37.7,,,percent of total billed charges,37.70% of total billed charges,806.4,37.7,,,percent of total billed charges,37.70% of total billed charges,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,72512.1,33.9,,,percent of total billed charges,33.9% of total billed charges,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1668.42,78,,,percent of total billed charges,78% of total billed charges,2139,100,,,percent of total billed charges,100% of total billed charges,1766.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1766.81,82.6,,,percent of total billed charges,82.6% of total billed charges,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.55,72512.1,
NEEDLE BIOPSY SPINAL CORD,62269,CDM,983,RC,62269,HCPCS,Outpatient,,,1836,1193.40,,1615.68,88,,,percent of total billed charges,88% of total Billed charges,19.09,100,,,Fee Schedule,100% of Medicare rate,145.28,100,,,Fee Schedule,100% of WA Medicaid,1836,100,,,percent of total billed charges,100% of total billed charges,149.64,103,,,Fee Schedule,103% of WA Medicaid,19.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,145.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1266.84,69,,,percent of total billed charges,69% of total billed charges,1836,100,,,percent of total billed charges,100% of total billed charges,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836,100,,,percent of total billed charges,100% of total billed charges,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836,100,,,percent of total billed charges,100% of total billed charges,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1135.57,61.85,,,percent of total billed charges,61.85% of total billed charges,145.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,188.86,130,,,Fee Schedule,130% of WA Medicaid ,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.17,37.7,,,percent of total billed charges,37.70% of total billed charges,692.17,37.7,,,percent of total billed charges,37.70% of total billed charges,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,62240.4,33.9,,,percent of total billed charges,33.9% of total billed charges,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1432.08,78,,,percent of total billed charges,78% of total billed charges,1836,100,,,percent of total billed charges,100% of total billed charges,1516.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1516.54,82.6,,,percent of total billed charges,82.6% of total billed charges,145.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.09,62240.4,
DRAIN CEREBRO SPINAL FLUID,62272,CDM,983,RC,62272,HCPCS,Outpatient,,,410,266.50,,360.8,88,,,percent of total billed charges,88% of total Billed charges,14.63,100,,,Fee Schedule,100% of Medicare rate,50.91,100,,,Fee Schedule,100% of WA Medicaid,410,100,,,percent of total billed charges,100% of total billed charges,52.44,103,,,Fee Schedule,103% of WA Medicaid,14.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,50.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,282.9,69,,,percent of total billed charges,69% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,410,100,,,percent of total billed charges,100% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,410,100,,,percent of total billed charges,100% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.59,61.85,,,percent of total billed charges,61.85% of total billed charges,50.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,66.18,130,,,Fee Schedule,130% of WA Medicaid ,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.57,37.7,,,percent of total billed charges,37.70% of total billed charges,154.57,37.7,,,percent of total billed charges,37.70% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,13899,33.9,,,percent of total billed charges,33.9% of total billed charges,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.8,78,,,percent of total billed charges,78% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,50.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.63,13899,
INJECT EPIDURAL PATCH,62273,CDM,983,RC,62273,HCPCS,Outpatient,,,693,450.45,,609.84,88,,,percent of total billed charges,88% of total Billed charges,9.09,100,,,Fee Schedule,100% of Medicare rate,63.97,100,,,Fee Schedule,100% of WA Medicaid,693,100,,,percent of total billed charges,100% of total billed charges,65.89,103,,,Fee Schedule,103% of WA Medicaid,9.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,478.17,69,,,percent of total billed charges,69% of total billed charges,693,100,,,percent of total billed charges,100% of total billed charges,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,693,100,,,percent of total billed charges,100% of total billed charges,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,693,100,,,percent of total billed charges,100% of total billed charges,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,428.62,61.85,,,percent of total billed charges,61.85% of total billed charges,63.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,83.16,130,,,Fee Schedule,130% of WA Medicaid ,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.26,37.7,,,percent of total billed charges,37.70% of total billed charges,261.26,37.7,,,percent of total billed charges,37.70% of total billed charges,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,23492.7,33.9,,,percent of total billed charges,33.9% of total billed charges,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,540.54,78,,,percent of total billed charges,78% of total billed charges,693,100,,,percent of total billed charges,100% of total billed charges,572.42,82.6,,,percent of total billed charges,82.6% of total billed charges,572.42,82.6,,,percent of total billed charges,82.6% of total billed charges,63.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.09,23492.7,
SPINAL FLUID TAP DIAGNOSTIC,62270,CDM,983,RC,62270,HCPCS,Outpatient,,,489,317.85,,430.32,88,,,percent of total billed charges,88% of total Billed charges,8.87,100,,,Fee Schedule,100% of Medicare rate,35.25,100,,,Fee Schedule,100% of WA Medicaid,489,100,,,percent of total billed charges,100% of total billed charges,36.31,103,,,Fee Schedule,103% of WA Medicaid,8.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,337.41,69,,,percent of total billed charges,69% of total billed charges,489,100,,,percent of total billed charges,100% of total billed charges,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,489,100,,,percent of total billed charges,100% of total billed charges,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,489,100,,,percent of total billed charges,100% of total billed charges,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.45,61.85,,,percent of total billed charges,61.85% of total billed charges,35.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.83,130,,,Fee Schedule,130% of WA Medicaid ,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.35,37.7,,,percent of total billed charges,37.70% of total billed charges,184.35,37.7,,,percent of total billed charges,37.70% of total billed charges,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,16577.1,33.9,,,percent of total billed charges,33.9% of total billed charges,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.42,78,,,percent of total billed charges,78% of total billed charges,489,100,,,percent of total billed charges,100% of total billed charges,403.91,82.6,,,percent of total billed charges,82.6% of total billed charges,403.91,82.6,,,percent of total billed charges,82.6% of total billed charges,35.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.87,16577.1,
TREAT SPINAL CORD LESION,62280,CDM,983,RC,62280,HCPCS,Outpatient,,,734,477.10,,645.92,88,,,percent of total billed charges,88% of total Billed charges,11.82,100,,,Fee Schedule,100% of Medicare rate,91.39,100,,,Fee Schedule,100% of WA Medicaid,734,100,,,percent of total billed charges,100% of total billed charges,94.13,103,,,Fee Schedule,103% of WA Medicaid,11.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,91.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,506.46,69,,,percent of total billed charges,69% of total billed charges,734,100,,,percent of total billed charges,100% of total billed charges,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,734,100,,,percent of total billed charges,100% of total billed charges,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,734,100,,,percent of total billed charges,100% of total billed charges,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.98,61.85,,,percent of total billed charges,61.85% of total billed charges,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,118.81,130,,,Fee Schedule,130% of WA Medicaid ,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.72,37.7,,,percent of total billed charges,37.70% of total billed charges,276.72,37.7,,,percent of total billed charges,37.70% of total billed charges,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,24882.6,33.9,,,percent of total billed charges,33.9% of total billed charges,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,572.52,78,,,percent of total billed charges,78% of total billed charges,734,100,,,percent of total billed charges,100% of total billed charges,606.28,82.6,,,percent of total billed charges,82.6% of total billed charges,606.28,82.6,,,percent of total billed charges,82.6% of total billed charges,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.82,24882.6,
TREAT SPINAL CORD LESION,62281,CDM,983,RC,62281,HCPCS,Outpatient,,,1058,687.70,,931.04,88,,,percent of total billed charges,88% of total Billed charges,10.65,100,,,Fee Schedule,100% of Medicare rate,88.77,100,,,Fee Schedule,100% of WA Medicaid,1058,100,,,percent of total billed charges,100% of total billed charges,91.43,103,,,Fee Schedule,103% of WA Medicaid,10.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,88.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,730.02,69,,,percent of total billed charges,69% of total billed charges,1058,100,,,percent of total billed charges,100% of total billed charges,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1058,100,,,percent of total billed charges,100% of total billed charges,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1058,100,,,percent of total billed charges,100% of total billed charges,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,654.37,61.85,,,percent of total billed charges,61.85% of total billed charges,88.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,115.4,130,,,Fee Schedule,130% of WA Medicaid ,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.87,37.7,,,percent of total billed charges,37.70% of total billed charges,398.87,37.7,,,percent of total billed charges,37.70% of total billed charges,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,35866.2,33.9,,,percent of total billed charges,33.9% of total billed charges,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,825.24,78,,,percent of total billed charges,78% of total billed charges,1058,100,,,percent of total billed charges,100% of total billed charges,873.91,82.6,,,percent of total billed charges,82.6% of total billed charges,873.91,82.6,,,percent of total billed charges,82.6% of total billed charges,88.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.65,35866.2,
PERCUTANEOUS DISKECTOMY,62287,CDM,983,RC,62287,HCPCS,Outpatient,,,3718,2416.70,,3271.84,88,,,percent of total billed charges,88% of total Billed charges,43.18,100,,,Fee Schedule,100% of Medicare rate,347.45,100,,,Fee Schedule,100% of WA Medicaid,3718,100,,,percent of total billed charges,100% of total billed charges,357.87,103,,,Fee Schedule,103% of WA Medicaid,43.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,347.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2565.42,69,,,percent of total billed charges,69% of total billed charges,3718,100,,,percent of total billed charges,100% of total billed charges,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3718,100,,,percent of total billed charges,100% of total billed charges,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,3718,100,,,percent of total billed charges,100% of total billed charges,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2299.58,61.85,,,percent of total billed charges,61.85% of total billed charges,347.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,347.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,451.69,130,,,Fee Schedule,130% of WA Medicaid ,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1401.69,37.7,,,percent of total billed charges,37.70% of total billed charges,1401.69,37.7,,,percent of total billed charges,37.70% of total billed charges,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,126040.2,33.9,,,percent of total billed charges,33.9% of total billed charges,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2900.04,78,,,percent of total billed charges,78% of total billed charges,3718,100,,,percent of total billed charges,100% of total billed charges,3071.07,82.6,,,percent of total billed charges,82.6% of total billed charges,3071.07,82.6,,,percent of total billed charges,82.6% of total billed charges,347.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,347.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.18,126040.2,
INJECTION FOR MYELOGRAM,62284,CDM,983,RC,62284,HCPCS,Outpatient,,,252,163.80,,221.76,88,,,percent of total billed charges,88% of total Billed charges,6.87,100,,,Fee Schedule,100% of Medicare rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,252,100,,,percent of total billed charges,100% of total billed charges,48.03,103,,,Fee Schedule,103% of WA Medicaid,6.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,173.88,69,,,percent of total billed charges,69% of total billed charges,252,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,252,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,252,100,,,percent of total billed charges,100% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.86,61.85,,,percent of total billed charges,61.85% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.62,130,,,Fee Schedule,130% of WA Medicaid ,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,95,37.7,,,percent of total billed charges,37.70% of total billed charges,95,37.7,,,percent of total billed charges,37.70% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,8542.8,33.9,,,percent of total billed charges,33.9% of total billed charges,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.56,78,,,percent of total billed charges,78% of total billed charges,252,100,,,percent of total billed charges,100% of total billed charges,208.15,82.6,,,percent of total billed charges,82.6% of total billed charges,208.15,82.6,,,percent of total billed charges,82.6% of total billed charges,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.87,8542.8,
INJECT FOR SPINE DISK X-RAY,62291,CDM,983,RC,62291,HCPCS,Outpatient,,,1130,734.50,,994.4,88,,,percent of total billed charges,88% of total Billed charges,10.46,100,,,Fee Schedule,100% of Medicare rate,80.01,100,,,Fee Schedule,100% of WA Medicaid,1130,100,,,percent of total billed charges,100% of total billed charges,82.41,103,,,Fee Schedule,103% of WA Medicaid,10.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,80.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,779.7,69,,,percent of total billed charges,69% of total billed charges,1130,100,,,percent of total billed charges,100% of total billed charges,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1130,100,,,percent of total billed charges,100% of total billed charges,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1130,100,,,percent of total billed charges,100% of total billed charges,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.91,61.85,,,percent of total billed charges,61.85% of total billed charges,80.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,104.01,130,,,Fee Schedule,130% of WA Medicaid ,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,426.01,37.7,,,percent of total billed charges,37.70% of total billed charges,426.01,37.7,,,percent of total billed charges,37.70% of total billed charges,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,38307,33.9,,,percent of total billed charges,33.9% of total billed charges,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,881.4,78,,,percent of total billed charges,78% of total billed charges,1130,100,,,percent of total billed charges,100% of total billed charges,933.38,82.6,,,percent of total billed charges,82.6% of total billed charges,933.38,82.6,,,percent of total billed charges,82.6% of total billed charges,80.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.46,38307,
INJECT FOR SPINE DISK X-RAY,62290,CDM,983,RC,62290,HCPCS,Outpatient,,,1286,835.90,,1131.68,88,,,percent of total billed charges,88% of total Billed charges,11.65,100,,,Fee Schedule,100% of Medicare rate,88.03,100,,,Fee Schedule,100% of WA Medicaid,1286,100,,,percent of total billed charges,100% of total billed charges,90.67,103,,,Fee Schedule,103% of WA Medicaid,11.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,88.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,887.34,69,,,percent of total billed charges,69% of total billed charges,1286,100,,,percent of total billed charges,100% of total billed charges,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1286,100,,,percent of total billed charges,100% of total billed charges,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1286,100,,,percent of total billed charges,100% of total billed charges,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,795.39,61.85,,,percent of total billed charges,61.85% of total billed charges,88.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,114.44,130,,,Fee Schedule,130% of WA Medicaid ,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,484.82,37.7,,,percent of total billed charges,37.70% of total billed charges,484.82,37.7,,,percent of total billed charges,37.70% of total billed charges,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,43595.4,33.9,,,percent of total billed charges,33.9% of total billed charges,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1003.08,78,,,percent of total billed charges,78% of total billed charges,1286,100,,,percent of total billed charges,100% of total billed charges,1062.24,82.6,,,percent of total billed charges,82.6% of total billed charges,1062.24,82.6,,,percent of total billed charges,82.6% of total billed charges,88.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.65,43595.4,
INJECT SPINE LUMBAR/SACRAL,84062322,CDM,983,RC,62322,HCPCS,Outpatient,,,753,489.45,,662.64,88,,,percent of total billed charges,88% of total Billed charges,6.77,100,,,Fee Schedule,100% of Medicare rate,44.57,100,,,Fee Schedule,100% of WA Medicaid,753,100,,,percent of total billed charges,100% of total billed charges,45.91,103,,,Fee Schedule,103% of WA Medicaid,6.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,44.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,519.57,69,,,percent of total billed charges,69% of total billed charges,753,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,753,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,753,100,,,percent of total billed charges,100% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,465.73,61.85,,,percent of total billed charges,61.85% of total billed charges,44.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,57.94,130,,,Fee Schedule,130% of WA Medicaid ,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.88,37.7,,,percent of total billed charges,37.70% of total billed charges,283.88,37.7,,,percent of total billed charges,37.70% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,25526.7,33.9,,,percent of total billed charges,33.9% of total billed charges,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,587.34,78,,,percent of total billed charges,78% of total billed charges,753,100,,,percent of total billed charges,100% of total billed charges,621.98,82.6,,,percent of total billed charges,82.6% of total billed charges,621.98,82.6,,,percent of total billed charges,82.6% of total billed charges,44.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.77,25526.7,
INJECT SPINE CERV/THORACIC,62320,CDM,983,RC,,,Outpatient,,,839,545.35,,738.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,839,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,578.91,69,,,percent of total billed charges,69% of total billed charges,839,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,839,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,839,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,518.92,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,316.3,37.7,,,percent of total billed charges,37.70% of total billed charges,316.3,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,28442.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,654.42,78,,,percent of total billed charges,78% of total billed charges,839,100,,,percent of total billed charges,100% of total billed charges,693.01,82.6,,,percent of total billed charges,82.6% of total billed charges,693.01,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",316.3,28442.1,
INJECT SPINE W/CATH CRV/THRC,62324,CDM,983,RC,,,Outpatient,,,902,586.30,,793.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,902,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,622.38,69,,,percent of total billed charges,69% of total billed charges,902,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,902,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,902,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,557.89,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,340.05,37.7,,,percent of total billed charges,37.70% of total billed charges,340.05,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,30577.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,703.56,78,,,percent of total billed charges,78% of total billed charges,902,100,,,percent of total billed charges,100% of total billed charges,745.05,82.6,,,percent of total billed charges,82.6% of total billed charges,745.05,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",340.05,30577.8,
INJECT SPINE W/CATH LMB/SCRL,62326,CDM,983,RC,,,Outpatient,,,812,527.80,,714.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,812,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,560.28,69,,,percent of total billed charges,69% of total billed charges,812,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,812,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,812,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,502.22,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,306.12,37.7,,,percent of total billed charges,37.70% of total billed charges,306.12,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,27526.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,633.36,78,,,percent of total billed charges,78% of total billed charges,812,100,,,percent of total billed charges,100% of total billed charges,670.71,82.6,,,percent of total billed charges,82.6% of total billed charges,670.71,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",306.12,27526.8,
IMPLANT SPINAL CANAL CATH,62350,CDM,983,RC,62350,HCPCS,Outpatient,,,2151,1398.15,,1892.88,88,,,percent of total billed charges,88% of total Billed charges,43.41,100,,,Fee Schedule,100% of Medicare rate,228.09,100,,,Fee Schedule,100% of WA Medicaid,2151,100,,,percent of total billed charges,100% of total billed charges,234.93,103,,,Fee Schedule,103% of WA Medicaid,43.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,228.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1484.19,69,,,percent of total billed charges,69% of total billed charges,2151,100,,,percent of total billed charges,100% of total billed charges,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2151,100,,,percent of total billed charges,100% of total billed charges,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2151,100,,,percent of total billed charges,100% of total billed charges,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1330.39,61.85,,,percent of total billed charges,61.85% of total billed charges,228.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,296.52,130,,,Fee Schedule,130% of WA Medicaid ,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,810.93,37.7,,,percent of total billed charges,37.70% of total billed charges,810.93,37.7,,,percent of total billed charges,37.70% of total billed charges,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,72918.9,33.9,,,percent of total billed charges,33.9% of total billed charges,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1677.78,78,,,percent of total billed charges,78% of total billed charges,2151,100,,,percent of total billed charges,100% of total billed charges,1776.73,82.6,,,percent of total billed charges,82.6% of total billed charges,1776.73,82.6,,,percent of total billed charges,82.6% of total billed charges,228.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.41,72918.9,
IMPLANT SPINAL CANAL CATH,62351,CDM,983,RC,62351,HCPCS,Outpatient,,,3608,2345.20,,3175.04,88,,,percent of total billed charges,88% of total Billed charges,140.09,100,,,Fee Schedule,100% of Medicare rate,522.39,100,,,Fee Schedule,100% of WA Medicaid,3608,100,,,percent of total billed charges,100% of total billed charges,538.06,103,,,Fee Schedule,103% of WA Medicaid,140.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,245.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,522.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2489.52,69,,,percent of total billed charges,69% of total billed charges,3608,100,,,percent of total billed charges,100% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3608,100,,,percent of total billed charges,100% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3608,100,,,percent of total billed charges,100% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2231.55,61.85,,,percent of total billed charges,61.85% of total billed charges,522.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,532.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,679.11,130,,,Fee Schedule,130% of WA Medicaid ,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1360.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1360.22,37.7,,,percent of total billed charges,37.70% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,122311.2,33.9,,,percent of total billed charges,33.9% of total billed charges,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2814.24,78,,,percent of total billed charges,78% of total billed charges,3608,100,,,percent of total billed charges,100% of total billed charges,2980.21,82.6,,,percent of total billed charges,82.6% of total billed charges,2980.21,82.6,,,percent of total billed charges,82.6% of total billed charges,522.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,140.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,140.09,122311.2,
REMOVE SPINAL CANAL CATHETER,62355,CDM,983,RC,62355,HCPCS,Outpatient,,,1474,958.10,,1297.12,88,,,percent of total billed charges,88% of total Billed charges,30.43,100,,,Fee Schedule,100% of Medicare rate,159.46,100,,,Fee Schedule,100% of WA Medicaid,1474,100,,,percent of total billed charges,100% of total billed charges,164.24,103,,,Fee Schedule,103% of WA Medicaid,30.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,159.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1017.06,69,,,percent of total billed charges,69% of total billed charges,1474,100,,,percent of total billed charges,100% of total billed charges,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1474,100,,,percent of total billed charges,100% of total billed charges,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1474,100,,,percent of total billed charges,100% of total billed charges,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,911.67,61.85,,,percent of total billed charges,61.85% of total billed charges,159.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,207.3,130,,,Fee Schedule,130% of WA Medicaid ,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,555.7,37.7,,,percent of total billed charges,37.70% of total billed charges,555.7,37.7,,,percent of total billed charges,37.70% of total billed charges,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,49968.6,33.9,,,percent of total billed charges,33.9% of total billed charges,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1149.72,78,,,percent of total billed charges,78% of total billed charges,1474,100,,,percent of total billed charges,100% of total billed charges,1217.52,82.6,,,percent of total billed charges,82.6% of total billed charges,1217.52,82.6,,,percent of total billed charges,82.6% of total billed charges,159.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.43,49968.6,
REMOVE SPINE INFUSION DEVICE,62365,CDM,983,RC,62365,HCPCS,Outpatient,,,1429,928.85,,1257.52,88,,,percent of total billed charges,88% of total Billed charges,35.24,100,,,Fee Schedule,100% of Medicare rate,171.95,100,,,Fee Schedule,100% of WA Medicaid,1429,100,,,percent of total billed charges,100% of total billed charges,177.11,103,,,Fee Schedule,103% of WA Medicaid,35.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,171.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,986.01,69,,,percent of total billed charges,69% of total billed charges,1429,100,,,percent of total billed charges,100% of total billed charges,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1429,100,,,percent of total billed charges,100% of total billed charges,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1429,100,,,percent of total billed charges,100% of total billed charges,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,883.84,61.85,,,percent of total billed charges,61.85% of total billed charges,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,223.54,130,,,Fee Schedule,130% of WA Medicaid ,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,538.73,37.7,,,percent of total billed charges,37.70% of total billed charges,538.73,37.7,,,percent of total billed charges,37.70% of total billed charges,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,48443.1,33.9,,,percent of total billed charges,33.9% of total billed charges,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1114.62,78,,,percent of total billed charges,78% of total billed charges,1429,100,,,percent of total billed charges,100% of total billed charges,1180.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1180.35,82.6,,,percent of total billed charges,82.6% of total billed charges,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.24,48443.1,
INSERT SPINE INFUSION DEVICE,62360,CDM,983,RC,62360,HCPCS,Outpatient,,,1442,937.30,,1268.96,88,,,percent of total billed charges,88% of total Billed charges,34.82,100,,,Fee Schedule,100% of Medicare rate,178.67,100,,,Fee Schedule,100% of WA Medicaid,1442,100,,,percent of total billed charges,100% of total billed charges,184.03,103,,,Fee Schedule,103% of WA Medicaid,34.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,60.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,178.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,994.98,69,,,percent of total billed charges,69% of total billed charges,1442,100,,,percent of total billed charges,100% of total billed charges,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1442,100,,,percent of total billed charges,100% of total billed charges,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1442,100,,,percent of total billed charges,100% of total billed charges,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,891.88,61.85,,,percent of total billed charges,61.85% of total billed charges,178.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,182.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,232.27,130,,,Fee Schedule,130% of WA Medicaid ,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,543.63,37.7,,,percent of total billed charges,37.70% of total billed charges,543.63,37.7,,,percent of total billed charges,37.70% of total billed charges,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,48883.8,33.9,,,percent of total billed charges,33.9% of total billed charges,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1124.76,78,,,percent of total billed charges,78% of total billed charges,1442,100,,,percent of total billed charges,100% of total billed charges,1191.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1191.09,82.6,,,percent of total billed charges,82.6% of total billed charges,178.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,178.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.82,48883.8,
IMPLANT SPINE INFUSION PUMP,62362,CDM,983,RC,62362,HCPCS,Outpatient,,,2122,1379.30,,1867.36,88,,,percent of total billed charges,88% of total Billed charges,45.87,100,,,Fee Schedule,100% of Medicare rate,220.82,100,,,Fee Schedule,100% of WA Medicaid,2122,100,,,percent of total billed charges,100% of total billed charges,227.44,103,,,Fee Schedule,103% of WA Medicaid,45.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,220.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1464.18,69,,,percent of total billed charges,69% of total billed charges,2122,100,,,percent of total billed charges,100% of total billed charges,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2122,100,,,percent of total billed charges,100% of total billed charges,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2122,100,,,percent of total billed charges,100% of total billed charges,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1312.46,61.85,,,percent of total billed charges,61.85% of total billed charges,220.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,225.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,287.07,130,,,Fee Schedule,130% of WA Medicaid ,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.99,37.7,,,percent of total billed charges,37.70% of total billed charges,799.99,37.7,,,percent of total billed charges,37.70% of total billed charges,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,71935.8,33.9,,,percent of total billed charges,33.9% of total billed charges,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.16,78,,,percent of total billed charges,78% of total billed charges,2122,100,,,percent of total billed charges,100% of total billed charges,1752.77,82.6,,,percent of total billed charges,82.6% of total billed charges,1752.77,82.6,,,percent of total billed charges,82.6% of total billed charges,220.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,220.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.87,71935.8,
ANALYZE SPINE INFUS PUMP,62367,CDM,983,RC,62367,HCPCS,Outpatient,,,153,99.45,,134.64,88,,,percent of total billed charges,88% of total Billed charges,2.3,100,,,Fee Schedule,100% of Medicare rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,153,100,,,percent of total billed charges,100% of total billed charges,14.41,103,,,Fee Schedule,103% of WA Medicaid,2.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,105.57,69,,,percent of total billed charges,69% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,153,100,,,percent of total billed charges,100% of total billed charges,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,153,100,,,percent of total billed charges,100% of total billed charges,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.63,61.85,,,percent of total billed charges,61.85% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.19,130,,,Fee Schedule,130% of WA Medicaid ,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,57.68,37.7,,,percent of total billed charges,37.70% of total billed charges,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,5186.7,33.9,,,percent of total billed charges,33.9% of total billed charges,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.34,78,,,percent of total billed charges,78% of total billed charges,153,100,,,percent of total billed charges,100% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,126.38,82.6,,,percent of total billed charges,82.6% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.3,5186.7,
ANALYZE SP INF PUMP W/REPROG,62368,CDM,983,RC,62368,HCPCS,Outpatient,,,227,147.55,,199.76,88,,,percent of total billed charges,88% of total Billed charges,3.09,100,,,Fee Schedule,100% of Medicare rate,19.21,100,,,Fee Schedule,100% of WA Medicaid,227,100,,,percent of total billed charges,100% of total billed charges,19.79,103,,,Fee Schedule,103% of WA Medicaid,3.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,156.63,69,,,percent of total billed charges,69% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,227,100,,,percent of total billed charges,100% of total billed charges,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,227,100,,,percent of total billed charges,100% of total billed charges,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.4,61.85,,,percent of total billed charges,61.85% of total billed charges,19.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.97,130,,,Fee Schedule,130% of WA Medicaid ,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,7695.3,33.9,,,percent of total billed charges,33.9% of total billed charges,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.06,78,,,percent of total billed charges,78% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,19.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.09,7695.3,
REMOVE SPINE LAMINA 1/2 LMBR,63005,CDM,983,RC,63005,HCPCS,Outpatient,,,5358,3482.70,,4715.04,88,,,percent of total billed charges,88% of total Billed charges,192.95,100,,,Fee Schedule,100% of Medicare rate,682.78,100,,,Fee Schedule,100% of WA Medicaid,5358,100,,,percent of total billed charges,100% of total billed charges,703.26,103,,,Fee Schedule,103% of WA Medicaid,192.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,337.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,682.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3697.02,69,,,percent of total billed charges,69% of total billed charges,5358,100,,,percent of total billed charges,100% of total billed charges,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,5358,100,,,percent of total billed charges,100% of total billed charges,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,5358,100,,,percent of total billed charges,100% of total billed charges,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,3313.92,61.85,,,percent of total billed charges,61.85% of total billed charges,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,887.61,130,,,Fee Schedule,130% of WA Medicaid ,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2019.97,37.7,,,percent of total billed charges,37.70% of total billed charges,2019.97,37.7,,,percent of total billed charges,37.70% of total billed charges,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,181636.2,33.9,,,percent of total billed charges,33.9% of total billed charges,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,4179.24,78,,,percent of total billed charges,78% of total billed charges,5358,100,,,percent of total billed charges,100% of total billed charges,4425.71,82.6,,,percent of total billed charges,82.6% of total billed charges,4425.71,82.6,,,percent of total billed charges,82.6% of total billed charges,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,192.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,192.95,181636.2,
REMOVE SPINE LAMINA 1/2 CRVL,63001,CDM,983,RC,63001,HCPCS,Outpatient,,,4266,2772.90,,3754.08,88,,,percent of total billed charges,88% of total Billed charges,203.03,100,,,Fee Schedule,100% of Medicare rate,696.39,100,,,Fee Schedule,100% of WA Medicaid,4266,100,,,percent of total billed charges,100% of total billed charges,717.28,103,,,Fee Schedule,103% of WA Medicaid,203.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,355.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,696.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2943.54,69,,,percent of total billed charges,69% of total billed charges,4266,100,,,percent of total billed charges,100% of total billed charges,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4266,100,,,percent of total billed charges,100% of total billed charges,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4266,100,,,percent of total billed charges,100% of total billed charges,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2638.52,61.85,,,percent of total billed charges,61.85% of total billed charges,696.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,710.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,905.31,130,,,Fee Schedule,130% of WA Medicaid ,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1608.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1608.28,37.7,,,percent of total billed charges,37.70% of total billed charges,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,144617.4,33.9,,,percent of total billed charges,33.9% of total billed charges,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3327.48,78,,,percent of total billed charges,78% of total billed charges,4266,100,,,percent of total billed charges,100% of total billed charges,3523.72,82.6,,,percent of total billed charges,82.6% of total billed charges,3523.72,82.6,,,percent of total billed charges,82.6% of total billed charges,696.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,203.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,696.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,203.03,144617.4,
REMOVE SPINE LAMINA 1/2 THRC,63003,CDM,983,RC,63003,HCPCS,Outpatient,,,4826,3136.90,,4246.88,88,,,percent of total billed charges,88% of total Billed charges,202.66,100,,,Fee Schedule,100% of Medicare rate,699.19,100,,,Fee Schedule,100% of WA Medicaid,4826,100,,,percent of total billed charges,100% of total billed charges,720.17,103,,,Fee Schedule,103% of WA Medicaid,202.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,354.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,699.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3329.94,69,,,percent of total billed charges,69% of total billed charges,4826,100,,,percent of total billed charges,100% of total billed charges,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,4826,100,,,percent of total billed charges,100% of total billed charges,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,4826,100,,,percent of total billed charges,100% of total billed charges,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2984.88,61.85,,,percent of total billed charges,61.85% of total billed charges,699.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,713.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,908.95,130,,,Fee Schedule,130% of WA Medicaid ,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1819.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1819.4,37.7,,,percent of total billed charges,37.70% of total billed charges,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,163601.4,33.9,,,percent of total billed charges,33.9% of total billed charges,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,3764.28,78,,,percent of total billed charges,78% of total billed charges,4826,100,,,percent of total billed charges,100% of total billed charges,3986.28,82.6,,,percent of total billed charges,82.6% of total billed charges,3986.28,82.6,,,percent of total billed charges,82.6% of total billed charges,699.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,202.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,202.66,163601.4,
REMOVE LAMINA/FACETS LUMBAR,63012,CDM,983,RC,63012,HCPCS,Outpatient,,,6194,4026.10,,5450.72,88,,,percent of total billed charges,88% of total Billed charges,184.15,100,,,Fee Schedule,100% of Medicare rate,678.3,100,,,Fee Schedule,100% of WA Medicaid,6194,100,,,percent of total billed charges,100% of total billed charges,698.65,103,,,Fee Schedule,103% of WA Medicaid,184.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,322.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,678.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4273.86,69,,,percent of total billed charges,69% of total billed charges,6194,100,,,percent of total billed charges,100% of total billed charges,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,6194,100,,,percent of total billed charges,100% of total billed charges,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,6194,100,,,percent of total billed charges,100% of total billed charges,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,3830.99,61.85,,,percent of total billed charges,61.85% of total billed charges,678.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,691.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,881.79,130,,,Fee Schedule,130% of WA Medicaid ,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,2335.14,37.7,,,percent of total billed charges,37.70% of total billed charges,2335.14,37.7,,,percent of total billed charges,37.70% of total billed charges,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,209976.6,33.9,,,percent of total billed charges,33.9% of total billed charges,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,4831.32,78,,,percent of total billed charges,78% of total billed charges,6194,100,,,percent of total billed charges,100% of total billed charges,5116.24,82.6,,,percent of total billed charges,82.6% of total billed charges,5116.24,82.6,,,percent of total billed charges,82.6% of total billed charges,678.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,184.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,184.15,209976.6,
REMOVE SPINE LAMINA >2 LMBR,63017,CDM,983,RC,63017,HCPCS,Outpatient,,,6234,4052.10,,5485.92,88,,,percent of total billed charges,88% of total Billed charges,209.11,100,,,Fee Schedule,100% of Medicare rate,718.77,100,,,Fee Schedule,100% of WA Medicaid,6234,100,,,percent of total billed charges,100% of total billed charges,740.33,103,,,Fee Schedule,103% of WA Medicaid,209.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,365.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,718.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4301.46,69,,,percent of total billed charges,69% of total billed charges,6234,100,,,percent of total billed charges,100% of total billed charges,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,6234,100,,,percent of total billed charges,100% of total billed charges,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,6234,100,,,percent of total billed charges,100% of total billed charges,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,3855.73,61.85,,,percent of total billed charges,61.85% of total billed charges,718.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,718.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,733.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,934.4,130,,,Fee Schedule,130% of WA Medicaid ,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2350.22,37.7,,,percent of total billed charges,37.70% of total billed charges,2350.22,37.7,,,percent of total billed charges,37.70% of total billed charges,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,211332.6,33.9,,,percent of total billed charges,33.9% of total billed charges,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,4862.52,78,,,percent of total billed charges,78% of total billed charges,6234,100,,,percent of total billed charges,100% of total billed charges,5149.28,82.6,,,percent of total billed charges,82.6% of total billed charges,5149.28,82.6,,,percent of total billed charges,82.6% of total billed charges,718.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,209.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,718.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,209.11,211332.6,
REMOVE SPINE LAMINA >2 THRC,63016,CDM,983,RC,63016,HCPCS,Outpatient,,,5471,3556.15,,4814.48,88,,,percent of total billed charges,88% of total Billed charges,254.08,100,,,Fee Schedule,100% of Medicare rate,862.19,100,,,Fee Schedule,100% of WA Medicaid,5471,100,,,percent of total billed charges,100% of total billed charges,888.06,103,,,Fee Schedule,103% of WA Medicaid,254.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,444.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,862.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3774.99,69,,,percent of total billed charges,69% of total billed charges,5471,100,,,percent of total billed charges,100% of total billed charges,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,5471,100,,,percent of total billed charges,100% of total billed charges,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,5471,100,,,percent of total billed charges,100% of total billed charges,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,3383.81,61.85,,,percent of total billed charges,61.85% of total billed charges,862.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,862.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,879.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1120.85,130,,,Fee Schedule,130% of WA Medicaid ,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2062.57,37.7,,,percent of total billed charges,37.70% of total billed charges,2062.57,37.7,,,percent of total billed charges,37.70% of total billed charges,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,185466.9,33.9,,,percent of total billed charges,33.9% of total billed charges,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,4267.38,78,,,percent of total billed charges,78% of total billed charges,5471,100,,,percent of total billed charges,100% of total billed charges,4519.05,82.6,,,percent of total billed charges,82.6% of total billed charges,4519.05,82.6,,,percent of total billed charges,82.6% of total billed charges,862.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,254.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,862.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,254.08,185466.9,
REMOVE SPINE LAMINA >2 CRVCL,63015,CDM,983,RC,63015,HCPCS,Outpatient,,,6902,4486.30,,6073.76,88,,,percent of total billed charges,88% of total Billed charges,248.94,100,,,Fee Schedule,100% of Medicare rate,838.88,100,,,Fee Schedule,100% of WA Medicaid,6902,100,,,percent of total billed charges,100% of total billed charges,864.05,103,,,Fee Schedule,103% of WA Medicaid,248.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,435.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,838.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4762.38,69,,,percent of total billed charges,69% of total billed charges,6902,100,,,percent of total billed charges,100% of total billed charges,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,6902,100,,,percent of total billed charges,100% of total billed charges,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,6902,100,,,percent of total billed charges,100% of total billed charges,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,4268.89,61.85,,,percent of total billed charges,61.85% of total billed charges,838.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,838.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,855.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1090.54,130,,,Fee Schedule,130% of WA Medicaid ,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,2602.05,37.7,,,percent of total billed charges,37.70% of total billed charges,2602.05,37.7,,,percent of total billed charges,37.70% of total billed charges,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,233977.8,33.9,,,percent of total billed charges,33.9% of total billed charges,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,5383.56,78,,,percent of total billed charges,78% of total billed charges,6902,100,,,percent of total billed charges,100% of total billed charges,5701.05,82.6,,,percent of total billed charges,82.6% of total billed charges,5701.05,82.6,,,percent of total billed charges,82.6% of total billed charges,838.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,248.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,838.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,248.94,233977.8,
REMOVE SPINE LAMINA 1/2 SCRL,63011,CDM,983,RC,63011,HCPCS,Outpatient,,,4731,3075.15,,4163.28,88,,,percent of total billed charges,88% of total Billed charges,142.22,100,,,Fee Schedule,100% of Medicare rate,621.23,100,,,Fee Schedule,100% of WA Medicaid,4731,100,,,percent of total billed charges,100% of total billed charges,639.87,103,,,Fee Schedule,103% of WA Medicaid,142.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,248.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,621.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3264.39,69,,,percent of total billed charges,69% of total billed charges,4731,100,,,percent of total billed charges,100% of total billed charges,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,4731,100,,,percent of total billed charges,100% of total billed charges,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,4731,100,,,percent of total billed charges,100% of total billed charges,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,2926.12,61.85,,,percent of total billed charges,61.85% of total billed charges,621.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,633.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,807.6,130,,,Fee Schedule,130% of WA Medicaid ,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1783.59,37.7,,,percent of total billed charges,37.70% of total billed charges,1783.59,37.7,,,percent of total billed charges,37.70% of total billed charges,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,160380.9,33.9,,,percent of total billed charges,33.9% of total billed charges,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,3690.18,78,,,percent of total billed charges,78% of total billed charges,4731,100,,,percent of total billed charges,100% of total billed charges,3907.81,82.6,,,percent of total billed charges,82.6% of total billed charges,3907.81,82.6,,,percent of total billed charges,82.6% of total billed charges,621.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,142.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,621.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,142.22,160380.9,
NECK SPINE DISK SURGERY,63020,CDM,983,RC,63020,HCPCS,Outpatient,,,6590,4283.50,,5799.2,88,,,percent of total billed charges,88% of total Billed charges,159.87,100,,,Fee Schedule,100% of Medicare rate,626.64,100,,,Fee Schedule,100% of WA Medicaid,6590,100,,,percent of total billed charges,100% of total billed charges,645.44,103,,,Fee Schedule,103% of WA Medicaid,159.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,279.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,626.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4547.1,69,,,percent of total billed charges,69% of total billed charges,6590,100,,,percent of total billed charges,100% of total billed charges,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6590,100,,,percent of total billed charges,100% of total billed charges,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6590,100,,,percent of total billed charges,100% of total billed charges,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,4075.92,61.85,,,percent of total billed charges,61.85% of total billed charges,626.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,626.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,814.63,130,,,Fee Schedule,130% of WA Medicaid ,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2484.43,37.7,,,percent of total billed charges,37.70% of total billed charges,2484.43,37.7,,,percent of total billed charges,37.70% of total billed charges,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,223401,33.9,,,percent of total billed charges,33.9% of total billed charges,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,5140.2,78,,,percent of total billed charges,78% of total billed charges,6590,100,,,percent of total billed charges,100% of total billed charges,5443.34,82.6,,,percent of total billed charges,82.6% of total billed charges,5443.34,82.6,,,percent of total billed charges,82.6% of total billed charges,626.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,159.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,626.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,159.87,223401,
SPINAL DISK SURGERY ADD-ON,63035,CDM,983,RC,63035,HCPCS,Outpatient,,,1466,952.90,,1290.08,88,,,percent of total billed charges,88% of total Billed charges,38.22,100,,,Fee Schedule,100% of Medicare rate,129.06,100,,,Fee Schedule,100% of WA Medicaid,1466,100,,,percent of total billed charges,100% of total billed charges,132.93,103,,,Fee Schedule,103% of WA Medicaid,38.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,129.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1011.54,69,,,percent of total billed charges,69% of total billed charges,1466,100,,,percent of total billed charges,100% of total billed charges,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1466,100,,,percent of total billed charges,100% of total billed charges,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1466,100,,,percent of total billed charges,100% of total billed charges,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,906.72,61.85,,,percent of total billed charges,61.85% of total billed charges,129.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,167.78,130,,,Fee Schedule,130% of WA Medicaid ,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.68,37.7,,,percent of total billed charges,37.70% of total billed charges,552.68,37.7,,,percent of total billed charges,37.70% of total billed charges,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,49697.4,33.9,,,percent of total billed charges,33.9% of total billed charges,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1143.48,78,,,percent of total billed charges,78% of total billed charges,1466,100,,,percent of total billed charges,100% of total billed charges,1210.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1210.92,82.6,,,percent of total billed charges,82.6% of total billed charges,129.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.22,49697.4,
LOW BACK DISK SURGERY,63030,CDM,983,RC,63030,HCPCS,Outpatient,,,5815,3779.75,,5117.2,88,,,percent of total billed charges,88% of total Billed charges,128.76,100,,,Fee Schedule,100% of Medicare rate,524.07,100,,,Fee Schedule,100% of WA Medicaid,5815,100,,,percent of total billed charges,100% of total billed charges,539.79,103,,,Fee Schedule,103% of WA Medicaid,128.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,225.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,524.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4012.35,69,,,percent of total billed charges,69% of total billed charges,5815,100,,,percent of total billed charges,100% of total billed charges,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,5815,100,,,percent of total billed charges,100% of total billed charges,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,5815,100,,,percent of total billed charges,100% of total billed charges,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,3596.58,61.85,,,percent of total billed charges,61.85% of total billed charges,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,534.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,681.29,130,,,Fee Schedule,130% of WA Medicaid ,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2192.26,37.7,,,percent of total billed charges,37.70% of total billed charges,2192.26,37.7,,,percent of total billed charges,37.70% of total billed charges,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,197128.5,33.9,,,percent of total billed charges,33.9% of total billed charges,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,4535.7,78,,,percent of total billed charges,78% of total billed charges,5815,100,,,percent of total billed charges,100% of total billed charges,4803.19,82.6,,,percent of total billed charges,82.6% of total billed charges,4803.19,82.6,,,percent of total billed charges,82.6% of total billed charges,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,128.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,524.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,128.76,197128.5,
LAMINOTOMY ADDL CERVICAL,63043,CDM,983,RC,63043,HCPCS,Outpatient,,,1298,843.70,,1142.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,390.34,100,,,Fee Schedule,100% of WA Medicaid,1298,100,,,percent of total billed charges,100% of total billed charges,402.05,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,895.62,69,,,percent of total billed charges,69% of total billed charges,1298,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1298,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1298,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,802.81,61.85,,,percent of total billed charges,61.85% of total billed charges,390.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,398.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,507.44,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,489.35,37.7,,,percent of total billed charges,37.70% of total billed charges,489.35,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,44002.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1012.44,78,,,percent of total billed charges,78% of total billed charges,1298,100,,,percent of total billed charges,100% of total billed charges,1072.15,82.6,,,percent of total billed charges,82.6% of total billed charges,1072.15,82.6,,,percent of total billed charges,82.6% of total billed charges,390.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,390.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,390.34,44002.2,
LAMINOTOMY ADDL LUMBAR,63044,CDM,983,RC,63044,HCPCS,Outpatient,,,1707,1109.55,,1502.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,368.15,100,,,Fee Schedule,100% of WA Medicaid,1707,100,,,percent of total billed charges,100% of total billed charges,379.19,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,368.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1177.83,69,,,percent of total billed charges,69% of total billed charges,1707,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1707,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1707,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1055.78,61.85,,,percent of total billed charges,61.85% of total billed charges,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,368.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,375.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,478.6,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,643.54,37.7,,,percent of total billed charges,37.70% of total billed charges,643.54,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,57867.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1331.46,78,,,percent of total billed charges,78% of total billed charges,1707,100,,,percent of total billed charges,100% of total billed charges,1409.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1409.98,82.6,,,percent of total billed charges,82.6% of total billed charges,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,368.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,368.15,57867.3,
REMOVE SPINAL LAMINA ADD-ON,63048,CDM,983,RC,63048,HCPCS,Outpatient,,,1394,906.10,,1226.72,88,,,percent of total billed charges,88% of total Billed charges,34.95,100,,,Fee Schedule,100% of Medicare rate,116.38,100,,,Fee Schedule,100% of WA Medicaid,1394,100,,,percent of total billed charges,100% of total billed charges,119.87,103,,,Fee Schedule,103% of WA Medicaid,34.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,116.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,961.86,69,,,percent of total billed charges,69% of total billed charges,1394,100,,,percent of total billed charges,100% of total billed charges,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1394,100,,,percent of total billed charges,100% of total billed charges,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1394,100,,,percent of total billed charges,100% of total billed charges,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,862.19,61.85,,,percent of total billed charges,61.85% of total billed charges,116.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,151.29,130,,,Fee Schedule,130% of WA Medicaid ,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.54,37.7,,,percent of total billed charges,37.70% of total billed charges,525.54,37.7,,,percent of total billed charges,37.70% of total billed charges,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,47256.6,33.9,,,percent of total billed charges,33.9% of total billed charges,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1087.32,78,,,percent of total billed charges,78% of total billed charges,1394,100,,,percent of total billed charges,100% of total billed charges,1151.44,82.6,,,percent of total billed charges,82.6% of total billed charges,1151.44,82.6,,,percent of total billed charges,82.6% of total billed charges,116.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,34.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,34.95,47256.6,
REMOVE SPINE LAMINA 1 CRVL,63045,CDM,983,RC,63045,HCPCS,Outpatient,,,7141,4641.65,,6284.08,88,,,percent of total billed charges,88% of total Billed charges,205.1,100,,,Fee Schedule,100% of Medicare rate,731.27,100,,,Fee Schedule,100% of WA Medicaid,7141,100,,,percent of total billed charges,100% of total billed charges,753.21,103,,,Fee Schedule,103% of WA Medicaid,205.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,358.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,731.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4927.29,69,,,percent of total billed charges,69% of total billed charges,7141,100,,,percent of total billed charges,100% of total billed charges,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7141,100,,,percent of total billed charges,100% of total billed charges,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,7141,100,,,percent of total billed charges,100% of total billed charges,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4416.71,61.85,,,percent of total billed charges,61.85% of total billed charges,731.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,950.65,130,,,Fee Schedule,130% of WA Medicaid ,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2692.16,37.7,,,percent of total billed charges,37.70% of total billed charges,2692.16,37.7,,,percent of total billed charges,37.70% of total billed charges,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,242079.9,33.9,,,percent of total billed charges,33.9% of total billed charges,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,5569.98,78,,,percent of total billed charges,78% of total billed charges,7141,100,,,percent of total billed charges,100% of total billed charges,5898.47,82.6,,,percent of total billed charges,82.6% of total billed charges,5898.47,82.6,,,percent of total billed charges,82.6% of total billed charges,731.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,205.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,205.1,242079.9,
REMOVE SPINE LAMINA 1 THRC,63046,CDM,983,RC,63046,HCPCS,Outpatient,,,5558,3612.70,,4891.04,88,,,percent of total billed charges,88% of total Billed charges,187.33,100,,,Fee Schedule,100% of Medicare rate,699.38,100,,,Fee Schedule,100% of WA Medicaid,5558,100,,,percent of total billed charges,100% of total billed charges,720.36,103,,,Fee Schedule,103% of WA Medicaid,187.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,327.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,699.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3835.02,69,,,percent of total billed charges,69% of total billed charges,5558,100,,,percent of total billed charges,100% of total billed charges,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,5558,100,,,percent of total billed charges,100% of total billed charges,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,5558,100,,,percent of total billed charges,100% of total billed charges,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3437.62,61.85,,,percent of total billed charges,61.85% of total billed charges,699.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,713.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,909.19,130,,,Fee Schedule,130% of WA Medicaid ,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2095.37,37.7,,,percent of total billed charges,37.70% of total billed charges,2095.37,37.7,,,percent of total billed charges,37.70% of total billed charges,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,188416.2,33.9,,,percent of total billed charges,33.9% of total billed charges,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4335.24,78,,,percent of total billed charges,78% of total billed charges,5558,100,,,percent of total billed charges,100% of total billed charges,4590.91,82.6,,,percent of total billed charges,82.6% of total billed charges,4590.91,82.6,,,percent of total billed charges,82.6% of total billed charges,699.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,187.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,187.33,188416.2,
REMOVE SPINE LAMINA 1 LMBR,63047,CDM,983,RC,63047,HCPCS,Outpatient,,,6603,4291.95,,5810.64,88,,,percent of total billed charges,88% of total Billed charges,160.84,100,,,Fee Schedule,100% of Medicare rate,630.18,100,,,Fee Schedule,100% of WA Medicaid,6603,100,,,percent of total billed charges,100% of total billed charges,649.09,103,,,Fee Schedule,103% of WA Medicaid,160.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,281.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,630.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4556.07,69,,,percent of total billed charges,69% of total billed charges,6603,100,,,percent of total billed charges,100% of total billed charges,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,6603,100,,,percent of total billed charges,100% of total billed charges,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,6603,100,,,percent of total billed charges,100% of total billed charges,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,4083.96,61.85,,,percent of total billed charges,61.85% of total billed charges,630.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,630.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,819.23,130,,,Fee Schedule,130% of WA Medicaid ,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2489.33,37.7,,,percent of total billed charges,37.70% of total billed charges,2489.33,37.7,,,percent of total billed charges,37.70% of total billed charges,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,223841.7,33.9,,,percent of total billed charges,33.9% of total billed charges,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,5150.34,78,,,percent of total billed charges,78% of total billed charges,6603,100,,,percent of total billed charges,100% of total billed charges,5454.08,82.6,,,percent of total billed charges,82.6% of total billed charges,5454.08,82.6,,,percent of total billed charges,82.6% of total billed charges,630.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,160.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,630.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,160.84,223841.7,
LAMINOTOMY SINGLE CERVICAL,63040,CDM,983,RC,63040,HCPCS,Outpatient,,,4620,3003.00,,4065.6,88,,,percent of total billed charges,88% of total Billed charges,201.5,100,,,Fee Schedule,100% of Medicare rate,780.69,100,,,Fee Schedule,100% of WA Medicaid,4620,100,,,percent of total billed charges,100% of total billed charges,804.11,103,,,Fee Schedule,103% of WA Medicaid,201.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,352.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,780.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3187.8,69,,,percent of total billed charges,69% of total billed charges,4620,100,,,percent of total billed charges,100% of total billed charges,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,4620,100,,,percent of total billed charges,100% of total billed charges,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,4620,100,,,percent of total billed charges,100% of total billed charges,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2857.47,61.85,,,percent of total billed charges,61.85% of total billed charges,780.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,796.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1014.9,130,,,Fee Schedule,130% of WA Medicaid ,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1741.74,37.7,,,percent of total billed charges,37.70% of total billed charges,1741.74,37.7,,,percent of total billed charges,37.70% of total billed charges,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,156618,33.9,,,percent of total billed charges,33.9% of total billed charges,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,3603.6,78,,,percent of total billed charges,78% of total billed charges,4620,100,,,percent of total billed charges,100% of total billed charges,3816.12,82.6,,,percent of total billed charges,82.6% of total billed charges,3816.12,82.6,,,percent of total billed charges,82.6% of total billed charges,780.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,201.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,780.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,201.5,156618,
LAMINOTOMY SINGLE LUMBAR,63042,CDM,983,RC,63042,HCPCS,Outpatient,,,6957,4522.05,,6122.16,88,,,percent of total billed charges,88% of total Billed charges,184.88,100,,,Fee Schedule,100% of Medicare rate,736.49,100,,,Fee Schedule,100% of WA Medicaid,6957,100,,,percent of total billed charges,100% of total billed charges,758.58,103,,,Fee Schedule,103% of WA Medicaid,184.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,323.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,736.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4800.33,69,,,percent of total billed charges,69% of total billed charges,6957,100,,,percent of total billed charges,100% of total billed charges,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,6957,100,,,percent of total billed charges,100% of total billed charges,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,6957,100,,,percent of total billed charges,100% of total billed charges,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,4302.9,61.85,,,percent of total billed charges,61.85% of total billed charges,736.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,957.44,130,,,Fee Schedule,130% of WA Medicaid ,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2622.79,37.7,,,percent of total billed charges,37.70% of total billed charges,2622.79,37.7,,,percent of total billed charges,37.70% of total billed charges,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,235842.3,33.9,,,percent of total billed charges,33.9% of total billed charges,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,5426.46,78,,,percent of total billed charges,78% of total billed charges,6957,100,,,percent of total billed charges,100% of total billed charges,5746.48,82.6,,,percent of total billed charges,82.6% of total billed charges,5746.48,82.6,,,percent of total billed charges,82.6% of total billed charges,736.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,184.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,184.88,235842.3,
DECOMPRESS SPINE CORD ADD-ON,63057,CDM,983,RC,63057,HCPCS,Outpatient,,,2115,1374.75,,1861.2,88,,,percent of total billed charges,88% of total Billed charges,55.82,100,,,Fee Schedule,100% of Medicare rate,177.18,100,,,Fee Schedule,100% of WA Medicaid,2115,100,,,percent of total billed charges,100% of total billed charges,182.5,103,,,Fee Schedule,103% of WA Medicaid,55.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,97.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,177.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1459.35,69,,,percent of total billed charges,69% of total billed charges,2115,100,,,percent of total billed charges,100% of total billed charges,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2115,100,,,percent of total billed charges,100% of total billed charges,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2115,100,,,percent of total billed charges,100% of total billed charges,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1308.13,61.85,,,percent of total billed charges,61.85% of total billed charges,177.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,230.33,130,,,Fee Schedule,130% of WA Medicaid ,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,797.36,37.7,,,percent of total billed charges,37.70% of total billed charges,797.36,37.7,,,percent of total billed charges,37.70% of total billed charges,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,71698.5,33.9,,,percent of total billed charges,33.9% of total billed charges,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1649.7,78,,,percent of total billed charges,78% of total billed charges,2115,100,,,percent of total billed charges,100% of total billed charges,1746.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1746.99,82.6,,,percent of total billed charges,82.6% of total billed charges,177.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,55.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,55.82,71698.5,
DECOMPRESS SPINAL CORD THRC,63055,CDM,983,RC,63055,HCPCS,Outpatient,,,6181,4017.65,,5439.28,88,,,percent of total billed charges,88% of total Billed charges,273.82,100,,,Fee Schedule,100% of Medicare rate,916.65,100,,,Fee Schedule,100% of WA Medicaid,6181,100,,,percent of total billed charges,100% of total billed charges,944.15,103,,,Fee Schedule,103% of WA Medicaid,273.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,479.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,916.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4264.89,69,,,percent of total billed charges,69% of total billed charges,6181,100,,,percent of total billed charges,100% of total billed charges,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,6181,100,,,percent of total billed charges,100% of total billed charges,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,6181,100,,,percent of total billed charges,100% of total billed charges,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,3822.95,61.85,,,percent of total billed charges,61.85% of total billed charges,916.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,934.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1191.65,130,,,Fee Schedule,130% of WA Medicaid ,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2330.24,37.7,,,percent of total billed charges,37.70% of total billed charges,2330.24,37.7,,,percent of total billed charges,37.70% of total billed charges,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,209535.9,33.9,,,percent of total billed charges,33.9% of total billed charges,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,4821.18,78,,,percent of total billed charges,78% of total billed charges,6181,100,,,percent of total billed charges,100% of total billed charges,5105.51,82.6,,,percent of total billed charges,82.6% of total billed charges,5105.51,82.6,,,percent of total billed charges,82.6% of total billed charges,916.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,273.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,916.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,273.82,209535.9,
DECOMPRESS SPINAL CORD LMBR,63056,CDM,983,RC,63056,HCPCS,Outpatient,,,6907,4489.55,,6078.16,88,,,percent of total billed charges,88% of total Billed charges,233.03,100,,,Fee Schedule,100% of Medicare rate,842.05,100,,,Fee Schedule,100% of WA Medicaid,6907,100,,,percent of total billed charges,100% of total billed charges,867.31,103,,,Fee Schedule,103% of WA Medicaid,233.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,407.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,842.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4765.83,69,,,percent of total billed charges,69% of total billed charges,6907,100,,,percent of total billed charges,100% of total billed charges,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6907,100,,,percent of total billed charges,100% of total billed charges,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6907,100,,,percent of total billed charges,100% of total billed charges,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4271.98,61.85,,,percent of total billed charges,61.85% of total billed charges,842.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,858.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1094.67,130,,,Fee Schedule,130% of WA Medicaid ,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,2603.94,37.7,,,percent of total billed charges,37.70% of total billed charges,2603.94,37.7,,,percent of total billed charges,37.70% of total billed charges,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,234147.3,33.9,,,percent of total billed charges,33.9% of total billed charges,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,5387.46,78,,,percent of total billed charges,78% of total billed charges,6907,100,,,percent of total billed charges,100% of total billed charges,5705.18,82.6,,,percent of total billed charges,82.6% of total billed charges,5705.18,82.6,,,percent of total billed charges,82.6% of total billed charges,842.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,235.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,233.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,842.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,233.03,234147.3,
C-LAMINOPLASTY W/GRAFT/PLATE,63051,CDM,983,RC,63051,HCPCS,Outpatient,,,5751,3738.15,,5060.88,88,,,percent of total billed charges,88% of total Billed charges,247.86,100,,,Fee Schedule,100% of Medicare rate,956,100,,,Fee Schedule,100% of WA Medicaid,5751,100,,,percent of total billed charges,100% of total billed charges,984.68,103,,,Fee Schedule,103% of WA Medicaid,247.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,433.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,956,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3968.19,69,,,percent of total billed charges,69% of total billed charges,5751,100,,,percent of total billed charges,100% of total billed charges,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,5751,100,,,percent of total billed charges,100% of total billed charges,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,5751,100,,,percent of total billed charges,100% of total billed charges,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,3556.99,61.85,,,percent of total billed charges,61.85% of total billed charges,956,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,956,100,,,Fee Schedule,100% of WA Medicare OPPS rate,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,975.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1242.8,130,,,Fee Schedule,130% of WA Medicaid ,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2168.13,37.7,,,percent of total billed charges,37.70% of total billed charges,2168.13,37.7,,,percent of total billed charges,37.70% of total billed charges,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,194958.9,33.9,,,percent of total billed charges,33.9% of total billed charges,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,4485.78,78,,,percent of total billed charges,78% of total billed charges,5751,100,,,percent of total billed charges,100% of total billed charges,4750.33,82.6,,,percent of total billed charges,82.6% of total billed charges,4750.33,82.6,,,percent of total billed charges,82.6% of total billed charges,956,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,247.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,956,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,247.86,194958.9,
DECOMPRESS SPINE CORD ADD-ON,63066,CDM,983,RC,63066,HCPCS,Outpatient,,,1771,1151.15,,1558.48,88,,,percent of total billed charges,88% of total Billed charges,40.99,100,,,Fee Schedule,100% of Medicare rate,112.65,100,,,Fee Schedule,100% of WA Medicaid,1771,100,,,percent of total billed charges,100% of total billed charges,116.03,103,,,Fee Schedule,103% of WA Medicaid,40.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,71.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1221.99,69,,,percent of total billed charges,69% of total billed charges,1771,100,,,percent of total billed charges,100% of total billed charges,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1771,100,,,percent of total billed charges,100% of total billed charges,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1771,100,,,percent of total billed charges,100% of total billed charges,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1095.36,61.85,,,percent of total billed charges,61.85% of total billed charges,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,146.45,130,,,Fee Schedule,130% of WA Medicaid ,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.67,37.7,,,percent of total billed charges,37.70% of total billed charges,667.67,37.7,,,percent of total billed charges,37.70% of total billed charges,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,60036.9,33.9,,,percent of total billed charges,33.9% of total billed charges,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1381.38,78,,,percent of total billed charges,78% of total billed charges,1771,100,,,percent of total billed charges,100% of total billed charges,1462.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1462.85,82.6,,,percent of total billed charges,82.6% of total billed charges,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.99,60036.9,
DECOMPRESS SPINAL CORD THRC,63064,CDM,983,RC,63064,HCPCS,Outpatient,,,6584,4279.60,,5793.92,88,,,percent of total billed charges,88% of total Billed charges,296.17,100,,,Fee Schedule,100% of Medicare rate,1000.76,100,,,Fee Schedule,100% of WA Medicaid,6584,100,,,percent of total billed charges,100% of total billed charges,1030.78,103,,,Fee Schedule,103% of WA Medicaid,296.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,518.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1000.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4542.96,69,,,percent of total billed charges,69% of total billed charges,6584,100,,,percent of total billed charges,100% of total billed charges,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,6584,100,,,percent of total billed charges,100% of total billed charges,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,6584,100,,,percent of total billed charges,100% of total billed charges,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4072.2,61.85,,,percent of total billed charges,61.85% of total billed charges,1000.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1000.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1300.99,130,,,Fee Schedule,130% of WA Medicaid ,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2482.17,37.7,,,percent of total billed charges,37.70% of total billed charges,2482.17,37.7,,,percent of total billed charges,37.70% of total billed charges,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,223197.6,33.9,,,percent of total billed charges,33.9% of total billed charges,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,5135.52,78,,,percent of total billed charges,78% of total billed charges,6584,100,,,percent of total billed charges,100% of total billed charges,5438.38,82.6,,,percent of total billed charges,82.6% of total billed charges,5438.38,82.6,,,percent of total billed charges,82.6% of total billed charges,1000.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,296.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1000.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,296.17,223197.6,
NECK SPINE DISK SURGERY,63076,CDM,983,RC,63076,HCPCS,Outpatient,,,1702,1106.30,,1497.76,88,,,percent of total billed charges,88% of total Billed charges,37.69,100,,,Fee Schedule,100% of Medicare rate,133.72,100,,,Fee Schedule,100% of WA Medicaid,1702,100,,,percent of total billed charges,100% of total billed charges,137.73,103,,,Fee Schedule,103% of WA Medicaid,37.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,65.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,133.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1174.38,69,,,percent of total billed charges,69% of total billed charges,1702,100,,,percent of total billed charges,100% of total billed charges,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1702,100,,,percent of total billed charges,100% of total billed charges,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1702,100,,,percent of total billed charges,100% of total billed charges,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1052.69,61.85,,,percent of total billed charges,61.85% of total billed charges,133.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,173.84,130,,,Fee Schedule,130% of WA Medicaid ,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,641.65,37.7,,,percent of total billed charges,37.70% of total billed charges,641.65,37.7,,,percent of total billed charges,37.70% of total billed charges,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,57697.8,33.9,,,percent of total billed charges,33.9% of total billed charges,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1327.56,78,,,percent of total billed charges,78% of total billed charges,1702,100,,,percent of total billed charges,100% of total billed charges,1405.85,82.6,,,percent of total billed charges,82.6% of total billed charges,1405.85,82.6,,,percent of total billed charges,82.6% of total billed charges,133.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.69,57697.8,
SPINE DISK SURGERY THORAX,63077,CDM,983,RC,63077,HCPCS,Outpatient,,,5642,3667.30,,4964.96,88,,,percent of total billed charges,88% of total Billed charges,165.91,100,,,Fee Schedule,100% of Medicare rate,829.37,100,,,Fee Schedule,100% of WA Medicaid,5642,100,,,percent of total billed charges,100% of total billed charges,854.25,103,,,Fee Schedule,103% of WA Medicaid,165.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,290.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,829.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3892.98,69,,,percent of total billed charges,69% of total billed charges,5642,100,,,percent of total billed charges,100% of total billed charges,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,5642,100,,,percent of total billed charges,100% of total billed charges,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,5642,100,,,percent of total billed charges,100% of total billed charges,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3489.58,61.85,,,percent of total billed charges,61.85% of total billed charges,829.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,845.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1078.18,130,,,Fee Schedule,130% of WA Medicaid ,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2127.03,37.7,,,percent of total billed charges,37.70% of total billed charges,2127.03,37.7,,,percent of total billed charges,37.70% of total billed charges,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,191263.8,33.9,,,percent of total billed charges,33.9% of total billed charges,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,4400.76,78,,,percent of total billed charges,78% of total billed charges,5642,100,,,percent of total billed charges,100% of total billed charges,4660.29,82.6,,,percent of total billed charges,82.6% of total billed charges,4660.29,82.6,,,percent of total billed charges,82.6% of total billed charges,829.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,165.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,165.91,191263.8,
NECK SPINE DISK SURGERY,63075,CDM,983,RC,63075,HCPCS,Outpatient,,,6585,4280.25,,5794.8,88,,,percent of total billed charges,88% of total Billed charges,205.17,100,,,Fee Schedule,100% of Medicare rate,766.7,100,,,Fee Schedule,100% of WA Medicaid,6585,100,,,percent of total billed charges,100% of total billed charges,789.7,103,,,Fee Schedule,103% of WA Medicaid,205.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,359.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,766.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4543.65,69,,,percent of total billed charges,69% of total billed charges,6585,100,,,percent of total billed charges,100% of total billed charges,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,6585,100,,,percent of total billed charges,100% of total billed charges,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,6585,100,,,percent of total billed charges,100% of total billed charges,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4072.82,61.85,,,percent of total billed charges,61.85% of total billed charges,766.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,782.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,996.71,130,,,Fee Schedule,130% of WA Medicaid ,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2482.55,37.7,,,percent of total billed charges,37.70% of total billed charges,2482.55,37.7,,,percent of total billed charges,37.70% of total billed charges,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,223231.5,33.9,,,percent of total billed charges,33.9% of total billed charges,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,5136.3,78,,,percent of total billed charges,78% of total billed charges,6585,100,,,percent of total billed charges,100% of total billed charges,5439.21,82.6,,,percent of total billed charges,82.6% of total billed charges,5439.21,82.6,,,percent of total billed charges,82.6% of total billed charges,766.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,205.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,205.17,223231.5,
REMOVE VERTEBRAL BODY ADD-ON,63082,CDM,983,RC,63082,HCPCS,Outpatient,,,1800,1170.00,,1584,88,,,percent of total billed charges,88% of total Billed charges,45.13,100,,,Fee Schedule,100% of Medicare rate,146.96,100,,,Fee Schedule,100% of WA Medicaid,1800,100,,,percent of total billed charges,100% of total billed charges,151.37,103,,,Fee Schedule,103% of WA Medicaid,45.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,146.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1242,69,,,percent of total billed charges,69% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1800,100,,,percent of total billed charges,100% of total billed charges,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1800,100,,,percent of total billed charges,100% of total billed charges,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1113.3,61.85,,,percent of total billed charges,61.85% of total billed charges,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,191.05,130,,,Fee Schedule,130% of WA Medicaid ,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,678.6,37.7,,,percent of total billed charges,37.70% of total billed charges,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,61020,33.9,,,percent of total billed charges,33.9% of total billed charges,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1404,78,,,percent of total billed charges,78% of total billed charges,1800,100,,,percent of total billed charges,100% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1486.8,82.6,,,percent of total billed charges,82.6% of total billed charges,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.13,61020,
REMOVE VERTEBRAL BODY ADD-ON,63086,CDM,983,RC,63086,HCPCS,Outpatient,,,1790,1163.50,,1575.2,88,,,percent of total billed charges,88% of total Billed charges,32.83,100,,,Fee Schedule,100% of Medicare rate,105.56,100,,,Fee Schedule,100% of WA Medicaid,1790,100,,,percent of total billed charges,100% of total billed charges,108.73,103,,,Fee Schedule,103% of WA Medicaid,32.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,105.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1235.1,69,,,percent of total billed charges,69% of total billed charges,1790,100,,,percent of total billed charges,100% of total billed charges,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1790,100,,,percent of total billed charges,100% of total billed charges,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1790,100,,,percent of total billed charges,100% of total billed charges,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1107.12,61.85,,,percent of total billed charges,61.85% of total billed charges,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,137.23,130,,,Fee Schedule,130% of WA Medicaid ,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,674.83,37.7,,,percent of total billed charges,37.70% of total billed charges,674.83,37.7,,,percent of total billed charges,37.70% of total billed charges,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,60681,33.9,,,percent of total billed charges,33.9% of total billed charges,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,1396.2,78,,,percent of total billed charges,78% of total billed charges,1790,100,,,percent of total billed charges,100% of total billed charges,1478.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1478.54,82.6,,,percent of total billed charges,82.6% of total billed charges,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,32.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.83,60681,
REMOVE VERT BODY DCMPRN CRVL,63081,CDM,983,RC,63081,HCPCS,Outpatient,,,8472,5506.80,,7455.36,88,,,percent of total billed charges,88% of total Billed charges,279.47,100,,,Fee Schedule,100% of Medicare rate,994.42,100,,,Fee Schedule,100% of WA Medicaid,8472,100,,,percent of total billed charges,100% of total billed charges,1024.25,103,,,Fee Schedule,103% of WA Medicaid,279.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,489.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,994.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5845.68,69,,,percent of total billed charges,69% of total billed charges,8472,100,,,percent of total billed charges,100% of total billed charges,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,8472,100,,,percent of total billed charges,100% of total billed charges,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,8472,100,,,percent of total billed charges,100% of total billed charges,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,5239.93,61.85,,,percent of total billed charges,61.85% of total billed charges,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,994.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1014.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1292.75,130,,,Fee Schedule,130% of WA Medicaid ,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,3193.94,37.7,,,percent of total billed charges,37.70% of total billed charges,3193.94,37.7,,,percent of total billed charges,37.70% of total billed charges,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,287200.8,33.9,,,percent of total billed charges,33.9% of total billed charges,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,6608.16,78,,,percent of total billed charges,78% of total billed charges,8472,100,,,percent of total billed charges,100% of total billed charges,6997.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6997.87,82.6,,,percent of total billed charges,82.6% of total billed charges,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,279.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,994.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,279.47,287200.8,
REMOVE VERT BODY DCMPRN THRC,63085,CDM,983,RC,63085,HCPCS,Outpatient,,,7071,4596.15,,6222.48,88,,,percent of total billed charges,88% of total Billed charges,314.51,100,,,Fee Schedule,100% of Medicare rate,1092.33,100,,,Fee Schedule,100% of WA Medicaid,7071,100,,,percent of total billed charges,100% of total billed charges,1125.1,103,,,Fee Schedule,103% of WA Medicaid,314.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,550.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1092.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4878.99,69,,,percent of total billed charges,69% of total billed charges,7071,100,,,percent of total billed charges,100% of total billed charges,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,7071,100,,,percent of total billed charges,100% of total billed charges,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,7071,100,,,percent of total billed charges,100% of total billed charges,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4373.41,61.85,,,percent of total billed charges,61.85% of total billed charges,1092.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1092.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1114.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1420.03,130,,,Fee Schedule,130% of WA Medicaid ,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2665.77,37.7,,,percent of total billed charges,37.70% of total billed charges,2665.77,37.7,,,percent of total billed charges,37.70% of total billed charges,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,239706.9,33.9,,,percent of total billed charges,33.9% of total billed charges,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,5515.38,78,,,percent of total billed charges,78% of total billed charges,7071,100,,,percent of total billed charges,100% of total billed charges,5840.65,82.6,,,percent of total billed charges,82.6% of total billed charges,5840.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1092.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,314.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1092.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,314.51,239706.9,
REMOVE VERTEBRAL BODY ADD-ON,63088,CDM,983,RC,63088,HCPCS,Outpatient,,,1881,1222.65,,1655.28,88,,,percent of total billed charges,88% of total Billed charges,44.91,100,,,Fee Schedule,100% of Medicare rate,142.67,100,,,Fee Schedule,100% of WA Medicaid,1881,100,,,percent of total billed charges,100% of total billed charges,146.95,103,,,Fee Schedule,103% of WA Medicaid,44.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,142.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1297.89,69,,,percent of total billed charges,69% of total billed charges,1881,100,,,percent of total billed charges,100% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1881,100,,,percent of total billed charges,100% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1881,100,,,percent of total billed charges,100% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1163.4,61.85,,,percent of total billed charges,61.85% of total billed charges,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,185.47,130,,,Fee Schedule,130% of WA Medicaid ,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.14,37.7,,,percent of total billed charges,37.70% of total billed charges,709.14,37.7,,,percent of total billed charges,37.70% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,63765.9,33.9,,,percent of total billed charges,33.9% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1467.18,78,,,percent of total billed charges,78% of total billed charges,1881,100,,,percent of total billed charges,100% of total billed charges,1553.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1553.71,82.6,,,percent of total billed charges,82.6% of total billed charges,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.91,63765.9,
REMOV VERTBR DCMPRN THRCLMBR,63087,CDM,983,RC,63087,HCPCS,Outpatient,,,9137,5939.05,,8040.56,88,,,percent of total billed charges,88% of total Billed charges,386.93,100,,,Fee Schedule,100% of Medicare rate,1357.91,100,,,Fee Schedule,100% of WA Medicaid,9137,100,,,percent of total billed charges,100% of total billed charges,1398.65,103,,,Fee Schedule,103% of WA Medicaid,386.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,677.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1357.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6304.53,69,,,percent of total billed charges,69% of total billed charges,9137,100,,,percent of total billed charges,100% of total billed charges,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,9137,100,,,percent of total billed charges,100% of total billed charges,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,9137,100,,,percent of total billed charges,100% of total billed charges,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5651.23,61.85,,,percent of total billed charges,61.85% of total billed charges,1357.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1765.28,130,,,Fee Schedule,130% of WA Medicaid ,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,3444.65,37.7,,,percent of total billed charges,37.70% of total billed charges,3444.65,37.7,,,percent of total billed charges,37.70% of total billed charges,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,309744.3,33.9,,,percent of total billed charges,33.9% of total billed charges,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,7126.86,78,,,percent of total billed charges,78% of total billed charges,9137,100,,,percent of total billed charges,100% of total billed charges,7547.16,82.6,,,percent of total billed charges,82.6% of total billed charges,7547.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1357.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,386.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1357.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,386.93,309744.3,
REMOVE VERTEBRAL BODY ADD-ON,63091,CDM,983,RC,63091,HCPCS,Outpatient,,,1620,1053.00,,1425.6,88,,,percent of total billed charges,88% of total Billed charges,25.89,100,,,Fee Schedule,100% of Medicare rate,97.17,100,,,Fee Schedule,100% of WA Medicaid,1620,100,,,percent of total billed charges,100% of total billed charges,100.09,103,,,Fee Schedule,103% of WA Medicaid,25.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,97.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1117.8,69,,,percent of total billed charges,69% of total billed charges,1620,100,,,percent of total billed charges,100% of total billed charges,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1620,100,,,percent of total billed charges,100% of total billed charges,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1620,100,,,percent of total billed charges,100% of total billed charges,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1001.97,61.85,,,percent of total billed charges,61.85% of total billed charges,97.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,126.32,130,,,Fee Schedule,130% of WA Medicaid ,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.74,37.7,,,percent of total billed charges,37.70% of total billed charges,610.74,37.7,,,percent of total billed charges,37.70% of total billed charges,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,54918,33.9,,,percent of total billed charges,33.9% of total billed charges,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1263.6,78,,,percent of total billed charges,78% of total billed charges,1620,100,,,percent of total billed charges,100% of total billed charges,1338.12,82.6,,,percent of total billed charges,82.6% of total billed charges,1338.12,82.6,,,percent of total billed charges,82.6% of total billed charges,97.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.89,54918,
REMOVE VERT BODY DCMPRN LMBR,63090,CDM,983,RC,63090,HCPCS,Outpatient,,,7257,4717.05,,6386.16,88,,,percent of total billed charges,88% of total Billed charges,276.81,100,,,Fee Schedule,100% of Medicare rate,1095.69,100,,,Fee Schedule,100% of WA Medicaid,7257,100,,,percent of total billed charges,100% of total billed charges,1128.56,103,,,Fee Schedule,103% of WA Medicaid,276.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,484.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1095.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5007.33,69,,,percent of total billed charges,69% of total billed charges,7257,100,,,percent of total billed charges,100% of total billed charges,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,7257,100,,,percent of total billed charges,100% of total billed charges,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,7257,100,,,percent of total billed charges,100% of total billed charges,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4488.45,61.85,,,percent of total billed charges,61.85% of total billed charges,1095.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1095.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1424.4,130,,,Fee Schedule,130% of WA Medicaid ,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2735.89,37.7,,,percent of total billed charges,37.70% of total billed charges,2735.89,37.7,,,percent of total billed charges,37.70% of total billed charges,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,246012.3,33.9,,,percent of total billed charges,33.9% of total billed charges,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,5660.46,78,,,percent of total billed charges,78% of total billed charges,7257,100,,,percent of total billed charges,100% of total billed charges,5994.28,82.6,,,percent of total billed charges,82.6% of total billed charges,5994.28,82.6,,,percent of total billed charges,82.6% of total billed charges,1095.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,276.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1095.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,276.81,246012.3,
REMOVE VERT BODY DCMPRN LMBR,63102,CDM,983,RC,63102,HCPCS,Outpatient,,,7058,4587.70,,6211.04,88,,,percent of total billed charges,88% of total Billed charges,358.02,100,,,Fee Schedule,100% of Medicare rate,1288.16,100,,,Fee Schedule,100% of WA Medicaid,7058,100,,,percent of total billed charges,100% of total billed charges,1326.8,103,,,Fee Schedule,103% of WA Medicaid,358.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,626.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1288.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4870.02,69,,,percent of total billed charges,69% of total billed charges,7058,100,,,percent of total billed charges,100% of total billed charges,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7058,100,,,percent of total billed charges,100% of total billed charges,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7058,100,,,percent of total billed charges,100% of total billed charges,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4365.37,61.85,,,percent of total billed charges,61.85% of total billed charges,1288.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1288.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1313.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1674.61,130,,,Fee Schedule,130% of WA Medicaid ,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2660.87,37.7,,,percent of total billed charges,37.70% of total billed charges,2660.87,37.7,,,percent of total billed charges,37.70% of total billed charges,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,239266.2,33.9,,,percent of total billed charges,33.9% of total billed charges,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,5505.24,78,,,percent of total billed charges,78% of total billed charges,7058,100,,,percent of total billed charges,100% of total billed charges,5829.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5829.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1288.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,358.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1288.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,358.02,239266.2,
REMOVE VERT BODY DCMPRN THRC,63101,CDM,983,RC,63101,HCPCS,Outpatient,,,7169,4659.85,,6308.72,88,,,percent of total billed charges,88% of total Billed charges,385.62,100,,,Fee Schedule,100% of Medicare rate,1309.6,100,,,Fee Schedule,100% of WA Medicaid,7169,100,,,percent of total billed charges,100% of total billed charges,1348.89,103,,,Fee Schedule,103% of WA Medicaid,385.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,674.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1309.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4946.61,69,,,percent of total billed charges,69% of total billed charges,7169,100,,,percent of total billed charges,100% of total billed charges,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,7169,100,,,percent of total billed charges,100% of total billed charges,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,7169,100,,,percent of total billed charges,100% of total billed charges,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,4434.03,61.85,,,percent of total billed charges,61.85% of total billed charges,1309.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1309.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1335.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1702.48,130,,,Fee Schedule,130% of WA Medicaid ,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2702.71,37.7,,,percent of total billed charges,37.70% of total billed charges,2702.71,37.7,,,percent of total billed charges,37.70% of total billed charges,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,243029.1,33.9,,,percent of total billed charges,33.9% of total billed charges,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,5591.82,78,,,percent of total billed charges,78% of total billed charges,7169,100,,,percent of total billed charges,100% of total billed charges,5921.59,82.6,,,percent of total billed charges,82.6% of total billed charges,5921.59,82.6,,,percent of total billed charges,82.6% of total billed charges,1309.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,385.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1309.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,385.62,243029.1,
DRAINAGE OF SPINAL CYST,63173,CDM,983,RC,63173,HCPCS,Outpatient,,,5857,3807.05,,5154.16,88,,,percent of total billed charges,88% of total Billed charges,314.77,100,,,Fee Schedule,100% of Medicare rate,974.84,100,,,Fee Schedule,100% of WA Medicaid,5857,100,,,percent of total billed charges,100% of total billed charges,1004.09,103,,,Fee Schedule,103% of WA Medicaid,314.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,550.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,974.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4041.33,69,,,percent of total billed charges,69% of total billed charges,5857,100,,,percent of total billed charges,100% of total billed charges,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,5857,100,,,percent of total billed charges,100% of total billed charges,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,5857,100,,,percent of total billed charges,100% of total billed charges,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,3622.55,61.85,,,percent of total billed charges,61.85% of total billed charges,974.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,974.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,994.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1267.29,130,,,Fee Schedule,130% of WA Medicaid ,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,2208.09,37.7,,,percent of total billed charges,37.70% of total billed charges,2208.09,37.7,,,percent of total billed charges,37.70% of total billed charges,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,198552.3,33.9,,,percent of total billed charges,33.9% of total billed charges,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,4568.46,78,,,percent of total billed charges,78% of total billed charges,5857,100,,,percent of total billed charges,100% of total billed charges,4837.88,82.6,,,percent of total billed charges,82.6% of total billed charges,4837.88,82.6,,,percent of total billed charges,82.6% of total billed charges,974.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,314.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,974.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,314.77,198552.3,
DRAINAGE OF SPINAL CYST,63172,CDM,983,RC,63172,HCPCS,Outpatient,,,5132,3335.80,,4516.16,88,,,percent of total billed charges,88% of total Billed charges,255.43,100,,,Fee Schedule,100% of Medicare rate,799.34,100,,,Fee Schedule,100% of WA Medicaid,5132,100,,,percent of total billed charges,100% of total billed charges,823.32,103,,,Fee Schedule,103% of WA Medicaid,255.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,447,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,799.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3541.08,69,,,percent of total billed charges,69% of total billed charges,5132,100,,,percent of total billed charges,100% of total billed charges,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,5132,100,,,percent of total billed charges,100% of total billed charges,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,5132,100,,,percent of total billed charges,100% of total billed charges,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3174.14,61.85,,,percent of total billed charges,61.85% of total billed charges,799.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1039.14,130,,,Fee Schedule,130% of WA Medicaid ,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1934.76,37.7,,,percent of total billed charges,37.70% of total billed charges,1934.76,37.7,,,percent of total billed charges,37.70% of total billed charges,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,173974.8,33.9,,,percent of total billed charges,33.9% of total billed charges,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,4002.96,78,,,percent of total billed charges,78% of total billed charges,5132,100,,,percent of total billed charges,100% of total billed charges,4239.03,82.6,,,percent of total billed charges,82.6% of total billed charges,4239.03,82.6,,,percent of total billed charges,82.6% of total billed charges,799.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,255.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,799.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,255.43,173974.8,
INCISE SPINE NRV HALF SEGMNT,63185,CDM,983,RC,63185,HCPCS,Outpatient,,,786,510.90,,691.68,88,,,percent of total billed charges,88% of total Billed charges,214.33,100,,,Fee Schedule,100% of Medicare rate,699.56,100,,,Fee Schedule,100% of WA Medicaid,786,100,,,percent of total billed charges,100% of total billed charges,720.55,103,,,Fee Schedule,103% of WA Medicaid,214.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,375.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,699.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,542.34,69,,,percent of total billed charges,69% of total billed charges,786,100,,,percent of total billed charges,100% of total billed charges,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,786,100,,,percent of total billed charges,100% of total billed charges,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,786,100,,,percent of total billed charges,100% of total billed charges,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.14,61.85,,,percent of total billed charges,61.85% of total billed charges,699.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,713.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,909.43,130,,,Fee Schedule,130% of WA Medicaid ,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.32,37.7,,,percent of total billed charges,37.70% of total billed charges,296.32,37.7,,,percent of total billed charges,37.70% of total billed charges,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,26645.4,33.9,,,percent of total billed charges,33.9% of total billed charges,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,613.08,78,,,percent of total billed charges,78% of total billed charges,786,100,,,percent of total billed charges,100% of total billed charges,649.24,82.6,,,percent of total billed charges,82.6% of total billed charges,649.24,82.6,,,percent of total billed charges,82.6% of total billed charges,699.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,214.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,699.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,214.33,26645.4,
INCISE SPINE NRV >2 SEGMNTS,63190,CDM,983,RC,63190,HCPCS,Outpatient,,,5692,3699.80,,5008.96,88,,,percent of total billed charges,88% of total Billed charges,138.42,100,,,Fee Schedule,100% of Medicare rate,706.84,100,,,Fee Schedule,100% of WA Medicaid,5692,100,,,percent of total billed charges,100% of total billed charges,728.05,103,,,Fee Schedule,103% of WA Medicaid,138.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,242.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,706.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3927.48,69,,,percent of total billed charges,69% of total billed charges,5692,100,,,percent of total billed charges,100% of total billed charges,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,5692,100,,,percent of total billed charges,100% of total billed charges,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,5692,100,,,percent of total billed charges,100% of total billed charges,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,3520.5,61.85,,,percent of total billed charges,61.85% of total billed charges,706.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,706.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,720.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,918.89,130,,,Fee Schedule,130% of WA Medicaid ,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2145.88,37.7,,,percent of total billed charges,37.70% of total billed charges,2145.88,37.7,,,percent of total billed charges,37.70% of total billed charges,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,192958.8,33.9,,,percent of total billed charges,33.9% of total billed charges,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,4439.76,78,,,percent of total billed charges,78% of total billed charges,5692,100,,,percent of total billed charges,100% of total billed charges,4701.59,82.6,,,percent of total billed charges,82.6% of total billed charges,4701.59,82.6,,,percent of total billed charges,82.6% of total billed charges,706.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,138.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,706.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,138.42,192958.8,
RELEASE SPINAL CORD LUMBAR,63200,CDM,983,RC,63200,HCPCS,Outpatient,,,7065,4592.25,,6217.2,88,,,percent of total billed charges,88% of total Billed charges,268.61,100,,,Fee Schedule,100% of Medicare rate,867.41,100,,,Fee Schedule,100% of WA Medicaid,7065,100,,,percent of total billed charges,100% of total billed charges,893.43,103,,,Fee Schedule,103% of WA Medicaid,268.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,470.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,867.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4874.85,69,,,percent of total billed charges,69% of total billed charges,7065,100,,,percent of total billed charges,100% of total billed charges,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,7065,100,,,percent of total billed charges,100% of total billed charges,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,7065,100,,,percent of total billed charges,100% of total billed charges,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4369.7,61.85,,,percent of total billed charges,61.85% of total billed charges,867.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,867.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,884.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1127.63,130,,,Fee Schedule,130% of WA Medicaid ,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2663.51,37.7,,,percent of total billed charges,37.70% of total billed charges,2663.51,37.7,,,percent of total billed charges,37.70% of total billed charges,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,239503.5,33.9,,,percent of total billed charges,33.9% of total billed charges,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,5510.7,78,,,percent of total billed charges,78% of total billed charges,7065,100,,,percent of total billed charges,100% of total billed charges,5835.69,82.6,,,percent of total billed charges,82.6% of total billed charges,5835.69,82.6,,,percent of total billed charges,82.6% of total billed charges,867.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,268.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,867.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,268.61,239503.5,
REVISE SPINAL CORD VSLS THRC,63251,CDM,983,RC,63251,HCPCS,Outpatient,,,9004,5852.60,,7923.52,88,,,percent of total billed charges,88% of total Billed charges,571.5,100,,,Fee Schedule,100% of Medicare rate,1693.61,100,,,Fee Schedule,100% of WA Medicaid,9004,100,,,percent of total billed charges,100% of total billed charges,1744.42,103,,,Fee Schedule,103% of WA Medicaid,571.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1000.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1693.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6212.76,69,,,percent of total billed charges,69% of total billed charges,9004,100,,,percent of total billed charges,100% of total billed charges,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,9004,100,,,percent of total billed charges,100% of total billed charges,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,9004,100,,,percent of total billed charges,100% of total billed charges,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,5568.97,61.85,,,percent of total billed charges,61.85% of total billed charges,1693.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1693.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1727.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2201.69,130,,,Fee Schedule,130% of WA Medicaid ,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,3394.51,37.7,,,percent of total billed charges,37.70% of total billed charges,3394.51,37.7,,,percent of total billed charges,37.70% of total billed charges,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,305235.6,33.9,,,percent of total billed charges,33.9% of total billed charges,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,7023.12,78,,,percent of total billed charges,78% of total billed charges,9004,100,,,percent of total billed charges,100% of total billed charges,7437.3,82.6,,,percent of total billed charges,82.6% of total billed charges,7437.3,82.6,,,percent of total billed charges,82.6% of total billed charges,1693.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,571.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1693.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,571.5,305235.6,
REVISE SPINAL CORD VSLS CRVL,63250,CDM,983,RC,63250,HCPCS,Outpatient,,,10399,6759.35,,9151.12,88,,,percent of total billed charges,88% of total Billed charges,561.21,100,,,Fee Schedule,100% of Medicare rate,1655.75,100,,,Fee Schedule,100% of WA Medicaid,10399,100,,,percent of total billed charges,100% of total billed charges,1705.42,103,,,Fee Schedule,103% of WA Medicaid,561.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,982.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1655.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7175.31,69,,,percent of total billed charges,69% of total billed charges,10399,100,,,percent of total billed charges,100% of total billed charges,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,10399,100,,,percent of total billed charges,100% of total billed charges,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,10399,100,,,percent of total billed charges,100% of total billed charges,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,6431.78,61.85,,,percent of total billed charges,61.85% of total billed charges,1655.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1688.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2152.48,130,,,Fee Schedule,130% of WA Medicaid ,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,3920.42,37.7,,,percent of total billed charges,37.70% of total billed charges,3920.42,37.7,,,percent of total billed charges,37.70% of total billed charges,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,352526.1,33.9,,,percent of total billed charges,33.9% of total billed charges,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,8111.22,78,,,percent of total billed charges,78% of total billed charges,10399,100,,,percent of total billed charges,100% of total billed charges,8589.57,82.6,,,percent of total billed charges,82.6% of total billed charges,8589.57,82.6,,,percent of total billed charges,82.6% of total billed charges,1655.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,566.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,561.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,1655.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,561.21,352526.1,
REVISE SPINE CORD VSL THRLMB,63252,CDM,983,RC,63252,HCPCS,Outpatient,,,12040,7826.00,,10595.2,88,,,percent of total billed charges,88% of total Billed charges,571.49,100,,,Fee Schedule,100% of Medicare rate,1693.42,100,,,Fee Schedule,100% of WA Medicaid,12040,100,,,percent of total billed charges,100% of total billed charges,1744.22,103,,,Fee Schedule,103% of WA Medicaid,571.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1000.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1693.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8307.6,69,,,percent of total billed charges,69% of total billed charges,12040,100,,,percent of total billed charges,100% of total billed charges,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,12040,100,,,percent of total billed charges,100% of total billed charges,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,12040,100,,,percent of total billed charges,100% of total billed charges,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,7446.74,61.85,,,percent of total billed charges,61.85% of total billed charges,1693.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1693.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1727.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2201.45,130,,,Fee Schedule,130% of WA Medicaid ,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4539.08,37.7,,,percent of total billed charges,37.70% of total billed charges,4539.08,37.7,,,percent of total billed charges,37.70% of total billed charges,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,408156,33.9,,,percent of total billed charges,33.9% of total billed charges,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,9391.2,78,,,percent of total billed charges,78% of total billed charges,12040,100,,,percent of total billed charges,100% of total billed charges,9945.04,82.6,,,percent of total billed charges,82.6% of total billed charges,9945.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1693.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,577.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,571.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1693.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,571.49,408156,
EXCISE INTRASPINL LESION CRV,63265,CDM,983,RC,63265,HCPCS,Outpatient,,,8908,5790.20,,7839.04,88,,,percent of total billed charges,88% of total Billed charges,287.17,100,,,Fee Schedule,100% of Medicare rate,943.69,100,,,Fee Schedule,100% of WA Medicaid,8908,100,,,percent of total billed charges,100% of total billed charges,972,103,,,Fee Schedule,103% of WA Medicaid,287.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,502.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,943.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6146.52,69,,,percent of total billed charges,69% of total billed charges,8908,100,,,percent of total billed charges,100% of total billed charges,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,8908,100,,,percent of total billed charges,100% of total billed charges,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,8908,100,,,percent of total billed charges,100% of total billed charges,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,5509.6,61.85,,,percent of total billed charges,61.85% of total billed charges,943.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,943.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,962.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1226.8,130,,,Fee Schedule,130% of WA Medicaid ,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,3358.32,37.7,,,percent of total billed charges,37.70% of total billed charges,3358.32,37.7,,,percent of total billed charges,37.70% of total billed charges,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,301981.2,33.9,,,percent of total billed charges,33.9% of total billed charges,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,6948.24,78,,,percent of total billed charges,78% of total billed charges,8908,100,,,percent of total billed charges,100% of total billed charges,7358.01,82.6,,,percent of total billed charges,82.6% of total billed charges,7358.01,82.6,,,percent of total billed charges,82.6% of total billed charges,943.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,287.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,943.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,287.17,301981.2,
EXCISE INTRSPINL LESION THRC,63266,CDM,983,RC,63266,HCPCS,Outpatient,,,8362,5435.30,,7358.56,88,,,percent of total billed charges,88% of total Billed charges,292.65,100,,,Fee Schedule,100% of Medicare rate,968.68,100,,,Fee Schedule,100% of WA Medicaid,8362,100,,,percent of total billed charges,100% of total billed charges,997.74,103,,,Fee Schedule,103% of WA Medicaid,292.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,512.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,968.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5769.78,69,,,percent of total billed charges,69% of total billed charges,8362,100,,,percent of total billed charges,100% of total billed charges,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,8362,100,,,percent of total billed charges,100% of total billed charges,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,8362,100,,,percent of total billed charges,100% of total billed charges,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5171.9,61.85,,,percent of total billed charges,61.85% of total billed charges,968.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,968.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,988.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1259.28,130,,,Fee Schedule,130% of WA Medicaid ,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3152.47,37.7,,,percent of total billed charges,37.70% of total billed charges,3152.47,37.7,,,percent of total billed charges,37.70% of total billed charges,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,283471.8,33.9,,,percent of total billed charges,33.9% of total billed charges,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,6522.36,78,,,percent of total billed charges,78% of total billed charges,8362,100,,,percent of total billed charges,100% of total billed charges,6907.01,82.6,,,percent of total billed charges,82.6% of total billed charges,6907.01,82.6,,,percent of total billed charges,82.6% of total billed charges,968.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,292.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,968.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,292.65,283471.8,
EXCISE INTRSPINL LESION LMBR,63267,CDM,983,RC,63267,HCPCS,Outpatient,,,7076,4599.40,,6226.88,88,,,percent of total billed charges,88% of total Billed charges,216.69,100,,,Fee Schedule,100% of Medicare rate,778.64,100,,,Fee Schedule,100% of WA Medicaid,7076,100,,,percent of total billed charges,100% of total billed charges,802,103,,,Fee Schedule,103% of WA Medicaid,216.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,379.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,778.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4882.44,69,,,percent of total billed charges,69% of total billed charges,7076,100,,,percent of total billed charges,100% of total billed charges,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,7076,100,,,percent of total billed charges,100% of total billed charges,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,7076,100,,,percent of total billed charges,100% of total billed charges,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4376.51,61.85,,,percent of total billed charges,61.85% of total billed charges,778.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,794.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1012.23,130,,,Fee Schedule,130% of WA Medicaid ,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2667.65,37.7,,,percent of total billed charges,37.70% of total billed charges,2667.65,37.7,,,percent of total billed charges,37.70% of total billed charges,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,239876.4,33.9,,,percent of total billed charges,33.9% of total billed charges,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,5519.28,78,,,percent of total billed charges,78% of total billed charges,7076,100,,,percent of total billed charges,100% of total billed charges,5844.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5844.78,82.6,,,percent of total billed charges,82.6% of total billed charges,778.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,216.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,216.69,239876.4,
EXCISE INTRSPINL LESION SCRL,63268,CDM,983,RC,63268,HCPCS,Outpatient,,,6379,4146.35,,5613.52,88,,,percent of total billed charges,88% of total Billed charges,259.87,100,,,Fee Schedule,100% of Medicare rate,829.74,100,,,Fee Schedule,100% of WA Medicaid,6379,100,,,percent of total billed charges,100% of total billed charges,854.63,103,,,Fee Schedule,103% of WA Medicaid,259.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,454.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,829.74,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4401.51,69,,,percent of total billed charges,69% of total billed charges,6379,100,,,percent of total billed charges,100% of total billed charges,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6379,100,,,percent of total billed charges,100% of total billed charges,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6379,100,,,percent of total billed charges,100% of total billed charges,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,3945.41,61.85,,,percent of total billed charges,61.85% of total billed charges,829.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.74,100,,,Fee Schedule,100% of WA Medicare OPPS rate,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,846.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1078.66,130,,,Fee Schedule,130% of WA Medicaid ,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2404.88,37.7,,,percent of total billed charges,37.70% of total billed charges,2404.88,37.7,,,percent of total billed charges,37.70% of total billed charges,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,216248.1,33.9,,,percent of total billed charges,33.9% of total billed charges,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,4975.62,78,,,percent of total billed charges,78% of total billed charges,6379,100,,,percent of total billed charges,100% of total billed charges,5269.05,82.6,,,percent of total billed charges,82.6% of total billed charges,5269.05,82.6,,,percent of total billed charges,82.6% of total billed charges,829.74,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,259.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,829.74,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,259.87,216248.1,
EXCISE INTRSPINL LESION THRC,63271,CDM,983,RC,63271,HCPCS,Outpatient,,,9088,5907.20,,7997.44,88,,,percent of total billed charges,88% of total Billed charges,378.32,100,,,Fee Schedule,100% of Medicare rate,1165.81,100,,,Fee Schedule,100% of WA Medicaid,9088,100,,,percent of total billed charges,100% of total billed charges,1200.78,103,,,Fee Schedule,103% of WA Medicaid,378.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,662.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1165.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6270.72,69,,,percent of total billed charges,69% of total billed charges,9088,100,,,percent of total billed charges,100% of total billed charges,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,9088,100,,,percent of total billed charges,100% of total billed charges,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,9088,100,,,percent of total billed charges,100% of total billed charges,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,5620.93,61.85,,,percent of total billed charges,61.85% of total billed charges,1165.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1165.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1189.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1515.55,130,,,Fee Schedule,130% of WA Medicaid ,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,3426.18,37.7,,,percent of total billed charges,37.70% of total billed charges,3426.18,37.7,,,percent of total billed charges,37.70% of total billed charges,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,308083.2,33.9,,,percent of total billed charges,33.9% of total billed charges,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7088.64,78,,,percent of total billed charges,78% of total billed charges,9088,100,,,percent of total billed charges,100% of total billed charges,7506.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7506.69,82.6,,,percent of total billed charges,82.6% of total billed charges,1165.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,382.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,378.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1165.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,378.32,308083.2,
EXCISE INTRSPINL LESION CRVL,63270,CDM,983,RC,63270,HCPCS,Outpatient,,,9418,6121.70,,8287.84,88,,,percent of total billed charges,88% of total Billed charges,383.92,100,,,Fee Schedule,100% of Medicare rate,1168.61,100,,,Fee Schedule,100% of WA Medicaid,9418,100,,,percent of total billed charges,100% of total billed charges,1203.67,103,,,Fee Schedule,103% of WA Medicaid,383.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,671.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1168.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6498.42,69,,,percent of total billed charges,69% of total billed charges,9418,100,,,percent of total billed charges,100% of total billed charges,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,9418,100,,,percent of total billed charges,100% of total billed charges,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,9418,100,,,percent of total billed charges,100% of total billed charges,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,5825.03,61.85,,,percent of total billed charges,61.85% of total billed charges,1168.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1168.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1191.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1519.19,130,,,Fee Schedule,130% of WA Medicaid ,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,3550.59,37.7,,,percent of total billed charges,37.70% of total billed charges,3550.59,37.7,,,percent of total billed charges,37.70% of total billed charges,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,319270.2,33.9,,,percent of total billed charges,33.9% of total billed charges,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,7346.04,78,,,percent of total billed charges,78% of total billed charges,9418,100,,,percent of total billed charges,100% of total billed charges,7779.27,82.6,,,percent of total billed charges,82.6% of total billed charges,7779.27,82.6,,,percent of total billed charges,82.6% of total billed charges,1168.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,383.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1168.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,383.92,319270.2,
EXCISE INTRSPINL LESION LMBR,63272,CDM,983,RC,63272,HCPCS,Outpatient,,,10264,6671.60,,9032.32,88,,,percent of total billed charges,88% of total Billed charges,311.32,100,,,Fee Schedule,100% of Medicare rate,1057.08,100,,,Fee Schedule,100% of WA Medicaid,10264,100,,,percent of total billed charges,100% of total billed charges,1088.79,103,,,Fee Schedule,103% of WA Medicaid,311.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,544.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1057.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7082.16,69,,,percent of total billed charges,69% of total billed charges,10264,100,,,percent of total billed charges,100% of total billed charges,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,10264,100,,,percent of total billed charges,100% of total billed charges,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,10264,100,,,percent of total billed charges,100% of total billed charges,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,6348.28,61.85,,,percent of total billed charges,61.85% of total billed charges,1057.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1057.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1078.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1374.2,130,,,Fee Schedule,130% of WA Medicaid ,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,3869.53,37.7,,,percent of total billed charges,37.70% of total billed charges,3869.53,37.7,,,percent of total billed charges,37.70% of total billed charges,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,347949.6,33.9,,,percent of total billed charges,33.9% of total billed charges,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,8005.92,78,,,percent of total billed charges,78% of total billed charges,10264,100,,,percent of total billed charges,100% of total billed charges,8478.06,82.6,,,percent of total billed charges,82.6% of total billed charges,8478.06,82.6,,,percent of total billed charges,82.6% of total billed charges,1057.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,311.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1057.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,311.32,347949.6,
EXCISE INTRSPINL LESION SCRL,63273,CDM,983,RC,63273,HCPCS,Outpatient,,,8654,5625.10,,7615.52,88,,,percent of total billed charges,88% of total Billed charges,342.02,100,,,Fee Schedule,100% of Medicare rate,1053.54,100,,,Fee Schedule,100% of WA Medicaid,8654,100,,,percent of total billed charges,100% of total billed charges,1085.15,103,,,Fee Schedule,103% of WA Medicaid,342.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,598.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1053.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5971.26,69,,,percent of total billed charges,69% of total billed charges,8654,100,,,percent of total billed charges,100% of total billed charges,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,8654,100,,,percent of total billed charges,100% of total billed charges,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,8654,100,,,percent of total billed charges,100% of total billed charges,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,5352.5,61.85,,,percent of total billed charges,61.85% of total billed charges,1053.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1053.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1369.6,130,,,Fee Schedule,130% of WA Medicaid ,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3262.56,37.7,,,percent of total billed charges,37.70% of total billed charges,3262.56,37.7,,,percent of total billed charges,37.70% of total billed charges,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,293370.6,33.9,,,percent of total billed charges,33.9% of total billed charges,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,6750.12,78,,,percent of total billed charges,78% of total billed charges,8654,100,,,percent of total billed charges,100% of total billed charges,7148.2,82.6,,,percent of total billed charges,82.6% of total billed charges,7148.2,82.6,,,percent of total billed charges,82.6% of total billed charges,1053.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,345.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,342.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,1053.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,342.02,293370.6,
BX/EXC XDRL SPINE LESN CRVL,63275,CDM,983,RC,63275,HCPCS,Outpatient,,,9832,6390.80,,8652.16,88,,,percent of total billed charges,88% of total Billed charges,311.48,100,,,Fee Schedule,100% of Medicare rate,1015.68,100,,,Fee Schedule,100% of WA Medicaid,9832,100,,,percent of total billed charges,100% of total billed charges,1046.15,103,,,Fee Schedule,103% of WA Medicaid,311.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,545.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1015.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6784.08,69,,,percent of total billed charges,69% of total billed charges,9832,100,,,percent of total billed charges,100% of total billed charges,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,9832,100,,,percent of total billed charges,100% of total billed charges,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,9832,100,,,percent of total billed charges,100% of total billed charges,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,6081.09,61.85,,,percent of total billed charges,61.85% of total billed charges,1015.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1015.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1320.38,130,,,Fee Schedule,130% of WA Medicaid ,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3706.66,37.7,,,percent of total billed charges,37.70% of total billed charges,3706.66,37.7,,,percent of total billed charges,37.70% of total billed charges,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,333304.8,33.9,,,percent of total billed charges,33.9% of total billed charges,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,7668.96,78,,,percent of total billed charges,78% of total billed charges,9832,100,,,percent of total billed charges,100% of total billed charges,8121.23,82.6,,,percent of total billed charges,82.6% of total billed charges,8121.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1015.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,314.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,311.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1015.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,311.48,333304.8,
BX/EXC XDRL SPINE LESN THRC,63276,CDM,983,RC,63276,HCPCS,Outpatient,,,9716,6315.40,,8550.08,88,,,percent of total billed charges,88% of total Billed charges,310.36,100,,,Fee Schedule,100% of Medicare rate,1009.15,100,,,Fee Schedule,100% of WA Medicaid,9716,100,,,percent of total billed charges,100% of total billed charges,1039.42,103,,,Fee Schedule,103% of WA Medicaid,310.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,543.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1009.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6704.04,69,,,percent of total billed charges,69% of total billed charges,9716,100,,,percent of total billed charges,100% of total billed charges,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,9716,100,,,percent of total billed charges,100% of total billed charges,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,9716,100,,,percent of total billed charges,100% of total billed charges,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6009.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1009.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1009.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1029.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1311.9,130,,,Fee Schedule,130% of WA Medicaid ,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3662.93,37.7,,,percent of total billed charges,37.70% of total billed charges,3662.93,37.7,,,percent of total billed charges,37.70% of total billed charges,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,329372.4,33.9,,,percent of total billed charges,33.9% of total billed charges,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,7578.48,78,,,percent of total billed charges,78% of total billed charges,9716,100,,,percent of total billed charges,100% of total billed charges,8025.42,82.6,,,percent of total billed charges,82.6% of total billed charges,8025.42,82.6,,,percent of total billed charges,82.6% of total billed charges,1009.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,310.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1009.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,310.36,329372.4,
BX/EXC XDRL SPINE LESN LMBR,63277,CDM,983,RC,63277,HCPCS,Outpatient,,,9464,6151.60,,8328.32,88,,,percent of total billed charges,88% of total Billed charges,255.44,100,,,Fee Schedule,100% of Medicare rate,883.45,100,,,Fee Schedule,100% of WA Medicaid,9464,100,,,percent of total billed charges,100% of total billed charges,909.95,103,,,Fee Schedule,103% of WA Medicaid,255.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,447.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,883.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6530.16,69,,,percent of total billed charges,69% of total billed charges,9464,100,,,percent of total billed charges,100% of total billed charges,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,9464,100,,,percent of total billed charges,100% of total billed charges,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,9464,100,,,percent of total billed charges,100% of total billed charges,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,5853.48,61.85,,,percent of total billed charges,61.85% of total billed charges,883.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,883.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,901.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1148.49,130,,,Fee Schedule,130% of WA Medicaid ,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,3567.93,37.7,,,percent of total billed charges,37.70% of total billed charges,3567.93,37.7,,,percent of total billed charges,37.70% of total billed charges,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,320829.6,33.9,,,percent of total billed charges,33.9% of total billed charges,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,7381.92,78,,,percent of total billed charges,78% of total billed charges,9464,100,,,percent of total billed charges,100% of total billed charges,7817.26,82.6,,,percent of total billed charges,82.6% of total billed charges,7817.26,82.6,,,percent of total billed charges,82.6% of total billed charges,883.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,255.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,883.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,255.44,320829.6,
BX/EXC XDRL SPINE LESN SCRL,63278,CDM,983,RC,63278,HCPCS,Outpatient,,,7694,5001.10,,6770.72,88,,,percent of total billed charges,88% of total Billed charges,286.55,100,,,Fee Schedule,100% of Medicare rate,902.47,100,,,Fee Schedule,100% of WA Medicaid,7694,100,,,percent of total billed charges,100% of total billed charges,929.54,103,,,Fee Schedule,103% of WA Medicaid,286.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,501.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,902.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5308.86,69,,,percent of total billed charges,69% of total billed charges,7694,100,,,percent of total billed charges,100% of total billed charges,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,7694,100,,,percent of total billed charges,100% of total billed charges,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,7694,100,,,percent of total billed charges,100% of total billed charges,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4758.74,61.85,,,percent of total billed charges,61.85% of total billed charges,902.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,920.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1173.21,130,,,Fee Schedule,130% of WA Medicaid ,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2900.64,37.7,,,percent of total billed charges,37.70% of total billed charges,2900.64,37.7,,,percent of total billed charges,37.70% of total billed charges,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,260826.6,33.9,,,percent of total billed charges,33.9% of total billed charges,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,6001.32,78,,,percent of total billed charges,78% of total billed charges,7694,100,,,percent of total billed charges,100% of total billed charges,6355.24,82.6,,,percent of total billed charges,82.6% of total billed charges,6355.24,82.6,,,percent of total billed charges,82.6% of total billed charges,902.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,286.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,902.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,286.55,260826.6,
BX/EXC IDRL IMED LESN THRLMB,63287,CDM,983,RC,63287,HCPCS,Outpatient,,,12805,8323.25,,11268.4,88,,,percent of total billed charges,88% of total Billed charges,514.38,100,,,Fee Schedule,100% of Medicare rate,1535.83,100,,,Fee Schedule,100% of WA Medicaid,12805,100,,,percent of total billed charges,100% of total billed charges,1581.9,103,,,Fee Schedule,103% of WA Medicaid,514.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,900.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1535.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8835.45,69,,,percent of total billed charges,69% of total billed charges,12805,100,,,percent of total billed charges,100% of total billed charges,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,12805,100,,,percent of total billed charges,100% of total billed charges,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,12805,100,,,percent of total billed charges,100% of total billed charges,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,7919.89,61.85,,,percent of total billed charges,61.85% of total billed charges,1535.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1535.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1566.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1996.58,130,,,Fee Schedule,130% of WA Medicaid ,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,4827.49,37.7,,,percent of total billed charges,37.70% of total billed charges,4827.49,37.7,,,percent of total billed charges,37.70% of total billed charges,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,434089.5,33.9,,,percent of total billed charges,33.9% of total billed charges,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,9987.9,78,,,percent of total billed charges,78% of total billed charges,12805,100,,,percent of total billed charges,100% of total billed charges,10576.93,82.6,,,percent of total billed charges,82.6% of total billed charges,10576.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1535.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,519.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,514.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,1535.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,514.38,434089.5,
BX/EXC IDRL SPINE LESN CRVL,63280,CDM,983,RC,63280,HCPCS,Outpatient,,,11589,7532.85,,10198.32,88,,,percent of total billed charges,88% of total Billed charges,387.53,100,,,Fee Schedule,100% of Medicare rate,1193.04,100,,,Fee Schedule,100% of WA Medicaid,11589,100,,,percent of total billed charges,100% of total billed charges,1228.83,103,,,Fee Schedule,103% of WA Medicaid,387.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,678.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1193.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7996.41,69,,,percent of total billed charges,69% of total billed charges,11589,100,,,percent of total billed charges,100% of total billed charges,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,11589,100,,,percent of total billed charges,100% of total billed charges,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,11589,100,,,percent of total billed charges,100% of total billed charges,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,7167.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1193.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1216.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1550.95,130,,,Fee Schedule,130% of WA Medicaid ,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,4369.05,37.7,,,percent of total billed charges,37.70% of total billed charges,4369.05,37.7,,,percent of total billed charges,37.70% of total billed charges,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,392867.1,33.9,,,percent of total billed charges,33.9% of total billed charges,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,9039.42,78,,,percent of total billed charges,78% of total billed charges,11589,100,,,percent of total billed charges,100% of total billed charges,9572.51,82.6,,,percent of total billed charges,82.6% of total billed charges,9572.51,82.6,,,percent of total billed charges,82.6% of total billed charges,1193.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,387.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1193.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,387.53,392867.1,
BX/EXC IDRL SPINE LESN THRC,63281,CDM,983,RC,63281,HCPCS,Outpatient,,,11433,7431.45,,10061.04,88,,,percent of total billed charges,88% of total Billed charges,383.14,100,,,Fee Schedule,100% of Medicare rate,1183.53,100,,,Fee Schedule,100% of WA Medicaid,11433,100,,,percent of total billed charges,100% of total billed charges,1219.04,103,,,Fee Schedule,103% of WA Medicaid,383.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,670.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1183.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7888.77,69,,,percent of total billed charges,69% of total billed charges,11433,100,,,percent of total billed charges,100% of total billed charges,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,11433,100,,,percent of total billed charges,100% of total billed charges,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,11433,100,,,percent of total billed charges,100% of total billed charges,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,7071.31,61.85,,,percent of total billed charges,61.85% of total billed charges,1183.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1183.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1207.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1538.59,130,,,Fee Schedule,130% of WA Medicaid ,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4310.24,37.7,,,percent of total billed charges,37.70% of total billed charges,4310.24,37.7,,,percent of total billed charges,37.70% of total billed charges,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,387578.7,33.9,,,percent of total billed charges,33.9% of total billed charges,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,8917.74,78,,,percent of total billed charges,78% of total billed charges,11433,100,,,percent of total billed charges,100% of total billed charges,9443.66,82.6,,,percent of total billed charges,82.6% of total billed charges,9443.66,82.6,,,percent of total billed charges,82.6% of total billed charges,1183.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,386.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,383.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1183.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,383.14,387578.7,
BX/EXC IDRL IMED LESN THRC,63286,CDM,983,RC,63286,HCPCS,Outpatient,,,12625,8206.25,,11110,88,,,percent of total billed charges,88% of total Billed charges,473.67,100,,,Fee Schedule,100% of Medicare rate,1443.14,100,,,Fee Schedule,100% of WA Medicaid,12625,100,,,percent of total billed charges,100% of total billed charges,1486.43,103,,,Fee Schedule,103% of WA Medicaid,473.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,828.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1443.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8711.25,69,,,percent of total billed charges,69% of total billed charges,12625,100,,,percent of total billed charges,100% of total billed charges,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,12625,100,,,percent of total billed charges,100% of total billed charges,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,12625,100,,,percent of total billed charges,100% of total billed charges,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,7808.56,61.85,,,percent of total billed charges,61.85% of total billed charges,1443.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1443.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1472,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1876.08,130,,,Fee Schedule,130% of WA Medicaid ,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,4759.63,37.7,,,percent of total billed charges,37.70% of total billed charges,4759.63,37.7,,,percent of total billed charges,37.70% of total billed charges,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,427987.5,33.9,,,percent of total billed charges,33.9% of total billed charges,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,9847.5,78,,,percent of total billed charges,78% of total billed charges,12625,100,,,percent of total billed charges,100% of total billed charges,10428.25,82.6,,,percent of total billed charges,82.6% of total billed charges,10428.25,82.6,,,percent of total billed charges,82.6% of total billed charges,1443.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,473.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1443.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,473.67,427987.5,
BX/EXC IDRL IMED LESN CERVL,63285,CDM,983,RC,63285,HCPCS,Outpatient,,,12506,8128.90,,11005.28,88,,,percent of total billed charges,88% of total Billed charges,488.62,100,,,Fee Schedule,100% of Medicare rate,1465.7,100,,,Fee Schedule,100% of WA Medicaid,12506,100,,,percent of total billed charges,100% of total billed charges,1509.67,103,,,Fee Schedule,103% of WA Medicaid,488.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,855.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1465.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8629.14,69,,,percent of total billed charges,69% of total billed charges,12506,100,,,percent of total billed charges,100% of total billed charges,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,12506,100,,,percent of total billed charges,100% of total billed charges,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,12506,100,,,percent of total billed charges,100% of total billed charges,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,7734.96,61.85,,,percent of total billed charges,61.85% of total billed charges,1465.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1465.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1495.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1905.41,130,,,Fee Schedule,130% of WA Medicaid ,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,4714.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4714.76,37.7,,,percent of total billed charges,37.70% of total billed charges,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,423953.4,33.9,,,percent of total billed charges,33.9% of total billed charges,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,9754.68,78,,,percent of total billed charges,78% of total billed charges,12506,100,,,percent of total billed charges,100% of total billed charges,10329.96,82.6,,,percent of total billed charges,82.6% of total billed charges,10329.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1465.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,493.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,488.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1465.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,488.62,423953.4,
BX/EXC IDRL SPINE LESN LMBR,63282,CDM,983,RC,63282,HCPCS,Outpatient,,,11619,7552.35,,10224.72,88,,,percent of total billed charges,88% of total Billed charges,356.51,100,,,Fee Schedule,100% of Medicare rate,1116.76,100,,,Fee Schedule,100% of WA Medicaid,11619,100,,,percent of total billed charges,100% of total billed charges,1150.26,103,,,Fee Schedule,103% of WA Medicaid,356.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,623.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1116.76,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8017.11,69,,,percent of total billed charges,69% of total billed charges,11619,100,,,percent of total billed charges,100% of total billed charges,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,11619,100,,,percent of total billed charges,100% of total billed charges,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,11619,100,,,percent of total billed charges,100% of total billed charges,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,7186.35,61.85,,,percent of total billed charges,61.85% of total billed charges,1116.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1139.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1451.79,130,,,Fee Schedule,130% of WA Medicaid ,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4380.36,37.7,,,percent of total billed charges,37.70% of total billed charges,4380.36,37.7,,,percent of total billed charges,37.70% of total billed charges,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,393884.1,33.9,,,percent of total billed charges,33.9% of total billed charges,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,9062.82,78,,,percent of total billed charges,78% of total billed charges,11619,100,,,percent of total billed charges,100% of total billed charges,9597.29,82.6,,,percent of total billed charges,82.6% of total billed charges,9597.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1116.76,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,356.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116.76,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,356.51,393884.1,
BX/EXC IDRL SPINE LESN SCRL,63283,CDM,983,RC,63283,HCPCS,Outpatient,,,8896,5782.40,,7828.48,88,,,percent of total billed charges,88% of total Billed charges,346.24,100,,,Fee Schedule,100% of Medicare rate,1074.61,100,,,Fee Schedule,100% of WA Medicaid,8896,100,,,percent of total billed charges,100% of total billed charges,1106.85,103,,,Fee Schedule,103% of WA Medicaid,346.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,605.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1074.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6138.24,69,,,percent of total billed charges,69% of total billed charges,8896,100,,,percent of total billed charges,100% of total billed charges,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,8896,100,,,percent of total billed charges,100% of total billed charges,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,8896,100,,,percent of total billed charges,100% of total billed charges,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,5502.18,61.85,,,percent of total billed charges,61.85% of total billed charges,1074.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1096.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1396.99,130,,,Fee Schedule,130% of WA Medicaid ,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,3353.79,37.7,,,percent of total billed charges,37.70% of total billed charges,3353.79,37.7,,,percent of total billed charges,37.70% of total billed charges,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,301574.4,33.9,,,percent of total billed charges,33.9% of total billed charges,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,6938.88,78,,,percent of total billed charges,78% of total billed charges,8896,100,,,percent of total billed charges,100% of total billed charges,7348.1,82.6,,,percent of total billed charges,82.6% of total billed charges,7348.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1074.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,346.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,346.24,301574.4,
BX/EXC XDRL/IDRL LSN ANY LVL,63290,CDM,983,RC,63290,HCPCS,Outpatient,,,10076,6549.40,,8866.88,88,,,percent of total billed charges,88% of total Billed charges,523.52,100,,,Fee Schedule,100% of Medicare rate,1561.56,100,,,Fee Schedule,100% of WA Medicaid,10076,100,,,percent of total billed charges,100% of total billed charges,1608.41,103,,,Fee Schedule,103% of WA Medicaid,523.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,916.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1561.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6952.44,69,,,percent of total billed charges,69% of total billed charges,10076,100,,,percent of total billed charges,100% of total billed charges,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,10076,100,,,percent of total billed charges,100% of total billed charges,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,10076,100,,,percent of total billed charges,100% of total billed charges,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,6232.01,61.85,,,percent of total billed charges,61.85% of total billed charges,1561.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1561.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1592.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2030.03,130,,,Fee Schedule,130% of WA Medicaid ,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,3798.65,37.7,,,percent of total billed charges,37.70% of total billed charges,3798.65,37.7,,,percent of total billed charges,37.70% of total billed charges,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,341576.4,33.9,,,percent of total billed charges,33.9% of total billed charges,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,7859.28,78,,,percent of total billed charges,78% of total billed charges,10076,100,,,percent of total billed charges,100% of total billed charges,8322.78,82.6,,,percent of total billed charges,82.6% of total billed charges,8322.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1561.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,523.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1561.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,523.52,341576.4,
REMOVE VERTEBRAL BODY ADD-ON,63308,CDM,983,RC,63308,HCPCS,Outpatient,,,2297,1493.05,,2021.36,88,,,percent of total billed charges,88% of total Billed charges,57.35,100,,,Fee Schedule,100% of Medicare rate,176.8,100,,,Fee Schedule,100% of WA Medicaid,2297,100,,,percent of total billed charges,100% of total billed charges,182.1,103,,,Fee Schedule,103% of WA Medicaid,57.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,176.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1584.93,69,,,percent of total billed charges,69% of total billed charges,2297,100,,,percent of total billed charges,100% of total billed charges,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2297,100,,,percent of total billed charges,100% of total billed charges,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2297,100,,,percent of total billed charges,100% of total billed charges,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1420.69,61.85,,,percent of total billed charges,61.85% of total billed charges,176.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,229.84,130,,,Fee Schedule,130% of WA Medicaid ,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,865.97,37.7,,,percent of total billed charges,37.70% of total billed charges,865.97,37.7,,,percent of total billed charges,37.70% of total billed charges,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,77868.3,33.9,,,percent of total billed charges,33.9% of total billed charges,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1791.66,78,,,percent of total billed charges,78% of total billed charges,2297,100,,,percent of total billed charges,100% of total billed charges,1897.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1897.32,82.6,,,percent of total billed charges,82.6% of total billed charges,176.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.35,77868.3,
REMOVE VERT XDRL BODY CRVCL,63300,CDM,983,RC,63300,HCPCS,Outpatient,,,7300,4745.00,,6424,88,,,percent of total billed charges,88% of total Billed charges,290.81,100,,,Fee Schedule,100% of Medicare rate,1022.39,100,,,Fee Schedule,100% of WA Medicaid,7300,100,,,percent of total billed charges,100% of total billed charges,1053.06,103,,,Fee Schedule,103% of WA Medicaid,290.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,508.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1022.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5037,69,,,percent of total billed charges,69% of total billed charges,7300,100,,,percent of total billed charges,100% of total billed charges,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,7300,100,,,percent of total billed charges,100% of total billed charges,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,7300,100,,,percent of total billed charges,100% of total billed charges,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,4515.05,61.85,,,percent of total billed charges,61.85% of total billed charges,1022.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1022.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1042.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1329.11,130,,,Fee Schedule,130% of WA Medicaid ,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2752.1,37.7,,,percent of total billed charges,37.70% of total billed charges,2752.1,37.7,,,percent of total billed charges,37.70% of total billed charges,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,247470,33.9,,,percent of total billed charges,33.9% of total billed charges,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,5694,78,,,percent of total billed charges,78% of total billed charges,7300,100,,,percent of total billed charges,100% of total billed charges,6029.8,82.6,,,percent of total billed charges,82.6% of total billed charges,6029.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1022.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,290.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1022.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,290.81,247470,
REMOVE VERT IDRL BODY CRVCL,63304,CDM,983,RC,63304,HCPCS,Outpatient,,,7683,4993.95,,6761.04,88,,,percent of total billed charges,88% of total Billed charges,435.23,100,,,Fee Schedule,100% of Medicare rate,1319.86,100,,,Fee Schedule,100% of WA Medicaid,7683,100,,,percent of total billed charges,100% of total billed charges,1359.46,103,,,Fee Schedule,103% of WA Medicaid,435.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,761.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1319.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5301.27,69,,,percent of total billed charges,69% of total billed charges,7683,100,,,percent of total billed charges,100% of total billed charges,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,7683,100,,,percent of total billed charges,100% of total billed charges,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,7683,100,,,percent of total billed charges,100% of total billed charges,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,4751.94,61.85,,,percent of total billed charges,61.85% of total billed charges,1319.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1346.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1715.82,130,,,Fee Schedule,130% of WA Medicaid ,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,2896.49,37.7,,,percent of total billed charges,37.70% of total billed charges,2896.49,37.7,,,percent of total billed charges,37.70% of total billed charges,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,260453.7,33.9,,,percent of total billed charges,33.9% of total billed charges,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,5992.74,78,,,percent of total billed charges,78% of total billed charges,7683,100,,,percent of total billed charges,100% of total billed charges,6346.16,82.6,,,percent of total billed charges,82.6% of total billed charges,6346.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1319.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,439.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,435.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1319.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,435.23,260453.7,
REMOVE VERT XDRL BODY THRC,63301,CDM,983,RC,63301,HCPCS,Outpatient,,,7206,4683.90,,6341.28,88,,,percent of total billed charges,88% of total Billed charges,406.95,100,,,Fee Schedule,100% of Medicare rate,1241.34,100,,,Fee Schedule,100% of WA Medicaid,7206,100,,,percent of total billed charges,100% of total billed charges,1278.58,103,,,Fee Schedule,103% of WA Medicaid,406.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,712.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1241.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4972.14,69,,,percent of total billed charges,69% of total billed charges,7206,100,,,percent of total billed charges,100% of total billed charges,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,7206,100,,,percent of total billed charges,100% of total billed charges,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,7206,100,,,percent of total billed charges,100% of total billed charges,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,4456.91,61.85,,,percent of total billed charges,61.85% of total billed charges,1241.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1241.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1266.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1613.74,130,,,Fee Schedule,130% of WA Medicaid ,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,2716.66,37.7,,,percent of total billed charges,37.70% of total billed charges,2716.66,37.7,,,percent of total billed charges,37.70% of total billed charges,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,244283.4,33.9,,,percent of total billed charges,33.9% of total billed charges,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,5620.68,78,,,percent of total billed charges,78% of total billed charges,7206,100,,,percent of total billed charges,100% of total billed charges,5952.16,82.6,,,percent of total billed charges,82.6% of total billed charges,5952.16,82.6,,,percent of total billed charges,82.6% of total billed charges,1241.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,406.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,1241.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,406.95,244283.4,
IMPLANT NEUROELECTRODES,63655,CDM,983,RC,63655,HCPCS,Outpatient,,,4538,2949.70,,3993.44,88,,,percent of total billed charges,88% of total Billed charges,124.4,100,,,Fee Schedule,100% of Medicare rate,480.61,100,,,Fee Schedule,100% of WA Medicaid,4538,100,,,percent of total billed charges,100% of total billed charges,495.03,103,,,Fee Schedule,103% of WA Medicaid,124.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,217.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,480.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3131.22,69,,,percent of total billed charges,69% of total billed charges,4538,100,,,percent of total billed charges,100% of total billed charges,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,4538,100,,,percent of total billed charges,100% of total billed charges,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,4538,100,,,percent of total billed charges,100% of total billed charges,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,2806.75,61.85,,,percent of total billed charges,61.85% of total billed charges,480.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,624.79,130,,,Fee Schedule,130% of WA Medicaid ,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,1710.83,37.7,,,percent of total billed charges,37.70% of total billed charges,1710.83,37.7,,,percent of total billed charges,37.70% of total billed charges,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,153838.2,33.9,,,percent of total billed charges,33.9% of total billed charges,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,3539.64,78,,,percent of total billed charges,78% of total billed charges,4538,100,,,percent of total billed charges,100% of total billed charges,3748.39,82.6,,,percent of total billed charges,82.6% of total billed charges,3748.39,82.6,,,percent of total billed charges,82.6% of total billed charges,480.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,124.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,124.4,153838.2,
IMPLANT NEUROELECTRODES,63650,CDM,983,RC,63650,HCPCS,Outpatient,,,3047,1980.55,,2681.36,88,,,percent of total billed charges,88% of total Billed charges,33.75,100,,,Fee Schedule,100% of Medicare rate,236.48,100,,,Fee Schedule,100% of WA Medicaid,3047,100,,,percent of total billed charges,100% of total billed charges,243.57,103,,,Fee Schedule,103% of WA Medicaid,33.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,59.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,236.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2102.43,69,,,percent of total billed charges,69% of total billed charges,3047,100,,,percent of total billed charges,100% of total billed charges,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3047,100,,,percent of total billed charges,100% of total billed charges,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,3047,100,,,percent of total billed charges,100% of total billed charges,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1884.57,61.85,,,percent of total billed charges,61.85% of total billed charges,236.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,307.42,130,,,Fee Schedule,130% of WA Medicaid ,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,1148.72,37.7,,,percent of total billed charges,37.70% of total billed charges,1148.72,37.7,,,percent of total billed charges,37.70% of total billed charges,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,103293.3,33.9,,,percent of total billed charges,33.9% of total billed charges,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,2376.66,78,,,percent of total billed charges,78% of total billed charges,3047,100,,,percent of total billed charges,100% of total billed charges,2516.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2516.82,82.6,,,percent of total billed charges,82.6% of total billed charges,236.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.75,103293.3,
REMOVREVISIN SPIN NEUROSTIM,63660,CDM,983,RC,63660,HCPCS,Outpatient,,,2594,1686.10,,2282.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2594,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1789.86,69,,,percent of total billed charges,69% of total billed charges,2594,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2594,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2594,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1604.39,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,977.94,37.7,,,percent of total billed charges,37.70% of total billed charges,977.94,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,87936.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2023.32,78,,,percent of total billed charges,78% of total billed charges,2594,100,,,percent of total billed charges,100% of total billed charges,2142.64,82.6,,,percent of total billed charges,82.6% of total billed charges,2142.64,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",977.94,87936.6,
INSRT/REDO SPINE N GENERATOR,63685,CDM,983,RC,63685,HCPCS,Outpatient,,,2724,1770.60,,2397.12,88,,,percent of total billed charges,88% of total Billed charges,39.04,100,,,Fee Schedule,100% of Medicare rate,194.33,100,,,Fee Schedule,100% of WA Medicaid,2724,100,,,percent of total billed charges,100% of total billed charges,200.16,103,,,Fee Schedule,103% of WA Medicaid,39.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,194.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1879.56,69,,,percent of total billed charges,69% of total billed charges,2724,100,,,percent of total billed charges,100% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2724,100,,,percent of total billed charges,100% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2724,100,,,percent of total billed charges,100% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1684.79,61.85,,,percent of total billed charges,61.85% of total billed charges,194.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,252.63,130,,,Fee Schedule,130% of WA Medicaid ,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1026.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1026.95,37.7,,,percent of total billed charges,37.70% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,92343.6,33.9,,,percent of total billed charges,33.9% of total billed charges,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2124.72,78,,,percent of total billed charges,78% of total billed charges,2724,100,,,percent of total billed charges,100% of total billed charges,2250.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2250.02,82.6,,,percent of total billed charges,82.6% of total billed charges,194.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.04,92343.6,
REVISE/REMOVE NEURORECEIVER,63688,CDM,983,RC,63688,HCPCS,Outpatient,,,2348,1526.20,,2066.24,88,,,percent of total billed charges,88% of total Billed charges,35.26,100,,,Fee Schedule,100% of Medicare rate,171.95,100,,,Fee Schedule,100% of WA Medicaid,2348,100,,,percent of total billed charges,100% of total billed charges,177.11,103,,,Fee Schedule,103% of WA Medicaid,35.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,61.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,171.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1620.12,69,,,percent of total billed charges,69% of total billed charges,2348,100,,,percent of total billed charges,100% of total billed charges,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2348,100,,,percent of total billed charges,100% of total billed charges,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2348,100,,,percent of total billed charges,100% of total billed charges,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1452.24,61.85,,,percent of total billed charges,61.85% of total billed charges,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,223.54,130,,,Fee Schedule,130% of WA Medicaid ,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,885.2,37.7,,,percent of total billed charges,37.70% of total billed charges,885.2,37.7,,,percent of total billed charges,37.70% of total billed charges,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,79597.2,33.9,,,percent of total billed charges,33.9% of total billed charges,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1831.44,78,,,percent of total billed charges,78% of total billed charges,2348,100,,,percent of total billed charges,100% of total billed charges,1939.45,82.6,,,percent of total billed charges,82.6% of total billed charges,1939.45,82.6,,,percent of total billed charges,82.6% of total billed charges,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.26,79597.2,
REPAIR SPINAL FLUID LEAKAGE,63709,CDM,983,RC,63709,HCPCS,Outpatient,,,7435,4832.75,,6542.8,88,,,percent of total billed charges,88% of total Billed charges,166.01,100,,,Fee Schedule,100% of Medicare rate,634.66,100,,,Fee Schedule,100% of WA Medicaid,7435,100,,,percent of total billed charges,100% of total billed charges,653.7,103,,,Fee Schedule,103% of WA Medicaid,166.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,290.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,634.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5130.15,69,,,percent of total billed charges,69% of total billed charges,7435,100,,,percent of total billed charges,100% of total billed charges,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,7435,100,,,percent of total billed charges,100% of total billed charges,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,7435,100,,,percent of total billed charges,100% of total billed charges,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,4598.55,61.85,,,percent of total billed charges,61.85% of total billed charges,634.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,647.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,825.06,130,,,Fee Schedule,130% of WA Medicaid ,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2803,37.7,,,percent of total billed charges,37.70% of total billed charges,2803,37.7,,,percent of total billed charges,37.70% of total billed charges,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,252046.5,33.9,,,percent of total billed charges,33.9% of total billed charges,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,5799.3,78,,,percent of total billed charges,78% of total billed charges,7435,100,,,percent of total billed charges,100% of total billed charges,6141.31,82.6,,,percent of total billed charges,82.6% of total billed charges,6141.31,82.6,,,percent of total billed charges,82.6% of total billed charges,634.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,166.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,634.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,166.01,252046.5,
REPAIR SPINAL FLUID LEAKAGE,63707,CDM,983,RC,63707,HCPCS,Outpatient,,,5335,3467.75,,4694.8,88,,,percent of total billed charges,88% of total Billed charges,139.78,100,,,Fee Schedule,100% of Medicare rate,536,100,,,Fee Schedule,100% of WA Medicaid,5335,100,,,percent of total billed charges,100% of total billed charges,552.08,103,,,Fee Schedule,103% of WA Medicaid,139.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,244.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,536,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3681.15,69,,,percent of total billed charges,69% of total billed charges,5335,100,,,percent of total billed charges,100% of total billed charges,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,5335,100,,,percent of total billed charges,100% of total billed charges,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,5335,100,,,percent of total billed charges,100% of total billed charges,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,3299.7,61.85,,,percent of total billed charges,61.85% of total billed charges,536,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,536,100,,,Fee Schedule,100% of WA Medicare OPPS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,696.8,130,,,Fee Schedule,130% of WA Medicaid ,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,2011.3,37.7,,,percent of total billed charges,37.70% of total billed charges,2011.3,37.7,,,percent of total billed charges,37.70% of total billed charges,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,180856.5,33.9,,,percent of total billed charges,33.9% of total billed charges,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,4161.3,78,,,percent of total billed charges,78% of total billed charges,5335,100,,,percent of total billed charges,100% of total billed charges,4406.71,82.6,,,percent of total billed charges,82.6% of total billed charges,4406.71,82.6,,,percent of total billed charges,82.6% of total billed charges,536,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,139.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,536,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,139.78,180856.5,
REPAIR OF SPINAL HERNIATION,63702,CDM,983,RC,63702,HCPCS,Outpatient,,,7245,4709.25,,6375.6,88,,,percent of total billed charges,88% of total Billed charges,252.31,100,,,Fee Schedule,100% of Medicare rate,814.63,100,,,Fee Schedule,100% of WA Medicaid,7245,100,,,percent of total billed charges,100% of total billed charges,839.07,103,,,Fee Schedule,103% of WA Medicaid,252.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,441.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,814.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4999.05,69,,,percent of total billed charges,69% of total billed charges,7245,100,,,percent of total billed charges,100% of total billed charges,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7245,100,,,percent of total billed charges,100% of total billed charges,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,7245,100,,,percent of total billed charges,100% of total billed charges,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,4481.03,61.85,,,percent of total billed charges,61.85% of total billed charges,814.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,814.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,830.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1059.02,130,,,Fee Schedule,130% of WA Medicaid ,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2731.37,37.7,,,percent of total billed charges,37.70% of total billed charges,2731.37,37.7,,,percent of total billed charges,37.70% of total billed charges,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,245605.5,33.9,,,percent of total billed charges,33.9% of total billed charges,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,5651.1,78,,,percent of total billed charges,78% of total billed charges,7245,100,,,percent of total billed charges,100% of total billed charges,5984.37,82.6,,,percent of total billed charges,82.6% of total billed charges,5984.37,82.6,,,percent of total billed charges,82.6% of total billed charges,814.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,252.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,814.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,252.31,245605.5,
REPAIR OF SPINAL HERNIATION,63700,CDM,983,RC,63700,HCPCS,Outpatient,,,6429,4178.85,,5657.52,88,,,percent of total billed charges,88% of total Billed charges,228.26,100,,,Fee Schedule,100% of Medicare rate,747.49,100,,,Fee Schedule,100% of WA Medicaid,6429,100,,,percent of total billed charges,100% of total billed charges,769.91,103,,,Fee Schedule,103% of WA Medicaid,228.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,399.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,747.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4436.01,69,,,percent of total billed charges,69% of total billed charges,6429,100,,,percent of total billed charges,100% of total billed charges,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,6429,100,,,percent of total billed charges,100% of total billed charges,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,6429,100,,,percent of total billed charges,100% of total billed charges,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,3976.34,61.85,,,percent of total billed charges,61.85% of total billed charges,747.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,747.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,762.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,971.74,130,,,Fee Schedule,130% of WA Medicaid ,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,2423.73,37.7,,,percent of total billed charges,37.70% of total billed charges,2423.73,37.7,,,percent of total billed charges,37.70% of total billed charges,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,217943.1,33.9,,,percent of total billed charges,33.9% of total billed charges,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,5014.62,78,,,percent of total billed charges,78% of total billed charges,6429,100,,,percent of total billed charges,100% of total billed charges,5310.35,82.6,,,percent of total billed charges,82.6% of total billed charges,5310.35,82.6,,,percent of total billed charges,82.6% of total billed charges,747.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,230.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,228.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,747.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,228.26,217943.1,
GRAFT REPAIR OF SPINE DEFECT,63710,CDM,983,RC,63710,HCPCS,Outpatient,,,6665,4332.25,,5865.2,88,,,percent of total billed charges,88% of total Billed charges,150.86,100,,,Fee Schedule,100% of Medicare rate,618.06,100,,,Fee Schedule,100% of WA Medicaid,6665,100,,,percent of total billed charges,100% of total billed charges,636.6,103,,,Fee Schedule,103% of WA Medicaid,150.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,264.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,618.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,4598.85,69,,,percent of total billed charges,69% of total billed charges,6665,100,,,percent of total billed charges,100% of total billed charges,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,6665,100,,,percent of total billed charges,100% of total billed charges,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,6665,100,,,percent of total billed charges,100% of total billed charges,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,4122.3,61.85,,,percent of total billed charges,61.85% of total billed charges,618.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,630.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,803.48,130,,,Fee Schedule,130% of WA Medicaid ,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,2512.71,37.7,,,percent of total billed charges,37.70% of total billed charges,2512.71,37.7,,,percent of total billed charges,37.70% of total billed charges,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,225943.5,33.9,,,percent of total billed charges,33.9% of total billed charges,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,5198.7,78,,,percent of total billed charges,78% of total billed charges,6665,100,,,percent of total billed charges,100% of total billed charges,5505.29,82.6,,,percent of total billed charges,82.6% of total billed charges,5505.29,82.6,,,percent of total billed charges,82.6% of total billed charges,618.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,150.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,150.86,225943.5,
INSTALL SPINAL SHUNT,63740,CDM,983,RC,63740,HCPCS,Outpatient,,,5710,3711.50,,5024.8,88,,,percent of total billed charges,88% of total Billed charges,165.67,100,,,Fee Schedule,100% of Medicare rate,564.35,100,,,Fee Schedule,100% of WA Medicaid,5710,100,,,percent of total billed charges,100% of total billed charges,581.28,103,,,Fee Schedule,103% of WA Medicaid,165.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,289.92,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,564.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3939.9,69,,,percent of total billed charges,69% of total billed charges,5710,100,,,percent of total billed charges,100% of total billed charges,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,5710,100,,,percent of total billed charges,100% of total billed charges,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,5710,100,,,percent of total billed charges,100% of total billed charges,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,3531.64,61.85,,,percent of total billed charges,61.85% of total billed charges,564.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,733.66,130,,,Fee Schedule,130% of WA Medicaid ,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2152.67,37.7,,,percent of total billed charges,37.70% of total billed charges,2152.67,37.7,,,percent of total billed charges,37.70% of total billed charges,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,193569,33.9,,,percent of total billed charges,33.9% of total billed charges,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,4453.8,78,,,percent of total billed charges,78% of total billed charges,5710,100,,,percent of total billed charges,100% of total billed charges,4716.46,82.6,,,percent of total billed charges,82.6% of total billed charges,4716.46,82.6,,,percent of total billed charges,82.6% of total billed charges,564.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,165.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,165.67,193569,
INSTALL SPINAL SHUNT,63741,CDM,983,RC,63741,HCPCS,Outpatient,,,2746,1784.90,,2416.48,88,,,percent of total billed charges,88% of total Billed charges,106.45,100,,,Fee Schedule,100% of Medicare rate,390.72,100,,,Fee Schedule,100% of WA Medicaid,2746,100,,,percent of total billed charges,100% of total billed charges,402.44,103,,,Fee Schedule,103% of WA Medicaid,106.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,186.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,390.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1894.74,69,,,percent of total billed charges,69% of total billed charges,2746,100,,,percent of total billed charges,100% of total billed charges,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2746,100,,,percent of total billed charges,100% of total billed charges,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2746,100,,,percent of total billed charges,100% of total billed charges,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1698.4,61.85,,,percent of total billed charges,61.85% of total billed charges,390.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,507.94,130,,,Fee Schedule,130% of WA Medicaid ,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1035.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1035.24,37.7,,,percent of total billed charges,37.70% of total billed charges,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,93089.4,33.9,,,percent of total billed charges,33.9% of total billed charges,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,2141.88,78,,,percent of total billed charges,78% of total billed charges,2746,100,,,percent of total billed charges,100% of total billed charges,2268.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2268.2,82.6,,,percent of total billed charges,82.6% of total billed charges,390.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,106.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,106.45,93089.4,
REMOVAL OF SPINAL SHUNT,63746,CDM,983,RC,63746,HCPCS,Outpatient,,,2397,1558.05,,2109.36,88,,,percent of total billed charges,88% of total Billed charges,97.42,100,,,Fee Schedule,100% of Medicare rate,352.67,100,,,Fee Schedule,100% of WA Medicaid,2397,100,,,percent of total billed charges,100% of total billed charges,363.25,103,,,Fee Schedule,103% of WA Medicaid,97.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,170.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,352.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1653.93,69,,,percent of total billed charges,69% of total billed charges,2397,100,,,percent of total billed charges,100% of total billed charges,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2397,100,,,percent of total billed charges,100% of total billed charges,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,2397,100,,,percent of total billed charges,100% of total billed charges,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1482.54,61.85,,,percent of total billed charges,61.85% of total billed charges,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,359.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,458.47,130,,,Fee Schedule,130% of WA Medicaid ,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,903.67,37.7,,,percent of total billed charges,37.70% of total billed charges,903.67,37.7,,,percent of total billed charges,37.70% of total billed charges,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,81258.3,33.9,,,percent of total billed charges,33.9% of total billed charges,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,1869.66,78,,,percent of total billed charges,78% of total billed charges,2397,100,,,percent of total billed charges,100% of total billed charges,1979.92,82.6,,,percent of total billed charges,82.6% of total billed charges,1979.92,82.6,,,percent of total billed charges,82.6% of total billed charges,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,97.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,352.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,97.42,81258.3,
REVISION OF SPINAL SHUNT,63744,CDM,983,RC,63744,HCPCS,Outpatient,,,3403,2211.95,,2994.64,88,,,percent of total billed charges,88% of total Billed charges,109.63,100,,,Fee Schedule,100% of Medicare rate,392.02,100,,,Fee Schedule,100% of WA Medicaid,3403,100,,,percent of total billed charges,100% of total billed charges,403.78,103,,,Fee Schedule,103% of WA Medicaid,109.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,191.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,392.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2348.07,69,,,percent of total billed charges,69% of total billed charges,3403,100,,,percent of total billed charges,100% of total billed charges,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,3403,100,,,percent of total billed charges,100% of total billed charges,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,3403,100,,,percent of total billed charges,100% of total billed charges,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2104.76,61.85,,,percent of total billed charges,61.85% of total billed charges,392.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,399.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,509.63,130,,,Fee Schedule,130% of WA Medicaid ,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1282.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1282.93,37.7,,,percent of total billed charges,37.70% of total billed charges,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,115361.7,33.9,,,percent of total billed charges,33.9% of total billed charges,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,2654.34,78,,,percent of total billed charges,78% of total billed charges,3403,100,,,percent of total billed charges,100% of total billed charges,2810.88,82.6,,,percent of total billed charges,82.6% of total billed charges,2810.88,82.6,,,percent of total billed charges,82.6% of total billed charges,392.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,109.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,392.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,109.63,115361.7,
N BLOCK INJ TRIGEMINAL,64400,CDM,983,RC,64400,HCPCS,Outpatient,,,280,182.00,,246.4,88,,,percent of total billed charges,88% of total Billed charges,6.98,100,,,Fee Schedule,100% of Medicare rate,29.09,100,,,Fee Schedule,100% of WA Medicaid,280,100,,,percent of total billed charges,100% of total billed charges,29.96,103,,,Fee Schedule,103% of WA Medicaid,6.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,193.2,69,,,percent of total billed charges,69% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,280,100,,,percent of total billed charges,100% of total billed charges,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,280,100,,,percent of total billed charges,100% of total billed charges,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.18,61.85,,,percent of total billed charges,61.85% of total billed charges,29.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.82,130,,,Fee Schedule,130% of WA Medicaid ,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.56,37.7,,,percent of total billed charges,37.70% of total billed charges,105.56,37.7,,,percent of total billed charges,37.70% of total billed charges,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,9492,33.9,,,percent of total billed charges,33.9% of total billed charges,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.4,78,,,percent of total billed charges,78% of total billed charges,280,100,,,percent of total billed charges,100% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,231.28,82.6,,,percent of total billed charges,82.6% of total billed charges,29.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.98,9492,
N BLOCK INJ OCCIPITAL,64405,CDM,983,RC,64405,HCPCS,Outpatient,,,169.3,110.05,,148.98,88,,,percent of total billed charges,88% of total Billed charges,7.26,100,,,Fee Schedule,100% of Medicare rate,29.47,100,,,Fee Schedule,100% of WA Medicaid,169.3,100,,,percent of total billed charges,100% of total billed charges,30.35,103,,,Fee Schedule,103% of WA Medicaid,7.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,116.82,69,,,percent of total billed charges,69% of total billed charges,169.3,100,,,percent of total billed charges,100% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.3,100,,,percent of total billed charges,100% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.3,100,,,percent of total billed charges,100% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.71,61.85,,,percent of total billed charges,61.85% of total billed charges,29.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,38.31,130,,,Fee Schedule,130% of WA Medicaid ,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.83,37.7,,,percent of total billed charges,37.70% of total billed charges,63.83,37.7,,,percent of total billed charges,37.70% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,5739.27,33.9,,,percent of total billed charges,33.9% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.05,78,,,percent of total billed charges,78% of total billed charges,169.3,100,,,percent of total billed charges,100% of total billed charges,139.84,82.6,,,percent of total billed charges,82.6% of total billed charges,139.84,82.6,,,percent of total billed charges,82.6% of total billed charges,29.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.26,5739.27,
"Unlisted procedure, nervous system",64999,CDM,983,RC,64999,HCPCS,Outpatient,,,234,152.10,,205.92,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,161.46,69,,,percent of total billed charges,69% of total billed charges,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,234,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,144.73,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88.22,37.7,,,percent of total billed charges,37.70% of total billed charges,88.22,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,7932.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,182.52,78,,,percent of total billed charges,78% of total billed charges,234,100,,,percent of total billed charges,100% of total billed charges,193.28,82.6,,,percent of total billed charges,82.6% of total billed charges,193.28,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",88.22,7932.6,
N BLOCK CONT INFUSE B PLEX,64416,CDM,983,RC,64416,HCPCS,Outpatient,,,733,476.45,,645.04,88,,,percent of total billed charges,88% of total Billed charges,6.17,100,,,Fee Schedule,100% of Medicare rate,42.9,100,,,Fee Schedule,100% of WA Medicaid,733,100,,,percent of total billed charges,100% of total billed charges,44.19,103,,,Fee Schedule,103% of WA Medicaid,6.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,505.77,69,,,percent of total billed charges,69% of total billed charges,733,100,,,percent of total billed charges,100% of total billed charges,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,733,100,,,percent of total billed charges,100% of total billed charges,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,733,100,,,percent of total billed charges,100% of total billed charges,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,453.36,61.85,,,percent of total billed charges,61.85% of total billed charges,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.77,130,,,Fee Schedule,130% of WA Medicaid ,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.34,37.7,,,percent of total billed charges,37.70% of total billed charges,276.34,37.7,,,percent of total billed charges,37.70% of total billed charges,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,24848.7,33.9,,,percent of total billed charges,33.9% of total billed charges,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.74,78,,,percent of total billed charges,78% of total billed charges,733,100,,,percent of total billed charges,100% of total billed charges,605.46,82.6,,,percent of total billed charges,82.6% of total billed charges,605.46,82.6,,,percent of total billed charges,82.6% of total billed charges,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.17,24848.7,
N BLOCK INJ BRACHIAL PLEXUS,64415,CDM,983,RC,64415,HCPCS,Outpatient,,,643,417.95,,565.84,88,,,percent of total billed charges,88% of total Billed charges,5.43,100,,,Fee Schedule,100% of Medicare rate,38.98,100,,,Fee Schedule,100% of WA Medicaid,643,100,,,percent of total billed charges,100% of total billed charges,40.15,103,,,Fee Schedule,103% of WA Medicaid,5.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,443.67,69,,,percent of total billed charges,69% of total billed charges,643,100,,,percent of total billed charges,100% of total billed charges,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,643,100,,,percent of total billed charges,100% of total billed charges,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,643,100,,,percent of total billed charges,100% of total billed charges,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.7,61.85,,,percent of total billed charges,61.85% of total billed charges,38.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.67,130,,,Fee Schedule,130% of WA Medicaid ,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.41,37.7,,,percent of total billed charges,37.70% of total billed charges,242.41,37.7,,,percent of total billed charges,37.70% of total billed charges,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,21797.7,33.9,,,percent of total billed charges,33.9% of total billed charges,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,501.54,78,,,percent of total billed charges,78% of total billed charges,643,100,,,percent of total billed charges,100% of total billed charges,531.12,82.6,,,percent of total billed charges,82.6% of total billed charges,531.12,82.6,,,percent of total billed charges,82.6% of total billed charges,38.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.43,21797.7,
N BLOCK INJ SUPRASCAPULAR,64418,CDM,983,RC,64418,HCPCS,Outpatient,,,336,218.40,,295.68,88,,,percent of total billed charges,88% of total Billed charges,4.76,100,,,Fee Schedule,100% of Medicare rate,31.15,100,,,Fee Schedule,100% of WA Medicaid,336,100,,,percent of total billed charges,100% of total billed charges,32.08,103,,,Fee Schedule,103% of WA Medicaid,4.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,31.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,231.84,69,,,percent of total billed charges,69% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,336,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.82,61.85,,,percent of total billed charges,61.85% of total billed charges,31.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.5,130,,,Fee Schedule,130% of WA Medicaid ,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,126.67,37.7,,,percent of total billed charges,37.70% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,11390.4,33.9,,,percent of total billed charges,33.9% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.08,78,,,percent of total billed charges,78% of total billed charges,336,100,,,percent of total billed charges,100% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,277.54,82.6,,,percent of total billed charges,82.6% of total billed charges,31.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.76,11390.4,
"Unlisted procedure, nervous system",64999,CDM,983,RC,64999,HCPCS,Outpatient,,,399,259.35,,351.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,399,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,275.31,69,,,percent of total billed charges,69% of total billed charges,399,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,399,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,399,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,246.78,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150.42,37.7,,,percent of total billed charges,37.70% of total billed charges,150.42,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,13526.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,311.22,78,,,percent of total billed charges,78% of total billed charges,399,100,,,percent of total billed charges,100% of total billed charges,329.57,82.6,,,percent of total billed charges,82.6% of total billed charges,329.57,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",150.42,13526.1,
N BLOCK INJ AXILLARY,64417,CDM,983,RC,64417,HCPCS,Outpatient,,,656,426.40,,577.28,88,,,percent of total billed charges,88% of total Billed charges,5.27,100,,,Fee Schedule,100% of Medicare rate,35.81,100,,,Fee Schedule,100% of WA Medicaid,656,100,,,percent of total billed charges,100% of total billed charges,36.88,103,,,Fee Schedule,103% of WA Medicaid,5.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,452.64,69,,,percent of total billed charges,69% of total billed charges,656,100,,,percent of total billed charges,100% of total billed charges,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,656,100,,,percent of total billed charges,100% of total billed charges,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,656,100,,,percent of total billed charges,100% of total billed charges,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.74,61.85,,,percent of total billed charges,61.85% of total billed charges,35.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.55,130,,,Fee Schedule,130% of WA Medicaid ,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,247.31,37.7,,,percent of total billed charges,37.70% of total billed charges,247.31,37.7,,,percent of total billed charges,37.70% of total billed charges,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,22238.4,33.9,,,percent of total billed charges,33.9% of total billed charges,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,511.68,78,,,percent of total billed charges,78% of total billed charges,656,100,,,percent of total billed charges,100% of total billed charges,541.86,82.6,,,percent of total billed charges,82.6% of total billed charges,541.86,82.6,,,percent of total billed charges,82.6% of total billed charges,35.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.27,22238.4,
N BLOCK INJ INTERCOST SNG,64420,CDM,983,RC,64420,HCPCS,Outpatient,,,367,238.55,,322.96,88,,,percent of total billed charges,88% of total Billed charges,4.33,100,,,Fee Schedule,100% of Medicare rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,367,100,,,percent of total billed charges,100% of total billed charges,34,103,,,Fee Schedule,103% of WA Medicaid,4.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,253.23,69,,,percent of total billed charges,69% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,367,100,,,percent of total billed charges,100% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,367,100,,,percent of total billed charges,100% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.99,61.85,,,percent of total billed charges,61.85% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.91,130,,,Fee Schedule,130% of WA Medicaid ,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,12441.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.26,78,,,percent of total billed charges,78% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.33,12441.3,
N BLOCK INJ ILIO-ING/HYPOGI,64425,CDM,983,RC,64425,HCPCS,Outpatient,,,430,279.50,,378.4,88,,,percent of total billed charges,88% of total Billed charges,4.22,100,,,Fee Schedule,100% of Medicare rate,30.77,100,,,Fee Schedule,100% of WA Medicaid,430,100,,,percent of total billed charges,100% of total billed charges,31.69,103,,,Fee Schedule,103% of WA Medicaid,4.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,296.7,69,,,percent of total billed charges,69% of total billed charges,430,100,,,percent of total billed charges,100% of total billed charges,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,430,100,,,percent of total billed charges,100% of total billed charges,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,430,100,,,percent of total billed charges,100% of total billed charges,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.96,61.85,,,percent of total billed charges,61.85% of total billed charges,30.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40,130,,,Fee Schedule,130% of WA Medicaid ,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.11,37.7,,,percent of total billed charges,37.70% of total billed charges,162.11,37.7,,,percent of total billed charges,37.70% of total billed charges,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,14577,33.9,,,percent of total billed charges,33.9% of total billed charges,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.4,78,,,percent of total billed charges,78% of total billed charges,430,100,,,percent of total billed charges,100% of total billed charges,355.18,82.6,,,percent of total billed charges,82.6% of total billed charges,355.18,82.6,,,percent of total billed charges,82.6% of total billed charges,30.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.22,14577,
N BLOCK INJ INTERCOST MLT,64421,CDM,983,RC,64421,HCPCS,Outpatient,,,555,360.75,,488.4,88,,,percent of total billed charges,88% of total Billed charges,2.04,100,,,Fee Schedule,100% of Medicare rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,555,100,,,percent of total billed charges,100% of total billed charges,14.41,103,,,Fee Schedule,103% of WA Medicaid,2.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,382.95,69,,,percent of total billed charges,69% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,555,100,,,percent of total billed charges,100% of total billed charges,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,555,100,,,percent of total billed charges,100% of total billed charges,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.27,61.85,,,percent of total billed charges,61.85% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.19,130,,,Fee Schedule,130% of WA Medicaid ,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,18814.5,33.9,,,percent of total billed charges,33.9% of total billed charges,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,432.9,78,,,percent of total billed charges,78% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.04,18814.5,
BLOCK INJ PARACERVICAL,64435,CDM,983,RC,64435,HCPCS,Outpatient,,,125,81.25,,110,88,,,percent of total billed charges,88% of total Billed charges,4.68,100,,,Fee Schedule,100% of Medicare rate,24.8,100,,,Fee Schedule,100% of WA Medicaid,125,100,,,percent of total billed charges,100% of total billed charges,25.54,103,,,Fee Schedule,103% of WA Medicaid,4.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,24.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,86.25,69,,,percent of total billed charges,69% of total billed charges,125,100,,,percent of total billed charges,100% of total billed charges,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,125,100,,,percent of total billed charges,100% of total billed charges,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,125,100,,,percent of total billed charges,100% of total billed charges,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.31,61.85,,,percent of total billed charges,61.85% of total billed charges,24.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.24,130,,,Fee Schedule,130% of WA Medicaid ,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.13,37.7,,,percent of total billed charges,37.70% of total billed charges,47.13,37.7,,,percent of total billed charges,37.70% of total billed charges,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,4237.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.5,78,,,percent of total billed charges,78% of total billed charges,125,100,,,percent of total billed charges,100% of total billed charges,103.25,82.6,,,percent of total billed charges,82.6% of total billed charges,103.25,82.6,,,percent of total billed charges,82.6% of total billed charges,24.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.68,4237.5,
N BLOCK INJ PUDENDAL,64430,CDM,983,RC,64430,HCPCS,Outpatient,,,412,267.80,,362.56,88,,,percent of total billed charges,88% of total Billed charges,4.74,100,,,Fee Schedule,100% of Medicare rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,412,100,,,percent of total billed charges,100% of total billed charges,31.89,103,,,Fee Schedule,103% of WA Medicaid,4.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,284.28,69,,,percent of total billed charges,69% of total billed charges,412,100,,,percent of total billed charges,100% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,412,100,,,percent of total billed charges,100% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,412,100,,,percent of total billed charges,100% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.82,61.85,,,percent of total billed charges,61.85% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.25,130,,,Fee Schedule,130% of WA Medicaid ,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.32,37.7,,,percent of total billed charges,37.70% of total billed charges,155.32,37.7,,,percent of total billed charges,37.70% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,13966.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.36,78,,,percent of total billed charges,78% of total billed charges,412,100,,,percent of total billed charges,100% of total billed charges,340.31,82.6,,,percent of total billed charges,82.6% of total billed charges,340.31,82.6,,,percent of total billed charges,82.6% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.74,13966.8,
N BLOCK INJ FEM SINGLE,64447,CDM,983,RC,64447,HCPCS,Outpatient,,,177,115.05,,155.76,88,,,percent of total billed charges,88% of total Billed charges,4.73,100,,,Fee Schedule,100% of Medicare rate,35.44,100,,,Fee Schedule,100% of WA Medicaid,177,100,,,percent of total billed charges,100% of total billed charges,36.5,103,,,Fee Schedule,103% of WA Medicaid,4.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,122.13,69,,,percent of total billed charges,69% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,177,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,177,100,,,percent of total billed charges,100% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.47,61.85,,,percent of total billed charges,61.85% of total billed charges,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,46.07,130,,,Fee Schedule,130% of WA Medicaid ,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.73,37.7,,,percent of total billed charges,37.70% of total billed charges,66.73,37.7,,,percent of total billed charges,37.70% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,6000.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.06,78,,,percent of total billed charges,78% of total billed charges,177,100,,,percent of total billed charges,100% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,146.2,82.6,,,percent of total billed charges,82.6% of total billed charges,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.73,6000.3,
N BLOCK INJ FEM CONT INF,64448,CDM,983,RC,64448,HCPCS,Outpatient,,,551,358.15,,484.88,88,,,percent of total billed charges,88% of total Billed charges,5.76,100,,,Fee Schedule,100% of Medicare rate,40.1,100,,,Fee Schedule,100% of WA Medicaid,551,100,,,percent of total billed charges,100% of total billed charges,41.3,103,,,Fee Schedule,103% of WA Medicaid,5.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,380.19,69,,,percent of total billed charges,69% of total billed charges,551,100,,,percent of total billed charges,100% of total billed charges,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,551,100,,,percent of total billed charges,100% of total billed charges,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,551,100,,,percent of total billed charges,100% of total billed charges,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.79,61.85,,,percent of total billed charges,61.85% of total billed charges,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,52.13,130,,,Fee Schedule,130% of WA Medicaid ,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.73,37.7,,,percent of total billed charges,37.70% of total billed charges,207.73,37.7,,,percent of total billed charges,37.70% of total billed charges,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,18678.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.78,78,,,percent of total billed charges,78% of total billed charges,551,100,,,percent of total billed charges,100% of total billed charges,455.13,82.6,,,percent of total billed charges,82.6% of total billed charges,455.13,82.6,,,percent of total billed charges,82.6% of total billed charges,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.76,18678.9,
N BLOCK INJ SCIATIC SNG,64445,CDM,983,RC,64445,HCPCS,Outpatient,,,396,257.40,,348.48,88,,,percent of total billed charges,88% of total Billed charges,5.78,100,,,Fee Schedule,100% of Medicare rate,40.66,100,,,Fee Schedule,100% of WA Medicaid,396,100,,,percent of total billed charges,100% of total billed charges,41.88,103,,,Fee Schedule,103% of WA Medicaid,5.78,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,273.24,69,,,percent of total billed charges,69% of total billed charges,396,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,396,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,396,100,,,percent of total billed charges,100% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.93,61.85,,,percent of total billed charges,61.85% of total billed charges,40.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,52.86,130,,,Fee Schedule,130% of WA Medicaid ,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.29,37.7,,,percent of total billed charges,37.70% of total billed charges,149.29,37.7,,,percent of total billed charges,37.70% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,13424.4,33.9,,,percent of total billed charges,33.9% of total billed charges,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.88,78,,,percent of total billed charges,78% of total billed charges,396,100,,,percent of total billed charges,100% of total billed charges,327.1,82.6,,,percent of total billed charges,82.6% of total billed charges,327.1,82.6,,,percent of total billed charges,82.6% of total billed charges,40.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.78,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.78,13424.4,
N BLOCK OTHER PERIPHERAL,64450,CDM,983,RC,64450,HCPCS,Outpatient,,,136.45,88.69,,120.08,88,,,percent of total billed charges,88% of total Billed charges,3.59,100,,,Fee Schedule,100% of Medicare rate,23.69,100,,,Fee Schedule,100% of WA Medicaid,136.45,100,,,percent of total billed charges,100% of total billed charges,24.4,103,,,Fee Schedule,103% of WA Medicaid,3.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,94.15,69,,,percent of total billed charges,69% of total billed charges,136.45,100,,,percent of total billed charges,100% of total billed charges,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.45,100,,,percent of total billed charges,100% of total billed charges,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.45,100,,,percent of total billed charges,100% of total billed charges,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.39,61.85,,,percent of total billed charges,61.85% of total billed charges,23.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.8,130,,,Fee Schedule,130% of WA Medicaid ,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.44,37.7,,,percent of total billed charges,37.70% of total billed charges,51.44,37.7,,,percent of total billed charges,37.70% of total billed charges,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,4625.66,33.9,,,percent of total billed charges,33.9% of total billed charges,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.43,78,,,percent of total billed charges,78% of total billed charges,136.45,100,,,percent of total billed charges,100% of total billed charges,112.71,82.6,,,percent of total billed charges,82.6% of total billed charges,112.71,82.6,,,percent of total billed charges,82.6% of total billed charges,23.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.59,4625.66,
INJ FORAMEN EPIDURAL C/T,64479,CDM,983,RC,64479,HCPCS,Outpatient,,,1038,674.70,,913.44,88,,,percent of total billed charges,88% of total Billed charges,9.36,100,,,Fee Schedule,100% of Medicare rate,74.23,100,,,Fee Schedule,100% of WA Medicaid,1038,100,,,percent of total billed charges,100% of total billed charges,76.46,103,,,Fee Schedule,103% of WA Medicaid,9.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,716.22,69,,,percent of total billed charges,69% of total billed charges,1038,100,,,percent of total billed charges,100% of total billed charges,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1038,100,,,percent of total billed charges,100% of total billed charges,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1038,100,,,percent of total billed charges,100% of total billed charges,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,642,61.85,,,percent of total billed charges,61.85% of total billed charges,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,96.5,130,,,Fee Schedule,130% of WA Medicaid ,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.33,37.7,,,percent of total billed charges,37.70% of total billed charges,391.33,37.7,,,percent of total billed charges,37.70% of total billed charges,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,35188.2,33.9,,,percent of total billed charges,33.9% of total billed charges,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,809.64,78,,,percent of total billed charges,78% of total billed charges,1038,100,,,percent of total billed charges,100% of total billed charges,857.39,82.6,,,percent of total billed charges,82.6% of total billed charges,857.39,82.6,,,percent of total billed charges,82.6% of total billed charges,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.36,35188.2,
INJ FORAMEN EPIDURAL ADD-ON,64480,CDM,983,RC,64480,HCPCS,Outpatient,,,707,459.55,,622.16,88,,,percent of total billed charges,88% of total Billed charges,4.67,100,,,Fee Schedule,100% of Medicare rate,34.32,100,,,Fee Schedule,100% of WA Medicaid,707,100,,,percent of total billed charges,100% of total billed charges,35.35,103,,,Fee Schedule,103% of WA Medicaid,4.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,34.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,487.83,69,,,percent of total billed charges,69% of total billed charges,707,100,,,percent of total billed charges,100% of total billed charges,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,707,100,,,percent of total billed charges,100% of total billed charges,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,707,100,,,percent of total billed charges,100% of total billed charges,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,437.28,61.85,,,percent of total billed charges,61.85% of total billed charges,34.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,44.62,130,,,Fee Schedule,130% of WA Medicaid ,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.54,37.7,,,percent of total billed charges,37.70% of total billed charges,266.54,37.7,,,percent of total billed charges,37.70% of total billed charges,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,23967.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.46,78,,,percent of total billed charges,78% of total billed charges,707,100,,,percent of total billed charges,100% of total billed charges,583.98,82.6,,,percent of total billed charges,82.6% of total billed charges,583.98,82.6,,,percent of total billed charges,82.6% of total billed charges,34.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.67,23967.3,
INJ FORAMEN EPIDURAL ADD-ON,64484,CDM,983,RC,64484,HCPCS,Outpatient,,,254,165.10,,223.52,88,,,percent of total billed charges,88% of total Billed charges,4.13,100,,,Fee Schedule,100% of Medicare rate,29.09,100,,,Fee Schedule,100% of WA Medicaid,254,100,,,percent of total billed charges,100% of total billed charges,29.96,103,,,Fee Schedule,103% of WA Medicaid,4.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,175.26,69,,,percent of total billed charges,69% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.1,61.85,,,percent of total billed charges,61.85% of total billed charges,29.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.82,130,,,Fee Schedule,130% of WA Medicaid ,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8610.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.12,78,,,percent of total billed charges,78% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,29.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.13,8610.6,
INJ FORAMEN EPIDURAL L/S,64483,CDM,983,RC,64483,HCPCS,Outpatient,,,278,180.70,,244.64,88,,,percent of total billed charges,88% of total Billed charges,8.01,100,,,Fee Schedule,100% of Medicare rate,63.41,100,,,Fee Schedule,100% of WA Medicaid,278,100,,,percent of total billed charges,100% of total billed charges,65.31,103,,,Fee Schedule,103% of WA Medicaid,8.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,191.82,69,,,percent of total billed charges,69% of total billed charges,278,100,,,percent of total billed charges,100% of total billed charges,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,278,100,,,percent of total billed charges,100% of total billed charges,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,278,100,,,percent of total billed charges,100% of total billed charges,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.94,61.85,,,percent of total billed charges,61.85% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.43,130,,,Fee Schedule,130% of WA Medicaid ,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.81,37.7,,,percent of total billed charges,37.70% of total billed charges,104.81,37.7,,,percent of total billed charges,37.70% of total billed charges,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,9424.2,33.9,,,percent of total billed charges,33.9% of total billed charges,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.84,78,,,percent of total billed charges,78% of total billed charges,278,100,,,percent of total billed charges,100% of total billed charges,229.63,82.6,,,percent of total billed charges,82.6% of total billed charges,229.63,82.6,,,percent of total billed charges,82.6% of total billed charges,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.01,9424.2,
INJ PARAVERT F JNT C/T 3 LEV,64492,CDM,983,RC,64492,HCPCS,Outpatient,,,253,164.45,,222.64,88,,,percent of total billed charges,88% of total Billed charges,4.91,100,,,Fee Schedule,100% of Medicare rate,33.94,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,34.96,103,,,Fee Schedule,103% of WA Medicaid,4.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,253,100,,,percent of total billed charges,100% of total billed charges,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,253,100,,,percent of total billed charges,100% of total billed charges,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.48,61.85,,,percent of total billed charges,61.85% of total billed charges,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,44.12,130,,,Fee Schedule,130% of WA Medicaid ,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,8576.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.91,8576.7,
INJ PARAVERT F JNT L/S 3 LEV,64495,CDM,983,RC,64495,HCPCS,Outpatient,,,227,147.55,,199.76,88,,,percent of total billed charges,88% of total Billed charges,4.14,100,,,Fee Schedule,100% of Medicare rate,29.28,100,,,Fee Schedule,100% of WA Medicaid,227,100,,,percent of total billed charges,100% of total billed charges,30.16,103,,,Fee Schedule,103% of WA Medicaid,4.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,156.63,69,,,percent of total billed charges,69% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,227,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,227,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.4,61.85,,,percent of total billed charges,61.85% of total billed charges,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,38.06,130,,,Fee Schedule,130% of WA Medicaid ,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,7695.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.06,78,,,percent of total billed charges,78% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.14,7695.3,
INJ PARAVERT F JNT C/T 1 LEV,64490,CDM,983,RC,64490,HCPCS,Outpatient,,,507,329.55,,446.16,88,,,percent of total billed charges,88% of total Billed charges,7.83,100,,,Fee Schedule,100% of Medicare rate,59.87,100,,,Fee Schedule,100% of WA Medicaid,507,100,,,percent of total billed charges,100% of total billed charges,61.67,103,,,Fee Schedule,103% of WA Medicaid,7.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,349.83,69,,,percent of total billed charges,69% of total billed charges,507,100,,,percent of total billed charges,100% of total billed charges,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,100,,,percent of total billed charges,100% of total billed charges,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,100,,,percent of total billed charges,100% of total billed charges,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.58,61.85,,,percent of total billed charges,61.85% of total billed charges,59.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,77.83,130,,,Fee Schedule,130% of WA Medicaid ,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.14,37.7,,,percent of total billed charges,37.70% of total billed charges,191.14,37.7,,,percent of total billed charges,37.70% of total billed charges,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,17187.3,33.9,,,percent of total billed charges,33.9% of total billed charges,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.46,78,,,percent of total billed charges,78% of total billed charges,507,100,,,percent of total billed charges,100% of total billed charges,418.78,82.6,,,percent of total billed charges,82.6% of total billed charges,418.78,82.6,,,percent of total billed charges,82.6% of total billed charges,59.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.83,17187.3,
INJ PARAVERT F JNT C/T 2 LEV,64491,CDM,983,RC,64491,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,4.87,100,,,Fee Schedule,100% of Medicare rate,33.38,100,,,Fee Schedule,100% of WA Medicaid,250,100,,,percent of total billed charges,100% of total billed charges,34.38,103,,,Fee Schedule,103% of WA Medicaid,4.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,250,100,,,percent of total billed charges,100% of total billed charges,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,250,100,,,percent of total billed charges,100% of total billed charges,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,33.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.39,130,,,Fee Schedule,130% of WA Medicaid ,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,8475,33.9,,,percent of total billed charges,33.9% of total billed charges,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,33.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.87,8475,
INJ PARAVERT F JNT L/S 1 LEV,64493,CDM,983,RC,64493,HCPCS,Outpatient,,,459,298.35,,403.92,88,,,percent of total billed charges,88% of total Billed charges,6.61,100,,,Fee Schedule,100% of Medicare rate,51.66,100,,,Fee Schedule,100% of WA Medicaid,459,100,,,percent of total billed charges,100% of total billed charges,53.21,103,,,Fee Schedule,103% of WA Medicaid,6.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,51.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,316.71,69,,,percent of total billed charges,69% of total billed charges,459,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,459,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,459,100,,,percent of total billed charges,100% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.89,61.85,,,percent of total billed charges,61.85% of total billed charges,51.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.16,130,,,Fee Schedule,130% of WA Medicaid ,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.04,37.7,,,percent of total billed charges,37.70% of total billed charges,173.04,37.7,,,percent of total billed charges,37.70% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,15560.1,33.9,,,percent of total billed charges,33.9% of total billed charges,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.02,78,,,percent of total billed charges,78% of total billed charges,459,100,,,percent of total billed charges,100% of total billed charges,379.13,82.6,,,percent of total billed charges,82.6% of total billed charges,379.13,82.6,,,percent of total billed charges,82.6% of total billed charges,51.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.61,15560.1,
INJ PARAVERT F JNT L/S 2 LEV,64494,CDM,983,RC,64494,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,4.11,100,,,Fee Schedule,100% of Medicare rate,28.53,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,29.39,103,,,Fee Schedule,103% of WA Medicaid,4.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,224,100,,,percent of total billed charges,100% of total billed charges,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,224,100,,,percent of total billed charges,100% of total billed charges,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.54,61.85,,,percent of total billed charges,61.85% of total billed charges,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.09,130,,,Fee Schedule,130% of WA Medicaid ,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,7593.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.11,7593.6,
N BLOCK STELLATE GANGLION,64510,CDM,983,RC,64510,HCPCS,Outpatient,,,587,381.55,,516.56,88,,,percent of total billed charges,88% of total Billed charges,5.43,100,,,Fee Schedule,100% of Medicare rate,44.01,100,,,Fee Schedule,100% of WA Medicaid,587,100,,,percent of total billed charges,100% of total billed charges,45.33,103,,,Fee Schedule,103% of WA Medicaid,5.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,44.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,405.03,69,,,percent of total billed charges,69% of total billed charges,587,100,,,percent of total billed charges,100% of total billed charges,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,587,100,,,percent of total billed charges,100% of total billed charges,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,587,100,,,percent of total billed charges,100% of total billed charges,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.06,61.85,,,percent of total billed charges,61.85% of total billed charges,44.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,57.21,130,,,Fee Schedule,130% of WA Medicaid ,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.3,37.7,,,percent of total billed charges,37.70% of total billed charges,221.3,37.7,,,percent of total billed charges,37.70% of total billed charges,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,19899.3,33.9,,,percent of total billed charges,33.9% of total billed charges,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.86,78,,,percent of total billed charges,78% of total billed charges,587,100,,,percent of total billed charges,100% of total billed charges,484.86,82.6,,,percent of total billed charges,82.6% of total billed charges,484.86,82.6,,,percent of total billed charges,82.6% of total billed charges,44.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.43,19899.3,
N BLOCK LUMBAR/THORACIC,64520,CDM,983,RC,64520,HCPCS,Outpatient,,,800,520.00,,704,88,,,percent of total billed charges,88% of total Billed charges,5.94,100,,,Fee Schedule,100% of Medicare rate,48.68,100,,,Fee Schedule,100% of WA Medicaid,800,100,,,percent of total billed charges,100% of total billed charges,50.14,103,,,Fee Schedule,103% of WA Medicaid,5.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,552,69,,,percent of total billed charges,69% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,800,100,,,percent of total billed charges,100% of total billed charges,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,800,100,,,percent of total billed charges,100% of total billed charges,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,494.8,61.85,,,percent of total billed charges,61.85% of total billed charges,48.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.28,130,,,Fee Schedule,130% of WA Medicaid ,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,301.6,37.7,,,percent of total billed charges,37.70% of total billed charges,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,27120,33.9,,,percent of total billed charges,33.9% of total billed charges,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,624,78,,,percent of total billed charges,78% of total billed charges,800,100,,,percent of total billed charges,100% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,660.8,82.6,,,percent of total billed charges,82.6% of total billed charges,48.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,6,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.94,27120,
"64566 Posterior tibial neurostimulation, percutaneous needle electrode, single t",64566,CDM,983,RC,64566,HCPCS,Outpatient,,,412,267.80,,362.56,88,,,percent of total billed charges,88% of total Billed charges,2.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,412,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,284.28,69,,,percent of total billed charges,69% of total billed charges,412,100,,,percent of total billed charges,100% of total billed charges,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,412,100,,,percent of total billed charges,100% of total billed charges,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,412,100,,,percent of total billed charges,100% of total billed charges,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.82,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.32,37.7,,,percent of total billed charges,37.70% of total billed charges,155.32,37.7,,,percent of total billed charges,37.70% of total billed charges,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,13966.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.36,78,,,percent of total billed charges,78% of total billed charges,412,100,,,percent of total billed charges,100% of total billed charges,340.31,82.6,,,percent of total billed charges,82.6% of total billed charges,340.31,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,3,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",2.97,13966.8,
REVISE/RMV PN/GASTR STIMUL,64595,CDM,983,RC,64595,HCPCS,Outpatient,,,430,279.50,,378.4,88,,,percent of total billed charges,88% of total Billed charges,21.43,100,,,Fee Schedule,100% of Medicare rate,130.92,100,,,Fee Schedule,100% of WA Medicaid,430,100,,,percent of total billed charges,100% of total billed charges,134.85,103,,,Fee Schedule,103% of WA Medicaid,21.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,130.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,296.7,69,,,percent of total billed charges,69% of total billed charges,430,100,,,percent of total billed charges,100% of total billed charges,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,430,100,,,percent of total billed charges,100% of total billed charges,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,430,100,,,percent of total billed charges,100% of total billed charges,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.96,61.85,,,percent of total billed charges,61.85% of total billed charges,130.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,170.2,130,,,Fee Schedule,130% of WA Medicaid ,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.11,37.7,,,percent of total billed charges,37.70% of total billed charges,162.11,37.7,,,percent of total billed charges,37.70% of total billed charges,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,14577,33.9,,,percent of total billed charges,33.9% of total billed charges,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,335.4,78,,,percent of total billed charges,78% of total billed charges,430,100,,,percent of total billed charges,100% of total billed charges,355.18,82.6,,,percent of total billed charges,82.6% of total billed charges,355.18,82.6,,,percent of total billed charges,82.6% of total billed charges,130.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.43,14577,
INJECTION TREATMENT OF NERVE,64600,CDM,983,RC,64600,HCPCS,Outpatient,,,1031,670.15,,907.28,88,,,percent of total billed charges,88% of total Billed charges,28.13,100,,,Fee Schedule,100% of Medicare rate,135.03,100,,,Fee Schedule,100% of WA Medicaid,1031,100,,,percent of total billed charges,100% of total billed charges,139.08,103,,,Fee Schedule,103% of WA Medicaid,28.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,135.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,711.39,69,,,percent of total billed charges,69% of total billed charges,1031,100,,,percent of total billed charges,100% of total billed charges,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031,100,,,percent of total billed charges,100% of total billed charges,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1031,100,,,percent of total billed charges,100% of total billed charges,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.67,61.85,,,percent of total billed charges,61.85% of total billed charges,135.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,175.54,130,,,Fee Schedule,130% of WA Medicaid ,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.69,37.7,,,percent of total billed charges,37.70% of total billed charges,388.69,37.7,,,percent of total billed charges,37.70% of total billed charges,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,34950.9,33.9,,,percent of total billed charges,33.9% of total billed charges,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.18,78,,,percent of total billed charges,78% of total billed charges,1031,100,,,percent of total billed charges,100% of total billed charges,851.61,82.6,,,percent of total billed charges,82.6% of total billed charges,851.61,82.6,,,percent of total billed charges,82.6% of total billed charges,135.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.13,34950.9,
INJECTION TREATMENT OF NERVE,64605,CDM,983,RC,64605,HCPCS,Outpatient,,,901,585.65,,792.88,88,,,percent of total billed charges,88% of total Billed charges,73.36,100,,,Fee Schedule,100% of Medicare rate,240.03,100,,,Fee Schedule,100% of WA Medicaid,901,100,,,percent of total billed charges,100% of total billed charges,247.23,103,,,Fee Schedule,103% of WA Medicaid,73.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,128.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,240.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,621.69,69,,,percent of total billed charges,69% of total billed charges,901,100,,,percent of total billed charges,100% of total billed charges,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,901,100,,,percent of total billed charges,100% of total billed charges,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,901,100,,,percent of total billed charges,100% of total billed charges,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.27,61.85,,,percent of total billed charges,61.85% of total billed charges,240.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,244.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,312.04,130,,,Fee Schedule,130% of WA Medicaid ,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,339.68,37.7,,,percent of total billed charges,37.70% of total billed charges,339.68,37.7,,,percent of total billed charges,37.70% of total billed charges,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,30543.9,33.9,,,percent of total billed charges,33.9% of total billed charges,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,702.78,78,,,percent of total billed charges,78% of total billed charges,901,100,,,percent of total billed charges,100% of total billed charges,744.23,82.6,,,percent of total billed charges,82.6% of total billed charges,744.23,82.6,,,percent of total billed charges,82.6% of total billed charges,240.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.36,30543.9,
DESTROY NERVE FACE MUSCLE,64612,CDM,983,RC,64612,HCPCS,Outpatient,,,351,228.15,,308.88,88,,,percent of total billed charges,88% of total Billed charges,11.4,100,,,Fee Schedule,100% of Medicare rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,351,100,,,percent of total billed charges,100% of total billed charges,71.08,103,,,Fee Schedule,103% of WA Medicaid,11.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,242.19,69,,,percent of total billed charges,69% of total billed charges,351,100,,,percent of total billed charges,100% of total billed charges,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,351,100,,,percent of total billed charges,100% of total billed charges,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,351,100,,,percent of total billed charges,100% of total billed charges,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.09,61.85,,,percent of total billed charges,61.85% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.71,130,,,Fee Schedule,130% of WA Medicaid ,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.33,37.7,,,percent of total billed charges,37.70% of total billed charges,132.33,37.7,,,percent of total billed charges,37.70% of total billed charges,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,11898.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.78,78,,,percent of total billed charges,78% of total billed charges,351,100,,,percent of total billed charges,100% of total billed charges,289.93,82.6,,,percent of total billed charges,82.6% of total billed charges,289.93,82.6,,,percent of total billed charges,82.6% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.4,11898.9,
"DESTROY NERVE, EXTREM MUSC",64614,CDM,983,RC,64614,HCPCS,Outpatient,,,513,333.45,,451.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,513,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,353.97,69,,,percent of total billed charges,69% of total billed charges,513,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,513,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,513,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,317.29,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,193.4,37.7,,,percent of total billed charges,37.70% of total billed charges,193.4,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,17390.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,400.14,78,,,percent of total billed charges,78% of total billed charges,513,100,,,percent of total billed charges,100% of total billed charges,423.74,82.6,,,percent of total billed charges,82.6% of total billed charges,423.74,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",193.4,17390.7,
CHEMODENERV MUSC MIGRAINE,64615,CDM,983,RC,64615,HCPCS,Outpatient,,,392,254.80,,344.96,88,,,percent of total billed charges,88% of total Billed charges,19.97,100,,,Fee Schedule,100% of Medicare rate,68.63,100,,,Fee Schedule,100% of WA Medicaid,392,100,,,percent of total billed charges,100% of total billed charges,70.69,103,,,Fee Schedule,103% of WA Medicaid,19.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,270.48,69,,,percent of total billed charges,69% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,392,100,,,percent of total billed charges,100% of total billed charges,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,392,100,,,percent of total billed charges,100% of total billed charges,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.45,61.85,,,percent of total billed charges,61.85% of total billed charges,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.22,130,,,Fee Schedule,130% of WA Medicaid ,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.78,37.7,,,percent of total billed charges,37.70% of total billed charges,147.78,37.7,,,percent of total billed charges,37.70% of total billed charges,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,13288.8,33.9,,,percent of total billed charges,33.9% of total billed charges,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.76,78,,,percent of total billed charges,78% of total billed charges,392,100,,,percent of total billed charges,100% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,323.79,82.6,,,percent of total billed charges,82.6% of total billed charges,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.97,13288.8,
CHEMODENERV MUSC NECK DYSTON,64616,CDM,983,RC,64616,HCPCS,Outpatient,,,285.62,185.65,,251.35,88,,,percent of total billed charges,88% of total Billed charges,16.75,100,,,Fee Schedule,100% of Medicare rate,61.92,100,,,Fee Schedule,100% of WA Medicaid,285.62,100,,,percent of total billed charges,100% of total billed charges,63.78,103,,,Fee Schedule,103% of WA Medicaid,16.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,61.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,197.08,69,,,percent of total billed charges,69% of total billed charges,285.62,100,,,percent of total billed charges,100% of total billed charges,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.62,100,,,percent of total billed charges,100% of total billed charges,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.62,100,,,percent of total billed charges,100% of total billed charges,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.66,61.85,,,percent of total billed charges,61.85% of total billed charges,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,80.5,130,,,Fee Schedule,130% of WA Medicaid ,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.68,37.7,,,percent of total billed charges,37.70% of total billed charges,107.68,37.7,,,percent of total billed charges,37.70% of total billed charges,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,9682.52,33.9,,,percent of total billed charges,33.9% of total billed charges,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.78,78,,,percent of total billed charges,78% of total billed charges,285.62,100,,,percent of total billed charges,100% of total billed charges,235.92,82.6,,,percent of total billed charges,82.6% of total billed charges,235.92,82.6,,,percent of total billed charges,82.6% of total billed charges,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.75,9682.52,
INJECTION TREATMENT OF NERVE,64610,CDM,983,RC,64610,HCPCS,Outpatient,,,751,488.15,,660.88,88,,,percent of total billed charges,88% of total Billed charges,74.73,100,,,Fee Schedule,100% of Medicare rate,270.61,100,,,Fee Schedule,100% of WA Medicaid,751,100,,,percent of total billed charges,100% of total billed charges,278.73,103,,,Fee Schedule,103% of WA Medicaid,74.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,130.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,270.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,518.19,69,,,percent of total billed charges,69% of total billed charges,751,100,,,percent of total billed charges,100% of total billed charges,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,751,100,,,percent of total billed charges,100% of total billed charges,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,751,100,,,percent of total billed charges,100% of total billed charges,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,464.49,61.85,,,percent of total billed charges,61.85% of total billed charges,270.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,276.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,351.79,130,,,Fee Schedule,130% of WA Medicaid ,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,283.13,37.7,,,percent of total billed charges,37.70% of total billed charges,283.13,37.7,,,percent of total billed charges,37.70% of total billed charges,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,25458.9,33.9,,,percent of total billed charges,33.9% of total billed charges,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.78,78,,,percent of total billed charges,78% of total billed charges,751,100,,,percent of total billed charges,100% of total billed charges,620.33,82.6,,,percent of total billed charges,82.6% of total billed charges,620.33,82.6,,,percent of total billed charges,82.6% of total billed charges,270.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,74.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,74.73,25458.9,
"DESTROY NERVE, NECK MUSCLE",64613,CDM,983,RC,64613,HCPCS,Outpatient,,,410,266.50,,360.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,410,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,282.9,69,,,percent of total billed charges,69% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,410,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,410,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,253.59,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,154.57,37.7,,,percent of total billed charges,37.70% of total billed charges,154.57,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,13899,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,319.8,78,,,percent of total billed charges,78% of total billed charges,410,100,,,percent of total billed charges,100% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,338.66,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",154.57,13899,
INJECTION TREATMENT OF NERVE,64620,CDM,983,RC,64620,HCPCS,Outpatient,,,877,570.05,,771.76,88,,,percent of total billed charges,88% of total Billed charges,14.17,100,,,Fee Schedule,100% of Medicare rate,101.64,100,,,Fee Schedule,100% of WA Medicaid,877,100,,,percent of total billed charges,100% of total billed charges,104.69,103,,,Fee Schedule,103% of WA Medicaid,14.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,101.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,605.13,69,,,percent of total billed charges,69% of total billed charges,877,100,,,percent of total billed charges,100% of total billed charges,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,877,100,,,percent of total billed charges,100% of total billed charges,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,877,100,,,percent of total billed charges,100% of total billed charges,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,542.42,61.85,,,percent of total billed charges,61.85% of total billed charges,101.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.13,130,,,Fee Schedule,130% of WA Medicaid ,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.63,37.7,,,percent of total billed charges,37.70% of total billed charges,330.63,37.7,,,percent of total billed charges,37.70% of total billed charges,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,29730.3,33.9,,,percent of total billed charges,33.9% of total billed charges,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,684.06,78,,,percent of total billed charges,78% of total billed charges,877,100,,,percent of total billed charges,100% of total billed charges,724.4,82.6,,,percent of total billed charges,82.6% of total billed charges,724.4,82.6,,,percent of total billed charges,82.6% of total billed charges,101.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.17,29730.3,
DESTROY C/TH FACET JNT ADDL,64634,CDM,983,RC,64634,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,5.37,100,,,Fee Schedule,100% of Medicare rate,37.67,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,38.8,103,,,Fee Schedule,103% of WA Medicaid,5.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,37.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.72,61.85,,,percent of total billed charges,61.85% of total billed charges,37.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,48.97,130,,,Fee Schedule,130% of WA Medicaid ,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,17085.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,37.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.37,17085.6,
DESTROY L/S FACET JNT ADDL,64636,CDM,983,RC,64636,HCPCS,Outpatient,,,454,295.10,,399.52,88,,,percent of total billed charges,88% of total Billed charges,4.6,100,,,Fee Schedule,100% of Medicare rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,454,100,,,percent of total billed charges,100% of total billed charges,34,103,,,Fee Schedule,103% of WA Medicaid,4.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,313.26,69,,,percent of total billed charges,69% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,454,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,454,100,,,percent of total billed charges,100% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.8,61.85,,,percent of total billed charges,61.85% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.91,130,,,Fee Schedule,130% of WA Medicaid ,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,15390.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.12,78,,,percent of total billed charges,78% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.6,15390.6,
DESTROY CERV/THOR FACET JNT,64633,CDM,983,RC,64633,HCPCS,Outpatient,,,1100,715.00,,968,88,,,percent of total billed charges,88% of total Billed charges,14.08,100,,,Fee Schedule,100% of Medicare rate,109.66,100,,,Fee Schedule,100% of WA Medicaid,1100,100,,,percent of total billed charges,100% of total billed charges,112.95,103,,,Fee Schedule,103% of WA Medicaid,14.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,109.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,759,69,,,percent of total billed charges,69% of total billed charges,1100,100,,,percent of total billed charges,100% of total billed charges,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1100,100,,,percent of total billed charges,100% of total billed charges,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1100,100,,,percent of total billed charges,100% of total billed charges,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,680.35,61.85,,,percent of total billed charges,61.85% of total billed charges,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,142.56,130,,,Fee Schedule,130% of WA Medicaid ,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.7,37.7,,,percent of total billed charges,37.70% of total billed charges,414.7,37.7,,,percent of total billed charges,37.70% of total billed charges,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37290,33.9,,,percent of total billed charges,33.9% of total billed charges,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,858,78,,,percent of total billed charges,78% of total billed charges,1100,100,,,percent of total billed charges,100% of total billed charges,908.6,82.6,,,percent of total billed charges,82.6% of total billed charges,908.6,82.6,,,percent of total billed charges,82.6% of total billed charges,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.08,37290,
DESTROY LUMB/SAC FACET JNT,64635,CDM,983,RC,64635,HCPCS,Outpatient,,,1081,702.65,,951.28,88,,,percent of total billed charges,88% of total Billed charges,14.09,100,,,Fee Schedule,100% of Medicare rate,109.85,100,,,Fee Schedule,100% of WA Medicaid,1081,100,,,percent of total billed charges,100% of total billed charges,113.15,103,,,Fee Schedule,103% of WA Medicaid,14.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,109.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,745.89,69,,,percent of total billed charges,69% of total billed charges,1081,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1081,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1081,100,,,percent of total billed charges,100% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.6,61.85,,,percent of total billed charges,61.85% of total billed charges,109.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,142.81,130,,,Fee Schedule,130% of WA Medicaid ,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.54,37.7,,,percent of total billed charges,37.70% of total billed charges,407.54,37.7,,,percent of total billed charges,37.70% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,36645.9,33.9,,,percent of total billed charges,33.9% of total billed charges,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,843.18,78,,,percent of total billed charges,78% of total billed charges,1081,100,,,percent of total billed charges,100% of total billed charges,892.91,82.6,,,percent of total billed charges,82.6% of total billed charges,892.91,82.6,,,percent of total billed charges,82.6% of total billed charges,109.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.09,36645.9,
N BLOCK INJ COMMON DIGIT,64632,CDM,983,RC,64632,HCPCS,Outpatient,,,255,165.75,,224.4,88,,,percent of total billed charges,88% of total Billed charges,4.62,100,,,Fee Schedule,100% of Medicare rate,38.42,100,,,Fee Schedule,100% of WA Medicaid,255,100,,,percent of total billed charges,100% of total billed charges,39.57,103,,,Fee Schedule,103% of WA Medicaid,4.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,175.95,69,,,percent of total billed charges,69% of total billed charges,255,100,,,percent of total billed charges,100% of total billed charges,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,255,100,,,percent of total billed charges,100% of total billed charges,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,255,100,,,percent of total billed charges,100% of total billed charges,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.72,61.85,,,percent of total billed charges,61.85% of total billed charges,38.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.95,130,,,Fee Schedule,130% of WA Medicaid ,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.14,37.7,,,percent of total billed charges,37.70% of total billed charges,96.14,37.7,,,percent of total billed charges,37.70% of total billed charges,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,8644.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.9,78,,,percent of total billed charges,78% of total billed charges,255,100,,,percent of total billed charges,100% of total billed charges,210.63,82.6,,,percent of total billed charges,82.6% of total billed charges,210.63,82.6,,,percent of total billed charges,82.6% of total billed charges,38.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.62,8644.5,
CHEMODENERV 1 EXTREMITY 1-4,64642,CDM,983,RC,64642,HCPCS,Outpatient,,,383,248.95,,337.04,88,,,percent of total billed charges,88% of total Billed charges,13.57,100,,,Fee Schedule,100% of Medicare rate,60.61,100,,,Fee Schedule,100% of WA Medicaid,383,100,,,percent of total billed charges,100% of total billed charges,62.43,103,,,Fee Schedule,103% of WA Medicaid,13.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,264.27,69,,,percent of total billed charges,69% of total billed charges,383,100,,,percent of total billed charges,100% of total billed charges,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,383,100,,,percent of total billed charges,100% of total billed charges,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,383,100,,,percent of total billed charges,100% of total billed charges,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,236.89,61.85,,,percent of total billed charges,61.85% of total billed charges,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,78.79,130,,,Fee Schedule,130% of WA Medicaid ,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.39,37.7,,,percent of total billed charges,37.70% of total billed charges,144.39,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,12983.7,33.9,,,percent of total billed charges,33.9% of total billed charges,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.74,78,,,percent of total billed charges,78% of total billed charges,383,100,,,percent of total billed charges,100% of total billed charges,316.36,82.6,,,percent of total billed charges,82.6% of total billed charges,316.36,82.6,,,percent of total billed charges,82.6% of total billed charges,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.57,12983.7,
CHEMODENERV 1 EXTREM 1-4 EA,64643,CDM,983,RC,64643,HCPCS,Outpatient,,,251,163.15,,220.88,88,,,percent of total billed charges,88% of total Billed charges,8.3,100,,,Fee Schedule,100% of Medicare rate,39.17,100,,,Fee Schedule,100% of WA Medicaid,251,100,,,percent of total billed charges,100% of total billed charges,40.35,103,,,Fee Schedule,103% of WA Medicaid,8.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,251,100,,,percent of total billed charges,100% of total billed charges,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,251,100,,,percent of total billed charges,100% of total billed charges,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.24,61.85,,,percent of total billed charges,61.85% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.92,130,,,Fee Schedule,130% of WA Medicaid ,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,8508.9,33.9,,,percent of total billed charges,33.9% of total billed charges,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.3,8508.9,
CHEMODENERV 1 EXTREM 5/> MUS,64644,CDM,983,RC,64644,HCPCS,Outpatient,,,438,284.70,,385.44,88,,,percent of total billed charges,88% of total Billed charges,13.84,100,,,Fee Schedule,100% of Medicare rate,65.65,100,,,Fee Schedule,100% of WA Medicaid,438,100,,,percent of total billed charges,100% of total billed charges,67.62,103,,,Fee Schedule,103% of WA Medicaid,13.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,65.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,302.22,69,,,percent of total billed charges,69% of total billed charges,438,100,,,percent of total billed charges,100% of total billed charges,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,438,100,,,percent of total billed charges,100% of total billed charges,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,438,100,,,percent of total billed charges,100% of total billed charges,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,270.9,61.85,,,percent of total billed charges,61.85% of total billed charges,65.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,85.35,130,,,Fee Schedule,130% of WA Medicaid ,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.13,37.7,,,percent of total billed charges,37.70% of total billed charges,165.13,37.7,,,percent of total billed charges,37.70% of total billed charges,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,14848.2,33.9,,,percent of total billed charges,33.9% of total billed charges,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.64,78,,,percent of total billed charges,78% of total billed charges,438,100,,,percent of total billed charges,100% of total billed charges,361.79,82.6,,,percent of total billed charges,82.6% of total billed charges,361.79,82.6,,,percent of total billed charges,82.6% of total billed charges,65.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.84,14848.2,
CHEMODENERV 1 EXTREM 5/> EA,64645,CDM,983,RC,64645,HCPCS,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,10.96,100,,,Fee Schedule,100% of Medicare rate,45.32,100,,,Fee Schedule,100% of WA Medicaid,308,100,,,percent of total billed charges,100% of total billed charges,46.68,103,,,Fee Schedule,103% of WA Medicaid,10.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,45.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,308,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,308,100,,,percent of total billed charges,100% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.5,61.85,,,percent of total billed charges,61.85% of total billed charges,45.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.92,130,,,Fee Schedule,130% of WA Medicaid ,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,10441.2,33.9,,,percent of total billed charges,33.9% of total billed charges,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,45.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.96,10441.2,
CHEMODENERV TRUNK MUSC 1-5,64646,CDM,983,RC,64646,HCPCS,Outpatient,,,412,267.80,,362.56,88,,,percent of total billed charges,88% of total Billed charges,16.16,100,,,Fee Schedule,100% of Medicare rate,65.28,100,,,Fee Schedule,100% of WA Medicaid,412,100,,,percent of total billed charges,100% of total billed charges,67.24,103,,,Fee Schedule,103% of WA Medicaid,16.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,28.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,65.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,284.28,69,,,percent of total billed charges,69% of total billed charges,412,100,,,percent of total billed charges,100% of total billed charges,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,412,100,,,percent of total billed charges,100% of total billed charges,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,412,100,,,percent of total billed charges,100% of total billed charges,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.82,61.85,,,percent of total billed charges,61.85% of total billed charges,65.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.86,130,,,Fee Schedule,130% of WA Medicaid ,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.32,37.7,,,percent of total billed charges,37.70% of total billed charges,155.32,37.7,,,percent of total billed charges,37.70% of total billed charges,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,13966.8,33.9,,,percent of total billed charges,33.9% of total billed charges,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,321.36,78,,,percent of total billed charges,78% of total billed charges,412,100,,,percent of total billed charges,100% of total billed charges,340.31,82.6,,,percent of total billed charges,82.6% of total billed charges,340.31,82.6,,,percent of total billed charges,82.6% of total billed charges,65.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.16,13966.8,
CHEMODENERV TRUNK MUSC 6/>,64647,CDM,983,RC,64647,HCPCS,Outpatient,,,477,310.05,,419.76,88,,,percent of total billed charges,88% of total Billed charges,19.27,100,,,Fee Schedule,100% of Medicare rate,74.97,100,,,Fee Schedule,100% of WA Medicaid,477,100,,,percent of total billed charges,100% of total billed charges,77.22,103,,,Fee Schedule,103% of WA Medicaid,19.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,329.13,69,,,percent of total billed charges,69% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,477,100,,,percent of total billed charges,100% of total billed charges,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,477,100,,,percent of total billed charges,100% of total billed charges,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.02,61.85,,,percent of total billed charges,61.85% of total billed charges,74.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,97.46,130,,,Fee Schedule,130% of WA Medicaid ,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,179.83,37.7,,,percent of total billed charges,37.70% of total billed charges,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,16170.3,33.9,,,percent of total billed charges,33.9% of total billed charges,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.06,78,,,percent of total billed charges,78% of total billed charges,477,100,,,percent of total billed charges,100% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,394,82.6,,,percent of total billed charges,82.6% of total billed charges,74.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,19.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,19.27,16170.3,
INJECTION TREATMENT OF NERVE,64640,CDM,983,RC,64640,HCPCS,Outpatient,,,394,256.10,,346.72,88,,,percent of total billed charges,88% of total Billed charges,9.03,100,,,Fee Schedule,100% of Medicare rate,68.07,100,,,Fee Schedule,100% of WA Medicaid,394,100,,,percent of total billed charges,100% of total billed charges,70.11,103,,,Fee Schedule,103% of WA Medicaid,9.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,271.86,69,,,percent of total billed charges,69% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,394,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,394,100,,,percent of total billed charges,100% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.69,61.85,,,percent of total billed charges,61.85% of total billed charges,68.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,88.49,130,,,Fee Schedule,130% of WA Medicaid ,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,148.54,37.7,,,percent of total billed charges,37.70% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,13356.6,33.9,,,percent of total billed charges,33.9% of total billed charges,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.32,78,,,percent of total billed charges,78% of total billed charges,394,100,,,percent of total billed charges,100% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,325.44,82.6,,,percent of total billed charges,82.6% of total billed charges,68.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.03,13356.6,
CHEMODENERV OF ECCRINE GLAND;BOTH AXILLA,64650,CDM,983,RC,64650,HCPCS,Outpatient,,,80,52.00,,70.4,88,,,percent of total billed charges,88% of total Billed charges,4.33,100,,,Fee Schedule,100% of Medicare rate,22.94,100,,,Fee Schedule,100% of WA Medicaid,80,100,,,percent of total billed charges,100% of total billed charges,23.63,103,,,Fee Schedule,103% of WA Medicaid,4.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,55.2,69,,,percent of total billed charges,69% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,80,100,,,percent of total billed charges,100% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,80,100,,,percent of total billed charges,100% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.48,61.85,,,percent of total billed charges,61.85% of total billed charges,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.82,130,,,Fee Schedule,130% of WA Medicaid ,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.16,37.7,,,percent of total billed charges,37.70% of total billed charges,30.16,37.7,,,percent of total billed charges,37.70% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,2712,33.9,,,percent of total billed charges,33.9% of total billed charges,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.4,78,,,percent of total billed charges,78% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.33,2712,
REVISE ARM/LEG NERVE,64708,CDM,983,RC,64708,HCPCS,Outpatient,,,1858,1207.70,,1635.04,88,,,percent of total billed charges,88% of total Billed charges,42.34,100,,,Fee Schedule,100% of Medicare rate,297.65,100,,,Fee Schedule,100% of WA Medicaid,1858,100,,,percent of total billed charges,100% of total billed charges,306.58,103,,,Fee Schedule,103% of WA Medicaid,42.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,297.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1282.02,69,,,percent of total billed charges,69% of total billed charges,1858,100,,,percent of total billed charges,100% of total billed charges,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1858,100,,,percent of total billed charges,100% of total billed charges,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1858,100,,,percent of total billed charges,100% of total billed charges,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1149.17,61.85,,,percent of total billed charges,61.85% of total billed charges,297.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,303.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,386.95,130,,,Fee Schedule,130% of WA Medicaid ,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.47,37.7,,,percent of total billed charges,37.70% of total billed charges,700.47,37.7,,,percent of total billed charges,37.70% of total billed charges,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,62986.2,33.9,,,percent of total billed charges,33.9% of total billed charges,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1449.24,78,,,percent of total billed charges,78% of total billed charges,1858,100,,,percent of total billed charges,100% of total billed charges,1534.71,82.6,,,percent of total billed charges,82.6% of total billed charges,1534.71,82.6,,,percent of total billed charges,82.6% of total billed charges,297.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.34,62986.2,
REVISE FINGER/TOE NERVE,64702,CDM,983,RC,64702,HCPCS,Outpatient,,,969,629.85,,852.72,88,,,percent of total billed charges,88% of total Billed charges,45.38,100,,,Fee Schedule,100% of Medicare rate,301.2,100,,,Fee Schedule,100% of WA Medicaid,969,100,,,percent of total billed charges,100% of total billed charges,310.24,103,,,Fee Schedule,103% of WA Medicaid,45.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,79.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,301.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,668.61,69,,,percent of total billed charges,69% of total billed charges,969,100,,,percent of total billed charges,100% of total billed charges,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,969,100,,,percent of total billed charges,100% of total billed charges,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,969,100,,,percent of total billed charges,100% of total billed charges,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.33,61.85,,,percent of total billed charges,61.85% of total billed charges,301.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,307.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,391.56,130,,,Fee Schedule,130% of WA Medicaid ,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,365.31,37.7,,,percent of total billed charges,37.70% of total billed charges,365.31,37.7,,,percent of total billed charges,37.70% of total billed charges,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,32849.1,33.9,,,percent of total billed charges,33.9% of total billed charges,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,755.82,78,,,percent of total billed charges,78% of total billed charges,969,100,,,percent of total billed charges,100% of total billed charges,800.39,82.6,,,percent of total billed charges,82.6% of total billed charges,800.39,82.6,,,percent of total billed charges,82.6% of total billed charges,301.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.83,101,,,Fee Schedule,101% of Medicare RBRVS rate,45.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,45.38,32849.1,
REVISE HAND/FOOT NERVE,64704,CDM,983,RC,64704,HCPCS,Outpatient,,,894,581.10,,786.72,88,,,percent of total billed charges,88% of total Billed charges,24.21,100,,,Fee Schedule,100% of Medicare rate,189.11,100,,,Fee Schedule,100% of WA Medicaid,894,100,,,percent of total billed charges,100% of total billed charges,194.78,103,,,Fee Schedule,103% of WA Medicaid,24.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,189.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,616.86,69,,,percent of total billed charges,69% of total billed charges,894,100,,,percent of total billed charges,100% of total billed charges,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,894,100,,,percent of total billed charges,100% of total billed charges,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,894,100,,,percent of total billed charges,100% of total billed charges,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,552.94,61.85,,,percent of total billed charges,61.85% of total billed charges,189.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.89,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,245.84,130,,,Fee Schedule,130% of WA Medicaid ,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.04,37.7,,,percent of total billed charges,37.70% of total billed charges,337.04,37.7,,,percent of total billed charges,37.70% of total billed charges,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,30306.6,33.9,,,percent of total billed charges,33.9% of total billed charges,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.32,78,,,percent of total billed charges,78% of total billed charges,894,100,,,percent of total billed charges,100% of total billed charges,738.44,82.6,,,percent of total billed charges,82.6% of total billed charges,738.44,82.6,,,percent of total billed charges,82.6% of total billed charges,189.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.21,30306.6,
REVISION OF ARM NERVE(S),64713,CDM,983,RC,64713,HCPCS,Outpatient,,,1994,1296.10,,1754.72,88,,,percent of total billed charges,88% of total Billed charges,94.76,100,,,Fee Schedule,100% of Medicare rate,459.72,100,,,Fee Schedule,100% of WA Medicaid,1994,100,,,percent of total billed charges,100% of total billed charges,473.51,103,,,Fee Schedule,103% of WA Medicaid,94.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,165.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,459.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1375.86,69,,,percent of total billed charges,69% of total billed charges,1994,100,,,percent of total billed charges,100% of total billed charges,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1994,100,,,percent of total billed charges,100% of total billed charges,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1994,100,,,percent of total billed charges,100% of total billed charges,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1233.29,61.85,,,percent of total billed charges,61.85% of total billed charges,459.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,597.64,130,,,Fee Schedule,130% of WA Medicaid ,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.74,37.7,,,percent of total billed charges,37.70% of total billed charges,751.74,37.7,,,percent of total billed charges,37.70% of total billed charges,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,67596.6,33.9,,,percent of total billed charges,33.9% of total billed charges,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1555.32,78,,,percent of total billed charges,78% of total billed charges,1994,100,,,percent of total billed charges,100% of total billed charges,1647.04,82.6,,,percent of total billed charges,82.6% of total billed charges,1647.04,82.6,,,percent of total billed charges,82.6% of total billed charges,459.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,94.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,459.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.76,67596.6,
REVISION OF SCIATIC NERVE,64712,CDM,983,RC,64712,HCPCS,Outpatient,,,1558,1012.70,,1371.04,88,,,percent of total billed charges,88% of total Billed charges,62.45,100,,,Fee Schedule,100% of Medicare rate,343.91,100,,,Fee Schedule,100% of WA Medicaid,1558,100,,,percent of total billed charges,100% of total billed charges,354.23,103,,,Fee Schedule,103% of WA Medicaid,62.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,109.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,343.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1075.02,69,,,percent of total billed charges,69% of total billed charges,1558,100,,,percent of total billed charges,100% of total billed charges,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1558,100,,,percent of total billed charges,100% of total billed charges,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1558,100,,,percent of total billed charges,100% of total billed charges,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,963.62,61.85,,,percent of total billed charges,61.85% of total billed charges,343.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,447.08,130,,,Fee Schedule,130% of WA Medicaid ,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,587.37,37.7,,,percent of total billed charges,37.70% of total billed charges,587.37,37.7,,,percent of total billed charges,37.70% of total billed charges,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,52816.2,33.9,,,percent of total billed charges,33.9% of total billed charges,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1215.24,78,,,percent of total billed charges,78% of total billed charges,1558,100,,,percent of total billed charges,100% of total billed charges,1286.91,82.6,,,percent of total billed charges,82.6% of total billed charges,1286.91,82.6,,,percent of total billed charges,82.6% of total billed charges,343.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,62.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.45,52816.2,
REVISION OF CRANIAL NERVE,64716,CDM,983,RC,64716,HCPCS,Outpatient,,,1242,807.30,,1092.96,88,,,percent of total billed charges,88% of total Billed charges,46.19,100,,,Fee Schedule,100% of Medicare rate,296.54,100,,,Fee Schedule,100% of WA Medicaid,1242,100,,,percent of total billed charges,100% of total billed charges,305.44,103,,,Fee Schedule,103% of WA Medicaid,46.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,80.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,296.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,856.98,69,,,percent of total billed charges,69% of total billed charges,1242,100,,,percent of total billed charges,100% of total billed charges,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1242,100,,,percent of total billed charges,100% of total billed charges,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,1242,100,,,percent of total billed charges,100% of total billed charges,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,768.18,61.85,,,percent of total billed charges,61.85% of total billed charges,296.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,302.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,385.5,130,,,Fee Schedule,130% of WA Medicaid ,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.23,37.7,,,percent of total billed charges,37.70% of total billed charges,468.23,37.7,,,percent of total billed charges,37.70% of total billed charges,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,42103.8,33.9,,,percent of total billed charges,33.9% of total billed charges,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,968.76,78,,,percent of total billed charges,78% of total billed charges,1242,100,,,percent of total billed charges,100% of total billed charges,1025.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1025.89,82.6,,,percent of total billed charges,82.6% of total billed charges,296.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.19,42103.8,
REVISE ULNAR NERVE AT ELBOW,64718,CDM,983,RC,64718,HCPCS,Outpatient,,,1851,1203.15,,1628.88,88,,,percent of total billed charges,88% of total Billed charges,56.93,100,,,Fee Schedule,100% of Medicare rate,353.23,100,,,Fee Schedule,100% of WA Medicaid,1851,100,,,percent of total billed charges,100% of total billed charges,363.83,103,,,Fee Schedule,103% of WA Medicaid,56.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,99.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,353.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1277.19,69,,,percent of total billed charges,69% of total billed charges,1851,100,,,percent of total billed charges,100% of total billed charges,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1851,100,,,percent of total billed charges,100% of total billed charges,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1851,100,,,percent of total billed charges,100% of total billed charges,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1144.84,61.85,,,percent of total billed charges,61.85% of total billed charges,353.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,459.2,130,,,Fee Schedule,130% of WA Medicaid ,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.83,37.7,,,percent of total billed charges,37.70% of total billed charges,697.83,37.7,,,percent of total billed charges,37.70% of total billed charges,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,62748.9,33.9,,,percent of total billed charges,33.9% of total billed charges,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1443.78,78,,,percent of total billed charges,78% of total billed charges,1851,100,,,percent of total billed charges,100% of total billed charges,1528.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1528.93,82.6,,,percent of total billed charges,82.6% of total billed charges,353.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,56.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.93,62748.9,
REVISE ULNAR NERVE AT WRIST,64719,CDM,983,RC,64719,HCPCS,Outpatient,,,1413,918.45,,1243.44,88,,,percent of total billed charges,88% of total Billed charges,37.71,100,,,Fee Schedule,100% of Medicare rate,239.09,100,,,Fee Schedule,100% of WA Medicaid,1413,100,,,percent of total billed charges,100% of total billed charges,246.26,103,,,Fee Schedule,103% of WA Medicaid,37.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,239.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,974.97,69,,,percent of total billed charges,69% of total billed charges,1413,100,,,percent of total billed charges,100% of total billed charges,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1413,100,,,percent of total billed charges,100% of total billed charges,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1413,100,,,percent of total billed charges,100% of total billed charges,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,873.94,61.85,,,percent of total billed charges,61.85% of total billed charges,239.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,310.82,130,,,Fee Schedule,130% of WA Medicaid ,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,532.7,37.7,,,percent of total billed charges,37.70% of total billed charges,532.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,47900.7,33.9,,,percent of total billed charges,33.9% of total billed charges,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1102.14,78,,,percent of total billed charges,78% of total billed charges,1413,100,,,percent of total billed charges,100% of total billed charges,1167.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1167.14,82.6,,,percent of total billed charges,82.6% of total billed charges,239.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.71,47900.7,
INTERNAL NERVE REVISION,64727,CDM,983,RC,64727,HCPCS,Outpatient,,,995,646.75,,875.6,88,,,percent of total billed charges,88% of total Billed charges,13.91,100,,,Fee Schedule,100% of Medicare rate,101.46,100,,,Fee Schedule,100% of WA Medicaid,995,100,,,percent of total billed charges,100% of total billed charges,104.5,103,,,Fee Schedule,103% of WA Medicaid,13.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,101.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,686.55,69,,,percent of total billed charges,69% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,995,100,,,percent of total billed charges,100% of total billed charges,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,995,100,,,percent of total billed charges,100% of total billed charges,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,615.41,61.85,,,percent of total billed charges,61.85% of total billed charges,101.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,131.9,130,,,Fee Schedule,130% of WA Medicaid ,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,375.12,37.7,,,percent of total billed charges,37.70% of total billed charges,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,33730.5,33.9,,,percent of total billed charges,33.9% of total billed charges,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,776.1,78,,,percent of total billed charges,78% of total billed charges,995,100,,,percent of total billed charges,100% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,821.87,82.6,,,percent of total billed charges,82.6% of total billed charges,101.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.91,33730.5,
CARPAL TUNNEL SURGERY,64721,CDM,983,RC,64721,HCPCS,Outpatient,,,1407,914.55,,1238.16,88,,,percent of total billed charges,88% of total Billed charges,39.69,100,,,Fee Schedule,100% of Medicare rate,257.18,100,,,Fee Schedule,100% of WA Medicaid,1407,100,,,percent of total billed charges,100% of total billed charges,264.9,103,,,Fee Schedule,103% of WA Medicaid,39.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,257.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,970.83,69,,,percent of total billed charges,69% of total billed charges,1407,100,,,percent of total billed charges,100% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1407,100,,,percent of total billed charges,100% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1407,100,,,percent of total billed charges,100% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,870.23,61.85,,,percent of total billed charges,61.85% of total billed charges,257.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,334.33,130,,,Fee Schedule,130% of WA Medicaid ,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.44,37.7,,,percent of total billed charges,37.70% of total billed charges,530.44,37.7,,,percent of total billed charges,37.70% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,47697.3,33.9,,,percent of total billed charges,33.9% of total billed charges,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1097.46,78,,,percent of total billed charges,78% of total billed charges,1407,100,,,percent of total billed charges,100% of total billed charges,1162.18,82.6,,,percent of total billed charges,82.6% of total billed charges,1162.18,82.6,,,percent of total billed charges,82.6% of total billed charges,257.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.69,47697.3,
RELIEVE PRESSURE ON NERVE(S),64722,CDM,983,RC,64722,HCPCS,Outpatient,,,522,339.30,,459.36,88,,,percent of total billed charges,88% of total Billed charges,38.82,100,,,Fee Schedule,100% of Medicare rate,215.59,100,,,Fee Schedule,100% of WA Medicaid,522,100,,,percent of total billed charges,100% of total billed charges,222.06,103,,,Fee Schedule,103% of WA Medicaid,38.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,67.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,215.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,360.18,69,,,percent of total billed charges,69% of total billed charges,522,100,,,percent of total billed charges,100% of total billed charges,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,522,100,,,percent of total billed charges,100% of total billed charges,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,522,100,,,percent of total billed charges,100% of total billed charges,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.86,61.85,,,percent of total billed charges,61.85% of total billed charges,215.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,280.27,130,,,Fee Schedule,130% of WA Medicaid ,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,196.79,37.7,,,percent of total billed charges,37.70% of total billed charges,196.79,37.7,,,percent of total billed charges,37.70% of total billed charges,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,17695.8,33.9,,,percent of total billed charges,33.9% of total billed charges,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,407.16,78,,,percent of total billed charges,78% of total billed charges,522,100,,,percent of total billed charges,100% of total billed charges,431.17,82.6,,,percent of total billed charges,82.6% of total billed charges,431.17,82.6,,,percent of total billed charges,82.6% of total billed charges,215.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.82,17695.8,
INCISION OF JAW NERVE,64738,CDM,983,RC,64738,HCPCS,Outpatient,,,1244,808.60,,1094.72,88,,,percent of total billed charges,88% of total Billed charges,30.79,100,,,Fee Schedule,100% of Medicare rate,260.17,100,,,Fee Schedule,100% of WA Medicaid,1244,100,,,percent of total billed charges,100% of total billed charges,267.98,103,,,Fee Schedule,103% of WA Medicaid,30.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,260.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,858.36,69,,,percent of total billed charges,69% of total billed charges,1244,100,,,percent of total billed charges,100% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1244,100,,,percent of total billed charges,100% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,1244,100,,,percent of total billed charges,100% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,769.41,61.85,,,percent of total billed charges,61.85% of total billed charges,260.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,338.22,130,,,Fee Schedule,130% of WA Medicaid ,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,468.99,37.7,,,percent of total billed charges,37.70% of total billed charges,468.99,37.7,,,percent of total billed charges,37.70% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,42171.6,33.9,,,percent of total billed charges,33.9% of total billed charges,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,970.32,78,,,percent of total billed charges,78% of total billed charges,1244,100,,,percent of total billed charges,100% of total billed charges,1027.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1027.54,82.6,,,percent of total billed charges,82.6% of total billed charges,260.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,260.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.79,42171.6,
INCISION OF CHEEK NERVE,64734,CDM,983,RC,64734,HCPCS,Outpatient,,,1092,709.80,,960.96,88,,,percent of total billed charges,88% of total Billed charges,75.34,100,,,Fee Schedule,100% of Medicare rate,298.4,100,,,Fee Schedule,100% of WA Medicaid,1092,100,,,percent of total billed charges,100% of total billed charges,307.35,103,,,Fee Schedule,103% of WA Medicaid,75.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,131.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,298.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,753.48,69,,,percent of total billed charges,69% of total billed charges,1092,100,,,percent of total billed charges,100% of total billed charges,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1092,100,,,percent of total billed charges,100% of total billed charges,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1092,100,,,percent of total billed charges,100% of total billed charges,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,675.4,61.85,,,percent of total billed charges,61.85% of total billed charges,298.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,387.92,130,,,Fee Schedule,130% of WA Medicaid ,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,411.68,37.7,,,percent of total billed charges,37.70% of total billed charges,411.68,37.7,,,percent of total billed charges,37.70% of total billed charges,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,37018.8,33.9,,,percent of total billed charges,33.9% of total billed charges,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,851.76,78,,,percent of total billed charges,78% of total billed charges,1092,100,,,percent of total billed charges,100% of total billed charges,901.99,82.6,,,percent of total billed charges,82.6% of total billed charges,901.99,82.6,,,percent of total billed charges,82.6% of total billed charges,298.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.34,37018.8,
INCISION OF BROW NERVE,64732,CDM,983,RC,64732,HCPCS,Outpatient,,,971,631.15,,854.48,88,,,percent of total billed charges,88% of total Billed charges,66.55,100,,,Fee Schedule,100% of Medicare rate,264.46,100,,,Fee Schedule,100% of WA Medicaid,971,100,,,percent of total billed charges,100% of total billed charges,272.39,103,,,Fee Schedule,103% of WA Medicaid,66.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,116.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,264.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,669.99,69,,,percent of total billed charges,69% of total billed charges,971,100,,,percent of total billed charges,100% of total billed charges,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,971,100,,,percent of total billed charges,100% of total billed charges,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,971,100,,,percent of total billed charges,100% of total billed charges,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,600.56,61.85,,,percent of total billed charges,61.85% of total billed charges,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,343.8,130,,,Fee Schedule,130% of WA Medicaid ,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,366.07,37.7,,,percent of total billed charges,37.70% of total billed charges,366.07,37.7,,,percent of total billed charges,37.70% of total billed charges,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,32916.9,33.9,,,percent of total billed charges,33.9% of total billed charges,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,757.38,78,,,percent of total billed charges,78% of total billed charges,971,100,,,percent of total billed charges,100% of total billed charges,802.05,82.6,,,percent of total billed charges,82.6% of total billed charges,802.05,82.6,,,percent of total billed charges,82.6% of total billed charges,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,66.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.55,32916.9,
INCISION OF CHIN NERVE,64736,CDM,983,RC,64736,HCPCS,Outpatient,,,1038,674.70,,913.44,88,,,percent of total billed charges,88% of total Billed charges,23.04,100,,,Fee Schedule,100% of Medicare rate,191.35,100,,,Fee Schedule,100% of WA Medicaid,1038,100,,,percent of total billed charges,100% of total billed charges,197.09,103,,,Fee Schedule,103% of WA Medicaid,23.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,191.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,716.22,69,,,percent of total billed charges,69% of total billed charges,1038,100,,,percent of total billed charges,100% of total billed charges,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1038,100,,,percent of total billed charges,100% of total billed charges,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,1038,100,,,percent of total billed charges,100% of total billed charges,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,642,61.85,,,percent of total billed charges,61.85% of total billed charges,191.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,248.76,130,,,Fee Schedule,130% of WA Medicaid ,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.33,37.7,,,percent of total billed charges,37.70% of total billed charges,391.33,37.7,,,percent of total billed charges,37.70% of total billed charges,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,35188.2,33.9,,,percent of total billed charges,33.9% of total billed charges,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,809.64,78,,,percent of total billed charges,78% of total billed charges,1038,100,,,percent of total billed charges,100% of total billed charges,857.39,82.6,,,percent of total billed charges,82.6% of total billed charges,857.39,82.6,,,percent of total billed charges,82.6% of total billed charges,191.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.04,35188.2,
INCISION OF FACIAL NERVE,64742,CDM,983,RC,64742,HCPCS,Outpatient,,,1537,999.05,,1352.56,88,,,percent of total billed charges,88% of total Billed charges,28.81,100,,,Fee Schedule,100% of Medicare rate,287.02,100,,,Fee Schedule,100% of WA Medicaid,1537,100,,,percent of total billed charges,100% of total billed charges,295.63,103,,,Fee Schedule,103% of WA Medicaid,28.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,50.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,287.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1060.53,69,,,percent of total billed charges,69% of total billed charges,1537,100,,,percent of total billed charges,100% of total billed charges,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1537,100,,,percent of total billed charges,100% of total billed charges,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1537,100,,,percent of total billed charges,100% of total billed charges,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,950.63,61.85,,,percent of total billed charges,61.85% of total billed charges,287.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,373.13,130,,,Fee Schedule,130% of WA Medicaid ,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,579.45,37.7,,,percent of total billed charges,37.70% of total billed charges,579.45,37.7,,,percent of total billed charges,37.70% of total billed charges,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,52104.3,33.9,,,percent of total billed charges,33.9% of total billed charges,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1198.86,78,,,percent of total billed charges,78% of total billed charges,1537,100,,,percent of total billed charges,100% of total billed charges,1269.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1269.56,82.6,,,percent of total billed charges,82.6% of total billed charges,287.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,287.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.81,52104.3,
INCISE NERVE BACK OF HEAD,64744,CDM,983,RC,64744,HCPCS,Outpatient,,,1117,726.05,,982.96,88,,,percent of total billed charges,88% of total Billed charges,76.89,100,,,Fee Schedule,100% of Medicare rate,293.18,100,,,Fee Schedule,100% of WA Medicaid,1117,100,,,percent of total billed charges,100% of total billed charges,301.98,103,,,Fee Schedule,103% of WA Medicaid,76.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,134.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,293.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,770.73,69,,,percent of total billed charges,69% of total billed charges,1117,100,,,percent of total billed charges,100% of total billed charges,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117,100,,,percent of total billed charges,100% of total billed charges,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117,100,,,percent of total billed charges,100% of total billed charges,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,690.86,61.85,,,percent of total billed charges,61.85% of total billed charges,293.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,299.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,381.13,130,,,Fee Schedule,130% of WA Medicaid ,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.11,37.7,,,percent of total billed charges,37.70% of total billed charges,421.11,37.7,,,percent of total billed charges,37.70% of total billed charges,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,37866.3,33.9,,,percent of total billed charges,33.9% of total billed charges,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,871.26,78,,,percent of total billed charges,78% of total billed charges,1117,100,,,percent of total billed charges,100% of total billed charges,922.64,82.6,,,percent of total billed charges,82.6% of total billed charges,922.64,82.6,,,percent of total billed charges,82.6% of total billed charges,293.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,293.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.89,37866.3,
INCISION OF TONGUE NERVE,64740,CDM,983,RC,64740,HCPCS,Outpatient,,,1479,961.35,,1301.52,88,,,percent of total billed charges,88% of total Billed charges,30.31,100,,,Fee Schedule,100% of Medicare rate,266.14,100,,,Fee Schedule,100% of WA Medicaid,1479,100,,,percent of total billed charges,100% of total billed charges,274.12,103,,,Fee Schedule,103% of WA Medicaid,30.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,53.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,266.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1020.51,69,,,percent of total billed charges,69% of total billed charges,1479,100,,,percent of total billed charges,100% of total billed charges,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1479,100,,,percent of total billed charges,100% of total billed charges,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1479,100,,,percent of total billed charges,100% of total billed charges,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,914.76,61.85,,,percent of total billed charges,61.85% of total billed charges,266.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,271.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,345.98,130,,,Fee Schedule,130% of WA Medicaid ,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.58,37.7,,,percent of total billed charges,37.70% of total billed charges,557.58,37.7,,,percent of total billed charges,37.70% of total billed charges,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,50138.1,33.9,,,percent of total billed charges,33.9% of total billed charges,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1153.62,78,,,percent of total billed charges,78% of total billed charges,1479,100,,,percent of total billed charges,100% of total billed charges,1221.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1221.65,82.6,,,percent of total billed charges,82.6% of total billed charges,266.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,266.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.31,50138.1,
REMOVE SKIN NERVE LESION,64774,CDM,983,RC,64774,HCPCS,Outpatient,,,1036,673.40,,911.68,88,,,percent of total billed charges,88% of total Billed charges,43.14,100,,,Fee Schedule,100% of Medicare rate,248.23,100,,,Fee Schedule,100% of WA Medicaid,1036,100,,,percent of total billed charges,100% of total billed charges,255.68,103,,,Fee Schedule,103% of WA Medicaid,43.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,248.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,714.84,69,,,percent of total billed charges,69% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1036,100,,,percent of total billed charges,100% of total billed charges,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1036,100,,,percent of total billed charges,100% of total billed charges,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,640.77,61.85,,,percent of total billed charges,61.85% of total billed charges,248.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,253.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,322.7,130,,,Fee Schedule,130% of WA Medicaid ,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,390.57,37.7,,,percent of total billed charges,37.70% of total billed charges,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,35120.4,33.9,,,percent of total billed charges,33.9% of total billed charges,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,808.08,78,,,percent of total billed charges,78% of total billed charges,1036,100,,,percent of total billed charges,100% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,855.74,82.6,,,percent of total billed charges,82.6% of total billed charges,248.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,43.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,248.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,43.14,35120.4,
SEVER CRANIAL NERVE,64771,CDM,983,RC,64771,HCPCS,Outpatient,,,1591,1034.15,,1400.08,88,,,percent of total billed charges,88% of total Billed charges,57.76,100,,,Fee Schedule,100% of Medicare rate,333.65,100,,,Fee Schedule,100% of WA Medicaid,1591,100,,,percent of total billed charges,100% of total billed charges,343.66,103,,,Fee Schedule,103% of WA Medicaid,57.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,333.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1097.79,69,,,percent of total billed charges,69% of total billed charges,1591,100,,,percent of total billed charges,100% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1591,100,,,percent of total billed charges,100% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1591,100,,,percent of total billed charges,100% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,984.03,61.85,,,percent of total billed charges,61.85% of total billed charges,333.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,433.75,130,,,Fee Schedule,130% of WA Medicaid ,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,599.81,37.7,,,percent of total billed charges,37.70% of total billed charges,599.81,37.7,,,percent of total billed charges,37.70% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,53934.9,33.9,,,percent of total billed charges,33.9% of total billed charges,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240.98,78,,,percent of total billed charges,78% of total billed charges,1591,100,,,percent of total billed charges,100% of total billed charges,1314.17,82.6,,,percent of total billed charges,82.6% of total billed charges,1314.17,82.6,,,percent of total billed charges,82.6% of total billed charges,333.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,57.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,333.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,57.76,53934.9,
LIMB NERVE SURGERY ADD-ON,64783,CDM,983,RC,64783,HCPCS,Outpatient,,,823,534.95,,724.24,88,,,percent of total billed charges,88% of total Billed charges,26.04,100,,,Fee Schedule,100% of Medicare rate,119.55,100,,,Fee Schedule,100% of WA Medicaid,823,100,,,percent of total billed charges,100% of total billed charges,123.14,103,,,Fee Schedule,103% of WA Medicaid,26.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,119.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,567.87,69,,,percent of total billed charges,69% of total billed charges,823,100,,,percent of total billed charges,100% of total billed charges,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,823,100,,,percent of total billed charges,100% of total billed charges,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,823,100,,,percent of total billed charges,100% of total billed charges,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,509.03,61.85,,,percent of total billed charges,61.85% of total billed charges,119.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,155.42,130,,,Fee Schedule,130% of WA Medicaid ,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.27,37.7,,,percent of total billed charges,37.70% of total billed charges,310.27,37.7,,,percent of total billed charges,37.70% of total billed charges,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,27899.7,33.9,,,percent of total billed charges,33.9% of total billed charges,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,641.94,78,,,percent of total billed charges,78% of total billed charges,823,100,,,percent of total billed charges,100% of total billed charges,679.8,82.6,,,percent of total billed charges,82.6% of total billed charges,679.8,82.6,,,percent of total billed charges,82.6% of total billed charges,119.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.04,27899.7,
REMOVE NERVE LESION,64784,CDM,983,RC,64784,HCPCS,Outpatient,,,1950,1267.50,,1716,88,,,percent of total billed charges,88% of total Billed charges,75.85,100,,,Fee Schedule,100% of Medicare rate,415.9,100,,,Fee Schedule,100% of WA Medicaid,1950,100,,,percent of total billed charges,100% of total billed charges,428.38,103,,,Fee Schedule,103% of WA Medicaid,75.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,132.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,415.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1345.5,69,,,percent of total billed charges,69% of total billed charges,1950,100,,,percent of total billed charges,100% of total billed charges,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1950,100,,,percent of total billed charges,100% of total billed charges,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1950,100,,,percent of total billed charges,100% of total billed charges,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1206.08,61.85,,,percent of total billed charges,61.85% of total billed charges,415.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,424.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,540.67,130,,,Fee Schedule,130% of WA Medicaid ,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,735.15,37.7,,,percent of total billed charges,37.70% of total billed charges,735.15,37.7,,,percent of total billed charges,37.70% of total billed charges,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,66105,33.9,,,percent of total billed charges,33.9% of total billed charges,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1521,78,,,percent of total billed charges,78% of total billed charges,1950,100,,,percent of total billed charges,100% of total billed charges,1610.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1610.7,82.6,,,percent of total billed charges,82.6% of total billed charges,415.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,75.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,75.85,66105,
REMOVE SKIN NERVE LESION,64788,CDM,983,RC,64788,HCPCS,Outpatient,,,955,620.75,,840.4,88,,,percent of total billed charges,88% of total Billed charges,40.25,100,,,Fee Schedule,100% of Medicare rate,237.97,100,,,Fee Schedule,100% of WA Medicaid,955,100,,,percent of total billed charges,100% of total billed charges,245.11,103,,,Fee Schedule,103% of WA Medicaid,40.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,70.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,237.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,658.95,69,,,percent of total billed charges,69% of total billed charges,955,100,,,percent of total billed charges,100% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,955,100,,,percent of total billed charges,100% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,955,100,,,percent of total billed charges,100% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,590.67,61.85,,,percent of total billed charges,61.85% of total billed charges,237.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,242.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,309.36,130,,,Fee Schedule,130% of WA Medicaid ,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.04,37.7,,,percent of total billed charges,37.70% of total billed charges,360.04,37.7,,,percent of total billed charges,37.70% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,32374.5,33.9,,,percent of total billed charges,33.9% of total billed charges,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,744.9,78,,,percent of total billed charges,78% of total billed charges,955,100,,,percent of total billed charges,100% of total billed charges,788.83,82.6,,,percent of total billed charges,82.6% of total billed charges,788.83,82.6,,,percent of total billed charges,82.6% of total billed charges,237.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,40.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,237.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.25,32374.5,
REMOVE LIMB NERVE LESION,64782,CDM,983,RC,64782,HCPCS,Outpatient,,,1585,1030.25,,1394.8,88,,,percent of total billed charges,88% of total Billed charges,39.03,100,,,Fee Schedule,100% of Medicare rate,263.71,100,,,Fee Schedule,100% of WA Medicaid,1585,100,,,percent of total billed charges,100% of total billed charges,271.62,103,,,Fee Schedule,103% of WA Medicaid,39.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,263.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1093.65,69,,,percent of total billed charges,69% of total billed charges,1585,100,,,percent of total billed charges,100% of total billed charges,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1585,100,,,percent of total billed charges,100% of total billed charges,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1585,100,,,percent of total billed charges,100% of total billed charges,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,980.32,61.85,,,percent of total billed charges,61.85% of total billed charges,263.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,268.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,342.82,130,,,Fee Schedule,130% of WA Medicaid ,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,597.55,37.7,,,percent of total billed charges,37.70% of total billed charges,597.55,37.7,,,percent of total billed charges,37.70% of total billed charges,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,53731.5,33.9,,,percent of total billed charges,33.9% of total billed charges,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1236.3,78,,,percent of total billed charges,78% of total billed charges,1585,100,,,percent of total billed charges,100% of total billed charges,1309.21,82.6,,,percent of total billed charges,82.6% of total billed charges,1309.21,82.6,,,percent of total billed charges,82.6% of total billed charges,263.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.03,53731.5,
REMOVAL OF NERVE LESION,64792,CDM,983,RC,64792,HCPCS,Outpatient,,,2849,1851.85,,2507.12,88,,,percent of total billed charges,88% of total Billed charges,137.87,100,,,Fee Schedule,100% of Medicare rate,612.47,100,,,Fee Schedule,100% of WA Medicaid,2849,100,,,percent of total billed charges,100% of total billed charges,630.84,103,,,Fee Schedule,103% of WA Medicaid,137.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,241.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,612.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1965.81,69,,,percent of total billed charges,69% of total billed charges,2849,100,,,percent of total billed charges,100% of total billed charges,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2849,100,,,percent of total billed charges,100% of total billed charges,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2849,100,,,percent of total billed charges,100% of total billed charges,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1762.11,61.85,,,percent of total billed charges,61.85% of total billed charges,612.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,796.21,130,,,Fee Schedule,130% of WA Medicaid ,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074.07,37.7,,,percent of total billed charges,37.70% of total billed charges,1074.07,37.7,,,percent of total billed charges,37.70% of total billed charges,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,96581.1,33.9,,,percent of total billed charges,33.9% of total billed charges,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,2222.22,78,,,percent of total billed charges,78% of total billed charges,2849,100,,,percent of total billed charges,100% of total billed charges,2353.27,82.6,,,percent of total billed charges,82.6% of total billed charges,2353.27,82.6,,,percent of total billed charges,82.6% of total billed charges,612.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,137.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,137.87,96581.1,
REMOVAL OF NERVE LESION,64790,CDM,983,RC,64790,HCPCS,Outpatient,,,2247,1460.55,,1977.36,88,,,percent of total billed charges,88% of total Billed charges,107.31,100,,,Fee Schedule,100% of Medicare rate,486.02,100,,,Fee Schedule,100% of WA Medicaid,2247,100,,,percent of total billed charges,100% of total billed charges,500.6,103,,,Fee Schedule,103% of WA Medicaid,107.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,187.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,486.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1550.43,69,,,percent of total billed charges,69% of total billed charges,2247,100,,,percent of total billed charges,100% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2247,100,,,percent of total billed charges,100% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,2247,100,,,percent of total billed charges,100% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1389.77,61.85,,,percent of total billed charges,61.85% of total billed charges,486.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,495.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,631.83,130,,,Fee Schedule,130% of WA Medicaid ,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.12,37.7,,,percent of total billed charges,37.70% of total billed charges,847.12,37.7,,,percent of total billed charges,37.70% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,76173.3,33.9,,,percent of total billed charges,33.9% of total billed charges,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,1752.66,78,,,percent of total billed charges,78% of total billed charges,2247,100,,,percent of total billed charges,100% of total billed charges,1856.02,82.6,,,percent of total billed charges,82.6% of total billed charges,1856.02,82.6,,,percent of total billed charges,82.6% of total billed charges,486.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,107.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,107.31,76173.3,
BIOPSY OF NERVE,64795,CDM,983,RC,64795,HCPCS,Outpatient,,,895,581.75,,787.6,88,,,percent of total billed charges,88% of total Billed charges,28.35,100,,,Fee Schedule,100% of Medicare rate,109.48,100,,,Fee Schedule,100% of WA Medicaid,895,100,,,percent of total billed charges,100% of total billed charges,112.76,103,,,Fee Schedule,103% of WA Medicaid,28.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,109.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,617.55,69,,,percent of total billed charges,69% of total billed charges,895,100,,,percent of total billed charges,100% of total billed charges,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,895,100,,,percent of total billed charges,100% of total billed charges,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,895,100,,,percent of total billed charges,100% of total billed charges,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,553.56,61.85,,,percent of total billed charges,61.85% of total billed charges,109.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,142.32,130,,,Fee Schedule,130% of WA Medicaid ,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.42,37.7,,,percent of total billed charges,37.70% of total billed charges,337.42,37.7,,,percent of total billed charges,37.70% of total billed charges,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,30340.5,33.9,,,percent of total billed charges,33.9% of total billed charges,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,698.1,78,,,percent of total billed charges,78% of total billed charges,895,100,,,percent of total billed charges,100% of total billed charges,739.27,82.6,,,percent of total billed charges,82.6% of total billed charges,739.27,82.6,,,percent of total billed charges,82.6% of total billed charges,109.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.35,30340.5,
REMOVE SYMPATHETIC NERVES,64804,CDM,983,RC,64804,HCPCS,Outpatient,,,2806,1823.90,,2469.28,88,,,percent of total billed charges,88% of total Billed charges,207.5,100,,,Fee Schedule,100% of Medicare rate,678.3,100,,,Fee Schedule,100% of WA Medicaid,2806,100,,,percent of total billed charges,100% of total billed charges,698.65,103,,,Fee Schedule,103% of WA Medicaid,207.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,363.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,678.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1936.14,69,,,percent of total billed charges,69% of total billed charges,2806,100,,,percent of total billed charges,100% of total billed charges,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2806,100,,,percent of total billed charges,100% of total billed charges,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2806,100,,,percent of total billed charges,100% of total billed charges,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1735.51,61.85,,,percent of total billed charges,61.85% of total billed charges,678.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,691.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,881.79,130,,,Fee Schedule,130% of WA Medicaid ,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,1057.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1057.86,37.7,,,percent of total billed charges,37.70% of total billed charges,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,95123.4,33.9,,,percent of total billed charges,33.9% of total billed charges,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,2188.68,78,,,percent of total billed charges,78% of total billed charges,2806,100,,,percent of total billed charges,100% of total billed charges,2317.76,82.6,,,percent of total billed charges,82.6% of total billed charges,2317.76,82.6,,,percent of total billed charges,82.6% of total billed charges,678.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,207.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,678.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,207.5,95123.4,
REMOVE SYMPATHETIC NERVES,64809,CDM,983,RC,64809,HCPCS,Outpatient,,,2770,1800.50,,2437.6,88,,,percent of total billed charges,88% of total Billed charges,191.43,100,,,Fee Schedule,100% of Medicare rate,619.37,100,,,Fee Schedule,100% of WA Medicaid,2770,100,,,percent of total billed charges,100% of total billed charges,637.95,103,,,Fee Schedule,103% of WA Medicaid,191.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,335,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,619.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1911.3,69,,,percent of total billed charges,69% of total billed charges,2770,100,,,percent of total billed charges,100% of total billed charges,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2770,100,,,percent of total billed charges,100% of total billed charges,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2770,100,,,percent of total billed charges,100% of total billed charges,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1713.25,61.85,,,percent of total billed charges,61.85% of total billed charges,619.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,619.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,631.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,805.18,130,,,Fee Schedule,130% of WA Medicaid ,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,1044.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1044.29,37.7,,,percent of total billed charges,37.70% of total billed charges,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,93903,33.9,,,percent of total billed charges,33.9% of total billed charges,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,2160.6,78,,,percent of total billed charges,78% of total billed charges,2770,100,,,percent of total billed charges,100% of total billed charges,2288.02,82.6,,,percent of total billed charges,82.6% of total billed charges,2288.02,82.6,,,percent of total billed charges,82.6% of total billed charges,619.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,191.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,619.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,191.43,93903,
SYMPATHECTOMY CERVICAL,64802,CDM,983,RC,64802,HCPCS,Outpatient,,,1863,1210.95,,1639.44,88,,,percent of total billed charges,88% of total Billed charges,137.41,100,,,Fee Schedule,100% of Medicare rate,486.39,100,,,Fee Schedule,100% of WA Medicaid,1863,100,,,percent of total billed charges,100% of total billed charges,500.98,103,,,Fee Schedule,103% of WA Medicaid,137.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,240.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,486.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1285.47,69,,,percent of total billed charges,69% of total billed charges,1863,100,,,percent of total billed charges,100% of total billed charges,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1863,100,,,percent of total billed charges,100% of total billed charges,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1863,100,,,percent of total billed charges,100% of total billed charges,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152.27,61.85,,,percent of total billed charges,61.85% of total billed charges,486.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,632.31,130,,,Fee Schedule,130% of WA Medicaid ,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,702.35,37.7,,,percent of total billed charges,37.70% of total billed charges,702.35,37.7,,,percent of total billed charges,37.70% of total billed charges,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,63155.7,33.9,,,percent of total billed charges,33.9% of total billed charges,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1453.14,78,,,percent of total billed charges,78% of total billed charges,1863,100,,,percent of total billed charges,100% of total billed charges,1538.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1538.84,82.6,,,percent of total billed charges,82.6% of total billed charges,486.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,137.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,486.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,137.41,63155.7,
REMOVE SYMPATHETIC NERVES,64818,CDM,983,RC,64818,HCPCS,Outpatient,,,1954,1270.10,,1719.52,88,,,percent of total billed charges,88% of total Billed charges,83.94,100,,,Fee Schedule,100% of Medicare rate,446.29,100,,,Fee Schedule,100% of WA Medicaid,1954,100,,,percent of total billed charges,100% of total billed charges,459.68,103,,,Fee Schedule,103% of WA Medicaid,83.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,146.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,446.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1348.26,69,,,percent of total billed charges,69% of total billed charges,1954,100,,,percent of total billed charges,100% of total billed charges,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1954,100,,,percent of total billed charges,100% of total billed charges,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1954,100,,,percent of total billed charges,100% of total billed charges,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1208.55,61.85,,,percent of total billed charges,61.85% of total billed charges,446.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,455.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,580.18,130,,,Fee Schedule,130% of WA Medicaid ,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.66,37.7,,,percent of total billed charges,37.70% of total billed charges,736.66,37.7,,,percent of total billed charges,37.70% of total billed charges,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,66240.6,33.9,,,percent of total billed charges,33.9% of total billed charges,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1524.12,78,,,percent of total billed charges,78% of total billed charges,1954,100,,,percent of total billed charges,100% of total billed charges,1614,82.6,,,percent of total billed charges,82.6% of total billed charges,1614,82.6,,,percent of total billed charges,82.6% of total billed charges,446.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,83.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,83.94,66240.6,
REPAIR NERVE ADD-ON,64832,CDM,983,RC,64832,HCPCS,Outpatient,,,1032,670.80,,908.16,88,,,percent of total billed charges,88% of total Billed charges,37.82,100,,,Fee Schedule,100% of Medicare rate,185.75,100,,,Fee Schedule,100% of WA Medicaid,1032,100,,,percent of total billed charges,100% of total billed charges,191.32,103,,,Fee Schedule,103% of WA Medicaid,37.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,185.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,712.08,69,,,percent of total billed charges,69% of total billed charges,1032,100,,,percent of total billed charges,100% of total billed charges,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032,100,,,percent of total billed charges,100% of total billed charges,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032,100,,,percent of total billed charges,100% of total billed charges,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,638.29,61.85,,,percent of total billed charges,61.85% of total billed charges,185.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,241.48,130,,,Fee Schedule,130% of WA Medicaid ,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.06,37.7,,,percent of total billed charges,37.70% of total billed charges,389.06,37.7,,,percent of total billed charges,37.70% of total billed charges,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,34984.8,33.9,,,percent of total billed charges,33.9% of total billed charges,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.96,78,,,percent of total billed charges,78% of total billed charges,1032,100,,,percent of total billed charges,100% of total billed charges,852.43,82.6,,,percent of total billed charges,82.6% of total billed charges,852.43,82.6,,,percent of total billed charges,82.6% of total billed charges,185.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,37.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.82,34984.8,
REPAIR OF HAND OR FOOT NERVE,64834,CDM,983,RC,64834,HCPCS,Outpatient,,,1984,1289.60,,1745.92,88,,,percent of total billed charges,88% of total Billed charges,70.58,100,,,Fee Schedule,100% of Medicare rate,429.32,100,,,Fee Schedule,100% of WA Medicaid,1984,100,,,percent of total billed charges,100% of total billed charges,442.2,103,,,Fee Schedule,103% of WA Medicaid,70.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,123.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,429.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1368.96,69,,,percent of total billed charges,69% of total billed charges,1984,100,,,percent of total billed charges,100% of total billed charges,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1984,100,,,percent of total billed charges,100% of total billed charges,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1984,100,,,percent of total billed charges,100% of total billed charges,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1227.1,61.85,,,percent of total billed charges,61.85% of total billed charges,429.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,437.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,558.12,130,,,Fee Schedule,130% of WA Medicaid ,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,747.97,37.7,,,percent of total billed charges,37.70% of total billed charges,747.97,37.7,,,percent of total billed charges,37.70% of total billed charges,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,67257.6,33.9,,,percent of total billed charges,33.9% of total billed charges,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1547.52,78,,,percent of total billed charges,78% of total billed charges,1984,100,,,percent of total billed charges,100% of total billed charges,1638.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1638.78,82.6,,,percent of total billed charges,82.6% of total billed charges,429.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,70.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,429.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.58,67257.6,
REPAIR OF DIGIT NERVE,64831,CDM,983,RC,64831,HCPCS,Outpatient,,,1954,1270.10,,1719.52,88,,,percent of total billed charges,88% of total Billed charges,65.52,100,,,Fee Schedule,100% of Medicare rate,402.84,100,,,Fee Schedule,100% of WA Medicaid,1954,100,,,percent of total billed charges,100% of total billed charges,414.93,103,,,Fee Schedule,103% of WA Medicaid,65.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,402.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1348.26,69,,,percent of total billed charges,69% of total billed charges,1954,100,,,percent of total billed charges,100% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1954,100,,,percent of total billed charges,100% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1954,100,,,percent of total billed charges,100% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1208.55,61.85,,,percent of total billed charges,61.85% of total billed charges,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,523.69,130,,,Fee Schedule,130% of WA Medicaid ,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,736.66,37.7,,,percent of total billed charges,37.70% of total billed charges,736.66,37.7,,,percent of total billed charges,37.70% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,66240.6,33.9,,,percent of total billed charges,33.9% of total billed charges,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1524.12,78,,,percent of total billed charges,78% of total billed charges,1954,100,,,percent of total billed charges,100% of total billed charges,1614,82.6,,,percent of total billed charges,82.6% of total billed charges,1614,82.6,,,percent of total billed charges,82.6% of total billed charges,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,402.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.52,66240.6,
REPAIR NERVE ADD-ON,64837,CDM,983,RC,64837,HCPCS,Outpatient,,,1385,900.25,,1218.8,88,,,percent of total billed charges,88% of total Billed charges,44.13,100,,,Fee Schedule,100% of Medicare rate,201.98,100,,,Fee Schedule,100% of WA Medicaid,1385,100,,,percent of total billed charges,100% of total billed charges,208.04,103,,,Fee Schedule,103% of WA Medicaid,44.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,77.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,201.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,955.65,69,,,percent of total billed charges,69% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385,100,,,percent of total billed charges,100% of total billed charges,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1385,100,,,percent of total billed charges,100% of total billed charges,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,856.62,61.85,,,percent of total billed charges,61.85% of total billed charges,201.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,262.57,130,,,Fee Schedule,130% of WA Medicaid ,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,522.15,37.7,,,percent of total billed charges,37.70% of total billed charges,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,46951.5,33.9,,,percent of total billed charges,33.9% of total billed charges,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1080.3,78,,,percent of total billed charges,78% of total billed charges,1385,100,,,percent of total billed charges,100% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,1144.01,82.6,,,percent of total billed charges,82.6% of total billed charges,201.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.13,46951.5,
REPAIR OF HAND OR FOOT NERVE,64835,CDM,983,RC,64835,HCPCS,Outpatient,,,2207,1434.55,,1942.16,88,,,percent of total billed charges,88% of total Billed charges,87.2,100,,,Fee Schedule,100% of Medicare rate,469.05,100,,,Fee Schedule,100% of WA Medicaid,2207,100,,,percent of total billed charges,100% of total billed charges,483.12,103,,,Fee Schedule,103% of WA Medicaid,87.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,152.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,469.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1522.83,69,,,percent of total billed charges,69% of total billed charges,2207,100,,,percent of total billed charges,100% of total billed charges,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2207,100,,,percent of total billed charges,100% of total billed charges,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2207,100,,,percent of total billed charges,100% of total billed charges,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1365.03,61.85,,,percent of total billed charges,61.85% of total billed charges,469.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,609.77,130,,,Fee Schedule,130% of WA Medicaid ,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,832.04,37.7,,,percent of total billed charges,37.70% of total billed charges,832.04,37.7,,,percent of total billed charges,37.70% of total billed charges,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,74817.3,33.9,,,percent of total billed charges,33.9% of total billed charges,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1721.46,78,,,percent of total billed charges,78% of total billed charges,2207,100,,,percent of total billed charges,100% of total billed charges,1822.98,82.6,,,percent of total billed charges,82.6% of total billed charges,1822.98,82.6,,,percent of total billed charges,82.6% of total billed charges,469.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.2,74817.3,
REPAIR OF HAND OR FOOT NERVE,64836,CDM,983,RC,64836,HCPCS,Outpatient,,,2208,1435.20,,1943.04,88,,,percent of total billed charges,88% of total Billed charges,87.2,100,,,Fee Schedule,100% of Medicare rate,469.05,100,,,Fee Schedule,100% of WA Medicaid,2208,100,,,percent of total billed charges,100% of total billed charges,483.12,103,,,Fee Schedule,103% of WA Medicaid,87.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,152.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,469.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1523.52,69,,,percent of total billed charges,69% of total billed charges,2208,100,,,percent of total billed charges,100% of total billed charges,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2208,100,,,percent of total billed charges,100% of total billed charges,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2208,100,,,percent of total billed charges,100% of total billed charges,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1365.65,61.85,,,percent of total billed charges,61.85% of total billed charges,469.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,478.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,609.77,130,,,Fee Schedule,130% of WA Medicaid ,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,832.42,37.7,,,percent of total billed charges,37.70% of total billed charges,832.42,37.7,,,percent of total billed charges,37.70% of total billed charges,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,74851.2,33.9,,,percent of total billed charges,33.9% of total billed charges,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1722.24,78,,,percent of total billed charges,78% of total billed charges,2208,100,,,percent of total billed charges,100% of total billed charges,1823.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1823.81,82.6,,,percent of total billed charges,82.6% of total billed charges,469.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.2,74851.2,
REPAIR OF LEG NERVE,64840,CDM,983,RC,64840,HCPCS,Outpatient,,,4331,2815.15,,3811.28,88,,,percent of total billed charges,88% of total Billed charges,103.73,100,,,Fee Schedule,100% of Medicare rate,551.11,100,,,Fee Schedule,100% of WA Medicaid,4331,100,,,percent of total billed charges,100% of total billed charges,567.64,103,,,Fee Schedule,103% of WA Medicaid,103.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,181.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,551.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2988.39,69,,,percent of total billed charges,69% of total billed charges,4331,100,,,percent of total billed charges,100% of total billed charges,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4331,100,,,percent of total billed charges,100% of total billed charges,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4331,100,,,percent of total billed charges,100% of total billed charges,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2678.72,61.85,,,percent of total billed charges,61.85% of total billed charges,551.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,562.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,716.44,130,,,Fee Schedule,130% of WA Medicaid ,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1632.79,37.7,,,percent of total billed charges,37.70% of total billed charges,1632.79,37.7,,,percent of total billed charges,37.70% of total billed charges,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,146820.9,33.9,,,percent of total billed charges,33.9% of total billed charges,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,3378.18,78,,,percent of total billed charges,78% of total billed charges,4331,100,,,percent of total billed charges,100% of total billed charges,3577.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3577.41,82.6,,,percent of total billed charges,82.6% of total billed charges,551.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,103.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,551.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,103.73,146820.9,
REPAIR/TRANSPOSE NERVE,64856,CDM,983,RC,64856,HCPCS,Outpatient,,,2740,1781.00,,2411.2,88,,,percent of total billed charges,88% of total Billed charges,111.17,100,,,Fee Schedule,100% of Medicare rate,573.86,100,,,Fee Schedule,100% of WA Medicaid,2740,100,,,percent of total billed charges,100% of total billed charges,591.08,103,,,Fee Schedule,103% of WA Medicaid,111.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,194.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,573.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1890.6,69,,,percent of total billed charges,69% of total billed charges,2740,100,,,percent of total billed charges,100% of total billed charges,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2740,100,,,percent of total billed charges,100% of total billed charges,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2740,100,,,percent of total billed charges,100% of total billed charges,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1694.69,61.85,,,percent of total billed charges,61.85% of total billed charges,573.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,573.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,585.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,746.02,130,,,Fee Schedule,130% of WA Medicaid ,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032.98,37.7,,,percent of total billed charges,37.70% of total billed charges,1032.98,37.7,,,percent of total billed charges,37.70% of total billed charges,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,92886,33.9,,,percent of total billed charges,33.9% of total billed charges,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2137.2,78,,,percent of total billed charges,78% of total billed charges,2740,100,,,percent of total billed charges,100% of total billed charges,2263.24,82.6,,,percent of total billed charges,82.6% of total billed charges,2263.24,82.6,,,percent of total billed charges,82.6% of total billed charges,573.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,111.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,573.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.17,92886,
REPAIR ARM/LEG NERVE,64857,CDM,983,RC,64857,HCPCS,Outpatient,,,2873,1867.45,,2528.24,88,,,percent of total billed charges,88% of total Billed charges,114.11,100,,,Fee Schedule,100% of Medicare rate,600.16,100,,,Fee Schedule,100% of WA Medicaid,2873,100,,,percent of total billed charges,100% of total billed charges,618.16,103,,,Fee Schedule,103% of WA Medicaid,114.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,199.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,600.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1982.37,69,,,percent of total billed charges,69% of total billed charges,2873,100,,,percent of total billed charges,100% of total billed charges,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2873,100,,,percent of total billed charges,100% of total billed charges,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2873,100,,,percent of total billed charges,100% of total billed charges,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1776.95,61.85,,,percent of total billed charges,61.85% of total billed charges,600.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,600.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,780.21,130,,,Fee Schedule,130% of WA Medicaid ,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1083.12,37.7,,,percent of total billed charges,37.70% of total billed charges,1083.12,37.7,,,percent of total billed charges,37.70% of total billed charges,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,97394.7,33.9,,,percent of total billed charges,33.9% of total billed charges,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2240.94,78,,,percent of total billed charges,78% of total billed charges,2873,100,,,percent of total billed charges,100% of total billed charges,2373.1,82.6,,,percent of total billed charges,82.6% of total billed charges,2373.1,82.6,,,percent of total billed charges,82.6% of total billed charges,600.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,114.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,600.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,114.11,97394.7,
NERVE SURGERY,64859,CDM,983,RC,64859,HCPCS,Outpatient,,,791,514.15,,696.08,88,,,percent of total billed charges,88% of total Billed charges,30.08,100,,,Fee Schedule,100% of Medicare rate,137.26,100,,,Fee Schedule,100% of WA Medicaid,791,100,,,percent of total billed charges,100% of total billed charges,141.38,103,,,Fee Schedule,103% of WA Medicaid,30.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,52.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,137.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,545.79,69,,,percent of total billed charges,69% of total billed charges,791,100,,,percent of total billed charges,100% of total billed charges,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,791,100,,,percent of total billed charges,100% of total billed charges,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,791,100,,,percent of total billed charges,100% of total billed charges,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,489.23,61.85,,,percent of total billed charges,61.85% of total billed charges,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,178.44,130,,,Fee Schedule,130% of WA Medicaid ,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,298.21,37.7,,,percent of total billed charges,37.70% of total billed charges,298.21,37.7,,,percent of total billed charges,37.70% of total billed charges,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,26814.9,33.9,,,percent of total billed charges,33.9% of total billed charges,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,616.98,78,,,percent of total billed charges,78% of total billed charges,791,100,,,percent of total billed charges,100% of total billed charges,653.37,82.6,,,percent of total billed charges,82.6% of total billed charges,653.37,82.6,,,percent of total billed charges,82.6% of total billed charges,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,30.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,30.08,26814.9,
REPAIR SCIATIC NERVE,64858,CDM,983,RC,64858,HCPCS,Outpatient,,,3348,2176.20,,2946.24,88,,,percent of total billed charges,88% of total Billed charges,130.96,100,,,Fee Schedule,100% of Medicare rate,668.79,100,,,Fee Schedule,100% of WA Medicaid,3348,100,,,percent of total billed charges,100% of total billed charges,688.85,103,,,Fee Schedule,103% of WA Medicaid,130.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,229.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,668.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2310.12,69,,,percent of total billed charges,69% of total billed charges,3348,100,,,percent of total billed charges,100% of total billed charges,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3348,100,,,percent of total billed charges,100% of total billed charges,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,3348,100,,,percent of total billed charges,100% of total billed charges,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2070.74,61.85,,,percent of total billed charges,61.85% of total billed charges,668.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,682.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,869.43,130,,,Fee Schedule,130% of WA Medicaid ,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1262.2,37.7,,,percent of total billed charges,37.70% of total billed charges,1262.2,37.7,,,percent of total billed charges,37.70% of total billed charges,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,113497.2,33.9,,,percent of total billed charges,33.9% of total billed charges,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2611.44,78,,,percent of total billed charges,78% of total billed charges,3348,100,,,percent of total billed charges,100% of total billed charges,2765.45,82.6,,,percent of total billed charges,82.6% of total billed charges,2765.45,82.6,,,percent of total billed charges,82.6% of total billed charges,668.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,130.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,668.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,130.96,113497.2,
REPAIR OF FACIAL NERVE,64864,CDM,983,RC,64864,HCPCS,Outpatient,,,3395,2206.75,,2987.6,88,,,percent of total billed charges,88% of total Billed charges,82.64,100,,,Fee Schedule,100% of Medicare rate,490.31,100,,,Fee Schedule,100% of WA Medicaid,3395,100,,,percent of total billed charges,100% of total billed charges,505.02,103,,,Fee Schedule,103% of WA Medicaid,82.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,144.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,490.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2342.55,69,,,percent of total billed charges,69% of total billed charges,3395,100,,,percent of total billed charges,100% of total billed charges,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,3395,100,,,percent of total billed charges,100% of total billed charges,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,3395,100,,,percent of total billed charges,100% of total billed charges,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2099.81,61.85,,,percent of total billed charges,61.85% of total billed charges,490.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,637.4,130,,,Fee Schedule,130% of WA Medicaid ,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1279.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1279.92,37.7,,,percent of total billed charges,37.70% of total billed charges,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,115090.5,33.9,,,percent of total billed charges,33.9% of total billed charges,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2648.1,78,,,percent of total billed charges,78% of total billed charges,3395,100,,,percent of total billed charges,100% of total billed charges,2804.27,82.6,,,percent of total billed charges,82.6% of total billed charges,2804.27,82.6,,,percent of total billed charges,82.6% of total billed charges,490.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,82.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,82.64,115090.5,
FUSION OF FACIAL/OTHER NERVE,64866,CDM,983,RC,64866,HCPCS,Outpatient,,,3211,2087.15,,2825.68,88,,,percent of total billed charges,88% of total Billed charges,118.36,100,,,Fee Schedule,100% of Medicare rate,711.87,100,,,Fee Schedule,100% of WA Medicaid,3211,100,,,percent of total billed charges,100% of total billed charges,733.23,103,,,Fee Schedule,103% of WA Medicaid,118.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,207.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,711.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2215.59,69,,,percent of total billed charges,69% of total billed charges,3211,100,,,percent of total billed charges,100% of total billed charges,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3211,100,,,percent of total billed charges,100% of total billed charges,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3211,100,,,percent of total billed charges,100% of total billed charges,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1986,61.85,,,percent of total billed charges,61.85% of total billed charges,711.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,726.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,925.43,130,,,Fee Schedule,130% of WA Medicaid ,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1210.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1210.55,37.7,,,percent of total billed charges,37.70% of total billed charges,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,108852.9,33.9,,,percent of total billed charges,33.9% of total billed charges,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2504.58,78,,,percent of total billed charges,78% of total billed charges,3211,100,,,percent of total billed charges,100% of total billed charges,2652.29,82.6,,,percent of total billed charges,82.6% of total billed charges,2652.29,82.6,,,percent of total billed charges,82.6% of total billed charges,711.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,118.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,118.36,108852.9,
FUSION OF FACIAL/OTHER NERVE,64868,CDM,983,RC,64868,HCPCS,Outpatient,,,3279,2131.35,,2885.52,88,,,percent of total billed charges,88% of total Billed charges,86.35,100,,,Fee Schedule,100% of Medicare rate,571.25,100,,,Fee Schedule,100% of WA Medicaid,3279,100,,,percent of total billed charges,100% of total billed charges,588.39,103,,,Fee Schedule,103% of WA Medicaid,86.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,151.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,571.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2262.51,69,,,percent of total billed charges,69% of total billed charges,3279,100,,,percent of total billed charges,100% of total billed charges,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3279,100,,,percent of total billed charges,100% of total billed charges,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3279,100,,,percent of total billed charges,100% of total billed charges,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2028.06,61.85,,,percent of total billed charges,61.85% of total billed charges,571.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,582.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,742.63,130,,,Fee Schedule,130% of WA Medicaid ,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1236.18,37.7,,,percent of total billed charges,37.70% of total billed charges,1236.18,37.7,,,percent of total billed charges,37.70% of total billed charges,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,111158.1,33.9,,,percent of total billed charges,33.9% of total billed charges,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2557.62,78,,,percent of total billed charges,78% of total billed charges,3279,100,,,percent of total billed charges,100% of total billed charges,2708.45,82.6,,,percent of total billed charges,82.6% of total billed charges,2708.45,82.6,,,percent of total billed charges,82.6% of total billed charges,571.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,86.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,571.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.35,111158.1,
NERVE GRAFT HEAD/NECK </4 CM,64885,CDM,983,RC,64885,HCPCS,Outpatient,,,3313,2153.45,,2915.44,88,,,percent of total billed charges,88% of total Billed charges,98.98,100,,,Fee Schedule,100% of Medicare rate,613.03,100,,,Fee Schedule,100% of WA Medicaid,3313,100,,,percent of total billed charges,100% of total billed charges,631.42,103,,,Fee Schedule,103% of WA Medicaid,98.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,173.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,613.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2285.97,69,,,percent of total billed charges,69% of total billed charges,3313,100,,,percent of total billed charges,100% of total billed charges,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3313,100,,,percent of total billed charges,100% of total billed charges,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3313,100,,,percent of total billed charges,100% of total billed charges,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2049.09,61.85,,,percent of total billed charges,61.85% of total billed charges,613.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,613.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,796.94,130,,,Fee Schedule,130% of WA Medicaid ,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1249,37.7,,,percent of total billed charges,37.70% of total billed charges,1249,37.7,,,percent of total billed charges,37.70% of total billed charges,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,112310.7,33.9,,,percent of total billed charges,33.9% of total billed charges,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2584.14,78,,,percent of total billed charges,78% of total billed charges,3313,100,,,percent of total billed charges,100% of total billed charges,2736.54,82.6,,,percent of total billed charges,82.6% of total billed charges,2736.54,82.6,,,percent of total billed charges,82.6% of total billed charges,613.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,98.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,613.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,98.98,112310.7,
NERVE GRAFT ARM/LEG </4 CM,64897,CDM,983,RC,64897,HCPCS,Outpatient,,,3518,2286.70,,3095.84,88,,,percent of total billed charges,88% of total Billed charges,141.65,100,,,Fee Schedule,100% of Medicare rate,718.77,100,,,Fee Schedule,100% of WA Medicaid,3518,100,,,percent of total billed charges,100% of total billed charges,740.33,103,,,Fee Schedule,103% of WA Medicaid,141.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,247.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,718.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2427.42,69,,,percent of total billed charges,69% of total billed charges,3518,100,,,percent of total billed charges,100% of total billed charges,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3518,100,,,percent of total billed charges,100% of total billed charges,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3518,100,,,percent of total billed charges,100% of total billed charges,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2175.88,61.85,,,percent of total billed charges,61.85% of total billed charges,718.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,718.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,733.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,934.4,130,,,Fee Schedule,130% of WA Medicaid ,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1326.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1326.29,37.7,,,percent of total billed charges,37.70% of total billed charges,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,119260.2,33.9,,,percent of total billed charges,33.9% of total billed charges,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,2744.04,78,,,percent of total billed charges,78% of total billed charges,3518,100,,,percent of total billed charges,100% of total billed charges,2905.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2905.87,82.6,,,percent of total billed charges,82.6% of total billed charges,718.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,141.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,718.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,141.65,119260.2,
NERVE GRAFT ARM/LEG >4 CM,64898,CDM,983,RC,64898,HCPCS,Outpatient,,,3786,2460.90,,3331.68,88,,,percent of total billed charges,88% of total Billed charges,153.35,100,,,Fee Schedule,100% of Medicare rate,778.45,100,,,Fee Schedule,100% of WA Medicaid,3786,100,,,percent of total billed charges,100% of total billed charges,801.8,103,,,Fee Schedule,103% of WA Medicaid,153.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,268.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,778.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2612.34,69,,,percent of total billed charges,69% of total billed charges,3786,100,,,percent of total billed charges,100% of total billed charges,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3786,100,,,percent of total billed charges,100% of total billed charges,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3786,100,,,percent of total billed charges,100% of total billed charges,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2341.64,61.85,,,percent of total billed charges,61.85% of total billed charges,778.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,794.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1011.99,130,,,Fee Schedule,130% of WA Medicaid ,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1427.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1427.32,37.7,,,percent of total billed charges,37.70% of total billed charges,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,128345.4,33.9,,,percent of total billed charges,33.9% of total billed charges,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2953.08,78,,,percent of total billed charges,78% of total billed charges,3786,100,,,percent of total billed charges,100% of total billed charges,3127.24,82.6,,,percent of total billed charges,82.6% of total billed charges,3127.24,82.6,,,percent of total billed charges,82.6% of total billed charges,778.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,153.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,778.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,153.35,128345.4,
NERVE GRAFT HAND/FOOT </4 CM,64895,CDM,983,RC,64895,HCPCS,Outpatient,,,3435,2232.75,,3022.8,88,,,percent of total billed charges,88% of total Billed charges,148.55,100,,,Fee Schedule,100% of Medicare rate,751.22,100,,,Fee Schedule,100% of WA Medicaid,3435,100,,,percent of total billed charges,100% of total billed charges,773.76,103,,,Fee Schedule,103% of WA Medicaid,148.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,259.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,751.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2370.15,69,,,percent of total billed charges,69% of total billed charges,3435,100,,,percent of total billed charges,100% of total billed charges,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3435,100,,,percent of total billed charges,100% of total billed charges,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3435,100,,,percent of total billed charges,100% of total billed charges,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2124.55,61.85,,,percent of total billed charges,61.85% of total billed charges,751.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,766.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,976.59,130,,,Fee Schedule,130% of WA Medicaid ,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1295,37.7,,,percent of total billed charges,37.70% of total billed charges,1295,37.7,,,percent of total billed charges,37.70% of total billed charges,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,116446.5,33.9,,,percent of total billed charges,33.9% of total billed charges,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2679.3,78,,,percent of total billed charges,78% of total billed charges,3435,100,,,percent of total billed charges,100% of total billed charges,2837.31,82.6,,,percent of total billed charges,82.6% of total billed charges,2837.31,82.6,,,percent of total billed charges,82.6% of total billed charges,751.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,148.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,751.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,148.55,116446.5,
NERVE GRAFT HAND/FOOT </4 CM,64890,CDM,983,RC,64890,HCPCS,Outpatient,,,2983,1938.95,,2625.04,88,,,percent of total billed charges,88% of total Billed charges,119.55,100,,,Fee Schedule,100% of Medicare rate,614.7,100,,,Fee Schedule,100% of WA Medicaid,2983,100,,,percent of total billed charges,100% of total billed charges,633.14,103,,,Fee Schedule,103% of WA Medicaid,119.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,209.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,614.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2058.27,69,,,percent of total billed charges,69% of total billed charges,2983,100,,,percent of total billed charges,100% of total billed charges,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2983,100,,,percent of total billed charges,100% of total billed charges,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2983,100,,,percent of total billed charges,100% of total billed charges,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1844.99,61.85,,,percent of total billed charges,61.85% of total billed charges,614.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,626.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,799.11,130,,,Fee Schedule,130% of WA Medicaid ,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1124.59,37.7,,,percent of total billed charges,37.70% of total billed charges,1124.59,37.7,,,percent of total billed charges,37.70% of total billed charges,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,101123.7,33.9,,,percent of total billed charges,33.9% of total billed charges,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,2326.74,78,,,percent of total billed charges,78% of total billed charges,2983,100,,,percent of total billed charges,100% of total billed charges,2463.96,82.6,,,percent of total billed charges,82.6% of total billed charges,2463.96,82.6,,,percent of total billed charges,82.6% of total billed charges,614.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,119.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,614.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.55,101123.7,
NERVE GRAFT ARM/LEG <4 CM,64892,CDM,983,RC,64892,HCPCS,Outpatient,,,2792,1814.80,,2456.96,88,,,percent of total billed charges,88% of total Billed charges,116.1,100,,,Fee Schedule,100% of Medicare rate,598.67,100,,,Fee Schedule,100% of WA Medicaid,2792,100,,,percent of total billed charges,100% of total billed charges,616.63,103,,,Fee Schedule,103% of WA Medicaid,116.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,203.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,598.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1926.48,69,,,percent of total billed charges,69% of total billed charges,2792,100,,,percent of total billed charges,100% of total billed charges,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2792,100,,,percent of total billed charges,100% of total billed charges,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2792,100,,,percent of total billed charges,100% of total billed charges,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1726.85,61.85,,,percent of total billed charges,61.85% of total billed charges,598.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,778.27,130,,,Fee Schedule,130% of WA Medicaid ,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1052.58,37.7,,,percent of total billed charges,37.70% of total billed charges,1052.58,37.7,,,percent of total billed charges,37.70% of total billed charges,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,94648.8,33.9,,,percent of total billed charges,33.9% of total billed charges,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,2177.76,78,,,percent of total billed charges,78% of total billed charges,2792,100,,,percent of total billed charges,100% of total billed charges,2306.19,82.6,,,percent of total billed charges,82.6% of total billed charges,2306.19,82.6,,,percent of total billed charges,82.6% of total billed charges,598.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.26,101,,,Fee Schedule,101% of Medicare RBRVS rate,116.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,598.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,116.1,94648.8,
NERVOUS SYSTEM SURGERY,64999,CDM,983,RC,64999,HCPCS,Outpatient,,,555,360.75,,488.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,382.95,69,,,percent of total billed charges,69% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,555,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,343.27,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,209.24,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,18814.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,432.9,78,,,percent of total billed charges,78% of total billed charges,555,100,,,percent of total billed charges,100% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,458.43,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",209.24,18814.5,
REMOVE FOREIGN BODY FROM EYE,65205,CDM,983,RC,65205,HCPCS,Outpatient,,,97.24,63.21,,85.57,88,,,percent of total billed charges,88% of total Billed charges,1.65,100,,,Fee Schedule,100% of Medicare rate,16.6,100,,,Fee Schedule,100% of WA Medicaid,97.24,100,,,percent of total billed charges,100% of total billed charges,17.1,103,,,Fee Schedule,103% of WA Medicaid,1.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,67.1,69,,,percent of total billed charges,69% of total billed charges,97.24,100,,,percent of total billed charges,100% of total billed charges,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.24,100,,,percent of total billed charges,100% of total billed charges,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.24,100,,,percent of total billed charges,100% of total billed charges,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.14,61.85,,,percent of total billed charges,61.85% of total billed charges,16.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.58,130,,,Fee Schedule,130% of WA Medicaid ,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.66,37.7,,,percent of total billed charges,37.70% of total billed charges,36.66,37.7,,,percent of total billed charges,37.70% of total billed charges,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3296.44,33.9,,,percent of total billed charges,33.9% of total billed charges,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.85,78,,,percent of total billed charges,78% of total billed charges,97.24,100,,,percent of total billed charges,100% of total billed charges,80.32,82.6,,,percent of total billed charges,82.6% of total billed charges,80.32,82.6,,,percent of total billed charges,82.6% of total billed charges,16.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.65,3296.44,
REMOVE FOREIGN BODY FROM EYE,65210,CDM,983,RC,65210,HCPCS,Outpatient,,,118.33,76.91,,104.13,88,,,percent of total billed charges,88% of total Billed charges,1.85,100,,,Fee Schedule,100% of Medicare rate,20.33,100,,,Fee Schedule,100% of WA Medicaid,118.33,100,,,percent of total billed charges,100% of total billed charges,20.94,103,,,Fee Schedule,103% of WA Medicaid,1.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,81.65,69,,,percent of total billed charges,69% of total billed charges,118.33,100,,,percent of total billed charges,100% of total billed charges,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.33,100,,,percent of total billed charges,100% of total billed charges,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.33,100,,,percent of total billed charges,100% of total billed charges,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.19,61.85,,,percent of total billed charges,61.85% of total billed charges,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.43,130,,,Fee Schedule,130% of WA Medicaid ,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.61,37.7,,,percent of total billed charges,37.70% of total billed charges,44.61,37.7,,,percent of total billed charges,37.70% of total billed charges,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,4011.39,33.9,,,percent of total billed charges,33.9% of total billed charges,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.3,78,,,percent of total billed charges,78% of total billed charges,118.33,100,,,percent of total billed charges,100% of total billed charges,97.74,82.6,,,percent of total billed charges,82.6% of total billed charges,97.74,82.6,,,percent of total billed charges,82.6% of total billed charges,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.85,4011.39,
REMOVE FOREIGN BODY FROM EYE,65220,CDM,983,RC,65220,HCPCS,Outpatient,,,98.41,63.97,,86.6,88,,,percent of total billed charges,88% of total Billed charges,3.57,100,,,Fee Schedule,100% of Medicare rate,23.31,100,,,Fee Schedule,100% of WA Medicaid,98.41,100,,,percent of total billed charges,100% of total billed charges,24.01,103,,,Fee Schedule,103% of WA Medicaid,3.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,67.9,69,,,percent of total billed charges,69% of total billed charges,98.41,100,,,percent of total billed charges,100% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.41,100,,,percent of total billed charges,100% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.41,100,,,percent of total billed charges,100% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.87,61.85,,,percent of total billed charges,61.85% of total billed charges,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.3,130,,,Fee Schedule,130% of WA Medicaid ,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.1,37.7,,,percent of total billed charges,37.70% of total billed charges,37.1,37.7,,,percent of total billed charges,37.70% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3336.1,33.9,,,percent of total billed charges,33.9% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.76,78,,,percent of total billed charges,78% of total billed charges,98.41,100,,,percent of total billed charges,100% of total billed charges,81.29,82.6,,,percent of total billed charges,82.6% of total billed charges,81.29,82.6,,,percent of total billed charges,82.6% of total billed charges,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.57,3336.1,
REMOVE FOREIGN BODY FROM EYE,65222,CDM,983,RC,65222,HCPCS,Outpatient,,,115.99,75.39,,102.07,88,,,percent of total billed charges,88% of total Billed charges,2.81,100,,,Fee Schedule,100% of Medicare rate,28.72,100,,,Fee Schedule,100% of WA Medicaid,115.99,100,,,percent of total billed charges,100% of total billed charges,29.58,103,,,Fee Schedule,103% of WA Medicaid,2.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,80.03,69,,,percent of total billed charges,69% of total billed charges,115.99,100,,,percent of total billed charges,100% of total billed charges,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.99,100,,,percent of total billed charges,100% of total billed charges,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.99,100,,,percent of total billed charges,100% of total billed charges,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.74,61.85,,,percent of total billed charges,61.85% of total billed charges,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.34,130,,,Fee Schedule,130% of WA Medicaid ,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,43.73,37.7,,,percent of total billed charges,37.70% of total billed charges,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,3932.06,33.9,,,percent of total billed charges,33.9% of total billed charges,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.47,78,,,percent of total billed charges,78% of total billed charges,115.99,100,,,percent of total billed charges,100% of total billed charges,95.81,82.6,,,percent of total billed charges,82.6% of total billed charges,95.81,82.6,,,percent of total billed charges,82.6% of total billed charges,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.81,3932.06,
"ORBITOTOMY, W/O FLAP, W/ DRAINAGE ONLY",67405,CDM,983,RC,67405,HCPCS,Outpatient,,,1355,880.75,,1192.4,88,,,percent of total billed charges,88% of total Billed charges,46.58,100,,,Fee Schedule,100% of Medicare rate,528.73,100,,,Fee Schedule,100% of WA Medicaid,1355,100,,,percent of total billed charges,100% of total billed charges,544.59,103,,,Fee Schedule,103% of WA Medicaid,46.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,81.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,528.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,934.95,69,,,percent of total billed charges,69% of total billed charges,1355,100,,,percent of total billed charges,100% of total billed charges,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1355,100,,,percent of total billed charges,100% of total billed charges,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1355,100,,,percent of total billed charges,100% of total billed charges,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,838.07,61.85,,,percent of total billed charges,61.85% of total billed charges,528.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,539.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,687.35,130,,,Fee Schedule,130% of WA Medicaid ,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,510.84,37.7,,,percent of total billed charges,37.70% of total billed charges,510.84,37.7,,,percent of total billed charges,37.70% of total billed charges,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,45934.5,33.9,,,percent of total billed charges,33.9% of total billed charges,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1056.9,78,,,percent of total billed charges,78% of total billed charges,1355,100,,,percent of total billed charges,100% of total billed charges,1119.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1119.23,82.6,,,percent of total billed charges,82.6% of total billed charges,528.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,46.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,528.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,46.58,45934.5,
DRAINAGE OF EYELID ABSCESS,67700,CDM,983,RC,67700,HCPCS,Outpatient,,,359,233.35,,315.92,88,,,percent of total billed charges,88% of total Billed charges,6.39,100,,,Fee Schedule,100% of Medicare rate,67.51,100,,,Fee Schedule,100% of WA Medicaid,359,100,,,percent of total billed charges,100% of total billed charges,69.54,103,,,Fee Schedule,103% of WA Medicaid,6.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,67.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,247.71,69,,,percent of total billed charges,69% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,359,100,,,percent of total billed charges,100% of total billed charges,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,359,100,,,percent of total billed charges,100% of total billed charges,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.04,61.85,,,percent of total billed charges,61.85% of total billed charges,67.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,87.76,130,,,Fee Schedule,130% of WA Medicaid ,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,12170.1,33.9,,,percent of total billed charges,33.9% of total billed charges,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.02,78,,,percent of total billed charges,78% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,67.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.39,12170.1,
REMOVE EYELID LESION,67840,CDM,983,RC,67840,HCPCS,Outpatient,,,526,341.90,,462.88,88,,,percent of total billed charges,88% of total Billed charges,9.16,100,,,Fee Schedule,100% of Medicare rate,90.45,100,,,Fee Schedule,100% of WA Medicaid,526,100,,,percent of total billed charges,100% of total billed charges,93.16,103,,,Fee Schedule,103% of WA Medicaid,9.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,90.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,362.94,69,,,percent of total billed charges,69% of total billed charges,526,100,,,percent of total billed charges,100% of total billed charges,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,526,100,,,percent of total billed charges,100% of total billed charges,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,526,100,,,percent of total billed charges,100% of total billed charges,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.33,61.85,,,percent of total billed charges,61.85% of total billed charges,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,117.59,130,,,Fee Schedule,130% of WA Medicaid ,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.3,37.7,,,percent of total billed charges,37.70% of total billed charges,198.3,37.7,,,percent of total billed charges,37.70% of total billed charges,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,17831.4,33.9,,,percent of total billed charges,33.9% of total billed charges,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.28,78,,,percent of total billed charges,78% of total billed charges,526,100,,,percent of total billed charges,100% of total billed charges,434.48,82.6,,,percent of total billed charges,82.6% of total billed charges,434.48,82.6,,,percent of total billed charges,82.6% of total billed charges,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.16,17831.4,
REPAIR EYELID DEFECT,67906,CDM,983,RC,67906,HCPCS,Outpatient,,,1030,669.50,,906.4,88,,,percent of total billed charges,88% of total Billed charges,29.22,100,,,Fee Schedule,100% of Medicare rate,289.82,100,,,Fee Schedule,100% of WA Medicaid,1030,100,,,percent of total billed charges,100% of total billed charges,298.51,103,,,Fee Schedule,103% of WA Medicaid,29.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,51.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,289.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,710.7,69,,,percent of total billed charges,69% of total billed charges,1030,100,,,percent of total billed charges,100% of total billed charges,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1030,100,,,percent of total billed charges,100% of total billed charges,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,1030,100,,,percent of total billed charges,100% of total billed charges,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,637.06,61.85,,,percent of total billed charges,61.85% of total billed charges,289.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,295.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,376.77,130,,,Fee Schedule,130% of WA Medicaid ,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,388.31,37.7,,,percent of total billed charges,37.70% of total billed charges,388.31,37.7,,,percent of total billed charges,37.70% of total billed charges,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,34917,33.9,,,percent of total billed charges,33.9% of total billed charges,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,803.4,78,,,percent of total billed charges,78% of total billed charges,1030,100,,,percent of total billed charges,100% of total billed charges,850.78,82.6,,,percent of total billed charges,82.6% of total billed charges,850.78,82.6,,,percent of total billed charges,82.6% of total billed charges,289.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,29.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,29.22,34917,
REPAIR EYELID DEFECT,67904,CDM,983,RC,67904,HCPCS,Outpatient,,,1211,787.15,,1065.68,88,,,percent of total billed charges,88% of total Billed charges,35.6,100,,,Fee Schedule,100% of Medicare rate,342.23,100,,,Fee Schedule,100% of WA Medicaid,1211,100,,,percent of total billed charges,100% of total billed charges,352.5,103,,,Fee Schedule,103% of WA Medicaid,35.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,62.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,342.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,835.59,69,,,percent of total billed charges,69% of total billed charges,1211,100,,,percent of total billed charges,100% of total billed charges,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1211,100,,,percent of total billed charges,100% of total billed charges,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1211,100,,,percent of total billed charges,100% of total billed charges,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,749,61.85,,,percent of total billed charges,61.85% of total billed charges,342.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,444.9,130,,,Fee Schedule,130% of WA Medicaid ,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.55,37.7,,,percent of total billed charges,37.70% of total billed charges,456.55,37.7,,,percent of total billed charges,37.70% of total billed charges,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,41052.9,33.9,,,percent of total billed charges,33.9% of total billed charges,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,944.58,78,,,percent of total billed charges,78% of total billed charges,1211,100,,,percent of total billed charges,100% of total billed charges,1000.29,82.6,,,percent of total billed charges,82.6% of total billed charges,1000.29,82.6,,,percent of total billed charges,82.6% of total billed charges,342.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,35.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,342.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,35.6,41052.9,
REPAIR BROW DEFECT,67900,CDM,983,RC,67900,HCPCS,Outpatient,,,1032,670.80,,908.16,88,,,percent of total billed charges,88% of total Billed charges,31.32,100,,,Fee Schedule,100% of Medicare rate,290.38,100,,,Fee Schedule,100% of WA Medicaid,1032,100,,,percent of total billed charges,100% of total billed charges,299.09,103,,,Fee Schedule,103% of WA Medicaid,31.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,290.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,712.08,69,,,percent of total billed charges,69% of total billed charges,1032,100,,,percent of total billed charges,100% of total billed charges,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032,100,,,percent of total billed charges,100% of total billed charges,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1032,100,,,percent of total billed charges,100% of total billed charges,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,638.29,61.85,,,percent of total billed charges,61.85% of total billed charges,290.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,377.49,130,,,Fee Schedule,130% of WA Medicaid ,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.06,37.7,,,percent of total billed charges,37.70% of total billed charges,389.06,37.7,,,percent of total billed charges,37.70% of total billed charges,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,34984.8,33.9,,,percent of total billed charges,33.9% of total billed charges,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,804.96,78,,,percent of total billed charges,78% of total billed charges,1032,100,,,percent of total billed charges,100% of total billed charges,852.43,82.6,,,percent of total billed charges,82.6% of total billed charges,852.43,82.6,,,percent of total billed charges,82.6% of total billed charges,290.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,290.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.32,34984.8,
INCISE/DRAIN EYELID LINING,68020,CDM,983,RC,68020,HCPCS,Outpatient,,,222,144.30,,195.36,88,,,percent of total billed charges,88% of total Billed charges,5.93,100,,,Fee Schedule,100% of Medicare rate,63.6,100,,,Fee Schedule,100% of WA Medicaid,222,100,,,percent of total billed charges,100% of total billed charges,65.51,103,,,Fee Schedule,103% of WA Medicaid,5.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,153.18,69,,,percent of total billed charges,69% of total billed charges,222,100,,,percent of total billed charges,100% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,222,100,,,percent of total billed charges,100% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,222,100,,,percent of total billed charges,100% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.31,61.85,,,percent of total billed charges,61.85% of total billed charges,63.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.68,130,,,Fee Schedule,130% of WA Medicaid ,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.69,37.7,,,percent of total billed charges,37.70% of total billed charges,83.69,37.7,,,percent of total billed charges,37.70% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,7525.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.16,78,,,percent of total billed charges,78% of total billed charges,222,100,,,percent of total billed charges,100% of total billed charges,183.37,82.6,,,percent of total billed charges,82.6% of total billed charges,183.37,82.6,,,percent of total billed charges,82.6% of total billed charges,63.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.93,7525.8,
DRAIN EXTERNAL EAR LESION,69000,CDM,983,RC,69000,HCPCS,Outpatient,,,525,341.25,,462,88,,,percent of total billed charges,88% of total Billed charges,9.81,100,,,Fee Schedule,100% of Medicare rate,73.29,100,,,Fee Schedule,100% of WA Medicaid,525,100,,,percent of total billed charges,100% of total billed charges,75.49,103,,,Fee Schedule,103% of WA Medicaid,9.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,73.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,362.25,69,,,percent of total billed charges,69% of total billed charges,525,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,525,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,525,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.71,61.85,,,percent of total billed charges,61.85% of total billed charges,73.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.28,130,,,Fee Schedule,130% of WA Medicaid ,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.93,37.7,,,percent of total billed charges,37.70% of total billed charges,197.93,37.7,,,percent of total billed charges,37.70% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,17797.5,33.9,,,percent of total billed charges,33.9% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,409.5,78,,,percent of total billed charges,78% of total billed charges,525,100,,,percent of total billed charges,100% of total billed charges,433.65,82.6,,,percent of total billed charges,82.6% of total billed charges,433.65,82.6,,,percent of total billed charges,82.6% of total billed charges,73.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.81,17797.5,
"DRAINAGE EXT EAR,ABSCESS/HEMATOMA;COMP",69005,CDM,983,RC,69005,HCPCS,Outpatient,,,436,283.40,,383.68,88,,,percent of total billed charges,88% of total Billed charges,13.49,100,,,Fee Schedule,100% of Medicare rate,93.81,100,,,Fee Schedule,100% of WA Medicaid,436,100,,,percent of total billed charges,100% of total billed charges,96.62,103,,,Fee Schedule,103% of WA Medicaid,13.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,93.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,300.84,69,,,percent of total billed charges,69% of total billed charges,436,100,,,percent of total billed charges,100% of total billed charges,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,436,100,,,percent of total billed charges,100% of total billed charges,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,436,100,,,percent of total billed charges,100% of total billed charges,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.67,61.85,,,percent of total billed charges,61.85% of total billed charges,93.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,121.95,130,,,Fee Schedule,130% of WA Medicaid ,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,164.37,37.7,,,percent of total billed charges,37.70% of total billed charges,164.37,37.7,,,percent of total billed charges,37.70% of total billed charges,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,14780.4,33.9,,,percent of total billed charges,33.9% of total billed charges,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,340.08,78,,,percent of total billed charges,78% of total billed charges,436,100,,,percent of total billed charges,100% of total billed charges,360.14,82.6,,,percent of total billed charges,82.6% of total billed charges,360.14,82.6,,,percent of total billed charges,82.6% of total billed charges,93.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.49,14780.4,
DRAIN OUTER EAR CANAL LESION,69020,CDM,983,RC,69020,HCPCS,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,10.14,100,,,Fee Schedule,100% of Medicare rate,84.67,100,,,Fee Schedule,100% of WA Medicaid,300,100,,,percent of total billed charges,100% of total billed charges,87.21,103,,,Fee Schedule,103% of WA Medicaid,10.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,84.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,300,100,,,percent of total billed charges,100% of total billed charges,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,300,100,,,percent of total billed charges,100% of total billed charges,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.55,61.85,,,percent of total billed charges,61.85% of total billed charges,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,110.07,130,,,Fee Schedule,130% of WA Medicaid ,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.1,37.7,,,percent of total billed charges,37.70% of total billed charges,113.1,37.7,,,percent of total billed charges,37.70% of total billed charges,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,10170,33.9,,,percent of total billed charges,33.9% of total billed charges,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.14,10170,
PIERCE EARLOBES,69090,CDM,983,RC,69090,HCPCS,Outpatient,,,73,47.45,,64.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,73,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,50.37,69,,,percent of total billed charges,69% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,73,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,73,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45.15,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2474.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,56.94,78,,,percent of total billed charges,78% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",27.52,2474.7,
BIOPSY EXTERNAL EAR,69100,CDM,983,RC,69100,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,3.72,100,,,Fee Schedule,100% of Medicare rate,26.3,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,27.09,103,,,Fee Schedule,103% of WA Medicaid,3.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,26.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,194,100,,,percent of total billed charges,100% of total billed charges,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,194,100,,,percent of total billed charges,100% of total billed charges,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.99,61.85,,,percent of total billed charges,61.85% of total billed charges,26.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,34.19,130,,,Fee Schedule,130% of WA Medicaid ,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6576.6,33.9,,,percent of total billed charges,33.9% of total billed charges,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,26.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.72,6576.6,
BIOPSY;EXTERNAL AUDITORY CANAL,69105,CDM,983,RC,69105,HCPCS,Outpatient,,,339,220.35,,298.32,88,,,percent of total billed charges,88% of total Billed charges,5.05,100,,,Fee Schedule,100% of Medicare rate,36.93,100,,,Fee Schedule,100% of WA Medicaid,339,100,,,percent of total billed charges,100% of total billed charges,38.04,103,,,Fee Schedule,103% of WA Medicaid,5.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,36.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,233.91,69,,,percent of total billed charges,69% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,339,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,339,100,,,percent of total billed charges,100% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.67,61.85,,,percent of total billed charges,61.85% of total billed charges,36.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,48.01,130,,,Fee Schedule,130% of WA Medicaid ,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,127.8,37.7,,,percent of total billed charges,37.70% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,11492.1,33.9,,,percent of total billed charges,33.9% of total billed charges,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.42,78,,,percent of total billed charges,78% of total billed charges,339,100,,,percent of total billed charges,100% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,280.01,82.6,,,percent of total billed charges,82.6% of total billed charges,36.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.05,11492.1,
EXCISION EXT EAR;PARTIAL SIMPLE REPAIR,69110,CDM,983,RC,69110,HCPCS,Outpatient,,,928,603.20,,816.64,88,,,percent of total billed charges,88% of total Billed charges,23.55,100,,,Fee Schedule,100% of Medicare rate,192.1,100,,,Fee Schedule,100% of WA Medicaid,928,100,,,percent of total billed charges,100% of total billed charges,197.86,103,,,Fee Schedule,103% of WA Medicaid,23.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,41.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,192.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,640.32,69,,,percent of total billed charges,69% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,928,100,,,percent of total billed charges,100% of total billed charges,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,928,100,,,percent of total billed charges,100% of total billed charges,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,573.97,61.85,,,percent of total billed charges,61.85% of total billed charges,192.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,249.73,130,,,Fee Schedule,130% of WA Medicaid ,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,349.86,37.7,,,percent of total billed charges,37.70% of total billed charges,349.86,37.7,,,percent of total billed charges,37.70% of total billed charges,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,31459.2,33.9,,,percent of total billed charges,33.9% of total billed charges,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,723.84,78,,,percent of total billed charges,78% of total billed charges,928,100,,,percent of total billed charges,100% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,766.53,82.6,,,percent of total billed charges,82.6% of total billed charges,192.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.55,31459.2,
EXCISION SOFT TISSUE LES EXT AUDITORY,69145,CDM,983,RC,69145,HCPCS,Outpatient,,,514,334.10,,452.32,88,,,percent of total billed charges,88% of total Billed charges,18.31,100,,,Fee Schedule,100% of Medicare rate,151.62,100,,,Fee Schedule,100% of WA Medicaid,514,100,,,percent of total billed charges,100% of total billed charges,156.17,103,,,Fee Schedule,103% of WA Medicaid,18.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,32.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,151.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,354.66,69,,,percent of total billed charges,69% of total billed charges,514,100,,,percent of total billed charges,100% of total billed charges,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,514,100,,,percent of total billed charges,100% of total billed charges,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,514,100,,,percent of total billed charges,100% of total billed charges,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.91,61.85,,,percent of total billed charges,61.85% of total billed charges,151.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,197.11,130,,,Fee Schedule,130% of WA Medicaid ,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.78,37.7,,,percent of total billed charges,37.70% of total billed charges,193.78,37.7,,,percent of total billed charges,37.70% of total billed charges,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,17424.6,33.9,,,percent of total billed charges,33.9% of total billed charges,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.92,78,,,percent of total billed charges,78% of total billed charges,514,100,,,percent of total billed charges,100% of total billed charges,424.56,82.6,,,percent of total billed charges,82.6% of total billed charges,424.56,82.6,,,percent of total billed charges,82.6% of total billed charges,151.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.31,17424.6,
CLEAR OUTER EAR CANAL,69200,CDM,983,RC,69200,HCPCS,Outpatient,,,353,229.45,,310.64,88,,,percent of total billed charges,88% of total Billed charges,4.28,100,,,Fee Schedule,100% of Medicare rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,353,100,,,percent of total billed charges,100% of total billed charges,27.85,103,,,Fee Schedule,103% of WA Medicaid,4.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,243.57,69,,,percent of total billed charges,69% of total billed charges,353,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,353,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,353,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.33,61.85,,,percent of total billed charges,61.85% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.15,130,,,Fee Schedule,130% of WA Medicaid ,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.08,37.7,,,percent of total billed charges,37.70% of total billed charges,133.08,37.7,,,percent of total billed charges,37.70% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,11966.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.34,78,,,percent of total billed charges,78% of total billed charges,353,100,,,percent of total billed charges,100% of total billed charges,291.58,82.6,,,percent of total billed charges,82.6% of total billed charges,291.58,82.6,,,percent of total billed charges,82.6% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.28,11966.7,
"REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL",69209,CDM,983,RC,69209,HCPCS,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,0.76,100,,,Fee Schedule,100% of Medicare rate,9.51,100,,,Fee Schedule,100% of WA Medicaid,34,100,,,percent of total billed charges,100% of total billed charges,9.8,103,,,Fee Schedule,103% of WA Medicaid,0.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,34,100,,,percent of total billed charges,100% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,34,100,,,percent of total billed charges,100% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.36,130,,,Fee Schedule,130% of WA Medicaid ,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152.6,33.9,,,percent of total billed charges,33.9% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.76,1152.6,
REMOVAL FOREIGN BODY EXTERNAL AUDITORY,69205,CDM,983,RC,69205,HCPCS,Outpatient,,,212,137.80,,186.56,88,,,percent of total billed charges,88% of total Billed charges,7.32,100,,,Fee Schedule,100% of Medicare rate,55.58,100,,,Fee Schedule,100% of WA Medicaid,212,100,,,percent of total billed charges,100% of total billed charges,57.25,103,,,Fee Schedule,103% of WA Medicaid,7.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,55.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,146.28,69,,,percent of total billed charges,69% of total billed charges,212,100,,,percent of total billed charges,100% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,212,100,,,percent of total billed charges,100% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,212,100,,,percent of total billed charges,100% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.12,61.85,,,percent of total billed charges,61.85% of total billed charges,55.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,72.25,130,,,Fee Schedule,130% of WA Medicaid ,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.92,37.7,,,percent of total billed charges,37.70% of total billed charges,79.92,37.7,,,percent of total billed charges,37.70% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7186.8,33.9,,,percent of total billed charges,33.9% of total billed charges,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.36,78,,,percent of total billed charges,78% of total billed charges,212,100,,,percent of total billed charges,100% of total billed charges,175.11,82.6,,,percent of total billed charges,82.6% of total billed charges,175.11,82.6,,,percent of total billed charges,82.6% of total billed charges,55.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.32,7186.8,
69200 Removal foreign body from external auditory canal; without general anesthe,69200,CDM,983,RC,69200,HCPCS,Outpatient,,,353,229.45,,310.64,88,,,percent of total billed charges,88% of total Billed charges,4.28,100,,,Fee Schedule,100% of Medicare rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,353,100,,,percent of total billed charges,100% of total billed charges,27.85,103,,,Fee Schedule,103% of WA Medicaid,4.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,243.57,69,,,percent of total billed charges,69% of total billed charges,353,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,353,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,353,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,218.33,61.85,,,percent of total billed charges,61.85% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.15,130,,,Fee Schedule,130% of WA Medicaid ,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.08,37.7,,,percent of total billed charges,37.70% of total billed charges,133.08,37.7,,,percent of total billed charges,37.70% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,11966.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.34,78,,,percent of total billed charges,78% of total billed charges,353,100,,,percent of total billed charges,100% of total billed charges,291.58,82.6,,,percent of total billed charges,82.6% of total billed charges,291.58,82.6,,,percent of total billed charges,82.6% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.28,11966.7,
"69209 Removal impacted cerumen using irrigation/lavage, unilateral",69209,CDM,983,RC,69209,HCPCS,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,0.76,100,,,Fee Schedule,100% of Medicare rate,9.51,100,,,Fee Schedule,100% of WA Medicaid,34,100,,,percent of total billed charges,100% of total billed charges,9.8,103,,,Fee Schedule,103% of WA Medicaid,0.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,34,100,,,percent of total billed charges,100% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,34,100,,,percent of total billed charges,100% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.36,130,,,Fee Schedule,130% of WA Medicaid ,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152.6,33.9,,,percent of total billed charges,33.9% of total billed charges,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.76,1152.6,
REMOVE IMPACTED EAR WAX UNI,69210,CDM,983,RC,69210,HCPCS,Outpatient,,,142,92.30,,124.96,88,,,percent of total billed charges,88% of total Billed charges,3.04,100,,,Fee Schedule,100% of Medicare rate,18.28,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,18.83,103,,,Fee Schedule,103% of WA Medicaid,3.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,18.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,142,100,,,percent of total billed charges,100% of total billed charges,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,142,100,,,percent of total billed charges,100% of total billed charges,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.83,61.85,,,percent of total billed charges,61.85% of total billed charges,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.76,130,,,Fee Schedule,130% of WA Medicaid ,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,4813.8,33.9,,,percent of total billed charges,33.9% of total billed charges,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.04,4813.8,
"69210 Removal impacted cerumen requiring instrumentation, unilateral",69210,CDM,983,RC,69210,HCPCS,Outpatient,,,142,92.30,,124.96,88,,,percent of total billed charges,88% of total Billed charges,3.04,100,,,Fee Schedule,100% of Medicare rate,18.28,100,,,Fee Schedule,100% of WA Medicaid,142,100,,,percent of total billed charges,100% of total billed charges,18.83,103,,,Fee Schedule,103% of WA Medicaid,3.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,18.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,97.98,69,,,percent of total billed charges,69% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,142,100,,,percent of total billed charges,100% of total billed charges,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,142,100,,,percent of total billed charges,100% of total billed charges,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.83,61.85,,,percent of total billed charges,61.85% of total billed charges,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.76,130,,,Fee Schedule,130% of WA Medicaid ,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,53.53,37.7,,,percent of total billed charges,37.70% of total billed charges,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,4813.8,33.9,,,percent of total billed charges,33.9% of total billed charges,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.76,78,,,percent of total billed charges,78% of total billed charges,142,100,,,percent of total billed charges,100% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,117.29,82.6,,,percent of total billed charges,82.6% of total billed charges,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.04,4813.8,
CLEAN OUT MASTOID CAVITY,69220,CDM,983,RC,69220,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,4.66,100,,,Fee Schedule,100% of Medicare rate,29.28,100,,,Fee Schedule,100% of WA Medicaid,75,100,,,percent of total billed charges,100% of total billed charges,30.16,103,,,Fee Schedule,103% of WA Medicaid,4.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,75,100,,,percent of total billed charges,100% of total billed charges,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,75,100,,,percent of total billed charges,100% of total billed charges,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.39,61.85,,,percent of total billed charges,61.85% of total billed charges,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,38.06,130,,,Fee Schedule,130% of WA Medicaid ,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2542.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.66,2542.5,
CLEAN OUT MASTOID CAVITY,69222,CDM,983,RC,69222,HCPCS,Outpatient,,,290,188.50,,255.2,88,,,percent of total billed charges,88% of total Billed charges,9.65,100,,,Fee Schedule,100% of Medicare rate,80.38,100,,,Fee Schedule,100% of WA Medicaid,290,100,,,percent of total billed charges,100% of total billed charges,82.79,103,,,Fee Schedule,103% of WA Medicaid,9.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,80.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,200.1,69,,,percent of total billed charges,69% of total billed charges,290,100,,,percent of total billed charges,100% of total billed charges,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,290,100,,,percent of total billed charges,100% of total billed charges,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,290,100,,,percent of total billed charges,100% of total billed charges,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.37,61.85,,,percent of total billed charges,61.85% of total billed charges,80.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,104.49,130,,,Fee Schedule,130% of WA Medicaid ,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.33,37.7,,,percent of total billed charges,37.70% of total billed charges,109.33,37.7,,,percent of total billed charges,37.70% of total billed charges,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,9831,33.9,,,percent of total billed charges,33.9% of total billed charges,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.2,78,,,percent of total billed charges,78% of total billed charges,290,100,,,percent of total billed charges,100% of total billed charges,239.54,82.6,,,percent of total billed charges,82.6% of total billed charges,239.54,82.6,,,percent of total billed charges,82.6% of total billed charges,80.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.65,9831,
REBUILD OUTER EAR CANAL,69310,CDM,983,RC,69310,HCPCS,Outpatient,,,2250,1462.50,,1980,88,,,percent of total billed charges,88% of total Billed charges,77.53,100,,,Fee Schedule,100% of Medicare rate,653.87,100,,,Fee Schedule,100% of WA Medicaid,2250,100,,,percent of total billed charges,100% of total billed charges,673.49,103,,,Fee Schedule,103% of WA Medicaid,77.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,135.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,653.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1552.5,69,,,percent of total billed charges,69% of total billed charges,2250,100,,,percent of total billed charges,100% of total billed charges,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2250,100,,,percent of total billed charges,100% of total billed charges,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2250,100,,,percent of total billed charges,100% of total billed charges,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1391.63,61.85,,,percent of total billed charges,61.85% of total billed charges,653.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,653.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,666.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,850.03,130,,,Fee Schedule,130% of WA Medicaid ,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,848.25,37.7,,,percent of total billed charges,37.70% of total billed charges,848.25,37.7,,,percent of total billed charges,37.70% of total billed charges,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,76275,33.9,,,percent of total billed charges,33.9% of total billed charges,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1755,78,,,percent of total billed charges,78% of total billed charges,2250,100,,,percent of total billed charges,100% of total billed charges,1858.5,82.6,,,percent of total billed charges,82.6% of total billed charges,1858.5,82.6,,,percent of total billed charges,82.6% of total billed charges,653.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,77.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,653.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,77.53,76275,
MYRINGOTOMY,69420,CDM,983,RC,69420,HCPCS,Outpatient,,,346,224.90,,304.48,88,,,percent of total billed charges,88% of total Billed charges,8.9,100,,,Fee Schedule,100% of Medicare rate,70.87,100,,,Fee Schedule,100% of WA Medicaid,346,100,,,percent of total billed charges,100% of total billed charges,73,103,,,Fee Schedule,103% of WA Medicaid,8.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,238.74,69,,,percent of total billed charges,69% of total billed charges,346,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,346,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,346,100,,,percent of total billed charges,100% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,214,61.85,,,percent of total billed charges,61.85% of total billed charges,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,92.13,130,,,Fee Schedule,130% of WA Medicaid ,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.44,37.7,,,percent of total billed charges,37.70% of total billed charges,130.44,37.7,,,percent of total billed charges,37.70% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,11729.4,33.9,,,percent of total billed charges,33.9% of total billed charges,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,269.88,78,,,percent of total billed charges,78% of total billed charges,346,100,,,percent of total billed charges,100% of total billed charges,285.8,82.6,,,percent of total billed charges,82.6% of total billed charges,285.8,82.6,,,percent of total billed charges,82.6% of total billed charges,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.9,11729.4,
MYRINGOTOMY W/ ASPIRATION AND/OR INFLATI,69421,CDM,983,RC,69421,HCPCS,Outpatient,,,359,233.35,,315.92,88,,,percent of total billed charges,88% of total Billed charges,11.14,100,,,Fee Schedule,100% of Medicare rate,88.77,100,,,Fee Schedule,100% of WA Medicaid,359,100,,,percent of total billed charges,100% of total billed charges,91.43,103,,,Fee Schedule,103% of WA Medicaid,11.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,88.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,247.71,69,,,percent of total billed charges,69% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,359,100,,,percent of total billed charges,100% of total billed charges,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,359,100,,,percent of total billed charges,100% of total billed charges,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.04,61.85,,,percent of total billed charges,61.85% of total billed charges,88.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,115.4,130,,,Fee Schedule,130% of WA Medicaid ,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,135.34,37.7,,,percent of total billed charges,37.70% of total billed charges,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,12170.1,33.9,,,percent of total billed charges,33.9% of total billed charges,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.02,78,,,percent of total billed charges,78% of total billed charges,359,100,,,percent of total billed charges,100% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,296.53,82.6,,,percent of total billed charges,82.6% of total billed charges,88.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.14,12170.1,
VENTILATING TUBE REMOV REQ GEN ANESTHES,69424,CDM,983,RC,69424,HCPCS,Outpatient,,,123,79.95,,108.24,88,,,percent of total billed charges,88% of total Billed charges,4.43,100,,,Fee Schedule,100% of Medicare rate,35.06,100,,,Fee Schedule,100% of WA Medicaid,123,100,,,percent of total billed charges,100% of total billed charges,36.11,103,,,Fee Schedule,103% of WA Medicaid,4.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,84.87,69,,,percent of total billed charges,69% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,123,100,,,percent of total billed charges,100% of total billed charges,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,123,100,,,percent of total billed charges,100% of total billed charges,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.08,61.85,,,percent of total billed charges,61.85% of total billed charges,35.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.58,130,,,Fee Schedule,130% of WA Medicaid ,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.37,37.7,,,percent of total billed charges,37.70% of total billed charges,46.37,37.7,,,percent of total billed charges,37.70% of total billed charges,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,4169.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.94,78,,,percent of total billed charges,78% of total billed charges,123,100,,,percent of total billed charges,100% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,101.6,82.6,,,percent of total billed charges,82.6% of total billed charges,35.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.43,4169.7,
TYMPANOSTOMY LOCAL OR OPICAL ANESTHESIA,69433,CDM,983,RC,69433,HCPCS,Outpatient,,,404,262.60,,355.52,88,,,percent of total billed charges,88% of total Billed charges,10.04,100,,,Fee Schedule,100% of Medicare rate,77.58,100,,,Fee Schedule,100% of WA Medicaid,404,100,,,percent of total billed charges,100% of total billed charges,79.91,103,,,Fee Schedule,103% of WA Medicaid,10.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,278.76,69,,,percent of total billed charges,69% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,404,100,,,percent of total billed charges,100% of total billed charges,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,404,100,,,percent of total billed charges,100% of total billed charges,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.87,61.85,,,percent of total billed charges,61.85% of total billed charges,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,100.85,130,,,Fee Schedule,130% of WA Medicaid ,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,13695.6,33.9,,,percent of total billed charges,33.9% of total billed charges,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.12,78,,,percent of total billed charges,78% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.04,13695.6,
TYPANOSTOMY,69436,CDM,983,RC,69436,HCPCS,Outpatient,,,340,221.00,,299.2,88,,,percent of total billed charges,88% of total Billed charges,12.42,100,,,Fee Schedule,100% of Medicare rate,93.25,100,,,Fee Schedule,100% of WA Medicaid,340,100,,,percent of total billed charges,100% of total billed charges,96.05,103,,,Fee Schedule,103% of WA Medicaid,12.42,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,93.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,234.6,69,,,percent of total billed charges,69% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.29,61.85,,,percent of total billed charges,61.85% of total billed charges,93.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,121.23,130,,,Fee Schedule,130% of WA Medicaid ,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,11526,33.9,,,percent of total billed charges,33.9% of total billed charges,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.2,78,,,percent of total billed charges,78% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,93.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.42,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.42,11526,
MIDDLE EAR EXPL THROUGH EAR-CANAL INCIS,69440,CDM,983,RC,69440,HCPCS,Outpatient,,,1450,942.50,,1276,88,,,percent of total billed charges,88% of total Billed charges,51.07,100,,,Fee Schedule,100% of Medicare rate,405.45,100,,,Fee Schedule,100% of WA Medicaid,1450,100,,,percent of total billed charges,100% of total billed charges,417.61,103,,,Fee Schedule,103% of WA Medicaid,51.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,405.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1000.5,69,,,percent of total billed charges,69% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1450,100,,,percent of total billed charges,100% of total billed charges,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1450,100,,,percent of total billed charges,100% of total billed charges,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,896.83,61.85,,,percent of total billed charges,61.85% of total billed charges,405.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,527.09,130,,,Fee Schedule,130% of WA Medicaid ,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.65,37.7,,,percent of total billed charges,37.70% of total billed charges,546.65,37.7,,,percent of total billed charges,37.70% of total billed charges,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,49155,33.9,,,percent of total billed charges,33.9% of total billed charges,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131,78,,,percent of total billed charges,78% of total billed charges,1450,100,,,percent of total billed charges,100% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,1197.7,82.6,,,percent of total billed charges,82.6% of total billed charges,405.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,405.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.07,49155,
TYMPANOLYSIS TRANSCANAL,69450,CDM,983,RC,69450,HCPCS,Outpatient,,,1107,719.55,,974.16,88,,,percent of total billed charges,88% of total Billed charges,38.9,100,,,Fee Schedule,100% of Medicare rate,322.09,100,,,Fee Schedule,100% of WA Medicaid,1107,100,,,percent of total billed charges,100% of total billed charges,331.75,103,,,Fee Schedule,103% of WA Medicaid,38.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.08,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,322.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,763.83,69,,,percent of total billed charges,69% of total billed charges,1107,100,,,percent of total billed charges,100% of total billed charges,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1107,100,,,percent of total billed charges,100% of total billed charges,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1107,100,,,percent of total billed charges,100% of total billed charges,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,684.68,61.85,,,percent of total billed charges,61.85% of total billed charges,322.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,328.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,418.72,130,,,Fee Schedule,130% of WA Medicaid ,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.34,37.7,,,percent of total billed charges,37.70% of total billed charges,417.34,37.7,,,percent of total billed charges,37.70% of total billed charges,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,37527.3,33.9,,,percent of total billed charges,33.9% of total billed charges,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,863.46,78,,,percent of total billed charges,78% of total billed charges,1107,100,,,percent of total billed charges,100% of total billed charges,914.38,82.6,,,percent of total billed charges,82.6% of total billed charges,914.38,82.6,,,percent of total billed charges,82.6% of total billed charges,322.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.9,37527.3,
REMOVAL OF MASTOID STRUCTURES,69505,CDM,983,RC,69505,HCPCS,Outpatient,,,1850,1202.50,,1628,88,,,percent of total billed charges,88% of total Billed charges,87.1,100,,,Fee Schedule,100% of Medicare rate,717.28,100,,,Fee Schedule,100% of WA Medicaid,1850,100,,,percent of total billed charges,100% of total billed charges,738.8,103,,,Fee Schedule,103% of WA Medicaid,87.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,152.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,717.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1276.5,69,,,percent of total billed charges,69% of total billed charges,1850,100,,,percent of total billed charges,100% of total billed charges,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1850,100,,,percent of total billed charges,100% of total billed charges,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1850,100,,,percent of total billed charges,100% of total billed charges,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1144.23,61.85,,,percent of total billed charges,61.85% of total billed charges,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,932.46,130,,,Fee Schedule,130% of WA Medicaid ,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.45,37.7,,,percent of total billed charges,37.70% of total billed charges,697.45,37.7,,,percent of total billed charges,37.70% of total billed charges,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,62715,33.9,,,percent of total billed charges,33.9% of total billed charges,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,1443,78,,,percent of total billed charges,78% of total billed charges,1850,100,,,percent of total billed charges,100% of total billed charges,1528.1,82.6,,,percent of total billed charges,82.6% of total billed charges,1528.1,82.6,,,percent of total billed charges,82.6% of total billed charges,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,717.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.1,62715,
EXTENSIVE MASTOID SURGERY,69511,CDM,983,RC,69511,HCPCS,Outpatient,,,2550,1657.50,,2244,88,,,percent of total billed charges,88% of total Billed charges,90.3,100,,,Fee Schedule,100% of Medicare rate,733.69,100,,,Fee Schedule,100% of WA Medicaid,2550,100,,,percent of total billed charges,100% of total billed charges,755.7,103,,,Fee Schedule,103% of WA Medicaid,90.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,158.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,733.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1759.5,69,,,percent of total billed charges,69% of total billed charges,2550,100,,,percent of total billed charges,100% of total billed charges,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2550,100,,,percent of total billed charges,100% of total billed charges,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2550,100,,,percent of total billed charges,100% of total billed charges,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1577.18,61.85,,,percent of total billed charges,61.85% of total billed charges,733.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,733.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,748.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,953.8,130,,,Fee Schedule,130% of WA Medicaid ,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,961.35,37.7,,,percent of total billed charges,37.70% of total billed charges,961.35,37.7,,,percent of total billed charges,37.70% of total billed charges,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,86445,33.9,,,percent of total billed charges,33.9% of total billed charges,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1989,78,,,percent of total billed charges,78% of total billed charges,2550,100,,,percent of total billed charges,100% of total billed charges,2106.3,82.6,,,percent of total billed charges,82.6% of total billed charges,2106.3,82.6,,,percent of total billed charges,82.6% of total billed charges,733.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,90.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,733.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,90.3,86445,
EXCISION AUROL POLYP,69540,CDM,983,RC,69540,HCPCS,Outpatient,,,246,159.90,,216.48,88,,,percent of total billed charges,88% of total Billed charges,8.95,100,,,Fee Schedule,100% of Medicare rate,76.84,100,,,Fee Schedule,100% of WA Medicaid,246,100,,,percent of total billed charges,100% of total billed charges,79.15,103,,,Fee Schedule,103% of WA Medicaid,8.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,76.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,169.74,69,,,percent of total billed charges,69% of total billed charges,246,100,,,percent of total billed charges,100% of total billed charges,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,246,100,,,percent of total billed charges,100% of total billed charges,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,246,100,,,percent of total billed charges,100% of total billed charges,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.15,61.85,,,percent of total billed charges,61.85% of total billed charges,76.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,99.89,130,,,Fee Schedule,130% of WA Medicaid ,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.74,37.7,,,percent of total billed charges,37.70% of total billed charges,92.74,37.7,,,percent of total billed charges,37.70% of total billed charges,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,8339.4,33.9,,,percent of total billed charges,33.9% of total billed charges,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.88,78,,,percent of total billed charges,78% of total billed charges,246,100,,,percent of total billed charges,100% of total billed charges,203.2,82.6,,,percent of total billed charges,82.6% of total billed charges,203.2,82.6,,,percent of total billed charges,82.6% of total billed charges,76.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.95,8339.4,
REVISION MATOIDECTOMY RESULT MODIFIED,69602,CDM,983,RC,69602,HCPCS,Outpatient,,,2570,1670.50,,2261.6,88,,,percent of total billed charges,88% of total Billed charges,85.35,100,,,Fee Schedule,100% of Medicare rate,632.79,100,,,Fee Schedule,100% of WA Medicaid,2570,100,,,percent of total billed charges,100% of total billed charges,651.77,103,,,Fee Schedule,103% of WA Medicaid,85.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,149.36,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,632.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1773.3,69,,,percent of total billed charges,69% of total billed charges,2570,100,,,percent of total billed charges,100% of total billed charges,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2570,100,,,percent of total billed charges,100% of total billed charges,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2570,100,,,percent of total billed charges,100% of total billed charges,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,1589.55,61.85,,,percent of total billed charges,61.85% of total billed charges,632.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,632.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,645.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,822.63,130,,,Fee Schedule,130% of WA Medicaid ,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,968.89,37.7,,,percent of total billed charges,37.70% of total billed charges,968.89,37.7,,,percent of total billed charges,37.70% of total billed charges,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,87123,33.9,,,percent of total billed charges,33.9% of total billed charges,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2004.6,78,,,percent of total billed charges,78% of total billed charges,2570,100,,,percent of total billed charges,100% of total billed charges,2122.82,82.6,,,percent of total billed charges,82.6% of total billed charges,2122.82,82.6,,,percent of total billed charges,82.6% of total billed charges,632.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,85.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,632.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,85.35,87123,
TYMPANIC MEMBRANE REPAIR,69610,CDM,983,RC,69610,HCPCS,Outpatient,,,729,473.85,,641.52,88,,,percent of total billed charges,88% of total Billed charges,25.82,100,,,Fee Schedule,100% of Medicare rate,165.24,100,,,Fee Schedule,100% of WA Medicaid,729,100,,,percent of total billed charges,100% of total billed charges,170.2,103,,,Fee Schedule,103% of WA Medicaid,25.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,165.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,503.01,69,,,percent of total billed charges,69% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,729,100,,,percent of total billed charges,100% of total billed charges,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,729,100,,,percent of total billed charges,100% of total billed charges,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,450.89,61.85,,,percent of total billed charges,61.85% of total billed charges,165.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,214.81,130,,,Fee Schedule,130% of WA Medicaid ,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,274.83,37.7,,,percent of total billed charges,37.70% of total billed charges,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,24713.1,33.9,,,percent of total billed charges,33.9% of total billed charges,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,568.62,78,,,percent of total billed charges,78% of total billed charges,729,100,,,percent of total billed charges,100% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,602.15,82.6,,,percent of total billed charges,82.6% of total billed charges,165.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.82,24713.1,
MYRINGOPLASTY,69620,CDM,983,RC,69620,HCPCS,Outpatient,,,956,621.40,,841.28,88,,,percent of total billed charges,88% of total Billed charges,38.23,100,,,Fee Schedule,100% of Medicare rate,288.7,100,,,Fee Schedule,100% of WA Medicaid,956,100,,,percent of total billed charges,100% of total billed charges,297.36,103,,,Fee Schedule,103% of WA Medicaid,38.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,288.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,659.64,69,,,percent of total billed charges,69% of total billed charges,956,100,,,percent of total billed charges,100% of total billed charges,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,956,100,,,percent of total billed charges,100% of total billed charges,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,956,100,,,percent of total billed charges,100% of total billed charges,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,591.29,61.85,,,percent of total billed charges,61.85% of total billed charges,288.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,294.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,375.31,130,,,Fee Schedule,130% of WA Medicaid ,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,360.41,37.7,,,percent of total billed charges,37.70% of total billed charges,360.41,37.7,,,percent of total billed charges,37.70% of total billed charges,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,32408.4,33.9,,,percent of total billed charges,33.9% of total billed charges,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.68,78,,,percent of total billed charges,78% of total billed charges,956,100,,,percent of total billed charges,100% of total billed charges,789.66,82.6,,,percent of total billed charges,82.6% of total billed charges,789.66,82.6,,,percent of total billed charges,82.6% of total billed charges,288.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.23,32408.4,
TYMPANOPLASTY,69631,CDM,983,RC,69631,HCPCS,Outpatient,,,1830,1189.50,,1610.4,88,,,percent of total billed charges,88% of total Billed charges,65.91,100,,,Fee Schedule,100% of Medicare rate,520.34,100,,,Fee Schedule,100% of WA Medicaid,1830,100,,,percent of total billed charges,100% of total billed charges,535.95,103,,,Fee Schedule,103% of WA Medicaid,65.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,115.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,520.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1262.7,69,,,percent of total billed charges,69% of total billed charges,1830,100,,,percent of total billed charges,100% of total billed charges,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1830,100,,,percent of total billed charges,100% of total billed charges,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1830,100,,,percent of total billed charges,100% of total billed charges,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1131.86,61.85,,,percent of total billed charges,61.85% of total billed charges,520.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,530.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,676.44,130,,,Fee Schedule,130% of WA Medicaid ,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,689.91,37.7,,,percent of total billed charges,37.70% of total billed charges,689.91,37.7,,,percent of total billed charges,37.70% of total billed charges,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,62037,33.9,,,percent of total billed charges,33.9% of total billed charges,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1427.4,78,,,percent of total billed charges,78% of total billed charges,1830,100,,,percent of total billed charges,100% of total billed charges,1511.58,82.6,,,percent of total billed charges,82.6% of total billed charges,1511.58,82.6,,,percent of total billed charges,82.6% of total billed charges,520.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,520.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.91,62037,
TYMPANOPLASTY W/O MASTOIDECTOMY,69632,CDM,983,RC,69632,HCPCS,Outpatient,,,2103,1366.95,,1850.64,88,,,percent of total billed charges,88% of total Billed charges,81.01,100,,,Fee Schedule,100% of Medicare rate,629.81,100,,,Fee Schedule,100% of WA Medicaid,2103,100,,,percent of total billed charges,100% of total billed charges,648.7,103,,,Fee Schedule,103% of WA Medicaid,81.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,141.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,629.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1451.07,69,,,percent of total billed charges,69% of total billed charges,2103,100,,,percent of total billed charges,100% of total billed charges,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2103,100,,,percent of total billed charges,100% of total billed charges,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,2103,100,,,percent of total billed charges,100% of total billed charges,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1300.71,61.85,,,percent of total billed charges,61.85% of total billed charges,629.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,642.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,818.75,130,,,Fee Schedule,130% of WA Medicaid ,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,792.83,37.7,,,percent of total billed charges,37.70% of total billed charges,792.83,37.7,,,percent of total billed charges,37.70% of total billed charges,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,71291.7,33.9,,,percent of total billed charges,33.9% of total billed charges,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1640.34,78,,,percent of total billed charges,78% of total billed charges,2103,100,,,percent of total billed charges,100% of total billed charges,1737.08,82.6,,,percent of total billed charges,82.6% of total billed charges,1737.08,82.6,,,percent of total billed charges,82.6% of total billed charges,629.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,629.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.01,71291.7,
TYMPANOPLASTY WITH OSSICULAR CHAIN RECON,69636,CDM,983,RC,69636,HCPCS,Outpatient,,,2700,1755.00,,2376,88,,,percent of total billed charges,88% of total Billed charges,101.11,100,,,Fee Schedule,100% of Medicare rate,821.16,100,,,Fee Schedule,100% of WA Medicaid,2700,100,,,percent of total billed charges,100% of total billed charges,845.79,103,,,Fee Schedule,103% of WA Medicaid,101.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,176.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,821.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1863,69,,,percent of total billed charges,69% of total billed charges,2700,100,,,percent of total billed charges,100% of total billed charges,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2700,100,,,percent of total billed charges,100% of total billed charges,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2700,100,,,percent of total billed charges,100% of total billed charges,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1669.95,61.85,,,percent of total billed charges,61.85% of total billed charges,821.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,821.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,837.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1067.51,130,,,Fee Schedule,130% of WA Medicaid ,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017.9,37.7,,,percent of total billed charges,37.70% of total billed charges,1017.9,37.7,,,percent of total billed charges,37.70% of total billed charges,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,91530,33.9,,,percent of total billed charges,33.9% of total billed charges,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,2106,78,,,percent of total billed charges,78% of total billed charges,2700,100,,,percent of total billed charges,100% of total billed charges,2230.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2230.2,82.6,,,percent of total billed charges,82.6% of total billed charges,821.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,101.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,821.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,101.11,91530,
PORT PARTIAL OSSICUL REPLACE PROSTHEIS,69633,CDM,983,RC,69633,HCPCS,Outpatient,,,2164,1406.60,,1904.32,88,,,percent of total billed charges,88% of total Billed charges,80.67,100,,,Fee Schedule,100% of Medicare rate,613.59,100,,,Fee Schedule,100% of WA Medicaid,2164,100,,,percent of total billed charges,100% of total billed charges,632,103,,,Fee Schedule,103% of WA Medicaid,80.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,141.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,613.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1493.16,69,,,percent of total billed charges,69% of total billed charges,2164,100,,,percent of total billed charges,100% of total billed charges,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2164,100,,,percent of total billed charges,100% of total billed charges,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,2164,100,,,percent of total billed charges,100% of total billed charges,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1338.43,61.85,,,percent of total billed charges,61.85% of total billed charges,613.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,613.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,797.67,130,,,Fee Schedule,130% of WA Medicaid ,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,815.83,37.7,,,percent of total billed charges,37.70% of total billed charges,815.83,37.7,,,percent of total billed charges,37.70% of total billed charges,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,73359.6,33.9,,,percent of total billed charges,33.9% of total billed charges,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1687.92,78,,,percent of total billed charges,78% of total billed charges,2164,100,,,percent of total billed charges,100% of total billed charges,1787.46,82.6,,,percent of total billed charges,82.6% of total billed charges,1787.46,82.6,,,percent of total billed charges,82.6% of total billed charges,613.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,613.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.67,73359.6,
REBUILD EARDRUM STRUCTURES,69637,CDM,983,RC,69637,HCPCS,Outpatient,,,2839,1845.35,,2498.32,88,,,percent of total billed charges,88% of total Billed charges,100.68,100,,,Fee Schedule,100% of Medicare rate,817.8,100,,,Fee Schedule,100% of WA Medicaid,2839,100,,,percent of total billed charges,100% of total billed charges,842.33,103,,,Fee Schedule,103% of WA Medicaid,100.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,176.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,817.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1958.91,69,,,percent of total billed charges,69% of total billed charges,2839,100,,,percent of total billed charges,100% of total billed charges,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2839,100,,,percent of total billed charges,100% of total billed charges,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2839,100,,,percent of total billed charges,100% of total billed charges,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1755.92,61.85,,,percent of total billed charges,61.85% of total billed charges,817.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,817.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,834.16,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1063.14,130,,,Fee Schedule,130% of WA Medicaid ,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,1070.3,37.7,,,percent of total billed charges,37.70% of total billed charges,1070.3,37.7,,,percent of total billed charges,37.70% of total billed charges,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,96242.1,33.9,,,percent of total billed charges,33.9% of total billed charges,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2214.42,78,,,percent of total billed charges,78% of total billed charges,2839,100,,,percent of total billed charges,100% of total billed charges,2345.01,82.6,,,percent of total billed charges,82.6% of total billed charges,2345.01,82.6,,,percent of total billed charges,82.6% of total billed charges,817.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,100.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,817.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,100.68,96242.1,
TYMP/MAST-ECTOMY R/C W/OSSIC CHAIN RECON,69646,CDM,983,RC,69646,HCPCS,Outpatient,,,3200,2080.00,,2816,88,,,percent of total billed charges,88% of total Billed charges,119.48,100,,,Fee Schedule,100% of Medicare rate,913.48,100,,,Fee Schedule,100% of WA Medicaid,3200,100,,,percent of total billed charges,100% of total billed charges,940.88,103,,,Fee Schedule,103% of WA Medicaid,119.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,209.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,913.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2208,69,,,percent of total billed charges,69% of total billed charges,3200,100,,,percent of total billed charges,100% of total billed charges,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3200,100,,,percent of total billed charges,100% of total billed charges,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,3200,100,,,percent of total billed charges,100% of total billed charges,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1979.2,61.85,,,percent of total billed charges,61.85% of total billed charges,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,931.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1187.52,130,,,Fee Schedule,130% of WA Medicaid ,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1206.4,37.7,,,percent of total billed charges,37.70% of total billed charges,1206.4,37.7,,,percent of total billed charges,37.70% of total billed charges,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,108480,33.9,,,percent of total billed charges,33.9% of total billed charges,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,2496,78,,,percent of total billed charges,78% of total billed charges,3200,100,,,percent of total billed charges,100% of total billed charges,2643.2,82.6,,,percent of total billed charges,82.6% of total billed charges,2643.2,82.6,,,percent of total billed charges,82.6% of total billed charges,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,119.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,913.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,119.48,108480,
REVISE MIDDLE EAR  MASTOID,69643,CDM,983,RC,69643,HCPCS,Outpatient,,,2477,1610.05,,2179.76,88,,,percent of total billed charges,88% of total Billed charges,95.88,100,,,Fee Schedule,100% of Medicare rate,709.82,100,,,Fee Schedule,100% of WA Medicaid,2477,100,,,percent of total billed charges,100% of total billed charges,731.11,103,,,Fee Schedule,103% of WA Medicaid,95.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,167.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,709.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1709.13,69,,,percent of total billed charges,69% of total billed charges,2477,100,,,percent of total billed charges,100% of total billed charges,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2477,100,,,percent of total billed charges,100% of total billed charges,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,2477,100,,,percent of total billed charges,100% of total billed charges,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1532.02,61.85,,,percent of total billed charges,61.85% of total billed charges,709.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,724.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,922.77,130,,,Fee Schedule,130% of WA Medicaid ,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,933.83,37.7,,,percent of total billed charges,37.70% of total billed charges,933.83,37.7,,,percent of total billed charges,37.70% of total billed charges,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,83970.3,33.9,,,percent of total billed charges,33.9% of total billed charges,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1932.06,78,,,percent of total billed charges,78% of total billed charges,2477,100,,,percent of total billed charges,100% of total billed charges,2046,82.6,,,percent of total billed charges,82.6% of total billed charges,2046,82.6,,,percent of total billed charges,82.6% of total billed charges,709.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,95.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,709.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.88,83970.3,
TYMPANOPLASTY W/ MASTOIDECTOMY,69641,CDM,983,RC,69641,HCPCS,Outpatient,,,2175,1413.75,,1914,88,,,percent of total billed charges,88% of total Billed charges,80.3,100,,,Fee Schedule,100% of Medicare rate,606.13,100,,,Fee Schedule,100% of WA Medicaid,2175,100,,,percent of total billed charges,100% of total billed charges,624.31,103,,,Fee Schedule,103% of WA Medicaid,80.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,140.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,606.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1500.75,69,,,percent of total billed charges,69% of total billed charges,2175,100,,,percent of total billed charges,100% of total billed charges,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2175,100,,,percent of total billed charges,100% of total billed charges,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,2175,100,,,percent of total billed charges,100% of total billed charges,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1345.24,61.85,,,percent of total billed charges,61.85% of total billed charges,606.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,618.25,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,787.97,130,,,Fee Schedule,130% of WA Medicaid ,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,819.98,37.7,,,percent of total billed charges,37.70% of total billed charges,819.98,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,73732.5,33.9,,,percent of total billed charges,33.9% of total billed charges,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1696.5,78,,,percent of total billed charges,78% of total billed charges,2175,100,,,percent of total billed charges,100% of total billed charges,1796.55,82.6,,,percent of total billed charges,82.6% of total billed charges,1796.55,82.6,,,percent of total billed charges,82.6% of total billed charges,606.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,80.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,606.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,80.3,73732.5,
STAPEDECTOMY,69660,CDM,983,RC,69660,HCPCS,Outpatient,,,1889,1227.85,,1662.32,88,,,percent of total billed charges,88% of total Billed charges,73.81,100,,,Fee Schedule,100% of Medicare rate,536.37,100,,,Fee Schedule,100% of WA Medicaid,1889,100,,,percent of total billed charges,100% of total billed charges,552.46,103,,,Fee Schedule,103% of WA Medicaid,73.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,129.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,536.37,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1303.41,69,,,percent of total billed charges,69% of total billed charges,1889,100,,,percent of total billed charges,100% of total billed charges,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1889,100,,,percent of total billed charges,100% of total billed charges,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1889,100,,,percent of total billed charges,100% of total billed charges,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1168.35,61.85,,,percent of total billed charges,61.85% of total billed charges,536.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,536.37,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,547.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,697.28,130,,,Fee Schedule,130% of WA Medicaid ,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.15,37.7,,,percent of total billed charges,37.70% of total billed charges,712.15,37.7,,,percent of total billed charges,37.70% of total billed charges,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,64037.1,33.9,,,percent of total billed charges,33.9% of total billed charges,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,1473.42,78,,,percent of total billed charges,78% of total billed charges,1889,100,,,percent of total billed charges,100% of total billed charges,1560.31,82.6,,,percent of total billed charges,82.6% of total billed charges,1560.31,82.6,,,percent of total billed charges,82.6% of total billed charges,536.37,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,536.37,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,64037.1,
CLOSE MASTOID FISTULA,69700,CDM,983,RC,69700,HCPCS,Outpatient,,,2006,1303.90,,1765.28,88,,,percent of total billed charges,88% of total Billed charges,52.25,100,,,Fee Schedule,100% of Medicare rate,387.55,100,,,Fee Schedule,100% of WA Medicaid,2006,100,,,percent of total billed charges,100% of total billed charges,399.18,103,,,Fee Schedule,103% of WA Medicaid,52.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,91.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,387.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1384.14,69,,,percent of total billed charges,69% of total billed charges,2006,100,,,percent of total billed charges,100% of total billed charges,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2006,100,,,percent of total billed charges,100% of total billed charges,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2006,100,,,percent of total billed charges,100% of total billed charges,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1240.71,61.85,,,percent of total billed charges,61.85% of total billed charges,387.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,503.82,130,,,Fee Schedule,130% of WA Medicaid ,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,756.26,37.7,,,percent of total billed charges,37.70% of total billed charges,756.26,37.7,,,percent of total billed charges,37.70% of total billed charges,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,68003.4,33.9,,,percent of total billed charges,33.9% of total billed charges,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1564.68,78,,,percent of total billed charges,78% of total billed charges,2006,100,,,percent of total billed charges,100% of total billed charges,1656.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1656.96,82.6,,,percent of total billed charges,82.6% of total billed charges,387.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.25,68003.4,
RELEASE FACIAL NERVE,69720,CDM,983,RC,69720,HCPCS,Outpatient,,,4931,3205.15,,4339.28,88,,,percent of total billed charges,88% of total Billed charges,91.65,100,,,Fee Schedule,100% of Medicare rate,683.71,100,,,Fee Schedule,100% of WA Medicaid,4931,100,,,percent of total billed charges,100% of total billed charges,704.22,103,,,Fee Schedule,103% of WA Medicaid,91.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,160.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,683.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,3402.39,69,,,percent of total billed charges,69% of total billed charges,4931,100,,,percent of total billed charges,100% of total billed charges,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,4931,100,,,percent of total billed charges,100% of total billed charges,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,4931,100,,,percent of total billed charges,100% of total billed charges,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3049.82,61.85,,,percent of total billed charges,61.85% of total billed charges,683.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,697.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,888.82,130,,,Fee Schedule,130% of WA Medicaid ,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1858.99,37.7,,,percent of total billed charges,37.70% of total billed charges,1858.99,37.7,,,percent of total billed charges,37.70% of total billed charges,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,167160.9,33.9,,,percent of total billed charges,33.9% of total billed charges,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,3846.18,78,,,percent of total billed charges,78% of total billed charges,4931,100,,,percent of total billed charges,100% of total billed charges,4073.01,82.6,,,percent of total billed charges,82.6% of total billed charges,4073.01,82.6,,,percent of total billed charges,82.6% of total billed charges,683.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,683.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.65,167160.9,
LABYRINTHOTOMY W/ PERFUSION;TRANSCANAL,69801,CDM,983,RC,69801,HCPCS,Outpatient,,,471,306.15,,414.48,88,,,percent of total billed charges,88% of total Billed charges,11.52,100,,,Fee Schedule,100% of Medicare rate,70.87,100,,,Fee Schedule,100% of WA Medicaid,471,100,,,percent of total billed charges,100% of total billed charges,73,103,,,Fee Schedule,103% of WA Medicaid,11.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,70.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,324.99,69,,,percent of total billed charges,69% of total billed charges,471,100,,,percent of total billed charges,100% of total billed charges,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,471,100,,,percent of total billed charges,100% of total billed charges,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,471,100,,,percent of total billed charges,100% of total billed charges,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.31,61.85,,,percent of total billed charges,61.85% of total billed charges,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,92.13,130,,,Fee Schedule,130% of WA Medicaid ,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.57,37.7,,,percent of total billed charges,37.70% of total billed charges,177.57,37.7,,,percent of total billed charges,37.70% of total billed charges,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,15966.9,33.9,,,percent of total billed charges,33.9% of total billed charges,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,367.38,78,,,percent of total billed charges,78% of total billed charges,471,100,,,percent of total billed charges,100% of total billed charges,389.05,82.6,,,percent of total billed charges,82.6% of total billed charges,389.05,82.6,,,percent of total billed charges,82.6% of total billed charges,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.52,15966.9,
MICROSURGERY ADD-ON,69990,CDM,983,RC,69990,HCPCS,Outpatient,,,1027,667.55,,903.76,88,,,percent of total billed charges,88% of total Billed charges,42.63,100,,,Fee Schedule,100% of Medicare rate,119.17,100,,,Fee Schedule,100% of WA Medicaid,1027,100,,,percent of total billed charges,100% of total billed charges,122.75,103,,,Fee Schedule,103% of WA Medicaid,42.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,74.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,119.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,708.63,69,,,percent of total billed charges,69% of total billed charges,1027,100,,,percent of total billed charges,100% of total billed charges,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1027,100,,,percent of total billed charges,100% of total billed charges,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,1027,100,,,percent of total billed charges,100% of total billed charges,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,635.2,61.85,,,percent of total billed charges,61.85% of total billed charges,119.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,154.92,130,,,Fee Schedule,130% of WA Medicaid ,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,387.18,37.7,,,percent of total billed charges,37.70% of total billed charges,387.18,37.7,,,percent of total billed charges,37.70% of total billed charges,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,34815.3,33.9,,,percent of total billed charges,33.9% of total billed charges,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,801.06,78,,,percent of total billed charges,78% of total billed charges,1027,100,,,percent of total billed charges,100% of total billed charges,848.3,82.6,,,percent of total billed charges,82.6% of total billed charges,848.3,82.6,,,percent of total billed charges,82.6% of total billed charges,119.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.63,34815.3,
VEIN X-RAY ARMS/LEGS,75822,CDM,983,RC,75822,HCPCS,Outpatient,,,272,176.80,,239.36,88,,,percent of total billed charges,88% of total Billed charges,7.71,100,,,Fee Schedule,100% of Medicare rate,38.23,100,,,Fee Schedule,100% of WA Medicaid,272,100,,,percent of total billed charges,100% of total billed charges,39.38,103,,,Fee Schedule,103% of WA Medicaid,7.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,187.68,69,,,percent of total billed charges,69% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,272,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,272,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.23,61.85,,,percent of total billed charges,61.85% of total billed charges,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.7,130,,,Fee Schedule,130% of WA Medicaid ,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,102.54,37.7,,,percent of total billed charges,37.70% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,9220.8,33.9,,,percent of total billed charges,33.9% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,212.16,78,,,percent of total billed charges,78% of total billed charges,272,100,,,percent of total billed charges,100% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,224.67,82.6,,,percent of total billed charges,82.6% of total billed charges,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.71,9220.8,
VEIN X-RAY CHEST,75827,CDM,983,RC,75827,HCPCS,Outpatient,,,190,123.50,,167.2,88,,,percent of total billed charges,88% of total Billed charges,7.26,100,,,Fee Schedule,100% of Medicare rate,29.65,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,30.54,103,,,Fee Schedule,103% of WA Medicaid,7.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.52,61.85,,,percent of total billed charges,61.85% of total billed charges,29.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,38.55,130,,,Fee Schedule,130% of WA Medicaid ,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,6441,33.9,,,percent of total billed charges,33.9% of total billed charges,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,29.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.26,6441,
FLUOROSCOPE EXAMINATION,76000,CDM,983,RC,76000,HCPCS,Outpatient,,,148,96.20,,130.24,88,,,percent of total billed charges,88% of total Billed charges,2.35,100,,,Fee Schedule,100% of Medicare rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,148,100,,,percent of total billed charges,100% of total billed charges,8.64,103,,,Fee Schedule,103% of WA Medicaid,2.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,102.12,69,,,percent of total billed charges,69% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,148,100,,,percent of total billed charges,100% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,148,100,,,percent of total billed charges,100% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.54,61.85,,,percent of total billed charges,61.85% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.91,130,,,Fee Schedule,130% of WA Medicaid ,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.8,37.7,,,percent of total billed charges,37.70% of total billed charges,55.8,37.7,,,percent of total billed charges,37.70% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,5017.2,33.9,,,percent of total billed charges,33.9% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.44,78,,,percent of total billed charges,78% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.35,5017.2,
GUIDENEEDLE PLACEMENT,76942,CDM,972,RC,76942,HCPCS,Outpatient,,,409,265.85,,359.92,88,,,percent of total billed charges,88% of total Billed charges,2.82,100,,,Fee Schedule,100% of Medicare rate,16.97,100,,,Fee Schedule,100% of WA Medicaid,409,100,,,percent of total billed charges,100% of total billed charges,17.48,103,,,Fee Schedule,103% of WA Medicaid,2.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,282.21,69,,,percent of total billed charges,69% of total billed charges,409,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,409,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,409,100,,,percent of total billed charges,100% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.97,61.85,,,percent of total billed charges,61.85% of total billed charges,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.06,130,,,Fee Schedule,130% of WA Medicaid ,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.19,37.7,,,percent of total billed charges,37.70% of total billed charges,154.19,37.7,,,percent of total billed charges,37.70% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,13865.1,33.9,,,percent of total billed charges,33.9% of total billed charges,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.02,78,,,percent of total billed charges,78% of total billed charges,409,100,,,percent of total billed charges,100% of total billed charges,337.83,82.6,,,percent of total billed charges,82.6% of total billed charges,337.83,82.6,,,percent of total billed charges,82.6% of total billed charges,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.82,13865.1,
NEEDLE LOCALIZATION BY XRAY,77002,CDM,983,RC,77002,HCPCS,Outpatient,,,222,144.30,,195.36,88,,,percent of total billed charges,88% of total Billed charges,4.63,100,,,Fee Schedule,100% of Medicare rate,15.11,100,,,Fee Schedule,100% of WA Medicaid,222,100,,,percent of total billed charges,100% of total billed charges,15.56,103,,,Fee Schedule,103% of WA Medicaid,4.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,15.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,153.18,69,,,percent of total billed charges,69% of total billed charges,222,100,,,percent of total billed charges,100% of total billed charges,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,222,100,,,percent of total billed charges,100% of total billed charges,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,222,100,,,percent of total billed charges,100% of total billed charges,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.31,61.85,,,percent of total billed charges,61.85% of total billed charges,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19.64,130,,,Fee Schedule,130% of WA Medicaid ,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.69,37.7,,,percent of total billed charges,37.70% of total billed charges,83.69,37.7,,,percent of total billed charges,37.70% of total billed charges,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,7525.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.16,78,,,percent of total billed charges,78% of total billed charges,222,100,,,percent of total billed charges,100% of total billed charges,183.37,82.6,,,percent of total billed charges,82.6% of total billed charges,183.37,82.6,,,percent of total billed charges,82.6% of total billed charges,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.63,7525.8,
FLUOROGUIDE FOR SPINE INJECT,77003,CDM,983,RC,77003,HCPCS,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,4.55,100,,,Fee Schedule,100% of Medicare rate,16.23,100,,,Fee Schedule,100% of WA Medicaid,96,100,,,percent of total billed charges,100% of total billed charges,16.72,103,,,Fee Schedule,103% of WA Medicaid,4.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,96,100,,,percent of total billed charges,100% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,96,100,,,percent of total billed charges,100% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.38,61.85,,,percent of total billed charges,61.85% of total billed charges,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.1,130,,,Fee Schedule,130% of WA Medicaid ,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,36.19,37.7,,,percent of total billed charges,37.70% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3254.4,33.9,,,percent of total billed charges,33.9% of total billed charges,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.55,3254.4,
77001 Fluor Guide Ven Plac/Replace/Rem,77001,CDM,983,RC,77001,HCPCS,Outpatient,,,451,293.15,,396.88,88,,,percent of total billed charges,88% of total Billed charges,4.35,100,,,Fee Schedule,100% of Medicare rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,451,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,4.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,311.19,69,,,percent of total billed charges,69% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,451,100,,,percent of total billed charges,100% of total billed charges,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,451,100,,,percent of total billed charges,100% of total billed charges,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.94,61.85,,,percent of total billed charges,61.85% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.84,130,,,Fee Schedule,130% of WA Medicaid ,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,170.03,37.7,,,percent of total billed charges,37.70% of total billed charges,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,15288.9,33.9,,,percent of total billed charges,33.9% of total billed charges,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.78,78,,,percent of total billed charges,78% of total billed charges,451,100,,,percent of total billed charges,100% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,372.53,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.35,15288.9,
Breath Alcohol Test,82075,CDM,300,RC,82075,HCPCS,Outpatient,,,41,26.65,,36.08,88,,,percent of total billed charges,88% of total Billed charges,30,100,,,Fee Schedule,100% of Medicare OPPS rate,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,41,100,,,percent of total billed charges,100% of total billed charges,7.09,17.304,,,percent of total billed charges,17.304% of total billed charges,30,100,,,Fee Schedule,100% of Medicare OPPS rate,25.83,63,,,percent of total billed charges,63% of total billed charges,52.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,15.3,,,percent of total billed charges,15.3% of total billed charges,28.29,69,,,percent of total billed charges,69% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,30,100,,,Fee Schedule,100% of Medicare OPPS rate,41,100,,,percent of total billed charges,100% of total billed charges,30,100,,,Fee Schedule,100% of Medicare OPPS rate,41,100,,,percent of total billed charges,100% of total billed charges,30,100,,,Fee Schedule,100% of Medicare OPPS rate,114.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,30,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,Fee Schedule,100% of Medicare OPPS rate,6.89,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,Fee Schedule,100% of Medicare OPPS rate,30,100,,,Fee Schedule,100% of Medicare OPPS rate,7.03,17.136,,,percent of total billed charges,17.136% of total billed charges,8.95,21.84,,,percent of total billed charges,21.84% of total billed charges,30,100,,,Fee Schedule,100% of Medicare OPPS rate,15.46,37.7,,,percent of total billed charges,37.70% of total billed charges,15.46,37.7,,,percent of total billed charges,37.70% of total billed charges,30,100,,,Fee Schedule,100% of Medicare OPPS rate,13.9,33.9,,,percent of total billed charges,33.9% of total billed charges,30,100,,,Fee Schedule,100% of Medicare OPPS rate,31.98,78,,,percent of total billed charges,78% of total billed charges,41,100,,,percent of total billed charges,100% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,33.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,30,100,,,Fee Schedule,100% of Medicare OPPS rate,30.3,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30,100,,,Fee Schedule,100% of Medicare OPPS rate,6.89,16.8,,,percent of total billed charges,16.8% of total billed charges,6.27,114.75,
87880 Rapid Strep POC,87880,CDM,300,RC,87880,HCPCS,Outpatient,,,60,39.00,QW,52.8,88,,,percent of total billed charges,88% of total Billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,60,100,,,percent of total billed charges,100% of total billed charges,6.68,103,,,Fee Schedule,103% of WA Medicaid,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,37.8,63,,,percent of total billed charges,63% of total billed charges,28.92,175,,,Fee Schedule,175% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid,9.18,15.3,,,percent of total billed charges,15.3% of total billed charges,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,63.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,4.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.44,130,,,Fee Schedule,130% of WA Medicaid ,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,20.34,33.9,,,percent of total billed charges,33.9% of total billed charges,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,16.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,16.53,100,,,Fee Schedule,100% of Medicare OPPS rate,6.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.81,63.22,
PSYTX COMPLEX INTERACTIVE,90785,CDM,983,RC,90785,HCPCS,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,0.65,100,,,Fee Schedule,100% of Medicare rate,9.18,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,9.46,103,,,Fee Schedule,103% of WA Medicaid,0.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,30,100,,,percent of total billed charges,100% of total billed charges,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,30,100,,,percent of total billed charges,100% of total billed charges,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,9.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.93,130,,,Fee Schedule,130% of WA Medicaid ,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,33.9,,,percent of total billed charges,33.9% of total billed charges,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,9.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.65,1017,
PSYCH DIAG EVAL,90791,CDM,983,RC,90791,HCPCS,Outpatient,,,265,172.25,,233.2,88,,,percent of total billed charges,88% of total Billed charges,7.05,100,,,Fee Schedule,100% of Medicare rate,103.28,100,,,Fee Schedule,100% of WA Medicaid,265,100,,,percent of total billed charges,100% of total billed charges,106.38,103,,,Fee Schedule,103% of WA Medicaid,7.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,103.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,182.85,69,,,percent of total billed charges,69% of total billed charges,265,100,,,percent of total billed charges,100% of total billed charges,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,265,100,,,percent of total billed charges,100% of total billed charges,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,265,100,,,percent of total billed charges,100% of total billed charges,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.9,61.85,,,percent of total billed charges,61.85% of total billed charges,103.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,134.26,130,,,Fee Schedule,130% of WA Medicaid ,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.91,37.7,,,percent of total billed charges,37.70% of total billed charges,99.91,37.7,,,percent of total billed charges,37.70% of total billed charges,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,8983.5,33.9,,,percent of total billed charges,33.9% of total billed charges,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.7,78,,,percent of total billed charges,78% of total billed charges,265,100,,,percent of total billed charges,100% of total billed charges,218.89,82.6,,,percent of total billed charges,82.6% of total billed charges,218.89,82.6,,,percent of total billed charges,82.6% of total billed charges,103.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.05,8983.5,
PSYTX W PT 30 MINS,90832,CDM,983,RC,90832,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,3.36,100,,,Fee Schedule,100% of Medicare rate,47.73,100,,,Fee Schedule,100% of WA Medicaid,130,100,,,percent of total billed charges,100% of total billed charges,49.16,103,,,Fee Schedule,103% of WA Medicaid,3.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,47.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,130,100,,,percent of total billed charges,100% of total billed charges,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,130,100,,,percent of total billed charges,100% of total billed charges,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,47.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.05,130,,,Fee Schedule,130% of WA Medicaid ,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4407,33.9,,,percent of total billed charges,33.9% of total billed charges,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,47.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.36,4407,
PSYTX W PT W E/M 30 MINS,90833,CDM,983,RC,90833,HCPCS,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,3.74,100,,,Fee Schedule,100% of Medicare rate,44.75,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,46.09,103,,,Fee Schedule,103% of WA Medicaid,3.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,44.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,135,100,,,percent of total billed charges,100% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,135,100,,,percent of total billed charges,100% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.5,61.85,,,percent of total billed charges,61.85% of total billed charges,44.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,58.18,130,,,Fee Schedule,130% of WA Medicaid ,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,4576.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,44.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.74,4576.5,
PSYTX W PT 45 MINS,90834,CDM,983,RC,90834,HCPCS,Outpatient,,,175,113.75,,154,88,,,percent of total billed charges,88% of total Billed charges,4.28,100,,,Fee Schedule,100% of Medicare rate,63.11,100,,,Fee Schedule,100% of WA Medicaid,175,100,,,percent of total billed charges,100% of total billed charges,65,103,,,Fee Schedule,103% of WA Medicaid,4.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,63.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,120.75,69,,,percent of total billed charges,69% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,175,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,175,100,,,percent of total billed charges,100% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.24,61.85,,,percent of total billed charges,61.85% of total billed charges,63.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.04,130,,,Fee Schedule,130% of WA Medicaid ,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,5932.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.5,78,,,percent of total billed charges,78% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,63.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.28,5932.5,
PSYTX W PT W E/M 45 MINS,90836,CDM,983,RC,90836,HCPCS,Outpatient,,,215,139.75,,189.2,88,,,percent of total billed charges,88% of total Billed charges,4.52,100,,,Fee Schedule,100% of Medicare rate,56.69,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,58.39,103,,,Fee Schedule,103% of WA Medicaid,4.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.98,61.85,,,percent of total billed charges,61.85% of total billed charges,56.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,73.7,130,,,Fee Schedule,130% of WA Medicaid ,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,7288.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,56.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.52,7288.5,
PSYTX W PT 60 MINS,90837,CDM,983,RC,90837,HCPCS,Outpatient,,,255,165.75,,224.4,88,,,percent of total billed charges,88% of total Billed charges,6.36,100,,,Fee Schedule,100% of Medicare rate,93.17,100,,,Fee Schedule,100% of WA Medicaid,255,100,,,percent of total billed charges,100% of total billed charges,95.97,103,,,Fee Schedule,103% of WA Medicaid,6.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,93.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,175.95,69,,,percent of total billed charges,69% of total billed charges,255,100,,,percent of total billed charges,100% of total billed charges,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,255,100,,,percent of total billed charges,100% of total billed charges,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,255,100,,,percent of total billed charges,100% of total billed charges,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.72,61.85,,,percent of total billed charges,61.85% of total billed charges,93.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.03,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,121.12,130,,,Fee Schedule,130% of WA Medicaid ,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.14,37.7,,,percent of total billed charges,37.70% of total billed charges,96.14,37.7,,,percent of total billed charges,37.70% of total billed charges,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,8644.5,33.9,,,percent of total billed charges,33.9% of total billed charges,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.9,78,,,percent of total billed charges,78% of total billed charges,255,100,,,percent of total billed charges,100% of total billed charges,210.63,82.6,,,percent of total billed charges,82.6% of total billed charges,210.63,82.6,,,percent of total billed charges,82.6% of total billed charges,93.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.36,8644.5,
PSYTX W PT W E/M 60 MINS,90838,CDM,983,RC,90838,HCPCS,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,6.09,100,,,Fee Schedule,100% of Medicare rate,75.05,100,,,Fee Schedule,100% of WA Medicaid,220,100,,,percent of total billed charges,100% of total billed charges,77.3,103,,,Fee Schedule,103% of WA Medicaid,6.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,75.05,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,220,100,,,percent of total billed charges,100% of total billed charges,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,220,100,,,percent of total billed charges,100% of total billed charges,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.07,61.85,,,percent of total billed charges,61.85% of total billed charges,75.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.05,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,97.57,130,,,Fee Schedule,130% of WA Medicaid ,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,7458,33.9,,,percent of total billed charges,33.9% of total billed charges,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,75.05,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.15,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.05,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.09,7458,
PSYTX CRISIS INITIAL 60 MINS,90839,CDM,983,RC,90839,HCPCS,Outpatient,,,270,175.50,,237.6,88,,,percent of total billed charges,88% of total Billed charges,6.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,270,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,186.3,69,,,percent of total billed charges,69% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,270,100,,,percent of total billed charges,100% of total billed charges,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,270,100,,,percent of total billed charges,100% of total billed charges,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,167,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,9153,33.9,,,percent of total billed charges,33.9% of total billed charges,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.6,78,,,percent of total billed charges,78% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",6.49,9153,
PSYTX CRISIS EA ADDL 30 MINS,90840,CDM,983,RC,90840,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,4.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,130,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,130,100,,,percent of total billed charges,100% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,130,100,,,percent of total billed charges,100% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4407,33.9,,,percent of total billed charges,33.9% of total billed charges,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",4.02,4407,
FAMILY PSYTX W/O PT 50 MINS,90846,CDM,983,RC,90846,HCPCS,Outpatient,,,210,136.50,,184.8,88,,,percent of total billed charges,88% of total Billed charges,4.75,100,,,Fee Schedule,100% of Medicare rate,67.92,100,,,Fee Schedule,100% of WA Medicaid,210,100,,,percent of total billed charges,100% of total billed charges,69.96,103,,,Fee Schedule,103% of WA Medicaid,4.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,67.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,144.9,69,,,percent of total billed charges,69% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,210,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,210,100,,,percent of total billed charges,100% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.89,61.85,,,percent of total billed charges,61.85% of total billed charges,67.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,88.3,130,,,Fee Schedule,130% of WA Medicaid ,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,7119,33.9,,,percent of total billed charges,33.9% of total billed charges,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.8,78,,,percent of total billed charges,78% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,67.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.75,7119,
FAMILY PSYTX W/PT 50 MINS,90847,CDM,983,RC,90847,HCPCS,Outpatient,,,215,139.75,,189.2,88,,,percent of total billed charges,88% of total Billed charges,4.88,100,,,Fee Schedule,100% of Medicare rate,71.15,100,,,Fee Schedule,100% of WA Medicaid,215,100,,,percent of total billed charges,100% of total billed charges,73.28,103,,,Fee Schedule,103% of WA Medicaid,4.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,71.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.98,61.85,,,percent of total billed charges,61.85% of total billed charges,71.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,92.5,130,,,Fee Schedule,130% of WA Medicaid ,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,7288.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,71.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.88,7288.5,
MULT FAMILY GROUP PSYTX,90849,CDM,983,RC,90849,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,1.41,100,,,Fee Schedule,100% of Medicare rate,20.66,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,21.28,103,,,Fee Schedule,103% of WA Medicaid,1.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,100,,,percent of total billed charges,100% of total billed charges,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,100,,,percent of total billed charges,100% of total billed charges,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,20.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.86,130,,,Fee Schedule,130% of WA Medicaid ,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2373,33.9,,,percent of total billed charges,33.9% of total billed charges,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,20.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.41,2373,
PSYCHOANALYSIS,90845,CDM,983,RC,90845,HCPCS,Outpatient,,,185,120.25,,162.8,88,,,percent of total billed charges,88% of total Billed charges,4.43,100,,,Fee Schedule,100% of Medicare rate,60.59,100,,,Fee Schedule,100% of WA Medicaid,185,100,,,percent of total billed charges,100% of total billed charges,62.41,103,,,Fee Schedule,103% of WA Medicaid,4.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,127.65,69,,,percent of total billed charges,69% of total billed charges,185,100,,,percent of total billed charges,100% of total billed charges,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,185,100,,,percent of total billed charges,100% of total billed charges,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,185,100,,,percent of total billed charges,100% of total billed charges,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.42,61.85,,,percent of total billed charges,61.85% of total billed charges,60.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,78.77,130,,,Fee Schedule,130% of WA Medicaid ,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.75,37.7,,,percent of total billed charges,37.70% of total billed charges,69.75,37.7,,,percent of total billed charges,37.70% of total billed charges,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,6271.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.3,78,,,percent of total billed charges,78% of total billed charges,185,100,,,percent of total billed charges,100% of total billed charges,152.81,82.6,,,percent of total billed charges,82.6% of total billed charges,152.81,82.6,,,percent of total billed charges,82.6% of total billed charges,60.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.43,6271.5,
NARCOSYNTHESIS,90865,CDM,983,RC,90865,HCPCS,Outpatient,,,340,221.00,,299.2,88,,,percent of total billed charges,88% of total Billed charges,7.03,100,,,Fee Schedule,100% of Medicare rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,340,100,,,percent of total billed charges,100% of total billed charges,71.08,103,,,Fee Schedule,103% of WA Medicaid,7.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,234.6,69,,,percent of total billed charges,69% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.29,61.85,,,percent of total billed charges,61.85% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.39,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.71,130,,,Fee Schedule,130% of WA Medicaid ,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,11526,33.9,,,percent of total billed charges,33.9% of total billed charges,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.2,78,,,percent of total billed charges,78% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.03,11526,
TCRANIAL MAGN STIM TX PLAN,90867,CDM,983,RC,90867,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,127.54,100,,,Fee Schedule,100% of WA Medicaid,250,100,,,percent of total billed charges,100% of total billed charges,131.37,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,127.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,250,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,127.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,127.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,165.8,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,8475,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,127.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,127.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,94.25,8475,
ELECTROCONVULSIVE THERAPY,90870,CDM,983,RC,90870,HCPCS,Outpatient,,,360,234.00,,316.8,88,,,percent of total billed charges,88% of total Billed charges,5.73,100,,,Fee Schedule,100% of Medicare rate,59.12,100,,,Fee Schedule,100% of WA Medicaid,360,100,,,percent of total billed charges,100% of total billed charges,60.89,103,,,Fee Schedule,103% of WA Medicaid,5.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,248.4,69,,,percent of total billed charges,69% of total billed charges,360,100,,,percent of total billed charges,100% of total billed charges,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,360,100,,,percent of total billed charges,100% of total billed charges,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,360,100,,,percent of total billed charges,100% of total billed charges,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.66,61.85,,,percent of total billed charges,61.85% of total billed charges,59.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.3,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,76.86,130,,,Fee Schedule,130% of WA Medicaid ,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.72,37.7,,,percent of total billed charges,37.70% of total billed charges,135.72,37.7,,,percent of total billed charges,37.70% of total billed charges,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,12204,33.9,,,percent of total billed charges,33.9% of total billed charges,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.8,78,,,percent of total billed charges,78% of total billed charges,360,100,,,percent of total billed charges,100% of total billed charges,297.36,82.6,,,percent of total billed charges,82.6% of total billed charges,297.36,82.6,,,percent of total billed charges,82.6% of total billed charges,59.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.73,12204,
PHYCHOPHYSIOLOGICAL THERAPY 30 MINS,90875,CDM,983,RC,90875,HCPCS,Outpatient,,,215,139.75,,189.2,88,,,percent of total billed charges,88% of total Billed charges,3.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,215,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,3.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.98,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,7288.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",3.57,7288.5,
PSYCHOPHYSIOLOGICAL THERAPY 45 MINS,90876,CDM,983,RC,90876,HCPCS,Outpatient,,,340,221.00,,299.2,88,,,percent of total billed charges,88% of total Billed charges,5.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,340,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,234.6,69,,,percent of total billed charges,69% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,340,100,,,percent of total billed charges,100% of total billed charges,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.29,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,128.18,37.7,,,percent of total billed charges,37.70% of total billed charges,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11526,33.9,,,percent of total billed charges,33.9% of total billed charges,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.2,78,,,percent of total billed charges,78% of total billed charges,340,100,,,percent of total billed charges,100% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,280.84,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",5.89,11526,
CONSULTATION WITH FAMILY,90887,CDM,983,RC,90887,HCPCS,Outpatient,,,130,84.50,,114.4,88,,,percent of total billed charges,88% of total Billed charges,4.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,130,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,89.7,69,,,percent of total billed charges,69% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,130,100,,,percent of total billed charges,100% of total billed charges,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,130,100,,,percent of total billed charges,100% of total billed charges,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,49.01,37.7,,,percent of total billed charges,37.70% of total billed charges,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4407,33.9,,,percent of total billed charges,33.9% of total billed charges,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.4,78,,,percent of total billed charges,78% of total billed charges,130,100,,,percent of total billed charges,100% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,107.38,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",4.49,4407,
ENVIRONMENTAL MANIPULATION,90882,CDM,983,RC,90882,HCPCS,Outpatient,,,155,100.75,,136.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,155,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,106.95,69,,,percent of total billed charges,69% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,155,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,155,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,95.87,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,5254.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,120.9,78,,,percent of total billed charges,78% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",58.44,5254.5,
PREPARE REPORT STATUS HX/TX/PR,90889,CDM,983,RC,90889,HCPCS,Outpatient,,,65,42.25,,57.2,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,65,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,44.85,69,,,percent of total billed charges,69% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,65,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,65,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,40.2,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,24.51,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2203.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,50.7,78,,,percent of total billed charges,78% of total billed charges,65,100,,,percent of total billed charges,100% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,53.69,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",24.51,2203.5,
PSY EVAL OF RECORDS,90885,CDM,983,RC,90885,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,2.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,100,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,100,100,,,percent of total billed charges,100% of total billed charges,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,100,100,,,percent of total billed charges,100% of total billed charges,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3390,33.9,,,percent of total billed charges,33.9% of total billed charges,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",2.98,3390,
HYPNOTHERAPY,90880,CDM,983,RC,90880,HCPCS,Outpatient,,,205,133.25,,180.4,88,,,percent of total billed charges,88% of total Billed charges,4.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,205,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,141.45,69,,,percent of total billed charges,69% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,205,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,205,100,,,percent of total billed charges,100% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,126.79,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.29,37.7,,,percent of total billed charges,37.70% of total billed charges,77.29,37.7,,,percent of total billed charges,37.70% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,6949.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.9,78,,,percent of total billed charges,78% of total billed charges,205,100,,,percent of total billed charges,100% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,169.33,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",4.14,6949.5,
PSYCHIATRIC SERVICE/THERAPY,90899,CDM,983,RC,90899,HCPCS,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,150,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,150,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,5085,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",56.55,5085,
BIOFEEDBACK TRAIN ANY METH,90901,CDM,983,RC,90901,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,1.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,75,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,75,100,,,percent of total billed charges,100% of total billed charges,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,75,100,,,percent of total billed charges,100% of total billed charges,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.39,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2542.5,33.9,,,percent of total billed charges,33.9% of total billed charges,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",1.09,2542.5,
HEMODIALYSIS ONE EVALUATION,90935,CDM,983,RC,90935,HCPCS,Outpatient,,,145,94.25,,127.6,88,,,percent of total billed charges,88% of total Billed charges,4.45,100,,,Fee Schedule,100% of Medicare rate,39.91,100,,,Fee Schedule,100% of WA Medicaid,145,100,,,percent of total billed charges,100% of total billed charges,41.11,103,,,Fee Schedule,103% of WA Medicaid,4.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,100.05,69,,,percent of total billed charges,69% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,145,100,,,percent of total billed charges,100% of total billed charges,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,145,100,,,percent of total billed charges,100% of total billed charges,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.68,61.85,,,percent of total billed charges,61.85% of total billed charges,39.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.88,130,,,Fee Schedule,130% of WA Medicaid ,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,54.67,37.7,,,percent of total billed charges,37.70% of total billed charges,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,4915.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.1,78,,,percent of total billed charges,78% of total billed charges,145,100,,,percent of total billed charges,100% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,119.77,82.6,,,percent of total billed charges,82.6% of total billed charges,39.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.45,4915.5,
HEMODIALYSIS REPEATED EVAL,90937,CDM,983,RC,90937,HCPCS,Outpatient,,,209,135.85,,183.92,88,,,percent of total billed charges,88% of total Billed charges,6.41,100,,,Fee Schedule,100% of Medicare rate,57.44,100,,,Fee Schedule,100% of WA Medicaid,209,100,,,percent of total billed charges,100% of total billed charges,59.16,103,,,Fee Schedule,103% of WA Medicaid,6.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,57.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,144.21,69,,,percent of total billed charges,69% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,209,100,,,percent of total billed charges,100% of total billed charges,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,209,100,,,percent of total billed charges,100% of total billed charges,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.27,61.85,,,percent of total billed charges,61.85% of total billed charges,57.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,74.67,130,,,Fee Schedule,130% of WA Medicaid ,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.79,37.7,,,percent of total billed charges,37.70% of total billed charges,78.79,37.7,,,percent of total billed charges,37.70% of total billed charges,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7085.1,33.9,,,percent of total billed charges,33.9% of total billed charges,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.02,78,,,percent of total billed charges,78% of total billed charges,209,100,,,percent of total billed charges,100% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,172.63,82.6,,,percent of total billed charges,82.6% of total billed charges,57.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.41,7085.1,
DIALYSIS ONE EVALUATION,90945,CDM,983,RC,90945,HCPCS,Outpatient,,,172,111.80,,151.36,88,,,percent of total billed charges,88% of total Billed charges,5.16,100,,,Fee Schedule,100% of Medicare rate,48.68,100,,,Fee Schedule,100% of WA Medicaid,172,100,,,percent of total billed charges,100% of total billed charges,50.14,103,,,Fee Schedule,103% of WA Medicaid,5.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,118.68,69,,,percent of total billed charges,69% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,172,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,172,100,,,percent of total billed charges,100% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.38,61.85,,,percent of total billed charges,61.85% of total billed charges,48.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.28,130,,,Fee Schedule,130% of WA Medicaid ,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,64.84,37.7,,,percent of total billed charges,37.70% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,5830.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.16,78,,,percent of total billed charges,78% of total billed charges,172,100,,,percent of total billed charges,100% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,142.07,82.6,,,percent of total billed charges,82.6% of total billed charges,48.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.16,5830.8,
DIALYSIS REPEATED EVAL,90947,CDM,983,RC,90947,HCPCS,Outpatient,,,249,161.85,,219.12,88,,,percent of total billed charges,88% of total Billed charges,8.31,100,,,Fee Schedule,100% of Medicare rate,68.82,100,,,Fee Schedule,100% of WA Medicaid,249,100,,,percent of total billed charges,100% of total billed charges,70.88,103,,,Fee Schedule,103% of WA Medicaid,8.31,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,68.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,171.81,69,,,percent of total billed charges,69% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,249,100,,,percent of total billed charges,100% of total billed charges,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,249,100,,,percent of total billed charges,100% of total billed charges,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.01,61.85,,,percent of total billed charges,61.85% of total billed charges,68.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,89.47,130,,,Fee Schedule,130% of WA Medicaid ,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,93.87,37.7,,,percent of total billed charges,37.70% of total billed charges,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,8441.1,33.9,,,percent of total billed charges,33.9% of total billed charges,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.22,78,,,percent of total billed charges,78% of total billed charges,249,100,,,percent of total billed charges,100% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,205.67,82.6,,,percent of total billed charges,82.6% of total billed charges,68.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.31,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.31,8441.1,
ESRD HOME PT SERV PER FULL MONTH 12-19,90965,CDM,983,RC,90965,HCPCS,Outpatient,,,1011,657.15,,889.68,88,,,percent of total billed charges,88% of total Billed charges,31.01,100,,,Fee Schedule,100% of Medicare rate,282.55,100,,,Fee Schedule,100% of WA Medicaid,1011,100,,,percent of total billed charges,100% of total billed charges,291.03,103,,,Fee Schedule,103% of WA Medicaid,31.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,54.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,697.59,69,,,percent of total billed charges,69% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1011,100,,,percent of total billed charges,100% of total billed charges,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1011,100,,,percent of total billed charges,100% of total billed charges,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.3,61.85,,,percent of total billed charges,61.85% of total billed charges,282.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.32,130,,,Fee Schedule,130% of WA Medicaid ,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,381.15,37.7,,,percent of total billed charges,37.70% of total billed charges,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,34272.9,33.9,,,percent of total billed charges,33.9% of total billed charges,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,788.58,78,,,percent of total billed charges,78% of total billed charges,1011,100,,,percent of total billed charges,100% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,835.09,82.6,,,percent of total billed charges,82.6% of total billed charges,282.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.01,34272.9,
ESRD HOME PT SERVICES PER MONTH 20 YRS,90966,CDM,983,RC,90966,HCPCS,Outpatient,,,534,347.10,,469.92,88,,,percent of total billed charges,88% of total Billed charges,17.62,100,,,Fee Schedule,100% of Medicare rate,166.73,100,,,Fee Schedule,100% of WA Medicaid,534,100,,,percent of total billed charges,100% of total billed charges,171.73,103,,,Fee Schedule,103% of WA Medicaid,17.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,166.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,368.46,69,,,percent of total billed charges,69% of total billed charges,534,100,,,percent of total billed charges,100% of total billed charges,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,534,100,,,percent of total billed charges,100% of total billed charges,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,534,100,,,percent of total billed charges,100% of total billed charges,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,330.28,61.85,,,percent of total billed charges,61.85% of total billed charges,166.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,216.75,130,,,Fee Schedule,130% of WA Medicaid ,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,201.32,37.7,,,percent of total billed charges,37.70% of total billed charges,201.32,37.7,,,percent of total billed charges,37.70% of total billed charges,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,18102.6,33.9,,,percent of total billed charges,33.9% of total billed charges,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,416.52,78,,,percent of total billed charges,78% of total billed charges,534,100,,,percent of total billed charges,100% of total billed charges,441.08,82.6,,,percent of total billed charges,82.6% of total billed charges,441.08,82.6,,,percent of total billed charges,82.6% of total billed charges,166.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.62,18102.6,
ESRD SERV 1 VISIT 20YRS AND OLDER,90962,CDM,983,RC,90962,HCPCS,Outpatient,,,413,268.45,,363.44,88,,,percent of total billed charges,88% of total Billed charges,11.79,100,,,Fee Schedule,100% of Medicare rate,115.44,100,,,Fee Schedule,100% of WA Medicaid,413,100,,,percent of total billed charges,100% of total billed charges,118.9,103,,,Fee Schedule,103% of WA Medicaid,11.79,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,115.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,284.97,69,,,percent of total billed charges,69% of total billed charges,413,100,,,percent of total billed charges,100% of total billed charges,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,413,100,,,percent of total billed charges,100% of total billed charges,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,413,100,,,percent of total billed charges,100% of total billed charges,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.44,61.85,,,percent of total billed charges,61.85% of total billed charges,115.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,150.07,130,,,Fee Schedule,130% of WA Medicaid ,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.7,37.7,,,percent of total billed charges,37.70% of total billed charges,155.7,37.7,,,percent of total billed charges,37.70% of total billed charges,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,14000.7,33.9,,,percent of total billed charges,33.9% of total billed charges,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.14,78,,,percent of total billed charges,78% of total billed charges,413,100,,,percent of total billed charges,100% of total billed charges,341.14,82.6,,,percent of total billed charges,82.6% of total billed charges,341.14,82.6,,,percent of total billed charges,82.6% of total billed charges,115.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.79,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.79,14000.7,
ESRD SRV 4 VISITS P MO 20+,90960,CDM,983,RC,90960,HCPCS,Outpatient,,,569,369.85,,500.72,88,,,percent of total billed charges,88% of total Billed charges,21.23,100,,,Fee Schedule,100% of Medicare rate,200.67,100,,,Fee Schedule,100% of WA Medicaid,569,100,,,percent of total billed charges,100% of total billed charges,206.69,103,,,Fee Schedule,103% of WA Medicaid,21.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,200.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,392.61,69,,,percent of total billed charges,69% of total billed charges,569,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,569,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,569,100,,,percent of total billed charges,100% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,351.93,61.85,,,percent of total billed charges,61.85% of total billed charges,200.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,260.87,130,,,Fee Schedule,130% of WA Medicaid ,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,214.51,37.7,,,percent of total billed charges,37.70% of total billed charges,214.51,37.7,,,percent of total billed charges,37.70% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,19289.1,33.9,,,percent of total billed charges,33.9% of total billed charges,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,443.82,78,,,percent of total billed charges,78% of total billed charges,569,100,,,percent of total billed charges,100% of total billed charges,469.99,82.6,,,percent of total billed charges,82.6% of total billed charges,469.99,82.6,,,percent of total billed charges,82.6% of total billed charges,200.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.44,101,,,Fee Schedule,101% of Medicare RBRVS rate,21.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,21.23,19289.1,
ESRD SRV 2-3 VSTS P MO 20+,90961,CDM,983,RC,90961,HCPCS,Outpatient,,,479,311.35,,421.52,88,,,percent of total billed charges,88% of total Billed charges,17.62,100,,,Fee Schedule,100% of Medicare rate,166.73,100,,,Fee Schedule,100% of WA Medicaid,479,100,,,percent of total billed charges,100% of total billed charges,171.73,103,,,Fee Schedule,103% of WA Medicaid,17.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,166.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,330.51,69,,,percent of total billed charges,69% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,479,100,,,percent of total billed charges,100% of total billed charges,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,479,100,,,percent of total billed charges,100% of total billed charges,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.26,61.85,,,percent of total billed charges,61.85% of total billed charges,166.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,216.75,130,,,Fee Schedule,130% of WA Medicaid ,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.58,37.7,,,percent of total billed charges,37.70% of total billed charges,180.58,37.7,,,percent of total billed charges,37.70% of total billed charges,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,16238.1,33.9,,,percent of total billed charges,33.9% of total billed charges,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,373.62,78,,,percent of total billed charges,78% of total billed charges,479,100,,,percent of total billed charges,100% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,395.65,82.6,,,percent of total billed charges,82.6% of total billed charges,166.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.62,16238.1,
OPHTHALMOLOGICAL SERVICES MED EX  EVAL,92014,CDM,983,RC,92014,HCPCS,Outpatient,,,175,113.75,,154,88,,,percent of total billed charges,88% of total Billed charges,3.3,100,,,Fee Schedule,100% of Medicare rate,42.9,100,,,Fee Schedule,100% of WA Medicaid,175,100,,,percent of total billed charges,100% of total billed charges,44.19,103,,,Fee Schedule,103% of WA Medicaid,3.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.9,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,120.75,69,,,percent of total billed charges,69% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,175,100,,,percent of total billed charges,100% of total billed charges,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,175,100,,,percent of total billed charges,100% of total billed charges,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.24,61.85,,,percent of total billed charges,61.85% of total billed charges,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.9,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.77,130,,,Fee Schedule,130% of WA Medicaid ,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,5932.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.5,78,,,percent of total billed charges,78% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.33,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.9,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.3,5932.5,
VISUAL FIELD EXAMINATION(S),92081,CDM,983,RC,92081,HCPCS,Outpatient,,,80,52.00,,70.4,88,,,percent of total billed charges,88% of total Billed charges,1.54,100,,,Fee Schedule,100% of Medicare rate,8.95,100,,,Fee Schedule,100% of WA Medicaid,80,100,,,percent of total billed charges,100% of total billed charges,9.22,103,,,Fee Schedule,103% of WA Medicaid,1.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.95,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,55.2,69,,,percent of total billed charges,69% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,80,100,,,percent of total billed charges,100% of total billed charges,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,80,100,,,percent of total billed charges,100% of total billed charges,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.48,61.85,,,percent of total billed charges,61.85% of total billed charges,8.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.95,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.64,130,,,Fee Schedule,130% of WA Medicaid ,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.16,37.7,,,percent of total billed charges,37.70% of total billed charges,30.16,37.7,,,percent of total billed charges,37.70% of total billed charges,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,2712,33.9,,,percent of total billed charges,33.9% of total billed charges,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.4,78,,,percent of total billed charges,78% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,8.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.54,2712,
SERIAL TONOMETRY EXAM(S),92100,CDM,983,RC,92100,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,1.48,100,,,Fee Schedule,100% of Medicare rate,18.28,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,18.83,103,,,Fee Schedule,103% of WA Medicaid,1.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,18.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,180,100,,,percent of total billed charges,100% of total billed charges,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,180,100,,,percent of total billed charges,100% of total billed charges,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.33,61.85,,,percent of total billed charges,61.85% of total billed charges,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.76,130,,,Fee Schedule,130% of WA Medicaid ,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,6102,33.9,,,percent of total billed charges,33.9% of total billed charges,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.48,6102,
OTOLARYNGOLOGIC EXAM UNDER ANESTHESIA,92502,CDM,983,RC,92502,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,5.48,100,,,Fee Schedule,100% of Medicare rate,54.83,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,56.47,103,,,Fee Schedule,103% of WA Medicaid,5.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,54.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,186,100,,,percent of total billed charges,100% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,186,100,,,percent of total billed charges,100% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.04,61.85,,,percent of total billed charges,61.85% of total billed charges,54.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,71.28,130,,,Fee Schedule,130% of WA Medicaid ,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,6305.4,33.9,,,percent of total billed charges,33.9% of total billed charges,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,54.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.48,6305.4,
EAR MICROSCOPY EXAMINATION,92504,CDM,983,RC,92504,HCPCS,Outpatient,,,67,43.55,,58.96,88,,,percent of total billed charges,88% of total Billed charges,0.53,100,,,Fee Schedule,100% of Medicare rate,5.22,100,,,Fee Schedule,100% of WA Medicaid,67,100,,,percent of total billed charges,100% of total billed charges,5.38,103,,,Fee Schedule,103% of WA Medicaid,0.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,5.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,46.23,69,,,percent of total billed charges,69% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,67,100,,,percent of total billed charges,100% of total billed charges,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,67,100,,,percent of total billed charges,100% of total billed charges,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.44,61.85,,,percent of total billed charges,61.85% of total billed charges,5.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.79,130,,,Fee Schedule,130% of WA Medicaid ,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.26,37.7,,,percent of total billed charges,37.70% of total billed charges,25.26,37.7,,,percent of total billed charges,37.70% of total billed charges,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2271.3,33.9,,,percent of total billed charges,33.9% of total billed charges,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.26,78,,,percent of total billed charges,78% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,5.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.53,2271.3,
AUDITORY FUNCTION TEST,92506,CDM,983,RC,92506,HCPCS,Outpatient,,,89,57.85,,78.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,89,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,61.41,69,,,percent of total billed charges,69% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,89,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,89,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,55.05,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.55,37.7,,,percent of total billed charges,37.70% of total billed charges,33.55,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,3017.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,69.42,78,,,percent of total billed charges,78% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",33.55,3017.1,
NASOPHARYNGOSCOPY W/ENDOSCOPE,92511,CDM,983,RC,92511,HCPCS,Outpatient,,,324,210.60,,285.12,88,,,percent of total billed charges,88% of total Billed charges,2.18,100,,,Fee Schedule,100% of Medicare rate,21.82,100,,,Fee Schedule,100% of WA Medicaid,324,100,,,percent of total billed charges,100% of total billed charges,22.47,103,,,Fee Schedule,103% of WA Medicaid,2.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,223.56,69,,,percent of total billed charges,69% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.39,61.85,,,percent of total billed charges,61.85% of total billed charges,21.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.37,130,,,Fee Schedule,130% of WA Medicaid ,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,10983.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.72,78,,,percent of total billed charges,78% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,21.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.18,10983.6,
TYMPANOMETRY  REFLEX MEASUREMENT,92550,CDM,983,RC,92550,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,0.92,100,,,Fee Schedule,100% of Medicare rate,12.68,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,13.06,103,,,Fee Schedule,103% of WA Medicaid,0.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,12.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,37,100,,,percent of total billed charges,100% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,37,100,,,percent of total billed charges,100% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,12.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16.48,130,,,Fee Schedule,130% of WA Medicaid ,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,1254.3,33.9,,,percent of total billed charges,33.9% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,12.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.92,1254.3,
PURE TONE HEARING TEST AIR,92551,CDM,983,RC,92551,HCPCS,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,0.65,100,,,Fee Schedule,100% of Medicare rate,7.65,100,,,Fee Schedule,100% of WA Medicaid,36,100,,,percent of total billed charges,100% of total billed charges,7.88,103,,,Fee Schedule,103% of WA Medicaid,0.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,7.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,36,100,,,percent of total billed charges,100% of total billed charges,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,36,100,,,percent of total billed charges,100% of total billed charges,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,7.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.95,130,,,Fee Schedule,130% of WA Medicaid ,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,1220.4,33.9,,,percent of total billed charges,33.9% of total billed charges,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,7.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.65,1220.4,
PURE TONE AUDIOMETRY AIR,92552,CDM,983,RC,92552,HCPCS,Outpatient,,,52.72,34.27,,46.39,88,,,percent of total billed charges,88% of total Billed charges,1.44,100,,,Fee Schedule,100% of Medicare rate,22.94,100,,,Fee Schedule,100% of WA Medicaid,52.72,100,,,percent of total billed charges,100% of total billed charges,23.63,103,,,Fee Schedule,103% of WA Medicaid,1.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,36.38,69,,,percent of total billed charges,69% of total billed charges,52.72,100,,,percent of total billed charges,100% of total billed charges,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.72,100,,,percent of total billed charges,100% of total billed charges,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.72,100,,,percent of total billed charges,100% of total billed charges,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.61,61.85,,,percent of total billed charges,61.85% of total billed charges,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.82,130,,,Fee Schedule,130% of WA Medicaid ,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.88,37.7,,,percent of total billed charges,37.70% of total billed charges,19.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1787.21,33.9,,,percent of total billed charges,33.9% of total billed charges,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.12,78,,,percent of total billed charges,78% of total billed charges,52.72,100,,,percent of total billed charges,100% of total billed charges,43.55,82.6,,,percent of total billed charges,82.6% of total billed charges,43.55,82.6,,,percent of total billed charges,82.6% of total billed charges,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.44,1787.21,
HEARING TEST/ AUDIOMETRY,92557,CDM,983,RC,92557,HCPCS,Outpatient,,,92,59.80,,80.96,88,,,percent of total billed charges,88% of total Billed charges,1.47,100,,,Fee Schedule,100% of Medicare rate,18.09,100,,,Fee Schedule,100% of WA Medicaid,92,100,,,percent of total billed charges,100% of total billed charges,18.63,103,,,Fee Schedule,103% of WA Medicaid,1.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,18.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,63.48,69,,,percent of total billed charges,69% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,92,100,,,percent of total billed charges,100% of total billed charges,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,92,100,,,percent of total billed charges,100% of total billed charges,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.9,61.85,,,percent of total billed charges,61.85% of total billed charges,18.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.52,130,,,Fee Schedule,130% of WA Medicaid ,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,34.68,37.7,,,percent of total billed charges,37.70% of total billed charges,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,3118.8,33.9,,,percent of total billed charges,33.9% of total billed charges,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.76,78,,,percent of total billed charges,78% of total billed charges,92,100,,,percent of total billed charges,100% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,75.99,82.6,,,percent of total billed charges,82.6% of total billed charges,18.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.47,3118.8,
SPEECH AUDIOMETRY THRESHOLD W/SPEECH,92556,CDM,983,RC,92556,HCPCS,Outpatient,,,51,33.15,,44.88,88,,,percent of total billed charges,88% of total Billed charges,1.66,100,,,Fee Schedule,100% of Medicare rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,51,100,,,percent of total billed charges,100% of total billed charges,27.85,103,,,Fee Schedule,103% of WA Medicaid,1.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,35.19,69,,,percent of total billed charges,69% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,51,100,,,percent of total billed charges,100% of total billed charges,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,51,100,,,percent of total billed charges,100% of total billed charges,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.54,61.85,,,percent of total billed charges,61.85% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.15,130,,,Fee Schedule,130% of WA Medicaid ,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,19.23,37.7,,,percent of total billed charges,37.70% of total billed charges,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1728.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.78,78,,,percent of total billed charges,78% of total billed charges,51,100,,,percent of total billed charges,100% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,42.13,82.6,,,percent of total billed charges,82.6% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.66,1728.9,
PURE TONE AUDIOMETRY,92553,CDM,983,RC,92553,HCPCS,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,1.69,100,,,Fee Schedule,100% of Medicare rate,27.6,100,,,Fee Schedule,100% of WA Medicaid,59,100,,,percent of total billed charges,100% of total billed charges,28.43,103,,,Fee Schedule,103% of WA Medicaid,1.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,59,100,,,percent of total billed charges,100% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,59,100,,,percent of total billed charges,100% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.49,61.85,,,percent of total billed charges,61.85% of total billed charges,27.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.15,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.88,130,,,Fee Schedule,130% of WA Medicaid ,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.24,37.7,,,percent of total billed charges,37.70% of total billed charges,22.24,37.7,,,percent of total billed charges,37.70% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,2000.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,27.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.69,2000.1,
SPEECH AUDIOMETRY THRESHOLD,92555,CDM,983,RC,92555,HCPCS,Outpatient,,,44,28.60,,38.72,88,,,percent of total billed charges,88% of total Billed charges,1.16,100,,,Fee Schedule,100% of Medicare rate,17.34,100,,,Fee Schedule,100% of WA Medicaid,44,100,,,percent of total billed charges,100% of total billed charges,17.86,103,,,Fee Schedule,103% of WA Medicaid,1.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,17.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,44,100,,,percent of total billed charges,100% of total billed charges,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,44,100,,,percent of total billed charges,100% of total billed charges,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.21,61.85,,,percent of total billed charges,61.85% of total billed charges,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.54,130,,,Fee Schedule,130% of WA Medicaid ,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.59,37.7,,,percent of total billed charges,37.70% of total billed charges,16.59,37.7,,,percent of total billed charges,37.70% of total billed charges,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1491.6,33.9,,,percent of total billed charges,33.9% of total billed charges,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.16,1491.6,
ACOUSTIC REFLEX TESTING,92568,CDM,983,RC,92568,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,0.7,100,,,Fee Schedule,100% of Medicare rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,8.64,103,,,Fee Schedule,103% of WA Medicaid,0.7,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,37,100,,,percent of total billed charges,100% of total billed charges,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,37,100,,,percent of total billed charges,100% of total billed charges,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.91,130,,,Fee Schedule,130% of WA Medicaid ,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,1254.3,33.9,,,percent of total billed charges,33.9% of total billed charges,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.7,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.7,1254.3,
TYMPANOMETRY,92567,CDM,983,RC,92567,HCPCS,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,0.58,100,,,Fee Schedule,100% of Medicare rate,6.15,100,,,Fee Schedule,100% of WA Medicaid,42,100,,,percent of total billed charges,100% of total billed charges,6.33,103,,,Fee Schedule,103% of WA Medicaid,0.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,6.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,42,100,,,percent of total billed charges,100% of total billed charges,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,42,100,,,percent of total billed charges,100% of total billed charges,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8,130,,,Fee Schedule,130% of WA Medicaid ,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.8,33.9,,,percent of total billed charges,33.9% of total billed charges,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.58,1423.8,
"STENGER TEST, PURE TONE",92565,CDM,983,RC,92565,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,0.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,37,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,0.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,37,100,,,percent of total billed charges,100% of total billed charges,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,37,100,,,percent of total billed charges,100% of total billed charges,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1254.3,33.9,,,percent of total billed charges,33.9% of total billed charges,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",0.91,1254.3,
VISUAL REINFORCEMENT AUDIOMETRY,92579,CDM,983,RC,92579,HCPCS,Outpatient,,,89,57.85,,78.32,88,,,percent of total billed charges,88% of total Billed charges,1.62,100,,,Fee Schedule,100% of Medicare rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,89,100,,,percent of total billed charges,100% of total billed charges,21.52,103,,,Fee Schedule,103% of WA Medicaid,1.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,61.41,69,,,percent of total billed charges,69% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,89,100,,,percent of total billed charges,100% of total billed charges,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,89,100,,,percent of total billed charges,100% of total billed charges,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.05,61.85,,,percent of total billed charges,61.85% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.16,130,,,Fee Schedule,130% of WA Medicaid ,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.55,37.7,,,percent of total billed charges,37.70% of total billed charges,33.55,37.7,,,percent of total billed charges,37.70% of total billed charges,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,3017.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.42,78,,,percent of total billed charges,78% of total billed charges,89,100,,,percent of total billed charges,100% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,73.51,82.6,,,percent of total billed charges,82.6% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.62,3017.1,
ACOUSTIC IMMITTANCE TESTING,92570,CDM,983,RC,92570,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,1.39,100,,,Fee Schedule,100% of Medicare rate,16.6,100,,,Fee Schedule,100% of WA Medicaid,75,100,,,percent of total billed charges,100% of total billed charges,17.1,103,,,Fee Schedule,103% of WA Medicaid,1.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,75,100,,,percent of total billed charges,100% of total billed charges,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,75,100,,,percent of total billed charges,100% of total billed charges,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.39,61.85,,,percent of total billed charges,61.85% of total billed charges,16.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.58,130,,,Fee Schedule,130% of WA Medicaid ,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,2542.5,33.9,,,percent of total billed charges,33.9% of total billed charges,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,16.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.39,2542.5,
STENGER TEST SPEECH,92577,CDM,983,RC,92577,HCPCS,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,0.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,36,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,0.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,36,100,,,percent of total billed charges,100% of total billed charges,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,36,100,,,percent of total billed charges,100% of total billed charges,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1220.4,33.9,,,percent of total billed charges,33.9% of total billed charges,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",0.94,1220.4,
EVOKED AUDITORY TST COMPLETE,92588,CDM,983,RC,92588,HCPCS,Outpatient,,,77,50.05,,67.76,88,,,percent of total billed charges,88% of total Billed charges,1.53,100,,,Fee Schedule,100% of Medicare rate,16.23,100,,,Fee Schedule,100% of WA Medicaid,77,100,,,percent of total billed charges,100% of total billed charges,16.72,103,,,Fee Schedule,103% of WA Medicaid,1.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,53.13,69,,,percent of total billed charges,69% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,77,100,,,percent of total billed charges,100% of total billed charges,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,77,100,,,percent of total billed charges,100% of total billed charges,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.62,61.85,,,percent of total billed charges,61.85% of total billed charges,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.1,130,,,Fee Schedule,130% of WA Medicaid ,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,29.03,37.7,,,percent of total billed charges,37.70% of total billed charges,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,2610.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.06,78,,,percent of total billed charges,78% of total billed charges,77,100,,,percent of total billed charges,100% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,63.6,82.6,,,percent of total billed charges,82.6% of total billed charges,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.53,2610.3,
983,,,983,RC,,,Outpatient,,,346,224.90,,304.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,346,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,238.74,69,,,percent of total billed charges,69% of total billed charges,346,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,346,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,346,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,214,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,130.44,37.7,,,percent of total billed charges,37.70% of total billed charges,130.44,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,11729.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,269.88,78,,,percent of total billed charges,78% of total billed charges,346,100,,,percent of total billed charges,100% of total billed charges,285.8,82.6,,,percent of total billed charges,82.6% of total billed charges,285.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",130.44,11729.4,
EVOKED OTOACOUSTIC EMISSIONS;LIMITED,92587,CDM,983,RC,92587,HCPCS,Outpatient,,,87,56.55,,76.56,88,,,percent of total billed charges,88% of total Billed charges,1.17,100,,,Fee Schedule,100% of Medicare rate,10.26,100,,,Fee Schedule,100% of WA Medicaid,87,100,,,percent of total billed charges,100% of total billed charges,10.57,103,,,Fee Schedule,103% of WA Medicaid,1.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,10.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,60.03,69,,,percent of total billed charges,69% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,87,100,,,percent of total billed charges,100% of total billed charges,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,87,100,,,percent of total billed charges,100% of total billed charges,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.81,61.85,,,percent of total billed charges,61.85% of total billed charges,10.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.34,130,,,Fee Schedule,130% of WA Medicaid ,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,32.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2949.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.86,78,,,percent of total billed charges,78% of total billed charges,87,100,,,percent of total billed charges,100% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,71.86,82.6,,,percent of total billed charges,82.6% of total billed charges,10.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.18,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.17,2949.3,
CONDITIONING PLAY AUDIOMETRY,92582,CDM,983,RC,92582,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,2.96,100,,,Fee Schedule,100% of Medicare rate,52.22,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,53.79,103,,,Fee Schedule,103% of WA Medicaid,2.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,52.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.34,61.85,,,percent of total billed charges,61.85% of total billed charges,52.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,67.89,130,,,Fee Schedule,130% of WA Medicaid ,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2813.7,33.9,,,percent of total billed charges,33.9% of total billed charges,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,52.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.96,2813.7,
SELECT PICTURE AUDIOMETRY,92583,CDM,983,RC,92583,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,2.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.34,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2813.7,33.9,,,percent of total billed charges,33.9% of total billed charges,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",2.04,2813.7,
PRQ CARD ANGIO/ATHRECT 1 ART,92924,CDM,983,RC,92924,HCPCS,Outpatient,,,1823,1184.95,,1604.24,88,,,percent of total billed charges,88% of total Billed charges,87.37,100,,,Fee Schedule,100% of Medicare rate,341.67,100,,,Fee Schedule,100% of WA Medicaid,1823,100,,,percent of total billed charges,100% of total billed charges,351.92,103,,,Fee Schedule,103% of WA Medicaid,87.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,152.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,341.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1257.87,69,,,percent of total billed charges,69% of total billed charges,1823,100,,,percent of total billed charges,100% of total billed charges,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1823,100,,,percent of total billed charges,100% of total billed charges,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1823,100,,,percent of total billed charges,100% of total billed charges,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1127.53,61.85,,,percent of total billed charges,61.85% of total billed charges,341.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,348.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,444.17,130,,,Fee Schedule,130% of WA Medicaid ,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,687.27,37.7,,,percent of total billed charges,37.70% of total billed charges,687.27,37.7,,,percent of total billed charges,37.70% of total billed charges,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,61799.7,33.9,,,percent of total billed charges,33.9% of total billed charges,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1421.94,78,,,percent of total billed charges,78% of total billed charges,1823,100,,,percent of total billed charges,100% of total billed charges,1505.8,82.6,,,percent of total billed charges,82.6% of total billed charges,1505.8,82.6,,,percent of total billed charges,82.6% of total billed charges,341.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,87.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.37,61799.7,
PRQ CARD ANGIO/ATHRECT ADDL,92925,CDM,983,RC,92925,HCPCS,Outpatient,,,364,236.60,,320.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,364,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,251.16,69,,,percent of total billed charges,69% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,364,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,364,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,225.13,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,137.23,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12339.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,283.92,78,,,percent of total billed charges,78% of total billed charges,364,100,,,percent of total billed charges,100% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,300.66,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",137.23,12339.6,
PRQ CARD STENT W/ANGIO ADDL,92929,CDM,983,RC,92929,HCPCS,Outpatient,,,328,213.20,,288.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,328,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,226.32,69,,,percent of total billed charges,69% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,328,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,328,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,202.87,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,123.66,37.7,,,percent of total billed charges,37.70% of total billed charges,123.66,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,11119.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,255.84,78,,,percent of total billed charges,78% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",123.66,11119.2,
PRQ CARD STENT W/ANGIO 1 VSL,92928,CDM,983,RC,92928,HCPCS,Outpatient,,,1638,1064.70,,1441.44,88,,,percent of total billed charges,88% of total Billed charges,81.23,100,,,Fee Schedule,100% of Medicare rate,318.73,100,,,Fee Schedule,100% of WA Medicaid,1638,100,,,percent of total billed charges,100% of total billed charges,328.29,103,,,Fee Schedule,103% of WA Medicaid,81.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,142.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,318.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1130.22,69,,,percent of total billed charges,69% of total billed charges,1638,100,,,percent of total billed charges,100% of total billed charges,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1638,100,,,percent of total billed charges,100% of total billed charges,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1638,100,,,percent of total billed charges,100% of total billed charges,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1013.1,61.85,,,percent of total billed charges,61.85% of total billed charges,318.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,414.35,130,,,Fee Schedule,130% of WA Medicaid ,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,617.53,37.7,,,percent of total billed charges,37.70% of total billed charges,617.53,37.7,,,percent of total billed charges,37.70% of total billed charges,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,55528.2,33.9,,,percent of total billed charges,33.9% of total billed charges,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1277.64,78,,,percent of total billed charges,78% of total billed charges,1638,100,,,percent of total billed charges,100% of total billed charges,1352.99,82.6,,,percent of total billed charges,82.6% of total billed charges,1352.99,82.6,,,percent of total billed charges,82.6% of total billed charges,318.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.23,55528.2,
PRQ CARDIAC ANGIO ADDL ART,92921,CDM,983,RC,92921,HCPCS,Outpatient,,,296,192.40,,260.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,296,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,204.24,69,,,percent of total billed charges,69% of total billed charges,296,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,296,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,296,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,183.08,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,111.59,37.7,,,percent of total billed charges,37.70% of total billed charges,111.59,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,10034.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,230.88,78,,,percent of total billed charges,78% of total billed charges,296,100,,,percent of total billed charges,100% of total billed charges,244.5,82.6,,,percent of total billed charges,82.6% of total billed charges,244.5,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",111.59,10034.4,
PRQ CARDIAC ANGIOPLAST 1 ART,92920,CDM,983,RC,92920,HCPCS,Outpatient,,,1475,958.75,,1298,88,,,percent of total billed charges,88% of total Billed charges,73.03,100,,,Fee Schedule,100% of Medicare rate,286.46,100,,,Fee Schedule,100% of WA Medicaid,1475,100,,,percent of total billed charges,100% of total billed charges,295.05,103,,,Fee Schedule,103% of WA Medicaid,73.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,127.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,286.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1017.75,69,,,percent of total billed charges,69% of total billed charges,1475,100,,,percent of total billed charges,100% of total billed charges,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1475,100,,,percent of total billed charges,100% of total billed charges,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1475,100,,,percent of total billed charges,100% of total billed charges,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,912.29,61.85,,,percent of total billed charges,61.85% of total billed charges,286.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,292.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,372.4,130,,,Fee Schedule,130% of WA Medicaid ,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,556.08,37.7,,,percent of total billed charges,37.70% of total billed charges,556.08,37.7,,,percent of total billed charges,37.70% of total billed charges,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,50002.5,33.9,,,percent of total billed charges,33.9% of total billed charges,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1150.5,78,,,percent of total billed charges,78% of total billed charges,1475,100,,,percent of total billed charges,100% of total billed charges,1218.35,82.6,,,percent of total billed charges,82.6% of total billed charges,1218.35,82.6,,,percent of total billed charges,82.6% of total billed charges,286.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.03,50002.5,
PRQ REVASC BYP GRAFT 1 VSL,92937,CDM,983,RC,92937,HCPCS,Outpatient,,,1636,1063.40,,1439.68,88,,,percent of total billed charges,88% of total Billed charges,81.48,100,,,Fee Schedule,100% of Medicare rate,318.73,100,,,Fee Schedule,100% of WA Medicaid,1636,100,,,percent of total billed charges,100% of total billed charges,328.29,103,,,Fee Schedule,103% of WA Medicaid,81.48,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,142.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,318.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1128.84,69,,,percent of total billed charges,69% of total billed charges,1636,100,,,percent of total billed charges,100% of total billed charges,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1636,100,,,percent of total billed charges,100% of total billed charges,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1636,100,,,percent of total billed charges,100% of total billed charges,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1011.87,61.85,,,percent of total billed charges,61.85% of total billed charges,318.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,325.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,414.35,130,,,Fee Schedule,130% of WA Medicaid ,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,616.77,37.7,,,percent of total billed charges,37.70% of total billed charges,616.77,37.7,,,percent of total billed charges,37.70% of total billed charges,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,55460.4,33.9,,,percent of total billed charges,33.9% of total billed charges,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,1276.08,78,,,percent of total billed charges,78% of total billed charges,1636,100,,,percent of total billed charges,100% of total billed charges,1351.34,82.6,,,percent of total billed charges,82.6% of total billed charges,1351.34,82.6,,,percent of total billed charges,82.6% of total billed charges,318.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.48,100,,,Fee Schedule,100% of Medicare RBRVS rate,318.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.48,55460.4,
PRQ REVASC BYP GRAFT ADDL,92938,CDM,983,RC,92938,HCPCS,Outpatient,,,328,213.20,,288.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,328,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,226.32,69,,,percent of total billed charges,69% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,328,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,328,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,202.87,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,123.66,37.7,,,percent of total billed charges,37.70% of total billed charges,123.66,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,11119.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,255.84,78,,,percent of total billed charges,78% of total billed charges,328,100,,,percent of total billed charges,100% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,270.93,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",123.66,11119.2,
PRQ CARD STENT/ATH/ANGIO,92934,CDM,983,RC,92934,HCPCS,Outpatient,,,367,238.55,,322.96,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,367,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,253.23,69,,,percent of total billed charges,69% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,367,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,367,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,226.99,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,138.36,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12441.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,286.26,78,,,percent of total billed charges,78% of total billed charges,367,100,,,percent of total billed charges,100% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,303.14,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",138.36,12441.3,
PRQ CARD STENT/ATH/ANGIO,92933,CDM,983,RC,92933,HCPCS,Outpatient,,,1832,1190.80,,1612.16,88,,,percent of total billed charges,88% of total Billed charges,91.32,100,,,Fee Schedule,100% of Medicare rate,357.52,100,,,Fee Schedule,100% of WA Medicaid,1832,100,,,percent of total billed charges,100% of total billed charges,368.25,103,,,Fee Schedule,103% of WA Medicaid,91.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,159.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,357.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1264.08,69,,,percent of total billed charges,69% of total billed charges,1832,100,,,percent of total billed charges,100% of total billed charges,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1832,100,,,percent of total billed charges,100% of total billed charges,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1832,100,,,percent of total billed charges,100% of total billed charges,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1133.09,61.85,,,percent of total billed charges,61.85% of total billed charges,357.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,364.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,464.78,130,,,Fee Schedule,130% of WA Medicaid ,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,690.66,37.7,,,percent of total billed charges,37.70% of total billed charges,690.66,37.7,,,percent of total billed charges,37.70% of total billed charges,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,62104.8,33.9,,,percent of total billed charges,33.9% of total billed charges,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,1428.96,78,,,percent of total billed charges,78% of total billed charges,1832,100,,,percent of total billed charges,100% of total billed charges,1513.23,82.6,,,percent of total billed charges,82.6% of total billed charges,1513.23,82.6,,,percent of total billed charges,82.6% of total billed charges,357.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.32,62104.8,
PRQ CARD REVASC MI 1 VSL,92941,CDM,983,RC,92941,HCPCS,Outpatient,,,1836,1193.40,,1615.68,88,,,percent of total billed charges,88% of total Billed charges,91.08,100,,,Fee Schedule,100% of Medicare rate,357.89,100,,,Fee Schedule,100% of WA Medicaid,1836,100,,,percent of total billed charges,100% of total billed charges,368.63,103,,,Fee Schedule,103% of WA Medicaid,91.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,159.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,357.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1266.84,69,,,percent of total billed charges,69% of total billed charges,1836,100,,,percent of total billed charges,100% of total billed charges,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836,100,,,percent of total billed charges,100% of total billed charges,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836,100,,,percent of total billed charges,100% of total billed charges,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1135.57,61.85,,,percent of total billed charges,61.85% of total billed charges,357.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,365.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,465.26,130,,,Fee Schedule,130% of WA Medicaid ,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.17,37.7,,,percent of total billed charges,37.70% of total billed charges,692.17,37.7,,,percent of total billed charges,37.70% of total billed charges,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,62240.4,33.9,,,percent of total billed charges,33.9% of total billed charges,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1432.08,78,,,percent of total billed charges,78% of total billed charges,1836,100,,,percent of total billed charges,100% of total billed charges,1516.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1516.54,82.6,,,percent of total billed charges,82.6% of total billed charges,357.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.08,62240.4,
PRQ CARD REVASC CHRONIC ADDL,92944,CDM,983,RC,92944,HCPCS,Outpatient,,,368,239.20,,323.84,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,368,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,253.92,69,,,percent of total billed charges,69% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,368,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,368,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,227.61,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,138.74,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12475.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,287.04,78,,,percent of total billed charges,78% of total billed charges,368,100,,,percent of total billed charges,100% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,303.97,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",138.74,12475.2,
PRQ CARD REVASC CHRONIC 1VSL,92943,CDM,983,RC,92943,HCPCS,Outpatient,,,1836,1193.40,,1615.68,88,,,percent of total billed charges,88% of total Billed charges,91.34,100,,,Fee Schedule,100% of Medicare rate,357.89,100,,,Fee Schedule,100% of WA Medicaid,1836,100,,,percent of total billed charges,100% of total billed charges,368.63,103,,,Fee Schedule,103% of WA Medicaid,91.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,159.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,357.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1266.84,69,,,percent of total billed charges,69% of total billed charges,1836,100,,,percent of total billed charges,100% of total billed charges,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836,100,,,percent of total billed charges,100% of total billed charges,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1836,100,,,percent of total billed charges,100% of total billed charges,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1135.57,61.85,,,percent of total billed charges,61.85% of total billed charges,357.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,365.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,465.26,130,,,Fee Schedule,130% of WA Medicaid ,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,692.17,37.7,,,percent of total billed charges,37.70% of total billed charges,692.17,37.7,,,percent of total billed charges,37.70% of total billed charges,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,62240.4,33.9,,,percent of total billed charges,33.9% of total billed charges,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1432.08,78,,,percent of total billed charges,78% of total billed charges,1836,100,,,percent of total billed charges,100% of total billed charges,1516.54,82.6,,,percent of total billed charges,82.6% of total billed charges,1516.54,82.6,,,percent of total billed charges,82.6% of total billed charges,357.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,91.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,357.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,91.34,62240.4,
TEMPORARY EXTERNAL PACING,92953,CDM,983,RC,92953,HCPCS,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,0.29,100,,,Fee Schedule,100% of Medicare rate,0.56,100,,,Fee Schedule,100% of WA Medicaid,31,100,,,percent of total billed charges,100% of total billed charges,0.58,103,,,Fee Schedule,103% of WA Medicaid,0.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,0.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,31,100,,,percent of total billed charges,100% of total billed charges,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,31,100,,,percent of total billed charges,100% of total billed charges,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.17,61.85,,,percent of total billed charges,61.85% of total billed charges,0.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,0.73,130,,,Fee Schedule,130% of WA Medicaid ,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,1050.9,33.9,,,percent of total billed charges,33.9% of total billed charges,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,0.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.29,1050.9,
HEART/LUNG RESUSCITATION CPR,92950,CDM,983,RC,92950,HCPCS,Outpatient,,,820,533.00,,721.6,88,,,percent of total billed charges,88% of total Billed charges,15.77,100,,,Fee Schedule,100% of Medicare rate,101.64,100,,,Fee Schedule,100% of WA Medicaid,820,100,,,percent of total billed charges,100% of total billed charges,104.69,103,,,Fee Schedule,103% of WA Medicaid,15.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,101.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,565.8,69,,,percent of total billed charges,69% of total billed charges,820,100,,,percent of total billed charges,100% of total billed charges,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,820,100,,,percent of total billed charges,100% of total billed charges,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,820,100,,,percent of total billed charges,100% of total billed charges,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,507.17,61.85,,,percent of total billed charges,61.85% of total billed charges,101.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.13,130,,,Fee Schedule,130% of WA Medicaid ,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,309.14,37.7,,,percent of total billed charges,37.70% of total billed charges,309.14,37.7,,,percent of total billed charges,37.70% of total billed charges,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,27798,33.9,,,percent of total billed charges,33.9% of total billed charges,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,639.6,78,,,percent of total billed charges,78% of total billed charges,820,100,,,percent of total billed charges,100% of total billed charges,677.32,82.6,,,percent of total billed charges,82.6% of total billed charges,677.32,82.6,,,percent of total billed charges,82.6% of total billed charges,101.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.77,27798,
CARDIOVERSION ELECTRIC INT,92961,CDM,983,RC,92961,HCPCS,Outpatient,,,675,438.75,,594,88,,,percent of total billed charges,88% of total Billed charges,31.97,100,,,Fee Schedule,100% of Medicare rate,133.53,100,,,Fee Schedule,100% of WA Medicaid,675,100,,,percent of total billed charges,100% of total billed charges,137.54,103,,,Fee Schedule,103% of WA Medicaid,31.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,55.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,133.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,465.75,69,,,percent of total billed charges,69% of total billed charges,675,100,,,percent of total billed charges,100% of total billed charges,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,675,100,,,percent of total billed charges,100% of total billed charges,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,675,100,,,percent of total billed charges,100% of total billed charges,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,417.49,61.85,,,percent of total billed charges,61.85% of total billed charges,133.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,173.59,130,,,Fee Schedule,130% of WA Medicaid ,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,254.48,37.7,,,percent of total billed charges,37.70% of total billed charges,254.48,37.7,,,percent of total billed charges,37.70% of total billed charges,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,22882.5,33.9,,,percent of total billed charges,33.9% of total billed charges,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,526.5,78,,,percent of total billed charges,78% of total billed charges,675,100,,,percent of total billed charges,100% of total billed charges,557.55,82.6,,,percent of total billed charges,82.6% of total billed charges,557.55,82.6,,,percent of total billed charges,82.6% of total billed charges,133.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,31.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,31.97,22882.5,
CARDIOVERSION ELECTRIC EXT,92960,CDM,983,RC,92960,HCPCS,Outpatient,,,605,393.25,,532.4,88,,,percent of total billed charges,88% of total Billed charges,7.09,100,,,Fee Schedule,100% of Medicare rate,60.61,100,,,Fee Schedule,100% of WA Medicaid,605,100,,,percent of total billed charges,100% of total billed charges,62.43,103,,,Fee Schedule,103% of WA Medicaid,7.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,417.45,69,,,percent of total billed charges,69% of total billed charges,605,100,,,percent of total billed charges,100% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,605,100,,,percent of total billed charges,100% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,605,100,,,percent of total billed charges,100% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.19,61.85,,,percent of total billed charges,61.85% of total billed charges,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,78.79,130,,,Fee Schedule,130% of WA Medicaid ,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.09,37.7,,,percent of total billed charges,37.70% of total billed charges,228.09,37.7,,,percent of total billed charges,37.70% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,20509.5,33.9,,,percent of total billed charges,33.9% of total billed charges,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.9,78,,,percent of total billed charges,78% of total billed charges,605,100,,,percent of total billed charges,100% of total billed charges,499.73,82.6,,,percent of total billed charges,82.6% of total billed charges,499.73,82.6,,,percent of total billed charges,82.6% of total billed charges,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.09,20509.5,
DISSOLVE CLOT HEART VESSEL,92975,CDM,983,RC,92975,HCPCS,Outpatient,,,1102,716.30,,969.76,88,,,percent of total billed charges,88% of total Billed charges,52.55,100,,,Fee Schedule,100% of Medicare rate,203.47,100,,,Fee Schedule,100% of WA Medicaid,1102,100,,,percent of total billed charges,100% of total billed charges,209.57,103,,,Fee Schedule,103% of WA Medicaid,52.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,91.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,203.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,760.38,69,,,percent of total billed charges,69% of total billed charges,1102,100,,,percent of total billed charges,100% of total billed charges,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1102,100,,,percent of total billed charges,100% of total billed charges,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,1102,100,,,percent of total billed charges,100% of total billed charges,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,681.59,61.85,,,percent of total billed charges,61.85% of total billed charges,203.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,207.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,264.51,130,,,Fee Schedule,130% of WA Medicaid ,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,415.45,37.7,,,percent of total billed charges,37.70% of total billed charges,415.45,37.7,,,percent of total billed charges,37.70% of total billed charges,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,37357.8,33.9,,,percent of total billed charges,33.9% of total billed charges,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,859.56,78,,,percent of total billed charges,78% of total billed charges,1102,100,,,percent of total billed charges,100% of total billed charges,910.25,82.6,,,percent of total billed charges,82.6% of total billed charges,910.25,82.6,,,percent of total billed charges,82.6% of total billed charges,203.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,52.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,52.55,37357.8,
PRQ CORONARY MECH THROMBECT,92973,CDM,983,RC,92973,HCPCS,Outpatient,,,499,324.35,,439.12,88,,,percent of total billed charges,88% of total Billed charges,24.26,100,,,Fee Schedule,100% of Medicare rate,95.49,100,,,Fee Schedule,100% of WA Medicaid,499,100,,,percent of total billed charges,100% of total billed charges,98.35,103,,,Fee Schedule,103% of WA Medicaid,24.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,95.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,344.31,69,,,percent of total billed charges,69% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,499,100,,,percent of total billed charges,100% of total billed charges,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,499,100,,,percent of total billed charges,100% of total billed charges,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,308.63,61.85,,,percent of total billed charges,61.85% of total billed charges,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,124.14,130,,,Fee Schedule,130% of WA Medicaid ,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,188.12,37.7,,,percent of total billed charges,37.70% of total billed charges,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,16916.1,33.9,,,percent of total billed charges,33.9% of total billed charges,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,389.22,78,,,percent of total billed charges,78% of total billed charges,499,100,,,percent of total billed charges,100% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,412.17,82.6,,,percent of total billed charges,82.6% of total billed charges,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.26,16916.1,
CARDIOASSIST INTERNAL,92970,CDM,983,RC,92970,HCPCS,Outpatient,,,486,315.90,,427.68,88,,,percent of total billed charges,88% of total Billed charges,26.17,100,,,Fee Schedule,100% of Medicare rate,102.2,100,,,Fee Schedule,100% of WA Medicaid,486,100,,,percent of total billed charges,100% of total billed charges,105.27,103,,,Fee Schedule,103% of WA Medicaid,26.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,45.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,102.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,335.34,69,,,percent of total billed charges,69% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.59,61.85,,,percent of total billed charges,61.85% of total billed charges,102.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,132.86,130,,,Fee Schedule,130% of WA Medicaid ,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,16475.4,33.9,,,percent of total billed charges,33.9% of total billed charges,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.08,78,,,percent of total billed charges,78% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,102.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,26.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.17,16475.4,
CARDIOASSIST EXTERNAL,92971,CDM,983,RC,92971,HCPCS,Outpatient,,,262,170.30,,230.56,88,,,percent of total billed charges,88% of total Billed charges,13.26,100,,,Fee Schedule,100% of Medicare rate,54.64,100,,,Fee Schedule,100% of WA Medicaid,262,100,,,percent of total billed charges,100% of total billed charges,56.28,103,,,Fee Schedule,103% of WA Medicaid,13.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,54.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,180.78,69,,,percent of total billed charges,69% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,262,100,,,percent of total billed charges,100% of total billed charges,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,262,100,,,percent of total billed charges,100% of total billed charges,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.05,61.85,,,percent of total billed charges,61.85% of total billed charges,54.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,71.03,130,,,Fee Schedule,130% of WA Medicaid ,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,8881.8,33.9,,,percent of total billed charges,33.9% of total billed charges,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.36,78,,,percent of total billed charges,78% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,54.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.39,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.26,8881.8,
INTRAVASC US HEART ADD-ON,92979,CDM,983,RC,92979,HCPCS,Outpatient,,,224,145.60,,197.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,40.84,100,,,Fee Schedule,100% of WA Medicaid,224,100,,,percent of total billed charges,100% of total billed charges,42.07,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,154.56,69,,,percent of total billed charges,69% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,224,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,224,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,138.54,61.85,,,percent of total billed charges,61.85% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,41.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,53.09,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,84.45,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,7593.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,174.72,78,,,percent of total billed charges,78% of total billed charges,224,100,,,percent of total billed charges,100% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,185.02,82.6,,,percent of total billed charges,82.6% of total billed charges,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,40.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,40.84,7593.6,
DISSOLVE CLOT HEART VESSEL,92977,CDM,983,RC,92977,HCPCS,Outpatient,,,341,221.65,,300.08,88,,,percent of total billed charges,88% of total Billed charges,5.32,100,,,Fee Schedule,100% of Medicare rate,32.64,100,,,Fee Schedule,100% of WA Medicaid,341,100,,,percent of total billed charges,100% of total billed charges,33.62,103,,,Fee Schedule,103% of WA Medicaid,5.32,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.64,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,235.29,69,,,percent of total billed charges,69% of total billed charges,341,100,,,percent of total billed charges,100% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,341,100,,,percent of total billed charges,100% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,341,100,,,percent of total billed charges,100% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.91,61.85,,,percent of total billed charges,61.85% of total billed charges,32.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.64,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.43,130,,,Fee Schedule,130% of WA Medicaid ,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.56,37.7,,,percent of total billed charges,37.70% of total billed charges,128.56,37.7,,,percent of total billed charges,37.70% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,11559.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.98,78,,,percent of total billed charges,78% of total billed charges,341,100,,,percent of total billed charges,100% of total billed charges,281.67,82.6,,,percent of total billed charges,82.6% of total billed charges,281.67,82.6,,,percent of total billed charges,82.6% of total billed charges,32.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.32,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.32,11559.9,
INTRAVASC US HEART ADD-ON,92978,CDM,983,RC,92978,HCPCS,Outpatient,,,279,181.35,,245.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,51.47,100,,,Fee Schedule,100% of WA Medicaid,279,100,,,percent of total billed charges,100% of total billed charges,53.01,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,51.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,192.51,69,,,percent of total billed charges,69% of total billed charges,279,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,279,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,279,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,172.56,61.85,,,percent of total billed charges,61.85% of total billed charges,51.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,51.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,66.91,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,105.18,37.7,,,percent of total billed charges,37.70% of total billed charges,105.18,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,9458.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,217.62,78,,,percent of total billed charges,78% of total billed charges,279,100,,,percent of total billed charges,100% of total billed charges,230.45,82.6,,,percent of total billed charges,82.6% of total billed charges,230.45,82.6,,,percent of total billed charges,82.6% of total billed charges,51.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,51.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.47,9458.1,
CATH PLACE CARDIO BRACHYTX,92974,CDM,983,RC,92974,HCPCS,Outpatient,,,456,296.40,,401.28,88,,,percent of total billed charges,88% of total Billed charges,22.28,100,,,Fee Schedule,100% of Medicare rate,87.47,100,,,Fee Schedule,100% of WA Medicaid,456,100,,,percent of total billed charges,100% of total billed charges,90.09,103,,,Fee Schedule,103% of WA Medicaid,22.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,38.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,87.47,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,314.64,69,,,percent of total billed charges,69% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,456,100,,,percent of total billed charges,100% of total billed charges,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,456,100,,,percent of total billed charges,100% of total billed charges,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.04,61.85,,,percent of total billed charges,61.85% of total billed charges,87.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.47,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,113.71,130,,,Fee Schedule,130% of WA Medicaid ,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,15458.4,33.9,,,percent of total billed charges,33.9% of total billed charges,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,355.68,78,,,percent of total billed charges,78% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,87.47,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.47,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.28,15458.4,
INSERT INTRACORONARY STENT,92980,CDM,983,RC,92980,HCPCS,Outpatient,,,2274,1478.10,,2001.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2274,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1569.06,69,,,percent of total billed charges,69% of total billed charges,2274,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2274,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2274,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1406.47,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,857.3,37.7,,,percent of total billed charges,37.70% of total billed charges,857.3,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,77088.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1773.72,78,,,percent of total billed charges,78% of total billed charges,2274,100,,,percent of total billed charges,100% of total billed charges,1878.32,82.6,,,percent of total billed charges,82.6% of total billed charges,1878.32,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",857.3,77088.6,
INSERT INTRACORONARY STENT,92981,CDM,983,RC,92981,HCPCS,Outpatient,,,633,411.45,,557.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,633,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,436.77,69,,,percent of total billed charges,69% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,633,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,633,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,391.51,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,238.64,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,21458.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,493.74,78,,,percent of total billed charges,78% of total billed charges,633,100,,,percent of total billed charges,100% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,522.86,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",238.64,21458.7,
CORONARY ARTERY DILATION,92982,CDM,983,RC,92982,HCPCS,Outpatient,,,1686,1095.90,,1483.68,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1686,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1163.34,69,,,percent of total billed charges,69% of total billed charges,1686,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1686,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1686,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1042.79,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,635.62,37.7,,,percent of total billed charges,37.70% of total billed charges,635.62,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,57155.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1315.08,78,,,percent of total billed charges,78% of total billed charges,1686,100,,,percent of total billed charges,100% of total billed charges,1392.64,82.6,,,percent of total billed charges,82.6% of total billed charges,1392.64,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",635.62,57155.4,
CORONARY ARTERY DILATION,92984,CDM,983,RC,92984,HCPCS,Outpatient,,,452,293.80,,397.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,452,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,311.88,69,,,percent of total billed charges,69% of total billed charges,452,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,452,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,452,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,279.56,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,170.4,37.7,,,percent of total billed charges,37.70% of total billed charges,170.4,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15322.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,352.56,78,,,percent of total billed charges,78% of total billed charges,452,100,,,percent of total billed charges,100% of total billed charges,373.35,82.6,,,percent of total billed charges,82.6% of total billed charges,373.35,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",170.4,15322.8,
ELECTROCARDIOGRAM COMPLETE,93000,CDM,983,RC,93000,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,0.96,100,,,Fee Schedule,100% of Medicare rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,45,100,,,percent of total billed charges,100% of total billed charges,8.64,103,,,Fee Schedule,103% of WA Medicaid,0.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,45,100,,,percent of total billed charges,100% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,45,100,,,percent of total billed charges,100% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.83,61.85,,,percent of total billed charges,61.85% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.91,130,,,Fee Schedule,130% of WA Medicaid ,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1525.5,33.9,,,percent of total billed charges,33.9% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.96,1525.5,
ELECTROCARDIOGRAM TRACING,93005,CDM,983,RC,93005,HCPCS,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,0.45,100,,,Fee Schedule,100% of Medicare rate,3.73,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,3.84,103,,,Fee Schedule,103% of WA Medicaid,0.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,3.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,30,100,,,percent of total billed charges,100% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,30,100,,,percent of total billed charges,100% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,3.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.85,130,,,Fee Schedule,130% of WA Medicaid ,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,33.9,,,percent of total billed charges,33.9% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,3.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.45,1017,
CARDIOVASCULAR STRESS TEST,93016,CDM,983,RC,93016,HCPCS,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,0.89,100,,,Fee Schedule,100% of Medicare rate,11.94,100,,,Fee Schedule,100% of WA Medicaid,62,100,,,percent of total billed charges,100% of total billed charges,12.3,103,,,Fee Schedule,103% of WA Medicaid,0.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,62,100,,,percent of total billed charges,100% of total billed charges,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,62,100,,,percent of total billed charges,100% of total billed charges,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.35,61.85,,,percent of total billed charges,61.85% of total billed charges,11.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.52,130,,,Fee Schedule,130% of WA Medicaid ,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2101.8,33.9,,,percent of total billed charges,33.9% of total billed charges,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,11.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.89,2101.8,
CARDIOVASCULAR STRESS TEST,93018,CDM,983,RC,93018,HCPCS,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,0.67,100,,,Fee Schedule,100% of Medicare rate,7.83,100,,,Fee Schedule,100% of WA Medicaid,42,100,,,percent of total billed charges,100% of total billed charges,8.06,103,,,Fee Schedule,103% of WA Medicaid,0.67,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,7.83,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,42,100,,,percent of total billed charges,100% of total billed charges,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,42,100,,,percent of total billed charges,100% of total billed charges,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,7.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.18,130,,,Fee Schedule,130% of WA Medicaid ,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.8,33.9,,,percent of total billed charges,33.9% of total billed charges,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.83,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.68,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.67,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.83,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.67,1423.8,
CARDIOVASCULAR STRESS TEST,93015,CDM,983,RC,93015,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,3.25,100,,,Fee Schedule,100% of Medicare rate,42.34,100,,,Fee Schedule,100% of WA Medicaid,250,100,,,percent of total billed charges,100% of total billed charges,43.61,103,,,Fee Schedule,103% of WA Medicaid,3.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,250,100,,,percent of total billed charges,100% of total billed charges,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,250,100,,,percent of total billed charges,100% of total billed charges,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.19,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.04,130,,,Fee Schedule,130% of WA Medicaid ,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,8475,33.9,,,percent of total billed charges,33.9% of total billed charges,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,8475,
CARDIOVASCULAR STRESS TEST,93017,CDM,983,RC,93017,HCPCS,Outpatient,,,144,93.60,,126.72,88,,,percent of total billed charges,88% of total Billed charges,1.69,100,,,Fee Schedule,100% of Medicare rate,22.57,100,,,Fee Schedule,100% of WA Medicaid,144,100,,,percent of total billed charges,100% of total billed charges,23.25,103,,,Fee Schedule,103% of WA Medicaid,1.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,99.36,69,,,percent of total billed charges,69% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,144,100,,,percent of total billed charges,100% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,144,100,,,percent of total billed charges,100% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,89.06,61.85,,,percent of total billed charges,61.85% of total billed charges,22.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.34,130,,,Fee Schedule,130% of WA Medicaid ,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.29,37.7,,,percent of total billed charges,37.70% of total billed charges,54.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,4881.6,33.9,,,percent of total billed charges,33.9% of total billed charges,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.32,78,,,percent of total billed charges,78% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,22.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.69,4881.6,
ELECTROCARDIOGRAM REPORT,93010,CDM,983,RC,93010,HCPCS,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,0.5,100,,,Fee Schedule,100% of Medicare rate,4.48,100,,,Fee Schedule,100% of WA Medicaid,24,100,,,percent of total billed charges,100% of total billed charges,4.61,103,,,Fee Schedule,103% of WA Medicaid,0.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,4.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,24,100,,,percent of total billed charges,100% of total billed charges,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,24,100,,,percent of total billed charges,100% of total billed charges,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.82,130,,,Fee Schedule,130% of WA Medicaid ,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.05,37.7,,,percent of total billed charges,37.70% of total billed charges,9.05,37.7,,,percent of total billed charges,37.70% of total billed charges,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,813.6,33.9,,,percent of total billed charges,33.9% of total billed charges,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.51,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.5,813.6,
RHYTHM ECG TRACING,93041,CDM,983,RC,93041,HCPCS,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,0.45,100,,,Fee Schedule,100% of Medicare rate,3.73,100,,,Fee Schedule,100% of WA Medicaid,16,100,,,percent of total billed charges,100% of total billed charges,3.84,103,,,Fee Schedule,103% of WA Medicaid,0.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,3.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,16,100,,,percent of total billed charges,100% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,16,100,,,percent of total billed charges,100% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.9,61.85,,,percent of total billed charges,61.85% of total billed charges,3.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.85,130,,,Fee Schedule,130% of WA Medicaid ,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.03,37.7,,,percent of total billed charges,37.70% of total billed charges,6.03,37.7,,,percent of total billed charges,37.70% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,542.4,33.9,,,percent of total billed charges,33.9% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,3.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.45,542.4,
RHYTHM ECG WITH REPORT,93040,CDM,983,RC,93040,HCPCS,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,0.91,100,,,Fee Schedule,100% of Medicare rate,7.46,100,,,Fee Schedule,100% of WA Medicaid,36,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,0.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,7.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,36,100,,,percent of total billed charges,100% of total billed charges,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,36,100,,,percent of total billed charges,100% of total billed charges,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,7.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.7,130,,,Fee Schedule,130% of WA Medicaid ,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,13.57,37.7,,,percent of total billed charges,37.70% of total billed charges,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1220.4,33.9,,,percent of total billed charges,33.9% of total billed charges,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,7.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.91,1220.4,
RHYTHM ECG REPORT,93042,CDM,983,RC,93042,HCPCS,Outpatient,,,20,13.00,,17.6,88,,,percent of total billed charges,88% of total Billed charges,0.46,100,,,Fee Schedule,100% of Medicare rate,3.73,100,,,Fee Schedule,100% of WA Medicaid,20,100,,,percent of total billed charges,100% of total billed charges,3.84,103,,,Fee Schedule,103% of WA Medicaid,0.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,3.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,13.8,69,,,percent of total billed charges,69% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,20,100,,,percent of total billed charges,100% of total billed charges,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,20,100,,,percent of total billed charges,100% of total billed charges,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.37,61.85,,,percent of total billed charges,61.85% of total billed charges,3.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.85,130,,,Fee Schedule,130% of WA Medicaid ,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.54,37.7,,,percent of total billed charges,37.70% of total billed charges,7.54,37.7,,,percent of total billed charges,37.70% of total billed charges,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,678,33.9,,,percent of total billed charges,33.9% of total billed charges,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.6,78,,,percent of total billed charges,78% of total billed charges,20,100,,,percent of total billed charges,100% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,16.52,82.6,,,percent of total billed charges,82.6% of total billed charges,3.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.46,678,
ECG MONIT/REPRT UP TO 48 HRS,93224,CDM,983,RC,93224,HCPCS,Outpatient,,,276,179.40,,242.88,88,,,percent of total billed charges,88% of total Billed charges,3,100,,,Fee Schedule,100% of Medicare rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,276,100,,,percent of total billed charges,100% of total billed charges,43.99,103,,,Fee Schedule,103% of WA Medicaid,3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,190.44,69,,,percent of total billed charges,69% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,276,100,,,percent of total billed charges,100% of total billed charges,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,276,100,,,percent of total billed charges,100% of total billed charges,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.71,61.85,,,percent of total billed charges,61.85% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.52,130,,,Fee Schedule,130% of WA Medicaid ,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.05,37.7,,,percent of total billed charges,37.70% of total billed charges,104.05,37.7,,,percent of total billed charges,37.70% of total billed charges,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,9356.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,215.28,78,,,percent of total billed charges,78% of total billed charges,276,100,,,percent of total billed charges,100% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,227.98,82.6,,,percent of total billed charges,82.6% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,3,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3,9356.4,
ECG MONIT/REPRT UP TO 48 HRS,93226,CDM,983,RC,93226,HCPCS,Outpatient,,,121,78.65,,106.48,88,,,percent of total billed charges,88% of total Billed charges,1.37,100,,,Fee Schedule,100% of Medicare rate,21.45,100,,,Fee Schedule,100% of WA Medicaid,121,100,,,percent of total billed charges,100% of total billed charges,22.09,103,,,Fee Schedule,103% of WA Medicaid,1.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,83.49,69,,,percent of total billed charges,69% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,121,100,,,percent of total billed charges,100% of total billed charges,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,121,100,,,percent of total billed charges,100% of total billed charges,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.84,61.85,,,percent of total billed charges,61.85% of total billed charges,21.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.89,130,,,Fee Schedule,130% of WA Medicaid ,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.62,37.7,,,percent of total billed charges,37.70% of total billed charges,45.62,37.7,,,percent of total billed charges,37.70% of total billed charges,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,4101.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.38,78,,,percent of total billed charges,78% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,21.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.37,4101.9,
REMOTE 30 DAY ECG REV/REPORT,93228,CDM,983,RC,93228,HCPCS,Outpatient,,,71,46.15,,62.48,88,,,percent of total billed charges,88% of total Billed charges,1.52,100,,,Fee Schedule,100% of Medicare rate,14.17,100,,,Fee Schedule,100% of WA Medicaid,71,100,,,percent of total billed charges,100% of total billed charges,14.6,103,,,Fee Schedule,103% of WA Medicaid,1.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,14.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,48.99,69,,,percent of total billed charges,69% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,71,100,,,percent of total billed charges,100% of total billed charges,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,71,100,,,percent of total billed charges,100% of total billed charges,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.91,61.85,,,percent of total billed charges,61.85% of total billed charges,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.42,130,,,Fee Schedule,130% of WA Medicaid ,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.77,37.7,,,percent of total billed charges,37.70% of total billed charges,26.77,37.7,,,percent of total billed charges,37.70% of total billed charges,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,2406.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.38,78,,,percent of total billed charges,78% of total billed charges,71,100,,,percent of total billed charges,100% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,58.65,82.6,,,percent of total billed charges,82.6% of total billed charges,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.52,2406.9,
ECG MONIT/REPRT UP TO 48 HRS,93225,CDM,983,RC,93225,HCPCS,Outpatient,,,82,53.30,,72.16,88,,,percent of total billed charges,88% of total Billed charges,0.83,100,,,Fee Schedule,100% of Medicare rate,11,100,,,Fee Schedule,100% of WA Medicaid,82,100,,,percent of total billed charges,100% of total billed charges,11.33,103,,,Fee Schedule,103% of WA Medicaid,0.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.45,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,56.58,69,,,percent of total billed charges,69% of total billed charges,82,100,,,percent of total billed charges,100% of total billed charges,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,82,100,,,percent of total billed charges,100% of total billed charges,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,82,100,,,percent of total billed charges,100% of total billed charges,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.72,61.85,,,percent of total billed charges,61.85% of total billed charges,11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.3,130,,,Fee Schedule,130% of WA Medicaid ,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.91,37.7,,,percent of total billed charges,37.70% of total billed charges,30.91,37.7,,,percent of total billed charges,37.70% of total billed charges,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,2779.8,33.9,,,percent of total billed charges,33.9% of total billed charges,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.96,78,,,percent of total billed charges,78% of total billed charges,82,100,,,percent of total billed charges,100% of total billed charges,67.73,82.6,,,percent of total billed charges,82.6% of total billed charges,67.73,82.6,,,percent of total billed charges,82.6% of total billed charges,11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.83,2779.8,
ECG MONIT/REPRT UP TO 48 HRS,93227,CDM,983,RC,93227,HCPCS,Outpatient,,,73,47.45,,64.24,88,,,percent of total billed charges,88% of total Billed charges,0.81,100,,,Fee Schedule,100% of Medicare rate,10.26,100,,,Fee Schedule,100% of WA Medicaid,73,100,,,percent of total billed charges,100% of total billed charges,10.57,103,,,Fee Schedule,103% of WA Medicaid,0.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.41,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,10.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,50.37,69,,,percent of total billed charges,69% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,73,100,,,percent of total billed charges,100% of total billed charges,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,73,100,,,percent of total billed charges,100% of total billed charges,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.15,61.85,,,percent of total billed charges,61.85% of total billed charges,10.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.34,130,,,Fee Schedule,130% of WA Medicaid ,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,2474.7,33.9,,,percent of total billed charges,33.9% of total billed charges,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.94,78,,,percent of total billed charges,78% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,10.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.81,2474.7,
REMOTE 30 DAY ECG TECH SUPP,93229,CDM,983,RC,93229,HCPCS,Outpatient,,,1936,1258.40,,1703.68,88,,,percent of total billed charges,88% of total Billed charges,27.71,100,,,Fee Schedule,100% of Medicare rate,490.5,100,,,Fee Schedule,100% of WA Medicaid,1936,100,,,percent of total billed charges,100% of total billed charges,505.22,103,,,Fee Schedule,103% of WA Medicaid,27.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,490.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1335.84,69,,,percent of total billed charges,69% of total billed charges,1936,100,,,percent of total billed charges,100% of total billed charges,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1936,100,,,percent of total billed charges,100% of total billed charges,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1936,100,,,percent of total billed charges,100% of total billed charges,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1197.42,61.85,,,percent of total billed charges,61.85% of total billed charges,490.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,637.65,130,,,Fee Schedule,130% of WA Medicaid ,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.87,37.7,,,percent of total billed charges,37.70% of total billed charges,729.87,37.7,,,percent of total billed charges,37.70% of total billed charges,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,65630.4,33.9,,,percent of total billed charges,33.9% of total billed charges,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,1510.08,78,,,percent of total billed charges,78% of total billed charges,1936,100,,,percent of total billed charges,100% of total billed charges,1599.14,82.6,,,percent of total billed charges,82.6% of total billed charges,1599.14,82.6,,,percent of total billed charges,82.6% of total billed charges,490.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,490.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.71,65630.4,
"Ext EKG 48 hr -7 days, record, scan, A/R",93241,CDM,985,RC,93241,HCPCS,Outpatient,,,227,147.55,,199.76,88,,,percent of total billed charges,88% of total Billed charges,9.07,100,,,Fee Schedule,100% of Medicare rate,154.98,100,,,Fee Schedule,100% of WA Medicaid,227,100,,,percent of total billed charges,100% of total billed charges,159.63,103,,,Fee Schedule,103% of WA Medicaid,9.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,154.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,156.63,69,,,percent of total billed charges,69% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,227,100,,,percent of total billed charges,100% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,227,100,,,percent of total billed charges,100% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.4,61.85,,,percent of total billed charges,61.85% of total billed charges,154.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,201.47,130,,,Fee Schedule,130% of WA Medicaid ,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,85.58,37.7,,,percent of total billed charges,37.70% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,7695.3,33.9,,,percent of total billed charges,33.9% of total billed charges,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.06,78,,,percent of total billed charges,78% of total billed charges,227,100,,,percent of total billed charges,100% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,187.5,82.6,,,percent of total billed charges,82.6% of total billed charges,154.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.07,7695.3,
"Ext EKG 48 hr -7 days, hookup and recording",93242,CDM,731,RC,93242,HCPCS,Outpatient,,,102,66.30,,89.76,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,61.52,100,,,Fee Schedule,100% of WA Medicaid,102,100,,,percent of total billed charges,100% of total billed charges,63.37,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,64.26,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,61.52,100,,,Fee Schedule,100% of WA Medicaid,15.61,15.3,,,percent of total billed charges,15.3% of total billed charges,70.38,69,,,percent of total billed charges,69% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,102,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,137.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,45.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,62.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.98,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,38.45,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,34.58,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,79.56,78,,,percent of total billed charges,78% of total billed charges,102,100,,,percent of total billed charges,100% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,84.25,82.6,,,percent of total billed charges,82.6% of total billed charges,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.61,137.47,
"Ext EKG  7 - 15 days, record, scan, A/",93245,CDM,985,RC,93245,HCPCS,Outpatient,,,390,253.50,,343.2,88,,,percent of total billed charges,88% of total Billed charges,9.49,100,,,Fee Schedule,100% of Medicare rate,163,100,,,Fee Schedule,100% of WA Medicaid,390,100,,,percent of total billed charges,100% of total billed charges,167.89,103,,,Fee Schedule,103% of WA Medicaid,9.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,163,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,269.1,69,,,percent of total billed charges,69% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,390,100,,,percent of total billed charges,100% of total billed charges,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,390,100,,,percent of total billed charges,100% of total billed charges,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.22,61.85,,,percent of total billed charges,61.85% of total billed charges,163,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,163,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,211.9,130,,,Fee Schedule,130% of WA Medicaid ,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,147.03,37.7,,,percent of total billed charges,37.70% of total billed charges,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,13221,33.9,,,percent of total billed charges,33.9% of total billed charges,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.2,78,,,percent of total billed charges,78% of total billed charges,390,100,,,percent of total billed charges,100% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,322.14,82.6,,,percent of total billed charges,82.6% of total billed charges,163,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,163,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.49,13221,
"Ext EKG  7 - 15 days, hookup and recording",93246,CDM,731,RC,93246,HCPCS,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,61.52,100,,,Fee Schedule,100% of WA Medicaid,167,100,,,percent of total billed charges,100% of total billed charges,63.37,103,,,Fee Schedule,103% of WA Medicaid,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,105.21,63,,,percent of total billed charges,63% of total billed charges,71.58,175,,,Fee Schedule,175% of Medicare OPPS Rate,61.52,100,,,Fee Schedule,100% of WA Medicaid,25.55,15.3,,,percent of total billed charges,15.3% of total billed charges,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,45.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,62.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.98,130,,,Fee Schedule,130% of WA Medicaid ,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,56.61,33.9,,,percent of total billed charges,33.9% of total billed charges,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,41.31,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,40.9,100,,,Fee Schedule,100% of Medicare OPPS rate,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.55,226.12,
"48 hr -7 days, analysis with report.",93243,CDM,731,RC,93243,HCPCS,Outpatient,,,167,108.55,,146.96,88,,,percent of total billed charges,88% of total Billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,61.52,100,,,Fee Schedule,100% of WA Medicaid,167,100,,,percent of total billed charges,100% of total billed charges,63.37,103,,,Fee Schedule,103% of WA Medicaid,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,105.21,63,,,percent of total billed charges,63% of total billed charges,228,175,,,Fee Schedule,175% of Medicare OPPS Rate,61.52,100,,,Fee Schedule,100% of WA Medicaid,25.55,15.3,,,percent of total billed charges,15.3% of total billed charges,115.23,69,,,percent of total billed charges,69% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,167,100,,,percent of total billed charges,100% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,45.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,62.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.98,130,,,Fee Schedule,130% of WA Medicaid ,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,62.96,37.7,,,percent of total billed charges,37.70% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,56.61,33.9,,,percent of total billed charges,33.9% of total billed charges,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,130.26,78,,,percent of total billed charges,78% of total billed charges,167,100,,,percent of total billed charges,100% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,137.94,82.6,,,percent of total billed charges,82.6% of total billed charges,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,131.59,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,130.29,100,,,Fee Schedule,100% of Medicare OPPS rate,61.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.55,228,
"Ext EKG 48 hr -7 days, review and interp.",93244,CDM,985,RC,93244,HCPCS,Outpatient,,,75,48.75,,66,88,,,percent of total billed charges,88% of total Billed charges,1.2,100,,,Fee Schedule,100% of Medicare rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,75,100,,,percent of total billed charges,100% of total billed charges,13.26,103,,,Fee Schedule,103% of WA Medicaid,1.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,51.75,69,,,percent of total billed charges,69% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,75,100,,,percent of total billed charges,100% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,75,100,,,percent of total billed charges,100% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.39,61.85,,,percent of total billed charges,61.85% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16.73,130,,,Fee Schedule,130% of WA Medicaid ,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.28,37.7,,,percent of total billed charges,37.70% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,2542.5,33.9,,,percent of total billed charges,33.9% of total billed charges,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.5,78,,,percent of total billed charges,78% of total billed charges,75,100,,,percent of total billed charges,100% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,61.95,82.6,,,percent of total billed charges,82.6% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.2,2542.5,
ECG RECORD/REVIEW,93268,CDM,983,RC,93268,HCPCS,Outpatient,,,664,431.60,,584.32,88,,,percent of total billed charges,88% of total Billed charges,6.47,100,,,Fee Schedule,100% of Medicare rate,104.63,100,,,Fee Schedule,100% of WA Medicaid,664,100,,,percent of total billed charges,100% of total billed charges,107.77,103,,,Fee Schedule,103% of WA Medicaid,6.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,104.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,458.16,69,,,percent of total billed charges,69% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,664,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,664,100,,,percent of total billed charges,100% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,410.68,61.85,,,percent of total billed charges,61.85% of total billed charges,104.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,136.02,130,,,Fee Schedule,130% of WA Medicaid ,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,250.33,37.7,,,percent of total billed charges,37.70% of total billed charges,250.33,37.7,,,percent of total billed charges,37.70% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,22509.6,33.9,,,percent of total billed charges,33.9% of total billed charges,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.92,78,,,percent of total billed charges,78% of total billed charges,664,100,,,percent of total billed charges,100% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,548.46,82.6,,,percent of total billed charges,82.6% of total billed charges,104.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.47,22509.6,
REMOTE 30 DAY ECG REV/REPORT,93270,CDM,983,RC,93270,HCPCS,Outpatient,,,35,22.75,,30.8,88,,,percent of total billed charges,88% of total Billed charges,0.52,100,,,Fee Schedule,100% of Medicare rate,5.04,100,,,Fee Schedule,100% of WA Medicaid,35,100,,,percent of total billed charges,100% of total billed charges,5.19,103,,,Fee Schedule,103% of WA Medicaid,0.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,5.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,24.15,69,,,percent of total billed charges,69% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,35,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,35,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.65,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.55,130,,,Fee Schedule,130% of WA Medicaid ,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,13.2,37.7,,,percent of total billed charges,37.70% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1186.5,33.9,,,percent of total billed charges,33.9% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.3,78,,,percent of total billed charges,78% of total billed charges,35,100,,,percent of total billed charges,100% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.52,1186.5,
ECG/MONITORING AND ANALYSIS,93271,CDM,983,RC,93271,HCPCS,Outpatient,,,561,364.65,,493.68,88,,,percent of total billed charges,88% of total Billed charges,4.72,100,,,Fee Schedule,100% of Medicare rate,86.16,100,,,Fee Schedule,100% of WA Medicaid,561,100,,,percent of total billed charges,100% of total billed charges,88.74,103,,,Fee Schedule,103% of WA Medicaid,4.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,86.16,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,387.09,69,,,percent of total billed charges,69% of total billed charges,561,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,561,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,561,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,346.98,61.85,,,percent of total billed charges,61.85% of total billed charges,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,112.01,130,,,Fee Schedule,130% of WA Medicaid ,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.5,37.7,,,percent of total billed charges,37.70% of total billed charges,211.5,37.7,,,percent of total billed charges,37.70% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,19017.9,33.9,,,percent of total billed charges,33.9% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,437.58,78,,,percent of total billed charges,78% of total billed charges,561,100,,,percent of total billed charges,100% of total billed charges,463.39,82.6,,,percent of total billed charges,82.6% of total billed charges,463.39,82.6,,,percent of total billed charges,82.6% of total billed charges,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.16,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.72,19017.9,
ECG/REVIEW INTERPRET ONLY,93272,CDM,983,RC,93272,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,1.24,100,,,Fee Schedule,100% of Medicare rate,13.61,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,14.02,103,,,Fee Schedule,103% of WA Medicaid,1.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,69,100,,,percent of total billed charges,100% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,69,100,,,percent of total billed charges,100% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.68,61.85,,,percent of total billed charges,61.85% of total billed charges,13.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,17.69,130,,,Fee Schedule,130% of WA Medicaid ,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,2339.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,13.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.24,2339.1,
PM DEVICE PROGR EVAL SNGL,93279,CDM,983,RC,93279,HCPCS,Outpatient,,,141,91.65,,124.08,88,,,percent of total billed charges,88% of total Billed charges,2.84,100,,,Fee Schedule,100% of Medicare rate,17.34,100,,,Fee Schedule,100% of WA Medicaid,141,100,,,percent of total billed charges,100% of total billed charges,17.86,103,,,Fee Schedule,103% of WA Medicaid,2.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.97,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,17.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,97.29,69,,,percent of total billed charges,69% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,141,100,,,percent of total billed charges,100% of total billed charges,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,141,100,,,percent of total billed charges,100% of total billed charges,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.21,61.85,,,percent of total billed charges,61.85% of total billed charges,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.54,130,,,Fee Schedule,130% of WA Medicaid ,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.16,37.7,,,percent of total billed charges,37.70% of total billed charges,53.16,37.7,,,percent of total billed charges,37.70% of total billed charges,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,4779.9,33.9,,,percent of total billed charges,33.9% of total billed charges,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.98,78,,,percent of total billed charges,78% of total billed charges,141,100,,,percent of total billed charges,100% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,116.47,82.6,,,percent of total billed charges,82.6% of total billed charges,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.84,4779.9,
PM DEVICE EVAL IN PERSON,93288,CDM,983,RC,93288,HCPCS,Outpatient,,,106,68.90,,93.28,88,,,percent of total billed charges,88% of total Billed charges,2.25,100,,,Fee Schedule,100% of Medicare rate,11.56,100,,,Fee Schedule,100% of WA Medicaid,106,100,,,percent of total billed charges,100% of total billed charges,11.91,103,,,Fee Schedule,103% of WA Medicaid,2.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.93,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,73.14,69,,,percent of total billed charges,69% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,106,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,106,100,,,percent of total billed charges,100% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.56,61.85,,,percent of total billed charges,61.85% of total billed charges,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.03,130,,,Fee Schedule,130% of WA Medicaid ,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,39.96,37.7,,,percent of total billed charges,37.70% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,3593.4,33.9,,,percent of total billed charges,33.9% of total billed charges,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.68,78,,,percent of total billed charges,78% of total billed charges,106,100,,,percent of total billed charges,100% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,87.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.25,3593.4,
ICD DEVICE PROGR EVAL MULT,93284,CDM,983,RC,93284,HCPCS,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,4.51,100,,,Fee Schedule,100% of Medicare rate,33.94,100,,,Fee Schedule,100% of WA Medicaid,250,100,,,percent of total billed charges,100% of total billed charges,34.96,103,,,Fee Schedule,103% of WA Medicaid,4.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,250,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,250,100,,,percent of total billed charges,100% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,44.12,130,,,Fee Schedule,130% of WA Medicaid ,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,94.25,37.7,,,percent of total billed charges,37.70% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,8475,33.9,,,percent of total billed charges,33.9% of total billed charges,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.51,8475,
PERI-PX ICD DEVICE EVALPRGR,93287,CDM,983,RC,93287,HCPCS,Outpatient,,,95,61.75,,83.6,88,,,percent of total billed charges,88% of total Billed charges,2.12,100,,,Fee Schedule,100% of Medicare rate,12.12,100,,,Fee Schedule,100% of WA Medicaid,95,100,,,percent of total billed charges,100% of total billed charges,12.48,103,,,Fee Schedule,103% of WA Medicaid,2.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,12.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,65.55,69,,,percent of total billed charges,69% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,95,100,,,percent of total billed charges,100% of total billed charges,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,95,100,,,percent of total billed charges,100% of total billed charges,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.76,61.85,,,percent of total billed charges,61.85% of total billed charges,12.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.76,130,,,Fee Schedule,130% of WA Medicaid ,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.82,37.7,,,percent of total billed charges,37.70% of total billed charges,35.82,37.7,,,percent of total billed charges,37.70% of total billed charges,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,3220.5,33.9,,,percent of total billed charges,33.9% of total billed charges,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.1,78,,,percent of total billed charges,78% of total billed charges,95,100,,,percent of total billed charges,100% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,78.47,82.6,,,percent of total billed charges,82.6% of total billed charges,12.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.12,3220.5,
ICD DEVICE INTERROGATE,93289,CDM,983,RC,93289,HCPCS,Outpatient,,,182,118.30,,160.16,88,,,percent of total billed charges,88% of total Billed charges,3.24,100,,,Fee Schedule,100% of Medicare rate,20.33,100,,,Fee Schedule,100% of WA Medicaid,182,100,,,percent of total billed charges,100% of total billed charges,20.94,103,,,Fee Schedule,103% of WA Medicaid,3.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,125.58,69,,,percent of total billed charges,69% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,182,100,,,percent of total billed charges,100% of total billed charges,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,182,100,,,percent of total billed charges,100% of total billed charges,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.57,61.85,,,percent of total billed charges,61.85% of total billed charges,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.43,130,,,Fee Schedule,130% of WA Medicaid ,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,6169.8,33.9,,,percent of total billed charges,33.9% of total billed charges,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.96,78,,,percent of total billed charges,78% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.24,6169.8,
ICD DEVICE PROGR EVAL 1 SNGL,93282,CDM,983,RC,93282,HCPCS,Outpatient,,,175,113.75,,154,88,,,percent of total billed charges,88% of total Billed charges,3.46,100,,,Fee Schedule,100% of Medicare rate,22.94,100,,,Fee Schedule,100% of WA Medicaid,175,100,,,percent of total billed charges,100% of total billed charges,23.63,103,,,Fee Schedule,103% of WA Medicaid,3.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,120.75,69,,,percent of total billed charges,69% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,175,100,,,percent of total billed charges,100% of total billed charges,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,175,100,,,percent of total billed charges,100% of total billed charges,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.24,61.85,,,percent of total billed charges,61.85% of total billed charges,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.82,130,,,Fee Schedule,130% of WA Medicaid ,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,65.98,37.7,,,percent of total billed charges,37.70% of total billed charges,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,5932.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.5,78,,,percent of total billed charges,78% of total billed charges,175,100,,,percent of total billed charges,100% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,144.55,82.6,,,percent of total billed charges,82.6% of total billed charges,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.46,5932.5,
ICD DEVICE PROGR EVAL DUAL,93283,CDM,983,RC,93283,HCPCS,Outpatient,,,225,146.25,,198,88,,,percent of total billed charges,88% of total Billed charges,4.27,100,,,Fee Schedule,100% of Medicare rate,31.15,100,,,Fee Schedule,100% of WA Medicaid,225,100,,,percent of total billed charges,100% of total billed charges,32.08,103,,,Fee Schedule,103% of WA Medicaid,4.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,31.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,155.25,69,,,percent of total billed charges,69% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,225,100,,,percent of total billed charges,100% of total billed charges,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,225,100,,,percent of total billed charges,100% of total billed charges,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.16,61.85,,,percent of total billed charges,61.85% of total billed charges,31.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.5,130,,,Fee Schedule,130% of WA Medicaid ,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,7627.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.5,78,,,percent of total billed charges,78% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,31.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.27,7627.5,
PERI-PX PACEMAKER DEVICE EVL,93286,CDM,983,RC,93286,HCPCS,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,1.91,100,,,Fee Schedule,100% of Medicare rate,8.21,100,,,Fee Schedule,100% of WA Medicaid,72,100,,,percent of total billed charges,100% of total billed charges,8.46,103,,,Fee Schedule,103% of WA Medicaid,1.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,72,100,,,percent of total billed charges,100% of total billed charges,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,72,100,,,percent of total billed charges,100% of total billed charges,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.53,61.85,,,percent of total billed charges,61.85% of total billed charges,8.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.67,130,,,Fee Schedule,130% of WA Medicaid ,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,2440.8,33.9,,,percent of total billed charges,33.9% of total billed charges,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,8.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.91,2440.8,
ILR DEVICE EVAL PROGR,93285,CDM,983,RC,93285,HCPCS,Outpatient,,,117,76.05,,102.96,88,,,percent of total billed charges,88% of total Billed charges,2.62,100,,,Fee Schedule,100% of Medicare rate,14.17,100,,,Fee Schedule,100% of WA Medicaid,117,100,,,percent of total billed charges,100% of total billed charges,14.6,103,,,Fee Schedule,103% of WA Medicaid,2.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,14.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,80.73,69,,,percent of total billed charges,69% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,117,100,,,percent of total billed charges,100% of total billed charges,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,117,100,,,percent of total billed charges,100% of total billed charges,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.36,61.85,,,percent of total billed charges,61.85% of total billed charges,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.42,130,,,Fee Schedule,130% of WA Medicaid ,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.11,37.7,,,percent of total billed charges,37.70% of total billed charges,44.11,37.7,,,percent of total billed charges,37.70% of total billed charges,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,3966.3,33.9,,,percent of total billed charges,33.9% of total billed charges,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.26,78,,,percent of total billed charges,78% of total billed charges,117,100,,,percent of total billed charges,100% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,96.64,82.6,,,percent of total billed charges,82.6% of total billed charges,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.62,3966.3,
PM DEVICE PROGR EVAL MULTI,93281,CDM,983,RC,93281,HCPCS,Outpatient,,,190,123.50,,167.2,88,,,percent of total billed charges,88% of total Billed charges,3.6,100,,,Fee Schedule,100% of Medicare rate,23.13,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,23.82,103,,,Fee Schedule,103% of WA Medicaid,3.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.52,61.85,,,percent of total billed charges,61.85% of total billed charges,23.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.07,130,,,Fee Schedule,130% of WA Medicaid ,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,6441,33.9,,,percent of total billed charges,33.9% of total billed charges,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.6,6441,
PM DEVICE PROGR EVAL DUAL,93280,CDM,983,RC,93280,HCPCS,Outpatient,,,164,106.60,,144.32,88,,,percent of total billed charges,88% of total Billed charges,3.19,100,,,Fee Schedule,100% of Medicare rate,20.7,100,,,Fee Schedule,100% of WA Medicaid,164,100,,,percent of total billed charges,100% of total billed charges,21.32,103,,,Fee Schedule,103% of WA Medicaid,3.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,113.16,69,,,percent of total billed charges,69% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,164,100,,,percent of total billed charges,100% of total billed charges,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,164,100,,,percent of total billed charges,100% of total billed charges,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.43,61.85,,,percent of total billed charges,61.85% of total billed charges,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.91,130,,,Fee Schedule,130% of WA Medicaid ,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.83,37.7,,,percent of total billed charges,37.70% of total billed charges,61.83,37.7,,,percent of total billed charges,37.70% of total billed charges,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,5559.6,33.9,,,percent of total billed charges,33.9% of total billed charges,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.92,78,,,percent of total billed charges,78% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.19,5559.6,
983,,,983,RC,,,Outpatient,,,81,52.65,,71.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,81,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,81,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,81,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,50.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2745.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",30.54,2745.9,
PM PHONE R-STRIP DEVICE EVAL,93293,CDM,983,RC,93293,HCPCS,Outpatient,,,151,98.15,,132.88,88,,,percent of total billed charges,88% of total Billed charges,1.88,100,,,Fee Schedule,100% of Medicare rate,8.02,100,,,Fee Schedule,100% of WA Medicaid,151,100,,,percent of total billed charges,100% of total billed charges,8.26,103,,,Fee Schedule,103% of WA Medicaid,1.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,104.19,69,,,percent of total billed charges,69% of total billed charges,151,100,,,percent of total billed charges,100% of total billed charges,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,151,100,,,percent of total billed charges,100% of total billed charges,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,151,100,,,percent of total billed charges,100% of total billed charges,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.39,61.85,,,percent of total billed charges,61.85% of total billed charges,8.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.43,130,,,Fee Schedule,130% of WA Medicaid ,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.93,37.7,,,percent of total billed charges,37.70% of total billed charges,56.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,5118.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.78,78,,,percent of total billed charges,78% of total billed charges,151,100,,,percent of total billed charges,100% of total billed charges,124.73,82.6,,,percent of total billed charges,82.6% of total billed charges,124.73,82.6,,,percent of total billed charges,82.6% of total billed charges,8.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.88,5118.9,
ICD DEVICE INTERROGAT REMOTE,93295,CDM,983,RC,93295,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,2.38,100,,,Fee Schedule,100% of Medicare rate,20.52,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,21.14,103,,,Fee Schedule,103% of WA Medicaid,2.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,180,100,,,percent of total billed charges,100% of total billed charges,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,180,100,,,percent of total billed charges,100% of total billed charges,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.33,61.85,,,percent of total billed charges,61.85% of total billed charges,20.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.68,130,,,Fee Schedule,130% of WA Medicaid ,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,6102,33.9,,,percent of total billed charges,33.9% of total billed charges,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,20.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.38,6102,
ILR DEVICE INTERROGATE,93291,CDM,983,RC,93291,HCPCS,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,2.02,100,,,Fee Schedule,100% of Medicare rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,101,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,2.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,101,100,,,percent of total billed charges,100% of total billed charges,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,101,100,,,percent of total billed charges,100% of total billed charges,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.47,61.85,,,percent of total billed charges,61.85% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.84,130,,,Fee Schedule,130% of WA Medicaid ,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,3423.9,33.9,,,percent of total billed charges,33.9% of total billed charges,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.02,3423.9,
ILR DEVICE INTERROGAT REMOTE,93298,CDM,983,RC,93298,HCPCS,Outpatient,,,73,47.45,,64.24,88,,,percent of total billed charges,88% of total Billed charges,4.18,100,,,Fee Schedule,100% of Medicare rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,73,100,,,percent of total billed charges,100% of total billed charges,14.41,103,,,Fee Schedule,103% of WA Medicaid,4.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,50.37,69,,,percent of total billed charges,69% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,73,100,,,percent of total billed charges,100% of total billed charges,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,73,100,,,percent of total billed charges,100% of total billed charges,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.15,61.85,,,percent of total billed charges,61.85% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.19,130,,,Fee Schedule,130% of WA Medicaid ,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,2474.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.94,78,,,percent of total billed charges,78% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.22,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.18,2474.7,
PM/ICD REMOTE TECH SERV,93296,CDM,983,RC,93296,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,0.92,100,,,Fee Schedule,100% of Medicare rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,13.26,103,,,Fee Schedule,103% of WA Medicaid,0.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.34,61.85,,,percent of total billed charges,61.85% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16.73,130,,,Fee Schedule,130% of WA Medicaid ,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2813.7,33.9,,,percent of total billed charges,33.9% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.92,2813.7,
PM DEVICE INTERROGATE REMOTE,93294,CDM,983,RC,93294,HCPCS,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,1.91,100,,,Fee Schedule,100% of Medicare rate,16.6,100,,,Fee Schedule,100% of WA Medicaid,91,100,,,percent of total billed charges,100% of total billed charges,17.1,103,,,Fee Schedule,103% of WA Medicaid,1.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.6,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,91,100,,,percent of total billed charges,100% of total billed charges,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,91,100,,,percent of total billed charges,100% of total billed charges,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.28,61.85,,,percent of total billed charges,61.85% of total billed charges,16.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.58,130,,,Fee Schedule,130% of WA Medicaid ,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,3084.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,16.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.91,3084.9,
ICM DEVICE EVAL,93290,CDM,983,RC,93290,HCPCS,Outpatient,,,84,54.60,,73.92,88,,,percent of total billed charges,88% of total Billed charges,2.41,100,,,Fee Schedule,100% of Medicare rate,11.56,100,,,Fee Schedule,100% of WA Medicaid,84,100,,,percent of total billed charges,100% of total billed charges,11.91,103,,,Fee Schedule,103% of WA Medicaid,2.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,57.96,69,,,percent of total billed charges,69% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,84,100,,,percent of total billed charges,100% of total billed charges,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,84,100,,,percent of total billed charges,100% of total billed charges,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.95,61.85,,,percent of total billed charges,61.85% of total billed charges,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.03,130,,,Fee Schedule,130% of WA Medicaid ,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,31.67,37.7,,,percent of total billed charges,37.70% of total billed charges,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2847.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.52,78,,,percent of total billed charges,78% of total billed charges,84,100,,,percent of total billed charges,100% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,69.38,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.41,2847.6,
ICM DEVICE INTERROGAT REMOTE,93297,CDM,983,RC,93297,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,2.64,100,,,Fee Schedule,100% of Medicare rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,14.41,103,,,Fee Schedule,103% of WA Medicaid,2.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,100,,,percent of total billed charges,100% of total billed charges,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,100,,,percent of total billed charges,100% of total billed charges,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.19,130,,,Fee Schedule,130% of WA Medicaid ,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2373,33.9,,,percent of total billed charges,33.9% of total billed charges,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.64,2373,
WCD DEVICE INTERROGATE,93292,CDM,983,RC,93292,HCPCS,Outpatient,,,91,59.15,,80.08,88,,,percent of total billed charges,88% of total Billed charges,2.35,100,,,Fee Schedule,100% of Medicare rate,11.56,100,,,Fee Schedule,100% of WA Medicaid,91,100,,,percent of total billed charges,100% of total billed charges,11.91,103,,,Fee Schedule,103% of WA Medicaid,2.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,62.79,69,,,percent of total billed charges,69% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,91,100,,,percent of total billed charges,100% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,91,100,,,percent of total billed charges,100% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.28,61.85,,,percent of total billed charges,61.85% of total billed charges,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.03,130,,,Fee Schedule,130% of WA Medicaid ,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,34.31,37.7,,,percent of total billed charges,37.70% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3084.9,33.9,,,percent of total billed charges,33.9% of total billed charges,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.98,78,,,percent of total billed charges,78% of total billed charges,91,100,,,percent of total billed charges,100% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,75.17,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.35,3084.9,
TTE W/DOPPLER COMPLETE,93306,CDM,983,RC,93306,HCPCS,Outpatient,,,638,414.70,,561.44,88,,,percent of total billed charges,88% of total Billed charges,8.13,100,,,Fee Schedule,100% of Medicare rate,38.61,100,,,Fee Schedule,100% of WA Medicaid,638,100,,,percent of total billed charges,100% of total billed charges,39.77,103,,,Fee Schedule,103% of WA Medicaid,8.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,440.22,69,,,percent of total billed charges,69% of total billed charges,638,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,638,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,638,100,,,percent of total billed charges,100% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.6,61.85,,,percent of total billed charges,61.85% of total billed charges,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.19,130,,,Fee Schedule,130% of WA Medicaid ,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,240.53,37.7,,,percent of total billed charges,37.70% of total billed charges,240.53,37.7,,,percent of total billed charges,37.70% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,21628.2,33.9,,,percent of total billed charges,33.9% of total billed charges,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,497.64,78,,,percent of total billed charges,78% of total billed charges,638,100,,,percent of total billed charges,100% of total billed charges,526.99,82.6,,,percent of total billed charges,82.6% of total billed charges,526.99,82.6,,,percent of total billed charges,82.6% of total billed charges,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.13,21628.2,
ECHO TRANSTHORACIC,93304,CDM,983,RC,93304,HCPCS,Outpatient,,,101,65.65,,88.88,88,,,percent of total billed charges,88% of total Billed charges,6.11,100,,,Fee Schedule,100% of Medicare rate,19.96,100,,,Fee Schedule,100% of WA Medicaid,101,100,,,percent of total billed charges,100% of total billed charges,20.56,103,,,Fee Schedule,103% of WA Medicaid,6.11,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,69.69,69,,,percent of total billed charges,69% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,101,100,,,percent of total billed charges,100% of total billed charges,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,101,100,,,percent of total billed charges,100% of total billed charges,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.47,61.85,,,percent of total billed charges,61.85% of total billed charges,19.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.95,130,,,Fee Schedule,130% of WA Medicaid ,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,38.08,37.7,,,percent of total billed charges,37.70% of total billed charges,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,3423.9,33.9,,,percent of total billed charges,33.9% of total billed charges,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.78,78,,,percent of total billed charges,78% of total billed charges,101,100,,,percent of total billed charges,100% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,83.43,82.6,,,percent of total billed charges,82.6% of total billed charges,19.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.11,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.11,3423.9,
TTE W/O DOPPLER COMPLETE,93307,CDM,983,RC,93307,HCPCS,Outpatient,,,127,82.55,,111.76,88,,,percent of total billed charges,88% of total Billed charges,5.51,100,,,Fee Schedule,100% of Medicare rate,24.25,100,,,Fee Schedule,100% of WA Medicaid,127,100,,,percent of total billed charges,100% of total billed charges,24.98,103,,,Fee Schedule,103% of WA Medicaid,5.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,24.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,87.63,69,,,percent of total billed charges,69% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,127,100,,,percent of total billed charges,100% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,127,100,,,percent of total billed charges,100% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.55,61.85,,,percent of total billed charges,61.85% of total billed charges,24.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,31.53,130,,,Fee Schedule,130% of WA Medicaid ,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.88,37.7,,,percent of total billed charges,37.70% of total billed charges,47.88,37.7,,,percent of total billed charges,37.70% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4305.3,33.9,,,percent of total billed charges,33.9% of total billed charges,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.06,78,,,percent of total billed charges,78% of total billed charges,127,100,,,percent of total billed charges,100% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,104.9,82.6,,,percent of total billed charges,82.6% of total billed charges,24.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.51,4305.3,
TTE F-UP OR LIMITED,93308,CDM,983,RC,93308,HCPCS,Outpatient,,,72,46.80,,63.36,88,,,percent of total billed charges,88% of total Billed charges,4.09,100,,,Fee Schedule,100% of Medicare rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,72,100,,,percent of total billed charges,100% of total billed charges,14.41,103,,,Fee Schedule,103% of WA Medicaid,4.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,49.68,69,,,percent of total billed charges,69% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,72,100,,,percent of total billed charges,100% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,72,100,,,percent of total billed charges,100% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.53,61.85,,,percent of total billed charges,61.85% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.19,130,,,Fee Schedule,130% of WA Medicaid ,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,27.14,37.7,,,percent of total billed charges,37.70% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,2440.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.16,78,,,percent of total billed charges,78% of total billed charges,72,100,,,percent of total billed charges,100% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,59.47,82.6,,,percent of total billed charges,82.6% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.13,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.09,2440.8,
ECHO TRANSTHORACIC,93303,CDM,983,RC,93303,HCPCS,Outpatient,,,178,115.70,,156.64,88,,,percent of total billed charges,88% of total Billed charges,8.6,100,,,Fee Schedule,100% of Medicare rate,34.32,100,,,Fee Schedule,100% of WA Medicaid,178,100,,,percent of total billed charges,100% of total billed charges,35.35,103,,,Fee Schedule,103% of WA Medicaid,8.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,34.32,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,122.82,69,,,percent of total billed charges,69% of total billed charges,178,100,,,percent of total billed charges,100% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,178,100,,,percent of total billed charges,100% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,178,100,,,percent of total billed charges,100% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.09,61.85,,,percent of total billed charges,61.85% of total billed charges,34.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.32,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,44.62,130,,,Fee Schedule,130% of WA Medicaid ,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.11,37.7,,,percent of total billed charges,37.70% of total billed charges,67.11,37.7,,,percent of total billed charges,37.70% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,6034.2,33.9,,,percent of total billed charges,33.9% of total billed charges,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,138.84,78,,,percent of total billed charges,78% of total billed charges,178,100,,,percent of total billed charges,100% of total billed charges,147.03,82.6,,,percent of total billed charges,82.6% of total billed charges,147.03,82.6,,,percent of total billed charges,82.6% of total billed charges,34.32,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.32,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.6,6034.2,
ECHO TRANSESOPHAGEAL,93316,CDM,983,RC,93316,HCPCS,Outpatient,,,135,87.75,,118.8,88,,,percent of total billed charges,88% of total Billed charges,2.06,100,,,Fee Schedule,100% of Medicare rate,14.36,100,,,Fee Schedule,100% of WA Medicaid,135,100,,,percent of total billed charges,100% of total billed charges,14.79,103,,,Fee Schedule,103% of WA Medicaid,2.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,14.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,93.15,69,,,percent of total billed charges,69% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,135,100,,,percent of total billed charges,100% of total billed charges,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,135,100,,,percent of total billed charges,100% of total billed charges,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.5,61.85,,,percent of total billed charges,61.85% of total billed charges,14.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.67,130,,,Fee Schedule,130% of WA Medicaid ,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,50.9,37.7,,,percent of total billed charges,37.70% of total billed charges,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4576.5,33.9,,,percent of total billed charges,33.9% of total billed charges,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.3,78,,,percent of total billed charges,78% of total billed charges,135,100,,,percent of total billed charges,100% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,111.51,82.6,,,percent of total billed charges,82.6% of total billed charges,14.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.06,4576.5,
ECHO TRANSESOPHAGEAL,93314,CDM,983,RC,93314,HCPCS,Outpatient,,,168,109.20,,147.84,88,,,percent of total billed charges,88% of total Billed charges,11.86,100,,,Fee Schedule,100% of Medicare rate,49.24,100,,,Fee Schedule,100% of WA Medicaid,168,100,,,percent of total billed charges,100% of total billed charges,50.72,103,,,Fee Schedule,103% of WA Medicaid,11.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,115.92,69,,,percent of total billed charges,69% of total billed charges,168,100,,,percent of total billed charges,100% of total billed charges,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,168,100,,,percent of total billed charges,100% of total billed charges,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,168,100,,,percent of total billed charges,100% of total billed charges,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,103.91,61.85,,,percent of total billed charges,61.85% of total billed charges,49.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.01,130,,,Fee Schedule,130% of WA Medicaid ,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.34,37.7,,,percent of total billed charges,37.70% of total billed charges,63.34,37.7,,,percent of total billed charges,37.70% of total billed charges,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,5695.2,33.9,,,percent of total billed charges,33.9% of total billed charges,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.04,78,,,percent of total billed charges,78% of total billed charges,168,100,,,percent of total billed charges,100% of total billed charges,138.77,82.6,,,percent of total billed charges,82.6% of total billed charges,138.77,82.6,,,percent of total billed charges,82.6% of total billed charges,49.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.86,5695.2,
ECHO TRANSESOPHAGEAL,93313,CDM,983,RC,93313,HCPCS,Outpatient,,,281,182.65,,247.28,88,,,percent of total billed charges,88% of total Billed charges,0.85,100,,,Fee Schedule,100% of Medicare rate,6.15,100,,,Fee Schedule,100% of WA Medicaid,281,100,,,percent of total billed charges,100% of total billed charges,6.33,103,,,Fee Schedule,103% of WA Medicaid,0.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,6.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,193.89,69,,,percent of total billed charges,69% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,281,100,,,percent of total billed charges,100% of total billed charges,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,281,100,,,percent of total billed charges,100% of total billed charges,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.8,61.85,,,percent of total billed charges,61.85% of total billed charges,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8,130,,,Fee Schedule,130% of WA Medicaid ,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.94,37.7,,,percent of total billed charges,37.70% of total billed charges,105.94,37.7,,,percent of total billed charges,37.70% of total billed charges,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,9525.9,33.9,,,percent of total billed charges,33.9% of total billed charges,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,219.18,78,,,percent of total billed charges,78% of total billed charges,281,100,,,percent of total billed charges,100% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,232.11,82.6,,,percent of total billed charges,82.6% of total billed charges,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.86,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.85,9525.9,
ECHO TRANSESOPHAGEAL 2D W/WO M MODE RCDG,93312,CDM,983,RC,93312,HCPCS,Outpatient,,,293,190.45,,257.84,88,,,percent of total billed charges,88% of total Billed charges,10.09,100,,,Fee Schedule,100% of Medicare rate,59.31,100,,,Fee Schedule,100% of WA Medicaid,293,100,,,percent of total billed charges,100% of total billed charges,61.09,103,,,Fee Schedule,103% of WA Medicaid,10.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,202.17,69,,,percent of total billed charges,69% of total billed charges,293,100,,,percent of total billed charges,100% of total billed charges,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,293,100,,,percent of total billed charges,100% of total billed charges,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,293,100,,,percent of total billed charges,100% of total billed charges,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.22,61.85,,,percent of total billed charges,61.85% of total billed charges,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,77.1,130,,,Fee Schedule,130% of WA Medicaid ,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.46,37.7,,,percent of total billed charges,37.70% of total billed charges,110.46,37.7,,,percent of total billed charges,37.70% of total billed charges,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,9932.7,33.9,,,percent of total billed charges,33.9% of total billed charges,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.54,78,,,percent of total billed charges,78% of total billed charges,293,100,,,percent of total billed charges,100% of total billed charges,242.02,82.6,,,percent of total billed charges,82.6% of total billed charges,242.02,82.6,,,percent of total billed charges,82.6% of total billed charges,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.09,9932.7,
ECHO TRANSESOPHAGEAL INTRAOP,93318,CDM,983,RC,93318,HCPCS,Outpatient,,,306,198.90,,269.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,56.51,100,,,Fee Schedule,100% of WA Medicaid,306,100,,,percent of total billed charges,100% of total billed charges,58.21,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.51,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,211.14,69,,,percent of total billed charges,69% of total billed charges,306,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,306,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,306,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,189.26,61.85,,,percent of total billed charges,61.85% of total billed charges,56.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.51,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,57.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,73.46,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,115.36,37.7,,,percent of total billed charges,37.70% of total billed charges,115.36,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,10373.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,238.68,78,,,percent of total billed charges,78% of total billed charges,306,100,,,percent of total billed charges,100% of total billed charges,252.76,82.6,,,percent of total billed charges,82.6% of total billed charges,252.76,82.6,,,percent of total billed charges,82.6% of total billed charges,56.51,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56.51,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,56.51,10373.4,
ECHO TRANSESOPHAGEAL,93315,CDM,983,RC,93315,HCPCS,Outpatient,,,387,251.55,,340.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,70.5,100,,,Fee Schedule,100% of WA Medicaid,387,100,,,percent of total billed charges,100% of total billed charges,72.62,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,70.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,267.03,69,,,percent of total billed charges,69% of total billed charges,387,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,387,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,387,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,239.36,61.85,,,percent of total billed charges,61.85% of total billed charges,70.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,70.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,91.65,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,145.9,37.7,,,percent of total billed charges,37.70% of total billed charges,145.9,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,13119.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,301.86,78,,,percent of total billed charges,78% of total billed charges,387,100,,,percent of total billed charges,100% of total billed charges,319.66,82.6,,,percent of total billed charges,82.6% of total billed charges,319.66,82.6,,,percent of total billed charges,82.6% of total billed charges,70.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,70.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,70.5,13119.3,
ECHO TRANSESOPHAGEAL,93317,CDM,983,RC,93317,HCPCS,Outpatient,,,253,164.45,,222.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,48.86,100,,,Fee Schedule,100% of WA Medicaid,253,100,,,percent of total billed charges,100% of total billed charges,50.33,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,174.57,69,,,percent of total billed charges,69% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,253,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,253,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,156.48,61.85,,,percent of total billed charges,61.85% of total billed charges,48.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,49.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,63.52,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,95.38,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,8576.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,197.34,78,,,percent of total billed charges,78% of total billed charges,253,100,,,percent of total billed charges,100% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,208.98,82.6,,,percent of total billed charges,82.6% of total billed charges,48.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,48.86,8576.7,
DOPPLER ECHOCARDIOGRAPHY OF HEART,93320,CDM,983,RC,93320,HCPCS,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,2.08,100,,,Fee Schedule,100% of Medicare rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,52,100,,,percent of total billed charges,100% of total billed charges,10.18,103,,,Fee Schedule,103% of WA Medicaid,2.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,52,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,52,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.84,130,,,Fee Schedule,130% of WA Medicaid ,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.08,1762.8,
DOPPLER ECHO EXAM HEART,93321,CDM,983,RC,93321,HCPCS,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,1.03,100,,,Fee Schedule,100% of Medicare rate,3.92,100,,,Fee Schedule,100% of WA Medicaid,21,100,,,percent of total billed charges,100% of total billed charges,4.04,103,,,Fee Schedule,103% of WA Medicaid,1.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.81,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,3.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,21,100,,,percent of total billed charges,100% of total billed charges,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,21,100,,,percent of total billed charges,100% of total billed charges,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,3.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.1,130,,,Fee Schedule,130% of WA Medicaid ,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.92,37.7,,,percent of total billed charges,37.70% of total billed charges,7.92,37.7,,,percent of total billed charges,37.70% of total billed charges,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,711.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,3.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.03,711.9,
DOPPLER ECHOCARDIOGRAPHY COLOR FLOW,93325,CDM,983,RC,93325,HCPCS,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,0.73,100,,,Fee Schedule,100% of Medicare rate,1.68,100,,,Fee Schedule,100% of WA Medicaid,11,100,,,percent of total billed charges,100% of total billed charges,1.73,103,,,Fee Schedule,103% of WA Medicaid,0.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,11,100,,,percent of total billed charges,100% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,11,100,,,percent of total billed charges,100% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.71,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2.18,130,,,Fee Schedule,130% of WA Medicaid ,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.15,37.7,,,percent of total billed charges,37.70% of total billed charges,4.15,37.7,,,percent of total billed charges,37.70% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.9,33.9,,,percent of total billed charges,33.9% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.73,372.9,
STRESS TTE COMPLETE,93351,CDM,983,RC,93351,HCPCS,Outpatient,,,242,157.30,,212.96,88,,,percent of total billed charges,88% of total Billed charges,9.75,100,,,Fee Schedule,100% of Medicare rate,46.25,100,,,Fee Schedule,100% of WA Medicaid,242,100,,,percent of total billed charges,100% of total billed charges,47.64,103,,,Fee Schedule,103% of WA Medicaid,9.75,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.06,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.25,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,166.98,69,,,percent of total billed charges,69% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,242,100,,,percent of total billed charges,100% of total billed charges,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,242,100,,,percent of total billed charges,100% of total billed charges,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.68,61.85,,,percent of total billed charges,61.85% of total billed charges,46.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.13,130,,,Fee Schedule,130% of WA Medicaid ,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,91.23,37.7,,,percent of total billed charges,37.70% of total billed charges,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,8203.8,33.9,,,percent of total billed charges,33.9% of total billed charges,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.76,78,,,percent of total billed charges,78% of total billed charges,242,100,,,percent of total billed charges,100% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,199.89,82.6,,,percent of total billed charges,82.6% of total billed charges,46.25,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.75,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.25,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.75,8203.8,
STRESS TTE ONLY,93350,CDM,983,RC,93350,HCPCS,Outpatient,,,201,130.65,,176.88,88,,,percent of total billed charges,88% of total Billed charges,7.53,100,,,Fee Schedule,100% of Medicare rate,38.61,100,,,Fee Schedule,100% of WA Medicaid,201,100,,,percent of total billed charges,100% of total billed charges,39.77,103,,,Fee Schedule,103% of WA Medicaid,7.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,38.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138.69,69,,,percent of total billed charges,69% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,201,100,,,percent of total billed charges,100% of total billed charges,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,201,100,,,percent of total billed charges,100% of total billed charges,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.32,61.85,,,percent of total billed charges,61.85% of total billed charges,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.19,130,,,Fee Schedule,130% of WA Medicaid ,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6813.9,33.9,,,percent of total billed charges,33.9% of total billed charges,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.78,78,,,percent of total billed charges,78% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.53,6813.9,
ADMIN ECG CONTRAST AGENT,93352,CDM,983,RC,93352,HCPCS,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,1.59,100,,,Fee Schedule,100% of Medicare rate,20.52,100,,,Fee Schedule,100% of WA Medicaid,104,100,,,percent of total billed charges,100% of total billed charges,21.14,103,,,Fee Schedule,103% of WA Medicaid,1.59,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.52,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,104,100,,,percent of total billed charges,100% of total billed charges,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,104,100,,,percent of total billed charges,100% of total billed charges,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.32,61.85,,,percent of total billed charges,61.85% of total billed charges,20.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.52,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.93,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.68,130,,,Fee Schedule,130% of WA Medicaid ,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,3525.6,33.9,,,percent of total billed charges,33.9% of total billed charges,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,20.52,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.59,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.52,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.59,3525.6,
ECHO TRANSESOPHAGEAL (TEE),93355,CDM,983,RC,93355,HCPCS,Outpatient,,,460,299.00,,404.8,88,,,percent of total billed charges,88% of total Billed charges,15.17,100,,,Fee Schedule,100% of Medicare rate,124.77,100,,,Fee Schedule,100% of WA Medicaid,460,100,,,percent of total billed charges,100% of total billed charges,128.51,103,,,Fee Schedule,103% of WA Medicaid,15.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,124.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,317.4,69,,,percent of total billed charges,69% of total billed charges,460,100,,,percent of total billed charges,100% of total billed charges,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,460,100,,,percent of total billed charges,100% of total billed charges,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,460,100,,,percent of total billed charges,100% of total billed charges,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.51,61.85,,,percent of total billed charges,61.85% of total billed charges,124.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,162.2,130,,,Fee Schedule,130% of WA Medicaid ,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.42,37.7,,,percent of total billed charges,37.70% of total billed charges,173.42,37.7,,,percent of total billed charges,37.70% of total billed charges,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,15594,33.9,,,percent of total billed charges,33.9% of total billed charges,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.8,78,,,percent of total billed charges,78% of total billed charges,460,100,,,percent of total billed charges,100% of total billed charges,379.96,82.6,,,percent of total billed charges,82.6% of total billed charges,379.96,82.6,,,percent of total billed charges,82.6% of total billed charges,124.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.32,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.17,15594,
R HRT ART/GRFT ANGIO,93457,CDM,983,RC,93457,HCPCS,Outpatient,,,1007,654.55,,886.16,88,,,percent of total billed charges,88% of total Billed charges,71.14,100,,,Fee Schedule,100% of Medicare rate,189.86,100,,,Fee Schedule,100% of WA Medicaid,1007,100,,,percent of total billed charges,100% of total billed charges,195.56,103,,,Fee Schedule,103% of WA Medicaid,71.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,189.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,694.83,69,,,percent of total billed charges,69% of total billed charges,1007,100,,,percent of total billed charges,100% of total billed charges,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1007,100,,,percent of total billed charges,100% of total billed charges,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,1007,100,,,percent of total billed charges,100% of total billed charges,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.83,61.85,,,percent of total billed charges,61.85% of total billed charges,189.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,246.82,130,,,Fee Schedule,130% of WA Medicaid ,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.64,37.7,,,percent of total billed charges,37.70% of total billed charges,379.64,37.7,,,percent of total billed charges,37.70% of total billed charges,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,34137.3,33.9,,,percent of total billed charges,33.9% of total billed charges,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,785.46,78,,,percent of total billed charges,78% of total billed charges,1007,100,,,percent of total billed charges,100% of total billed charges,831.78,82.6,,,percent of total billed charges,82.6% of total billed charges,831.78,82.6,,,percent of total billed charges,82.6% of total billed charges,189.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.85,101,,,Fee Schedule,101% of Medicare RBRVS rate,71.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,71.14,34137.3,
L HRT ART/VENT ANGIO,93458,CDM,983,RC,93458,HCPCS,Outpatient,,,856,556.40,,753.28,88,,,percent of total billed charges,88% of total Billed charges,60.58,100,,,Fee Schedule,100% of Medicare rate,160.02,100,,,Fee Schedule,100% of WA Medicaid,856,100,,,percent of total billed charges,100% of total billed charges,164.82,103,,,Fee Schedule,103% of WA Medicaid,60.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,106.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,160.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,590.64,69,,,percent of total billed charges,69% of total billed charges,856,100,,,percent of total billed charges,100% of total billed charges,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,856,100,,,percent of total billed charges,100% of total billed charges,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,856,100,,,percent of total billed charges,100% of total billed charges,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,529.44,61.85,,,percent of total billed charges,61.85% of total billed charges,160.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,208.03,130,,,Fee Schedule,130% of WA Medicaid ,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,322.71,37.7,,,percent of total billed charges,37.70% of total billed charges,322.71,37.7,,,percent of total billed charges,37.70% of total billed charges,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,29018.4,33.9,,,percent of total billed charges,33.9% of total billed charges,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,667.68,78,,,percent of total billed charges,78% of total billed charges,856,100,,,percent of total billed charges,100% of total billed charges,707.06,82.6,,,percent of total billed charges,82.6% of total billed charges,707.06,82.6,,,percent of total billed charges,82.6% of total billed charges,160.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,60.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,60.58,29018.4,
L HRT ART/GRFT ANGIO,93459,CDM,983,RC,93459,HCPCS,Outpatient,,,965,627.25,,849.2,88,,,percent of total billed charges,88% of total Billed charges,66.83,100,,,Fee Schedule,100% of Medicare rate,181.28,100,,,Fee Schedule,100% of WA Medicaid,965,100,,,percent of total billed charges,100% of total billed charges,186.72,103,,,Fee Schedule,103% of WA Medicaid,66.83,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,116.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,181.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,665.85,69,,,percent of total billed charges,69% of total billed charges,965,100,,,percent of total billed charges,100% of total billed charges,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,965,100,,,percent of total billed charges,100% of total billed charges,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,965,100,,,percent of total billed charges,100% of total billed charges,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,596.85,61.85,,,percent of total billed charges,61.85% of total billed charges,181.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,235.66,130,,,Fee Schedule,130% of WA Medicaid ,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.81,37.7,,,percent of total billed charges,37.70% of total billed charges,363.81,37.7,,,percent of total billed charges,37.70% of total billed charges,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,32713.5,33.9,,,percent of total billed charges,33.9% of total billed charges,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,752.7,78,,,percent of total billed charges,78% of total billed charges,965,100,,,percent of total billed charges,100% of total billed charges,797.09,82.6,,,percent of total billed charges,82.6% of total billed charges,797.09,82.6,,,percent of total billed charges,82.6% of total billed charges,181.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,66.83,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,66.83,32713.5,
CORONARY ART/GRFT ANGIO SI,93455,CDM,983,RC,93455,HCPCS,Outpatient,,,811,527.15,,713.68,88,,,percent of total billed charges,88% of total Billed charges,58.04,100,,,Fee Schedule,100% of Medicare rate,151.07,100,,,Fee Schedule,100% of WA Medicaid,811,100,,,percent of total billed charges,100% of total billed charges,155.6,103,,,Fee Schedule,103% of WA Medicaid,58.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,101.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,151.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,559.59,69,,,percent of total billed charges,69% of total billed charges,811,100,,,percent of total billed charges,100% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,811,100,,,percent of total billed charges,100% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,811,100,,,percent of total billed charges,100% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,501.6,61.85,,,percent of total billed charges,61.85% of total billed charges,151.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,154.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.39,130,,,Fee Schedule,130% of WA Medicaid ,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.75,37.7,,,percent of total billed charges,37.70% of total billed charges,305.75,37.7,,,percent of total billed charges,37.70% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,27492.9,33.9,,,percent of total billed charges,33.9% of total billed charges,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,632.58,78,,,percent of total billed charges,78% of total billed charges,811,100,,,percent of total billed charges,100% of total billed charges,669.89,82.6,,,percent of total billed charges,82.6% of total billed charges,669.89,82.6,,,percent of total billed charges,82.6% of total billed charges,151.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,58.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,58.04,27492.9,
RIGHT HEART CATH,93451,CDM,983,RC,93451,HCPCS,Outpatient,,,398,258.70,,350.24,88,,,percent of total billed charges,88% of total Billed charges,38.26,100,,,Fee Schedule,100% of Medicare rate,71.24,100,,,Fee Schedule,100% of WA Medicaid,398,100,,,percent of total billed charges,100% of total billed charges,73.38,103,,,Fee Schedule,103% of WA Medicaid,38.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,66.95,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,71.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,274.62,69,,,percent of total billed charges,69% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,398,100,,,percent of total billed charges,100% of total billed charges,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,398,100,,,percent of total billed charges,100% of total billed charges,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,246.16,61.85,,,percent of total billed charges,61.85% of total billed charges,71.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,92.61,130,,,Fee Schedule,130% of WA Medicaid ,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,150.05,37.7,,,percent of total billed charges,37.70% of total billed charges,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,13492.2,33.9,,,percent of total billed charges,33.9% of total billed charges,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.44,78,,,percent of total billed charges,78% of total billed charges,398,100,,,percent of total billed charges,100% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,328.75,82.6,,,percent of total billed charges,82.6% of total billed charges,71.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,38.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,38.26,13492.2,
R HRT CORONARY ARTERY ANGIO,93456,CDM,983,RC,93456,HCPCS,Outpatient,,,898,583.70,,790.24,88,,,percent of total billed charges,88% of total Billed charges,64.72,100,,,Fee Schedule,100% of Medicare rate,168.97,100,,,Fee Schedule,100% of WA Medicaid,898,100,,,percent of total billed charges,100% of total billed charges,174.04,103,,,Fee Schedule,103% of WA Medicaid,64.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,113.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,168.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,619.62,69,,,percent of total billed charges,69% of total billed charges,898,100,,,percent of total billed charges,100% of total billed charges,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,898,100,,,percent of total billed charges,100% of total billed charges,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,898,100,,,percent of total billed charges,100% of total billed charges,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,555.41,61.85,,,percent of total billed charges,61.85% of total billed charges,168.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,219.66,130,,,Fee Schedule,130% of WA Medicaid ,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.55,37.7,,,percent of total billed charges,37.70% of total billed charges,338.55,37.7,,,percent of total billed charges,37.70% of total billed charges,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,30442.2,33.9,,,percent of total billed charges,33.9% of total billed charges,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,700.44,78,,,percent of total billed charges,78% of total billed charges,898,100,,,percent of total billed charges,100% of total billed charges,741.75,82.6,,,percent of total billed charges,82.6% of total billed charges,741.75,82.6,,,percent of total billed charges,82.6% of total billed charges,168.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,64.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,64.72,30442.2,
RL HRT CATH W/VENTRICLGRPHY,93453,CDM,983,RC,93453,HCPCS,Outpatient,,,913,593.45,,803.44,88,,,percent of total billed charges,88% of total Billed charges,65.57,100,,,Fee Schedule,100% of Medicare rate,171.39,100,,,Fee Schedule,100% of WA Medicaid,913,100,,,percent of total billed charges,100% of total billed charges,176.53,103,,,Fee Schedule,103% of WA Medicaid,65.57,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,114.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,171.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,629.97,69,,,percent of total billed charges,69% of total billed charges,913,100,,,percent of total billed charges,100% of total billed charges,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,913,100,,,percent of total billed charges,100% of total billed charges,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,913,100,,,percent of total billed charges,100% of total billed charges,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,564.69,61.85,,,percent of total billed charges,61.85% of total billed charges,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.82,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,222.81,130,,,Fee Schedule,130% of WA Medicaid ,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,344.2,37.7,,,percent of total billed charges,37.70% of total billed charges,344.2,37.7,,,percent of total billed charges,37.70% of total billed charges,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,30950.7,33.9,,,percent of total billed charges,33.9% of total billed charges,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,712.14,78,,,percent of total billed charges,78% of total billed charges,913,100,,,percent of total billed charges,100% of total billed charges,754.14,82.6,,,percent of total billed charges,82.6% of total billed charges,754.14,82.6,,,percent of total billed charges,82.6% of total billed charges,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,65.57,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,65.57,30950.7,
CORONARY ARTERY ANGIO SI,93454,CDM,983,RC,93454,HCPCS,Outpatient,,,701,455.65,,616.88,88,,,percent of total billed charges,88% of total Billed charges,51.04,100,,,Fee Schedule,100% of Medicare rate,129.8,100,,,Fee Schedule,100% of WA Medicaid,701,100,,,percent of total billed charges,100% of total billed charges,133.69,103,,,Fee Schedule,103% of WA Medicaid,51.04,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,89.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,129.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,483.69,69,,,percent of total billed charges,69% of total billed charges,701,100,,,percent of total billed charges,100% of total billed charges,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,701,100,,,percent of total billed charges,100% of total billed charges,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,701,100,,,percent of total billed charges,100% of total billed charges,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,433.57,61.85,,,percent of total billed charges,61.85% of total billed charges,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,168.74,130,,,Fee Schedule,130% of WA Medicaid ,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,264.28,37.7,,,percent of total billed charges,37.70% of total billed charges,264.28,37.7,,,percent of total billed charges,37.70% of total billed charges,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,23763.9,33.9,,,percent of total billed charges,33.9% of total billed charges,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,546.78,78,,,percent of total billed charges,78% of total billed charges,701,100,,,percent of total billed charges,100% of total billed charges,579.03,82.6,,,percent of total billed charges,82.6% of total billed charges,579.03,82.6,,,percent of total billed charges,82.6% of total billed charges,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,51.04,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,51.04,23763.9,
LEFT HRT CATH W/VENTRCLGRPHY,93452,CDM,983,RC,93452,HCPCS,Outpatient,,,697,453.05,,613.36,88,,,percent of total billed charges,88% of total Billed charges,50.55,100,,,Fee Schedule,100% of Medicare rate,128.5,100,,,Fee Schedule,100% of WA Medicaid,697,100,,,percent of total billed charges,100% of total billed charges,132.36,103,,,Fee Schedule,103% of WA Medicaid,50.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,88.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,128.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,480.93,69,,,percent of total billed charges,69% of total billed charges,697,100,,,percent of total billed charges,100% of total billed charges,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,697,100,,,percent of total billed charges,100% of total billed charges,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,697,100,,,percent of total billed charges,100% of total billed charges,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,431.09,61.85,,,percent of total billed charges,61.85% of total billed charges,128.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.07,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,167.05,130,,,Fee Schedule,130% of WA Medicaid ,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.77,37.7,,,percent of total billed charges,37.70% of total billed charges,262.77,37.7,,,percent of total billed charges,37.70% of total billed charges,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,23628.3,33.9,,,percent of total billed charges,33.9% of total billed charges,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,543.66,78,,,percent of total billed charges,78% of total billed charges,697,100,,,percent of total billed charges,100% of total billed charges,575.72,82.6,,,percent of total billed charges,82.6% of total billed charges,575.72,82.6,,,percent of total billed charges,82.6% of total billed charges,128.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,50.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,50.55,23628.3,
RL HRT ART/VENTRICLE ANGIO,93461,CDM,983,RC,93461,HCPCS,Outpatient,,,1185,770.25,,1042.8,88,,,percent of total billed charges,88% of total Billed charges,81.94,100,,,Fee Schedule,100% of Medicare rate,224.17,100,,,Fee Schedule,100% of WA Medicaid,1185,100,,,percent of total billed charges,100% of total billed charges,230.9,103,,,Fee Schedule,103% of WA Medicaid,81.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,143.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,224.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,817.65,69,,,percent of total billed charges,69% of total billed charges,1185,100,,,percent of total billed charges,100% of total billed charges,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1185,100,,,percent of total billed charges,100% of total billed charges,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1185,100,,,percent of total billed charges,100% of total billed charges,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,732.92,61.85,,,percent of total billed charges,61.85% of total billed charges,224.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,291.42,130,,,Fee Schedule,130% of WA Medicaid ,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.75,37.7,,,percent of total billed charges,37.70% of total billed charges,446.75,37.7,,,percent of total billed charges,37.70% of total billed charges,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,40171.5,33.9,,,percent of total billed charges,33.9% of total billed charges,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,924.3,78,,,percent of total billed charges,78% of total billed charges,1185,100,,,percent of total billed charges,100% of total billed charges,978.81,82.6,,,percent of total billed charges,82.6% of total billed charges,978.81,82.6,,,percent of total billed charges,82.6% of total billed charges,224.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,81.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,224.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,81.94,40171.5,
DRUG ADMIN  HEMODYNMIC MEAS,93463,CDM,983,RC,93463,HCPCS,Outpatient,,,338,219.70,,297.44,88,,,percent of total billed charges,88% of total Billed charges,7.02,100,,,Fee Schedule,100% of Medicare rate,54.27,100,,,Fee Schedule,100% of WA Medicaid,338,100,,,percent of total billed charges,100% of total billed charges,55.9,103,,,Fee Schedule,103% of WA Medicaid,7.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,54.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,233.22,69,,,percent of total billed charges,69% of total billed charges,338,100,,,percent of total billed charges,100% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,338,100,,,percent of total billed charges,100% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,338,100,,,percent of total billed charges,100% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,209.05,61.85,,,percent of total billed charges,61.85% of total billed charges,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,70.55,130,,,Fee Schedule,130% of WA Medicaid ,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.43,37.7,,,percent of total billed charges,37.70% of total billed charges,127.43,37.7,,,percent of total billed charges,37.70% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,11458.2,33.9,,,percent of total billed charges,33.9% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.64,78,,,percent of total billed charges,78% of total billed charges,338,100,,,percent of total billed charges,100% of total billed charges,279.19,82.6,,,percent of total billed charges,82.6% of total billed charges,279.19,82.6,,,percent of total billed charges,82.6% of total billed charges,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.02,11458.2,
RL HRT ART/VENTRICLE ANGIO,93460,CDM,983,RC,93460,HCPCS,Outpatient,,,1074,698.10,,945.12,88,,,percent of total billed charges,88% of total Billed charges,73.91,100,,,Fee Schedule,100% of Medicare rate,202.73,100,,,Fee Schedule,100% of WA Medicaid,1074,100,,,percent of total billed charges,100% of total billed charges,208.81,103,,,Fee Schedule,103% of WA Medicaid,73.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,129.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,202.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,741.06,69,,,percent of total billed charges,69% of total billed charges,1074,100,,,percent of total billed charges,100% of total billed charges,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074,100,,,percent of total billed charges,100% of total billed charges,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1074,100,,,percent of total billed charges,100% of total billed charges,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,664.27,61.85,,,percent of total billed charges,61.85% of total billed charges,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,206.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,263.55,130,,,Fee Schedule,130% of WA Medicaid ,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,404.9,37.7,,,percent of total billed charges,37.70% of total billed charges,404.9,37.7,,,percent of total billed charges,37.70% of total billed charges,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,36408.6,33.9,,,percent of total billed charges,33.9% of total billed charges,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,837.72,78,,,percent of total billed charges,78% of total billed charges,1074,100,,,percent of total billed charges,100% of total billed charges,887.12,82.6,,,percent of total billed charges,82.6% of total billed charges,887.12,82.6,,,percent of total billed charges,82.6% of total billed charges,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,73.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.91,36408.6,
EXERCISE W/HEMODYNAMIC MEAS,93464,CDM,983,RC,93464,HCPCS,Outpatient,,,254,165.10,,223.52,88,,,percent of total billed charges,88% of total Billed charges,9.81,100,,,Fee Schedule,100% of Medicare rate,49.24,100,,,Fee Schedule,100% of WA Medicaid,254,100,,,percent of total billed charges,100% of total billed charges,50.72,103,,,Fee Schedule,103% of WA Medicaid,9.81,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,49.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,175.26,69,,,percent of total billed charges,69% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.1,61.85,,,percent of total billed charges,61.85% of total billed charges,49.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,64.01,130,,,Fee Schedule,130% of WA Medicaid ,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,8610.6,33.9,,,percent of total billed charges,33.9% of total billed charges,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.12,78,,,percent of total billed charges,78% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,49.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.91,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.81,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.81,8610.6,
L HRT CATH TRNSPTL PUNCTURE,93462,CDM,983,RC,93462,HCPCS,Outpatient,,,640,416.00,,563.2,88,,,percent of total billed charges,88% of total Billed charges,28.02,100,,,Fee Schedule,100% of Medicare rate,112.65,100,,,Fee Schedule,100% of WA Medicaid,640,100,,,percent of total billed charges,100% of total billed charges,116.03,103,,,Fee Schedule,103% of WA Medicaid,28.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,49.03,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,112.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,441.6,69,,,percent of total billed charges,69% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,640,100,,,percent of total billed charges,100% of total billed charges,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,640,100,,,percent of total billed charges,100% of total billed charges,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.84,61.85,,,percent of total billed charges,61.85% of total billed charges,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,146.45,130,,,Fee Schedule,130% of WA Medicaid ,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,241.28,37.7,,,percent of total billed charges,37.70% of total billed charges,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,21696,33.9,,,percent of total billed charges,33.9% of total billed charges,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.2,78,,,percent of total billed charges,78% of total billed charges,640,100,,,percent of total billed charges,100% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,528.64,82.6,,,percent of total billed charges,82.6% of total billed charges,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,28.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.02,21696,
INSERT/PLACE HEART CATHETER,93503,CDM,983,RC,93503,HCPCS,Outpatient,,,738,479.70,,649.44,88,,,percent of total billed charges,88% of total Billed charges,7.23,100,,,Fee Schedule,100% of Medicare rate,48.3,100,,,Fee Schedule,100% of WA Medicaid,738,100,,,percent of total billed charges,100% of total billed charges,49.75,103,,,Fee Schedule,103% of WA Medicaid,7.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,509.22,69,,,percent of total billed charges,69% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,738,100,,,percent of total billed charges,100% of total billed charges,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,738,100,,,percent of total billed charges,100% of total billed charges,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,456.45,61.85,,,percent of total billed charges,61.85% of total billed charges,48.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.79,130,,,Fee Schedule,130% of WA Medicaid ,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.23,37.7,,,percent of total billed charges,37.70% of total billed charges,278.23,37.7,,,percent of total billed charges,37.70% of total billed charges,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,25018.2,33.9,,,percent of total billed charges,33.9% of total billed charges,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,575.64,78,,,percent of total billed charges,78% of total billed charges,738,100,,,percent of total billed charges,100% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,609.59,82.6,,,percent of total billed charges,82.6% of total billed charges,48.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.23,25018.2,
CARDIAC OUTPUT MEASUREMENT,93561,CDM,983,RC,93598,HCPCS,Outpatient,,,69,44.85,,60.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,37.11,100,,,Fee Schedule,100% of WA Medicaid,69,100,,,percent of total billed charges,100% of total billed charges,38.22,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,47.61,69,,,percent of total billed charges,69% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,69,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,69,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,42.68,61.85,,,percent of total billed charges,61.85% of total billed charges,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,48.24,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,26.01,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2339.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,53.82,78,,,percent of total billed charges,78% of total billed charges,69,100,,,percent of total billed charges,100% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,56.99,82.6,,,percent of total billed charges,82.6% of total billed charges,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,26.01,2339.1,
CARD OUTPUT MEASURE SUBSQ,93562,CDM,983,RC,93598,HCPCS,Outpatient,,,21,13.65,,18.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,37.11,100,,,Fee Schedule,100% of WA Medicaid,21,100,,,percent of total billed charges,100% of total billed charges,38.22,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,14.49,69,,,percent of total billed charges,69% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,21,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,21,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,12.99,61.85,,,percent of total billed charges,61.85% of total billed charges,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.85,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,48.24,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,7.92,37.7,,,percent of total billed charges,37.70% of total billed charges,7.92,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,711.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,16.38,78,,,percent of total billed charges,78% of total billed charges,21,100,,,percent of total billed charges,100% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,17.35,82.6,,,percent of total billed charges,82.6% of total billed charges,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.92,711.9,
INJECT SUPRVLV AORTOGRAPHY,93567,CDM,983,RC,93567,HCPCS,Outpatient,,,152,98.80,,133.76,88,,,percent of total billed charges,88% of total Billed charges,5.23,100,,,Fee Schedule,100% of Medicare rate,20.33,100,,,Fee Schedule,100% of WA Medicaid,152,100,,,percent of total billed charges,100% of total billed charges,20.94,103,,,Fee Schedule,103% of WA Medicaid,5.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,104.88,69,,,percent of total billed charges,69% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,152,100,,,percent of total billed charges,100% of total billed charges,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,152,100,,,percent of total billed charges,100% of total billed charges,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.01,61.85,,,percent of total billed charges,61.85% of total billed charges,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.43,130,,,Fee Schedule,130% of WA Medicaid ,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.3,37.7,,,percent of total billed charges,37.70% of total billed charges,57.3,37.7,,,percent of total billed charges,37.70% of total billed charges,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,5152.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,118.56,78,,,percent of total billed charges,78% of total billed charges,152,100,,,percent of total billed charges,100% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,125.55,82.6,,,percent of total billed charges,82.6% of total billed charges,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.23,5152.8,
INJECT PULM ART HRT CATH,93568,CDM,983,RC,93568,HCPCS,Outpatient,,,140,91.00,,123.2,88,,,percent of total billed charges,88% of total Billed charges,6.01,100,,,Fee Schedule,100% of Medicare rate,25.36,100,,,Fee Schedule,100% of WA Medicaid,140,100,,,percent of total billed charges,100% of total billed charges,26.12,103,,,Fee Schedule,103% of WA Medicaid,6.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,96.6,69,,,percent of total billed charges,69% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,140,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,140,100,,,percent of total billed charges,100% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.59,61.85,,,percent of total billed charges,61.85% of total billed charges,25.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.97,130,,,Fee Schedule,130% of WA Medicaid ,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.78,37.7,,,percent of total billed charges,37.70% of total billed charges,52.78,37.7,,,percent of total billed charges,37.70% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,4746,33.9,,,percent of total billed charges,33.9% of total billed charges,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.2,78,,,percent of total billed charges,78% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,25.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.01,4746,
INJECT HRT CONGNTL ART/GRFT,93564,CDM,983,RC,93564,HCPCS,Outpatient,,,180,117.00,,158.4,88,,,percent of total billed charges,88% of total Billed charges,7.82,100,,,Fee Schedule,100% of Medicare rate,30.03,100,,,Fee Schedule,100% of WA Medicaid,180,100,,,percent of total billed charges,100% of total billed charges,30.93,103,,,Fee Schedule,103% of WA Medicaid,7.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.68,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.03,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,124.2,69,,,percent of total billed charges,69% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,180,100,,,percent of total billed charges,100% of total billed charges,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,180,100,,,percent of total billed charges,100% of total billed charges,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.33,61.85,,,percent of total billed charges,61.85% of total billed charges,30.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.03,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,39.04,130,,,Fee Schedule,130% of WA Medicaid ,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,67.86,37.7,,,percent of total billed charges,37.70% of total billed charges,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,6102,33.9,,,percent of total billed charges,33.9% of total billed charges,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,140.4,78,,,percent of total billed charges,78% of total billed charges,180,100,,,percent of total billed charges,100% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,148.68,82.6,,,percent of total billed charges,82.6% of total billed charges,30.03,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.03,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.82,6102,
INJECT CONGENITAL CARD CATH,93563,CDM,983,RC,93563,HCPCS,Outpatient,,,176,114.40,,154.88,88,,,percent of total billed charges,88% of total Billed charges,5.65,100,,,Fee Schedule,100% of Medicare rate,28.35,100,,,Fee Schedule,100% of WA Medicaid,176,100,,,percent of total billed charges,100% of total billed charges,29.2,103,,,Fee Schedule,103% of WA Medicaid,5.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,121.44,69,,,percent of total billed charges,69% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,176,100,,,percent of total billed charges,100% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,176,100,,,percent of total billed charges,100% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.86,61.85,,,percent of total billed charges,61.85% of total billed charges,28.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,36.86,130,,,Fee Schedule,130% of WA Medicaid ,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5966.4,33.9,,,percent of total billed charges,33.9% of total billed charges,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.28,78,,,percent of total billed charges,78% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,28.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.65,5966.4,
INJECT R VENTR/ATRIAL ANGIO,93566,CDM,983,RC,93566,HCPCS,Outpatient,,,136,88.40,,119.68,88,,,percent of total billed charges,88% of total Billed charges,3.09,100,,,Fee Schedule,100% of Medicare rate,14.17,100,,,Fee Schedule,100% of WA Medicaid,136,100,,,percent of total billed charges,100% of total billed charges,14.6,103,,,Fee Schedule,103% of WA Medicaid,3.09,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,14.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,93.84,69,,,percent of total billed charges,69% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,136,100,,,percent of total billed charges,100% of total billed charges,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,136,100,,,percent of total billed charges,100% of total billed charges,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.12,61.85,,,percent of total billed charges,61.85% of total billed charges,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.45,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.42,130,,,Fee Schedule,130% of WA Medicaid ,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.27,37.7,,,percent of total billed charges,37.70% of total billed charges,51.27,37.7,,,percent of total billed charges,37.70% of total billed charges,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,4610.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.08,78,,,percent of total billed charges,78% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.09,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.09,4610.4,
INJECT L VENTR/ATRIAL ANGIO,93565,CDM,983,RC,93565,HCPCS,Outpatient,,,136,88.40,,119.68,88,,,percent of total billed charges,88% of total Billed charges,3.89,100,,,Fee Schedule,100% of Medicare rate,14.55,100,,,Fee Schedule,100% of WA Medicaid,136,100,,,percent of total billed charges,100% of total billed charges,14.99,103,,,Fee Schedule,103% of WA Medicaid,3.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,14.55,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,93.84,69,,,percent of total billed charges,69% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,136,100,,,percent of total billed charges,100% of total billed charges,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,136,100,,,percent of total billed charges,100% of total billed charges,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.12,61.85,,,percent of total billed charges,61.85% of total billed charges,14.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.92,130,,,Fee Schedule,130% of WA Medicaid ,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.27,37.7,,,percent of total billed charges,37.70% of total billed charges,51.27,37.7,,,percent of total billed charges,37.70% of total billed charges,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,4610.4,33.9,,,percent of total billed charges,33.9% of total billed charges,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.08,78,,,percent of total billed charges,78% of total billed charges,136,100,,,percent of total billed charges,100% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,112.34,82.6,,,percent of total billed charges,82.6% of total billed charges,14.55,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.55,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.89,4610.4,
HEART FLOW RESERVE MEASURE,93571,CDM,983,RC,93571,HCPCS,Outpatient,,,251,163.15,,220.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,39.17,100,,,Fee Schedule,100% of WA Medicaid,251,100,,,percent of total billed charges,100% of total billed charges,40.35,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,251,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,251,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,155.24,61.85,,,percent of total billed charges,61.85% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.92,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,8508.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.17,8508.9,
HEART FLOW RESERVE MEASURE,93572,CDM,983,RC,93572,HCPCS,Outpatient,,,201,130.65,,176.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,28.53,100,,,Fee Schedule,100% of WA Medicaid,201,100,,,percent of total billed charges,100% of total billed charges,29.39,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138.69,69,,,percent of total billed charges,69% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,201,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,201,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,124.32,61.85,,,percent of total billed charges,61.85% of total billed charges,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.09,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,75.78,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,6813.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,156.78,78,,,percent of total billed charges,78% of total billed charges,201,100,,,percent of total billed charges,100% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,166.03,82.6,,,percent of total billed charges,82.6% of total billed charges,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,28.53,6813.9,
RIGHT VENTRICULAR RECORDING,93603,CDM,983,RC,93603,HCPCS,Outpatient,,,320,208.00,,281.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,62.1,100,,,Fee Schedule,100% of WA Medicaid,320,100,,,percent of total billed charges,100% of total billed charges,63.96,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,220.8,69,,,percent of total billed charges,69% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,320,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,320,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,197.92,61.85,,,percent of total billed charges,61.85% of total billed charges,62.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,80.73,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,10848,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,249.6,78,,,percent of total billed charges,78% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,62.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.1,10848,
BUNDLE OF HIS RECORDING,93600,CDM,983,RC,93600,HCPCS,Outpatient,,,320,208.00,,281.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,63.22,100,,,Fee Schedule,100% of WA Medicaid,320,100,,,percent of total billed charges,100% of total billed charges,65.12,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,220.8,69,,,percent of total billed charges,69% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,320,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,320,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,197.92,61.85,,,percent of total billed charges,61.85% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,82.19,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,10848,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,249.6,78,,,percent of total billed charges,78% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,63.22,10848,
MAP TACHYCARDIA ADD-ON,93609,CDM,983,RC,93609,HCPCS,Outpatient,,,758,492.70,,667.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,148.27,100,,,Fee Schedule,100% of WA Medicaid,758,100,,,percent of total billed charges,100% of total billed charges,152.72,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,148.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,523.02,69,,,percent of total billed charges,69% of total billed charges,758,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,758,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,758,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,468.82,61.85,,,percent of total billed charges,61.85% of total billed charges,148.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,148.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,151.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,192.75,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,285.77,37.7,,,percent of total billed charges,37.70% of total billed charges,285.77,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,25696.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,591.24,78,,,percent of total billed charges,78% of total billed charges,758,100,,,percent of total billed charges,100% of total billed charges,626.11,82.6,,,percent of total billed charges,82.6% of total billed charges,626.11,82.6,,,percent of total billed charges,82.6% of total billed charges,148.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,148.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,148.27,25696.2,
INTRA-ATRIAL RECORDING,93602,CDM,983,RC,93602,HCPCS,Outpatient,,,320,208.00,,281.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,62.1,100,,,Fee Schedule,100% of WA Medicaid,320,100,,,percent of total billed charges,100% of total billed charges,63.96,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,220.8,69,,,percent of total billed charges,69% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,320,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,320,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,197.92,61.85,,,percent of total billed charges,61.85% of total billed charges,62.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63.34,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,80.73,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,120.64,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,10848,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,249.6,78,,,percent of total billed charges,78% of total billed charges,320,100,,,percent of total billed charges,100% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,264.32,82.6,,,percent of total billed charges,82.6% of total billed charges,62.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,62.1,10848,
ESOPHAGEAL RECORDING,93615,CDM,983,RC,93615,HCPCS,Outpatient,,,137,89.05,,120.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,20.14,100,,,Fee Schedule,100% of WA Medicaid,137,100,,,percent of total billed charges,100% of total billed charges,20.74,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,94.53,69,,,percent of total billed charges,69% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,137,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,137,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,84.73,61.85,,,percent of total billed charges,61.85% of total billed charges,20.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.54,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.18,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,51.65,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,4644.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,106.86,78,,,percent of total billed charges,78% of total billed charges,137,100,,,percent of total billed charges,100% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,113.16,82.6,,,percent of total billed charges,82.6% of total billed charges,20.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,20.14,4644.3,
ESOPHAGEAL RECORDING,93616,CDM,983,RC,93616,HCPCS,Outpatient,,,184,119.60,,161.92,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,32.45,100,,,Fee Schedule,100% of WA Medicaid,184,100,,,percent of total billed charges,100% of total billed charges,33.42,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,126.96,69,,,percent of total billed charges,69% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,184,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,184,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,113.8,61.85,,,percent of total billed charges,61.85% of total billed charges,32.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,33.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.19,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,69.37,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,6237.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,143.52,78,,,percent of total billed charges,78% of total billed charges,184,100,,,percent of total billed charges,100% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,151.98,82.6,,,percent of total billed charges,82.6% of total billed charges,32.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,32.45,6237.6,
ELECTROPHYS MAP 3D ADD-ON,93613,CDM,983,RC,93613,HCPCS,Outpatient,,,809,525.85,,711.92,88,,,percent of total billed charges,88% of total Billed charges,39.77,100,,,Fee Schedule,100% of Medicare rate,158.34,100,,,Fee Schedule,100% of WA Medicaid,809,100,,,percent of total billed charges,100% of total billed charges,163.09,103,,,Fee Schedule,103% of WA Medicaid,39.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,69.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,158.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,558.21,69,,,percent of total billed charges,69% of total billed charges,809,100,,,percent of total billed charges,100% of total billed charges,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,809,100,,,percent of total billed charges,100% of total billed charges,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,809,100,,,percent of total billed charges,100% of total billed charges,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,500.37,61.85,,,percent of total billed charges,61.85% of total billed charges,158.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,161.51,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,205.84,130,,,Fee Schedule,130% of WA Medicaid ,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,304.99,37.7,,,percent of total billed charges,37.70% of total billed charges,304.99,37.7,,,percent of total billed charges,37.70% of total billed charges,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,27425.1,33.9,,,percent of total billed charges,33.9% of total billed charges,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,631.02,78,,,percent of total billed charges,78% of total billed charges,809,100,,,percent of total billed charges,100% of total billed charges,668.23,82.6,,,percent of total billed charges,82.6% of total billed charges,668.23,82.6,,,percent of total billed charges,82.6% of total billed charges,158.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.77,27425.1,
HEART RHYTHM PACING,93618,CDM,983,RC,93618,HCPCS,Outpatient,,,645,419.25,,567.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,117.12,100,,,Fee Schedule,100% of WA Medicaid,645,100,,,percent of total billed charges,100% of total billed charges,120.63,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,117.12,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,445.05,69,,,percent of total billed charges,69% of total billed charges,645,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,645,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,645,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,398.93,61.85,,,percent of total billed charges,61.85% of total billed charges,117.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,117.12,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,119.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,152.26,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,243.17,37.7,,,percent of total billed charges,37.70% of total billed charges,243.17,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,21865.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,503.1,78,,,percent of total billed charges,78% of total billed charges,645,100,,,percent of total billed charges,100% of total billed charges,532.77,82.6,,,percent of total billed charges,82.6% of total billed charges,532.77,82.6,,,percent of total billed charges,82.6% of total billed charges,117.12,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,117.12,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,117.12,21865.5,
ELECTROPHYSIOLOGY EVALUATION,93619,CDM,983,RC,93619,HCPCS,Outpatient,,,1114,724.10,,980.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,209.44,100,,,Fee Schedule,100% of WA Medicaid,1114,100,,,percent of total billed charges,100% of total billed charges,215.72,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,209.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,768.66,69,,,percent of total billed charges,69% of total billed charges,1114,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1114,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1114,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,689.01,61.85,,,percent of total billed charges,61.85% of total billed charges,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,209.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,213.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,272.27,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,419.98,37.7,,,percent of total billed charges,37.70% of total billed charges,419.98,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,37764.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,868.92,78,,,percent of total billed charges,78% of total billed charges,1114,100,,,percent of total billed charges,100% of total billed charges,920.16,82.6,,,percent of total billed charges,82.6% of total billed charges,920.16,82.6,,,percent of total billed charges,82.6% of total billed charges,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,209.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,209.44,37764.6,
INTRAVENTRICULAR PACING,93612,CDM,983,RC,93612,HCPCS,Outpatient,,,454,295.10,,399.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,86.35,100,,,Fee Schedule,100% of WA Medicaid,454,100,,,percent of total billed charges,100% of total billed charges,88.94,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,86.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,313.26,69,,,percent of total billed charges,69% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,454,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,454,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,280.8,61.85,,,percent of total billed charges,61.85% of total billed charges,86.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,86.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,88.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,112.26,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,171.16,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15390.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,354.12,78,,,percent of total billed charges,78% of total billed charges,454,100,,,percent of total billed charges,100% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,375,82.6,,,percent of total billed charges,82.6% of total billed charges,86.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,86.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,86.35,15390.6,
INTRA-ATRIAL PACING,93610,CDM,983,RC,93610,HCPCS,Outpatient,,,456,296.40,,401.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,87.66,100,,,Fee Schedule,100% of WA Medicaid,456,100,,,percent of total billed charges,100% of total billed charges,90.29,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,87.66,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,314.64,69,,,percent of total billed charges,69% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,456,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,456,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,282.04,61.85,,,percent of total billed charges,61.85% of total billed charges,87.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,87.66,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,89.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,113.96,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,171.91,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15458.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,355.68,78,,,percent of total billed charges,78% of total billed charges,456,100,,,percent of total billed charges,100% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,376.66,82.6,,,percent of total billed charges,82.6% of total billed charges,87.66,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,87.66,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,87.66,15458.4,
STIMULATION PACING HEART,93623,CDM,983,RC,93623,HCPCS,Outpatient,,,433,281.45,,381.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,37.67,100,,,Fee Schedule,100% of WA Medicaid,433,100,,,percent of total billed charges,100% of total billed charges,38.8,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,298.77,69,,,percent of total billed charges,69% of total billed charges,433,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,433,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,433,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,267.81,61.85,,,percent of total billed charges,61.85% of total billed charges,37.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,48.97,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,163.24,37.7,,,percent of total billed charges,37.70% of total billed charges,163.24,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,14678.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,337.74,78,,,percent of total billed charges,78% of total billed charges,433,100,,,percent of total billed charges,100% of total billed charges,357.66,82.6,,,percent of total billed charges,82.6% of total billed charges,357.66,82.6,,,percent of total billed charges,82.6% of total billed charges,37.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,37.67,14678.7,
ELECTROPHYSIOLOGY EVALUATION,93620,CDM,983,RC,93620,HCPCS,Outpatient,,,1759,1143.35,,1547.92,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,335.89,100,,,Fee Schedule,100% of WA Medicaid,1759,100,,,percent of total billed charges,100% of total billed charges,345.97,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,335.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1213.71,69,,,percent of total billed charges,69% of total billed charges,1759,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1759,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1759,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1087.94,61.85,,,percent of total billed charges,61.85% of total billed charges,335.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,335.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,342.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,436.66,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,663.14,37.7,,,percent of total billed charges,37.70% of total billed charges,663.14,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,59630.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,1372.02,78,,,percent of total billed charges,78% of total billed charges,1759,100,,,percent of total billed charges,100% of total billed charges,1452.93,82.6,,,percent of total billed charges,82.6% of total billed charges,1452.93,82.6,,,percent of total billed charges,82.6% of total billed charges,335.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,335.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,335.89,59630.1,
ELECTROPHYSIOLOGY EVALUATION,93621,CDM,983,RC,93621,HCPCS,Outpatient,,,319,207.35,,280.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,44.57,100,,,Fee Schedule,100% of WA Medicaid,319,100,,,percent of total billed charges,100% of total billed charges,45.91,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,44.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,220.11,69,,,percent of total billed charges,69% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,319,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,319,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,197.3,61.85,,,percent of total billed charges,61.85% of total billed charges,44.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,44.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,57.94,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,120.26,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,10814.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,248.82,78,,,percent of total billed charges,78% of total billed charges,319,100,,,percent of total billed charges,100% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,263.49,82.6,,,percent of total billed charges,82.6% of total billed charges,44.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,44.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.57,10814.1,
ELECTROPHYSIOLOGY EVALUATION,93622,CDM,983,RC,93622,HCPCS,Outpatient,,,470,305.50,,413.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,92.13,100,,,Fee Schedule,100% of WA Medicaid,470,100,,,percent of total billed charges,100% of total billed charges,94.89,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,92.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,324.3,69,,,percent of total billed charges,69% of total billed charges,470,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,470,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,470,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,290.7,61.85,,,percent of total billed charges,61.85% of total billed charges,92.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,92.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,93.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.77,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,177.19,37.7,,,percent of total billed charges,37.70% of total billed charges,177.19,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15933,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,366.6,78,,,percent of total billed charges,78% of total billed charges,470,100,,,percent of total billed charges,100% of total billed charges,388.22,82.6,,,percent of total billed charges,82.6% of total billed charges,388.22,82.6,,,percent of total billed charges,82.6% of total billed charges,92.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,92.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,92.13,15933,
ELECTROPHYSIOLOGIC STUDY,93624,CDM,983,RC,93624,HCPCS,Outpatient,,,732,475.80,,644.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,129.8,100,,,Fee Schedule,100% of WA Medicaid,732,100,,,percent of total billed charges,100% of total billed charges,133.69,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,129.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,505.08,69,,,percent of total billed charges,69% of total billed charges,732,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,732,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,732,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,452.74,61.85,,,percent of total billed charges,61.85% of total billed charges,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,129.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,132.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,168.74,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,275.96,37.7,,,percent of total billed charges,37.70% of total billed charges,275.96,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,24814.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,570.96,78,,,percent of total billed charges,78% of total billed charges,732,100,,,percent of total billed charges,100% of total billed charges,604.63,82.6,,,percent of total billed charges,82.6% of total billed charges,604.63,82.6,,,percent of total billed charges,82.6% of total billed charges,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,129.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,129.8,24814.8,
HEART PACING MAPPING,93631,CDM,983,RC,93631,HCPCS,Outpatient,,,1122,729.30,,987.36,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,213.36,100,,,Fee Schedule,100% of WA Medicaid,1122,100,,,percent of total billed charges,100% of total billed charges,219.76,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,213.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,774.18,69,,,percent of total billed charges,69% of total billed charges,1122,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1122,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1122,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,693.96,61.85,,,percent of total billed charges,61.85% of total billed charges,213.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,213.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,217.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,277.37,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,422.99,37.7,,,percent of total billed charges,37.70% of total billed charges,422.99,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,38035.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,875.16,78,,,percent of total billed charges,78% of total billed charges,1122,100,,,percent of total billed charges,100% of total billed charges,926.77,82.6,,,percent of total billed charges,82.6% of total billed charges,926.77,82.6,,,percent of total billed charges,82.6% of total billed charges,213.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,213.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,213.36,38035.8,
ELECTROPHYSIOLOGY EVALUATION,93642,CDM,983,RC,93642,HCPCS,Outpatient,,,1048,681.20,,922.24,88,,,percent of total billed charges,88% of total Billed charges,33.64,100,,,Fee Schedule,100% of Medicare rate,136.7,100,,,Fee Schedule,100% of WA Medicaid,1048,100,,,percent of total billed charges,100% of total billed charges,140.8,103,,,Fee Schedule,103% of WA Medicaid,33.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,58.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,136.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,723.12,69,,,percent of total billed charges,69% of total billed charges,1048,100,,,percent of total billed charges,100% of total billed charges,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1048,100,,,percent of total billed charges,100% of total billed charges,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1048,100,,,percent of total billed charges,100% of total billed charges,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,648.19,61.85,,,percent of total billed charges,61.85% of total billed charges,136.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,177.71,130,,,Fee Schedule,130% of WA Medicaid ,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.1,37.7,,,percent of total billed charges,37.70% of total billed charges,395.1,37.7,,,percent of total billed charges,37.70% of total billed charges,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,35527.2,33.9,,,percent of total billed charges,33.9% of total billed charges,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,817.44,78,,,percent of total billed charges,78% of total billed charges,1048,100,,,percent of total billed charges,100% of total billed charges,865.65,82.6,,,percent of total billed charges,82.6% of total billed charges,865.65,82.6,,,percent of total billed charges,82.6% of total billed charges,136.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,33.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,33.64,35527.2,
ELECTROPHYSIOLOGY EVALUATION,93641,CDM,983,RC,93641,HCPCS,Outpatient,,,899,584.35,,791.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,167.48,100,,,Fee Schedule,100% of WA Medicaid,899,100,,,percent of total billed charges,100% of total billed charges,172.5,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,167.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,620.31,69,,,percent of total billed charges,69% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,899,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,899,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,556.03,61.85,,,percent of total billed charges,61.85% of total billed charges,167.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,167.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,170.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,217.72,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,338.92,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,30476.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,701.22,78,,,percent of total billed charges,78% of total billed charges,899,100,,,percent of total billed charges,100% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,742.57,82.6,,,percent of total billed charges,82.6% of total billed charges,167.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,167.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,167.48,30476.1,
EVALUATION HEART DEVICE,93640,CDM,983,RC,93640,HCPCS,Outpatient,,,533,346.45,,469.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,95.86,100,,,Fee Schedule,100% of WA Medicaid,533,100,,,percent of total billed charges,100% of total billed charges,98.74,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,95.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,367.77,69,,,percent of total billed charges,69% of total billed charges,533,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,533,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,533,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,329.66,61.85,,,percent of total billed charges,61.85% of total billed charges,95.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,95.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,124.62,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,200.94,37.7,,,percent of total billed charges,37.70% of total billed charges,200.94,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,18068.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,415.74,78,,,percent of total billed charges,78% of total billed charges,533,100,,,percent of total billed charges,100% of total billed charges,440.26,82.6,,,percent of total billed charges,82.6% of total billed charges,440.26,82.6,,,percent of total billed charges,82.6% of total billed charges,95.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,95.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,95.86,18068.7,
EP  ABLATE SUPRAVENT ARRHYT,93653,CDM,983,RC,93653,HCPCS,Outpatient,,,2231,1450.15,,1963.28,88,,,percent of total billed charges,88% of total Billed charges,112.76,100,,,Fee Schedule,100% of Medicare rate,454.13,100,,,Fee Schedule,100% of WA Medicaid,2231,100,,,percent of total billed charges,100% of total billed charges,467.75,103,,,Fee Schedule,103% of WA Medicaid,112.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,197.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,454.13,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1539.39,69,,,percent of total billed charges,69% of total billed charges,2231,100,,,percent of total billed charges,100% of total billed charges,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2231,100,,,percent of total billed charges,100% of total billed charges,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,2231,100,,,percent of total billed charges,100% of total billed charges,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1379.87,61.85,,,percent of total billed charges,61.85% of total billed charges,454.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.13,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,463.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,590.37,130,,,Fee Schedule,130% of WA Medicaid ,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,841.09,37.7,,,percent of total billed charges,37.70% of total billed charges,841.09,37.7,,,percent of total billed charges,37.70% of total billed charges,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,75630.9,33.9,,,percent of total billed charges,33.9% of total billed charges,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,1740.18,78,,,percent of total billed charges,78% of total billed charges,2231,100,,,percent of total billed charges,100% of total billed charges,1842.81,82.6,,,percent of total billed charges,82.6% of total billed charges,1842.81,82.6,,,percent of total billed charges,82.6% of total billed charges,454.13,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,112.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,454.13,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.76,75630.9,
TX ATRIAL FIB PULM VEIN ISOL,93656,CDM,983,RC,93656,HCPCS,Outpatient,,,2979,1936.35,,2621.52,88,,,percent of total billed charges,88% of total Billed charges,127.66,100,,,Fee Schedule,100% of Medicare rate,514.93,100,,,Fee Schedule,100% of WA Medicaid,2979,100,,,percent of total billed charges,100% of total billed charges,530.38,103,,,Fee Schedule,103% of WA Medicaid,127.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,223.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,514.93,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2055.51,69,,,percent of total billed charges,69% of total billed charges,2979,100,,,percent of total billed charges,100% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2979,100,,,percent of total billed charges,100% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2979,100,,,percent of total billed charges,100% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1842.51,61.85,,,percent of total billed charges,61.85% of total billed charges,514.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,514.93,100,,,Fee Schedule,100% of WA Medicare OPPS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,525.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,669.41,130,,,Fee Schedule,130% of WA Medicaid ,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,1123.08,37.7,,,percent of total billed charges,37.70% of total billed charges,1123.08,37.7,,,percent of total billed charges,37.70% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,100988.1,33.9,,,percent of total billed charges,33.9% of total billed charges,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2323.62,78,,,percent of total billed charges,78% of total billed charges,2979,100,,,percent of total billed charges,100% of total billed charges,2460.65,82.6,,,percent of total billed charges,82.6% of total billed charges,2460.65,82.6,,,percent of total billed charges,82.6% of total billed charges,514.93,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.94,101,,,Fee Schedule,101% of Medicare RBRVS rate,127.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,514.93,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,127.66,100988.1,
TX L/R ATRIAL FIB ADDL,93657,CDM,983,RC,93657,HCPCS,Outpatient,,,1117,726.05,,982.96,88,,,percent of total billed charges,88% of total Billed charges,41.25,100,,,Fee Schedule,100% of Medicare rate,166.73,100,,,Fee Schedule,100% of WA Medicaid,1117,100,,,percent of total billed charges,100% of total billed charges,171.73,103,,,Fee Schedule,103% of WA Medicaid,41.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,166.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,770.73,69,,,percent of total billed charges,69% of total billed charges,1117,100,,,percent of total billed charges,100% of total billed charges,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117,100,,,percent of total billed charges,100% of total billed charges,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,1117,100,,,percent of total billed charges,100% of total billed charges,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,690.86,61.85,,,percent of total billed charges,61.85% of total billed charges,166.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,216.75,130,,,Fee Schedule,130% of WA Medicaid ,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,421.11,37.7,,,percent of total billed charges,37.70% of total billed charges,421.11,37.7,,,percent of total billed charges,37.70% of total billed charges,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,37866.3,33.9,,,percent of total billed charges,33.9% of total billed charges,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,871.26,78,,,percent of total billed charges,78% of total billed charges,1117,100,,,percent of total billed charges,100% of total billed charges,922.64,82.6,,,percent of total billed charges,82.6% of total billed charges,922.64,82.6,,,percent of total billed charges,82.6% of total billed charges,166.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.25,37866.3,
EP  ABLATE VENTRIC TACHY,93654,CDM,983,RC,93654,HCPCS,Outpatient,,,2978,1935.70,,2620.64,88,,,percent of total billed charges,88% of total Billed charges,135.84,100,,,Fee Schedule,100% of Medicare rate,547,100,,,Fee Schedule,100% of WA Medicaid,2978,100,,,percent of total billed charges,100% of total billed charges,563.41,103,,,Fee Schedule,103% of WA Medicaid,135.84,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,237.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,547,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2054.82,69,,,percent of total billed charges,69% of total billed charges,2978,100,,,percent of total billed charges,100% of total billed charges,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2978,100,,,percent of total billed charges,100% of total billed charges,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2978,100,,,percent of total billed charges,100% of total billed charges,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1841.89,61.85,,,percent of total billed charges,61.85% of total billed charges,547,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,547,100,,,Fee Schedule,100% of WA Medicare OPPS rate,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,557.94,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,711.1,130,,,Fee Schedule,130% of WA Medicaid ,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,1122.71,37.7,,,percent of total billed charges,37.70% of total billed charges,1122.71,37.7,,,percent of total billed charges,37.70% of total billed charges,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,100954.2,33.9,,,percent of total billed charges,33.9% of total billed charges,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,2322.84,78,,,percent of total billed charges,78% of total billed charges,2978,100,,,percent of total billed charges,100% of total billed charges,2459.83,82.6,,,percent of total billed charges,82.6% of total billed charges,2459.83,82.6,,,percent of total billed charges,82.6% of total billed charges,547,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,135.84,100,,,Fee Schedule,100% of Medicare RBRVS rate,547,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,135.84,100954.2,
ABLATE ARRHYTHMIA ADD ON,93655,CDM,983,RC,93655,HCPCS,Outpatient,,,1116,725.40,,982.08,88,,,percent of total billed charges,88% of total Billed charges,41.24,100,,,Fee Schedule,100% of Medicare rate,166.36,100,,,Fee Schedule,100% of WA Medicaid,1116,100,,,percent of total billed charges,100% of total billed charges,171.35,103,,,Fee Schedule,103% of WA Medicaid,41.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,72.17,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,166.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,770.04,69,,,percent of total billed charges,69% of total billed charges,1116,100,,,percent of total billed charges,100% of total billed charges,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116,100,,,percent of total billed charges,100% of total billed charges,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,1116,100,,,percent of total billed charges,100% of total billed charges,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,690.25,61.85,,,percent of total billed charges,61.85% of total billed charges,166.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,216.27,130,,,Fee Schedule,130% of WA Medicaid ,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,420.73,37.7,,,percent of total billed charges,37.70% of total billed charges,420.73,37.7,,,percent of total billed charges,37.70% of total billed charges,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,37832.4,33.9,,,percent of total billed charges,33.9% of total billed charges,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,870.48,78,,,percent of total billed charges,78% of total billed charges,1116,100,,,percent of total billed charges,100% of total billed charges,921.82,82.6,,,percent of total billed charges,82.6% of total billed charges,921.82,82.6,,,percent of total billed charges,82.6% of total billed charges,166.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,41.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,41.24,37832.4,
ABLATE HEART DYSRHYTHM FOCUS,93650,CDM,983,RC,93650,HCPCS,Outpatient,,,1794,1166.10,,1578.72,88,,,percent of total billed charges,88% of total Billed charges,76.94,100,,,Fee Schedule,100% of Medicare rate,316.68,100,,,Fee Schedule,100% of WA Medicaid,1794,100,,,percent of total billed charges,100% of total billed charges,326.18,103,,,Fee Schedule,103% of WA Medicaid,76.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,134.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,316.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1237.86,69,,,percent of total billed charges,69% of total billed charges,1794,100,,,percent of total billed charges,100% of total billed charges,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1794,100,,,percent of total billed charges,100% of total billed charges,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1794,100,,,percent of total billed charges,100% of total billed charges,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1109.59,61.85,,,percent of total billed charges,61.85% of total billed charges,316.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,323.01,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,411.68,130,,,Fee Schedule,130% of WA Medicaid ,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,676.34,37.7,,,percent of total billed charges,37.70% of total billed charges,676.34,37.7,,,percent of total billed charges,37.70% of total billed charges,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,60816.6,33.9,,,percent of total billed charges,33.9% of total billed charges,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,1399.32,78,,,percent of total billed charges,78% of total billed charges,1794,100,,,percent of total billed charges,100% of total billed charges,1481.84,82.6,,,percent of total billed charges,82.6% of total billed charges,1481.84,82.6,,,percent of total billed charges,82.6% of total billed charges,316.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,76.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,316.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,76.94,60816.6,
TILT TABLE EVALUATION,93660,CDM,983,RC,93660,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,7.3,100,,,Fee Schedule,100% of Medicare rate,51.1,100,,,Fee Schedule,100% of WA Medicaid,260,100,,,percent of total billed charges,100% of total billed charges,52.63,103,,,Fee Schedule,103% of WA Medicaid,7.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.78,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,51.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,260,100,,,percent of total billed charges,100% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,260,100,,,percent of total billed charges,100% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,51.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,66.43,130,,,Fee Schedule,130% of WA Medicaid ,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,8814,33.9,,,percent of total billed charges,33.9% of total billed charges,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,51.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.3,8814,
INTRACARDIAC ECG (ICE),93662,CDM,983,RC,93662,HCPCS,Outpatient,,,393,255.45,,345.84,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,39.17,100,,,Fee Schedule,100% of WA Medicaid,393,100,,,percent of total billed charges,100% of total billed charges,40.35,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.17,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,271.17,69,,,percent of total billed charges,69% of total billed charges,393,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,393,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,393,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,243.07,61.85,,,percent of total billed charges,61.85% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.17,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,50.92,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,148.16,37.7,,,percent of total billed charges,37.70% of total billed charges,148.16,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,13322.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,306.54,78,,,percent of total billed charges,78% of total billed charges,393,100,,,percent of total billed charges,100% of total billed charges,324.62,82.6,,,percent of total billed charges,82.6% of total billed charges,324.62,82.6,,,percent of total billed charges,82.6% of total billed charges,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.17,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.17,13322.7,
ANALYZE PACEMAKER SYSTEM,93724,CDM,983,RC,93724,HCPCS,Outpatient,,,670,435.50,,589.6,88,,,percent of total billed charges,88% of total Billed charges,12.56,100,,,Fee Schedule,100% of Medicare rate,131.86,100,,,Fee Schedule,100% of WA Medicaid,670,100,,,percent of total billed charges,100% of total billed charges,135.82,103,,,Fee Schedule,103% of WA Medicaid,12.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,21.98,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,131.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,462.3,69,,,percent of total billed charges,69% of total billed charges,670,100,,,percent of total billed charges,100% of total billed charges,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,670,100,,,percent of total billed charges,100% of total billed charges,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,670,100,,,percent of total billed charges,100% of total billed charges,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.4,61.85,,,percent of total billed charges,61.85% of total billed charges,131.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,171.42,130,,,Fee Schedule,130% of WA Medicaid ,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.59,37.7,,,percent of total billed charges,37.70% of total billed charges,252.59,37.7,,,percent of total billed charges,37.70% of total billed charges,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,22713,33.9,,,percent of total billed charges,33.9% of total billed charges,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,522.6,78,,,percent of total billed charges,78% of total billed charges,670,100,,,percent of total billed charges,100% of total billed charges,553.42,82.6,,,percent of total billed charges,82.6% of total billed charges,553.42,82.6,,,percent of total billed charges,82.6% of total billed charges,131.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.56,22713,
SET-UP CARDIOVERT-DEFIBRILL,93745,CDM,983,RC,93745,HCPCS,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,38.1,100,,,Fee Schedule,100% of WA Medicaid,47,100,,,percent of total billed charges,100% of total billed charges,39.24,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,47,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,47,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,38.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.53,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,17.72,37.7,,,percent of total billed charges,37.70% of total billed charges,17.72,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1593.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,38.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.72,1593.3,
MEASURE VENOUS PRESSURE,93770,CDM,983,RC,93770,HCPCS,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,0.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,0.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,22,100,,,percent of total billed charges,100% of total billed charges,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,22,100,,,percent of total billed charges,100% of total billed charges,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.29,37.7,,,percent of total billed charges,37.70% of total billed charges,8.29,37.7,,,percent of total billed charges,37.70% of total billed charges,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,745.8,33.9,,,percent of total billed charges,33.9% of total billed charges,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",0.49,745.8,
AMBULATORY BP MONITORING,93784,CDM,983,RC,93784,HCPCS,Outpatient,,,164,106.60,,144.32,88,,,percent of total billed charges,88% of total Billed charges,2.19,100,,,Fee Schedule,100% of Medicare rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,164,100,,,percent of total billed charges,100% of total billed charges,27.85,103,,,Fee Schedule,103% of WA Medicaid,2.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,27.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,113.16,69,,,percent of total billed charges,69% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,164,100,,,percent of total billed charges,100% of total billed charges,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,164,100,,,percent of total billed charges,100% of total billed charges,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.43,61.85,,,percent of total billed charges,61.85% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,35.15,130,,,Fee Schedule,130% of WA Medicaid ,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.83,37.7,,,percent of total billed charges,37.70% of total billed charges,61.83,37.7,,,percent of total billed charges,37.70% of total billed charges,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,5559.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.92,78,,,percent of total billed charges,78% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.19,5559.6,
AMBULATORY BP RECORDING,93786,CDM,983,RC,93786,HCPCS,Outpatient,,,88,57.20,,77.44,88,,,percent of total billed charges,88% of total Billed charges,0.96,100,,,Fee Schedule,100% of Medicare rate,13.61,100,,,Fee Schedule,100% of WA Medicaid,88,100,,,percent of total billed charges,100% of total billed charges,14.02,103,,,Fee Schedule,103% of WA Medicaid,0.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.61,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,60.72,69,,,percent of total billed charges,69% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,88,100,,,percent of total billed charges,100% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,88,100,,,percent of total billed charges,100% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.43,61.85,,,percent of total billed charges,61.85% of total billed charges,13.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.61,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,17.69,130,,,Fee Schedule,130% of WA Medicaid ,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,33.18,37.7,,,percent of total billed charges,37.70% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2983.2,33.9,,,percent of total billed charges,33.9% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.64,78,,,percent of total billed charges,78% of total billed charges,88,100,,,percent of total billed charges,100% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,72.69,82.6,,,percent of total billed charges,82.6% of total billed charges,13.61,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.61,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.96,2983.2,
AMBULATORY BP ANALYSIS,93788,CDM,983,RC,93788,HCPCS,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,0.43,100,,,Fee Schedule,100% of Medicare rate,3.36,100,,,Fee Schedule,100% of WA Medicaid,25,100,,,percent of total billed charges,100% of total billed charges,3.46,103,,,Fee Schedule,103% of WA Medicaid,0.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,3.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,25,100,,,percent of total billed charges,100% of total billed charges,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,25,100,,,percent of total billed charges,100% of total billed charges,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,3.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.37,130,,,Fee Schedule,130% of WA Medicaid ,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.5,33.9,,,percent of total billed charges,33.9% of total billed charges,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,3.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.43,847.5,
CARDIOVASCULAR PROCEDURE,93799,CDM,983,RC,93799,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,74,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,74,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,74,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,45.77,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2508.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",27.9,2508.6,
REVIEW/REPORT BP RECORDING,93790,CDM,983,RC,93790,HCPCS,Outpatient,,,52,33.80,,45.76,88,,,percent of total billed charges,88% of total Billed charges,0.8,100,,,Fee Schedule,100% of Medicare rate,10.07,100,,,Fee Schedule,100% of WA Medicaid,52,100,,,percent of total billed charges,100% of total billed charges,10.37,103,,,Fee Schedule,103% of WA Medicaid,0.8,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,10.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,35.88,69,,,percent of total billed charges,69% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,52,100,,,percent of total billed charges,100% of total billed charges,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,52,100,,,percent of total billed charges,100% of total billed charges,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.16,61.85,,,percent of total billed charges,61.85% of total billed charges,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.09,130,,,Fee Schedule,130% of WA Medicaid ,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,19.6,37.7,,,percent of total billed charges,37.70% of total billed charges,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,1762.8,33.9,,,percent of total billed charges,33.9% of total billed charges,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.56,78,,,percent of total billed charges,78% of total billed charges,52,100,,,percent of total billed charges,100% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,42.95,82.6,,,percent of total billed charges,82.6% of total billed charges,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.8,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.8,1762.8,
CARDIAC REHAB/MONITOR,93798,CDM,983,RC,93798,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,0.92,100,,,Fee Schedule,100% of Medicare rate,7.65,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,7.88,103,,,Fee Schedule,103% of WA Medicaid,0.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,7.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,100,,,percent of total billed charges,100% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,100,,,percent of total billed charges,100% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,7.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.95,130,,,Fee Schedule,130% of WA Medicaid ,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,2373,33.9,,,percent of total billed charges,33.9% of total billed charges,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,7.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.93,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.92,2373,
CARDIAC REHAB,93797,CDM,983,RC,93797,HCPCS,Outpatient,,,47,30.55,,41.36,88,,,percent of total billed charges,88% of total Billed charges,0.52,100,,,Fee Schedule,100% of Medicare rate,5.04,100,,,Fee Schedule,100% of WA Medicaid,47,100,,,percent of total billed charges,100% of total billed charges,5.19,103,,,Fee Schedule,103% of WA Medicaid,0.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,5.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,32.43,69,,,percent of total billed charges,69% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,47,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,47,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.07,61.85,,,percent of total billed charges,61.85% of total billed charges,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.55,130,,,Fee Schedule,130% of WA Medicaid ,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.72,37.7,,,percent of total billed charges,37.70% of total billed charges,17.72,37.7,,,percent of total billed charges,37.70% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1593.3,33.9,,,percent of total billed charges,33.9% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.66,78,,,percent of total billed charges,78% of total billed charges,47,100,,,percent of total billed charges,100% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,38.82,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.52,1593.3,
INTRACRANIAL COMPLETE STUDY,93886,CDM,983,RC,93886,HCPCS,Outpatient,,,552,358.80,,485.76,88,,,percent of total billed charges,88% of total Billed charges,10.58,100,,,Fee Schedule,100% of Medicare rate,25.92,100,,,Fee Schedule,100% of WA Medicaid,552,100,,,percent of total billed charges,100% of total billed charges,26.7,103,,,Fee Schedule,103% of WA Medicaid,10.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.92,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,380.88,69,,,percent of total billed charges,69% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,552,100,,,percent of total billed charges,100% of total billed charges,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,552,100,,,percent of total billed charges,100% of total billed charges,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,341.41,61.85,,,percent of total billed charges,61.85% of total billed charges,25.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.92,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.44,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.7,130,,,Fee Schedule,130% of WA Medicaid ,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,18712.8,33.9,,,percent of total billed charges,33.9% of total billed charges,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,430.56,78,,,percent of total billed charges,78% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,25.92,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.92,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.58,18712.8,
INTRACRANIAL LIMITED STUDY,93888,CDM,983,RC,93888,HCPCS,Outpatient,,,262,170.30,,230.56,88,,,percent of total billed charges,88% of total Billed charges,6.25,100,,,Fee Schedule,100% of Medicare rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,262,100,,,percent of total billed charges,100% of total billed charges,14.41,103,,,Fee Schedule,103% of WA Medicaid,6.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.99,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,180.78,69,,,percent of total billed charges,69% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,262,100,,,percent of total billed charges,100% of total billed charges,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,262,100,,,percent of total billed charges,100% of total billed charges,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.05,61.85,,,percent of total billed charges,61.85% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,18.19,130,,,Fee Schedule,130% of WA Medicaid ,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,98.77,37.7,,,percent of total billed charges,37.70% of total billed charges,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,8881.8,33.9,,,percent of total billed charges,33.9% of total billed charges,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,204.36,78,,,percent of total billed charges,78% of total billed charges,262,100,,,percent of total billed charges,100% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,216.41,82.6,,,percent of total billed charges,82.6% of total billed charges,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.99,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.25,8881.8,
EXTRACRANIAL UNI/LTD STUDY,93882,CDM,983,RC,93882,HCPCS,Outpatient,,,480,312.00,,422.4,88,,,percent of total billed charges,88% of total Billed charges,5.93,100,,,Fee Schedule,100% of Medicare rate,13.06,100,,,Fee Schedule,100% of WA Medicaid,480,100,,,percent of total billed charges,100% of total billed charges,13.45,103,,,Fee Schedule,103% of WA Medicaid,5.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.37,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,331.2,69,,,percent of total billed charges,69% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,480,100,,,percent of total billed charges,100% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,480,100,,,percent of total billed charges,100% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,296.88,61.85,,,percent of total billed charges,61.85% of total billed charges,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16.98,130,,,Fee Schedule,130% of WA Medicaid ,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,180.96,37.7,,,percent of total billed charges,37.70% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,16272,33.9,,,percent of total billed charges,33.9% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.4,78,,,percent of total billed charges,78% of total billed charges,480,100,,,percent of total billed charges,100% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,396.48,82.6,,,percent of total billed charges,82.6% of total billed charges,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.93,16272,
EXTRACRANIAL BILAT STUDY,93880,CDM,983,RC,93880,HCPCS,Outpatient,,,506,328.90,,445.28,88,,,percent of total billed charges,88% of total Billed charges,8.47,100,,,Fee Schedule,100% of Medicare rate,21.07,100,,,Fee Schedule,100% of WA Medicaid,506,100,,,percent of total billed charges,100% of total billed charges,21.7,103,,,Fee Schedule,103% of WA Medicaid,8.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,349.14,69,,,percent of total billed charges,69% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,506,100,,,percent of total billed charges,100% of total billed charges,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,506,100,,,percent of total billed charges,100% of total billed charges,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,312.96,61.85,,,percent of total billed charges,61.85% of total billed charges,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.39,130,,,Fee Schedule,130% of WA Medicaid ,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,190.76,37.7,,,percent of total billed charges,37.70% of total billed charges,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,17153.4,33.9,,,percent of total billed charges,33.9% of total billed charges,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,394.68,78,,,percent of total billed charges,78% of total billed charges,506,100,,,percent of total billed charges,100% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,417.96,82.6,,,percent of total billed charges,82.6% of total billed charges,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.47,17153.4,
TCD VASOREACTIVITY STUDY,93890,CDM,983,RC,93890,HCPCS,Outpatient,,,404,262.60,,355.52,88,,,percent of total billed charges,88% of total Billed charges,10.88,100,,,Fee Schedule,100% of Medicare rate,28.72,100,,,Fee Schedule,100% of WA Medicaid,404,100,,,percent of total billed charges,100% of total billed charges,29.58,103,,,Fee Schedule,103% of WA Medicaid,10.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,278.76,69,,,percent of total billed charges,69% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,404,100,,,percent of total billed charges,100% of total billed charges,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,404,100,,,percent of total billed charges,100% of total billed charges,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,249.87,61.85,,,percent of total billed charges,61.85% of total billed charges,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.29,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.34,130,,,Fee Schedule,130% of WA Medicaid ,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,152.31,37.7,,,percent of total billed charges,37.70% of total billed charges,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,13695.6,33.9,,,percent of total billed charges,33.9% of total billed charges,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.12,78,,,percent of total billed charges,78% of total billed charges,404,100,,,percent of total billed charges,100% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,333.7,82.6,,,percent of total billed charges,82.6% of total billed charges,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.88,13695.6,
TCD EMBOLI DETECT W/O INJ,93892,CDM,983,RC,93892,HCPCS,Outpatient,,,425,276.25,,374,88,,,percent of total billed charges,88% of total Billed charges,12.74,100,,,Fee Schedule,100% of Medicare rate,33.2,100,,,Fee Schedule,100% of WA Medicaid,425,100,,,percent of total billed charges,100% of total billed charges,34.2,103,,,Fee Schedule,103% of WA Medicaid,12.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,293.25,69,,,percent of total billed charges,69% of total billed charges,425,100,,,percent of total billed charges,100% of total billed charges,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,425,100,,,percent of total billed charges,100% of total billed charges,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,425,100,,,percent of total billed charges,100% of total billed charges,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,262.86,61.85,,,percent of total billed charges,61.85% of total billed charges,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.86,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.16,130,,,Fee Schedule,130% of WA Medicaid ,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.23,37.7,,,percent of total billed charges,37.70% of total billed charges,160.23,37.7,,,percent of total billed charges,37.70% of total billed charges,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,14407.5,33.9,,,percent of total billed charges,33.9% of total billed charges,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.5,78,,,percent of total billed charges,78% of total billed charges,425,100,,,percent of total billed charges,100% of total billed charges,351.05,82.6,,,percent of total billed charges,82.6% of total billed charges,351.05,82.6,,,percent of total billed charges,82.6% of total billed charges,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.74,14407.5,
TCD EMBOLI DETECT W/INJ,93893,CDM,983,RC,93893,HCPCS,Outpatient,,,426,276.90,,374.88,88,,,percent of total billed charges,88% of total Billed charges,15.62,100,,,Fee Schedule,100% of Medicare rate,33.57,100,,,Fee Schedule,100% of WA Medicaid,426,100,,,percent of total billed charges,100% of total billed charges,34.58,103,,,Fee Schedule,103% of WA Medicaid,15.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,293.94,69,,,percent of total billed charges,69% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,426,100,,,percent of total billed charges,100% of total billed charges,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,426,100,,,percent of total billed charges,100% of total billed charges,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,263.48,61.85,,,percent of total billed charges,61.85% of total billed charges,33.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,43.64,130,,,Fee Schedule,130% of WA Medicaid ,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.6,37.7,,,percent of total billed charges,37.70% of total billed charges,160.6,37.7,,,percent of total billed charges,37.70% of total billed charges,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,14441.4,33.9,,,percent of total billed charges,33.9% of total billed charges,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.28,78,,,percent of total billed charges,78% of total billed charges,426,100,,,percent of total billed charges,100% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,351.88,82.6,,,percent of total billed charges,82.6% of total billed charges,33.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.62,14441.4,
UPR/LXTR ART STDY 3+ LVLS,93923,CDM,983,RC,93923,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,6.36,100,,,Fee Schedule,100% of Medicare rate,11.94,100,,,Fee Schedule,100% of WA Medicaid,450,100,,,percent of total billed charges,100% of total billed charges,12.3,103,,,Fee Schedule,103% of WA Medicaid,6.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,450,100,,,percent of total billed charges,100% of total billed charges,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,450,100,,,percent of total billed charges,100% of total billed charges,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,11.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.52,130,,,Fee Schedule,130% of WA Medicaid ,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,15255,33.9,,,percent of total billed charges,33.9% of total billed charges,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,11.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.36,15255,
UPR/L XTREMITY ART 2 LEVELS,93922,CDM,983,RC,93922,HCPCS,Outpatient,,,291,189.15,,256.08,88,,,percent of total billed charges,88% of total Billed charges,3.85,100,,,Fee Schedule,100% of Medicare rate,6.53,100,,,Fee Schedule,100% of WA Medicaid,291,100,,,percent of total billed charges,100% of total billed charges,6.73,103,,,Fee Schedule,103% of WA Medicaid,3.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,6.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,200.79,69,,,percent of total billed charges,69% of total billed charges,291,100,,,percent of total billed charges,100% of total billed charges,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,291,100,,,percent of total billed charges,100% of total billed charges,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,291,100,,,percent of total billed charges,100% of total billed charges,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.98,61.85,,,percent of total billed charges,61.85% of total billed charges,6.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.66,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.49,130,,,Fee Schedule,130% of WA Medicaid ,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.71,37.7,,,percent of total billed charges,37.70% of total billed charges,109.71,37.7,,,percent of total billed charges,37.70% of total billed charges,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,9864.9,33.9,,,percent of total billed charges,33.9% of total billed charges,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.98,78,,,percent of total billed charges,78% of total billed charges,291,100,,,percent of total billed charges,100% of total billed charges,240.37,82.6,,,percent of total billed charges,82.6% of total billed charges,240.37,82.6,,,percent of total billed charges,82.6% of total billed charges,6.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.85,9864.9,
LWR XTR VASC STDY BILAT,93924,CDM,983,RC,93924,HCPCS,Outpatient,,,566,367.90,,498.08,88,,,percent of total billed charges,88% of total Billed charges,7.29,100,,,Fee Schedule,100% of Medicare rate,13.06,100,,,Fee Schedule,100% of WA Medicaid,566,100,,,percent of total billed charges,100% of total billed charges,13.45,103,,,Fee Schedule,103% of WA Medicaid,7.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.75,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,390.54,69,,,percent of total billed charges,69% of total billed charges,566,100,,,percent of total billed charges,100% of total billed charges,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,566,100,,,percent of total billed charges,100% of total billed charges,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,566,100,,,percent of total billed charges,100% of total billed charges,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,350.07,61.85,,,percent of total billed charges,61.85% of total billed charges,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16.98,130,,,Fee Schedule,130% of WA Medicaid ,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,213.38,37.7,,,percent of total billed charges,37.70% of total billed charges,213.38,37.7,,,percent of total billed charges,37.70% of total billed charges,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,19187.4,33.9,,,percent of total billed charges,33.9% of total billed charges,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,441.48,78,,,percent of total billed charges,78% of total billed charges,566,100,,,percent of total billed charges,100% of total billed charges,467.52,82.6,,,percent of total billed charges,82.6% of total billed charges,467.52,82.6,,,percent of total billed charges,82.6% of total billed charges,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.29,19187.4,
LOWER EXTREMITY STUDY,93926,CDM,983,RC,93926,HCPCS,Outpatient,,,322,209.30,,283.36,88,,,percent of total billed charges,88% of total Billed charges,6.53,100,,,Fee Schedule,100% of Medicare rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,322,100,,,percent of total billed charges,100% of total billed charges,13.26,103,,,Fee Schedule,103% of WA Medicaid,6.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.43,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,222.18,69,,,percent of total billed charges,69% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,322,100,,,percent of total billed charges,100% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,322,100,,,percent of total billed charges,100% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.16,61.85,,,percent of total billed charges,61.85% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16.73,130,,,Fee Schedule,130% of WA Medicaid ,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,121.39,37.7,,,percent of total billed charges,37.70% of total billed charges,121.39,37.7,,,percent of total billed charges,37.70% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,10915.8,33.9,,,percent of total billed charges,33.9% of total billed charges,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.16,78,,,percent of total billed charges,78% of total billed charges,322,100,,,percent of total billed charges,100% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,265.97,82.6,,,percent of total billed charges,82.6% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.53,10915.8,
LOWER EXTREMITY STUDY,93925,CDM,983,RC,93925,HCPCS,Outpatient,,,502,326.30,,441.76,88,,,percent of total billed charges,88% of total Billed charges,10.3,100,,,Fee Schedule,100% of Medicare rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,502,100,,,percent of total billed charges,100% of total billed charges,21.52,103,,,Fee Schedule,103% of WA Medicaid,10.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,18.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,346.38,69,,,percent of total billed charges,69% of total billed charges,502,100,,,percent of total billed charges,100% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,502,100,,,percent of total billed charges,100% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,502,100,,,percent of total billed charges,100% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.49,61.85,,,percent of total billed charges,61.85% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.16,130,,,Fee Schedule,130% of WA Medicaid ,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.25,37.7,,,percent of total billed charges,37.70% of total billed charges,189.25,37.7,,,percent of total billed charges,37.70% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,17017.8,33.9,,,percent of total billed charges,33.9% of total billed charges,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.56,78,,,percent of total billed charges,78% of total billed charges,502,100,,,percent of total billed charges,100% of total billed charges,414.65,82.6,,,percent of total billed charges,82.6% of total billed charges,414.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.3,17017.8,
UPPER EXTREMITY STUDY,93931,CDM,983,RC,93931,HCPCS,Outpatient,,,441,286.65,,388.08,88,,,percent of total billed charges,88% of total Billed charges,5.64,100,,,Fee Schedule,100% of Medicare rate,13.06,100,,,Fee Schedule,100% of WA Medicaid,441,100,,,percent of total billed charges,100% of total billed charges,13.45,103,,,Fee Schedule,103% of WA Medicaid,5.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,304.29,69,,,percent of total billed charges,69% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,441,100,,,percent of total billed charges,100% of total billed charges,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,441,100,,,percent of total billed charges,100% of total billed charges,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.76,61.85,,,percent of total billed charges,61.85% of total billed charges,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16.98,130,,,Fee Schedule,130% of WA Medicaid ,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.26,37.7,,,percent of total billed charges,37.70% of total billed charges,166.26,37.7,,,percent of total billed charges,37.70% of total billed charges,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,14949.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,343.98,78,,,percent of total billed charges,78% of total billed charges,441,100,,,percent of total billed charges,100% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,364.27,82.6,,,percent of total billed charges,82.6% of total billed charges,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.64,14949.9,
UPPER EXTREMITY STUDY,93930,CDM,983,RC,93930,HCPCS,Outpatient,,,645,419.25,,567.6,88,,,percent of total billed charges,88% of total Billed charges,8.98,100,,,Fee Schedule,100% of Medicare rate,21.07,100,,,Fee Schedule,100% of WA Medicaid,645,100,,,percent of total billed charges,100% of total billed charges,21.7,103,,,Fee Schedule,103% of WA Medicaid,8.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,445.05,69,,,percent of total billed charges,69% of total billed charges,645,100,,,percent of total billed charges,100% of total billed charges,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,645,100,,,percent of total billed charges,100% of total billed charges,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,645,100,,,percent of total billed charges,100% of total billed charges,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,398.93,61.85,,,percent of total billed charges,61.85% of total billed charges,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.39,130,,,Fee Schedule,130% of WA Medicaid ,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,243.17,37.7,,,percent of total billed charges,37.70% of total billed charges,243.17,37.7,,,percent of total billed charges,37.70% of total billed charges,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,21865.5,33.9,,,percent of total billed charges,33.9% of total billed charges,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,503.1,78,,,percent of total billed charges,78% of total billed charges,645,100,,,percent of total billed charges,100% of total billed charges,532.77,82.6,,,percent of total billed charges,82.6% of total billed charges,532.77,82.6,,,percent of total billed charges,82.6% of total billed charges,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.98,21865.5,
EXTREMITY STUDY,93965,CDM,983,RC,,,Outpatient,,,354,230.10,,311.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,354,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,244.26,69,,,percent of total billed charges,69% of total billed charges,354,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,354,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,354,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,218.95,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,133.46,37.7,,,percent of total billed charges,37.70% of total billed charges,133.46,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12000.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,276.12,78,,,percent of total billed charges,78% of total billed charges,354,100,,,percent of total billed charges,100% of total billed charges,292.4,82.6,,,percent of total billed charges,82.6% of total billed charges,292.4,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",133.46,12000.6,
VASCULAR STUDY,93978,CDM,983,RC,93978,HCPCS,Outpatient,,,513,333.45,,451.44,88,,,percent of total billed charges,88% of total Billed charges,8.94,100,,,Fee Schedule,100% of Medicare rate,21.07,100,,,Fee Schedule,100% of WA Medicaid,513,100,,,percent of total billed charges,100% of total billed charges,21.7,103,,,Fee Schedule,103% of WA Medicaid,8.94,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.64,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,353.97,69,,,percent of total billed charges,69% of total billed charges,513,100,,,percent of total billed charges,100% of total billed charges,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,513,100,,,percent of total billed charges,100% of total billed charges,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,513,100,,,percent of total billed charges,100% of total billed charges,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,317.29,61.85,,,percent of total billed charges,61.85% of total billed charges,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.39,130,,,Fee Schedule,130% of WA Medicaid ,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,193.4,37.7,,,percent of total billed charges,37.70% of total billed charges,193.4,37.7,,,percent of total billed charges,37.70% of total billed charges,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,17390.7,33.9,,,percent of total billed charges,33.9% of total billed charges,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,400.14,78,,,percent of total billed charges,78% of total billed charges,513,100,,,percent of total billed charges,100% of total billed charges,423.74,82.6,,,percent of total billed charges,82.6% of total billed charges,423.74,82.6,,,percent of total billed charges,82.6% of total billed charges,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.94,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.94,17390.7,
VASCULAR STUDY,93979,CDM,983,RC,93979,HCPCS,Outpatient,,,329,213.85,,289.52,88,,,percent of total billed charges,88% of total Billed charges,5.72,100,,,Fee Schedule,100% of Medicare rate,13.06,100,,,Fee Schedule,100% of WA Medicaid,329,100,,,percent of total billed charges,100% of total billed charges,13.45,103,,,Fee Schedule,103% of WA Medicaid,5.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,227.01,69,,,percent of total billed charges,69% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,329,100,,,percent of total billed charges,100% of total billed charges,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,329,100,,,percent of total billed charges,100% of total billed charges,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.49,61.85,,,percent of total billed charges,61.85% of total billed charges,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16.98,130,,,Fee Schedule,130% of WA Medicaid ,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.03,37.7,,,percent of total billed charges,37.70% of total billed charges,124.03,37.7,,,percent of total billed charges,37.70% of total billed charges,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,11153.1,33.9,,,percent of total billed charges,33.9% of total billed charges,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.62,78,,,percent of total billed charges,78% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.72,11153.1,
VASCULAR STUDY,93975,CDM,983,RC,93975,HCPCS,Outpatient,,,668,434.20,,587.84,88,,,percent of total billed charges,88% of total Billed charges,11.55,100,,,Fee Schedule,100% of Medicare rate,30.59,100,,,Fee Schedule,100% of WA Medicaid,668,100,,,percent of total billed charges,100% of total billed charges,31.51,103,,,Fee Schedule,103% of WA Medicaid,11.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.59,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,460.92,69,,,percent of total billed charges,69% of total billed charges,668,100,,,percent of total billed charges,100% of total billed charges,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,668,100,,,percent of total billed charges,100% of total billed charges,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,668,100,,,percent of total billed charges,100% of total billed charges,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,413.16,61.85,,,percent of total billed charges,61.85% of total billed charges,30.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.59,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,39.77,130,,,Fee Schedule,130% of WA Medicaid ,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,251.84,37.7,,,percent of total billed charges,37.70% of total billed charges,251.84,37.7,,,percent of total billed charges,37.70% of total billed charges,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,22645.2,33.9,,,percent of total billed charges,33.9% of total billed charges,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,521.04,78,,,percent of total billed charges,78% of total billed charges,668,100,,,percent of total billed charges,100% of total billed charges,551.77,82.6,,,percent of total billed charges,82.6% of total billed charges,551.77,82.6,,,percent of total billed charges,82.6% of total billed charges,30.59,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.59,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.55,22645.2,
VASCULAR STUDY,93976,CDM,983,RC,93976,HCPCS,Outpatient,,,587,381.55,,516.56,88,,,percent of total billed charges,88% of total Billed charges,6.72,100,,,Fee Schedule,100% of Medicare rate,21.26,100,,,Fee Schedule,100% of WA Medicaid,587,100,,,percent of total billed charges,100% of total billed charges,21.9,103,,,Fee Schedule,103% of WA Medicaid,6.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.76,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.26,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,405.03,69,,,percent of total billed charges,69% of total billed charges,587,100,,,percent of total billed charges,100% of total billed charges,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,587,100,,,percent of total billed charges,100% of total billed charges,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,587,100,,,percent of total billed charges,100% of total billed charges,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,363.06,61.85,,,percent of total billed charges,61.85% of total billed charges,21.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.26,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.64,130,,,Fee Schedule,130% of WA Medicaid ,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.3,37.7,,,percent of total billed charges,37.70% of total billed charges,221.3,37.7,,,percent of total billed charges,37.70% of total billed charges,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,19899.3,33.9,,,percent of total billed charges,33.9% of total billed charges,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,457.86,78,,,percent of total billed charges,78% of total billed charges,587,100,,,percent of total billed charges,100% of total billed charges,484.86,82.6,,,percent of total billed charges,82.6% of total billed charges,484.86,82.6,,,percent of total billed charges,82.6% of total billed charges,21.26,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.26,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.72,19899.3,
EXTREMITY STUDY,93971,CDM,983,RC,93971,HCPCS,Outpatient,,,329,213.85,,289.52,88,,,percent of total billed charges,88% of total Billed charges,4.98,100,,,Fee Schedule,100% of Medicare rate,11.75,100,,,Fee Schedule,100% of WA Medicaid,329,100,,,percent of total billed charges,100% of total billed charges,12.1,103,,,Fee Schedule,103% of WA Medicaid,4.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.75,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,227.01,69,,,percent of total billed charges,69% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,329,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,329,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,203.49,61.85,,,percent of total billed charges,61.85% of total billed charges,11.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.75,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.99,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.28,130,,,Fee Schedule,130% of WA Medicaid ,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.03,37.7,,,percent of total billed charges,37.70% of total billed charges,124.03,37.7,,,percent of total billed charges,37.70% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,11153.1,33.9,,,percent of total billed charges,33.9% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,256.62,78,,,percent of total billed charges,78% of total billed charges,329,100,,,percent of total billed charges,100% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,271.75,82.6,,,percent of total billed charges,82.6% of total billed charges,11.75,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.75,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.98,11153.1,
EXTREMITY STUDY,93970,CDM,983,RC,93970,HCPCS,Outpatient,,,517,336.05,,454.96,88,,,percent of total billed charges,88% of total Billed charges,8.12,100,,,Fee Schedule,100% of Medicare rate,18.28,100,,,Fee Schedule,100% of WA Medicaid,517,100,,,percent of total billed charges,100% of total billed charges,18.83,103,,,Fee Schedule,103% of WA Medicaid,8.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,18.28,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,356.73,69,,,percent of total billed charges,69% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,517,100,,,percent of total billed charges,100% of total billed charges,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,517,100,,,percent of total billed charges,100% of total billed charges,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,319.76,61.85,,,percent of total billed charges,61.85% of total billed charges,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.28,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,23.76,130,,,Fee Schedule,130% of WA Medicaid ,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,194.91,37.7,,,percent of total billed charges,37.70% of total billed charges,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,17526.3,33.9,,,percent of total billed charges,33.9% of total billed charges,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,403.26,78,,,percent of total billed charges,78% of total billed charges,517,100,,,percent of total billed charges,100% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,427.04,82.6,,,percent of total billed charges,82.6% of total billed charges,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.12,17526.3,
DOPPLER FLOW TESTING,93990,CDM,983,RC,93990,HCPCS,Outpatient,,,546,354.90,,480.48,88,,,percent of total billed charges,88% of total Billed charges,7.4,100,,,Fee Schedule,100% of Medicare rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,546,100,,,percent of total billed charges,100% of total billed charges,13.26,103,,,Fee Schedule,103% of WA Medicaid,7.4,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.94,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,376.74,69,,,percent of total billed charges,69% of total billed charges,546,100,,,percent of total billed charges,100% of total billed charges,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,546,100,,,percent of total billed charges,100% of total billed charges,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,546,100,,,percent of total billed charges,100% of total billed charges,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,337.7,61.85,,,percent of total billed charges,61.85% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16.73,130,,,Fee Schedule,130% of WA Medicaid ,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.84,37.7,,,percent of total billed charges,37.70% of total billed charges,205.84,37.7,,,percent of total billed charges,37.70% of total billed charges,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,18509.4,33.9,,,percent of total billed charges,33.9% of total billed charges,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,425.88,78,,,percent of total billed charges,78% of total billed charges,546,100,,,percent of total billed charges,100% of total billed charges,451,82.6,,,percent of total billed charges,82.6% of total billed charges,451,82.6,,,percent of total billed charges,82.6% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.4,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.4,18509.4,
BREATHING CAPACITY TEST,94010,CDM,983,RC,94010,HCPCS,Outpatient,,,63.58,41.33,,55.95,88,,,percent of total billed charges,88% of total Billed charges,1.36,100,,,Fee Schedule,100% of Medicare rate,4.48,100,,,Fee Schedule,100% of WA Medicaid,63.58,100,,,percent of total billed charges,100% of total billed charges,4.61,103,,,Fee Schedule,103% of WA Medicaid,1.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,4.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,43.87,69,,,percent of total billed charges,69% of total billed charges,63.58,100,,,percent of total billed charges,100% of total billed charges,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.58,100,,,percent of total billed charges,100% of total billed charges,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.58,100,,,percent of total billed charges,100% of total billed charges,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.82,130,,,Fee Schedule,130% of WA Medicaid ,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.97,37.7,,,percent of total billed charges,37.70% of total billed charges,23.97,37.7,,,percent of total billed charges,37.70% of total billed charges,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,2155.36,33.9,,,percent of total billed charges,33.9% of total billed charges,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.59,78,,,percent of total billed charges,78% of total billed charges,63.58,100,,,percent of total billed charges,100% of total billed charges,52.52,82.6,,,percent of total billed charges,82.6% of total billed charges,52.52,82.6,,,percent of total billed charges,82.6% of total billed charges,4.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.36,2155.36,
EVALUATION OF WHEEZING,94060,CDM,983,RC,94060,HCPCS,Outpatient,,,170,110.50,,149.6,88,,,percent of total billed charges,88% of total Billed charges,1.72,100,,,Fee Schedule,100% of Medicare rate,5.78,100,,,Fee Schedule,100% of WA Medicaid,170,100,,,percent of total billed charges,100% of total billed charges,5.95,103,,,Fee Schedule,103% of WA Medicaid,1.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.02,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,5.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,117.3,69,,,percent of total billed charges,69% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,170,100,,,percent of total billed charges,100% of total billed charges,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,170,100,,,percent of total billed charges,100% of total billed charges,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,105.15,61.85,,,percent of total billed charges,61.85% of total billed charges,5.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,7.51,130,,,Fee Schedule,130% of WA Medicaid ,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,64.09,37.7,,,percent of total billed charges,37.70% of total billed charges,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5763,33.9,,,percent of total billed charges,33.9% of total billed charges,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.6,78,,,percent of total billed charges,78% of total billed charges,170,100,,,percent of total billed charges,100% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,140.42,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.72,5763,
EVALUATION OF WHEEZING,94070,CDM,983,RC,94070,HCPCS,Outpatient,,,169,109.85,,148.72,88,,,percent of total billed charges,88% of total Billed charges,2.97,100,,,Fee Schedule,100% of Medicare rate,15.48,100,,,Fee Schedule,100% of WA Medicaid,169,100,,,percent of total billed charges,100% of total billed charges,15.94,103,,,Fee Schedule,103% of WA Medicaid,2.97,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,15.48,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,116.61,69,,,percent of total billed charges,69% of total billed charges,169,100,,,percent of total billed charges,100% of total billed charges,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,169,100,,,percent of total billed charges,100% of total billed charges,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,169,100,,,percent of total billed charges,100% of total billed charges,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.53,61.85,,,percent of total billed charges,61.85% of total billed charges,15.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.12,130,,,Fee Schedule,130% of WA Medicaid ,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.71,37.7,,,percent of total billed charges,37.70% of total billed charges,63.71,37.7,,,percent of total billed charges,37.70% of total billed charges,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,5729.1,33.9,,,percent of total billed charges,33.9% of total billed charges,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.82,78,,,percent of total billed charges,78% of total billed charges,169,100,,,percent of total billed charges,100% of total billed charges,139.59,82.6,,,percent of total billed charges,82.6% of total billed charges,139.59,82.6,,,percent of total billed charges,82.6% of total billed charges,15.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,3,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.97,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.97,5729.1,
VITAL CAPACITY TEST,94150,CDM,983,RC,94150,HCPCS,Outpatient,,,44,28.60,,38.72,88,,,percent of total billed charges,88% of total Billed charges,1.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,30.36,69,,,percent of total billed charges,69% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,44,100,,,percent of total billed charges,100% of total billed charges,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,44,100,,,percent of total billed charges,100% of total billed charges,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.21,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.59,37.7,,,percent of total billed charges,37.70% of total billed charges,16.59,37.7,,,percent of total billed charges,37.70% of total billed charges,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1491.6,33.9,,,percent of total billed charges,33.9% of total billed charges,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.32,78,,,percent of total billed charges,78% of total billed charges,44,100,,,percent of total billed charges,100% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,36.34,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",1.3,1491.6,
LUNG FUNCTION TEST (MBC/MVV),94200,CDM,983,RC,94200,HCPCS,Outpatient,,,70,45.50,,61.6,88,,,percent of total billed charges,88% of total Billed charges,0.98,100,,,Fee Schedule,100% of Medicare rate,1.49,100,,,Fee Schedule,100% of WA Medicaid,70,100,,,percent of total billed charges,100% of total billed charges,1.53,103,,,Fee Schedule,103% of WA Medicaid,0.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,48.3,69,,,percent of total billed charges,69% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,100,,,percent of total billed charges,100% of total billed charges,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,70,100,,,percent of total billed charges,100% of total billed charges,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.3,61.85,,,percent of total billed charges,61.85% of total billed charges,1.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1.94,130,,,Fee Schedule,130% of WA Medicaid ,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,26.39,37.7,,,percent of total billed charges,37.70% of total billed charges,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,2373,33.9,,,percent of total billed charges,33.9% of total billed charges,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.6,78,,,percent of total billed charges,78% of total billed charges,70,100,,,percent of total billed charges,100% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,57.82,82.6,,,percent of total billed charges,82.6% of total billed charges,1.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.98,2373,
RESPIRATORY FLOW VOLUME LOOP,94375,CDM,983,RC,94375,HCPCS,Outpatient,,,109,70.85,,95.92,88,,,percent of total billed charges,88% of total Billed charges,1.72,100,,,Fee Schedule,100% of Medicare rate,8.02,100,,,Fee Schedule,100% of WA Medicaid,109,100,,,percent of total billed charges,100% of total billed charges,8.26,103,,,Fee Schedule,103% of WA Medicaid,1.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,75.21,69,,,percent of total billed charges,69% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,109,100,,,percent of total billed charges,100% of total billed charges,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,109,100,,,percent of total billed charges,100% of total billed charges,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.42,61.85,,,percent of total billed charges,61.85% of total billed charges,8.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.43,130,,,Fee Schedule,130% of WA Medicaid ,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,41.09,37.7,,,percent of total billed charges,37.70% of total billed charges,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3695.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.02,78,,,percent of total billed charges,78% of total billed charges,109,100,,,percent of total billed charges,100% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,90.03,82.6,,,percent of total billed charges,82.6% of total billed charges,8.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.72,3695.1,
"94618 Pulmonary stress testing (eg, 6-minute walk test)",94618,CDM,983,RC,94618,HCPCS,Outpatient,,,502,326.30,,441.76,88,,,percent of total billed charges,88% of total Billed charges,1.82,100,,,Fee Schedule,100% of Medicare rate,12.31,100,,,Fee Schedule,100% of WA Medicaid,502,100,,,percent of total billed charges,100% of total billed charges,12.68,103,,,Fee Schedule,103% of WA Medicaid,1.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,12.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,346.38,69,,,percent of total billed charges,69% of total billed charges,502,100,,,percent of total billed charges,100% of total billed charges,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,502,100,,,percent of total billed charges,100% of total billed charges,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,502,100,,,percent of total billed charges,100% of total billed charges,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,310.49,61.85,,,percent of total billed charges,61.85% of total billed charges,12.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16,130,,,Fee Schedule,130% of WA Medicaid ,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.25,37.7,,,percent of total billed charges,37.70% of total billed charges,189.25,37.7,,,percent of total billed charges,37.70% of total billed charges,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,17017.8,33.9,,,percent of total billed charges,33.9% of total billed charges,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,391.56,78,,,percent of total billed charges,78% of total billed charges,502,100,,,percent of total billed charges,100% of total billed charges,414.65,82.6,,,percent of total billed charges,82.6% of total billed charges,414.65,82.6,,,percent of total billed charges,82.6% of total billed charges,12.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.84,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.82,17017.8,
PULMONARY STRESS TEST/SIMPLE,94620,CDM,983,RC,,,Outpatient,,,94.31,61.30,,82.99,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,94.31,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,65.07,69,,,percent of total billed charges,69% of total billed charges,94.31,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,94.31,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,94.31,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,58.33,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,35.55,37.7,,,percent of total billed charges,37.70% of total billed charges,35.55,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,3197.11,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,73.56,78,,,percent of total billed charges,78% of total billed charges,94.31,100,,,percent of total billed charges,100% of total billed charges,77.9,82.6,,,percent of total billed charges,82.6% of total billed charges,77.9,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",35.55,3197.11,
CBT 1ST HOUR,94644,CDM,983,RC,94644,HCPCS,Outpatient,,,124,80.60,,109.12,88,,,percent of total billed charges,88% of total Billed charges,2.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,124,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.16,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,85.56,69,,,percent of total billed charges,69% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,124,100,,,percent of total billed charges,100% of total billed charges,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,124,100,,,percent of total billed charges,100% of total billed charges,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.69,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,4203.6,33.9,,,percent of total billed charges,33.9% of total billed charges,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.72,78,,,percent of total billed charges,78% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.4,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",2.38,4203.6,
CBT EACH ADDL HOUR,94645,CDM,983,RC,94645,HCPCS,Outpatient,,,40,26.00,,35.2,88,,,percent of total billed charges,88% of total Billed charges,0.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,0.77,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,27.6,69,,,percent of total billed charges,69% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,40,100,,,percent of total billed charges,100% of total billed charges,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,40,100,,,percent of total billed charges,100% of total billed charges,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.74,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,15.08,37.7,,,percent of total billed charges,37.70% of total billed charges,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,1356,33.9,,,percent of total billed charges,33.9% of total billed charges,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.2,78,,,percent of total billed charges,78% of total billed charges,40,100,,,percent of total billed charges,100% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,33.04,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.77,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",0.77,1356,
POS AIRWAY PRESSURE CPAP,94660,CDM,983,RC,94660,HCPCS,Outpatient,,,80,52.00,,70.4,88,,,percent of total billed charges,88% of total Billed charges,2.66,100,,,Fee Schedule,100% of Medicare rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,80,100,,,percent of total billed charges,100% of total billed charges,21.52,103,,,Fee Schedule,103% of WA Medicaid,2.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.66,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,55.2,69,,,percent of total billed charges,69% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,80,100,,,percent of total billed charges,100% of total billed charges,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,80,100,,,percent of total billed charges,100% of total billed charges,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.48,61.85,,,percent of total billed charges,61.85% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.16,130,,,Fee Schedule,130% of WA Medicaid ,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.16,37.7,,,percent of total billed charges,37.70% of total billed charges,30.16,37.7,,,percent of total billed charges,37.70% of total billed charges,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2712,33.9,,,percent of total billed charges,33.9% of total billed charges,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.4,78,,,percent of total billed charges,78% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.66,2712,
EVALUATE PT USE OF INHALER,94664,CDM,983,RC,94664,HCPCS,Outpatient,,,48,31.20,,42.24,88,,,percent of total billed charges,88% of total Billed charges,1.08,100,,,Fee Schedule,100% of Medicare rate,10.82,100,,,Fee Schedule,100% of WA Medicaid,48,100,,,percent of total billed charges,100% of total billed charges,11.14,103,,,Fee Schedule,103% of WA Medicaid,1.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,10.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,33.12,69,,,percent of total billed charges,69% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,48,100,,,percent of total billed charges,100% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,48,100,,,percent of total billed charges,100% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.69,61.85,,,percent of total billed charges,61.85% of total billed charges,10.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.07,130,,,Fee Schedule,130% of WA Medicaid ,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,18.1,37.7,,,percent of total billed charges,37.70% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1627.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.44,78,,,percent of total billed charges,78% of total billed charges,48,100,,,percent of total billed charges,100% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,39.65,82.6,,,percent of total billed charges,82.6% of total billed charges,10.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.08,1627.2,
PFT INTERPRETATION,94726,CDM,983,RC,94726,HCPCS,Outpatient,,,18.5,12.03,,16.28,88,,,percent of total billed charges,88% of total Billed charges,2.51,100,,,Fee Schedule,100% of Medicare rate,6.71,100,,,Fee Schedule,100% of WA Medicaid,18.5,100,,,percent of total billed charges,100% of total billed charges,6.91,103,,,Fee Schedule,103% of WA Medicaid,2.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.39,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,6.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,12.77,69,,,percent of total billed charges,69% of total billed charges,18.5,100,,,percent of total billed charges,100% of total billed charges,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.5,100,,,percent of total billed charges,100% of total billed charges,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.5,100,,,percent of total billed charges,100% of total billed charges,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.44,61.85,,,percent of total billed charges,61.85% of total billed charges,6.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.84,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8.72,130,,,Fee Schedule,130% of WA Medicaid ,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.97,37.7,,,percent of total billed charges,37.70% of total billed charges,6.97,37.7,,,percent of total billed charges,37.70% of total billed charges,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,627.15,33.9,,,percent of total billed charges,33.9% of total billed charges,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.43,78,,,percent of total billed charges,78% of total billed charges,18.5,100,,,percent of total billed charges,100% of total billed charges,15.28,82.6,,,percent of total billed charges,82.6% of total billed charges,15.28,82.6,,,percent of total billed charges,82.6% of total billed charges,6.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.54,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.51,627.15,
MEASURE BLOOD OXYGEN LEVEL,94761,CDM,983,RC,94761,HCPCS,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,0.38,100,,,Fee Schedule,100% of Medicare rate,2.42,100,,,Fee Schedule,100% of WA Medicaid,14,100,,,percent of total billed charges,100% of total billed charges,2.49,103,,,Fee Schedule,103% of WA Medicaid,0.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2.42,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,14,100,,,percent of total billed charges,100% of total billed charges,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,14,100,,,percent of total billed charges,100% of total billed charges,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.42,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.15,130,,,Fee Schedule,130% of WA Medicaid ,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,5.28,37.7,,,percent of total billed charges,37.70% of total billed charges,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,474.6,33.9,,,percent of total billed charges,33.9% of total billed charges,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.42,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.42,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.38,474.6,
MEASURE BLOOD OXYGEN LEVEL,94760,CDM,983,RC,94760,HCPCS,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,0.34,100,,,Fee Schedule,100% of Medicare rate,1.49,100,,,Fee Schedule,100% of WA Medicaid,9,100,,,percent of total billed charges,100% of total billed charges,1.53,103,,,Fee Schedule,103% of WA Medicaid,0.34,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1.49,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,9,100,,,percent of total billed charges,100% of total billed charges,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,9,100,,,percent of total billed charges,100% of total billed charges,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.57,61.85,,,percent of total billed charges,61.85% of total billed charges,1.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.49,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,1.94,130,,,Fee Schedule,130% of WA Medicaid ,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.39,37.7,,,percent of total billed charges,37.70% of total billed charges,3.39,37.7,,,percent of total billed charges,37.70% of total billed charges,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,305.1,33.9,,,percent of total billed charges,33.9% of total billed charges,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.49,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.34,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.34,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.49,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.34,305.1,
PERCUT ALLERGY SKIN TESTS,95004,CDM,983,RC,95004,HCPCS,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,0.37,100,,,Fee Schedule,100% of Medicare rate,2.24,100,,,Fee Schedule,100% of WA Medicaid,19,100,,,percent of total billed charges,100% of total billed charges,2.31,103,,,Fee Schedule,103% of WA Medicaid,0.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2.24,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,19,100,,,percent of total billed charges,100% of total billed charges,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,19,100,,,percent of total billed charges,100% of total billed charges,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,2.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.24,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2.91,130,,,Fee Schedule,130% of WA Medicaid ,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.16,37.7,,,percent of total billed charges,37.70% of total billed charges,7.16,37.7,,,percent of total billed charges,37.70% of total billed charges,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,2.24,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.37,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.24,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.37,644.1,
INTRACUTANEOUS TEST,95024,CDM,983,RC,95024,HCPCS,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,0.29,100,,,Fee Schedule,100% of Medicare rate,0.56,100,,,Fee Schedule,100% of WA Medicaid,15,100,,,percent of total billed charges,100% of total billed charges,0.58,103,,,Fee Schedule,103% of WA Medicaid,0.29,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,0.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,15,100,,,percent of total billed charges,100% of total billed charges,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,15,100,,,percent of total billed charges,100% of total billed charges,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,0.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.57,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,0.73,130,,,Fee Schedule,130% of WA Medicaid ,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.66,37.7,,,percent of total billed charges,37.70% of total billed charges,5.66,37.7,,,percent of total billed charges,37.70% of total billed charges,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,508.5,33.9,,,percent of total billed charges,33.9% of total billed charges,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,0.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.29,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.29,508.5,
INTRADERMAL ALLERGY SKIN TEST,95027,CDM,983,RC,95027,HCPCS,Outpatient,,,13,8.45,,11.44,88,,,percent of total billed charges,88% of total Billed charges,0.41,100,,,Fee Schedule,100% of Medicare rate,2.98,100,,,Fee Schedule,100% of WA Medicaid,13,100,,,percent of total billed charges,100% of total billed charges,3.07,103,,,Fee Schedule,103% of WA Medicaid,0.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,2.98,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,8.97,69,,,percent of total billed charges,69% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,13,100,,,percent of total billed charges,100% of total billed charges,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,13,100,,,percent of total billed charges,100% of total billed charges,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.04,61.85,,,percent of total billed charges,61.85% of total billed charges,2.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.87,130,,,Fee Schedule,130% of WA Medicaid ,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.9,37.7,,,percent of total billed charges,37.70% of total billed charges,4.9,37.7,,,percent of total billed charges,37.70% of total billed charges,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,440.7,33.9,,,percent of total billed charges,33.9% of total billed charges,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.14,78,,,percent of total billed charges,78% of total billed charges,13,100,,,percent of total billed charges,100% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,10.74,82.6,,,percent of total billed charges,82.6% of total billed charges,2.98,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.98,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.41,440.7,
ANTIGEN THERAPY SERVICES,95165,CDM,983,RC,95165,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,0.36,100,,,Fee Schedule,100% of Medicare rate,1.87,100,,,Fee Schedule,100% of WA Medicaid,37,100,,,percent of total billed charges,100% of total billed charges,1.93,103,,,Fee Schedule,103% of WA Medicaid,0.36,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,1.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,37,100,,,percent of total billed charges,100% of total billed charges,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,37,100,,,percent of total billed charges,100% of total billed charges,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,1.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.91,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2.43,130,,,Fee Schedule,130% of WA Medicaid ,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1254.3,33.9,,,percent of total billed charges,33.9% of total billed charges,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,1.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.36,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.36,1254.3,
GLUCOSE MONITORING CONT,95250,CDM,983,RC,95250,HCPCS,Outpatient,,,481,312.65,,423.28,88,,,percent of total billed charges,88% of total Billed charges,5.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,481,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,331.89,69,,,percent of total billed charges,69% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,481,100,,,percent of total billed charges,100% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,481,100,,,percent of total billed charges,100% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,297.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,181.34,37.7,,,percent of total billed charges,37.70% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,16305.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,375.18,78,,,percent of total billed charges,78% of total billed charges,481,100,,,percent of total billed charges,100% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,397.31,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.69,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",5.63,16305.9,
GLUC MONITOR CONT PHYS IR,95251,CDM,983,RC,95251,HCPCS,Outpatient,,,73,47.45,,64.24,88,,,percent of total billed charges,88% of total Billed charges,2.08,100,,,Fee Schedule,100% of Medicare rate,19.58,100,,,Fee Schedule,100% of WA Medicaid,73,100,,,percent of total billed charges,100% of total billed charges,20.17,103,,,Fee Schedule,103% of WA Medicaid,2.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,50.37,69,,,percent of total billed charges,69% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,73,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,73,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.15,61.85,,,percent of total billed charges,61.85% of total billed charges,19.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.45,130,,,Fee Schedule,130% of WA Medicaid ,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,27.52,37.7,,,percent of total billed charges,37.70% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2474.7,33.9,,,percent of total billed charges,33.9% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.94,78,,,percent of total billed charges,78% of total billed charges,73,100,,,percent of total billed charges,100% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,60.3,82.6,,,percent of total billed charges,82.6% of total billed charges,19.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.08,2474.7,
POLYSOM <6YRS 4/>PARAMETERS,95782,CDM,983,RC,95782,HCPCS,Outpatient,,,213,138.45,,187.44,88,,,percent of total billed charges,88% of total Billed charges,39.2,100,,,Fee Schedule,100% of Medicare rate,69.38,100,,,Fee Schedule,100% of WA Medicaid,213,100,,,percent of total billed charges,100% of total billed charges,71.46,103,,,Fee Schedule,103% of WA Medicaid,39.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,68.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,69.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,146.97,69,,,percent of total billed charges,69% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,213,100,,,percent of total billed charges,100% of total billed charges,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,213,100,,,percent of total billed charges,100% of total billed charges,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,131.74,61.85,,,percent of total billed charges,61.85% of total billed charges,69.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.77,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,90.19,130,,,Fee Schedule,130% of WA Medicaid ,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,80.3,37.7,,,percent of total billed charges,37.70% of total billed charges,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,7220.7,33.9,,,percent of total billed charges,33.9% of total billed charges,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,166.14,78,,,percent of total billed charges,78% of total billed charges,213,100,,,percent of total billed charges,100% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,175.94,82.6,,,percent of total billed charges,82.6% of total billed charges,69.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,39.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,39.2,7220.7,
POLYSOM <6YRS CPAP/BILVL,95783,CDM,983,RC,95783,HCPCS,Outpatient,,,259,168.35,,227.92,88,,,percent of total billed charges,88% of total Billed charges,42.06,100,,,Fee Schedule,100% of Medicare rate,75.72,100,,,Fee Schedule,100% of WA Medicaid,259,100,,,percent of total billed charges,100% of total billed charges,77.99,103,,,Fee Schedule,103% of WA Medicaid,42.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,73.61,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,75.72,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,178.71,69,,,percent of total billed charges,69% of total billed charges,259,100,,,percent of total billed charges,100% of total billed charges,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,259,100,,,percent of total billed charges,100% of total billed charges,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,259,100,,,percent of total billed charges,100% of total billed charges,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.19,61.85,,,percent of total billed charges,61.85% of total billed charges,75.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.72,100,,,Fee Schedule,100% of WA Medicare OPPS rate,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,98.44,130,,,Fee Schedule,130% of WA Medicaid ,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.64,37.7,,,percent of total billed charges,37.70% of total billed charges,97.64,37.7,,,percent of total billed charges,37.70% of total billed charges,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,8780.1,33.9,,,percent of total billed charges,33.9% of total billed charges,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.02,78,,,percent of total billed charges,78% of total billed charges,259,100,,,percent of total billed charges,100% of total billed charges,213.93,82.6,,,percent of total billed charges,82.6% of total billed charges,213.93,82.6,,,percent of total billed charges,82.6% of total billed charges,75.72,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,42.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.72,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,42.06,8780.1,
MULT SLEEP LATENCY TEST UNATTENDED  RES,95805,CDM,983,RC,95805,HCPCS,Outpatient,,,110,71.50,,96.8,88,,,percent of total billed charges,88% of total Billed charges,17.55,100,,,Fee Schedule,100% of Medicare rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,110,100,,,percent of total billed charges,100% of total billed charges,33.04,103,,,Fee Schedule,103% of WA Medicaid,17.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,30.71,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,75.9,69,,,percent of total billed charges,69% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,110,100,,,percent of total billed charges,100% of total billed charges,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,110,100,,,percent of total billed charges,100% of total billed charges,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.04,61.85,,,percent of total billed charges,61.85% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.7,130,,,Fee Schedule,130% of WA Medicaid ,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,3729,33.9,,,percent of total billed charges,33.9% of total billed charges,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.8,78,,,percent of total billed charges,78% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.73,101,,,Fee Schedule,101% of Medicare RBRVS rate,17.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,17.55,3729,
EFFT,95806,CDM,983,RC,95806,HCPCS,Outpatient,,,110,71.50,,96.8,88,,,percent of total billed charges,88% of total Billed charges,4.2,100,,,Fee Schedule,100% of Medicare rate,24.62,100,,,Fee Schedule,100% of WA Medicaid,110,100,,,percent of total billed charges,100% of total billed charges,25.36,103,,,Fee Schedule,103% of WA Medicaid,4.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,24.62,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,75.9,69,,,percent of total billed charges,69% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,110,100,,,percent of total billed charges,100% of total billed charges,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,110,100,,,percent of total billed charges,100% of total billed charges,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.04,61.85,,,percent of total billed charges,61.85% of total billed charges,24.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.62,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.01,130,,,Fee Schedule,130% of WA Medicaid ,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,41.47,37.7,,,percent of total billed charges,37.70% of total billed charges,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3729,33.9,,,percent of total billed charges,33.9% of total billed charges,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,85.8,78,,,percent of total billed charges,78% of total billed charges,110,100,,,percent of total billed charges,100% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,90.86,82.6,,,percent of total billed charges,82.6% of total billed charges,24.62,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.62,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.2,3729,
ACTIGRAPHY TESTING,95803,CDM,983,RC,95803,HCPCS,Outpatient,,,80,52.00,,70.4,88,,,percent of total billed charges,88% of total Billed charges,4.96,100,,,Fee Schedule,100% of Medicare rate,23.5,100,,,Fee Schedule,100% of WA Medicaid,80,100,,,percent of total billed charges,100% of total billed charges,24.21,103,,,Fee Schedule,103% of WA Medicaid,4.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.5,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,55.2,69,,,percent of total billed charges,69% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,80,100,,,percent of total billed charges,100% of total billed charges,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,80,100,,,percent of total billed charges,100% of total billed charges,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.48,61.85,,,percent of total billed charges,61.85% of total billed charges,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.55,130,,,Fee Schedule,130% of WA Medicaid ,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.16,37.7,,,percent of total billed charges,37.70% of total billed charges,30.16,37.7,,,percent of total billed charges,37.70% of total billed charges,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,2712,33.9,,,percent of total billed charges,33.9% of total billed charges,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.4,78,,,percent of total billed charges,78% of total billed charges,80,100,,,percent of total billed charges,100% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,66.08,82.6,,,percent of total billed charges,82.6% of total billed charges,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.5,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.96,2712,
EEG OVER 1 HOUR,95813,CDM,983,RC,95813,HCPCS,Outpatient,,,239,155.35,,210.32,88,,,percent of total billed charges,88% of total Billed charges,16.86,100,,,Fee Schedule,100% of Medicare rate,48.3,100,,,Fee Schedule,100% of WA Medicaid,239,100,,,percent of total billed charges,100% of total billed charges,49.75,103,,,Fee Schedule,103% of WA Medicaid,16.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,48.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,164.91,69,,,percent of total billed charges,69% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,239,100,,,percent of total billed charges,100% of total billed charges,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,239,100,,,percent of total billed charges,100% of total billed charges,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,147.82,61.85,,,percent of total billed charges,61.85% of total billed charges,48.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,62.79,130,,,Fee Schedule,130% of WA Medicaid ,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,90.1,37.7,,,percent of total billed charges,37.70% of total billed charges,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,8102.1,33.9,,,percent of total billed charges,33.9% of total billed charges,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,186.42,78,,,percent of total billed charges,78% of total billed charges,239,100,,,percent of total billed charges,100% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,197.41,82.6,,,percent of total billed charges,82.6% of total billed charges,48.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.86,8102.1,
POLYSOM 6/> YRS 4/> PARAM,95810,CDM,983,RC,95810,HCPCS,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,25.55,100,,,Fee Schedule,100% of Medicare rate,66.21,100,,,Fee Schedule,100% of WA Medicaid,220,100,,,percent of total billed charges,100% of total billed charges,68.2,103,,,Fee Schedule,103% of WA Medicaid,25.55,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,44.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,66.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,220,100,,,percent of total billed charges,100% of total billed charges,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,220,100,,,percent of total billed charges,100% of total billed charges,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.07,61.85,,,percent of total billed charges,61.85% of total billed charges,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,67.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,86.07,130,,,Fee Schedule,130% of WA Medicaid ,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,7458,33.9,,,percent of total billed charges,33.9% of total billed charges,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,25.55,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,25.55,7458,
EEG AWAKE AND DROWSY,95816,CDM,983,RC,95816,HCPCS,Outpatient,,,938,609.70,,825.44,88,,,percent of total billed charges,88% of total Billed charges,14.86,100,,,Fee Schedule,100% of Medicare rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,938,100,,,percent of total billed charges,100% of total billed charges,33.04,103,,,Fee Schedule,103% of WA Medicaid,14.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,647.22,69,,,percent of total billed charges,69% of total billed charges,938,100,,,percent of total billed charges,100% of total billed charges,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,938,100,,,percent of total billed charges,100% of total billed charges,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,938,100,,,percent of total billed charges,100% of total billed charges,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,580.15,61.85,,,percent of total billed charges,61.85% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.7,130,,,Fee Schedule,130% of WA Medicaid ,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.63,37.7,,,percent of total billed charges,37.70% of total billed charges,353.63,37.7,,,percent of total billed charges,37.70% of total billed charges,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,31798.2,33.9,,,percent of total billed charges,33.9% of total billed charges,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,731.64,78,,,percent of total billed charges,78% of total billed charges,938,100,,,percent of total billed charges,100% of total billed charges,774.79,82.6,,,percent of total billed charges,82.6% of total billed charges,774.79,82.6,,,percent of total billed charges,82.6% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.01,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.86,31798.2,
EEG AWAKE AND ASLEEP,95819,CDM,983,RC,95819,HCPCS,Outpatient,,,149,96.85,,131.12,88,,,percent of total billed charges,88% of total Billed charges,16.99,100,,,Fee Schedule,100% of Medicare rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,149,100,,,percent of total billed charges,100% of total billed charges,33.04,103,,,Fee Schedule,103% of WA Medicaid,16.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,29.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,102.81,69,,,percent of total billed charges,69% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,149,100,,,percent of total billed charges,100% of total billed charges,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,149,100,,,percent of total billed charges,100% of total billed charges,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.16,61.85,,,percent of total billed charges,61.85% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.7,130,,,Fee Schedule,130% of WA Medicaid ,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,5051.1,33.9,,,percent of total billed charges,33.9% of total billed charges,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.22,78,,,percent of total billed charges,78% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,16.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,16.99,5051.1,
EEG 41-60 MINUTES,95812,CDM,983,RC,95812,HCPCS,Outpatient,,,149,96.85,,131.12,88,,,percent of total billed charges,88% of total Billed charges,13.22,100,,,Fee Schedule,100% of Medicare rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,149,100,,,percent of total billed charges,100% of total billed charges,33.04,103,,,Fee Schedule,103% of WA Medicaid,13.22,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.13,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,102.81,69,,,percent of total billed charges,69% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,149,100,,,percent of total billed charges,100% of total billed charges,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,149,100,,,percent of total billed charges,100% of total billed charges,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.16,61.85,,,percent of total billed charges,61.85% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.7,130,,,Fee Schedule,130% of WA Medicaid ,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,5051.1,33.9,,,percent of total billed charges,33.9% of total billed charges,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.22,78,,,percent of total billed charges,78% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.35,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.22,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.22,5051.1,
EEG COMA OR SLEEP ONLY,95822,CDM,983,RC,95822,HCPCS,Outpatient,,,149,96.85,,131.12,88,,,percent of total billed charges,88% of total Billed charges,15.43,100,,,Fee Schedule,100% of Medicare rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,149,100,,,percent of total billed charges,100% of total billed charges,33.04,103,,,Fee Schedule,103% of WA Medicaid,15.43,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,102.81,69,,,percent of total billed charges,69% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,149,100,,,percent of total billed charges,100% of total billed charges,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,149,100,,,percent of total billed charges,100% of total billed charges,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.16,61.85,,,percent of total billed charges,61.85% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.72,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,41.7,130,,,Fee Schedule,130% of WA Medicaid ,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,56.17,37.7,,,percent of total billed charges,37.70% of total billed charges,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,5051.1,33.9,,,percent of total billed charges,33.9% of total billed charges,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.22,78,,,percent of total billed charges,78% of total billed charges,149,100,,,percent of total billed charges,100% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,123.07,82.6,,,percent of total billed charges,82.6% of total billed charges,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.58,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.43,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.43,5051.1,
CHOLINESTERASE CHALLENGE,95857,CDM,983,RC,95857,HCPCS,Outpatient,,,140,91.00,,123.2,88,,,percent of total billed charges,88% of total Billed charges,1.88,100,,,Fee Schedule,100% of Medicare rate,16.04,100,,,Fee Schedule,100% of WA Medicaid,140,100,,,percent of total billed charges,100% of total billed charges,16.52,103,,,Fee Schedule,103% of WA Medicaid,1.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,96.6,69,,,percent of total billed charges,69% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,140,100,,,percent of total billed charges,100% of total billed charges,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,140,100,,,percent of total billed charges,100% of total billed charges,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.59,61.85,,,percent of total billed charges,61.85% of total billed charges,16.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.85,130,,,Fee Schedule,130% of WA Medicaid ,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.78,37.7,,,percent of total billed charges,37.70% of total billed charges,52.78,37.7,,,percent of total billed charges,37.70% of total billed charges,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,4746,33.9,,,percent of total billed charges,33.9% of total billed charges,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.2,78,,,percent of total billed charges,78% of total billed charges,140,100,,,percent of total billed charges,100% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,115.64,82.6,,,percent of total billed charges,82.6% of total billed charges,16.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.88,4746,
ROM BASIC,95851,CDM,983,RC,95851,HCPCS,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,0.49,100,,,Fee Schedule,100% of Medicare rate,4.29,100,,,Fee Schedule,100% of WA Medicaid,30,100,,,percent of total billed charges,100% of total billed charges,4.42,103,,,Fee Schedule,103% of WA Medicaid,0.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,4.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,30,100,,,percent of total billed charges,100% of total billed charges,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,30,100,,,percent of total billed charges,100% of total billed charges,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.56,61.85,,,percent of total billed charges,61.85% of total billed charges,4.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.38,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.58,130,,,Fee Schedule,130% of WA Medicaid ,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,11.31,37.7,,,percent of total billed charges,37.70% of total billed charges,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,1017,33.9,,,percent of total billed charges,33.9% of total billed charges,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,4.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.49,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.49,1017,
MUSCLE TEST 2 LIMBS,95861,CDM,983,RC,95861,HCPCS,Outpatient,,,387,251.55,,340.56,88,,,percent of total billed charges,88% of total Billed charges,6.98,100,,,Fee Schedule,100% of Medicare rate,45.69,100,,,Fee Schedule,100% of WA Medicaid,387,100,,,percent of total billed charges,100% of total billed charges,47.06,103,,,Fee Schedule,103% of WA Medicaid,6.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,45.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,267.03,69,,,percent of total billed charges,69% of total billed charges,387,100,,,percent of total billed charges,100% of total billed charges,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,387,100,,,percent of total billed charges,100% of total billed charges,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,387,100,,,percent of total billed charges,100% of total billed charges,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.36,61.85,,,percent of total billed charges,61.85% of total billed charges,45.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,59.4,130,,,Fee Schedule,130% of WA Medicaid ,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.9,37.7,,,percent of total billed charges,37.70% of total billed charges,145.9,37.7,,,percent of total billed charges,37.70% of total billed charges,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,13119.3,33.9,,,percent of total billed charges,33.9% of total billed charges,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.86,78,,,percent of total billed charges,78% of total billed charges,387,100,,,percent of total billed charges,100% of total billed charges,319.66,82.6,,,percent of total billed charges,82.6% of total billed charges,319.66,82.6,,,percent of total billed charges,82.6% of total billed charges,45.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.05,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.98,13119.3,
MUSCLE TEST 3 LIMBS,95863,CDM,983,RC,95863,HCPCS,Outpatient,,,468,304.20,,411.84,88,,,percent of total billed charges,88% of total Billed charges,8.71,100,,,Fee Schedule,100% of Medicare rate,55.58,100,,,Fee Schedule,100% of WA Medicaid,468,100,,,percent of total billed charges,100% of total billed charges,57.25,103,,,Fee Schedule,103% of WA Medicaid,8.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,55.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,322.92,69,,,percent of total billed charges,69% of total billed charges,468,100,,,percent of total billed charges,100% of total billed charges,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,468,100,,,percent of total billed charges,100% of total billed charges,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,468,100,,,percent of total billed charges,100% of total billed charges,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,289.46,61.85,,,percent of total billed charges,61.85% of total billed charges,55.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,72.25,130,,,Fee Schedule,130% of WA Medicaid ,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.44,37.7,,,percent of total billed charges,37.70% of total billed charges,176.44,37.7,,,percent of total billed charges,37.70% of total billed charges,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,15865.2,33.9,,,percent of total billed charges,33.9% of total billed charges,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,365.04,78,,,percent of total billed charges,78% of total billed charges,468,100,,,percent of total billed charges,100% of total billed charges,386.57,82.6,,,percent of total billed charges,82.6% of total billed charges,386.57,82.6,,,percent of total billed charges,82.6% of total billed charges,55.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.8,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.71,15865.2,
MUSCLE TEST 4 LIMBS,95864,CDM,983,RC,95864,HCPCS,Outpatient,,,507,329.55,,446.16,88,,,percent of total billed charges,88% of total Billed charges,9.98,100,,,Fee Schedule,100% of Medicare rate,59.31,100,,,Fee Schedule,100% of WA Medicaid,507,100,,,percent of total billed charges,100% of total billed charges,61.09,103,,,Fee Schedule,103% of WA Medicaid,9.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,349.83,69,,,percent of total billed charges,69% of total billed charges,507,100,,,percent of total billed charges,100% of total billed charges,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,100,,,percent of total billed charges,100% of total billed charges,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,507,100,,,percent of total billed charges,100% of total billed charges,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,313.58,61.85,,,percent of total billed charges,61.85% of total billed charges,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,77.1,130,,,Fee Schedule,130% of WA Medicaid ,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.14,37.7,,,percent of total billed charges,37.70% of total billed charges,191.14,37.7,,,percent of total billed charges,37.70% of total billed charges,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,17187.3,33.9,,,percent of total billed charges,33.9% of total billed charges,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,395.46,78,,,percent of total billed charges,78% of total billed charges,507,100,,,percent of total billed charges,100% of total billed charges,418.78,82.6,,,percent of total billed charges,82.6% of total billed charges,418.78,82.6,,,percent of total billed charges,82.6% of total billed charges,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.98,17187.3,
MUSCLE TEST ONE LIMB,95860,CDM,983,RC,95860,HCPCS,Outpatient,,,267,173.55,,234.96,88,,,percent of total billed charges,88% of total Billed charges,4.76,100,,,Fee Schedule,100% of Medicare rate,28.53,100,,,Fee Schedule,100% of WA Medicaid,267,100,,,percent of total billed charges,100% of total billed charges,29.39,103,,,Fee Schedule,103% of WA Medicaid,4.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.33,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,184.23,69,,,percent of total billed charges,69% of total billed charges,267,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,267,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,267,100,,,percent of total billed charges,100% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,165.14,61.85,,,percent of total billed charges,61.85% of total billed charges,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.09,130,,,Fee Schedule,130% of WA Medicaid ,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.66,37.7,,,percent of total billed charges,37.70% of total billed charges,100.66,37.7,,,percent of total billed charges,37.70% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,9051.3,33.9,,,percent of total billed charges,33.9% of total billed charges,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,208.26,78,,,percent of total billed charges,78% of total billed charges,267,100,,,percent of total billed charges,100% of total billed charges,220.54,82.6,,,percent of total billed charges,82.6% of total billed charges,220.54,82.6,,,percent of total billed charges,82.6% of total billed charges,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.76,9051.3,
MUSCLE TEST THOR PARASPINAL,95869,CDM,983,RC,95869,HCPCS,Outpatient,,,190,123.50,,167.2,88,,,percent of total billed charges,88% of total Billed charges,3.72,100,,,Fee Schedule,100% of Medicare rate,11.19,100,,,Fee Schedule,100% of WA Medicaid,190,100,,,percent of total billed charges,100% of total billed charges,11.53,103,,,Fee Schedule,103% of WA Medicaid,3.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,131.1,69,,,percent of total billed charges,69% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,190,100,,,percent of total billed charges,100% of total billed charges,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,117.52,61.85,,,percent of total billed charges,61.85% of total billed charges,11.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.55,130,,,Fee Schedule,130% of WA Medicaid ,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,71.63,37.7,,,percent of total billed charges,37.70% of total billed charges,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6441,33.9,,,percent of total billed charges,33.9% of total billed charges,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.2,78,,,percent of total billed charges,78% of total billed charges,190,100,,,percent of total billed charges,100% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,156.94,82.6,,,percent of total billed charges,82.6% of total billed charges,11.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.76,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.72,6441,
MUSCLE TEST CRAN NERV UNILAT,95867,CDM,983,RC,95867,HCPCS,Outpatient,,,254,165.10,,223.52,88,,,percent of total billed charges,88% of total Billed charges,4.58,100,,,Fee Schedule,100% of Medicare rate,23.31,100,,,Fee Schedule,100% of WA Medicaid,254,100,,,percent of total billed charges,100% of total billed charges,24.01,103,,,Fee Schedule,103% of WA Medicaid,4.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,175.26,69,,,percent of total billed charges,69% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.1,61.85,,,percent of total billed charges,61.85% of total billed charges,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.3,130,,,Fee Schedule,130% of WA Medicaid ,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,8610.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.12,78,,,percent of total billed charges,78% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.58,8610.6,
MUSCLE TEST CRAN NERVE BILAT,95868,CDM,983,RC,95868,HCPCS,Outpatient,,,341,221.65,,300.08,88,,,percent of total billed charges,88% of total Billed charges,5.82,100,,,Fee Schedule,100% of Medicare rate,35.06,100,,,Fee Schedule,100% of WA Medicaid,341,100,,,percent of total billed charges,100% of total billed charges,36.11,103,,,Fee Schedule,103% of WA Medicaid,5.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,35.06,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,235.29,69,,,percent of total billed charges,69% of total billed charges,341,100,,,percent of total billed charges,100% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,341,100,,,percent of total billed charges,100% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,341,100,,,percent of total billed charges,100% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.91,61.85,,,percent of total billed charges,61.85% of total billed charges,35.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.76,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.58,130,,,Fee Schedule,130% of WA Medicaid ,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,128.56,37.7,,,percent of total billed charges,37.70% of total billed charges,128.56,37.7,,,percent of total billed charges,37.70% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,11559.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,265.98,78,,,percent of total billed charges,78% of total billed charges,341,100,,,percent of total billed charges,100% of total billed charges,281.67,82.6,,,percent of total billed charges,82.6% of total billed charges,281.67,82.6,,,percent of total billed charges,82.6% of total billed charges,35.06,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.06,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.82,11559.9,
GUIDE NERV DESTR NEEDLE EMG,95874,CDM,983,RC,95874,HCPCS,Outpatient,,,176,114.40,,154.88,88,,,percent of total billed charges,88% of total Billed charges,2.62,100,,,Fee Schedule,100% of Medicare rate,11,100,,,Fee Schedule,100% of WA Medicaid,176,100,,,percent of total billed charges,100% of total billed charges,11.33,103,,,Fee Schedule,103% of WA Medicaid,2.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,121.44,69,,,percent of total billed charges,69% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,176,100,,,percent of total billed charges,100% of total billed charges,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,176,100,,,percent of total billed charges,100% of total billed charges,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.86,61.85,,,percent of total billed charges,61.85% of total billed charges,11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.3,130,,,Fee Schedule,130% of WA Medicaid ,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,5966.4,33.9,,,percent of total billed charges,33.9% of total billed charges,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.28,78,,,percent of total billed charges,78% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.62,5966.4,
GUIDE NERV DESTR ELEC STIM,95873,CDM,983,RC,95873,HCPCS,Outpatient,,,186,120.90,,163.68,88,,,percent of total billed charges,88% of total Billed charges,2.44,100,,,Fee Schedule,100% of Medicare rate,11,100,,,Fee Schedule,100% of WA Medicaid,186,100,,,percent of total billed charges,100% of total billed charges,11.33,103,,,Fee Schedule,103% of WA Medicaid,2.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,128.34,69,,,percent of total billed charges,69% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,186,100,,,percent of total billed charges,100% of total billed charges,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,186,100,,,percent of total billed charges,100% of total billed charges,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.04,61.85,,,percent of total billed charges,61.85% of total billed charges,11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.22,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.3,130,,,Fee Schedule,130% of WA Medicaid ,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,70.12,37.7,,,percent of total billed charges,37.70% of total billed charges,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,6305.4,33.9,,,percent of total billed charges,33.9% of total billed charges,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.08,78,,,percent of total billed charges,78% of total billed charges,186,100,,,percent of total billed charges,100% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,153.64,82.6,,,percent of total billed charges,82.6% of total billed charges,11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.44,6305.4,
MUSCLE TEST NONPARASPINAL,95870,CDM,983,RC,95870,HCPCS,Outpatient,,,182,118.30,,160.16,88,,,percent of total billed charges,88% of total Billed charges,3.35,100,,,Fee Schedule,100% of Medicare rate,11.19,100,,,Fee Schedule,100% of WA Medicaid,182,100,,,percent of total billed charges,100% of total billed charges,11.53,103,,,Fee Schedule,103% of WA Medicaid,3.35,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.19,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,125.58,69,,,percent of total billed charges,69% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,182,100,,,percent of total billed charges,100% of total billed charges,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,182,100,,,percent of total billed charges,100% of total billed charges,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.57,61.85,,,percent of total billed charges,61.85% of total billed charges,11.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.19,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,14.55,130,,,Fee Schedule,130% of WA Medicaid ,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,6169.8,33.9,,,percent of total billed charges,33.9% of total billed charges,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.96,78,,,percent of total billed charges,78% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,11.19,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.35,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.19,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.35,6169.8,
MUSC TEST DONE W/N TEST COMP,95886,CDM,983,RC,95886,HCPCS,Outpatient,,,243,157.95,,213.84,88,,,percent of total billed charges,88% of total Billed charges,3.74,100,,,Fee Schedule,100% of Medicare rate,25.36,100,,,Fee Schedule,100% of WA Medicaid,243,100,,,percent of total billed charges,100% of total billed charges,26.12,103,,,Fee Schedule,103% of WA Medicaid,3.74,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.36,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,167.67,69,,,percent of total billed charges,69% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,243,100,,,percent of total billed charges,100% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,243,100,,,percent of total billed charges,100% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.3,61.85,,,percent of total billed charges,61.85% of total billed charges,25.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.36,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.97,130,,,Fee Schedule,130% of WA Medicaid ,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,8237.7,33.9,,,percent of total billed charges,33.9% of total billed charges,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.54,78,,,percent of total billed charges,78% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,25.36,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.78,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.74,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.36,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.74,8237.7,
MUSC TST DONE W/NERV TST LIM,95885,CDM,983,RC,95885,HCPCS,Outpatient,,,155,100.75,,136.4,88,,,percent of total billed charges,88% of total Billed charges,2.17,100,,,Fee Schedule,100% of Medicare rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,155,100,,,percent of total billed charges,100% of total billed charges,10.75,103,,,Fee Schedule,103% of WA Medicaid,2.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.8,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,106.95,69,,,percent of total billed charges,69% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,155,100,,,percent of total billed charges,100% of total billed charges,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,155,100,,,percent of total billed charges,100% of total billed charges,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.87,61.85,,,percent of total billed charges,61.85% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.57,130,,,Fee Schedule,130% of WA Medicaid ,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,5254.5,33.9,,,percent of total billed charges,33.9% of total billed charges,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.9,78,,,percent of total billed charges,78% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.17,5254.5,
MUSC TST DONE W/N TST NONEXT,95887,CDM,983,RC,95887,HCPCS,Outpatient,,,217,141.05,,190.96,88,,,percent of total billed charges,88% of total Billed charges,3.33,100,,,Fee Schedule,100% of Medicare rate,20.7,100,,,Fee Schedule,100% of WA Medicaid,217,100,,,percent of total billed charges,100% of total billed charges,21.32,103,,,Fee Schedule,103% of WA Medicaid,3.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.7,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,149.73,69,,,percent of total billed charges,69% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,217,100,,,percent of total billed charges,100% of total billed charges,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,217,100,,,percent of total billed charges,100% of total billed charges,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,134.21,61.85,,,percent of total billed charges,61.85% of total billed charges,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.7,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.11,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.91,130,,,Fee Schedule,130% of WA Medicaid ,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.81,37.7,,,percent of total billed charges,37.70% of total billed charges,81.81,37.7,,,percent of total billed charges,37.70% of total billed charges,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,7356.3,33.9,,,percent of total billed charges,33.9% of total billed charges,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.26,78,,,percent of total billed charges,78% of total billed charges,217,100,,,percent of total billed charges,100% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,179.24,82.6,,,percent of total billed charges,82.6% of total billed charges,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.7,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.33,7356.3,
NVR CNDJ TST 1-2 STUDIES,95907,CDM,983,RC,95907,HCPCS,Outpatient,,,263,170.95,,231.44,88,,,percent of total billed charges,88% of total Billed charges,4.06,100,,,Fee Schedule,100% of Medicare rate,29.65,100,,,Fee Schedule,100% of WA Medicaid,263,100,,,percent of total billed charges,100% of total billed charges,30.54,103,,,Fee Schedule,103% of WA Medicaid,4.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,181.47,69,,,percent of total billed charges,69% of total billed charges,263,100,,,percent of total billed charges,100% of total billed charges,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,263,100,,,percent of total billed charges,100% of total billed charges,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,263,100,,,percent of total billed charges,100% of total billed charges,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,162.67,61.85,,,percent of total billed charges,61.85% of total billed charges,29.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,38.55,130,,,Fee Schedule,130% of WA Medicaid ,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.15,37.7,,,percent of total billed charges,37.70% of total billed charges,99.15,37.7,,,percent of total billed charges,37.70% of total billed charges,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,8915.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,205.14,78,,,percent of total billed charges,78% of total billed charges,263,100,,,percent of total billed charges,100% of total billed charges,217.24,82.6,,,percent of total billed charges,82.6% of total billed charges,217.24,82.6,,,percent of total billed charges,82.6% of total billed charges,29.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.06,8915.7,
NRV CNDJ TST 3-4 STUDIES,95908,CDM,983,RC,95908,HCPCS,Outpatient,,,324,210.60,,285.12,88,,,percent of total billed charges,88% of total Billed charges,4.98,100,,,Fee Schedule,100% of Medicare rate,37.3,100,,,Fee Schedule,100% of WA Medicaid,324,100,,,percent of total billed charges,100% of total billed charges,38.42,103,,,Fee Schedule,103% of WA Medicaid,4.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,37.3,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,223.56,69,,,percent of total billed charges,69% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.39,61.85,,,percent of total billed charges,61.85% of total billed charges,37.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.3,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.05,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,48.49,130,,,Fee Schedule,130% of WA Medicaid ,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10983.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.72,78,,,percent of total billed charges,78% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,37.3,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.3,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.98,10983.6,
NRV CNDJ TST 5-6 STUDIES,95909,CDM,983,RC,95909,HCPCS,Outpatient,,,387,251.55,,340.56,88,,,percent of total billed charges,88% of total Billed charges,5.93,100,,,Fee Schedule,100% of Medicare rate,44.57,100,,,Fee Schedule,100% of WA Medicaid,387,100,,,percent of total billed charges,100% of total billed charges,45.91,103,,,Fee Schedule,103% of WA Medicaid,5.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,44.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,267.03,69,,,percent of total billed charges,69% of total billed charges,387,100,,,percent of total billed charges,100% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,387,100,,,percent of total billed charges,100% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,387,100,,,percent of total billed charges,100% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.36,61.85,,,percent of total billed charges,61.85% of total billed charges,44.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.46,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,57.94,130,,,Fee Schedule,130% of WA Medicaid ,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,145.9,37.7,,,percent of total billed charges,37.70% of total billed charges,145.9,37.7,,,percent of total billed charges,37.70% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,13119.3,33.9,,,percent of total billed charges,33.9% of total billed charges,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.86,78,,,percent of total billed charges,78% of total billed charges,387,100,,,percent of total billed charges,100% of total billed charges,319.66,82.6,,,percent of total billed charges,82.6% of total billed charges,319.66,82.6,,,percent of total billed charges,82.6% of total billed charges,44.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.99,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.93,13119.3,
MOTOR NERVE CONDUCTION TEST,95900,CDM,983,RC,95900,HCPCS,Outpatient,,,179,116.35,,157.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,179,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,123.51,69,,,percent of total billed charges,69% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,179,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,179,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,110.71,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,67.48,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,6068.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,139.62,78,,,percent of total billed charges,78% of total billed charges,179,100,,,percent of total billed charges,100% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,147.85,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",67.48,6068.1,
NRV CNDJ TEST 7-8 STUDIES,95910,CDM,983,RC,95910,HCPCS,Outpatient,,,510,331.50,,448.8,88,,,percent of total billed charges,88% of total Billed charges,7.71,100,,,Fee Schedule,100% of Medicare rate,59.31,100,,,Fee Schedule,100% of WA Medicaid,510,100,,,percent of total billed charges,100% of total billed charges,61.09,103,,,Fee Schedule,103% of WA Medicaid,7.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,13.49,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,351.9,69,,,percent of total billed charges,69% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,510,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,510,100,,,percent of total billed charges,100% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.44,61.85,,,percent of total billed charges,61.85% of total billed charges,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.5,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,77.1,130,,,Fee Schedule,130% of WA Medicaid ,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,192.27,37.7,,,percent of total billed charges,37.70% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,17289,33.9,,,percent of total billed charges,33.9% of total billed charges,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,397.8,78,,,percent of total billed charges,78% of total billed charges,510,100,,,percent of total billed charges,100% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,421.26,82.6,,,percent of total billed charges,82.6% of total billed charges,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.71,17289,
NRV CNDJ TEST 9-10 STUDIES,95911,CDM,983,RC,95911,HCPCS,Outpatient,,,617,401.05,,542.96,88,,,percent of total billed charges,88% of total Billed charges,9.33,100,,,Fee Schedule,100% of Medicare rate,74.04,100,,,Fee Schedule,100% of WA Medicaid,617,100,,,percent of total billed charges,100% of total billed charges,76.26,103,,,Fee Schedule,103% of WA Medicaid,9.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.32,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,74.04,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,425.73,69,,,percent of total billed charges,69% of total billed charges,617,100,,,percent of total billed charges,100% of total billed charges,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,617,100,,,percent of total billed charges,100% of total billed charges,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,617,100,,,percent of total billed charges,100% of total billed charges,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,381.61,61.85,,,percent of total billed charges,61.85% of total billed charges,74.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.04,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,96.25,130,,,Fee Schedule,130% of WA Medicaid ,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.61,37.7,,,percent of total billed charges,37.70% of total billed charges,232.61,37.7,,,percent of total billed charges,37.70% of total billed charges,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,20916.3,33.9,,,percent of total billed charges,33.9% of total billed charges,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,481.26,78,,,percent of total billed charges,78% of total billed charges,617,100,,,percent of total billed charges,100% of total billed charges,509.64,82.6,,,percent of total billed charges,82.6% of total billed charges,509.64,82.6,,,percent of total billed charges,82.6% of total billed charges,74.04,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.42,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.04,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.33,20916.3,
NRV CNDJ TEST 11-12 STUDIES,95912,CDM,983,RC,95912,HCPCS,Outpatient,,,722,469.30,,635.36,88,,,percent of total billed charges,88% of total Billed charges,11.19,100,,,Fee Schedule,100% of Medicare rate,88.4,100,,,Fee Schedule,100% of WA Medicaid,722,100,,,percent of total billed charges,100% of total billed charges,91.05,103,,,Fee Schedule,103% of WA Medicaid,11.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.59,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,88.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,498.18,69,,,percent of total billed charges,69% of total billed charges,722,100,,,percent of total billed charges,100% of total billed charges,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,722,100,,,percent of total billed charges,100% of total billed charges,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,722,100,,,percent of total billed charges,100% of total billed charges,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,446.56,61.85,,,percent of total billed charges,61.85% of total billed charges,88.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,114.92,130,,,Fee Schedule,130% of WA Medicaid ,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,272.19,37.7,,,percent of total billed charges,37.70% of total billed charges,272.19,37.7,,,percent of total billed charges,37.70% of total billed charges,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,24475.8,33.9,,,percent of total billed charges,33.9% of total billed charges,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,563.16,78,,,percent of total billed charges,78% of total billed charges,722,100,,,percent of total billed charges,100% of total billed charges,596.37,82.6,,,percent of total billed charges,82.6% of total billed charges,596.37,82.6,,,percent of total billed charges,82.6% of total billed charges,88.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.19,24475.8,
NRV CNDJ TEST 13/> STUDIES,95913,CDM,983,RC,95913,HCPCS,Outpatient,,,837,544.05,,736.56,88,,,percent of total billed charges,88% of total Billed charges,12.87,100,,,Fee Schedule,100% of Medicare rate,104.44,100,,,Fee Schedule,100% of WA Medicaid,837,100,,,percent of total billed charges,100% of total billed charges,107.57,103,,,Fee Schedule,103% of WA Medicaid,12.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,22.53,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,104.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,577.53,69,,,percent of total billed charges,69% of total billed charges,837,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,837,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,837,100,,,percent of total billed charges,100% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,517.68,61.85,,,percent of total billed charges,61.85% of total billed charges,104.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,106.53,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,135.77,130,,,Fee Schedule,130% of WA Medicaid ,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,315.55,37.7,,,percent of total billed charges,37.70% of total billed charges,315.55,37.7,,,percent of total billed charges,37.70% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,28374.3,33.9,,,percent of total billed charges,33.9% of total billed charges,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,652.86,78,,,percent of total billed charges,78% of total billed charges,837,100,,,percent of total billed charges,100% of total billed charges,691.36,82.6,,,percent of total billed charges,82.6% of total billed charges,691.36,82.6,,,percent of total billed charges,82.6% of total billed charges,104.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,13,101,,,Fee Schedule,101% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,12.87,28374.3,
SOMATOSENSORY TESTING,95927,CDM,983,RC,95927,HCPCS,Outpatient,,,455,295.75,,400.4,88,,,percent of total billed charges,88% of total Billed charges,7.21,100,,,Fee Schedule,100% of Medicare rate,15.29,100,,,Fee Schedule,100% of WA Medicaid,455,100,,,percent of total billed charges,100% of total billed charges,15.75,103,,,Fee Schedule,103% of WA Medicaid,7.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.62,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,15.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,313.95,69,,,percent of total billed charges,69% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,455,100,,,percent of total billed charges,100% of total billed charges,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,455,100,,,percent of total billed charges,100% of total billed charges,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,281.42,61.85,,,percent of total billed charges,61.85% of total billed charges,15.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19.88,130,,,Fee Schedule,130% of WA Medicaid ,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,171.54,37.7,,,percent of total billed charges,37.70% of total billed charges,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,15424.5,33.9,,,percent of total billed charges,33.9% of total billed charges,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,354.9,78,,,percent of total billed charges,78% of total billed charges,455,100,,,percent of total billed charges,100% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,375.83,82.6,,,percent of total billed charges,82.6% of total billed charges,15.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.21,15424.5,
SOMATOSENSORY TESTING,95926,CDM,983,RC,95926,HCPCS,Outpatient,,,450,292.50,,396,88,,,percent of total billed charges,88% of total Billed charges,6.19,100,,,Fee Schedule,100% of Medicare rate,15.29,100,,,Fee Schedule,100% of WA Medicaid,450,100,,,percent of total billed charges,100% of total billed charges,15.75,103,,,Fee Schedule,103% of WA Medicaid,6.19,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,15.29,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,310.5,69,,,percent of total billed charges,69% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,450,100,,,percent of total billed charges,100% of total billed charges,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,450,100,,,percent of total billed charges,100% of total billed charges,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,278.33,61.85,,,percent of total billed charges,61.85% of total billed charges,15.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.29,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19.88,130,,,Fee Schedule,130% of WA Medicaid ,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,169.65,37.7,,,percent of total billed charges,37.70% of total billed charges,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,15255,33.9,,,percent of total billed charges,33.9% of total billed charges,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,351,78,,,percent of total billed charges,78% of total billed charges,450,100,,,percent of total billed charges,100% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,371.7,82.6,,,percent of total billed charges,82.6% of total billed charges,15.29,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.19,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.29,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.19,15255,
SOMATOSENSORY TESTING,95925,CDM,983,RC,95925,HCPCS,Outpatient,,,464,301.60,,408.32,88,,,percent of total billed charges,88% of total Billed charges,7.01,100,,,Fee Schedule,100% of Medicare rate,15.67,100,,,Fee Schedule,100% of WA Medicaid,464,100,,,percent of total billed charges,100% of total billed charges,16.14,103,,,Fee Schedule,103% of WA Medicaid,7.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,15.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,320.16,69,,,percent of total billed charges,69% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,464,100,,,percent of total billed charges,100% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,464,100,,,percent of total billed charges,100% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.98,61.85,,,percent of total billed charges,61.85% of total billed charges,15.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.37,130,,,Fee Schedule,130% of WA Medicaid ,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,174.93,37.7,,,percent of total billed charges,37.70% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,15729.6,33.9,,,percent of total billed charges,33.9% of total billed charges,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,361.92,78,,,percent of total billed charges,78% of total billed charges,464,100,,,percent of total billed charges,100% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,383.26,82.6,,,percent of total billed charges,82.6% of total billed charges,15.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.08,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.01,15729.6,
VISUAL EVOKED POTENTIAL TEST,95930,CDM,983,RC,95930,HCPCS,Outpatient,,,422,274.30,,371.36,88,,,percent of total billed charges,88% of total Billed charges,2.6,100,,,Fee Schedule,100% of Medicare rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,422,100,,,percent of total billed charges,100% of total billed charges,10.75,103,,,Fee Schedule,103% of WA Medicaid,2.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,10.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,291.18,69,,,percent of total billed charges,69% of total billed charges,422,100,,,percent of total billed charges,100% of total billed charges,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,422,100,,,percent of total billed charges,100% of total billed charges,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,422,100,,,percent of total billed charges,100% of total billed charges,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,261.01,61.85,,,percent of total billed charges,61.85% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.65,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.57,130,,,Fee Schedule,130% of WA Medicaid ,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,159.09,37.7,,,percent of total billed charges,37.70% of total billed charges,159.09,37.7,,,percent of total billed charges,37.70% of total billed charges,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,14305.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.16,78,,,percent of total billed charges,78% of total billed charges,422,100,,,percent of total billed charges,100% of total billed charges,348.57,82.6,,,percent of total billed charges,82.6% of total billed charges,348.57,82.6,,,percent of total billed charges,82.6% of total billed charges,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.6,14305.8,
BLINK REFLEX TEST,95933,CDM,983,RC,95933,HCPCS,Outpatient,,,225,146.25,,198,88,,,percent of total billed charges,88% of total Billed charges,3.58,100,,,Fee Schedule,100% of Medicare rate,17.53,100,,,Fee Schedule,100% of WA Medicaid,225,100,,,percent of total billed charges,100% of total billed charges,18.06,103,,,Fee Schedule,103% of WA Medicaid,3.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,17.53,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,155.25,69,,,percent of total billed charges,69% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,225,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,225,100,,,percent of total billed charges,100% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,139.16,61.85,,,percent of total billed charges,61.85% of total billed charges,17.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.53,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.88,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.79,130,,,Fee Schedule,130% of WA Medicaid ,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,84.83,37.7,,,percent of total billed charges,37.70% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,7627.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.5,78,,,percent of total billed charges,78% of total billed charges,225,100,,,percent of total billed charges,100% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,185.85,82.6,,,percent of total billed charges,82.6% of total billed charges,17.53,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.62,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.53,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.58,7627.5,
NEUROMUSCULAR JUNCTION TEST,95937,CDM,983,RC,95937,HCPCS,Outpatient,,,193,125.45,,169.84,88,,,percent of total billed charges,88% of total Billed charges,4.25,100,,,Fee Schedule,100% of Medicare rate,19.4,100,,,Fee Schedule,100% of WA Medicaid,193,100,,,percent of total billed charges,100% of total billed charges,19.98,103,,,Fee Schedule,103% of WA Medicaid,4.25,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.4,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,133.17,69,,,percent of total billed charges,69% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,193,100,,,percent of total billed charges,100% of total billed charges,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,193,100,,,percent of total billed charges,100% of total billed charges,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.37,61.85,,,percent of total billed charges,61.85% of total billed charges,19.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.4,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.22,130,,,Fee Schedule,130% of WA Medicaid ,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,72.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,6542.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.54,78,,,percent of total billed charges,78% of total billed charges,193,100,,,percent of total billed charges,100% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,159.42,82.6,,,percent of total billed charges,82.6% of total billed charges,19.4,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.25,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.4,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.25,6542.7,
H-REFLEX TEST,95934,CDM,983,RC,95934,HCPCS,Outpatient,,,171,111.15,,150.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,171,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,117.99,69,,,percent of total billed charges,69% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,171,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,171,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,105.76,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,64.47,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,5796.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,133.38,78,,,percent of total billed charges,78% of total billed charges,171,100,,,percent of total billed charges,100% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,141.25,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",64.47,5796.9,
H-REFLEX TEST,95936,CDM,983,RC,95936,HCPCS,Outpatient,,,138,89.70,,121.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,138,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,95.22,69,,,percent of total billed charges,69% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,138,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,138,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,85.35,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,52.03,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,4678.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,107.64,78,,,percent of total billed charges,78% of total billed charges,138,100,,,percent of total billed charges,100% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,113.99,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",52.03,4678.2,
ELECTRODE STIMULATION BRAIN,95961,CDM,983,RC,95961,HCPCS,Outpatient,,,416,270.40,,366.08,88,,,percent of total billed charges,88% of total Billed charges,18.88,100,,,Fee Schedule,100% of Medicare rate,90.27,100,,,Fee Schedule,100% of WA Medicaid,416,100,,,percent of total billed charges,100% of total billed charges,92.98,103,,,Fee Schedule,103% of WA Medicaid,18.88,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,33.04,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,90.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,287.04,69,,,percent of total billed charges,69% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,416,100,,,percent of total billed charges,100% of total billed charges,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,416,100,,,percent of total billed charges,100% of total billed charges,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,257.3,61.85,,,percent of total billed charges,61.85% of total billed charges,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,117.35,130,,,Fee Schedule,130% of WA Medicaid ,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,156.83,37.7,,,percent of total billed charges,37.70% of total billed charges,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,14102.4,33.9,,,percent of total billed charges,33.9% of total billed charges,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,324.48,78,,,percent of total billed charges,78% of total billed charges,416,100,,,percent of total billed charges,100% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,343.62,82.6,,,percent of total billed charges,82.6% of total billed charges,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,18.88,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,18.88,14102.4,
ELECTRODE STIM BRAIN ADD-ON,95962,CDM,983,RC,95962,HCPCS,Outpatient,,,446,289.90,,392.48,88,,,percent of total billed charges,88% of total Billed charges,15.26,100,,,Fee Schedule,100% of Medicare rate,96.79,100,,,Fee Schedule,100% of WA Medicaid,446,100,,,percent of total billed charges,100% of total billed charges,99.69,103,,,Fee Schedule,103% of WA Medicaid,15.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,26.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,96.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,307.74,69,,,percent of total billed charges,69% of total billed charges,446,100,,,percent of total billed charges,100% of total billed charges,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,446,100,,,percent of total billed charges,100% of total billed charges,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,446,100,,,percent of total billed charges,100% of total billed charges,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,275.85,61.85,,,percent of total billed charges,61.85% of total billed charges,96.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.73,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,125.83,130,,,Fee Schedule,130% of WA Medicaid ,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.14,37.7,,,percent of total billed charges,37.70% of total billed charges,168.14,37.7,,,percent of total billed charges,37.70% of total billed charges,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,15119.4,33.9,,,percent of total billed charges,33.9% of total billed charges,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,347.88,78,,,percent of total billed charges,78% of total billed charges,446,100,,,percent of total billed charges,100% of total billed charges,368.4,82.6,,,percent of total billed charges,82.6% of total billed charges,368.4,82.6,,,percent of total billed charges,82.6% of total billed charges,96.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.41,101,,,Fee Schedule,101% of Medicare RBRVS rate,15.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,15.26,15119.4,
ANALYZE NEUROSTIM COMPLEX,95972,CDM,983,RC,95972,HCPCS,Outpatient,,,299,194.35,,263.12,88,,,percent of total billed charges,88% of total Billed charges,3.27,100,,,Fee Schedule,100% of Medicare rate,22.57,100,,,Fee Schedule,100% of WA Medicaid,299,100,,,percent of total billed charges,100% of total billed charges,23.25,103,,,Fee Schedule,103% of WA Medicaid,3.27,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.72,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,206.31,69,,,percent of total billed charges,69% of total billed charges,299,100,,,percent of total billed charges,100% of total billed charges,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,299,100,,,percent of total billed charges,100% of total billed charges,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,299,100,,,percent of total billed charges,100% of total billed charges,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.93,61.85,,,percent of total billed charges,61.85% of total billed charges,22.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.34,130,,,Fee Schedule,130% of WA Medicaid ,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.72,37.7,,,percent of total billed charges,37.70% of total billed charges,112.72,37.7,,,percent of total billed charges,37.70% of total billed charges,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,10136.1,33.9,,,percent of total billed charges,33.9% of total billed charges,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,233.22,78,,,percent of total billed charges,78% of total billed charges,299,100,,,percent of total billed charges,100% of total billed charges,246.97,82.6,,,percent of total billed charges,82.6% of total billed charges,246.97,82.6,,,percent of total billed charges,82.6% of total billed charges,22.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.27,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.27,10136.1,
CANALITH REPOSITIONING PROCEDRES,95992,CDM,983,RC,95992,HCPCS,Outpatient,,,98,63.70,,86.24,88,,,percent of total billed charges,88% of total Billed charges,1.85,100,,,Fee Schedule,100% of Medicare rate,20.33,100,,,Fee Schedule,100% of WA Medicaid,98,100,,,percent of total billed charges,100% of total billed charges,20.94,103,,,Fee Schedule,103% of WA Medicaid,1.85,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,67.62,69,,,percent of total billed charges,69% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,98,100,,,percent of total billed charges,100% of total billed charges,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,98,100,,,percent of total billed charges,100% of total billed charges,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.61,61.85,,,percent of total billed charges,61.85% of total billed charges,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,26.43,130,,,Fee Schedule,130% of WA Medicaid ,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,36.95,37.7,,,percent of total billed charges,37.70% of total billed charges,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,3322.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.44,78,,,percent of total billed charges,78% of total billed charges,98,100,,,percent of total billed charges,100% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,80.95,82.6,,,percent of total billed charges,82.6% of total billed charges,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.85,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.85,3322.2,
SPIN/BRAIN PUMP REFIL  MAIN,95991,CDM,983,RC,95991,HCPCS,Outpatient,,,324,210.60,,285.12,88,,,percent of total billed charges,88% of total Billed charges,3.51,100,,,Fee Schedule,100% of Medicare rate,22.38,100,,,Fee Schedule,100% of WA Medicaid,324,100,,,percent of total billed charges,100% of total billed charges,23.05,103,,,Fee Schedule,103% of WA Medicaid,3.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,223.56,69,,,percent of total billed charges,69% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,324,100,,,percent of total billed charges,100% of total billed charges,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.39,61.85,,,percent of total billed charges,61.85% of total billed charges,22.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.09,130,,,Fee Schedule,130% of WA Medicaid ,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,122.15,37.7,,,percent of total billed charges,37.70% of total billed charges,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,10983.6,33.9,,,percent of total billed charges,33.9% of total billed charges,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.72,78,,,percent of total billed charges,78% of total billed charges,324,100,,,percent of total billed charges,100% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,267.62,82.6,,,percent of total billed charges,82.6% of total billed charges,22.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.55,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.51,10983.6,
SPIN/BRAIN PUMP REFIL  MAIN,95990,CDM,983,RC,95990,HCPCS,Outpatient,,,240,156.00,,211.2,88,,,percent of total billed charges,88% of total Billed charges,4.1,100,,,Fee Schedule,100% of Medicare rate,54.27,100,,,Fee Schedule,100% of WA Medicaid,240,100,,,percent of total billed charges,100% of total billed charges,55.9,103,,,Fee Schedule,103% of WA Medicaid,4.1,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,54.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,240,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,240,100,,,percent of total billed charges,100% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.44,61.85,,,percent of total billed charges,61.85% of total billed charges,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,70.55,130,,,Fee Schedule,130% of WA Medicaid ,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,90.48,37.7,,,percent of total billed charges,37.70% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,8136,33.9,,,percent of total billed charges,33.9% of total billed charges,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.1,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.1,8136,
DEVELOPMENTAL SCREEN W INTER AND REPORT,96110,CDM,983,RC,96110,HCPCS,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,0.62,100,,,Fee Schedule,100% of Medicare rate,13.8,100,,,Fee Schedule,100% of WA Medicaid,18,100,,,percent of total billed charges,100% of total billed charges,14.21,103,,,Fee Schedule,103% of WA Medicaid,0.62,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,18,100,,,percent of total billed charges,100% of total billed charges,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,18,100,,,percent of total billed charges,100% of total billed charges,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.13,61.85,,,percent of total billed charges,61.85% of total billed charges,13.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,17.94,130,,,Fee Schedule,130% of WA Medicaid ,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.79,37.7,,,percent of total billed charges,37.70% of total billed charges,6.79,37.7,,,percent of total billed charges,37.70% of total billed charges,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,610.2,33.9,,,percent of total billed charges,33.9% of total billed charges,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,13.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.62,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.62,610.2,
HYDRATION IV INFUSION INIT,96360,CDM,983,RC,96360,HCPCS,Outpatient,,,160,104.00,,140.8,88,,,percent of total billed charges,88% of total Billed charges,1.26,100,,,Fee Schedule,100% of Medicare rate,19.21,100,,,Fee Schedule,100% of WA Medicaid,160,100,,,percent of total billed charges,100% of total billed charges,19.79,103,,,Fee Schedule,103% of WA Medicaid,1.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,110.4,69,,,percent of total billed charges,69% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,160,100,,,percent of total billed charges,100% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,160,100,,,percent of total billed charges,100% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.96,61.85,,,percent of total billed charges,61.85% of total billed charges,19.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.59,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.97,130,,,Fee Schedule,130% of WA Medicaid ,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,60.32,37.7,,,percent of total billed charges,37.70% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,5424,33.9,,,percent of total billed charges,33.9% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.8,78,,,percent of total billed charges,78% of total billed charges,160,100,,,percent of total billed charges,100% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,132.16,82.6,,,percent of total billed charges,82.6% of total billed charges,19.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.26,5424,
HYDRATE IV INFUSION ADD-ON,96361,CDM,983,RC,96361,HCPCS,Outpatient,,,43,27.95,,37.84,88,,,percent of total billed charges,88% of total Billed charges,0.64,100,,,Fee Schedule,100% of Medicare rate,7.27,100,,,Fee Schedule,100% of WA Medicaid,43,100,,,percent of total billed charges,100% of total billed charges,7.49,103,,,Fee Schedule,103% of WA Medicaid,0.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,7.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,29.67,69,,,percent of total billed charges,69% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,43,100,,,percent of total billed charges,100% of total billed charges,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,43,100,,,percent of total billed charges,100% of total billed charges,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.6,61.85,,,percent of total billed charges,61.85% of total billed charges,7.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.45,130,,,Fee Schedule,130% of WA Medicaid ,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,16.21,37.7,,,percent of total billed charges,37.70% of total billed charges,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1457.7,33.9,,,percent of total billed charges,33.9% of total billed charges,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.54,78,,,percent of total billed charges,78% of total billed charges,43,100,,,percent of total billed charges,100% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,35.52,82.6,,,percent of total billed charges,82.6% of total billed charges,7.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.64,1457.7,
THER/PROPH/DIAG INJ IV PUSH,96374,CDM,940,RC,96374,HCPCS,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,382.57,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,22.49,15.3,,,percent of total billed charges,15.3% of total billed charges,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,147,100,,,percent of total billed charges,100% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,826.71,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,49.83,33.9,,,percent of total billed charges,33.9% of total billed charges,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,220.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,218.61,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.49,826.71,
TX/PRO/DX INJ NEW DRUG ADDON,96375,CDM,983,RC,96375,HCPCS,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,0.73,100,,,Fee Schedule,100% of Medicare rate,9.14,100,,,Fee Schedule,100% of WA Medicaid,63,100,,,percent of total billed charges,100% of total billed charges,9.41,103,,,Fee Schedule,103% of WA Medicaid,0.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,9.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,63,100,,,percent of total billed charges,100% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,63,100,,,percent of total billed charges,100% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.97,61.85,,,percent of total billed charges,61.85% of total billed charges,9.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.88,130,,,Fee Schedule,130% of WA Medicaid ,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,23.75,37.7,,,percent of total billed charges,37.70% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,2135.7,33.9,,,percent of total billed charges,33.9% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,9.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.73,2135.7,
"96376 Therapeutic, prophylactic, or diagnostic injection, ea addl push >30min",96376,CDM,983,RC,96376,HCPCS,Outpatient,,,128,83.20,,112.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,128,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,88.32,69,,,percent of total billed charges,69% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,128,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,128,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,79.17,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,48.26,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,4339.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,99.84,78,,,percent of total billed charges,78% of total billed charges,128,100,,,percent of total billed charges,100% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,105.73,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",48.26,4339.2,
96402 Chemo hormone antineopl SUBQ/IM,96402,CDM,983,RC,96402,HCPCS,Outpatient,,,147,95.55,,129.36,88,,,percent of total billed charges,88% of total Billed charges,1.61,100,,,Fee Schedule,100% of Medicare rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,147,100,,,percent of total billed charges,100% of total billed charges,21.52,103,,,Fee Schedule,103% of WA Medicaid,1.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,20.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,101.43,69,,,percent of total billed charges,69% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,147,100,,,percent of total billed charges,100% of total billed charges,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,147,100,,,percent of total billed charges,100% of total billed charges,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,90.92,61.85,,,percent of total billed charges,61.85% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.16,130,,,Fee Schedule,130% of WA Medicaid ,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,55.42,37.7,,,percent of total billed charges,37.70% of total billed charges,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4983.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.66,78,,,percent of total billed charges,78% of total billed charges,147,100,,,percent of total billed charges,100% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,121.42,82.6,,,percent of total billed charges,82.6% of total billed charges,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.63,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.61,4983.3,
CHEMO ANTI-NEOPL SQ/IM,96401,CDM,983,RC,96401,HCPCS,Outpatient,,,150,97.50,,132,88,,,percent of total billed charges,88% of total Billed charges,3.26,100,,,Fee Schedule,100% of Medicare rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,150,100,,,percent of total billed charges,100% of total billed charges,43.99,103,,,Fee Schedule,103% of WA Medicaid,3.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,42.71,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,103.5,69,,,percent of total billed charges,69% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,150,100,,,percent of total billed charges,100% of total billed charges,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,150,100,,,percent of total billed charges,100% of total billed charges,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.78,61.85,,,percent of total billed charges,61.85% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,55.52,130,,,Fee Schedule,130% of WA Medicaid ,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,56.55,37.7,,,percent of total billed charges,37.70% of total billed charges,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,5085,33.9,,,percent of total billed charges,33.9% of total billed charges,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,117,78,,,percent of total billed charges,78% of total billed charges,150,100,,,percent of total billed charges,100% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,123.9,82.6,,,percent of total billed charges,82.6% of total billed charges,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.71,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.26,5085,
96405 Chemo Adm:Intralesional 1-7 Les,96405,CDM,983,RC,96405,HCPCS,Outpatient,,,374,243.10,,329.12,88,,,percent of total billed charges,88% of total Billed charges,1.64,100,,,Fee Schedule,100% of Medicare rate,16.23,100,,,Fee Schedule,100% of WA Medicaid,374,100,,,percent of total billed charges,100% of total billed charges,16.72,103,,,Fee Schedule,103% of WA Medicaid,1.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.23,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,258.06,69,,,percent of total billed charges,69% of total billed charges,374,100,,,percent of total billed charges,100% of total billed charges,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,374,100,,,percent of total billed charges,100% of total billed charges,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,374,100,,,percent of total billed charges,100% of total billed charges,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,231.32,61.85,,,percent of total billed charges,61.85% of total billed charges,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.23,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.55,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.1,130,,,Fee Schedule,130% of WA Medicaid ,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,141,37.7,,,percent of total billed charges,37.70% of total billed charges,141,37.7,,,percent of total billed charges,37.70% of total billed charges,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,12678.6,33.9,,,percent of total billed charges,33.9% of total billed charges,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,291.72,78,,,percent of total billed charges,78% of total billed charges,374,100,,,percent of total billed charges,100% of total billed charges,308.92,82.6,,,percent of total billed charges,82.6% of total billed charges,308.92,82.6,,,percent of total billed charges,82.6% of total billed charges,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.66,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.23,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.64,12678.6,
96406 Chemo Adm: Intralesional >7 lesions,96406,CDM,983,RC,96406,HCPCS,Outpatient,,,532,345.80,,468.16,88,,,percent of total billed charges,88% of total Billed charges,2.89,100,,,Fee Schedule,100% of Medicare rate,25.18,100,,,Fee Schedule,100% of WA Medicaid,532,100,,,percent of total billed charges,100% of total billed charges,25.94,103,,,Fee Schedule,103% of WA Medicaid,2.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,367.08,69,,,percent of total billed charges,69% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,532,100,,,percent of total billed charges,100% of total billed charges,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,532,100,,,percent of total billed charges,100% of total billed charges,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,329.04,61.85,,,percent of total billed charges,61.85% of total billed charges,25.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.73,130,,,Fee Schedule,130% of WA Medicaid ,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,200.56,37.7,,,percent of total billed charges,37.70% of total billed charges,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,18034.8,33.9,,,percent of total billed charges,33.9% of total billed charges,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,414.96,78,,,percent of total billed charges,78% of total billed charges,532,100,,,percent of total billed charges,100% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,439.43,82.6,,,percent of total billed charges,82.6% of total billed charges,25.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.92,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.89,18034.8,
96409 IV push Technique sgl/init drug,96409,CDM,983,RC,96409,HCPCS,Outpatient,,,504,327.60,,443.52,88,,,percent of total billed charges,88% of total Billed charges,4.65,100,,,Fee Schedule,100% of Medicare rate,59.68,100,,,Fee Schedule,100% of WA Medicaid,504,100,,,percent of total billed charges,100% of total billed charges,61.47,103,,,Fee Schedule,103% of WA Medicaid,4.65,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.14,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.68,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,347.76,69,,,percent of total billed charges,69% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,504,100,,,percent of total billed charges,100% of total billed charges,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,311.72,61.85,,,percent of total billed charges,61.85% of total billed charges,59.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.68,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.87,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,77.58,130,,,Fee Schedule,130% of WA Medicaid ,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,190.01,37.7,,,percent of total billed charges,37.70% of total billed charges,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,17085.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.12,78,,,percent of total billed charges,78% of total billed charges,504,100,,,percent of total billed charges,100% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,416.3,82.6,,,percent of total billed charges,82.6% of total billed charges,59.68,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.65,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.68,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.65,17085.6,
96411 IV push Technique ea add'd drug,96411,CDM,983,RC,96411,HCPCS,Outpatient,,,285,185.25,,250.8,88,,,percent of total billed charges,88% of total Billed charges,2.46,100,,,Fee Schedule,100% of Medicare rate,32.45,100,,,Fee Schedule,100% of WA Medicaid,285,100,,,percent of total billed charges,100% of total billed charges,33.42,103,,,Fee Schedule,103% of WA Medicaid,2.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,32.45,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,196.65,69,,,percent of total billed charges,69% of total billed charges,285,100,,,percent of total billed charges,100% of total billed charges,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,285,100,,,percent of total billed charges,100% of total billed charges,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,285,100,,,percent of total billed charges,100% of total billed charges,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.27,61.85,,,percent of total billed charges,61.85% of total billed charges,32.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.45,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.19,130,,,Fee Schedule,130% of WA Medicaid ,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.45,37.7,,,percent of total billed charges,37.70% of total billed charges,107.45,37.7,,,percent of total billed charges,37.70% of total billed charges,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,9661.5,33.9,,,percent of total billed charges,33.9% of total billed charges,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.3,78,,,percent of total billed charges,78% of total billed charges,285,100,,,percent of total billed charges,100% of total billed charges,235.41,82.6,,,percent of total billed charges,82.6% of total billed charges,235.41,82.6,,,percent of total billed charges,82.6% of total billed charges,32.45,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.45,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.46,9661.5,
96413 Chemo Adm IV inf 1 hr SGL Init,96413,CDM,983,RC,96413,HCPCS,Outpatient,,,616,400.40,,542.08,88,,,percent of total billed charges,88% of total Billed charges,5.82,100,,,Fee Schedule,100% of Medicare rate,77.21,100,,,Fee Schedule,100% of WA Medicaid,616,100,,,percent of total billed charges,100% of total billed charges,79.53,103,,,Fee Schedule,103% of WA Medicaid,5.82,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.19,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,77.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,425.04,69,,,percent of total billed charges,69% of total billed charges,616,100,,,percent of total billed charges,100% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,616,100,,,percent of total billed charges,100% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,616,100,,,percent of total billed charges,100% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,381,61.85,,,percent of total billed charges,61.85% of total billed charges,77.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,78.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,100.37,130,,,Fee Schedule,130% of WA Medicaid ,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.23,37.7,,,percent of total billed charges,37.70% of total billed charges,232.23,37.7,,,percent of total billed charges,37.70% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,20882.4,33.9,,,percent of total billed charges,33.9% of total billed charges,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,480.48,78,,,percent of total billed charges,78% of total billed charges,616,100,,,percent of total billed charges,100% of total billed charges,508.82,82.6,,,percent of total billed charges,82.6% of total billed charges,508.82,82.6,,,percent of total billed charges,82.6% of total billed charges,77.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.82,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.82,20882.4,
96415 Chemo Adm IV inf Ea ADD'l Hr,96415,CDM,983,RC,96415,HCPCS,Outpatient,,,129,83.85,,113.52,88,,,percent of total billed charges,88% of total Billed charges,1.37,100,,,Fee Schedule,100% of Medicare rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,129,100,,,percent of total billed charges,100% of total billed charges,16.9,103,,,Fee Schedule,103% of WA Medicaid,1.37,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.41,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,89.01,69,,,percent of total billed charges,69% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,129,100,,,percent of total billed charges,100% of total billed charges,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,129,100,,,percent of total billed charges,100% of total billed charges,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.79,61.85,,,percent of total billed charges,61.85% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.74,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.33,130,,,Fee Schedule,130% of WA Medicaid ,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,48.63,37.7,,,percent of total billed charges,37.70% of total billed charges,48.63,37.7,,,percent of total billed charges,37.70% of total billed charges,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,4373.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.62,78,,,percent of total billed charges,78% of total billed charges,129,100,,,percent of total billed charges,100% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,106.55,82.6,,,percent of total billed charges,82.6% of total billed charges,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.38,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.37,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.41,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.37,4373.1,
96416 Int or prolong chem >8hr w pump,96416,CDM,983,RC,96416,HCPCS,Outpatient,,,641,416.65,,564.08,88,,,percent of total billed charges,88% of total Billed charges,5.76,100,,,Fee Schedule,100% of Medicare rate,76.09,100,,,Fee Schedule,100% of WA Medicaid,641,100,,,percent of total billed charges,100% of total billed charges,78.37,103,,,Fee Schedule,103% of WA Medicaid,5.76,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.09,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,76.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,442.29,69,,,percent of total billed charges,69% of total billed charges,641,100,,,percent of total billed charges,100% of total billed charges,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,641,100,,,percent of total billed charges,100% of total billed charges,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,641,100,,,percent of total billed charges,100% of total billed charges,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,396.46,61.85,,,percent of total billed charges,61.85% of total billed charges,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,98.92,130,,,Fee Schedule,130% of WA Medicaid ,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.66,37.7,,,percent of total billed charges,37.70% of total billed charges,241.66,37.7,,,percent of total billed charges,37.70% of total billed charges,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,21729.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,499.98,78,,,percent of total billed charges,78% of total billed charges,641,100,,,percent of total billed charges,100% of total billed charges,529.47,82.6,,,percent of total billed charges,82.6% of total billed charges,529.47,82.6,,,percent of total billed charges,82.6% of total billed charges,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.82,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.76,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.76,21729.9,
96417 Ea add'l seq inf dif drug/1 hr,96417,CDM,983,RC,96417,HCPCS,Outpatient,,,285,185.25,,250.8,88,,,percent of total billed charges,88% of total Billed charges,3.01,100,,,Fee Schedule,100% of Medicare rate,37.86,100,,,Fee Schedule,100% of WA Medicaid,285,100,,,percent of total billed charges,100% of total billed charges,39,103,,,Fee Schedule,103% of WA Medicaid,3.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,37.86,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,196.65,69,,,percent of total billed charges,69% of total billed charges,285,100,,,percent of total billed charges,100% of total billed charges,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,285,100,,,percent of total billed charges,100% of total billed charges,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,285,100,,,percent of total billed charges,100% of total billed charges,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.27,61.85,,,percent of total billed charges,61.85% of total billed charges,37.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.62,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,49.22,130,,,Fee Schedule,130% of WA Medicaid ,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.45,37.7,,,percent of total billed charges,37.70% of total billed charges,107.45,37.7,,,percent of total billed charges,37.70% of total billed charges,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,9661.5,33.9,,,percent of total billed charges,33.9% of total billed charges,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,222.3,78,,,percent of total billed charges,78% of total billed charges,285,100,,,percent of total billed charges,100% of total billed charges,235.41,82.6,,,percent of total billed charges,82.6% of total billed charges,235.41,82.6,,,percent of total billed charges,82.6% of total billed charges,37.86,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.86,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.01,9661.5,
96523 Irrigate implanted venous access dev,96523,CDM,260,RC,96523,HCPCS,Outpatient,,,53,34.45,,46.64,88,,,percent of total billed charges,88% of total Billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,53,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,109.18,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,8.11,15.3,,,percent of total billed charges,15.3% of total billed charges,36.57,69,,,percent of total billed charges,69% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,53,100,,,percent of total billed charges,100% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,226.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,19.98,37.7,,,percent of total billed charges,37.70% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,17.97,33.9,,,percent of total billed charges,33.9% of total billed charges,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,41.34,78,,,percent of total billed charges,78% of total billed charges,53,100,,,percent of total billed charges,100% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,43.78,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,63.01,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,62.38,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.11,226.12,
LASER TX SKIN < 250 SQ CM,96920,CDM,983,RC,96920,HCPCS,Outpatient,,,487,316.55,,428.56,88,,,percent of total billed charges,88% of total Billed charges,3.2,100,,,Fee Schedule,100% of Medicare rate,36.18,100,,,Fee Schedule,100% of WA Medicaid,487,100,,,percent of total billed charges,100% of total billed charges,37.27,103,,,Fee Schedule,103% of WA Medicaid,3.2,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,36.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,336.03,69,,,percent of total billed charges,69% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,487,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,487,100,,,percent of total billed charges,100% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,301.21,61.85,,,percent of total billed charges,61.85% of total billed charges,36.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.03,130,,,Fee Schedule,130% of WA Medicaid ,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,183.6,37.7,,,percent of total billed charges,37.70% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,16509.3,33.9,,,percent of total billed charges,33.9% of total billed charges,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.86,78,,,percent of total billed charges,78% of total billed charges,487,100,,,percent of total billed charges,100% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,402.26,82.6,,,percent of total billed charges,82.6% of total billed charges,36.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.2,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.2,16509.3,
HOT OR COLD PACKS THERAPY,97010,CDM,983,RC,97010,HCPCS,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,0.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,34,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,0.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.79,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,34,100,,,percent of total billed charges,100% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,34,100,,,percent of total billed charges,100% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152.6,33.9,,,percent of total billed charges,33.9% of total billed charges,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.45,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",0.45,1152.6,
ULTRASOUND THERAPY,97035,CDM,983,RC,97035,HCPCS,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,0.69,100,,,Fee Schedule,100% of Medicare rate,8.21,100,,,Fee Schedule,100% of WA Medicaid,42,100,,,percent of total billed charges,100% of total billed charges,8.46,103,,,Fee Schedule,103% of WA Medicaid,0.69,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.2,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.21,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,42,100,,,percent of total billed charges,100% of total billed charges,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,42,100,,,percent of total billed charges,100% of total billed charges,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,8.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.21,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.67,130,,,Fee Schedule,130% of WA Medicaid ,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.8,33.9,,,percent of total billed charges,33.9% of total billed charges,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,8.21,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.69,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.21,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.69,1423.8,
RMVL DEVITAL TIS 20 CM/<,97597,CDM,983,RC,97597,HCPCS,Outpatient,,,130.63,84.91,,114.95,88,,,percent of total billed charges,88% of total Billed charges,2.61,100,,,Fee Schedule,100% of Medicare rate,19.77,100,,,Fee Schedule,100% of WA Medicaid,130.63,100,,,percent of total billed charges,100% of total billed charges,20.36,103,,,Fee Schedule,103% of WA Medicaid,2.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.77,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,90.13,69,,,percent of total billed charges,69% of total billed charges,130.63,100,,,percent of total billed charges,100% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.63,100,,,percent of total billed charges,100% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,130.63,100,,,percent of total billed charges,100% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,80.79,61.85,,,percent of total billed charges,61.85% of total billed charges,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.77,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.7,130,,,Fee Schedule,130% of WA Medicaid ,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.25,37.7,,,percent of total billed charges,37.70% of total billed charges,49.25,37.7,,,percent of total billed charges,37.70% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4428.36,33.9,,,percent of total billed charges,33.9% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.89,78,,,percent of total billed charges,78% of total billed charges,130.63,100,,,percent of total billed charges,100% of total billed charges,107.9,82.6,,,percent of total billed charges,82.6% of total billed charges,107.9,82.6,,,percent of total billed charges,82.6% of total billed charges,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.77,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.61,4428.36,
RMVL DEVITAL TIS ADDL 20CM/<,97598,CDM,983,RC,97598,HCPCS,Outpatient,,,155,100.75,,136.4,88,,,percent of total billed charges,88% of total Billed charges,2.28,100,,,Fee Schedule,100% of Medicare rate,13.8,100,,,Fee Schedule,100% of WA Medicaid,155,100,,,percent of total billed charges,100% of total billed charges,14.21,103,,,Fee Schedule,103% of WA Medicaid,2.28,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,106.95,69,,,percent of total billed charges,69% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,155,100,,,percent of total billed charges,100% of total billed charges,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,155,100,,,percent of total billed charges,100% of total billed charges,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.87,61.85,,,percent of total billed charges,61.85% of total billed charges,13.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,17.94,130,,,Fee Schedule,130% of WA Medicaid ,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,58.44,37.7,,,percent of total billed charges,37.70% of total billed charges,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,5254.5,33.9,,,percent of total billed charges,33.9% of total billed charges,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.9,78,,,percent of total billed charges,78% of total billed charges,155,100,,,percent of total billed charges,100% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,128.03,82.6,,,percent of total billed charges,82.6% of total billed charges,13.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.3,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.28,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.28,5254.5,
WOUND(S) CARE NON-SELECTIVE,97602,CDM,983,RC,97602,HCPCS,Outpatient,,,52.14,33.89,,45.88,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52.14,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,35.98,69,,,percent of total billed charges,69% of total billed charges,52.14,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,52.14,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,52.14,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,32.25,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.66,37.7,,,percent of total billed charges,37.70% of total billed charges,19.66,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1767.55,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,40.67,78,,,percent of total billed charges,78% of total billed charges,52.14,100,,,percent of total billed charges,100% of total billed charges,43.07,82.6,,,percent of total billed charges,82.6% of total billed charges,43.07,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",19.66,1767.55,
NEG PRESS WOUND TX </=50 CM,97605,CDM,983,RC,97605,HCPCS,Outpatient,,,143,92.95,,125.84,88,,,percent of total billed charges,88% of total Billed charges,0.99,100,,,Fee Schedule,100% of Medicare rate,13.8,100,,,Fee Schedule,100% of WA Medicaid,143,100,,,percent of total billed charges,100% of total billed charges,14.21,103,,,Fee Schedule,103% of WA Medicaid,0.99,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,13.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,98.67,69,,,percent of total billed charges,69% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,143,100,,,percent of total billed charges,100% of total billed charges,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,143,100,,,percent of total billed charges,100% of total billed charges,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.45,61.85,,,percent of total billed charges,61.85% of total billed charges,13.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.08,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,17.94,130,,,Fee Schedule,130% of WA Medicaid ,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,53.91,37.7,,,percent of total billed charges,37.70% of total billed charges,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,4847.7,33.9,,,percent of total billed charges,33.9% of total billed charges,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.54,78,,,percent of total billed charges,78% of total billed charges,143,100,,,percent of total billed charges,100% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,118.12,82.6,,,percent of total billed charges,82.6% of total billed charges,13.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,1,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.99,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.99,4847.7,
NEG PRESS WOUND TX >50 CM,97606,CDM,983,RC,97606,HCPCS,Outpatient,,,159,103.35,,139.92,88,,,percent of total billed charges,88% of total Billed charges,1.06,100,,,Fee Schedule,100% of Medicare rate,15.11,100,,,Fee Schedule,100% of WA Medicaid,159,100,,,percent of total billed charges,100% of total billed charges,15.56,103,,,Fee Schedule,103% of WA Medicaid,1.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,15.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,109.71,69,,,percent of total billed charges,69% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,159,100,,,percent of total billed charges,100% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,159,100,,,percent of total billed charges,100% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.34,61.85,,,percent of total billed charges,61.85% of total billed charges,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,19.64,130,,,Fee Schedule,130% of WA Medicaid ,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,5390.1,33.9,,,percent of total billed charges,33.9% of total billed charges,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.02,78,,,percent of total billed charges,78% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.07,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.06,5390.1,
PHYSICAL PERFORMANCE TEST,97750,CDM,983,RC,97750,HCPCS,Outpatient,,,100,65.00,,88,88,,,percent of total billed charges,88% of total Billed charges,1.3,100,,,Fee Schedule,100% of Medicare rate,19.96,100,,,Fee Schedule,100% of WA Medicaid,100,100,,,percent of total billed charges,100% of total billed charges,20.56,103,,,Fee Schedule,103% of WA Medicaid,1.3,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,69,69,,,percent of total billed charges,69% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,100,100,,,percent of total billed charges,100% of total billed charges,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,100,100,,,percent of total billed charges,100% of total billed charges,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.85,61.85,,,percent of total billed charges,61.85% of total billed charges,19.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,20.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.95,130,,,Fee Schedule,130% of WA Medicaid ,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,37.7,37.7,,,percent of total billed charges,37.70% of total billed charges,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,3390,33.9,,,percent of total billed charges,33.9% of total billed charges,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,78,78,,,percent of total billed charges,78% of total billed charges,100,100,,,percent of total billed charges,100% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,82.6,82.6,,,percent of total billed charges,82.6% of total billed charges,19.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.3,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.3,3390,
OSTEOPATH MANJ 1-2 REGIONS,98925,CDM,983,RC,98925,HCPCS,Outpatient,,,85,55.25,,74.8,88,,,percent of total billed charges,88% of total Billed charges,1.46,100,,,Fee Schedule,100% of Medicare rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,85,100,,,percent of total billed charges,100% of total billed charges,13.26,103,,,Fee Schedule,103% of WA Medicaid,1.46,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,12.87,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,58.65,69,,,percent of total billed charges,69% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,85,100,,,percent of total billed charges,100% of total billed charges,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,85,100,,,percent of total billed charges,100% of total billed charges,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,52.57,61.85,,,percent of total billed charges,61.85% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,16.73,130,,,Fee Schedule,130% of WA Medicaid ,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,32.05,37.7,,,percent of total billed charges,37.70% of total billed charges,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,2881.5,33.9,,,percent of total billed charges,33.9% of total billed charges,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.3,78,,,percent of total billed charges,78% of total billed charges,85,100,,,percent of total billed charges,100% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,70.21,82.6,,,percent of total billed charges,82.6% of total billed charges,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.47,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.46,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.87,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.46,2881.5,
OSTEOPATH MANJ 3-4 REGIONS,98926,CDM,983,RC,98926,HCPCS,Outpatient,,,121,78.65,,106.48,88,,,percent of total billed charges,88% of total Billed charges,2.08,100,,,Fee Schedule,100% of Medicare rate,19.58,100,,,Fee Schedule,100% of WA Medicaid,121,100,,,percent of total billed charges,100% of total billed charges,20.17,103,,,Fee Schedule,103% of WA Medicaid,2.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,83.49,69,,,percent of total billed charges,69% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,121,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,121,100,,,percent of total billed charges,100% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,74.84,61.85,,,percent of total billed charges,61.85% of total billed charges,19.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.97,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,25.45,130,,,Fee Schedule,130% of WA Medicaid ,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.62,37.7,,,percent of total billed charges,37.70% of total billed charges,45.62,37.7,,,percent of total billed charges,37.70% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,4101.9,33.9,,,percent of total billed charges,33.9% of total billed charges,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.38,78,,,percent of total billed charges,78% of total billed charges,121,100,,,percent of total billed charges,100% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,99.95,82.6,,,percent of total billed charges,82.6% of total billed charges,19.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.1,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.08,4101.9,
OSTEOPATH MANJ 5-6 REGIONS,98927,CDM,983,RC,98927,HCPCS,Outpatient,,,159,103.35,,139.92,88,,,percent of total billed charges,88% of total Billed charges,2.68,100,,,Fee Schedule,100% of Medicare rate,26.11,100,,,Fee Schedule,100% of WA Medicaid,159,100,,,percent of total billed charges,100% of total billed charges,26.89,103,,,Fee Schedule,103% of WA Medicaid,2.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.69,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,26.11,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,109.71,69,,,percent of total billed charges,69% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,159,100,,,percent of total billed charges,100% of total billed charges,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,159,100,,,percent of total billed charges,100% of total billed charges,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.34,61.85,,,percent of total billed charges,61.85% of total billed charges,26.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.11,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.63,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,33.94,130,,,Fee Schedule,130% of WA Medicaid ,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,59.94,37.7,,,percent of total billed charges,37.70% of total billed charges,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,5390.1,33.9,,,percent of total billed charges,33.9% of total billed charges,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,124.02,78,,,percent of total billed charges,78% of total billed charges,159,100,,,percent of total billed charges,100% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,131.33,82.6,,,percent of total billed charges,82.6% of total billed charges,26.11,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.71,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.11,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.68,5390.1,
OSTEOPATH MANJ 7-8 REGIONS,98928,CDM,983,RC,98928,HCPCS,Outpatient,,,194,126.10,,170.72,88,,,percent of total billed charges,88% of total Billed charges,3.56,100,,,Fee Schedule,100% of Medicare rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,194,100,,,percent of total billed charges,100% of total billed charges,34,103,,,Fee Schedule,103% of WA Medicaid,3.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.23,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,33.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,133.86,69,,,percent of total billed charges,69% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,194,100,,,percent of total billed charges,100% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,194,100,,,percent of total billed charges,100% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,119.99,61.85,,,percent of total billed charges,61.85% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,42.91,130,,,Fee Schedule,130% of WA Medicaid ,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,73.14,37.7,,,percent of total billed charges,37.70% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,6576.6,33.9,,,percent of total billed charges,33.9% of total billed charges,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,151.32,78,,,percent of total billed charges,78% of total billed charges,194,100,,,percent of total billed charges,100% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,160.24,82.6,,,percent of total billed charges,82.6% of total billed charges,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.6,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.56,6576.6,
OSTEOPATH MANJ 9-10 REGIONS,98929,CDM,983,RC,98929,HCPCS,Outpatient,,,231,150.15,,203.28,88,,,percent of total billed charges,88% of total Billed charges,4.16,100,,,Fee Schedule,100% of Medicare rate,39.35,100,,,Fee Schedule,100% of WA Medicaid,231,100,,,percent of total billed charges,100% of total billed charges,40.53,103,,,Fee Schedule,103% of WA Medicaid,4.16,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,159.39,69,,,percent of total billed charges,69% of total billed charges,231,100,,,percent of total billed charges,100% of total billed charges,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,231,100,,,percent of total billed charges,100% of total billed charges,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,231,100,,,percent of total billed charges,100% of total billed charges,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,142.87,61.85,,,percent of total billed charges,61.85% of total billed charges,39.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.16,130,,,Fee Schedule,130% of WA Medicaid ,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.09,37.7,,,percent of total billed charges,37.70% of total billed charges,87.09,37.7,,,percent of total billed charges,37.70% of total billed charges,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,7830.9,33.9,,,percent of total billed charges,33.9% of total billed charges,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.18,78,,,percent of total billed charges,78% of total billed charges,231,100,,,percent of total billed charges,100% of total billed charges,190.81,82.6,,,percent of total billed charges,82.6% of total billed charges,190.81,82.6,,,percent of total billed charges,82.6% of total billed charges,39.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.16,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.16,7830.9,
TRANS CARE MGMT 14 DAY DISCH,99495,CDM,983,RC,99495,HCPCS,Outpatient,,,453,294.45,,398.64,88,,,percent of total billed charges,88% of total Billed charges,8.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,453,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,8.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,312.57,69,,,percent of total billed charges,69% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,453,100,,,percent of total billed charges,100% of total billed charges,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,453,100,,,percent of total billed charges,100% of total billed charges,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.18,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,15356.7,33.9,,,percent of total billed charges,33.9% of total billed charges,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.34,78,,,percent of total billed charges,78% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",8.86,15356.7,
ADDITION OF WALKER TO CAST,29440,CDM,983,RC,29440,HCPCS,Outpatient,,,113,73.45,,99.44,88,,,percent of total billed charges,88% of total Billed charges,2.14,100,,,Fee Schedule,100% of Medicare rate,15.85,100,,,Fee Schedule,100% of WA Medicaid,113,100,,,percent of total billed charges,100% of total billed charges,16.33,103,,,Fee Schedule,103% of WA Medicaid,2.14,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.74,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,15.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,77.97,69,,,percent of total billed charges,69% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,113,100,,,percent of total billed charges,100% of total billed charges,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,113,100,,,percent of total billed charges,100% of total billed charges,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.89,61.85,,,percent of total billed charges,61.85% of total billed charges,15.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.61,130,,,Fee Schedule,130% of WA Medicaid ,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,42.6,37.7,,,percent of total billed charges,37.70% of total billed charges,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,3830.7,33.9,,,percent of total billed charges,33.9% of total billed charges,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,88.14,78,,,percent of total billed charges,78% of total billed charges,113,100,,,percent of total billed charges,100% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,93.34,82.6,,,percent of total billed charges,82.6% of total billed charges,15.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.16,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.14,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.14,3830.7,
APPLY FINGER CAST,29086,CDM,983,RC,29086,HCPCS,Outpatient,,,124,80.60,,109.12,88,,,percent of total billed charges,88% of total Billed charges,3.33,100,,,Fee Schedule,100% of Medicare rate,28.91,100,,,Fee Schedule,100% of WA Medicaid,124,100,,,percent of total billed charges,100% of total billed charges,29.78,103,,,Fee Schedule,103% of WA Medicaid,3.33,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,5.82,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.91,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,85.56,69,,,percent of total billed charges,69% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,124,100,,,percent of total billed charges,100% of total billed charges,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,124,100,,,percent of total billed charges,100% of total billed charges,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.69,61.85,,,percent of total billed charges,61.85% of total billed charges,28.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.91,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.49,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,37.58,130,,,Fee Schedule,130% of WA Medicaid ,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,46.75,37.7,,,percent of total billed charges,37.70% of total billed charges,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,4203.6,33.9,,,percent of total billed charges,33.9% of total billed charges,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,96.72,78,,,percent of total billed charges,78% of total billed charges,124,100,,,percent of total billed charges,100% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,102.42,82.6,,,percent of total billed charges,82.6% of total billed charges,28.91,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.33,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.91,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.33,4203.6,
APPLY LONG ARM SPLINT,29105,CDM,983,RC,29105,HCPCS,Outpatient,,,148.79,96.71,,130.94,88,,,percent of total billed charges,88% of total Billed charges,5.38,100,,,Fee Schedule,100% of Medicare rate,23.31,100,,,Fee Schedule,100% of WA Medicaid,148.79,100,,,percent of total billed charges,100% of total billed charges,24.01,103,,,Fee Schedule,103% of WA Medicaid,5.38,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,23.31,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,102.67,69,,,percent of total billed charges,69% of total billed charges,148.79,100,,,percent of total billed charges,100% of total billed charges,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.79,100,,,percent of total billed charges,100% of total billed charges,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,148.79,100,,,percent of total billed charges,100% of total billed charges,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.03,61.85,,,percent of total billed charges,61.85% of total billed charges,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.31,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.78,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,30.3,130,,,Fee Schedule,130% of WA Medicaid ,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.09,37.7,,,percent of total billed charges,37.70% of total billed charges,56.09,37.7,,,percent of total billed charges,37.70% of total billed charges,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,5043.98,33.9,,,percent of total billed charges,33.9% of total billed charges,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.06,78,,,percent of total billed charges,78% of total billed charges,148.79,100,,,percent of total billed charges,100% of total billed charges,122.9,82.6,,,percent of total billed charges,82.6% of total billed charges,122.9,82.6,,,percent of total billed charges,82.6% of total billed charges,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.43,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.38,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.31,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.38,5043.98,
APPLICATION OF LONG LEG CAST,29355,CDM,983,RC,29355,HCPCS,Outpatient,,,327,212.55,,287.76,88,,,percent of total billed charges,88% of total Billed charges,10.98,100,,,Fee Schedule,100% of Medicare rate,60.8,100,,,Fee Schedule,100% of WA Medicaid,327,100,,,percent of total billed charges,100% of total billed charges,62.62,103,,,Fee Schedule,103% of WA Medicaid,10.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.22,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,60.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,225.63,69,,,percent of total billed charges,69% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,327,100,,,percent of total billed charges,100% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,327,100,,,percent of total billed charges,100% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.25,61.85,,,percent of total billed charges,61.85% of total billed charges,60.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,62.02,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,79.04,130,,,Fee Schedule,130% of WA Medicaid ,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,123.28,37.7,,,percent of total billed charges,37.70% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,11085.3,33.9,,,percent of total billed charges,33.9% of total billed charges,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,255.06,78,,,percent of total billed charges,78% of total billed charges,327,100,,,percent of total billed charges,100% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,270.1,82.6,,,percent of total billed charges,82.6% of total billed charges,60.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,60.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.98,11085.3,
APPLY SHORT LEG CAST,29425,CDM,983,RC,29425,HCPCS,Outpatient,,,260,169.00,,228.8,88,,,percent of total billed charges,88% of total Billed charges,4.24,100,,,Fee Schedule,100% of Medicare rate,31.33,100,,,Fee Schedule,100% of WA Medicaid,260,100,,,percent of total billed charges,100% of total billed charges,32.27,103,,,Fee Schedule,103% of WA Medicaid,4.24,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.42,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,31.33,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,179.4,69,,,percent of total billed charges,69% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,260,100,,,percent of total billed charges,100% of total billed charges,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,260,100,,,percent of total billed charges,100% of total billed charges,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,160.81,61.85,,,percent of total billed charges,61.85% of total billed charges,31.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.33,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.96,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.73,130,,,Fee Schedule,130% of WA Medicaid ,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,98.02,37.7,,,percent of total billed charges,37.70% of total billed charges,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,8814,33.9,,,percent of total billed charges,33.9% of total billed charges,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.8,78,,,percent of total billed charges,78% of total billed charges,260,100,,,percent of total billed charges,100% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,214.76,82.6,,,percent of total billed charges,82.6% of total billed charges,31.33,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.28,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.24,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.33,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.24,8814,
APPLY RIGID LEG CAST,29445,CDM,983,RC,29445,HCPCS,Outpatient,,,486,315.90,,427.68,88,,,percent of total billed charges,88% of total Billed charges,8.15,100,,,Fee Schedule,100% of Medicare rate,56.14,100,,,Fee Schedule,100% of WA Medicaid,486,100,,,percent of total billed charges,100% of total billed charges,57.82,103,,,Fee Schedule,103% of WA Medicaid,8.15,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,56.14,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,335.34,69,,,percent of total billed charges,69% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,486,100,,,percent of total billed charges,100% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,300.59,61.85,,,percent of total billed charges,61.85% of total billed charges,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.14,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.26,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,72.98,130,,,Fee Schedule,130% of WA Medicaid ,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,183.22,37.7,,,percent of total billed charges,37.70% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,16475.4,33.9,,,percent of total billed charges,33.9% of total billed charges,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,379.08,78,,,percent of total billed charges,78% of total billed charges,486,100,,,percent of total billed charges,100% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,401.44,82.6,,,percent of total billed charges,82.6% of total billed charges,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.15,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.14,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.15,16475.4,
"BIOPSY, INTRANASAL",30100,CDM,983,RC,30100,HCPCS,Outpatient,,,251,163.15,,220.88,88,,,percent of total billed charges,88% of total Billed charges,5.45,100,,,Fee Schedule,100% of Medicare rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,251,100,,,percent of total billed charges,100% of total billed charges,40.73,103,,,Fee Schedule,103% of WA Medicaid,5.45,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,39.54,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,173.19,69,,,percent of total billed charges,69% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,251,100,,,percent of total billed charges,100% of total billed charges,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,251,100,,,percent of total billed charges,100% of total billed charges,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.24,61.85,,,percent of total billed charges,61.85% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicare OPPS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.4,130,,,Fee Schedule,130% of WA Medicaid ,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,94.63,37.7,,,percent of total billed charges,37.70% of total billed charges,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,8508.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.78,78,,,percent of total billed charges,78% of total billed charges,251,100,,,percent of total billed charges,100% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,207.33,82.6,,,percent of total billed charges,82.6% of total billed charges,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.5,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.45,100,,,Fee Schedule,100% of Medicare RBRVS rate,39.54,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.45,8508.9,
RELEASE OF FOOT CONTRACTURE,28270,CDM,983,RC,28270,HCPCS,Outpatient,,,1003,651.95,,882.64,88,,,percent of total billed charges,88% of total Billed charges,22.96,100,,,Fee Schedule,100% of Medicare rate,195.08,100,,,Fee Schedule,100% of WA Medicaid,1003,100,,,percent of total billed charges,100% of total billed charges,200.93,103,,,Fee Schedule,103% of WA Medicaid,22.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,195.08,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,692.07,69,,,percent of total billed charges,69% of total billed charges,1003,100,,,percent of total billed charges,100% of total billed charges,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1003,100,,,percent of total billed charges,100% of total billed charges,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1003,100,,,percent of total billed charges,100% of total billed charges,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,620.36,61.85,,,percent of total billed charges,61.85% of total billed charges,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.08,100,,,Fee Schedule,100% of WA Medicare OPPS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.98,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,253.6,130,,,Fee Schedule,130% of WA Medicaid ,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,378.13,37.7,,,percent of total billed charges,37.70% of total billed charges,378.13,37.7,,,percent of total billed charges,37.70% of total billed charges,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,34001.7,33.9,,,percent of total billed charges,33.9% of total billed charges,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,782.34,78,,,percent of total billed charges,78% of total billed charges,1003,100,,,percent of total billed charges,100% of total billed charges,828.48,82.6,,,percent of total billed charges,82.6% of total billed charges,828.48,82.6,,,percent of total billed charges,82.6% of total billed charges,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,22.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,22.96,34001.7,
TREAT FX TIB SHAFT +/- FIB,27750,CDM,983,RC,27750,HCPCS,Outpatient,,,1156,751.40,,1017.28,88,,,percent of total billed charges,88% of total Billed charges,27.6,100,,,Fee Schedule,100% of Medicare rate,195.27,100,,,Fee Schedule,100% of WA Medicaid,1156,100,,,percent of total billed charges,100% of total billed charges,201.13,103,,,Fee Schedule,103% of WA Medicaid,27.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,48.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,195.27,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,797.64,69,,,percent of total billed charges,69% of total billed charges,1156,100,,,percent of total billed charges,100% of total billed charges,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1156,100,,,percent of total billed charges,100% of total billed charges,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,1156,100,,,percent of total billed charges,100% of total billed charges,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.99,61.85,,,percent of total billed charges,61.85% of total billed charges,195.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.27,100,,,Fee Schedule,100% of WA Medicare OPPS rate,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,199.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,253.85,130,,,Fee Schedule,130% of WA Medicaid ,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,435.81,37.7,,,percent of total billed charges,37.70% of total billed charges,435.81,37.7,,,percent of total billed charges,37.70% of total billed charges,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,39188.4,33.9,,,percent of total billed charges,33.9% of total billed charges,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,901.68,78,,,percent of total billed charges,78% of total billed charges,1156,100,,,percent of total billed charges,100% of total billed charges,954.86,82.6,,,percent of total billed charges,82.6% of total billed charges,954.86,82.6,,,percent of total billed charges,82.6% of total billed charges,195.27,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.88,101,,,Fee Schedule,101% of Medicare RBRVS rate,27.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,195.27,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,27.6,39188.4,
CLOSED TX OF NASAL BONE FX W/STABILIZTIO,21320,CDM,983,RC,21320,HCPCS,Outpatient,,,457,297.05,,402.16,88,,,percent of total billed charges,88% of total Billed charges,9.08,100,,,Fee Schedule,100% of Medicare rate,54.09,100,,,Fee Schedule,100% of WA Medicaid,457,100,,,percent of total billed charges,100% of total billed charges,55.71,103,,,Fee Schedule,103% of WA Medicaid,9.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.88,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,54.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,315.33,69,,,percent of total billed charges,69% of total billed charges,457,100,,,percent of total billed charges,100% of total billed charges,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,457,100,,,percent of total billed charges,100% of total billed charges,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,457,100,,,percent of total billed charges,100% of total billed charges,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.65,61.85,,,percent of total billed charges,61.85% of total billed charges,54.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,70.32,130,,,Fee Schedule,130% of WA Medicaid ,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.29,37.7,,,percent of total billed charges,37.70% of total billed charges,172.29,37.7,,,percent of total billed charges,37.70% of total billed charges,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,15492.3,33.9,,,percent of total billed charges,33.9% of total billed charges,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.46,78,,,percent of total billed charges,78% of total billed charges,457,100,,,percent of total billed charges,100% of total billed charges,377.48,82.6,,,percent of total billed charges,82.6% of total billed charges,377.48,82.6,,,percent of total billed charges,82.6% of total billed charges,54.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.17,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,54.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.08,15492.3,
TREAT FX PROX FIB/FIB SHAFT,27780,CDM,983,RC,27780,HCPCS,Outpatient,,,725,471.25,,638,88,,,percent of total billed charges,88% of total Billed charges,23.06,100,,,Fee Schedule,100% of Medicare rate,172.89,100,,,Fee Schedule,100% of WA Medicaid,725,100,,,percent of total billed charges,100% of total billed charges,178.08,103,,,Fee Schedule,103% of WA Medicaid,23.06,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,40.35,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,172.89,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,500.25,69,,,percent of total billed charges,69% of total billed charges,725,100,,,percent of total billed charges,100% of total billed charges,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,725,100,,,percent of total billed charges,100% of total billed charges,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,725,100,,,percent of total billed charges,100% of total billed charges,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,448.41,61.85,,,percent of total billed charges,61.85% of total billed charges,172.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.89,100,,,Fee Schedule,100% of WA Medicare OPPS rate,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,176.35,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,224.76,130,,,Fee Schedule,130% of WA Medicaid ,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,273.33,37.7,,,percent of total billed charges,37.70% of total billed charges,273.33,37.7,,,percent of total billed charges,37.70% of total billed charges,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,24577.5,33.9,,,percent of total billed charges,33.9% of total billed charges,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,565.5,78,,,percent of total billed charges,78% of total billed charges,725,100,,,percent of total billed charges,100% of total billed charges,598.85,82.6,,,percent of total billed charges,82.6% of total billed charges,598.85,82.6,,,percent of total billed charges,82.6% of total billed charges,172.89,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.29,101,,,Fee Schedule,101% of Medicare RBRVS rate,23.06,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.89,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,23.06,24577.5,
TREAT FX BI-MALLEOLUS,27808,CDM,983,RC,27808,HCPCS,Outpatient,,,602,391.30,,529.76,88,,,percent of total billed charges,88% of total Billed charges,24.5,100,,,Fee Schedule,100% of Medicare rate,185.57,100,,,Fee Schedule,100% of WA Medicaid,602,100,,,percent of total billed charges,100% of total billed charges,191.14,103,,,Fee Schedule,103% of WA Medicaid,24.5,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,185.57,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,415.38,69,,,percent of total billed charges,69% of total billed charges,602,100,,,percent of total billed charges,100% of total billed charges,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,602,100,,,percent of total billed charges,100% of total billed charges,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,602,100,,,percent of total billed charges,100% of total billed charges,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,372.34,61.85,,,percent of total billed charges,61.85% of total billed charges,185.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.57,100,,,Fee Schedule,100% of WA Medicare OPPS rate,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,241.24,130,,,Fee Schedule,130% of WA Medicaid ,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.95,37.7,,,percent of total billed charges,37.70% of total billed charges,226.95,37.7,,,percent of total billed charges,37.70% of total billed charges,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,20407.8,33.9,,,percent of total billed charges,33.9% of total billed charges,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,469.56,78,,,percent of total billed charges,78% of total billed charges,602,100,,,percent of total billed charges,100% of total billed charges,497.25,82.6,,,percent of total billed charges,82.6% of total billed charges,497.25,82.6,,,percent of total billed charges,82.6% of total billed charges,185.57,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,24.75,101,,,Fee Schedule,101% of Medicare RBRVS rate,24.5,100,,,Fee Schedule,100% of Medicare RBRVS rate,185.57,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,24.5,20407.8,
TREAT TOE DISLOCATION,28660,CDM,983,RC,28660,HCPCS,Outpatient,,,216,140.40,,190.08,88,,,percent of total billed charges,88% of total Billed charges,9.12,100,,,Fee Schedule,100% of Medicare rate,55.02,100,,,Fee Schedule,100% of WA Medicaid,216,100,,,percent of total billed charges,100% of total billed charges,56.67,103,,,Fee Schedule,103% of WA Medicaid,9.12,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.96,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,55.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,149.04,69,,,percent of total billed charges,69% of total billed charges,216,100,,,percent of total billed charges,100% of total billed charges,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,216,100,,,percent of total billed charges,100% of total billed charges,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,216,100,,,percent of total billed charges,100% of total billed charges,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,133.6,61.85,,,percent of total billed charges,61.85% of total billed charges,55.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,56.12,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,71.53,130,,,Fee Schedule,130% of WA Medicaid ,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.43,37.7,,,percent of total billed charges,37.70% of total billed charges,81.43,37.7,,,percent of total billed charges,37.70% of total billed charges,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,7322.4,33.9,,,percent of total billed charges,33.9% of total billed charges,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,168.48,78,,,percent of total billed charges,78% of total billed charges,216,100,,,percent of total billed charges,100% of total billed charges,178.42,82.6,,,percent of total billed charges,82.6% of total billed charges,178.42,82.6,,,percent of total billed charges,82.6% of total billed charges,55.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.12,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.12,7322.4,
"DRAINAGE ABSCESSOR HEMATOMA,NASAL SEPTUM",30020,CDM,983,RC,30020,HCPCS,Outpatient,,,576,374.40,,506.88,88,,,percent of total billed charges,88% of total Billed charges,9.47,100,,,Fee Schedule,100% of Medicare rate,71.8,100,,,Fee Schedule,100% of WA Medicaid,576,100,,,percent of total billed charges,100% of total billed charges,73.95,103,,,Fee Schedule,103% of WA Medicaid,9.47,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,16.58,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,71.8,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,397.44,69,,,percent of total billed charges,69% of total billed charges,576,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,576,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,576,100,,,percent of total billed charges,100% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,356.26,61.85,,,percent of total billed charges,61.85% of total billed charges,71.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.8,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.24,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,93.34,130,,,Fee Schedule,130% of WA Medicaid ,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,217.15,37.7,,,percent of total billed charges,37.70% of total billed charges,217.15,37.7,,,percent of total billed charges,37.70% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,19526.4,33.9,,,percent of total billed charges,33.9% of total billed charges,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,449.28,78,,,percent of total billed charges,78% of total billed charges,576,100,,,percent of total billed charges,100% of total billed charges,475.78,82.6,,,percent of total billed charges,82.6% of total billed charges,475.78,82.6,,,percent of total billed charges,82.6% of total billed charges,71.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.56,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.47,100,,,Fee Schedule,100% of Medicare RBRVS rate,71.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.47,19526.4,
PROSTATE CA SCREENING; DRE,G0102,CDM,983,RC,,,Outpatient,,,55,35.75,,48.4,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,55,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,37.95,69,,,percent of total billed charges,69% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,55,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,55,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,34.02,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,20.74,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1864.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,42.9,78,,,percent of total billed charges,78% of total billed charges,55,100,,,percent of total billed charges,100% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,45.43,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",20.74,1864.5,
CA SCREEN;PELVIC/BREAST EXAM,G0101,CDM,983,RC,,,Outpatient,,,104,67.60,,91.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,104,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,71.76,69,,,percent of total billed charges,69% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,104,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,104,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,64.32,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,39.21,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,3525.6,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,81.12,78,,,percent of total billed charges,78% of total billed charges,104,100,,,percent of total billed charges,100% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,85.9,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",39.21,3525.6,
CA SCREEN;FLEXI SIGMOIDSCOPE,G0104,CDM,983,RC,,,Outpatient,,,385,250.25,,338.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,385,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,265.65,69,,,percent of total billed charges,69% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,385,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,385,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,238.12,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,13051.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,300.3,78,,,percent of total billed charges,78% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",145.15,13051.5,
G0105 Colonoscopy; High Risk,G0105,CDM,983,RC,,,Outpatient,,,552,358.80,,485.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,380.88,69,,,percent of total billed charges,69% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,341.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,18712.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,430.56,78,,,percent of total billed charges,78% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",208.1,18712.8,
TRIM NAIL(S),G0127,CDM,983,RC,,,Outpatient,,,62,40.30,,54.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,62,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,42.78,69,,,percent of total billed charges,69% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,62,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,62,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,38.35,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,23.37,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2101.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,48.36,78,,,percent of total billed charges,78% of total billed charges,62,100,,,percent of total billed charges,100% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,51.21,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",23.37,2101.8,
G0121 Colorectal Cancer Screen,G0121,CDM,983,RC,,,Outpatient,,,552,358.80,,485.76,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,380.88,69,,,percent of total billed charges,69% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,552,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,341.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,208.1,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,18712.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,430.56,78,,,percent of total billed charges,78% of total billed charges,552,100,,,percent of total billed charges,100% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,455.95,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",208.1,18712.8,
Initial foot exam pt lops,G0245,CDM,983,RC,,,Outpatient,,,378,245.70,,332.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,260.82,69,,,percent of total billed charges,69% of total billed charges,378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,233.79,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,142.51,37.7,,,percent of total billed charges,37.70% of total billed charges,142.51,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12814.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,294.84,78,,,percent of total billed charges,78% of total billed charges,378,100,,,percent of total billed charges,100% of total billed charges,312.23,82.6,,,percent of total billed charges,82.6% of total billed charges,312.23,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",142.51,12814.2,
Routine foot care by physician of a diabetic,G0247,CDM,983,RC,,,Outpatient,,,632,410.80,,556.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,632,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,436.08,69,,,percent of total billed charges,69% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,632,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,632,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,390.89,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,238.26,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,21424.8,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,492.96,78,,,percent of total billed charges,78% of total billed charges,632,100,,,percent of total billed charges,100% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,522.03,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",238.26,21424.8,
G0246 F/U EVAL DIABETIC PT W/LOPS,G0246,CDM,983,RC,,,Outpatient,,,378,245.70,,332.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,260.82,69,,,percent of total billed charges,69% of total billed charges,378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,378,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,233.79,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,142.51,37.7,,,percent of total billed charges,37.70% of total billed charges,142.51,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,12814.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,294.84,78,,,percent of total billed charges,78% of total billed charges,378,100,,,percent of total billed charges,100% of total billed charges,312.23,82.6,,,percent of total billed charges,82.6% of total billed charges,312.23,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",142.51,12814.2,
INITIAL PREVENTIVE EXAM,G0402,CDM,983,RC,,,Outpatient,,,431,280.15,,379.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,431,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,297.39,69,,,percent of total billed charges,69% of total billed charges,431,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,431,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,431,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,266.57,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,162.49,37.7,,,percent of total billed charges,37.70% of total billed charges,162.49,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,14610.9,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,336.18,78,,,percent of total billed charges,78% of total billed charges,431,100,,,percent of total billed charges,100% of total billed charges,356.01,82.6,,,percent of total billed charges,82.6% of total billed charges,356.01,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",162.49,14610.9,
"PPPS, INITIAL VISIT",G0438,CDM,983,RC,,,Outpatient,,,460,299.00,,404.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,460,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,317.4,69,,,percent of total billed charges,69% of total billed charges,460,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,460,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,460,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,284.51,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,173.42,37.7,,,percent of total billed charges,37.70% of total billed charges,173.42,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15594,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,358.8,78,,,percent of total billed charges,78% of total billed charges,460,100,,,percent of total billed charges,100% of total billed charges,379.96,82.6,,,percent of total billed charges,82.6% of total billed charges,379.96,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",173.42,15594,
"PPPS, SUBSEQ VISIT",G0439,CDM,983,RC,,,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,308,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,308,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,308,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,190.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,10441.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",116.12,10441.2,
G0439 Telehealth Annual Wellness Visit FFS - Subsequent AMB,TELEG0439,CDM,983,RC,,,Outpatient,,,308,200.20,,271.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,308,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,212.52,69,,,percent of total billed charges,69% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,308,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,308,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,190.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,116.12,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,10441.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,240.24,78,,,percent of total billed charges,78% of total billed charges,308,100,,,percent of total billed charges,100% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,254.41,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",116.12,10441.2,
G0438 Telehealth Annual Wellness Visit FFS - Initial AMB,TELEG0438,CDM,983,RC,,,Outpatient,,,460,299.00,,404.8,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,460,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,317.4,69,,,percent of total billed charges,69% of total billed charges,460,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,460,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,460,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,284.51,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,173.42,37.7,,,percent of total billed charges,37.70% of total billed charges,173.42,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,15594,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,358.8,78,,,percent of total billed charges,78% of total billed charges,460,100,,,percent of total billed charges,100% of total billed charges,379.96,82.6,,,percent of total billed charges,82.6% of total billed charges,379.96,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",173.42,15594,
DEPRESSION SCREEN ANNUAL,G0444,CDM,983,RC,,,Outpatient,,,50,32.50,,44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,34.5,69,,,percent of total billed charges,69% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,50,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,50,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,30.93,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18.85,37.7,,,percent of total billed charges,37.70% of total billed charges,18.85,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1695,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,39,78,,,percent of total billed charges,78% of total billed charges,50,100,,,percent of total billed charges,100% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,41.3,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",18.85,1695,
BEHAVIOR COUNSEL OBESITY 15M,G0447,CDM,983,RC,,,Outpatient,,,56,36.40,,49.28,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,56,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,38.64,69,,,percent of total billed charges,69% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,56,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,56,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,34.64,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,21.11,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1898.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,43.68,78,,,percent of total billed charges,78% of total billed charges,56,100,,,percent of total billed charges,100% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,46.26,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",21.11,1898.4,
EAR CARTILAGE GRAFT,21235,CDM,983,RC,21235,HCPCS,Outpatient,,,1180,767.00,,1038.4,88,,,percent of total billed charges,88% of total Billed charges,44.91,100,,,Fee Schedule,100% of Medicare rate,331.78,100,,,Fee Schedule,100% of WA Medicaid,1180,100,,,percent of total billed charges,100% of total billed charges,341.73,103,,,Fee Schedule,103% of WA Medicaid,44.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,78.6,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,331.78,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,814.2,69,,,percent of total billed charges,69% of total billed charges,1180,100,,,percent of total billed charges,100% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1180,100,,,percent of total billed charges,100% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,1180,100,,,percent of total billed charges,100% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,729.83,61.85,,,percent of total billed charges,61.85% of total billed charges,331.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.78,100,,,Fee Schedule,100% of WA Medicare OPPS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,338.42,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,431.31,130,,,Fee Schedule,130% of WA Medicaid ,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,444.86,37.7,,,percent of total billed charges,37.70% of total billed charges,444.86,37.7,,,percent of total billed charges,37.70% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,40002,33.9,,,percent of total billed charges,33.9% of total billed charges,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,920.4,78,,,percent of total billed charges,78% of total billed charges,1180,100,,,percent of total billed charges,100% of total billed charges,974.68,82.6,,,percent of total billed charges,82.6% of total billed charges,974.68,82.6,,,percent of total billed charges,82.6% of total billed charges,331.78,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,45.36,101,,,Fee Schedule,101% of Medicare RBRVS rate,44.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,331.78,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,44.91,40002,
Hematocrit POC,85014,CDM,300,RC,85014,HCPCS,Outpatient,,,18,11.70,,15.84,88,,,percent of total billed charges,88% of total Billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,18,100,,,percent of total billed charges,100% of total billed charges,5.23,103,,,Fee Schedule,103% of WA Medicaid,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,11.34,63,,,percent of total billed charges,63% of total billed charges,4.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid,2.75,15.3,,,percent of total billed charges,15.3% of total billed charges,12.42,69,,,percent of total billed charges,69% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,18,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,18,100,,,percent of total billed charges,100% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.06,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,3.76,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.61,130,,,Fee Schedule,130% of WA Medicaid ,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,6.79,37.7,,,percent of total billed charges,37.70% of total billed charges,6.79,37.7,,,percent of total billed charges,37.70% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,6.1,33.9,,,percent of total billed charges,33.9% of total billed charges,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,14.04,78,,,percent of total billed charges,78% of total billed charges,18,100,,,percent of total billed charges,100% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,14.87,82.6,,,percent of total billed charges,82.6% of total billed charges,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,2.39,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,2.37,100,,,Fee Schedule,100% of Medicare OPPS rate,5.08,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.37,18,
Hemoglobin A1c POC,83036,CDM,300,RC,83036,HCPCS,Outpatient,,,60,39.00,,52.8,88,,,percent of total billed charges,88% of total Billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,60,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,37.8,63,,,percent of total billed charges,63% of total billed charges,16.99,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,9.18,15.3,,,percent of total billed charges,15.3% of total billed charges,41.4,69,,,percent of total billed charges,69% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,60,100,,,percent of total billed charges,100% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,37.14,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,22.62,37.7,,,percent of total billed charges,37.70% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,20.34,33.9,,,percent of total billed charges,33.9% of total billed charges,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,46.8,78,,,percent of total billed charges,78% of total billed charges,60,100,,,percent of total billed charges,100% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,49.56,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,9.8,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,9.71,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,60,
Hemoccult POC.,82270,CDM,300,RC,82270,HCPCS,Outpatient,,,25,16.25,QW,22,88,,,percent of total billed charges,88% of total Billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,25,100,,,percent of total billed charges,100% of total billed charges,4.53,103,,,Fee Schedule,103% of WA Medicaid,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,15.75,63,,,percent of total billed charges,63% of total billed charges,7.66,175,,,Fee Schedule,175% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,25,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,25,100,,,percent of total billed charges,100% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,16.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,3.25,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.48,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.71,130,,,Fee Schedule,130% of WA Medicaid ,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,8.48,33.9,,,percent of total billed charges,33.9% of total billed charges,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.42,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.38,100,,,Fee Schedule,100% of Medicare OPPS rate,4.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.25,25,
"NASAL/SINUS ENDOSCOPY,SURG W BIOPSY,POLY",31237,CDM,983,RC,31237,HCPCS,Outpatient,,,605,393.25,,532.4,88,,,percent of total billed charges,88% of total Billed charges,14.66,100,,,Fee Schedule,100% of Medicare rate,91.01,100,,,Fee Schedule,100% of WA Medicaid,605,100,,,percent of total billed charges,100% of total billed charges,93.74,103,,,Fee Schedule,103% of WA Medicaid,14.66,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25.65,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,91.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,417.45,69,,,percent of total billed charges,69% of total billed charges,605,100,,,percent of total billed charges,100% of total billed charges,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,605,100,,,percent of total billed charges,100% of total billed charges,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,605,100,,,percent of total billed charges,100% of total billed charges,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,374.19,61.85,,,percent of total billed charges,61.85% of total billed charges,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,118.31,130,,,Fee Schedule,130% of WA Medicaid ,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,228.09,37.7,,,percent of total billed charges,37.70% of total billed charges,228.09,37.7,,,percent of total billed charges,37.70% of total billed charges,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,20509.5,33.9,,,percent of total billed charges,33.9% of total billed charges,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,471.9,78,,,percent of total billed charges,78% of total billed charges,605,100,,,percent of total billed charges,100% of total billed charges,499.73,82.6,,,percent of total billed charges,82.6% of total billed charges,499.73,82.6,,,percent of total billed charges,82.6% of total billed charges,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.81,101,,,Fee Schedule,101% of Medicare RBRVS rate,14.66,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,14.66,20509.5,
PPD Administration (TB Screen) POC,86580,CDM,300,RC,86580,HCPCS,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,33,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,20.79,63,,,percent of total billed charges,63% of total billed charges,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,11.19,33.9,,,percent of total billed charges,33.9% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.05,100.22,
PT/INR POC.,85610,CDM,300,RC,85610,HCPCS,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,22,100,,,percent of total billed charges,100% of total billed charges,3.45,103,,,Fee Schedule,103% of WA Medicaid,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,13.86,63,,,percent of total billed charges,63% of total billed charges,7.5,175,,,Fee Schedule,175% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,22,100,,,percent of total billed charges,100% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,16.4,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.41,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,4.35,130,,,Fee Schedule,130% of WA Medicaid ,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,8.29,37.7,,,percent of total billed charges,37.70% of total billed charges,8.29,37.7,,,percent of total billed charges,37.70% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,7.46,33.9,,,percent of total billed charges,33.9% of total billed charges,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,4.33,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,4.29,100,,,Fee Schedule,100% of Medicare OPPS rate,3.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.48,22,
REMOVAL/REVISION OF CAST,29705,CDM,983,RC,29705,HCPCS,Outpatient,,,132,85.80,,116.16,88,,,percent of total billed charges,88% of total Billed charges,4.44,100,,,Fee Schedule,100% of Medicare rate,25.18,100,,,Fee Schedule,100% of WA Medicaid,132,100,,,percent of total billed charges,100% of total billed charges,25.94,103,,,Fee Schedule,103% of WA Medicaid,4.44,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,25.18,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,91.08,69,,,percent of total billed charges,69% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,132,100,,,percent of total billed charges,100% of total billed charges,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,132,100,,,percent of total billed charges,100% of total billed charges,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.64,61.85,,,percent of total billed charges,61.85% of total billed charges,25.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.18,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,32.73,130,,,Fee Schedule,130% of WA Medicaid ,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,49.76,37.7,,,percent of total billed charges,37.70% of total billed charges,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,4474.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.96,78,,,percent of total billed charges,78% of total billed charges,132,100,,,percent of total billed charges,100% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,109.03,82.6,,,percent of total billed charges,82.6% of total billed charges,25.18,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.48,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.44,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.18,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.44,4474.8,
STRAPPING OF KNEE,29530,CDM,983,RC,29530,HCPCS,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,1.05,100,,,Fee Schedule,100% of Medicare rate,10.07,100,,,Fee Schedule,100% of WA Medicaid,90,100,,,percent of total billed charges,100% of total billed charges,10.37,103,,,Fee Schedule,103% of WA Medicaid,1.05,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,10.07,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,90,100,,,percent of total billed charges,100% of total billed charges,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,90,100,,,percent of total billed charges,100% of total billed charges,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.67,61.85,,,percent of total billed charges,61.85% of total billed charges,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.07,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,13.09,130,,,Fee Schedule,130% of WA Medicaid ,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,33.93,37.7,,,percent of total billed charges,37.70% of total billed charges,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,3051,33.9,,,percent of total billed charges,33.9% of total billed charges,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.06,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.05,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.07,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.05,3051,
Urine Microscopy POC,81001,CDM,300,RC,81001,HCPCS,Outpatient,,,31,20.15,,27.28,88,,,percent of total billed charges,88% of total Billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,31,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,19.53,63,,,percent of total billed charges,63% of total billed charges,5.54,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,4.74,15.3,,,percent of total billed charges,15.3% of total billed charges,21.39,69,,,percent of total billed charges,69% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,31,100,,,percent of total billed charges,100% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,12.12,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,11.69,37.7,,,percent of total billed charges,37.70% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,10.51,33.9,,,percent of total billed charges,33.9% of total billed charges,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,24.18,78,,,percent of total billed charges,78% of total billed charges,31,100,,,percent of total billed charges,100% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,25.61,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,3.2,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,3.17,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,31,
EKG W/12 Leads,93000,CDM,985,RC,93000,HCPCS,Outpatient,,,45,29.25,,39.6,88,,,percent of total billed charges,88% of total Billed charges,0.96,100,,,Fee Schedule,100% of Medicare rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,45,100,,,percent of total billed charges,100% of total billed charges,8.64,103,,,Fee Schedule,103% of WA Medicaid,0.96,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.39,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,31.05,69,,,percent of total billed charges,69% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,45,100,,,percent of total billed charges,100% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,45,100,,,percent of total billed charges,100% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.83,61.85,,,percent of total billed charges,61.85% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,10.91,130,,,Fee Schedule,130% of WA Medicaid ,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,16.97,37.7,,,percent of total billed charges,37.70% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,1525.5,33.9,,,percent of total billed charges,33.9% of total billed charges,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.1,78,,,percent of total billed charges,78% of total billed charges,45,100,,,percent of total billed charges,100% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,37.17,82.6,,,percent of total billed charges,82.6% of total billed charges,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.96,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.96,1525.5,
ATTENDING PHYSICIAN FINAL REPORT,1026M,CDM,983,RC,1026M,HCPCS,Outpatient,,,26.35,17.13,,23.19,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26.35,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,18.18,69,,,percent of total billed charges,69% of total billed charges,26.35,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,26.35,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,26.35,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,16.3,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.93,37.7,,,percent of total billed charges,37.70% of total billed charges,9.93,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,893.27,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,20.55,78,,,percent of total billed charges,78% of total billed charges,26.35,100,,,percent of total billed charges,100% of total billed charges,21.77,82.6,,,percent of total billed charges,82.6% of total billed charges,21.77,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",9.93,893.27,
LOSS OF EARNINGS POWER FORM,1027M,CDM,983,RC,1027M,HCPCS,Outpatient,,,23,14.95,,20.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,15.87,69,,,percent of total billed charges,69% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,23,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,23,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,14.23,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.67,37.7,,,percent of total billed charges,37.70% of total billed charges,8.67,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,779.7,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,17.94,78,,,percent of total billed charges,78% of total billed charges,23,100,,,percent of total billed charges,100% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,19,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",8.67,779.7,
JOB ANALYSIS ADDITIONAL,1028M,CDM,983,RC,1028M,HCPCS,Outpatient,,,39.67,25.79,,34.91,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.67,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,27.37,69,,,percent of total billed charges,69% of total billed charges,39.67,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,39.67,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,39.67,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,24.54,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.96,37.7,,,percent of total billed charges,37.70% of total billed charges,14.96,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1344.81,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,30.94,78,,,percent of total billed charges,78% of total billed charges,39.67,100,,,percent of total billed charges,100% of total billed charges,32.77,82.6,,,percent of total billed charges,82.6% of total billed charges,32.77,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",14.96,1344.81,
JOB ANALYSIS FIRST,1038M,CDM,983,RC,1038M,HCPCS,Outpatient,,,52.88,34.37,,46.53,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,52.88,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,36.49,69,,,percent of total billed charges,69% of total billed charges,52.88,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,52.88,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,52.88,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,32.71,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.94,37.7,,,percent of total billed charges,37.70% of total billed charges,19.94,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1792.63,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,41.25,78,,,percent of total billed charges,78% of total billed charges,52.88,100,,,percent of total billed charges,100% of total billed charges,43.68,82.6,,,percent of total billed charges,82.6% of total billed charges,43.68,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",19.94,1792.63,
RPT OF INJURY,1040M,CDM,983,RC,1040M,HCPCS,Outpatient,,,61.02,39.66,,53.7,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,61.02,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,42.1,69,,,percent of total billed charges,69% of total billed charges,61.02,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,61.02,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,61.02,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,37.74,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23,37.7,,,percent of total billed charges,37.70% of total billed charges,23,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2068.58,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,47.6,78,,,percent of total billed charges,78% of total billed charges,61.02,100,,,percent of total billed charges,100% of total billed charges,50.4,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",23,2068.58,
LI RE-OPEN CLAIM,1041M,CDM,983,RC,1041M,HCPCS,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,59,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,59,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36.49,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.24,37.7,,,percent of total billed charges,37.70% of total billed charges,22.24,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2000.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",22.24,2000.1,
ESTIMATE OF PHYSICIAN CAP LI,1048M,CDM,510,RC,1048M,HCPCS,Outpatient,,,22.47,14.61,,19.77,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.47,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",3.44,15.3,,,percent of total billed charges,15.3% of total billed charges,15.5,69,,,percent of total billed charges,69% of total billed charges,22.47,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,22.47,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,22.47,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.53,78,,,percent of total billed charges,78% of total billed charges,22.47,100,,,percent of total billed charges,100% of total billed charges,18.56,82.6,,,percent of total billed charges,82.6% of total billed charges,18.56,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",3.44,22.47,
OCCUPATIONAL HX FORM,1055M,CDM,510,RC,1055M,HCPCS,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,220,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,138.6,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",33.66,15.3,,,percent of total billed charges,15.3% of total billed charges,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,220,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,220,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",33.66,220,
PHYSICIANS SUPPLEMENTAL RPT,1056M,CDM,510,RC,1056M,HCPCS,Outpatient,,,15.1,9.82,,13.29,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15.1,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.51,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",2.31,15.3,,,percent of total billed charges,15.3% of total billed charges,10.42,69,,,percent of total billed charges,69% of total billed charges,15.1,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,15.1,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,15.1,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.78,78,,,percent of total billed charges,78% of total billed charges,15.1,100,,,percent of total billed charges,100% of total billed charges,12.47,82.6,,,percent of total billed charges,82.6% of total billed charges,12.47,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",2.31,15.1,
OPIOID PROGRESS RPT SUPP,1057M,CDM,510,RC,1057M,HCPCS,Outpatient,,,30.27,19.68,,26.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,30.27,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,19.07,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",4.63,15.3,,,percent of total billed charges,15.3% of total billed charges,20.89,69,,,percent of total billed charges,69% of total billed charges,30.27,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,30.27,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,30.27,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.61,78,,,percent of total billed charges,78% of total billed charges,30.27,100,,,percent of total billed charges,100% of total billed charges,25,82.6,,,percent of total billed charges,82.6% of total billed charges,25,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",4.63,30.27,
IME REVIEW,1063M,CDM,983,RC,1063M,HCPCS,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,46,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,46,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,46,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1559.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",17.34,1559.4,
ATTENDING DOCTOR IME REVIEW WRITTEN REPO,1065M,CDM,983,RC,1065M,HCPCS,Outpatient,,,29.91,19.44,,26.32,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.91,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,20.64,69,,,percent of total billed charges,69% of total billed charges,29.91,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,29.91,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,29.91,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,18.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.28,37.7,,,percent of total billed charges,37.70% of total billed charges,11.28,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1013.95,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,23.33,78,,,percent of total billed charges,78% of total billed charges,29.91,100,,,percent of total billed charges,100% of total billed charges,24.71,82.6,,,percent of total billed charges,82.6% of total billed charges,24.71,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",11.28,1013.95,
IMPEDIMENTS TO RETURN TO WORK,1068M,CDM,510,RC,1068M,HCPCS,Outpatient,,,154.15,100.20,,135.65,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,154.15,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,97.11,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",23.58,15.3,,,percent of total billed charges,15.3% of total billed charges,106.36,69,,,percent of total billed charges,69% of total billed charges,154.15,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,154.15,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,154.15,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,120.24,78,,,percent of total billed charges,78% of total billed charges,154.15,100,,,percent of total billed charges,100% of total billed charges,127.33,82.6,,,percent of total billed charges,82.6% of total billed charges,127.33,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",23.58,154.15,
COHE WORK STATUS ACTIVITY RX,1069M,CDM,510,RC,1069M,HCPCS,Outpatient,,,50.82,33.03,,44.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,50.82,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.02,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",7.78,15.3,,,percent of total billed charges,15.3% of total billed charges,35.07,69,,,percent of total billed charges,69% of total billed charges,50.82,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,50.82,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,50.82,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,39.64,78,,,percent of total billed charges,78% of total billed charges,50.82,100,,,percent of total billed charges,100% of total billed charges,41.98,82.6,,,percent of total billed charges,82.6% of total billed charges,41.98,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",7.78,50.82,
INCENTIVE PAY,1071M,CDM,510,RC,1071M,HCPCS,Outpatient,,,111.12,72.23,,97.79,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,111.12,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,70.01,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",17,15.3,,,percent of total billed charges,15.3% of total billed charges,76.67,69,,,percent of total billed charges,69% of total billed charges,111.12,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,111.12,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,111.12,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,86.67,78,,,percent of total billed charges,78% of total billed charges,111.12,100,,,percent of total billed charges,100% of total billed charges,91.79,82.6,,,percent of total billed charges,82.6% of total billed charges,91.79,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",17,111.12,
ACTIVITY PRESCRIPTION FORM,1073M,CDM,983,RC,1073M,HCPCS,Outpatient,,,59,38.35,,51.92,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,59,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,40.71,69,,,percent of total billed charges,69% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,59,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,59,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,36.49,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,22.24,37.7,,,percent of total billed charges,37.70% of total billed charges,22.24,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2000.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,46.02,78,,,percent of total billed charges,78% of total billed charges,59,100,,,percent of total billed charges,100% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,48.73,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",22.24,2000.1,
PHYSICAL CAPACITIES EVAL,1074M,CDM,983,RC,1074M,HCPCS,Outpatient,,,32.22,20.94,,28.35,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,32.22,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,22.23,69,,,percent of total billed charges,69% of total billed charges,32.22,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,32.22,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,32.22,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,19.93,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.15,37.7,,,percent of total billed charges,37.70% of total billed charges,12.15,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1092.26,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,25.13,78,,,percent of total billed charges,78% of total billed charges,32.22,100,,,percent of total billed charges,100% of total billed charges,26.61,82.6,,,percent of total billed charges,82.6% of total billed charges,26.61,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",12.15,1092.26,
FRI TRACKING SHEET,1075M,CDM,510,RC,1075M,HCPCS,Outpatient,,,37.8,24.57,,33.26,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37.8,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",5.78,15.3,,,percent of total billed charges,15.3% of total billed charges,26.08,69,,,percent of total billed charges,69% of total billed charges,37.8,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,37.8,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,37.8,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,29.48,78,,,percent of total billed charges,78% of total billed charges,37.8,100,,,percent of total billed charges,100% of total billed charges,31.22,82.6,,,percent of total billed charges,82.6% of total billed charges,31.22,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",5.78,37.8,
OPIOID REQUEST FOR SUBACUTE PAIN,1076M,CDM,510,RC,1076M,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,23.31,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",5.66,15.3,,,percent of total billed charges,15.3% of total billed charges,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,37,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,37,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",5.66,37,
OPIOID REQ FOR SUBACUTE PAIN W/DOCUMENTATION,1077M,CDM,983,RC,1077M,HCPCS,Outpatient,,,68,44.20,,59.84,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,68,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,46.92,69,,,percent of total billed charges,69% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,68,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,68,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,42.06,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,2305.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,53.04,78,,,percent of total billed charges,78% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",25.64,2305.2,
OPIOID REQUEST FOR CHRONIC PAIN,1078M,CDM,983,RC,1078M,HCPCS,Outpatient,,,37,24.05,,32.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,37,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,25.53,69,,,percent of total billed charges,69% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,37,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,37,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,22.88,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,13.95,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1254.3,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,28.86,78,,,percent of total billed charges,78% of total billed charges,37,100,,,percent of total billed charges,100% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,30.56,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",13.95,1254.3,
IME EXPANDED,1191M,CDM,983,RC,1191M,HCPCS,Outpatient,,,636,413.40,,559.68,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,636,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,438.84,69,,,percent of total billed charges,69% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,636,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,636,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,393.37,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,21560.4,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,496.08,78,,,percent of total billed charges,78% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",239.77,21560.4,
IME DETAILED,1192M,CDM,983,RC,1192M,HCPCS,Outpatient,,,769,499.85,,676.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,769,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,530.61,69,,,percent of total billed charges,69% of total billed charges,769,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,769,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,769,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,475.63,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,289.91,37.7,,,percent of total billed charges,37.70% of total billed charges,289.91,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,26069.1,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,599.82,78,,,percent of total billed charges,78% of total billed charges,769,100,,,percent of total billed charges,100% of total billed charges,635.19,82.6,,,percent of total billed charges,82.6% of total billed charges,635.19,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",289.91,26069.1,
IMPAIR RATE ADDENDUM PER 30,1198M,CDM,510,RC,1198M,HCPCS,Outpatient,,,144,93.60,,126.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,90.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",22.03,15.3,,,percent of total billed charges,15.3% of total billed charges,99.36,69,,,percent of total billed charges,69% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,144,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,112.32,78,,,percent of total billed charges,78% of total billed charges,144,100,,,percent of total billed charges,100% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,118.94,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",22.03,144,
"96368 Intravenous infusion, for therapy, prophylaxis, or diagnosis, concurrent",96368,CDM,983,RC,96368,HCPCS,Outpatient,,,185,120.25,,162.8,88,,,percent of total billed charges,88% of total Billed charges,0.86,100,,,Fee Schedule,100% of Medicare rate,11.56,100,,,Fee Schedule,100% of WA Medicaid,185,100,,,percent of total billed charges,100% of total billed charges,11.91,103,,,Fee Schedule,103% of WA Medicaid,0.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.51,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.56,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,127.65,69,,,percent of total billed charges,69% of total billed charges,185,100,,,percent of total billed charges,100% of total billed charges,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,185,100,,,percent of total billed charges,100% of total billed charges,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,185,100,,,percent of total billed charges,100% of total billed charges,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,114.42,61.85,,,percent of total billed charges,61.85% of total billed charges,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.56,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.79,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.03,130,,,Fee Schedule,130% of WA Medicaid ,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,69.75,37.7,,,percent of total billed charges,37.70% of total billed charges,69.75,37.7,,,percent of total billed charges,37.70% of total billed charges,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,6271.5,33.9,,,percent of total billed charges,33.9% of total billed charges,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,144.3,78,,,percent of total billed charges,78% of total billed charges,185,100,,,percent of total billed charges,100% of total billed charges,152.81,82.6,,,percent of total billed charges,82.6% of total billed charges,152.81,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.87,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.56,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.86,6271.5,
"96367 Intravenous infusion, for therapy, prophylaxis, or diagnosis , each addtl",96367,CDM,983,RC,96367,HCPCS,Outpatient,,,148,96.20,,130.24,88,,,percent of total billed charges,88% of total Billed charges,1.13,100,,,Fee Schedule,100% of Medicare rate,16.79,100,,,Fee Schedule,100% of WA Medicaid,148,100,,,percent of total billed charges,100% of total billed charges,17.29,103,,,Fee Schedule,103% of WA Medicaid,1.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,16.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,102.12,69,,,percent of total billed charges,69% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,148,100,,,percent of total billed charges,100% of total billed charges,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,148,100,,,percent of total billed charges,100% of total billed charges,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.54,61.85,,,percent of total billed charges,61.85% of total billed charges,16.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.13,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,21.83,130,,,Fee Schedule,130% of WA Medicaid ,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,55.8,37.7,,,percent of total billed charges,37.70% of total billed charges,55.8,37.7,,,percent of total billed charges,37.70% of total billed charges,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,5017.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,115.44,78,,,percent of total billed charges,78% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,16.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.14,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.13,5017.2,
COMM/WORK REINT/15MIN/-GO,97537,CDM,983,RC,97537,HCPCS,Outpatient,,,81,52.65,GO,71.28,88,,,percent of total billed charges,88% of total Billed charges,1.23,100,,,Fee Schedule,100% of Medicare rate,18.46,100,,,Fee Schedule,100% of WA Medicaid,81,100,,,percent of total billed charges,100% of total billed charges,19.01,103,,,Fee Schedule,103% of WA Medicaid,1.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,18.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,55.89,69,,,percent of total billed charges,69% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,81,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,81,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,50.1,61.85,,,percent of total billed charges,61.85% of total billed charges,18.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24,130,,,Fee Schedule,130% of WA Medicaid ,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,30.54,37.7,,,percent of total billed charges,37.70% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,2745.9,33.9,,,percent of total billed charges,33.9% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,63.18,78,,,percent of total billed charges,78% of total billed charges,81,100,,,percent of total billed charges,100% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,66.91,82.6,,,percent of total billed charges,82.6% of total billed charges,18.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.23,2745.9,
ACT DAILY LIV/15MIN/-GO,97535,CDM,983,RC,97535,HCPCS,Outpatient,,,93,60.45,GO,81.84,88,,,percent of total billed charges,88% of total Billed charges,1.26,100,,,Fee Schedule,100% of Medicare rate,19.02,100,,,Fee Schedule,100% of WA Medicaid,93,100,,,percent of total billed charges,100% of total billed charges,19.59,103,,,Fee Schedule,103% of WA Medicaid,1.26,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.21,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,19.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,64.17,69,,,percent of total billed charges,69% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,93,100,,,percent of total billed charges,100% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,93,100,,,percent of total billed charges,100% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,57.52,61.85,,,percent of total billed charges,61.85% of total billed charges,19.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24.73,130,,,Fee Schedule,130% of WA Medicaid ,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,35.06,37.7,,,percent of total billed charges,37.70% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,3152.7,33.9,,,percent of total billed charges,33.9% of total billed charges,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.54,78,,,percent of total billed charges,78% of total billed charges,93,100,,,percent of total billed charges,100% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,76.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.27,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.26,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.26,3152.7,
WHEELCHAIR MNGT/15MIN/-GP,97542,CDM,983,RC,97542,HCPCS,Outpatient,,,83,53.95,GP,73.04,88,,,percent of total billed charges,88% of total Billed charges,1.23,100,,,Fee Schedule,100% of Medicare rate,18.46,100,,,Fee Schedule,100% of WA Medicaid,83,100,,,percent of total billed charges,100% of total billed charges,19.01,103,,,Fee Schedule,103% of WA Medicaid,1.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,18.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.34,61.85,,,percent of total billed charges,61.85% of total billed charges,18.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.83,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,24,130,,,Fee Schedule,130% of WA Medicaid ,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,2813.7,33.9,,,percent of total billed charges,33.9% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,18.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.23,2813.7,
"97763 Orthotic/prosthetic subsequent mgt, each 15 minutes",97763,CDM,983,RC,97763,HCPCS,Outpatient,,,188,122.20,,165.44,88,,,percent of total billed charges,88% of total Billed charges,1.87,100,,,Fee Schedule,100% of Medicare rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,188,100,,,percent of total billed charges,100% of total billed charges,31.89,103,,,Fee Schedule,103% of WA Medicaid,1.87,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.28,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,30.96,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,129.72,69,,,percent of total billed charges,69% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,188,100,,,percent of total billed charges,100% of total billed charges,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,188,100,,,percent of total billed charges,100% of total billed charges,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.28,61.85,,,percent of total billed charges,61.85% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,40.25,130,,,Fee Schedule,130% of WA Medicaid ,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,70.88,37.7,,,percent of total billed charges,37.70% of total billed charges,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,6373.2,33.9,,,percent of total billed charges,33.9% of total billed charges,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.64,78,,,percent of total billed charges,78% of total billed charges,188,100,,,percent of total billed charges,100% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,155.29,82.6,,,percent of total billed charges,82.6% of total billed charges,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.89,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.87,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.96,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.87,6373.2,
Medical nutrition therapy; initial assessment and interventi,97802,CDM,983,RC,97802,HCPCS,Outpatient,,,94,61.10,,82.72,88,,,percent of total billed charges,88% of total Billed charges,1.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,94,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1.23,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.15,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,64.86,69,,,percent of total billed charges,69% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,94,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,94,100,,,percent of total billed charges,100% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,58.14,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,35.44,37.7,,,percent of total billed charges,37.70% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,3186.6,33.9,,,percent of total billed charges,33.9% of total billed charges,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.32,78,,,percent of total billed charges,78% of total billed charges,94,100,,,percent of total billed charges,100% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,77.64,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.24,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.23,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",1.23,3186.6,
MED NUT THERAPY GROUP 30MIN,97804,CDM,983,RC,97804,HCPCS,Outpatient,,,42,27.30,,36.96,88,,,percent of total billed charges,88% of total Billed charges,0.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,42,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,0.73,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.27,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,28.98,69,,,percent of total billed charges,69% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,42,100,,,percent of total billed charges,100% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,42,100,,,percent of total billed charges,100% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.98,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,15.83,37.7,,,percent of total billed charges,37.70% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,1423.8,33.9,,,percent of total billed charges,33.9% of total billed charges,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,32.76,78,,,percent of total billed charges,78% of total billed charges,42,100,,,percent of total billed charges,100% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,34.69,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.74,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.73,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",0.73,1423.8,
97803 Nutrition Consult Profee,97803,CDM,983,RC,97803,HCPCS,Outpatient,,,83,53.95,,73.04,88,,,percent of total billed charges,88% of total Billed charges,1.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,83,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1.08,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.9,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,57.27,69,,,percent of total billed charges,69% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,83,100,,,percent of total billed charges,100% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,51.34,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,31.29,37.7,,,percent of total billed charges,37.70% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,2813.7,33.9,,,percent of total billed charges,33.9% of total billed charges,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,64.74,78,,,percent of total billed charges,78% of total billed charges,83,100,,,percent of total billed charges,100% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,68.56,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.08,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",1.08,2813.7,
98967,98967,CDM,983,RC,98967,HCPCS,Outpatient,,,46,29.90,,40.48,88,,,percent of total billed charges,88% of total Billed charges,1.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,46,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,2.07,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,31.74,69,,,percent of total billed charges,69% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,46,100,,,percent of total billed charges,100% of total billed charges,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,46,100,,,percent of total billed charges,100% of total billed charges,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.45,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,17.34,37.7,,,percent of total billed charges,37.70% of total billed charges,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1559.4,33.9,,,percent of total billed charges,33.9% of total billed charges,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.88,78,,,percent of total billed charges,78% of total billed charges,46,100,,,percent of total billed charges,100% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,38,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.19,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.18,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",1.18,1559.4,
98966,98966,CDM,983,RC,98966,HCPCS,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,0.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,25,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,0.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,25,100,,,percent of total billed charges,100% of total billed charges,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,25,100,,,percent of total billed charges,100% of total billed charges,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.46,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,9.43,37.7,,,percent of total billed charges,37.70% of total billed charges,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,847.5,33.9,,,percent of total billed charges,33.9% of total billed charges,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",0.6,847.5,
SPECIAL REPORTS OR FORMS,99080,CDM,983,RC,99080,HCPCS,Outpatient,,,44.96,29.22,,39.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,44.96,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,31.02,69,,,percent of total billed charges,69% of total billed charges,44.96,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,44.96,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,44.96,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,27.81,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16.95,37.7,,,percent of total billed charges,37.70% of total billed charges,16.95,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,1524.14,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,35.07,78,,,percent of total billed charges,78% of total billed charges,44.96,100,,,percent of total billed charges,100% of total billed charges,37.14,82.6,,,percent of total billed charges,82.6% of total billed charges,37.14,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",16.95,1524.14,
OFFICE/OUTPATIENT VISIT NEW,99205,CDM,983,RC,99205,HCPCS,Outpatient,,,358.66,233.13,,315.62,88,,,percent of total billed charges,88% of total Billed charges,13.98,100,,,Fee Schedule,100% of Medicare rate,81.65,100,,,Fee Schedule,100% of WA Medicaid,358.66,100,,,percent of total billed charges,100% of total billed charges,84.1,103,,,Fee Schedule,103% of WA Medicaid,13.98,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,24.46,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,81.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,247.48,69,,,percent of total billed charges,69% of total billed charges,358.66,100,,,percent of total billed charges,100% of total billed charges,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.66,100,,,percent of total billed charges,100% of total billed charges,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.66,100,,,percent of total billed charges,100% of total billed charges,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.83,61.85,,,percent of total billed charges,61.85% of total billed charges,81.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,106.15,130,,,Fee Schedule,130% of WA Medicaid ,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,135.21,37.7,,,percent of total billed charges,37.70% of total billed charges,135.21,37.7,,,percent of total billed charges,37.70% of total billed charges,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,12158.57,33.9,,,percent of total billed charges,33.9% of total billed charges,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,279.75,78,,,percent of total billed charges,78% of total billed charges,358.66,100,,,percent of total billed charges,100% of total billed charges,296.25,82.6,,,percent of total billed charges,82.6% of total billed charges,296.25,82.6,,,percent of total billed charges,82.6% of total billed charges,81.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.98,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.98,12158.57,
OFFICE/OUTPATIENT VISIT NEW,99204,CDM,983,RC,99204,HCPCS,Outpatient,,,286.68,186.34,,252.28,88,,,percent of total billed charges,88% of total Billed charges,10.21,100,,,Fee Schedule,100% of Medicare rate,59.97,100,,,Fee Schedule,100% of WA Medicaid,286.68,100,,,percent of total billed charges,100% of total billed charges,61.77,103,,,Fee Schedule,103% of WA Medicaid,10.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.86,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,59.97,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,197.81,69,,,percent of total billed charges,69% of total billed charges,286.68,100,,,percent of total billed charges,100% of total billed charges,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.68,100,,,percent of total billed charges,100% of total billed charges,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,286.68,100,,,percent of total billed charges,100% of total billed charges,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,177.31,61.85,,,percent of total billed charges,61.85% of total billed charges,59.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.97,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.17,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,77.96,130,,,Fee Schedule,130% of WA Medicaid ,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.08,37.7,,,percent of total billed charges,37.70% of total billed charges,108.08,37.7,,,percent of total billed charges,37.70% of total billed charges,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,9718.45,33.9,,,percent of total billed charges,33.9% of total billed charges,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,223.61,78,,,percent of total billed charges,78% of total billed charges,286.68,100,,,percent of total billed charges,100% of total billed charges,236.8,82.6,,,percent of total billed charges,82.6% of total billed charges,236.8,82.6,,,percent of total billed charges,82.6% of total billed charges,59.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.31,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,59.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.21,9718.45,
OFFICE/OUTPATIENT VISIT NEW,99203,CDM,983,RC,99203,HCPCS,Outpatient,,,291,189.15,,256.08,88,,,percent of total billed charges,88% of total Billed charges,6.6,100,,,Fee Schedule,100% of Medicare rate,36.82,100,,,Fee Schedule,100% of WA Medicaid,291,100,,,percent of total billed charges,100% of total billed charges,37.92,103,,,Fee Schedule,103% of WA Medicaid,6.6,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,36.82,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,200.79,69,,,percent of total billed charges,69% of total billed charges,291,100,,,percent of total billed charges,100% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,291,100,,,percent of total billed charges,100% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,291,100,,,percent of total billed charges,100% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,179.98,61.85,,,percent of total billed charges,61.85% of total billed charges,36.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.82,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.56,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,47.87,130,,,Fee Schedule,130% of WA Medicaid ,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,109.71,37.7,,,percent of total billed charges,37.70% of total billed charges,109.71,37.7,,,percent of total billed charges,37.70% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,9864.9,33.9,,,percent of total billed charges,33.9% of total billed charges,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.98,78,,,percent of total billed charges,78% of total billed charges,291,100,,,percent of total billed charges,100% of total billed charges,240.37,82.6,,,percent of total billed charges,82.6% of total billed charges,240.37,82.6,,,percent of total billed charges,82.6% of total billed charges,36.82,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.67,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.6,100,,,Fee Schedule,100% of Medicare RBRVS rate,36.82,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.6,9864.9,
OFFICE/OUTPATIENT VISIT NEW,99202,CDM,983,RC,99202,HCPCS,Outpatient,,,200,130.00,,176,88,,,percent of total billed charges,88% of total Billed charges,3.49,100,,,Fee Schedule,100% of Medicare rate,21.38,100,,,Fee Schedule,100% of WA Medicaid,200,100,,,percent of total billed charges,100% of total billed charges,22.02,103,,,Fee Schedule,103% of WA Medicaid,3.49,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.11,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.38,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,138,69,,,percent of total billed charges,69% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,200,100,,,percent of total billed charges,100% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,200,100,,,percent of total billed charges,100% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.7,61.85,,,percent of total billed charges,61.85% of total billed charges,21.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.38,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.81,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,27.79,130,,,Fee Schedule,130% of WA Medicaid ,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,75.4,37.7,,,percent of total billed charges,37.70% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,6780,33.9,,,percent of total billed charges,33.9% of total billed charges,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,156,78,,,percent of total billed charges,78% of total billed charges,200,100,,,percent of total billed charges,100% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,165.2,82.6,,,percent of total billed charges,82.6% of total billed charges,21.38,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.49,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.38,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.49,6780,
OFFICE/OUTPATIENT VISIT EST,99215,CDM,983,RC,99215,HCPCS,Outpatient,,,252.85,164.35,,222.51,88,,,percent of total billed charges,88% of total Billed charges,10.02,100,,,Fee Schedule,100% of Medicare rate,65.02,100,,,Fee Schedule,100% of WA Medicaid,252.85,100,,,percent of total billed charges,100% of total billed charges,66.97,103,,,Fee Schedule,103% of WA Medicaid,10.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.54,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,65.02,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,174.47,69,,,percent of total billed charges,69% of total billed charges,252.85,100,,,percent of total billed charges,100% of total billed charges,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.85,100,,,percent of total billed charges,100% of total billed charges,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,252.85,100,,,percent of total billed charges,100% of total billed charges,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,156.39,61.85,,,percent of total billed charges,61.85% of total billed charges,65.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.02,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.32,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,84.53,130,,,Fee Schedule,130% of WA Medicaid ,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.32,37.7,,,percent of total billed charges,37.70% of total billed charges,95.32,37.7,,,percent of total billed charges,37.70% of total billed charges,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,8571.62,33.9,,,percent of total billed charges,33.9% of total billed charges,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,197.22,78,,,percent of total billed charges,78% of total billed charges,252.85,100,,,percent of total billed charges,100% of total billed charges,208.85,82.6,,,percent of total billed charges,82.6% of total billed charges,208.85,82.6,,,percent of total billed charges,82.6% of total billed charges,65.02,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,65.02,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.02,8571.62,
OFFICE/OUTPATIENT VISIT EST,99214,CDM,983,RC,99214,HCPCS,Outpatient,,,188.25,122.36,,165.66,88,,,percent of total billed charges,88% of total Billed charges,6.54,100,,,Fee Schedule,100% of Medicare rate,43.79,100,,,Fee Schedule,100% of WA Medicaid,188.25,100,,,percent of total billed charges,100% of total billed charges,45.1,103,,,Fee Schedule,103% of WA Medicaid,6.54,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,11.44,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,43.79,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,129.89,69,,,percent of total billed charges,69% of total billed charges,188.25,100,,,percent of total billed charges,100% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.25,100,,,percent of total billed charges,100% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.25,100,,,percent of total billed charges,100% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.43,61.85,,,percent of total billed charges,61.85% of total billed charges,43.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.79,100,,,Fee Schedule,100% of WA Medicare OPPS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.67,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,56.93,130,,,Fee Schedule,130% of WA Medicaid ,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,70.97,37.7,,,percent of total billed charges,37.70% of total billed charges,70.97,37.7,,,percent of total billed charges,37.70% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,6381.68,33.9,,,percent of total billed charges,33.9% of total billed charges,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,146.84,78,,,percent of total billed charges,78% of total billed charges,188.25,100,,,percent of total billed charges,100% of total billed charges,155.49,82.6,,,percent of total billed charges,82.6% of total billed charges,155.49,82.6,,,percent of total billed charges,82.6% of total billed charges,43.79,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.54,100,,,Fee Schedule,100% of Medicare RBRVS rate,43.79,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.54,6381.68,
OFFICE/OUTPATIENT VISIT EST,99213,CDM,983,RC,99213,HCPCS,Outpatient,,,195,126.75,,171.6,88,,,percent of total billed charges,88% of total Billed charges,4.56,100,,,Fee Schedule,100% of Medicare rate,29.69,100,,,Fee Schedule,100% of WA Medicaid,195,100,,,percent of total billed charges,100% of total billed charges,30.58,103,,,Fee Schedule,103% of WA Medicaid,4.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.99,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,29.69,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,134.55,69,,,percent of total billed charges,69% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,195,100,,,percent of total billed charges,100% of total billed charges,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,195,100,,,percent of total billed charges,100% of total billed charges,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,120.61,61.85,,,percent of total billed charges,61.85% of total billed charges,29.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.69,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.28,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,38.6,130,,,Fee Schedule,130% of WA Medicaid ,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,73.52,37.7,,,percent of total billed charges,37.70% of total billed charges,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,6610.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.1,78,,,percent of total billed charges,78% of total billed charges,195,100,,,percent of total billed charges,100% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,161.07,82.6,,,percent of total billed charges,82.6% of total billed charges,29.69,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.61,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,29.69,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.56,6610.5,
OFFICE/OUTPATIENT VISIT EST,99212,CDM,983,RC,99212,HCPCS,Outpatient,,,118,76.70,,103.84,88,,,percent of total billed charges,88% of total Billed charges,2.61,100,,,Fee Schedule,100% of Medicare rate,15.88,100,,,Fee Schedule,100% of WA Medicaid,118,100,,,percent of total billed charges,100% of total billed charges,16.36,103,,,Fee Schedule,103% of WA Medicaid,2.61,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,4.57,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,15.88,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,81.42,69,,,percent of total billed charges,69% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,118,100,,,percent of total billed charges,100% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,118,100,,,percent of total billed charges,100% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.98,61.85,,,percent of total billed charges,61.85% of total billed charges,15.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.88,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.2,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,20.64,130,,,Fee Schedule,130% of WA Medicaid ,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.49,37.7,,,percent of total billed charges,37.70% of total billed charges,44.49,37.7,,,percent of total billed charges,37.70% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,4000.2,33.9,,,percent of total billed charges,33.9% of total billed charges,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.04,78,,,percent of total billed charges,78% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,15.88,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.61,100,,,Fee Schedule,100% of Medicare RBRVS rate,15.88,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.61,4000.2,
OFFICE/OUTPATIENT VISIT EST,99211,CDM,983,RC,99211,HCPCS,Outpatient,,,34.79,22.61,,30.62,88,,,percent of total billed charges,88% of total Billed charges,0.52,100,,,Fee Schedule,100% of Medicare rate,4.01,100,,,Fee Schedule,100% of WA Medicaid,34.79,100,,,percent of total billed charges,100% of total billed charges,4.13,103,,,Fee Schedule,103% of WA Medicaid,0.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,4.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,24.01,69,,,percent of total billed charges,69% of total billed charges,34.79,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.79,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,34.79,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.52,61.85,,,percent of total billed charges,61.85% of total billed charges,4.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.21,130,,,Fee Schedule,130% of WA Medicaid ,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.12,37.7,,,percent of total billed charges,37.70% of total billed charges,13.12,37.7,,,percent of total billed charges,37.70% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,1179.38,33.9,,,percent of total billed charges,33.9% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,27.14,78,,,percent of total billed charges,78% of total billed charges,34.79,100,,,percent of total billed charges,100% of total billed charges,28.74,82.6,,,percent of total billed charges,82.6% of total billed charges,28.74,82.6,,,percent of total billed charges,82.6% of total billed charges,4.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.52,1179.38,
INITIAL HOSPITAL CARE,99223,CDM,983,RC,99223,HCPCS,Outpatient,,,537,349.05,,472.56,88,,,percent of total billed charges,88% of total Billed charges,11.91,100,,,Fee Schedule,100% of Medicare rate,97.73,100,,,Fee Schedule,100% of WA Medicaid,537,100,,,percent of total billed charges,100% of total billed charges,100.66,103,,,Fee Schedule,103% of WA Medicaid,11.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.84,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,97.73,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,370.53,69,,,percent of total billed charges,69% of total billed charges,537,100,,,percent of total billed charges,100% of total billed charges,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,537,100,,,percent of total billed charges,100% of total billed charges,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,537,100,,,percent of total billed charges,100% of total billed charges,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,332.13,61.85,,,percent of total billed charges,61.85% of total billed charges,97.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.73,100,,,Fee Schedule,100% of WA Medicare OPPS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,99.68,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,127.05,130,,,Fee Schedule,130% of WA Medicaid ,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,202.45,37.7,,,percent of total billed charges,37.70% of total billed charges,202.45,37.7,,,percent of total billed charges,37.70% of total billed charges,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,18204.3,33.9,,,percent of total billed charges,33.9% of total billed charges,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,418.86,78,,,percent of total billed charges,78% of total billed charges,537,100,,,percent of total billed charges,100% of total billed charges,443.56,82.6,,,percent of total billed charges,82.6% of total billed charges,443.56,82.6,,,percent of total billed charges,82.6% of total billed charges,97.73,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.03,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,97.73,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.91,18204.3,
INITIAL HOSPITAL CARE,99222,CDM,983,RC,99222,HCPCS,Outpatient,,,366,237.90,,322.08,88,,,percent of total billed charges,88% of total Billed charges,9.86,100,,,Fee Schedule,100% of Medicare rate,73.67,100,,,Fee Schedule,100% of WA Medicaid,366,100,,,percent of total billed charges,100% of total billed charges,75.88,103,,,Fee Schedule,103% of WA Medicaid,9.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,17.25,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,73.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,252.54,69,,,percent of total billed charges,69% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,366,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,366,100,,,percent of total billed charges,100% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,226.37,61.85,,,percent of total billed charges,61.85% of total billed charges,73.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,95.77,130,,,Fee Schedule,130% of WA Medicaid ,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,137.98,37.7,,,percent of total billed charges,37.70% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,12407.4,33.9,,,percent of total billed charges,33.9% of total billed charges,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,285.48,78,,,percent of total billed charges,78% of total billed charges,366,100,,,percent of total billed charges,100% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,302.32,82.6,,,percent of total billed charges,82.6% of total billed charges,73.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,9.96,101,,,Fee Schedule,101% of Medicare RBRVS rate,9.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,9.86,12407.4,
INITIAL HOSPITAL CARE,99221,CDM,983,RC,99221,HCPCS,Outpatient,,,270,175.50,,237.6,88,,,percent of total billed charges,88% of total Billed charges,7.13,100,,,Fee Schedule,100% of Medicare rate,46.44,100,,,Fee Schedule,100% of WA Medicaid,270,100,,,percent of total billed charges,100% of total billed charges,47.83,103,,,Fee Schedule,103% of WA Medicaid,7.13,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.48,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,46.44,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,186.3,69,,,percent of total billed charges,69% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,270,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,270,100,,,percent of total billed charges,100% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,167,61.85,,,percent of total billed charges,61.85% of total billed charges,46.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.44,100,,,Fee Schedule,100% of WA Medicare OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.37,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,60.37,130,,,Fee Schedule,130% of WA Medicaid ,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,101.79,37.7,,,percent of total billed charges,37.70% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,9153,33.9,,,percent of total billed charges,33.9% of total billed charges,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,210.6,78,,,percent of total billed charges,78% of total billed charges,270,100,,,percent of total billed charges,100% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,223.02,82.6,,,percent of total billed charges,82.6% of total billed charges,46.44,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.2,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.13,100,,,Fee Schedule,100% of Medicare RBRVS rate,46.44,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,7.13,9153,
OUTPT CONSULT LEVEL 4,99244,CDM,983,RC,99244,HCPCS,Outpatient,,,210,136.50,,184.8,88,,,percent of total billed charges,88% of total Billed charges,8.17,100,,,Fee Schedule,100% of Medicare rate,76.09,100,,,Fee Schedule,100% of WA Medicaid,210,100,,,percent of total billed charges,100% of total billed charges,78.37,103,,,Fee Schedule,103% of WA Medicaid,8.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,14.3,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,76.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,144.9,69,,,percent of total billed charges,69% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,210,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,210,100,,,percent of total billed charges,100% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,129.89,61.85,,,percent of total billed charges,61.85% of total billed charges,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,77.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,98.92,130,,,Fee Schedule,130% of WA Medicaid ,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,79.17,37.7,,,percent of total billed charges,37.70% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,7119,33.9,,,percent of total billed charges,33.9% of total billed charges,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,163.8,78,,,percent of total billed charges,78% of total billed charges,210,100,,,percent of total billed charges,100% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,173.46,82.6,,,percent of total billed charges,82.6% of total billed charges,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.25,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,8.17,7119,
PREV VISIT NEW AGE 18-39,99385,CDM,983,RC,99385,HCPCS,Outpatient,,,241.82,157.18,,212.8,88,,,percent of total billed charges,88% of total Billed charges,5.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,241.82,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5.91,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.34,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,166.86,69,,,percent of total billed charges,69% of total billed charges,241.82,100,,,percent of total billed charges,100% of total billed charges,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.82,100,,,percent of total billed charges,100% of total billed charges,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.82,100,,,percent of total billed charges,100% of total billed charges,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,149.57,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.17,37.7,,,percent of total billed charges,37.70% of total billed charges,91.17,37.7,,,percent of total billed charges,37.70% of total billed charges,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,8197.7,33.9,,,percent of total billed charges,33.9% of total billed charges,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,188.62,78,,,percent of total billed charges,78% of total billed charges,241.82,100,,,percent of total billed charges,100% of total billed charges,199.74,82.6,,,percent of total billed charges,82.6% of total billed charges,199.74,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.97,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.91,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",5.91,8197.7,
PREV VISIT NEW AGE 40-64,99386,CDM,983,RC,99386,HCPCS,Outpatient,,,309,200.85,,271.92,88,,,percent of total billed charges,88% of total Billed charges,7.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,309,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,7.02,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,12.29,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,213.21,69,,,percent of total billed charges,69% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,309,100,,,percent of total billed charges,100% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,309,100,,,percent of total billed charges,100% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,191.12,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,116.49,37.7,,,percent of total billed charges,37.70% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,10475.1,33.9,,,percent of total billed charges,33.9% of total billed charges,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,241.02,78,,,percent of total billed charges,78% of total billed charges,309,100,,,percent of total billed charges,100% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,255.23,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,7.02,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",7.02,10475.1,
PREV VISIT NEW AGE 5-11,99383,CDM,983,RC,99383,HCPCS,Outpatient,,,220,143.00,,193.6,88,,,percent of total billed charges,88% of total Billed charges,5.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,220,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,151.8,69,,,percent of total billed charges,69% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,220,100,,,percent of total billed charges,100% of total billed charges,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,220,100,,,percent of total billed charges,100% of total billed charges,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.07,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,82.94,37.7,,,percent of total billed charges,37.70% of total billed charges,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,7458,33.9,,,percent of total billed charges,33.9% of total billed charges,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.6,78,,,percent of total billed charges,78% of total billed charges,220,100,,,percent of total billed charges,100% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,181.72,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",5.07,7458,
PREV VISIT NEW AGE 12-17,99384,CDM,983,RC,99384,HCPCS,Outpatient,,,243,157.95,,213.84,88,,,percent of total billed charges,88% of total Billed charges,6.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,243,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,167.67,69,,,percent of total billed charges,69% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,243,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,243,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.3,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,91.61,37.7,,,percent of total billed charges,37.70% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,8237.7,33.9,,,percent of total billed charges,33.9% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,189.54,78,,,percent of total billed charges,78% of total billed charges,243,100,,,percent of total billed charges,100% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,200.72,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",6.03,8237.7,
INIT PM E/M NEW PAT 1-4 YRS,99382,CDM,983,RC,99382,HCPCS,Outpatient,,,215,139.75,,189.2,88,,,percent of total billed charges,88% of total Billed charges,4.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,215,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.63,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,148.35,69,,,percent of total billed charges,69% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,215,100,,,percent of total billed charges,100% of total billed charges,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,132.98,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,81.06,37.7,,,percent of total billed charges,37.70% of total billed charges,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,7288.5,33.9,,,percent of total billed charges,33.9% of total billed charges,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.7,78,,,percent of total billed charges,78% of total billed charges,215,100,,,percent of total billed charges,100% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,177.59,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.98,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",4.93,7288.5,
99381 Preventive exam < 1 year new pt,99381,CDM,983,RC,99381,HCPCS,Outpatient,,,199,129.35,,175.12,88,,,percent of total billed charges,88% of total Billed charges,4.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,199,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,137.31,69,,,percent of total billed charges,69% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,199,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,199,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,123.08,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,75.02,37.7,,,percent of total billed charges,37.70% of total billed charges,75.02,37.7,,,percent of total billed charges,37.70% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,6746.1,33.9,,,percent of total billed charges,33.9% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,155.22,78,,,percent of total billed charges,78% of total billed charges,199,100,,,percent of total billed charges,100% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,164.37,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",4.52,6746.1,
PER PM REEVAL EST PAT INFANT,99391,CDM,983,RC,99391,HCPCS,Outpatient,,,163,105.95,,143.44,88,,,percent of total billed charges,88% of total Billed charges,4.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,163,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,112.47,69,,,percent of total billed charges,69% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,163,100,,,percent of total billed charges,100% of total billed charges,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,163,100,,,percent of total billed charges,100% of total billed charges,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,100.82,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,61.45,37.7,,,percent of total billed charges,37.70% of total billed charges,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,5525.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,127.14,78,,,percent of total billed charges,78% of total billed charges,163,100,,,percent of total billed charges,100% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,134.64,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",4.07,5525.7,
PREV VISIT EST AGE 12-17,99394,CDM,983,RC,99394,HCPCS,Outpatient,,,221,143.65,,194.48,88,,,percent of total billed charges,88% of total Billed charges,5.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,221,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5.07,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,152.49,69,,,percent of total billed charges,69% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,221,100,,,percent of total billed charges,100% of total billed charges,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,221,100,,,percent of total billed charges,100% of total billed charges,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,136.69,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,83.32,37.7,,,percent of total billed charges,37.70% of total billed charges,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,7491.9,33.9,,,percent of total billed charges,33.9% of total billed charges,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,172.38,78,,,percent of total billed charges,78% of total billed charges,221,100,,,percent of total billed charges,100% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,182.55,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.12,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.07,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",5.07,7491.9,
PREV VISIT EST AGE 1-4,99392,CDM,983,RC,99392,HCPCS,Outpatient,,,176,114.40,,154.88,88,,,percent of total billed charges,88% of total Billed charges,4.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,176,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,121.44,69,,,percent of total billed charges,69% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,176,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,176,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,108.86,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,66.35,37.7,,,percent of total billed charges,37.70% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,5966.4,33.9,,,percent of total billed charges,33.9% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,137.28,78,,,percent of total billed charges,78% of total billed charges,176,100,,,percent of total billed charges,100% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,145.38,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",4.52,5966.4,
PREV VISIT EST AGE 18-39,99395,CDM,983,RC,99395,HCPCS,Outpatient,,,232,150.80,,204.16,88,,,percent of total billed charges,88% of total Billed charges,5.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,232,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5.41,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,9.47,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,160.08,69,,,percent of total billed charges,69% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,232,100,,,percent of total billed charges,100% of total billed charges,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,232,100,,,percent of total billed charges,100% of total billed charges,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,143.49,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,87.46,37.7,,,percent of total billed charges,37.70% of total billed charges,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,7864.8,33.9,,,percent of total billed charges,33.9% of total billed charges,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,180.96,78,,,percent of total billed charges,78% of total billed charges,232,100,,,percent of total billed charges,100% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,191.63,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.46,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.41,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",5.41,7864.8,
PREV VISIT EST AGE 40-64,99396,CDM,983,RC,99396,HCPCS,Outpatient,,,254,165.10,,223.52,88,,,percent of total billed charges,88% of total Billed charges,5.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,254,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,175.26,69,,,percent of total billed charges,69% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,254,100,,,percent of total billed charges,100% of total billed charges,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,157.1,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,95.76,37.7,,,percent of total billed charges,37.70% of total billed charges,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,8610.6,33.9,,,percent of total billed charges,33.9% of total billed charges,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,198.12,78,,,percent of total billed charges,78% of total billed charges,254,100,,,percent of total billed charges,100% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,209.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,5.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,5.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",5.89,8610.6,
PREV VISIT EST AGE 5-11,99393,CDM,983,RC,99393,HCPCS,Outpatient,,,182,118.30,,160.16,88,,,percent of total billed charges,88% of total Billed charges,4.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,182,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,125.58,69,,,percent of total billed charges,69% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,182,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,182,100,,,percent of total billed charges,100% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.57,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,68.61,37.7,,,percent of total billed charges,37.70% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,6169.8,33.9,,,percent of total billed charges,33.9% of total billed charges,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,141.96,78,,,percent of total billed charges,78% of total billed charges,182,100,,,percent of total billed charges,100% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,150.33,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",4.52,6169.8,
PER PM REEVAL EST PAT 65+ YR,99397,CDM,983,RC,99397,HCPCS,Outpatient,,,271,176.15,,238.48,88,,,percent of total billed charges,88% of total Billed charges,6.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,271,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,6.03,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,10.56,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,186.99,69,,,percent of total billed charges,69% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,271,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,271,100,,,percent of total billed charges,100% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,167.61,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,102.17,37.7,,,percent of total billed charges,37.70% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,9186.9,33.9,,,percent of total billed charges,33.9% of total billed charges,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,211.38,78,,,percent of total billed charges,78% of total billed charges,271,100,,,percent of total billed charges,100% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,223.85,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,6.03,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",6.03,9186.9,
99417 Prolonged services per charge for each additional 15 m,99417,CDM,983,RC,99417,HCPCS,Outpatient,,,277,180.05,,243.76,88,,,percent of total billed charges,88% of total Billed charges,1.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,277,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1.93,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.38,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,191.13,69,,,percent of total billed charges,69% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,277,100,,,percent of total billed charges,100% of total billed charges,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,277,100,,,percent of total billed charges,100% of total billed charges,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,171.32,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,104.43,37.7,,,percent of total billed charges,37.70% of total billed charges,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,9390.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,216.06,78,,,percent of total billed charges,78% of total billed charges,277,100,,,percent of total billed charges,100% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,228.8,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.93,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",1.93,9390.3,
DISABILITY EXAMINATION,99456,CDM,983,RC,99456,HCPCS,Outpatient,,,480.83,312.54,,423.13,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,480.83,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,331.77,69,,,percent of total billed charges,69% of total billed charges,480.83,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,480.83,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,480.83,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,297.39,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,181.27,37.7,,,percent of total billed charges,37.70% of total billed charges,181.27,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,16300.14,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,375.05,78,,,percent of total billed charges,78% of total billed charges,480.83,100,,,percent of total billed charges,100% of total billed charges,397.17,82.6,,,percent of total billed charges,82.6% of total billed charges,397.17,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",181.27,16300.14,
TRANS CARE MGMT 7 DAY DISCH,99496,CDM,983,RC,99496,HCPCS,Outpatient,,,636,413.40,,559.68,88,,,percent of total billed charges,88% of total Billed charges,11.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,636,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,11.92,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,20.85,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,438.84,69,,,percent of total billed charges,69% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,636,100,,,percent of total billed charges,100% of total billed charges,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,636,100,,,percent of total billed charges,100% of total billed charges,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,393.37,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,239.77,37.7,,,percent of total billed charges,37.70% of total billed charges,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,21560.4,33.9,,,percent of total billed charges,33.9% of total billed charges,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,496.08,78,,,percent of total billed charges,78% of total billed charges,636,100,,,percent of total billed charges,100% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,525.34,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.04,101,,,Fee Schedule,101% of Medicare RBRVS rate,11.92,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",11.92,21560.4,
99495 Transitional care management service- moderate,99495,CDM,983,RC,99495,HCPCS,Outpatient,,,453,294.45,,398.64,88,,,percent of total billed charges,88% of total Billed charges,8.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,453,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,8.86,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,15.5,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,312.57,69,,,percent of total billed charges,69% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,453,100,,,percent of total billed charges,100% of total billed charges,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,453,100,,,percent of total billed charges,100% of total billed charges,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,280.18,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,170.78,37.7,,,percent of total billed charges,37.70% of total billed charges,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,15356.7,33.9,,,percent of total billed charges,33.9% of total billed charges,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,353.34,78,,,percent of total billed charges,78% of total billed charges,453,100,,,percent of total billed charges,100% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,374.18,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.95,101,,,Fee Schedule,101% of Medicare RBRVS rate,8.86,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",8.86,15356.7,
ADVNCD CARE PLAN ADDL 30 MIN,99498,CDM,983,RC,99498,HCPCS,Outpatient,,,203,131.95,,178.64,88,,,percent of total billed charges,88% of total Billed charges,4.72,100,,,Fee Schedule,100% of Medicare rate,40.1,100,,,Fee Schedule,100% of WA Medicaid,203,100,,,percent of total billed charges,100% of total billed charges,41.3,103,,,Fee Schedule,103% of WA Medicaid,4.72,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.26,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,40.1,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,140.07,69,,,percent of total billed charges,69% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,203,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,203,100,,,percent of total billed charges,100% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,125.56,61.85,,,percent of total billed charges,61.85% of total billed charges,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.1,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.9,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,52.13,130,,,Fee Schedule,130% of WA Medicaid ,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,76.53,37.7,,,percent of total billed charges,37.70% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,6881.7,33.9,,,percent of total billed charges,33.9% of total billed charges,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,158.34,78,,,percent of total billed charges,78% of total billed charges,203,100,,,percent of total billed charges,100% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,167.68,82.6,,,percent of total billed charges,82.6% of total billed charges,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.77,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.72,100,,,Fee Schedule,100% of Medicare RBRVS rate,40.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.72,6881.7,
OFFICE/OUTPATIENT VISIT LVL 1,99211,CDM,983,RC,99211,HCPCS,Outpatient,,,118,76.70,,103.84,88,,,percent of total billed charges,88% of total Billed charges,0.52,100,,,Fee Schedule,100% of Medicare rate,4.01,100,,,Fee Schedule,100% of WA Medicaid,118,100,,,percent of total billed charges,100% of total billed charges,4.13,103,,,Fee Schedule,103% of WA Medicaid,0.52,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.91,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,4.01,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,81.42,69,,,percent of total billed charges,69% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,118,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,118,100,,,percent of total billed charges,100% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.98,61.85,,,percent of total billed charges,61.85% of total billed charges,4.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.01,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.09,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,5.21,130,,,Fee Schedule,130% of WA Medicaid ,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.49,37.7,,,percent of total billed charges,37.70% of total billed charges,44.49,37.7,,,percent of total billed charges,37.70% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4000.2,33.9,,,percent of total billed charges,33.9% of total billed charges,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,92.04,78,,,percent of total billed charges,78% of total billed charges,118,100,,,percent of total billed charges,100% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,97.47,82.6,,,percent of total billed charges,82.6% of total billed charges,4.01,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.53,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.52,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.01,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.52,4000.2,
"G0108 Diabetes management treatment, per 30 minutes",G0108,CDM,983,RC,,,Outpatient,,,148,96.20,,130.24,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,102.12,69,,,percent of total billed charges,69% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,148,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,91.54,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,55.8,37.7,,,percent of total billed charges,37.70% of total billed charges,55.8,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,5017.2,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,115.44,78,,,percent of total billed charges,78% of total billed charges,148,100,,,percent of total billed charges,100% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,122.25,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",55.8,5017.2,
G2211 Visit Complexity add on,G2211,CDM,983,RC,G2211,HCPCS,Outpatient,,,57,37.05,,50.16,88,,,percent of total billed charges,88% of total Billed charges,1.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,57,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.77,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,39.33,69,,,percent of total billed charges,69% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,57,100,,,percent of total billed charges,100% of total billed charges,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,57,100,,,percent of total billed charges,100% of total billed charges,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,35.25,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.49,37.7,,,percent of total billed charges,37.70% of total billed charges,21.49,37.7,,,percent of total billed charges,37.70% of total billed charges,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1932.3,33.9,,,percent of total billed charges,33.9% of total billed charges,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,44.46,78,,,percent of total billed charges,78% of total billed charges,57,100,,,percent of total billed charges,100% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,47.08,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,1.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,1.01,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",1.01,1932.3,
94640 Aerosol treatment,94640,CDM,983,RC,94640,HCPCS,Outpatient,,,49,31.85,,43.12,88,,,percent of total billed charges,88% of total Billed charges,0.51,100,,,Fee Schedule,100% of Medicare rate,4.85,100,,,Fee Schedule,100% of WA Medicaid,49,100,,,percent of total billed charges,100% of total billed charges,5,103,,,Fee Schedule,103% of WA Medicaid,0.51,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,0.89,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,4.85,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,33.81,69,,,percent of total billed charges,69% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,49,100,,,percent of total billed charges,100% of total billed charges,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,49,100,,,percent of total billed charges,100% of total billed charges,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,30.31,61.85,,,percent of total billed charges,61.85% of total billed charges,4.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.95,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,6.31,130,,,Fee Schedule,130% of WA Medicaid ,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,18.47,37.7,,,percent of total billed charges,37.70% of total billed charges,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,1661.1,33.9,,,percent of total billed charges,33.9% of total billed charges,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,38.22,78,,,percent of total billed charges,78% of total billed charges,49,100,,,percent of total billed charges,100% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,40.47,82.6,,,percent of total billed charges,82.6% of total billed charges,4.85,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.52,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.51,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.85,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.51,1661.1,
IMMUNOTHERAPY ONE INJECTION,95115,CDM,983,RC,95115,HCPCS,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,0.58,100,,,Fee Schedule,100% of Medicare rate,6.15,100,,,Fee Schedule,100% of WA Medicaid,28,100,,,percent of total billed charges,100% of total billed charges,6.33,103,,,Fee Schedule,103% of WA Medicaid,0.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.01,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,6.15,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,28,100,,,percent of total billed charges,100% of total billed charges,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,28,100,,,percent of total billed charges,100% of total billed charges,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.15,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.27,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,8,130,,,Fee Schedule,130% of WA Medicaid ,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.56,37.7,,,percent of total billed charges,37.70% of total billed charges,10.56,37.7,,,percent of total billed charges,37.70% of total billed charges,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,949.2,33.9,,,percent of total billed charges,33.9% of total billed charges,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.59,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,6.15,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.58,949.2,
IMMUNOTHERAPY INJECTIONS,95117,CDM,983,RC,95117,HCPCS,Outpatient,,,34,22.10,,29.92,88,,,percent of total billed charges,88% of total Billed charges,0.64,100,,,Fee Schedule,100% of Medicare rate,7.46,100,,,Fee Schedule,100% of WA Medicaid,34,100,,,percent of total billed charges,100% of total billed charges,7.68,103,,,Fee Schedule,103% of WA Medicaid,0.64,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.12,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,7.46,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,23.46,69,,,percent of total billed charges,69% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,34,100,,,percent of total billed charges,100% of total billed charges,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,34,100,,,percent of total billed charges,100% of total billed charges,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.03,61.85,,,percent of total billed charges,61.85% of total billed charges,7.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.46,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.7,130,,,Fee Schedule,130% of WA Medicaid ,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,12.82,37.7,,,percent of total billed charges,37.70% of total billed charges,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,1152.6,33.9,,,percent of total billed charges,33.9% of total billed charges,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,26.52,78,,,percent of total billed charges,78% of total billed charges,34,100,,,percent of total billed charges,100% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,28.08,82.6,,,percent of total billed charges,82.6% of total billed charges,7.46,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.65,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.64,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.46,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.64,1152.6,
"96366 IV infusion, for therapy, prophylaxis, or diagnosis; each additional hour",96366,CDM,983,RC,96366,HCPCS,Outpatient,,,68,44.20,,59.84,88,,,percent of total billed charges,88% of total Billed charges,0.89,100,,,Fee Schedule,100% of Medicare rate,11.94,100,,,Fee Schedule,100% of WA Medicaid,68,100,,,percent of total billed charges,100% of total billed charges,12.3,103,,,Fee Schedule,103% of WA Medicaid,0.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.55,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,11.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,46.92,69,,,percent of total billed charges,69% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,68,100,,,percent of total billed charges,100% of total billed charges,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,68,100,,,percent of total billed charges,100% of total billed charges,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,42.06,61.85,,,percent of total billed charges,61.85% of total billed charges,11.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,12.18,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,15.52,130,,,Fee Schedule,130% of WA Medicaid ,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,25.64,37.7,,,percent of total billed charges,37.70% of total billed charges,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,2305.2,33.9,,,percent of total billed charges,33.9% of total billed charges,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,53.04,78,,,percent of total billed charges,78% of total billed charges,68,100,,,percent of total billed charges,100% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,56.17,82.6,,,percent of total billed charges,82.6% of total billed charges,11.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.9,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.89,2305.2,
THER/PROPH/DIAG INJ SC/IM,96372,CDM,510,RC,96372,HCPCS,Outpatient,,,44.39,28.85,,39.06,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,44.39,100,,,percent of total billed charges,100% of total billed charges,41,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid,6.79,15.3,,,percent of total billed charges,15.3% of total billed charges,30.63,69,,,percent of total billed charges,69% of total billed charges,44.39,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,44.39,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,44.39,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,29.48,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,40.6,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,51.74,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.62,78,,,percent of total billed charges,78% of total billed charges,44.39,100,,,percent of total billed charges,100% of total billed charges,36.67,82.6,,,percent of total billed charges,82.6% of total billed charges,36.67,82.6,,,percent of total billed charges,82.6% of total billed charges,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,39.8,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.79,251.75,
Epipen (epinephrine injection) Charge,EPIPEN,CDM,510,RC,,,Outpatient,,,350,227.50,,308,88,,,percent of total billed charges,88% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,60.56,17.304,,,percent of total billed charges,17.304% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,220.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,15.3,,,percent of total billed charges,15.3% of total billed charges,241.5,69,,,percent of total billed charges,69% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,350,100,,,percent of total billed charges,100% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,59.98,17.136,,,percent of total billed charges,17.136% of total billed charges,76.44,21.84,,,percent of total billed charges,21.84% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,273,78,,,percent of total billed charges,78% of total billed charges,350,100,,,percent of total billed charges,100% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,289.1,82.6,,,percent of total billed charges,82.6% of total billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,175,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,175,50,,,percent of total billed charges,50% of total Billed charges,58.8,16.8,,,percent of total billed charges,16.8% of total billed charges,53.55,350,
LIDOCAINE INJECTION,J2001,CDM,636,RC,,,Outpatient,,,0.07,0.05,,0.06,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",0.06,0.06,
ADRENALIN EPINEPHRINE INJECT .1MG,J0171,CDM,510,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
AMPICILLIN 500 MG INJ,J0290,CDM,510,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
"INJ PEN GBENZA PROC 100,000 UNITS SYR",J0558,CDM,510,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
PENICILLIN G BENZATHINE INJ,J0561,CDM,510,RC,,,Outpatient,,,30,19.50,,26.4,88,,,percent of total billed charges,88% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,5.19,17.304,,,percent of total billed charges,17.304% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,18.9,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,15.3,,,percent of total billed charges,15.3% of total billed charges,20.7,69,,,percent of total billed charges,69% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,30,100,,,percent of total billed charges,100% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,5.14,17.136,,,percent of total billed charges,17.136% of total billed charges,6.55,21.84,,,percent of total billed charges,21.84% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,23.4,78,,,percent of total billed charges,78% of total billed charges,30,100,,,percent of total billed charges,100% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,24.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,15,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,15,50,,,percent of total billed charges,50% of total Billed charges,5.04,16.8,,,percent of total billed charges,16.8% of total billed charges,4.59,30,
"J0588- Injection, incobotulinumtoxin A, 1 unit",J0588,CDM,510,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
J0670 inj mepivacaine hcl/10 ml,J0670,CDM,510,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
CEFTRIAXONE SODIUM INJECTION 250 MG.,J0696,CDM,510,RC,,,Outpatient,,,53.25,34.61,,46.86,88,,,percent of total billed charges,88% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,9.21,17.304,,,percent of total billed charges,17.304% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,33.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,8.15,15.3,,,percent of total billed charges,15.3% of total billed charges,36.74,69,,,percent of total billed charges,69% of total billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,9.12,17.136,,,percent of total billed charges,17.136% of total billed charges,11.63,21.84,,,percent of total billed charges,21.84% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.63,50,,,percent of total billed charges,50% of total Billed charges,41.54,78,,,percent of total billed charges,78% of total billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,43.98,82.6,,,percent of total billed charges,82.6% of total billed charges,43.98,82.6,,,percent of total billed charges,82.6% of total billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.63,50,,,percent of total billed charges,50% of total Billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,8.15,53.25,
CEFAZOLIN SODIUM INJECTION 500MG,J0690,CDM,510,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
J0697 sterile cefuroxime injection 750 mg,J0697,CDM,510,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
J0694,J0694,CDM,510,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
"J0696 Injection, ceftriaxone sodium, per 250 mg, 500 mg vial",J0696,CDM,510,RC,,,Outpatient,,,53.25,34.61,,46.86,88,,,percent of total billed charges,88% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,9.21,17.304,,,percent of total billed charges,17.304% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,33.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,8.15,15.3,,,percent of total billed charges,15.3% of total billed charges,36.74,69,,,percent of total billed charges,69% of total billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,9.12,17.136,,,percent of total billed charges,17.136% of total billed charges,11.63,21.84,,,percent of total billed charges,21.84% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.63,50,,,percent of total billed charges,50% of total Billed charges,41.54,78,,,percent of total billed charges,78% of total billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,43.98,82.6,,,percent of total billed charges,82.6% of total billed charges,43.98,82.6,,,percent of total billed charges,82.6% of total billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.63,50,,,percent of total billed charges,50% of total Billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,8.15,53.25,
"J0696 Injection, ceftriaxone sodium, per 250 mg, 1 GM vial",J0696,CDM,510,RC,,,Outpatient,,,53.25,34.61,,46.86,88,,,percent of total billed charges,88% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,9.21,17.304,,,percent of total billed charges,17.304% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,33.55,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,8.15,15.3,,,percent of total billed charges,15.3% of total billed charges,36.74,69,,,percent of total billed charges,69% of total billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,9.12,17.136,,,percent of total billed charges,17.136% of total billed charges,11.63,21.84,,,percent of total billed charges,21.84% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.63,50,,,percent of total billed charges,50% of total Billed charges,41.54,78,,,percent of total billed charges,78% of total billed charges,53.25,100,,,percent of total billed charges,100% of total billed charges,43.98,82.6,,,percent of total billed charges,82.6% of total billed charges,43.98,82.6,,,percent of total billed charges,82.6% of total billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,26.63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,26.63,50,,,percent of total billed charges,50% of total Billed charges,8.95,16.8,,,percent of total billed charges,16.8% of total billed charges,8.15,53.25,
BETAMETHASONE ACETSOD PHOSP 3MG,J0702,CDM,510,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
PROCHLORPERAZINE INJECTION,J0780,CDM,510,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
J0795 corticorelin ovine triflutal,J0795,CDM,510,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
J0834  Cosyntropin Cortrosyn Injection,J0834,CDM,510,RC,,,Outpatient,,,240,156.00,,211.2,88,,,percent of total billed charges,88% of total Billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,40.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,240,100,,,percent of total billed charges,100% of total billed charges,41.53,17.304,,,percent of total billed charges,17.304% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,151.2,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,40.32,16.8,,,percent of total billed charges,16.8% of total billed charges,36.72,15.3,,,percent of total billed charges,15.3% of total billed charges,165.6,69,,,percent of total billed charges,69% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,240,100,,,percent of total billed charges,100% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,240,100,,,percent of total billed charges,100% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,40.32,16.8,,,percent of total billed charges,16.8% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,40.32,16.8,,,percent of total billed charges,16.8% of total Billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,41.13,17.136,,,percent of total billed charges,17.136% of total billed charges,52.42,21.84,,,percent of total billed charges,21.84% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120,50,,,percent of total billed charges,50% of total Billed charges,187.2,78,,,percent of total billed charges,78% of total billed charges,240,100,,,percent of total billed charges,100% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,198.24,82.6,,,percent of total billed charges,82.6% of total billed charges,40.32,16.8,,,percent of total billed charges,16.8% of total billed charges,120,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,120,50,,,percent of total billed charges,50% of total Billed charges,40.32,16.8,,,percent of total billed charges,16.8% of total billed charges,36.72,240,
"EPOETIN ALFA, NON-ESRD",J0885,CDM,510,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
DENOSUMAB INJECTION,J0897,CDM,636,RC,,,Outpatient,,,59.18,38.47,,52.08,88,,,percent of total billed charges,88% of total Billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,9.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,59.18,100,,,percent of total billed charges,100% of total billed charges,10.24,17.304,,,percent of total billed charges,17.304% of total billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,37.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,9.94,16.8,,,percent of total billed charges,16.8% of total billed charges,9.05,15.3,,,percent of total billed charges,15.3% of total billed charges,40.83,69,,,percent of total billed charges,69% of total billed charges,59.18,100,,,percent of total billed charges,100% of total billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,59.18,100,,,percent of total billed charges,100% of total billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,59.18,100,,,percent of total billed charges,100% of total billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,9.94,16.8,,,percent of total billed charges,16.8% of total billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,9.94,16.8,,,percent of total billed charges,16.8% of total Billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,10.14,17.136,,,percent of total billed charges,17.136% of total billed charges,12.92,21.84,,,percent of total billed charges,21.84% of total billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,22.31,37.7,,,percent of total billed charges,37.70% of total billed charges,22.31,37.7,,,percent of total billed charges,37.70% of total billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,20.06,33.9,,,percent of total billed charges,33.9% of total billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,46.16,78,,,percent of total billed charges,78% of total billed charges,59.18,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,9.94,16.8,,,percent of total billed charges,16.8% of total billed charges,29.59,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,29.59,50,,,percent of total billed charges,50% of total Billed charges,9.94,16.8,,,percent of total billed charges,16.8% of total billed charges,9.05,59.18,
DEPO-ESTRADIOL CYPIONATE INJ,J1000,CDM,510,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
METHYLPREDNISOLONE 80 MG INJ,J1040,CDM,510,RC,,,Outpatient,,,23.5,15.28,,20.68,88,,,percent of total billed charges,88% of total Billed charges,11.75,50,,,percent of total billed charges,50% of total Billed charges,3.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,23.5,100,,,percent of total billed charges,100% of total billed charges,4.07,17.304,,,percent of total billed charges,17.304% of total billed charges,11.75,50,,,percent of total billed charges,50% of total Billed charges,14.81,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.95,16.8,,,percent of total billed charges,16.8% of total billed charges,3.6,15.3,,,percent of total billed charges,15.3% of total billed charges,16.22,69,,,percent of total billed charges,69% of total billed charges,23.5,100,,,percent of total billed charges,100% of total billed charges,11.75,50,,,percent of total billed charges,50% of total Billed charges,23.5,100,,,percent of total billed charges,100% of total billed charges,11.75,50,,,percent of total billed charges,50% of total Billed charges,23.5,100,,,percent of total billed charges,100% of total billed charges,11.75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.95,16.8,,,percent of total billed charges,16.8% of total billed charges,11.75,50,,,percent of total billed charges,50% of total Billed charges,11.75,50,,,percent of total billed charges,50% of total Billed charges,3.95,16.8,,,percent of total billed charges,16.8% of total Billed charges,11.75,50,,,percent of total billed charges,50% of total Billed charges,11.75,50,,,percent of total billed charges,50% of total Billed charges,4.03,17.136,,,percent of total billed charges,17.136% of total billed charges,5.13,21.84,,,percent of total billed charges,21.84% of total billed charges,11.75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11.75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.75,50,,,percent of total billed charges,50% of total Billed charges,18.33,78,,,percent of total billed charges,78% of total billed charges,23.5,100,,,percent of total billed charges,100% of total billed charges,19.41,82.6,,,percent of total billed charges,82.6% of total billed charges,19.41,82.6,,,percent of total billed charges,82.6% of total billed charges,3.95,16.8,,,percent of total billed charges,16.8% of total billed charges,11.75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11.75,50,,,percent of total billed charges,50% of total Billed charges,3.95,16.8,,,percent of total billed charges,16.8% of total billed charges,3.6,23.5,
"J1020 Injection, methylprednisolone acetate, 20 mg",J1020,CDM,510,RC,,,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
METHYLPREDNISOLONE 40 MG INJ,J1030,CDM,636,RC,,,Outpatient,,,12.5,8.13,,11,88,,,percent of total billed charges,88% of total Billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,2.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,100,,,percent of total billed charges,100% of total billed charges,2.16,17.304,,,percent of total billed charges,17.304% of total billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,7.88,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.1,16.8,,,percent of total billed charges,16.8% of total billed charges,1.91,15.3,,,percent of total billed charges,15.3% of total billed charges,8.63,69,,,percent of total billed charges,69% of total billed charges,12.5,100,,,percent of total billed charges,100% of total billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,12.5,100,,,percent of total billed charges,100% of total billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,12.5,100,,,percent of total billed charges,100% of total billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.1,16.8,,,percent of total billed charges,16.8% of total billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,2.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,2.14,17.136,,,percent of total billed charges,17.136% of total billed charges,2.73,21.84,,,percent of total billed charges,21.84% of total billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,4.71,37.7,,,percent of total billed charges,37.70% of total billed charges,4.71,37.7,,,percent of total billed charges,37.70% of total billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,4.24,33.9,,,percent of total billed charges,33.9% of total billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,9.75,78,,,percent of total billed charges,78% of total billed charges,12.5,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.1,16.8,,,percent of total billed charges,16.8% of total billed charges,6.25,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6.25,50,,,percent of total billed charges,50% of total Billed charges,2.1,16.8,,,percent of total billed charges,16.8% of total billed charges,1.91,12.5,
MEDROXYPROGESTERONE ACETATE 1MG,J1050,CDM,510,RC,,,Outpatient,,,300,195.00,,264,88,,,percent of total billed charges,88% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,51.91,17.304,,,percent of total billed charges,17.304% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,189,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,15.3,,,percent of total billed charges,15.3% of total billed charges,207,69,,,percent of total billed charges,69% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,300,100,,,percent of total billed charges,100% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,51.41,17.136,,,percent of total billed charges,17.136% of total billed charges,65.52,21.84,,,percent of total billed charges,21.84% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,234,78,,,percent of total billed charges,78% of total billed charges,300,100,,,percent of total billed charges,100% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,247.8,82.6,,,percent of total billed charges,82.6% of total billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,150,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,150,50,,,percent of total billed charges,50% of total Billed charges,50.4,16.8,,,percent of total billed charges,16.8% of total billed charges,45.9,300,
INJ TESTOSTERONE CYPIONATE 1MG,J1071,CDM,636,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.38,37.7,,,percent of total billed charges,37.70% of total billed charges,0.38,37.7,,,percent of total billed charges,37.70% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.34,33.9,,,percent of total billed charges,33.9% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
DEXAMETHASONE SODIUM PHOS 1MG,J1100,CDM,510,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
INJ DIHYDROERGOTAMINE MESYLT,J1110,CDM,510,RC,,,Outpatient,,,63,40.95,,55.44,88,,,percent of total billed charges,88% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,10.9,17.304,,,percent of total billed charges,17.304% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,39.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,15.3,,,percent of total billed charges,15.3% of total billed charges,43.47,69,,,percent of total billed charges,69% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,63,100,,,percent of total billed charges,100% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.8,17.136,,,percent of total billed charges,17.136% of total billed charges,13.76,21.84,,,percent of total billed charges,21.84% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,49.14,78,,,percent of total billed charges,78% of total billed charges,63,100,,,percent of total billed charges,100% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,52.04,82.6,,,percent of total billed charges,82.6% of total billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,31.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,31.5,50,,,percent of total billed charges,50% of total Billed charges,10.58,16.8,,,percent of total billed charges,16.8% of total billed charges,9.64,63,
HYDROMORPHONE INJECTION,J1170,CDM,510,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
DIPHENHYDRAMINE HCL INJECTIO 50 MG,J1200,CDM,510,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
J1240 dimenhydrinate injection,J1240,CDM,510,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
ESTRADIOL VALERATE 10 MG INJ,J1380,CDM,510,RC,,,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,2.77,17.304,,,percent of total billed charges,17.304% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,10.08,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,16,100,,,percent of total billed charges,100% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,2.74,17.136,,,percent of total billed charges,17.136% of total billed charges,3.49,21.84,,,percent of total billed charges,21.84% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,8,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,8,50,,,percent of total billed charges,50% of total Billed charges,2.69,16.8,,,percent of total billed charges,16.8% of total billed charges,2.45,16,
J1435 injection estrone per 1 mg,J1435,CDM,510,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
"J1460 Injection, gamma globulin, intramuscular, 1 cc",J1460,CDM,510,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
J1560 gamma globulin > 10 cc inj,J1560,CDM,510,RC,,,Outpatient,,,164,106.60,,144.32,88,,,percent of total billed charges,88% of total Billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,27.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,164,100,,,percent of total billed charges,100% of total billed charges,28.38,17.304,,,percent of total billed charges,17.304% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,103.32,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,27.55,16.8,,,percent of total billed charges,16.8% of total billed charges,25.09,15.3,,,percent of total billed charges,15.3% of total billed charges,113.16,69,,,percent of total billed charges,69% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,164,100,,,percent of total billed charges,100% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,164,100,,,percent of total billed charges,100% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,27.55,16.8,,,percent of total billed charges,16.8% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,27.55,16.8,,,percent of total billed charges,16.8% of total Billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,28.1,17.136,,,percent of total billed charges,17.136% of total billed charges,35.82,21.84,,,percent of total billed charges,21.84% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,82,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,82,50,,,percent of total billed charges,50% of total Billed charges,127.92,78,,,percent of total billed charges,78% of total billed charges,164,100,,,percent of total billed charges,100% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,135.46,82.6,,,percent of total billed charges,82.6% of total billed charges,27.55,16.8,,,percent of total billed charges,16.8% of total billed charges,82,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,82,50,,,percent of total billed charges,50% of total Billed charges,27.55,16.8,,,percent of total billed charges,16.8% of total billed charges,25.09,164,
J1580,J1580,CDM,510,RC,J1580,HCPCS,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,8,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,8,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
"J1600 Injection, gold sodium thiomalate, up to 50 mg",J1600,CDM,510,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
GLUCAGON HYDROCHLORIDE/1 MG,J1610,CDM,510,RC,,,Outpatient,,,96,62.40,,84.48,88,,,percent of total billed charges,88% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,16.61,17.304,,,percent of total billed charges,17.304% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,60.48,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,14.69,15.3,,,percent of total billed charges,15.3% of total billed charges,66.24,69,,,percent of total billed charges,69% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,96,100,,,percent of total billed charges,100% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,16.45,17.136,,,percent of total billed charges,17.136% of total billed charges,20.97,21.84,,,percent of total billed charges,21.84% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,74.88,78,,,percent of total billed charges,78% of total billed charges,96,100,,,percent of total billed charges,100% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,79.3,82.6,,,percent of total billed charges,82.6% of total billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,48,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,48,50,,,percent of total billed charges,50% of total Billed charges,16.13,16.8,,,percent of total billed charges,16.8% of total billed charges,14.69,96,
J1630,J1630,CDM,510,RC,J1630,HCPCS,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
J1642,J1642,CDM,510,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
INJ ENOXAPARIN SODIUM 10MG,J1650,CDM,510,RC,,,Outpatient,,,25,16.25,,22,88,,,percent of total billed charges,88% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,4.33,17.304,,,percent of total billed charges,17.304% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,15.75,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,15.3,,,percent of total billed charges,15.3% of total billed charges,17.25,69,,,percent of total billed charges,69% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,25,100,,,percent of total billed charges,100% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.28,17.136,,,percent of total billed charges,17.136% of total billed charges,5.46,21.84,,,percent of total billed charges,21.84% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,19.5,78,,,percent of total billed charges,78% of total billed charges,25,100,,,percent of total billed charges,100% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,20.65,82.6,,,percent of total billed charges,82.6% of total billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,12.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.5,50,,,percent of total billed charges,50% of total Billed charges,4.2,16.8,,,percent of total billed charges,16.8% of total billed charges,3.83,25,
TETANUS IMMUNE GLOBULIN INJ,J1670,CDM,510,RC,,,Outpatient,,,407.82,265.08,,358.88,88,,,percent of total billed charges,88% of total Billed charges,203.91,50,,,percent of total billed charges,50% of total Billed charges,68.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,407.82,100,,,percent of total billed charges,100% of total billed charges,70.57,17.304,,,percent of total billed charges,17.304% of total billed charges,203.91,50,,,percent of total billed charges,50% of total Billed charges,256.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,68.51,16.8,,,percent of total billed charges,16.8% of total billed charges,62.4,15.3,,,percent of total billed charges,15.3% of total billed charges,281.4,69,,,percent of total billed charges,69% of total billed charges,407.82,100,,,percent of total billed charges,100% of total billed charges,203.91,50,,,percent of total billed charges,50% of total Billed charges,407.82,100,,,percent of total billed charges,100% of total billed charges,203.91,50,,,percent of total billed charges,50% of total Billed charges,407.82,100,,,percent of total billed charges,100% of total billed charges,203.91,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,68.51,16.8,,,percent of total billed charges,16.8% of total billed charges,203.91,50,,,percent of total billed charges,50% of total Billed charges,203.91,50,,,percent of total billed charges,50% of total Billed charges,68.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,203.91,50,,,percent of total billed charges,50% of total Billed charges,203.91,50,,,percent of total billed charges,50% of total Billed charges,69.88,17.136,,,percent of total billed charges,17.136% of total billed charges,89.07,21.84,,,percent of total billed charges,21.84% of total billed charges,203.91,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,203.91,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,203.91,50,,,percent of total billed charges,50% of total Billed charges,318.1,78,,,percent of total billed charges,78% of total billed charges,407.82,100,,,percent of total billed charges,100% of total billed charges,336.86,82.6,,,percent of total billed charges,82.6% of total billed charges,336.86,82.6,,,percent of total billed charges,82.6% of total billed charges,68.51,16.8,,,percent of total billed charges,16.8% of total billed charges,203.91,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,203.91,50,,,percent of total billed charges,50% of total Billed charges,68.51,16.8,,,percent of total billed charges,16.8% of total billed charges,62.4,407.82,
J1720,J1720,CDM,510,RC,J1720,HCPCS,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,7,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,7,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
"HYDROXYPROGESTERONE CAPROATE, 250 mg/1 mL",J1726,CDM,510,RC,,,Outpatient,,,1026,666.90,,902.88,88,,,percent of total billed charges,88% of total Billed charges,513,50,,,percent of total billed charges,50% of total Billed charges,172.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,1026,100,,,percent of total billed charges,100% of total billed charges,177.54,17.304,,,percent of total billed charges,17.304% of total billed charges,513,50,,,percent of total billed charges,50% of total Billed charges,646.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,172.37,16.8,,,percent of total billed charges,16.8% of total billed charges,156.98,15.3,,,percent of total billed charges,15.3% of total billed charges,707.94,69,,,percent of total billed charges,69% of total billed charges,1026,100,,,percent of total billed charges,100% of total billed charges,513,50,,,percent of total billed charges,50% of total Billed charges,1026,100,,,percent of total billed charges,100% of total billed charges,513,50,,,percent of total billed charges,50% of total Billed charges,1026,100,,,percent of total billed charges,100% of total billed charges,513,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,172.37,16.8,,,percent of total billed charges,16.8% of total billed charges,513,50,,,percent of total billed charges,50% of total Billed charges,513,50,,,percent of total billed charges,50% of total Billed charges,172.37,16.8,,,percent of total billed charges,16.8% of total Billed charges,513,50,,,percent of total billed charges,50% of total Billed charges,513,50,,,percent of total billed charges,50% of total Billed charges,175.82,17.136,,,percent of total billed charges,17.136% of total billed charges,224.08,21.84,,,percent of total billed charges,21.84% of total billed charges,513,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,513,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,513,50,,,percent of total billed charges,50% of total Billed charges,800.28,78,,,percent of total billed charges,78% of total billed charges,1026,100,,,percent of total billed charges,100% of total billed charges,847.48,82.6,,,percent of total billed charges,82.6% of total billed charges,847.48,82.6,,,percent of total billed charges,82.6% of total billed charges,172.37,16.8,,,percent of total billed charges,16.8% of total billed charges,513,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,513,50,,,percent of total billed charges,50% of total Billed charges,172.37,16.8,,,percent of total billed charges,16.8% of total billed charges,156.98,1026,
"J1740 Injection, ibandronate sodium, 1 mg",J1740,CDM,510,RC,,,Outpatient,,,326,211.90,,286.88,88,,,percent of total billed charges,88% of total Billed charges,163,50,,,percent of total billed charges,50% of total Billed charges,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,326,100,,,percent of total billed charges,100% of total billed charges,56.41,17.304,,,percent of total billed charges,17.304% of total billed charges,163,50,,,percent of total billed charges,50% of total Billed charges,205.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,49.88,15.3,,,percent of total billed charges,15.3% of total billed charges,224.94,69,,,percent of total billed charges,69% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,163,50,,,percent of total billed charges,50% of total Billed charges,326,100,,,percent of total billed charges,100% of total billed charges,163,50,,,percent of total billed charges,50% of total Billed charges,326,100,,,percent of total billed charges,100% of total billed charges,163,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,163,50,,,percent of total billed charges,50% of total Billed charges,163,50,,,percent of total billed charges,50% of total Billed charges,54.77,16.8,,,percent of total billed charges,16.8% of total Billed charges,163,50,,,percent of total billed charges,50% of total Billed charges,163,50,,,percent of total billed charges,50% of total Billed charges,55.86,17.136,,,percent of total billed charges,17.136% of total billed charges,71.2,21.84,,,percent of total billed charges,21.84% of total billed charges,163,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,163,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,163,50,,,percent of total billed charges,50% of total Billed charges,254.28,78,,,percent of total billed charges,78% of total billed charges,326,100,,,percent of total billed charges,100% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,269.28,82.6,,,percent of total billed charges,82.6% of total billed charges,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,163,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,163,50,,,percent of total billed charges,50% of total Billed charges,54.77,16.8,,,percent of total billed charges,16.8% of total billed charges,49.88,326,
J1750,J1750,CDM,510,RC,J1750,HCPCS,Outpatient,,,16,10.40,,14.08,88,,,percent of total billed charges,88% of total Billed charges,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,82.95,100,,,Fee Schedule,100% of WA Medicaid,16,100,,,percent of total billed charges,100% of total billed charges,85.44,103,,,Fee Schedule,103% of WA Medicaid,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,10.08,63,,,percent of total billed charges,63% of total billed charges,30.29,175,,,Fee Schedule,175% of Medicare OPPS Rate,82.95,100,,,Fee Schedule,100% of WA Medicaid,2.45,15.3,,,percent of total billed charges,15.3% of total billed charges,11.04,69,,,percent of total billed charges,69% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16,100,,,percent of total billed charges,100% of total billed charges,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,16,100,,,percent of total billed charges,100% of total billed charges,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,60.39,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,82.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,55.86,100,,,Fee Schedule,100% of WA Medicare OPPS rate,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,84.61,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,107.83,130,,,Fee Schedule,130% of WA Medicaid ,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,12.48,78,,,percent of total billed charges,78% of total billed charges,16,100,,,percent of total billed charges,100% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,13.22,82.6,,,percent of total billed charges,82.6% of total billed charges,82.95,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,17.48,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,17.3,100,,,Fee Schedule,100% of Medicare OPPS rate,82.95,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.45,107.83,
J1790,J1790,CDM,510,RC,J1790,HCPCS,Outpatient,,,4,2.60,,3.52,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,100,,,percent of total billed charges,100% of total billed charges,0.69,17.304,,,percent of total billed charges,17.304% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,15.3,,,percent of total billed charges,15.3% of total billed charges,2.76,69,,,percent of total billed charges,69% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,4,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.69,17.136,,,percent of total billed charges,17.136% of total billed charges,0.87,21.84,,,percent of total billed charges,21.84% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.12,78,,,percent of total billed charges,78% of total billed charges,4,100,,,percent of total billed charges,100% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,3.3,82.6,,,percent of total billed charges,82.6% of total billed charges,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.67,16.8,,,percent of total billed charges,16.8% of total billed charges,0.61,4,
J1815,J1815,CDM,510,RC,,,Outpatient,,,9,5.85,,7.92,88,,,percent of total billed charges,88% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,1.56,17.304,,,percent of total billed charges,17.304% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,5.67,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,15.3,,,percent of total billed charges,15.3% of total billed charges,6.21,69,,,percent of total billed charges,69% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,9,100,,,percent of total billed charges,100% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.54,17.136,,,percent of total billed charges,17.136% of total billed charges,1.97,21.84,,,percent of total billed charges,21.84% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,7.02,78,,,percent of total billed charges,78% of total billed charges,9,100,,,percent of total billed charges,100% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,7.43,82.6,,,percent of total billed charges,82.6% of total billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,4.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.5,50,,,percent of total billed charges,50% of total Billed charges,1.51,16.8,,,percent of total billed charges,16.8% of total billed charges,1.38,9,
KETOROLAC TROMETHAMINE INJ 15MG,J1885,CDM,510,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
FUROSEMIDE INJECTION 20 MG,J1940,CDM,510,RC,,,Outpatient,,,15,9.75,,13.2,88,,,percent of total billed charges,88% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,2.6,17.304,,,percent of total billed charges,17.304% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.45,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15.3,,,percent of total billed charges,15.3% of total billed charges,10.35,69,,,percent of total billed charges,69% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,15,100,,,percent of total billed charges,100% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,9.28,61.85,,,percent of total billed charges,61.85% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.57,17.136,,,percent of total billed charges,17.136% of total billed charges,3.28,21.84,,,percent of total billed charges,21.84% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,11.7,78,,,percent of total billed charges,78% of total billed charges,15,100,,,percent of total billed charges,100% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,12.39,82.6,,,percent of total billed charges,82.6% of total billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,7.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7.5,50,,,percent of total billed charges,50% of total Billed charges,2.52,16.8,,,percent of total billed charges,16.8% of total billed charges,2.3,15,
MEPERIDINE HYDROCHL /100 MG,J2175,CDM,510,RC,,,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
J2180 meperidine/promethazine inj,J2180,CDM,510,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
J2250,J2250,CDM,510,RC,J2250,HCPCS,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
MORPHINE SULFATE INJECTION 10MG,J2270,CDM,510,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
INJ NALOXONE HYDROCHLORIDE 1MG,J2310,CDM,510,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
J2360,J2360,CDM,510,RC,J2360,HCPCS,Outpatient,,,28,18.20,,24.64,88,,,percent of total billed charges,88% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,4.85,17.304,,,percent of total billed charges,17.304% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.64,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,15.3,,,percent of total billed charges,15.3% of total billed charges,19.32,69,,,percent of total billed charges,69% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,28,100,,,percent of total billed charges,100% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,17.32,61.85,,,percent of total billed charges,61.85% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,4.8,17.136,,,percent of total billed charges,17.136% of total billed charges,6.12,21.84,,,percent of total billed charges,21.84% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,21.84,78,,,percent of total billed charges,78% of total billed charges,28,100,,,percent of total billed charges,100% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,23.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,14,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,14,50,,,percent of total billed charges,50% of total Billed charges,4.7,16.8,,,percent of total billed charges,16.8% of total billed charges,4.28,28,
ONDANSETRON HCL INJECTION 1MG,J2405,CDM,510,RC,,,Outpatient,,,0.45,0.29,,0.4,88,,,percent of total billed charges,88% of total Billed charges,0.23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.45,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,0.23,50,,,percent of total billed charges,50% of total Billed charges,0.28,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,0.31,69,,,percent of total billed charges,69% of total billed charges,0.45,100,,,percent of total billed charges,100% of total billed charges,0.23,50,,,percent of total billed charges,50% of total Billed charges,0.45,100,,,percent of total billed charges,100% of total billed charges,0.23,50,,,percent of total billed charges,50% of total Billed charges,0.45,100,,,percent of total billed charges,100% of total billed charges,0.23,50,,,percent of total billed charges,50% of total Billed charges,0.28,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,0.23,50,,,percent of total billed charges,50% of total Billed charges,0.23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.23,50,,,percent of total billed charges,50% of total Billed charges,0.23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.23,50,,,percent of total billed charges,50% of total Billed charges,0.35,78,,,percent of total billed charges,78% of total billed charges,0.45,100,,,percent of total billed charges,100% of total billed charges,0.37,82.6,,,percent of total billed charges,82.6% of total billed charges,0.37,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,0.23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.23,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,"Not Separately reimbursable
",0.23,0.45,
PROMETHAZINE HCL INJECTION 50 MG,J2550,CDM,510,RC,,,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
"J2680 Injection, fluphenazine decanoate, up to 25 mg",J2680,CDM,510,RC,,,Outpatient,,,32,20.80,,28.16,88,,,percent of total billed charges,88% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,5.54,17.304,,,percent of total billed charges,17.304% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,20.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,15.3,,,percent of total billed charges,15.3% of total billed charges,22.08,69,,,percent of total billed charges,69% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,32,100,,,percent of total billed charges,100% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,19.79,61.85,,,percent of total billed charges,61.85% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,5.48,17.136,,,percent of total billed charges,17.136% of total billed charges,6.99,21.84,,,percent of total billed charges,21.84% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,24.96,78,,,percent of total billed charges,78% of total billed charges,32,100,,,percent of total billed charges,100% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,26.43,82.6,,,percent of total billed charges,82.6% of total billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,16,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,16,50,,,percent of total billed charges,50% of total Billed charges,5.38,16.8,,,percent of total billed charges,16.8% of total billed charges,4.9,32,
J2725 inj protirelin per 250 mcg,J2725,CDM,510,RC,,,Outpatient,,,36,23.40,,31.68,88,,,percent of total billed charges,88% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,6.23,17.304,,,percent of total billed charges,17.304% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.68,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,15.3,,,percent of total billed charges,15.3% of total billed charges,24.84,69,,,percent of total billed charges,69% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,36,100,,,percent of total billed charges,100% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,22.27,61.85,,,percent of total billed charges,61.85% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,6.17,17.136,,,percent of total billed charges,17.136% of total billed charges,7.86,21.84,,,percent of total billed charges,21.84% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,28.08,78,,,percent of total billed charges,78% of total billed charges,36,100,,,percent of total billed charges,100% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,29.74,82.6,,,percent of total billed charges,82.6% of total billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,18,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,18,50,,,percent of total billed charges,50% of total Billed charges,6.05,16.8,,,percent of total billed charges,16.8% of total billed charges,5.51,36,
METOCLOPRAMIDE HCL INJECTION UP TO 10MG,J2765,CDM,510,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
RHO D IMMUNE GLOBULIN INJ,J2790,CDM,510,RC,,,Outpatient,,,126,81.90,,110.88,88,,,percent of total billed charges,88% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,126,100,,,percent of total billed charges,100% of total billed charges,21.8,17.304,,,percent of total billed charges,17.304% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,79.38,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,19.28,15.3,,,percent of total billed charges,15.3% of total billed charges,86.94,69,,,percent of total billed charges,69% of total billed charges,126,100,,,percent of total billed charges,100% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,126,100,,,percent of total billed charges,100% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,126,100,,,percent of total billed charges,100% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,77.93,61.85,,,percent of total billed charges,61.85% of total billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,21.59,17.136,,,percent of total billed charges,17.136% of total billed charges,27.52,21.84,,,percent of total billed charges,21.84% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,63,50,,,percent of total billed charges,50% of total Billed charges,98.28,78,,,percent of total billed charges,78% of total billed charges,126,100,,,percent of total billed charges,100% of total billed charges,104.08,82.6,,,percent of total billed charges,82.6% of total billed charges,104.08,82.6,,,percent of total billed charges,82.6% of total billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,63,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,63,50,,,percent of total billed charges,50% of total Billed charges,21.17,16.8,,,percent of total billed charges,16.8% of total billed charges,19.28,126,
METHYLPREDNISOLONE INJECTION UP TO 125MG,J2930,CDM,510,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
SUMATRIPTAN SUCCINATE / 6 MG,J3030,CDM,510,RC,,,Outpatient,,,90,58.50,,79.2,88,,,percent of total billed charges,88% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,90,100,,,percent of total billed charges,100% of total billed charges,15.57,17.304,,,percent of total billed charges,17.304% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,56.7,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,13.77,15.3,,,percent of total billed charges,15.3% of total billed charges,62.1,69,,,percent of total billed charges,69% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,90,100,,,percent of total billed charges,100% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,90,100,,,percent of total billed charges,100% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,55.67,61.85,,,percent of total billed charges,61.85% of total billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,15.42,17.136,,,percent of total billed charges,17.136% of total billed charges,19.66,21.84,,,percent of total billed charges,21.84% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45,50,,,percent of total billed charges,50% of total Billed charges,70.2,78,,,percent of total billed charges,78% of total billed charges,90,100,,,percent of total billed charges,100% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,74.34,82.6,,,percent of total billed charges,82.6% of total billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,45,50,,,percent of total billed charges,50% of total Billed charges,15.12,16.8,,,percent of total billed charges,16.8% of total billed charges,13.77,90,
J3111 Romosozumab syringe 210mg/3.34ml dose,J3111,CDM,510,RC,,,Outpatient,,,5880,3822.00,,5174.4,88,,,percent of total billed charges,88% of total Billed charges,2940,50,,,percent of total billed charges,50% of total Billed charges,987.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,4695,100,,,percent of total billed charges,100% of total billed charges,1017.48,17.304,,,percent of total billed charges,17.304% of total billed charges,2940,50,,,percent of total billed charges,50% of total Billed charges,3704.4,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,987.84,16.8,,,percent of total billed charges,16.8% of total billed charges,899.64,15.3,,,percent of total billed charges,15.3% of total billed charges,4057.2,69,,,percent of total billed charges,69% of total billed charges,5880,100,,,percent of total billed charges,100% of total billed charges,2940,50,,,percent of total billed charges,50% of total Billed charges,5880,100,,,percent of total billed charges,100% of total billed charges,2940,50,,,percent of total billed charges,50% of total Billed charges,5880,100,,,percent of total billed charges,100% of total billed charges,2940,50,,,percent of total billed charges,50% of total Billed charges,3636.78,61.85,,,percent of total billed charges,61.85% of total billed charges,987.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2940,50,,,percent of total billed charges,50% of total Billed charges,2940,50,,,percent of total billed charges,50% of total Billed charges,987.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2940,50,,,percent of total billed charges,50% of total Billed charges,2940,50,,,percent of total billed charges,50% of total Billed charges,1007.6,17.136,,,percent of total billed charges,17.136% of total billed charges,1284.19,21.84,,,percent of total billed charges,21.84% of total billed charges,2940,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2940,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2940,50,,,percent of total billed charges,50% of total Billed charges,4586.4,78,,,percent of total billed charges,78% of total billed charges,5880,100,,,percent of total billed charges,100% of total billed charges,4856.88,82.6,,,percent of total billed charges,82.6% of total billed charges,4856.88,82.6,,,percent of total billed charges,82.6% of total billed charges,987.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2940,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2940,50,,,percent of total billed charges,50% of total Billed charges,987.84,16.8,,,percent of total billed charges,16.8% of total billed charges,899.64,5880,
J3250 trimethobenzamide hcl inj,J3250,CDM,510,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
TRIAMCINOLONE ACET INJ,J3301,CDM,510,RC,,,Outpatient,,,25.5,16.58,,22.44,88,,,percent of total billed charges,88% of total Billed charges,12.75,50,,,percent of total billed charges,50% of total Billed charges,4.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,25.5,100,,,percent of total billed charges,100% of total billed charges,4.41,17.304,,,percent of total billed charges,17.304% of total billed charges,12.75,50,,,percent of total billed charges,50% of total Billed charges,16.07,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3.9,15.3,,,percent of total billed charges,15.3% of total billed charges,17.6,69,,,percent of total billed charges,69% of total billed charges,25.5,100,,,percent of total billed charges,100% of total billed charges,12.75,50,,,percent of total billed charges,50% of total Billed charges,25.5,100,,,percent of total billed charges,100% of total billed charges,12.75,50,,,percent of total billed charges,50% of total Billed charges,25.5,100,,,percent of total billed charges,100% of total billed charges,12.75,50,,,percent of total billed charges,50% of total Billed charges,15.77,61.85,,,percent of total billed charges,61.85% of total billed charges,4.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12.75,50,,,percent of total billed charges,50% of total Billed charges,12.75,50,,,percent of total billed charges,50% of total Billed charges,4.28,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.75,50,,,percent of total billed charges,50% of total Billed charges,12.75,50,,,percent of total billed charges,50% of total Billed charges,4.37,17.136,,,percent of total billed charges,17.136% of total billed charges,5.57,21.84,,,percent of total billed charges,21.84% of total billed charges,12.75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.75,50,,,percent of total billed charges,50% of total Billed charges,19.89,78,,,percent of total billed charges,78% of total billed charges,25.5,100,,,percent of total billed charges,100% of total billed charges,21.06,82.6,,,percent of total billed charges,82.6% of total billed charges,21.06,82.6,,,percent of total billed charges,82.6% of total billed charges,4.28,16.8,,,percent of total billed charges,16.8% of total billed charges,12.75,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.75,50,,,percent of total billed charges,50% of total Billed charges,4.28,16.8,,,percent of total billed charges,16.8% of total billed charges,3.9,25.5,
DIAZEPAM INJECTION UP TO 5MG,J3360,CDM,510,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
J3370,J3370,CDM,510,RC,J3370,HCPCS,Outpatient,,,14,9.10,,12.32,88,,,percent of total billed charges,88% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,2.42,17.304,,,percent of total billed charges,17.304% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.82,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,15.3,,,percent of total billed charges,15.3% of total billed charges,9.66,69,,,percent of total billed charges,69% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,14,100,,,percent of total billed charges,100% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,8.66,61.85,,,percent of total billed charges,61.85% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,2.4,17.136,,,percent of total billed charges,17.136% of total billed charges,3.06,21.84,,,percent of total billed charges,21.84% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,10.92,78,,,percent of total billed charges,78% of total billed charges,14,100,,,percent of total billed charges,100% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,11.56,82.6,,,percent of total billed charges,82.6% of total billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,7,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,7,50,,,percent of total billed charges,50% of total Billed charges,2.35,16.8,,,percent of total billed charges,16.8% of total billed charges,2.14,14,
HYDROXYZINE HCL INJECTION UP TO 25MG,J3410,CDM,510,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
"VITAMIN B-1 INJECTION, 100 mg",J3411,CDM,510,RC,,,Outpatient,,,24.9,16.19,,21.91,88,,,percent of total billed charges,88% of total Billed charges,12.45,50,,,percent of total billed charges,50% of total Billed charges,4.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,24.9,100,,,percent of total billed charges,100% of total billed charges,4.31,17.304,,,percent of total billed charges,17.304% of total billed charges,12.45,50,,,percent of total billed charges,50% of total Billed charges,15.69,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.81,15.3,,,percent of total billed charges,15.3% of total billed charges,17.18,69,,,percent of total billed charges,69% of total billed charges,24.9,100,,,percent of total billed charges,100% of total billed charges,12.45,50,,,percent of total billed charges,50% of total Billed charges,24.9,100,,,percent of total billed charges,100% of total billed charges,12.45,50,,,percent of total billed charges,50% of total Billed charges,24.9,100,,,percent of total billed charges,100% of total billed charges,12.45,50,,,percent of total billed charges,50% of total Billed charges,15.4,61.85,,,percent of total billed charges,61.85% of total billed charges,4.18,16.8,,,percent of total billed charges,16.8% of total billed charges,12.45,50,,,percent of total billed charges,50% of total Billed charges,12.45,50,,,percent of total billed charges,50% of total Billed charges,4.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,12.45,50,,,percent of total billed charges,50% of total Billed charges,12.45,50,,,percent of total billed charges,50% of total Billed charges,4.27,17.136,,,percent of total billed charges,17.136% of total billed charges,5.44,21.84,,,percent of total billed charges,21.84% of total billed charges,12.45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12.45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.45,50,,,percent of total billed charges,50% of total Billed charges,19.42,78,,,percent of total billed charges,78% of total billed charges,24.9,100,,,percent of total billed charges,100% of total billed charges,20.57,82.6,,,percent of total billed charges,82.6% of total billed charges,20.57,82.6,,,percent of total billed charges,82.6% of total billed charges,4.18,16.8,,,percent of total billed charges,16.8% of total billed charges,12.45,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12.45,50,,,percent of total billed charges,50% of total Billed charges,4.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.81,24.9,
VITAMIN B12 INJECTION UP TO 1000MCG,J3420,CDM,510,RC,,,Outpatient,,,21.85,14.20,,19.23,88,,,percent of total billed charges,88% of total Billed charges,10.93,50,,,percent of total billed charges,50% of total Billed charges,3.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,21.85,100,,,percent of total billed charges,100% of total billed charges,3.78,17.304,,,percent of total billed charges,17.304% of total billed charges,10.93,50,,,percent of total billed charges,50% of total Billed charges,13.77,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.67,16.8,,,percent of total billed charges,16.8% of total billed charges,3.34,15.3,,,percent of total billed charges,15.3% of total billed charges,15.08,69,,,percent of total billed charges,69% of total billed charges,21.85,100,,,percent of total billed charges,100% of total billed charges,10.93,50,,,percent of total billed charges,50% of total Billed charges,21.85,100,,,percent of total billed charges,100% of total billed charges,10.93,50,,,percent of total billed charges,50% of total Billed charges,21.85,100,,,percent of total billed charges,100% of total billed charges,10.93,50,,,percent of total billed charges,50% of total Billed charges,13.51,61.85,,,percent of total billed charges,61.85% of total billed charges,3.67,16.8,,,percent of total billed charges,16.8% of total billed charges,10.93,50,,,percent of total billed charges,50% of total Billed charges,10.93,50,,,percent of total billed charges,50% of total Billed charges,3.67,16.8,,,percent of total billed charges,16.8% of total Billed charges,10.93,50,,,percent of total billed charges,50% of total Billed charges,10.93,50,,,percent of total billed charges,50% of total Billed charges,3.74,17.136,,,percent of total billed charges,17.136% of total billed charges,4.77,21.84,,,percent of total billed charges,21.84% of total billed charges,10.93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,10.93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.93,50,,,percent of total billed charges,50% of total Billed charges,17.04,78,,,percent of total billed charges,78% of total billed charges,21.85,100,,,percent of total billed charges,100% of total billed charges,18.05,82.6,,,percent of total billed charges,82.6% of total billed charges,18.05,82.6,,,percent of total billed charges,82.6% of total billed charges,3.67,16.8,,,percent of total billed charges,16.8% of total billed charges,10.93,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,10.93,50,,,percent of total billed charges,50% of total Billed charges,3.67,16.8,,,percent of total billed charges,16.8% of total billed charges,3.34,21.85,
VITAMIN K PHYTONADIONE INJ 1MG,J3430,CDM,510,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
J3490,J3490,CDM,510,RC,,,Outpatient,,,12,7.80,,10.56,88,,,percent of total billed charges,88% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,2.08,17.304,,,percent of total billed charges,17.304% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,15.3,,,percent of total billed charges,15.3% of total billed charges,8.28,69,,,percent of total billed charges,69% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,12,100,,,percent of total billed charges,100% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,7.42,61.85,,,percent of total billed charges,61.85% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,2.06,17.136,,,percent of total billed charges,17.136% of total billed charges,2.62,21.84,,,percent of total billed charges,21.84% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,9.36,78,,,percent of total billed charges,78% of total billed charges,12,100,,,percent of total billed charges,100% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,9.91,82.6,,,percent of total billed charges,82.6% of total billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,6,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,6,50,,,percent of total billed charges,50% of total Billed charges,2.02,16.8,,,percent of total billed charges,16.8% of total billed charges,1.84,12,
J7030,J7030,CDM,636,RC,J7030,HCPCS,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,2.64,37.7,,,percent of total billed charges,37.70% of total billed charges,2.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,2.37,33.9,,,percent of total billed charges,33.9% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
J7040,J7040,CDM,510,RC,J7040,HCPCS,Outpatient,,,2,1.30,,1.76,88,,,percent of total billed charges,88% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,0.35,17.304,,,percent of total billed charges,17.304% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.26,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,15.3,,,percent of total billed charges,15.3% of total billed charges,1.38,69,,,percent of total billed charges,69% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1.24,61.85,,,percent of total billed charges,61.85% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,17.136,,,percent of total billed charges,17.136% of total billed charges,0.44,21.84,,,percent of total billed charges,21.84% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,1.56,78,,,percent of total billed charges,78% of total billed charges,2,100,,,percent of total billed charges,100% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,1.65,82.6,,,percent of total billed charges,82.6% of total billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1,50,,,percent of total billed charges,50% of total Billed charges,0.34,16.8,,,percent of total billed charges,16.8% of total billed charges,0.31,2,
J7050,J7050,CDM,510,RC,J7050,HCPCS,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
5% DEXTROSE/WATER,J7060,CDM,510,RC,,,Outpatient,,,24,15.60,,21.12,88,,,percent of total billed charges,88% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,4.15,17.304,,,percent of total billed charges,17.304% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,15.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,15.3,,,percent of total billed charges,15.3% of total billed charges,16.56,69,,,percent of total billed charges,69% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,24,100,,,percent of total billed charges,100% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,14.84,61.85,,,percent of total billed charges,61.85% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,4.11,17.136,,,percent of total billed charges,17.136% of total billed charges,5.24,21.84,,,percent of total billed charges,21.84% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,18.72,78,,,percent of total billed charges,78% of total billed charges,24,100,,,percent of total billed charges,100% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,19.82,82.6,,,percent of total billed charges,82.6% of total billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,12,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,12,50,,,percent of total billed charges,50% of total Billed charges,4.03,16.8,,,percent of total billed charges,16.8% of total billed charges,3.67,24,
J7070,J7070,CDM,510,RC,J7070,HCPCS,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,5.78,82.6,,,percent of total billed charges,82.6% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
J7120,J7120,CDM,636,RC,J7120,HCPCS,Outpatient,,,7,4.55,,6.16,88,,,percent of total billed charges,88% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,1.21,17.304,,,percent of total billed charges,17.304% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.41,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,15.3,,,percent of total billed charges,15.3% of total billed charges,4.83,69,,,percent of total billed charges,69% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,7,100,,,percent of total billed charges,100% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,4.33,61.85,,,percent of total billed charges,61.85% of total billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.2,17.136,,,percent of total billed charges,17.136% of total billed charges,1.53,21.84,,,percent of total billed charges,21.84% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,2.64,37.7,,,percent of total billed charges,37.70% of total billed charges,2.64,37.7,,,percent of total billed charges,37.70% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,2.37,33.9,,,percent of total billed charges,33.9% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,5.46,78,,,percent of total billed charges,78% of total billed charges,7,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,3.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3.5,50,,,percent of total billed charges,50% of total Billed charges,1.18,16.8,,,percent of total billed charges,16.8% of total billed charges,1.07,7,
"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM, 52 MG, 5 YEAR DURATI",J7298,CDM,510,RC,,,Outpatient,,,1322,859.30,,1163.36,88,,,percent of total billed charges,88% of total Billed charges,661,50,,,percent of total billed charges,50% of total Billed charges,222.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,228.76,17.304,,,percent of total billed charges,17.304% of total billed charges,661,50,,,percent of total billed charges,50% of total Billed charges,832.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,222.1,16.8,,,percent of total billed charges,16.8% of total billed charges,202.27,15.3,,,percent of total billed charges,15.3% of total billed charges,912.18,69,,,percent of total billed charges,69% of total billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,661,50,,,percent of total billed charges,50% of total Billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,661,50,,,percent of total billed charges,50% of total Billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,661,50,,,percent of total billed charges,50% of total Billed charges,817.66,61.85,,,percent of total billed charges,61.85% of total billed charges,222.1,16.8,,,percent of total billed charges,16.8% of total billed charges,661,50,,,percent of total billed charges,50% of total Billed charges,661,50,,,percent of total billed charges,50% of total Billed charges,222.1,16.8,,,percent of total billed charges,16.8% of total Billed charges,661,50,,,percent of total billed charges,50% of total Billed charges,661,50,,,percent of total billed charges,50% of total Billed charges,226.54,17.136,,,percent of total billed charges,17.136% of total billed charges,288.72,21.84,,,percent of total billed charges,21.84% of total billed charges,661,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,661,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,661,50,,,percent of total billed charges,50% of total Billed charges,1031.16,78,,,percent of total billed charges,78% of total billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,1091.97,82.6,,,percent of total billed charges,82.6% of total billed charges,1091.97,82.6,,,percent of total billed charges,82.6% of total billed charges,222.1,16.8,,,percent of total billed charges,16.8% of total billed charges,661,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,661,50,,,percent of total billed charges,50% of total Billed charges,222.1,16.8,,,percent of total billed charges,16.8% of total billed charges,202.27,1322,
ETONOGESTREL IMPLANT SYSTEM,J7307,CDM,510,RC,,,Outpatient,,,1311,852.15,,1153.68,88,,,percent of total billed charges,88% of total Billed charges,655.5,50,,,percent of total billed charges,50% of total Billed charges,220.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,1311,100,,,percent of total billed charges,100% of total billed charges,226.86,17.304,,,percent of total billed charges,17.304% of total billed charges,655.5,50,,,percent of total billed charges,50% of total Billed charges,825.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,220.25,16.8,,,percent of total billed charges,16.8% of total billed charges,200.58,15.3,,,percent of total billed charges,15.3% of total billed charges,904.59,69,,,percent of total billed charges,69% of total billed charges,1311,100,,,percent of total billed charges,100% of total billed charges,655.5,50,,,percent of total billed charges,50% of total Billed charges,1311,100,,,percent of total billed charges,100% of total billed charges,655.5,50,,,percent of total billed charges,50% of total Billed charges,1311,100,,,percent of total billed charges,100% of total billed charges,655.5,50,,,percent of total billed charges,50% of total Billed charges,810.85,61.85,,,percent of total billed charges,61.85% of total billed charges,220.25,16.8,,,percent of total billed charges,16.8% of total billed charges,655.5,50,,,percent of total billed charges,50% of total Billed charges,655.5,50,,,percent of total billed charges,50% of total Billed charges,220.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,655.5,50,,,percent of total billed charges,50% of total Billed charges,655.5,50,,,percent of total billed charges,50% of total Billed charges,224.65,17.136,,,percent of total billed charges,17.136% of total billed charges,286.32,21.84,,,percent of total billed charges,21.84% of total billed charges,655.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,655.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,655.5,50,,,percent of total billed charges,50% of total Billed charges,1022.58,78,,,percent of total billed charges,78% of total billed charges,1311,100,,,percent of total billed charges,100% of total billed charges,1082.89,82.6,,,percent of total billed charges,82.6% of total billed charges,1082.89,82.6,,,percent of total billed charges,82.6% of total billed charges,220.25,16.8,,,percent of total billed charges,16.8% of total billed charges,655.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,655.5,50,,,percent of total billed charges,50% of total Billed charges,220.25,16.8,,,percent of total billed charges,16.8% of total billed charges,200.58,1311,
SKYLA 13.5MG,J7301,CDM,510,RC,,,Outpatient,,,832,540.80,,732.16,88,,,percent of total billed charges,88% of total Billed charges,416,50,,,percent of total billed charges,50% of total Billed charges,139.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,832,100,,,percent of total billed charges,100% of total billed charges,143.97,17.304,,,percent of total billed charges,17.304% of total billed charges,416,50,,,percent of total billed charges,50% of total Billed charges,524.16,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,139.78,16.8,,,percent of total billed charges,16.8% of total billed charges,127.3,15.3,,,percent of total billed charges,15.3% of total billed charges,574.08,69,,,percent of total billed charges,69% of total billed charges,832,100,,,percent of total billed charges,100% of total billed charges,416,50,,,percent of total billed charges,50% of total Billed charges,832,100,,,percent of total billed charges,100% of total billed charges,416,50,,,percent of total billed charges,50% of total Billed charges,832,100,,,percent of total billed charges,100% of total billed charges,416,50,,,percent of total billed charges,50% of total Billed charges,514.59,61.85,,,percent of total billed charges,61.85% of total billed charges,139.78,16.8,,,percent of total billed charges,16.8% of total billed charges,416,50,,,percent of total billed charges,50% of total Billed charges,416,50,,,percent of total billed charges,50% of total Billed charges,139.78,16.8,,,percent of total billed charges,16.8% of total Billed charges,416,50,,,percent of total billed charges,50% of total Billed charges,416,50,,,percent of total billed charges,50% of total Billed charges,142.57,17.136,,,percent of total billed charges,17.136% of total billed charges,181.71,21.84,,,percent of total billed charges,21.84% of total billed charges,416,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,416,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,416,50,,,percent of total billed charges,50% of total Billed charges,648.96,78,,,percent of total billed charges,78% of total billed charges,832,100,,,percent of total billed charges,100% of total billed charges,687.23,82.6,,,percent of total billed charges,82.6% of total billed charges,687.23,82.6,,,percent of total billed charges,82.6% of total billed charges,139.78,16.8,,,percent of total billed charges,16.8% of total billed charges,416,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,416,50,,,percent of total billed charges,50% of total Billed charges,139.78,16.8,,,percent of total billed charges,16.8% of total billed charges,127.3,832,
INTRAUT COPPER CONTRACEPTIVE,J7300,CDM,510,RC,,,Outpatient,,,1061,689.65,,933.68,88,,,percent of total billed charges,88% of total Billed charges,530.5,50,,,percent of total billed charges,50% of total Billed charges,178.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,1061,100,,,percent of total billed charges,100% of total billed charges,183.6,17.304,,,percent of total billed charges,17.304% of total billed charges,530.5,50,,,percent of total billed charges,50% of total Billed charges,668.43,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,178.25,16.8,,,percent of total billed charges,16.8% of total billed charges,162.33,15.3,,,percent of total billed charges,15.3% of total billed charges,732.09,69,,,percent of total billed charges,69% of total billed charges,1061,100,,,percent of total billed charges,100% of total billed charges,530.5,50,,,percent of total billed charges,50% of total Billed charges,1061,100,,,percent of total billed charges,100% of total billed charges,530.5,50,,,percent of total billed charges,50% of total Billed charges,1061,100,,,percent of total billed charges,100% of total billed charges,530.5,50,,,percent of total billed charges,50% of total Billed charges,656.23,61.85,,,percent of total billed charges,61.85% of total billed charges,178.25,16.8,,,percent of total billed charges,16.8% of total billed charges,530.5,50,,,percent of total billed charges,50% of total Billed charges,530.5,50,,,percent of total billed charges,50% of total Billed charges,178.25,16.8,,,percent of total billed charges,16.8% of total Billed charges,530.5,50,,,percent of total billed charges,50% of total Billed charges,530.5,50,,,percent of total billed charges,50% of total Billed charges,181.81,17.136,,,percent of total billed charges,17.136% of total billed charges,231.72,21.84,,,percent of total billed charges,21.84% of total billed charges,530.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,530.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,530.5,50,,,percent of total billed charges,50% of total Billed charges,827.58,78,,,percent of total billed charges,78% of total billed charges,1061,100,,,percent of total billed charges,100% of total billed charges,876.39,82.6,,,percent of total billed charges,82.6% of total billed charges,876.39,82.6,,,percent of total billed charges,82.6% of total billed charges,178.25,16.8,,,percent of total billed charges,16.8% of total billed charges,530.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,530.5,50,,,percent of total billed charges,50% of total Billed charges,178.25,16.8,,,percent of total billed charges,16.8% of total billed charges,162.33,1061,
SYNVISC OR SYNVISC-ONE,J7325,CDM,510,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
"J7321 Injection, Hyaluronan or derivative, hyalgan or supart",J7321,CDM,510,RC,,,Outpatient,,,250,162.50,,220,88,,,percent of total billed charges,88% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,43.26,17.304,,,percent of total billed charges,17.304% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,157.5,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,15.3,,,percent of total billed charges,15.3% of total billed charges,172.5,69,,,percent of total billed charges,69% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,250,100,,,percent of total billed charges,100% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,154.63,61.85,,,percent of total billed charges,61.85% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,42.84,17.136,,,percent of total billed charges,17.136% of total billed charges,54.6,21.84,,,percent of total billed charges,21.84% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,195,78,,,percent of total billed charges,78% of total billed charges,250,100,,,percent of total billed charges,100% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,206.5,82.6,,,percent of total billed charges,82.6% of total billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,125,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,125,50,,,percent of total billed charges,50% of total Billed charges,42,16.8,,,percent of total billed charges,16.8% of total billed charges,38.25,250,
"J7320 Injection, Hylan G-F 20, intra-articular, 16 mg",J7320,CDM,510,RC,,,Outpatient,,,5,3.25,,4.4,88,,,percent of total billed charges,88% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,0.87,17.304,,,percent of total billed charges,17.304% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.15,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,15.3,,,percent of total billed charges,15.3% of total billed charges,3.45,69,,,percent of total billed charges,69% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,5,100,,,percent of total billed charges,100% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.09,61.85,,,percent of total billed charges,61.85% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.86,17.136,,,percent of total billed charges,17.136% of total billed charges,1.09,21.84,,,percent of total billed charges,21.84% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,3.9,78,,,percent of total billed charges,78% of total billed charges,5,100,,,percent of total billed charges,100% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,4.13,82.6,,,percent of total billed charges,82.6% of total billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,2.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,2.5,50,,,percent of total billed charges,50% of total Billed charges,0.84,16.8,,,percent of total billed charges,16.8% of total billed charges,0.77,5,
"J7323 Hyaluronan or derivative, euflexxa, for intra-articula",J7323,CDM,510,RC,,,Outpatient,,,424,275.60,,373.12,88,,,percent of total billed charges,88% of total Billed charges,212,50,,,percent of total billed charges,50% of total Billed charges,71.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,424,100,,,percent of total billed charges,100% of total billed charges,73.37,17.304,,,percent of total billed charges,17.304% of total billed charges,212,50,,,percent of total billed charges,50% of total Billed charges,267.12,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,71.23,16.8,,,percent of total billed charges,16.8% of total billed charges,64.87,15.3,,,percent of total billed charges,15.3% of total billed charges,292.56,69,,,percent of total billed charges,69% of total billed charges,424,100,,,percent of total billed charges,100% of total billed charges,212,50,,,percent of total billed charges,50% of total Billed charges,424,100,,,percent of total billed charges,100% of total billed charges,212,50,,,percent of total billed charges,50% of total Billed charges,424,100,,,percent of total billed charges,100% of total billed charges,212,50,,,percent of total billed charges,50% of total Billed charges,262.24,61.85,,,percent of total billed charges,61.85% of total billed charges,71.23,16.8,,,percent of total billed charges,16.8% of total billed charges,212,50,,,percent of total billed charges,50% of total Billed charges,212,50,,,percent of total billed charges,50% of total Billed charges,71.23,16.8,,,percent of total billed charges,16.8% of total Billed charges,212,50,,,percent of total billed charges,50% of total Billed charges,212,50,,,percent of total billed charges,50% of total Billed charges,72.66,17.136,,,percent of total billed charges,17.136% of total billed charges,92.6,21.84,,,percent of total billed charges,21.84% of total billed charges,212,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,212,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,212,50,,,percent of total billed charges,50% of total Billed charges,330.72,78,,,percent of total billed charges,78% of total billed charges,424,100,,,percent of total billed charges,100% of total billed charges,350.22,82.6,,,percent of total billed charges,82.6% of total billed charges,350.22,82.6,,,percent of total billed charges,82.6% of total billed charges,71.23,16.8,,,percent of total billed charges,16.8% of total billed charges,212,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,212,50,,,percent of total billed charges,50% of total Billed charges,71.23,16.8,,,percent of total billed charges,16.8% of total billed charges,64.87,424,
"J7325 Hyaluronan or derivative, Synvisc- One for",J7325,CDM,510,RC,,,Outpatient,,,22,14.30,,19.36,88,,,percent of total billed charges,88% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,3.81,17.304,,,percent of total billed charges,17.304% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,15.3,,,percent of total billed charges,15.3% of total billed charges,15.18,69,,,percent of total billed charges,69% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,22,100,,,percent of total billed charges,100% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,13.61,61.85,,,percent of total billed charges,61.85% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,3.77,17.136,,,percent of total billed charges,17.136% of total billed charges,4.8,21.84,,,percent of total billed charges,21.84% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,17.16,78,,,percent of total billed charges,78% of total billed charges,22,100,,,percent of total billed charges,100% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,18.17,82.6,,,percent of total billed charges,82.6% of total billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,11,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,11,50,,,percent of total billed charges,50% of total Billed charges,3.7,16.8,,,percent of total billed charges,16.8% of total billed charges,3.37,22,
ALBUTEROL NON-COMP UNIT,J7613,CDM,510,RC,,,Outpatient,,,1,0.65,,0.88,88,,,percent of total billed charges,88% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.17,17.304,,,percent of total billed charges,17.304% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.63,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,15.3,,,percent of total billed charges,15.3% of total billed charges,0.69,69,,,percent of total billed charges,69% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.62,61.85,,,percent of total billed charges,61.85% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,17.136,,,percent of total billed charges,17.136% of total billed charges,0.22,21.84,,,percent of total billed charges,21.84% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.78,78,,,percent of total billed charges,78% of total billed charges,1,100,,,percent of total billed charges,100% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.83,82.6,,,percent of total billed charges,82.6% of total billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,0.5,50,,,percent of total billed charges,50% of total Billed charges,0.17,16.8,,,percent of total billed charges,16.8% of total billed charges,0.15,1,
"Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 m",J7620,CDM,510,RC,,,Outpatient,,,6,3.90,,5.28,88,,,percent of total billed charges,88% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,1.04,17.304,,,percent of total billed charges,17.304% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.78,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,15.3,,,percent of total billed charges,15.3% of total billed charges,4.14,69,,,percent of total billed charges,69% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,6,100,,,percent of total billed charges,100% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3.71,61.85,,,percent of total billed charges,61.85% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,1.03,17.136,,,percent of total billed charges,17.136% of total billed charges,1.31,21.84,,,percent of total billed charges,21.84% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,4.68,78,,,percent of total billed charges,78% of total billed charges,6,100,,,percent of total billed charges,100% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,4.96,82.6,,,percent of total billed charges,82.6% of total billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,3,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,3,50,,,percent of total billed charges,50% of total Billed charges,1.01,16.8,,,percent of total billed charges,16.8% of total billed charges,0.92,6,
J7626,J7626,CDM,510,RC,,,Outpatient,,,11,7.15,,9.68,88,,,percent of total billed charges,88% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,1.9,17.304,,,percent of total billed charges,17.304% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.93,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,11,100,,,percent of total billed charges,100% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,6.8,61.85,,,percent of total billed charges,61.85% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.88,17.136,,,percent of total billed charges,17.136% of total billed charges,2.4,21.84,,,percent of total billed charges,21.84% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,5.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,5.5,50,,,percent of total billed charges,50% of total Billed charges,1.85,16.8,,,percent of total billed charges,16.8% of total billed charges,1.68,11,
J7644 ipratropium bromide non-comp,J7644,CDM,510,RC,,,Outpatient,,,8,5.20,,7.04,88,,,percent of total billed charges,88% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,1.38,17.304,,,percent of total billed charges,17.304% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,5.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,15.3,,,percent of total billed charges,15.3% of total billed charges,5.52,69,,,percent of total billed charges,69% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,8,100,,,percent of total billed charges,100% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4.95,61.85,,,percent of total billed charges,61.85% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,1.37,17.136,,,percent of total billed charges,17.136% of total billed charges,1.75,21.84,,,percent of total billed charges,21.84% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,6.24,78,,,percent of total billed charges,78% of total billed charges,8,100,,,percent of total billed charges,100% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,6.61,82.6,,,percent of total billed charges,82.6% of total billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,4,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,4,50,,,percent of total billed charges,50% of total Billed charges,1.34,16.8,,,percent of total billed charges,16.8% of total billed charges,1.22,8,
J8499 oral prescrip drug non chemo,J8499,CDM,510,RC,,,Outpatient,,,3,1.95,,2.64,88,,,percent of total billed charges,88% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,0.52,17.304,,,percent of total billed charges,17.304% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.89,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,15.3,,,percent of total billed charges,15.3% of total billed charges,2.07,69,,,percent of total billed charges,69% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,3,100,,,percent of total billed charges,100% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.86,61.85,,,percent of total billed charges,61.85% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.51,17.136,,,percent of total billed charges,17.136% of total billed charges,0.66,21.84,,,percent of total billed charges,21.84% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,2.34,78,,,percent of total billed charges,78% of total billed charges,3,100,,,percent of total billed charges,100% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,82.6,,,percent of total billed charges,82.6% of total billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,1.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,1.5,50,,,percent of total billed charges,50% of total Billed charges,0.5,16.8,,,percent of total billed charges,16.8% of total billed charges,0.46,3,
VFC 90471 Immunization Admin Perc/ID/Subq/IM; 1 Vaccine,VFC90471,CDM,510,RC,90471,HCPCS,Outpatient,,,42.76,27.79,,37.63,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,42.76,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,26.94,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,6.54,15.3,,,percent of total billed charges,15.3% of total billed charges,29.5,69,,,percent of total billed charges,69% of total billed charges,42.76,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,42.76,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,42.76,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,33.35,78,,,percent of total billed charges,78% of total billed charges,42.76,100,,,percent of total billed charges,100% of total billed charges,35.32,82.6,,,percent of total billed charges,82.6% of total billed charges,35.32,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,6.54,251.75,
VFC 90472 Immunization Admin Perc/ID/Subq/IM; Each Addtl Vaccine,VFC90472,CDM,983,RC,90472,HCPCS,Outpatient,,,21.09,13.71,,18.56,88,,,percent of total billed charges,88% of total Billed charges,0.71,100,,,Fee Schedule,100% of Medicare rate,8.58,100,,,Fee Schedule,100% of WA Medicaid,21.09,100,,,percent of total billed charges,100% of total billed charges,8.84,103,,,Fee Schedule,103% of WA Medicaid,0.71,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.24,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,8.58,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,14.55,69,,,percent of total billed charges,69% of total billed charges,21.09,100,,,percent of total billed charges,100% of total billed charges,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.09,100,,,percent of total billed charges,100% of total billed charges,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.09,100,,,percent of total billed charges,100% of total billed charges,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.04,61.85,,,percent of total billed charges,61.85% of total billed charges,8.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.58,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.75,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,11.15,130,,,Fee Schedule,130% of WA Medicaid ,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.95,37.7,,,percent of total billed charges,37.70% of total billed charges,7.95,37.7,,,percent of total billed charges,37.70% of total billed charges,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,714.95,33.9,,,percent of total billed charges,33.9% of total billed charges,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,16.45,78,,,percent of total billed charges,78% of total billed charges,21.09,100,,,percent of total billed charges,100% of total billed charges,17.42,82.6,,,percent of total billed charges,82.6% of total billed charges,17.42,82.6,,,percent of total billed charges,82.6% of total billed charges,8.58,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.72,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.71,100,,,Fee Schedule,100% of Medicare RBRVS rate,8.58,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.71,714.95,
VFC 90473 Immunization Admin Intranasal/Oral; 1 Vaccine,VFC90473,CDM,510,RC,90473,HCPCS,Outpatient,,,67,43.55,,58.96,88,,,percent of total billed charges,88% of total Billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,67,100,,,percent of total billed charges,100% of total billed charges,35.67,103,,,Fee Schedule,103% of WA Medicaid,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,42.21,63,,,percent of total billed charges,63% of total billed charges,125.74,175,,,Fee Schedule,175% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid,10.25,15.3,,,percent of total billed charges,15.3% of total billed charges,46.23,69,,,percent of total billed charges,69% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,67,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,67,100,,,percent of total billed charges,100% of total billed charges,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,251.75,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,25.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,35.33,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,45.03,130,,,Fee Schedule,130% of WA Medicaid ,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,52.26,78,,,percent of total billed charges,78% of total billed charges,67,100,,,percent of total billed charges,100% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,55.34,82.6,,,percent of total billed charges,82.6% of total billed charges,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,72.57,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,71.85,100,,,Fee Schedule,100% of Medicare OPPS rate,34.64,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.25,251.75,
VFC 90474 Immunization Admin Intranasal/Oral; Each Addtl Vaccine,VFC90474,CDM,983,RC,90474,HCPCS,Outpatient,,,19,12.35,,16.72,88,,,percent of total billed charges,88% of total Billed charges,0.63,100,,,Fee Schedule,100% of Medicare rate,7.09,100,,,Fee Schedule,100% of WA Medicaid,19,100,,,percent of total billed charges,100% of total billed charges,7.3,103,,,Fee Schedule,103% of WA Medicaid,0.63,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1.1,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,7.09,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,13.11,69,,,percent of total billed charges,69% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,19,100,,,percent of total billed charges,100% of total billed charges,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,19,100,,,percent of total billed charges,100% of total billed charges,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,11.75,61.85,,,percent of total billed charges,61.85% of total billed charges,7.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.09,100,,,Fee Schedule,100% of WA Medicare OPPS rate,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.23,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.22,130,,,Fee Schedule,130% of WA Medicaid ,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.16,37.7,,,percent of total billed charges,37.70% of total billed charges,7.16,37.7,,,percent of total billed charges,37.70% of total billed charges,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,644.1,33.9,,,percent of total billed charges,33.9% of total billed charges,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,14.82,78,,,percent of total billed charges,78% of total billed charges,19,100,,,percent of total billed charges,100% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,15.69,82.6,,,percent of total billed charges,82.6% of total billed charges,7.09,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,0.64,101,,,Fee Schedule,101% of Medicare RBRVS rate,0.63,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.09,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,0.63,644.1,
81003 Urine Dipstick POC,81003,CDM,983,RC,81003,HCPCS,Outpatient,,,8.47,5.51,,7.45,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,2,100,,,Fee Schedule,100% of WA Medicaid,8.47,100,,,percent of total billed charges,100% of total billed charges,2.06,103,,,Fee Schedule,103% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5.84,69,,,percent of total billed charges,69% of total billed charges,8.47,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,8.47,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,8.47,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,5.24,61.85,,,percent of total billed charges,61.85% of total billed charges,2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,100,,,Fee Schedule,100% of WA Medicare OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2.04,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2.6,130,,,Fee Schedule,130% of WA Medicaid ,,,,,Other,Not Separately reimbursable,3.19,37.7,,,percent of total billed charges,37.70% of total billed charges,3.19,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,287.13,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,6.61,78,,,percent of total billed charges,78% of total billed charges,8.47,100,,,percent of total billed charges,100% of total billed charges,7,82.6,,,percent of total billed charges,82.6% of total billed charges,7,82.6,,,percent of total billed charges,82.6% of total billed charges,2,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2,287.13,
Urine Pregnancy Test POC,81025,CDM,300,RC,81025,HCPCS,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,33,100,,,percent of total billed charges,100% of total billed charges,2.55,103,,,Fee Schedule,103% of WA Medicaid,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,20.79,63,,,percent of total billed charges,63% of total billed charges,15.06,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,32.93,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,1.83,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2.52,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,3.22,130,,,Fee Schedule,130% of WA Medicaid ,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,11.19,33.9,,,percent of total billed charges,33.9% of total billed charges,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,8.69,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.61,100,,,Fee Schedule,100% of Medicare OPPS rate,2.48,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.83,33,
ROUTINE VENIPUNCTURE,36415,CDM,300,RC,36415,HCPCS,Outpatient,,,11,7.15,,,,,,Other,Not Separately reimbursable,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.1,100,,,Fee Schedule,100% of WA Medicaid,11,100,,,percent of total billed charges,100% of total billed charges,2.16,103,,,Fee Schedule,103% of WA Medicaid,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,,,,,Other,Not Separately reimbursable,15.45,175,,,Fee Schedule,175% of Medicare OPPS Rate,2.1,100,,,Fee Schedule,100% of WA Medicaid,1.68,15.3,,,percent of total billed charges,15.3% of total billed charges,7.59,69,,,percent of total billed charges,69% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,11,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,11,100,,,percent of total billed charges,100% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,11.47,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,1.55,100,,,Fee Schedule,100% of WA Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.14,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,2.73,130,,,Fee Schedule,130% of WA Medicaid ,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,4.15,37.7,,,percent of total billed charges,37.70% of total billed charges,4.15,37.7,,,percent of total billed charges,37.70% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,3.73,33.9,,,percent of total billed charges,33.9% of total billed charges,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.58,78,,,percent of total billed charges,78% of total billed charges,11,100,,,percent of total billed charges,100% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,9.09,82.6,,,percent of total billed charges,82.6% of total billed charges,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,8.91,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,8.83,100,,,Fee Schedule,100% of Medicare OPPS rate,2.1,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,1.55,15.45,
"EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES L",15839,CDM,983,RC,15839,HCPCS,Outpatient,,,1650,1072.50,,1452,88,,,percent of total billed charges,88% of total Billed charges,72.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,1650,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,126.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,1138.5,69,,,percent of total billed charges,69% of total billed charges,1650,100,,,percent of total billed charges,100% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650,100,,,percent of total billed charges,100% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1650,100,,,percent of total billed charges,100% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1020.53,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,622.05,37.7,,,percent of total billed charges,37.70% of total billed charges,622.05,37.7,,,percent of total billed charges,37.70% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,55935,33.9,,,percent of total billed charges,33.9% of total billed charges,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,1287,78,,,percent of total billed charges,78% of total billed charges,1650,100,,,percent of total billed charges,100% of total billed charges,1362.9,82.6,,,percent of total billed charges,82.6% of total billed charges,1362.9,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,73.11,101,,,Fee Schedule,101% of Medicare RBRVS rate,72.39,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,"Not Separately reimbursable
",72.39,55935,
Suction assisted lipectomy; trunk,15877,CDM,983,RC,15877,HCPCS,Outpatient,,,2995,1946.75,,2635.6,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",,,,,Other,Not Separately reimbursable,2066.55,69,,,percent of total billed charges,69% of total billed charges,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,2995,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable,1852.41,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,1129.12,37.7,,,percent of total billed charges,37.70% of total billed charges,1129.12,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable,101530.5,33.9,,,percent of total billed charges,33.9% of total billed charges,,,,,Other,Not Separately reimbursable,2336.1,78,,,percent of total billed charges,78% of total billed charges,2995,100,,,percent of total billed charges,100% of total billed charges,2473.87,82.6,,,percent of total billed charges,82.6% of total billed charges,2473.87,82.6,,,percent of total billed charges,82.6% of total billed charges,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,"Not Separately reimbursable
",1129.12,101530.5,
Breast reduction,19318,CDM,975,RC,19318,HCPCS,Outpatient,,,7995,5196.75,,7035.6,88,,,percent of total billed charges,88% of total Billed charges,110.68,100,,,Fee Schedule,100% of Medicare rate,624.22,100,,,Fee Schedule,100% of WA Medicaid,7995,100,,,percent of total billed charges,100% of total billed charges,642.95,103,,,Fee Schedule,103% of WA Medicaid,110.68,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,193.7,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,624.22,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,5516.55,69,,,percent of total billed charges,69% of total billed charges,7995,100,,,percent of total billed charges,100% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,7995,100,,,percent of total billed charges,100% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,7995,100,,,percent of total billed charges,100% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,4944.91,61.85,,,percent of total billed charges,61.85% of total billed charges,624.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.22,100,,,Fee Schedule,100% of WA Medicare OPPS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,636.7,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,811.49,130,,,Fee Schedule,130% of WA Medicaid ,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,3014.12,37.7,,,percent of total billed charges,37.70% of total billed charges,3014.12,37.7,,,percent of total billed charges,37.70% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,271030.5,33.9,,,percent of total billed charges,33.9% of total billed charges,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,6236.1,78,,,percent of total billed charges,78% of total billed charges,7995,100,,,percent of total billed charges,100% of total billed charges,6603.87,82.6,,,percent of total billed charges,82.6% of total billed charges,6603.87,82.6,,,percent of total billed charges,82.6% of total billed charges,624.22,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.79,101,,,Fee Schedule,101% of Medicare RBRVS rate,110.68,100,,,Fee Schedule,100% of Medicare RBRVS rate,624.22,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,110.68,271030.5,
ARTHROSCOP ROTATOR CUFF REPR,29827,CDM,983,RC,29827,HCPCS,Outpatient,,,2652,1723.80,,2333.76,88,,,percent of total billed charges,88% of total Billed charges,111.9,100,,,Fee Schedule,100% of Medicare rate,612.84,100,,,Fee Schedule,100% of WA Medicaid,2652,100,,,percent of total billed charges,100% of total billed charges,631.23,103,,,Fee Schedule,103% of WA Medicaid,111.9,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,195.83,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,612.84,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,1829.88,69,,,percent of total billed charges,69% of total billed charges,2652,100,,,percent of total billed charges,100% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2652,100,,,percent of total billed charges,100% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2652,100,,,percent of total billed charges,100% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,1640.26,61.85,,,percent of total billed charges,61.85% of total billed charges,612.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.84,100,,,Fee Schedule,100% of WA Medicare OPPS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,625.1,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,796.69,130,,,Fee Schedule,130% of WA Medicaid ,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,999.8,37.7,,,percent of total billed charges,37.70% of total billed charges,999.8,37.7,,,percent of total billed charges,37.70% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,89902.8,33.9,,,percent of total billed charges,33.9% of total billed charges,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,2068.56,78,,,percent of total billed charges,78% of total billed charges,2652,100,,,percent of total billed charges,100% of total billed charges,2190.55,82.6,,,percent of total billed charges,82.6% of total billed charges,2190.55,82.6,,,percent of total billed charges,82.6% of total billed charges,612.84,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,113.02,101,,,Fee Schedule,101% of Medicare RBRVS rate,111.9,100,,,Fee Schedule,100% of Medicare RBRVS rate,612.84,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,111.9,89902.8,
CESAREAN SECTION,59514,CDM,983,RC,59514,HCPCS,Outpatient,,,2997,1948.05,,2637.36,88,,,percent of total billed charges,88% of total Billed charges,150.58,100,,,Fee Schedule,100% of Medicare rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,2997,100,,,percent of total billed charges,100% of total billed charges,291.29,103,,,Fee Schedule,103% of WA Medicaid,150.58,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,263.52,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,282.81,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,2067.93,69,,,percent of total billed charges,69% of total billed charges,2997,100,,,percent of total billed charges,100% of total billed charges,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2997,100,,,percent of total billed charges,100% of total billed charges,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2997,100,,,percent of total billed charges,100% of total billed charges,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1853.64,61.85,,,percent of total billed charges,61.85% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,288.47,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,367.65,130,,,Fee Schedule,130% of WA Medicaid ,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,1129.87,37.7,,,percent of total billed charges,37.70% of total billed charges,1129.87,37.7,,,percent of total billed charges,37.70% of total billed charges,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,101598.3,33.9,,,percent of total billed charges,33.9% of total billed charges,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,2337.66,78,,,percent of total billed charges,78% of total billed charges,2997,100,,,percent of total billed charges,100% of total billed charges,2475.52,82.6,,,percent of total billed charges,82.6% of total billed charges,2475.52,82.6,,,percent of total billed charges,82.6% of total billed charges,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.09,101,,,Fee Schedule,101% of Medicare RBRVS rate,150.58,100,,,Fee Schedule,100% of Medicare RBRVS rate,282.81,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,150.58,101598.3,
US OB Greater Than 14 Weeks,76805,CDM,402,RC,76805,HCPCS,Outpatient,,,422,274.30,TC,371.36,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,422,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,265.86,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,291.18,69,,,percent of total billed charges,69% of total billed charges,422,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,422,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,422,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,159.09,37.7,,,percent of total billed charges,37.70% of total billed charges,159.09,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,143.06,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,329.16,78,,,percent of total billed charges,78% of total billed charges,422,100,,,percent of total billed charges,100% of total billed charges,348.57,82.6,,,percent of total billed charges,82.6% of total billed charges,348.57,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,442.69,
76810 OB US >/= 14 WKS ADDL FETUS,76810,CDM,402,RC,76810,HCPCS,Outpatient,,,683,443.95,TC,601.04,88,,,percent of total billed charges,88% of total Billed charges,341.5,50,,,percent of total billed charges,50% of total Billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid,683,100,,,percent of total billed charges,100% of total billed charges,94.35,103,,,Fee Schedule,103% of WA Medicaid,341.5,50,,,percent of total billed charges,50% of total Billed charges,430.29,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,91.6,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,471.27,69,,,percent of total billed charges,69% of total billed charges,683,100,,,percent of total billed charges,100% of total billed charges,341.5,50,,,percent of total billed charges,50% of total Billed charges,683,100,,,percent of total billed charges,100% of total billed charges,341.5,50,,,percent of total billed charges,50% of total Billed charges,683,100,,,percent of total billed charges,100% of total billed charges,341.5,50,,,percent of total billed charges,50% of total Billed charges,422.44,61.85,,,percent of total billed charges,61.85% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,341.5,50,,,percent of total billed charges,50% of total Billed charges,341.5,50,,,percent of total billed charges,50% of total Billed charges,67.85,100,,,Fee Schedule,100% of WA Medicare OPPS rate,341.5,50,,,percent of total billed charges,50% of total Billed charges,341.5,50,,,percent of total billed charges,50% of total Billed charges,93.43,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,119.08,130,,,Fee Schedule,130% of WA Medicaid ,341.5,50,,,percent of total billed charges,50% of total Billed charges,257.49,37.7,,,percent of total billed charges,37.70% of total billed charges,257.49,37.7,,,percent of total billed charges,37.70% of total billed charges,341.5,50,,,percent of total billed charges,50% of total Billed charges,231.54,33.9,,,percent of total billed charges,33.9% of total billed charges,341.5,50,,,percent of total billed charges,50% of total Billed charges,532.74,78,,,percent of total billed charges,78% of total billed charges,683,100,,,percent of total billed charges,100% of total billed charges,564.16,82.6,,,percent of total billed charges,82.6% of total billed charges,564.16,82.6,,,percent of total billed charges,82.6% of total billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,341.5,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,341.5,50,,,percent of total billed charges,50% of total Billed charges,91.6,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,67.85,683,
76815 OB US LIMITED FETUS(S),76815,CDM,983,RC,76815,HCPCS,Outpatient,,,298,193.70,,262.24,88,,,percent of total billed charges,88% of total Billed charges,3.53,100,,,Fee Schedule,100% of Medicare rate,17.34,100,,,Fee Schedule,100% of WA Medicaid,298,100,,,percent of total billed charges,100% of total billed charges,17.86,103,,,Fee Schedule,103% of WA Medicaid,3.53,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,6.18,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,17.34,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,205.62,69,,,percent of total billed charges,69% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,298,100,,,percent of total billed charges,100% of total billed charges,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,298,100,,,percent of total billed charges,100% of total billed charges,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,184.31,61.85,,,percent of total billed charges,61.85% of total billed charges,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of WA Medicare OPPS rate,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.69,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,22.54,130,,,Fee Schedule,130% of WA Medicaid ,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,112.35,37.7,,,percent of total billed charges,37.70% of total billed charges,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,10102.2,33.9,,,percent of total billed charges,33.9% of total billed charges,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,232.44,78,,,percent of total billed charges,78% of total billed charges,298,100,,,percent of total billed charges,100% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,246.15,82.6,,,percent of total billed charges,82.6% of total billed charges,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,3.57,101,,,Fee Schedule,101% of Medicare RBRVS rate,3.53,100,,,Fee Schedule,100% of Medicare RBRVS rate,17.34,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,3.53,10102.2,
US OB Follow Up,76816,CDM,972,RC,76816,HCPCS,Outpatient,,,284,184.60,TC,249.92,88,,,percent of total billed charges,88% of total Billed charges,4.17,100,,,Fee Schedule,100% of Medicare rate,22.94,100,,,Fee Schedule,100% of WA Medicaid,284,100,,,percent of total billed charges,100% of total billed charges,23.63,103,,,Fee Schedule,103% of WA Medicaid,4.17,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,7.31,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,22.94,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,195.96,69,,,percent of total billed charges,69% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,284,100,,,percent of total billed charges,100% of total billed charges,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,284,100,,,percent of total billed charges,100% of total billed charges,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,175.65,61.85,,,percent of total billed charges,61.85% of total billed charges,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.94,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,23.4,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,29.82,130,,,Fee Schedule,130% of WA Medicaid ,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,107.07,37.7,,,percent of total billed charges,37.70% of total billed charges,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,9627.6,33.9,,,percent of total billed charges,33.9% of total billed charges,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,221.52,78,,,percent of total billed charges,78% of total billed charges,284,100,,,percent of total billed charges,100% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,234.58,82.6,,,percent of total billed charges,82.6% of total billed charges,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.21,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.17,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.94,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.17,9627.6,
ULTRASOUND BIOPHYSICAL PROFILE,76818,CDM,972,RC,76818,HCPCS,Outpatient,,,460,299.00,TC,404.8,88,,,percent of total billed charges,88% of total Billed charges,4.95,100,,,Fee Schedule,100% of Medicare rate,28.35,100,,,Fee Schedule,100% of WA Medicaid,460,100,,,percent of total billed charges,100% of total billed charges,29.2,103,,,Fee Schedule,103% of WA Medicaid,4.95,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,8.67,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,28.35,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,317.4,69,,,percent of total billed charges,69% of total billed charges,460,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,460,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,460,100,,,percent of total billed charges,100% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,284.51,61.85,,,percent of total billed charges,61.85% of total billed charges,28.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.35,100,,,Fee Schedule,100% of WA Medicare OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.92,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,36.86,130,,,Fee Schedule,130% of WA Medicaid ,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,173.42,37.7,,,percent of total billed charges,37.70% of total billed charges,173.42,37.7,,,percent of total billed charges,37.70% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,15594,33.9,,,percent of total billed charges,33.9% of total billed charges,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,358.8,78,,,percent of total billed charges,78% of total billed charges,460,100,,,percent of total billed charges,100% of total billed charges,379.96,82.6,,,percent of total billed charges,82.6% of total billed charges,379.96,82.6,,,percent of total billed charges,82.6% of total billed charges,28.35,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,5,101,,,Fee Schedule,101% of Medicare RBRVS rate,4.95,100,,,Fee Schedule,100% of Medicare RBRVS rate,28.35,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,4.95,15594,
AST PELVIC TRANSVAGINAL,76830,CDM,402,RC,76830,HCPCS,Outpatient,,,381,247.65,,335.28,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,381,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,240.03,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,262.89,69,,,percent of total billed charges,69% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,381,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,381,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,143.64,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,129.16,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,297.18,78,,,percent of total billed charges,78% of total billed charges,381,100,,,percent of total billed charges,100% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,314.71,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,442.69,
US Pelvis Comp w/Transvag if indicated,76856,CDM,402,RC,76856,HCPCS,Outpatient,,,385,250.25,TC,338.8,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,385,100,,,percent of total billed charges,100% of total billed charges,155.82,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,242.55,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,265.65,69,,,percent of total billed charges,69% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,385,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.06,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,154.31,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,196.67,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,145.15,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,130.52,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,300.3,78,,,percent of total billed charges,78% of total billed charges,385,100,,,percent of total billed charges,100% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,318.01,82.6,,,percent of total billed charges,82.6% of total billed charges,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,151.28,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,112.06,442.69,
US Pelvis Ltd w/Transvag if indicated,76857,CDM,402,RC,76857,HCPCS,Outpatient,,,245,159.25,TC,215.6,88,,,percent of total billed charges,88% of total Billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,245,100,,,percent of total billed charges,100% of total billed charges,102.64,103,,,Fee Schedule,103% of WA Medicaid,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,154.35,63,,,percent of total billed charges,63% of total billed charges,196.23,175,,,Fee Schedule,175% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid,235,100,,,Case rate,pays based on per visit rate,169.05,69,,,percent of total billed charges,69% of total billed charges,245,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,245,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,245,100,,,percent of total billed charges,100% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,442.69,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,73.81,100,,,Fee Schedule,100% of WA Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,101.64,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,129.55,130,,,Fee Schedule,130% of WA Medicaid ,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,92.37,37.7,,,percent of total billed charges,37.70% of total billed charges,92.37,37.7,,,percent of total billed charges,37.70% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,83.06,33.9,,,percent of total billed charges,33.9% of total billed charges,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,191.1,78,,,percent of total billed charges,78% of total billed charges,245,100,,,percent of total billed charges,100% of total billed charges,202.37,82.6,,,percent of total billed charges,82.6% of total billed charges,202.37,82.6,,,percent of total billed charges,82.6% of total billed charges,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,113.24,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,112.13,100,,,Fee Schedule,100% of Medicare OPPS rate,99.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,73.81,442.69,
76937 ULTRASOUND GUIDANCE FOR VASCULAR ACCESS,76937,CDM,983,RC,76937,HCPCS,Outpatient,,,61,39.65,,53.68,88,,,percent of total billed charges,88% of total Billed charges,2.21,100,,,Fee Schedule,100% of Medicare rate,7.65,100,,,Fee Schedule,100% of WA Medicaid,61,100,,,percent of total billed charges,100% of total billed charges,7.88,103,,,Fee Schedule,103% of WA Medicaid,2.21,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,3.87,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,7.65,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,42.09,69,,,percent of total billed charges,69% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,61,100,,,percent of total billed charges,100% of total billed charges,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,61,100,,,percent of total billed charges,100% of total billed charges,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,37.73,61.85,,,percent of total billed charges,61.85% of total billed charges,7.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.65,100,,,Fee Schedule,100% of WA Medicare OPPS rate,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.8,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,9.95,130,,,Fee Schedule,130% of WA Medicaid ,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,23,37.7,,,percent of total billed charges,37.70% of total billed charges,23,37.7,,,percent of total billed charges,37.70% of total billed charges,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2067.9,33.9,,,percent of total billed charges,33.9% of total billed charges,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,47.58,78,,,percent of total billed charges,78% of total billed charges,61,100,,,percent of total billed charges,100% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,50.39,82.6,,,percent of total billed charges,82.6% of total billed charges,7.65,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,2.23,101,,,Fee Schedule,101% of Medicare RBRVS rate,2.21,100,,,Fee Schedule,100% of Medicare RBRVS rate,7.65,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,2.21,2067.9,
FLOURO CENTRAL VENUOUS ACCESS,84077001,CDM,320,RC,77001,HCPCS,Outpatient,,,74,48.10,,65.12,88,,,percent of total billed charges,88% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid,74,100,,,percent of total billed charges,100% of total billed charges,166.83,103,,,Fee Schedule,103% of WA Medicaid,37,50,,,percent of total billed charges,50% of total Billed charges,46.62,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable,161.97,100,,,Fee Schedule,100% of WA Medicaid,11.32,15.3,,,percent of total billed charges,15.3% of total billed charges,51.06,69,,,percent of total billed charges,69% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,74,100,,,percent of total billed charges,100% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,45.77,61.85,,,percent of total billed charges,61.85% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,119.98,100,,,Fee Schedule,100% of WA Medicare OPPS rate,37,50,,,percent of total billed charges,50% of total Billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,165.21,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,210.57,130,,,Fee Schedule,130% of WA Medicaid ,37,50,,,percent of total billed charges,50% of total Billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,27.9,37.7,,,percent of total billed charges,37.70% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,25.09,33.9,,,percent of total billed charges,33.9% of total billed charges,37,50,,,percent of total billed charges,50% of total Billed charges,57.72,78,,,percent of total billed charges,78% of total billed charges,74,100,,,percent of total billed charges,100% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,61.12,82.6,,,percent of total billed charges,82.6% of total billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,37,50,,,percent of total billed charges,50% of total Billed charges,,,,,Other,Not Separately reimbursable,37,50,,,percent of total billed charges,50% of total Billed charges,161.97,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,11.32,210.57,
NM Thyroid Cancer Imaging Whole Body,78018,CDM,972,RC,78018,HCPCS,Outpatient,,,247,160.55,TC,217.36,88,,,percent of total billed charges,88% of total Billed charges,10.89,100,,,Fee Schedule,100% of Medicare rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,247,100,,,percent of total billed charges,100% of total billed charges,22.28,103,,,Fee Schedule,103% of WA Medicaid,10.89,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,19.05,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,21.63,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,170.43,69,,,percent of total billed charges,69% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,247,100,,,percent of total billed charges,100% of total billed charges,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,247,100,,,percent of total billed charges,100% of total billed charges,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,152.77,61.85,,,percent of total billed charges,61.85% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicare OPPS rate,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,22.06,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,28.12,130,,,Fee Schedule,130% of WA Medicaid ,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,93.12,37.7,,,percent of total billed charges,37.70% of total billed charges,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,8373.3,33.9,,,percent of total billed charges,33.9% of total billed charges,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,192.66,78,,,percent of total billed charges,78% of total billed charges,247,100,,,percent of total billed charges,100% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,204.02,82.6,,,percent of total billed charges,82.6% of total billed charges,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,11,101,,,Fee Schedule,101% of Medicare RBRVS rate,10.89,100,,,Fee Schedule,100% of Medicare RBRVS rate,21.63,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,10.89,8373.3,
Miscellaneous Supply,MISCSUP,CDM,983,RC,52310,HCPCS,Outpatient,,,,,,,,,,Other,Not Separately reimbursable,13.56,100,,,Fee Schedule,100% of Medicare rate,84.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,87.21,103,,,Fee Schedule,103% of WA Medicaid,13.56,100,,,Fee Schedule,100% of Medicare rate,,,,,Other,Not Separately reimbursable,23.73,175,,,Fee Schedule,175% of Medicare RBRVS  Rate,84.67,100,,,Fee Schedule,100% of WA Medicaid,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.67,100,,,Fee Schedule,100% of WA Medicare OPPS rate,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,86.36,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,110.07,130,,,Fee Schedule,130% of WA Medicaid ,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,,,,,Other,Not Separately reimbursable,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,13.7,101,,,Fee Schedule,101% of Medicare RBRVS rate,13.56,100,,,Fee Schedule,100% of Medicare RBRVS rate,84.67,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,13.56,110.07,
PPD Administration (TB Screen) POC,86580,CDM,300,RC,86580,HCPCS,Outpatient,,,33,21.45,,29.04,88,,,percent of total billed charges,88% of total Billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,33,100,,,percent of total billed charges,100% of total billed charges,9.67,103,,,Fee Schedule,103% of WA Medicaid,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,20.79,63,,,percent of total billed charges,63% of total billed charges,53.14,175,,,Fee Schedule,175% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid,5.05,15.3,,,percent of total billed charges,15.3% of total billed charges,22.77,69,,,percent of total billed charges,69% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,33,100,,,percent of total billed charges,100% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,100.22,382.5,,,Fee Schedule,382.5% of Medicare OPPS Rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,6.96,100,,,Fee Schedule,100% of WA Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.58,102,,,Fee Schedule,102% of WA Medicaid OPPS Rate,12.21,130,,,Fee Schedule,130% of WA Medicaid ,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,12.44,37.7,,,percent of total billed charges,37.70% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,11.19,33.9,,,percent of total billed charges,33.9% of total billed charges,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,25.74,78,,,percent of total billed charges,78% of total billed charges,33,100,,,percent of total billed charges,100% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,27.26,82.6,,,percent of total billed charges,82.6% of total billed charges,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS rate,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,30.67,101,,,Fee Schedule,101% of MEDICARE OPPS RATE,30.37,100,,,Fee Schedule,100% of Medicare OPPS rate,9.39,100,,,Fee Schedule,100% of WA Medicaid OPPS Rate,5.05,100.22,
ROOM/BED: ICU,,,200,RC,,,Inpatient,,,3112,2022.80,,2738.56,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,3112,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1960.56,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,3427,100,,,per diem,Pays based on per day rate ,2147.28,69,,,percent of total billed charges,69% of total billed charges,3112,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3112,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3112,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1924.77,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1002.06,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1173.22,37.7,,,percent of total billed charges,37.70% of total billed charges,1173.22,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1531.1,49.2,,,percent of total billed charges,49.2% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2427.36,78,,,percent of total billed charges,78% of total billed charges,3112,100,,,percent of total billed charges,100% of total billed charges,2723,87.5,,,percent of total billed charges,87.5% of total billed charges,2723,87.5,,,percent of total billed charges,87.5% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,1002.06,3427,
ROOM/BED: Med/Surg,,,121,RC,,,Inpatient,,,1608,1045.20,,1415.04,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,1608,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1013.04,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,3184,100,,,per diem,Pays based on per day rate ,1109.52,69,,,percent of total billed charges,69% of total billed charges,1608,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1608,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1608,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,994.55,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,517.78,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,606.22,37.7,,,percent of total billed charges,37.70% of total billed charges,606.22,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,791.14,49.2,,,percent of total billed charges,49.2% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1254.24,78,,,percent of total billed charges,78% of total billed charges,1608,100,,,percent of total billed charges,100% of total billed charges,1407,87.5,,,percent of total billed charges,87.5% of total billed charges,1407,87.5,,,percent of total billed charges,87.5% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,517.78,3184,
SEMI PRIVATE,,,121,RC,,,Inpatient,,,1388,902.20,,1221.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,1388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,874.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,3184,100,,,per diem,Pays based on per day rate ,957.72,69,,,percent of total billed charges,69% of total billed charges,1388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,858.48,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,446.94,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,523.28,37.7,,,percent of total billed charges,37.70% of total billed charges,523.28,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,682.9,49.2,,,percent of total billed charges,49.2% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1082.64,78,,,percent of total billed charges,78% of total billed charges,1388,100,,,percent of total billed charges,100% of total billed charges,1214.5,87.5,,,percent of total billed charges,87.5% of total billed charges,1214.5,87.5,,,percent of total billed charges,87.5% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,446.94,3184,
ROOM/BED: Nursery Level 2,,,172,RC,,,Inpatient,,,1288,837.20,,1133.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,1288,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,811.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,1665,100,,,per diem,Pays based on per day rate ,888.72,69,,,percent of total billed charges,69% of total billed charges,1288,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1288,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1288,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,796.63,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,414.74,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,485.58,37.7,,,percent of total billed charges,37.70% of total billed charges,485.58,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,633.7,49.2,,,percent of total billed charges,49.2% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1004.64,78,,,percent of total billed charges,78% of total billed charges,1288,100,,,percent of total billed charges,100% of total billed charges,1127,87.5,,,percent of total billed charges,87.5% of total billed charges,1127,87.5,,,percent of total billed charges,87.5% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,414.74,1665,
PRIVATE,,,111,RC,,,Inpatient,,,1388,902.20,,1221.44,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,1388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,874.44,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,3184,100,,,per diem,Pays based on per day rate ,957.72,69,,,percent of total billed charges,69% of total billed charges,1388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1388,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,858.48,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,446.94,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,523.28,37.7,,,percent of total billed charges,37.70% of total billed charges,523.28,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,682.9,49.2,,,percent of total billed charges,49.2% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1082.64,78,,,percent of total billed charges,78% of total billed charges,1388,100,,,percent of total billed charges,100% of total billed charges,1214.5,87.5,,,percent of total billed charges,87.5% of total billed charges,1214.5,87.5,,,percent of total billed charges,87.5% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,446.94,3184,
ROOM/BED: MW Semi Private,,,121,RC,,,Inpatient,,,2244,1458.60,,1974.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,2244,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1413.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,3184,100,,,per diem,Pays based on per day rate ,1548.36,69,,,percent of total billed charges,69% of total billed charges,2244,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2244,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2244,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1387.91,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,722.57,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,845.99,37.7,,,percent of total billed charges,37.70% of total billed charges,845.99,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1104.05,49.2,,,percent of total billed charges,49.2% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1750.32,78,,,percent of total billed charges,78% of total billed charges,2244,100,,,percent of total billed charges,100% of total billed charges,1963.5,87.5,,,percent of total billed charges,87.5% of total billed charges,1963.5,87.5,,,percent of total billed charges,87.5% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,722.57,3184,
ROOM/BED: Intermediate ICU,,,206,RC,,,Inpatient,,,2557,1662.05,,2250.16,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,2557,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1610.91,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,3168,100,,,per diem,Pays based on per day rate ,1764.33,69,,,percent of total billed charges,69% of total billed charges,2557,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2557,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2557,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1581.5,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,823.35,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,963.99,37.7,,,percent of total billed charges,37.70% of total billed charges,963.99,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1258.04,49.2,,,percent of total billed charges,49.2% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1994.46,78,,,percent of total billed charges,78% of total billed charges,2557,100,,,percent of total billed charges,100% of total billed charges,2237.38,87.5,,,percent of total billed charges,87.5% of total billed charges,2237.38,87.5,,,percent of total billed charges,87.5% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,823.35,3168,
ROOM/BED: Obstetrics,,,122,RC,,,Inpatient,,,1322,859.30,,1163.36,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,1322,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,832.86,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,3184,100,,,per diem,Pays based on per day rate ,912.18,69,,,percent of total billed charges,69% of total billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1322,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1322,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,817.66,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,425.68,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,498.39,37.7,,,percent of total billed charges,37.70% of total billed charges,498.39,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,650.42,49.2,,,percent of total billed charges,49.2% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1031.16,78,,,percent of total billed charges,78% of total billed charges,1322,100,,,percent of total billed charges,100% of total billed charges,1156.75,87.5,,,percent of total billed charges,87.5% of total billed charges,1156.75,87.5,,,percent of total billed charges,87.5% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,425.68,3184,
ROOM/BED: Nursery Level 1,,,171,RC,,,Inpatient,,,1178,765.70,,1036.64,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,1178,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,742.14,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,1089,100,,,per diem,Pays based on per day rate ,812.82,69,,,percent of total billed charges,69% of total billed charges,1178,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1178,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1178,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,728.59,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,379.32,61.85,,,percent of total billed charges,61.85% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,444.11,37.7,,,percent of total billed charges,37.70% of total billed charges,444.11,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,579.58,49.2,,,percent of total billed charges,49.2% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,918.84,78,,,percent of total billed charges,78% of total billed charges,1178,100,,,percent of total billed charges,100% of total billed charges,1030.75,87.5,,,percent of total billed charges,87.5% of total billed charges,1030.75,87.5,,,percent of total billed charges,87.5% of total billed charges,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See APR-DRG rows for rates,379.32,1178,
ROOM/BED: Psych Semi Private,,,124,RC,,,Inpatient,,,2244,1458.60,,1974.72,88,,,percent of total billed charges,88% of total Billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1349.63,100,,,per diem,Pays based on per day rate ,2244,100,,,percent of total billed charges,100% of total billed charges,1349.63,100,,,per diem,Pays based on per day rate ,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1413.72,63,,,percent of total billed charges,63% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1349.63,100,,,per diem,Pays based on per day rate ,1753,100,,,per diem,Pays based on per day rate ,1548.36,69,,,percent of total billed charges,69% of total billed charges,2244,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2244,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2244,100,,,percent of total billed charges,100% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1387.91,61.85,,,percent of total billed charges,61.85% of total billed charges,1349.63,100,,,per diem,Pays based on per day rate ,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1191.09,61.85,,,percent of total billed charges,61.85% of total billed charges,1349.63,100,,,per diem,Pays based on per day rate ,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1349.63,100,,,per diem,Pays based on per day rate ,1754.52,100,,,per diem,Pays based on per day rate ,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,845.99,37.7,,,percent of total billed charges,37.70% of total billed charges,845.99,37.7,,,percent of total billed charges,37.70% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1104.05,49.2,,,percent of total billed charges,49.2% of total billed charges,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1750.32,78,,,percent of total billed charges,78% of total billed charges,2244,100,,,percent of total billed charges,100% of total billed charges,1963.5,87.5,,,percent of total billed charges,87.5% of total billed charges,1963.5,87.5,,,percent of total billed charges,87.5% of total billed charges,1349.63,100,,,per diem,Pays based on per day rate ,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1349.63,100,,,per diem,Pays based on per day rate ,845.99,2244,
HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,1,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,454474.23,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,262296.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,259699.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,259699.56,454474.23,
HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,2,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,205977.43,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,118878.4,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,117701.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,117701.39,205977.43,
"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",3,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,357810.65,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,206507.86,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,204463.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,204463.23,357810.65,
"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",4,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,247061.5,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,142589.78,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,141178,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,141178,247061.5,
LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,5,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,174291.57,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,100591.13,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,99595.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,99595.18,174291.57,
LIVER TRANSPLANT WITHOUT MCC,6,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,82064.47,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,47362.92,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,46893.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46893.98,82064.47,
LUNG TRANSPLANT,7,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,206350.48,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,119093.71,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,117914.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,117914.56,206350.48,
SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,8,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,89170.8,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,51464.29,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,50954.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50954.74,89170.8,
PANCREAS TRANSPLANT,10,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81674.67,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,47137.95,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,46671.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46671.24,81674.67,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",11,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,87407.6,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,50446.67,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,49947.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49947.2,87407.6,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",12,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,68146.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39330.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,38940.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38940.66,68146.16,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",13,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46077.61,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26593.36,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26330.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26330.06,46077.61,
ALLOGENEIC BONE MARROW TRANSPLANT,14,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,192875.5,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,111316.72,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,110214.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,110214.57,192875.5,
AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,16,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,104482.61,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,60301.39,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59704.35,104482.61,
AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,17,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,104482.61,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,60301.39,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,59704.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59704.35,104482.61,
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,18,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,617480.57,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,356374.5,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,352846.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,352846.04,617480.57,
SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,19,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,134870.35,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,77839.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,77068.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,77068.77,134870.35,
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,20,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,142547.14,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,82270.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,81455.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81455.51,142547.14,
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,21,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,103887.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,59957.68,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,59364.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59364.04,103887.07,
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,22,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66771.06,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38536.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,38154.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38154.89,66771.06,
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,23,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,95981.06,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,55394.78,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,54846.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54846.32,95981.06,
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,24,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,64531.08,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37243.65,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,36874.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36874.9,64531.08,
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,25,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,75023.32,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43299.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,42870.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42870.47,75023.32,
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,26,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50550.87,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29175.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,28886.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28886.21,50550.87,
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,27,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41848.59,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24152.61,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,23913.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23913.48,41848.59,
SPINAL PROCEDURES WITH MCC,28,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,101958.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58844.47,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,58261.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58261.85,101958.24,
SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,29,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58498.69,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33762.1,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,33427.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33427.82,58498.69,
SPINAL PROCEDURES WITHOUT CC/MCC,30,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39943.19,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23052.93,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22824.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22824.68,39943.19,
VENTRICULAR SHUNT PROCEDURES WITH MCC,31,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,70014.75,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40408.51,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,40008.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40008.43,70014.75,
VENTRICULAR SHUNT PROCEDURES WITH CC,32,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37179.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21457.96,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21245.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21245.5,37179.63,
VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,33,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28298.32,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16332.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16170.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16170.47,28298.32,
CAROTID ARTERY STENT PROCEDURES WITH MCC,34,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66414.72,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38330.78,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,37951.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37951.27,66414.72,
CAROTID ARTERY STENT PROCEDURES WITH CC,35,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39616.99,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22864.66,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22638.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22638.28,39616.99,
CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,36,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31398.19,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18121.24,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17941.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17941.82,31398.19,
EXTRACRANIAL PROCEDURES WITH MCC,37,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,57618.77,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33254.26,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,32925.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32925.01,57618.77,
EXTRACRANIAL PROCEDURES WITH CC,38,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27913.57,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16110.12,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15950.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15950.61,27913.57,
EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,39,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20236.76,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11679.5,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11563.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11563.86,20236.76,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",40,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,65563.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37839.36,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,37464.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37464.71,65563.24,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",41,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38466.05,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22200.41,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21980.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21980.6,38466.05,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",42,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30253.91,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17460.83,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17287.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17287.95,30253.91,
SPINAL DISORDERS AND INJURIES WITH CC/MCC,52,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33678.28,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19437.18,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19244.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19244.73,33678.28,
SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,53,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17607.01,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10161.76,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10061.15,17607.01,
NERVOUS SYSTEM NEOPLASMS WITH MCC,54,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25799.06,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14889.74,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14742.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14742.32,25799.06,
NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,55,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19102.56,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11024.91,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10915.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10915.75,19102.56,
DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,56,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1707.69,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,985.58,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,1707.69,
DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,57,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1707.69,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,985.58,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,1707.69,
MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,58,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30054.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17345.94,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17174.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17174.2,30054.85,
MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,59,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21009.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12125.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12005.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12005.5,21009.63,
MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,60,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16161.65,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9327.58,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9235.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9235.23,16161.65,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",61,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48036.54,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27723.94,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,27449.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27449.45,48036.54,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",62,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32460.45,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18734.32,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18548.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18548.83,32460.45,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",63,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26021.56,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15018.15,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14869.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14869.46,26021.56,
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,64,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34656.93,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20002,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19803.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19803.96,34656.93,
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,65,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18152.37,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10476.51,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10372.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10372.78,18152.37,
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,66,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12650.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7301.03,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7228.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7228.74,12650.3,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,67,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24852.22,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14343.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14201.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14201.27,24852.22,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,68,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15720.01,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9072.69,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8982.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8982.86,15720.01,
TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,69,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14510.53,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8374.65,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8291.73,14510.53,
NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC,70,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31085.34,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17940.68,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17763.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17763.05,31085.34,
NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC,71,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18911.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10914.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10806.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10806.77,18911.85,
NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,72,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14247.87,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8223.06,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8141.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8141.64,14247.87,
CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,73,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26459.84,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15271.11,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15119.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15119.91,26459.84,
CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,74,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18316.31,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10571.12,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10466.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10466.46,18316.31,
VIRAL MENINGITIS WITH CC/MCC,75,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33164.71,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19140.77,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18951.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18951.26,33164.71,
VIRAL MENINGITIS WITHOUT CC/MCC,76,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16581.53,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9569.91,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9475.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9475.16,16581.53,
HYPERTENSIVE ENCEPHALOPATHY WITH MCC,77,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26424.7,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15250.83,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15099.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15099.83,26424.7,
HYPERTENSIVE ENCEPHALOPATHY WITH CC,78,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18160.71,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10481.33,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10377.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10377.55,18160.71,
HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC,79,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13541.92,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7815.62,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7738.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7738.24,13541.92,
NONTRAUMATIC STUPOR AND COMA WITH MCC,80,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1740.22,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,1004.35,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,994.41,1740.22,
NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,81,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1740.22,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,1004.35,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,994.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,994.41,1740.22,
TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,82,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39262.34,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22659.98,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22435.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22435.62,39262.34,
TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,83,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23840.13,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13759.16,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13622.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13622.93,23840.13,
TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,84,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16534.7,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9542.88,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9448.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9448.4,16534.7,
TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,85,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39170.34,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22606.88,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22383.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22383.05,39170.34,
TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,86,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23182.69,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13379.72,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13247.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13247.25,23182.69,
TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,87,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15974.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9219.45,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9128.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9128.17,15974.3,
CONCUSSION WITH MCC,88,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26807.8,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15471.93,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15318.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15318.74,26807.8,
CONCUSSION WITH CC,89,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20385.65,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11765.43,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11648.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11648.94,20385.65,
CONCUSSION WITHOUT CC/MCC,90,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16787.31,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9688.68,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9592.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9592.75,16787.31,
OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,91,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31080.33,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17937.79,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17760.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17760.19,31080.33,
OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,92,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18314.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10570.16,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10465.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10465.5,18314.63,
OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,93,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14104.02,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8140.03,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8059.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8059.44,14104.02,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,94,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,61752.44,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35639.98,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,35287.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35287.11,61752.44,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,95,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41033.91,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23682.43,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,23447.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23447.95,41033.91,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,96,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37612.91,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21708.02,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21493.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21493.09,37612.91,
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,97,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,61989.99,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35777.08,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,35422.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35422.85,61989.99,
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,98,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37191.32,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21464.7,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21252.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21252.18,37191.32,
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,99,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23234.54,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13409.65,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13276.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13276.88,23234.54,
SEIZURES WITH MCC,100,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34313.97,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19804.06,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19607.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19607.98,34313.97,
SEIZURES WITHOUT MCC,101,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16365.74,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9445.37,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9351.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9351.85,16365.74,
HEADACHES WITH MCC,102,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21334.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12312.87,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12190.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12190.96,21334.18,
HEADACHES WITHOUT MCC,103,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15241.57,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8796.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8709.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8709.47,15241.57,
ORBITAL PROCEDURES WITH CC/MCC,113,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43093.23,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24870.95,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,24624.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24624.7,43093.23,
ORBITAL PROCEDURES WITHOUT CC/MCC,114,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21755.74,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12556.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12431.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12431.85,21755.74,
EXTRAOCULAR PROCEDURES EXCEPT ORBIT,115,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27319.71,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15767.37,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15611.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15611.26,27319.71,
INTRAOCULAR PROCEDURES WITH CC/MCC,116,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31776.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18339.43,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18157.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18157.85,31776.24,
INTRAOCULAR PROCEDURES WITHOUT CC/MCC,117,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21197,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12233.7,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12112.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12112.57,21197,
ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,121,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22582.12,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13033.11,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12904.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12904.07,22582.12,
ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,122,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13603.8,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7851.34,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7773.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7773.6,13603.8,
NEUROLOGICAL EYE DISORDERS,123,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14599.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8425.81,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8342.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8342.39,14599.18,
OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,124,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23263,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13426.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13293.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13293.14,23263,
OTHER DISORDERS OF THE EYE WITHOUT MCC,125,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14490.46,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8363.06,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8280.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8280.26,14490.46,
SINUS AND MASTOID PROCEDURES WITH CC/MCC,135,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45515.54,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26268.97,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26008.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26008.88,45515.54,
SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,136,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18619.11,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10745.88,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10639.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10639.49,18619.11,
MOUTH PROCEDURES WITH CC/MCC,137,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26321,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15190.98,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15040.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15040.57,26321,
MOUTH PROCEDURES WITHOUT CC/MCC,138,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15631.33,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9021.51,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8932.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8932.19,15631.33,
SALIVARY GLAND PROCEDURES,139,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21017.99,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12130.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12010.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12010.28,21017.99,
MAJOR HEAD AND NECK PROCEDURES WITH MCC,140,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,64352.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37140.34,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,36772.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36772.61,64352.07,
MAJOR HEAD AND NECK PROCEDURES WITH CC,141,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35806.17,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20665.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20460.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20460.67,35806.17,
MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,142,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26995.17,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15580.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15425.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15425.81,26995.17,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",143,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,56782.32,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32771.51,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,32447.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32447.04,56782.32,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",144,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30098.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17371.05,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17199.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17199.06,30098.36,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",145,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21576.73,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12452.86,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12329.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12329.56,21576.73,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",146,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36463.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21044.72,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20836.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20836.36,36463.63,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",147,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21822.66,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12594.79,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12470.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12470.09,21822.66,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",148,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16032.84,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9253.24,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9161.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9161.62,16032.84,
DYSEQUILIBRIUM,149,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13607.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7853.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,13607.16,
EPISTAXIS WITH MCC,150,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23139.22,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13354.63,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13222.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13222.41,23139.22,
EPISTAXIS WITHOUT MCC,151,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14042.12,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8104.31,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8024.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8024.07,14042.12,
OTITIS MEDIA AND URI WITH MCC,152,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21026.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12135.21,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12015.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12015.06,21026.36,
OTITIS MEDIA AND URI WITHOUT MCC,153,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13441.56,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7757.7,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7680.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7680.89,13441.56,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",154,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26881.42,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15514.42,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15360.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15360.81,26881.42,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",155,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16984.7,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9802.6,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9705.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9705.54,16984.7,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",156,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12114.97,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6992.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6922.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6922.84,12114.97,
DENTAL AND ORAL DISEASES WITH MCC,157,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29705.22,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17144.15,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16974.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16974.41,29705.22,
DENTAL AND ORAL DISEASES WITH CC,158,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16849.19,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9724.39,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9628.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9628.11,16849.19,
DENTAL AND ORAL DISEASES WITHOUT CC/MCC,159,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12444.53,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7182.27,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7111.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7111.16,12444.53,
MAJOR CHEST PROCEDURES WITH MCC,163,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,80001.79,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46172.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,45715.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45715.31,80001.79,
MAJOR CHEST PROCEDURES WITH CC,164,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43814.23,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25287.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,25036.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25036.7,43814.23,
MAJOR CHEST PROCEDURES WITHOUT CC/MCC,165,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32539.05,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18779.68,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18593.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18593.74,32539.05,
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,166,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,69031.1,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39840.8,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,39446.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39446.34,69031.1,
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,167,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31592.21,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18233.22,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18052.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18052.69,31592.21,
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,168,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23828.42,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13752.4,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13616.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13616.24,23828.42,
ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,173,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,52590.13,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30352.02,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,30051.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30051.5,52590.13,
PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,175,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24619.7,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14209.08,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14068.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14068.4,24619.7,
PULMONARY EMBOLISM WITHOUT MCC,176,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14793.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8537.81,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8453.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8453.28,14793.24,
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,177,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29527.89,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17041.81,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16873.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16873.08,29527.89,
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,178,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17655.52,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10189.76,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10088.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10088.87,17655.52,
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,179,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13918.31,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8032.85,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7953.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7953.32,13918.31,
RESPIRATORY NEOPLASMS WITH MCC,180,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30227.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17445.39,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17272.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17272.66,30227.16,
RESPIRATORY NEOPLASMS WITH CC,181,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19569.27,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11294.26,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11182.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11182.44,19569.27,
RESPIRATORY NEOPLASMS WITHOUT CC/MCC,182,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14512.17,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8375.6,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8292.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8292.67,14512.17,
MAJOR CHEST TRAUMA WITH MCC,183,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27488.67,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15864.89,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15707.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15707.81,27488.67,
MAJOR CHEST TRAUMA WITH CC,184,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18746.25,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10819.26,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10712.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10712.14,18746.25,
MAJOR CHEST TRAUMA WITHOUT CC/MCC,185,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13791.19,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7959.49,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7880.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7880.68,13791.19,
PLEURAL EFFUSION WITH MCC,186,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27113.92,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15648.61,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15493.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15493.67,27113.92,
PLEURAL EFFUSION WITH CC,187,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17816.1,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10282.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10180.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10180.63,17816.1,
PLEURAL EFFUSION WITHOUT CC/MCC,188,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13637.28,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7870.66,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7792.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7792.73,13637.28,
PULMONARY EDEMA AND RESPIRATORY FAILURE,189,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21759.08,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12558.1,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12433.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12433.76,21759.08,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,190,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19584.34,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11302.96,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11191.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11191.05,19584.34,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,191,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15351.96,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8860.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8772.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8772.55,15351.96,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,192,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11885.77,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6859.79,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6791.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6791.87,11885.77,
SIMPLE PNEUMONIA AND PLEURISY WITH MCC,193,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23341.61,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13471.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13338.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13338.06,23341.61,
SIMPLE PNEUMONIA AND PLEURISY WITH CC,194,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14903.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8601.52,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8516.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8516.36,14903.63,
SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,195,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11614.79,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6703.39,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6637.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6637.02,11614.79,
INTERSTITIAL LUNG DISEASE WITH MCC,196,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32856.92,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18963.13,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18775.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18775.38,32856.92,
INTERSTITIAL LUNG DISEASE WITH CC,197,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17836.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10294.02,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10192.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10192.1,17836.18,
INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,198,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14167.56,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8176.71,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8095.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8095.75,14167.56,
PNEUMOTHORAX WITH MCC,199,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30827.72,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17792,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17615.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17615.84,30827.72,
PNEUMOTHORAX WITH CC,200,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19166.12,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11061.59,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10952.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10952.07,19166.12,
PNEUMOTHORAX WITHOUT CC/MCC,201,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12961.45,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7480.61,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7406.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7406.54,12961.45,
BRONCHITIS AND ASTHMA WITH CC/MCC,202,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17167.05,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9907.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9809.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9809.74,17167.05,
BRONCHITIS AND ASTHMA WITHOUT CC/MCC,203,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12774.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7372.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7299.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7299.47,12774.07,
RESPIRATORY SIGNS AND SYMPTOMS,204,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14915.37,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8608.3,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8523.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8523.07,14915.37,
OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,205,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31433.31,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18141.51,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17961.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17961.89,31433.31,
OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,206,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16430.98,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9483.02,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9389.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9389.13,16430.98,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,207,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,116711.28,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,67359.08,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,66692.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66692.16,116711.28,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,208,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46380.39,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26768.11,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26503.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26503.08,46380.39,
CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,212,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,181329.33,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,104652.93,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,103616.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,103616.76,181329.33,
OTHER HEART ASSIST SYSTEM IMPLANT,215,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,172029.83,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,99285.79,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,98302.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,98302.76,172029.83,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,216,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,163506.56,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,94366.64,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,93432.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,93432.32,163506.56,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,217,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,107632.61,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,62119.39,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,61504.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,61504.35,107632.61,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,218,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,96447.79,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,55664.15,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,55113.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,55113.02,96447.79,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,219,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,130147.8,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,75113.87,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,74370.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,74370.17,130147.8,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,220,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,88884.76,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,51299.2,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,50791.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50791.29,88884.76,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,221,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,78914.43,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,45544.9,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,45093.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45093.96,78914.43,
OTHER CARDIOTHORACIC PROCEDURES WITH MCC,228,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,85440.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,49311.26,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,48823.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48823.03,85440.3,
OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,229,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54339.93,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31361.9,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,31051.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31051.39,54339.93,
CORONARY BYPASS WITH PTCA WITH MCC,231,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,136906.21,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,79014.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,78232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,78232.12,136906.21,
CORONARY BYPASS WITH PTCA WITHOUT MCC,232,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,100661.77,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58096.22,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,57521.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,57521.01,100661.77,
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,233,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,131626.64,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,75967.37,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,75215.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,75215.22,131626.64,
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,234,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,88103.52,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,50848.32,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,50344.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50344.87,88103.52,
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,235,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,99524.22,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,57439.69,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,56870.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,56870.98,99524.22,
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,236,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,68753.41,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39680.54,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,39287.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39287.66,68753.41,
AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,239,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81560.92,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,47072.3,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,46606.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46606.24,81560.92,
AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,240,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48143.62,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27785.75,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,27510.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27510.64,48143.62,
AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,241,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24469.11,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14122.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13982.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13982.35,24469.11,
PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,242,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58948.68,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34021.81,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,33684.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33684.96,58948.68,
PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,243,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39250.65,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22653.23,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22428.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22428.94,39250.65,
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,244,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31754.49,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18326.87,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18145.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18145.42,31754.49,
AICD GENERATOR PROCEDURES,245,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,76953.82,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,44413.35,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,43973.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43973.61,76953.82,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,250,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40475.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23359.95,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,23128.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23128.66,40475.16,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,251,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27696.1,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15984.6,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15826.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15826.34,27696.1,
OTHER VASCULAR PROCEDURES WITH MCC,252,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,57254.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33043.78,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,32716.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32716.61,57254.07,
OTHER VASCULAR PROCEDURES WITH CC,253,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43825.93,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25293.82,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,25043.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25043.39,43825.93,
OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,254,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30175.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17415.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17243.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17243.03,30175.3,
UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,255,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47109.79,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27189.08,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26919.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26919.88,47109.79,
UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,256,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28579.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16494.37,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16331.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16331.06,28579.36,
UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,257,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17727.47,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10231.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10129.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10129.98,17727.47,
CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,258,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46460.7,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26814.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26548.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26548.97,46460.7,
CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,259,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32375.12,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18685.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18500.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18500.07,32375.12,
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,260,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,56608.34,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32671.1,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,32347.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32347.62,56608.34,
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,261,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32629.42,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18831.83,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18645.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18645.38,32629.42,
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,262,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28673.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16548.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16384.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16384.61,28673.07,
VEIN LIGATION AND STRIPPING,263,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48411.27,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27940.22,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,27663.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27663.58,48411.27,
OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,264,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,55785.29,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32196.08,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,31877.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31877.31,55785.29,
AICD LEAD PROCEDURES,265,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60270.26,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34784.55,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,34440.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34440.15,60270.26,
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,266,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,105638.56,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,60968.54,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,60364.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60364.89,105638.56,
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,267,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,82788.81,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,47780.97,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,47307.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47307.89,82788.81,
AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,268,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,115819.67,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,66844.5,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,66182.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66182.67,115819.67,
AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,269,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,70717.34,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40814.01,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,40409.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40409.91,70717.34,
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,270,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,85744.77,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,49486.98,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,48997.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48997.01,85744.77,
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,271,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58967.09,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34032.43,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,33695.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33695.48,58967.09,
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,272,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41959,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24216.34,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,23976.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23976.57,41959,
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,273,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66341.12,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38288.3,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,37909.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37909.21,66341.12,
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,274,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,55363.74,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31952.78,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,31636.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31636.42,55363.74,
CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,275,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,118849.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,68592.99,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,67913.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,67913.85,118849.24,
CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,276,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,105037.99,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,60621.93,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,60021.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60021.71,105037.99,
CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,277,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81152.73,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46836.72,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,46372.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46372.99,81152.73,
ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,278,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,75766.09,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43727.86,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,43294.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43294.91,75766.09,
ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,279,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54691.25,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31564.66,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,31252.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31252.14,54691.25,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",280,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27689.41,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15980.75,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15822.52,27689.41,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",281,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16422.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9478.2,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9384.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9384.36,16422.63,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",282,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13162.17,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7596.45,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7521.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7521.24,13162.17,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",283,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34128.29,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19696.9,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19501.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19501.88,34128.29,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",284,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13523.55,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7805.02,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7727.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7727.74,13523.55,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",285,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9324.61,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,5381.63,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,5328.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5328.35,9324.61,
"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",286,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37209.71,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21475.32,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21262.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21262.69,37209.71,
"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",287,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19243.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11106,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10996.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10996.04,19243.07,
ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,288,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,44526.86,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25698.36,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,25443.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25443.92,44526.86,
ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,289,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25869.32,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14930.29,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14782.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14782.47,25869.32,
ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,290,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19301.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11139.8,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11029.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11029.5,19301.63,
HEART FAILURE AND SHOCK WITH MCC,291,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22627.29,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13059.18,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12929.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12929.88,22627.29,
HEART FAILURE AND SHOCK WITH CC,292,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15477.44,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8932.69,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8844.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8844.25,15477.44,
HEART FAILURE AND SHOCK WITHOUT CC/MCC,293,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10542.47,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6084.51,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6024.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6024.27,10542.47,
DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC,294,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19445.49,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11222.83,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11111.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11111.71,19445.49,
DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC,295,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14483.75,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8359.19,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8276.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8276.43,14483.75,
"CARDIAC ARREST, UNEXPLAINED WITH MCC",296,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27968.76,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16141.97,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15982.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15982.15,27968.76,
"CARDIAC ARREST, UNEXPLAINED WITH CC",297,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13337.84,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7697.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7621.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7621.62,13337.84,
"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",298,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8504.93,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,4908.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,4859.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,4859.96,8504.93,
PERIPHERAL VASCULAR DISORDERS WITH MCC,299,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27517.11,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15881.3,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15724.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15724.06,27517.11,
PERIPHERAL VASCULAR DISORDERS WITH CC,300,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18998.84,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10965.04,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10856.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10856.48,18998.84,
PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,301,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13023.34,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7516.33,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7441.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7441.91,13023.34,
ATHEROSCLEROSIS WITH MCC,302,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19903.87,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11487.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11373.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11373.64,19903.87,
ATHEROSCLEROSIS WITHOUT MCC,303,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12158.44,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7017.16,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6947.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6947.68,12158.44,
HYPERTENSION WITH MCC,304,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20370.6,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11756.74,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11640.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11640.34,20370.6,
HYPERTENSION WITHOUT MCC,305,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13754.39,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7938.25,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7859.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7859.65,13754.39,
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,306,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26857.99,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15500.89,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15347.42,26857.99,
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,307,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16917.79,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9763.98,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9667.31,16917.79,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,308,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21260.58,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12270.39,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12148.9,21260.58,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,309,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13607.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7853.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,13607.16,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,310,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10400.27,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6002.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5943.01,10400.27,
ANGINA PECTORIS,311,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12827.62,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7403.37,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7330.07,12827.62,
SYNCOPE AND COLLAPSE,312,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15594.55,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9000.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8911.17,15594.55,
CHEST PAIN,313,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13254.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7649.57,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7573.83,13254.2,
OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,314,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36170.86,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20875.75,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20669.06,36170.86,
OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,315,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17330.99,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10002.45,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9903.42,17330.99,
OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,316,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12737.27,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7351.22,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7278.44,12737.27,
CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,317,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26857.99,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15500.89,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15347.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15347.42,26857.99,
OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,319,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,74118.29,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,42776.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,42353.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42353.31,74118.29,
OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,320,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38387.44,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22155.04,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21935.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21935.68,38387.44,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,321,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49239.35,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28418.14,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,28136.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28136.77,49239.35,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,322,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31652.44,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18267.98,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18087.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18087.11,31652.44,
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,323,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,70406.21,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40634.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,40232.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40232.12,70406.21,
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,324,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50810.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29324.73,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,29034.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29034.39,50810.18,
CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,325,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45385.06,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26193.66,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,25934.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25934.32,45385.06,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",326,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,86114.47,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,49700.35,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,49208.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49208.27,86114.47,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",327,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42927.61,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24775.36,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,24530.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24530.06,42927.61,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",328,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27870.06,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16085.01,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15925.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15925.75,27870.06,
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,329,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,76709.59,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,44272.39,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,43834.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43834.05,76709.59,
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,330,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40831.49,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23565.6,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,23332.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23332.28,40831.49,
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,331,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29119.72,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16806.24,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16639.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16639.84,29119.72,
RECTAL RESECTION WITH MCC,332,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,62281.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35945.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,35589.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35589.18,62281.07,
RECTAL RESECTION WITH CC,333,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35936.65,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20740.58,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20535.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20535.23,35936.65,
RECTAL RESECTION WITHOUT CC/MCC,334,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28000.54,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16160.31,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16000.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16000.31,28000.54,
PERITONEAL ADHESIOLYSIS WITH MCC,335,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60954.48,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35179.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,34831.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34831.13,60954.48,
PERITONEAL ADHESIOLYSIS WITH CC,336,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36368.27,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20989.69,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20781.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20781.87,36368.27,
PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,337,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26182.15,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15110.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14961.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14961.23,26182.15,
MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,344,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46992.68,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27121.49,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26852.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26852.96,46992.68,
MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,345,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26921.55,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15537.58,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15383.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15383.74,26921.55,
MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,346,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22692.55,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13096.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12967.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12967.17,22692.55,
ANAL AND STOMAL PROCEDURES WITH MCC,347,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43792.46,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25274.5,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,25024.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25024.26,43792.46,
ANAL AND STOMAL PROCEDURES WITH CC,348,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22920.05,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13228.14,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13097.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13097.17,22920.05,
ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,349,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17473.19,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10084.53,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9984.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9984.68,17473.19,
INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,350,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41298.23,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23834.98,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,23598.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23598.99,41298.23,
INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,351,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25499.62,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14716.92,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14571.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14571.21,25499.62,
INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,352,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19701.45,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11370.55,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11257.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11257.97,19701.45,
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,353,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50069.08,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28897.01,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,28610.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28610.9,50069.08,
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,354,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29885.89,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17248.43,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17077.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17077.65,29885.89,
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,355,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23943.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13819.02,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13682.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13682.2,23943.85,
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,356,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,72726.47,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,41973.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,41557.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41557.98,72726.47,
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,357,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37898.95,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21873.11,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21656.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21656.54,37898.95,
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,358,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22580.46,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13032.15,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12903.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12903.12,22580.46,
MAJOR ESOPHAGEAL DISORDERS WITH MCC,368,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28785.14,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16613.14,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16448.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16448.65,28785.14,
MAJOR ESOPHAGEAL DISORDERS WITH CC,369,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17682.28,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10205.2,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10104.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10104.16,17682.28,
MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,370,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13590.45,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7843.63,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7765.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7765.97,13590.45,
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,371,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30386.09,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17537.11,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17363.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17363.48,30386.09,
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,372,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18585.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10726.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10620.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10620.36,18585.63,
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,373,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13135.41,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7581.01,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7505.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7505.95,13135.41,
DIGESTIVE MALIGNANCY WITH MCC,374,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36262.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20928.85,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20721.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20721.63,36262.85,
DIGESTIVE MALIGNANCY WITH CC,375,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21195.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12232.72,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12111.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12111.6,21195.3,
DIGESTIVE MALIGNANCY WITHOUT CC/MCC,376,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16061.26,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9269.64,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9177.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9177.86,16061.26,
GASTROINTESTINAL HEMORRHAGE WITH MCC,377,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31098.73,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17948.41,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17770.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17770.7,31098.73,
GASTROINTESTINAL HEMORRHAGE WITH CC,378,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17607.01,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10161.76,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10061.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10061.15,17607.01,
GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,379,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11741.92,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6776.77,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6709.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6709.67,11741.92,
COMPLICATED PEPTIC ULCER WITH MCC,380,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33745.22,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19475.81,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19282.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19282.98,33745.22,
COMPLICATED PEPTIC ULCER WITH CC,381,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19099.22,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11022.98,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10913.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10913.84,19099.22,
COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,382,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13814.59,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7972.99,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7894.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7894.05,13814.59,
UNCOMPLICATED PEPTIC ULCER WITH MCC,383,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24539.39,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14162.74,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14022.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14022.51,24539.39,
UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,384,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15798.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9118.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9027.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9027.79,15798.63,
INFLAMMATORY BOWEL DISEASE WITH MCC,385,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27361.53,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15791.51,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15635.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15635.16,27361.53,
INFLAMMATORY BOWEL DISEASE WITH CC,386,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17402.91,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10043.97,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9944.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9944.52,17402.91,
INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,387,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12593.42,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7268.2,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7196.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7196.24,12593.42,
GASTROINTESTINAL OBSTRUCTION WITH MCC,388,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25464.5,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14696.65,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14551.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14551.14,25464.5,
GASTROINTESTINAL OBSTRUCTION WITH CC,389,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14472.06,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8352.45,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8269.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8269.75,14472.06,
GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,390,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10500.65,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6060.37,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6000.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6000.37,10500.65,
"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",391,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22490.11,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12980,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12851.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12851.49,22490.11,
"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",392,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14291.38,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8248.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8166.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8166.5,14291.38,
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,393,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28243.13,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16300.32,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16138.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16138.93,28243.13,
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,394,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16822.44,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9708.95,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9612.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9612.82,16822.44,
OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,395,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11981.15,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6914.83,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6846.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6846.37,11981.15,
APPENDIX PROCEDURES WITH MCC,397,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38732.02,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22353.91,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22132.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22132.58,38732.02,
APPENDIX PROCEDURES WITH CC,398,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26464.87,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15274.01,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15122.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15122.78,26464.87,
APPENDIX PROCEDURES WITHOUT CC/MCC,399,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19770.03,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11410.13,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11297.16,19770.03,
SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,402,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16917.79,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9763.98,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9667.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9667.31,16917.79,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",405,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,93244.25,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,53815.25,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,53282.43,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,53282.43,93244.25,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",406,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49451.8,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28540.75,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,28258.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28258.17,49451.8,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",407,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37132.76,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21430.91,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21218.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21218.72,37132.76,
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,408,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,63416.96,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36600.64,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,36238.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36238.26,63416.96,
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,409,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33892.41,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19560.76,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19367.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19367.09,33892.41,
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,410,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27333.08,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15775.09,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15618.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15618.9,27333.08,
CHOLECYSTECTOMY WITH C.D.E. WITH MCC,411,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,52011.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30017.95,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,29720.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29720.74,52011.3,
CHOLECYSTECTOMY WITH C.D.E. WITH CC,412,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35712.5,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20611.21,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20407.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20407.14,35712.5,
CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,413,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26402.97,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15238.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15087.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15087.41,26402.97,
CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,414,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60121.37,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34698.62,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,34355.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34355.07,60121.37,
CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,415,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34201.9,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19739.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19543.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19543.94,34201.9,
CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,416,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23552.39,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13593.1,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13458.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13458.51,23552.39,
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,417,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39923.12,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23041.34,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22813.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22813.21,39923.12,
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,418,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28495.74,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16446.11,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16283.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16283.28,28495.74,
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,419,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23117.47,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13342.08,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13209.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13209.98,23117.47,
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,420,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54694.59,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31566.59,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,31254.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31254.05,54694.59,
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,421,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29748.71,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17169.25,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16999.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16999.26,29748.71,
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,422,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24753.52,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14286.32,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14144.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14144.87,24753.52,
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,423,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66573.64,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38422.5,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,38042.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38042.08,66573.64,
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,424,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36809.9,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21244.57,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21034.23,36809.9,
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,425,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27947.03,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16129.43,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15969.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15969.73,27947.03,
MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,426,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21260.58,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12270.39,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12148.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12148.9,21260.58,
MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,427,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13607.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7853.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7775.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7775.52,13607.16,
MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,428,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10400.27,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6002.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,5943.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5943.01,10400.27,
COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,429,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12827.62,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7403.37,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7330.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7330.07,12827.62,
COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,430,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15594.55,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9000.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8911.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8911.17,15594.55,
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,432,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33201.53,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19162.02,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18972.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18972.3,33201.53,
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,433,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18396.61,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10617.47,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10512.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10512.35,18396.61,
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,434,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12349.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7127.23,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7056.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7056.66,12349.16,
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,435,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30590.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17654.89,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17480.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17480.09,30590.16,
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,436,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19562.6,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11290.42,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11178.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11178.63,19562.6,
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,437,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15052.52,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8687.45,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8601.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8601.44,15052.52,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,438,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29066.17,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16775.33,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16609.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16609.24,29066.17,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,439,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15455.67,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8920.13,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8831.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8831.81,15455.67,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,440,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11447.49,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6606.83,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6541.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6541.42,11447.49,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",441,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31732.73,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18314.32,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18132.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18132.99,31732.73,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",442,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17066.68,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9849.91,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9752.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9752.39,17066.68,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",443,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13105.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7563.63,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7488.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7488.74,13105.3,
DISORDERS OF THE BILIARY TRACT WITH MCC,444,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28470.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16431.62,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16268.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16268.93,28470.63,
DISORDERS OF THE BILIARY TRACT WITH CC,445,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19330.06,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11156.21,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11045.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11045.75,19330.06,
DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,446,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14557.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8401.67,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8318.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8318.49,14557.36,
MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,447,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13254.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7649.57,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7573.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7573.83,13254.2,
MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,448,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36170.86,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20875.75,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20669.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20669.06,36170.86,
SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,450,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17330.99,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10002.45,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9903.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9903.42,17330.99,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",456,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,142162.39,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,82048.01,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,81235.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,81235.65,142162.39,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",457,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,102781.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,59319.49,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,58732.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58732.17,102781.3,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",458,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,76947.13,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,44409.49,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,43969.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43969.79,76947.13,
BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,461,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,115214.09,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,66494.99,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,65836.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,65836.62,115214.09,
BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,462,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48764.26,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28143.94,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,27865.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27865.29,48764.26,
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,463,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,95895.75,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,55345.55,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,54797.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54797.57,95895.75,
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,464,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,51358.88,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29641.41,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,29347.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29347.93,51358.88,
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,465,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32445.39,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18725.62,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18540.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18540.22,32445.39,
REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,466,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,87914.47,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,50739.21,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,50236.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50236.84,87914.47,
REVISION OF HIP OR KNEE REPLACEMENT WITH CC,467,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59470.64,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34323.05,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,33983.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33983.22,59470.64,
REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,468,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45808.28,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26437.92,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26176.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26176.16,45808.28,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,469,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,56852.6,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32812.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,32487.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32487.2,56852.6,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,470,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32627.72,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18830.85,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18644.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18644.41,32627.72,
CERVICAL SPINAL FUSION WITH MCC,471,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,83437.87,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,48155.57,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,47678.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47678.78,83437.87,
CERVICAL SPINAL FUSION WITH CC,472,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50589.35,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29197.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,28908.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28908.2,50589.35,
CERVICAL SPINAL FUSION WITHOUT CC/MCC,473,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42311.97,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24420.05,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,24178.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24178.27,42311.97,
AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,474,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,73129.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,42206.24,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,41788.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41788.36,73129.63,
AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,475,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37027.39,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21370.1,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21158.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21158.51,37027.39,
AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,476,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20837.32,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12026.11,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11907.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11907.04,20837.32,
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,477,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,57508.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33190.54,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,32861.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32861.92,57508.36,
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,478,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41025.55,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23677.6,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,23443.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23443.17,41025.55,
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,479,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32331.62,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18659.96,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18475.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18475.21,32331.62,
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,480,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50480.62,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29134.53,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,28846.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28846.07,50480.62,
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,481,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35859.71,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20696.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20491.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20491.26,35859.71,
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,482,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27721.19,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15999.09,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15840.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15840.68,27721.19,
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,483,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42706.79,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24647.92,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,24403.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24403.88,42706.79,
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,485,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,56253.72,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32466.43,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,32144.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32144.98,56253.72,
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,486,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34745.59,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20053.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19854.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19854.62,34745.59,
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,487,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26993.51,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15579.11,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15424.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15424.86,26993.51,
KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,488,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36390.03,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21002.24,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20794.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20794.3,36390.03,
KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,489,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21854.42,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12613.12,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12488.24,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12488.24,21854.42,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",492,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59065.79,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34089.4,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,33751.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33751.88,59065.79,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",493,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41326.65,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23851.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,23615.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23615.23,41326.65,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",494,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32418.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18710.18,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18524.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18524.93,32418.63,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,495,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,61058.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35239.3,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,34890.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34890.4,61058.2,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,496,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34397.62,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19852.34,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19655.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19655.78,34397.62,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,497,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25027.87,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14444.66,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14301.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14301.64,25027.87,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,498,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,44827.98,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25872.15,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,25615.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25615.99,44827.98,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,499,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22726.01,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13116.15,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12986.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12986.29,22726.01,
SOFT TISSUE PROCEDURES WITH MCC,500,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,55397.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31972.09,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,31655.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31655.53,55397.18,
SOFT TISSUE PROCEDURES WITH CC,501,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30185.31,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17421.24,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17248.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17248.75,30185.31,
SOFT TISSUE PROCEDURES WITHOUT CC/MCC,502,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24280.1,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14013.08,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13874.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13874.34,24280.1,
FOOT PROCEDURES WITH MCC,503,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46014.05,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26556.68,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26293.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26293.74,46014.05,
FOOT PROCEDURES WITH CC,504,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30041.48,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17338.23,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17166.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17166.56,30041.48,
FOOT PROCEDURES WITHOUT CC/MCC,505,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29683.47,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17131.6,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16961.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16961.98,29683.47,
MAJOR THUMB OR JOINT PROCEDURES,506,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25616.73,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14784.51,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14638.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14638.13,25616.73,
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,507,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36809.9,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21244.57,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21034.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21034.23,36809.9,
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,508,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25138.28,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14508.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14364.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14364.73,25138.28,
ARTHROSCOPY,509,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24002.41,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13852.82,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13715.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13715.66,24002.41,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",510,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46661.46,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26930.33,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26663.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26663.69,46661.46,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",511,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34503.02,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19913.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19716.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19716.01,34503.02,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",512,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28146.09,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16244.31,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16083.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16083.48,28146.09,
"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",513,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28266.56,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16313.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16152.32,28266.56,
"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",514,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18572.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10718.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10612.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10612.71,18572.24,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,515,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54037.15,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31187.15,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,30878.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30878.37,54037.15,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,516,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35289.28,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20366.95,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20165.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20165.3,35289.28,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,517,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26148.68,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15091.52,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14942.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14942.1,26148.68,
BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,518,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,62239.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35920.93,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,35565.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35565.28,62239.24,
BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,519,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34081.48,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19669.88,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19475.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19475.13,34081.48,
BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,520,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25096.45,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14484.24,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14340.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14340.83,25096.45,
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,521,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,51238.43,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29571.89,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,29279.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29279.1,51238.43,
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,522,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36483.7,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21056.31,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20847.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20847.83,36483.7,
FRACTURES OF FEMUR WITH MCC,533,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28440.53,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16414.25,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16251.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16251.73,28440.53,
FRACTURES OF FEMUR WITHOUT MCC,534,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14699.56,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8483.75,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8399.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8399.75,14699.56,
FRACTURES OF HIP AND PELVIS WITH MCC,535,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22841.44,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13182.77,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13052.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13052.25,22841.44,
FRACTURES OF HIP AND PELVIS WITHOUT MCC,536,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14316.45,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8262.64,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8180.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8180.83,14316.45,
"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",537,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17325.96,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9999.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9900.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9900.55,17325.96,
"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",538,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13011.62,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7509.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7435.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7435.21,13011.62,
OSTEOMYELITIS WITH MCC,539,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34345.76,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19822.41,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19626.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19626.15,34345.76,
OSTEOMYELITIS WITH CC,540,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22866.5,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13197.24,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13066.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13066.57,22866.5,
OSTEOMYELITIS WITHOUT CC/MCC,541,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15500.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8946.21,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8857.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8857.63,15500.85,
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,542,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31657.45,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18270.87,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18089.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18089.97,31657.45,
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,543,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19395.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11193.86,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11083.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11083.03,19395.3,
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,544,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13988.59,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8073.41,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7993.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7993.48,13988.59,
CONNECTIVE TISSUE DISORDERS WITH MCC,545,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42857.34,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24734.81,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,24489.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24489.91,42857.34,
CONNECTIVE TISSUE DISORDERS WITH CC,546,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21212.05,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12242.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12121.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12121.17,21212.05,
CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,547,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14922.04,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8612.15,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8526.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8526.88,14922.04,
SEPTIC ARTHRITIS WITH MCC,548,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33766.95,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19488.35,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19295.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19295.4,33766.95,
SEPTIC ARTHRITIS WITH CC,549,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21327.48,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12309,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12187.13,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12187.13,21327.48,
SEPTIC ARTHRITIS WITHOUT CC/MCC,550,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16932.84,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9772.67,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9675.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9675.91,16932.84,
MEDICAL BACK PROBLEMS WITH MCC,551,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29619.91,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17094.92,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16925.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16925.66,29619.91,
MEDICAL BACK PROBLEMS WITHOUT MCC,552,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17314.26,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9992.8,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9893.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9893.86,17314.26,
BONE DISEASES AND ARTHROPATHIES WITH MCC,553,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23758.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13711.85,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13576.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13576.09,23758.16,
BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,554,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14896.96,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8597.68,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8512.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8512.55,14896.96,
SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,555,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24552.76,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14170.45,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14030.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14030.15,24552.76,
SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,556,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14940.45,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8622.77,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8537.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8537.4,14940.45,
"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",557,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27192.59,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15694.01,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15538.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15538.62,27192.59,
"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",558,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15843.8,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9144.14,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9053.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9053.6,15843.8,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",559,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32105.78,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18529.62,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18346.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18346.16,32105.78,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",560,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20087.88,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11593.58,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11478.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11478.79,20087.88,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",561,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14201.02,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8196.02,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8114.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8114.87,14201.02,
"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",562,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26588.66,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15345.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15193.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15193.52,26588.66,
"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",563,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16131.55,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9310.21,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9218.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9218.03,16131.55,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,564,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27277.88,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15743.23,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15587.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15587.36,27277.88,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,565,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17867.99,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10312.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10210.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10210.28,17867.99,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,566,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13704.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7909.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7830.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7830.97,13704.2,
SKIN DEBRIDEMENT WITH MCC,570,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50033.95,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28876.74,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,28590.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28590.83,50033.95,
SKIN DEBRIDEMENT WITH CC,571,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29452.61,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16998.36,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16830.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16830.06,29452.61,
SKIN DEBRIDEMENT WITHOUT CC/MCC,572,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20213.34,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11665.98,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11550.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11550.48,20213.34,
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,573,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,105170.15,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,60698.2,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,60097.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,60097.23,105170.15,
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,574,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58123.98,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33545.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,33213.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33213.7,58123.98,
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,575,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35376.25,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20417.15,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20215,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20215,35376.25,
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,576,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,96220.29,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,55532.85,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,54983.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54983.02,96220.29,
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,577,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45465.35,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26240,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,25980.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25980.2,45465.35,
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,578,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28090.9,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16212.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16051.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16051.94,28090.9,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",579,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,57060.03,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32931.79,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,32605.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32605.73,57060.03,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",580,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30367.68,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17526.49,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17352.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17352.96,30367.68,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",581,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23677.87,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13665.51,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13530.21,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13530.21,23677.87,
MASTECTOMY FOR MALIGNANCY WITH CC/MCC,582,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30279.03,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17475.32,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17302.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17302.3,30279.03,
MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,583,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26608.73,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15357.04,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15204.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15204.99,26608.73,
"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",584,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33914.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19573.32,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19379.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19379.52,33914.16,
"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",585,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29320.46,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16922.1,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16754.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16754.55,29320.46,
SKIN ULCERS WITH MCC,592,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36114,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20842.94,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20636.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20636.57,36114,
SKIN ULCERS WITH CC,593,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21389.38,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12344.73,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12222.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12222.5,21389.38,
SKIN ULCERS WITHOUT CC/MCC,594,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14321.49,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8265.55,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8183.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8183.71,14321.49,
MAJOR SKIN DISORDERS WITH MCC,595,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37534.26,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21662.63,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21448.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21448.15,37534.26,
MAJOR SKIN DISORDERS WITHOUT MCC,596,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18028.57,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10405.06,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10302.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10302.04,18028.57,
MALIGNANT BREAST DISORDERS WITH MCC,597,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27923.6,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16115.9,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15956.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15956.34,27923.6,
MALIGNANT BREAST DISORDERS WITH CC,598,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21203.7,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12237.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12116.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12116.4,21203.7,
MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,599,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12404.39,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7159.1,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7088.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7088.22,12404.39,
NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,600,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18304.6,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10564.37,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10459.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10459.77,18304.6,
NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,601,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11746.95,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6779.67,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6712.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6712.54,11746.95,
CELLULITIS WITH MCC,602,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26033.25,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15024.9,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14876.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14876.14,26033.25,
CELLULITIS WITHOUT MCC,603,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15949.19,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9204.96,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9113.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9113.82,15949.19,
"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",604,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26346.09,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15205.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15054.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15054.91,26346.09,
"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",605,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16352.35,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9437.64,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9344.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9344.2,16352.35,
MINOR SKIN DISORDERS WITH MCC,606,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27677.69,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15973.98,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15815.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15815.82,27677.69,
MINOR SKIN DISORDERS WITHOUT MCC,607,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16096.41,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9289.93,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9197.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9197.95,16096.41,
ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,614,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38829.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22409.92,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22188.04,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22188.04,38829.07,
ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,615,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25758.92,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14866.57,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14719.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14719.38,25758.92,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",616,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,67356.54,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38874.34,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,38489.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38489.45,67356.54,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",617,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34347.44,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19823.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19627.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19627.11,34347.44,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",618,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20579.7,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11877.43,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11759.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11759.83,20579.7,
O.R. PROCEDURES FOR OBESITY WITH MCC,619,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,44685.78,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25790.08,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,25534.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25534.73,44685.78,
O.R. PROCEDURES FOR OBESITY WITH CC,620,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28286.63,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16325.43,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16163.79,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16163.79,28286.63,
O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,621,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26531.79,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15312.63,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15161.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15161.02,26531.79,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",622,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,65146.69,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37598.95,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,37226.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37226.68,65146.69,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",623,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32288.13,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18634.86,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18450.36,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18450.36,32288.13,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",624,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19793.46,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11423.66,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11310.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11310.55,19793.46,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",625,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,50017.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28867.09,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,28581.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28581.28,50017.24,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",626,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26106.89,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15067.4,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14918.22,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14918.22,26106.89,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",627,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21825.98,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12596.71,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12471.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12471.99,21825.98,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",628,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,68306.74,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39422.74,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,39032.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39032.42,68306.74,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",629,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39003.06,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22510.33,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22287.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22287.46,39003.06,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",630,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24507.6,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14144.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14004.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14004.34,24507.6,
DIABETES WITH MCC,637,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25394.23,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14656.1,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14510.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14510.99,25394.23,
DIABETES WITH CC,638,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16195.1,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9346.88,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9254.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9254.34,16195.1,
DIABETES WITHOUT CC/MCC,639,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11562.92,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6673.45,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6607.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6607.38,11562.92,
"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",640,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23150.91,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13361.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13229.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13229.09,23150.91,
"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",641,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14221.1,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8207.6,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8126.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8126.34,14221.1,
INBORN AND OTHER DISORDERS OF METABOLISM,642,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22951.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13246.49,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13115.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13115.34,22951.85,
ENDOCRINE DISORDERS WITH MCC,643,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28669.71,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16546.52,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16382.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16382.69,28669.71,
ENDOCRINE DISORDERS WITH CC,644,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18910.15,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10913.86,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10805.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10805.8,18910.15,
ENDOCRINE DISORDERS WITHOUT CC/MCC,645,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13878.17,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8009.68,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7930.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7930.38,13878.17,
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,650,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,76386.73,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,44086.06,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,43649.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43649.56,76386.73,
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,651,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,59003.89,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,34053.68,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,33716.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33716.51,59003.89,
KIDNEY TRANSPLANT,652,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,51409.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29670.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,29376.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29376.61,51409.07,
MAJOR BLADDER PROCEDURES WITH MCC,653,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,91711.9,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,52930.87,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,52406.8,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,52406.8,91711.9,
MAJOR BLADDER PROCEDURES WITH CC,654,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46944.15,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27093.48,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26825.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26825.23,46944.15,
MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,655,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36410.1,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21013.83,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20805.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20805.77,36410.1,
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,656,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,53637.33,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30956.4,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,30649.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30649.9,53637.33,
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,657,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32000.4,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18468.8,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18285.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18285.94,32000.4,
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,658,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25914.49,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14956.36,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14808.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14808.28,25914.49,
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,659,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,44458.28,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25658.78,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,25404.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25404.73,44458.28,
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,660,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23664.48,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13657.79,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13522.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13522.56,23664.48,
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,661,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18687.67,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10785.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10678.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10678.67,18687.67,
MINOR BLADDER PROCEDURES WITH MCC,662,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,51280.23,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29596.02,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,29302.99,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29302.99,51280.23,
MINOR BLADDER PROCEDURES WITH CC,663,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25556.49,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14749.75,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14603.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14603.71,25556.49,
MINOR BLADDER PROCEDURES WITHOUT CC/MCC,664,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18908.51,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10912.91,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10804.86,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10804.86,18908.51,
PROSTATECTOMY WITH MCC,665,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,52825.99,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30488.14,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,30186.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30186.28,52825.99,
PROSTATECTOMY WITH CC,666,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29879.19,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17244.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17073.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17073.82,29879.19,
PROSTATECTOMY WITHOUT CC/MCC,667,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18707.76,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10797.05,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10690.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10690.15,18707.76,
TRANSURETHRAL PROCEDURES WITH MCC,668,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48290.83,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27870.71,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,27594.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27594.76,48290.83,
TRANSURETHRAL PROCEDURES WITH CC,669,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26821.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15479.66,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15326.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15326.4,26821.2,
TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,670,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17252.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9957.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9858.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9858.49,17252.36,
URETHRAL PROCEDURES WITH CC/MCC,671,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29787.19,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17191.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17021.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17021.25,29787.19,
URETHRAL PROCEDURES WITHOUT CC/MCC,672,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16832.48,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9714.75,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9618.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9618.56,16832.48,
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,673,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,63012.11,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36366.99,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,36006.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36006.92,63012.11,
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,674,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,41000.45,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23663.12,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,23428.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23428.83,41000.45,
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,675,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27689.41,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15980.75,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15822.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15822.52,27689.41,
RENAL FAILURE WITH MCC,682,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26255.76,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15153.32,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15003.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15003.29,26255.76,
RENAL FAILURE WITH CC,683,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16218.51,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9360.4,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9267.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9267.72,16218.51,
RENAL FAILURE WITHOUT CC/MCC,684,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11328.71,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6538.29,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6473.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6473.55,11328.71,
KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,686,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31920.12,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18422.47,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18240.07,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18240.07,31920.12,
KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,687,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18635.84,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10755.54,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10649.05,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10649.05,18635.84,
KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,688,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14212.75,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8202.79,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8121.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8121.57,14212.75,
KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,689,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20795.5,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12001.97,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11883.14,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11883.14,20795.5,
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,690,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14647.69,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8453.81,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8370.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8370.11,14647.69,
URINARY STONES WITH MCC,693,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24842.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14337.49,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14195.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14195.53,24842.18,
URINARY STONES WITHOUT MCC,694,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14242.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8220.16,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8138.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8138.77,14242.85,
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,695,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21156.84,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12210.52,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12089.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12089.62,21156.84,
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,696,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12727.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7345.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7272.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7272.71,12727.24,
URETHRAL STRICTURE,697,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19770.03,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11410.13,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11297.16,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11297.16,19770.03,
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,698,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28825.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16636.32,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16471.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16471.6,28825.3,
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,699,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18225.97,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10518.99,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10414.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10414.84,18225.97,
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,700,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12998.23,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7501.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7427.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7427.56,12998.23,
MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,707,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33969.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19605.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19411.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19411.06,33969.36,
MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,708,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25548.15,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14744.93,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14598.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14598.94,25548.15,
PENIS PROCEDURES WITH CC/MCC,709,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37464,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21622.08,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21408,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21408,37464,
PENIS PROCEDURES WITHOUT CC/MCC,710,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22851.45,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13188.55,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13057.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13057.97,22851.45,
TESTES PROCEDURES WITH CC/MCC,711,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36662.71,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21159.62,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20950.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20950.12,36662.71,
TESTES PROCEDURES WITHOUT CC/MCC,712,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21029.7,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12137.14,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12016.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12016.97,21029.7,
TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,713,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25417.65,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14669.61,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14524.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14524.37,25417.65,
TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,714,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17183.78,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9917.49,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9819.3,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9819.3,17183.78,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,715,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38077.94,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21976.41,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21758.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21758.82,38077.94,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,716,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24940.88,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14394.45,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14251.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14251.93,24940.88,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,717,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31490.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18174.33,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17994.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17994.39,31490.18,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,718,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20818.93,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12015.5,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11896.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11896.53,20818.93,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",722,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32512.31,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18764.24,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18578.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18578.46,32512.31,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",723,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19790.1,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11421.72,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11308.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11308.63,19790.1,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",724,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14691.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8478.91,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8394.96,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8394.96,14691.18,
BENIGN PROSTATIC HYPERTROPHY WITH MCC,725,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21907.95,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12644.02,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12518.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12518.83,21907.95,
BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,726,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13376.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7720.04,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7643.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7643.6,13376.3,
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,727,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28266.56,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16313.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16152.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16152.32,28266.56,
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,728,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14533.94,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8388.16,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8305.11,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8305.11,14533.94,
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,729,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17943.26,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10355.82,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10253.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10253.29,17943.26,
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,730,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11547.87,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6664.77,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6598.78,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6598.78,11547.87,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",734,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37510.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21649.12,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21434.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21434.77,37510.85,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",735,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22230.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12830.37,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12703.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12703.34,22230.85,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,736,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66177.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38193.7,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,37815.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37815.54,66177.2,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,737,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34168.44,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19720.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19524.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19524.82,34168.44,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,738,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23977.31,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13838.33,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13701.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13701.32,23977.31,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,739,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,61645.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,35578.18,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,35225.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35225.92,61645.36,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,740,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31043.51,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17916.54,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17739.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17739.15,31043.51,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,741,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22884.93,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13207.87,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13077.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13077.1,22884.93,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,742,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30958.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17867.3,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17690.4,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17690.4,30958.2,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,743,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20588.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11882.26,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11764.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11764.61,20588.07,
"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",744,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32639.43,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18837.61,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18651.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18651.1,32639.43,
"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",745,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18478.58,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10664.78,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10559.19,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10559.19,18478.58,
"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",746,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29188.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16845.82,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16679.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16679.03,29188.3,
"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",747,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15991.01,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9229.1,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9137.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9137.72,15991.01,
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,748,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24651.46,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14227.42,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14086.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14086.55,24651.46,
OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,749,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43258.83,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24966.52,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,24719.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24719.33,43258.83,
OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,750,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23900.35,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13793.91,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13657.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13657.34,23900.35,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",754,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32139.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18548.93,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18365.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18365.28,32139.24,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",755,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19294.94,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11135.94,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11025.68,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11025.68,19294.94,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",756,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17705.7,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10218.72,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10117.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10117.54,17705.7,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",757,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26101.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15064.49,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14915.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14915.34,26101.85,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",758,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17754.21,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10246.71,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10145.26,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10145.26,17754.21,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",759,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11959.41,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6902.29,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6833.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6833.95,11959.41,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,760,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17801.05,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10273.75,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10172.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10172.03,17801.05,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,761,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11280.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6510.29,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6445.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6445.83,11280.2,
VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,768,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21526.54,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12423.89,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12300.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12300.88,21526.54,
POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,769,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26976.76,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15569.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15415.29,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15415.29,26976.76,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",770,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14510.53,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8374.65,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8291.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8291.73,14510.53,
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,776,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13138.77,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7582.95,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7507.87,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7507.87,13138.77,
ABORTION WITHOUT D&C,779,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17697.33,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10213.89,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10112.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10112.76,17697.33,
CESAREAN SECTION WITH STERILIZATION WITH MCC,783,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30789.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17769.79,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17593.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17593.85,30789.24,
CESAREAN SECTION WITH STERILIZATION WITH CC,784,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18281.17,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10550.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10446.38,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10446.38,18281.17,
CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,785,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15641.38,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9027.31,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8937.93,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8937.93,15641.38,
CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,786,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30416.21,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17554.5,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17380.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17380.69,30416.21,
CESAREAN SECTION WITHOUT STERILIZATION WITH CC,787,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18732.86,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10811.53,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10704.49,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10704.49,18732.86,
CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,788,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15452.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8918.22,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8829.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8829.92,15452.36,
"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",789,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31585.54,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18229.37,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18048.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18048.88,31585.54,
"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",790,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,101523.29,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58593.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,58013.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58013.31,101523.29,
PREMATURITY WITH MAJOR PROBLEMS,791,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,69698.56,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40226.03,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,39827.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39827.75,69698.56,
PREMATURITY WITHOUT MAJOR PROBLEMS,792,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42511.05,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24534.95,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,24292.03,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24292.03,42511.05,
FULL TERM NEONATE WITH MAJOR PROBLEMS,793,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,71565.48,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,41303.51,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,40894.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,40894.56,71565.48,
NEONATE WITH OTHER SIGNIFICANT PROBLEMS,794,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26073.41,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15048.08,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14899.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14899.09,26073.41,
NORMAL NEWBORN,795,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,4523.47,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,2610.69,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,2584.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,2584.84,4523.47,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,796,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24877.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14357.76,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14215.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14215.6,24877.3,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,797,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17809.42,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10278.58,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10176.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10176.81,17809.42,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,798,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15119.46,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8726.09,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8639.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8639.69,15119.46,
SPLENIC PROCEDURES WITH MCC,799,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,84033.41,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,48499.28,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,48019.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48019.09,84033.41,
SPLENIC PROCEDURES WITH CC,800,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48285.81,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27867.81,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,27591.89,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27591.89,48285.81,
SPLENIC PROCEDURES WITHOUT CC/MCC,801,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31088.7,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17942.62,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17764.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17764.97,31088.7,
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,802,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58542.17,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33787.2,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,33452.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,33452.67,58542.17,
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,803,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32234.6,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18603.97,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18419.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18419.77,32234.6,
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,804,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21397.74,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12349.55,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12227.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12227.28,21397.74,
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,805,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18015.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10397.33,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10294.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10294.39,18015.18,
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,806,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13640.64,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7872.6,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7794.65,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7794.65,13640.64,
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,807,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12094.9,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6980.48,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6911.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6911.37,12094.9,
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,808,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37786.88,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21808.43,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21592.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21592.5,37786.88,
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,809,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21297.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12291.62,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12169.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12169.92,21297.36,
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,810,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17953.29,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10361.61,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10259.02,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10259.02,17953.29,
RED BLOOD CELL DISORDERS WITH MCC,811,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24629.71,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14214.86,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14074.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14074.12,24629.71,
RED BLOOD CELL DISORDERS WITHOUT MCC,812,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16216.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9359.44,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9266.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9266.77,16216.85,
COAGULATION DISORDERS,813,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27246.1,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15724.89,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15569.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15569.2,27246.1,
RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,814,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36749.67,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21209.81,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20999.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20999.81,36749.67,
RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,815,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17780.98,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10262.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10160.56,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10160.56,17780.98,
RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,816,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13030.03,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7520.19,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7445.73,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7445.73,13030.03,
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,817,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48270.74,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27859.11,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,27583.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27583.28,48270.74,
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,818,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,25089.75,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14480.37,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14337,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14337,25089.75,
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,819,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16325.58,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9422.19,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9328.9,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9328.9,16325.58,
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,820,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,102302.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,59043.36,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,58458.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58458.77,102302.85,
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,821,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38489.47,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22213.92,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21993.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21993.98,38489.47,
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,822,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21872.83,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12623.75,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12498.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12498.76,21872.83,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,823,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,76460.34,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,44128.54,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,43691.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43691.62,76460.34,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,824,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38502.87,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22221.66,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22001.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22001.64,38502.87,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,825,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22752.78,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13131.61,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13001.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13001.59,22752.78,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,826,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,78564.8,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,45343.11,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,44894.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,44894.17,78564.8,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,827,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39913.09,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,23035.55,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22807.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22807.48,39913.09,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,828,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28591.08,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16501.14,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16337.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16337.76,28591.08,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,829,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,53908.33,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31112.81,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,30804.76,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30804.76,53908.33,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,830,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27600.74,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15929.57,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15771.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15771.85,27600.74,
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,831,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19137.69,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11045.18,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10935.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10935.82,19137.69,
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,832,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13490.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7785.7,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7708.61,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7708.61,13490.07,
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,833,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9711.05,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,5604.66,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,5549.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,5549.17,9711.05,
ACUTE LEUKEMIA WITH MCC,834,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,94813.41,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,54720.88,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,54179.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54179.09,94813.41,
ACUTE LEUKEMIA WITH CC,835,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,38546.34,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,22246.74,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,22026.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22026.48,38546.34,
ACUTE LEUKEMIA WITHOUT CC/MCC,836,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24768.57,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14295,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14153.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14153.47,24768.57,
CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,837,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,82183.22,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,47431.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,46961.84,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46961.84,82183.22,
CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,838,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34635.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19989.45,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19791.53,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19791.53,34635.18,
CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,839,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22948.49,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13244.55,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13113.42,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13113.42,22948.49,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,840,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,53429.9,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,30836.68,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,30531.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30531.37,53429.9,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,841,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27471.94,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15855.23,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15698.25,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15698.25,27471.94,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,842,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18988.8,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10959.25,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10850.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10850.74,18988.8,
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,843,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32274.74,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18627.14,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18442.71,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18442.71,32274.74,
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,844,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20507.76,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11835.91,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11718.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11718.72,20507.76,
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,845,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15617.96,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9013.8,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8924.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8924.55,15617.96,
CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,846,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42034.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24259.8,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,24019.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24019.6,42034.3,
CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,847,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21434.54,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12370.79,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12248.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12248.31,21434.54,
CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,848,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15137.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8736.7,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8650.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8650.2,15137.85,
RADIOTHERAPY,849,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46172.96,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26648.4,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26384.55,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26384.55,46172.96,
ACUTE LEUKEMIA WITH OTHER PROCEDURES,850,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12737.27,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7351.22,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7278.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7278.44,12737.27,
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,853,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,84781.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,48930.85,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,48446.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,48446.39,84781.18,
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,854,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35245.77,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20341.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20140.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20140.44,35245.77,
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,855,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29618.23,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17093.95,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16924.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16924.7,29618.23,
POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,856,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,75230.77,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,43418.9,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,42989.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42989.01,75230.77,
POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,857,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36876.84,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21283.2,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21072.48,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21072.48,36876.84,
POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,858,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22618.93,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13054.35,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12925.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12925.1,22618.93,
POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,862,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31963.59,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18447.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18264.91,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18264.91,31963.59,
POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,863,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17970.02,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10371.27,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10268.58,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10268.58,17970.02,
FEVER AND INFLAMMATORY CONDITIONS,864,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15917.42,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9186.63,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9095.67,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9095.67,15917.42,
VIRAL ILLNESS WITH MCC,865,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28582.72,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16496.31,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16332.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16332.98,28582.72,
VIRAL ILLNESS WITHOUT MCC,866,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16501.22,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9523.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9429.27,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9429.27,16501.22,
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,867,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36150.78,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20864.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20657.59,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20657.59,36150.78,
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,868,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19308.31,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11143.65,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,11033.32,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11033.32,19308.31,
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,869,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12703.83,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7331.92,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7259.33,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7259.33,12703.83,
SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,870,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,117663.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,67908.46,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,67236.1,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,67236.1,117663.18,
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,871,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34315.66,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19805.04,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19608.95,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19608.95,34315.66,
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,872,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18378.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10606.85,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10501.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10501.83,18378.2,
O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,876,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1984.17,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,1145.15,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,1133.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1133.81,1984.17,
ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,880,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1707.69,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,985.58,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,975.82,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,975.82,1707.69,
DEPRESSIVE NEUROSES,881,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1610.11,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,929.26,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,920.06,1610.11,
NEUROSES EXCEPT DEPRESSIVE,882,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1658.9,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,957.42,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,1658.9,
DISORDERS OF PERSONALITY AND IMPULSE CONTROL,883,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1658.9,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,957.42,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,1658.9,
ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,884,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1675.15,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,966.8,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,957.23,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,957.23,1675.15,
PSYCHOSES,885,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1626.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,938.64,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,929.35,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,929.35,1626.36,
BEHAVIORAL AND DEVELOPMENTAL DISORDERS,886,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1610.11,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,929.26,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,920.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,920.06,1610.11,
OTHER MENTAL DISORDER DIAGNOSES,887,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1496.27,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,863.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,855.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,855.01,1496.27,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",894,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1577.57,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,910.48,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,901.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,901.47,1577.57,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",895,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1658.9,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,957.42,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,947.94,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,947.94,1658.9,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",896,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1431.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,826.01,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,817.83,1431.2,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",897,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,1431.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,826.01,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,817.83,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,817.83,1431.2,
WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,901,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,73547.85,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,42447.61,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,42027.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42027.34,73547.85,
WOUND DEBRIDEMENTS FOR INJURIES WITH CC,902,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32677.91,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18859.82,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18673.09,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18673.09,32677.91,
WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,903,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21918,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12649.82,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12524.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12524.57,21918,
SKIN GRAFTS FOR INJURIES WITH CC/MCC,904,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,55621.37,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32101.48,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,31783.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31783.64,55621.37,
SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,905,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27642.56,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15953.71,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15795.75,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15795.75,27642.56,
HAND PROCEDURES FOR INJURIES,906,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32626.06,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18829.89,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18643.46,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18643.46,32626.06,
OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,907,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,63371.77,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,36574.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,36212.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36212.44,63371.77,
OTHER O.R. PROCEDURES FOR INJURIES WITH CC,908,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,34675.32,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20012.61,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,19814.47,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19814.47,34675.32,
OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,909,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23838.45,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13758.19,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13621.97,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13621.97,23838.45,
TRAUMATIC INJURY WITH MCC,913,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26150.36,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15092.49,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14943.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14943.06,26150.36,
TRAUMATIC INJURY WITHOUT MCC,914,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16333.96,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9427.03,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9333.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9333.69,16333.96,
ALLERGIC REACTIONS WITH MCC,915,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30826.04,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17791.03,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17614.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17614.88,30826.04,
ALLERGIC REACTIONS WITHOUT MCC,916,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12170.18,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7023.93,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6954.39,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6954.39,12170.18,
POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,917,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27846.65,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16071.49,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15912.37,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15912.37,27846.65,
POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,918,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15551.04,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8975.17,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8886.31,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8886.31,15551.04,
COMPLICATIONS OF TREATMENT WITH MCC,919,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31674.2,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18280.54,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18099.54,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18099.54,31674.2,
COMPLICATIONS OF TREATMENT WITH CC,920,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18443.46,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10644.51,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10539.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10539.12,18443.46,
COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,921,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12822.6,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,7400.47,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,7327.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,7327.2,12822.6,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",922,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,30339.23,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17510.07,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,17336.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17336.7,30339.23,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",923,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18068.72,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10428.23,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10324.98,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10324.98,18068.72,
EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,927,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,442096.66,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,255152.93,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,252626.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,252626.66,442096.66,
FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,928,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,116907.02,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,67472.05,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,66804.01,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66804.01,116907.02,
FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,929,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54940.5,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31708.52,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,31394.57,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31394.57,54940.5,
EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,933,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,51870.77,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,29936.84,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,29640.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29640.44,51870.77,
FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,934,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,36154.14,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20866.11,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20659.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20659.51,36154.14,
NON-EXTENSIVE BURNS,935,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,35294.3,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,20369.85,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,20168.17,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,20168.17,35294.3,
O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,939,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,54937.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,31706.59,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,31392.66,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,31392.66,54937.16,
O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,940,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37393.74,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,21581.53,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,21367.85,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,21367.85,37393.74,
O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,941,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32197.8,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,18582.73,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,18398.74,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18398.74,32197.8,
REHABILITATION WITH CC/MCC,945,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26401.29,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15237.31,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15086.45,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15086.45,26401.29,
REHABILITATION WITHOUT CC/MCC,946,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,18090.47,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10440.78,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10337.41,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10337.41,18090.47,
SIGNS AND SYMPTOMS WITH MCC,947,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,22086.96,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,12747.33,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,12621.12,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,12621.12,22086.96,
SIGNS AND SYMPTOMS WITHOUT MCC,948,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14549.01,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8396.86,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8313.72,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8313.72,14549.01,
AFTERCARE WITH CC/MCC,949,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19095.86,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11021.04,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10911.92,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10911.92,19095.86,
AFTERCARE WITHOUT CC/MCC,950,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11832.24,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6828.89,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6761.28,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6761.28,11832.24,
OTHER FACTORS INFLUENCING HEALTH STATUS,951,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,11019.23,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,6359.67,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,6296.7,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,6296.7,11019.23,
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,955,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,103030.55,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,59463.35,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,58874.6,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,58874.6,103030.55,
"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",956,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66026.64,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,38106.81,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,37729.51,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,37729.51,66026.64,
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,957,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,122139.76,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,70492.09,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,69794.15,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,69794.15,122139.76,
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,958,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,68813.64,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,39715.3,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,39322.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,39322.08,68813.64,
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,959,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,43513.12,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,25113.29,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,24864.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24864.64,43513.12,
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,963,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,46890.62,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27062.59,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,26794.64,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26794.64,46890.62,
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,964,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,26259.1,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,15155.25,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,15005.2,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15005.2,26259.1,
OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,965,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,17140.27,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,9892.38,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,9794.44,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,9794.44,17140.27,
HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,969,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,116119.1,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,67017.31,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,66353.77,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,66353.77,116119.1,
HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,970,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,47648.46,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,27499.97,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,27227.69,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,27227.69,47648.46,
HIV WITH MAJOR RELATED CONDITION WITH MCC,974,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,49938.6,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,28821.7,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,28536.34,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28536.34,49938.6,
HIV WITH MAJOR RELATED CONDITION WITH CC,975,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,23955.54,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,13825.77,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,13688.88,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,13688.88,23955.54,
HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,976,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,15290.07,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,8824.55,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,8737.18,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,8737.18,15290.07,
HIV WITH OR WITHOUT OTHER RELATED CONDITION,977,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24838.84,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,14335.56,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,14193.62,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,14193.62,24838.84,
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,981,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,80450.13,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,46431.22,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,45971.5,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,45971.5,80450.13,
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,982,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,42736.89,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,24665.29,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,24421.08,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,24421.08,42736.89,
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,983,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,28504.11,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16450.94,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16288.06,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16288.06,28504.11,
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,987,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,57637.16,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,33264.88,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,32935.52,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,32935.52,57637.16,
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,988,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,29537.92,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,17047.6,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,16878.81,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,16878.81,29537.92,
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,989,MS-DRG,,,,,inpatient,,,,,,,,,,other,Not separately reimbursable,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,19221.35,175,MS-DRG,,case rate,175% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,,,,,other,Not separately reimbursable,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,11093.47,101,MS-DRG,,case rate,101% CMS MS-DRG rate for inpatient,10983.63,100,MS-DRG,,case rate,100% CMS MS-DRG rate for inpatient,,,,,other,Not separately reimbursable,10983.63,19221.35,
TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,41,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61276.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,63115.12,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61276.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61276.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61276.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62502.35,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,79659.86,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61276.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61276.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,61276.82,79659.86,
TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,42,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,72743.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,74926.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,72743.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,72743.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,72743.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,74198.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,94567.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,72743.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,72743.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,72743.92,94567.09,
TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,43,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,103852.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,106968.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,103852.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,103852.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,103852.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105929.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,135008.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,103852.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,103852.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,103852.56,135008.33,
TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,44,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,151878.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,156434.44,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,151878.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,151878.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,151878.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,154915.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,197441.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,151878.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,151878.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,151878.1,197441.53,
TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,51,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40487.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41702.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40487.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40487.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40487.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41297.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,52634.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40487.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40487.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,40487.88,52634.24,
TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,52,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55111.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56764.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55111.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55111.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55111.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56213.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,71644.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55111.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55111.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,55111.35,71644.76,
TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,53,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70066.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,72168.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70066.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70066.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70066.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71467.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,91086.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70066.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70066.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,70066.22,91086.09,
TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,54,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99679.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,102670.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99679.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99679.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99679.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,101673.43,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,129583.78,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99679.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99679.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,99679.83,129583.78,
EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),91,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47209.13,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46750.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,59584.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,45834.11,59584.34,
EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),92,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47209.13,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46750.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,59584.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45834.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,45834.11,59584.34,
EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),93,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76560.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,78857.47,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76560.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76560.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76560.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,78091.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,99528.85,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76560.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76560.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,76560.65,99528.85,
EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),94,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,172982.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,178171.93,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,172982.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,172982.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,172982.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,176442.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,224877.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,172982.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,172982.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,172982.46,224877.2,
OPEN CRANIOTOMY FOR TRAUMA,201,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20770.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21394.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20770.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20770.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20770.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21186.33,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27002.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20770.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20770.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20770.91,27002.19,
OPEN CRANIOTOMY FOR TRAUMA,202,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26054.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26835.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26054.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26054.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26054.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26575.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,33870.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26054.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26054.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26054.15,33870.39,
OPEN CRANIOTOMY FOR TRAUMA,203,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33693.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34704.03,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33693.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33693.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33693.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34367.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,43801.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33693.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33693.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,33693.23,43801.2,
OPEN CRANIOTOMY FOR TRAUMA,204,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55732.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57404.12,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55732.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55732.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55732.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56846.8,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,72451.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55732.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55732.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,55732.16,72451.8,
OPEN CRANIOTOMY EXCEPT TRAUMA,211,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18766.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19330,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18766.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18766.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18766.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19142.33,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24397.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18766.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18766.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18766.99,24397.08,
OPEN CRANIOTOMY EXCEPT TRAUMA,212,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24549.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25286.17,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24549.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24549.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24549.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25040.68,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31914.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24549.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24549.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24549.68,31914.59,
OPEN CRANIOTOMY EXCEPT TRAUMA,213,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38077.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39219.93,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38077.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38077.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38077.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38839.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49500.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38077.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38077.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,38077.61,49500.89,
OPEN CRANIOTOMY EXCEPT TRAUMA,214,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62309.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64178.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62309.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62309.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62309.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,63555.51,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,81002.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62309.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62309.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,62309.32,81002.12,
VENTRICULAR SHUNT PROCEDURES,221,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12020.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12380.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12020.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12020.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12020.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12260.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15626.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12020.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12020.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12020.03,15626.05,
VENTRICULAR SHUNT PROCEDURES,222,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15388.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15850.07,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15388.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15388.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15388.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15696.19,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20004.94,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15388.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15388.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15388.42,20004.94,
VENTRICULAR SHUNT PROCEDURES,223,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25232.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25989.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25232.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25232.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25232.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25737.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,32802.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25232.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25232.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,25232.59,32802.36,
VENTRICULAR SHUNT PROCEDURES,224,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55678.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57348.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55678.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55678.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55678.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56791.81,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,72381.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55678.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55678.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,55678.25,72381.72,
SPINAL PROCEDURES,231,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14662.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15102.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14662.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14662.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14662.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14955.59,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19061.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14662.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14662.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14662.35,19061.05,
SPINAL PROCEDURES,232,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20115.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20719.12,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20115.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20115.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20115.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20517.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26150.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20115.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20115.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20115.65,26150.35,
SPINAL PROCEDURES,233,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35808.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36882.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35808.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35808.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35808.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36524.68,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,46551.07,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35808.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35808.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,35808.51,46551.07,
SPINAL PROCEDURES,234,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56398.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,58090.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56398.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56398.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56398.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57526.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,73317.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56398.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56398.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,56398.26,73317.74,
OPEN EXTRACRANIAL VASCULAR PROCEDURES,241,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8520.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8776.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8520.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8520.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8520.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8691.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11077.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8520.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8520.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8520.8,11077.04,
OPEN EXTRACRANIAL VASCULAR PROCEDURES,242,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11657.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12006.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11657.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11657.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11657.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11890.18,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15154.15,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11657.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11657.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11657.04,15154.15,
OPEN EXTRACRANIAL VASCULAR PROCEDURES,243,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21427.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22070.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21427.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21427.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21427.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21856.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27855.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21427.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21427.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21427.51,27855.76,
OPEN EXTRACRANIAL VASCULAR PROCEDURES,244,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39150.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40324.99,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39150.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39150.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39150.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39933.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,50895.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39150.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39150.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39150.48,50895.62,
OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,261,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12480.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12854.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12480.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12480.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12480.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12729.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16224.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12480.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12480.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12480.12,16224.16,
OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,262,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16212.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16054.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20462.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15740.13,20462.17,
OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,263,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23638.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24348.05,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23638.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23638.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23638.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24111.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30730.55,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23638.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23638.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23638.88,30730.55,
OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,264,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47600.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49028.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47600.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47600.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47600.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48552.28,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,61880.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47600.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47600.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,47600.28,61880.36,
OTHER OPEN CRANIOTOMY,271,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15648.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16117.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15648.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15648.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15648.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15961.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20342.73,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15648.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15648.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15648.25,20342.73,
OTHER OPEN CRANIOTOMY,272,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19355.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19936.61,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19355.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19355.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19355.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19743.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25162.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19355.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19355.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19355.94,25162.72,
OTHER OPEN CRANIOTOMY,273,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30339.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31249.46,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30339.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30339.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30339.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30946.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,39441.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30339.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30339.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,30339.28,39441.06,
OTHER OPEN CRANIOTOMY,274,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56964.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,58673.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56964.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56964.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56964.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,58103.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,74053.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56964.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56964.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,56964.55,74053.91,
OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,291,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18935.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18751.59,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23899.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18383.91,23899.08,
OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,292,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18935.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18751.59,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23899.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18383.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18383.91,23899.08,
OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,293,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24913.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25661.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24913.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24913.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24913.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25412.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,32387.96,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24913.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24913.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24913.82,32387.96,
OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,294,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44744.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46086.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44744.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44744.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44744.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45638.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,58167.32,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44744.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44744.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,44744.09,58167.32,
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,301,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18166.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18711.57,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18166.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18166.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18166.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18529.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23616.54,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18166.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18166.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18166.57,23616.54,
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,302,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25973.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26752.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25973.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25973.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25973.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26492.54,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,33765.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25973.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25973.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,25973.08,33765.01,
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,303,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36362.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37453.38,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36362.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36362.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36362.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37089.75,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,47271.25,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36362.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36362.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,36362.5,47271.25,
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,304,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51266.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52804.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51266.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51266.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51266.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52291.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,66646.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51266.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51266.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,51266.46,66646.4,
SPINAL DISORDERS AND INJURIES,401,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9540.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9827.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9540.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9540.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9540.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9731.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12403.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9540.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9540.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9540.8,12403.04,
SPINAL DISORDERS AND INJURIES,402,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12920.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13308.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12920.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12920.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12920.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13178.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16796.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12920.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12920.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12920.41,16796.53,
SPINAL DISORDERS AND INJURIES,403,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19405.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19987.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19405.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19405.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19405.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19793.17,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25226.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19405.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19405.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19405.07,25226.59,
SPINAL DISORDERS AND INJURIES,404,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32454.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33427.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32454.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32454.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32454.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33103.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,42190.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32454.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32454.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,32454.32,42190.61,
NERVOUS SYSTEM MALIGNANCY,411,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7283.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7501.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7283.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7283.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7283.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7428.73,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9467.99,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7283.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7283.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7283.07,9467.99,
NERVOUS SYSTEM MALIGNANCY,412,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8143.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8387.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8143.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8143.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8143.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8306.54,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10586.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8143.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8143.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8143.66,10586.76,
NERVOUS SYSTEM MALIGNANCY,413,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10876.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11202.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10876.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10876.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10876.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11093.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14139.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10876.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10876.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10876.23,14139.1,
NERVOUS SYSTEM MALIGNANCY,414,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17040.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17552.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17040.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17040.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17040.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17381.68,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22153.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17040.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17040.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17040.86,22153.12,
DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,421,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6454.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6392.04,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8146.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6266.7,8146.71,
DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,422,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7518.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7743.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7518.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7518.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7518.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7668.42,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9773.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7518.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7518.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7518.06,9773.48,
DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,423,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11395.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11737.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11395.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11395.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11395.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11623.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14814.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11395.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11395.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11395.58,14814.26,
DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,424,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23998.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24718.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23998.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23998.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23998.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24478.75,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31198.41,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23998.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23998.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23998.78,31198.41,
"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",431,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7959.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8198.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7959.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7959.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7959.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8119.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10347.86,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7959.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7959.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7959.89,10347.86,
"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",432,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10932.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11260.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10932.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10932.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10932.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11150.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14211.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10932.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10932.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10932.26,14211.93,
"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",433,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16925.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17432.88,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16925.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16925.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16925.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17263.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22002.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16925.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16925.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16925.13,22002.67,
"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",434,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32673.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33654.17,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32673.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32673.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32673.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33327.43,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,42476.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32673.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32673.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,32673.95,42476.14,
INTRACRANIAL HEMORRHAGE,441,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7663.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7893.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7663.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7663.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7663.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7817.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9963.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7663.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7663.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7663.85,9963.01,
INTRACRANIAL HEMORRHAGE,442,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10122.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10426.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10122.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10122.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10122.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10324.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13159.13,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10122.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10122.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10122.4,13159.13,
INTRACRANIAL HEMORRHAGE,443,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14347.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14777.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14347.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14347.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14347.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14634.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18651.49,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14347.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14347.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14347.3,18651.49,
INTRACRANIAL HEMORRHAGE,444,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19864.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20460.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19864.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19864.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19864.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20261.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25823.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19864.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19864.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19864.48,25823.82,
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,451,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6808.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7012.34,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6808.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6808.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6808.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6944.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8850.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6808.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6808.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6808.09,8850.52,
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,452,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8813.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8727.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11123.56,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8556.58,11123.56,
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,453,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12363.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12734.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12363.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12363.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12363.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12610.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16072.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12363.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12363.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12363.31,16072.31,
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,454,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22279.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22948.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22279.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22279.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22279.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22725.51,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28963.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22279.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22279.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22279.91,28963.89,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,461,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6771.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6974.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6771.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6771.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6771.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6906.8,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8802.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6771.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6771.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6771.38,8802.79,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,462,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7887.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8124.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7887.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7887.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7887.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8045.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10254.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7887.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7887.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7887.72,10254.04,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,463,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10402.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10714.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10402.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10402.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10402.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10610.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13523.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10402.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10402.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10402.79,13523.62,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,464,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18672.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19232.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18672.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18672.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18672.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19046.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24274.6,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18672.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18672.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18672.77,24274.6,
TRANSIENT ISCHEMIA,471,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5974.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6153.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5974.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5974.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5974.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6093.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7766.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5974.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5974.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5974.42,7766.75,
TRANSIENT ISCHEMIA,472,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6620.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6818.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6620.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6620.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6620.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6752.49,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8606.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6620.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6620.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6620.09,8606.12,
TRANSIENT ISCHEMIA,473,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8813.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8727.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11123.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8556.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8556.77,11123.8,
TRANSIENT ISCHEMIA,474,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15814.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16288.54,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15814.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15814.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15814.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16130.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20558.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15814.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15814.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15814.12,20558.35,
"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",481,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6011.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6191.47,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6011.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6011.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6011.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6131.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7814.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6011.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6011.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6011.14,7814.48,
"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",482,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6870.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7076.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6870.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6870.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6870.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7007.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8931.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6870.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6870.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6870.41,8931.53,
"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",483,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9875.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10171.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9875.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9875.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9875.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10072.67,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12837.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9875.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9875.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9875.17,12837.72,
"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",484,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20328.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20938.58,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20328.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20328.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20328.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20735.29,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26427.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20328.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20328.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20328.72,26427.33,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,491,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8127.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8371.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8127.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8127.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8127.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8290.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10565.98,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8127.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8127.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8127.68,10565.98,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,492,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17650.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18179.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17650.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17650.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17650.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18003.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22945.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17650.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17650.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17650.24,22945.31,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,493,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23336.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24036.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23336.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23336.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23336.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23802.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30336.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23336.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23336.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23336.13,30336.97,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,494,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37685.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38816.47,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37685.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37685.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37685.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38439.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,48991.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37685.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37685.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37685.89,48991.66,
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,501,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6144.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6329.34,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6144.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6144.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6144.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6267.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7988.49,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6144.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6144.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6144.99,7988.49,
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,502,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11138.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11473.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11138.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11138.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11138.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11361.75,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14480.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11138.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11138.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11138.97,14480.66,
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,503,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19480.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20064.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19480.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19480.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19480.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19869.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25324.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19480.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19480.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19480.28,25324.37,
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,504,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39494.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40679.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39494.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39494.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39494.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40284.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,51343.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39494.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39494.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39494.88,51343.34,
VIRAL MENINGITIS,511,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4380.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4511.79,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4380.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4380.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4380.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4467.98,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5694.49,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4380.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4380.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4380.38,5694.49,
VIRAL MENINGITIS,512,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6603.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6801.98,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6603.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6603.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6603.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6735.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8585.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6603.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6603.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6603.86,8585.02,
VIRAL MENINGITIS,513,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12437.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12810.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12437.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12437.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12437.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12686.07,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16168.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12437.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12437.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12437.33,16168.53,
VIRAL MENINGITIS,514,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21572.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22219.65,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21572.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21572.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21572.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22003.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28044.22,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21572.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21572.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21572.48,28044.22,
ALTERATION IN CONSCIOUSNESS,521,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5593,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5760.79,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5593,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5593,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5593,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5704.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7270.9,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5593,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5593,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5593,7270.9,
ALTERATION IN CONSCIOUSNESS,522,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6285.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6473.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6285.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6285.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6285.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6410.74,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8170.55,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6285.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6285.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6285.03,8170.55,
ALTERATION IN CONSCIOUSNESS,523,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8107.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8350.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8107.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8107.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8107.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8269.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10539.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8107.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8107.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8107.56,10539.82,
ALTERATION IN CONSCIOUSNESS,524,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19000.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19570.54,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19000.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19000.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19000.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19380.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24700.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19000.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19000.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19000.52,24700.68,
SEIZURE,531,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5134.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5288.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5134.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5134.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5134.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5237.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6674.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5134.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5134.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5134.42,6674.75,
SEIZURE,532,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6454.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6391.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8146.49,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6266.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6266.53,8146.49,
SEIZURE,533,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8279.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8527.88,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8279.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8279.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8279.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8445.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10763.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8279.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8279.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8279.5,10763.34,
SEIZURE,534,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20678.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21298.57,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20678.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20678.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20678.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21091.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26881.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20678.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20678.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20678.23,26881.69,
MIGRAINE AND OTHER HEADACHES,541,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5531.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5697.79,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5531.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5531.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5531.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5642.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7191.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5531.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5531.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5531.84,7191.39,
MIGRAINE AND OTHER HEADACHES,542,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6501.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6696.15,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6501.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6501.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6501.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6631.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8451.45,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6501.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6501.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6501.12,8451.45,
MIGRAINE AND OTHER HEADACHES,543,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8018.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8259.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8018.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8018.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8018.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8179.3,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10424.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8018.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8018.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8018.92,10424.59,
MIGRAINE AND OTHER HEADACHES,544,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15082.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15535.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15082.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15082.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15082.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15384.57,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19607.78,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15082.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15082.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15082.91,19607.78,
HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,551,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6667.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6867.63,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6667.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6667.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6667.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6800.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8667.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6667.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6667.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6667.6,8667.88,
HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,552,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9069.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9341.13,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9069.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9069.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9069.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9250.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11789.77,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9069.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9069.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9069.06,11789.77,
HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,553,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13788.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14201.73,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13788.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13788.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13788.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14063.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17924.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13788.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13788.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13788.09,17924.52,
HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,554,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27885.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28722.16,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27885.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27885.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27885.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28443.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,36251.27,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27885.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27885.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,27885.6,36251.27,
"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",561,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6047.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6229.09,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6047.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6047.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6047.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6168.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7861.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6047.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6047.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6047.66,7861.95,
"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",562,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8702.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8963.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8702.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8702.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8702.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8876.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11313.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8702.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8702.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8702.86,11313.71,
"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",563,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13875.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14292.05,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13875.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13875.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13875.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14153.3,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18038.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13875.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13875.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13875.78,18038.51,
"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",564,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26013.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26793.44,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26013.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26013.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26013.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26533.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,33816.96,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26013.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26013.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26013.05,33816.96,
"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",571,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6043.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6225.05,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6043.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6043.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6043.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6164.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7856.86,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6043.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6043.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6043.74,7856.86,
"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",572,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8346.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8596.83,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8346.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8346.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8346.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8513.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10850.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8346.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8346.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8346.44,10850.37,
"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",573,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11658.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12008.38,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11658.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11658.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11658.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11891.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15156.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11658.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11658.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11658.62,15156.21,
"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",574,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22498.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23173.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22498.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22498.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22498.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22948.68,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29248.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22498.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22498.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22498.7,29248.31,
OTHER DISORDERS OF NERVOUS SYSTEM,581,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7748.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7980.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7748.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7748.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7748.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7903.27,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10072.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7748.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7748.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7748.31,10072.8,
OTHER DISORDERS OF NERVOUS SYSTEM,582,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10377.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10688.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10377.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10377.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10377.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10585.18,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13490.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10377.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10377.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10377.63,13490.91,
OTHER DISORDERS OF NERVOUS SYSTEM,583,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13462.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13866.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13462.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13462.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13462.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13731.7,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17501.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13462.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13462.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13462.45,17501.19,
OTHER DISORDERS OF NERVOUS SYSTEM,584,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19998.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20598.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19998.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19998.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19998.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20398.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25998.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19998.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19998.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19998.47,25998.01,
ANOXIC AND OTHER SEVERE BRAIN DAMAGE,591,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5922.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6100.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5922.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5922.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5922.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6041.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7699.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5922.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5922.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5922.64,7699.43,
ANOXIC AND OTHER SEVERE BRAIN DAMAGE,592,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9375.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9656.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9375.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9375.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9375.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9562.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12188.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9375.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9375.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9375.41,12188.04,
ANOXIC AND OTHER SEVERE BRAIN DAMAGE,593,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13678.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14088.93,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13678.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13678.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13678.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13952.15,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17782.15,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13678.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13678.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13678.58,17782.15,
ANOXIC AND OTHER SEVERE BRAIN DAMAGE,594,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21365.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22006.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21365.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21365.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21365.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21792.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27774.9,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21365.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21365.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21365.31,27774.9,
ORBIT AND EYE PROCEDURES,731,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8703.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8964.9,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8703.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8703.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8703.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8877.87,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11314.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8703.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8703.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8703.79,11314.93,
ORBIT AND EYE PROCEDURES,732,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12367.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12738.35,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12367.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12367.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12367.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12614.67,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16077.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12367.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12367.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12367.33,16077.53,
ORBIT AND EYE PROCEDURES,733,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21042.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21673.47,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21042.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21042.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21042.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21463.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27354.87,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21042.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21042.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21042.21,27354.87,
ORBIT AND EYE PROCEDURES,734,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39947.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41145.61,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39947.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39947.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39947.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40746.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,51931.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39947.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39947.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39947.2,51931.36,
EYE INFECTIONS AND OTHER EYE DISORDERS,821,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5325.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5485.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5325.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5325.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5325.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5432.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6923.64,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5325.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5325.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5325.88,6923.64,
EYE INFECTIONS AND OTHER EYE DISORDERS,822,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6497.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6692.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6497.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6497.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6497.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6627.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8446.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6497.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6497.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6497.19,8446.35,
EYE INFECTIONS AND OTHER EYE DISORDERS,823,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9961.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10259.89,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9961.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9961.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9961.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10160.28,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12949.38,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9961.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9961.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9961.06,12949.38,
EYE INFECTIONS AND OTHER EYE DISORDERS,824,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23172.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23867.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23172.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23172.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23172.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23635.87,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30124.15,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23172.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23172.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23172.42,30124.15,
MAJOR CRANIAL OR FACIAL BONE PROCEDURES,891,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15272.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15730.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15272.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15272.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15272.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15577.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19853.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15272.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15272.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15272.12,19853.75,
MAJOR CRANIAL OR FACIAL BONE PROCEDURES,892,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19966.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20565.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19966.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19966.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19966.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20366.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25956.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19966.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19966.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19966.9,25956.97,
MAJOR CRANIAL OR FACIAL BONE PROCEDURES,893,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35073.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36125.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35073.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35073.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35073.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35774.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,45595.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35073.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35073.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,35073.23,45595.2,
MAJOR CRANIAL OR FACIAL BONE PROCEDURES,894,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59100.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60873.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59100.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59100.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59100.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60282.65,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,76830.83,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59100.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59100.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,59100.64,76830.83,
OTHER MAJOR HEAD AND NECK PROCEDURES,911,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13444.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13847.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13444.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13444.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13444.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13713.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17477.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13444.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13444.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13444.42,17477.74,
OTHER MAJOR HEAD AND NECK PROCEDURES,912,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20166.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20771.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20166.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20166.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20166.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20569.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26216.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20166.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20166.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20166.55,26216.51,
OTHER MAJOR HEAD AND NECK PROCEDURES,913,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35366.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36427.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35366.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35366.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35366.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36073.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,45975.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35366.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35366.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,35366.12,45975.95,
OTHER MAJOR HEAD AND NECK PROCEDURES,914,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59417.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61200.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59417.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59417.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59417.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60606.3,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,77243.32,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59417.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59417.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,59417.94,77243.32,
FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,921,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12853.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12728.26,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16222.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12478.68,16222.29,
FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,922,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15898.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16375.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15898.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15898.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15898.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16216.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20668.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15898.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15898.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15898.97,20668.66,
FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,923,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24971.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25720.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24971.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24971.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24971.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25471.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,32463.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24971.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24971.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24971.61,32463.1,
FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,924,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44826.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46170.84,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44826.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44826.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44826.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45722.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,58273.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44826.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44826.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,44826.06,58273.88,
CLEFT LIP AND PALATE REPAIR,951,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7084.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7296.73,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7084.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7084.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7084.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7225.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9209.47,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7084.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7084.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7084.21,9209.47,
CLEFT LIP AND PALATE REPAIR,952,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7720.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7952.2,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7720.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7720.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7720.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7874.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10036.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7720.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7720.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7720.58,10036.75,
CLEFT LIP AND PALATE REPAIR,953,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11985.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12345.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11985.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11985.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11985.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12225.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15581.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11985.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11985.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11985.66,15581.36,
CLEFT LIP AND PALATE REPAIR,954,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26850.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27655.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26850.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26850.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26850.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27387.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,34905.07,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26850.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26850.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26850.06,34905.07,
TONSIL AND ADENOID PROCEDURES,971,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5262.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5419.9,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5262.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5262.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5262.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5367.28,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6840.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5262.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5262.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5262.04,6840.66,
TONSIL AND ADENOID PROCEDURES,972,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7671.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7901.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7671.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7671.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7671.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7824.52,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9972.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7671.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7671.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7671.1,9972.43,
TONSIL AND ADENOID PROCEDURES,973,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13419.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13822.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13419.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13419.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13419.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13687.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17445.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13419.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13419.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13419.43,17445.26,
TONSIL AND ADENOID PROCEDURES,974,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23872.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24588.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23872.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23872.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23872.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24349.73,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31033.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23872.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23872.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23872.28,31033.97,
"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES",981,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8620.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8879.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8620.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8620.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8620.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8792.87,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11206.6,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8620.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8620.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8620.46,11206.6,
"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES",982,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12184.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12549.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12184.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12184.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12184.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12428.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15839.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12184.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12184.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12184.42,15839.74,
"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES",983,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20926.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21554.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20926.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20926.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20926.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21345.01,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27204.42,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20926.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20926.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20926.48,27204.42,
"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES",984,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38511.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39666.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38511.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38511.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38511.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39281.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,50064.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38511.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38511.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,38511.48,50064.92,
"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",1101,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6820.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7025.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6820.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6820.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6820.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6957.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8867.25,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6820.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6820.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6820.96,8867.25,
"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",1102,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8290.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8539.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8290.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8290.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8290.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8456.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10778.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8290.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8290.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8290.79,10778.03,
"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",1103,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12683.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13064.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12683.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12683.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12683.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12937.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16489.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12683.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12683.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12683.88,16489.04,
"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",1104,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21596.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22244.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21596.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21596.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21596.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22028.73,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28075.83,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21596.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21596.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21596.79,28075.83,
VERTIGO AND OTHER LABYRINTH DISORDERS,1111,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5331.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5491.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5331.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5331.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5331.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5438.42,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6931.32,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5331.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5331.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5331.79,6931.32,
VERTIGO AND OTHER LABYRINTH DISORDERS,1112,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5888.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6065.03,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5888.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5888.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5888.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6006.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7654.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5888.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5888.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5888.38,7654.89,
VERTIGO AND OTHER LABYRINTH DISORDERS,1113,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7418.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7641.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7418.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7418.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7418.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7567.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9644.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7418.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7418.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7418.76,9644.39,
VERTIGO AND OTHER LABYRINTH DISORDERS,1114,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9697.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9988.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9697.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9697.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9697.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9891.34,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12606.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9697.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9697.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9697.39,12606.61,
INFECTIONS OF UPPER RESPIRATORY TRACT,1131,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3360.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3460.99,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3360.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3360.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3360.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3427.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4368.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3360.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3360.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3360.18,4368.24,
INFECTIONS OF UPPER RESPIRATORY TRACT,1132,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4667.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4807.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4667.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4667.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4667.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4760.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6067.73,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4667.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4667.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4667.49,6067.73,
INFECTIONS OF UPPER RESPIRATORY TRACT,1133,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6827.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7032.49,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6827.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6827.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6827.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6964.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8875.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6827.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6827.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6827.66,8875.95,
INFECTIONS OF UPPER RESPIRATORY TRACT,1134,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13072.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13464.17,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13072.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13072.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13072.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13333.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16993.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13072.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13072.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13072.01,16993.62,
DENTAL DISEASES AND DISORDERS,1141,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3952.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4071,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3952.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3952.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3952.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4031.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5138.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3952.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3952.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3952.43,5138.16,
DENTAL DISEASES AND DISORDERS,1142,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5378.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5539.67,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5378.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5378.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5378.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5485.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6991.81,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5378.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5378.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5378.32,6991.81,
DENTAL DISEASES AND DISORDERS,1143,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9048.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9319.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9048.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9048.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9048.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9229.27,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11762.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9048.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9048.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9048.3,11762.79,
DENTAL DISEASES AND DISORDERS,1144,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22086.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22749.47,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22086.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22086.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22086.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22528.6,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28712.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22086.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22086.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22086.86,28712.92,
"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",1151,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4766.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4909.3,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4766.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4766.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4766.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4861.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6196.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4766.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4766.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4766.31,6196.21,
"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",1152,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6341.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6531.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6341.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6341.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6341.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6468.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8244.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6341.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6341.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6341.67,8244.17,
"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",1153,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9981.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10280.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9981.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9981.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9981.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10180.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12975.65,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9981.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9981.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9981.27,12975.65,
"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",1154,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18845.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19411.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18845.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18845.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18845.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19222.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24499.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18845.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18845.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18845.99,24499.79,
MAJOR RESPIRATORY AND CHEST PROCEDURES,1201,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15954.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16433.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15954.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15954.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15954.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16273.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20741.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15954.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15954.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15954.69,20741.09,
MAJOR RESPIRATORY AND CHEST PROCEDURES,1202,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19799.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20393.85,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19799.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19799.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19799.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20195.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25739.81,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19799.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19799.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19799.85,25739.81,
MAJOR RESPIRATORY AND CHEST PROCEDURES,1203,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30155.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31060.2,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30155.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30155.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30155.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30758.65,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,39202.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30155.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30155.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,30155.54,39202.2,
MAJOR RESPIRATORY AND CHEST PROCEDURES,1204,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52776.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54360.09,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52776.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52776.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52776.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,53832.32,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,68609.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52776.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52776.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,52776.79,68609.82,
OTHER RESPIRATORY AND CHEST PROCEDURES,1211,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11802.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12156.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11802.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11802.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11802.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12038.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15342.94,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11802.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11802.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11802.27,15342.94,
OTHER RESPIRATORY AND CHEST PROCEDURES,1212,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16529.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16368.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20862.23,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16047.87,20862.23,
OTHER RESPIRATORY AND CHEST PROCEDURES,1213,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24983.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25732.93,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24983.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24983.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24983.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25483.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,32478.45,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24983.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24983.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24983.42,32478.45,
OTHER RESPIRATORY AND CHEST PROCEDURES,1214,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43189.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44485.38,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43189.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43189.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43189.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44053.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,56146.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43189.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43189.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,43189.69,56146.59,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,1301,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26498.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27293.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26498.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26498.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26498.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27028.6,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,34448.22,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26498.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26498.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26498.63,34448.22,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,1302,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31471.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32415.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31471.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31471.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31471.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32100.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,40912.99,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31471.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31471.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,31471.53,40912.99,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,1303,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37007.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38118.05,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37007.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37007.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37007.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37747.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,48110.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37007.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37007.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37007.82,48110.16,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,1304,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49677.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51167.84,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49677.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49677.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49677.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50671.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,64580.77,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49677.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49677.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,49677.51,64580.77,
CYSTIC FIBROSIS - PULMONARY DISEASE,1311,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11585.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11933.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11585.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11585.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11585.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11817.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15061.56,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11585.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11585.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11585.81,15061.56,
CYSTIC FIBROSIS - PULMONARY DISEASE,1312,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14266.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14694.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14266.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14266.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14266.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14551.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18546.63,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14266.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14266.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14266.64,18546.63,
CYSTIC FIBROSIS - PULMONARY DISEASE,1313,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19383.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19965.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19383.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19383.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19383.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19771.49,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25198.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19383.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19383.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19383.81,25198.95,
CYSTIC FIBROSIS - PULMONARY DISEASE,1314,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25723.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26495.63,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25723.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25723.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25723.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26238.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,33441.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25723.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25723.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,25723.91,33441.08,
BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,1321,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4542.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4498.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5732.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4409.91,5732.89,
BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,1322,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5846.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6021.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5846.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5846.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5846.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5963.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7599.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5846.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5846.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5846.13,7599.97,
BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,1323,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9763.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10056.79,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9763.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9763.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9763.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9959.15,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12693.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9763.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9763.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9763.87,12693.04,
BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,1324,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16986.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17496.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16986.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16986.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16986.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17326.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22082.87,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16986.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16986.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16986.82,22082.87,
RESPIRATORY FAILURE,1331,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3900.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4017.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3900.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3900.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3900.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3978.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5070.81,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3900.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3900.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3900.62,5070.81,
RESPIRATORY FAILURE,1332,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6436.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6629.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6436.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6436.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6436.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6565.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8367.55,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6436.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6436.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6436.58,8367.55,
RESPIRATORY FAILURE,1333,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9837.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10133.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9837.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9837.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9837.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10034.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12789.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9837.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9837.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9837.96,12789.35,
RESPIRATORY FAILURE,1334,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17266.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17784.25,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17266.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17266.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17266.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17611.59,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22446.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17266.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17266.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17266.26,22446.14,
PULMONARY EMBOLISM,1341,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5236.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5393.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5236.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5236.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5236.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5340.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6806.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5236.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5236.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5236.13,6806.97,
PULMONARY EMBOLISM,1342,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6947.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7156.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6947.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6947.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6947.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7086.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9032.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6947.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6947.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6947.88,9032.24,
PULMONARY EMBOLISM,1343,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10356.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10667.3,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10356.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10356.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10356.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10563.74,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13463.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10356.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10356.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10356.61,13463.59,
PULMONARY EMBOLISM,1344,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15834.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16309.07,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15834.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15834.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15834.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16150.73,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20584.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15834.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15834.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15834.05,20584.26,
MAJOR CHEST AND RESPIRATORY TRAUMA,1351,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6717.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6919.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6717.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6717.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6717.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6851.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8732.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6717.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6717.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6717.49,8732.74,
MAJOR CHEST AND RESPIRATORY TRAUMA,1352,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7856.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8091.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7856.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7856.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7856.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8013.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10212.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7856.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7856.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7856.08,10212.91,
MAJOR CHEST AND RESPIRATORY TRAUMA,1353,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11151.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11485.71,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11151.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11151.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11151.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11374.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14496.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11151.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11151.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11151.17,14496.52,
MAJOR CHEST AND RESPIRATORY TRAUMA,1354,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19332.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19912.73,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19332.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19332.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19332.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19719.41,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25132.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19332.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19332.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19332.75,25132.58,
RESPIRATORY MALIGNANCY,1361,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6563.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6759.9,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6563.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6563.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6563.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6694.27,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8531.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6563.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6563.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6563.01,8531.92,
RESPIRATORY MALIGNANCY,1362,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8587.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8845.38,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8587.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8587.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8587.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8759.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11164.07,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8587.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8587.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8587.75,11164.07,
RESPIRATORY MALIGNANCY,1363,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12177.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12542.62,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12177.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12177.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12177.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12420.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15830.49,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12177.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12177.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12177.3,15830.49,
RESPIRATORY MALIGNANCY,1364,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18007.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18548.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18007.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18007.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18007.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18368.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23410.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18007.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18007.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18007.97,23410.36,
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,1371,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5543.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5710.15,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5543.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5543.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5543.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5654.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7206.99,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5543.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5543.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5543.84,7206.99,
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,1372,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7262.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7479.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7262.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7262.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7262.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7407.29,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9440.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7262.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7262.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7262.05,9440.67,
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,1373,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10239.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10546.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10239.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10239.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10239.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10444.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13311.18,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10239.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10239.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10239.37,13311.18,
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,1374,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15047.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15498.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15047.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15047.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15047.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15348.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19561.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15047.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15047.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15047.18,19561.33,
BRONCHIOLITIS AND RSV PNEUMONIA,1381,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2988.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3078.47,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2988.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2988.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2988.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3048.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,3885.45,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2988.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2988.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,2988.81,3885.45,
BRONCHIOLITIS AND RSV PNEUMONIA,1382,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4442.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4575.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4442.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4442.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4442.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4531.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5774.98,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4442.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4442.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4442.29,5774.98,
BRONCHIOLITIS AND RSV PNEUMONIA,1383,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7536.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7762.29,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7536.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7536.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7536.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7686.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9797.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7536.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7536.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7536.2,9797.06,
BRONCHIOLITIS AND RSV PNEUMONIA,1384,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17619.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18148.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17619.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17619.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17619.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17972.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22905.63,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17619.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17619.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17619.72,22905.63,
OTHER PNEUMONIA,1391,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4138.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4263.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4138.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4138.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4138.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4221.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5380.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4138.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4138.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4138.93,5380.62,
OTHER PNEUMONIA,1392,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5575.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5742.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5575.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5575.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5575.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5686.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7248.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5575.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5575.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5575.48,7248.12,
OTHER PNEUMONIA,1393,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7979.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8218.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7979.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7979.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7979.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8138.96,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10373.18,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7979.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7979.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7979.37,10373.18,
OTHER PNEUMONIA,1394,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12781.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13165.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12781.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12781.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12781.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13037.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16616.28,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12781.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12781.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12781.75,16616.28,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE,1401,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4749.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4892.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4749.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4749.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4749.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4844.52,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6174.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4749.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4749.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4749.53,6174.39,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE,1402,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5931.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6109,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5931.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5931.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5931.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6049.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7710.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5931.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5931.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5931.07,7710.39,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE,1403,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7620.65,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7546.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9618.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7398.69,9618.29,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE,1404,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11701.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12052.34,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11701.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11701.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11701.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11935.33,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15211.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11701.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11701.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11701.3,15211.69,
ASTHMA,1411,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3807.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3922.2,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3807.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3807.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3807.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3884.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4950.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3807.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3807.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3807.96,4950.35,
ASTHMA,1412,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5536.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5702.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5536.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5536.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5536.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5647.01,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7197.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5536.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5536.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5536.28,7197.17,
ASTHMA,1413,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6657.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6857.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6657.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6657.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6657.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6790.47,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8654.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6657.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6657.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6657.32,8654.51,
ASTHMA,1414,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12524.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12900.63,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12524.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12524.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12524.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12775.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16282.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12524.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12524.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12524.88,16282.35,
INTERSTITIAL AND ALVEOLAR LUNG DISEASES,1421,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5605.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5774.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5605.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5605.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5605.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5718.02,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7287.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5605.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5605.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5605.9,7287.68,
INTERSTITIAL AND ALVEOLAR LUNG DISEASES,1422,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7252.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7470.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7252.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7252.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7252.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7397.87,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9428.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7252.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7252.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7252.82,9428.66,
INTERSTITIAL AND ALVEOLAR LUNG DISEASES,1423,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9946.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10245.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9946.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9946.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9946.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10145.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12931.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9946.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9946.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9946.96,12931.04,
INTERSTITIAL AND ALVEOLAR LUNG DISEASES,1424,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15333.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15793.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15333.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15333.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15333.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15640.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19933.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15333.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15333.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15333.47,19933.51,
"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1431,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4570.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4708.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4570.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4570.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4570.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4662.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5942.27,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4570.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4570.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4570.97,5942.27,
"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1432,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6843.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6777.04,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8637.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6644.16,8637.4,
"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1433,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9582.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9869.62,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9582.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9582.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9582.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9773.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12456.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9582.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9582.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9582.15,12456.8,
"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1434,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14894.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15341.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14894.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14894.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14894.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15192.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19362.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14894.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14894.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14894.36,19362.66,
"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1441,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4979.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5128.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4979.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4979.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4979.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5079.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6473.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4979.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4979.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4979.49,6473.33,
"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1442,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6339.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6530.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6339.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6339.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6339.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6466.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8241.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6339.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6339.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6339.91,8241.88,
"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1443,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8885.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9152.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8885.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8885.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8885.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9063.54,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11551.57,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8885.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8885.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8885.82,11551.57,
"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1444,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15169.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15625.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15169.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15169.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15169.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15473.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19720.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15169.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15169.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15169.91,19720.89,
ACUTE BRONCHITIS AND RELATED SYMPTOMS,1451,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4695.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4649.81,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5926.22,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4558.63,5926.22,
ACUTE BRONCHITIS AND RELATED SYMPTOMS,1452,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5457.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5620.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5457.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5457.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5457.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5566.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7094.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5457.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5457.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5457.11,7094.24,
ACUTE BRONCHITIS AND RELATED SYMPTOMS,1453,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7263.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7481.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7263.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7263.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7263.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7408.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9442.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7263.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7263.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7263.36,9442.37,
ACUTE BRONCHITIS AND RELATED SYMPTOMS,1454,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12458.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12831.83,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12458.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12458.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12458.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12707.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16195.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12458.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12458.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12458.09,16195.52,
MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,1601,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31192.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32128.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31192.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31192.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31192.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31816.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,40550.3,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31192.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31192.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,31192.54,40550.3,
MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,1602,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36773.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37876.61,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36773.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36773.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36773.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37508.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,47805.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36773.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36773.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,36773.41,47805.43,
MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,1603,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49877.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51373.61,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49877.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49877.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49877.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50874.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,64840.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49877.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49877.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,49877.29,64840.48,
MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,1604,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105144.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108298.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105144.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105144.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105144.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,107247.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,136687.42,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105144.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105144.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,105144.17,136687.42,
IMPLANTABLE HEART ASSIST SYSTEMS,1611,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,111894.18,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,110807.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,141225.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,108635.13,141225.67,
IMPLANTABLE HEART ASSIST SYSTEMS,1612,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,111894.18,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,110807.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,141225.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108635.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,108635.13,141225.67,
IMPLANTABLE HEART ASSIST SYSTEMS,1613,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,155104.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,159757.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,155104.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,155104.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,155104.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,158206.73,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,201636.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,155104.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,155104.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,155104.64,201636.03,
IMPLANTABLE HEART ASSIST SYSTEMS,1614,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,222474.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,229148.79,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,222474.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,222474.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,222474.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,226924.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,289216.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,222474.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,222474.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,222474.55,289216.92,
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1621,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38370.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39521.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38370.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38370.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38370.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39137.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49881.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38370.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38370.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,38370.12,49881.16,
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1622,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44340.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45671.15,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44340.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44340.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44340.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45227.74,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,57643.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44340.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44340.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,44340.92,57643.19,
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1623,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59498.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61283.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59498.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59498.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59498.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60688.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,77348.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59498.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59498.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,59498.79,77348.43,
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1624,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,91737.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,94489.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,91737.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,91737.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,91737.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,93572.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,119258.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,91737.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,91737.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,91737.39,119258.61,
CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1631,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32975.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33964.65,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32975.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32975.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32975.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33634.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,42868.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32975.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32975.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,32975.39,42868.01,
CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1632,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36454.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37548.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36454.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36454.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36454.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37183.59,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,47390.85,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36454.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36454.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,36454.5,47390.85,
CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1633,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48602.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50060.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48602.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48602.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48602.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49574.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,63183.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48602.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48602.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,48602.35,63183.06,
CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1634,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76312.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,78601.9,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76312.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76312.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76312.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77838.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,99206.28,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76312.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76312.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,76312.52,99206.28,
CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1651,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32077.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33040.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32077.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32077.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32077.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32719.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,41701.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32077.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32077.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,32077.94,41701.33,
CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1652,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37885.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39021.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37885.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37885.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37885.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38642.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49250.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37885.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37885.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37885.01,49250.52,
CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1653,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48074.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49516.46,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48074.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48074.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48074.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49035.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,62496.5,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48074.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48074.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,48074.23,62496.5,
CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1654,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70429.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,72542.07,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70429.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70429.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70429.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71837.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,91557.96,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70429.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70429.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,70429.2,91557.96,
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1661,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28190.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29036.24,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28190.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28190.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28190.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28754.33,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,36647.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28190.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28190.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,28190.52,36647.68,
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1662,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31461.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32404.9,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31461.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31461.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31461.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32090.29,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,40899.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31461.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31461.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,31461.07,40899.39,
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1663,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39446.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40629.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39446.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39446.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39446.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40235.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,51280.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39446.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39446.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39446.55,51280.51,
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1664,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60693.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62514.57,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60693.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60693.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60693.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61907.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,78901.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60693.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60693.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,60693.75,78901.88,
OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,1671,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28035.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27763.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,35384.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,27219.19,35384.95,
OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,1672,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28035.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27763.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,35384.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27219.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,27219.19,35384.95,
OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,1673,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42370.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43641.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42370.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42370.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42370.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43217.98,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,55081.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42370.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42370.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,42370.57,55081.74,
OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,1674,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73855.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76070.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73855.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73855.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73855.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,75332.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,96011.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73855.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73855.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,73855.29,96011.88,
MAJOR ABDOMINAL VASCULAR PROCEDURES,1691,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23756.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24469.62,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23756.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23756.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23756.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24232.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30883.99,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23756.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23756.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23756.91,30883.99,
MAJOR ABDOMINAL VASCULAR PROCEDURES,1692,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25090.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25843.12,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25090.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25090.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25090.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25592.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,32617.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25090.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25090.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,25090.41,32617.53,
MAJOR ABDOMINAL VASCULAR PROCEDURES,1693,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34895.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35942.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34895.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34895.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34895.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35593.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,45364.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34895.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34895.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,34895.72,45364.43,
MAJOR ABDOMINAL VASCULAR PROCEDURES,1694,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59383.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61164.83,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59383.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59383.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59383.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60570.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,77198.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59383.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59383.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,59383.33,77198.33,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",1701,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18485.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19039.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18485.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18485.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18485.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18854.87,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24030.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18485.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18485.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18485.17,24030.71,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",1702,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21798.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22452.46,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21798.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21798.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21798.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22234.47,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28338.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21798.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21798.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21798.5,28338.05,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",1703,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25476.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26240.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25476.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25476.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25476.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25986.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,33119.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25476.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25476.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,25476.52,33119.48,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",1704,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41988.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43247.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41988.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41988.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41988.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42827.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,54584.56,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41988.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41988.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,41988.12,54584.56,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",1711,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13910.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14328.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13910.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13910.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13910.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14189.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18084.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13910.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13910.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13910.86,18084.12,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",1712,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15906.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16384.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15906.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15906.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15906.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16225.01,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20678.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15906.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15906.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15906.87,20678.93,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",1713,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20928.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21556.24,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20928.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20928.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20928.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21346.96,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27206.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20928.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20928.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20928.39,27206.91,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",1714,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33617.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34625.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33617.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33617.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33617.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34289.73,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,43702.6,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33617.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33617.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,33617.39,43702.6,
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,1741,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16741.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17243.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16741.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16741.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16741.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17076.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21763.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16741.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16741.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16741.31,21763.71,
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,1742,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18547.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19103.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18547.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18547.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18547.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18918.33,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24111.6,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18547.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18547.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18547.39,24111.6,
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,1743,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24005.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24725.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24005.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24005.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24005.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24485.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31206.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24005.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24005.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24005.2,31206.76,
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,1744,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35246.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36304.15,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35246.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35246.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35246.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35951.68,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,45820.77,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35246.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35246.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,35246.74,45820.77,
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,1751,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18948.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18764.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23915.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18396.85,23915.91,
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,1752,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20816.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21441.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20816.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20816.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20816.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21232.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27061.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20816.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20816.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20816.61,27061.59,
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,1753,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25572.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26339.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25572.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25572.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25572.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26084.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,33244.6,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25572.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25572.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,25572.77,33244.6,
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,1754,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39076.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40249.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39076.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39076.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39076.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39858.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,50800.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39076.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39076.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39076.96,50800.05,
"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",1761,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16212.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16054.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20462.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15740.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15740.11,20462.14,
"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",1762,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19298.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19877.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19298.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19298.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19298.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19684.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25088.18,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19298.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19298.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19298.6,25088.18,
"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",1763,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29739.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30631.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29739.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29739.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29739.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30334.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,38661.3,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29739.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29739.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,29739.46,38661.3,
"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",1764,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50918.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52446.2,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50918.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50918.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50918.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51937.02,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,66194.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50918.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50918.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,50918.64,66194.24,
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,1771,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11727.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12079.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11727.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11727.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11727.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11962.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15246.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11727.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11727.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11727.92,15246.29,
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,1772,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17188.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17704.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17188.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17188.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17188.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17532.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22345.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17188.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17188.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17188.85,22345.51,
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,1773,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23518.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24224.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23518.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23518.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23518.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23989.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30574.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23518.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23518.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23518.99,30574.69,
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,1774,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32023.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32984.13,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32023.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32023.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32023.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32663.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,41630.45,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32023.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32023.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,32023.43,41630.45,
EXTERNAL HEART ASSIST SYSTEMS,1781,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40941.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42169.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40941.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40941.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40941.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41760.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,53224.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40941.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40941.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,40941.7,53224.21,
EXTERNAL HEART ASSIST SYSTEMS,1782,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46053.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47434.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46053.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46053.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46053.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46974.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,59869.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46053.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46053.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,46053.32,59869.31,
EXTERNAL HEART ASSIST SYSTEMS,1783,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54059.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55681.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54059.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54059.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54059.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55140.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,70277.63,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54059.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54059.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,54059.71,70277.63,
EXTERNAL HEART ASSIST SYSTEMS,1784,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77079.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,79391.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77079.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77079.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77079.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,78620.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,100202.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77079.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77079.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,77079.14,100202.88,
DEFIBRILLATOR IMPLANTS,1791,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32369.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33340.67,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32369.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32369.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32369.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33016.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,42080.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32369.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32369.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,32369.58,42080.46,
DEFIBRILLATOR IMPLANTS,1792,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36676.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37776.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36676.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36676.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36676.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37410.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,47679.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36676.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36676.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,36676.67,47679.67,
DEFIBRILLATOR IMPLANTS,1793,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44608.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45946.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44608.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44608.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44608.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45500.29,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,57990.57,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44608.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44608.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,44608.13,57990.57,
DEFIBRILLATOR IMPLANTS,1794,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60387.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62199.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60387.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60387.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60387.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61595.67,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,78504.28,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60387.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60387.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,60387.91,78504.28,
OTHER CIRCULATORY SYSTEM PROCEDURES,1801,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10903.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11230.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10903.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10903.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10903.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11121.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14174.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10903.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10903.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10903.17,14174.12,
OTHER CIRCULATORY SYSTEM PROCEDURES,1802,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14449.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14882.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14449.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14449.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14449.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14738.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18784.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14449.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14449.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14449.39,18784.2,
OTHER CIRCULATORY SYSTEM PROCEDURES,1803,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20693.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21314.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20693.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20693.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20693.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21107.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26901.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20693.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20693.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20693.3,26901.29,
OTHER CIRCULATORY SYSTEM PROCEDURES,1804,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38780.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39944.03,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38780.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38780.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38780.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39556.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,50414.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38780.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38780.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,38780.61,50414.8,
LOWER EXTREMITY ARTERIAL PROCEDURES,1811,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13036.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13427.49,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13036.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13036.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13036.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13297.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16947.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13036.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13036.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13036.39,16947.31,
LOWER EXTREMITY ARTERIAL PROCEDURES,1812,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18912.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19479.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18912.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18912.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18912.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19290.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24585.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18912.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18912.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18912.15,24585.79,
LOWER EXTREMITY ARTERIAL PROCEDURES,1813,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30642.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31562.25,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30642.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30642.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30642.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31255.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,39835.85,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30642.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30642.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,30642.97,39835.85,
LOWER EXTREMITY ARTERIAL PROCEDURES,1814,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51732.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,53284.71,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51732.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51732.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51732.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52767.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,67252.55,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51732.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51732.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,51732.73,67252.55,
OTHER PERIPHERAL VASCULAR PROCEDURES,1821,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17819.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18353.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17819.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17819.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17819.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18175.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23164.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17819.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17819.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17819.17,23164.92,
OTHER PERIPHERAL VASCULAR PROCEDURES,1822,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19975.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20574.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19975.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19975.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19975.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20375.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25968.41,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19975.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19975.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19975.7,25968.41,
OTHER PERIPHERAL VASCULAR PROCEDURES,1823,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24407.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25139.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24407.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24407.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24407.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24895.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31729.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24407.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24407.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24407.49,31729.74,
OTHER PERIPHERAL VASCULAR PROCEDURES,1824,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43665.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44975.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43665.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43665.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43665.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44539.02,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,56765.42,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43665.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43665.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,43665.71,56765.42,
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,1831,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37354.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38475.09,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37354.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37354.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37354.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38101.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,48560.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37354.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37354.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37354.46,48560.8,
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,1832,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39291.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40469.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39291.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39291.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39291.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40076.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,51078.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39291.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39291.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39291.01,51078.31,
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,1833,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46721.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48123.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46721.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46721.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46721.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47655.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,60738.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46721.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46721.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,46721.56,60738.03,
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,1834,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67937.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69975.18,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67937.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67937.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67937.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69295.81,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,88318.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67937.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67937.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,67937.07,88318.19,
ACUTE MYOCARDIAL INFARCTION,1901,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7083.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7296.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7083.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7083.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7083.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7225.18,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9208.57,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7083.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7083.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7083.51,9208.57,
ACUTE MYOCARDIAL INFARCTION,1902,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7988.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8228.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7988.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7988.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7988.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8148.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10385.32,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7988.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7988.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7988.71,10385.32,
ACUTE MYOCARDIAL INFARCTION,1903,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10622.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10941.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10622.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10622.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10622.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10835.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13809.38,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10622.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10622.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10622.6,13809.38,
ACUTE MYOCARDIAL INFARCTION,1904,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16581.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17079.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16581.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16581.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16581.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16913.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21556.28,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16581.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16581.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16581.76,21556.28,
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,1911,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8458.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8712.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8458.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8458.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8458.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8627.67,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10996.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8458.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8458.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8458.5,10996.06,
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,1912,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9920.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10218.49,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9920.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9920.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9920.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10119.28,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12897.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9920.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9920.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9920.86,12897.12,
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,1913,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13226.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13622.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13226.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13226.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13226.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13490.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17194.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13226.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13226.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13226.17,17194.02,
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,1914,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20856.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21482,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20856.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20856.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20856.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21273.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27113.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20856.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20856.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20856.31,27113.2,
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,1921,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9290.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9200.33,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11725.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9019.93,11725.91,
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,1922,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11315.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11655.09,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11315.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11315.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11315.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11541.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14710.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11315.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11315.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11315.62,14710.31,
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,1923,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16492.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16987.61,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16492.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16492.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16492.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16822.68,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21440.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16492.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16492.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16492.83,21440.67,
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,1924,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26727.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27529.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26727.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26727.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26727.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27262.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,34745.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26727.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26727.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26727.67,34745.97,
ACUTE AND SUBACUTE ENDOCARDITIS,1931,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7719.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7950.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7719.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7719.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7719.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7873.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10035.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7719.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7719.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7719.24,10035.02,
ACUTE AND SUBACUTE ENDOCARDITIS,1932,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10365.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10676.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10365.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10365.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10365.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10572.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13474.83,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10365.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10365.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10365.25,13474.83,
ACUTE AND SUBACUTE ENDOCARDITIS,1933,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15971.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16450.24,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15971.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15971.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15971.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16290.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20762.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15971.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15971.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15971.1,20762.43,
ACUTE AND SUBACUTE ENDOCARDITIS,1934,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22934.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23622.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22934.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22934.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22934.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23392.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29814.3,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22934.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22934.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22934.08,29814.3,
HEART FAILURE,1941,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4628.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4767.17,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4628.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4628.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4628.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4720.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6016.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4628.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4628.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4628.32,6016.82,
HEART FAILURE,1942,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6256.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6444.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6256.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6256.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6256.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6382.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8134.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6256.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6256.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6256.99,8134.09,
HEART FAILURE,1943,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8832.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9097.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8832.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8832.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8832.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9009.01,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11482.07,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8832.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8832.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8832.36,11482.07,
HEART FAILURE,1944,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14464.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14897.99,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14464.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14464.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14464.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14753.35,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18803.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14464.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14464.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14464.07,18803.29,
CARDIAC ARREST AND SHOCK,1961,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3993.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4112.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3993.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3993.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3993.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4072.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5191.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3993.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3993.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3993.08,5191.01,
CARDIAC ARREST AND SHOCK,1962,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5475.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5639.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5475.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5475.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5475.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5584.75,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7117.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5475.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5475.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5475.24,7117.82,
CARDIAC ARREST AND SHOCK,1963,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7864.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8100.29,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7864.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7864.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7864.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8021.65,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10223.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7864.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7864.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7864.36,10223.67,
CARDIAC ARREST AND SHOCK,1964,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16036.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16518.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16036.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16036.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16036.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16357.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20848.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16036.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16036.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16036.95,20848.04,
PERIPHERAL AND OTHER VASCULAR DISORDERS,1971,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4957.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5106.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4957.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4957.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4957.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5056.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6444.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4957.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4957.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4957.54,6444.8,
PERIPHERAL AND OTHER VASCULAR DISORDERS,1972,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6438.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6631.47,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6438.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6438.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6438.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6567.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8369.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6438.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6438.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6438.33,8369.82,
PERIPHERAL AND OTHER VASCULAR DISORDERS,1973,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8934.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9202.93,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8934.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8934.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8934.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9113.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11615.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8934.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8934.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8934.88,11615.35,
PERIPHERAL AND OTHER VASCULAR DISORDERS,1974,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18640.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19200.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18640.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18640.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18640.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19013.7,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24233.15,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18640.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18640.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18640.89,24233.15,
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,1981,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4840.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4985.35,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4840.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4840.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4840.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4936.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6292.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4840.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4840.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4840.15,6292.19,
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,1982,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5640.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5809.29,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5640.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5640.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5640.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5752.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7332.11,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5640.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5640.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5640.09,7332.11,
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,1983,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7530.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7756.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7530.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7530.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7530.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7680.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9789.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7530.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7530.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7530.3,9789.39,
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,1984,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14606.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15045.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14606.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14606.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14606.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14899.04,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18988.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14606.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14606.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14606.9,18988.97,
HYPERTENSION,1991,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4826.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4971.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4826.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4826.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4826.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4922.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6274.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4826.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4826.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4826.42,6274.34,
HYPERTENSION,1992,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5670.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5840.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5670.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5670.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5670.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5783.62,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7371.28,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5670.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5670.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5670.21,7371.28,
HYPERTENSION,1993,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7922.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8160.67,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7922.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7922.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7922.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8081.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10299.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7922.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7922.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7922.99,10299.88,
HYPERTENSION,1994,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12782.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13165.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12782.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12782.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12782.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13037.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16616.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12782.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12782.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12782.12,16616.76,
CARDIAC STRUCTURAL AND VALVULAR DISORDERS,2001,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5187.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5342.79,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5187.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5187.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5187.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5290.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6743.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5187.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5187.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5187.17,6743.33,
CARDIAC STRUCTURAL AND VALVULAR DISORDERS,2002,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6565.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6762.16,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6565.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6565.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6565.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6696.51,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8534.77,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6565.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6565.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6565.2,8534.77,
CARDIAC STRUCTURAL AND VALVULAR DISORDERS,2003,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9354.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9635.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9354.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9354.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9354.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9541.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12161.07,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9354.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9354.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9354.67,12161.07,
CARDIAC STRUCTURAL AND VALVULAR DISORDERS,2004,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17249.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17766.65,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17249.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17249.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17249.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17594.15,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22423.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17249.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17249.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17249.17,22423.92,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,2011,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4085.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4207.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4085.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4085.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4085.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4166.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5310.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4085.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4085.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4085.09,5310.61,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,2012,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5368.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5529.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5368.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5368.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5368.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5475.54,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6978.63,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5368.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5368.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5368.18,6978.63,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,2013,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8057.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8299.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8057.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8057.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8057.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8218.7,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10474.81,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8057.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8057.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8057.55,10474.81,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,2014,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14509.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14944.71,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14509.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14509.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14509.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14799.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18862.25,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14509.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14509.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14509.42,18862.25,
CHEST PAIN,2031,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5022.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5172.71,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5022.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5022.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5022.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5122.49,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6528.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5022.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5022.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5022.05,6528.66,
CHEST PAIN,2032,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5706.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5877.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5706.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5706.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5706.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5820.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7418.11,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5706.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5706.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5706.24,7418.11,
CHEST PAIN,2033,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7080.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7293.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7080.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7080.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7080.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7222.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9205.28,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7080.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7080.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7080.99,9205.28,
CHEST PAIN,2034,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9943.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10241.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9943.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9943.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9943.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10141.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12925.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9943.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9943.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9943.02,12925.92,
SYNCOPE AND COLLAPSE,2041,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5495.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5659.93,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5495.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5495.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5495.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5604.98,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7143.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5495.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5495.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5495.08,7143.61,
SYNCOPE AND COLLAPSE,2042,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6166.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6351.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6166.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6166.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6166.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6289.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8016.23,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6166.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6166.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6166.33,8016.23,
SYNCOPE AND COLLAPSE,2043,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7814.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8048.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7814.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7814.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7814.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7970.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10158.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7814.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7814.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7814.1,10158.34,
SYNCOPE AND COLLAPSE,2044,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12600.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12978.2,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12600.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12600.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12600.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12852.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16380.25,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12600.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12600.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12600.2,16380.25,
CARDIOMYOPATHY,2051,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5018.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5169.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5018.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5018.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5018.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5119.07,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6524.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5018.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5018.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5018.7,6524.31,
CARDIOMYOPATHY,2052,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6520.17,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6456.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8229.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6330.26,8229.33,
CARDIOMYOPATHY,2053,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9288.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9567.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9288.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9288.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9288.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9474.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12075.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9288.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9288.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9288.86,12075.52,
CARDIOMYOPATHY,2054,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18384.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18936.49,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18384.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18384.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18384.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18752.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23900.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18384.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18384.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18384.95,23900.43,
"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",2061,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6965.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7174.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6965.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6965.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6965.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7105.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9055.45,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6965.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6965.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6965.73,9055.45,
"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",2062,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7176.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7391.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7176.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7176.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7176.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7319.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9329.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7176.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7176.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7176.46,9329.39,
"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",2063,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10458.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10771.79,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10458.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10458.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10458.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10667.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13595.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10458.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10458.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10458.05,13595.46,
"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",2064,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22448.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23122.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22448.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22448.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22448.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22897.54,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29183.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22448.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22448.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22448.57,29183.14,
OTHER CIRCULATORY SYSTEM DIAGNOSES,2071,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4982.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5131.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4982.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4982.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4982.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5081.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6476.78,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4982.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4982.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4982.14,6476.78,
OTHER CIRCULATORY SYSTEM DIAGNOSES,2072,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6340.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6530.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6340.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6340.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6340.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6467.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8242.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6340.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6340.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6340.27,8242.35,
OTHER CIRCULATORY SYSTEM DIAGNOSES,2073,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9163.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9438.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9163.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9163.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9163.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9347.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11913.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9163.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9163.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9163.87,11913.03,
OTHER CIRCULATORY SYSTEM DIAGNOSES,2074,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16100.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16583.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16100.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16100.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16100.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16422.47,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20930.6,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16100.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16100.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16100.46,20930.6,
"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2201,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12358.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12729.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12358.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12358.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12358.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12605.43,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16065.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12358.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12358.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12358.26,16065.74,
"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2202,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18821.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19386.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18821.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18821.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18821.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19198.42,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24468.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18821.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18821.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18821.98,24468.58,
"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2203,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29321.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30200.85,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29321.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29321.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29321.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29907.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,38117.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29321.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29321.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,29321.22,38117.58,
"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2204,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55573.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57241.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55573.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55573.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55573.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56685.3,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,72245.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55573.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55573.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,55573.82,72245.97,
"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2221,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7036.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7247.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7036.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7036.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7036.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7177.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9147.27,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7036.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7036.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7036.36,9147.27,
"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2222,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11303.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11642.46,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11303.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11303.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11303.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11529.43,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14694.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11303.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11303.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11303.36,14694.37,
"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2223,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18870.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19436.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18870.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18870.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18870.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19247.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24531.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18870.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18870.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18870.37,24531.48,
"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2224,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38169.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39314.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38169.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38169.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38169.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38932.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49620.41,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38169.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38169.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,38169.55,49620.41,
OTHER SMALL AND LARGE BOWEL PROCEDURES,2231,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9333.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9613.17,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9333.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9333.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9333.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9519.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12133.13,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9333.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9333.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9333.18,12133.13,
OTHER SMALL AND LARGE BOWEL PROCEDURES,2232,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13507.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13912.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13507.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13507.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13507.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13777.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17559.5,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13507.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13507.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13507.31,17559.5,
OTHER SMALL AND LARGE BOWEL PROCEDURES,2233,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20252.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20860.47,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20252.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20252.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20252.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20657.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26328.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20252.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20252.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20252.88,26328.74,
OTHER SMALL AND LARGE BOWEL PROCEDURES,2234,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37954.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39092.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37954.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37954.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37954.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38713.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49340.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37954.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37954.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37954.12,49340.36,
PERITONEAL ADHESIOLYSIS,2241,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10732.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11054.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10732.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10732.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10732.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10947.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13952.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10732.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10732.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10732.72,13952.53,
PERITONEAL ADHESIOLYSIS,2242,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13993.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14413.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13993.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13993.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13993.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14273.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18191.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13993.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13993.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13993.21,18191.17,
PERITONEAL ADHESIOLYSIS,2243,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20147.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20751.98,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20147.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20147.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20147.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20550.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26191.81,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20147.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20147.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20147.55,26191.81,
PERITONEAL ADHESIOLYSIS,2244,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37005.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38115.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37005.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37005.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37005.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37745.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,48107.5,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37005.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37005.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37005.77,48107.5,
ANAL PROCEDURES,2261,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7917.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8155.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7917.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7917.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7917.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8076.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10293.07,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7917.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7917.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7917.75,10293.07,
ANAL PROCEDURES,2262,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10880.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11206.83,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10880.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10880.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10880.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11098.03,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14144.54,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10880.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10880.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10880.42,14144.54,
ANAL PROCEDURES,2263,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15822.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16297.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15822.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15822.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15822.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16138.8,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20569.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15822.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15822.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15822.35,20569.05,
ANAL PROCEDURES,2264,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37113.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38227.34,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37113.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37113.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37113.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37856.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,48248.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37113.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37113.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37113.92,48248.1,
"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",2271,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10446.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10760.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10446.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10446.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10446.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10655.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13580.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10446.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10446.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10446.85,13580.91,
"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",2272,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13197.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13593.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13197.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13197.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13197.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13461.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17156.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13197.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13197.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13197.16,17156.31,
"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",2273,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20417.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21030.29,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20417.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20417.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20417.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20826.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26543.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20417.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20417.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20417.76,26543.08,
"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",2274,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36321.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37411.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36321.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36321.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36321.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37048.42,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,47218.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36321.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36321.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,36321.98,47218.58,
"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",2281,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8134.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8378.85,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8134.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8134.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8134.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8297.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10575.25,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8134.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8134.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8134.81,10575.25,
"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",2282,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10460.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10773.89,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10460.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10460.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10460.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10669.29,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13598.11,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10460.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10460.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10460.09,13598.11,
"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",2283,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15633.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16102.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15633.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15633.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15633.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15945.75,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20323.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15633.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15633.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15633.09,20323.01,
"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",2284,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29714.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30605.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29714.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29714.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29714.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30308.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,38628.32,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29714.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29714.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,29714.09,38628.32,
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,2291,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10299.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10608.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10299.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10299.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10299.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10505.87,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13389.83,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10299.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10299.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10299.87,13389.83,
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,2292,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13698.98,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13565.98,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17289.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13299.98,17289.97,
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,2293,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19336.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19916.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19336.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19336.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19336.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19723.03,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25137.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19336.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19336.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19336.3,25137.19,
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,2294,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37761.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38894.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37761.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37761.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37761.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38516.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49089.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37761.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37761.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37761.28,49089.66,
MAJOR SMALL BOWEL PROCEDURES,2301,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12131.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12495,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12131.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12131.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12131.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12373.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15770.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12131.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12131.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12131.07,15770.39,
MAJOR SMALL BOWEL PROCEDURES,2302,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16823.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17328.54,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16823.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16823.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16823.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17160.3,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21870.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16823.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16823.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16823.82,21870.97,
MAJOR SMALL BOWEL PROCEDURES,2303,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24861.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25607.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24861.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24861.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24861.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25358.67,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,32319.87,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24861.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24861.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24861.44,32319.87,
MAJOR SMALL BOWEL PROCEDURES,2304,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47957.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49396.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47957.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47957.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47957.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48917.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,62345.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47957.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47957.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,47957.98,62345.37,
MAJOR LARGE BOWEL PROCEDURES,2311,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12555.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12932.62,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12555.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12555.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12555.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12807.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16322.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12555.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12555.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12555.94,16322.72,
MAJOR LARGE BOWEL PROCEDURES,2312,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16528.89,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16368.41,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20861.7,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16047.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16047.46,20861.7,
MAJOR LARGE BOWEL PROCEDURES,2313,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24719.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25461.3,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24719.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24719.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24719.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25214.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,32135.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24719.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24719.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24719.7,32135.62,
MAJOR LARGE BOWEL PROCEDURES,2314,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42107.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43370.25,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42107.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42107.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42107.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42949.18,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,54739.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42107.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42107.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,42107.04,54739.16,
GASTRIC FUNDOPLICATION,2321,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8973.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9242.73,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8973.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8973.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8973.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9153,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11665.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8973.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8973.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8973.53,11665.58,
GASTRIC FUNDOPLICATION,2322,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11862.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12218.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11862.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11862.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11862.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12099.57,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15421.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11862.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11862.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11862.32,15421.02,
GASTRIC FUNDOPLICATION,2323,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18695.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19256.86,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18695.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18695.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18695.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19069.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24304.78,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18695.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18695.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18695.99,24304.78,
GASTRIC FUNDOPLICATION,2324,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64324.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66254.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64324.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64324.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64324.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65611.15,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,83622.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64324.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64324.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,64324.66,83622.06,
APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,2331,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8983.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9253.05,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8983.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8983.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8983.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9163.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11678.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8983.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8983.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8983.55,11678.61,
APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,2332,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11678.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12028.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11678.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11678.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11678.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11912.17,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15182.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11678.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11678.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11678.6,15182.17,
APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,2333,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17308.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17827.29,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17308.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17308.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17308.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17654.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22500.47,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17308.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17308.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17308.05,22500.47,
APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,2334,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29152.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30026.62,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29152.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29152.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29152.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29735.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,37897.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29152.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29152.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,29152.06,37897.68,
APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,2341,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8063.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8305.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8063.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8063.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8063.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8225.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10482.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8063.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8063.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8063.81,10482.95,
APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,2342,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10020.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10321.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10020.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10020.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10020.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10221.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13026.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10020.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10020.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10020.69,13026.89,
APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,2343,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14941.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15390,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14941.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14941.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14941.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15240.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19424.27,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14941.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14941.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14941.74,19424.27,
APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,2344,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28413.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29266.03,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28413.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28413.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28413.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28981.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,36937.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28413.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28413.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,28413.63,36937.71,
DIGESTIVE MALIGNANCY,2401,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7221.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7438.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7221.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7221.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7221.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7366.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9388.22,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7221.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7221.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7221.71,9388.22,
DIGESTIVE MALIGNANCY,2402,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8316.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8566.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8316.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8316.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8316.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8483.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10811.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8316.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8316.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8316.77,10811.8,
DIGESTIVE MALIGNANCY,2403,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11743.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12095.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11743.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11743.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11743.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11978.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15266.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11743.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11743.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11743.3,15266.29,
DIGESTIVE MALIGNANCY,2404,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21886.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22543.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21886.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21886.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21886.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22324.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28452.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21886.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21886.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21886.67,28452.67,
PEPTIC ULCER AND GASTRITIS,2411,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5700.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5871.58,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5700.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5700.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5700.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5814.57,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7410.73,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5700.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5700.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5700.56,7410.73,
PEPTIC ULCER AND GASTRITIS,2412,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6948.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7157.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6948.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6948.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6948.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7087.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9033.44,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6948.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6948.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6948.8,9033.44,
PEPTIC ULCER AND GASTRITIS,2413,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10233.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10540.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10233.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10233.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10233.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10438.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13304.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10233.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10233.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10233.95,13304.14,
PEPTIC ULCER AND GASTRITIS,2414,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22269.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22937.63,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22269.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22269.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22269.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22714.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28950.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22269.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22269.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22269.54,28950.4,
MAJOR ESOPHAGEAL DISORDERS,2421,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5182.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5337.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5182.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5182.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5182.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5285.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6736.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5182.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5182.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5182.12,6736.76,
MAJOR ESOPHAGEAL DISORDERS,2422,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6633.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6832.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6633.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6633.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6633.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6766.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8623.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6633.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6633.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6633.55,8623.62,
MAJOR ESOPHAGEAL DISORDERS,2423,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9650.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9939.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9650.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9650.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9650.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9843.27,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12545.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9650.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9650.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9650.26,12545.34,
MAJOR ESOPHAGEAL DISORDERS,2424,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22526.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23202.13,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22526.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22526.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22526.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22976.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29284.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22526.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22526.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22526.34,29284.24,
OTHER ESOPHAGEAL DISORDERS,2431,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5276.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5434.34,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5276.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5276.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5276.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5381.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6858.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5276.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5276.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5276.06,6858.88,
OTHER ESOPHAGEAL DISORDERS,2432,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6337.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6527.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6337.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6337.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6337.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6464.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8238.6,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6337.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6337.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6337.39,8238.6,
OTHER ESOPHAGEAL DISORDERS,2433,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9253.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9531.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9253.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9253.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9253.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9438.74,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12029.77,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9253.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9253.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9253.67,12029.77,
OTHER ESOPHAGEAL DISORDERS,2434,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18310.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18859.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18310.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18310.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18310.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18676.32,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23803.15,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18310.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18310.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18310.12,23803.15,
DIVERTICULITIS AND DIVERTICULOSIS,2441,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4695.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4836.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4695.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4695.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4695.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4789.07,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6103.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4695.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4695.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4695.17,6103.72,
DIVERTICULITIS AND DIVERTICULOSIS,2442,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6230.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6417.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6230.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6230.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6230.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6354.8,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8099.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6230.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6230.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6230.2,8099.26,
DIVERTICULITIS AND DIVERTICULOSIS,2443,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10006.61,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9909.46,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12629.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9715.16,12629.71,
DIVERTICULITIS AND DIVERTICULOSIS,2444,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18752.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19314.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18752.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18752.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18752.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19127.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24377.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18752.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18752.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18752.15,24377.8,
INFLAMMATORY BOWEL DISEASE,2451,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5289.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5447.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5289.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5289.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5289.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5394.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6875.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5289.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5289.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5289.01,6875.71,
INFLAMMATORY BOWEL DISEASE,2452,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6712.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6913.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6712.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6712.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6712.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6846.52,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8725.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6712.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6712.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6712.27,8725.95,
INFLAMMATORY BOWEL DISEASE,2453,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10111.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10414.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10111.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10111.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10111.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10313.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13145.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10111.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10111.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10111.56,13145.03,
INFLAMMATORY BOWEL DISEASE,2454,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19113.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19687.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19113.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19113.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19113.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19495.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24847.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19113.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19113.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19113.63,24847.72,
GASTROINTESTINAL VASCULAR INSUFFICIENCY,2461,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5334.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5494.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5334.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5334.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5334.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5441.15,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6934.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5334.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5334.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5334.46,6934.8,
GASTROINTESTINAL VASCULAR INSUFFICIENCY,2462,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6844.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6777.57,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8638.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6644.68,8638.08,
GASTROINTESTINAL VASCULAR INSUFFICIENCY,2463,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10162.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10467.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10162.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10162.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10162.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10366.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13211.63,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10162.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10162.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10162.79,13211.63,
GASTROINTESTINAL VASCULAR INSUFFICIENCY,2464,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17733.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18265.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17733.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17733.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17733.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18087.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23053.32,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17733.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17733.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17733.32,23053.32,
INTESTINAL OBSTRUCTION,2471,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4306.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4435.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4306.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4306.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4306.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4392.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5598.77,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4306.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4306.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4306.75,5598.77,
INTESTINAL OBSTRUCTION,2472,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5730.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5902.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5730.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5730.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5730.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5845.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7450.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5730.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5730.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5730.83,7450.08,
INTESTINAL OBSTRUCTION,2473,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9278.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9556.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9278.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9278.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9278.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9464,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12061.96,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9278.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9278.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9278.43,12061.96,
INTESTINAL OBSTRUCTION,2474,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17737.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18269.17,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17737.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17737.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17737.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18091.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23058.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17737.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17737.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17737.05,23058.17,
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,2481,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4786.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4930.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4786.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4786.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4786.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4882.62,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6222.94,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4786.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4786.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4786.88,6222.94,
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,2482,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6506.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6701.89,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6506.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6506.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6506.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6636.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8458.7,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6506.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6506.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6506.69,8458.7,
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,2483,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9897.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10194.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9897.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9897.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9897.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10095.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12866.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9897.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9897.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9897.18,12866.33,
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,2484,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19346.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19927.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19346.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19346.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19346.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19733.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25151,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19346.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19346.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19346.92,25151,
"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",2491,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4341.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4471.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4341.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4341.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4341.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4428.28,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5643.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4341.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4341.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4341.45,5643.89,
"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",2492,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5177.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5332.44,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5177.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5177.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5177.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5280.67,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6730.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5177.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5177.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5177.13,6730.26,
"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",2493,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7616.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7844.54,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7616.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7616.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7616.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7768.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9900.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7616.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7616.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7616.06,9900.88,
"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",2494,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15537.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16003.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15537.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15537.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15537.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15848.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20198.83,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15537.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15537.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15537.56,20198.83,
ABDOMINAL PAIN,2511,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4868.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5014.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4868.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4868.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4868.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4965.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6328.86,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4868.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4868.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4868.35,6328.86,
ABDOMINAL PAIN,2512,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5832.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6007.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5832.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5832.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5832.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5948.98,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7582.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5832.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5832.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5832.34,7582.04,
ABDOMINAL PAIN,2513,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7750.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7982.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7750.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7750.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7750.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7905.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10075.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7750.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7750.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7750.06,10075.08,
ABDOMINAL PAIN,2514,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14624.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15063.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14624.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14624.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14624.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14917.43,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19012.42,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14624.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14624.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14624.94,19012.42,
"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",2521,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5523.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5689.09,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5523.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5523.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5523.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5633.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7180.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5523.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5523.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5523.38,7180.4,
"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",2522,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6973.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7182.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6973.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6973.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6973.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7113.18,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9065.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6973.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6973.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6973.71,9065.82,
"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",2523,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10632.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10951.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10632.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10632.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10632.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10845.42,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13822.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10632.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10632.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10632.76,13822.59,
"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",2524,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22513.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23189.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22513.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22513.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22513.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22964.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29268.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22513.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22513.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22513.86,29268.02,
OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,2531,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5294.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5453.15,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5294.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5294.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5294.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5400.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6882.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5294.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5294.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5294.32,6882.61,
OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,2532,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6685.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6885.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6685.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6685.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6685.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6819.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8691.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6685.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6685.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6685.41,8691.03,
OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,2533,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9929.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10226.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9929.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9929.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9929.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10127.65,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12907.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9929.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9929.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9929.07,12907.79,
OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,2534,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17693.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18223.86,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17693.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17693.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17693.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18046.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23000.98,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17693.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17693.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17693.06,23000.98,
OTHER DIGESTIVE SYSTEM DIAGNOSES,2541,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4970.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5119.96,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4970.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4970.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4970.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5070.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6462.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4970.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4970.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4970.83,6462.08,
OTHER DIGESTIVE SYSTEM DIAGNOSES,2542,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6411.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6603.98,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6411.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6411.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6411.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6539.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8335.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6411.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6411.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6411.63,8335.12,
OTHER DIGESTIVE SYSTEM DIAGNOSES,2543,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9493.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9777.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9493.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9493.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9493.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9682.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12340.94,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9493.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9493.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9493.03,12340.94,
OTHER DIGESTIVE SYSTEM DIAGNOSES,2544,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18070.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18613.12,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18070.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18070.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18070.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18432.41,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23492.28,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18070.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18070.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18070.99,23492.28,
"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",2601,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16802.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17307.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16802.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16802.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16802.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17139.03,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21843.86,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16802.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16802.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16802.97,21843.86,
"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",2602,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21863.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21651.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27594.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21226.52,27594.48,
"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",2603,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30925.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31853.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30925.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30925.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30925.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31544.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,40203.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30925.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30925.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,30925.96,40203.75,
"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",2604,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65449.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67412.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65449.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65449.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65449.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66758.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,85083.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65449.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65449.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,65449.18,85083.93,
MAJOR BILIARY TRACT PROCEDURES,2611,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12914.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13302.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12914.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12914.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12914.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13173.28,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16789.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12914.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12914.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12914.98,16789.48,
MAJOR BILIARY TRACT PROCEDURES,2612,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17899.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18436.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17899.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17899.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17899.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18257.15,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23268.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17899.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17899.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17899.17,23268.92,
MAJOR BILIARY TRACT PROCEDURES,2613,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26764.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27567.84,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26764.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26764.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26764.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27300.19,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,34794.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26764.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26764.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26764.89,34794.36,
MAJOR BILIARY TRACT PROCEDURES,2614,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51434.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52977.18,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51434.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51434.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51434.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52462.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,66864.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51434.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51434.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,51434.15,66864.4,
CHOLECYSTECTOMY,2631,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9609.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9897.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9609.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9609.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9609.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9801.49,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12492.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9609.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9609.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9609.31,12492.1,
CHOLECYSTECTOMY,2632,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12118.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12481.63,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12118.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12118.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12118.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12360.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15753.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12118.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12118.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12118.09,15753.52,
CHOLECYSTECTOMY,2633,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15848.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16323.89,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15848.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15848.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15848.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16165.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20602.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15848.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15848.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15848.44,20602.97,
CHOLECYSTECTOMY,2634,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32242.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33209.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32242.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32242.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32242.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32887.32,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,41915.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32242.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32242.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,32242.47,41915.21,
"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",2641,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12550.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12927.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12550.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12550.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12550.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12801.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16316.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12550.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12550.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12550.9,16316.17,
"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",2642,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12633.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13012.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12633.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12633.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12633.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12886.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16424.11,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12633.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12633.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12633.93,16424.11,
"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",2643,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14426.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14858.96,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14426.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14426.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14426.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14714.7,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18754.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14426.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14426.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14426.17,18754.03,
"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",2644,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37679.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38810.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37679.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37679.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37679.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38433.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,48983.55,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37679.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37679.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37679.65,48983.55,
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,2791,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4689.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4830.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4689.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4689.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4689.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4783.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6096.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4689.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4689.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4689.34,6096.14,
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,2792,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5947.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6125.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5947.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5947.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5947.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6066.27,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7731.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5947.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5947.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5947.33,7731.52,
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,2793,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9489.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9774,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9489.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9489.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9489.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9679.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12336.11,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9489.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9489.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9489.32,12336.11,
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,2794,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22356.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23027.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22356.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22356.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22356.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22803.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29063.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22356.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22356.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22356.85,29063.91,
ALCOHOLIC LIVER DISEASE,2801,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4827.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4972.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4827.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4827.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4827.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4924.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6276.3,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4827.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4827.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4827.92,6276.3,
ALCOHOLIC LIVER DISEASE,2802,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6301.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6490.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6301.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6301.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6301.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6427.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8192.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6301.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6301.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6301.61,8192.1,
ALCOHOLIC LIVER DISEASE,2803,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9915.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10212.58,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9915.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9915.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9915.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10113.43,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12889.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9915.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9915.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9915.13,12889.67,
ALCOHOLIC LIVER DISEASE,2804,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23664.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24374.2,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23664.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23664.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23664.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24137.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30763.55,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23664.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23664.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23664.27,30763.55,
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,2811,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6550.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6747.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6550.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6550.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6550.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6681.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8516.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6550.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6550.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6550.97,8516.26,
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,2812,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8345.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8595.65,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8345.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8345.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8345.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8512.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10848.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8345.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8345.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8345.29,10848.88,
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,2813,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10972.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11301.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10972.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10972.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10972.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11191.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14263.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10972.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10972.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10972.11,14263.75,
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,2814,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17759.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18292.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17759.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17759.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17759.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18114.62,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23087.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17759.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17759.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17759.43,23087.26,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY,2821,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4801.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4945.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4801.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4801.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4801.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4897.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6241.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4801.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4801.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4801.03,6241.33,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY,2822,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6324.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6514.73,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6324.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6324.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6324.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6451.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8222.47,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6324.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6324.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6324.98,8222.47,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY,2823,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10430.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10743.18,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10430.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10430.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10430.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10638.87,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13559.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10430.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10430.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10430.27,13559.35,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY,2824,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26343.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27134.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26343.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26343.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26343.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26870.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,34247.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26343.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26343.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26343.89,34247.06,
OTHER DISORDERS OF THE LIVER,2831,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5171.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5326.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5171.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5171.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5171.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5274.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6722.78,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5171.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5171.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5171.37,6722.78,
OTHER DISORDERS OF THE LIVER,2832,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6302.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6491.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6302.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6302.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6302.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6428.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8192.81,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6302.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6302.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6302.16,8192.81,
OTHER DISORDERS OF THE LIVER,2833,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9299.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9577.99,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9299.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9299.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9299.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9485,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12088.73,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9299.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9299.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9299.02,12088.73,
OTHER DISORDERS OF THE LIVER,2834,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19884.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20481.18,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19884.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19884.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19884.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20282.34,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25850.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19884.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19884.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19884.64,25850.04,
DISORDERS OF GALLBLADDER AND BILIARY TRACT,2841,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6137.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6321.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6137.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6137.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6137.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6260.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7978.99,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6137.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6137.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6137.68,7978.99,
DISORDERS OF GALLBLADDER AND BILIARY TRACT,2842,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7848.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8083.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7848.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7848.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7848.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8005.03,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10202.49,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7848.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7848.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7848.07,10202.49,
DISORDERS OF GALLBLADDER AND BILIARY TRACT,2843,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11296.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11635.84,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11296.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11296.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11296.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11522.87,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14686.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11296.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11296.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11296.93,14686.01,
DISORDERS OF GALLBLADDER AND BILIARY TRACT,2844,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21514.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22160.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21514.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21514.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21514.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21944.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27969.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21514.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21514.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21514.64,27969.04,
DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,3031,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38388.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39540.09,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38388.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38388.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38388.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39156.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49904.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38388.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38388.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,38388.44,49904.97,
DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,3032,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49571.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51058.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49571.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49571.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49571.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50562.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,64442.54,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49571.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49571.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,49571.18,64442.54,
DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,3033,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70888.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73015.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70888.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70888.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70888.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,72306.52,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,92155.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70888.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70888.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,70888.74,92155.37,
DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,3034,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,92311.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,95080.73,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,92311.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,92311.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,92311.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,94157.62,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,120004.81,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,92311.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,92311.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,92311.39,120004.81,
DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,3041,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23832.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24547.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23832.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23832.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23832.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24308.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30981.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23832.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23832.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23832.25,30981.92,
DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,3042,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29991.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30891.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29991.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29991.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29991.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30591.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,38989.3,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29991.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29991.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,29991.77,38989.3,
DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,3043,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45743.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47115.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45743.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45743.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45743.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46657.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,59465.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45743.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45743.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,45743.02,59465.93,
DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,3044,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66109.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,68092.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66109.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66109.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66109.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67431.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,85942.38,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66109.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66109.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,66109.52,85942.38,
AMPUTATION OF LOWER LIMB EXCEPT TOES,3051,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9362.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9642.99,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9362.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9362.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9362.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9549.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12170.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9362.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9362.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9362.12,12170.76,
AMPUTATION OF LOWER LIMB EXCEPT TOES,3052,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12837.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13222.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12837.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12837.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12837.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13094.32,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16688.83,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12837.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12837.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12837.56,16688.83,
AMPUTATION OF LOWER LIMB EXCEPT TOES,3053,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20769.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21392.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20769.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20769.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20769.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21184.57,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26999.94,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20769.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20769.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20769.18,26999.94,
AMPUTATION OF LOWER LIMB EXCEPT TOES,3054,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41403.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42645.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41403.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41403.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41403.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42231.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,53824.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41403.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41403.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,41403.49,53824.53,
HIP AND FEMUR FRACTURE REPAIR,3081,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11653.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12003.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11653.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11653.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11653.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11886.98,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15150.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11653.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11653.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11653.9,15150.08,
HIP AND FEMUR FRACTURE REPAIR,3082,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13579.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13986.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13579.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13579.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13579.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13850.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17653.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13579.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13579.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13579.31,17653.1,
HIP AND FEMUR FRACTURE REPAIR,3083,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18521.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19077.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18521.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18521.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18521.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18892.34,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24078.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18521.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18521.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18521.91,24078.48,
HIP AND FEMUR FRACTURE REPAIR,3084,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27744.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28577.07,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27744.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27744.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27744.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28299.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,36068.15,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27744.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27744.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,27744.73,36068.15,
OTHER SIGNIFICANT HIP AND FEMUR SURGERY,3091,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12808.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13193.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12808.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12808.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12808.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13065.02,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16651.49,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12808.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12808.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12808.84,16651.49,
OTHER SIGNIFICANT HIP AND FEMUR SURGERY,3092,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16927.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17435.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16927.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16927.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16927.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17266.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22006.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16927.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16927.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16927.76,22006.09,
OTHER SIGNIFICANT HIP AND FEMUR SURGERY,3093,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24888.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25635.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24888.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24888.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24888.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25386.18,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,32354.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24888.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24888.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24888.41,32354.93,
OTHER SIGNIFICANT HIP AND FEMUR SURGERY,3094,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40609.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41828.12,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40609.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40609.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40609.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41422.02,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,52792.78,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40609.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40609.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,40609.83,52792.78,
INTERVERTEBRAL DISC EXCISION AND DECOMPRESSION,3101,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10303.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10613.05,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10303.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10303.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10303.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10510.01,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13395.11,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10303.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10303.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10303.93,13395.11,
INTERVERTEBRAL DISC EXCISION AND DECOMPRESSION,3102,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13219.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13616.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13219.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13219.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13219.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13483.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17185.42,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13219.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13219.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13219.55,17185.42,
INTERVERTEBRAL DISC EXCISION AND DECOMPRESSION,3103,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18868.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19434.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18868.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18868.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18868.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19245.65,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24528.77,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18868.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18868.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18868.28,24528.77,
INTERVERTEBRAL DISC EXCISION AND DECOMPRESSION,3104,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37270.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38389.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37270.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37270.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37270.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38016.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,48452.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37270.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37270.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37270.89,48452.16,
"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",3121,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12076.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12438.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12076.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12076.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12076.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12317.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15699.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12076.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12076.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12076.25,15699.12,
"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",3122,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21043.13,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20838.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26559.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20430.23,26559.29,
"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",3123,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34720.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35761.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34720.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34720.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34720.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35414.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,45136.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34720.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34720.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,34720.15,45136.2,
"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",3124,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65450.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67414.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65450.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65450.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65450.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66760,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,85086.27,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65450.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65450.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,65450.98,85086.27,
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,3131,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11293.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11632.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11293.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11293.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11293.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11519.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14681.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11293.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11293.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11293.69,14681.79,
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,3132,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15301.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15760.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15301.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15301.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15301.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15607.7,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19892.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15301.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15301.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15301.67,19892.17,
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,3133,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23931.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24649.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23931.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23931.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23931.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24410.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31111.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23931.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23931.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23931.76,31111.29,
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,3134,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39020.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40191.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39020.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39020.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39020.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39801.34,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,50727.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39020.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39020.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39020.92,50727.19,
FOOT AND TOE PROCEDURES,3141,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10097.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10400.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10097.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10097.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10097.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10299.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13126.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10097.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10097.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10097.44,13126.67,
FOOT AND TOE PROCEDURES,3142,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10905.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11232.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10905.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10905.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10905.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11123.47,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14176.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10905.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10905.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10905.37,14176.97,
FOOT AND TOE PROCEDURES,3143,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15359.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15820.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15359.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15359.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15359.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15667.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19967.83,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15359.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15359.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15359.87,19967.83,
FOOT AND TOE PROCEDURES,3144,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29627.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30516.07,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29627.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29627.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29627.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30219.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,38515.42,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29627.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29627.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,29627.25,38515.42,
"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",3151,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9415.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9697.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9415.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9415.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9415.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9603.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12240.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9415.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9415.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9415.46,12240.1,
"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",3152,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13986.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14405.88,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13986.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13986.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13986.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14266.02,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18182.18,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13986.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13986.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13986.3,18182.18,
"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",3153,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21502.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22147.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21502.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21502.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21502.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21932.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27953.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21502.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21502.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21502.46,27953.19,
"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",3154,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40483.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41698.29,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40483.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40483.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40483.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41293.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,52628.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40483.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40483.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,40483.78,52628.91,
HAND AND WRIST PROCEDURES,3161,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8075.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8318.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8075.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8075.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8075.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8237.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10498.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8075.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8075.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8075.74,10498.46,
HAND AND WRIST PROCEDURES,3162,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10754.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11077.03,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10754.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10754.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10754.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10969.49,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13980.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10754.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10754.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10754.4,13980.72,
HAND AND WRIST PROCEDURES,3163,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17183,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17698.49,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17183,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17183,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17183,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17526.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22337.9,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17183,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17183,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17183,22337.9,
HAND AND WRIST PROCEDURES,3164,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32405.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33378.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32405.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32405.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32405.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33054.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,42127.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32405.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32405.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,32405.96,42127.75,
"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",3171,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8855.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9121.38,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8855.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8855.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8855.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9032.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11512.42,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8855.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8855.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8855.71,11512.42,
"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",3172,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12232.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12599.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12232.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12232.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12232.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12476.98,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15902.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12232.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12232.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12232.34,15902.04,
"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",3173,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19841.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20436.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19841.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19841.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19841.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20238.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25793.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19841.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19841.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19841.4,25793.82,
"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",3174,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38705.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39866.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38705.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38705.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38705.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39479.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,50317.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38705.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38705.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,38705.39,50317.01,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,3201,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9549.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9835.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9549.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9549.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9549.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9740.26,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12414.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9549.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9549.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9549.27,12414.05,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,3202,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13837.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14252.86,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13837.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13837.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13837.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14114.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17989.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13837.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13837.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13837.73,17989.05,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,3203,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21468.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22112.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21468.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21468.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21468.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21898.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27909.5,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21468.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21468.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21468.85,27909.5,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,3204,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35537.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36603.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35537.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35537.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35537.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36247.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,46198.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35537.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35537.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,35537.11,46198.24,
CERVICAL SPINAL FUSION AND OTHER BACK OR NECK PROCEDURES EXCEPT DISC EXCISION OR DECOMPRESSION,3211,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15086.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15539.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15086.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15086.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15086.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15388.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19612.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15086.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15086.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15086.87,19612.93,
CERVICAL SPINAL FUSION AND OTHER BACK OR NECK PROCEDURES EXCEPT DISC EXCISION OR DECOMPRESSION,3212,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19039.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19610.63,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19039.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19039.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19039.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19420.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24751.28,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19039.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19039.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19039.44,24751.28,
CERVICAL SPINAL FUSION AND OTHER BACK OR NECK PROCEDURES EXCEPT DISC EXCISION OR DECOMPRESSION,3213,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29497.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30382.89,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29497.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29497.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29497.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30087.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,38347.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29497.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29497.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,29497.96,38347.34,
CERVICAL SPINAL FUSION AND OTHER BACK OR NECK PROCEDURES EXCEPT DISC EXCISION OR DECOMPRESSION,3214,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49757.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51250.18,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49757.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49757.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49757.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50752.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,64684.7,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49757.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49757.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,49757.46,64684.7,
SHOULDER AND ELBOW JOINT REPLACEMENT,3221,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13963.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14382.88,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13963.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13963.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13963.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14243.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18153.15,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13963.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13963.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13963.96,18153.15,
SHOULDER AND ELBOW JOINT REPLACEMENT,3222,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15835.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16310.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15835.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15835.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15835.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16151.96,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20585.83,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15835.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15835.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15835.25,20585.83,
SHOULDER AND ELBOW JOINT REPLACEMENT,3223,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22015.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22675.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22015.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22015.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22015.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22455.59,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28619.87,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22015.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22015.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22015.29,28619.87,
SHOULDER AND ELBOW JOINT REPLACEMENT,3224,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36859.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37965.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36859.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36859.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36859.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37596.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,47917.45,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36859.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36859.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,36859.58,47917.45,
NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,3231,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13744.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14156.34,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13744.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13744.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13744.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14018.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17867.23,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13744.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13744.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13744.02,17867.23,
NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,3232,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15592.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16059.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15592.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15592.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15592.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15903.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20269.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15592.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15592.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15592.11,20269.74,
NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,3233,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21118.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21751.88,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21118.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21118.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21118.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21540.7,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27453.84,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21118.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21118.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21118.33,27453.84,
NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,3234,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31800.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32754.46,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31800.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31800.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31800.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32436.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,41340.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31800.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31800.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,31800.44,41340.58,
ELECTIVE HIP JOINT REPLACEMENT,3241,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11970.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12329.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11970.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11970.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11970.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12210.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15561.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11970.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11970.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11970.69,15561.89,
ELECTIVE HIP JOINT REPLACEMENT,3242,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13326.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13726.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13326.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13326.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13326.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13592.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17324.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13326.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13326.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13326.42,17324.35,
ELECTIVE HIP JOINT REPLACEMENT,3243,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19154.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19728.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19154.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19154.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19154.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19537.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24900.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19154.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19154.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19154.13,24900.37,
ELECTIVE HIP JOINT REPLACEMENT,3244,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32090.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33052.98,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32090.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32090.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32090.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32732.07,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,41717.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32090.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32090.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,32090.27,41717.35,
NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,3251,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17686.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18216.62,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17686.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17686.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17686.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18039.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22991.85,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17686.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17686.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17686.04,22991.85,
NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,3252,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21552.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22199.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21552.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21552.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21552.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21983.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28018.81,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21552.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21552.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21552.93,28018.81,
NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,3253,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27536.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28362.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27536.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27536.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27536.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28086.96,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,35797.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27536.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27536.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,27536.23,35797.1,
NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,3254,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40083.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41286.35,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40083.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40083.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40083.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40885.51,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,52108.98,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40083.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40083.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,40083.83,52108.98,
ELECTIVE KNEE JOINT REPLACEMENT,3261,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11623.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11972.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11623.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11623.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11623.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11856.42,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15111.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11623.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11623.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11623.94,15111.12,
ELECTIVE KNEE JOINT REPLACEMENT,3262,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12724.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13105.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12724.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12724.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12724.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12978.52,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16541.25,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12724.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12724.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12724.04,16541.25,
ELECTIVE KNEE JOINT REPLACEMENT,3263,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17908.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18445.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17908.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17908.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17908.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18266.87,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23281.3,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17908.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17908.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17908.69,23281.3,
ELECTIVE KNEE JOINT REPLACEMENT,3264,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26927.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27735.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26927.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26927.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26927.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27466.04,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,35005.73,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26927.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26927.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26927.49,35005.73,
FRACTURE OF FEMUR,3401,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4367.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4498.2,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4367.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4367.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4367.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4454.52,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5677.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4367.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4367.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4367.18,5677.33,
FRACTURE OF FEMUR,3402,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5329.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5489.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5329.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5329.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5329.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5435.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6928.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5329.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5329.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5329.38,6928.2,
FRACTURE OF FEMUR,3403,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7844.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8079.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7844.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7844.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7844.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8001.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10197.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7844.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7844.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7844.18,10197.43,
FRACTURE OF FEMUR,3404,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14316.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14745.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14316.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14316.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14316.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14602.6,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18611.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14316.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14316.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14316.28,18611.16,
FRACTURE OF PELVIS OR DISLOCATION OF HIP,3411,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4522.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4658.35,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4522.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4522.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4522.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4613.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5879.47,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4522.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4522.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4522.67,5879.47,
FRACTURE OF PELVIS OR DISLOCATION OF HIP,3412,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5409.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5571.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5409.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5409.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5409.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5517.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7032.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5409.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5409.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5409.26,7032.03,
FRACTURE OF PELVIS OR DISLOCATION OF HIP,3413,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7269.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7487.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7269.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7269.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7269.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7414.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9449.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7269.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7269.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7269.01,9449.71,
FRACTURE OF PELVIS OR DISLOCATION OF HIP,3414,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15224.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15680.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15224.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15224.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15224.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15528.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19791.27,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15224.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15224.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15224.05,19791.27,
"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",3421,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5060.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5212,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5060.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5060.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5060.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5161.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6578.25,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5060.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5060.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5060.19,6578.25,
"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",3422,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6374.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6565.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6374.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6374.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6374.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6501.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8286.47,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6374.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6374.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6374.21,8286.47,
"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",3423,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8952.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9220.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8952.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8952.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8952.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9131.26,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11637.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8952.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8952.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8952.22,11637.88,
"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",3424,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17571.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18098.16,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17571.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17571.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17571.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17922.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22842.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17571.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17571.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17571.03,22842.34,
MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,3431,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7801.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8035.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7801.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7801.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7801.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7957.41,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10141.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7801.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7801.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7801.39,10141.8,
MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,3432,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9216.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9493.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9216.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9216.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9216.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9401.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11981.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9216.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9216.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9216.89,11981.95,
MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,3433,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14009.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14430.13,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14009.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14009.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14009.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14290.03,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18212.78,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14009.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14009.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14009.83,18212.78,
MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,3434,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24643.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25383.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24643.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24643.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24643.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25136.7,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,32036.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24643.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24643.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24643.83,32036.97,
"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",3441,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6794.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6998.79,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6794.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6794.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6794.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6930.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8833.42,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6794.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6794.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6794.94,8833.42,
"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",3442,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8533.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8789.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8533.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8533.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8533.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8704.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11093.44,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8533.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8533.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8533.42,11093.44,
"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",3443,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12999.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12873.47,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16407.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12621.05,16407.37,
"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",3444,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22074.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22736.79,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22074.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22074.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22074.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22516.04,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28696.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22074.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22074.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22074.55,28696.92,
CONNECTIVE TISSUE DISORDERS,3461,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6096.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6279.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6096.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6096.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6096.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6218.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7925.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6096.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6096.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6096.78,7925.82,
CONNECTIVE TISSUE DISORDERS,3462,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8313.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8563.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8313.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8313.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8313.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8479.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10807.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8313.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8313.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8313.63,10807.72,
CONNECTIVE TISSUE DISORDERS,3463,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13838.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14254.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13838.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13838.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13838.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14115.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17990.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13838.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13838.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13838.91,17990.58,
CONNECTIVE TISSUE DISORDERS,3464,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31765.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32718.35,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31765.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31765.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31765.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32400.7,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,41295.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31765.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31765.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,31765.39,41295.01,
"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",3471,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6001.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6181.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6001.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6001.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6001.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6121.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7801.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6001.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6001.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6001.03,7801.34,
"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",3472,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7353.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7573.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7353.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7353.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7353.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7500.41,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9559.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7353.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7353.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7353.34,9559.35,
"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",3473,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9843.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10138.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9843.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9843.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9843.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10039.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12795.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9843.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9843.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9843.04,12795.95,
"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",3474,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19321.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19901.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19321.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19321.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19321.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19708.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25118.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19321.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19321.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19321.76,25118.29,
"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",3491,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5061.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5213.25,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5061.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5061.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5061.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5162.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6579.83,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5061.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5061.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5061.41,6579.83,
"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",3492,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7546.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7772.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7546.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7546.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7546.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7697.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9809.98,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7546.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7546.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7546.14,9809.98,
"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",3493,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11279.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11618.16,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11279.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11279.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11279.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11505.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14663.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11279.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11279.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11279.76,14663.69,
"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",3494,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20775.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21398.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20775.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20775.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20775.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21190.98,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27008.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20775.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20775.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20775.47,27008.12,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,3511,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4966.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5115.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4966.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4966.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4966.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5065.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6456.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4966.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4966.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4966.56,6456.53,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,3512,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5795.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5969.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5795.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5795.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5795.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5911.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7534.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5795.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5795.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5795.9,7534.67,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,3513,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9036.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9307.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9036.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9036.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9036.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9216.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11747.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9036.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9036.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9036.17,11747.03,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,3514,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17176.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17692.03,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17176.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17176.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17176.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17520.26,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22329.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17176.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17176.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17176.72,22329.74,
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,3611,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14107.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14531.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14107.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14107.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14107.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14390.03,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18340.23,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14107.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14107.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14107.87,18340.23,
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,3612,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17413.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17935.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17413.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17413.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17413.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17761.3,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22636.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17413.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17413.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17413.04,22636.95,
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,3613,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28656.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29516.25,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28656.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28656.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28656.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29229.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,37253.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28656.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28656.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,28656.56,37253.52,
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,3614,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55238.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56895.85,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55238.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55238.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55238.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56343.47,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,71810.3,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55238.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55238.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,55238.69,71810.3,
MASTECTOMY PROCEDURES,3621,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11693.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12044.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11693.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11693.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11693.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11927.26,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15201.41,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11693.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11693.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11693.39,15201.41,
MASTECTOMY PROCEDURES,3622,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16102.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16585.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16102.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16102.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16102.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16424.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20933.23,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16102.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16102.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16102.48,20933.23,
MASTECTOMY PROCEDURES,3623,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20527.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21143.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20527.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20527.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20527.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20937.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26685.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20527.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20527.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20527.22,26685.39,
MASTECTOMY PROCEDURES,3624,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24296.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25025.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24296.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24296.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24296.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24782.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31585.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24296.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24296.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24296.3,31585.19,
BREAST PROCEDURES EXCEPT MASTECTOMY,3631,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11259.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11596.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11259.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11259.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11259.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11484.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14636.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11259.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11259.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11259.04,14636.76,
BREAST PROCEDURES EXCEPT MASTECTOMY,3632,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19410.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19993.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19410.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19410.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19410.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19798.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25233.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19410.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19410.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19410.72,25233.93,
BREAST PROCEDURES EXCEPT MASTECTOMY,3633,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23826.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24541.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23826.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23826.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23826.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24303.01,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30974.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23826.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23826.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23826.49,30974.43,
BREAST PROCEDURES EXCEPT MASTECTOMY,3634,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33606.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34614.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33606.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33606.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33606.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34278.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,43688.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33606.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33606.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,33606.51,43688.46,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",3641,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7345.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7566.29,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7345.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7345.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7345.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7492.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9549.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7345.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7345.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7345.91,9549.69,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",3642,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10497.58,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10395.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13249.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10191.82,13249.37,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",3643,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16902.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17409.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16902.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16902.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16902.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17240.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21973.22,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16902.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16902.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16902.48,21973.22,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",3644,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32282.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33250.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32282.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32282.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32282.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32927.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,41966.99,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32282.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32282.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,32282.3,41966.99,
SKIN ULCERS,3801,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5399.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5561.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5399.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5399.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5399.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5507.28,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7019.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5399.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5399.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5399.3,7019.08,
SKIN ULCERS,3802,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6566.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6763.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6566.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6566.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6566.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6697.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8536.49,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6566.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6566.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6566.53,8536.49,
SKIN ULCERS,3803,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10026.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10327.09,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10026.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10026.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10026.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10226.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13034.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10026.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10026.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10026.3,13034.19,
SKIN ULCERS,3804,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21067.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21699.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21067.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21067.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21067.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21488.73,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27387.6,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21067.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21067.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21067.39,27387.6,
MAJOR SKIN DISORDERS,3811,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4115.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4238.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4115.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4115.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4115.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4197.65,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5349.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4115.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4115.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4115.35,5349.95,
MAJOR SKIN DISORDERS,3812,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7372.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7593.57,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7372.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7372.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7372.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7519.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9584.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7372.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7372.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7372.4,9584.12,
MAJOR SKIN DISORDERS,3813,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13877.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14293.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13877.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13877.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13877.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14154.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18040.6,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13877.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13877.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13877.38,18040.6,
MAJOR SKIN DISORDERS,3814,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33305.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34304.44,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33305.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33305.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33305.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33971.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,43296.87,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33305.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33305.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,33305.29,43296.87,
MALIGNANT BREAST DISORDERS,3821,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6117.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6058.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7721.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5939.27,7721.06,
MALIGNANT BREAST DISORDERS,3822,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7618.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7846.73,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7618.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7618.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7618.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7770.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9903.64,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7618.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7618.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7618.18,9903.64,
MALIGNANT BREAST DISORDERS,3823,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10636.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10956.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10636.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10636.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10636.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10849.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13828.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10636.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10636.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10636.96,13828.04,
MALIGNANT BREAST DISORDERS,3824,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17891.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18428.47,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17891.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17891.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17891.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18249.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23259.23,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17891.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17891.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17891.71,23259.23,
CELLULITIS AND OTHER SKIN INFECTIONS,3831,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4182,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4307.46,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4182,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4182,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4182,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4265.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5436.6,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4182,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4182,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4182,5436.6,
CELLULITIS AND OTHER SKIN INFECTIONS,3832,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5544.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5711.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5544.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5544.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5544.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5655.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7208.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5544.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5544.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5544.87,7208.33,
CELLULITIS AND OTHER SKIN INFECTIONS,3833,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8376.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8628.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8376.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8376.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8376.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8544.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10889.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8376.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8376.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8376.84,10889.89,
CELLULITIS AND OTHER SKIN INFECTIONS,3834,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16848.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17354.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16848.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16848.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16848.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17185.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21903.5,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16848.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16848.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16848.85,21903.5,
"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",3841,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5498.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5663.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5498.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5498.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5498.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5608.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7147.77,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5498.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5498.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5498.28,7147.77,
"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",3842,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6843.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6777.27,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8637.7,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6644.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6644.39,8637.7,
"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",3843,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9728.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10020.18,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9728.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9728.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9728.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9922.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12646.83,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9728.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9728.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9728.33,12646.83,
"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",3844,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18948.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18764.42,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23915.44,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18396.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18396.49,23915.44,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",3851,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4392.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4524.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4392.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4392.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4392.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4480.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5710.87,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4392.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4392.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4392.98,5710.87,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",3852,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5579.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5746.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5579.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5579.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5579.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5690.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7252.84,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5579.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5579.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5579.11,7252.84,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",3853,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8633.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8892.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8633.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8633.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8633.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8806.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11223.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8633.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8633.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8633.76,11223.89,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",3854,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18301.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18850.73,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18301.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18301.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18301.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18667.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23792.18,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18301.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18301.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18301.68,23792.18,
ADRENAL PROCEDURES,4011,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11719.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12070.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11719.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11719.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11719.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11953.49,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15234.84,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11719.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11719.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11719.11,15234.84,
ADRENAL PROCEDURES,4012,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22860.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23546.03,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22860.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22860.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22860.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23317.42,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29718.28,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22860.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22860.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22860.22,29718.28,
ADRENAL PROCEDURES,4013,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30880,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31806.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30880,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30880,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30880,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31497.6,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,40144,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30880,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30880,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,30880,40144,
ADRENAL PROCEDURES,4014,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38251.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39399.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38251.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38251.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38251.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39017.03,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49727.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38251.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38251.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,38251.99,49727.59,
PROCEDURES FOR OBESITY,4031,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10120.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10424.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10120.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10120.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10120.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10323.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13156.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10120.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10120.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10120.71,13156.92,
PROCEDURES FOR OBESITY,4032,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11703.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12055.03,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11703.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11703.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11703.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11937.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15215.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11703.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11703.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11703.91,15215.08,
PROCEDURES FOR OBESITY,4033,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18771.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19334.84,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18771.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18771.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18771.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19147.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24403.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18771.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18771.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18771.69,24403.2,
PROCEDURES FOR OBESITY,4034,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41170.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42405.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41170.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41170.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41170.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41994.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,53521.86,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41170.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41170.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,41170.66,53521.86,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",4041,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8472.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8726.88,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8472.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8472.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8472.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8642.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11014.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8472.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8472.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8472.7,11014.51,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",4042,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12591.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12969.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12591.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12591.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12591.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12843.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16369.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12591.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12591.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12591.65,16369.14,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",4043,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23332.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24032.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23332.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23332.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23332.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23799.33,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30332.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23332.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23332.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23332.68,30332.48,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",4044,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44194.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45520.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44194.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44194.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44194.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45078.7,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,57453.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44194.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44194.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,44194.8,57453.24,
"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",4051,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12571.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12948.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12571.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12571.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12571.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12822.51,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16342.41,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12571.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12571.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12571.09,16342.41,
"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",4052,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14915.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15362.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14915.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14915.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14915.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15213.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19389.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14915.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14915.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14915.25,19389.82,
"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",4053,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22447.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23120.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22447.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22447.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22447.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22896.04,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29181.23,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22447.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22447.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22447.1,29181.23,
"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",4054,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49476.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50960.88,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49476.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49476.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49476.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50466.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,64319.55,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49476.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49476.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,49476.58,64319.55,
DIABETES,4201,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4202.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4328.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4202.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4202.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4202.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4286.62,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5463.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4202.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4202.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4202.57,5463.34,
DIABETES,4202,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5067.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5219.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5067.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5067.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5067.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5169.07,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6588.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5067.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5067.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5067.71,6588.03,
DIABETES,4203,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7736.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7968.12,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7736.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7736.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7736.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7890.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10056.86,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7736.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7736.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7736.04,10056.86,
DIABETES,4204,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16518.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17014.3,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16518.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16518.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16518.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16849.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21474.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16518.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16518.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16518.74,21474.36,
"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",4211,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4694.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4649.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5925.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4558.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4558.2,5925.66,
"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",4212,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5917.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6094.63,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5917.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5917.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5917.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6035.46,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7692.25,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5917.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5917.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5917.12,7692.25,
"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",4213,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9541.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9827.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9541.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9541.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9541.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9732.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12404.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9541.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9541.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9541.66,12404.16,
"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",4214,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21367.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22008.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21367.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21367.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21367.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21794.75,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27777.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21367.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21367.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21367.4,27777.62,
HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,4221,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3433.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3536.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3433.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3433.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3433.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3502.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4463.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3433.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3433.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3433.68,4463.79,
HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,4222,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4587.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4724.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4587.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4587.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4587.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4678.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5963.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4587.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4587.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4587.2,5963.36,
HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,4223,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6985.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7194.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6985.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6985.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6985.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7124.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9080.77,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6985.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6985.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6985.21,9080.77,
HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,4224,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14023.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14444.62,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14023.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14023.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14023.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14304.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18231.07,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14023.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14023.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14023.9,18231.07,
INBORN ERRORS OF METABOLISM,4231,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5446.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5609.93,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5446.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5446.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5446.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5555.47,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7080.5,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5446.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5446.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5446.54,7080.5,
INBORN ERRORS OF METABOLISM,4232,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7925.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8162.9,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7925.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7925.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7925.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8083.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10302.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7925.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7925.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7925.14,10302.68,
INBORN ERRORS OF METABOLISM,4233,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11994.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12354.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11994.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11994.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11994.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12234.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15592.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11994.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11994.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11994.2,15592.46,
INBORN ERRORS OF METABOLISM,4234,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28116.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28960.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28116.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28116.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28116.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28679.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,36551.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28116.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28116.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,28116.86,36551.92,
OTHER ENDOCRINE DISORDERS,4241,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4972.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5121.67,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4972.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4972.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4972.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5071.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6464.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4972.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4972.49,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4972.49,6464.24,
OTHER ENDOCRINE DISORDERS,4242,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6640.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6840.07,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6640.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6640.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6640.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6773.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8633.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6640.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6640.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6640.84,8633.1,
OTHER ENDOCRINE DISORDERS,4243,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9871.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10167.83,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9871.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9871.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9871.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10069.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12833.18,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9871.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9871.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9871.68,12833.18,
OTHER ENDOCRINE DISORDERS,4244,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18898.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19465.18,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18898.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18898.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18898.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19276.19,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24567.7,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18898.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18898.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18898.23,24567.7,
OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,4251,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4024.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4145.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4024.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4024.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4024.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4105.02,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5231.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4024.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4024.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4024.53,5231.89,
OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,4252,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5108.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5261.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5108.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5108.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5108.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5210.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6640.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5108.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5108.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5108.21,6640.67,
OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,4253,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7196.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7412.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7196.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7196.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7196.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7340.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9355.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7196.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7196.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7196.51,9355.46,
OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,4254,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15201.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15657.86,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15201.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15201.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15201.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15505.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19762.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15201.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15201.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15201.81,19762.35,
NON-HYPOVOLEMIC SODIUM DISORDERS,4261,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4184.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4309.99,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4184.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4184.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4184.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4268.15,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5439.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4184.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4184.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4184.46,5439.79,
NON-HYPOVOLEMIC SODIUM DISORDERS,4262,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5551.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5718.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5551.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5551.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5551.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5662.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7217.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5551.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5551.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5551.55,7217.01,
NON-HYPOVOLEMIC SODIUM DISORDERS,4263,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8434.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8687.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8434.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8434.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8434.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8602.8,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10964.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8434.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8434.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8434.11,10964.35,
NON-HYPOVOLEMIC SODIUM DISORDERS,4264,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16728.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17230.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16728.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16728.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16728.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17062.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21746.84,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16728.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16728.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16728.34,21746.84,
THYROID DISORDERS,4271,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4595.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4733,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4595.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4595.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4595.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4687.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5973.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4595.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4595.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4595.14,5973.69,
THYROID DISORDERS,4272,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6295.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6484.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6295.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6295.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6295.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6421.73,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8184.56,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6295.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6295.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6295.82,8184.56,
THYROID DISORDERS,4273,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10096.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10399.84,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10096.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10096.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10096.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10298.87,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13126.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10096.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10096.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10096.93,13126.01,
THYROID DISORDERS,4274,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18765.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19328.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18765.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18765.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18765.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19140.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24394.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18765.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18765.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18765.09,24394.61,
MAJOR BLADDER PROCEDURES,4411,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13860.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14276.05,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13860.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13860.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13860.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14137.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18018.32,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13860.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13860.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13860.25,18018.32,
MAJOR BLADDER PROCEDURES,4412,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20491.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21106.03,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20491.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20491.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20491.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20901.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26638.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20491.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20491.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20491.29,26638.68,
MAJOR BLADDER PROCEDURES,4413,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26280.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27068.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26280.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26280.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26280.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26806.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,34164.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26280.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26280.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26280.53,34164.68,
MAJOR BLADDER PROCEDURES,4414,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54622.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56261.63,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54622.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54622.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54622.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55715.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,71009.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54622.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54622.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,54622.94,71009.82,
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,4421,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12388.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12760.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12388.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12388.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12388.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12636.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16105.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12388.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12388.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12388.76,16105.39,
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,4422,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14183.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14609.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14183.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14183.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14183.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14467.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18439.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14183.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14183.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14183.98,18439.17,
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,4423,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21906.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22563.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21906.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21906.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21906.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22344.67,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28478.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21906.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21906.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21906.54,28478.51,
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,4424,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38372.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39523.88,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38372.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38372.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38372.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39140.15,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49884.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38372.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38372.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,38372.7,49884.51,
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,4431,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10959.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11288.24,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10959.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10959.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10959.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11178.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14247.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10959.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10959.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10959.45,14247.29,
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,4432,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12780.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13163.93,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12780.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12780.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12780.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13036.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16614.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12780.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12780.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12780.51,16614.67,
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,4433,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19963.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20562.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19963.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19963.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19963.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20363.18,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25953.07,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19963.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19963.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19963.9,25953.07,
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,4434,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37430.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38553.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37430.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37430.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37430.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38179.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,48659.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37430.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37430.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37430.63,48659.82,
RENAL DIALYSIS ACCESS DEVICE PROCEDURES AND VESSEL REPAIR,4441,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9492.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9777.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9492.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9492.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9492.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9682.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12340.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9492.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9492.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9492.67,12340.48,
RENAL DIALYSIS ACCESS DEVICE PROCEDURES AND VESSEL REPAIR,4442,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14497.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14932.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14497.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14497.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14497.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14787.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18846.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14497.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14497.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14497.43,18846.66,
RENAL DIALYSIS ACCESS DEVICE PROCEDURES AND VESSEL REPAIR,4443,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23121.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23814.96,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23121.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23121.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23121.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23583.75,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30057.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23121.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23121.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23121.32,30057.72,
RENAL DIALYSIS ACCESS DEVICE PROCEDURES AND VESSEL REPAIR,4444,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41433.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42676.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41433.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41433.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41433.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42262.07,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,53863.42,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41433.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41433.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,41433.4,53863.42,
OTHER BLADDER PROCEDURES,4451,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8909,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9176.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8909,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8909,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8909,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9087.18,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11581.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8909,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8909,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8909,11581.71,
OTHER BLADDER PROCEDURES,4452,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11562.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11909.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11562.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11562.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11562.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11794.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15031.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11562.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11562.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11562.88,15031.74,
OTHER BLADDER PROCEDURES,4453,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16603.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17101.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16603.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16603.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16603.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16935.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21584.73,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16603.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16603.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16603.64,21584.73,
OTHER BLADDER PROCEDURES,4454,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33712.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34723.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33712.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33712.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33712.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34386.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,43826.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33712.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33712.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,33712.32,43826.01,
URETHRAL AND TRANSURETHRAL PROCEDURES,4461,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7498.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7723.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7498.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7498.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7498.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7648.33,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9747.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7498.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7498.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7498.37,9747.88,
URETHRAL AND TRANSURETHRAL PROCEDURES,4462,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9263.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9541.18,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9263.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9263.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9263.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9448.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12042.27,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9263.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9263.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9263.28,12042.27,
URETHRAL AND TRANSURETHRAL PROCEDURES,4463,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15584.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16052.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15584.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15584.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15584.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15896.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20260.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15584.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15584.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15584.68,20260.08,
URETHRAL AND TRANSURETHRAL PROCEDURES,4464,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28146.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28990.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28146.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28146.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28146.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28709.04,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,36589.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28146.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28146.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,28146.11,36589.95,
"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",4471,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12879.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13265.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12879.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12879.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12879.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13137.01,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16743.25,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12879.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12879.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12879.42,16743.25,
"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",4472,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13878.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14294.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13878.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13878.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13878.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14155.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18041.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13878.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13878.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13878.16,18041.61,
"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",4473,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20087.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20689.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20087.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20087.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20087.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20489.07,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26113.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20087.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20087.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20087.32,26113.52,
"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",4474,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45314.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46673.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45314.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45314.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45314.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46220.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,58908.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45314.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45314.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,45314.03,58908.24,
KIDNEY AND URINARY TRACT MALIGNANCY,4611,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7028.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7239.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7028.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7028.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7028.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7168.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9136.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7028.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7028.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7028.22,9136.68,
KIDNEY AND URINARY TRACT MALIGNANCY,4612,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7709.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7940.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7709.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7709.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7709.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7863.32,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10021.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7709.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7709.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7709.14,10021.88,
KIDNEY AND URINARY TRACT MALIGNANCY,4613,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11882.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12239.13,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11882.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11882.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11882.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12120.3,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15447.44,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11882.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11882.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11882.65,15447.44,
KIDNEY AND URINARY TRACT MALIGNANCY,4614,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18541.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19097.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18541.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18541.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18541.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18912,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24103.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18541.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18541.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18541.17,24103.52,
NEPHRITIS AND NEPHROSIS,4621,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4487.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4622.09,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4487.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4487.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4487.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4577.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5833.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4487.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4487.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4487.47,5833.71,
NEPHRITIS AND NEPHROSIS,4622,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6490.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6685.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6490.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6490.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6490.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6620.49,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8437.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6490.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6490.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6490.68,8437.88,
NEPHRITIS AND NEPHROSIS,4623,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13199.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13595.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13199.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13199.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13199.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13463.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17159.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13199.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13199.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13199.91,17159.88,
NEPHRITIS AND NEPHROSIS,4624,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30751.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31673.86,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30751.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30751.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30751.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31366.35,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,39976.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30751.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30751.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,30751.32,39976.72,
KIDNEY AND URINARY TRACT INFECTIONS,4631,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4541.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4497.19,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5731.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4409.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4409.01,5731.71,
KIDNEY AND URINARY TRACT INFECTIONS,4632,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5367.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5528.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5367.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5367.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5367.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5474.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6977.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5367.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5367.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5367.03,6977.14,
KIDNEY AND URINARY TRACT INFECTIONS,4633,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7620.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7546.54,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9618.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7398.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7398.57,9618.14,
KIDNEY AND URINARY TRACT INFECTIONS,4634,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13078.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13471.16,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13078.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13078.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13078.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13340.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17002.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13078.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13078.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13078.79,17002.43,
URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,4651,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4894.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5041.71,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4894.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4894.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4894.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4992.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6363.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4894.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4894.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4894.87,6363.33,
URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,4652,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5943.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6121.98,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5943.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5943.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5943.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6062.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7726.77,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5943.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5943.67,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5943.67,7726.77,
URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,4653,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9712.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10003.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9712.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9712.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9712.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9906.29,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12625.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9712.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9712.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9712.05,12625.67,
URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,4654,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17196.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17712.17,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17196.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17196.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17196.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17540.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22355.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17196.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17196.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17196.28,22355.16,
"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",4661,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4377.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4508.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4377.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4377.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4377.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4464.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5690.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4377.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4377.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4377.28,5690.46,
"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",4662,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5886.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6062.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5886.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5886.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5886.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6003.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7652.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5886.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5886.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5886.19,7652.05,
"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",4663,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9004.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9274.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9004.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9004.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9004.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9184.51,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11705.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9004.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9004.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9004.42,11705.75,
"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",4664,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15362.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15823.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15362.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15362.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15362.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15670.03,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19971.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15362.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15362.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15362.78,19971.61,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",4681,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4842.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4987.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4842.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4842.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4842.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4939.01,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6294.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4842.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4842.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4842.17,6294.82,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",4682,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6238.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6425.54,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6238.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6238.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6238.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6363.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8109.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6238.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6238.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6238.39,8109.91,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",4683,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9383.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9665.2,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9383.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9383.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9383.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9571.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12198.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9383.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9383.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9383.69,12198.8,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",4684,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16351.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16841.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16351.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16351.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16351.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16678.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21256.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16351.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16351.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16351.22,21256.58,
ACUTE KIDNEY INJURY,4691,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4179.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4305.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4179.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4179.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4179.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4263.43,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5433.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4179.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4179.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4179.84,5433.79,
ACUTE KIDNEY INJURY,4692,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5657.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5826.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5657.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5657.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5657.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5770.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7354.22,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5657.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5657.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5657.09,7354.22,
ACUTE KIDNEY INJURY,4693,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9134.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9408.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9134.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9134.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9134.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9317.43,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11875.15,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9134.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9134.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9134.73,11875.15,
ACUTE KIDNEY INJURY,4694,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17776.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18310.17,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17776.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17776.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17776.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18132.41,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23109.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17776.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17776.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17776.87,23109.93,
CHRONIC KIDNEY DISEASE,4701,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4404.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4536.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4404.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4404.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4404.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4492.29,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5725.47,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4404.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4404.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4404.2,5725.47,
CHRONIC KIDNEY DISEASE,4702,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6118.09,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6058.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7721.86,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5939.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5939.89,7721.86,
CHRONIC KIDNEY DISEASE,4703,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8795.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9058.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8795.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8795.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8795.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8970.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11433.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8795.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8795.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8795.09,11433.62,
CHRONIC KIDNEY DISEASE,4704,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16587.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17084.62,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16587.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16587.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16587.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16918.75,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21563.12,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16587.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16587.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16587.01,21563.12,
MAJOR MALE PELVIC PROCEDURES,4801,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11227.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11564.65,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11227.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11227.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11227.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11452.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14596.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11227.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11227.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11227.81,14596.16,
MAJOR MALE PELVIC PROCEDURES,4802,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12592.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12969.85,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12592.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12592.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12592.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12843.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16369.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12592.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12592.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12592.09,16369.72,
MAJOR MALE PELVIC PROCEDURES,4803,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19982.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20581.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19982.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19982.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19982.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20381.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25976.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19982.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19982.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19982.27,25976.95,
MAJOR MALE PELVIC PROCEDURES,4804,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44373.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45704.34,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44373.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44373.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44373.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45260.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,57685.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44373.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44373.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,44373.15,57685.09,
TRANSURETHRAL PROSTATECTOMY,4821,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6968.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7177.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6968.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6968.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6968.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7108.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9059.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6968.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6968.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6968.72,9059.33,
TRANSURETHRAL PROSTATECTOMY,4822,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8123.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8367.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8123.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8123.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8123.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8286.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10561.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8123.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8123.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8123.88,10561.04,
TRANSURETHRAL PROSTATECTOMY,4823,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16500.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16995.84,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16500.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16500.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16500.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16830.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21451.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16500.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16500.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16500.81,21451.05,
TRANSURETHRAL PROSTATECTOMY,4824,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30977.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31906.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30977.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30977.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30977.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31596.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,40270.47,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30977.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30977.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,30977.28,40270.47,
"PENIS, TESTES AND SCROTAL PROCEDURES",4831,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9851.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10147.44,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9851.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9851.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9851.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10048.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12807.44,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9851.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9851.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9851.88,12807.44,
"PENIS, TESTES AND SCROTAL PROCEDURES",4832,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12976.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13365.47,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12976.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12976.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12976.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13235.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16869.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12976.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12976.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12976.18,16869.04,
"PENIS, TESTES AND SCROTAL PROCEDURES",4833,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19050.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19621.96,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19050.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19050.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19050.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19431.46,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24765.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19050.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19050.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19050.45,24765.59,
"PENIS, TESTES AND SCROTAL PROCEDURES",4834,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34311.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35341.18,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34311.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34311.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34311.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34998.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,44605.38,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34311.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34311.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,34311.83,44605.38,
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,4841,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10873.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11199.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10873.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10873.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10873.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11090.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14135.15,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10873.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10873.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10873.19,14135.15,
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,4842,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12254.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12622.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12254.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12254.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12254.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12499.59,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15930.85,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12254.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12254.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12254.5,15930.85,
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,4843,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14871.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15317.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14871.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14871.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14871.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15168.6,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19332.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14871.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14871.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14871.18,19332.53,
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,4844,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37562.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38689.88,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37562.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37562.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37562.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38314.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,48831.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37562.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37562.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37562.99,48831.88,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",5001,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5916.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6094.44,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5916.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5916.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5916.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6035.27,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7692.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5916.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5916.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5916.94,7692.02,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",5002,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7318.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7538.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7318.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7318.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7318.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7465.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9514.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7318.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7318.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7318.83,9514.48,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",5003,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10534.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10850.57,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10534.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10534.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10534.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10745.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13694.9,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10534.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10534.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10534.54,13694.9,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",5004,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18575.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19133.13,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18575.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18575.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18575.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18947.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24148.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18575.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18575.85,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18575.85,24148.61,
MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,5011,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4586.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4724.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4586.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4586.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4586.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4678.41,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5962.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4586.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4586.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4586.68,5962.68,
MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,5012,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5959.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6138.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5959.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5959.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5959.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6078.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7747.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5959.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5959.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5959.6,7747.48,
MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,5013,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8730.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8992.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8730.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8730.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8730.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8904.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11349.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8730.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8730.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8730.28,11349.36,
MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,5014,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17198.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17714.85,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17198.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17198.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17198.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17542.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22358.55,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17198.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17198.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17198.88,22358.55,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",5101,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11998.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12358.3,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11998.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11998.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11998.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12238.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15597.85,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11998.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11998.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11998.35,15597.85,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",5102,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15221.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15677.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15221.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15221.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15221.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15525.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19787.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15221.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15221.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15221.3,19787.69,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",5103,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23032.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23723.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23032.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23032.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23032.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23493.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29942.87,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23032.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23032.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23032.98,29942.87,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",5104,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47418.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48841.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47418.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47418.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47418.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48367.18,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,61644.44,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47418.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47418.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,47418.8,61644.44,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,5111,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12341.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12711.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12341.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12341.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12341.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12587.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16043.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12341.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12341.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12341.17,16043.51,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,5112,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14764.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15207.3,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14764.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14764.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14764.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15059.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19193.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14764.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14764.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14764.37,19193.68,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,5113,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23306.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24005.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23306.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23306.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23306.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23772.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30298.23,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23306.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23306.33,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23306.33,30298.23,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,5114,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42778.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44061.57,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42778.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42778.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42778.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43633.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,55611.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42778.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42778.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,42778.22,55611.69,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,5121,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11341.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11681.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11341.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11341.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11341.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11567.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14743.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11341.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11341.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11341.1,14743.43,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,5122,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13158.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13553.38,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13158.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13158.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13158.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13421.8,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17106.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13158.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13158.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13158.63,17106.21,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,5123,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22226.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22893.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22226.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22226.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22226.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22671.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28894.57,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22226.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22226.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22226.59,28894.57,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,5124,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37777.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38911.25,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37777.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37777.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37777.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38533.47,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49111.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37777.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37777.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37777.91,49111.29,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,5131,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8354.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8605.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8354.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8354.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8354.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8521.73,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10861.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8354.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8354.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8354.64,10861.03,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,5132,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9941.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10239.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9941.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9941.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9941.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10140.07,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12923.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9941.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9941.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9941.25,12923.62,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,5133,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17008.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17519.05,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17008.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17008.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17008.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17348.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22111.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17008.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17008.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17008.79,22111.43,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,5134,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31335.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32275.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31335.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31335.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31335.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31962.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,40736.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31335.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31335.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,31335.83,40736.58,
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,5141,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7015.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7225.98,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7015.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7015.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7015.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7155.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9120.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7015.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7015.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7015.52,9120.17,
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,5142,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10793.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11117.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10793.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10793.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10793.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11009.15,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14031.27,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10793.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10793.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10793.28,14031.27,
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,5143,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19486.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20071.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19486.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19486.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19486.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19876.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25332.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19486.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19486.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19486.87,25332.93,
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,5144,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35440.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36503.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35440.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35440.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35440.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36148.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,46072.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35440.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35440.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,35440.18,46072.24,
DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,5171,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6546.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6743.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6546.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6546.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6546.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6677.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8511.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6546.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6546.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6546.99,8511.09,
DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,5172,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8297.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8546.35,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8297.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8297.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8297.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8463.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10786.65,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8297.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8297.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8297.43,10786.65,
DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,5173,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14360.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14791.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14360.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14360.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14360.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14647.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18668.65,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14360.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14360.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14360.5,18668.65,
DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,5174,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34914.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35962.2,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34914.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34914.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34914.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35613.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,45389.18,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34914.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34914.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,34914.75,45389.18,
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,5181,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8064.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8306,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8064.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8064.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8064.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8225.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10483.3,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8064.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8064.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8064.08,10483.3,
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,5182,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10875.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11202.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10875.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10875.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10875.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11093.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14138.78,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10875.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10875.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10875.98,14138.78,
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,5183,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21416.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22059.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21416.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21416.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21416.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21844.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,27841.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21416.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21416.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21416.61,27841.59,
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,5184,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29914.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30811.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29914.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29914.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29914.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30512.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,38888.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29914.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29914.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,29914.08,38888.31,
UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,5191,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8161.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8406.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8161.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8161.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8161.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8325.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10610.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8161.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8161.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8161.84,10610.4,
UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,5192,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10157.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10462.46,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10157.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10157.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10157.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10360.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13205.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10157.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10157.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10157.72,13205.04,
UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,5193,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17594.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18122.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17594.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17594.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17594.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17946.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22872.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17594.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17594.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17594.56,22872.92,
UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,5194,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33786.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34800.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33786.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33786.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33786.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34462.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,43922.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33786.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33786.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,33786.87,43922.93,
FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,5301,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5598.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5766.47,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5598.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5598.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5598.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5710.49,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7278.07,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5598.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5598.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5598.52,7278.07,
FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,5302,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7306.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7525.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7306.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7306.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7306.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7452.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9497.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7306.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7306.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7306.09,9497.92,
FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,5303,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10988.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11317.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10988.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10988.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10988.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11208.07,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14284.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10988.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10988.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10988.31,14284.8,
FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,5304,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20187.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20793.58,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20187.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20187.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20187.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20591.7,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26244.32,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20187.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20187.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20187.94,26244.32,
FEMALE REPRODUCTIVE SYSTEM INFECTIONS,5311,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4517.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4653.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4517.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4517.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4517.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4607.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5872.73,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4517.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4517.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4517.48,5872.73,
FEMALE REPRODUCTIVE SYSTEM INFECTIONS,5312,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6255.58,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6194.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7895.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6073.38,7895.39,
FEMALE REPRODUCTIVE SYSTEM INFECTIONS,5313,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10006.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9909.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12630.13,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9715.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9715.48,12630.13,
FEMALE REPRODUCTIVE SYSTEM INFECTIONS,5314,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17655.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18185.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17655.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17655.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17655.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18008.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22952.3,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17655.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17655.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17655.61,22952.3,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,5321,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4332.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4462.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4332.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4332.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4332.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4419.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5632.22,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4332.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4332.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4332.48,5632.22,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,5322,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5347.58,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5295.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6749.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5191.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5191.82,6749.37,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,5323,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7571.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7798.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7571.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7571.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7571.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7722.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9842.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7571.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7571.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7571.46,9842.89,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,5324,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16502.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16997.15,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16502.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16502.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16502.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16832.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21452.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16502.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16502.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16502.09,21452.71,
CESAREAN SECTION WITH STERILIZATION,5391,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4964.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5113.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4964.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4964.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4964.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5063.96,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6454.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4964.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4964.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4964.66,6454.06,
CESAREAN SECTION WITH STERILIZATION,5392,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5722.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5894.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5722.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5722.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5722.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5836.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7439.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5722.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5722.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5722.34,7439.04,
CESAREAN SECTION WITH STERILIZATION,5393,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8960.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9228.85,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8960.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8960.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8960.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9139.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11648.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8960.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8960.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8960.05,11648.06,
CESAREAN SECTION WITH STERILIZATION,5394,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22548.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23225.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22548.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22548.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22548.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22999.8,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29313.47,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22548.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22548.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22548.82,29313.47,
CESAREAN SECTION WITHOUT STERILIZATION,5401,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4983.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5132.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4983.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4983.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4983.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5082.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6478.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4983.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4983.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4983.18,6478.14,
CESAREAN SECTION WITHOUT STERILIZATION,5402,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6255.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6194.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7895.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6073.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6073.12,7895.05,
CESAREAN SECTION WITHOUT STERILIZATION,5403,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8249.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8496.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8249.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8249.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8249.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8414.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10724.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8249.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8249.26,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8249.26,10724.04,
CESAREAN SECTION WITHOUT STERILIZATION,5404,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16356.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16847.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16356.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16356.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16356.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16683.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21263.73,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16356.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16356.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16356.71,21263.73,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,5411,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4482.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4616.84,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4482.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4482.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4482.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4572.02,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5827.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4482.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4482.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4482.37,5827.08,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,5412,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4705.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4847.15,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4705.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4705.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4705.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4800.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6117.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4705.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4705.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4705.97,6117.76,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,5413,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6323.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6513.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6323.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6323.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6323.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6450.04,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8220.65,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6323.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6323.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6323.57,8220.65,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,5414,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10558.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10455.73,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13325.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10250.71,13325.93,
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,5421,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3297.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3396.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3297.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3297.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3297.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3363.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4287.23,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3297.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3297.87,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3297.87,4287.23,
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,5422,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3972.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4091.29,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3972.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3972.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3972.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4051.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5163.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3972.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3972.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3972.12,5163.76,
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,5423,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6272.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6460.3,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6272.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6272.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6272.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6397.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8153.78,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6272.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6272.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6272.14,8153.78,
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,5424,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18017.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18557.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18017.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18017.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18017.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18377.51,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23422.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18017.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18017.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18017.16,23422.31,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5431,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4702.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4844.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4702.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4702.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4702.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4797.03,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6113.86,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4702.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4702.97,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4702.97,6113.86,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5432,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5760.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5933.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5760.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5760.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5760.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5875.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7488.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5760.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5760.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5760.71,7488.92,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5433,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7990.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8230.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7990.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7990.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7990.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8150.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10388.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7990.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7990.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7990.83,10388.08,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5434,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18377.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18929.12,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18377.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18377.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18377.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18745.35,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23891.13,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18377.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18377.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18377.79,23891.13,
ANTEPARTUM WITH O.R. PROCEDURE,5471,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5510.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5675.85,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5510.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5510.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5510.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5620.74,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7163.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5510.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5510.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5510.53,7163.69,
ANTEPARTUM WITH O.R. PROCEDURE,5472,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7900.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8137.16,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7900.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7900.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7900.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8058.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10270.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7900.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7900.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7900.16,10270.21,
ANTEPARTUM WITH O.R. PROCEDURE,5473,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12687.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13067.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12687.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12687.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12687.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12940.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16493.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12687.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12687.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12687.08,16493.2,
ANTEPARTUM WITH O.R. PROCEDURE,5474,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23696.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24407.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23696.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23696.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23696.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24170.52,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30805.56,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23696.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23696.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23696.59,30805.56,
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,5481,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3400.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3502.17,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3400.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3400.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3400.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3468.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4420.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3400.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3400.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3400.16,4420.21,
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,5482,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7379.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7600.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7379.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7379.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7379.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7526.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9593.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7379.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7379.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7379.34,9593.14,
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,5483,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14421.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14854.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14421.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14421.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14421.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14709.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18747.9,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14421.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14421.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14421.46,18747.9,
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,5484,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45044.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46395.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45044.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45044.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45044.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45945.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,58557.49,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45044.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45044.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,45044.23,58557.49,
VAGINAL DELIVERY,5601,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2911.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2999.09,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2911.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2911.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2911.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2969.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,3785.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2911.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2911.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,2911.74,3785.26,
VAGINAL DELIVERY,5602,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3281.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3380.44,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3281.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3281.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3281.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3347.62,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4266.57,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3281.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3281.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3281.98,4266.57,
VAGINAL DELIVERY,5603,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4593.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4730.86,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4593.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4593.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4593.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4684.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5970.99,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4593.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4593.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4593.07,5970.99,
VAGINAL DELIVERY,5604,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6896.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7103.86,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6896.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6896.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6896.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7034.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8966.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6896.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6896.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6896.95,8966.03,
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,5611,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2563.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2640.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2563.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2563.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2563.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2614.57,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,3332.3,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2563.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2563.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,2563.31,3332.3,
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,5612,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3841.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3956.71,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3841.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3841.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3841.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3918.3,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4993.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3841.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3841.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3841.47,4993.91,
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,5613,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6198.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6384.34,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6198.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6198.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6198.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6322.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8057.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6198.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6198.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6198.39,8057.91,
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,5614,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13092.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13485.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13092.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13092.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13092.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13354.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17020.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13092.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13092.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13092.37,17020.08,
"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5641,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2814.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2898.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2814.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2814.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2814.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2870.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,3658.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2814.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2814.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,2814.25,3658.52,
"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5642,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3733.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3845.84,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3733.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3733.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3733.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3808.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4853.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3733.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3733.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3733.82,4853.97,
"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5643,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5840.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6015.3,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5840.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5840.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5840.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5956.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7592.13,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5840.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5840.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5840.1,7592.13,
"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5644,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13953.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14371.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13953.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13953.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13953.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14232.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18139.13,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13953.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13953.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13953.17,18139.13,
ANTEPARTUM WITHOUT O.R. PROCEDURE,5661,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2631.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2710.84,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2631.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2631.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2631.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2684.52,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,3421.45,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2631.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2631.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,2631.89,3421.45,
ANTEPARTUM WITHOUT O.R. PROCEDURE,5662,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3445.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3548.9,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3445.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3445.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3445.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3514.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4479.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3445.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3445.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3445.54,4479.2,
ANTEPARTUM WITHOUT O.R. PROCEDURE,5663,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5107.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5261.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5107.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5107.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5107.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5210.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6640.28,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5107.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5107.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5107.91,6640.28,
ANTEPARTUM WITHOUT O.R. PROCEDURE,5664,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11132.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11466.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11132.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11132.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11132.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11355.42,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14472.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11132.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11132.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11132.76,14472.59,
"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",5801,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2293.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2271.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,2894.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2226.52,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,2226.52,2894.48,
"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",5802,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3229.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3326.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3229.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3229.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3229.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3293.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4197.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3229.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3229.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3229.19,4197.95,
"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",5803,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5474.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5638.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5474.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5474.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5474.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5584.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7117.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5474.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5474.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5474.64,7117.03,
"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",5804,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9730.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10022.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9730.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9730.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9730.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9925.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12649.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9730.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9730.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9730.44,12649.58,
"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",5811,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,940.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,969.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,940.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,940.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,940.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,959.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,1223.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,940.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,940.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,940.81,1223.06,
"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",5812,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1432.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1475.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1432.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1432.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1432.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1461.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,1862.56,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1432.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1432.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,1432.74,1862.56,
"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",5813,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2471.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2545.62,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2471.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2471.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2471.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2520.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,3212.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2471.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2471.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,2471.47,3212.92,
"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",5814,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4562.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4699.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4562.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4562.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4562.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4654.03,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5931.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4562.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4562.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4562.78,5931.61,
NEONATE WITH ECMO,5831,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,156232.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,160919.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,156232.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,156232.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,156232.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,159356.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,203101.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,156232.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,156232.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,156232.29,203101.97,
NEONATE WITH ECMO,5832,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,197731.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,203663.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,197731.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,197731.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,197731.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,201686.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,257051.49,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,197731.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,197731.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,197731.91,257051.49,
NEONATE WITH ECMO,5833,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,291418.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,300161.35,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,291418.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,291418.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,291418.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,297247.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,378844.42,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,291418.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,291418.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,291418.78,378844.42,
NEONATE WITH ECMO,5834,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,362755.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,373637.95,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,362755.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,362755.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,362755.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,370010.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,471581.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,362755.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,362755.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,362755.3,471581.88,
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,5881,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,87095.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,86250.35,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,109926.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,84559.16,109926.91,
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,5882,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,87095.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,86250.35,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,109926.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84559.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,84559.16,109926.91,
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,5883,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,175155.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,180409.67,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,175155.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,175155.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,175155.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,178658.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,227701.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,175155.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,175155.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,175155.02,227701.53,
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,5884,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,287345.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,295966.21,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,287345.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,287345.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,287345.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,293092.75,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,373549.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,287345.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,287345.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,287345.83,373549.58,
"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",5891,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,121168.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,124803.29,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,121168.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,121168.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,121168.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,123591.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,157518.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,121168.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,121168.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,121168.24,157518.71,
"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",5892,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116881.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,120388.05,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116881.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116881.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116881.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,119219.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,151946.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116881.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116881.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,116881.6,151946.09,
"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",5893,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,106256.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,109443.9,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,106256.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,106256.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,106256.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108381.34,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,138133.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,106256.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,106256.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,106256.21,138133.08,
"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",5894,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20132.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20736.57,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20132.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20132.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20132.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20535.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26172.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20132.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20132.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20132.59,26172.37,
NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,5911,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76048.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,78330.16,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76048.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76048.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76048.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77569.67,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,98863.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76048.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76048.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,76048.7,98863.31,
NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,5912,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105476.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108641,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105476.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105476.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105476.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,107586.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,137119.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105476.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105476.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,105476.7,137119.71,
NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,5913,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116593.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,120091.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116593.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116593.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116593.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,118925.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,151572.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116593.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116593.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,116593.96,151572.14,
NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,5914,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,196184.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,202069.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,196184.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,196184.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,196184.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,200108.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,255039.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,196184.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,196184.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,196184.43,255039.76,
NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,5931,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25512.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26278.2,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25512.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25512.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25512.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26023.07,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,33166.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25512.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25512.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,25512.82,33166.66,
NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,5932,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,97708.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,100639.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,97708.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,97708.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,97708.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99662.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,127020.66,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,97708.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,97708.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,97708.2,127020.66,
NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,5933,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,112794.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,116177.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,112794.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,112794.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,112794.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,115050,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,146632.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,112794.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,112794.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,112794.11,146632.35,
NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,5934,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,162874.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,167760.61,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,162874.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,162874.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,162874.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,166131.87,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,211736.7,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,162874.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,162874.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,162874.38,211736.7,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6021,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26828.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27633.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26828.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26828.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26828.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27365.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,34877.64,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26828.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26828.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26828.95,34877.64,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6022,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77015.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,79325.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77015.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77015.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77015.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,78555.62,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,100119.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77015.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,77015.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,77015.32,100119.91,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6023,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,85930.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,88508.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,85930.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,85930.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,85930.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,87649.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,111710.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,85930.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,85930.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,85930.77,111710.01,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6024,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,126040.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,129821.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,126040.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,126040.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,126040.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,128560.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,163852.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,126040.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,126040.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,126040.06,163852.08,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6031,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25286.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26044.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25286.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25286.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25286.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25791.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,32872.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25286.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25286.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,25286.22,32872.09,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6032,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47973.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49412.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47973.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47973.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47973.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48933.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,62365.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47973.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47973.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,47973.66,62365.75,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6033,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73559.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,75766.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73559.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73559.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73559.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,75030.42,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,95627.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73559.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73559.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,73559.24,95627.01,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6034,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,152580.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,157157.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,152580.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,152580.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,152580.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,155631.8,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,198354.25,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,152580.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,152580.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,152580.19,198354.25,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6071,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30841.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31766.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30841.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30841.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30841.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31458.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,40094,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30841.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30841.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,30841.54,40094,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6072,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54089.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55711.71,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54089.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54089.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54089.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55170.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,70315.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54089.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54089.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,54089.04,70315.75,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6073,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67405.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69427.3,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67405.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67405.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67405.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,68753.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,87626.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67405.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67405.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,67405.15,87626.69,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6074,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,108227.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,107176.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,136598.07,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,105075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,105075.44,136598.07,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6081,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14410.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14842.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14410.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14410.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14410.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14698.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18733.57,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14410.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14410.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14410.44,18733.57,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6082,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39167.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40342.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39167.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39167.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39167.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39951.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,50918.11,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39167.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39167.78,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39167.78,50918.11,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6083,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57322.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59042.61,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57322.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57322.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57322.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,58469.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,74519.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57322.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57322.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,57322.92,74519.8,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6084,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,93079.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,95871.55,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,93079.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,93079.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,93079.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,94940.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,121002.93,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,93079.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,93079.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,93079.18,121002.93,
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,6091,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,53663.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,53142.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,67730.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,52100.68,67730.88,
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,6092,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,53663.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,53142.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,67730.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52100.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,52100.68,67730.88,
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,6093,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76855.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,79160.98,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76855.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76855.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76855.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,78392.42,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,99911.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76855.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,76855.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,76855.32,99911.91,
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,6094,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,192182.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,197947.88,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,192182.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,192182.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,192182.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,196026.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,249837.13,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,192182.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,192182.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,192182.41,249837.13,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,6111,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17593.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18121.49,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17593.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17593.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17593.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17945.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22871.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17593.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17593.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17593.68,22871.79,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,6112,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28535.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29391.83,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28535.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28535.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28535.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29106.47,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,37096.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28535.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28535.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,28535.76,37096.48,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,6113,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48826.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50291.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48826.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48826.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48826.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49802.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,63474.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48826.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,48826.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,48826.46,63474.4,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,6114,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84687.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,87228.13,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84687.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84687.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84687.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,86381.26,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,110093.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84687.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84687.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,84687.51,110093.76,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6121,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21959.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22618.7,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21959.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21959.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21959.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22399.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28547.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21959.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21959.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21959.9,28547.88,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6122,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33467.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34471.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33467.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33467.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33467.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34137.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,43508.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33467.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33467.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,33467.71,43508.02,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6123,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45949.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47328.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45949.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45949.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45949.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46868.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,59734.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45949.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45949.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,45949.79,59734.72,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6124,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69515.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71600.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69515.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69515.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69515.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70905.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,90370.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69515.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69515.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,69515.45,90370.09,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6131,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18931.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19499.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18931.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18931.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18931.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19310.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24611.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18931.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18931.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18931.8,24611.35,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6132,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31659.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32609.63,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31659.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31659.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31659.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32293.03,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,41157.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31659.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31659.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,31659.84,41157.79,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6133,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43664.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44974.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43664.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43664.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43664.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44537.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,56763.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43664.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43664.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,43664.3,56763.58,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6134,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69861.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71957.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69861.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69861.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69861.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71259.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,90820.47,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69861.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69861.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,69861.9,90820.47,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,6141,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11822.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12177.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11822.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11822.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11822.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12059.17,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15369.54,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11822.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11822.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11822.72,15369.54,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,6142,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23013.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23704.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23013.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23013.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23013.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23474.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29918.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23013.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23013.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23013.95,29918.14,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,6143,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39295.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40474.49,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39295.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39295.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39295.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40081.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,51084.3,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39295.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39295.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39295.62,51084.3,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,6144,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54474,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56108.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54474,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54474,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54474,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55563.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,70816.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54474,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,54474,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,54474,70816.2,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,6211,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7069.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7281.44,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7069.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7069.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7069.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7210.74,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9190.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7069.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7069.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7069.36,9190.16,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,6212,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20346,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20956.38,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20346,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20346,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20346,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20752.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26449.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20346,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20346,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20346,26449.8,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,6213,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37811.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38945.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37811.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37811.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37811.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38567.34,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49154.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37811.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37811.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,37811.12,49154.46,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,6214,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65692.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67663.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65692.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65692.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65692.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67006.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,85399.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65692.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65692.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,65692.24,85399.91,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6221,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14207.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14633.98,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14207.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14207.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14207.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14491.9,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18470.07,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14207.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14207.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14207.75,18470.07,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6222,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20707.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21329.05,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20707.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20707.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20707.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21121.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26920.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20707.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20707.81,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20707.81,26920.16,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6223,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28349.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29200.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28349.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28349.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28349.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28916.57,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,36854.45,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28349.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28349.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,28349.57,36854.45,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6224,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50724,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52245.72,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50724,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50724,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50724,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51738.48,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,65941.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50724,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50724,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,50724,65941.2,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6231,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10841.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11166.86,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10841.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10841.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10841.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11058.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14094.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10841.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10841.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10841.61,14094.1,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6232,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19038.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19609.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19038.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19038.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19038.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19419.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24749.98,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19038.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19038.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19038.44,24749.98,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6233,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36020.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37101.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36020.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36020.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36020.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36740.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,46826.58,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36020.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36020.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,36020.44,46826.58,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6234,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59106.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60879.71,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59106.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59106.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59106.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,60288.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,76838.47,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59106.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,59106.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,59106.51,76838.47,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6251,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12301.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12670.09,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12301.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12301.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12301.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12547.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15991.38,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12301.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12301.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12301.06,15991.38,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6252,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18994.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19563.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18994.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18994.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18994.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19374,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24692.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18994.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18994.12,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18994.12,24692.35,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6253,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31796.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32749.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31796.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31796.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31796.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32431.96,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,41334.85,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31796.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31796.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,31796.04,41334.85,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6254,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71730.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73882.65,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71730.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71730.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71730.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73165.35,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,93249.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71730.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71730.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,71730.73,93249.95,
"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6261,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1703.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1754.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1703.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1703.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1703.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1737.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,2214.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1703.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1703.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,1703.1,2214.03,
"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6262,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2447.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2521.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2447.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2447.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2447.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2496.6,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,3181.94,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2447.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2447.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,2447.65,3181.94,
"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6263,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6428.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6621.39,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6428.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6428.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6428.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6557.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8357.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6428.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6428.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6428.53,8357.09,
"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6264,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23467.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24171.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23467.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23467.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23467.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23936.52,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30507.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23467.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23467.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23467.18,30507.33,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,6301,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28340.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29190.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28340.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28340.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28340.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28907.46,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,36842.84,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28340.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28340.65,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,28340.65,36842.84,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,6302,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45860.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47236.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45860.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45860.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45860.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46777.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,59618.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45860.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,45860.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,45860.71,59618.92,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,6303,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,82393.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84865.16,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,82393.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,82393.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,82393.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,84041.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,107111.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,82393.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,82393.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,82393.36,107111.37,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,6304,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,165021.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,169972.2,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,165021.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,165021.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,165021.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,168321.98,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,214528.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,165021.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,165021.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,165021.55,214528.02,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,6311,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13096.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13489.58,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13096.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13096.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13096.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13358.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17025.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13096.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13096.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13096.68,17025.68,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,6312,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30615.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31534.29,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30615.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30615.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30615.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31228.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,39800.56,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30615.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30615.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,30615.82,39800.56,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,6313,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57101.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,58814.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57101.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57101.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57101.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,58243.41,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,74231.79,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57101.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,57101.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,57101.38,74231.79,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,6314,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,171341.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,176481.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,171341.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,171341.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,171341.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,174768.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,222744.23,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,171341.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,171341.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,171341.72,222744.23,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,6331,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2649.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2728.94,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2649.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2649.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2649.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2702.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,3444.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2649.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,2649.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,2649.46,3444.29,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,6332,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9838.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10133.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9838.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9838.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9838.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10034.92,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12789.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9838.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9838.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9838.16,12789.61,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,6333,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27183.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27999.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27183.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27183.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27183.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27727.57,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,35339.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27183.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27183.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,27183.89,35339.05,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,6334,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64630.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66569.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64630.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64630.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64630.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65922.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,84019.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64630.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64630.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,64630.15,84019.2,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6341,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6140.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6324.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6140.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6140.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6140.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6263.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7982.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6140.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6140.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6140.31,7982.4,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6342,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11946.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12304.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11946.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11946.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11946.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12184.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15529.89,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11946.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11946.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11946.07,15529.89,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6343,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17290.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17809.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17290.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17290.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17290.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17636.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,22477.5,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17290.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17290.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,17290.39,22477.5,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6344,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43536.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44842.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43536.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43536.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43536.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,44406.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,56596.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43536.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43536.13,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,43536.13,56596.97,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6361,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6368.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6559.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6368.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6368.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6368.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6495.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8279.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6368.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6368.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6368.58,8279.16,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6362,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11237.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11575.07,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11237.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11237.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11237.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11462.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14609.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11237.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11237.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11237.93,14609.31,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6363,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22585.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23263.31,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22585.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22585.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22585.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23037.46,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29361.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22585.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22585.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22585.74,29361.46,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6364,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40770.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41993.65,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40770.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40770.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40770.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41585.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,53001.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40770.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40770.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,40770.53,53001.69,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6391,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5449.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5612.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5449.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5449.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5449.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5558.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7084.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5449.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5449.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5449.27,7084.05,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6392,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10710.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11031.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10710.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10710.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10710.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10924.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13923.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10710.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10710.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10710.37,13923.48,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6393,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18472.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19027.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18472.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18472.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18472.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18842.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24014.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18472.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18472.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18472.93,24014.8,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6394,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24585.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25322.96,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24585.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24585.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24585.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25077.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31961.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24585.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24585.4,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24585.4,31961.02,
"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6401,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,962.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,990.96,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,962.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,962.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,962.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,981.34,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,1250.73,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,962.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,962.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,962.1,1250.73,
"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6402,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1399.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1441.16,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1399.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1399.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1399.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1427.17,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,1818.94,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1399.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,1399.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,1399.19,1818.94,
"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6403,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3268.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3366.98,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3268.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3268.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3268.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3334.3,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4249.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3268.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3268.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3268.92,4249.59,
"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6404,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24361.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25092.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24361.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24361.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24361.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24848.43,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31669.57,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24361.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24361.21,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24361.21,31669.57,
SPLENECTOMY,6501,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13000.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12874.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16408.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12621.8,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12621.8,16408.34,
SPLENECTOMY,6502,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16245.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16733.34,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16245.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16245.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16245.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16570.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21119.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16245.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16245.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16245.96,21119.75,
SPLENECTOMY,6503,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26718.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27520.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26718.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26718.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26718.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27252.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,34734,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26718.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26718.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26718.46,34734,
SPLENECTOMY,6504,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39902.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41099.58,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39902.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39902.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39902.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40700.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,51873.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39902.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39902.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39902.51,51873.26,
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,6511,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9673.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9963.9,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9673.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9673.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9673.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9867.17,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12575.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9673.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9673.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9673.69,12575.8,
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,6512,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13735.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14147.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13735.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13735.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13735.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14009.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17855.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13735.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13735.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13735.14,17855.68,
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,6513,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23980.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24699.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23980.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23980.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23980.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24459.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31174.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23980.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23980.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23980.37,31174.48,
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,6514,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64441.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66374.67,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64441.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64441.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64441.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65730.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,83773.85,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64441.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64441.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,64441.42,83773.85,
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,6601,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6473.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6668.13,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6473.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6473.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6473.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6603.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8416.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6473.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6473.91,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6473.91,8416.08,
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,6602,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7454.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7677.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7454.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7454.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7454.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7603.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9690.22,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7454.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7454.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7454.02,9690.22,
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,6603,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12746.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13129.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12746.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12746.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12746.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13001.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16570.61,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12746.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12746.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12746.62,16570.61,
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,6604,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33772.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34785.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33772.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33772.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33772.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34447.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,43903.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33772.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33772.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,33772.06,43903.68,
COAGULATION AND PLATELET DISORDERS,6611,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7644.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7873.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7644.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7644.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7644.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7796.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9937.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7644.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7644.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7644.05,9937.26,
COAGULATION AND PLATELET DISORDERS,6612,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9949.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10247.89,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9949.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9949.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9949.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10148.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12934.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9949.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9949.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9949.41,12934.24,
COAGULATION AND PLATELET DISORDERS,6613,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14524.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14960.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14524.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14524.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14524.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14815.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18881.98,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14524.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14524.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14524.6,18881.98,
COAGULATION AND PLATELET DISORDERS,6614,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29764,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30656.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29764,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29764,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29764,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30359.28,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,38693.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29764,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29764,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,29764,38693.21,
SICKLE CELL ANEMIA CRISIS,6621,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5141.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5295.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5141.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5141.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5141.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5244.34,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6683.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5141.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5141.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5141.51,6683.97,
SICKLE CELL ANEMIA CRISIS,6622,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6902.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7109.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6902.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6902.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6902.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7040.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8973.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6902.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6902.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6902.66,8973.46,
SICKLE CELL ANEMIA CRISIS,6623,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10423.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10736.44,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10423.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10423.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10423.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10632.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13550.85,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10423.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10423.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10423.73,13550.85,
SICKLE CELL ANEMIA CRISIS,6624,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22881.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23568.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22881.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22881.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22881.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23339.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29746.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22881.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22881.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22881.99,29746.59,
OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,6631,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4774.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4918.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4774.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4774.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4774.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4870.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6207.32,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4774.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4774.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4774.86,6207.32,
OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,6632,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6194.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6380.54,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6194.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6194.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6194.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6318.59,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8053.11,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6194.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6194.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6194.7,8053.11,
OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,6633,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8780.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9043.84,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8780.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8780.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8780.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8956.04,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11414.56,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8780.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8780.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8780.43,11414.56,
OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,6634,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15440.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15903.63,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15440.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15440.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15440.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15749.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20072.55,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15440.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15440.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15440.42,20072.55,
"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6801,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14419.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14852.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14419.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14419.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14419.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14707.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18745.32,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14419.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14419.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14419.47,18745.32,
"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6802,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21043.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20839.43,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26560.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20430.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20430.82,26560.06,
"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6803,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33370.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34371.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33370.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33370.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33370.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34037.41,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,43381.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33370.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33370.01,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,33370.01,43381.02,
"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6804,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71141.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,73276.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71141.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71141.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71141.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,72564.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,92484.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71141.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71141.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,71141.93,92484.51,
"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6811,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10894.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11221.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10894.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10894.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10894.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11112.59,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14163.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10894.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10894.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10894.69,14163.1,
"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6812,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15417.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15879.73,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15417.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15417.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15417.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15725.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20042.38,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15417.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15417.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15417.22,20042.38,
"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6813,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27693.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28524.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27693.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27693.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27693.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28247.34,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,36001.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27693.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27693.47,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,27693.47,36001.51,
"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6814,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62894.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64781.48,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62894.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62894.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62894.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64152.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,81763.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62894.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62894.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,62894.64,81763.03,
ACUTE LEUKEMIA,6901,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12266.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12634.38,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12266.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12266.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12266.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12511.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15946.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12266.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12266.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12266.39,15946.31,
ACUTE LEUKEMIA,6902,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20604.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21222.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20604.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20604.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20604.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21016.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26785.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20604.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20604.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20604.3,26785.59,
ACUTE LEUKEMIA,6903,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42029.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,43289.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42029.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42029.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42029.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42869.62,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,54637.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42029.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42029.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,42029.04,54637.75,
ACUTE LEUKEMIA,6904,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67382.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69404.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67382.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67382.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67382.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,68730.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,87597.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67382.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,67382.59,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,67382.59,87597.36,
"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",6911,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9508.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9793.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9508.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9508.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9508.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9698.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12361.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9508.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9508.66,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9508.66,12361.26,
"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",6912,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11966.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12325.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11966.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11966.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11966.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12206.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15556.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11966.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11966.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11966.86,15556.92,
"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",6913,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19042.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19613.61,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19042.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19042.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19042.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19423.18,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24755.04,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19042.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19042.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19042.34,24755.04,
"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",6914,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40247.71,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39856.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,50798.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39075.44,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39075.44,50798.08,
RADIOTHERAPY,6921,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7389.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7611.65,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7389.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7389.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7389.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7537.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9606.94,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7389.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7389.96,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7389.96,9606.94,
RADIOTHERAPY,6922,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13605.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14013.25,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13605.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13605.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13605.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13877.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17686.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13605.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13605.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13605.09,17686.62,
RADIOTHERAPY,6923,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22265.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22933.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22265.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22265.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22265.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22710.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28944.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22265.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22265.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22265.14,28944.68,
RADIOTHERAPY,6924,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35850.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36926.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35850.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35850.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35850.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36567.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,46605.98,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35850.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35850.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,35850.76,46605.98,
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,6941,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6072.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6254.35,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6072.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6072.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6072.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6193.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7893.84,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6072.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6072.19,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6072.19,7893.84,
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,6942,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7942.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8180.38,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7942.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7942.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7942.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8100.96,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10324.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7942.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7942.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7942.11,10324.75,
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,6943,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12018.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12379.07,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12018.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12018.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12018.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12258.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15624.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12018.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12018.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12018.51,15624.06,
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,6944,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22935.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23623.63,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22935.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22935.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22935.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23394.28,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29816.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22935.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22935.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22935.57,29816.24,
CHEMOTHERAPY FOR ACUTE LEUKEMIA,6951,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8835.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8749.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11151.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8578.02,11151.43,
CHEMOTHERAPY FOR ACUTE LEUKEMIA,6952,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8835.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8749.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11151.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8578.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8578.02,11151.43,
CHEMOTHERAPY FOR ACUTE LEUKEMIA,6953,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22563.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23239.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22563.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22563.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22563.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23014.28,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,29331.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22563.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22563.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,22563.02,29331.92,
CHEMOTHERAPY FOR ACUTE LEUKEMIA,6954,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61490.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,63335.46,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61490.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61490.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61490.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,62720.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,79937.95,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61490.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,61490.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,61490.73,79937.95,
OTHER CHEMOTHERAPY,6961,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7102.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7315.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7102.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7102.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7102.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7244.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9233.56,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7102.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7102.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7102.73,9233.56,
OTHER CHEMOTHERAPY,6962,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9289.93,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9199.74,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11725.15,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9019.35,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9019.35,11725.15,
OTHER CHEMOTHERAPY,6963,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15394.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15856.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15394.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15394.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15394.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15702.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,20012.45,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15394.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15394.2,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15394.2,20012.45,
OTHER CHEMOTHERAPY,6964,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35978.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,37057.45,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35978.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35978.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35978.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,36697.67,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,46771.54,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35978.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,35978.11,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,35978.11,46771.54,
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,7101,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10557.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10455.32,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13325.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10250.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10250.31,13325.4,
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,7102,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14792.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15236.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14792.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14792.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14792.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15088.16,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19230.01,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14792.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14792.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14792.31,19230.01,
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,7103,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24126.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24850.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24126.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24126.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24126.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24609.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31364.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24126.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24126.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24126.71,31364.72,
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,7104,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46488.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47882.66,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46488.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46488.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46488.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47417.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,60434.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46488.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46488.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,46488.02,60434.43,
"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",7111,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9936.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10234.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9936.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9936.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9936.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10135.04,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12917.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9936.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9936.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9936.32,12917.21,
"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",7112,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13698.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13565.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17288.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13299.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13299.14,17288.88,
"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",7113,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23261.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23959.46,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23261.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23261.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23261.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23726.84,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30240.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23261.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23261.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23261.61,30240.09,
"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",7114,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46011.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,47391.96,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46011.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46011.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46011.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46931.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,59815.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46011.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,46011.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,46011.61,59815.1,
SEPTICEMIA AND DISSEMINATED INFECTIONS,7201,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5380.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5541.99,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5380.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5380.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5380.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5488.18,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6994.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5380.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5380.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5380.57,6994.74,
SEPTICEMIA AND DISSEMINATED INFECTIONS,7202,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6899.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7106.34,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6899.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6899.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6899.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7037.35,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8969.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6899.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6899.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6899.36,8969.17,
SEPTICEMIA AND DISSEMINATED INFECTIONS,7203,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10517.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10832.57,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10517.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10517.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10517.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10727.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13672.18,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10517.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10517.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10517.06,13672.18,
SEPTICEMIA AND DISSEMINATED INFECTIONS,7204,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20575.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21192.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20575.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20575.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20575.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20987.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26748.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20575.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20575.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20575.69,26748.4,
"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",7211,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5583.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5750.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5583.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5583.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5583.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5694.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7258.31,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5583.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5583.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5583.32,7258.31,
"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",7212,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7346.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7566.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7346.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7346.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7346.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7493.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9549.98,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7346.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7346.14,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7346.14,9549.98,
"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",7213,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11936.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12294.8,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11936.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11936.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11936.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12175.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15517.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11936.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11936.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11936.7,15517.71,
"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",7214,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21702.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22353.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21702.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21702.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21702.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22136.26,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28212.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21702.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21702.22,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21702.22,28212.88,
FEVER AND INFLAMMATORY CONDITIONS,7221,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3850.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3966.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3850.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3850.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3850.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3927.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5006.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3850.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3850.84,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3850.84,5006.09,
FEVER AND INFLAMMATORY CONDITIONS,7222,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5491.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5656.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5491.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5491.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5491.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5601.11,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7138.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5491.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5491.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5491.28,7138.67,
FEVER AND INFLAMMATORY CONDITIONS,7223,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7426.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7649.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7426.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7426.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7426.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7575.06,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9654.48,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7426.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7426.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7426.53,9654.48,
FEVER AND INFLAMMATORY CONDITIONS,7224,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12852.73,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12727.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16221.9,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12478.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12478.38,16221.9,
VIRAL ILLNESS,7231,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3604.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3712.75,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3604.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3604.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3604.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3676.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4686,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3604.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3604.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3604.61,4686,
VIRAL ILLNESS,7232,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5111.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5264.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5111.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5111.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5111.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5213.53,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6644.69,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5111.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5111.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5111.3,6644.69,
VIRAL ILLNESS,7233,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8241.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8489.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8241.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8241.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8241.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8406.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10714.41,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8241.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8241.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8241.86,10714.41,
VIRAL ILLNESS,7234,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18973.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19542.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18973.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18973.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18973.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19353.01,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24665.6,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18973.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18973.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18973.54,24665.6,
OTHER INFECTIOUS AND PARASITIC DISEASES,7241,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5412.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5575.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5412.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5412.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5412.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5521.14,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7036.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5412.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5412.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5412.89,7036.75,
OTHER INFECTIOUS AND PARASITIC DISEASES,7242,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6548.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6744.86,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6548.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6548.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6548.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6679.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8512.94,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6548.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6548.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6548.41,8512.94,
OTHER INFECTIOUS AND PARASITIC DISEASES,7243,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11309.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11648.64,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11309.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11309.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11309.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11535.55,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14702.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11309.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11309.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11309.36,14702.17,
OTHER INFECTIOUS AND PARASITIC DISEASES,7244,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25792.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26566.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25792.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25792.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25792.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26308.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,33529.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25792.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25792.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,25792.24,33529.91,
EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7921,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13480.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13884.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13480.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13480.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13480.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13749.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17524.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13480.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13480.16,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13480.16,17524.21,
EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7922,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16732.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17234.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16732.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16732.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16732.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,17067.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,21752.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16732.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,16732.45,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,16732.45,21752.19,
EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7923,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24605.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25343.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24605.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24605.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24605.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25097.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31986.83,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24605.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24605.25,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24605.25,31986.83,
EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7924,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49553.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51040.54,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49553.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49553.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49553.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50545,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,64420.1,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49553.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49553.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,49553.92,64420.1,
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7931,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8671.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8931.69,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8671.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8671.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8671.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8844.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11273,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8671.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8671.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8671.54,11273,
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7932,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12313.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12682.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12313.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12313.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12313.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12559.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16007.44,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12313.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12313.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12313.42,16007.44,
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7933,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19658.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20248.14,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19658.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19658.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19658.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20051.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25555.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19658.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19658.39,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19658.39,25555.91,
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7934,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39340.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40520.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39340.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39340.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39340.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40127.56,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,51142.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39340.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39340.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,39340.75,51142.97,
NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7941,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7766.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7999.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7766.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7766.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7766.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7922.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10096.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7766.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7766.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7766.77,10096.8,
NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7942,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9337.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9618.12,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9337.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9337.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9337.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9524.74,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12139.37,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9337.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9337.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9337.98,12139.37,
NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7943,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15316.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15775.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15316.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15316.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15316.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15622.75,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19911.35,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15316.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15316.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,15316.42,19911.35,
NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7944,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24544.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25281.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24544.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24544.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24544.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,25035.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,31908.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24544.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24544.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,24544.74,31908.16,
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,8101,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4785.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4928.79,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4785.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4785.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4785.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4880.94,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6220.81,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4785.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4785.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4785.23,6220.81,
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,8102,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6520.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6457.51,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8230.16,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6330.89,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6330.89,8230.16,
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,8103,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10014.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10315.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10014.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10014.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10014.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10215.07,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13019.2,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10014.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10014.77,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10014.77,13019.2,
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,8104,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19989.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20588.82,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19989.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19989.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19989.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20388.93,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25985.9,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19989.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19989.15,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19989.15,25985.9,
ALLERGIC REACTIONS,8111,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3210.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3306.49,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3210.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3210.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3210.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3274.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4173.23,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3210.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3210.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3210.18,4173.23,
ALLERGIC REACTIONS,8112,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4778.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4921.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4778.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4778.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4778.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4873.58,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6211.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4778.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4778.02,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4778.02,6211.43,
ALLERGIC REACTIONS,8113,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9111.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9384.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9111.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9111.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9111.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9293.25,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11844.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9111.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9111.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9111.03,11844.33,
ALLERGIC REACTIONS,8114,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18269.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18817.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18269.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18269.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18269.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18634.66,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23750.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18269.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18269.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18269.28,23750.06,
POISONING OF MEDICINAL AGENTS,8121,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3562.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3668.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3562.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3562.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3562.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3633.3,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4630.68,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3562.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3562.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3562.06,4630.68,
POISONING OF MEDICINAL AGENTS,8122,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4810.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4955.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4810.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4810.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4810.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4906.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6253.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4810.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4810.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4810.7,6253.91,
POISONING OF MEDICINAL AGENTS,8123,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7194.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7409.93,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7194.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7194.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7194.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7337.99,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9352.34,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7194.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7194.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7194.1,9352.34,
POISONING OF MEDICINAL AGENTS,8124,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13808.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14222.56,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13808.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13808.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13808.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14084.47,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17950.8,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13808.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13808.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13808.31,17950.8,
OTHER COMPLICATIONS OF TREATMENT,8131,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5546.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5712.77,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5546.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5546.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5546.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5657.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7210.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5546.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5546.38,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5546.38,7210.29,
OTHER COMPLICATIONS OF TREATMENT,8132,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6852.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7058.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6852.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6852.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6852.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6989.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8908.43,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6852.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6852.64,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6852.64,8908.43,
OTHER COMPLICATIONS OF TREATMENT,8133,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10174.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10479.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10174.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10174.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10174.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10377.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,13226.57,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10174.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,10174.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,10174.29,13226.57,
OTHER COMPLICATIONS OF TREATMENT,8134,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19676.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20267.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19676.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19676.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19676.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20070.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25579.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19676.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19676.71,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19676.71,25579.72,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",8151,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4137.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4261.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4137.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4137.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4137.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4220.23,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5378.72,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4137.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4137.48,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4137.48,5378.72,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",8152,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5335.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5495.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5335.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5335.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5335.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5442.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6936.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5335.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5335.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5335.69,6936.4,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",8153,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8995.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9265.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8995.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8995.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8995.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9175.85,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11694.71,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8995.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8995.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8995.93,11694.71,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",8154,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23474.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,24178.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23474.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23474.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23474.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23944.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,30517.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23474.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,23474.72,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,23474.72,30517.14,
TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,8161,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5655.35,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5600.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7137.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5490.63,7137.82,
TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,8162,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5655.35,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5600.44,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7137.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5490.63,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5490.63,7137.82,
TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,8163,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6995.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7205.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6995.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6995.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6995.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7135.33,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9094.05,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6995.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6995.42,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6995.42,9094.05,
TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,8164,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14336.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14766.16,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14336.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14336.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14336.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14622.8,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18636.9,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14336.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14336.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14336.08,18636.9,
INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,8171,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3500.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3605.78,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3500.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3500.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3500.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3570.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,4550.98,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3500.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,3500.76,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,3500.76,4550.98,
INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,8172,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4427.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4560.33,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4427.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4427.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4427.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4516.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5755.75,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4427.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4427.5,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4427.5,5755.75,
INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,8173,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7237.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7454.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7237.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7237.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7237.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7382.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9408.5,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7237.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7237.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7237.31,9408.5,
INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,8174,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14470.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14904.8,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14470.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14470.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14470.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14760.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18811.88,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14470.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14470.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14470.68,18811.88,
EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,8411,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,53251.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52734.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,67210.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,51700.36,67210.46,
EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,8412,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,53251.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,52734.36,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,67210.46,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51700.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,51700.36,67210.46,
EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,8413,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,79558.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,81945.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,79558.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,79558.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,79558.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,81149.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,103426.19,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,79558.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,79558.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,79558.61,103426.19,
EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,8414,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,200277.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,206286.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,200277.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,200277.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,200277.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,204283.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,260361.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,200277.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,200277.75,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,200277.75,260361.08,
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,8421,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14017.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14438.07,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14017.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14017.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14017.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14297.89,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18222.81,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14017.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14017.54,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14017.54,18222.81,
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,8422,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21984.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22643.85,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21984.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21984.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21984.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22424.01,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28579.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21984.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21984.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21984.32,28579.62,
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,8423,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40551.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41768.29,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40551.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40551.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40551.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41362.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,52717.26,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40551.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40551.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,40551.74,52717.26,
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,8424,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99596.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,102584.73,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99596.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99596.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99596.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,101588.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,129475.87,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99596.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,99596.82,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,99596.82,129475.87,
EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,8431,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5647.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5816.98,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5647.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5647.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5647.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5760.5,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7341.81,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5647.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5647.55,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5647.55,7341.81,
EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,8432,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9588.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9876.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9588.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9588.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9588.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9780.52,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12465.36,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9588.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9588.74,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9588.74,12465.36,
EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,8433,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13473.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13877.83,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13473.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13473.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13473.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13743.09,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17515.7,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13473.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13473.62,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13473.62,17515.7,
EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,8434,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49570.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,51057.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49570.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49570.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49570.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,50561.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,64441.54,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49570.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,49570.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,49570.41,64441.54,
PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,8441,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4307.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4436.68,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4307.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4307.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4307.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4393.61,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,5599.7,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4307.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4307.46,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4307.46,5599.7,
PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,8442,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7319.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7538.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7319.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7319.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7319.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7465.73,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9515.14,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7319.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7319.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7319.34,9515.14,
PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,8443,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12024.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12385.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12024.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12024.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12024.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12264.77,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15631.56,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12024.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12024.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12024.28,15631.56,
PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,8444,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26977.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27786.85,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26977.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26977.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26977.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,27517.08,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,35070.78,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26977.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,26977.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,26977.53,35070.78,
"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",8611,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4640.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4779.26,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4640.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4640.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4640.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4732.86,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6032.08,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4640.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,4640.06,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,4640.06,6032.08,
"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",8612,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5788.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5962.16,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5788.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5788.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5788.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5904.28,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7525.06,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5788.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5788.51,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5788.51,7525.06,
"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",8613,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8314.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8563.71,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8314.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8314.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8314.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8480.57,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10808.57,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8314.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8314.29,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8314.29,10808.57,
"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",8614,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13704.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14115.43,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13704.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13704.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13704.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13978.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17815.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13704.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13704.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13704.3,17815.59,
OTHER AFTERCARE AND CONVALESCENCE,8621,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6200.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6386.1,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6200.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6200.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6200.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6324.1,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,8060.13,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6200.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6200.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,6200.1,8060.13,
OTHER AFTERCARE AND CONVALESCENCE,8622,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9147.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9421.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9147.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9147.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9147.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9330.02,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11891.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9147.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9147.08,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9147.08,11891.21,
OTHER AFTERCARE AND CONVALESCENCE,8623,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12518.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12893.81,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12518.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12518.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12518.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12768.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16273.74,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12518.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12518.27,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12518.27,16273.74,
OTHER AFTERCARE AND CONVALESCENCE,8624,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12796.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13180.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12796.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12796.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12796.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13052.26,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,16635.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12796.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12796.34,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12796.34,16635.24,
NEONATAL AFTERCARE,8631,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5112.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5266.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5112.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5112.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5112.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5215.15,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,6646.76,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5112.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5112.9,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5112.9,6646.76,
NEONATAL AFTERCARE,8632,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14329.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14759.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14329.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14329.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14329.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14616.2,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18628.49,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14329.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14329.61,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14329.61,18628.49,
NEONATAL AFTERCARE,8633,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38465.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39619.54,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38465.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38465.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38465.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39234.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,50005.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38465.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38465.57,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,38465.57,50005.24,
NEONATAL AFTERCARE,8634,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,100170.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,103175.52,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,100170.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,100170.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,100170.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,102173.82,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,130221.53,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,100170.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,100170.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,100170.41,130221.53,
HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,8901,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8184.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8430.23,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8184.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8184.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8184.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8348.38,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10640.09,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8184.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8184.69,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8184.69,10640.09,
HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,8902,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8846.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9112.35,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8846.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8846.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8846.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9023.88,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11501.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8846.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8846.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8846.94,11501.02,
HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,8903,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14811.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15255.41,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14811.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14811.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14811.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,15107.3,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,19254.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14811.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14811.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14811.07,19254.4,
HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,8904,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30397.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31309.76,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30397.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30397.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30397.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31005.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,39517.17,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30397.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30397.83,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,30397.83,39517.17,
HIV WITH MAJOR HIV RELATED CONDITION,8921,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5927.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6105,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5927.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5927.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5927.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,6045.72,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7705.33,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5927.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5927.18,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5927.18,7705.33,
HIV WITH MAJOR HIV RELATED CONDITION,8922,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7516.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7742.08,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7516.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7516.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7516.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7666.91,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9771.55,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7516.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7516.58,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7516.58,9771.55,
HIV WITH MAJOR HIV RELATED CONDITION,8923,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11145.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11479.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11145.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11145.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11145.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11367.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,14488.57,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11145.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11145.05,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11145.05,14488.57,
HIV WITH MAJOR HIV RELATED CONDITION,8924,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19285.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19864.25,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19285.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19285.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19285.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19671.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25071.38,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19285.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19285.68,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19285.68,25071.38,
HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,8931,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5668.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5838.07,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5668.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5668.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5668.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5781.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7368.44,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5668.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5668.03,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5668.03,7368.44,
HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,8932,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8174.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8419.51,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8174.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8174.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8174.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8337.76,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10626.56,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8174.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8174.28,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8174.28,10626.56,
HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,8933,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12136.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12500.19,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12136.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12136.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12136.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12378.83,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15776.94,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12136.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12136.1,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,12136.1,15776.94,
HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,8934,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18029.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18570.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18029.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18029.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18029.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18390.57,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23438.97,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18029.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18029.98,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18029.98,23438.97,
HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,8941,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5528.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5694.07,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5528.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5528.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5528.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5638.79,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,7186.7,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5528.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,5528.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,5528.23,7186.7,
HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,8942,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7021.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7232.59,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7021.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7021.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7021.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7162.37,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9128.51,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7021.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7021.93,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7021.93,9128.51,
HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,8943,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9497.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9782.28,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9497.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9497.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9497.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9687.31,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12346.57,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9497.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9497.36,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9497.36,12346.57,
HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,8944,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14434.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14867.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14434.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14434.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14434.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14723.05,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18764.67,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14434.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14434.37,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14434.37,18764.67,
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,9101,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32591.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32274.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,41134.41,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,31641.86,41134.41,
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,9102,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32591.11,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,32274.69,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,41134.41,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31641.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,31641.86,41134.41,
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,9103,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40085.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41287.87,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40085.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40085.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40085.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40887.02,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,52110.91,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40085.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,40085.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,40085.31,52110.91,
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,9104,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69614.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71703.37,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69614.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69614.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69614.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,71007.22,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,90499.4,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69614.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69614.92,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,69614.92,90499.4,
EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9111,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18194.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18739.89,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18194.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18194.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18194.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18557.95,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,23652.29,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18194.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18194.07,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18194.07,23652.29,
EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9112,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20320,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20929.6,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20320,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20320,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20320,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20726.4,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26416,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20320,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20320,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20320,26416,
EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9113,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28895.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29762.74,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28895.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28895.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28895.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29473.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,37564.62,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28895.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28895.86,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,28895.86,37564.62,
EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9114,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,68337.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,70388.02,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,68337.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,68337.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,68337.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,69704.64,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,88839.24,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,68337.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,68337.88,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,68337.88,88839.24,
MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9121,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18978.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19547.92,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18978.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18978.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18978.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19358.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24672.13,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18978.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,18978.56,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,18978.56,24672.13,
MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9122,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20583.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21201.04,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20583.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20583.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20583.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20995.21,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,26758.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20583.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,20583.53,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,20583.53,26758.59,
MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9123,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33351.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34352.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33351.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33351.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33351.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,34018.98,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,43357.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33351.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,33351.94,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,33351.94,43357.52,
MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9124,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64094.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,66017.06,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64094.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64094.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64094.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,65376.12,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,83322.5,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64094.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,64094.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,64094.23,83322.5,
MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,9301,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7087.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7299.85,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7087.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7087.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7087.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7228.98,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,9213.41,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7087.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,7087.24,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,7087.24,9213.41,
MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,9302,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9171.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9446.36,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9171.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9171.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9171.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9354.65,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,11922.59,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9171.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9171.23,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9171.23,11922.59,
MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,9303,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14553.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14990.32,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14553.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14553.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14553.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14844.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18919.82,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14553.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14553.7,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,14553.7,18919.82,
MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,9304,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30160.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,31065.42,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30160.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30160.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30160.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30763.81,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,39208.78,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30160.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,30160.6,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,30160.6,39208.78,
EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9501,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13287.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13685.65,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13287.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13287.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13287.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13552.78,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,17273.15,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13287.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13287.04,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13287.04,17273.15,
EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9502,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19161.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19736.01,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19161.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19161.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19161.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19544.39,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,24909.52,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19161.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19161.17,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19161.17,24909.52,
EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9503,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28725.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29587.5,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28725.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28725.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28725.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,29300.24,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,37343.45,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28725.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,28725.73,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,28725.73,37343.45,
EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9504,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55120.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56773.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55120.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55120.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55120.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,56222.71,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,71656.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55120.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,55120.3,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,55120.3,71656.39,
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9511,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9627.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9915.91,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9627.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9627.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9627.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9819.63,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,12515.22,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9627.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,9627.09,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,9627.09,12515.22,
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9512,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13983.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14403.3,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13983.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13983.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13983.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,14263.46,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,18178.92,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13983.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,13983.79,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,13983.79,18178.92,
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9513,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21836.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22491.4,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21836.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21836.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21836.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,22273.04,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,28387.21,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21836.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,21836.31,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,21836.31,28387.21,
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9514,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41351.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42591.97,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41351.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41351.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41351.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,42178.45,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,53756.85,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41351.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,41351.43,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,41351.43,53756.85,
NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9521,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8408.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8661.22,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8408.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8408.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8408.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8577.13,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,10931.64,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8408.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,8408.95,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,8408.95,10931.64,
NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9522,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11782.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12135.79,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11782.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11782.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11782.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,12017.97,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,15317.02,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11782.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,11782.32,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,11782.32,15317.02,
NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9523,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19295.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19874.27,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19295.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19295.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19295.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19681.32,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,25084.03,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19295.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,19295.41,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,19295.41,25084.03,
NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9524,APR-DRG,,,,,Inpatient,,,,,,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38217.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,39364.53,103,APR-DRG,,case rate,103% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38217.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38217.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38217.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38982.35,102,APR-DRG,,case rate,102% WA Medicaid APR-DRG rate for inpatient,49683.39,130,APR-DRG,,case rate,130% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38217.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,,,,,Other,Not Separately reimbursable. See MS-DRG rows for rates,38217.99,100,APR-DRG,,case rate,100% WA Medicaid APR-DRG rate for inpatient,38217.99,49683.39,